Objective: Chronic recurrent multifocal osteomyelitis/ chronic non-bacterial osteomyelitis (CRMO/CNO) is a rare auto-inflammatory disease and typically manifests in terms of musculoskeletal pain. Because of a high frequency of musculoskeletal disorders in children/ adolescents, it can be quite challenging to distinguish CRMO/ CNO from nonspecific musculosketetal pain or from malignancies. The purpose of this study was to evaluate the visibility of CRMO lesions in a whole-body diffusion-weighted imaging (WB-DWI) technique and its potential clinical value to better characterize MR-visible lesions. Materials and methods: Whole-body imaging at 3T was performed in 16 patients (average: 13 years) with confirmed CRMO. The protocol included 2D Short Tau Inversion Recovery (STIR) imaging in coronal and axial orientation as well as diffusion-weighted imaging in axial orientation. Visibility of lesions in DWI and STIR was evaluated by two readers in consensus. The apparent diffusion coefficient (ADC) was measured for every lesion and corresponding reference locations. Results: A total of 33 lesions (on average 2 per patient) visible in STIR and DWI images (b = 800 s/mm2 and ADC maps) were included, predominantly located in the long bones. With a mean value of 1283 mm2/s in lesions, the ADC was significantly higher than in corresponding reference regions (782 mm2/s). By calculating the ratio (lesion to reference), 82% of all lesions showed a relative signal increase of 10% or higher and 76% (25 lesions) showed a signal increase of more than 15%. The median relative signal increase was 69%. Conclusion: This study shows that WB-DWI can be reliably performed in children at 3T and predominantly, the ADC values were substantially elevated in CRMO lesions. WB-DWI in conjunction with clinical data is seen as a promising technique to distinguish benign inflammatory processes (in terms of increased ADC values) from particular malignancies.

Für Patienten mit fortgeschrittener Herzinsuffizienz ist die Herztransplantation die einzige kurative Therapieoption. Die akute Abstoßungsreaktion ist ein entscheidender Faktor der Mortalität nach Transplantation. Zur Früherkennung einer Abstoßungsreaktion gilt nach wie vor die Endomyokardbiopsie als Goldstandard. Diese stellt jedoch ein invasives Verfahren mit seltenen, aber potentiell schwerwiegenden Komplikationen dar. In der vorliegenden Studie wurde die diagnostische Wertigkeit der kardialen Magnetresonanztomographie zur Detektion der Abstoßungsreaktion nach Herztransplantation untersucht. Als Referenz diente die Myokardbiopsie mit histologischer Beurteilung nach dem Schema der International Society of Heart and Lung Transplantation (ISHLT). Insbesondere bei Kombination mehrerer Parameter konnte ein hoher negativ prädiktiver Wert zum Ausschluss einer akuten Abstoßungsreaktion erzielt werden. Dagegen waren Spezifität und positiv prädiktiver Wert zu gering, um eine Therapie-Änderung alleine auf Basis eines positiven MRT-Befundes zu rechtfertigen.:1 Titelblatt 1 2 Bibliographische Beschreibung 4 3 Einführung 5 3.1 Hintergrund zur Herztransplantation 5 3.1.1 Indikation und Epidemiologie 5 3.1.2 Abstoßungsreaktion und Immunsuppression 6 3.1.3 Statistiken zu Abstoßung und Immunsuppression 8 3.1.4 Verfahren und Probleme der Endomyokardbiopsie 10 3.2 Bisherige Ansätze zum nicht-invasiven Screening 12 3.2.1 Echokardiographie 12 3.2.2 Elektrokardiogramm 14 3.2.3 Biomarker im peripheren Blut 14 3.2.4 Kardiale Magnetresonanztomographie 16 3.3 Rationale und Fragestellungen zur vorliegenden Studie 19 4 Publikationsmanuskript 21 5 Zusammenfassung der Arbeit 33 6 Anlagen 39

Auf Basis der vorgestellten Untersuchungen lässt sich ein großes Potenzial der OCT für die Erkennung initialer Kariesstadien sowie für die Darstellung der dentalen Mikrostruktur ableiten. Die eingeführte Depolarisationsbildgebung stellt dabei eine Erweiterung bisheriger OCT-basierter Ansätze dar und wurde im Rahmen dieser Arbeit erstmalig für die Anwendung am Zahn präsentiert. Darüber hinaus bilden die Ergebnisse der Untersuchungen die Grundlage für die Entwicklung weiterer Prototypen für die intraorale OCT-Bildgebung, die zukünftig eine vielversprechende Ergänzung zu klinisch etablierten Verfahren bei der Diagnostik der Approximalbereiche und Okklusalflächen darstellen könnte.

No description available.

Introduction Since its development by Al Wolf and colleagues in the 1970s1, [11C]cyanide has been a useful synthon for a wide variety of reactions, most notably those producing [1-11C]-labeled amino acids2. However, despite its position as rote gas-phase product, the catalytic synthesis is difficult to optimize and often only perfunctorily dis-cussed in the radiochemical literature. Recently, [11C]CN– has been used in the synthesis of indole-3-[1-11C]acetic acid ([11C]IAA), the principal phytohormone responsible for a wide variety of growth and development functions in plants3. The University of Wisconsin has expertise in cyclotron production and radiochemistry of 11C and previous experience in the PET imaging of plants4,5. In this abstract, we present work on optimizing [11C]CN– production for the synthesis of [11C]IAA and the PET imaging of auxin transport in living plants. Material and Methods [11C]CH4 was produced by irradiating 270 psi of 90% N2, 10% H2 with 30 µA of 16.1 MeV protons from a GE PETtrace cyclotron. After irradiation, the [11C]CH4 was converted to [11C]CN– by passing through a quartz tube containing 3.0 g of Pt wire and powder between quartz wool frits inside a 800–1000 ˚C Carbolite tube furnace. The constituents and flow rate of the [11C]CH4 carrier gas were varied in an effort to optimize the oven\'s catalytic production of [11C]CN– from CH4 and NH3. The following conditions were investigated: i. Directly flowing irradiated target gas versus trapping, purging and releasing [11C]CH4 from a −178 ˚C HayeSep D column in He through the Pt furnace. ii. Varying the amount of anhydrous NH3 (99.995%) mixed with the [11C]CH4 carrier gas prior to the Pt furnace. Amounts varied from zero to 35 % of gas flow. iii. Varying the purity of the added NH3 gas with the addition of a hydride gas purifier (Entegris model 35KF), reducing O2 and H2O impurities to < 12 ppb. iv. Varying the flow rate of He gas carrying trapped, purged and released [11C]CH4. After flowing through the Pt furnace, the gas stream was bubbled through 300 µL of DMSO containing IAA precursor gramine (1 mg), then passed through a 60×5 cm column containing ascarite to absorb [11C]CO2, followed by a −178˚C Porapak Q column to trap [11C]CH4 and [11C]CO. After bubbling, the DMSO/gramine vial was heated to 140 ˚C to react the gramine with [11C]CN–, forming the intermediate indole-3-[1-11C]acetonitrile ([11C]IAN), which was subsequently purified by solid phase extraction (SPE). The reaction mixture was diluted into 20 mL water and loaded onto a Waters Sep-Pak light C18 cartridge, followed by rinsing with 5 mL of 0.1% HCl : acetonitrile (99 : 1) and 10 mL of the same mixture in ratio 95 : 5, and finally eluted with 0.5 mL of diethyl ether. The ether was subsequently evaporated under argon flow, followed by the hydrolysis of [11C]IAN to [11C]IAA with the addition of 300 µL 1 M NaOH and heating to 140 ˚C for 5 minutes. After hydrolysis, the solution was neutralized with 300 µL 1 M HCl and purified using preparative high-performance liquid chromatography (HPLC) using a Phenomenex Luna C18 (10μ, 250×10mm) column with a mobile phase acetonitrile : 0.1% formic acid in H2O (35 : 65) at flow rate of 3 mL/min. The [11C]IAA peak, eluting at 12 minutes, was collected and rotary evaporated to dryness, then again after the addition of 5 mL acetonitrile, followed by its reconstitution in 50 µL of water. Analytical HPLC was performed on the [11C]IAA before and after this evaporation procedure using a Phenomenex Kinetex C18 (2.6μ, 75× 4.6 mm) column with a linear gradient elution over 20 minutes of 10 : 90–30 : 70 (acetonitrile : 0.1% formic acid) at a 1 mL/min flow rate, eluting at 7.6 minutes. The transport of [11C]IAA was monitored following administration through the severed petiole of rapid cycling Brassica oleracea (rcBo) using a Siemens microPET P4 scanner. Transport was compared following administration to the first true leaf versus the final fully formed leaf in plants with and without exposure to the polar auxin transport inhibitor naphthylphthalamic acid (NPA). Results and Conclusion Optimization of the [11C]CN– gas phase chemistry was performed using two key metrics for measuring conversion yield. First is the fraction of total produced radioactivity that trapped in the DMSO/gramine solution (denoted %DMSO), and second, the fraction of DMSO/gramine-trapped activity that was able to react with gramine to form [11C]IAN (denoted %CN–). Under certain conditions, the former of these metrics experienced significant losses due to unconverted [11C]CH4 or through combustion, forming [11C]CO2 or [11C]CO. The latter metric experienced losses due to production of incomplete oxidation products of the CH4-NH3 reaction, such as methylamine. Total [11C]CH4 to [11C]CN– con-version yields is reported by the product of the two metrics. It was initially hypothesized that the irradiation of a 90% N2, 10% H2 target gas would produce sufficient in-target-hot-atom-produced NH3 to convert [11C]CH4 to [11C]CN– in the Pt furnace. However, conversion yields were found to be low and highly variable, with 13 ± 8 % trapping in DMSO/gramine, 9 ± 9 % of which reacted as CN– (n = 15). While in disagreement with previous reports1, this is likely as a result the batch irradiation conditions resulting ammonia losses in the target chamber and along the tubing walls. Yields and reproducibility were improved when combining the target gas with a stream of anhydrous NH3 gas flow with conversion yields reported in TABLE 1. However, these yields remained undesirably low, potentially as a result of the 10% H2 carrier gas having an adverse effect on the oxidative conversion of [11C]CH4 to [11C]CN–. To remedy this, the irradiated target gas was trapped, purged, released in He and combined with NH3 gas before flowing through the Pt furnace. Initial experiments using 99.995% anhydrous NH3 gas resulted in very poor (< 0.1%) [11C]CN– yields as a result of nearly quantitative combustion forming [11C]CO2. Installation of a hydride gas purifier to reduce O2 and H2O impurities in NH3 improved yields for CH4 in He, but did not significantly affect those from [11C]CH4 in N2/H2 target gas. In disagreement with previous reports2, conversion yields were found to be highly sensitive to overall carrier gas flow rate, with lower flow rates giving the best yields, as shown in TABLE 1. Optimization experiments are continuing. The total decay-corrected yield for the 1 hour synthesis of [11C]IAA in 50 µL of water is 2.3 ± 0.7 %, based on the total produced [11C]CH4 with a specific activity ranging from 1–100 GBq/µmol. The principal radiochemical impurity was determined to be indole-3-carboxylic acid. The SPE procedure isolating the [11C]IAN intermediate product was optimized to minimize this impurity in the final sample. After a rapid distribution of the administered [11C]IAA through the cut petiole and throughout the rcBO plant, upward vascular transport of auxin and downward polar auxin transport was visualized through time-activity curves (TACs) of regions of interest along the shoot. Comparison of these TACS with and without exposure to NPA yields insight into the fundamental physiological process of polar auxin transport in plants. In conclusion, the Pt-catalyzed oxidative conversion of [11C]CH4 and NH3 to [11C]CN– is a challenging process to optimize and highly sensitive to carrier gas composition and flow rate. Optimization for our experimental conditions yielded several results which disagreed with previous reports. [11C]IAA produced using [11C]CN– is well suited for PET imaging of polar auxin transport in living plants.

No description available.

The heart and its mechanical components, especially the heart valves and leaflets, are under enormous strain during lifetime. Like all highly stressed materials, also these biological components undergo fatigue and signs of wear, which impinge upon cardiac output and in the end on health and living comfort of affected patients. Thereby pathophysiological changes of the aortic valve leading to calcific aortic valve stenosis (AVS) as most frequent heart valve disease in humans are of particular interest. The knowledge about changes of the dynamic behavior during the course of this disease and the possibility of early stage diagnosis could lead to the development of new treatment strategies and drug-based options of prevention or therapy. ApoE-/- mice as established model of AVS versus wildtype mice were introduced in an ex vivo artificially stimulated heart model. 4D optical coherence tomography (OCT) in combination with high-speed video microscopy were applied to characterize dynamic behavior of the murine aortic valve and to characterize dynamic properties during artificial stimulation. OCT and high-speed video microscopy with high spatial and temporal resolution represent promising tools for the investigation of dynamic behavior and their changes in calcific aortic stenosis disease models in mice.

Background Caseous mitral annular calcification (CMAC) is a rare liquefactive variant of mitral annular calcification (MAC) and superficially mimics a cardiac vegetation or abscess. CMAC is viewed as a benign condition of MAC, while MAC has clinical implications for patients’ lives. Correctly diagnosing CMAC is essential in order to avoid unnecessary interventions, cardiac surgery or even psychological suffering for the patient. Case presentation We report on 6 patients with suspected intra-cardiac masses of the mitral annulus that were referred to our institution for further clarification. A definitive diagnosis of CMAC was achieved by combining echocardiography (Echo), cardiac magnetic resonance imaging (MRI) and cardiac computed tomography (CT) for these patients. Echo assessed the mass itself and possible interactions with the mitral valve. MRI was useful in differentiating the tissue from other benign or malign neoplasms. CT revealed the typical structure of CMAC with a “soft” liquefied centre and an outer capsule with calcification. Conclusion CMAC is a rare condition, and most clinicians and even radiologists are not familiar with it. CMAC can be mistaken for an intra-cardiac tumour, thombus, vegetation, or abscess. Non-invasive multimodality imaging (i.e. Echo, MRI, and CT) helps to establish a definitive diagnosis of CMAC and avoid unnecessary interventions especially in uncertain cases.

Quantitative phase imaging (QPI) is a label-free technique providing both morphology and quantitative biophysical information in biomedicine. However, applying such a powerful technique to in vivo pathological diagnosis remains challenging. Multi-core fiber bundles (MCFs) enable ultra-thin probes for in vivo imaging, but current MCF imaging techniques are limited to amplitude imaging modalities. We demonstrate a computational lensless microendoscope that uses an ultra-thin bare MCF to perform quantitative phase imaging with microscale lateral resolution and nanoscale axial sensitivity of the optical path length. The incident complex light field at the measurement side is precisely reconstructed from the far-field speckle pattern at the detection side, enabling digital refocusing in a multi-layer sample without any mechanical movement. The accuracy of the quantitative phase reconstruction is validated by imaging the phase target and hydrogel beads through the MCF. With the proposed imaging modality, three-dimensional imaging of human cancer cells is achieved through the ultra-thin fiber endoscope, promising widespread clinical applications.

Impulsivität ist ein zentraler Aspekt der Persönlichkeit, welcher entlang eines Kontinuums in normaler bis devianter Ausprägung auftreten kann. So moduliert persönlichkeitsbezogene Impulsivität sowohl das Verhalten Gesunder, als auch, in ihrer extremen Ausprägung, klinisch relevante Verhaltensweisen. Signifikant überdurchschnittlich ausgeprägte Impulsivität gilt als charakteristisch für eine Vielzahl psychiatrischer Krankheitsbilder wie Abhängigkeitserkrankungen. Die differentiell-psychologische Forschung geht von einer Persönlichkeitseigenschaft aus, welche den verschiedenen Facetten des Phänomens Impulsivität zu Grunde liegt. Jedoch sind strukturelle Bildgebungsstudien an gesunden Probanden zu diesem Gegenstand noch immer rar und ihre Befunde sehr heterogen. Ziel der vorliegenden publikationsbasierten Dissertationsschrift ist es, einen Beitrag zu einem vertieften Verständnis zerebraler struktureller Korrelate persönlichkeitsbezogener Impulsivität bei Gesunden zu leisten. In drei empirischen Untersuchungen wurden Daten struktureller Magnetresonanztomographie bei Gesunden erhoben und jeweils auf korrelative Zusammenhänge mit persönlichkeitsbezogener Impulsivität getestet. Insgesamt zeigten die für multiple Testung korrigierten Ergebnisse dieser Arbeit negative Korrelationen zwischen persönlichkeitsbezogener Impulsivität und morphometrischen Maßen (kortikale Dicke, kortikales Volumen) des linken superior frontalen Kortex, des linken mittleren frontalen Kortex sowie des linken orbitofrontalen Kortex. Erstmalig wurden Zusammenhänge zwischen Impulsivität als spezifischer Persönlichkeitsfacette und der Kortexdicke an einer repräsentativen gesunden Stichprobe gezeigt. Insgesamt weisen die Ergebnisse auf eine zentrale Rolle linkshemisphärischer Strukturen im Bereich des präfrontalen Kortex für Impulsivität hin. / Impulsiveness is a pivotal aspect of personality comprising a continuum from normal to deviant occurrence. Trait impulsiveness modulates both behavior in healthy individuals and, in its extreme occurrence, even clinically relevant behavior. So, inhibition disorder is understood to be a characteristic in a number of mental health problems such as addiction disorders, personality disorders and attention deficit/ hyperactivity disorders. Research in the field of personality psychology views impulsiveness as a broad trait underlying all of the different facets of impulsiveness. The interest in the biological correlates of trait impulsiveness has stimulated a growing number of neuroscientific studies. However, non-clinical structural imaging studies on impulsiveness are still rare and their findings very heterogeneous. The present cumulative thesis aims to contribute to an advanced understanding of structural cerebral correlates of trait impulsiveness in healthy individuals. Within the scope of three empirical studies structural data were acquired by means of high-resolution magnetic resonance scans in healthy participants and tested respectively for correlations with trait impulsiveness. Summarizing these present studies’ findings, the results surviving a multiple comparison corrected threshold showed negative correlations between trait impulsiveness and morphometric measurements (cortical thickness, cortical volume) of the left superior frontal cortex, the left middle frontal cortex and the left orbitofrontal cortex. For the first time, associations between impulsiveness as a certain facet of personality and cortical thickness have been shown in a representative healthy sample. The present work provides further insight into structural cerebral substrates of trait impulsiveness considering novel methodological aspects. In summary, the results suggest structures of the left prefrontal cortex play a central role in impulsiveness.