bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive coronary angiography using 64-detector-row computed tomography in patients with a low to moderate pretest probability of significant coronary artery disease
Authors: Schlosser T. , Mohrs O. K. , Magedanz A. , Nowak B. , Voigtländer T. , Barkhausen J. , Schmermund A. 
Published: May 2007

Purpose: To evaluate the value of 64-detector-row computed tomography for ruling out high-grade coronary stenoses in patients with a low to moderate pretest probability of significant coronary artery disease. Material and Methods: The study included 61 patients with a suspicion of coronary artery disease on the basis of atypical angina or ambiguous findings in noninvasive stress testing and a class II indication for invasive coronary angiography (ICA). All patients were examined by 64-detector-row computed tomography angiography (CTA) and ICA. On a coronary segmental level, the presence of significant (⩾50% diameter) stenoses was examined. Results: In a total of 915 segments, CTA detected 62 significant stenoses. Thirty-four significant stenoses were confirmed by ICA, whereas 28 stenoses could not be confirmed by ICA. Twenty-two of them showed wall irregularities on ICA, and six were angiographically normal. Accordingly, on a coronary segmental basis, 28 false-positive and 0 false-negative findings resulted in a sensitivity of 100%, a specificity of 96.8%, a positive predictive value of 54.8%, and a negative predictive value of 100%. The diagnostic accuracy was 96.9%. Conclusion: Sixty-four-detector-row computed tomography reliably detects significant coronary stenoses in patients with suspected coronary artery disease and appears to be helpful in the selection of patients who need to undergo ICA. Calcified and non-calcified plaques are detected. Grading of stenoses in areas with calcification is difficult. Frequently, stenosis severity is overestimated by 64-detector-row computed tomography.
Influence of radiographic contrast media on myocardial oxygen tension: a randomized, NaCL-controlled comparative study of iodixanol versus iomeprol in pigs
Authors: Matschke K. , Gerk U. , Mrowietz C. , Park J. -W. , Jung F. 
Published: May 2007

Purpose: To examine how a one-time bolus injection of radiographic contrast media (RCM; iodixanol 320 and iomeprol 350) into the left coronary artery of six pigs affects tissue oxygen tension in the artery's supply area (pO2 LAD) compared to a 0.9% sodium-chloride (NaCl) bolus. Material and Methods: Each animal received a total of three boluses: one iodixanol, one iomeprol, and one NaCl (10 ml each). The radiographic contrast media and NaCl boluses were randomly assigned, and pO2 profiles were recorded. Results: 26.7±16.4 s after iodixanol injection, pO2 LAD had declined by 3.5% from 42.2±5.6 mmHg to 40.7±5.9 mmHg ( P = 0.0357). After 53±16.7 s, the initial value was restored. The pO2 LAD was 41.9±7.4 mmHg before iomeprol injection, and, 303.3±58.9 s after injection, pO2 LAD had declined by 13.1% to 36.4±7.5 mmHg ( P = 0.0001). After 577±22 s, the initial value was restored. The bolus application of an isotonic NaCl solution resulted in no effect on pO2 LAD. Immediately after injection, it increased by 3%. In the supply area of the right coronary artery and the peripheral skeletal muscle, no effect of the RCM or NaCl on tissue oxygen tension was observed. Furthermore, no effect on tissue temperature, heart rate, systolic and diastolic blood pressure, or cardiac output per minute occurred. Conclusion: The injection of RCM in a coronary artery can result in a significant local contrast-medium-induced microcirculation disorder. The high viscosity of iodixanol led to a very short-term insignificant effect on the microcirculation, while iomeprol induced a slight time-delayed pO2 decrease, which might be caused by the rigidification of erythrocytes. In comparison to a previous study with iopromide, the influence of iodixanol and iomeprol on myocardial oxygen tension was markedly less pronounced.
Lung cancer detection with low-dose spiral computed tomography in chronic obstructive pulmonary disease patients
Authors: Cilli A. , Ozkaynak C. , Onur R. , Erogullari I. , Ogus C. , Cubuk M. , Arslan G. , Ozdemir T. 
Published: May 2007

Purpose: To determine whether low-dose spiral computed tomography (LDCT) can improve the lung cancer detection rate in chronic obstructive pulmonary disease (COPD) subjects. Material and Methods: From October 1999 to December 2003, 374 COPD patients underwent LDCT for lung carcinoma screening. All subjects with an abnormal baseline CT scan were followed with serial CT scans as part of our protocol. Follow-up was continued until the demonstration of no change over a minimum of 24 months, or resolution. Sputum samples were also obtained for cytological analysis. Results: On the baseline spiral CT scan, 132 of 374 patients (35.2%) had at least one non-calcified nodule that required periodic follow-up with CT scans. The median follow-up time was 21 months (range 2–48 months). Of the 374 COPD subjects, nine patients with primary lung cancer (2.4%) were detected: six were squamous cell carcinomas, two were small-cell lung carcinomas (SCLC), and one was adenosquamous carcinoma. Three of the nine tumors were in stage IA, two in stage IIB, two in stage IIIA, and two were limited SCLC. Potentially curative pulmonary resection was performed in four patients, pulmonary lobectomy in three, and wedge excision in one. One subject with stage IA squamous cell carcinoma received radiotherapy, as pulmonary function was severely impaired. In addition, four patients underwent removal of benign lesions. Sputum was collected in 205 (54.8%) of 374 patients. There were 154 (75 %) metaplasia, 14 (6%) moderate dysplasia, and one (0.4%) malignant case. Conclusion: LDCT increases early lung carcinoma detection rate in COPD patients, but pulmonary function impairment may reduce its benefit.
Correlation of femoral artery flow velocity waveform with ipsilateral iliac artery stenoses assessed with magnetic resonance imaging
Authors: Wikström J. , Johansson L. , Karacagil S. , Ahlström H. 
Published: May 2007

Background: Magnetic resonance (MR) permits quantitative flow velocity measurements that could be used to detect changes in the curve profile downstream of a high-grade stenosis. Purpose: To assess whether MR flow measurements can be used to detect iliac artery stenoses. Material and Methods: Contrast-enhanced magnetic resonance angiography (MRA) and quantitative flow measurements in the lower aorta and proximal femoral arteries were performed in 29 patients with suspected iliac artery stenoses. Stenoses were graded into five degrees: 0%, 1–49%, 50–74%, 75–99%, and 100% diameter reduction. The femoral artery waveforms were evaluated qualitatively by two independent reviewers regarding peak systolic velocity (PSV), aortofemoral difference in time-to-peak (ΔTTP), systolic acceleration (SA), curve-shape index (CSI), and the presence of an early diastolic flow reversal. The correlation between these parameters and the degree of stenosis was assessed. Results: A significant correlation with degree of stenosis was observed for the qualitative flow waveform evaluations, with a high degree of interobserver agreement (κ = 0.84). A significant correlation was also found between degree of stenosis and PSV, ΔTTP, SA, CSI, and presence of diastolic flow reversal. The flow velocity pattern, however, remained unchanged, both qualitatively and quantitatively, up to a stenosis degree of at least 75%. Conclusion: Iliac artery stenoses cause femoral artery flow waveform changes that can be detected with MRI, but only at high-grade levels.
Dynamic susceptibility contrast perfusion magnetic resonance imaging in patients with symptomatic unilateral middle cerebral artery stenosis or occlusion
Authors: Lu Jie , Li Kuncheng , zhang Miao , Jiao Liqun 
Published: May 2007

Purpose: To evaluate cerebral hemodynamic disturbance in patients with symptomatic unilateral middle cerebral artery (MCA) high-grade stenosis or occlusion using dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-pMRI). Material and Methods: DSC-pMRI was performed in 28 patients with symptomatic unilateral MCA high-grade stenosis or occlusion. Hemodynamic parameters including relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), and time to peak (TTP) were calculated and compared between the stenosed or occluded side and contralateral side. Seven of the 28 patients underwent surgery or interventional therapy, and hemodynamic changes between pre- and post-therapy were investigated. Results: Prolonged rMTT and TTP were found in the stenosed or occluded MCA territories in all 28 patients. Significant differences were found in rCBV ( P<0.05), rMTT ( P<0.001), and TTP ( P<0.001) between the stenosed or occluded side and the contralateral side. However, no significant difference was observed in rCBF ( P>0.05). In the seven patients with surgical or interventional therapy, the values of rMTT and TTP significantly decreased after surgery or interventional therapy ( P<0.001). Conclusion: DSC-pMRI may be a useful tool for evaluating and monitoring cerebral hemodynamic disturbance in patients with symptomatic unilateral MCA high-grade stenosis or occlusion.
Creatine depletion and altered fatty acid metabolism in diseased human hearts: clinical investigation using 1h magnetic resonance spectroscopy and 123I BMIPP myocardial scintigraphy
Authors: Nakae I. , Mitsunami K. , Matsuo S. , Horie M. 
Published: May 2007

Background: In the heart, the creatine kinase system plays an important role in energy reserves, and myocardial energy production essentially depends upon fatty acid metabolism. Purpose: To examine myocardial creatine (CR) concentration and altered cardiac fatty acid metabolism in various forms of heart disease. Material and Methods: Myocardial CR concentration of the septum was measured by gated 1H magnetic resonance spectroscopy (MRS), applying a point-resolved spectroscopy (PRESS) sequence in 34 patients with heart disease. Of these patients, 14 underwent 123I BMIPP (radioactive fatty acid analogue) myocardial scintigraphy to evaluate myocardial fatty acid metabolism. Cardiac 123I BMIPP uptake was calculated as the heart-to-mediastinum count ratio. Results: Myocardial CR concentration correlated positively with the left ventricular ejection fraction (LVEF) by echocardiography ( R = 0.61, P<0.001, n = 34), suggesting that the degree of reduced CR is related to the severity of contractile dysfunction. Cardiac 123I BMIPP uptake also correlated positively with LVEF (initial image, R = 0.60, P<0.05; delayed image, R = 0.63, P<0.05; n = 14). There was a significant correlation between myocardial CR and cardiac 123I BMIPP uptake (initial image, R = 0.77, P<0.01; delayed image, R = 0.82, P<0.001; n = 14). Conclusion: Our study suggests an association between CR depletion and impaired fatty acid metabolism in various forms of heart diseases.
Patellar cartilage lesions: comparison of magnetic resonance imaging and T2 relaxation-time mapping
Authors: Hannila I. , Nieminen M. T. , Rauvala E. , Tervonen O. , Ojala R. 
Published: May 2007

Purpose: To evaluate the detection and the size of focal patellar cartilage lesions in T2 mapping as compared to standard clinical magnetic resonance imaging (MRI) at 1.5T. Material and Methods: Fifty-five consecutive clinical patients referred to knee MRI were imaged both with a standard knee MRI protocol (proton-density-weighted sagittal and axial series, T2-weighted sagittal and coronal series, and T1-weighted coronal series) and with an axial multislice multi-echo spin-echo measurement to determine the T2 relaxation time of the patellar cartilage. MR images and T2 maps of patellar cartilage were evaluated for focal lesions. The lesions were evaluated for lesion width (mm), lesion depth (1/3, 2/3, or 3/3 of cartilage thickness), and T2 value (20–40 ms, 40–60 ms, or 60–80 ms) based on visual evaluation. Results: Altogether, 36 focal patellar cartilage lesions were detected from 20 human subjects (11 male, nine female, mean age 40±15 years). Twenty-eight lesions were detected both on MRI and T2 maps, while eight lesions were only visible on T2 maps. Cartilage lesions were significantly wider ( P = 0.001) and thicker ( P<0.001) on T2 maps as compared to standard knee MRI. Most lesions [27] had moderately (T2 40–60 ms) increased T2 values, while two lesions had slightly (T2 20–40 ms) and seven lesions remarkably (T2 60–80 ms) increased T2 relaxation times. Conclusion: T2 mapping of articular cartilage is feasible in the clinical setting and may reveal early cartilage lesions not visible with standard clinical MRI.
Attempts to improve absolute quantification of cerebral blood flow in dynamic susceptibility contrast magnetic resonance imaging: a simplified T1-weighted steady-state cerebral blood volume approach
Authors: Wirestam R. , Knutsson L. , Risberg J. , Börjesson S. , Larsson E.-M. , Gustafson L. , Passant U. , Ståhlberg F. 
Published: May 2007

Background: Attempts to retrieve absolute values of cerebral blood flow (CBF) by dynamic susceptibility contrast magnetic resonance imaging (DSC-MRI) have typically resulted in overestimations. Purpose: To improve DSC-MRI CBF estimates by calibrating the DSC-MRI-based cerebral blood volume (CBV) with a corresponding T1-weighted (T1W) steady-state (ss) CBV estimate. Material and Methods: 17 volunteers were investigated by DSC-MRI and 133Xe SPECT. Steady-state CBV calculation, assuming no water exchange, was accomplished using signal values from blood and tissue, before and after contrast agent, obtained by T1W spin-echo imaging. Using steady-state and DSC-MRI CBV estimates, a calibration factor K = CBV(ss)/CBV(DSC) was obtained for each individual. Average whole-brain CBF(DSC) was calculated, and the corrected MRI-based CBF estimate was given by CBF(ss) = K×CBF(DSC). Results: Average whole-brain SPECT CBF was 40.1±6.9 ml/min·100 g, while the corresponding uncorrected DSC-MRI-based value was 69.2±13.8 ml/min·100 g. After correction with the calibration factor, a CBF(ss) of 42.7±14.0 ml/min·100 g was obtained. The linear fit to CBF(ss)-versus-CBF(SPECT) data was close to proportionality ( R = 0.52). Conclusion: Calibration by steady-state CBV reduced the population average CBF to a reasonable level, and a modest linear correlation with the reference 133Xe SPECT technique was observed. Possible explanations for the limited accuracy are, for example, large-vessel partial-volume effects, low post-contrast signal enhancement in T1W images, and water-exchange effects.
Lymph drainage studied by lymphoscintigraphy in the arms after sentinel node biopsy compared with axillary lymph node dissection following conservative breast cancer surgery
Authors: Celebioglu F. , Perbeck L. , Frisell J. , Gröndal E. , Svensson L. , Danielsson R. 
Published: May 2007

Purpose: To investigate lymphatic drainage as measured by lymphoscintigraphy in the arms of patients undergoing either sentinel lymph node biopsy (SNB) or axillary lymph node dissection (ALND). Material and Methods: From January 2001 to December 2002, 30 patients with unilateral invasive breast carcinoma underwent breast-conserving surgery with SNB and 30 patients with ALND. All patients received radiotherapy to the breast. Lymphoscintigraphy was performed, and skin circulation, skin temperature, and arm volume were measured 2–3 years after radiotherapy. Results: None of the 30 patients who underwent SNB showed any clinical manifestation of lymphedema. Of the 30 patients undergoing ALND, six (20%) had clinical lymphedema, with an arm volume that was >10% larger on the operated than on the non-operated side ( P<0.01). Scintigraphically, visual analysis revealed lymphatic dysfunction in three patients, manifested as forearm dermal back flow. Two of these patients also had an increased arm volume. Quantitative analysis showed no differences between the groups, apart from a smaller amount of isotope in the axilla in the ALND group. There was no difference in skin circulation or skin temperature. Conclusion: Our study shows that lymph drainage in the operated arm compared with the non-operated arm was less affected by SNB than by ALND, and that morbidity associated with SNB was lower than with ALND. However, the results do not confirm our hypothesis that lymphoscintigraphy can reveal differences in lymph circulation that are not evident clinically in the form of manifest lymphedema. The most sensitive clinical method of assessing lymph drainage seems to be measurement of arm volume.
Illegal drug‐attributable morbidity in Canada 2002
Authors: POPOVA SVETLANA , REHM JURGEN , PATRA JAYADEEP , BALIUNAS DOLLY , TAYLOR BENJAMIN 
Published: May 2007

AbstractUse of illegal drugs is an important behavioral risk factor for burden of morbidity in developed countries. The objective was to estimate the number of diagnoses in acute care hospitals, psychiatric hospitalizations, admissions in specialized treatment, and number of days in treatment attributable to use of illegal drugs for Canada in 2002. The number of diagnoses in acute care hospitals, psychiatric hospitalizations, and hospital days were obtained from the Canadian Institute for Health Information (CIHI). Number of admissions and number of days in specialized inpatient and outpatient treatment of illegal drug dependency were obtained from provincial ministerial officials or drug addiction program coordinators. Except for effects of maternal use of drugs of addiction on the newborn, and suicide, drug‐attributable fractions (DAFs) were estimated directly from available statistics in published literature. There were 61,026 illegal drug‐related diagnoses in acute care hospitals, 1,517 psychiatric hospitalizations, and 139,773 admissions to specialized treatment attributable to illegal drug use in Canada. The largest contributors were mental and behavioral disorders due to psychoactive substance use in acute care hospitals, and drug psychoses in psychiatric hospitalizations. Length of stay amounted to 352,121 days in acute care hospitals, 31,508 days in psychiatric hospitals, and 2,851,829 days in specialized treatment. Drug use constitutes a major contributor to burden of morbidity in Canada. Compared to 1992, the total number of illegal drug‐attributable days in 2002 increased, especially in acute hospitals by a factor of 9.6. A mixture of prevention and harm reduction measures is proposed to reduce the burden of morbidity associated with drug use.
The use of psychoactive substances among medical students in southern Brazil
Authors: BONIATTI MÁRCIO MANOZZO , ZUBARAN CARLOS , PANAROTTO DANIEL , DELAZERI GERSON JACOB , TIRELLO JACSON LUÍS , FELDENS MAURÍCIO DE OLIVEIRA , SPEROTTO VAGNER FRANCISCO REMONTI 
Published: May 2007

AbstractThe objective of our study was to investigate the patterns of use of psychoactive substances among students of a medical school in Southern Brazil and to explore a putative role of discrete behavioral and social variables in their drug use. This is a descriptive and transversal cut study. All regularly enrolled medical students at the University of Caxias do Sul were invited to participate in the study. A self‐administered questionnaire, which analyses lifetime drug use as well as drug use in the previous 30 days and 12 months was utilized to collect data. From a total of 318 regularly enrolled students, 183 (57.5%) completed and returned the questionnaires. The highest prevalence rates of lifetime drug use, drug use in the last 12 months and drug use in the last 30 days were observed, according to drug type, as follow in descending order: alcohol, tobacco, marijuana, inhalants, tranquilizers, amphetamine and cocaine. A multivariate analysis indicated that research respondents who live with their parents as well as those whose parents live together harmoniously, those who deny close ties to drug users, those who disapprove drug use, those who are not tobacco smokers and those who manifest religious beliefs and practice presented the most reduced levels of illicit drug use. The use of psychoactive substances among medical students in the University of Caxias do Sul is a significant problem. Appropriate and timely initiatives are needed to prevent and curb drug use among medical students.
The gendered context of initiation to injecting drug use: evidence for women as active initiates
Authors: BRYANT JOANNE , TRELOAR CARLA 
Published: May 2007

AbstractThis paper explores differences between women's and men's first experience of injecting in relation to socio‐demographic context, drug use, and the role of others. We collected cross‐sectional retrospective data from 334 recently initiated (≤ 5 years) injecting drug users in New South Wales and Queensland, Australia using a structured questionnaire in face‐to‐face interviews. Logistic regression was used to estimate crude and adjusted odds ratios (OR). Findings from the adjusted analysis show that women had a shorter duration of illicit drug use prior to initiation (adjusted OR 0.84, 95%CI: 0.74 ‐ 0.94), and were more likely to have their romantic‐sexual partner facilitate the initiation by paying for the drugs (adjusted OR 4.64, 95%CI: 1.21‐17.73). Women also reported a greater likelihood of being initiated in groups of other women (adjusted OR 2.87, 95%CI: 1.24‐6.67), suggesting that some women play an active role in their initiation experience rather than relying on, or being lead by, a romantic‐sexual partner. These findings demonstrate the crucial role that romantic‐sexual partners play in women's initiation experience, but also provide evidence for the way that women can be active participants in their own initiation and in initiating other women.
Screening for drugs in oral fluid: illicit drug use and drug driving in a sample of Queensland motorists
Authors: DAVEY J. , LEAL N. , FREEMAN J. 
Published: May 2007

AbstractPolice Services in a number of Australian states have indicated random roadside drug testing will be implemented to target drug driving. This paper outlines research conducted to provide an estimate of the prevalence of drug driving in a sample of Queensland drivers. Oral fluid samples were collected from 781 drivers who volunteered to participate at Random Breath Testing (RBT) sites in a large Queensland regional area. Illicit substances tested for included cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamine type substances, heroin and cocaine. Drivers also completed a self‐report questionnaire regarding their drug‐related driving behaviour. Samples that were drug‐positive at initial screening were sent to a government laboratory for confirmation. Oral fluid samples from 27 participants (3.5%) were confirmed positive for at least one illicit substance. The most common drugs detected in oral fluid were cannabis (delta 9 THC) (n = 13) followed by amphetamine type substances (n = 11). A key finding was that cannabis was also confirmed as the most common self‐reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs drink driving detection rates for the study period revealed a higher detection rate for drug driving (3.5%) vs drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland Roads. The paper will further outline the study findings and present possible directions for future drug driving research.