The diagnosis of pulmonary embolism (PE) is usually established by a combination of clinical assessment, D-dimer testing, and imaging with either pulmonary ventilation-perfusion (V/Q) scintigraphy or pulmonary multidetector CT (MDCT) angiography. Both V/Q SPECT and MDCT angiography seem to have high diagnostic accuracy. However, only limited data directly comparing these 2 modalities are available. Hybrid g-camera/MDCT systems have been introduced and allow simultaneous 3-dimensional lung V/Q SPECT and MDCT angiography, suitable for diagnosing PE. The aim of our study was to compare, in a prospective design, the diagnostic ability of V/Q SPECT, V/Q SPECT combined with low-dose CT, and pulmonary MDCT angiography obtained simultaneously using a combined SPECT/MDCT scanner in patients suspected of having PE. Methods: Consecutive patients from June 2006 to February 2008 suspected of having acute PE were referred to the Department of Nuclear Medicine at Rigshospitalet or Frederiksberg Hospital, Denmark, for V/Q SPECT as a first-line imaging procedure. The number of eligible patients was 196. Patients with positive D-dimer results (.0.5 mmol/mL) or a clinical assessment with a Wells score greater than 2 were included and underwent V/Q SPECT, lowdose CT, and pulmonary MDCT angiography in a single session. Patient follow-up was 6 mo. Results: A total of 81 simultaneous studies were available for analysis, of which 38% were from patients with PE. V/Q SPECT had a sensitivity of 97% and a specificity of 88%. When low-dose CT was added, the sensitivity was still 97% and the specificity increased to 100%. Perfusion SPECT with low-dose CT had a sensitivity of 93% and a specificity of 51%. MDCT angiography alone had a sensitivity of 68% and a specificity of 100%. Conclusion: We conclude that V/Q SPECT in combination with low-dose CT without contrast enhancement has an excellent diagnostic performance and should therefore probably be considered first-line imaging in the workup of PE in most cases.

SummaryThe Escherichia coli ompA mRNA, encoding a highly abundant outer membrane protein, has served as a model for regulated mRNA decay in bacteria. The halflife of this transcript correlates inversely with the bacterial growth rate and is growth stage-dependent. The stability of the messenger is determined by the 5 ′ ′ ′ ′ -untranslated region which possesses cleavage sites for RNase E. Hfq binds to this region, is essential for controlling the stability and has been suggested to directly regulate ompA mRNA decay. Here we report that the 78 nucleotide SraD RNA, which is highly conserved among Enterobacteriaceae, acts in destabilizing the ompA transcript when rapidly grown cells enter the stationary phase of growth. During this growth-stage the expression of SraD RNA becomes strongly increased. The SraD-mediated decay of ompA mRNA depends on Hfq and in vitro studies revealed that Hfq facilitates binding of the regulatory RNA to the translational initiation region of the messenger. Deletion of sraD , however, does not significantly affect the stability of the ompA mRNA in slowly growing cells. Our results indicate that distinct regulatory circuits are responsible for growth phase-and growth rate-dependent control of the ompA mRNA stability.

3D echocardiographic estimates of RV size and RVEF show only moderate correlation to MRI measures of these parameters, and simple 2D echocardiographic estimates of RV size and function show similar correlations. For routine clinical purposes the simple TAPSE may be preferred over 3D and SPECT techniques for RVEF estimation.

Crop yields and yield potentials on Danish coarse sandy soils are strongly limited due to restricted root growth and poor water and nutrient retention. We investigated if biochar amendment to subsoil can improve root development in barley and significantly increase soil water retention. Spring barley (Hordeum vulgare cv. Anakin) was grown in soil columns (diameter: 30 cm) prepared with 25 cm topsoil, 75 cm biochar‐amended subsoil, and 30 cm un‐amended subsoil lowermost placed on an impervious surface. Low‐temperature gasification straw‐biochar (at 0, 0.50, 1.0, 2.0, and 4.0 wt%) and slow pyrolysis hardwood‐biochar (at 2 wt%) were investigated. One wt% can be scaled up to 102 Mg/ha of char. After full irrigation and drainage, the in‐situ moisture content at 30‐80 cm depth increased linearly (R2 = 0.99) with straw‐biochar content at a rate corresponding to 0.029 m3/m3/%. The lab determined wilting point also increased linearly with char content (R2 = 0.99) but at a much lower rate (0.003 m3/m3/%). Biochar at concentrations up to 2% significantly increased the density of roots in the 40–80 cm depth interval. Addition of 1% straw‐biochar had the most positive effect on root penetration resulting in the highest average root density (54% coverage compared to 33% without biochar). This treatment also resulted in the greatest spring barley grain yield increase (22%). Improving the quality of sandy subsoils has global potentials, and incorporation of the right amount of correctly treated residues from bioenergy technologies such as straw‐biochar is a promising option.

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More than 150 point mutations have now been identified in the ATP7A gene. Most of these mutations lead to the classic form of Menkes disease (MD), and a few lead to the milder occipital horn syndrome (OHS). To get a better understanding of molecular changes leading to classic MD and OHS, we took advantage of the unique finding of three patients with similar mutations but different phenotypes. Although all three patients had mutations located in the splice-donor site of intron 6, only two of the patients had the MD phenotype; the third had the OHS phenotype. Fibroblast cultures from the three patients were analyzed by reverse transcriptase (RT)-PCR to try to find an explanation of the different phenotypes. In all three patients, exon 6 was deleted in the majority of the ATP7A transcripts. However, by RT-PCR amplification with an exon 6-specific primer, we were able to amplify exon 6-containing mRNA products from all three patients, even though they were in low abundance. Sequencing of these products indicated that only the patient with OHS had correctly spliced exon 6-containing transcripts. We used two different methods of quantitative RT-PCR analysis and found that the level of correctly spliced mRNA in this patient was 2%-5% of the level found in unaffected individuals. These findings indicate that the presence of barely detectable amounts of correctly spliced ATP7A transcript is sufficient to permit the development of the milder OHS phenotype, as opposed to classic MD.

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We conclude that V/Q SPECT has a superior diagnostic performance compared with planar V/Q scintigraphy and should be preferred when diagnosing PE.