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Background Patients with pancreatic cancer have an unfavourable prognosis. A central role in pancreatic cancer progression has been suggested for tissue factor (TF), the main initiator of the blood coagulation cascade. We hypothesized that elevated levels of plasma microparticle (MP)-associated TF activity might indicate the presence of poorly differentiated pancreatic cancer, disease dissemination and infiltration of peripancreatic vessels. Methods MP-TF activity was measured in 73 pancreatic cancer patients and 22 healthy controls. Abdominal computerized tomography (CT) scans performed at study inclusion were investigated for probability of tumoural vascular invasion. In addition, intratumoural TF expression, D-dimer and CA 19-9 levels were determined. Results MP-TF activity (pg/mL) was significantly higher in patients (median: 0·37 [range: 0·00–11·91]) than in controls (median: 0·05 [range: 0·00–0·76]; P

OBJECTIVE: To examine the effect of a 4-month progressive strength training program on muscle and fat mass assessed by computed tomography (CT) in type 2 diabetes mellitus (T2DM) patients, and to assess the relationships of changes in muscle cross-section area (CSA) with glycaemic control. METHODS: Twenty adults (mean age ± SE: 56.4 ± 0.9 a) with T2DM participated in a supervised strength training program for 4 months 3 days/week. Muscle and fat areas of the quadriceps muscle were estimated by CT volumetry before and immediately after the training. Glycaemic (HbA1c) and anthropometric (BMI, skinfolds) measurements were assessed at 0 and 4 months, respectively. RESULTS: After strength training, muscle strength increased significantly in all measured muscle groups. Quadriceps size (CSA of the muscle) was increased by 2.4% (from 7.99 ± 0.3 cm3 to 8.18 ± 0.3 cm3, p = 0.003) for the right extremity, 3.9% (from 8.1 ± 0.4 cm3 to 8.41 ± 0.5 cm3, p = 0.04) for the left side. Fat tissue CSA reduced from 0.66 ± 0.1 cm3 to 0.56 ± 0.12 cm3 for the right leg (15.3% reduction) and from 0.58 ± 0.12 cm3 to 0.37 ± 0.13 cm3 for the left leg (35.8% reduction), resulting in a mean fat CSA reduction of 24.8%. Fat mass assessed by skin folds was significantly reduced and lean body mass was significantly increased. The change in muscle CSA was not correlated with the changes in HbA1c or muscle strength. CONCLUSIONS: Strength training significantly improves both muscle mass and the muscle to fat ratio in T2DM. However, changes in muscle observed with computed tomography were not related to changes observed in HbA1c with training.

Objective: To compare the effects of a 4-month strength training (ST) versus aerobic endurance training (ET) program on metabolic control, muscle strength, and cardiovascular endurance in subjects with type 2 diabetes mellitus (T2D). Design: Randomized controlled trial. Setting: Large public tertiary hospital. Participants: Twenty-two T21) participants (I I men, I I women; mean age +/- standard error, 56.2 +/- 1.1 y; diabetes duration, 8.8 +/- 3.5y) were randomized into a 4-month ST program and 17 T2D participants (9 men, 8 women; mean age, 57.9 +/- 1.4y; diabetes duration, 9.2 +/- 1.7y) into a 4-month ET program. Interventions: ST (up to 6 sets per muscle group per week) and ET (with an intensity of maximal oxygen consumption of 60% and a volume beginning at 15min and advancing to a maximum of 30min 3X/wk) for 4 months. Main Outcome Measures: Laboratory tests included determinations of blood glucose, glycosylated hemoglobin (Hb A(1c)), insulin, and lipid assays. Results: A significant decline in Hb A, was only observed in the ST group (8.3% +/- 1.7% to 7.1% +/- 0.2%, P=.001). Blood glucose (204 +/- 16mg/dL to 147 +/- 8mg/dL, P

It is the purpose of this review to provide information about the safe use of intravenously administered, iodinated, non-ionic, low or isoosmolar contrast media for radiological examinations, how to avoid adverse events, and how to react professionally in case of an anaphylactic reaction. Methods of prophylaxis and therapy for anaphylactic and chemotoxic effects of contrast media administration as well as absolute and relative contraindications are discussed. Medico-legal considerations of contrast agent administration, informed consent of patients, and methods of risk management for undesired contrast media reactions are considered in this article. Establishment of administration standards for contrast media is of tremendous importance to standardize radiological procedures. This basic radiological documentation is part of the institutional and individual legal safety management.

The purpose of this study was to retrospectively assess the detection rate of skull-base fractures for three different three-dimensional (3D) reconstruction methods of cranial CT examinations in trauma patients. A total of 130 cranial CT examinations of patients with previous head trauma were subjected to 3D reconstruction of the skull base, using solid (SVR) and transparent (TVR) volume-rendering technique and maximum intensity projection (MIP). Three radiologists independently evaluated all reconstructions as well as standard high-resolution multiplanar reformations (HR-MPRs). Mean fracture detection rates for all readers reading rotating reconstructions were 39, 36, 61 and 64% for SVR, TVR, MIP and HR-MPR respectively. Although not significantly different from HR-MPR with respect to sensitivity (P = 0.9), MIP visualised 18% of fractures that were not reported in HR-MPR. Because of the relatively low detection rate using HR-MPRs alone, we recommend reading MIP reconstructions in addition to the obligatory HR-MPRs to improve fracture detection.

Pulmonary MALT lymphoma is a rare disease entity and generally follows an indolent clinical course. Due to scarce information from randomized prospective trials, no standardized therapy protocols exist. Besides irradiation and chemotherapy, novel biological agents such as the anti CD20-antibody rituximab and thalidomide constitute a promising new approach. In this report we demonstrate the case of a 52-year-old male patient with extra-intestinal MALT lymphoma of the lung. After 10 months of treatment with low dose thalidomide (100mg/d), very good partial response of the intrapulmonary lesions was achieved.

Thrombopoietin (TPO) deficiency has been proposed as an important etiologic factor for thrombocytopenia in advanced-stage liver disease. To clarify the contributions of platelet production, platelet consumption, coagulation activation, and splenic sequestration to thrombocytopenia in liver disease, we studied TPO serum levels and markers of platelet production, platelet activation, and coagulation activation before and 14 days after orthotopic liver transplantation (OLT) in 18 patients with advanced liver cirrhosis. Thrombocytopenia before transplantation occurred with low-normal serum levels of TPO, normal levels of platelet and coagulation activation markers, and no increase in bone marrow production of platelets. TPO serum levels increased significantly on the first day after OLT, preceding the increase of reticulated platelets by 3 days and peripheral platelets by 5 days. Normalization of the peripheral platelet count occurred in most patients within 14 days of OLT, irrespective of the change in spleen size assessed by computed tomography volumetry. Normalization of platelet counts was not hampered by a certain degree of platelet activation observed during the steepest increase in the peripheral platelet count. Bone marrow production of platelets increased significantly within 2 weeks of transplantation. Low TPO serum levels with low platelet counts and without platelet consumption suggests low TPO production in end-stage liver disease. The rapid increase in TPO serum levels after transplantation induces an increase in the bone marrow production of platelets. Decreased TPO production in the cirrhotic liver is an important etiologic factor for thrombocytopenia in liver disease that is rapidly reversed by transplantation.