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Localised Cerebral Phosphorus-31 MR Spectroscopy in Man Before and Immediately after Coronary Bypass Surgery with Hypothermic Cardiopulmonary Bypass (1998)

Wilson, Jason A. ; Taylor-Robinson, Simon D. ; Bryant, David J. ; [et al.]

Springer

Metabolic brain disease 13 (1998), S. 191-200

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ISSN: 1573-7365

Keywords: Coronary artery bypass surgery ; cerebral bioenergetics ; 31P magnetic resonance spectroscopy ; hypothermia ; cardiopulmonary bypass

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Coronary artery bypass surgery classically is undertaken with hypothermic cardiopulmonary bypass (CPB). There is a high incidence of neuropsychological defects after cardiac surgery, which may be related to cerebral ischaemia during the rewarming period. In this study, phosphorus-31 magnetic resonance spectroscopy (31P MRS) was used to identify changes in cerebral 31P MR spectra in patients before and immediately after hypothermic CPB. Four neurologically normal patients undergoing coronary artery bypass surgery were studied. Localised cerebral 31P MRS (TR 5000 ms) was performed at 1.5 Tesla on each patient the day before and within an hour of completion of surgery. Peak areas for phosphomonoesters (PME), inorganic phosphate (Pi), phosphodiesters (PDE), phosphocreatine (PCr) and beta ATP (βATP) were measured. Metabolite peak area ratios and relative percentages of each 31P MR resonance with respect to the total 31P MR signal were calculated. In the post-operative MR spectra, each patient displayed a marked reduction in Pi/βATP and increase in PCr/Pi ratios. Spectral changes in percentage metabolite signals following surgery varied both in magnitude and pattern between patients. In two patients there was an increased postoperative percentage PME and percentage PCr with a decrease in percentage βATP. The converse was found in the other two patients, but all four subjects displayed a markedly decreased percentage Pi after CPB. These metabolite changes probably reflect rebound phosphorylation in the immediate postoperative period and suggest increased metabolic activity in the hyperaemic brain on rewarming from hypothermic CPB.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1023/A:1023219924498

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Early detection and screening for ovarian cancer (1995)

Schwartz, Peter E. ; Chambers, Joseph T. ; Taylor, Kenneth J.

New York, N.Y. : Wiley-Blackwell

Journal of Cellular Biochemistry 59 (1995), S. 233-237

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ISSN: 0730-2312

Keywords: CA-125 ; ovarian cancer screening ; tumor markers ; UGP ; Life and Medical Sciences ; Cell & Developmental Biology

Source: Wiley InterScience Backfile Collection 1832-2000

Topics: Biology , Chemistry and Pharmacology , Medicine

Notes: Ovarian cancer is associated with potmenopausal women on North Ameican or European descent, nulliparous women, and women with a first-degree relative with an epithelial overaina cancer. Methods for early detection of ovarian cancer are the pelvic examination, ultrasound techniques, and CA-125 monitoring, none of which are highly sensitive or specific for the disease. At the Yale-New Haven Medical Center, first-degree relatives of women with epithelial ovarian cancer were invited to participate in an intense ovarian cancer screening program consisting of tumor markers, endovaginal ultrasound and color Doppler flow studies, and physical examinations performed in a serial fashion. The false-postive rate for the tumor markers varied from 2 to 9% at initial evaluation of the first 247 participants. Endovaginal ultrasound and color Doppler flow techniques were used to evaluate 326 ovaries in 169 womens. Resistive indices 〈 0.5 were present in 26 ovaries (8.4%) and peak systolic velocities 〉 30 cm/sec occurred in 7 ovaries (2.3%). To date, four breast cancers have been detected, three cervical intraepithelial neoplasias have been identified, and three atypical adenomatous hyperplasias were diagnosed. No epithelial ovarian cancer was found. Isolated screening for ovarian cancer even in high-risk womed is not cost effective. Women screened for ovarian cancer should also be evaluated for cancers of the breast, cervix, colon rectum and endometrium. Isolated abnormal screening test values are not an indication for surgery.