Apameh Khatam-Lashgari

It is believed by many that reference data for age estimation purposes must be imaging-modality specific. A study from our department has however proven otherwise. We therefore found it interesting to investigate this further by looking at the level of agreement between different imaging modalities. The aim of this study was to investigate the level of agreement between the three radiological modalities, computed tomography (CT), magnetic resonance imaging (MRI), and digital radiography (DR), in assessing the ossification of the epiphyses of the knee. A total of 34 deceased individuals of 10–25 years of age, brought in for a medicolegal autopsy at our department, were scanned by CT, MRI, and DR. The ossification stages of the three bones of the right knee, distal femoral, proximal tibial, and proximal fibular epiphysis were assessed using the established combined staging method by Schmeling et al. and Kellinghaus et al. Analysis of the results by Cohen’s weighted kappa showed a good agreement between CT and DR (K = 0.61–0.70), and MRI and DR (K = 0.68–0.79) but only moderate agreement between CT and MRI (K = 0.55–0.57). This leads us to conclude that different radiological images cannot be used interchangeably for age estimation purposes, so reference material needs to be imaging-modality specific. However, to make a more general conclusion research on a larger population is needed.

The immunosuppressive drug cyclosporin A (CsA) inhibits the production of nitric oxide (NO) through inhibition of the NO synthases. Especially iNOS is involved in the synthesis of large amounts of NO seen in sepsis, which leads to hypotension and multiple organ dysfunction. We hypothesized that CsA counteracts the LPS‐induced blood pressure decrease and reduced vasoreactivity in isolated murine aorta rings in a model of septic shock. To test this, blood pressure and heart rate was measured in conscious mice with indwelling catheters given a bolus (20 or 40 mg/kg) of CsA followed by continuous infusion (20 or 40 mg/kg/day) for one day before an LPS bolus was given (2 mg/kg). In vitro, studies were performed with aortic rings incubated with LPS (50 μg/ml) w/wo CsA, with CsA alone or vehicle. CsA (20 and 40 mg/kg) induced a significant increase in blood pressure (≈11 mmHg), with no effect on heart rate. After an LPS bolus, blood pressure and heart rate decreased, but there was no difference in delta blood pressure and heart rate compared to LPS alone. iNOS mRNA and protein expression was significantly reduced by CsA as well as plasma NOx excretion. CsA significantly attenuated the LPS‐induced decrease in vasoreactivity. It is concluded that CsA improve vasoreactivity in vitro while in a murine model of septic shock in vivo, CsA at 20 and 40 mg/kg did not counteract the effect of LPS on blood pressure.