Background: Whereas it is generally accepted that maternal environment plays a key role in child health, emerging evidence suggests that paternal environment before conception also impacts child health. We aimed to investigate the association between children's asthma risk and parental smoking and welding exposures prior to conception. Methods: In a longitudinal, multi-country study, parents of 24 168 offspring aged 2-51 years provided information on their life-course smoking habits, occupational exposure to welding and metal fumes, and offspring's asthma before/after age 10 years and hay fever. Logistic regressions investigated the relevant associations controlled for age, study centre, parental characteristics (age, asthma, education) and clustering by family. Results: Non-allergic early-onset asthma (asthma without hay fever, present in 5.8%) was more common in the offspring with fathers who smoked before conception {odds ratio [OR] ¼ 1.68 [95% confidence interval (CI) ¼ 1.18-2.41]}, whereas mothers' smoking before conception did not predict offspring asthma. The risk was highest if father started smoking before age 15 years [3.24 (1.67-6.27)], even if he stopped more than 5 years before conception [2.68 (1.17-6.13)]. Fathers' pre-conception welding was independently associated with non-allergic asthma in his offspring [1.80 (1.29-2.50)]. There was no effect if the father started welding or smoking after birth. The associations were consistent across countries. Conclusions: Environmental exposures in young men appear to influence the respiratory health of their offspring born many years later. Influences during susceptible stages of spermatocyte development might be important and needs further investigation in humans. We hypothesize that protecting young men from harmful exposures may lead to improved respiratory health in future generations.
The purpose of this study was to compare prospectively computed tomography (CT) and magnetic resonance (MR) imaging before and after mangafodipir trisodium infusion for the detection and staging of focal pancreatic lesions. From November 1996 to October 1997, 43 consecutive patients suspected to have a focal pancreatic lesion were included in a phase III study. Triphasic helical CT was performed, as well as MRI at 1.5 T, as follows: axial T1‐weighted (T1w) turbo spin echo (TSE), spectral presaturation with inversion recovery (SPIR) T1w TSE, T1w turbo field echo (TFE), and SPIR T2w TSE before and after mangafodipir trisodium (0.01 mmol/ml, 0.5 ml/kg) infusion. Imaging results were correlated with surgery, laparoscopy, laparoscopic ultrasound, and biopsy. Objective measurements were performed by measuring signal intensities (SIs) of lesion and parenchyma and calculating contrast indexes (CIs) and contrast‐to‐noise‐ratios (CNRs) to assess the delineation of the tumor. SIs were correlated with four phantom standards with a known SI. Thirty‐eight pancreatic adenocarcinomas were present, as well as one cystadenoma, two papillomas, and two cases of focal pancreatitis. SI measurements revealed significant increases in CIs for the lesion compared with the parenchyma in T1w TSE (69.7 vs 152.7; P = 0.0003) and T1w TFE (107.8 vs 194.2; P = 0.0002). These series also revealed significant increases in CNRs (for T1w TSE: 9.7 vs 13.0; P = 0.0407 and for T1w TFE: 14.5 vs 26.1; P = 0.0001). In the other series, there was no significant increase. CT detected 38 lesions, MRI without mangafodipir trisodium detected 39 lesions, and MRI with mangafodipir trisodium detected 40 lesions, giving detection accuracy rates of 88%, 91%, and 93%, respectively. Staging accuracy rates for vascular ingrowth were 81%, 75%, and 81%, respectively. Overall staging accuracy rates were 57%, 54%, and 54%, respectively, mostly due to undetected small metastases in the peritoneum, omentum, or liver (< 1 cm). This study indicates that a) MRI after mangafodipir trisodium gives a better delineation of the tumor in T1w series, but b) does not significantly improve the detection rate and staging accuracy of focal pancreatic lesions over MRI without this contrast medium. J. Magn. Reson. Imaging 2000;12:261–268. © 2000 Wiley‐Liss, Inc.
Purpose:To evaluate the diagnostic efficacy and safety of MnDPDP (Teslascan) in enhanced MR imaging.Material and Methods: In 2 multiple independent trials in Europe 624 patients weregiven MnDPDP intravenously at 5 pmolkg b.w. Patients underwent an unenhanced MR examination comprising T1 -weighted spin-echo and breath-hold gradient-echo sequences and a T2-weighted spin-echo sequence. The T I sequences were repeated after the administration of MnDPDP. In a subgroup of 137 patients the results of the enhanced MR images were compared with the results of contrast-enhanced CT (CECT) images. Results: For both types of T1-weighted sequences and when evaluating the maximum numbers of lesions seen in all imaging sequences, the total numbers of lesions seen were significantly higher in the MnDPDP-enhanced images than in the unenhanced images (p=0.0005 and p=O.OOOl , respectively). The investigators considered the enhanced images to contain "other additional information not found in the unenhanced images" in 279 (45%) of the 621 patients examined. The MnDPDP-enhanced images were also superior to the CECT images in the detection of lesions @=0.02). Adverse events were reported by 46 patients (7%) and infusion-associated discomfort by 26 (4%). Heart rates and systolic and diastolic blood pressures showed no clinically significant changes from baseline as a result of the administration of the contrast medium.Conclusion: MnDPDP was shown to be effective and safe in enhanced MR imaging of the liver. Mangafodipir FAX +47-23 18 60 00.
The evolution of contrast agents for NIR imaging of the liver has proceeded along several different paths with the common goal of improving liver-lesion contrast. These contrast agents are used to accentuate the inherent differences in liver-lesion signal intensity through differential enhancement of proton relaxation within adjacent tissues. Contrast agents used for hepatic MR imaging can be broadly categorized into those that target the extracellular space, the hepatobiliary system, and the reticuloendothelial system. Although only a small number of liver contrast agents are currently available, others are rapidly proceeding through clinical trials and may soon be added to our clinical armamentarium. This article will briefly review the current clinical experience with these agents, discussing their mechanism of contrast enhancement, pharmacokinetics. and efficacy in the evaluation of focal liver lesions.Index terms: MR imaging -Liver -MR, contrast agents * Liver neoplasms -Gadolinium * Manganese -Iron JMRI 1997; 7:5&67 Abbreviations: CT = computed tomography, HCC = Hepatocellular carcinoma, Mn-DPDP = Mangafodipir Msodium. FNH = focal nodular hyperplasla, Gd-EOB-DTPA = gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid. CNR = contrast-tonoise ratio. FLASH = fast low-angle shot, Gd-BOPTA = Gadobenate Dimeglumine, CTAP = C T during arterial portography, SPiO = superparamagnetic iron oxide; USPlO = ultrasmall SPIO.From the Sharp and Children's MRI Center, SHARP Healthcare,
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