Detection and characterisation of renal lesions by multiphasic helical CT

Purpose: The fast helical CT technique allows examination of the kidneys during different phases of contrast medium enhancement. However, every additional phase increases the radiation dosage to the patients. We investigated the detection rate and characterisation of renal lesions during different phases and evaluated them separately, and considered the possibility of excluding phases without loss of important information.Material and Methods: Sixty patients who underwent contrast-enhanced multiphasic renal helical CT examination were included. Every CT phase was evaluated separately. The number of lesions and the characteristics of the lesions were noted and all lesions were viewed together.Results: A total of 153 cysts and 17 solid lesions were detected. The largest and an equal number of cysts (142/143) was detected in the nephrographic and excretory phases. However, the nephrographic phase detected more cortical cysts and the excretory phase detected more sinus cysts. All solid lesions were detected in all phases. Renal parenchymal tumours were best characterised in the cortical phase and angiomyolipomas in the native phase.Conclusion: The cortical phase was best for characterisation of renal parenchymal tumours. The nephrographic and excretory phases were best in detecting and characterising renal cysts. The nephrographic phase was the phase giving the least diagnostic information.     

CGMP increases in satellite cells of nitric oxide synthase-containing sensory ganglia

cGMP and the enzymes, nitric oxide synthase (NOS) and heme oxygenase-1 (HO-1), the products of which stimulate soluble guanylyl cyclase activity, were investigated in cultured dorsal root ganglia (DRG), and nodose ganglia of adult rats. A dramatic increase of cGMP-positive satellite cells in ganglia cultured for 24 or 48 h was observed, particularly in Th8-L2 DRG and in nodose ganglia. These ganglia also contained most NOS-positive neurones, as reflected by NADPH-diaphorase histochemistry. HO-1 immunoreactivity increased in satellite cells, but in different cells to those in which cGMP increased. These results suggest that both NO and CO could be involved in signalling between neurones and satellite cells in sensory ganglia during regeneration.     

The effects of galvanic stimulation on the human vestibulo-ocular reflex

We studied the effects of 5 mA bilateral or unilateral, bipolar or monopolar, galvanic stimulation on the horizontal vestibulo-ocular reflex (hVOR) in six normal subjects during 0.01, 0.05, 0.1, 0.5 and 1 Hz yaw rotations and in two subjects during high-acceleration, low-amplitude yaw head rotations (head impulses). Bipolar galvanic stimulation induced horizontal nystagmus in all subjects and an asymmetry of the hVOR only during rotations below 0.1 Hz. Monopolar stimulation had no significant effect. The findings suggest that in humans galvanic stimulation affects those primary horizontal semicircular canal neurons that mediate the hVOR via indirect pathways through the velocity storage mechanism.     

Conserved epitopes in human and mouse tissue-nonspecific alkaline phosphatase. Second report of the ISOBM TD-9 workshop.

A panel of 19 monoclonal antibodies (MAbs) against human tissue-nonspecific (liver/bone/kidney) alkaline phosphatase (TNAP) was obtained through the ISOBM TD-9 workshop. In the present study, the reactivity of these MAbs has been characterized against mouse TNAP. A mouse embryonic stem cell line, frozen sections of long bones, alkaline phosphatase extracted from mouse bone, and serum were used as the source of TNAP for individual assays. Each MAb was tested for immunoreactivity to mouse TNAP by Western blot analysis, immunohistochemistry and enzyme immunoassay. Antibodies 314 and 315 reacted strongly with mouse TNAP in Western blots, while all other antibodies were negative. By immunohistochemistry, antibodies 314, 315 and 333 produced strong positive staining using frozen sections, while antibody 334 was moderately positive. Enzyme immunoassays indicated that MAb 333 was also able to bind to serum TNAP. These antibodies represent very useful reagents to study the pathophysiological expression of TNAP in mouse tissues and in mouse serum.     

Five-year Longitudinal Study of Signs and Symptoms of Mandibular Dysfunction in Adolescents

A longitudinal study covering five years of clinical signs and subjective symptoms of mandibular dysfunction was performed in 119 adolescents, 15 years old at the first examination and 20 years old at the follow-up. Sixty-two percent had clinical signs of mandibular dysfunction, but the signs were in most cases mild, while moderate and severe signs were found in 17%. No change in clinical signs between the two examinations were noted in nearly half of the individuals, and improvement and impairment had occurred at an almost equal rate.

At the follow-up, 31% of the participants reported that they sometimes had TMJ sound, tiredness in the jaws, or difficulties in mouth opening, and another 8% suffered from one or more of these symptoms frequently. The frequency of subjective symptoms as well as reports of bruxism had increased statistically significantly compared with five years previously.

A statistically significant correlation was found between the subjective symptoms and the clinical dysfunction index used. No single subjective or clinical variable or combination of variables seemed to have any significant influence on the positive or negative changes of the clinical dysfunction index between the two examinations. The explanation suggested is that the development of clinical signs of mandibular dysfunction is very complex, including numerous variables, some of which were not recorded in the present investigation.     

Group sequential enrichment design incorporating subgroup selection

An important component of clinical trials in drug development is the analysis of treatment efficacy in patient subgroups (subpopulations). Because of concerns of multiplicity and of the small sample sizes often involved, such analyses can present substantial statistical challenges and may lead to misleading conclusions. As a confirmatory seamless phase II/III design, we propose an adaptive enrichment group sequential procedure whereby resources can be concentrated on subgroups most likely to respond to treatment. Stopping boundaries are defined through upper and lower spending functions. The procedure is presented in terms of the efficient score, enabling the analysis of normal, binary, or time‐to‐event data. It addresses the dilution effect by eliminating populations at the first stage that appear likely to derive no therapeutic benefit. It subsequently proceeds with the definitive assessment of treatment efficacy among the remaining pooled populations using a group sequential design. The procedure provides strong protection of familywise type I error rate, and we employ a bootstrap algorithm to obtain point and interval estimates that are adjusted for the selection bias. We give examples to demonstrate how the design is used. We make comparisons with adaptive two‐stage combination test procedures and with a group sequential test that does not account for the presence of subgroups. Numerical results show that the procedure has high power to detect subgroup‐specific effects and the use of multiple interim analysis points can lead to substantial sample size savings. Copyright © 2013 John Wiley & Sons, Ltd.