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4. Posters display III clinical outcome and PET

Author

Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., and Rener, A.

Published
2018

6. Automated CT volumetry of pulmonary metastases: evaluation of varied volume change thresholds for response assessment

Author

Marten, K, Rummeny, E J, Engelke, C, MacManus, M P, Alam, N, Hicks, R J, Ball, D L, Cronin, P, Dwamena, B, Kelly, A, Carlos, R, Rasmussen, K, Madsen, H T, Rasmussen, F, Rasmussen, T R, Baandrup, U, Pilegaard, H K, Pedersen, U, Palshof, T, Rehling, M, Vilarino-Varela, M J, Taylor, A, Rockall, A G, Reznek, R H, Powell, M E B, Anstee, A, Scott, F, Culver, L, Rustin, G, Padwick, M, Padhani, A R, Bhatia, K, Sahdev, A, Hogarth, K, Chew, S, Grossman, A, O’Regan, K, Hodnett, P, Corrigan, M, Redmond, H, Barry, J, Sandomenico, F, Catalano, O, Fazioli, F, Mattace Raso, M, De Chiara, A, Apice, G, Petrillo, A, De Lutio di Castelguidone, E, and Siani, A

Subjects
Workshops, Article
Abstract

Aim To evaluate volume change thresholds for reliable volumetric evaluation of pulmonary metastatic tumour response in comparison with the response evaluation criteria of solid tumours (RECIST). Methods Fifty consecutive patients with pulmonary metastases undergoing follow-up chest multidetector-row CT under chemotherapy were prospectively included. Metastatic volumes were estimated twice by two independent observers using commercially available automated volumetry software. Intra- and interobserver agreements of metastatic volume change were estimated by 95% limits of agreement. The response to chemotherapy, as defined by an incrementally increasing percentual metastatic volume change (20%–70%), was assessed by extended Kappa statistics. Categorical agreement was correlated with percentual volume change thresholds as defined for pulmonary tumour response. Results A total of 202 metastases were evaluated. The 95% intra- and interobserver limits of agreement were −2.16%–1.88% and −1.79%–2.14%, respectively. Partial response, total remission or progressive disease were present in 46% of patients using a 70% volume change threshold and in 48%, 56%, 62%, 70% and 82% of patients using 60%, 50%, 40%, 30% and 20% thresholds, respectively. Discordant response ratings occurred in 0%–6% of patients. General combined categorical agreement on treatment response was very good (κ=0.94–1), but was diminished with volume thresholds 0.05). Kappa values correlated in linear fashion with the threshold values (r2=0.868; p, Aim Relapse after chemoradiation for non-small cell lung cancer (NSCLC) carries a dismal prognosis. A prospective positron emission tomography (PET)-response database was used to estimate how many patients could benefit from response-adapted surgery. Method Pre- and post-treatment fluorodeoxyglucose (FDG)-PET scans were performed for 88 patients who received 60 Gy with concurrent platinum-based chemotherapy (n=73) or 60 Gy alone (n=15). Response categories were complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), or progressive metabolic disease (PMD). We considered that medically operable patients who attained a PMR with potentially resectable residual disease confined to the lung and patients who attained a CMR but subsequently relapsed locally with anatomically resectable disease could benefit from surgery. Twenty-four medically inoperable patients could not have tolerated thoracotomy, (predominantly chronic obstructive airways disease, but also heart disease (n=6), rheumatoid arthritis (n=1), and renal failure (n=1)). Of the remaining 64 patients, 29 attained CMR (45%), 25 PMR (39%), 4 SMD (6%) and 6 PMD (9%). Of 29 CMR patients, 5 ultimately had local relapses that could potentially have been prevented by surgery, 15 never relapsed and 9 relapsed with extensive disease. Of 26 PMR patients, 12 might have benefited from salvage surgery as they had absent (n=10) or minimal (2) evidence of mediastinal disease and potentially resectable residual parenchymal disease. Of 64 patients, potentially fit for thoracotomy, 17 might have benefited from salvage or adjuvant surgery after chemoradiation. To benefit 5 CMR patients, surgery would have been necessary in 29, including 15 who may have already been cured. PMR patients represent the best candidates for response-adapted salvage surgery., Aim To estimate the diagnostic accuracy of dynamic contrast enhanced (DCE) computed tomography (CT) and magnetic resonance (MR) imaging, and [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) and Tc-99m depretiode single photon emission computed tomography (SPECT) imaging for the evaluation of solitary pulmonary nodules using a meta-analysis. Data sources Studies published between January 1990 and December 2005 in PubMed. Study selection Studies that examined (DCE) CT and MR imaging patterns and MR imaging signal characteristics, and studies that examined [18F]FDG PET, Tc-99m depretiode SPECT imaging for the evaluation of solitary pulmonary nodules and; enrolled at least 10 participants with a pulmonary nodule, with histological confirmation of the majority of lesions; and presented sufficient data to permit calculation of contingency tables were included in the analysis. Data extraction Two reviewers independently abstracted data regarding true positive, false positive, false negative and true negative of the imaging test, and independently assessed study quality and disagreements were resolved by a third reviewer. Data synthesis Forty-five studies met the inclusion criteria in total, 10 DCE CT studies, 6 DCE MRI studies, 22 [18F]FDG PET studies, and 7 99mTc-depreotide SPECT studies. Study methodological quality was fair. Sample sizes were small, minimum 20, maximum 356 and mean 65 subjects. We used a meta-analytic method to construct summary receiver-operating characteristic curves. These showed no statistically significant difference between the modalities although DCE CT performed slightly less well. Conclusions Dynamic contrast-enhanced CT and MR imaging and FGD PET and 99mTc-depreotide SPECT imaging are accurate non-invasive imaging tests for distinguishing malignant from benign solitary pulmonary nodules or mass lesions., Aim To assess, separately and in combination, the diagnostic impact of high resolution computed tomography (HRCT) and 99mTc-depreotide (a somatostatin receptor scintigraphy), in patients with pulmonary lesions verified by CT. Methods We included 127 patients presenting with one or more pulmonary lesions suspected of malignancy on CT. Supplementary HRCT and 99mTc-depreotide tomography were performed. HRCT findings were classified into three groups: high, intermediate and low probability of malignancy. The final diagnosis was based on cytology, histology or CT follow-up. Results Sixty-one out of 127 patients had lung cancer. The overall sensitivity, specificity and accuracy of 99mTc-depreotide were 95%, 58%, and 76%, respectively. The sensitivity of 99mTc-depreotide in tumours >15 mm was 100%; the three false negatives were tumours ≤15 mm. HRCT showed high probability of malignancy in 58 patients; 48 had lung cancer. Twenty patients were classified as low probability, one was false negative. The intermediate group consisted of 49 patients (39%); 12 had lung cancer. When adding the intermediate group to the high probability group sensitivity, specificity and accuracy of HRCT were 98%, 29%, and 62%, respectively. Of the 49 patients in the intermediate group 99mTc-depreotide was positive in 23 patients (nine true positive) and negative in 26 (three false negative). Conclusion The sensitivity of 99mTc-depreotide alone was high in patients with lung lesions >15 mm. HRCT alone was accurate in the group of patients with high and low probability of malignancy. However, HRCT was indeterminate in 39% of the patients. In this group additional 99mTc-depreotide contributed to further diagnostic strategy., Aim Accurate target volume delineation is essential for effective radiotherapy. Pelvic lymph nodes are not easily identifiable on conventional imaging, but can be visualised by contrast-enhanced magnetic resonance imaging (MRI) using intravenous ultra-small particles of iron-oxide (USPIO). We have previously reported pelvic node clinical target volume (CTV) delineation guidelines for use with conventional imaging, based on nodal mapping studies using USPIO. The aim of this study was to independently verify these guidelines in a further cohort of patients. Methods Ten patients with gynaecological malignancy underwent MRI with and without intravenous USPIO. MR sequences were transferred to a radiotherapy 3D planning system. The proposed guidelines were used to outline a pelvic node CTV on pre-contrast T2-weighted images. On post-contrast T2 *-weighted images the pelvic nodes were identified and outlined. The pre- and post-contrast images were co-registered and CTV examined for node coverage. Results By applying the guidelines, full coverage of 737 node outlines out of a total of 741 was achieved. Of the 4 outlines not fully covered, 2 were in the anterior external iliac and 2 in the lateral external iliac node regions. Conclusion MRI using USPIO has enabled the production of guidelines for localising a pelvic node CTV with conventional imaging. Application of these guidelines to a further cohort of patients resulted in coverage of 99.5% of node outlines demonstrating the reliability of this technique., Aim To record water diffusion coefficients of normal uterine structures and to correlate water diffusion with tumour grade and stage of endometrial cancer. Methods Seventeen women with endometrial cancer (85% undergoing hysterectomy) were evaluated at 1.5 and 3 T using multiplanar T2-weighted, dynamic T1-weighted contrast enhanced and single shot echo-planar imaging (EPI) diffusion-weighted magnetic resonance imaging (MRI) (b=0, 50, 150, 500, 1000 s /mm 2) for staging purposes. Apparent diffusion coefficients (ADC) (from all b-values) of imaging determined and histologically confirmed normal myometrium, cervix stroma and cervical mucosa were obtained. Tumour ADCs were correlated with histological grade and pathological stage. Results An overlap in ADC values between cervical mucosa (median = 1.33 × 10 −3 mm 2/s; inter-quartile range = 0.95–1.52 × 10 −3 mm 2/s) and myometrium (median = 1.25 × 10 −3 mm 2/s; inter-quartile range = 0.97–1.41 × 10 −3 mm 2/s) was observed but both were greater than cervix stroma (median = 0.62 × 10 −3 mm 2/s; inter-quartile range = 0.23–0.82 × 10 −3 mm 2/s) (Mann–Whitney test; p=0.002). Fifteen tumours, 13 endometrioid carcinomas (grade 1=6; grade 2=3; grade 3=6), 1 clear cell (grade = 3) and 1 mullerian tumour (grade = 3) were found at pathology. The pathological tumour stages for the 17 tumours were T0 = 1, T1a/b = 2, T1c = 8, T2 = 3, T3 = 3. There was a significant difference between the ADC values of tumours (median = 0.73 × 10 −3 mm 2/s; interquartile range = 0.66–0.78 × 10 −3 mm 2/s) and myometrium (p=0.001) with greater restriction in tumours. There was a negative Kendall’s rank correlation between adenocarcinoma ADC and histological grade (τ=−0.52, p=0.018) and pathological stage (τ=−0.60, and p=0.006); that is aggressive lesions had lower ADC values. Conclusion Intrinsic differences in water diffusion profile between normal myometrium and tumour enable tumour detection on MRI and also reflect aggressiveness of histological lesion., Aim To evaluate and compare the performance of [123I]meta-iodobenzylguanidine (MIBG) with cross sectional imaging in the detection and localisation of adrenal and extra-adrenal phaeochromocytomas. Methods All patients between 1993 and 2005 with adrenal or extra-adrenal phaeochromocytomas that had computed tomography (CT) and magnetic resonance (MR) imaging were identified. Patients included in the study had biochemical or clinical evidence of a phaeochromocytoma or were part of a paraganglioma syndrome. Imaging features on CT and MRI including tumour location, size, and CT contrast enhancement, MRI signal characteristics and MIBG positivity were compared. In particular tumours not detected on MIBG were closely interrogated. Results We identified 65 patients with 72 adrenal phaeochromocytomas, 1 of which had metastases at presentation. 60 of these had [123I]MIBG (9 negative/51 positive). We identified 38 patients with extra-adrenal tumours (18 neck, 2 chest, 17 abdomen, 4 pelvis, 2 spine) including 7 with disseminated metastases and either resected primary or unknown primary at presentation. Thirty-three of these had MIBG studies (12 negative/21 positive). The sensitivity of MIBG when compared against CT and MRI was 85% and 63% for adrenal and extra-adrenal tumours respectively. The radiological features of phaeochromocytomas in patients with MIBG-negative studies are emphasised. Conclusion MIBG is more sensitive in detecting phaeochromocytomas at adrenal compared to extra-adrenal locations. MIBG is more likely to be negative in adrenal tumours with only a thin rim of peripheral viable tissue and central necrosis. No specific feature predicts negativity for extra-adrenal sites., Aim Malignant melanoma is the commonest cause of skin-cancer related deaths worldwide. Nodular melanoma is an aggressive type of melanoma due to its vertical growth and tendency to metastasise. Its incidence may also be increasing. The aims of this study were to review a cohort of patients with histologically proven nodular melanoma to determine if the incidence is increasing. We also investigated the incidence and distribution of metastatic spread of nodular melanoma based on follow-up computed tomography (CT) imaging. Methods A retrospective review was performed using a local database of melanoma patients in a tertiary referral centre. Radiological investigations were reviewed and evidence of the development of visceral, skeletal or soft tissue metastases based on follow up CT imaging was recorded. Results A total of 269 patients with malignant melanoma were identified. Histological analysis was available in 144 of these patients. Nodular melanoma accounted for 46% (n=66) of these patients. Metastatic disease was identified in 15% (n=10) of patients with nodular melanoma, either at presentation or on follow-up CT examination. The commonest sites of metastatic spread included lung (50%), liver (30%), spleen (20%), skin (20%) and peritoneum (20%). Sentinel lymph node mapping was negative in 50% (n=5) of patients who subsequently developed distant metastases. Conclusion Nodular melanoma is an aggressive condition and may be increasing in incidence with 46% prevalence in our study. Sentinel node status is not a reliable predictor of disease progression in patients with nodular melanoma. Nodular melanoma metastasised to distant sites more often than other histological subtypes in our study and therefore close follow-up of these patients is recommended., Aim To discuss the role of contrast-enhanced ultrasonography (CEUS) in the evaluation of soft-tissue tumors and to correlate these results with those from computed tomography (CT) and magnetic resonance imaging (MRI). Methods Twenty-seven patients with soft tissue tumors evaluated with SonoVue contrast agent (Bracco, Italy) and Technos software (Esaote, Italy) were reviewed. Cases included: malignant fibrous histiocytoma (2), myxoid liposarcoma (2), well-differentiated liposarcoma of the salivary gland (1), recurring fibrosarcoma (2), Merckel tumour (1), breast MALToma (1), low-grade sarcoma (1), hepatocellular carcinoma (HCC) subcutaneous seeding (2), soft-tissue metastasis (5), benign nerve sheath tumor (2), post-traumatic neuroma (2), lipoma (3), intramuscular haemangioma (1), elastofibroma dorsi (2). We subjectively evaluated intralesional microcirculation and macrocirculation, intensity and distribution of contrast enhancement and identified five patterns: (1) absence of enhancement; (2) slight enhancement; (3) diffuse macrocirculation with slow wash-out; (4) macrocirculation and microcirculation with fast enhancement and quick wash-out; (5) diffuse, intense, and heterogeneous enhancement with macrocirculation and persistent microcirculation. Ten of these patients were examined with contrast enhanced CT, 17 patients with MRI. Results Pattern 1 was found in lipomas, pattern 2 in elastofibroma dorsi and post-traumatic neuroma, pattern 3 in haemangioma and neurinomas, pattern 4 in fibrosarcoma, Merckel tumor, well-differentiated sarcoma and seeding HCCs; pattern 5 in malignant fibrous histiocytomas, myxoid liposarcomas, and subcutaneous metastasis. Only in the well-differentiated liposarcoma of the salivary gland, did CEUS demonstrate a pattern 1 with erroneous diagnosis of lipoma. In all other lesions there was good correlation with CT, MRI, and histological exams. Conclusion CEUS is a non-invasive diagnostic method in the initial work-up of soft-tissue tumors. The description of vascular patterns can be important for diagnosis and differentiation of benign from malignant tumours.

Published
2006

7. Clinical assessment of excretory renal function

Author

Petersen, L.J., Birn, H., Ladefoged, S.A., Randers, E., Rehling, M., Reinholdt, B., Rossing, P., Petersen, L.J., Birn, H., Ladefoged, S.A., Randers, E., Rehling, M., Reinholdt, B., and Rossing, P.

Abstract

Udgivelsesdato: 2009/3/23

Published
2009

8. Renal physiology

Author

Amel, S., primary, Crambert, G., additional, Alain, D., additional, Soleimani, M., additional, Amlal, H., additional, Barone, S., additional, Xu, J., additional, Zahedi, K., additional, Walter, Z., additional, Jankowski, V., additional, Joachim, J., additional, Weyer, K., additional, Nielsen, R., additional, Christensen, E., additional, Rehling, M., additional, Birn, H., additional, Dimuccio, V., additional, Ranghino, A., additional, Camussi, G., additional, and Bussolati, B., additional

Published
2012
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9. Abstracts

Author

Dunet, V., primary, Dabiri, A., additional, Allenbach, G., additional, Goyeneche Achigar, A., additional, Waeber, B., additional, Feihl, F., additional, Heinzer, R., additional, Prior, J. O., additional, Van Velzen, J. E., additional, Schuijf, J. D., additional, De Graaf, F. R., additional, De Graaf, M. A., additional, Schalij, M. J., additional, Kroft, L. J., additional, De Roos, A., additional, Jukema, J. W., additional, Van Der Wall, E. E., additional, Bax, J. J., additional, Lankinen, E., additional, Saraste, A., additional, Noponen, T., additional, Klen, R., additional, Teras, M., additional, Kokki, T., additional, Kajander, S., additional, Pietila, M., additional, Ukkonen, H., additional, Knuuti, J., additional, Pazhenkottil, A. P., additional, Nkoulou, R. N., additional, Ghadri, J. R., additional, Herzog, B. A., additional, Buechel, R. R., additional, Kuest, S. M., additional, Wolfrum, M., additional, Gaemperli, O., additional, Husmann, L., additional, Kaufmann, P. A., additional, Andreini, D., additional, Pontone, G., additional, Mushtaq, S., additional, Antonioli, L., additional, Bertella, E., additional, Formenti, A., additional, Cortinovis, S., additional, Ballerini, G., additional, Fiorentini, C., additional, Pepi, M., additional, Koh, A. S., additional, Flores, J. S., additional, Keng, F. Y. J., additional, Tan, R. S., additional, Chua, T. S. J., additional, Annoni, A. D., additional, Tamborini, G., additional, Fusari, M., additional, Bartorelli, A. L., additional, Ewe, S. H., additional, Ng, A. C. T., additional, Delgado, V., additional, Schuijf, J., additional, Van Der Kley, F., additional, Colli, A., additional, De Weger, A., additional, Marsan, N. A., additional, Yiu, K. H., additional, Ng, A. C., additional, Timmer, S. A. J., additional, Knaapen, P., additional, Germans, T., additional, Dijkmans, P. A., additional, Lubberink, M., additional, Ten Berg, J. M., additional, Ten Cate, F. J., additional, Russel, I. K., additional, Lammertsma, A. A., additional, Van Rossum, A. C., additional, Wong, Y. Y., additional, Ruiter, G., additional, Raijmakers, P., additional, Van Der Laarse, W. J., additional, Westerhof, N., additional, Vonk-Noordegraaf, A., additional, Youssef, G., additional, Leung, E., additional, Wisenberg, G., additional, Marriot, C., additional, Williams, K., additional, Etele, J., additional, Dekemp, R. A., additional, Dasilva, J., additional, Birnie, D., additional, Beanlands, R. S. B., additional, Thompson, R. C., additional, Allam, A. H., additional, Wann, L. S., additional, Nureldin, A. H., additional, Adelmaksoub, G., additional, Badr, I., additional, Sutherland, M. L., additional, Sutherland, J. D., additional, Miyamoto, M. I., additional, Thomas, G. S., additional, Harms, H. J., additional, De Haan, S., additional, Huisman, M. C., additional, Schuit, R. C., additional, Windhorst, A. D., additional, Allaart, C., additional, Einstein, A. J., additional, Khawaja, T., additional, Greer, C., additional, Chokshi, A., additional, Jones, M., additional, Schaefle, K., additional, Bhatia, K., additional, Shimbo, D., additional, Schulze, P. C., additional, Srivastava, A., additional, Chettiar, R., additional, Moody, J., additional, Weyman, C., additional, Natale, D., additional, Bruni, W., additional, Liu, Y., additional, Ficaro, E., additional, Sinusas, A. J., additional, Peix, A., additional, Batista, E., additional, Cabrera, L. O., additional, Padron, K., additional, Rodriguez, L., additional, Sainz, B., additional, Mendoza, V., additional, Carrillo, R., additional, Fernandez, Y., additional, Mena, E., additional, Naum, A., additional, Bach-Gansmo, T., additional, Kleven-Madsen, N., additional, Biermann, M., additional, Johnsen, B., additional, Aase Husby, J., additional, Rotevatn, S., additional, Nordrehaug, J. E., additional, Schaap, J., additional, Kauling, R. M., additional, Post, M. C., additional, Rensing, B. J. W. M., additional, Verzijlbergen, J. F., additional, Sanchez, J., additional, Giamouzis, G., additional, Tziolas, N., additional, Georgoulias, P., additional, Karayannis, G., additional, Chamaidi, A., additional, Zavos, N., additional, Koutrakis, K., additional, Sitafidis, G., additional, Skoularigis, J., additional, Triposkiadis, F., additional, Radovanovic, S., additional, Djokovic, A., additional, Simic, D. V., additional, Krotin, M., additional, Savic-Radojevic, A., additional, Pljesa-Ercegovac, M., additional, Zdravkovic, M., additional, Saponjski, J., additional, Jelic, S., additional, Simic, T., additional, Eckardt, R., additional, Kjeldsen, B. J., additional, Andersen, L. I., additional, Haghfelt, T., additional, Grupe, P., additional, Johansen, A., additional, Hesse, B., additional, Pena, H., additional, Cantinho, G., additional, Wilk, M., additional, Srour, Y., additional, Godinho, F., additional, Zafrir, N., additional, Gutstein, A., additional, Mats, I., additional, Battler, A., additional, Solodky, A., additional, Sari, E., additional, Singh, N., additional, Vara, A., additional, Peters, A. M., additional, De Belder, A., additional, Nair, S., additional, Ryan, N., additional, James, R., additional, Dizdarevic, S., additional, Depuey, G., additional, Friedman, M., additional, Wray, R., additional, Old, R., additional, Babla, H., additional, Chuanyong, B., additional, Maddahi, J., additional, Tragardh Johansson, E., additional, Sjostrand, K., additional, Edenbrandt, L., additional, Aguade-Bruix, S., additional, Cuberas-Borros, G., additional, Pizzi, M. N., additional, Sabate-Fernandez, M., additional, De Leon, G., additional, Garcia-Dorado, D., additional, Castell-Conesa, J., additional, Candell-Riera, J., additional, Casset-Senon, D., additional, Edjlali-Goujon, M., additional, Alison, D., additional, Delhommais, A., additional, Cosnay, P., additional, Low, C. S., additional, Notghi, A., additional, O'brien, J., additional, Tweddel, A. 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P., additional, Zijlstra, F., additional, Sato, M., additional, Taniguchi, K., additional, Kurabayashi, M., additional, Pop Gjorcheva, D., additional, Zdraveska-Kochovska, M., additional, Moriwaki, K., additional, Kawamura, A., additional, Watanabe, K., additional, Omura, T., additional, Sakabe, S., additional, Seko, T., additional, Kasai, A., additional, Ito, M., additional, Obana, M., additional, Akasaka, T., additional, Hruska, C., additional, Truong, D., additional, Pletta, C., additional, Collins, D., additional, Tortorelli, C., additional, Rhodes, D., additional, El-Prince, M., additional, Martinez-Moeller, A., additional, Marinelli, M., additional, Weismueller, S., additional, Hillerer, C., additional, Jensen, B., additional, Nekolla, S. G., additional, Wakabayashi, H., additional, Tsukamoto, K., additional, Baker, S. M. E. A., additional, Sirajul Haque, K. M. H. S., additional, Siddique, A., additional, Krishna Banarjee, S., additional, Ahsan, A., additional, Rahman, F., additional, Mukhlesur Rahman, M., additional, Parveen, T., additional, Lutfinnessa, M., additional, Nasreen, F., additional, Sano, H., additional, Naito, S., additional, De Rimini, M. L., additional, Borrelli, G., additional, Baldascino, F., additional, Calabro, P., additional, Maiello, C., additional, Russo, A., additional, Amarelli, C., additional, Muto, P., additional, Danad, I., additional, Raijmakers, P. G., additional, Appelman, Y. E., additional, Hoekstra, O. S., additional, Marcus, J. T., additional, Boonstra, A., additional, Ryzhkova, D. V., additional, Kuzmina, T. V., additional, Borodina, O. S., additional, Trukshina, M. A., additional, Kostina, I. S., additional, Hommel, H., additional, Feuchtner, G., additional, Pachinger, O., additional, Friedrich, G., additional, Stel, A. M., additional, Deckers, J. W., additional, Gama, V., additional, Ciarka, A., additional, Neefjes, L. A., additional, Mollet, N. R., additional, Sijbrands, E. J., additional, Wilczek, J., additional, Llibre Pallares, C., additional, Abdul-Jawad Altisent, O., additional, Cuellar Calabria, H., additional, Mahia Casado, P., additional, Gonzalez-Alujas, M. T., additional, Evangelista Masip, A., additional, Garcia-Dorado Garcia, D., additional, Tekabe, Y., additional, Shen, X., additional, Li, Q., additional, Luma, J., additional, Weisenberger, D., additional, Schmidt, A. M., additional, Haubner, R., additional, Johnson, L., additional, Sleiman, L., additional, Thorn, S., additional, Hasu, M., additional, Thabet, M., additional, Dasilva, J. N., additional, Whitman, S. C., additional, Genovesi, D., additional, Giorgetti, A., additional, Gimelli, A., additional, Cannizzaro, G., additional, Bertagna, F., additional, Fagioli, G., additional, Rossi, M., additional, Bonini, R., additional, Marzullo, P., additional, Paterson, C. A., additional, Smith, S. A., additional, Small, A. D., additional, Goodfield, N. E. R., additional, Martin, W., additional, Nekolla, S., additional, Sherif, H., additional, Reder, S., additional, Yu, M., additional, Kusch, A., additional, Li, D., additional, Zou, J., additional, Lloyd, M. S., additional, Cao, K., additional, Motherwell, D. W., additional, Rice, A., additional, Mccurrach, G. M., additional, Cobbe, S. M., additional, Petrie, M. C., additional, Al Younis, I., additional, Van Der Wall, E., additional, Mirza, T., additional, Raza, M., additional, Hashemizadeh, H., additional, Santos, L., additional, Krishna, B. A., additional, Perna, F., additional, Lago, M., additional, Leo, M., additional, Pelargonio, G., additional, Bencardino, G., additional, Narducci, M. L., additional, Casella, M., additional, Bellocci, F., additional, Kirac, S., additional, Yaylali, O., additional, Serteser, M., additional, Yaylali, T., additional, Okizaki, A., additional, Urano, Y., additional, Nakayama, M., additional, Ishitoya, S., additional, Sato, J., additional, Ishikawa, Y., additional, Sakaguchi, M., additional, Nakagami, N., additional, Aburano, T., additional, Solav, S. V., additional, Bhandari, R., additional, Burrell, S., additional, Dorbala, S., additional, Bruno, I., additional, Caldarella, C., additional, Collarino, A., additional, Mattoli, M. V., additional, Stefanelli, A., additional, Cannarile, A., additional, Maggi, F., additional, Soukhov, V., additional, Bondarev, S., additional, Yalfimov, A., additional, Khan, M., additional, Priyadharshan, P. P., additional, Chandok, G., additional, Aziz, T., additional, Avison, M., additional, Smith, R. A., additional, Bulugahapitya, D. S., additional, Vakhtangadze, T., additional, Todua, F., additional, Baramia, M., additional, Antelava, G., additional, Roche, N.- C., additional, Paule, P., additional, Kerebel, S., additional, Gil, J.- M., additional, Fourcade, L., additional, Tzonevska, A., additional, Tzvetkov, K., additional, Atanasova, M., additional, Parvanova, V., additional, Chakarova, A., additional, Piperkova, E., additional, Kocabas, B., additional, Muderrisoglu, H., additional, Allaart, C. P., additional, Entok, E., additional, Simsek, S., additional, Akcay, B., additional, Ak, I., additional, Vardareli, E., additional, Stachura, M., additional, Kwasiborski, P. J., additional, Horszczaruk, G. J., additional, Komar, E., additional, Cwetsch, A., additional, Zraik, B., additional, Morales Demori, R., additional, Almeida, A. D. J., additional, Siqueira, M. E., additional, Vieira, E., additional, Balogh, I., additional, Kerecsen, G., additional, Marosi, E., additional, Szelid, Z. S., additional, Sattar, A., additional, Swadia, T., additional, Chattahi, J., additional, Qureshi, W., additional, Khalid, F., additional, Gonzalez, A., additional, Hechavarria, S., additional, Takamura, K., additional, Fujimoto, S., additional, Nakanishi, R., additional, Yamashina, S., additional, Namiki, A., additional, Yamazaki, J., additional, Koshino, K., additional, Hashikawa, Y., additional, Teramoto, N., additional, Hikake, M., additional, Ishikane, S., additional, Ikeda, T., additional, Iida, H., additional, Takahashi, Y., additional, Oriuchi, N., additional, Higashino, H., additional, Endo, K., additional, Mochizuki, T., additional, Murase, K., additional, Baali, A., additional, Moreno, R., additional, Chau, M., additional, Rousseau, H., additional, Nicoud, F., additional, Dolliner, P., additional, Brammen, L., additional, Steurer, G., additional, Traub-Weidinger, T., additional, Ubl, P., additional, Schaffarich, P., additional, Dobrozemsky, G., additional, Staudenherz, A., additional, Ozgen Kiratli, M., additional, Temelli, B., additional, Kanat, N. B., additional, Aksoy, T., additional, Slavich, G. A., additional, Piccoli, G., additional, Puppato, M., additional, Grillone, S., additional, Gasparini, D., additional, Dunet, V., additional, Perruchoud, S., additional, Poitry-Yamate, C., additional, Lepore, M., additional, Gruetter, R., additional, Pedrazzini, T., additional, Anselm, D., additional, Anselm, A., additional, Atkins, H., additional, Renaud, J., additional, Dekemp, R., additional, Burwash, I., additional, Guo, A., additional, Beanlands, R., additional, Glover, C., additional, Vilardi, I., additional, Zangheri, B., additional, Calabrese, L., additional, Romano, P., additional, Bruno, A., additional, Fernandez Cimadevilla, O. C., additional, Uusitalo, V. A., additional, Luotolahti, M., additional, Wendelin-Saarenhovi, M., additional, Sundell, J., additional, Raitakari, O., additional, Huidu, S., additional, Gadiraju, R., additional, Ghesani, M., additional, Uddin, Q., additional, Wosnitzer, B., additional, Takahashi, N., additional, Alhaj, E., additional, Legasto, A., additional, Abiri, B., additional, Elsaban, K., additional, El Khouly, T., additional, El Kammash, T., additional, Al Ghamdi, A., additional, Kyung Deok, B., additional, Bon Seung, K., additional, Sang Geun, Y., additional, Chang Min, D., additional, and Gwan Hong, M., additional

Published
2011
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11. Infarct size and myocardial salvage after primary angioplasty in patients presenting with symptoms for <12 h vs. 12-72 h

Author

Busk, M., primary, Kaltoft, A., additional, Nielsen, S. S., additional, Bottcher, M., additional, Rehling, M., additional, Thuesen, L., additional, Botker, H. E., additional, Lassen, J. F., additional, Christiansen, E. H., additional, Krusell, L. R., additional, Andersen, H. R., additional, Nielsen, T. T., additional, and Kristensen, S. D., additional

Published
2009
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12. Effects of a long-acting formulation of octreotide on renal function and renal sodium handling in cirrhotic patients with portal hypertension: a randomized, double-blind, controlled trial

Author

Ottesen, LH, Aagaard, N K, Kiszka-Kanowitz, M, Rehling, M, Henriksen, Jens Henrik Sahl, Pedersen, E B, Flyvbjerg, A, Bendtsen, F, Ottesen, LH, Aagaard, N K, Kiszka-Kanowitz, M, Rehling, M, Henriksen, Jens Henrik Sahl, Pedersen, E B, Flyvbjerg, A, and Bendtsen, F

Abstract

Udgivelsesdato: 2001-Sep, Octreotide seems to have a beneficial effect on variceal bleeding, and long-term administration for the prevention of rebleeding is currently being evaluated. Experimental studies have suggested a beneficial effect of chronic octreotide treatment on renal function, while clinical studies have shown variable effects. Twenty-five cirrhotic patients with portal hypertension were randomized in a double-blind design to placebo or a single subcutaneous dose of a long-acting formulation of octreotide (octreotide-LAR) (20 mg). Renal function tests were performed before dosing and repeated after 30 days. The patients were in sodium steady state at the time of study. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by a constant infusion clearance technique. Renal sodium handling was determined by lithium and sodium clearance measurements. Therapeutic serum levels of octreotide along with a reduction of insulin-like growth factor I (IGF-I) (P <.01) and an increase of IGF binding protein 1 (P <.05) were demonstrated. No effect of octreotide was observed on GFR, ERPF, or filtration fraction (GFR/ERPF). Changes in clearance and extraction fraction of sodium and lithium during octreotide treatment were not significantly different from those of placebo. In addition, no changes in free water clearance, urinary flow rate, or 24-hour Na excretion were demonstrated. A significant increase of mean arterial pressure (+5 mm Hg; P <.01) was observed after treatment with octreotide-LAR. It is concluded that in spite of increased arterial pressure, octreotide-LAR has no significant effect on renal hemodynamics and tubular function in clinically stable cirrhotic patients with portal hypertension.

Published
2001

14. Renal vein oxygen saturation in renal artery stenosis

Author

Nielsen, K, Rehling, M, Henriksen, Jens Henrik Sahl, Nielsen, K, Rehling, M, and Henriksen, Jens Henrik Sahl

Abstract

Udgivelsesdato: 1992-Mar, Renal vein oxygen-saturation was measured in 56 patients with arterial hypertension and unilateral stenosis or occlusion of the renal artery. Oxygen-saturation in blood from the ischaemic kidney (84.4%, range 73-93%) was significantly higher than that from the 'normal' contralateral kidney (81.2%, range 70-90%, P less than 0.001). In only six patients, the ischaemic kidney revealed a venous oxygen-saturation below the contralateral value (mean difference ischaemic-normal kidney 3.2%, range -6 to 15%). The results indicate that the oxygen uptake in the chronic ischaemic kidney is more decreased than its blood flow. This is probably due to decreased filtration fraction and filtered sodium with subsequent reduction in absolute tubular re-absorption of sodium ions.

Published
1992

17. Arterio-venous concentration difference of [51Cr]EDTA after a single injection in man. Significance of renal function and local blood flow

Author

Rehling, M, Hyldstrup, L, Henriksen, Jens Henrik Sahl, Rehling, M, Hyldstrup, L, and Henriksen, Jens Henrik Sahl

Abstract

Udgivelsesdato: 1989-Jun, The present investigation was undertaken in order to study (1) the difference in arterial (Ca) and venous (Cv) concentration of [51Cr]EDTA (ethylenediaminetetraacetate) after a single intravenous injection, (2) the impact of different physiological variables on this difference, and (3) the error introduced in the measurement of renal plasma clearance and total plasma clearance by using venous blood samples instead of arterial. In 13 patients with GFR ranging from 29 to 150 ml min-1, Ca was higher than Cv immediately after the injection. After mean 38 min (range 12-82 min) the two curves crossed, and 180-300 min post-injection (p.i.) Cv was 5.9% higher than Ca (range 0.5-13.9%, P less than 0.001). The more reduced renal function, the smaller was the concentration difference. The areas under the arterial and the venous plasma concentration curves did not differ significantly at either 0-infinity or 0-300 min p.i. whereas the venous area 0-100 min p.i. underestimated the arterial area in the same period by 4.1% (P less than 0.05). In a computer simulation model, variation in the forearm capillary permeability-surface area product did not have any significant influence on the Cv-Ca difference, whereas the difference was very sensitive to even small changes in forearm blood flow within the physiological range. For measurement of renal plasma clearance it is recommended to use one long period: from the time of injection until 300 min p.i. or longer. If the clearance period is too short, the use of venous samples will overestimate the true renal clearance. Plasma clearance determined by venous and arterial blood samples does not differ significantly as long as the concentration is followed from the time of injection and a long period is applied. When simplified plasma clearance techniques are used, different results may be obtained from venous and arterial samples. The simplified techniques using venous blood samples--which usually include some empirical corrections--shoul

Published
1989

18. Posters display III clinical outcome and PET

Author

Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., Rener, A., Baliño, N., Masoli, O., Traverso, S., Grynberg, L., Rappallo, C., Redruello, M., Rosa, D., Cragnolino, D., Meretta, A., Vidal, L., Graf, S., Khorsand, A., Gyongyosi, M., Karanikas, G., Eidherr, H., Kletter, K., Porenta, G., Glogar, D., Sochor, H., Beheshti, M., Poetzi, C., Wadsak, W., Maurer, G., Wolfram, J., Winter, O., Velghe, A., Veire, N., Bondt, P., Buyzere, M., Wiele, C., Backer, G., Gillebert, T., Dierckx, R., Sutter, J., Bernard, D., Langlois, M., Duarte, P., Mastrocolla, L., Sampaio, C., Rossi, J., Smanio, P., Lima, E., Oliveira, C., Pereira, J., Beraldo, P., Rodrigues, F., Thom, A., Yoshinaga, K., Ukkonen, H., Burwash, I., DeKemp, R., Dafoe, W., Davies, R., Haddad, H., Ruddy, T., DaSilva, J., Beanlands, R., Chow, B., Williams, K., Garrard, L., Szeto, A., Aung, M., Sondergaard, H., Bottcher, M., Madsen, M., Schmitz, O., Nielsen, T., Botker, H., Høilund-Carlsen, P., Johansen, A., Christensen, H., Vach, W., Møldrup, M., Haghfelt, T., Kristensen, J., Maeng, M., Mortensen, U., Berg, J., Rehling, M., Elsaban, K., El-Kady, T., El-Gabaly, M., Yehia, A., El-Sayed, M., Naum, A., Laaksonen, M., Tuunanen, H., Oikonen, V., Kemppainen, J., Järvisalo, M., Nuutila, P., Knuuti, J., Vanzetto, G., Jacon, P., Fagret, D., Machecourt, J., Lindner, O., Vogt, J., Kammeier, A., Fricke, E., Wielepp, P., Baller, D., Lamp, B., Holzinger, J., Horstkotte, D., Burchert, W., Nekolla, S., Souvatzoglou, M., Hausleiter, J., Henke, N., Kruschke, K., Bengel, F., Schwaiger, M., Sundaram, P., Padma, S., Haridas, K., Kumar, S., Zachariah, M., Livschitz, S., Zornitzki, T., Vered, S., Oettinger, M., Levy, R., Caspi, A., Faraggi, D., Knobler, H., Mats, I., Solodky, A., Ben-Gal, T., Battler, A., Zafrir, N., Varani, E., Balducelli, M., Severi, S., Patroncini, A., Vecchi, G., Gatti, C., Corbelli, C., Casanova, R., Maresta, A., Cittanti, C., Valgimigli, M., Giganti, M., Malagutti, P., Percoco, G., Bagatin, E., Panareo, S., Avigni, N., Ferrari, R., Feggi, L., Filardi, P., Cuocolo, A., Storto, G., Brevetti, G., Dellegrottaglie, S., Corrado, L., Cafiero, M., Polimeno, M., Zarrilli, A., Chiariello, M., Marcassa, C., Campini, R., Calza, P., Giannuzzi, P., Galassi, A., Grasso, C., Azzarelli, S., Leotta, E., Moshiri, S., Tamburino, C., Acampa, W., Ferro, A., Petretta, M., Salvatore, M., Pieri, P., Berta, R., Moscatelli, G., Buccoliero, F., Inglese, E., Medolago, G., Imperiale, A., Rimini, M., Bertagna, F., Sullo, P., Lupo, M., Cappagli, M., Fukuda, H., Kunimasa, T., Furuhashi, T., Moroi, M., Yasuhi, W., Akihiro, S., Akio, Y., Ryou, K., Kimio, T., Yasunori, W., Yasuhiko, T., Nariaki, E., Watabe, H., Teramoto, N., Ohta, Y., Kou, Y., Hayashi, T., Iida, H., Bom, H., Song, H., Min, J., Heo, Y., Seo, J., Lee, J., Bae, J., Jeong, S., Ahn, B., Chae, S., Lee, K., Popiel, M., Grajek, S., Czepczynski, R., Breborowicz, P., Lesiak, M., Czyz, A., Sawinski, K., Komarnicki, M., Cieslinski, A., Sowinski, J., Ferreira, A., Ventosa, A., Gil, V., Calqueiro, J., Lima, S., Aguiar, C., Couto, R., Raposo, L., Seabra-Gomes, R., Vasconcelos, M., Martins, E., Faria, T., Oliveira, A., Garcia, M., Rocha-Gonçalves, F., Lourenço, C., Roque, C., Ferrer-Antunes, A., Ferreira, M., Providência, L., Lima, J., Medrea, C., Bogdan, R., Lazar, A., Mot, S., Capilneanu, R., Kozulin, V., Berkovich, O., Ivashchenko, T., Larionova, V., Esipovich, I., Gordeev, M., Panov, A., Shlyakhto, E., Burova, N., Baranov, D., Timoshin, V., Chuprova, S., Shkolnikova, M., Zaklyazminskaya, E., Poliakov, A., Sazonova, S., Romero-Farina, G., Arenillas, J., Candell-Riera, J., Aguadè-Bruix, S., Leon, G., Molina, C., Chacon, P., Montaner, J., Rovira, A., Alvarez-Sabin, J., Namdar, M., Siegrist, P., Grathwohl, R., Delaloye, R., Koepfli, P., Wyss, C., Kaufmann, P., Bartenstein, N., Hellermann, J., Pollack, C., Schurr, U., Zellweger, M., Burger, P., Mueller-Brand, J., Pfisterer, M., Gordon, L., Epps, A., Chiarameda, S., Navare, S., Ahlberg, A., Cyr, G., Katten, D., Ausef, A., Heller, G., Darrow, B., Thomas, G., Ip, T., Thompson, R., Kramer, D., Rice, D., Thomas, J., Miyamoto, M., Druz, R., Nichols, K., Akinboboye, O., Reichek, N., Podrasky, E., Tuttle, R., Shaw, L., Hanson, M., Borges-Neto, S., Lundbye, J., Werden, S., Kazi, F., Whalen, A., Noble, G., O'Sullivan, D., Boden, W., Danias, P., Papaioannou, G., Leka, I., Beretta, M., Viňas, S., Gonzalez, A., Vidal, I., and Rener, A.

21. Corticomedullary shunting after ischaemia and reperfusion in the porcine kidney?

Author

Rehling M, Skjøth SG, Frøkiær J, Nielsen LE, Flø C, Jespersen B, and Keller AK

Subjects
Animals, Humans, Ischemia, Kidney, Kidney Medulla, Reperfusion, Swine, Reperfusion Injury
Abstract

Background: Renal perfusion may redistribute from cortex to medulla during systemic hypovolaemia and after renal ischaemia for other reasons, but there is no consensus on this matter. We studied renal perfusion after renal ischaemia and reperfusion., Methods: Renal perfusion distribution was examined by use of 153 Gadolinium-labeled microspheres (MS) after 2 h (hrs) and 4 h ischaemia of the pig kidney followed by 4 h of reperfusion. Intra-arterial injected MS are trapped in the glomeruli in renal cortex, which means that MS are not present in the medulla under normal physiological conditions., Results: Visual evaluation after reperfusion demonstrated that MS redistributed from the renal cortex to the medulla in 6 out of 16 pigs (38%) subjected to 4 h ischaemia and in one out of 18 pigs subjected to 2 h ischaemia. Central renal uptake of MS covering the medullary/total renal uptake was significantly higher in kidneys subjected to 4 h ischaemia compared with pigs subjected to 2 h ischaemia (69 ± 5% vs. 63 ± 1%, p < 0.001), and also significantly higher than in the contralateral kidney (69 ± 5% vs. 63 ± 2%, p < 0.001). Analysis of blood and urine demonstrated no presence of radioactivity., Conclusion: The study demonstrated the presence of MS in the renal medulla in response to renal ischaemia and reperfusion suggesting that severe ischaemia and reperfusion of the pig kidney leads to opening of functional shunts bypassing glomeruli., (© 2022. The Author(s).)

Published
2022
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22. Mediastinal staging in Non-Small-Cell Lung Carcinoma: computed tomography versus F-18-fluorodeoxyglucose positron-emission tomography and computed tomography.

Author

Harders SW, Madsen HH, Hjorthaug K, Arveschoug AK, Rasmussen TR, Meldgaard P, Hoejbjerg JA, Pilegaard HK, Hager H, Rehling M, and Rasmussen F

Subjects
Carcinoma, Non-Small-Cell Lung diagnostic imaging, Humans, Lung Neoplasms diagnostic imaging, Neoplasm Staging, Carcinoma, Non-Small-Cell Lung pathology, Fluorodeoxyglucose F18, Lung Neoplasms pathology, Mediastinum pathology, Positron-Emission Tomography methods, Radiopharmaceuticals, Tomography, X-Ray Computed methods
Abstract

Background: After the diagnosis Non-Small-Cell Lung Carcinoma (NSCLC) has been established, consideration must turn toward the stage of disease, because this will impact directly on management and prognosis. Staging is used to predict survival and to guide the patient toward the most appropriate treatment regimen or clinical trial. Distinguishing malignant involvement of the mediastinal lymph nodes (N2 or N3) from the hilar lymph nodes, or no lymph nodes (N0 or N1) is critical, because malignant involvement of N2 or N3 lymph nodes usually indicates non-surgically resectable disease. The purpose of this study was to examine and compare CT versus integrated F18-FDG PET/low dose CT (FDG PET/CT) for mediastinal staging in NSCLC, and the desire was to safely distinguish between malignant and benign lesions without the need for invasive procedures. All results were controlled for reproducibility., Methods: 114 participants with NSCLC were included in a prospective cohort study. Blinded CT and FDG PET/CT images were reviewed. The participants' mediastinums were staged based on lymph node sizes (CT), or on FDG uptake (FDG PET/CT). Reference standard was tissue sampling., Results: We found that there was no measureable difference between CT and FDG PET/CT mediastinal staging results; overall two-thirds of the participants in the study were correctly staged, and almost one-third of the participants were falsely staged., Conclusion: Neither CT nor FDG PET/CT could obviate the need for further invasive staging prior to thoracotomy in patients with NSCLC; for that purpose, the results of both modalities were too meagre. Therefore, these patients still depend on invasive staging methods. In our study, invasive staging was accomplished by mediastinoscopy. However, today this is increasingly replaced by EBUS or EUS.

Published
2014
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23. Cell injury after ischemia and reperfusion in the porcine kidney evaluated by radiolabelled microspheres, sestamibi, and lactadherin.

Author

Pedersen SS, Keller AK, Nielsen MK, Jespersen B, Falborg L, Rasmussen JT, Heegaard CW, and Rehling M

Abstract

Background: The purpose of the present study was to quantify renal cell injury after ischemia and reperfusion in a pig model using (99m)Tc-lactadherin as a marker of apoptosis and (99m)Tc-sestamibi as a marker of mitochondrial dysfunction., Methods: Thirty-four pigs were randomized into unilateral renal warm ischemia of 120 (WI120) or 240 min (WI240). The glomerular filtration rate (GFR) was calculated by renal clearance of (51)Cr-ethylenediaminetetraacetic acid, and apoptosis was quantified by immunohistochemical detection of caspase-3. After 240 min of reperfusion, intravenous (99m)Tc-lactadherin or (99m)Tc-sestamibi was injected simultaneously with (153)Gd microspheres into the aorta. Ex-vivo static planar images of the kidneys were acquired for determination of the differential renal function of tracer distribution using a gamma camera., Results: In WI120, there was no significant difference in the uptake of microspheres in the ischemic and contralateral normal kidney indicating adequate perfusion (uptake in ischemic kidney relative to the sum of uptake in both kidneys; 46% ± 12% and 51% ± 5%). In WI240, the uptake of microspheres was severely reduced in both groups (17% ± 11% and 27% ± 17%). GFR was severely reduced in the post ischemic kidney in both groups. In both groups, the uptake of lactadherin was reduced (41% ± 8%, 17% ± 13%) but not different from the uptake of (153)Gd microspheres. Caspase-3-positive cell profiles were increased in the post-ischemic kidneys (p < 0.001) and increased as the length of ischemia increased (p = 0.003). In both WI120 and WI240, the amount of (99m)Tc-sestamibi in the ischemic kidney was significantly lower than the amount of (153)Gd microspheres (40 ± 5 versus 51 ± 5 and 20 ± 11 versus 27 ± 17; p < 0.05)., Conclusions: In an established pig model with unilateral renal warm ischemia, we found significantly reduced (99m)Tc-sestamibi uptake relative to perfusion in the kidneys exposed to ischemia indicating a potential ability to detect renal ischemic and reperfusion injuries. However, apoptosis was not detected using (99m)Tc-lactadherin in the post-ischemic kidneys despite increased number of caspase-3-positive cell profiles., Trial Registration: This study is approved by the Danish Inspectorate of Animal Experiments (2010/561-1837).

Published
2013
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24. Pharmacokinetics of the phosphatidylserine tracers 99mTc-lactadherin and 99mTc-annexin V in pigs.

Author

Poulsen RH, Rasmussen JT, Ejlersen JA, Flø C, Falborg L, Heegaard CW, and Rehling M

Abstract

Background: Phosphatidylserine (PS) is a phospholipid normally located in the inner leaflet of the cell membrane. PS is translocated from the inner to the outer leaflet of the plasma membrane during the early stages of apoptosis and in necrosis. In cell and animal studies, reversible PS externalisation to the outer membrane leaflet has been observed in viable cells. Hence, PS markers have been proposed as markers of both reversibly and irreversibly damaged cells. The purpose of this experimental study in pigs was to investigate the kinetics of the newly introduced PS marker technetium-99m-labelled lactadherin (99mTc-lactadherin) in comparison with the well-known PS tracer 99mTc-annexin V with special reference to the renal handling of the tracers. The effective dose for humans was estimated from the biodistribution in 24 mice., Methods: Nine anaesthetised pigs randomly allocated into two treatment groups were administered a single injection of either 99mTc-lactadherin or 99mTc-annexin V. Renal perfusion was assessed by simultaneous injection of 51Cr-EDTA. Throughout the examinations, planar, dynamic scintigraphy of the trunk was performed, urine was collected and arterial and renal vein blood was sampled. The effective dose was estimated using the adult male phantom from the RADAR website., Results: 99mTc-lactadherin was cleared four times faster from plasma than 99mTc-annexin V, 57 ± 13 ml/min (mean ± SD) versus 14 ± 2 ml/min. 99mTc-lactadherin had a predominant uptake in the liver, whereas 99mTc-annexin V was primarily taken up by the kidneys. The estimated effective human dose after single injection of 99mTc-lactadherin and 99mTc-annexin V was 5.8 and 11 μSv/MBq, respectively., Conclusions: The high hepatic uptake of 99mTc-lactadherin compromises the use of 99mTc-lactadherin for imaging PS externalisation in the liver. Due to scatter from the liver, the use of in vivo visualisation of PS externalisation in the lower thorax and upper abdomen by 99mTc-lactadherin is challenged, but not precluded. In contrast to 99mTc-annexin, 99mTc-lactadherin has a low renal uptake and may be the preferred tracer for imaging PS externalisation in the kidneys. The effective dose after injection of 99mTc-lactadherin and 99mTc-annexin was low. Recommendations regarding the clinical use of 99mTc-lactadherin must await tracer kinetic studies in patients.

Published
2013
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25. Endogenous markers for estimation of renal function in peritoneal dialysis patients.

Author

Kjaergaard KD, Jensen JD, Rehling M, and Jespersen B

Subjects
Adult, Aged, Aged, 80 and over, Biomarkers blood, Cohort Studies, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Renal Insufficiency, Chronic therapy, Reproducibility of Results, Creatinine blood, Cystatin C blood, Glomerular Filtration Rate, Peritoneal Dialysis, Renal Insufficiency, Chronic blood, Urea blood
Abstract

Objective: This method comparison study, conducted at the peritoneal dialysis (PD) outpatient clinic of the Department of Renal Medicine, Aarhus University Hospital, Denmark, set out to evaluate the accuracy and reproducibility of methods for estimating glomerular filtration rate (GFR) based on endogenous markers in PD patients., Patients: The 12 consecutive patients included in the study were examined twice while in a stable condition. All patients finished the study. Inclusion criteria were age 18 years or older, ability to collect 24-hour urine, and urine production greater than 300 mL in 24 hours., Main Outcome Measures: The methods for estimating GFR using endogenous markers included the average of urinary clearances of creatinine and urea [U-Cl(crea-urea)] and two equations using the serum concentration of cystatin C [eGFR(CysC)]. The resulting GFR estimates were compared with those obtained using urinary and corrected plasma clearances of (51)Cr-EDTA [U-Cl(EDTA) and cP-Cl(EDTA)], the corrected plasma clearance being plasma clearance minus dialysate clearance., Results: Compared with the U-Cl(EDTA), the U-Cl(crea-urea) GFR estimate was 12% higher [95% confidence limits (CL): 3%, 21%]. Although significantly different (p = 0.01), the latter two methods showed the best agreement. The estimates obtained using the eGFR(CysC) methods were skewed from y = x compared with the estimates obtained using other methods, indicating strong bias, probably because of extrarenal elimination. The cP-Cl(EDTA) estimate was 34% (95% CL: 26%, 42%), higher than the U-Cl(EDTA) estimate (p < 0.001). The reproducibility (coefficients of variation) differed significantly between methods: cP-Cl(EDTA), 7%; U-Cl(EDTA), 14%; U-Cl(crea-urea), 18%; and both eGFR(CysC) methods, 3%., Conclusions: In PD patients, GFR may be estimated as U-Cl(crea-urea) when complete urine collection is performed, taking into account an overestimation of approximately 12%. The available equations for eGFR(CysC) seem to be inaccurate; further development and validation is desirable. Omitting the eGFR(CysC) methods, cP-Cl(EDTA) was the most reproducible method and might be useful in certain situations.

Published
2013
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26. Renal uptake of 99mTc-dimercaptosuccinic acid is dependent on normal proximal tubule receptor-mediated endocytosis.

Author

Weyer K, Nielsen R, Petersen SV, Christensen EI, Rehling M, and Birn H

Subjects
Alpha-Globulins metabolism, Animals, Glomerular Filtration Rate, Kidney Tubules, Proximal physiology, Mice, Mice, Inbred C57BL, Radioactive Tracers, Technetium Tc 99m Dimercaptosuccinic Acid urine, Technetium Tc 99m Mertiatide metabolism, Endocytosis, Kidney Tubules, Proximal metabolism, Low Density Lipoprotein Receptor-Related Protein-2 metabolism, Receptors, Cell Surface metabolism, Technetium Tc 99m Dimercaptosuccinic Acid metabolism
Abstract

Unlabelled: (99m)Tc-labeled dimercaptosuccinic acid ((99m)Tc-DMSA) accumulates in the kidney cortex and is widely used for imaging of the renal parenchyma. Despite its extensive clinical use, the mechanism for renal targeting of the tracer is unresolved. Megalin and cubilin are cooperating receptors essential to the proximal tubule endocytic uptake of proteins from the glomerular ultrafiltrate. We have used megalin/cubilin-deficient mice produced by gene knockout to determine whether receptor-mediated endocytosis is responsible for the renal uptake of (99m)Tc-DMSA., Methods: Control or megalin/cubilin-deficient mice were injected intravenously with 0.5 MBq of (99m)Tc-DMSA or (99m)Tc-mercaptoacetyltriglycine (MAG3). Whole-body scintigrams and the activity in plasma, urine, and the kidneys were examined 6 h after injection. The size and identity of (99m)Tc-DMSA-bound proteins in urine were analyzed by fractionation by centrifugation and separation by sodium dodecyl sulfate polyacrylamide gel electrophoresis, followed by autoradiography and mass spectrometry., Results: No renal accumulation of (99m)Tc-DMSA was identified in scintigrams of megalin/cubilin-deficient mice. The renal accumulated activity of the tracer was reduced to 11.4% (± 2.5%, n = 7) of the normal uptake in control mice, correlating with a reduction in renal megalin/cubilin expression in knockout mice to about 10% of normal. The reduced renal uptake in megalin/cubilin-deficient mice was accompanied by an increase in the urinary excretion of (99m)Tc-DMSA. Size separation of the urine by ultracentrifugation and sodium dodecyl sulfate polyacrylamide gel electrophoresis demonstrated that in megalin/cubilin-deficient mice an increased amount of (99m)Tc-DMSA was excreted in an approximately 27-kDa form, which by mass spectrometry was identified as the plasma protein α1-microglobulin, an established megalin/cubilin ligand., Conclusion: (99m)Tc-DMSA is filtered bound to α1-microglobulin and accumulates in the kidneys by megalin/cubilin-mediated endocytosis of the (99m)Tc-DMSA protein complex. Renal accumulation of (99m)Tc-DMSA is thus critically dependent on megalin/cubilin receptor function and therefore is a marker of proximal tubule endocytic activity.

Published
2013
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27. Characterization of pulmonary lesions in patients with suspected lung cancer: computed tomography versus [¹⁸F] fluorodeoxyglucose-positron emission tomography/computed tomography.

Author

Harders SW, Madsen HH, Hjorthaug K, Arveschoug AK, Rasmussen TR, Meldgaard P, Andersen JB, Pilegaard HK, Hager H, Rehling M, and Rasmussen F

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Lung Neoplasms diagnostic imaging, Lung Neoplasms pathology, Male, Middle Aged, Reproducibility of Results, Fluorodeoxyglucose F18, Lung pathology, Lung Neoplasms diagnosis, Multimodal Imaging methods, Positron-Emission Tomography, Radiopharmaceuticals, Tomography, X-Ray Computed methods
Abstract

Pulmonary nodules are of high clinical importance, given they may prove to be an early manifestation of lung cancer. Pulmonary nodules are small, focal, radiographic opacities that may be solitary or multiple. A solitary pulmonary nodule is a single, small (<-30 mm in diameter) opacity. Larger opacities are called masses and are often malignant. As imaging techniques improve and more nodules are detected, the optimal management of pulmonary nodules remains unclear. However, the question of malignancy of any given nodule remains the same. A standard contrast-enhanced computed tomography (CT) scan is often the first examination, followed by a number of other examinations. The purpose of this study was to examine the clinical feasibility of CT versus integrated [18F]fluorodeoxyglucose-positron emission tomography (PET)/low-dose CT scan in patients with suspected lung cancer and pulmonary lesions on CT. All results were controlled for reproducibility. We found that when used early in the work-up of the lesions, CT raised the prevalence of lung cancer in the population to the point where further diagnostic imaging examination could be considered futile. We also found that the overall diagnostic accuracy, as well as the classification probabilities and predictive values of the two modalities were not significantly different; the reproducibility of these results was substantial.

Published
2012
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28. The value of HRCT and Tc-depreotide in the evaluation of pulmonary lesions.

Author

Rasmussen K, Madsen HH, Rasmussen F, Rasmussen TR, Baandrup U, Pilegaard HK, Pedersen U, Palshof T, and Rehling M

Subjects
Adult, Aged, Aged, 80 and over, False Negative Reactions, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms pathology, Male, Middle Aged, Radionuclide Imaging, Receptors, Somatostatin analysis, Sensitivity and Specificity, Lung Neoplasms diagnostic imaging, Organotechnetium Compounds, Somatostatin analogs & derivatives, Tomography, X-Ray Computed
Published
2006

29. Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy.

Author

Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, and Mogensen CE

Subjects
Albuminuria, Female, Humans, Male, Middle Aged, Permeability, Regression Analysis, Tomography methods, Blood Vessels physiopathology, Diabetes Mellitus, Type 2 physiopathology, Diabetic Retinopathy physiopathology, Macular Degeneration physiopathology
Abstract

Objective: Diabetic maculopathy (DMa) is the most prevalent sight-threatening type of retinopathy in type 2 diabetes and a leading cause of visual loss in the western world. The disease is characterized by hyperpermeability of retinal blood vessels and subsequent formation of hard exudates and macular edema, the degree of which can be estimated by measurement of retinal thickness. We examined associations between retinal thickness as evaluated by optical coherence tomography scanning (OCT), glomerular leakage as evaluated by urinary albumin excretion rate (UAE), and general vascular leakage as evaluated by the transcapillary escape rate of albumin (TER(alb)) in type 2 diabetic patients with and without DMa., Research Design and Methods: In 20 type 2 diabetic patients with DMa and 20 type 2 diabetic patients without retinopathy matched for age, sex, and duration of diabetes, we performed OCT, fundus photography, fluorescein angiography, and 24-h ambulatory blood pressure measurement. UAE was determined by radioimmunoassay. TER(alb) was determined as the initial disappearance of intravenously injected (125)I-labeled human serum albumin., Results: Patients with diabetic maculopathy had higher HbA(1c) (8.5 +/- 1.5 vs. 7.4 +/- 1.2%, P < 0.05) and higher total cholesterol (5.8 +/- 0.7 vs. 5.2 +/- 0.9 mmol/l, P < 0.05) than patients without retinopathy. UAE was higher in the DMa group than in the group with no retinopathy (9.3 x// 3.1 vs. 3.9 x// 1.9 micro g/min, P < 0.01). There was no difference in TER(alb) between the two groups (6.0 +/- 1.6 vs. 6.6 +/- 1.5%, NS). In the group with DMa, OCT, TER(alb), and UAE correlated significantly (OCT versus TER(alb): r = 0.55, P < 0.05; OCT versus UAE: r = 0.58, P < 0.01; UAE versus TER(alb): r = 0.81, P < 0.01). Conversely, there were no correlations between these three parameters in the group without retinopathy., Conclusions: Macular edema seems to reflect a generalized vascular leakage in type 2 diabetic patients.

Published
2002
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30. Use of plasma clearance of technetium Tc 99m pentetate to estimate renal clearance during postnatal development in pigs.

Author

Eskild-Jensen A, Rehling M, Nielsen AS, Nielsen LE, and Frøkiaer J

Subjects
Animals, Body Weight physiology, Female, Glomerular Filtration Rate veterinary, Radiopharmaceuticals blood, Radiopharmaceuticals urine, Technetium Tc 99m Pentetate blood, Technetium Tc 99m Pentetate urine, Kidney metabolism, Radiopharmaceuticals pharmacokinetics, Swine metabolism, Technetium Tc 99m Pentetate pharmacokinetics
Abstract

Objective: To compare renal clearance of technetium Tc 99m pentetate with plasma clearance by use of a glomerular filtration rate technique in pigs from 3 to 24 weeks of age., Animals: 24 female pigs., Procedure: At the time of investigation, 5 pigs were 3 weeks old, 6 pigs were 6 weeks old, 8 pigs were 12 weeks old, and 5 pigs were 24 weeks old. Plasma clearance of technetium Tc 99m pentetate was measured by the use of a single injection technique followed by collection of multiple blood samples until 5 hours after the injection. Simultaneously, urine was collected through a urinary catheter, and the renal clearance of technetiumTc 99m pentetate was calculated. Plasma clearance of technetium Tc 99m pentetate was correlated with the renal clearance (r = 0.95). Plasma clearance was higher than renal clearance at all ages (mean, 5.8%), indicating extrarenal clearance of technetium Tc 99m pentetate or methodologic errors. Volume of distribution increased with increasing age but decreased as a fraction of body weight., Conclusions: Plasma clearance of technetium Tc 99m pentetate estimates renal clearance with acceptable precision when using single injection technique and multiple biood samples in pigs from 3 to 24 weeks of age.

Published
2002
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31. Functional significance of recruitable collaterals during temporary coronary occlusion evaluated by 99mTc-sestamibi single-photon emission computerized tomography.

Author

Sand NP, Rehling M, Bagger JP, Thuesen L, Flø C, and Nielsen TT

Subjects
Angina Pectoris complications, Angioplasty, Balloon, Coronary, Coronary Disease diagnostic imaging, Coronary Disease therapy, Coronary Vessels diagnostic imaging, Electrocardiography, Female, Hemodynamics, Humans, Injections, Intravenous, Male, Middle Aged, Prognosis, Prospective Studies, Reproducibility of Results, Collateral Circulation physiology, Coronary Circulation physiology, Coronary Disease physiopathology, Coronary Vessels physiopathology, Radiopharmaceuticals administration & dosage, Technetium Tc 99m Sestamibi administration & dosage, Tomography, Emission-Computed, Single-Photon
Abstract

Objectives: The present study evaluated the impact of recruitable collaterals on regional myocardial perfusion measured by 99mtechnetium (Tc)-sestamibi single-photon emission computerized tomography (SPECT) during temporary coronary occlusion and related these estimates to the coronary wedge pressure and electrocardiographic (ECG) ST-segment changes., Background: Clinical variables (angina and ECG changes) and intracoronary flow and pressure recordings have indicated a protective role of recruitable collaterals on myocardial perfusion during percutaneous transluminal coronary angioplasty (PTCA)., Methods: Thirty patients (mean age 55 years, SD 9; 20 men) with stable angina pectoris and proximal nonocluding single-vessel left anterior descending coronary artery (LAD)-stenosis scheduled for PTCA were included. Visualization of recruitable collaterals by ipsilateral and contralateral contrast injection, registration of coronary wedge pressure and injection of 99mTc-sestamibi during 90-s LAD occlusions were undertaken. A rest perfusion study was performed within four days before PTCA. As an estimate of the severity of regional hypoperfusion during occlusion, an occlusion/rest count ratio was calculated (mean defect pixel count during occlusion divided by mean pixel count in identical regions at rest)., Results: The scintigraphic occlusion/rest count ratio was higher in patients with recruitable collaterals (n = 16), 67 +/- 11%, compared to patients without collaterals (n = 14), 60 +/- 6% (p < 0.05). The occlusion/rest count ratio correlated with the coronary wedge pressure (R2 = 0.34; p < 0.001). The occlusion/rest count ratio was lower, 61 +/- 6%, in patients with ST-segment elevation (n = 23) versus 74 +/- 9% in patients without ST-segment elevation (n = 7) (p < 0.0001)., Conclusions: Using 99mTc-sestamibi SPECT imaging during brief episodes of coronary occlusion, the severity of regional myocardial hypoperfusion was reduced by the presence of recruitable collaterals in a selected patient population with proximal LAD stenoses. Our results demonstrate a protective effect of recruitable collaterals on myocardial perfusion during temporary coronary occlusion.

Published
2000
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32. Chromium-51-EDTA clearance in adults with a single-plasma sample.

Author

Mårtensson J, Groth S, Rehling M, and Gref M

Subjects
Adult, Age Factors, Aged, Body Surface Area, Chromium Radioisotopes administration & dosage, Chromium Radioisotopes blood, Edetic Acid administration & dosage, Edetic Acid blood, Humans, Injections, Intravenous, Metabolic Clearance Rate, Middle Aged, Models, Biological, Radiopharmaceuticals blood, Radiopharmaceuticals pharmacokinetics, Regression Analysis, Reproducibility of Results, Technetium Tc 99m Pentetate blood, Technetium Tc 99m Pentetate pharmacokinetics, Time Factors, Chromium Radioisotopes pharmacokinetics, Edetic Acid pharmacokinetics, Glomerular Filtration Rate, Kidney physiology
Abstract

Unlabelled: In 1996, a committee on renal clearance recommended a mean sojourn time-based methodology for single-sample determination of plasma clearance of 99mTc-diethylenetriamine pentaacetic acid (DTPA) to be used on adults if the patient's glomerular filtration rate (GFR) is suspected to be >30 ml/min. The main purpose of this study was to derive a mean sojourn time-based formula for calculation of 51Cr-ethylenediamine tetraacetic acid (EDTA) clearance in adults., Methods: Two groups of patients with 51Cr-EDTA clearance (Cl) between 16 and 172 ml/min were studied. In Group I (n = 46), reference Cl was determined as a multiplasma sample, single-injection method (ClSM). Sixteen blood samples were drawn from 0 until 5 hr after a single intravenous injection of 51Cr-EDTA. In Group II (n = 1046), reference Cl was determined by the Brøchner-Mortensen four-sample clearance method (ClBM). The plasma time-activity curves of Group I were used to derive two mean sojourn time-based formulas (Formulas 1 and 2) for calculation of a single-sample clearance. Formula 1 was derived from the entire time-activity curve, whereas the derivation of Formula 2 used only the final slope of the time-activity curve. The accuracy of the two formulas and the Christensen and Groth 99mTc-DTPA formula was tested on Group II., Results: Chromium-51-EDTA Cl calculated by Formula 1 was almost identical to the Cl calculated by the reference Cl method (r = 0.982; SDdiff = 5.82 ml/min). Both 51Cr-EDTA Cl calculated by Formula 2 and by the 99mTc-DTPA formula showed close correlation with the reference method (r = 0.976, r = 0.985, respectively) but systematically overestimated GFR for the whole range of clearance values by 3.5 and 3.2 ml/min (p<0.001), respectively., Conclusion: It is possible to get an accurate determination of 51Cr-EDTA Cl from a single-plasma sample in adults by the mean sojourn time methodology. The determination is marginally more accurate (p<0.001) if using a formula derived from the entire plasma time-activity curve than from only the final slope. The single-sample formula derived for determination of 99mTc-DTPA Cl tends slightly to overestimate GFR if used to calculate 51Cr-EDTA Cl.

Published
1998

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