Quantitative assessment of pulmonary edema by nuclear magnetic resonance methods

Journal ArticleConsiderable progress has been made in the application of nuclear magnetic resonance (NMR) imaging and nonimaging techniques to the quantitative assessment of pulmonary edema. NMR measurements offer the advantages of being noninvasive, relatively rapid, and easily repeatable. In addition, NMR imaging is suitable for the determination of lung water distribution. Studies of various animal models have shown that NMR techniques can adequately detect and quantify relative changes in lung water content and distribution in various types of experimental lung injury. Preliminary observations in humans suggest that NMR measurement of relative lung water changes in clinical pulmonary edema should be feasible. Although the application of NMR to the assessment of pulmonary edema appears to be very promising, it also poses significant problems that must be solved before it can be established as a standard experimental and clinical method

Determination of lung water content and distribution by nuclear magnetic resonance imaging

Journal ArticleNMR imaging techniques are applicable to the assessment of lung water content and distribution because the NMR signal is, under certain conditions, proportional to tissue proton density. NMR imaging is noninvasive, easily repeatable, free from ionizing radiation, and particularly suitable for the assessment of spatial lung water distribution. Lung water content and distribution have been estimated in excised animal lungs and in intact dead or living animals, under normal conditions and in various types of experimental pulmonary edema. Excised human lungs arid human subjects have also been studied. Published data indicate that measurements of lung water content by NMR imaging techniques are feasible. These techniques estimate lung water spatial distribution with satisfactory accuracy and excellent resolving power. The application of NMR imaging techniques poses several problems and limitations, but available data suggest that most of the problems can be solved. NMR imaging has the potential to become a powerful tool for lung water research. Prospects of clinical application are also encouraging; numerous applications can be foreseen, although lack of mobility of NMR imaging systems may be a significant limitation in critical care medicine

Effect of opiate receptor blockade on the insulin response to oral glucose load in polycystic ovarian disease

In order to test the hypothesis that endogenous opiates are at least partially responsible for hyperinsulinaemia in patients with polycystic ovarian disease (PCOD), the effect of naloxone (an opiate receptor blocker) on the insulin response to oral glucose load (OGTT) was studied in 20 women with PCOD and 17 control subjects at days 5-8 of their follicular phase. After fasting overnight for 10-12 h, each woman received an i.v. bolus injection (2 mg) of naloxone or an equal volume of saline infusion followed by a constant infusion of naloxone or saline solution at a rate of 8 ml/h (1 mg/h of naloxone) for 5 h. OGTT (75 g) was performed 1 h after the bolus injection. The naloxone study was performed 48 h after the saline study. Naloxone did not modify the insulin response to OGTT in either group. When the data were related to the insulin response, in PCOD hyperinsulinaemic patients, naloxone significantly reduced (P less than 0.02) the insulin response to OGTT without any change in glycaemic response curves. In control and PCOD normoinsulinaemic patients, naloxone did not change significantly either the glycaemia or the insulin levels after OGTT. No change of gonadotrophin and steroid secretion was found in any patient receiving naloxone. In conclusion, endogenous opiates may play a significant role in hyperinsulinaemia in PCO

Preoperative work-up for definition of lymph node risk involvement in early stage endometrial cancer: 5-year follow-up

This prospective cohort study aimed to analyze the accuracy of magnetic resonance imaging (MRI) and hysteroscopic excisional biopsy (HEB) for predicting the low- and high-risk patients with endometrial carcinoma for nodal involvement at preoperative evaluation. From January 2005 to December 2006, all patients with a diagnosis of endometrial carcinoma were prospectively included in the study and underwent pelvic MRI and HEB. The pelvic MRI (without contrast) was aimed to evaluate the extent of myometrial invasion (MI < 50%, MI ≥ 50%), the possible involvement of cervical stroma, the ovarian, and lymph nodes status. HEB was performed under general anesthesia, retrieving multiple biopsies through a 5-mm, monopolar, loop electrode. According to our data analysis, the integration of MRI and HEB showed an elevated accuracy and high rates of sensitivity (85.0%), specificity (88.5%), negative predictive value (91.9%) and positive predictive value (79.0%) in identifying low-risk patients who do not need comprehensive surgical staging