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Purpose: To demonstrate and evaluate uterine peristalsis on cine magnetic resonance imaging (MRI) using ultrafast imaging. Materials and Methods:Serial MR uterine images (300) were obtained from 15 normal volunteers over four menstrual phases using true fast imaging with steady-state precession (true FISP) technique over 117 seconds and videotaped. Three radiologists independently evaluated videotapes of 59 studies. Uterine peristalsis was defined as wavy movements of subendometrial myometrium or endometrium. Interobserver reliability was evaluated using a Kappa coefficient. Fifty-four studies obtained in appropriate phases were analyzed.Results: Cine MRI displayed uterine peristalsis in 30 of 59 studies; consensus reading showed direction in 23 studies. Reliability between the final consensus of the recognition of uterine peristalsis and those of the three readers was extremely concordant, with a Kappa coefficient of 0.908. Wave direction was cervico-fundal in follicular and periovulatory phases, with frequency of contraction waves being 1.2-2.3 per minute in positive studies. Conclusion:Uterine peristalsis was demonstrated on cine MR using ultrafast MRI. Direction and frequency of peristaltic waves are closely related to menstrual cycle phases. Supplementary material for this article can be found on the JMRI website at www.interscience.wiley.com/jpages/ 1053-1807/suppmat/index.html.

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Patients with less severe obstructive sleep apnoea (OSA) are usually prescribed oral appliances and/or smaller optimal nasal continuous positive airway pressure (PnCPAP) in nCPAP therapy. We hypothesised that OSA patients with greater PnCPAP would not respond favourably to oral appliances.Oral appliances were inserted in nCPAP users after washing-out the nCPAP effect. Follow-up polysomnography was undertaken with the adjusted oral appliance in place. The predictability of PnCPAP was evaluated with receiver-operating characteristic (ROC) curves.The median baseline apnoea/hypopnoea index (AHI) was reduced with the oral appliance from 36 to 12 events?h -1 in 35 patients. When responders were defined as patients showing a follow-up AHI of ,5 events?h -1 with .50% reduction in baseline AHI, the area under the ROC curve for PnCPAP was 0.76. The best cut-off value of PnCPAP turned out to be 10.5 cmH 2 O with a high negative predictive value (0.93) and a low negative likelihood ratio (0.18). OSA patients with a PnCPAP of .10.5 cmH 2 O are unlikely to respond to oral appliance therapy. This prediction is clinically helpful to both OSA patients and medical personnel in discussing oral appliances as a temporary substitute and/or alternative for nCPAP.

Aims: The pleiotropic effects of statins on recurrent stroke remain unclear. We investigated the effects of pravastatin on high-sensitivity C-reactive proteins (Hs-CRP) in ischemic stroke, and explored the impact of Hs-CRP on recurrent stroke and vascular events.Methods: This randomized open-label trial was ancillary to the J-STARS trial. One thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin (n = 545) or control groups (n = 550). The primary and secondary endpoints were serum Hs-CRP reduction and stroke recurrence, including both ischemic and hemorrhagic ones, respectively. Onset of vascular events and each stroke subtype in relation to Hs-CRP levels were also determined.Results: In the pravastatin treatment group, Hs-CRP levels (median 711 µg/L, IQR 344–1500) significantly decreased 2 months later (median 592 µg/L, IQR 301–1390), and they remained significantly lower until the end of the study. However, in the control group, baseline Hs-CRP levels were similar to those 2 months later. The reduction of Hs-CRP levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control (p = 0.007). One SD increase in log-transformed Hs-CRP increased the risk of stroke recurrence (HR 1.17, 95% CI 0.97–1.40) and vascular events (HR 1.30, 95% CI 1.12–1.51). With an Hs-CRP cut-off of 1000 µg/L, higher Hs-CRP significantly increased the risk of recurrent stroke (HR 1.50, 95% CI 1.03–2.17) and vascular events (HR 1.68, 95% CI 1.23–2.29).Conclusion: In non-cardiogenic ischemic stroke, pravastatin treatment may reduce vascular inflammation as assessed by Hs-CRP, and higher Hs-CRP levels appeared to increase the risk of recurrent stroke and vascular events.