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30. HLA typing in families with multiple cases of rheumatoid arthritis

Author

Strotzer, M., Menninger, H., Scholz, S., and Albert, E.D.

Subjects
HLA histocompatibility antigens -- Genetic aspects, Rheumatoid arthritis -- Physiological aspects, Health
Abstract

The HLA (human leukocyte antigen) system of cell-surface antigens (molecules capable of provoking an immune response) is similar to the blood group ABO antigens in that subtle differences in these molecules, coded for by the DNA in genes, identify an individual's cells as his own, immunologically speaking, and provoke graft rejection after transplantation. Certain HLA subgroups are strongly related to particular diseases, such as diabetes. Studies of some families have shown a relationship between frequent cases of rheumatoid arthritis (RA) and the subgroup HLA-DR4, while in some ethnic groups, HLA-DR1 is linked to RA instead. Whether the proteins made from the sequences of DR genes or the DR genes themselves are linked to other genes predisposing to RA is uncertain. Complete HLA typing was done in 31 RA patients from 14 families with multiple occurrences of RA, as well as in 42 healthy relatives. Class I antigens, HLA-A, -B, and -C were not more prevalent in patients. The class II antigens DR1 occurred in 32 percent of patients and in 12 percent of healthy subjects, while DR4 occurred in 48 percent and 28 percent, respectively, with the increased frequencies in patients being significant. These results were combined with those from other reports, and analysis revealed that DR1 and DR4 have a dominant influence in the inheritance of RA. The data suggest that some DR antigens may play a direct role in the development of RA. HLA antigens did not correlate with medical variables such as disease severity. Only 68 percent of the patients in this study had DR1 or DR4, suggesting that about one third of RA patients may have a type of disease which is independent of HLA factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

33. Diagnostic efficacy of gadoxetic acid (Primovist)-enhanced MRI and spiral CT for a therapeutic strategy: comparison with intraoperative and histopathologic findings in focal liver lesions

Author

Hammerstingl, R, Huppertz, A, Breuer, J, Balzer, T, Blakeborough, A, Carter, R, Fusté, Lc, Heinz Peer, G, Judmaier, W, Laniado, M, Manfredi, Riccardo, Mathieu, Dg, Müller, D, Mortelè, K, Reimer, P, Reiser, Mf, Robinson, Pj, Shamsi, K, Strotzer, M, Taupitz, M, Tombach, B, Valeri, G, van Beers BE, Vogl, Tj, and For the European EOB study group

Subjects
Adult, Gadolinium DTPA, Male, Magnetic resonance imaging, Computed tomography, Focal liver lesions, Liver-specific, Hepatobiliary, Gadoxetic acid-enhanced MRI, Therapeutic strategy, medicine.medical_specialty, Gadoxetic acid, Contrast Media, Sensitivity and Specificity, Gadoxetate Disodium, medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Neuroradiology, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Ultrasound, Liver Neoplasms, Interventional radiology, General Medicine, Middle Aged, Spiral computed tomography, Female, Radiology, Differential diagnosis, business, Tomography, Spiral Computed, medicine.drug
Abstract

A multicenter study has been employed to evaluate the diagnostic efficacy of magnetic resonance imaging (MRI) using the new liver-specific contrast agent gadoxetic acid (Gd-EOB-DTPA, Primovist), as opposed to contrast-enhanced biphasic spiral computed tomography (CT), in the diagnosis of focal liver lesions, compared with a standard of reference (SOR). One hundred and sixty-nine patients with hepatic lesions eligible for surgery underwent Gd-EOB-DTPA-enhanced MRI as well as CT within 6 weeks. Pathologic evaluation of the liver specimen combined with intraoperative ultrasound established the SOR. Data sets were evaluated on-site (14 investigators) and off-site (three independent blinded readers). Gd-EOB-DTPA was well tolerated. Three hundred and two lesions were detected in 131 patients valid for analysis by SOR. The frequency of correctly detected lesions was significantly higher on Gd-EOB-DTPA-enhanced MRI compared with CT in the clinical evaluation [10.44%; 95% confidence interval (CI): 4.88, 16.0]. In the blinded reading there was a trend towards Gd-EOB-DTPA-enhanced MRI, not reaching statistical significance (2.14%; 95% CI: -4.32, 8.6). However, the highest rate of correctly detected lesions with a diameter below 1 cm was achieved by Gd-EOB-DTPA-enhanced MRI. Differential diagnosis was superior for Gd-EOB-DTPA-enhanced MRI (82.1%) versus CT (71.0%). A change in surgical therapy was documented in 19 of 131 patients (14.5%) post Gd-EOB-DTPA-enhanced MRI. Gd-EOB-DTPA-enhanced MRI was superior in the diagnosis and therapeutic management of focal liver lesions compared with CT.

Published
2008

40. Computertomographie-gesteuerte Gastrostomie, Jejunostomie und Gastrojejunostomie: Eine zuverlässige nicht-chirurgische Methode auch bei Kontraindikationen oder Scheitern der perkutanen endoskopischen Gastrostomie

Author

Seitz, J., primary, Gmeinwieser, J., additional, Strotzer, M., additional, Dorenbeck, U., additional, Paetzel, C., additional, Lock, G., additional, Manke, C., additional, Feuerbach, St., additional, and Schölmerich, J., additional

Published
2008
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