Back muscle as a promising site for ovarian tissue transplantation, an animal model

BACKGROUND: The aim of this study was to evaluate the optimal transplantationsite for ovarian tissue fragments in murine hosts. We comparedthe transplantation to the back muscle (B) versus the kidneycapsule (K) in a mouse allograft model. METHODS: Hemi-ovaries from 12-day-old mice were allografted into B andK of bilaterally ovariectomized same strain recipients whichhad undergone gonadotrophin stimulation (n = 15). Graft survivalafter 27 days, angiogenesis and follicle development were scoredand compared to age-matched control ovaries (38-day old, n =5). The ability of oocytes to be fertilized was studied afterIVF, ICSI and embryos were transferred to recipient mothers.Anti-mouse CD 31+ antibody was used to evaluate neo-vascularizationin grafts. RESULTS: Primordial follicle survival was higher (P < 0.01) and vascularsupport was better (P < 0.01) in B- than in K-grafts. From34 oocytes retrieved from B-grafts (15 metaphase I, of which14 matured in vitro, and 19 collected at metaphase II), 18 morulaewere obtained. Transfer of 12 embryos obtained by ICSI led tothree live offspring, and transfer of six IVF embryos to anotherrecipient mother yielded four offspring, one of which was borndead and one showed placental anomalies. CONCLUSIONS: The back muscle is a promising site for ovarian allografts inmice. This is the first report of live offspring obtained afterback muscle grafting using both IVF and ICSI.     

Cardiac fluorine-18 fluorodeoxyglucose imaging using a dual-head gamma camera with coincidence detection: a clinical pilot study

Dual-headed gamma cameras with coincidence detection (MCD) are increasingly used for imaging of positron-emitting tracers, such as fluorine-18 fluorodeoxyglucose (FDG). In this study, we examined differences between FDG MCD and FDG positron emission tomography (PET) as the gold standard to determine whether FDG MCD could be used for assessment of myocardial viability in daily practice. Nineteen patients with a previous myocardial infarction (17 men; mean left ventricular ejection fraction 44%±13%) underwent FDG MCD, FDG PET, resting echocardiography and technetium-99m tetrofosmin gated single-photon emission tomography (SPET). At the 50% threshold value for FDG PET, the area under the receiver operating characteristic curve for FDG MCD was 0.77±0.03. In 107 dyssynergic segments on echocardiography and 151 segments with hypoperfusion on ^99mTc-tetrofosmin SPET, the specificity of FDG MCD for the detection of myocardial viability was 72% and 76% respectively, with a sensitivity of 69% and 72% respectively. Regional analysis showed a significantly lower agreement of FDG MCD and FDG PET in the inferior and septal regions (58% for dyssynergic segments and 65% for segments with hypoperfusion), as compared with the other regions (85% for dyssynergic regions, P<0.05, and 86% for segments with hypoperfusion, P<0.05). Five patients (26%), who all had a body mass index ≥25% kg/m², showed more than 25% disagreement between FDG MCD and FDG PET. Because of the moderate overall agreement with FDG PET, the low sensitivity in akinetic or dyskinetic regions and the low agreement in the inferior and septal regions, further studies and implementations of technical developments are needed before FDG MCD can be introduced into clinical practice for the assessment of myocardial viability. Received 4 December 1999 and in revised form 5 February 2000     

Biodistribution and dosimetry of (iodine-123)-iodomethyl-N, N-diethyltamoxifen, an (anti)oestrogen receptor radioligand.

This study reports on the distribution and radiation dosimetry of iodine-123 labelled trans-Z-iodomethyl-N,N-diethyltamoxifen (123-ITX), a promising radioligand for prediction of the therapeutic efficacy of unlabelled tamoxifen in human breast carcinoma. Whole-body scans were performed up to 24 h after intravenous injection of 123-ITX (mean: 146 MBq, range: 142-148 MBq) in five female volunteers, four with and one without thyroid blockade. Blood samples were taken at various times up to 24 h after injection. Urine was also collected up to 24 h after injection, allowing calculation of renal clearance and interpretation of whole-body clearance. Time-activity curves were generated for the thyroid, heart, brain, breasts, liver and gallbladder by fitting the organ-specific geometric mean counts, obtained from regions of interest. The MIRD formulation was applied to calculate the absorbed radiation doses for various organs. The images showed rapid hepatobiliary excretion, resulting in good imaging conditions for the thoracic region, whereas imaging of the abdominal region was impeded by extensive bowel activity. The breast to non-specific uptake ratio increased over time. 123-ITX was cleared by both the kidneys and the gastrointestinal tract. At 50 h p.i. the mean excretion in the urine was 89.4% (SD 5.7%). If the thyroid was not blocked, it was one of the critical organs. The highest absorbed doses were received by the excretory organs, i.e. the urinary bladder wall, the lower and upper large intestine, and the gallbladder wall. The average effective dose of 123-ITX was estimated to be 0.0084 mSv/MBq. The amount of 123-ITX required for adequate imaging of tumoral uptake results in an acceptable effective dose to the patient.     

Using multi-stimulus VEP source localization to obtain a retinotopic map of human primary visual cortex.

OBJECTIVE: The goal of this study was to acquire a detailed spatial and temporal map of primary visual cortex using a novel VEP stimulus and analysis technique. METHODS: A multi-stimulus array spanning the central 18 degrees of the visual field was used where each of 60 checkerboard stimulus 'patches' was simultaneously modulated with an independent binary m-sequence (Sutter, 1992). VEPs corresponding to each patch were recorded from 3 subjects using a dense posterior electrode array. For each stimulus patch, single dipole source localization was conducted to determine the location, magnitude, and time-function of the underlying neural activation. To reduce ambiguity in the solution, a common time-function was assumed for stimulus patches at the same visual eccentricity (defining an annulus). The analysis was conducted independently for each annulus composed of 4-12 patches. RESULTS: The loci of the dipole solutions followed a smooth retinotopic pattern across annuli consistent with the classical organization of primary visual cortex. Specifically, each dipole was found contralateral to the corresponding stimulus patch and field inversion was observed for all subjects. CONCLUSIONS: Using this technique, the most detailed spatial and temporal retinotopic map of primary visual cortex to date has been obtained.     

Poliomyelitis prevention in the United States. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP).

These recommendations of the Advisory Committee on Immunization Practices (ACIP) for poliomyelitis prevention replace those issued in 1997. As of January 1, 2000, ACIP recommends exclusive use of inactivated poliovirus vaccine (IPV) for routine childhood polio vaccination in the United States. All children should receive four doses of IPV at ages 2, 4, and 6-18 months and 4-6 years. Oral poliovirus vaccine (OPV) should be used only in certain circumstances, which are detailed in these recommendations. Since 1979, the only indigenous cases of polio reported in the United States have been associated with the use of the live OPV. Until recently, the benefits of OPV use (i.e., intestinal immunity, secondary spread) outweighed the risk for vaccine-associated paralytic poliomyelitis (VAPP) (i.e., one case among 2.4 million vaccine doses distributed). In 1997, to decrease the risk for VAPP but maintain the benefits of OPV, ACIP recommended replacing the all-OPV schedule with a sequential schedule of IPV followed by OPV. Since 1997, the global polio eradication initiative has progressed rapidly, and the likelihood of poliovirus importation into the United States has decreased substantially. In addition, the sequential schedule has been well accepted. No declines in childhood immunization coverage were observed, despite the need for additional injections. On the basis of these data, ACIP recommended on June 17, 1999, an all-IPV schedule for routine childhood polio vaccination in the United States to eliminate the risk for VAPP. ACIP reaffirms its support for the global polio eradication initiative and the use of OPV as the only vaccine recommended to eradicate polio from the remaining countries where polio is endemic.     

Comparison of tendency-oriented perimetry and dynamic strategy in octopus perimetry as a screening tool in a clinical setting: a prospective study

OBJECTIVE: The aim of this study was to compare the results of tendency-oriented perimetry (TOP) and a dynamic strategy in octopus perimetry as screening methods in clinical practice. DESIGN: A prospective single centre observational case series was performed. PARTICIPANTS AND METHODS: In a newly opened general ophthalmologic practice 89 consecutive patients (171 eyes) with a clinical indication for octopus static perimetry testing (ocular hypertension or suspicious optic nerve cupping) were examined prospectively with TOP and a dynamic strategy. The visual fields were graded by 3 masked observers as normal, borderline or abnormal without any further clinical information. RESULTS: 83% eyes showed the same result for both strategies. In 14% there was a small difference (with one visual field being abnormal or normal, the other being borderline). In only 2.9% of the eyes (5 cases) was there a contradictory result. In 4 out of 5 cases the dynamic visual field was abnormal and TOP was normal. 4 of these cases came back for a second examination. In all 4 the follow-up examination showed a normal second dynamic visual field. CONCLUSIONS: Octopus static perimetry using a TOP strategy is a fast, patient-friendly and very reliable screening tool for the general ophthalmological practice. We found no false-negative results in our series.     

Intravitreal triamcinolone acetonide for serous retinal pigment epithelial detachments in exudative age-related macular degeneration

BACKGROUND: Due to the high risk of RPE tears PDT is usually not performed in eyes with serous RPE detachments (sRPED). For this reason this subform of exudative AMD was so far untreatable. PATIENTS AND METHODS: We report on a prospective uncontrolled observational case series. 20 eyes of 20 patients with subfoveal sRPED demonstrated by OCT were treated between June 2005 and April 2006 with intravitreal triamcinolone acetonide (IVTA). In 15 cases there was a primary sRPED, in 5 cases it had developed after one or more sessions of photodynamic therapy with Visudyne. RESULTS: There was a trend for better average visual acuity in the group with primary sRPED from 0.73 logMAR (0.19 Snellen equivalent) at baseline (n = 15) to 0.68 logMAR (0.21 Snellen) after one month (n = 15) (p = 0.19) and to 0.60 logMAR (0.25 Snellen) after three months (n = 14) (p = 0.41). The maximal height of sRPED decreased to an average of 35.3 % after one month (n = 15) and increased again to 56.9 % after 3 months (n = 14). One patient was lost to follow-up. In the group of eyes with sRPED after PDT, one eye developed an RPE tear with severe vision loss two weeks after IVTA. In the remaining four eyes average visual acuity improved from 0.90 logMAR (0.13 Snellen) at baseline to 0.73 logMAR (0.19 Snellen) after one month and to 0.80 logMAR (0.16 Snellen) after 3 months. Complete resolution of sRPED was observed in 8/20 eyes (4/5 eyes with sRPED after PDT and 4/15 eyes with primary sRPED). CONCLUSIONS: IVTA seems to be a therapeutic option in otherwise untreatable eyes with sRPED.