bluuebunny/crossref_metadata_2025 huggingface dataset:
MRA is useful as a follow‐up technique after endovascular repair of aortic aneurysms with nitinol endoprostheses
Authors: Ayuso Juan R. , de Caralt Teresa M. , Pages Mario , Riambau Vicente , Ayuso Carmen , Sanchez Marcelo , Real María I. , Montaña Xavier
Published: October 2004

Purpose

To evaluate whether MR angiography (MRA) is a useful tool for the follow‐up of aortic aneurysms treated with nitinol endoluminal grafts.

Materials and Methods

We examined 28 patients treated with nitinol endovascular stents to repair an aortic aneurysm with CT angiography (CTA) and MRA. Eleven patients (group 1) underwent an MRA after a positive CTA for endoleak was observed. Afterwards, 17 patients (group 2) were scheduled for both follow‐up examinations. The kind of endoleak that occurred and the maximum aortic diameter were compared. The sensitivity of CTA relative to MRA for detecting endoleaks in group 2 was calculated. Signal‐to‐noise ratios (SNRs) were measured in the aortoiliac lumen at the arterial phase in, above, and below the endoprostheses. Student's t‐test was used to compare aneurysm dimensions and SNR measurements.

Results

Three type III leaks were correctly assessed at both examinations; however, CTA was less sensitive (50%) than MRA in depicting type II or unclassified leaks. No differences in aneurismal size were observed between the two examinations or between arterial SNRs observed in or out of the devices.

Conclusion

MRA can provide all relevant information necessary for the follow‐up of patients treated with nitinol endoprostheses, and performs better than CTA in detecting endoleaks. J. Magn. Reson. Imaging 2004;20:803–810. © 2004 Wiley‐Liss, Inc.
Glomerular filtration rate: Assessment with dynamic contrast‐enhanced MRI and a cortical‐compartment model in the rabbit kidney
Authors: Annet Laurence , Hermoye Laurent , Peeters Frank , Jamar François , Dehoux Jean‐Paul , Van Beers Bernard E.
Published: October 2004

Purpose

To describe the use of MRI and a cortical‐compartment model to measure the glomerular filtration rate (GFR), and compare the results with those obtained with the Patlak‐Rutland model.

Materials and Methods

Dynamic MRI of rabbit kidneys was performed during and after injection of gadoterate dimeglumine. The enhancement curves in the aorta and the kidney were analyzed with the cortical‐compartment and Patlak‐Rutland models to assess the GFR.

Results

A substantial correlation was observed between the GFR measured with MRI using the cortical‐compartment model and the plasma clearance of 51Cr‐EDTA (r = 0.821,P= 0.004). No significant correlation was observed between the 51Cr‐EDTA clearance (r = 0.628,P= 0.052) and the GFR obtained with the Patlak‐Rutland model in regions of interest (ROIs) encompassing the renal cortex and medulla. A Bland and Altman analysis showed that GFRcorticalcompartmentagreed better with the 51Cr‐EDTA clearance compared to GFRPatlakwhen ROIs were limited to the cortex. However, the GFR values obtained by MRI were lower than the plasma clearance of 51Cr‐EDTA.

Conclusion

MRI with a cortical‐compartment model provides more accurate assessments of glomerular filtration than the Patlak‐Rutland model. J. Magn. Reson. Imaging 2004;20:843–849. © 2004 Wiley‐Liss, Inc.
Discovery and disclosure of incidental findings in neuroimaging research
Authors: Illes Judy , Kirschen Matthew P. , Karetsky Kim , Kelly Megan , Saha Arnold , Desmond John E. , Raffin Thomas A. , Glover Gary H. , Atlas Scott W.
Published: October 2004

Purpose

To examine different protocols for handling incidental findings on brain research MRIs, and provide a platform for establishing formal discussions of related ethical and policy issues.

Materials and Methods

Corresponding authors identified from a database of peer‐reviewed publications in 1991–2002 involving functional MRI (fMRI), alone or in combination with other imaging modalities, were invited to participate in this web‐based survey. The survey asked questions regarding knowledge and handling of incidental findings, as well as characteristics of the scanning environment, training required, IRB protocol requirements, and neuroradiologist involvement.

Results

Seventy‐four investigators who conduct MRI studies in the United States and abroad responded. Eighty‐two percent (54/66) reported discovering incidental findings in their studies, such as arteriovenous malformations, brain tumors, and developmental abnormalities. Substantial variability was found in the procedures for handling and communicating findings to subjects, neuroradiologist involvement, personnel permitted to operate equipment, and training.

Conclusion

Guidelines for minimum and optimum standards for detecting and communicating incidental findings on brain MRI research are needed. J. Magn. Reson. Imaging 2004;20:743–747. © 2004 Wiley‐Liss, Inc.
Comparative study of methods for determining vascular permeability and blood volume in human gliomas
Authors: Harrer Judith U. , Parker Geoff J.M. , Haroon Hamied A. , Buckley David L. , Embelton Karl , Roberts Caleb , Balériaux Danielle , Jackson Alan
Published: October 2004

Purpose

To characterize human gliomas using T1‐weighted dynamic contrast‐enhanced MRI (DCE‐MRI), and directly compare three pharmacokinetic analysis techniques: a conventional established technique and two novel techniques that aim to reduce erroneous overestimation of the volume transfer constant between plasma and the extravascular extracellular space (EES) (Ktrans) in areas of high blood volume.

Materials and Methods

Eighteen patients with high‐grade gliomas underwent DCE‐MRI. Three kinetic models were applied to estimate Ktrans and fractional blood plasma volume (vp). We applied the Tofts and Kermode (TK) model without arterial input function (AIF) estimation, the TK model modified to include vp and AIF estimation (mTK), and a “first pass” variant of the TK model (FP).

Results

KTK values were considerably higher than KmTK and KFP values (P < 0.001). KmTK and KFP were more comparable and closely correlated (ρ = 0.744), with KmTK generally higher than KFP (P < 0.001). Estimates of vp(mTK) and vp(FP) also showed a significant difference (P < 0.001); however, these values were very closely correlated (ρ = 0.901). KTK parameter maps showed “pseudopermeability” effects displaying numerous vessels. These were not visualized on KmTK and KFP maps but appeared on the corresponding vp maps, indicating a failure of the TK model in commonly occurring vascular regions.

Conclusion

Both of the methods that incorporate a measured AIF and an estimate of vp provide similar pathophysiological information and avoid erroneous overestimation of Ktrans in areas of significant vessel density, and thus allow a more accurate estimation of endothelial permeability. J. Magn. Reson. Imaging 2004;20:748–757. © 2004 Wiley‐Liss, Inc.
MRI monitoring of Avastin™ antiangiogenesis therapy using B22956/1, a new blood pool contrast agent, in an experimental model of human cancer
Authors: Preda Anda , Novikov Viktor , Möglich Martina , Turetschek Karl , Shames David M. , Brasch Robert C. , Cavagna Friedrich M. , Roberts Timothy P.L.
Published: October 2004

Purpose

To evaluate the diagnostic and prognostic potential of a new protein‐binding contrast medium, B22956/1, for quantitatively characterizing tumor microvessels by MRI and monitoring response to antiangiogenic therapy.

Materials and Methods

Dynamic contrast‐enhanced MRI (DCE‐MRI) was performed in an experimental cancer model with the use of the novel protein‐binding agent B22956/1, a low molecular contrast agent (ProHance™), and a macromolecular contrast medium, albumin‐(Gd‐DTPA). MDA‐MB‐435, a human cancer cell line, was implanted in 22 athymic rats. Animals were assigned randomly to a control (saline) or drug‐treated (Avastin™) group. MRI was performed at baseline and after nine days of treatment. The transendothelial permeability (KPS) and the fractional blood volume (fBV) were estimated from the kinetic analysis of dynamic MR data using a two‐compartment model. Tumor growth was also measured from volumetric MRI.

Results

Tumors grew more slowly, although not significantly (P = 0.07), in the drug‐treated group. The KPS determined for B22956/1 decreased significantly in the drug‐treated group compared to baseline (P < 0.05), and progressed significantly in the control group. However, no significant changes were resolved with the use of ProHance or albumin‐(Gd‐DTPA).

Conclusion

With the use of appropriate contrast media, the therapeutic effects of an anti‐VEGF antibody on tumor microvessels can be monitored by dynamic MRI. The dynamic range of permeability to B22956/1, and the sensitivity to change of this parameter suggest a potential application in the clinical setting. J. Magn. Reson. Imaging 2004;20:865–873. © 2004 Wiley‐Liss, Inc.
Detection of myocardial infarctions by acquisition‐weighted 31P‐MR spectroscopy in humans
Authors: Beer Meinrad , Spindler Matthias , Sandstede Joern J.W. , Remmert Haiko , Beer Stephanie , Köstler Herbert , Hahn Dietbert
Published: October 2004

Purpose

To determine whether the recently applied technique of acquisition‐weighted 31P‐MR spectroscopy (AW‐MRS) allows for the detection of depressed energy metabolism in patients with inferior wall myocardial infarctions.

Materials and Methods

Eight patients with subacute myocardial infarction and wall motion abnormalities restricted to the inferior wall were examined with a 1.5‐T MR scanner. Global and regional left ventricular (LV) function was assessed by cine MRI, and the size and extent of myocardial infarction was assessed by late enhancement (LE). MRS was performed with an AW three‐dimensional chemical shift imaging sequence. Phosphocreatine/ATP ratios were determined with the postprocessing model AMARES for four voxels positioned in the anterior, lateral, inferior, and septal parts of the LV.

Results

The LV ejection fraction (EF) was reduced to 37.5% ± 9.0%. Seven of eight patients had transmural LE in the inferior wall, and one patient showed subendocardial enhancement in the inferior‐lateral parts. Phosphocreatine/ATP ratios of the inferior wall were significantly reduced (P < 0.05) compared to all other parts of the LV (1.03 ± 0.39 (inferior), 1.67 ± 0.81 (lateral), 1.73 ± 0.29 (anterior), and 1.49 ± 0.31 (septal)). The ratios in five of seven patients with transmural enhancement were <1.00 in the inferior wall.

Conclusion

Acquisition weighting allows for the detection of inferior wall infarctions in patients. Transmural signal enhancement is associated with significant depression of phosphocreatine/ATP ratios. J. Magn. Reson. Imaging 2004;20:798–802. © 2004 Wiley‐Liss, Inc.
Peak‐combination HARP: A method to correct for phase errors in HARP
Authors: Ryf Salome , Tsao Jeffrey , Schwitter Juerg , Stuessi Anja , Boesiger Peter
Published: October 2004

Purpose

To introduce a method to correct phase errors (e.g., from B0 inhomogeneity) in tagging images, which may affect harmonic phase (HARP) evaluation.

Materials and Methods

The phase images corresponding to the negative and positive harmonic peaks in k‐space are combined before HARP evaluation to eliminate any spurious phase. To validate in vivo, two complementary spatial modulation of magnetization (CSPAMM) data sets were collected for each volunteer and evaluated with conventional HARP, using either the positive or the negative harmonic peak, and with peak‐combination HARP.

Results

Elimination of phase distortion by peak combination was observed in vitro and in vivo. Improved reproducibility of motion parameters was found with peak‐combination HARP.

Conclusion

With peak‐combination HARP, reproducibility of contractile parameters is improved, and consequently, the number of subjects needed to detect statistically significant changes in contractile function can be reduced to one third compared to conventional HARP evaluation. J. Magn. Reson. Imaging 2004;20:874–880. © 2004 Wiley‐Liss, Inc.
Three‐dimensional dynamic liver MR imaging using sensitivity encoding for detection of hepatocellular carcinomas: Comparison with superparamagnetic iron oxide‐enhanced MR imaging
Authors: Kim Young Kon , Kim Chong Soo , Kwak Hyo Sung , Lee Jeong Min
Published: October 2004

Purpose

To assess the diagnostic performance of three‐dimensional dynamic liver imaging with sensitivity encoding (SENSE), including double arterial phase images and increased resolution, by comparing it to superparamagnetic iron oxide (SPIO)‐enhanced magnetic resonance (MR) imaging for the detection of hypervascular hepatocellular carcinoma (HCC).

Materials and Methods

Twenty‐seven consecutive patients with 50 HCCs underwent Gd‐BOPTA‐enhanced dynamic imaging using SENSE and SPIO‐enhanced MR imaging with at least a 24‐hour interval between examinations. Using a three‐dimensional gradient‐echo technique applying SENSE, dynamic imaging consisting of double arterial phase‐, portal phase‐ and delayed phase‐images, was obtained. Using T2‐weighted turbo spin‐echo and T2*‐weighted fast imaging with steady‐state precession sequence, SPIO‐enhanced MR imaging was obtained. For qualitative analysis, the diagnostic accuracy of both MR examinations for detecting the 50 HCCs was evaluated using the alternative free‐response receiver operating characteristic method. Sensitivity and positive predictive value were also evaluated.

Results

The mean sensitivity and positive predictive value of three‐dimensional dynamic imaging with SENSE were 91.3% and 89.2%, respectively, and those of SPIO‐enhanced imaging were 77.3% and 92.6 %, respectively. There was a significant difference in sensitivity between the two images (P < 0.05). The mean Az value of three‐dimensional dynamic imaging with SENSE (0.97 ± 0.01) was significantly higher than that of SPIO‐enhanced imaging (0.90 ± 0.02) (P = 0.00).

Conclusion

Three‐dimensional dynamic liver MR imaging using SENSE for acquiring double arterial phase images is more efficient than SPIO‐enhanced MR imaging for detecting HCCs. J. Magn. Reson. Imaging 2004;20:826–837. © 2004 Wiley‐Liss, Inc.
Contrast‐enhanced peripheral magnetic resonance angiography using time‐resolved vastly undersampled isotropic projection reconstruction
Authors: Du Jiang , Carroll Timothy J. , Brodsky Ethan , Lu Aiming , Grist T.M. , Mistretta Charles A. , Block Walter F.
Published: October 2004

Purpose

To investigate the application of time‐resolved vastly undersampled isotropic projection reconstruction (VIPR) in contrast‐enhanced magnetic resonance angiography of the distal extremity (single station), and peripheral run‐off vasculature in the abdomen, thigh, and calf (three stations).

Materials and Methods

Time‐resolved distal extremity imaging was performed using VIPR sequence through the comparison of two acquisition matrix sizes: 256 with TR/TE = 3.7/1.4 msec and 320 with TR/TE = 4.5/1.8 msec under the same scan time of two minutes. VIPR acquisition was combined with a bolus‐chase technique to image the peripheral run‐off vasculature. The time‐resolved images were reconstructed using a revised sliding window reconstruction filter whose temporal aperture remained narrow for low spatial frequencies and increased quadratically to include all the projection data for high spatial frequencies.

Results

The new temporal filter significantly suppressed the undersampling streak artifacts and venous contamination, while maintaining a high temporal resolution. Both high spatial resolution (ranging from 1.56 × 1.56 × 1.56 mm to 1.25 × 1.25 × 1.25 mm) and high temporal resolution (three seconds per frame) distal extremity images and peripheral run‐off images were generated using time‐resolved VIPR acquisition, which provides isotropic spatial resolution and isotropic coverage.

Conclusion

Time‐resolved VIPR acquisition was demonstrated to be well suited for distal extremity imaging by providing isotropic spatial resolution, isotropic coverage, and high temporal resolution. The combination of time‐resolved VIPR and bolus chase technique provided a novel approach for peripheral run‐off examinations. J. Magn. Reson. Imaging 2004;20:894–900. © 2004 Wiley‐Liss, Inc.
Reversible heterogeneous arterial phase liver perfusion associated with transient acute hepatitis: Findings on gadolinium‐enhanced MRI
Authors: Martin Diego R. , Seibert Donald , Yang Ming , Salman Khalil , Frick Mathis P.
Published: October 2004

Purpose

To assess a possible correlation between active acute hepatitis and the development of abnormal liver perfusion demonstrated as heterogeneous enhancement on arterial phase gadolinium‐enhanced MRI. Dynamically‐enhanced MRI of the liver can detect reversible perfusion abnormalities that correlate with acute hepatitis.

Materials and Methods

Six patients presenting with symptoms and clinical findings in keeping with transient acute hepatitis underwent serial MRI of the liver throughout the course of the disease. Serial liver enzyme analysis was performed for all six patients, and histopathology was assessed for three patients. Imaging included gadolinium‐enhanced arterial and venous‐phase gradient‐echo sequences.

Results

Arterial phase gadolinium‐enhanced MRI showed abnormal irregular liver perfusion in the setting of acute hepatitis, and the degree of irregularity, as well as the persistence of irregular enhancement into the venous phase, correlated with the clinical severity of the disease.

Conclusion

Acute hepatitis can cause irregular enhancement of the liver on arterial‐phase, gadolinium‐enhanced, gradient‐echo MRI, a reversible finding that improves with clinical improvement of the disease. J. Magn. Reson. Imaging 2004;20:838–842. © 2004 Wiley‐Liss, Inc.
Magnetic resonance imaging of articular cartilage of the knee: Comparison between fat‐suppressed three‐dimensional SPGR imaging, fat‐suppressed FSE imaging, and fat‐suppressed three‐dimensional DEFT imaging, and correlation with arthroscopy
Authors: Yoshioka Hiroshi , Stevens Kathryn , Hargreaves Brian A. , Steines Daniel , Genovese Mark , Dillingham Michael F. , Winalski Carl S. , Lang Philipp
Published: October 2004

Purpose

To compare signal‐to‐noise ratios (S/N) and contrast‐to‐noise ratios (C/N) in various MR sequences, including fat‐suppressed three‐dimensional spoiled gradient‐echo (SPGR) imaging, fat‐suppressed fast spin echo (FSE) imaging, and fat‐suppressed three‐dimensional driven equilibrium Fourier transform (DEFT) imaging, and to determine the diagnostic accuracy of these imaging sequences for detecting cartilage lesions in osteoarthritic knees, as compared with arthroscopy.

Materials and Methods

Two sagittal fat‐suppressed FSE images (repetition time [TR] / echo time [TE], 4000/13 [FSE short TE] and 4000/39 [FSE long TE]), sagittal fat‐suppressed three‐dimensional SPGR images (60/5, 40° flip angle), and sagittal fat‐suppressed echo‐planar three‐dimensional DEFT images (400/21.2) were acquired in 35 knees from 28 patients with osteoarthritis of the knee. The S/N efficiencies (S/Neffs) of cartilage, synovial fluid, muscle, meniscus, bone marrow, and fat tissue, and the C/N efficiencies (C/Neffs) of these structures were calculated. Kappa values, exact agreement, sensitivity, specificity, positive predictive value, and negative predictive value were determined by comparison of MR grading with arthroscopic results.

Results

The synovial fluid S/Neff on fat‐suppressed FSE short TE images, fat‐suppressed FSE long TE images, and fat‐suppressed three‐dimensional DEFT images showed similar values. Fat‐suppressed three‐dimensional DEFT images showed the highest fluid‐cartilage C/Neff of all sequences. All images showed fair to good agreement with arthroscopy (kappa, 0.615 in FSE short TE, 0.601 in FSE long TE, 0.583 in three‐dimensional SPGR, and 0.561 in three‐dimensional DEFT). Although the sensitivity of all sequences was high (100% in FSE short TE, FSE long TE, and DEFT; 96.7% in SPGR), specificity was relatively low (67.6% in FSE short TE and FSE long TE; 85.3% in SPGR; 58.3% in DEFT). The peripheral area of bone marrow edema or whole area of bone marrow edema on fat‐suppressed FSE images was demonstrated as low or iso‐signal intensity on fat‐suppressed three‐dimensional DEFT images.

Conclusion

Fat‐suppressed three‐dimensional SPGR imaging and fat‐suppressed FSE imaging showed high sensitivity and high negative predictive values, but relatively low specificity. The Kappa value and exact agreement was the highest on fat‐suppressed FSE short TE images. Fat‐suppressed three‐dimensional DEFT images showed results similar to the conventional sequences. J. Magn. Reson. Imaging 2004;20:857–864. © 2004 Wiley‐Liss, Inc.
Quantitative proton MR spectroscopic imaging of the mesial temporal lobe
Authors: Arslanoglu Atilla , Bonekamp David , Barker Peter B. , Horská Alena
Published: October 2004

Purpose

To evaluate variations in regional metabolite concentrations in the anterior mesial temporal lobe (ATL), and compare metabolite concentrations between the allocortex and neocortex using quantitative proton MR spectroscopic imaging (MRSI).

Materials and Methods

Metabolite concentrations and ratios were measured in 20 healthy young subjects with the use of a multislice spin‐echo (SE) sequence (TR/TE = 2300/280 msec). Quantitation of MRSI data was performed by means of the phantom replacement methodology.

Results

The highest choline (Cho) concentration (4.1 ± 1.1 mM) was found in the ATL (P = 0.0015 compared to the middle mesial temporal lobe (MTL), and P = 0.0008 compared to the posterior mesial temporal lobe (PTL)). The ATL also had a higher Cho/creatine (Cr) ratio and a lower N‐acetyl aspartate (NAA)/Cho ratio compared to other examined regions (P < 0.0001 and P ≤ 0.052, respectively). In the allocortical regions, the average Cho concentration (3.5 ± 0.8 mM) was 68% higher, and the NAA concentration (9.5 ± 1.8 mM) was 13% lower than in the neocortex (P < 10−6 and P < 0.008, respectively). Cho/Cr was 64% higher, NAA/Cr 14% lower, and NAA/Cho 47% lower in the allocortex than in the neocortex (P < 10−6, P = 0.013, and P < 10−6, respectively).

Conclusion

The mesial temporal lobe shows high levels of Cho, which presumably reflect a difference in cellular composition between the allocortex and neocortex. Regional metabolite variations must be considered when pathological conditions involving the mesial temporal lobe are evaluated. J. Magn. Reson. Imaging 2004;20:772–778. © 2004 Wiley‐Liss, Inc.
Diffusion‐weighted imaging of the parotid gland: Influence of the choice of b‐values on the apparent diffusion coefficient value
Authors: Thoeny Harriet C. , De Keyzer Frederik , Boesch Chris , Hermans Robert
Published: October 2004

Purpose

To determine how the ADC value of parotid glands is influenced by the choice of b‐values.

Materials and Methods

In eight healthy volunteers, diffusion‐weighted echo‐planar imaging (DW‐EPI) was performed on a 1.5 T system, with b‐values (in seconds/mm2) of 0, 50, 100, 150, 200, 250, 300, 500, 750, and 1000. ADC values were calculated by two alternative methods (exponential vs. logarithmic fit) from five different sets of b‐values: (A) all b‐values; (B) b = 0, 50, and 100; (C) b = 0 and 750; (D) b = 0, 500, and 1000; and (E) b = 500, 750, and 1000.

Results

The mean ADC values for the different settings were (in 10−3 mm2/second, exponential fit): (A) 0.732 ± 0.019, (B) 2.074 ± 0.084, (C) 0.947 ± 0.020, (D) 0.890 ± 0.023, and (E) 0.581 ± 0.021. ADC values were significantly (P < 0.001) different for all pairwise comparisons of settings (A–E) of b‐values, except for A vs. D (P = 0.172) and C vs. D (P = 0.380). The ADC(B) was significantly higher than ADC(C) or ADC(D), which was significantly higher than ADC(E). ADC values from exponential vs. logarithmic fit (P = 0.542), as well as left vs. right parotid gland (P = 0.962), were indistinguishable.

Conclusion

The ADC values calculated from low b‐value settings were significantly higher than those calculated from high b‐value settings. These results suggest that not only true diffusion but also perfusion and saliva flow may contribute to the ADC. J. Magn. Reson. Imaging 2004;20:786–790. © 2004 Wiley‐Liss, Inc.
Changing prevalence of hepatitis C virus genotypes: Molecular epidemiology and clinical implications in the hepatitis C virus hyperendemic areas and a tertiary referral center in Taiwan
Authors: Yu Ming‐Lung , Chuang Wan‐Long , Chen Shinn‐Cherng , Dai Chia‐Yen , Hou Cheng , Wang Jing‐Houng , Lu Sheng‐Nan , Huang Jee‐Fu , Lin Zu‐Yau , Hsieh Ming‐Yuh , Tsai Jung‐Fa , Wang Liang‐Yen , Chang Wen‐Yu
Published: October 2004

To determine the hepatitis C virus (HCV) genotype distribution in Taiwan and to clarify the relationship between genotype and the pathogenesis of HCV infection, 1,164 subjects positive for serum HCV antibodies and HCV RNA from three HCV hyperendemic areas (Masago, Tzukuan, and Taoyuan) and a tertiary referral center in Taiwan were studied during 1995–1997. HCV genotypes and viral loads were determined using Okamoto's method and branched DNA assay, respectively. Genotype 1b was the most prevalent in Tzukuan (61.9%), Taoyuan (76.9%), and the referral center (47.0%). By contrast, genotype 2a was the major HCV type in Masago (63.5%). Prevalence of genotype 1b positively and that of genotype 2a negatively correlated to age, regardless of study populations (P < 0.01). Based on multivariate analysis, the significant factors associated with the presence of cirrhosis, with or without hepatocellular carcinoma, in chronic hepatitis C patients were genotype 1b and age. In conclusion, these results underline that independent HCV outbreaks continue in HCV hyperendemic areas in Taiwan, concomitant with a changing relative prevalence of HCV genotypes in relation to age. Both the correlation of genotype 1b with age (cohort effect) and intrinsic properties of HCV genotypes are probably responsible for the association between genotype and the pathogenesis of HCV infection. J. Med. Virol. 65:58–65, 2001. © 2001 Wiley‐Liss, Inc.
No mutations of SAP/SH2D1A/DSHP and perforin genes in patients with Epstein‐Barr virus‐associated hemophagocytic syndrome in Japan
Authors: Ma Xiaoming , Okamura Akiko , Yosioka Mikio , Ishiguro Nobuhisa , Kikuta Hideaki , Kobayashi Kunihiko
Published: October 2004

Recently, mutations of two genes, SAP/SH2D1A/DSHP and perforin genes, have been identified in two fatal inherited lymphoproliferative diseases, X‐linked lymphoproliferative disease and familial hemophagocytic lymphohistiocytosis, respectively. Epstein‐Barr virus (EBV)‐associated hemophagocytic syndrome, a fulminant non‐inherited T‐cell lymphoproliferative disease, is relatively common in Japan and is extremely difficult to distinguish from X‐linked lymphoproliferative disease and familial hemophagocytic lymphohistiocytosis, especially in sporadic cases, because of similarities in clinical and laboratory features. Mutation analysis was carried out of samples obtained from 14 patients with EBV‐associated hemophagocytic syndrome by sequencing the genomic SAP/SH2D1A/DSHP and perforin genes. However, a specific mutation was not identified in either of the genes, suggesting that mutations of the SAP/SH2D1A/DSHP and perforin genes are not responsible for the pathogenesis of EBV‐associated hemophagocytic syndrome in Japan. J. Med. Virol. 65:358–361, 2001. © 2001 Wiley‐Liss, Inc.
Adverse effect of the CCR5 promoter −2459A allele on HIV‐1 disease progression
Authors: Knudsen Troels B. , Kristiansen Thomas B. , Katzenstein Terese L. , Eugen‐Olsen Jesper
Published: October 2004

HIV positive individuals heterozygous for a 32 basepair deletion in the CCR5 encoding gene (CCR5 Δ32) have a reduced number of CCR5 receptors on the cell surface and a slower progression towards AIDS and death. Other human polymorphisms, such as the CCR2 64I and the CCR5 promoter −2459 A/G transition that has been discovered recently, have also been shown to influence HIV progression. Since genetic linkages make these polymorphisms interdependent variables, the aim of the present study was to isolate and evaluate the effect on HIV disease progression for each of these mutations independently. Genotypes were determined in 119 individuals enrolled in the Copenhagen AIDS Cohort. When including the concurrent effects of the CCR5 Δ32 and CCR2 64I mutations, homozygous carriers of the CCR5 promoter −2459A allele had a significantly faster progression towards death than heterozygous A/G individuals (P = 0.03), whereas this adverse effect was not significant when comparing A/A and G/G individuals. However, independent analysis revealed a significant adverse effect of the CCR5 promoter −2459A allele. Homozygous carriers of the −2459A allele that lack the protective effects of the CCR5 Δ32 and CCR2 64I mutations were found to have a median survival of 6.0 years, whereas carriers of the −2459G allele had a median survival of 9.4 years (P < 0.01). J. Med. Virol. 65:441–444, 2001. © 2001 Wiley‐Liss, Inc.
Phylogenetic analysis of new hepatitis B virus isolates from Nigeria supports endemicity of genotype E in West Africa*
Authors: Odemuyiwa Solomon O. , Mulders Mick N. , Oyedele Oluseyi I. , Ola Samuel O. , Odaibo Georgina N. , Olaleye David O. , Muller Claude P.
Published: October 2004

Isolates of hepatitis B viruses were collected from 20 acute and chronic hepatitis patients in a highly endemic region of Nigeria. Sequencing classified the isolates to the ayw4, as they all contained the amino acid variations characteristic for that serotype. In the pre‐S2 region of five isolates, three to seven amino acids were deleted, suggesting that immune escape mutations previously associated only with chronic HBV infection may be observed also in acute disease. Phylogenetic analysis of the complete pre‐S2/S (large S) genes (831 nt) demonstrated that all the viruses belonged to the same genotype E. So far, no isolates of genotype E have been found in any other region of the world, including the Americas. This may suggest a relatively recent introduction of this genotype into humans and would explain the relatively low genetic diversity of viruses belonging to this genotype. One genotype E virus had been found previously in a chimpanzee, and viruses belonging to the CHIMP genotype are related to other genotype E viruses. These findings are compatible with a transmission of genotype E viruses from chimpanzees to humans. J. Med. Virol. 65:463–469, 2001. © 2001 Wiley‐Liss, Inc.
Bronchoalveolar lavage fluid analysis in individuals with chronic hepatitis C
Authors: Idilman Ramazan , Çetinkaya Hülya , Savaş İsmail , Aslan Nuray , Sak Serpil Dizbay , Baştemir Mehmet , Sarioğlu Mustafa , Soykan İrfan , Bozdayı Mithat , Colantoni Alessandra , Aydıntuğ Olcay , Bahar Kadir , Uzunalimoğlu Özden , Van Thiel David H. , Numanoğlu Numan , Dökmeci Abdulkadir
Published: October 2004

A number of disorders for which an association with hepatitis C virus infection exist. These disorders include essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and idiopathic pulmonary fibrosis. This study was initiated to investigate the cellular content and lymphocyte subpopulations of bronchoalveolar lavage fluid obtained from individuals with chronic hepatitis C and to compare the results to those of controls. Eighteen patients with chronic hepatitis C (male/female, 6/12) and 14 healthy volunteers (male/female, 6/8), were studied. Bronchoalveolar lavage fluid was obtained from each; and the lymphocyte subtypes and the presence of HCV‐RNA in the bronchoalveolar lavage fluid were determined. All anti‐HCV positive subjects were HCV‐RNA positive in serum. One (5.6%) had a HCV‐RNA positive bronchoalveolar lavage. The total cell and neutrophil counts of the bronchoalveolar lavage fluid were significantly greater in patients with chronic hepatitis C as compared to controls (5,799.6 ± 957.4 × 103/ml vs. 1,835.7 ± 447.8 × 103/ml, P = 0.001; 1,175.8 ± 634.7 × 103/ml vs. 53.1 ± 28.1 × 103/ml, P = 0.029). In contrast, the lymphocyte, macrophage and eosinophil counts did not differ. No difference in the percentage, median or range of individual T cell subsets or B cell numbers in the bronchoalveolar lavage fluid existed between the groups. It is concluded that hepatitis C virus infection may be associated with an occult pulmonary inflammatory reaction manifested by an increased number of polymorphonuclear neutrophils in bronchoalveolar lavage fluid. This finding may contribute to the process that leads to idiopathic pulmonary fibrosis seen in a minority of cases of chronic hepatitis C. J. Med. Virol. 66:34–39, 2002. © 2002 Wiley‐Liss, Inc.
Human recombinant myeloperoxidase antiviral activity on cytomegalovirus
Authors: El Messaoudi K. , Verheyden A.‐M. , Thiry L. , Fourez S. , Tasiaux N. , Bollen A. , Moguilevsky N.
Published: October 2004

In vitro incubation of human cytomegalovirus (Towne strain) with 8 U/ml human recombinant myeloperoxidase plus sodium chloride and glucose nearly abolished viral infectivity. To assay the effect on intracellular infection, cell toxicity of the enzymes was first studied. Even the high dose of 16 U/ml of recombinant myeloperoxidase plus 10 mU/ml glucose oxidase did not decrease MRC5 cell growth. By contrast, this dose reduced proliferation of activated THP1 cells. Even half of the myeloperoxidase dose proved slightly toxic to these cells. Non‐cytotoxic concentrations of the reagents were used to monitor their effect on cytomegalovirus infection. In MRC5 cells, even the low dose of 4 U/ml myeloperoxidase plus glucose oxidase inhibited synthesis of cytomegalovirus early antigens, as tested by immunofluorescence. Viral release in the supernatant was decreased by 4 logs. In THP1 cells, which produce endogenously hydrogen peroxide, myeloperoxidase alone (8 U/ml) decreased the formation of early and late antigens by 53 and 44%, respectively. J. Med. Virol. 66:218–223, 2002. © 2002 Wiley‐Liss, Inc.
Efficacy of lamivudine in HBeAg‐negative chronic hepatitis B
Authors: Rizzetto Mario
Published: October 2004

Hepatitis B e antigen (HBeAg)‐negative chronic hepatitis B results from infection with hepatitis B virus mutants unable to produce HBeAg. It accounts for 7–30% of patients with chronic hepatitis B virus (HBV) worldwide, with the highest rates reported for Mediterranean Europe and Asia. Interferon (IFN) is currently the only approved therapy for these patients, but it has an unfavorable tolerance profile and limited efficacy. Studies show that responses to IFN are lower in HBeAg‐negative than in HBeAg‐positive patients; joint HBV DNA loss/ALT normalization is obtained in 38–59% of HBeAg‐negative patients treated for 4–24 months with a high rate of virological relapse (54–87%), at 6–24 months posttreatment. Lamivudine is a nucleoside analogue with potent antiviral properties against HBV. Studies show that response rates in HBeAg‐negative and HBeAg‐positive patients are equivalent. After 12 months of treatment, 65–96% of HBeAg‐negative patients have joint HBV DNA loss/ALT normalization, although 48–74% of patients relapse within 1 year posttreatment. 60% of patients have histological improvement after 12 months of treatment. Lamivudine is well tolerated with a safety profile equivalent to that of placebo. The incidence of YMDD variants increases with extended lamivudine treatment, present in up to 57–64% of patients after 2 years. Their clinical impact is unclear; some studies show breakthrough infection associated with their emergence, whereas other studies show maintained response to lamivudine. Lamivudine has benefits over IFN in its safety and efficacy profile in this patient group. Extended lamivudine treatment beyond 2 years is an option, but further investigation is required to define stopping criteria and the impact of YMDD variants. J. Med. Virol. 66:435–451, 2002. © 2002 Wiley‐Liss, Inc.
Latent infection of human herpesvirus 6 in astrocytoma cell line and alteration of cytokine synthesis
Authors: Yoshikawa Tetsushi , Asano Yoshizo , Akimoto Shiho , Ozaki Takao , Iwasaki Takuya , Kurata Takeshi , Goshima Fumi , Nishiyama Yukihiro
Published: October 2004

In order to study the pathogenesis of HHV‐6 infection in central nervous system disorders, U251 cell line was infected with freshly isolated variant B HHV‐6. Although IEA/ex 3 antigen (immediate early protein) was detected in infected cell nuclei, neither the presence of OHV‐3 antigen (late antigen) nor production of infectious virus was demonstrated. These results indicate that abortive infection was established in the cells. After viral infection, the viral genome copy in the infected cells gradually decreased and became stable after 6 cell passages. At that point, HHV‐6 gene expression was restricted to only 2 immediate early genes (U90 and U94). However, 12‐O‐tetra‐decanoyl (TPA) treatment induced transcription of other genes (U31 and U39) by the 10th cell passage, indicating HHV‐6 reactivation. Moreover, production of two proinflamatory cytokines (IL‐6 and IL‐1β) was up‐regulated by the presence of the HHV‐6 genome and TPA‐induced activation of the viral transcripts. J. Med. Virol. 66:497–505, 2002. © 2002 Wiley‐Liss, Inc.
TTV infection and its relation to serum transaminases in apparently healthy blood donors and in patients with clotting disorders who have been investigated previously for hepatitis C virus and GBV‐C/HGV infection in Belgium
Authors: Ali Soegianto , Fevery Johan , Peerlinck Kathelijne , Verslype Chris , Schelstraete Robert , Gyselinck Fanny , Emonds Marie‐Paule , Vermylen Jozef , Hiem Yap Sing
Published: October 2004

A novel DNA virus, TT virus (TTV), has been proposed as a possible etiologic agent for non A‐E hepatitis. The aim of the present study was to determine the prevalence of TTV infection using PCR in healthy blood donors and in patients with clotting disorders who have been investigated previously for GBV‐C/HGV and HCV infection in Belgium. In this study, PCR using primers proposed by Takahashi et al. [(1998) Hepatology Research 12:233–239] proved far more sensitive than those used by Okamoto et al. [(1998) Journal of Medical Virology 56:128–132]. The sequence of the PCR products showed 87% identity to the published sequence. TTV was present in 29.7% of healthy blood donors, a figure intermediate between the low rate of infection observed in Scotland and the high rates in the Far East. TTV was detected in 46.5% of 127 patients studied with clotting disorders as compared to 79.5% for HCV and 11.8% for GBV‐C/HGV infection. However, there was no impact on the level of serum transaminases. Treatment with interferon for HCV infection co‐infected with TTV suppressed temporarily serum TTV DNA. Therefore, it was concluded that TTV DNA is detected frequently in serum of healthy blood donors in Belgium and more often in patients with clotting disorders. TTV does not cause liver disease or contribute to the severity of liver disease. J. Med. Virol. 66:561–566, 2002. © 2002 Wiley‐Liss, Inc.
Trafficking mechanism of west Nile (Sarafend) virus structural proteins
Authors: Chu J.J.H. , Ng M.L.
Published: October 2004

Previous studies have shown that West Nile (Sarafend) virus matured by budding at the plasma membrane, which differs from the usual intracellular maturation of other flaviviruses. The present study investigated the trafficking mechanism of the envelope (E) and capsid (C) proteins of West Nile (Sarafend) virus during the replication cycle. The use of time‐based double‐immunofluorescence labelling coupled with the Triton X‐100 extraction procedure revealed that both the E and C proteins were transported from the perinuclear region towards the plasma membrane along the microtubules simultaneously. The strong association of these virus proteins with the microtubules was demonstrated further with Triton X‐100 extraction procedure coupled with double immunogold‐labelling. Extraction of infected cells with Triton X‐100 in high salt also revealed that virus E proteins were associated with the microtubules via protein‐protein interaction. The disruption of microtubules with vinblastine sulphate inhibited the trafficking of both the virus E and C proteins. Both virus structural proteins were observed to co‐localise and retained within vinblastine sulphate‐induced microtubulin paracrystals. Extracellular virus production was also reduced drastically by vinblastine sulphate at non‐cytotoxic concentration. Subsequent studies revealed that the transportation of virus E protein was associated with the microtubules‐based motor protein, kinesin. J. Med. Virol. 67:127–136, 2002. © 2002 Wiley‐Liss, Inc.
Management of well‐differentiated thyroid carcinoma presenting within a thyroglossal duct cyst
Authors: Patel Snehal G. , Escrig Margarita , Shaha Ashok R. , Singh Bhuvanesh , Shah Jatin P.
Published: October 2004

Background and Objective

Well‐differentiated thyroid carcinoma (WDTC) is diagnosed in approximately 1.5% of thyroglossal duct cysts (TGDC). No clear consensus exists regarding further management after adequate excision of the cyst, especially the role of total thyroidectomy and postoperative radioactive iodine therapy. The current review was undertaken in an attempt to clarify these issues.

Methods

Demographic, clinical, tumor, treatment, pathology, and outcome data on 57 eligible patients reported in recent literature were pooled together with 5 patients treated at our institution for this analysis.

Results

A Sistrunk operation was performed for resection of the thyroglossal duct cyst in the majority (90%) of patients. Histologic examination of the tumor in the cyst revealed that papillary carcinoma was the most frequent (92%) histologic type. A total thyroidectomy was performed consequent to the diagnosis of thyroglossal duct cyst carcinoma in approximately half of the 62 patients. A malignant tumor was reported in 27% of the thyroidectomy specimens. Postoperative radioactive iodine therapy was administered in 16 (26%) patients. With a median follow‐up of 71 months (range 1–456 months), the 5‐ and 10‐year Kaplan–Meier overall survival was 100 and 95.6%, respectively. There were no disease‐related deaths reported in any of the patients. Univariate analysis revealed that the only significant predictor of overall survival was the extent of primary surgery for the thyroglossal cyst. The addition of total thyroidectomy to Sistrunk operation did not have a significant impact on outcome (P = 0.1). Patients treated with postoperative radioactive iodine (RAI) fared significantly worse than those that did not need RAI, which may be explained by the fact that this modality would generally be used in patients with higher risk tumors.

Conclusions

The Sistrunk operation is adequate for most patients with incidentally diagnosed TGDC carcinoma in the presence of a clinically and radiologically normal thyroid gland. Results of adequate excision using the Sistrunk operation are excellent and the concept of risk‐groups should be used to identify patients, who would benefit from more aggressive treatment. J. Surg. Oncol. 2002;79:134–139. © 2002 Wiley–Liss, Inc.
Regression of metastatic carcinoid tumors with octreotide therapy: Two case reports and a review of the literature
Authors: Leong Wey L. , Pasieka Janice L.
Published: October 2004

Background

The antiproliferative effect of the somatostatin analogue, octreotide, on metastatic carcinoid tumors is poorly understood. Partial tumor regression seen radiogaphically has been reported with the use of octreotide therapy for neuroendocrine tumors. Complete regression of carcinoid tumors is rarely reported.

Results

Two patients with metastatic midgut carcinoid tumors were treated with subcutaneous octreotide 300 μg/day for symptomatic control of their carcinoid syndrome before debulking palliative surgery. During the laporatomies, both patients were found to have complete macroscopic regression of the metastastatic lesions that had been identified radiologically before surgery, including liver metastases in one patient and periportal and retrocaval lymph nodes in the other. After surgery, the patients were evaluated every 3 months, and had no detectable disease at 30 and 43 months, respectively. Thirty cases of partial tumor regression with octreotide administered with or without other treatment modalities have been reported in the literature. Most of the patients involved received other treatment modalities. Only one other case reported in the literature showed complete regression with octreotide monotherapy.

Conclusions

We report two cases of metastatic midgut carcinoid tumors that demonstrated a significant anti‐proliferative response to octreotide monotherapy. Review of the literature failed to identify any specific prognostic factors with which the response to octreotide can be predicted. Possible mechanisms for this antiproliferative effect of octreotide on carcinoid tumors are discussed. J. Surg. Oncol. 2002;79:180–187. © 2002 Wiley–Liss, Inc.
Gastrointestinal cancer and sentinel node navigation surgery
Authors: Kitagawa Yuko , Kitajima Masaki
Published: October 2004

In the twentieth century, lymph node dissection based on metastatic distribution has developed as the standard procedure for surgical management of gastrointestinal cancer [1]. The fear that invisible micrometastases might be present has encouraged aggressive resection with lymphadenectomy to control the disease. However, the prognostic benefits of extensive surgery are still unknown and the universal application of radical surgery may affect surgical morbidity, mortality, and quality of life after surgery, particularly in patients without lymphatic spread. In the twenty‐first century, a novel technology to detect micrometastases without extensive surgical resection is required to establish an individualized surgical management approach to gastrointestinal cancer. Lymphatic mapping techniques are now used in the control of superficial malignancies, such as malignant melanoma and breast cancer, providing a novel tool that may also be of use for gastrointestinal cancers. J. Surg. Oncol. 2002;79:188–193. © 2002 Wiley–Liss, Inc.
Immunohistochemical study of receptor activator of nuclear factor kappa‐B ligand (RANK‐L) in human osteolytic bone tumors
Authors: Good Christopher R. , O'Keefe Regis J. , Puzas J. Edward , Schwarz Edward M. , Rosier Randy N.
Published: October 2004

Background and Objectives

Osteolytic bone tumors produce intercellular signaling proteins that regulate bone remodeling by altering the rates of osteoclast and osteoblast differentiation and activity. This report examines osteolytic bone tumor expression of receptor activator of nuclear factor B‐ligand (RANK‐L), a cytokine that is arguably the most critical regulator of osteoclast differentiation and activation.

Methods

This prospective immunohistochemical study examined RANK‐L expression in frozen tissues from sixteen surgical specimens of patients who underwent surgery for the treatment of osteolytic bone tumors between 1999 and 2000.

Results

RANK‐L was positive in 13 of the 16 cases. Primary benign bone tumors, primary malignant bone tumors, and metastasis to bone were positive for RANK‐L.

Conclusions

The cells in some, but not all, osteolytic tumors produce the cytokine RANK‐L. Further study is necessary to determine in which specific tumors RANK‐L is the cytokine responsible for increased osteoclastic activity, and to develop possible therapeutic use of RANK‐L antagonists such as osteoprotegerin (OPG). J. Surg. Oncol. 2002;79:174–179. © 2002 Wiley–Liss, Inc.
En bloc pancreaticoduodenectomy for right colon cancer invading adjacent organs*
Authors: Berrospi Francisco , Celis Juan , Ruiz Eloy , Payet Eduardo
Published: October 2004

Background and Objective

Surgical treatment of colorectal cancer needs an extended resection of the tumor en block with invaded organs. There is little information about the surgical treatment of right‐sided colon carcinoma directly involving duodenum and pancreas. Our objective is to report our experience with three patients who underwent en bloc pancreaticoduodenectomy and hemicolectomy for locally advanced right colon cancer.

Methods

Retrospective review of clinical records of patients with colon cancer.

Results

Three patients with right colon cancer adherent to adjacent organs underwent en block surgery. No operative deaths occurred. All patients are alive without evidence of disease at 10, 30, 113 months of follow‐up, respectively.

Conclusion

Locally advanced right‐sided colon cancer can be safely treated with en bloc pancreaticoduodenectomy and colectomy with excellent long‐term results. J. Surg. Oncol. 2002;79:194–197. © 2002 Wiley–Liss, Inc.