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Abstract Objective. To assess the relative radiographic conspicuity of gadolinium-based contrast agents (GBCAs) that may be used in spinal injection procedures when iodine-based contrast agents are contraindicated. Methods. Eight GBCAs and three iodinated agents of varying iodine concentrations were radiographed under conditions representative of lumbar spinal injections at four kilovoltage peak (kVp) values. Radiographic contrast of each agent was measured as the percent pixel value difference with respect to background. Results. Gadobutrol (Gadovist, 1 mM/mL) had the highest radiographic contrast among the gadolinium agents tested. Measured radiographic contrast correlated with the molar concentration of gadolinium. Gadobutrol radiographic contrast lies between the contrast of iohexol concentrations of 240 and 140 mgI/mL. All agents have decreasing contrast as kVp increases, but GBCAs decrease less than iodine-based agents. Conclusions. Gadobutrol is the GBCA with the greatest conspicuity for use in spinal injection procedures. It also has the highest molar concentration of gadolinium, and potential neural toxicity from intrathecal delivery must be considered.

Fluoroscopic imaging has become increasingly popular to investigate total knee arthroplasty kinematics non-invasively − 3D implant models are aligned with 2D image projections, and optimized via an edge-contour alignment technique. Previous studies have quantified the accuracy of this approach, however they do not always adequately address the impact of image collection parameters. A particularly sensitive parameter is the pulse width, or exposure time per frame. At longer pulse widths, more motion is captured in a single frame; this can lead to image blur and subsequent degradation to image edge quality. Therefore, the comparative accuracy of relative joint kinematics as a function of pulse width and joint velocity needs to be defined. A limits of agreement approach was taken to define the mean differences between optoelectric kinematic measures (gold standard) and fluoroscopic methods at various pulse widths (1, 8 and 16ms) and knee velocities (50, 100 and 225°/s). The mean absolute differences between the optoelectric and fluoroscopic methods for 1ms pulse width were less than 1.5° and 0.9mm. Comparable rotational differences (1.3°) were observed for the 8ms pulse width but had larger translational differences (1.4mm). The 16ms pulse width yielded the greatest mean differences (2.0° and 1.6mm), which increased with knee flexion velocity. The importance of pulse width and velocity should not be overlooked for future studies – this parameter has proven to be a sensitive metric in the quantification of joint motion via fluoroscopy and must be identified and reported in future studies.

In this long-term trial, the combination of an alpha-blocker (doxazosin) and a 5α-reductase inhibitor (finasteride) was superior to either drug alone in retarding the clinical progression of benign prostatic hyperplasia. This long-term trial may change the management of prostate disease. Benign prostatic hyperplasia is the main cause of lower urinary tract symptoms in older men. 1 These symptoms may adversely affect the quality of life and interfere with activities of daily living. 2 – 4 Less commonly, benign prostatic hyperplasia causes acute urinary retention, a need for surgery, urinary incontinence, recurrent urinary tract infection, or obstructive uropathy. 4 , 5 The preferred medical treatment for many men with symptomatic benign prostatic hyperplasia is either an alpha-adrenergic–receptor antagonist (alpha-blocker), which reduces smooth-muscle tone in the prostate and bladder neck, or a 5α-reductase inhibitor, which reduces prostate volume by inducing epithelial atrophy. 6 – 9 Short-to-moderate-term clinical trials have . . .

Glucokinase Gene Locus Transgenic Mice Are Resistant to the Development of Obesity-Induced Type 2 Diabetes Masakazu Shiota 1 , Catherine Postic 1 , Yuka Fujimoto 1 , Thomas L. Jetton 1 , Kathryn Dixon 1 , Danhua Pan 1 , Joseph Grimsby 2 , Joseph F. Grippo 2 , Mark A. Magnuson 1 and Alan D. Cherrington 1 1 Department of Molecular Physiology and Biophysics, School of Medicine, Vanderbilt University, Nashville, Tennessee 2 Department of Metabolic Disease, Hoffmann-La Roche Inc., Nutley, New Jersey Abstract Transgenic mice that overexpress the entire glucokinase (GK) gene locus have been previously shown to be mildly hypoglycemic and to have improved tolerance to glucose. To determine whether increased GK might also prevent or diminish diabetes in diet-induced obese animals, we examined the effect of feeding these mice a high-fat high–simple carbohydrate low-fiber diet (HF diet) for 30 weeks. In response to this diet, both normal and transgenic mice became obese and had similar BMIs (5.3 ± 0.1 and 5.0 ± 0.1 kg/m 2 in transgenic and nontransgenic mice, respectively). The blood glucose concentration of the control mice increased linearly with time and reached 17.0 ± 1.3 mmol/l at the 30th week. In contrast, the blood glucose of GK transgenic mice rose to only 9.7 ± 1.2 mmol/l at the 15th week, after which it returned to 7.6 ± 1.0 mmol/l by the 30th week. The plasma insulin concentration was also lower in the GK transgenic animals (232 ± 79 pmol/l) than in the controls (595 ± 77 pmol/l), but there was no difference in plasma glucagon concentrations. Together, these data indicate that increased GK levels dramatically lessen the development of both hyperglycemia and hyperinsulinemia associated with the feeding of an HF diet. ANOVA, analysis of variance DTT, dithioerythritol G6Pase, glucose-6-phosphatase GK, glucokinase GKRP, GK regulatory protein HF diet, high-fat high–simple carbohydrate low-fiber diet NEFA, nonesterified fatty acid Footnotes Address correspondence and reprint requests to Masakazu Shiota, DVM, Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, 710 Medical Research Bldg. 1, Nashville, TN 37232-0615. E-mail: masakazu.shiota{at}mcmail.vanderbilt.edu . Received for publication 21 January 2000 and accepted in revised form 6 December 2000. A.D.C. and M.A.M. are on an advisory panel of OSI Pharmaceuticals.