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Sample records for admission chest ct

  1. Chest CT Scan

    MedlinePlus

    ... pictures to create a very detailed, three-dimensional (3D) model of organs. Sometimes, a substance called contrast dye is injected into a vein in your arm for the CT scan. This substance highlights areas in your chest, which ...

  2. Chest pain: coronary CT in the ER.

    PubMed

    Maffei, Erica; Seitun, Sara; Guaricci, Andrea I; Cademartiri, Filippo

    2016-01-01

    Cardiac CT has developed into a robust clinical tool during the past 15 years. Of the fields in which the potential of cardiac CT has raised more interest is chest pain in acute settings. In fact, the possibility to exclude with high reliability obstructive coronary artery disease (CAD) in patients at low-to-intermediate risk is of great interest both from the clinical standpoint and from the management standpoint. Several other modalities, with or without imaging, have been used during the past decades in the settings of new onset chest pain or in acute chest pain for both diagnostic and prognostic assessment of CAD. Each one has advantages and disadvantages. Most imaging modalities also focus on inducible ischaemia to guide referral to invasive coronary angiography. The advent of cardiac CT has introduced a new practice diagnostic paradigm, being the most accurate non-invasive method for identification and exclusion of CAD. Furthermore, the detection of subclinical CAD and plaque imaging offer the opportunity to improve risk stratification. Moreover, recent advances of the latest generation CT scanners allow combining both anatomical and functional imaging by stress myocardial perfusion. The role of cardiac CT in acute settings is already important and will become progressively more important in the coming years. PMID:26866681

  3. Impact of routine admission chest X-ray films on patient care

    SciTech Connect

    Hubbell, F.A.; Greenfield, S.; Tyler, J.L.; Chetty, K.; Wyle, F.A.

    1985-01-24

    The authors evaluated the impact of routine chest X-ray films, obtained on admission, on the treatment of patients on internal medicine wards of the Veterans Administration Medical Center, Long Beach, California - a population known to have a high prevalence of cardiopulmonary disease. The reasons for ordering chest films were determined prospectively, and three Department of Medicine faculty members reviewed the charts of admitted patients to determine the impact of chest-film results on patient care. Routine chest X-ray films were ordered for 294 (60 per cent) of the 491 patients studied. Abnormalities were noted in 106 (36 per cent) of these 294 patients. The findings were previously known, chronic, and stable in 86 patients; they were new in only 20. Treatment was changed because of chest-film results in only 12 (4 per cent) of the patients. In only one of these patients would appropriate treatment probably have been omitted if a chest film had not been obtained, and the patient's outcome was not improved by the treatment instituted. The authors conclude that the impact of routine admission chest X-ray films on patient care is very small, even in a population with a high prevalence of cardiopulmonary disease. They recommend that such films not be ordered solely because of admission. 16 references, 3 tables.

  4. Organ doses to adult patients for chest CT

    SciTech Connect

    Huda, Walter; Sterzik, Alexander; Tipnis, Sameer; Schoepf, U. Joseph

    2010-02-15

    Purpose: The goal of this study was to estimate organ doses for chest CT examinations using volume computed tomography dose index (CTDI{sub vol}) data as well as accounting for patient weight. Methods: A CT dosimetry spreadsheet (ImPACT CT patient dosimetry calculator) was used to compute organ doses for a 70 kg patient undergoing chest CT examinations, as well as volume computed tomography dose index (CTDI{sub vol}) in a body CT dosimetry phantom at the same CT technique factors. Ratios of organ dose to CTDI{sub vol} (f{sub organ}) were generated as a function of anatomical location in the chest for the breasts, lungs, stomach, red bone marrow, liver, thyroid, liver, and thymus. Values of f{sub organ} were obtained for x-ray tube voltages ranging from 80 to 140 kV for 1, 4, 16, and 64 slice CT scanners from two vendors. For constant CT techniques, we computed ratios of dose in water phantoms of differing diameter. By modeling patients of different weights as equivalent water cylinders of different diameters, we generated factors that permit the estimation of the organ doses in patients weighing between 50 and 100 kg who undergo chest CT examinations relative to the corresponding organ doses received by a 70 kg adult. Results: For a 32 cm long CT scan encompassing the complete lungs, values of f{sub organ} ranged from 1.7 (thymus) to 0.3 (stomach). Organs that are directly in the x-ray beam, and are completely irradiated, generally had f{sub organ} values well above 1 (i.e., breast, lung, heart, and thymus). Organs that are not completely irradiated in a total chest CT scan generally had f{sub organ} values that are less than 1 (e.g., red bone marrow, liver, and stomach). Increasing the x-ray tube voltage from 80 to 140 kV resulted in modest increases in f{sub organ} for the heart (9%) and thymus (8%), but resulted in larger increases for the breast (19%) and red bone marrow (21%). Adult patient chests have been modeled by water cylinders with diameters between

  5. CT guided percutaneous needle biopsy of the chest: initial experience

    PubMed Central

    Lazguet, Younes; Maarouf, Rachid; Karrou, Marouan; Skiker, Imane; Alloubi, Ihsan

    2016-01-01

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015. Diagnosis was achieved in 18 patients (75%), negative results were found in 3 patients (12,5%). Biopsy was repeated in these cases with two positive results. Complications were seen in 7 patients (29%), Hemoptysis in 5 patients (20%), Pneumothorax in 1 patient (4,1%) and vaso-vagal shock in 1 patient (4,1%). CT Guided Percutaneous Needle Biopsy of the Chest is a safe, minimally invasive procedure with high sensitivity, specificity and accuracy for diagnosis of lung lesions.

  6. Construction of a multimodal CT-video chest model

    NASA Astrophysics Data System (ADS)

    Byrnes, Patrick D.; Higgins, William E.

    2014-03-01

    Bronchoscopy enables a number of minimally invasive chest procedures for diseases such as lung cancer and asthma. For example, using the bronchoscope's continuous video stream as a guide, a physician can navigate through the lung airways to examine general airway health, collect tissue samples, or administer a disease treatment. In addition, physicians can now use new image-guided intervention (IGI) systems, which draw upon both three-dimensional (3D) multi-detector computed tomography (MDCT) chest scans and bronchoscopic video, to assist with bronchoscope navigation. Unfortunately, little use is made of the acquired video stream, a potentially invaluable source of information. In addition, little effort has been made to link the bronchoscopic video stream to the detailed anatomical information given by a patient's 3D MDCT chest scan. We propose a method for constructing a multimodal CT-video model of the chest. After automatically computing a patient's 3D MDCT-based airway-tree model, the method next parses the available video data to generate a positional linkage between a sparse set of key video frames and airway path locations. Next, a fusion/mapping of the video's color mucosal information and MDCT-based endoluminal surfaces is performed. This results in the final multimodal CT-video chest model. The data structure constituting the model provides a history of those airway locations visited during bronchoscopy. It also provides for quick visual access to relevant sections of the airway wall by condensing large portions of endoscopic video into representative frames containing important structural and textural information. When examined with a set of interactive visualization tools, the resulting fused data structure provides a rich multimodal data source. We demonstrate the potential of the multimodal model with both phantom and human data.

  7. ROI extraction of chest CT images using adaptive opening filter

    NASA Astrophysics Data System (ADS)

    Yamada, Nobuhiro; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Eguchi, Kenji; Omatsu, Hironobu; Kakinuma, Ryutaro; Kaneko, Masahiro; Kusumoto, Masahiko; Nishiyama, Hiroyuki; Moriyama, Noriyuki

    2003-05-01

    We have already developed a prototype of computer-aided diagnosis (CAD) system that can automatically detect suspicious shadows from Chest CT images. But the CAD system cannot detect Ground-Grass-Attenuation perfectly. In many cases, this reason depends on the inaccurate extraction of the region of interests (ROI) that CAD system analyzes, so we need to improve it. In this paper, we propose a method of an accurate extraction of the ROI, and compare proposed method to ordinary method that have used in CAD system. Proposed Method is performed by application of the three steps. Firstly we extract lung area using threshold. Secondly we remove the slowly varying bias field using flexible Opening Filter. This Opening Filter is calculated by the combination of the ordinary opening value and the distribution which CT value and contrast follow. Finally we extract Region of Interest using fuzzy clustering. When we applied proposal method to Chest CT images, we got a good result in which ordinary method cannot achieve. In this study we used the Helical CT images that are obtained under the following measurement: 10mm beam width; 20mm/sec table speed; 120kV tube voltage; 50mA tube current; 10mm reconstruction interval.

  8. CT after reconstructive repair of the sternum and chest wall.

    PubMed

    Maddern, I R; Goodman, L R; Almassi, G H; Haasler, G B; McManus, R P; Olinger, G N

    1993-03-01

    Acute mediastinitis and sternal infection after sternotomy are potentially devastating complications, but considerable advances in treatment have been made during the past decade. Sternectomy followed by reconstruction with use of either an omental transposition or a muscle flap has markedly decreased mortality and morbidity. After extensive rib resection, various reconstructive repairs, including the use of polytetrafluoroethylene mesh, have proved successful. The authors retrospectively reviewed 27 postoperative computed tomographic (CT) scans obtained in 19 patients. Twelve of these patients had sternal wounds repaired with either omental or muscle flap procedures. Seven patients had chest wall reconstructions with polytetrafluoroethylene patches, muscle transpositions, or both. The authors found no cases of unexpected or unexplained fluid collections on CT scans obtained beyond the 1st month. Any persistent or recurrent collection is suggestive of infection. If clinical and imaging findings are at odds, imaging-directed needle aspiration can help determine whether a fluid collection is infected and in need of further treatment. PMID:8430171

  9. Automatic mediastinal lymph node detection in chest CT

    NASA Astrophysics Data System (ADS)

    Feuerstein, Marco; Deguchi, Daisuke; Kitasaka, Takayuki; Iwano, Shingo; Imaizumi, Kazuyoshi; Hasegawa, Yoshinori; Suenaga, Yasuhito; Mori, Kensaku

    2009-02-01

    Computed tomography (CT) of the chest is a very common staging investigation for the assessment of mediastinal, hilar, and intrapulmonary lymph nodes in the context of lung cancer. In the current clinical workflow, the detection and assessment of lymph nodes is usually performed manually, which can be error-prone and timeconsuming. We therefore propose a method for the automatic detection of mediastinal, hilar, and intrapulmonary lymph node candidates in contrast-enhanced chest CT. Based on the segmentation of important mediastinal anatomy (bronchial tree, aortic arch) and making use of anatomical knowledge, we utilize Hessian eigenvalues to detect lymph node candidates. As lymph nodes can be characterized as blob-like structures of varying size and shape within a specific intensity interval, we can utilize these characteristics to reduce the number of false positive candidates significantly. We applied our method to 5 cases suspected to have lung cancer. The processing time of our algorithm did not exceed 6 minutes, and we achieved an average sensitivity of 82.1% and an average precision of 13.3%.

  10. Estimation of cartilaginous region in noncontrast CT of the chest

    NASA Astrophysics Data System (ADS)

    Zhao, Qian; Safdar, Nabile; Yu, Glenna; Myers, Emmarie; Sandler, Anthony; Linguraru, Marius George

    2014-03-01

    Pectus excavatum is a posterior depression of the sternum and adjacent costal cartilages and is the most common congenital deformity of the anterior chest wall. Its surgical repair can be performed via minimally invasive procedures that involve sternum and cartilage relocation and benefit from adequate surgical planning. In this study, we propose a method to estimate the cartilage regions in thoracic CT scans, which is the first step of statistical modeling of the osseous and cartilaginous structures for the rib cage. The ribs and sternum are first segmented by using interactive region growing and removing the vertebral column with morphological operations. The entire chest wall is also segmented to estimate the skin surface. After the segmentation, surface meshes are generated from the volumetric data and the skeleton of the ribs is extracted using surface contraction method. Then the cartilage surface is approximated via contracting the skin surface to the osseous structure. The ribs' skeleton is projected to the cartilage surface and the cartilages are estimated using cubic interpolation given the joints with the sternum. The final cartilage regions are formed by the cartilage surface inside the convex hull of the estimated cartilages. The method was validated with the CT scans of two pectus excavatum patients and three healthy subjects. The average distance between the estimated cartilage surface and the ground truth is 2.89 mm. The promising results indicate the effectiveness of cartilage surface estimation using the skin surface.

  11. Radiation doses in chest, abdomen and pelvis CT procedures.

    PubMed

    Manssor, E; Abuderman, A; Osman, S; Alenezi, S B; Almehemeid, S; Babikir, E; Alkhorayef, M; Sulieman, A

    2015-07-01

    Computed tomography (CT) scanning is recognised as a high-radiation dose modality and estimated to be 17 % of the radiological procedure and responsible for 70 % of medical radiation exposure. Although diagnostic X rays provide great benefits, their use involves some risk for developing cancer. The objectives of this study are to estimate radiation doses during chest, abdomen and pelvis CT. A total of 51 patients were examined for the evaluation of metastasis of a diagnosed primary tumour during 4 months. A calibrated CT machine from Siemens 64 slice was used. The mean age was 48.0 ± 18.6 y. The mean patient weight was 73.8 ± 16.1 kg. The mean dose-length product was 1493.8 ± 392.1 mGy cm, Volume CT dose index (CTDI vol) was 22.94 ± 5.64 mGy and the mean effective dose was 22.4 ± 5.9 mSv per procedure. The radiation dose per procedure was higher as compared with previous studies. Therefore, the optimisation of patient's radiation doses is required in order to reduce the radiation risk. PMID:25852181

  12. Patient-specific dose estimation for pediatric chest CT

    SciTech Connect

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2008-12-15

    Current methods for organ and effective dose estimations in pediatric CT are largely patient generic. Physical phantoms and computer models have only been developed for standard/limited patient sizes at discrete ages (e.g., 0, 1, 5, 10, 15 years old) and do not reflect the variability of patient anatomy and body habitus within the same size/age group. In this investigation, full-body computer models of seven pediatric patients in the same size/protocol group (weight: 11.9-18.2 kg) were created based on the patients' actual multi-detector array CT (MDCT) data. Organs and structures in the scan coverage were individually segmented. Other organs and structures were created by morphing existing adult models (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. Organ and effective dose of these patients from a chest MDCT scan protocol (64 slice LightSpeed VCT scanner, 120 kVp, 70 or 75 mA, 0.4 s gantry rotation period, pitch of 1.375, 20 mm beam collimation, and small body scan field-of-view) was calculated using a Monte Carlo program previously developed and validated to simulate radiation transport in the same CT system. The seven patients had normalized effective dose of 3.7-5.3 mSv/100 mAs (coefficient of variation: 10.8%). Normalized lung dose and heart dose were 10.4-12.6 mGy/100 mAs and 11.2-13.3 mGy/100 mAs, respectively. Organ dose variations across the patients were generally small for large organs in the scan coverage (<7%), but large for small organs in the scan coverage (9%-18%) and for partially or indirectly exposed organs (11%-77%). Normalized effective dose correlated weakly with body weight (correlation coefficient: r=-0.80). Normalized lung dose and heart dose correlated strongly with mid-chest equivalent diameter (lung: r=-0.99, heart: r=-0.93); these strong correlation relationships can be used to estimate patient-specific organ dose for

  13. An audit of CT chest surveillance following oral cancer treatment.

    PubMed

    Nugent, G; Hughes, T; Hanlon, R; Jones, H Lewis; Rogers, S N

    2016-07-01

    Computed tomography (CT) of the chest is an integral part of the staging of patients with oral cancer. It identifies metastases, synchronous pulmonary primaries, and detects small nodules of indeterminate character that require a follow-up scan. We aimed to find out how many patients with small nodules had had subsequent scans, and the outcome of those who did. Between 2010 and 2013, 413 patients with oral squamous cell carcinoma (SCC) were treated with curative intent or were actively monitored at the Merseyside and Cheshire Regional Surgical Head and Neck Unit. A total of 324 (78%) had CT at diagnosis. The scans of 246 were clear, metastases were detected in 4, and 51 showed abnormalities. Forty-nine of the patients with abnormalities were recommended for further interval scans but only 20 (41%) actually had them. Further pathological findings were found in 11 (increase in the size of the nodule n=2; metastatic disease n=5; and primary pulmonary tumour n=4). A substantial number of patients did not have the recommended follow-up scans and potentially serious disease was found in some who did. As a result of this audit we have changed the process regarding the booking of CT surveillance scans, and we now check periodically that they have been done. The audit will be repeated to include other sites in the head and neck. PMID:27156437

  14. Seamless Insertion of Pulmonary Nodules in Chest CT Images.

    PubMed

    Pezeshk, Aria; Sahiner, Berkman; Zeng, Rongping; Wunderlich, Adam; Chen, Weijie; Petrick, Nicholas

    2015-12-01

    The availability of large medical image datasets is critical in many applications, such as training and testing of computer-aided diagnosis systems, evaluation of segmentation algorithms, and conducting perceptual studies. However, collection of data and establishment of ground truth for medical images are both costly and difficult. To address this problem, we are developing an image blending tool that allows users to modify or supplement existing datasets by seamlessly inserting a lesion extracted from a source image into a target image. In this study, we focus on the application of this tool to pulmonary nodules in chest CT exams. We minimize the impact of user skill on the perceived quality of the composite image by limiting user involvement to two simple steps: the user first draws a casual boundary around a nodule in the source, and, then, selects the center of desired insertion area in the target. We demonstrate the performance of our system on clinical samples, and report the results of a reader study evaluating the realism of inserted nodules compared to clinical nodules. We further evaluate our image blending techniques using phantoms simulated under different noise levels and reconstruction filters. Specifically, we compute the area under the ROC curve of the Hotelling observer (HO) and noise power spectrum of regions of interest enclosing native and inserted nodules, and compare the detectability, noise texture, and noise magnitude of inserted and native nodules. Our results indicate the viability of our approach for insertion of pulmonary nodules in clinical CT images. PMID:26080378

  15. Seamless insertion of real pulmonary nodules in chest CT exams

    NASA Astrophysics Data System (ADS)

    Pezeshk, Aria; Sahiner, Berkman; Zeng, Rongping; Wunderlich, Adam; Chen, Weijie; Petrick, Nicholas

    2014-03-01

    The availability of large medical image datasets is critical in many applications such as training and testing of computer aided diagnosis (CAD) systems, evaluation of segmentation algorithms, and conducting perceptual studies. However, collection of large repositories of clinical images is hindered by the high cost and difficulties associated with both the accumulation of data and establishment of the ground truth. To address this problem, we are developing an image blending tool that allows users to modify or supplement existing datasets by seamlessly inserting a real lesion extracted from a source image into a different location on a target image. In this study we focus on the application of this tool to pulmonary nodules in chest CT exams. We minimize the impact of user skill on the perceived quality of the blended image by limiting user involvement to two simple steps: the user first draws a casual boundary around the nodule of interest in the source, and then selects the center of desired insertion area in the target. We demonstrate examples of the performance of the proposed system on samples taken from the Lung Image Database Consortium (LIDC) dataset, and compare the noise power spectrum (NPS) of blended nodules versus that of native nodules in simulated phantoms.

  16. CT Chest with IV Contrast Compared with CT Angiography after Blunt Trauma.

    PubMed

    Zaw, Andrea A; Stewart, Donovan; Murry, Jason S; Hoang, David M; Sun, Beatrice; Ashrafian, Sogol; Hotz, Heidi; Chung, Rex; Margulies, Daniel R; Ley, Eric J

    2016-01-01

    Blunt aortic injury (BAI) after chest trauma is a potentially lethal condition. Rapid diagnosis is important to appropriately treat patients. The purpose of this study was to compare CT with intravenous contrast (CTI) to CT with angiography (CTA) in the initial evaluation of blunt chest trauma patients. This was a retrospective review of all blunt trauma patients who received a CTI or CTA during the initial evaluation at an urban Level I trauma center from January 1, 2010 to December 31, 2013. Two-hundred and eighty-one trauma patients met inclusion criteria. Most, 167/281 (59%) received CTI and 114/281 (41%) received CTA. There were no differences between cohorts in age, gender, initial heart rate, systolic blood pressure, and Glasgow Coma Scale in emergency department. Mortality rates were similar for CTI and CTA (4% vs 8%, P = 0.20). CTI identified an injury in 54 per cent compared with 46 per cent in CTA (P = 0.05). Overall, 2 per cent of patients had BAI with similar rates in CTI and CTA (2% vs 2%, P = 0.80). BAI was not missed using either CTI or CTA. Trauma patients studied with CTI had similar diagnostic findings as CTA. CTI may be preferable to CTA during the initial assessment for possible BAI because of a single contrast injection for whole body CT. PMID:26802856

  17. CT Chest with IV Contrast Compared with CT Angiography after Blunt Trauma.

    PubMed

    Zaw, Andrea A; Stewart, Donovan; Murry, Jason S; Hoang, David M; Sun, Beatrice; Ashrafian, Sogol; Hotz, Heidi; Chung, Rex; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Blunt aortic injury (BAI) after chest trauma is a potentially lethal condition that requires rapid diagnosis for appropriate treatment. We compared CT with IV contrast (CTI) with CT with angiography (CTA) during the initial phase of care at an urban Level I trauma center from January 1, 2010 to December 31, 2013. Overall, 281 patients met inclusion criteria with 167 (59%) CTI and 114 (41%) CTA. There were no differences between cohorts in age, gender, initial heart rate, systolic blood pressure, and Glasgow Coma Scale. Mortality rates were similar for CTI and CTA (4% vs 8%, P = 0.20). CTI identified any chest injury in 54 per cent of patients compared with 46 per cent with CTA (P = 0.05). The rate of BAI was similar with CTI and CTA (2% vs 2%, P = 0.80), and neither modality was falsely negative. We conclude that CTI and CTA are similar at evaluating trauma patients for BAI, although CTI may be preferable during the initial assessment phase because the contrast injection may be combined with abdominal scanning and image time is reduced when whole-body CT is required. PMID:26463312

  18. Derivation and Validation of Two Decision Instruments for Selective Chest CT in Blunt Trauma: A Multicenter Prospective Observational Study (NEXUS Chest CT)

    PubMed Central

    Rodriguez, Robert M.; Langdorf, Mark I.; Nishijima, Daniel; Baumann, Brigitte M.; Hendey, Gregory W.; Medak, Anthony J.; Raja, Ali S.; Allen, Isabel E.; Mower, William R.

    2015-01-01

    Background Unnecessary diagnostic imaging leads to higher costs, longer emergency department stays, and increased patient exposure to ionizing radiation. We sought to prospectively derive and validate two decision instruments (DIs) for selective chest computed tomography (CT) in adult blunt trauma patients. Methods and Findings From September 2011 to May 2014, we prospectively enrolled blunt trauma patients over 14 y of age presenting to eight US, urban level 1 trauma centers in this observational study. During the derivation phase, physicians recorded the presence or absence of 14 clinical criteria before viewing chest imaging results. We determined injury outcomes by CT radiology readings and categorized injuries as major or minor according to an expert-panel-derived clinical classification scheme. We then employed recursive partitioning to derive two DIs: Chest CT-All maximized sensitivity for all injuries, and Chest CT-Major maximized sensitivity for only major thoracic injuries (while increasing specificity). In the validation phase, we employed similar methodology to prospectively test the performance of both DIs. We enrolled 11,477 patients—6,002 patients in the derivation phase and 5,475 patients in the validation phase. The derived Chest CT-All DI consisted of (1) abnormal chest X-ray, (2) rapid deceleration mechanism, (3) distracting injury, (4) chest wall tenderness, (5) sternal tenderness, (6) thoracic spine tenderness, and (7) scapular tenderness. The Chest CT-Major DI had the same criteria without rapid deceleration mechanism. In the validation phase, Chest CT-All had a sensitivity of 99.2% (95% CI 95.4%–100%), a specificity of 20.8% (95% CI 19.2%–22.4%), and a negative predictive value (NPV) of 99.8% (95% CI 98.9%–100%) for major injury, and a sensitivity of 95.4% (95% CI 93.6%–96.9%), a specificity of 25.5% (95% CI 23.5%–27.5%), and a NPV of 93.9% (95% CI 91.5%–95.8%) for either major or minor injury. Chest CT-Major had a sensitivity

  19. 20 percent lower lung cancer mortality with low-dose CT vs chest X-ray

    Cancer.gov

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray.

  20. Fat segmentation on chest CT images via fuzzy models

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Wu, Caiyun; Pednekar, Gargi; Subramanian, Janani Rajan; Lederer, David J.; Christie, Jason; Torigian, Drew A.

    2016-03-01

    Quantification of fat throughout the body is vital for the study of many diseases. In the thorax, it is important for lung transplant candidates since obesity and being underweight are contraindications to lung transplantation given their associations with increased mortality. Common approaches for thoracic fat segmentation are all interactive in nature, requiring significant manual effort to draw the interfaces between fat and muscle with low efficiency and questionable repeatability. The goal of this paper is to explore a practical way for the segmentation of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) components of chest fat based on a recently developed body-wide automatic anatomy recognition (AAR) methodology. The AAR approach involves 3 main steps: building a fuzzy anatomy model of the body region involving all its major representative objects, recognizing objects in any given test image, and delineating the objects. We made several modifications to these steps to develop an effective solution to delineate SAT/VAT components of fat. Two new objects representing interfaces of SAT and VAT regions with other tissues, SatIn and VatIn are defined, rather than using directly the SAT and VAT components as objects for constructing the models. A hierarchical arrangement of these new and other reference objects is built to facilitate their recognition in the hierarchical order. Subsequently, accurate delineations of the SAT/VAT components are derived from these objects. Unenhanced CT images from 40 lung transplant candidates were utilized in experimentally evaluating this new strategy. Mean object location error achieved was about 2 voxels and delineation error in terms of false positive and false negative volume fractions were, respectively, 0.07 and 0.1 for SAT and 0.04 and 0.2 for VAT.

  1. Chest CT abnormalities and quality of life: relationship in adult cystic fibrosis

    PubMed Central

    Kilcoyne, Aoife; Lavelle, Lisa P.; McCarthy, Colin J.; McEvoy, Sinead H.; Fleming, Hannah; Gallagher, Annika; Loeve, Martine; Tiddens, Harm; McKone, Edward; Gallagher, Charles C.

    2016-01-01

    Background To evaluate the relationship between lung parenchymal abnormalities on chest CT and health-related quality of life in adult cystic fibrosis (CF). Methods The chest CT scans of 101 consecutive CF adults (mean age 27.8±7.9, 64 males) were prospectively scored by two blinded radiologists in consensus using a modified Bhalla score. Health-related quality of life was assessed using the revised Quittner Cystic Fibrosis Questionnaire (CFQ-R). Multiple regressions were performed with each of the CFQ-R domains and all clinical and imaging findings to assess independent correlations. Results There were 18 inpatients and 83 outpatients. For the cohort of inpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Air Trapping), and also with Social Functioning (Consolidation) and Role Functioning (Consolidation). For outpatients, CT abnormalities were significantly (P<0.005 for all) associated with Respiratory Symptoms (Consolidation) and also with Physical Functioning (Consolidation), Vitality (Consolidation, Severity of Bronchiectasis), Eating Problems (airway wall thickening), Treatment Burden (Total CT Score), Body Image (Severity of Bronchiectasis) and Role Functioning (Tree-in-bud nodules). Consolidation was the commonest independent CT predictor for both inpatients (predictor for 2 domains) and outpatients (predictor in 3 domains). Several chest CT abnormalities excluded traditional measures such as FEV1 and BMI from the majority of CFQ-R domains. Conclusions Chest CT abnormalities are significantly associated with quality of life measures in adult CF, independent of clinical or spirometric measurements. PMID:27047946

  2. Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome

    PubMed Central

    Dehghani, Mohammad Reza; Taghipour-Sani, Leila; Rezaei, Yousef; Rostami, Rahim

    2014-01-01

    Objective Acute coronary syndrome (ACS) is a challenging issue in cardiovascular medicine. Given platelet role in atherothrombosis, we sought to determine whether platelet indices can be used as diagnostic tests for patients who suffered from an acute chest discomfort. Methods We prospectively enrolled 862 patients with an acute chest pain and 184 healthy matched controls. They were divided into four groups: 184 controls, 249 of non-ACS, 421 of unstable angina (UA), and 192 of myocardial infarction (MI) cases. Blood samples were collected at admission to the emergency department for routine hematologic tests. Results The mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly greater in patients with MI compared with those of non-ACS or control subjects. Negative and significant correlations existed between MPV, PDW, and P-LCR values and platelet count (P < 0.001). Receiver operating characteristic (ROC) curves showed that the MPV, PDW, and P-LCR with cut-off values of 9.15 fL, 11.35 fL, and 20.25% and with area under the curves of 0.563, 0.557, and 0.560, respectively, detected MI patients among those who had chest discomfort. The sensitivities and specificities were found to be 72% and 40%, 73% and 37%, and 68% and 44% for MPV, PDW, and P-LCR, respectively. Conclusion An elevated admission MPV, PDW, and P-LCR may be of benefit to detect chest pain resulting in MI from that of non-cardiac one, and also for risk stratification of patients who suffered from an acute chest discomfort. PMID:25634396

  3. The “dirty chest”—correlations between chest radiography, multislice CT and tobacco burden

    PubMed Central

    Kirchner, J; Goltz, J P; Lorenz, F; Obermann, A; Kirchner, E M; Kickuth, R

    2012-01-01

    Objectives Cigarette smoking-induced airway disease commonly results in an overall increase of non-specific lung markings on chest radiography. This has been described as “dirty chest”. As the morphological substrate of this condition is similar to the anthracosilicosis of coal workers, we hypothesised that it is possible to quantify the radiological changes using the International Labour Organization (ILO) classification of pneumoconiosis. The aims of this study were to evaluate whether there is a correlation between the extent of cigarette smoking and increased lung markings on chest radiography and to correlate the chest radiographic scores with findings on CT studies. Methods In a prospective analysis a cohort of 85 smokers was examined. The cigarette consumption was evaluated in pack years (defined as 20 cigarettes per day over 1 year). Film reading was performed by two board-certified radiologists. Chest radiographs were evaluated for the presence of thickening of bronchial walls, the presence of linear or nodular opacities, and emphysema. To correlate the smoking habits with the increase of overall lung markings in chest radiography, the ILO profusion score was converted to numbers ranging from zero to nine. Chest radiographs were rated according to the complete set of standard films of the revised ILO classification. Results 63/85 (74%) of the smokers showed an increase in overall lung markings on chest radiography; 32 (37%) had an ILO profusion score of <1/1, 29 (34%) had an ILO profusion score of <2/2 and 2 (2%) had an ILO score of ≥2/2. There was a significant positive linear correlation between the increase of overall lung markings on chest radiography and the cigarette consumption quantified as pack years (r=0.68). The majority of the heavy smokers (>40 pack years) showed emphysema; there was no significant difference between the prevalence of emphysema as diagnosed by CT (62%) or chest radiography (71%) (p<0.05).The most common findings in CT

  4. Chest CT for suspected pulmonary complications of oncologic therapies: how I review and report.

    PubMed

    Diederich, Stefan

    2016-01-01

    In cancer patient during or following oncologic therapies with respiratory symptoms and pulmonary pathology at chest CT the differential diagnosis includes infection, therapy-induced disease and tumour progression.Although CT morphology may be typical or even pathognomonic in some conditions the diagnosis is usually made by a synopsis of imaging, clinical and laboratory features.Close communication with referring colleagues and a good knowledge of potential side effects of therapeutic concepts, their time course and CT morphology is crucial in the differential diagnosis.This review describes a personal approach to the radiological diagnosis of therapy-induced pulmonary abnormalities in cancer patients. PMID:27067027

  5. Reconstruction of the sternum and chest wall with methyl methacrylate: CT and MRI appearance.

    PubMed

    Gayer, G; Yellin, A; Apter, S; Rozenman, Y

    1998-01-01

    The aim of our study was to define the appearance of methyl methacrylate grafts replacing resected sternum and ribs on CT and MRI and how the sternal graft may mimic an abnormally sclerotic sternum on CT images. We reviewed the CT scans of nine patients who had undergone chest wall resection (eight with malignant and one with benign disease) and reconstruction with a composite of methyl methacrylate and Marlex mesh graft. One of them had an MRI study as well. The size, shape and CT attenuation were assessed on mediastinal and bone window settings. The sternal graft was seen on mediastinal and even better on bone windows as an abnormally wide, irregularly shaped structure, somewhat denser than the normal sternum. The chest wall prosthesis replacing resected ribs was seen as a continuous dense structure and of similar attenuation as that of the sternal graft. On MRI the prosthesis appeared as a well-defined structure with no signal. Reconstruction of the chest wall with methyl methacrylate appears on CT as a diffusely dense sclerotic bone lesion not unlike a malignant lesion. The possibility of a graft has to be included in the differential diagnosis in these cases. PMID:9477274

  6. Fireworks-induced chest wall granulomatous disease: 18F-FDG PET/CT imaging.

    PubMed

    Le, Stephanie T; Nguyen, Ba Duong

    2014-04-01

    The authors present a case of 18F-FDG-avid granulomatous reaction induced by fireworks injury of the chest wall in a patient with esophageal adenocarcinoma. This hypermetabolic lesion, involving the right pectoralis muscles, appeared slightly more prominent on restaging PET/CT imaging following chemotherapy and radiation therapy. Excisional biopsy of the lesion established the diagnosis of foreign-body granulomatous-type inflammation with surrounding foci of non-polarizable black foreign material and ruled out malignancy. The patient recalled accidentally shooting himself in the chest with a Roman candle at the age of 3. PMID:23877517

  7. Association between Image Characteristics on Chest CT and Severe Pleural Adhesion during Lung Cancer Surgery

    PubMed Central

    Jin, Kwang Nam; Sung, Yong Won; Oh, Se Jin; Choi, Ye Ra; Cho, Hyoun; Choi, Jae-Sung; Moon, Hyeon-Jong

    2016-01-01

    The aim of this study was to investigate the association between image characteristics on preoperative chest CT and severe pleural adhesion during surgery in lung cancer patients. We included consecutive 124 patients who underwent lung cancer surgeries. Preoperative chest CT was retrospectively reviewed to assess pleural thickening or calcification, pulmonary calcified nodules, active pulmonary inflammation, extent of emphysema, interstitial pneumonitis, and bronchiectasis in the operated thorax. The extent of pleural thickening or calcification was visually estimated and categorized into two groups: localized and diffuse. We measured total size of pulmonary calcified nodules. The extent of emphysema, interstitial pneumonitis, and bronchiectasis was also evaluated with a visual scoring system. The occurrence of severe pleural adhesion during lung cancer surgery was retrospectively investigated from the electrical medical records. We performed logistic regression analysis to determine the association of image characteristic on chest CT with severe pleural adhesion. Localized pleural thickening was found in 8 patients (6.5%), localized pleural calcification in 8 (6.5%), pulmonary calcified nodules in 28 (22.6%), and active pulmonary inflammation in 22 (17.7%). There was no patient with diffuse pleural thickening or calcification in this study. Trivial, mild, and moderate emphysema was found in 31 (25.0%), 21 (16.9%), and 12 (9.7%) patients, respectively. Severe pleural adhesion was found in 31 (25.0%) patients. The association of localized pleural thickening or calcification on CT with severe pleural adhesion was not found (P = 0.405 and 0.107, respectively). Size of pulmonary calcified nodules and extent of emphysema were significant variables in a univariate analysis (P = 0.045 and 0.005, respectively). In a multivariate analysis, moderate emphysema was significantly associated with severe pleural adhesion (odds ratio of 11.202, P = 0.001). In conclusion, severe

  8. A fateful kiss: the use of CT coronary angiogram in the diagnosis of non-cardiac chest pathology

    PubMed Central

    Topan, Rabia; Hyde, Tom

    2012-01-01

    A 34-year-old dental nurse presented with a 2-day history of retrosternal chest pain that was constant and ‘burning’ in nature. She was otherwise fit and well, no significant prior medical history and no ischaemic heart disease risk factors. Clinical examination was entirely normal apart from pyrexia of 38.3°C. Admission ECG showed ST depression in the inferior and anterolateral leads suggestive of myocardial ischaemia, consequently a CT coronary angiogram (CTCA) was performed. This showed normal coronary arteries, incidental distal oesophageal thickening was seen. Further history taking revealed that her youngest daughter had recently suffered from cold sores. The patient went on to have a diagnostic procedure, an oesophagogastroduodenoscopy. Biopsies confirmed acute oesophagitis with features suggestive of herpes virus infection. The patient responded promptly to oral acyclovir. This case highlights the value of CT coronary angiogram in identifying non-cardiac pathology in patients with a low pretest probability of coronary artery disease. PMID:22922929

  9. Simulating nodules in chest radiographs with real nodules from multi-slice CT images

    NASA Astrophysics Data System (ADS)

    Schilham, Arnold; van Ginneken, Bram

    2006-03-01

    To improve the detection of nodules in chest radiographs, large databases of chest radiographs with annotated, proven nodules are needed for training of both radiologists and computer-aided detection systems. The construction of such databases is a laborious and time-consuming task. This study presents a novel technique to produce large amounts of chest x-rays with annotated, simulated nodules. Realistic nodules in radiographs are generated using real nodules segmented from CT images. Results from an observer study indicate that the simulated nodules can not be distinguished from real nodules. This method has great potential to aid the development of automated detection systems and to generate teaching files for human observers.

  10. Where Does It Lead? Imaging Features of Cardiovascular Implantable Electronic Devices on Chest Radiograph and CT

    PubMed Central

    Lanzman, Rotem S.; Winter, Joachim; Blondin, Dirk; Fürst, Günter; Scherer, Axel; Miese, Falk R; Abbara, Suhny

    2011-01-01

    Pacemakers and implantable cardioverter defibrillators (ICDs) are being increasingly employed in patients suffering from cardiac rhythm disturbances. The principal objective of this article is to familiarize radiologists with pacemakers and ICDs on chest radiographs and CT scans. Therefore, the preferred lead positions according to pacemaker types and anatomic variants are introduced in this study. Additionally, the imaging features of incorrect lead positions and defects, as well as complications subsequent to pacemaker implantation are demonstrated herein. PMID:21927563

  11. Severe adenovirus community-acquired pneumonia in immunocompetent adults: chest radiographic and CT findings

    PubMed Central

    Tan, Dingyu; Fu, Yangyang; Wang, Zhiwei; Cao, Jian; Walline, Joseph; Zhu, Huadong

    2016-01-01

    Background Severe adenovirus pneumonia and its associated imaging features are well-described in immunocompromised patients but are rare and poorly understood in immunocompetent adults. We sought to describe the radiographic and CT findings of severe adenovirus community-acquired pneumonia (CAP) in eight immunocompetent adults. Methods We reviewed systematically chest imaging manifestations of laboratory-confirmed severe adenovirus pneumonia in eight immunocompetent adults from April 2012 to April 2014. Results All patients showed abnormal results on initial chest radiograph and CT, with the exception of one normal initial chest radiograph. The abnormalities of the initial chest radiographs were unilateral (n=4) or bilateral (n=3), including consolidation (n=4), dense patchy opacity (n=3), ground glass opacity (GGO) (n=1), and pleural effusion (n=1). The initial CT findings consisted of unilateral (n=5) and bilateral (n=3) abnormalities, including consolidation (n=8), GGO (n=2), pleural effusion (n=3) and small nodules (n=1). Focal consolidation was the predominant finding in six patients whose initial CT scans were examined within one week after illness onset. Follow-up radiologic findings showed rapid development of bilateral consolidation within ten days after illness onset, usually accompanied by adjacent ground-glass opacity and pleural effusion. The parenchymal abnormalities began to absorb around two weeks after illness onset, with no appearances of fibrosis. Conclusions Severe adenovirus CAP in immunocompetent adults mainly appears as focal consolidation followed by rapid progression to bilateral consolidation, usually accompanied by adjacent GGO and pleural effusion, which may resemble bacterial pneumonia. Adenovirus should be considered in severe pneumonia cases with negative cultures and failure to respond to antibiotics. PMID:27162658

  12. Pulmonary nodule size evaluation with chest tomosynthesis and CT: a phantom study

    PubMed Central

    Shim, S S; Kong, K A; Ryu, Y J; Kim, Y; Jang, D H

    2015-01-01

    Objective: We compared digital tomosynthesis (TOMO) and chest CT in terms of assessing the sizes of nodules located in zones where evaluation by simple radiography is limited. Methods: A total of 48 images comprising phantom nodules of four sizes in six different locations were used. Nodule size measurement errors for measurements using TOMO and CT images compared with the actual size from each observer were calculated. The inter- and intraobserver repeatability of the measured values and the agreement between the two techniques were assessed using the method described by Bland and Altman. Results: The mean measurement errors for all of the nodules and four observers were −0.84 mm [standard deviation (SD), 0.60 mm] on TOMO and −0.18 mm (SD, 0.71 mm) on CT images. The mean measurement errors for the different observers ranged from −1.11 to −0.55 mm for TOMO and from −0.39 to 0.08 mm for CT. Assessing the agreement between nodule size measurements using TOMO and CT resulted in mean measurement errors of −0.65 mm, with a 95% limit of agreement of −2.53 to 1.22 mm for comparison of TOMO with CT. Conclusion: Our results suggest that nodule sizes obtained using TOMO and chest CT are comparable, even for nodules located in areas where the size measurement is limited on simple radiography. Advances in knowledge: TOMO and CT can be used interchangeably, even for nodules located in a blind area on simple radiography. PMID:25605344

  13. Low grade coal worker's pneumoconiosis. Comparison of CT and chest radiography.

    PubMed

    Gevenois, P A; Pichot, E; Dargent, F; Dedeire, S; Vande Weyer, R; De Vuyst, P

    1994-07-01

    We compared CT with chest radiography (CR) in the assessment of low grade coal worker's pneumoconiosis (CWP) in a population of 83 subjects. All subjects had a high-voltage p.a. CR, graded according to the ILO classification between 0/0 and 1/1, a conventional CT (CCT) using contiguous 1-cm-thick sections on the entire thorax and a set of 10 high-resolution CT (HRCT) images. CR and CT were separately read by consensus by 2 teams of 2 trained readers. CR was coded 0/0 in 9 subjects; 0/1 in 31; 1/0 in 28; 1/1 in 15. Among these groups of patients, micronodules were detected by CT in respectively 2 (22%), 14 (45%), 17 (61%) and 10 (67%) patients. In all groups, micronodules were more often detected by CT when the opacities detected on CR were scored as rounded (p, q) than irregular (s, t). Among the patients graded 0/0 or 0/1, CT showed micronodules in 40%. By contrast, among the patients graded 1/0 or 1/1, CT did not show micronodules in 37%, but revealed in numerous patients that opacities detected on CR were related to bronchiectasis and/or emphysema only. Comparative analysis of HRCT and CCT showed that both techniques are complementary and proved the usefulness of CCT in the detection or confirmation of low profusion of micronodules. PMID:8011384

  14. Classification of pulmonary emphysema from chest CT scans using integral geometry descriptors

    NASA Astrophysics Data System (ADS)

    van Rikxoort, E. M.; Goldin, J. G.; Galperin-Aizenberg, M.; Brown, M. S.

    2011-03-01

    To gain insight into the underlying pathways of emphysema and monitor the effect of treatment, methods to quantify and phenotype the different types of emphysema from chest CT scans are of crucial importance. Current standard measures rely on density thresholds for individual voxels, which is influenced by inspiration level and does not take into account the spatial relationship between voxels. Measures based on texture analysis do take the interrelation between voxels into account and therefore might be useful for distinguishing different types of emphysema. In this study, we propose to use Minkowski functionals combined with rotation invariant Gaussian features to distinguish between healthy and emphysematous tissue and classify three different types of emphysema. Minkowski functionals characterize binary images in terms of geometry and topology. In 3D, four Minkowski functionals are defined. By varying the threshold and size of neighborhood around a voxel, a set of Minkowski functionals can be defined for each voxel. Ten chest CT scans with 1810 annotated regions were used to train the method. A set of 108 features was calculated for each training sample from which 10 features were selected to be most informative. A linear discriminant classifier was trained to classify each voxel in the lungs into a subtype of emphysema or normal lung. The method was applied to an independent test set of 30 chest CT scans with varying amounts and types of emphysema with 4347 annotated regions of interest. The method is shown to perform well, with an overall accuracy of 95%.

  15. Blinded Validation of Breath Biomarkers of Lung Cancer, a Potential Ancillary to Chest CT Screening

    PubMed Central

    Phillips, Michael; Bauer, Thomas L.; Cataneo, Renee N.; Lebauer, Cassie; Mundada, Mayur; Pass, Harvey I.; Ramakrishna, Naren; Rom, William N.; Vallières, Eric

    2015-01-01

    Background Breath volatile organic compounds (VOCs) have been reported as biomarkers of lung cancer, but it is not known if biomarkers identified in one group can identify disease in a separate independent cohort. Also, it is not known if combining breath biomarkers with chest CT has the potential to improve the sensitivity and specificity of lung cancer screening. Methods Model-building phase (unblinded): Breath VOCs were analyzed with gas chromatography mass spectrometry in 82 asymptomatic smokers having screening chest CT, 84 symptomatic high-risk subjects with a tissue diagnosis, 100 without a tissue diagnosis, and 35 healthy subjects. Multiple Monte Carlo simulations identified breath VOC mass ions with greater than random diagnostic accuracy for lung cancer, and these were combined in a multivariate predictive algorithm. Model-testing phase (blinded validation): We analyzed breath VOCs in an independent cohort of similar subjects (n = 70, 51, 75 and 19 respectively). The algorithm predicted discriminant function (DF) values in blinded replicate breath VOC samples analyzed independently at two laboratories (A and B). Outcome modeling: We modeled the expected effects of combining breath biomarkers with chest CT on the sensitivity and specificity of lung cancer screening. Results Unblinded model-building phase. The algorithm identified lung cancer with sensitivity 74.0%, specificity 70.7% and C-statistic 0.78. Blinded model-testing phase: The algorithm identified lung cancer at Laboratory A with sensitivity 68.0%, specificity 68.4%, C-statistic 0.71; and at Laboratory B with sensitivity 70.1%, specificity 68.0%, C-statistic 0.70, with linear correlation between replicates (r = 0.88). In a projected outcome model, breath biomarkers increased the sensitivity, specificity, and positive and negative predictive values of chest CT for lung cancer when the tests were combined in series or parallel. Conclusions Breath VOC mass ion biomarkers identified lung cancer in a

  16. Chest CT scanning for clinical suspected thoracic aortic dissection: beware the alternate diagnosis.

    PubMed

    Thoongsuwan, Nisa; Stern, Eric J

    2002-11-01

    The aim of the study was retrospectively to evaluate the spectrum of chest diseases in patients presenting with clinical suspicion of thoracic aortic dissection in the emergency department. We performed a retrospective medical records review of 86 men and 44 women (ages ranging between 23 and 106 years) with clinically suspected aortic dissection, for CT scan findings and final clinical diagnoses dating between January 1996 and September 2001. All images were obtained by using a standard protocol for aortic dissection. We found aortic dissection in 32 patients (24.6%), 22 of which were Stanford classification type A and 10 Stanford type B. In 70 patients (53.9%), chest pain could not be explained by the CT scan findings. However, in 28 patients (21.5%), CT scanning did reveal an alternate diagnosis that, along with the clinical impression, probably explained the patients' presenting symptoms, including: hiatal hernia (7), pneumonia (5), intrathoracic mass (4), pericardial effusion/hemopericardium (3), esophageal mass/rupture (2), aortic aneurysm without dissection (2), pulmonary embolism (2), pleural effusion (1), aortic rupture (1), and pancreatitis (1). In cases where there is clinical suspicion of aortic dissection, CT scan findings of an alternate diagnosis for the presenting symptoms are only slightly less common than the finding of aortic dissection itself. Although the spectrum of findings will vary depending upon your patient population, beware the alternate diagnosis. PMID:15290550

  17. Computer-aided diagnosis workstation and database system for chest diagnosis based on multihelical CT images

    NASA Astrophysics Data System (ADS)

    Sato, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Moriyama, Noriyuki; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Masuda, Hideo; Machida, Suguru; Sasagawa, Michizou

    2004-04-01

    Lung cancer is the most common cause, accounting for about 20% of all cancer deaths for males in Japan. Myocardial infarction is also known as a most fearful adult disease. Recently, multi-helical CT scanner advanced remarkably at the speed at which the chest CT images were acquired for screening examination. This screening examination requires a considerable number of images to be read. It is this time-consuming step that makes the use of multi-helical CT for mass screening. To overcome this problem, our group has developed a computer-aided diagnosis algorithm to automatically detect suspicious regions of lung cancer and coronary calcifications in chest CT images, so far. And in this time, our group has developed a newly computer-aided diagnosis workstation and database. These consist in three. First, it is an image processing system to automatically detect suspicious bronchial regions, pulmonary artery regions, plumonary vein regions and myocardial infarction regions at high speed. Second, they are two 1600 x 1200 matrix black and white liquid crystal monitor. Third, it is a terminal of image storage. These are connected mutually on the network. This makes it much easier to read images, since the 3D image of suspicious regions and shadow of suspicious regions can be displayed simultaneously on two 1600 x 1200 matrix liquid crystal monitor. The experimental results indicate that a newly computer-aided diagnosis workstation and database system can be effectively used in clinical practice to increase the speed and accuracy of routine diagnosis.

  18. The Role of Chest Computed Tomography (CT) as a Surveillance Tool in Children with High-risk Neuroblastoma

    PubMed Central

    Federico, Sara M.; Brady, Samuel L.; Pappo, Alberto; Wu, Jianrong; Mao, Shenghua; McPherson, Valerie J.; Young, Alison; Furman, Wayne L.; Kaufman, Robert; Kaste, Sue

    2015-01-01

    Purpose Standardization of imaging obtained in children with neuroblastoma is not well established. This study examines chest CT in pediatric patients with high-risk neuroblastoma. Methods Medical records and imaging from 88 patients with high-risk neuroblastoma, diagnosed at St. Jude Children's Research Hospital between January, 2002 and December, 2009, were reviewed. Surveillance imaging was conducted through 2013. Ten patients with thoracic disease at diagnosis were excluded. Event free survival (EFS) and overall survival (OS) were estimated. Size specific dose estimates for CT scans of the chest, abdomen, and pelvis were used to estimate absolute organ doses to 23 organs. Organ dosimetry was used to calculate cohort effective dose. Results The 5 year OS and EFS were 51.9%±6.5% and 42.6%±6.5%, respectively. Forty-six (58.9%) patients progressed/recurred and 41 (52.6%) died of disease. Eleven patients (14%) developed thoracic disease progression/recurrence identified by chest CT (1 paraspinal mass, 1 pulmonary nodules, and 9 nodal). MIBG (metaiodobenzylguanidine) scans identified thoracic disease in 6 patients. Five of the 11 had normal chest MIBG scans; 3 were symptomatic and 2 were asymptomatic with normal chest MIBG scans but avid bone disease. The estimated radiation dose savings from surveillance without CT chest imaging was 42%, 34% when accounting for modern CT acquisition (2011-13). Conclusions Neuroblastoma progression/recurrence in the chest is rare and often presents with symptoms or is identified using standard non-CT imaging modalities. For patients with non-thoracic high-risk neuroblastoma at diagnosis, omission of surveillance chest CT imaging can save 35-42% of the radiation burden without compromising disease detection. PMID:25641708

  19. Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Kakinuma, Ryutarou; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

    2007-03-01

    Multislice CT scanner advanced remarkably at the speed at which the chest CT images were acquired for mass screening. Mass screening based on multislice CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images and a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification. Moreover, we have provided diagnostic assistance methods to medical screening specialists by using a lung cancer screening algorithm built into mobile helical CT scanner for the lung cancer mass screening done in the region without the hospital. We also have developed electronic medical recording system and prototype internet system for the community health in two or more regions by using the Virtual Private Network router and Biometric fingerprint authentication system and Biometric face authentication system for safety of medical information. Based on these diagnostic assistance methods, we have now developed a new computer-aided workstation and database that can display suspected lesions three-dimensionally in a short time. This paper describes basic studies that have been conducted to evaluate this new system.

  20. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    SciTech Connect

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-02-15

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDI{sub vol} and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose

  1. Comparison of patient specific dose metrics between chest radiography, tomosynthesis, and CT for adult patients of wide ranging body habitus

    PubMed Central

    Zhang, Yakun; Li, Xiang; Segars, W. Paul; Samei, Ehsan

    2014-01-01

    Purpose: Given the radiation concerns inherent to the x-ray modalities, accurately estimating the radiation doses that patients receive during different imaging modalities is crucial. This study estimated organ doses, effective doses, and risk indices for the three clinical chest x-ray imaging techniques (chest radiography, tomosynthesis, and CT) using 59 anatomically variable voxelized phantoms and Monte Carlo simulation methods. Methods: A total of 59 computational anthropomorphic male and female extended cardiac-torso (XCAT) adult phantoms were used in this study. Organ doses and effective doses were estimated for a clinical radiography system with the capability of conducting chest radiography and tomosynthesis (Definium 8000, VolumeRAD, GE Healthcare) and a clinical CT system (LightSpeed VCT, GE Healthcare). A Monte Carlo dose simulation program (PENELOPE, version 2006, Universitat de Barcelona, Spain) was used to mimic these two clinical systems. The Duke University (Durham, NC) technique charts were used to determine the clinical techniques for the radiographic modalities. An exponential relationship between CTDIvol and patient diameter was used to determine the absolute dose values for CT. The simulations of the two clinical systems compute organ and tissue doses, which were then used to calculate effective dose and risk index. The calculation of the two dose metrics used the tissue weighting factors from ICRP Publication 103 and BEIR VII report. Results: The average effective dose of the chest posteroanterior examination was found to be 0.04 mSv, which was 1.3% that of the chest CT examination. The average effective dose of the chest tomosynthesis examination was found to be about ten times that of the chest posteroanterior examination and about 12% that of the chest CT examination. With increasing patient average chest diameter, both the effective dose and risk index for CT increased considerably in an exponential fashion, while these two dose metrics

  2. A method for smoothing segmented lung boundary in chest CT images

    NASA Astrophysics Data System (ADS)

    Yim, Yeny; Hong, Helen

    2007-03-01

    To segment low density lung regions in chest CT images, most of methods use the difference in gray-level value of pixels. However, radiodense pulmonary vessels and pleural nodules that contact with the surrounding anatomy are often excluded from the segmentation result. To smooth lung boundary segmented by gray-level processing in chest CT images, we propose a new method using scan line search. Our method consists of three main steps. First, lung boundary is extracted by our automatic segmentation method. Second, segmented lung contour is smoothed in each axial CT slice. We propose a scan line search to track the points on lung contour and find rapidly changing curvature efficiently. Finally, to provide consistent appearance between lung contours in adjacent axial slices, 2D closing in coronal plane is applied within pre-defined subvolume. Our method has been applied for performance evaluation with the aspects of visual inspection, accuracy and processing time. The results of our method show that the smoothness of lung contour was considerably increased by compensating for pulmonary vessels and pleural nodules.

  3. Pulmonary cysts identified on chest CT: Are they part of aging change or of clinical significance?

    PubMed Central

    Araki, Tetsuro; Nishino, Mizuki; Gao, Wei; Dupuis, Josée; Putman, Rachel K.; Washko, George R.; Hunninghake, Gary M.; O'Connor, George T.; Hatabu, Hiroto

    2016-01-01

    Objective To investigate the prevalence and natural course of pulmonary cysts in a population-based cohort and to describe the CT image characteristics in association with participant demographics and pulmonary functions. Materials and Methods Chest CT scans of 2633 participants (mean 59.2 years; 50% female) of the Framingham Heart Study (FHS) were visually evaluated for the presence of pulmonary cysts and their image characteristics. These findings were correlated with participant demographics and results of pulmonary function tests as well as the presence of emphysema independently detected on CT. The interval change was investigated by comparison with previous CT scans (median interval, 6.1 years). Results Pulmonary cysts were seen in 7.6% (95% CI, 6.6-8.7; 200/2633). They were not observed in participants younger than 40 years old, and the prevalence increased with age. Multiple cysts (≥5) were seen in 0.9% of all participants. Participants with pulmonary cysts showed significantly lower BMI (P<0.001). Pulmonary cysts were most likely to appear solitary in the peripheral area of the lower lobes and remain unchanged or slightly increase in size over time. Pulmonary cysts showed no significant influence on pulmonary functions (P=0.07-0.6) except for DLCO (P=0.03) and no association with cigarette smoking (P=0.1-0.9) or emphysema (P=0.7). Conclusions Pulmonary cysts identified on chest CT may be a part of the aging changes of the lungs, occurring in asymptomatic individuals older than 40 years, and are associated with decreased BMI and DLCO. Multiple pulmonary cysts may need to be evaluated for the possibility of cystic lung diseases. PMID:26514407

  4. Automated detection system for pulmonary emphysema on 3D chest CT images

    NASA Astrophysics Data System (ADS)

    Hara, Takeshi; Yamamoto, Akira; Zhou, Xiangrong; Iwano, Shingo; Itoh, Shigeki; Fujita, Hiroshi; Ishigaki, Takeo

    2004-05-01

    An automatic extraction of pulmonary emphysema area on 3-D chest CT images was performed using an adaptive thresholding technique. We proposed a method to estimate the ratio of the emphysema area to the whole lung volume. We employed 32 cases (15 normal and 17 abnormal) which had been already diagnosed by radiologists prior to the study. The ratio in all the normal cases was less than 0.02, and in abnormal cases, it ranged from 0.01 to 0.26. The effectiveness of our approach was confirmed through the results of the present study.

  5. Interactive lung segmentation in abnormal human and animal chest CT scans

    SciTech Connect

    Kockelkorn, Thessa T. J. P. Viergever, Max A.; Schaefer-Prokop, Cornelia M.; Bozovic, Gracijela; Muñoz-Barrutia, Arrate; Rikxoort, Eva M. van; Brown, Matthew S.; Jong, Pim A. de; Ginneken, Bram van

    2014-08-15

    Purpose: Many medical image analysis systems require segmentation of the structures of interest as a first step. For scans with gross pathology, automatic segmentation methods may fail. The authors’ aim is to develop a versatile, fast, and reliable interactive system to segment anatomical structures. In this study, this system was used for segmenting lungs in challenging thoracic computed tomography (CT) scans. Methods: In volumetric thoracic CT scans, the chest is segmented and divided into 3D volumes of interest (VOIs), containing voxels with similar densities. These VOIs are automatically labeled as either lung tissue or nonlung tissue. The automatic labeling results can be corrected using an interactive or a supervised interactive approach. When using the supervised interactive system, the user is shown the classification results per slice, whereupon he/she can adjust incorrect labels. The system is retrained continuously, taking the corrections and approvals of the user into account. In this way, the system learns to make a better distinction between lung tissue and nonlung tissue. When using the interactive framework without supervised learning, the user corrects all incorrectly labeled VOIs manually. Both interactive segmentation tools were tested on 32 volumetric CT scans of pigs, mice and humans, containing pulmonary abnormalities. Results: On average, supervised interactive lung segmentation took under 9 min of user interaction. Algorithm computing time was 2 min on average, but can easily be reduced. On average, 2.0% of all VOIs in a scan had to be relabeled. Lung segmentation using the interactive segmentation method took on average 13 min and involved relabeling 3.0% of all VOIs on average. The resulting segmentations correspond well to manual delineations of eight axial slices per scan, with an average Dice similarity coefficient of 0.933. Conclusions: The authors have developed two fast and reliable methods for interactive lung segmentation in

  6. Pediatric Chest and Abdominopelvic CT: Organ Dose Estimation Based on 42 Patient Models

    PubMed Central

    Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Paulson, Erik K.; Frush, Donald P.

    2014-01-01

    Purpose To estimate organ dose from pediatric chest and abdominopelvic computed tomography (CT) examinations and evaluate the dependency of organ dose coefficients on patient size and CT scanner models. Materials and Methods The institutional review board approved this HIPAA–compliant study and did not require informed patient consent. A validated Monte Carlo program was used to perform simulations in 42 pediatric patient models (age range, 0–16 years; weight range, 2–80 kg; 24 boys, 18 girls). Multidetector CT scanners were modeled on those from two commercial manufacturers (LightSpeed VCT, GE Healthcare, Waukesha, Wis; SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). Organ doses were estimated for each patient model for routine chest and abdominopelvic examinations and were normalized by volume CT dose index (CTDIvol). The relationships between CTDIvol-normalized organ dose coefficients and average patient diameters were evaluated across scanner models. Results For organs within the image coverage, CTDIvol-normalized organ dose coefficients largely showed a strong exponential relationship with the average patient diameter (R2 > 0.9). The average percentage differences between the two scanner models were generally within 10%. For distributed organs and organs on the periphery of or outside the image coverage, the differences were generally larger (average, 3%–32%) mainly because of the effect of overranging. Conclusion It is feasible to estimate patient-specific organ dose for a given examination with the knowledge of patient size and the CTDIvol. These CTDIvol-normalized organ dose coefficients enable one to readily estimate patient-specific organ dose for pediatric patients in clinical settings. This dose information, and, as appropriate, attendant risk estimations, can provide more substantive information for the individual patient for both clinical and research applications and can yield more expansive information on dose profiles

  7. Automated segmentation of cardiac visceral fat in low-dose non-contrast chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Liang, Mingzhu; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    Cardiac visceral fat was segmented from low-dose non-contrast chest CT images using a fully automated method. Cardiac visceral fat is defined as the fatty tissues surrounding the heart region, enclosed by the lungs and posterior to the sternum. It is measured by constraining the heart region with an Anatomy Label Map that contains robust segmentations of the lungs and other major organs and estimating the fatty tissue within this region. The algorithm was evaluated on 124 low-dose and 223 standard-dose non-contrast chest CT scans from two public datasets. Based on visual inspection, 343 cases had good cardiac visceral fat segmentation. For quantitative evaluation, manual markings of cardiac visceral fat regions were made in 3 image slices for 45 low-dose scans and the Dice similarity coefficient (DSC) was computed. The automated algorithm achieved an average DSC of 0.93. Cardiac visceral fat volume (CVFV), heart region volume (HRV) and their ratio were computed for each case. The correlation between cardiac visceral fat measurement and coronary artery and aortic calcification was also evaluated. Results indicated the automated algorithm for measuring cardiac visceral fat volume may be an alternative method to the traditional manual assessment of thoracic region fat content in the assessment of cardiovascular disease risk.

  8. Three-dimensional automatic computer-aided evaluation of pleural effusions on chest CT images

    NASA Astrophysics Data System (ADS)

    Bi, Mark; Summers, Ronald M.; Yao, Jianhua

    2011-03-01

    The ability to estimate the volume of pleural effusions is desirable as it can provide information about the severity of the condition and the need for thoracentesis. We present here an improved version of an automated program to measure the volume of pleural effusions using regular chest CT images. First, the lungs are segmented using region growing, mathematical morphology, and anatomical knowledge. The visceral and parietal layers of the pleura are then extracted based on anatomical landmarks, curve fitting and active contour models. The liver and compressed tissues are segmented out using thresholding. The pleural space is then fitted to a Bezier surface which is subsequently projected onto the individual two-dimensional slices. Finally, the volume of the pleural effusion is quantified. Our method was tested on 15 chest CT studies and validated against three separate manual tracings. The Dice coefficients were 0.74+/-0.07, 0.74+/-0.08, and 0.75+/-0.07 respectively, comparable to the variation between two different manual tracings.

  9. Alternative diagnoses based on CT angiography of the chest in patients with suspected pulmonary thromboembolism

    PubMed Central

    Ferreira, Eleci Vaz; Gazzana, Marcelo Basso; Sarmento, Muriel Bossle; Guazzelli, Pedro Arends; Hoffmeister, Mariana Costa; Guerra, Vinicius André; Seligman, Renato; Knorst, Marli Maria

    2016-01-01

    Objective : To determine the prevalence of alternative diagnoses based on chest CT angiography (CTA) in patients with suspected pulmonary thromboembolism (PTE) who tested negative for PTE, as well as whether those alternative diagnoses had been considered prior to the CTA. Methods : This was a cross-sectional, retrospective study involving 191 adult patients undergoing CTA for suspected PTE between September of 2009 and May of 2012. Chest X-rays and CTAs were reviewed to determine whether the findings suggested an alternative diagnosis in the cases not diagnosed as PTE. Data on symptoms, risk factors, comorbidities, length of hospital stay, and mortality were collected. Results : On the basis of the CTA findings, PTE was diagnosed in 47 cases (24.6%). Among the 144 patients not diagnosed with PTE via CTA, the findings were abnormal in 120 (83.3%). Such findings were consistent with an alternative diagnosis that explained the symptoms in 75 patients (39.3%). Among those 75 cases, there were only 39 (20.4%) in which the same alterations had not been previously detected on chest X-rays. The most common alternative diagnosis, made solely on the basis of the CTA findings, was pneumonia (identified in 20 cases). Symptoms, risk factors, comorbidities, and the in-hospital mortality rate did not differ significantly between the patients with and without PTE. However, the median hospital stay was significantly longer in the patients with PTE than in those without (18.0 and 9.5 days, respectively; p = 0.001). Conclusions : Our results indicate that chest CTA is useful in cases of suspected PTE, because it can confirm the diagnosis and reveal findings consistent with an alternative diagnosis in a significant number of patients. PMID:26982039

  10. Automated measurement of pulmonary artery in low-dose non-contrast chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Liang, Mingzhu; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    A new measurement of the pulmonary artery diameter is obtained where the artery may be robustly segmented between the heart and the artery bifurcation. An automated algorithm is presented that can make this pulmonary artery measurement in low-dose non-contrast chest CT images. The algorithm uses a cylinder matching method following geometric constraints obtained from other adjacent organs that have been previously segmented. This new measurement and the related ratio of pulmonary artery to aortic artery measurement are compared to traditional manual approaches for pulmonary artery characterization. The algorithm was qualitatively evaluated on 124 low-dose and 223 standard-dose non-contrast chest CT scans from two public datasets; 324 out of the 347 cases had good segmentations and in the other 23 cases there was significant boundary inaccuracy. For quantitative evaluation, the comparison was to manually marked pulmonary artery boundary in an axial slice in 45 cases; the resulting average Dice Similarity Coefficient was 0.88 (max 0.95, min 0.74). For the 45 cases with manual markings, the correlation between the automated pulmonary artery to ascending aorta diameter ratio and manual ratio at pulmonary artery bifurcation level was 0.81. Using Bland-Altman analysis, the mean difference of the two ratios was 0.03 and the limits of agreement was (-0.12, 0.18). This automated measurement may have utility as an alternative to the conventional manual measurement of pulmonary artery diameter at the bifurcation level especially in the context of noisy low-dose CT images.

  11. Enhanced CT images by the wavelet transform improving diagnostic accuracy of chest nodules.

    PubMed

    Guo, Xiuhua; Liu, Xiangye; Wang, Huan; Liang, Zhigang; Wu, Wei; He, Qian; Li, Kuncheng; Wang, Wei

    2011-02-01

    The objective of this study was to compare the diagnostic accuracy in the interpretation of chest nodules using original CT images versus enhanced CT images based on the wavelet transform. The CT images of 118 patients with cancers and 60 with benign nodules were used in this study. All images were enhanced through an algorithm based on the wavelet transform. Two experienced radiologists interpreted all the images in two reading sessions. The reading sessions were separated by a minimum of 1 month in order to minimize the effect of observer's recall. The Mann-Whitney U nonparametric test was used to analyze the interpretation results between original and enhanced images. The Kruskal-Wallis H nonparametric test of K independent samples was used to investigate the related factors which could affect the diagnostic accuracy of observers. The area under the ROC curves for the original and enhanced images was 0.681 and 0.736, respectively. There is significant difference in diagnosing the malignant nodules between the original and enhanced images (z = 7.122, P < 0.001), whereas there is no significant difference in diagnosing the benign nodules (z = 0.894, P = 0.371). The results showed that there is significant difference between original and enhancement images when the size of nodules was larger than 2 cm (Z = -2.509, P = 0.012, indicating the size of the nodules is a critical evaluating factor of the diagnostic accuracy of observers). This study indicated that the image enhancement based on wavelet transform could improve the diagnostic accuracy of radiologists for the malignant chest nodules. PMID:19937084

  12. Adaptive model based pulmonary artery segmentation in 3D chest CT

    NASA Astrophysics Data System (ADS)

    Feuerstein, Marco; Kitasaka, Takayuki; Mori, Kensaku

    2010-03-01

    The extraction and analysis of the pulmonary artery in computed tomography (CT) of the chest can be an important, but time-consuming step for the diagnosis and treatment of lung disease, in particular in non-contrast data, where the pulmonary artery has low contrast and frequently merges with adjacent tissue of similar intensity. We here present a new method for the automatic segmentation of the pulmonary artery based on an adaptive model, Hough and Euclidean distance transforms, and spline fitting, which works equally well on non-contrast and contrast enhanced data. An evaluation on 40 patient data sets and a comparison to manual segmentations in terms of Jaccard index, sensitivity, specificity, and minimum mean distance shows its overall robustness.

  13. Automated Image Retrieval of Chest CT Images Based on Local Grey Scale Invariant Features.

    PubMed

    Arrais Porto, Marcelo; Cordeiro d'Ornellas, Marcos

    2015-01-01

    Textual-based tools are regularly employed to retrieve medical images for reading and interpretation using current retrieval Picture Archiving and Communication Systems (PACS) but pose some drawbacks. All-purpose content-based image retrieval (CBIR) systems are limited when dealing with medical images and do not fit well into PACS workflow and clinical practice. This paper presents an automated image retrieval approach for chest CT images based local grey scale invariant features from a local database. Performance was measured in terms of precision and recall, average retrieval precision (ARP), and average retrieval rate (ARR). Preliminary results have shown the effectiveness of the proposed approach. The prototype is also a useful tool for radiology research and education, providing valuable information to the medical and broader healthcare community. PMID:26262345

  14. Analysis of uncertainties in Monte Carlo simulated organ dose for chest CT

    NASA Astrophysics Data System (ADS)

    Muryn, John S.; Morgan, Ashraf G.; Segars, W. P.; Liptak, Chris L.; Dong, Frank F.; Primak, Andrew N.; Li, Xiang

    2015-03-01

    In Monte Carlo simulation of organ dose for a chest CT scan, many input parameters are required (e.g., half-value layer of the x-ray energy spectrum, effective beam width, and anatomical coverage of the scan). The input parameter values are provided by the manufacturer, measured experimentally, or determined based on typical clinical practices. The goal of this study was to assess the uncertainties in Monte Carlo simulated organ dose as a result of using input parameter values that deviate from the truth (clinical reality). Organ dose from a chest CT scan was simulated for a standard-size female phantom using a set of reference input parameter values (treated as the truth). To emulate the situation in which the input parameter values used by the researcher may deviate from the truth, additional simulations were performed in which errors were purposefully introduced into the input parameter values, the effects of which on organ dose per CTDIvol were analyzed. Our study showed that when errors in half value layer were within ± 0.5 mm Al, the errors in organ dose per CTDIvol were less than 6%. Errors in effective beam width of up to 3 mm had negligible effect (< 2.5%) on organ dose. In contrast, when the assumed anatomical center of the patient deviated from the true anatomical center by 5 cm, organ dose errors of up to 20% were introduced. Lastly, when the assumed extra scan length was longer by 4 cm than the true value, dose errors of up to 160% were found. The results answer the important question: to what level of accuracy each input parameter needs to be determined in order to obtain accurate organ dose results.

  15. Automated coronary artery calcification detection on low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Cham, Matthew D.; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

    2014-03-01

    Coronary artery calcification (CAC) measurement from low-dose CT images can be used to assess the risk of coronary artery disease. A fully automatic algorithm to detect and measure CAC from low-dose non-contrast, non-ECG-gated chest CT scans is presented. Based on the automatically detected CAC, the Agatston score (AS), mass score and volume score were computed. These were compared with scores obtained manually from standard-dose ECG-gated scans and low-dose un-gated scans of the same patient. The automatic algorithm segments the heart region based on other pre-segmented organs to provide a coronary region mask. The mitral valve and aortic valve calcification is identified and excluded. All remaining voxels greater than 180HU within the mask region are considered as CAC candidates. The heart segmentation algorithm was evaluated on 400 non-contrast cases with both low-dose and regular dose CT scans. By visual inspection, 371 (92.8%) of the segmentations were acceptable. The automated CAC detection algorithm was evaluated on 41 low-dose non-contrast CT scans. Manual markings were performed on both low-dose and standard-dose scans for these cases. Using linear regression, the correlation of the automatic AS with the standard-dose manual scores was 0.86; with the low-dose manual scores the correlation was 0.91. Standard risk categories were also computed. The automated method risk category agreed with manual markings of gated scans for 24 cases while 15 cases were 1 category off. For low-dose scans, the automatic method agreed with 33 cases while 7 cases were 1 category off.

  16. Patient-specific radiation dose and cancer risk estimation in pediatric chest CT: a study in 30 patients

    NASA Astrophysics Data System (ADS)

    Li, Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2010-04-01

    Radiation-dose awareness and optimization in CT can greatly benefit from a dosereporting system that provides radiation dose and cancer risk estimates specific to each patient and each CT examination. Recently, we reported a method for estimating patientspecific dose from pediatric chest CT. The purpose of this study is to extend that effort to patient-specific risk estimation and to a population of pediatric CT patients. Our study included thirty pediatric CT patients (16 males and 14 females; 0-16 years old), for whom full-body computer models were recently created based on the patients' clinical CT data. Using a validated Monte Carlo program, organ dose received by the thirty patients from a chest scan protocol (LightSpeed VCT, 120 kVp, 1.375 pitch, 40-mm collimation, pediatric body scan field-of-view) was simulated and used to estimate patient-specific effective dose. Risks of cancer incidence were calculated for radiosensitive organs using gender-, age-, and tissue-specific risk coefficients and were used to derive patientspecific effective risk. The thirty patients had normalized effective dose of 3.7-10.4 mSv/100 mAs and normalized effective risk of 0.5-5.8 cases/1000 exposed persons/100 mAs. Normalized lung dose and risk of lung cancer correlated strongly with average chest diameter (correlation coefficient: r = -0.98 to -0.99). Normalized effective risk also correlated strongly with average chest diameter (r = -0.97 to -0.98). These strong correlations can be used to estimate patient-specific dose and risk prior to or after an imaging study to potentially guide healthcare providers in justifying CT examinations and to guide individualized protocol design and optimization.

  17. Improving CAD performance by seamless insertion of pulmonary nodules in chest CT exams

    NASA Astrophysics Data System (ADS)

    Pezeshk, Aria; Sahiner, Berkman; Chen, Weijie; Petrick, Nicholas

    2015-03-01

    The availability of large medical image datasets is critical in training and testing of computer aided diagnosis (CAD) systems. However, collection of data and establishment of ground truth for medical images are both costly and difficult. To address this problem, we have developed an image composition tool that allows users to modify or supplement existing datasets by seamlessly inserting a clinical lesion extracted from a source image into a different location on a target image. In this study we focus on the application of this tool to the training of a CAD system designed to detect pulmonary nodules in chest CT. To compare the performance of a CAD system without and with the use of our image composition tool, we trained the system on two sets of data. The first training set was obtained from original CT cases, while the second set consisted of the first set plus nodules in the first set inserted into new locations. We then compared the performance of the two CAD systems in differentiating nodules from normal areas by testing each trained system against a fixed dataset containing natural nodules, and using the area under the ROC curve (AUC) as the figure of merit. The performance of the system trained with the augmented dataset was found to be significantly better than that trained with the original dataset under several training scenarios.

  18. The Value of Restaging With Chest and Abdominal CT/MRI Scan After Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer.

    PubMed

    Liu, Guo-Chen; Zhang, Xu; Xie, E; An, Xin; Cai, Pei-Qiang; Zhu, Ying; Tang, Jing-Hua; Kong, Ling-Heng; Lin, Jun-Zhong; Pan, Zhi-Zhong; Ding, Pei-Rong

    2015-11-01

    Little was known with regard to the value of preoperative systemic restaging for patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT). This study was designed to evaluate the role of chest and abdominal computed tomography (CT) scan or magnetic resonance imaging (MRI) on preoperative restaging in LARC after neoadjuvant CRT and to assess the impact on treatment strategy.Between January 2007 and April 2013, 386 newly diagnosed consecutive patients with LARC who underwent neoadjuvant CRT and received restaging with chest and abdominal CT/MRI scan were included. Imaging results before and after CRT were analyzed.Twelve patients (3.1%) (6 liver lesions, 2 peritoneal lesions, 2 distant lymph node lesions, 1 lung lesions, 1 liver and lung lesions) were diagnosed as suspicious metastases on the restaging scan after radiotherapy. Seven patients (1.8%) were confirmed as metastases by pathology or long-term follow-up. The treatment strategy was changed in 5 of the 12 patients as a result of restaging CT/MRI findings. Another 10 patients (2.6%) who present with normal restaging imaging findings were diagnosed as metastases intra-operatively. The sensitivity, specificity accuracy, negative predictive value, and positive predictive values of restaging CT/MRI was 41.4%, 98.6%, 58.3%, and 97.3%, respectively.The low incidence of metastases and minimal consequences for the treatment plan question the clinical value of routine restaging of chest and abdomen after neoadjuvant CRT. Based on this study, a routine restaging CT/MRI of chest and abdomen in patients with rectal cancer after neoadjuvant CRT is not advocated, carcino-embryonic antigen (CEA) -guided CT/MRI restaging might be an alternative. PMID:26632714

  19. Chest X-Ray

    MedlinePlus Videos and Cool Tools

    ... Prostate Ultrasound Video: IMRT Video: Chest CT Video:Thyroid Ultrasound Video: Pediatric MRI Radiology and You About ... Prostate Ultrasound Video: IMRT Video: Chest CT Video:Thyroid Ultrasound Video: Pediatric MRI Radiology and You About ...

  20. Tree-in-bud pattern of chest CT images for diagnosis of Mycobacterium abscesses

    PubMed Central

    Chu, Haiqing; Li, Bing; Zhao, Lan; Huang, Dongdong; Xu, Jinfu; Zhang, Jingbo; Gui, Tao; Xu, Liyun; Luo, Liulin; Zhang, Zhemin; Sun, Xiwen

    2015-01-01

    Objectives: Changes of chest CT images in Mycobacterium and non-Mycobacterium abscesses in patients with lung disease were with a view to making an early diagnosis. Methods: 124 primary patients diagnosed with non-tuberculosis Mycobacterium infections with a positive sputum acid-fast smear were enrolled in this retrospective study. CT images and clinical data of these patients were analyzed. Results: The 52 Mycobacterium abscess lung disease cases included bronchiectasis 82.7% (43/52), which was more easily detected bilaterally than unilaterally (29/52 vs. 14/52), lung consolidation 44.2% (23/52), nodules 44.2% (22/52), cavities 32.7% (17/52), tree-in-bud pattern 42.3% (22/52) and patchy shadow 63.5% (33/52) in CT images. Tree-in-bud pattern was more common in Mycobacterium abscess compared with non-Mycobacterium abscess lung disease (42.3% vs. 18.1%, P = 0.004). A significant difference of the lung area involved by tree-in-bud in CT was found between non-Mycobacteria abscess and Mycobacterium abscess lung disease (17.0% vs. 7.2%, P < 0.001), and tree-in-bud occurred more readily unilaterally (21.2% vs. 6.9%, P = 0.029), and in the inferior lobe of the right lung (3.2% vs. 0.2%, P = 0.029) in Mycobacterium abscess lung disease. Patchy shadow was more common in non-Mycobacterium abscess lung disease (63.5% vs. 80.1%, P = 0.041). Further multi-factor analysis confirmed that tree-in-bud was an independent predictor of Mycobacterium abscess lung disease. Conclusions: Different CT results existed between non-Mycobacterium abscess and Mycobacterium abscess lung diseases. The tree-in-bud pattern might be helpful to choose a suitable therapy in patients, with an acid-fast bacilli smear-positive diagnosis of lung disease. PMID:26770485

  1. Triple Rule Out versus CT Angiogram Plus Stress Test for Evaluation of Chest Pain in the Emergency Department

    PubMed Central

    Sawyer, Kelly N.; Shah, Payal; Qu, Lihua; Kurz, Michael C.; Clark, Carol L.; Swor, Robert A.

    2015-01-01

    Introduction Undifferentiated chest pain in the emergency department (ED) is a diagnostic challenge. One approach includes a dedicated chest computed tomography (CT) for pulmonary embolism or dissection followed by a cardiac stress test (TRAD). An alternative strategy is a coronary CT angiogram with concurrent chest CT (Triple Rule Out, TRO). The objective of this study was to describe the ED patient course and short-term safety for these evaluation methods. Methods This was a retrospective observational study of adult patients presenting to a large, community ED for acute chest pain who had non-diagnostic electrocardiograms (ECGs) and normal biomarkers. We collected demographics, ED length of stay, hospital costs, and estimated radiation exposures. We evaluated 30-day return visits for major adverse cardiac events. Results A total of 829 patients underwent TRAD, and 642 patients had TRO. Patients undergoing TRO tended to be younger (mean 52.3 vs 56.5 years) and were more likely to be male (42.4% vs. 30.4%). TRO patients tended to have a shorter ED length of stay (mean 14.45 vs. 21.86 hours), to incur less cost (median $449.83 vs. $1147.70), and to be exposed to less radiation (median 7.18 vs. 16.6mSv). No patient in either group had a related 30-day revisit. Conclusion Use of TRO is feasible for assessment of chest pain in the ED. Both TRAD and TRO safely evaluated patients. Prospective studies investigating this diagnostic strategy are needed to further assess this approach to ED chest pain evaluation. PMID:26587090

  2. Segmentation of the sternum from low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Liu, Shuang; Xie, Yiting; Reeves, Anthony P.

    2015-03-01

    Segmentation of the sternum in medical images is of clinical significance as it frequently serves as a stable reference to image registration and segmentation of other organs in the chest region. In this paper we present a fully automated algorithm to segment the sternum in low-dose chest CT images (LDCT). The proposed algorithm first locates an axial seed slice and then segments the sternum cross section on the seed slice by matching a rectangle model. Furthermore, it tracks and segments the complete sternum in the cranial and caudal direction respectively through sequential axial slices starting from the seed slice. The cross section on each axial slice is segmented using score functions that are designed to have local maxima at the boundaries of the sternum. Finally, the sternal angle is localized. The algorithm is designed to be specifically robust with respect to cartilage calcifications and to accommodate the high noise levels encountered with LDCT images. Segmentation of 351 cases from public datasets was evaluated visually with only 1 failing to produce a usable segmentation. 87.2% of the 351 images have good segmentation and 12.5% have acceptable segmentation. The sternal body segmentation and the localization of the sternal angle and the vertical extents of the sternum were also evaluated quantitatively for 25 good cases and 25 acceptable cases. The overall weighted mean DC of 0.897 and weighted mean distance error of 2.88 mm demonstrate that the algorithm achieves encouraging performance in both segmenting the sternal body and localizing the sternal angle.

  3. Estimating lesion volume in low-dose chest CT: How low can we go?

    NASA Astrophysics Data System (ADS)

    Young, Stefano; McNitt-Gray, Michael F.

    2014-03-01

    Purpose: To examine the potential for dose reduction in chest CT studies where lesion volume is the primary output (e.g. in therapy-monitoring applications). Methods: We added noise to the raw sinogram data from 15 chest exams with lung lesions to simulate a series of reduced-dose scans for each patient. We reconstructed the reduced-dose data on the clinical workstation and imported the resulting image series into our quantitative imaging database for lesion contouring. One reader contoured the lesions (one per patient) at the clinical reference dose (100%) and 8 simulated fractions of the clinical dose (50, 25, 15, 10, 7, 5, 4, and 3%). Dose fractions were hidden from the reader to reduce bias. We compared clinical and reduced-dose volumes in terms of bias error and variability (4x the standard deviation of the percent differences). Results: Averaging over all lesions, the bias error ranged from -0.6% to 10.6%. Variability ranged from 92% at 3% of clinical dose to 54% at 50% of clinical dose. Averaging over only the smaller lesions (<1cm equivalent diameter), bias error ranged from -9.2% to 14.1% and variability ranged from 125% at 3% dose to 33.9% at 50% dose. Conclusions: The reader's variability decreased with dose, especially for smaller lesions. However, these preliminary results are limited by potential recall bias, a small patient cohort, and an overly-simplified task. Therapy monitoring often involves checking for new lesions, which may influence the reader's clinical dose threshold for acceptable performance.

  4. Fat quantification and analysis of lung transplant patients on unenhanced chest CT images based on standardized anatomic space

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Wu, Caiyun; Christie, Jason; Lederer, David J.

    2016-03-01

    Chest fat estimation is important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of this paper is to seek answers to the following questions related to chest fat quantification on single slice versus whole volume CT, which have not been addressed in the literature. What level of correlation exists between total chest fat volume and fat areas measured on single abdominal and thigh slices? What is the anatomic location in the chest where maximal correlation of fat area with fat volume can be expected? Do the components of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) have the same area-to-volume correlative behavior or do they differ? The SAS approach includes two steps: calibration followed by transformation which will map the patient slice locations non-linearly to SAS. The optimal slice locations found for SAT and VAT based on SAS are different and at the mid-level of the T8 vertebral body for SAT and mid-level of the T7 vertebral body for VAT. Fat volume and area on optimal slices for SAT and VAT are correlated with Pearson correlation coefficients of 0.97 and 0.86, respectively. The correlation of chest fat volume with abdominal and thigh fat areas is weak to modest.

  5. Automated aortic calcification detection in low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Xie, Yiting; Htwe, Yu Maw; Padgett, Jennifer; Henschke, Claudia; Yankelevitz, David; Reeves, Anthony P.

    2014-03-01

    The extent of aortic calcification has been shown to be a risk indicator for vascular events including cardiac events. We have developed a fully automated computer algorithm to segment and measure aortic calcification in low-dose noncontrast, non-ECG gated, chest CT scans. The algorithm first segments the aorta using a pre-computed Anatomy Label Map (ALM). Then based on the segmented aorta, aortic calcification is detected and measured in terms of the Agatston score, mass score, and volume score. The automated scores are compared with reference scores obtained from manual markings. For aorta segmentation, the aorta is modeled as a series of discrete overlapping cylinders and the aortic centerline is determined using a cylinder-tracking algorithm. Then the aortic surface location is detected using the centerline and a triangular mesh model. The segmented aorta is used as a mask for the detection of aortic calcification. For calcification detection, the image is first filtered, then an elevated threshold of 160 Hounsfield units (HU) is used within the aorta mask region to reduce the effect of noise in low-dose scans, and finally non-aortic calcification voxels (bony structures, calcification in other organs) are eliminated. The remaining candidates are considered as true aortic calcification. The computer algorithm was evaluated on 45 low-dose non-contrast CT scans. Using linear regression, the automated Agatston score is 98.42% correlated with the reference Agatston score. The automated mass and volume score is respectively 98.46% and 98.28% correlated with the reference mass and volume score.

  6. Airway morphometry in the lungs as depicted in chest CT examinations variability of measurements

    NASA Astrophysics Data System (ADS)

    Leader, J. K.; Zheng, Bin; Scuirba, Frank C.; Coxson, Harvey O.; Weissfeld, Joel L.; Fuhrman, Carl R.; Maitz, Glenn S.; Gur, David

    2006-03-01

    The purpose of the study was to decrease the variability of computed tomographic airway measurements. We to developed and evaluated a novel computer scheme to automatically segment airways depicted on chest CT examinations at the level of the lobar and segmental bronchi and to decrease. The computer scheme begins with manual selection of a seed point within the airway from which the airway wall and lumen are automatically segmented and airway pixels were assigned full or partial membership to the lumen or wall. Airway pixels not assigned full membership to the lumen (< -900 HU) or wall (> 0 HU) were assigned partial membership to the lumen and wall. In fifteen subjects with no visible signs of emphysema and a range of pulmonary obstruction from none to severe, airway measures were compared to pulmonary function parameters in a rank order analysis to evaluate measuring a single airway versus multiple airways. The quality of the automated airway segmentation was visually acceptable. The Pearson Correlation coefficients for the ranking of FEV I versus wall area percent (percent of total airway size) and FVC versus wall area percent were 0.164 and 0.175 for a single measurement, respectively, and were 0.243 and 0.239 for multiple measurements, respectively. Our preliminary results suggest that averaging the measurements from multiple airways may improve the relation between airway measures and lung function compared to measurement from a single airway, which improve quantification of airway remodeling in COPD patients.

  7. Segmentation of the whole breast from low-dose chest CT images

    NASA Astrophysics Data System (ADS)

    Liu, Shuang; Salvatore, Mary; Yankelevitz, David F.; Henschke, Claudia I.; Reeves, Anthony P.

    2015-03-01

    The segmentation of whole breast serves as the first step towards automated breast lesion detection. It is also necessary for automatically assessing the breast density, which is considered to be an important risk factor for breast cancer. In this paper we present a fully automated algorithm to segment the whole breast in low-dose chest CT images (LDCT), which has been recommended as an annual lung cancer screening test. The automated whole breast segmentation and potential breast density readings as well as lesion detection in LDCT will provide useful information for women who have received LDCT screening, especially the ones who have not undergone mammographic screening, by providing them additional risk indicators for breast cancer with no additional radiation exposure. The two main challenges to be addressed are significant range of variations in terms of the shape and location of the breast in LDCT and the separation of pectoral muscles from the glandular tissues. The presented algorithm achieves robust whole breast segmentation using an anatomy directed rule-based method. The evaluation is performed on 20 LDCT scans by comparing the segmentation with ground truth manually annotated by a radiologist on one axial slice and two sagittal slices for each scan. The resulting average Dice coefficient is 0.880 with a standard deviation of 0.058, demonstrating that the automated segmentation algorithm achieves results consistent with manual annotations of a radiologist.

  8. Automatic detection method of lung cancers including ground-glass opacities from chest x-ray CT images

    NASA Astrophysics Data System (ADS)

    Ezoe, Toshiharu; Takizawa, Hotaka; Yamamoto, Shinji; Shimizu, Akinobu; Matsumoto, Tohru; Tateno, Yukio; Iimura, Takeshi; Matsumoto, Mitsuomi

    2002-05-01

    In this paper, we described an algorithm of automatic detection of ground glass opacities (GGO) from X-ray CT images. In this algorithm, at first, pathological shadow candidates are extracted by our variable N-Quoit filter which is a kind of mathematical morphology filter. Next, shadow candidates are classified into some classes using feature values calculated from the shadow candidates. By using discriminate functions, at last, shadow candidates are discriminated between normal shadows and abnormal ones. This method was examined by 38 samples (including GGO's shadows) of chest CT images, and proved to be very effective.

  9. Re-evaluating the need for hospital admission and observation of pediatric traumatic brain injury after a normal head CT.

    PubMed

    Plackett, Timothy P; Asturias, Sabrina; Tadlock, Matthew; Wright, Franklin; Ton-That, Hieu; Demetriades, Demetrios; Esposito, Thomas; Inaba, Kenji

    2015-10-01

    There is no consensus on the optimal management of pediatric patients with suspected trauma brain injury and a normal head CT. This study characterizes the clinical outcomes of patients with a normal initial CT scan of the head. A retrospective chart review of pediatric blunt trauma patients who underwent head CT for closed head injury at two trauma centers was performed. Charts were reviewed for demographics, neurologic function, CT findings, and complications. 631 blunt pediatric trauma patients underwent a head CT. 63% had a negative CT, 7% had a non-displaced skull fracture, and 31% had an intracranial hemorrhage and/or displaced skull fracture. For patients without intracranial injury, the mean age was 8 years, mean ISS was 5, and 92% had a GCS of 13-15 on arrival. All patients with an initial GCS of 13-15 and no intracranial injury were eventually discharged to home with a normal neurologic exam and no patient required craniotomy. Not admitting those children with an initial GCS of 13-15, normal CT scan, and no other injuries would have saved 1.8 ± 1.5 hospital days per patient. Pediatric patients who have sustained head trauma, have a negative CT scan, and present with a GCS 13-15 can safely be discharged home without admission. PMID:25957025

  10. Image quality and age-specific dose estimation in head and chest CT examinations with organ-based tube-current modulation.

    PubMed

    Yamauchi-Kawaura, C; Yamauchi, M; Imai, K; Ikeda, M; Aoyama, T

    2013-12-01

    The purpose of this study was to investigate the effects of an organ-based tube-current modulation (OBTCM) system on image quality and age-specific dose in head and chest CT examinations. Image noise, contrast-to-noise ratio (CNR) and image entropy were assessed using statistical and entropy analyses. Radiation doses for newborn, 6-y-old child and adult phantoms were measured with in-phantom dosimetry systems. The quality of CT images obtained with OBTCM was not different from that obtained without OBTCM. In head CT scans, the eye lens dose decreased by 20-33 % using OBTCM. In chest CT scans, breast dose decreased by 5-32 % using OBTCM. Posterior skin dose, however, increased by 11-20 % using OBTCM in head and chest CT scans. The reduction of effective dose using OBTCM was negligibly small. Detailed image quality and dose information provided in this study can be effectively used for OBTCM application. PMID:23734058

  11. Influence of model based iterative reconstruction algorithm on image quality of multiplanar reformations in reduced dose chest CT

    PubMed Central

    Dunet, Vincent; Hachulla, Anne-Lise; Grimm, Jochen; Beigelman-Aubry, Catherine

    2016-01-01

    Background Model-based iterative reconstruction (MBIR) reduces image noise and improves image quality (IQ) but its influence on post-processing tools including maximal intensity projection (MIP) and minimal intensity projection (mIP) remains unknown. Purpose To evaluate the influence on IQ of MBIR on native, mIP, MIP axial and coronal reformats of reduced dose computed tomography (RD-CT) chest acquisition. Material and Methods Raw data of 50 patients, who underwent a standard dose CT (SD-CT) and a follow-up RD-CT with a CT dose index (CTDI) of 2–3 mGy, were reconstructed by MBIR and FBP. Native slices, 4-mm-thick MIP, and 3-mm-thick mIP axial and coronal reformats were generated. The relative IQ, subjective IQ, image noise, and number of artifacts were determined in order to compare different reconstructions of RD-CT with reference SD-CT. Results The lowest noise was observed with MBIR. RD-CT reconstructed by MBIR exhibited the best relative and subjective IQ on coronal view regardless of the post-processing tool. MBIR generated the lowest rate of artefacts on coronal mIP/MIP reformats and the highest one on axial reformats, mainly represented by distortions and stairsteps artifacts. Conclusion The MBIR algorithm reduces image noise but generates more artifacts than FBP on axial mIP and MIP reformats of RD-CT. Conversely, it significantly improves IQ on coronal views, without increasing artifacts, regardless of the post-processing technique.

  12. Automated Coronary Artery Calcification Scoring in Non-Gated Chest CT: Agreement and Reliability

    PubMed Central

    Takx, Richard A. P.; de Jong, Pim A.; Leiner, Tim; Oudkerk, Matthijs; de Koning, Harry J.; Mol, Christian P.; Viergever, Max A.; Išgum, Ivana

    2014-01-01

    Objective To determine the agreement and reliability of fully automated coronary artery calcium (CAC) scoring in a lung cancer screening population. Materials and Methods 1793 low-dose chest CT scans were analyzed (non-contrast-enhanced, non-gated). To establish the reference standard for CAC, first automated calcium scoring was performed using a preliminary version of a method employing coronary calcium atlas and machine learning approach. Thereafter, each scan was inspected by one of four trained raters. When needed, the raters corrected initially automaticity-identified results. In addition, an independent observer subsequently inspected manually corrected results and discarded scans with gross segmentation errors. Subsequently, fully automatic coronary calcium scoring was performed. Agatston score, CAC volume and number of calcifications were computed. Agreement was determined by calculating proportion of agreement and examining Bland-Altman plots. Reliability was determined by calculating linearly weighted kappa (κ) for Agatston strata and intraclass correlation coefficient (ICC) for continuous values. Results 44 (2.5%) scans were excluded due to metal artifacts or gross segmentation errors. In the remaining 1749 scans, median Agatston score was 39.6 (P25–P75∶0–345.9), median volume score was 60.4 mm3 (P25–P75∶0–361.4) and median number of calcifications was 2 (P25–P75∶0–4) for the automated scores. The κ demonstrated very good reliability (0.85) for Agatston risk categories between the automated and reference scores. The Bland-Altman plots showed underestimation of calcium score values by automated quantification. Median difference was 2.5 (p25–p75∶0.0–53.2) for Agatston score, 7.6 (p25–p75∶0.0–94.4) for CAC volume and 1 (p25–p75∶0–5) for number of calcifications. The ICC was very good for Agatston score (0.90), very good for calcium volume (0.88) and good for number of calcifications (0.64). Discussion Fully automated

  13. Impact of radiation dose and iterative reconstruction on pulmonary nodule measurements at chest CT: a phantom study

    PubMed Central

    Kim, Hyungjin; Min Park, Chang; Chae, Hee-Dong; Lee, Sang Min; Goo, Jin Mo

    2015-01-01

    PURPOSE We aimed to identify the impact of radiation dose and iterative reconstruction (IR) on measurement of pulmonary nodules by chest computed tomography (CT). METHODS CT scans were performed on a chest phantom containing various nodules (diameters of 3, 5, 8, 10, and 12 mm; +100, −630 and −800 HU for each diameter) at 80, 100, 120 kVp and 10, 20, 50, 100 mAs (a total of 12 radiation dose settings). Each CT was reconstructed using filtered back projection, iDose4, and iterative model reconstruction (IMR). Thereafter, two radiologists measured the diameter and attenuation of the nodules. Noise, contrast-to-noise ratio and signal-to-noise ratio of CT images were also obtained. Influence of radiation dose and reconstruction algorithm on measurement error and objective image quality metrics was analyzed using generalized estimating equations. RESULTS The 80 kVp, 10 mAs CT scan was not feasible for the measurement of 3 mm sized simulated ground-glass nodule (GGN); otherwise, diameter measurement error was not significantly influenced by radiation dose (P > 0.05). IR did not have a significant impact on diameter measurement error for simulated solid nodules (P > 0.05). However, for simulated GGNs, IMR was associated with significantly decreased relative diameter measurement error (P < 0.001). Attenuation measurement error was not significantly influenced by either radiation dose or reconstruction algorithm (P > 0.05). Objective image quality was significantly better with IMR (P < 0.05). CONCLUSION Nodule measurements were not affected by radiation dose except for 3 mm simulated GGN on 80 kVp, 10 mAs dose setting. However, for GGNs, IMR may help reduce diameter measurement error while improving image quality. PMID:26359871

  14. Determination of the Optimal Dose Reduction Level via Iterative Reconstruction Using 640-Slice Volume Chest CT in a Pig Model

    PubMed Central

    Liu, Xingli; Wang, Jingshi; Liu, Qin; Zhao, Pengfei; Hou, Yang; Ma, Yue; Guo, Qiyong

    2015-01-01

    Aim To determine the optimal dose reduction level of iterative reconstruction technique for paediatric chest CT in pig models. Materials and Methods 27 infant pigs underwent 640-slice volume chest CT with 80kVp and different mAs. Automatic exposure control technique was used, and the index of noise was set to SD10 (Group A, routine dose), SD12.5, SD15, SD17.5, SD20 (Groups from B to E) to reduce dose respectively. Group A was reconstructed with filtered back projection (FBP), and Groups from B to E were reconstructed using iterative reconstruction (IR). Objective and subjective image quality (IQ) among groups were compared to determine an optimal radiation reduction level. Results The noise and signal-to-noise ratio (SNR) in Group D had no significant statistical difference from that in Group A (P = 1.0). The scores of subjective IQ in Group A were not significantly different from those in Group D (P>0.05). There were no obvious statistical differences in the objective and subjective index values among the subgroups (small, medium and large subgroups) of Group D. The effective dose (ED) of Group D was 58.9% lower than that of Group A (0.20±0.05mSv vs 0.48±0.10mSv, p <0.001). Conclusions In infant pig chest CT, using iterative reconstruction can provide diagnostic image quality; furthermore, it can reduce the dosage by 58.9%. PMID:25764485

  15. Adaptive Iterative Dose Reduction Using Three Dimensional Processing (AIDR3D) Improves Chest CT Image Quality and Reduces Radiation Exposure

    PubMed Central

    Yamashiro, Tsuneo; Miyara, Tetsuhiro; Honda, Osamu; Kamiya, Hisashi; Murata, Kiyoshi; Ohno, Yoshiharu; Tomiyama, Noriyuki; Moriya, Hiroshi; Koyama, Mitsuhiro; Noma, Satoshi; Kamiya, Ayano; Tanaka, Yuko; Murayama, Sadayuki

    2014-01-01

    Objective To assess the advantages of Adaptive Iterative Dose Reduction using Three Dimensional Processing (AIDR3D) for image quality improvement and dose reduction for chest computed tomography (CT). Methods Institutional Review Boards approved this study and informed consent was obtained. Eighty-eight subjects underwent chest CT at five institutions using identical scanners and protocols. During a single visit, each subject was scanned using different tube currents: 240, 120, and 60 mA. Scan data were converted to images using AIDR3D and a conventional reconstruction mode (without AIDR3D). Using a 5-point scale from 1 (non-diagnostic) to 5 (excellent), three blinded observers independently evaluated image quality for three lung zones, four patterns of lung disease (nodule/mass, emphysema, bronchiolitis, and diffuse lung disease), and three mediastinal measurements (small structure visibility, streak artifacts, and shoulder artifacts). Differences in these scores were assessed by Scheffe's test. Results At each tube current, scans using AIDR3D had higher scores than those without AIDR3D, which were significant for lung zones (p<0.0001) and all mediastinal measurements (p<0.01). For lung diseases, significant improvements with AIDR3D were frequently observed at 120 and 60 mA. Scans with AIDR3D at 120 mA had significantly higher scores than those without AIDR3D at 240 mA for lung zones and mediastinal streak artifacts (p<0.0001), and slightly higher or equal scores for all other measurements. Scans with AIDR3D at 60 mA were also judged superior or equivalent to those without AIDR3D at 120 mA. Conclusion For chest CT, AIDR3D provides better image quality and can reduce radiation exposure by 50%. PMID:25153797

  16. Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT

    PubMed Central

    Cho, S H; Sung, Y M; Kim, M S

    2012-01-01

    Objective The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients. Methods 130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated. Results 58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p=0.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs. Conclusion Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images. PMID:22514102

  17. Chest radiology

    SciTech Connect

    Reed, J.C.

    1990-01-01

    This book is a reference in plain chest film diagnosis provides a thorough background in the differential diagnosis of 22 of the most common radiologic patterns of chest disease. Each chapter is introduced with problem cases and a set of questions, followed by a tabular listing of the appropriate differential considerations. The book emphasizes plain films, CT and some MR scans are integrated to demonstrate how these modalities enhance the work of a case.

  18. Computer-aided diagnosis workstation and database system for chest diagnosis based on multi-helical CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Kakinuma, Ryutarou; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru; Sasagawa, Michizou

    2006-03-01

    Multi-helical CT scanner advanced remarkably at the speed at which the chest CT images were acquired for mass screening. Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images and a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification. We also have developed electronic medical recording system and prototype internet system for the community health in two or more regions by using the Virtual Private Network router and Biometric fingerprint authentication system and Biometric face authentication system for safety of medical information. Based on these diagnostic assistance methods, we have now developed a new computer-aided workstation and database that can display suspected lesions three-dimensionally in a short time. This paper describes basic studies that have been conducted to evaluate this new system. The results of this study indicate that our computer-aided diagnosis workstation and network system can increase diagnostic speed, diagnostic accuracy and safety of medical information.

  19. CT-CBF Maps Optimally Correlate with Admission DWI in Acute Stroke, but Thresholds Vary by Post-Processing Platform

    PubMed Central

    Kamalian, Shahmir; Kamalian, Shervin; Maas, Matthew B.; Goldmacher, Greg V; Payabvash, Seyedmehdi; Akbar, Adnan; Schaefer, Pamela W; Furie, Karen L; Gilberto Gonzalez, R.; Lev, Michael H

    2011-01-01

    Purpose Admission infarct core lesion size is an important determinant of management and outcome in acute (<9 hrs) stroke. Our purpose was to: (1) determine the optimal CT perfusion (CTP) parameter to define infarct core using various post-processing platforms, and (2) establish the degree of variability in threshold values between these different platforms. Methods We evaluated 48 consecutive cases with vessel occlusion and admission CTP and DWI within 3 hours of each other. CTP was acquired with a “second-generation” 66-second biphasic cine protocol, and post-processed using “standard” (from two vendors, “A-std” and “B-std”) and “delay-corrected” (from one vendor, “A-dc”) commercial software. ROC curve analysis was performed comparing each CTP parameter - both absolute and normalized to the contralateral uninvolved hemisphere - between infarcted and non-infarcted regions, as defined by co-registered DWI. Results Cerebral blood flow (CBF) had the highest accuracy (ROC “area under curve”, AUC), for all three platforms (p<0.01). The maximal AUC's for each parameter were: absolute CBF 0.88, CBV 0.81, and MTT 0.82, and relative CBF 0.88, CBV 0.83, and MTT 0.82. Optimal ROC operating point thresholds varied significantly between different platforms (Friedman test, p<0.01). Conclusion Admission absolute and normalized “second-generation” cine acquired CT-CBF lesion volumes correlate more closely with DWI defined infarct core than do those of CT-CBV or MTT. Although limited availability of DWI for some patients creates impetus to develop alternative methods of estimating core, the marked variability in quantification amongst different post-processing software limits generalizability of parameter map thresholds between platforms. PMID:21546490

  20. A 42-Year-Old Woman With Abnormal Chest CT Scan and Chylous Ascites.

    PubMed

    Panchabhai, Tanmay S; Bandyopadhyay, Debabrata; Yadav, Ruchi; Arrossi, Andrea V; Mehta, Atul C; Faress, Jihane A

    2016-01-01

    A 42-year-old white woman presented to the pulmonary clinic for evaluation of abnormal chest imaging. Twenty years prior to presentation, she was noted to have an abnormal chest radiograph during a routine preemployment evaluation. A subsequent bronchoscopy was nondiagnostic. She was followed up with annual imaging, which demonstrated little or no progression of her disease. She remained symptom free throughout this period. A year before her visit to the pulmonary clinic, she developed abdominal discomfort and was found to have ascites. Subsequently, she underwent three paracenteses with analysis revealing chylous fluid. She was a nonsmoker without a history of exposures or travel. PMID:26757302

  1. Utilization of 3-D elastic transformation in the registration of chest x-ray CT and whole body PET

    SciTech Connect

    Tai, Yuan-Chuan; Hoh, C.K.; Hoffman, E.J.

    1996-12-31

    X-ray CT is widely used for detection and localization of lesions in the thorax. Whole Body PET with 18-FDG is becoming accepted for staging of cancer because of its ability to detect malignancy. Combining information from these two modalities has a significant value to improve lung cancer staging and treatment planning. Due to the non-rigid nature of the thorax and the differences in the acquisition conventions, the subject is stretched non-uniformly and the images of these two modalities requires non-rigid transformation for proper registration. Techniques to register chest x-ray CT and Whole Body PET images were developed and evaluated. Accuracy of 3-D elastic transformation was tested by phantom study. Studies on patients with lung carcinoma were used to validate the technique in localizing the 18-FDG uptake and in correlating PET to x-ray CT images. The fused images showed an accurate alignment and provided confident identification of the detailed anatomy of the CT with the functional information of the PET images.

  2. Chest CT findings of influenza virus‐associated pneumonia in 12 adult patients

    PubMed Central

    Fujita, Jiro; Bandoh, Shuji; Yamaguchi, Masahiro; Higa, Futoshi; Tateyama, Masao

    2008-01-01

    Objective  In this study, we describe the chest computed tomography findings of influenza virus‐associated pneumonia in adult patients. Methods  Our retrospective study included 12 adult patients who had proven influenza virus ‐ associated pneumonia. Results  Out of 12 patients, six were diagnosed as having pure influenza virus pneumonia, five as having bronchopneumonia caused by bacteria associated with influenza A infection, and one as having a cryptogenic organizing pneumonia associated with influenza A infection. Conclusion  Radiographic findings of influenza virus pneumonia in adult patients consist of ground‐glass attenuation. Localized patchy consolidations were observed in cases of bronchopneumonia. PMID:19453425

  3. Automatic segmentation of solitary pulmonary nodules based on local intensity structure analysis and 3D neighborhood features in 3D chest CT images

    NASA Astrophysics Data System (ADS)

    Chen, Bin; Kitasaka, Takayuki; Honma, Hirotoshi; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Mori, Kensaku

    2012-03-01

    This paper presents a solitary pulmonary nodule (SPN) segmentation method based on local intensity structure analysis and neighborhood feature analysis in chest CT images. Automated segmentation of SPNs is desirable for a chest computer-aided detection/diagnosis (CAS) system since a SPN may indicate early stage of lung cancer. Due to the similar intensities of SPNs and other chest structures such as blood vessels, many false positives (FPs) are generated by nodule detection methods. To reduce such FPs, we introduce two features that analyze the relation between each segmented nodule candidate and it neighborhood region. The proposed method utilizes a blob-like structure enhancement (BSE) filter based on Hessian analysis to augment the blob-like structures as initial nodule candidates. Then a fine segmentation is performed to segment much more accurate region of each nodule candidate. FP reduction is mainly addressed by investigating two neighborhood features based on volume ratio and eigenvector of Hessian that are calculates from the neighborhood region of each nodule candidate. We evaluated the proposed method by using 40 chest CT images, include 20 standard-dose CT images that we randomly chosen from a local database and 20 low-dose CT images that were randomly chosen from a public database: LIDC. The experimental results revealed that the average TP rate of proposed method was 93.6% with 12.3 FPs/case.

  4. Computer-aided diagnosis workstation and network system for chest diagnosis based on multislice CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru

    2008-03-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The function to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and Success in login" effective. As a result, patients' private information is protected. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and security improvement of medical information.

  5. A detection method of ground glass opacities in chest x-ray CT images using automatic clustering techniques

    NASA Astrophysics Data System (ADS)

    Tanino, Mitsuhiro; Takizawa, Hotaka; Yamamoto, Shinji; Matsumoto, Tohru; Tateno, Yukio; Iinuma, Takeshi

    2003-05-01

    In this paper, we described an algorithm of automatic detection of Ground Glass Opacities (GGO) from X-ray CT images. In this algorithm, first, suspicious shadows are extracted by our Variable N-Quoit (VNQ) filter which is a type of Mathematical Morphology filters. This filter can detect abnormal shadows with high sensitivity. Next, the suspicious shadows are classified into a certain number of classes using feature values calculated from the suspicious shadows. In our traditional clustering method, a medical doctor has to manually classify the suspicious shadows into 5 clusters. The manual classification is very hard for the doctor. Thus, in this paper, we propose a new automatic clustering method which is based on a Principal Component (PC) theory. In this method, first, the detected shadows are classified into two sub-clusters according to their sizes. And then, each sub-cluster is further classified into two sub-sub-clusters according to PC Scores(PCS) calcuated from the feature values of the shadows in the sub-cluster. In this PCS-based classification, we use a threshold which maximizes the distance between the two sub-sub-clusters. The PCS-based classification is iterated recursively. Using discriminate functions based on Mahalanobis distance, the suspicious shadows are determined to be normal or abnormal. This method was examined by many samples (including GGO's shadows) of chest CT images, and proved to be very effective.

  6. Computer-aided diagnosis workstation for chest diagnosis based on multihelical CT images

    NASA Astrophysics Data System (ADS)

    Sato, Hitoshi; Niki, Noboru; Mori, Kiyoshi; Eguchi, Kenji; Kaneko, Masahiro; Kakinuma, Ryutarou; Moriyama, Noriyuki; Ohmatsu, Hironobu; Masuda, Hideo; Machida, Suguru; Sasagawa, Michizou

    2005-04-01

    Mass screening based on helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. To overcome this problem, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images and a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification. We also have developed electronic medical recording system and prototype internet system for the community health in two or more regions by using the Virtual Private Network router. This electronic medical recording system and prototype internet system were developed so as not to loosen the communication among staffs of hospital. Based on these diagnostic assistance methods, we have now developed a new computer-aided workstation and database that can display suspected lesions three-dimensionally in a short time. This paper describes basic studies that have been conducted to evaluate this new system.

  7. Automatic classication of pulmonary function in COPD patients using trachea analysis in chest CT scans

    NASA Astrophysics Data System (ADS)

    van Rikxoort, E. M.; de Jong, P. A.; Mets, O. M.; van Ginneken, B.

    2012-03-01

    Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that is characterized by airflow limitation. COPD is clinically diagnosed and monitored using pulmonary function testing (PFT), which measures global inspiration and expiration capabilities of patients and is time-consuming and labor-intensive. It is becoming standard practice to obtain paired inspiration-expiration CT scans of COPD patients. Predicting the PFT results from the CT scans would alleviate the need for PFT testing. It is hypothesized that the change of the trachea during breathing might be an indicator of tracheomalacia in COPD patients and correlate with COPD severity. In this paper, we propose to automatically measure morphological changes in the trachea from paired inspiration and expiration CT scans and investigate the influence on COPD GOLD stage classification. The trachea is automatically segmented and the trachea shape is encoded using the lengths of rays cast from the center of gravity of the trachea. These features are used in a classifier, combined with emphysema scoring, to attempt to classify subjects into their COPD stage. A database of 187 subjects, well distributed over the COPD GOLD stages 0 through 4 was used for this study. The data was randomly divided into training and test set. Using the training scans, a nearest mean classifier was trained to classify the subjects into their correct GOLD stage using either emphysema score, tracheal shape features, or a combination. Combining the proposed trachea shape features with emphysema score, the classification performance into GOLD stages improved with 11% to 51%. In addition, an 80% accuracy was achieved in distinguishing healthy subjects from COPD patients.

  8. Airway Count and Emphysema Assessed by Chest CT Imaging Predicts Clinical Outcome in Smokers

    PubMed Central

    Valim, Clarissa; Yamashiro, Tsuneo; Estépar, Raúl San José; Ross, James C.; Matsuoka, Shin; Bartholmai, Brian; Hatabu, Hiroto; Silverman, Edwin K.; Washko, George R.

    2010-01-01

    Background: Recently, it has been shown that emphysematous destruction of the lung is associated with a decrease in the total number of terminal bronchioles. It is unknown whether a similar decrease is visible in the more proximal airways. We aimed to assess the relationships between proximal airway count, CT imaging measures of emphysema, and clinical prognostic factors in smokers, and to determine whether airway count predicts the BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index. Methods: In 50 smokers, emphysema was measured on CT scans and airway branches from the third to eighth generations of the right upper lobe apical bronchus were counted manually. The sum of airway branches from the sixth to eighth generations represented the total airway count (TAC). For each subject, the BODE index was determined. We used logistic regression to assess the ability of TAC to predict a high BODE index (≥ 7 points). Results: TAC was inversely associated with emphysema (r = −0.54, P < .0001). TAC correlated with the modified Medical Research Council dyspnea score (r = −0.42, P = .004), FEV1% predicted (r = 0.52, P = .0003), 6-min walk distance (r = 0.36, P = .012), and BODE index (r = −0.55, P < .0001). The C-statistics, which correspond to the area under the receiver operating characteristic curve, for the ability of TAC alone and TAC, emphysema, and age to predict a high BODE index were 0.84 and 0.92, respectively. Conclusions: TAC is lower in subjects with greater emphysematous destruction and is a predictor of a high BODE index. These results suggest that CT imaging-based TAC may be a unique COPD-related phenotype in smokers. PMID:20558554

  9. Efficiency and safety of coronary CT angiography compared to standard care in the evaluation of patients with acute chest pain: a Canadian study.

    PubMed

    Peña, Elena; Rubens, Fraser; Stiell, Ian; Peterson, Rebecca; Inacio, Joao; Dennie, Carole

    2016-08-01

    The optimal assessment of patients with chest pain and possible acute coronary syndrome (ACS) remains a diagnostic dilemma for emergency physicians. Cardiac computed tomographic angiography (CCTA) may identify patients who can be safely discharged home from the emergency department (ED). The objective of the study was to compare the efficiency and safety of CCTA to standard care in patients presenting to the ED with low- to intermediate-risk chest pain. This was a single-center before-after study enrolling ED patients with chest pain and low to intermediate risk of ACS, before and after implementing a cardiac CT-based management protocol. The primary outcome was efficiency (time to diagnosis). Secondary outcomes included safety (30-day incidence of major adverse cardiovascular events (MACE)) and length of stay in the ED. We enrolled 258 patients: 130 in the standard care group and 128 in the cardiac CT-based management group. The cardiac CT group had a shorter time to diagnosis of 7.1 h (IQR 5.8-14.0) compared to 532.9 h (IQR 312.8-960.5) for the standard care group (p < 0.0001) but had a longer length of stay in the ED of 7.9 h (IQR 6.5-10.8) versus 5.5 h (IQR 3.9-7.7) (p < 0.0001). The MACE rate was 1.6 % in the standard care group and 0 % in the cardiac CT group. In conclusion, a cardiac CT-based management strategy to rule out ACS in ED patients with low- to intermediate-risk chest pain was safe and led to a shorter time to diagnosis but increased length of stay in the ED. PMID:27220653

  10. Local SIMPLE multi-atlas-based segmentation applied to lung lobe detection on chest CT

    NASA Astrophysics Data System (ADS)

    Agarwal, M.; Hendriks, E. A.; Stoel, B. C.; Bakker, M. E.; Reiber, J. H. C.; Staring, M.

    2012-02-01

    For multi atlas-based segmentation approaches, a segmentation fusion scheme which considers local performance measures may be more accurate than a method which uses a global performance measure. We improve upon an existing segmentation fusion method called SIMPLE and extend it to be localized and suitable for multi-labeled segmentations. We demonstrate the algorithm performance on 23 CT scans of COPD patients using a leave-one- out experiment. Our algorithm performs significantly better (p < 0.01) than majority voting, STAPLE, and SIMPLE, with a median overlap of the fissure of 0.45, 0.48, 0.55 and 0.6 for majority voting, STAPLE, SIMPLE, and the proposed algorithm, respectively.

  11. A clinical evaluation of total variation-Stokes image reconstruction strategy for low-dose CT imaging of the chest

    NASA Astrophysics Data System (ADS)

    Liu, Yan; Zhang, Hao; Moore, William; Bhattacharji, Priya; Liang, Zhengrong

    2015-03-01

    One hundred "normal-dose" computed tomography (CT) studies of the chest (i.e., 1,160 projection views, 120kVp, 100mAs) data sets were acquired from the patients who were scheduled for lung biopsy at Stony Brook University Hospital under informed consent approved by our Institutional Review Board. To mimic low-dose CT imaging scenario (i.e., sparse-view scan), sparse projection views were evenly extracted from the total 1,160 projections of each patient and the total radiation dose was reduced according to how many sparse views were selected. A standard filtered backprojection (FBP) algorithm was applied to the 1160 projections to produce reference images for comparison purpose. In the low-dose scenario, both the FBP and total variation-stokes (TVS) algorithms were applied to reconstruct the corresponding low-dose images. The reconstructed images were evaluated by an experienced thoracic radiologist against the reference images. Both the low-dose reconstructions and the reference images were displayed on a 4- megapixel monitor in soft tissue and lung windows. The images were graded by a five-point scale from 0 to 4 (0, nondiagnostic; 1, severe artifact with low confidence; 2, moderate artifact or moderate diagnostic confidences; 3, mild artifact or high confidence; 4, well depicted without artifacts). Quantitative evaluation measurements such as standard deviations for different tissue types and universal quality index were also studied and reported for the results. The evaluation concluded that the TVS can reduce the view number from 1,160 to 580 with slightly lower scores as the reference, resulting in a dose reduction to close 50%.

  12. Is diagnostic accuracy for detecting pulmonary nodules in chest CT reduced after a long day of reading?

    NASA Astrophysics Data System (ADS)

    Krupinski, Elizabeth A.; Berbaum, Kevin S.; Caldwell, Robert; Schartz, Kevin M.

    2012-02-01

    Radiologists are reading more cases with more images, especially in CT and MRI and thus working longer hours than ever before. There have been concerns raised regarding fatigue and whether it impacts diagnostic accuracy. This study measured the impact of reader visual fatigue by assessing symptoms, visual strain via dark focus of accommodation, and diagnostic accuracy. Twenty radiologists and 20 radiology residents were given two diagnostic performance tests searching CT chest sequences for a solitary pulmonary nodule before (rested) and after (tired) a day of clinical reading. 10 cases used free search and navigation, and the other 100 cases used preset scrolling speed and duration. Subjects filled out the Swedish Occupational Fatigue Inventory (SOFI) and the oculomotor strain subscale of the Simulator Sickness Questionnaire (SSQ) before each session. Accuracy was measured using ROC techniques. Using Swensson's technique yields an ROC area = 0.86 rested vs. 0.83 tired, p (one-tailed) = 0.09. Using Swensson's LROC technique yields an area = 0.73 rested vs. 0.66 tired, p (one-tailed) = 0.09. Using Swensson's Loc Accuracy technique yields an area = 0.77 rested vs. 0.72 tired, p (one-tailed) = 0.13). Subjective measures of fatigue increased significantly from early to late reading. To date, the results support our findings with static images and detection of bone fractures. Radiologists at the end of a long work day experience greater levels of measurable visual fatigue or strain, contributing to a decrease in diagnostic accuracy. The decrease in accuracy was not as great however as with static images.

  13. Evaluation of a Chest Circumference-Adapted Protocol for Low-Dose 128-Slice Coronary CT Angiography with Prospective Electrocardiogram Triggering

    PubMed Central

    Lu, Chenying; Wang, Zufei; Wang, Hailin; Hu, Xianghua; Chen, Chunmiao

    2015-01-01

    Objective To assess the effect of chest circumference-adapted scanning protocol on radiation exposure and image quality in patients undergoing prospective electrocardiogram (ECG)-triggered coronary CT angiography (CCTA). Materials and Methods One hundred-eighty-five consecutive patients, who had undergone prospective ECG triggering CCTA with a 128-slice CT, were included in the present study. Nipple-level chest circumference, body weight and height were measured before CT examinations. Patients were divided into four groups based on kV/ref·mAs = 100/200, 100/250, 120/200, and 120/250, when patient's chest circumference was ≤ 85.0 (n = 56), 85.0-90.0 (n = 53), 90.0-95.0 (n = 44), and > 95.0 (n = 32), respectively. Image quality per-segment was independently assessed by two experienced observers. Image noise and attenuation were also measured. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The effective radiation dose was calculated using CT dose volume index and the dose-length product. Results A significant correlation was observed between patients' chest circumference and body mass index (r = 0.762, p < 0.001). Chest circumference ranged from 74 to 105 cm, and the mean effective radiation dose was 1.9-3.8 mSv. Diagnostic image quality was obtained in 98.5% (2440/2478) of all evaluated coronary segments without any significant differences among the four groups (p = 0.650). No significant difference in image noise was observed among the four groups (p = 0.439), thus supporting the validity of the chest circumference-adapted scanning protocol. However, vessel attenuation, SNR and CNR were significantly higher in the 100 kV groups than in the 120 kV groups (p < 0.05). Conclusion A measure of chest circumference can be used to adapt tube voltage and current for individualized radiation dose control, with resultant similar image noise and sustained diagnostic image quality. PMID:25598671

  14. Automated extraction of aorta and pulmonary artery in mediastinum from 3D chest x-ray CT images without contrast medium

    NASA Astrophysics Data System (ADS)

    Kitasaka, Takayuki; Mori, Kensaku; Hasegawa, Jun-ichi; Toriwaki, Jun-ichiro; Katada, Kazuhiro

    2002-05-01

    This paper proposes a method for automated extraction of the aorta and pulmonary artery (PA) in the mediastinum of the chest from uncontrasted chest X-ray CT images. The proposed method employs a model fitting technique to use shape features of blood vessels for extraction. First, edge voxels are detected based on the standard deviation of CT values. A likelihood image, which shows the degree of likelihood on medial axes of vessels, are calculated by applying the Euclidean distance transformation to non-edge voxels. Second, the medial axis of each vessel is obtained by fitting the model. This is done by referring the likelihood image. Finally, the aorta and PA areas are recovered from the medial axes by executing the reverse Euclidean distance transformation. We applied the proposed method to seven cases of uncontrasted chest X-ray CT images and evaluated the results by calculating the coincidence index computed from the extracted regions and the regions manually traced. Experimental results showed that the extracted aorta and the PA areas coincides with manually input regions with the coincidence indexes values 90% and 80-90%,respectively.

  15. Coronary artery disease in patients with atypical chest pain with and without diabetes mellitus assessed with coronary CT angiography

    PubMed Central

    Krul, Marije M G; Bogaard, Kjell; Knol, Remco J J; van Rossum, Albert C; Knaapen, Paul; Cornel, Jan H; van der Zant, Friso M

    2014-01-01

    Introduction Coronary artery disease (CAD) in diabetes mellitus (DM) is often widespread when diagnosed. Non-invasive coronary calcium scoring and coronary CT angiography (CAC-score/CCTA) are accurate in the detection of CAD. This study compared CAD characteristics as identified by CCTA between patients with and without DM with atypical chest pain. Methods CAD was defined as CAC-score >0 and/or presence of coronary plaque. Several CAD characteristics (number of affected segments, obstructive (>50% stenosis) CAD and CAD distribution) were compared on a per patient and segment basis. Subanalysis of duration of DM (<5 or >5 years) and gender was performed. Results A total of 1148 patients (63.3% men, mean age 57.7±10.7), of whom 99 (8.6%) suffered from DM, were referred for CCTA. There was no difference in the prevalence of CAD between patients with and without DM (53.5% vs 50.9%, p=0.674). However patients with DM showed more affected coronary segments compared with patients without DM (2.5±3.4 vs 1.7±2.4, p=0.003). Multivariate analysis indicated that DM was an independent predictor of obstructive CAD (OR 2.16, 95% CI 1.23 to 3.78), as were age, women, and Diamond-Forrester score. In our study, obstructive CAD was more prevalent in women than in men (DM 40.0% vs 14.1%, p=0.003; non-DM 16.8% vs 8.4%, p<0.001). Patients suffering from DM >5 years showed more distal plaques (11.2% vs 7.7%, p=0.030). Conclusions Patients with atypical chest pain and DM showed more extensive CAD, as well as more obstructive CAD, particularly in women. Diabetes duration (>5 years) was not associated with more obstructive coronary disease or different plaque morphology, although more distal disease was present. PMID:25452855

  16. SU-D-BRA-06: Dual-Energy Chest CT: The Effects of Virtual Monochromatic Reconstructions On Texture Analysis Features

    SciTech Connect

    Sorensen, J; Duran, C; Stingo, F; Wei, W; Rao, A; Zhang, L; Court, L; Erasmus, J; Godoy, M

    2015-06-15

    Purpose: To characterize the effect of virtual monochromatic reconstructions on several commonly used texture analysis features in DECT of the chest. Further, to assess the effect of monochromatic energy levels on the ability of these textural features to identify tissue types. Methods: 20 consecutive patients underwent chest CTs for evaluation of lung nodules using Siemens Somatom Definition Flash DECT. Virtual monochromatic images were constructed at 10keV intervals from 40–190keV. For each patient, an ROI delineated the lesion under investigation, and cylindrical ROI’s were placed within 5 different healthy tissues (blood, fat, muscle, lung, and liver). Several histogram- and Grey Level Cooccurrence Matrix (GLCM)-based texture features were then evaluated in each ROI at each energy level. As a means of validation, these feature values were then used in a random forest classifier to attempt to identify the tissue types present within each ROI. Their predictive accuracy at each energy level was recorded. Results: All textural features changed considerably with virtual monochromatic energy, particularly below 70keV. Most features exhibited a global minimum or maximum around 80keV, and while feature values changed with energy above this, patient ranking was generally unaffected. As expected, blood demonstrated the lowest inter-patient variability, for all features, while lung lesions (encompassing many different pathologies) exhibited the highest. The accuracy of these features in identifying tissues (76% accuracy) was highest at 80keV, but no clear relationship between energy and classification accuracy was found. Two common misclassifications (blood vs liver and muscle vs fat) accounted for the majority (24 of the 28) errors observed. Conclusion: All textural features were highly dependent on virtual monochromatic energy level, especially below 80keV, and were more stable above this energy. However, in a random forest model, these commonly used features were

  17. Early detection of intravascular large B-cell lymphoma by 18FDG-PET/CT with diffuse FDG uptake in the lung without respiratory symptoms or chest CT abnormalities

    PubMed Central

    Shiiba, Masato; Izutsu, Koji; Ishihara, Makiko

    2014-01-01

    Intravascular large B-cell lymphoma (IVLBCL) is a rare and aggressive subtype of systemic extranodal non-Hodgkin diffuse large B-cell lymphoma (DLBCL). We report a rare case of IVLBCL who showed diffuse 18F-fluorodeoxyglucose (FDG) uptake in the lung in FDG-positron emission tomography/computed tomography (PET/CT) without respiratory symptoms or chest CT abnormalities. Serum biochemical studies showed a raised level of lactate dehydrogenase (LDH) and serum soluble interleukin-2 receptor (sIL-2R), which suggested the presence of malignant lymphoma strongly. A non-contrast CT showed no abnormalities in the lung fields, no lymphadenopathy was found. FDG-PET/CT revealed diffuse FDG uptake in the both lungs and in spleen as well as multiple hot spots in the liver. Under the suspicion of IVLBCL especially by the diffuse FDG uptake in the lung, a random skin biopsy was performed from three regions, the left forearm, right abdomen and left thigh in which there had been no evidence of FDG uptake. The definite diagnosis of IVLBCL was made based on the pathological analysis of the specimen from the left thigh. She achieved complete remission (CR) after combined chemoimmunotherapy. FDG-PET/CT was useful for the early detection of IVLBCL even without respiratory symptoms or any abnormal findings by chest CT.

  18. Screening for distant metastases in head and neck cancer patients using FDG-PET and chest CT: validation of an algorithm.

    PubMed

    Senft, Asaf; Hoekstra, Otto S; Witte, Birgit I; Leemans, C René; de Bree, Remco

    2016-09-01

    In patients with head and neck squamous cell carcinoma and high-risk factors, the combination of whole body FDG-PET and contrast-enhanced chest CT has the highest sensitivity and accuracy when screening for distant metastases. The aim of the present study was to retrospectively validate an earlier developed algorithm for interpreting the combination of screening PET and CT. The test cohort consisted of 47 consecutive HNSCC patients with high-risk factors for distant metastases, who had previously undergone FDG-PET and CT and had a minimum 12 months of follow-up. In 12 (26 %) patients, distant metastases were detected during screening or within 12-month follow-up. In patients with locoregional control during follow-up, the sensitivity and specificity were 55 % (95 % CI 23-83 %) and 97 % (95 % CI 82-99 %), respectively, for chest CT, 55 % (95 % CI 23-83 %) and 100 % (95 % CI 88-100 %), respectively, for PET and 73 % (95 % CI 39-94 %) and 100 % (95 % CI 88-100 %), respectively, for the combination of PET and CT. The proposed algorithm was considered to have been validated. In this algorithm, all FDG-PET positive scans for distant metastases (regardless of interpretation of a solid lung lesion on CT) and CT scans with suspicious pulmonary lesions of less than 5-mm diameter (regardless of FDG-PET findings) are considered positive for distant metastases. PMID:26350882

  19. A visual query-by-example image database for chest CT images: potential role as a decision and educational support tool for radiologists.

    PubMed

    Sasso, Giuseppe; Marsiglia, Hugo Raul; Pigatto, Francesca; Basilicata, Antonio; Gargiulo, Mario; Abate, Andrea Francesco; Nappi, Michele; Pulley, Jenny; Sasso, Francesco Silvano

    2005-03-01

    Primary reading or further evaluation of diagnostic imaging examination often needs a comparison between the actual findings and the relevant prior images of the same patient or similar radiological data found in other patients. This support is of clinical importance and may have significant effects on physicians' examination reading efficiency, service-quality, and work satisfaction. We developed a visual query-by-example image database for storing and retrieving chest CT images by means of a visual browser Image Management Environment (IME) and tested its retrieval efficiency. The visual browser IME included four fundamental features (segmentation, indexing, quick load and recall, user-friendly interface) in an integrated graphical environment for a user-friendly image database management. The system was tested on a database of 2000 chest CT images, randomly chosen from the digital archives of our institutions. A sample of eight heterogeneous images were used as queries and, for each of them a team of three expert radiologists selected the most similar images from the database (a set of 15 images containing similar abnormalities in the same position of the query). The sensitivity and the positive predictive factor, both averaged over the 8 test queries and 15 answers, were respectively 0.975 and 0.91 The IME system is currently under evaluation at our institutions as an experimental application. We consider it a useful work-in-progress tool for clinical practice facilitating searches for a variety of radiological tasks. PMID:15937719

  20. Acute myocardial infarction due to coronary thrombosis caused by blunt chest trauma.

    PubMed

    Treuth, Gregory M; Baibars, Motaz; Alraiyes, Abdul Hamid; Alraies, M Chadi

    2014-01-01

    A 65-year-old man presented to the emergency department following an anterior chest trauma. He had significant chest pain and chest X-ray was significant for revealed multiple rib fractures and negative. CT scan of the chest ruled out pulmonary embolism or aortic dissection. However, few hours later he developed hypotension requiring admission to medical intensive care unit and intravenous vasopressors. Further workup showed ST elevation myocardial infarction involving the anterior ECG leads. Emergent coronary angiography was performed with intervention to the mid-left anterior descending occlusion. Cardiogenic shock resolved and patient was discharged few days later. One-year follow-up with echocardiogram showed stable ischaemic cardiomyopathy with improved left ventricular ejection fraction to 50%. PMID:24769662

  1. Right coronary artery dissection following blunt chest trauma.

    PubMed

    Regueiro, Ander; Alvarez-Contreras, Luis; Martín-Yuste, Victoria; Kasa, Gizem; Sabaté, Manel

    2012-04-01

    Chest trauma is a major health problem with a high mortality. Myocardial infarction secondary to coronary dissection following blunt chest trauma is a rare entity. We describe the case of an inferior MI following blunt chest trauma. A 61-year-old male without any relevant medical history was transported to a hospital after a low-velocity motorcycle accident. The patient was asymptomatic before the accident. The patient developed severe chest pain and an ECG revealed inferior ST segment elevation. After ruling out aortic dissection with angio-CT, a coronary angiograph depicted a proximal occlusion of the right coronary artery. After thrombectomy, a typical image of coronary artery dissection was observed; the image persisted after several runs of thrombectomy and for that reason a bare metal stent was implanted with a good final angiographic result. Five days after admission the patient was discharged home. Cardiac contusion is not uncommon; however acute myocardial infarction is a rare complication of blunt chest trauma. Thorough evaluation with clinical suspicion can lead to optimal medical care. PMID:24062888

  2. Optimal Dose Levels in Screening Chest CT for Unimpaired Detection and Volumetry of Lung Nodules, with and without Computer Assisted Detection at Minimal Patient Radiation

    PubMed Central

    Christe, Andreas; Szucs-Farkas, Zsolt; Huber, Adrian; Steiger, Philipp; Leidolt, Lars; Roos, Justus E.; Heverhagen, Johannes; Ebner, Lukas

    2013-01-01

    Objectives The aim of this phantom study was to minimize the radiation dose by finding the best combination of low tube current and low voltage that would result in accurate volume measurements when compared to standard CT imaging without significantly decreasing the sensitivity of detecting lung nodules both with and without the assistance of CAD. Methods An anthropomorphic chest phantom containing artificial solid and ground glass nodules (GGNs, 5–12 mm) was examined with a 64-row multi-detector CT scanner with three tube currents of 100, 50 and 25 mAs in combination with three tube voltages of 120, 100 and 80 kVp. This resulted in eight different protocols that were then compared to standard CT sensitivity (100 mAs/120 kVp). For each protocol, at least 127 different nodules were scanned in 21–25 phantoms. The nodules were analyzed in two separate sessions by three independent, blinded radiologists and computer-aided detection (CAD) software. Results The mean sensitivity of the radiologists for identifying solid lung nodules on a standard CT was 89.7%±4.9%. The sensitivity was not significantly impaired when the tube and current voltage were lowered at the same time, except at the lowest exposure level of 25 mAs/80 kVp [80.6%±4.3% (p = 0.031)]. Compared to the standard CT, the sensitivity for detecting GGNs was significantly lower at all dose levels when the voltage was 80 kVp; this result was independent of the tube current. The CAD significantly increased the radiologists’ sensitivity for detecting solid nodules at all dose levels (5–11%). No significant volume measurement errors (VMEs) were documented for the radiologists or the CAD software at any dose level. Conclusions Our results suggest a CT protocol with 25 mAs and 100 kVp is optimal for detecting solid and ground glass nodules in lung cancer screening. The use of CAD software is highly recommended at all dose levels. PMID:24386126

  3. Coronary artery calcification in clinical practice: what we have learned and why should it routinely be reported on chest CT?

    PubMed

    Shemesh, Joseph

    2016-04-01

    The recent acceptance of low dose chest computed tomography (LDCT) as a screening modality for early lung cancer detection will significantly increase the number of LDCT among high risk population. The target subjects are at the same time at high risk to develop cardiovascular (CV) events. The routine report on coronary artery calcification (CAC) will therefore, enhances the screening benefit by providing the clinicians with an additive powerful risk stratification tool for the management or primary prevention of CV events. This review will provide the radiologists with helpful information for the daily practice regarding on what is CAC, its clinical applications and how to diagnose, quantify and report on CAC while reading the LDCT. PMID:27195277

  4. Coronary artery calcification in clinical practice: what we have learned and why should it routinely be reported on chest CT?

    PubMed Central

    2016-01-01

    The recent acceptance of low dose chest computed tomography (LDCT) as a screening modality for early lung cancer detection will significantly increase the number of LDCT among high risk population. The target subjects are at the same time at high risk to develop cardiovascular (CV) events. The routine report on coronary artery calcification (CAC) will therefore, enhances the screening benefit by providing the clinicians with an additive powerful risk stratification tool for the management or primary prevention of CV events. This review will provide the radiologists with helpful information for the daily practice regarding on what is CAC, its clinical applications and how to diagnose, quantify and report on CAC while reading the LDCT. PMID:27195277

  5. Computer-aided diagnosis workstation and telemedicine network system for chest diagnosis based on multislice CT images

    NASA Astrophysics Data System (ADS)

    Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kakinuma, Ryutaru; Moriyama, Noriyuki

    2009-02-01

    Mass screening based on multi-helical CT images requires a considerable number of images to be read. It is this time-consuming step that makes the use of helical CT for mass screening impractical at present. Moreover, the doctor who diagnoses a medical image is insufficient in Japan. To overcome these problems, we have provided diagnostic assistance methods to medical screening specialists by developing a lung cancer screening algorithm that automatically detects suspected lung cancers in helical CT images, a coronary artery calcification screening algorithm that automatically detects suspected coronary artery calcification and a vertebra body analysis algorithm for quantitative evaluation of osteoporosis likelihood by using helical CT scanner for the lung cancer mass screening. The functions to observe suspicious shadow in detail are provided in computer-aided diagnosis workstation with these screening algorithms. We also have developed the telemedicine network by using Web medical image conference system with the security improvement of images transmission, Biometric fingerprint authentication system and Biometric face authentication system. Biometric face authentication used on site of telemedicine makes "Encryption of file" and "Success in login" effective. As a result, patients' private information is protected. We can share the screen of Web medical image conference system from two or more web conference terminals at the same time. An opinion can be exchanged mutually by using a camera and a microphone that are connected with workstation. Based on these diagnostic assistance methods, we have developed a new computer-aided workstation and a new telemedicine network that can display suspected lesions three-dimensionally in a short time. The results of this study indicate that our radiological information system without film by using computer-aided diagnosis workstation and our telemedicine network system can increase diagnostic speed, diagnostic accuracy and

  6. Computed tomography of the chest

    SciTech Connect

    Godwin, J.D.

    1984-01-01

    In this reference book readers have access to information pertaining to the role of thoracic CT, its limitations, normal anatomy and variations, scanning techniques, confusing artifacts, and pathologic anatomy. Major sections provide detailed, explicit data on lung cancer staging, the thoracic inlet, the heart, the esophagus, CT-guided invasive techniques, and the pediatric chest CT. Controversies are explored fully and presented fairly. This book is profusely illustrated with almost 500 CT scans for greater recognition and comprehension of the material presented.

  7. Graph-Based Airway Tree Reconstruction from Chest CT Scans: Evaluation of Different Features on Five Cohorts

    PubMed Central

    Bauer, Christian; Eberlein, Michael; Beichel, Reinhard R.

    2014-01-01

    We present a graph-based framework for airway tree reconstruction from CT scans and evaluate the performance of different feature categories and their combinations on five lung cohorts. The approach consists of two main processing steps. First, potential airway branch and connection candidates are identified and represented by a graph structure with weighted nodes and edges, respectively. Second, an optimization algorithm is utilized for generating an airway detection result by selecting a subset of airway branches and connections based on graph weights derived from image features. The performance of the algorithm with different feature categories and their combinations was assessed on a set of 50 lung CT scans from five different cohorts, including normal and diseased lungs. Results show tradeoffs between feature categories/combinations in terms of correctly (true positive) and incorrectly (false positive) identified airways. Also, the performance of features in dependence of lung cohort was analyzed. Across all cohorts, a good trade-off with high true positive rate (TPR) and low false positive rate (FPR) was achieved by a combination of gray-value, local shape, and structural features. This combination enabled extracting 91.80% of reference airways (TPR) in combination with a low FPR of 1.00%. In addition, this variant was evaluated on the public EXACT’09 test set, and a comparison with other airway detection approaches is provided. One of the main advantages of the presented method is that it is robust against local disturbances/artifacts or other ambiguities that are frequently occurring in lung CT scans. PMID:25438305

  8. Eigen nodule: view-based recognition of lung nodule in chest x-ray CT images using subspace method

    NASA Astrophysics Data System (ADS)

    Nakamura, Yoshihiko; Fukano, Gentaro; Takizawa, Hotaka; Mizuno, Shinji; Yamamoto, Shinji; Matsumoto, Tohru; Tateno, Yukio; Iinuma, Takeshi

    2004-05-01

    We previously proposed a recognition method of lung nodules based on experimentally selected feature values (such as contrast, circularities, etc.) of the suspicious shadows detected by our Quoit filter. In this paper, we propose a new recognition method of lung nodule using each CT value itself in ROI (region of interest) area as a feature value. In the clustering stage, first, the suspicious shadows are classified into some clusters using Principal Component (PC) theories. A set of CT values in each ROI is regarded as a feature vector, and then the eigen vectors and the eigen values are calculated for each cluster by applying Principal Component Analysis (PCA). The eigen vectors (we call them Eigen Images) corresponding to the first 10 largest eigen values, are utilized as base vectors for subspaces of the clusters in the feature space. In the discrimination stage, correlations are measured between the unknown shadow and the subspace which is spanned by the Eigen Images. If the correlation with the abnormal subspace is large, the suspicious shadow is determined to be abnormal. Otherwise, it is determined to be normal. By applying our new method, good results have been acquired.

  9. Sex Differences in the Effectiveness of Early Coronary CT Angiography Compared to Standard Emergency Department Evaluation for Acute Chest Pain: The ROMICAT II Trial

    PubMed Central

    Truong, Quynh A.; Hayden, Douglas; Woodard, Pamela K.; Kirby, Ruth; Chou, Eric T.; Nagurney, John T.; Wiviott, Stephen D.; Fleg, Jerome L.; Schoenfeld, David A.; Udelson, James E.; Hoffmann, Udo

    2013-01-01

    Background We evaluate sex-based differences in the effectiveness of early cardiac computed tomographic angiography (CCTA) versus standard emergency department (ED) evaluation in patients with acute chest pain. Methods and Results In the ROMICAT II multicenter controlled trial, we randomized 1000 patients (47% women) 40-74 years old with symptoms suggestive of acute coronary syndrome (ACS) to an early CCTA or standard ED evaluation. In this pre-specified analysis, women in the CCTA arm had greater reduction in length of stay (LOS), lower hospital admission rates, and lesser increased cumulative radiation dose than men when comparing ED strategies (p-interactions≤0.02). While women had lower ACS rates than men (3% vs 12%, p<0.0001), sex differences in LOS persisted after adjustment for baseline differences including ACS rate (p-interaction<0.03). LOS was similar between sexes with normal CCTA findings (p=0.11). There was no missed ACS for either sex. No difference was observed in major adverse cardiac events between sex and ED strategies (p-interaction=0.39). Women had more normal CCTA examinations than men (58% vs 37%, p<0.0001), less obstructive coronary disease by CCTA (5% vs 17%, p=0.0001), but similar normalcy rates for functional testing (p=1.0). Men in the CCTA arm had the highest rate of invasive coronary angiography (18%), while women had comparable low 5% rates irrespective of ED strategies. Conclusions This trial provides data supporting an early CCTA strategy as an attractive option in women presenting to the ED with symptoms suggestive of ACS. The findings may be explained by lower CAD prevalence and severity in women than men. PMID:23685743

  10. Acoustical markers for CAD-detected pulmonary nodules in chest CT: A way to avoid suggestion and distraction of radiologist's attention?

    NASA Astrophysics Data System (ADS)

    Beyer, Florian; Heindel, Walter; Wormanns, Dag

    2009-02-01

    Purpose: To compare the influence of visual and acoustical CAD markers on radiologist's performance with regard to suggestive and distractive effects. Materials and methods: Ten radiologists analyzed 150 pictures of chest CT slices. Every picture contained a visual CAD marker. 100 pictures showed one nodule: CAD marker marked this in 50 cases and in 50 cases a false positive finding (f.p.). The other 50 cases showed no nodule but an f.p. marker. After 3 years same images were presented to thirteen radiologists with only a sound as CAD marker. 55 of 150 images were marked, 30 true positive and 25 f.p. Sensitivity and f.p. rate were calculated for both marker types. Significance between sensitivities and f.p. rates were calculated by multiple-analysis-of-variance (MANOVA). Results: Without CAD mean sensitivity resp. f.p. were 57.7% /.13. In case of correct optical resp. acoustical marker sensitivity increased to 75.6% resp. 63.1%. For incorrect set marker mean f.p. rate increased to .31 resp. .24. MANOVA showed that marker's correctness highly significantly influenced sensitivity (p<.001) and f.n. (p=.005). Type of marker showed no significant influence on sensitivity (p=.26) or f.n. (p=.23) but on f.p. (p<.001). New work to be presented: Acoustical markers are a new means to increase radiologist's awareness of the presence of pulmonary nodules at CT scans with much less suggestive effect compared to optical markers. Conclusion: We found an unexpectedly low distraction effect for misplaced CAD markers. A suggestive effect was remarkable especially for optical markers. However acoustical markers offered less increase of sensitivity.

  11. Age Estimation in Living Adults using 3D Volume Rendered CT Images of the Sternal Plastron and Lower Chest.

    PubMed

    Oldrini, Guillaume; Harter, Valentin; Witte, Yannick; Martrille, Laurent; Blum, Alain

    2016-01-01

    Age estimation is commonly of interest in a judicial context. In adults, it is less documented than in children. The aim of this study was to evaluate age estimation in adults using CT images of the sternal plastron with volume rendering technique (VRT). The evaluation criteria are derived from known methods used for age estimation and are applicable in living or dead subjects. The VRT images of 456 patients were analyzed. Two radiologists performed age estimation independently from an anterior view of the plastron. Interobserver agreement and correlation coefficients between each reader's classification and real age were calculated. The interobserver agreement was 0.86, and the correlation coefficients between readers classifications and real age classes were 0.60 and 0.65. Spearman correlation coefficients were, respectively, 0.89, 0.67, and 0.71. Analysis of the plastron using VRT allows age estimation in vivo quickly and with results similar than methods such as Iscan, Suchey-Brooks, and radiographs used to estimate the age of death. PMID:27092960

  12. Chest Pain

    MedlinePlus

    Having a pain in your chest can be scary. It does not always mean that you are having a heart attack. There can be many other causes, ... embolism Costochondritis - an inflammation of joints in your chest Some of these problems can be serious. Get ...

  13. [Chest pain].

    PubMed

    Horn, Benedikt

    2015-01-01

    Chest pain in ambulatory setting is predominantly not heart-associated. Most patients suffer from muskuloskeletal or functional (psychogenic) chest pain. Differential diagnosis covers aortic dissection, rib-fracture, shingles, GERD, Tietze-Syndrome, pulmonary embolism, pleuritis, pneumothorax, pleurodynia and metastatic disease. In most cases history, symptoms and signs allow a clinical diagnosis of high pretest-probability. PMID:25533261

  14. Chest tomosynthesis: technical and clinical perspectives.

    PubMed

    Johnsson, Ase Allansdotter; Vikgren, Jenny; Bath, Magnus

    2014-02-01

    The recent implementation of chest tomosynthesis is built on the availability of large, dose-efficient, high-resolution flat panel detectors, which enable the acquisition of the necessary number of projection radiographs to allow reconstruction of section images of the chest within one breath hold. A chest tomosynthesis examination obtains the increased diagnostic information provided by volumetric imaging at a radiation dose comparable to that of conventional chest radiography. There is evidence that the sensitivity of chest tomosynthesis may be at least three times higher than for conventional chest radiography for detection of pulmonary nodules. The sensitivity increases with increasing nodule size and attenuation and decreases for nodules with subpleural location. Differentiation between pleural and subpleural lesions is a known pitfall due to the limited depth resolution in chest tomosynthesis. Studies on different types of pathology report increased detectability in favor of chest tomosynthesis in comparison to chest radiography. The technique provides improved diagnostic accuracy and confidence in the diagnosis of suspected pulmonary lesions on chest radiography and facilitates the exclusion of pulmonary lesions in a majority of patients, avoiding the need for computed tomography (CT). However, motion artifacts can be a cumbersome limitation and breathing during the tomosynthesis image acquisition may result in severe artifacts significantly affecting the detectability of pathology. In summary, chest tomosynthesis has been shown to be superior to chest conventional radiography for many tasks and to be able to replace CT in selected cases. In our experience chest tomosynthesis is an efficient problem solver in daily clinical work. PMID:24481756

  15. Shocking Admission

    ERIC Educational Resources Information Center

    Hoover, Eric; Millman, Sierra

    2007-01-01

    Marilee Jones's career had been a remarkable success. She joined Massachusetts Institute of Technology's (MIT's) admissions office in 1979, landing a job in Cambridge at a time when boys ruled the sandbox of the admissions profession. Her job was to help MIT recruit more women, who then made up less than one-fifth of the institute's students. She…

  16. Painful Chest Wall Swellings: Tietze Syndrome or Chest Wall Tumor?

    PubMed

    Kaplan, Tevfik; Gunal, Nesimi; Gulbahar, Gultekin; Kocer, Bulent; Han, Serdar; Eryazgan, Mehmet Ali; Ozsoy, Arzu; Naldoken, Seniha; Alhan, Aslıhan; Sakinci, Unal

    2016-04-01

    Background Tietze syndrome (TS) is an inflammatory condition characterized by chest pain and swelling of costochondral junction. Primary chest wall tumors may mimic TS. In this article, we report our experience of approximately 121 patients initially diagnosed as TS and determined chest wall tumor in some cases at the follow-up. Methods This is a retrospective review of patients diagnosed as TS by clinical examination, chest X-ray, electrocardiogram, routine laboratory tests, and computed tomography (CT) of chest: all treated and followed up between March 2001 and July 2012. There were 121 cases (41 males and 80 females; mean age, 39.6 ± 3.2 years) of TS. Results In 27 patients with initial normal radiological findings, the size of swellings had doubled during the follow-up period (mean, 8.51 ± 2.15 months). These patients were reevaluated with chest CT and bone scintigraphy and then early diagnostic biopsy was performed. Pathologic examination revealed primary chest wall tumor in 13 patients (5 malignant, 8 benign). CT had a sensitivity of 92.3% and a specificity of 64.2% in detection of tumors (kappa: 0.56, p = 0.002), whereas the sensitivity and the specificity of bone scan were 84.6 and 35.7%, respectively (kappa: 0.199, p = 0.385). Conclusion Primary chest wall tumors could mimic TS. Bone scintigraphy or CT is not specific enough to determine malignant and other benign disorders of costochondral junction. Therefore, clinicians should follow TS patients more closely, and in case of increasing size of swelling, early diagnostic biopsy should be considered. PMID:25742551

  17. Utility of Coronary Artery Calcium Scanning Beyond Coronary CT Angiography in the Emergency Department Evaluation for Acute Chest Pain: The ROMICAT II Trial

    PubMed Central

    Pursnani, Amit; Chou, Eric; Zakroysky, Pearl; Deaño, Roderick C.; Mamuya, Wilfred S.; Woodard, Pamela K.; Nagurney, John T.; Fleg, Jerome L.; Lee, Hang; Schoenfeld, David; Udelson, James E.; Hoffmann, Udo; Truong, Quynh A.

    2015-01-01

    Background Whether a coronary artery calcium (CAC) scan provides added value to coronary CT angiography (CCTA) in emergency department (ED) patients with acute chest pain (ACP) remains unsettled. We sought to determine the value of CAC scan in ACP patients undergoing CCTA. Methods and Results In the multicenter ROMICAT II trial, we enrolled low-intermediate risk ED patients with symptoms suggesting acute coronary syndrome (ACS). In this pre-specified sub-analysis of 473 patients (54±8years, 53%male) who underwent both CAC scanning and CCTA, the ACS rate was 8%. Overall, 53% of patients had CAC=0 of whom 2 (0.8%) developed ACS, while 7% had CAC>400 with 49% whom developed ACS. C-statistic of CAC>0 was 0.76, while that using the optimal cutpoint of CAC≥22 was 0.81. Continuous CAC score had lower discriminatory capacity than CCTA (c-statistic 0.86 vs. 0.92, p=0.03). Compared to CCTA alone, there was no benefit combining CAC score with CCTA (c-statistic 0.93, p=0.88) or with selective CCTA strategies after initial CAC>0 or optimal cutpoint CAC≥22 (p≥0.09). Mean radiation dose from CAC acquisition was 1.4±0.7mSv. Higher CAC scores resulted in more non-diagnostic CCTA studies though the majority remained interpretable. Conclusions In ED patients with ACP, CAC score does not provide incremental value beyond CCTA for ACS diagnosis. CAC=0 does not exclude ACS, nor a high CAC score preclude interpretation of CCTA in most patients. Thus, CAC results should not influence the decision to proceed with CCTA, and the decision to perform a CAC scan should be balanced with the additional radiation exposure required. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01084239. PMID:25710925

  18. Chest MRI

    MedlinePlus

    ... imaging test that uses powerful magnetic fields and radio waves to create pictures of the chest (thoracic area). ... no side effects from the magnetic fields and radio waves have been reported. The most common type of ...

  19. Chest MRI

    MedlinePlus

    ... Restrictive cardiomyopathy Superior vena cava (SVC) obstruction Thoracic aortic aneurysm Thymus tumor Tumors of the chest Consult your ... Restrictive cardiomyopathy SVC obstruction Swollen lymph nodes Thoracic aortic aneurysm Patient Instructions Abdominal aortic aneurysm repair - open - discharge ...

  20. Chest drainage.

    PubMed

    Carter, Chris

    2014-07-15

    As an intensive care nurse with experience of caring for critically ill patients in the UK and on deployed operations overseas, I found the CPD article useful in reviewing the pathophysiology of a pneumothorax, use of intrapleural chest drains, observations that should be recorded, and nursing care and management of a patient with an intrapleural chest drain. Reflecting on the time out activities in the CPD article was valuable. PMID:25005418

  1. [Chest trauma].

    PubMed

    Freixinet Gilart, Jorge; Ramírez Gil, María Elena; Gallardo Valera, Gregorio; Moreno Casado, Paula

    2011-01-01

    Chest trauma is a frequent problem arising from lesions caused by domestic and occupational activities and especially road traffic accidents. These injuries can be analyzed from distinct points of view, ranging from consideration of the most severe injuries, especially in the context of multiple trauma, to the specific characteristics of blunt and open trauma. In the present article, these injuries are discussed according to the involvement of the various thoracic structures. Rib fractures are the most frequent chest injuries and their diagnosis and treatment is straightforward, although these injuries can be severe if more than three ribs are affected and when there is major associated morbidity. Lung contusion is the most common visceral lesion. These injuries are usually found in severe chest trauma and are often associated with other thoracic and intrathoracic lesions. Treatment is based on general support measures. Pleural complications, such as hemothorax and pneumothorax, are also frequent. Their diagnosis is also straightforward and treatment is based on pleural drainage. This article also analyzes other complex situations, notably airway trauma, which is usually very severe in blunt chest trauma and less severe and even suitable for conservative treatment in iatrogenic injury due to tracheal intubation. Rupture of the diaphragm usually causes a diaphragmatic hernia. Treatment is always surgical. Myocardial contusions should be suspected in anterior chest trauma and in sternal fractures. Treatment is conservative. Other chest injuries, such as those of the great thoracic and esophageal vessels, are less frequent but are especially severe. PMID:21640287

  2. Chest x-ray

    MedlinePlus

    ... Images Aortic rupture, chest x-ray Lung cancer, frontal chest x-ray Adenocarcinoma - chest x-ray Coal ... cancer - chest x-ray Lung nodule, right middle lobe - chest x-ray Lung mass, right upper lung - ...

  3. Acute non-traumatic gastrothorax: presentation of a case with chest pain and atypical radiologic findings.

    PubMed

    Singh, Deepwant; Mackeith, Pieter; Gopal, Dipesh Pravin

    2016-01-01

    A previously well 71-year-old woman presented to the Emergency Department with acute-onset left-sided chest pain. She was haemodynamically stable with unremarkable systemic examination. Her electrocardiogram and troponin were within normal limits and her chest radiograph showed a raised left hemi-diaphragm. Two hours after admission, this woman became acutely breathless, and suffered a pulseless electrical activity cardiac arrest. After cardiopulmonary resuscitation, there was a return of spontaneous circulation and regained consciousness. A repeat clinical assessment revealed a new left-sided dullness to percussion with contralateral percussive resonance on respiratory examination. CXR revealed a left pan-hemi-thoracic opacity whilst better definition using CT-pulmonary angiography (CTPA) indicated an acute tension gastrothorax secondary to a large left-sided diaphragmatic hernia. Nasogastric (NG) tube insertion was used to decompress the stomach and the patient underwent uncomplicated emergency laparoscopic hernia reduction. She remained well at 1-year follow-up. PMID:27027934

  4. Case report of idiopathic pulmonary haemosiderosis in a child with recurrent chest infections.

    PubMed

    Ibrahem, Renan; Arasaretnam, Anita; Ordidge, Katherine; Vedelago, John; Toy, Rosemary

    2011-01-01

    Idiopathic pulmonary haemosiderosis (IPH) is a rare condition that usually presents as a triad of haemoptysis, iron deficiency anaemia and pulmonary infiltrates. We report a case of IPH diagnosed in a 7 year old boy who had recurrent hospital admissions with severe chest infections and haemoptysis from his first few months of life. He was found to have microcytic hypochromic anaemia, diffuse infiltrate shadowing on his chest X-ray (CXR) and ground-glass opacification on his computed tomogram (CT). Perl's Prussian blue staining of his bronchoalveolar lavage fluid revealed haemosiderin-laden macrophage infiltration. After exclusion of infective, cardiac, immunological and glomerular causes, he was diagnosed with idiopathic pulmonary haemosiderosis. He has since been treated intermittently with steroids, which have failed to control his symptoms fully. PMID:22470815

  5. What Is Chest MRI?

    MedlinePlus

    ... page from the NHLBI on Twitter. What Is Chest MRI? Chest MRI (magnetic resonance imaging) is a safe, noninvasive ... creates detailed pictures of the structures in your chest, such as your chest wall, heart, and blood ...

  6. [Imaging signs in chest diagnostics].

    PubMed

    Krombach, G A

    2016-08-01

    Signs in chest imaging are defined as typical findings which can be easily recognized on x‑ray photographs or computed tomography (CT) scans of the chest. They are caused by different typical pathophysiological processes. Due to the association of a certain pathophysiological cause with a given sign, knowledge and use of these signs can allow the possible differential diagnoses to be narrowed down. If other imaging findings and clinical data are additionally taken into account, the diagnosis can be made with a high degree of confidence in many cases. PMID:27369549

  7. Novel Logistic Regression Model of Chest CT Attenuation Coefficient Distributions for the Automated Detection of Abnormal (Emphysema or ILD) versus Normal Lung

    PubMed Central

    Chan, Kung-Sik; Jiao, Feiran; Mikulski, Marek A.; Gerke, Alicia; Guo, Junfeng; Newell, John D; Hoffman, Eric A.; Thompson, Brad; Lee, Chang Hyun; Fuortes, Laurence J.

    2015-01-01

    Rationale and Objectives We evaluated the role of automated quantitative computed tomography (CT) scan interpretation algorithm in detecting Interstitial Lung Disease (ILD) and/or emphysema in a sample of elderly subjects with mild lung disease.ypothesized that the quantification and distributions of CT attenuation values on lung CT, over a subset of Hounsfield Units (HU) range [−1000 HU, 0 HU], can differentiate early or mild disease from normal lung. Materials and Methods We compared results of quantitative spiral rapid end-exhalation (functional residual capacity; FRC) and end-inhalation (total lung capacity; TLC) CT scan analyses in 52 subjects with radiographic evidence of mild fibrotic lung disease to 17 normal subjects. Several CT value distributions were explored, including (i) that from the peripheral lung taken at TLC (with peels at 15 or 65mm), (ii) the ratio of (i) to that from the core of lung, and (iii) the ratio of (ii) to its FRC counterpart. We developed a fused-lasso logistic regression model that can automatically identify sub-intervals of [−1000 HU, 0 HU] over which a CT value distribution provides optimal discrimination between abnormal and normal scans. Results The fused-lasso logistic regression model based on (ii) with 15 mm peel identified the relative frequency of CT values over [−1000, −900] and that over [−450,−200] HU as a means of discriminating abnormal versus normal, resulting in a zero out-sample false positive rate and 15%false negative rate of that was lowered to 12% by pooling information. Conclusions We demonstrated the potential usefulness of this novel quantitative imaging analysis method in discriminating ILD and/or emphysema from normal lungs. PMID:26776294

  8. Chest tube insertion

    MedlinePlus

    Chest drainage tube insertion; Insertion of tube into chest; Tube thoracostomy; Pericardial drain ... When your chest tube is inserted, you will lie on your side or sit partly upright, with one arm over your ...

  9. Chest tube insertion

    MedlinePlus

    ... leaks from inside the lung into the chest ( pneumothorax ) Fluid buildup in the chest (called a pleural ... on the reason a chest tube is inserted. Pneumothorax usually improves, but sometimes needs minimally invasive surgery. ...

  10. Thymic carcinoma presenting as atypical chest pain.

    PubMed

    Siddiqui, Sadiq; Connelly, Tara; Keita, Luther; Blazkova, Sylvie; Veerasingam, Dave

    2015-01-01

    A 58-year-old woman with a 2-month history of atypical chest pain was referred to the chest pain clinic by the general practitioner. Exercise stress test was positive and subsequent coronary angiogram revealed significant triple vessel disease with left ventricular impairment requiring a coronary artery bypass graft (CABG). The patient had a chest X-ray as part of the preoperative work up. Chest X-ray revealed a large anterior mediastinal mass. Subsequent thorax CT revealed a 7.2 cm anterior mediastinal mass. CT-guided biopsy of the mass revealed the diagnosis of a poorly differentiated thymic basaloid carcinoma. The patient was successfully treated with concomitant surgery involving complete resection of the mass and a CABG procedure. PMID:26607199

  11. Intercostal hemangioma of the chest wall

    PubMed Central

    Hamzík, Julian

    2016-01-01

    The authors describe a case of a 36-year-old patient who had six months’ pain of the thoracic spine and left chest. A soft slowly growing resistance was present on the dorso-lateral side of the left chest wall, in the range of the seventh to ninth rib. According to the medical history, the patient did not have any prior trauma and malignancy. A well-defined tumor of the left chest wall with calcifications, which grew to the seventh and eighth intercostal space, was present on computed tomography (CT) and magnetic resonance (MR) scans. The patient underwent resection of the tumor with the chest wall and reconstruction with polypropylene mesh. Histologically, it was a venous hemangioma, one of very rare tumors of the chest wall. PMID:27212983

  12. Can Computers Simplify Admissions?

    ERIC Educational Resources Information Center

    Bruker, Robert M.

    1978-01-01

    Based on experience with a simplified admissions concept, Southern Illinois University is satisfied that the admissions process has been made easier for prospective students, high school counselors, and admissions staff. The computer does not make decisions regarding admission of a student, but reduced work loads for everyone concerned. (Author)

  13. CT detection of occult pneumothorax in head trauma

    SciTech Connect

    Tocino, I.M.; Miller, M.H.; Frederick, P.R.; Bahr, A.L.; Thomas, F.

    1984-11-01

    A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneuomothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothorax during subsequent mechanical ventilation or emergency surgery under general anesthesia.

  14. Chest pain in children.

    PubMed Central

    Leung, A. K.; Robson, W. L.; Cho, H.

    1996-01-01

    Chest pain is usually a benign symptom in children. The most common identifiable causes are musculoskeletal. Often, no cause can be identified. Cardiac disorders are uncommon causes of chest pain children. Most causes can be diagnosed from history and physical examination. Treatment should be directed at the underlying cause. For idiopathic chest pain, reassurance and regular follow-up examinations are important. PMID:8704491

  15. Chest x-ray

    MedlinePlus

    Chest radiography; Serial chest x-ray; X-ray - chest ... You stand in front of the x-ray machine. You will be told to hold your breath when the x-ray is taken. Two images are usually taken. You will ...

  16. Investigation of the dosimetry of chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Svalkvist, Angelica; Zachrisson, Sara; Månsson, Lars Gunnar; Båth, Magnus

    2009-02-01

    Chest tomosynthesis has recently been introduced to healthcare as a low-dose alternative to CT or as a tool for improved diagnostics in chest radiography with only a modest increase in radiation dose to the patient. However, no detailed description of the dosimetry for this type of examination has been presented. The aim of this work was therefore to investigate the dosimetry of chest tomosynthesis. The chest tomosynthesis examination was assumed to be performed using a stationary detector and a vertically moving x-ray tube, exposing the patient from different angles. The Monte Carlo based computer software PCXMC was used to determine the effective dose delivered to a standard-sized patient from various angles using different assumptions of the distribution of the effective dose over the different projections. The obtained conversion factors between input dose measures and effective dose for chest tomosynthesis for different angular intervals were then compared with the horizontal projection. The results indicate that the error introduced by using conversion factors for the PA projection in chest radiography for estimating the effective dose of chest tomosynthesis is small for normally sized patients, especially if a conversion factor between KAP and effective dose is used.

  17. [A rare case of chest pain].

    PubMed

    Bodócsi, Beáta; Koncz, István; Hum, Zsigmond; Serfőző, Orsolya; Pap-Szekeres, József; Szabó, István

    2016-09-01

    Chest pain is a common symptom in patients who visit Emergency Departments. The main task is to exclude life-threatening diseases such as acute coronary syndrome, pulmonary embolization and dissection of thoracic aorta. The authors present the history of a patient, who had an intense chest pain for 7 hours. In accordance with the diagnostic algorithm of chest pain, ECG, blood collection, chest X-ray and chest computed tomography angiography were performed. Acute coronary syndrome, pulmonary embolization and dissection of the thoracic aorta were excluded, however, chest computed tomography CT revealed a huge hiatal hernia as an incidental finding. An emergency surgical repair was performed and the patient recovered without any complications. The authors emphasize that the diagnostic algorithms focus on the confirmation or rejection of possible life threatening diseases in case of chest pain. However, it should be kept in mind that rarer causes may occur, which may require involvement of the relevant disciplines and multidisciplinary thinking. Orv. Hetil., 2016, 157(36), 1445-1448. PMID:27596512

  18. American College of Chest Physicians

    MedlinePlus

    ... of Certification (MOC) CHEST GAIN NSCLC CHEST SEEK Innovation, Simulation, and Training Center Professional Representative Education Program ( ... of Certification (MOC) CHEST GAIN NSCLC CHEST SEEK Innovation, Simulation, and Training Center Professional Representative Education Program ( ...

  19. Admissions Variables as Predictors of Performance in Basic Science Coursework.

    ERIC Educational Resources Information Center

    Leonard, D. Lisa; Niebuhr, Bruce R.

    1986-01-01

    This study was designed to determine the relative contribution of several types of admissions data in predicting the success of junior occupational therapy students in the first term of a human anatomy and physiology course. (Author/CT)

  20. Seeking the Admission Hybrid

    ERIC Educational Resources Information Center

    Lucido, Jerome A.

    2012-01-01

    When one thinks of seminal publications in college admission, the first piece that comes to mind is B. Alden Thresher's "College Admissions in the Public Interest" (1966). Thresher's work, relevant to this day, is credited with being the foundational document of the admission profession. McDonough and Robertson's 1995 study, commissioned by NACAC,…

  1. Lyme Myocarditis Presenting as Chest Pain in an Adolescent Girl.

    PubMed

    Fishe, Jennifer N; Marchese, Ronald F; Callahan, James M

    2016-07-01

    A previously healthy adolescent girl presented to the emergency department with new onset chest and right upper quadrant abdominal pain. Laboratory studies and imaging were consistent with myocarditis. She developed heart block after admission and required stabilization in the cardiac intensive care unit. Lyme serology returned positive, and her condition was diagnosed as Lyme disease-associated myocarditis. PMID:26945194

  2. Pocket atlas of normal CT anatomy

    SciTech Connect

    Weinstein, J.B.; Lee, J.K.T.; Sagel, S.S.

    1985-01-01

    This book is a quick reference for interpreting CT scans of the extracranial organs. This collection of 41 CT scans covers all the major organs of the body: neck and larynx; chest; abdomen; male pelvis; and female pelvis.

  3. Tube Thoracostomy (Chest Tube) Removal in Traumatic Patients: What Do We Know? What Can We Do?

    PubMed Central

    Paydar, Shahram; Ghahramani, Zahra; Ghoddusi Johari, Hamed; Khezri, Samad; Ziaeian, Bizhan; Ghayyoumi, Mohammad Ali; Fallahi, Mohammad Javad; Niakan, Mohammad Hadi; Sabetian, Golnar; Abbasi, Hamid Reza; Bolandparvaz, Shahram

    2015-01-01

    Chest tube (CT) or tube thoracostomy placement is often indicated following traumatic injuries. Premature movement of the chest tube leads to increased hospital complications and costs for patients. Placement of a chest tube is indicated in drainage of blood, bile, pus, drain air, and other fluids. Although there is a general agreement for the placement of a chest tube, there is little consensus on the subsequent management. Chest tube removal in trauma patients increases morbidity and hospital expense if not done at the right time. A review of relevant literature showed that the best answers to some questions about time and decision-making have been long sought. Issues discussed in this manuscript include chest tube removal conditions, the need for chest radiography before and after chest tuberemoval, the need to clamp the chest tube prior to removal, and drainage rate and acceptability prior to removal. PMID:27162900

  4. Use of chest sonography in acute-care radiology☆

    PubMed Central

    De Luca, C.; Valentino, M.; Rimondi, M.R.; Branchini, M.; Baleni, M. Casadio; Barozzi, L.

    2008-01-01

    Diagnosis of acute lung disease is a daily challenge for radiologists working in acute-care areas. It is generally based on the results of chest radiography performed under technically unfavorable conditions. Computed tomography (CT) is undoubtedly more accurate in these cases, but it cannot always be performed on critically ill patients who need continuous care. The use of thoracic ultrasonography (US) has recently been proposed for the study of acute lung disease. It can be carried out rapidly at the bedside and does not require any particularly sophisticated equipment. This report analyzes our experience with chest sonography as a supplement to chest radiography in an Emergency Radiology Unit. We performed chest sonography – as an adjunct to chest radiography – on 168 patients with acute chest pathology. Static and dynamic US signs were analyzed in light of radiographic findings and, when possible, CT. The use of chest US improved the authors' ability to provide confident diagnoses of acute disease of the chest and lungs. PMID:23397048

  5. Trends of CT utilisation in an emergency department in Taiwan: a 5-year retrospective study

    PubMed Central

    Hu, Sung-Yuan; Hsieh, Ming-Shun; Lin, Meng-Yu; Hsu, Chiann-Yi; Lin, Tzu-Chieh; How, Chorng-Kuang; Wang, Chen-Yu; Tsai, Jeffrey Che-Hung; Wu, Yu-Hui; Chang, Yan-Zin

    2016-01-01

    Objectives To investigate the association between the trends of CT utilisation in an emergency department (ED) and changes in clinical imaging practice and patients' disposition. Setting A hospital-based retrospective observational study of a public 1520-bed referral medical centre in Taiwan. Participants Adult ED visits (aged ≥18 years) during 2009–2013, with or without receiving CT, were enrolled as the study participants. Main outcome measures For all enrolled ED visits, we retrospectively analysed: (1) demographic characteristics, (2) triage categories, (3) whether CT was performed and the type of CT scan, (4) further ED disposition, (5) ED cost and (6) ED length of stay. Results In all, 269 239 adult ED visits (148 613 male patients and 120 626 female patients) were collected during the 5-year study period, comprising 38 609 CT scans. CT utilisation increased from 11.10% in 2009 to 17.70% in 2013 (trend test, p<0.001). Four in 5 types of CT scan (head, chest, abdomen and miscellaneous) were increasingly utilised during the study period. Also, CT was increasingly ordered annually in all age groups. Although ED CT utilisation rates increased markedly, the annual ED visits did not actually increase. Moreover, the subsequent admission rate, after receiving ED CT, declined (59.9% in 2009 to 48.2% in 2013). Conclusions ED CT utilisation rates increased significantly during 2009–2013. Emergency physicians may be using CT for non-emergent studies in the ED. Further investigation is needed to determine whether increasing CT utilisation is efficient and cost-effective. PMID:27279477

  6. Technology in International Admissions

    ERIC Educational Resources Information Center

    White, Elizabeth

    2012-01-01

    In a relatively short time, technology applications have become an essential feature of the admissions business. They make the jobs of international admissions professionals easier in many ways, allowing for more robust communication with applicants and counselors, a streamlined application process, and quicker access to information about…

  7. An Admissions Officer's Credentials

    ERIC Educational Resources Information Center

    Chronicle of Higher Education, 2007

    2007-01-01

    Marilee Jones has resigned as a dean of admissions at the Massachusetts Institute of Technology after admitting that she had misrepresented her academic degrees when first applying to work at the university in 1979. As one of the nation's most prominent admissions officers--and a leader in the movement to make the application process less…

  8. What Admissions Officials Think

    ERIC Educational Resources Information Center

    Hoover, Eric

    2008-01-01

    Over the past two decades, college admissions has become a prime-time preoccupation. Most people know at least something about the process, especially if they have a teenager in high school and a college guide on their coffee table. Nonetheless, widespread public misconceptions persist about admissions requirements, the selection process, and the…

  9. Selection of patients for x-ray examinations: Chest x-ray screening examinations

    SciTech Connect

    Not Available

    1983-08-01

    Five chest x-ray referral criteria statements have been developed and unanimously endorsed by a panel of physicians convened as part of a major voluntary cooperative effort between FDA's National Center for Devices and Radiological Health (NCDRH) and the medical professional community. The referral criteria statements include recommendations concerning the following applications of chest x-ray screening: mandated routine chest x-ray screening examinations, routine prenatal chest x-ray examinations, routine hospital admission chest x-ray examinations, chest x-ray examinations for tuberculosis detection and control, and routine chest x-ray examinations for occupational medicine. The complete text of the five referral criterial statements plus a brief discussion of the rationale for the development of each statement is presented.

  10. The chest pain center in the emergency department.

    PubMed

    Zalenski, R J; Grzybowski, M

    2001-05-01

    Despite the improvement of medical treatment for acute coronary syndromes throughout the 20th century, the authors believe that many cases of life-threatening coronary events could be avoided through early detection of CAD and the use of preventive strategies. Establishing chest pain units that are linked to the ED is one excellent strategy to risk-stratify patients with symptoms who are at risk for sustaining an AMI or having lethal arrhythmias. There is a need for more research on chest pain units to determine the value for cost and to further optimize strategies for ACI detection and screening. In EDs with high volumes of chest pain patients, or high pressures to avoid hospital admissions, a planned, systematic, and rapid approach to the treatment of AMI and the diagnosis of chest pain is a rewarding necessity. PMID:11373990

  11. Chest Injuries and Disorders

    MedlinePlus

    ... your neck and your abdomen. It includes the ribs and breastbone. Inside your chest are several organs, ... and collapsed lung Pleural disorders Esophagus disorders Broken ribs Thoracic aortic aneurysms Disorders of the mediastinum, the ...

  12. Role of PET/CT in Workup of Fever without a Source.

    PubMed

    Dibble, Elizabeth H; Yoo, Don C; Noto, Richard B

    2016-01-01

    Fever without source is a febrile illness without localizing signs or initial obvious cause. Early workup will often include chest radiography and computed tomography (CT) of the abdomen and pelvis, with or without CT of the chest. To evaluate localizing signs or symptoms or to further evaluate findings from initial studies, targeted imaging according to body part can be performed by using radiography, ultrasonography, CT, or magnetic resonance (MR) imaging. Nuclear medicine studies can provide imaging of the whole body and may be helpful when the clinical and conventional imaging workup findings are negative or equivocal in identifying a source of fever. Nuclear medicine studies can be used to detect pathologic changes early in a disease course, even in the absence of an anatomic abnormality. Gallium 67 scintigraphy, indium 111- and technetium 99m-labeled leukocyte scintigraphy, and fluorine 18 fluorodeoxyglucose positron emission tomography (PET)/CT studies are all useful in the evaluation of fever, but the radiopharmaceutical cost for PET/CT is much lower than that for radiolabeled leukocyte studies. The increased use of bundled payments for inpatient admissions requires updated cost evaluations for the preferred nuclear medicine study. For inpatients in whom the findings from the initial clinical workup and imaging studies are nondiagnostic, PET/CT examination may be preferable to radiolabeled leukocyte studies because of its high sensitivity and lower cost. Negative findings at PET/CT can be helpful in excluding a suspected site of infection, and positive findings at PET/CT can be helpful in confirming a suspected site of infection or in identifying an unexpected cause of fever. (©)RSNA, 2016. PMID:27399241

  13. Cardiac findings on non-gated chest computed tomography: A clinical and pictorial review.

    PubMed

    Kanza, Rene Epunza; Allard, Christian; Berube, Michel

    2016-02-01

    The use of chest computed tomography (CT) as an imaging test for the evaluation of thoracic pathology has significantly increased during the last four decades. Although cardiopulmonary diseases often overlap in their clinical manifestation, radiologists tend to overlook the heart while interpreting routine chest CT. Recent advances in CT technology have led to significant reduction of heart motion artefacts and now allow for the identification of several cardiac findings on chest CT even without electrocardiogram (ECG) gating. These observations range from simple curiosity to both benign and malignant discoveries, to life-threatening discoveries. We here present a clinical and radiologic review of common and less common cardiac findings discovered on non-gated chest CT in order to draw the attention of radiologists and referring physicians to these possibilities. PMID:26781150

  14. [CT diagnosis of coal workers' pneumoconiosis].

    PubMed

    Pan, J S

    1989-02-01

    In order to evaluate the usefulness of CT in CWP, 100 coal workers were examined with both chest radiograph and CT scan. Comparison was done, the result indicated that both modalities yielded similar sensitivity to simple CWP. The CT score of simple CWP correlated well with ILO classification and 1986 Chinese criteria for staging of pneumoconiosis, whereas in complicated CWP, the CT scan was significantly superior to chest radiograph. CT scan identified readily large opacities. It could detect large opacities in 40% of simple CWP diagnosed on the basis of chest radiograph. CT scan also identified more cavities and calcifications within large opacities. The CT attenuation values were less reliable. The authors were of the opinion that at present CT attenuation values is not recommended for routine evaluation of CWP. PMID:2758921

  15. Quick identification of acute chest pain patients study (QICS)

    PubMed Central

    Willemsen, Hendrik M; de Jong, Gonda; Tio, René A; Nieuwland, Wybe; Kema, Ido P; van der Horst, Iwan CC; Oudkerk, Mattijs; Zijlstra, Felix

    2009-01-01

    Background Patients with acute chest pain are often referred to the emergency ward and extensively investigated. Investigations are costly and could induce unnecessary complications, especially with invasive diagnostics. Nevertheless, chest pain patients have high mortalities. Fast identification of high-risk patients is crucial. Therefore several strategies have been developed including specific symptoms, signs, laboratory measurements, and imaging. Methods/Design The Quick Identification of acute Chest pain Study (QICS) will investigate whether a combined use of specific symptoms and signs, electrocardiography, routine and new laboratory measures, adjunctive imaging including electron beam (EBT) computed tomography (CT) and contrast multislice CT (MSCT) will have a high diagnostic yield for patients with acute chest pain. All patients will be investigated according a standardized protocol in the Emergency Department. Serum and plasma will be frozen for future analysis for a wide range of biomarkers at a later time point. The primary endpoint is the safe recognition of low-risk chest pain patients directly at presentation. Secondary endpoint is the identification of a wide range of sensitive predictive clinical markers, chemical biomarkers and radiological markers in acute chest pain patients. Chemical biomarkers will be compared to quantitative CT measurements of coronary atherosclerosis as a surrogate endpoint. Chemical biomarkers will also be compared in head to head comparison and for their additional value. Discussion This will be a very extensive investigation of a wide range of risk predictors in acute chest pain patients. New reliable fast and cheap diagnostic algorithm resulting from the test results might improve chest pain patients' prognosis, and reduce unnecessary costs and diagnostic complications. PMID:19527487

  16. Provider-Directed Imaging Stress Testing Reduces Health-Care Expenditures in Lower-Risk Chest Pain Patients Presenting to the Emergency Department

    PubMed Central

    Miller, Chadwick D.; Hoekstra, James W.; Lefebvre, Cedric; Blumstein, Howard; Hamilton, Craig A.; Harper, Erin N.; Mahler, Simon; Diercks, Deborah B.; Neiberg, Rebecca; Hundley, W. Gregory

    2012-01-01

    Background Among intermediate to high-risk patients with chest pain, we have shown that a cardiac magnetic resonance (CMR) stress-test strategy implemented in an observation unit (OU) reduces 1-year healthcare costs compared to inpatient care. In this study, we compare two OU strategies to determine among lower-risk patients if a mandatory CMR stress test strategy was more effective than a physicians’ ability to select a stress test modality. Methods and Results Upon ED arrival and referral to the OU for management of low to intermediate-risk chest pain, 120 individuals were randomized to receive an a) CMR stress imaging test (n=60), or b) a provider selected stress test (n=60: stress echo [62%], CMR (32%), cardiac catheterization (3%), nuclear (2%), and coronary CT [2%]). No differences were detected in length of stay (median CMR = 24.2 hours vs 23.8 hours, p=0.75), catheterization without revascularization (CMR=0% vs 3%), appropriateness of admission decisions (CMR 87% vs 93%, p=0.36), or 30-day ACS (both 3%). Median cost was higher among those randomized to the CMR mandated group ($2005 vs $1686, p<0.001). Conclusions In patients with lower-risk chest pain receiving ED-directed OU care, the ability of a physician to select a cardiac stress imaging modality (including echocardiography, CMR, or radionuclide testing) was more cost effective than a pathway that mandates a CMR stress test. Contrary to prior observations in individuals with intermediate to high-risk chest pain, in those with lower risk chest pain, these results highlight the importance of physician-related choices during ACS diagnostic protocols. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00869245. PMID:22128195

  17. Musculoskeletal chest wall pain

    PubMed Central

    Fam, Adel G.; Smythe, Hugh A.

    1985-01-01

    The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

  18. Salmonella typhimurium abscess of the chest wall

    PubMed Central

    Tonziello, Gilda; Valentinotti, Romina; Arbore, Enrico; Cassetti, Paolo; Luzzati, Roberto

    2013-01-01

    Patient: Male, 73 Final Diagnosis: Salmonella typhimurium abscess of the chest wall Symptoms: — Medication: Ciprofloxacin Clinical Procedure:— Specialty: Infectious Diseases Objective: Unusual clinical course Background: Non-typhoid Salmonella extra-intestinal infections usually develop in infants and in adult patients with pre-existing predisposing conditions. Blood stream infections and urinary tract infections are the most common clinical presentations, but other sites of infection may be involved as well. Case Report: We describe a case of invasive salmonellosis caused by Salmonella typhimurium involving the chest wall in a 73-year-old man. The patient had suffered from gastroenteritis followed by left basal pneumonia with pleural effusion 7 weeks before. The CT scan of the chest wall showed a pericostal abscess with shirt-stud morphology near the left last cartilaginous arch. The abscess was surgically drained and patient was cured after a 40-day ciprofloxacin treatment. Conclusions: A review of the literature on extra-intestinal non-typhoid salmonellosis shows that pleuropulmonary and soft-tissue infections are uncommon. We argue that non-typhoid Salmonella might be considered as a possible cause of chest wall abscess in individuals with recent history of gastroenteritis complicated by pneumonia and pleural effusion. PMID:24298305

  19. [Chest wall reconstruction after resection of malignant chest wall tumors].

    PubMed

    Ayabe, H; Oka, T; Akamine, S; Takahashi, T; Nagayasu, T

    1998-05-01

    Full-thickness chest wall resection is performed for complete removal of primary and secondary malignant chest wall tumors. Large defects of the chest wall after resection must be repaired to maintain adequate ventilation, to protect important intrathoracic structures, and to preserve cosmetic integrity. Various materials have been utilized over the years to replace the rigid chest wall. At present, Marlex mesh and a composite of Marlex mesh and methylmethacrylate are frequently used to reconstruct rigid chest wall defects. On the other hand, to replace the soft part of the chest wall and cover the rigid materials, pedicled muscle flaps, myocutaneous flaps, or omentum are used. Major pedicled flaps include the pectoralis major, rectus abdominis and latissimus dorsi muscular, and musculocutaneous flaps. Techniques are now available to repair any chest wall site, and to restore chest continuity in patients whose tumors are curatively resected. PMID:9656244

  20. Chest Pain (Beyond the Basics)

    MedlinePlus

    ... coronary arteries. Heart attack — A heart attack, or myocardial infarction (MI), occurs when the surface covering of a ... chest pain Criteria for the diagnosis of acute myocardial infarction Outpatient evaluation of the adult with chest pain ...

  1. Sonography of the Pediatric Chest.

    PubMed

    Goh, Yonggeng; Kapur, Jeevesh

    2016-05-01

    Traditionally, pediatric chest diseases are evaluated with chest radiography. Due to advancements in technology, the use of sonography has broadened. It has now become an established radiation-free imaging tool that may supplement plain-film findings and, in certain cases, the first-line modality for evaluation of the pediatric chest. This pictorial essay will demonstrate the diagnostic potential of sonography, review a spectrum of pediatric chest conditions, and discuss their imaging features and clinical importance. PMID:27009313

  2. Bone suppression technique for chest radiographs

    NASA Astrophysics Data System (ADS)

    Huo, Zhimin; Xu, Fan; Zhang, Jane; Zhao, Hui; Hobbs, Susan K.; Wandtke, John C.; Sykes, Anne-Marie; Paul, Narinder; Foos, David

    2014-03-01

    High-contrast bone structures are a major noise contributor in chest radiographic images. A signal of interest in a chest radiograph could be either partially or completely obscured or "overshadowed" by the highly contrasted bone structures in its surrounding. Thus, removing the bone structures, especially the posterior rib and clavicle structures, is highly desirable to increase the visibility of soft tissue density. We developed an innovative technology that offers a solution to suppress bone structures, including posterior ribs and clavicles, on conventional and portable chest X-ray images. The bone-suppression image processing technology includes five major steps: 1) lung segmentation, 2) rib and clavicle structure detection, 3) rib and clavicle edge detection, 4) rib and clavicle profile estimation, and 5) suppression based on the estimated profiles. The bone-suppression software outputs an image with both the rib and clavicle structures suppressed. The rib suppression performance was evaluated on 491 images. On average, 83.06% (±6.59%) of the rib structures on a standard chest image were suppressed based on the comparison of computer-identified rib areas against hand-drawn rib areas, which is equivalent to about an average of one rib that is still visible on a rib-suppressed image based on a visual assessment. Reader studies were performed to evaluate reader performance in detecting lung nodules and pneumothoraces with and without a bone-suppression companion view. Results from reader studies indicated that the bone-suppression technology significantly improved radiologists' performance in the detection of CT-confirmed possible nodules and pneumothoraces on chest radiographs. The results also showed that radiologists were more confident in making diagnoses regarding the presence or absence of an abnormality after rib-suppressed companion views were presented

  3. Spontaneous pneumomediastinum: an important differential in acute chest pain.

    PubMed

    Hogan, Francesca; McCullough, Chris; Rahman, Asif

    2014-01-01

    A 38-year-old man presented with pleuritic chest pain that was present on waking and localised to the left costal margin with no radiation. He was otherwise asymptomatic and denied preceding trauma, heavy lifting, coughing or recent vomiting. Observations and examination were unremarkable; however, a chest radiograph showed a pneumomediastinum. Spontaneous pneumomediastinum (SPM) is a rare condition that tends to follow a benign clinical course. A CT of the chest is generally only indicated if the chest X-ray fails to show an SPM in patients for whom there is a high index of clinical suspicion. A contrast-enhanced swallow study is only indicated if there is suspicion of an oesophageal tear or rupture. Evidence suggests that patients with SPM can be managed conservatively and observed for 24 h. PMID:25432910

  4. The Admissions Equity Struggle

    ERIC Educational Resources Information Center

    Freedman, Eric

    2012-01-01

    It has been a long, litigious road from Heman Sweatt, an African-American mail carrier who wanted to attend the prestigious, all-White law school at the University of Texas at Austin in 1946, to Abigail Fisher, a White high school student who failed to win undergraduate admission to the same university a half-century later. Depending on what the…

  5. Approach to Pediatric Chest Radiograph.

    PubMed

    Jana, Manisha; Bhalla, Ashu Seith; Gupta, Arun Kumar

    2016-06-01

    Chest radiograph remains the first line imaging modality even today, especially in ICU settings. Hence proper interpretation of chest radiographs is crucial, which can be achieved by adopting a systematic approach and proper description and identification of abnormalities. In this review, the authors describe a short and comprehensive way of interpreting the pediatric chest radiograph. PMID:26983619

  6. Pediatric digital chest imaging

    SciTech Connect

    Tarver, R.D.; Cohen, M.; Broderick, N.J.; Conces, D.J. Jr. )

    1990-01-01

    The Philips Computed Radiography system performs well with pediatric portable chest radiographs, handling the throughout of a busy intensive care service 24 hours a day. Images are excellent and routinely provide a conventional (unenhanced) image and an edge-enhanced image. Radiation dose is decreased by the lowered frequency of repeat examinations and the ability of the plates to respond to a much lower dose and still provide an adequate image. The high quality and uniform density of serial PCR portable radiographs greatly enhances diagnostic content of the films. Decreased resolution has not been a problem clinically. Image manipulation and electronic transfer to remote viewing stations appear to be helpful and are currently being evaluated further. The PCR system provides a marked improvement in pediatric portable chest radiology.

  7. Filters For Chest Radiography

    NASA Astrophysics Data System (ADS)

    Ramanathan, N.; Paron, J.

    1980-08-01

    The objective of low dose radiography is achieved by a judicious combination of proper kV selection, fast film-screen systems and beam filtration. A systematic study of filters was undertaken to evaluate the improvements that can be realized in terms of patient Entrance Skin Exposures (ESE) for chest radiographs. The Picker CD 135 Generator and the Automatic Chest Filmer with dynamic phototiming were used for the study. The kV dependence of ESE with various amounts of zinc and aluminum filtration is presented. The effect of filtration on image contrast is discussed. The variations of ESE with phantom thickness under different filtration conditions are also considered. It was found that the ESE can be reduced by as much as a factor of 1.8 ± .1 with no significant increase in tube loading.

  8. [Acute Chest Pain].

    PubMed

    Gmür, Christian

    2016-02-17

    Acute chest pain is a frequent consultation reason in general practice as well as in emergency departments. With the help of history, physical examination, ECG, laboratory and newly developed risk scores, potentially life-threatening diseases and high-risk patients may be detected and treated early, quickly and cost-effectively. New biomarkers and their combination with risk scores can increase the negative predictive value to exclude certain diseases. PMID:26886697

  9. FDG PET/CT in Hepatoid Adenocarcinoma of the Lung.

    PubMed

    Wang, Shouyang; Li, Mengxi; Chen, Huai; Li, Jianyu; Zeng, Qingsi

    2016-07-01

    A right upper lung mass was incidentally found on a chest radiograph in a routine health examination in a 56-year-old man. The mass showed mild heterogeneous enhancement on contrast chest CT images and intense FDG uptake on PET/CT images. Pathological examination demonstrated hepatoid adenocarcinoma in the lung. PMID:27124679

  10. Necrotizing Fasciitis of the Chest in a Neonate in Southern Nigeria

    PubMed Central

    Awe, Oluwafemi Olasupo; Kesieme, Emeka B.; Aigbonoga, Quinzy O.

    2014-01-01

    We discuss the successful saving of a male neonate with necrotizing fasciitis of the chest following a hot fomentation of the umbilicus with exposure of the ribs and the pleural space on the right side. He recovered 5 weeks after admission. We stressed the need to recognize necrotizing fasciitis extending from the upper anterior abdominal wall to the chest following hot fomentation of the umbilicus. The need for multidisciplinary cooperation for excellent outcome is very important, that is, neonatologist, medical microbiologist, and plastic and chest surgeons. PMID:25610690

  11. Multicentre chest computed tomography standardisation in children and adolescents with cystic fibrosis: the way forward.

    PubMed

    Kuo, Wieying; Kemner-van de Corput, Mariette P C; Perez-Rovira, Adria; de Bruijne, Marleen; Fajac, Isabelle; Tiddens, Harm A W M; van Straten, Marcel

    2016-06-01

    Progressive cystic fibrosis (CF) lung disease is the main cause of mortality in CF patients. CF lung disease starts in early childhood. With current standards of care, respiratory function remains largely normal in children and more sensitive outcome measures are needed to monitor early CF lung disease. Chest CT is currently the most sensitive imaging modality to monitor pulmonary structural changes in children and adolescents with CF. To quantify structural lung disease reliably among multiple centres, standardisation of chest CT protocols is needed. SCIFI CF (Standardised Chest Imaging Framework for Interventions and Personalised Medicine in CF) was founded to characterise chest CT image quality and radiation doses among 16 participating European CF centres in 10 different countries. We aimed to optimise CT protocols in children and adolescents among several CF centres. A large variety was found in CT protocols, image quality and radiation dose usage among the centres. However, the performance of all CT scanners was found to be very similar, when taking spatial resolution and radiation dose into account. We conclude that multicentre standardisation of chest CT in children and adolescents with CF can be achieved for future clinical trials. PMID:27076593

  12. [Development of a digital chest phantom for studies on energy subtraction techniques].

    PubMed

    Hayashi, Norio; Taniguchi, Anna; Noto, Kimiya; Shimosegawa, Masayuki; Ogura, Toshihiro; Doi, Kunio

    2014-03-01

    Digital chest phantoms continue to play a significant role in optimizing imaging parameters for chest X-ray examinations. The purpose of this study was to develop a digital chest phantom for studies on energy subtraction techniques under ideal conditions without image noise. Computed tomography (CT) images from the LIDC (Lung Image Database Consortium) were employed to develop a digital chest phantom. The method consisted of the following four steps: 1) segmentation of the lung and bone regions on CT images; 2) creation of simulated nodules; 3) transformation to attenuation coefficient maps from the segmented images; and 4) projection from attenuation coefficient maps. To evaluate the usefulness of digital chest phantoms, we determined the contrast of the simulated nodules in projection images of the digital chest phantom using high and low X-ray energies, soft tissue images obtained by energy subtraction, and "gold standard" images of the soft tissues. Using our method, the lung and bone regions were segmented on the original CT images. The contrast of simulated nodules in soft tissue images obtained by energy subtraction closely matched that obtained using the gold standard images. We thus conclude that it is possible to carry out simulation studies based on energy subtraction techniques using the created digital chest phantoms. Our method is potentially useful for performing simulation studies for optimizing the imaging parameters in chest X-ray examinations. PMID:24647055

  13. Acute myocardial infarction due to left anterior descending coronary artery dissection after blunt chest trauma.

    PubMed

    Oghlakian, Gerard; Maldjian, Pierre; Kaluski, Edo; Saric, Muhamed

    2010-03-01

    Cardiac complications of chest trauma range from arrhythmias to valvular avulsions to myocardial contusion, rupture, and rarely myocardial infarction. We describe a case of a young patient with blunt chest trauma after a motor vehicle accident in whom the diagnosis of myocardial infarction was established a week later because no electrocardiogram or cardiac biomarkers were obtained on presentation. Retrospective review of contrast-enhanced computed tomography (CT) of the chest done on presentation demonstrated a perfusion defect in the distribution of the left anterior descending artery (LAD). Subsequent coronary angiography demonstrated dissection in the proximal LAD. Our case illustrates the importance of electrocardiography and contrast-enhanced chest CT in initial evaluation of patients with blunt chest trauma and suspected injury to the coronary arteries. PMID:19214607

  14. Catastrophic chest pain: blinded by cardiopulmonary disease.

    PubMed

    Barreiro, Timothy John; Asiimwe, Denis D; Gemmel, David; Brine, Patrick

    2015-01-01

    A 53-year-old man with a history of diabetic foot ulcer, osteomyelitis, coronary artery disease, hypertension and hyperlipidaemia, presented with chest pain of 3 weeks duration. Eleven days earlier, the patient had had a drug-eluting stent (DES) placed in a branch of the right coronary artery (RCA) after similar chest pain, leading to the findings of a positive nuclear stress test. Since discharge, he was not compliant with taking clopidegrel (Plavix), a concern for in-stent thrombosis with recurrent myocardial ischaemia; but work up was negative and medications were restarted. Within 24 h of admission, he developed bilateral flaccid leg weakness, urine retention and loss of sensation from the umbilicus level down. MRI revealed a T4-T6 epidural abscess. Emergent decompression laminectomy and abscess drainage was completed. Neurological symptoms improved hours after surgery with complete resolution of sensory deficits. Cultures grew Streptococcus sp., treated with intravenous nafcillin for 8 weeks. He regained leg strength with continued improvement seen in rehabilitation. PMID:26135489

  15. Chest pain prevalence, causes, and disposition in the emergency department of a regional hospital in Pretoria

    PubMed Central

    2016-01-01

    Background Chest pain is a common clinical syndrome. However, there is a paucity of African studies describing the causes, prevalence, aetiology, and disposition of patients with chest pain presenting in the emergency department (ED). Aim The aim of this retrospective descriptive study was to determine the prevalence, causes, demographics, and disposition of all adult patients with the main complaint of chest pain presenting at the ED of a regional hospital in South Africa. Methods Records of all patients 18 years and older presenting with the complaint of chest pain from 1 December 2011 through 10 April 2012 were assessed. A data collection sheet capturing patient demographics and disposition from the ED was used. The diagnosis was subdivided into groups: cardiovascular, respiratory, gastrointestinal, musculoskeletal, psychiatric/psychogenic, other, and unknown. Results Of the 312 patients presenting with chest pain, 210 patient files were retrieved. The prevalence of non-traumatic chest pain was 1.66%. Respiratory disease was the most common cause (36.19%), with pneumonia the most common diagnosis (24.40%). Logistic regression showed diagnoses of acute cardiovascular disease or respiratory disease, older age, and transport by ambulance as being associated with admission. Conclusion The main cause of acute chest pain was found to be respiratory disease, followed by musculoskeletal disorders. In the African context, the aetiology of acute chest pain differs from that in first world countries. Health workers should therefore pay special attention to respiratory conditions during diagnosis and management in African patients with acute chest pain. PMID:27380782

  16. Dual-energy CT imaging of thoracic malignancies

    PubMed Central

    Zhang, Long Jiang; Yang, Gui Fen; Wu, Sheng Yong; Lu, Guang Ming; Schoepf, U. Joseph

    2013-01-01

    Abstract Computed tomography (CT) plays a pivotal role in the detection, characterization, and staging of lung cancer and other thoracic malignancies. Since the introduction of clinically viable dual-energy CT techniques, substantial evidence has accumulated on the use of this modality for imaging chest malignancies. This article describes the principles of dual-energy CT along with suitable image acquisition, reconstruction, and postprocessing strategies for oncologic applications in the chest. The potential of dual-energy CT techniques for the detection, characterization, staging, and surveillance of chest malignancy, as well as the limitations of this modality are discussed. PMID:23470989

  17. Comparison of Computed Tomography and Chest Radiography in the Detection of Rib Fractures in Abused Infants

    ERIC Educational Resources Information Center

    Wootton-Gorges, Sandra L.; Stein-Wexler, Rebecca; Walton, John W.; Rosas, Angela J.; Coulter, Kevin P.; Rogers, Kristen K.

    2008-01-01

    Purpose: Chest radiographs (CXR) are the standard method for evaluating rib fractures in abused infants. Computed tomography (CT) is a sensitive method to detect rib fractures. The purpose of this study was to compare CT and CXR in the evaluation of rib fractures in abused infants. Methods: This retrospective study included all 12 abused infants…

  18. Chest pain units: A necessity or only a name to encourage patients

    PubMed Central

    Reza Assareh, Ahmad; Azadi, Nasim; Tahmasebi, Safar Ali; Sahraei, Tooba; Dabbagh, Razieh; Hajizadeh, Ebrahim; Mahdavi, Kamran; Heydari, Ali; Alasti, Mohammad

    2012-01-01

    BACKGROUND Acute chest pain is a common symptom among patients presenting to emergency wards. Identification and admission of patients with real acute coronary syndrome and preventing the hospitalization of people with false diagnosis of coronary syndrome are the most important tasks in emergency wards. The purpose of this study was to investigate the usefulness of designing a special chest pain unit in emergency department of Imam Khomeini Hospital (Ahvaz, Iran). METHODS The patients with markers of ongoing cardiac ischemia underwent selective coronary angiography. The chest pain unit protocol was applied to selected patients with no definite evidence of acute coronary syndrome or alternative pathology. The protocol consisted of twelve hours of observation and serial 12-lead electrocardiography, transthoracic echocardiography, and biochemical testing followed by an exercise treadmill test. We compared the number of patients who were discharged after work up, discharged themselves against medical advice, admitted at coronary care unit (CCU), underwent invasive procedures or died between 2007 and 2010. RESULTS During 2010, 43% of patients were discharged after evaluation in the chest pain unit. In 2007 however, 26% were discharged following traditional assessments. The admission rate increased from 23% in 2007 to 36% in 2010. The percentage of patients who discharged themselves against medical advice decreased from 37% in 2007 to 14% in 2010. There was not a statistically significant difference between mortality rates in 2007 and 2010. CONCLUSION Providing a special chest pain unit in emergency ward in our condition is helpful. It reduces unnecessary admissions and improves patient satisfaction. PMID:23359791

  19. [Optimization of the chest computed tomography scan by varying the position of the arms].

    PubMed

    Matsumoto, Yoriaki; Masuda, Takanori; Imada, Naoyuki; Maruyama, Naoya; Inada, Satoshi; Ishibashi, Tooru; Satou, Tomoyasu

    2012-01-01

    Computed tomography automatic exposure control (CT-AEC) technique is calculated from a localizer radiograph. When we perform neck and chest CT examination, at first, we acquire localizer radiograph and neck images by placing the arm in a lowered position. Next, the arm is raised for the chest scan. Therefore, the localizer radiograph and subject information are different in the chest scan. In this situation, the chest scan with the use of the CT-AEC causes radiation over-dose. The purpose of this study is to optimize the CT-AEC by controlling noise index (NI), and make a chest CT scan condition considering the position of the arms. We measured the image noise (SD) in the phantom by using CT-AEC. In addition, dose length product (DLP) was recorded. Moreover, we examined the correlation with the clinical images. The results of our experiments show that radiation dose can be reduced with the image quality kept by controlling NI. PMID:22821158

  20. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET: Is CT thorax necessary to exclude significant injury in paediatric patients with blunt chest trauma?

    PubMed

    de la Morandiere, Katherine

    2015-08-01

    A shortcut review was carried out to establish if CXR had sufficient sensitivity to rule out significant thoracic injury in haemodynamically stable, paediatric patients with a significant mechanism of trauma. No studies were found that directly answered the three-part question, but 13 studies were found which were considered relevant. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that important thoracic injuries may not be clinically apparent and that CT scans have a significantly higher sensitivity than CXR in detecting such injuries. PMID:26195475

  1. System for definition of the central-chest vasculature

    NASA Astrophysics Data System (ADS)

    Taeprasartsit, Pinyo; Higgins, William E.

    2009-02-01

    Accurate definition of the central-chest vasculature from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. For instance, the aorta and pulmonary artery help in automatic definition of the Mountain lymph-node stations for lung-cancer staging. This work presents a system for defining major vascular structures in the central chest. The system provides automatic methods for extracting the aorta and pulmonary artery and semi-automatic methods for extracting the other major central chest arteries/veins, such as the superior vena cava and azygos vein. Automatic aorta and pulmonary artery extraction are performed by model fitting and selection. The system also extracts certain vascular structure information to validate outputs. A semi-automatic method extracts vasculature by finding the medial axes between provided important sites. Results of the system are applied to lymph-node station definition and guidance of bronchoscopic biopsy.

  2. Pain in the chest in a user of cocaine

    SciTech Connect

    Wiener, M.D.; Putnam, C.E.

    1987-10-16

    A 21-year-old man presented with pleuritic substernal chest pain of one hour's duration. The pain was exacerbated in a supine position and did not radiate. Questioning revealed that he was a recreational user of cocaine and had inhaled free-based cocaine via a pipe the previous evening and as recently as two hours before admission to the hospital. Physical examination demonstrated an anxious young man with a respiratory rate of 26 breaths per minute and shallow. He was afebrile with normal heart rate and blood pressure. His sternum was tender to palpation, and auscultation revealed precordial crepitus synchronous with systole. His electrocardiogram showed sinus rhythm at a rate of 62 beats per minute. Posteroanterior and lateral roentgenograms of the chest were obtained. A diagnosis of spontaneous pneumomediastinum was made.

  3. Lung cancer detection with digital chest tomosynthesis: first round results from the SOS observational study

    PubMed Central

    Viti, Andrea; Tavella, Chiara; Priotto, Roberto; Ghirardo, Donatella; Grosso, Maurizio; Terzi, Alberto

    2015-01-01

    Objective Baseline results of the Studio OSservazionale (SOS), observational study, a single-arm observational study of digital chest tomosynthesis for lung cancer detection in an at-risk population demonstrated a detection rate of lung cancer comparable to that of studies that used low dose CT scan (LDCT). We present the results of the first round. Methods Totally 1,703 out of 1,843 (92%) subjects who had a baseline digital chest tomosynthesis underwent a first round reevaluation after 1 year. Results At first round chest digital tomosynthesis, 13 (0.7%) subjects had an indeterminate nodule larger than 5 mm and underwent low-dose CT scan for nodule confirmation. PET/CT study was obtained in 10 (0.5%) subjects and 2 subjects had a low-dose CT follow up. Surgery, either video-assisted thoracoscopic or open surgery for indeterminate pulmonary nodules was performed in 10 (0.2%) subjects. A lung cancer was diagnosed and resected in five patients. The lung cancer detection rate at first round was 0.3% (5/1,703). Conclusions The detection rate of lung cancer at first round for tomosynthesis is comparable to rates reported for CT. In addition, results of first round digital chest tomosynthesis confirm chest tomosynthesis as a possible first-line lung cancer-screening tool. PMID:25992366

  4. Issues in College Admissions Testing.

    ERIC Educational Resources Information Center

    Noble, Julie P.; Camara, Wayne J.

    College admissions tests provide a standardized and objective measure of student achievement and generalized skills. Unlike high school grades or rank, admission tests are a common measure for comparing students who have attended different high schools, completed different courses, received different grades in courses taught by different teachers,…

  5. The Changing College Admissions Scene.

    ERIC Educational Resources Information Center

    Sjogren, Cliff

    1983-01-01

    Discusses the status of college admissions and some of the forces that influenced college admissions policies during each of four three-year periods: the Sputnik Era (1957-60), the Postwar Baby Boom Era (1964-67), the "New Groups" Era (1971-74), and the Stable Enrollment Era (1978-81). (PGD)

  6. Toward More Effective Admissions Interviews.

    ERIC Educational Resources Information Center

    Maly, Nancy J.

    1983-01-01

    Suggests ways to improve college admissions interviews. Discusses the purpose, format, technique, and content, of the interview as well as selling the college, concluding the interview, and writing the final interview report. Emphasizes the benefits of good interviewing skills to admissions officers. (WAS)

  7. Imaging of Chest and Abdominal Trauma in Children.

    PubMed

    Goodwin, Susie J; Flanagan, Sean G; McDonald, Kirsteen

    2015-01-01

    Trauma is the commonest cause of death in children over a year old. The injuries sustained and management of these children differs to adults, due to differences in anatomy and physiology. Careful thought must also be given to exposing children to radiation, and CT scans should be performed only in select patients. This article reviews these important points and explains the imaging findings in chest and abdominal trauma. PMID:26219741

  8. [An asylum seeker with an abnormal chest X-ray].

    PubMed

    Akkerman, Onno W; Rook, Mieneke; van der Werf, Tjip S

    2016-01-01

    A 29-year-old pregnant woman from Syria was screened for tuberculosis upon arrival in the Netherlands. The chest X-ray showed a smooth sharply demarcated mass in her left upper lobe. A low-dose CT showed that the mass was lobulated and surrounded by a hyperlucent pulmonary segment. To protect the foetus from further exposure to radiation, an MRI was performed, which confirmed bronchial atresia with a mucocele of the distal bronchus. PMID:27096483

  9. Chest pain in lupus patients: the emergency department experience.

    PubMed

    Modi, Masoom; Ishimori, Mariko L; Sandhu, Vaneet K; Wallace, Daniel J; Weisman, Michael H

    2015-11-01

    Heart disease, a major cause of morbidity and mortality in SLE patients, often manifests as chest pain (CP). Our goal was to understand the prevalence and outcome of CP presentations for SLE patients in the emergency department (ED). Billing records of patients who presented to Cedars-Sinai Medical Center ED with ICD-9 codes for SLE and secondary ICD-9 codes for CP (786.50-786.59) between March 2009 and October 2013 were reviewed. Two study groups were formed: discharge from ED versus hospital admission. Visits were evaluated for basic cardiac work-up with an electrocardiogram (EKG) and cardiac enzymes; hospital admissions were evaluated for CP etiology and discharge diagnoses. Of 2675 ED visits with ICD-9 codes for SLE, 397 visits had secondary codes for CP (15%); 173 were discharged and 224 became hospital admissions. While 92% of admissions had basic cardiac work-up, over 50% had chest pain attributed to non-cardiac causes. Only 7.2% had a discharge diagnosis related to cardiovascular disease. Fifteen percent of all SLE coded patients had complaints of CP, a figure higher than the national average for non-SLE CP (10%). There is a majority of non-cardiac diagnoses given to SLE patients at discharge. CP is likely to be a window of opportunity to address the known cardiac morbidity and mortality in SLE patients perhaps at an early stage of development of this complication. Our study strengthens the need for more investigations to assess the etiology of CP in this population. PMID:25912215

  10. Cardiac computed tomography in patients with acute chest pain.

    PubMed

    Nieman, Koen; Hoffmann, Udo

    2015-04-14

    The efficient and reliable evaluation of patients with acute chest pain is one of the most challenging tasks in the emergency department. Coronary computed tomography (CT) angiography may play a major role, since it permits ruling out coronary artery disease with high accuracy if performed with expertise in properly selected and prepared patients. Several randomized trials have established early cardiac CT as a viable safe and potentially more efficient alternative to functional testing in the evaluation of acute chest pain. Ongoing investigations explore whether advanced anatomic and functional assessments such as high-risk coronary plaque, resting myocardial perfusion, and left ventricular function, or the simulation of the fractional coronary flow reserve will add information to the anatomic assessment for stenosis, which would allow expanding the benefits of cardiac CT from triage to treatment decisions. Especially, the combination of high-sensitive troponins and coronary computed tomography angiography may play a valuable role in future strategies for the management of patients presenting with acute chest pain. PMID:25687351

  11. Male chest enhancement: pectoral implants.

    PubMed

    Benito-Ruiz, J; Raigosa, J M; Manzano-Surroca, M; Salvador, L

    2008-01-01

    The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries. PMID:17676376

  12. Chest tuberculosis: Radiological review and imaging recommendations

    PubMed Central

    Bhalla, Ashu Seith; Goyal, Ankur; Guleria, Randeep; Gupta, Arun Kumar

    2015-01-01

    Chest tuberculosis (CTB) is a widespread problem, especially in our country where it is one of the leading causes of mortality. The article reviews the imaging findings in CTB on various modalities. We also attempt to categorize the findings into those definitive for active TB, indeterminate for disease activity, and those indicating healed TB. Though various radiological modalities are widely used in evaluation of such patients, no imaging guidelines exist for the use of these modalities in diagnosis and follow-up. Consequently, imaging is not optimally utilized and patients are often unnecessarily subjected to repeated CT examinations, which is undesirable. Based on the available literature and our experience, we propose certain recommendations delineating the role of imaging in the diagnosis and follow-up of such patients. The authors recognize that this is an evolving field and there may be future revisions depending on emergence of new evidence. PMID:26288514

  13. Modern CT applications in veterinary medicine.

    PubMed

    Garland, Melissa R; Lawler, Leo P; Whitaker, Brent R; Walker, Ian D F; Corl, Frank M; Fishman, Elliot K

    2002-01-01

    Although computed tomography (CT) is used primarily for diagnosis in humans, it can also be used to diagnose disease in veterinary patients. CT and associated three-dimensional reconstruction have a role in diagnosis of a range of illnesses in a variety of animals. In a sea turtle with failure to thrive, CT showed a nodal mass in the chest, granulomas in the lungs, and a ball in the stomach. CT of a sea dragon with balance and movement problems showed absence of the swim bladder. In a sloth with failure to thrive, CT allowed diagnosis of a coin in the intestine. CT of a puffin with failure to thrive showed a mass in the chest, which was found to be a hematoma. In a smooth-sided toad whose head was tilted to one side and who was circling in that direction, CT showed partial destruction of the temporal bone. CT of a domestic cat with listlessness showed a mass with focal calcification, which proved to be a leiomyosarcoma. CT of a sea otter showed pectus excavatum, which is caused by the animal smashing oysters against its chest. In a Japanese koi with abdominal swelling, CT allowed diagnosis of a hepatoma. PMID:11796898

  14. Chest drainage systems in use.

    PubMed

    Zisis, Charalambos; Tsirgogianni, Katerina; Lazaridis, George; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos; Zarogoulidis, Paul

    2015-03-01

    A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air in the case of pneumothorax or fluid such as in the case of pleural effusion, blood, chyle, or pus when empyema occurs from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter. Insertion of chest tubes is widely performed by radiologists, pulmonary physicians and thoracic surgeons. Large catheters or small catheters are used based on each situation that the medical doctor encounters. In the current review we will focus on the chest drain systems that are in use. PMID:25815304

  15. Chest drainage systems in use

    PubMed Central

    Zisis, Charalambos; Tsirgogianni, Katerina; Lazaridis, George; Lampaki, Sofia; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Karapantzos, Ilias; Karapantzou, Chrysanthi; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

    2015-01-01

    A chest tube is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum. It is used to remove air in the case of pneumothorax or fluid such as in the case of pleural effusion, blood, chyle, or pus when empyema occurs from the intrathoracic space. It is also known as a Bülau drain or an intercostal catheter. Insertion of chest tubes is widely performed by radiologists, pulmonary physicians and thoracic surgeons. Large catheters or small catheters are used based on each situation that the medical doctor encounters. In the current review we will focus on the chest drain systems that are in use. PMID:25815304

  16. AN ANALYSIS OF THE POTENTIAL ROLE OF CHEST TOMOSYNTHESIS IN OPTIMISING IMAGING RESOURCES IN THORACIC RADIOLOGY

    PubMed Central

    Petersson, Cecilia; Båth, Magnus; Vikgren, Jenny; Johnsson, Åse Allansdotter

    2016-01-01

    The aim of the study was to investigate the potential role of chest tomosynthesis (CTS) at a tertiary referral centre by exploring to what extent CTS could substitute chest radiography (CXR) and computed tomography (CT). The study comprised 1433 CXR, 523 CT and 216 CTS examinations performed 5 years after the introduction of CTS. For each examination, it was decided if CTS would have been appropriate instead of CXR (CXR cases), if CTS could have replaced the performed CT (CT cases) or if CT would have been performed had CTS not been available (CTS cases). It was judged that (a) CTS had been appropriate in 15 % of the CXR examinations, (b) CTS could have replaced additionally 7 % of the CT examinations and (c) CT would have been carried out in 63 % of the performed CTS examinations, had CTS not been available. In conclusion, the potential role for CTS to substitute other modalities during office hours at a tertiary referral centre may be in the order of 20 and 25 % of performed CXR and chest CT, respectively. PMID:26979807

  17. AN ANALYSIS OF THE POTENTIAL ROLE OF CHEST TOMOSYNTHESIS IN OPTIMISING IMAGING RESOURCES IN THORACIC RADIOLOGY.

    PubMed

    Petersson, Cecilia; Båth, Magnus; Vikgren, Jenny; Johnsson, Åse Allansdotter

    2016-06-01

    The aim of the study was to investigate the potential role of chest tomosynthesis (CTS) at a tertiary referral centre by exploring to what extent CTS could substitute chest radiography (CXR) and computed tomography (CT). The study comprised 1433 CXR, 523 CT and 216 CTS examinations performed 5 years after the introduction of CTS. For each examination, it was decided if CTS would have been appropriate instead of CXR (CXR cases), if CTS could have replaced the performed CT (CT cases) or if CT would have been performed had CTS not been available (CTS cases). It was judged that (a) CTS had been appropriate in 15 % of the CXR examinations, (b) CTS could have replaced additionally 7 % of the CT examinations and (c) CT would have been carried out in 63 % of the performed CTS examinations, had CTS not been available. In conclusion, the potential role for CTS to substitute other modalities during office hours at a tertiary referral centre may be in the order of 20 and 25 % of performed CXR and chest CT, respectively. PMID:26979807

  18. A national survey of emergency department chest pain centers in the United States.

    PubMed

    Zalenski, R J; Rydman, R J; Ting, S; Kampe, L; Selker, H P

    1998-06-01

    Although chest pain centers are promoted as improving emergency cardiac care, no data exist on their structure and processes. This national study determines the 1995 prevalence rate for emergency department (ED)-based chest pain centers in the United States and compares organizational differences of EDs with and without such centers. A mail survey was directed to 476 EDs randomly selected from the American Hospital Association's database of metropolitan hospitals (n = 2,309); the response rate was 63%. The prevalence of chest pain centers was 22.5% (95% confidence interval 18% to 27%), which yielded a projection of 520 centers in the United States in 1995. EDs with centers had higher overall patient volumes, greater use of high-technology testing, lower treatment times for thrombolytic therapy, and more advertising (all p <0.05). Hospitals with centers had greater market competition and more beds per annual admissions, cardiac catheterization, and open heart surgery capability (all p <0.05). Logistic regression identified open heart surgery, high-admission volumes, and nonprofit status as independent predictors of hospitals having chest pain centers. Thus, chest pain centers have a moderate prevalence, offer more services and marketing efforts than standard EDs, and tend to be hosted by large nonprofit hospitals. PMID:9631967

  19. Differential Freshman Admission by Sex

    ERIC Educational Resources Information Center

    Suddick, David E.; McBee, M. Louise

    1974-01-01

    The authors report on a study whose purpose was to determine if, after adjusting for initial differences in high school averages and SAT scores via separate regression equations, differential admissions criterion by sex is justifiable. No justification is found. (RP)

  20. ED navigators prevent unnecessary admissions.

    PubMed

    2012-02-01

    RN Navigators in the emergency department at Montefiore Medical Center work with social workers to prevent unnecessary admissions. Program targets the homeless and patients with tenuous living situations. CMs work with the emergency department staff to identify patients who don't meet admission criteria but can't be safely discharged. The hospital collaborates with a local housing assistance agency which sends a van to transport appropriate patients to a shelter. PMID:22299178

  1. Patient doses from CT examinations in Turkey

    PubMed Central

    Ataç, Gökçe Kaan; Parmaksız, Aydın; İnal, Tolga; Bulur, Emine; Bulgurlu, Figen; Öncü, Tolga; Gündoğdu, Sadi

    2015-01-01

    PURPOSE We aimed to establish the first diagnostic reference levels (DRLs) for computed tomography (CT) examinations in adult and pediatric patients in Turkey and compare these with international DRLs. METHODS CT performance information and examination parameters (for head, chest, high-resolution CT of the chest [HRCT-chest], abdominal, and pelvic protocols) from 1607 hospitals were collected via a survey. Dose length products and effective doses for standard patient sizes were calculated from the reported volume CT dose index (CTDIvol). RESULTS The median number of protocols reported from the 167 responding hospitals (10% response rate) was 102 across five different age groups. Third quartile CTDIvol values for adult pelvic and all pediatric body protocols were higher than the European Commission standards but were comparable to studies conducted in other countries. CONCLUSION The radiation dose indicators for adult patients were similar to those reported in the literature, except for those associated with head protocols. CT protocol optimization is necessary for adult head and pediatric chest, HRCT-chest, abdominal, and pelvic protocols. The findings from this study are recommended for use as national DRLs in Turkey. PMID:26133189

  2. [Castleman's Disease of the Chest Wall Successfully Resected by Thoracoscopic Surgery;Report of a Case].

    PubMed

    Naomi, Akira; Kuroda, Hiroaki; Seto, Katsutoshi; Iiduka, Shuhei; Dejima, Hitoshi; Mizuno, Tetsuya; Sakakura, Noriaki; Sakao, Yukinori

    2015-12-01

    A 61-year-old woman without a significant past medical history was pointed out the abnormal shadow on the annual medical checkup. Chest computed tomography (CT) revealed a well-defined paravertebral chest wall tumor of 20 mm in maxmum size. Furthermore, diffusion weighted image on magnetic resonance imaging (MRI) showed high intensity, and standardized uptake value (SUV) max on positron emission tomography/computed tomography (PET/CT) was 13.4. Schwanoma, solitary fibrous tumor (SFT) or malignant lymphoma was suggested. Complete resection was performed with thoracoscopic surgery. The histological diagnosis was Castleman's disease with hyalineized type. PMID:26759958

  3. 44 CFR 68.9 - Admissible evidence.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Admissible evidence. 68.9 Section 68.9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF... admissible. (b) Documentary and oral evidence shall be admissible. (c) Admissibility of non-expert...

  4. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 618.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in admission, by...

  5. Assessment of the chest wall thickness of the lawrence livermore torso phantom using a voxel image.

    PubMed

    Ahmed, A S M Sabbir; Capello, Kevin; Kramer, Gary H

    2011-06-01

    This paper describes the methodology of measuring the chest wall thickness using the voxel image of the Lawrence Livermore National Lab (LLNL) torso phantom. The LLNL phantom is used as a standard to calibrate a lung counter consisting of a 2 × 2 array of germanium detectors. In general, an average thickness estimated from four counting positions is used as the chest wall thickness for a given overlay plate. For a given overlay, the outer chest surface differs from that of inner one, and the chest wall thickness varies from one position to other. The LLNL phantom with chest plate and C4 overlay plate installed was scanned with a CT (computed tomography) scanner. The image data, collected in DICOM (Digital Imaging and Communication) format, were converted to the MCNP input file by using the Scan2Mcnp program. The MCNP file was visualized and analyzed with the Moritz visual editor. An analytic expression was formulated and solved to calculate the chest wall thickness by using the point detector responses (F 5 tally of MCNP). To map the chest thickness, the entire chest wall was meshed into virtual grids of 1 cm width. A source and detector pair was moved along the inner and outer surface of the chest wall from right to left at different heights from neck to abdomen. For each height (z(k)), (x(i), y(j)) coordinates for the detector source pair were calculated from the visual editor and were scaled on-screen. For each (x(i), y(j), z(k)) position, a mesh thickness was measured from on-screen measurement and by solving the detector responses. The chest wall thicknesses at different positions on the outer surface of the chest were compared and verified using two methods. PMID:22004927

  6. Supporting the early use of echocardiography in blunt chest trauma

    PubMed Central

    2012-01-01

    This case reports a very unusual mechanism of cardiac rupture following an episode of multiple blunt chest trauma. The patient, a professional jockey, was trampled by horses, and although shocked on hospital admission, he did not present with signs and symptoms that were consistent with cardiogenic shock. This case highlights the difficult and subjective nature of clinical examination in emergency situations when dealing with cases of acute cardiac tamponade. It further emphasises the lack of sensitivity of traditional trauma imaging and investigative approaches such as the standard anteroposterior chest X-ray and electrocardiogram. The diagnosis of acute cardiac tamponade was not made until tertiary-care-centre arrival, when ultrasound technology in the form of bedside echocardiography was used, facilitating emergency surgery to repair a ruptured left ventricle. It is hoped that the sharing of this case will alert fellow clinicians to this uncommon but possible mechanism of cardiac rupture and subsequent tamponade, encourage the early use of echocardiography at the bedside in hypotensive blunt chest trauma cases and reinforce the principles of the Advanced Trauma Life Support course in treating trauma victims. PMID:22870886

  7. Initial clinical evaluation of stationary digital chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Hartman, Allison E.; Shan, Jing; Wu, Gongting; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping; Heath, Michael; Wang, Xiaohui; Foos, David

    2016-03-01

    Computed Tomography (CT) is the gold standard for image evaluation of lung disease, including lung cancer and cystic fibrosis. It provides detailed information of the lung anatomy and lesions, but at a relatively high cost and high dose of radiation. Chest radiography is a low dose imaging modality but it has low sensitivity. Digital chest tomosynthesis (DCT) is an imaging modality that produces 3D images by collecting x-ray projection images over a limited angle. DCT is less expensive than CT and requires about 1/10th the dose of radiation. Commercial DCT systems acquire the projection images by mechanically scanning an x-ray tube. The movement of the tube head limits acquisition speed. We recently demonstrated the feasibility of stationary digital chest tomosynthesis (s-DCT) using a carbon nanotube (CNT) x-ray source array in benchtop phantom studies. The stationary x-ray source allows for fast image acquisition. The objective of this study is to demonstrate the feasibility of s-DCT for patient imaging. We have successfully imaged 31 patients. Preliminary evaluation by board certified radiologists suggests good depiction of thoracic anatomy and pathology.

  8. [Chest ultrasonography in pleurapulmonary disease].

    PubMed

    Gallego Gómez, M P; García Benedito, P; Pereira Boo, D; Sánchez Pérez, M

    2014-01-01

    Although the initial diagnosis and follow-up of pleuropulmonary disease are normally done with plain chest films and the gold standard for chest disease is computed tomography, diverse studies have established the usefulness of chest ultrasonography in the diagnosis of different pleuropulmonary diseases like pleural effusion and lung consolidation, among others. In this article, we show the different ultrasonographic patterns for pleuropulmonary disease. The availability of ultrasonography in different areas (ICU, recovery areas) makes this technique especially important for critical patients because it obviates the need to transfer the patient. Moreover, ultrasonography is noninvasive and easy to repeat. On the other hand, it enables the direct visualization of pleuropulmonary disease that is necessary for interventional procedures. PMID:22819690

  9. Coronary vasospasm during CT angiography.

    PubMed

    Nakahara, Takehiro; Toyama, Takuji; Tsushima, Yoshito; Kurabayashi, Masahiko

    2014-01-01

    A 71-year-old man, a heavy smoker, was admitted for evaluation of "chest oppression" after every dinner. Cardiac CT with a beta-blocker showed coronary stenosis in the left circumflex. Although adenosine triphosphate-stress perfusion single-photon emission CT revealed no ischemia, Holter electrocardiography belatedly indicated an ST elevation associated with his symptoms while smoking. He was diagnosed to have vasospastic angina. Cardiac CT without a beta-blocker showed thin diffuse plaque and negative remolding without any significant stenosis at the same site. Asian patients have a tendency to develop vasospastic angina. Although beta-blockers are recommended for cardiac CT, the routine administration of beta-blockers in cardiac CT may have some risk for such cases. PMID:25065860

  10. Chest pain syndromes in pregnancy.

    PubMed

    Sahni, Gagan

    2012-08-01

    Chest pain syndromes in pregnancy include numerous catastrophic cardiovascular events. Acute myocardial infarction, aortic dissection, pulmonary embolism, and amniotic fluid embolism are the most important causes of nonobstetric mortality and morbidity in pregnancy. Each of these could result in poor maternal and fetal outcomes if not diagnosed and treated in a timely fashion. However, their diagnosis and management is limited by fetal risks of diagnostic procedures, dangers of pharmacotherapy and interventions that have neither been widely studied nor validated. This article reviews the current literature on epidemiology, risk factors, pathogenesis, diagnosis, and management of 4 potentially lethal chest pain syndromes in pregnancy. PMID:22813362

  11. Contemporary management of flail chest.

    PubMed

    Vana, P Geoff; Neubauer, Daniel C; Luchette, Fred A

    2014-06-01

    Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management. PMID:24887787

  12. Admission, Heal Thyself: A Prescription for Reclaiming College Admission as a Profession

    ERIC Educational Resources Information Center

    Jump, Jim

    2004-01-01

    Is college admission a business or a profession? This question is timeless because no issue (with possible exception of the perennial debate about whether admission(s) is singular or plural) sparks as much passion among admission practitioners, and it is timely because many of the controversial issues found in college admission today beg the…

  13. Thoracic textilomas: CT findings*

    PubMed Central

    Machado, Dianne Melo; Zanetti, Gláucia; Araujo, Cesar Augusto; Nobre, Luiz Felipe; Meirelles, Gustavo de Souza Portes; Pereira e Silva, Jorge Luiz; Guimarães, Marcos Duarte; Escuissato, Dante Luiz; Souza, Arthur Soares; Hochhegger, Bruno; Marchiori, Edson

    2014-01-01

    OBJECTIVE: The aim of this study was to analyze chest CT scans of patients with thoracic textiloma. METHODS: This was a retrospective study of 16 patients (11 men and 5 women) with surgically confirmed thoracic textiloma. The chest CT scans of those patients were evaluated by two independent observers, and discordant results were resolved by consensus. RESULTS: The majority (62.5%) of the textilomas were caused by previous heart surgery. The most common symptoms were chest pain (in 68.75%) and cough (in 56.25%). In all cases, the main tomographic finding was a mass with regular contours and borders that were well-defined or partially defined. Half of the textilomas occurred in the right hemithorax and half occurred in the left. The majority (56.25%) were located in the lower third of the lung. The diameter of the mass was ≤ 10 cm in 10 cases (62.5%) and > 10 cm in the remaining 6 cases (37.5%). Most (81.25%) of the textilomas were heterogeneous in density, with signs of calcification, gas, radiopaque marker, or sponge-like material. Peripheral expansion of the mass was observed in 12 (92.3%) of the 13 patients in whom a contrast agent was used. Intraoperatively, pleural involvement was observed in 14 cases (87.5%) and pericardial involvement was observed in 2 (12.5%). CONCLUSIONS: It is important to recognize the main tomographic aspects of thoracic textilomas in order to include this possibility in the differential diagnosis of chest pain and cough in patients with a history of heart or thoracic surgery, thus promoting the early identification and treatment of this postoperative complication. PMID:25410842

  14. Crush injuries of the chest

    PubMed Central

    Davidson, I. A.; Bargh, W.; Cruickshank, A. N.; Duthie, W. H.

    1969-01-01

    Fifty-four patients previously treated for a severe chest injury in an artificial ventilation unit have been followed up. An attempt has been made to determine their state of health and activity. Particular attention has been paid to their respiratory function. The significance of the findings has been discussed. Images PMID:4899979

  15. Chest physiotherapy in acute bronchiolitis.

    PubMed Central

    Webb, M S; Martin, J A; Cartlidge, P H; Ng, Y K; Wright, N A

    1985-01-01

    Forty four children with acute bronchiolitis were given twice daily chest physiotherapy in addition to standard supportive measures and were compared with 46 controls who were not given physiotherapy. There was no clinically discernable benefit on the course of their illness. PMID:3907510

  16. Device Assists Cardiac Chest Compression

    NASA Technical Reports Server (NTRS)

    Eichstadt, Frank T.

    1995-01-01

    Portable device facilitates effective and prolonged cardiac resuscitation by chest compression. Developed originally for use in absence of gravitation, also useful in terrestrial environments and situations (confined spaces, water rescue, medical transport) not conducive to standard manual cardiopulmonary resuscitation (CPR) techniques.

  17. A Monte Carlo estimation of effective dose in chest tomosynthesis

    SciTech Connect

    Sabol, John M.

    2009-12-15

    Purpose: The recent introduction of digital tomosynthesis imaging into routine clinical use has enabled the acquisition of volumetric patient data within a standard radiographic examination. Tomosynthesis requires the acquisition of multiple projection views, requiring additional dose compared to a standard projection examination. Knowledge of the effective dose is needed to make an appropriate decision between standard projection, tomosynthesis, and CT for thoracic x-ray examinations. In this article, the effective dose to the patient of chest tomosynthesis is calculated and compared to a standard radiographic examination and to values published for thoracic CT. Methods: Radiographic technique data for posterior-anterior (PA) and left lateral (LAT) radiographic chest examinations of medium-sized adults was obtained from clinical sites. From these data, the average incident air kerma for the standard views was determined. A commercially available tomosynthesis system was used to define the acquisition technique and geometry for each projection view. Using Monte Carlo techniques, the effective dose of the PA, LAT, and each tomosynthesis projection view was calculated. The effective dose for all projections of the tomosynthesis sweep was summed and compared to the calculated PA and LAT values and to the published values for thoracic CT. Results: The average incident air kerma for the PA and left lateral clinical radiographic examinations were found to be 0.10 and 0.40 mGy, respectively. The effective dose for the PA view of a patient of the size of an average adult male was determined to be 0.017 mSv (ICRP 60) [0.018 mSv (ICRP 103)]. For the left lateral view of the same sized patient, the effective dose was determined to be 0.039 mSv (ICRP 60) [0.050 mSv (ICRP 103)]. The cumulative mA s for a tomosynthesis examination is recommended to be ten times the mA s of the PA image. With this technique, the effective dose for an average tomosynthesis examination was

  18. Electron arc therapy: chest wall irradiation of breast cancer patients.

    PubMed

    McNeely, L K; Jacobson, G M; Leavitt, D D; Stewart, J R

    1988-06-01

    From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35 electively because of high risk of local failure, and 9 following local recurrence. One patient with advanced local regional disease was treated primarily. The target volume boundaries on the chest wall were defined by a foam lined cerrobend cast which rested on the patient during treatment, functioning as a tertiary collimator. A variable width secondary collimator was used to account for changes in the radius of the thorax from superior to inferior border. All patients had computerized tomography performed to determine Internal Mammary Chain depth and chest wall thickness. Electron energies were selected based on these thicknesses and often variable energies over different segments of the arc were used. The chest wall and regional node areas were irradiated to 45 Gy-50 Gy in 5-6 weeks by this technique. The supraclavicular and upper axillary nodes were treated by a direct anterior photon field abutted to the superior edge of the electron arc field. Follow-up is from 10-73 months with a median of 50 months. No major complications were observed. Acute and late effects and local control are comparable to standard chest wall irradiation. The disadvantages of this technique are that the preparation of the tertiary field defining cast and CT treatment planning are labor intensive and expensive. The advantage is that for specific clinical situations large areas of chest wall with marked topographical variation can be optimally, homogeneously irradiated while sparing normal uninvolved tissues. PMID:3384727

  19. Electron arc therapy: chest wall irradiation of breast cancer patients

    SciTech Connect

    McNeely, L.K.; Jacobson, G.M.; Leavitt, D.D.; Stewart, J.R.

    1988-06-01

    From 1980 to October 1985 we treated 45 breast cancer patients with electron arc therapy. This technique was used in situations where optimal treatment with fixed photon or electron beams was technically difficult: long scars, recurrent tumor extending across midline or to the posterior thorax, or marked variation in depth of target tissue. Forty-four patients were treated following mastectomy: 35 electively because of high risk of local failure, and 9 following local recurrence. One patient with advanced local regional disease was treated primarily. The target volume boundaries on the chest wall were defined by a foam lined cerrobend cast which rested on the patient during treatment, functioning as a tertiary collimator. A variable width secondary collimator was used to account for changes in the radius of the thorax from superior to inferior border. All patients had computerized tomography performed to determine Internal Mammary Chain depth and chest wall thickness. Electron energies were selected based on these thicknesses and often variable energies over different segments of the arc were used. The chest wall and regional node areas were irradiated to 45 Gy-50 Gy in 5-6 weeks by this technique. The supraclavicular and upper axillary nodes were treated by a direct anterior photon field abutted to the superior edge of the electron arc field. Follow-up is from 10-73 months with a median of 50 months. No major complications were observed. Acute and late effects and local control are comparable to standard chest wall irradiation. The disadvantages of this technique are that the preparation of the tertiary field defining cast and CT treatment planning are labor intensive and expensive. The advantage is that for specific clinical situations large areas of chest wall with marked topographical variation can be optimally, homogeneously irradiated while sparing normal uninvolved tissues.

  20. Using Multimedia for Admission Recruitment.

    ERIC Educational Resources Information Center

    Gudema, Louis

    1995-01-01

    Multimedia can grab the attention of prospective students in an engaging, appealing way, while giving admission officers the opportunity to deliver information about every facet of campus life. Describes multimedia, its potential, and the production process as well as five current distribution methods. Discusses appropriateness of multimedia for…

  1. Personal Qualities and College Admissions.

    ERIC Educational Resources Information Center

    Willingham, Warren W.; Breland, Hunter M.

    The extent to which personal and academic factors are important in college admission decisions was studied in 1978, based on data on 25,000 applicants to 9 colleges (Colgate University, Williams College, Ohio Wesleyan University, Kenyon College, Kalamazoo College, Occidental College, Hartwick College, University of Richmond, and Bucknell…

  2. College Admissions: Beyond Conventional Testing

    ERIC Educational Resources Information Center

    Sternberg, Robert J.

    2012-01-01

    Standardized admissions tests such as the SAT (originally stood for "Scholastic Aptitude Test") and the ACT measure only a narrow segment of the skills needed to become an active citizen and possibly a leader who makes a positive, meaningful, and enduring difference to the world. The problem with these tests is that they promised, under what have…

  3. Admission Conditions and Graduates' Employability

    ERIC Educational Resources Information Center

    Alexandre, Fernando; Portela, Miguel; Sa, Carla

    2009-01-01

    In a context of increasing competition for students, admission conditions have been used as an instrument in a strategy of differentiation. Such a strategy is guided by short-run concerns, that is, the immediate need to attract more students. This article takes a longer term view, by examining graduates' employability. The authors find that…

  4. Admissions Plan Goes beyond Numbers

    ERIC Educational Resources Information Center

    Hoover, Eric

    2007-01-01

    Northeastern University's Torch Scholars Program is designed to seek out first-generation students who would not qualify under the university's regular admissions process. The scholarships go to motivated students who have shown determination in overcoming personal challenges. Northeastern believes the experiment will enhance the socioeconomic…

  5. Admission to Selective Schools, Alphabetically

    ERIC Educational Resources Information Center

    Jurajda, Stepan; Munich, Daniel

    2010-01-01

    One's position in an alphabetically sorted list may be important in determining access to over-subscribed public services. Motivated by anecdotal evidence, we investigate the importance of the position in the alphabet of Czech students for their admission chances into over-subscribed schools. Empirical evidence based on the population of students…

  6. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  7. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  8. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  9. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  10. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  11. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound, weather-resistant, equipped...

  12. Chest pain in sickle cell disease.

    PubMed

    Tonino, S H; Nur, E; Otten, H M; Wykrzykowska, J J; Hoekstra, J B L; Biemond, B J

    2013-06-01

    The differential diagnosis of chest pain in a patient with sickle cell disease is difficult and may encompass several serious conditions, including chest syndrome, pulmonary embolism and infectious complications. In this manuscript we provide an overview on the various underlying diseases that may cause chest pain in patients with sickle cell disease and provide clues for a proper diagnostic workup. PMID:23799317

  13. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  14. 30 CFR 57.6133 - Powder chests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in accordance with 5 U.S.C. 552(a) and 1 CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Powder chests. 57.6133 Section 57.6133 Mineral... § 57.6133 Powder chests. (a) Powder chests (day boxes) shall be— (1) Structurally sound,...

  15. Stationary digital chest tomosynthesis for coronary artery calcium scoring

    NASA Astrophysics Data System (ADS)

    Wu, Gongting; Wang, Jiong; Potuzko, Marci; Harman, Allison; Pearce, Caleb; Shan, Jing; Lee, Yueh Z.; Zhou, Otto; Lu, Jianping

    2016-03-01

    The coronary artery calcium score (CACS) measures the buildup of calcium on the coronary artery wall and has been shown to be an important predictor of the risk of coronary artery diseases (CAD). Currently CACS is measured using CT, though the relatively high cost and high radiation dose has limited its adoption as a routine screening procedure. Digital Chest Tomosynthesis (DCT), a low dose and low cost alternative to CT, and has been shown to achieve 90% of sensitivity of CT in lung disease screening. However commercial DCT requires long scanning time and cannot be adapted for high resolution gated cardiac imaging, necessary for CACS. The stationary DCT system (s- DCT), developed in our lab, has the potential to significantly shorten the scanning time and enables high resolution cardiac gated imaging. Here we report the preliminary results of using s-DCT to estimate the CACS. A phantom heart model was developed and scanned by the s-DCT system and a clinical CT in a phantom model with realistic coronary calcifications. The adapted fan-beam volume reconstruction (AFVR) method, developed specifically for stationary tomosynthesis systems, is used to obtain high resolution tomosynthesis images. A trained cardiologist segmented out the calcifications and the CACS was obtained. We observed a strong correlation between the tomosynthesis derived CACS and CT CACS (r2 = 0.88). Our results shows s-DCT imaging has the potential to estimate CACS, thus providing a possible low cost and low dose imaging protocol for screening and monitoring CAD.

  16. Advising and Admission: Partners in Enrollment Management.

    ERIC Educational Resources Information Center

    Devine, Joseph E.

    1987-01-01

    Focuses on marketing strategies for college admission and examines the essential interaction between admission and academic units as a means of enhancing retention and producing informed, satisfied consumers/students. (KS)

  17. 49 CFR 1114.1 - Admissibility.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Admissibility. Any evidence which is sufficiently reliable and probative to support a decision under the provisions of the Administrative Procedure Act, or which would be admissible under the general statutes...

  18. 10 CFR 2.708 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... admission of the genuineness and authenticity of any relevant document described in or attached to the... document for which an admission of genuineness and authenticity is requested must be delivered with...

  19. Radiology of occupational chest disease

    SciTech Connect

    Solomon, A. ); Kreel, L.

    1989-01-01

    Radiologic manifestations of occupational lung disease are summarized and classified in this book according to the ILO system. The interpretation of chest roentgenograms outlines the progression of each disease and is accompanied with clinically-oriented explanations. Some of the specific diseases covered include asbestosis, coal worker's pneumoconiosis, silicosis, non-mining inhalation of silica and silicates, beryllium induced disease, inhalation of organics and metallics, and occupationally induced asthma.

  20. CT of the pulmonary ligament

    SciTech Connect

    Godwin, J.D.; Vock, P.; Osborne, D.R.

    1983-08-01

    Most computed tomographic (CT) scans of the chest show the inferior pulmonary ligament and an associated septum in the lower lobe, although CT descriptions of these structures have not been reported. Conventional radiography of the ligament has relied on indirect signs: the position of the lower lobe in the presence of pneumothorax or pleural effusion, soft-tissue peaks along the upper surface of the diaphragm, and the rare traumatic paramediastinal pneumatocele (attributed to air in the ligament). CT clarifies the anatomic relations of the ligament and alterations caused by pleural effusion and pneumothorax. The ligament is probably responsible for some long linear shadows at the lung bases, and CT helps to distinguish these from scars, walls of bullae, and normal structures such as the phrenic nerve and the interlobar fissures.

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

    PubMed Central

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

    2010-01-01

    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

  2. The Role of Noncognitive Assessment in Admissions

    ERIC Educational Resources Information Center

    Hoerle, Heather

    2014-01-01

    Confident that understanding and employing new approaches to assessment is a top priority for admissions professionals, the Secondary School Admission Test Board (SSATB) recently launched a Think Tank on the Future of Admission Assessment, with a two-year timeline and a charge to educate its membership and inspire greater innovation in admissions…

  3. Admission to Medical Education in Ten Countries.

    ERIC Educational Resources Information Center

    Burn, Barbara B., Ed.

    As part of a study of access and admission to higher education in Germany and the United States, a group of papers on medical admissions in various countries was commissioned. The papers presented in this book reveal wide differences in admissions policies and procedures. Barbara Burn examines some of the major issues in a foreword: representation…

  4. Merit and Competition in Selective College Admissions

    ERIC Educational Resources Information Center

    Killgore, Leslie

    2009-01-01

    Using interview data from 34 admissions officers at 17 elite colleges, this paper compares two perspectives shaping admissions policy. Admissions officers apply a "merit" perspective that relies on indicators of student academic and nonacademic achievement. They also employ a "competition" perspective that evaluates student characteristics…

  5. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to...

  6. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to...

  7. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to...

  8. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to...

  9. 7 CFR 501.2 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Admission. 501.2 Section 501.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON U.S. MEAT ANIMAL RESEARCH CENTER, CLAY CENTER, NEBRASKA § 501.2 Admission. Admission to...

  10. 34 CFR 106.21 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 106.21 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in...

  11. 29 CFR 36.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

  12. 13 CFR 113.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... the Basis of Sex in Education Programs or Activities Receiving Federal Financial Assistance Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 113.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in...

  13. 10 CFR 1042.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission,...

  14. 10 CFR 5.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... COMMISSION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 5.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected...

  15. 36 CFR 1211.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1211.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to discrimination in...

  16. The Journal of College Admission Ethics Series.

    ERIC Educational Resources Information Center

    Loveland, Elaina C., Ed.; Raynor, Joyce, Ed.

    This book is the first significant body of literature on ethics in college admission published by the National Association for College Admission Counseling. The series is a select compilation of articles on ethics published in the Journal of College Admission in 1998 and 1999. The book is a source of information for the beginning and experienced…

  17. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 2 2011-07-01 2011-07-01 false Admission procedures. 242.5 Section 242.5 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES § 242.5 Admission...

  18. 29 CFR 36.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

  19. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Admission. 1317.300... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  20. 7 CFR 15a.21 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 15a.21 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to... 15a.18. (b) Specific prohibitions. (1) In determining whether a person satisfies any policy...

  1. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Admission. 1317.300... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  2. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Admission. 1317.300... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  3. 7 CFR 15a.21 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 15a.21 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to... 15a.18. (b) Specific prohibitions. (1) In determining whether a person satisfies any policy...

  4. 7 CFR 15a.21 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 15a.21 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or be subjected to... 15a.18. (b) Specific prohibitions. (1) In determining whether a person satisfies any policy...

  5. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Admission. 1317.300... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  6. 18 CFR 1317.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Admission. 1317.300... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1317.300 Admission. (a) General....

  7. An Economic Model for Selective Admissions

    ERIC Educational Resources Information Center

    Haglund, Alma

    1978-01-01

    The author presents an economic model for selective admissions to postsecondary nursing programs. Primary determinants of the admissions model are employment needs, availability of educational resources, and personal resources (ability and learning potential). As there are more applicants than resources, selective admission practices are…

  8. Policies Governing Admission to Jordanian Public Universities

    ERIC Educational Resources Information Center

    Massadeh, Nassar

    2012-01-01

    This paper intends to discuss the policy of admission to Jordanian public universities. This admission rules are variable and open to almost 100% of the graduates from secondary schools. This might refer to the historical events and economic conditions that the country has gone through since its establishment. Furthermore, the admission policy is…

  9. Playing the Private College Admissions Game.

    ERIC Educational Resources Information Center

    Moll, Richard

    Truths and myths involved with student admission to Ivy League colleges are revealed by a director of admissions whose experience includes admission work at Vassar, Bowdoin, Harvard and Yale. Several basic concepts are offered as fact: most private colleges in America today are not highly selective; many colleges pose as being more selective than…

  10. 10 CFR 1042.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission,...

  11. 29 CFR 36.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

  12. 29 CFR 36.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Secretary of Labor NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 36.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission, or...

  13. 10 CFR 1042.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENERGY (GENERAL PROVISIONS) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 1042.300 Admission. (a) General. No person shall, on the basis of sex, be denied admission,...

  14. Anatomical decomposition in dual energy chest digital tomosynthesis

    NASA Astrophysics Data System (ADS)

    Lee, Donghoon; Kim, Ye-seul; Choi, Sunghoon; Lee, Haenghwa; Choi, Seungyeon; Kim, Hee-Joung

    2016-03-01

    Lung cancer is the leading cause of cancer death worldwide and the early diagnosis of lung cancer has recently become more important. For early screening lung cancer, computed tomography (CT) has been used as a gold standard for early diagnosis of lung cancer [1]. The major advantage of CT is that it is not susceptible to the problem of misdiagnosis caused by anatomical overlapping while CT has extremely high radiation dose and cost compared to chest radiography. Chest digital tomosynthesis (CDT) is a recently introduced new modality for lung cancer screening with relatively low radiation dose compared to CT [2] and also showing high sensitivity and specificity to prevent anatomical overlapping occurred in chest radiography. Dual energy material decomposition method has been proposed for better detection of pulmonary nodules as means of reducing the anatomical noise [3]. In this study, possibility of material decomposition in CDT was tested by simulation study and actual experiment using prototype CDT. Furthermore organ absorbed dose and effective dose were compared with single energy CDT. The Gate v6 (Geant4 application for tomographic emission), and TASMIP (Tungsten anode spectral model using the interpolating polynomial) code were used for simulation study and simulated cylinder shape phantom consisted of 4 inner beads which were filled with spine, rib, muscle and lung equivalent materials. The patient dose was estimated by PCXMC 1.5 Monte Carlo simulation tool [4]. The tomosynthesis scan was performed with a linear movement and 21 projection images were obtained over 30 degree of angular range with 1.5° degree of angular interval. The proto type CDT system has same geometry with simulation study and composed of E7869X (Toshiba, Japan) x-ray tube and FDX3543RPW (Toshiba, Japan) detector. The result images showed that reconstructed with dual energy clearly visualize lung filed by removing unnecessary bony structure. Furthermore, dual energy CDT could enhance

  15. Left anterior descending coronary artery dissection after blunt chest trauma.

    PubMed

    Sadr-Ameli, Mohammad Ali; Amiri, Elaheh; Pouraliakbar, Hamidreza; Heidarali, Mona

    2014-01-01

    Coronary artery dissection is a well-known albeit unusual complication of blunt chest trauma. It is also an uncommon cause of myocardial infarction. Only a few such cases have been reported, probably due to the high rate of sudden death. We report a case of left anterior descending (LAD) coronary artery dissection in a healthy 38-year-old female caused by blunt chest trauma. The patient was referred to our hospital with a complaint of chest pain. Electrocardiography showed T-wave inversion, echocardiography a revealed circumferential pericardial effusion, and the coronary angiogram demonstrated a thrombotic dissection of the LAD.  Troponin I was the only biomarker with elevated level. CT coronary angiography was performed using the subtotal occlusion of the LAD and illustrated a relatively good LAD run-off, and thallium scintigraphy displayed viable myocardium in this territory. Despite the total occlusion of the LAD in our case, myocardial injury was not significant due to the relatively good LAD run-off. She underwent coronary artery bypass graft surgery with an excellent result. PMID:24444069

  16. CT -- Body

    MedlinePlus

    ... News Physician Resources Professions Site Index A-Z Computed Tomography (CT) - Body Computed tomography (CT) of the body uses special x-ray ... Body? What is CT Scanning of the Body? Computed tomography, more commonly known as a CT or CAT ...

  17. An Open Library of CT Patient Projection Data

    PubMed Central

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Holmes, David; Fletcher, Joel; McCollough, Cynthia

    2016-01-01

    Lack of access to projection data from patient CT scans is a major limitation for development and validation of new reconstruction algorithms. To meet this critical need, we are building a library of CT patient projection data in an open and vendor-neutral format, DICOM-CT-PD, which is an extended DICOM format that contains sinogram data, acquisition geometry, patient information, and pathology identification. The library consists of scans of various types, including head scans, chest scans, abdomen scans, electrocardiogram (ECG)-gated scans, and dual-energy scans. For each scan, three types of data are provided, including DICOM-CT-PD projection data at various dose levels, reconstructed CT images, and a free-form text file. Several instructional documents are provided to help the users extract information from DICOM-CT-PD files, including a dictionary file for the DICOM-CT-PD format, a DICOM-CT-PD reader, and a user manual. Radiologist detection performance based on the reconstructed CT images is also provided. So far 328 head cases, 228 chest cases, and 228 abdomen cases have been collected for potential inclusion. The final library will include a selection of 50 head, chest, and abdomen scans each from at least two different manufacturers, and a few ECG-gated scans and dual-source, dual-energy scans. It will be freely available to academic researchers, and is expected to greatly facilitate the development and validation of CT reconstruction algorithms. PMID:27239087

  18. An open library of CT patient projection data

    NASA Astrophysics Data System (ADS)

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Holmes, David; Fletcher, Joel; McCollough, Cynthia

    2016-03-01

    Lack of access to projection data from patient CT scans is a major limitation for development and validation of new reconstruction algorithms. To meet this critical need, we are building a library of CT patient projection data in an open and vendor-neutral format, DICOM-CT-PD, which is an extended DICOM format that contains sinogram data, acquisition geometry, patient information, and pathology identification. The library consists of scans of various types, including head scans, chest scans, abdomen scans, electrocardiogram (ECG)-gated scans, and dual-energy scans. For each scan, three types of data are provided, including DICOM-CT-PD projection data at various dose levels, reconstructed CT images, and a free-form text file. Several instructional documents are provided to help the users extract information from DICOM-CT-PD files, including a dictionary file for the DICOM-CT-PD format, a DICOM-CT-PD reader, and a user manual. Radiologist detection performance based on the reconstructed CT images is also provided. So far 328 head cases, 228 chest cases, and 228 abdomen cases have been collected for potential inclusion. The final library will include a selection of 50 head, chest, and abdomen scans each from at least two different manufacturers, and a few ECG-gated scans and dual-source, dual-energy scans. It will be freely available to academic researchers, and is expected to greatly facilitate the development and validation of CT reconstruction algorithms.

  19. Distribution of the radiation dose in multislice computer tomography of the chest – phantom study

    PubMed Central

    Gorycki, Tomasz; Kamiński, Kamil; Studniarek, Michał; Szlęzak, Przemysław; Szumska, Agnieszka

    2014-01-01

    Summary Background The most commonly used form of reporting doses in multislice computed tomography involves a CT dose index per slice and dose-length product for the whole series. The purpose of this study was to analyze the actual dose distribution in routine chest CT examination protocols using an antropomorphic phantom. Material/Methods We included in the analysis readings from a phantom filled with thermoluminescent detectors (Art Phantom Canberra) during routine chest CT examinations (64 MDCT TK LIGHT SPEED GE Medical System) performed using three protocols: low-dose, helical and angio-CT. Results Mean dose values (mSv) reported from anterior parts of the phantom sections in low-dose/helical/angio-CT protocols were as follows: 3.74; 16.95; 30.17; from central parts: 3.18; 14.15; 26.71; from posterior parts: 3.01; 12.47; 24.98 respectively. Correlation coefficients for mean doses registered in anterior parts of the phantom between low-dose/helical, low-dose/angio-CT and helical/angio-CT protocols were 0.49; 0.63; 0.36; from central parts: 0.73; 0.66; 0.83, while in posterior parts values were as follows: 0.06; 0.21; 0.57. Conclusions The greatest doses were recorded in anterior parts of all phantom sections in all protocols in reference to largest doses absorbed in the anterior part of the chest during CT examination. The doses were decreasing from anterior to posterior parts of all sections. In the long axis of the phantom, in all protocols, lower doses were measured in the upper part of the phantom and at the very lowest part. PMID:24744819

  20. Spontaneous Pneumomediastinum: A Rare Disease Associated with Chest Pain in Adolescents

    PubMed Central

    Kim, Sung Hoon; Song, Jinyoung; Kang, I-Seok

    2015-01-01

    Purpose Spontaneous pneumomediastinum (SPM) is a rare entity, with only a few cases reported, especially in adolescents. We aimed to analyze the clinical characteristics of SPM in adolescents and the diagnostic implications of computed tomography (CT) and esophagography therein. Materials and Methods This retrospective descriptive study was conducted as a review of medical records of 416 adolescents (10-18 years of age) with chest pain from March 2005 to June 2013. Information on clinical presentation, methods of diagnosis, hospital stay, and outcomes were collected and analyzed. Results Among adolescents complaining of chest pain, 11 patients had SPM (11/416, 2.64%). All patients presented with pleuritic chest pain, and 54.5% reported neck pain as the most common associated complaint. Clinical findings were nonspecific, and initial chest X-ray assessment was diagnostic only in three of 11 patients. However, reassessment of chest X-ray revealed diagnostic findings of SPM in five of the remaining eight patients. CT was diagnostic in all patients, while esophagography and echocardiogram were uninformative. Symptomatic improvement was noted within 2.45±1.2 hours (range, 0.5 to 4) after supportive care; mean hospital stay was 4.54±0.99 days (range, 2 to 6). No recurrence was observed. Conclusion SPM is a rare disease that should be considered in adolescent patients with pleuritic chest pain. Careful reading of initial chest X-rays is important to avoiding further unnecessary investigations. SPM is self-limited and treatment is supportive; nevertheless, if there are no indications of esophageal rupture, urgent esophagography is not recommended. PMID:26256992

  1. Image processing in digital chest radiography: effect on diagnostic efficacy.

    PubMed

    Manninen, H; Partanen, K; Lehtovirta, J; Matsi, P; Soimakallio, S

    1992-01-01

    The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512 x 512 image format) viewed on a 625 line monitor were processed in three different ways: (1) standard display; (2) digital edge enhancement for the standard display; and (3) inverse intensity display. The radiographs were interpreted independently by three radiologists. The diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease and 17 cases with pneumonia/atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases, respectively. The sensitivity of conventional radiography when averaged overall findings was better than that of the digital techniques (P less than 0.001). The differences in diagnostic accuracy measured by sensitivity and specificity between the three digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P less than 0.05) but poorer specificity for pulmonary emphysema (0.85 vs. 0.93; P less than 0.05) compared with inverse intensity display. We conclude that when using 512 x 512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted. PMID:1563421

  2. Researchers: new resources, tools needed to reduce variation in the admissions decisions.

    PubMed

    2014-11-01

    New research suggests there is considerable variation in the decisions emergency providers make regarding whether to admit patients with certain common, low-mortality conditions. ln some cases, the researchers found that patients were as much as six times more likely to be admitted at some hospitals than others. While available resources and cultural differences likely play a role in this variation, the researchers estimate that reducing this variation in decision making could potentially save as much as $5 billion per year. Data show that EDs are the main source of hospitalizations in this country, and emergency providers make a decision about admission approximately 350,000 times each day, resulting in close to 20 million admissions per year. Researchers found that variation in the admission decision was most prominent for patients presenting with chest pain but no heart attaclk, soft-tissue infections, urinary tract infections, asthma-related difficulties, and COPD. There was little variation in the admission decisions regarding patients with high-risk conditions such as heart attacks, sepsis, or kidney failure. Researchers suggest that reducing this variation in admission decisions will require better tools for determining which patients with lower-mortality conditions likely require hospitalization, and more resources so that physician have good alternatives to hospitalization at their disposal. PMID:25362751

  3. Pulmonary complications of crack cocaine use: high-resolution computed tomography of the chest.

    PubMed

    Mançano, Alexandre; Marchiori, Edson; Zanetti, Gláucia; Escuissato, Dante Luiz; Duarte, Beatriz Cunha; Apolinário, Lourenço de Araujo

    2008-05-01

    Here, we report high-resolution computed tomography (HRCT) findings in a patient who developed sudden hemoptysis, dyspnea and chest pain after smoking crack cocaine. Chest X-rays showed consolidations, primarily in the upper lobes, and HRCT scans showed ground glass attenuation opacities, consolidations and air-space nodules. A follow-up CT, after drug use discontinuation and administration of corticosteroids, showed partial resolution of pulmonary lesions and the appearance of cavitations. Clinical, imaging and laboratory findings led to a diagnosis of 'crack lung'. PMID:18545829

  4. Chest wall resection for extrapulmonary tumor.

    PubMed

    Long, W P; Kline, R; Levine, E A

    1997-09-01

    Despite progress in early detection of breast cancer, a minority of women continue to present with extensive disease which may necessitate chest wall resection. Between 1992 and 1996, 14 patients were treated by surgical resection of the chest wall and reconstruction by the LSU Sections of Surgical Oncology and Plastic Surgery. Indications included resection of primary tumor, resection of recurrent tumor, and resection of radiation therapy induced damage to the chest wall. We report chest wall excision and reconstruction with no operative mortality and minor surgical morbidity in 21% of cases. Local control was achieved in 13 of 14 cases. Additionally we report uniform success in the palliation of ulcerating, painful, or infected chest wall lesions. Approximately 25% of patients treated for breast cancer and followed up for more than 6 months have remained free of disease. Chest wall resection is a useful modality in selected patients with extensive disease. PMID:9316348

  5. Normalized mean shapes and reference index values for computerized quantitative assessment indices of chest wall deformities

    NASA Astrophysics Data System (ADS)

    Kim, Ho Chul; Park, Man Sik; Lee, Seong Keon; Nam, Ki Chang; Park, Hyung Joo; Kim, Min Gi; Song, Jae-Jun; Choi, Hyuk

    2015-11-01

    We previously proposed a computerized index (eccentricity index [EI]) for chest-wall deformity measurements, such as pectus excavatum. We sought to define mean shapes based on normal chest walls and to propose for computerized index reference values of that are used in the quantitative analysis of the severity of chest-wall deformities. A total of 584 patients were classified into 18 groups, and a database of their chest-wall computed tomography (CT) scan images was constructed. The boundaries of the chest wall were extracted by using a segmentation algorithm, and the mean shapes were subsequently developed. The reference index values were calculated from the developed mean shapes. Reference index values for the EI were compared with a conventional index, the Haller index (HI). A close association has been shown between the two indices in multiple subjects (r = 0.974, P < 0.001). The newly developed mean shapes and reference index values supply both reliability and objectivity to the diagnosis, analysis, and treatment of chest-wall deformities. They promise to be highly useful in clinical settings.

  6. Technique for chest compressions in adult CPR

    PubMed Central

    2011-01-01

    Chest compressions have saved the lives of countless patients in cardiac arrest as they generate a small but critical amount of blood flow to the heart and brain. This is achieved by direct cardiac massage as well as a thoracic pump mechanism. In order to optimize blood flow excellent chest compression technique is critical. Thus, the quality of the delivered chest compressions is a pivotal determinant of successful resuscitation. If a patient is found unresponsive without a definite pulse or normal breathing then the responder should assume that this patient is in cardiac arrest, activate the emergency response system and immediately start chest compressions. Contra-indications to starting chest compressions include a valid Do Not Attempt Resuscitation Order. Optimal technique for adult chest compressions includes positioning the patient supine, and pushing hard and fast over the center of the chest with the outstretched arms perpendicular to the patient's chest. The rate should be at least 100 compressions per minute and any interruptions should be minimized to achieve a minimum of 60 actually delivered compressions per minute. Aggressive rotation of compressors prevents decline of chest compression quality due to fatigue. Chest compressions are terminated following return of spontaneous circulation. Unconscious patients with normal breathing are placed in the recovery position. If there is no return of spontaneous circulation, then the decision to terminate chest compressions is based on the clinical judgment that the patient's cardiac arrest is unresponsive to treatment. Finally, it is important that family and patients' loved ones who witness chest compressions be treated with consideration and sensitivity. PMID:22152601

  7. Chest pain evaluation in the emergency department.

    PubMed

    Foy, Andrew J; Filippone, Lisa

    2015-07-01

    Chest pain is a common complaint in the emergency department. Recognition of chest pain symptoms and electrocardiographic changes consistent with acute coronary syndrome (ACS) can lead to prompt initiation of goal-directed therapy. Cardiac troponin testing confirms the diagnosis of acute myocardial infarction, but does not reveal the mechanism of injury. When patients with chest pain rule out for ACS the use of advanced, noninvasive testing has not been found to be associated with better patient outcomes. PMID:26042885

  8. Patient Admission Preferences and Perceptions

    PubMed Central

    Wu, Clayton; Melnikow, Joy; Dinh, Tu; Holmes, James F.; Gaona, Samuel D.; Bottyan, Thomas; Paterniti, Debora; Nishijima, Daniel K.

    2015-01-01

    Introduction Understanding patient perceptions and preferences of hospital care is important to improve patients’ hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions. Methods This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire. Results Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated “very important,” while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated “very important.” When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference. Conclusion Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed. PMID:26587095

  9. Hydatid disease of the chest

    PubMed Central

    Xanthakis, D.; Efthimiadis, M.; Papadakis, G.; Primikirios, N.; Chassapakis, G.; Roussaki, A.; Veranis, N.; Akrivakis, A.; Aligizakis, C. J.

    1972-01-01

    Ninety-one cases of hydatid disease of the chest are reported. Eighty-eight were involving the lung, two the chest wall, and one the mediastinum. All the patients were treated surgically. Conservative operations (simple removal of the parasite and closure of the remaining cavity) were performed in 78 patients, 37 unruptured and 41 ruptured cysts. Late postoperative complications occurred in eleven. In 10 patients, recurrent haemoptysis was the main symptom due to residual cavity in four, bronchiectatic changes in two, and unknown aetiology in four. In one patient, recurrence of multiple cysts occurred in the affected lobe. Radical operations were carried out in 10 patients, including segmental resection in four and lobectomy in six. Conservative operations were performed in all cases of unruptured cysts, with the exception of a giant cyst in which resection was the operation of choice. For ruptured cysts with mild infection conservative operation was also performed. Resection was necessary only in patients with ruptured cysts with suppuration, bronchiectatic changes, and giant cysts replacing a whole lobe. There was no mortality. We believe that conservative operation is the treatment of choice for hydatid disease of the lung. Indications for resection are very limited. Images

  10. Common errors in evaluating chest radiographs.

    PubMed

    Mann, H

    1990-01-01

    Chest radiographs that are correctly obtained and interpreted provide valuable diagnostic information. However, some radiographs are not taken at total lung capacity, and the appearance of the lungs on film may mimic certain lung disorders. Most common interpretive pitfalls in chest radiography can be avoided by physicians who are familiar with the film appearance of varying degrees of lung inflation, technical limitations of portable radiography, and common chest abnormalities. When further definition is necessary, additional projections should be obtained. Chest fluoroscopy and computed tomography can offer further clarification, if needed. PMID:2296566

  11. Prognosis of Low-Risk Young Women Presenting to the Emergency Department With Chest Pain.

    PubMed

    Stauber, Stacey M; Teleten, Aleksander; Li, Zhongmin; Venugopal, Sandhya; Amsterdam, Ezra A

    2016-01-01

    Identification of patients at low risk presenting to the emergency department with chest pain is a continuing challenge. We examined a cohort of low-risk women with negative cardiac injury markers, electrocardiogram with normal results, and clinical stability. We hypothesized that these patients can be safely and accurately managed in a chest pain unit (CPU), may not require predischarge cardiac testing, and have an excellent short-term prognosis. The primary end point was major cardiovascular events during index admission or follow-up. Mean age of the 403 women was 42 ± 4.3 years (30 to 50 years). No patient had a cardiovascular event in the CPU, and none of the 321 patients followed for 6 months had a late cardiovascular event. Most (211, 52%) did not receive predischarge cardiac testing. The remaining 192 patients (48%) had predischarge exercise treadmill test, stress imaging, or cardiac catheterization. Of those patients who underwent treadmill testing, almost 90% had no exercise-induced chest pain and approximately 50% had functional capacity 8 to 14 METs. In addition, 166 patients (41%) were discharged from the CPU after <2 hours and 21% (n = 86) within 2 to 8 hours. In conclusion, this group of low-risk women was safely and accurately managed in the CPU and discharged promptly. There were no cardiac events on index admission or 6-month follow-up, and in most patients, predischarge cardiac testing was unnecessary. PMID:26552512

  12. Chest radiograph--a poor method for determining the size of a pneumothorax.

    PubMed

    Engdahl, O; Toft, T; Boe, J

    1993-01-01

    The ability of chest radiographs to determine the size of a pneumothorax was tested in 16 patients using computed tomographic (CT) scan as a reference method. To determine if CT with a slice thickness of 12 mm could be used, its accuracy was assessed in a lung model experiment. The lung model consisted of a water-filled plastic bag (lung) fitted into a plastic chamber (hemithorax), both of approximately the same size and shape as in man. Water was drawn off in incremental steps and a CT was done after each step. The area of the pneumothorax was calculated by computer and when multiplied by slice thickness and number of slices, the total volume of the pneumothorax could be compared with the extracted amount of water. A good correlation (r = 0.99), with the line of regression close to the line of identity, was found between the CT investigation and the artificial pneumothorax. In the patients, the size of the pneumothorax, judged by radiograph using two different methods of calculation, was correlated to the size obtained by CT. The correlation was poor (r = 0.71) irrespective of method of calculation. The size of the pneumothorax estimated by CT showed a good correlation (r = 0.99) to the initial aspirated air volumes in 12 of the 16 patients treated with drainage. A cautious attitude toward the use of chest radiographs for calculations of the degree of lung collapse in patients with pneumothorax is recommended. PMID:8417891

  13. Application of a computed tomography based cystic fibrosis scoring system to chest tomosynthesis

    NASA Astrophysics Data System (ADS)

    Söderman, Christina; Johnsson, Åse; Vikgren, Jenny; Rystedt, Hans; Ivarsson, Jonas; Rossi Norrlund, Rauni; Nyberg Andersson, Lena; Bâth, Magnus

    2013-03-01

    In the monitoring of progression of lung disease in patients with cystic fibrosis (CF), recurrent computed tomography (CT) examinations are often used. The relatively new imaging technique chest tomosynthesis (CTS) may be an interesting alternative in the follow-up of these patients due to its visualization of the chest in slices at radiation doses and costs significantly lower than is the case with CT. A first step towards introducing CTS imaging in the diagnostics of CF patients is to establish a scoring system appropriate for evaluating the severity of CF pulmonary disease based on findings in CTS images. Previously, several such CF scoring systems based on CT imaging have been published. The purpose of the present study was to develop a CF scoring system for CTS, by starting from an existing scoring system dedicated for CT images and making modifications regarded necessary to make it appropriate for use with CTS images. In order to determine any necessary changes, three thoracic radiologists independently used a scoring system dedicated for CT on both CT and CTS images from CF patients. The results of the scoring were jointly evaluated by all the observers, which lead to suggestions for changes to the scoring system. Suggested modifications include excluding the scoring of air trapping and doing the scoring of the findings in quadrants of the image instead of in each lung lobe.

  14. CT Scans

    MedlinePlus

    ... cross-sectional pictures of your body. Doctors use CT scans to look for Broken bones Cancers Blood clots Signs of heart disease Internal bleeding During a CT scan, you lie still on a table. The table ...

  15. Chest neoplasms with infectious etiologies

    PubMed Central

    Restrepo, Carlos S; Chen, Melissa M; Martinez-Jimenez, Santiago; Carrillo, Jorge; Restrepo, Catalina

    2011-01-01

    A wide spectrum of thoracic tumors have known or suspected viral etiologies. Oncogenic viruses can be classified by the type of genomic material they contain. Neoplastic conditions found to have viral etiologies include post-transplant lymphoproliferative disease, lymphoid granulomatosis, Kaposi’s sarcoma, Castleman’s disease, recurrent respiratory papillomatosis, lung cancer, malignant mesothelioma, leukemia and lymphomas. Viruses involved in these conditions include Epstein-Barr virus, human herpes virus 8, human papillomavirus, Simian virus 40, human immunodeficiency virus, and Human T-lymphotropic virus. Imaging findings, epidemiology and mechanism of transmission for these diseases are reviewed in detail to gain a more thorough appreciation of disease pathophysiology for the chest radiologist. PMID:22224176

  16. Bronchial cancer - chest x-ray (image)

    MedlinePlus

    This is a chest x-ray of a person with bronchial cancer. This is a front view. The lungs are the two dark ... white areas visible in the middle of the chest. The light areas that appear as subtle branches ...

  17. [Wooden chests for the midwife's equipment].

    PubMed

    Carlén-Nilsson, C

    1993-01-01

    In the museum of medical history in Lund there are several wooden chests containing partly identical instruments apparently belonging to a midwife. The instruments dated from before 1900, e.g. lancets and horn cups for blood-letting, a pewter enema syringe, a wooden stethoscope, a "tobacco pipe" and glass bottles. The use of the tobacco pipe was first puzzling, but it appeared to be a breast reliver. What do we know about the date of the chests? One chest has belonged to Kjersti Nilsdotter, a midwife educated in Lund 1872-1873. Her certificate was in the chest. From Ronnie Hunt, Minnesota we have got information about another chest of the same type. That belonged to Nelly Gustafsson, a midwife educated in Lund probably about 1870. She emigrated to USA and was a practising midwife in Lindstrom, Minnesota from about 1900. PMID:11639439

  18. [How to do - the chest tube drainage].

    PubMed

    Klopp, Michael; Hoffmann, Hans; Dienemann, Hendrik

    2015-03-01

    A chest tube is used to drain the contents of the pleural space to reconstitute the physiologic pressures within the pleural space and to allow the lungs to fully expand. Indications for chest tube placement include pneumothorax, hemothorax, pleural effusion, pleural empyema, and major thoracic surgery. The most appropriate site for chest tube placement is the 4th or 5th intercostal space in the mid- or anterior- axillary line. Attention to technique in placing the chest tube is vital to avoid complications from the procedure. Applying the step-by-step technique presented, placement of a chest tube is a quick and safe procedure. Complications - frequently occurring when the tube is inserted with a steel trocar - include hemothorax, dislocation, lung lacerations, and injury to organs in the thoracic or abdominal cavity." PMID:25734676

  19. Another cause of chest pain: Staphylococcus aureus sternal osteomyelitis in an otherwise healthy adult

    PubMed Central

    Vacek, Thomas P; Rehman, Shahnaz; Yu, Shipeng; Moza, Ankush; Assaly, Ragheb

    2014-01-01

    Chest pain requires a detailed differential diagnosis with good history-taking skills to differentiate between cardiogenic and noncardiogenic causes. Moreover, when other symptoms such as fever and elevated white blood cell count are involved, it may be necessary to consider causes that include infectious sources. A 53-year-old female with no significant past medical history returned to the hospital with recurrent complaints of chest pain that was constant, substernal, reproducible, and exacerbated with inspiration and expiration. The chest pain was thought to be noncardiogenic, as electrocardiography did not demonstrate changes, and cardiac enzymes were found to be negative for signs of ischemia. The patient’s blood cultures were analyzed from a previous admission and were shown to be positive for Staphylococcus aureus. The patient was started empirically on vancomycin, which was later switched to ceftriaxone as the bacteria were more sensitive to this antibiotic. A transthoracic echocardiogram did not demonstrate any vegetation or signs of endocarditis. There was a small right pleural effusion discovered on X-ray. Therefore, computed tomography as well as magnetic resonance imaging of the chest were performed, and showed osteomyelitis of the chest. The patient was continued on intravenous ceftriaxone for a total of 6 weeks. Tests for HIV, hepatitis A, B, and C were all found to be negative. The patient had no history of childhood illness, recurrent infections, or previous trauma to the chest, and had had no recent respiratory infections, pneumonia, or any underlying lung condition. Hence, her condition was thought to be a case of primary sternal osteomyelitis without known cause. PMID:25246811

  20. School Admissions: Fairness versus Diverse Types of Schools, Choice and Own Admission Authorities

    ERIC Educational Resources Information Center

    Harris, Richard

    2014-01-01

    This article examines the minefield that now surrounds admissions starting with a comparison of the relatively easy system of the 1950s and early 1960s and the complexity of multiple admission authorities of today. Taking evidence from a range of agencies, including government official bodies, and admission issues, the article aims to show that a…

  1. Recent Trends in Advance Directives at Nursing Home Admission and One Year after Admission

    ERIC Educational Resources Information Center

    McAuley, William J.; Buchanan, Robert J.; Travis, Shirley S.; Wang, Suojin; Kim, MyungSuk

    2006-01-01

    Purpose: Advance directives are important planning and decision-making tools for individuals in nursing homes. Design and Methods: By using the nursing facility Minimum Data Set, we examined the prevalence of advance directives at admission and 12 months post-admission. Results: The prevalence of having any advance directive at admission declined…

  2. [Cardiac arrest following blunt chest injury. Emergency thoracotomy without ifs or buts?].

    PubMed

    Leidel, B A; Kanz, K G; Kirchhoff, C; Bürklein, D; Wismüller, A; Mutschler, W

    2007-10-01

    In German-speaking countries, most serious thoracic injuries are attributable to the impact of blunt force; they are the second most frequent result of injury after head injury in polytrauma patients with multiple injuries. Almost one in every three polytraumatized patients with significant chest injury develops acute lung failure, and one in every four, acute circulatory failure. The acute circulatory arrest following serious chest injury involves a high mortality rate, and in most cases it reflects a tension pneumothorax, cardiac tamponade, or hemorrhagic shock resulting from injury to the heart or one of the large vessels close to it. Brisk drainage of tension pneumothorax and adequate volume restoration are therefore particularly important in resuscitation of multiply traumatized patients, as are rapid resuscitative thoracotomy to allow direct heart massage, drainage of pericardial tamponade, and control of hemorrhage. However the probability of survival described in the literature is very low for patients sustaining severe chest trauma with acute cardiac arrest. The case report presented here describes a female polytrauma patient who suffered an acute cardiac arrest following cardiac tamponade after admission in the emergency department and who survived without neurological deficits after an emergency thoracotomy. Selections from the topical literature can help the treating physician in the emergency department in making decisions on whether an emergency thoracotomy is indicated after a blunt chest injury and on the procedure itself. PMID:17909734

  3. Bilateral Pneumothoraces Following BiV ICD Placement: A Case of Buffalo Chest Syndrome

    PubMed Central

    Rali, Aniket S.; Manyam, Harish

    2015-01-01

    Patient: Female, 73 Final Diagnosis: Buffalo chest syndrome Symptoms: — Medication: — Clinical Procedure: Bi-ventricular ICD Specialty: Cardiology Objective: Rare disease Background: Contralateral pneumothorax following device implantation on the left side has been reported in a few cases. The majority of contralateral pneumothoraces showed evidence of atrial perforation on computed tomography (CT), echocardiography, or chest x-rays and required lead revision. To the best of our knowledge there is only 1 other reported case of contralateral pneumothorax without evidence of macro-displacement of the atrial lead. In that case the patient experienced a right-sided pneumothorax on day 1 after undergoing repositioning of the atrial lead. Case Report: The current case is unique on several accounts, including timing of the contralateral pneumothorax and no evidence of associated atrial lead perforation on device interrogation or CT imaging. Furthermore, the appearance of contralateral pneumothorax within 8 hours of clamping of the ipsilateral chest tube argues in favor of a pleuro-pleural fistula. Conclusions: The term ‘buffalo chest’ refers to a single pleural space, with no anatomical separation of the 2 hemithoraces, as seen in an American buffalo or bison. We believe this to be a case of buffalo chest syndrome. PMID:26431396

  4. 10 CFR 2.708 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Admissions. 2.708 Section 2.708 Energy NUCLEAR REGULATORY COMMISSION AGENCY RULES OF PRACTICE AND PROCEDURE Rules for Formal Adjudications § 2.708 Admissions. (a... request or such further time as may be allowed on motion, the party to whom the request is directed...

  5. 10 CFR 2.708 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Admissions. 2.708 Section 2.708 Energy NUCLEAR REGULATORY COMMISSION AGENCY RULES OF PRACTICE AND PROCEDURE Rules for Formal Adjudications § 2.708 Admissions. (a... request or such further time as may be allowed on motion, the party to whom the request is directed...

  6. Admissions Deans Dish on Their Jobs

    ERIC Educational Resources Information Center

    Farrell, Elizabeth F.; Hoover, Eric

    2008-01-01

    Over the last decade, admissions has become a front-page fixation, and the industry's professionals have higher profiles than ever, on campuses and off. In turn, today's admissions jobs come with heavy doses of prestige and pressure. In this article, the authors discuss the results of a new survey of college officers which suggest that, despite…

  7. Admissions and Preferences: Sequel to Defunis

    ERIC Educational Resources Information Center

    Wilson, James B.

    1973-01-01

    Three unresolved affirmative action admissions problems are examined: the role of students in admissions decisions, the validity of racial quotas, and to what extent applicants are entitled to due process protection of the fourteenth ammendment. Included is a synopsis of DeFunis v. Odegaard, which upheld a reverse discrimination claim. (JT)

  8. 49 CFR 25.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 25.300 Admission. (a) General. No person shall, on the basis of sex, be...

  9. 28 CFR 54.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 54.300 Admission. (a) General. No person shall, on the basis of sex, be...

  10. 6 CFR 17.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  11. 14 CFR 1253.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  12. Why Do We Stay in Admissions?

    ERIC Educational Resources Information Center

    Piersol, Marion Kandel; And Others

    1993-01-01

    Admission counselors (n=200) completed surveys about employment, title, on-the-job training, travel, and availability and satisfaction with certain responsibilities. Most satisfying admission responsibilities were program organization and implementation, applicant review and decision, and formal presentations. Least satisfying were telemarketing,…

  13. Understanding the Bologna Process for Admissions Officers

    ERIC Educational Resources Information Center

    Baxton, Mary; Johnson, Johnny Kent; Nathanson, Gloria; Paver, William; Watkins, Robert

    2009-01-01

    In Spring 2008, senior members of the international admission and credential evaluation community met to deliberate over the admission and placement of Bologna Compliant degree holders into U.S. graduate programs. This group comprised several individuals holding top leadership positions in NAFSA, AACRAO, and closely allied groups involved in…

  14. The Terms and Tasks of "Open Admissions"

    ERIC Educational Resources Information Center

    Scott, Robert A.

    1976-01-01

    Noting the need to define the terms used for policies which are changing the role of admissions offices, the author defines "open admissions" as "universal opportunity for post-secondary schooling" and points out changes in the core tasks of recruiting, selecting, counseling, and management of student records and data. (JT)

  15. Grade Inflation and Law School Admissions

    ERIC Educational Resources Information Center

    Wongsurawat, Winai

    2008-01-01

    Purpose: The purpose of this paper is to evaluate the evidence on whether grade inflation has led to an increasing emphasis on standardized test scores as a criterion for law school admissions. Design/methodology/approach: Fit probabilistic models to admissions data for American law schools during the mid to late 1990s, a period during which…

  16. Rank in Class and College Admission

    ERIC Educational Resources Information Center

    Walker, Karen

    2010-01-01

    Traditionally class rankings have been used by high schools to determine valedictorians and salutatorians. These rankings have also been used by colleges to make admission decisions and for awarding scholarships. While there is no direct link between college rank and college admission, there is evidence that not using class rank can reduce stress…

  17. 22 CFR 146.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Relations DEPARTMENT OF STATE CIVIL RIGHTS NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 146.300 Admission. (a) General. No person shall, on the basis of sex, be...

  18. Alphabetical Order Effects in School Admissions

    ERIC Educational Resources Information Center

    Jurajda, Štepán; Münich, Daniel

    2016-01-01

    If school admission committees use alphabetically sorted lists of applicants in their evaluations, one's position in the alphabet according to last name initial may be important in determining access to selective schools. Jurajda and Münich (2010) "Admission to Selective Schools, Alphabetically". "Economics of Education…

  19. Lexical Profiles of Thailand University Admission Tests

    ERIC Educational Resources Information Center

    Cherngchawano, Wirun; Jaturapitakkul, Natjiree

    2014-01-01

    University Admission Tests in Thailand are important documents which reflect Thailand's education system. To study at a higher education level, all students generally need to take the University Admission Tests designed by the National Institute of Educational Testing Service (NIETS). For the English test, vocabulary and reading comprehension is…

  20. 38 CFR 17.365 - Admission priorities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of §...

  1. Admission to Law School: New Measures

    ERIC Educational Resources Information Center

    Shultz, Marjorie M.; Zedeck, Sheldon

    2012-01-01

    Standardized tests have been increasingly controversial over recent years in high-stakes admission decisions. Their role in operationalizing definitions of merit and qualification is especially contested, but in law schools this challenge has become particularly intense. Law schools have relied on the Law School Admission Test (LSAT) and an INDEX…

  2. Profile in Action: Linking Admission and Retention

    ERIC Educational Resources Information Center

    Cortes, Carla M.

    2013-01-01

    A profile-oriented retention strategy embraces the admission process as a powerful lever in improving retention and completion rates and recognizes that the student profile can be shaped by changes in admission policies or priorities--even within the current market position of the institution. In addition, the student body can be oriented toward…

  3. Simulated Admissions Exercise in Health Services Administration.

    ERIC Educational Resources Information Center

    Quatrano, Louis A.; And Others

    This workbook is intended for use in a Simulated Admissions Exercise (SAE). Done in group settings, the SAE establishes mock admissions committees which work through simulated student applications to choose a certain number to be "admitted" to a hypothetical class of students. The applicants are seeking positions in a health services…

  4. 43 CFR 41.300 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  5. 45 CFR 86.21 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Department of Health and Human Services GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  6. 49 CFR 25.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 25.300 Admission. (a) General. No person shall, on the basis of sex, be...

  7. 40 CFR 5.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  8. 28 CFR 54.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Admission and Recruitment Prohibited § 54.300 Admission. (a) General. No person shall, on the basis of sex, be...

  9. 45 CFR 86.21 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  10. 45 CFR 86.21 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  11. 43 CFR 41.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Lands: Interior Office of the Secretary of the Interior NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex... basis of sex, be denied admission, or be subjected to discrimination in admission, by any recipient...

  12. An Economic Analysis of College Admission Standards.

    ERIC Educational Resources Information Center

    Costrell, Robert M.

    1993-01-01

    The effects of relaxed college admission standards vary across students. A relaxed standard may raise the number of graduates but reduces nongraduates' productivity. The effect on the graduation rate is ambiguous, since "marginal" college attendees are less likely to graduate. A lower admission standard reduces performance among students exceeding…

  13. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 6 2012-01-01 2012-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC,...

  14. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 6 2010-01-01 2010-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC,...

  15. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 6 2014-01-01 2014-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC,...

  16. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 6 2011-01-01 2011-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC,...

  17. 7 CFR 503.2 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 6 2013-01-01 2013-01-01 false Admission. 503.2 Section 503.2 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE CONDUCT ON PLUM ISLAND ANIMAL DISEASE CENTER § 503.2 Admission. No person will be admitted to PIADC,...

  18. Student System, On-Line Admissions.

    ERIC Educational Resources Information Center

    White, Stephen R.

    This report provides technical information on an on-line admissions system developed by Montgomery College. Part I, Systems Development, describes the background, objectives and responsibilities, system design, and reports generated by the system. Part II, Operating Instructions, describes input forms and controls, admission system functions, file…

  19. 38 CFR 17.365 - Admission priorities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of §...

  20. 38 CFR 17.365 - Admission priorities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of §...

  1. 38 CFR 17.365 - Admission priorities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of §...

  2. 38 CFR 17.365 - Admission priorities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Admission priorities. 17.365 Section 17.365 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Grants to the Republic of the Philippines § 17.365 Admission priorities. Appropriate provisions of §...

  3. An Admissions Race that's Already Won

    ERIC Educational Resources Information Center

    Stevens, Mitchell L.

    2008-01-01

    The author recently spent a year and a half in the admissions office of a highly selective Eastern college as an ethnographer, seeking to understand just how admissions officers make their decisions. He accompanied them on recruitment trips to high schools and college fairs, helped manage their offices' relentless current of visitors and mail, and…

  4. Special Report on the Transfer Admission Process

    ERIC Educational Resources Information Center

    National Association for College Admission Counseling, 2010

    2010-01-01

    Each Spring, much media attention is focused on the college admission process for first-year students, with particular emphasis on acceptance rates and factors that colleges consider when choosing among applicants. However, less attention is focused on the transfer admission process, which affects approximately one-third of students beginning at…

  5. Universal radiographic screening for tuberculosis among inmates upon admission to jail.

    PubMed Central

    Layton, M C; Henning, K J; Alexander, T A; Gooding, A L; Reid, C; Heyman, B M; Leung, J; Gilmore, D M; Frieden, T R

    1997-01-01

    OBJECTIVES: This study evaluated the efficacy of radiographic screening for tuberculosis in correctional facilities. METHODS: Inmates at an admission facility in New York, NY, were screened for tuberculosis by registry cross-match, symptom interviews, tuberculin testing, and chest radiography. RESULTS: Thirty-two cases of tuberculosis were detected among 4172 inmate admissions (767 cases per 100,000). Twenty-five inmates (78%) were previously diagnosed but incompletely treated; all were identified by registry cross-match. Seven inmates (22%) were newly diagnosed, of whom four (57%) were asymptomatic, had negative skin tests, and were detected only by their abnormal radiographs. CONCLUSIONS: Screening strategies that limit radiographic testing to inmates with either positive skin tests or symptoms may result in missed opportunities for diagnosing active tuberculosis. PMID:9279270

  6. Testing of Low-Risk Patients Presenting to the Emergency Department With Chest Pain

    PubMed Central

    Amsterdam, Ezra A.; Kirk, J. Douglas; Bluemke, David A.; Diercks, Deborah; Farkouh, Michael E.; Garvey, J. Lee; Kontos, Michael C.; McCord, James; Miller, Todd D.; Morise, Anthony; Newby, L. Kristin; Ruberg, Frederick L.; Scordo, Kristine Anne; Thompson, Paul D.

    2011-01-01

    The management of low-risk patients presenting to emergency departments is a common and challenging clinical problem entailing 8 million emergency department visits annually. Although a majority of these patients do not have a life-threatening condition, the clinician must distinguish between those who require urgent treatment of a serious problem and those with more benign entities who do not require admission. Inadvertent discharge of patients with acute coronary syndrome from the emergency department is associated with increased mortality and liability, whereas inappropriate admission of patients without serious disease is neither indicated nor cost-effective. Clinical judgment and basic clinical tools (history, physical examination, and electrocardiogram) remain primary in meeting this challenge and affording early identification of low-risk patients with chest pain. Additionally, established and newer diagnostic methods have extended clinicians' diagnostic capacity in this setting. Low-risk patients presenting with chest pain are increasingly managed in chest pain units in which accelerated diagnostic protocols are performed, comprising serial electrocardiograms and cardiac injury markers to exclude acute coronary syndrome. Patients with negative findings usually complete the accelerated diagnostic protocol with a confirmatory test to exclude ischemia. This is typically an exercise treadmill test or a cardiac imaging study if the exercise treadmill test is not applicable. Rest myocardial perfusion imaging has assumed an important role in this setting. Computed tomography coronary angiography has also shown promise in this setting. A negative accelerated diagnostic protocol evaluation allows discharge, whereas patients with positive findings are admitted. This approach has been found to be safe, accurate, and cost-effective in low-risk patients presenting with chest pain. PMID:20660809

  7. Reducing variation in hospital admissions from the emergency department for low-mortality conditions may produce savings.

    PubMed

    Sabbatini, Amber K; Nallamothu, Brahmajee K; Kocher, Keith E

    2014-09-01

    The emergency department (ED) is now the primary source for hospitalizations in the United States, and admission rates for all causes differ widely between EDs. In this study we used a national sample of ED visits to examine variation in risk-standardized hospital admission rates from EDs and the relationship of this variation to inpatient mortality for the fifteen most commonly admitted medical and surgical conditions. We then estimated the impact of variation on national health expenditures under different utilization scenarios. Risk-standardized admission rates differed substantially across EDs, ranging from 1.03-fold for sepsis to 6.55-fold for chest pain between the twenty-fifth and seventy-fifth percentiles of the visits. Conditions such as chest pain, soft tissue infection, asthma, chronic obstructive pulmonary disease, and urinary tract infection were low-mortality conditions that showed the greatest variation. This suggests that some of these admissions might not be necessary, thus representing opportunities to improve efficiency and reduce health spending. Our data indicate that there may be sizeable savings to US payers if differences in ED hospitalization practices could be narrowed among a few of these high-variation, low-mortality conditions. PMID:25201672

  8. Evaluation of the safety of high-frequency chest wall oscillation (HFCWO) therapy in blunt thoracic trauma patients

    PubMed Central

    Anderson, Casandra A; Palmer, Cassandra A; Ney, Arthur L; Becker, Brian; Schaffel, Steven D; Quickel, Robert R

    2008-01-01

    Background Airway clearance is frequently needed by patients suffering from blunt chest wall trauma. High Frequency Chest Wall Oscillation (HFCWO) has been shown to be effective in helping to clear secretions from the lungs of patients with cystic fibrosis, bronchiectasis, asthma, primary ciliary dyskinesia, emphysema, COPD, and many others. Chest wall trauma patients are at increased risk for development of pulmonary complications related to airway clearance. These patients frequently have chest tubes, drains, catheters, etc. which could become dislodged during HFCWO. This prospective observational study was conducted to determine if HFCWO treatment, as provided by The Vest™ Airway Clearance System (Hill-Rom, Saint Paul, MN), was safe and well tolerated by these patients. Methods Twenty-five blunt thoracic trauma patients were entered into the study. These patients were consented. Each patient was prescribed 2, 15 minute HFCWO treatments per day using The Vest® Airway Clearance System (Hill-Rom, Inc., St Paul, MN). The Vest® system was set to a frequency of 10–12 Hz and a pressure of 2–3 (arbitrary unit). Physiological parameters were measured before, during, and after treatment. Patients were free to refuse or terminate a treatment early for any reason. Results No chest tubes, lines, drains or catheters were dislodged as a result of treatment. One patient with flail chest had a chest tube placed after one treatment due to increasing serous effusion. No treatments were missed and continued without further incident. Post treatment survey showed 76% experienced mild or no pain and more productive cough. Thirty days after discharge there were no deaths or hospital re-admissions. Conclusion This study suggests that HFCWO treatment is safe for trauma patients with lung and chest wall injuries. These findings support further work to demonstrate the airway clearance benefits of HFCWO treatment. PMID:18837992

  9. Severe Chest Wall Toxicity From Cryoablation in the Setting of Prior Stereotactic Ablative Radiotherapy.

    PubMed

    Chaudhuri, Aadel A; Binkley, Michael S; Aggarwal, Sonya; Qian, Yushen; Carter, Justin N; Shah, Rajesh; Loo, Billy W

    2016-01-01

    We present the case of a 42-year-old woman with metastatic synovial sarcoma of parotid origin, treated definitively with chemoradiation, who subsequently developed oligometastatic disease limited to the lungs. She underwent multiple left and right lung wedge resections and left lower lobectomy, followed by right lower lobe stereotactic ablative radiotherapy (SABR), 54 Gy in three fractions to a right lower lobe lesion abutting the chest wall. Two years later, she was treated with cryoablation for a separate right upper lobe nodule abutting the chest wall. Two months later, she presented with acute shortness of breath, pleuritic chest pain, decreased peripheral blood O2 saturation, and productive cough. A computed tomography (CT) scan demonstrated severe chest wall necrosis in the area of recent cryoablation that, in retrospect, also received a significant radiation dose from her prior SABR. This case demonstrates that clinicians should exercise caution in using cryoablation when treating lung tumors abutting a previously irradiated chest wall. Note: Drs. Loo and Shah contributed equally as co-senior authors. PMID:27004154

  10. Severe Chest Wall Toxicity From Cryoablation in the Setting of Prior Stereotactic Ablative Radiotherapy

    PubMed Central

    Chaudhuri, Aadel A; Binkley, Michael S; Aggarwal, Sonya; Qian, Yushen; Carter, Justin N; Shah, Rajesh

    2016-01-01

    We present the case of a 42-year-old woman with metastatic synovial sarcoma of parotid origin, treated definitively with chemoradiation, who subsequently developed oligometastatic disease limited to the lungs. She underwent multiple left and right lung wedge resections and left lower lobectomy, followed by right lower lobe stereotactic ablative radiotherapy (SABR), 54 Gy in three fractions to a right lower lobe lesion abutting the chest wall. Two years later, she was treated with cryoablation for a separate right upper lobe nodule abutting the chest wall. Two months later, she presented with acute shortness of breath, pleuritic chest pain, decreased peripheral blood O2 saturation, and productive cough. A computed tomography (CT) scan demonstrated severe chest wall necrosis in the area of recent cryoablation that, in retrospect, also received a significant radiation dose from her prior SABR. This case demonstrates that clinicians should exercise caution in using cryoablation when treating lung tumors abutting a previously irradiated chest wall. Note: Drs. Loo and Shah contributed equally as co-senior authors. PMID:27004154

  11. Small subdural hemorrhages: is routine intensive care unit admission necessary?

    PubMed

    Albertine, Paul; Borofsky, Samuel; Brown, Derek; Patel, Smita; Lee, Woojin; Caputy, Anthony; Taheri, M Reza

    2016-03-01

    With advancing technology, the sensitivity of computed tomography (CT) for the detection of subdural hematoma (SDH) continues to improve. In some cases, the finding is limited to one or 2 images of the CT examination. At our institution, all patients with an SDH require intensive care unit (ICU) admission, regardless of size. In this report, we tested the hypothesis that patients with a small traumatic SDH on their presenting CT examination do not require the intensive monitoring offered in the ICU and can instead be managed on a hospital unit with a lower level of monitoring. This is a retrospective study of patients evaluated and treated at a level I trauma center for acute traumatic intracranial hemorrhage between 2011 and 2014. The clinical and imaging profile of 87 patients with traumatic SDH were studied. Patients with small isolated traumatic subdural hemorrhage (tSDH) (<10cm(3) blood volume) spent less time in the ICU, demonstrated neurologic and medical stability during hospitalization, and did not require any neurosurgical intervention. It is our recommendation that patients with isolated tSDH (<10cm(3)) do not require ICU monitoring. Patients with small tSDH and additional intracranial hemorrhages overall show low rates of medical decline (4%) and neurologic decline (4%) but may still benefit from ICU observation. Patients with tSDH greater than 10cm(3) overall demonstrated poor clinical courses and outcome and would benefit ICU monitoring. PMID:26795895

  12. Impacts to the chest of PMHSs - Influence of impact location and load distribution on chest response.

    PubMed

    Holmqvist, Kristian; Svensson, Mats Y; Davidsson, Johan; Gutsche, Andreas; Tomasch, Ernst; Darok, Mario; Ravnik, Dean

    2016-02-01

    The chest response of the human body has been studied for several load conditions, but is not well known in the case of steering wheel rim-to-chest impact in heavy goods vehicle frontal collisions. The aim of this study was to determine the response of the human chest in a set of simulated steering wheel impacts. PMHS tests were carried out and analysed. The steering wheel load pattern was represented by a rigid pendulum with a straight bar-shaped front. A crash test dummy chest calibration pendulum was utilised for comparison. In this study, a set of rigid bar impacts were directed at various heights of the chest, spanning approximately 120mm around the fourth intercostal space. The impact energy was set below a level estimated to cause rib fracture. The analysed results consist of responses, evaluated with respect to differences in the impacting shape and impact heights on compression and viscous criteria chest injury responses. The results showed that the bar impacts consistently produced lesser scaled chest compressions than the hub; the Middle bar responses were around 90% of the hub responses. A superior bar impact provided lesser chest compression; the average response was 86% of the Middle bar response. For inferior bar impacts, the chest compression response was 116% of the chest compression in the middle. The damping properties of the chest caused the compression to decrease in the high speed bar impacts to 88% of that in low speed impacts. From the analysis it could be concluded that the bar impact shape provides lower chest criteria responses compared to the hub. Further, the bar responses are dependent on the impact location of the chest. Inertial and viscous effects of the upper body affect the responses. The results can be used to assess the responses of human substitutes such as anthropomorphic test devices and finite element human body models, which will benefit the development process of heavy goods vehicle safety systems. PMID:26687541

  13. The Depths from Skin to the Major Organs at Chest Acupoints of Pediatric Patients

    PubMed Central

    Ma, Yi-Chun; Peng, Ching-Tien; Huang, Yu-Chuen; Lin, Hung-Yi; Lin, Jaung-Geng

    2015-01-01

    Background. Acupuncture is applied to treat numerous diseases in pediatric patients. Few reports have been published on the depth to which it is safe to insert needle acupoints in pediatric patients. We evaluated the depths to which acupuncture needles can be inserted safely in chest acupoints in pediatric patients and the variations in safe depth according to sex, age, body weight, and body mass index (BMI). Methods. We retrospectively studied computed tomography (CT) images of pediatric patients aged 4 to 18 years who had undergone chest CT at China Medical University Hospital from December 2004 to May 2013. The safe depth of chest acupoints was directly measured from the CT images. The relationships between the safe depth of these acupoints and sex, age, body weight, and BMI were analyzed. Results. The results demonstrated significant differences in depth among boys and girls at KI25 (kidney meridian), ST16 (stomach meridian), ST18, SP17 (spleen meridian), SP19, SP20, PC1 (pericardium meridian), LU2 (lung meridian), and GB22 (gallbladder meridian). Safe depth significantly differed among the age groups (P < 0.001), weight groups (P < 0.05), and BMI groups (P < 0.05). Conclusion. Physicians should focus on large variations in needle depth during acupuncture for achieving optimal therapeutic effect and preventing complications. PMID:26457105

  14. Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

    PubMed Central

    Weissman, David N.

    2015-01-01

    This review provides an update on literature published over the past 5 years that is relevant to using chest computed tomography (CT) as a tool for preventing occupational respiratory disease. An important area of investigation has been in the use of low-dose CT (LDCT) to screen asbestos-exposed populations for lung cancer. Two recent systematic reviews have reached conclusions in support of screening. Based on the limited evidence that is currently available, the Finnish Institute of Occupational Health has recommended LDCT screening in asbestos-exposed individuals if their personal combination of risk factors yields a risk for lung cancer equal to that needed for entry into the National Lung Screening Trial. It has also recommended further research, such as to document the optimal frequency of screening and the effectiveness of screening. Recent literature continues to support high-resolution CT (HRCT) as being more sensitive than chest radiography in detecting pneumoconiosis. However, there are insufficient data to determine the effectiveness of HRCT screening in improving individual outcomes if used in screening for pneumoconiosis and its routine use for this purpose cannot be recommended. However, if HRCT is used to evaluate populations, recent literature shows that the International Classification of HRCT for Occupational and Environmental Respiratory Diseases provides an important tool for reproducible evaluation and recording of findings. HRCT is an important tool for individual patient management and recent literature has documented that chest HRCT findings are significantly associated with outcomes such as pulmonary function and mortality. PMID:26024350

  15. Compression of digital chest x-rays

    NASA Astrophysics Data System (ADS)

    Cohn, Michael; Trefler, Martin; Young, Tzay S.

    1990-07-01

    The application of digital technologies to chest radiography holds the promise of routine application of intage processing techniques to effect image enhancement. However, due to their inherent spatial resolution, digital chest images impose severe constraints on data storage devices. Compression of these images will relax such constraints and facilitate image transmission on a digital network. We have evaluated image processing algorithms aimed at compression of digital chest images while improving the diagnostic quality of the image. The image quality has been measured with respect to the task of tumor detection. Compression ratios of as high as 2:1 have been achieved. This compression can then be supplemented by irreversible methods.

  16. Technique for chest radiography for pneumoconiosis

    SciTech Connect

    Sargent, E.N.

    1982-01-01

    Routine radiographic chest examinations have been performed using a variety of techniques. Although chest radiography is one of the most commonly performed radiographic examinations, it is often difficult to obtain consistently good quality roentgenograms. This publication provides a simple guide and relatively easy solution to the many problems that radiologic technologists might encounter. The language is purposely relatively simple and care has been taken to avoid difficult mathematical and physical explanations. The intent is to provide an easily referrable text for those who may encounter difficulties in producing acceptable chest radiographs.

  17. Classification of chest wall diseases.

    PubMed

    Pozzi, E; Gulotta, C

    1993-01-01

    Several disorders of the thoracic cage are known to cause respiratory failure, by means of relatively simple mechanisms, such as the increased work of breathing, which results in alveolar hypoventilation. A variety of pathogenic mechanisms may be considered, as functions of the types of thoracic disorders present. As causes of these additional potential mechanisms, we considered the following: 1) ventilation-perfusion (V/Q) inhomogeneity; 2) inability to cough; 3) malformation or acquired defect of the respiratory centres; and 4) excess blood volume and fluid retention, which aggravate work of breathing and V/Q inhomogeneity. All of these disorders can be grouped into two major categories (which nevertheless have some of the pathophysiology in common): the mechanical syndrome and the neuromuscular or paralytic syndrome. In this paper we discuss chest wall diseases falling into the first category; namely, kyphoscoliosis, fibrothorax, thoracoplasty, ankylosing spondylitis and obesity-hypoventilation. Congenital deformities of the thoracic cage, which do not have important effects on ventilatory apparatus (e.g. pectus excavatum and pectus carinatum), were also considered. PMID:8472068

  18. Head CT scan

    MedlinePlus

    Brain CT; Cranial CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial ... or other growth (mass) Cerebral atrophy (loss of brain tissue) ... with the hearing nerve Stroke or transient ischemic attack (TIA)

  19. Aspergillosis - chest x-ray (image)

    MedlinePlus

    ... usually occurs in immunocompromised individuals. Here, a chest x-ray shows that the fungus has invaded the lung ... are usually seen as black areas on an x-ray. The cloudiness on the left side of this ...

  20. Tuberculosis, advanced - chest x-rays (image)

    MedlinePlus

    ... tissue, and can cause tissue death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light ... location of cavities within these light areas. The x-ray on the left clearly shows that the opacities ...

  1. Imaging of diseases of the chest

    SciTech Connect

    Armstrong, P.; Dee, P.; Wilson, A.

    1988-01-01

    This book promises to be the first intermediate length chest imaging book that successfully integrates material on the newer modalities (MRI, Nuclear Medicine) with that on conventional techniques (plain film radiography).

  2. Chest pain in focal musculoskeletal disorders.

    PubMed

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-03-01

    The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice. PMID:20380955

  3. [Dedifferentiated Chondrosarcoma of the Chest Wall].

    PubMed

    Saitoh, Genkichi; Yoneshima, Yasuto; Nakamura, Toshihiko; Kitagawa, Dai; Kinjo, Nao; Ohgaki, Kippei; Maehara, Shinichiro; Teramoto, Seiichi; Adachi, Eisuke; Ikeda, Yoichi; Mine, Mari

    2016-08-01

    A 79-year-old man complaining of an anterior chest mass with pain had an abnormal shadow on chest X-ray. A mass, 7 cm in size, with destruction of the right 4th rib was found on chest computed tomography. A F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) corresponding to the lesion showed an abnormal accumulation of FDG with the standardized uptake value(SUV) max=16.19. A malignant tumor of the chest wall origin was suspected and the tumor was resected with the 3th, 4th, and 5th ribs. Histologically, the tumor was diagnosed as dedifferentiated chondrosarcoma. He died of local recurrence about 5 months after the operation. PMID:27476566

  4. Tuberculosis, advanced - chest x-rays (image)

    MedlinePlus

    Tuberculosis is an infectious disease that causes inflammation, the formation of tubercules and other growths within tissue, ... death. These chest x-rays show advanced pulmonary tuberculosis. There are multiple light areas (opacities) of varying ...

  5. Revision breast and chest wall reconstruction in Poland and pectus excavatum following implant complication using free deep inferior epigastric perforator flap

    PubMed Central

    Dionyssiou, Dimitrios; Demiri, Efterpi; Batsis, Georgios; Pavlidis, Leonidas

    2015-01-01

    This study aims to present the case of a female patient with Poland's syndrome and pectus excavatum deformity who underwent breast and chest wall reconstruction with a pre-shaped free deep inferior epigastric perforator flap. A 57-year-old female patient with Poland's syndrome and pectus excavatum presented with a Baker III capsular contracture following a previously performed implant-based right breast reconstruction. After a chest and abdominal CT angiography, she was staged as 2A1 chest wall deformity according to Park's classification and underwent implant removal and capsulectomy, followed by a pre-shaped free abdominal flap transfer, providing both breast reconstruction and chest wall deformity correction in a single stage operation. Post-operative course was uneventful, and the aesthetic result remains highly satisfactory 24 months after surgery. Deep inferior epigastric free flap represents an interesting reconstructive solution when treating Poland's syndrome female patients with chest wall and breast deformities. PMID:25991894

  6. Fluoroscopic chest tube insertion and patient care.

    PubMed Central

    Collins, J. D.; Shaver, M. L.; Disher, A. C.; Miller, T. Q.

    1992-01-01

    Catheters and chest tubes may be placed under fluoroscopic control to reduce pleural effusions. This procedure has been adopted as a routine procedure at the UCLA School of Medicine in Los Angeles, California to improve patient care. This technique was modified for the placement of large chest tubes, which can be placed by a radiologist without multiple attempts or complications. Our experience with 2234 patients who underwent this procedure between 1977 and 1990 is described. PMID:1404463

  7. Dual-Energy CT: Spectrum of Thoracic Abnormalities.

    PubMed

    Otrakji, Alexi; Digumarthy, Subba R; Lo Gullo, Roberto; Flores, Efren J; Shepard, Jo-Anne O; Kalra, Mannudeep K

    2016-01-01

    Recent studies have demonstrated that dual-energy computed tomography (CT) can provide useful information in several chest-related clinical indications. Compared with single-energy CT, dual-energy CT of the chest is feasible with the use of a radiation-dose-neutral scanning protocol. This article highlights the different types of images that can be generated by using dual-energy CT protocols such as virtual monochromatic, virtual unenhanced (ie, water), and pulmonary blood volume (ie, iodine) images. The physical basis of dual-energy CT and material decomposition are explained. The advantages of the use of virtual low-monochromatic images include reduced volume of intravenous contrast material and improved contrast resolution of images. The use of virtual high-monochromatic images can reduce beam hardening and contrast streak artifacts. The pulmonary blood volume images can help differentiate various parenchymal abnormalities, such as infarcts, atelectasis, and pneumonias, as well as airway abnormalities. The pulmonary blood volume images allow quantitative and qualitative assessment of iodine distribution. The estimation of iodine concentration (quantitative assessment) provides objective analysis of enhancement. The advantages of virtual unenhanced images include differentiation of calcifications, talc, and enhanced thoracic structures. Dual-energy CT has applications in oncologic imaging, including diagnosis of thoracic masses, treatment planning, and assessment of response to treatment. Understanding the concept of dual-energy CT and its clinical application in the chest are the goals of this article. PMID:26761530

  8. Reducing admissions with patient group directions.

    PubMed

    Wat, Dennis; Glossage, Elaine; Hampson, Onnor; Sibley, Sarah

    In times of financial restrictions and reform impediments, health services need to invest in resources that provide value for money and reduce hospital admissions. Improving disease management in the community is a primary target for those trying to reduce costs. The second most common cause of emergency admissions to hospital is chronic obstructive pulmonary disease and it has been suggested that more effective treatments and better management of the condition would likely result in an estimated 5% fewer admissions to hospital, saving around pound 15.5m each year. This article discusses how savings could be made by improving care provided in the community. PMID:24834601

  9. Management of chest trauma: a review.

    PubMed

    Adebonojo, S A

    1993-01-01

    The incidence of chest trauma has increased significantly since the turn of the century especially in developed countries where rapid means of transportation has become part of daily life. Although gunshot wounds (GSWs) were the commonest causes of chest trauma in wartime, road traffic accidents (RTAs) have become the scourge of peacetime and modern civilization. Chest trauma is more common in males during the 2nd to the 5th decades of life with an average age of 40 years reducing their life expectancy by another 40 years at the most productive and active period of their lives. Despite improvement in ambulance service and rapid mobilization of victims from the scene of accident, about 10% of chest injured patients will die on the spot and another 5% die within an hour of reaching the hospital. Of the remaining 85%, five percent will require emergency thoracotomy for various reasons while 80% will respond to resuscitative measures and tube thoracostomy drainage alone. The primary aims in the management of chest trauma are prompt restoration of normal cardiorespiratory functions, control of haemorrhage, treatment of associated injuries and prevention of sepsis. Although the overall survival rate of trauma has improved in recent years, deaths are often due to airway obstruction, exsanguinating haemorrhage, flail chest, tension pneumothorax, cardiac tamponade and associated intracranial, intraabdominal and skeletal injuries. PMID:8398932

  10. [Differential diagnosis "non-cardiac chest pain"].

    PubMed

    Frieling, Thomas

    2015-07-01

    Non cardiac chest pain (NCCP) are recurrent angina pectoris like pain without evidence of coronary heart diesease in conventional diagnostic evaluation. The prevalence of NCCP is up to 70% and may be detected in this order at all levels of the medical health care system (general practitioner, emergency department, chest pain unit, coronary care). Reduction of quality of life in NCCP is comparable, partially even higher compared to cardiac chest pain. Reasons for psychological strain are symptom recurrence in app. 50%, nonspecific diagnosis with resulting uncertainty and insufficient integration of other medical disciplines in diagnostic work-up. Managing of patients with NCCP has to be interdisciplinary because non cardiac causes of chest pain may be found frequently. This are musculosceletal in app. 40%, gastrointestinal in app. 20%, psychiatric in app. 10% and pulmonary and mediastinal diseases in app. 5% of cases. Also gastroenterological expertise is required because here gastroesophageal reflux disease (GERD) in app. 60%, hypercontractile esophageal motility disorders with nutcracker, jackhammer esophagus or distal esophageal spasmus or achalasia in app. 20% and other esophageal alterations (e. g. infectious esophageal inflammation, drug-induced ulcer, rings, webs, eosinophilic esophagits) in app. 30% of cases may be detected as cause of chest pain may. This implicates that regular interdisciplinary round wards and interdisciplinary management of chest pain units are mandatory. PMID:26230070

  11. How to remove a chest drain.

    PubMed

    Allibone, Elizabeth

    2015-10-01

    RATIONALE AND KEY POINTS: This article aims to help nurses to undertake the removal of a chest drain in a safe, effective and patient-centred manner. This procedure requires two practitioners. The chest drain will have been inserted aseptically to remove air, blood, fluid or pus from the pleural cavity. ▶ Chest drains may be small or wide bore depending on the underlying condition and clinical setting. They may be secured with a mattress suture and/or an anchor suture. ▶ Chest drains are usually removed under medical instructions when the patient's lung has inflated, the underlying condition has resolved, there is no evidence of respiratory compromise or failure, and their anticoagulation status has been assessed as satisfactory. ▶ Chest drains secured with a mattress suture should be removed by two practitioners. One practitioner is required to remove the tube and the other to tie the mattress suture (if present) and secure the site. REFLECTIVE ACTIVITY: Clinical skills articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: 1. How reading this article will change your practice. 2. How this article could be used to educate patients with chest drains. Subscribers can upload their reflective accounts at: rcni.com/portfolio . PMID:26443174

  12. Surgical stabilization of traumatic flail chest.

    PubMed Central

    París, F; Tarazona, V; Blasco, E; Cantó, A; Casillas, M; Pastor, J; París, M; Montero, R

    1975-01-01

    Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good. Images PMID:1105874

  13. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 7 2014-10-01 2014-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  14. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 7 2013-10-01 2013-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  15. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  16. 42 CFR 37.4 - Plans for chest roentgenographic examinations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Plans for chest roentgenographic examinations. 37.4... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.4 Plans for chest roentgenographic examinations. (a) Every plan for chest...

  17. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 7 2012-10-01 2012-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  18. 42 CFR 37.4 - Plans for chest roentgenographic examinations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Plans for chest roentgenographic examinations. 37.4... EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations § 37.4 Plans for chest roentgenographic examinations. (a) Every plan for chest...

  19. 46 CFR 196.37-47 - Portable magazine chests.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 7 2011-10-01 2011-10-01 false Portable magazine chests. 196.37-47 Section 196.37-47... Markings for Fire and Emergency Equipment, etc. § 196.37-47 Portable magazine chests. (a) Portable magazine chests shall be marked in letters at least 3 inches high: PORTABLE MAGAZINE CHEST — FLAMMABLE —...

  20. A framework for analytical estimation of patient-specific CT dose

    NASA Astrophysics Data System (ADS)

    Youn, Hanbean; Kim, Jin Woo; Jeon, Hosang; Nam, Jiho; Yun, Seungman; Cho, Min Kook; Kim, Ho Kyung

    2016-03-01

    The authors introduce an algorithm to estimate the spatial dose distributions in computed tomography (CT) images. The algorithm calculates dose distributions due to the primary and scattered photons separately. The algorithm only requires the CT data set that includes the patient CT images and the scanner acquisition parameters. Otherwise the scanner acquisition parameters are extracted from the CT images. Using the developed algorithm, the dose distributions for head and chest phantoms are computed and the results show the excellent agreements with the dose distributions obtained using a commercial Monte Carlo code. The developed algorithm can be applied to a patient-specific CT dose estimation based on the CT data.

  1. The Impact of Bakke on Admissions Programs.

    ERIC Educational Resources Information Center

    Simmons, Ron; Macklin, Dave

    1980-01-01

    The Bakke decision will cause institutions to strengthen academic support programs, improve admissions procedures, and develop stronger evaluation programs. Institutions will see more "reverse discrimination" cases in the future. (Author)

  2. 40 CFR 5.220 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GENERAL NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage § 5.220 Admissions. (a... education, professional education, graduate higher education, and public institutions of...

  3. 16 CFR 3.32 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ADJUDICATIVE PROCEEDINGS Discovery; Compulsory Process § 3.32 Admissions. (a) At any time after thirty (30... unless the party states that it has made reasonable inquiry and that the information known to or...

  4. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  5. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  6. 43 CFR 4.1141 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... directed serves on the requesting party— (1) A sworn statement denying specifically the relevant matters of which an admission is requested; (2) A sworn statement setting forth in detail the reasons why he...

  7. Coronary thrombus detected by cardiac CT angiography before cardiac catheterization.

    PubMed

    Slim, Ahmad M; Slim, Jennifer N; Haney, Brian R; Shry, Eric A

    2010-11-01

    A patient presented with a complaint of pleuritic chest discomfort with elevated cardiac biomarkers. After a cardiac magnetic resonance imaging scan for the suspicion of myopericarditis showed a potential myocardial infarct, a coronary CT scan was performed. This revealed a thrombus of the left anterior descending artery. Cardiac catheterization confirmed the findings, and a small clot was removed. To our knowledge, this is the first reported case of coronary thrombus being detected by CT angiography with cardiac catheterization correlation. Coronary CT angiography has been increasingly used to evaluate acute chest pain with a negative predictive value close to 100%. In a young patient with suspicion of myopericarditis, CT angiography proved to be useful in diagnosing thrombus in the coronary tree. PMID:20463613

  8. Analysis of biological tissues in infant chest for the development of an equivalent radiographic phantom

    SciTech Connect

    Pina, D. R.; Souza, Rafael T. F.; Duarte, Sergio B.; Alvarez, Matheus; Miranda, Jose R. A.

    2012-03-15

    Purpose: The main purpose of the present study was to determine the amounts of different tissues in the chest of the newborn patient (age {<=}1 year), with the aim of developing a homogeneous phantom chest equivalent. This type of phantom is indispensable in the development of optimization procedures for radiographic techniques, including dosimetric control, which is a crucial aspect of pediatric radiology. The authors present a systematic set of procedures, including a computational algorithm, to estimate the amounts of tissues and thicknesses of the corresponding simulator material plates used to construct the phantom. Methods: The Gaussian fit of computed tomographic (CT) analysis was applied to classify and quantify different biological tissues. The methodology is summarized with a computational algorithm, which was used to quantify tissues through automated CT analysis. The thicknesses of the equivalent homogeneous simulator material plates were determined to construct the phantom. Results: A total of 180 retrospective CT examinations with anterior-posterior diameter values ranging 8.5-13.0 cm were examined. The amounts of different tissues were evaluated. The results provided elements to construct a phantom to simulate the infant chest in the posterior-anterior or anterior-posterior (PA/AP) view. Conclusions: To our knowledge, this report represents the first demonstration of an infant chest phantom dedicated to the radiology of children younger than one year. This phantom is a key element in the development of clinical charts for optimizing radiographic technique in pediatric patients. Optimization procedures for nonstandard patients were reported previously [Pina et al., Phys. Med. Biol. 49, N215-N226 (2004) and Pina et al., Appl. Radiat. Isot. 67, 61-69 (2009)]. The constructed phantom represents a starting point to obtain radiologic protocols for the infant patient.

  9. Immigration, moving house and psychiatric admissions.

    PubMed

    Johansson, L M; Sundquist, J; Johansson, S E; Bergman, B

    1998-08-01

    This study was designed to elucidate psychiatric admission rates for native Swedes and foreign-born individuals during the period 1991-1994, when Sweden had a great influx of refugees. During the same period, and even earlier, psychiatric in-patient care had been reduced. Tests of differences between Swedes and foreign-born individuals in first psychiatric admission rates were performed using Poisson regressions, and the risk of a readmission was assessed using a proportional hazard model. Foreign-born individuals and native Swedes, both males and females, showed a similar admission pattern with regard to the number of admissions. Foreign-born males under 55 years of age and foreign-born females under 35 years of age had significantly higher admission rates than native Swedes. In total, native Swedes, both males and females, were hospitalized for a significantly longer period than the foreign-born subjects. About 43% of the patients were readmitted. The risk of a readmission was significantly increased among those with a high rate of internal migration. The high admission rates for young foreign-born individuals might be explained by a high incidence of mental illness owing to the trauma of being violently forced to migrate, acculturation difficulties, or unsatisfactory social circumstances such as high unemployment. The shorter hospitalization time could be due to undertreatment or less serious mental illness. PMID:9718235

  10. Borne identity: CT imaging of vascular infections.

    PubMed

    Huang, Jessica S; Ho, Alexander S; Ahmed, Absar; Bhalla, Sanjeev; Menias, Christine O

    2011-08-01

    Vascular infections present in a multitude of ways with computed tomography (CT) aiding in the diagnosis of many of the uncommon vascular infections, which are equally dangerous and carry severe life-threatening consequences if untreated from a delay in diagnosis. This pictorial review aims to discuss and illustrate the CT findings of the following vascular infections including aortitis, mycotic aneurysms, infective endocarditis, septic thrombophlebitis in the chest and abdomen, and Kawasaki disease. Recognition and prompt diagnosis of these uncommon vascular infections are critical to the initiation of the appropriate management and therapy. PMID:21424803

  11. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward.

    PubMed

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a 'VTE risk assessment champion' to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor who

  12. Improving VTE risk assessment at point of admission to a tertiary centre cardiology ward

    PubMed Central

    Wilson, Rachel

    2015-01-01

    Cardiology wards are generally high turnover units, which may receive primary PCI, high-risk NSTEMI patients, and other general cardiac admissions from a large geographical area. Many centres also provide national specialist services for rarer cardiac conditions for which admissions may be lengthy. Cardiac patients have significant risk factors for venous thromboembolism (VTE) as immobility may be due to systolic dysfunction, attachment to continuous monitoring and predisposition to chest pain, or cardiac syncope. It is recommended by NICE that an initial VTE risk assessment is undertaken at the time of patient admission, with reassessment within 24 hours. For this purpose a risk assessment tool is featured on the front of many Trust drug charts. It is noted that this risk assessment is electronic in other trusts. We undertook an audit into the drug chart documentation of VTE risk assessment on the cardiology ward and the Coronary Care Unit (CCU) at The Royal Free Hospital. It was evident that documentation of VTE risk assessment was poor. The audit interventions were; a teaching presentation to the cardiology department, an educational poster, several update emails to the department and the identification of a ‘VTE risk assessment champion’ to audit ongoing compliance. Following these measures the second audit round demonstrated that documentation of initial risk assessment was slightly improved, but significant improvement was seen in documentation of risk assessment at 24 hours post admission. Results from a third audit cycle indicated that the improvement in initial VTE risk assessment was sustained, and that there was a significant sustained improvement in risk assessment at 24 hours (p <0.05). Recommendations for sustained improvement included: redesigning the drug chart so that the VTE risk assessment tool was linked to the VTE prophylaxis prescription box, and designating the responsibility of the initial VTE risk assessment to the on call junior doctor

  13. Use of a titanium alloy (Chest Way) in the surgical stabilization of flail chest.

    PubMed

    Nakagawa, Tomoki; Matsuzaki, Tomohiko; Aruga, Naohiro; Imamura, Naoko; Hamanaka, Rurika; Ikoma, Yoichiro; Masuda, Ryota; Iwazaki, Masayuki

    2016-09-01

    To avoid the complications of internal pneumatic stabilization for flail chest, we performed stabilization of the chest wall with a metal bar using the Nuss procedure. Here, we used a highly elastic lightweight biocompatible titanium alloy Chest Way (Solve Corporation, Kanagawa, Japan), enabling magnetic resonance imaging. The patient was a 37-year-old man who sustained injuries in a car crash. Gradually increasing subcutaneous emphysema was present. Bilateral pleural drainage and tracheal intubation were conducted on the scene, and a peripheral venous line was established. The patient was then transferred to our hospital by helicopter. A titanium alloy Chest Way was inserted to manage his flail chest accompanied by multiple rib fractures on the left side. Two days later, artificial respiration was no longer required. PMID:26096325

  14. Computing effective dose in cardiac CT

    NASA Astrophysics Data System (ADS)

    Huda, Walter; Tipnis, Sameer; Sterzik, Alexander; Schoepf, U. Joseph

    2010-07-01

    We present a method of estimating effective doses in cardiac CT that accounts for selected techniques (kV mAs-1), anatomical location of the scan and patient size. A CT dosimetry spreadsheet (ImPACT CT Patient Dosimetry Calculator) was used to estimate effective doses (E) using ICRP 103 weighting factors for a 70 kg patient undergoing cardiac CT examinations. Using dose length product (DLP) for the same scans, we obtained values of E/DLP for three CT scanners used in cardiac imaging from two vendors. E/DLP ratios were obtained as a function of the anatomical location in the chest and for x-ray tube voltages ranging from 80 to 140 kV. We also computed the ratio of the average absorbed dose in a water cylinder modeling a patient weighing W kg to the corresponding average absorbed dose in a water cylinder equivalent to a 70 kg patient. The average E/DLP for a 16 cm cardiac heart CT scan was 26 µSv (mGy cm)-1, which is about 70% higher than the current E/DLP values used for chest CT scans (i.e. 14-17 µSv (mGy cm)-1). Our cardiac E/DLP ratios are higher because the cardiac region is ~30% more radiosensitive than the chest, and use of the ICRP 103 tissue weighting factors increases cardiac CT effective doses by ~30%. Increasing the x-ray tube voltage from 80 to 140 kV increases the E/DLP conversion factor for cardiac CT by 17%. For the same incident radiation at 120 kV, doses in 45 kg adults were ~22% higher than those in 70 kg adults, whereas doses in 120 kg adults were ~28% lower. Accurate estimates of the patient effective dose in cardiac CT should use ICRP 103 tissue weighting factors, and account for a choice of scan techniques (kV mAs-1), exposed scan region, as well as patient size.

  15. A Review of Esophageal Chest Pain

    PubMed Central

    Coss-Adame, Enrique

    2015-01-01

    Noncardiac chest pain is a term that encompasses all causes of chest pain after a cardiac source has been excluded. This article focuses on esophageal sources for chest pain. Esophageal chest pain (ECP) is common, affects quality of life, and carries a substantial health care burden. The lack of a systematic approach toward the diagnosis and treatment of ECP has led to significant disability and increased health care costs for this condition. Identifying the underlying cause(s) or mechanism(s) for chest pain is key for its successful management. Common etiologies include gastroesophageal reflux disease, esophageal hypersensitivity, dysmotility, and psychological conditions, including panic disorder and anxiety. However, the pathophysiology of this condition is not yet fully understood. Randomized controlled trials have shown that proton pump inhibitor therapy (either omeprazole, lansoprazole, or rabeprazole) can be effective. Evidence for the use of antidepressants and the adenosine receptor antagonist theophylline is fair. Psychological treatments, notably cognitive behavioral therapy, may be useful in select patients. Surgery is not recommended. There remains a large unmet need for identifying the phenotype and prevalence of pathophysiologic mechanisms of ECP as well as for well-designed multicenter clinical trials of current and novel therapies. PMID:27134590

  16. A Review of Esophageal Chest Pain.

    PubMed

    Coss-Adame, Enrique; Rao, Satish S C

    2015-11-01

    Noncardiac chest pain is a term that encompasses all causes of chest pain after a cardiac source has been excluded. This article focuses on esophageal sources for chest pain. Esophageal chest pain (ECP) is common, affects quality of life, and carries a substantial health care burden. The lack of a systematic approach toward the diagnosis and treatment of ECP has led to significant disability and increased health care costs for this condition. Identifying the underlying cause(s) or mechanism(s) for chest pain is key for its successful management. Common etiologies include gastroesophageal reflux disease, esophageal hypersensitivity, dysmotility, and psychological conditions, including panic disorder and anxiety. However, the pathophysiology of this condition is not yet fully understood. Randomized controlled trials have shown that proton pump inhibitor therapy (either omeprazole, lansoprazole, or rabeprazole) can be effective. Evidence for the use of antidepressants and the adenosine receptor antagonist theophylline is fair. Psychological treatments, notably cognitive behavioral therapy, may be useful in select patients. Surgery is not recommended. There remains a large unmet need for identifying the phenotype and prevalence of pathophysiologic mechanisms of ECP as well as for well-designed multicenter clinical trials of current and novel therapies. PMID:27134590

  17. Do Tiers Affect Student Transfer? Examining the Student Admission Ratio

    ERIC Educational Resources Information Center

    Moodie, Gavin

    2007-01-01

    This study considers whether formally segmenting 4-year institutions by admissions selectivity affects the admission of transfer students. It develops a new measure, the student admission ratio, to compare the admission of transfer students in formally and highly segmented systems, informally and less segmented systems, and in formally unified…

  18. Post mastectomy linac IMRT irradiation of chest wall and regional nodes: dosimetry data and acute toxicities

    PubMed Central

    2013-01-01

    Background Conventional post-mastectomy radiation therapy is delivered with tangential fields for chest wall and separate fields for regional nodes. Although chest wall and regional nodes delineation has been discussed with RTOG contouring atlas, CT-based planning to treat chest wall and regional nodes as a whole target has not been widely accepted. We herein discuss the dosimetric characteristics of a linac IMRT technique for treating chest wall and regional nodes as a whole PTV after modified radical mastectomy, and observe acute toxicities following irradiation. Methods Patients indicated for PMRT were eligible. Chest wall and supra/infraclavicular region +/−internal mammary nodes were contoured as a whole PTV on planning CT. A simplified linac IMRT plan was designed using either integrated full beams or two segments of half beams split at caudal edge of clavicle head. DVHs were used to evaluate plans. The acute toxicities were followed up regularly. Results Totally, 85 patients were enrolled. Of these, 45 had left-sided lesions, and 35 received IMN irradiation. Planning designs yielded 55 integrated and 30 segmented plans, with median number of beams of 8 (6–12). The integrated and segmented plans had similar conformity (1.41±0.14 vs. 1.47±0.15, p=0.053) and homogeneity indexes (0.13±0.01 vs. 0.14±0.02, p=0.069). The percent volume of PTV receiving >110% prescription dose was <5%. As compared to segmented plans, integrated plans typically increased V5 of ipsilateral lung (p=0.005), and heart (p=0.001) in patients with left-sided lesions. Similarly, integrated plans had higher spinal cord Dmax (p=0.009), ipsilateral humeral head (p<0.001), and contralateral lung Dmean (p=0.019). During follow-up, 36 (42%) were identified to have ≥ grade 2 radiation dermatitis (RD). Of these, 35 developed moist desquamation. The median time to onset of moist desquamation was 6 (4–7) weeks from start of RT. The sites of moist desquamation were most frequently occurred

  19. Coordinated Digital-Assisted Program Improved Door-to-Balloon Time for Acute Chest Pain Patients.

    PubMed

    Chen, Hao; Liu, Jian; Xiang, Dingcheng; Qin, Weiyi; Zhou, Minwei; Tian, Yan; Wang, Mingyu; Yang, Jijiang; Gao, Qiang

    2016-05-25

    Emergency care for patients with chest pain can be a challenge in remote areas. Digital communication technology has the potential to improve outcomes by allowing early diagnosis and faster treatment. The aim of the present study was to investigate whether implementation of a coordinated digital-assisted program (CDAP) for Chinese hospitals can reduce the door-to-balloon (D2B) time for percutaneous coronary intervention (PCI) in acute chest pain patients in China. From March to December 2011, 609 patients (CDAP group) requiring an emergency response for acute chest pain were evaluated using this CDAP. The results were compared in terms of time interval reduction (including D2B) and economic indices with those of 528 patients (non-CDAP group) previously treated by conventional protocols after admission. We screened 154 and 127 eligible patients under PCI in the CDAP and non-CDAP groups, respectively. PCI patients achieved a D2B time < 90 minutes using CDAP (82.5 versus 26.0%, P < 0.001). CDAP reduced D2B time under PCI and reduced hospitalization lengths and costs (all P < 0.001). PMID:27150005

  20. Representation Of Dynamic Information On Static Chest Films By Interlaced Radioaraphy

    NASA Astrophysics Data System (ADS)

    Wernikoff, Robert E.; Dinsmore, Robert E.; Miller, Stephen W.

    1980-08-01

    To date, 696 patients being admitted to the Cardiac Unit have been examined by a new method-Intergated Radiography-that adds information about cardiovascular pulsations to the conventional admission chest x-ray, without interfering with the ordinary purposes of chest radiography and without increasing radiation dose to the patient. The Intergated Radiography System (IRS) is a simple attachment for existing chest radiography units. It images the heart at end-diastole and end-systole on alternate thin strips of a single film, thus producing a composite image in which moving walls have a serrated appearance that easily permits objective measurement of wall motion while the appearance of stationary thoracic structures is substantially unaffected. Patients with coronary artery disease, aortic regurgitation and left-to-right shunts demonstrate characteristic motion patterns. IRS films compared with ventriculography and aortography show excellent correlation. Preliminary results suggest IRS may increase the diagnostic accuracy of electrocardiographic exercise stress testing for detection of coronary artery disease. Thus Intergated Radiography is a simple and objective method for screening and for following the results of therapy in patients.

  1. Negative predictive value of cardiac troponin for predicting adverse cardiac events following blunt chest trauma.

    PubMed

    Guild, Cameron S; deShazo, Matthew; Geraci, Stephen A

    2014-01-01

    Cardiac-specific troponins (Tns) are sensitive and specific markers of myocardial injury that have been shown to be predictive of outcomes in many cardiac and noncardiac conditions. We sought to determine whether normal cardiac Tn concentrations obtained during the first 24 hours following blunt chest trauma would predict good cardiac outcomes. A PubMed/MEDLINE search was performed to identify prospective studies in patients with blunt chest trauma in which serial cardiac TnT or TnI values were measured within 24 hours of admission and clinical outcomes assessed. Ten studies qualified for review. Studies that used the lower reference limit of Tn as the cutoff for cardiac injury showed 100% negative predictive value (NPV) for developing cardiac complications, whereas studies using higher Tn cutoffs showed wider variation in NPV (50%-98%). Cardiac Tn measured within 24 hours using the lower reference limit (LRL) as the cutoff appears to have excellent NPV for clinically significant adverse cardiac events. This could allow for early discharge after a 24-hour observation period in otherwise uncomplicated blunt chest trauma patients and avoid the need for more expensive cardiac imaging and additional resource utilization. PMID:24389788

  2. Pulmonary evaluation of patients with osteosarcoma: roles of standard radiography, tomography, CT, scintigraphy, and tomoscintigraphy

    SciTech Connect

    Vanel, D.; Henry-Amar, M.; Lumbroso, J.; Lemalet, E.; Couanet, D.; Piekarski, J.D.; Masselot, J.; Boddaert, A.; Kalifa, C.; Le Chevalier, T.

    1984-09-01

    Sixty-one radiologic evaluations were performed on 32 patients with possible pulmonary metastases from osteosarcoma. CT scanning was performed 61 times; standard chest radiography, 58; tomography, 36; scintigraphy, 40; and tomoscintigraphy, 33. Using CT as a reference, the sensitivities of the other examinations were 57% (32% of total metastases) for standard radiography, 88% (48%) for tomography, 21% (5%) for scintigraphy, and 41% (8%) for tomoscintigraphy. Of the 193 metastases, 98 were subpleural and 95 were parenchymatous. The authors' current evaluation of patients with metastases from osteosarcoma includes chest radiography and CT; the other three examinations are performed only before surgery.

  3. Treatment of Morbidity with Atypical Chest Pain

    PubMed Central

    Cott, Arthur

    1987-01-01

    The appropriate management of atypical chest pain requires an integration of medical and behavioural treatments. Unnecessary medicalization can increase morbidity. A sensitivity to the behavioural factors contributing to symptoms and disability may reduce both. The purpose of this paper is to provide physicians with a cognitive-behavioural perspective of the nature of morbidity and disability associated with chronic chest discomfort; some strategies for detecting heretofore unsuspected disability associated with chronic chest pain and related discomfort in patients with organic findings (both cardiac and non-cardiac), as well those with no identifiable disease process or organic cause; and some simple behavioural and cognitive-behavioural therapeutic techniques for treating and preventing such problems. PMID:21263912

  4. VAC® for external fixation of flail chest

    PubMed Central

    Winge, Rikke; Berg, Jais O.; Albret, Rikke; Krag, Christen

    2012-01-01

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient's need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU). This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation. PMID:24765464

  5. Enhancement of chest radiographs using eigenimage processing

    NASA Astrophysics Data System (ADS)

    Bones, Philip J.; Butler, Anthony P. H.; Hurrell, Michael

    2006-08-01

    Frontal chest radiographs ("chest X-rays") are routinely used by medical personnel to assess patients for a wide range of suspected disorders. Often large numbers of images need to be analyzed. Furthermore, at times the images need to analyzed ("reported") when no radiological expert is available. A system which enhances the images in such a way that abnormalities are more obvious is likely to reduce the chance that an abnormality goes unnoticed. The authors previously reported the use of principal components analysis to derive a basis set of eigenimages from a training set made up of images from normal subjects. The work is here extended to investigate how best to emphasize the abnormalities in chest radiographs. Results are also reported for various forms of image normalizing transformations used in performing the eigenimage processing.

  6. VAC® for external fixation of flail chest.

    PubMed

    Winge, Rikke; Berg, Jais O; Albret, Rikke; Krag, Christen

    2012-05-29

    A large aterior chest wall defect following tumor resection was reconstructed with a Gore-Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC®) resulted in immediate chest wall stability and a decrease in the patient's need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU). This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation. PMID:24765464

  7. Enhancement and compression of digital chest radiographs.

    PubMed

    Cohn, M; Trefler, M; Young, T Y

    1990-01-01

    The application of digital technologies to chest radiography holds the promise of routine application of image processing techniques to effect image enhancement. Because of their inherent spatial resolution, however, digital chest images impose severe constraints on data storage devices. Compression of these images will relax such constraints and facilitate image transmission on a digital network. We evaluated an algorithm for enhancing digital chest images that has allowed significant data compression while improving the diagnostic quality of the image. This algorithm is based on the photographic technique of unsharp masking. Image quality was measured with respect to the task of tumor detection and compression ratios as high as 2:1 were achieved. This compression can be supplemented by irreversible methods. PMID:2299708

  8. CT scan

    MedlinePlus

    ... that slides into the center of the CT scanner. Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern spiral scanners can perform the exam without stopping. A computer ...

  9. Fatal right coronary artery rupture following blunt chest trauma: detection by postmortem selective coronary angiography.

    PubMed

    Inokuchi, Go; Makino, Yohsuke; Motomura, Ayumi; Chiba, Fumiko; Torimitsu, Suguru; Hoshioka, Yumi; Iwase, Hirotaro

    2016-05-01

    Coronary artery injury is a rare complication following blunt chest trauma (BCT), and can be fatal. Here we report findings on postmortem selective coronary angiography of right coronary artery rupture after an assault involving blunt trauma to the chest. A woman in her 60s died after her son stomped on her chest. There were no appreciable signs of injury on external examination, and cause of death could not be determined by postmortem computed tomography (PMCT). Internal findings indicated that an external force had been applied to the anterior chest, as evidenced by subcutaneous hemorrhage and pericardial and cardiac contusions. Postmortem coronary angiography revealed irregularity of the intima and of the fat tissue surrounding the proximal part of the right coronary artery associated with a local filling defect. Histopathological examination suggested coronary rupture with dissection of the tunica media and compression of the lumen cavity. The key points in the present case are that no fatal injuries could be determined on external examination, and the heart and coronary artery injuries were not evident on PMCT. Criminality might be overlooked in such cases, as external investigation at the crime scene would be inadequate and could result in a facile diagnosis of cause of death. This is the first report of coronary artery rupture with dissection that was detected by CT coronary angiography, and provides helpful findings for reaching an appropriate decision both forensically and clinically. PMID:26126482

  10. Quantitative analysis of the central-chest lymph nodes based on 3D MDCT image data

    NASA Astrophysics Data System (ADS)

    Lu, Kongkuo; Bascom, Rebecca; Mahraj, Rickhesvar P. M.; Higgins, William E.

    2009-02-01

    Lung cancer is the leading cause of cancer death in the United States. In lung-cancer staging, central-chest lymph nodes and associated nodal stations, as observed in three-dimensional (3D) multidetector CT (MDCT) scans, play a vital role. However, little work has been done in relation to lymph nodes, based on MDCT data, due to the complicated phenomena that give rise to them. Using our custom computer-based system for 3D MDCT-based pulmonary lymph-node analysis, we conduct a detailed study of lymph nodes as depicted in 3D MDCT scans. In this work, the Mountain lymph-node stations are automatically defined by the system. These defined stations, in conjunction with our system's image processing and visualization tools, facilitate lymph-node detection, classification, and segmentation. An expert pulmonologist, chest radiologist, and trained technician verified the accuracy of the automatically defined stations and indicated observable lymph nodes. Next, using semi-automatic tools in our system, we defined all indicated nodes. Finally, we performed a global quantitative analysis of the characteristics of the observed nodes and stations. This study drew upon a database of 32 human MDCT chest scans. 320 Mountain-based stations (10 per scan) and 852 pulmonary lymph nodes were defined overall from this database. Based on the numerical results, over 90% of the automatically defined stations were deemed accurate. This paper also presents a detailed summary of central-chest lymph-node characteristics for the first time.

  11. Primary Cardiac Lymphoma: Helical CT Findings and Radiopathologic Correlation

    SciTech Connect

    Marco de Lucas, Enrique Pagola, Miguel Angel; Fernandez, Fidel; Lastra, Pedro; Delgado, M. Luisa Ruiz; Sadaba, Pablo; Pinto, Jesus; Ballesteros, Ma Angeles; Ortiz, Antonio

    2004-03-15

    Primary tumors of the heart are extremely rare.Clinical manifestations are nondiagnostic and the patients are often misdiagnosed. Magnetic resonance imaging and echocardiography are standard in this diagnostic workup. We report a case of a man with acromegaly, dysphagia, chest pain and weight loss. An invasive cardiac mass was diagnosed by helical-CT. Autopsy demonstrated a B-cell aggressive lymphoma.

  12. Assessing Practical Intelligence in Business School Admissions: A Supplement to the Graduate Management Admissions Test

    ERIC Educational Resources Information Center

    Hedlund, Jennifer; Wilt, Jeanne M.; Nebel, Kristina L.; Ashford, Susan J.; Sternberg, Robert J.

    2006-01-01

    The Graduate Management Admission Test (GMAT) is the most widely used measure of managerial potential in MBA admissions. GMAT scores, although predictive of grades in business school, leave much of the variance in graduate school performance unexplained. The GMAT also produces disparities in test scores between groups, generating the potential for…

  13. Major Research Efforts of the Law School Admission Council. Law School Admission Research.

    ERIC Educational Resources Information Center

    Hart, Frederick M.; Evans, Franklin R.

    Research conducted by the Law School Admission Council since the development of the Law School Admission Test (LSAT) in 1948 is described. An overview of the research topics is provided, and relevant published reports are cited in 61 footnotes. The following topics of study are discussed: (1) use and validity of traditional predictors of law…

  14. The relationship between asthma admission rates, routes of admission, and socioeconomic deprivation.

    PubMed

    Watson, J P; Cowen, P; Lewis, R A

    1996-10-01

    This study aimed to explore the relationship between hospital admissions for asthma and socioeconomic deprivation. A retrospective study examined one year of hospital admissions for asthma in the West Midlands region of England (n = 10,044), and in one of the region's wealthier districts, Worcester (n = 251). Age standardized admission ratios (SARs) for asthma, and the routes of hospital admission, were compared with the Towns- end Deprivation Index for the place of residence. Asthma SAR was strongly associated with deprivation as measured by the Towns end Index for the district of residence (Spearman rank correlation coefficient rho = 0.65; p = 0.004). Asthma admission rates for all age groups, except those aged over 65 yrs, were higher in poorer districts. A significantly greater proportion of emergency admissions in poorer districts came via Accident and Emergency departments, rather than general practitioner referrals (rho = 0.76; p < 0.001). Within Worcester District, SAR was associated with Townsend Index for the ward of residence (rho = 0.39; p < 0.001). This remained significant after excluding repeat admissions (rho = 0.45; p < 0.001). We conclude that asthma admissions are strongly associated with deprivation in the community. Differences in the health care received during acute exacerbations by asthma patients from different economic backgrounds is likely to be an important factor in this relationship. PMID:8902471

  15. Noninvasive ventilation in large postoperative flail chest.

    PubMed

    Piastra, Marco; De Luca, Daniele; Zorzi, Giulia; Ruggiero, Antonio; Antonelli, Massimo; Conti, Giorgio; Pietrini, Domenico

    2008-12-01

    An 11-year-old male developed a severe respiratory failure due to a iatrogenic flail chest following a surgery for removing a large chest wall area. A rare Ewing sarcoma was histologically diagnosed and intensive chemotherapy was administered. Postoperatively, because of the failure in ventilation weaning, the patient was electively extubated and noninvasive positive pressure ventilation through face-mask was provided. Respiratory support avoided asynchronous paradoxical movements and achieved pneumatic stabilization. Clinical and respiratory improvement allowed a successful weaning from ventilator. PMID:18798557

  16. Homicidal tandem bullet wound of the chest.

    PubMed

    Bentley, A J; Busuttil, A; Clifton, B; Sibbald, P

    1997-03-01

    An unusual case of a homicidal gunshot wound to the chest is reported in which two bullets were fired in unison as tandem bullets from a handgun. At autopsy, two intact bullets were retrieved from the body of the victim, yet there was only one entrance wound and a single bullet track across the chest wall and thoracic organs. An examination of the weapon and ammunition supported the likelihood of tandem bullets and suggested the probable mechanism for this event. Very few similar cases have been documented. PMID:9095302

  17. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    PubMed Central

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  18. [Coronary artery dissection following blunt chest trauma].

    PubMed

    Seven, Ekim; Henningsen, Kristoffer; Abildgaard, Ulrik

    2015-03-16

    A previously healthy 38-year-old man was admitted to hospital with chest pain. The day before the patient had been to a karate session and had received multiple punches and kicks to the chest region. An ECG showed Q-waves in V1 and V2 and flattening of the T-waves in V1-V6. Levels of cardiac enzyme markers were elevated. The patient subsequently underwent coronary angiography with supplemental optical coherence tomography that revealed a bifurcate dissection involving the proximal parts of left ramus interventricularis anterior and circumflex coronary artery. Two drug-eluting stents were implanted with good angiographic result. PMID:25786846

  19. Possible adverse drug events leading to hospital admission in a Brazilian teaching hospital

    PubMed Central

    Varallo, Fabiana Rossi; Capucho, Helaine Carneiro; da Silva Planeta, Cleópatra; de Carvalho Mastroianni, Patrícia

    2014-01-01

    OBJECTIVES: Drug safety problems can lead to hospital admission. In Brazil, the prevalence of hospitalization due to adverse drug events is unknown. This study aims to estimate the prevalence of hospitalization due to adverse drug events and to identify the drugs, the adverse drug events, and the risk factors associated with hospital admissions. METHOD: A cross-sectional study was performed in the internal medicine ward of a teaching hospital in São Paulo State, Brazil, from August to December 2008. All patients aged ≥18 years with a length of stay ≥24 hours were interviewed about the drugs used prior to hospital admission and their symptoms/complaints/causes of hospitalization. RESULTS: In total, 248 patients were considered eligible. The prevalence of hospitalization due to potential adverse drug events in the ward was 46.4%. Overprescribed drugs and those indicated for prophylactic treatments were frequently associated with possible adverse drug events. Frequently reported symptoms were breathlessness (15.2%), fatigue (12.3%), and chest pain (9.0%). Polypharmacy was a risk factor for the occurrence of possible adverse drug events. CONCLUSION: Possible adverse drug events led to hospitalization in a high-complexity hospital, mainly in polymedicated patients. The clinical outcomes of adverse drug events are nonspecific, which delays treatment, hinders causality analysis, and contributes to the underreporting of cases. PMID:24626940

  20. Should computed chest tomography be recommended in the medical certification of professional divers? A report of three cases with pulmonary air cysts.

    PubMed

    Toklu, A S; Kiyan, E; Aktas, S; Cimsit, M

    2003-08-01

    Pulmonary barotrauma (PBT) is a recognised risk of compressed gas diving. Any reason that causes air trapping in the lung during ascent may cause PBT by increasing intrapulmonary pressure. Chest x ray examination is mandatory for medical certification of the professional divers in many countries, but pulmonary air trapping lesions such as an air cyst in the lungs cannot always be detected by plain chest x ray examination. Computed tomography (CT) is a reliable, but expensive measure for detecting pulmonary abnormalities in divers. Three cases with pulmonary air cysts are reported in which air cysts were invisible on the x ray pictures, but well defined by CT. It is impractical and not cost effective to perform CT for medical certification of all divers, but it can be an option to recommend CT once during the initial examination of the candidates for professional diving, especially if there is a history of predisposing factors, such as smoking or pulmonary infections. PMID:12883024

  1. Chest wall reconstruction after resection using hernia repair piece

    PubMed Central

    Wu, Yimin; Zhang, Guofei; Zhu, Zhouyu

    2016-01-01

    Reconstruction of chest wall tumor is very important link of chest wall tumor resection. Many implants have been reported to be used to reconstruct the chest wall, such as steelwire, titanium mesh and polypropylene mesh. It is really hard for clinicians to decide which implant is the best one to replace the chest wall. We herein report a 68-year-old man who had underwent a chest wall reconstruction with a hernia repair piece and a Dacron hernia repair piece. The patient has maintained an excellent cosmetic and functional outcome since surgery, which proves that the hernia piece still has its place in reconstruction of chest wall. PMID:27293859

  2. 3D intrathoracic region definition and its application to PET-CT analysis

    NASA Astrophysics Data System (ADS)

    Cheirsilp, Ronnarit; Bascom, Rebecca; Allen, Thomas W.; Higgins, William E.

    2014-03-01

    Recently developed integrated PET-CT scanners give co-registered multimodal data sets that offer complementary three-dimensional (3D) digital images of the chest. PET (positron emission tomography) imaging gives highly specific functional information of suspect cancer sites, while CT (X-ray computed tomography) gives associated anatomical detail. Because the 3D CT and PET scans generally span the body from the eyes to the knees, accurate definition of the intrathoracic region is vital for focusing attention to the central-chest region. In this way, diagnostically important regions of interest (ROIs), such as central-chest lymph nodes and cancer nodules, can be more efficiently isolated. We propose a method for automatic segmentation of the intrathoracic region from a given co-registered 3D PET-CT study. Using the 3D CT scan as input, the method begins by finding an initial intrathoracic region boundary for a given 2D CT section. Next, active contour analysis, driven by a cost function depending on local image gradient, gradient-direction, and contour shape features, iteratively estimates the contours spanning the intrathoracic region on neighboring 2D CT sections. This process continues until the complete region is defined. We next present an interactive system that employs the segmentation method for focused 3D PET-CT chest image analysis. A validation study over a series of PET-CT studies reveals that the segmentation method gives a Dice index accuracy of less than 98%. In addition, further results demonstrate the utility of the method for focused 3D PET-CT chest image analysis, ROI definition, and visualization.

  3. [Involuntary admission of addict during early pregnancy].

    PubMed

    Hondius, Adger J K; Stikker, Tineke E; Wennink, J M B Hanneke; Honig, Adriaan

    2012-01-01

    A 30-year-old cocaine-dependent woman was 16 weeks pregnant. Because of possible endangerment of the fetus, an involuntary provisional admission was authorized. Of particular interest is the application of the Dutch Act on Formal Admissions to Psychiatric Hospitals for the primary diagnosis 'addiction' and the fact that the fetus was regarded as a legal 'other'. In severe cases of addiction combined with pregnancy an earlier intervention is needed and arrangement of accelerated legal custody of the newborn before birth should be considered. For the protection of the unborn, we advocate a stricter application of the United Nations Convention on the Rights of the Child. Information for addicted women with preconception counselling can help prevent a compulsory admission. PMID:22258443

  4. Affirmative action policy in medical school admissions.

    PubMed

    Frazer, Ricardo A

    2005-02-01

    Legal challenges to affirmative action are growing, a trend suggesting that a proactive stance is needed to maintain a policy that still has viability, legitimacy, and utility. Medical schools admissions offices in the United States emphasize the Medical College Admissions Test (MCAT), even though many studies have found that grade point averages are better single predictors of future academic achievement, regardless of the student's socioeconomic or racial category. The current essay suggests there is an overreliance on the MCAT in medical school admissions. Medical colleges should encourage the development of additional applicant selection criteria, while continuing to use affirmative action programs, in part to address the need for increased community-oriented health care. PMID:15741705

  5. Late Intrathoracic Tracheal Stricture After Blunt Chest Trauma: A Rare Life-Threatening Condition.

    PubMed

    Chaudhry, Ikram; Aldulaijan, Fozan W; Alhajji, Zahra; Cheema, Ahsan; Mutairi, Hadi

    2016-02-01

    Tracheal injury after blunt chest trauma is a rare but life-threatening condition. If diagnosed and treated early, the outcome is excellent. We report a case of an 18-year-old man who sustained a fracture of the right femur in a traffic accident. He underwent operation under spinal anesthesia and was discharged home after 2 weeks. Six weeks later, he was readmitted with acute respiratory distress, stridor, and drowsiness. Arterial blood gas analysis showed hypercarbia (PCO2 of 80 mm Hg; PO2 of 60 mm Hg). He was intubated with difficulty and ventilated. A computed tomographic (CT) scan of the chest showed a very tight supracarinal tracheal stricture. Emergency surgical resection of the tracheal stricture was performed, and an end-to-end anastomosis was fashioned. The patient had an excellent recovery. PMID:26777938

  6. Osteoarthritis of the Manubriosternal Joint: An Uncommon Cause of Chest Pain.

    PubMed

    Vaishya, Raju; Vijay, Vipul; Rai, Bibek K

    2015-01-01

    Osteoarthritis of the manubriosternal joint is a rare cause of chest pain. The diagnosis is difficult, and other serious causes of chest pain have to be ruled out first. We report one case that was treated with fusion of the manubriosternal joint using an iliac crest bone graft with a cervical locking plate and screws with excellent results. Preoperative CT scan images were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint when other measures fail. Furthermore, the use of a cervical locking plate with appropriate and careful preoperative planning affords a safe surgical technique, rapid pain relief, and ultimately, sound and asymptomatic union of the joint. PMID:26677420

  7. [Manifestations of lobar atelectasis on chest x-rays and correlation with computed tomography findings].

    PubMed

    Cortés Campos, A; Martínez Rodríguez, M

    2014-01-01

    Atelectasis is an important indicator of potentially severe underlying disease that must be diagnosed as early as possible. One of the most common mechanisms is the reabsorption of air distal to respiratory tract obstruction. The chest x-ray is an excellent tool to diagnose atelectasis, and it is especially useful for ruling out central bronchial obstructions (e.g., from endobronchial tumors). If the signs of volume loss are not recognized correctly, the diagnosis and treatment can be delayed. This article describes the main findings of lobar atelectasis on chest x-rays and their correlations with CT findings, including the classic signs described in the literature and other, less known and sometimes subtle signs. PMID:24252304

  8. Osteoarthritis of the Manubriosternal Joint: An Uncommon Cause of Chest Pain

    PubMed Central

    Vaishya, Raju; Rai, Bibek K

    2015-01-01

    Osteoarthritis of the manubriosternal joint is a rare cause of chest pain. The diagnosis is difficult, and other serious causes of chest pain have to be ruled out first. We report one case that was treated with fusion of the manubriosternal joint using an iliac crest bone graft with a cervical locking plate and screws with excellent results. Preoperative CT scan images were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint when other measures fail. Furthermore, the use of a cervical locking plate with appropriate and careful preoperative planning affords a safe surgical technique, rapid pain relief, and ultimately, sound and asymptomatic union of the joint. PMID:26677420

  9. Multidetector CT of blunt abdominal trauma.

    PubMed

    Soto, Jorge A; Anderson, Stephan W

    2012-12-01

    The morbidity, mortality, and economic costs resulting from trauma in general, and blunt abdominal trauma in particular, are substantial. The "panscan" (computed tomographic [CT] examination of the head, neck, chest, abdomen, and pelvis) has become an essential element in the early evaluation and decision-making algorithm for hemodynamically stable patients who sustained abdominal trauma. CT has virtually replaced diagnostic peritoneal lavage for the detection of important injuries. Over the past decade, substantial hardware and software developments in CT technology, especially the introduction and refinement of multidetector scanners, have expanded the versatility of CT for examination of the polytrauma patient in multiple facets: higher spatial resolution, faster image acquisition and reconstruction, and improved patient safety (optimization of radiation delivery methods). In this article, the authors review the elements of multidetector CT technique that are currently relevant for evaluating blunt abdominal trauma and describe the most important CT signs of trauma in the various organs. Because conservative nonsurgical therapy is preferred for all but the most severe injuries affecting the solid viscera, the authors emphasize the CT findings that are indications for direct therapeutic intervention. PMID:23175542

  10. Cytomegalovirus pneumonia in transplant patients: CT findings

    SciTech Connect

    Eun-Young Kang; Patz, E.F. Jr.; Mueller, N.L.

    1996-03-01

    Our goal was to assess the CT findings of cytomegalovirus (CMV) pneumonia in transplant patients. The study included 10 transplant patients who had chest CT scan and pathologically proven isolated pulmonary CMV infection. Five patients had bone marrow transplant and five had solid organ transplant. The CT scans were retrospectively reviewed for pattern and distribution of disease and the CT findings compared with the findings on open lung biopsy (n = 9) and autopsy (n = 1). Nine of 10 patients had parenchymal abnormalities apparent at CT and I had normal CT scans. The findings in the nine patients included small nodules (n = 6), consolidation (n = 4), ground-glass attenuation (n = 4), and irregular lines (n = 1). The nodules had a bilateral and symmetric distribution and involved all lung zones. The consolidation was most marked in the lower lung zones. The CT findings of CMV pneumonia in transplant patients are heterogeneous. The most common patterns include small nodules and areas of consolidation. 13 refs., 4 figs., 1 tab.

  11. Adenocarcinoma - chest x-ray (image)

    MedlinePlus

    This chest x-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side ... density. Diseases that may cause this type of x-ray result would be tuberculous or fungal granuloma, and ...

  12. Coccidioidomycosis - chest x-ray (image)

    MedlinePlus

    This chest x-ray shows the affects of a fungal infection, coccidioidomycosis. In the middle of the left lung (seen on the ... defined borders. Other diseases that may explain these x-ray findings include lung abscesses, chronic pulmonary tuberculosis, chronic ...

  13. Effect of gravity on chest wall mechanics.

    PubMed

    Bettinelli, D; Kays, C; Bailliart, O; Capderou, A; Techoueyres, P; Lachaud, J L; Vaïda, P; Miserocchi, G

    2002-02-01

    Chest wall mechanics was studied in four subjects on changing gravity in the craniocaudal direction (G(z)) during parabolic flights. The thorax appears very compliant at 0 G(z): its recoil changes only from -2 to 2 cmH(2)O in the volume range of 30-70% vital capacity (VC). Increasing G(z) from 0 to 1 and 1.8 G(z) progressively shifted the volume-pressure curve of the chest wall to the left and also caused a fivefold exponential decrease in compliance. For lung volume <30% VC, gravity has an inspiratory effect, but this effect is much larger going from 0 to 1 G(z) than from 1 to 1.8 G(z). For a volume from 30 to 70% VC, the effect is inspiratory going from 0 to 1 G(z) but expiratory from 1 to 1.8 G(z). For a volume greater than approximately 70% VC, gravity always has an expiratory effect. The data suggest that the chest wall does not behave as a linear system when exposed to changing gravity, as the effect depends on both chest wall volume and magnitude of G(z). PMID:11796685

  14. [Optimal beam quality for chest digital radiography].

    PubMed

    Oda, Nobuhiro; Tabata, Yoshito; Nakano, Tsutomu

    2014-11-01

    To investigate the optimal beam quality for chest computed radiography (CR), we measured the radiographic contrast and evaluated the image quality of chest CR using various X-ray tube voltages. The contrast between lung and rib or heart increased on CR images obtained by lowering the tube voltage from 140 to 60 kV, but the degree of increase was less. Scattered radiation was reduced on CR images with a lower tube voltage. The Wiener spectrum of CR images with a low tube voltage showed a low value under identical conditions of amount of light stimulated emission. The quality of chest CR images obtained using a lower tube voltage (80 kV and 100 kV) was evaluated as being superior to those obtained with a higher tube voltage (120 kV and 140 kV). Considering the problem of tube loading and exposure in clinical applications, a tube voltage of 90 to 100 kV (0.1 mm copper filter backed by 0.5 mm aluminum) is recommended for chest CR. PMID:25410333

  15. Unsupervised segmentation of lungs from chest radiographs

    NASA Astrophysics Data System (ADS)

    Ghosh, Payel; Antani, Sameer K.; Long, L. Rodney; Thoma, George R.

    2012-03-01

    This paper describes our preliminary investigations for deriving and characterizing coarse-level textural regions present in the lung field on chest radiographs using unsupervised grow-cut (UGC), a cellular automaton based unsupervised segmentation technique. The segmentation has been performed on a publicly available data set of chest radiographs. The algorithm is useful for this application because it automatically converges to a natural segmentation of the image from random seed points using low-level image features such as pixel intensity values and texture features. Our goal is to develop a portable screening system for early detection of lung diseases for use in remote areas in developing countries. This involves developing automated algorithms for screening x-rays as normal/abnormal with a high degree of sensitivity, and identifying lung disease patterns on chest x-rays. Automatically deriving and quantitatively characterizing abnormal regions present in the lung field is the first step toward this goal. Therefore, region-based features such as geometrical and pixel-value measurements were derived from the segmented lung fields. In the future, feature selection and classification will be performed to identify pathological conditions such as pulmonary tuberculosis on chest radiographs. Shape-based features will also be incorporated to account for occlusions of the lung field and by other anatomical structures such as the heart and diaphragm.

  16. Uncommon Flaps for Chest Wall Reconstruction

    PubMed Central

    Matros, Evan; Disa, Joseph J.

    2011-01-01

    The omentum, external oblique musculocutaneous, and thoracoepigastric flaps are uncommonly used for chest wall reconstruction. Nevertheless, awareness and knowledge of these flaps is essential for reconstructive surgeons because they fill specific niche indications or serve as lifeboats when workhorse flaps are unavailable. The current report describes the anatomic basis, technical aspects of flap elevation, and indications for these unusual flaps. PMID:22294943

  17. [Functional Outcome after Chest Wall Stabilisation].

    PubMed

    Kyriss, T; Lenz, U; Friedel, G

    2016-09-01

    This overview reviews the current literature to compare the functional results after surgical and conservative treatment of patients with flail chest and multiple rib fractures. Regarding functional aspects, patients in the early phase after a thoracic trauma are those that benefit most from the stabilisation of the chest wall by internal fixation of the ribs. Patients recover faster from restrictive respiratory disorders, have less pain and return to the workplace earlier after an operation compared with those that receive conservative treatment. In the medium term, however, patients that are treated conservatively also achieve normal pulmonary function values and become free of pain. The period of convalescence after blunt thoracic trauma is generally underestimated. Future studies of the functional outcome after severe chest injuries should take this into account and the development of functional parameters should be monitored for at least 24 months. A prospective data collection of early and long-term surgical results in registries would be suitable to evaluate benefits and indications of chest wall stabilisation. PMID:27607891

  18. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Storage § 56.6133...

  19. 30 CFR 56.6133 - Powder chests.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... CFR part 51. Copies are available at MSHA, 1100 Wilson Blvd., Room 2436, Arlington, Virginia 22209... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Powder chests. 56.6133 Section 56.6133 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Storage § 56.6133...

  20. Mechanical versus manual chest compressions for out-of-hospital cardiac arrest: a meta-analysis of randomized controlled trials.

    PubMed

    Tang, Lu; Gu, Wan-Jie; Wang, Fei

    2015-01-01

    Recent evidence regarding mechanical chest compressions in out-of-hospital cardiac arrest (OHCA) is conflicting. The objective of this study was to perform a meta-analysis of randomized controlled trials (RCTs) to compare the effect of mechanical versus manual chest compressions on resuscitation outcomes in OHCA. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and the ClinicalTrials.gov registry were searched. In total, five RCTs with 12,510 participants were included. Compared with manual chest compressions, mechanical chest compressions did not significantly improve survival with good neurological outcome to hospital discharge (relative risks (RR) 0.80, 95% CI 0.61-1.04, P = 0.10; I(2) = 65%), return of spontaneous circulation (RR 1.02, 95% CI 0.95-1.09, P = 0.59; I(2) = 0%), or long-term (≥6 months) survival (RR 0.96, 95% CI 0.79-1.16, P = 0.65; I(2) = 16%). In addition, mechanical chest compressions were associated with worse survival to hospital admission (RR 0.94, 95% CI 0.89-1.00, P = 0.04; I(2) = 0%) and to hospital discharge (RR 0.88, 95% CI 0.78-0.99, P = 0.03; I(2) = 0%). Based on the current evidence, widespread use of mechanical devices for chest compressions in OHCA cannot be recommended. PMID:26503429

  1. A computer-aided diagnosis approach for emphysema recognition in chest radiography.

    PubMed

    Coppini, Giuseppe; Miniati, Massimo; Monti, Simonetta; Paterni, Marco; Favilla, Riccardo; Ferdeghini, Ezio Maria

    2013-01-01

    The purpose of this work is twofold: (i) to develop a CAD system for the assessment of emphysema by digital chest radiography and (ii) to test it against CT imaging. The system is based on the analysis of the shape of lung silhouette as imaged in standard chest examination. Postero-anterior and lateral views are processed to extract the contours of the lung fields automatically. Subsequently, the shape of lung silhouettes is described by polyline approximation and the computed feature-set processed by a neural network to estimate the probability of emphysema. Images of radiographic studies from 225 patients were collected and properly annotated to build an experimental dataset named EMPH. Each patient had undergone a standard two-views chest radiography and CT for diagnostic purposes. In addition, the images (247) from JSRT dataset were used to evaluate lung segmentation in postero-anterior view. System performances were assessed by: (i) analyzing the quality of the automatic segmentation of the lung silhouette against manual tracing and (ii) measuring the capabilities of emphysema recognition. As to step i, on JSRT dataset, we obtained overlap percentage (Ω) 92.7±3.3%, Dice Similarity Coefficient (DSC) 95.5±3.7% and average contour distance (ACD) 1.73±0.87 mm. On EMPH dataset we had Ω=93.1±2.9%, DSC=96.1±3.5% and ACD=1.62±0.92 mm, for the postero-anterior view, while we had Ω=94.5±4.6%, DSC=91.0±6.3% and ACD=2.22±0.86 mm, for the lateral view. As to step ii, accuracy of emphysema recognition was 95.4%, with sensitivity and specificity 94.5% and 96.1% respectively. According to experimental results our system allows reliable and inexpensive recognition of emphysema on digital chest radiography. PMID:22522287

  2. The Landscape of Graduate Admissions: Surveying Physics Programs about Doctoral Admissions Practices

    NASA Astrophysics Data System (ADS)

    Potvin, Geoff

    2014-03-01

    Sustaining or improving the best graduate programs as well as increasing the diversity of the physics community requires us to better understand the critical gatekeeping role played by graduate admissions. Admissions processes determine not only who is allowed to begin graduate study but can also influence who chooses to even consider applying. Recently, in concert with some of the activities of the APS Bridge Program, a survey was conducted of directors of graduate admissions and associated faculty in doctoral-granting departments about their admissions practices. Receiving responses from over 75% of departments that award PhDs in physics, respondents were probed about their admissions decisions with special attention on the criteria used in admissions and their relative importance, and how student representation considerations are dealt with in the admissions process (if at all). Results indicate a number of important issues for future students, faculty, and administrators to consider including the importance placed on GRE scores. Results also indicate a sizable number of departments express a latent demand for greater numbers of students from traditionally-underrepresented backgrounds (including women) but simultaneously report a dearth of such students who even apply to their doctoral programs. Implications of these and other findings will be discussed.

  3. An Autopsied Case of Malignant Sarcomatoid Pleural Mesothelioma in Which Chest Pain Developed Several Months Earlier without Abnormality on Imaging

    PubMed Central

    Yaguchi, Daizo; Ichikawa, Motoshi; Inoue, Noriko; Kobayashi, Daisuke; Matsuura, Akinobu; Shizu, Masato; Imai, Naoyuki; Watanabe, Kazuko

    2015-01-01

    The patient experienced chest pain for about 7 months, but a diagnosis could not be made until after death. He was diagnosed with malignant sarcomatoid pleural mesothelioma on autopsy. In this case report, difficult aspects of the diagnosis are discussed. The 70-year-old Japanese man was a driver who transported ceramic-related products. Right chest pain developed in July 2013, but no abnormality was detected on a chest computed tomography (CT) performed in September 2013, and the pain was managed as right intercostal neuralgia. A chest CT performed in late October 2013 revealed a right pleural effusion, and the patient was referred to our hospital in early November 2013. Thoracentesis was performed, but the cytology was negative, and no diagnosis could be made. Close examination was postponed because the patient developed a subarachnoid hemorrhage. He underwent 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) after discharge from the neurosurgery department, and extensive right pleural thickening and 18F-FDG accumulation in this region were observed. Based on these findings, malignant pleural mesothelioma was suspected, and a thoracoscopy was performed under local anesthesia in early December 2013, but no definite diagnosis could be made. The patient selected best supportive care and died about 7 months after the initial development of right chest pain. The disease was definitively diagnosed as malignant sarcomatoid pleural mesothelioma by a pathological autopsy. When chronic chest pain of unknown cause is observed and past exposure to asbestos is suspected, actions to prevent delay in diagnosis should be taken, including testing for suspicion of malignant pleural mesothelioma. PMID:26600776

  4. An Autopsied Case of Malignant Sarcomatoid Pleural Mesothelioma in Which Chest Pain Developed Several Months Earlier without Abnormality on Imaging.

    PubMed

    Yaguchi, Daizo; Ichikawa, Motoshi; Inoue, Noriko; Kobayashi, Daisuke; Matsuura, Akinobu; Shizu, Masato; Imai, Naoyuki; Watanabe, Kazuko

    2015-01-01

    The patient experienced chest pain for about 7 months, but a diagnosis could not be made until after death. He was diagnosed with malignant sarcomatoid pleural mesothelioma on autopsy. In this case report, difficult aspects of the diagnosis are discussed. The 70-year-old Japanese man was a driver who transported ceramic-related products. Right chest pain developed in July 2013, but no abnormality was detected on a chest computed tomography (CT) performed in September 2013, and the pain was managed as right intercostal neuralgia. A chest CT performed in late October 2013 revealed a right pleural effusion, and the patient was referred to our hospital in early November 2013. Thoracentesis was performed, but the cytology was negative, and no diagnosis could be made. Close examination was postponed because the patient developed a subarachnoid hemorrhage. He underwent (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) after discharge from the neurosurgery department, and extensive right pleural thickening and (18)F-FDG accumulation in this region were observed. Based on these findings, malignant pleural mesothelioma was suspected, and a thoracoscopy was performed under local anesthesia in early December 2013, but no definite diagnosis could be made. The patient selected best supportive care and died about 7 months after the initial development of right chest pain. The disease was definitively diagnosed as malignant sarcomatoid pleural mesothelioma by a pathological autopsy. When chronic chest pain of unknown cause is observed and past exposure to asbestos is suspected, actions to prevent delay in diagnosis should be taken, including testing for suspicion of malignant pleural mesothelioma. PMID:26600776

  5. Algorithm of chest wall keloid treatment.

    PubMed

    Long, Xiao; Zhang, Mingzi; Wang, Yang; Zhao, Ru; Wang, Youbin; Wang, Xiaojun

    2016-08-01

    Keloids are common in the Asian population. Multiple or huge keloids can appear on the chest wall because of its tendency to develop acne, sebaceous cyst, etc. It is difficult to find an ideal treatment for keloids in this area due to the limit of local soft tissues and higher recurrence rate. This study aims at establishing an individualized protocol that could be easily applied according to the size and number of chest wall keloids.A total of 445 patients received various methods (4 protocols) of treatment in our department from September 2006 to September 2012 according to the size and number of their chest wall keloids. All of the patients received adjuvant radiotherapy in our hospital. Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment effect by both doctors and patients. With mean follow-up time of 13 months (range: 6-18 months), 362 patients participated in the assessment of POSAS with doctors.Both the doctors and the patients themselves used POSAS to evaluate the treatment effect. The recurrence rate was 0.83%. There was an obvious significant difference (P < 0.001) between the before-surgery score and the after-surgery score from both doctors and patients, indicating that both doctors and patients were satisfied with the treatment effect.Our preliminary clinical result indicates that good clinical results could be achieved by choosing the proper method in this algorithm for Chinese patients with chest wall keloids. This algorithm could play a guiding role for surgeons when dealing with chest wall keloid treatment. PMID:27583896

  6. Algorithm of chest wall keloid treatment

    PubMed Central

    Long, Xiao; Zhang, Mingzi; Wang, Yang; Zhao, Ru; Wang, Youbin; Wang, Xiaojun

    2016-01-01

    Abstract Keloids are common in the Asian population. Multiple or huge keloids can appear on the chest wall because of its tendency to develop acne, sebaceous cyst, etc. It is difficult to find an ideal treatment for keloids in this area due to the limit of local soft tissues and higher recurrence rate. This study aims at establishing an individualized protocol that could be easily applied according to the size and number of chest wall keloids. A total of 445 patients received various methods (4 protocols) of treatment in our department from September 2006 to September 2012 according to the size and number of their chest wall keloids. All of the patients received adjuvant radiotherapy in our hospital. Patient and Observer Scar Assessment Scale (POSAS) was used to assess the treatment effect by both doctors and patients. With mean follow-up time of 13 months (range: 6–18 months), 362 patients participated in the assessment of POSAS with doctors. Both the doctors and the patients themselves used POSAS to evaluate the treatment effect. The recurrence rate was 0.83%. There was an obvious significant difference (P < 0.001) between the before-surgery score and the after-surgery score from both doctors and patients, indicating that both doctors and patients were satisfied with the treatment effect. Our preliminary clinical result indicates that good clinical results could be achieved by choosing the proper method in this algorithm for Chinese patients with chest wall keloids. This algorithm could play a guiding role for surgeons when dealing with chest wall keloid treatment. PMID:27583896

  7. [Chest Wall Reconstruction Using Titanium Plates Sandwiched Between Sheets after Resection of Chest Wall Chondrosarcoma].

    PubMed

    Endoh, Makoto; Oizumi, Hiroyuki; Kato, Hirohisa; Suzuki, Jun; Watarai, Hikaru; Hamada, Akira; Suzuki, Katsuyuki; Takahashi, Ai; Nakahashi, Kenta; Sugawara, Masato; Tsuchiya, Takashi; Sadahiro, Mitsuaki

    2016-07-01

    Extensive chest wall resection carries the risk of difficult reconstruction and surgical complications. We report our experience on chest wall reconstruction using titanium plates for a wide thoracic defect after tumor resection. A 74-year-old man was diagnosed with chondrosarcoma of the 6th rib on the right. He needed extensive chest wall resection because of skip lesions on 4th rib noted on operative inspection, leaving a defect measuring 33 × 20 cm. Reconstruction using 5 transverse titanium plates sandwiched between an expanded polytetrafluoroethylene patch and a polypropylene mesh sheet stabilized the chest wall. This reconstruction allowed successful separation from ventilatory support after operation. The postoperative course was uneventful, and he was discharged on postoperative day 20. The advantages of this form of reconstruction over conventional prostheses are rigidity, and stability and usability. PMID:27365062

  8. A simple method for labeling CT images with respiratory states

    SciTech Connect

    Berlinger, Kajetan; Sauer, Otto; Vences, Lucia; Roth, Michael

    2006-09-15

    A method is described for labeling CT images with their respiratory state by a needle, connected to the patient's chest/abdomen. By means of a leverage the needle follows the abdominal respiratory motion. The needle is visible as a blurred spot in every CT slice. The method was tested with nine patients. A series of volume scans during free breathing was performed. The detected positions of the moving needle in every single slice were compared to each other thus enabling respiratory state assignment. The tool is an inexpensive alternative to complex respiratory measuring tools for four dimensional (4D) CT and was greatly accepted in the clinic due to its simplicity.

  9. Psoriasis, guttate on the arms and chest (image)

    MedlinePlus

    ... guttate (drop-shaped) psoriasis on the arms and chest. Guttate psoriasis is a rare form of psoriasis. ... streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and ...

  10. Coughing Wheezing Shortness of Breath Tightness in Chest

    MedlinePlus

    ... Issues Coughing Wheezing Shortness of Breath Tightness in Chest Past Issues / Fall 2006 Table of Contents For ... short of breath or feel tightness in your chest, you might have asthma. If you do, you ...

  11. 42 CFR 37.50 - Interpreting and classifying chest roentgenograms.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Interpreting and classifying chest roentgenograms... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of...

  12. 42 CFR 37.50 - Interpreting and classifying chest roentgenograms.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Interpreting and classifying chest roentgenograms... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of...

  13. 42 CFR 37.50 - Interpreting and classifying chest roentgenograms.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Interpreting and classifying chest roentgenograms... MEDICAL CARE AND EXAMINATIONS SPECIFICATIONS FOR MEDICAL EXAMINATIONS OF UNDERGROUND COAL MINERS Chest Roentgenographic Examinations Specifications for Interpretation, Classification, and Submission of...

  14. Noncardiac chest pain: epidemiology, natural course and pathogenesis.

    PubMed

    Fass, Ronnie; Achem, Sami R

    2011-04-01

    Noncardiac chest pain is defined as recurrent chest pain that is indistinguishable from ischemic heart pain after a reasonable workup has excluded a cardiac cause. Noncardiac chest pain is a prevalent disorder resulting in high healthcare utilization and significant work absenteeism. However, despite its chronic nature, noncardiac chest pain has no impact on patients' mortality. The main underlying mechanisms include gastroesophageal reflux, esophageal dysmotility and esophageal hypersensitivity. Gastroesophageal reflux disease is likely the most common cause of noncardiac chest pain. Esophageal dysmotility affects only the minority of noncardiac chest pain patients. Esophageal hypersensitivity may be present in non-GERD-related noncardiac chest pain patients regardless if esophageal dysmotility is present or absent. Psychological co-morbidities such as panic disorder, anxiety, and depression are also common in noncardiac chest pain patients and often modulate patients' perception of disease severity. PMID:21602987

  15. Coughing Wheezing Shortness of Breath Tightness in Chest

    MedlinePlus

    ... Current Issue Past Issues Coughing Wheezing Shortness of Breath Tightness in Chest Past Issues / Fall 2006 Table ... you cough a lot, wheeze, are short of breath or feel tightness in your chest, you might ...

  16. Reduce chest pain using modified silicone fluted drain tube for chest drainage after video-assisted thoracic surgery (VATS) lung resection

    PubMed Central

    Li, Xin; Hu, Bin; Miao, Jinbai

    2016-01-01

    Background The aim of this study was to assess the feasibility, efficacy and safety of a modified silicone fluted drain tube after video-assisted thoracic surgery (VATS) lung resection. Methods The prospective randomized study included 50 patients who underwent VATS lung resection between March 2015 and June 2015. Eligible patients were randomized into two groups: experimental group (using the silicone fluted drain tubes for chest drainage) and control group (using standard drain tubes for chest drainage). The volume and characteristics of drainage, postoperative (PO) pain scores and hospital stay were recorded. All patients received standard care during hospital admission. Results In accordance with the exit criteria, three patients were excluded from study. The remaining 47 patients included in the final analysis were divided into two groups: experiment group (N=24) and control group (N=23). There was no significant difference between the two groups in terms of age, sex, height, weight, clinical diagnosis and type of surgical procedure. There was a trend toward less PO pain in experimental group on postoperative day (POD) 1, with a statistically significant difference. Patients in experimental group had a reduced occurrence of fever [temperature (T) >37.4 °C] compared to the control group. Conclusions The silicone fluted drain tube is feasible and safe and may relieve patient PO pain and reduce occurrence of fever without the added risk of PO complications. PMID:26941976

  17. Clinical Presentation and Time-Based Mortality in Patients With Chest Injuries Associated With Road Traffic Accidents

    PubMed Central

    El-Menyar, Ayman; Abdelrahman, Husham; Al-Hassani, Ammar; Ellabib, Mohammad; Asim, Mohammad; Zarour, Ahmad; Al-Thani, Hassan

    2016-01-01

    Background: Blunt chest trauma (BCT) poses significant morbidity and mortality worldwide. Objectives: We investigated the clinical presentation and outcome of BCT related to road traffic accidents (RTA). Patients and Methods: A retrospective observational analysis for patients who sustained BCT secondary to RTA in terms of motor vehicle crash (MVC) and pedestrian-motor vehicle accidents (PMVA) who were admitted to the trauma center at Hamad general hospital, Doha, Qatar, between 2008 and 2011. Results: Of 5118 traumatic injury cases, 1004 (20%) were found to have BCT secondary to RTA (77% MVC and 23% PMVA). The majority were males (92%), and expatriates (72%). Among MVCs, 84% reported they did not use protective devices. There was a correlation between chest abbreviated injury score (AIS) and injury severity scoring (ISS) (r = 0.35, r2 = 0.12, P < 0.001). Regardless of mechanism of injury (MOI), multivariate analysis showed that the head injury associated with chest AIS and ISS was a predictor of mortality in BCT. Overall mortality was 15%, and the highest rate was observed within the first 24 hours post-trauma. Conclusions: Blunt chest trauma from RTA represents one-fifth of the total trauma admissions in Qatar, with a high overall mortality. Pedestrians are likely to have more severe injuries and higher fatality rates than MVC victims. Specific injury prevention programs focusing on road safety should be implemented to minimize the incidence of such preventable injuries. PMID:27148499

  18. Tube thoracostomy; chest tube implantation and follow up

    PubMed Central

    Kuhajda, Ivan; Zarogoulidis, Konstantinos; Kougioumtzi, Ioanna; Huang, Haidong; Li, Qiang; Dryllis, Georgios; Kioumis, Ioannis; Pitsiou, Georgia; Machairiotis, Nikolaos; Katsikogiannis, Nikolaos; Papaiwannou, Antonis; Lampaki, Sofia; Papaiwannou, Antonis; Zaric, Bojan; Branislav, Perin; Porpodis, Konstantinos

    2014-01-01

    Pneumothorax is an urgent medical situation that requires urgent treatment. We can divide this entity based on the etiology to primary and secondary. Chest tube implantation can be performed either in the upper chest wall or lower. Both thoracic surgeons and pulmonary physicians can place a chest tube with minimal invasive techniques. In our current work, we will demonstrate chest tube implantation to locations, methodology and tools. PMID:25337405

  19. Effectiveness of the Chest Pain Choice decision aid in emergency department patients with low-risk chest pain: study protocol for a multicenter randomized trial

    PubMed Central

    2014-01-01

    Background Chest pain is the second most common reason patients visit emergency departments (EDs) and often results in very low-risk patients being admitted for prolonged observation and advanced cardiac testing. Shared decision-making, including educating patients regarding their 45-day risk for acute coronary syndrome (ACS) and management options, might safely decrease healthcare utilization. Methods/Design This is a protocol for a multicenter practical patient-level randomized trial to compare an intervention group receiving a decision aid, Chest Pain Choice (CPC), to a control group receiving usual care. Adults presenting to five geographically and ethnically diverse EDs who are being considered for admission for observation and advanced cardiac testing will be eligible for enrollment. We will measure the effect of CPC on (1) patient knowledge regarding their 45-day risk for ACS and the available management options (primary outcome); (2) patient engagement in the decision-making process; (3) the degree of conflict patients experience related to feeling uninformed (decisional conflict); (4) patient and clinician satisfaction with the decision made; (5) the rate of major adverse cardiac events at 30 days; (6) the proportion of patients admitted for advanced cardiac testing; and (7) healthcare utilization. To assess these outcomes, we will administer patient and clinician surveys immediately after each clinical encounter, obtain video recordings of the patient-clinician discussion, administer a patient healthcare utilization diary, analyze hospital billing records, review the electronic medical record, and conduct telephone follow-up. Discussion This multicenter trial will robustly assess the effectiveness of a decision aid on patient-centered outcomes, safety, and healthcare utilization in low-risk chest pain patients from a variety of geographically and ethnically diverse EDs. Trial registration NCT01969240. PMID:24884807

  20. 40 CFR 85.1504 - Conditional admission.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Conditional admission. 85.1504 Section 85.1504 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor Vehicle Engines §...

  1. 42 CFR 412.3 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.3 Admissions. (a) For... patient history and comorbidities, the severity of signs and symptoms, current medical needs, and the...

  2. 42 CFR 412.3 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.3 Admissions. (a) For... patient history and comorbidities, the severity of signs and symptoms, current medical needs, and the...

  3. "Stealth Applicants" Are Changing the Admissions Equation

    ERIC Educational Resources Information Center

    Hoover, Eric

    2008-01-01

    Jeff Rickey is a numbers guy. But three years ago, a colleague asked him about something he'd never counted: applicants who came out of nowhere. The question intrigued Mr. Rickey, dean of admissions and financial aid at Earlham College in Indiana. He found that 17 percent of the college's applicants that year had not called, taken a tour, or…

  4. 16 CFR 3.32 - Admissions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Admissions. 3.32 Section 3.32 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE RULES OF PRACTICE FOR... the truth of any matters relevant to the pending proceeding set forth in the request that relate...

  5. 17 CFR 12.33 - Admissions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 17 Commodity and Securities Exchanges 1 2011-04-01 2011-04-01 false Admissions. 12.33 Section 12.33 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... truth of any matters set forth in the request that relate to statements or opinions of fact or of...

  6. 17 CFR 12.33 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Admissions. 12.33 Section 12.33 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION RULES RELATING TO... truth of any matters set forth in the request that relate to statements or opinions of fact or of...

  7. 10 CFR 2.708 - Admissions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... COMMISSION RULES OF PRACTICE FOR DOMESTIC LICENSING PROCEEDINGS AND ISSUANCE OF ORDERS Rules for Formal... request, or for the admission of the truth of any specified relevant matter of fact. A copy of the... unless, within a time designated by the presiding officer or the Commission, and not less than ten...

  8. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 3 2012-10-01 2012-10-01 false Admission. 618.300 Section 618.300 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS... manner and under the same policies as any other temporary disability or physical condition; and (4)...

  9. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 3 2013-10-01 2013-10-01 false Admission. 618.300 Section 618.300 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS... manner and under the same policies as any other temporary disability or physical condition; and (4)...

  10. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 3 2011-10-01 2011-10-01 false Admission. 618.300 Section 618.300 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS... manner and under the same policies as any other temporary disability or physical condition; and (4)...

  11. 45 CFR 618.300 - Admission.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Admission. 618.300 Section 618.300 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS... manner and under the same policies as any other temporary disability or physical condition; and (4)...

  12. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE... to the School of Medicine shall make direct application following instructions published in the... concerned or his designee prior to submitting formal application to the School of Medicine for...

  13. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE... to the School of Medicine shall make direct application following instructions published in the... concerned or his designee prior to submitting formal application to the School of Medicine for...

  14. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE... to the School of Medicine shall make direct application following instructions published in the... concerned or his designee prior to submitting formal application to the School of Medicine for...

  15. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...) MISCELLANEOUS ADMISSION POLICIES AND PROCEDURES FOR THE SCHOOL OF MEDICINE, UNIFORMED SERVICES UNIVERSITY OF THE... to the School of Medicine shall make direct application following instructions published in the... concerned or his designee prior to submitting formal application to the School of Medicine for...

  16. Screening for Pervasive Intolerance in Admissions Candidates.

    ERIC Educational Resources Information Center

    Henderson, Phyllis; Self, Eileen Fernandez; Jones, Mary Ann

    This paper describes the Pre-Admission Workshop, which is designed as a screening procedure to achieve optimal selection outcomes for graduate study in counseling. The workshop not only assesses the academic potential of the applicants, but also allows for observation of multicultural competencies developed by Sue, Arredondo, and McDavis (1992).…

  17. University Admissions. Policy Note. Number 3

    ERIC Educational Resources Information Center

    Group of Eight (NJ1), 2012

    2012-01-01

    University admissions, like many other aspects of the higher education sector, are going through a time of significant change. From 2012, universities will receive full funding under the Commonwealth Grants Scheme (CGS) for as many places as they offer. Previously, the Government limited the number of funded places, with a tolerance band for…

  18. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Admissions. 1317.220... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage... recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the basis of sex...

  19. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Admissions. 1317.220... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage... recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the basis of sex...

  20. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Admissions. 1317.220... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage... recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the basis of sex...

  1. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Admissions. 1317.220... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage... recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the basis of sex...

  2. 18 CFR 1317.220 - Admissions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Admissions. 1317.220... THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Coverage... recipient to which §§ 1317.300 through 1317.310 apply shall not discriminate on the basis of sex...

  3. Predicting Academic Success Using Admission Profiles

    ERIC Educational Resources Information Center

    Davidovitch, Nitza; Soen, Dan

    2015-01-01

    This study, conducted at a tertiary education institution in Israel, following two previous studies, was designed to deal again with a question that is a topic of debate in Israel and worldwide: Is there justification for the approach that considers restrictive university admission policies an efficient tool for predicting students' success at the…

  4. Foreign Language, the Classics, and College Admissions.

    ERIC Educational Resources Information Center

    LaFleur, Richard A.

    1993-01-01

    This article reports the results of a survey, funded by the American Classical League (ACL) and conducted during 1990-91, that assessed attitudes toward high school foreign-language study, in particular the study of Latin and Greek, in the college admissions process. (21 references) (VWL)

  5. The Progression of the College Admissions Professional

    ERIC Educational Resources Information Center

    Tremblay, Christopher

    2010-01-01

    In his sixteen years in college admissions, the author has evolved in his work, role, and mission. He began as an eager recruiter, excited to help high school students get into college; now he is a seasoned director committed to college access. As he reflects on his career, a five-stage progression merges: "learn," "execute," "lead," "contribute,"…

  6. The New Imperative for Admissions Transparency

    ERIC Educational Resources Information Center

    La Noue, George R.

    2003-01-01

    Given the overwhelming popular appeal of merit-based college admissions, George La Noue advocates a new transparency in how colleges and universities select their students. He has some suggestions about how colleges might comply with court-mandated requirements for case-by-case evaluations. He also provides hints from which NAS members might…

  7. 15 CFR 8a.220 - Admissions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Admissions. 8a.220 Section 8a.220 Commerce and Foreign Trade Office of the Secretary of Commerce NONDISCRIMINATION ON THE BASIS OF SEX IN... institution. (c) Application of §§ 8a.300 through .310. Except as provided in paragraphs (d) and (e) of...

  8. The National Center Test for University Admissions

    ERIC Educational Resources Information Center

    Watanabe, Yoshinori

    2013-01-01

    This article describes the National Center Test for University Admissions, a unified national test in Japan, which is taken by 500,000 students every year. It states that implementation of the Center Test began in 1990, with the English component consisting only of the written section until 2005, when the listening section was first implemented…

  9. 40 CFR 85.1504 - Conditional admission.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Conditional admission. 85.1504 Section 85.1504 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Importation of Motor Vehicles and Motor Vehicle Engines §...

  10. Selecting Tests for an Open Admissions Population.

    ERIC Educational Resources Information Center

    Tittle, Carol; Kay, Patricia

    The establishment of an open admissions policy necessitated an evaluative procedure to identify groups requiring remedial instruction and to assist in estimating budgeting and staffing needs. This study was undertaken, therefore, to select tests in reading and mathematics which would: (1) discriminate adequately between non-college and college…

  11. 4 CFR 28.66 - Admissibility.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 4 Accounts 1 2010-01-01 2010-01-01 false Admissibility. 28.66 Section 28.66 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

  12. What Should University Admissions Tests Predict?

    ERIC Educational Resources Information Center

    Stemler, Steven E.

    2012-01-01

    University admissions tests should predict an applicant's ability to succeed in college, but how should this success be defined and measured? The status quo has been to use 1st-year grade point average (FYGPA) as the key indicator of college success, but a review of documents such as university mission statements reveals that universities expect…

  13. Colleges Making SAT Optional as Admissions Requirement

    ERIC Educational Resources Information Center

    Gilroy, Marilyn

    2007-01-01

    This article reports that more colleges are dropping the SAT as a requirement for admission and, in many cases, these institutions are attracting a larger and more diverse pool of applicants. According to the National Center for Fair & Open Testing (FairTest), 740 schools have made the SATs optional. The list includes some of the nation's most…

  14. Predictive Validity of the Dental Admission Test.

    ERIC Educational Resources Information Center

    Kramer, Gene A.

    1986-01-01

    The relationship of Dental Admission Test (DAT) scales and predental grade point averages with freshman and sophomore dental school performance measures and National Board Dental Examination (NBDE) Part I averages were examined. The results indicated that the DAT scales had limited predictive validity. (Author/MLW)

  15. The Admissions Criteria of Secondary Free Schools

    ERIC Educational Resources Information Center

    Morris, Rebecca

    2014-01-01

    This paper presents the results of an analysis of the admissions criteria used by the first two waves of secondary Free Schools in England. The type of criteria and their ranked order is explored and their potential impact on the school composition is considered. The findings demonstrate the diversity of criteria being used by this new type of…

  16. CT effective dose per dose length product using ICRP 103 weighting factors

    SciTech Connect

    Huda, Walter; Magill, Dennise; He Wenjun

    2011-03-15

    Purpose: To generate effective dose per unit dose length product (E/DLP) conversion factors incorporating ICRP Publication 103 tissue weighting factors. Methods: Effective doses for CT examinations were obtained using the IMPACT Dosimetry Calculator using all 23 dose data sets that are offered by this spreadsheet. CT examinations were simulated for scans performed along the patient long axis for each dosimetry data set using a 4 cm beam width ranging from the upper thighs to top of the head. Five basic body regions (head, neck, chest, abdomen, and pelvis), as well as combinations of the regions (head/neck, chest/abdomen, abdomen/pelvis, and chest/abdomen/pelvis) and whole body CT scans were investigated. Correction factors were generated that can be applied to convert E/DLP conversion factors based on ICRP 60 data to conversion factors that are valid for ICRP 103 data (i.e., E{sub 103}/E{sub 60}). Results: Use of ICRP 103 weighting factors increase effective doses for head scans by {approx}11%, for chest scans by {approx}20%, and decrease effective doses for pelvis scans by {approx}25%. Current E/DLP conversion factors are estimated to be 2.4 {mu}Sv/mGy cm for head CT examinations and range between 14 and 20 {mu}Sv/mGy cm for body CT examinations. Conclusions: Factors that enable patient CT doses to be adjusted to account for ICRP 103 tissue weighting factors are provided, which result in E/DLP factors that were increased in head and chest CT, reduced in pelvis CT, and showed no marked change in neck and abdomen CT.

  17. Drug related admissions to medical wards

    PubMed Central

    Hallas, Jesper; Gram, Lars F.; Grodum, Ellen; Damsbo, Niels; Brøsen, Kim; Haghfelt, Torben; Harvald, Bent; Beck-Nielsen, Jørgen; Worm, Jørgen; Birger Jensen, Kurt; Davidsen, Otto; Frandsen, Niels E.; Hagen, Claus; Andersen, Morten; Frølund, Flemming; Kromann-Andersen, Hans; Schou, Jens

    1992-01-01

    1 In total 1999 consecutive admissions to six medical wards were subjected to a prospective high-intensity drug event monitoring scheme to assess the extent and pattern of admissions caused by adverse drug reactions (ADRs) or dose related therapeutic failures (TF), in a population-based design. The wards were sub-specialised in general medicine, geriatrics, endocrinology, cardiology, respiratory medicine and gastroenterology. 2 Considering definite, probable and possible drug events, the prevalence of drug related hospital admissions was 11.4% of which 8.4% were caused by ADRs and 3.0% by TFs. There were large inter-department differences. 3 The six classes of drugs most frequently involved in admissions caused by ADRs were anti-rheumatics and analgesics (27%), cardiovascular drugs (23%), psychotropic drugs (14%), anti-diabetics (12%), antibiotics (7%), and corticosteroids (5%). Non-compliance accounted for 66% of the TFs with diuretics and anti-asthmatics most frequently involved. 4 The pattern of drugs involved in ADRs was compared with the regional drug sales statistics. Drugs with a particularly high rate of ADR related admissions per unit dispensed were nitrofurantoin and insulin (617 and 182 admissions per 1,000,000 defined daily doses), while low rates were seen for diuretics and benzodiazepines (10 and 7 admissions per 1,000,000 defined daily doses). Confidence intervals were wide. 5 Patients who had their therapy prescribed by a hospital doctor had a slightly higher prevalence of drug events than those who were treated by a general practitioner (12.6% vs 11.8%). The reverse applied for drug events assessed as avoidable (3.3% vs 4.6%). Although these differences were not statistically significant, it may suggest general practitioners as the appropriate target for interventive measures. 6 Only one ADR was reported to The Danish Committee on Adverse Drug Reactions, indicating a severe under-reporting and a potential for gross selectivity. The data collection

  18. An Official American Thoracic Society/American College of Chest Physicians Policy Statement

    PubMed Central

    Ouellette, Daniel R.; Diamond, Edward; Fan, Vincent S.; Maurer, Janet R.; Mularski, Richard A.; Peters, Jay I.; Halpern, Scott D.

    2014-01-01

    The American Board of Internal Medicine Foundation’s Choosing Wisely campaign aims to curb health-care costs and improve patient care by soliciting lists from medical societies of the top five tests or treatments in their specialty that are used too frequently and inappropriately. The American Thoracic Society (ATS) and American College of Chest Physicians created a joint task force, which produced a top five list for adult pulmonary medicine. Our top five recommendations, which were approved by the executive committees of the ATS and American College of Chest Physicians and published by Choosing Wisely in October 2013, are as follows: (1) Do not perform CT scan surveillance for evaluation of indeterminate pulmonary nodules at more frequent intervals or for a longer period of time than recommended by established guidelines; (2) do not routinely offer pharmacologic treatment with advanced vasoactive agents approved only for the management of pulmonary arterial hypertension to patients with pulmonary hypertension resulting from left heart disease or hypoxemic lung diseases (groups II or III pulmonary hypertension); (3) for patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, do not renew the prescription without assessing the patient for ongoing hypoxemia; (4) do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay; (5) do not perform CT scan screening for lung cancer among patients at low risk for lung cancer. We hope pulmonologists will use these recommendations to stimulate frank discussions with patients about when these tests and treatments are indicated—and when they are not. PMID:24889436

  19. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest...

  20. 20 CFR 718.102 - Chest roentgenograms (X-rays).

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 4 2013-04-01 2013-04-01 false Chest roentgenograms (X-rays). 718.102... roentgenograms (X-rays). (a) A chest roentgenogram (X-ray) shall be of suitable quality for proper classification of pneumoconiosis and shall conform to the standards for administration and interpretation of chest...