Radiation Dose Reduction in Computed Tomography-Guided Lung Interventions using an Iterative Reconstruction Technique.

PURPOSE: To compare the radiation doses and image qualities of computed tomography (CT)-guided interventions using a standard-dose CT (SDCT) protocol with filtered back projection and a low-dose CT (LDCT) protocol with both filtered back projection and iterative reconstruction. MATERIALS AND METHODS: Image quality and radiation doses (dose-length product and CT dose index) were retrospectively reviewed for 130 patients who underwent CT-guided lung interventions. SDCT at 120 kVp and automatic mA modulation and LDCT at 100 kVp and a fixed exposure were each performed for 65 patients. Image quality was objectively evaluated as the contrast-to-noise ratio and subjectively by two radiologists for noise impression, sharpness, artifacts and diagnostic acceptability on a four-point scale. RESULTS: The groups did not significantly differ in terms of diagnostic acceptability and complication rate. LDCT yielded a median 68.6% reduction in the radiation dose relative to SDCT. In the LDCT group, iterative reconstruction was superior to filtered back projection in terms of noise reduction and subjective image quality. The groups did not differ in terms of beam hardening artifacts. CONCLUSION: LDCT was feasible for all procedures and yielded a more than two-thirds reduction in radiation exposure while maintaining overall diagnostic acceptability, safety and precision. The iterative reconstruction algorithm is preferable according to the objective and subjective image quality analyses. KEY POINTS: Implementation of a low-dose computed tomography (LDCT) protocol for lung interventions is feasible and safe. LDCT protocols yield a significant reduction (more than 2/3) in radiation exposure. Iterative reconstruction algorithms considerably improve the image quality in LDCT protocols.

Gelatinase activities and haptoglobin concentrations in healthy and in degenerative articular cartilage of pigs.

The objectives of this study were to investigate the activity of the matrix metalloproteinase (MMP)-2 and MMP-9 in healthy and in degenerative cartilage and to characterize the relation with the acute phase protein haptoglobin (HP) in articular cartilages of pigs. Joint surfaces of the proximal and distal humerus and femur of fattening pigs were histopathologically classified. In addition, cartilage homogenates and synovia were obtained. The tissue homogenates were analysed for gelatinase activity by zymography and by activity assay. The concentrations of HP in cartilage homogenates, in synovia and in serum were analysed by ELISA. High enzymatic activity of the MMP-2 latent form was observed in zymography in all samples. Zymographic activities of MMP-2 active form and MMP-9 (active and latent form) were detected at low levels in some samples. Comparison of the zymographic activities of gelatinases in unaltered vs. altered cartilages yielded no differences. In contrast to zymography, cartilage homogenates were negative for MMP-2 and MMP-9 in the activity assays. The concentrations of HP in cartilage homogenates and in synovia from samples without alteration and from samples with massive alterations were not different. When classified according to their HP concentration, cartilage homogenates with increased HP concentrations had higher (p < 0.05) zymographic activities of the MMP-2 active form. For the two MMPs investigated, there was no detectable relationship with degenerative processes in the cartilage.

Short communication: Relationship between metabolic status and the milk concentrations of haptoglobin and lactoferrin in dairy cows during early lactation.

To investigate the relationship between metabolic status and the acute phase proteins haptoglobin (Hp) and lactoferrin (Lf) in milk, the concentrations of beta-hydroxybutyrate (BHBA), nonesterified fatty acids (NEFA) and Hp were determined in blood samples collected weekly from 4 wk prepartum until 12 wk postpartum. Haptoglobin and Lf were determined in weekly milk samples. The cows (n = 49) were retrospectively classified according to NEFA and BHBA concentrations using different time intervals and threshold values for NEFA and BHBA, respectively. For BHBA, 4 threshold concentrations, (0.8, 1.0, 1.2, and 1.6 mM) were evaluated either at the first week before calving, at wk 1 or 2 postpartum, or when considering the means of wk 2 and 3 postpartum. For NEFA, the tested thresholds were 0.5 and 0.6 mM at wk 1 prepartum, wk 1 or 2 postpartum, or the means of wk 1 and 2 postpartum. All variables showed changes during the interval of observation. Comparing the time course of the acute phase proteins in the subgroups classified according to BHBA or NEFA, consistently greater concentrations of Hp in serum and milk and of Lf in milk were observed in those animals with BHBA concentrations above 1.6 mM during the last week before calving (n = 3/47) than in those with BHBA concentrations below this threshold. For NEFA, analogous differences for Hp in both serum and milk (0.52 +/- 0.07 and 18.1 +/- 4.6 for NEFA >0.6 mM vs. 0.36 +/- 0.04 mg/mL and 8.46 +/- 1.63 microg/mL for NEFA <0.6 mM, respectively) and for Lf in milk (130 +/- 8.5 vs. 89.2 +/- 7.1 microg/mL, respectively) were detected when a threshold of 0.6 mM at wk 2 postpartum was used. Our results indicated that cows having BHBA and NEFA serum concentrations above these thresholds at defined times could be identified.

Individual variability in physiological adaptation to metabolic stress during early lactation in dairy cows kept under equal conditions.

This study was conducted to investigate individual metabolic and endocrine adaptation to lactation under conditions of identical housing and feeding conditions in high-yielding dairy cows. Forty-five cows were studied on a research farm under standardized but practical conditions. From wk 2 before calving until wk 14 postpartum, blood samples were collected at weekly intervals and assayed for blood chemistry and various metabolites and hormones. Body weight, BCS, and backfat thickness were also recorded weekly. Milk yield, milk composition, and feed intake and energy balance were accordingly measured during the postpartum phase. The animals were retrospectively classified according to their plasma concentration of beta-hydroxybutyrate (BHB): cows in which a BHB threshold of 1 mM was exceeded at least once during the experiment were classified as BHB positive (BHB+); cows with BHB values consistently below this threshold were classified as BHB negative (BHB -). Using this classification, differences for NEFA and glucose concentrations were observed, but the mean calculated energy balance did not differ between the groups during the experimental period (-22.2 MJ of NE(1)/d +/- 4.7 for BHB+ and -18.9 MJ of NE(1)/d +/- 4.9 for BHB-). In BHB+ cows, the peripartum decrease (P < 0.05) of BW, BCS, and backfat thickness was more pronounced than in BHB- cows. Mean milk yields did not differ between groups. However, BHB+ cows had greater milk fat and lesser milk protein contents (P < 0.05), resulting in a greater (P < 0.05) fat:protein ratio than in BHB- cows. Thus, to some extent, cows were able to compensate for the negative energy balance by adjustments in performance. Milk acetone concentrations followed BHB concentrations in blood. Insulin-like growth factor-I and leptin concentrations were greater (P < 0.05) in BHB- cows during the time of observation than in the BHB+ cows. Comparing the reproductive variables recorded (first increase of progesterone, first service conception rate, number of services per conception, interval from calving to first AI, interval from first AI to conception, and days open) between the 2 groups yielded no significant differences. Our findings imply that despite comparable energy balance, there is considerable individual variation of the adaptive ability of cows during early lactation based on a variety of metabolic and endocrine variables.

Immunohistochemical localization of haptoglobin in porcine lungs.

The extravasation of erythrocytes into the lower respiratory tract occurs in numerous lung injuries and may lead to oxidative damages in lung tissues. Haptoglobin (Hp), the major haemoglobin-binding protein, is known to reduce lung injury associated with exposure to blood in mice. In pigs, Hp is a major acute phase protein and its serum concentrations are elevated in various infections of the respiratory tract. However, information on the porcine Hp response towards inflammatory stimuli is restricted to blood. We herein investigated the presence of Hp in lung tissues from pigs with acute and chronic bronchopneumonia via immunohistochemistry. Hp was localized in airway epithelial cells and immigrated leucocytes whereas in alveolar epithelial cells there was no distinct signal. Unaltered lungs showed less Hp-positive cells compared with lungs from pigs with acute or chronic bronchopneumonia.

Effects of a dietary application of a yeast cell wall extract on innate and acquired immunity, on oxidative status and growth performance in weanling piglets and on the ileal epithelium in fattened pigs.

Potential immunomodulatory effects of a cell wall extract from Saccharomyces cerevisiae (Y; Antaferm MG) were tested in pigs: in trial I, 0.03% Y and in trial II 0.3% Y was used. Based on earlier observations that Y may increase feed intake, two treatment groups, Y-a (fed ad libitum) and Y-r (fed restrictively) were studied in comparison with a control group (C) in both trials. Y-r received the amount of feed consumed by C. Immune status was surveyed by determining phagocytic activity and oxidative burst of neutrophils and blood concentrations of haptoglobin (Hp), and immunoglobulin (Ig) G and A. Oxidative stress was monitored by recording reactive oxygen metabolites (ROM) and total antioxidant capacity. In a third trial, fattened pigs were used for morphological and immunohistochemical studies (IgM and IgA as well as CD4(+) and CD8(+) T cells) in ileal epithelium. Pigs fed 0.03% Y for 2 weeks prior to slaughter were compared with the C group. Feed intake was identical in the Y-a and Y-b groups and data subsets were accordingly pooled. Treatment and time as well as treatment x time interactions were detectable for most of the parameters studied, but a distinct immunomodulatory effect of Y was not consistently identifiable and performance did not improve. In trial III, the intestinal parameters investigated were not different between Y and C.

Evaluation of classification modes potentially suitable to identify metabolic stress in healthy dairy cows during the peripartal period.

The transition of pregnancy to lactation, with the concomitant negative energy balance during early lactation, requires substantial adaptive performance of the cow. Apart from clinical disease problems, the identification of cows with suboptimal adaptation is relevant to be able to adequately treat these animals or modify the ration. Effective approaches are necessary to provide maximal information at the earliest time possible. We therefore aimed to identify a measurement that, when applied at a defined point in time relative to calving, was relevant as much as possible to other information on metabolic and health status during early lactation. Blood samples were collected weekly from 4 wk antepartum to 12 wk postpartum from 38 high-yielding Holstein-Friesian cows. Nonesterified fatty acids, beta-hydroxybutyrate, IGF-I, and leptin were measured in serum, and BCS was recorded. Health status was characterized using the concentrations of haptoglobin, the number of leukocytes and neutrophils, as well as the activity of glutamate dehydrogenase (GLDH) in blood to evaluate liver status. Using the factors related to fat mobilization, the animals were classified according to their values recorded at one defined point in time or time interval as being above or below certain thresholds. For each criterion, the groups classified were compared with regard to the time-course yielded from all recordings. From 7 criteria of classification, the most closely related to the variables of fat mobilization was obtained when using NEFA and IGF-I (thresholds of 0.5 mM and 39 ng/mL in wk 1 postpartum, respectively). Both items were then combined into to the criterion NEFA + IGF-I. Applying these criteria, the relations to indices of health and liver status were detectable on the basis of NEFA- and NEFA + IGF-I-classes, which yielded differences in both GLDH and leukocyte numbers. Animals with NEFA > 0.5 mM showed increased GLDH activity but decreased leukocyte numbers. The time and effort required for measuring the IGF-I-concentration in addition to NEFA is not justified for evaluating the metabolic status. Nonesterified fatty acid values > or = 0.5 mM during the first week of lactation were considered as the most suitable criterion for identifying limited adaptive performance.

Short communication: Cellular localization of haptoglobin mRNA in the experimentally infected bovine mammary gland.

Expression of haptoglobin (Hp) mRNA, one of the major acute phase proteins in cattle, was demonstrated in homogenates of the bovine mammary gland. The aim of this study was to localize Hp mRNA expression within the udder at the cellular level during the first 24 h of infection with Escherichia coli. For this purpose, 3 quarters of 3 cows were subsequently inoculated with E. coli at 6, 12, and 24 h preslaughter; the fourth quarter received saline at 24 h preslaughter as a control. After slaughter, tissue samples of each quarter were collected for analyses by in situ hybridization and real-time reverse-transcription PCR. Haptoglobin mRNA expression was allocated to the alveolar epithelium of the mammary gland. Quantification of Hp-positive cells in in situ hybridization of Hp mRNA from tissue homogenates and of Hp protein in milk confirmed increasing concentrations within 24 h of infection.

Haptoglobin concentrations in blood and milk after endotoxin challenge and quantification of mammary Hp mRNA expression.

Haptoglobin (Hp), an acute phase protein mostly secreted by the liver, is an inflammatory marker. To use the full diagnostic potential of Hp measurements for mastitis, we developed and validated an ELISA sensitive to quantify even basal and subclinical concentrations in both blood and milk. Bovine Hp was purified from serum and was used as a standard and to generate polyclonal antiserum. The limit of detection was 0.07 microg of Hp/mL. From 6 cows challenged by intracisternal injection of lipopolysaccharide (LPS) into one quarter, blood samples were collected 0, 3, 6, 9, and 12 h after LPS administration. Milk samples from the treated and from the contralateral quarters were collected 0, 3, 6, 9, 12, 24, 36, 48, and 60 h after LPS administration. Haptoglobin concentrations in blood were increased above basal at 9 h, whereas milk Hp concentration increased 3 h after LPS administration. We therefore evaluated Hp mRNA synthesis within the mammary gland and specifically demonstrated Hp mRNA expression in parenchymal tissue, in tissue around the cisternal milk ducts and also in teat tissue by RT-PCR. Haptoglobin mRNA expression was then quantitatively evaluated by real-time RT-PCR in mammary biopsies collected from the treated and the control quarter before, and 3, 6, 9, and 12 h after LPS challenge from 6 other cows. Haptoglobin mRNA expression in the treated vs. the control quarters was different. The relation between mammary Hp expression and milk Hp concentrations needs further investigation, but the results suggest good diagnostic potential of this parameter for mastitis.

Influence of dietary ss-glucan on growth performance, lymphocyte proliferation, specific immune response and haptoglobin plasma concentrations in pigs.

Immunomodulatory feed additives might offer alternatives to anti-microbial growth promoters in swine production. The present study was conducted to assess the effects of beta-1,3/1,6 glucans, i.e. of specific yeast cell wall components, on immune function and growth performance in pigs. After weaning at 4 weeks of age, 75 piglets were allocated to 3 different groups for 4 weeks, the diet was supplemented with 0, 0.015 or 0.03% of beta-glucan, respectively. All animals were vaccinated against porcine reproductive and respiratory syndrome (PRRS). After 4 weeks, average daily gains (ADG) of beta-glucan treated pigs were not different from the controls. Feed intake was tendentiously (p < 0.1) increased at 0.03%beta-glucan, without alteration of feed efficiency. Serum haptoglobin concentrations at the end of the 4 week treatment were increased in all groups when compared to the initial levels (p < 0.001), without differences between the groups (p > 0.05). Haptoglobin levels were inversely related to ADG. Lymphocyte proliferation indices were not different in control and treatment groups. Specific vaccination responses, as quantified by the PRRS antibody titres occurred in all animals, but no relation with beta-glucan feeding was observed. Our results indicate marginal benefits of beta-glucan supplements for growth performance and no effect on the immune parameters tested. The observed trend towards increased feed intake needs further elucidation.

Effect of age, gender, and repeated measures on intraoral air pressure in normal adults.

The effect of age, gender, and repeated measures on intraoral air pressure (P0) was examined. Sixty adults comprised of 10 males and 10 females in each of three age groups (i.e., 20-39, 40-59, and 60-83 years) participated. P0 was assessed during voiceless stop plosive /p/ productions in repeated vowel/consonant syllables. The three medial plosives of a seven-syllable train were averaged to comprise a token. Five tokens were obtained and averaged for each of three trials. Thus each participant contributed 105 syllables and a subsequent three P0s for analyses. There was no statistically significant difference in P0 as a function of age or gender (P > 0.05). These findings support the conception that P0 remains stable throughout adulthood and is not dependent on gender. Differences in repeated measures of P0 attained statistical significance (P = 0.03), however the mean differences between trials (0.23 cm H20) were negligible and deemed to be clinically insignificant. Thus, across a short sampling session, P0 is a relatively stable measurement and does not change as a function of age or gender.

Effects of age, gender, bolus volume, and trial on swallowing apnea duration and swallow/respiratory phase relationships of normal adults.

The effects of age, gender, bolus volume, and trial on swallowing apnea duration (SAD) and swallow/respiratory phase relationships were examined. Sixty adults, composed of ten males and ten females in each of three age groups (i.e., 20-39, 40-59, and 60-83 years), participated. SAD was assessed via nasal airflow during saliva swallows and 10-, 15-, 20-, 25-mL bolus volumes across three trials. Results revealed SAD is consistent across trial (p > 0.05). Significant main effects of age, gender, and bolus volume were found (p < 0.05), i.e., elderly adults had longer SAD than young and middle-aged adults; women had longer SAD than men; and SAD increased as bolus volume increased. With respect to saliva swallows, a significant interaction of age by gender was found (p < 0.05), i.e., males exhibited a decrease in SAD with increasing age while females exhibited an increase in SAD with increasing age. Concerning swallow/respiratory phase relationships, the pattern of exhale-swallow-exhale was evident during 62% of participants' swallows. Furthermore, age, gender, or bolus volume did not predict the pattern of exhale-swallow-exhale (p > 0.05).

Technique management.

Good technique management is an imperative in modern, efficient departmental routine and patient care. The control of processor efficiency and generator output, along with the production of comprehensive technique charts are factors that contribute to this effective management. They fall well within the responsibility area of the radiologic technologist and require minimal time in department routine.