Note: This page contains sample records for the topic patients expanding image from
While these samples are representative of the content of,
they are not comprehensive nor are they the most current set.
We encourage you to perform a real-time search of
to obtain the most current and comprehensive results.
Last update: November 12, 2013.

Treatment Options Expand for Psoriasis Patients  


... page, please enable JavaScript. Treatment Options Expand for Psoriasis Patients There's no cure, but experts cite reasons ... 2013) Friday, September 13, 2013 Related MedlinePlus Page Psoriasis FRIDAY, Sept. 13 (HealthDay News) -- For the legions ...


Angiographic imaging evaluation of patient-specific bifurcation-aneurysm phantom treatment with pre-shaped, self-expanding, flow-diverting stents: feasibility study  

PubMed Central

Aneurysm treatment using flow diversion could become the treatment of choice in the near future. While such side-wall aneurysm treatments have been studied in many publications and even implemented in selected clinical cases, bifurcation aneurysm treatment using flow diversion has not been addressed in detail. Using angiographic imaging, we evaluated treatment of such cases with several stent designs using patient-specific aneurysm phantoms. The aim is to find a way under fluoroscopic image guidance to place a low-porosity material across the aneurysm orifice while keeping the vessel blockage minimal. Three pre-shaped self-expanding stent designs were developed: the first design uses a middle-flap wing stent, the second uses a two-tapered-wing-ended stent, and the third is a slight modification of the first design in which the middle-flap is anchored tightly against the aneurysm using a standard stent. Treatment effects on flow were evaluated using high-speed angiography (30 fps) and compared with the untreated aneurysm. Contrast inflow was reduced in all the cases: 25% for Type 1, 63% for type 2 and 88% for Type 3. The first and the second stent design allowed some but substantially-reduced flow inside the aneurysm neck as indicated by the time-density curves. The third stent design eliminated almost all flow directed at the aneurysm dome, and only partial filling was observed. In the same time Type 1 and 3 delayed the inflow in the branches up to 100% compared to the untreated phantom. The results are quite promising and warrant future study.

Ionita, Ciprian N; Suri, Himanshu; Nataranjian, Sabareesh; Siddiqui, Adnan; Levy, Elad; Hopkins, Nelson L; Bednarek, Daniel R; Rudin, Stephen



Angiographic imaging evaluation of patient-specific bifurcation-aneurysm phantom treatment with pre-shaped, self-expanding, flow-diverting stents: feasibility study.  


Aneurysm treatment using flow diversion could become the treatment of choice in the near future. While such side-wall aneurysm treatments have been studied in many publications and even implemented in selected clinical cases, bifurcation aneurysm treatment using flow diversion has not been addressed in detail. Using angiographic imaging, we evaluated treatment of such cases with several stent designs using patient-specific aneurysm phantoms. The aim is to find a way under fluoroscopic image guidance to place a low-porosity material across the aneurysm orifice while keeping the vessel blockage minimal. Three pre-shaped self-expanding stent designs were developed: the first design uses a middle-flap wing stent, the second uses a two-tapered-wing-ended stent, and the third is a slight modification of the first design in which the middle-flap is anchored tightly against the aneurysm using a standard stent. Treatment effects on flow were evaluated using high-speed angiography (30 fps) and compared with the untreated aneurysm. Contrast inflow was reduced in all the cases: 25% for Type 1, 63% for type 2 and 88% for Type 3. The first and the second stent design allowed some but substantially-reduced flow inside the aneurysm neck as indicated by the time-density curves. The third stent design eliminated almost all flow directed at the aneurysm dome, and only partial filling was observed. In the same time Type 1 and 3 delayed the inflow in the branches up to 100% compared to the untreated phantom. The results are quite promising and warrant future study. PMID:21760699

Ionita, Ciprian N; Suri, Himanshu; Nataranjian, Sabareesh; Siddiqui, Adnan; Levy, Elad; Hopkins, Nelson L; Bednarek, Daniel R; Rudin, Stephen



Potential risks and artifacts of magnetic resonance imaging of self-expandable esophageal stents  

Microsoft Academic Search

Background: Several types of coated and uncoated self-expandable stents composed of various metals are available for palliation of malignant esophageal stenoses and fistulas. We encountered poor visualization of the mediastinum and skeletal axis with magnetic resonance imaging in a patient with a Gianturco self-expandable stent. Methods: To evaluate potential problems, such as stent migration in the magnetic field of the

Babs G. Taal; Muller Sara; Henk Boot; Wim Koops



Expanding Perspectives for Comprehending Visual Images in Multimodal Texts  

ERIC Educational Resources Information Center

|The texts that adolescents encounter today are often multimodal, meaning they incorporate a variety of modes, including visual images, hypertext, and graphic design elements along with written text. Expanding the perspectives readers use to make sense of the multimodal texts is an important aspect of comprehension instruction. Moving beyond the…

Serafini, Frank



Expanded beam non-imaging fiber optic connector  


There is disclosed an expanded beam fiber to fiber connector, based on non-imaging optic principles for coupling light beams from one optical fiber to another. The system consists of two identical connector parts, referred to herein as a collimating part and a concentrating part, each having a preferred partially curved reflective boundary surface for minimizing power loss and surrounding either a hollow space or a space filled with a uniform transparent medium. In one embodiment the boundary is metallic while in a second embodiment the boundary is in the form of an interface allowing total internal reflection. In both the hollow and filled case a lens may be located at the expanded end of both the collimator part and the concentrator part forming the connector. The connector is preferably located in a housing in order to protect and preserve the mechanical stability of the coupler. 13 figs.

Jannson, T.; Jannson, J.; Yeung, P.



Expandable endoprosthesis reconstruction in skeletally immature patients with tumors.  


Between September 1984 and January 1996, 32 expandable endoprostheses were used for limb reconstruction after resection of malignant bone tumors in patients who were skeletally immature. The 20 boys and 12 girls ranged in age from 3 to 15 years (mean, 9.7 years). One patient had a Stage IIA tumor, 22 patients had Stage IIB tumors, and seven patients had Stage III tumors according to the classification of the Musculoskeletal Tumor Society. There also were two patients with parosteal osteosarcomas. The histologic diagnosis was osteosarcoma in 23 patients and Ewing's sarcoma in nine. All patients except the patients with parosteal osteosarcoma received standard neoadjuvant therapy. Twenty-two Lewis Expandable Adjustable Prostheses, four modular Wright Medical prostheses, four modular Howmedica prostheses, and two Techmedica expandable prostheses were used. Thirteen patients died, two have no evidence of disease, and 17 are continuously disease free. Sixteen of 32 patients (50%) have not had an expansion procedure because of early death in 10 and early amputation in three. Three patients are waiting to undergo an expansion procedure. Sixteen of the 32 patients (50%) have undergone 32 expansion procedures, to a maximum of 9 cm, without any infection. To maintain range of motion before the expansion procedure, a complete resection of the pseudocapsule was done routinely. Fourteen of the 32 patients did not have complications. Eighteen of the 32 patients had 27 complications. All Lewis Expandable Adjustable Prosthesis endoprostheses and the two nonmodular Techmedica prostheses were associated with a large amount of titanium debris. The children's functional results were similar to the results reported for adults with an average Musculoskeletal Tumor Society rating of good to excellent at the knee, fair to good at the hip, and fair about the shoulder. Rehabilitation of the knee in very young patients (5-8 years) remains problematic and careful selection of patient and family is necessary. The Lewis Expandable Adjustable Prosthesis probably should be reserved for very young patients (5-8 years) and modular systems should be used for large preadolescent and adolescent children. PMID:10810462

Eckardt, J J; Kabo, J M; Kelley, C M; Ward, W G; Asavamongkolkul, A; Wirganowicz, P Z; Yang, R S; Eilber, F R



Nanoscale imaging reveals laterally expanding antimicrobial pores in lipid bilayers  

PubMed Central

Antimicrobial peptides are postulated to disrupt microbial phospholipid membranes. The prevailing molecular model is based on the formation of stable or transient pores although the direct observation of the fundamental processes is lacking. By combining rational peptide design with topographical (atomic force microscopy) and chemical (nanoscale secondary ion mass spectrometry) imaging on the same samples, we show that pores formed by antimicrobial peptides in supported lipid bilayers are not necessarily limited to a particular diameter, nor they are transient, but can expand laterally at the nano-to-micrometer scale to the point of complete membrane disintegration. The results offer a mechanistic basis for membrane poration as a generic physicochemical process of cooperative and continuous peptide recruitment in the available phospholipid matrix.

Rakowska, Paulina D.; Jiang, Haibo; Ray, Santanu; Pyne, Alice; Lamarre, Baptiste; Carr, Matthew; Judge, Peter J.; Ravi, Jascindra; M. Gerling, Ulla I.; Koksch, Beate; Martyna, Glenn J.; Hoogenboom, Bart W.; Watts, Anthony; Crain, Jason; Grovenor, Chris R. M.; Ryadnov, Maxim G.



Expanding patient involvement in care. Effects on patient outcomes  

Microsoft Academic Search

An intervention was developed to increase patient involvement in care. Using a treatment algorithm as a guide, patients were helped to read their medical record and coached to ask questions and negotiate medical decisions with their physicians during a 20-minute session before their regularly scheduled visit. In a randomized controlled trial we compared this intervention with a standard educational session

Sheldon Greenfield; Sherrie H. Kaplan; Ware John E. Jr



Expandable metal biliary stenting in patients with recurrent premature polyethylene stent occlusion  

Microsoft Academic Search

OBJECTIVES:Expandable metal stents are currently used to treat biliary tract obstruction. Few data exist on the role of metal stents in patients with recurrent premature plastic biliary stent occlusion. We report our preliminary results using an expandable metal biliary stent with enhanced stent flexibility in this group of patients. Our aim was to assess the efficacy of the Diamond biliary

Krishna Menon; Joseph Romagnuolo; Alan N. Barkun



Expanding Imaging Platform Functionality for Microfluidic Applications (Brandeis\\/National Science Foundation)  

Microsoft Academic Search

Microfluidics promises solutions to problems ranging from genome sequencing to point-of-care diagnostics. The Microfluidics Laboratory at Brandeis is studying a number of applications including protein crystallization and chemical oscillators. Under a MRSEC grant from the National Science Foundation, Brandeis is expanding user facilities for microfluidics research. Last year, the Olin SCOPE team designed an automated microscope platform capable of imaging

Julie Baca; Spencer Backus; Ashley Banks; Katherine Elliot; Heena Mutha; Matthew Ritter; Emanuel Towns



Instrument for collimating and expanding Gaussian beams for underwater laser imaging systems  

Microsoft Academic Search

Based on the propagation properties of Gaussian beams, a new scheme for an instrument for collimating and expanding (ICE) Gaussian beams for underwater laser imaging systems is proposed, as well as a method for its optimal design. The aberration of a Gaussian beam passing through the ICE is calculated approximately. A design example of the aligning system for the underwater

Xueming Liu; Jinglin He; Xiaohan Sun; Mingde Zhang



A method for classification training samples spatial-time expanding of remote sensing image  

NASA Astrophysics Data System (ADS)

Because of the environment conditions of the ground targets have been changing when the remote sensing images are acquired, so it is known that labeled samples from one remote sensing image is almost imposable to be used in another image classification, because the spectral signatures are various. But once it can be done successfully it will lead to great resource preserving and high work efficiency. This article proposes a classification samples spatial-time domain expanding method to address this issue. In this method, we choose training samples from a reference image, then classify the images in space and time neighborhood of the reference image by the classifier which is trained with these labeled samples. Before classifying, the relative radio-correcting (or to say radiometric normalization) of the images to be classified need be done, and it is the key step. Three classification experiments, which were the reference image and the image need be classified have only different acquisition time, only different cover region, and both the different acquisition time and different cover region, are successfully carried out. The results prove that our method has done well in classification samples expanding application in time domain, in space domain and both in the two domains.

Ren, Guangbo; Zhang, Jie; Ma, Yi; Zheng, Rong-Er



Palliation of malignant dysphagia and fistulae with coated expandable metal stents: experience with 101 patients  

Microsoft Academic Search

Background: Insertion of coated expandable esophageal stents is the preferred endoscopic palliative treatment for malignant dysphagia and digestive-respiratory fistulae. Methods: One hundred one patients with malignant dysphagia and digestive-respiratory fistulae, 83 due to esophageal cancer and 18 due to metastatic disease, underwent placement of a coated expandable metal stent. Thirteen patients had a digestive-respiratory fistula. The stricture location (99 patients)

Isaac Raijman; Iqbal Siddique; Jaffer Ajani; Patrick Lynch



Imaging Stroke Patients with Unclear Onset Times  

PubMed Central

Despite significant progress in stroke prevention and acute treatment, stroke remains a leading cause of death and adult morbidity worldwide. By defining “stroke symptom onset” in the most conservative manner, namely the time the patient was last known to be well, many patients whose onsets are unwitnessed are automatically ineligible for thrombolytic therapy even if their true time of onset would make them eligible. Many groups are trying to determine if advanced brain imaging can serve as a substitute “witness” to estimate stroke onset and duration in those patients who do not have a human witness. We review and compare some of these imaging-based approaches to thrombolysis eligbility, which if successful, can potentially expand the use of thrombolytic therapy to a broader stroke patient population.

Wu, Ona; Schwamm, Lee H.; Sorensen, A. Gregory



Expanding the Guidelines for Electronic Communication with Patients  

PubMed Central

In 1998, the American Medical Informatics Association (AMIA) published a white paper entitled “Guidelines for the Clinical Use of Electronic Mail with Patients,” which outlined a practical framework for this interaction. Interest in the use of other Internet-based tools, such as the World Wide Web, to enhance clinical communication is increasing. In such systems, static information can be made centrally available to patients and interactive tools such as messaging systems, schedules, and individualized care regimens can be integrated within the site. Sitespecific guidelines are needed to address potential problems inherent in the particular services being offered. This article presents advice on developing site-specific guidelines, with examples, based on experience gained in developing and refining guidelines for the use of PatientWeb at the Massachusetts General Hospital Department of Neurology.

Prady, Stephanie L.; Norris, Deirdre; Lester, John E.; Hoch, Daniel B.



Expanded Dempster-Shafer reasoning technique for image feature integration and object recognition  

NASA Astrophysics Data System (ADS)

Integration of information from multiple sources has been one of the key steps to the success of general vision systems. It is also an essential problem to the development of color image understanding algorithms that make full use of the multichannel color data for object recognition. This paper presents a feature integration system characterized by a hybrid combination of a statistic-based reasoning technique and a symbolic logic-based inference method. A competitive evidence enhancement scheme is used in the process to fuse information from multiple sources. The scheme expands the Dempster-Shafer's function of combination and improves the reliability of the object recognition. When applied to integrate the object features extracted from the multiple spectra of the color images, the system alleviates the drawback of traditional Baysian classification system.

Zhu, Qiuming; Huang, Yinghua; Payne, Matt G.



Exit pupil expander: image quality performance enhancements and environmental testing results  

NASA Astrophysics Data System (ADS)

The numerical aperture of the light emanating from display pixels in a given display system determines the exit pupil size. In retinal scanning displays, the exit pupil is defined by the scanner optics, creating a rastered, projected image at an intermediate plane, typically resulting in an exit pupil approximately the size of an eye"s pupil. Positional freedom of the eye and relative display placement define the required expansion of the limited input NA for producing the desired exit pupil size for the display system. Currently Microvision utilizes an optical element comprised of two Microlens Arrays (MLAs) in tandem to expand the NA. The dual-MLA system has demonstrated exit pupil size that is independent of color; and uniformity of the beamlet structure is quite Top-Hat like. To further improve the perceived image quality, Microvision has now refined the optical system to minimize interference effects in the Exit Pupil plane that were caused by the coherent nature of the light source. We describe here a single refractive double-sided aspheric element that diminishes this interference effect by converting an input Gaussian beam profile to a Top-Hat profile. We also discuss the theory behind the use of a Gaussian-to-Top-Hat Converter, the tradeoffs associated with its use, as well as experimental results showing the uniformity improvements when using a Top-Hat converter element in conjunction with the MLA-based Exit Pupil Expander. In addition, we report the progress of environmental testing of the Exit Pupil Expander (EPE).

Powell, Karlton D.; Lopez, Peggy A.; Malik, Amjad



Expanded image database of pistachio x-ray images and classification by conventional methods  

NASA Astrophysics Data System (ADS)

In order to develop sorting methods for insect damaged pistachio nuts, a large data set of pistachio x-ray images (6,759 nuts) was created. Both film and linescan sensor images were acquired, nuts dissected and internal conditions coded using the U.S. Grade standards and definitions for pistachios. A subset of 1199 good and 686 insect damaged nuts was used to calculate and test discriminant functions. Statistical parameters of image histograms were evaluated for inclusion by forward stepwise discrimination. Using three variables in the discriminant function, 89% of test set nuts were correctly identified. Comparable data for 6 human subjects ranged from 67 to 92%. If the loss of good nuts is held to 1% by requiring a high probability to discard a nut as insect damaged, approximately half of the insect damage present in clean pistachio nuts may be detected and removed by x-ray inspection.

Keagy, Pamela M.; Schatzki, Thomas F.; Le, Lan Chau; Casasent, David P.; Weber, David



Neurotrophic factor expression in expandable cell populations from brain samples in living patients with Parkinson's disease.  


Cell-based therapies offer promise for patients with Parkinson's disease (PD); however, durable and effective transplantation substrates need to be defined. This study characterized the feasibility and growth properties of primary cultures established from small-volume brain biopsies taken during deep brain stimulation (DBS) surgery in patients with PD. The lineage and expression of neurotrophic factors with known beneficial actions in PD-affected brain circuitry were also evaluated. Nineteen patients with PD undergoing DBS surgery consented to brain biopsies prior to electrode implantation. Cultures from these samples exhibited exponential and plateau phases of growth and were readily expanded throughout multiple passages. There was robust expression of progenitor markers and the unexpected colocalization of neural and mesenchymal proteins. The oligodendrocyte transcription factor, Olig1, and the myelin-specific sphingolipid, galactocerebroside, were coexpressed with each of glial-derived neurotrophic factor, brain-derived neurotrophic factor, and cerebral dopamine neurotrophic factor. Fluorescence-activated cell sorting demonstrated homogeneous expression of both nestin and Olig1 throughout the expanded cultures. Cells remained viable after a year in cryostorage. These findings confirm the feasibility of small brain biopsies as an expandable source of autologous cell substrate in living patients and demonstrate the complex phenotype of these cells, with implications for therapeutic application in PD and other neurological diseases.- Xu, H., Belkacemi, L., Jog, M., Parrent, A., Hebb. M. O. Neurotrophic factor expression in expandable cell populations from brain samples in living patients with Parkinson's disease. PMID:23825231

Xu, Hu; Belkacemi, Louiza; Jog, Mandar; Parrent, Andrew; Hebb, Matthew O



Dosimetry around metallic ports in tissue expanders in patients receiving postmastectomy radiation therapy: an ex vivo evaluation  

Microsoft Academic Search

Postmastectomy breast reconstruction can be accomplished utilizing tissue expanders and implants. However, in patients who require postoperative radiotherapy, the complication rate with tissue expander\\/implant reconstruction can exceed 50%. One potential cause of this high complication rate may be the metallic port in the tissue expander producing altered dosimetry in the region of the metallic device. The purpose of this study

Janaki Moni; Maria Graves-Ditman; Paul Cederna; Kent Griffith; Editha A. Krueger; Benedick A. Fraass; Lori J Pierce



Morbidity and mortality after self-expandable metallic stent placement in patients with progressive or recurrent esophageal cancer after chemoradiotherapy  

Microsoft Academic Search

Background: Placemet of self-expandable metallic stents in patients with advance esophageal cancer improves dysphagia and occludes tracheoesophageal fistulas. However, the safety of self-expandable metallic stents for patients who have undergone chemoradiotherapy is controversial. This study evaluated the morbidity and modality after self-expandable metallic stent placement in patients with progressive or recurrent esophageal cancer after chemoradiotherapy. Methods: A total of 22

Tetsuya Sumiyoshi; Takuji Gotoda; Kei Muro; Bjorn Rembacken; Masahiro Goto; Yoko Sumiyoshi; Hiroyuki Ono; Daizo Saito



An Imaging Spectral Line Survey of IRC+10216 using the Expanded Very Large Array (EVLA)  

NASA Astrophysics Data System (ADS)

The Expanded Very Large Array (EVLA) is currently undergoing scientific commissioning, with full scientific operations expected in 2013. During the commissioning, we have performed a rather coarse ( 25 km/s) and shallow imaging spectral survey of the circumstellar environment of the well-known and nearby carbon-rich asymptotic giant branch (AGB) star IRC+10°216 (CW Leo) in the frequency range 18 - 26.5 GHz, using the capability of the WIDAR correlator to simultaneously observe 2 GHz of bandwidth. In addition we have used the additional capability of WIDAR to observe widely spaced sub-bands to observe eight pairs of targeted lines with much better spectral resolution (1.0 - 2.0 km/s) in the 18 - 26.5 GHz receiver band (selected from the coarse survey) and the 26.5 - 40 GHz receiver band (selected from the single-dish survey of Kawaguchi et al. (1995, PASJ, 47, 853). In the coarse survey, we detected twenty-one transitions of eleven molecules including eight transitions of HC7N, ranging from 18.049 GHz to 25.946 GHz, the J = 1 - 0 maser transition of SiS at 18.156 GHz, and three transitions of HC5N. We will present further results of the survey and images of the emission from the targeted lines. The National Radio Astronomy is a facility of the National Science Foundation operated under cooperative agreement by Associated Universities, Inc.

Claussen, Mark J.; EVLA Scientific Commissioning Team



Spectroscopic, imaging, and probe diagnostics of laser plasma plumes expanding between confining surfaces  

SciTech Connect

Laser plasma plumes were generated in aluminum rectangular cavities of fixed depth (6 mm) and varying height (2.0, 1.5, and 1.0 mm). Space and time resolved visible emission spectroscopy, gated intensified visible imaging, and Langmuir probe diagnostics were utilized to diagnose the evolution of the confined plasma plumes in comparison to freely expanding plasma plume generated from ablation of a planar target. The constrained plasma behavior displayed a multiphase history. Early stage interactions (t<100 ns) resulted in enhanced continuum and line emission, shockwave formation and plasma plume rebound. Later phase, long duration plasma-surface interactions (t>160 ns) resulted in sustained 'decay', i.e., a rapid termination of continuum emission, in concert with decreases in peak electron density (N{sub e}) and plasma temperature (T). This later phase originates from loss mechanisms which bleed the plasma plume of thermal energy and charged particles. These loss mechanisms increase in magnitude as the duration of the plasma-surface interaction increases. The transition from enhancement phase, originating from hydrodynamic containment, and plasma-surface collisions, to decay phase is described and occurs for each cavity at a different point in the space time history.

Yeates, P. [National Centre for Plasma Science and Technology, Dublin City University, Dublin 9 (Ireland); Kennedy, E. T. [School of Physical Sciences, Dublin City University, Dublin 9 (Ireland)



Dendritic cells can be rapidly expanded ex vivo and safely administered in patients with metastatic breast cancer  

Microsoft Academic Search

Purpose Immunotherapy using either dendritic cells (DCs) or expanded cytotoxic T cells (CTLs) has received increased interest in the treatment of specific malignancies including metastatic breast cancer (MBC). DCs can be generated ex vivo from monocytes or CD34 + precursors. The ability to expand and safely administer CD34-derived DCs in patients with MBC that have received prior cytotoxic chemotherapy has

E. Claire Dees; Karen P. McKinnon; Jennifer J. Kuhns; Kathryn A. Chwastiak; Scotty Sparks; Mary Myers; Edward J. Collins; Jeffrey A. Frelinger; Henrik Van Deventer; Frances Collichio; Lisa A. Carey; Mark E. Brecher; Mark Graham; H. Shelton Earp; Jonathan S. Serody



Is the Vertebral Expandable Prosthetic Titanium Rib a Surgical Alternative in Patients with Spina Bifida?  

Microsoft Academic Search

Background  Nonambulatory children with myelodysplasia are most likely to develop spinal deformity. As the deformity progresses, the overall\\u000a health of the patient deteriorates. Traditional management of the deformity with fusion results in a short trunk, crankshaft\\u000a deformity, and spine and lung growth inhibition. One alternative that potentially minimizes these problems is the vertebral\\u000a expandable prosthetic titanium rib (VEPTR).\\u000a \\u000a \\u000a \\u000a \\u000a Questions\\/purposes  We therefore asked

John M. Flynn; Norman Ramirez; John B. Emans; John T. Smith; Mary Jane Mulcahey; Randal R. Betz



Expanding spectrum of TNFRSF1A gene mutations among patients with idiopathic recurrent acute pericarditis.  


Although idiopathic recurrent acute pericarditis (IRAP) is generally presumed to derive from an autoimmune process, increasing interest is currently being devoted to autoinflammatory diseases, a group of disorders of the innate immune system caused by mutations of genes involved in the regulation or activation of the inflammatory response, without any apparent involvement of autoimmunity. The tumour necrosis factor receptor-1-associated periodic syndrome is the most common autosomal dominant autoinflammatory disorder and is caused by mutations in the TNFRSF1A gene encoding the 55-kD receptor for tumour necrosis factor-?. IRAP patients carrying TNFRSF1A gene mutations have been recently described. We report herein the first IRAP patients carrying the rare R104Q and D12E?TNFRSF1A gene mutations, thus expanding the spectrum of tumour necrosis factor receptor-1-associated periodic syndrome mutations in IRAP patients. PMID:23745996

Cantarini, L; Lucherini, O M; Vitale, A; Sabadini, L; Brizi, M G; Frediani, B; Muscari, I; Galeazzi, M



Image navigation as a means to expand the boundaries of fluorescence-guided surgery  

NASA Astrophysics Data System (ADS)

Hybrid tracers that are both radioactive and fluorescent help extend the use of fluorescence-guided surgery to deeper structures. Such hybrid tracers facilitate preoperative surgical planning using (3D) scintigraphic images and enable synchronous intraoperative radio- and fluorescence guidance. Nevertheless, we previously found that improved orientation during laparoscopic surgery remains desirable. Here we illustrate how intraoperative navigation based on optical tracking of a fluorescence endoscope may help further improve the accuracy of hybrid surgical guidance. After feeding SPECT/CT images with an optical fiducial as a reference target to the navigation system, optical tracking could be used to position the tip of the fluorescence endoscope relative to the preoperative 3D imaging data. This hybrid navigation approach allowed us to accurately identify marker seeds in a phantom setup. The multispectral nature of the fluorescence endoscope enabled stepwise visualization of the two clinically approved fluorescent dyes, fluorescein and indocyanine green. In addition, the approach was used to navigate toward the prostate in a patient undergoing robot-assisted prostatectomy. Navigation of the tracked fluorescence endoscope toward the target identified on SPECT/CT resulted in real-time gradual visualization of the fluorescent signal in the prostate, thus providing an intraoperative confirmation of the navigation accuracy.

Brouwer, Oscar R.; Buckle, Tessa; Bunschoten, Anton; Kuil, Joeri; Vahrmeijer, Alexander L.; Wendler, Thomas; Valdés-Olmos, Renato A.; van der Poel, Henk G.; van Leeuwen, Fijs W. B.



Body mass index is inversely correlated with the expanded CAG repeat length in SCA3/MJD patients.  


Spinocerebellar ataxia type 3, also known as Machado-Joseph disease (SCA3/MJD), is an autosomal dominant neurodegenerative disorder with no current treatment. We aimed to evaluate the body mass index (BMI) of patients with SCA3/MJD and to assess the correlations with clinical, molecular, biochemical, and neuroimaging findings. A case-control study with 46 SCA3/MJD patients and 42 healthy, non-related control individuals with similar age and sex was performed. Clinical evaluation was done with the ataxia scales SARA and NESSCA. Serum insulin, insulin-like growth factor 1 (IGF-1) and magnetic resonance imaging normalized volumetries of cerebellum and brain stem were also assessed. BMI was lower in SCA3/MJD patients when compared to controls (p?=?0.01). BMI was associated with NESSCA, expanded CAG repeat number (CAG)n, age of onset, age, disease duration, and serum insulin levels; however, in the linear regression model, (CAG)n was the only variable independently associated with BMI, in an inverse manner (R?=?-0.396, p?=?0.015). In this report, we present evidence that low BMI is not only present in SCA3/MJD, but is also directly related to the length of the expanded CAG repeats, which is the causative mutation of the disease. This association points that weight loss might be a primary disturbance of SCA3/MJD, although further detailed analyses are necessary for a better understanding of the nutritional deficit and its role in the pathophysiology of SCA3/MJD. PMID:22090366

Saute, Jonas Alex Morales; Silva, Andrew Chaves Feitosa da; Souza, Gabriele Nunes; Russo, Aline Dutra; Donis, Karina Carvalho; Vedolin, Leonardo; Saraiva-Pereira, Maria Luiza; Portela, Luis Valmor Cruz; Jardim, Laura Bannach



Dosimetry around metallic ports in tissue expanders in patients receiving postmastectomy radiation therapy: an ex vivo evaluation  

SciTech Connect

Postmastectomy breast reconstruction can be accomplished utilizing tissue expanders and implants. However, in patients who require postoperative radiotherapy, the complication rate with tissue expander/implant reconstruction can exceed 50%. One potential cause of this high complication rate may be the metallic port in the tissue expander producing altered dosimetry in the region of the metallic device. The purpose of this study was to quantify the radiation dose distribution in the vicinity of the metallic port and determine its potential contribution to this extremely high complication rate. The absolute dosimetric effect of the tissue expander's metallic port was quantified using film and thermoluminescent dosimetry (TLD) studies with a single beam incident on a metallic port extracted from an expander. TLD measurements were performed at 11 reproducible positions on an intact expander irradiated with tangential fields. A computed tomography (CT)-based treatment plan without inhomogeneity corrections was used to derive expected doses for all TLD positions. Multiple irradiation experiments were performed for all TLD data. Confidence intervals for the dose at TLD sites with the metallic port in place were compared to the expected dose at the site without the metallic port. Film studies did not reveal a significant component of scatter around the metallic port. TLD studies of the extracted metallic port revealed highest doses within the casing of the metallic port and no consistent increased dose at the surface of the expander. No excess dose due to the metallic port in the expander was noted with the phantom TLD data. Based upon these results, it does not appear that the metallic port in tissue expanders significantly contributes to the high complication rate experienced in patients undergoing tissue expander breast reconstruction and receiving radiation therapy. Strategies designed to reduce the breast reconstruction complication rate in this clinical setting will need to focus on factors other than adjusting the dosimetry around the tissue expander metallic port.

Moni, Janaki; Graves-Ditman, Maria; Cederna, Paul; Griffith, Kent; Krueger, Editha A.; Fraass, Benedick A.; Pierce, Lori J



A Pilot Imaging Line Survey of RW LMi and IK Tau Using the Expanded Very Large Array  

NASA Astrophysics Data System (ADS)

We report on a pilot imaging line survey (36.0-37.0 GHz, with ~1 km s-1 spectral channels) with the Expanded Very Large Array for two asymptotic giant branch stars, RW LMi (= CIT6, which has a carbon-rich circumstellar envelope, CSE) and IK Tau (=NML Tau, with an oxygen-rich CSE). Radio continuum emission consistent with photospheric emission was detected from both stars. From RW LMi we imaged the HC3N (J = 4?3) emission. The images show several partial rings of emission; these multiple shells trace the evolution of the CSE from 400 to 1200 years. SiS (J = 2?1) emission was detected from both RW LMi and IK Tau. For both stars the SiS emission is centrally condensed with the peak line emission coincident with the stellar radio continuum emission. In addition, we have detected weak HC7N (J = 32?31) emission from RW LMi.

Claussen, M. J.; Sjouwerman, L. O.; Rupen, M. P.; Olofsson, H.; Schöier, F. L.; Bergman, P.; Knapp, G. R.



Nanodiamond molecular imaging with enhanced contrast and expanded field of view.  


ABSTRACT. Nanodiamond imaging is a new molecular imaging modality that takes advantage of nitrogen-vacancy (NV) centers in nanodiamonds to image a distribution of nanodiamonds with high sensitivity and high spatial resolution. Since nanodiamonds are nontoxic and are easily conjugated to biomolecules, nanodiamond imaging can potentially elicit physiological information from within a living organism. The position of the nanodiamonds is measured using optically detected electron spin resonance of the NVs. In a previous paper, we described a proof-of-principle nanodiamond imaging system with the ability to image in two dimensions over a 1×1??cm field of view and demonstrated imaging within scattering tissue. Here, we describe a second-generation nanodiamond imaging system with a field of view of 30×200??mm, and with three-dimensional imaging potential. The new system has a comparable spatial resolution of 1.2 mm FWHM and a sensitivity (in terms of the concentration of carbon atoms in a ?mm3? voxel) of 1.6??mM?mm3?Hz-1/2, a 3-dB improvement relative to the old system. We show that imaging at 2.872 GHz versus imaging at 2.869 GHz offers a 1.73× improvement in sensitivity with only a 20% decrease in resolution and motivate this by describing the observed lineshape starting from the NV spin Hamiltonian. PMID:24057337

Hegyi, Alex; Yablonovitch, Eli



Imaging obese patients: problems and solutions.  


Obesity is an epidemic in the United States and Western World with an associated increasing impact on radiology departments. The increased prevalence of obesity in conjunction with the growing use and success of bariatric surgery results in an influx of obese patients into the health system in need of hospital services and care. Imaging services in particular are in demand in this patient population. Obese patients place special needs upon facilities and imaging equipment and also create technical challenges. This manuscript will address problems and potential solutions for imaging obese patients, specifically with regards to the modalities of radiography, fluoroscopy, computed tomography, and magnetic resonance imaging. PMID:23008055

Carucci, Laura R



Management of patients with stroke: is it time to expand treatment options?  


Approximately 700,000 people in the United States have an ischemic stroke annually. Substantial research has tested therapies for the very early treatment of ischemic stroke but, to date, only intravenous thrombolysis and intra-arterial measures to restore perfusion have shown success. Despite a 15-year effort to increase the use of these therapies, only approximately 5% of patients with stroke are currently being treated. Although most patients with stroke have some neurological recovery, more than half of stroke survivors have residual impairments that lead to disability or long-term institutionalized care. Laboratory research has demonstrated several mechanisms that help the brain to recover after a stroke. New pharmacological and cell-based approaches that are known to promote brain plasticity are emerging from laboratory studies and may soon expand the window for stroke treatment to restore function. It is time to build on this knowledge and to translate the understanding of recovery after stroke into the clinical setting. Measures that might augment recovery should become a major focus of clinical research in stroke in the 21st century. PMID:23720339

Adams, Harold P; Nudo, Randolph J



Body Image in Hansen's Disease Patients  

Microsoft Academic Search

In a group of 26 hospitalized male Hansen's disease patients, Barrier, Penetration, and Anatomy scores were obtained as projective indicators of body image, using the Holtzman Inkblot Technique. As predicted, patients did not differ from healthy controls. The body image measures were not related to length of hospitalization nor to observable disfigurement. The hypothesis was strengthened that concepts about the

Barbara S. Allardice; Arthur A. Dole



Thallium-201 stress imaging in hypertensive patients  

SciTech Connect

To assess the potential effect of hypertension on the results of thallium-201 stress imaging in patients with chest pain, 272 thallium-201 stress tests performed in 133 hypertensive patients and 139 normotensive patients over a 1-year period were reviewed. Normotensive and hypertensive patients were similar in age, gender distribution, prevalence of cardiac risk factors (tobacco smoking, hyperlipidemia, and diabetes mellitus), medications, and clinical symptoms of coronary disease. Electrocardiographic criteria for left ventricular hypertrophy were present in 16 hypertensive patients. Stepwise probability analysis was used to determine the likelihood of coronary artery disease for each patient. In patients with mid to high likelihood of coronary disease (greater than 25% probability), abnormal thallium-201 stress images were present in 54 of 60 (90%) hypertensive patients compared with 51 of 64 (80%) normotensive patients. However, in 73 patients with a low likelihood of coronary disease (less than or equal to 25% probability), abnormal thallium-201 stress images were present in 21 patients (29%) of the hypertensive group compared with only 5 of 75 (7%) of the normotensive patients (p less than 0.001). These findings suggest that in patients with a mid to high likelihood of coronary artery disease, coexistent hypertension does not affect the results of thallium-201 exercise stress testing. However, in patients with a low likelihood of coronary artery disease, abnormal thallium-201 stress images are obtained more frequently in hypertensive patients than in normotensive patients.

Schulman, D.S.; Francis, C.K.; Black, H.R.; Wackers, F.J.



Expanding the boundaries: reconfiguring the demographics of the "typical" eating disordered patient.  


Eating disorders have long been recognized as problems afflicting a narrow segment of select populations: Caucasian, adolescent or young adult women from high-income Western countries. This review highlights recent data that reexamine and revise this constricted view of eating disorders in two specific ways. First, data are steadily accumulating that document the increasing prevalence of eating disorders among younger and older individuals. Pre-pubertal children and women in middle and late adulthood are increasingly presenting for eating disorder treatment. Second, data from around the globe indicate that there is nothing uniquely "Western" about eating disorders. As highlighted in this review, eating disorders are a global health problem, and they are predictably on the rise in many parts of the world. The data are also clear that ethnic and racial minority groups and immigrants within North America are vulnerable to eating disorders. This growing knowledge base expands the boundaries of what has historically been considered the "typical" eating disordered patient and should raise awareness among health care providers of the needs of the broader community that is at risk for eating disturbances. PMID:24122512

Pike, Kathleen M; Dunne, Patricia E; Addai, Evette



Exit pupil expander: image quality performance enhancements and environmental testing results  

Microsoft Academic Search

The numerical aperture of the light emanating from display pixels in a given display system determines the exit pupil size. In retinal scanning displays, the exit pupil is defined by the scanner optics, creating a rastered, projected image at an intermediate plane, typically resulting in an exit pupil approximately the size of an eye\\

Karlton D. Powell; Peggy A. Lopez; Amjad Malik



Advances and New Approaches in Imaging Technology: Expanding the Reach of High-Content Analysis  

NSDL National Science Digital Library

Over the past decade, high-content analysis (HCA) has become widely adopted in both academic research and drug discovery laboratories. This webinar will discuss the pros and cons of the most commonly used imaging methods across a range of applications and highlight recent advances which promise to increase the power of HCA to answer more complex research questions and to yield deeper insights to advance the drug discovery process.

n/a n/a (AAAS;)



Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction  

PubMed Central

Background To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT) following tissue expander placement. Methods and Materials Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. Results The mean coverage of the level I/II axillary volume by the 95% isodose line (VD95%) was 23.9% (range 0.3 - 65.4%). The mean Ipsilateral Lung VD50% was 8.8% (2.2-20.9). Ipsilateral and contralateral expander volume correlated to Axillary VD95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively) but not those with ipsilateral only reconstruction (p = 0.60). Ipsilateral Lung VD50% correlated with angle of the expander from midline (p = 0.05). Conclusions In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated.




SciTech Connect

We report on a pilot imaging line survey (36.0-37.0 GHz, with {approx}1 km s{sup -1} spectral channels) with the Expanded Very Large Array for two asymptotic giant branch stars, RW LMi (= CIT6, which has a carbon-rich circumstellar envelope, CSE) and IK Tau (=NML Tau, with an oxygen-rich CSE). Radio continuum emission consistent with photospheric emission was detected from both stars. From RW LMi we imaged the HC{sub 3}N (J = 4{yields}3) emission. The images show several partial rings of emission; these multiple shells trace the evolution of the CSE from 400 to 1200 years. SiS (J = 2{yields}1) emission was detected from both RW LMi and IK Tau. For both stars the SiS emission is centrally condensed with the peak line emission coincident with the stellar radio continuum emission. In addition, we have detected weak HC{sub 7}N (J = 32{yields}31) emission from RW LMi.

Claussen, M. J.; Sjouwerman, L. O.; Rupen, M. P. [National Radio Astronomy Observatory, Socorro, NM 87801 (United States); Olofsson, H.; Schoeier, F. L.; Bergman, P. [Onsala Space Observatory, Department of Radio and Space Science, Chalmers University of Technology, 43992 Onsala (Sweden); Knapp, G. R. [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States)




Microsoft Academic Search

OBJECTIVE: Vertebral body reconstruction after corpectomy has become a common surgical procedure. The authors describe a prospectively followed case series of patients treated with expandable cages for various indications. METHODS: Sixty patients underwent single or multilevel corpectomy for degenerative stenosis (13 patients), herniated disc (7 patients), deformity (14 patients), traumatic frac- ture (3 patients), infection (1 patient), or tumor (22

Mark P. Arts



Selling the female image as mental patient  

Microsoft Academic Search

Tabulations of the sex and role (patient, helping professional, other) of all human images found in advertisements for psychoactive drugs in one half of the issues of The American Journal of Psychiatry from years 1963 to 1974 were made. Women were found to be portrayed as mentally ill significantly more often than men, while the images of men were used

David W. Stockburger; James O. Davis



Megapixel imaging camera for expanded H{sup {minus}} beam measurements  

SciTech Connect

A charge coupled device (CCD) imaging camera system has been developed as part of the Ground Test Accelerator project at the Los Alamos National Laboratory to measure the properties of a large diameter, neutral particle beam. The camera is designed to operate in the accelerator vacuum system for extended periods of time. It would normally be cooled to reduce dark current. The CCD contains 1024 {times} 1024 pixels with pixel size of 19 {times} 19 {mu}m{sup 2} and with four phase parallel clocking and two phase serial clocking. The serial clock rate is 2.5{times}10{sup 5} pixels per second. Clock sequence and timing are controlled by an external logic-word generator. The DC bias voltages are likewise located externally. The camera contains circuitry to generate the analog clocks for the CCD and also contains the output video signal amplifier. Reset switching noise is removed by an external signal processor that employs delay elements to provide noise suppression by the method of double-correlated sampling. The video signal is digitized to 12 bits in an analog to digital converter (ADC) module controlled by a central processor module. Both modules are located in a VME-type computer crate that communicates via ethernet with a separate workstation where overall control is exercised and image processing occurs. Under cooled conditions the camera shows good linearity with dynamic range of 2000 and with dark noise fluctuations of about {plus_minus}1/2 ADC count. Full well capacity is about 5{times}10{sup 5} electron charges.

Simmons, J.E.; Lillberg, J.W.; McKee, R.J.; Slice, R.W.; Torrez, J.H. [Los Alamos National Lab., NM (United States); McCurnin, T.W.; Sanchez, P.G. [EG and G Energy Measurements, Inc., Los Alamos, NM (United States). Los Alamos Operations



Titanium Expandable Pedicle Screw for the Treatment of Degenerative and Traumatic Spinal Diseases in Osteoporotic Patients: Preliminary Experience.  


Osteoporosis is a major global health problem, with over 10 million people currently diagnosed with the disease. Although 80% of osteoporotic patients are women, a considerable number of men are also affected. Also, due to increasing life expectancy, the number of elderly patients with osteoporosis affected by degenerative and traumatic spinal diseases will increase further. Osteoporosis reduces bone quality through negative bone remodelling. Low bone quality can reduce the pull-out strength of pedicle screw, and negative bone remodelling can cause delayed bone fusion. However, pedicle screw instrumentation of the osteoporotic spine carries an increased risk of screw loosening, pull-out, and fixation failure. Our preliminary study aims to investigate the efficiency of expandable pedicle screws (OsseoScrew-Zodiac,® Scient'x® Alphatec Spine Inc, Carlsbad, CA) in osteoporotic spinal patients. All osteoporotic patients with degenerative and traumatic spinal diseases admitted in our department underwent a pre-operative spinal x-Ray and MRI or CT. Pre-operative clinical assesment of patients was based on the visual analog scale (VAS) and Owestry Disability (ODI) questionnaire-a disease-specific outcome measure. Ten osteoporotic patients were treated with expandable pedicle screws (OsseoScrew®). Post-operative clinical assessment of patients was based on the VAS and ODI questionnaire at 3 months and 1 year of follow-up. Post-operative radiologic follow-up was performed after 3 days (CT, x-ray); 3 months (xray); 6 months (spinal CT); and 1 year (spinal CT). Expandable pedicle screws improved pull-out strength as compared to standard pedicle screws in steoporotic patients with degenerative and traumatic spinal diseases. PMID:23023577

Gazzeri, Roberto; Roperto, Raffaelino; Fiore, Claudio



Somatic instability of the expanded allele of IT-15 from patients with Huntington disease  

SciTech Connect

Huntington`s disease (HD) is an inherited neurodegenerative disorder caused by an expanded trinucleotide repeat in the gene IT-15. Although the expanded allele of IT-15 is unstable during gametogenesis, particularly, spermatogenesis, it is not clear if there is somatic stability. There are two reports of stability and one of instability. In order to test whether somatic instability occurs in the expansions found in HD, we have compared amplified genomic DNA isolated from either blood or distinct regions of autopsied brains of persons with Huntington disease. We find that somatic variation occurs in at least two ways. First, in cases with longer repeats (n > 47), the cerebellum often (8 of 9 cases) has a smaller number of repeats (2 to 10 less) than other tested regions of the brain. The larger the expanded allele, the larger the reduction in size of the repeat in the cerebellum (r=0.94, p<0.0001, df=12). Second, regardless of the repeat size, the number of amplification products from genomic DNA isolated from the cerebellum is smaller than that from genomic DNA from other forebrain regions such as the dorsal parietal cortex. As the length of the expanded allele increases, the number of amplification products increase in either tissue (r=0.86, p<0.001, df=12). Therefore our data demonstrates somatic instability especially for longer repeats.

Stine, O.C.; Pleasant, N.; Ross, C.A. [Johns Hopkins Univ., Baltimore, MD (United States)] [and others



A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease  

Microsoft Academic Search

BACKGROUND. Balloon-expandable coronary-artery stents were developed to prevent coronary restenosis after coronary angioplasty. These devices hold coronary vessels open at sites that have been dilated. However, it is unknown whether stenting improves long-term angiographic and clinical outcomes as compared with standard balloon angioplasty. METHODS. A total of 520 patients with stable angina and a single coronary-artery lesion were randomly assigned

Patrick W. Serruys; Peter de Jaegere; Ferdinand Kiemeneij; C. M. Miguel; Wolfgang Rutsch; Guy Heyndrickx; Hakan Emanuelsson; Jean Marco; Victor Legrand; Pierre Materne; Jorge Belardi; Ulrich Sigwart; Antonio Colombo; Jean Jacques Goy; Paul van den Heuvel; Juan Delcan; Marie-angele Morel



Patient Dose From Megavoltage Computed Tomography Imaging  

Microsoft Academic Search

Purpose: Megavoltage computed tomography (MVCT) can be used daily for imaging with a helical tomotherapy unit for patient alignment before treatment delivery. The purpose of this investigation was to show that the MVCT dose can be computed in phantoms, and further, that the dose can be reported for actual patients from MVCT on a helical tomotherapy unit. Methods and Materials:

Amish P. Shah; Katja M. Langen; Kenneth J. Ruchala; Andrea Cox; Patrick A. Kupelian; Sanford L. Meeks



Patient handling arrangements for NMR imaging systems  

SciTech Connect

In a nuclear magnetic resonance imaging system, including a magnet having a bore in which a subject to be imaged is to be located, a patient handling system is described comprising: a patient table which may be located so as to oppose the magnet bore, the patient table including a bottom portion and a top portion; a patient pallet, movably located on the top portion and adapted to be moved between the top portion and the magnet bore; mechanically driven transport means for transporting the patient pallet into and out of the magnet bore, including latch means for connecting the transport means to the patient pallet; and release means, located on the pallet, for manually releasing the latch means from the pallet, whereby the pallet may be manually removed from the magnet bore.

Carper, R.L.; Keller, J.T.



The effect of a vertical expandable prosthetic titanium rib on shoulder balance in patients with congenital scoliosis  

Microsoft Academic Search

Purpose  To evaluate the effect of a vertical expandable prosthetic titanium rib (VEPTR) on shoulder balance in patients with congenital\\u000a scoliosis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Fifteen patients had a thoracic congenital scoliosis. The Cobb angles of the thoracic primary curves were measured. Preoperative\\u000a measurements of the coracoid height difference (CHD; expressed in millimeters) and the clavicular tilt angle difference (CTAD;\\u000a expressed in degrees) were performed

Mohamed Ahmed Samy; Zayed Saleh Al Zayed; Mahmood Farouk Shaheen



Initial experience with the use of an expandable titanium cage as a vertebral body replacement in patients with tumors of the spinal column: a report of 95 patients  

Microsoft Academic Search

Objective  Vertebral body resection to treat spine tumors necessitates reconstruction to maintain spinal stability. The durability of\\u000a reconstruction may be a challenge in cancer patients as treatment with chemotherapy and\\/or radiation coupled with poor nutritional\\u000a status may compromise bone quality. We present a series of patients who underwent implantation of an expandable titanium cage\\u000a (ETC) for reconstruction after vertebral body resection

Ashwin Viswanathan; Muhammad M. Abd-El-Barr; Egon Doppenberg; Dima Suki; Ziya Gokaslan; Ehud Mendel; Ganesh Rao; Laurence D. Rhines


Imaging of trauma in a pregnant patient.  


Trauma is the number one nonobstetric cause of maternal death. This chapter presents the latest consensus from the literature on the best approach to radiographic imaging of these patients. The central issues of discussion include the rationale and protocols for screening for pregnancy in trauma setting; the effects of radiation and its risks to the fetus; obtaining informed consent; how to estimate fetal dose; and the role of ultrasound, computed tomography, and magnetic resonance imaging, including the intravenous contrast agents used for the assessment of abdominal trauma. The team approach to the management of these patients is also highlighted. PMID:22264901

Puri, Ajay; Khadem, Paryssa; Ahmed, Salman; Yadav, Parul; Al-Dulaimy, Khaldoon



Expanding nurse practice in COPD: is it key to providing high quality, effective and safe patient care?  


The prevalence of chronic obstructive pulmonary disease (COPD), a common and preventable chronic disease, is on the increase, and so are the financial and social burdens associated with it. The management of COPD is particularly challenging, as patients have complex health and social needs requiring life-long monitoring and treatment. In order to address these issues and reduce the burden imposed by COPD, the development of innovative disease management models is vital. Nurses are in a key position to assume a leading role in the management of COPD since they frequently represent the first point of contact for patients and are involved in all stages of care. Although evidence is still limited, an increasing number of studies have suggested that nurse-led consultations and interventions for the management of COPD have the potential to impact positively on the health and quality of life of patients. The role of nurses in the management of COPD around the world could be significantly expanded and strengthened. Providing adequate educational opportunities and support to nurses, as well as addressing funding issues and system barriers and recognising the importance of the expanding roles of nurses, is vital to the well-being of patients with long-term medical conditions such as COPD and to society as a whole, in order to reduce the burden of this disease. PMID:23666716

Fletcher, Monica J; Dahl, Birthe H



Patient Dose From Megavoltage Computed Tomography Imaging  

SciTech Connect

Purpose: Megavoltage computed tomography (MVCT) can be used daily for imaging with a helical tomotherapy unit for patient alignment before treatment delivery. The purpose of this investigation was to show that the MVCT dose can be computed in phantoms, and further, that the dose can be reported for actual patients from MVCT on a helical tomotherapy unit. Methods and Materials: An MVCT beam model was commissioned and verified through a series of absorbed dose measurements in phantoms. This model was then used to retrospectively calculate the imaging doses to the patients. The MVCT dose was computed for five clinical cases: prostate, breast, head/neck, lung, and craniospinal axis. Results: Validation measurements in phantoms verified that the computed dose can be reported to within 5% of the measured dose delivered at the helical tomotherapy unit. The imaging dose scaled inversely with changes to the CT pitch. Relative to a normal pitch of 2.0, the organ dose can be scaled by 0.67 and 2.0 for scans done with a pitch of 3.0 and 1.0, respectively. Typical doses were in the range of 1.0-2.0 cGy, if imaged with a normal pitch. The maximal organ dose calculated was 3.6 cGy in the neck region of the craniospinal patient, if imaged with a pitch of 1.0. Conclusion: Calculation of the MVCT dose has shown that the typical imaging dose is approximately 1.5 cGy per image. The uniform MVCT dose delivered using helical tomotherapy is greatest when the anatomic thickness is the smallest and the pitch is set to the lowest value.

Shah, Amish P. [Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL (United States)], E-mail:; Langen, Katja M. [Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL (United States); Ruchala, Kenneth J.; Cox, Andrea [TomoTherapy, Inc., Madison, WI (United States); Kupelian, Patrick A.; Meeks, Sanford L. [Department of Radiation Oncology, M. D. Anderson Cancer Center Orlando, Orlando, FL (United States)



Results of Expandable Metal Stents for Malignant Esophageal Obstruction in 100 Patients: Short-Term and Long-Term Follow-up  

Microsoft Academic Search

Background. Expandable metal stents palliate malig- nant dysphagia in most cases, but early complications and outcomes in long-term survivors have not been well described. This report summarizes our experience with expandable metal stents for malignant dysphagia. Methods. Over a 48-month period, 127 stents were placed in 100 patients with dysphagia from esophageal cancer (93%) or lung cancer. Most had undergone

Neil A. Christie; Percival O. Buenaventura; Hiran C. Fernando; Ninh T. Nguyen; Tracey L. Weigel; Peter F. Ferson; James D. Luketich



Scroll Expander  

NASA Astrophysics Data System (ADS)

Loss analysis of scroll expanders using R134a refrigerant was investigated and the following results were obtained. A loss estimating method of scroll expanders was proposed by using indicated power calculated by measured P-V diagram and another values. Leakage gas loss in suction process was large, so tip seals of scroll clearance are very important to realize high efficient scroll expanders. A new suction port system was designed and by this new type scroll expanders gas leakage decreased about 10% and expander efficiency increased about 10%.

Nagatomo, Shigemi; Ootaka, Toshio; Morishima, Akira


Expanding the role of the iPad and tablet devices to cosmetic patient consultations.  


The iPad is a useful reference tool for patient education in cosmetic consultations. In this article, we plan to (1) discuss how the iPad can be implemented and used by patients and physicians in consultations, (2) compare the advantages and disadvantages of the iPad with other forms of technology, (3) discuss the optimal way of using the iPad for patient care, (4) see how this tool complies with privacy regulations, and (5) look at other uses of the iPad in the patient care setting. There has been positive feedback from both patients and physicians regarding the addition of the tablet computer during consultations. In addition to showing patients pictures of cosmetic procedures, the iPad also has various multimedia capabilities such as videos and drawing tools that are useful in optimizing patient satisfaction, increasing clinical efficacy, and improving the overall patient experience. PMID:22929358

Wang, Jing; Hsu, Jeffrey T S; Bhatia, Ashish C



Ipilimumab experience in heavily pretreated patients with melanoma in an expanded access program at the University Hospital of Siena (Italy)  

Microsoft Academic Search

Aim of study  To evaluate the feasibility of ipilimumab treatment for metastatic melanoma outside the boundaries of clinical trials, in\\u000a a setting similar to that of daily practice.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Ipilimumab was available upon physician request in the Expanded Access Programme for patients with life-threatening, unresectable\\u000a stage III\\/IV melanoma who failed or did not tolerate previous treatments and for whom no therapeutic option

Anna Maria Di Giacomo; Riccardo Danielli; Luana Calabrò; Erica Bertocci; Chiara Nannicini; Diana Giannarelli; Angelo Balestrazzi; Francesco Vigni; Valentina Riversi; Clelia Miracco; Maurizio Biagioli; Maresa Altomonte; Michele Maio



The effect of a vertical expandable prosthetic titanium rib on shoulder balance in patients with congenital scoliosis  

PubMed Central

Purpose To evaluate the effect of a vertical expandable prosthetic titanium rib (VEPTR) on shoulder balance in patients with congenital scoliosis. Methods Fifteen patients had a thoracic congenital scoliosis. The Cobb angles of the thoracic primary curves were measured. Preoperative measurements of the coracoid height difference (CHD; expressed in millimeters) and the clavicular tilt angle difference (CTAD; expressed in degrees) were performed for all patients. All of the patients were treated with VEPTR open wedge thoracostomy. Result There was a statistically significant improvement in thoracic Cobb angle. At the end of follow-up there was a significant improvement in CHD; all but three of the patients had CHD < 9 mm. Preoperatively, CTAD was 8.9°. It improved to 4.4° postoperatively and significantly decreased to 3.9° by the end of follow-up. Complications included device migration (one patient), infection (one patient), and pedicle screw loosening or displacement (two patients). Conclusion VEPTR is able to produce a modest intraoperative correction of shoulder imbalance.

Al Zayed, Zayed Saleh; Shaheen, Mahmood Farouk



Scroll Expander  

NASA Astrophysics Data System (ADS)

Scroll expander for room air conditioning system was developed. The performance characteristics of scroll expander using R134a refrigerant were investigated experimentally. The following results were obtained. (1) Shaft power index Nexp was proposed newly and effective to evaluate the shaft power of scroll expander. (2) Shaft power index Nexp and expander efficiency ? exp increased with the increase in the pressure ratio in the range of the pressure ratio over 2.6. (3) Mass flow rate difference between measured and theoretical values decreased with the increase in the rotational speed and the decrease in the pressure ratio of expander. Mass flow rate ratio ? of 0.98 to 0.9 were obtained at these operating conditions. (4) Maximum shaft power index Nexp of 0.8 and maximum expander efficiency ? exp of 0.74 were obtained at the pressure ratio of 3.7 and rotational speed of 50 (1/s).

Nagatomo, Shigemi; Ootaka, Toshio; Morishima, Akira


Expanding the role of percutaneous coronary intervention in patients resuscitated from cardiac arrest.  


Special attention to post-cardiac arrest management is important to long-term survival and favorable neurological outcome in patients resuscitated from cardiac arrest. The use of emergent percutaneous coronary intervention in resuscitated patients presenting with ST-segment elevation myocardial infarction has long been considered an appropriate approach for coronary revascularization. Recent evidence suggests that other subsets of patients, namely, post-cardiac arrest patients without ST-segment elevation myocardial infarction, may benefit from immediate percutaneous coronary intervention following resuscitation. These findings could eventually have important implications for the care of resuscitated patients, including transportation of resuscitated patients to appropriate cardiac interventional facilities, access to treatment modalities such as therapeutic hypothermia, and coordinated care with cardiac catheterization laboratories. PMID:23541172

Mehta, Christopher K; Hu, Kami M; Nable, Jose V; Brady, William J



Expanding the Walls of the Health Care Encounter: Support and Outcomes for Patients Online  

Microsoft Academic Search

This paper assesses the relationship between patient–health care provider (HCP) interaction and health behaviors. In total, 109 Native American patients diagnosed with diabetes mellitus were enrolled in a Web-based diabetes monitoring system. The system tracks patient–HCP interaction, and in total 924 personal messages were exchanged. These 924 messages contained 6,411 message units that were content analyzed using a nine-category scheme.

James D. Robinson; Jeanine Warisse Turner; Betty Levine; Yan Tian



The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment  

Microsoft Academic Search

Long waiting times for inpatient treatment in the UK National Health Service have been a source of popular and political concern, and therefore a target for policy initiatives. In the London Patient Choice Project, patients at risk of breaching inpatient waiting time targets were offered the choice of an alternative hospital with a guaranteed shorter wait. This paper develops a

Diane Dawson; Hugh Gravelle; Rowena Jacobs; Stephen Martin; Peter C. Smith



Expanding the Psoriasis Disease Profile: Interrogation of the Skin and Serum of Patients with Moderate-to-Severe Psoriasis  

PubMed Central

Psoriasis is a complex disease with an expanding definition of its pathological features. We sought to expand/refine the psoriasis transcriptome using 85 paired lesional and non-lesional samples from a cohort of patients with moderate-to-severe psoriasis vulgaris who were not receiving active psoriasis therapy. This new analysis identified 4,175 probe sets (representing 2,725 unique known genes) as being differentially expressed in psoriasis lesions compared with matched biopsies of non-lesional skin when the following criteria were applied: >2-fold change and false discovery rate <0.05. These probe sets represent the largest and most comprehensive set of genes defining psoriasis at the molecular level and within the previously unidentified genes, a link to functional pathways associated with metabolic diseases/diabetes and to cardiovascular risk pathways is identified. In addition, we profiled the serum of moderate-to-severe psoriatics compared with healthy controls to assess the overlap of overexpressed lesional genes with overexpressed systemic proteins. We identified linkage of functional pathways in lesional skin associated with metabolic diseases/diabetes and cardiovascular risk with those pathways overexpressed in the serum, suggesting a potential linkage between altered gene transcription in the skin and comorbidities commonly seen in patients with moderate-to-severe psoriasis.

Suarez-Farinas, Mayte; Li, Katherine; Fuentes-Duculan, Judilyn; Hayden, Karen; Brodmerkel, Carrie; Krueger, James G



Patient-Adaptive Reconstruction and Acquisition in Dynamic Imaging with Sensitivity Encoding (PARADISE)  

PubMed Central

MR imaging of the human heart without explicit cardiac synchronization promises to extend the applicability of cardiac MR to a larger patient population and potentially expand its diagnostic capabilities. However, conventional non-gated imaging techniques typically suffer from low image quality or inadequate spatio-temporal resolution and fidelity. Patient-Adaptive Reconstruction and Acquisition in Dynamic Imaging with Sensitivity Encoding (PARADISE) is a highly-accelerated non-gated dynamic imaging method that enables artifact-free imaging with high spatio-temporal resolutions by utilizing novel computational techniques to optimize the imaging process. In addition to using parallel imaging, the method gains acceleration from a physiologically-driven spatio-temporal support model; hence, it is doubly accelerated. The support model is patient-adaptive, i.e., its geometry depends on dynamics of the imaged slice, e.g., subject’s heart-rate and heart location within the slice. The proposed method is also doubly adaptive as it adapts both the acquisition and reconstruction schemes. Based on the theory of time-sequential sampling, the proposed framework explicitly accounts for speed limitations of gradient encoding and provides performance guarantees on achievable image quality. The presented in-vivo results demonstrate the effectiveness and feasibility of the PARADISE method for high resolution non-gated cardiac MRI during a short breath-hold.

Sharif, Behzad; Derbyshire, J. Andrew; Faranesh, Anthony Z.; Bresler, Yoram



Expanding cardiac resynchronization for systolic heart failure to patients with mechanical dyssynchrony and atrial fibrillation.  


Despite progress in the management of heart failure (HF) using pharmacotherapy, the mortality and morbidity associated with this condition remain unacceptably high. Cardiac resynchronization therapy (CRT), a left-sided pacing therapy for drug-refractory and highly symptomatic HF patients with ventricular conduction delay, has been shown to improve left ventricular (LV) systolic function, myocardial oxygen consumption, and New York Heart Association functional class and to inhibit or reverse LV chamber dilation and remodeling. Atrial fibrillation is common in patients with HF and is associated with significant worsening of HF and myocardial function. Only recently have trials been designed to specifically study CRT in patients with HF and chronic atrial fibrillation. These studies have shown that CRT with biventricular or univentricular LV pacing in patients with atrial fibrillation corrects mechanical dyssynchrony and results in significant and sustained improvement in functional capacity, LV ejection fraction, quality of life, and QRS duration. PMID:16195687

Ghanbari, Hamid; Hassunizadeh, Bischan; Machado, Christian



Expanding the National Naval Medical Center's Patient Appointment Call Center: An Analysis.  

National Technical Information Service (NTIS)

The new TRICARE contracts will shift the burden of providing outpatient appointing services from the contractors to Military Treatment Facilities (MTF). Through the Patient Appointment Call Center (PACC), the MTEs at Bethesda and Annapolis are ready for t...

D. C. Tolentino



Body image concerns of breast augmentation patients.  


This study investigated the body image concerns of women who sought cosmetic breast augmentation. Thirty breast augmentation candidates completed several measures of body image before their initial surgical consultation. Thirty physically similar women who were not interested in breast augmentation were recruited from the medical center and university community and also completed the measures. Breast augmentation candidates, as compared with women not seeking augmentation, reported greater dissatisfaction with their breasts. Augmentation candidates rated their ideal breast size, as well as the breast size preferred by women, as significantly larger than did controls. In addition, women interested in breast augmentation reported greater investment in their appearance, greater distress about their appearance in a variety of situations, and more frequent teasing about their appearance. Finally, breast augmentation candidates also reported more frequent use of psychotherapy in the year before the operation as compared with women not seeking augmentation. These results replicate and extend previous studies of body image in cosmetic surgery patients. PMID:12832880

Sarwer, David B; LaRossa, Don; Bartlett, Scott P; Low, David W; Bucky, Louis P; Whitaker, Linton A



Analysis of spinocerebellar ataxias due to expanded triplet repeats in Greek patients with cerebellar ataxia.  


The relative frequency of different autosomal dominant cerebellar ataxias, commonly referred to as spinocerebellar ataxias (SCAs), varies considerably among populations of different ethnic origin. No data exist at present on the frequency of different SCAs in the Greek population. In the present study we investigated the presence of triplet repeat expansion SCAs (SCA1, SCA2, SCA3, SCA6, SCA7, SCA8, SCA12, SCA17 and DRPLA) in a cohort of 83 Greek patients with slowly progressive cerebellar ataxia. Twenty patients came from autosomal dominant (AD) pedigrees, seven displayed recessive or unclear inheritance and 56 were sporadic. We found four patients with pathological SCA expansions, all from AD pedigrees. Two patients had SCA1, one SCA2 and one SCA7 (10.0, 5.0 and 5.0% of the AD group, respectively). The clinical features of these patients were within the expected spectrum. In total, a pathological expansion was detected in 20% of patients from AD pedigrees. Interestingly, no cases of SCA3 or SCA6 were detected in the AD group. No expansions were found in other familial cases or in sporadic patients. Overall, no cases of SCA3, SCA6, SCA12, SCA17 or DRPLA were identified in the Greek population. In conclusion, SCA1, SCA2 and SCA7 are present in Greek patients with AD cerebellar ataxia in frequencies similar to those observed in other populations. SCA3 and SCA6 appear however to be rare in Greece. The genetic cause for the majority of AD ataxias remains to be identified. PMID:22520093

Koutsis, Georgios; Pemble, Sally; Sweeney, Mary G; Paudel, Reema; Wood, Nicholas W; Panas, Marios; Kladi, Athina; Houlden, Henry



Contemporary Imaging of Renal Mass Patients  

PubMed Central

Purpose To evaluate the difference between radiographic size on computed tomography (CT) and the pathologic size of renal tumors using a contemporary cohort. Materials and Methods We retrospectively reviewed the records of 521 patients undergoing surgical resection of a renal mass between 2000 and 2007 who had tumor sizes recorded from both preoperative CT imaging and pathologic evaluation of the tumor specimen. Data regarding histologic tumor type were also extracted. The paired student’s t-test was utilized to compare the mean radiographic size as measured on CT with the mean pathologic size, and p values <0.05 were considered statistically significant. Results For all patients, the mean radiographic size and mean pathologic size was 4.79 and 4.69 cm, respectively (p = 0.02). Therefore, on average, radiographic size overestimated pathologic size by 1 mm. In patients with a tumor size of 4 to 7 cm, radiographic size overestimated pathologic size by 0.21 cm (p = 0.007). However, no significant difference was noted in patients with a tumor size of <4 cm or >7 cm. Conclusions Using a contemporary cohort of patients, we observed a statistically significant overestimation of renal tumor sizes by CT imaging as compared to pathologic assessment. However, the overall difference between radiographic and pathologic tumor size was 1 mm, suggesting that CT provides an accurate modality with which to estimate renal tumor size.

Kurta, Jordan M.; Thompson, R. Houston; Kundu, Shilajit; Kaag, Matthew; Manion, M. Thomas; Herr, Harry W.; Russo, Paul



Effect of speed difference between time-expanded speech and moving image of talker’s face on word intelligibility  

Microsoft Academic Search

This study investigated effects of asynchrony between speech signal and moving image of talker’s face induced by time-expansion\\u000a of the speech signal on speech intelligibility. Word intelligibility test was performed to younger listeners. Japanese 4-mora\\u000a words were uttered by a female speaker. Each word was processed with STRAIGHT software to expand the speech signal by from\\u000a 0 to 400 ms. These

Shuichi Sakamoto; Akihiro Tanaka; Komi Tsumura; Yôiti Suzuki



Expanding the physician care team: its effect on patient care, resident function, and education.  


Recent attempts to improve surgical resident working conditions have taken many forms. We evaluated a system in which a well-trained physician extender had been hired to assist residents taking call on a busy cardiothoracic teaching service. The physician extender ("night nurse," NN) helped with perioperative care using well-defined protocols. The NN, who was in-house Sunday-Friday, 7 pm-7 am, rounded with the residents at the beginning of the evening. Concerns were discussed and care plans formulated. Thereafter, all pages (except codes and extreme emergencies) were directed to the NN, freeing the residents to complete work-ups, patient assessments, or study. The NN assessed patients and initiated care plans including orders that followed either care protocols or plans previously arranged with the resident. For unanticipated concerns, the resident was notified for input and/or patient assessment. For 30 consecutive nights, the patient load and acuity were evaluated. Residents and NN kept diaries of all pages received. The residents also documented time slept and times awakened. Residents received 10 times fewer calls when the NN was available (21.8 +/- 10.5 vs 2.9 +/- 2.4) and slept an average of 2.5 hr more (135 +/- 106.1 vs 286.2 +/- 68.2 min). Care was maintained as judged by morbidity and mortality statistics. Such a system has allowed us to avoid cross coverage, thereby maintaining resident continuity of care and involvement in meaningful care plans, while providing increased time for patient evaluation, self-education, and increased uninterrupted sleep. PMID:7912293

Holzman, M D; Elkins, C C; Neuzil, D F; Williams, L F



[Dilatation and balloon-expandable stents for the treatment of central venous stenosis in dialysis patients].  


On 10 dialysis patients we performed 12 balloon dilatations, 2 catheter lyses, 6 stent implants (Palmaz stent) and one atherectomy of central venous stenoses or occlusions (v. subclavia, v. brachiocephalica) at the shunt arm of the patient. The primary success rate was, in balloon PTA and lysis, 12/14 interventions, and in stent placement and atherectomy 7/7. The angiographical and clinical primary result after stent implantation was significantly better than after conventional dilatation. After 66% of the balloon dilatations recidivation occurred within the first year; this can be treated by means of repeated PTA. Whether long-term exclusion of recurrence can be achieved by stent implantation, must be established by means of follow-up studies that are at present in progress. PMID:2171054

Landwehr, P; Lackner, K; Götz, R



Breast reconstruction using tissue expanders: assessing patients' needs utilizing a holistic approach.  


Breast cancer is the most common diagnosed cancer in women. One out of 8 women is diagnosed with this disease (). Today many women are candidates for breast reconstruction and opt for reconstructive surgery at the time of mastectomy. Plastic surgical nurses provide a vital link in assessing and assisting patients to acquire and assimilate the necessary information required to make informed decisions regarding reconstruction. Although there are a variety of options in breast reconstruction, the purpose of this article is to discuss tissue expansion after mastectomy for breast restoration. The article identifies the needs women may have both preoperatively and postoperatively. Orem's self-care theory model is used to describe roles nurses may assume to assist patients in decision making and performance of self-care activities during the reconstructive process. PMID:18344816

Spittler, Cheryl A


Optimizing HIV Care by Expanding the Nursing Role: Patient and Provider Perspectives  

PubMed Central

Aim This paper is a report of a study conducted to explore HIV healthcare services from the perspectives of both healthcare providers and patients in order to understand how to optimize HIV nursing care. Background In China, healthcare providers usually first diagnose HIV in a general hospital. Then, HIV-positive individuals are transferred to a specialist hospital. Between healthcare providers and healthcare institutions, there are many gaps in the process from diagnosis to treatment. Methods One focus group with 6 healthcare providers and 29 in-depth interviews with people living with HIV/AIDS were conducted during 2005. Findings Patients who were diagnosed with HIV in a general hospital often did not discuss their condition with a healthcare provider before being sent to a specialist hospital. Furthermore, since the patients had already been diagnosed, healthcare providers in the specialist hospital did not deal adequately with the disclosure process and emotional reactions to the diagnosis. They reported feeling overwhelmed in their role in providing healthcare services. Nurses reported that they were responsible for many “non-nursing” tasks and did not have the opportunity to give the type of care they were trained to offer. Conclusion Optimizing HIV care in China will involve establishing clear boundaries between general and specialist hospitals and a division of labour among healthcare providers that eases the burden of care and takes advantage of the full scope of practice that nurses are trained to provide.

Chen, Wei-Ti; Shiu, Cheng-Shi; Simoni, Jane; Fredriksen-Goldsen, Karen; Zhang, Fujie; Zhao, Hongxin



Prior HIV Testing among STD Patients in Guangdong Province, China: Opportunities for Expanding Detection of Sexually Transmitted HIV Infection  

PubMed Central

Background Expanding HIV testing is important among individuals at increased risk for sexual HIV transmission in China, but little is known about prior HIV testing experiences among sexually transmitted disease (STD) patients. Methods This cross-sectional study of 1792 outpatients from six public sexually transmitted disease (STD) clinics in Guangdong Province recorded detailed information about ever having been tested for HIV infection in addition to socio-demographic variables, health seeking, clinical STD history, and HIV stigma using a validated survey instrument. Results 456 (25.4%) of the STD patients in this sample had ever been tested for HIV infection. STD patients who were male, had higher income, more education, were at City A and City C, received STD services at public facilities, had used intravenous drugs, and had a history of an STD were more likely to ever receive an HIV test in multivariate analysis. Low perceived HIV risk was the most common reason for not receiving an HIV test. Only 7.7% of the sample reported fear of discrimination or loss of face as influencing their lack of HIV testing. Conclusion Incomplete prior HIV screening among STD patients in China suggests the need for broadening HIV testing opportunities at STD clinics and similar clinical settings attended by those with increased sexual risk.

Tucker, Joseph D; Yang, Li-Gang; Yang, Bin; Young, Darwin; Henderson, Gail E; Huang, Shu-Jie; Lu, He-Kun; Chen, Xiang-Sheng; Cohen, Myron S



Insertion of Self Expandable Metal Stent for Malignant Stomal Obstruction in a Patient with Advanced Colon Cancer  

PubMed Central

Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.

Wi, Jeong Ook; Yoo, Jun Hwan; Choi, Jeong Woo; Yoo, Byung-Hyun; Lim, Sun Gyo; Lee, Kee Myung; Kim, Jin Hong



Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up  

Microsoft Academic Search

Background. Expandable metal stents palliate malignant dysphagia in most cases, but early complications and outcomes in long-term survivors have not been well described. This report summarizes our experience with expandable metal stents for malignant dysphagia.Methods. Over a 48-month period, 127 stents were placed in 100 patients with dysphagia from esophageal cancer (93%) or lung cancer. Most had undergone prior treatment.

Neil A Christie; Percival O Buenaventura; Hiran C Fernando; Ninh T Nguyen; Tracey L Weigel; Peter F Ferson; James D Luketich



Expanding the boundaries of informed consent: disclosing alcoholism and HIV status to patients.  


Since informed consent became legally required in the therapeutic setting, the risks physicians were to disclose have been limited to the risks of particular procedures. Two recent court decisions in which disclosure of surgeons' alcoholism and positive human immunodeficiency virus status was required may begin to erode that limit. The grounds for this expansion of disclosure requirements were inherent in the 20-year-old "materiality" standard for disclosure; nevertheless, the change they signal is profound. These cases may signal a trend that, in the long term, could result in a shift in physician-patient communication and a significant loss of privacy for physicians. PMID:1497019

Spielman, B



A comparison of laser therapy, plastic stents, and expandable metal stents for palliation of malignant dysphagia in patients without a fistula  

Microsoft Academic Search

Background: Many options are available for palliation of inoperable malignant stenoses of the esophagus. We report our experience with different modalities of endoscopic therapy. Methods: From 1986 to 1996, we treated 125 patients with dysphagia caused by unresectable malignant tumors with endoscopic therapy. Seventy patients were treated with laser therapy, 34 with a plastic endoprosthesis, and 21 with an expandable

Anna Maria Gevers; Elisabeth Macken; Martin Hiele; Paul Rutgeerts



Prompt and durable engraftment in two older adult patients with high risk chronic myelogenous leukemia (CML) using ex vivo expanded and unmanipulated unrelated umbilical cord blood  

Microsoft Academic Search

Delayed engraftment, graft failure, and adverse transplant-related events have been observed in unrelated umbilical cord blood (UCB) recipients, particularly in those receiving a low leukocyte cell dose and in CML patients. We report the outcomes of two older adult patients with high risk CML who received a low leukocyte cell dose of unmanipulated UCB cells supplemented with ex vivo expanded

AL Pecora; P Stiff; A Jennis; S Goldberg; R Rosenbluth; P Price; KL Goltry; J Douville; AK Smith; RA Preti



Diagnostic imaging of the acutely injured patient  

SciTech Connect

This book provides an analysis of pathophysiologic concepts of trauma and reviews the effectiveness of the available imaging modalities in acute trauma of various organ system. Topics covered are chest injuries; abdominal trauma; fractures of long bones; the foot and ankle; the knee; hand and wrist; the elbow; the shoulder; the pelvis hips; the spine; the skull and facial trauma and the clinical assessment of multiple injuries patients. Comparative evaluation of diagnostic techniques of radiography is discussed. Normal anatomy and bone fractures along with soft-tissue injuries are described.

Berquist, T.H.



Tracing the molecular gas in distant submillimetre galaxies via CO(1-0) imaging with the Expanded Very Large Array  

NASA Astrophysics Data System (ADS)

We report the results of a pilot study with the Expanded Very Large Array (EVLA) of 12CO J= 1-0 emission from four submillimetre-selected galaxies at z= 2.2-2.5, each with an existing detection of 12CO J= 3-2, one of which comprises two distinct spatial components. Using the EVLA's most compact configuration, we detect strong, broad [medians: 990 km s-1 full width at zero intensity; 540 km s-1 full width at half-maximum (FWHM)]J= 1-0 line emission from all of our targets - coincident in position and velocity with their J= 3-2 emission. The median linewidth ratio, ?1-0/?3-2= 1.15 ± 0.06, suggests that the J= 1-0 is more spatially extended than the J= 3-2 emission, a situation confirmed by our maps which reveal velocity structure in several cases and typical sizes of ˜16 kpc FWHM. The median brightness temperature (Tb) ratio is r3-2/1-0= 0.55 ± 0.05, consistent with local galaxies with LIR > 1011 L?, noting that our value may be biased high because of the J= 3-2 based sample selection. Naively, this suggests gas masses roughly two times higher than estimates made using higher J transitions of CO, with the discrepancy due entirely to the difference in assumed Tb ratio. We also estimate molecular gas masses using the 12CO J= 1-0 line and the observed global Tb ratios, assuming standard underlying Tb ratios for the non-star-forming and star-forming gas phases as well as a limiting star formation efficiency for the latter in all systems, i.e. without calling upon XCO (??). Using this new method, we find a median molecular gas mass of (2.5 ± 0.8) × 1010 M?, with a plausible range stretching up to three times higher. Even larger masses cannot be ruled out, but are not favoured by dynamical constraints: the median dynamical mass within R˜ 7 kpc for our sample is (2.3 ± 1.4) × 1011 M? or ˜6 times more massive than UV-selected galaxies at this epoch. We examine the Schmidt-Kennicutt (S-K) relation for all the distant galaxy populations for which CO J= 1-0 or J= 2-1 data are available, finding small systematic differences between galaxy populations. These have previously been interpreted as evidence for different modes of star formation, but we argue that these differences are to be expected, given the still considerable uncertainties, certainly when considering the probable excitation biases due to the molecular lines used, and the possibility of sustained S-K offsets during the evolution of individual gas-rich systems. Finally, we discuss the morass of degeneracies surrounding molecular gas mass estimates, the possibilities for breaking them, and the future prospects for imaging and studying cold, quiescent molecular gas at high redshifts.

Ivison, R. J.; Papadopoulos, P. P.; Smail, Ian; Greve, T. R.; Thomson, A. P.; Xilouris, E. M.; Chapman, S. C.



The wound healing process in surgical patients evaluated by the expanded polytetrafluoroethylene and the polyvinyl alcohol sponge: a comparison with special reference to intrapatient variability.  


The aim of this study was to compare two wound healing models in surgical patients with special reference to the intrapatient variability. Two pieces of expanded polytetrafluoroethylene tubing and one perforated silicone tube containing two polyvinyl alcohol sponges were subcutaneously inserted into 28 patients and were removed after 10 (9 to 11) days. The amount of hydroxy-l-proline in two segments of the same piece of expanded polytetrafluoroethylene tubing correlated significantly with each other. Similar results were found for proline. Proline content in each polyvinyl alcohol sponge correlated weakly with each other, whereas no correlation was found between hydroxy-l-proline content in the two polyvinyl alcohol sponges from the same patient. In addition, no correlation was found between leucine in the two adjacent polyvinyl alcohol sponges or between the hydroxy-l-proline/leucine ratio in these same sponges. No concordance could be detected between the averages of hydroxy-l-proline content in the two segments of expanded polytetrafluoroethylene tubing and the hydroxy-l-proline content in the two polyvinyl alcohol sponges from the same person, although an association between the averages of proline in the two pieces of expanded polytetrafluoroethylene tubing and proline content in the two polyvinyl alcohol sponges from the same individual was observed. The measurement error was greater for the polyvinyl alcohol sponges than for the expanded polytetrafluoroethylene tubing implants during the first 10 days after wounding. The expanded polytetrafluoroethylene tubing accumulated 2.5 times more hydroxy-l-proline per length unit than the polyvinyl alcohol sponge. We concluded that the expanded polytetrafluoroethylene implant rather than the polyvinyl alcohol implant is preferred for quantitation of subcutaneous collagen deposition in surgical patients because it accumulates more new tissue and has a lower variability. PMID:17147666

Jorgensen, L N; Olsen, L; Kallehave, F; Karlsmark, T; Diegelmann, R F; Cohen, I K; Gottrup, F


Treatment of a rapidly expanding thoracoabdominal aortic aneurysm after endovascular repair of descending thoracic aortic aneurysm in an old patient  

PubMed Central

Background Aortic pathology progression and/or procedure related complications following endovascular repair should always be considered mostly in older patients. We herein describe a hybrid procedure for treatment of rapidly expanding thoracoabdominal aneurysm following endovascular treatment of a descending thoracic aortic aneurysm in an older patient. Case presentation A 82-year-old man at 18 months after endovascular surgery for a contained rupture of descending thoracic aortic aneurysm revealed a type IV thoracoabdominal aneurysm with significant increase of the aortic diameters at superior mesenteric and renal artery levels. A hybrid approach consisting of preventive visceral vessel revascularization and endovascular repair of entire abdominal aorta was performed. Under general anaesthesia and by xyphopubic laparotomy, the infrarenal aneurysmatic aorta and common iliac arteries were replaced by a bifurcated woven prosthetic graf. From each of the prosthetic branches two reverse 14x7 mm bifurcated PTFE prosthetic grafts were anastomized to both renal arteries and to the celiac axis and superior mesenteric artery, respectively. Vessel ischemia was restricted to the time required for anastomosis. Three 10 cm Gore endovascular stent-grafts for a total length of 15 cm, were used. The overlapping of the stent-grafts was carried out from the bottom upwards, starting from the aorto-iliac prosthetic body up to the healthy segment of thoracic aorta, 40 mm from the previous stent-grafts. The patient was discharged on the 9th postoperative day. Conclusion This technique offers the advantage of a less invasive treatment, reducing the risk of paraplegia, visceral ischaemia and pulmonary complications, mostly in older patients.



Self-expandable device for percutaneous closing of left atrial appendage with organized thrombus in a patient with permanent atrial fibrillation.  


While a left atrial appendage (LAA) occlusion device may reduce the risk of cardioembolic stroke in patients with nonvalvular atrial fibrillation, an antithromboembolic strategy for patients with an organized thrombus in the LAA is still unclear. The present case is the first report of percutaneous closing of an LAA and organized thrombus with a self-expandable LAA occlusion device without complication. This minimally invasive intervention is a potential treatment option in a patient with significant risk of recurrent thromboembolism. PMID:23228490

Pak, Hui-Nam; Shim, Chi-Young; Kim, Jung Sun; Park, Jai-Wun; Jang, Yangsoo



Expanding the scope of fiduciary duties to fill a gap in the law: the role of nonprofit hospital directors to ensure patient safety.  


In the wake of the patient safety movement, there is a glaring disconnect between the increasing responsibilities placed on hospital board members and the limited accountability for those board members if they fail to meet their responsibilities. This Article discusses how the effectiveness of new patient safety laws is diminished by the lack of accountability of nonprofit board members. The Article suggests that an expanded notion of corporatefiduciary duties, enhanced by shifts in social norms, would contribute to patient safety reform. PMID:15968941

Kaput, Sarah



Low frequency of GITR+ T cells in ex vivo and in vitro expanded Treg cells from type 1 diabetic patients.  


Reported alterations in Treg cells from type 1 diabetes (T1D) patients led us to a revision of their phenotypical features compared with controls. A fine cytometric analysis was designed for their characterization, using a panel of markers including FOXP3, CTLA4, glucocorticoid-induced TNFR family related (GITR) and CD127. The frequency of peripheral CD4(+)CD25(hi) Treg cells was similar between samples. However, the yield of sorted Treg cells was significantly lower in patients than in controls. When comparing the Treg-cell phenotype between samples, the only difference concerned the expression of GITR. A significant decrease of GITR(+) cells and GITR mean fluorescence intensity within the Treg-cell population, and to a lesser extent in the effector population, was observed in T1D compared with controls. Moreover, GITR expression was analyzed in several conditions of T-cell activation and differences were only observed in T1D Treg cells versus controls when responding to sub-optimal stimulation, that is, soluble anti-CD3 or medium alone but not in the presence of anti-CD3-/anti-CD28-coated beads. However, expanded T1D Treg-cell-mediated suppression was as efficient as that mediated by their control counterparts, showing no association between their regulatory capacity and the reduced GITR. Our results show a higher susceptibility to apoptosis in patients' versus controls' Treg cells, suggesting that GITR is a Treg-cell marker that would be primarily involved in Treg-cell survival rather than in their suppressor function. PMID:23929911

Xufré, Cristina; Costa, Manuela; Roura-Mir, Carme; Codina-Busqueta, Eva; Usero, Lorena; Pizarro, Eduarda; Obiols, Gabriel; Jaraquemada, Dolores; Martí, Mercè



Comparison of an expanded ataxia interactome with patient medical records reveals a relationship between macular degeneration and ataxia.  


Spinocerebellar ataxias 6 and 7 (SCA6 and SCA7) are neurodegenerative disorders caused by expansion of CAG repeats encoding polyglutamine (polyQ) tracts in CACNA1A, the alpha1A subunit of the P/Q-type calcium channel, and ataxin-7 (ATXN7), a component of a chromatin-remodeling complex, respectively. We hypothesized that finding new protein partners for ATXN7 and CACNA1A would provide insight into the biology of their respective diseases and their relationship to other ataxia-causing proteins. We identified 118 protein interactions for CACNA1A and ATXN7 linking them to other ataxia-causing proteins and the ataxia network. To begin to understand the biological relevance of these protein interactions within the ataxia network, we used OMIM to identify diseases associated with the expanded ataxia network. We then used Medicare patient records to determine if any of these diseases co-occur with hereditary ataxia. We found that patients with ataxia are at 3.03-fold greater risk of these diseases than Medicare patients overall. One of the diseases comorbid with ataxia is macular degeneration (MD). The ataxia network is significantly (P= 7.37 × 10(-5)) enriched for proteins that interact with known MD-causing proteins, forming a MD subnetwork. We found that at least two of the proteins in the MD subnetwork have altered expression in the retina of Ataxin-7(266Q/+) mice suggesting an in vivo functional relationship with ATXN7. Together these data reveal novel protein interactions and suggest potential pathways that can contribute to the pathophysiology of ataxia, MD, and diseases comorbid with ataxia. PMID:21078624

Kahle, Juliette J; Gulbahce, Natali; Shaw, Chad A; Lim, Janghoo; Hill, David E; Barabási, Albert-László; Zoghbi, Huda Y




SciTech Connect

We report the first subarcsecond (0.''65 x 0.''51) image of the dimethyl ether molecule, (CH{sub 3}){sub 2}O, toward the Orion Kleinmann-Low nebula. The observations were carried at 43.4 GHz with the Expanded Very Large Array (EVLA). The distribution of the lower energy transition 6{sub 1,5}-6{sub 0,6}, EE (E {sub u} = 21 K) mapped in this study is in excellent agreement with the published dimethyl ether emission maps imaged with a lower resolution. The main emission peaks are observed toward the Compact Ridge and Hot Core southwest components, at the northern parts of the Compact Ridge and in an intermediate position between the Compact Ridge and the Hot Core. A notable result is that the distribution of dimethyl ether is very similar to that of another important larger O-bearing species, the methyl formate (HCOOCH{sub 3}), imaged at a lower resolution. Our study shows that higher spectral resolution (WIDAR correlator) and increased spectral coverage provided by the EVLA offer new possibilities for imaging complex molecular species. The sensitivity improvement and the other EVLA improvements make this instrument well suited for high sensitivity, high angular resolution, and molecular line imaging.

Favre, C. [Department of Physics and Astronomy, University of Arhus, Ny Munkegade 120, DK-8000 Arhus C (Denmark); Wootten, H. A.; Remijan, A. J. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22903-2475 (United States); Brouillet, N.; Despois, D.; Baudry, A. [Universite de Bordeaux, OASU, 2 rue de l'Observatoire, BP 89, 33271 Floirac Cedex (France); Wilson, T. L., E-mail:, E-mail:, E-mail:, E-mail:, E-mail:, E-mail:, E-mail: [Naval Research Laboratory, Code 7210, Washington, DC 20375 (United States)



Transcriptomic and phospho-proteomic analyzes of erythroblasts expanded in vitro from normal donors and from patients with polycythemia vera.  


Erythropoiesis is a tightly regulated process which becomes decoupled from its normal differentiation program in patients with polycythemia vera (PV). Somatic mutations in JAK2 are commonly associated with this myeloid proliferative disorder. To gain insight into the molecular events that are required for abnormally developing erythroid cells to escape dependence on normal growth signals, we performed in vitro expansion of mature erythroblasts (ERY) from seven normal healthy donors and from seven polycythemic patients in the presence of IL3, EPO, SCF for 10, 11, or 13 days. Normal ERYs required exposure to the glucocorticoid dexamethasone (Dex) for expansion, while PV-derived ERYs expanded in the absence of dexamethasone. RNA expression profiling revealed enrichment of two known oncogenes, GPR56 and RAB4a, in PV-derived ERYs along with reduced expression levels of transcription factor TAL1 (ANOVA FDR < 0.05). While both normal and polycythemic-derived ERYs integrated signaling cascades for growth, they did so via different signaling pathways which are represented by their differential phospho-profiles. Our results show that normal ERYs displayed greater levels of phosphorylation of EGFR, PDGFR?, TGF?, and cKit, while PV-derived ERYs were characterized by increased phosphorylation of cytoplasmic kinases in the JAK/STAT, PI3K, and GATA1 pathways. Together these data suggest that PV erythroblast expansion and maturation may be maintained and enriched in the absence of dexamethasone through reduced TAL1 expression and by accessing additional signaling cascades. Members of this acquired repertoire may provide important insight into the pathogenesis of aberrant erythropoiesis in myeloproliferative neoplasms such as polycythemia vera. Am. J. Hematol. 88:723-729, 2013. © 2013 Wiley Periodicals, Inc. PMID:23720412

Hricik, Todd; Federici, Giulia; Zeuner, Ann; Alimena, Giuliana; Tafuri, Agostino; Tirelli, Valentina; Varricchio, Lilian; Masiello, Francesca; Ciaffoni, Fiorella; Vaglio, Stefania; Petricoin, Emanuel F; Girelli, Gabriella; Levine, Ross L; Migliaccio, Anna Rita F



The influence of patient thickness and imaging system on patient dose and physical image quality in digital chest imaging.  


The aim of this work was to study the influence of patient thickness, tube voltage and image detector on patient dose, contrast and ideal observer signal-to-noise ratio (SNR(I)), for pathological details positioned at different regions in the image in posterior-anterior (PA) chest radiology. A Monte Carlo computational model was used to compute measures of physical image quality (contrast, SNR(I)) and patient effective dose, E. Two metastasis-like details positioned in the central right lung and right lung near the spine, respectively, were studied. The tube voltage was varied between 100 and 150 kV and the patient thickness between 20 and 28 cm. Both, a computed radiography (CR) system and a direct radiography (DR) system, were investigated. The DR system provides both lower doses and better image quality compared with the CR system. The SNR(I)2/E is approximately 2.9 times higher for the DR system compared with the CR system. PMID:15933124

Ullman, Gustaf; Sandborg, Michael; Dance, David R; Hunt, Roger; Alm Carlsson, Gudrun



Imaging informatics for consumer health: towards a radiology patient portal.  


OBJECTIVE: With the increased routine use of advanced imaging in clinical diagnosis and treatment, it has become imperative to provide patients with a means to view and understand their imaging studies. We illustrate the feasibility of a patient portal that automatically structures and integrates radiology reports with corresponding imaging studies according to several information orientations tailored for the layperson. METHODS: The imaging patient portal is composed of an image processing module for the creation of a timeline that illustrates the progression of disease, a natural language processing module to extract salient concepts from radiology reports (73% accuracy, F1 score of 0.67), and an interactive user interface navigable by an imaging findings list. The portal was developed as a Java-based web application and is demonstrated for patients with brain cancer. RESULTS AND DISCUSSION: The system was exhibited at an international radiology conference to solicit feedback from a diverse group of healthcare professionals. There was wide support for educating patients about their imaging studies, and an appreciation for the informatics tools used to simplify images and reports for consumer interpretation. Primary concerns included the possibility of patients misunderstanding their results, as well as worries regarding accidental improper disclosure of medical information. CONCLUSIONS: Radiologic imaging composes a significant amount of the evidence used to make diagnostic and treatment decisions, yet there are few tools for explaining this information to patients. The proposed radiology patient portal provides a framework for organizing radiologic results into several information orientations to support patient education. PMID:23739614

Arnold, Corey W; McNamara, Mary; El-Saden, Suzie; Chen, Shawn; Taira, Ricky K; Bui, Alex A T



Laparoscopic Deployment of Biliary Self-Expandable Metal Stent (SEMS) for One-Step Palliation in 23 Patients with Advanced Pancreatico-Biliary Tumors—a Pilot Trial  

Microsoft Academic Search

Background  Exploratory laparoscopy is commonly undertaken in patients with highly suspicious biliary and pancreatic lesions to facilitate\\u000a diagnosis and staging cancer is present. If an unresectable tumor is identified, a second endoscopic procedure may be required\\u000a do deploy a self-expandable metal stent (SEMS) for palliation. As endoscopic retrograde cholangio pancreatography (ERCP) may\\u000a be unsuccessful in up to 20% of patients, we

Everson L. A. Artifon; Airton Z. Rodrigues; Sergio Marques; Bhawna Halwan; Paulo Sakai; Claudio Bresciani; Atul Kumar



Subcortical physiology deformed into a patient-specific brain atlas for image-guided stereotaxy  

NASA Astrophysics Data System (ADS)

Stereotactic neurosurgery for movement disorders involves the accurate localization of functionally distinct subcortical anatomy that appears homogeneous on magnetic resonance or computed tomographic images. To aid localization of these surgical targets on patient images, we have developed a visualization oriented searchable and expandable database of functional organization representing bilaterally the sensorimotor thalamus, pallidum, internal capsule, and subthalamic nucleus. Data were obtained through microelectrode recording and stimulation mapping routinely performed during 123 functional stereotactic procedures. Electrophysiologic data were standardized using a multi-parameter coding system and annotated to their respective MRIs at the appropriate position in patient stereotactic space. To accommodate for normal anatomical variability, we have developed an intensity-based nonlinear registration algorithm that rapidly warps a patient's volumetric MRI to a high-resolution MRI average brain. The annotated functional data are subsequently transformed into the average brain coordinate system using the displacement grids generated by the algorithm. When the database is searched, clustering of like inter-patient physiologic responses within target anatomy and adjacent structures is revealed. These data may in turn be registered to a preoperative MRI using a desktop computer enabling prior to surgery interactive delineation of surgical targets. The database is expandable, fully searchable, and provides a visual 3D representation of subcortical functional organization.

Finnis, Kirk; Starreveld, Yves P.; Parrent, Andrew; Peters, Terence M.




SciTech Connect

The radio continuum emission from the Galaxy has a rich mix of thermal and non-thermal emission. This very richness makes its interpretation challenging since the low radio opacity means that a radio image represents the sum of all emission regions along the line of sight. These challenges make the existing narrowband radio surveys of the Galactic plane difficult to interpret: e.g., a small region of emission might be a supernova remnant (SNR) or an H II region, or a complex combination of both. Instantaneous wide bandwidth radio observations in combination with the capability for high-resolution spectral-index mapping can be directly used to disentangle these effects. Here we demonstrate simultaneous continuum and spectral-index imaging capability at the full continuum sensitivity and resolution using newly developed wide-band wide-field imaging algorithms. Observations were conducted in the L and C bands with a total bandwidth of 1 and 2 GHz, respectively. We present preliminary results in the form of a full-field continuum image covering the wide-band sensitivity pattern of the EVLA centered on a large but poorly studied SNR (G55.7 + 3.4) and relatively narrower field continuum and spectral-index maps of three fields containing SNR and diffused thermal emission. We demonstrate that spatially resolved spectral-index maps differentiate regions with emission of different physical origins (spectral-index variation across composite SNRs and separation of thermal and non-thermal emission), superimposed along the line of sight. The wide-field image centered on the SNR G55.7+3.4 also demonstrates the excellent wide-field wide-band imaging capability of the EVLA.

Bhatnagar, S.; Rau, U.; Rupen, M. P. [National Radio Astronomy Observatory, Socorro, NM 87801 (United States); Green, D. A., E-mail:, E-mail:, E-mail:, E-mail: [Astrophysics Group, Cavendish Laboratory, Cambridge CB3 0HE (United Kingdom)



Colloquial descriptions of body image in older surgical patients  

Microsoft Academic Search

Major surgery and associated experiences in critical care settings affect patients’ perceptions of their body images. This paper discusses several colloquial terms related to body image used in interviews by elderly patients following major surgery for abdominal aortic aneurysm. The terms ‘badly failed, and well mended’, and ‘out of sorts’, and ‘in tune with my body’ recurred. These referred to

Pat Deeny; Michael Kirk-Smith



CIK cells from recurrent or refractory AML patients can be efficiently expanded in vitro and used for reduction of leukemic blasts in vivo.  


Autologous cytokine-induced killer (CIK) cell transfusion may prevent tumor relapse in acute myeloid leukemia (AML). This study investigated whether CIK cells from recurrent or refractory AML patients with high peripheral leukemia cell burdens could be expanded to a clinically usable number, and it further evaluated the antitumor potentials in vitro and in vivo. The numbers and phenotypes of CIK cells expanded from nine AML patients and 10 healthy donors were compared. Cytotoxicity (against K562 and U937 cell lines) and cytokine secretion (interleukin-2, interferon-?, tumor necrosis factor-? and vascular endothelial growth factor) were tested for AML-derived and healthy donor-derived CIK cells and fresh peripheral blood mononuclear cells from healthy donors. Importantly, we assessed the therapeutic effects of autologous CIK cell infusions in two patients with AML. The proportions of CD3(+)and CD3(+)CD56(+) CIK cells from patients with AML were similar to those from healthy donors, and the number of CD3(+)CD56(+) cells in AML-derived CIK cells was expanded approximately 1,020-fold. Phenotype analyses with flow cytometry showed that the leukemic cells were gradually eliminated during the process of CIK cell preparation to an almost undetectable level. Although the cytotoxic effect of AML-derived CIK cells was equivalent to that of healthy donors, AML-derived CIK cells had a significantly higher cytokine-secreting capacity. In clinical treatment, the leukemia burden in the peripheral blood of one patient was dramatically decreased after four transfusions within 4 months. CIK cells can be efficiently expanded in vitro from patients with recurrent or refractory AML and may be used for reduction of leukemic blasts in vivo. PMID:23123634

Wang, Yao; Bo, Jian; Dai, Han-ren; Lu, Xue-chun; Lv, Hai-yan; Yang, Bo; Wang, Tao; Han, Wei-dong



Preprocedural Imaging for Patients with Atrial Fibrillation and Heart Failure  

PubMed Central

Various electrophysiological procedures and device implantation has been shown to improve morbidity and mortality in patients with atrial fibrillation (AF) and patients with heart failure (HF). Non-invasive cardiac imaging is used extensively in the pre-procedural patient selection and for procedural guidance. In this review, we will discuss the application of pre-procedural cardiac imaging in patients with AF prior to pulmonary vein and left atrial ablation as well as insertion of left atrial occluder device. We also discuss the role of non-invasive cardiac imaging in the selection of appropriate HF patients for device therapy as well as their use in guiding implantation of biventricular pacemaker for cardiac resynchronization therapy by assessing left ventricular ejection fraction, coronary venous anatomy, mechanical dyssynchrony and myocardial scar. We describe new research associated with pre-procedural imaging in these patient cohorts.

Thai, Wai-ee; Wai, Bryan; Truong, Quynh A.



Body Image Disturbance in Patients with Acne Vulgaris  

PubMed Central

Psychosocial outcome measures, which attempt to examine acne from the patient's perspective, have become increasingly important in dermatology research. One such measure is the Body Image Disturbance Questionnaire. The authors' primary aim was to determine the validity and internal consistency of the Body Image Disturbance Questionnaire in patients with acne vulgaris. The secondary aim was to investigate the relationship between body image disturbance and quality of life. This cross-sectional investigation included 52 consecutive acne patients presenting to an outpatient dermatology clinic. Subjects completed the Body Image Disturbance Questionnaire, Skindex-16, and other body image and psychosocial functioning measures. An objective assessment of acne was performed. The Body Image Disturbance Questionnaire was internally consistent and converged with other known body image indices. Body Image Disturbance Questionnaire scores also correlated with Skindex-16 scores, confirming that quality of life and body image are related psychosocial constructs. The Body Image Disturbance Questionnaire appears to be an accurate instrument that can assess appearance-related concern and impairment in patients with acne vulgaris. Limitations include a small sample size and the cross-sectional design.

Bowe, Whitney P.; Crerand, Canice E.; Margolis, David J.; Shalita, Alan R.



Radioaerosol ventilation imaging in ventilator-dependent patients. Technical considerations  

SciTech Connect

The differentiation of pulmonary embolism (PE) from regional ventilatory abnormalities accompanied by reduced perfusion requires contemporary perfusion and ventilation studies. Distinguishing these conditions in ventilator-dependent patients is aided by administering a Tc-99m aerosol to characterize regional ventilation, and by performing a conventional Tc-99m MAA perfusion study. The technique uses a simple in-house constructed apparatus. Simple photographic techniques suffice, but computer subtraction of perfusion from the combined perfusion-ventilation image renders interpretation easier if aerosol administration follows perfusion imaging. Multiple defects can be examined in a single study. Excluding normal or near-normal perfusion studies, PE was thought to be present in eight of 16 patients after perfusion imaging alone, but in only one of eight after added aerosol imaging. Angiography confirmed the diagnosis in that patient. Of the eight patients who had abnormal perfusion but were thought unlikely to have PE from the perfusion study alone, two had normal ventilation, and subsequently were shown to have PE by angiography. Because angiography was only performed on patients who were thought to have a high probability of PE on sequential perfusion-ventilation imaging, the true incidence of PE may have been higher. Aerosol ventilation imaging is a useful adjunct to perfusion imaging in patients on ventilators. It requires an efficient delivery system, particularly if aerosol administration follows perfusion imaging, as it does in this study.

Vezina, W.; Chamberlain, M.; Vinitski, S.; King, M.; Nicholson, R.; Morgan, W.K.



Expanded Yegua  

SciTech Connect

The upper Eocene Yegua Formation expands dramatically across a regional flexure generally 12-15 km wide. During each of several postulated Yegua sea level drops, this flexure became a focal point for deltaic deposition of good to excellent reservoir-quality sands. From the western edge of the Houston salt dome basin to the San Marcos arch, this trend has yielded, since 1982, at least seven noteworthy discoveries: Toro Grande and Lost Bridge fields in Jackson County, and Black Owl, Shanghai, Shanghai East, El Campo, and Phase Four fields in Wharton County, Texas. El Campo field in Wharton County, Texas, was discovered in December 1985 by Ladd Petroleum Corporation with the drilling of the Ladd Petroleum 1 Popp well. Mud logs acquired while drilling indicated that a very sandy reservoir, with encouraging quantities of natural gas and condensate had been encountered. Subsequent open-hold logging generated more questions than answers about the prospective sand section. Additional open hole logs (EPT/ML,SHDT) were run to identify what turned out to be an extremely laminated sand-shale sequence over 400 ft thick. Subsequent development drilling and the acquisition of a 120 ft whole core provided valuable data in analyzing this prolific, geopressured natural gas and condensate Yegua reservoir. Whole-core data, open-hole logs, and computer logs were integrated to develop petro-physical evaluation procedures and to determine the environment of deposition. El Campo field is believed to represent an extremely thick, delta front slope to distal delta front facies.

Hart, R.E.; Grayson, S.; Benes, J.



Quantitative diffusion weighted imaging measures in patients with multiple sclerosis.  


Diffusion-weighted imaging (DWI) has been proposed as a sensitive measure of disease severity capable of detecting subtle changes in gray matter and white matter brain compartments in patients with multiple sclerosis (MS). However, DWI has been applied to the study of MS clinical subtypes in only a few studies. The objective of this study was to demonstrate the validity of a novel, fully automated method for the calculation of quantitative DWI measures. We also wanted to assess the correlation between whole brain (WB)-DWI variables and clinical and MRI measures of disease severity in a large cohort of MS patients. For this purpose we studied 432 consecutive MS patients (mean age 44.4+/-10.2 years), 16 patients with clinically isolated syndrome (CIS) and 38 normal controls (NC) using 1.5 T brain MRI. Clinical disease subtypes were as follows: 294 relapsing-remitting (RR), 123 secondary-progressive (SP) and 15 primary-progressive (PP). Mean disease duration was 12+/-10 years. Mean Expanded Disability Status Scale (EDSS) was 3.3+/-2.1. Brain parenchymal fraction (BPF), gray matter fraction (GMF) and white matter fraction (WMF) were calculated using a fully automated method. Mean parenchymal diffusivity (MPD) maps were created. DWI indices of peak position (PP), peak height (PH), MPD and entropy (ENT) were obtained. T2- and T1-lesion volumes (LV), EDSS, ambulation index (AI) and nine-hole peg test (9-HPT) were also assessed. MS patients had significantly lower BPF (d=1.26; p<0.001) and GMF (d=0.61; p=0.003), and higher ENT (d=1.2; p<0.0001), MPD (d=1.04; p<0.0001) and PH (d=0.47; p=0.045) than NC subjects. A GLM analysis, adjusted for age and multiple comparisons, revealed significant differences between different clinical subtypes for BPF, GMF, ENT, PH, PP, T2-LV and T1-LV (p<0.0001), WMF (p=0.001) and MPD (p=0.023). In RR and SP MS patients, ENT showed a more robust correlation with other MRI (r=0.54 to 0.67, p<0.0001) and clinical (r=0.31 to 0.36, p<0.0001) variables than MPD (r=0.23 to 0.41, p<0.001 for MRI and r=0.13 to 0.18; p=0.006 to p<0.001 for clinical variables). The GMF and BPF showed a slightly stronger relationship with all clinical variables (r=0.33 to 0.48; p<0.0001), when compared to both lesion and DWI measures. ENT (R2=0.28; p<0.0001) and GMF (R2=0.26; p<0.001) were best related with SP disease course. This study highlights the validity of DWI in discerning differences between NC and MS patients, as well as between different MS subtypes. ENT is a sensitive marker of overall brain damage that is strongly related to clinical impairment in patients with SP MS. PMID:17498974

Tavazzi, Eleonora; Dwyer, Michael G; Weinstock-Guttman, Bianca; Lema, Jordan; Bastianello, Stefano; Bergamaschi, Roberto; Cosi, Vittorio; Benedict, Ralph H B; Munschauer, Frederick E; Zivadinov, Robert



Cumulative radiation dose from medical imaging in chronic adult patients.  


Chronic patients require ongoing care that results in repeated imaging and exposure to ionizing radiation for both diagnostic and therapeutic purposes. This is of concern due to the long-term effects of radiation exposure, namely the association between radiation and increased cancer risk. In this study, the scientific literature on cumulated dose of radiation accrued from medical imaging by 4 cohorts of chronic patients (cardiac disease, end-stage kidney disease, inflammatory bowel disease, and patients undergoing endovascular aortic repair) was systematically reviewed. We found that the cumulative effective dose is moderate in cardiac and inflammatory bowel disease patients, high in end-stage kidney disease patients, and very high in endovascular aortic repair patients. We concluded that radiation burden of medical imaging is high in selected cohorts of chronic patients. Efforts should be implemented to reduce this cumulative dose and its potential attendant risks. PMID:23541374

Brambilla, Marco; De Mauri, Andreana; Leva, Lucia; Carriero, Alessandro; Picano, Eugenio



Imaging Approaches to Patients with Polycystic Kidney Disease  

PubMed Central

Imaging is an important approach to diagnosis, monitoring and predicting outcomes for patients with Autosomal Dominant polycystic Kidney Disease (ADPKD). This paper reviews three common clinical imaging techniques, ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and their role in management of ADPKD. Ultrasonographic criteria for diagnosis in children and adults are reviewed. Total kidney volume (TKV), as measured by MRI, is suggested as important potential marker to determine disease progression and overall prognosis. Renal blood flow (RBF) and a novel approach to interpreting non-cystic renal parenchymal by CT images are other innovative imaging approaches described.

Chapman, Arlene B.; Wei, Wenjing



Coma Patient Monitoring System Using Image Processing  

NASA Astrophysics Data System (ADS)

COMA PATIENT MONITORING SYSTEM provides high quality healthcare services in the near future. To provide more convenient and comprehensive medical monitoring in big hospitals since it is tough job for medical personnel to monitor each patient for 24 hours.. The latest development in patient monitoring system can be used in Intensive Care Unit (ICU), Critical Care Unit (CCU), and Emergency Rooms of hospital. During treatment, the patient monitor is continuously monitoring the coma patient to transmit the important information. Also in the emergency cases, doctor are able to monitor patient condition efficiently to reduce time consumption, thus it provides more effective healthcare system. So due to importance of patient monitoring system, the continuous monitoring of the coma patient can be simplified. This paper investigates about the effects seen in the patient using ``Coma Patient Monitoring System'' which is a very advanced product related to physical changes in body movement of the patient and gives Warning in form of alarm and display on the LCD in less than one second time. It also passes a sms to a person sitting at the distant place if there exists any movement in any body part of the patient. The model for the system uses Keil software for the software implementation of the developed system.

Sankalp, Meenu



A body image scale for use with cancer patients  

Microsoft Academic Search

Body image is an important endpoint in quality of life evaluation since cancer treatment may result in major changes to patients' appearance from disfiguring surgery, late effects of radiotherapy or adverse effects of systemic treatment. A need was identified to develop a short body image scale (BIS) for use in clinical trials. A 10-item scale was constructed in collaboration with

P Hopwood; I Fletcher; A Lee; S Al Ghazal



Neural net learning for intelligent patient-image retrieval  

Microsoft Academic Search

A neural net algorithm for learning patient image retrieval heuristics may solve the bottlenecks that radiologists experience in searching for relevant prior images. Its accuracy is comparable to that of a manually engineered knowledge base, but it requires considerably less time and resources

Olivia R. Liu Sheng; Chih-Ping Wei; P. J.-H. Hu



Improved MR imaging for patients with metallic implants  

Microsoft Academic Search

Pediatric oncology patients with large metallic prostheses were imaged with one of two MR imaging techniques: 1) the “tilted view-angle” technique, 2) or a higher readout bandwidth technique. The tilted view-angle method uses an additional gradient in the slice selection direction during readout. The high bandwidth technique increases the readout bandwidth and shortens the echo time (TE). High bandwidth and

Ann M. Viano; Suzanne A. Gronemeyer; Mithat Haliloglu; Fredric A. Hoffer



Pelvic masses in pregnant patients: MR and US imaging  

SciTech Connect

Sixteen pregnant patients with pelvic masses detected with ultrasound (US) were studied with magnetic resonance (MR) imaging at 0.35 T. Two patients were in their first trimester, eight in the second, and six in the last. On MR images, 34 masses were seen, including 19 uterine leiomyomas. With US, 20 masses were detected. All masses not seen with US were leiomyomas. Only 20 masses (in 11 patients) were removed for histologic study. In nine cases, MR imaging and US provided similar information on the origin, extent, and type of mass. In seven patients, MR imaging contributed additional information. MR imaging depicted more leiomyomas than US in three patients. In another case, MR images showed that a mass depicted with US was actually a loop of bowel. MR images allowed differentiation between a solid soft tissue mass and a hemorrhagic fluid-containing mass, correctly depicted the presence of an abdominal pregnancy, and allowed evaluation of the parametrium for spread of cervical carcinoma.

Weinreb, J.C.; Brown, C.E.; Lowe, T.W.; Cohen, J.M.; Erdman, W.A.



Impact of sirolimus-eluting stents on outcome in diabetic patients: A SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable stent in the treatment of patients with de novo coronary artery lesions) substudy  

Microsoft Academic Search

Background—Randomized clinical trials have shown that a sirolimus-eluting stent significantly reduces restenosis after percutaneous coronary revascularization. Diabetic patients are known to have a higher risk of restenosis compared with nondiabetic patients. The purpose of this analysis was to determine the impact of sirolimus-eluting stents on outcomes of diabetic compared with nondiabetic patients. Methods and Results—The SIRIUS (SIRolImUS-coated Bx Velocity balloon-expandable

Issam Moussa; Martin B. Leon; Donald S. Baim



Body Image Dissatisfaction in Male Cosmetic Surgery Patients  

Microsoft Academic Search

.   This study was the first empirical investigation of body image dissatisfaction in male cosmetic surgery patients. Thirty\\u000a men completed two body image measures prior to their initial consultation. Results were compared to the norms for each of\\u000a the measures and with a sample of 30 women seeking similar cosmetic procedures. Results indicated that patients did not demonstrate\\u000a greater dissatisfaction

Michael J. Pertschuk; David B. Sarwer; Thomas A. Wadden; Linton A. Whitaker



Noninvasive imaging workup of patients with vascular disease.  


The diagnostic workup of patients with cardiovascular disease is frequently challenging, and requires a multimodality approach to appropriately determine management. Depending on the presenting symptoms and their acuity, noninvasive diagnostic imaging strategies can include radiography, ultrasonography, computed tomography, and magnetic resonance imaging. This article provides an introduction to the use of these imaging modalities for commonly encountered diseases of the aorta, mesenteric arteries, and renal arteries, focusing on how the acuity of presentation and likelihood of disease affects the workup of patients with known or suspected vascular disease. PMID:23885929

François, Christopher J



Magnetic Resonance Imaging in patients with ICDs and Pacemakers  

PubMed Central

Magnetic resonance (MR) imaging has unparalleled soft-tissue imaging capabilities. The presence of devices such as pacemakers and implantable cardioverter/defibrillators (ICDs), however, is historically considered a contraindication to MR imaging. These devices are now smaller, with less magnetic material and improved electromagnetic interference protection. This review summarizes the potential hazards of the device-MR environment interaction, and presents updated information regarding in-vivo and in-vitro experiments. Recent reports on patients with implantable pacemakers and ICDs who underwent MR scan shows that under certain conditions patients with these implanted systems may benefit from this imaging modality. The data presented suggests that certain modern pacemaker and ICD systems may indeed be MR safe. This may have major clinical implications on current imaging practice.

Nair, Prashant; Roguin, Ariel



JAMA Patient Page: Magnetic Resonance Imaging  


... Radiology; National Library of Medicine; International Society for Magnetic Resonance in Medicine; National Heart, Lung, and Blood Institute; Radiological Society of North America The JAMA Patient Page is a public ...


Adenomyoma of the ampullary region: imaging findings in four patients  

Microsoft Academic Search

Background: We report the imaging features of adenomyoma of the distal common bile duct (CBD) and increase awareness of this rare benign disease. Methods: Four patients (age range = 66–71 years) with abdominal pain and biliary obstruction had spiral computed tomography (CT) and cholangiography with or without papilla biopsy. Two patients also had endoscopic ultrasound. Results: The CT appearance of

N. Aoun; S. Zafatayeff; T. Smayra; S. Haddad-Zebouni; C. Tohmé; M. Ghossain



Noninvasive Cardiac Imaging in Chest Pain Syndromes  

Microsoft Academic Search

The use of cardiac ultrasound imaging has enhanced the management of patients with acute coronary syndromes. As ultrasound technology has advanced in the last decade, the indications for imaging patients with coronary artery disease have expanded. There are many advantages of using echocardiography as an imaging technique in patients with chest pain syndromes because it is portable, entirely noninvasive, and

Sharon C. Reimold; Elliott M. Antman



Expanded Occupational Safety and Health Administration 300 log as metric for bariatric patient-handling staff injuries  

Microsoft Academic Search

BackgroundMobilization of morbidly obese patients poses significant physical challenges to healthcare providers. The purpose of this study was to examine the staff injuries associated with the patient handling of the obese, to describe a process for identifying injuries associated with their mobilization, and to report on the need for safer bariatric patient handling.

Stephen B. Randall; Walter J. Pories; Amy Pearson; Daniel J. Drake



Expanding the clinical spectrum of the 16p11.2 chromosomal rearrangements: three patients with syringomyelia  

PubMed Central

16p11.2 rearrangements are associated with developmental delay, cognitive impairment, autism spectrum disorder, behavioral problems (especially attention-deficit hyperactivity disorder), seizures, obesity, dysmorphic features, and abnormal head size. In addition, congenital anomalies and abnormal brain findings were frequently observed in patients with these rearrangements. We identified and performed a detailed microarray, phenotypic, and radiological characterization of three new patients with 16p11.2 rearrangements: two deletion patients and one patient with the reciprocal duplication. All patients have a heterozygous loss (deletion) or gain (duplication) corresponding to chromosomal coordinates (chr16: 29?528?190–30?107?184) with a minimal size of 579?kb. The deletion patients had language delay and learning disabilities and one met criteria for pervasive developmental disorder not otherwise specified. The duplication patient received a diagnosis of autism and had academic deficits and behavioral problems. The patients with deletion had long cervicothoracic syringomyelia and the duplication patient had long thoracolumbar syringomyelia. The syringomyelia in one patient with deletion was associated with Chiari malformation. Our findings highlight the broad spectrum of clinical and neurological manifestations in patients with 16p11.2 rearrangements. Our observation suggests that genes (or a single gene) within the implicated interval have significant roles in the pathogenesis of syringomyelia. A more comprehensive and systematic research is warranted to study the frequency and spectrum of malformations in the central nervous system in these patients.

Schaaf, Christian P; Goin-Kochel, Robin P; Nowell, Kerri P; Hunter, Jill V; Aleck, Kirk A; Cox, Sarah; Patel, Ankita; Bacino, Carlos A; Shinawi, Marwan



Expanding the clinical spectrum of the 16p11.2 chromosomal rearrangements: three patients with syringomyelia.  


16p11.2 rearrangements are associated with developmental delay, cognitive impairment, autism spectrum disorder, behavioral problems (especially attention-deficit hyperactivity disorder), seizures, obesity, dysmorphic features, and abnormal head size. In addition, congenital anomalies and abnormal brain findings were frequently observed in patients with these rearrangements. We identified and performed a detailed microarray, phenotypic, and radiological characterization of three new patients with 16p11.2 rearrangements: two deletion patients and one patient with the reciprocal duplication. All patients have a heterozygous loss (deletion) or gain (duplication) corresponding to chromosomal coordinates (chr16: 29?528?190-30?107?184) with a minimal size of 579?kb. The deletion patients had language delay and learning disabilities and one met criteria for pervasive developmental disorder not otherwise specified. The duplication patient received a diagnosis of autism and had academic deficits and behavioral problems. The patients with deletion had long cervicothoracic syringomyelia and the duplication patient had long thoracolumbar syringomyelia. The syringomyelia in one patient with deletion was associated with Chiari malformation. Our findings highlight the broad spectrum of clinical and neurological manifestations in patients with 16p11.2 rearrangements. Our observation suggests that genes (or a single gene) within the implicated interval have significant roles in the pathogenesis of syringomyelia. A more comprehensive and systematic research is warranted to study the frequency and spectrum of malformations in the central nervous system in these patients. PMID:20959866

Schaaf, Christian P; Goin-Kochel, Robin P; Nowell, Kerri P; Hunter, Jill V; Aleck, Kirk A; Cox, Sarah; Patel, Ankita; Bacino, Carlos A; Shinawi, Marwan



Psychopathology and Body Image in Cosmetic Surgery Patients  

Microsoft Academic Search

.   The purpose of this study was to investigate the presence of psychiatric symptoms and evaluate the perceptive, cognitive,\\u000a and behavioral aspects of body image in cosmetic surgery patients. These parameters of 20 cosmetic patients and of 20 control\\u000a patients matched for age, gender, education, and marital status who attended the general surgery department for minor surgery\\u000a were compared in

Serpil Vargel; Aylin Ulu?ahin



Expanded CTG repeat demarcates a boundary for abnormal CpG methylation in myotonic dystrophy patient tissues  

PubMed Central

Myotonic dystrophy (DM1) affects multiple organs, shows age-dependent progression and is caused by CTG expansions at the DM1 locus. We determined the DM1 CpG methylation profile and CTG length in tissues from DM1 foetuses, DM1 adults, non-affected individuals and transgenic DM1 mice. Analysis included CTCF binding sites upstream and downstream of the CTG tract, as methylation-sensitive CTCF binding affects chromatinization and transcription of the DM1 locus. In humans, in a given foetus, expansions were largest in heart and smallest in liver, differing by 40–400 repeats; in adults, the largest expansions were in heart and cerebral cortex and smallest in cerebellum, differing by up to 5770 repeats in the same individual. Abnormal methylation was specific to the mutant allele. In DM1 adults, heart, liver and cortex showed high-to-moderate methylation levels, whereas cerebellum, kidney and skeletal muscle were devoid of methylation. Methylation decreased between foetuses and adults. Contrary to previous findings, methylation was not restricted to individuals with congenital DM1. The expanded repeat demarcates an abrupt boundary of methylation. Upstream sequences, including the CTCF site, were methylated, whereas the repeat itself and downstream sequences were not. In DM1 mice, expansion-, tissue- and age-specific methylation patterns were similar but not identical to those in DM1 individuals; notably in mice, methylation was present up- and downstream of the repeat, but greater upstream. Thus, in humans, the CpG-free expanded CTG repeat appears to maintain a highly polarized pattern of CpG methylation at the DM1 locus, which varies markedly with age and tissues.

Lopez Castel, Arturo; Nakamori, Masayuki; Tome, Stephanie; Chitayat, David; Gourdon, Genevieve; Thornton, Charles A.; Pearson, Christopher E.



Magnetic resonance imaging in patients with panhypopituitarism  

Microsoft Academic Search

Primary panhypopituitarism consists of functional deficiency of the anterior pituitary lobe, which appears during infancy or adolescence. The magnetic resonance findings in 10 patients with a history of primary hopopituitarism are presented. The findings include: reduced pituitary size in all cases: partially (8 cases) or totally (2 cases) empty sella; thin (4 cases), partially visible (3 cases) or absent (2

R. S. Pozzi Mucelli; F. Frezza; S. Magnaldi; G. Proto



Accurate setup of paraspinal patients using a noninvasive patient immobilization cradle and portal imaging  

SciTech Connect

Because of the proximity of the spinal cord, effective radiotherapy of paraspinal tumors to high doses requires highly conformal dose distributions, accurate patient setup, setup verification, and patient immobilization. An immobilization cradle has been designed to facilitate the rapid setup and radiation treatment of patients with paraspinal disease. For all treatments, patients were set up to within 2.5 mm of the design using an amorphous silicon portal imager. Setup reproducibility of the target using the cradle and associated clinical procedures was assessed by measuring the setup error prior to any correction. From 350 anterior/posterior images, and 303 lateral images, the standard deviations, as determined by the imaging procedure, were 1.3 m, 1.6 m, and 2.1 in the ant/post, right/left, and superior/inferior directions. Immobilization was assessed by measuring patient shifts between localization images taken before and after treatment. From 67 ant/post image pairs and 49 lateral image pairs, the standard deviations were found to be less than 1 mm in all directions. Careful patient positioning and immobilization has enabled us to develop a successful clinical program of high dose, conformal radiotherapy of paraspinal disease using a conventional Linac equipped with dynamic multileaf collimation and an amorphous silicon portal imager.

Lovelock, D. Michael; Hua Chiaho; Wang Ping; Hunt, Margie; Fournier-Bidoz, Nathalie; Yenice, Kamil; Toner, Sean; Lutz, Wendell; Amols, Howard; Bilsky, Mark; Fuks, Zvi; Yamada, Yoshiya [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, 10021 (United States); Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021 (United States); Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021 (United States)



Patient dose and image quality from mega-voltage cone beam computed tomography imaging  

SciTech Connect

The evolution of ever more conformal radiation delivery techniques makes the subject of accurate localization of increasing importance in radiotherapy. Several systems can be utilized including kilo-voltage and mega-voltage cone-beam computed tomography (MV-CBCT), CT on rail or helical tomography. One of the attractive aspects of mega-voltage cone-beam CT is that it uses the therapy beam along with an electronic portal imaging device to image the patient prior to the delivery of treatment. However, the use of a photon beam energy in the mega-voltage range for volumetric imaging degrades the image quality and increases the patient radiation dose. To optimize image quality and patient dose in MV-CBCT imaging procedures, a series of dose measurements in cylindrical and anthropomorphic phantoms using an ionization chamber, radiographic films, and thermoluminescent dosimeters was performed. Furthermore, the dependence of the contrast to noise ratio and spatial resolution of the image upon the dose delivered for a 20-cm-diam cylindrical phantom was evaluated. Depending on the anatomical site and patient thickness, we found that the minimum dose deposited in the irradiated volume was 5-9 cGy and the maximum dose was between 9 and 17 cGy for our clinical MV-CBCT imaging protocols. Results also demonstrated that for high contrast areas such as bony anatomy, low doses are sufficient for image registration and visualization of the three-dimensional boundaries between soft tissue and bony structures. However, as the difference in tissue density decreased, the dose required to identify soft tissue boundaries increased. Finally, the dose delivered by MV-CBCT was simulated using a treatment planning system (TPS), thereby allowing the incorporation of MV-CBCT dose in the treatment planning process. The TPS-calculated doses agreed well with measurements for a wide range of imaging protocols.

Gayou, Olivier; Parda, David S.; Johnson, Mark; Miften, Moyed [Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212 and Drexel University College of Medicine, Allegheny Campus, Pittsburgh, Pennsylvania 15212 (United States)



Diffusion-weighted imaging in patients with progressive multifocal leukoencephalopathy  

Microsoft Academic Search

Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system due to JC\\u000a polyoma virus infection of oligodendrocytes. PML develops in patients with impaired T-cell function as occurs in HIV, malignancy\\u000a or immunosuppressive drugs users. Until now no imaging methods have been reported to correlate with clinical status. Diffusion-weighted\\u000a imaging (DWI) is a robust MRI tool

M. Cosottini; C. Tavarelli; L. Del Bono; G. Doria; M. Giannelli; S. De Cori; M. C. Michelassi; C. Bartolozzi; L. Murri



Metabolic imaging of patients with cardiomyopathy  

SciTech Connect

The cardiomyopathies comprise a diverse group of illnesses that can be characterized functionally by several techniques. However, the delineation of derangements of regional perfusion and metabolism have been accomplished only relatively recently with positron emission tomography (PET). Regional myocardial accumulation and clearance of 11C-palmitate, the primary myocardial substrate under most conditions, demonstrate marked spatial heterogeneity when studied under fasting conditions or with glucose loading. PET with 11C-palmitate permits the noninvasive differentiation of patients with nonischemic from ischemic dilated cardiomyopathy, since patients with ischemic cardiomyopathy demonstrate large zones of intensely depressed accumulation of 11C-palmitate, probably reflecting prior infarction. Patients with hypertrophic cardiomyopathy and Duchenne's muscular dystrophy demonstrate relatively unique patterns of myocardial abnormalities of perfusion and metabolism. The availability of new tracers and techniques for the evaluation of myocardial metabolism (11C-acetate), perfusion (H2(15)O), and autonomic tone (11-C-hydroxyephedrine) should facilitate further understanding of the pathogenesis of the cardiomyopathies.

Geltman, E.M. (Cardiovascular Division, Washington University School of Medicine, St. Louis, MO (United States))



Expanded CD4+CD45RO+ phenotype and defective proliferative response in T lymphocytes from patients with Crohn's disease  

Microsoft Academic Search

BACKGROUND & AIMS: An abnormal immune response may play a pathogenic role in Crohn's disease. The aim of this study was to determine the role of regulatory T cells in Crohn's disease. METHODS: T-cell phenotype and function were studied in blood lymphocytes from patients with Crohn's disease and a control group consisting of healthy donors and patients with ulcerative colitis.

LI Roman; L Manzano; A De La Hera; L Abreu; I Rossi; M Alvarez-Mon



Posttraumatic syringomyelia: volumetric phantom and patient studies using MR imaging  

Microsoft Academic Search

.   The purpose of this study was to determine the volume of posttraumatic syringomyelia (PTS) based on standard MRI data acquisitions,\\u000a and to compare the volumes with the neurological deficits of the patients. Firstly, phantom studies were performed using routine\\u000a T1- (T1W; TR 500 ms, TE 13 ms) spin-echo (SE) images, 3D gradient-echo (GE) images and T2-weighted (T2W) turbo spin-echo (TSE)\\u000a images

Michael Freund; Dirk Habicht; Alfred Aschoff; Kira Kalvine; Klaus Sartor



Percutaneous Placement of Self-Expandable Metallic Stents in Patients with Obstructive Jaundice Secondary to Metastatic Gastric Cancer after Gastrectomy  

PubMed Central

Objective To evaluate the outcomes of patients undergoing percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy. Materials and Methods Fifty patients (mean age, 62.4 years; range, 27-86 years) who underwent percutaneous placements of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy were included. The technical success rate, clinical success rate, complication rate, stent patency, patient survival and factors associated with stent patency were being evaluated. Results The median interval between the gastrectomy and stent placement was 23.1 months (range, 3.9-94.6 months). The 50 patients received a total of 65 stents without any major procedure-related complications. Technical success was achieved in all patients. The mean total serum bilirubin level, which had been 7.19 mg/dL ± 6.8 before stent insertion, decreased to 4.58 mg/dL ± 5.4 during the first week of follow-up (p < 0.001). Clinical success was achieved in 42 patients (84%). Percutaneous transhepatic biliary drainage catheters were removed from 45 patients (90%). Infectious complications were noted in two patients (4%), and stent malfunction occurred in seven patients (14%). The median stent patency was 233 ± 99 days, and the median patient survival was 179 ± 83 days. Total serum bilirubin level after stenting was an independent factor for stent patency (p = 0.009). Conclusion Percutaneous transhepatic placement of a biliary stent for obstructive jaundice secondary to metastatic gastric cancer after gastrectomy is a technically feasible and clinically effective palliative procedure.

Hong, Hyun Pyo; Cha, In-Ho; Yu, Jung Rim; Mok, Young Jae; Oh, Joo Hyeong; Kwon, Se Hwan; Kim, Sam Soo; Kim, Seung Kwon



High frequency of the expanded C9ORF72 hexanucleotide repeat in familial and sporadic Greek ALS patients.  


An intronic expansion of a hexanucleotide GGGGCC repeat in the C9ORF72 gene has recently been shown to be an important cause of amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) in familial and sporadic cases. The frequency has only been defined in a small number of populations where the highest sporadic rate was identified in Finland (21.1%) and the lowest in mainland Italy (4.1%). We examined the C9ORF72 expansion in a series of 146 Greek ALS cases, 10.95% (n = 16) of cases carried the pathological expansion defined as greater than 30 repeats. In the 10 familial ALS probands, 50% (n = 5) of them carried a pathologically large expansion. In the remaining 136 sporadic ALS cases, 11 were carriers (8.2%). None of the 228 Greek controls carried an expanded repeat. The phenotype of our cases was spinal (13/16) or bulbar (3/16) ALS, the familial cases were all spinal ALS and none of our cases had behavioral frontotemporal dementia. Expansions in the C9ORF72 gene therefore represent a common cause of ALS in Greece and this test will be diagnostically very important to implement in the Greek population. The frequency is higher than other populations with the exception of Finland and this may be due to Greece being a relatively isolated population. PMID:22445326

Mok, Kin Y; Koutsis, Georgios; Schottlaender, Lucia V; Polke, James; Panas, Marios; Houlden, Henry



Expanding the clinical spectrum of the 16p11.2 chromosomal rearrangements: three patients with syringomyelia  

Microsoft Academic Search

16p11.2 rearrangements are associated with developmental delay, cognitive impairment, autism spectrum disorder, behavioral problems (especially attention-deficit hyperactivity disorder), seizures, obesity, dysmorphic features, and abnormal head size. In addition, congenital anomalies and abnormal brain findings were frequently observed in patients with these rearrangements. We identified and performed a detailed microarray, phenotypic, and radiological characterization of three new patients with 16p11.2 rearrangements:

Christian P Schaaf; Robin P Goin-Kochel; Kerri P Nowell; Jill V Hunter; Kirk A Aleck; Sarah Cox; Ankita Patel; Carlos A Bacino; Marwan Shinawi



Somatic mosaicism of expanded CAG repeats in brains of patients with dentatorubral-pallidoluysian atrophy: Cellular populaton-dependent dynamics of mitotic instability  

SciTech Connect

Dentatorubral-pallidoluysian atrophy (DRPLA) is an autosomal dominant neurodegenerative disease caused by unstable expansion of a CAG repeat in the DRPLA gene. We performed detailed quantitative analysis of the size and the size distribution (range) of the expanded CAG repeats in various regions of the CNS of eight autopsied patients with DRPLA. Expanded alleles (AE) showed considerable variations in size, as well as in range, depending on the region of the CNS, whereas normal alleles did not show such variations, which indicates the occurrence of somatic mosaicism of AE in the CNS. The AE in the cerebellar cortex were consistently smaller by two to five repeat units than those in the cerebellar white matter. Moreover, the AE in the cerebral cortex were smaller by one to four repeat units than those in the cerebral white matter. These results suggest that the smaller AE in the cerebellar and cerebral cortices represent those of neuronal cells. The ranges of the AE in the cerebral cortex, cerebral white matter, and cerebellar white matter showed considerable variation ranging from 9 to 23 repeat units, whereas those in the cerebellar cortex showed little variance and were {approximately}7 repeat units. The ranges of the AE in the cerebral cortex, cerebral white matter, and cerebellar white matter were much broader in patients with higher ages at death than they were in patients with lower ages at death, raising the possibility that the range of AE increases with time, as the result of mitotic instability of AE. 41 refs., 6 figs., 1 tab.

Takano, Hiroki; Onodera, Osamu; Igarashi, Shuichi; Oyake, Mutsuo [Niigata Univ. (Japan)] [and others



Gene therapy imaging in patients for oncological applications  

Microsoft Academic Search

Thus far, traditional methods for evaluating gene transfer and expression have been shown to be of limited value in the clinical arena. Consequently there is a real need to develop new methods that could be repeatedly and safely performed in patients for such purposes. Molecular imaging techniques for gene expression monitoring have been developed and successfully used in animal models,

Iván Peñuelas; Uwe Haberkorn; Shahriar Yaghoubi; Sanjiv S. Gambhir



Patient Position Detection for SAR Optimization in Magnetic Resonance Imaging  

Microsoft Academic Search

Although magnetic resonance imaging is considered to be non-invasive, there is at least one effect on the patient which has to be monitored: The heating which is generated by absorbed radio frequency (RF) power. It is described using the specific absorption rate (SAR). In order to obey legal limits for these SAR values, the scanner's duty cycle has to be

Andreas Keil; Christian Wachinger; Gerhard Brinker; Stefan Thesen; Nassir Navab



Depression in adults with congenital heart disease-public health challenge in a rapidly expanding new patient population  

PubMed Central

There is a growing population of adults with congenital heart disease (CHD) due to improved survival beyond childhood. It has been suggested that adults with CHD may be at increased risk for mental health problems, particularly depression. The reported incidence of depression in CHD varies from 9% to 30%. This review examines the evidence for a higher depression rate in CHD vs general population. Possible explanations are offered from a variety of disease models, ranging from brain injury to the psychoanalytical approach. Risk factors for an abnormal emotional adjustment and depression include early exposure to stress from illness and medical interventions in infancy, separation from the parents during hospitalizations and brain organic syndromes. Later in life, patients often have to cope with physical limitations. Recent improvements in care may be protective. Current patients may benefit from an earlier age at first surgical intervention, fewer reoperations and inclusion to the mainstream schooling, among other factors. At this point, there is little systematic knowledge about evidence-based therapeutic interventions for depression in adults with CHD. Health care providers of patients with CHD should be aware of mental health challenges and may take a more proactive approach to identifying patients at risk for depression.

Pauliks, Linda B



Pulmonary Cryptococcosis: Imaging Findings in 23 Non-AIDS Patients  

PubMed Central

Objective We aimed to review the patterns of lung abnormalities of pulmonary cryptococcosis on CT images, position emission tomography (PET) findings of the disease, and the response of lung abnormalities to the therapies in non-AIDS patients. Materials and Methods We evaluated the initial CT (n = 23) and 18F-fluorodeoxyglucose (FDG) PET (n = 10), and follow-up (n = 23) imaging findings of pulmonary cryptococcosis in 23 non-AIDS patients. Lung lesions were classified into five patterns at CT: single nodular, multiple clustered nodular, multiple scattered nodular, mass-like, and bronchopneumonic patterns. The CT pattern analyses, PET findings, and therapeutic responses were recorded. Results A clustered nodular pattern was the most prevalent and was observed in 10 (43%) patients. This pattern was followed by solitary pulmonary nodular (n = 4, 17%), scattered nodular (n = 3, 13%), bronchopneumonic (n = 2, 9%), and single mass (n = 1, 4%) patterns. On PET scans, six (60%) of 10 patients showed higher FDG uptake and four (40%) demonstrated lower FDG uptake than the mediastinal blood pool. With specific treatment of the disease, a complete clearance of lung abnormalities was noted in 15 patients, whereas a partial response was noted in seven patients. In one patient where treatment was not performed, the disease showed progression. Conclusion Pulmonary cryptococcosis most commonly appears as clustered nodules and is a slowly progressive and slowly resolving pulmonary infection. In two-thirds of patients, lung lesions show high FDG uptake, thus simulating a possible malignant condition.

Song, Kyoung Doo; Chung, Man Pyo; Kwon, O Jung; Kim, Tae Sung; Yi, Chin A; Chung, Myung Jin



Patient-centered outcomes in imaging: quantifying value.  


The Patient-Centered Outcomes Research Institute was created in response to a mandate to conduct comparative effectiveness research in clinical care to inform decision making. The institute will be funded by the Patient-Centered Outcomes Research Trust Fund, through congressional set-asides, and by Medicare and private health insurers, through a per beneficiary fee. The institute is governed by a board with a broad stakeholder constitution. Key committees set the national agenda for patient-centered outcomes research, the agenda for funding priorities, and communication and dissemination of the evidence with the goal of increasing the rate of implementation of the evidence into policy. In imaging, patient-centered outcomes go beyond the traditional metrics of patient satisfaction. Instead, these outcomes need to encompass the benefits and harms, focus on outcomes relevant to patients, and provide information to inform decision making. Therefore, radiologists need to be involved as stakeholders in the design, conduct, and dissemination of this research. PMID:23025867

Carlos, Ruth C; Buist, Diana S M; Wernli, Karen J; Swan, J Shannon



Expandable display system  

US Patent & Trademark Office Database

Described herein are embodiments of an expandable display system that have an expanded position for retail display and a collapsed position for efficient shipping. The expandable display system includes a product tray and an associated easel support, with the easel support being configured to expand and lock into the expanded position to support the product tray at an inclined angle relative to a surface on which the easel support rests. In some embodiments, the product tray and the associated easel support are integral.

Howlett; Robert J. (Edison, NJ)



Expanded CTG repeats trigger miRNA alterations in Drosophila that are conserved in myotonic dystrophy type 1 patients.  


Myotonic dystrophy type 1 (DM1) is caused by the expansion of CTG repeats in the 3' untranslated region of the DMPK gene. Several missplicing events and transcriptional alterations have been described in DM1 patients. A large number of these defects have been reproduced in animal models expressing CTG repeats alone. Recent studies have also reported miRNA dysregulation in DM1 patients. In this work, a Drosophila model was used to investigate miRNA transcriptome alterations in the muscle, specifically triggered by CTG expansions. Twenty miRNAs were differentially expressed in CTG-expressing flies. Of these, 19 were down-regulated, whereas 1 was up-regulated. This trend was confirmed for those miRNAs conserved between Drosophila and humans (miR-1, miR-7 and miR-10) in muscle biopsies from DM1 patients. Consistently, at least seven target transcripts of these miRNAs were up-regulated in DM1 skeletal muscles. The mechanisms involved in dysregulation of miR-7 included a reduction of its primary precursor both in CTG-expressing flies and in DM1 patients. Additionally, a regulatory role for Muscleblind (Mbl) was also suggested for miR-1 and miR-7, as these miRNAs were down-regulated in flies where Mbl had been silenced. Finally, the physiological relevance of miRNA dysregulation was demonstrated for miR-10, since over-expression of this miRNA in Drosophila extended the lifespan of CTG-expressing flies. Taken together, our results contribute to our understanding of the origin and the role of miRNA alterations in DM1. PMID:23139243

Fernandez-Costa, Juan M; Garcia-Lopez, Amparo; Zuñiga, Sheila; Fernandez-Pedrosa, Victoria; Felipo-Benavent, Amelia; Mata, Manuel; Jaka, Oihane; Aiastui, Ana; Hernandez-Torres, Francisco; Aguado, Begoña; Perez-Alonso, Manuel; Vilchez, Jesus J; Lopez de Munain, Adolfo; Artero, Ruben D



Clinical Benefit in NSCLC: Advanced-Stage Patients Require Symptom-Improving Palliation. Experiences from the ?Iressa? Expanded Access Program  

Microsoft Academic Search

Background: The molecular genesis of lung cancer and its treatment remain hot spots of medical research be-cause of the high mortality rates especially associated with non-small-cell lung cancer (NSCLC). New agents are required. The epidermal growth factor receptor (EGFR) pathway inhibitor gefitinib (Iressa?) has been the first approved drug for NSCLC within this new therapeutic class. Patients and Methods: The

Wolfgang Schuette; Sylke Nagel; Steffen Schaedlich; Daniel Brust; Thomas Blankenburg



Expanding the horizons of histoplasmosis: disseminated histoplasmosis in a renal transplant patient after a trip to Bangladesh.  


Histoplasmosis is recognized to occur in the Ohio and Mississippi River Valleys of the United States, but less widely appreciated is its worldwide distribution. We report a case of disseminated histoplasmosis with disease involving skin, lungs, and epiglottis in a renal transplant patient 6 months after a trip to Bangladesh, to highlight the potential risk of acquisition of this infection in the Indian subcontinent. PMID:19878490

Rappo, U; Beitler, J R; Faulhaber, J R; Firoz, B; Henning, J S; Thomas, K M; Maslow, M; Goldfarb, D S; Horowitz, H W



The dominant negative ? isoform of the glucocorticoid receptor is uniquely expressed in erythroid cells expanded from polycythemia vera patients  

PubMed Central

Glucocorticoid receptor (GR) agonists increase erythropoiesis in vivo and in vitro. To clarify the effect of the dominant negative GR? isoform (unable to bind STAT-5) on erythropoiesis, erythroblast (EB) expansion cultures of mononuclear cells from 18 healthy (nondiseased) donors (NDs) and 16 patients with polycythemia vera (PV) were studied. GR? was expressed in all PV EBs but only in EBs from 1 ND. The A3669G polymorphism, which stabilizes GR? mRNA, had greater frequency in PV (55%; n = 22; P = .0028) and myelofibrosis (35%; n = 20) patients than in NDs (9%; n = 22) or patients with essential thrombocythemia (6%; n = 15). Dexamethasone stimulation of ND cultures increased the number of immature EBs characterized by low GATA1 and ?-globin expression, but PV cultures generated great numbers of immature EBs with low levels of GATA1 and ?-globin irrespective of dexamethasone stimulation. In ND EBs, STAT-5 was not phosphorylated after dexamethasone and erythropoietin treatment and did not form transcriptionally active complexes with GR?, whereas in PV EBs, STAT-5 was constitutively phosphorylated, but the formation of GR/STAT-5 complexes was prevented by expression of GR?. These data indicate that GR? expression and the presence of A3669G likely contribute to development of erythrocytosis in PV and provide a potential target for identification of novel therapeutic agents.

Varricchio, Lilian; Masselli, Elena; Alfani, Elena; Battistini, Angela; Migliaccio, Giovanni; Vannucchi, Alessandro Maria; Zhang, Wenyong; Rondelli, Damiano; Godbold, James; Ghinassi, Barbara; Whitsett, Carolyn; Hoffman, Ronald



Combination therapy of in vitro-expanded natural killer T cells and alpha-galactosylceramide-pulsed antigen-presenting cells in patients with recurrent head and neck carcinoma.  


The aim of this clinical trial was to investigate the feasibility of intra-arterial infusion of in vitro-expanded Valpha24 natural killer T (NKT) cells combined with submucosal injection of alpha-galactosylceramide (KRN7000; alphaGalCer)-pulsed antigen-presenting cells (APC). A phase I clinical study was carried out in patients with head and neck squamous cell carcinoma (HNSCC). Patients with locally recurrent HNSCC refractory to standard therapy were eligible. Eight patients received super-selective transcatheter intra-arterial infusion of activated Valpha24 NKT cells into tumor-feeding arteries and nasal submucosal injections of alphaGalCer-pulsed APC twice with a 1-week interval. Valpha24 NKT cell-specific immune responses, safety, and antitumor effects were evaluated. The number of Valpha24 NKT cells and interferon-gamma-producing cells in peripheral blood mononuclear cells increased in seven out of eight patients enrolled. Grade 3 toxicity with a pharyngocutaneous fistula related to local tumor reduction was observed in one patient and mild adverse events with grade 1-2 symptoms occurred in seven patients. Regarding the clinical responses, three cases exhibited a partial but significant response, four were classified as stable disease, and one patient continued to develop progressive disease. The use of the intra-arterial infusion of activated Valpha24 NKT cells and the submucosal injection of alphaGalCer-pulsed APC has been shown to induce significant antitumor immunity and had beneficial clinical effects in the management of advanced HNSCC. The use of such therapeutic modalities may be helpful in the management of tumors and therefore needs to be explored in further detail. The clinical trial registration number was UMIN000000722. PMID:19302288

Kunii, Naoki; Horiguchi, Shigetoshi; Motohashi, Shinichiro; Yamamoto, Heizaburo; Ueno, Naoyuki; Yamamoto, Seiji; Sakurai, Daiju; Taniguchi, Masaru; Nakayama, Toshinori; Okamoto, Yoshitaka



Indium-111 leukocyte imaging in patients with rheumatoid arthritis  

SciTech Connect

This study evaluates the usefulness of labeled leukocyte imaging in patients with rheumatoid arthritis. In 33 patients, the incidence of pain and swelling in 66 wrist joints and 66 knee joints was compared with the accumulation of (/sup 111/In)leukocytes. No accumulation of (/sup 111/In)leukocytes was seen in any of the patients' wrists (0/12) or knee joints (0/14) when both pain and swelling were absent. In contrast, 93% (25/27) of wrist joints and 80% (24/30) of knee joints with both pain and swelling were positive by (/sup 111/In)leukocyte scintigraphy. There was little correlation between the stage of the disease, as determined by radiography, and (/sup 111/In)leukocyte accumulation. This study suggests that (/sup 111/In)leukocyte imaging may be a reliable procedure for monitoring the activity of rheumatoid arthritis, especially for confirming the lack of an ongoing inflammatory response.

Uno, K.; Matsui, N.; Nohira, K.; Suguro, T.; Kitakata, Y.; Uchiyama, G.; Miyoshi, T.; Uematsu, S.; Inoue, S.; Arimizu, N.



Patient specific prostate segmentation in 3-d magnetic resonance images.  


Accurate localization of the prostate and its surrounding tissue is essential in the treatment of prostate cancer. This paper presents a novel approach to fully automatically segment the prostate, including its seminal vesicles, within a few minutes of a magnetic resonance (MR) scan acquired without an endorectal coil. Such MR images are important in external beam radiation therapy, where using an endorectal coil is highly undesirable. The segmentation is obtained using a deformable model that is trained on-the-fly so that it is specific to the patient's scan. This case specific deformable model consists of a patient specific initialized triangulated surface and image feature model that are trained during its initialization. The image feature model is used to deform the initialized surface by template matching image features (via normalized cross-correlation) to the features of the scan. The resulting deformations are regularized over the surface via well established simple surface smoothing algorithms, which is then made anatomically valid via an optimized shape model. Mean and median Dice's similarity coefficients (DSCs) of 0.85 and 0.87 were achieved when segmenting 3T MR clinical scans of 50 patients. The median DSC result was equal to the inter-rater DSC and had a mean absolute surface error of 1.85 mm. The approach is showed to perform well near the apex and seminal vesicles of the prostate. PMID:22875243

Chandra, Shekhar S; Dowling, Jason A; Shen, Kai-Kai; Raniga, Parnesh; Pluim, Josien P W; Greer, Peter B; Salvado, Olivier; Fripp, Jurgen



Using a patient image archive to diagnose retinopathy  

SciTech Connect

Diabetes has become an epidemic that is expected to impact 365 million people worldwide by 2025. Consequently, diabetic retinopathy is the leading cause of blindness in the industrialized world today. If detected early, treatments can preserve vision and significantly reduce debilitating blindness. Through this research we are developing and testing a method for automating the diagnosis of retinopathy in a screening environment using a patient archive and digital fundus imagery. We present an overview of our content-based image retrieval (CBIR) approach and provide performance results for a dataset of 98 images from a study in Canada when compared to an archive of 1,355 patients from a study in the Netherlands. An aggregate performance of 89% correct diagnosis is achieved, demonstrating the potential of automated, web-based diagnosis for a broad range of imagery collected under different conditions and with different cameras.

Tobin Jr, Kenneth William [ORNL; Abramoff, M.D. [University of Iowa; Chaum, Edward [University of Tennessee, Knoxville (UTK); Giancardo, Luca [ORNL; Govindaswamy, Priya [Oak Ridge National Laboratory (ORNL); Karnowski, Thomas Paul [ORNL; Tennant, M [University of Alberta; Swainson, Stephen [University of Alberta



Evaluation of cutaneous body image dissatisfaction in the dermatology patient.  


Cutaneous body image (CBI), defined as the individual's mental representation of his or her skin, hair, and nails, is an important clinical factor in dermatologic disorders and often the primary consideration in deciding whether to proceed with cosmetic procedures or institute treatment in some skin disorders such as acne. CBI is a highly subjective construct that can be significantly confounded by cultural, psychosocial, and psychiatric factors. Assessment of CBI in the dermatology patient is best accomplished using a biopsychosocial model that involves (1) evaluation of concerns about the appearance of the skin, hair, and nails, (2) assessment of comorbid body image pathologies, especially body dysmorphic disorder, and (3) assessment of other psychiatric comorbidities such as major depressive disorder that can confound the presentation of the CBI complaint. Depending on the psychiatric comobidities, an assessment of suicide risk may have to be done, and if necessary, a referral made to a mental health professional. The clinician should consider the patient's developmental stage (eg, body image concerns are likely to be much greater in the adolescent patient independent of his or her dermatologic disorder) and sociocultural background (eg, a desire for lighter skin in some ethnic groups), factors that can also have a major effect on CBI. PMID:23245977

Gupta, Madhulika A; Gupta, Aditya K


Near-Infrared Fluorescence Imaging in Patients Undergoing Pancreaticoduodenectomy  

PubMed Central

Background Intraoperative visualization of pancreatic tumors has the potential to improve radical resection rates. Intraoperative visualization of the common bile duct and bile duct anastomoses could be of added value. In this study, we explored the use of indocyanine green (ICG) for these applications and attempted to optimize injection timing and dose. Methods Eight patients undergoing a pancreaticoduodenectomy were injected intravenously with 5 or 10 mg ICG. During and after injection, the pancreas, tumor, common bile duct and surrounding organs were imaged in real time using the Mini-FLARE™ near-infrared (NIR) imaging system. Results No clear tumor-to-pancreas contrast was observed, except for incidental contrast in 1 patient. The common bile duct was clearly visualized using NIR fluorescence, within 10 min after injection, with a maximal contrast between 30 and 90 min after injection. Patency of biliary anastomoses could be visualized due to biliary excretion of ICG. Conclusion No useful tumor demarcation could be visualized in pancreatic cancer patients after intravenous injection of ICG. However, the common bile duct and biliary anastomoses were clearly visualized during the observation period. Therefore, these imaging strategies could be beneficial during biliary surgery in cases where the surgical anatomy is aberrant or difficult to identify.

Hutteman, M.; van der Vorst, J.R.; Mieog, J.S.D.; Bonsing, B.A.; Hartgrink, H.H.; Kuppen, P.J.K.; Lowik, C.W.G.M.; Frangioni, J.V.; van de Velde, C.J.H.; Vahrmeijer, A.L.



A Case of Aorto-Bronchial Fistula After Insertion of Left Main Bronchial Self-Expanding Metallic Stent in a Patient with Recurrent Esophageal Cancer  

SciTech Connect

We report a case of aorto-bronchial fistula (ABF) caused by a self-expanding metallic stent (EMS) 51 days after insertion into the left main bronchus. The patient presented with left main bronchial stenosis caused by post-operative local recurrence of esophageal cancer. Post-operative radio therapy totaling 40 Gy and post-recurrence radiotherapy totaling 34 Gy were administered, with daily fractions of 2 Gy. Stenosis of the left main bronchus improved slightly, and was followed with insertion of EMS to prevent re-stenosis. The patient experienced massive hemoptysis for 3 days before sudden death. Autopsy revealed the EMS edge perforating the descending aortic lumen. Tumor infiltration and bacterial infection were observed on the wall of the left bronchus, and atherosclerosis was present on the aortic wall around the fistula. It should be noted that the left main bronchus was at considerable risk of ABF after insertion of EMS for malignant stenosis, and prophylactic stent insertion into the bronchus without imperative need must be avoided.

Onishi, Hiroshi, E-mail:; Kuriyama, Kengo; Komiyama, Takafumi; Tanaka, Shiho; Marino, Kan; Tsukamoto, Tatsuaki; Araki, Tsutomu [Yamanashi Medical University, Department of Radiation Oncology (Japan)



Clonal B cells in patients with hepatitis C virus-associated mixed cryoglobulinemia contain an expanded anergic CD21low B-cell subset  

PubMed Central

Hepatitis C virus (HCV) is associated with the B-cell lymphoproliferative disorders mixed cryoglobulinemia (MC) and non-Hodgkin lymphoma. We have previously reported that HCV+MC+ patients have clonal expansions of hypermutated, rheumatoid factor–bearing marginal zone-like IgM+CD27+ peripheral B cells using the VH1-69 gene. Here we coupled transcriptional profiling with immunophenotypic and functional studies to ascertain these cells' role in MC pathogenesis. Despite their fundamental role in MC disease, these B cells have overall transcriptional features of anergy and apoptosis instead of neoplastic transformation. Highly up-regulated genes include SOX5, CD11C, galectin-1, and FGR, similar to a previously described FCRL4+ memory B-cell subset and to an “exhausted,” anergic CD21low memory B-cell subset in HIV+ patients. Moreover, HCV+MC+ patients' clonal peripheral B cells are enriched with CD21low, CD11c+, FCRL4high, IL-4Rlow memory B cells. In contrast to the functional, rheumatoid factor–secreting CD27+CD21high subset, the CD27+CD21low subpopulation exhibits decreased calcium mobilization and does not efficiently differentiate into rheumatoid factor–secreting plasmablasts, suggesting that a large proportion of HCV+MC+ patients' clonally expanded peripheral B cells is prone to anergy and/or apoptosis. Down-regulation of multiple activation pathways may represent a homeostatic mechanism attenuating otherwise uncontrolled stimulation of circulating HCV-containing immune complexes. This study was registered at as #NCT00435201.

Charles, Edgar D.; Brunetti, Claudia; Marukian, Svetlana; Ritola, Kimberly D.; Talal, Andrew H.; Marks, Kristen; Jacobson, Ira M.; Rice, Charles M.



Comparison of hair from rectum cancer patients and from healthy persons by Raman microspectroscopy and imaging  

NASA Astrophysics Data System (ADS)

Raman spectra of hair from cancer patients show some abnormality.Raman imaging provides more details by identifying patient hair micro-structures.Raman microspectroscopy and imaging of hair may be useful for cancer diagnosis.

Wei, Xiaoli; Wang, Xin; Fang, Yusheng; Huang, Qing



Fast-flow lingual vascular anomalies in the young patient: is imaging diagnostic?  

Microsoft Academic Search

Aim. To describe the imaging findings (MR imaging and angiography) of high-flow vascular anomalies of the tongue, hemangiomas and arteriovenous malformations (AVMs), with emphasis on the discrepant imaging findings in lingual AVMs. Materials and methods. Retrospective review of clinical records, histologic reports and imaging studies of five consecutive patients with high-flow lingual vascular anomalies. Results. One patient had hemangioma (aged

Pek-Lan Khong; Patricia E. Burrows; Harry P. Kozakewich; John B. Mulliken





PURPOSE: To evaluate the findings in a case of acute macular neuroretinopathy involving sudden development of scotomas accompanied by rapid focal increases in fundus autofluorescence. METHODS: The clinical presentation of the patient was documented by color fundus photographs, fundus autofluorescence, infrared imaging, and high-resolution spectral domain optical coherence tomography. The scotomas were assessed by Humphrey visual field 10-2 and MP-1 microperimetry. RESULTS: Visual field defects exhibited spatial correspondence with wedge-shaped lesions demonstrable in color fundus photographs and infrared imaging. It was notable that the lesions exhibited increased intensity on autofluorescence images obtained within 3 weeks of presentation. Optical coherence tomography revealed focal loss of photoreceptor inner segment/outer segment junctions in both eyes. CONCLUSION: This case was distinguished by the relative rapidity with which the lesions became hyperautofluorescent in fundus autofluorescence images. Given that the bisretinoids that are the source of autofluorescence form in photoreceptor cells and are transferred to retinal pigment epithelium secondarily, the rapid increase in autofluorescence is unlikely to only reflect retinal pigment epithelium status and is more likely to be indicative of photoreceptor cell dysfunctioning and loss of structural integrity. PMID:23293707

Gelman, Rony; Chen, Royce; Blonska, Anna; Barile, Gaetano; Sparrow, Janet R



Molecular imaging for monitoring treatment response in breast cancer patients.  


Currently, tumour response following drug treatment is based on measurement of anatomical size changes. This is often done according to Response Evaluation Criteria in Solid Tumours (RECIST) and is generally performed every 2-3 cycles. Bone metastases, being the most common site of distant metastases in breast cancer, are not measurable by RECIST. The standard response measurement provides no insight in changes of molecular characteristics. In the era of targeted medicine, knowledge of specific molecular tumour characteristics becomes more important. A potential way to assess this is by means of molecular imaging. Molecular imaging can visualise general tumour processes, such as glucose metabolism with (18)F-fluorodeoxyglucose ((18)F-FDG) and DNA synthesis with (18)F-fluorodeoxythymidine ((18)F-FLT). In addition, an increasing number of more specific targets, such as hormone receptors, growth factor receptors, and growth factors can be visualised. In the future molecular imaging may thus be of value for personalised treatment-selection by providing insight in the expression of these drug targets. Additionally, when molecular changes can be detected early during therapy, this may serve as early predictor of response. However, in order to define clinical utility of this approach results from (ongoing) clinical trials is required. In this review we summarise the potential role of molecular imaging of general tumour processes as well as hormone receptors, growth factor receptors, and tumour micro-environment for predicting and monitoring treatment response in breast cancer patients. PMID:23545359

Bensch, Frederike; van Kruchten, Michel; Lamberts, Laetitia E; Schröder, Carolien P; Hospers, Geke A P; Brouwers, Adrienne H; van Vugt, Marcel A T M; de Vries, Elisabeth G E



Cardiac magnetic resonance imaging in patients with Fabry's disease.  


Fabry's disease (FD) is a rare hereditary disorder caused by the loss of alpha galactosidase A activity leading to accumulation of glycosphingolipids in various organs including hypertrophy of the heart. Most reports on cardiac involvement in FD focus on the left ventricular hypertrophy (LVH) and its relation to diastolic function. However, recent studies demonstrated large subset of patients with FD and right ventricle (RV) hypertophy. The accurate depiction of RV volumes, function and mass is possible with cardiovascular magnetic resonance (CMR). The CMR study can be also used to identify typically localised regions of intramyocardial fibrosis (infero-lateral segments of the LV), which have been shown to be a marker of inefficacious response to enzyme replacement therapy. We present series of 8 patients with genetically confirmed FD who underwent CMR study. We demonstrated a typical concentric and diffuse pattern of LVH with RV involvement in patients with the most severe LVH without significant impact on RV function and volumes. We showed that myocardial fibrosis can be observed not only in LV but also in RV. In 2 patients FD coexisted with symptomatic coronary artery disease with evidence of subendocardial myocardial fibrosis typical for ischaemic origin in one patient. The CMR confirmation of the presence of FD in one patient at an early stage of the disease, before the onset of advanced hypertrophy or failure of other organs, supports the value of this imaging technique in differential diagnosis of concentric and diffuse LVH. PMID:20730727

Ma?ek, Lukasz A; Chojnowska, Lidia; Spiewak, Mateusz; K?opotowski, Mariusz; Mi?ko, Jolanta; Petryka, Joanna; Mi?osz, Barbara; Ruzy??o, Witold



Imaging patients with suspected brain tumour: guidance for primary care  

PubMed Central

The number of referrals by primary care practitioners to secondary care neurology services, particularly for headache, may be difficult to justify. Access to imaging by primary care practitioners could avoid referral without compromising patient outcomes, but the decision to refer is based on a number of complex factors. Due to the paucity of rigorous evidence in this area, available data are combined with expert opinion to offer support for GPs. The study suggests management for three levels of risk of tumour: red flags >1%; orange flags 0.1–1%; and yellow flags <0.1% but above the background population rate of 0.01%. Clinical presentations are stratified into these three groups. Important secondary causes of headache where imaging is normal should not be overlooked, and normal investigation does not eliminate the need for follow-up or appropriate management of headache.

Kernick, David P; Ahmed, Fayyaz; Bahra, Anish; Dowson, Andrew; Elrington, Giles; Fontebasso, Manuela; Giffin, Nicola J; Lipscombe, Sue; MacGregor, Anne; Peatfield, Richard; Weatherby, Stuart; Whitmarsh, Tom; Goadsby, Peter J



Imaging patients with suspected brain tumour: guidance for primary care.  


The number of referrals by primary care practitioners to secondary care neurology services, particularly for headache, may be difficult to justify. Access to imaging by primary care practitioners could avoid referral without compromising patient outcomes, but the decision to refer is based on a number of complex factors. Due to the paucity of rigorous evidence in this area, available data are combined with expert opinion to offer support for GPs. The study suggests management for three levels of risk of tumour: red flags>1%; orange flags 0.1-1%; and yellow flags<0.1% but above the background population rate of 0.01%. Clinical presentations are stratified into these three groups. Important secondary causes of headache where imaging is normal should not be overlooked, and normal investigation does not eliminate the need for follow-up or appropriate management of headache. PMID:19068162

Kernick, David P; Ahmed, Fayyaz; Bahra, Anish; Dowson, Andrew; Elrington, Giles; Fontebasso, Manuela; Giffin, Nicola J; Lipscombe, Sue; MacGregor, Anne; Peatfield, Richard; Weatherby, Stuart; Whitmarsh, Tom; Goadsby, Peter J



Brains of anorexia nervosa patients process self-images differently from non-self-images: An fMRI study  

Microsoft Academic Search

The central disturbance in anorexia nervosa (AN) is a distorted body image. This perceptual error does not extend to judging others’ body shapes. We used fMRI to examine if the brain processing of an image of self is different in the brains of AN patients. The sample comprised 10 patients with AN and 10 healthy control women. In a controlled

Perminder Sachdev; Naresh Mondraty; Wei Wen; Kylie Gulliford



FDG PET/CT imaging in canine cancer patients.  


2-Deoxy-2-[¹?F]fluoro-D-glucose positron emission tomography/computed tomography (FDG PET/CT) is becoming increasingly available as an imaging modality in veterinary medicine. The purpose of this study was to report semiquantitative standard uptake values (SUV) of malignant and nonmalignant tissues and organs in canine cancer patients. FDG PET/CT was performed in 14 dogs including, nine mesenchymal tumors, four carcinomas, and one incompletely excised mast cell tumor. A generally higher FDG uptake was observed in carcinomas relative to sarcomas. Maximum SUV of carcinomas ranged from 7.6 to 27.0, and for sarcomas from 2.0 to 10.6. The FDG SUV of several organs and tissues, including regional brain uptake is reported, to serve as a reference for future FDG PET studies in canine cancer patients. Several potential pitfalls have been recognized in interpretation of FDG PET images of human patients, a number of these were also observed in this study. PMID:21388475

Hansen, Anders E; McEvoy, Fintan; Engelholm, Svend A; Law, Ian; Kristensen, Annemarie T



Vascular anomalies in pediatric patients: updated classification, imaging, and therapy.  


Recent advances in knowledge regarding histopathology, cause, and treatment of pediatric vascular anomalies have led to substantial changes in classification and terminology. Over the past two decades, various subspecialists have adopted a new classification system proposed by the International Society for the Study of Vascular Anomalies (ISSVA). The ISSVA classification of vascular anomalies divides vascular anomalies into two categories: vascular neoplasms and malformations. It has been widely adopted by various pediatric subspecialists, because it reliably correlates patient presentation and disease progression, with more accurate histology, diagnosis, imaging, and treatment. PMID:23830791

Kollipara, Ramya; Odhav, Ashika; Rentas, Kenny E; Rivard, Douglas C; Lowe, Lisa H; Dinneen, Laura



Functional MR imaging in assessment of language dominance in epileptic patients  

Microsoft Academic Search

The value of functional MR Imaging (fMRI) in assessing language lateralization in epileptic patients candidate for surgical treatment is increasingly recognized. However few data are available for left-handed patients. Moreover determining factors for atypical dominance in patients investigated with contemporary imaging have not been reported. We studied 20 patients (14 males, 6 females; 9 right handed, 11 left handed) aged

P Sabbah; F Chassoux; C Leveque; E Landre; S Baudoin-Chial; B Devaux; M Mann; S Godon-Hardy; C Nioche; A Aït-Ameur; J. L Sarrazin; J. P Chodkiewicz; Y. S Cordoliani



Water expandable polystyrene (WEPS)  

Microsoft Academic Search

In Part 1 (Polymer 1999;40:3685) of this series, the concept for the preparation of expandable polystyrene (PS) applying water as a blowing agent was presented. This paper focuses on the expansion characteristics of water expandable polystyrene (WEPS) beads. The influence of temperature, amount of blowing agent, molar mass of the PS matrix and slight crosslinking of the matrix were investigated

J. J. Crevecoeur; J. F. Coolegem; L. Nelissen; P. J. Lemstra



Water expandable polystyrene (WEPS)  

Microsoft Academic Search

Conventional expandable polystyrene (PS) is prepared via the suspension polymerisation of styrene containing pentane isomers as a blowing agent. The polystyrene beads are expanded by heating above the glass transition temperature, Tg. During the expansion process, pentane, which contributes to the formation of ozone in the lower atmosphere, is released into the environment. The objective of this study was to

J. J. Crevecoeur; L. Nelissen; P. J. Lemstra



Correlation of PET Images of Metabolism, Proliferation and Hypoxia to Characterize Tumor Phenotype in Patients with Cancer of the Oropharynx  

PubMed Central

Spatial organization of tumor phenotype is of great interest to radiotherapy target definition and outcome prediction. We characterized tumor phenotype in patients with cancers of the oropharynx through voxel-based correlation of PET images of metabolism, proliferation, and hypoxia. Methods Patients with oropharyngeal cancer received 18F-fluorodeoxyglucose (FDG) PET/CT, 18F-fluorothymidine (FLT) PET/CT, and 61Cu-diacetyl-bis(N4-methylthiosemicarbazone) (Cu-ATSM) PET/CT. Images were co-registered and standardized uptake values (SUV) were calculated for all modalities. Voxel-based correlation was evaluated with Pearson’s correlation coefficient in tumor regions. Additionally, sensitivity studies were performed to quantify the effects of image segmentation, registration, noise, and segmentation on R. Results On average, FDG PET and FLT PET images were most highly correlated (RFDG:FLT=0.76, range 0.53–0.85), while Cu-ATSM PET showed greater heterogeneity in correlation to other tracers (RFDG:Cu-ATSM=0.64, range 0.51–0.79; RFLT:Cu-ATSM=0.61, range 0.21–0.80). Of the tested parameters, correlation was most sensitive to image registration. Misregistration of one voxel lead to ?RFDG=0.25, ?RFLT=0.39, and ?RCu-ATSM=0.27. Image noise and reconstruction also had quantitative effects on correlation. No significant quantitative differences were found between GTV, expanded GTV, or CTV regions. Conclusions Voxel-based correlation represents a first step into understanding spatial organization of tumor phenotype. These results have implications for radiotherapy target definition and provide a framework to test outcome prediction based on pretherapy distribution of phenotype.

Nyflot, Matthew J; Harari, Paul M; Yip, Stephen; Perlman, Scott B; Jeraj, Robert



Early molecular imaging of interstitial changes in patients after myocardial infarction: Comparison with delayed contrast-enhanced magnetic resonance imaging  

PubMed Central

Introduction The clinical feasibility of noninvasive imaging of interstitial alterations after myocardial infarction (MI) was assessed using a technetium-99m-labeled RGD imaging peptide (RIP). In experimental studies, RIP has been shown to target integrins associated with collagen-producing myofibroblasts (MFB). Methods and Results Ten patients underwent myocardial perfusion imaging (MPI) within the first week after MI. At 3 and 8 weeks after MI, RIP was administered intravenously and SPECT images acquired for interstitial imaging. RIP imaging was compared to initial MPI and to the extent of scar formation defined by late gadolinium-enhanced (LGE) cardiac magnetic resonance (CMR) imaging 1 year after MI. RIP uptake was observed in 7 of the 10 patients at both 3 and 8 weeks. Although, RIP uptake corresponded to areas of perfusion defects, it usually extended beyond the infarct zone to a variable extent; 2 of 7 patients showed tracer uptake throughout myocardium. In all positive cases, RIP uptake was similar to the extent of scar observed at 1 year by LGE-CMR imaging. Conclusion This study demonstrates that RGD-based imaging early after MI may predict the eventual extent of scar formation, which often exceeds initial MPI deficit but colocalizes with LGE in CMR imaging performed subsequently.

Verjans, Johan; Wolters, Sander; Laufer, Ward; Schellings, Mark; Lax, Michelle; Lovhaug, Dagfinn; Boersma, Hendrikus; Kemerink, Gerrit; Schalla, Simon; Gordon, Paul; Teule, Jaap



[Management of color-Doppler imaging in dialysis patients].  


In recent decades, the survival of dialysis patients has gradually increased thanks to the evolution of dialysis techniques and the availability of new drug therapies. These elements have led to an increased incidence of a series of dialysis-related diseases that might compromise the role of dialysis rehabilitation: vascular disease, skeletal muscle disease, infectious disease, cystic kidney disease and cancer. The nephrologist is therefore in charge of a patient group with complex characteristics including the presence of indwelling vascular and/or peritoneal catheters, conditions secondary to chronic renal failure (hyperparathyroidism, anemia, amyloid disease, etc.) and superimposed disorders due to old age (cardiac and respiratory failure, cancer, type 2 diabetes mellitus, etc.). Early clinical and organizational management of such patients is essential in a modern and ''economic'' vision of nephrology. The direct provision of ultrasound services by the nephrologist responds to these requirements. A minimum level of expertise in diagnostic ultrasonography of the urinary tract and dialysis access should be part of the nephrologist's cultural heritage, acquired through theoretical and practical training programs validated by scientific societies, especially for those who choose to specialize in these procedures and become experts in imaging or interventional ultrasonography. PMID:23229666

Battaglia, Yuri; Granata, Antonio; Zamboli, Pasquale; Lusenti, Tiziano; Di Lullo, Luca; Floccari, Fulvio; Logias, Franco; D'Amelio, Alessandro; Fiorini, Fulvio


Objective perimetry using functional magnetic resonance imaging in patients with visual field loss.  


In ophthalmic clinics, subjective perimetry is a standard examination method. However, for certain patients, objective perimetry is useful since it avoids the need for subjective judgments. The purpose of the present study is to demonstrate the feasibility of objective perimetry using functional magnetic resonance imaging (fMRI). fMRI was performed in 8 patients with visual field defects caused by cerebral lesions. The composite stimulus was either the combination of an expanding ring and a clockwise rotating wedge, or a contracting ring and a counter-clockwise rotating wedge. The largest radius was a 10 degrees visual angle with magnifying glasses. The cycle period for the ring and wedge components differed, enabling us to distinguish the two targets within a single time series. Data were analyzed using custom software that interprets the two stimuli and estimates visual field maps. Regions of interest (ROIs) were set covering the entirety of the occipital lobes, and the most effective visual field location for each voxel was calculated from these two response components. The visual field maps obtained with fMRI were compared with the 10-2 Humphrey visual field (HVF) program. While some divergences were observed, in most subjects the visual field defects on fMRI agreed with those on HVF. Cross-correlation coefficients between grayscale values of visual field maps obtained with fMRI and decibel values obtained with HVF were significant (P<0.05) in all subjects. fMRI in conjunction with our method is feasible for objectively and efficiently measuring the visual field of patients with visual field loss. PMID:19348794

Furuta, Ayumu; Nakadomari, Satoshi; Misaki, Masaya; Miyauchi, Satoru; Iida, Tomohiro



A Multidimensional Analysis of Body Image Concerns Among Newly Diagnosed Patients with Oral Cavity Cancer  

PubMed Central

Background Body image is a critical psychosocial issue for patients facing treatment for oral cancer yet there is limited research conducted in this area. This study utilizes a multidimensional approach to body image assessment and evaluates relationships between body image, demographic, health, and psychosocial variables. Methods Newly diagnosed patients with oral cancer completed self-report questionnaires and a structured clinical interview. Results Most participants identified current and/or future body image concerns primarily related to impending surgery. Adequate psychometric properties were demonstrated on a range of body image measures. Depression was the strongest and most consistent predictor of body image outcomes. Conclusions Preliminary evidence supports the importance of evaluating body image concerns in oral cancer patients prior to surgical intervention. Our findings have implications for developing validated body image tools and can be used to guide psychosocial interventions targeting body image disturbance.

Fingeret, Michelle Cororve; Vidrine, Damon J.; Reece, Gregory P.; Gillenwater, Ann M.; Gritz, Ellen R.



Patient setup error measurement using 3D intensity-based image registration techniques  

Microsoft Academic Search

PurposeConformal radiotherapy requires accurate patient positioning with reference to the initial three-dimensional (3D) CT image. Patient setup is controlled by comparison with portal images acquired immediately before patient treatment. Several automatic methods have been proposed, generally based on segmentation procedures. However, portal images are of very low contrast, leading to segmentation inaccuracies. In this study, we propose an intensity-based (with

S. ébastien Clippe; David Sarrut; Claude Malet; Serge Miguet; Chantal Ginestet; Christian Carrie



The Expanding Universe  

NSDL National Science Digital Library

This site begins by discussing Edwin Hubble's great contribution to astronomy, that the universe is expanding. The major points in his paper overviews the possibility of an infinite or finite universe, the history of our universe and how it has evolved, and he finishes by discussing wheter the fate of our universe is one that expands and eventually grows cold or the possibility that it will end in a big crunch.

Felder, Gary



Instability of the Expanded (CTG) n Repeats in the Myotonin Protein Kinase Gene in Cultured Lymphoblastoid Cell Lines from Patients with Myotonic Dystrophy  

Microsoft Academic Search

The mutation associated with myotonic dystrophy (DM) is the expansion of an unstable trinucleotide repeat, (CTG)n, in the 3?-untranslated region of the myotonin protein kinase gene. Although expanded repeats show both germline and somatic instability, the mechanisms of the instability are poorly understood. To establish a model system in which somatic instability of the DM repeat could be studied in

Tetsuo Ashizawa; Darren G. Monckton; Sukeshi Vaishnav; Bhavna J. Patel; Alica Voskova; C. Thomas Caskey



Morphing voxels: the hype around structural imaging of headache patients.  


Neuroimaging analysis using structural data has begun to provide insights into the pathophysiology of headache syndromes. Several independent studies have suggested a decrease in grey matter in pain-transmitting areas in migraine patients. Most of these data are discussed as damage or loss of brain grey matter, reinforcing the idea of migraine as a progressive disease. However, given what we know about the nature of morphometric changes detectable by the methods we have to date, this interpretation is highly speculative and not supported by the data. It is likely that these changes are the consequence and not the cause of the respective headache syndromes, as they are probably not irreversible and only mirror the proportion or duration of pain suffered. Moreover, structural changes are not headache specific and have to be seen in the light of a wealth of pain studies using these methods. The studies in cluster headache patients prompted the use of stereotactic stimulation of the hypothalamic target point identified by functional and structural neuroimaging. Due to the nature of the methods used and due to a high anatomical variance it is more than questionable to use this point as a definite answer to the source of the headache in clusters and even more so when it is uncritically used in individuals. We need a way to study each patient individually using the functional imaging method with the highest spatial and temporal resolution available to enable us to target the seed point for deep brain stimulation on this individual basis. One of the major future challenges is to understand the behavioural consequences and cellular mechanisms underlying neuroanatomic changes in pain and headache. PMID:19443629

May, Arne



18 F-Fluoromethylcholine (FCH) PET imaging in patients with castration-resistant prostate cancer: prospective comparison with standard imaging  

Microsoft Academic Search

Purpose  The aim of the study was to assess the utility of 18F-fluorocholine (FCH), compared to standard imaging of bone scan (BS) and contrast-enhanced abdominopelvic computed tomography\\u000a (CT), in patients with castration-resistant prostate carcinoma.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  FCH has shown promise as a metabolic imaging agent for prostate carcinoma. Twenty-six patients with castration-resistant prostate\\u000a carcinoma had FCH, BS and CT imaging within a 2-month

Michael McCarthy; Teck Siew; Andrew Campbell; Nat Lenzo; Nigel Spry; Justin Vivian; Laurence Morandeau



Impact of StentBoost subtract imaging on patient radiation exposure during percutaneous coronary intervention.  


The purpose of this study was to assess the impact of StentBoost Subtract (SBS) imaging on patient radiation dose during percutaneous coronary intervention. Data were prospectively collected between February 2010 and November 2012 at a tertiary cardiac catheterization. All patients who had scheduled for coronary stent implantation performed by one expert interventional cardiologist with sufficient experience in SBS imaging and radiation protection, were included. The patients were divided into groups with or without SBS. A multiple linear regression analysis was used to determine the impact of SBS imaging on patient radiation dose. Of 712 patients screened, 414 patients were enrolled in the study (with SBS: n = 177, without SBS: n = 237). Although the DAP, fluoroscopy time and cine frames used in the group with SBS were significantly increased when compared with those used in the group without SBS (P < 0.05), multiple linear regression shows SBS imaging has no significant impact on patient radiation dose (P > 0.05). Multivariate predictors of patient radiation dose were the patients' BMI, B2/C lesions, number of stents placed and bifurcation stenting (P < 0.05). In selected patients, SBS imaging can be performed with comparable patient radiation dose, compared with plain fluoroscopic imaging. This may attribute to the operator's sufficient experience in SBS imaging and radiation protection. PMID:23456360

Jin, Zhigeng; Yang, Shengli; Jing, Limin; Liu, Huiliang



Efficacy of technetium Tc 99m pyrophosphate imaging in patients with equivocal myocardial infarction  

SciTech Connect

We studied the efficacy of technetium Tc 99m pyrophosphate imaging in patients with equivocal evidence of acute myocardial infarction. Only patients with positive enzyme findings (regardless of ECG findings) had scans with greater than or equal to 2+ focal uptake. None of 26 patients with negative or equivocal enzyme findings (regardless of ECG findings) had greater than 2+ diffuse uptake. These results support the contention that infarct-avid imaging has little clinical utility in patients with equivocal evidence of myocardial infarction.

Powers, T.A.; Tyler, J.L.; Kulkarni, M.V.



MR Imaging Evaluation of Hemidiaphragms in Acute Blunt Trauma: Experience with 16 Patients  

Microsoft Academic Search

OBJECTIVE. The aim of this retrospective study was to evaluate the usefulness of MR imaging in excluding or confirming the diagnosis of diaphragmatic injury after blunt trauma. MATERIALS AND METHODS. MR imaging studies were performed in 16 patients with blunt trauma and with indeterminate radiographs of the chest suspicious for but not diagnostic of diaphragmatic injury. TI-weighted images were obtained

K. Shanmuganathan; Stuart E. Mirvis; Charles S. White; Steve M. Pomerantz


Dynamic infrared imaging of cutaneous melanoma and normal skin in patients treated with BNCT  

Microsoft Academic Search

We recently initiated a program aimed to investigate the suitability of dynamic infrared imaging for following-up nodular melanoma patients treated with BNCT. The reason that makes infrared imaging attractive is the fact that it constitutes a functional and non-invasive imaging method, providing information on the normal and abnormal physiologic response of the nervous and vascular systems, as well as the

G. A. Santa Cruz; J. Bertotti; J. Marín; S. J. González; S. Gossio; D. Alvarez; B. M. C. Roth; P. Menéndez; M. D. Pereira; M. Albero; L. Cubau; P. Orellano; S. J. Liberman



Relevance of Spinal Cord Abnormalities to Clinical Disability in Multiple Sclerosis: MR Imaging Findings in a Large Cohort of Patients.  


Purpose: To determine whether spinal cord atrophy differs among disease subtypes in multiple sclerosis (MS) and whether it offers diagnostic and clinical correlative information beyond that provided by other magnetic resonance (MR) imaging markers. Materials and Methods: The institutional review board approved the study; all subjects gave written informed consent. Upper cervical cord cross-sectional area (UCCA), brain and spinal cord lesion loads, and brain atrophy were measured in 440 patients with MS (311 with relapsing-remitting [RR] MS, 92 with secondary-progressive [SP] MS, and 37 with primary-progressive [PP] MS) studied in two centers. Disability was scored with the Expanded Disability Status Scale (EDSS), the timed 25-foot walk test (TWT), and the nine-hole peg test. UCCA was compared between groups with the Mann-Whitney U test. Correlations were assessed with the Spearman ? test. Multivariate associations between UCCA and clinical and other MR imaging parameters, including number of hypointense brain lesions on T1-weighted MR images, presence of diffuse abnormalities, and number of involved segments in the spinal cord, were assessed by using multiple linear regression, adjusted for study center site. Results: The UCCA in patients with SP MS (median, 79 mm(2); interquartile range, 72.4-84.9 mm(2)) and PP MS (median, 77.3 mm(2); interquartile range, 69-82.5 mm(2)) was significantly smaller (P < .001) than that in patients with RR MS (median, 84 mm(2); interquartile range, 78.7-89.3 mm(2)). UCCA was inversely correlated with EDSS score, TWT, and nine-hole peg test findings (? ? -0.29, P < .001 for all comparisons). UCCA, number of hypointense brain lesions on T1-weighted MR images, presence of diffuse abnormalities, and number of involved segments in the spinal cord were found to be significant explanatory factors for clinical disability (R(2) = 0.564). The UCCA and the number of hypointense brain lesions on T1-weighted images were the strongest MR imaging parameters for explaining physical disability, as measured with the EDSS. Conclusion: Spinal cord abnormalities have a strong effect on clinical disability in MS. MR imaging-derived UCCA was found to be the most significant spinal cord parameter for explaining EDSS score. © RSNA, 2013. PMID:23737540

Lukas, Carsten; Sombekke, Madeleine H; Bellenberg, Barbara; Hahn, Horst K; Popescu, Veronica; Bendfeldt, Kerstin; Radue, Ernst W; Gass, Achim; Borgwardt, Stefan J; Kappos, Ludwig; Naegelin, Yvonne; Knol, Dirk L; Polman, Chris H; Geurts, Jeroen J G; Barkhof, Frederik; Vrenken, Hugo



Measurement of patient imaging dose for real-time kilovoltage x-ray intrafraction tumour position monitoring in prostate patients.  


The dose for image-based motion monitoring of prostate tumours during radiotherapy delivery has not been established. This study aimed to provide quantitative analysis and optimization of the fluoroscopic patient imaging dose during radiotherapy for IMRT and VMAT treatments using standard and hypofractionated treatment schedules. Twenty-two patients with type T1c N0/M0 prostate cancer and three implanted fiducial markers were considered. Minimum field sizes encompassing all fiducial markers plus a 7.5 mm motion margin were determined for each treatment beam, each patient and the complete cohort. Imaging doses were measured for different field sizes and depths in a phantom at 75 and 120 kV. Based on these measurements, the patient imaging doses were then estimated according to beam-on time for clinical settings. The population minimum field size was 5.3 × 6.1 cm², yielding doses of 406 and 185 mGy over the course of an IMRT treatment for 75 kV (10 mAs) and 120 kV (1.04 mAs) imaging respectively, at 1 Hz. The imaging dose was reduced by an average of 28% and 32% by adopting patient-specific and treatment-beam-specific field sizes respectively. Standard fractionation VMAT imaging doses were 37% lower than IMRT doses over a complete treatment. Hypofractionated IMRT stereotactic body radiotherapy (SBRT) and VMAT SBRT imaging doses were 58% and 76% lower than IMRT doses respectively. The patient dose for kilovoltage intrafraction monitoring of the prostate was quantified. Tailoring imaging field sizes to specific patients yielded a significant reduction in the imaging dose, as did adoption of faster treatment modalities such as VMAT. PMID:22517054

Crocker, James K; Ng, Jin Aun; Keall, Paul J; Booth, Jeremy T



Measurement of patient imaging dose for real-time kilovoltage x-ray intrafraction tumour position monitoring in prostate patients  

NASA Astrophysics Data System (ADS)

The dose for image-based motion monitoring of prostate tumours during radiotherapy delivery has not been established. This study aimed to provide quantitative analysis and optimization of the fluoroscopic patient imaging dose during radiotherapy for IMRT and VMAT treatments using standard and hypofractionated treatment schedules. Twenty-two patients with type T1c N0/M0 prostate cancer and three implanted fiducial markers were considered. Minimum field sizes encompassing all fiducial markers plus a 7.5 mm motion margin were determined for each treatment beam, each patient and the complete cohort. Imaging doses were measured for different field sizes and depths in a phantom at 75 and 120 kV. Based on these measurements, the patient imaging doses were then estimated according to beam-on time for clinical settings. The population minimum field size was 5.3 × 6.1 cm2, yielding doses of 406 and 185 mGy over the course of an IMRT treatment for 75 kV (10 mAs) and 120 kV (1.04 mAs) imaging respectively, at 1 Hz. The imaging dose was reduced by an average of 28% and 32% by adopting patient-specific and treatment-beam-specific field sizes respectively. Standard fractionation VMAT imaging doses were 37% lower than IMRT doses over a complete treatment. Hypofractionated IMRT stereotactic body radiotherapy (SBRT) and VMAT SBRT imaging doses were 58% and 76% lower than IMRT doses respectively. The patient dose for kilovoltage intrafraction monitoring of the prostate was quantified. Tailoring imaging field sizes to specific patients yielded a significant reduction in the imaging dose, as did adoption of faster treatment modalities such as VMAT.

Crocker, James K.; Aun Ng, Jin; Keall, Paul J.; Booth, Jeremy T.



An evaluation of expanded function auxiliaries in general dentistry  

Microsoft Academic Search

A simulation model of private dental practice has been developed to evaluate the effects of introducing expanded function auxiliary personnel. The model permits the experimental investigation of a variety of staffing patterns and facility configurations. Results of these experiments indicate that a solo practice can expand its patient volume 169% and increase net revenue by 233% by adding expanded function

Kerry E. Kilpatrick; Richard S. Mackenzie; Allen G. Delaney



Distribution of Breath Sound Images in Patients with Pneumothoraces Compared to Healthy Subjects  

Microsoft Academic Search

Background: Vibration response imaging (VRI) is a new technology that provides a radiation-free dynamic lung image from the vibrations produced by airflow. The vibration energy from the respiratory cycle can be quantified for any lung region. This is obtained by integrating the energy profiles from 42 acoustic sensors placed on the patient’s back. Objective: The aim of this study was

Montserrat Blanco; Ram Mor; Anne Fraticelli; David P. Breen; Hervé Dutau



Influence of exposure parameters on patient dose and image noise in computed tomography  

Microsoft Academic Search

This work presents the results of investigation of influence of main exposure parameters on the patient dose and image noise on five clinical computed tomography units. Patient dose was determined by means of the quantity CTDIair free on air measured with pencil shaped ionization chamber. The image noise was estimated as a standard deviation of CT numbers in a 500

Desislav Stoyanov; Jenia Vassileva



Neural network object recognition for inspection of patient setup in radiation therapy using portal images  

Microsoft Academic Search

This paper presents a method to improve the performance of inspection of patient setup in radiation therapy using portal images. The proposed algorithm is used to match real-time portal and simulator images which contain the information of patient position relative to the beam position. Two approaches are proposed for this purpose. One approach is to use a multi-scale (multiresolution) analysis

Susan S. Young; Claudio H. Sibata; Anthony K. Ho; Kyu H. Shin



Does bracing affect self-image? A prospective study on 54 patients with adolescent idiopathic scoliosis  

Microsoft Academic Search

To evaluate the effect of brace treatment on self-image in patients with adolescent idiopathic scoliosis, 54 consecutive\\u000a patients admitted for brace treatment were interviewed before bracing. A prevalidated questionnaire including the following\\u000a five aspects of self-image was used: (1) body-image, (2) self-perception of skills and talents, (3) emotional well-being,\\u000a (4) relations with family, and (5) relations with others. As a

Yngvi Ólafsson; Helena Saraste; Rose-Marie Ahlgren



Objectification and negotiation in interpreting clinical images: implications for computer-based patient records.  


This paper concerns the role of images and visualization in clinical practice and decision making. In particular, how physicians talk about and use images are discussed. Findings from evaluation studies of clinical imaging computer information systems suggest that the role and interpretation of images is negotiated, an example of how what is seen is influenced by the practice community, and, therefore is situated in specific instances of clinical decision making. An understanding of professional vision with respect to how physicians use and think about images may aid in developing clinical imaging systems, computer-based patient records, and other clinical information systems that could integrate well with clinical work practice. PMID:8547967

Kaplan, B



Expanded Roles for HRD.  

ERIC Educational Resources Information Center

|This document contains three papers from a symposium on expanded roles for human resource development (HRD). "The Roles of Consultants in Gainsharing Firms: Empirical Results" (Eunsang Cho, Gary N. McLean) reports findings that consultants are moderately involved at the separation, preparation, evaluation, and design stages and have low…




Microsoft Academic Search

These notes discuss formalizing contexts as first class objects. The basic relation is ist(c,p). It asserts that the pro-position ? is true in the context c. The most important formulas relate the propositions true in different contexts. Introducing contexts as formal objects will permit axiomatizations in limited contexts to be expanded to tran- scend the original limitations. This seems necessary

John McCarthy; Sasa Buvac



Redefining the Expanded Role.  

ERIC Educational Resources Information Center

A generation ago the model for an expanded role for nurses included comprehensive health assessment through appropriate and systematic data collection. Today the scope of nursing practice has made aspects of that model obsolete and it is time to redefine that role to reflect nursing education and practice in the 1980s. (JOW)

Mechanic, Hedy Freyone



The Expanding Universe  

NSDL National Science Digital Library

This activity demonstrates with balloons the expansion of the universe. Distances between points on the balloon are meausred as the balloon expands, showing how all are getting farther apart. After the activity the students are asked questions about the universe's expansion.

Slater, Tim P.



Expanding community psychology's domain  

Microsoft Academic Search

Community psychology's twin goals of prevention and empowerment are ill-served when researchers and practitioners restrict their activities to traditional mental health settings. This paper echoes the call of the Swampscott conference for expanding community psychology's domain of inquiry and action. It reviews examples from the research literature of efforts at prevention and empowerment in five classes of behavior settings identified

Marybeth Shinn



Tuberculosis of the sternum and clavicle: imaging findings in 15 patients  

Microsoft Academic Search

Objective. To describe the imaging findings in sterno-clavicular tubercular involvement.\\u000a \\u000a \\u000a Design and patients. Fifteen patients with pathologically proven tuberculosis of the sternum and clavicle were retrospectively evaluated. Routine\\u000a radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical\\u000a information and imaging features were evaluated in each case.\\u000a \\u000a \\u000a \\u000a \\u000a Results. Eight patients had

Jeshil Shah; Deepak Patkar; Bipin Parikh; Hemant Parmar; Ravi Varma; Tufail Patankar; Srinivasa Prasad



The VA's use of DICOM to integrate image data seamlessly into the online patient record.  

PubMed Central

The US Department of Veterans Affairs (VA) is using the Digital Imaging and Communications in Medicine (DICOM) standard to integrate image data objects from multiple systems for use across the healthcare enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire radiology images and store them directly into the online patient record. Images can then be displayed on low-cost clinician's workstations throughout the medical center. High-resolution diagnostic quality multi-monitor VistA workstations with specialized viewing software can be used for reading radiology images. Various image and study specific items from the DICOM data object are essential for the correct display of images. The VA's DICOM capabilities are now used to interface seven different commercial Picture Archiving and Communication Systems (PACS) and over twenty different radiology image acquisition modalities.

Kuzmak, P. M.; Dayhoff, R. E.



The Effect of Obesity Management on Body Image in Patients Seeking Treatment at Medical Centers  

Microsoft Academic Search

Objective: Body image dissatisfaction is common in treatment-seeking patients with obesity. We aimed to investigate the effects of obesity management on body image in patients with obesity attending Italian medical centers for weight loss programs.Research Methods and Procedures: A total of 473 obese patients seeking treatment in 13 Italian medical centers (80% females; age, 45.9 ± standard deviation 11.0 years;

Riccardo Dalle Grave; Massimo Cuzzolaro; Simona Calugi; Franco Tomasi; Flavia Temperilli; Giulio Marchesini



Value of Surgery In Patients With Negative Imaging And Sporadic Zollinger-Ellison Syndrome (ZES)  

PubMed Central

Objectives To address the value of surgery in sporadic Zollinger-Ellison syndrome (ZES) patients with negative imaging studies. Background Medical control of acid hypersecretion in patients with sporadic Zollinger-Ellison syndrome (ZES) is highly effective. This has led to these patients frequently not sent to surgery, especially if preoperative imaging studies are negative, due in large part because almost no data exists on the success of surgery in this group. Methods 58 prospectively studied sporadic ZES patients (17% of total studied) had negative imaging studies and their surgical outcome was compared to 117 patients with positive imaging results. Results 35 patients had negative imaging in the pre-somatostatin receptor scintigraphy era (SRS) and 23 in the post-SRS era. The image negative patients had long disease histories prior to surgery (mean±SEM, from onset=7.9±1[range ?0.25-35 yrs]) and 25% were followed ?2yrs from diagnosis. At surgery, gastrinoma was found in 57/58 patients (98%). Tumors were small (mean=0.8cm, 60% < 1 cm). The most common primary sites were: duodenal 64%, pancreatic 17%, and lymph node (LN)(10%). 50% had a primary only, 41% primary + LN, and 7% had liver metastases. 35/58(60%) were cured immediately postoperatively and at last follow-up [mean-9.4yrs, range 0.2-22yrs], 27 patients (46%) remained cured. During follow-up 3 patients died, each was found to have liver metastases at surgery. In comparison to the image positive patients, those with negative imaging had lower preop fasting gastrin levels; a longer delay prior to surgery; more frequently had a small duodenal tumors; less frequently had a pancreatic tumor, multiple tumors or developed a new lesion postoperatively and had a longer survival. Conclusions Imaging negative sporadic ZES patients are not rare even in the post-SRS period. An experienced surgeon can find gastrinoma in almost every patient (98%) and nearly one-half (46%) are cured, a rate similar to imaging positive tumor patients. Because liver metastases were found in 7%, which may have been caused by a long delay in surgery and all the disease-related deaths occurred in this group, surgery should be routinely undertaken early in ZES patients despite negative imaging studies.

Norton, Jeffrey A.; Fraker, Douglas L.; Alexander, H. Richard; Jensen, Robert T



Discovering the Expanding Universe  

NASA Astrophysics Data System (ADS)

Acknowledgments; Foreword; 1. Introduction; 2. Cosmological concepts at the end of the Middle Ages; 3. Nebulae as a new astronomical phenomenon; 4. On the construction of the Heavens; 5. Island universes turn into astronomical facts: a universe of galaxies; 6. The early cosmology of Einstein and de Sitter; 7. The dynamical universe of Friedmann; 8. Redshifts: how to reconcile Slipher and de Sitter?; 9. Lemaître discovers the expanding universe; 10. Hubble's contribution of 1929; 11. The breakthrough for the expanding universe; 12. Hubble's anger about de Sitter; 13. Robertson and Tolman join the game; 14. The Einstein-de Sitter universe; 15. Are Sun and Earth older than the universe?; 16. In search of alternative tracks; 17. The seed for the Big Bang; 18. Summary and Postscript; Appendix; References; Index.

Nussbaumer, Harry; Bieri, Lydia; Sandage, Foreword by Allan



Water expandable polystyrene (WEPS)  

Microsoft Academic Search

In Part 1 of this series (Polymer 1999;40:3685), the concept for the preparation of expandable polystyrene (PS) applying water as a blowing agent was presented. In order to achieve this goal, water was emulsified by means of a commercially available surfactant (sodium bis(2-ethylhexyl)sulfosuccinate) in a prepolymerised styrene\\/PS mixture. This mixture was subsequently suspended in water and polymerisation was continued to

J. J. Crevecoeur; L. Nelissen; P. J. Lemstra



The Expanding Universe  

NSDL National Science Digital Library

This lesson plan is part of the Center for Educational Resources (CERES), a series of web-based astronomy lessons created by a team of master teachers, university faculty, and NASA researchers. In this lesson, students gain a deeper understanding of cosmology by gathering evidence for the Big Bang theory. They explore the Hubble Law and create a model of the expanding universe. This lesson contains expected outcomes for students, materials, background information, follow-up questions, and assessment procedures.

Tuthill, George; Obbink, Kim


A patient image-based technique to assess the image quality of clinical chest radiographs  

NASA Astrophysics Data System (ADS)

Current clinical image quality assessment techniques mainly analyze image quality for the imaging system in terms of factors such as the capture system DQE and MTF, the exposure technique, and the particular image processing method and processing parameters. However, when assessing a clinical image, radiologists seldom refer to these factors, but rather examine several specific regions of the image to see whether the image is suitable for diagnosis. In this work, we developed a new strategy to learn and simulate radiologists' evaluation process on actual clinical chest images. Based on this strategy, a preliminary study was conducted on 254 digital chest radiographs (38 AP without grids, 35 AP with 6:1 ratio grids and 151 PA with 10:1 ratio grids). First, ten regional based perceptual qualities were summarized through an observer study. Each quality was characterized in terms of a physical quantity measured from the image, and as a first step, the three physical quantities in lung region were then implemented algorithmically. A pilot observer study was performed to verify the correlation between image perceptual qualities and physical quantitative qualities. The results demonstrated that our regional based metrics have promising performance for grading perceptual properties of chest radiographs.

Lin, Yuan; Samei, Ehsan; Luo, Hui; Dobbins, James T., III; McAdams, H. Page; Wang, Xiaohui; Sehnert, William J.; Barski, Lori; Foos, David H.



Body Image in Patients with Systemic Lupus Erythematosus  

Microsoft Academic Search

Background  Systemic lupus erythematosus (SLE), a multisystemic disease of young women may be disfiguring and affect physical and emotional\\u000a health. Body image literature in SLE is scant and controversial.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose  We compared body image-related quality of life in subjects with (n?=?87) and without (n?=?78) SLE and determined its correlates using the body image quality of life inventory (BIQLI).\\u000a \\u000a \\u000a \\u000a \\u000a Method  The tool was self-administered

Meenakshi Jolly; A. Simon Pickard; Rachel A. Mikolaitis; Jessica Cornejo; Winston Sequeira; Thomas F. Cash; Joel A. Block


Chronic expanding pituitary hematoma without rebleeding after pituitary apoplexy  

PubMed Central

Background: Enlargement of intracerebral hematoma without rebleeding in chronic phase is a rare but well-known clinical condition, and is well-described as chronic expanding intracerebral hematoma. However, chronic enlargement of pituitary hematoma without rebleeding after pituitary apoplexy is extremely rare. Case Description: We report a case of chronic expanding pituitary hematoma without rebleeding after pituitary apoplexy. A 29-year-old male presented with sudden onset of headache and vomiting. Magnetic resonance imaging (MRI) demonstrated a pituitary mass lesion with hematoma, consistent with pituitary apoplexy. Neuro-ophthalmological examination revealed no visual field defect, and endocrinological evaluations showed an elevated prolactin level. Pituitary apoplexy due to a prolactinoma was the most likely diagnosis. He was conservatively treated because he exhibited no visual disturbance. Three weeks after the onset, he gradually began to complain of blurred vision and neuro-ophthalamological examination revealed bitemporal upper quadrant hemianopsia. MRI showed enlargement of the pituitary hematoma without any finding suggestive of rebleeding. This enlarged mass lesion compressed the chiasm. The patient was operated on via transsphenoidal approach. After dural opening, xanthochromic fluid spouted out, but no fresh clot could be detected within the cyst. After the operation, the visual field disturbance resolved completely. The possible mechanism of hematoma enlargement is considered to be expansion due to the serum exudation from capillaries of the hematoma capsule. This pathogenetic mechanism is common in enlargement of chronic subdural hematoma. Conclusions: This case is the first report of chronic expanding pituitary hematoma without rebleeding after pituitary apoplexy.

Hojo, Masato; Goto, Masanori; Miyamoto, Susumu



A nursing approach to body image and sexuality adaptation in the mastectomy patient  

Microsoft Academic Search

Surgery for the removal of a breast causes a dramatic shock to the whole being. Crisis theory is used as a framework to view changes in body image and sexuality of mastectomy patients. Hospital nurses can help these patients by their frequent exposure to the patient and her family. Nursing care is directed by a data base collected about the

Ellen Fortune



Selection of patients for preoperative coronary angiography: use of dipyridamole-stress--thallium myocardial imaging  

Microsoft Academic Search

To identify patients likely to benefit from preoperative coronary angiography, a method utilizing pharmacologically induced coronary vasodilatation in conjunction with serial thallium 201 myocardial perfusion imaging was investigated. Fifty-four patients admitted for elective aortic or femoropopliteal procedures were studied. There were no cardiac ischemic complications in 32 patients with normal scans or persistent defects (scar). In contrast, 7 of 15

David C. Brewster; Robert D. Okada; H. William Strauss; William M. Abbott; R. Clement Darling; Charles A. Boucher



Coronary calcium scoring in selected patients after normal or equivocal myocardial perfusion imaging studies, clinical usefulness  

Microsoft Academic Search

Background: Coronary calcium scoring (CCS) by CT after myocardial perfusion imaging (MPI) in selected patients might improve sensitivity for the detection of significant coronary artery disease (CAD), or in patients with symptoms, improve diagnostic confidence for the absence of significant CAD.Methods: We reviewed all 132 patients who were referred for CCS shortly after MPI at our medical center (4-slice MDCT;

R. C Thompson; A. I McGhie; K Moser; J. H O'Keefe; T. M Bateman



Imaging techniques for infections in the surgical patient  

SciTech Connect

Gallium-67 citrate is easy to use and readily available, but the need to delay imaging for 2 to 4 days after injection hinders rapid diagnosis. Moreover, normal gastrointestinal activity limits its usefulness in evaluating the abdomen. Labeling leukocytes with Indium-111 oxine is a time-consuming, technically involved process, yet the images obtained at 24 hours will usually reveal sites of inflammation or infection. Although the techniques have similar sensitivities, the higher specificity of In-111 makes it the superior agent for many clinical situations. When there are localizing signs or symptoms or a reason to suspect a specific body region, CT or ultrasonography is the imaging modality of choice. Guided needle aspiration can then be performed and is usually diagnostic. Radionuclide imaging with either Ga-67 or In-111 is available as an adjunct if needle aspiration cannot be performed or is inconclusive. Since it provides total-body surveillance, radionuclide imaging is particularly useful for screening when there are no localizing signs and in cases of occult sepsis or fever of unknown origin. If positive, it can direct further imaging with CT or ultrasound. 46 references.

Gerzof, S.G.; Oates, M.E.



NMR imaging of forearms in healthy volunteers and patients with giant cell tumor of bone  

SciTech Connect

Serial proton nuclear magnetic resonance (NMR) images of distal upper extremities were obtained in four healthy volunteers and four patients with giant cell tumor of the distal radius. The steady-state-free-precession (SSFP) data collection technique and an 8-cm bore superconducting magnet (1.44 tesla) were used. All images demonstrated high spatial resolution and excellent soft-tissue contrast. In patients with giant cell tumor, the NMR images revealed bone marrow replacement by tumor, cortical bone thinning, and cortical bone destruction. The extent of tumor involvement was clearly delineated by the NMR images and corresponded to radiographic and surgical findings. NMR signal intensity was lower in tumors, suggesting altered relaxation times. These findings demonstrate that proton NMR imaging can provide high-resolution images of extremities and detect tumors by changes in both anatomic structure and relaxation times.

Brady, T.J.; Gebhardt, M.C.; Pykett, I.L.



Imaging findings and transcatheter arterial chemoembolization of hepatic malignancy with right atrial embolus in 46 patients  

PubMed Central

AIM: To analyze the imaging findings of hepatic malignancy with right atrial (RA) embolus. METHODS: Forty-six patients with an embolus in the RA were diagnosed, including 44 patients with hepatocellular carcinoma (HCC), 1 patient with cholangiocellular carcinoma and 1 patient with hepatic carcinoma metastasis. The diagnosis was confirmed by clinical examination, serum ?-fetoprotein and imaging. Seventeen patients underwent transcatheter arterial chemoembolization (TACE). RESULTS: On enhancement computer tomography (CT) or magnetic resonance (MR) imaging, a nodular filling defect in the RA could be easily found, with a slight enhancement in the arterial phase. The coronal images of CT or MR showed the extent of lesion. Lipiodol entered the embolus after TACE, hence reducing the speed of embolus growth. There was a survival benefit for patients receiving anticancer treatment. CONCLUSION: Patients with HCC, showing a filling defect of the inferior vena cava (IVC), hepatic vein (HV) and RA on images, can be diagnosed with RA embolus. Encroachment of the RA is very rare in patients with hepatic malignancies. Furthermore, a prolongation of survival time is found in those patients who underwent TACE.

Cheng, Hong-Yan; Wang, Xiao-Yan; Zhao, Guo-Li; Chen, Dong



Outcomes in patients with abnormal myocardial perfusion imaging and normal coronary angiogram.  


A subset of subjects undergoing myocardial perfusion imaging has perfusion abnormalities that are subsequently labeled false positive based on coronary angiography. We evaluated the long-term prevalence of cardiovascular events in these patients. We retrospectively identified 48 patients who had reversible perfusion abnormalities with myocardial perfusion imaging and normal coronary angiography. Patients with known coronary artery disease, left ventricular dysfunction, valvular disease, and cardiomyopathy were excluded. Patient follow-up, conducted for at least 3 (mean interval, 7.4) years from the index myocardial perfusion imaging, was accomplished by a review of medical records and telephone interviews. Study endpoints were cardiovascular events defined as sudden cardiac death, myocardial infarction, percutaneous coronary revascularization, coronary artery bypass grafting, and cerebrovascular or peripheral revascularization. Thirty-one percent (15 of 48) of the patients had cardiovascular events. Six of the 48 patients had coronary events. These patients had abnormal myocardial perfusion imaging and normal coronary angiogram. The time between myocardial perfusion imaging and coronary event was 0.5 to 8.67 years. There was a strong correlation between the regions of original perfusion abnormality and the ultimate coronary ischemia or revascularization. Abnormal findings on myocardial perfusion imaging may predict a higher prevalence of coronary and peripheral vascular events than suggested by a normal coronary angiogram. PMID:18796451

Delcour, Kimberly S; Khaja, Azamuddin; Chockalingam, Anand; Kuppuswamy, Saravanan; Dresser, Thomas



Registration of electronic portal images for patient set-up verification  

NASA Astrophysics Data System (ADS)

Images acquired from an electronic portal imaging device are aligned with digitally reconstructed radiographs (DRRs) or other portal images to verify patient positioning during radiation therapy. Most of the currently available computer aided registration methods are based on the manual placement of corresponding landmarks. The purpose of the paper is twofold: (a) the establishment of a methodology for patient set-up verification during radiotherapy based on the registration of electronic portal images, and (b) the evaluation of the proposed methodology in a clinical environment. The estimation of set-up errors, using the proposed methodology, can be accomplished by matching the portal image of the current fraction of the treatment with the portal image of the baseline treatment (reference portal image) using a nearly automated technique. The proposed registration method is tested on a number of phantom data as well as on data from four patients. The phantom data included portal images that corresponded to various positions of the phantom on the treatment couch. For each patient, a set of 30 portal images was used. For the phantom data (for both transverse and lateral portal images), the maximum absolute deviations of the translational shifts were within 1.5 mm, whereas the in-plane rotation angle error was less than 0.5°. The two-way Anova revealed no statistical significant variability both within observer and between-observer measurements (P > 0.05). For the patient data, the mean values obtained with manual and the proposed registration methods were within 0.5 mm. In conclusion, the proposed registration method has been incorporated within a system, called ESTERR-PRO. Its image registration capability achieves high accuracy and both intra- and inter-user reproducibility. The system is fully operational within the Radiotherapy Department of 'HYGEIA' Hospital in Athens and it could be easily installed in any other clinical environment since it requires standardized hardware specifications and minimal human intervention.

Matsopoulos, George K.; Asvestas, Pantelis A.; Delibasis, Konstantinos K.; Kouloulias, Vassilios; Uzunoglu, Nikolaos; Karaiskos, Pantelis; Sandilos, Panagiotis



Expanding maps, shrinking targets and hitting times  

NASA Astrophysics Data System (ADS)

We study the (metric) Diophantine approximation properties of uniformly expanding transformations and some non-uniformly expanding transformations, i.e. transformations T(x) with an associated countable (not necessarily finite) partition and a return time function R(x) (constant on the blocks of the partition) so that \\widehat{T}(x)=T^{R(x)}(x) is uniformly expanding, and we obtain Borel-Cantelli results on hitting times of shrinking targets. Our arguments do not require the so-called big image property for \\widehat{T} and our results contain most of the diversity of examples of slowly mixing systems. We also obtain, with related techniques, results for one-sided topological Markov chains over a countable alphabet with a Gibbs measure.

Fernández, J. L.; Melián, M. V.; Pestana, D.



Study of Relationships between the Laryngectomee's Body Image and Patient Education Outcomes.  

National Technical Information Service (NTIS)

A methodology is discussed for determining the relationships between a laryngectomy patient's body image, knowledge of the treatment process, and adherence to a post-operation self-care regimen. Information is presented on nurse education in this area pri...

I. K. Blues



Virtual center for renal support: technological approach to patient physiological image  

Microsoft Academic Search

The patient physiological image (PPI) is a novel concept which manages the knowledge of the virtual center for renal support (VCRS), currently being developed by the Biomedical Engineering Group of the University of Seville. PPI is a virtual \\

Manuel Prado; Laura Roa; Javier Reina-Tosina; Alfonso Palma; José Antonio Milán



Imaging Findings of a Patient with Incomplete Phenotypical Expression of the PHACES Syndrome  

PubMed Central

Summary We present imaging findings of a patient with an incomplete form of the PHACES syndrome with dolichosegmental intracranial arteries as the predominant component, and discuss the etiopathological and clinical significance of this finding.

Sarikaya, B.; Altugan, F.S.; Firat, M.; Lasjaunias, P.L.



Imaging Acute Ischemic Stroke Patients' Brains Did Not Lead to Improved Outcomes  


... m. EST Imaging acute ischemic stroke patients’ brains did not lead to improved outcomes NIH-funded study ... IMS III), which was halted early because it did not find the procedure to be of significant ...


Investment in body image among patients diagnosed with or at risk for malignant melanoma  

Microsoft Academic Search

We examined investment in body image among 48 patients diagnosed with, or at risk for malignant melanoma (MM), as well as factors hypothesized as related to increased investment, such as gender, perceived stress, mood, fatigue, and personality characteristics. Investment in body image was evaluated using the Measure of Body Apperception [Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V.,

Wendy G. Lichtenthal; Dean G. Cruess; Vicki L. Clark; Michael E. Ming



Patient preparation for diagnostic nuclear medicine imaging procedures: an analysis of ward nurse knowledge  

Microsoft Academic Search

Purpose This study examined ward nurse understanding of diagnostic nuclear medicine imaging procedures in order to assess whether they were adequately informed to prepare their patients for nuclear medicine imaging examinations.Method A questionnaire was used to establish ward nurse knowledge and understanding of nuclear medicine. The questionnaire had two sections: nurse characteristics and nurse knowledge of information sources about nuclear

R. Higgins; P. Hogg



Multiplane transesophageal echocardiography: a basic oblique plane patient imaging sequence.  

PubMed Central

We have previously reported a standardized 10-step sequence of monoplane (transverse plane) transesophageal two-dimensional echocardiographic views and a standardized 7-step vertical plane examination, both suitable for expeditious intraoperative use by the beginning practitioner. A multiplane transesophageal examination involves transverse plane views, vertical plane views and the remaining "in-between" oblique plane views. This report describes a sequence of specific oblique views to be used as a framework for the completion of a multiplane transesophageal examination. Each of these steps is illustrated with a two-dimensional echocardiographic image, a matching diagram and a schematic representation of the corresponding axis of interrogation. This description of oblique plane imaging, therefore, completes the components of a multiplane transesophageal examination. Images Figure 2 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16

Griffin, M.; Rafferty, T.



Body Image and Quality of Life in Post Massive Weight Loss Body Contouring Patients  

Microsoft Academic Search

Objective: Because post-bariatric surgery patients undergo massive weight loss, the resulting skin excess can lead to both functional problems and profound dissatisfaction with appearance. Correcting skin excess could improve all these corollaries, including body image. Presently, few data are available documenting body image and weight-related quality of life in this population.Research Methods and Procedures: Eighteen patients who underwent both bariatric

Angela Y. Song; J. Peter Rubin; Veena Thomas; Jason R. Dudas; Kacey G. Marra; Madelyn H. Fernstrom



Volumetric Evaluation of the Thalamus in Schizophrenic Male Patients Using Magnetic Resonance Imaging  

Microsoft Academic Search

Background: The thalamus, an important subcortical brain region connecting limbic and prefrontal cortices, has a significant role in sensory and cortical processing. Although inconsistently, previous studies have demonstrated neuroanatomical abnormalities in the thalamus of schizophrenic patients.Methods: This structural magnetic resonance imaging study, based on segmentation of contiguous coronal 1.5-mm images, compared thalamic brain volumes of 15 chronic, male schizophrenic patients

Chiara M. Portas; Jill M. Goldstein; Martha E. Shenton; Hiroto H. Hokama; Cynthia G. Wible; Iris Fischer; Ron Kikinis; Robert Donnino; Ferenc A. Jolesz; Robert W. McCarley



Brain Stem Magnetic Resonance Imaging and Evoked Potential Studies of Symptomatic Multiple Sclerosis Patients  

Microsoft Academic Search

In this study we evaluated the sensitivity of neuroradiological and neurophysi-ological tests for detecting brain stem (BS) lesions in multiple sclerosis patients, since the recent introduction of the gradient motion rephasing technique has markedly increased the image quality of magnetic resonance imaging (MRI). From 50 MS patients (33 women and 17 men; mean age 35.9 ± 8.3 years; mean duration

G. Comi; M. Filippi; V. Martinelli; G. Scotti; T. Locatelli; S. Medaglini; F. Triulzi; M. Rovaris; N. Canal



Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging  

Microsoft Academic Search

The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients\\u000a with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal\\u000a T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal

Fumiko Kodama; Toshihide Ogawa; Shuji Sugihara; Masayuki Kamba; Norimasa Kohaya; Shinji Kondo; Toshibumi Kinoshita



Prognostic significance of ischemic electrocardiographic changes during vasodilator stress testing in patients with normal SPECT images  

Microsoft Academic Search

Background. Patients with ischemic electrocardiographic (ECG) findings during exercise stress testing but normal perfusion\\u000a images generally have a low risk of cardiac death or myocardial infarction (>1% per year). During vasodilator stress testing,\\u000a however, the prognostic significance of the combination of normal perfusion images and ischemic ECG changes is unknown.\\u000a \\u000a Methods and Results. Among 5526 patients who underwent vasodilator stress

Elizabeth Klodas; Todd D. Miller; Timothy F. Christian; David O. Hodge; Raymond J. Gibbons



The need for routine delayed radionuclide hepatobiliary imaging in patients with intercurrent disease  

SciTech Connect

A retrospective review was made of all radionuclide hepatobiliary studies performed in a major trauma center over a 27-month period and correlated with the patients' clinical course. In a population of 42 patients (27 of whom were on total parenteral nutrition (TPN)) who had severe intercurrent illness (primarily trauma), and an additional 18 patients who had hepatocellular dysfunction, hepatobiliary imaging confirmed a patent cystic duct in 43 of 60 patients (72%). Fourteen of these 43 patients (33%) had gallbladder visualization at later than one hour after radiotracer administration, and seven of these 14 required imaging from four to 24 hours. Of 17 patients who had nonvisualization of the gallbladder, four had surgically proved acute cholecystitis. Images of nine of the remaining 13 patients with gallbladder nonvisualization were not obtained for 24 hours. The presence of gallstones, wall thickening, or sludge on sonograms did not correlate with cystic duct patency, and was not specific for acute cholecystitis. Though gallbladder function is compromised in the population with severe intercurrent disease, radionuclide hepatobiliary imaging is still valuable; it can confirm a patent cystic duct in at least 72% of patients if routine imaging is continued for up to 24 hours.

Drane, W.E.; Nelp, W.B.; Rudd, T.G.



Extraction of acne lesion in acne patients from multispectral images.  


In acne treatment, it is important to accurately evaluate the severity of Acne. The acne should be classified into several skin lesions including comedo, reddish papule, pustule, and scar. However, in some cases, a visual detection from RGB image maybe difficult for the proper evaluation of acne skin lesions. This paper proposes an extraction method using the spectral information of the various type of acne skin lesions calculated from the multispectral images (MSI) of the lesions. In the experiment, we showed the possibility of classifying acne lesion types by applying a combination of several linear discriminant functions (LDF's). PMID:19163608

Fujii, Hideaki; Yanagisawa, Takashi; Mitsui, Masanori; Murakami, Yuri; Yamaguchi, Masahiro; Ohyama, Nagaaki; Abe, Tokiya; Yokoi, Ikumi; Matsuoka, Yoshie; Kubota, Yasuo



Prognostic value of intravenous dipyridamole thallium imaging in patients with diabetes mellitus considered for renal transplantation  

SciTech Connect

Patients with diabetes and end-stage renal failure are known to have a high risk for cardiac morbidity and mortality associated with renal transplantation. The most efficient method to determine preoperative cardiac risk has not been established. To determine the effectiveness of intravenous dipyridamole thallium imaging in predicting cardiac events, 40 diabetic renal transplant candidates were studied preoperatively in a prospective trial. The study group consisted of 40 patients whose average age was 42 years (range 27 to 64); 34 (85%) were hypertensive and 21 (53%) were cigarette smokers. Cardiac history included chest pain in 6 patients and prior myocardial infarction in 3 patients. Dipyridamole thallium imaging showed reversible defects in 9 patients, fixed defects in 8 patients and normal scans in 23 patients. Dipyridamole thallium imaging was performed using 0.56 mg/kg of dipyridamole infused intravenously over 4 minutes. Cardiac events occurred only in patients with reversible thallium defects, of which there were 6. Of these 6 patients, 3 had cardiac events before transplantation and 3 had them in the early postoperative phase (within 6 weeks of surgery). Of 21 patients who underwent renal transplantation, 3 had cardiac events within 6 weeks of transplantation. The average duration of follow-up was 11 months (range 1 to 21). Thus, dipyridamole thallium imaging is an effective method of identifying renal transplant candidates likely to develop cardiac complications. Routine coronary angiography may not be necessary to screen all renal transplant candidates for coronary artery disease before surgery.

Camp, A.D.; Garvin, P.J.; Hoff, J.; Marsh, J.; Byers, S.L.; Chaitman, B.R. (St. Louis Univ. School of Medicine, MO (USA))



Magnetic resonance imaging in patients with unstable angina: comparison with acute myocardial infarction and normals  

SciTech Connect

The role of magnetic resonance imaging in characterizing normal, ischemic and infarcted segments of myocardium was examined in 8 patients with unstable angina, 11 patients with acute myocardial infarction, and 7 patients with stable angina. Eleven normal volunteers were imaged for comparison. Myocardial segments in short axis magnetic resonance images were classified as normal or abnormal on the basis of perfusion changes observed in thallium-201 images in 22 patients and according to the electrocariographic localization of infarction in 4 patients. T2 relaxation time was measured in 57 myocardial segments with abnormal perfusion (24 with reversible and 33 with irreversible perfusion changes) and in 25 normally perfused segments. T2 measurements in normally perfused segments of patients with acute myocardial infarction, unstable angina and stable angina were within normal range derived from T2 measurements in 48 myocardial segments of 11 normal volunteers (42 +/- 10 ms). T2 in abnormal myocardial segments of patients with stable angina also was not significantly different from normal. T2 of abnormal segments in patients with unstable angina (64 +/- 14 in reversibly ischemic and 67 +/- 21 in the irreversibly ischemic segments) was prolonged when compared to normal (p less than 0.0001) and was not significantly different from T2 in abnormal segments of patients with acute myocardial infarction (62 +/- 18 for reversibly and 66 +/- 11 for irreversibly ischemic segments). The data indicate that T2 prolongation is not specific for acute myocardial infarction and may be observed in abnormally perfused segments of patients with unstable angina.

Ahmad, M.; Johnson, R.F. Jr.; Fawcett, H.D.; Schreiber, M.H.



Investigation of Gamma Knife image registration errors resulting from misalignment between the patient and the imaging axis  

SciTech Connect

The ability of Leksell GammaPlan to perform stereotactic space localizations with image sets where there is misalignment of the patient's head (stereotactic frame and fiducial apparatus) relative to the computed tomography (CT) scanner coordinate system was studied. Misalignment is sometimes necessary for patient comfort. Results equally apply to magnetic resonance imaging. Seven 0.5 mm diameter CT-visible spheres were rigidly mounted to a string tied tightly at each end to diagonally opposite posts attached to a Leksell stereotactic frame. A standard CT fiducial box was applied to the frame in the usual clinical manner. A baseline CT scan (1 mm slice thickness) was obtained with the fiducial box perfectly aligned with the scanner axis. After localization of the image set, the (x,y,z) coordinate of the center of each sphere was recorded. Repeat CT scans with varying fiducial box misalignments with the imaging axis were subsequently obtained. The mean difference between the base line and the respective coordinates in misaligned geometries was approximately 0.2 mm ({sigma}=0.2 mm), well within the accuracy of the image sets and the delivery of radiosurgery with the Gamma Knife.

Cernica, George; Wang Zhou; Malhotra, Harish; Boer, Steven de; Podgorsak, Matthew B. [Department of Physics, State University of New York, Buffalo, New York 14260 (United States) and Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263 (United States); Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, New York 14263 (United States)



The Psychiatric View of Patients of Aesthetic Surgery: Self-Esteem, Body Image, and Eating Attitude  

Microsoft Academic Search

The patient who presents for aesthetic surgery possesses various demands depending on the characteristic properties of the individual. Evaluation of self-esteem, body image and eating habits in patients of aesthetic surgery could help in understanding patients and their demands. We performed Rosenberg Scale Test for evaluation of self-esteem on 98 patients who presented for any kind of aesthetic surgery. Seventy-five

Murat S Sahin Alagoz; Ay?e Devrim Ba?terzi; Ahmet Ça?r? Uysal; Verda Tüzer; Ramazan Erkin Ünlü; Ömer ?ensöz; Erol Göka



Gadolinium-DTPA enhanced magnetic resonance imaging of bone cysts in patients with rheumatoid arthritis.  

PubMed Central

OBJECTIVES--To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. METHODS--The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological abnormality consisted of intraosseous cysts without erosions) were imaged before and after intravenous administration of Gd-DTPA. A 0.6 unit, T1 weighted spin echo and T2* weighted gradient echo were used to obtain images in at least two perpendicular planes. RESULTS--Most cysts showed a low signal intensity on the non-enhanced T1 weighted (spin echo) images and a high signal intensity on the T2* weighted (gradient echo) images, consistent with a fluid content. No cyst showed an enhancement of signal intensity on the T1 weighted images after intravenous administration of Gd-DTPA, whereas synovium hyperplasia at the site of bony erosions did show an increased signal intensity after Gd-DTPA. Magnetic resonance imaging detected more cysts (as small as 2 mm) than plain films, and the cysts were located truly intraosseously. In six patients no other joint abnormalities were identified by magnetic resonance imaging; the three other patients also showed, after Gd-DTPA administration, an enhanced synovium at the site of bony erosions. CONCLUSIONS--It is suggested that intraosseous bone cysts in patients with RA do not contain hyperaemic synovial proliferation. The bone cysts in patients with the cystic form of RA may be the only joint abnormality. Images

Gubler, F M; Algra, P R; Maas, M; Dijkstra, P F; Falke, T H



Optical Molecular Imaging: From Single Cell to Patient  

Microsoft Academic Search

Optical imaging is an emerging field with a wide range of biomedical research and clinical applications, both current and future. It comprises several classes of techniques that are capable of providing information at the molecular, cellular, tissue, and whole-animal levels. These techniques match well with emerging genomic and proteomic technologies that enable development of optical “probes,” as well as with

EH Moriyama; G Zheng; BC Wilson



A potentially expanded role for enoxaparin in preventing venous thromboembolism in high risk blunt trauma patients 1 1 No competing interests declared  

Microsoft Academic Search

BACKGROUND:Venous thromboembolism (VTE) is a frequent and potentially life-threatening complication after trauma. The purpose of this study is to investigate the effectiveness of enoxaparin in preventing deep venous thrombosis (DVT) and pulmonary embolism (PE) after injury in patients who are at high risk for developing VTE.STUDY DESIGN:A prospective single-cohort observational study was initiated for seriously injured blunt trauma patients admitted

Scott H Norwood; Clyde E McAuley; John D Berne; Van L Vallina; D. Brent Kerns; Thomas W Grahm; Jerry W McLarty



DRR and portal image registration for automatic patient positioning in radiotherapy treatment.  


Image processing turns out to be essential in the planning and verification of radiotherapy treatments. Before applying a radiotherapy treatment, a dosimetry planning must be performed. Usually, the planning is done by means of an X-ray volumetric analysis using computerized tomography, where the area to be radiated is marked out. During the treatment phase, it is necessary to place the patient under the particle accelerator exactly as considered in the dosimetry stage. Coarse alignment is achieved using fiduciary markers placed over the patient's skin as external references. Later, fine alignment is provided by comparing a digitally reconstructed radiography (DRR) from the planning stage and a portal image captured by the accelerator in the treatment stage. The preprocessing of DRR and portal images, as well as the minimization of the non-shared information between both kinds of images, is mandatory for the correct operation of the image registration algorithm. With this purpose, mathematical morphology and image processing techniques have been used. The present work describes a fully automatic method to calculate more accurately the necessary displacement of the couch to place the patient exactly at the planned position. The proposed method to achieve the correct positioning of the patient is based on advanced image registration techniques. Preliminary results show a perfect match with the displacement estimated by the physician. PMID:21455811

Bastida-Jumilla, Ma Consuelo; Larrey-Ruiz, Jorge; Verdú-Monedero, Rafael; Morales-Sánchez, Juan; Sancho-Gómez, José-Luis



Using cortical vessels for patient registration during image-guided neurosurgery: a phantom study  

NASA Astrophysics Data System (ADS)

Patient registration, a key step in establishing image guidance, has to be performed in real-time after the patient is anesthetized in the operating room (OR) prior to surgery. We propose to use cortical vessels as landmarks for registering the preoperative images to the operating space. To accomplish this, we have attached a video camera to the optics of the operating microscope and acquired a pair of images by moving the scope. The stereo imaging system is calibrated to obtain both intrinsic and extrinsic camera parameters. During neurosurgery, right after opening of dura, a pair of stereo images is acquired. The 3-D locations of blood vessels are estimated via stereo vision techniques. The same series of vessels are localized in the preoperative image volume. From these 3-D coordinates, the transformation matrix between preoperative images and the operating space is estimated. Using a phantom, we have demonstrated that patient registration from cortical vessels is not only feasible but also more accurate than using conventional scalp-attached fiducials. The Fiducial Registration Error (FRE) has been reduced from 1 mm using implanted fiducials to 0.3 mm using cortical vessels. By replacing implanted fiducials with cortical features, we can automate the registration procedure and reduce invasiveness to the patient.

Sun, Hai; Roberts, David W.; Hartov, Alex; Rick, Kyle R.; Paulsen, Keith D.



Developing image-based electronic patient records for collaborative medical applications  

NASA Astrophysics Data System (ADS)

We developed a Web-based system to interactively display image-based electronic patient records (EPR) for intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). We have successfully used this system two times for the teleconsultation on Severe acute respiratory syndrome (SARS) in Shanghai Xinhua Hospital and Shanghai Infection Hospital. During the consultation, both the physicians in infection control area and the experts outside the control area could interactively study, manipulate and navigate the EPR of the SARS patients to make more precise diagnosis on images with this system assisting. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications.

Zhang, Jianguo; Sun, Jianyong; Yong, Yuanyuan; Chen, Xiaomeng; Yu, Fenghai; Zhang, Xiaoyan; Lian, Ping; Sun, Kun; Huang, H. K.



Muscle Hemangiomatosis Presenting as a Severe Feature in a Patient with the Pten Mutation: Expanding the Phenotype of Vascular Malformations in Bannayan-Riley-Ruvalcaba Syndrome  

PubMed Central

Bannayan-Riley-Ruvalcaba syndrome (BRRS) is a rare autosomal, dominantly-inherited, hamartoma syndrome with distinct phenotypic features. Mutations in the PTEN gene have been identified in PTEN hamartoma tumor syndromes. Our aim was to determine the correlation of phenotype-genotype relationships in a BRRS case. We have evaluated a PTEN mutation in a patient with vascular anomalies and the phenotypic findings of BRRS. We described an 8-year-old girl with the clinical features of BRRS, specifically with vascular anomalies. The mutation in the PTEN gene was identified by DNA sequencing. In our patient, we defined a de novo nonsense R335X (c.1003 C>T) mutation in exon 8, which results in a premature termination codon. Due to vascular anomalies and hemangioma, the patient’s left leg was amputated 1 year after the hemangioma diagnosis. Bannayan - Riley - Ruvalcaba syndrome patients with macrocephaly and vascular anomalies should be considered for PTEN mutation analysis and special medical care.

Soysal, Y; Acun, T; Lourenco, CM; Marques, W; Yak?c?er, MC



Magnetic resonance imaging for radiotherapy planning of brain cancer patients using immobilization and surface coils  

NASA Astrophysics Data System (ADS)

This study investigated the compatibility of a head and neck immobilization device with magnetic resonance imaging (MRI). The immobilization device is used to position a patient in the same way as when receiving a computed tomography (CT) scan for radiotherapy planning and radiation treatment. The advantage of using immobilization in MR is improved accuracy in CT/MR image registration enabling greater confidence in the delineation of structures. The main practical difficulty in using an immobilization device in MRI is that physical constraints make their use incompatible with head imaging coils. Within this paper we describe a method for MR imaging of the brain which allows the use of head and neck immobilization devices. By a series of image quality tests we obtained the same or better image quality as a multi-channel head coil.

Hanvey, S.; Glegg, M.; Foster, J.



Education and Outreach for Breast Imaging and Breast Cancer Patients.  

National Technical Information Service (NTIS)

In October 2003, we completed data collection on 123 subjects for the research project: Evaluating the Effect of Inormed Consent and Procedure Scheduling on Breast biopsy Patient Outcomes. This project evaluated the impact of visual educational aids durin...

D. M. Farria



Measurement of sacroiliac joint stiffness in peripartum pelvic pain patients with Doppler imaging of vibrations (DIV)  

Microsoft Academic Search

Objectives. The research question of the present study was: are sacroiliac joint stiffness levels of peripartum pelvic pain patients different from those of healthy subjects?Study design. A cross-sectional comparative sacroiliac joint stiffness analysis of peripartum pelvic pain patients with healthy subjects. In previous studies we introduced a new technique, Doppler imaging of vibrations (DIV), to assess sacroiliac joint stiffness using

H. Muzaffer Buyruk; Hendrik J. Stam; Christian J. Snijders; Johan S. Laméris; Wim P. J. Holland; Theo H. Stijnen



Body Image of Greek Breast Cancer Patients Treated with Mastectomy or Breast Conserving Surgery  

Microsoft Academic Search

The aim of this study was to assess and compare the body image of breast cancer patients (n = 70) whom underwent breast conserving surgery or mastectomy, as well as to compare patients’ scores with that of a sample of healthy control women (n = 70). A secondary objective of this study was to examine the reliability and validity of the 10-item Greek version

Fotios Anagnostopoulos; Spyridoula Myrgianni



Muscle magnetic resonance imaging in patients with congenital muscular dystrophy and Ullrich phenotype  

Microsoft Academic Search

The aim of this study was to evaluate muscle magnetic resonance imaging findings in patients with congenital muscular dystrophy and Ullrich phenotype. Fifteen children with congenital muscular dystrophy and Ullrich phenotype were included in the study. All patients had collagen VI studies in muscle and, when family structure was informative, linkage studies to the collagen 6 loci. Three of the

E Mercuri; C Cini; A Pichiecchio; J Allsop; S Counsell; Z Zolkipli; S Messina; M Kinali; S. C Brown; C Jimenez; M Brockington; Y Yuva; C. A Sewry; F Muntoni



Does magnetic resonance imaging make a difference for patients with musculoskeletal sarcoma?  

Microsoft Academic Search

MR imaging has had an unparalleled impact on the treatment of patients with musculo- skeletal sarcoma. Basically, the high accuracy of local staging has made the introduction of reconstructive and limb salvage procedures instead of amputation or disarticulation available to the majority of patients with musculoskeletal sarcoma. Pre-operative work-up with MRI is not only more accurate, but also much faster




Patent foramen ovale size and embolic brain imaging findings among patients with ischemic stroke  

Microsoft Academic Search

Background and Purpose—Although the cause of stroke among patients with patent foramen ovale (PFO) may be due to paradoxical cerebral embolism (PCE), this mechanism is often difficult to prove. The aim of our study was to evaluate the association between brain imaging findings suggestive of embolism and PFO among ischemic stroke patients. Methods—As part of the Northern Manhattan Stroke Study,

Michaela M. Steiner; Di Tullio; Tanja Rundek; Robert Gan; Xun Chen; Chiara Liguori; Michael Brainin; Shunichi Homma; Ralph L. Sacco



Magnetic resonance imaging findings of internal derangement and effusion in patients with unilateral temporomandibular joint pain  

Microsoft Academic Search

Objectives: The purpose of this study was to investigate the relationship between the presence of temporomandibular joint (TMJ) pain and the magnetic resonance (MR) imaging findings of internal derangement (ID) and effusion. Study Design: The study was comprised of 41 consecutive patients with TMJ pain. Criteria for including a patient were report of unilateral pain near the TMJ, with the

Ansgar Rudisch; Katharina Innerhofer; Stefan Bertram; Rüdiger Emshoff



The reproductive outcome of female patients with myotonic dystrophy type 1 (DM1) undergoing PGD is not affected by the size of the expanded CTG repeat tract  

Microsoft Academic Search

Purpose  This study aims to analyze the relationship between trinucleotide repeat length and reproductive outcome in a large cohort\\u000a of DM1 patients undergoing ICSI and PGD.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Prospective cohort study. The effect of trinucleotide repeat length on reproductive outcome per patient was analyzed using\\u000a bivariate analysis (T-test) and multivariate analysis using Kaplan-Meier and Cox regression analysis.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Between 1995 and 2005, 205 cycles

Willem Verpoest; Sara Seneca; Marjan De Rademaeker; Karen Sermon; Martine De Rycke; Michel De Vos; Patrick Haentjens; Paul Devroey; Ingeborg Liebaers



Vessel architectural imaging identifies cancer patient responders to anti-angiogenic therapy.  


Measurement of vessel caliber by magnetic resonance imaging (MRI) is a valuable technique for in vivo monitoring of hemodynamic status and vascular development, especially in the brain. Here, we introduce a new paradigm in MRI termed vessel architectural imaging (VAI) that exploits an overlooked temporal shift in the magnetic resonance signal, forming the basis for vessel caliber estimation, and show how this phenomenon can reveal new information on vessel type and function not assessed by any other noninvasive imaging technique. We also show how this biomarker can provide new biological insights into the treatment of patients with cancer. As an example, we demonstrate using VAI that anti-angiogenic therapy can improve microcirculation and oxygen saturation and reduce vessel calibers in patients with recurrent glioblastomas and, more crucially, that patients with these responses have prolonged survival. Thus, VAI has the potential to identify patients who would benefit from therapies. PMID:23955713

Emblem, Kyrre E; Mouridsen, Kim; Bjornerud, Atle; Farrar, Christian T; Jennings, Dominique; Borra, Ronald J H; Wen, Patrick Y; Ivy, Percy; Batchelor, Tracy T; Rosen, Bruce R; Jain, Rakesh K; Sorensen, A Gregory



Repair of large abdominal wall defects with expanded polytetrafluoroethylene (PTFE).  

PubMed Central

Most abdominal wall incisional hernias can be repaired by primary closure. However, where the defect is large or there is tension on the closure, the use of a prosthetic material is indicated. Expanded polytetrafluoroethylene (PTFE) patches were used to repair incisional hernias in 28 patients between November 1983 and December 1986. Twelve of these patients (43%) had a prior failure of a primary repair. Reherniation occurred in three patients (10.7%). Wound infections developed in two patients (7.1%), both of whom had existing intestinal stomas, one with an intercurrent pelvic abscess. The prosthetic patch was removed in the patient with the abscess, but the infection was resolved in the other without sequelae. Septic complications did not occur after any operations performed in uncontaminated fields. None of the patients exhibited any undue discomfort, wound pain, erythema, or induration. Complications related to adhesions, erosion of the patch material into the viscera, bowel obstruction, or fistula formation did not occur. Based on this clinical experience, the authors believe that the PTFE patch appears to represent an advance in synthetic abdominal wall substitutes. Images Fig. 1. Fig. 2(left)., Fig. 3(right).

Bauer, J J; Salky, B A; Gelernt, I M; Kreel, I



Muscle hemangiomatosis presenting as a severe feature in a patient with the pten mutation: expanding the phenotype of vascular malformations in bannayan-riley-ruvalcaba syndrome.  


Bannayan-Riley-Ruvalcaba syndrome (BRRS) is a rare autosomal, dominantly-inherited, hamartoma syndrome with distinct phenotypic features. Mutations in the PTEN gene have been identified in PTEN hamartoma tumor syndromes. Our aim was to determine the correlation of phenotype-genotype relationships in a BRRS case. We have evaluated a PTEN mutation in a patient with vascular anomalies and the phenotypic findings of BRRS. We described an 8-year-old girl with the clinical features of BRRS, specifically with vascular anomalies. The mutation in the PTEN gene was identified by DNA sequencing. In our patient, we defined a de novo nonsense R335X (c.1003 C>T) mutation in exon 8, which results in a premature termination codon. Due to vascular anomalies and hemangioma, the patient's left leg was amputated 1 year after the hemangioma diagnosis. Bannayan - Riley - Ruvalcaba syndrome patients with macrocephaly and vascular anomalies should be considered for PTEN mutation analysis and special medical care. PMID:24052722

Soysal, Y; Acun, T; Lourenço, Cm; Marques, W; Yak?c?er, Mc



Longitudinal evaluation of patients with oral potentially malignant disorders using optical imaging and spectroscopy  

NASA Astrophysics Data System (ADS)

Dysplastic and cancerous alterations in oral tissue can be detected noninvasively in vivo using optical techniques including autofluorescence imaging, high-resolution imaging, and spectroscopy. Interim results are presented from a longitudinal study in which optical imaging and spectroscopy were used to evaluate the progression of lesions over time in patients at high risk for development of oral cancer. Over 100 patients with oral potentially malignant disorders have been enrolled in the study to date. Areas of concern in the oral cavity are measured using widefield autofluorescence imaging and depth-sensitive optical spectroscopy during successive clinical visits. Autofluorescence intensity patterns and autofluorescence spectra are tracked over time and correlated with clinical observations. Patients whose lesions progress and who undergo surgery are also measured in the operating room immediately prior to surgery using autofluorescence imaging and spectroscopy, with the addition of intraoperative high-resolution imaging to characterize nuclear size, nuclear crowding, and tissue architecture at selected sites. Optical measurements are compared to histopathology results from biopsies and surgical specimens collected from the measured sites. Autofluorescence imaging and spectroscopy measurements are continued during post-surgery followup visits. We examined correlations between clinical impression and optical classification over time with an average followup period of 4 months. The data collected to date suggest that multimodal optical techniques may aid in noninvasive monitoring of the progression of oral premalignant lesions, biopsy site selection, and accurate delineation of lesion extent during surgery.

Schwarz, Richard A.; Pierce, Mark C.; Mondrik, Sharon; Gao, Wen; Quinn, Mary K.; Bhattar, Vijayashree; Williams, Michelle D.; Vigneswaran, Nadarajah; Gillenwater, Ann M.; Richards-Kortum, Rebecca



Recent advances in MRI technology: Implications for image quality and patient safety  

PubMed Central

Recent advances in MRI technology are presented, with emphasis on how this new technology impacts clinical operations (better image quality, faster exam times, and improved throughput). In addition, implications for patient safety are discussed with emphasis on the risk of patient injury due to either high local specific absorption rate (SAR) or large cumulative energy doses delivered during long exam times. Patient comfort issues are examined as well.

Sobol, Wlad T.



FDG-PET for Evaluation of Recurrent Lymph Node Metastases in Patients with Surgically Resected Breast Cancer: Adding Spot Images to Whole Body Images  

Microsoft Academic Search

Background  To evaluate the role of18F-Fluorodeoxyglucose positron emission tomography (FDG-PET), spot images were added to whole-body FDG-PET images in a patient\\u000a with suspected lymph node recurrence of breast cancer.\\u000a \\u000a \\u000a \\u000a Methods  FDG-PET spot images were obtained of 44 patients who had undergone surgical resection of breast cancer as were whole-body\\u000a FDG-PET images. A total of 33 lesions in 19 patients (mean age, 59

Tsuneo Tamaki; Akihiro Naito; Masami Nisbio; Katsuhiko Kawahara



Molecular imaging in cancer.  


Medical imaging technologies have undergone explosive growth over the past few decades and now play a central role in clinical oncology. But the truly transformative power of imaging in the clinical management of cancer patients lies ahead. Today, imaging is at a crossroads, with molecularly targeted imaging agents expected to broadly expand the capabilities of conventional anatomical imaging methods. Molecular imaging will allow clinicians to not only see where a tumor is located in the body, but also to visualize the expression and activity of specific molecules (e.g., proteases and protein kinases) and biological processes (e.g., apoptosis, angiogenesis, and metastasis) that influence tumor behavior and/or response to therapy. This information is expected to have a major impact on cancer detection, individualized treatment, and drug development, as well as our understanding of how cancer arises. PMID:16728630

Weissleder, Ralph



Molecular Imaging in Cancer  

NASA Astrophysics Data System (ADS)

Medical imaging technologies have undergone explosive growth over the past few decades and now play a central role in clinical oncology. But the truly transformative power of imaging in the clinical management of cancer patients lies ahead. Today, imaging is at a crossroads, with molecularly targeted imaging agents expected to broadly expand the capabilities of conventional anatomical imaging methods. Molecular imaging will allow clinicians to not only see where a tumor is located in the body, but also to visualize the expression and activity of specific molecules (e.g., proteases and protein kinases) and biological processes (e.g., apoptosis, angiogenesis, and metastasis) that influence tumor behavior and/or response to therapy. This information is expected to have a major impact on cancer detection, individualized treatment, and drug development, as well as our understanding of how cancer arises.

Weissleder, Ralph



Seeing, mirroring, desiring: the impact of the analyst's pregnant body on the patient's body image.  


The paper explores the impact of the analyst's pregnant body on the course of two analyses, a young man, and a young woman, specifically focusing on how each patient's visual perception and affective experience of being with the analyst's pregnant body affected their own body image and subjective experience of their body. The pre-verbal or 'subsymbolic' material evoked in the analyses contributed to a greater understanding of the patients' developmental experiences in infancy and adolescence, which had resulted in both carrying a profoundly distorted body image into adulthood. The analyst's pregnancy offered a therapeutic window in which a shift in the patient's body image could be initiated. Clinical material is presented in detail with reference to the psychoanalytic literature on the pregnant analyst, and that of the development of the body image, particularly focusing on the role of visual communication and the face. The author proposes a theory of psychic change, drawing on Bucci's multiple code theory, in which the patients' unconscious or 'subsymbolic' awareness of her pregnancy, which were manifest in their bodily responses, feeling states and dreams, as well as in the analyst s countertransference, could gradually be verbalized and understood within the transference. Thus visual perception, or 'external seeing', could gradually become 'internal seeing', or insight into unconscious phantasies, leading to a shift in the patients internal object world towards a less persecutory state and more realistic appraisal of their body image. PMID:23924329

Yakeley, Jessica



Functional Brain Imaging Alterations in Acne Patients Treated With Isotretinoin  

Microsoft Academic Search

Objective: Although there have been case reports suggesting a relationship be- tween treatment with the acne medica- tion isotretinoin and the development of depression and suicide, this topic remains controversial. In order for isotretinoin to cause depression, it must have an effect on the brain; however, the effects of isotretinoin on brain functioning in acne patients have not been established.

J. Douglas Bremner; Negar Fani; M. S. Ali Ashraf; John R. Votaw; Marijn E. Brummer; D. Thomas Cummins; Viola Vaccarino; Mark M. Goodman; D. Lai Reed; Sajid Siddiq; Charles B. Nemeroff



Soviet gas processing expands  

SciTech Connect

The Soviet gas processing industry expanded with the recent completion of two new gas processing plants, the Krasnoleninskiy and Noyabr'sk plants, both located in West Siberia. Both process associated gas from nearby oil fields to remove valuable liquid hydrocarbons before putting the dry gas into pipelines; previously the gas was flared or vented. These plants represent part of a major program, ongoing since the 1970s, to increase the level of utilization of the tremendous amount of valuable associated gas now being produced in West Siberia. Another major effort to develop gas processing is under way in western Kazakhstan at the Tengiz and Zhanazhol' fields. At Zhanazhol', a small gas recovery plant went into operation in late 1984 in conjunction with a separation plant with a processing capacity of 1 million tons of oil per year. A much larger enterprise to refine oil and process associated gas is under construction at the Tengiz field. This enterprise is different from the major petrochemical operation planned to use feedstocks from Tengiz; the petrochemical operation will be constructed at Kulsary, 120 kilometers from Tengiz, and produce polyethylene, polypropylene, and other plastics.

Sagers, M.J.



Magnetic resonance imaging and image analysis of post - radiation changes of bone marrow in patients with skeletal metastases.  


Purpose: To evaluate the post-radiation lesions of the bone marrow with magnetic resonance imaging (MRI) and image analysis in patients with bone metastases undergoing radiation therapy (RT). Methods: Thirty-five patients with bone metastases were studied from June 2008 to December 2010. All patients had osseous metastases from various primary malignancies and underwent palliative RT. MRI was performed in a Philips Gyroscan Intera 1T scanner at the beginning of RT and 12-18 days later. T1-TSE, T2-TSE and short tau inversion recovery (STIR) sequences were used. All images obtained were evaluated for early post-radiation lesions. Additionally, 1st and 2nd order textural features were extracted from these images and were introduced into a probabilistic neural network (PNN) classifier in order to create an automated classification system for those lesions. Results: Changes of signal intensity in T1-TSE, T2-TSE and STIR sequences were evaluated for the presence of edema, fatty conversion of the bone marrow or areas of hemorrhage within the limits of the irradiated area. The automated classification system showed positive results in correctly discriminating the post-radiation lesions that MRI revealed. The overall classification accuracy for discriminating between pre-radiation and post-radiation lesions was 93.2%. Furthermore, the overall classification accuracy for discriminating between post-radiation lesions was 86.67%. Conclusion: It seems that MRI can evaluate the degree of early therapy-induced bone marrow lesions observed during the first 18 days from the beginning of RT. The proposed neural network-based classification system might be used as an assisting tool for the characterization of these lesions. PMID:24065500

Romanos, O; Solomou, E; Georgiadis, P; Kardamakis, D; Siablis, D


Development of Fast and Highly Efficient Gas Ionization Chamber For Patient Imaging and Dosimetry in Radiation Therapy  

SciTech Connect

In radiation therapy of cancer, more accurate delivery techniques spur the need for improved patient imaging during treatment. To this purpose, the megavoltage radiation protocol that is used for treatment is also used for imaging.

R. Hinderler; H. Keller; T.R. Mackie; M.L. Corradini



Visual search performance of patients with vision impairment: Effect of JPEG image enhancement  

PubMed Central

Purpose To measure natural image search performance in patients with central vision impairment. To evaluate the performance effect for a JPEG based image enhancement technique using the visual search task. Method 150 JPEG images were presented on a touch screen monitor in either an enhanced or original version to 19 patients (visual acuity 0.4 to 1.2 logMAR, 6/15 to 6/90, 20/50 to 20/300) and 7 normally sighted controls (visual acuity ?0.12 to 0.1 logMAR, 6/4.5 to 6/7.5, 20/15 to 20/25). Each image fell into one of three categories: faces, indoors, and collections. The enhancement was realized by moderately boosting a mid-range spatial frequency band in the discrete cosine transform (DCT) coefficients of the image luminance component. Participants pointed to an object in a picture that matched a given target displayed at the upper-left corner of the monitor. Search performance was quantified by the percentage of correct responses, the median search time of correct responses, and an “integrated performance” measure – the area under the curve of cumulative correct response rate over search time. Results Patients were able to perform the search tasks but their performance was substantially worse than the controls. Search performances for the 3 image categories were significantly different (p?0.001) for all the participants, with searching for faces being the most difficult. When search time and correct response were analyzed separately, the effect of enhancement led to increase in one measure but decrease in another for many patients. Using the integrated performance, it was found that search performance declined with decrease in acuity (p=0.005). An improvement with enhancement was found mainly for the patients whose acuity ranged from 0.4 to 0.8 logMAR (6/15 to 6/38, 20/50 to 20/125). Enhancement conferred a small but significant improvement in integrated performance for indoor and collection images (p=0.025) in the patients. Conclusion Search performance for natural images can be measured in patients with impaired vision to evaluate the effect of image enhancement. Patients with moderate vision loss might benefit from the moderate level of enhancement used here.

Luo, Gang; Satgunam, PremNandhini; Peli, Eli



N-isopropyl-p-(I-123)iodoamphetamine lung imaging in a patient with chronic pulmonary thromboembolism  

SciTech Connect

A patient with a brain infarct was found to have chronic pulmonary embolism associated with perfusion defects on blood flow imaging with N-isopropyl-p-(I-123)iodoamphetamine (I-123 IMP). However, gradually increasing uptake of I-123 IMP was seen in later images, in areas distal to the embolus. The increased uptake to the embolized lung seemed to be through the systemic collateral circulation.

Kosuda, S.; Kawahara, S.; Tamura, K.; Ishikawa, N.; Ono, A.; Kubo, A.; Hashimoto, S. (Okura National Hospital, Tokyo (Japan))



Myocardial perfusion imaging to evaluate the efficacy of medical therapy in patients with coronary artery disease  

Microsoft Academic Search

Myocardial perfusion imaging is commonly used to risk-stratify patients based on the presence and extent of stress-induced\\u000a myocardial ischemia. Recent studies have shown that both positron and single photon emission tomography techniques can be\\u000a used to assess the effectiveness of coronary revascularization procedures as well as various anti-ischemic medical therapies\\u000a on myocardial perfusion. In this regard, perfusion imaging may be

John J. Mahmarian



Limbic changes identified by imaging in bipolar patients  

Microsoft Academic Search

The hippocampus and amygdala are key limbic regions for memory formation and emotion modulation that are potentially involved\\u000a in the cognitive and affective symptoms of bipolar disorder. Here we discuss the most consistent MRI literature in bipolar\\u000a disorder, focusing on the role of the hippocampus and amygdala. In child and adolescent patients, a unique pattern of abnormalities\\u000a has begun to

Paolo Brambilla; John P. Hatch; Jair C. Soares



Comprehensive Non-contrast CT Imaging of the Vulnerable Patient  

Microsoft Academic Search

\\u000a Atherosclerotic cardiovascular disease is the leading cause of death in developed countries. Every year, one million people\\u000a in the US experience a heart attack or sudden cardiac death. A large percentage of these patients have no prior symptoms of\\u000a any kind but suffer from silent heart disease, which may cause a heart attack at any time. Currently, there is no

Damini Dey; Ioannis A. Kakadiaris; Matthew J. Budoff; Morteza Naghavi; Daniel S. Berman


The role of public relations for image creating in health services: a sample patient satisfaction survey.  


This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment. PMID:19042527

Kirdar, YalçIn



Low brain iron content in idiopathic restless legs syndrome patients detected by phase imaging.  


BACKGROUND: The objective of this study was to use phase imaging to evaluate brain iron content in patients with idiopathic restless legs syndrome (RLS). METHODS: Fifteen RLS patients and 15 healthy controls were studied using gradient-echo imaging. Phase analysis was performed on localized brain regions of interest selected on phase maps, sensitive to paramagnetic tissue. Differences between the 2 subject groups were evaluated using ANCOVA including age as a covariate. RESULTS: Significantly higher phase values were present in the RLS patients compared with healthy controls at the level of the substantia nigra, thalamus, putamen, and pallidum, indicating reduced iron content in several regions of the brain of the patients. CONCLUSIONS: We have used MRI phase analysis to study brain iron content in idiopathic RLS in vivo for the first time. Our results support the hypothesis of reduced brain iron content in RLS patients, which may have an important role in the pathophysiology of the disorder. © 2013 Movement Disorder Society. PMID:23780623

Rizzo, Giovanni; Manners, David; Testa, Claudia; Tonon, Caterina; Vetrugno, Roberto; Marconi, Sara; Plazzi, Giuseppe; Pizza, Fabio; Provini, Federica; Malucelli, Emil; Gramegna, Laura Ludovica; Lodi, Raffaele



Patterns of disease activity in multiple sclerosis: clinical and magnetic resonance imaging study  

Microsoft Academic Search

OBJECTIVE--To compare the abnormalities shown by magnetic resonance imaging of the brain in three clinically distinct groups of patients with multiple sclerosis, and to correlate the extent of abnormality with the degree of clinical disability in the three groups. DESIGN--All patients underwent magnetic resonance imaging and full neurological examination, and their disability was scored according to the expanded Kurtzke disability

A J Thompson; A G Kermode; D G MacManus; B E Kendall; D P Kingsley; I F Moseley; W I McDonald



[Expanded, radical perineal prostatectomy].  


One hundred and twenty-five consecutive patients with prostate cancer underwent an extended, radical perineal prostatectomy according to the technique described by VE Weldon. This technique was modified by an initial complete mobilization of the posterior aspect of the prostate and seminal vesicles from the rectum and pelvic wall, incision of the endopelvic fascia, and partial resection of the dorsal vein complex after suture ligature. The perioperative morbidity was low. An operative revision was necessary in four (3.2%) patients because of arterial bleeding from a drainage channel (n = 1), wound infection (n = 2), and rectocutaneous fistula (n = 1). The in-dwelling catheter was removed on day 4-8 in 104 (83%) patients. Positive surgical margins were diagnosed in 22 (17.6%) patients only. These patients had pT3 (n = 17) and pT4 (n = 5) tumors with a Gleason score > or = 7 (n = 17) mostly; extensive, multifocal capsular penetration (n = 18); seminal vesicle invasion (n = 11); and lymph node metastases (n = 4). The unifocal positive margins were localized at the apex (n = 3), dorsolateral (n = 6) aspect, and bladder neck (n = 4). In nine patients, multifocal positive surgical margins were noted. The risk for a positive surgical margin depends on the serum PSA level, Gleason score, and tumor volume. In case potency preservation is not considered, the extended, radical perineal prostatectomy with the above mentioned modifications should be considered to guarantee a low rate of surgical margins. PMID:11045048

Jakse, G; Manegold, E; Reineke, T; Borchers, H; Brehmer, B; Wolff, J M; Mittermayer, C



Influence of exposure parameters on patient dose and image noise in computed tomography  

NASA Astrophysics Data System (ADS)

This work presents the results of investigation of influence of main exposure parameters on the patient dose and image noise on five clinical computed tomography units. Patient dose was determined by means of the quantity CTDIair free on air measured with pencil shaped ionization chamber. The image noise was estimated as a standard deviation of CT numbers in a 500 mm2 central region of interest in a water-equivalent phantom positioned in the centre of rotation. The alteration of tube voltage and tube current show the potential in patient dose reduction up to 40% but may deteriorate image quality and has to be carefully applied in order to optimize the clinical CT protocols taking into account the specific clinical task. This survey is essential for optimization of routine CT protocols especially for CT units without automatic exposure control systems, which are main part of CT units in Bulgaria.

Stoyanov, Desislav; Vassileva, Jenia



Contrast-Enhanced MR Imaging of Lymph Nodes in Cancer Patients  

PubMed Central

The accurate identification and characterization of lymph nodes by modern imaging modalities has important therapeutic and prognostic significance for patients with newly diagnosed cancers. The presence of nodal metastases limits the therapeutic options, and it generally indicates a worse prognosis for the patients with nodal metastases. Yet anatomic imaging (CT and MR imaging) is of limited value for depicting small metastatic deposits in normal-sized nodes, and nodal size is a poor criterion when there is no extracapsular extension or focal nodal necrosis to rely on for diagnosing nodal metastases. Thus, there is a need for functional methods that can be reliably used to identify small metastases. Contrast-enhanced MR imaging of lymph nodes is a non-invasive method for the analysis of the lymphatic system after the interstitial or intravenous administration of contrast media. Moreover, some lymphotrophic contrast media have been developed and used for detecting lymph node metastases, and this detection is independent of the nodal size. This article will review the basic principles, the imaging protocols, the interpretation and the accuracies of contrast-enhanced MR imaging of lymph nodes in patients with malignancies, and we also focus on the recent issues cited in the literature. In addition, we discuss the results of several pre-clinical studies and animal studies that were conducted in our institution.

Choi, Seung Hong



Lower Levels of Glutathione (GSH) in the Brains of Secondary Progressive Multiple Sclerosis Patients Measured by 1H Magnetic Resonance Chemical Shift Imaging at 3 T  

PubMed Central

Background Disability levels for patients with secondary progressive multiple sclerosis (SPMS) often worsen despite a stable MRI T2 lesion burden. The presence of oxidative stress in the absence of measurable inflammation could help explain this phenomenon. In this study, the assessment of an in vivo marker of oxidative stress, cerebral glutathione (GSH), using magnetic resonance chemical shift imaging (CSI) is described, and GSH levels were compared in patients with SPMS and healthy controls. Objective To assess whether GSH, a key antioxidant in the brain, is lower in the SPMS patients compared to matched controls. Methods Seventeen patients with SPMS (Expanded Disability Status Scale = 4.0–7.0; length of MS diagnosis = 19.4±7 years) and 17 age- and gender-matched healthy controls were studied. GSH levels were measured in the fronto-parietal regions of the brain using a specially designed magnetic resonance spectroscopy technique, CSI of GSH, at 3T. Results The levels of GSH were lower for SPMS patients than for controls, the largest reduction (18.5%) being in the frontal region (p=0.001). Conclusion The lower GSH levels in these patients indicate the presence of oxidative stress in SPMS. This process could be at least partially responsible for ongoing functional decline in SPMS.

Choi, I.-Y.; Lee, S.-P.; Denney, D.R.; Lynch, S.G.



Breast reconstruction with anatomical expanders and implants: our early experience  

Microsoft Academic Search

Dissatisfied with the upper pole fullness produced by the Becker expander\\/mammary prosthesis, we started using ‘anatomically’ shaped expanders and implants, as described by Maxwell, for breast reconstruction. We reviewed the results of our first 24 breast reconstructions in 19 patients, who were deemed suitable for reconstruction with this technique between August 1994 and April 1995 (9 months). The most commonly

D. D. McGeorge; S. Mahdi; A. Tsekouras



Use of tissue expander for tamponade of presacral hemorrhage  

Microsoft Academic Search

A silastic tissue expander has been used to tamponade severe presacral hemorrhage in a patient undergoing abdominoperineal resection for rectal carcinoma. This technique may be applicable in similar cases when tamponade is required for uncontrolled venous hemorrhage. The presence of an expandable pelvic prosthesis may be of use postoperatively in avoiding radiation-associated small bowel injury.

Bard C. Cosman; Gregory A. Lackides; David P. Fisher; Loren B. Eskenazi



Patient dose evaluation by means of DICOM images for a direct radiography system  

Microsoft Academic Search

Purpose  The purpose of this work was to evaluate the statistical distribution of patient dose for different examinations by using\\u000a the data stored in a DICOM image archive of a direct digital radiography system.\\u000a \\u000a \\u000a \\u000a Materials and methods  An automatic procedure to extract dose data and exposure parameters from the image archives was implemented. During a 4.5-month\\u000a period, 8,292 images were collected. Exposure

O. Rampado; E. Garelli; R. Zatteri; U. Escoffier; R. De Lucchi; R. Ropolo



Pancreas imaging by computed tomography after endoscopic retrograde pancreatography. [Dogs; patients  

SciTech Connect

A method using CT after endoscopic retrograde pancreatography (CT-ERP) is described for pancreatic imaging. When using an ERP technique in the canine model comparable to that used in humans, small amounts of contrast material in peripheral pancreatic radicles resulted in enhancement of the pancreas on CT scans. Nine patients were also studied by CT-ERP images. The main pancreatic duct was seen on delayed images. In cases of chronic pancreatitis (n = 2), pancreatic opacification was patchy and heterogeneous. There was no contrast-material enhancement in areas of pancreatic carcimomas (n = 2). CT-ERP showed the true extent of carcinoma better than ERP alone.

Frick, M.P.; O'Leary, J.F.; Salomonowitz, E.; Stoltenberg, E.; Hutton, S.; Gedgaudas, E.



Pseudoprogression following concurrent temozolomide and radiotherapy in a patient with glioblastoma: findings on functional imaging techniques.  


Concurrent temozolomide (TMZ) and radiotherapy became the new standard of care for patients diagnosed with glioblastoma multiforme (GBM). Recently, there has been an increasing awareness of progressive and enhancing lesions on MR images immediately after treatment. These lesions may be a treatment effect, so-called pseudoprogression. We experienced one case pathologically and clinically diagnosed as pseudoprogression. The lesion showed a high apparent diffusion coefficient on diffusion-weighted imaging, low blood volume on perfusion imaging, and low uptake of 18F-fluorodeoxyglucose on positron emission tomography. The lesion was pathologically diagnosed as pseudoprogression after additional surgical resection. PMID:21476455

Shirakawa, Yuko; Yoshiura, Takashi; Hiwatashi, Akio; Yamashita, Koji; Kamano, Hironori; Shioyama, Yoshiyuki; Abe, Kouichiro; Amano, Toshiyuki; Nakamizo, Akira; Yoshimoto, Koji; Honda, Hiroyuki; Torisu, Rina; Suzuki, Satoshi; Honda, Hiroshi



An expandable multiprocessor architecture for video graphics (Preliminary Report)  

Microsoft Academic Search

Presented is the design of a flexible expandable multi-processor system for video graphics and image processing. The design involves a central controller which broadcasts data to a variable number of independently executing processing units, each of which in turn controls a variable number of memory units among which the video (frame buffer) image is distributed. An interleaved addressing organization of

Henry Fuchs; Brian W. Johnson



3D modeling of patient-specific geometries of portal veins using MR images.  


In this note, we present an approach for developing patient-specific 3D models of portal veins to provide geometric boundary conditions for computational fluid dynamics (CFD) simulations of the blood flow inside portal veins. The study is based on MRI liver images of individual patients to which we apply image registration and segmentation techniques and inlet and outlet velocity profiles acquired using PC-MRI in the same imaging session. The portal vein and its connected veins are then extracted and visualized in 3D as surfaces. Image registration is performed to align shifted images between each breath-hold when the MRI images are acquired. The image segmentation method first labels each voxel in the 3D volume of interest by using a Bayesian probability approach, and then isolates the portal veins via active surfaces initialized inside the vessel. The method was tested with two healthy volunteers. In both cases, the main portal vein and its connected veins were successfully modeled and visualized. PMID:17946691

Yang, Yan; George, Stephanie; Martin, Diego R; Tannenbaum, Allen R; Giddens, Don P



3D Modeling of Patient-Specific Geometries of Portal Veins Using MR Images  

PubMed Central

In this note, we present an approach for developing patient-specific 3D models of portal veins to provide geometric boundary conditions for computational fluid dynamics (CFD) simulations of the blood flow inside portal veins. The study is based on MRI liver images of individual patients to which we apply image registration and segmentation techniques and inlet and outlet velocity profiles acquired using PC-MRI in the same imaging session. The portal vein and its connected veins are then extracted and visualized in 3D as surfaces. Image registration is performed to align shifted images between each breath-hold when the MRI images are acquired. The image segmentation method first labels each voxel in the 3D volume of interest by using a Bayesian probability approach, and then isolates the portal veins via active surfaces initialized inside the vessel. The method was tested with two healthy volunteers. In both cases, the main portal vein and its connected veins were successfully modeled and visualized.

Yang, Yan; George, Stephanie; Martin, Diego R.; Tannenbaum, Allen R.; Giddens, Don P.



Th22 Cells as Well as Th17 Cells Expand Differentially in Patients with Early-Stage and Late-Stage Myelodysplastic Syndrome  

PubMed Central

Background Immunological mechanisms are increasingly recognized in the progression of myelodysplastic syndrome (MDS). Early-stage MDS (E-MDS) is characterized by autoimmune-mediated myelosuppression whereas late-stage MDS (L-MDS) involves immune evasion, giving dysplastic cells growth potential to progress into acute myeloid leukemia. T-helper (Th) 22 is involved in the pathogenesis of inflammatory autoimmunity and tumorigenesis. The roles of Th22 cells in the pathophysiology of E-MDS and L-MDS remain unsettled. Design and Methods We studied 37 MDS patients (E-MDS, n?=?17; L-MDS, n?=?20) and 20 healthy controls to characterize their peripheral blood (PB), as well as 25 MDS patients and 10 healthy controls to characterize their bone marrow(BM). The expression of Interleukin-22 (IL-22), IL-17 or interferon gamma (IFN-?) was examined in E-MDS, L-MDS patients and controls by flow cytometry. The mRNA expression levels of RAR-related orphan receptor C (RORC), IL-6, tumor necrosis factor alpha (TNF-?) and IL-23 in peripheral blood mononuclear cells (PBMCs) were determined by real-time quantitative polymerase chain reaction. The levels of IL-22 and IL-17 both in PB and BM plasma were examined by enzyme-linked immunosorbent assay. Results In E-MDS, peripheral Th17 cells were significantly elevated and correlated with peripheral Th22 cells compared with healthy controls and L-MDS. Significantly higher levels of peripheral Th22 expansion, mRNA expression of IL-6, TNF-? and lower level of RORC mRNA expression were observed in L-MDS compared with E-MDS. No statistical difference was found in IL-23 mRNA expression or plasma IL-22, IL-17 levels among E-MDS, L-MDS and controls. Conclusions Our data demonstrated that L-MDS cohort had increased frequencies of peripheral Th22 cells and higher mRNA expression levels of IL-6 and TNF-?, indicating that Th22 cells along with Th17 cells or not are involved in the dynamic immune responses of MDS.

Shao, Lin-lin; Zhang, Lei; Hou, Yu; Yu, Shuang; Liu, Xin-guang; Huang, Xiao-yang; Sun, Yuan-xin; Tian, Tian; He, Na; Ma, Dao-xin; Peng, Jun; Hou, Ming



Potential impact of amyloid imaging on diagnosis and intended management in patients with progressive cognitive decline.  


Florbetapir F18 has been approved by the Food and Drug Administration for in vivo assessment of amyloid pathology in patients undergoing evaluation for Alzheimer disease (AD). The aim of this study was to determine the impact of amyloid imaging on the diagnoses and management of patients undergoing evaluation for cognitive decline. Patients were recruited to participate at 19 clinical sites. The site physician provided a provisional diagnosis, an estimate of their diagnostic confidence, and their plan for diagnostic evaluation and management both before and after receiving the results from amyloid imaging with florbetapir F18. Analyses compared the frequency of AD and non-AD diagnoses, plans for ancillary testing, and intended patient management before and after florbetapir imaging. A total of 229 patients participated in the trial (113 amyloid positive, 116 amyloid negative). After receiving the results of the florbetapir scan, diagnosis changed in 125/229, or 54.6% [95% confidence intervals (CI), 48.1%-60.9%], of cases, and diagnostic confidence increased by an average of 21.6% (95% CI, 18.3%-24.8%). A total of 199/229 or 86.9% (95% CI, 81.9%-90.7%) of cases had at least 1 change in their management plan. Intended cholinesterase inhibitor or memantine treatment increased by 17.7% (95% CI, 11.8%-25.8%) of all cases with positive scans and decreased by 23.3% (95% CI, 16.5%-31.8%) of all those with negative scans. Among subjects who had not yet undergone a completed work up, planned brain structural imaging (computed tomographic/magnetic resonance imaging) decreased by 24.4% (95% CI, 17.5%-32.8%) and planned neuropsychological testing decreased by 32.8% (95% CI, 25.0%-41.6%). In summary, amyloid imaging results altered physician's diagnostic thinking, intended testing, and management of patients undergoing evaluation for cognitive decline. PMID:23203162

Grundman, Michael; Pontecorvo, Michael J; Salloway, Stephen P; Doraiswamy, P Murali; Fleisher, Adam S; Sadowsky, Carl H; Nair, Anil K; Siderowf, Andrew; Lu, Ming; Arora, Anupa K; Agbulos, Abigail; Flitter, Matthew L; Krautkramer, Michael J; Sarsour, Khaled; Skovronsky, Daniel M; Mintun, Mark A


Integration of patient specific modeling and advanced image processing techniques for image-guided neurosurgery  

NASA Astrophysics Data System (ADS)

A major challenge in neurosurgery oncology is to achieve maximal tumor removal while avoiding postoperative neurological deficits. Therefore, estimation of the brain deformation during the image guided tumor resection process is necessary. While anatomic MRI is highly sensitive for intracranial pathology, its specificity is limited. Different pathologies may have a very similar appearance on anatomic MRI. Moreover, since fMRI and diffusion tensor imaging are not currently available during the surgery, non-rigid registration of preoperative MR with intra-operative MR is necessary. This article presents a translational research effort that aims to integrate a number of state-of-the-art technologies for MRI-guided neurosurgery at the Brigham and Women's Hospital (BWH). Our ultimate goal is to routinely provide the neurosurgeons with accurate information about brain deformation during the surgery. The current system is tested during the weekly neurosurgeries in the open magnet at the BWH. The preoperative data is processed, prior to the surgery, while both rigid and non-rigid registration algorithms are run in the vicinity of the operating room. The system is tested on 9 image datasets from 3 neurosurgery cases. A method based on edge detection is used to quantitatively validate the results. 95% Hausdorff distance between points of the edges is used to estimate the accuracy of the registration. Overall, the minimum error is 1.4 mm, the mean error 2.23 mm, and the maximum error 3.1 mm. The mean ratio between brain deformation estimation and rigid alignment is 2.07. It demonstrates that our results can be 2.07 times more precise then the current technology. The major contribution of the presented work is the rigid and non-rigid alignment of the pre-operative fMRI with intra-operative 0.5T MRI achieved during the neurosurgery.

Archip, Neculai; Fedorov, Andriy; Lloyd, Bryn; Chrisochoides, Nikos; Golby, Alexandra; Black, Peter M.; Warfield, Simon K.



Post-traumatic and stress-induced osteolysis of the distal clavicle: MR imaging findings in 17 patients  

Microsoft Academic Search

Objective. To describe the MR imaging findings in patients with osteolysis of the distal clavicle and to compare the MR imaging appearance\\u000a of clavicular osteolysis following acute injury with that related to chronic stress. Design and patients. MR imaging examinations were reviewed in 17 patients (14 men, 3 women; ages 16–55 years) with the diagnosis of post-traumatic\\u000a or stress-induced osteolysis

Rosa de la Puente; Robert D. Boutin; Daphne J. Theodorou; Andrew Hooper; Mark Schweitzer; Donald Resnick



The catatonic dilemma expanded  

PubMed Central

Catatonia is a common syndrome that was first described in the literature by Karl Kahlbaum in 1874. The literature is still developing and remains unclear on many issues, especially classification, diagnosis, and pathophysiology. Clinicians caring for psychiatric patients with catatonic syndromes continue to face many dilemmas in diagnosis and treatment. We discuss many of the common problems encountered in the care of a catatonic patient, and discuss each problem with a review of the literature. Focus is on practical aspects of classification, epidemiology, differential diagnosis, treatment, medical comorbidity, cognition, emotion, prognosis, and areas for future research in catatonic syndromes.

Penland, Heath R; Weder, Natalie; Tampi, Rajesh R



Sexual Functioning and Body Image of Patients Treated for Ovarian Cancer  

Microsoft Academic Search

Aim  The aim of the study was to determine differences in sexual functioning and body image of patients treated for ovarian cancer,\\u000a depending on treatment modality: surgery, surgery in combination with chemotherapy or chemotherapy alone.\\u000a \\u000a \\u000a \\u000a Patients and Methods  A total of 483 patients treated for ovarian cancer between 1995 and 2005 completed the questionnaire 2–6 months after finishing\\u000a the treatment. Patients were divided

Damir Bukovi?; Hrvoje Silovski; Tajana Silovski; Iva Hojsak; Kata Šaki?; Zlatko Hrgovi?



The influence of patient centering on CT dose and image noise.  


Although x-ray intensity shaping filters (bowtie filters) have been used since the introduction of some of the earliest CT scanner models, the clinical implications on dose and noise are not well understood. To achieve the intended dose and noise advantage requires the patient to be centered in the scan field of view. In this study we explore the implications of patient centering in clinical practice. We scanned various size and shape phantoms on a GE LightSpeed VCT scanner using each available source filter with the phantom centers positioned at 0, 3, and 6 cm below the center of rotation (isocenter). Surface doses were measured along with image noise over a large image region. Regression models of surface dose and noise were generated as a function of phantom size and centering error. Methods were also developed to determine the amount of miscentering using a scout scan projection radiograph (SPR). These models were then used to retrospectively evaluate 273 adult body patients for clinical implications. When miscentered by 3 and 6 cm, the surface dose on a 32 cm CTDI phantom increased by 18% and 41% while image noise also increased by 6% and 22%. The retrospective analysis of adult body scout SPR scans shows that 46% of patients were miscentered in elevation by 20-60 mm with a mean position 23 mm below the center of rotation (isocenter). The analysis indicated a surface dose penalty of up to 140% with a mean dose penalty of 33% assuming that tube current is increased to compensate for the increased noise due to miscentering. Clinical image quality and dose efficiency can be improved on scanners with bowtie filters if care is exercised when positioning patients. Automatically providing patient specific centering and scan parameter selection information can help the technologist improve workflow, achieve more consistent image quality and reduce patient dose. PMID:17822016

Toth, Thomas; Ge, Zhanyu; Daly, Michael P



The influence of patient centering on CT dose and image noise  

SciTech Connect

Although x-ray intensity shaping filters (bowtie filters) have been used since the introduction of some of the earliest CT scanner models, the clinical implications on dose and noise are not well understood. To achieve the intended dose and noise advantage requires the patient to be centered in the scan field of view. In this study we explore the implications of patient centering in clinical practice. We scanned various size and shape phantoms on a GE LightSpeed VCT scanner using each available source filter with the phantom centers positioned at 0, 3, and 6 cm below the center of rotation (isocenter). Surface doses were measured along with image noise over a large image region. Regression models of surface dose and noise were generated as a function of phantom size and centering error. Methods were also developed to determine the amount of miscentering using a scout scan projection radiograph (SPR). These models were then used to retrospectively evaluate 273 adult body patients for clinical implications. When miscentered by 3 and 6 cm, the surface dose on a 32 cm CTDI phantom increased by 18% and 41% while image noise also increased by 6% and 22%. The retrospective analysis of adult body scout SPR scans shows that 46% of patients were miscentered in elevation by 20-60 mm with a mean position 23 mm below the center of rotation (isocenter). The analysis indicated a surface dose penalty of up to 140% with a mean dose penalty of 33% assuming that tube current is increased to compensate for the increased noise due to miscentering. Clinical image quality and dose efficiency can be improved on scanners with bowtie filters if care is exercised when positioning patients. Automatically providing patient specific centering and scan parameter selection information can help the technologist improve workflow, achieve more consistent image quality and reduce patient dose.

Toth, Thomas; Ge Zhanyu; Daly, Michael P. [CT Systems Engineering W-1140, G.E. Healthcare, General Electric Company, 3000 N. Grandview Boulevard, Waukesha, Wisconsin 53201-0414 (United States); Electromagnetics Laboratory, Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States)



A computational analysis of mental image generation: evidence from functional dissociations in split-brain patients.  


Recent efforts to build computer simulation models of mental imagery have suggested that imagery is not a unitary phenomenon. Rather, such efforts have led to a modular analysis of the image-generation process, with separate modules that can activate visual memories, inspect parts of imaged patterns, and arrange separate parts into a composite image. This idea was supported by the finding of functional dissociations between the kinds of imagery tasks that could be performed in the left and right cerebral hemispheres of two patients who had previously undergone surgical transection of their corpus callosa. The left hemisphere in both subjects could inspect imaged patterns and could generate single and multipart images. In contrast, although the right hemisphere could inspect imaged patterns and could generate images of overall shape, it had difficulty in generating multipart images. The results suggest a deficit in the module that arranges parts into a composite. The observed pattern of deficits and abilities implied that this module is not used in language, visual perception, or drawing. Furthermore, the results suggest that the basis for this deficit is not a difficulty in simply remembering visual details or engaging in sequential processing. PMID:3161979

Kosslyn, S M; Holtzman, J D; Farah, M J; Gazzaniga, M S



Arrival Time Correction for Dynamic Susceptibility Contrast MR Permeability Imaging in Stroke Patients  

PubMed Central

Purpose To determine if applying an arrival time correction (ATC) to dynamic susceptibility contrast (DSC) based permeability imaging will improve its ability to identify contrast leakage in stroke patients for whom the shape of the measured curve may be very different due to hypoperfusion. Materials and Methods A technique described in brain tumor patients was adapted to incorporate a correction for delayed contrast delivery due to perfusion deficits. This technique was applied to the MRIs of 9 stroke patients known to have blood-brain barrier (BBB) disruption on T1 post contrast imaging. Regions of BBB damage were compared with normal tissue from the contralateral hemisphere. Receiver operating characteristic (ROC) analysis was performed to compare the detection of BBB damage before and after ATC. Results ATC improved the area under the curve (AUC) of the ROC from 0.53 to 0.70. The sensitivity improved from 0.51 to 0.67 and the specificity improved from 0.57 to 0.66. Visual inspection of the ROC curve revealed that the performance of the uncorrected analysis was worse than random guess at some thresholds. Conclusions The ability of DSC permeability imaging to identify contrast enhancing tissue in stroke patients improved considerably when an ATC was applied. Using DSC permeability imaging in stroke patients without an ATC may lead to false identification of BBB disruption.

Leigh, Richard; Jen, Shyian S.; Varma, Daniel D.; Hillis, Argye E.; Barker, Peter B.



Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale  

PubMed Central

Background The acute abdomen is a frequent entity at the Emergency Department (ED), which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US), computed tomography (CT) and even diagnostic laparoscopy. However, no evidence-based guidelines exist in current literature. The actual diagnostic work-up of a patient with acute abdominal pain presenting to the ED varies greatly between hospitals and physicians. The OPTIMA study was designed to provide the evidence base for constructing an optimal diagnostic imaging guideline for patients with acute abdominal pain at the ED. Methods/design Thousand consecutive patients with abdominal pain > 2 hours and < 5 days will be enrolled in this multicentre trial. After clinical history, physical and laboratory examination all patients will undergo a diagnostic imaging protocol, consisting of plain X-ray (upright chest and supine abdomen), US and CT. The reference standard will be a post hoc assignment of the final diagnosis by an expert panel. The focus of the analysis will be on the added value of the imaging modalities over history and clinical examination, relative to the incremental costs. Discussion This study aims to provide the evidence base for the development of a diagnostic algorithm that can act as a guideline for ED physicians to evaluate patients with acute abdominal pain.

Lameris, Wytze; van Randen, Adrienne; Dijkgraaf, Marcel GW; Bossuyt, Patrick MM; Stoker, Jaap; Boermeester, Marja A



Study of novel techniques for verification imaging and patient dose reconstruction in external beam radiation therapy  

NASA Astrophysics Data System (ADS)

Treatment delivery verification is an essential step of radiotherapy. The purpose of this thesis is to develop new methods to improve the verification of photon and electron beam radiotherapy treatments. This is achieved through developing and testing (1) a way to acquire portal images during electron beam treatments, (2) a method to reconstruct the dose delivered to patients during photon beam treatments and (3) a technique to improve image quality in kilovoltage (kV) cone beam computed tomography (CBCT) by correcting for scattered radiation. The portal images were acquired using the Varian CL21EX linac and the Varian aS500 electronic portal imaging device (EPID). The EGSnrc code was used to model fully the CL21EX, the aS500 and the kV CBCT system. We demonstrate that portal images of electron beam treatments with adequate contrast and resolution can be produced using the bremsstrahlung photons portion of the electron beam. Monte Carlo (MC) calculations were used to characterize the bremsstrahlung photons and to obtain predicted images of various phantoms. The technique was applied on a head and neck patient. An algorithm to reconstruct the dose given to patients during photon beam radiotherapy was developed and validated. The algorithm uses portal images and MC simulations. The primary fluence at the detector is back-projected through the patient. CT geometry to obtain a reconstructed phase space file. The reconstructed phase space file is used to calculate the reconstructed dose to the patient using MC simulations. The reconstruction method was validated in homogeneous and heterogeneous phantoms for conventional and IMRT fields. The scattered radiation present in kV CBCT images was evaluated using MC simulations. Simulated predictions of the scatter distribution were subtracted from CBCT projection images prior to the reconstruction to improve the reconstructed image quality. Reducing the scattered radiation was found to improve contrast and reduce shading artifacts. MC simulations, in combination with experimental techniques, have been shown to be valuable tools in the development of treatment verification methods. The three novel methods presented in this thesis contribute to the improvement of radiotherapy treatment verification. They can potentially improve treatment outcome by ensuring a better target coverage.

Jarry, Genevieve


Longitudinal changes in patients with traumatic brain injury assessed with diffusion tensor and volumetric imaging  

PubMed Central

Traumatic brain injury (TBI) is associated with brain volume loss, but there is little information on the regional gray matter (GM) and white matter (WM) changes that contribute to overall loss. Since axonal injury is a common occurrence in TBI, imaging methods that are sensitive to WM damage such as diffusion-tensor imaging (DTI) may be useful for characterizing microstructural brain injury contributing to regional WM loss in TBI. High-resolution T1-weighted imaging and DTI were used to evaluate regional changes in TBI patients compared to matched controls. Patients received neuropsychological testing and were imaged approximately 2 months and 12.7 months post injury. Paradoxically, neuropsychological function improved from Visit 1 to Visit 2, while voxel-based analyses of fractional anisotropy (FA), and mean diffusivity (MD) from the DTI images, and voxel-based analyses of the GM and WM probability maps from the T1-weighted images, mainly revealed significantly greater deleterious GM and WM change over time in patients compared to controls. Cross-sectional comparisons of the DTI measures indicated that patients have decreased FA and increased MD compared to controls over large regions of the brain. TBI affected virtually all of the major fiber bundles in the brain including the corpus callosum, cingulum, the superior and inferior longitudinal fascicules, the uncinate fasciculus, and brain stem fiber tracts. The results indicate that both GM and WM degeneration are significant contributors to brain volume loss in the months following brain injury, and also suggest that DTI measures may be more useful than high-resolution anatomical images in assessment of group differences.

Bendlin, Barbara; Ries, Michele L.; Lazar, Mariana; Alexander, Andrew L.; Dempsey, Robert J.; Rowley, Howard A.; Sherman, Jack E.; Johnson, Sterling C.



Usefulness of spinal magnetic resonance imaging in patients with myelodysplastic syndromes  

PubMed Central

Summary Background: Myelodysplastic syndrome is a rare, chronic hematological disease characterized by heterogeneous clinical presentations. Subtypes of myelodysplastic syndrome are characterized by different survival times and ability to transform into acute myeloid leukemia. Objectives: The objective of the study included the assessment of the relationship between the images obtained by magnetic resonance scans of lumbar spine and the clinical symptoms of the disease in patients diagnosed with myelodysplastic syndrome, as well as the assessment of the correlation of the images with the phase of transformation into acute myeloid leukemia. Material/Methods: The study-related tests were carried out in Specialist Hospital No. 1 in Bytom between 2006 and 2011 and involved 53 patients aged 55÷77, divided into groups according to the diagnosed subtype of myelodysplastic syndrome. The study also included the prognosis of overall survival and time to transformation into AML on the basis of valid classifications. The spinal magnetic resonance scans were obtained from medical documentation. The analysis included images obtained using T1- and T2-weighted sequences in sagittal, transverse and frontal planes in all patients, images obtained using the STIR sequence from 21 patients as well as 40 images obtained after contrast administration. The statistical analysis of the results was carried out using STATISTICA software. Conclusions: The obtained results demonstrated that the magnetic resonance scans revealed statistically significant changes in the images of bone marrow in vertebral body scans; with a decrease in the intensity of MRI signals correlated with the RAEB subtype, particularly with transformation into acute myeloid leukemia as well as with the high IPSS risk score with regard to the time of survival and transformation into acute myeloid leukemia. The research-related test results indicate the importance of magnetic resonance imaging in diagnostics and the assessment of the disease dynamics.

Kwiatkowska-Pamula, Anna; Ziolko, Ewa; Muc-Wierzgon, Malgorzata; Nowakowska-Zajdel, Ewa; Podwinska, Ewa; Adamczyk, Tomasz




SciTech Connect

The role of images of information (charts, diagrams, maps, and symbols) for effective presentation of facts and concepts is expanding dramatically because of advances in computer graphics technology, increasingly hetero-lingual, hetero-cultural world target populations of information providers, the urgent need to convey more efficiently vast amounts of information, the broadening population of (non-expert) computer users, the decrease of available time for reading texts and for decision making, and the general level of literacy. A coalition of visual performance experts, human engineering specialists, computer scientists, and graphic designers/artists is required to resolve human factors aspects of images of information. The need for, nature of, and benefits of interdisciplinary effort are discussed. The results of an interdisciplinary collaboration are demonstrated in a product for visualizing complex information about global energy interdependence. An invited panel will respond to the presentation.

Marcus, A.



Radiation form relativistilly expanding envelopes  

Microsoft Academic Search

Gamma-Ray Bursts are breaks-in of Gamma Ray that are measured by satellites about once a day. The source of GRB is unknown. The goal of this project is to use a simple model of a relativistilly expanding envelope to describe an approximation to GRB spectrum. The Model The model of the problem is an expanding sphere with each point on

Yotam Soreq; M. Gedalin


Energy Efficient Expanding Ring Search  

Microsoft Academic Search

Energy consumption is a major issue in designing protocols for ad hoc wireless networks due to battery constrains. This paper identifies the inefficient elements of expanding ring search protocol and proposes the new blocking expanding ring search approach which demonstrates substantial energy savings without an increase in route discovery latency

Ida Pu



Error exponents of expander codes  

Microsoft Academic Search

We show that expander codes attain the capacity of the binary symmetric channelunder iterative decoding. The error probability has a positive exponent for all ratesbetween 0 and channel capacity. The decoding complexity grows linearly with code length.Index terms: Expander code, Iterative decoding, Ramanujan graph.1

Alexander Barg; Gilles Zémor



Natural Gas Expanders-Compressors  

Microsoft Academic Search

Natural gas expanders-compressors serve a variety of natural gas plants, ranging from primary treatment at the well (installations for comprehensive treatment of natural gas) to liquefaction for separation, storage, and transport. Natural gas expanders-compressors take on particular importance for wells with throttling cold. The growing demand for this equipment has been satisfied by imports until recently. The most popular was

V. M. Kulakov; V. V. Kulakov; A. V. Kulakov



How does the Universe expand?  

Microsoft Academic Search

Quantization of gravity suggests that a finite region of space has a finite\\u000anumber of degrees of freedom or `bits'. What happens to these bits when\\u000aspacetime expands, as in cosmological evolution? Using gravity\\/field theory\\u000aduality we argue that bits `fuse together' when space expands.

Samir D. Mathur



How does the Universe Expand?  

Microsoft Academic Search

Quantization of gravity suggests that a finite region of space has a finite number of degrees of freedom or 'bits'. What happens to these bits when spacetime expands, as in cosmological evolution? Using gravity\\/field theory duality we argue that bits 'fuse together' when space expands.

Samir D. Mathur



Use of the tabbed expander in latissimus dorsi breast reconstruction.  


Latissimus dorsi (LD) myocutaneous flap breast reconstruction with a tissue expander/implant is a post-mastectomy option often used as a salvage procedure for a failed tissue expander (TE). The patient is traditionally placed in the lateral decubitus position for flap dissection and is re-prepped and re-draped in the supine position for placement of the tissue expander. A new generation of anatomically-shaped, tabbed tissue expanders are increasingly being used in place of traditional untabbed expanders. The innovative suture tabs allow for more predictable and controlled expander placement while the patient is in the lateral decubitus position, eliminating the need to reposition the patient intraoperatively. The objective of this study was to evaluate the use of tabbed tissue expanders in latissimus dorsi breast reconstruction, with respect to total operative time, complication rates, and aesthetic outcomes. The outcomes of 34 LD breast reconstruction procedures with tissue expanders were evaluated. Eight patients received tabbed tissue expanders with no position change, while 26 patients underwent an intraoperative position change. Demographic information, total operative time, and follow-up complication data were collected. Aesthetic outcomes were evaluated by three blinded individuals using a validated scoring scale. The mean operative time for procedures with no position change was 107 minutes. The mean operative time for position change cohort was 207 minutes. There was no statistical difference in complication rates or aesthetic outcomes between the two groups. In conclusion, tabbed tissue expanders decrease operative time by eliminating the need for an intraoperative position change without influencing complication rates while maintaining equivalent aesthetic outcomes. PMID:23350739

Gust, Madeleine J; Nguyen, Khang T; Hirsch, Elliot M; Connor, Caitlin M; Davila, Armando; Rawlani, Vinay; Kim, John Y S



Imaging descriptors improve the predictive power of survival models for glioblastoma patients.  


Background Because effective prediction of survival time can be highly beneficial for the treatment of glioblastoma patients, the relationship between survival time and multiple patient characteristics has been investigated. In this paper, we investigate whether the predictive power of a survival model based on clinical patient features improves when MRI features are also included in the model. Methods The subjects in this study were 82 glioblastoma patients for whom clinical features as well as MR imaging exams were made available by The Cancer Genome Atlas (TCGA) and The Cancer Imaging Archive (TCIA). Twenty-six imaging features in the available MR scans were assessed by radiologists from the TCGA Glioma Phenotype Research Group. We used multivariate Cox proportional hazards regression to construct 2 survival models: one that used 3 clinical features (age, gender, and KPS) as the covariates and 1 that used both the imaging features and the clinical features as the covariates. Then, we used 2 measures to compare the predictive performance of these 2 models: area under the receiver operating characteristic curve for the 1-year survival threshold and overall concordance index. To eliminate any positive performance estimation bias, we used leave-one-out cross-validation. Results The performance of the model based on both clinical and imaging features was higher than the performance of the model based on only the clinical features, in terms of both area under the receiver operating characteristic curve (P < .01) and the overall concordance index (P < .01). Conclusions Imaging features assessed using a controlled lexicon have additional predictive value compared with clinical features when predicting survival time in glioblastoma patients. PMID:23396489

Mazurowski, Maciej Andrzej; Desjardins, Annick; Malof, Jordan Milton



Smaragdyrins: emeralds of expanded porphyrin family.  


Porphyrins are tetrapyrrolic 18 ? electron conjugated macrocycles with wide applications that range from materials to medicine. Expanded porphyrins, synthetic analogues of porphyrins that contain more than 18 ? electrons in the conjugated pathway, have an increased number of pyrroles or other heterocyles or multiple meso-carbon bridges. The expanded porphyrins have attracted tremendous attention because of unique features such as anion binding or transport that are not present in porphyrins. Expanded porphyrins exhibit wide applications that include their use in the coordination of large metal ions, as contrasting agents in magnetic resonance imaging (MRI), as sensitizers for photodynamic therapy (PDT) and as materials for nonlinear optical (NLO) studies. Pentaphyrin 1, sapphyrin 2, and smaragdyrin 3 are expanded porphyrins that include five pyrroles or heterocyclic rings. They differ from each other in the number of bridging carbons and direct bonds that connect the five heterocyclic rings. Sapphyrins were the first stable expanded porphyrins reported in the literature and remain one of the most extensively studied macrocycles. The strategies used to synthesize sapphyrins are well established, and these macrocycles are versatile anion binding agents. They possess rich porphyrin-like coordination chemistry and have been used in diverse applications. This Account reviews developments in smaragdyrin chemistry. Although smaragdyrins were discovered at the same time as sapphyrins, the chemistry of smaragdyrins remained underdeveloped because of synthetic difficulties and their comparative instability. Earlier efforts resulted in the isolation of stable ?-substituted smaragdyrins and meso-aryl isosmaragdyrins. Recently, researchers have synthesized stable meso-aryl smaragdyrins by [3 + 2] oxidative coupling reactions. These results have stimulated renewed research interest in the exploration of these compounds for anion and cation binding, energy transfer, fluorescent sensors, and their NLO properties. Recently reported results on smaragdyrin macrocycles have set the stage for further synthetic studies to produce stable meso-aryl smaragdyrins with different inner cores to study their properties and potential for various applications. PMID:22939582

Pareek, Yogita; Ravikanth, M; Chandrashekar, T K



The Role of the Nurse in the Rehabilitation of Patients with Radical Changes in Body Image Due to Burn Injuries  

PubMed Central

Summary Burn injuries are among the most serious causes of radical changes in body image. The subject of body image and self-image is essential in rehabilitation, and the nurse must be aware of the issues related to these concepts and take them seriously into account in drafting out the nursing programme. This paper defines certain key words related to body image and discusses the social context of body image. Burn injuries are considered in relation to the way each of these affects the patient's body image. The aim of nursing is defined and the nurse's role in cases of severe changes in body image due to burn injuries is discussed.

Aacovou, I.



Pressure-enhanced near-infrared breast imaging: toward cancer patient imaging  

NASA Astrophysics Data System (ADS)

An NIRS tomography system that can simultaneously acquire data at three wavelengths has been developed to measure changes in physiological properties with 15 second time resolution. The results of homogenous and heterogeneous blood phantom studies indicated that the R2 values between average estimated total hemoglobin (HbT) values and blood concentrations are 0.99 and 0.9, respectively. In preliminary normal subject clinical trials, a cohort of normal subjects were tested by acquiring the series images as well as the pressure is adding to and releasing from the breast. The recovered data shown that by adding measurable pressure, HbT is reduced and the maximum HbT reduction is correlated to the Body Mass Index.

Jiang, Shudong; Pogue, Brian W.; Laughney, Ashley M.; Paulsen, Keith D.



Diffusion tensor imaging of subcortical brain injury in patients infected with human immunodeficiency virus  

Microsoft Academic Search

Diffusion tensor imaging (DTI) was used to derive in vivo tissue status measurements of subcortical brain regions that are vulnerable to injury in human immunodeficiency virus (HIV)-infected\\u000a patients. Quantitative measurements, including the mean diffusivity (MD) and fractional anisotropy (FA), were determined in\\u000a lateralized basal ganglia (caudate and putamen) and centrum semiovale in 11 well-characterized HIV patients and in 11 control

Ann B. Ragin; Ying Wu; Pippa Storey; Bruce A. Cohen; Robert R. Edelman; Leon G. Epstein



Magnetic resonance imaging of the inner ear in patients with idiopathic sudden sensorineural hearing loss  

Microsoft Academic Search

Although gadolinium-enhanced magnetic resonance imaging (Gd-MRI) has been used to indicate the presence of a subclinical\\u000a labyrinthitis in patients with idiopathic sudden sensorineural hearing loss (ISSHL), its sensitivity in daily clinical practice\\u000a is unknown. We describe Gd-MRI findings in 27 ISSHL patients taking part in a prospective multicenter clinical trial. MRI\\u000a findings were related to the severity of the hearing

R. J. Stokroos; F. W. J. Albers; A. P. Krikke; J. W. Casselman



Accurate positioning for head and neck cancer patients using 2D and 3D image guidance  

PubMed Central

Our goal is to determine an optimized image-guided setup by comparing setup errors determined by two-dimensional (2D) and three-dimensional (3D) image guidance for head and neck cancer (HNC) patients immobilized by customized thermoplastic masks. Nine patients received weekly imaging sessions, for a total of 54, throughout treatment. Patients were first set up by matching lasers to surface marks (initial) and then translationally corrected using manual registration of orthogonal kilovoltage (kV) radiographs with DRRs (2D-2D) on bony anatomy. A kV cone beam CT (kVCBCT) was acquired and manually registered to the simulation CT using only translations (3D-3D) on the same bony anatomy to determine further translational corrections. After treatment, a second set of kVCBCT was acquired to assess intrafractional motion. Averaged over all sessions, 2D-2D registration led to translational corrections from initial setup of 3.5 ± 2.2 (range 0–8) mm. The addition of 3D-3D registration resulted in only small incremental adjustment (0.8 ± 1.5 mm). We retrospectively calculated patient setup rotation errors using an automatic rigid-body algorithm with 6 degrees of freedom (DoF) on regions of interest (ROI) of in-field bony anatomy (mainly the C2 vertebral body). Small rotations were determined for most of the imaging sessions; however, occasionally rotations > 3° were observed. The calculated intrafractional motion with automatic registration was < 3.5 mm for eight patients, and < 2° for all patients. We conclude that daily manual 2D-2D registration on radiographs reduces positioning errors for mask-immobilized HNC patients in most cases, and is easily implemented. 3D-3D registration adds little improvement over 2D-2D registration without correcting rotational errors. We also conclude that thermoplastic masks are effective for patient immobilization.

Kang, Hyejoo; Lovelock, Dale M.; Yorke, Ellen D.; Kriminiski, Sergey; Lee, Nancy; Amols, Howard I.



Prognostic value of iodine-123 labelled BMIPP fatty acid analogue imaging in patients with myocardial infarction  

Microsoft Academic Search

This study was undertaken to evaluate the prognostic value of iodine-123 labelled 15-iodophenyl3-R,S-methyl pentadecanoic acid (BMIPP) imaging in patients with myocardial infarction. BMIPP is an iodinated methyl branched fatty acid analogue which is trapped in the myocardium with little washout, thereby reflecting fatty acid utilization in the myocardium. We previously reported that in patients with myocardial infarction, regions are often

Nagara Tamaki; Eiji Tadamura; Takashi Kudoh; Naoya Hattori; Yoshiharu Yonekura; Ryuji Nohara; Shigetake Sasayama; Katsuji Ikekubo; Hiroshi Kato; Junji Konishi



Velocity-Encoded Magnetic Resonance Image Assessment of Regional Aortic Flow in Coarctation Patients  

Microsoft Academic Search

Background. During primary coarctation repair, collat- eral blood vessels contribute significantly to distal per- fusion. We sought to determine if velocity-encoded cine magnetic resonance imaging (VENC-MRI) could provide insight into anatomy and hemodynamics of collateral flow in patients with unrepaired coarctation. Methods. Sixteen patients (median age, 6.2 years; range, 1 to 18) with discrete coarctation (65% severe, 29% mild- moderate)

Tiffany J. Riehle; John N. Oshinski; Marijn E. Brummer; Jennifer Favaloro-Sabatier; William T. Mahle; Derek A. Fyfe; Kirk R. Kanter; W. James Parks



Doctors, Patients, and Perceived Job Image: An Empirical Study of Stress and Nurses in Singapore  

Microsoft Academic Search

This study examined the relationships among three potential sources of stress, namely, demands from patients\\/relatives, demands from doctors, and perceived job image, and several work-related outcomes, namely, job satisfaction, organizational commitment, intention to quit, and job-induced tension. Respondents consist of nurses from two tertiary-care hospitals in Singapore. Findings of this study suggest that demands from patients\\/relatives, doctors, and perceived job

Vivien K. G. Lim; Edith C. Yuen



Prognosis in patients achieving ?10 METS on exercise stress testing: Was SPECT imaging useful?  

Microsoft Academic Search

Background  The benefit of myocardial perfusion imaging (MPI) over exercise ECG stress testing alone is unclear in individuals attaining\\u000a a workload of ?10 METS. The purpose of this prospective study is to determine mortality and nonfatal cardiac events in patients\\u000a at either intermediate pretest risk for CAD or patients with known CAD, achieving ?10 METS regardless of peak exercise heart\\u000a rate.

Jamieson M. Bourque; George T. Charlton; Benjamin H. Holland; Christopher M. Belyea; Denny D. Watson; George A. Beller



Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study  

Microsoft Academic Search

Objective To identify an optimal imaging strategy for the accurate detection of urgent conditions in patients with acute abdominal pain.Design Fully paired multicentre diagnostic accuracy study with prospective data collection.Setting Emergency departments of two university hospitals and four large teaching hospitals in the Netherlands.Participants 1021 patients with non-traumatic abdominal pain of >2 hours’ and <5 days’ duration. Exclusion criteria were

Wytze Laméris; Adrienne van Randen; H Wouter van Es; Johannes P M van Heesewijk; Bert van Ramshorst; Wim H Bouma; Wim ten Hove; Maarten S van Leeuwen; Esteban M van Keulen; Marcel G W Dijkgraaf; Patrick M M Bossuyt; Marja A Boermeester; Jaap Stoker



Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study  

PubMed Central

Objective To identify an optimal imaging strategy for the accurate detection of urgent conditions in patients with acute abdominal pain. Design Fully paired multicentre diagnostic accuracy study with prospective data collection. Setting Emergency departments of two university hospitals and four large teaching hospitals in the Netherlands. Participants 1021 patients with non-traumatic abdominal pain of >2 hours’ and <5 days’ duration. Exclusion criteria were discharge from the emergency department with no imaging considered warranted by the treating physician, pregnancy, and haemorrhagic shock. Intervention All patients had plain radiographs (upright chest and supine abdominal), ultrasonography, and computed tomography (CT) after clinical and laboratory examination. A panel of experienced physicians assigned a final diagnosis after six months and classified the condition as urgent or non-urgent. Main outcome measures Sensitivity and specificity for urgent conditions, percentage of missed cases and false positives, and exposure to radiation for single imaging strategies, conditional imaging strategies (CT after initial ultrasonography), and strategies driven by body mass index and age or by location of pain. Results 661 (65%) patients had a final diagnosis classified as urgent. The initial clinical diagnosis resulted in many false positive urgent diagnoses, which were significantly reduced after ultrasonography or CT. CT detected more urgent diagnoses than did ultrasonography: sensitivity was 89% (95% confidence interval 87% to 92%) for CT and 70% (67% to 74%) for ultrasonography (P<0.001). A conditional strategy with CT only after negative or inconclusive ultrasonography yielded the highest sensitivity, missing only 6% of urgent cases. With this strategy, only 49% (46% to 52%) of patients would have CT. Alternative strategies guided by body mass index, age, or location of the pain would all result in a loss of sensitivity. Conclusion Although CT is the most sensitive imaging investigation for detecting urgent conditions in patients with abdominal pain, using ultrasonography first and CT only in those with negative or inconclusive ultrasonography results in the best sensitivity and lowers exposure to radiation.



[Roentgen image presentation in the patient's room. Simple equipment for demonstration and storage of roentgen images].  


Immediate presentation of the more significant X-ray pictures facilitates planning and supervision of therapy in trauma surgery and orthopedics. If a wire rope is stretched in front of the window X-ray pictures can be clipped onto it, which avoids time-consuming searches. Suspended filing boxes placed in each sickroom make appropriate storage of each patient's X-ray pictures possible. The expenditure for all this amounted to 100 DM for each two-bedded room. Wire ropes and boxes were technically easy to install with a minimum investment of time. The presentation of X-ray pictures considerably increased the patients' understanding of their illness. It was also very rare for X-ray pictures to get mixed up once this system had been instituted. PMID:9082570

Prokop, A; Rehm, K E; Sagebiel, A



Balancing dose and image registration accuracy for cone beam tomosynthesis (CBTS) for breast patient setup  

SciTech Connect

Purpose: To balance dose reduction and image registration accuracy in breast setup imaging. In particular, the authors demonstrate the relationship between scan angle and dose delivery for cone beam tomosynthesis (CBTS) when employed for setup verification of breast cancer patients with surgical clips. Methods: The dose measurements were performed in a female torso phantom for varying scan angles of CBTS. Setup accuracy was measured using three registration methods: Clip centroid localization accuracy and the accuracy of two semiautomatic registration algorithms. The dose to the organs outside of the ipsilateral breast and registration accuracy information were compared to determine the optimal scan angle for CBTS for breast patient setup verification. Isocenter positions at the center of the patient and at the breast-chest wall interface were considered. Results: Image registration accuracy was within 1 mm for the CBTS scan angles {theta} above 20 deg. for some scenarios and as large as 80 deg. for the worst case, depending on the imaged breast and registration algorithm. Registration accuracy was highest based on clip centroid localization. For left and right breast imaging with the isocenter at the chest wall, the dose to the contralateral side of the patient was very low (<0.5 cGy) for all scan angles considered. For central isocenter location, the optimal scan angles were 30 deg. - 50 deg. for the left breast imaging and 40 deg. - 50 deg. for the right breast imaging, with the difference due to the geometric asymmetry of the current clinical imaging system. Conclusions: The optimal scan angles for CBTS imaging were found to be between 10 deg. and 50 deg., depending on the isocenter location and ipsilateral breast. Use of the isocenter at the breast-chest wall locations always resulted in greater accuracy of image registration (<1 mm) at smaller angles (10 deg. - 20 deg.) and at lower doses (<0.1 cGy) to the contralateral organs. For chest wall isocenters, doses delivered to organs outside of the target breast were much smaller than the scattered and leakage doses of the treatment beams. The complete volumetric information of all clips in the region of interest, combined with the small dose to the contralateral organs and the small scan angle, could result in an advantage for small angle CBTS with off center isocenters over simple orthogonal pairs.

Winey, B. A.; Zygmanski, P.; Cormack, R. A.; Lyatskaya, Y. [Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, Massachusetts 02115 (United States)



Comparison of setup error using different reference images: a phantom and lung cancer patients study  

SciTech Connect

The purpose of this study was to compare setup errors obtained with kilovoltage cone-beam computed tomography (CBCT) and 2 different kinds of reference images, free-breathing 3D localization CT images (FB-CT) and the average images of 4-D localization CT images (AVG-CT) for phantom and lung cancer patients. This study also explored the correlation between the difference of translational setup errors and the gross tumor volume (GTV) motion. A respiratory phantom and 14 patients were enrolled in this study. For phantom and each patient, 3D helical CT and 4D CT images were acquired, and AVG-CT images were generated from the 4D CT. The setup errors were determined based on the image registration between the CBCT and the 2 different reference images, respectively. The data for both translational and rotational setup errors were analyzed and compared. The GTV centroid movement as well as its correlation with the translational setup error differences was also evaluated. In the phantom study, the AVG-CT method was more accurate than the FB-CT method. For patients, the translational setup errors based on FB-CT were significantly larger than those from AVG-CT in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) directions (p < 0.05). Translational setup errors differed by >1 mm in 32.6% and >2 mm in 12.9% of CBCT scans. The rotational setup errors from FB-CT were significantly different from those from AVG-CT in the LR and AP directions (p < 0.05). The correlation coefficient of the translational setup error differences and the GTV centroid movement in the LR, SI, and AP directions was 0.515 (p = 0.060), 0.902 (p < 0.001), and 0.510 (p = 0.062), respectively. For lung cancer patients, respiration may affect the on-line target position location. AVG-CT provides different reference information than FB-CT. The difference in SI direction caused by the 2 methods increases with the GTV movement. Therefore, AVG-CT should be the prefered choice of reference images.

Jiang Bo [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Dai Jianrong, E-mail: [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China); Zhang Ye; Zhang Ke; Men Kuo; Zhou Zongmei; Liang Jun; Wang Lvhua [Department of Radiation Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing (China)



Clinical findings and imaging features of 67 nasopharyngeal carcinoma patients with postradiation nasopharyngeal necrosis.  


Postradiation nasopharyngeal necrosis is an important late effect of radiotherapy that affects prognosis in patients with nasopharyngeal carcinoma. In the present study, we reviewed the clinical and imaging features of 67 patients with pathologically diagnosed postradiation nasopharyngeal necrosis who were treated at Sun Yat-sen University Cancer Center between June 2006 and January 2010. Their clinical manifestations, endoscopic findings, and imaging features were analyzed. Early nasopharyngeal necrosis was limited to a local site in the nasopharyngeal region, and the tissue defect was not obvious, whereas deep parapharyngeal ulcer or signs of osteoradionecrosis in the basilar region was observed in serious cases. Those with osteoradionecrosis and/or exposed carotid artery had a high mortality. In conclusion, Postradiation nasopharyngeal necrosis has characteristic magnetic resonance imaging appearances, which associate well with clinical findings, but pathologic examination is essential to make the diagnosis. PMID:23816556

Chen, Ming-Yuan; Mai, Hai-Qiang; Sun, Rui; Guo, Xiang; Zhao, Chong; Hong, Ming-Huang; Hua, Yi-Jun



Are maladaptive schema domains and perfectionism related to body image concerns in eating disorder patients?  


Both maladaptive schemas (MS) and perfectionism have been associated with eating pathology. However, previous research has not examined these variables simultaneously and has not studied possible mediating relationships between MS and multidimensional perfectionism for body image concerns in eating disorder (ED) patients. Eighty-eight female ED patients completed the Young Schema Questionnaire, the Frost Multidimensional Perfectionism Scale, and the Body Attitude Test. Body image concerns were found to be positively related to Personal Standards (PS) and Evaluative Concerns (EC) perfectionism and all five schema domains. PS Perfectionism was positively associated with Disconnection, Other-directedness, and Overvigilance. EC Perfectionism was positively related to Disconnection, Impaired Autonomy, Other-directedness, and Overvigilance. Moreover, EC perfectionism was found to be a significant mediator in the relationship between the schema domains Impaired Autonomy and Overvigilance and body image concerns. These findings denote the importance to address both core beliefs and perfectionism in ED treatment. PMID:22556040

Boone, Liesbet; Braet, Caroline; Vandereycken, Walter; Claes, Laurence



The comparison between self-expanding and balloon expandable stent results in left anterior descending artery  

Microsoft Academic Search

The first Wallstent results had high thrombosis and death. It was reported that the left anterior descending (LAD) artery was the vessel implicated in major complications that occurred in patients who received a Wallstent. Subsequently, Wallstent applications were refrained from with LAD lesions. However, the promising results of second-generation self-expanding Magic Wallstent implantation have been reported recently. The purpose of

Mehtap K. ?i?man; Öner Engin; Erdinç Arikan; Mehmet Özaydin; Abdurrahman Eksik; Hasan Sunay; Bahadir Da?deviren; Güney Özkan; Aydin Ça?il



Thallium-201 imaging in a patient with mid-ventricular hypertrophic obstructive cardiomyopathy  

SciTech Connect

Findings specific to mid-ventricular hypertrophic obstructive cardiomyopathy were obtained in a patient by means of /sup 201/Tl planar myocardial scintigraphy. Namely, a myocardial band-like image dividing the left ventricle into two chambers was clearly shown. This was identified as hypertrophic muscle with sphincter-like muscular stenosis at the mid portion of the left ventricle.

Wakasugi, S.; Shibata, N.; Kobayashi, T.; Fudemoto, Y.; Hasegawa, Y.; Nakano, S.



Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas  

Microsoft Academic Search

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female

Mizuki Nishino; Kaori Togashi; Asako Nakai; Katsumi Hayakawa; Shotarou Kanao; Kazuhiro Iwasaku; Shingo Fujii



Modulation of brain response to emotional images by alcohol cues in alcohol-dependent patients  

Microsoft Academic Search

Alcohol is often used to modulate mood states. Alcohol drinkers report that they use alcohol both to enhance positive affect and to reduce dysphoria, and alcohol-dependent patients specifically state reduction of negative affect as a primary reason for drinking.The current study proposes that alcohol cues may reduce negative affect in alcoholics. We used functional magnetic resonance imaging to examine brain

Jodi M. Gilman; Daniel W. Hommer



Hypointense and Hyperintense Lesions on Magnetic Resonance Imaging in Secondary-Progressive MS Patients  

Microsoft Academic Search

Cranial magnetic resonance imaging (MRI) is widely used to monitor disease activity in clinical trials in multiple sclerosis (MS). The purpose of this study is to examine lesion burden as determined from hypointense regions on postcontrast T1-weighted scans (or black holes), and lesion burden on conventional T2-weighted scans, from a cohort of secondary progressive MS patients who participated in a

H.-P. Adams; S. Wagner; D. F. Sobel; L. S. Slivka; J. C. Sipe; J. S. Romine; E. Beutler; J. A. Koziol



The body and visual boundaries: A study of patient images in televised sexual health news reports  

Microsoft Academic Search

This dissertation's focus involves formerly private medical examinations\\/procedures in television sexual health news reports. Based on post-structural theory, this dissertation includes a consideration of social concerns related to body boundaries, privacy, medical paternalism, and medical dependency. In particular, these concerns serve as the theoretical backdrop for an investigation of patient images depicted in television sexual health news reports. ^ This

Marie Louise Dick



Corneal Optical Aberrations and Retinal Image Quality in Patients in Whom Monofocal Intraocular Lenses Were Implanted  

Microsoft Academic Search

Objectives: To compare retinal image quality and op- tical corneal aberrations in patients in whom monofocal polymethyl methacrylate intraocular lenses (IOLs) were implanted with those in healthy subjects of a similar older age (60-70 years old) and to use the results to suggest improved optical designs of IOLs to maximize retinal im- age quality. Methods: A double-pass apparatus was used

Antonio Guirao; Manuel Redondo; Edward Geraghty; Patricia Piers; Sverker Norrby; Pablo Artal



Magnetic resonance imaging and prediction of outcome in patients with major depressive disorder  

PubMed Central

Whether magnetic resonance imaging studies can provide useful information to clinicians who treat people with major depressive disorder remains to be established. There are, however, several recent findings that suggest that likelihood of response may be predicted by imaging findings. For example, morphometric studies have examined whether hippocampus volume is associated with clinically meaningful outcomes such as response to treatment. In general, patients who remit have larger pretreatment hippocampus volumes bilaterally compared with those who do not remit. There are similar preliminary findings for the anterior cingulate cortex. There are also a number of functional imaging studies that have identified different activity patterns in those who are likely to respond to treatment compared with those who are not. Using positron emission tomography, investigators have reported different patterns of response to treatment in those treated with medication compared with those treated with psychotherapy. Some of the potential barriers to the routine use of imaging in psychiatric practice are reviewed briefly.

MacQueen, Glenda M.



Indium-111 chloride imaging in patients with suspected abscesses: concise communication  

SciTech Connect

Two hundred and fifty-eight patients with clinically suspected inflammatory processes were studied. Seventy-two images were categorized as true positive; 211 as true negative. There were nine false-positive studies, four of which were due to activity in beds of excised organs. There were six false-negative studies, four of which were due to walled-off abscesses found either at surgery or biopsy. The sensitivity was 92%, the specificity 95%, and the accuracy 94%. This study shows that indium-111 chloride imaging provides a reliable way to locate inflammatory processes and overcomes the disadvantages of other imaging agents, for example gastrointestinal activity or the demonstration of healing surgical wounds with gallium-67, and the false-positive images due to cystic fibrosis and other respiratory diseases, or accessory spleens as seen with In-111-labeled white cells.

Sayle, B.A.; Balachandran, S.; Rogers, C.A.



[An evaluation of problems arising from the use of soft tissue expander].  


From November 1987 to July 1992, expanded skin was examined with both light and electron microscopes in 15 patients. Using these results, several problems arising from clinical use of skin expander were evaluated. PMID:8221323

Zha, Y K



Novel Functional Imaging of Changes in Small Airways of Patients Treated with Extrafine Beclomethasone/Formoterol.  


Background: Inhaled formulations using extrafine particles of long-acting ?2-agonists and corticosteroids were developed to optimize asthma treatment. Findings that these combinations reach and treat smaller airways more effectively are predominantly based on general non-specific outcomes with little information on regional characteristics. Objectives: This study aims to assess long-term effects of extrafine beclomethasone/formoterol on small airways of asthmatic patients using novel functional imaging methods. Methods: Twenty-four stable asthma patients were subdivided into three groups (steroid naive, n = 7; partially controlled, n = 6; well controlled, n = 11). Current treatment was switched to a fixed combination of extrafine beclomethasone/formoterol (Foster®; Chiesi Pharmaceuticals, Parma, Italy). Patients underwent lung function evaluation and thorax high-resolution computerized tomography (HRCT) scan. Local airway resistance was obtained from computational fluid dynamics (CFD). Results: After 6 months, the entire population showed improvement in pre-bronchodilation imaging parameters, including small airway volume (p = 0.0007), resistance (p = 0.011), and asthma control score (p = 0.016). Changes in small airway volume correlated with changes in asthma control score (p = 0.004). Forced expiratory volume in 1 s (p = 0.044) and exhaled nitric oxide (p = 0.040) also improved. Functional imaging provided more detail and clinical relevance compared to lung function tests, especially in the well-controlled group where only functional imaging parameters showed significant improvement, while the correlation with asthma control score remained. Conclusions: Extrafine beclomethasone/formoterol results in a significant reduction of small airway obstruction, detectable by functional imaging (HRCT/CFD). Changes in imaging parameters correlated significantly with clinically relevant improvements. This indicates that functional imaging is a useful tool for sensitive assessment of changes in the respiratory system after asthma treatment. PMID:23595105

Vos, Wim; De Backer, Jan; Poli, Gianluigi; De Volder, Annick; Ghys, Liesbet; Van Holsbeke, Cedric; Vinchurkar, Samir; De Backer, Lieve; De Backer, Wilfried



A longitudinal study about the body image and psychosocial adjustment of breast cancer patients during the course of the disease  

Microsoft Academic Search

PurposeThe research of body image among breast cancer patients is characterized by some limitations, such as the lack of longitudinal studies or the absence of a multidimensional perspective of body image. This study intends to overcome these limitations, by examining the evolution of body image dimensions (investment, emotions and evaluations) from the period of surgery (T1) to 6-months after the

Helena Moreira; Maria Cristina Canavarro



The Portuguese version of the Body Image Scale (BIS) – psychometric properties in a sample of breast cancer patients  

Microsoft Academic Search

PurposeThe aim of this study was to analyse the psychometric properties of the Portuguese version of the body image scale (BIS; Hopwood, P., Fletcher, I., Lee, A., Al Ghazal, S., 2001. A body image scale for use with cancer patients. European Journal of Cancer, 37, 189–197). This is a brief and psychometric robust measure of body image for use with

Helena Moreira; Sónia Silva; Andreia Marques; Maria Cristina Canavarro



Assessment of body image in patients undergoing surgery for colorectal cancer  

Microsoft Academic Search

Purpose  This study tested the scale properties and validity of the ten-item body image scale (BIS) in patients undergoing surgery\\u000a for colorectal cancer (CRC).\\u000a \\u000a \\u000a \\u000a Methods  Patients completed the BIS and a validated measure of health-related quality of life (European Organisation for Research and\\u000a Treatment of Cancer (EORTC) QLQ-C30) after open or laparoscopic resection. A sample of the patients had also previously completed

Robert N. Whistance; Rebecca Gilbert; Peter Fayers; Robert J. Longman; Anne Pullyblank; Michael Thomas; Jane M. Blazeby



PET imaging in patients with coal workers pneumoconiosis and suspected malignancy  

SciTech Connect

Abstract: Positron Emission Tomography (PET) with F-18-fluorodeoxyglucose is commonly used in the evaluation of lung nodules; however, there is limited data on the PET appearance of coal worker's pneumoconiosis (CWP) and its utility for diagnosing lung malignancy in this setting. Six cases of CWP and suspected malignancy are reported. Each patient had at least one nodule >1 cm in diameter for a total of 19 nodules >1 cm. On PET imaging 18 of the 19 nodules were hypermetabolic and five of the six patients had at least one nodule that was PET positive. Based on pathologic data and clinical follow-up, none of the six patients had any evidence of malignancy. In this series, PET imaging was often positive in patients with CWP; however, all were false positives with standardized uptake value measurements in the range that are typically seen with malignant nodules. Due to its high rate of false positives, PET imaging seems to be of limited utility in diagnosing malignancy in patients with underlying coal worker's pneumoconiosis.

Reichert, M.; Bensadoun, E.S. [University of Kentucky, Lexington, KY (United States)



Measurements of occupational and patient exposure as well as image quality for two C-arms.  


Two different C-arms, a Philips Veradius and a Ziehm Vision FD were evaluated with regard to occupational and patient radiation exposure as well as image quality. For this, the scatter radiation, the entrance surface dose rate (ESD rate) and the low contrast detectability (LCD) were evaluated with regard to different examination modes, using phantoms with different thicknesses as well as a Leeds Test Object. The results show a large range of variance between the two systems in relation to the topics investigated. Within comparable modes the Phillips Veradius causes a lower occupational and patient exposure than the Ziehm Vision FD. Furthermore, a lower radiation burden does not necessarily decrease the image quality, and a slight increase in LCD for particular settings is foiled by a big escalation in patient dose. PMID:23509391

Blaickner, Matthias; Neuwirth, Johannes



Comparison of visual and semiquantitative analysis of stress thallium-201 myocardial images in patients with suspected ischemic heart disease  

SciTech Connect

Three methods of analyzing stress thallium-201 myocardial images were performed on 79 patients with suspected coronary artery disease. The results of visual analysis of unprocessed Polaroid images, background subtracted and contrast enhanced computer generated color television images, and a semiquantitative regions-of-interest method were each compared to the coronary arteriographic findings in all patients. Analysis by the semiquantitative method achieved the highest accuracy for the classification of patients as either having or not having coronary artery disease. This method of interpreting myocardial images appears worthy of further study.

McKillop, J.H.; Murray, R.G.; Turner, J.G.; Bessent, R.G.



ORIGINAL RESEARCH MR Imaging of the Brain in Patients Cured of Acute Lymphoblastic Leukemia—the Value of Gradient Echo Imaging  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Hemosiderin and white matter lesions are 2 of the most common neurologic complications found on MR imaging that may be related to cranial irradiation and intrathecal methotrexate (MTX) therapy in childhood acute lymphoblastic leukemia (ALL). We evaluated the brains of patients previously treated for ALL with cranial irradiation and intrathecal MTX with MR imaging and tested the

M. S. M. Chan; D. J. Roebuck; P. Yuen; C.-K. Li; Y.-L. Chan


Thallium-201 versus technetium-99m pyrophosphate myocardial imaging in detection and evaluation of patients with acute myocardial infarction  

SciTech Connect

Thallium-201 myocardial imaging is of value in the early detection and evaluation of patients with suspected acute infarction. Thallium imaging may have a special value in characterizing patients with cardiogenic shock and in detecting patients at risk for subsequent infarction or death or death or both, before hospital discharge. Approximately 95 percent of pateints with transmural or nontransmural myocardial infarction can be detected with technetium-99m pyrophosphate myocardial imaging if the imaging is performed 24 to 72 hours after the onset of symptoms. Pyrophosphate imaging may have an important role in the evaluation of patients during the early follow-up period after hospital discharge from an episode of acute infarction. The finding of a persistently positive pyrophosphate image suggests a poor prognosis and is associated with a relatively large incidence of subsequent myocardial infarction and death.

Pitt, B.; Thrall, J.H.



Gait analysis does not correlate with clinical and MR imaging parameters in patients with symptomatic lumbar spinal stenosis  

Microsoft Academic Search

BACKGROUND: Parameters of MR imaging play a pivotal role in diagnosing lumbar spinal stenosis (LSS), and serve as an important tool in clinical decision-making. Despite the importance of MR imaging, little is known about the correlation between MRI parameters, objective gait analysis, and clinical presentation of patients with lumbar spinal stenosis. METHODS: Sixty-three patients from our clinic with symptomatic lumbar

Felix Zeifang; Marcus Schiltenwolf; Rainer Abel; Babak Moradi



Transient MR Signal Changes in Patients with Generalized Tonicoclonic Seizure or Status Epilepticus: Periictal Diffusion-weighted Imaging  

Microsoft Academic Search

BACKGROUND AND PURPOSE:Our purpose was to investigate transient MR signal chang- es on periictal MR images of patients with generalized tonicoclonic seizure or status epilepticus and to evaluate the clinical significance of these findings for differential diagnosis and under- standing of the pathophysiology of seizure-induced brain changes. METHODS: Eight patients with MR images that were obtained within 3 days after

Jeong-Ah Kim; Jin Il Chung; Pyeong Ho Yoon; Dong Ik Kim; Tae-Sub Chung; Eun-Ju Kim; Eun-Kee Jeong


The Primary Patency and Fracture Rates of Self-Expandable Nitinol Stents Placed in the Popliteal Arteries, Especially in the P2 and P3 Segments, in Korean Patients  

PubMed Central

Objective We wanted to evaluate the status of self-expandable nitinol stents implanted in the P2 and P3 segments of the popliteal artery in Korean patients. Materials and Methods We retrospectively analyzed 189 consecutive patients who underwent endovascular treatment for stenoocclusive lesions in the femoropopliteal artery from July 2003 to March 2009, and 18 patients who underwent stent placement in popliteal arterial P2 and P3 segments were finally enrolled. Lesion patency was evaluated by ultrasound or CT angiography, and stent fracture was assessed by plain X-rays at 1, 3, 6 and 12 months and annually thereafter. Results At the 1-month follow-up, stent fracture (Type 2) was seen in one limb (up to P3, 1 of 18, 6%) and it was identified in seven limbs at the 3-month follow-up (Type 2, Type 3, Type 4) (n = 1: up to P2; n = 6: P3). At the 6-month follow-up, one more fracture (Type 1) (up to P3) was noted. At the 1-year follow-up, there were no additional stent fractures. Just four limbs (up to P2) at the 2-year follow-up did not have stent fracture. The primary patency was 94%, 61% and 44% at 1, 3 and 6 months, respectively, and the group with stent implantation up to P3 had a higher fracture rate than that of the group that underwent stenting up to P2 (p < 0.05). Conclusion We suggest that stent placement up to the popliteal arterial P3 segment and over P2 in an Asian population can worsen the stent patency owing to stent fracture. It may be necessary to develop a stent design and structure for the Asian population that can resist the bending force in the knee joint.

Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Kim, Jun Seok; Chang, Seong-Hwan; Jung, Hong Geun



Advanced expander test bed program  

NASA Astrophysics Data System (ADS)

The Advanced Expander Test Bed (AETB) is a key element in NASA's Space Chemical Engine Technology Program for development and demonstration of expander cycle oxygen/hydrogen engine and advanced component technologies applicable to space engines as well as launch vehicle upper stage engines. The AETB will be used to validate the high-pressure expander cycle concept, investigate system interactions, and conduct investigations of advanced mission focused components and new health monitoring techniques in an engine system environment. The split expander cycle AETB will operate at combustion chamber pressures up to 1200 psia with propellant flow rates equivalent to 20,000 lbf vacuum thrust. Contract work began 27 Apr. 1990. During 1992, a major milestone was achieved with the review of the final design of the oxidizer turbopump in Sep. 1992.

Riccardi, D. P.; Mitchell, J. C.



Helical Screw Expander Evaluation Project.  

National Technical Information Service (NTIS)

A one MW helical rotary screw expander power system for electric power generation from geothermal brine was evaluated. The technology explored in the testing is simple, potentially very efficient, and ideally suited to wellhead installations in moderate t...

R. Mckay



Error exponents of expander codes  

Microsoft Academic Search

We show that expander codes attain the capacity of the binary symmetric channel under iterative decoding. The error probability has a positive exponent for all rates between 0 and channel capacity. The decoding complexity grows linearly with code length

Alexander Barg; G. Zemor



Gravity and the Expanding Universe  

NSDL National Science Digital Library

This video segment, adapted from NOVA, traces the evolving history of theories about gravity and a force that may oppose it, along with our understanding of the impact of both of these forces on our expanding universe.

Foundation, Wgbh E.



MR Imaging of the Spine and Sacroiliac Joints for Spondyloarthritis: Influence on Clinical Diagnostic Confidence and Patient Management.  


Purpose: To quantify the effect of magnetic resonance (MR) imaging of the spine and sacroiliac joints on clinical diagnostic confidence and to determine if MR imaging affects treatment of patients with axial spondyloarthritis. Materials and Methods: This prospective observational study was approved by the research ethics board and included 55 consecutive patients referred by three rheumatologists for MR imaging of the spine and sacroiliac joints. Measures of diagnostic confidence for clinical features (inflammatory back pain, mechanical back pain, muscular back pain, radicular back pain, spondylitis, sacroiliitis, and other) and overall diagnoses were made by using a Likert scale both before and after MR imaging. Proposed treatment was similarly recorded before and after MR imaging interpretation. The McNemar test was performed to determine the change in diagnostic confidence and consequent effect on patient treatment. Results: Diagnostic confidence for specific clinical features improved significantly after MR imaging for inflammatory back pain (14% vs 76%, before vs after; P < .001), mechanical back pain (4% vs 49%, P < .001), spondylitis (7% vs 76%, P < .001) and sacroiliitis (9% vs 87%, P < .001). Confidence for overall diagnoses also improved significantly after MR imaging for ankylosing spondylitis (29% vs 80%, P < .001), undifferentiated spondyloarthritis (58% vs 93%, P < .001) and osteoarthritis (29% vs 64%, P < .001). Of the 23 patients for whom tumor necrosis factor-? inhibitor (TNFi) therapy was recommended before MR imaging, 12 (52%) were prescribed TNFi therapy after MR imaging. Of the 32 patients for whom TNFi therapy was not recommended before MR imaging, 10 (31%) patients were prescribed TNFi therapy after MR imaging. Overall, 22 (40%) patients had a change in treatment recommendation regarding TNFi therapy after MR imaging. Conclusion: MR imaging of the spine and sacroiliac joints significantly influences the diagnostic confidence of rheumatologists regarding clinical features and overall diagnoses of axial spondyloarthritis, and consequently significantly affects treatment plans. © RSNA, 2013. PMID:23813394

Carmona, Raj; Harish, Srinivasan; Linda, Dorota D; Ioannidis, George; Matsos, Mark; Khalidi, Nader A



Magnetic resonance imaging in patients with cardiac pacemakers: era of "MR Conditional" designs.  


Advances in cardiac device technology have led to the first generation of magnetic resonance imaging (MRI) conditional devices, providing more diagnostic imaging options for patients with these devices, but also new controversies. Prior studies of pacemakers in patients undergoing MRI procedures have provided groundwork for design improvements. Factors related to magnetic field interactions and transfer of electromagnetic energy led to specific design changes. Ferromagnetic content was minimized. Reed switches were modified. Leads were redesigned to reduce induced currents/heating. Circuitry filters and shielding were implemented to impede or limit the transfer of certain unwanted electromagnetic effects. Prospective multicenter clinical trials to assess the safety and efficacy of the first generation of MR conditional cardiac pacemakers demonstrated no significant alterations in pacing parameters compared to controls. There were no reported complications through the one month visit including no arrhythmias, electrical reset, inhibition of generator output, or adverse sensations. The safe implementation of these new technologies requires an understanding of the well-defined patient and MR system conditions. Although scanning a patient with an MR conditional device following the strictly defined patient and MR system conditions appears straightforward, issues related to patients with pre-existing devices remain complex. Until MR conditional devices are the routine platform for all of these devices, there will still be challenging decisions regarding imaging patients with pre-existing devices where MRI is required to diagnose and manage a potentially life threatening or serious scenario. A range of other devices including ICDs, biventricular devices, and implantable physiologic monitors as well as guidance of medical procedures using MRI technology will require further biomedical device design changes and testing. The development and implementation of cardiac MR conditional devices will continue to require the expertise and collaboration of multiple disciplines and will need to prove safety, effectiveness, and cost effectiveness in patient care. PMID:22032338

Shinbane, Jerold S; Colletti, Patrick M; Shellock, Frank G



Expandable metal stents in chronic pancreatitis  

PubMed Central

Background Biliary obstruction in chronic pancreatitis may be relieved by the insertion of a biliary endoprosthesis. Stenting is usually achieved with a plastic device, but self-expandable metal stents may also be used. Case outlines Two patients are described with severe chronic pancreatitis complicated by biliary obstruction and portal vein thrombosis, who underwent insertion of metallic biliary endoprostheses. In both patients the endoprostheses became occluded, at 12 and 7 months respectively, which necessitated open operation. Both patients experienced surgical complications and one patient died postoperatively. Discussion The use of metal endoprostheses in chronic pancreatitis may result in occlusion, necessitating open operation. Such stents should be used with caution in these patients, who are likely to be high-risk surgical candidates.

Charnley, RM



Response of patients to the introduction of a private Magnetic Resonance Imaging service in Western Jamaica  

PubMed Central

Background: Magnetic Resonance Imaging (MRI) is one of today's fastest growing imaging modalities, spurred in part by rapid advances in technology and important new applications in patient care. It was introduced in Western Jamaica in March 2005 at a non-hospital-based facility called North Coast Imaging MRI Service. Aims: The study examined the socio-demographics, accessibility and affordability of the services to patients. Materials and Method: A random sample of 100 patients was used and the research instrument was a questionnaire. The study was conducted between August and November 2008. Results: The findings of the study showed that majority of the respondents lived in rural areas and were within the age group 30 - 59 years. One-half of the respondents resided in St. James, were employed; earned more than US$1,351.00 per month and could afford the cost of the MRI procedure. More than one half of the respondents indicated that it took 15 – 30 minutes to be examined after arrival at the Centre; most (81%) of the respondents indicated that the MRI procedure was adequately explained, and 99% indicated that questions about the procedure were satisfactorily answered. The MRI Scans performed at the North Coast Imaging MRI Service showed an increase of 157.49% in 2006 when compared with 2005, and 70.90% in 2007 when compared with 2006. Our findings suggest that the number of MRI scans done at the North Coast Imaging MRI Service is likely to increase. Conclusion: Although most of the respondents were able to afford the procedure there are concerns about persons in the lower socio-economic group who are unable to afford expensive diagnostic imaging tests such as MRI scans. There is an urgent need for government-owned hospital-based MRI Units in Jamaica to offer lower cost MRI scans to the public.

Anderson-Jackson, Lennox; McGrowder, Donovan A.; Bourne, Paul A.; Crawford, Tazhmoye; Whittaker, Wayne H. A.



Flavors in an expanding plasma  

SciTech Connect

We consider the effect of an expanding plasma on probe matter by determining time-dependent D7 embeddings in the holographic dual of an expanding viscous plasma. We calculate the chiral condensate and meson spectra including contributions of viscosity. The chiral condensate essentially confirms the expectation from the static black hole. For the meson spectra we propose a scheme that is in agreement with the adiabatic approximation. New contributions arise for the vector mesons at the order of the viscosity terms.

Grosse, Johannes; Janik, Romuald A.; Surowka, Piotr [Institute of Physics, Jagiellonian University, Reymonta 4, 30-059 Krakow (Poland)



Usefulness of pulsed tissue Doppler imaging for evaluating systolic and diastolic left ventricular function in patients with AL (primary) amyloidosis  

Microsoft Academic Search

To clarify whether pulsed tissue Doppler imaging at multiple left ventricular LV sites could help to explain the mechanism of congestive heart failure (CHF) in patients with primary amyloidosis, we examined 86 consecutive patients with primary amyloidosis confirmed by biopsy (group I, 31 patients without cardiac involvement; group II, 31 patients with evidence of heart involvement but no CHF; and

Jun Koyama; Patricia A Ray-Sequin; Ravin Davidoff; Rodney H Falk



Body image disturbance in patients with borderline personality disorder: impact of eating disorders and perceived childhood sexual abuse.  


Body image disturbances occur in women with borderline personality disorder (BPD). Systematic research on these characteristics in well-defined BPD groups is lacking. It is unknown, if the disturbances are related to eating disorders and childhood sexual abuse (CSA), which frequently co-occur in patients with BPD. In the present study, cognitive-affective and behavioral components of body image for 89 female patients with BPD (49 with lifetime eating disorders) and 41 healthy participants were assessed via Body Image Avoidance Questionnaire (BIAQ) and Multidimensional Body-Self Relations Questionnaire (MBSRQ). Within the BPD group, 43 patients reported a history of CSA. Compared to healthy controls, BPD patients reported significantly more negative scores in the BIAQ and the MBSRQ. Both a history of CSA and a comorbid eating disorder were independently associated with an even more negative body image. Results suggest a disturbance of cognitive-affective and behavioral components of body image in female BPD patients. PMID:23375838

Dyer, Anne; Borgmann, Elisabeth; Feldmann, Robert E; Kleindienst, Nikolaus; Priebe, Kathlen; Bohus, Martin; Vocks, Silja



Effect of patient position on interpretation of lung images complicated by chest radiograph opacities  

SciTech Connect

Lung images in which perfusion defects correspond to chest radiograph (CXR) opacities in size and location are generally classified as having an intermediate probability for pulmonary embolism, while those studies in which the perfusion defects are considerably smaller than the CXR opacities are classified as having a low probability for pulmonary embolism. A case is presented in which, by imaging a patient in both the erect and supine positions, the authors were able to change the interpretation of the study from intermediate probability (perfusion defect = CXR opacity) to low probability (perfusion defect less than CXR opacity).

Solomon, R.W.; Palestro, C.J.; Kim, C.K.; Goldsmith, S.J.



Magnetic resonance imaging of the small bowel in patients with Crohn's disease  

PubMed Central

Purpose of the review The purpose of this review is to highlight the advances in magnetic resonance (MR) imaging of the small intestine in patients with Crohn's disease. MR imaging of the gut has become more feasible with improved spatial resolution and speed of the MR sequences allowing parallel evaluation for both disease activity and extra-enteric complications. Recent findings Recent literature highlights excellent diagnostic accuracy of MR enterography (MRE) that is comparable to CT enterography (CTE). Compared to CTE the image quality is not quite as good, and there is slightly more inter-observer variability in interpretation. Despite these performance characteristics, the overall diagnostic yield of MRE is comparable to CTE. The lack of radiation exposure related to MRE is a significant strength, especially in the Crohn's population that by virtue of their younger age, body habitus and potential need for repeated imaging, is at highest risk of cancer from radiation exposure due to diagnostic imaging. MRE should not be viewed as a “safer” version of a CTE. The physics of MRI allows the application of unique sequences that add novel insights not possible with other imaging modalities. Summary MRE is a highly effective technique for assessing Crohn's disease. We are only starting to explore new MRI sequences and the future of this technology is extremely exciting.

Zimmermann, Ellen M.; Al-Hawary, Mahmoud M.



Radiological staging in breast cancer: which asymptomatic patients to image and how  

PubMed Central

Background: Approximately 4% of patients diagnosed with early breast cancer have occult metastases at presentation. Current national and international guidelines lack consensus on whom to image and how. Methods: We assessed practice in baseline radiological staging against local guidelines for asymptomatic newly diagnosed breast cancer patients presenting to the Cambridge Breast Unit over a 9-year period. Results: A total of 2612 patients were eligible for analysis; 91.7% were appropriately investigated. However in the subset of lymph node negative stage II patients, only 269 out of 354 (76.0%) investigations were appropriate. No patients with stage 0 or I disease had metastases; only two patients (0.3%) with stage II and ?3 positive lymph nodes had metastases. Conversely, 2.2, 2.6 and 3.8% of these groups had false-positive results. The incidence of occult metastases increased by stage, being present in 6, 13.9 and 57% of patients with stage II (?4 positive lymph nodes), III and IV disease, respectively. Conclusion: These results prompted us to propose new local guidelines for staging asymptomatic breast cancer patients: only clinical stage III or IV patients require baseline investigation. The high specificity and convenience of computed tomography (chest, abdomen and pelvis) led us to recommend this as the investigation of choice in breast cancer patients requiring radiological staging.

Barrett, T; Bowden, D J; Greenberg, D C; Brown, C H; Wishart, G C; Britton, P D



Lubricin in human breast tissue expander capsules.  


Capsular contraction is the most common complication of breast reconstruction surgery. While presence of the contractile protein alpha smooth muscle actin (?-SMA) is considered among the causes of capsular contraction, the exact etiology and pathophysiology is not fully understood. The objective of this study was to investigate the possible role of lubricin in capsular formation and contraction by determining the presence and distribution of the lubricating protein lubricin in human breast tissue expander capsules. Related aims were to evaluate select histopathologic features of the capsules, and the percentage of cells expressing ?-SMA, which reflects the myofibroblast phenotype. Capsules from tissue expanders were obtained from eight patients. Lubricin, at the tissue-implant interface, in the extracellular matrix, and in cells, and ?-SMA-containing cells were evaluated immunohistochemically. The notable finding was that lubricin was identified in all tissue expander capsules: as a discrete layer at the tissue-implant interface, extracellular, and intracellular. There was a greater amount of lubricin in the extracellular matrix in the intimal-subintimal zone when compared with the tissue away from the implant. Varying degrees of synovial metaplasia were seen at the tissue-implant interface. ?-SMA-containing cells were also seen in all but one patient. The findings might help us better understand factors involved in capsule formation. PMID:22865664

Cheriyan, Thomas; Guo, Lifei; Orgill, Dennis P; Padera, Robert F; Schmid, Thomas M; Spector, Myron



Adult polyglucosan body disease: case description of an expanding genetic and clinical syndrome.  


A non-Jewish patient is described who had adult polyglucosan body disease (APBD) and glycogen branching enzyme (GBE) deficiency without GBE mutation. A heterozygous polymorphism (Val160Ile) was found, and also discovered in 1 of 50 normal individuals. Magnetic resonance imaging demonstrated increased T2 signal in the midbrain, medullary olives, dentate nuclei, cerebellar peduncles, and internal and external capsules, with vermian atrophy. Both muscle and nerve biopsy revealed perivascular inflammatory infiltrates. These findings expand the clinical and genetic spectrum of APBD. Factors other than mutation of the expressed GBE gene may cause enzyme deficiency and varied expression and development of APBD. PMID:14755501

Klein, Christopher J; Boes, Christopher J; Chapin, John E; Lynch, Christopher D; Campeau, Norbert G; Dyck, P James B; Dyck, Peter J



Brain stem magnetic resonance imaging and evoked potential studies of symptomatic multiple sclerosis patients.  


In this study we evaluated the sensitivity of neuroradiological and neurophysiological tests for detecting brain stem (BS) lesions in multiple sclerosis patients, since the recent introduction of the gradient motion rephasing technique has markedly increased the image quality of magnetic resonance imaging (MRI). From 50 MS patients (33 women and 17 men; mean age 35.9 +/- 8.3 years; mean duration of the disease 7.2 +/- 4.1 years) with clinical signs of BS involvement, brain MRI, BS auditory evoked potentials (BAEPs), and left and right median somatosensory evoked potentials (mSEPs) were obtained. BS MRI lesions were detected in 41 patients (82%); in 14 cases they were located in the medulla oblongata, in 55 in the pons, and in 24 in the midbrain. Single lesions were present in 20 patients, while two or more BS lesions were demonstrated in 21 patients; 30 patients had at least one lesion located close to the inner or the outer cerebrospinal fluid border. BAEPs were abnormal in 19 of the 50 patients (38%), and BS components of mSEPs were abnormal in 15 of 46 (33%). With combined use of these neurophysiological techniques, BS abnormalities were revealed in 24 patients (48%). Only 1 patient had neurophysiological BS abnormalities and normal MRI. Moreover, there was a good correlation (74%) between the clinical and MRI BS findings in the 23 patients with signs referable to focal neurological BS lesions. The concordances considering clinical and evoked potential reports were positive, but less marked.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8467844

Comi, G; Filippi, M; Martinelli, V; Scotti, G; Locatelli, T; Medaglini, S; Triulzi, F; Rovaris, M; Canal, N



An Explicit Construction of Quantum Expanders  

Microsoft Academic Search

Quantum expanders are a natural generalization of classical expanders. These objects were introduced and studied by Ben-Aroya and Ta-Shma and by Hastings. In this note we show how to construct explicit, constant-degree quantum expanders. The construction is essentially the classical Zig-Zag expander construction, applied to quantum expanders.

Avraham Ben-Aroya; Oded Schwartz; Amnon Ta-Shma



Leg edema quantification for heart failure patients via 3D imaging.  


Heart failure is a common cardiac disease in elderly patients. After discharge, approximately 50% of all patients are readmitted to a hospital within six months. Recent studies show that home monitoring of heart failure patients can reduce the number of readmissions. Still, a large number of false positive alarms as well as underdiagnoses in other cases require more accurate alarm generation algorithms. New low-cost sensors for leg edema detection could be the missing link to help home monitoring to its breakthrough. We evaluated a 3D camera-based measurement setup in order to geometrically detect and quantify leg edemas. 3D images of legs were taken and geometric parameters were extracted semi-automatically from the images. Intra-subject variability for five healthy subjects was evaluated. Thereafter, correlation of 3D parameters with body weight and leg circumference was assessed during a clinical study at the Medical University of Graz. Strong correlation was found in between both reference values and instep height, while correlation in between curvature of the lower leg and references was very low. We conclude that 3D imaging might be a useful and cost-effective extension of home monitoring for heart failure patients, though further (prospective) studies are needed. PMID:23948874

Hayn, Dieter; Fruhwald, Friedrich; Riedel, Arthur; Falgenhauer, Markus; Schreier, Günter



Leg Edema Quantification for Heart Failure Patients via 3D Imaging  

PubMed Central

Heart failure is a common cardiac disease in elderly patients. After discharge, approximately 50% of all patients are readmitted to a hospital within six months. Recent studies show that home monitoring of heart failure patients can reduce the number of readmissions. Still, a large number of false positive alarms as well as underdiagnoses in other cases require more accurate alarm generation algorithms. New low-cost sensors for leg edema detection could be the missing link to help home monitoring to its breakthrough. We evaluated a 3D camera-based measurement setup in order to geometrically detect and quantify leg edemas. 3D images of legs were taken and geometric parameters were extracted semi-automatically from the images. Intra-subject variability for five healthy subjects was evaluated. Thereafter, correlation of 3D parameters with body weight and leg circumference was assessed during a clinical study at the Medical University of Graz. Strong correlation was found in between both reference values and instep height, while correlation in between curvature of the lower leg and references was very low. We conclude that 3D imaging might be a useful and cost-effective extension of home monitoring for heart failure patients, though further (prospective) studies are needed.

Hayn, Dieter; Fruhwald, Friedrich; Riedel, Arthur; Falgenhauer, Markus; Schreier, Gunter



Predictors of cardiovascular events in hemodialysis patients after stress myocardial perfusion imaging.  


Cardiovascular prognosis in patients under normal stress myocardial perfusion images (MPI) is generally excellent. However, this is not true for patients with chronic kidney disease (CKD) treated by hemodialysis. This study evaluated prognostic factors of adverse cardiovascular events in hemodialysis patients in whom stress MPI was performed. Pharmacological stress MPI was performed in 88 hemodialysis patients, and we retrospectively followed-up for 26 months. Cardiovascular events included cardiac death, nonfatal myocardial infarction, and unstable angina. Cardiovascular events occurred in 16 patients (18%). Univariate Cox regression analysis revealed that peripheral artery disease (PAD) and parameters of stress MPI were significant predictors of cardiovascular events. Multivariate Cox regression analysis revealed that only PAD (hazard ratio?=?6.54; P?=?0.002), and abnormal stress MPI (hazard ratio?=?8.26; P?=?0.008) were independent and significant predictors of cardiovascular events. Kaplan-Meier analysis showed better prognosis in patients with normal stress MPI than in patients with abnormal stress MPI (P?patients with normal stress MPI, cardiovascular events occurred in 10 of the 76 patients (13%). Among patients with normal stress MPI, Kaplan-Meier analysis showed that patients with no PAD had better prognosis than patients with PAD (P?=?0.001, log-rank test). In hemodialysis patients, both PAD and stress MPI were powerful cardiovascular predictors. Normal stress MPI alone cannot guarantee good prognosis in terms of cardiovascular events. Consideration of PAD may improve the predictive value of stress MPI in some patients. PMID:23574392

Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Minakawa, Megumi; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru



What Does PET Imaging Add to Conventional Staging of Head and Neck Cancer Patients?  

SciTech Connect

Purpose: To determine the value of PET scans in the staging of patients with head and neck carcinoma. Methods and Materials: The charts of 25 patients who underwent neck dissection, computed tomography (CT) scan, and F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging as part of their initial work-up for a head and neck squamous cell cancer between 2000-2003 were reviewed. All patients underwent clinical examination, triple endoscopy, and chest radiograph as part of their clinical staging, adhering to American Joint Commission for Cancer criteria. In addition to the clinical nodal (N) stage, PET findings were incorporated to determine a second type of N staging: clinical N + PET stage. The number of neck sides and nodal levels involved on CT or PET and on pathologic examination were recorded. Results: The sensitivity and specificity for detection of nodal disease were similar for CT and FDG-PET. Positive and negative likelihood ratios were similar for both diagnostic tests. None of our 25 patients had unsuspected distant disease detected by PET. Conclusion: The addition of PET imaging did not improve diagnostic accuracy in our patients compared with CT. PET scanning did not alter clinical management in any of the patients.

Pohar, Surjeet [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States) and Department of Radiation Oncology, Eastern Virginia Medical School, Norfolk, VA (United States)]. E-mail:; Brown, Robert B.S. [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States); Newman, Nancy [Department of Medicine, SUNY Upstate Medical University, Syracuse, NY (United States); Koniarczyk, Michael [Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY (United States); Hsu, Jack [Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, NY (United States); Feiglin, David [Department of Radiology, SUNY Upstate Medical University, Syracuse, NY (United States)



Decorative elements in the medical imaging area improve patients' perception of pleasantness.  


OBJECTIVES: To evaluate the sensation of pleasantness perceived by patients attended in the radiology department in response to decorative elements hung on the walls in the waiting rooms and in the hallways of the imaging area. MATERIAL AND METHODS: The material resources comprised works of art in the form of "magic windows" representing scenes from nature installed on the ceilings and walls of the waiting area and hallways of the imaging area. Patients were given a brief questionnaire with general data and questions (sadness-cheerfulness, coldness-warmth, darkness-light, and pessimism-optimism) about their perception of the decorative elements. RESULTS: Of the 150 questionnaires collected, 142 were filled out correctly. The overall health of these patients was good in 84 (56%), not bad in 58 (39%), and poor in 8 (5%). The idea seemed very good to 70 patients (47%), good to 58 (39%), not bad to 8 (5%), indifferent to 11 (7%), bad to 1 (1%), and very bad to 2 (1%). As far a patients' mobility, 119 patients (79%) walked into the department, 18 (12%) were wheeled in on beds, and 13 (9%) needed wheelchairs. CONCLUSIONS: We found a high level of satisfaction with the decorative elements. PMID:23195038

García Marcos, R; Martí-Bonmatí, L; Martínez, J J; Vilar, J; Katic, N; Lemercier, P; Díaz Dhó, R



Diffusion Tensor Imaging Reliably Differentiates Patients With Schizophrenia from Healthy Volunteers  

PubMed Central

The objective of this research was to determine whether fractional anisotropy (FA) and mean diffusivity (MD) maps derived from diffusion tensor imaging (DTI) of the brain are able to reliably differentiate patients with schizophrenia from healthy volunteers. DTI and high resolution structural magnetic resonance scans were acquired in 50 patients with schizophrenia and 50 age- and sex-matched healthy volunteers. FA and MD maps were estimated from the DTI data and spatially normalized to the Montreal Neurologic Institute standard stereotactic space. Individuals were divided randomly into two groups of 50, a training set and a test set, each comprising 25 patients and 25 healthy volunteers. A pattern classifier was designed using Fisher’s linear discriminant analysis based on the training set of images to categorize individuals in the test set as either patients or healthy volunteers. Using the FA maps the classifier correctly identified 94% of the cases in the test set (96% sensitivity and 92% specificity). The classifier achieved 98% accuracy (96% sensitivity and 100% specificity) when using the MD maps as inputs to distinguish schizophrenia patients from healthy volunteers in the test dataset. Utilizing FA and MD data in combination did not significantly alter the accuracy (96% sensitivity and specificity). Patterns of water self-diffusion in the brain as estimated by DTI can be used in conjunction with automated pattern recognition algorithms to reliably distinguish between patients with schizophrenia and normal control subjects.

Ardekani, Babak A.; Tabesh, Ali; Sevy, Serge; Robinson, Delbert G.; Bilder, Robert M.; Szeszko, Philip R.



Frequency of errors and pathology in panoramic images of young orthodontic patients.  


The aims of this study were to evaluate the frequency of errors in panoramic radiographs in young orthodontic patients, to register pathologic and abnormal conditions, and to compare these findings with the patient's record. A total of 1287 panoramic radiographs of children and adolescents (530 boys and 757 girls; mean age 14.2 years) were analyzed. The radiographs were obtained of patients referred for orthodontic treatment during a 1 year period. Four observers evaluated the radiographs for 10 common errors, pathologies, and/or anomalies. Cohen's kappa was used for the calculations of inter- and intraobserver variability. Five of the errors were divided into clinically relevant or not clinically relevant errors, i.e. errors influencing diagnosis. Only those pathological findings with a possible influence on orthodontic treatment were compared with the patient's record. Of the 1287 radiographs, 96 per cent had errors. The number of errors in each image varied between 1 and 5, and in 24 per cent of these images, the errors could be of importance for clinical decision making. The most common error was that the tongue was not in contact with the hard palate. Pathologies or anomalies were found in 558 patients and a total of 1221 findings were recorded. Findings of possible relevance for orthodontic treatment were 63, and 12 of those were registered in the patient records. Pathological findings outside the dental arches were low and could be an argument for minimizing the radiation field. PMID:21511820

Granlund, Christina M; Lith, Agneta; Molander, Björn; Gröndahl, Kerstin; Hansen, Ken; Ekestubbe, Annika



Susceptibility-weighted imaging in patient with consciousness disturbance after traffic accident.  


Both diffuse axonal injury (DAI) and fat embolism syndrome could be the cause of altered consciousness in patients who suffered from traffic accident. In some situations, distinguishing DAI from fat embolism syndrome may be difficult because routine brain imaging could not detect the lesions. Susceptibility weighted imaging is sensitive to detect petechial hemorrhages in cerebral fat embolism and DAI. The areas most vulnerable to DAI are the cerebral gray-white matter junction, splenium of the corpus callosum, and dorsolateral brainstem. However, cerebral and cerebellar white matter and splenium of corpus callosum are the areas most vulnerable to cerebral fat embolism. In additional to history, clinical manifestation, and prognosis, evaluating the distribution of hypointense lesions in susceptibility-weighted imaging could be useful to differentiate these 2 conditions. PMID:22560099

Huang, Ling-Chun; Wu, Meng-Ni; Chen, Chun-Hung; Huang, Poyin



Tissue Doppler imaging and tissue strain imaging for the evaluation of hepatic fibrosis in patients with chronic hepatitis B.  


We studied the feasibility of evaluating the stages of liver fibrosis with tissue Doppler imaging (TDI) and tissue strain imaging (TSI) for patients with chronic hepatitis B virus infection. One hundred ten patients were divided into two groups: normal adult group (n = 38) and chronic liver disease group (n = 72, patients infected with HBVs). The chronic liver disease group was divided into three subgroups on the basis of the Scheuer scoring system and clinical evidence: mild fibrosis (S0 and S1, n = 11), moderate fibrosis (S2 and S3, n = 27) and cirrhosis (S4 and clinically typical cirrhosis, n = 34) groups. TDI was performed for a chosen oblique section. Four regions of interest (ROIs), A-D, were chosen in the hepatic parenchyma based on the direction of propagation from the heart to the liver. Strain rate curves were obtained on the basis of TDI and TSI findings. Strain peak rates (SPRs) of all ROIs and the differences in times to SPRs for the four ROIs (TA-B, TB-C and TC-D) in the hepatic parenchyma were measured with TDI and TSI. Strain rate curves were analyzed for each ROI. The strain rate curves for the normal adult group were synchronous, whereas those for the chronic liver disease group were asynchronous. SPRs of the ROIs gradually decreased with the progression of liver fibrosis. The SPRs of ROI B significantly correlated with chronic liver disease severity (r = 0.991, p < 0.05). Areas under the curve (AUCs) of the ROI A and ROI B SPRs at the moderate fibrosis and cirrhosis stages were 0.86 ± 0.06, 0.81 ± 0.56 and 0.90 ± 0.65, 0.92 ± 0.04, respectively. The AUC of the SPRs of ROIs A and B correlated better than the platelet/age/phosphatase/?-fetoprotein/aspartate aminotransferase (PAPAS) index for advanced fibrosis. The differences in time to SPRs among the peaks of the four ROIs (TA-B, TB-C and TC-D) gradually increased with the progression of liver fibrosis. TDI and TSI with quantitative measurements using tissue Doppler analysis software (TDIQ, GE Medical Systems, Horten, Norway) provided reliable information for evaluating non-invasive liver fibrosis in patients with chronic hepatitis B. PMID:23791352

Wang, Ying; Wu, Zhifeng; Ju, Yan; Cao, Li; Shi, Lin; Tong, Fa; Jiang, Xuan; Zhu, Changren



Preoperative localization of a parathyroid adenoma with Tc-99m sestamibi imaging in a patient with concomitant nontoxic multinodular goiter.  


Preoperative localization of parathyroid adenomas is useful in patients undergoing parathyroidectomy. The authors report a patient with hyperparathyroidism and an associated nontoxic nodular goiter. Technetium-99m sestamibi scintigraphy localized and differentiated the parathyroid adenoma from the multinodular goiter. Excellent correlation was found between preoperative radionuclide imaging and surgical pathology. Technetium-99m sestamibi parathyroid imaging may be a simple and helpful test in the surgical management of parathyroid adenomas, particularly in patients with nontoxic multinodular goiter. PMID:7895432

Zuback, J; Patel, K A; Guzman, R; Thakur, N; Zonszein, J



Inflammation assessment in patients with arthritis using a novel in vivo fluorescence optical imaging technology  

PubMed Central

Background Indocyanine green (ICG)-enhanced fluorescence optical imaging (FOI) is an established technology for imaging of inflammation in animal models. In experimental models of arthritis, FOI findings corresponded to histologically proven synovitis. This is the first comparative study of FOI with other imaging modalities in humans with arthritis. Methods 252 FOI examinations (Xiralite system, mivenion GmbH, Berlin, Germany; ICG bolus of 0.1 mg/kg/body weight, sequence of 360 images, one image per second) were compared with clinical examination (CE), ultrasonography (US) and MRI of patients with arthritis of the hands. Results In an FOI sequence, three phases could be distinguished (P1–P3). With MRI as reference, FOI had a sensitivity of 76% and a specificity of 54%, while the specificity of phase 1 was 94%. FOI had agreement rates up to 88% versus CE, 64% versus greyscale US, 88% versus power Doppler US and 83% versus MRI, depending on the compared phase and parameter. FOI showed a higher rate of positive results compared to CE, US and MRI. In individual patients, FOI correlated significantly (p<0.05) with disease activity (Disease Activity Score 28, r=0.41), US (r=0.40) and RAMRIS (Rheumatoid Arthritis MRI Score) (r=0.56). FOI was normal in 97.8% of joints of controls. Conclusion ICG-enhanced FOI is a new technology offering sensitive imaging detection of inflammatory changes in subjects with arthritis. FOI was more sensitive than CE and had good agreement with CE, US in power Doppler mode and MRI, while showing more positive results than these. An adequate interpretation of an FOI sequence requires a separate evaluation of all phases. For the detection of synovitis and tenosynovitis, FOI appears to be as informative as 1.5 T MRI and US.

Werner, Stephanie G; Langer, Hans-Eckhard; Ohrndorf, Sarah; Bahner, Malte; Schott, Peter; Schwenke, Carsten; Schirner, Michael; Bastian, Hans; Lind-Albrecht, Gudrun; Kurtz, Bernward; Burmester, Gerd R; Backhaus, Marina



Expanding Clinical Empathy: An Activist Perspective  

PubMed Central

ABTRACT BACKGROUND Discussions of empathy in health care offer important ways of enabling communication and interpersonal connection that are therapeutic for the patient and satisfying for the physician. While the best of these discussions offer valuable insights into the patient-physician relationship, many of them lack an action component for alleviating the patient’s suffering and emphasize the physician’s experience of empathy rather than the patient’s experience of illness. METHODS By examining educational methods, such as reflective writing exercises and the study of literary texts, and by analyzing theoretical approaches to empathy and suggestions for clinical practice, this article considers how to mindfully keep the focus on what the patient is going through. CONCLUSION Clinical empathy can be improved by strategies that address (1) the patient’s authority in providing first-person accounts of illness and disability, (2) expanding the concept of empathy to include an action component geared toward relieving patients’ suffering, and (3) the potential value of extending empathy to include the social context of illness.



Measurement of patient imaging dose for real-time kilovoltage x-ray intra-fraction tumour position monitoring in prostate patients  

PubMed Central

The dose for image-based motion monitoring of prostate tumours during radiotherapy delivery has not been established. This study aimed to provide quantitative analysis and optimisation of the fluoroscopic patient imaging dose during radiotherapy for IMRT and VMAT treatments using standard and hypofractionated treatment schedules. Twenty-two patients with type T1c N0/M0 prostate cancer and three implanted fiducial markers were considered. Minimum field sizes encompassing all fiducial markers plus a 7.5mm motion margin were determined for each treatment beam, each patient and the complete cohort. Imaging doses were measured for different field sizes and depths in a phantom at 75kV and 120kV. Based on these measurements, the patient imaging doses were then estimated according to beam-on time for clinical settings. The population minimum field size was 5.3 × 6.1cm2, yielding doses of 406mGy and 185mGy over the course of an IMRT treatment for 75kV (10 mAs) and 120kV (1.04 mAs) imaging, respectively at 1Hz. The imaging dose was reduced by an average of 28% and 32% by adopting patient specific and treatment-beam specific field sizes respectively. Standard fractionation VMAT imaging doses were 37% lower than IMRT doses over a complete treatment. Hypofractionated IMRT SBRT and VMAT SBRT imaging doses were 58% and 76% lower than IMRT doses respectively. The patient dose for kilovoltage intrafraction monitoring of the prostate was quantified. Tailoring imaging field sizes to specific patients yielded a significant reduction in the imaging dose, as did adoption of faster treatment modalities such as VMAT.

Crocker, James K; Ng, Jin Aun; Keall, Paul J; Booth, Jeremy T



Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients  

SciTech Connect

Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico 'Dr. Federico Gomez.' We measured the entrance surface air kerma (K{sub P}) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.

Hernandez, M. R.; Gamboa-deBuen, I. [Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, A.P. 70-543, Mexico 04510 DF (Mexico); Dies, P. [Hospital Infantil de Mexico 'Dr. Federico Gomez', Dr.Marquez 162, Mexico 06720 DF (Mexico); Rickards, J.; Ruiz, C. [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, A.P. 20-364, Mexico 01000 DF (Mexico)



Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients  

NASA Astrophysics Data System (ADS)

Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de México ``Dr. Federico Gómez.'' We measured the entrance surface air kerma (KP) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level.

Hernández, M. R.; Dies, P.; Gamboa-Debuen, I.; Rickards, J.; Ruiz, C.



Glaucoma Tube Imaging Using Anterior Segment Optical Coherence Tomography in Patients With Opaque Cornea.  


PURPOSE:: Anterior segment optical coherence tomography (AS-OCT) was used to diagnose Ahmed tube tip patency in patients with opaque corneas after corneal transplantation and tube shortening. MATERIALS AND METHODS:: Noncomparative observational case series: 3 consecutive patients with nonvisualized tubes and uncontrolled intraocular pressure after corneal transplantation underwent AS-OCT to determine tube tip patency. RESULTS:: In each case, AS-OCT allowed for imaging of the tube position, wall passage, and osteum patency that could not be visualized on gonioscopy. Two of 3 tubes were found to be nonpatent. CONCLUSIONS:: High-resolution noncontact cross-sectional AS-OCT images provide information on tube position and patency in the presence of opaque media after corneal transplantation, assisting with clinical decision-making. PMID:22668979

Kiddee, Weerawat; Trope, Graham E



Phase image evaluation of patients with ventricular pre-excitation syndromes.  


To localize bypass pathways, left and right ventricular regions were analyzed at rest by phase image analysis in 18 patients with ventricular pre-excitation syndromes. These were compared with image findings in 18 normal subjects. In each of 17 patients with pre-excitation, the site localized on electrophysiologic study correlated closely with the region of earliest ventricular phase angle. This site could be objectively separated from that in normal subjects in each of eight patients with an active left-sided pathway and in both patients with a right-sided pathway. Those with a septal pathway revealed earliest septal phase angle, but could not be separated from normal subjects. In the eight patients with an active left bypass tract, the onset, upstroke and peak of the left ventricular phase histogram preceded those of the right ventricular histogram. Those with a left-sided pathway demonstrated a mean left ventricular phase angle, a difference between mean left and mean right ventricular phase angle and a difference between earliest left and right ventricular phase angles which was significantly less than that in normal subjects (p less than 0.05). These variables presented characteristic converse changes in those with a right-sided pathway. Sequential phase changes in 10 studies suggested "fusion" of normal septal with lateral bypass fronts. Electrocardiographic and electrophysiologic localization of the bypass pathway agreed in only 8 of 14 patients with a recognized delta wave. The phase image represents a new, noninvasive method of evaluating ventricular pre-excitation. The method may provide useful information complementary to that of electrocardiographic and electrophysiologic analysis. PMID:6693651

Botvinick, E; Frais, M; O'Connell, W; Faulkner, D; Scheinman, M; Morady, F; Sung, R; Shosa, D; Dae, M



24 CFR 3285.502 - Expanding rooms.  

Code of Federal Regulations, 2010 CFR

...2009-04-01 2009-04-01 false Expanding rooms. 3285.502 Section 3285...STANDARDS Optional Features § 3285.502 Expanding rooms. The support and anchoring systems for expanding rooms must be installed in accordance...



24 CFR 3285.502 - Expanding rooms.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Expanding rooms. 3285.502 Section 3285...STANDARDS Optional Features § 3285.502 Expanding rooms. The support and anchoring systems for expanding rooms must be installed in accordance...



24 CFR 3285.502 - Expanding rooms.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Expanding rooms. 3285.502 Section 3285...STANDARDS Optional Features § 3285.502 Expanding rooms. The support and anchoring systems for expanding rooms must be installed in accordance...



Evaluation of intraoperative optical imaging analysis methods by phantom and patient measurements.  


Intraoperative optical imaging (IOI) is a localization method for functional areas of the human brain cortex during neurosurgical procedures. The aim of the current work was to develop of a new analysis technique for the computation of two-dimensional IOI activity maps that is suited especially for use in clinical routine. The new analysis technique includes a stimulation scheme that comprises 30-s rest and 30-s stimulation conditions, in connection with pixelwise spectral power analysis for activity map calculation. A software phantom was used for verification of the implemented algorithms as well as for the comparison with the commonly used relative difference imaging method. Furthermore, the analysis technique was tested using intraoperative measurements on eight patients. The comparison with the relative difference algorithm revealed an averaged improvement of the signal-to-noise ratio between 95% and 130% for activity maps computed from intraoperatively acquired patient datasets. The results show that the new imaging technique improves the activity map quality of IOI especially under difficult intraoperative imaging conditions and is therefore especially suited for use in clinical routine. PMID:23729532

Oelschlägel, Martin; Meyer, Tobias; Wahl, Hannes; Sobottka, Stephan B; Kirsch, Matthias; Schackert, Gabriele; Morgenstern, Ute



Simultaneous Bilateral Magnetic Resonance Imaging of the Femoral Arteries in Peripheral Arterial Disease Patients  

PubMed Central

Purpose To image the femoral arteries in peripheral arterial disease (PAD) patients using a bilateral receive coil. Materials and Methods An eight-channel surface coil array for bilateral MRI of the femoral arteries at 3T was constructed and evaluated. Results The bilateral array enabled imaging of a 25-cm segment of the superficial femoral arteries (SFA) from the profunda to the popliteal. The array provided improved the signal-to-noise ratio (SNR) at the periphery and similar SNR in the middle of a phantom compared to three other commercially available coils (4-channel torso, quadrature head, whole body). Multicontrast bilateral images of the in vivo SFA with 1 mm inplane resolution made it possible to directly compare lesions in the index SFA to the corresponding anatomical site in the contralateral vessel without repositioning the patient or coil. A set of bilateral time-of-flight, T1-weighted, T2-weighted, and proton density-weighted images was acquired in a clinically acceptable exam time of ?45 minutes. Conclusion The developed bilateral coil is well suited for monitoring dimensional changes in atherosclerotic lesions of the SFA.

Brown, Ryan; Karmonik, Christof; Brunner, Gerd; Lumsden, Alan; Ballantyne, Christie; Johnson, Shawna; Wang, Yi; Morrisett, Joel



Accuracy of an automatic patient-positioning system based on the correlation of two edge images in radiotherapy.  


We have clinically evaluated the accuracy of an automatic patient-positioning system based on the image correlation of two edge images in radiotherapy. Ninety-six head & neck images from eight patients undergoing proton therapy were compared with a digitally reconstructed radiograph (DRR) of planning CT. Two edge images, a reference image and a test image, were extracted by applying a Canny edge detector algorithm to a DRR and a 2D X-ray image, respectively, of each patient before positioning. In a simulation using a humanoid phantom, performed to verify the effectiveness of the proposed method, no registration errors were observed for given ranges of rotation, pitch, and translation in the x, y, and z directions. For real patients, however, there were discrepancies between the automatic positioning method and manual positioning by physicians or technicians. Using edged head coronal- and sagittal-view images, the average differences in registration between these two methods for the x, y, and z directions were 0.11 cm, 0.09 cm and 0.11 cm, respectively, whereas the maximum discrepancies were 0.34 cm, 0.38 cm, and 0.50 cm, respectively. For rotation and pitch, the average registration errors were 0.95° and 1.00°, respectively, and the maximum errors were 3.6° and 2.3°, respectively. The proposed automatic patient-positioning system based on edge image comparison was relatively accurate for head and neck patients. However, image deformation during treatment may render the automatic method less accurate, since the test image many differ significantly from the reference image. PMID:20127267

Yoon, Myonggeun; Cheong, Minho; Kim, Jinsung; Shin, Dong Ho; Park, Sung Yong; Lee, Se Byeong



Feasibility of sentinel lymph node biopsy in breast cancer patients clinically suspected of axillary lymph node metastasis on preoperative imaging  

PubMed Central

Background Generally, sentinel lymph node biopsy (SLNB) is performed in patients with clinically negative axillary lymph node (LN). This study was to assess imaging techniques in axillary LN staging and to evaluate the feasibility of SLNB in patients clinically suspected of axillary LN metastasis on preoperative imaging techniques (SI). Methods A prospectively maintained database of 767 breast cancer patients enrolled between January 2006 and December 2009 was reviewed. All patients were offered preoperative breast ultrasound, magnetic resonance imaging, and positron emission tomography scanning. SI patients were regarded as those for whom preoperative imaging was “suspicious for axillary LN metastasis” and NSI as “non-suspicious for axillary LN metastasis” on preoperative imaging techniques. Patients were subgrouped by presence of SI and types of axillary operation, and analyzed. Results For 323 patients who received SLNB, there was no statistically significant difference in axillary recurrence (P=0.119) between SI and NSI groups. There also was no significant difference in axillary recurrence between SLNB and axillary lymph node dissection (ALND) groups in 356 SI patients (P=0.420). The presence of axillary LN metastasis on preoperative imaging carried 82.1% sensitivity and 45.9% specificity for determining axillary LN metastasis on the final pathology. Conclusions SLNB in SI patents is safe and feasible. Complications might be avoided by not performing ALND. Therefore, we recommend SLNB, instead of a direct ALND, even in SI patients, for interpreting the exact nodal status and avoiding unnecessary morbidity by performing ALND.



Dipyridamole thallium imaging may not be a reliable screening test for coronary artery disease in patients undergoing vascular surgery  

SciTech Connect

Dipyridamole thallium imaging has been proposed for cardiac risk stratification in patients undergoing peripheral vascular surgery. The purpose of this study was to define the benefit of this investigation in routine preoperative evaluation of these patients. The outcome of 86 patients undergoing vascular surgery procedures was examined in light of preoperative clinical assessment and dipyridamole SPECT thallium imaging (DST). Fifty-one patients (59%) were considered at high risk on clinical grounds, and 22 patients (26%) had perfusion defects. Ten patients suffered a perioperative coronary event, including unstable angina, myocardial infarction, or cardiac death. Seven of the patients with such events were among the 51 clinically high-risk subjects (14%). Three perioperative events occurred in the group of 19 patients with positive DST images who underwent surgery (16%), but the DST test failed to identify 7 patients who suffered coronary events. The frequency of abnormal thallium imaging was similar to the prevalence of angiographically significant coronary disease reported previously at this center, but considerably less than the rate of abnormal thallium imaging in past studies of vascular surgery patients. The application of the test to a low to moderate risk population is probably responsible for its lower predictive accuracy for coronary events. DST is not an ideal routine noninvasive technique for risk stratification in patients undergoing vascular surgery.

Marwick, T.H.; Underwood, D.A. (Cleveland Clinic Foundation, OH (USA))



Myocardial perfusion defect on thallium-201 imaging in patients with chronic obstructive pulmonary disease  

SciTech Connect

Six patients with angina pectoris had reversible perfusion defects on stress and redistribution thallium imaging. Three patients had a positive electrocardiographic response to exercise. No significant coronary artery lesions were seen on coronary arteriography in any of the six patients. All had mild to moderate hypoxemia at rest and physiologic evidence of chronic obstructive pulmonary disease as defined by the decrease in the ratio of forced expiratory volume at 1 second to forced vital capacity (FEV1/FVC X 100) or decrease in the forced midexpiratory flow rate (FEF25-75), or both. None had clinical findings suggestive of any of the reported causes of positive thallium scans in patients with normal coronary arteriograms. Cellular dysfunction produced by hypoxemia affecting the uptake of thallium seems to be the most likely mechanism of this abnormality.

Mehrotra, P.P.; Weaver, Y.J.; Higginbotham, E.A.



Positron Emission Tomography Imaging of Risperidone Augmentation in Serotonin Reuptake Inhibitor-Refractory Patients  

Microsoft Academic Search

We studied 15 nondepressed patients with obsessive-compulsive disorder (OCD) who were nonresponders to serotonin reuptake inhibitors with an additive trial of risperidone. Positron emission tomography with 18F-deoxyglucose and magnetic resonance imaging was obtained at baseline and following 8 weeks of either risperidone or placebo in a double-blind parallel group design. Risperidone treatment was associated with significant increases in relative metabolic

Monte S. Buchsbaum; Eric Hollander; Stefano Pallanti; Nicolò Baldini Rossi; Jimcy Platholi; Randall Newmark; Rachel Bloom; Erica Sood



The Concept of Body Image Disturbance in Anorexia Nervosa: An Empirical Inquiry Utilizing Patients' Subjective Experiences  

Microsoft Academic Search

We explored the concept body image disturbance (BID) by utilizing the subjective experience of 32 women (aged 20–39 years) diagnosed with AN (DSM-V). Using methods from Grounded Theory we identified four phenotypes of BID—“Integration,” “Denial,” “Dissociation,” and “Delusion”—which differed according to whether the patients overestimated their own body size (“Subjective reality”), and whether they acknowledged the objective truth that they

Ester M. S. Espeset; Ragnfrid H. S. Nordbø; Kjersti S. Gulliksen; Finn Skårderud; Josie Geller; Arne Holte



Clinical safety of magnetic resonance imaging in patients with implanted SynchroMed EL infusion pumps  

Microsoft Academic Search

Introduction  Patients with implanted SynchroMed spinal infusion pumps (Medtronic, Inc., Minneapolis, MN) routinely undergo magnetic resonance\\u000a imaging at our institution. In August 2008, Medtronic issued an urgent medical device correction report regarding several\\u000a pumps. Because of the rare potential “for a delay in the return of proper drug infusion” and “for a delay in the logging of\\u000a motor stall events,” “a

Felix E. Diehn; Christopher P. Wood; Robert E. Watson Jr; William D. Mauck; Michelle M. Burke; Christopher H. Hunt



Molecular imaging in patients with mood disorders: a review of PET findings  

Microsoft Academic Search

Mood disorders are chronic, recurrent psychiatric disorders with high morbidity rates that cause severe disability. Researchers\\u000a have used molecular imaging extensively in studies of mood disorders. In this article, we concisely and selectively review\\u000a the major findings of positron emission tomography studies of patients with mood disorders. Specifically, we describe findings\\u000a from cerebral blood flow, cerebral glucose\\/oxygen metabolism, and radioligand

Qiaozhen Chen; Weibo Liu; Huichun Li; Hong Zhang; Mei Tian



Regionally Specific Neuronal Pathology in Untreated Patients with Schizophrenia: A Proton Magnetic Resonance Spectroscopic Imaging Study  

Microsoft Academic Search

Background: Proton magnetic resonance spectroscopic imaging (1H-MRSI) studies have reported reductions of N-acetyl aspartate (NAA), a marker of neuronal integrity, in the hippocampal region (HIPPO) and dorsolateral prefrontal cortex (DLPFC) of pharmacologically treated patients with schizophrenia. The purpose of the present study was twofold: to exclude drug treatment as a source of the previous findings and to examine NAA relative

Alessandro Bertolino; Joseph H. Callicott; Igor Elman; Venkata S. Mattay; Gioacchino Tedeschi; Joseph A. Frank; Alan Breier; Daniel R. Weinberger



Body-image, self-concept and mental exposure in patients with pectus excavatum  

Microsoft Academic Search

Background  Pectus excavatum is the most common congenital anomaly of the sternum and anterior chest wall, which occurs about 3–4 times\\u000a more often in boys than girls [1]. Although most patients do not report physical symptoms as cardiovascular and respiratory problems, they show a loss of\\u000a self-esteem and a poor self-image. There exist very rare data about psychological state before the

Barbara HadoltA; A. Wallisch; J. W. Egger; M. E. Höllwarth



Cognitive functions correlate with diffusion tensor imaging metrics in patients with spina bifida cystica  

Microsoft Academic Search

Purpose  Spina bifida cystica (SBC) is a group of neurodevelopmental defects caused by improper neural tube closure, which may be responsible\\u000a for deficits in cognitive functions. The purpose of this study was to examine changes in normal appearing deep gray and white\\u000a matter brain regions in SBC patients compared with controls through diffusion tensor imaging (DTI) and correlate these changes\\u000a with

Manoj Kumar; Arti Srivastava; Shruti Agarwal; Sanjay Behari; Gyanendra K. Malik; Ram K. S. Rathore; Rakesh K. Gupta



Cerebral Aneurysms: A Patient-Specific and Image-Based Management Pipeline  

Microsoft Academic Search

\\u000a This work presents an image- and biomechanics-based data processing pipeline able to build patient-specific models of cerebral\\u000a aneurysms. The pipeline also contemplates the virtual modeling and release of endovascular devices such as stents and coils.\\u000a As a result of the morphological, morphodynamic, hemodynamic and structural analyses, a set of complex descriptors relevant\\u000a for aneurysm’s diagnosis and prognosis is derived. On

M. C. Villa-Uriol; I. Larrabide; J. M. Pozo; M. Kim; M. Craene; O. Camara; C. Zhang; A. J. Geers; H. Bogunovi?; H. Morales; A. F. Frangi


Effectiveness of cosmetic rehabilitation on the body image of oral cancer patients in Taiwan  

Microsoft Academic Search

Goals of the work  Oral tumors and their treatment cause obvious changes in disfigurement and functions of cancer patients. Therefore, some kind\\u000a of strategy to improve personal appearance is important in nursing care. This prospective study intended to verify the effects\\u000a of a cosmetic rehabilitation program on the body image of oral cancer patients.\\u000a \\u000a \\u000a \\u000a Materials and methods  A single-blind quasi-experimental design with

Sharen Huang; Hsueh-Erh Liu



MR imaging-guided cryoablation of metastatic brain tumours: initial experience in six patients  

Microsoft Academic Search

Objective  The objective was to evaluate the initial experience and safety of magnetic resonance imaging (MRI)-guided transcranial cryoablation\\u000a in cystic metastatic brain tumours.\\u000a \\u000a \\u000a \\u000a Material and methods  Seven cystic metastatic brain tumours in six patients were treated with cryoablation. The approval from the local ethics committee\\u000a and individual patient consent were acquired before the study. Before the procedure the tumours were detected with

Chengli Li; Lebin Wu; Jiqing Song; Ming Liu; Yubo Lv; Roberto Blanco Sequeiros



Correlation between blink reflex abnormalities and magnetic resonance imaging findings in patients with multiple sclerosis.  


This study investigates the correlation between brain magnetic resonance imaging findings and blink reflex abnormalities in patients with relapsing remitting multiple sclerosis. Twenty-six patients and 17 healthy subjects were included in this study. Blink reflex test (BRT) results were obtained using right and left stimulations; thus, 52 BRT results were recorded for the patient group, and 34 BRT results were recorded for the control group. The magnetic resonance imaging (MRI) findings were classified based on the existence of brainstem lesions (hyperintense lesion on T2 weighted (W) and fast fluid-attenuated inversion recovery MRI or contrast-enhancing lesion on T1W MRI). Correlation analysis was performed for the BRT and MRI findings. The percentage of individuals with abnormal BRT results (including R1 latency, ipsilateral R2 latency, and contralateral R2 latency) was significantly higher in the patient group as compared to the control group (p values: 0.015, 0.001, and 0.002, respectively). Correlation analysis revealed significant correlations between contralateral R2 latency abnormalities and brainstem lesions (p value: 0.011). Our results showed significant correlation correlations between contralateral R2 latency abnormalities and brainstem lesions and these results may be explained the effects of multiple demyelinating lesions of the brain stem of patients with relapsing remitting multiple sclerosis. PMID:23358960

Degirmenci, Eylem; Erdogan, Cagdas; Bir, Levent Sinan



Increased Diffusivity in Superior Temporal Gyrus in Patients with Schizophrenia: A Diffusion Tensor Imaging Study  

PubMed Central

Background Superior temporal gyrus (STG) volume reduction is one of the most consistent findings in schizophrenia. The goal of this study was to conduct the first diffusion tensor imaging (DTI) study to investigate altered structural integrity in STG gray and white matter in patients with chronic schizophrenia compared with healthy controls. Methods Magnetic resonance imaging (MRI) and DTI were acquired in 21 male patients with schizophrenia and 22 age-, handedness-, and parental social economic status-matched male comparison subjects. After manual segmentation of gray and white matter, mean diffusivity and fractional anisotropy were measured within STG. Correlational analyses were also conducted to test possible associations between DTI and clinical measures, including positive and negative symptoms of schizophrenia. Results Compared with controls, patients demonstrated reduced volume, bilaterally, in STG gray matter but not in white matter. For DTI measures, patients showed increased mean diffusivity, bilaterally, in STG gray matter, and in left-sided STG white matter. In addition, mean diffusivity in left-sided STG white matter showed statistically significant correlations with auditory hallucinations and attentional impairments in patients. Conclusions These findings suggest a disruption of tissue integrity in STG gray and white matter in schizophrenia. In addition, increased water diffusivity in left-side STG, which was associated with auditory hallucinations and attentional impairments, suggests the possibility of a disconnection among auditory/language processing regions in schizophrenia.

Lee, KangUk; Yoshida, Takeshi; Kubicki, Marek; Bouix, Sylvain; Westin, Carl-Fredrik; Kindlmann, Gordon; Niznikiewicz, Margaret; Cohen, Adam; McCarley, Robert W.; Shenton, Martha E.



Blurring in patients with temporal lobe epilepsy: clinical, high-field imaging and ultrastructural study.  


Magnetic resonance imaging-positive temporal lobe atrophy with temporo-polar grey/white matter abnormalities (usually called 'blurring') has been frequently reported in patients with temporal lobe epilepsy associated with hippocampal sclerosis. The poor distinction of grey and white matter has been attributed to various causes, including developmental cortical abnormalities, gliosis, myelin alterations, a non-specific increase in temporal lobe water content and metabolic/perfusion alterations. However, there is still no consensus regarding the genesis of these abnormalities and no histopathological proof for a structural nature of magnetic resonance imaging changes. The aim of this study was to investigate the pathological substrate of temporo-polar blurring using different methodological approaches and evaluate the possible clinical significance of the abnormalities. The study involved 32 consecutive patients with medically intractable temporal lobe epilepsy and hippocampal sclerosis who underwent surgery after a comprehensive electroclinical and imaging evaluation. They were divided into two groups on the basis of the presence/absence of temporo-polar blurring. Surgical specimens were examined neuropathologically, and selected samples from both groups underwent high-field 7?T magnetic resonance imaging and ultrastructural studies. At the clinical level, the two groups were significantly different in terms of age at epilepsy onset (earlier in the patients with blurring) and epilepsy duration (longer in the patients with blurring). Blurring was also associated with lower neuropsychological test scores, with a significant relationship to abstract reasoning. On 7?T magnetic resonance image examination, the borders between the grey and white matter were clear in all of the samples, but only those with blurring showed a dishomogeneous signal in the white matter, with patchy areas of hyperintensity mainly in the depth of the white matter. Sections from the patients with blurring that were processed for myelin staining revealed dishomogeneous staining of the white matter, which was confirmed by analyses of the corresponding semi-thin sections. Ultrastructural examinations revealed the presence of axonal degeneration and a significant reduction in the number of axons in the patients with blurring; there were no vascular alterations in either group. These data obtained using different methodological approaches provide robust evidence that temporo-polar blurring is caused by the degeneration of fibre bundles and suggest slowly evolving chronic degeneration with the redistribution of the remaining fibres. The article also discusses the correlations between the morphological findings and clinical data. PMID:22734123

Garbelli, Rita; Milesi, Gloria; Medici, Valentina; Villani, Flavio; Didato, Giuseppe; Deleo, Francesco; D'Incerti, Ludovico; Morbin, Michela; Mazzoleni, Giulia; Giovagnoli, Anna Rita; Parente, Annalisa; Zucca, Ileana; Mastropietro, Alfonso; Spreafico, Roberto



Preoperative Diffusion-Weighted Imaging of Single Brain Metastases Correlates with Patient Survival Times  

PubMed Central

Background MRI-based diffusion-weighted imaging (DWI) visualizes the local differences in water diffusion in vivo. The prognostic value of DWI signal intensities on the source images and apparent diffusion coefficient (ADC) maps respectively has not yet been studied in brain metastases (BM). Methods We included into this retrospective analysis all patients operated for single BM at our institution between 2002 and 2010, in whom presurgical DWI and BM tissue samples were available. We recorded relevant clinical data, assessed DWI signal intensity and apparent diffusion coefficient (ADC) values and performed histopathological analysis of BM tissues. Statistical analyses including uni- and multivariate survival analyses were performed. Results 65 patients (34 female, 31 male) with a median overall survival time (OS) of 15 months (range 0–99 months) were available for this study. 19 (29.2%) patients presented with hyper-, 3 (4.6%) with iso-, and 43 (66.2%) with hypointense DWI. ADCmean values could be determined in 32 (49.2%) patients, ranged from 456.4 to 1691.8*10?6 mm2/s (median 969.5) and showed a highly significant correlation with DWI signal intensity. DWI hyperintensity correlated significantly with high amount of interstitial reticulin deposition. In univariate analysis, patients with hyperintense DWI (5 months) and low ADCmean values (7 months) had significantly worse OS than patients with iso/hypointense DWI (16 months) and high ADCmean values (30 months), respectively. In multivariate survival analysis, high ADCmean values retained independent statistical significance. Conclusions Preoperative DWI findings strongly and independently correlate with OS in patients operated for single BM and are related to interstitial fibrosis. Inclusion of DWI parameters into established risk stratification scores for BM patients should be considered.

Berghoff, Anna Sophie; Spanberger, Thomas; Ilhan-Mutlu, Aysegul; Magerle, Manuel; Hutterer, Markus; Woehrer, Adelheid; Hackl, Monika; Widhalm, Georg; Dieckmann, Karin; Marosi, Christine; Birner, Peter; Prayer, Daniela; Preusser, Matthias



Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain  

SciTech Connect

The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery disease present in percentages and to assess the need for coronary angiography on a five-point scale (1 . definitely not indicated, 5 . definitely indicated). After obtaining the results of thallium-201 imaging following dipyridamole (0.50 mg/kg intravenously) administration, the physicians were again requested to estimate probability and need for angiography. In the 43 patients with coronary artery disease the judgment of probability was increased significantly after /sup 201/Tl from 75.6 +/- 20.2% to 82.9 +/- 23.2% (p less than 0.001) and the need for angiography from 4.3 +/- 0.9% to 4.5 +/- 0.9% (p less than 0.001). In the subgroup of patients with atypical angina the relative change in probability was higher than in other subgroups of patients with coronary artery disease. In the 17 patients with normal coronary arteries the probability estimation fell after /sup 201/Tl from 36.7 +/- 22.0% to 24.8 +/- 21.0% (p less than 0.001), the need for angiography was decreased from 2.7 +/- 1.1% to 2.2 +/- 1.2% (p less than 0.001). With the /sup 201/Tl information, cardiologists performed a better diagnostic differentiation of patients with and without coronary artery disease than noncardiologists. The study demonstrates the improvement of clinical diagnosis in patients with chest pain by thallium-201 imaging and confirms the favorable influence of the method on the management of the patients in terms of indications for coronary angiography.

Schmoliner, R.; Dudczak, R.; Kronik, G.; Moesslacher, H.; Zangeneh, M.; Pollak, C.; Schurz, B.; Schoberwalter, A.



Analysis of the appropriate age and weight for pediatric patient sedation for magnetic resonance imaging.  


Sedatives with a long duration are required for pediatric magnetic resonance imaging (MRI) in the emergency department. The success rate of chloral hydrate for pediatric sedation is 80% to 100% according to some studies. However, the success rate varies by age, weight, and underlying disease. To identify factors affecting the success rate, we compared the chloral hydrate sedation success rate and adverse event rate by age, weight, and underlying disease. Compared with patients in the failure group, patients in the successful group were younger (23.8 vs 36.9 months, P < .01) and weighed less (11.4 vs 14.4 kg, P < .01). No differences in neurological problems, reasons for MRI, or adverse events were observed between the 2 groups. Patients 18 months old had a success rate greater than 95%, but the success rate decreased in children older than 18 months. The adverse event rate was about 10% in patients 18 months old and increased to 20% in patients older than 36 months. Patients 24 months of age who had a neurological problem (seizure disorder or developmental delay) had a success rate greater than 95%, but the adverse event rate increased after 24 months of age. Chloral hydrate sedation was appropriate for pediatric MRI in patients younger than 18 months. Although we observed no fatal adverse events, it is necessary to monitor patients until full recovery from sedation. PMID:22424999

Lee, Yu Jin; Kim, Do Kyun; Kwak, Young Ho; Kim, Hahn Bom; Park, Jeong Ho; Jung, Jin Hee



Restriction-Spectrum Imaging of Bevacizumab-Related Necrosis in a Patient with GBM  

PubMed Central

Importance: With the increasing use of antiangiogenic agents in the treatment of high-grade gliomas, we are becoming increasingly aware of distinctive imaging findings seen in a subset of patients treated with these agents. Of particular interest is the development of regions of marked and persistent restricted diffusion. We describe a case with histopathologic validation, confirming that this region of restricted diffusion represents necrosis and not viable tumor. Observations: We present a case report of a 52-year-old man with GBM treated with temozolomide, radiation, and concurrent bevacizumab following gross total resection. The patient underwent sequential MRI’s which included restriction-spectrum imaging (RSI), an advanced diffusion-weighted imaging (DWI) technique, and MR perfusion. Following surgery, the patient developed an area of restricted diffusion on RSI which became larger and more confluent over the next several months. Marked signal intensity on RSI and very low cerebral blood volume (CBV) on MR perfusion led us to favor bevacizumab-related necrosis over recurrent tumor. Subsequent histopathologic evaluation confirmed coagulative necrosis. Conclusion and Relevance: Our report increases the number of pathologically proven cases of bevacizumab-related necrosis in the literature from three to four. Furthermore, our case demonstrates this phenomenon on RSI, which has been shown to have good sensitivity to restricted diffusion.

Farid, Nikdokht; Almeida-Freitas, Daniela B.; White, Nathan S.; McDonald, Carrie R.; Muller, Karra A.; VandenBerg, Scott R.; Kesari, Santosh; Dale, Anders M.



Reliability of rehabilitative ultrasound imaging for the medial gastrocnemius muscle in poststroke patients.  


OBJECTIVE: The purpose of this study was to evaluate the suitability of rehabilitative ultrasound imaging for quantification of medial gastrocnemius muscle in poststroke patients. PARTICIPANTS: Thirty stroke patients (15 men and 15 women; age 64·7 ± 5·66 years; stroke duration 437·40 ± 168·24 days) participated in this study. METHODS: Real-time B-mode ultrasonography with a 7·5-MHz linear transducer was used to measure pennation angle and muscle thickness of the medial gastrocnemius muscles with ankle joint 90° and maximal plantar flexion. Two examiners acquired images from all participants during three separate testing sessions. After the first measurement was performed, the second measurement was performed one hour later, and the third measurement was performed 1 week later. Intraclass correlation coefficients (ICCs(3,1) ) were used for estimation of reliability. RESULTS: The ICC (95% CI) for all intra-examiner reliability was good to very good, ranging from 0·69 to 0·99 (0·51-0·99), and the ICC for all interexaminer reliability was good to very good, ranging from 0·70 to 0·99 (0·46-0·99). CONCLUSION: In this study, the intra- and interexaminer reliability of the pennation angle and muscle thickness measurements of the medial gastrocnemius muscle was good to very good. Therefore, we suggest that the pennation angle and muscle thickness measurements of the medial gastrocnemius muscle obtained from rehabilitative ultrasound imaging would be useful for clinical assessment in poststroke patients. PMID:23758734

Cho, Ki Hun; Lee, Hwang Jae; Lee, Wan Hee



Restriction-Spectrum Imaging of Bevacizumab-Related Necrosis in a Patient with GBM.  


Importance: With the increasing use of antiangiogenic agents in the treatment of high-grade gliomas, we are becoming increasingly aware of distinctive imaging findings seen in a subset of patients treated with these agents. Of particular interest is the development of regions of marked and persistent restricted diffusion. We describe a case with histopathologic validation, confirming that this region of restricted diffusion represents necrosis and not viable tumor. Observations: We present a case report of a 52-year-old man with GBM treated with temozolomide, radiation, and concurrent bevacizumab following gross total resection. The patient underwent sequential MRI's which included restriction-spectrum imaging (RSI), an advanced diffusion-weighted imaging (DWI) technique, and MR perfusion. Following surgery, the patient developed an area of restricted diffusion on RSI which became larger and more confluent over the next several months. Marked signal intensity on RSI and very low cerebral blood volume (CBV) on MR perfusion led us to favor bevacizumab-related necrosis over recurrent tumor. Subsequent histopathologic evaluation confirmed coagulative necrosis. Conclusion and Relevance: Our report increases the number of pathologically proven cases of bevacizumab-related necrosis in the literature from three to four. Furthermore, our case demonstrates this phenomenon on RSI, which has been shown to have good sensitivity to restricted diffusion. PMID:24137566

Farid, Nikdokht; Almeida-Freitas, Daniela B; White, Nathan S; McDonald, Carrie R; Muller, Karra A; Vandenberg, Scott R; Kesari, Santosh; Dale, Anders M



Noninvasive imaging of pancreatic islet inflammation in type 1A diabetes patients  

PubMed Central

Type 1A diabetes (T1D) is an autoimmune disease characterized by leukocyte infiltration of the pancreatic islets of Langerhans. A major impediment to advances in understanding, preventing, and curing T1D has been the inability to “see” the disease initiate, progress, or regress, especially during the occult phase. Here, we report the development of a noninvasive method to visualize T1D at the target organ level in patients with active insulitis. Specifically, we visualized islet inflammation, manifest by microvascular changes and monocyte/macrophage recruitment and activation, using magnetic resonance imaging of magnetic nanoparticles (MNPs). As a proof of principle for this approach, imaging of infused ferumoxtran-10 nanoparticles permitted effective visualization of the pancreas and distinction of recent-onset diabetes patients from nondiabetic controls. The observation that MNPs accumulate in the pancreas of T1D patients opens the door to exploiting this noninvasive imaging method to follow T1D progression and monitoring the ability of immunomodulatory agents to clear insulitis.

Gaglia, Jason L.; Guimaraes, Alexander R.; Harisinghani, Mukesh; Turvey, Stuart E.; Jackson, Richard; Benoist, Christophe; Mathis, Diane; Weissleder, Ralph



I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain.  


The conscious sense of our body, or body image, is often taken for granted, but it is disrupted in many clinical states including complex regional pain syndrome and phantom limb pain. Is the same true for chronic back pain? Body image was assessed, via participant drawings, in six patients with chronic back pain and ten healthy controls. Tactile threshold and two-point discrimination threshold (TPD) were assessed in detail. All the patients, and none of the controls, showed disrupted body image of the back. Five patients were unable to clearly delineate the outline of their trunk and stated that they could not "find it". TPD was greatly increased in the same zone as the absence or disruption of body image, but was otherwise similar to controls. The disturbance of body image and decrease in tactile acuity coincided with the normal distribution of pain, although there was no allodynia and there was no relationship between resting pain level and TPD. Tactile threshold was unremarkable for patients and controls. These preliminary data indicate that body image is disrupted, and tactile acuity is decreased, in the area of usual pain, in patients with chronic back pain. This finding raises the possibility that training body image or tactile acuity may help patients in chronic spinal pain, as it has been shown to do in patients with complex regional pain syndrome or phantom limb pain. PMID:18786763

Moseley, G Lorimer




Microsoft Academic Search

Most geotechnical and structural engineers are now aware of the well established and proven use of expanded polystyrene (EPS) geofoam as a lightweight fill material. However much less well known and utilized to date in practice are the many other functional applications of EPS geofoam, most of which cannot be provided by any other geosynthetic product. Therefore greater use of

John S. Horvath



Patient-specific dosimetry of conventional and intensity modulated radiation therapy using a novel full Monte Carlo phase space reconstruction method from electronic portal images  

Microsoft Academic Search

Electronic portal imagers have promising dosimetric applications in external beam radiation therapy. In this study a patient dose computation algorithm based on Monte Carlo (MC) simulations and on portal images is developed and validated. The patient exit fluence from primary photons is obtained from the portal image after correction for scattered radiation. The scattered radiation at the portal imager and


Patient dosimetry for 90Y selective internal radiation treatment based on 90Y PET imaging.  


Until recently, the radiation dose to patients undergoing the 90Y selective internal radiation treatment (SIRT) procedure is determined by applying the partition model to 99mTc MAA pretreatment scan. There can be great uncertainty in radiation dose calculated from this approach and we presented a method to compute the 3D dose distributions resulting from 90Y SIRT based on 90Y positron emission tomography (PET) imaging. Five 90Y SIRT treatments were retrospectively analyzed. After 90Y SIRT, patients had 90Y PET/CT imaging within 6 hours of the procedure. To obtain the 3D dose distribution of the patients, their respective 90Y PET images were convolved with a Monte Carlo generated voxel dose kernel. The sensitivity of the PET/CT scanner for 90Y was determined through phantom studies. The 3D dose distributions were then presented in DICOM RT dose format. By applying the linear quadratic model to the dose data, we derived the biologically effective dose and dose equivalent to 2 Gy/fraction delivery, taking into account the spatial and temporal dose rate variations specific for SIRT. Based on this data, we intend to infer tumor control probability and risk of radiation induced liver injury from SIRT by comparison with established dose limits. For the five cases, the mean dose to target ranged from 51.7 ± 28.6 Gy to 163 ± 53.7 Gy. Due to the inhomogeneous nature of the dose distribution, the GTVs were not covered adequately, leading to very low values of tumor control probability. The mean dose to the normal liver ranged from 21.4 ± 30.7 to 36.7 ± 25.9 Gy. According to QUANTEC recommendation, a patient with primary liver cancer and a patient with metastatic liver cancer has more than 5% risk of radiotherapy-induced liver disease (RILD). PMID:24036875

Ng, Sherry C; Lee, Victor H; Law, Martin W; Liu, Rico K; Ma, Vivian W; Tso, Wai Kuen; Leung, To Wai



Indium 111 platelet imaging for the detection of deep venous thrombosis and pulmonary embolism in patients without symptoms after surgery  

SciTech Connect

Indium 111 platelet imaging for the detection of deep vein thrombosis and pulmonary emboli was performed in 171 patients after abdominal and pelvic surgery. Fifteen patients were found to have inadequate circulating blood pools of indium 111 platelets, making the study nondiagnostic. Of 156 patients with technically satisfactory images, 46 (29.5%) had images consistent with deep venous thrombosis and/or pulmonary emboli. The incidence, time of occurrence, and location of thromboemboli was similar to those of other reports of postoperative patients groups studied by iodine 125 fibrinogen uptake testing. Eighty patients had normal indium 111 platelets and 30 patients had diffusely distributed indium 111 platelets found in the operative field, suggesting accumulation in a postoperative hematoma. None of these results was confused with a diagnosis of deep venous thrombosis. When compared with another accurate diagnostic test in 23 patients, indium 111 platelet imaging was found to have a sensitivity of 100% and specificity of 90%. The technique of indium 111 platelet imaging is performed easily in patients after surgery with some limitations as to the use of donor platelets and the occasionally altered imaging of the operative site. This diagnostic technique enjoys the distinct advantage in that it allows surveillance of the legs, pelvis, abdomen, and chest by a single method, making it a near-ideal method of postoperative thromboembolism surveillance.

Clarke-Pearson, D.L.; Coleman, R.E.; Siegel, R.; Synan, I.S.; Petry, N.



Imaging and Clinical Findings in Patients with Aberrant Course of the Cervical Internal Carotid Arteries  

PubMed Central

Background and Purpose: Aberrrant course of the cervical internal carotid arteries (ICAs) may result in submucosal masses in the posterior pharyngeal wall, may cause confusion at physical examination, may be symptomatic, and can be at risk of surgical injury. The aim of this report is to present the clinical and imaging characteristics associated with aberrant course of the cervical portion of the ICAs. Methods: Imaging studies of 5.500 patients were prospectively selected from CT studies of the head and neck performed in a five years period, in which the course of the one or both ICAs at the level of the hypopharynx and oropharynx was assessed as aberrant by means of a proposed classification. We then reviewed the medical records to establish which symptoms were present and if these symptoms could be caused by these variations in the course of the ICAs. In selected cases, further studies including magnetic resonance (MR) imaging, MR angiography (MRA), or selective catheter angiography were obtained. Results: In our restricted classification, we found 14 (0.2%) patients who met the cervical ICA aberrancy criteria. In all patients contrast enhanced CT or CT angiography was performed, 4 also have had MRI and MRA, and in two additional catheter angiograms were performed. Mean age was 62 years. Eight patients were male and seven were female. Four patients (28%) were considered to have clinical symptoms related to aberrant course of the ICAs. In most of the symptomatic patients both ICAs had aberrant courses. Overall, the course of the right ICA was aberrant in 43%, the left ICA in 14%, and both in 43%. In 50% of the cases the aberrancy of the artery was focal (localized to the oropharynx or laryngopharynx) and in the other 50% it involved the entire cervical course of the ICA. Conclusions: In most of our patients variations in the course of the cervical portion of the ICA involved the right side and were asymptomatic, except with regard to potential surgical risks. However, in about 25% of our patients these variations were thought to be the culprit of patient complaints, particularly oropharyngeal pulsatile sensation. Furthermore, extreme degrees of medialization of the ICAs resulted in progressive symptoms including hoarseness and upper respiratory distress.

Munoz, Alberto; De Vergas, Joaquin; Crespo, Jose



Vector Analysis of Prostate Patient Setup With Image-Guided Radiation Therapy via kV Cone Beam Computed Tomography  

SciTech Connect

Purpose: To analyze the daily setup variations in a cohort of intensity-modulated radiation therapy (IMRT) prostate cancer patients who had received daily image-guided RT without the use of fiducial markers to determine if daily image guidance is necessary. Methods and Materials: 2134 Kilovoltage (kV) cone beam computed tomography (CBCT) images were analyzed, with three shifts recorded for each image. The number of times that the vector of the combined shifts would have exceeded the planning tumor volume (PTV) margin was tallied. Then, the average scalar shift of the first five images was removed from all subsequent images for a given patient, and the number of days for which the shift vector was greater than the three-dimensional clinical tumor volume-PTV (3D CTV-PTV) margin (8 mm, created with rolling ball technique) was recorded. Additionally, the scalar shifts from every other fraction were studied to determine if the individual patient's shift vector would be adequately sampled if CBCT was not performed daily, thus reducing patient imaging dose without compromising treatment quality. Results: There were 297 cases where the vector shift was initially greater than the PTV margin. By correcting each patient's data set by the average shift of their first five images the total was 248 cases. By considering only every other image of each patient data set (after correction for the first 5 days), only 137 days in which the CTV was outside the PTV would have been seen. Conclusions: Daily imaging is recommended for prostate cancer IMRT patients in order to know the 3D (vector) position of the CTV and to ensure that it is always within the PTV margin. Correcting the data set by the average shift from the firs