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Prener M, Drejer V, Ziebell M, Jensen P, Madsen CG, Olsen S, Thomsen G, Pinborg LH, Paulson OB. Ictal and interictal SPECT with 99m Tc-HMPAO in presurgical epilepsy. II: Methodological considerations on hyper- and hypoperfusion. Epilepsia Open 2023; 8:1503-1511. [PMID: 37750050 PMCID: PMC10690685 DOI: 10.1002/epi4.12833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Single-photon emission computed tomography (SPECT) with the tracer 99m Tc-HMPAO is a method to visualize the cerebral hyperperfusion during an epileptic seizure and thus localize the epileptogenic zone and seizure propagation. Subtraction of interictal from Ictal SPECT Co-registered to MRI (SISCOM) visualizes areas with relative increases in cerebral blood flow. The purpose of this retrospective study is to explore the added value of visualizing areas of hypoperfusion as well as hyperperfusion, so-called reversed SISCOM. METHODS Fifty-six patients operated for epilepsy who had been investigated with SISCOM were included in the analysis. The patients were divided into two groups based on seizure duration after tracer injection, above or below 30 s. The preoperative SISCOM description was compared to the area of resection and given a concordance score. The 56 SISCOM were recalculated visualizing also areas of hypoperfusion and again compared to the site of resection using the same scale of concordance. The reversed SISCOM were categorized into three subgroups: "Altered Conclusion," "Confirmed Conclusion," and "Adds Nothing." If an area of hyperperfusion had an area of hypoperfusion in close proximity, it was re-interpreted as noise, thus possibly altering the conclusion. If the areas of hypoperfusion were in the opposite hemisphere it was interpreted as confirming factor. Further the concordance scores from conventional SISCOM and reversed SISCOM was compared to surgical outcome to explore the difference in sensitivity, positive predictive value (PPV), and odds ratio. RESULTS In approximately half of the cases reversed SISCOM added additional value, meaning either altered the conclusion or confirmed the conclusion. The sensitivity, PPV, and odds ratio was also better in the subgroup of long, >30 s seizure duration after injection, and got worse in the group with short, <30 s seizure duration after injection. SIGNIFICANCE Adding reversed SISCOM performed better than conventional SISCOM at predicting good surgical outcome.
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Affiliation(s)
- Martin Prener
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Veronica Drejer
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Morten Ziebell
- Department of NeurosurgeryRigshospitaletCopenhagenDenmark
| | - Per Jensen
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Camilla Gøbel Madsen
- Department of Radiology, Centre for Functional and Diagnostic imaging and ResearchCopenhagen University Hospital Amager and HvidovreHvidovreDenmark
| | - Svitlana Olsen
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Gerda Thomsen
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Lars H. Pinborg
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
- Epilepsy Clinic, Department of Neurology, Rigshospitalet, Copenhagen, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Olaf B. Paulson
- Neurobiology Research Unit, Department of NeurologyRigshospitalet BlegdamsvejCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Prener M, Drejer V, Ziebell M, Jensen P, Madsen CG, Olsen S, Thomsen G, Pinborg LH, Paulson OB. Ictal and interictal SPECT with 99m Tc-HMPAO in presurgical epilepsy. I: Predictive value and methodological considerations. Epilepsia Open 2023; 8:1064-1074. [PMID: 37464953 PMCID: PMC10472396 DOI: 10.1002/epi4.12786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/30/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE This retrospective study investigates the predictive value of ictal subtraction single-photon emission computed tomography (SPECT) co-registered to magnetic resonance imaging (MRI) (SISCOM) for successful epilepsy surgery. METHODS 57 patients examined with SISCOM as a part of epilepsy surgery evaluation were divided into two groups based on seizure duration after tracer injection (group 1: Seizure duration above or equal to 30 s, group 2: Seizure duration under 30 s). SISCOM was compared to the surgical site and categorized as good or poor concordance. Subsequently, Odds ratios (ORs) and positive predictive values (PPVs) were calculated for each group for good surgical outcome, freedom from disabling seizures. RESULTS The PPVs and ORs for good surgical outcome was 74.1% and 5.71 for group 1 and 40% and 0.22 for group 2. SISCOM had a similar positive predictive value regardless of whether the focus was in the same or neighboring lobe, but same hemisphere as the resection. CONCLUSION In conclusion, the implementation of a precise definition for a well-executed ictal SPECT scan with respect to seizure duration after injection enhances the positive predictive value (PPV) and odds ratio (OR) for successful surgical outcome, surpassing previous findings, whether the focus in resected lobe or the neighboring.
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Affiliation(s)
- Martin Prener
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Veronica Drejer
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Morten Ziebell
- Department of NeurosurgeryRigshospitaletCopenhagenDenmark
| | - Per Jensen
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Camilla Gøbel Madsen
- Department of Radiology, Centre for Functional and Diagnostic imaging and ResearchCopenhagen University Hospital Amager and HvidovreHvidovreDenmark
| | - Svitlana Olsen
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Gerda Thomsen
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
| | - Lars H. Pinborg
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
- Department of Neurology, Epilepsy ClinicRigshospitaletCopenhagenDenmark
- Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Olaf B. Paulson
- Department of Neurology, Neurobiology Research UnitRigshospitalet BlegdamsvejCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
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Kaspar B, Thomsen G, Hsieh C, Do J, Solano S, Chu B, Barkho B, Fugere M, Kaufmann P, Foust K, Kaspar A, L'Italien J, Sproule D, Feltner D, Chung W, Burghes A, McGovern V, Hevner R, Conces M, Mendell J. O.24Biodistribution of onasemnogene abeparvovec (AVXS-101) DNA, mRNA, and SMN protein in human tissue. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ebert SE, Jensen P, Ozenne B, Armand S, Svarer C, Stenbaek DS, Moeller K, Dyssegaard A, Thomsen G, Steinmetz J, Forchhammer BH, Knudsen GM, Pinborg LH. Molecular imaging of neuroinflammation in patients after mild traumatic brain injury: a longitudinal 123 I-CLINDE single photon emission computed tomography study. Eur J Neurol 2019; 26:1426-1432. [PMID: 31002206 DOI: 10.1111/ene.13971] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 04/15/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Neuroinflammation has been proposed as part of the pathogenesis of post-concussion symptoms (PCS), but the inflammatory response of the human brain to mild traumatic brain injury (mTBI) remains unknown. We hypothesized that a neuroinflammatory response is present in mTBI at 1-2 weeks post-injury and persists in patients with PCS. METHODS We scanned 14 patients with mTBI without signs of structural damage at 1-2 weeks and 3-4 months post-injury and 22 healthy controls once using the single photon emission computed tomography tracer 123 I-CLINDE, which visualizes translocator protein (TSPO), a protein upregulated in active immune cells. PCS was defined as three or more persisting symptoms from the Rivermead Post Concussion Symptoms Questionnaire at 3 months post-injury. RESULTS Across brain regions, patients had significantly higher 123 I-CLINDE binding to TSPO than healthy controls, both at 1-2 weeks after the injury in all patients (P = 0.011) and at 3-4 months in the seven patients with PCS (P = 0.006) and in the six patients with good recovery (P = 0.018). When the nine brain regions were tested separately and results were corrected for multiple comparisons, no individual region differed significantly, but all estimated parameters indicated increased 123 I-CLINDE binding to TSPO, ranging from 2% to 19% in all patients at 1-2 weeks, 13% to 27% in patients with PCS at 3-4 months and -9% to 17% in patients with good recovery at 3-4 months. CONCLUSIONS Neuroinflammation was present in mTBI at 1-2 weeks post-injury and persisted at 3-4 months post-injury with a tendency to be most pronounced in patients with PCS.
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Affiliation(s)
- S E Ebert
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Jensen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - B Ozenne
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Armand
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - C Svarer
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - D S Stenbaek
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - K Moeller
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Neuroanaesthesiology, Rigshospitalet, Copenhagen, Denmark
| | - A Dyssegaard
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - G Thomsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - J Steinmetz
- Trauma Center, Rigshospitalet, Copenhagen, Denmark
| | - B H Forchhammer
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G M Knudsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L H Pinborg
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Rigshospitalet, Copenhagen, Denmark
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Feng L, Jensen P, Thomsen G, Dyssegaard A, Svarer C, Knudsen LV, Møller K, Thomsen C, Mikkelsen JD, Guilloteau D, Knudsen GM, Pinborg LH. The Variability of Translocator Protein Signal in Brain and Blood of Genotyped Healthy Humans Using In Vivo 123I-CLINDE SPECT Imaging: A Test–Retest Study. J Nucl Med 2016; 58:989-995. [DOI: 10.2967/jnumed.116.183202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 10/21/2016] [Indexed: 11/16/2022] Open
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Jensen P, Feng L, Law I, Svarer C, Knudsen GM, Mikkelsen JD, de Nijs R, Larsen VA, Dyssegaard A, Thomsen G, Fischer W, Guilloteau D, Pinborg LH. TSPO Imaging in Glioblastoma Multiforme: A Direct Comparison Between 123I-CLINDE SPECT, 18F-FET PET, and Gadolinium-Enhanced MR Imaging. J Nucl Med 2015; 56:1386-90. [PMID: 26182972 DOI: 10.2967/jnumed.115.158998] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/06/2015] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Here we compare translocator protein (TSPO) imaging using 6-chloro-2-(4'-(123)I-iodophenyl)-3-(N,N-diethyl)-imidazo[1,2-a]pyridine-3-acetamide SPECT ((123)I-CLINDE) and amino acid transport imaging using O-(2-(18)F-fluoroethyl)-l-tyrosine PET ((18)F-FET) and investigate whether (123)I-CLINDE is superior to (18)F-FET in predicting progression of glioblastoma multiforme (GBM) at follow-up. METHODS Three patients with World Health Organization grade IV GBM were scanned with (123)I-CLINDE SPECT, (18)F-FET PET, and gadolinium-enhanced MR imaging. Molecular imaging data were compared with follow-up gadolinium-enhanced MR images or contrast-enhanced CT scans. RESULTS The percentage overlap between volumes of interest (VOIs) of increased (18)F-FET uptake and (123)I-CLINDE binding was variable (12%-42%). The percentage overlap of MR imaging baseline VOIs was greater for (18)F-FET (79%-93%) than (123)I-CLINDE (15%-30%). In contrast, VOIs of increased contrast enhancement at follow-up compared with baseline overlapped to a greater extent with baseline (123)I-CLINDE VOIs than (18)F-FET VOIs (21% vs. 8% and 72% vs. 55%). CONCLUSION Our preliminary results suggest that TSPO brain imaging in GBM may be a useful tool for predicting tumor progression at follow-up and may be less susceptible to changes in blood-brain barrier permeability than (18)F-FET. Larger studies are warranted to test the clinical potential of TSPO imaging in GBM, including presurgical planning and radiotherapy.
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Affiliation(s)
- Per Jensen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Ling Feng
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine, and PET, Rigshospitalet, Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | | | - Robin de Nijs
- Department of Clinical Physiology, Nuclear Medicine, and PET, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke A Larsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
| | | | - Gerda Thomsen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Walter Fischer
- Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark
| | - Denis Guilloteau
- Université François-Rabelais de Tours, INSERM U930 "Imaging and Brain," Tours, France; and
| | - Lars H Pinborg
- Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark Epilepsy Clinic, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
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Jensen P, Kondziella D, Thomsen G, Dyssegaard A, Svarer C, Pinborg LH. Anti-NMDAR encephalitis: demonstration of neuroinflammation and the effect of immunotherapy. Neurology 2015; 84:859. [PMID: 25713112 DOI: 10.1212/wnl.0000000000001278] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Per Jensen
- From Department of Neurology, Rigshospitalet, København, Denmark
| | | | - Gerda Thomsen
- From Department of Neurology, Rigshospitalet, København, Denmark
| | | | - Claus Svarer
- From Department of Neurology, Rigshospitalet, København, Denmark
| | - Lars H Pinborg
- From Department of Neurology, Rigshospitalet, København, Denmark.
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Nalla AA, Thomsen G, Knudsen GM, Frokjaer VG. The effect of storage conditions on salivary cortisol concentrations using an Enzyme Immunoassay. Scandinavian Journal of Clinical and Laboratory Investigation 2014; 75:92-5. [DOI: 10.3109/00365513.2014.985252] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Feng L, Svarer C, Thomsen G, de Nijs R, Larsen VA, Jensen P, Adamsen D, Dyssegaard A, Fischer W, Meden P, Krieger D, Møller K, Knudsen GM, Pinborg LH. In Vivo Quantification of Cerebral Translocator Protein Binding in Humans Using 6-Chloro-2-(4′-123I-Iodophenyl)-3-(N,N-Diethyl)-Imidazo[1,2-a]Pyridine-3-Acetamide SPECT. J Nucl Med 2014; 55:1966-72. [DOI: 10.2967/jnumed.114.143727] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Nixon J, Budge D, Stoker S, Caine W, Alharethi R, Smith H, Reid B, Thomsen G, Clayson S, Goddard M, Doty J, Kfoury A. Improving Prothrombin Time International Normalized Ratio (INR) Control in Left Ventricular Assist Device (LVAD) Patients with Computerized Decision Support. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Thomsen G. A Case of Unilateral Pulmonary Agenesis with Ipsilateral Absence of the Diaphragm. Acta Radiol 2013. [DOI: 10.1177/028418514803000303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thomsen G, Guttadauro M. Cleidocranial Dysostosis Associated with Osteosclerosis and Bone Fragility. Acta Radiol 2013. [DOI: 10.1177/028418515203700607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thomsen G. Peptic Ulcer of the Oesophagus. Acta Radiol 2013. [DOI: 10.1177/028418514903200212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Davidsen HG, Petersen O, Thomsen G. Roentgenologic Findings in Five Cases of Congenital Aneurysm of the Aortic Sinuses(Sinuses of Valsalva). Acta Radiol 2013. [DOI: 10.1177/028418515804900304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thomsen G, Chrom SA. A Case of Primary Lung Cancer, Presumably Arisen from an Old Tuberculous Cavern. Acta Radiol 2013. [DOI: 10.1177/028418514502600119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gudbjerg CE, Thomsen G. Inflammatory Changes in the Bronchial Glands in Chronic Bronchitis, Demonstrated Bronchographically. Acta Radiol 2013. [DOI: 10.1177/028418515404200403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Thomsen G, Vesterdal J. Atypical Hurler's Syndrome: A Report of 3 Cases with a Discussion of the Differential Diagnosis. Acta Radiol 2013. [DOI: 10.1177/028418515103500502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Thomsen G, Ziebell M, Jensen PS, da Cuhna-Bang S, Knudsen GM, Pinborg LH. No correlation between body mass index and striatal dopamine transporter availability in healthy volunteers using SPECT and [123I]PE2I. Obesity (Silver Spring) 2013; 21:1803-6. [PMID: 23696269 DOI: 10.1002/oby.20225] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 11/19/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Dopamine plays an important role in both the rewarding and conditioning effects of food. These effects involve mesolimbic, mesocortical, and nigrostriatal pathways. In humans, the most consistent finding has been reduced striatal dopamine D2/3 receptor availability. In striatum, dopamine is inactivated by reuptake via the dopamine transporter (DAT). The aim of the study was to test the hypothesis of lower DAT availability in obese healthy subjects using a selective DAT radiotracer in a sample of subjects with a wide range of BMI values. DESIGN AND METHODS Thirty-three healthy subjects with a mean age of 48.4 ± 13.3 (range, 21-71) years and a mean BMI of 29.6 ± 7.8 kg/m2 (range, 21.0-49.5) were included in the study. We used [123I]PE2I and SPECT to measure DAT availability. RESULTS Using multiple linear regression analyses with striatal DAT as the dependent variable and BMI, age and gender as predictors was performed. We found no correlation between BMI and striatal DAT availability in striatum (P = 0.99), caudate nucleus (P = 0.61), and putamen (P = 0.30). Furthermore, we found no group difference between obese/severely obese (BMI > 30 kg/m2) and normal weight controls (BMI ≤ 25 kg/m2). CONCLUSIONS We did not find any correlation between BMI and DAT availability in healthy volunteers.
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Affiliation(s)
- G Thomsen
- Neurobiology Research Unit 9201, Copenhagen University Hospital, Rigshospitalet, Denmark
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Thomsen G, Knudsen GM, Jensen PS, Ziebell M, Holst KK, Asenbaum S, Booij J, Darcourt J, Dickson JC, Kapucu OL, Nobili F, Sabri O, Sera T, Tatsch K, Tossici-Bolt L, Laere KV, Borght TV, Varrone A, Pagani M, Pinborg LH. No difference in striatal dopamine transporter availability between active smokers, ex-smokers and non-smokers using [123I]FP-CIT (DaTSCAN) and SPECT. EJNMMI Res 2013; 3:39. [PMID: 23688063 PMCID: PMC3671201 DOI: 10.1186/2191-219x-3-39] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 05/10/2013] [Indexed: 11/30/2022] Open
Abstract
Background Mesolimbic and nigrostriatal dopaminergic pathways play important roles in both the rewarding and conditioning effects of drugs. The dopamine transporter (DAT) is of central importance in regulating dopaminergic neurotransmission and in particular in activating the striatal D2-like receptors. Molecular imaging studies of the relationship between DAT availability/dopamine synthesis capacity and active cigarette smoking have shown conflicting results. Through the collaboration between 13 SPECT centres located in 10 different European countries, a database of FP-CIT-binding in healthy controls was established. We used the database to test the hypothesis that striatal DAT availability is changed in active smokers compared to non-smokers and ex-smokers. Methods A total of 129 healthy volunteers were included. Subjects were divided into three categories according to past and present tobacco smoking: (1) non-smokers (n = 64), (2) ex-smokers (n = 39) and (3) active smokers (n = 26). For imaging of the DAT availability, we used [123I]FP-CIT (DaTSCAN) and single photon emission computed tomography (SPECT). Data were collected in collaboration between 13 SPECT centres located in 10 different European countries. The striatal measure of DAT availability was analyzed in a multiple regression model with age, SPECT centre and smoking as predictor. Results There was no statistically significant difference in DAT availability between the groups of active smokers, ex-smokers and non-smokers (p = 0.34). Further, we could not demonstrate a significant association between striatal DAT and the number of cigarettes per day or total lifetime cigarette packages in smokers and ex-smokers. Conclusion Our results do not support the hypothesis that large differences in striatal DAT availability are present in smokers compared to ex-smokers and healthy volunteers with no history of smoking.
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Affiliation(s)
- Gerda Thomsen
- Neurobiology Research Unit 9201, Rigshospitalet and Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.
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Ziebell M, Andersen BB, Pinborg LH, Knudsen GM, Stokholm J, Thomsen G, Karlsborg M, Høgh P, Mørk ML, Hasselbalch SG. Striatal dopamine transporter binding does not correlate with clinical severity in dementia with Lewy bodies. J Nucl Med 2013; 54:1072-6. [PMID: 23637201 DOI: 10.2967/jnumed.112.114025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Patients who have dementia with Lewy bodies (DLB) show both clinical and histopathologic overlap with Alzheimer disease patients and Parkinson disease patients. In this study, we correlated the core features of DLB (dementia, parkinsonism, hallucinations, and fluctuations) with striatal dopamine transporter (DAT) availability as assessed with SPECT and (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) nortropane ((123)I-PE2I) in patients with newly diagnosed DLB. METHODS Two hundred eighty-eight patients were consecutively included in the study as they were referred for diagnostic SPECT scanning of DAT with (123)I-PE2I. Of those patients, 51 had, on the basis of clinical guideline criteria, a probable-DLB diagnosis at follow-up 16 ± 11.6 mo later. Before or on the day of the SPECT scan, DLB patients had a routine neurologic examination including Hoehn and Yahr grading and were cognitively evaluated with the Mini Mental State Examination. RESULTS There was no correlation between Mini Mental State Examination, Hoehn and Yahr score, fluctuations or hallucinations, and striatal DAT availability as measured with (123)I-PE2I and SPECT. CONCLUSION In patients with newly diagnosed DLB, symptoms are not associated with a reduction in striatal DAT despite its firm involvement in DLB pathology.
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Affiliation(s)
- Morten Ziebell
- Neurobiology Research Unit and Cimbi, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
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Söderlund TA, Dickson JC, Prvulovich E, Ben-Haim S, Kemp P, Booij J, Nobili F, Thomsen G, Sabri O, Koulibaly PM, Akdemir OU, Pagani M, van Laere K, Asenbaum-Nan S, George J, Sera T, Tatsch K, Bomanji J. Value of Semiquantitative Analysis for Clinical Reporting of 123I-2-β-Carbomethoxy-3β-(4-Iodophenyl)-N-(3-Fluoropropyl)Nortropane SPECT Studies. J Nucl Med 2013; 54:714-22. [DOI: 10.2967/jnumed.112.110106] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Ziebell M, Khalid U, Klein AB, Aznar S, Thomsen G, Jensen P, Knudsen GM. Striatal dopamine transporter binding correlates with serum BDNF levels in patients with striatal dopaminergic neurodegeneration. Neurobiol Aging 2012; 33:428.e1-5. [DOI: 10.1016/j.neurobiolaging.2010.11.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 10/22/2010] [Accepted: 11/10/2010] [Indexed: 12/25/2022]
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Jensen PS, Ziebell M, Skouboe G, Khalid U, de Nijs R, Thomsen G, Knudsen GM, Svarer C. Validation of a method for accurate and highly reproducible quantification of brain dopamine transporter SPECT studies. J Nucl Med Technol 2011; 39:271-8. [PMID: 22072699 DOI: 10.2967/jnmt.111.090324] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED In nuclear medicine brain imaging, it is important to delineate regions of interest (ROIs) so that the outcome is both accurate and reproducible. The purpose of this study was to validate a new time-saving algorithm (DATquan) for accurate and reproducible quantification of the striatal dopamine transporter (DAT) with appropriate radioligands and SPECT and without the need for structural brain scanning. METHODS In a reconstructed DAT SPECT image, DATquan automatically calculated the ratio at steady state of specifically bound radioligand to nondisplaceable radioligand in tissue (BP(ND)) within striatal ROIs that were delineated by use of a semiautomatic template-based alignment approach. DATquan was tested with (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) SPECT images from 15 patients. In each image, ROIs were first manually delineated, and then corresponding BP(ND) values were derived by an experienced physician. Afterward, 2 independent novice operators used DATquan to analyze the same 15 images. The resulting DATquan-derived BP(ND) data were compared with the data retrieved by manual delineation to assess the accuracy and reproducibility of DATquan. Also, the operational aspects of DATquan were assessed on the basis of measurements of the mean running time of the algorithm as well as on the basis of quantification of the overlap of the DATquan-delineated ROIs obtained by the 2 operators. RESULTS The mean algorithm running time was 3 min, and the operators' striatal ROIs had a mean overlap of more than 82%. DATquan-derived BP(ND) values obtained by the 2 operators showed high agreement (the mean difference was 0.00 [SD, 0.05] in the striatum, 0.02 [SD, 0.26] in the putamen, and 0.03 [SD, 0.43] in the caudate nucleus). The interoperator variability was 2.2% (SD, 1.3%) in the striatum, 11.7% (SD, 9.9%) in the putamen, and 12.9% (SD, 4.0%) in the caudate nucleus. DATquan-derived BP(ND) values showed high agreement with the values manually derived by the experienced delineator. CONCLUSION DATquan is a freely available, accurate, and highly reproducible method for quantification of DAT binding in the brain by SPECT. Once implemented in clinics, DATquan will serve as a useful and time-saving tool.
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Affiliation(s)
- Peter S Jensen
- Neurobiology Research Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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de Nijs R, Holm S, Thomsen G, Ziebell M, Svarer C. Experimental determination of the weighting factor for the energy window subtraction-based downscatter correction for I-123 in brain SPECT studies. J Med Phys 2011; 35:215-22. [PMID: 21170186 PMCID: PMC2990116 DOI: 10.4103/0971-6203.71765] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 04/15/2010] [Accepted: 04/19/2010] [Indexed: 11/12/2022] Open
Abstract
Correction for downscatter in I-123 SPECT can be performed by the subtraction of a secondary energy window from the main window, as in the triple-energy window method. This is potentially noise sensitive. For studies with limited amount of counts (e.g. dynamic studies), a broad subtraction window with identical width is preferred. This secondary window needs to be weighted with a factor higher than one, due to a broad backscatter peak from high-energy photons appearing at 172 keV. Spatial dependency and the numerical value of this weighting factor and the image contrast improvement of this correction were investigated in this study. Energy windows with a width of 32 keV were centered at 159 keV and 200 keV. The weighting factor was measured both with an I-123 point source and in a dopamine transporter brain SPECT study in 10 human subjects (5 healthy subjects and 5 patients) by minimizing the background outside the head. Weighting factors ranged from 1.11 to 1.13 for the point source and from 1.16 to 1.18 for human subjects. Point source measurements revealed no position dependence. After correction, the measured specific binding ratio (image contrast) increased significantly for healthy subjects, typically by more than 20%, while the background counts outside of all subjects were effectively removed. A weighting factor of 1.1–1.2 can be applied in clinical practice. This correction effectively removes downscatter and significantly improves image contrast inside the brain.
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Affiliation(s)
- Robin de Nijs
- Department of Clinical Physiology, Nuclear Medicine, PET and Cyclotron Unit, Copenhagen University Hospital, Copenhagen, Denmark
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Madsen J, Elfving B, Frokjaer VG, Kornum BR, Thomsen G, Martiny L, Knudsen GM. Synthesis and biological evaluation of 125I/123I-labelled analogues of citalopram and escitalopram as potential radioligands for imaging of the serotonin transporter. J Labelled Comp Radiopharm 2010. [DOI: 10.1002/jlcr.1841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ziebell M, Holm-Hansen S, Thomsen G, Wagner A, Jensen P, Pinborg LH, Knudsen GM. Serotonin transporters in dopamine transporter imaging: a head-to-head comparison of dopamine transporter SPECT radioligands 123I-FP-CIT and 123I-PE2I. J Nucl Med 2010; 51:1885-91. [PMID: 21078806 DOI: 10.2967/jnumed.110.078337] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Current SPECT radioligands available for in vivo imaging of the dopamine transporter (DAT) also show affinity for monoamine transporters other than DAT, especially the serotonin transporter (SERT). The effect of this lack of selectivity for in vivo imaging is unknown. In this study, we compared the SPECT radioligands (123)I-2-β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)nortropane ((123)I-FP-CIT) and (123)I-N-(3-iodoprop-2E-enyl)-2-β-carbomethoxy-3β-(4-methylphenyl) nortropane ((123)I-PE2I), which has a 10-fold higher selectivity than (123)I-FP-CIT for DAT versus SERT [corrected]. METHODS Sixteen healthy individuals were scanned in random order with both radioligands. The radioligands were administered according to standard recommendations: (123)I-FP-CIT was given as a bolus injection, and the ratio between the striatum and reference tissue was measured after 3 h. (123)I-PE2I was administered in a bolus-infusion setup, and the nondisplaceable binding potential (BP(ND)) was measured after 2 h. To assess the contribution of SERT to the overall SPECT signal, SERT was blocked by intravenous citalopram in 6 of the individuals. RESULTS The striatum-to-reference ratio - 1 of (123)I-FP-CIT was on average 18% higher than the striatal BP(ND) of (123)I-PE2I. Equal doses of radioactivity resulted in 3 times higher counting rates for (123)I-FP-CIT than for (123)I-PE2I, both in target and in reference brain regions. Citalopram infusion led to significant reductions in both striatal (22.8% ± 20.4%, P < 0.05) and thalamic (63.0% ± 47.9%, P < 0.05) (123)I-FP-CIT binding ratios, whereas BP(ND) of (123)I-PE2I was unaltered. Likewise, blocking of SERT led to increased (21% ± 30.1%, P < 0.001) plasma (123)I-FP-CIT, probably as a result of significant blocking of peripheral SERT binding sites. By contrast, plasma (123)I-PE2I remained stable. CONCLUSION (123)I-FP-CIT and (123)I-PE2I had approximately the same target-to-background ratios, but per injected megabecquerel, (123)I-FP-CIT gave rise to 3-fold higher cerebral counting rates. We found that (123)I-FP-CIT, but not (123)I-PE2I, brain images have a highly interindividual but significant signal contribution from SERT. Whether the SERT signal contribution is of clinical importance needs to be established in future patient studies.
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Affiliation(s)
- Morten Ziebell
- Neurobiology Research Unit and Cimbi, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
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Ziebell M, Pinborg LH, Thomsen G, de Nijs R, Svarer C, Wagner A, Knudsen GM. MRI-Guided Region-of-Interest Delineation Is Comparable to Manual Delineation in Dopamine Transporter SPECT Quantification in Patients: A Reproducibility Study. J Nucl Med Technol 2010; 38:61-8. [DOI: 10.2967/jnmt.109.072801] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mason N, Reid B, Harmstan G, Jones J, Stoker S, Budge D, Alharethi R, Thomsen G, Clayson S, Caine W. 539: Characterization of Gastrointestinal Bleeding in HeartMate II Left Ventricular Assist Device Patients. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Burney P, Potts J, Makowska J, Kowalski M, Phillips J, Gnatiuc L, Shaheen S, Joos G, Van Cauwenberge P, van Zele T, Verbruggen K, van Durme Y, Derudder I, Wohrl S, Godnic-Cvar J, Salameh B, Skadhauge L, Thomsen G, Zuberbier T, Bergmann KC, Heinzerling L, Renz H, Al-Fakhri N, Kosche B, Hildenberg A, Papadopoulos NG, Xepapadaki P, Zannikos K, Gjomarkaj M, Bruno A, Pace E, Bonini S, Bresciani M, Gramiccioni C, Fokkens W, Weersink EJM, Carlsen KH, Bakkeheim E, Loureiro C, Villanueva CM, Sanjuas C, Zock JP, Lundback B, Janson C. A case-control study of the relation between plasma selenium and asthma in European populations: a GAL2EN project. Allergy 2008; 63:865-71. [PMID: 18588552 DOI: 10.1111/j.1398-9995.2008.01716.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. METHODS The GA(2)LEN network has organized a multicentre case-control study in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12 months. RESULTS All cases and controls were selected from the same population defined by age and place of residence. Mean plasma selenium concentrations among the controls ranged from 116.3 microg/l in Palermo to 67.7 microg/l in Vienna and 56.1 microg/l among the children in Oslo. Random effects meta-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally significant adverse effect in Amsterdam (OR: 1.68; 95% CI: 0.98-2.90) and Ghent (OR: 1.35; 95% CI: 1.03-1.77). CONCLUSION This study does not support a role for selenium in protection against asthma, but effect modification and confounding cannot be ruled out.
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Affiliation(s)
- P Burney
- National Heart Lung Institute, Imperial College, London, UK
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Shaheen S, Potts J, Gnatiuc L, Makowska J, Kowalski ML, Joos G, van Zele T, van Durme Y, De Rudder I, Wöhrl S, Godnic-Cvar J, Skadhauge L, Thomsen G, Zuberbier T, Bergmann KC, Heinzerling L, Gjomarkaj M, Bruno A, Pace E, Bonini S, Fokkens W, Weersink EJM, Loureiro C, Todo-Bom A, Villanueva CM, Sanjuas C, Zock JP, Janson C, Burney P. The relation between paracetamol use and asthma: a GA2LEN European case-control study. Eur Respir J 2008; 32:1231-6. [PMID: 18579547 DOI: 10.1183/09031936.00039208] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Studies from the UK and USA suggest that frequent use of paracetamol (acetaminophen) may increase the risk of asthma, but data across Europe are lacking. As part of a multicentric case-control study organised by the Global Allergy and Asthma European Network (GA(2)LEN), it was examined whether or not frequent paracetamol use is associated with adult asthma across Europe. The network compared 521 cases with a diagnosis of asthma and reporting of asthma symptoms within the last 12 months with 507 controls with no diagnosis of asthma and no asthmatic symptoms within the last 12 months across 12 European centres. All cases and controls were selected from the same population, defined by age (20-45 yrs) and place of residence. In a random effects meta-analysis, weekly use of paracetamol, compared with less frequent use, was strongly positively associated with asthma after controlling for confounders. There was no evidence for heterogeneity across centres. No association was seen between use of other analgesics and asthma. These data add to the increasing and consistent epidemiological evidence implicating frequent paracetamol use in asthma in diverse populations.
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Affiliation(s)
- S Shaheen
- National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
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32
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Shaheen S, Potts J, Gnatiuc L, Makowska J, Kowalski ML, Joos G, van Zele T, van Durme Y, De Rudder I, Wöhrl S, Godnic-Cvar J, Skadhauge L, Thomsen G, Zuberbier T, Bergmann KC, Heinzerling L, Gjomarkaj M, Bruno A, Pace E, Bonini S, Fokkens W, Weersink EJM, Loureiro C, Todo-Bom A, Villanueva CM, Sanjuas C, Zock JP, Janson C, Burney P. The relation between paracetamol use and asthma: a GA2LEN European case-control study. Eur Respir J 2008. [PMID: 18579547 DOI: 10.1183/09031936.00039208.] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Studies from the UK and USA suggest that frequent use of paracetamol (acetaminophen) may increase the risk of asthma, but data across Europe are lacking. As part of a multicentric case-control study organised by the Global Allergy and Asthma European Network (GA(2)LEN), it was examined whether or not frequent paracetamol use is associated with adult asthma across Europe. The network compared 521 cases with a diagnosis of asthma and reporting of asthma symptoms within the last 12 months with 507 controls with no diagnosis of asthma and no asthmatic symptoms within the last 12 months across 12 European centres. All cases and controls were selected from the same population, defined by age (20-45 yrs) and place of residence. In a random effects meta-analysis, weekly use of paracetamol, compared with less frequent use, was strongly positively associated with asthma after controlling for confounders. There was no evidence for heterogeneity across centres. No association was seen between use of other analgesics and asthma. These data add to the increasing and consistent epidemiological evidence implicating frequent paracetamol use in asthma in diverse populations.
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Affiliation(s)
- S Shaheen
- National Heart and Lung Institute, Imperial College London, Emmanuel Kaye Building, Manresa Road, London SW3 6LR, UK.
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Joensen JB, Juul S, Henneberg E, Thomsen G, Ostergaard L, Lindholt JS. Can long-term antibiotic treatment prevent progression of peripheral arterial occlusive disease? A large, randomized, double-blinded, placebo-controlled trial. Atherosclerosis 2007; 196:937-42. [PMID: 17418218 DOI: 10.1016/j.atherosclerosis.2007.02.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Revised: 02/21/2007] [Accepted: 02/26/2007] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose was to investigate in a large, randomized, double-blinded, placebo-controlled trial, whether antibiotic treatment can prevent progression of peripheral arterial disease (PAD). MATERIAL AND METHODS Five hundred and seven patients were included; all patients had an established diagnosis of PAD. Their mean age was 66 years (36-85), and 59% were males. Patients were randomized to Roxithromycin 300 mg daily for 28 days. Baseline investigations were ankle blood pressure, ankle-brachial blood pressure index (ABPI), walking distance, C. pneumoniae serology, cholesterol and medical history. Follow-up was performed every 6 months. Primary events were defined as death, peripheral revascularization and major lower limb amputation. Secondary events were thrombosis, stroke, transient cerebral ischaemic attack and myocardial infarction. Change in ABPI was also investigated. Data were analyzed mainly by Cox regression and linear regression. RESULTS Included patients with PAD were randomized. Two patients withdrew. Of the remaining, 248 received roxithromycin and 257 placebo. In the treatment group 55% were seropositive and 53% in the placebo group. Mean follow-up was 2.1 years (range 0.06-5.1 years). In the placebo group, 26 died and 80 primary events occurred in total. In the treatment group, 28 died and 74 primary events were observed. The hazard ratio of death was 1.13 (95% CI: 0.68; 1.90), and of primary events 0.92 (95% CI: 0.67; 1.26). Also on secondary events and ABPI changes, no significant differences were found. CONCLUSION Long-term treatment with roxithromycin is ineffective in preventing death, amputation, peripheral revascularization, myocardial infarction, stroke, transient cerebral ischaemic attack, thrombosis and decline in ABPI in patients with an established diagnosis of PAD.
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Affiliation(s)
- J B Joensen
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
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Ziebell M, Thomsen G, Knudsen GM, de Nijs R, Svarer C, Wagner A, Pinborg LH. Reproducibility of [123I]PE2I binding to dopamine transporters with SPECT. Eur J Nucl Med Mol Imaging 2006; 34:101-9. [PMID: 16896668 DOI: 10.1007/s00259-006-0161-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2005] [Revised: 04/11/2006] [Accepted: 04/30/2006] [Indexed: 10/24/2022]
Abstract
PURPOSE The iodinated cocaine derivative [(123)I]PE2I is a new selective ligand for in vivo studies of the dopamine transporter (DAT) with SPECT. Recently, a bolus/infusion (B/I) protocol for [(123)I]PE2I measurements of DAT density was established [Pinborg LH et al. J Nucl Med 2005;46:1119-271]. The aims of this study were, firstly, to evaluate the test-retest variability using the B/I protocol and, secondly, to evaluate the B/I approach in a new group of healthy subjects using two outcome parameters, BP(1) (C(ROI)/C(plasma)) and BP(2) (C(ROI)/C(REF)). METHODS Seven healthy subjects were subjected to [(123)I]PE2I SPECT scanning twice. For both studies, the two outcome parameters BP(1) and BP(2) were calculated based on two different methods for region of interest (ROI) delineation, namely manual delineation and probability map-based automatic delineation with MRI co-registration. RESULTS With manual delineation, striatal test-retest variability (absolute difference between first and second scan as a percentage of the mean) of BP(1) and BP(2) was 13.9% (range 1.8-35.7%) and 4.1% (range 0.5-9.7%) respectively. The probability map-based automatic delineation resulted in striatal test-retest variability of 17.2% (range 4.3-40.5%) and 5.2% (range 0.1-10.9%) respectively. The B/I approach provided stable brain activity from 120 to 180 min post injection in both high- and low-count regions with a mean % change/hour in striatal BP(2) of 10.6. CONCLUSION [(123)I]PE2I SPECT with the B/I approach yields a highly reproducible measure of striatal dopamine transporter binding. The appropriateness of a B/I protocol with a B/I ratio of 2.7 h (i.e. with a bolus worth 2.7 h of infusion) was confirmed in an independent sample of healthy subjects.
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Affiliation(s)
- Morten Ziebell
- Neurobiology Research Unit, Rigshospitalet, N9201, 9 Blegdamsvej, Copenhagen, 2100, Denmark.
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Svarer C, Thomsen G, Frokjaer V, Hasselbalch S, Knudsen G. Automatic extraction of VOI data from functional images. Neuroimage 2006. [DOI: 10.1016/j.neuroimage.2006.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Knudsen GM, Karlsborg M, Thomsen G, Krabbe K, Regeur L, Nygaard T, Videbaek C, Werdelin L. Imaging of dopamine transporters and D2 receptors in patients with Parkinson's disease and multiple system atrophy. Eur J Nucl Med Mol Imaging 2004; 31:1631-8. [PMID: 15583914 DOI: 10.1007/s00259-004-1578-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2004] [Accepted: 04/13/2004] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to ascertain whether combined presynaptic and postsynaptic dopaminergic single-photon emission computed tomography (SPECT) scanning is useful for differentiation between patients with idiopathic Parkinson's disease (IPD), patients with multiple system atrophy of the striatonigral type (MSA) and healthy subjects. METHODS SPECT measurements of the dopamine transporter (DAT) were done with 123I-beta-CIT, while for determination of the dopamine D2-like receptors (D2), 123I-epidepride was used. Clinical evaluation and SPECT scans were carried out in 14 patients with IPD, eight patients with MSA and 11 healthy age-matched control subjects. RESULTS Putaminal DAT binding was reduced to 32% of control values in IPD and to 19% of control values in MSA . Significantly higher striatal asymmetry in DAT binding was found in MSA than in controls, but IPD patients had significantly higher asymmetry than MSA patients. Striatal D2 binding did not differ significantly between patients and healthy controls but the ratio between caudate DAT and D2 binding was significantly higher in patients with IPD than in those with MSA, even when disease severity was taken into account. CONCLUSION Patients with reduced striatal 123I-beta-CIT binding and a side-to-side difference greater than 15% are likely to suffer from IPD. Patients with reduced striatal 123I-beta-CIT binding and a side-to-side difference of between 5% and 15% are more likely to have MSA. 123I-epidepride SPECT measurements may add further diagnostic information, since the ratio between DAT and D2 receptor binding is significantly higher in IPD than in MSA.
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Affiliation(s)
- G M Knudsen
- Neurobiology Research Unit 9201, Department of Neurology, University Hospital Rigshospitalet, Copenhagen, Denmark.
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Bonde JP, Mikkelsen S, Andersen JH, Fallentin N, Baelum J, Svendsen SW, Thomsen JF, Frost P, Thomsen G, Overgaard E, Kaergaard A. Prognosis of shoulder tendonitis in repetitive work: a follow up study in a cohort of Danish industrial and service workers. Occup Environ Med 2003; 60:E8. [PMID: 12937204 PMCID: PMC1740623 DOI: 10.1136/oem.60.9.e8] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The physical and psychosocial work environment is expected to modify recovery from shoulder disorders, but knowledge is limited. METHODS In a follow up study of musculoskeletal disorders in industrial and service workers, 113 employees were identified with a history of shoulder pain combined with clinical signs of shoulder tendonitis. The workers had yearly re-examinations up to three times. Quantitative estimates of duration, repetitiveness, and forcefulness of current tasks were obtained from video recordings. Perception of job demands, decision latitude, and social support was recorded by a job content questionnaire. Recovery of shoulder tendonitis was analysed by Kaplan-Meier survival technique and by logistic regression on exposure variables and individual characteristics in models, allowing for time varying exposures. RESULTS Some 50% of workers recovered within 10 months (95% CI 6 to 14 months). Higher age was strongly related to slow recovery, while physical job exposures were not. Perception of demands, control, and social support at the time when the shoulder disorder was diagnosed, were associated with delayed recovery, but these psychosocial factors did not predict slow recovery in incident cases identified during follow up. CONCLUSION The median duration of shoulder tendonitis in a cross sectional sample of industrial and service workers was in the order of 10 months. This estimate is most likely biased towards too high a value. Recovery was strongly reduced in higher age. Physical workplace exposures and perceived psychosocial job characteristics during the period preceding diagnosis seem not to be important prognostic factors.
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Affiliation(s)
- J P Bonde
- Department of Occupational Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 2C, DK-8000 Aarhus C, Denmark.
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Møller K, Strauss GI, Thomsen G, Larsen FS, Holm S, Sperling BK, Skinhøj P, Knudsen GM. Cerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis. Acta Anaesthesiol Scand 2002; 46:567-78. [PMID: 12027852 DOI: 10.1034/j.1399-6576.2002.460515.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The optimal arterial carbon dioxide tension (P(a)CO(2)) in patients with acute bacterial meningitis (ABM) is unknown and controversial. The objective of this study was to measure global cerebral blood flow (CBF), cerebrovascular CO(2) reactivity (CO(2)R), and cerebral metabolic rates (CMR) of oxygen (O(2)), glucose (glu), and lactate (lac), in patients with ABM and compare the results to those obtained in healthy volunteers. METHODS We studied 19 patients (17 of whom were sedated) with ABM and eight healthy volunteers (controls). CBF was measured during baseline ventilation and hyperventilation with single-photon emission computed tomography (SPECT) (14 patients) and/or the Kety-Schmidt technique (KS) (11 patients and all controls). In KS studies, CMR was measured by multiplying the arterial to jugular venous concentration difference (a-v D) by CBF. RESULTS CBF did not differ significantly among groups, although a larger variation was seen in patients than in controls. CO(2)R was not significantly different among groups. At baseline, patients had significantly lower a-v DO(2), CMR(O(2)), CMR(glu), and CMR(lac) than controls. CMR(O(2)) did not change between hyperventilation compared to baseline ventilation, whereas CMR(glu) increased. CONCLUSION In patients with acute bacterial meningitis, we found variable levels of CBF and cerebrovascular CO(2) reactivity, a low a-v DO(2), low cerebral metabolic rates of oxygen and glucose, and a cerebral lactate efflux. In these patients, a ventilation strategy guided by jugular bulb oximetry and/or repeated CBF measurements may be more optimal in terms of cerebral oxygenation than a strategy aiming at identical levels of P(a)CO(2) for all patients.
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Affiliation(s)
- K Møller
- Department of Infectious Diseases, University Hospital Rigshospitalet, Copenhagen, Denmark.
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Gruhn N, Larsen FS, Boesgaard S, Knudsen GM, Mortensen SA, Thomsen G, Aldershvile J. Cerebral blood flow in patients with chronic heart failure before and after heart transplantation. Stroke 2001; 32:2530-3. [PMID: 11692012 DOI: 10.1161/hs1101.098360] [Citation(s) in RCA: 215] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Arterial blood pressure and cardiac output are often reduced in patients with chronic heart failure (CHF). Counterregulatory mechanisms with increased neurohormonal activation and changes in the distribution of cardiac output are assumed to secure vital organ perfusion. However, clinical examination of patients with CHF frequently reveals neurological symptoms with dizziness and memory problems, suggesting altered brain perfusion. In this study we determined whether cerebral blood flow (CBF) is reduced in patients with New York Heart Association (NYHA) functional class III and IV (n=12) compared with healthy control subjects (n=12). Furthermore, we examined whether heart transplantation (n=5) could restore CBF. METHODS CBF was estimated by single-photon emission computed tomography and (133)Xe as tracer, and middle cerebral artery velocity was measured by transcranial Doppler ultrasound. RESULTS In the CHF patients, CBF was 36+/-1 mL/min per 100 g, corresponding to a 31% reduction compared with the control group (52+/-5 mL/min per 100 g) (P<0.05). After heart transplantation, CBF increased from 35+/-3 mL/min per 100 g before transplantation to 50+/-3 mL/min per 100 g within the first postoperative month (P<0.05). CONCLUSIONS We conclude that CBF is substantially, but reversibly, reduced in patients with NYHA class III/IV heart failure. This phenomenon suggests that redistribution of cardiac output inadequately secures brain perfusion in patients with severe CHF.
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Affiliation(s)
- N Gruhn
- Department of Medicine, Division of Cardiology, Rigshospitalet, University of Copenhagen, Denmark
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Guralnick B, Thomsen G, Citovsky V. Transport of DNA into the nuclei of xenopus oocytes by a modified VirE2 protein of Agrobacterium. Plant Cell 1996; 8:363-73. [PMID: 8721747 PMCID: PMC161106 DOI: 10.1105/tpc.8.3.363] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We used Agrobacterium T-DNA nuclear transport to examine the specificity of nuclear targeting between plants and animals and the nuclear import of DNA by a specialized transport protein. Two karyophilic Agrobacterium virulence (Vir) proteins, VirD2 and VirE2, which presumably associate with the transported T-DNA and function in many plant species, were microinjected into Drosophila embryos and Xenopus oocytes. In both animal systems, VirD2 localized to the cell nuclei and VirE2 remained exclusively cytoplasmic, suggesting that VirE2 nuclear localization signals may be plant specific. Repositioning one amino acid residue within VirE2 nuclear localization signals enabled them to function in animal cells. The modified VirE2 protein bound DNA and actively transported it into the nuclei of Xenopus oocytes. These observations suggest a functional difference in nuclear import between animals and plants and show that DNA can be transported into the cell nucleus via a protein-specific pathway.
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Affiliation(s)
- B Guralnick
- Department of Biochemistry and Cell Biology, State University of New York, Stony Brook 11794-5215, USA
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Rutledge G, Thomsen G, Farr B, Tovar M, Sheiner L, Fagan L. VentPlan: a ventilator-management advisor. Proc Annu Symp Comput Appl Med Care 1991:869-71. [PMID: 1807733 PMCID: PMC2247656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
VentPlan assists physicians, nurses, and respiratory therapists in the management of artificial respiration for critically ill patients in the intensive-care unit (ICU). VentPlan interprets clinical observations, monitored data, and arterial-blood-gas analyses to make recommendations for setting the ventilator. The VentPlan interface allows users to examine the physiologic model, to inspect details of the data on which the model is based, and to exercise the model to try out different ventilator settings before they implement a new setting. We also report here a preliminary evaluation of VentPlan's ability to predict the arterial oxygen and carbon-dioxide tensions following adjustments to the ventilator. We conclude that VentPlan's physiologic models are acceptably accurate for predicting the effects of small adjustments of the ventilator.
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Affiliation(s)
- G Rutledge
- Department of Medicine, Stanford University
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Thomsen G, Woolf T, Whitman M, Sokol S, Vaughan J, Vale W, Melton DA. Activins are expressed early in Xenopus embryogenesis and can induce axial mesoderm and anterior structures. Cell 1990; 63:485-93. [PMID: 2225062 DOI: 10.1016/0092-8674(90)90445-k] [Citation(s) in RCA: 477] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We show that mammalian and Xenopus activins induce dorsal axial mesoderm and anterior structures in explants of Xenopus blastula cells that would otherwise form epidermis. The induced explants of animal cap cells can form notochord, muscle, neural tissue, and eyes all arranged in a rudimentary axial pattern. Activin A shares inductive properties and antigenic determinants with PIF, an inducing factor recently isolated from mouse macrophage culture supernatants. Genes encoding Xenopus activin beta A and beta B chains were cloned. Activin beta B transcripts are first detected in Xenopus blastula, whereas activin beta A transcripts do not appear until the late gastrula stage. Recombinant Xenopus activin beta B protein induces mesodermal and neural tissues similar to those induced by mammalian activin A and PIF. Furthermore, ectopic expression of Xenopus activin beta B produces a second body axis in embryos injected with synthetic mRNA. Our results suggest that early induction and axial patterning are accomplished by endogenous activin B, not activin A, in Xenopus.
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Affiliation(s)
- G Thomsen
- Department of Biochemistry and Molecular Biology, Harvard University, Cambridge, Massachusetts 02138
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Mitrani E, Ziv T, Thomsen G, Shimoni Y, Melton DA, Bril A. Activin can induce the formation of axial structures and is expressed in the hypoblast of the chick. Cell 1990; 63:495-501. [PMID: 2225063 DOI: 10.1016/0092-8674(90)90446-l] [Citation(s) in RCA: 161] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We show that PIF/activin can induce the formation of axial structures including a full-length notochord, segmented somites, and a neural tube in isolated epiblasts from chick blastulae. Using degenerate PCR primers, we have cloned a fragment of the activin beta B chain from chick hypoblast cDNA, and a fragment of the activin beta A chain from chick genomic DNA. Furthermore, we show that in the chick, activin is transcribed precisely when axial mesoderm is being induced. Since exogenous PIF/activin can induce the formation of axial structures and since activin beta B is transcribed at the time and place where the mesodermal axial structures are being induced, we propose that in the chick, activin B is the endogenous inducer of the body axis.
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Affiliation(s)
- E Mitrani
- Department of Zoology, Hebrew University of Jerusalem, Israel
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Abstract
At two x ray examinations in 1957 and 1967, 17 cases of skeletal fluorosis were identified among long term cryolite workers in Copenhagen. In 1982 four of these patients were alive, eight to 15 years after exposure had ended. Radiographs were obtained, and the urinary fluoride excretion was measured. A similar picture emerged in all four cases: extensive fading of the sclerosis of trabecular bone in ribs, vertebral bodies, and pelvis, whereas cortical bone thickening and calcification of muscle insertions and ligaments remained virtually unchanged. The fluoride excretion was increased in three cases (with the shortest exposure free period). These findings indicate that with continuous remodelling of bone tissue trabecular sclerosis is slowly reversible and the excess fluoride is excreted in the urine.
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Thomsen HS, Bonnevie A, Thomsen G. [Pleural calcifications--exposure to asbestos?]. Ugeskr Laeger 1977; 139:2777-80. [PMID: 595164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Thomsen G. [Radiographic examination of the small intestine]. Ugeskr Laeger 1973; 135:716. [PMID: 4719918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Thomsen G. Die Bindung von Quecksilber an verschiedene reine und elektrophoretisch auf Filtrierpapier getrennte Serumproteine. Naturwissenschaften 1952. [DOI: 10.1007/bf00589287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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