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Gadodiamide injection, a new nonionic, MRI contrast medium, was compared with the ionic agent gadolinium (Gd)-DTPA at 0.1 mmol/kg body weight in a double-blind, randomised trial in 60 patients, 30 receiving each substance, with known or suspected lesions of the central nervous system. The patients were closely questioned about adverse events. In the Gadodiamide injection group, four patients reported six adverse advents, three of which were judged to be related to the contrast medium. In the Gd-DTPA group, two patients each reported one adverse event, both of which had an uncertain relation to the contrast medium. All events were mild and no medical treatment was needed. No significant change in neurological findings, blood pressure, pulse rate or blood parameters were noted in any patient. Both contrast media were effective; no difference in overall efficacy or safety was observed.

A double-blind, randomized, parallel study was conducted to evaluate the safety and diagnostic utility of gadodiamide injection (a nonionic chelate of gadolinium and diethylenetriamine pentaacetic acid bis-(methylamide) [Gd-DTPA-BMA]) when administered IV for MRI of the central nervous system (CNS) at doses of 0.1 mmol/kg body weight (b. w.) or 0.3 mmol/kg b. w. A total of 24 patients received the lower dose and 23 the higher dose. Gadodiamide injection was administered to patients referred for MRI due to known or suspected CNS lesions. No clinically significant difference in blood parameters or efficacy was found between the two groups. The number of patients with adverse events other than discomfort was higher in the 0.3 group compared with the 0.1 group. In the 0.1 group, none of the 24 patients experienced any adverse events other than discomfort, and in the 0.3 group, 5 of 23 patients (21.7%) experienced a total of five adverse events other than discomfort. All adverse events were of mild or moderate intensity. Postinjection MR scans provided new information that affected patient management in the case of 6 patients in the 0.1 group and 9 in the 0.3 group.

A nasal vaccine, consisting of outer membrane vesicles (OMVs) from group B Neisseria meningitidis, was given to 12 volunteers in the form of nose drops or nasal spray four times at weekly intervals, with a fifth dose 5 months later. Each nasal dose consisted of 250 microg of protein, equivalent to 10 times the intramuscular dose that was administered twice with a 6-week interval to 11 other volunteers. All individuals given the nasal vaccine developed immunoglobulin A (IgA) antibody responses to OMVs in nasal secretions, and eight developed salivary IgA antibodies which persisted for at least 5 months. Intramuscular immunizations did not lead to antibody responses in the secretions. Modest increases in serum IgG antibodies were obtained in 5 volunteers who had been immunized intranasally, while 10 individuals responded strongly to the intramuscular vaccine. Both the serum and secretory antibody responses reached a maximum after two to three doses of the nasal vaccine, with no significant booster effect of the fifth dose. The pattern of serum antibody specificities against the different OMV components after intranasal immunizations was largely similar to that obtained with the intramuscular vaccine. Five and eight vaccinees in the nasal group developed persistent increases in serum bactericidal titers to the homologous meningococcal vaccine strain expressing low and high levels, respectively, of the outer membrane protein Opc. Our results indicate that meningococcal OMVs possess the structures necessary to initiate systemic as well as local mucosal immune responses when presented as a nasal vaccine. Although the serum antibody levels were less conspicuous than those after intramuscular vaccinations, the demonstration of substantial bactericidal activity indicates that a nonproliferating nasal vaccine might induce antibodies of high functional quality.

In 23 patients with treated ovarian cancer, 24 magnetic resonance (MR) examinations of the abdomen and pelvis were performed before and after administration of an oral superparamagnetic contrast medium. Depiction of bowel loops was judged sufficient in 47% with plain scans and in 85% with enhanced scans. Minor artefacts attributed to the agent were noted in 32% of examinations and were classified as disturbing in 8%. The diagnostic information obtained after contrast enhancement was estimated to be superior to that from plain MRI in 20% of patients. The use of oral contrast medium did not alter the MR diagnosis of “tumour recurrence” or “disease-free” in any patient. Our results suggest that superparamagnetic iron oxide is an effective and reliable approach to negative bowel contrast enhancement, increasing the confidence level when distinguishing intestines from solid structures.

Objectives: To investigate the frequency of subclinical skin inflammation in both hands by fluorescence optical imaging (FOI) in patients with psoriasis/psoriatic arthritis (Pso/PsA) vs. rheumatoid arthritis (RA) and healthy individuals, and to correlate these findings with cardiovascular (CV) risk factors. Patients and methods: The FOI scans were analyzed retrospectively to detect clinically invisible skin enhancement (0–3 scale) in both hands without relationship to underlying joints or blood vessels. We further characterized the FOI patterns and sorted the scans into groups based on the assumed diagnosis (Pso/PsA, RA, and healthy controls), which was compared with the physician’s diagnosis. Furthermore, the associations between CV risk factors and imaging findings were investigated by regression analyses. Results: We included FOI scans of patients with Pso/PsA (n= 80), RA (n= 78), and healthy controls (n= 25). Subclinical skin enhancement on the back of their hands was more common in Pso/PsA (72.5%) than in RA patients (20.5%) and healthy individuals (28.0%) (p< 0.001). Based on the FOI pattern, the majority of patients with Pso/PsA (72.5%), RA (76.9%), and healthy controls (68.0%) were classified correctly using the physician-based diagnosis as reference (overall agreement of 74%, kappa = 0.57). No CV risk factors except body weight (kg) were associated with subclinical skin enhancement (OR 1.04, 95% CI 1.02–1.06; p< 0.001). Conclusion: Subclinical subdermal skin inflammation was common in Pso/PsA patients using FOI. Based on the FOI pattern, most patients with Pso/PsA and were classified with the correct diagnosis. We demonstrated an important influence of the body weight on our FOI results. FOI may be a helpful novel tool to study microcirculation in rheumatic diseases with skin involvement.