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1

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

2011-01-01

2

Expanded beam non-imaging fiber optic connector  

DOEpatents

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 collimater 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.

Jannson, Tommasz (Redondo Beach, CA); Jannson, Joanna (Redondo Beach, CA); Yeung, Peter (Redondo Beach, CA)

1990-01-01

3

Expanded beam non-imaging fiber optic connector  

DOEpatents

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.

1990-02-06

4

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

1985-01-01

5

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. PMID:21640303

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

2011-01-01

6

As Patient Navigation Expands and Evolves, Nurses Assume Many Roles  

Cancer.gov

It can be difficult to access care in our labyrinthine health care system. Oncology nurses are joining the ranks of patient navigators—a diverse group of people who help patients at all stages of cancer care, from screening and diagnosis to treatment and survivorship.

7

Type II collagen is a target antigen of clonally expanded T cells in the synovium of patients with rheumatoid arthritis  

Microsoft Academic Search

OBJECTIVETo investigate whether type II collagen (CII) is recognised by oligoclonally expanded synovial T cells of patients with rheumatoid arthritis (RA).METHODSPeripheral blood mononuclear cells (PBMC) from 15 RA patients were stimulated with CII in vitro. T cell clones expanded by such stimulation were compared with the clonally expanded synovial T cells by using T cell receptor (TCR) B chain gene

Taichi Sekine; Tomohiro Kato; Kayo Masuko-Hongo; Hiroshi Nakamura; Shin-ichi Yoshino; Kusuki Nishioka; Kazuhiko Yamamoto

1999-01-01

8

Imaging the back pain patient.  

PubMed

Imaging is an integral part of the clinical examination of the patient with back pain; it is, however, often used excessively and without consideration of the underlying literature. The primary role of imaging is the identification of systemic disease as a cause of the back or limb pain; magnetic resonance imaging (MRI) excels at this. Systemic disease as a cause of back or limb pain is, however, rare. Most back and radiating limb pain is of benign nature, owing to degenerative phenomena. There is no role for imaging in the initial evaluation of the patient with back pain in the absence of signs or symptoms of systemic disease. When conservative care fails, imaging may be undertaken with due consideration of its risks: labeling the patient as suffering from a degenerative disease, cost, radiation exposure, and provoking unwarranted minimally invasive or surgical intervention. Imaging can well depict disc degeneration and disc herniation. Imaging can suggest the presence of discogenic pain, but the lack of a pathoanatomic gold standard obviates any definitive conclusions. The imaging natural history of disc herniation is resolution. There is very poor correlation between imaging findings of disc herniation and the clinical presentation or course. Psychosocial factors predict functional disability due to disc herniation better than imaging. Imaging with MRI, computed tomography (CT), or CT myelography can readily identify central canal, lateral recess, or foraminal compromise. Only when an imaging finding is concordant with the patient's pain pattern or neurologic deficit can causation be considered. The zygapophysial (facet) and sacroiliac joint are thought to be responsible for axial back pain, although with less frequency than the disc. Imaging findings of the structural changes of osteoarthritis do not correlate with pain production. Physiologic imaging, either with single-photon emission CT bone scan, heavily T2-weighted MRI sequences (short-tau inversion recovery), or gadolinium enhancement, can detect inflammation and are more predictive of an axial pain generator. PMID:20977958

Maus, Timothy

2010-11-01

9

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

2003-09-01

10

[The neuropsychological study of 21 patients with expanding cerebral lesions. Preliminary results].  

PubMed

Twenty-one right-handed patients with cerebral expanding space-occupying lesion underwent neuropsychological evaluation before surgery. Testing included the Bender Motor Gestalt Test (BMGT), the Benton Visual Retention Test (BVRT), and four subtests of the Wechsler Adult Intelligence Scale (WAIS), namely Digit span, Digit symbol, Picture completion, and Block design. Statistical analysis showed significant differences in cognitive efficiency between the groups defined by the side and biological behaviour of the lesions. PMID:8721198

Bucciero, A; Malsa, R; Vizioli, L

1995-12-01

11

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, Quiming; Huang, Yinghua; Payne, Matt G.

1992-12-01

12

Patient attitudes regarding the role of the pharmacist and interest in expanded pharmacist services  

PubMed Central

Background: Pharmacists are consistently ranked among the most trusted professionals, and research shows high levels of satisfaction with pharmacist services. Studies have also shown that the public is generally unaware of the full range of roles and responsibilities of a pharmacist. The purpose of this study was to explore the public’s knowledge and attitudes regarding the role of the community pharmacist and to determine their likelihood of using expanded pharmacist services. Methods: Adults across Newfoundland and Labrador were surveyed by telephone. Survey questions addressed how frequently participants visited the pharmacy, understanding of duties undertaken by pharmacists, perceptions and attitudes regarding pharmacists as health care professionals, likelihood of using expanded pharmacist services and participant demographics. Comparisons were made between responses from urban and rural participants and frequent versus nonfrequent pharmacy users, to determine if there were any differences. Results: The majority of participants were generally aware of what pharmacists do when filling prescriptions; those who visited the pharmacy more frequently appeared to be more informed. Participants indicated they would take advantage of the expanded services suggested, with greatest interest in receiving advice for minor ailment management and prescription refills from pharmacists. Results support the prevailing view that pharmacists are trusted health professionals who should have access to patients’ health information to provide best care. Conclusion: The public is aware of aspects of the pharmacist’s role, but opportunities exist to better educate the public on the knowledge, skills and unique professional abilities of pharmacists to support uptake of expanded pharmacist services.

Young, Stephanie; Phillips, Leslie; Clark, Deidre

2014-01-01

13

Expanding neurosurgery.  

PubMed

The history of medicine is replete with innovations in neurosurgery that have spurred further developments across the medical spectrum. Surgeons treating pathologies in the head and spine have broken ground with new approaches, techniques, and technologies since ancient times. Neurosurgeons occupy a vital nexus in patient care, interfacing with the clinical symptoms and signs afflicting patients, the pathology at surgery, and imaging studies. No other physicians occupy this role within the nervous system. This power of observation and the ability to intercede place neurosurgeons in a unique position for impacting disease. Yet despite these pioneering achievements, more recently, forces in the workplace may be challenging neurosurgery's opportunities to contribute to the future growth of the neurosciences and medicine. The authors posit that, in the current health care climate, revenue generation by neurosurgical clinical activity is valued by the system more than neurosurgical research and academic output. Without providing the talented stream of new neurosurgeons with the opportunities and, in fact, the directive to achieve beyond simple financial success, the specialty is missing the opportunity to optimize its progress. The authors contend that the key to remaining relevant with the incorporation of new technologies to the treatment of neurosurgical patients will be to be flexible, open-minded, and nimble with the adaptation of new procedures by training and encouraging neurosurgical residents to pursue new or neglected areas of the specialty. Only by doing so can neurosurgery continue to expand. PMID:25434710

Couldwell, William T; Mortimer, Vance; Kraus, Kristin L

2014-12-01

14

Expanding the use of patient reports about patient-centered care.  

PubMed

In an informative article on the assessment of patient care experiences, Zimlichman, Rozenblum, and Millenson describe the evolving use of surveys that elicit patient reports about medical care experiences in Israel, a trend that parallels developments in the U.S. This commentary summarizes some of experiences in the U.S. that might inform the development of more consistent and extensive strategies for assessing and promoting patient-centered care in Israel.More comprehensive patient experience surveys, the results of which would be publicly available, as Zimlichman and colleagues advocate, would facilitate quality improvements, especially if users are provided with support for the use and interpretation of the data. Developing more efficient survey methods will facilitate the broader use of such surveys, although it is important to use methods that yield results that are as representative of the target population as possible and to account for survey mode effects when data are reported. Although the surveys need to be appropriate for the Israeli context, the use of standard questions used in other countries would facilitate comparisons that could help to identify best practices that can be adopted in different settings. Those who work on assessing patient-centered care in the U.S. look forward to learning from the work of their Israeli colleagues.This is a commentary on http://www.ijhpr.org/content/2/1/35/. PMID:24044702

Cleary, Paul D

2013-01-01

15

Frequent Occurrence of Highly Expanded but Unrelated B-Cell Clones in Patients with Multiple Myeloma  

PubMed Central

Clonal diversity in multiple myeloma (MM) includes both MM-related and MM-unrelated clonal expansions which are subject to dominance exerted by the MM clone. Here we show evidence for the existence of minor but highly expanded unrelated B-cell clones in patients with MM defined by their complementary determining region 3 (CDR3) peak. We further characterize these clones over the disease and subsequent treatment. Second clones were identified by their specific IgH-VDJ sequences that are distinct from those of dominant MM clones. Clonal frequencies were determined through semi-quantitative PCR, quantitative PCR and single-cell polymerase chain reaction of the clone-specific sequence. In 13/74 MM patients, more than one dominant CDR3 peak was identified with 12 patients (16%) being truly biclonal. Second clones had different frequencies, were found in different locations and were found in different cell types from the dominant MM clone. Where analysis was possible, they were shown to have chromosomal characteristic distinct from those of the MM clone. The frequency of the second clone also changed over the course of the disease and often persisted despite treatment. Molecularly-defined second clones are infrequent in monoclonal gammopathy of undetermined significance (MGUS, 1/43 individuals or 2%), suggesting that they may arise at relatively late stages of myelomagenesis. In further support of our findings, biclonal gammopathy and concomitant MM and CLL (chronic lymphocytic leukemia) were confirmed to originate from two unrelated clones. Our data supports the idea that the clone giving rise to symptomatic myeloma exerts clonal dominance to prevent expansion of other clones. MM and second clones may arise from an underlying niche permissive of clonal expansion. The clinical significance of these highly expanded but unrelated clones remains to be confirmed. Overall, our findings add new dimensions to evaluating related and unrelated clonal expansions in MM and the impact of disease evolution and treatment on clonal diversity. PMID:23724106

Kriangkum, Jitra; Motz, Sarah N.; Debes Marun, Carina S.; Lafarge, Sandrine T.; Gibson, Spencer B.; Venner, Christopher P.; Johnston, James B.; Belch, Andrew R.; Pilarski, Linda M.

2013-01-01

16

Frequent occurrence of highly expanded but unrelated B-cell clones in patients with multiple myeloma.  

PubMed

Clonal diversity in multiple myeloma (MM) includes both MM-related and MM-unrelated clonal expansions which are subject to dominance exerted by the MM clone. Here we show evidence for the existence of minor but highly expanded unrelated B-cell clones in patients with MM defined by their complementary determining region 3 (CDR3) peak. We further characterize these clones over the disease and subsequent treatment. Second clones were identified by their specific IgH-VDJ sequences that are distinct from those of dominant MM clones. Clonal frequencies were determined through semi-quantitative PCR, quantitative PCR and single-cell polymerase chain reaction of the clone-specific sequence. In 13/74 MM patients, more than one dominant CDR3 peak was identified with 12 patients (16%) being truly biclonal. Second clones had different frequencies, were found in different locations and were found in different cell types from the dominant MM clone. Where analysis was possible, they were shown to have chromosomal characteristic distinct from those of the MM clone. The frequency of the second clone also changed over the course of the disease and often persisted despite treatment. Molecularly-defined second clones are infrequent in monoclonal gammopathy of undetermined significance (MGUS, 1/43 individuals or 2%), suggesting that they may arise at relatively late stages of myelomagenesis. In further support of our findings, biclonal gammopathy and concomitant MM and CLL (chronic lymphocytic leukemia) were confirmed to originate from two unrelated clones. Our data supports the idea that the clone giving rise to symptomatic myeloma exerts clonal dominance to prevent expansion of other clones. MM and second clones may arise from an underlying niche permissive of clonal expansion. The clinical significance of these highly expanded but unrelated clones remains to be confirmed. Overall, our findings add new dimensions to evaluating related and unrelated clonal expansions in MM and the impact of disease evolution and treatment on clonal diversity. PMID:23724106

Kriangkum, Jitra; Motz, Sarah N; Debes Marun, Carina S; Lafarge, Sandrine T; Gibson, Spencer B; Venner, Christopher P; Johnston, James B; Belch, Andrew R; Pilarski, Linda M

2013-01-01

17

Investigation of the Near-Field Acoustic and Flow Properties of Imperfectly Expanded Supersonic Jets using Particle Image Velocimetry  

Microsoft Academic Search

The flow fields of imperfectly Expanded Supersonic Jets from conical CD nozzles are investigated by Particle Image Velocimetry. This nozzle geometry represents the exhaust nozzles on high-performance military engines. The results are compared with shadowgraph to bring out the details of the highly accelerated regions where seed particles may lag behind the flow, viz. the shocks and Prandtl-Meyer fans. Nozzles

Ephraim Gutmark; David Munday; Junhui Liu; K. Kailasanath

2008-01-01

18

Development of a bent Laue beam-expanding double-crystal monochromator for biomedical X-ray imaging  

PubMed Central

The Biomedical Imaging and Therapy (BMIT) beamline at the Canadian Light Source has produced some excellent biological imaging data. However, the disadvantage of a small vertical beam limits its usability in some applications. Micro-computed tomography (micro-CT) imaging requires multiple scans to produce a full projection, and certain dynamic imaging experiments are not possible. A larger vertical beam is desirable. It was cost-prohibitive to build a longer beamline that would have produced a large vertical beam. Instead, it was proposed to develop a beam expander that would create a beam appearing to originate at a source much farther away. This was accomplished using a bent Laue double-crystal monochromator in a non-dispersive divergent geometry. The design and implementation of this beam expander is presented along with results from the micro-CT and dynamic imaging tests conducted with this beam. Flux (photons per unit area per unit time) has been measured and found to be comparable with the existing flat Bragg double-crystal monochromator in use at BMIT. This increase in overall photon count is due to the enhanced bandwidth of the bent Laue configuration. Whilst the expanded beam quality is suitable for dynamic imaging and micro-CT, further work is required to improve its phase and coherence properties. PMID:24763635

Martinson, Mercedes; Samadi, Nazanin; Belev, George; Bassey, Bassey; Lewis, Rob; Aulakh, Gurpreet; Chapman, Dean

2014-01-01

19

Imaging obese patients: problems and solutions.  

PubMed

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

2013-08-01

20

A randomized trial of thermal ablative therapy versus expandable metal stents in the palliative treatment of patients with esophageal carcinoma  

Microsoft Academic Search

Background: Expandable metal stent insertion and thermal tumor ablation (TTA) both improve dysphagia in patients with advanced esophageal cancer, but no direct comparison study of their efficacy on health-related quality of life has been published. The aim of this study was to compare survival, relief of dysphagia, quality of life, and cost in patients treated by thermal ablation or stent

Helen J. Dallal; Graeme D. Smith; Douglas C. Grieve; Subrata Ghosh; Ian D. Penman; Kelvin R. Palmer

2001-01-01

21

Anti leukemia effect of ex vivo expanded DNT cells from AML patients: a potential novel autologous T cell adoptive immunotherapy  

PubMed Central

CD3+CD56?, CD4 and CD8 double negative T (DNT) cells comprise 1–3% of peripheral blood mononuclear cells. Their role in tumor immunity remains largely unknown due to their limited numbers and lack of effective methods to expand them. Here we developed a novel protocol by which DNT cells can be expanded ex vivo to therapeutic levels in 2 weeks from 13 of 16 acute myeloid leukemia (AML) patients during chemotherapy-induced complete remission. The expanded DNT cells expressed similar or higher levels of IFN-? and TNF-?, and Granzyme B as that seen in bulk activated CD8 T cells from the same patient but significantly higher levels of perforin. The expanded DNT cells could effectively kill both allogeneic and autologous primary CD34+ leukemic blasts isolated from peripheral blood of AML patients in a perforin-dependant manner. These results demonstrate, for the first time, that DNT cells from AML patients can be expanded ex vivo even after intensive chemotherapy, and are effective at killing both allogeneic and autologous primary leukemic blasts. These findings warrant studies further exploring the potential of DNT cells as a novel adjuvant immunotherapy to decrease the risk of relapse in patients with AML and, perhaps other cancers. PMID:21566657

Merims, Sharon; Li, Xujian; Joe, Betty; Dokouhaki, Pouneh; Han, Mei; Childs, Richard W.; Wang, Zhen-yi; Gupta, Vikas; Minden, Mark D.; Zhang, Li

2014-01-01

22

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.

1987-07-01

23

Type II collagen is a target antigen of clonally expanded T cells in the synovium of patients with rheumatoid arthritis  

PubMed Central

OBJECTIVE—To investigate whether type II collagen (CII) is recognised by oligoclonally expanded synovial T cells of patients with rheumatoid arthritis (RA).?METHODS—Peripheral blood mononuclear cells (PBMC) from 15 RA patients were stimulated with CII in vitro. T cell clones expanded by such stimulation were compared with the clonally expanded synovial T cells by using T cell receptor (TCR) B chain gene specific reverse transcription-polymerase chain reaction and subsequent single strand conformation polymorphism analyses.?RESULTS—Stimulation of the heterogeneous peripheral T cells with CII induced clonal expansion of T cells. In three of 15 patients, a proportion of these clones (approximately 17% to 25%) was found to be identical to expanded T cell clones in the synovium in vivo.?CONCLUSION—T cell clones that had TCR CDR3 sequences identical to those induced by purified CII were found in a proportion of RA patients. This finding suggests that CII is recognised by T cells that accumulate clonally in RA joints. Oligoclonal T cell expansion in RA joints is probably driven, at least in part, by intra-articular components such as CII.?? PMID:10381490

Sekine, T.; Kato, T.; Masuko-Hongo, K.; Nakamura, H.; Yoshino, S.; Nishioka, K.; Yamamoto, K.

1999-01-01

24

Endoscopic palliation of malignant gastric outlet obstruction using self-expanding metal stents: experience in 36 patients  

Microsoft Academic Search

OBJECTIVE:Malignant gastric outlet obstruction is seen in the setting of a variety of cancers, most commonly pancreatic. Self-expanding metal stents can be used to palliate these patients and restore the ability to eat.METHODS:We reviewed the Mayo Clinic experience in the endoscopic treatment of malignant gastric outlet obstruction. Thirty-six patients (26 male, 10 female) were treated between October, 1998 and January,

Douglas G Adler; Todd H Baron

2002-01-01

25

Cardiothoracic imaging in the pregnant patient.  

PubMed

Cardiovascular imaging during pregnancy poses a unique challenge to clinicians in differentiating between physiological changes mimicking pathology and true pathologic conditions, as well as for radiologists in terms of image quality. This review article will focus on 3 goals: first, to familiarize radiologists with safety issues related to imaging pregnant women using computed tomography and magnetic resonance imaging; second, to review the current, evidence-based recommendations for radiology topics unique and common to pregnant and lactating patients; and third, to provide practical algorithms to minimize risk and increase safety for both the pregnant woman and the fetus. PMID:24361975

Litmanovich, Diana E; Tack, Dennis; Lee, Karen S; Shahrzad, Maryam; Bankier, Alexander A

2014-01-01

26

An Adolescent Patient with Coarctation of Aorta Treated with Self-Expandable Nitinol Stent  

PubMed Central

Transcatheter treatment of aortic coarctation, with balloon angioplasty or stent implantation, is now an acceptable alternative to surgical repair. However these procedures may result in complications, such as vascular wall injury and re-stenosis of the lesion. A nitinol self-expandable stent, when deployed at the coarctation site, produces low constant radial force, which may result in a gradual widening of the stenotic lesion leaving less tissue injury ('stretching rather than tearing'). For an adolescent with a native aortic coarctation, a self-expandable stent of 20 mm diameter was inserted at the discrete stenotic lesion of 5 mm diameter without previous balloon dilatation procedure. No further balloon dilatation was done immediately after the stent insertion. With the self-expandable stent only, the stenosis of the lesion was partially relieved immediately after the stent deployment. Over several months after the stent insertion, gradual further widening of the stent waist to an acceptable dimension was observed. PMID:23613702

Song, Jin Young; Lee, Sang Yun; Baek, Jae Suk; Jang, So Ick; Kim, Seong Ho; Kim, Yang Min

2013-01-01

27

An adolescent patient with coarctation of aorta treated with self-expandable nitinol stent.  

PubMed

Transcatheter treatment of aortic coarctation, with balloon angioplasty or stent implantation, is now an acceptable alternative to surgical repair. However these procedures may result in complications, such as vascular wall injury and re-stenosis of the lesion. A nitinol self-expandable stent, when deployed at the coarctation site, produces low constant radial force, which may result in a gradual widening of the stenotic lesion leaving less tissue injury ('stretching rather than tearing'). For an adolescent with a native aortic coarctation, a self-expandable stent of 20 mm diameter was inserted at the discrete stenotic lesion of 5 mm diameter without previous balloon dilatation procedure. No further balloon dilatation was done immediately after the stent insertion. With the self-expandable stent only, the stenosis of the lesion was partially relieved immediately after the stent deployment. Over several months after the stent insertion, gradual further widening of the stent waist to an acceptable dimension was observed. PMID:23613702

Shim, Woo Sup; Song, Jin Young; Lee, Sang Yun; Baek, Jae Suk; Jang, So Ick; Kim, Seong Ho; Kim, Yang Min

2013-03-01

28

Low light imaging system with? Expanding spectrum band for digital camera  

Microsoft Academic Search

This paper presents the camera system for increasing sensitivity especially in the low light condition. The camera system consists of two parts. The one is the unique image sensor structure which includes special pixels with broad band spectrum response (White+Near IR) and the other is image processing algorithm which fuses color and White+Near IR (WNIR) information to produce high sensitivity

Byung Kwan Park; Sang-Wook Han; Wonhee Choe; JaeGuyn Lim; Youngjin Yoo; SeongDeok Lee

2012-01-01

29

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;)

2011-05-25

30

HLA-haploidentical bone marrow transplantation with posttransplant cyclophosphamide expands the donor pool for patients with sickle cell disease  

PubMed Central

Allogeneic marrow transplantation can cure sickle cell disease; however, HLA-matched donors are difficult to find, and the toxicities of myeloablative conditioning are prohibitive for most adults with this disease. We developed a nonmyeloablative bone marrow transplantation platform using related, including HLA-haploidentical, donors for patients with sickle cell disease. The regimen consisted of antithymocyte globulin, fludarabine, cyclophosphamide, and total body irradiation, and graft-versus-host disease prophylaxis with posttransplantation high-dose cyclophosphamide, mycophenolate mofetil, and tacrolimus or sirolimus. After screening 19 patients, we transplanted 17, 14 from HLA-haploidentical and 3 from HLA-matched related donors. Eleven patients engrafted durably. With a median follow-up of 711 days (minimal follow up 224 days), 10 patients are asymptomatic, and 6 patients are off immunosupression. Only 1 patient developed skin-only acute graft-versus-host disease that resolved without any therapy; no mortality was seen. Nonmyeloablative conditioning with posttransplantation high-dose cyclophosphamide expands the donor pool, making marrow transplantation feasible for most patients with sickle cell disease, and is associated with a low risk of complications, even with haploidentical related donors. Graft failure, 43% in haploidentical pairs, remains a major obstacle but may be acceptable in a fraction of patients if the majority can be cured without serious toxicities. PMID:22955919

Fuchs, Ephraim J.; Luznik, Leo; Lanzkron, Sophie M.; Gamper, Christopher J.; Jones, Richard J.; Brodsky, Robert A.

2012-01-01

31

Investigation of the Near-Field Acoustic and Flow Properties of Imperfectly Expanded Supersonic Jets using Particle Image Velocimetry  

NASA Astrophysics Data System (ADS)

The flow fields of imperfectly Expanded Supersonic Jets from conical CD nozzles are investigated by Particle Image Velocimetry. This nozzle geometry represents the exhaust nozzles on high-performance military engines. The results are compared with shadowgraph to bring out the details of the highly accelerated regions where seed particles may lag behind the flow, viz. the shocks and Prandtl-Meyer fans. Nozzles with three area ratios are examined over a wide range of under- and over-expanded conditions as well as the design conditions for each nozzle. It is found that this type of nozzle is not shock free at the design condition due to the sharp change of the geometry in the throat area. Both near-field and far-field acoustic measurements are presented. Flow-field and near-field acoustic measurements are compared with Numerical simulations in the accompanying presentation by Liu, Kailasanath and Ramamurti. The distributions of the centerline static pressure and noise spectra are in good agreement with the corresponding experimental data.

Gutmark, Ephraim; Munday, David; Liu, Junhui; Kailasanath, K.

2008-11-01

32

Geodetic Imaging: Expanding the Boundaries of Geodesy in the 21st Century  

NASA Astrophysics Data System (ADS)

High resolution (sub-meter) geodetic images covering tens to thousands of square kilometers have extended the boundaries of geodesy into related areas of the earth sciences, such as geomorphology and geodynamics, during the past decade, to archaeological exploration and site mapping during the past few years, and are now poised to transform studies of flora and fauna in the more remote regions of the world. Geodetic images produced from airborne laser scanning (ALS), a.k.a. airborne light detection and ranging (LiDAR) have proven transformative to the modern practice of geomorphology where researchers have used decimeter resolution digital elevation models (DEMs) to determine the spatial frequencies of evenly spaced features in terrain, and developed models and mathematical equations to explain how the terrain evolved to its present state and how it is expected to change in the future (Perron et al., 2009). In geodynamics researchers have used ';before' and ';after' geodetic images of the terrain near earthquakes, such as the 2010 El Mayor-Cucapah Earthquake, to quantify surface displacements and suggest models to explain the observed deformations (Oskin et. al., 2012). In archaeology, the ability of ALS to produce ';bare earth' DEMs of terrain covered with dense vegetation, including even tropical rain forests, has revolutionized the study of archaeology in highly forested areas, finding ancient structures and human modifications of landscapes not discovered by archaeologists working at sites for decades (Chase et al., 2011 & Evans et al., 2013), and finding previously unknown ruins in areas that ground exploration has not been able to penetrate since the arrival of the conquistadors in the new world in the 17th century (Carter et al., 2012). The improved spatial resolution and ability of the third generation ALS units to obtain high resolution bare earth DEMs and canopy models in areas covered in dense forests, brush, and even shallow water (steams, lakes, and coastal waters) is just beginning to attract the attention of researchers studying such plant life as marsh vegetation and sea grasses, and the habitats of animals as diverse as fish, migratory birds, and lions (Vierling et al., 2008). From thousands and thousands of survey markers covering large regions of the earth common to geodesy a half century ago, the focus of some geodesist has changed to billions and billions of points covering landscapes, which are enabling them to redefine and extend the limits of geodesy in the 21st century. References: Carter, W. E. et al., (2012), 'Geodetic Imaging: A New Tool for Mesoamerican Archaeology,' Eos, Trans. American Geophysical Union, Vol. 93, No. 42, pages 413-415. Chase, A. F. et al., (2010) 'Airborne LiDAR, archaeology, and the ancient Maya landscape at Caracol, Belize,' Journal Of Archaeological Science, vol. 38, no. 2, p. 387-398. Evans, D. H. et al., (2013), 'Uncovering archaeological landscapes at Angkor using lidar.' PNAS. Oskin, M. E. et al., (2012), 'Near-Field Deformation from the El Mayor-Cucapah Earthquake Revealed by Differential LIDAR,' Science. Vol. 335 no.6069, pp. 702-705. Perron, J. Taylor, et al (2009), 'Formation of evenly spaced ridges and valleys,' Nature, Vol. 460/23. Vierling, K. T. et al., (2008),'Lidar: shedding new light on habitat characterization and modeling,' Front Ecol Environ 2008, 6(2): 90-98.

Fernandez Diaz, J. C.; Carter, W. E.; Shrestha, R. L.; Glennie, C. L.

2013-12-01

33

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

1994-02-01

34

Genetically-Encoded Yellow Fluorescent cAMP Indicator with an Expanded Dynamic Range for Dual-Color Imaging  

PubMed Central

Cyclic AMP is a ubiquitous second messenger, which mediates many cellular responses mainly initiated by activation of cell surface receptors. Various Förster resonance energy transfer-based ratiometric cAMP indicators have been created for monitoring the spatial and temporal dynamics of cAMP at the single-cell level. However, single fluorescent protein-based cAMP indicators have been poorly developed, with improvement required for dynamic range and brightness. Based on our previous yellow fluorescent protein-based cAMP indicator, Flamindo, we developed an improved yellow fluorescent cAMP indicator named Flamindo2. Flamindo2 has a 2-fold expanded dynamic range and 8-fold increased brightness compared with Flamindo by optimization of linker peptides in the vicinity of the chromophore. We found that fluorescence intensity of Flamindo2 was decreased to 25% in response to cAMP. Live-cell cAMP imaging of the cytosol and nucleus in COS7 cells using Flamindo2 and nlsFlamindo2, respectively, showed that forskolin elevated cAMP levels in each compartment with different kinetics. Furthermore, dual-color imaging of cAMP and Ca2+ with Flamindo2 and a red fluorescent Ca2+ indicator, R-GECO, showed that cAMP and Ca2+ elevation were induced by noradrenaline in single HeLa cells. Our study shows that Flamindo2, which is feasible for multi-color imaging with other intracellular signaling molecules, is useful and is an alternative tool for live-cell imaging of intracellular cAMP dynamics. PMID:24959857

Odaka, Haruki; Arai, Satoshi; Inoue, Takafumi; Kitaguchi, Tetsuya

2014-01-01

35

Four-Year Treatment Outcomes of Adult Patients Enrolled in Mozambique's Rapidly Expanding Antiretroviral Therapy Program  

Microsoft Academic Search

BackgroundIn Mozambique during 2004–2007 numbers of adult patients (?15 years old) enrolled on antiretroviral therapy (ART) increased about 16-fold, from <5,000 to 79,500. All ART patients were eligible for co-trimoxazole. ART program outcomes, and determinants of outcomes, have not yet been reported.Methodology\\/Principal FindingsIn a retrospective cohort study, we investigated rates of mortality, attrition (death, loss to follow-up, or treatment cessation),

Andrew F. Auld; Francisco Mbofana; Ray W. Shiraishi; Mauro Sanchez; Charity Alfredo; Lisa J. Nelson; Tedd Ellerbrock; Rupert Kaul

2011-01-01

36

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

PubMed

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

2012-07-15

37

Balloon-Expandable Stent Placement in Patients with Immediate Reocclusion after Initial Successful Thrombolysis of Acute middle Cerebral Arterial Obstruction  

PubMed Central

Summary We present the results of our approach for treating 12 consecutive cases of acute middle cerebral artery (MCA) stroke by performing balloon-expandable stent (BES) placement after immediate reocclusion due to the underlying stenosis after intra-arterial thrombolysis (IAT). We retrospectively reviewed the clinical outcomes of 12 patients with acute MCA stroke who underwent recanalization by BES placement in an underlying stenosis after IAT. The time to treatment, urokinase dose, duration of the procedure, recanalization rates and symptomatic hemorrhage were analyzed. Clinical outcome measures were assessed on admission and at discharge (the National Institutes of Health stroke scores [NIHSS]) as well as three months after treatment (modified Rankin scales [mRS]). The median NIHSS score on admission was 8.6. Four patients received IV rtPA. The median time from symptom onset to IAT was 236 minutes and the median duration of IAT was 62 minutes. The median dose of urokinase was 140,000 units. Initial recanalization after stent deployment (thrombolysis in cerebral ischemia attack grade of II or III) was achieved in all patients. Two patients died in the hospital due to aspiration pneumonia during medical management. In two patients, in-stent reocclusion occurred within 48 hours after stent deployment. At discharge, the median NIHSS score in ten patients (including the patients with reobstruction) was 2.4. The three-month outcome was excellent (mRS, 0-1) in eight patients. In this study, BES deployment was safe and effective in patients with an immediately reoccluded MCA after successful IAT. PMID:22440605

Lee, H.K.; Kwak, H.S.; Chung, G.H.; Hwang, S.B.

2012-01-01

38

Designing the Expanded Programme on Immunisation (EPI) as a service: Prioritising patients over administrative logic.  

PubMed

Expanded Programme on Immunisation (EPI) vaccination rates remain well below herd immunity in regions of many countries despite huge international resources devoted to both financing and access. We draw upon service marketing theory, organisational sociology, development anthropology and cultural consumer research to conduct an ethnographic study of vaccination delivery in Jimma Zone, Ethiopia - one such region. We find that Western public health sector policies are dominated by an administrative logic. Critical failures in delivery are produced by a system that obfuscates the on-the-ground problems that mothers face in trying to vaccinate their children, while instead prioritising administrative processes. Our ethnographic analysis of 83 mothers who had not vaccinated their children reveals key barriers to vaccination from a 'customer' perspective. While mothers value vaccination, it is a 'low involvement' good compared to the acute daily needs of a subsistence life. The costs imposed by poor service - such as uncaring staff with class hostilities, unpredictable and missed schedules and long waits - are too much and so they forego the service. Our service design framework illuminates specific service problems from the mother's perspective and points towards simple service innovations that could improve vaccination rates in regions that have poor uptake. PMID:25363481

McKnight, Jacob; Holt, Douglas B

2014-12-01

39

Sems (self expanding metal stents) in a patient with esophagogastric cancer and esophagorespiratory fistula (ERF).  

PubMed

Esophagorespiratory fistulas, especially in the upper third of the esophagus, are a complication of malignant esophageal tumors, whose management is difficult and prognosis is poor. Treatment is palliative and involves restoration of the ability to ingest food and prevention of aspiration by insertion of esophageal or tracheobronchial stents. In selected patients the insertion of a single stent may be insufficient for pallation therefore the placement of parallel stents may be indicated in patients with symptoms caused by malignant esophagorespiratory fistula. A case of esophagorespiratory fistula managed with insertion of parallel stents is presented. PMID:16999371

Montesano, Marilena; Crucitti, Pierfilippo; Pandolfi, Monica; Zanca, Annie; Gabbrielli, Armando; Coppola, Roberto

2006-01-01

40

Expanding the spectrum of megalencephalic leukoencephalopathy with subcortical cysts in two patients with GLIALCAM mutations.  

PubMed

Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a heterogeneous neurodegenerative leukodystrophy caused by recessive mutations in MLC1 or GLIALCAM (types MLC1 and MLC2A) of by dominant mutations in GLIALCAM (MLC2B). GlialCAM functions as an auxiliary subunit of both MLC1 and ClC-2 chloride channel, increasing and modifying the function of the latter. Dominant mutations in GLIALCAM cause transient features of MLC but lacks clinical deterioration. Most recessive and dominant mutations in GLIALCAM studied so far affect the targeting of GlialCAM and its associated subunits. Here, we have investigated two patients with MLC2. The first patient has MLC2B disease, as shown by the improvement in MRI and clinical parameters. In this case, we identified a novel GLIALCAM mutation (p.Q56P) which affected the localization of GlialCAM and its associated subunits, however activating ClC-2 function as the wild-type protein. The second patient has MLC2A disease, as indicated by the lack of clinical improvement, even though, interestingly, the MRI of this patient shows a partial improvement. In this case, we found a recessive mode of inheritance, as the patient harbors two compound heterozygous mutations in GLIALCAM. One of them introduces a stop codon (p.Q56X), whereas the second mutation is a missense mutation (p.R73W), for which we could not identify any trafficking defect or an altered functional effect on ClC-2 in vitro. PMID:24202401

Arnedo, Tanit; Aiello, Chiara; Jeworutzki, Elena; Dentici, Maria Lisa; Uziel, Graziella; Simonati, Alessandro; Pusch, Michael; Bertini, Enrico; Estévez, Raúl

2014-03-01

41

Expanding the clinical phenotype of patients with a ZDHHC9 mutation.  

PubMed

In 2007, 250 families with X-linked intellectual disability (XLID) were screened for mutations in genes on the X-chromosome, and in 4 of these families, mutations in the ZDHHC9 gene were identified. The ID was either isolated or associated with a marfanoid habitus. ZDHHC9 encodes a palmitoyl transferase that catalyzes the posttranslational modification of NRAS and HRAS. Since this first description, no additional patient with a ZDHHC9 mutation has been reported in the literature. Here, we describe a large family in which we identified a novel pathogenic ZDHHC9 nonsense mutation (p.Arg298*) by parallel sequencing of all X-chromosome exons. The mutation cosegregated with the clinical phenotype in this family. An 18-year-old patient and his 40-year-old maternal uncle were evaluated. Clinical examination showed normal growth parameters, lingual fasciculation, limited extension of the elbows and metacarpophalangeal joints, and acrocyanosis. There was neither facial dysmorphism nor marfanoid habitus. Brain MRI detected a dysplastic corpus callosum. Neuropsychological testing showed mild intellectual disability. They both displayed generalized anxiety disorder, and the younger patient also suffered from significant behavior impairment that required attention or treatment. Speech evaluation detected satisfactory spoken language since both were able to provide information and to understand conversations of everyday life. Occupational therapy examination showed impaired visual-spatial and visual-motor performance with poor drawing/graphic skills. These manifestations are not specific enough to guide ZDHHC9 screening in patients with ID, and emphasize the value of next generation sequencing for making a molecular diagnosis and genetic counseling in families with XLID. PMID:24357419

Masurel-Paulet, Alice; Kalscheuer, Vera M; Lebrun, Nicolas; Hu, Hao; Levy, Fabienne; Thauvin-Robinet, Christel; Darmency-Stamboul, Véronique; El Chehadeh, Salima; Thevenon, Julien; Chancenotte, Sophie; Ruffier-Bourdet, Marie; Bonnet, Marlène; Pinoit, Jean-Michel; Huet, Frédéric; Desportes, Vincent; Chelly, Jamel; Faivre, Laurence

2014-03-01

42

Prospectively versus retrospectively ECG-gated 256-slice coronary CT angiography: image quality and radiation dose over expanded heart rates.  

PubMed

To compare image quality and radiation dose estimates for coronary computed tomography angiography (CCTA) obtained with a prospectively gated transaxial (PGT) CT technique and a retrospectively gated helical (RGH) CT technique using a 256-slice multidetector CT (MDCT) scanner and establish an upper limit of heart rate to achieve reliable diagnostic image quality using PGT. 200 patients (135 males, 65 females) with suspected coronary artery disease (CAD) underwent CCTA on a 256-slice MDCT scanner. The PGT patients were enrolled prospectively from January to June, 2009. For each PGT patient, we found the paired ones in retrospective-gating patients database and randomly selected one patient in these match cases and built up the RGH group. Image quality for all coronary segments was assessed and compared between the two groups using a 4-point scale (1: non-diagnostic; 4: excellent). Effective radiation doses were also compared. The average heart rate ± standard deviation (HR ± SD) between the two groups was not significantly different (PGT: 64.6 ± 12.9 bpm, range 45-97 bpm; RGH: 66.7 ± 10.9 bpm, range 48-97 bpm, P = 0.22). A receiver-operating characteristic (ROC) analysis determined a cutoff HR of 75 bpm up to which diagnostic image quality could be achieved using the PGT technique (P < 0.001). There were no significant differences in assessable coronary segments between the two groups for HR ? 75 bpm (PGT: 99.9% [961 of 962 segments]; RGH: 99.8% [1038 of 1040 segments]; P = 1.0). At HR > 75 bpm, the performance of the PGT technique was affected, resulting in a moderate reduction of percentage assessable coronary segments using this approach (PGT: 95.5% [323 of 338 segments]; RGH: 98.5% [261 of 265 segments]; P = 0.04). The mean estimated effective radiation dose for the PGT group was 3.0 ± 0.7 mSv, representing reduction of 73% compared to that of the RGH group (11.1 ± 1.6 mSv) (P < 0.001). Prospectively-gated axial coronary computed tomography using a 256-slice multidetector CT scanner with a 270 ms tube rotation time enables a significant reduction in effective radiation dose while simultaneously providing image quality comparable to the retrospectively gated helical technique. Our experience demonstrates the applicability of this technique over a wider range of heart rates (up to 75 bpm) than previously reported. PMID:21153709

Hou, Yang; Yue, Yong; Guo, Wenli; Feng, Guoqiang; Yu, Tao; Li, Guangwei; Vembar, Mani; Olszewski, Mark E; Guo, Qiyong

2012-01-01

43

Patient-centered medical home initiatives expanded in 2009-13: providers, patients, and payment incentives increased.  

PubMed

Patient-centered medical home initiatives are central to many efforts to reform the US health care delivery system. To better understand the extent and nature of these initiatives, in 2013 we performed a nationwide cross-sectional survey of initiatives that included payment reform incentives in their models, and we compared the results to those of a similar survey we conducted in 2009. We found that the number of initiatives featuring payment reform incentives had increased from 26 in 2009 to 114 in 2013. The number of patients covered by these initiatives had increased from nearly five million to almost twenty-one million. We also found that the proportion of time-limited initiatives-those with a planned end date-was 20 percent in 2013, a decrease from 77 percent in 2009. Finally, we found that the dominant payment model for patient-centered medical homes remained fee-for-service payments augmented by per member per month payments and pay-for-performance bonuses. However, those payments and bonuses were higher in 2013 than they were in 2009, and the use of shared-savings models was greater. The patient-centered medical home model is likely to continue both to become more common and to play an important role in delivery system reform. PMID:25288429

Edwards, Samuel T; Bitton, Asaf; Hong, Johan; Landon, Bruce E

2014-10-01

44

The Self-Expanding Symetis Acurate Does Not Increase Cerebral Microembolic Load When Compared to the Balloon-Expandable Edwards Sapien Prosthesis: A Transcranial Doppler Study in Patients Undergoing Transapical Aortic Valve Implantation  

PubMed Central

Objectives The aim of this study was to quantify potential differences in count, frequency and pattern of high-intensity transient signals (HITS) during transapical transcatheter aortic valve implantation (TA-TAVI), by comparing the Symetis Acurate TA (SA) with the balloon-expandable Edwards Sapien XT (ES) system. Background Recently, the Symetis Acurate TA revalving system has been introduced for TA-TAVI. The Symetis Acurate TA aortic bioprosthesis is self-expanding and is deployed by a specific two-step implantation technique. Whether this novel method increases the load of intraprocedural emboli, detected by transcranial Doppler ultrasound (TCD) as HITS, or not is not clear. Methods Twenty-two patients (n?=?11 in each study arm, median logistic EuroScore 20%, median STS score 7%) displayed continuous TCD signals of good quality throughout the entire TA-TAVI procedure and were included in the final analysis. Data are presented as median with interquartile ranges. Results No significant differences were detected in total procedural or interval-related HITS load (SA: 303 [200; 594], ES: 499 [285; 941]; p?=?0.16). With both devices, HITS peaked during prosthesis deployment (PD), whereas significantly fewer HITS occurred during instrumentation (SA: p?=?0.002; ES: <0.001) or post-implantation PI (SA: p?=?0.007; ES: <0.001). PD-associated HITS amounted to almost half of the total HITS load. One patient suffered new disabling stroke at 30 days. Thirty-day mortality amounted to 13.6% (3 of 22 patients). Conclusions Simplified transapical delivery using the self-expanding SA device does not increase HITS, despite of a two-step deployment technique with more interactions with the native aortic valve, when compared to the balloon-expandable ES valve. The similarity in HITS count, frequency and pattern with the two systems suggests a common mechanism for the release of cerebral microemboli. PMID:25289688

Erdoes, Gabor; Huber, Christoph; Basciani, Reto; Stortecky, Stefan; Windecker, Stephan; Wenaweser, Peter; Carrel, Thierry; Eberle, Balthasar

2014-01-01

45

Long-Term Quality-of-Life Assessment following One-Stage Immediate Breast Reconstruction Using Biodimensional Expander Implants: The Patient?s Perspective  

Microsoft Academic Search

Background: Biodimensional devices may provide a superior breast form when an implant is considered for immediate breast reconstruction for breast cancer. The authors prospectively report patient perception of outcome using a per- manentanatomicalexpanderimplantfollowingaplannedone-stageprocedure. Methods: The Quality of Life Questionnaire BR-23 was modified to measure body image perception, physical effects, cancer worry, and surgical choice. Responses were classified into four categories.

Gerald P. H. Gui; Geeta Kadayaprath; Su-Ming Tan; Eleni C. Faliakou; Christina Choy; Ann Ward

2008-01-01

46

Imaging informatics for consumer health: towards a radiology patient portal  

PubMed Central

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

2013-01-01

47

Body image concerns of reconstructive surgery patients: an underrecognized problem.  

PubMed

This study assessed the body image concerns of reconstructive plastic surgery patients. Forty-three reconstructive surgery patients completed two measures of body image. Responses were compared with a group of patients seeking cosmetic procedures. The two groups did not differ in the degree of dissatisfaction with their overall appearance or dissatisfaction with the specific feature for which they were seeking surgery. Reconstructive patients did consider themselves less healthy and less invested in their appearance than did cosmetic patients. Seven of the reconstructive surgery patients (all scar revision patients) reported a level of dissatisfaction and preoccupation consistent with the psychiatric diagnostic of body dysmorphic disorder. These results underscore the importance of screening for body image dissatisfaction in persons with an objective deformity. Plastic surgeons are in an optimal position to identify body image concerns in these patients and provide appropriate referrals for psychotherapy. PMID:9555996

Sarwer, D B; Whitaker, L A; Pertschuk, M J; Wadden, T A

1998-04-01

48

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.

2002-05-01

49

Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients  

PubMed Central

In the article entitled “Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients: A Joint Statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery”, we are proposing a simple, pragmatic approach that will allow the reader to develop an optimal imaging algorithm for stroke patients at their institution. PMID:23948676

Wintermark, Max; Sanelli, Pina C.; Albers, Gregory W.; Bello, Jacqueline A.; Derdeyn, Colin P.; Hetts, Steven W.; Johnson, Michele H.; Kidwell, Chelsea S.; Lev, Michael H.; Liebeskind, David S.; Rowley, Howard A.; Schaefer, Pamela W.; Sunshine, Jeffrey L.; Zaharchuk, Greg; Meltzer, Carolyn C.

2014-01-01

50

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

2000-01-01

51

Use of expandable metal stents in the treatment of bronchial obstruction.  

PubMed Central

An expandable metal stent has been used to treat bronchial collapse due to polychondritis in one patient and extrinsic bronchial compression secondary to bronchogenic tumour in another. Images PMID:2799747

Simonds, A K; Irving, J D; Clarke, S W; Dick, R

1989-01-01

52

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.

2011-04-01

53

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

2011-12-01

54

Expanding Universe  

NASA Astrophysics Data System (ADS)

Preface; Part I. The de Sitter Universe: 1. Synthetic construction; 2. The reduced model: geodesics; 3. The elliptic interpretation; 4. The static frame; 5. The determination of parallaxes; 6. The Lemaître-Robertson frame; Part II. The Theory of Geodesics: 7. On null geodesics; i. Determination of the parameter for null lines in special cases; ii. Frequency shift; 8. Free particles and light rays in general expanding spaces, flat or hyperspherical; i. Flat spaces; ii. Spherical spaces; iii. The red shift for spherical spaces; Part III. Waves in General Riemannian Space-Time: 9. The nature of our approximation; 10. The Hamilton-Jacobi theory in a gravitational field; 11. Procuring approximate solutions of the Hamilton-Jacobi equation from wave theory; Part IV. Waves in an Expanding Universe: 12. General considerations; 13. Proper vibrations and wave parcels; Bibliography.

Schrödinger, E.

2011-02-01

55

Expander codes  

Microsoft Academic Search

We present a new class of asymptotically good, linearerror-correcting codes based upon expander graphs.These codes have linear time sequential decoding algorithms,logarithmic time parallel decoding algorithmswith a linear number of processors, and are simple tounderstand. We present both randomized and explicitconstructions for some of these codes. Experimentalresults demonstrate the extremely good performance ofthe randomly chosen codes.1. IntroductionWe present a new class

Michael Sipser; Daniel A. Spielman

1996-01-01

56

Expanding Gravity  

NASA Astrophysics Data System (ADS)

Newton's gravitational constant Gn and Laws of Gravity are based upon observations in our solar system. Mysteries appear when they are used far outside our solar system Apparently, Newton's gravitational constant can not be applied at large distances. Dark matter was needed to explain the observed flat rotational velocity curves of spiral galaxies (Rubin), and of groups of remote galaxies (Zwicky). Our expansion of Newton's gravitational constant Gn as a power series in distance r, is sufficient to explain these observations without using dark matter. This is different from the MOND theory of Milgrom involving acceleration. Also, our Expanded Gravitational Constant (EGC) can show the correct use of the red shift. In addition to the Doppler contribution, there are three other contributions and these depend only upon gravity. Thus, velocity observations only based on the red shift can not be used to support the concept of the expanding universe, the accelerating expansion, or dark energy. Our expanded gravity constant can predict and explain Olbers' paradox (dark sky), and the temperature of the CMB (cosmic microwave background). Thus, CMB may not support the big bang and inflation.

Aisenberg, Sol

2005-04-01

57

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

1998-01-01

58

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

2001-01-01

59

HIGH-RESOLUTION EXPANDED VERY LARGE ARRAY IMAGE OF DIMETHYL ETHER (CH{sub 3}){sub 2}O IN ORION-KL  

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: favre@phys.au.dk, E-mail: brouillet@obs.u-bordeaux1.fr, E-mail: despois@obs.u-bordeaux1.fr, E-mail: baudry@obs.u-bordeaux1.fr, E-mail: awootten@nrao.edu, E-mail: aremijan@nrao.edu, E-mail: tom.wilson@nrl.navy.mil [Naval Research Laboratory, Code 7210, Washington, DC 20375 (United States)

2011-09-20

60

Cotransplantation of HLA-Identical Sibling Culture-Expanded Mesenchymal Stem Cells and Hematopoietic Stem Cells in Hematologic Malignancy Patients  

Microsoft Academic Search

Mesenchymal stem cells (MSCs) are found in a variety of tissues, including human bone marrow; secrete hematopoietic cytokines; support hematopoietic progenitors in vitro; and possess potent immunosuppressive properties. We hypothesized that cotransplantation of culture-expanded MSCs and hematopoietic stem cells (HSCs) from HLA-identical sibling donors after myeloablative therapy could facilitate engraftment and lessen graft-versus-host disease (GVHD); however, the safety and feasibility

Hillard M. Lazarus; Omer N. Koc; Steven M. Devine; Peter Curtin; Richard T. Maziarz; H. Kent Holland; Elizabeth J. Shpall; Philip McCarthy; Kerry Atkinson; Brenda W. Cooper; Stanton L. Gerson; Mary J. Laughlin; Fausto R. Loberiza; Annemarie B. Moseley; Andrea Bacigalupo

2005-01-01

61

Study of Patient's Self-Image during Orthodontic Treatment.  

National Technical Information Service (NTIS)

There has been little research done that has attempted to study the patient's self-image and record what changes occur with a correction of the patient's malocclusion through orthodontic treatment. A study was done to determine what changes occur in the o...

B. B. Jacobus

1985-01-01

62

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. PMID:16943868

Nair, Prashant; Roguin, Ariel

2005-01-01

63

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

2001-01-01

64

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. 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

2011-01-01

65

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

PubMed

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. PMID:16193791

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

2005-08-01

66

Imaging of patients with congenital heart disease  

Microsoft Academic Search

Congenital defects most-commonly affect the heart, with an estimated incidence of up to 10 in 1,000 live births. Over the past few decades, mortality has decreased and subsequent survival has increased; approximately 90% of all patients with congenital heart disease (CHD) reach adulthood. Echocardiography is sufficient in most cases for prenatal and postnatal diagnosis of CHD and to plan an

Albert de Roos; Arno A. W. Roest

2011-01-01

67

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))

1991-09-01

68

Clinical and imaging heterogeneity of polymicrogyria: a study of 328 patients  

PubMed Central

Polymicrogyria is one of the most common malformations of cortical development and is associated with a variety of clinical sequelae including epilepsy, intellectual disability, motor dysfunction and speech disturbance. It has heterogeneous clinical manifestations and imaging patterns, yet large cohort data defining the clinical and imaging spectrum and the relative frequencies of each subtype are lacking. The aims of this study were to determine the types and relative frequencies of different polymicrogyria patterns, define the spectrum of their clinical and imaging features and assess for clinical/imaging correlations. We studied the imaging features of 328 patients referred from six centres, with detailed clinical data available for 183 patients. The ascertainment base was wide, including referral from paediatricians, geneticists and neurologists. The main patterns of polymicrogyria were perisylvian (61%), generalized (13%), frontal (5%) and parasagittal parieto-occipital (3%), and in 11% there was associated periventricular grey matter heterotopia. Each of the above patterns was further divided into subtypes based on distinguishing imaging characteristics. The remaining 7% were comprised of a number of rare patterns, many not described previously. The most common clinical sequelae were epileptic seizures (78%), global developmental delay (70%), spasticity (51%) and microcephaly (50%). Many patients presented with neurological or developmental abnormalities prior to the onset of epilepsy. Patients with more extensive patterns of polymicrogyria presented at an earlier age and with more severe sequelae than those with restricted or unilateral forms. The median age at presentation for the entire cohort was 4 months with 38% presenting in either the antenatal or neonatal periods. There were no significant differences between the prevalence of epilepsy for each polymicrogyria pattern, however patients with generalized and bilateral forms had a lower age at seizure onset. There was significant skewing towards males with a ratio of 3:2. This study expands our understanding of the spectrum of clinical and imaging features of polymicrogyria. Progression from describing imaging patterns to defining anatomoclinical syndromes will improve the accuracy of prognostic counselling and will aid identification of the aetiologies of polymicrogyria, including genetic causes. PMID:20403963

Jansen, Anna; Pilz, Daniela T.; Stoodley, Neil; Marini, Carla; Dubeau, Francois; Malone, Jodie; Mitchell, L. Anne; Mandelstam, Simone; Scheffer, Ingrid E.; Berkovic, Samuel F.; Andermann, Frederick; Andermann, Eva; Guerrini, Renzo; Dobyns, William B.

2010-01-01

69

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. PMID:24043974

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

2013-01-01

70

Imaging of the orthopaedic patient: implications for primary care.  

PubMed

Pain in the skeleton is the foundation on which this article is based. Patients with musculoskeletal pain are frequently seen in primary care. There are many diagnostic imaging studies available to aid the practitioner in formulating and confirming a working diagnosis. This article offers specific guidelines for ordering imaging studies for common orthopaedic problems. The authors take into consideration costs and reliability of tests with each recommendation. The trend in many cases is to order magnetic resonance imaging scans rather than traditional radiographs. The indications for the commonly requested studies are reviewed. PMID:1840984

Gates, S J; Brooks, M

1991-12-01

71

Septicemia in neutropenic patients infected with Clostridium tertium resistant to cefepime and other expanded-spectrum cephalosporins.  

PubMed

Clostridium tertium was isolated from two immunocompromised patients with septicemia, fever, and gastrointestinal symptoms. The strains were resistant to ceftazidime, cefepime, and clindamycin; intermediately resistant to penicillin; and susceptible to metronidazole, quinolones, and vancomycin. PMID:10523601

Steyaert, S; Peleman, R; Vaneechoutte, M; De Baere, T; Claeys, G; Verschraegen, G

1999-11-01

72

Does a continuous local anaesthetic pain treatment after immediate tissue expander reconstruction in breast carcinoma patients more efficiently reduce acute postoperative pain - a prospective randomised study  

PubMed Central

Background Immediate breast reconstruction with an expander is a reasonable option for properly selected patients. After reconstruction, patients have severe postoperative pain, which responds poorly to opioids. Our aim was to evaluate if continuous wound infusion of a local anaesthetic into the surgical wound reduces postoperative pain, consumption of opioids and incidence of chronic pain compared to standard intravenous piritramide after primary breast reconstruction in breast carcinoma patients. Methods Altogether, 60 patients were enrolled in our study; one half in the group with wound infusion of a local anaesthetic, and the other half in the standard (piritramide) group. Parameters measured included: pain intensity (visual analogue scale), drug requirements, alertness, hospitalisation, side-effects and late complications. A p-value of?expander breast reconstruction, wound infusion of a local anaesthetic significantly reduces acute pain and enables reduced opioid consumption, resulting in less postoperative sedation and reduced need for antiemetic drugs. Wound infusion of a local anaesthetic reduces chronic pain. PMID:24433317

2014-01-01

73

Stem cell treatment for patients with autoimmune disease by systemic infusion of culture-expanded autologous adipose tissue derived mesenchymal stem cells.  

PubMed

Prolonged life expectancy, life style and environmental changes have caused a changing disease pattern in developed countries towards an increase of degenerative and autoimmune diseases. Stem cells have become a promising tool for their treatment by promoting tissue repair and protection from immune-attack associated damage. Patient-derived autologous stem cells present a safe option for this treatment since these will not induce immune rejection and thus multiple treatments are possible without any risk for allogenic sensitization, which may arise from allogenic stem cell transplantations. Here we report the outcome of treatments with culture expanded human adipose-derived mesenchymal stem cells (hAdMSCs) of 10 patients with autoimmune associated tissue damage and exhausted therapeutic options, including autoimmune hearing loss, multiple sclerosis, polymyotitis, atopic dermatitis and rheumatoid arthritis. For treatment, we developed a standardized culture-expansion protocol for hAdMSCs from minimal amounts of fat tissue, providing sufficient number of cells for repetitive injections. High expansion efficiencies were routinely achieved from autoimmune patients and from elderly donors without measurable loss in safety profile, genetic stability, vitality and differentiation potency, migration and homing characteristics. Although the conclusions that can be drawn from the compassionate use treatments in terms of therapeutic efficacy are only preliminary, the data provide convincing evidence for safety and therapeutic properties of systemically administered AdMSC in human patients with no other treatment options. The authors believe that ex-vivo-expanded autologous AdMSCs provide a promising alternative for treating autoimmune diseases. Further clinical studies are needed that take into account the results obtained from case studies as those presented here. PMID:22017805

Ra, Jeong Chan; Kang, Sung Keun; Shin, Il Seob; Park, Hyeong Geun; Joo, Sang Aun; Kim, Jeong Geun; Kang, Byeong-Cheol; Lee, Yong Soon; Nakama, Ken; Piao, Min; Sohl, Bertram; Kurtz, Andras

2011-01-01

74

Stem cell treatment for patients with autoimmune disease by systemic infusion of culture-expanded autologous adipose tissue derived mesenchymal stem cells  

PubMed Central

Prolonged life expectancy, life style and environmental changes have caused a changing disease pattern in developed countries towards an increase of degenerative and autoimmune diseases. Stem cells have become a promising tool for their treatment by promoting tissue repair and protection from immune-attack associated damage. Patient-derived autologous stem cells present a safe option for this treatment since these will not induce immune rejection and thus multiple treatments are possible without any risk for allogenic sensitization, which may arise from allogenic stem cell transplantations. Here we report the outcome of treatments with culture expanded human adipose-derived mesenchymal stem cells (hAdMSCs) of 10 patients with autoimmune associated tissue damage and exhausted therapeutic options, including autoimmune hearing loss, multiple sclerosis, polymyotitis, atopic dermatitis and rheumatoid arthritis. For treatment, we developed a standardized culture-expansion protocol for hAdMSCs from minimal amounts of fat tissue, providing sufficient number of cells for repetitive injections. High expansion efficiencies were routinely achieved from autoimmune patients and from elderly donors without measurable loss in safety profile, genetic stability, vitality and differentiation potency, migration and homing characteristics. Although the conclusions that can be drawn from the compassionate use treatments in terms of therapeutic efficacy are only preliminary, the data provide convincing evidence for safety and therapeutic properties of systemically administered AdMSC in human patients with no other treatment options. The authors believe that ex-vivo-expanded autologous AdMSCs provide a promising alternative for treating autoimmune diseases. Further clinical studies are needed that take into account the results obtained from case studies as those presented here. PMID:22017805

2011-01-01

75

Association of Expanded Disability Status Scale and Cytokines after Intervention with Co-supplemented Hemp Seed, Evening Primrose Oils and Hot-natured Diet in Multiple Sclerosis Patients?  

PubMed Central

Introduction Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). Because of limited efficacy and adverse side effects, identifying novel therapeutic and protective agents is important. The aim of this study is to examine the correlations between expanded disability status scale (EDSS) and cytokines after intervention with co-supplemented hemp seed and evening primrose oils and hot-natured diet in patients with relapsing-remitting multiple sclerosis (RRMS). Methods We studied a group of 23 patients with clinically definite RRMS, with EDSS<6 who received co-supplemented hemp seed and evening primrose oils with advising hot-natured diet. Clinically EDSS and immunological factors (plasma cytokines of IL-4, IFN-? and IL-17) were assessed at baseline and after 6 months. Results Mean follow-up was 180±2.9 days (N=23, 7 Male and 16 Females aged 25.0±7.5 years with disease duration 6.26±3.9 years). After 6 months, significant improvements in extended disability status score were found in the patients in agreement with decrease cytokines of IFN-? and IL-17 and increase cytokines of IL-4. Clinical and immunological parameters showed improvement in the patients after the intervention. Conclusion Our study shows that co-supplemented hemp seed and evening primrose oils with hot-natured diet can have beneficial effects in improving clinical symptoms in relapsing remitting MS patients and significant correlation was found between EDSS and immunological findings. PMID:23678469

Rezapour-Firouzi, Soheila; Arefhosseini, Seyed Rafie; Farhoudi, Mehdi; Ebrahimi-Mamaghani, Mehrangiz; Rashidi, Mohammad-Reza; Torbati, Mohammad-Ali; Baradaran, Behzad

2013-01-01

76

Remote auscultatory patient monitoring during magnetic resonance imaging  

Microsoft Academic Search

A system for patient monitoring during magnetic resonance imaging (MRI) is described. The system is based on remote auscultation of heart sounds and respiratory sounds using specially developed pickup heads that are positioned on the precordium or at the nostrils and connected to microphones via polymer tubing. The microphones operate in a differential mode outside the strong magnetic field to

S. Henneberg; B. Hök; L. Wiklund; G. Sjödin

1991-01-01

77

CASE REPORT Septicemia in Neutropenic Patients Infected with Clostridium tertium Resistant to Cefepime and Other Expanded-Spectrum Cephalosporins  

Microsoft Academic Search

Clostridium tertium was isolated from two immunocompromised patients with septicemia, fever, and gastro- intestinal symptoms. The strains were resistant to ceftazidime, cefepime, and clindamycin; intermediately resistant to penicillin; and susceptible to metronidazole, quinolones, and vancomycin. CASE REPORTS Case 1. A 65-year-old male was diagnosed with acute my- eloid leukemia and treated with chemotherapy. During neu- tropenia, he became febrile and

SOPHIA STEYAERT; RENAAT PELEMAN; MARIO VANEECHOUTTE; THIERRY DE BAERE; GEERT CLAEYS; GERDA VERSCHRAEGEN

1999-01-01

78

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

1996-06-01

79

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

PubMed

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. PMID:21355091

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; Migliaccio, Anna Rita

2011-07-14

80

Cardiac imaging in evaluating patients prone to sudden death  

PubMed Central

Identifying subjects who are at risk for SCD and stratifying them correctly into low or high-risk groups is the holy grail of Cardiology. While imaging shows a lot of promise, it is plagued by the fact that most SCD occurs in relatively healthy subjects, a massive group who would not ordinarily be subjected to imaging. Left ventricular ejection fraction (LVEF) currently is our primary parameter for risk stratification for sudden cardiac death but is a poor marker with low sensitivity and specificity. Current data shows that sophisticated imaging with techniques, mainly Cardiac magnetic resonance Imaging (CMR), have the potential to identify novel high-risk markers underlying SCD, beyond ejection fraction. Imaging seems to further refine risk in patients with low LVEF as well as in those with normal EF; this is a major strength of advanced imaging. Clinical application has been slow and not fully prime time. It is important to remember that while promising, imaging techniques including CMR, have not been tested in rigorous prospective studies and thus have not as yet replaced EF as the gatekeeper to ICD implantation. PMID:24568832

Tamene, Ashenafi; Tholakanahalli, Venkatakrishna N.; Chandrashekhar, Y.

2014-01-01

81

Bromohydrin pyrophosphate-stimulated Vgamma9delta2 T cells expanded ex vivo from patients with poor-prognosis neuroblastoma lyse autologous primary tumor cells.  

PubMed

Gamma/delta T cells (Vgamma9delta2) contribute to innate immunity and exert natural cytotoxicity against a variety of tumors. Using a synthetic phosphoantigen (Bromohydrin Pyrophosphate, BrHPP), we amplified Vgamma9delta2 T cells in vitro from neuroblastoma patients. In the presence of BrHPP and low doses of IL-2, robust proliferation of Vgamma9delta2 T cells was obtained from peripheral blood mononuclear cells (PBMC) harvested at diagnosis. Moderate proliferation was observed from PBMC harvested after stem cell transplantation, whereas modest levels of Vgamma9delta2 T cells were obtained from PBMC harvested after induction therapy. Proliferation was observed after a single in vitro stimulation with BrHPP. After 21 days in culture, Vgamma9delta2 T cells represented more than 80% of cultured cells (a 50-fold expansion from baseline). Moreover, BrHPP-amplified Vgamma9delta2 T cells from patients-expressed activation markers and were able to lyse allogeneic and autologous neuroblasts. This cytotoxic activity was gammadelta T-cell receptor-dependent. Clinical trials using BrHPP are warranted in patients with poor-prognosis neuroblastoma, either to expand patient-derived Vgamma9delta2 T cells ex vivo or by direct administration to in vivo to boost the pool of resident Vgamma9delta2 T cells in vivo. PMID:20551838

Chargui, Jamel; Combaret, Valérie; Scaglione, Virginie; Iacono, Isabelle; Péri, Valentine; Valteau-Couanet, Dominique; Dubrel, Marie; Angevin, Eric; Puisieux, Alain; Romagne, François; Bergeron, Christophe

2010-01-01

82

Spectral CT Imaging in Patients with Budd-Chiari Syndrome: Investigation of Image Quality.  

PubMed

To assess the image quality of monochromatic imaging from spectral CT in patients with Budd-Chiari syndrome (BCS), fifty patients with BCS underwent spectral CT to generate conventional 140 kVp polychromatic images (group A) and monochromatic images, with energy levels from 40 to 80, 40 + 70, and 50 + 70 keV fusion images (group B) during the portal venous phase (PVP) and the hepatic venous phase (HVP). Two-sample t tests compared vessel-to-liver contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) for the portal vein (PV), hepatic vein (HV), inferior vena cava. Readers' subjective evaluations of the image quality were recorded. The highest SNR values in group B were distributed at 50 keV; the highest CNR values in group B were distributed at 40 keV. The higher CNR values and SNR values were obtained though PVP of PV (SNR 18.39 ± 6.13 vs. 10.56 ± 3.31, CNR 7.81 ± 3.40 vs. 3.58 ± 1.31) and HVP of HV (3.89 ± 2.08 vs. 1.27 ± 1.55) in the group B; the lower image noise for group B was at 70 keV and 50 + 70 keV (15.54 ± 8.39 vs. 18.40 ± 4.97, P = 0.0004 and 18.97 ± 7.61 vs. 18.40 ± 4.97, P = 0.0691); the results show that the 50 + 70 keV fusion image quality was better than that in group A. Monochromatic energy levels of 40-70, 40 + 70, and 50 + 70 keV fusion image can increase vascular contrast and that will be helpful for the diagnosis of BCS, we select the 50 + 70 keV fusion image to acquire the best BCS images. PMID:24833430

Su, Lei; Dong, Junqiang; Sun, Qiang; Liu, Jie; Lv, Peijie; Hu, Lili; Yan, Liangliang; Gao, Jianbo

2014-11-01

83

A GMP-compliant protocol to expand and transfect cancer patient T cells with mRNA encoding a tumor-specific chimeric antigen receptor.  

PubMed

Chimeric antigen receptors (CARs), which combine an antibody-derived binding domain (single chain fragment variable) with T-cell-activating signaling domains, have become a promising tool in the adoptive cellular therapy of cancer. Retro- and lenti-viral transductions are currently the standard methods to equip T cells with a CAR; permanent CAR expression, however, harbors several risks like uncontrolled auto-reactivity. Modification of T cells by electroporation with CAR-encoding RNA to achieve transient expression likely circumvents these difficulties. We here present a GMP-compliant protocol to activate and expand T cells for clinical application. The protocol is optimized in particular to produce CAR-modified T cells in clinically sufficient numbers under full GMP-compliance from late-stage cancer patients. This protocol allows the generation of 6.7 × 10(8) CAR-expressing T cells from one patient leukapheresis. The CAR-engineered T cells produced pro-inflammatory cytokines after stimulation with antigen-bearing tumor cells and lysed tumor cells in an antigen-specific manner. This functional capacity was maintained after cryopreservation. Taken together, we provide a clinically applicable protocol to transiently engineer sufficient numbers of antigen-specific patient T cells for use in adoptive cell therapy of cancer. PMID:24938475

Krug, Christian; Wiesinger, Manuel; Abken, Hinrich; Schuler-Thurner, Beatrice; Schuler, Gerold; Dörrie, Jan; Schaft, Niels

2014-10-01

84

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

2008-01-01

85

Predictive factors and clinical consequences of proximal aortic neck dilatation in 230 patients undergoing abdominal aorta aneurysm repair with self-expandable stent-grafts 1 1 Competition of interest: none  

Microsoft Academic Search

Objective: Several studies have suggested that proximal aortic neck dilatation (AND) is a frequent event after balloon-expandable endografting. Yet few data are available on AND after repair with self-expandable stent grafts. To investigate incidence, predictive factors, and clinical consequences of AND, computed tomography (CT) scans obtained at intervals during follow-up of 230 patients who had undergone endoluminal abdominal aortic aneurysm

Piergiorgio Cao; Fabio Verzini; Gianbattista Parlani; Paola De Rango; Basso Parente; Giuseppe Giordano; Stefano Mosca; Agostino Maselli

2003-01-01

86

Nuclear imaging of the brain in electrical burn patients  

Microsoft Academic Search

Patients surviving high-voltage electrical injury may have early or delayed sequelae. Technetium-99m (Tc-99m) hexamethylpropyleneamine oxime (HMPAO) is a lipid soluble brain perfusion agent rapidly retained in the brain tissue in proportion to regional cerebral blood flow without any redistribution. The aim of this study is to point out the importance of nuclear imaging of the brain and estimate the possible

Mustafa Deveci; Mehmet Bozkurt; Nuri Arslan; Mustafa Sengezer

2002-01-01

87

Bardet-Biedl Syndrome in an African-American patient: should the diagnostic criteria be expanded to include hydrometrocolpos?  

PubMed

Bardet-Biedl Syndrome (BBS) is a multisystemic disorder diagnosed on the basis of a combination of primary and secondary clinical features that include retinal dystrophy, obesity, polydactyly, cognitive dysfunction, and renal malformations. We report a unique case of BBS in a 13-year old girl of African-American descent who presented with retinitis pigmentosa, obesity, polydactyly, learning disabilities, precocious puberty, hypertension, renal cysts, and Hirschprung disease. Further evaluation revealed a history of precocious puberty, which is antithetical to the common manifestations of BBS, while neuroimaging was suggestive of periventricular leukomalacia and neuro-electrophysiologic studies revealed diffuse cerebral disturbance, which may contribute to her neurological abnormalities. The patient was also diagnosed with hydrometrocolpos, a finding typical of McKusick-Kaufman Syndrome (MKKS) but infrequent in other disorders. This observation, together with recent findings in some mouse models of BBS, raises the question of whether hydrometrocolpos should be considered as an additional diagnostic criterion for BBS to be used in females in parallel to the criterion of hypogonadism in males, thereby improving diagnostic sensitivity. PMID:17558852

Toma, Hassanain S; Tan, Perciliz L; McKusick, Victor A; Katsanis, Nicholas; Adams, N A

2007-06-01

88

IR imaging of blood circulation of patients with vascular disease  

NASA Astrophysics Data System (ADS)

We conducted a preliminary IR imaging study of blood circulation in patients with peripheral vascular diseases. Abnormal blood flow is common in older adults, especially those with elevated blood lipids, diabetes, hypertension, and a history of smoking. All of these conditions have a high prevalence in our population, often with more than one condition in the same individual. The differences in blood flow is revealed by temperature differences in areas of the extremities as well as other regions of the body. However, what is needed is an imaging technique that is relatively inexpensive and can reveal the blood flow in real time. The IR imaging can show detailed venous system and small tempearture changes associated with blood flow. Six patients with vascular diseases were tested in a clinic set up. Their legs and feet were imaged. We observed large temperature differences (cooling of more than 10° C) at the foot, especially toes. More valuable information were obtained from the temperature distribution maps. IR thermography is potentially a very valuable tool for medical application, especially for vascular diseases.

Wang, Hsin; Wade, Dwight R., Jr.; Kam, Jack

2004-04-01

89

Evaluation of cutaneous body image dissatisfaction in the dermatology patient.  

PubMed

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

2013-01-01

90

Automatic segmentation of MR brain images in multiple sclerosis patients  

NASA Astrophysics Data System (ADS)

A totally automatic scheme for segmenting brain from extracranial tissues and to classify all intracranial voxels as CSF, gray matter (GM), white matter (WM), or abnormality such as multiple sclerosis (MS) lesions is presented in this paper. It is observed that in MR head images, if a tissue's intensity values are normalized, its relationship to the other tissues is essentially constant for a given type of image. Based on this approach, the subcutaneous fat surrounding the head is normalized to classify other tissues. Spatially registered 3 mm MR head image slices of T1 weighted, fast spin echo [dual echo T2 weighted and proton density (PD) weighted images] and fast fluid attenuated inversion recovery (FLAIR) sequences are used for segmentation. Subcutaneous fat surrounding the skull was identified based on intensity thresholding from T1 weighted images. A multiparametric space map was developed for CSF, GM and WM by normalizing each tissue with respect to the mean value of corresponding subcutaneous fat on each pulse sequence. To reduce the low frequency noise without blurring the fine morphological high frequency details an anisotropic diffusion filter was applied to all images before segmentation. An initial slice by slice classification was followed by morphological operations to delete any brides connecting extracranial segments. Finally 3-dimensional region growing of the segmented brain extracts GM, WM and pathology. The algorithm was tested on sequential scans of 10 patients with MS lesions. For well registered sequences, tissues and pathology have been accurately classified. This procedure does not require user input or image training data sets, and shows promise for automatic classification of brain and pathology.

Avula, Ramesh T. V.; Erickson, Bradley J.

1996-04-01

91

Patient specific tumor growth prediction using multimodal images.  

PubMed

Personalized tumor growth model is valuable in tumor staging and therapy planning. In this paper, we present a patient specific tumor growth model based on longitudinal multimodal imaging data including dual-phase CT and FDG-PET. The proposed Reaction-Advection-Diffusion model is capable of integrating cancerous cell proliferation, infiltration, metabolic rate and extracellular matrix biomechanical response. To bridge the model with multimodal imaging data, we introduce Intracellular Volume Fraction (ICVF) measured from dual-phase CT and Standardized Uptake Value (SUV) measured from FDG-PET into the model. The patient specific model parameters are estimated by fitting the model to the observation, which leads to an inverse problem formalized as a coupled Partial Differential Equations (PDE)-constrained optimization problem. The optimality system is derived and solved by the Finite Difference Method. The model was evaluated by comparing the predicted tumors with the observed tumors in terms of average surface distance (ASD), root mean square difference (RMSD) of the ICVF map, average ICVF difference (AICVFD) of tumor surface and tumor relative volume difference (RVD) on six patients with pathologically confirmed pancreatic neuroendocrine tumors. The ASD between the predicted tumor and the reference tumor was 2.4±0.5mm, the RMSD was 4.3±0.4%, the AICVFD was 2.6±0.6%, and the RVD was 7.7±1.3%. PMID:24607911

Liu, Yixun; Sadowski, Samira M; Weisbrod, Allison B; Kebebew, Electron; Summers, Ronald M; Yao, Jianhua

2014-04-01

92

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. 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

2008-01-01

93

Aggressive primary thyroid lymphoma: imaging features of two elderly patients.  

PubMed

We report two cases of aggressive thyroid lymphoma in elderly patients that presented as Epub ahead of print large infiltrative thyroid masses with extensive invasion to adjacent structures including trachea, esophagus, and common carotid artery. Ultrasonography displayed irregular shaped, heterogeneous hypoechoic mass, mimicking anaplastic carcinoma. Computed tomography showed heterogeneously enhancing mass compared to surrounding muscles without calcification and hemorrhage. After biopsy, the masses were histopathologically diagnosed as lymphoma. Aggressive primary thyroid lymphoma is rare; therefore, here we report its image features, with emphasis on ultrasonographic findings, and discuss its differential diagnosis. PMID:25060184

Kim, Eu Hyun; Kim, Jee Young; Kim, Tae-Jung

2014-10-01

94

Aggressive primary thyroid lymphoma: imaging features of two elderly patients  

PubMed Central

We report two cases of aggressive thyroid lymphoma in elderly patients that presented as Epub ahead of print large infiltrative thyroid masses with extensive invasion to adjacent structures including trachea, esophagus, and common carotid artery. Ultrasonography displayed irregular shaped, heterogeneous hypoechoic mass, mimicking anaplastic carcinoma. Computed tomography showed heterogeneously enhancing mass compared to surrounding muscles without calcification and hemorrhage. After biopsy, the masses were histopathologically diagnosed as lymphoma. Aggressive primary thyroid lymphoma is rare; therefore, here we report its image features, with emphasis on ultrasonographic findings, and discuss its differential diagnosis. PMID:25060184

2014-01-01

95

Fox Chase study finds breast cancer patients face increasing number of imaging visits before surgery:  

Cancer.gov

Breast cancer patients frequently undergo imaging like mammograms or ultrasounds between their first breast cancer-related doctor visit and surgery to remove the tumor. In recent years, however, imaging has increased in dramatic and significant ways, say researchers from Fox Chase Cancer Center. More patients have repeat visits for imaging than they did 20 years ago, and single imaging appointments increasingly include multiple types of imaging.

96

Fundus autofluorescence imaging of patients with idiopathic macular hole  

PubMed Central

AIM To investigate the role of fundus autofluorescence (FAF) both in the diagnosis and the preoperative and postoperative evaluation of patients with idiopathic macular hole (MH). METHODS Forty eyes of 40 patients diagnosed as idiopathic MH between May 2010 and May 2011 were included in this retrospective study. All patients underwent full ophthalmologic examinations and imagings including fluorescein angiography, fundus autofluorescence (FAF) and optical coherence tomography. Thirty of these patients underwent MH surgery. FAF findings were associated with duration of symptoms, visual acuity at presentation, stage of MH, and postoperative anatomical correction. RESULTS The mean duration of patients' symptoms was 3.8±2.0 (1–9) months. The MH was stage 2 in 4 (10%), stage 3 in 24 (60%) and stage 4 in 12 (30%) eyes. The median preoperative best corrected visual acuity was 20/200 (between 20/800 and 20/100). Twenty-eight of cases (70%) showed a stellate appearance with dark radiating striae. Having a visual acuity ?20/200 was significantly more common in eyes with stellate appearance (P<0.001). The mean duration of symptoms was significantly shorter in eyes with stellate appearance (2.75±0.8 vs 6.33±1.61 months) (P<0.001). The frequency of stage 4 MH was significantly higher in eyes with non-stellate appearance (P<0.001). Anatomical correction of MH was achieved in 91.3% (21/23) of eyes with stellate appearance and 71.4% (5/7) of eyes without this appearance (P=0.225). CONCLUSION Stellate appearance in FAF is associated with earlier stages of macular hole, better visual acuity at presentation, shorter duration of symptoms, thus more favorable prognosis. PMID:24195050

Teke, Mehmet Yasin; Cakar-Ozdal, Pinar; Sen, Emine; Elgin, Ufuk; Nalcac?oglu-Yuksekkaya, Pinar; Ozturk, Faruk

2013-01-01

97

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

E-print Network

Visual search performance of patients with vision impairment: effect of JPEG image enhancement Gang & Peli E. Visual search performance of patients with vision impairment: effect of JPEG image enhancement, image enhancement, low vision rehabilitation, visual search Correspondence: Gang Luo E-mail address

Peli, Eli

98

Time Dependence of Intrafraction Patient Motion Assessed by Repeat Stereoscopic Imaging  

Microsoft Academic Search

Purpose: To quantify intrafraction patient motion and its time dependence in immobilized intracranial and extracranial patients. The data can be used to optimize the intrafraction imaging frequency and consequent patient setup correction with an image guidance and tracking system, and to establish the required safety margins in the absence of such a system. Method and Materials: The intrafraction motion of

Mischa S. Hoogeman; Joost J. Nuyttens; Peter C. Levendag; Ben J. M. Heijmen

2008-01-01

99

Multislice CT scans in patients on extracorporeal membrane oxygenation: emphasis on hemodynamic changes and imaging pitfalls.  

PubMed

This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO. PMID:24843236

Liu, Kao-Lang; Wang, Yu-Feng; Chang, Yeun-Chung; Huang, Shu-Chien; Chen, Shyh-Jye; Tsang, Yuk-Ming; Chang, Chin-Chen

2014-05-01

100

Multislice CT Scans in Patients on Extracorporeal Membrane Oxygenation: Emphasis on Hemodynamic Changes and Imaging Pitfalls  

PubMed Central

This pictorial review provides the principles of extracorporeal membrane oxygenation (ECMO) support and associated CT imaging features with emphasis on the hemodynamic changes and possible imaging pitfalls encountered. It is important that radiologists in ECMO centers apply well-designed imaging protocols and familiarize themselves with post-contrast CT imaging findings in patients on ECMO. PMID:24843236

Liu, Kao-Lang; Wang, Yu-Feng; Chang, Yeun-Chung; Huang, Shu-Chien; Chen, Shyh-Jye; Tsang, Yuk-Ming

2014-01-01

101

Introduction Properties of Expander Codes  

E-print Network

of Expander Codes Our Results Conclusions Background Basic Definitions LDPC Codes Expander Codes Turbo CodesIntroduction Properties of Expander Codes Our Results Conclusions Expander Codes: Constructions, Haifa 32000, Israel. Vitaly Skachek Expander Codes: Constructions and Bounds #12;Introduction Properties

Skachek, Vitaly

102

Expanding nail or expanding femur? An adverse event with the expandable intramedullary nail.  

PubMed

The expandable intramedullary nail is self-locking and has the advantage of reducing operating time and exposure to ionizing radiation. The nail is recommended for simple diaphyseal fractures involving the middle third of long bones, where the nail can bypass the fracture site by at least 5 cm. We encountered a unique complication with the expandable nail in a simple transverse shaft fracture at the junction of the middle and distal third of the left femur in an otherwise healthy 57-year-old man. The fracture was reduced and a 12-mm expandable nail was inserted. Following full expansion, intraoperative radiographs were obtained prior to closure. After six postoperative weeks, it was noted that the nail expanded the femoral canal, converting a simple fracture to a distally progressing comminuted fracture with a butterfly fragment. A review of the intraoperative radiographs showed slight widening of the medullary canal at the level of the fracture. As the alignment was satisfactory and callus was present, no further surgical intervention was considered. The patient was advised not to bear weight and was provided with a locked knee brace in extension to wear for six weeks. Radiographs at 12 weeks demonstrated good progress of healing with adequate callus and the patient was permitted to bear weight as tolerated and commence knee flexion. The fracture united satisfactorily at four months. This adverse experience emphasizes that caution should be exercised when expanding the nail, with close observation of the medullary canal diameter during the later stages of expansion. PMID:20676021

Gangopadhyay, Soham; Riley, Nicholas D; Sivaji, Chellappan K

2010-01-01

103

Image management and communication in patient care: Perspectives on implementation and impact  

Microsoft Academic Search

Image management and communication (IMAC) systems are automated and integrated systems that capture digital medical images\\u000a and related patient information and transmit them electronically, display them for interpretation, and store them for future\\u000a retrieval. The IMAC system concept includes images and relevant information from all clinical sources. The First International\\u000a Conference on Image Management and Communication in Patient Care (IMAC

Melvyn Greberman; Seong K. Mun

1989-01-01

104

MR imaging with quantitative diffusion mapping of tacrolimus-induced neurotoxicity in organ transplant patients  

Microsoft Academic Search

.   Our objective was to investigate brain MR imaging findings and the utility of diffusion-weighted (DW) imaging in organ transplant\\u000a patients who developed neurologic symptoms during tacrolimus therapy. Brain MR studies, including DW imaging, were prospectively\\u000a performed in 14 organ transplant patients receiving tacrolimus who developed neurologic complications. In each patient who\\u000a had abnormalities on the initial MR study, a

Taro Shimono; Yukio Miki; Hiroshi Toyoda; Hiroto Egawa; Shinji Uemoto; Koichi Tanaka; Haruo Hattori; Mitsunori Kanagaki; Kyo Itoh; Junji Konishi

2003-01-01

105

T2 hyperintense foci on magnetic resonance images of schizophrenic patients and controls.  

PubMed

High resolution magnetic resonance imaging (MRI) of the brain was performed on 18 male schizophrenic patients and 15 male normal control subjects using an identical imaging protocol. The number and size of T2 hyperintense foci were clinically quantified by an academic radiologist. Large foci (greater than or equal to 3 mm in diameter) were observed more frequently on patient images (7/18) than on control images (1/15). The imaging protocol detected high rates of focal hyperintensities, but no differences between patients and controls were noted in the total affected brain area (sum of focal areas) or in the presence or absence of foci. PMID:1811241

Bartzokis, G; Garber, H J; Griswold, V J; Oldendorf, W H; Mintz, J; Marder, S R

1991-12-01

106

Radiologists' role in the communication of imaging examination results to patients: perceptions and preferences of patients.  

PubMed

OBJECTIVE. It has been suggested that radiology reporting practices would be improved if radiologists were to discuss the results of an examination directly with the patient. The attitudes and preferences of patients with regard to direct communication with the radiologist are not well-defined. The purpose of this study was to survey patients about their preferred method of receiving radiologic results. MATERIALS AND METHODS. An anonymous survey was distributed to adult patients undergoing contrast-enhanced CT or MRI over a 2-week period in June 2013. RESULTS. The response rate was 58.4% (642 responses). For normal examination results, the preferred mode of communication was a telephone call from the ordering physician (34.1%); only 12% of respondents opted for a telephone call from the radiologist, and 2.6% chose a face-to-face meeting with the radiologist. For abnormal test results, the preferred mode of communication was also a telephone call from the ordering physician (49.8%); 14.4% of respondents selected a telephone call from the radiologist, and 8.3% chose a face-to-face meeting with the radiologist. Patients preferred receiving very detailed versions of radiology reports for both normal (46.4%) and abnormal (81.8%) test results. Patients also expressed a desire to have access to at least key images from their examinations. CONCLUSION. Patients prefer receiving both normal and abnormal examination results from the physicians who ordered the examination rather than the radiologist. They also prefer to receive very detailed examination results rather than a brief summary in lay terms. PMID:25341142

Mangano, Mark D; Rahman, Arifeen; Choy, Garry; Sahani, Dushyant V; Boland, Giles W; Gunn, Andrew J

2014-11-01

107

Dosimetry of FDG PET\\/CT and other molecular imaging applications in pediatric patients  

Microsoft Academic Search

Effective doses for PET and SPECT imaging of molecular imaging agents depend on the radiopharmaceutical, administered activity\\u000a and the weight of the patient. Effective doses for the accompanying CT scan depend on the CT protocol being used. CT protocols\\u000a can be designed to produce diagnostic quality images, localization images or attenuation correction data without imaging.\\u000a In each case, the co-registered

Michael J. Gelfand

2009-01-01

108

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

Microsoft Academic Search

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

George Cernica; Wang Zhou; Harish Malhotra; Steven de Boer; Matthew B. Podgorsak

2006-01-01

109

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.

1983-03-01

110

Analyses of patient dose and image quality for chest digital radiography  

Microsoft Academic Search

Patient dose should be kept as low as reasonably achievable with satisfactory image quality in diagnostic radiology. Patient dose indices, i.e. entrance surface dose and dose-area product (DAP), were measured during routine chest examination procedures using TLD-100H TLDs and a DAP meter. Patient effective doses were estimated using WinODS software, patient data, and technical factors. In addition, chest X-ray images

H. Y. Tsai; C. H. Yang; K. M. Huang; M. J. Li; C. J. Tung

2010-01-01

111

Patient-controlled sharing of medical imaging data across unaffiliated healthcare organizations  

PubMed Central

Background Current image sharing is carried out by manual transportation of CDs by patients or organization-coordinated sharing networks. The former places a significant burden on patients and providers. The latter faces challenges to patient privacy. Objective To allow healthcare providers efficient access to medical imaging data acquired at other unaffiliated healthcare facilities while ensuring strong protection of patient privacy and minimizing burden on patients, providers, and the information technology infrastructure. Methods An image sharing framework is described that involves patients as an integral part of, and with full control of, the image sharing process. Central to this framework is the Patient Controlled Access-key REgistry (PCARE) which manages the access keys issued by image source facilities. When digitally signed by patients, the access keys are used by any requesting facility to retrieve the associated imaging data from the source facility. A centralized patient portal, called a PCARE patient control portal, allows patients to manage all the access keys in PCARE. Results A prototype of the PCARE framework has been developed by extending open-source technology. The results for feasibility, performance, and user assessments are encouraging and demonstrate the benefits of patient-controlled image sharing. Discussion The PCARE framework is effective in many important clinical cases of image sharing and can be used to integrate organization-coordinated sharing networks. The same framework can also be used to realize a longitudinal virtual electronic health record. Conclusion The PCARE framework allows prior imaging data to be shared among unaffiliated healthcare facilities while protecting patient privacy with minimal burden on patients, providers, and infrastructure. A prototype has been implemented to demonstrate the feasibility and benefits of this approach. PMID:22886546

Ahn, David K; Unde, Bhagyashree; Gage, H Donald; Carr, J Jeffrey

2013-01-01

112

Preliminary Evidence Differentiating ADHD Using Brain SPECT Imaging in Older Patients  

Microsoft Academic Search

The objective of this study was to differentiate ADHD patients from a healthy comparison group using high resolution brain SPECT imaging in older patients. Using extensive chart reviews of structured interviews, DSM-IV criteria, and psychiatrist-given diagnoses, we identified 27 patients over age 50 with ADHD, either combined or inattentive types. Patients were compared to an agematched group of healthy subjects

Daniel G. Amen; Chris Hanks; Jill Prunella

2008-01-01

113

Expandable space frames  

NASA Technical Reports Server (NTRS)

Expandable space frames having essentially infinite periodicity limited only by practical considerations, are described. Each expandable space frame comprises a plurality of hinge joint assemblies having arms that extend outwardly in predetermined symmetrically related directions from a central or vertex point. The outer ends of the arms form one part of a hinge point. The outer expandable space frame also comprises a plurality of struts. The outer ends of the struts from the other part of the hinged joint. The struts interconnect the plurality of hinge point in sychronism, the spaceframes can be expanded or collapsed. Three-dimensional as well as two-dimensional spaceframes of this general nature are described.

Schoen, A. H. (inventor)

1973-01-01

114

Body Image in Chronic Alcoholics and Non-Alcoholic Psychiatric Patients  

Microsoft Academic Search

The present study evaluates the body image of chronic alcoholics and compares the body attitudes of alcoholics with those entertained by a group of nonalcoholic psychiatric patients. Seventy male veterans hospitalized for chronic alcoholism were compared with 50 non-alcoholic psychiatric patients on a variety of body image measures. Chronic alcoholics differed from controls in their body attitudes and perceptions. Alcoholics

Sidney E. Cleveland; Melvin P. Sikes

1966-01-01

115

Decreasing pediatric patient anxiety about radiology imaging tests: prospective evaluation of an educational intervention  

Microsoft Academic Search

This trial investigated anxiety levels and effect of an educational coloring book (CB) among pediatric patients about to undergo radiology imaging tests. Control group (N = 101) and intervention group (N = 175) children ages 3—10 years and their parents were surveyed to determine anxiety levels before the imaging test, with the intervention group being surveyed after patient and parental

Annette J. Johnson; Jennifer Steele; Gregory B. Russell; Rhonda Moran; Kirsten P. Fredericks; S. Gregory Jennings

2009-01-01

116

Noninvasive imaging approach to patients with suspected hepatobiliary disease  

Microsoft Academic Search

Technologic advances in ultrasound, computed tomography (CT), and magnetic resonance imaging over the past decade have greatly improved the noninvasive evaluation of the liver and biliary tree. Each imaging modality offers unique and valuable information that aids in the evaluation of the liver and biliary tree. Improved spatial resolution, harmonic imaging, and color and power Doppler have transformed hepatobiliary ultrasound

Angela D Levy

2001-01-01

117

Using image metadata for automatic patient staging in Lymphoma  

Microsoft Academic Search

Today, clinicians rely on medical images for screening, diagnosis, treatment planning and follow-ups. While medical images provide a wealth of information for clinicians, the content information cannot automatically be integrated into advanced medical applications, such as Clinical Decision Support. The implementation of advanced medical applications requires to enhance image metadata by formalized practical clinical knowledge sources. We introduce an application

Sonja Zillner

2011-01-01

118

Imaging.  

PubMed

Imaging of the musculoskeletal system includes many modalities and is an area that is changing rapidly. Selection of the most accurate techniques and avoidance of duplication are vital to both good patient care and cost containment. PMID:3466135

Wilkinson, R

1986-12-01

119

Expanded-function Auxiliaries in General Dentistry  

PubMed Central

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 indicate that a solo practice can expand its patient volume 169 percent and increase net revenue 233 percent by adding expanded-function auxiliaries, while simultaneously reducing patient waiting time and the time spent at chairside by the dentist. Field validations of the simulation results are described. PMID:4652600

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

1972-01-01

120

Body image among eating disorder patients with disabilities: a review of published case studies.  

PubMed

While individual cases of eating disorder (ED) patients with disabilities have been reported, there has been little synthesis of their experiences of body image and thin idealization. This study reviews 19 published clinical reports of ED patients with sensory, mobility-related, or intellectual disabilities and evaluates the extent to which their experiences align with or challenge current conceptions of body image in ED. ED patients with visual impairment reported a profound disturbance of body image, perceived intersubjectively and through tactile sensations. Reducing dependence in mobility was an important motivation to control body size for ED patients with mobility-related disabilities. ED as a way of coping with and compensating for the psychosocial consequences of disability was a recurrent theme for patients across a range of disabilities. These experiential accounts of ED patients with disabilities broaden current understandings of body image to include touch and kinaesthetic awareness, intersubjective dynamics, and perceptions of normalcy. PMID:24958662

Cicmil, Nela; Eli, Karin

2014-06-01

121

Psychological Burden in Adult Neurofibromatosis Type 1 Patients: Impact of Disease Visibility on Body Image  

Microsoft Academic Search

Aim: To evaluate the impact of disease visibility on psychological stress factors in neurofibromatosis type 1 (NF1) and to explore the body image of NF1 patients. Methods: 228 adult NF1 patients participated in this cross-sectional survey. The questionnaire assessed perceived disease visibility and patients’ body image. Outcome parameters were depression, distress and quality of life. Mediation models were performed to

Sofia Granström; Anna Langenbruch; Matthias Augustin; Victor-Felix Mautner

2012-01-01

122

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

2007-01-01

123

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

PubMed

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

1995-10-01

124

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

1979-01-01

125

Increased Diffusivity in Superior Temporal Gyrus in Patients with Schizophrenia: A Diffusion Tensor Imaging Study  

E-print Network

Increased Diffusivity in Superior Temporal Gyrus in Patients with Schizophrenia: A Diffusion Tensor 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

126

Patterns of Acute Cerebral Infarcts in Patients with Active Malignancy Using Diffusion-Weighted Imaging  

Microsoft Academic Search

Background and Purpose: It is still controversial whether the nature of cerebral infarcts differs between cancer patients and the general population. The aim of this study is to delineate the characteristics of acute cerebral infarction in patients with active malignancy using diffusion-weighted imaging (DWI). Materials and Methods: Seventy consecutive patients with both active malignancy and acute cerebral infarction (confirmed by

Chien-Tai Hong; Li-Kai Tsai; Jiann-Shing Jeng

2009-01-01

127

Relationships between patient size, dose and image noise under automatic tube current modulation systems.  

PubMed

Automatic tube current modulation (ATCM) systems are now used for the majority of CT scans. The principles of ATCM operation are different in CT scanners from different manufacturers. Toshiba and GE scanners base the current modulation on a target noise setting, while Philips and Siemens scanners use reference image and reference mAs concepts respectively. Knowledge of the relationships between patient size, dose and image noise are important for CT patient dose optimisation. In this study, the CT patient doses were surveyed for 14 CT scanners from four different CT scanner manufacturers. The patient cross sectional area, the tube current modulation and the image noise from the CT images were analysed using in-house software. The Toshiba and GE scanner results showed that noise levels are relatively constant but tube currents are dependent on patient size. As a result of this there is a wide range in tube current values across different patient sizes, and doses for large patients are significantly higher in these scanners. In contrast, in the Philips and Siemens scanners, tube currents are less dependent on patient size, the range in tube current is narrower, and the doses for larger patients are not as high. Image noise is more dependent on the patient size. PMID:24334678

Sookpeng, S; Martin, C J; Gentle, D J; Lopez-Gonzalez, M R

2014-03-01

128

The expandable network disk  

E-print Network

This thesis presents a virtual disk cluster called END, the Expandable Network Disk. END aggregates storage on a cluster of servers into a single virtual disk. END's main goals are to offer good performance during normal ...

Muthitacharoen, Athicha, 1976-

2008-01-01

129

Expanding the Universe  

NASA Astrophysics Data System (ADS)

Proceedings of the International Conference EXPANDING THE UNIVERSE, On the occasion of the 200th anniversary of the Tartu Observatory, Tartu, Estonia 2011 April 27-29. C. Sterken, L. Leedjarv, E. Tempel (Eds.)

Sterken, Christiaan; Leedjärv, Laurits; Tempel, Elmo

2011-12-01

130

Evidence for the Expanding Universe  

NSDL National Science Digital Library

In this activity, students examine the first line of evidence, galactic motion, for the notion of an expanding universe. By examining the spectrum of light from a galaxy, students can determine whether a galaxy is moving toward or away from us, and how fast. Students will look at optical images of four galaxies, compare the emission spectra from these same four galaxies, and measure the wavelength of the red hydrogen line for each galaxy. This activity is part of the "Cosmic Questions" educator's guide developed to support the Cosmic Questions exhibit. This activity can be used in conjunction with, or independently of, the exhibit.

131

Developing a Theoretical Framework to Illustrate Associations Among Patient Satisfaction, Body Image and Quality of Life for Women Undergoing Breast Reconstruction  

PubMed Central

Within the field of breast reconstruction there is increasing focus on patient-reported outcomes related to satisfaction, body image, and quality of life. These outcomes are deemed highly relevant because the primary goal of breast reconstruction is to recreate the appearance of a breast (or breasts) that is satisfying to the patient. Prominent researchers have suggested the need to develop improved standards for outcome evaluation which can ultimately benefit patients as well as physicians. The purpose of this article is to summarize key findings in the area of patient-reported outcomes for breast reconstruction and introduce a theoretical framework for advancing research in this field. We conducted an extensive literature review of outcome studies for breast reconstruction focusing on patient-reported results. We developed a theoretical framework illustrating core patient-reported outcomes related to breast reconstruction and factors associated with these outcomes. Our theoretical model highlights domains and distinguishing features of patient satisfaction, body image, and quality of life outcomes for women undergoing breast reconstruction. This model further identifies a broad range of variables (e.g., historical/premorbid influences, disease and treatment-related factors) that have been found to influence patient-reported outcomes and need to be taken into consideration when designing future research in this area. Additional attention is given to examining the relationship between patient reported outcomes and outside evaluation of breast reconstruction. Our proposed theoretical framework suggests key opportunities to expand research in this area with the goal of optimizing body image adjustment, satisfaction, and psychosocial outcomes for the individual patient. PMID:23380309

Fingeret, Michelle Cororve; Nipomnick, Summer; Crosby, Melissa A.; Reece, Gregory P.

2013-01-01

132

Expanding Eligibility for Outpatient Treatment of Deep Venous Thrombosis and Pulmonary Embolism With Low-Molecular-Weight Heparin A Comparison of Patient Self-Injection With Homecare Injection  

Microsoft Academic Search

Background: The outpatient treatment of patients with deep vein thrombosis and pulmonary embolism using low- molecular-weight heparin has the potential to reduce health care costs, but it is unclear if most patients with deep vein thrombosis and pulmonary embolism can be treated as out- patients. In the published studies, more than 50% of pa- tients were excluded from outpatient treatment

Philip S. Wells; Michael J. Kovacs; Janis Bormanis; Melissa A. Forgie; Donna Goudie; Bev Morrow; Judy Kovacs

1998-01-01

133

Optimization of expander plants  

SciTech Connect

A computer program that uses the Tomich technique to solve multistage, multi-feed distillation problems was modified. The MSEQ method was utilized to generate initial temperature and vapor rate profiles. The modified fractionator program coupled with the MSEQ method was used to generate required rigorous data for expander-plant demethanizer splits. Furthermore, a shortcut method was developed to facilitate expander process simulation. Calculated demethanizer results from a simulation were compared with a commercial program with good agreement. The results from the shortcut method were in good agreement with rigorous calculations. Computer simulations were made for four different natural gases ranging from lean to rich in liquefiable hydrocarbons for various turboexpander plant processes. These processes included self-refrigerated expander process with/without external refrigeration, and with/without demethanizer heat recovery. Only lean gases can be utilized in the self-refrigerated expander process with high ethane recovery. While the use of external refrigeration in conjunction with the expander process can reduce overall horsepower requirements, it may not be economical to do so. In general, the processing should be carried out at the highest practical processing pressure. The use of demethanizer heat recovery is an efficient method to reduce both refrigeration horsepower and recompression energy requirements. This work emphasizes high ethane recovery. Further study of expander processes emphasizing ethane rejection is advisable.

Wang, W.B.

1985-01-01

134

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%). Of 17 patients who had nonvisualization of the gallbladder, four had surgically proved acute cholecystitis. 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 systic 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.

1984-06-01

135

Indium 111 platelet imaging for the detection of deep venous thrombosis and pulmonary embolism in patients without symptoms after surgery  

Microsoft Academic Search

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

D. L. Clarke-Pearson; R. E. Coleman; R. Siegel; I. S. Synan; N. Petry

1985-01-01

136

Development of A Novel Image Guidance Alternative for Patient Localization using Topographic Images for TomoTherapy  

NASA Astrophysics Data System (ADS)

To develop a faster and lower dose topogram based image registration for TomoTherapy as an alternative image guidance tool to volumetric megavoltage computed tomography (MVCT). Topogram procedures were performed for an anthropomorphic thorax phantom on a TomoTherapy HD unit (Accuray Inc., Sunnyvale, CA) using couch speeds from 1-4 cm/s and gantry angles of 0 and 90 degrees, other scanning parameters are: 1 mm imaging jaw, compression factor of 1, 30 seconds scanning duration with all multileaf collimators (MLCs) open. The raw exit detector data was exported after each scan. The topogram was reconstructed from a fan beam source for TomoTherapy beam and detector geometry at a SSD of 85 cm. A reference image, so called Digitally Reconstructed Topogram (DRT) was created by integrating the trajectories through the kVCT simulation with the topogram geometry. Image registration was performed by visually aligning the bony structure in topogram to the DRT. Image resolution was determined by the radius of curvature for the detector array, source to axis distance, source to detector distance, detector spacing, and number of detectors. The localization errors were 1.5, 2.5 mm in medio-lateral and anterior-posterior direction, larger errors in cranial-caudal direction was observed for faster couch speeds (i.e., >=3cm/s). The topographic imaging time was 30 sec (versus 3-5 minutes for MVCT thorax scan) with imaging dose less than 1% of MVCT scan. Topograms with appropriate couch speed provide reliable patient localization images while significantly reducing pre-treatment imaging time. Topogram can be used as an alternative and/or additional patient alignment tool to MVCT on TomoTherapy.

Qi, X. Sharon; White, Benjamin; Low, Daniel A.

2014-03-01

137

Advanced imaging technology in surgical innovation.  

PubMed

Advanced imaging technologies including computed tomography (CT) and magnetic resonance imaging (MRI) have immensely expanded possibilities in imaging and surgery. The accurate visualization of bones and soft tissue has transformed the surgical management of numerous diseases, including middle ear disease, orthopedic and reconstructive cases, and cancer. In fact, in surgical subspecialties such as neurosurgery, CT and MRI are the diagnostic modalities of choice for preoperative evaluation of patients. Furthermore, the ongoing development of the newer imaging technologies continues to expand image-guided surgical treatments. The development of new radiological modalities combined with the modern training of surgeons will provide an exciting landscape for future practicing physicians. PMID:22047196

Kotecha, Rupesh; Toledo-Pereyra, Luis H

2011-01-01

138

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

PubMed

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

2009-01-01

139

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

2003-01-01

140

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.

1988-09-01

141

Towards adapting a normal patient database for SPECT brain perfusion imaging  

NASA Astrophysics Data System (ADS)

Single-photon emission computerized tomography (SPECT) is a tool which can be used to image perfusion in the brain. Clinicians can use such images to help diagnose dementias such as Alzheimer's disease. Due to the intrinsic stochasticity in the photon imaging system, some form of statistical comparison of an individual image with a 'normal' patient database gives a clinician additional confidence in interpreting the image. Due to the variations between SPECT camera systems, ideally a normal patient database is required for each individual system. However, cost or ethical considerations often prohibit the collection of such a database for each new camera system. Some method of adapting existing normal patient databases to new camera systems would be beneficial. This paper introduces a method which may be regarded as a 'first-pass' attempt based on 2-norm regularization and a codebook of discrete spatially stationary convolutional kernels. Some preliminary illustrative results are presented, together with discussion on limitations and possible improvements.

Smith, N. D.; Holmes, R. B.; Soleimani, M.; Evans, M. J.; Cade, S. C.; Mitchell, C. N.

2012-06-01

142

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.

1984-06-01

143

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

1982-01-01

144

Prospective Changes in Body Image Dissatisfaction among Adolescent Bariatric Patients: The Importance of Body Size Estimation  

Microsoft Academic Search

BackgroundBody image dissatisfaction (BID) is pervasive among patients presenting for bariatric surgery but significantly improves post-operatively. These findings are based primarily on studies of adults.

M. B. Ratcliff; K. E. Eshleman; J. Reiter-Purtill; M. H. Zeller

145

Self-image and perception of mother and father in psychotic and borderline patients.  

PubMed

Psychotic and borderline patients rated their self-image and their perception of their mother and father using the Structural Analysis of Social Behavior model (SASB). The borderline patients had more negative images of themselves and their parents, especially their fathers, than did the psychotic patients and the normal subjects, while the psychotic patients' ratings did not differ much from those of the normal subjects. The self-image was related to the images of both parents for borderline patients and normal subjects, while for the psychotic patients only the image of the mother was important for the self-image. In addition, the psychotic patients did not differentiate between the poles of control and autonomy in the introjected self-image. It was concluded that borderline patients are characterized by negative attachment, while psychotic patients are characterized by poor separation from the mother and poor differentiation between autonomy and control. The paper also discusses how this may influence the patients' relations to others. Psychotische und Borderline Patienten beurteilten ihr Selbstbild und ihre Wahrnehmung von Mutter und Vater mit Hilfe der strukturalen Analyse sozialen Verhaltens (SASB). Die Borderline Patienten hattten negativere Selbstbilder und Elternbilder (speziell Vaterbilder) als die psychotischen Patienten und gesunde Personen. Die Beurteilungen der psychotischen Patienten unterschieden sich dagegen nicht besonders von jenen Gesunder. Das Selbstbild stand in Beziehung zu beiden Elternbildern bei den Borderline Patienten und den Gesunden, während bei den psychotischen Patienten nur das Mutterbild für das Selbstbild bedeutsam war. Außerdem konnte bei den psychotischen Patienten nicht zwischen den Polen der Kontrolle und Autonomie bzgl. der introjizierten Selbstbilder differenziert werden. Aus den Ergebnissen wird gefolgert, dass Borderline Patienten durch eine negative Bindung charackterisiert sind, psychotische Patienten dagegen durch eine mangelnde Separation von ihren Müttern und eine geringe Differenzierung zwischen Autonomie und Kontrolle. Es wird außerdem diskutiert, wie die Ergebnisse auf die realen Beziehungen der Patienten zu anderen Menschen Einflus nehmen könnten. Des patients psychotiques et Borderline ont évalué leur image d'eux-mêmes et leur perception de leur mère et père à l'aide du modèle de l'Analyse Structural du Comportement Social (SASB. Les patients Borderline avaient des imagess plus négatives d'eux-mêmes et de leurs parents, surtout de leur père, que les patients psychotiques et les sujets normaux, alors que les patients psychotiques se jugeaient à peine différemment des sujets normaux. L'image de soi était en relation avec les images des deux parents pour les patients Borderline et pour les sujets normaux, alors que pour les patients psychotiques, seulement l'image de la mère jouait un rôle pour leur image. En plus, les patients psychotiques ne différenciaient pas entre les pôles de contrôle et d'autonomie dans l'image de soi introjectée. Nous en avons conclu que les patients Borderline se caractérisent par un attachement négatif, et les patients psychotiques par une faible séparation de la mère ainsi qu'une différenciation modeste entre autonomie et contrôle. L'influence de ceci sur les relations des patients avec les autrs est discutée dans cet article. Pacientes limítrofes y psicóticos evaluaron su autoimagen y la percepción que tenían de sus padres usando el modelo de Análisis estructural del comportamiento social (SASB). Los pacientes limítrofes registraron imágenes más negativas de sí mismos y de sus progenitores, especialmente de su padre, que los pacientes psicóticos y los normales, mientras que las evaluaciones de los pacientes psicóticos no difirieron mucho de las de los sujetos normales. La autoimagen tuvo relación con la imagen de ambos progenitores tanto en el caso de los pacientes limítrofes como de los sujetos normales, mientras que para los pacientes psicóticos no diferenciaron entre control y autonomía en la a

Armelius, K; Granberg

2000-02-01

146

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

1998-01-01

147

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

2006-01-01

148

Motion Tracking on Elbow Tissue from Ultrasonic Image Sequence for Patients with Lateral Epicondylitis  

Microsoft Academic Search

In this study, Kinesio Tape is used in patients with lateral epicondylitis. The ultrasonic image sequences of elbow are recorded dynamically, and then motion tracking is applied to assist in understanding the effect of the therapy. Motion tracking, based on optical flow method, is used to track certain landmark on the ultrasound image, which is very ambiguous, for estimating the

Yuh-Hwan Liu; Shu-Min Chen; Chi-Yi Lin; Chung-I Huang; Yung-Nien Sun

2007-01-01

149

Magnetic resonance imaging of femoral head development in roentgenographically normal patients  

Microsoft Academic Search

Magnetic resonance images (MRI) of 22 patients with roentgenographically normal hips were reviewed retrospectively and the findings categorized according to age. With increasing maturity, the MR intensity of the femoral heads on spin echo images increased, as marrow fat became a dominant tissue in the head. The femoral head pattern was relatively inhomogeneous, with a broad band of diminished intensity

Peter J. Littrup; Alex M. Aisen; Ethan M. Braunstein; William Martel

1985-01-01

150

Body image in obese patients before and after stable weight reduction following bariatric surgery  

Microsoft Academic Search

The role of possessing an abnormal body weight in the body image alterations of obese patients was evaluated in bariatric surgery subjects prior to and at long term after operation, when body weight and shape had become steadily normalized. Body image was assessed by the body dissatisfaction scale of the Eating Disorders Inventory, the Body Shape Questionnaire, and the Body

Gian Franco Adami; Anna Meneghelli; Annalisa Bressani; Nicola Scopinaro

1999-01-01

151

A Patient-Specific Segmentation Framework for Longitudinal MR Images of Traumatic Brain Injury  

E-print Network

A Patient-Specific Segmentation Framework for Longitudinal MR Images of Traumatic Brain Injury Bo Science, e Brain Injury Research Center, Departments of Neurosurgery and Neurology, University and disability worldwide. Robust, reproducible segmen- tations of MR images with TBI are crucial for quantitative

Utah, University of

152

Coping and self-image in patients with symptoms attributed to indoor environment.  

PubMed

This study investigated self-image and coping ability in a group of patients with symptoms from indoor environment. A follow-up questionnaire was sent to 239 patients previously referred with nonspecific building-related symptoms at University Hospital in Umeå, Sweden. One hundred seventy-four women and 14 men answered and the patient group rated their self-image as more spontaneous, more positive, and less negative than a control group. The patient group rated higher on the cognitive scale in the Coping Resources Inventory (CRI) than the control group. The female patients had an increased risk of not being able to work associated with a low score on negative self-image. The authors conclude that certain personality traits may be potential risk factors that increase the probability of encountering and experiencing stressful work situations. The resulting stress may increase workers' susceptibility to indoor environment exposure. PMID:23566321

Edvardsson, B; Bergdahl, J; Eriksson, N; Stenberg, B

2013-01-01

153

Clinical decision support for imaging in the era of the Patient Protection and Affordable Care Act.  

PubMed

Imaging clinical decision support (CDS) systems provide evidence for or against imaging procedures ordered within a computerized physician order entry system at the time of the image order. Depending on the pertinent clinical history provided by the ordering clinician, CDS systems can optimize imaging by educating providers on appropriate image order entry and by alerting providers to the results of prior, potentially relevant imaging procedures, thereby reducing redundant imaging. The American Recovery and Reinvestment Act (ARRA) has expedited the adoption of computerized physician order entry and CDS systems in health care through the creation of financial incentives and penalties to promote the "meaningful use" of health IT. Meaningful use represents the latest logical next step in a long chain of legislation promoting the areas of appropriate imaging utilization, accurate reporting, and IT. It is uncertain if large-scale implementation of imaging CDS will lead to improved health care quality, as seen in smaller settings, or to improved patient outcomes. However, imaging CDS enables the correlation of existing imaging evidence with outcome measures, including morbidity, mortality, and short-term imaging-relevant management outcomes (eg, biopsy, chemotherapy). The purposes of this article are to review the legislative sequence relevant to imaging CDS and to give guidance to radiology practices focused on quality and financial performance improvement during this time of accelerating regulatory change. PMID:23206649

Zafar, Hanna M; Mills, Angela M; Khorasani, Ramin; Langlotz, Curtis P

2012-12-01

154

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 PMID:8257207

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

1993-01-01

155

Method and system for the diagnosis of disease using retinal image content and an archive of diagnosed human patient data  

DOEpatents

A method for diagnosing diseases having retinal manifestations including retinal pathologies includes the steps of providing a CBIR system including an archive of stored digital retinal photography images and diagnosed patient data corresponding to the retinal photography images, the stored images each indexed in a CBIR database using a plurality of feature vectors, the feature vectors corresponding to distinct descriptive characteristics of the stored images. A query image of the retina of a patient is obtained. Using image processing, regions or structures in the query image are identified. The regions or structures are then described using the plurality of feature vectors. At least one relevant stored image from the archive based on similarity to the regions or structures is retrieved, and an eye disease or a disease having retinal manifestations in the patient is diagnosed based on the diagnosed patient data associated with the relevant stored image(s).

Tobin, Kenneth W; Karnowski, Thomas P; Chaum, Edward

2013-08-06

156

Cardiac electrophysiological activation pattern estimation from images using a patient-specific database of synthetic image sequences.  

PubMed

While abnormal patterns of cardiac electrophysiological activation are at the origin of important cardiovascular diseases (e.g., arrhythmia, asynchrony), the only clinically available method to observe detailed left ventricular endocardial surface activation pattern is through invasive catheter mapping. However, this electrophysiological activation controls the onset of the mechanical contraction; therefore, important information about the electrophysiology could be deduced from the detailed observation of the resulting motion patterns. In this paper, we present the study of this inverse cardiac electrokinematic relationship. The objective is to predict the activation pattern knowing the cardiac motion from the analysis of cardiac image sequences. To achieve this, we propose to create a rich patient-specific database of synthetic time series of the cardiac images using simulations of a personalized cardiac electromechanical model, in order to study this complex relationship between electrical activity and kinematic patterns in the context of this specific patient. We use this database to train a machine-learning algorithm which estimates the depolarization times of each cardiac segment from global and regional kinematic descriptors based on displacements or strains and their derivatives. Finally, we use this learning to estimate the patient’s electrical activation times using the acquired clinical images. Experiments on the inverse electrokinematic learning are demonstrated on synthetic sequences and are evaluated on clinical data with promising results. The error calculated between our prediction and the invasive intracardiac mapping ground truth is relatively small (around 10 ms for ischemic patients and 20 ms for nonischemic patient). This approach suggests the possibility of noninvasive electrophysiological pattern estimation using cardiac motion imaging. PMID:24058008

Prakosa, Adityo; Sermesant, Maxime; Allain, Pascal; Villain, Nicolas; Rinaldi, C Aldo; Rhode, Kawal; Razavi, Reza; Delingette, Hervé; Ayache, Nicholas

2014-02-01

157

Surface imaging for patient setup and monitoring for breast radiotherapy  

E-print Network

Approximately one in eight women will get breast cancer at some point in their lives. A promising new treatment is partial breast irradiation, in which multiple radiation beams cross at the tumor site within the patient. ...

Book, Lynn Novella

2007-01-01

158

Electronic decision protocols for ART patient triaging to expand access to HIV treatment in South Africa: A cross sectional study for development and validation  

PubMed Central

Background The shortage of doctors and nurses, along with future expansion into rural clinics, will require that the majority of clinic visits by HIV infected patients on antiretroviral therapy (ART) are managed by non-doctors. The goal of this study was to develop and evaluate a screening protocol to determine which patients needed a full clinical assessment and which patients were stable enough to receive their medications without a doctor’s consultation. For this study, we developed an electronic, handheld tool to guide non-physician counselors through screening questions. Methods Patients visiting two ART clinics in South Africa for routine follow-up visits between March 2007 – April 2008 were included in our study. Each patient was screened by non-physician counselors using the handheld device and then received a full clinical assessment. Clinicians’ report on whether full clinical assessment had been necessary was used as the gold standard for determining “required referral”. Observations were randomly divided into two datasets – 989 for developing a referral protocol and 200 for validating protocol performance. Results A third of patients had at least one physical complaint, and 16% had five or more physical complaints. 38% of patients required referral for full clinical assessment. We identify a subset of questions which are 87% sensitive and 47% specific for recommended patient referral. Conclusions The final screening protocol is highly sensitive and could reduce burden on ART clinicians by 30%. The uptake and acceptance of the handheld tool to support implementation of the protocol was high. Further examination of the data reveals several important questions to include in future referral algorithms to improve sensitivity and specificity. Based on these results, we identify a refined algorithm to explore in future evaluations. PMID:22178295

MITCHELL, Marc; HEDT, Bethany L.; ESHUN-WILSON, Ingrid; FRASER, Hamish; JOHN, Melanie-Anne; MENEZES, Colin; GROBUSCH, Martin P.; JACKSON, Jonathan; TALJAARD, Jantjie; LESH, Neal

2012-01-01

159

Abnormal brain magnetic resonance imaging in two patients with Smith-Magenis syndrome.  

PubMed

Smith-Magenis syndrome (SMS) is a clinically recognizable contiguous gene syndrome ascribed to an interstitial deletion in chromosome 17p11.2. Seventy percent of SMS patients have a common deletion interval spanning 3.5 megabases (Mb). Clinical features of SMS include characteristic mild dysmorphic features, ocular anomalies, short stature, brachydactyly, and hypotonia. SMS patients have a unique neurobehavioral phenotype that includes intellectual disability, self-injurious behavior and severe sleep disturbance. Little has been reported in the medical literature about anatomical brain anomalies in patients with SMS. Here we describe two patients with SMS caused by the common deletion in 17p11.2 diagnosed using chromosomal microarray (CMA). Both patients had a typical clinical presentation and abnormal brain magnetic resonance imaging (MRI) findings. One patient had subependymal periventricular gray matter heterotopia, and the second had a thin corpus callosum, a thin brain stem and hypoplasia of the cerebellar vermis. This report discusses the possible abnormal MRI images in SMS and reviews the literature on brain malformations in SMS. Finally, although structural brain malformations in SMS patients are not a common feature, we suggest baseline routine brain imaging in patients with SMS in particular, and in patients with chromosomal microdeletion/microduplication syndromes in general. Structural brain malformations in these patients may affect the decision-making process regarding their management. PMID:24788350

Maya, Idit; Vinkler, Chana; Konen, Osnat; Kornreich, Liora; Steinberg, Tamar; Yeshaya, Josepha; Latarowski, Victoria; Shohat, Mordechai; Lev, Dorit; Baris, Hagit N

2014-08-01

160

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

1998-01-01

161

Detection of Hepatic Masses in Patients with Carcinoma: Comparative Sensitivities of Sonography, CT, and MR Imaging  

Microsoft Academic Search

To evaluate the sensitivity of sonography, CT, and MR imaging in the detection of hepatic masses in carcinoma patients, we conducted a prospective study of 75 consec- utive patients with gastrointestinal tumors who were admitted for surgical resection of the primary tumor. Sonography was performed with convex transducers of 3.5 and 5.0 MHz. Three noninvasive CT techniques were used: unenhanced

Karl Wernecke; Ernst Aummeny; Georg Bongartz; Pierre Vassallo; Dietmar Kivelitz; Werner Wiesmann; Berthold Reers; Maximilian Reiser; Wilfried Pircher

162

Fundus imaging in patients with cataract: role for a variable wavelength scanning laser ophthalmoscope  

Microsoft Academic Search

AIMS--An investigation was carried out to compare the image quality of the ocular fundus obtained clinically, photographically, and with the scanning laser ophthalmoscope (SLO) at visible and infrared wavelengths in patients with significant cataract. METHODS--Nineteen patients admitted for routine cataract extraction were examined clinically by two independent observers to ascertain cataract type and clarity of fundus view with an indirect

J N Kirkpatrick; A Manivannan; A K Gupta; J Hipwell; J V Forrester; P F Sharp

1995-01-01

163

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

2009-01-01

164

Magnetic Resonance Imaging after Seizures in Patients with an Ischemic Stroke  

Microsoft Academic Search

Background: Seizures related to ischemic strokes are harmful. Their pathogenesis is not very well understood. The present study investigates whether diffusion-weighted imaging (DWI) can detect if those seizures are due to recurrent infarction or responsible for secondary ischemic changes. Patients and Methods: DWI was obtained within 8 days in 60 patients with seizures (7 early and 53 late onset) related

J. De Reuck; F. Vanhee; G. Van Maele; I. Claeys

2007-01-01

165

Brain MR Imaging in the Evaluation of Chronic Headache in Patients without Other Neurologic Symptoms  

Microsoft Academic Search

Rationale and ObjectivesThe authors investigated the use of magnetic resonance (MR) imaging of the brain in adult patients with a primary complaint of chronic headache and no other neurologic symptoms or findings and determined the yield and MR predictors of major abnormalities in these patients.

Henry Z. Wang; Teresa M. Simonson; William R. Greco; William T. C. Yuh

2001-01-01

166

Urban Waters partnership expands  

NASA Astrophysics Data System (ADS)

The Urban Waters Federal Partnership has expanded to include 11 new additions throughout the United States, bringing the number of sites in the program to 18, the White House Council on Environmental Quality (CEQ) announced on 10 May at a briefing in Grand Rapids, Mich.

Showstack, Randy

2013-05-01

167

Expanding Views on Transition.  

ERIC Educational Resources Information Center

This position paper proposes an expanded definition of transition, based on common components of early childhood and secondary perspectives. It advocates for a seamless model of transition service delivery for students with disabilities, including program planning, from birth through age 21. The model addresses curriculum, location of services,…

Repetto, Jeanne B.; Correa, Vivian I.

1996-01-01

168

Expand Your Wildcat Network  

E-print Network

Expand Your Wildcat Network Presented by: Aspasia Sia Apostolakis Miller #12;Learn how to: ­ build a series of win/win relationships ­ make a strong introduction ­ build and maintain your network ­ avoid some common networking mistakes ­ discover what it means to be a part of a 200,000+ alumni network #12

Shull, Kenneth R.

169

EXPANDED BED BIOLOGICAL TREATMENT  

EPA Science Inventory

A three-year pilot-scale research investigation at the EPA Lebanon Pilot Plant was conducted to evaluate the feasibility of a unique biological secondary treatment process, designated the Expanded Bed Biological Treatment Process (EBBT). The EBBT process is a three-phase (oxygen/...

170

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.

2004-07-16

171

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…

1998

172

Patient Dosimetry and Image Quality in Conventional Diagnostic Radiology: A Practical Optimization Experience from a Serbian Hospital  

Microsoft Academic Search

\\u000a The optimization of image quality vs. patient dose is an important task in medical imaging. Maximal validity of optimization\\u000a has to be based on clinical images. Simultaneous measurement of patient dose levels and image quality assessment is used to\\u000a investigate possibilities for dose reduction and maintain image quality. The survey was conducted in a general hospital performing\\u000a more than 60000

O. Ciraj-Bjelac; D. Arandjic; D. Kosutic; M. Kovacevic

173

Non-invasive imaging for subclinical coronary atherosclerosis in patients with peripheral artery disease.  

PubMed

Patients with peripheral artery disease are at high risk of coronary artery disease. An increasing number of studies show that a large proportion of patients with peripheral artery disease have significant coronary atherosclerosis, even in the absence of symptoms. Although the reported prevalence of subclinical coronary artery disease varies widely in patients with peripheral artery disease, it could include more than half of patients. No consensus exists to date on either the rationale for screening patients with peripheral artery disease for coronary atherosclerosis or the optimal algorithm and method for screening. An increasing number of imaging modalities are emerging that allow improved in vivo non-invasive characterization of atherosclerotic plaques. These novel imaging methods may lead to early detection of high-risk vulnerable plaques, enabling clinicians to improve risk stratification of patients with peripheral artery disease, and thus paving the way for individualized therapy. PMID:24691587

Ripa, Rasmus Sejersten; Kjaer, Andreas; Hesse, Birger

2014-06-01

174

Clinical review: Lung imaging in acute respiratory distress syndrome patients - an update  

PubMed Central

Over the past 30 years lung imaging has greatly contributed to the current understanding of the pathophysiology and the management of acute respiratory distress syndrome (ARDS). In the past few years, in addition to chest X-ray and lung computed tomography, newer functional lung imaging techniques, such as lung ultrasound, positron emission tomography, electrical impedance tomography and magnetic resonance, have been gaining a role as diagnostic tools to optimize lung assessment and ventilator management in ARDS patients. Here we provide an updated clinical review of lung imaging in ARDS over the past few years to offer an overview of the literature on the available imaging techniques from a clinical perspective. PMID:24238477

2013-01-01

175

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)

2006-04-15

176

Investigation of gamma knife image registration errors resulting from misalignment between the patient and the imaging axis.  

PubMed

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. PMID:16696470

Cernica, George; Wang, Zhou; Malhotra, Harish; de Boer, Steven; Podgorsak, Matthew B

2006-04-01

177

Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy  

Microsoft Academic Search

Kilovoltage cone-beam computerized tomography (kV-CBCT) systems integrated into the gantry of linear accelerators can be used to acquire high-resolution volumetric images of the patient in the treatment position. Using on-line software and hardware, patient position can be determined accurately with a high degree of precision and, subsequently, set-up parameters can be adjusted to deliver the intended treatment. While the patient

Mohammad K. Islam; Thomas G. Purdie; Bernhard D. Norrlinger; Hamideh Alasti; Douglas J. Moseley; Michael B. Sharpe; Jeffrey H. Siewerdsen; David A. Jaffray

2006-01-01

178

Pancreatic magnetic resonance imaging after manganese injection distinguishes type 2 diabetic and normoglycemic patients  

PubMed Central

A non-invasive method to image the mass and/or function of human pancreatic islets is needed to monitor the progression of diabetes, and the effect of therapeutic interventions. As yet, no method is available for this purpose, which could be applied to in situ human islets. Animal and in vitro studies have documented that manganese infusion could improve the magnetic resonance imaging (MRI) of the endocrine pancreas. Here, we have tested whether a similar approach could discriminate diabetic and non-diabetic patients. In vitro, human isolated islets readily incorporated manganese. In vivo, 243 manganese-enhanced magnetic resonance imaging (MEMRI) examinations were reviewed, including 41 examinations which were run on 24 patients with type 2 diabetes and 202 examinations which were run on 119 normoglycemic patients. The results show that MEMRI discriminates type 2 diabetics from non-diabetic patients, based on the signal enhancement of pancreas. PMID:22722479

Botsikas, Diomidis; Terraz, Sylvain; Vinet, Laurent; Lamprianou, Smaragda; Becker, Christoph; Bosco, Domenico; Meda, Paolo; Montet, Xavier

2012-01-01

179

Imaging of Microglia in Patients with Neurodegenerative Disorders  

PubMed Central

Microglia constitute the main immune defense in the central nervous system. In response to neuronal injury, microglia become activated, acquire phagocytic properties, and release a wide range of pro-inflammatory mediators that are essential for the annihilation of the neuronal insult. Although the role of microglial activation in acute neuronal damage is well defined, the pathophysiological processes underlying destructive or protective role to neurons following chronic exposure to microglial activation is still a subject of debate. It is likely that chronic exposure induces detrimental effects by promoting neuronal death through the release of neurotoxic factors. Positron emission tomography (PET) imaging with the use of translocator protein (TSPO) radioligands provides an in vivo tool for tracking the progression and severity of neuroinflammation in neurodegenerative disease. TSPO expression is correlated to the extent of microglial activation and the measurement of TSPO uptake in vivo with PET is a useful indicator of active disease. Although understanding of the interaction between radioligands and TSPO is not completely clear, there is a wide interest in application of TSPO imaging in neurodegenerative disease. In this article, we aim to review the applications of in vivo microglia imaging in neurodegenerative disorders such as Parkinson’s disease, Huntington’s disease, Dementias, and Multiple Sclerosis. PMID:22661951

Politis, Marios; Su, Paul; Piccini, Paola

2012-01-01

180

High-Resolution Imaging of Patients with Bietti Crystalline Dystrophy with CYP4V2 Mutation  

PubMed Central

The purpose of this study was to determine the retinal morphology of eyes with Bietti crystalline dystrophy (BCD) associated with a CYP4V2 mutation using high-resolution imaging techniques. Three subjects with BCD underwent detailed ophthalmic examinations. High-resolution fundus images were obtained with an adaptive optics (AO) fundus camera. A common homozygous mutation was detected in the three patients. Funduscopic examination of the three patients revealed the presence of crystalline deposits in the retina, and all of the crystalline deposits were also detected in the infrared (IR) images. The crystals observed in the IR images were seen as bright reflective plaques located on the RPE layer in the SD-OCT images. The clusters of hyperreflective signals in the AO images corresponded to the crystals in the IR images. High-magnification AO images revealed that the clusters of hyperreflective signals consisted of circular spots that are similar to the signals of cone photoreceptors. Most of these circular spots were detected in healthy areas in the FAF images. There is a possibility that circular spots observed by AO are residual cone photoreceptors located over the crystals.

Gocho, Kiyoko; Kameya, Shuhei; Akeo, Keiichiro; Kikuchi, Sachiko; Usui, Ayumi; Yamaki, Kunihiko; Hayashi, Takaaki; Tsuneoka, Hiroshi; Mizota, Atsushi; Takahashi, Hiroshi

2014-01-01

181

Value of exercise thallium-201 imaging in patients with diagnostic and nondiagnostic exercise electrocardiograms  

SciTech Connect

The role of exercise imaging with thallium-201 in the evaluation of patients suspected of having coronary artery disease was studied in 194 patients undergoing diagnostic coronary arteriography. Ninety-eight patients had 70 percent or more narrowing of one or more coronary vessels and 96 patients had either no or insignificant coronary artery disease. One hundren twenty-three of the 194 patients had conclusive treadmill exercise electrocardiograms (either positive or negative), and 71 had inconclusive exercise electrocardiograms. The specificity of exercise imaging (97 percent) was higher than that of exercise electrocardiograms (86 percent, p less than 0.02). The specificity of both tests combined was not significantly different from that of exercise electrocardiograms alone. The sensitivity (79 percent) and specificity (95 percent) of exercise imaging were not significantly different in patients with inconclusive exercise electrocardiograms when compared with those in patients whose exercise electrocardiograms were conclusive. These data indicate that exercise imaging is sensitive and specific in diagnosing coronary artery disease in the presence of diagnostic as well as nondiagnostic exercise electrocardiograms and that propranolol therapy does not affect the results.

Iskandrian, A.S.; Segal, B.L.

1981-08-01

182

Dose reduction and image quality optimizations in CT of pediatric and adult patients: phantom studies  

NASA Astrophysics Data System (ADS)

Multi-detector computed tomography (MDCT) can be used to easily and rapidly perform numerous acquisitions, possibly leading to a marked increase in the radiation dose to individual patients. Technical options dedicated to automatically adjusting the acquisition parameters according to the patient's size are of specific interest in pediatric radiology. A constant tube potential reduction can be achieved for adults and children, while maintaining a constant detector energy fluence. To evaluate radiation dose, the weighted CT dose index (CTDIw) was calculated based on the CT dose index (CTDI) measured using an ion chamber, and image noise and image contrast were measured from a scanned image to evaluate image quality. The dose-weighted contrast-to-noise ratio (CNRD) was calculated from the radiation dose, image noise, and image contrast measured from a scanned image. The noise derivative (ND) is a quality index for dose efficiency. X-ray spectra with tube voltages ranging from 80 to 140 kVp were used to compute the average photon energy. Image contrast and the corresponding contrast-to-noise ratio (CNR) were determined for lesions of soft tissue, muscle, bone, and iodine relative to a uniform water background, as the iodine contrast increases at lower energy (i.e., k-edge of iodine is 33 keV closer to the beam energy) using mixed water-iodine contrast normalization (water 0, iodine 25, 100, 200, and 1000 HU, respectively). The proposed values correspond to high quality images and can be reduced if only high-contrast organs are assessed. The potential benefit of lowering the tube voltage is an improved CNRD, resulting in a lower radiation dose and optimization of image quality. Adjusting the tube potential in abdominal CT would be useful in current pediatric radiography, where the choice of X-ray techniques generally takes into account the size of the patient as well as the need to balance the conflicting requirements of diagnostic image quality and radiation dose optimization.

Jeon, P.-H.; Lee, C.-L.; Kim, D.-H.; Lee, Y.-J.; Jeon, S.-S.; Kim, H.-J.

2014-03-01

183

Thallium-technetium subtraction parathyroid imaging in patients having previous parathyroid surgery  

SciTech Connect

Parathyroid imaging based on the principle of differential uptakes of Tc-99m and T1-201 in the anterior neck to localize parathyroid (PT) disease has been reported with widely varying results. To evaluate the usefulness of this method, we have performed PT imaging on 47 patients prior to exploratory surgery for PT disease. Using pinhole collimation and digital acquisition, a 50k count image of the thyroid was obtained 20 minutes after injection of 1mCi99m Tc-pertechnetate. Then a lmCi dose of Tl-201 chloride was injected and a series of images acquired for 30 minutes at 30 sec/image. Raw data was spatially filtered and normalized by summing sufficient T1-201 images to equal the Tc-99m image scale of maximum cts/pixel. Image subtraction (Tl-Tc) gave the final PT image. Of 10 pts who had previous neck exploration, all had PT pathology accurately localized by preoperative scanning (7=single adenoma, 2=single hyperplastic gland, 1=two hyperplastic glands). In two causes distant ectopic pathology was localized in the strap muscles of the neck. For the 37 pts without previous surgery, scanning localized 85% of adenomas and 44% of hyperplastic glands with a false positive rate of 17%. Patient motion and coexisting thyroid disease particularly degraded final image quality. The authors conclude that preoperative PT imaging is a valuable aid for localizing pathology in patients who undergo secondary neck exploration but has only limited use for screening primary surgical cases.

O'Donnell, J.K.; Broughan, T.A.; Kropilak, M.D.; Esselstyn, C.B. Jr.

1985-05-01

184

High response rate to bortezomib with or without dexamethasone in patients with relapsed or refractory multiple myeloma: results of a global phase 3b expanded access program.  

PubMed

Phase 2 trials have demonstrated that bortezomib +/- dexamethasone is safe and effective in relapsed multiple myeloma (MM). In this multicentre, open-label, phase 3b trial, 638 patients with relapsed or refractory MM (median 3 prior therapies) received bortezomib 1.3 mg/m2 on days 1, 4, 8, and 11 of a maximum of eight 3-week cycles (median 5 cycles). Dexamethasone 20 mg/d was added the day of and day after each bortezomib dose for progressive disease after > or =2 cycles or for stable disease after > or =4 cycles. Responses were assessed based on M-protein changes. Overall response rate was 67%, including 11% complete (100% M-protein reduction), 22% very good partial (75-99% reduction), 18% partial (50-74% reduction), and 16% minimal response (25-49% reduction). Dexamethasone was added in 208 patients (33%), of whom 70 (34%) showed improved response. Median time to best response of minimal response or better was 84 d. Most common grade 3/4 adverse events were thrombocytopenia (39%), neutropenia (16%), anaemia (12%), diarrhoea (7%), and peripheral neuropathy (6%). Neuropathy (any grade) was seen in 25% of the patients and led to discontinuation in 5%. Bortezomib, alone and combined with dexamethasone, is safe and effective in heavily pretreated patients with relapsed or refractory MM. PMID:19036114

Mikhael, Joseph R; Belch, Andrew R; Prince, H Miles; Lucio, Maria Nambo; Maiolino, Angelo; Corso, Alessandro; Petrucci, Maria Teresa; Musto, Pellegrino; Komarnicki, Mieczyslaw; Stewart, A Keith

2009-01-01

185

Cavernous hemangiomas in patients with chronic liver disease: MR imaging findings.  

PubMed

The purpose of our study was to assess the difference in magnetic resonance imaging (MRI) features of cavernous hemangiomas in patients with chronic liver disease compared them with hemangiomas in normal livers. We retrospectively searched our records of MRI of the liver between October 1998 and June 2002, and identified 76 hemangiomas in 49 patients (18 men and 31 women; age range 29-81 years [mean, 57 years]). Hemangiomas were classified into 3 groups: patients with cirrhosis [group 1, 8 lesions in 8 patients], patients with chronic hepatitis [group 2, 6 lesions in 5 patients], and patients without underlying liver disease [group 3, 62 lesions in 36 patients]. Four radiologists, blinded to clinical information, retrospectively reviewed in consensus the MRI findings of hemangiomas for number, size, signal intensities on T1- and T2-weighted images, and enhancement patterns on early- and late-phase postcontrast images. The mean lesion numbers and sizes were 1.0 and 16.2 +/- 9.6 mm, 1.2 and 15.3 +/- 7.1 mm, and 1.7 and 26.1 +/- 24.7 mm in groups 1-3, respectively. There was a correlation (p < 0.05, coefficient: 0.35) between lesion number and severity of liver disease. Although there was no significant difference in lesion size among the 3 groups, all of 11 lesions larger than 4 cm in diameter belonged to group 3. Almost all lesions appeared moderately hypointense on T1-weighted images and moderately hyperintense on T2-weighted images. Twenty-seven lesions showed immediate homogeneous enhancement (pattern 1), and 49 showed peripheral nodular enhancement with centripetal enhancement progression (pattern 2). There was no difference in frequency of enhancement patterns among the 3 groups. Hemangiomas were more often solitary in livers with chronic liver disease, large lesions were exclusively seen in livers without chronic liver disease, and there was a trend for small lesions in patients with chronic liver disease. PMID:14972389

Mastropasqua, Maria; Kanematsu, Masayuki; Leonardou, Polytimi; Braga, Larissa; Woosley, John T; Semelka, Richard C

2004-01-01

186

An optically stimulated luminescence dosimeter for measuring patient exposure from imaging guidance procedures.  

PubMed

There is a growing interest in patient exposure resulting from an x-ray imaging procedure used in image-guided radiation therapy. This study explores a feasibility to use a commercially available optically stimulated luminescence (OSL) dosimeter, nanoDot, for estimating imaging radiation exposure to patients. The kilovoltage x-ray sources used for kV-cone-beam CT (CBCT) imaging acquisition procedures were from a Varian on-board imager (OBI) image system. An ionization chamber was used to determine the energy response of nanoDot dosimeters. The chamber calibration factors for x-ray beam quality specified by half-value layer were obtained from an Accredited Dosimetry Calibration Laboratory. The Monte Carlo calculated dose distributions were used to validate the dose distributions measured by using the nanoDot dosimeters in phantom and in vivo. The range of the energy correction factors for the nanoDot as a function of photon energy and bow-tie filters was found to be 0.88-1.13 for different kVp and bow-tie filters. Measurement uncertainties of nanoDot were approximately 2-4% after applying the energy correction factors. The tests of nanoDot placed on a RANDO phantom and on patient's skin showed consistent results. The nanoDot is suitable dosimeter for in vivo dosimetry due to its small size and manageable energy dependence. The dosimeter placed on a patient's skin has potential to serve as an experimental method to monitor and to estimate patient exposure resulting from a kilovoltage x-ray imaging procedure. Due to its large variation in energy response, nanoDot is not suitable to measure radiation doses resulting from mixed beams of megavoltage therapeutic and kilovoltage imaging radiations. PMID:23920245

Ding, George X; Malcolm, Arnold W

2013-09-01

187

Improved Late Gadolinium Enhancement MR Imaging for Patients with Implanted Cardiac Devices  

PubMed Central

Purpose To propose and test a modified wideband late gadolinium enhancement (LGE) magnetic resonance (MR) imaging technique to overcome hyperintensity image artifacts caused by implanted cardiac devices. Materials and Methods Written informed consent was obtained from all participants, and the HIPAA-compliant study protocol was approved by the institutional review board. Studies in phantoms and in a healthy volunteer were performed to test the hypothesis that the hyperintensity artifacts that are typically observed on LGE images in patients with implanted cardiac devices are caused by insufficient inversion of the affected myocardial signal. The conventional LGE MR imaging pulse sequence was modified by replacing the nonselective inversion pulse with a wideband inversion pulse. The modified LGE sequence, along with the conventional LGE sequence, was evaluated in 12 patients with implantable cardioverter defibrillators (ICDs) who were referred for cardiac MR imaging. Results The ICD causes 2–6 kHz in frequency shift at locations 5–10 cm away from the device. This off-resonance falls outside the typical spectral bandwidth of the nonselective inversion pulse used in conventional LGE, which results in the hyperintensity artifact. In 10 of the 12 patients, the conventional LGE technique produced severe, uninterpretable hyperintensity artifacts in the anterior and lateral portions of the left ventricular wall. These artifacts were eliminated with use of the wideband LGE sequence, thereby enabling confident evaluation of myocardial viability. Conclusion The modified wideband LGE MR imaging technique eliminates the hyperintensity artifacts seen in patients with cardiac devices. The technique may enable LGE MR imaging in patients with cardiac devices, in whom LGE MR imaging otherwise could not be used for diagnosis. © RSNA, 2013 Online supplemental material is available for this article. PMID:24086074

Rashid, Shams; Rapacchi, Stanislas; Vaseghi, Marmar; Tung, Roderick; Shivkumar, Kalyanam; Finn, J. Paul

2014-01-01

188

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

189

The Expanding Place Value  

NSDL National Science Digital Library

This collection of three lesson plans is designed to provide students with practice understanding place value (0 to 999), using standard and word form to represent numbers, and using expanded form to represent place value. Each lesson plan provides activities that will help build student understanding of the concepts and practice to help reinforce the skill. Thirteen resource sheets are included and can be used with these lessons or as independent activities.

Thomson, Erin; Pugh, Dana

2005-01-01

190

Adaptive optics fundus images of cone photoreceptors in the macula of patients with retinitis pigmentosa  

PubMed Central

Background The purpose of this study was to examine cone photoreceptors in the macula of patients with retinitis pigmentosa using an adaptive optics fundus camera and to investigate any correlations between cone photoreceptor density and findings on optical coherence tomography and fundus autofluorescence. Methods We examined two patients with typical retinitis pigmentosa who underwent ophthalmological examination, including measurement of visual acuity, and gathering of electroretinographic, optical coherence tomographic, fundus autofluorescent, and adaptive optics fundus images. The cone photoreceptors in the adaptive optics images of the two patients with retinitis pigmentosa and five healthy subjects were analyzed. Results An abnormal parafoveal ring of high-density fundus autofluorescence was observed in the macula in both patients. The border of the ring corresponded to the border of the external limiting membrane and the inner segment and outer segment line in the optical coherence tomographic images. Cone photoreceptors at the abnormal parafoveal ring were blurred and decreased in the adaptive optics images. The blurred area corresponded to the abnormal parafoveal ring in the fundus autofluorescence images. Cone densities were low at the blurred areas and at the nasal and temporal retina along a line from the fovea compared with those of healthy controls. The results for cone spacing and Voronoi domains in the macula corresponded with those for the cone densities. Conclusion Cone densities were heavily decreased in the macula, especially at the parafoveal ring on high-density fundus autofluorescence in both patients with retinitis pigmentosa. Adaptive optics images enabled us to observe in vivo changes in the cone photoreceptors of patients with retinitis pigmentosa, which corresponded to changes in the optical coherence tomographic and fundus autofluorescence images. PMID:23378739

Tojo, Naoki; Nakamura, Tomoko; Fuchizawa, Chiharu; Oiwake, Toshihiko; Hayashi, Atsushi

2013-01-01

191

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

2012-02-01

192

Initial Clinical Experience Performing Patient Treatment Verification With an Electronic Portal Imaging Device Transit Dosimeter  

SciTech Connect

Purpose: To prospectively evaluate a 2-dimensional transit dosimetry algorithm's performance on a patient population and to analyze the issues that would arise in a widespread clinical adoption of transit electronic portal imaging device (EPID) dosimetry. Methods and Materials: Eleven patients were enrolled on the protocol; 9 completed and were analyzed. Pretreatment intensity modulated radiation therapy (IMRT) patient-specific quality assurance was performed using a stringent local 3%, 3-mm ? criterion to verify that the planned fluence had been appropriately transferred to and delivered by the linear accelerator. Transit dosimetric EPID images were then acquired during treatment and compared offline with predicted transit images using a global 5%, 3-mm ? criterion. Results: There were 288 transit images analyzed. The overall ? pass rate was 89.1% ± 9.8% (average ± 1 SD). For the subset of images for which the linear accelerator couch did not interfere with the measurement, the ? pass rate was 95.7% ± 2.4%. A case study is presented in which the transit dosimetry algorithm was able to identify that a lung patient's bilateral pleural effusion had resolved in the time between the planning CT scan and the treatment. Conclusions: The EPID transit dosimetry algorithm under consideration, previously described and verified in a phantom study, is feasible for use in treatment delivery verification for real patients. Two-dimensional EPID transit dosimetry can play an important role in indicating when a treatment delivery is inconsistent with the original plan.

Berry, Sean L., E-mail: BerryS@MSKCC.org [Department of Applied Physics and Applied Mathematics, Columbia University, New York, New York (United States); Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Polvorosa, Cynthia; Cheng, Simon; Deutsch, Israel; Chao, K. S. Clifford; Wuu, Cheng-Shie [Department of Radiation Oncology, Columbia University, New York, New York (United States)

2014-01-01

193

Computer-extracted MR imaging features are associated with survival in glioblastoma patients.  

PubMed

Automatic survival prognosis in glioblastoma (GBM) could result in improved treatment planning for the patient. The purpose of this research is to investigate the association of survival in GBM patients with tumor features in pre-operative magnetic resonance (MR) images assessed using a fully automatic computer algorithm. MR imaging data for 68 patients from two US institutions were used in this study. The images were obtained from the Cancer Imaging Archive. A fully automatic computer vision algorithm was applied to segment the images and extract eight imaging features from the MRI studies. The features included tumor side, proportion of enhancing tumor, proportion of necrosis, T1/FLAIR ratio, major axis length, minor axis length, tumor volume, and thickness of enhancing margin. We constructed a multivariate Cox proportional hazards regression model and used a likelihood ratio test to establish whether the imaging features are prognostic of survival. We also evaluated the individual prognostic value of each feature through multivariate analysis using the multivariate Cox model and univariate analysis using univariate Cox models for each feature. We found that the automatically extracted imaging features were predictive of survival (p = 0.031). Multivariate analysis of individual features showed that two individual features were predictive of survival: proportion of enhancing tumor (p = 0.013), and major axis length (p = 0.026). Univariate analysis indicated the same two features as significant (p = 0.021, and p = 0.017 respectively). We conclude that computer-extracted MR imaging features can be used for survival prognosis in GBM patients. PMID:25151504

Mazurowski, Maciej A; Zhang, Jing; Peters, Katherine B; Hobbs, Hasan

2014-12-01

194

Balloon-expandable stent repair of severe coarctation of aorta  

Microsoft Academic Search

Experimental studies have shown that stents implanted at the aorta become incorporated within the aortic wall and can be further expanded in growing animals. This study evaluates the feasibility and immediate results of balloon-expandable stent implantation in 10 patients with severe coarctation of aorta. The ages of the patients ranged from 1 month to 43 years; 1 was an infant,

José Suárez de Lezo; Manuel Pan; Miguel Romero; Alfonso Medina; José Segura; Djordje Pavlovic; Carlos Martinez; Ignacio Tejero; Juan Perez Navero; Francisco Torres; Mercedes Lafuente; Enrique Hernández; Francisco Melián; Manuel Concha

1995-01-01

195

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

196

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

2008-01-01

197

Optimal steel thickness combined with computed radiography for portal imaging of nasopharyngeal cancer patients  

SciTech Connect

The poor image quality of conventional metal screen-film portal imaging system has long been of concern, and various methods have been investigated in an attempt to enhance the quality of portal images. Computed radiography (CR) used in combination with a steel plate displays image enhancement. The optimal thickness of the steel plate had been studied by measuring the modulation transfer function (MTF) characteristics. Portal images of nasopharyngeal carcinoma patients were taken by both a conventional metal screen-film system and this optimal steel and CR plate combination system. Compared with a conventional metal screen-film system, the CR-metal screen system achieves a much higher image contrast. The measured modulation transfer function (MTF) of the CR combination is greater than conventional film-screen portal imaging systems and also results in superior image performance, as demonstrated by receiver operator characteristic (ROC) analysis. This optimal combination steel CR plate portal imaging system is capable of producing high contrast portal images conveniently.

Wu Shixiu; Jin Xiance; Xie Congying; Cao Guoquan [Radiation Oncology Department of the 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000 (China); Radiography Department of the 1st Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang, 325000 (China)

2005-10-15

198

Whole-brain arterial spin labeling perfusion MR imaging in patients with acute stroke  

PubMed Central

Background and purpose Perfusion MRI can be used to identify patients with acute ischemic stroke that may benefit from reperfusion therapies. The risk of nephrogenic systemic fibrosis, however, limits the use of contrast agents. Our objective was to evaluate the ability of arterial spin labeling (ASL), an alternative non-invasive perfusion technique, to detect perfusion deficits compared with dynamic susceptibility contrast (DSC) perfusion imaging. Methods Consecutive patients referred for emergency assessment of suspected acute stroke within a seven-month period were imaged with both ASL and DSC perfusion MRI. Images were interpreted in a random order by two experts blinded to clinical information for image quality, presence of perfusion deficits and diffusion-perfusion mismatches. Results 156 patients were scanned with a median time of 5.6 (3.0–17.7) hours from last seen normal. Stroke diagnosis was clinically confirmed in 78 patients. ASL and DSC imaging were available in 64 of these patients. A perfusion deficit was detected with DSC in 39 of these patients; ASL detected 32 of these index perfusion deficits, missing 7 lesions. The median volume of the perfusion deficits as determined with DSC was smaller in patients which were evaluated as normal with ASL than in those with a deficit (median, interquartile range; 56 (10–116) vs. 114 (41–225) ml, p=0.01). Conclusions ASL can depict large perfusion deficits and perfusion/diffusion mismatches in correspondence with DSC. Our findings show that a fast 2½ minute ASL perfusion scan may be adequate for screening acute stroke patients with contraindications to gadolinium-based contrast agents. PMID:22426319

Bokkers, Reinoud P.H.; Hernandez, Daymara A.; Merino, Jose G.; Mirasol, Raymond V.; van Osch, M.J.; Hendrikse, Jeroen; Warach, Steven; Latour, Lawrence L.

2012-01-01

199

Body image in obese patients before and after stable weight reduction following bariatric surgery.  

PubMed

The role of possessing an abnormal body weight in the body image alterations of obese patients was evaluated in bariatric surgery subjects prior to and at long term after operation, when body weight and shape had become steadily normalized. Body image was assessed by the body dissatisfaction scale of the Eating Disorders Inventory, the Body Shape Questionnaire, and the Body Attitude Questionnaire. When the individuals were obese, a sharply impaired body image was observed; following operation, weight loss corresponded to normalization of body dissatisfaction, feeling of fatness, and physical attractiveness, whereas body disparagement and salience of shape, although improved in comparison to preoperative data, remained significantly different from that of controls. In the obese patients, some aspects of body image alterations are substantially accounted for by overweight status; other aspects reflect inner feelings, which are partially independent of the actual body weight and shape. PMID:10193918

Adami, G F; Meneghelli, A; Bressani, A; Scopinaro, N

1999-03-01

200

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?

2008-01-01

201

Model-based estimation of breast percent density in raw and processed full-field digital mammography images from image-acquisition physics and patient-image characteristics  

NASA Astrophysics Data System (ADS)

Breast percent density (PD%), as measured mammographically, is one of the strongest known risk factors for breast cancer. While the majority of studies to date have focused on PD% assessment from digitized film mammograms, digital mammography (DM) is becoming increasingly common, and allows for direct PD% assessment at the time of imaging. This work investigates the accuracy of a generalized linear model-based (GLM) estimation of PD% from raw and postprocessed digital mammograms, utilizing image acquisition physics, patient characteristics and gray-level intensity features of the specific image. The model is trained in a leave-one-woman-out fashion on a series of 81 cases for which bilateral, mediolateral-oblique DM images were available in both raw and post-processed format. Baseline continuous and categorical density estimates were provided by a trained breast-imaging radiologist. Regression analysis is performed and Pearson's correlation, r, and Cohen's kappa, ?, are computed. The GLM PD% estimation model performed well on both processed (r=0.89, p<0.001) and raw (r=0.75, p<0.001) images. Model agreement with radiologist assigned density categories was also high for processed (?=0.79, p<0.001) and raw (?=0.76, p<0.001) images. Model-based prediction of breast PD% could allow for a reproducible estimation of breast density, providing a rapid risk assessment tool for clinical practice.

Keller, Brad M.; Nathan, Diane L.; Conant, Emily F.; Kontos, Despina

2012-03-01

202

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

2003-09-08

203

Effect of imaging and catheter characteristics on clinical outcome for patients in the PRECISE study  

PubMed Central

The PRECISE study used convection enhanced delivery (CED) to infuse IL13-PE38QQR in patients with recurrent glioblastoma multiforme (GBM) and compared survival to Gliadel Wafers (GW). The objectives of this retrospective evaluation were to assess: (1) catheter positioning in relation to imaging features and (2) to examine the potential impact of catheter positioning, overall catheter placement and imaging features on long term clinical outcome in the PRECISE study. Catheter positioning and overall catheter placement were scored and used as a surrogate of adequate placement. Imaging studies obtained on day 43 and day 71 after resection were each retrospectively reviewed. Catheter positioning scores, catheter overall placement scores, local tumor control and imaging change scores were reviewed and correlated using Generalized Linear Mixed Models. Cox PH regression analysis was used to examine whether these imaging based variables predicted overall survival (OS) and progression free survival (PFS) after adjusting for age and KPS. Of 180 patients in the CED group, 20 patients did not undergo gross total resection. Of the remaining 160 patients only 53% of patients had fully conforming catheters in respect to overall placement and 51% had adequate catheter positioning scores. Better catheter positioning scores were not correlated with local tumor control (P = 0.61) or imaging change score (P = 0.86). OS and PFS were not correlated with catheter positioning score (OS: P = 0.53; PFS: P = 0.72 respectively), overall placement score (OS: P = 0.55; PFS: P = 0.35) or imaging changes on day 43 MRI (P = 0.88). Catheter positioning scores and overall catheter placement scores were not associated with clinical outcome in this large prospective trial. PMID:20563833

Polley, Mei-Yin; Lee, Benjamin; Kunwar, Sandeep; Pedain, Christoph; Wembacher-Schroder, Eva; Mittermeyer, Stephan; Westphal, Manfred; Sampson, John H.; Vogelbaum, Michael A.; Croteau, David; Chang, Susan M.

2010-01-01

204

An image-based modeling framework for patient-specific computational hemodynamics  

Microsoft Academic Search

We present a modeling framework designed for patient-specific computational hemodynamics to be performed in the context of\\u000a large-scale studies. The framework takes advantage of the integration of image processing, geometric analysis and mesh generation\\u000a techniques, with an accent on full automation and high-level interaction. Image segmentation is performed using implicit deformable\\u000a models taking advantage of a novel approach for selective

Luca Antiga; Marina Piccinelli; Lorenzo Botti; Bogdan Ene-Iordache; Andrea Remuzzi; David A. Steinman

2008-01-01

205

Fungal splenic abscesses in the immunosuppressed patient. Correlation of imaging modalities  

SciTech Connect

A patient with fungal splenic abscesses is presented in whom multiple noninvasive diagnostic imaging modalities were available for correlation. Of the five imaging modalities, three (Gallium-67, ultrasound and computed tomography) were diagnostically useful, while two (liver-spleen scan and In-111 white blood cell scan) were not as useful. This case also stresses the use of repeated studies correlating with clinical impressions to obtain an accurate diagnosis in a potentially life-threatening condition such as splenic abscess.

Vasquez, T.E.; Evans, D.G.; Schiffman, H.; Ashburn, W.L.

1987-01-01

206

[Abnormal findings of magnetic resonance imaging (MRI) in patients with systemic lupus erythematosus involving the brain].  

PubMed

To elucidate the clinical significance of MRI on CNS-SLE, MRI and CT scans were performed in 35 patients with SLE, of 18 patients who had CNS manifestations at the time of MRI examinations. The investigations were also carried out with 17 patients without CNS-SLE. The rate of detection of abnormal findings on MRI in patients with CNS-SLE was 77.2% (14/18), which was high, as compared with the rate of those on CT scans (50%: 9/18). Especially, all of 4 patients with seizure and 3 patients with encephalopathy showed abnormal MRI findings, although respectively 50% and 33.3% of them had abnormal CT scan findings. MRI findings were classified into 4 groups as below: 1) Large focal are as of increased signal intensity at T2 weighted image. These were observed in 2 of 4 patients with seizure and 1 of 3 patients with encephalopathy, which were completely resolved after treatment. 2) Patchy subcortical foci of increased signal intensity at T2 weighted image. These were observed in 11 of 18 CNS-SLE and 7 of 17 without CNS-SLE, which were not detected by CT scan. 3) All of six patients with cerebral infarctions showed high signal intensity areas at T2 weighted image and low signal intensity areas at T1 weighted image. 4) Normal findings were observed in 4 of 18 CNS-SLE (22.2%). We concluded that MRI is useful for the evaluation of CNS-SLE and provides more information than CT scan. PMID:1523521

Ishikawa, A; Okada, J; Kondo, H; Kashiwazaki, S

1992-06-01

207

Results of stereotactic radiosurgery for patients with imaging defined cavernous sinus meningiomas  

SciTech Connect

Introduction: The purpose of this study was to evaluate the efficacy and safety of stereotactic radiosurgery as primary management for patients with imaging defined cavernous sinus meningiomas. Methods: Between 1992 and 2001, 49 patients had radiosurgery for dural-based masses of the cavernous sinus presumed to be meningiomas. The mean patient age was 55.5 years. The mean tumor volume was 10.2 mL; the mean tumor margin dose was 15.9 Gy. The mean follow-up was 58 months (range, 16-144 months). Results: No tumor enlarged after radiosurgery. Twelve of 38 patients (26%) with preexisting diplopia or facial numbness/pain had improvement in cranial nerve function. Five patients (10%) had new (n = 3) or worsened (n = 2) trigeminal dysfunction; 2 of these patients (4%) underwent surgery at 20 and 25 months after radiosurgery despite no evidence of tumor progression. Neither patient improved after partial tumor resection. One patient (2%) developed an oculomotor nerve injury. One patient (2%) had an ischemic stroke related to occlusion of the cavernous segment of the internal carotid artery. Event-free survival was 98%, 85%, and 80% at 1, 3, and 7 years after radiosurgery, respectively. Univariate analysis of patient and dosimetric factors found no analyzed factor correlated with postradiosurgical morbidity. Conclusions: Radiosurgery was an effective primary management strategy for patients with an imaging defined cavernous sinus meningioma. Except in situations of symptomatic mass effect, unusual clinical presentation, or atypical imaging features, surgery to confirm the histologic diagnosis is unlikely to provide clinical benefit.

Pollock, Bruce E. [Department of Neurological Surgery, Mayo Clinic College of Medicine, Rochester, MN (United States) and Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)]. E-mail: pollock.bruce@mayo.edu; Stafford, Scott L. [Division of Radiation Oncology, Mayo Clinic College of Medicine, Rochester, MN (United States)

2005-08-01

208

Deformable image registration for geometrical evaluation of DIBH radiotherapy treatment of lung cancer patients  

NASA Astrophysics Data System (ADS)

Respiration and anatomical variation during radiotherapy (RT) of lung cancer yield dosimetric uncertainties of the delivered dose, possibly affecting the clinical outcome if not corrected for. Adaptive radiotherapy (ART), based on deformable image registration (DIR) and Deep-Inspiration-Breath-Hold (DIBH) gating can potentially improve the accuracy of RT. Purpose: The objective was to investigate the performance of contour propagation on repeated CT and Cone Beam CT (CBCT) images in DIBH compared to images acquired in free breathing (FB), using a recently released DIR software. Method: Three locally advanced non-small cell lung cancer patients were included, each with a planning-, midterm- and final CT (pCT, mCT, fCT) and 7 CBCTs acquired weekly and on the same day as the mCT and fCT. All imaging were performed in both FB and DIBH, using Varian RPM system for respiratory tracking. Delineations of anatomical structures were performed on each image set. The CT images were retrospective rigidly and deformable registered to all obtained images using the Varian Smart Adapt v. 11.0. The registered images were analysed for volume change and Dice Similarity Coefficient (DSC). Result: Geometrical similarities were found between propagated and manually delineated structures, with a slightly favour of FB imaging. Special notice should be taken to registrations where image artefacts or low tissue contrast are present. Conclusion: This study does not support the hypothesis that DIBH images perform better image registration than FB images. However DIR is a feasible tool for ART of lung cancer.

Ottosson, W.; Lykkegaard Andersen, J. A.; Borrisova, S.; Mellemgaard, A.; Behrens, C. F.

2014-03-01

209

Diffusion tensor imaging of peripheral nerve in patients with chronic inflammatory demyelinating polyradiculoneuropathy: a feasibility study  

Microsoft Academic Search

Introduction  The purpose of this study was to assess the clinical feasibility of diffusion tensor imaging (DTI) for the evaluation of peripheral\\u000a nerves in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Using a 3-T magnetic resonance imaging scanner, we obtained DTI scans of the tibial nerves of 10 CIDP patients and 10 sex-\\u000a and age-matched healthy volunteers. We prepared fractional anisotropy

Takako Kakuda; Hiroshi Fukuda; Keizo Tanitame; Miyuki Takasu; Shuji Date; Kazuhide Ochi; Tomohiko Ohshita; Tatsuo Kohriyama; Katsuhide Ito; Masayasu Matsumoto; Kazuo Awai

210

On the way to a patient table integrated scanner system in magnetic particle imaging  

NASA Astrophysics Data System (ADS)

Magnetic Particle Imaging is capable of three-dimensional real-time imaging. Due to high spatial and temporal resolution, the method offers a great potential to be used in interventional scenarios. In this contribution, a design study integrating a single-sided coil assembly into a patient table is presented. An elliptical and an approximated elliptical coil topology are compared and proposed as alternatives to the commonly used circular shaped coils. Through this, the size of the field of view can be extended while not exceeding the lateral width of the patient table.

Kaethner, C.; Ahlborg, M.; Gräfe, K.; Bringout, G.; Sattel, T. F.; Buzug, T. M.

2014-03-01

211

Kilovoltage Imaging Doses in the Radiotherapy of Pediatric Cancer Patients  

SciTech Connect

Purpose: To investigate doses induced by kilovoltage cone-beam computed tomography (kVCBCT) to pediatric cancer patients undergoing radiotherapy, as well as strategies for dose reduction. Methods and Materials: An EGS4 Monte Carlo code was used to calculate three-dimensional dose deposition due to kVCBCT on 4 pediatric cancer patients. Absorbed doses to various organs were analyzed for both half-fan and full-fan modes. Clinical conditions, such as distance from organ at risk (OAR) to CBCT field border, kV peak energy, and testicular shielding, were studied. Results: The mean doses induced by one CBCT scan operated at 125 kV in half-fan mode to testes, liver, kidneys, femoral heads, spinal cord, brain, eyes, lens, and optical nerves were 2.9, 4.7, 7.7, 10.5, 8.8, 7.6, 7.7, 7.8, and 7.2 cGy, respectively. Increasing the distances from OARs to CBCT field border greatly reduced the doses to OARs, ranging from 33% reduction for spinal cord to 2300% reduction for testes. As photon beam energy increased from 60 to 125 kV, the dose increase due to kVCBCT ranged from 170% for lens to 460% for brain and spinal cord. A testicular shielding made of 1-cm cerrobend could reduce CBCT doses down to 31%, 51%, 68%, and 82%, respectively, for 60, 80, 100, and 125 kV when the testes lay within the CBCT field. Conclusions: Generally speaking, kVCBCT deposits much larger doses to critical structures in children than in adults, usually by a factor of 2 to 3. Increasing the distances from OARs to CBCT field border greatly reduces doses to OARs. Depending on OARs, kVCBCT-induced doses increase linearly or exponentially with photon beam energy. Testicular shielding works more efficiently at lower kV energies. On the basis of our study, it is essential to choose an appropriate scanning protocol when kVCBCT is applied to pediatric cancer patients routinely.

Deng Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States); Chen Zhe; Roberts, Kenneth B.; Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States)

2012-04-01

212

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)

2007-07-15

213

Splenic imaging in a patient with functional asplenia  

SciTech Connect

A 65-year-old woman presented with right upper extremity paralysis and left cerebrovascular accident. A routine complete blood count (CBC) demonstrated Howell-Jolly bodies on peripheral smear, and a liver-spleen scan showed absent splenic sulfur colloid uptake suggesting functional asplenia. A subsequent heat damaged red blood cell study demonstrated a normal sized spleen with preserved sequestering function, thereby excluding anatomic asplenia, vascular alterations, or congenital anomalies in the differential diagnosis of functional asplenia. This case illustrates the use of Tc-99m heat damaged red blood cells as a unique and useful diagnostic aid in identifying the presence and size of a spleen in patients with functional asplenia. It also demonstrates an apparent qualitative separation of splenic functions in processing sulfur colloid and heat damaged red blood cells.

Wagman, P.G.; Dworkin, H.J.

1989-04-01

214

Optimization of MR imaging for pretreatment evaluation of patients with endometrial and cervical cancer.  

PubMed

Endometrial and cervical cancer are the most common gynecologic malignancies in the world. Accurate staging of cervical and endometrial cancer is essential to determine the correct treatment approach. The current International Federation of Gynecology and Obstetrics (FIGO) staging system does not include modern imaging modalities. However, magnetic resonance (MR) imaging has proved to be the most accurate noninvasive modality for staging endometrial and cervical carcinomas and often helps with risk stratification and making treatment decisions. Multiparametric MR imaging is increasingly being used to evaluate the female pelvis, an approach that combines anatomic T2-weighted imaging with functional imaging (ie, dynamic contrast material-enhanced and diffusion-weighted imaging). MR imaging helps guide treatment decisions by depicting the depth of myometrial invasion and cervical stromal involvement in patients with endometrial cancer and tumor size and parametrial invasion in those with cervical cancer. However, its accuracy for local staging depends on technique and image quality, namely thin-section high-resolution multiplanar T2-weighted imaging with simple modifications, such as double oblique T2-weighting supplemented by diffusion weighting and contrast enhancement. PMID:25019443

Rauch, Gaiane M; Kaur, Harmeet; Choi, Haesun; Ernst, Randy D; Klopp, Ann H; Boonsirikamchai, Piyaporn; Westin, Shannon N; Marcal, Leonardo P

2014-01-01

215

Cervical Spine Computed Tomography Imaging Artifact Affecting Clinical Decision-Making in the Traumatized Patient  

PubMed Central

CT scanning is an important tool in the evaluation of trauma patients. We review a case involving a trauma patient in which a cervical spine computed tomography (CT) artifact affected decision-making by physicians. The CT artifact mimicked bilateral dislocated facets (51-B1.1). On the basis of CT findings, the patient was transferred to a different hospital for evaluation. Discrepancy between the primary CT scan and patient physical exam prompted secondary CT scans and X-ray evaluation; neither of these studies showed osseous abnormalities. This case reinforces the necessity for physicians to formulate their diagnosis based upon multiple areas of information including physical examination, plain x-ray and subsequent advanced imaging, rather than relying solely on advanced imaging. PMID:25352931

Coats, Aaron C; Nies, Matthew S; Rispler, David

2014-01-01

216

Clinical utility of image-guided chest wall mass biopsy: results in 28 patients  

PubMed Central

Abstract The purpose of our study was to determine the clinical usefulness of percutaneous image-guided biopsy of chest wall masses. A retrospective study of 28 patients who underwent image-guided biopsy of chest wall masses from 2005 to 2007 was performed. In 19 (68%) patients, the mass was detected as part of a staging evaluation in patients with known malignancy; 9 (32%) patients had no known malignancy. Biopsy results were classified as diagnostic (malignant or benign) or non-diagnostic (atypical and insufficient). Sensitivity, specificity and negative predictive value were calculated for all patients, and the Fisher–Freeman–Halton exact test was used to determine if test characteristics varied in patients with and without a history of cancer, masses smaller and greater than 5 cm, or according to needle size. The overall diagnostic rate was 71%. Of these, there were 20 true-positives, 3 true-negatives, 5 false-negatives and no false-positive results (sensitivity 80% (20/25), specificity 100% (3/3) and negative predictive value 37.5% (3/8)). There were no differences between patients with and without cancer. Among 19 patients with known cancer, 10 had metastatic disease from their known primary. Biopsy test characteristics did not differ with respect to mass or needle size. Minor complications were seen in 7% of patients. Image-guided chest wall mass biopsy is a sensitive and specific procedure, which is clinically important in the care of patients both with and without a known primary cancer. PMID:21555261

De Angelo Andrade, Mauricio; Smith, Andrew; Dei Santi, Daniel B.

2011-01-01

217

A phantom evaluation of a stereo-vision surface imaging system for radiotherapy patient setup  

Microsoft Academic Search

External beam irradiation requires precise positioning of the target relative to the treatment planning coordinate system. A three-dimensional (3D) surface imaging system for patient positioning has recently been installed in one of our linear accelerator (linac) rooms. The device utilizes close-range photogrammetry to generate a 3D model of the patient's surface. This geometric model can be made to look like

Christoph Bert; Karen Doppke; Katherine G. Metheany

2005-01-01

218

Tissue Doppler imaging estimation of pulmonary artery occlusion pressure in ICU patients  

Microsoft Academic Search

Objective Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E\\/E’) measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E\\/E’ for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E\\/E’ ratio provides an

Alain Combes; Florence Arnoult; Jean-Louis Trouillet

2004-01-01

219

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

PubMed

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. PMID:21330971

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

2011-01-01

220

Diffusion-Weighted Imaging of White Matter Abnormalities in Patients with Phenylketonuria  

Microsoft Academic Search

Summary: Phenylketonuria (PKU) is an autosomal reces- sive disorder caused by a deficiency of the enzyme phenyl- alanine hydroxylase (EC 1.14.16.1). Affected patients de- velop elevated plasma and tissue levels of phenylalanine and its related ketoacids. Untreated patients usually exhibit severe mental retardation and poor motor function, with characteristic T2 white matter signal abnormalities on con- ventional MR images. In

Micheal D. Phillips; Peter McGraw; Mark J. Lowe; Vincent P. Mathews; Bryan E. Hainline

2001-01-01

221

[Magnetic resonance imaging in a patient with an implantable cardioverter-defibrillator].  

PubMed

The number of patients with cardiac pacemakers (PM), implantable cardioverter-defibrillators (ICD) and cardiac resynchronisation therapy PM systems is increasing. The number of magnetic resonance imaging (MRI) examinations is also growing and amounts to about 60 million tests per year worldwide. The presence of an ICD is still considered to be an absolute contraindication to MRI by most experts. We present a patient with an implanted ICD who successfully underwent brain MRI with use of special precautions. PMID:23797438

Fija?kowski, Marcin; Mielczarek, Maksymilian; Szurowska, Edyta; Zacharek, Dariusz; Kempa, Maciej; Dorniak, Karolina; Bohdan, Micha?; Sabisz, Agnieszka; Dubaniewicz, Miros?awa; Rynkiewicz, Andrzej

2013-01-01

222

Body image and health locus of control among male patients with incisional hernias  

Microsoft Academic Search

Incisional hernias form after surgery through incision sites and can enlarge over time. Relations between body image (BI) and health locus of control (HLC) were investigated in male patients undergoing evaluation for incisional hernia repair (n=32) and non-hernia controls (n=34). Analyses revealed that patients with incisional hernias reported significantly less satisfaction with general appearance and appearance of the mid-torso than

Emily L. Hiatt; Robert L. Collins; Nicholas J. Pastorek; Charles F. Bellows

2009-01-01

223

Eye movements in patients with glaucoma when viewing images of everyday scenes.  

PubMed

This study tests the hypothesis that patients with bilateral glaucoma exhibit different eye movements compared to normally-sighted people when viewing computer displayed photographs of everyday scenes. Thirty glaucomatous patients and 30 age-related controls with normal vision viewed images on a computer monitor whilst eye movements were simultaneously recorded using an eye tracking system. The patients demonstrated a significant reduction in the average number of saccades compared to controls (P = 0.02; mean reduction of 7% (95% confidence interval (CI): 3-11%)). There was no difference in average saccade amplitude between groups but there was between-person variability in patients. The average elliptical region scanned by the patients by a bivariate contour ellipse area (BCEA) analysis, was more restricted compared to controls (P = 0.004; mean reduction of 23% (95% (CI): 11-35%)). A novel analysis mapping areas of interest in the images indicated a weak association between severity of functional deficit and a tendency to not view regions typically viewed by the controls. In conclusion, some eye movements in some patients with bilateral glaucomatous defects differ from normal-sighted people of a similar age when viewing images of everyday scenes, providing evidence for a potential new window for looking into the functional consequences of the disease. PMID:23193606

Smith, Nicholas D; Crabb, David P; Glen, Fiona C; Burton, Robyn; Garway-Heath, David F

2012-01-01

224

In a patient with biclonal Waldenstrom macroglobulinemia only one clone expands in three-dimensional culture and includes putative cancer stem cells.  

PubMed

A small percentage of cases of Waldenstrom macroglobulinemia (WM) present with biclonality, defined here as the rearrangement of two distinct VDJ gene segments. Here we investigated the expansion of two clones from a patient with WM expressing molecularly detectable clonotypic gene rearrangements, one V(H)3 and one V(H)4. Biclonality was determined in blood and bone marrow mononuclear cells using real-time quantitative PCR (RQ-PCR). V(H)4 expressing cells but not V(H)3 expressing cells underwent clonal expansion in 3-D culture of reconstructed WM bone marrow. After 3-D culture, secondary culture in a colony forming unit assay, and RQ-PCR, only the V(H)4 clone was shown to harbor a subpopulation with characteristics of cancer stem cells, including proliferative quiescence, self-regeneration, and the ability to generate clonotypic progeny, suggesting that the V(H)4, but not the V(H)3, clone is clinically significant. Enrichment of potential WM stem cells in 3-D cultures holds promise for monitoring their response to treatment and for testing new therapies. PMID:21133724

Kirshner, Julia; Thulien, Kyle J; Kriangkum, Jitra; Motz, Sarah; Belch, Andrew R; Pilarski, Linda M

2011-02-01

225

Brain Magnetic Resonance Imaging Screening Is Not Useful for HIV-1-Infected Patients Without Neurological Symptoms.  

PubMed

Abstract We investigated the diagnostic usefulness of brain magnetic resonance imaging (MRI) screening in HIV-1-infected patients without neurological symptoms in detecting intracranial diseases at early stages. In this retrospective analysis, the study patients were HIV-1-infected patients who underwent brain MRI scan in clinical practice between 2001 and 2013. We excluded patients with MRI for (1) follow-up examination for prediagnosed intracranial diseases, (2) cancer staging, (3) screening mycobacterium/bacteria/fungi disease proliferation in the brain, and (4) evaluation for meningitis/encephalitis. The study patients (n=485) were classified into two groups: those who underwent brain MRI scan without any neurological symptoms/signs (asymptomatic patients, n=158) and those who underwent MRI due to such symptoms (symptomatic patients, n=327). Asymptomatic patients had lower CD4 counts than symptomatic patients (median 78 versus 241/?l). Intracranial diseases were detected in three (2%) of the asymptomatic patients [two toxoplasmosis and one progressive multifocal leukoencephalopathy (PML)] compared to 58 (19%) of the symptomatic patients (the ?(2) test, p<0.01). The latter included toxoplasmosis (n=10), PML (n=7), cytomegalovirus encephalitis (n=3), primary central nervous system lymphoma (n=3), cryptococcoma/meningitis (n=3), and HIV-associated dementia (n=17). Among symptomatic patients, intracranial diseases were common in those with slurred speech (3/6, 50%), seizure (4/10, 40%), eyesight/vision abnormality (5/16, 31%), altered mental status (8/31, 26%), and hemiplegia/numbness (13/50, 26%). For patients with CD4 count <200/?l, intracranial diseases were detected in only 3 (3%) of 144 asymptomatic patients, compared with 46 (32%) of 113 symptomatic patients (p<0.01). Brain MRI screening for HIV-1-infected patients without neurological symptoms is of little value. PMID:25084148

Nishijima, Takeshi; Gatanaga, Hiroyuki; Teruya, Katsuji; Tajima, Tsuyoshi; Kikuchi, Yoshimi; Hasuo, Kanehiro; Oka, Shinichi

2014-10-01

226

Magnetic Resonance Imaging in Multiple Sclerosis – Patients' Experiences, Information Interests and Responses to an Education Programme  

PubMed Central

Background Magnetic resonance imaging (MRI) is a key diagnostic and monitoring tool in multiple sclerosis (MS) management. However, many scientific uncertainties, especially concerning correlates to impairment and prognosis remain. Little is known about MS patients' experiences, knowledge, attitudes, and unmet information needs concerning MRI. Methods We performed qualitative interviews (n?=?5) and a survey (n?=?104) with MS patients regarding MRI patient information, and basic MRI knowledge. Based on these findings an interactive training program of 2 hours was developed and piloted in n?=?26 patients. Results Interview analyses showed that patients often feel lost in the MRI scanner and left alone with MRI results and images while 90% of patients in the survey expressed a high interest in MRI education. Knowledge on MRI issues was fair with some important knowledge gaps. Major information interests were relevance of lesions as well as the prognostic and diagnostic value of MRI results. The education program was highly appreciated and resulted in a substantial knowledge increase. Patients reported that, based on the program, they felt more competent to engage in encounters with their physicians. Conclusion This work strongly supports the further development of an evidence-based MRI education program for MS patients to enhance participation in health-care. PMID:25415501

Brand, Judith; Köpke, Sascha; Kasper, Jürgen; Rahn, Anne; Backhus, Imke; Poettgen, Jana; Stellmann, Jan-Patrick; Siemonsen, Susanne; Heesen, Christoph

2014-01-01

227

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. PMID:19561056

2009-01-01

228

Potential Applications of Imaging and Image-Guided Radiotherapy for Brain Metastases and Glioblastoma to Improve Patient Quality of Life  

PubMed Central

Treatment of glioblastoma multiforme (GBM) and brain metastasis remains a challenge because of the poor survival and the potential for brain damage following radiation. Despite concurrent chemotherapy and radiation dose escalation, local recurrence remains the predominant pattern of failure in GBM most likely secondary to repopulation of cancer stem cells. Even though radiotherapy is highly effective for local control of radio-resistant tumors such as melanoma and renal cell cancer, systemic disease progression is the cause of death in most patients with brain metastasis. Preservation of quality of life (QOL) of cancer survivors is the main issue for patients with brain metastasis. Image-guided radiotherapy (IGRT) by virtue of precise radiation dose delivery may reduce treatment time of patients with GBM without excessive toxicity and potentially improve neurocognitive function with preservation of local control in patients with brain metastasis. Future prospective trials for primary brain tumors or brain metastasis should include IGRT to assess its efficacy to improve patient QOL. PMID:24312897

Nguyen, Nam P.; Nguyen, Mai L.; Vock, Jacqueline; Lemanski, Claire; Kerr, Christine; Vinh-Hung, Vincent; Chi, Alexander; Khan, Rihan; Woods, William; Altdorfer, Gabor; D'Andrea, Mark; Karlsson, Ulf; Hamilton, Russ; Ampil, Fred

2013-01-01

229

Multi observation PET image analysis for patient follow-up quantitation and therapy assessment  

E-print Network

1 Multi observation PET image analysis for patient follow-up quantitation and therapy assessment S Institut Telecom - Telecom Bretagne, Brest, F-29200 France. Abstract. In Positron Emission Tomography (PET-quantitative parameters restricted to maximum SUV measured in PET scans during the treatment. Such measurements do

Brest, Université de

230

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.

1988-10-01

231

Tc99m HMPAO brain perfusion imaging in young Down's syndrome patients  

Microsoft Academic Search

Down's syndrome (DS) is characterized by moderate mental retardation and a variety of abnormalities involving multiple organ systems. There is a high incidence of Alzheimer's disease (AD) type dementia beyond the age of 35. In this study, single photon emission computed tomography (SPECT) brain perfusion imaging of young Down's syndrome patients was performed to define the perfusion pattern. Tc-99m HMPAO

Nahide Gökçora; Tamer Atasever; Ne?e ?lgin Karabacak; Gülin Vural; K?v?lc?m Gücüyener

1999-01-01

232

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: jiangbo122@126.com [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)

2012-04-01

233

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

NASA Astrophysics Data System (ADS)

In this work, Raman microspectroscopy and imaging was employed to analyze cancer patients' hair tissue. The comparison between the hair from rectum cancer patients and the hair from healthy people reveals some remarkable differences, such as for the rectum cancer patients, there are more lipids but less content of ?-helix proteins in the hair medulla section. Though more statistic data are required to establish universary rules for practical and accurate diagnosis, this work based on case study demonstrates the possibility of applying Raman microspectroscopy to reveal abnormality in non-cancer tissues such as hair in order to predict and diagnose cancers.

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

2013-09-01

234

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

2010-01-01

235

Incidental papillary fibroelastoma multimodal: imaging and surgical decisions in 2 patients.  

PubMed

Papillary fibroelastoma is a rare, benign cardiac tumor typically found on the heart valves. It is usually discovered incidentally on echocardiography. The clinical presentation of cardiac papillary fibroelastoma varies from no symptoms to severe embolic sequelae. We report the incidental finding of papillary fibroelastoma in 2 patients. In each, we chose to excise the tumor. The relevant medical literature provides little guidance regarding whether to excise a small papillary fibroelastoma in an asymptomatic patient. Multimodal imaging, which we discuss in the context of our patients' cases, aids the cardiologist and cardiovascular surgeon in more accurately evaluating papillary fibroelastoma preoperatively. PMID:23109781

Bouhzam, Najime; Kurtz, Baptiste; Doguet, Fabien; Eltchaninoff, Helene; Bauer, Fabrice

2012-01-01

236

Shaped, lead-loaded acrylic filters for patient exposure reduction and image-quality improvement  

SciTech Connect

Shaped filters that are constructed of lead-loaded acrylic material for use in patient radiography are discussed. Use of the filters will result in improved overall image quality with significant exposure reduction to the patient (approximately a 2X reduction in breast exposure and a 3X reduction in thyroid gland exposure). Detailed drawings of the shaped filters for scoliosis radiography, cervical spine radiography, and for long film changers in special procedures are provided. The use of the scoliosis filters is detailed and includes phantom and patient radiographs and dose reduction information.

Gray, J.E.; Stears, J.G.; Frank, E.D.

1983-03-01

237

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

PubMed

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

2013-01-01

238

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

PubMed Central

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

2013-01-01

239

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

PubMed

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

2013-10-01

240

Expanding hollow metal rings  

DOEpatents

A sealing device that may expand more planar dimensions due to internal thermal expansion of a filler material. The sealing material is of a composition such that when desired environment temperatures and internal actuating pressures are reached, the sealing materials undergoes a permanent deformation. For metallic compounds, this permanent deformation occurs when the material enters the plastic deformation phase. Polymers, and other materials, may be using a sealing mechanism depending on the temperatures and corrosivity of the use. Internal pressures are generated by either rapid thermal expansion or material phase change and may include either liquid or solid to gas phase change, or in the gaseous state with significant pressure generation in accordance with the gas laws. Sealing material thickness and material composition may be used to selectively control geometric expansion of the seal such that expansion is limited to a specific facing and or geometric plane.

Peacock, Harold B. (Evans, GA); Imrich, Kenneth J. (Grovetown, GA)

2009-03-17

241

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)

2010-08-15

242

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)

2009-05-15

243

The Role of Magnetic Resonance Imaging in Preoperative Planning for Patients Undergoing Therapeutic Mammoplasty  

PubMed Central

Background. Assessment of the ratio between tumour volume and breast volume in therapeutic mammoplasty is paramount. Traditionally based on clinical assessment and conventional breast imaging, the role of breast magnetic resonance imaging (MRI) in this context has not been established. Methods. Data was collected from all women undergoing therapeutic mammoplasty (TM) between 2006 and 2011. Each case was discussed at an MDT where MRI was considered to facilitate surgical planning. The contribution of MRI to disease assessment and surgical outcome was then reviewed. Results. 35 women underwent TM, 15 of whom had additional MRI. 33% of patients within the MRI subgroup had abnormalities not seen on either mammography or USS. Of those undergoing MRI, 1/15 patients required completion mastectomy versus 3 patients requiring completion mastectomy and 1 patient requiring further wide local excision (4/20) in the conventional imaging group. No statistical difference was seen between size on MRI and size on mammography versus final histological size, but a general trend for greater correlation between size on MRI and final histological size was seen. Conclusion. MRI should be considered in selected patients undergoing therapeutic mammoplasty. Careful planning can identify those who are most likely to benefit from MRI, potentially reducing the need for further surgery. PMID:24455305

Turton, Philip; Rajan, Sree; Nunn, April; Sharma, Nisha; Achuthan, Raj

2013-01-01

244

Image-Guided Radiotherapy for Cardiac Sparing in Patients with Left-Sided Breast Cancer  

PubMed Central

Patients with left-sided breast cancer are at risk of cardiac toxicity because of cardiac irradiation during radiotherapy with the conventional 3-dimensional conformal radiotherapy technique. In addition, many patients may receive chemotherapy prior to radiation, which may damage the myocardium and may increase the potential for late cardiac complications. New radiotherapy techniques such as intensity-modulated radiotherapy (IMRT) may decrease the risk of cardiac toxicity because of the steep dose gradient limiting the volume of the heart irradiated to a high dose. Image-guided radiotherapy (IGRT) is a new technique of IMRT delivery with daily imaging, which may further reduce excessive cardiac irradiation. Preliminary results of IGRT for cardiac sparing in patients with left-sided breast cancer are promising and need to be investigated in future prospective clinical studies. PMID:25295227

Lemanski, Claire; Thariat, Juliette; Ampil, Federico L.; Bose, Satya; Vock, Jacqueline; Davis, Rick; Chi, Alexander; Dutta, Suresh; Woods, William; Desai, Anand; Godinez, Juan; Karlsson, Ulf; Mills, Melissa; Nguyen, Nam Phong; Vinh-Hung, Vincent

2014-01-01

245

Single-Beat Noninvasive Imaging of Ventricular Endocardial and Epicardial Activation in Patients Undergoing CRT  

PubMed Central

Background Little is known about the effect of cardiac resynchronization therapy (CRT) on endo- and epicardial ventricular activation. Noninvasive imaging of cardiac electrophysiology (NICE) is a novel imaging tool for visualization of both epi- and endocardial ventricular electrical activation. Methodology/Principal Findings NICE was performed in ten patients with congestive heart failure (CHF) undergoing CRT and in ten patients without structural heart disease (control group). NICE is a fusion of data from high-resolution ECG mapping with a model of the patient's individual cardiothoracic anatomy created from magnetic resonance imaging. Beat-to-beat endocardial and epicardial ventricular activation sequences were computed during native rhythm as well as during ventricular pacing using a bidomain theory-based heart model to solve the related inverse problem. During right ventricular (RV) pacing control patients showed a deterioration of the ventricular activation sequence similar to the intrinsic activation pattern of CHF patients. Left ventricular propagation velocities were significantly decreased in CHF patients as compared to the control group (1.6±0.4 versus 2.1±0.5 m/sec; p<0.05). CHF patients showed right-to-left septal activation with the latest activation epicardially in the lateral wall of the left ventricle. Biventricular pacing resulted in a resynchronization of the ventricular activation sequence and in a marked decrease of total LV activation duration as compared to intrinsic conduction and RV pacing (129±16 versus 157±28 and 173±25 ms; both p<0.05). Conclusions/Significance Endocardial and epicardial ventricular activation can be visualized noninvasively by NICE. Identification of individual ventricular activation properties may help identify responders to CRT and to further improve response to CRT by facilitating a patient-specific lead placement and device programming. PMID:21298045

Berger, Thomas; Pfeifer, Bernhard; Hanser, Friedrich F.; Hintringer, Florian; Fischer, Gerald; Netzer, Michael; Trieb, Thomas; Stuehlinger, Markus; Dichtl, Wolfgang; Baumgartner, Christian; Pachinger, Otmar; Seger, Michael

2011-01-01

246

A contextual based double watermarking of PET images by patient ID and ECG signal.  

PubMed

This paper presents a novel digital watermarking framework using electrocardiograph (ECG) and demographic text data as double watermarks. It protects patient medical information and prevents mismatching diagnostic information. The watermarks are embedded in selected texture regions of a PET image using multi-resolution wavelet decomposition. Experimental results show that modifications in these locations are visually imperceptible. The robustness of the watermarks is verified through measurement of peak signal to noise ratio (PSNR), cross-correlation (CC%), structural similarity measure (SSIM) and universal image quality index (UIQI). Their robustness is also computed using pixel-based metrics and human visual system metrics. Additionally, beta factor (?) as an edge preservation measure is used for degradation evaluation of the image boundaries throughout the watermarked PET image. Assessment of the extracted watermarks shows watermarking robustness to common attacks such as embedded zero-tree wavelet (EZW) compression and median filtering. PMID:20934773

Nambakhsh, Mohammad-Saleh; Ahmadian, Alireza; Zaidi, Habib

2011-12-01

247

Population of 100 realistic, patient-based computerized breast phantoms for multi-modality imaging research  

NASA Astrophysics Data System (ADS)

Breast imaging is an important area of research with many new techniques being investigated to further reduce the morbidity and mortality of breast cancer through early detection. Computerized phantoms can provide an essential tool to quantitatively compare new imaging systems and techniques. Current phantoms, however, lack sufficient realism in depicting the complex 3D anatomy of the breast. In this work, we created one-hundred realistic and detailed 3D computational breast phantoms based on high-resolution CT datasets from normal patients. We also developed a finiteelement application to simulate different compression states of the breast, making the phantoms applicable to multimodality imaging research. The breast phantoms and tools developed in this work were packaged into user-friendly software applications to distribute for breast imaging research.

Segars, W. Paul; Veress, Alexander I.; Wells, Jered R.; Sturgeon, Gregory M.; Kiarashi, Nooshin; Lo, Joseph Y.; Samei, Ehsan; Dobbins, James T.

2014-03-01

248

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.

1983-12-01

249

Tomographic and planar radionuclide imaging in patients suspected meniscal injury: Arthroscopic correlation  

SciTech Connect

In patients (pts) with knee pain which may be related to meniscal tears, clinical judgment is used to determine whether medical management or arthroscopy is indicated. Based on the assumption that meniscal injury will result in adjacent changes in Tc-99m MDP bone images, studies using both planar and tomographic techniques were performed in 12 pts referred for arthroscopy. Planar imaging was performed in the anterior, posterior, and posterior medial and lateral oblique positions of the symptomatic knee. Single photon emission computed tomography was performed using a 64 view 360/sup 0/ acquisition of both knees. In this series, both imaging techniques were accurate in identifying abnormality, but analysis of transaxial tomographic data showed greater contrast and facilitated localization because of the better spatial orientation provided by this method. Thus, tomographic bone imaging appears valuable in defining areas of localized abnormality in the knees of pts with meniscal injury.

Fajman, W.A.; Diehl, M.; Dunaway, E.; Stephenson, R.; Eisner, R.; Riggins, R.S.; Berger, H.J.

1985-05-01

250

Brain Magnetic Resonance Imaging Findings in Young Patients with Hepatosplenic Schistosomiasis Mansoni without Overt Symptoms  

PubMed Central

The purpose of this study was to describe the brain magnetic resonance imaging (MRI) findings in young patients with hepatosplenic schistosomiasis mansoni without overt neurologic manifestations. This study included 34 young persons (age range = 9–25 years) with hepatosplenic schistosomiasis mansoni who had been previously treated. Patients were scanned on a 1.5-T system that included multiplanar pre-contrast and post-contrast sequences, and reports were completed by two radiologists after a consensus review. Twenty (58.8%) patients had MRI signal changes that were believed to be related to schistosomiasis mansoni. Twelve of the 20 patients had small focal hyperintensities on T2WI in the cerebral white matter, and eight patients had symmetric hyperintense basal ganglia on T1WI. There was a high frequency of brain MRI signal abnormalities in this series. Although not specific, these findings may be related to schistosomiasis. PMID:22665605

Manzella, Adonis; Borba-Filho, Paulo; Brandt, Carlos T.; Oliveira, Keyla

2012-01-01

251

The integration of medical images with the electronic patient record and their web-based distribution 1  

Microsoft Academic Search

Medical images are currently created digitally and stored in the radiology department’s picture archiving and communication system. Reports are usually stored in the electronic patient record of other information systems, such as the radiology information system (RIS) and the hospital information system (HIS). But high-quality services can only be provided if electronic patient record data is integrated with digital images

H. Münch; U. Engelmann; A. Schröter; H. P. Meinzer

2004-01-01

252

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.

1980-07-01

253

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.

1980-12-18

254

PRACTICAL PARALLEL IMAGING COMPRESSED SENSING MRI: SUMMARY OF TWO YEARS OF EXPERIENCE IN ACCELERATING BODY MRI OF PEDIATRIC PATIENTS.  

E-print Network

years1 , we have been experimenting with ap- plying compressed sensing parallel imaging for body imagPRACTICAL PARALLEL IMAGING COMPRESSED SENSING MRI: SUMMARY OF TWO YEARS OF EXPERIENCE IN ACCELERATING BODY MRI OF PEDIATRIC PATIENTS. SS Vasanawala2 MJ Murphy 1 MT Alley2 P Lai3 K Keutzer1 JM Pauly4 M

Lustig, Michael 'Miki'

255

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

2010-01-01

256

Body image disturbance in patients with borderline personality disorder: impact of eating disorders and perceived childhood sexual abuse.  

PubMed

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

2013-03-01

257

Magnetic resonance imaging in patients with newly diagnosed breast cancer: a review of the literature.  

PubMed

The use of magnetic resonance imaging (MRI) in patients with newly diagnosed breast cancer remains controversial. Here we review the current use of breast MRI and the impact of MRI on short-term surgical outcomes and rates of local recurrence. In addition, we address the use of MRI in specific patient populations, such as those with ductal carcinoma in situ, invasive lobular carcinoma, and occult primary breast cancer, and discuss the potential role of MRI for assessing response to neoadjuvant chemotherapy. Although MRI has improved sensitivity compared with conventional imaging, this has not translated into improved short-term surgical outcomes or long-term patient benefit, such as improved local control or survival, in any patient population. MRI is an important diagnostic test in the evaluation of patients presenting with occult primary breast cancer and has shown promise in monitoring response to neoadjuvant chemotherapy; however, the data do not support the routine use of perioperative MRI in patients with newly diagnosed breast cancer. Cancer 2014;120:120:2080-2089. © 2014 American Cancer Society. PMID:24752817

Pilewskie, Melissa; King, Tari A

2014-07-15

258

Diffusion tensor imaging reliably differentiates patients with schizophrenia from healthy volunteers.  

PubMed

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 (LDA) 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. PMID:20205252

Ardekani, Babak A; Tabesh, Ali; Sevy, Serge; Robinson, Delbert G; Bilder, Robert M; Szeszko, Philip R

2011-01-01

259

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. PMID:21430937

Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Hwang, Jae Joon; Lee, Song Am; Kim, Jun Seok; Chang, Seong-Hwan; Jung, Hong Geun

2011-01-01

260

Evaluation of intranasal Midazolam spray as a sedative in pediatric patients for radiological imaging procedures  

PubMed Central

Context: Preoperative anxiety and uncooperativeness experienced by pediatric patients are commonly associated with postoperative behavioral problems. Aims: We aimed to evaluate the efficacy and safety of intranasal Midazolam as a sedative in a pediatric age group for radiological imaging procedures and to note onset of sedation, level of sedation, condition of patient during separation from parents and effect on the cardio-respiratory system. Settings and Design: Randomized double-blinded study. Subjects and Methods: Fifty patients of the pediatric age group of American Society of Anesthesiologist grade 2 and 3 who came for any radiological imaging procedures were studied. Patients were randomly allocated to receive, intranasally, either Midazolam 0.5 mg/kg (group A N = 25) or normal saline (group B N = 25) in both nostrils (0.25 mg/kg in each) 15 min before the procedure. Time for onset of sedation and satisfactory sedation, sedation score, separation score, hemodynamic changes and side-effects were recorded. Statistical Analysis Used: Student's t-test. Results: Intranasal Midazolam group had a significantly shorter time for onset of sedation and satisfactory sedation. Mean sedation score and mean separation score at 10 min and 15 min intervals were significant in intranasal Midazolam as compared with normal saline (P < 0.001). Conclusions: Intranasal Midazolam 0.5 mg/kg is safe and effective and provides adequate sedation for easy separation from the parents and reduced requirement of intravenous supplementation during radiological imaging procedures without any untoward side-effects.

Chokshi, Anisha A.; Patel, Vipul R.; Chauhan, Parthiv R.; Patel, Deep J.; Chadha, Indu A.; Ramani, Monal N.

2013-01-01

261

IVUS Validation of Patient Coronary Artery Lumen Area Obtained from CT Images  

PubMed Central

Aims Accurate computed tomography (CT)-based reconstruction of coronary morphometry (diameters, length, bifurcation angles) is important for construction of patient-specific models to aid diagnosis and therapy. The objective of this study is to validate the accuracy of patient coronary artery lumen area obtained from CT images based on intravascular ultrasound (IVUS). Methods and Results Morphometric data of 5 patient CT scans with 11 arteries from IVUS were reconstructed including the lumen cross sectional area (CSA), diameter and length. The volumetric data from CT images were analyzed at sub-pixel accuracy to obtain accurate vessel center lines and CSA. A new center line extraction approach was used where an initial estimated skeleton in discrete value was obtained using a traditional thinning algorithm. The CSA was determined directly without any circular shape assumptions to provide accurate reconstruction of stenosis. The root-mean-square error (RMSE) for CSA and diameter were 16.2% and 9.5% respectively. Conclusions The image segmentation and CSA extraction algorithm for reconstruction of coronary arteries proved to be accurate for determination of vessel lumen area. This approach provides fundamental morphometric data for patient-specific models to diagnose and treat coronary artery disease. PMID:24489811

Luo, Tong; Wischgoll, Thomas; Kwon Koo, Bon; Huo, Yunlong; Kassab, Ghassan S.

2014-01-01

262

Radiation risks associated with serial imaging in colorectal cancer patients: Should we worry?  

PubMed Central

To provide an overview of the radiation related cancer risk associated with multiple computed tomographic scans required for follow up in colorectal cancer patients. A literature search of the PubMed and Cochrane Library databases was carried out and limited to the last 10 years from December 2012. Inclusion criteria were studies where computed tomographic scans or radiation from other medical imaging modalities were used and the risks associated with ionizing radiation reported. Thirty-six studies were included for appraisal with no randomized controlled trials. Thirty-four of the thirty-six studies showed a positive association between medical imaging radiation and increased risk of cancer. The radiation dose absorbed and cancer risk was greater in children and young adults than in older patients. Most studies included in the review used a linear, no-threshold model to calculate cancer risks and this may not be applicable at low radiation doses. Many studies are retrospective and ensuring complete follow up on thousands of patients is difficult. There was a minor increased risk of cancer from ionizing radiation in medical imaging studies. The radiation risks of low dose exposure (< 50 milli-Sieverts) are uncertain. A clinically justified scan in the context of colorectal cancer is likely to provide more benefits than harm but current guidelines for patient follow up will need to be revised to accommodate a more aggressive approach to treating metastatic disease. PMID:24415862

Oh, Jeong Suk; Koea, Jonathan B

2014-01-01

263

[Development of an automated patient recognition method for chest CT images using a template-matching technique].  

PubMed

If patient information, such as identification number or patient name, has been entered incorrectly in a picture archiving and communication system (PACS) environment, the image may be stored in the wrong place. To prevent such cases of misfiling, we have developed an automated patient recognition system for chest CT images. The image database consisted of 100 cases with present and previous chest CT images. A volume of interest (VOI) measuring 40 × 40 pixels was selected from the left lung region, bronchus region, and right lung region. Next, the overall lung region and these three regions in a current chest CT image were used as a template for determining the residual value with the corresponding four regions in previous chest CT images. To ensure separation between the same and different patients, we applied a combined analysis that employed the ruled-based plus artificial neural network (ANN) method. The overall performance of the method developed was examined in terms of receiver operating characteristic (ROC) curves. The performance of the rule-based plus ANN method using a combination of the four regions was higher than obtained using a rule-based method using these four regions separately. The automated patient recognition system using the rule-based plus ANN method achieved an area under the curve (AUC) value of 0.987. This automated patient recognition method for chest CT images is promising for helping to retrieve misfiled patient images, especially in a PACS environment. PMID:25327422

Okumura, Eiichiro; Aridome, Kazushige; Iwakiri, Chika; Oda, Kenji; Nakamura, Keita; Yamamoto, Masateru

2014-10-01

264

Value of a 24-hour image (four-phase bone scan) in assessing osteomyelitis in patients with peripheral vascular disease  

SciTech Connect

The delayed images of the four-phase /sup 99m/Tc phosphonate bone scan are compared with the delayed images of the three-phase study in patients with diabetes mellitus and/or peripheral vascular disease and suspected osteomyelitis. Three-phase bone imaging includes an immediate postinjection radionuclide angiogram, a blood-pool image, and delayed static images to 7 hr. The four-phase study adds a 24-hr static image. The scan is positive for osteomyelitis if images show progressively increasing lesion to background activity ratios over time. The results of analyzing 21 three- and four-phase bone scans in 17 patients were correlated with clinical course, cultures, and/or x-rays, gallium scans, and CT scans. The accuracy of four-phase bone imaging for diagnosing osteomyelitis was 85%; for three phase, 80%. Sensitivity for four phase was 80%; specificity was 87%. Sensitivity for three phase was 100%; specificity was 73%.

Alazraki, N.; Dries, D.; Datz, F.; Lawrence, P.; Greenberg, E.; Taylor, A. Jr.

1985-07-01

265

Expanding Patient Options: Minilaparotomy for Hysterectomy  

MedlinePLUS

... recommend putting a curve clamp on the inferior aspect of the peritoneum. This helps put a self- ... loss. We have another question. “What is the learning curve with the minilap procedure? How many cases ...

266

Comparison of Myocardial Perfusion Imaging and Cardiac Troponin I in Patients Admitted to the Emergency Department With Chest Pain  

Microsoft Academic Search

Background—Identification of patients with acute coronary syndromes (ACS) among those who present to emergency departments with possible myocardial ischemia is difficult. Myocardial perfusion imaging with 99mTc sestamibi and measurement of serum cardiac troponin I (cTnI) both can identify patients with ACS. Methods and Results—Patients considered at low to moderate risk for ACS underwent gated single-photon emission CT sestamibi imaging and

Michael C. Kontos; Robert L. Jesse; F. Philip Anderson; Kristin L. Schmidt; Joseph P. Ornato; James L. Tatum

2010-01-01

267

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.

1983-08-01

268

The effectiveness of digital infrared thermographic imaging in patients with shoulder impingement syndrome.  

PubMed

We prospectively evaluated 100 patients with unilateral impingement syndrome, before they underwent an arthroscopic subacromial decompression, to detect the relationship between clinical and operative findings and digital infrared thermographic imaging (DITI) findings in patients with shoulder impingement syndrome. The DITI system was used to measure the temperature of each patient's upper body, and the relative temperature values between involved and the uninvolved sides were used for analysis. A control group of 30 subjects without impingement syndrome was also evaluated. In DITI findings, 73% of patients had abnormal thermal changes in more than 1 of the 4 regions of interest: 51% displayed hypothermia, and 22% had hyperthermia. In the hypothermic group, limitation of shoulder motion was more prominent than in the hyperthermic and normal groups (P < .05). Other clinical findings did not correlate with the DITI findings, however. DITI can be used to reflect shoulder stiffness objectively in impingement syndrome, especially in those cases with a hypothermic thermal pattern. PMID:17560803

Park, Jin-Young; Hyun, Jung Keun; Seo, Joong-Bae

2007-01-01

269

The catatonic dilemma expanded  

Microsoft Academic Search

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

Heath R Penland; Natalie Weder; Rajesh R Tampi

2006-01-01

270

SUMMER 2013 CENTER EXPANDS  

E-print Network

sleep onset and sleep maintenance insomnia are common in patients with PD and are likely multi), may contribute to insomnia in PD. Motor fluctuations related to wearing-off of dopaminergic therapy be necessary. Other causes of insomnia not specific to the PD population include psychophysiologic insomnia (in

Bushman, Frederic

271

Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis  

SciTech Connect

Current standards for detection of myocarditis in a clinical setting rely on endomyocardial biopsy for accurate diagnosis. With this technique a subset of patients with dilated cardiomyopathy show unsuspected myocarditis histologically. Endomyocardial biopsy, despite its specificity, may lack sensitivity due to sampling error if the inflammation is patchy or focal. Therefore, inflammation-sensitive radioisotopic imaging may be a useful adjunct in the diagnosis of myocarditis. This study was designed to evaluate the applicability of gallium-67 (67Ga) myocardial imaging as an adjunct to endomyocardial biopsy in the diagnosis of myocarditis. Sixty-eight consecutive patients referred for evaluation of dilated cardiomyopathy underwent 71 parallel studies with 67Ga imaging and biopsies that served as the basis of comparison for this study. Histologic myocarditis was identified in 8% of biopsy specimens. Clinical and hemodynamic parameters could not be used to predict the presence of myocarditis. Five of six biopsy samples (87%) with myocarditis showed dense 67Ga uptake, whereas only nine of 65 negative biopsy samples (14%) were paired with equivocally positive 67Ga scans. The single patient with myocarditis and no myocardial 67Ga uptake had dense mediastinal lymph node uptake that may have obscured cardiac uptake. The incidence of myocarditis on biopsy with a positive 67Ga scan was 36% (5/14); however, the incidence of myocarditis with a negative 67Ga scan was only 1.8% (1/57). Follow-up scans for three patients showed close correlation of 67Ga uptake with myocarditis on biopsy. In conclusion 67Ga may be a useful screening test for identifying patients with a high yield of myocarditis on biopsy, and serial scans may eliminate the need for frequent biopsies in patients with proven myocarditis.

O'Connell, J.B.; Henkin, R.E.; Robinson, J.A.; Subramanian, R.; Scanlon, P.J.; Gunnar, R.M.

1984-07-01

272

Advanced expander test bed program  

NASA Technical Reports Server (NTRS)

The Advanced Expander Test Bed (AETB) is a key element in NASA's Chemical Transfer Propulsion Program for development and demonstration of expander cycle oxygen/hydrogen engine technology component technology for the next space engine. The AETB will be used to validate the high-pressure expander cycle concept, investigate system interactions, and conduct investigations of advanced missions focused components and new health monitoring techniques. 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.

Masters, A. I.; Mitchell, J. C.

1991-01-01

273

Advanced expander test bed engine  

NASA Technical Reports Server (NTRS)

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, study system interactions, and conduct studies 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.

Mitchell, J. P.

1992-01-01

274

Tc-99m-diethyl-IDA imaging: clinical evaluation in jaundiced patients  

SciTech Connect

Hepatobiliary imaging with Tc-99m-N,..cap alpha..-(2,6-diethylacetanilide)-iminodiacetic acid (Tc-diethyl-IDA) was performed in 91 jaundiced patients with documented hepatobiliary damage and serum total bilirubin up to 35 mg/dl. There were 56 patients with obstructive jaundice and 35 with hepatocellular disease. Correct discrimination between hepatocellular and obstructive jaundice was possible with an overall accuracy of 90%. Agreement with the final clinical diagnosis was obtained in 97% of patients with hepatocellular disease, and in 86% of patients with obstructive jaundice. The reliability of the test was inversely related to the serum bilirubin levels below 10 mg/dl to 83% for bilirubin between 10 and 20 mg/dl. Above 20 mg/dl, the demonstration of a mechanical obstruction was possible in only one out of the four patients with obstructive jaundice. The high predictive values of the test illustrate that Tc-diethyl-IDA imaging constitutes a reliable method to demonstrate an obstructive cause for the jaundice as long as the bilirubin level remains below 20 mg/dl.

Pauwels, S.; Piret, L.; Schoutens, A.; Vandermoten, G.; Beckers, C.

1980-11-01

275

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.

2008-08-01

276

Expanding roles for atorvastatin.  

PubMed

Atherosclerosis, especially when manifested as coronary artery disease (CAD), continues to be the number one cause of mortality and morbidity in developed nations and will soon become so in developing countries. Survivors of an acute heart attack have an increased risk of illness and death that is 1.5-15 times greater than in the general population. Sudden death occurs in myocardial infarction (MI) survivors at a rate 4-6 times greater than in the general population. After an initial recognized MI, 25% of male and 38% of female survivors die within 1 year. Within 6 years after a recognized MI, 18% of men and 35% of women will have a second MI, 7% of men and 6% of women will suffer sudden death, and 22% of men and 46% of women will be disabled with heart failure. Aggressive secondary prevention, therefore, is the key to containing and reversing the "malignant" natural history of CAD, since patients with CAD or CAD risk equivalents are already in the "high risk" category according to the Adult Treatment Panel III (ATP III) of the National Cholesterol Education rogram (NCEP). Treatment of dyslipidemia, especially the reduction of low-density lipoprotein (LDL) cholesterol levels to below 100 mg/dl, was recommended by the 2001 NCEP-ATP Guidelines. In 2004, based on the increasing evidence from several major clinical trials between 2001 and 2004, the NCEP-ATP reaffirmed its LDL goal of < 100 mg/dl in patients with CAD or coronary disease risk equivalents (including multiple risk factors), with an optional LDL goal of < 70 mg/dl in very-high-risk patients (including patients with established coronary heart disease plus other highrisk conditions) Findings from major studies, such as the Treating to New Targets (TNT) study, the Scandinavian Simvastatin Survival Study (4S), the Collaborative Atorvastatin Diabetes Study (CARDS), the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial and, more recently, the Lipid-Lowering Arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LAA), lend support to the idea that greater LDL cholesterol lowering than that achieved with standard doses of statins may be warranted in patients with CAD and metabolic syndrome, CAD and diabetes, CAD and congestive heart failure, and CAD and renal insufficiency. On the other hand, additional lipid reduction may also be warranted in patients with risk factors such as diabetes, hypertension or a history of stroke, but without manifest CAD and despite relatively normal cholesterol levels. These newer indications for statins, atorvastatin in particular, as part of more aggressive secondary and primary prevention, are reviewed in this paper. PMID:18596999

Singh, Vibhuti; Deedwania, Prakash

2008-06-01

277

Motion tracking on elbow tissue from ultrasonic image sequence for patients with lateral epicondylitis.  

PubMed

In this study, Kinesio Tape(R) is used in patients with lateral epicondylitis. The ultrasonic image sequences of elbow are recorded dynamically, and then motion tracking is applied to assist in understanding the effect of the therapy. Motion tracking, based on optical flow method, is used to track certain landmark on the ultrasound image, which is very ambiguous, for estimating the motion of muscle. Hierarchical block tracking technique is proposed to perform this task. The motions with and without Kinesio Taping are compared and can be used as quantitative indicators for the treatment. The experimental results show that Kinesio Taping makes the motion of muscle on the ultrasonic images enlarge. It means that the performance of muscle motion gets improve. PMID:18001897

Liu, Yuh-Hwan; Chen, Shu-Min; Lin, Chi-Yi; Huang, Chung-I; Sun, Yung-Nien

2007-01-01

278

Estimating Patient Dose from X-ray Tube Output Metrics: Automated Measurement of Patient Size from CT Images Enables Large-scale Size-specific Dose Estimates  

PubMed Central

Purpose To test the hypothesis that patient size can be accurately calculated from axial computed tomographic (CT) images, including correction for the effects of anatomy truncation that occur in routine clinical CT image reconstruction. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent. Water-equivalent diameter (DW) was computed from the attenuation-area product of each image within 50 adult CT scans of the thorax and of the abdomen and pelvis and was also measured for maximal field of view (FOV) reconstructions. Linear regression models were created to compare DW with the effective diameter (Deff) used to select size-specific volume CT dose index (CTDIvol) conversion factors as defined in report 204 of the American Association of Physicists in Medicine. Linear regression models relating reductions in measured DW to a metric of anatomy truncation were used to compensate for the effects of clinical image truncation. Results In the thorax, DW versus Deff had an R2 of 0.51 (n = 200, 50 patients at four anatomic locations); in the abdomen and pelvis, R2 was 0.90 (n = 150, 50 patients at three anatomic locations). By correcting for image truncation, the proportion of clinically reconstructed images with an extracted DW within ±5% of the maximal FOV DW increased from 54% to 90% in the thorax (n = 3602 images) and from 95% to 100% in the abdomen and pelvis (6181 images). Conclusion The DW extracted from axial CT images is a reliable measure of patient size, and varying degrees of clinical image truncation can be readily corrected. Automated measurement of patient size combined with CT radiation exposure metrics may enable patient-specific dose estimation on a large scale. © RSNA, 2013 PMID:24086075

Ikuta, Ichiro; Warden, Graham I.; Andriole, Katherine P.; Khorasani, Ramin

2014-01-01

279

Changes in Body Image Disturbance in Morbidly Obese Patients 1 Year after Laparoscopic Adjustable Gastric Banding  

Microsoft Academic Search

\\u000a Background  The effectiveness of post-surgical weight loss in improving body image disturbance (BID) in morbidly obese patients is still\\u000a unclear. Providing multidimensional measures of BID and controlling for the effect of co-morbid eating psychopathology may\\u000a help to clarify this issue. This preliminary study explores whether 1) BID improves 1 year after laparoscopic adjustable gastric\\u000a banding (LAGB), and whether 2) such improvement

Chiara De Panfilis; Sara Cero; Mariateresa Torre; Paola Salvatore; Elisabetta Dall’Aglio; Aristodemo Adorni; Carlo Maggini

2007-01-01

280

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

2011-01-01

281

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

282

Segmenting CT prostate images using population and patient-specific statistics for radiotherapy  

SciTech Connect

Purpose: In the segmentation of sequential treatment-time CT prostate images acquired in image-guided radiotherapy, accurately capturing the intrapatient variation of the patient under therapy is more important than capturing interpatient variation. However, using the traditional deformable-model-based segmentation methods, it is difficult to capture intrapatient variation when the number of samples from the same patient is limited. This article presents a new deformable model, designed specifically for segmenting sequential CT images of the prostate, which leverages both population and patient-specific statistics to accurately capture the intrapatient variation of the patient under therapy. Methods: The novelty of the proposed method is twofold: First, a weighted combination of gradient and probability distribution function (PDF) features is used to build the appearance model to guide model deformation. The strengths of each feature type are emphasized by dynamically adjusting the weight between the profile-based gradient features and the local-region-based PDF features during the optimization process. An additional novel aspect of the gradient-based features is that, to alleviate the effect of feature inconsistency in the regions of gas and bone adjacent to the prostate, the optimal profile length at each landmark is calculated by statistically investigating the intensity profile in the training set. The resulting gradient-PDF combined feature produces more accurate and robust segmentations than general gradient features. Second, an online learning mechanism is used to build shape and appearance statistics for accurately capturing intrapatient variation. Results: The performance of the proposed method was evaluated on 306 images of the 24 patients. Compared to traditional gradient features, the proposed gradient-PDF combination features brought 5.2% increment in the success ratio of segmentation (from 94.1% to 99.3%). To evaluate the effectiveness of online learning mechanism, the authors carried out a comparison between partial online update strategy and full online update strategy. Using the full online update strategy, the mean DSC was improved from 86.6% to 89.3% with 2.8% gain. On the basis of full online update strategy, the manual modification before online update strategy was introduced and tested, the best performance was obtained; here, the mean DSC and the mean ASD achieved 92.4% and 1.47 mm, respectively. Conclusions: The proposed prostate segmentation method provided accurate and robust segmentation results for CT images even under the situation where the samples of patient under radiotherapy were limited. A conclusion that the proposed method is suitable for clinical application can be drawn.

Feng, Qianjin; Foskey, Mark; Chen Wufan; Shen Dinggang [Biomedical Engineering College, South Medical University, Guangzhou (China) and Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27510 (United States); Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina 27599 (United States); Biomedical Engineering College, South Medical University, Guangzhou 510510 (China); Department of Radiology, University of North Carolina, Chapel Hill, North Carolina 27510 (United States)

2010-08-15

283

Vasodilator Stress Perfusion CMR Imaging Is Feasible and Prognostic in Obese Patients  

PubMed Central

Objectives This study sought to determine feasibility and prognostic performance of stress cardiac magnetic resonance (CMR) in obese patients (body mass index [BMI] ?30 kg/m2). Background Current stress imaging methods remain limited in obese patients. Given the impact of the obesity epidemic on cardiovascular disease, alternative methods to effectively risk stratify obese patients are needed. Methods Consecutive patients with a BMI ?30 kg/m2 referred for vasodilating stress CMR were followed for major adverse cardiovascular events (MACE), defined as cardiac death or nonfatal myocardial infarction. Univariable and multivariable Cox regressions for MACE were performed to determine the prognostic association of inducible ischemia or late gadolinium enhancement (LGE) by CMR beyond traditional clinical risk indexes. Results Of 285 obese patients, 272 (95%) completed the CMR protocol, and among these, 255 (94%) achieved diagnostic imaging quality. Mean BMI was 35.4 ± 4.8 kg/m2, with a maximum weight of 200 kg. Reasons for failure to complete CMR included claustrophobia (n = 4), intolerance to stress agent (n = 4), poor gating (n = 4), and declining participation (n = 1). Sedation was required in 19 patients (7%; 2 patients with intravenous sedation). Sixteen patients required scanning by a 70-cm-bore system (6%). Patients without inducible ischemia or LGE experienced a substantially lower annual rate of MACE (0.3% vs. 6.3% for those with ischemia and 6.7% for those with ischemia and LGE). Median follow-up of the cohort was 2.1 years. In a multivariable stepwise Cox regression including clinical characteristics and CMR indexes, inducible ischemia (hazard ratio 7.5; 95% confidence interval: 2.0 to 28.0; p = 0.002) remained independently associated with MACE. When patients with early coronary revascularization (within 90 days of CMR) were censored on the day of revascularization, both presence of inducible ischemia and ischemia extent per segment maintained a strong association with MACE. Conclusions Stress CMR is feasible and effective in prognosticating obese patients, with a very low negative event rate in patients without ischemia or infarction. PMID:24726254

Shah, Ravi V.; Heydari, Bobak; Coelho-Filho, Otavio; Abbasi, Siddique A.; Feng, Jiazhuo H.; Neilan, Tomas G.; Francis, Sanjeev; Blankstein, Ron; Steigner, Michael; Jerosch-Herold, Michael; Kwong, Raymond Y.

2014-01-01

284

Patient-specific daily pretreatment setup protocol using electronic portal imaging for radiation therapy.  

PubMed

The purpose of this study was to evaluate electronic portal imaging (EPI) as a means of identifying and correcting field displacement in patients with problematic external beam radiotherapy setups. Fourteen patients with problematic setups were identified for pretreatment daily EPI beam monitoring as part of a physician-directed therapist intervention protocol. Pretreatment EPIs were used to realign fields as necessary to bring the setup within the physician-prescribed tolerance level. For comparison, daily EPIs were available for 12 control patients who had no particular setup difficulties and for whom online beam realignment was not made. Anatomy-matching software was used to measure setup variation along medial-lateral, superior-inferior, and anterior-posterior axes. Online field realignment yielded a significant (p = 0.001) improvement when comparing initial and final setup variations. The mean standard deviation of setup displacement averaged over three axes was reduced from 6.4 mm to 3.1 mm after realignment. The final variation of protocol patients was comparable to that of control patients. In conclusion, EPI provided effective means to perform online beam realignment in a group of difficult-to-position patients. This procedure resulted in a reduction in setup displacement that was statistically significant, clinically relevant, and approached that of a more typical patient group. PMID:16421496

Wittmer, Michael H; Pisansky, Thomas M; Kruse, Jon J; Herman, Michael G

2005-01-01

285

Sensorimotor cortical activity in patients with complete spinal cord injury: a functional magnetic resonance imaging study.  

PubMed

Residual activation of the cortex was investigated in nine patients with complete spinal cord injury between T6 and L1 by functional magnetic resonance imaging (fMRI). Brain activations were recorded under four conditions: (1) a patient attempting to move his toes with flexion-extension, (2) a patient imagining the same movement, (3) passive proprio-somesthesic stimulation of the big toes without visual control, and (4) passive proprio-somesthesic stimulation of the big toes with visual control by the patient. Passive proprio-somesthesic stimulation of the toes generated activation posterior to the central sulcus in the three patients who also showed a somesthesic evoked potential response to somesthesic stimulation. When performed under visual control, activations were observed in two more patients. In all patients, activations were found in the cortical areas involved in motor control (i.e., primary sensorimotor cortex, premotor regions and supplementary motor area [SMA]) during attempts to move or mental imagery of these tasks. It is concluded that even several years after injury with some local cortical reorganization, activation of lower limb cortical networks can be generated either by the attempt to move, the mental evocation of the action, or the visual feedback of a passive proprio-somesthesic stimulation. PMID:11852978

Sabbah, P; de, Schonen S; Leveque, C; Gay, S; Pfefer, F; Nioche, C; Sarrazin, J L; Barouti, H; Tadie, M; Cordoliani, Y S

2002-01-01

286

Imaging of the brain in patients with human immunodeficiency virus infection.  

PubMed

Neurologic disease in acquired immunodeficiency syndrome (AIDS) patients is related either to opportunistic pathogens or to direct central nervous system (CNS) invasion by the human immunodeficiency virus. Despite the increasing availability of antiretroviral therapy, opportunistic infections continue to afflict patients in the developing world and in other populations with limited access to appropriate treatment. Classic CNS infections in the setting of AIDS include toxoplasmosis, cryptococcosis, progressive multifocal leukoencephalopathy, and cytomegalovirus encephalitis. Additionally, AIDS patients are far more susceptible to acquiring CNS tuberculosis and neurosyphilis, both of which exhibit altered disease characteristics in the setting of immunosuppression. Neuroimaging is a crucial component of the diagnostic work-up of these conditions, and findings include, but are not limited to, intracranial mass lesions, white matter disease, meningoencephalitis, vascular complications, and hydrocephalus. Though various disease processes can produce imaging findings that overlap with one another, certain characteristic patterns may suggest a particular pathogen, and advanced imaging techniques and laboratory tests allow for definitive diagnosis. Knowledge of the imaging patterns seen in the setting of AIDS-related CNS disease is vital to the neuroradiologist, whose interpretation may guide decisions related to treatment and further work-up. PMID:25296273

Gottumukkala, Ravi V; Romero, Javier M; Riascos, Roy F; Rojas, Rafael; Glikstein, Rafael S

2014-10-01

287

Prevalence of bilateral 'mirror-image' lesions in patients with oral potentially malignant epithelial lesions.  

PubMed

Early detection of oral potentially malignant epithelial lesions (PMELs) is aimed at improving survival rates as carcinogenesis is a multistep process and prevention is possible if these lesions are detected at an early and reversible stage of the disease. A prospective clinical study aimed at determining the prevalence of bilateral 'mirror-image' oral PMELs was carried out. Sample consisted of 32 (53.3%) Indians, 23 (38.3%) Chinese, 4 (6.7%) Malays and one (1.7%) Nepalese. All had histopathological confirmation of their primary existing PMEL as inclusion criteria. A total of 70 primary lesions were detected. The most common PMEL found was oral lichen planus. Of these, 28 (46.7%) patients exhibited bilateral 'mirror-image' lesions (n = 42) either synchronously (n = 32/42) or metachronously (n = 10/42). The remaining 32 (53.3%) patients had normal-looking contralateral mucosa. Present findings suggest that patients presenting with oral PMELs are at greater risk of developing a second lesion, most probably in the contralateral 'mirror-image' site. PMID:21789676

Siar, Chong Huat; Mah, Michelle Clare; Gill, Praveen Preet

2012-03-01

288

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. PMID:21283647

Munoz, Alberto; De Vergas, Joaquin; Crespo, Jose

2010-01-01

289

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. PMID:18332959

Charnley, RM

2003-01-01

290

Short paths in expander graphs  

SciTech Connect

Graph expansion has proved to be a powerful general tool for analyzing the behavior of routing algorithms and the interconnection networks on which they run. We develop new routing algorithms and structural results for bounded-degree expander graphs. Our results are unified by the fact that they are all based upon, and extend, a body of work asserting that expanders are rich in short, disjoint paths. In particular, our work has consequences for the disjoint paths problem, multicommodify flow, and graph minor containment. We show: (i) A greedy algorithm for approximating the maximum disjoint paths problem achieves a polylogarithmic approximation ratio in bounded-degree expanders. Although our algorithm is both deterministic and on-line, its performance guarantee is an improvement over previous bounds in expanders. (ii) For a multicommodily flow problem with arbitrary demands on a bounded-degree expander, there is a (1 + {epsilon})-optimal solution using only flow paths of polylogarithmic length. It follows that the multicommodity flow algorithm of Awerbuch and Leighton runs in nearly linear time per commodity in expanders. Our analysis is based on establishing the following: given edge weights on an expander G, one can increase some of the weights very slightly so the resulting shortest-path metric is smooth - the min-weight path between any pair of nodes uses a polylogarithmic number of edges. (iii) Every bounded-degree expander on n nodes contains every graph with O(n/log{sup O(1)} n) nodes and edges as a minor.

Kleinberg, J. [MIT, Cambridge, MA (United States); Rubinfeld, R. [Cornell Univ., Ithaca, NY (United States)

1996-12-31

291

Helical screw expander evaluation project  

Microsoft Academic Search

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 to high enthalpy, liquid dominated field. A functional one MW geothermal electric power plant that featured a helical screw expander was produced and

R. McKay

1982-01-01

292

An adaptive patient specific deformable registration for breast images of positron emission tomography and magnetic resonance imaging using finite element approach  

NASA Astrophysics Data System (ADS)

A patient specific registration model based on finite element method was investigated in this study. Image registration of Positron Emission Tomography (PET) and Magnetic Resonance imaging (MRI) has been studied a lot. Surface-based registration is extensively applied in medical imaging. We develop and evaluate a registration method combine surface-based registration with biomechanical modeling. .Four sample cases of patients with PET and MRI breast scans performed within 30 days were collected from hospital. K-means clustering algorithm was used to segment images into two parts, which is fat tissue and neoplasm [2]. Instead of placing extrinsic landmarks on patients' body which may be invasive, we proposed a new boundary condition to simulate breast deformation during two screening. Then a three dimensional model with meshes was built. Material properties were assigned to this model according to previous studies. The whole registration was based on a biomechanical finite element model, which could simulate deformation of breast under pressure.

Xue, Cheng; Tang, Fuk-Hay

2014-03-01

293

Assessment of a radiotherapy patient cranial immobilization device using daily on-board kilovoltage imaging.  

PubMed

The purpose of this study was to utilize state-of-the-art on-board digital kilovoltage (kV) imaging to determine the systematic and random set-up errors of an immobilization device designed for canine and feline cranial radiotherapy treatments. The immobilization device is comprised of a custom made support bridge, bite block, vacuum-based foam mold and a modified thermoplastic mask attached to a commercially available head rest designed for human radiotherapy treatments. The immobilization device was indexed to a Varian exact couch-top designed for image guided radiation therapy (IGRT). Daily orthogonal kV images were compared to Eclipse treatment planning digitally reconstructed radiographs (DRRs). The orthogonal kV images and DRRs were directly compared online utilizing the Varian on-board imaging (OBI) system with set-up corrections mmediately and remotely transferred to the treatment couch prior to treatment delivery. Off-line review of 124 patient treatments indicates systematic errors consisting of +0.18 mm vertical, +0.39mm longitudinal and -0.08 mm lateral. The random errors corresponding to 2 standard deviations (95% CI) consist of 4.02 mm vertical, 2.97 mm longitudinal and 2.53 mm lateral and represent conservative CTV to PTV margins if kV OBI is not available. Use of daily kV OBI along with the cranial immobilization device permits reduction of the CTV to PTV margins to approximately 2.0 mm. PMID:19400474

Harmon, Joseph; Van Ufflen, Derek; Larue, Susan

2009-01-01

294

Attitudinal and perceptual factors in body image distortion: an exploratory study in patients with anorexia nervosa  

PubMed Central

Background Body image disturbance is a core feature of anorexia nervosa (AN). Attitudinal and cognitive biases as well as fundamental perceptual differences have been hypothesized to play a role in this disturbance. Method This study investigated body image dissatisfaction and distortion, haptic perception and perfectionism in 30 patients with AN and 31 age-matched healthy controls. Participants completed perceptual tasks and self-report measures. Results As predicted, participants with AN scored significantly higher on body dissatisfaction, perfectionism measures and had greater body distortion (as assessed by a body size estimation task). Cognitive–affective factors and perfectionism were highly correlated with body image distortion in AN. No significant differences were found between groups on the generic perception task. Conclusions Findings did not confirm the hypothesis of fundamental perceptual inefficiencies in body image disturbance in individuals with AN. Despite renewed interest in fundamental perceptual factors implicated in body image disturbance, these findings suggest that it continues to be important to focus treatment on cognitive affective biases versus fundamental perceptual inefficiencies. PMID:24999398

2013-01-01

295

Prostate Cancer: Can Multiparametric MR Imaging Help Identify Patients Who Are Candidates for Active Surveillance?  

PubMed Central

Purpose: To determine whether multiparametric magnetic resonance (MR) imaging can help identify patients with prostate cancer who would most appropriately be candidates for active surveillance (AS) according to current guidelines and to compare the results with those of conventional clinical assessment scoring systems, including the D’Amico, Epstein, and Cancer of the Prostate Risk Assessment (CAPRA) systems, on the basis of findings at prostatectomy. Materials and Methods: This institutional review board–approved HIPAA-compliant retrospectively designed study included 133 patients (mean age, 59.3 years) with a mean prostate-specific antigen level of 6.73 ng/mL (median, 4.39 ng/mL) who underwent multiparametric MR imaging at 3.0 T before radical prostatectomy. Informed consent was obtained from all patients. Patients were then retrospectively classified as to whether they would have met AS eligibility criteria or were better served by surgery. AS eligibility criteria for prostatectomy specimens were a dominant tumor smaller than 0.5 mL without Gleason 4 or 5 patterns or extracapsular or seminal vesicle invasion. Conventional clinical assessment scores (the D’Amico, Epstein, and CAPRA scoring systems) were compared with multiparametric MR imaging findings for predicting AS candidates. The level of significance of difference between scoring systems was determined by using the ?2 test for categoric variables with the level of significance set at P < .05. Results: Among 133 patients, 14 were eligible for AS on the basis of prostatectomy results. The sensitivity, positive predictive value (PPV), and overall accuracy, respectively, were 93%, 25%, and 70% for the D’Amico system, 64%, 45%, and 88% for the Epstein criteria, and 93%, 20%, and 59% for the CAPRA scoring system for predicting AS candidates (P < .005 for all, ?2 test), while multiparametric MR imaging had a sensitivity of 93%, a PPV of 57%, and an overall accuracy of 92% (P < .005). Conclusion: Multiparametric MR imaging provides useful additional information to existing clinicopathologic scoring systems of prostate cancer and improves the assignment of treatment (eg, AS or active treatment). © RSNA, 2013 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13121325/-/DC1 PMID:23468576

Turkbey, Baris; Mani, Haresh; Aras, Omer; Ho, Jennifer; Hoang, Anthony; Rastinehad, Ardeshir R.; Agarwal, Harsh; Shah, Vijay; Bernardo, Marcelino; Pang, Yuxi; Daar, Dagane; McKinney, Yolanda L.; Linehan, W. Marston; Kaushal, Aradhana; Merino, Maria J.; Wood, Bradford J.; Pinto, Peter A.

2013-01-01

296

Motor co-activation in siblings of patients with juvenile myoclonic epilepsy: an imaging endophenotype?  

PubMed

Juvenile myoclonic epilepsy is a heritable idiopathic generalized epilepsy syndrome, characterized by myoclonic jerks and frequently triggered by cognitive effort. Impairment of frontal lobe cognitive functions has been reported in patients with juvenile myoclonic epilepsy and their unaffected siblings. In a recent functional magnetic resonance imaging study we reported abnormal co-activation of the motor cortex and increased functional connectivity between the motor system and prefrontal cognitive networks during a working memory paradigm, providing an underlying mechanism for cognitively triggered jerks. In this study, we used the same task in 15 unaffected siblings (10 female; age range 18-65 years, median 40) of 11 of those patients with juvenile myoclonic epilepsy (six female; age range 22-54 years, median 35) and compared functional magnetic resonance imaging activations with 20 age- and gender-matched healthy control subjects (12 female; age range 23-46 years, median 30.5). Unaffected siblings showed abnormal primary motor cortex and supplementary motor area co-activation with increasing cognitive load, as well as increased task-related functional connectivity between motor and prefrontal cognitive networks, with a similar pattern to patients (P < 0.001 uncorrected; 20-voxel threshold extent). This finding in unaffected siblings suggests that altered motor system activation and functional connectivity is not medication- or seizure-related, but represents a potential underlying mechanism for impairment of frontal lobe functions in both patients and siblings, and so constitutes an endophenotype of juvenile myoclonic epilepsy. PMID:25001494

Wandschneider, Britta; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J; Duncan, John S; Koepp, Matthias J

2014-09-01

297

Diffusion tensor imaging of Guillain-Mollaret triangle in patients with hypertrophic olivary degeneration.  

PubMed

The aim of the study is to analyze diffusion tensor imaging (DTI) characteristics of the Guillain-Mollaret triangle (GMT) in patients with hypertrophic olivary degeneration (HOD) and to investigate their correlation with previously reported histopathology. DTI was performed in 10 patients diagnosed with HOD. Fractional anisotropy, apparent diffusion coefficient, axial diffusivity, and radial diffusivity were measured in the inferior olivary nucleus (IO), the central tegmental tract, the red and the dentate nuclei, and the superior cerebellar peduncle of HOD patients and compared to age, sex, and side-matched 10 neurologically normal population. The prominent finding on DTI in affected IO was an increase in radial diffusivity compatible with demyelination. While conventional magnetic resonance imaging did not show any sign of involvement in the other components of GMT, DTI demonstrated signal changes in all anatomical components of the GMT. Main DTI findings in GMT of patients with HOD were an increase in radial diffusivity representing demyelination and an increase in axial diffusivity that is reflective of neuronal hypertrophy. DTI parameters can reflect the spatiotemporal evolution of transneuronal degeneration associated with HOD in a manner consistent with the known pathologic stages of HOD. PMID:20040011

Dinçer, Alp; Özyurt, Onur; Kaya, Dilaver; Ko?ak, Elif; Öztürk, Cengizhan; Erzen, Canan; Pamir, M Necmettin

2011-04-01

298

Neurological adverse events in patients receiving anti-TNF therapy: a prospective imaging and electrophysiological study  

PubMed Central

Introduction The aim was to investigate the frequency of neurological adverse events in patients with rheumatoid arthritis (RA) and spondylarthropathies (SpA) treated with tumor necrosis factor (TNF) ? antagonists. Methods Seventy-seven patients eligible for anti-TNF? therapy were evaluated. There were 36 patients with RA, 41 with SpA [24 psoriatic arthritis (PsA) and 17 with ankylosing spondylitis (AS)]. All patients had a complete physical and neurological examination. Brain and cervical spine magnetic resonance imaging (MRI) and neurophysiological tests were performed in all patients before the initiation of anti-TNF? therapy and after a mean of 18 months or when clinical symptoms and signs indicated a neurological disease. Exclusion criteria included hypertension, diabetes mellitus, dyslipidemia, heart arrhythmias, atherothrombotic events, vitamin B12 and iron deficiency, head and neck trauma and neurological surgeries. Results Two patients did not receive anti-TNF? therapy because brain MRIs at baseline revealed lesions compatible with demyelinating diseases. Thus, 75 patients received anti-TNF? (38 infliximab, 19 adalimumab and 18 etanercept). Three patients developed neurological adverse events. A 35-year-old man with PsA after 8 months of infliximab therapy presented with paresis of the left facial nerve and brain MRI showed demyelinating lesions. Infliximab was discontinued and he was treated with pulses of corticosteroids recovering completely after two months. The second patient was a 45-year-old woman with RA who after 6 months of adalimumab therapy presented with optic neuritis. The third patient was a 50-year-old woman with AS, whom after 25 months of infliximab therapy, presented with tingling and numbness of the lower extremities and neurophysiological tests revealed peripheral neuropathy. In both patients anti-TNF were discontinued and they improved without treatment after 2 months. The rest of our patients showed no symptoms and MRIs showed no abnormalities. The estimated rate of neurological adverse events in patients treated with anti-TNF therapy is 4% (3/75). Conclusions Neurological adverse events after anti-TNF? therapy were observed in our patient. Brain MRI and neurophysiological tests are essential tools to discriminate neurological diseases. PMID:24938855

2014-01-01

299

Quality of life for our patients: how media images and messages: influence their perceptions.  

PubMed

Media messages and images shape patients' perceptions about quality of life (QOL) through various "old" media-literature, film, television, and music-and so-called "new" media-the Internet, e-mail, blogs, and cell phones. In this article, the author provides a brief overview of QOL from the academic perspectives of nursing, psychology, behavioral medicine, multicultural studies, and consumer marketing. Selected theories about mass communication are discussed, as well as new technologies and their impact on QOL in our society. Examples of media messages about QOL and the QOL experience reported by patients with cancer include an excerpt from the Canadian Broadcasting Corporation radio interview with author Carol Shields, the 60 Minutes television interview focusing on Elizabeth Edwards (wife of presidential candidate John Edwards), and an excerpt from the 1994 filmThe Shawshank Redemption. Nurses are challenged to think about how they and their patients develop their perceptions about QOL through the media. PMID:18258574

Carr, Ellen R

2008-02-01

300

Diffusion Tensor Imaging Studies on Arcuate Fasciculus in Stroke Patients: A Review  

PubMed Central

Aphasia is one of the most common and devastating sequelae of stroke. The arcuate fasciculus (AF), an important neural tract for language function, connects Broca’s and Wernicke’s areas. In this review article, previous diffusion tensor imaging (DTI) studies on the AF in stroke patients were reviewed with regard to the usefulness for diagnosis (seven studies), prediction of prognosis (two studies), and recovery of aphasia (three studies). Although scant studies on this topic have been conducted in stroke patients, DTI for the AF appears to provide useful information on the presence or severity of injury of the AF, prognosis prediction of aphasia, and recovery mechanisms of aphasia in stroke patients. Therefore, further DTI studies on these topics should be encouraged, especially studies on prognosis prediction and recovery mechanisms of aphasia. In addition, research on other neural tracts known to be involved in aphasia as well as the AF in both hemispheres should be encouraged. PMID:24198780

Jang, Sung Ho

2013-01-01

301

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 first 5 days reduces the overall number of outlier days but does not eliminate them completely.

Perks, Julian, E-mail: julian.perks@ucdmc.ucdavis.ed [Department of Radiation Oncology, University of California, Davis, Sacramento, California (United States); Turnbull, Helen; Liu Tianxiao; Purdy, James; Valicenti, Richard [Department of Radiation Oncology, University of California, Davis, Sacramento, California (United States)

2011-03-01

302

Management of patients with thyroid carcinoma: Application of thallium-201 scintigraphy and magnetic resonance imaging  

SciTech Connect

Thyroid carcinoma has the ability to concentrate radioiodine, an attribute that can be used both for detection of thyroid cells and for treatment. Unfortunately, however, radioiodine uptake is not observed in all patients and a radioiodine scan requires that the patient be rendered hypothyroid for 4-6 wk. In the present study, we analyzed the utility of thallium-201 scanning and the usefulness of magnetic resonance imaging (MRI) in the detection of thyroid cancer. Nineteen patients with thyroid cancer had a total of 24 radioiodine scans, 33 thallium scans, and 10 MRI examinations. Of the 19 patients in the study, 17 had differentiated thyroid carcinoma. In these 17 cases, all paired studies were concordant for the presence (n = 7) or absence (n = 10) of disease. However, in one case (Patient 10), the {sup 201}Tl studies showed far more extensive disease than was observed on the {sup 131}I scan. Thyroid cancer was also detected on seven MRI studies. In summary, thallium and MRI scans are adjunctive techniques to radioiodine scanning that can either confirm the presence of neck bed activity, residual disease or metastatic cancer and may delineate tumor deposits not detected by radioiodine scanning. Thallium may be capable of detecting tumor deposits even while a patient remains euthyroid.

Burman, K.D.; Anderson, J.H.; Wartofsky, L.; Mong, D.P.; Jelinek, J.J. (Walter Reed Army Medical Center, Washington, DC (USA))

1990-12-01

303

Differences in body image between anorexics and in-vitro-fertilization patients - a study with Body Grid  

PubMed Central

Objectives: The purpose of the investigation was to explore the body image disturbance of anorexics and in-vitro-fertilization patients (IvF-patients) with Body Grid and Body Identity Plot. Methods: The paper reports on an empirical study conducted with 32 anorexic patients and 30 IvF-patients. The structure of the body image was derived from the Body Grid, an idiographic approach following the Role Repertory Grid developed by George A. Kelly [17]. The representation of the body image and the degree of body-acceptance is represented graphically. Results: By the Body Grid and Body Identity Plot measures we were able to identify important differences in body image between anorexics and IvF-patients. Conclusion: The tendencies of dissociation in the body image of anorexics which we found must be seen in the sense of a specific body image disturbance which differs significantly from the body-experience profile of IvF-patients. With the grid approach it was possible to elicit the inner structure of body image and determine the acceptance of the body and integration of single body parts. PMID:19742059

Borkenhagen, Ada; Klapp, Burghard F.; Schoeneich, Frank; Brahler, Elmar

2005-01-01

304

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

PubMed

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 local metabolic rate and inflammatory processes that ultimately appear as differences in the skin temperature. An infrared camera, with a focal plane array of 320 x 240 uncooled ferroelectric detectors is employed, which provides a video stream of the infrared emission in the 7-14 microm wavelength band. A double blackbody is used as reference for absolute temperature calibration. After following a protocol for patient preparation and acclimatization, a basal study is performed. Subsequently, the anatomic region of interest is subjected to a provocation test (a cold stimulus), which induces an autonomic vasoconstriction reflex in normal structures, thus enhancing the thermal contrast due to the differences in the vasculature of the different skin regions. Radiation erythema reactions and melanoma nodules possess typically a faster temperature recovery than healthy, non-irradiated skin. However, some other non-pathological structures are also detectable by infrared imaging, (e.g. scars, vessels, arteriovenous anastomoses and injuries), thus requiring a multi-study comparison in order to discriminate the tumor signal. Besides the superficial nodules, which are readily noticeable by infrared imaging, we have detected thermal signals that are coincident with the location of non-palpable nodules, which are observable by CT and ultrasound. Diffuse regions of fast temperature recovery after a cold stimulus were observed between the third and sixth weeks post-BNCT, concurrent with the clinical manifestation of radiation erythema. The location of the erythematous visible and infrared regions is consistent with the 3D dosimetry calculations. PMID:19380232

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

2009-07-01

305

Magnetic resonance imaging of intracranial tumors: intra-patient comparison of gadoteridol and ferumoxytol  

PubMed Central

This study aims to compare gadoteridol with ferumoxytol for contrast-enhanced and perfusion-weighted (PW) MRI of intracranial tumors. The final analysis included 26 patients, who underwent 3 consecutive days of 3T MRI. Day 1 consisted of anatomical pre- and postcontrast images, and PW MRI was acquired using gadoteridol (0.1 mmol/kg). On Day 2, the same MRI sequences were obtained with ferumoxytol (510 mg) and on Day 3, the anatomical images were repeated to detect delayed ferumoxytol-induced signal changes. The T1-weighted images were evaluated qualitatively and quantitatively for enhancement volume and signal intensity (SI) changes; PW data were used to estimate the relative cerebral blood volume (rCBV). All 26 lesions showed 24-hour T1-weighted ferumoxytol enhancement; 16 also had T2-weighted hypointensities. In 6 patients, ferumoxytol-induced signal changes were noted in areas with no gadoteridol enhancement. Significantly greater (P< .0001) SI changes were seen with gadoteridol, and qualitative analyses (lesion border delineation, internal morphology, contrast enhancement) also showed significant preferences (P= .0121; P = .0015; P < .0001, respectively) for this agent. There was no significant difference in lesion enhancement volumes between contrast materials. The ferumoxytol-rCBV values were significantly higher (P = .0016) compared with the gadoteridol-rCBV values. In conclusion, ferumoxytol provides important information about tumor biology that complements gadoteridol imaging. The rCBV measurements indicate areas of tumor undergoing rapid growth, whereas the 24-hour scans mark the presence of inflammatory cells. Both of these functions provide useful information about tumor response to treatment. We suggest that dynamic and anatomical imaging with ferumoxytol warrant further assessment in brain tumor therapy. PMID:21163809

Dosa, Edit; Guillaume, Daniel J.; Haluska, Marianne; Lacy, Cynthia A.; Hamilton, Bronwyn E.; Njus, Jeffrey M.; Rooney, William D.; Kraemer, Dale F.; Muldoon, Leslie L.; Neuwelt, Edward A.

2011-01-01

306

Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy  

SciTech Connect

Purpose: The aim of this study was to measure interfraction prostate bed motion, setup error, and total positioning error in 10 consecutive patients undergoing postprostatectomy radiotherapy. Methods and Materials: Daily image-guided target localization and alignment using electronic portal imaging of gold seed fiducials implanted into the prostate bed under transrectal ultrasound guidance was used in 10 patients undergoing adjuvant or salvage radiotherapy after prostatectomy. Prostate bed motion, setup error, and total positioning error were measured by analysis of gold seed fiducial location on the daily electronic portal images compared with the digitally reconstructed radiographs from the treatment-planning CT. Results: Mean ({+-} standard deviation) prostate bed motion was 0.3 {+-} 0.9 mm, 0.4 {+-} 2.4 mm, and -1.1 {+-} 2.1 mm in the left-right (LR), superior-inferior (SI), and anterior-posterior (AP) axes, respectively. Mean set-up error was 0.1 {+-} 4.5 mm, 1.1 {+-} 3.9 mm, and -0.2 {+-} 5.1 mm in the LR, SI, and AP axes, respectively. Mean total positioning error was 0.2 {+-} 4.5 mm, 1.2 {+-} 5.1 mm, and -0.3 {+-} 4.5 mm in the LR, SI, and AP axes, respectively. Total positioning errors >5 mm occurred in 14.1%, 38.7%, and 28.2% of all fractions in the LR, SI, and AP axes, respectively. There was no significant migration of the gold marker seeds. Conclusions: This study validates the use of daily image-guided target localization and alignment using electronic portal imaging of implanted gold seed fiducials as a valuable method to correct for interfraction target motion and to improve precision in the delivery of postprostatectomy radiotherapy.

Schiffner, Daniel C. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Gottschalk, Alexander R. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States) and Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States)]. E-mail: gottschalk@radonc17.ucsf.edu; Lometti, Michael M.S. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Aubin, Michele M.Sc.E.E. [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Pouliot, Jean [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Speight, Joycelyn [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Hsu, I.-Chow [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Shinohara, Katsuto [Department of Urology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States); Roach, Mack [Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA (United States); Department of Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA (United States)

2007-02-01

307

Multimode C-arm fluoroscopy, tomosynthesis, and cone-beam CT for image-guided interventions: from proof of principle to patient protocols  

Microsoft Academic Search

High-performance intraoperative imaging is essential to an ever-expanding scope of therapeutic procedures ranging from tumor surgery to interventional radiology. The need for precise visualization of bony and soft-tissue structures with minimal obstruction to the therapy setup presents challenges and opportunities in the development of novel imaging technologies specifically for image-guided procedures. Over the past ~5 years, a mobile C-arm has

J. H. Siewerdsen; M. J. Daly; G. Bachar; D. J. Moseley; G. Bootsma; K. K. Brock; S. Ansell; G. A. Wilson; S. Chhabra; D. A. Jaffray; J. C. Irish

2007-01-01

308

Pelvic Floor Magnetic Resonance Imaging after Neonatal Single Stage Reconstruction in Male Patients With Classic Bladder Exstrophy  

Microsoft Academic Search

PurposeWe evaluate a magnetic resonance imaging (MRI) protocol used to study the pelvic floor anatomy in male patients following neonatal single stage complete bladder exstrophy and epispadias repair with osteotomies.

SAREL HALACHMI; WALID FARHAT; OSNAT KONEN; AZRA KHAN; JOHN HODAPP; DARIUS J. BAGLI; GORDON A. McLORIE; ANTOINE E. KHOURY

2003-01-01

309

Monolithical aspherical beam expanding systems  

NASA Astrophysics Data System (ADS)

Beam expanding is a common task, where Galileo telescopes are preferred. However researches and customers have found limitations when using these systems. A new monolithical solution which is based on the usage of only one aspherical component will be presented. It will be shown how to combine up to five monolithical beam expanding systems and to keep the beam quality at diffraction limitation. Insights will be given how aspherical beam expanding systems will help using larger incoming beams and reducing the overall length of such a system. Additionally an add-on element for divergence and wavelength adaption will be presented.

Fuchs, U.; Matthias, Sabrina

2014-10-01

310

Chest imaging features of patients afflicted with Influenza A (H1N1) in a Malaysian tertiary referral centre  

PubMed Central

This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis. PMID:21611071

Bux, SI; Mohd. Ramli, N; Ahmad Sarji, S; Kamarulzaman, A

2010-01-01

311

Dynamic contrast-enhanced magnetic resonance imaging in patients with pulmonary arterial hypertension  

PubMed Central

Abstract Dynamic contrast–enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby the passage of an intravenous contrast bolus can be tracked through the pulmonary vascular system. The aim of this study was to investigate the prognostic significance of DCE-MR pulmonary blood transit times in patients with pulmonary arterial hypertension (PAH). Seventy-nine patients diagnosed with PAH underwent pulmonary DCE imaging at 1.5 T using a time-resolved three-dimensional spoiled gradient echo sequence. The prognostic significance of two DCE parameters, full width at half maximum (FWHM) of the first-pass clearance curve and pulmonary transit time (PTT), along with demographic and invasive catheter measurements, was evaluated by univariate and bivariate Cox proportional hazards regression and Kaplan-Meier analysis. DCE-MR transit times were most closely correlated with cardiac index (CI) and pulmonary vascular resistance index (PVRI) and were both found to be accurate for detecting reduced CI (FWHM area under the curve [AUC] at receiver operating characteristic analysis = 0.91 and PTT AUC = 0.92, respectively) and for detecting elevated PVRI (FWHM AUC = 0.88 and PTT AUC = 0.84, respectively). During the follow-up period, 25 patients died. Patients with longer measurements of FWHM (P = 0.0014) and PTT (P = 0.004) were associated with poor outcome at Kaplan-Meier analysis, and both parameters were strong predictors of adverse outcome from Cox proportional hazards analysis (P = 0.013 and 0.010, respectively). At bivariate analysis, DCE measurements predicted mortality independent of age, gender, and World Health Organization functional class; however, invasive hemodynamic indexes CI, PVRI, and DCE measurements were not independent of one another. In conclusion, DCE-MR transit times predict mortality in patients with PAH and are closely associated with clinical gold standards CI and PVRI. PMID:25006422

Condliffe, Robin; Marshall, Helen; Elliot, Charlie; Kiely, David G.; Wild, Jim M.

2014-01-01

312

Multi-observation PET image analysis for patient follow-up quantitation and therapy assessment  

NASA Astrophysics Data System (ADS)

In positron emission tomography (PET) imaging, an early therapeutic response is usually characterized by variations of semi-quantitative parameters restricted to maximum SUV measured in PET scans during the treatment. Such measurements do not reflect overall tumor volume and radiotracer uptake variations. The proposed approach is based on multi-observation image analysis for merging several PET acquisitions to assess tumor metabolic volume and uptake variations. The fusion algorithm is based on iterative estimation using a stochastic expectation maximization (SEM) algorithm. The proposed method was applied to simulated and clinical follow-up PET images. We compared the multi-observation fusion performance to threshold-based methods, proposed for the assessment of the therapeutic response based on functional volumes. On simulated datasets the adaptive threshold applied independently on both images led to higher errors than the ASEM fusion and on clinical datasets it failed to provide coherent measurements for four patients out of seven due to aberrant delineations. The ASEM method demonstrated improved and more robust estimation of the evaluation leading to more pertinent measurements. Future work will consist in extending the methodology and applying it to clinical multi-tracer datasets in order to evaluate its potential impact on the biological tumor volume definition for radiotherapy applications.

David, S.; Visvikis, D.; Roux, C.; Hatt, M.

2011-09-01

313

Diffusion tensor imaging (DTI) studies in patients with obsessive-compulsive disorder (OCD): a review.  

PubMed

This review presents an overview of studies investigating white-matter integrity in patients with obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI). There is increasing evidence for white matter alterations in OCD. In adult patients the majority of all studies reported abnormalities in terms of decreased fractional anisotropy (FA) compared to healthy volunteers. Although findings are heterogeneous, the cingulate bundle, the corpus callosum and the anterior limb of the internal capsule are most commonly affected by decreased white matter integrity in adult OCD patients. In pediatric and adolescent patients initial evidence points more towards increased white matter connectivity. Thus, current results suggest alterations in various white matter regions in both pediatric and adult OCD patients. They indicate that alterations may vary as a function of clinical characteristics and may be amenable to pharmacologic treatment. Although the findings have important implications for the neurobiology of OCD they also raise a number of important questions that are discussed in this review and need to be taken into consideration in future studies. PMID:24694669

Koch, Kathrin; Reess, Tim J; Rus, O Georgiana; Zimmer, Claus; Zaudig, Michael

2014-07-01

314

Image-Guided Hypofractionated Radiotherapy in Low-Risk Prostate Cancer Patients  

PubMed Central

Aim. To evaluate efficacy and toxicity of image-guided hypofractionated radiotherapy (HFRT) in the treatment of low-risk prostate cancer. Outcomes and toxicities of this series of patients were compared to another group of 32 low-risk patients treated with conventional fractionation (CFRT). Methods. Fifty-nine patients with low-risk prostate cancer were analysed. Total dose for the prostate and proximal seminal vesicles was 60?Gy delivered in 20 fractions. Results. The median follow-up was 30 months. The actuarial 4-year overall survival, biochemical free survival, and disease specific survival were 100%, 97.4%, and 97.4%, respectively. Acute grade 1-2 gastrointestinal (GI) and genitourinary (GU) toxicity rates were 11.9% and 40.7%, respectively. Grade 1?GI and GU late toxicity rates were 8.5% and 13.6%, respectively. No grade ?2 late toxicities were recorded. Acute grade 2-3?GU toxicity resulted significantly lower (P = 0.04) in HFRT group compared to the CFRT group. The cumulative 4-year incidence of grade 1-2?GU toxicity was significantly higher (P < 0.001) for HFRT patients. Conclusions. Our study demonstrated that hypofractionated regimen provided excellent biochemical control in favorable risk prostate cancer patients. The incidence of GI and GU toxicity was low. However, HFRT presented higher cumulative incidence of low-grade late GU toxicity than CFRT. PMID:24864248

Valeriani, Maurizio; Carnevale, Alessia; Bonome, Paolo; Montalto, Adelaide; Nicosia, Luca; Osti, Mattia F.; De Sanctis, Vitaliana; Minniti, Giuseppe; Maurizi Enrici, Riccardo

2014-01-01

315

Prevalence and Imaging Characteristics of Palatine Tonsilloliths Detected by CT in 2,873 Consecutive Patients  

PubMed Central

Aim. Tonsilloliths are calcified structures that develop in tonsillar crypts. They are commonly detected in daily clinical practice. The prevalence of tonsilloliths was 16 to 24% in previous reports, but it is inconsistent with clinical experience. The aim of this study is to clarify the prevalence, number, and size distribution of tonsilloliths using computed tomography (CT) in a relatively large number of patients. Materials and Methods. We retrospectively reviewed the scans of 2,873 patients referred for CT examinations with regard to tonsilloliths. Results. Palatine tonsilloliths were found in 1,145 out of 2,873 patients (39.9%). The prevalence of tonsilloliths increased with age, and most commonly in patients of ages 50–69. The prevalence in the 30s and younger was statistically lower than in the 40s and older (P < 0.05). The number of tonsilloliths per palatine tonsil ranged from one to 18. The size of the tonsilloliths ranged from 1 to 10?mm. For the patients with multiple CT examinations,the number of tonsilloliths increased in 51 (3.9%) and decreased in 84 (6.5%) of the tonsils. Conclusions. As palatine tonsilloliths are common conditions, screenings for tonsilloliths during the diagnosis of soft tissue calcifications should be included in routine diagnostic imaging.

Takahashi, Akira; Sugawara, Chieko; Kudoh, Takaharu; Uchida, Daisuke; Tamatani, Tetsuya; Nagai, Hirokazu; Miyamoto, Youji

2014-01-01

316

Noninvasive magnetic resonance imaging evaluation of cerebral blood flow with acetazolamide challenge in patients with cerebrovascular stenosis  

Microsoft Academic Search

To evaluate the utility of using magnetic resonance imag- ing (MRI) of cerebral blood flow (CBF) in conjunction with pharmacologic flow augmentation, the authors imaged 14 patients with ischemic symptoms referable to large artery cerebrovascular stenosis of the anterior circulation. CBF was measured by using continuous arterial spin labeling (CASL) both at rest and 10 minutes afte r1gi ntravenous acetazolamide

John A. Detre; Owen B. Samuels; David C. Alsop; Scott E. Kasner; Eric C. Raps

1999-01-01

317

Energy recovery with turbo expanders  

SciTech Connect

In the oil, gas and petrochemical industry, there are many instances where energy is under-utilized, if not actually wasted. In many cases it may be possible to recover some of this energy and obtain useful work, thereby improving plant efficiency and the economics of the operation. The turbo expander is a simple device that can make a significant contribution to the recovery of energy in all kinds of plants. This paper considers some ways in which turbo expanders may be used and looks in detail at an application in the gas industry where the energy lost in pressure reduction may be recovered and used to assist in reducing operating costs. The design criteria for such turbo expanders are discussed and areas for future development are proposed. The paper concludes that there are significant gains to be made in the recovery of waste energy and that the turbo expander can play a major role in this activity.

Cleveland, A.

1986-01-01

318

Flavors in an expanding plasma  

E-print Network

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.

Johannes Große; Romuald A. Janik; Piotr Surówka

2007-09-25

319

[A review of the position adopted by patients when acquiring images of the base of the hamate hook].  

PubMed

The hamate bone, one of the carpal (wrist) bones, has a large uncinate process protruding from the palm side. In sports such as golf and tennis, the hamate bone can break if is subjected to a high external force, such as from the handle of a racquet or club. At our hospital we take X-ray images of the hamate bone from two directions: an axial image through the carpal tunnel and an image at the base of the hamate hook (conventional method). While the conventional method makes it easy to create images of the base of the hamate hook, the patient may suffer pain during image-taking because the hamate bone is pulled to cause radial flexion. We therefore investigated a method of imaging that would create three-dimensional computed tomography (3DCT) images of the base of the hamate hook in which the patient would only have to only rotate the wrist externally and elevate the fore-arm without any radial flexion. Our results suggest that it is possible to obtain images of the base of the hamate hook as clear as those acquired using the conventional method with the patient in a comfortable and painless position taking images at an external rotation angle of 50.3° and a forearm elevation angle of 20.3°. PMID:24953320

Takamatsu, Shunsuke; Miyakawa, Seiichirou; Sato, Hisaya; Suzuki, Wataru; Nishizawa, Takeshi; Nakamura, Masami; Umeda, Hirotaka; Sai, Shogo; Kato, Kyoichi; Nakazawa, Yasuo; Ikeda, Jun

2014-06-01

320

Effect of clozapine on white matter integrity in patients with schizophrenia: a diffusion tensor imaging study.  

PubMed

Several diffusion tensor imaging (DTI) studies have reported disturbed white matter integrity in various brain regions in patients with schizophrenia, whereas only a few studied the effect of antipsychotics on DTI measures. The aim of this study was to investigate the effect of 12 weeks of clozapine treatment on DTI findings in patients with schizophrenia, and to compare the findings with those in unaffected controls. The study included 16 patients with schizophrenia who were assessed with the Positive and Negative Syndrome Scale, a neurocognitive test battery, and DTI at baseline and 12 weeks after the initiation of clozapine treatment. Eight unaffected controls were assessed once with the neurocognitive test battery and DTI. Voxel-wise analysis of DTI data was performed via tract-based spatial statistics (TBSS). Compared with the control group, the patient group exhibited lower fractional anisotropy (FA) in 16 brain regions, including the bilateral superior longitudinal fasciculi, inferior fronto-occipital fasciculi, superior and inferior parietal lobules, cingulate bundles, cerebellum, middle cerebellar peduncles, and left inferior longitudinal fasciculus, whereas the patients had higher FA in six regions, including the right parahippocampus, left anterior thalamic radiation, and right posterior limb of the internal capsule before clozapine treatment. After 12 weeks of treatment with clozapine, white matter FA was increased in widespread brain regions. In two of the regions where FA had initially been lower in patients compared with controls (left inferior fronto-occipital fasciculus and superior parietal lobule), clozapine appeared to increase FA. An improvement in semantic fluency was correlated with the increase in FA value in the left inferior fronto-occipital fasciculus. An increase in FA following 12 weeks of treatment with clozapine suggests that this treatment alters white matter microstructural integrity in patients with schizophrenia previously treated with typical and/or atypical antipsychotics and, in some locations, reverses a previous deficit. PMID:25012780

Ozcelik-Eroglu, Elcin; Ertugrul, Aygun; Oguz, Kader Karli; Has, Arzu Ceylan; Karahan, Sevilay; Yazici, Mumin Kazim

2014-09-30

321

Diffusion tensor imaging of patients with proteolipid protein 1 gene mutations.  

PubMed

Pelizaeus-Merzbacher disease (PMD) is an X-linked disorder of the central nervous system (CNS) caused by a wide variety of mutations affecting proteolipid protein 1 (PLP1). We assessed the effects of PLP1 mutations on water diffusion in CNS white matter by using diffusion tensor imaging. Twelve patients with different PLP1 point mutations encompassing a range of clinical phenotypes were analyzed, and the results were compared with a group of 12 age-matched controls. The parallel (?// ), perpendicular (?? ), and apparent diffusion coefficients (ADC) and fractional anisotropy were measured in both limbs of the internal capsule, the genu and splenium of corpus callosum, the base of the pons, and the cerebral peduncles. The mean ADC and ?? in the PMD patient group were both significantly increased in all selected structures, except for the base of the pons, compared with controls. PMD patients with the most severe disease, however, had a significant increase of both ?// and ?? . In contrast, more mildly affected patients had much smaller changes in ?// and ?? . These data suggest that myelin, the structure responsible in part for the ?? barrier, is the major site of disease pathogenesis in this heterogeneous group of patients. Axons, in contrast, the structures mainly responsible for ?// , are much less affected, except within the subgroup of patients with the most severe disease. Clinical disability in patients with PLP1 point mutation is thus likely determined by the extent of pathological involvement of both myelin and axons, with alterations of both structures causing the most severe disease. © 2014 Wiley Periodicals, Inc. PMID:25156430

Laukka, Jeremy J; Makki, Malek I; Lafleur, Tori; Stanley, Jeffrey; Kamholz, John; Garbern, James Y

2014-12-01

322

Quality of life in patients with prostate cancer treated with radical image-guided radiotherapy  

PubMed Central

Aim of the study The evaluation of quality of life during image-guided radiotherapy (IGRT) in patients with prostate cancer. Materials and methods The study consisted of 180 prostate cancer patients treated with radical radiotherapy (IGRT). The patients were irradiated using conformal or dynamic techniques with 2 Gy fractionation doses to a total dose of 76 Gy. Patients in the high-risk group (41%) were also irradiated to the pelvic lymph nodes. Quality of life was assessed with EORTC questionnaires: general QLQ-C30 and prostate-specific module QLQ-PR25, which were filled in by patients before and upon completion of radiotherapy. A change of ? 10 points in a linearised scale (0–100) was considered clinically significant. Results Global quality of life decreased slightly during radiotherapy (from 61 to 57 points), but from the clinical point of view, likewise most of the other quality of life parameters remained stable. In the general module (QLQ-C30) only diarrhoea changed in a clinically relevant way, i.e. by 10 points (from 10 to 20 points), which was mainly observed in patients with elective pelvic irradiation (increase of 18 points, from 10 to 28 points). In the prostate-specific module (QLQ-PR25) only urinary symptoms changed significantly, i.e. by 13 points (from 24 to 37 points). Conclusions The quality of life in patients with prostate cancer does not change in a clinically significant way during radiotherapy, which corroborates good treatment tolerance. Increased urinary symptoms and, in the case of pelvic irradiation, also increased diarrhoea have a negative impact on symptom-related quality of life. PMID:25258588

Tabor, Kamil; Prokop, Elzbieta; Kulik, Roland

2014-01-01

323

Reliability of tumor volume estimation from MR images in patients with malignant glioma. Results from the American College of Radiology Imaging Network (ACRIN) 6662 Trial  

Microsoft Academic Search

Reliable assessment of tumor growth in malignant glioma poses a common problem both clinically and when studying novel therapeutic\\u000a agents. We aimed to evaluate two software-systems in their ability to estimate volume change of tumor and\\/or edema on magnetic\\u000a resonance (MR) images of malignant gliomas. Twenty patients with malignant glioma were included from different sites. Serial\\u000a post-operative MR images were

Birgit B. Ertl-Wagner; Jeffrey D. Blume; Donald Peck; Jayaram K. Udupa; Benjamin Herman; Anthony Levering; Ilona M. Schmalfuss

2009-01-01

324

Patient dose from kilovoltage cone beam computed tomography imaging in radiation therapy  

SciTech Connect

Kilovoltage cone-beam computerized tomography (kV-CBCT) systems integrated into the gantry of linear accelerators can be used to acquire high-resolution volumetric images of the patient in the treatment position. Using on-line software and hardware, patient position can be determined accurately with a high degree of precision and, subsequently, set-up parameters can be adjusted to deliver the intended treatment. While the patient dose due to a single volumetric imaging acquisition is small compared to the therapy dose, repeated and daily image guidance procedures can lead to substantial dose to normal tissue. The dosimetric properties of a clinical CBCT system have been studied on an Elekta linear accelerator (Synergy[reg] RP, XVI system) and additional measurements performed on a laboratory system with identical geometry. Dose measurements were performed with an ion chamber and MOSFET detectors at the center, periphery, and surface of 30 and 16-cm-diam cylindrical shaped water phantoms, as a function of x-ray energy and longitudinal field-of-view (FOV) settings of 5,10,15, and 26 cm. The measurements were performed for full 360 deg.CBCT acquisition as well as for half-rotation scans for 120 kVp beams using the 30-cm-diam phantom. The dose at the center and surface of the body phantom were determined to be 1.6 and 2.3 cGy for a typical imaging protocol, using full rotation scan, with a technique setting of 120 kVp and 660 mAs. The results of our measurements have been presented in terms of a dose conversion factor f{sub CBCT}, expressed in cGy/R. These factors depend on beam quality and phantom size as well as on scan geometry and can be utilized to estimate dose for any arbitrary mAs setting and reference exposure rate of the x-ray tube at standard distance. The results demonstrate the opportunity to manipulate the scanning parameters to reduce the dose to the patient by employing lower energy (kVp) beams, smaller FOV, or by using half-rotation scan.

Islam, Mohammad K.; Purdie, Thomas G.; Norrlinger, Bernhard D.; Alasti, Hamideh; Moseley, Douglas J.; Sharpe, Michael B.; Siewerdsen, Jeffrey H.; Jaffray, David A. [Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation, University of Toronto, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital, Toronto (Canada); Department of Radiation Physics, Princess Margaret Hospital and Department of Radiation Oncology, University of Toronto, Toronto (Canada); Ontario Cancer Institute Princess Margaret Hospital and Department of Medical Biophysics, University of Toronto, Toronto (Canada); Department of Radiation Physics and Ontario Cancer Institute, Princess Margaret Hospital and Department of Radiation Oncology and Department of Medical Biophysics, University of Toronto, Toronto (Canada)

2006-06-15

325

Clinical Usefulness of Novel Serum and Imaging Biomarkers in Risk Stratification of Patients with Stable Angina  

PubMed Central

Inflammatory mediators appear to be the most intriguing yet confusing subject, regarding the management of patients with acute coronary syndromes (ACS). The current inflammatory concept of atherosclerotic coronary artery disease (CAD) led many investigators to concentrate on systemic markers of inflammation, as well as imaging techniques, which may be helpful in risk stratification and prognosis assessment for cardiovascular events. In this review, we try to depict many of the recently studied markers regarding stable angina (SA), their clinical usefulness, and possible future applications in the field. PMID:25045198

Ikonomidis, Ignatios; Tsantes, Argirios

2014-01-01

326

Value of planar 201Tl imaging in risk stratification of patients recovering from acute myocardial infarction  

SciTech Connect

Although exercise ECG testing has been shown to have important prognostic value after acute myocardial infarction, exercise 201Tl scintigraphy offers several potential advantages, including: (1) increased sensitivity for detecting residual myocardial ischemia; (2) the ability to localize ischemia to a specific area or areas subtended by a specific coronary artery; (3) the ability to identify exercise-induced left ventricular dysfunction, which is manifested by increased lung uptake or transient left ventricular dilation; and (4) more reliable risk stratification of individual patients. The more optimal prognostic efficiency of 201Tl scintigraphy partially results from the fact that the error rate in falsely classifying patients as low risk is significantly smaller with 201Tl scintigraphy than with stress ECG. Because of these substantial advantages, there seems to be adequate rationale for recommending exercise perfusion imaging rather than exercise ECG alone as the preferred method for evaluating mortality and morbidity risks after acute myocardial infarction.

Gibson, R.S.; Watson, D.D. (Medical Center, University of Virginia Health Sciences Center, Charlottesville (United States))

1991-09-01

327

Radionuclide scrotal imaging: further experience with 210 patients. Part I. Anatomy, pathophysiology, and methods  

SciTech Connect

Ten years' experience with radionuclide scrotal imaging (RSI) to evaluate perfusion of the scrotal contents has confirmed the value of this examination. In 1973, Nadel et al. first proposed using sodium pertechnetate (Tc-99m) to diagnose testicular torsion. By the end of 1982, more than thirty articles have been published on this topic, with most emphasizing the usefulness of RSI in managing patients with acute scrotal pain. The present communication describes our findings in 210 patients, not previously reported. There were four groups with relatively distinct clinical presentations: (a) acute scrotal pain, (b) chronic scrotal pain, (c) scrotal injury, and (d) scrotal mass. The anatomic and pathophysiologic bases for the scan findings will be emphasized. We discuss the staging of testicular torsion; viability of the compromised testicle; variability in the presentation of acute infection; anatomy of trauma, varicocele, and inguinal hernia; and the correlation with scrotal sonography.

Chen, D.C.P.; Holder, L.E.; Melloul, M.

1983-08-01

328

Hybrid PET/MR imaging in two sarcoma patients – clinical benefits and implications for future trials  

PubMed Central

PET/MRI is an evolving hybrid imaging modality which combines the inherent strengths of MRIs soft-tissue and contrast resolution and PETs functional metabolic capabilities. Bone and soft-tissue sarcoma are a relatively rare tumor entity, relying on MRI for local staging and often on PET/CT for lymph node involvement and metastatic spread evaluation. The purpose of this article is to demonstrate the successful use of PET/MRI in two sarcoma patients. We also use these patients as a starting point to discuss how PET/MRI might be of value in sarcoma. Among its potential benefits are: superior TNM staging than either modality alone, decreased radiation dose, more sensitive and specific follow-up and better assessment of treatment response. These potentials need to be investigated in future PET/MRI soft-tissue sarcoma trials. PMID:24753758

Partovi, Sasan; Kohan, Andres A; Zipp, Lisa; Faulhaber, Peter; Kosmas, Christos; Ros, Pablo R; Robbin, Mark R

2014-01-01

329

Image quality and signal distribution in 1.5-T and 3-T MRI in mild traumatic brain injury patients  

NASA Astrophysics Data System (ADS)

Clear standards are lacking in the imaging modalities of the deficit in mild traumatic brain injury (MTBI) patients. The purpose of this study is to compare the image quality by signal distribution between 1.5 Tesla and 3 Tesla MRI in turbo spin echo (TSE) and gradient echo (GRE) images in normal hospital settings and to find preferences for which field to use in MTBI patients. We studied 40 MTBI patients with TSE and GRE; 20 patients were imaged at 1.5 T and 20 at 3 T. The imaging parameters were optimized separately for the two scanners. Histograms of the signal distribution in 22 ROIs were fitted to a 1-peak Gaussian model and the resulting peak positions were scaled in respect to the peak positions of genu of the corpus callosum and the caudate nuclei. Correlation of the contrast of the ROIs in reference to genu of the corpus callosum between both the two scanners and the two imaging sequences was good. Image contrast was similar at both in the TSE images; in the GRE images contrast improved from 1.5 T to 3 T. However, based on peak positions and widths, a slight drawback in the separability between the ROIs was observed when 1.5 T MRI was replaced by 3 T. No clear improvement in tissue contrast or separability of 3 T was found compared to 1.5 T. Imaging of MTBI with 3 T should therefore be based on other advantages of high-field imaging, such as improved SNR and spatial resolution.

Rossi, Maija E.; Dastidar, Prasun; Ryymin, Pertti; Ylinen, Aarne; Öhman, Juha; Soimakallio, Seppo; Eskola, Hannu

2009-02-01

330

Pharmacokinetics and Imaging of 212Pb-TCMC-Trastuzumab After Intraperitoneal Administration in Ovarian Cancer Patients  

PubMed Central

Abstract Purpose: Study distribution, pharmacokinetics, and safety of intraperitoneal (IP) 212Pb-TCMC-trastuzumab in patients with HER-2-expressing malignancy. Experimental Design: IP 212Pb-TCMC-trastuzumab was delivered, after 4?mg/kg intravenous (IV) trastuzumab, to 3 patients with HER-2-expressing cancer who had failed standard therapies. Patients were monitored for toxicity and pharmacokinetics/dosimetry parameters. Results: Imaging studies after 0.2?mCi/m2 (7.4?MBq/m2) show little redistribution out of the peritoneal cavity and no significant uptake in major organs. Peak blood level of the radiolabeled antibody, determined by decay corrected counts, was <23% injected dose at 63 hours; maximum blood radioactivity concentration was 6.3nCi/mL at 18 hours. Cumulative urinary excretion was ?6% in 2.3 half-lives. The maximum external exposure rate immediately post-infusion at skin contact over the abdomen averaged 7.67?mR/h and dropped to 0.67?mR/h by 24 hours. The exposure rates at the other positions monitored (axilla, chest, and femur) decreased as a function of distance from the abdomen. The data points correlate closely with 212Pb physical decay (T1/2=10.6 hours). Follow-up >6 months showed no evidence of agent-related toxicity. Conclusions: Pharmacokinetics and imaging after 0.2?mCi/m2 IP 212Pb-TCMC-trastuzumab in patients with HER-2-expressing malignancy showed minimal distribution outside the peritoneal cavity, ?6% urinary excretion, and good tolerance. PMID:24229395

Torgue, Julien; Azure, Michael T.; Shen, Sui; Saddekni, Souheil; Banaga, Eileen; Carlise, Ronda; Bunch, Patty; Yoder, Daniel; Alvarez, Ronald

2014-01-01

331

Impact of Bariatric Surgery on Body Image Perception and Sexuality in Morbidly Obese Patients and their Partners.  

PubMed

BACKGROUND: This study was undertaken to determine whether surgery for morbid obesity affects sexual attitudes and performance in patients and their partners. METHODS: Questionnaires concerning sexuality were sent to 94 patients who underwent gastric restriction procedures and their partners. Twenty-eight patients at least 1 year postoperatively (range of 1-11 years, mean 4.2 years +/- 3.24 SD) and 16 of their partners responded. The blinded questionnaires addressed the enjoyment and frequency of sexual intercourse, orgasms, body image, number of partners, abuse, sexual problems and masturbation. Comparisons were made before and after surgery. Patient answers were compared with their partners. RESULTS: Preoperatively, 64% of patients stated that they enjoyed sexual intercourse. Postoperatively, 50% of patients and 78% of partners stated that they enjoyed sex more. Improved orgasms were noted by 44% of patients and 40% partners after surgery. Improvement in body image was also achieved. Only 27% of patients felt they were attractive before surgery, while 80% felt they were more attractive after surgery; 94% of their partners agreed. While 48% of patients undressed in darkness in front of their partners before surgery, only 27% did so after surgery. CONCLUSIONS: Weigh loss attained though bariatric surgery improves body image and sexuality. Sexual intercourse and orgasms are improved postoperatively both for patient and partner. PMID:10729879

Camps; Zervos; Goode; Rosemurgy

1996-08-01

332

Value of Acute Rest Sestamibi Perfusion Imaging for Evaluation of Patients Admitted to the Emergency Department With Chest Pain  

Microsoft Academic Search

Objectives. This study sought to determine the ability of early perfusion imaging using technetium-99m sestamibi to predict adverse cardiac outcomes in patients who present to the emergency department with possible cardiac ischemia and nondiagnostic electrocardiograms (ECGs).Background. Evaluation of patients presenting to the emergency department with possible acute coronary syndromes and nondiagnostic ECGs is problematic. Accurate risk stratification is necessary to

Michael C Kontos; Robert L Jesse; Kristin L Schmidt; Joseph P Ornato; James L Tatum

1997-01-01

333

An Explicit Construction of Quantum Expanders  

E-print Network

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

2007-09-06

334

Expanding Disparity Range in an FPGA Stereo System While Keeping Resource Utilization Low  

E-print Network

Expanding Disparity Range in an FPGA Stereo System While Keeping Resource Utilization Low Divyang K adapting a system to deal with larger image sizes or, in the case of stereo disparity estimation, larger to expand the dispar- ity range and input image size of an existing FPGA-based stereo system [8] while

MacLean, W. James

335

Automated Patient Identification and Localization Error Detection Using 2-Dimensional to 3-Dimensional Registration of Kilovoltage X-Ray Setup Images  

SciTech Connect

Purpose: To determine whether kilovoltage x-ray projection radiation therapy setup images could be used to perform patient identification and detect gross errors in patient setup using a computer algorithm. Methods and Materials: Three patient cohorts treated using a commercially available image guided radiation therapy (IGRT) system that uses 2-dimensional to 3-dimensional (2D-3D) image registration were retrospectively analyzed: a group of 100 cranial radiation therapy patients, a group of 100 prostate cancer patients, and a group of 83 patients treated for spinal lesions. The setup images were acquired using fixed in-room kilovoltage imaging systems. In the prostate and cranial patient groups, localizations using image registration were performed between computed tomography (CT) simulation images from radiation therapy planning and setup x-ray images corresponding both to the same patient and to different patients. For the spinal patients, localizations were performed to the correct vertebral body, and to an adjacent vertebral body, using planning CTs and setup x-ray images from the same patient. An image similarity measure used by the IGRT system image registration algorithm was extracted from the IGRT system log files and evaluated as a discriminant for error detection. Results: A threshold value of the similarity measure could be chosen to separate correct and incorrect patient matches and correct and incorrect vertebral body localizations with excellent accuracy for these patient cohorts. A 10-fold cross-validation using linear discriminant analysis yielded misclassification probabilities of 0.000, 0.0045, and 0.014 for the cranial, prostate, and spinal cases, respectively. Conclusions: An automated measure of the image similarity between x-ray setup images and corresponding planning CT images could be used to perform automated patient identification and detection of localization errors in radiation therapy treatments.

Lamb, James M., E-mail: jlamb@mednet.ucla.edu; Agazaryan, Nzhde; Low, Daniel A.

2013-10-01

336

Quantitative Magnetic Resonance Imaging Volumetry of Facial Muscles in Healthy Patients with Facial Palsy  

PubMed Central

Background: Magnetic resonance imaging (MRI) has not yet been established systematically to detect structural muscular changes after facial nerve lesion. The purpose of this pilot study was to investigate quantitative assessment of MRI muscle volume data for facial muscles. Methods: Ten healthy subjects and 5 patients with facial palsy were recruited. Using manual or semiautomatic segmentation of 3T MRI, volume measurements were performed for the frontal, procerus, risorius, corrugator supercilii, orbicularis oculi, nasalis, zygomaticus major, zygomaticus minor, levator labii superioris, orbicularis oris, depressor anguli oris, depressor labii inferioris, and mentalis, as well as for the masseter and temporalis as masticatory muscles for control. Results: All muscles except the frontal (identification in 4/10 volunteers), procerus (4/10), risorius (6/10), and zygomaticus minor (8/10) were identified in all volunteers. Sex or age effects were not seen (all P > 0.05). There was no facial asymmetry with exception of the zygomaticus major (larger on the left side; P = 0.012). The exploratory examination of 5 patients revealed considerably smaller muscle volumes on the palsy side 2 months after facial injury. One patient with chronic palsy showed substantial muscle volume decrease, which also occurred in another patient with incomplete chronic palsy restricted to the involved facial area. Facial nerve reconstruction led to mixed results of decreased but also increased muscle volumes on the palsy side compared with the healthy side. Conclusions: First systematic quantitative MRI volume measures of 5 different clinical presentations of facial paralysis are provided. PMID:25289366

Volk, Gerd F.; Karamyan, Inna; Klingner, Carsten M.; Reichenbach, Jurgen R.

2014-01-01

337

Comparison Between Infrared Optical and Stereoscopic X-Ray Technologies for Patient Setup in Image Guided Stereotactic Radiotherapy  

SciTech Connect

Purpose: To compare infrared (IR) optical vs. stereoscopic X-ray technologies for patient setup in image-guided stereotactic radiotherapy. Methods and Materials: Retrospective data analysis of 233 fractions in 127 patients treated with hypofractionated stereotactic radiotherapy was performed. Patient setup at the linear accelerator was carried out by means of combined IR optical localization and stereoscopic X-ray image fusion in 6 degrees of freedom (6D). Data were analyzed to evaluate the geometric and dosimetric discrepancy between the two patient setup strategies. Results: Differences between IR optical localization and 6D X-ray image fusion parameters were on average within the expected localization accuracy, as limited by CT image resolution (3 mm). A disagreement between the two systems below 1 mm in all directions was measured in patients treated for cranial tumors. In extracranial sites, larger discrepancies and higher variability were observed as a function of the initial patient alignment. The compensation of IR-detected rotational errors resulted in a significantly improved agreement with 6D X-ray image fusion. On the basis of the bony anatomy registrations, the measured differences were found not to be sensitive to patient breathing. The related dosimetric analysis showed that IR-based patient setup caused limited variations in three cases, with 7% maximum dose reduction in the clinical target volume and no dose increase in organs at risk. Conclusions: In conclusion, patient setup driven by IR external surrogates localization in 6D featured comparable accuracy with respect to procedures based on stereoscopic X-ray imaging.

Tagaste, Barbara, E-mail: tagaste@cnao.it [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Riboldi, Marco [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Spadea, Maria F. [TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Department of Experimental and Clinical Medicine, Universita degli Studi Magna Graecia, Catanzaro (Italy); Bellante, Simone [TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Baroni, Guido [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); TBM Lab, Department of Bioengineering, Politecnico di Milano University, Milano (Italy); Cambria, Raffaella; Garibaldi, Cristina [Medical Physics, European Institute of Oncology, Milano (Italy); Ciocca, Mario [Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Medical Physics, European Institute of Oncology, Milano (Italy); Catalano, Gianpiero [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Unit of Radiotherapy, Multimedica Holding Clinical Institute, Castellanza (Italy); Alterio, Daniela [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Orecchia, Roberto [Division of Radiation Oncology, European Institute of Oncology, Milano (Italy); Centro Nazionale di Adroterapia Oncologica, Pavia (Italy); Department of Science and Biomedical Technologies, Universita di Milano, Milano (Italy)

2012-04-01

338

11C-Acetate PET Imaging in Patients with Multiple Sclerosis  

PubMed Central

Background Activation of glial cells is a cardinal feature in multiple sclerosis (MS) pathology, and acetate has been reported to be selectively uptaken by astrocytes in the CNS. The aim of this study was to investigate the efficacy of PET with 11C-acetate for MS diagnosis. Materials and Methods Six patients with relapsing-remitting MS and 6 healthy volunteers (HV) were enrolled. The 11C-acetate brain uptake on PET was measured in patients with MS and HV. Volume-of-interest analysis of cerebral gray and white matter based on the segmentation technique for co-registered MRI and voxel-based statistical parametric analysis were performed. Correlation between 11C-acetate uptake and the lesion number in T1- and T2- weighted MR images were also assessed. Results The standardized uptake value (SUV) of 11C-acetate was increased in both white and gray matter in MS patients compared to HV. Voxel-based statistical analysis revealed a significantly increased SUV relative to that in the bilateral thalami (SUVt) in a broad area of white matter, particularly in the subcortical white matter of MS patients. The numbers of T2 lesions and T1 black holes were significantly correlated with SUV of 11C-acetate in white and gray matter. Conclusions The 11C-acetate uptake significantly increased in MS patients and correlated to the number of MRI lesions. These preliminary data suggest that 11C-acetate PET can be a useful clinical examination for MS patients. PMID:25369426

Shimosegawa, Eku; Okuno, Tatsusada; Koda, Toru; Sugimoto, Tomoyuki; Mochizuki, Hideki; Hatazawa, Jun; Nakatsuji, Yuji

2014-01-01

339

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

PubMed

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 "replica" of the patient, built by means of a mathematical model, which represents several physiological subsystems of a renal patient. From a technical point of view, PPI is a component-oriented software module based on cutting-edge modeling and simulation technology. This paper provides a methodological and technological approach to the PPI. Computational architecture of PPI-based VCRS is also described. This is a multi-tier and multi-protocol system. Data are managed by several ORDBMS instances. Communications design is based on the virtual private network (VPN) concept. Renal patients have a minimum reliable access to the VCRS through a public switch telephone network--X.25 gateway. Design complies with the universal access requirement, allowing an efficient and inexpensive connection even in rural environments and reducing computational requirements in the patient's remote access unit. VCRS provides support for renal patients' healthcare, increasing the quality and quantity of monitored biomedical signals, predicting events as hypotension or low dialysis dose, assisting further to avoid them by an online therapy modification and easing diagnostic tasks. An online therapy adjustment experiment simulation is presented. Finally, the presented system serves as a computational aid for research in renal physiology. This is achieved by an open and reusable modeling and simulation architecture which allows the interaction among models and data from different scales and computer platforms, and a faster transference of investigation models toward clinical applications. PMID:12542237

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

2002-12-01

340

The role of imaging in patient selection, preoperative planning, and postoperative monitoring in human upper extremity allotransplantation.  

PubMed

Objective. To describe the role of imaging in vascular composite allotransplantation based on one institution's experience with upper extremity allotransplant patients. Methods. The institutional review board approved this review of HIPAA-compliant patient data without the need for individual consent. A retrospective review was performed of imaging from 2008 to 2011 on individuals undergoing upper extremity transplantation. This demonstrated that, of the 19 patients initially considered, 5 patients with a mean age of 37 underwent transplantation. Reports were correlated clinically to delineate which preoperative factors lead to patient selection versus disqualification and what concerns dictated postoperative imaging. Findings were subdivided into musculoskeletal and vascular imaging criterion. Results. Within the screening phase, musculoskeletal exclusion criterion included severe shoulder arthropathy, poor native bone integrity, and marked muscular atrophy. Vascular exclusion criterion included loss of sufficient arterial or venous supply and significant distortion of the native vascular architecture. Postoperative imaging was used to document healing and hardware integrity. Postsurgical angiography and ultrasound were used to monitor for endothelial proliferation or thrombosis as signs of rejection and vascular complication. Conclusion. Multimodality imaging is an integral component of vascular composite allotransplantation surgical planning and surveillance to maximize returning form and functionality while minimizing possible complications. PMID:24800056

Roth, Eira S; Buck, David G; Gorantla, Vijay S; Losee, Joseph E; Foust, Daniel E; Britton, Cynthia A

2014-01-01

341

Eating disorder symptoms, psychiatric correlates and self-image in normal, overweight and obese eating disorder patients.  

PubMed

The impression from Swedish eating disorder (ED) units is that there has been an increase in the number of overweight or obese patients. There is, however, no research studying whether these patients differ from normal-weight ED patients in other aspects than weight. Differences between normal-weight and overweight or obese ED patients could indicate that these groups of patients need different treatment approaches. The aim of this study was to investigate possible differences between normal-weight and overweight or obese ED patients in psychiatric and psychological pre-treatment variables. The study was based on data from a Swedish quality assurance system for ED care. In total, data from 3,798 adult patients with body mass index ? 18.5 were used. The sample included all normal-weight ED diagnoses. Significant differences between normal-weight, overweight and obese patients were found for five of eight self-image variables, for all eating disorder examination questionnaire subscales and for most key diagnostic symptoms. However, effect sizes were mostly small or very small. Overweight or obese patients did not display greater levels of psychiatric psychopathology than normal-weight patients. They did, however, show a tendency towards more negative self-image and more severe ED symptoms than normal-weight patients. Overweight and obesity in ED patients are thus not only associated with physical health problems, but also with mental health issues. Further studies are required to investigate the clinical relevance of these findings. PMID:24639071

Lapidoth, Joakim de Man; von Hausswolff-Juhlin, Yvonne

2014-06-01

342

Assessment of allograft function using diffusion-weighted magnetic resonance imaging in kidney transplant patients.  

PubMed

Developing a non-invasive method such as diffusion-weighted magnetic resonance imaging (DWMRI) could be used as a feasible and reproducible modality in the differential diagnosis of allograft dysfunction. We assessed the functional status of the renal allograft by DWMRI and its applicability in assessment of graft dysfunction on all end-stage renal transplant patients who attained normal renal function on the 7 th day post-transplantation. Follow-up imaging of the recipient allograft was performed at the end of 90 and 180 days and in case of graft dysfunction. Kidney biopsies were performed to correlate with the corresponding MRI. The apparent diffusion coefficient (ADC) maps of the cortex and medulla were obtained by studying the DWMRI. The ADC values were significantly lower in the medulla compared with the cortex in normal donor kidneys and normally functioning transplanted kidneys, while they decreased significantly when rejection occurred. The reduction in ADC values occurred both in the cortex and in the medulla, and correlated with the degree of rejection on the kidney biopsies. The ADC values increased significantly during the recovery from rejection. We conclude that DWMRI can be beneficial in the diagnosis and follow-up of transplant patients during acute rejection. PMID:25394428

Kaul, Anupma; Sharma, Raj Kumar; Gupta, Rakesh Kumar; Lal, Hira; Yadav, Abhishek; Bhadhuria, Dharmendra; Prasad, Narayan; Gupta, Amit

2014-01-01

343

Generation and performance of patient-specific forward models for breast imaging with EIT  

NASA Astrophysics Data System (ADS)

It has now been well established that accurate geometric conformity of the forward model for EIT reconstruction has significant benefits for artefact reduction and localisation of conductivity changes within the domain. The problems of generation of patient specific forward models need to be addressed as segmentation of volumetric data from CT or MRI is inadequate for time-critical clinical use. This group has pioneered methods of generating patient-specific surface models from known landmarks and electrode positions and have used this data to warp finite element models for EIT reconstruction. This paper presents a further application of these methods to use known electrode positions for breast imaging to generate an accurate B-Spline surface model of a subject and to warp an existing finite element model to the surface using elastic deformation. Results will show that a forward model can be generated, conforming more realistically to actual subject geometry, that will further enhance the performance of the reconstruction algorithm offering significant benefits to clinical EIT breast imaging.

Tizzard, A.; Borsic, A.; Halter, R.; Bayford, R.

2010-04-01

344

Skeletal muscle magnetic resonance imaging study in a patient with diabetic lumbosacral radiculoplexus neuropathy.  

PubMed

A 63-year-old man with type 2 diabetes mellitus developed deep aching and numbness in the right hip and lower extremity with rapid body weight loss. Neurological examination revealed weakness of the right hamstrings, tibialis anterior, and peroneus longus muscles with diminished ankle tendon reflex. We diagnosed him with diabetic lumbosacral radicuoloplexus neuropathy (DLRPN) based on neurological, radiological, and neurophysiological findings. Magnetic resonance imaging (MRI) of skeletal muscles showed high intensity signals on T2-weighted images in bilateral hamstrings, adductor magnus and right tensor fasciae latae, and lower leg extensor muscles. The MRI findings suggested muscle edema caused by acute denervation. DLRPN, or diabetic amyotrophy, is known to be caused by ischemic axonal degeneration. Our patient showed good functional recovery, and abnormal MRI signals in the involved muscles mostly disappeared in parallel to the clinical course. Distribution of the denervated muscles suggested that our patient had either patchy lesions in the lumbosacaral plexus or mononeuropathy multiplex in the nerve branches. The current study highlights the potential of skeletal muscle MRI for clinical evaluation of DLRPN. PMID:25283832

Matsuda, Nozomu; Kobayashi, Shunsuke; Ugawa, Yoshikazu

2014-01-01

345

Efficient Storage and Transmission of Digital Fundus Images with Patient Information Using Reversible Watermarking Technique and Error Control Codes  

Microsoft Academic Search

Handling of patient records is increasing overhead costs for most of the hospitals in this digital age. In most hospitals\\u000a and health care centers, the patient text information and corresponding medical images are stored separately as different\\u000a files. There is a possibility of mishandling the text file containing patient history. We are proposing a novel method for\\u000a the compact storage

Jagadish Nayak; P. Subbanna Bhat; U. Rajendra Acharya; M. Sathish Kumar

2009-01-01

346

Tissue Doppler imaging for the detection and quantitation of myocardial dysfunction in patients with type 2 diabetes mellitus  

Microsoft Academic Search

The prevalence of type 2 diabetes mellitus is rapidly increasing. Myocardial dysfunction may be a consequence of diabetic cardiomyopathy and it contributes to the poor prognosis of diabetic patients.Aims This study was designed to test whether tissue Doppler imaging might be a suitable tool for early detection of myocardial dysfunction in diabetic patients.Methods Forty-three diabetic patients and 33 non-diabetic controls,

Helene Von Bibra; Inga S Thrainsdottir; Alexander Hansen; Vasilios Dounis; Klas Malmberg; Lars Rydén

2005-01-01

347

Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients  

Microsoft Academic Search

Background: The impact of various medical and demographic factors on the quality of life (QoL) of breast cancer patients has been discussed controversially. We investigated the influence of six different factors on long-term QoL and body image of women with primary breast cancer. Patients and methods: Two-hundred and seventy-four breast cancer patients were administered the QoL questionnaire following a mean

K. Härtl; W. Janni; R. Kästner; H. Sommer; B. Strobl; B. Rack; M. Stauber

348

Three-Dimensional Microwave Breast Imaging: Dispersive Dielectric Properties Estimation using Patient-Specific Basis Functions  

PubMed Central

Breast imaging via microwave tomography involves estimating the distribution of dielectric properties within the patient's breast on a discrete mesh. The number of unknowns in the discrete mesh can be very large for three-dimensional imaging, and this results in computational challenges. We propose a new approach where the discrete mesh is replaced with a relatively small number of smooth basis functions. The dimension of the tomography problem is reduced by estimating the coefficients of the basis functions instead of the dielectric properties at each element in the discrete mesh. The basis functions are constructed using knowledge of the location of the breast surface. The number of functions used in the basis can be varied to balance resolution and computational complexity. The reduced dimension of the inverse problem enables application of a computationally efficient, multiple-frequency inverse scattering algorithm in 3-D. The efficacy of the proposed approach is verified using two 3-D anatomically realistic numerical breast phantoms. It is shown for the case of single-frequency microwave tomography that the imaging accuracy is comparable to that obtained when the original discrete mesh is used, despite the reduction of the dimension of the inverse problem. Results are also shown for a multiple-frequency algorithm where it is computationally challenging to use the original discrete mesh. PMID:19211350

Winters, David W.; Shea, Jacob D.; Kosmas, Panagiotis; Van Veen, Barry D.; Hagness, Susan C.

2009-01-01

349

Dynamic positron tomographic imaging with nitrogen-13 glutamate in patients with coronary artery disease: Comparison with nitrogen-13 ammonia and fluorine-18 fluorodeoxyglucose imaging  

SciTech Connect

This study was designed to test the usefulness of nitrogen-13 (N-13) glutamate imaging with positron emission tomography in defining myocardial ischemia in humans. Seventeen patients who had undergone coronary arteriography were studied with N-13 glutamate at peak supine exercise using a bicycle ergometer, as well as with the flow tracer N-13 ammonia at peak exercise during a second similar exercise test. Six of the patients also underwent imaging with N-13 glutamate at rest before exercise testing; in the remaining 11 patients imaging with fluorine-18 (F-18) fluorodeoxyglucose was performed to assess glucose metabolism after the second exercise test. Seven patients had classic metabolism-flow mismatches consistent with ischemia (that is, decreased N-13 ammonia uptake in a region with relatively increased F-18 fluorodeoxyglucose uptake). There was no evidence of increased N-13 glutamate uptake in the ischemic mismatched regions in any of these patients. In all 17 patients, the uptake of N-13 glutamate during exercise paralleled the uptake of N-13 ammonia during exercise, suggesting that N-13 glutamate behaves as a flow tracer rather than as a metabolic marker of ischemia in humans.

Krivokapich, J.; Barrio, J.R.; Huang, S.C.; Schelbert, H.R. (Univ. of California, Los Angeles (USA))

1990-11-01

350

Silent ischemia after coronary angioplasty: Evaluation of restenosis and extent of ischemia in asymptomatic patients by tomographic thallium-201 exercise imaging and comparison with symptomatic patients  

SciTech Connect

One hundred sixteen patients were evaluated to determine the ability of single photon emission computed tomographic (SPECT) thallium-201 exercise and redistribution imaging to detect silent ischemia secondary to restenosis in asymptomatic patients after single and multiple vessel percutaneous transluminal coronary angioplasty and the findings were compared with SPECT imaging detection of restenosis in symptomatic patients. The value of exercise electrocardiography (ECG) and the amount of ischemic myocardium in symptomatic and asymptomatic patients were determined. Forty-one patients were asymptomatic after angioplasty; 77% of these had chest pain before angioplasty. Seventy-five patients had chest pain after angioplasty; 99% of these had chest pain before angioplasty. Restenosis occurred in 61% of asymptomatic and 59% of symptomatic patients and in 46% of the vessels in both asymptomatic and symptomatic patients. Sensitivity, specificity and accuracy for detection of restenosis by SPECT in individual patients were 96%, 75% and 88% versus 91%, 77% and 85%, respectively, in the asymptomatic versus symptomatic groups (p = NS). Sensitivity, specificity and accuracy for restenosis detection in individual vessels were 90%, 89% and 89% versus 84%, 77% and 84%, respectively, in the asymptomatic and symptomatic groups (p = NS), with similar results for the three major arteries. Sensitivity and accuracy of exercise ECG were significantly less than those of SPECT imaging for the patients with silent (40% and 44%) and symptomatic (59% and 64%) ischemia (p less than 0.001). Restenosis of vessels in the patients with silent and symptomatic ischemia was associated with an equal amount and degree of severity of ischemic myocardium in the two groups.

Hecht, H.S.; Shaw, R.E.; Chin, H.L.; Ryan, C.; Stertzer, S.H.; Myler, R.K. (San Francisco Heart Institute, Daly City, CA (USA))

1991-03-01

351

Metabolic Imaging of Patients with Prostate Cancer Using Hyperpolarized [1-13C]Pyruvate  

PubMed Central

This first-in-man imaging study evaluated the safety and feasibility of hyperpolarized [1-13C]pyruvate as an agent for noninvasively characterizing alterations in tumor metabolism for patients with prostate cancer. Imaging living systems with hyperpolarized agents can result in more than 10,000-fold enhancement in signal relative to conventional magnetic resonance (MR) imaging. When combined with the rapid acquisition of in vivo 13C MR data, it is possible to evaluate the distribution of agents such as [1-13C]pyruvate and its metabolic products lactate, alanine, and bicarbonate in a matter of seconds. Preclinical studies in cancer models have detected elevated levels of hyperpolarized [1-13C]lactate in tumor, with the ratio of [1-13C]lactate/[1-13C]pyruvate being increased in high-grade tumors and decreased after successful treatment. Translation of this technology into humans was achieved by modifying the instrument that generates the hyperpolarized agent, constructing specialized radio frequency coils to detect 13C nuclei, and developing new pulse sequences to efficiently capture the signal. The study population comprised patients with biopsy-proven prostate cancer, with 31 subjects being injected with hyperpolarized [1-13C]pyruvate. The median time to deliver the agent was 66 s, and uptake was observed about 20 s after injection. No dose-limiting toxicities were observed, and the highest dose (0.43 ml/kg of 230 mM agent) gave the best signal-to-noise ratio for hyperpolarized [1-13C]pyruvate. The results were extremely promising in not only confirming the safety of the agent but also showing elevated [1-13C]lactate/[1-13C]pyruvate in regions of biopsy-proven cancer. These findings will be valuable for noninvasive cancer diagnosis and treatment monitoring in future clinical trials. PMID:23946197

Nelson, Sarah J.; Kurhanewicz, John; Vigneron, Daniel B.; Larson, Peder E. Z.; Harzstark, Andrea L.; Ferrone, Marcus; van Criekinge, Mark; Chang, Jose W.; Bok, Robert; Park, Ilwoo; Reed, Galen; Carvajal, Lucas; Small, Eric J.; Munster, Pamela; Weinberg, Vivian K.; Ardenkjaer-Larsen, Jan Henrik; Chen, Albert P.; Hurd, Ralph E.; Odegardstuen, Liv-Ingrid; Robb, Fraser J.; Tropp, James; Murray, Jonathan A.

2014-01-01

352

Radiation dose to patients and image quality evaluation from coronary 256-slice computed tomographic angiography  

NASA Astrophysics Data System (ADS)

The aim of this study is to assess radiation dose and the corresponding image quality from suggested CT protocols which depends on different mean heart rate and high heart rate variability by using 256-slice CT. Fifty consecutive patients referred for a cardiac CT examination were included in this study. All coronary computed tomographic angiography (CCTA) examinations were performed on a 256-slice CT scanner with one of five different protocols: retrospective ECG-gating (RGH) with full dose exposure in all R-R intervals (protocol A), RGH of 30-80% pulsing window with tube current modulation (B), RGH of 78±5% pulsing window with tube current modulation (C), prospective ECG-triggering (PGT) of 78% R-R interval with 5% padding window (D) and PGT of 78% R-R interval without padding window (E). Radiation dose parameters and image quality scoring were determined and compared. In this study, no significant differences were found in comparison on image quality of the five different protocols. Protocol A obtained the highest radiation dose comparing with those of protocols B, C, D and E by a factor of 1.6, 2.4, 2.5 and 4.3, respectively ( p<0.001), which were ranged between 2.7 and 11.8 mSv. The PGT could significantly reduce radiation dose delivered to patients, as compared to the RGH. However, the use of PGT has limitations and is only good in assessing cases with lower mean heart rate and stable heart rate variability. With higher mean heart rate and high heart rate variability circumstances, the RGH within 30-80% of R-R interval pulsing window is suggested as a feasible technique for assessing diagnostic performance.

Chen, Liang-Kuang; Wu, Tung-Hsin; Yang, Ching-Ching; Tsai, Chia-Jung; Lee, Jason J. S.

2010-07-01

353

MRI plaque imaging reveals high-risk carotid plaques especially in diabetic patients irrespective of the degree of stenosis  

PubMed Central

Background Plaque imaging based on magnetic resonance imaging (MRI) represents a new modality for risk assessment in atherosclerosis. It allows classification of carotid plaques in high-risk and low-risk lesion types (I-VIII). Type 2 diabetes mellitus (DM 2) represents a known risk factor for atherosclerosis, but its specific influence on plaque vulnerability is not fully understood. This study investigates whether MRI-plaque imaging can reveal differences in carotid plaque features of diabetic patients compared to nondiabetics. Methods 191 patients with moderate to high-grade carotid artery stenosis were enrolled after written informed consent was obtained. Each patient underwent MRI-plaque imaging using a 1.5-T scanner with phased-array carotid coils. The carotid plaques were classified as lesion types I-VIII according to the MRI-modified AHA criteria. For 36 patients histology data was available. Results Eleven patients were excluded because of insufficient MR-image quality. DM 2 was diagnosed in 51 patients (28.3%). Concordance between histology and MRI-classification was 91.7% (33/36) and showed a Cohen's kappa value of 0.81 with a 95% CI of 0.98-1.15. MRI-defined high-risk lesion types were overrepresented in diabetic patients (n = 29; 56.8%). Multiple logistic regression analysis revealed association between DM 2 and MRI-defined high-risk lesion types (OR 2.59; 95% CI [1.15-5.81]), independent of the degree of stenosis. Conclusion DM 2 seems to represent a predictor for the development of vulnerable carotid plaques irrespective of the degree of stenosis and other risk factors. MRI-plaque imaging represents a new tool for risk stratification of diabetic patients. See Commentary: http://www.biomedcentral.com/1741-7015/8/78/abstract PMID:21118504

2010-01-01

354

Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method.  

PubMed

The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach. PMID:25304711

Larson, David B

2014-10-01

355

Pancreatitis in patients with pancreas divisum: Imaging features at MRI and MRCP  

PubMed Central

AIM: To determine the magnetic resonance cholangiopancreatography (MRCP) and magnetic resonance imaging (MRI) features of pancreatitis with pancreas divisum (PD) and the differences vs pancreatitis without divisum. METHODS: Institutional review board approval was obtained and the informed consent requirement was waived for this HIPAA-compliant study. During one year period, 1439 consecutive patients underwent successful MRCP without injection of secretin and abdominal MRI studies for a variety of clinical indications using a 1.5 T magnetic resonance scanner. Two experienced radiologists retrospectively reviewed all the studies in consensus. Disputes were resolved via consultation with a third experienced radiologist. The assessment included presence and the imaging findings of PD, pancreatitis, and distribution of abnormalities. The pancreatitis with divisum constituted the study group while the pancreatitis without divisum served as the control group. MRCP and MRI findings were correlated with final diagnosis. Fisher exact tests and Pearson × 2 tests were performed. RESULTS: Pancreatitis was demonstrated at MRCP and MRI in 173 cases (38 cases with and 135 cases without divisum) among the 1439 consecutive cases. The recurrent acute pancreatitis accounted for 55.26% (21 of 38) in pancreatitis patients associated with PD, which was higher than 6.67% (9 of 135) in the control group, whereas the chronic pancreatitis was a dominant type in the control group (85.19%, 115 of 135) when compared to the study group (42.11%, 16 of 38) (?2 = 40.494, P < 0.0001). In cases of pancreatitis with PD, the dorsal pancreatitis accounted for a much higher percentage than that in pancreatitis without PD (17 of 38, 44.74% vs 30 of 135, 22.22%) (?2 = 7.257, P < 0.05). CONCLUSION: MRCP and MRI can depict the features of pancreatitis associated with divisum. Recurrent acute pancreatitis and isolated dorsal involvement are more common in patients with divisum. PMID:23946595

Wang, Deng-Bin; Yu, Jinxing; Fulcher, Ann S; Turner, Mary A

2013-01-01

356

Molecular Imaging and Pharmacokinetic Analysis of Carbon-11 Labeled Antisense Oligonucleotide LY2181308 in Cancer Patients  

PubMed Central

Antisense oligonucleotides (ASOs) have potential as anti-cancer agents by specifically modulating genes involved in tumorigenesis. However, little is known about ASO biodistribution and tissue pharmacokinetics (PKs) in humans, including whether sufficient delivery to target tumor tissue may be achieved. In this preliminary study in human subjects, we used combined positron emission and computed tomography (PET-CT) imaging and subsequent modeling analysis of acquired dynamic data, to examine the in vivo biodistribution and PK properties of LY2181308 - a second generation ASO which targets the apoptosis inhibitor protein survivin. Following radiolabeling of LY2181308 with methylated carbon-11 ([11C]methylated-LY2181308), micro-doses (<1mg) were administered to three patients with solid tumors enrolled in a phase I trial. Moderate uptake of [11C]methylated-LY2181308 was observed in tumors (mean=32.5ng*h /mL, per mg administered intravenously). Highest uptake was seen in kidney and liver and lowest uptake was seen in lung and muscle. One patient underwent repeat analysis on day 15 of multiple dose therapy, during administration of LY2181308 (750mg), when altered tissue PKs and a favorable change in biodistribution was seen. [11C]methylated-LY2181308 exposure increased in tumor, lung and muscle, whereas renal and hepatic exposure decreased. This suggests that biological barriers to ASO tumor uptake seen at micro-doses were overcome by therapeutic dosing. In addition, 18F-labeled fluorodeoxyglucose (FDG) scans carried out in the same patient before and after treatment showed up to 40% decreased tumor metabolism. For the development of anti-cancer ASOs, the results provide evidence of LY2181308 tumor tissue delivery and add valuable in vivo pharmacological information. For the development of novel therapeutic agents in general, the study exemplifies the merits of applying PET imaging methodology early in clinical investigations. PMID:21772926

Saleem, Azeem; Matthews, Julian C.; Ranson, Malcolm; Callies, Sophie; André, Valérie; Lahn, Michael; Dickinson, Claire; Prenant, Christian; Brown, Gavin; McMahon, Adam; Talbot, Denis C.; Jones, Terry; Price, Patricia M.

2011-01-01

357

The use of digital imaging and communications in medicine (DICOM) in the integration of imaging into the electronic patient record at the Department of Veterans Affairs.  

PubMed

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 health care enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire images from multiple sources and store them directly into the online patient record. The VA can obtain both radiology and nonradiology images using DICOM, and can display them on low-cost clinician's color workstations throughout the medical center. High-resolution gray-scale diagnostic-quality multimonitor workstations with specialized viewing software can be used for reading radiology images. The VA's DICOM capabilities can interface six different commercial picture archiving and communication systems (PACS) and more than 20 different image acquisition modalities. The VA is advancing its use of DICOM beyond radiology. New color imaging applications for gastrointestinal endoscopy and ophthalmology using DICOM are under development. These are the first DICOM offerings for the vendors, who are planning to support the recently passed DICOM Visible Light and Structured Reporting service classes. Implementing these in VistA is a challenge because of the different workflow and software support for these disciplines within the VA hospital information system (HIS) environment. PMID:10847382

Kuzmak, P M; Dayhoff, R E

2000-05-01

358

Increasing patient throughput in magnetic resonance imaging: a practical approach. Oxford MRI Group.  

PubMed

A major factor governing the throughput of patients in a magnetic resonance imaging (MRI) service is the number and length of sequences employed. This study investigated the feasibility of prospectively selecting patients for whom a pre-planned examination of the brain, spine or knee could be applied with a high chance of success. The implications on throughput of using these pre-planned examinations were determined. 173 patients were studied. A successful outcome was defined as an examination in which a diagnosis could be made with 100% confidence and without the need for further sequences. Examinations of the brain (n = 113), knee (n = 23) and lumbar spine (for disc degeneration, n = 14) were performed with success rates of 96%, 87% and 64%, respectively. Examinations of the lumbar spine (for radicular symptoms, n = 20) and cervical spine (n = 3) were performed with success rates of 85% and 66%, respectively. The examinations of the brain, knee and lumbar spine (for disc degeneration) were completed within the target time of 20 min in 92%, 95% and 69% of cases, respectively. Examinations of the lumbar spine (for radicular symptoms) and cervical spine were completed within 30 min in 75% and 33% of cases, respectively. Analysis of our results suggests that success rates could be improved by minor changes in sequence design. Carefully selected patients can be successfully examined in short examination times. Instituting these practices would increase the efficiency of MR machine time and improve patient throughput by 80-125%. This would have a marked effect on the length of waiting lists, and would increase the general availability of MRI. PMID:1628176

Moore, N R; Golding, S J

1992-06-01

359

IEEE TRANSACTIONS ON MEDICAL IMAGING, VOL. 24, NO. 4, APRIL 2005 457 Efficient Pipeline for Image-Based Patient-Specific  

E-print Network

and characterization of the hemodynamics in cerebral aneurysms from medical images is described. A sensitivity analysis-Based Patient-Specific Analysis of Cerebral Aneurysm Hemodynamics: Technique and Sensitivity Juan R. Cebral numbers cerebral aneurysms are feasible. Index Terms--Cerebral aneurysm, computational fluid dy- namics

Frangi, Alejandro

360

A combined neuropsychological and brain imaging study of obstructive sleep apnea Running head: Cognitive and brain imaging study of OSA patients  

E-print Network

1 A combined neuropsychological and brain imaging study of obstructive sleep apnea Running head.1365-2869.2008.00705.x #12;2 Patients with obstructive sleep apnea show neuropsychological impairments, neuropsychology, resting state, cognitive reserve INTRODUCTION Obstructive sleep apnea (OSA) is characterized

Paris-Sud XI, Université de

361

Federal government expands compliance initiatives.  

PubMed

In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner. PMID:10170318

Dugan, J K

1997-09-01

362

A community hospital experience with correlative imaging in patients with suspected postoperative intra-abdominal  

SciTech Connect

In the unoperated abdomen the anatomic information supplied by CT scanning is usually conducive to a correct diagnosis. The situation is somewhat different in the postoperative patient. Changes in anatomic relationships, loss of landmarks, artifacts, ''ghosts'' and fluid accumulations at times make it necessary to complement the anatomic data with functional imaging such as gallium 67 scintigraphy. Over the last 30 months the authors have studied 34 patients to whom existed strong clinical suspicion of postoperative intra-abdominal abscess. Ct scans were performed one or two days before the radionuclide study. Abdominal scintigraphy was done 6-18 hours after the administration of 6 millicuries of gallium-67 Citrate. CT and scintigraphic studies were in agreement in 21 laparotomy proven cases. Discordant CT and radionuclide scans occurred in 13 patients, in each case CT was suggestive of abscess and the Gallium scan was interpreted originally as negative for intra-abdominal abscess. In 3 instances, unsuspected extra-abdominal infectious sites were identified in the radionuclide study. No intra-abdominal abscess was demonstrated in any of the cases where CT was suggestive of abscess and the Gallium scan was negative. The authors' limited experience suggests that in the clinical setting of possible postoperative intra-abdominal abscess it is prudent to complement the anatomic data from CT studies with a functional radionuclide study, such as Gallium scanning.

Franco, J.; Schwartz, M.; Kovaleski, B.; Vanags, K.; Morris, M.; Mac Affee, J.; Singlenton, N.; Prevost, L.; Boyd, M.

1984-01-01

363

Exercise Profile and Diastolic Functions Measured via Tissue Doppler Imaging of Fibromyalgia Patients  

PubMed Central

Background Our aim was to evaluate electrocardiographic and echocardiographic properties and exercise response of patients with fibromyalgia (FM). Methods The study included 60 women with primary FM and 30 healthy individuals. Resting electrocardiography, echocardiography and exercise treadmill test were used to compare these two groups. At apical four-chamber window, samples of transmitral diastolic inflow and tissue Doppler imaging of left ventricle lateral wall were obtained. Left ventricle ejection fraction was measured via modified Simpson’s method. Exercise duration, maximal exercise capacity, maximal heart rate (HR) (bpm), maximal HR (%), rate-pressure product at maximal HR (bpm × mmHg), heart rate recovery 1 (bpm), heart rate recovery 2 (bpm) and chronotropic reserve (%) values were calculated. Results Resting HR and QTc values were similar in both groups. Echocardiographic measurements in both groups did not reveal statistically significant difference except left ventricle end-diastolic diameter and left atrial diameter. Parameters related to diastolic function of the left ventricle did not differ significantly in both groups. Also, there was not any significant difference between the groups for E/E’ ratio and chronotropic reserve. Exercise treadmill test results were statistically similar for both groups. Conclusion Patients with FM presented a normal HR response to exercise and those patients had normal diastolic function similar to their healthy controls. PMID:24734144

Balbaloglu, Ozlem; Ede, Huseyin; Yolcu, Sadiye; Ak, Hakan; Tanik, Nermin; Tekin, Gulacan

2014-01-01

364

Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance  

PubMed Central

Background Image-guided radiotherapy (IGRT) facilitates the delivery of a very precise radiation dose. In this study we compare the toxicity and biochemical progression-free survival between patients treated with daily image-guided intensity-modulated radiotherapy (IG-IMRT) and 3D conformal radiotherapy (3DCRT) without daily image guidance for high risk prostate cancer (PCa). Methods A total of 503 high risk PCa patients treated with radiotherapy (RT) and endocrine treatment between 2000 and 2010 were retrospectively reviewed. 115 patients were treated with 3DCRT, and 388 patients were treated with IG-IMRT. 3DCRT patients were treated to 76 Gy and without daily image guidance and with 1–2 cm PTV margins. IG-IMRT patients were treated to 78 Gy based on daily image guidance of fiducial markers, and the PTV margins were 5–7 mm. Furthermore, the dose-volume constraints to both the rectum and bladder were changed with the introduction of IG-IMRT. Results The 2-year actuarial likelihood of developing grade?>?= 2 GI toxicity following RT was 57.3% in 3DCRT patients and 5.8% in IG-IMRT patients (p??= 2 GI toxicity compared to IG-IMRT (p?image guidance and margin reduction. PMID:24495815

2014-01-01

365

The Expanding Frontier of Pluralism.  

ERIC Educational Resources Information Center

Looks at the expanding frontier of pluralism in terms of reappraising the relationship of formal education to the advent of the constant change (occupational and social) accelerated by the microprocessor revolution and readjusting provisions in educational systems to meet the different needs of different populations. (AH)

King, Edmund

1983-01-01

366

Particle Production in Expanding Spacetime  

Microsoft Academic Search

The complex time WKB (CWKB) approximation has been an effective technique to study particle production in expanding space time. The success of the approximation technique both in time and space dependent gauge has motivated us to study the method in relation to the time dependent approximation. In this work we try to understand the adiabatic and non-adiabatic transition within the

S. Biswas; A. Shaw; P. Misra

2002-01-01

367

Plant growth in expanded perlite  

Microsoft Academic Search

The chemical and physical properties of expanded perlite as a growth medium are described.The growth of cress in perlite receiving additions of inorganic fertilisers is described and assessed. Only slightly less growth was made in perlite fortified with plant nutrients than in a good potting soil.The medium is simple to handle and is suitable for the growth of plants in

T. M. Morrison; D. C. McDonald; Jean A. Sutton

1960-01-01

368

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2009-11-17

369

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2010-09-14

370

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2009-10-27

371

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2009-12-01

372

Emotional Giftedness: An Expanded View.  

ERIC Educational Resources Information Center

This paper discusses an expanded definition of the concept of emotional giftedness in children as defined by Annemarie Roeper. In contrast to examples of academic and artistic prodigies, cases are reviewed that illustrate less tangibly measured examples of children's giftedness, such as expressions of compassion, moral sensitivity, positive…

Piechowski, Michael M.

373

Gravity and the Expanding Universe  

NSDL National Science Digital Library

This lesson explores the idea of the expanding universe through video, text and questions. Discussion includes the cosmological constant, a universal force that opposes gravity which Albert Einstein called his biggest blunder, rate of expansion of the universe and dark energy. Registration is required and is free.

374

Energy recovery with turbo expanders  

Microsoft Academic Search

In the oil, gas and petrochemical industry, there are many instances where energy is under-utilized, if not actually wasted. In many cases it may be possible to recover some of this energy and obtain useful work, thereby improving plant efficiency and the economics of the operation. The turbo expander is a simple device that can make a significant contribution to

1986-01-01

375

Drizo protects turbo expander plant  

Microsoft Academic Search

A triethylene glycol (TEG) unit using Dow's Drizo technology in front of processes was installed in a turbo expander plant owned by Valero Hydrocarbons, San Antonio, Texas. The TEG unit was placed in the process because methanol consumption had run higher than design conditions had predicted; gas flow rates and water content varied widely; and the gas was found to

C. W. Frazier; J. E. Force

1982-01-01

376

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W.; Cropp, T. Ashton; Anderson, J. Christopher; Schultz, Peter G.

2013-01-22

377

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2012-02-14

378

Expanding the eukaryotic genetic code  

DOEpatents

This invention provides compositions and methods for producing translational components that expand the number of genetically encoded amino acids in eukaryotic cells. The components include orthogonal tRNAs, orthogonal aminoacyl-tRNA synthetases, orthogonal pairs of tRNAs/synthetases and unnatural amino acids. Proteins and methods of producing proteins with unnatural amino acids in eukaryotic cells are also provided.

Chin, Jason W. (Cambridge, GB); Cropp, T. Ashton (Bethesda, MD); Anderson, J. Christopher (San Francisco, CA); Schultz, Peter G. (La Jolla, CA)

2012-05-08

379

Clinical Application of 7.0 T Magnetic Resonance Images in Gamma Knife Radiosurgery for a Patient with Brain Metastases  

PubMed Central

In the study we assessed the distortion of 7.0 T magnetic resonance (MR) images in reference to 1.5 T MR images in the radiosurgery of metastatic brain tumors. Radiosurgery with Gamma Knife Perfexion® was performed for the treatment of a 54-yr-old female patient with multiple brain metastases by the co-registered images of the 7.0 T and 1.5 T magnetic resonance images (MRI). There was no significant discrepancy in the positions of anterior and posterior commissures as well as the locations of four metastatic brain tumors in the co-registered images between 7.0 T and 1.5 T MRI with better visualization of the anatomical details in 7.0 T MR images. This study demonstrates for the first time that 7.0 T MR images can be safely utilized in Perfexion® Gamma Knife radiosurgery for the treatment of metastatic brain tumors. Furthermore 7.0 T MR images provide better visualization of brain tumors without image distortion in comparison to 1.5 T MR images. PMID:21655075

Paek, Sun Ha; Son, Young Don; Chung, Hyun-Tai; Kim, Dong Gyu

2011-01-01

380

Texture analysis of MR images of patients with Mild Traumatic Brain Injury  

PubMed Central

Background Our objective was to study the effect of trauma on texture features in cerebral tissue in mild traumatic brain injury (MTBI). Our hypothesis was that a mild trauma may cause microstructural changes, which are not necessarily perceptible by visual inspection but could be detected with texture analysis (TA). Methods We imaged 42 MTBI patients by using 1.5 T MRI within three weeks of onset of trauma. TA was performed on the area of mesencephalon, cerebral white matter at the levels of mesencephalon, corona radiata and centrum semiovale and in different segments of corpus callosum (CC) which have been found to be sensitive to damage. The same procedure was carried out on a control group of ten healthy volunteers. Patients' TA data was compared with the TA results of the control group comparing the amount of statistically significantly differing TA parameters between the left and right sides of the cerebral tissue and comparing the most discriminative parameters. Results There were statistically significant differences especially in several co-occurrence and run-length matrix based parameters between left and right side in the area of mesencephalon, in cerebral white matter at the level of corona radiata and in the segments of CC in patients. Considerably less difference was observed in the healthy controls. Conclusions TA revealed significant changes in texture parameters of cerebral tissue between hemispheres and CC segments in TBI patients. TA may serve as a novel additional tool for detecting the conventionally invisible changes in cerebral tissue in MTBI and help the clinicians to make an early diagnosis. PMID:20462439

2010-01-01

381

Visualization of flow structures in Fontan patients using 3-dimensional phase contrast magnetic resonance imaging  

PubMed Central

Objective Our objective was to analyze 3-dimensional (3D) blood flow patterns within the total cavopulmonary connection (TCPC) using in vivo phase contrast magnetic resonance imaging (PC MRI). Methods Sixteen single-ventricle patients were prospectively recruited at 2 leading pediatric institutions for PC MRI evaluation of their Fontan pathway. Patients were divided into 2 groups. Group 1 comprised 8 patients with an extracardiac (EC) TCPC, and group 2 comprised 8 patients with a lateral tunnel (LT) TCPC. A coronal stack of 5 to 10 contiguous PC MRI slices with 3D velocity encoding (5–9 ms resolution) was acquired and a volumetric flow field was reconstructed. Results Analysis revealed large vortices in LT TCPCs and helical flow structures in EC TCPCs. On average, there was no difference between LT and EC TCPCs in the proportion of inferior vena cava flow going to the left pulmonary artery (43% ± 7% vs 46% ± 5%; P = .34). However, for EC TCPCs, the presence of a caval offset was a primary determinant of inferior vena caval flow distribution to the pulmonary arteries with a significant bias to the offset side. Conclusions 3D flow structures within LT and EC TCPCs were reconstructed and analyzed for the first time using PC MRI. TCPC flow patterns were shown to be different, not only on the basis of LT or EC considerations, but with significant influence from the superior vena cava connection as well. This work adds to the ongoing body of research demonstrating the impact of TCPC geometry on the overall hemodynamic profile. PMID:22088274

Sundareswaran, Kartik S.; Haggerty, Christopher M.; de Zelicourt, Diane; Dasi, Lakshmi P.; Pekkan, Kerem; Frakes, David H.; Powell, Andrew J.; Kanter, Kirk R.; Fogel, Mark A.; Yoganathan, Ajit P.

2012-01-01

382

EVOLUTION OF TUMEFACTIVE LESIONS IN MULTIPLE SCLEROSIS: A 12-YEAR STUDY WITH SERIAL IMAGING IN A SINGLE PATIENT  

PubMed Central

Objective We describe the acute presentation and the long-term evolution of recurrent tumefactive lesions (TLs) in a patient with relapsing-remitting multiple sclerosis. Background Five TLs occurred at three separate timepoints over 12 years and these were followed by 73 serial magnetic resonance images. Methods TL evolution was described by means of magnetization transfer (MT) imaging and cerebrospinal fluid tissue specific imaging (TSI) over the period of the follow-up. Results During the study period, the patient had three clinical relapses with only minimal disability progression. MT imaging demonstrated that only the peripheral portion of each TL reverted to pre-lesional MT ratios within six months post-enhancement. Conclusions Recurring TLs may present a similar pattern of recovery that may be associated with a long-term favorable clinical outcome. PMID:24062416

Ikonomidou, Vasiliki N.; Richert, Nancy D.; Vortmeyer, Alexander; Tovar-Moll, Fernanda; Bielekova, Bibiana; Cook, Natalie E.; Duyn, Jeff H.; Bagnato, Francesca

2013-01-01

383

Distribution of Proliferating Bone Marrow in Adult Cancer Patients Determined Using FLT-PET Imaging  

SciTech Connect

Purpose: Given that proliferating hematopoietic stem cells are especially radiosensitive, the bone marrow is a potential organ at risk, particularly with the use of concurrent chemotherapy and radiotherapy. Existing data on bone marrow distribution have been determined from the weight and visual appearance of the marrow in cadavers. {sup 18}F-fluoro-L-deoxythymidine concentrates in bone marrow, and we used its intensity on positron emission tomography imaging to quantify the location of the proliferating bone marrow. Methods and Materials: The {sup 18}F-fluoro-L-deoxythymidine positron emission/computed tomography scans performed at the Peter MacCallum Cancer Centre between 2006 and 2009 on adult cancer patients were analyzed. At a minimum, the scans included the mid-skull through the proximal femurs. A software program developed at our institution was used to calculate the percentage of administered activity in 11 separately defined bony regions. Results: The study population consisted of 13 patients, 6 of whom were men. Their median age was 61 years. Of the 13 patients, 9 had lung cancer, 2 had colon cancer, and 1 each had melanoma and leiomyosarcoma; 6 had received previous, but not recent, chemotherapy. The mean percentage of proliferating bone marrow by anatomic site was 2.9% {+-} 2.1% at the skull, 1.9% {+-} 1.2% at the proximal humeri, 2.9% {+-} 1.3% at the sternum, 8.8% {+-} 4.7% at the ribs and clavicles, 3.8% {+-} 0.9% at the scapulas, 4.3% {+-} 1.6% at the cervical spine, 19.9% {+-} 2.6% at the thoracic spine, 16.6% {+-} 2.2% at the lumbar spine, 9.2% {+-} 2.3% at the sacrum, 25.3% {+-} 4.9% at the pelvis, and 4.5% {+-} 2.5% at the proximal femurs. Conclusion: Our modern estimates of bone marrow distribution in actual cancer patients using molecular imaging of the proliferating marrow provide updated data for optimizing normal tissue sparing during external beam radiotherapy planning.

Hayman, James A., E-mail: hayman@umich.ed [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); University of Michigan Health Systems, Ann Arbor, MI (United States); Callahan, Jason W.; Herschtal, Alan [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Everitt, Sarah [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Monash University, Melbourne, VIC (Australia); Binns, David S. [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Hicks, Rod J.; Mac Manus, Michael [Peter MacCallum Cancer Centre, Melbourne, VIC (Australia); Melbourne University, Melbourne, VIC (Australia)

2011-03-01

384

FDG PET images in a patient with Erdheim-Chester disease.  

PubMed

Erdheim-Chester disease is an uncommon non-Langerhans-cell histiocytosis, due to excessive production of histiocytes deposited in various organs and tissues in the human body. FDG PET was performed in a 68-year-old man with documented active Erdheim-Chester disease to evaluate the extent of the disease. The patient was previously treated with high-dose subcutaneous Interferon ?2b, 1,000,000 units 3 times a week, but treatment was interrupted approximately 5 weeks before evaluation at the National Institutes of Health because of adverse effects of the medication. FDG PET/CT showed lesions were imaged in brain, heart, mediastinum, abdomen, and skeleton. PMID:23640213

Sioka, Chrissa; Estrada-Veras, Juvianee; Maric, Irinia; Gahl, William A; Chen, Clara C

2014-02-01

385

Three-dimensional brain metabolic imaging in patients with toxic encephalopathy  

SciTech Connect

Thirty-three workers, ages 24 to 63, developed clinical toxic encephalopathy after exposure to neurotoxins and were studied by SPECT brain scans. Five were exposed to pesticides, 13 were acutely exposed to mixtures of solvents, 8 were chronically exposed to mixtures of hazardous wastes that contained organic solvents, 2 were acutely exposed to phosgene and other toxins, and 5 had exposures to hydrogen sulfide. Twenty-nine had neuropsychological testing and all had a medical history and physical. Of the workers who had a clinical diagnosis of toxic encephalopathy, 31 (93.9%) had abnormal SPECT brain scans with the most frequent areas of abnormality being temporal lobes (67.7%), frontal lobes (61.3%), basal ganglia (45.2%), thalamus (29.0%), parietal lobes (12.9%), motorstrip (9.68%), cerebral hemisphere (6.45%), occipital lobes (3.23%), and caudate nucleus (3.23%). Twenty-three out of 29 (79.3%) neuropsychological evaluations were abnormal. Other modalities when performed included the following percentages of abnormals: NCV, 33.3%; CPT sensory nerve testing, 91.3%, vestibular function testing, 71.4%; olfactory testing, 89.2%; sleep EEG analysis, 85.7%; EEG, 8.33%; CT, 7.14%; and MRI brain scans, 28.6%. The complex of symptoms seen in toxic encephalopathy implies dysfunction involving several CNS regions. This series of patients adds to the previous experience of brain metabolic imaging and demonstrates that certain areas of the brain are typically affected despite differences in toxin structure, that these lesions can be globally defined by SPECT/PET brain scans, that these lesions correlate well with clinical and neuropsychological testing, and that such testing is a useful adjunct to previous methods. EEG and structural brain imaging such as CT and MRI are observed to have poor sensitivity in this type of patient. 32 refs., 5 tabs.

Callender, T.J.; Duhon, D.; Ristovv, M. (Med-Health, Ltd. Clinic, Lafayette, LA (United States)); Morrow, L. (Univ. of Pittsburgh, PA (United States)); Subramanian, K. (Lafayette General Hospital, LA (United States))

1993-02-01

386

Comparison of daily megavoltage electronic portal imaging or kilovoltage imaging with marker seeds to ultrasound imaging or skin marks for prostate localization and treatment positioning in patients with prostate cancer  

SciTech Connect

Purpose: To compare the accuracy of imaging modalities, immobilization, localization, and positioning techniques in patients with prostate cancer. Methods and Materials: Thirty-five patients with prostate cancer had gold marker seeds implanted transrectally and were treated with fractionated radiotherapy. Twenty of the 35 patients had limited immobilization; the remaining had a vacuum-based immobilization. Patient positioning consisted of alignment with lasers to skin marks, ultrasound or kilovoltage X-ray imaging, optical guidance using infrared reflectors, and megavoltage electronic portal imaging (EPI). The variance of each positioning technique was compared to the patient position determined from the pretreatment EPI. Results: With limited immobilization, the average difference between the skin marks' laser position and EPI pretreatment position is 9.1 {+-} 5.3 mm, the average difference between the skin marks' infrared position and EPI pretreatment position is 11.8 {+-} 7.2 mm, the average difference between the ultrasound position and EPI pretreatment position is 7.0 {+-} 4.6 mm, the average difference between kV imaging and EPI pretreatment position is 3.5 {+-} 3.1 mm, and the average intrafraction movement during treatment is 3.4 {+-} 2.7 mm. For the patients with the vacuum-style immobilization, the average difference between the skin marks' laser position and EPI pretreatment position is 10.7 {+-} 4.6 mm, the average difference between kV imaging and EPI pretreatment position is 1.9 {+-} 1.5 mm, and the average intrafraction movement during treatment is 2.1 {+-} 1.5 mm. Conclusions: Compared with use of skin marks, ultrasound imaging for positioning provides an increased degree of agreement to EPI-based positioning, though not as favorable as kV imaging fiducial seeds. Intrafraction movement during treatment decreases with improved immobilization.

Serago, Christopher F. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL (United States)]. E-mail: serago.christopher@mayo.edu; Buskirk, Steven J. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL (United States); Igel, Todd C. [Department of Urology, Mayo Clinic, Jacksonville, FL (United States); Gale, Ashley A. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL (United States); Serago, Nicole E. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL (United States); Earle, John D. [Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL (United States)

2006-08-01

387

High-Resolution Images of Retinal Structure in Patients with Choroideremia  

PubMed Central

Purpose. To study retinal structure in choroideremia patients and carriers using high-resolution imaging techniques. Methods. Subjects from four families (six female carriers and five affected males) with choroideremia (CHM) were characterized with best-corrected visual acuity (BCVA), kinetic and static perimetry, full-field electroretinography, and fundus autofluorescence (FAF). High-resolution macular images were obtained with adaptive optics scanning laser ophthalmoscopy (AOSLO) and spectral domain optical coherence tomography (SD-OCT). Coding regions of the CHM gene were sequenced. Results. Molecular analysis of the CHM gene identified a deletion of exons 9 to 15 in family A, a splice site mutation at position 79+1 of exon 1 in family B, deletion of exons 6 to 8 in family C, and a substitution at position 106 causing a premature stop in family D. BCVA ranged from 20/16 to 20/63 in carriers and from 20/25 to 5/63 in affected males. FAF showed abnormalities in all subjects. SD-OCT showed outer retinal layer loss, outer retinal tubulations at the margin of outer retinal loss, and inner retinal microcysts. Patchy cone loss was present in two symptomatic carriers. In two affected males, cone mosaics were disrupted with increased cone spacing near the fovea but more normal cone spacing near the edge of atrophy. Conclusions. High-resolution retinal images in CHM carriers and affected males demonstrated RPE and photoreceptor cell degeneration. As both RPE and photoreceptor cells were affected, these cell types may degenerate simultaneously in CHM. These findings provide insight into the effect of CHM mutations on macular retinal structure, with implications for the development of treatments for CHM. (ClinicalTrials.gov number, NCT00254605.) PMID:23299470

Syed, Reema; Sundquist, Sanna M.; Ratnam, Kavitha; Zayit-Soudry, Shiri; Zhang, Yuhua; Crawford, J. Brooks; MacDonald, Ian M.; Godara, Pooja; Rha, Jungtae; Carroll, Joseph; Roorda, Austin; Stepien, Kimberly E.; Duncan, Jacque L.

2013-01-01

388

Measuring the relative extent of pulmonary infiltrates by hierarchical classification of patient-specific image features  

NASA Astrophysics Data System (ADS)

Pulmonary infiltrates are common radiological findings indicating the filling of airspaces with fluid, inflammatory exudates, or cells. They are most common in cases of pneumonia, acute respiratory syndrome, atelectasis, pulmonary oedema and haemorrhage, whereas their extent is usually correlated with the extent or the severity of the underlying disease. In this paper we propose a novel pattern recognition framework for the measurement of the extent of pulmonary infiltrates in routine chest radiographs. The proposed framework follows a hierarchical approach to the assessment of image content. It includes the following: (a) sampling of the lung fields; (b) extraction of patient-specific grey-level histogram signatures from each sample; (c) classification of the extracted signatures into classes representing normal lung parenchyma and pulmonary infiltrates; (d) the samples for which the probability of belonging to one of the two classes does not reach an acceptable level are rejected and classified according to their textural content; (e) merging of the classification results of the two classification stages. The proposed framework has been evaluated on real radiographic images with pulmonary infiltrates caused by bacterial infections. The results show that accurate measurements of the infiltration areas can be obtained with respect to each lung field area. The average measurement error rate on the considered dataset reached 9.7% ± 1.0%.

Tsevas, S.; Iakovidis, D. K.

2011-11-01

389

Imaging tumour heterogeneity of the consequences of a PKC?-substrate interaction in breast cancer patients.  

PubMed

Breast cancer heterogeneity demands that prognostic models must be biologically driven and recent clinical evidence indicates that future prognostic signatures need evaluation in the context of early compared with late metastatic risk prediction. In pre-clinical studies, we and others have shown that various protein-protein interactions, pertaining to the actin microfilament-associated proteins, ezrin and cofilin, mediate breast cancer cell migration, a prerequisite for cancer metastasis. Moreover, as a direct substrate for protein kinase C?, ezrin has been shown to be a determinant of cancer metastasis for a variety of tumour types, besides breast cancer; and has been described as a pivotal regulator of metastasis by linking the plasma membrane to the actin cytoskeleton. In the present article, we demonstrate that our tissue imaging-derived parameters that pertain to or are a consequence of the PKC-ezrin interaction can be used for breast cancer prognostication, with inter-cohort reproducibility. The application of fluorescence lifetime imaging microscopy (FLIM) in formalin-fixed paraffin-embedded patient samples to probe protein proximity within the typically <10 nm range to address the oncological challenge of tumour heterogeneity, is discussed. PMID:25399560

Weitsman, Gregory; Lawler, Katherine; Kelleher, Muireann T; Barrett, James E; Barber, Paul R; Shamil, Eamon; Festy, Frederic; Patel, Gargi; Fruhwirth, Gilbert O; Huang, Lufei; Tullis, Iain D C; Woodman, Natalie; Ofo, Enyinnaya; Ameer-Beg, Simon M; Irshad, Sheeba; Condeelis, John; Gillett, Cheryl E; Ellis, Paul A; Vojnovic, Borivoj; Coolen, Anthony C C; Ng, Tony

2014-12-01

390

Optimizing visualization in enhanced depth imaging OCT in healthy subjects and patients with retinal pigment epithelial detachment  

PubMed Central

Background This study’s objective was to optimize the visualization of three different spectral-domain optical coherence tomography (SD-OCT) display modalities and evaluate enhanced depth imaging (EDI) by comparing the maximum depth of assessment in conventional versus inverted cross-sectional OCT images in healthy subjects and in patients with retinal pigment epithelial detachment (PED). Methods Cross-sectional SD-OCT conventional and inverted images were obtained with the HRA2 (Heidelberg Retina Angiograph II, Heidelberg Engineering, Heidelberg, Germany). Horizontal as well as vertical sections in three different display modes were blinded for evaluation by three independent, experienced graders for maximal imaging depth of the deep ocular fundus layers. Results The mean imaging depth as measured from the inner segment/outer segment (IS/OS) to the outer choroid of all 14 healthy subjects was 197 ± 44 ?m vs 263 ± 56 ?m for conventional vs EDI scans: in black/white mode, it was significantly lower (P < 0.001) than in white/black mode (249 ± 42 ?m vs 337 ± 71 ?m) and color/heat mode (254 ± 48 ?m vs 354 ± 73 ?m). The mean imaging depth of all 14 study eyes with PED was 240 ± 78 ?m vs 345 ± 100 ?m for conventional vs EDI scans in black/white mode, and was significantly lower (P < 0.001) than in white/black mode (393 ± 104 ?m vs 464 ± 126 ?m) and in color/heat mode (373 ± 106 ?m vs 453 ± 114 ?m). In each display modality of healthy subjects and of patients with PED, EDI scans showed a significantly higher imaging depth than the corresponding conventional scans. Conclusion White/black and color/heat modes allow increased imaging depth, compared to black/white mode using both conventional or EDI OCT scans in healthy subjects or patients with PED. EDI obtained with HRA2 significantly improves the imaging depth, compared to conventional OCT scans. PMID:23204834

Reznicek, Lukas; Vounotrypidis, Efstathios; Seidensticker, Florian; Kortuem, Karsten; Kampik, Anselm; Neubauer, Aljoscha S; Wolf, Armin

2012-01-01

391

The value of diffusion-weighted MR imaging in the diagnosis of primary acquired and residual cholesteatoma: a surgical verified study of 100 patients  

Microsoft Academic Search

Our goal was to determine the value of echo-planar diffusion-weighted MR imaging in detecting the presence of primary acquired\\u000a and residual cholesteatoma. One hundred patients were evaluated by preoperative magnetic resonance (MR) imaging with diffusion-weighted\\u000a MR imaging. The patient population consisted of a first group of 55 patients evaluated in order to detect the presence of\\u000a a primary acquired cholesteatoma.

Jean-Philippe Vercruysse; Bert De Foer; Marc Pouillon; Thomas Somers; Jan Casselman; Erwin Offeciers

2006-01-01

392

Intravenous administration of auto serum-expanded autologous mesenchymal stem cells in stroke  

PubMed Central

Transplantation of human mesenchymal stem cells has been shown to reduce infarct size and improve functional outcome in animal models of stroke. Here, we report a study designed to assess feasibility and safety of transplantation of autologous human mesenchymal stem cells expanded in autologous human serum in stroke patients. We report an unblinded study on 12 patients with ischaemic grey matter, white matter and mixed lesions, in contrast to a prior study on autologous mesenchymal stem cells expanded in foetal calf serum that focused on grey matter lesions. Cells cultured in human serum expanded more rapidly than in foetal calf serum, reducing cell preparation time and risk of transmissible disorders such as bovine spongiform encephalomyelitis. Autologous mesenchymal stem cells were delivered intravenously 36–133 days post-stroke. All patients had magnetic resonance angiography to identify vascular lesions, and magnetic resonance imaging prior to cell infusion and at intervals up to 1 year after. Magnetic resonance perfusion-