A study on subjective perception has been carried out in order to gain further insight into subjective discomfort and sensations experienced during 7 T magnetic resonance imaging (MRI). This study provides information about subjective acceptance, which is essential if 7 T MRI is to become a clinical diagnostic tool. Of 573 subjects who underwent 7 T MRI, 166 were also examined at 1.5 T, providing a means of discriminating field-dependent discomfort. All subjects judged sources of discomfort and physiological sensations on an 11-point scale (0 = no side effects, 10 = intolerable side effects) and scores were analyzed separately for exam phases, with and without table movement at each field strength. Results revealed that 7 T MRI was, in general, judged more uncomfortable than 1.5 T; however, most subjects rated the effects as being non-critical (mean scores between 0.5 and 3.5). Significant differences were detected regarding vertigo and sweating between subjects positioned "head-first" and "feet-first" at 7 T (worse in "head-first") and between 7 and 1.5 T (worse at 7 T), with the effects being more pronounced in the moving compared to the stationary table position. The most unpleasant factor at 7 T was the extensive examination duration, while potentially field-dependent sensations were rated less bothersome. In summary, our study indicates that although certain sensations increase at 7 T compared to 1.5 T, they are unlikely to hinder the use of 7 T MRI as a clinical diagnostic tool.

Adrenomedullin (ADM) is a potent hypotensive peptide produced by macrophages and endothelial cells during ischemia and sepsis. The molecular mechanisms that control ADM gene expression in tumor cells are still poorly defined. It is known, however, that hypoxia potently increases ADM expression by activation of the transcription factor complex hypoxia inducible factor 1 (HIF-1). Proinflammatory cytokines produced by tumor invading macrophages likewise activate expression of ADM. Herein, we show that apart from hypoxia, the proinflammatory cytokine interleukin 1B (IL-1B) induced the expression of ADM mRNA through activation of HIF-1 under normoxic conditions and enhanced the hypoxiainduced expression in the human ovarian carcinoma cell line OVCAR-3. IL-1B significantly increased accumulation and nuclear translocation of HIF-1A under normoxic conditions and amplified hypoxic HIF-1 activation. IL-1B treatment affected neither HIF-1A mRNA levels nor the hydroxylation status of HIF-1A and, thus, stability of the protein.

in terms of longer length of stay, more readmissions and higher consumption of drugs. The average quality of the studies was moderate. Further research is needed to establish the degree of burden of agitation and containment borne by hospitals and the health care system.

: III.