996 resultados para T2


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RESUME: L'objectif de cette étude était de déterminer l'impact de la grossesse non compliquée sur l'onde de pouls de la pression aortique centrale. Méthode 66 femmes au total avec une grossesse simple ont été réparties en trois groupes selon le stade de leur gestation: premier trimestre (T1, n=22), deuxième trimestre (T2, n=20) et troisième trimestre (T3, n=24). Le groupe contrôle (C, n=21) était constitué de femmes non enceintes, en bonne santé habituelle, prenant une contraception oestroprogestative. La tonométrie d'aplanation a été utilisée pour l'acquisition des ondes de pouls centrale un appareil disponible dans le commerce (SphygmoCor) permet l'enregistrement de l'onde de pouls périphérique avec un tonomètre d'aplanation de l'artère radiale au niveau du poignet, puis effectue sa transformation en sa forme centrale, grâce à une analyse de Fourrier et une fonction de transfert. L'influence des ondes réfléchies sur l'onde de pouls a été déterminée non seulement pendant la systole (augmentation systolique), comme on procède habituellement dans l'analyse de l'onde de pouls, mais aussi pendant la diastole (augmentation diastolique). Résultats Au cours de la grossesse, les pressions centrales systolique et diastolique sont restées inchangées et comparables aux valeurs mesurées chez les femmes qui ne sont pas enceintes. Dans le groupe contrôle, l'augmentation systolique s'élevait à 8.1±7.5% de la pression de pouls ; il n'y avait pas de différence statistiquement significative avec les valeurs obtenues chez les femmes enceintes, et ce, à n'importe quel stade de la grossesse (T1 : 4.6±11.4%, T2: 5.0±9.3%, T3 : 4.7±8.1%). Par contre, l'amplitude de l'augmentation diastolique diminuait avec la progression de la grossesse (C 6.5±2.4%, T1 : 5.2±3.1%, T2 : 3.8±2.6%; P=0.002 versus C; T3 : 2.3±2.0%; P<0.0001 versus C et P=0.004 versus T 1). Conclusion La grossesse ne modifie pas la forme de l'onde de pouls systolique centrale, ce qui implique de la part du système cardiovasculaire une adaptation fine à la demande croissante de flux sanguin, et ce, à tous les stades de la grossesse. Par contre, l'amplitude de l'onde de réflexion atteignant l'aorte pendant la diastole diminue progressivement au cours de la grossesse. Perspectives De récentes études montrent qu'une valeur anormalement haute de l'augmentation systolique de la pression centrale, comme on peut la déterminer avec la tonométrie d'aplanation, pourrait être un indice de trouble hypertensif de la grossesse débutant. Cette technique simple pourrait être d'autant plus facile à mettre en oeuvre si les valeurs normales pour l'augmentation systolique étaient indépendantes du stade de la grossesse, comme le suggèrent nos résultats, du moins pour les mesures prises en position assise.

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BACKGROUND: Conventional x-ray angiography frequently underestimates the true burden of atherosclerosis. Although intravascular ultrasound allows for imaging of coronary plaque, this invasive technique is inappropriate for screening or serial examinations. We therefore sought to develop a noninvasive free-breathing MR technique for coronary vessel wall imaging. We hypothesized that such an approach would allow for in vivo imaging of coronary atherosclerosis. METHODS AND RESULTS: Ten subjects, including 5 healthy adult volunteers (aged 35+/-17 years, range 19 to 56 years) and 5 patients (aged 60+/-4 years, range 56 to 66 years) with x-ray-confirmed coronary artery disease (CAD), were studied with a T2-weighted, dual-inversion, fast spin-echo MR sequence. Multiple adjacent 5-mm cross-sectional images of the proximal right coronary artery were obtained with an in-plane resolution of 0.5x1.0 mm. A right hemidiaphragmatic navigator was used to facilitate free-breathing MR acquisition. Coronary vessel wall images were readily acquired in all subjects. Both coronary vessel wall thickness (1.5+/-0.2 versus 1.0+/-0.2 mm) and wall area (21.2+/-3.1 versus 13.7+/-4.2 mm(2)) were greater in patients with CAD (both P:<0.02 versus healthy adults). CONCLUSIONS: In vivo free-breathing coronary vessel wall and plaque imaging with MR has been successfully implemented in humans. Coronary wall thickness and wall area were significantly greater in patients with angiographic CAD. The presented technique may have potential applications in patients with known or suspected atherosclerotic CAD or for serial evaluation after pharmacological intervention.

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Panurginae have a pair of cuticular depressions in the second metasomal tergum, recognized as lateral foveae of the T2. These structures have been used as systematic and taxonomic characters, although their functions are yet unknown. We aimed a morphological analysis at lateral foveae of three species of Panurgillus Moure, 1998: P. vagabundus (Cockerell, 1918), P. reticulatus Schlindwein & Moure, 1998 e P. flavitarsis Schlindwein & Moure, 1998. The study of the external morphology showed that the lateral foveae of the T2 are evident among females, but in males they are undistinguishable or absent. The surface of the foveae is micropunctuated in all species. The histological analysis has shown that the region of the lateral foveae of the T2, of female and male of the three species, presented tegumentar specializations. The inner part showed an evident secretory epithelium recognized as Class I gland. The height of this secretory epithelium was not uniform, although the cellular features are similar independent of sex. We have not found any previous information regarding the presence of glands related to abdominal foveae in Panurginae species.

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PURPOSE: This study was performed to determine the impact of perfusion and diffusion magnetic resonance imaging (MRI) sequences on patients during treatment of newly diagnosed glioblastoma. Special emphasis has been given to these imaging technologies as tools to potentially anticipate disease progression, as progression-free survival is frequently used as a surrogate endpoint. METHODS AND MATERIALS: Forty-one patients from a phase II temolozomide clinical trial were included. During follow-up, images were integrated 21 to 28 days after radiochemotherapy and every 2 months thereafter. Assessment of scans included measurement of size of lesion on T1 contrast-enhanced, T2, diffusion, and perfusion images, as well as mass effect. Classical criteria on tumor size variation and clinical parameters were used to set disease progression date. RESULTS: A total of 311 MRI examinations were reviewed. At disease progression (32 patients), a multivariate Cox regression determined 2 significant survival parameters: T1 largest diameter (p < 0.02) and T2 size variation (p < 0.05), whereas perfusion and diffusion were not significant. CONCLUSION: Perfusion and diffusion techniques cannot be used to anticipate tumor progression. Decision making at disease progression is critical, and classical T1 and T2 imaging remain the gold standard. Specifically, a T1 contrast enhancement over 3 cm in largest diameter together with an increased T2 hypersignal is a marker of inferior prognosis.

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Le ROTEM est un test de coagulation réalisable au près du malade qui permet d'objectiver la coagulopathie, de distinguer la contribution des différents éléments du système de coagulation et de cibler les produits procoagulants comme le plasma frais congelé (PFC), les plaquettes, le fibrinogène et les facteurs de coagulation purifiés ou les antifibrinolytiques. 3 des tests disponibles pour le ROTEM sont: EXTEM, INTEM, HEPTEM. Le premier test est stable sous hautes doses d'héparine alors que le deuxième est très sensible à sa présence. Dans le dernier test on rajoute de l'héparinase pour mettre en évidence l'éventuel effet résiduel de l'héparine en le comparant à l'INTEM. Idéalement, le ROTEM devrait être effectué avant la fin du bypass cardiopulmonaire (CEC), donc sous anticoagulation maximale pas héparine, afin de pouvoir administrer des produits pro¬coagulants dans les délais les plus brefs et ainsi limiter au maximum les pertes sanguines. En effet la commande et la préparation de certains produits procoagulants peut prendre plus d'une heure. Le but de cette étude est de valider l'utilisation du ROTEM en présence de hautes concentrations d'héparine. Il s'agit d'une étude observationnelle prospective sur 20 patients opérés électivement de pontages aorto-coronariens sous CEC. Méthode : l'analyse ROTEM a été réalisée avant l'administration d'héparine (TO), 10 minutes après l'administration d'héparine (Tl), à la fin de la CEC (T2) et 10 minutes après la neutralisation de l'anticoagulation avec la protamine (T3). L'état.d'héparinisation a été évalué par l'activité anti-Xa à T1,T2,T3. Résultats : Comparé à TO, la phase de polymérisation de la cascade de coagulation et l'interaction fibrine-plaquettes sont significativement détériorées par rapport à Tl pour les canaux EXTEM et HEPTEM. A T2 l'analyse EXTEM et INTEM sont comparables à celles de EXTEM et HEPTEM à T3. Conclusion: les hautes doses d'héparine utilisées induisent une coagulopathie qui reste stable durant toute la durée de la CEC et qui persiste même après la neutralisation de l'anticoagulation. Les mesures EXTEM et HEPTEM sont donc valides en présence de hautes concentrations d'héparine et peuvent être réalisés pendant la CEC avant l'administration de protamine.

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Introduction: Quantitative measures of degree of lumbar spinal stenosis (LSS) such as antero-posterior diameter of the canal or dural sac cross sectional area vary widely and do not correlate with clinical symptoms or results of surgical decompression. In an effort to improve quantification of stenosis we have developed a grading system based on the morphology of the dural sac and its contents as seen on T2 axial images. The grading comprises seven categories ranging form normal to the most severe stenosis and takes into account the ratio of rootlet/CSF content. Material and methods: Fifty T2 axial MRI images taken at disc level from twenty seven symptomatic lumbar spinal stenosis patients who underwent decompressive surgery were classified into seven categories by five observers and reclassified 2 weeks later by the same investigators. Intra- and inter-observer reliability of the classification were assessed using Cohen's and Fleiss' kappa statistics, respectively. Results: Generally, the morphology grading system itself was well adopted by the observers. Its success in application is strongly influenced by the identification of the dural sac. The average intraobserver Cohen's kappa was 0.53 ± 0.2. The inter-observer Fleiss' kappa was 0.38 ± 0.02 in the first rating and 0.3 ± 0.03 in the second rating repeated after two weeks. Discussion: In this attempt, the teaching of the observers was limited to an introduction to the general idea of the morphology grading system and one example MRI image per category. The identification of the dimension of the dural sac may be a difficult issue in absence of complete T1 T2 MRI image series as it was the case here. The similarity of the CSF to possibly present fat on T2 images was the main reason of mismatch in the assignment of the cases to a category. The Fleiss correlation factors of the five observers are fair and the proposed morphology grading system is promising.

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BACKGROUND: Spinal cord ischaemia is rare in childhood and information on clinical presentation and outcome is scarce. METHODS: This is a retrospective analysis of eight patients and 75 additional cases from the literature. Data search included: patient's age, primary manifestation, risk factors, neuroimaging and outcome. RESULTS: Five female and three male patients gave consent to participate. Mean age was 12.5 years (10-15 years). Six patients presented with paraplegia; this was preceded by pain in four. Brown Sequard syndrome and quadriparesis were the two others' presenting condition. Sensation levels were thoracolumbar in seven cases. Bladder dysfunction only or bladder and bowel dysfunction were reported in eight and five patients respectively. Time to maximal symptom manifestation was <12 h in 7/8. Risk factors included surgery, minor trauma, recent infection, and thrombophilia. Mean follow-up was 3.3 years (0.25-6.3 years). Three patients remained wheelchair-dependent and three patients were ambulatory without aid. Bladder function recovered fully in five children. Most affected aspects of quality of life were physical and mental well-being and self-perception. T2-weighted-MR images showed pencil-like hyperintensity (8/8) in sagittal and H-shaped or snake-eyes-like lesion (6/8) in axial views. Analyses of all 83 patients were in congruence with the above results of the study group. CONCLUSION: Spinal cord ischaemia in childhood presenting with pain, paraplegia, and bladder dysfunction has high morbidity concerning motor problems and quality of life. Acute arterial ischaemic event in children seems similar to adult events with respect to clinical presentation and, surprisingly, also in outcome.

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With improved B 0 homogeneity along with satisfactory gradient performance at high magnetic fields, snapshot gradient-recalled echo-planar imaging (GRE-EPI) would perform at long echo times (TEs) on the order of T2*, which intrinsically allows obtaining strongly T2*-weighted images with embedded substantial anatomical details in ultrashort time. The aim of this study was to investigate the feasibility and quality of long TE snapshot GRE-EPI images of rat brain at 9.4 T. When compensating for B 0 inhomogeneities, especially second-order shim terms, a 200 x 200 microm2 in-plane resolution image was reproducibly obtained at long TE (>25 ms). The resulting coronal images at 30 ms had diminished geometric distortions and, thus, embedded substantial anatomical details. Concurrently with the very consistent stability, such GRE-EPI images should permit to resolve functional data not only with high specificity but also with substantial anatomical details, therefore allowing coregistration of the acquired functional data on the same image data set.

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BACKGROUND: Coronary in-stent restenosis cannot be directly assessed by magnetic resonance angiography (MRA) because of the local signal void of currently used stainless steel stents. The aim of this study was to investigate the potential of a new, dedicated, coronary MR imaging (MRI) stent for artifact-free, coronary MRA and in-stent lumen and vessel wall visualization. METHODS AND RESULTS: Fifteen prototype stents were deployed in coronary arteries of 15 healthy swine and investigated with a double-oblique, navigator-gated, free-breathing, T2-prepared, 3D cartesian gradient-echo sequence; a T2-prepared, 3D spiral gradient-echo sequence; and a T2-prepared, 3D steady-state, free-precession coronary MRA sequence. Furthermore, black-blood vessel wall imaging by a dual-inversion-recovery, turbo spin-echo sequence was performed. Artifacts of the stented vessel segment and signal intensities of the coronary vessel lumen inside and outside the stent were assessed. With all investigated sequences, the vessel lumen and wall could be visualized without artifacts, including the stented vessel segment. No signal intensity alterations inside the stent when compared with the vessel lumen outside the stent were found. CONCLUSIONS: The new, coronary MRI stent allows for completely artifact-free coronary MRA and vessel wall imaging.

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Foram estudados os efeitos do cultivo contínuo da cana-de-açúcar nas principais propriedades físicas e morfológicas de um latossolo amarelo argiloso da região dos tabuleiros costeiros do estado de Alagoas. Quatro talhões foram selecionados na Usina Caeté, município de São Miguel dos Campos (AL), em janeiro de 1995; um com vegetação nativa (Tn) e os demais cultivados por períodos de dois (T2), dezoito (T18) e vinte e cinco (T25) anos. Os solos foram caracterizados morfologicamente e, nas amostras de cada horizonte, foram determinados granulometria, grau de floculação, umidade a -0,034 MPa e -1,52 MPa, densidade do solo e das partículas, macroporosidade e porosidade total. Foram coletadas amostras indeformadas dos horizontes A, AB e BA de cada perfil para determinação de condutividade hidráulica saturada, microporosidade e densidade do solo. Os resultados mostraram que o uso agrícola dos solos causou mudanças na morfologia do horizonte superficial com o desenvolvimento de um horizonte Ap, apresentando transição abrupta para o horizonte AB subjacente e perda de estrutura. Em relação às propriedades físicas, os resultados indicaram que o cultivo contínuo causou diminuição no conteúdo de argila, nos horizontes superficiais, e um aumento significativo, nos horizontes subsuperficiais. Após evidente impacto negativo nas propriedades físicas com o primeiro plantio da cana-de-açúcar, o manejo adotado promoveu novo equilíbrio, com recuperação parcial da porosidade total e sensível aumento no conteúdo de água disponível. Por outro lado, o uso agrícola promoveu significativa redução na condutividade hidráulica saturada do horizonte superficial, quando comparado com o solo sob vegetação nativa.

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BACKGROUND: Both induction chemotherapy followed by irradiation and concurrent chemotherapy and radiotherapy have been reported as valuable alternatives to total laryngectomy in patients with advanced larynx or hypopharynx cancer. We report results of the randomized phase 3 trial 24954 from the European Organization for Research and Treatment of Cancer. METHODS: Patients with resectable advanced squamous cell carcinoma of the larynx (tumor stage T3-T4) or hypopharynx (T2-T4), with regional lymph nodes in the neck staged as N0-N2 and with no metastasis, were randomly assigned to treatment in the sequential (or control) or the alternating (or experimental) arm. In the sequential arm, patients with a 50% or more reduction in primary tumor size after two cycles of cisplatin and 5-fluorouracil received another two cycles, followed by radiotherapy (70 Gy total). In the alternating arm, a total of four cycles of cisplatin and 5-fluorouracil (in weeks 1, 4, 7, and 10) were alternated with radiotherapy with 20 Gy during the three 2-week intervals between chemotherapy cycles (60 Gy total). All nonresponders underwent salvage surgery and postoperative radiotherapy. The Kaplan-Meier method was used to obtain time-to-event data. RESULTS: The 450 patients were randomly assigned to treatment (224 to the sequential arm and 226 to the alternating arm). Median follow-up was 6.5 years. Survival with a functional larynx was similar in sequential and alternating arms (hazard ratio of death and/or event = 0.85, 95% confidence interval = 0.68 to 1.06), as were median overall survival (4.4 and 5.1 years, respectively) and median progression-free interval (3.0 and 3.1 years, respectively). Grade 3 or 4 mucositis occurred in 64 (32%) of the 200 patients in the sequential arm who received radiotherapy and in 47 (21%) of the 220 patients in the alternating arm. Late severe edema and/or fibrosis was observed in 32 (16%) patients in the sequential arm and in 25 (11%) in the alternating arm. CONCLUSIONS: Larynx preservation, progression-free interval, and overall survival were similar in both arms, as were acute and late toxic effects.

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Foram estudados os efeitos do cultivo contínuo da cana-de-açúcar nas principais propriedades químicas de um Latossolo Amarelo argiloso da região dos tabuleiros costeiros do estado de Alagoas, Brasil. Quatro talhões foram selecionados na Usina Caeté, município de São Miguel dos Campos, sendo um com vegetação nativa (Tn), e os demais cultivados por períodos de 2 (T2), 18 (T18) e 25 (T25) anos. Os solos foram morfologicamente caracterizados e, nas amostras de cada horizonte, determinados pH (H2O e KCl), carbono orgânico, fósforo disponível, bases trocáveis, capacidade de troca catiônica, saturação por bases e saturação por alumínio. Os resultados mostraram que o manejo adotado no cultivo da cana-de-açúcar melhorou a fertilidade dos solos estudados, proporcionando aumentos no pH, nos teores de cálcio, de magnésio, de fósforo, de bases trocáveis e diminuição da saturação por alumínio. Observou-se também a movimentação de cálcio e de magnésio para os horizontes inferiores.

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Foram estudados os efeitos do cultivo contínuo da cana-de-açúcar por meio da análise micromorfológica de Latossolos Amarelos argilosos da região dos tabuleiros costeiros do estado de Alagoas, Brasil. Quatro talhões foram selecionados na Usina Caeté, município de São Miguel dos Campos, AL, em janeiro de 1995, sendo um com vegetação nativa (Tn), e os demais cultivados por períodos de dois (T2), dezoito (T18) e vinte e cinco (T25) anos. Os solos foram morfologicamente caracterizados, sendo coletadas amostras indeformadas dos horizontes A, AB e BA de cada perfil, em caixas de Kubiena, para análises micromorfológicas. Foram coletadas amostras para análises de densidade do solo, macroposidade, carbono orgânico e condutividade hidráulica saturada. Os resultados evidenciam que o uso agrícola dos solos causou mudanças na morfologia do horizonte superficial, com o desenvolvimento de um horizonte Ap, com sensível perda de estrutura. Após um evidente impacto negativo nas propriedades físicas com o primeiro plantio da cana-de-açúcar, o manejo adotado promoveu uma recuperação parcial da macroporosidade no horizonte superficial após 18 e 25 anos de cultivo. Além da formação inicial de uma camada compactada nos horizontes Ap e AB, foi observado um adensamento pedogenético natural do solo no BA, acelerado com o cultivo da cana-de-açúcar, pelo preenchimento de poros com argila iluvial. A porosidade total obtida pelo analisador de imagem nas fotografias das lâminas delgadas corrobora uma sensível redução da porosidade no horizonte superficial com a introdução do cultivo. Mostra também que a porosidade do horizonte BA é baixa no perfil com vegetação nativa, comprovando o caráter pedogenético do adensamento desse horizonte. Apesar de não ter sido observado nenhum revestimento nas unidades estruturais em campo, a micromorfologia mostrou pedofeições morfológicas com revestimentos argilosos nos agregados e enchimento de poros com argila iluvial, o que indica a tendência à formação de horizonte B textural com o tempo.

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A aveia e a ervilhaca são as principais culturas de cobertura de solo utilizadas durante o inverno na região sul do Brasil. O cultivo consorciado dessas duas espécies, estratégia ainda pouco utilizada, pode potencialmente resultar numa fitomassa com relação C/N mais equilibrada do que aquela proveniente das culturas solteiras, bem como proporcionar resíduos culturais que atuem, simultaneamente, na proteção do solo contra os agentes erosivos e no suprimento de N ao milho. Com o objetivo de avaliar esta hipótese, realizou-se este trabalho, durante o ano agrícola de 1992/93, em área do Departamento de Solos da Universidade Federal de Santa Maria, num Argissolo Vermelho distrófico arênico (Hapludalf). Os tratamentos constaram de diferentes proporções de densidade de semeadura de ervilhaca comum (E) e aveia preta (A): T1: 100% E (80 kg ha-1de sementes); T2: 90% E (72 kg ha-1) + 10% A (8 kg ha-1); T3: 75% E (60 kg ha-1) + 25% A (20 kg ha-1); T4: 50% E (40 kg ha-1) + 50% A (40 kg ha-1); T5: 25% E (20 kg ha-1) + 75% A (60 kg ha-1) e T6: 100% A (80 kg ha-1). Além desses, foram utilizados dois tratamentos, nos quais o solo permaneceu em pousio durante o inverno: no primeiro tratamento, foram aplicados 75 kg ha-1 de N-uréia no milho (T7) e, no segundo, a cultura foi plantada sem adubação nitrogenada (T8). Em sucessão à ervilhaca como cultura solteira, com relação C/N de 13,5, a produtividade de grãos de milho chegou a 5,44 t ha-1, não diferindo do tratamento em pousio com aplicação de N-uréia. Todavia, a ervilhaca foi rapidamente decomposta e, seis meses após o seu manejo, apenas 19,5% da fitomassa inicial encontrava-se na superfície do solo. Com a inclusão da aveia em consórcio com a ervilhaca ocorreu um aumento gradativo na relação C/N da fitomassa, diminuindo o fornecimento de N ao milho e aumentando a persistência dos resíduos culturais. O consórcio que apresentou melhor equilíbrio entre produção de fitomassa, proteção do solo pelos resíduos culturais e fornecimento de N ao milho foi o que continha 10% de aveia + 90% de ervilhaca (relação C/N = 18,6).

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O conhecimento das características e propriedades dos solos de várzea do RS, utilizados atualmente com a cultura do arroz irrigado, torna-se essencial para a adoção de práticas que envolvam irrigação, drenagem, correção da acidez e da fertilidade, principalmente quando se deseja obter altos níveis de produtividade, com menor custo e com menores possibilidades de degradação destes solos e do ambiente onde estão situados. Dentro deste panorama, avaliou-se a compactação de um Planossolo cultivado sob diferentes sistemas de manejo, através da resistência mecânica do solo à penetração. Camadas compactadas foram identificadas, de forma mais acentuada, na profundidade intermediária (0,10-0,20 m) nos sistemas com maior utilização da mecanização agrícola (T2 - sistema de cultivo contínuo de arroz e T3 - sistema de cultivo de arroz x rotação de culturas). Observou-se que, em todos os sistemas, houve aumento dos valores de resistência mecânica do solo à penetração em relação à testemunha (T6 - solo mantido sem cultivo), principalmente na camada intermediária (0,10-0,20 m), quando o solo foi submetido ao sistema de cultivo contínuo de arroz (T2). Os tratamentos T3 (sistema de cultivo de arroz x rotação de culturas) e T5 (sucessão de culturas: soja (sistema convencional) x arroz (sistema de semeadura direta)) apresentaram os valores mais altos de resistência à penetração, provavelmente em decorrência da baixa umidade e dos efeitos do cultivo e da utilização de máquinas responsáveis pela deformação da estrutura do solo.