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Peters L, Mocroft A, Grint D, Moreno S, Calmy A, Jevtovic D, Sambatakou H, Lacombe K, De Wit S, Rockstroh J, Smidt J, Karpov I, Grzeszczuk A, Haziosmanovic V, Gottfredsson M, Radoi R, Kuzovatova E, Orkin C, Ridolfo AL, Zapirain J, Lundgren J. Uptake of tenofovir-based antiretroviral therapy among HIV-HBV-coinfected patients in the EuroSIDA study. Antivir Ther 2019; 23:405-413. [PMID: 29303483 DOI: 10.3851/imp3218] [Citation(s) in RCA: 4] [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] [Accepted: 12/07/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND According to guidelines all HIV-HBV-coinfected patients should receive tenofovir-based combination antiretroviral therapy (cART). We aimed to investigate uptake and outcomes of tenofovir-based cART among HIV-HBV patients in the EuroSIDA study. METHODS All hepatitis B surface antigen (HBsAg)+ patients followed up after 1 March 2002 were included. Changes in the proportion taking tenofovir-based cART over time were described. Poisson regression was used to investigate the relationship between tenofovir use and clinical events. RESULTS 953 HIV-HBV patients were included. Median age was 41 years and patients were predominantly male (85%), White (82%) and ART-experienced (88%). 697 and 256 were from Western and Eastern Europe, respectively. 55 started cART during follow-up, the proportion starting with CD4+ T-cell count <350 cells/mm3 decreased from 85% to 52% in the periods 2002-2006 to 2007-2015. Tenofovir use, among those taking cART, increased from 4% in 2002 to 73% in 2015. Compared to West, tenofovir use was lower in East in 2005 (7% versus 42%), and remained lower in 2015 (63% versus 76%). Among 602 patients taking tenofovir-based cART during follow-up, 155 (26%) discontinued tenofovir. 27 of all discontinuations were due to adverse effects. Only 14 started entecavir and/or adefovir after tenofovir discontinuation, whereas 10 started pegylated interferon. Tenofovir use was not significantly associated with lower risk of liver-related clinical events (n=51), adjusted incidence rate ratio (IRR) 0.64 (95% CI 0.35, 1.18) for comparing patients on tenofovir with those off tenofovir. CONCLUSIONS Although use of tenofovir-based cART among HIV-HBV patients has increased across Europe, a substantial proportion are still starting cART late and are receiving suboptimal HBV therapy.
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Affiliation(s)
- Lars Peters
- CHIP, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Amanda Mocroft
- University College London Medical School, Primary Care and Population Sciences, London, United Kingdom
| | - Daniel Grint
- London School of Hygiene and Tropical Medicine, Department of Infectious Disease Epidemiology, London, United Kingdom
| | - Santiago Moreno
- Hospital Universitario Ramón y Cajal-IRYCIS, Infectious Diseases Department, Madrid, Spain
| | | | - Djordje Jevtovic
- The Institute for Infectious & Tropical Diseases, Belgrade, Serbia
| | - Helen Sambatakou
- Athens Medical School, Hippokration General Hospital, Athens, Greece
| | | | | | | | | | - Igor Karpov
- Belarus State Medical University, Minsk, Belarus
| | - Anna Grzeszczuk
- Uniwersytet Medyczny w Bialymstoku, Department of Infectious Diseases, Bialystok, Poland
| | | | - Magnus Gottfredsson
- University of Iceland and Landspitali University Hospital, Reykjavik, Iceland
| | - Roxana Radoi
- Dr. Victor Babes Hospital, Spitalul de Boli Infectioase si Tropicale, Bucharest, Romania
| | - Elena Kuzovatova
- Nizhny Novgorod Scientific and Research Institute of Epidemiology and Microbiology, Nizhny Novgorod, Russia
| | - Chloe Orkin
- Royal London Hospital, London, United Kingdom
| | | | - Jose Zapirain
- Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
| | - Jens Lundgren
- CHIP, Department of Infectious Diseases, Rigshospitalet, Copenhagen, Denmark
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Cozzi-Lepri A, Zangerle R, Machala L, Zilmer K, Ristola M, Pradier C, Kirk O, Sambatakou H, Fätkenheuer G, Yust I, Schmid P, Gottfredsson M, Khromova I, Jilich D, Flisiak R, Smidt J, Rozentale B, Radoi R, Losso MH, Lundgren JD, Mocroft A. Incidence of cancer and overall risk of mortality in individuals treated with raltegravir-based and non-raltegravir-based combination antiretroviral therapy regimens. HIV Med 2017; 19:102-117. [PMID: 28984429 PMCID: PMC5813233 DOI: 10.1111/hiv.12557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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] [Accepted: 08/04/2017] [Indexed: 11/27/2022]
Abstract
Objectives There are currently few data on the long‐term risk of cancer and death in individuals taking raltegravir (RAL). The aim of this analysis was to evaluate whether there is evidence for an association. Methods The EuroSIDA cohort was divided into three groups: those starting RAL‐based combination antiretroviral therapy (cART) on or after 21 December 2007 (RAL); a historical cohort (HIST) of individuals adding a new antiretroviral (ARV) drug (not RAL) to their cART between 1 January 2005 and 20 December 2007, and a concurrent cohort (CONC) of individuals adding a new ARV drug (not RAL) to their cART on or after 21 December 2007. Baseline characteristics were compared using logistic regression. The incidences of newly diagnosed malignancies and death were compared using Poisson regression. Results The RAL cohort included 1470 individuals [with 4058 person‐years of follow‐up (PYFU)] compared with 3787 (4472 PYFU) and 4467 (10 691 PYFU) in the HIST and CONC cohorts, respectively. The prevalence of non‐AIDS‐related malignancies prior to baseline tended to be higher in the RAL cohort vs. the HIST cohort [adjusted odds ratio (aOR) 1.31; 95% confidence interval (CI) 0.95–1.80] and vs. the CONC cohort (aOR 1.89; 95% CI 1.37–2.61). In intention‐to‐treat (ITT) analysis (events: RAL, 50; HIST, 45; CONC, 127), the incidence of all new malignancies was 1.11 (95% CI 0.84–1.46) per 100 PYFU in the RAL cohort vs. 1.20 (95% CI 0.90–1.61) and 0.83 (95% CI 0.70–0.99) in the HIST and CONC cohorts, respectively. After adjustment, there was no evidence for a difference in the risk of malignancies [adjusted rate ratio (RR) 0.73; 95% CI 0.47–1.14 for RALvs. HIST; RR 0.95; 95% CI 0.65–1.39 for RALvs. CONC] or mortality (adjusted RR 0.87; 95% CI 0.53–1.43 for RALvs. HIST; RR 1.14; 95% CI 0.76–1.72 for RALvs. CONC). Conclusions We found no evidence for an oncogenic risk or poorer survival associated with using RAL compared with control groups.
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Affiliation(s)
- A Cozzi-Lepri
- Centre for Clinical Research, Modelling and Epidemiology, Research Department of Infection and Population Health, Institute for Global Health, University College London Medical School, Royal Free Campus, London, UK
| | - R Zangerle
- Medical University Innsbruck, Innsbruck, Austria
| | - L Machala
- Department of Infectious and Tropical Diseases, Third Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | - K Zilmer
- West-Tallinn Central Hospital, Tallinn, Estonia
| | - M Ristola
- Helsinki University Hospital, Helsinki, Finland
| | - C Pradier
- L'Archet 1 Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - O Kirk
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - G Fätkenheuer
- Department of Internal Medicine 1, University Hospital of Cologne, Cologne, Germany.,German Center for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | - I Yust
- Ichilov Hospital, Tel Aviv-Yafo, Israel
| | - P Schmid
- Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - M Gottfredsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland and Landspitali University Hospital, Reykjavík, Iceland
| | - I Khromova
- Centre for HIV/AIDS and infectious diseases, Kaliningrad, Russian Federation
| | - D Jilich
- Department of Infectious and Tropical Diseases, First Faculty of Medicine, Charles University and Na Bulovce Hospital, Prague, Czech Republic
| | - R Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland
| | - J Smidt
- Ida-Viru Central Hospital, Kohtla-Jarve
| | | | - R Radoi
- Dr. Victor Babes Hospital, Bucureşti, Romania
| | - M H Losso
- Hospital J.M. Ramos Mejia, Buenos Aires, Argentina
| | - J D Lundgren
- Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - A Mocroft
- Centre for Clinical Research, Modelling and Epidemiology, Research Department of Infection and Population Health, Institute for Global Health, University College London Medical School, Royal Free Campus, London, UK
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Westra JG, Huysmans WGB, Mijs WJ, Gaur HA, Vriend J, Smidt J. Structure analysis by nmr spectroscopy of a quinone methide trimer formed by oxidation of 4-methoxy-2,6-dimethylphenol. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19680871004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Weber AJM, Huysmans WGB, Mijs WJ, Bovée WMMJ, Smidt J, Vriend J. The structure of the condensation product of methyl cyanoacetate and 2,4-dimethoxy-6-chloro-l,3,5-triazine. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19780970406] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Adema EH, Bartelink HJM, Smidt J. Electron spin resonance studies on ziegler catalyst systems: Part I. The system titanium tetrachloride-aluminium diethyl chloride. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19610800207] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Smidt J, Groenewege MP, de Vries H. Exchange of alkylgroups in triethyl aluminium, diethyl aluminium chloride and a mixture of these substances, and in a mixture of methyl aluminium dichloride and dimethyl aluminium chloride. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19620810813] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [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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Beyerman HC, van Leeuwen M, Smidt J, van Veen A. γ-Coniceine of conium maculatum L., a revision of the generally accepted structure. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19610800506] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Adema EH, Bartelink HJM, Smidt J. Electron spin resonance studies on ziegler catalyst systems: Part II. The system titanium tetrachloride-aluminium ethyl dichloride. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19620810111] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Bartelink HJM, Bos H, Smidt J, Vrinssen CH, Adema EH. Electron spin resonance studies on Ziegler catalyst systems: Part III. Some mixtures of aluminium methyl compounds and aluminium chloride with bis-cyclopentadienyl titanium dichloride and bis-cyclopentadienyl methyl chlorotitanium. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/recl.19620810309] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [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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Avi R, Huik K, Karki T, Sadam M, Paap P, Smidt J, Ainsalu K, Krispin T, Lutsar I. P1914 The coexistence of secondary PR mutations M36I, K20I and L63H predominates in CRF06–cpx and its next generation recombinant viruses circulating in Estonian treatment–naïve patients. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71753-3] [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: 10/23/2022]
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Walitza S, Renner TJ, Dempfle A, Konrad K, Wewetzer C, Halbach A, Herpertz-Dahlmann B, Remschmidt H, Smidt J, Linder M, Flierl L, Knölker U, Friedel S, Schäfer H, Gross C, Hebebrand J, Warnke A, Lesch KP. Transmission disequilibrium of polymorphic variants in the tryptophan hydroxylase-2 gene in attention-deficit/hyperactivity disorder. Mol Psychiatry 2005; 10:1126-32. [PMID: 16116490 DOI: 10.1038/sj.mp.4001734] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [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] [Indexed: 02/03/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in childhood with substantial heritability. Pharmacological and molecular genetic studies as well as characterization of animal models have implicated serotonergic dysfunction in the pathophysiology of ADHD. Here, we investigated the effect of polymorphic variants in the gene of the tryptophan hydroxylase-2 (TPH2), the rate-limiting enzyme of serotonin (5-HT) synthesis in the brain, in children and adolescents with ADHD. We analyzed three single nucleotide polymorphisms (SNPs) in and downstream of the transcriptional control region of the TPH2 gene in 103 families with 225 affected children. Allelic association in families with more than one affected child was assessed using the pedigree disequilibrium test. Preferential transmissions were detected for the two SNPs in TPH2's regulatory region (rs4570625, P=0.049; rs11178997, P=0.034), but not for the third SNP in intron 2 (rs4565946, P=0.3517). Haplotype analysis revealed a strong trend of association between the regulatory region SNPs (rs4570625, rs11178997) and ADHD (P=0.064). Our results link potentially functional TPH2 variations to the pathophysiology of ADHD, and further support the relevance of 5-HT in disorders related to altered motor activity and cognitive processes.
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Affiliation(s)
- S Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Julius-Maximilians-University, Würzburg, Germany.
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Smidt J. Buchbesprechung. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2005. [DOI: 10.1024/1422-4917.33.3.247a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Heiser P, Friedel S, Dempfle A, Konrad K, Smidt J, Grabarkiewicz J, Herpertz-Dahlmann B, Remschmidt H, Hebebrand J. Molecular genetic aspects of attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev 2005; 28:625-41. [PMID: 15527867 DOI: 10.1016/j.neubiorev.2004.09.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2004] [Revised: 09/07/2004] [Accepted: 09/08/2004] [Indexed: 10/26/2022]
Abstract
Two genome wide scans, one of which was subsequently extended, have led to the identification of different chromosomal regions assumed to harbour genes underlying attention-deficit/hyperactivity disorder (ADHD). Some of these regions were also identified in patients with autism and/or dyslexia. The only region for which both studies detected a LOD score >1 was on chr 5p13 which is in the vicinity of the location of the candidate gene DAT1. The candidate gene approach has revealed the most robust and replicated findings for DRD4, DRD5, and DAT1 polymorphisms. Meanwhile interesting endophenotype studies have also been conducted suggesting a genetic basis for different diagnostic and therapeutic criteria. Animal studies for ADHD have investigated especially hyperactivity and have focused mainly on knockout and QTL designs. In knockout mice models the most promising results were obtained for genes of the dopaminergic pathway. QTL results in rodents suggest multiple loci underlying different forms of natural and induced hyperactivity. The molecular results mentioned above are presented and discussed in detail, thus providing both clinicians and geneticists with an overview of the current research status of this important child and adolescent psychiatric disorder.
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Affiliation(s)
- P Heiser
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
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Friedel S, Horro FF, Wermter AK, Geller F, Dempfle A, Reichwald K, Smidt J, Brönner G, Konrad K, Herpertz-Dahlmann B, Warnke A, Hemminger U, Linder M, Kiefl H, Goldschmidt HP, Siegfried W, Remschmidt H, Hinney A, Hebebrand J. Mutation screen of the brain derived neurotrophic factor gene (BDNF): identification of several genetic variants and association studies in patients with obesity, eating disorders, and attention-deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2005; 132B:96-9. [PMID: 15457498 DOI: 10.1002/ajmg.b.30090] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [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] [Indexed: 11/06/2022]
Abstract
Several lines of evidence indicate an involvement of brain derived neurotrophic factor (BDNF) in body weight regulation and activity: heterozygous Bdnf knockout mice (Bdnf(+/-)) are hyperphagic, obese, and hyperactive; furthermore, central infusion of BDNF leads to severe, dose-dependent appetite suppression and weight loss in rats. We searched for the role of BDNF variants in obesity, eating disorders, and attention-deficit/hyperactivity disorder (ADHD). A mutation screen (SSCP and DHPLC) of the translated region of BDNF in 183 extremely obese children and adolescents and 187 underweight students was performed. Additionally, we genotyped two common polymorphisms (rs6265: p.V66M; c.-46C > T) in 118 patients with anorexia nervosa, 80 patients with bulimia nervosa, 88 patients with ADHD, and 96 normal weight controls. Three rare variants (c.5C > T: p.T2I; c.273G > A; c.*137A > G) and the known polymorphism (p.V66M) were identified. A role of the I2 allele in the etiology of obesity cannot be excluded. We found no association between p.V66M or the additionally genotyped variant c.-46C > T and obesity, ADHD or eating disorders. This article contains supplementary material, which may be viewed at the American Journal of Medical Genetics website at http://www.interscience.wiley.com/jpages/0148-7299:1/suppmat/index.html.
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Affiliation(s)
- S Friedel
- Clinical Research Group, Department of Child and Adolescent Psychiatry and Psychotherapy, Philipps-University of Marburg, 35039 Marburg, Germany
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Smidt J. Buchbesprechung. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2004. [DOI: 10.1024/1422-4917.32.3.213a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Heiser P, Frey J, Smidt J, Sommerlad C, Wehmeier PM, Hebebrand J, Remschmidt H. Objective measurement of hyperactivity, impulsivity, and inattention in children with hyperkinetic disorders before and after treatment with methylphenidate. Eur Child Adolesc Psychiatry 2004; 13:100-4. [PMID: 15103535 DOI: 10.1007/s00787-004-0365-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [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] [Accepted: 08/19/2003] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether values of the respective parameters of the OPTAx test dependently differ due to the medication with methylphenidate (MPH) in children with hyperkinetic disorders (HD) suffering from hyperactivity, impulsivity, and attention deficits. METHODS The OPTAx test is an infrared motion analysis to record the movement pattern during a continuous performance test. We tested 25 children between 6 and 12 years with HD (ICD-10: F90.0 or F90.1) before and after treatment with MPH. The parameters under investigation were activity (microevents and spatial scaling), impulsivity (errors of commission), and attentiveness (accuracy and variability). For statistical analysis a one-tailed matched pairs test (adj. p = 0.01) was conducted to discriminate differences found from those occurred at random. A post hoc partial correlation of absolute differences in the respective parameters and the daily dose of MPH (adj. for BMI) was performed if p < 0.01. RESULTS Statistically significant results were found for microevents, spatial scaling, errors of commission, accuracy, and variability. The partial correlation showed significant results for microevents and variability. CONCLUSION The mean pre-post changes found in all parameters investigated consistently correspond with benefits desired from medication with MPH in children with HD. Absolute differences in microevents and variability seem to depend on the daily dose of MPH after adjustment for BMI.
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Affiliation(s)
- P Heiser
- Department of Child and Adolescent Psychiatry, Philipps-University of Marburg, Hans-Sachs-Strasse 6, 35037 Marburg, Germany
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Smidt J, Heiser P, Dempfle A, Konrad K, Hemminger U, Kathöfer A, Halbach A, Strub J, Grabarkiewicz J, Kiefl H, Linder M, Knölker U, Warnke A, Remschmidt H, Herpertz-Dahlmann B, Hebebrand J. [Formal genetic findings in attention-deficit/hyperactivity-disorder]. Fortschr Neurol Psychiatr 2003; 71:366-77. [PMID: 12858257 DOI: 10.1055/s-2003-40561] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Twin, family and adoption studies have led to a solid understanding of the contribution of both genetic and environmental factors to the development of attention deficit/hyperactivity disorder (ADHD). We review recent studies under consideration of both methodological aspects and relevant findings. Heritability estimates in the range of 0.6 - 0.8 surpass those for most other child and adolescent psychiatric disorders. First degree relatives have elevated rates for ADHD, affective disorders, conduct disorders and substance abuse and dependency. The ADHD subtype of the index patient does not predict the subtype of other family members affected with ADHD; hence non-genetic factors seemingly account for this intrafamilial variability. Because the familial rates for ADHD are not higher in families of female in comparison to male index patients, there is no indication that the genetic loading is higher in affected females. Recently, rater effects have been discussed broadly: Whereas the heritability estimates are uniformly high independent of the informant (mother, father, teacher), the correlations between quantitatively rated symptoms are low between different informants. Knowledge of the formal genetic aspects of ADHD is a prerequisite for understanding the results of recent molecular genetic studies.
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Affiliation(s)
- J Smidt
- Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Philipps-Universität Marburg
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Langeveld PTM, Mehlkopf AF, Smidt J. The sensitivity of electron paramagnetic spectrometers using parametric and maser preamplifiers. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0022-3735/1/8/145] [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: 11/12/2022]
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De Jongh HAP, De Jonge CRHI, Sinnige HJM, De Klein WJ, Huysmans WGB, Mijs WJ, Van den Hoek WJ, Smidt J. Oxidative carbon-carbon coupling. II. Effect of ring substituents on the oxidative carbon-carbon coupling of arylmalonic esters, arylmalodinitriles, and arylcyanoacetic esters. J Org Chem 2002. [DOI: 10.1021/jo00977a021] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Van der Drift E, Rousseeuw BAC, Smidt J. EPR and ELDOR studies on spin relaxation in perdeuterated 2,2,6,6-tetramethyl-4-piperidone N-oxide in liquid solutions. The slowly relaxing local structure mechanism. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j150655a019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bovee WMMJ, Alberts JH, Peters JA, Smidt J. Temperature dependence of the lanthanide-induced shifts, structure, and dynamics of adducts of quinuclidine and Ln(fod)3 chelates as studied by variable-temperature NMR shift and relaxation measurements. J Am Chem Soc 2002. [DOI: 10.1021/ja00370a031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wind RA, Emid S, Pourquie JFJM, Smidt J. Complete determination of the relaxation matrix of CH3groups in solids by means of experiment-dependent NMR relaxation measurements. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3719/9/1/021] [Citation(s) in RCA: 14] [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: 11/11/2022]
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Mair J, Smidt J, Lechleitner P, Dienstl F, Puschendorf B. A decision tree for the early diagnosis of acute myocardial infarction in nontraumatic chest pain patients at hospital admission. Chest 1995; 108:1502-9. [PMID: 7497751 DOI: 10.1378/chest.108.6.1502] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [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: 01/25/2023] Open
Abstract
STUDY OBJECTIVE To find an accurate algorithm for the diagnosis of acute myocardial infarction in nontraumatic chest pain patients on presentation to the emergency department. DESIGN In a prospective clinical study, we compared the diagnostic performances of clinical symptoms, presenting ECG, creatinine kinase, creatine kinase MB activity and mass concentration, myoglobin, and cardiac troponin T test results of hospital admission blood samples. By classification and regression trees, a decision tree for the diagnosis of acute myocardial infarction was developed. SETTING Emergency room of a Department of Internal Medicine (University Hospital). PATIENTS One hundred fourteen nontraumatic chest pain patients (median delay from onset of chest pain to hospital admission, 3 h; range, 0.33 to 22): 26 Q-wave and 19 non-Q-wave myocardial infarctions, 49 patients with unstable angina pectoris, and 20 patients with chest pain caused by other diseases. MEASUREMENTS AND RESULTS Of each parameter taken by itself, the ECG was tendentiously most informative (areas under receiver operating characteristic plots: 0.87 +/- 0.04 [ECG], 0.80 +/- 0.08 [myoglobin], 0.80 +/- 0.04 [creatine kinase MB mass], 0.77 +/- 0.04 [creatine kinase activity], 0.69 +/- 0.06 [clinical symptoms] 0.67 +/- 0.06 [creatine kinase MB activity], 0.67 +/- 0.05 [troponin T]). In patients presenting 3 h or less after the onset of chest pain, ECG signs of acute transmural myocardial ischemia were the best discriminator between patients with and without myocardial infarction. In patients presenting more than 3 h, however, creatine kinase MB mass concentrations (discriminator value, 6.7 micrograms/L) were superior to the ECG, clinical symptoms, and all other biochemical markers tested. This algorithm for diagnosing acute myocardial infarction was superior to each parameter by itself and was characterized by 0.91 sensitivity, a 0.90 specificity, a 0.90 positive and negative predictive value, and a 0.90 efficiency. CONCLUSIONS We found an algorithm that could accurately separate the myocardial infarction patients from the others on admission to the emergency department. Therefore, this classifier could be a valuable diagnostic aid for rapid confirmation of a suspected myocardial infarction.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry, University of Innsbruck (Austria) School of Medicine
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Mair J, Smidt J, Lechleitner P, Dienstl F, Puschendorf B. Rapid accurate diagnosis of acute myocardial infarction in patients with non-traumatic chest pain within 1 h of admission. Coron Artery Dis 1995; 6:539-45. [PMID: 7582192] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Accurate diagnosis of impending acute myocardial infarction (AMI) in patients presenting at an emergency department with acute chest pain is essential for proper triage and treatment. We have developed an algorithm for the early diagnosis of AMI. METHODS The diagnostic performances of ECG, creatine kinase (CK) and creatine kinase isoenzyme MB (CKMB) activities, CKMB mass, myoglobin, and cardiac troponin T (cTnT) were compared for early diagnosis of AMI in 60 non-traumatic chest pain patients (22 AMI, 29 unstable angina, nine other diseases) on presentation to an internal medicine emergency department and 1 h thereafter. The classification and regression trees method was used for data analysis and revealed the following results. RESULTS In patients with electrocardographic signs of acute transmural myocardial ischaemia on admission (mostly regional ST-segment elevations), biochemical markers could not improve the diagnostic accuracy either on admission or 1 h later. By contrast, in patients with non-diagnostic ECG, CKMB mass concentration measured 1h after admission was the best discriminator between AMI and non-AMI patients (discriminator value 5.8 micrograms/l) and was superior to ECG and all other biochemical markers tested. This algorithm for diagnosing AMI is characterized by 96% sensitivity, 90% specificity, 84% positive predictive value, 97% negative predictive value, 92% accuracy, 0.05 negative likelihood ratio, and 9.1 positive likelihood ratio. CONCLUSION The classification procedure obtained allows accurate rapid and early diagnosis of AMI and could therefore be a valuable diagnostic aid to physicians of emergency medicine.
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Affiliation(s)
- J Mair
- Department of Internal Medicine, University of Innsbruck School of Medicine, Austria
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Mair J, Puschendorf B, Smidt J, Lechleitner P, Dienstl F, Noll F, Krause EG, Rabitzsch G. Early release of glycogen phosphorylase in patients with unstable angina and transient ST-T alterations. Heart 1994; 72:125-7. [PMID: 7917682 PMCID: PMC1025473 DOI: 10.1136/hrt.72.2.125] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [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] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To determine whether transient ST-T alterations in patients with unstable angina are associated with an increase in plasma glycogen phosphorylase BB concentrations on admission to hospital. DESIGN Prospective screening of patients with unstable angina for markers of myocardial cell damage. SETTING Accident and emergency department of university hospital. PATIENTS 48 consecutive patients admitted for angina pectoris (18 with transient ST-T alterations). None of the patients had acute myocardial infarction according to standard criteria. MAIN OUTCOME MEASURES Creatine kinase and creatine kinase MB activities, creatine kinase MB mass concentration, and myoglobin, cardiac troponin T, and glycogen phosphorylase BB concentrations on admission. RESULTS All variables except for creatine kinase and creatine kinase MB activities were significantly higher on admission in patients with unstable angina and transient ST-T alterations than in patients without. However, glycogen phosphorylase BB concentration was the only marker that was significantly (p = 0.0001) increased above its discriminator value in most patients (16). In the 18 patients with transient ST-T alterations creatine kinase MB mass concentration and troponin T and myoglobin concentrations were significantly (p = 0.0001) less commonly increased on admission (in five, three, and two patients, respectively). CONCLUSIONS The early release of glycogen phosphorylase BB may help to identify high risk patients with unstable angina even on admission to an emergency department. Glycogen phosphorylase BB concentrations could help to guide decisions about patient management.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry and Biochemistry, University of Innsbruck, Austria
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Mair J, Artner-Dworzak E, Lechleitner P, Morass B, Smidt J, Wagner I, Dienstl F, Puschendorf B. Early diagnosis of acute myocardial infarction by a newly developed rapid immunoturbidimetric assay for myoglobin. Br Heart J 1992; 68:462-8. [PMID: 1467029 PMCID: PMC1025188 DOI: 10.1136/hrt.68.11.462] [Citation(s) in RCA: 96] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To evaluate a rapid immunoturbidimetric assay for myoglobin and to investigate its clinical usefulness in the early detection of acute myocardial infarction. DESIGN Prospective study. Immunoturbidimetrically determined myoglobin concentrations were compared with radioimmunoassay results obtained with the same blood samples. The diagnostic performance of myoglobin determination was compared with creatine kinase and creatine kinase MB activity (current standard of routine diagnosis). SETTINGS Part 1: coronary care unit. Part 2: emergency room in a university hospital. PATIENTS Part 1:30 patients with acute myocardial infarction admitted not later than four hours (median two hours) after the onset of symptoms. Part 2: 126 patients admitted to the emergency room with chest pain not caused by trauma (51 cases of acute myocardial infarction, 51 cases of angina pectoris, and 24 cases of chest pain not related to coronary artery disease). INTERVENTIONS Part 1: routine treatment including intravenous thrombolytic treatment (28 patients). Part 2: routine emergency treatment without thrombolytic treatment. MAIN OUTCOME MEASURES The analytical quality of the immunoturbidimetric myoglobin assay and a comparison between the myoglobin assay and creatine kinase and creatine kinase MB for diagnostic sensitivity and performance. RESULTS The immunoturbidimetric myoglobin assay was fast and convenient and gave myoglobin determinations of high analytical quality. The concentration of myoglobin increased, peaked, and returned to the reference range significantly earlier than creatine kinase (p < or = 0.0001) and creatine kinase MB (p < or = 0.0002). Before thrombolytic therapy was started the diagnostic sensitivity of myoglobin was significantly higher than that of creatine kinase MB activity 0-6 h after the onset of chest pain and significantly higher (0.82 v 0.29) than creatine kinase 2-4 h after the onset of chest pain. In almost all patients (92%) plasma myoglobin concentrations were increased 4-6 h after the onset of chest pain. CONCLUSION Myoglobin was more sensitive in detecting early myocardial infarction than creatine kinase and creatine kinase MB activity. Immunoturbidimetric myoglobin measurements could be useful in the early evaluation of patients with suspected myocardial infarction because this assay takes less than two minutes.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry and Biochemistry, University of Innsbruck, Austria
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Mair J, Artner-Dworzak E, Dienstl A, Lechleitner P, Morass B, Smidt J, Wagner I, Wettach C, Puschendorf B. Early detection of acute myocardial infarction by measurement of mass concentration of creatine kinase-MB. Am J Cardiol 1991; 68:1545-50. [PMID: 1746453 DOI: 10.1016/0002-9149(91)90307-7] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.8] [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] [Indexed: 12/28/2022]
Abstract
The diagnostic sensitivity and performance of immunoenzymometric measurements of creatine kinase (CK)-MB mass concentrations in the early diagnosis of acute myocardial infarction (AMI) were examined and compared with the sensitivities and performances of CK and CK-MB activity, in the context of simultaneous measurements of CK, CK-MB activity, and CK-MB mass concentrations in serially drawn blood samples obtained immediately from 36 patients with AMI and 126 patients with chest pain on admission to the emergency room of the department of internal medicine. In the 36 patients with AMI, who were all admitted no later than 4 hours after the onset of chest pain, pathologic increase occurred significantly earlier in CK-MB mass than in both CK and CK-MB activity, with a median difference of 1 hour each. In patients coming to the emergency room (51 with AMI, 51 with angina pectoris and 24 with chest pain not related to coronary artery disease), CK-MB mass was the best diagnostic measurement for AMI of all markers tested (significantly higher efficiency, Youden index and likelihood ratio than both CK and CK-MB activity). Before initiating thrombolytic therapy, the sensitivity of CK-MB mass is significantly higher than CK-MB activity during the 0- to 6-hour period and significantly higher than CK activity during the 2- to 4-hour period after the onset of chest pain. Consequently, it is often possible to diagnose an AMI on the basis of increased CK-MB mass concentrations even at a time when CK and CK-MB activities are still within the reference interval.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry and Biochemistry, University of Innsbruck School of Medicine, Austria
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Mair J, Artner-Dworzak E, Lechleitner P, Smidt J, Wagner I, Dienstl F, Puschendorf B. Cardiac troponin T in diagnosis of acute myocardial infarction. Clin Chem 1991; 37:845-52. [PMID: 2049849] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Troponin T is a structurally bound protein found in striated muscle cells. We tested concentrations of its cardiac-specific isotype in peripheral venous blood samples serially drawn from 72 patients with confirmed myocardial infarction. Fifty-nine patients received thrombolytic treatment with intravenous streptokinase, urokinase, or recombinant tissue-type plasminogen activator; because of contraindications, the remaining 13 patients did not. Concentrations of troponin T in plasma, measured by an enzyme-linked immunosorbent assay, started increasing within a few hours after the onset of symptoms (median, 4 h; range, 1-10 h). The sensitivity of troponin T for detecting myocardial infarction was 100% from 10 to 120 h after the onset of symptoms; sensitivity on the seventh day after admission was 84%. Concentrations were increased for up to three weeks in some patients with late or high peak values. Successful reperfusion in Q-wave infarction obviously influences the release of troponin T into plasma, with all such cases showing peak values less than or equal to 26 h (median, 14 h) after the onset of symptoms. Troponin T concentrations in these patients returned to within the reference interval more rapidly than in nonreperfused subjects. In the 13 patients without fibrinolytic therapy, troponin T tended to peak approximately 48 h (median) after the onset of chest pain. Troponin T concentrations in patients for whom thrombolysis was unsuccessful resembled those in patients without fibrinolytic therapy. The specificity of the assay was 96% as tested in samples of 96 emergency-room patients. The reference interval (less than 0.5 micrograms/L) was established from samples of 100 healthy blood donors. Troponin T measurements are a specific and sensitive method for the early and late diagnosis of acute myocardial infarction and could, therefore, provide a new criterion in laboratory diagnosis of its occurrence.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry and Biochemistry, University of Innsbruck, Austria
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Mair J, Smidt J, Artner-Dworzak E, Lechleitner P, Dienstl F, Puschendorf B. Rapid diagnosis of myocardial infarction by immunoturbidimetric myoglobin measurement. Lancet 1991; 337:1343-4. [PMID: 1674313 DOI: 10.1016/0140-6736(91)93013-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Chamuleau RA, Creyghton JH, De Nie I, Moerland MA, Van der Lende OR, Smidt J. Is the magnetic resonance imaging proton spin-lattice relaxation time a reliable noninvasive parameter of developing liver fibrosis? Hepatology 1988; 8:217-21. [PMID: 3356402 DOI: 10.1002/hep.1840080204] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [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] [Indexed: 01/05/2023]
Abstract
During the development of liver fibrosis in rats by an individual dose-titrated CCl4 administration, hepatic proton spin-lattice relaxation time (T1) has been measured in vivo every 2 weeks for 8 weeks. Liver content of collagen, triglycerides and water has been measured biochemically in biopsy material. After 4 weeks of CCl4 treatment, T1 increased significantly and remained at the same level, whereas liver collagen reached its maximum at 8 weeks. It is concluded that, under our experimental conditions, increased hepatic T1 represents drug-induced edema and that hepatic T1 is not a reliable noninvasive parameter for developing liver fibrosis in vivo.
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Affiliation(s)
- R A Chamuleau
- Laboratory of Experimental Medicine, University of Amsterdam, The Netherlands
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Duijvestijn M, Manenschijn A, Smidt J, Wind R. Structural information of undoped trans-polyacetylene obtained by 13C 2D NMR combined with dynamic nuclear polarization. ACTA ACUST UNITED AC 1985. [DOI: 10.1016/0022-2364(85)90109-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Duijvestijn M, van der Lugt C, Smidt J, Wind R, Zilm K, Staplin D. 13C NMR spectroscopy in diamonds using dynamic nuclear polarization. Chem Phys Lett 1983. [DOI: 10.1016/0009-2614(83)80650-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wind R, Anthonio F, Duijvestijn M, Smidt J, Trommel J, de Vette G. Experimental setup for enhanced 13C NMR spectroscopy in solids using dynamic nuclear polarization. ACTA ACUST UNITED AC 1983. [DOI: 10.1016/0022-2364(83)90168-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bovée WM, Creyghton JH, Getreuer KW, Korbee D, Lobregt S, Smidt J, Wind RA, Lindeman J, Smid L, Posthuma H. N.m.r. relaxation and images of human breast tumours in vitro. Philos Trans R Soc Lond B Biol Sci 1980; 289:535-6. [PMID: 6106228 DOI: 10.1098/rstb.1980.0072] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
It is found that fat and non-fatty tissue in dissected samples of the mamma differ in their T1/T2 ratios. This opens the possibility of locating tumours by n.m.r. imaging, because they have a lower fat content than their surroundings. By means of a sensitive point method, samples were scanned with a resolution of about 0.4 mm X 0.4 mm. The similarity between the shape of a tumour in an n.m.r. and in an X-ray image of a thin section of mamma tissue is quite convincing.
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Emid S, Konijnendijk J, Smidt J, Pines A. On the short time behavior of the dipolar signal in relaxation measurements by the pulse method. ACTA ACUST UNITED AC 1980. [DOI: 10.1016/0378-4363(80)90008-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bax A, Mehlkopf A, Smidt J. Homonuclear broadband-decoupled absorption spectra, with linewidths which are independent of the transverse relaxation rate. ACTA ACUST UNITED AC 1979. [DOI: 10.1016/0022-2364(79)90088-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [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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Abstract
Malignant, benign, and normal breast tissues corrected for fat appeared to have similar nuclear magnetic proton spin-lattice relaxation times, contrary to previously published reports. However, due to a lower fat content, benign and malignant tumors relaxed more slowly than the surrounding normal tissue. This provides a possibility for locating them (but not for discriminating between them) in a breast by the nuclear magnetic resonance imaging technique zeugmatography.
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