An unusual case of lumbar paravertebral miositis ossificans mimicking muscular skeletal tumor.
Zoccali, C; Chichierchia, G; Covello, R
2013-12-01
Several lesions have clinical and radiological characteristics mimicking muscular skeletal tumor. Myositis ossificans usually presents a typical pattern making biopsy unnecessary; nevertheless, in rare cases, neoplasm must be ruled out. Biopsy is often sufficient to allow a diagnosis and a correct related treatment, but, unfortunately, sometimes it may lead to erroneous treatment. We report an unusual case of a lumbar paravertebral mass that had an MRI aspect similar to a chondrosarcoma, a histology pattern based on biopsy compatible with neurinoma and a definitive diagnosis of myosistis ossificans.
An initial MRI picture of limbic encephalitis in subacute sclerosing panencephalitis.
Lebon, Sébastien; Maeder, Philippe; Maeder-Ingvar, Malin; Poloni, Claudia; Mayor-Dubois, Claire; Roulet-Perez, Eliane; Jeannet, Pierre-Yves
2011-11-01
Subacute sclerosing panencephalitis (SSPE) is a rare and severe long-term complication of measles. Hallmarks of this entity include progressive cognitive decline, myoclonia, a generalized periodic pattern on EEG and deep white matter abnormalities on MRI. However, imaging can be normal in early stages. We report herein the case of a previously healthy 13-years-old girl with an unusual radiological presentation. She presented with unilateral myoclonia, cognitive decline with memory impairment and a first brain MRI with swelling of both hippocampi mimicking limbic encephalitis. Measles antibodies were positive in CSF and the EEG showed slow periodic complexes. This unusual radiological presentation has never been described in SSPE. Relationship between virus and limbic system are discussed. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
An unusual cause of an anterior mediastinal mass
Hassan, I.; Goolam-Mahomed, A.
2014-01-01
Mesothelioma is a rare tumour and its radiological growth pattern varies. We report the case of a biopsy proven Malignant Pleural Mesothelioma (MPM) presenting as an anterior mediastinal mass in a platinum miner. The prognosis for this aggressive tumour remains poor, despite combination treatment modalities. PMID:26029542
Clinical characterization of unusual cystic echinococcosis in southern part of Turkey.
Akcam, Atlgan Tolga; Ulku, Abdullah; Koltas, Ismail Soner; Izol, Volkan; Bicer, Omer Sunkar; Kilicbagir, Emine; Sakman, Gurhan; Poyrazoglu, Hakan; Erman, Tahsin; Aridogan, Ibrahim Atilla; Parsak, Cem Kaan; Inal, Mehmet; Iskit, Serdar
2014-01-01
The incidence of primary extrahepatic cystic echinococcosis (CE) is rare. Generally, radiological and serological findings can help establish the diagnosis of hepatic and pulmonary CE, but a CE in an unusual location with atypical radiological findings may complicate the differential diagnosis. The objective of this study is to present the characteristics of cases with extrahepatic CE in respect of sites of involvement, clinical presentations, radiological findings, serological diagnostic evaluations, and outcomes of infected patients. A retrospective analysis of surgically treated CE was conducted between January 1993 and January 2014 in the General Surgery, Pediatric Surgery, Urology, Cardiovascular Surgery, Neurosurgery, and Orthopedics departments of University of Cukurova, Faculty of Medicine, Balcal Hospital. Among the 661 patients managed for CE, 134 had unusual sites of involvement. Radiological and serological examinations were used to differentiate CE from alveolar echinococcosis. Of 134 cases with unusual sites of involvement, 32 cases had liver CE (23.9%), 7 cases had lung CE (5.2%), and 2 cases had concomitant liver and lung CE (1.5%). In 93 (69.4%) cases, unusual organ involvement was isolated without any liver or lung involvement. The mean age was 45 years. Abdominal pain was the main symptom and was found in 104 patients. Thirty-one (23.1%) of 134 extrahepatic CE cases were evaluated as negative with indirect hemagglutination (IHA). However, positive results were obtained in 54 cases evaluated with Echinococcus granulosus IgG Western blot (WB), including 10 IHA-negative cases. CE with unusual localizations may cause serious problems of diagnostic confusion. The combination of clinical history, radiological findings, and serological test results (especially the WB) are valuable in diagnosing extrahepatic CE.
Hepatobiliary fascioliasis: a case with unusual radiological features.
Yeşildağ, Ahmet; Senol, Altuğ; Köroğlu, Mert; Koçkar, Cem; Oyar, Orhan; Işler, Mehmet
2010-12-01
We report a case of hepatobiliary fascioliasis presenting with unusual radiological findings that have not been reported previously. Imaging studies revealed hepatic cystic pouches communicating with intrahepatic bile ducts. Snail-like, oval shaped and conglomerated echogenic particles with no acoustic shadowing, suggesting F. hepatica, were detected in these cystic pouches. In addition, secondary sclerosing cholangitis developed after fascioliasis.
Kim, Young-sun; Rhim, Hyunchul; Lim, Hyo Keun; Choi, Dongil; Lee, Min Woo; Park, Min Jung
2011-01-01
As the clinical role of radiofrequency ablation (RFA) of the liver grows, the importance of radiologic imaging after liver RFA to depict the diversity of post-RFA manifestations is also increasing. Because RFA induces coagulation necrosis of the hepatic parenchyma, cross-sectional imaging studies, in principle, demonstrate an area with a defect in contrast enhancement. However, for various reasons, such as the occurrence of a complication, the RFA zone may demonstrate different patterns or be accompanied by other abnormalities. In this investigation, a large number of imaging studies performed after more than 4000 procedures of liver RFA during the past 10-year period were reviewed, and various radiologic manifestations of the RFA zone were compiled. Herein, the basic principles of RFA, as well as the histopathologic features of coagulation necrosis of the liver, are catalogued to provide a more complete understanding of such changes. Through this review, the reader will become more familiar with the usual and unusual radiologic findings of coagulation necrosis induced by RFA in the liver. This increased familiarity will not only facilitate the daily practice of radiology but also deepen understanding of the therapeutic modality of RFA. © RSNA, 2011.
Ollague Sierra, Jose E; Ollague Torres, Jose M
2013-04-01
Histoplasmosis has attained increasing relevance in the past 3 decades because of the appearance of the human immunodeficiency virus (HIV). In most immunocompetent persons, the infection is asymptomatic or can produce a respiratory condition with symptoms and radiological images similar to those observed in pulmonary tuberculosis; in non-HIV+ immunocompromised patients, it can cause respiratory symptoms or evolve into a disseminated infection. The same can occur in acquired immunodeficiency syndrome (AIDS) patients. We have observed a series of HIV+ patients with AIDS who presented with cutaneous histoplasmosis and in whom the clinical and histopathological features were highly unusual, including variable mucocutaneous lesions that were difficult to diagnose clinically. These patients displayed unusual, previously undescribed, histological patterns, including lichenoid pattern, nodular pseudomyxoid pattern, pyogenic granuloma-like pattern, perifollicular pattern, and superficial (S), mid (M), and deep perivascular dermatitis; and more commonly encountered patterns, such as histiocytic lobular panniculitis and focal nodular dermatitis. The novel histopathological patterns of cutaneous involvement by histoplasmosis seen in these patients resembled other common inflammatory and infectious conditions and required a high level of suspicion and the application of special stains for organisms for confirmation. These new, clinical, and histological findings do not seem to be commonly encountered in HIV- patients infected with the fungus but seem to be displayed most prominently in HIV+ patients with AIDS.
Intra-abdominal primary monophasic synovial sarcoma with hemangiopericytoma-like areas.
Rao, Lakshmi; Jaiprakash, Padmapriya; Palankar, Nagaraj; Gowda, Vinay
2013-01-01
We report a case of retroperitoneal intra-abdominal primary monophasic synovial sarcoma (SS) with hemangiopericytomatous (HPC) pattern in a 25-year-old male arising from the triangular ligament on the superior surface of liver encasing the inferior vena cava (IVC) and masquerading as a hepatic tumor. A large heterogeneously enhancing, well defined, lobulated, exophytic lesion was seen involving segment VIII of the liver with foci of calcification in the periphery. A biopsy, followed by total resection of the tumor, showed a spindle cell sarcoma with HPC pattern, which was consistent with monophasic SS on histology and immunohistochemistry. The unusual clinical presentation, radiology, pathology, and differential diagnosis will be discussed in detail.
Locally Aggressive Fibrous Dysplasia Mimicking Malign Calvarial Lesion.
Ogul, Hayri; Keskin, Emine
2018-05-01
Fibrous dysplasia is an unusual benign bone tumor. It is divided into 3 groups as monostotic, polyostotic, and craniofacial form. The authors reported an unusual patient with fibrous dysplasia with an aggressive radiologic appearance.
Unusual fan shaped ossification in a female fetus with radiological features of boomerang dysplasia
Odent, S.; Loget, P.; Le Marec, B.; Delezoide, A.; Maroteaux, P.
1999-01-01
We report on a female fetus of 24 weeks whose clinical and radiological findings were compatible with boomerang dysplasia (BD). However, histopathology was unusual with a lateral fan shaped diaphyseal ossification. This has never been described either in typical atelosteogenesis I (AT-I) or in BD. The purpose of this report is to find out if this condition is a separate lethal bone dysplasia or another histological feature of the nosological group of AT-I and BD. Keywords: boomerang dysplasia; atelosteogenesis; lethal chondrodysplasia; lethal dwarfism PMID:10227404
Effects of radiation therapy on the lung: radiologic appearances and differential diagnosis.
Choi, Yo Won; Munden, Reginald F; Erasmus, Jeremy J; Park, Kyung Joo; Chung, Woo Kyung; Jeon, Seok Chol; Park, Choong-Ki
2004-01-01
Radiation-induced lung disease (RILD) due to radiation therapy is common. Radiologic manifestations are usually confined to the lung tissue within the radiation port and are dependent on the interval after completion of treatment. In the acute phase, RILD typically manifests as ground-glass opacity or attenuation or as consolidation; in the late phase, it typically manifests as traction bronchiectasis, volume loss, and scarring. However, the use of oblique beam angles and the development of newer irradiation techniques such as three-dimensional conformal radiation therapy can result in an unusual distribution of these findings. Awareness of the atypical manifestations of RILD can be useful in preventing confusion with infection, recurrent malignancy, lymphangitic carcinomatosis, and radiation-induced tumors. In addition, knowledge of radiologic findings that are outside the expected pattern for RILD can be useful in diagnosis of infection or recurrent malignancy. Such findings include the late appearance or enlargement of a pleural effusion; development of consolidation, a mass, or cavitation; and occlusion of bronchi within an area of radiation-induced fibrosis. A comprehensive understanding of the full spectrum of these manifestations is important to facilitate diagnosis and management in cancer patients treated with radiation therapy. Copyright RSNA, 2004
Radiological features of late-onset lymphoedema in Noonan's syndrome.
Ho, Wan-Ling; Wang, Jou-Kou; Li, Yiu-Wah
2003-03-01
Noonan's syndrome is a multiple congenital anomaly syndrome with diverse manifestations. Lymphatic abnormalities occur in less than 20% of patients. We report a 14-year-old boy who presented with swollen lower limbs and dysmorphic features characteristic of Noonan's syndrome. The radiological features of this unusual case of late-onset lymphoedema in association with Noonan's syndrome are presented.
Hariharavel, V. P.; Kumar, A. Ashok; Ganesh, C.; Aravindhan, R.
2014-01-01
Anatomic and internal morphology of a root canal system is more complex and differs for each individual tooth of which mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate foramina in mandibular second premolars is very rare. A wider knowledge on both clinical and radiological anatomy especially spiral computed tomographic is absolutely essential for the success of endodontic treatment. These teeth may require skillful and special root canal special shaping and obturating techniques. This paper reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically. PMID:25101187
Clinico-Radiological Diagnosis of Isolated Congenital Esophageal Stenosis in a Preterm Neonate
Sham, Minakshi
2013-01-01
A 2-day-old preterm female neonate weighing 1.6 kg and having excessive frothing from mouth was investigated for suspected esophageal atresia and tracheoesophageal fistula. X-ray findings of an unusually low-ending upper pouch (up to T8 level) and the absence of gas in abdomen lead to suspicion of an unusual variety of esophageal atresia. Hence unlike the usual management of pure esophageal atresia, in terms of esophagostomy and gastrostomy in neonatal period, right thoracotomy was performed allowing successful primary anastomosis. A high index of suspicion on the basis of radiological picture led to early diagnosis of a rare anomaly like congenital esophageal stenosis and successful management of this low birth weight baby. PMID:25755945
[Mitochondrial leukoencephalopathy of infancy: is it an early expression of Leigh syndrome?].
Rouco Axpe, I; Garaizar Axpe, C; Labairu Echevarría, M; Sanjurjo Crespo, P; Aldamiz Echevarría, L; Prats Viñas, J M
2003-06-01
Leigh syndrome is probably the most frequent metabolic disorder in infancy and childhood. The classic form of the disease is characterized by bilateral lesions of basal ganglia and brainstem. The extensive involvement of white matter, without radiological basal ganglia abnormalities, is an unusual manifestation of the disease. Four patients who presented the disease during the first year of life are described. The four patients presented a stereotyped clinical picture, consisting of regression of already acquired psychomotor abilities and very prominent pyramidal signs. These clinical manifestations and results of neuroimaging studies suggested a primary leukodystrophy. Increased values of lactic and piruvic acids suggested a mitochondrial disorder. Enzymatic studies confirmed a mitochondrial respiratory chain deficiency in two patients, and a pyruvate dehydrogenase complex defect in the remaining two patients. The pathological findings in the latter two sisters were consistent with the characteristic microscopic lesions of Leigh syndrome, but with atypical distribution. Diagnosis of Leigh syndrome must be taken into consideration in infants presenting with a leukodystrophic clinical and radiological pattern, despite the lack of basal ganglia involvement.
Fatty metamorphosis and other patterns in fibrous dysplasia
Shidham, Vinod B; Chavan, Ashwini; Rao, R Nagarjun; Komorowski, Richard A; Asma, Zeenath
2003-01-01
Background Interpretation of small biopsy fragments from suspected lesions of fibrous dysplasia with unusual clinical and / or radiological features may be challenging due to wide histomorphological spectrum of stromal appearances. Awareness of these variations should improve diagnostic confidence. Methods We retrospectively studied 26 cases of fibrous dysplasia (F- 19, M- 7; Ages ranged from 10 to 53 years) with confirmed diagnosis. The sites of the lesions were skull bones (9), humerus (1), femur (8), tibia (2), fibula (3), talus (1), mandible (1), and maxilla (1). Results Different stromal patterns, variably admixed with the classical pattern, were observed in 58%(15/26) of the cases. 20%(3/15) of these had more than one pattern. Focal fatty metamorphosis as groups of fat cells in the central portion of the lesion in the stroma of fibrous dysplasia between osseous trabeculae was observed in 23%(6/26) cases. Other patterns included myxoid stroma in 16%(4/26), collagenization of stroma in 12%(3/26), stroma rich pattern (with paucity of trabeculae) in 12%(3/26), foci of few foam cells in 23% (6/26), and calcified spherules in 12%(3/26). Focal osteoblastic rimming of trabeculae was observed only in 4%(1/26). Conclusions Various stromal variations and previously unreported fatty metamorphosis were frequently observed in fibrous dysplasia. PMID:12946277
Wolf, Michael S.; Chadha, Ashley D.; Carroll, Clinton M.; Borinstein, Scott C.
2014-01-01
Radiation-induced lung disease is a known complication of therapeutic lung irradiation, but the features have not been well described in children. We report the clinical, radiologic and histologic features of interstitial lung disease (ILD) in a 4-year-old child who had previously received lung irradiation as part of successful treatment for metastatic Wilms tumor. Her radiologic abnormalities and clinical symptoms developed in an indolent manner. Clinical improvement gradually occurred with corticosteroid therapy. However, the observed radiologic progression from interstitial and reticulonodular opacities to diffuse cystic lung disease, with subsequent improvement, is striking and has not been previously described in children. PMID:25434733
Massive Broad Ligament Cellular Leiomyoma with Cystic Change: A Diagnostic Dilemma.
Sharma, Preeti; Zaheer, Sufian; Yadav, Amit Kumar; Mandal, Ashish Kumar
2016-04-01
Leiomyomas are known to arise from uterus, but rarely from broad ligament. Further, cellular leiomyoma of broad ligament is the least common variant reported in literature. The diagnostic dilemma arises when leiomyomas undergo degenerative changes. This poses both clinical and radiological difficulty in differentiating with an ovarian tumour. We present an unusual case of a huge broad ligament mass measuring 29x19x09cm, mimicking an ovarian tumour both clinically and radiologically. Histopathology revealed cellular leiomyoma of broad ligament with cystic and myxoid degeneration hereby being the second case reported in literature. This case is being presented not only because of the rare incidence but also due to its diagnostic confusion with ovarian malignancy on clinical evaluation and radiological findings.
Mullerian papilloma-like proliferation arising in cystic pelvic endosalpingiosis.
McCluggage, W Glenn; O'Rourke, Declan; McElhenney, Clodagh; Crooks, Michael
2002-09-01
This report describes an unusual epithelial proliferation occurring in pelvic cystic endosalpingiosis. A cyst mass lined by a layer of ciliated epithelial cells involved the posterior surface of the cervix and vagina. The epithelial proliferation within the wall resembled a mullerian papilloma with fibrous and fibrovascular cores lined by bland cuboidal epithelial cells. Other areas had a microglandular growth pattern resembling cervical microglandular hyperplasia, and focally there was a solid growth pattern. Foci of typical endosalpingiosis involved the surface of both ovaries and pelvic soft tissues. The cystic lesion recurred after partial cystectomy and drainage and was followed up radiologically and with periodic fine-needle aspiration. Part of the wall of the cyst removed 11 years after the original surgery showed an identical epithelial proliferation. MIB1 staining showed a proliferation index of less than 5%, contrasting with the higher proliferation index of a typical serous borderline tumor. The differential diagnosis is discussed. As far as we are aware, this is the first report of such a benign epithelial proliferation involving cystic endosalpingiosis. Copyright 2002, Elsevier Science (USA). All rights reserved.
Geographic Patterns of Radiology Referrals in the United States: A Descriptive Network Analysis.
Liao, Geraldine J; Liao, Joshua M; Cook, Tessa S
2018-06-01
To provide a nationwide description of radiology referral patterns for Medicare beneficiaries and network-based measures that can describe and monitor shifts in referral patterns. We linked publicly available Medicare data with the National Plan and Provider Enumeration System data set to analyze 3,925,366 encounters representing referrals from nonradiology referrers to diagnostic radiology providers in 2015. We assessed per-state referral volume as well as in-state and in-region referrals and the correlation between state referral volume and in-state referrals. Additionally, we applied the conceptual framework of networks to create two measures to evaluate referrer-radiologist connections within each state: number of referrer relationships and referral density index (RDI). In 2015, there was considerable variation in in-state referrals across states, and the correlation between state referral volume and in-state referrals was low (0.18). Across census regions, in-region referrals were high (84.3% in the South to 89.2% in the Midwest). Across states, the mean number of referrer relationships ranged from 7.0 in Utah to 25.0 in California, and the number of referrer relationships varied significantly within states. Radiology provider RDI also varied both within and across states, with mean radiology provider RDI spanning from 0.05 in Kansas to 0.25 in Hawaii. In a nationwide description of geographic patterns in radiology referrals among Medicare beneficiaries, we demonstrate wide variation in radiology referral patterns and utilized network methods to develop two measures that can be used in the future to monitor shifts in referral patterns. Copyright © 2018 American College of Radiology. All rights reserved.
A case-report of a pulmonary tuberculosis with lymphadenopathy mimicking a lymphoma.
Collu, Claudia; Fois, Alessandro; Crivelli, Paola; Tidore, Gianni; Fozza, Claudio; Sotgiu, Giovanni; Pirina, Pietro
2018-05-01
Clinical and radiological manifestations of tuberculosis (TB) are heterogeneous, and differential diagnosis can include both benign and malignant diseases (e.g., sarcoidosis, metastatic diseases, and lymphoma). Diagnostic dilemmas can delay appropriate therapy, favoring Mycobacterium tuberculosis transmission. We report on a case of TB in an immunocompetent, Somalian 22-year-old boy admitted in the respiratory unit of an Italian university hospital. His symptoms and clinical signs were thoracic pain, weight loss, latero-cervical, mediastinal, and abdominal lymphadenopathy. Smear microscopy and PCR were negative for Mycobacterium tuberculosis. The unclear histological pattern, the unusual clinical presentation, the CT scan signs, the BAL lymphocytes suggested the suspicion a lymphoma. Culture conversion proved Mycobacterium tuberculosis infection. This case report highlights the risk of misdiagnosis in patients with generalized lympho-adenopathy and pulmonary infiltrates, particularly in Africans young patients. Copyright © 2018. Published by Elsevier Ltd.
A Genetic Algorithm for Learning Significant Phrase Patterns in Radiology Reports
DOE Office of Scientific and Technical Information (OSTI.GOV)
Patton, Robert M; Potok, Thomas E; Beckerman, Barbara G
2009-01-01
Radiologists disagree with each other over the characteristics and features of what constitutes a normal mammogram and the terminology to use in the associated radiology report. Recently, the focus has been on classifying abnormal or suspicious reports, but even this process needs further layers of clustering and gradation, so that individual lesions can be more effectively classified. Using a genetic algorithm, the approach described here successfully learns phrase patterns for two distinct classes of radiology reports (normal and abnormal). These patterns can then be used as a basis for automatically analyzing, categorizing, clustering, or retrieving relevant radiology reports for themore » user.« less
Khan, M Sarwar; Kirkland, P M; Kumar, R
2002-02-01
Firework injuries can manifest themselves in many different ways; usually as an explosive or burn injury. This case describes an unusual presentation of a firework penetrating injury resulting in a sharp coiled metal foreign body travelling through a small entry wound in the neck and subsequently lodging itself in the tracheobronchial tree. A foreign body such as this can potentially travel a considerable distance through the soft tissues and end up in an unsuspecting distant site. There must, therefore, be a high index of suspicion with the appropriate radiological investigations for appropriate management of such cases.
Idiopathic thoracic transdural intravertebral spinal cord herniation
Turel, Mazda K; Wewel, Joshua T; Kerolus, Mena G; O'Toole, John E
2017-01-01
Idiopathic spinal cord herniation is a rare and often missed cause of thoracic myelopathy. The clinical presentation and radiological appearance is inconsistent and commonly confused with a dorsal arachnoid cyst and often is a misdiagnosed entity. While ventral spinal cord herniation through a dural defect has been previously described, intravertebral herniation is a distinct entity and extremely rare. We present the case of a 70-year old man with idiopathic thoracic transdural intravertebral spinal cord herniation and discuss the clinico-radiological presentation, pathophysiology and operative management along with a review the literature of this unusual entity. PMID:29021685
1983-06-15
GREENHOUSE, DOG. 107 28 Runit Island radiological safety survey results following GREENHOUSE, DOG. 108 29 Estimate of maximum possible exposure at Parry...Enjebi Island radiological safety survey results following GREENHOUSE, EASY. 116 35 GREENHOUSE, EASY flight patterns. 118 36 Surface radex area and ship...positions during GREENHOUSE, GEORGE. 120 37 GREENHOUSE, GEORGE flight patterns. 122 38 Eleleron, Aomon, and Bijire island radiological safety survey
Cystic echinococcosis: A neglected disease at usual and unusual locations.
Sarkar, Soma; Roy, Himansu; Saha, Puranjay; Sengupta, Mallika; Sarder, Krisnendu; Sengupta, Manideepa
2017-01-01
Echinococcus granulosus causes a zoonotic infection called cystic echinococcosis (CE) or more commonly known as hydatid disease. Although the two most common locations of hydatid cyst are liver and lung, it may also appear in other parts of the body. Clinical presentation of the hydatid disease depends on the site and size of the lesion. A retrospective study was done in Medical College and Hospital, Kolkata, from January 2012 to June 2014, to find the site of involvement, distribution, clinical features, history of contact, mode of presentation, laboratory diagnosis, and treatment modalities of the cases of hydatid cyst. The cases were identified by radiological and laboratory methods, the data were entered in Excel spreadsheet, and analysis was done. Among the 21 cases of hydatid cyst included in the study, solitary hepatic involvement was seen in 11 (52.38%), pulmonary involvement in 4 (19%), and 6 (28.71%) were in unusual locations such as liver cyst extending as retroperitoneal, omental cyst, choledochal cyst, splenic cyst, and in hepatorenal pouch. History of contact with dog was seen in 15 (71.43%). All the patients were treated with surgery and albendazole and were discharged in healthy condition. CE may be present in usual and unusual locations with a lot of variations in the clinical features. Hence, proper radiological and laboratory diagnosis is required for accurate diagnosis and appropriate management of these cases.
Unusual pattern of the first dorsal metacarpal artery.
Bianchi, Homero; Saravia, Diego; Ottone, Nicolas Ernesto
2017-07-01
This report describes an unusual pattern of the first dorsal metacarpal artery (FDMA) regarding its course and termination. This FDMA had an abnormal course, passing deep to various anatomical elements related to the index finger, with unusual termination in the radial and ulnar proper palmar digital arteries feeding the second and third fingers, respectively. There is no mention of this anatomical variation in the literature. We report the possible embryological origin of this case and other variations related to the FDMA. This unusual pattern represents a new reason to consider anatomical knowledge important for surgeons whose procedures are in this area and to ensure an accurate diagnosis and safe treatment of pathologies that might engage this anatomical variation.
Leadership in a Network of Communities: A Phenomenographic Study
ERIC Educational Resources Information Center
MacGillivray, Alice
2010-01-01
Purpose: Canada's Chemical, Biological, Radiological, and Nuclear Research and Technology Initiative (CRTI) uses an operating model that is unusual in government. It is created to enable cross-boundary capability and capacity building and learning. Some consider it a model for other federal science initiatives. The purpose of this paper is to…
Presumed Perinatal Stroke in a Child with Down Syndrome and Moyamoya Disease
ERIC Educational Resources Information Center
Pysden, Karen; Fallon, Penny; Moorthy, Bhagavatheswaran; Ganesan, Vijeya
2010-01-01
Moyamoya disease describes a cerebral arteriopathy characterized by stenosis or occlusion of the terminal internal carotid and/or the proximal middle cerebral arteries. We report a female child with trisomy 21 and bilateral moyamoya disease who presented, unusually, with a presumed perinatal cerebral infarct. The clinical, radiological, and…
ERIC Educational Resources Information Center
Haberman, Shelby J.; Lee, Yi-Hsuan
2017-01-01
In investigations of unusual testing behavior, a common question is whether a specific pattern of responses occurs unusually often within a group of examinees. In many current tests, modern communication techniques can permit quite large numbers of examinees to share keys, or common response patterns, to the entire test. To address this issue,…
Spontaneous resolution of traumatic acute subdural haematomas: A systematic review.
Vital, Roberto Bezerra; Hamamoto Filho, Pedro Tadao; Oliveira, Victor Azevedo de; Romero, Flávio Ramalho; Zanini, Marco Antônio
2016-01-01
Traumatic subdural haematomas often require emergency surgical evacuation. Spontaneous resolution of traumatic acute subdural haematomas (TASDH) is under-reported. Two patients are described with spontaneous resolution of TASDH correlating with previous reports. A discussion is presented on the clinical, pathological and radiological features of TASDH. A review of the literature was performed using PubMed (Medline), Embase, and Cochrane Library for similar cases. A total 21 articles were included, involving 27 cases well detailed of TASDH with spontaneous resolution or neurological and radiological improvement in less than 24 h. There are two main mechanisms for the spontaneous resolution of acute subdural haematomas: dilution in subarachnoid space and redistribution of the haematoma in the subdural space. The primary radiological characteristic of these lesions is a hypodense rim on the outer surface of the clot. Spontaneous resolution of TASDH is unusual. Clinical and radiological surveillance is essential for appropriate management of these patients. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.
Classical and unusual imaging appearances of melorheostosis.
Suresh, S; Muthukumar, T; Saifuddin, A
2010-08-01
This comprehensive review will discuss the classical and unusual radiological features of melorheostosis, which is an uncommon, non-hereditary, benign, sclerosing mesodermal disease with an incidence of 0.9 cases per million. The presentation of melorheostosis in the appendicular skeleton (more commonly involved) and in the axial skeleton (very few documented case reports) will be discussed. The aim of the review is to illustrate the associations and rare, but recognized, complications of the disorder. The role of cross-sectional imaging in the form of magnetic resonance imaging (MRI) and computed tomography (CT) in revealing the spectrum of disease manifestation and differentiation from other disease entities and malignancy will be explored.
Temporal Dermoid Cyst with Unusual Imaging Appearance: Case Report.
Abderrahmen, Khansa; Bouhoula, Asma; Aouidj, Lasaad; Jemel, Hafedh
2016-01-01
Intracranial dermoid cysts are benign, slow growing tumors derived from ectopic inclusions of epithelial cells during closure of neural tube. These lesions, accounting for less than 1% of intracranial tumors, have characteristic computed tomography (CT) and magnetic resonance imaging (MRI) appearances that generally permits preoperative diagnosis. However, the radiologic features are uncommon and the cyst can be easily misdiagnosed with other tumors in rare cases. Herein, we report a case of a left temporoparietal dermoid cyst in a 48-year-old woman that was peroperatively and histopathologically proven but not advocated on CT and MRI. Clinical, radiological and histopathological features of a dermoid cyst are reviewed.
Epithelioid Haemangioendothelioma (EHE) of the Liver.
Khan, Abidullah; Humayun, Mohammad; Haider, Iqbal; Khan, Wazir Muhammad; Ajmal, Fahad; Ayub, Maimoona
2016-06-01
A45-year previously known hypertensive lady presented with 2-year history of upper abdominal pain, heaviness, and weight loss. Her radiological assessment suggested the possibility of hepatoma or liver metastases. Considering her age, overall good health and absence of cirrhosis, a liver biopsy was taken which showed hepatic epithelioidhaemangioendothelioma (HEHE), a rare and unusual intermediate grade vascular tumor which can easily be confused with hepatoma or metastatic liver disease. To the best of their knowledge, the authors are most probably reporting the first ever case of HEHE from Pakistan with special emphasis on its clinical presentations, clinico-radiological diagnostic clues, and the management options in the light of the limited retrospective studies.
ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.
López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C
2018-03-01
In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).
A painful perineal lump: an unusual case of ectopic breast tissue
Yongue, G; Leff, D; Lamb, BW; Karim, S; Aref, F; Vashisht, R
2011-01-01
We report the case of a 40-year-old lady who presented with an episodically painful perineal lump. Clinical and radiological investigations were inconclusive. Excision biopsy confirmed an ectopic breast mass. Ectopic breast tissue is difficult to diagnose but close attention to clinical findings can help to guide further investigation and diagnosis. PMID:22004627
Pareés, Isabel
2017-11-01
This clinical commentary discusses the phenomenology and treatment of paroxysmal dyskinesia in patients with multiple sclerosis. It calls for a consensus on the definition as well as for larger studies to better understand this unusual clinical association.
Learning Cue Phrase Patterns from Radiology Reports Using a Genetic Algorithm
DOE Office of Scientific and Technical Information (OSTI.GOV)
Patton, Robert M; Beckerman, Barbara G; Potok, Thomas E
2009-01-01
Various computer-assisted technologies have been developed to assist radiologists in detecting cancer; however, the algorithms still lack high degrees of sensitivity and specificity, and must undergo machine learning against a training set with known pathologies in order to further refine the algorithms with higher validity of truth. This work describes an approach to learning cue phrase patterns in radiology reports that utilizes a genetic algorithm (GA) as the learning method. The approach described here successfully learned cue phrase patterns for two distinct classes of radiology reports. These patterns can then be used as a basis for automatically categorizing, clustering, ormore » retrieving relevant data for the user.« less
Analysis of Operation Dominic II SMALL BOY radiological and meteorological data
DOE Office of Scientific and Technical Information (OSTI.GOV)
Quinn, V.E., Kennedy, N.C.; Steadman, C.R.
1984-08-01
This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the Operation Dominic II nuclear test SMALL BOY. Inconsistencies in the radiological data and their resolution are discussed. The methods of estimating fallout-arrival times are discussed. The meteorological situation on D-day and a few days following are described. A comparison of the fallout patterns resulting from these analyses and earlier (1966) analyses is presented. The radiological data used to derive the fallout pattern in this report are tabulated in an appendix. 11 references, 20 figures.
New neotropical species of Trupanea (Diptera: Tephritidae) with unusual wing patterns
USDA-ARS?s Scientific Manuscript database
Four species of Trupanea (Diptera: Tephritidae) with unusual wing patterns are described from the Neotropical Region: T. dimorphica (Argentina), T. fasciata (Argentina), T. polita (Argentina and Bolivia), and T. trivittata (Argentina). Celidosphenella Hendel, 1914 and Melanotrypana Hering, 1944 are ...
Miranda Rius, Jaume; Nadal, Alfons; Lahor, Eduard; Mtui, Beatus; Brunet, Lluís
2013-01-01
Unusual presentation of localized gingival enlargement associated with a subjacent tumoural pathology is reported. The patient was a 55-year-old black male, whose chief complaint was a progressive gingival overgrowth for more than ten years, in the buccal area of the anterior left mandible. According to the clinical features and the radiological diagnosis of odontogenic keratocyst, a conservative surgery with enucleation and curettage was performed. Tissue submitted for histopathological analysis rendered the diagnosis of odontogenic myxoma. After 12-month of follow-up, no evidence of recurrence was found. Clinicians should be cautious when facing any gingival enlargement to avoid diagnostic pitfalls and to indicate the appropriate treatment. PMID:23722914
[Rare bone tumour of the hand: capillary haemangioma of the second finger: case report].
Chbani, L; Benmlih, A; Hammas, N; Znati, K; Marzouki, A; Chbani, B; Boutayeb, F; Amarti, A
2011-04-01
Primary vascular tumours of bone are rare. Haemangiomas occur as incidental findings in the skull or in the spine. A solitary haemangioma of the hand skeleton is rare and difficult in radiological and histological differential diagnosis. We report a case of a 23 year-old patient presenting with a capillary hemangioma of the left second finger of few months duration for which he underwent amputation. Postoperative evolution was good and showed no recurrence. We discuss this through observation and a review of the literature including the different clinical, radiological and pathological diagnostic problems associated with an unusual site for vascular proliferation. Copyright © 2011. Published by Elsevier SAS.
Young, A; Dixon, A; Getty, J; Renton, P; Vacher, H
1981-06-01
A case of the cauda equina syndrome complicating ankylosing spondylitis (AS) is described. An unusual feature of this case was the relapsing and remitting nature of the condition, but there is sufficient evidence to explain the clinical picture on the basis of a recurrent intraspinal inflammatory process. The clinical and radiological features are similar to those of a further 28 reported in the literature. An electromyogram (EMG) proved important in defining the extent of neurological involvement. Computerised tomography (CT) showed marked laminar erosion and no bony exit foramen encroachment. We believe that the clinical diagnosis of this condition can be adequately confirmed with plain radiology, EMG, and CT scan.
Real view radiology-impact on search patterns and confidence in radiology education.
Bailey, Jared H; Roth, Trenton D; Kohli, Mark D; Heitkamp, Darel E
2014-07-01
Search patterns are important for radiologists because they enable systematic case review. Because radiology residents are exposed to so many imaging modalities and anatomic regions, and they rotate on-and-off service so frequently, they may have difficulty establishing effective search patterns. We developed Real View Radiology (RVR), an educational system founded on guided magnetic resonance imaging (MRI) case review and evaluated its impact on search patterns and interpretative confidence of junior radiology residents. RVR guides learners through unknown examinations by sequentially prompting learners to certain aspects of a case via a comprehensive question set and then providing immediate feedback. Junior residents first completed a brief evaluation regarding their level of confidence when interpreting certain joint MRI cases and frequency of search pattern use. They spent four half-days interpreting cases using RVR. Once finished, they repeated the evaluations. The junior resident results were compared to third-year residents who had not used RVR. The data were analyzed for change in confidence, use of search patterns, and number of cases completed. Twelve first-year and thirteen second-year residents (trained cohort) were enrolled in the study. During their 4-week musculoskeletal rotations, they completed on average 29.3 MRI knee (standard deviation [SD], 1.6) and 17.4 shoulder (SD, 1.2) cases using RVR. Overall search pattern scores of the trained cohort increased significantly both from pretraining to posttraining (knee P < .01, shoulder P < .01) and compared to the untrained third-year residents (knee (P < .01, and shoulder P < .01). The trained cohort confidence scores also increased significantly from pre to post for all joints (knee P < .01, shoulder P < .01, pelvis P < .01, and ankle P < .01). Radiology residents can increase their MRI case interpretation confidence and improve the consistency of search pattern use by training with a question-based sequential reveal educational program. RVR could be used to supplement training and assist with search pattern creation in areas in which residents often do not acquire adequate clinical exposure. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.
Isolated colonic inertia is not usually the cause of chronic constipation.
Ragg, J; McDonald, R; Hompes, R; Jones, O M; Cunningham, C; Lindsey, I
2011-11-01
Chronic constipation is classified as outlet obstruction, colonic inertia or both. We aimed to determine the incidence of isolated colonic inertia in chronic constipation and to study symptom pattern in those with prolonged colonic transit time. Chronic constipation patients were classified radiologically by surgeon-reported defaecating proctography and transit study into four groups: isolated outlet obstruction, isolated colonic inertia, outlet obstruction plus colonic inertia, or normal. Symptom patterns were defined as stool infrequency (twice weekly or less) or frequent unsuccessful evacuations (more than twice weekly). Of 541 patients with chronic constipation, 289 (53%) were classified as isolated outlet obstruction, 26 (5%) as isolated colonic inertia, 159 (29%) as outlet obstruction plus colonic inertia and 67 (12%) as normal. Of 448 patients (83%) with outlet obstruction, 35% had additional colonic inertia. Only 14% of those with prolonged colonic transit time had isolated colonic inertia. Frequent unsuccessful evacuations rather than stool infrequency was the commonest symptom pattern in all three disease groups (isolated outlet obstruction 86%, isolated colonic inertia 54% and outlet obstruction plus colonic inertia 63%). Isolated colonic inertia is an unusual cause of chronic constipation. Most patients with colonic inertia have associated outlet obstruction. These data question the clinical significance of isolated colonic inertia. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.
Detection of unusual strains of RV in patients with acute diarrhoea in Mexico.
del R González-Losa, Maria; Rodríguez-Angulo, Elsa; Manzano-Cabrera, Luis; Mejía-Cámara, Javier; Puerto-Solís, Marylin
2005-04-01
Group A rotaviruses are a major cause of acute gastroenteritis in infants. Human strains with a short RNA pattern generally exhibit subgroup I, G2, P1B[4] specificity, those with a long RNA pattern show subgroup II, G1, G3 or G4, P1A[8] specificity. The presence of strains with unusual specificities has been reported worldwide over the last decade. To determine antigenic diversity among rotaviruses isolated from patients with diarrhoea. A laboratory-based survey study was carried out with faecal samples from patients with acute gastroenteritis form January to April 2000. To classify the samples PAGE and ELISA with specific antibodies to serotype G and P and RT-PCR were carried out. Twenty one specimens from patients with dehydrating diarrhoea had unusual specifies. Nine specimens had unusual combination of long pattern and subgroup I. Twelve specimens with short pattern belong to G1 serotype. As far as the serotypes and genotypes concern 11 samples were P1A, P[4] and one specimen was P1A, P[9]. These results demonstrated the unexpected presence of unusual strains of rotavirus in Mexico. Detection of strains with both human and animal characteristics may indicate interspecies transmission of RV between humans and animals.
Becker, Edmund R; Constantine, Robert J; McPherson, Marie A; Jones, Mary Elizabeth
2013-01-01
The rapid growth in the use of antipsychotic medications and their related costs have resulted in states developing programs to measure, monitor, and insure their beneficial relevance to public program populations. One such program developed in the state of Florida has adopted an evidence-based approach to identify prescribers with unusual psychotherapeutic prescription patterns and track their utilization and costs among Florida Medicaid patients. This study reports on the prescriber prescription and cost patterns for adults and children using three measures of unusual antipsychotic prescribing patterns: (1) two antipsychotics for 60 days (2AP60), (2) three antipsychotics for 60 days (3AP60), and (2) two antipsychotics for 90 or more days (2AP90). We find that over the four-year study period there were substantial increases in several aspects of the Florida Medicaid behavioral drug program. Overall, for adults and children, patient participation increased by 29 percent, the number of prescriptions grew by 30 percent, and the number of prescribers that wrote at least one prescription grew 48.5 percent, while Medicaid costs for behavioral drugs increased by 32 percent. But the results are highly skewed. We find that a relatively small number of prescribers account for a disproportionately large share of prescriptions and costs of the unusual antipsychotic prescriptions. In general, the top 350 Medicaid prescribers accounted for more than 70 percent of the unusual antipsychotic prescriptions, and we find that this disparity in unusual prescribing patterns appears to be substantially more pronounced in adults than in children prescribers. For just the top 13 adult and children prescribers, their practice patterns accounted for 11 percent to 21 percent of the unusual prescribing activity and, overall, these 13 top prescribers accounted for 13 percent of the total spent on antipsychotics by the Florida Medicaid program and 9.3 percent of the total expenditure by the state for all drugs. Our findings suggest that a strategy to monitor and ensure patient safety and prescribing patterns that targets a relatively small number of Medicaid providers could have a substantial benefit and prove to be cost effective.
Patnaik, Ashis; Mishra, Sudhansu Sekhar; Das, Srikanta
2017-01-01
Pseudo-TORCH syndrome or congenital infection-like syndrome is a group of conditions which resemble congenital infections such as those caused by toxoplasmosis, rubella, cytomegalovirus (CMV), herpes (TORCH) group of organisms, clinico-radiologically, but serological tests are negative for the organisms. One of the variety shows features such as microcephaly, extensive intracranial calcification showing gross resemblance to congenital CMV infection, making its other name as microcephaly intracranial calcification syndrome (MICS). Dandy–Walker malformation (DWM), in addition to posterior fossa large cyst, cerebellar vermis hypoplasia, and hydrocephalus is often associated with agenesis of the corpus callosum and callosal lipomas, dysplasia of the brainstem, and cerebellar hypoplasia or dysgenesis. But radiological features of DWM with microcephaly and intracranial calcification are very unusual and have been rarely reported in the literature.[1] We report a case of infant showing clinical features suggestive of congenital CMV infection with negative serology and radiological imaging suggestive of DWM with extensive intracranial calcification. Pseudo-TORCH syndrome with radiological features of DWM is a congenital developmental abnormality. Inspite of hydrocephalus, it does not require cerebrospinal fluid (CSF) diversionary procedure due to lack of increased intracranial pressure. Conservative management for seizure disorder is the optimal therapy. PMID:28761539
Patnaik, Ashis; Mishra, Sudhansu Sekhar; Das, Srikanta
2017-01-01
Pseudo-TORCH syndrome or congenital infection-like syndrome is a group of conditions which resemble congenital infections such as those caused by toxoplasmosis, rubella, cytomegalovirus (CMV), herpes (TORCH) group of organisms, clinico-radiologically, but serological tests are negative for the organisms. One of the variety shows features such as microcephaly, extensive intracranial calcification showing gross resemblance to congenital CMV infection, making its other name as microcephaly intracranial calcification syndrome (MICS). Dandy-Walker malformation (DWM), in addition to posterior fossa large cyst, cerebellar vermis hypoplasia, and hydrocephalus is often associated with agenesis of the corpus callosum and callosal lipomas, dysplasia of the brainstem, and cerebellar hypoplasia or dysgenesis. But radiological features of DWM with microcephaly and intracranial calcification are very unusual and have been rarely reported in the literature.[1] We report a case of infant showing clinical features suggestive of congenital CMV infection with negative serology and radiological imaging suggestive of DWM with extensive intracranial calcification. Pseudo-TORCH syndrome with radiological features of DWM is a congenital developmental abnormality. Inspite of hydrocephalus, it does not require cerebrospinal fluid (CSF) diversionary procedure due to lack of increased intracranial pressure. Conservative management for seizure disorder is the optimal therapy.
van der Gijp, A; Ravesloot, C J; Jarodzka, H; van der Schaaf, M F; van der Schaaf, I C; van Schaik, J P J; Ten Cate, Th J
2017-08-01
Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology domain aims to identify visual search patterns associated with high perceptual performance. Databases PubMed, EMBASE, ERIC, PsycINFO, Scopus and Web of Science were searched using 'visual perception' OR 'eye tracking' AND 'radiology' and synonyms. Two authors independently screened search results and included eye tracking studies concerning visual skills in radiology published between January 1, 1994 and July 31, 2015. Two authors independently assessed study quality with the Medical Education Research Study Quality Instrument, and extracted study data with respect to design, participant and task characteristics, and variables. A thematic analysis was conducted to extract and arrange study results, and a textual narrative synthesis was applied for data integration and interpretation. The search resulted in 22 relevant full-text articles. Thematic analysis resulted in six themes that informed the relation between visual search and level of expertise: (1) time on task, (2) eye movement characteristics of experts, (3) differences in visual attention, (4) visual search patterns, (5) search patterns in cross sectional stack imaging, and (6) teaching visual search strategies. Expert search was found to be characterized by a global-focal search pattern, which represents an initial global impression, followed by a detailed, focal search-to-find mode. Specific task-related search patterns, like drilling through CT scans and systematic search in chest X-rays, were found to be related to high expert levels. One study investigated teaching of visual search strategies, and did not find a significant effect on perceptual performance. Eye tracking literature in radiology indicates several search patterns are related to high levels of expertise, but teaching novices to search as an expert may not be effective. Experimental research is needed to find out which search strategies can improve image perception in learners.
Desoubeaux, Guillaume; Chaussade, Hélène; Thellier, Marc; Poussing, Sophie; Bastides, Frédéric; Bailly, Eric; Lanotte, Philippe; Alison, Daniel; Brunereau, Laurent; Bernard, Louis; Chandenier, Jacques
2014-01-01
We report a rare case of amebiasis generating 19 large liver abscesses. Such a quantity of abscesses is rare, especially when occurring in a young casual traveler without any immunodeficiency disorders. A possible co-infection was excluded. By contrast, the amebic etiology was confirmed by means of serology and real-time PCR.
CT of the "Tegernsee Giant": juvenile gigantism and polyostotic fibrous dysplasia.
Vogl, T J; Nerlich, A; Dresel, S H; Bergman, C
1994-01-01
We report the radiological findings in the unusual case of the Bavarian "Tegernsee Giant." With conventional radiography, CT, and histologic examination, we succeeded in diagnosing two disorders: The Tegernsee Giant suffered from (a) juvenile gigantism caused by a growth hormone-secreting tumor of the pituitary gland and (b) a polyostotic form of fibrous dysplasia of the skull and multiple bones particularly on the left side of the body.
The influence of a fire-induced convection column on radiological fallout patterns
A. Broido; A.W. McMasters
1959-01-01
Since no nuclear devices have been detonated by the United States under conditions leading to both mass fires and radiological fallout, a theoretical and small-scale experimental study was undertaken to see if fire-induced convection columns could significantly affect fallout patterns. Experiments were conducted in a 6- by 6-foot low-velocity wind tunnel using full-...
DOE Office of Scientific and Technical Information (OSTI.GOV)
Black, R.R.; Fernandez-Ulloa, M.; ter Penning, B.
1988-12-01
Indium-111 WBC imaging of a patient with occult septicemia revealed a large focal pattern of radiopharmaceutical distribution within the abdominal cavity at 24 hours post radiopharmaceutical administration. This finding was felt to represent a large intra-abdominal abscess. A five liter peritoneal abscess was found at surgery. This case illustrates an unusual presentation of an intra-abdominal abscess.
Acute abdomen: an unusual presentation of disseminated Penicillium marneffei infection.
George, I A; Sudarsanam, T D; Pulimood, A B; Mathews, M S
2008-01-01
Varied clinical presentations of Penicillium marneffei, an opportunistic pathogen in HIV disease has been rarely described in literature. We report a patient with advanced AIDS who presented to us with prolonged fever and had features of an acute abdomen. On radiologic imaging he had features of intestinal obstruction and mesenteric lymphadenitis. A diagnosis was made possible by endoscopic biopsies of the small bowel and bone marrow culture which grew P. Marneffei. He was treated with intravenous amphotericin for 2 weeks followed by oral itraconazole. This case is reported for its rarity and unusual presentation and to sensitise clinicians and microbiologists to consider this as an aetiology in patients with advanced HIV/AIDS who present with acute abdomen, more so in patients from a distinct geographic region--South-East Asia.
Aung, Ar Kar; Teh, Bing Mei; McGrath, Christopher; Thompson, Philip J
2013-07-01
Pulmonary infections by Sporothrix spp. manifest radiologically as cavitary or non-cavitary disease depending on whether the infection is primary pulmonary or multifocal sporotrichosis. Despite current guidelines, the optimal management for pulmonary sporotrichosis remains unclear. In order to clarify this, we present two cases of pulmonary sporotrichosis, as well as the results of a comprehensive literature review of treatment outcomes based on clinico-radiological presentation patterns of the disease. A literature search of all case reports in English language over the last 50 years (1960-2010) was conducted. Data on patient characteristics, risk factors, clinico-radiological patterns, treatment modalities and outcomes were collected and analyzed. A total of 86 cases were identified, i.e., 64 (74.4%) primary pulmonary and 22 (25.6%) multifocal sporotrichosis. Radiologically, primary pulmonary disease was commonly characterized by cavity formation which was lacking in multifocal infections (P = 0.0001). Immunosuppressant use was more common in multifocal sporotrichosis (P = 0.0001), while hemoptysis was more common in primary pulmonary form (P = 0.01). No other differences in patient characteristics or risk factors were noted. Extra-pulmonary multifocal sporotrichosis most commonly involved skin (81.8%) and joints (45.4%). For patients with cavitary primary pulmonary sporotrichosis, outcomes from medical therapy alone were inferior to surgical intervention (P = 0.02). However, for both primary pulmonary and multifocal sporotrichosis with non-cavitary disease, medical therapy alone provided good outcomes. Only 12 (16.7%) cases were treated with itraconazole. Treatment of pulmonary sporotrichosis should be guided by the clinico-radiological patterns of presentation. Medical therapy alone is likely sufficient for non-cavitary disease while early surgery should be considered for cavitary primary pulmonary sporotrichosis. The experience in treating cavitary disease with itraconazole alone is limited and further data are required.
Accidental hanging by a T-shirt collar in a man with morphine intoxication: an unusual case.
Kodikara, Sarathchandra; Alagiyawanna, Ramesh
2011-09-01
Accidental hanging is rare across all age groups, and it is even rarer in the adult population except in autoerotic asphyxia. Few cases have been reported in the literature, which describe unusual patterns of accidental hanging. This article focuses on an unusual pattern of accidental hanging of a 25-year-old man, who was in a state of morphine-induced central nervous system depression and found dead in a sitting position with the collar of his T-shirt hanging off a jutting-out root of a tree. The hanged collar acted as a ligature compressing the neck.
Unusual and Interesting Adverse Cutaneous Drug Reactions.
Masatkar, Vaishali; Nagure, Ashok; Gupta, Lalit Kumar
2018-01-01
Any drug can cause any rash! Cutaneous adverse drug reactions (CADRs) are great mimickers and can be included in the differential diagnosis of any inflammatory dermatoses. Several drugs can cause rash of similar morphology and the same drug can cause rash of different morphology. While some common and specific drug reaction patterns are recognized easily by the clinicians, many a times unusual and interesting patterns can be induced by drug(s), thus leading to erroneous diagnosis and mistreatment. This review aims to familiarize clinicians with some rare, yet interesting patterns of CADR.
Unusual and Interesting Adverse Cutaneous Drug Reactions
Masatkar, Vaishali; Nagure, Ashok; Gupta, Lalit Kumar
2018-01-01
Any drug can cause any rash! Cutaneous adverse drug reactions (CADRs) are great mimickers and can be included in the differential diagnosis of any inflammatory dermatoses. Several drugs can cause rash of similar morphology and the same drug can cause rash of different morphology. While some common and specific drug reaction patterns are recognized easily by the clinicians, many a times unusual and interesting patterns can be induced by drug(s), thus leading to erroneous diagnosis and mistreatment. This review aims to familiarize clinicians with some rare, yet interesting patterns of CADR. PMID:29692451
Candanedo-Gonzalez, Fernando; Ortiz-Arce, Cindy Sharon; Rosales-Perez, Samuel; Remirez-Castellanos, Ana Lilia; Cordova-Uscanga, Candelaria; Gamboa-Dominguez, Armando
2017-01-14
Giant cell ependymoma of the filum terminale is a rare variant, generally manifested as a well-circunscribed intradural mass with an indolent biological behavior. We describe the case of a 48-year-old Mexican female who non-relevant past medical history, that developed a GCE of the filum terminale. Magnetic resonance imaging and computed tomography revealed the presence of an intra-axial tumor extending from L3 to L5 with extra-medullary invasion. Therefore the tumor was considered unresectable and only incisional biopsy was obtained, establishing the tentative diagnosis of a poorly differentiated neoplasia. A second evaluation of the case revealed the presence of numerous non-cohesive pleomorphic giant cells with intranuclear inclusions and broad eosinophilic cytoplasm, alternating with intermediate size cells with round, hyperchromatic nuclei and forming a perivascular pseudo-rosettes pattern. The ependymal phenotype was supported by light microscopy and corroborated by immunohistochemistry analysis. The patient was subsequently treated with radiotherapy 54Gy. She is alive after a 27-month follow-up, with residual disease, difficulty ambulating and pain. GCE of filum terminale may have an atypical clinical and radiological presentation, albeit with invasive characteristics and anaplasia on histologic analysis. However, its biological behavior is indolent and associated to longer survival. Due to the presence of giant cells, the differential diagnosis of other primary neoplasias at that site were considered, including paraganglioma, malignant peripheral nerve sheath tumors as well as metastatic malignant melanoma, adrenal carcinoma, thyroid gland carcinoma and urothelial carcinoma, that may all harbor giant cells.
Analysis of Operation TEAPOT nuclear test BEE radiological and meteorological data
DOE Office of Scientific and Technical Information (OSTI.GOV)
Quinn, V.E.
This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BEE nuclear test of Operation TEAPOT. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time and estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed in the 1950's is presented. The radiological data used to derive the WSNSO fallout pattern are tabulated in an appendix.
Lei, M H; Ko, Y L; Kuan, P; Lien, W P; Chen, D S
1992-04-01
Unusual patterns of cardiac metastasis were noted in three cases of hepatocellular carcinoma (HCC): one patient was noted to have a large right ventricular (RV) tumor mass with intracavitary growth and myocardial invasion; the second had massive pulmonary and left atrial (LA) metastasis; and the third patient had a right atrial tumor mass with concomitant RV and LA involvement. Tumor implantation to the RV without right atrial involvement and extensive myocardial invasion is unusual in HCC. The LA involvement is probably related to tumor growth from the pulmonary veins following massive metastasis to the lung, direct invasion of the atrial septum or tumor implantation via a subclinical right-to-left shunt through the patent foramen ovale. To the best of our knowledge, such unusual intracavitary metastases in HCC have not been reported previously. Cardiac metastasis, without local gross recurrence, may be one of the presentations after lobectomy in patients with HCC.
Zoccali, Carmine; Attala, Dario; Rossi, Barbara; Zoccali, Giovanni; Ferraresi, Virginia
2018-05-23
Fibrous dysplasia (FD) is a benign fibro-osseous disease of the bone that may be solitary or multicentric. It is important to distinguish this type of lesion from low-grade osteosarcomas (LGOS) and from secondary sarcomas, because malignant transformation has rarely been reported. It is classically described as having a ground-glass appearance, endosteal scalloping, and thinning of the cortex. Cortical disruption is considered evidence of malignancy, but it can also be present in benign FD with aggressive behavior. We present an unusual case of aggressive FD of the 7th left rib, already diagnosed more than 22 years ago, where cortical and costo-vertebral joint disruption and 7th thoracic vertebral body involvement were not evidence of malignant behavior. From a histological perspective, FD and LGOS are similar; even if histology is of fundamental importance, the diagnosis has to be made based on the clinical and radiological aspects as well, although at imaging, differentiation between FD and LGOS can be difficult. In the present case, even though the histological examination suggested a benign lesion, the radiological examination instead consistently suggests malignancy. It is for this reason that there should be a high index of suspicion during follow-up and a new biopsy should be scheduled in case any changes occur during follow-up.
Breast as an unusual site of metastasis- series of 3 cases and review of literature.
Hebbar, Ashwin K; Shashidhar, K; S, Krishna Murthy; Kumar, Veerendra; Arjunan, Ravi
2014-09-01
Background and objectives Metastasis to the breast from extra mammary sites is uncommon with an incidence ranging from 1.2 to 2 % in clinical reports. Approximately 300 cases of breast metastasis from extra mammary sites have been reported, mostly in small series or as a single case report. Gastrointestinal adenocarcinoma metastasising to the breast is also very rare and only 30 cases have been reported in the literature. Metastatic deposits within the breast may be difficult to distinguish from primary breast carcinoma. Radiological features and immunohistochemistry especially for steroid hormone receptors (ER/PR) and expression of gross cystic disease fluid protein (GCDFP) and presence of other immunohistochemistry protein factors in breast metastasis which are specific to primary site may be helpful in differentiating these two conditions. Materials and methods In this series of 3 cases of breast as an unusual site of metastasis, we present different cases of adenocarcinoma of stomach, sigmoid colon and kidney with metastasis to the breast and discuss the differential diagnosis and management plans. Conclusion In conclusion, secondary tumors to the breast are rare and thus differentiating primary tumors from metastatic breast carcinoma is important for rational and optimum therapy and avoidance of unnecessary radical surgery. Palpable breast lump without typical radiological signs of primary breast carcinoma in patients with known primary should be suspected of representing metastasis.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Muder, R.R.; Reddy, S.C.; Yu, V.L.
Using an objective scoring system, chest radiographs were reviewed in 23 cases of pneumonia due to the Pittsburgh pneumonia agent (PPA, Tatlockia micdadei, Legionella micdadei), including six cases of pneumonia with simultaneous isolation of PPA and L pneumophila (Legionnaires' disease). Infiltrates were typically segmental to lobar; nodular infiltrates were noted in three cases. Spread to additional lobes after presentation occurred in four of 17 PPA infections. Pneumonia caused by both PPA and L pneumophila was unusually severe, with involvement of all lobes occurring in four of six cases, compared with one of 17 cases of PPA infection (p>0.02). Radiographic severitymore » did not correlate with underlying disease, immune status, or outcome. The majority of patients receiving erythromycin demonstrated objective radiologic improvement. In a patients, population that included nonimmunosuppressed patient, nodule formation and rapid radiologic progression were not found to be characteristic of PPA pneumonia.« less
Giesbrandt, Kirk J; Bulatao, Ilynn G; Keaveny, Andrew P; Nguyen, Justin H; Paz-Fumagalli, Ricardo; Taner, C Burcin
2015-11-01
The purpose of this study was to define the cholangiographic patterns of ischemic cholangiopathy and clinically silent nonanastomotic biliary strictures in donation-after-cardiac-death (DCD) liver grafts in a large single-institution series. We also examined the correlation of the radiologic findings with laboratory data and clinical outcomes. Data were collected for all DCD liver transplants at one institution from December 1998 to December 2011. Posttransplant cholangiograms were obtained during postoperative weeks 1 and 3 and when clinically indicated. Intrahepatic biliary strictures were classified by anatomic distribution and chronologic development. Radiologic findings were correlated with laboratory data and with 1-, 3-, and 5-year graft and patient survival rates. A total of 231 patients received DCD grafts. Cholangiograms were available for 184 of these patients. Postoperative cholangiographic findings were correlated with clinical data and divided into the following three groups: A, normal cholangiographic findings with normal laboratory values; B, radiologic abnormalities and cholangiopathy according to laboratory values; and C, radiologic abnormalities without laboratory abnormalities. Group B had four distinct abnormal cholangiographic patterns that were predictive of graft survival. Group C had mild nonprogressive multifocal stenoses and decreased graft and patient survival rates, although cholangiopathy was not detected in these patients according to laboratory data. Patterns and severity of nonanastomotic biliary abnormalities in DCD liver transplants can be defined radiologically and correlate with clinical outcomes. Postoperative cholangiography can depict the mild biliary abnormalities that occur in a subclinical manner yet cause a marked decrease in graft and patient survival rates in DCD liver transplants.
Xiang, Ying; Zhou, Meng-jie; Xu, Ming-Ya; Salamon, Péter; Éber, Nándor; Buka, Ágnes
2015-04-01
Electric-field-induced patterns of diverse morphology have been observed over a wide frequency range in a recently synthesized bent-core nematic (BCN) liquid crystal. At low frequencies (up to ∼25 Hz), the BCN exhibited unusual polarity-dependent patterns. When the amplitude of the ac field was enhanced, these two time-asymmetrical patterns turned into time-symmetrical prewavylike stripes. At ac frequencies in the middle-frequency range (∼50-3000 Hz), zigzag patterns were detected whose obliqueness varied with the frequency. Finally, if the frequency was increased above 3 kHz, the zigzag pattern was replaced by another, prewavylike pattern, whose threshold voltage depended on the frequency; however, the wave vector did not. For a more complete characterization, material parameters such as elastic constants, dielectric permittivities, and the anisotropy of the diamagnetic susceptibility were also determined.
A woman with a dangling digit.
Roesch, Alexander; Kinner, Bernd; Schaechinger, Ulrich; Obermann, Ellen C; Landthaler, Michael; Hohenleutner, Ulrich
2007-11-01
Ainhum (dactylolysis spontanea) is a distinct clinical and radiological disorder of dark-skinned people characterized by a progressive development of a constricting band encircling the toe which usually results in spontaneous amputation. Ainhum mainly occurs in African natives, but in times of global migration and tourism, Ainhum is likely to be more often encountered outside Africa. Even though the clinical presentation can mimic more common entities such as arthritis and trauma, the correct diagnosis and treatment is easy if one knows this unusual entity.
Gramann, T; Stamm, B; Buchmann, P
2007-04-01
A 33-year-old snowboarder fell and underwent radiological examination, which was suspicious for a vertebral body fracture. Accidentally we found a tumour of the left suprarenal gland. Two days after the fall, he developed a hypertensive crisis with peak blood pressure levels up to 280/120 mmHg. Further endocrinologic testing indicated a pheochromocytoma which was confirmed by post-operative histology. The fall is supposed to have activated the pheochromocytoma. The course of examinations and significance of the tumour are described.
Extravasation of radiographic contrast media: prevention, diagnosis, and treatment.
Tonolini, Massimo; Campari, Alessandro; Bianco, Roberto
2012-01-01
Contrast media extravasation represents a not unusual problem in radiological practice. Incidence, patient-, and procedure-related risk factors, pathogenesis, and clinical manifestations of extravasation injuries are discussed with a review of recent literature, and a practical preventive approach is proposed. A diagnostic and therapeutic protocol, to be applied whenever contrast extravasation is detected, includes radiographic assessment of compartmentalization, antidote application, local care, and clinical follow-up; indications for surgical consultation and adverse event reporting are provided. Copyright © 2012 Mosby, Inc. All rights reserved.
An unusual case of lung abscess caused by Acremonium species treated with itraconazole.
Qazi, M S; Bowalekar, S S; Wanjare, V S; Shankar, A
2015-01-01
We present a report of a 37-year-old female with lung abscess due to Acremonium species that responded to oral itraconazole. There was a marked clinical as well as radiological improvement in patient. To the best of our knowledge, this is the first case of lung abscess due to Acremonium species which was treated by oral itraconazole. This cost-effective treatment modality proved to be significant in improving symptoms as well as morbidity in this patient.
Aneurysmal bone cyst of the scapula. A case report.
Megas, Panagiotis; Papathanassiou, Zafiria G; Kasimatis, George; Papachristou, Dionysios J
2009-10-01
Aneurysmal bone cyst (ABC) is an uncommon, benign but locally destructive bone lesion of unknown origin. Differential diagnosis can be challenging as it shares common radiological and pathological features with other benign and malignant bone lesions. The degree of diagnostic difficulty grows even more when an unusual location has to be taken into account. We report a rare and challenging case of a large primary ABC located at the scapula of a young male, who was surgically treated with subtotal removal of the scapula.
Florid cemento osseous dysplasia in association with dentigerous cyst.
Sanjai, Karpagaselvi; Kumarswamy, Jayalakshmi; Kumar, Vinod K; Patil, Archana
2010-07-01
We present a case of florid cemento-osseous dysplasia occurring in a 20-year-old Indian woman. The subject presented with three lesions involving the maxillary right quadrant, maxillary left quadrant and mandibular left quadrant. The mandibular left quadrant also demonstrated a cyst.The diagnosis was made by correlating the clinical presentation with that of the radiological and histopathological findings. This is a rare entity because of an unusual combination of Asian race along with the association of dentigerous cyst.
Actinomycotic osteomyelitis of the cranial vault presenting with headache: an unusual presentation.
Roopesh Kumar, V R; Madhugiri, Venkatesh S; Gundamaneni, Sudheer Kumar; Verma, Surendra Kumar
2014-11-24
A case of left parietal calvarial actinomycotic osteomyelitis in a young woman is described. She had no predisposing illnesses. She had delivered a live child at term and presented in the puerperal period. No extracranial focus of infection was identified. She responded well to a combination of surgery and medical therapy and had an excellent outcome. The authors emphasise the importance of establishing a histopathological diagnosis since radiological signs are non-specific and unreliable. 2014 BMJ Publishing Group Ltd.
Single-rooted maxillary first molar with a single canal: endodontic retreatment.
de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José
2008-12-01
This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.
Unusual blunt force wound produced by a gun muzzle.
Hanzlick, R; Zaki, S A
1986-09-01
Most blunt force injuries produced by guns are associated with gun butts, and patterned, muzzle/sight impressions are usually produced by discharging firearms. An unusual and distinct forehead laceration produced by a blow with the muzzle end of a .32 caliber revolver is presented.
Szymańska, Anna; Szymański, Marcin; Czekajska-Chehab, Elżbieta; Szczerbo-Trojanowska, Małgorzata
2014-07-01
Juvenile nasopharyngeal angiofibroma is a benign lesion with locally aggressive nature. Knowledge of its typical growth patterns is crucial for precise preoperative staging and adequate preoperative patient counseling. This pictorial essay focuses on characteristic radiological features and paths of invasive growth of this rare tumor. Also, the impact of accurate preoperative evaluation of tumor extensions on surgical planning and results of treatment are discussed. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Analysis of operation UPSHOT-KNOTHOLE nuclear test BADGER radiological and meteorological data
DOE Office of Scientific and Technical Information (OSTI.GOV)
Quinn, V.E.
1986-04-01
This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BADGER nuclear test of Operation UPSHOT-KNOTHOLE. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time, of converting the aerial data to equivalent ground-level values, and of estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed during the 1950's is presented. The radiological data used to derive the WSNSO falloutmore » pattern are tabulated in an appendix.« less
Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Schoepf, U Joseph; Xu, Jiaqian; Lu, Guang Ming; Li, Enzhong
2017-10-01
To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P < 0.001). Within Mainland China's Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. • Radiology research in Mainland China saw a substantial increase. • Neuroradiology, vascular/interventional Radiology, and abdominal Radiology are the most productive fields. • MRI is the most used modality in Mainland China's Radiology research. • Guangdong, Shanghai, and Beijing are the most productive provinces.
Machine Learning and Radiology
Wang, Shijun; Summers, Ronald M.
2012-01-01
In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. PMID:22465077
Internal contamination of an irradiator discovered during security enhancement.
Harvey, R P
2014-08-01
High-risk radioactive sources regulated under Increased Controls Regulations have been protected by licensed facilities, but the federal government has placed significant emphasis on these sources and has developed initiatives to assist radioactive material licensees. The Department of Energy's Global Threat Reduction Initiative (GTRI) Domestic Threat Reduction Program is a voluntary federally funded program for security enhancements of high-risk radiological material. During the hardening or security enhancement process by the United States Department of Energy (U.S. DOE) contractors, a small amount of radioactive contamination was discovered in a Cesium irradiator. Ultimately, it was decided to pursue disposal with U.S. DOE's Off-Site Recovery Program (OSRP). Radiological devices may have a leaking source or known internal contamination that may cause difficulty during security enhancement. If the licensee understands this, it may provide facilities the opportunity to plan and prepare for unusual circumstances.
Spranger, J. W.
1977-01-01
Any review of the metaphyseal chondrodysplasias is complicated by their variety and mainly unknown pathogenesis. The more familiar types display considerable clinical and radiological diversity: even more so the rarer disorders which still require complete definition, but differences in their mode of inheritance make diagnostic precision mandatory. These dysplasias present in infancy or in childhood, when the patient, usually dwarfed, may be proportionate, so that some forms may be confused with rickets or other lesions. Mental retardation is unusual, but the skin, hair, nails and facies provide valuable diagnostic features. Radiological abnormalities mainly affect the metaphyses of the shortened limb bones, less often the skull, vertebrae, pelvis, ribs and extremities, and sometimes their distribution may indicate the specific type of dysplasia. In a further complex group multiple systems are involved, notably the pancreas, intestine and lympho-reticular, causing malabsorption and haematological or immunological disorders. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:335375
Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.
Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace
2015-12-01
The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Starnoni, Daniele; Daniel, Roy Thomas; George, Mercy; Messerer, Mahmoud
2017-01-01
Spontaneous meningoencephaloceles of the lateral sphenoid sinus are rare entities, and their peculiar location represents a surgical challenge due to the importance of a wide exposure and skull base reconstruction. They are thought to arise from the congenital base defect of the lateral sphenoid or in some cases have been postulated to represent a rare manifestation of altered cerebrospinal fluid (CSF) dynamics. We report the first case in the literature of a Chiari malformation type I (CMI) and a lateral sphenoid encephalocele, revising the theoretic etiology and surgical technique of endoscopic repair. A 50-year-old woman with a surgical history of symptomatic CMI presented with episodes of spontaneous CSF rhinorrhea. Radiologic investigations revealed a left mesial temporal encephalocele herniating into the lateral recess of the sphenoid sinus and radiologic features of altered CSF dynamics, which may have played an etiologic role. An endoscopic transpterygoid excision of the encephalocele and multilayer skull base repair were performed. The association of spontaneous lateral sphenoid encephaloceles with CMI is distinctly unusual. Predisposing factors and disruption of CSF dynamics may play a major role in the development of these rare complications in patients with CMI. Because of their distinct location, transethmoid or transpterygoid endoscopic approaches represent an excellent surgical technique to treat these lesions thanks to their wide and direct visualization of the entire skull base defect following the encephalocele excision, allowing an adequate multilayer repair and lateral sphenoid recess occlusion. Copyright © 2016 Elsevier Inc. All rights reserved.
Di-Battista, Adriana; Meloni, Vera Ayres; da Silva, Magnus Dias; Moysés-Oliveira, Mariana; Melaragno, Maria Isabel
2016-12-01
In females carrying structural rearrangements of an X-chromosome, cells with the best dosage balance are preferentially selected, frequently resulting in a skewed inactivation pattern and amelioration of the phenotype. The Xp11.23-p11.22 region is involved in a recently described microduplication syndrome associated with severe clinical consequences in males and females, causing intellectual disability, behavior problems, epilepsy with electroencephalogram anomalies, minor facial anomalies, and early onset of puberty. Female carriers usually present an unusual X-chromosome inactivation pattern in favor of the aberrant chromosome, resulting in functional disomy of the duplicated segment. Here, we describe a girl carrying a de novo ∼9.7 Mb Xp11.3-p11.22 duplication of paternal origin and skewed X-chromosome inactivation pattern of the normal X-chromosome. We reviewed other cases previously reported and determined the minimal critical region possibly responsible for this unusual inactivation pattern. The critical region encompasses 36 RefSeq genes, including at least 10 oncogenes and/or genes related to the cell cycle control. We discuss the molecular mechanisms that underlie the positive selection of the cells with the active duplicated chromosome. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Jajic, I.
It is well known that deposits of urates in soft tissues occur commonly in gout, particularly in para-articular areas and in articular cartilages of the limbs. Involvement of the spine and sacro-iliac joints by such deposits, however, has been regarded as being relatively unusual and has attracted little attention in the literature. As we were impressed by the frequency of episodes of acute back pain in our patients with gouty arthritis, established definitely on clinical and biochemical grounds, we undertook a radiological investigation of the spine and sacro-iliac joints in a series of 54 subjects. It was suspected that theirmore » episodes of pain were clinical manifestations of gout, and 12 of the group had suffered one or more attacks. Of these 12 subjects, eight were found to have radiological abnormalities. In six subjects, evidence of sacro-iliitis was demonstrated, which is comparable to the report of Resnick and Reinke (8), and in two patients vertebral lesions corresponded to those described by Jaffe (5). Hyperostotic spondylosis was present in no fewer than 29 of the series. Although lacking histological confirmation of the lesions demonstrated radiologically, we believe that our suspicions have been confirmed.« less
Pogue, Robert; Marques, Felipe A; Kopacek, Cristiane; Rosa, Rosana C M; Dorfman, Luiza E; Mazzeu, Juliana F; Flores, José A M; Zen, Paulo R G; Rosa, Rafael F M
2017-05-01
Delta phalanx is a rare abnormality typically associated with additional features. We describe a patient with a phenotype resembling Catel-Manzke syndrome, but with delta phalanx and abnormal vertebrae and ribs. The patient was the only child of half siblings born with a marked prenatal growth deficiency. At 10 years of age, she had a short stature, long face, long and tubular nose with small alae nasi, high palate, short and broad thorax, and short index fingers with radial deviation. There were hyperpigmentations following Blaschko's lines. Radiology showed a proximal delta phalanx in the index finger of hands, abnormal vertebrae, and fused and small ribs. GTG-Banding karyotype and microarray analysis yielded normal results. Exome sequencing identified 25 genes that harbored homozygous variants, but none of these is assumed to be a good candidate to explain (part of) the phenotype. The here described patient may have a new condition, possibly following an autosomal recessive pattern of inheritance, although due to the high degree of consanguinity a compound etiology of the phenotype by variants in various genes may be present as well. © 2017 Wiley Periodicals, Inc.
Diagnostic imaging of solitary tumors of the spine: what to do and say.
Rodallec, Mathieu H; Feydy, Antoine; Larousserie, Frédérique; Anract, Philippe; Campagna, Raphaël; Babinet, Antoine; Zins, Marc; Drapé, Jean-Luc
2008-01-01
Metastatic disease, myeloma, and lymphoma are the most common malignant spinal tumors. Hemangioma is the most common benign tumor of the spine. Other primary osseous lesions of the spine are more unusual but may exhibit characteristic imaging features that can help the radiologist develop a differential diagnosis. Radiologic evaluation of a patient who presents with osseous vertebral lesions often includes radiography, computed tomography (CT), and magnetic resonance (MR) imaging. Because of the complex anatomy of the vertebrae, CT is more useful than conventional radiography for evaluating lesion location and analyzing bone destruction and condensation. The diagnosis of spinal tumors is based on patient age, topographic features of the tumor, and lesion pattern as seen at CT and MR imaging. A systematic approach is useful for recognizing tumors of the spine with characteristic features such as bone island, osteoid osteoma, osteochondroma, chondrosarcoma, vertebral angioma, and aneurysmal bone cyst. In the remaining cases, the differential diagnosis may include other primary spinal tumors, vertebral metastases and major nontumoral lesions simulating a vertebral tumor, Paget disease, spondylitis, echinococcal infection, and aseptic osteitis. In many cases, vertebral biopsy is warranted to guide treatment.
Dose assessment activities in the Republic of the Marshall Islands.
Simon, S L; Graham, J C
1996-10-01
Dose assessments, both retrospective and prospective, comprise one important function of a radiological study commissioned by the Republic of the Marshall Islands (RMI) government in late 1989. Estimating past or future exposure requires the synthesis of information from historical data, results from a recently completed field monitoring program, laboratory measurements, and some experimental studies. Most of the activities in the RMI to date have emphasized a pragmatic rather than theoretical approach. In particular, most of the recent effort has been expended on conducting an independent radiological monitoring program to determine the degree of deposition and the geographical extent of weapons test fallout over the nation. Contamination levels on 70% of the land mass of the Marshall Islands were unknown prior to 1994. The environmental radioactivity data play an integral role in both retrospective and prospective assessments. One recent use of dose assessment has been to interpret environmental measurements of radioactivity into annual doses that might be expected at every atoll. A second use for dose assessment has been to determine compliance with a dose action level for the rehabilitation of Rongelap Island. Careful examination of exposure pathways relevant to the island lifestyle has been necessary to accommodate these purposes. Examples of specific issues studied include defining traditional island diets as well as current day variations, sources of drinking water, uses of tropical plants including those consumed for food and for medicinal purposes, the nature and microvariability of plutonium particles in the soil and unusual pathways of exposure, e.g., that which might be associated with cooking and washing outdoors and inadvertent soil ingestion. A study on the prevalence of thyroid disease is also being conducted and the geographic pattern of disease may be useful as a bioindicator of the geographic pattern of exposure to radioiodine. Finally, an examination is underway of gummed film, fixed-instrument, and aerial survey data accumulated during the 1950's by the Health and Safety Laboratory of the U.S. AEC. This article gives an overview of these many different activities and a summary of recent dose assessments.
Machine learning and radiology.
Wang, Shijun; Summers, Ronald M
2012-07-01
In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. Copyright © 2012. Published by Elsevier B.V.
[Clinical manifestations of organizing pneumonia].
Hunter, Martín; Ludueña, Ana; Telias, Irene; Aruj, Patricia; Rausch, Silvia; Suárez, Juan Pablo
Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP) or secondary to other causes (SOP). It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there's a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.
[Verrucous carcinoma of the kidney: report of 2 cases].
Sellami-Boudawara, T; Gouiaa, N; Makni, S; Sellami, A; Bahri, I; Mhiri, M N; Jlidi, R
2001-07-01
The verrucous carcinoma is an unusual shape of well differentiated squamous cell carcinoma, first described at the ORL region; the kidney location is rare; the risk factors are represented essentially by lithiasis and/or urinary infection; the clinical symptom is not specific. Diagnosis is facilitated by radiological investigations and particularly excretory urogram/ultrasound; certainly diagnosis is pathological. The nephro-ureterectomy with collar resection of the bladder is the choice treatment. We report two observations and we clarify clinicopathological aspects of this type of carcinoma and we discuss the prognosis.
Pinet, F; Vuilliez, J G; Gourdol, Y; Celard, P; Villard, J; Cognet, J B
1983-10-27
Fifty-two traumatic ruptures of the thoracic aorta were hospitalized between 1972 and 1982, with 46 angiographies. The most significant clinical sign of aortic rupture is the difference in blood pressure between the upper and lower limbs. The frequency of chest film findings is discussed. The aortography by arterial route must be performed at the sligh test suspicion, sometimes without radiographic signs, to establish diagnostics and detect associated lesions (dissection) and unusual types (low localization, multiple localization, localized rupture of the intima.
Hepatocellular carcinoma arising in a telangiectatic hepatocellular adenoma.
González-Lara, María Fernanda; Córdova-Ramón, Juan Carlos; Gamboa-Domínguez, Armando; Cosme-Labarthe, Juan; Carrillo-Pérez, Diego Luis
2013-01-01
Telangiectatic hepatocellular adenoma is a rare, recently recognized subtype of benign liver tumor that may very rarely undergo transformation into hepatocellular carcinoma. We report an unusual case of a 75-year-old woman with no history of oral contraceptive use that underwent malignant transformation of a telangiectactic hepatocellular adenoma. No risk factors for adenoma development were identified in this otherwise healthy woman. Radiological characteristics, gross features and histopathology are herein described. In conclusion, telangiectatic hepatocellular adenoma can undergo malignant transformation. Further studies are needed to better clarify the factors associated with malignant progression.
Artificial Intelligence: Threat or Boon to Radiologists?
Recht, Michael; Bryan, R Nick
2017-11-01
The development and integration of machine learning/artificial intelligence into routine clinical practice will significantly alter the current practice of radiology. Changes in reimbursement and practice patterns will also continue to affect radiology. But rather than being a significant threat to radiologists, we believe these changes, particularly machine learning/artificial intelligence, will be a boon to radiologists by increasing their value, efficiency, accuracy, and personal satisfaction. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Characteristics of tuberculosis patients who generate secondary cases.
Rodrigo, T; Caylà, J A; García de Olalla, P; Galdós-Tangüis, H; Jansà, J M; Miranda, P; Brugal, T
1997-08-01
To determine the characteristics of smear positive tuberculosis (TB) patients who generate secondary TB cases. Those smear positive TB patients detected by the Barcelona Tuberculosis Program between 1990-1993, and for whom contact studies had been performed, were studied. We analyzed the predictive role of the variables: age, sex, intravenous drug use (IVDU), the presence of the acquired immune deficiency syndrome (AIDS), human immunodeficiency virus (HIV) infection, radiology pattern, district of residence, history of imprisonment, alcoholism, smoking, history of TB, treatment compliance and the number of secondary cases generated. Statistical analysis was based on the logistic regression model, calculating the odds ratios (OR) with 95% confidence intervals (CI). Of the 1079 patients studied, 78 (7.2%) had generated only one secondary case, and 30 (2.8%) two or more. The variables associated with generating two or more secondary cases were: IVDU (P < 0.001; OR = 4.06; CI: 1.80-9.15), cavitary radiology pattern (P = 0.002; OR = 3.69; CI: 1.62-8.43), and age (P = 0.016; OR = 0.98; CI: 0.96-0.99). When we examined those who had generated one or more secondary cases, the following variables were significant: IVDU (P = 0.043; OR = 1.75; CI: 1.02-3.02), cavitary radiology pattern (P < 0.001; OR = 3.07; CI: 1.98-4.77) and age (P < 0.001; OR = 0.98; CI: 0.97-0.99). The study of the contacts of smear positive TB patients allows us to detect an important number of secondary cases. Young adults, those with cavitary radiology pattern, and IVDU are more likely to generate secondary cases.
Unusual polarization patterns in flat epitaxial ferroelectric nanoparticles
NASA Astrophysics Data System (ADS)
Naumov, Ivan; Bratkovsky, Alexandr
2009-03-01
We investigate the effects of a lattice misfit strain on a ground state and polarization patterns in flat perovskite nanoparticles (nanoislands of BaTiO3 and PbZr0.5Ti0.5O3) with the use of an ab-initio derived effective Hamiltonian. We show that the strain strongly controls the balance between the depolarizing field and the polarization anizotropy in determining the equilibrium polarization patterns. Compressive strain favors 180 ^0 stripe/tweed domains while a tensile strain leads to in-plane vortex formation, with the unusual intermediate phase (s) where both ordering motifs coexist [1]. The results may allow to explain contradictions in recent experimental data for ferroelectric nanoparticles. [1] Ivan Naumov and Alexander M. Bratkovsky, Phys. Rev. Lett. 101, 107601 (2008).
MoniQA: a general approach to monitor quality assurance
NASA Astrophysics Data System (ADS)
Jacobs, J.; Deprez, T.; Marchal, G.; Bosmans, H.
2006-03-01
MoniQA ("Monitor Quality Assurance") is a new, non-commercial, independent quality assurance software application developed in our medical physics team. It is a complete Java TM - based modular environment for the evaluation of radiological viewing devices and it thus fits in the global quality assurance network of our (film less) radiology department. The purpose of the software tool is to guide the medical physicist through an acceptance protocol and the radiologist through a constancy check protocol by presentation of the necessary test patterns and by automated data collection. Data are then sent to a central management system for further analysis. At the moment more than 55 patterns have been implemented, which can be grouped in schemes to implement protocols (i.e. AAPMtg18, DIN and EUREF). Some test patterns are dynamically created and 'drawn' on the viewing device with random parameters as is the case in a recently proposed new pattern for constancy testing. The software is installed on 35 diagnostic stations (70 monitors) in a film less radiology department. Learning time was very limited. A constancy check -with the new pattern that assesses luminance decrease, resolution problems and geometric distortion- takes only 2 minutes and 28 seconds per monitor. The modular approach of the software allows the evaluation of new or emerging test patterns. We will report on the software and its usability: practicality of the constancy check tests in our hospital and on the results from acceptance tests of viewing stations for digital mammography.
Londoño, Ana; Castillo, Mauricio; Armao, Diane; Kwock, Lester; Suzuki, Kinuko
2003-05-01
We present the case of a patient with an MR imaging study showing an ill-defined intra-axial mass in the right insula and frontal lobe. The mass showed high signal intensity on T2-weighted and fluid-attenuated inversion recovery images and an unusual proton MR spectroscopic imaging pattern characterized by the presence of high levels of myo-inositol/glycine, no significant elevation of choline, and mildly reduced N-acetylaspartate. The histopathologic diagnosis was of diffuse astrocytoma with oligodendroglial components (World Health Organization grade II).
Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; van Ooijen, Peter M A
2016-01-01
To perform a post-deployment usability evaluation of a radiology Picture Archiving and Communication System (PACS) client based on pattern mining of user interaction log data, and to assess the usefulness of this approach compared to a field study. All user actions performed on the PACS client were logged for four months. A data mining technique called closed sequential pattern mining was used to automatically extract frequently occurring interaction patterns from the log data. These patterns were used to identify usability issues with the PACS. The results of this evaluation were compared to the results of a field study based usability evaluation of the same PACS client. The interaction patterns revealed four usability issues: (1) the display protocols do not function properly, (2) the line measurement tool stays active until another tool is selected, rather than being deactivated after one use, (3) the PACS's built-in 3D functionality does not allow users to effectively perform certain 3D-related tasks, (4) users underuse the PACS's customization possibilities. All usability issues identified based on the log data were also found in the field study, which identified 48 issues in total. Post-deployment usability evaluation based on pattern mining of user interaction log data provides useful insights into the way users interact with the radiology PACS client. However, it reveals few usability issues compared to a field study and should therefore not be used as the sole method of usability evaluation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Landslides and liquefaction triggered by the M 7.9 denali fault earthquake of 3 November 2002
Harp, E.L.; Jibson, R.W.; Kayen, R.E.; Keefer, D.K.; Sherrod, B.L.; Carver, G.A.; Collins, B.D.; Moss, R.E.S.; Sitar, N.
2003-01-01
The moment magnitude (M) 7.9 Denali Fault earthquake in Alaska of 3 November 2002 triggered an unusual pattern of landslides and liquefaction effects. The landslides were primarily rock falls and rock slides that ranged in volume from a few cubic meters to the 40 million-cubic-meter rock avalanche that covered much of the McGinnis Glacier. Landslides were concentrated in a narrow zone ???30 km wide that straddled the fault rupture zone over its entire 300 km length. Large rock avalanches all clustered at the western end of the rupture zone where acceleration levels are reported to have been the highest. Liquefaction effects, consisting of sand blows, lateral spreads, and settlement, were widespread within susceptible alluvial deposits extending from Fairbanks eastward several hundred kilometers. The liquefaction effects displayed a pattern of increasing concentration and severity from west to east and extended well beyond the zone of landslides, which is unusual. The contrasting patterns formed by the distributions of landslides and liquefaction effects initially seemed to be inconsistent; however, preliminary analyses of strong-motion records from the earthquake offer a possible explanation for the unusual ground-failure patterns that are related to three subevents that have been discerned from the earthquake records.
Zajonz, D; Werner, M; Panzert, S; Strübing, A S; Tiepolt, S; Fabsits, E; Brandmaier, P; Heyde, C-E; Prietzel, T
2014-05-01
This article presents the unusual case of a 73-year-old male patient who was treated with primary interlocking nailing after a pathological femoral fracture. Despite comprehensive diagnostics including several biopsies, a tumor could not be detected. In 2008 when progressive cystic femoral destruction leading to loosening of the nail necessitated a partial femoral prosthesis, an osteosarcoma could first be diagnosed in the resected bone. Advanced progression of the tumor required an extended hip exarticulation. During the current restaging of the now 84-year-old patient no tumor could be detected. When a malignancy cannot be excluded even by repeated biopsies of radiologically suspicious structures, an adequate tumor staging followed by close monitoring should be carried out. For a clinically silent, long-term course of cystic destruction of a long bone over several years, an age over 60 years and a lack of distant metastases, an atypical osteosarcoma should be considered in the differential diagnosis.
Pulmonary fibrosis secondary to siderosis causing symptomatic respiratory disease: a case report.
McCormick, Liam M; Goddard, Martin; Mahadeva, Ravi
2008-08-05
Pulmonary siderosis secondary to the inhalation of iron compounds is a rare condition which, despite striking radiological and histopathological features, has not traditionally been associated with symptoms or functional impairment. Although not the first of its kind, we present an unusual case of pulmonary siderosis with symptomatic respiratory disease, most likely secondary to associated fibrosis. A 66-year-old Caucasian man was referred to the outpatient clinic with a 2-year history of exertional breathlessness. He had worked as an engineer for 20 years where he did a significant amount of welding but always wore a face shield. Clinical, radiological and histological features were consistent with a diagnosis of pulmonary siderosis, with associated fibrosis, most likely related to his occupational welding history. Our report illustrates that symptomatic respiratory disease due to mild peribronchiolar fibrosis can occur with pulmonary siderosis despite wearing a mask. Furthermore, it reinforces the need for all clinicians to compile a detailed occupational history in individuals presenting with breathlessness.
[Fluctuant pulmonary nodules as presentation of a MALT lymphoma].
Dolz Aspas, R; Toyas Miazza, C; Ruiz Ruiz, F; Morales Rull, J L; Pérez Calvo, J I
2003-11-01
Mucosa associated lymphoid tissue (MALT) lymphomas are a group of non- Hodgkin"s lymphomas of low malignancy degree. The most frequent location is the gastrointestinal tract. Its primary pulmonary presentation is unusual and heterogeneous from point of view radiological. Woman 61 years old with antecedents of vitiligo, gastric ulcus, cirrhosis by VHC, that go into the hospital by sudden disnea, thoracic paint with pleural characterises and fever of 38.5 degrees C, Her thorax radiography and thoracic TAC showed nodes that affect to different pulmonary lobes. The cytology by PAAF confirms their malignant nature. In subsequent radiological controls it was notice the nodels took away completely and returns in different pulmonary place in each recurrence. The presentation like fluctuant pulmonary nodes is exceptional in a MALT lymphoma. It was described a higher incidence of VHC infection and tumour. The evidence of chronic hepatitis by virus C disease, and local chronic inflammatory process as well as autoimmune disorders may be considerate like a factor that contribute to MALT lymphoma.
Progression of an osteoid osteoma to an osteoblastoma. Case report.
Bruneau, Michaël; Polivka, Marc; Cornelius, Jan Frédérick; George, Bernard
2005-09-01
The authors report the unusual case of a 25-year-old man with occipitocervical pain related to a lesion of the C-1 lateral mass. Initially this lesion measured 8 mm and exhibited radiological features of an osteoid osteoma. Seven years later, as pain increased and became unresponsive to antiinflammatory drugs, computerized tomography scanning demonstrated progression to a 16-mm lesion, highly suspicious of an osteoblastoma. After mobilization of the vertebral artery from the C-1 groove, the lesion was completely resected via an anterolateral approach. Complete symptomatic relief, restoration of cervical range of motion and preservation of cervical stability were achieved immediately after surgery, and the results were confirmed at the 4-year follow-up examination. Pathological examination of tissue samples confirmed the diagnosis of osteoblastoma. Osteoid osteoma rarely evolves to osteoblastoma. Deterioration of a patient's ability to control pain is a warning sign. Insight into such cases underlines the importance of close long-term radiological follow-up examination in patients with conservatively treated osteoid osteomas.
Tremor-Ataxia syndrome and primary ovarian insufficiency in anFMR1 premutation carrier
Rodriguez-Guerrero, Tatiana; Fandiño-Losada, Andres; Ramirez-Cheyne, Julian
2017-01-01
Abstract Introduction: The FMR1 gene has four allelic variants according to the number of repeats of the CGG triplet. Premutation carriers with between 55 and 200 repeats are susceptible to developing pathologies such as tremor and ataxia syndrome (FXTAS) and fragile X-associated primary ovarian insufficiency (FXPOI) syndrome. Case description: The patient was a 53-year-old female farmer with severe tremor in the upper limbs at rest that worsens with movement, tremor in the jaw and tongue, and generalized cerebral atrophy. She is a carrier of the FMR1 premutation diagnosed by PCR and Southern Blot, complying with the clinical and radiological criteria of FXTAS, and in addition, has a history of vagal symptoms suggestive of ovarian failure and menstrual cycle disorders that led to hysterectomy at age 33 and was subsequently diagnosed with FXPOI. Conclusion: An unusual case of FXTAS and FXPOI complying with clinical and radiological criteria is reported in a premutation carrier of the FMR1 gene. PMID:29299012
21 CFR 892.1420 - Radionuclide test pattern phantom.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radionuclide test pattern phantom. 892.1420 Section 892.1420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1420 Radionuclide test pattern phantom...
When Absence of Evidence Is Evidence of Absence: Rational Inferences from Absent Data
ERIC Educational Resources Information Center
Hsu, Anne S.; Horng, Andy; Griffiths, Thomas L.; Chater, Nick
2017-01-01
Identifying patterns in the world requires noticing not only unusual occurrences, but also unusual absences. We examined how people learn from absences, manipulating the extent to which an absence is expected. People can make two types of inferences from the absence of an event: either the event is possible but has not yet occurred, or the event…
Pulmonary Toxocariasis: Initial and Follow-Up CT Findings in 63 Patients.
Lee, Kyung Hee; Kim, Tae Jung; Lee, Kyung Won
2015-06-01
The objective of our study was to describe the characteristic radiologic findings of pulmonary toxocariasis on initial and follow-up chest CT. Between June 2010 and May 2014, 63 patients with serologically proven, clinically diagnosed pulmonary toxocariasis and chest CT examinations performed within 2 months of an enzyme-linked immunosorbent assay for toxocariasis were identified. Two chest radiologists retrospectively analyzed the chest CT examinations in consensus; they focused on the distribution, location, number, and internal characteristics of the pulmonary lesions. The pulmonary lesions tended to involve three or more lobes (49% [31/63]) on the initial CT; predominance of the abnormalities in a subpleural location (81% [51/63]) and in the lower lung zone (98% [62/63]) was noted. The number of pulmonary lesions per patient were from two to five (46% [29/63]), more than five (32% [20/63]), or one (22% [14/63]). The radiologic findings of pulmonary toxocariasis could be categorized into four different patterns: ground-glass opacities (GGOs), solid nodules, consolidations, and linear opacities. The most common pattern was ill-defined GGOs with or without solid portions (84% [53/63]). The solid nodule and patchy consolidation patterns were found in 29% (18/63) and 21% (13/63) of patients, respectively. In addition, linear opacities (1-2 mm thick and 8-25 mm long) were present in 19% of patients (12/63); this finding is a subtle, yet novel, finding. On follow-up CT, the pulmonary lesions had either disappeared or migrated; when they had migrated, they revealed radiologic manifestations similar to the findings on the initial CT. Pulmonary toxocariasis manifested as multiple lesions in four radiologic patterns with subpleural and lower lung predominance on initial and follow-up CT. A linear opacity may be one of many clues in the diagnosis of pulmonary toxocariasis on CT.
Macular pattern dystrophy and homonymous hemianopia in MELAS syndrome.
Kamal-Salah, Radua; Baquero-Aranda, Isabel; Grana-Pérez, María Del Mar; García-Campos, Jose Manuel
2015-03-12
We report an unusual association of a pattern dystrophy of the retinal pigment epithelium and homonymous hemianopia in a woman diagnosed with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes syndrome. 2015 BMJ Publishing Group Ltd.
Zhang, L; Liu, J J; Li, M T
2013-11-01
In this report we discuss a case of a patient with systemic lupus erythematosus who developed herpes simplex virus type 1(HSV-1) infection presenting with encephalitis as well as necrotic and non-necrotic retinitis. The patient presented with typical clinical symptoms and radiologic abnormalities consistent with HSV-1 encephalitis and HSV-1 retinitis in patients with HIV infection, but lacked cerebrospinal fluid pleocytosis and had bilateral retinitis with poor visual acuity. To the best of our knowledge, this is the first such case reported in the literature.
Barreda, F; Contardo, C; León, A; Navarrete, J; Figueroa, R; Attanasio, F
1989-01-01
Primary Sclerosing Cholangitis (PSC) is an unusual chronic, cholestatic disease of unknown etiology, more frequently seen in young adults in close relationship with Chronic Ulcerative Colitis. We report the case of a 30 year old woman, coming from the peruvian amazon with PSC associated with Sjögren Syndrome, Chronic Pancreatitis and Retroperitoneal Fibrosis, without colonic involvement. She was treated with external biliary drainage and controlled for 12 months. In this paper, clinical, biochemical, radiological, histological and therapeutic features are reviewed as well as its possible immunologie autoimmune origin.
Kanza, Rene Epunza; Gagnon, Sylvain; Villeneuve, Helene; Laverdiere, David; Rousseau, Isabelle; Bordeleau, Edith; Berube, Michel
2013-01-01
We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult, non-pregnant woman. Her condition was triggered by unrecognized primary hypothyroidism, which regressed after thyroid hormone replacement therapy. This case highlights the need for clinicians and radiologists to familiarize themselves with the clinical and imaging features detected in case of these complications of primary hypothyroidism, which are not well known in the medical and radiological profession. Such improved knowledge will help avoid delays in diagnosis, progression to life-threatening complications, and unnecessary surgery. PMID:23494012
Gharib, A M; Stern, E J
2001-11-01
Infection of the lower respiratory tract, acquired by way of the airways and confined to the lung parenchyma and airways, typically presents radiologically as one of three patterns: (1) focal nonsegmental or lobar pneumonia, (2) multifocal bronchopneumonia or lobular pneumonia, and (3) focal or diffuse "interstitial" pneumonia. These patterns can be useful in identifying the etiological organism in the appropriate clinical setting. To serve the purpose of this article, these patterns are used as the primary method of classification of pulmonary infections caused by different organisms. Mycobacterial and fungal pulmonary infections are reviewed separately because of their wide range of radiographic appearance that depend on the stage of the disease at presentation. This article discusses the clinical and radiographic features of the most common causes of pneumonia, primarily in the adult population of the United States.
ERIC Educational Resources Information Center
van der Gijp, A.; Ravesloot, C. J.; Jarodzka, H.; van der Schaaf, M. F.; van der Schaaf, I. C.; van Schaik, J. P.; ten Cate, Th. J.
2017-01-01
Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology…
Evolution of IPv6 Internet topology with unusual sudden changes
NASA Astrophysics Data System (ADS)
Ai, Jun; Zhao, Hai; Kathleen, M. Carley; Su, Zhan; Li, Hui
2013-07-01
The evolution of Internet topology is not always smooth but sometimes with unusual sudden changes. Consequently, identifying patterns of unusual topology evolution is critical for Internet topology modeling and simulation. We analyze IPv6 Internet topology evolution in IP-level graph to demonstrate how it changes in uncommon ways to restructure the Internet. After evaluating the changes of average degree, average path length, and some other metrics over time, we find that in the case of a large-scale growing the Internet becomes more robust; whereas in a top—bottom connection enhancement the Internet maintains its efficiency with links largely decreased.
NegBio: a high-performance tool for negation and uncertainty detection in radiology reports.
Peng, Yifan; Wang, Xiaosong; Lu, Le; Bagheri, Mohammadhadi; Summers, Ronald; Lu, Zhiyong
2018-01-01
Negative and uncertain medical findings are frequent in radiology reports, but discriminating them from positive findings remains challenging for information extraction. Here, we propose a new algorithm, NegBio, to detect negative and uncertain findings in radiology reports. Unlike previous rule-based methods, NegBio utilizes patterns on universal dependencies to identify the scope of triggers that are indicative of negation or uncertainty. We evaluated NegBio on four datasets, including two public benchmarking corpora of radiology reports, a new radiology corpus that we annotated for this work, and a public corpus of general clinical texts. Evaluation on these datasets demonstrates that NegBio is highly accurate for detecting negative and uncertain findings and compares favorably to a widely-used state-of-the-art system NegEx (an average of 9.5% improvement in precision and 5.1% in F1-score). https://github.com/ncbi-nlp/NegBio.
Role of enterocele in the obstructed defecation syndrome (ODS): a new radiological point of view.
Morandi, C; Martellucci, J; Talento, P; Carriero, A
2010-08-01
The aim of this study was to understand the role of enterocele in the pathogenesis of the obstructed defecation syndrome (ODS) a new defecographic classification based on function. A total of 597 patients (551 women, 46 men) who underwent cinedefecography between November 2001 and November 2005 were studied. A total of 567 (95%) underwent cinedefecography as they had symptoms of ODS. Enterocele was classified into three types. Enterocele was found in 127 (23%) female and one (2.2%) male patients. Thirty-eight (6.9%) patients had type A, 38(6.9%) type B, and 27(4.9%) type C enterocele. A total of 24 patients (4.35%) had sigmoidocele. In patients with type C enterocele, the finding of a radiological pattern of ODS was higher (26/27) than that in the other groups (A + B + Sigmoidocele) (23/100) (P < 0.001). An obstructed evacuation pattern was found in 49 (38.5%) patients with enterocele and in 148 (34.9%) patients in the control group. Type C enterocele is often associated with a radiological pattern of ODS and usually presents as an isolated condition. Type B is less frequently associated with ODS and is more frequently accompanied by other pathological conditions.
Conditional anomaly detection methods for patient–management alert systems
Valko, Michal; Cooper, Gregory; Seybert, Amy; Visweswaran, Shyam; Saul, Melissa; Hauskrecht, Milos
2010-01-01
Anomaly detection methods can be very useful in identifying unusual or interesting patterns in data. A recently proposed conditional anomaly detection framework extends anomaly detection to the problem of identifying anomalous patterns on a subset of attributes in the data. The anomaly always depends (is conditioned) on the value of remaining attributes. The work presented in this paper focuses on instance–based methods for detecting conditional anomalies. The methods rely on the distance metric to identify examples in the dataset that are most critical for detecting the anomaly. We investigate various metrics and metric learning methods to optimize the performance of the instance–based anomaly detection methods. We show the benefits of the instance–based methods on two real–world detection problems: detection of unusual admission decisions for patients with the community–acquired pneumonia and detection of unusual orders of an HPF4 test that is used to confirm Heparin induced thrombocytopenia — a life–threatening condition caused by the Heparin therapy. PMID:25392850
ERIC Educational Resources Information Center
Van Etten, Hannah M.; Kaur, Maninderjit; Srinivasan, Sudha M.; Cohen, Shereen J.; Bhat, Anjana; Dobkins, Karen R.
2017-01-01
The current study investigated the prevalence and pattern of unusual sensory behaviors (USBs) in teens with Autism Spectrum Disorder (ASD) and infants (3-36 months) at risk for ASD. From two different sites (UCSD and UConn), caregivers of infants at high (n = 32) and low risk (n = 33) for ASD, and teenagers with (n = 12) and without ASD (n = 11),…
DOE Office of Scientific and Technical Information (OSTI.GOV)
Demmer, Rick; Fox, Don; Reese, Stephen
The Idaho National Laboratory (INL) and the United Kingdom (UK) National Nuclear Laboratory (NNL) have been collaborating for several years on materials and methods for the fogged/misted introduction of fixatives into radiologically contaminated facilities. The objective of the project is to deliver a process for reducing airborne radiological and/or mercury contamination and affixing loose contamination in place, thereby reducing contamination risk to employees and decreasing D&D cost and schedule. The developed process provides a reliable, unmanned method of introducing a coating that captures and fixes contamination in place within facilities. The INL coating, termed FX2, has undergone extensive non-radiological testing,more » including determination that it is non-flammable, affixes contamination and flows well through unusual geometries (testing at Florida International University). A series of non-active fogging trials for activity knock/tie-down application have been completed at NNL Workington on behalf of Idaho National Laboratory (INL). These trials performed by the NNL employed commercially available agricultural fogging equipment and the INL’s knock/tie-down latex formulation (FX-2). This testing successfully demonstrated the ability of the fogging devices to successfully spray the FX-2 formulation within various scenarios, and prepared the project for a radioactive trial. The INL has also developed a mercury vapor reducing form of the coating termed FX-Hg, which has shown great promise in laboratory studies.« less
Radiologic Percutaneous Gastrostomy in Nondistended Stomach: A Modified Approach
DOE Office of Scientific and Technical Information (OSTI.GOV)
Petrocelli, Francesco, E-mail: francesco.petrocelli@hsanmartino.it; Salsano, Giancarlo, E-mail: giancarlo.salsano@yahoo.it; Bovio, Giulio, E-mail: giulio.bovio@hsanmartino.it
IntroductionGastrostomy tube placement for patients requiring long-term nutritional support may be performed using different techniques including endoscopic, surgical, and percutaneous radiologically guided methods. Radiologically inserted gastrostomy (RIG), typically performed when percutaneous endoscopic gastrostomy is not possible, requires proper gastric distension that is achieved by insufflating air through a nasogastric tube. We describe a simple technique to prevent air escape from the stomach during gastrostomy tube placement. To the best of our knowledge, this technique has not yet been described in the literature.Materials and MethodsFour patients with unsuccessful percutaneous endoscopic gastrostomy were referred for fluoroscopic-guided gastrostomy. One patient had a pyriformmore » sinus tumor and three had an ischemic stroke causing dysphagia. Gastric distention was not achieved in the patients due to air escaping into the bowel during the standard RIG procedure. A modified approach using a balloon catheter inflated in the pylorus to avoid air passing into the duodenum permitted successful RIG.ResultsThe modified RIG procedure was successfully carried out in all cases without complications.DiscussionInadequate air distension of the stomach is an unusual event that causes a failure of gastrostomy tube placement and an increased risk of both major and minor complications. The use of a balloon catheter inflated in the first part of the duodenum prevents the air passage into the bowel allowing the correct positioning of the gastrostomy.« less
Tabassum, Sumera; Haider, Shahbaz
2016-01-01
To determine frequencies of different MRI patterns of tuberculous spondylitisin a public sector hospital in Karachi. This descriptive multidisciplinary case series study was done from October 25, 2011 to May 28, 2012 in Radiology Department and Department of Medicine in the Jinnah Postgraduate Medical Center Karachi. MRI scans (dorsal / lumbosacral spine) of the Patients presenting with backache in Medical OPD, were performed in Radiology Department. Axial and sagittal images of T1 weighted, T2 weighted and STIR sequences of the affected region were taken. A total of 140 patients who were diagnosed as having tuberculous spondylitis were further evaluated and analyzed for having different patterns of involvement of the spine and compared with similar studies. Among frequencies of different MRI pattern of tuberculous spondylitis, contiguous vertebral involvement was 100%, discal involvement 98.6%, paravertebral abscess 92.1% cases, epidural abscess 91.4%, spinal cord / thecal sac compression 89.3%, vertebral collapse 72.9%, gibbus deformity 42.9% and psoas abscess 36.4%. Contiguous vertebral involvement was commonest MRI pattern, followed by disk involvement, paravertebral & epidural abscesses, thecal sac compression and vertebral collapse.
Adenomyomatous Polyp with Inverted Growth Pattern and Serosal Pseudoinvasion
2016-09-25
muscle with thick -walled vessels. We present a novel case of a 48-year old female with an adenomyomatous polyp with an unusual inverted growth pattern...displaying full- thickness pseudoinvasion beyond the serosal surface. Prior to surgery, imaging showed an infiltrative lesion suggestive of endometrial
DOE Office of Scientific and Technical Information (OSTI.GOV)
Adelstein, D.J.; Padhya, T.; Tomashefski, J.F. Jr.
We describe a patient with recurrent small cell undifferentiated lung carcinoma after chemotherapy and mediastinal radiation therapy who presented with peripheral pulmonary infiltrates on chest radiograph. At autopsy the patient was found to have carcinomatous pneumonia confined to the radiographically abnormal lung. The descriptive term reverse radiation pneumonitis is applied in view of the striking nonsegmental distribution of these pulmonary infiltrates, which occurred only outside the irradiated field. In this patient, radiation therapy successfully controlled disease in the treated lung parenchyma, thus accounting for this unusual radiologic and histologic picture. Pneumonia carcinomatosa, occurring after lung irradiation, can therefore be addedmore » to the differential diagnosis of radiographic peripheral pulmonary infiltrates.« less
Destructive discovertebral degenerative disease of the lumbar spine.
Charran, A K; Tony, G; Lalam, R; Tyrrell, P N M; Tins, B; Singh, J; Eisenstein, S M; Balain, B; Trivedi, J M; Cassar-Pullicino, V N
2012-09-01
The uncommon variant of degenerative hip joint disease, termed rapidly progressive osteoarthritis, and highlighted by severe joint space loss and osteochondral disintegration, is well established. We present a similar unusual subset in the lumbar spine termed destructive discovertebral degenerative disease (DDDD) with radiological features of vertebral malalignment, severe disc resorption, and "bone sand" formation secondary to vertebral fragmentation. Co-existing metabolic bone disease is likely to promote the development of DDDD of the lumbar spine, which presents with back pain and sciatica due to nerve root compression by the "bone sand" in the epidural space. MRI and CT play a complimentary role in making the diagnosis.
Sato, Mitsuo; Okachi, Shotaro; Fukihara, Jun; Shimoyama, Yoshie; Wakahara, Keiko; Sakakibara, Toshihiro; Hase, Tetsunari; Onishi, Yasuharu; Ogura, Yasuhiro; Maeda, Osamu; Hasegawa, Yoshinori
2018-05-15
We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection. A biopsy with bronchoscopy from a mass lesion beyond a segmental bronchus revealed adenocarcinoma identical to that of her bile duct adenocarcinoma, leading to the diagnosis of multiple lung metastases from bile duct adenocarcinoma.
Sato, Mitsuo; Okachi, Shotaro; Fukihara, Jun; Shimoyama, Yoshie; Wakahara, Keiko; Sakakibara, Toshihiro; Hase, Tetsunari; Onishi, Yasuharu; Ogura, Yasuhiro; Maeda, Osamu; Hasegawa, Yoshinori
2017-01-01
We herein report a case of lung metastases with unusual radiological appearances that mimicked those of chronic airway infection, causing diagnostic difficulty. A 60-year-old woman who underwent liver transplantation from a living donor was incidentally diagnosed with bile duct adenocarcinoma after a histopathological analysis of her explanted liver. Six months later, chest computed tomography (CT) revealed bilateral bronchogenic dissemination that had gradually worsened, suggesting chronic airway infection. A biopsy with bronchoscopy from a mass lesion beyond a segmental bronchus revealed adenocarcinoma identical to that of her bile duct adenocarcinoma, leading to the diagnosis of multiple lung metastases from bile duct adenocarcinoma. PMID:29279503
An unusual presentation of presentation of a branchial cleft cyst.
Vemula, Rahul; Greco, Gregory
2012-05-01
Branchial cleft cysts are congenital anomalies that arise from the aberrant embryological development of the branchial apparatus. The location of a branchial cleft cyst is determined by which branchial cleft failed to obliterate during embryological development, with the second branchial cleft cyst being the most commonly recognized lesion. Although the most common location for branchial cleft cysts is between the external auditory canal and the level of the clavicle, the literature does describe unusual locations. We present a case a 15-year-old boy who had an enlarging lesion on his back that had been present since birth. A presumptive radiologic diagnosis of lymphangioma circumscriptum was made. Upon excision of the lesion and pathologic examination, it was determined to be a branchial cleft cyst. The patient had an uneventful postoperative course, and no recurrence was noted after a 2-year follow-up. Our clinical report demonstrates a lesion on the posterior thorax that proved to be a branchial cleft cyst and should always be part of the differential diagnosis for soft tissue masses of the thorax.
Higley, Meghan; Beckett, Brooke; Schmahmann, Sandra; Dacey, Elizabeth; Foss, Erik
2015-12-01
Tumor-induced osteomalacia (TIO) has long been recognized as a clinical paraneoplastic syndrome. The identification of a unique histopathologic entity, the phosphaturic mesenchymal tumor (PMT), as a distinct etiology for TIO has been a more recent discovery. The majority of published cases describe a solitary, non-aggressive appearing soft tissue or osseous lesions in patients with osteomalacia; aggressive appearing or multifocal lesions appear to be exceedingly rare. These tumors characteristically secrete fibroblast growth factor 23 (FGF23). Elevated serum levels of FGF23 result in phosphate wasting and osteomalacia. In the majority of cases, laboratory abnormalities and clinical signs and symptoms of osteomalacia precede identification of the causative lesion by years. Following diagnosis, complete resection with wide margins to prevent local recurrence is most often curative. Imaging characteristics of PMT are diverse and remain incompletely defined, as the majority of previous publications are outside of the radiologic literature. We present multiple imaging modalities in two cases of patients with debilitating osteomalacia and unusual appearing PMTs: one with a locally aggressive lesion leading to pathologic fracture, the second presenting with exceedingly rare multifocal PMT.
Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.
Holderrieth, Silke; Gernhardt, Christian Ralf
2009-07-01
The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.
Biopsy in idiopathic pulmonary fibrosis: back to the future.
Rossi, Giulio; Spagnolo, Paolo
2017-09-01
Idiopathic Pulmonary Fibrosis (IPF) is a relentlessly progressive, fibrosing interstitial pneumonia characterized by a radiologic and/or histologic pattern of usual interstitial pneumonia (UIP). The availability of two effective anti-fibrotic drugs in IPF has encouraged the identification and treatment of patients in early stages in order to maximize clinical benefit. The ability of high-resolution computed tomography (HRCT) to identify a 'definite' UIP pattern is suboptimal, particularly in the absence of honeycombing. Therefore, radiologic criteria for UIP are currently being redefined. Histology represents the major source of information to define a UIP pattern. Novel and less invasive approaches (particularly cryobiopsy) to sample interstitial lung diseases have demonstrated high sensitivity and specificity. In parallel, researchers are focusing on molecular mechanisms underlying IPF with the aim to identify more specific druggable targets. Lung tissue is therefore essential for diagnostic, pathogenetic and therapeutic purposes. Areas covered: We identified and critically reviewed the most relevant recent literature related to the limitations of current radiologic criteria, new lung sampling procedures, and molecular pathways in support of the need of lung tissue to better understand IPF. Expert commentary: The development of truly effective treatments for IPF requires the identification of key pathogenetic molecules and pathways. To this end, the availability of lung tissue is vital.
ERIC Educational Resources Information Center
Donkers, Franc C. L.; Schipul, Sarah E.; Baranek, Grace T.; Cleary, Katherine M.; Willoughby, Michael T.; Evans, Anna M.; Bulluck, John C.; Lovmo, Jeanne E.; Belger, Aysenil
2015-01-01
Neurobiological underpinnings of unusual sensory features in individuals with autism are unknown. Event-related potentials elicited by task-irrelevant sounds were used to elucidate neural correlates of auditory processing and associations with three common sensory response patterns (hyperresponsiveness; hyporesponsiveness; sensory seeking).…
Ethnic and Gender Diversity in Radiology Fellowships.
West, Derek L; Nguyen, HaiThuy
2017-06-01
The purpose of the study is to assess ethnic and gender diversity in US radiology fellowship programs from 2006 to 2013. Data for this study was obtained from Journal of the American Medical Association supplements publications from 2005 to 2006 to 2012-2013 (Gonzalez-Moreno, Innov Manag Policy Pract. 15(2):149, 2013; Nivet, Acad Med. 86(12):1487-9, 2011; Reede, Health Aff. 22(4):91-3, 2003; Chapman et al., Radiology 270(1):232-40, 2014; Getto, 2005; Rivo and Satcher, JAMA 270(9):1074-8, 1993; Schwartz et al., Otolaryngol Head Neck Surg. 149(1):71-6, 2013; Simon, Clin Orthop Relat Res. 360:253-9, 1999) and the US census 2010. For each year, Fisher's exact test was used to compare the percentage of women and under-represented minorities in each Accreditation Council for Graduate Medical Education (ACGME)-certified radiology fellowship to the percentage of women and under-represented minorities in (1) all ACGME-certified radiology fellowships combined, (2) radiology residents, (3) ACGME-certified fellows in all of medicine combined, (4) ACGME-certified residents in all of medicine combined, and (5) graduating medical students. Chi-Squared test was used to compare the percentage of women and under-represented minorities and the 2010 US census. p < 0.05 was used as indicator of significance. Interventional radiology and neuroradiology demonstrated the highest levels of disparities, compared to every level of medical education. Abdominal and musculoskeletal radiology fellowships demonstrated disparity patterns consistent with lack of female and URM medical graduates entering into radiology residency. All radiology fellowships demonstrated variable levels of gender and ethnic disparities. Outreach efforts, pipeline programs, and mentoring may be helpful in addressing this issue.
Mosunjac, Marina B; Sundstrom, J Bruce; Mosunjac, Mario I
2008-10-01
To describe a subset of cases with the unusual clinical and histomorphological presentation of anaplastic large cell lymphoma (ALCL) mimicking fever of unknown origin (FUO) and sepsis. A pathology database was searched using full term Systematized Nomenclature of Medicine codes for ALCL to identify 23ALCL cases from the period 1999-2006. Of those, five cases that did not have a correct premortem diagnosis were further analyzed to elucidate the reasons for delayed and incorrect pre-mortem diagnosis. The analyzed data included clinical presentation, duration of symptoms, duration of hospital stay, premortem presumed cause of death, white blood cell count, platelet count, anion gap and blood pH, liver enzymes (alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase), lactate, coagulation tests (prothrombin time, partial thromboplastin time, fibrinogen, D-dimers), microbiology cultures, and radiology and surgical pathology reports. Autopsy reports were reviewed for description of major gross findings, initial clinical diagnosis, and cause of death. Five fatal and pre-mortem unrecognized ALCL cases were characterized by rapid decline, with histologic findings showing predominantly extranodal involvement, intravascular lymphomatosis, and hemophagocytosis. The cases were also characterized by unusual clinical manifestations including a FUO, sepsis, and disseminated intravascular coagulation-like picture, lactic acidosis, hepatosplenomegaly, and absence of significant peripheral adenopathy. There is a distinct group of ALCLs with unique and specific clinical, gross autopsy, and histopathologic findings. Recognition of this clinical variant may facilitate early detection and potentially timely diagnosis and therapy.
An Unusual Complication of EVAR, Spontaneous Rectus Sheath Hematoma: A Case Report
Sirivanichai, Chusak
2009-01-01
Objective: To report a successful conservative management in a case of spontaneous rectus sheath hematoma (SRSH) after Endovascular Aneurysmal Repair (EVAR) of infrarenal Abdominal Aortic Aneurysm (AAA). Case Presentation: An 84-year-old woman with a 6 cm in diameter infrarenal AAA underwent EVAR at our hospital. During the procedure, intravenous heparin was administered to keep the activated clotting time around 300 seconds. One hour after the procedure, the patient complained of pain on her right side abdomen. Physical examination revealed a tender mass in the right lower abdominal wall. Laboratory studies showed a fall in hemoglobin from 12.7 g/dl to 9.3 g/dl. Ultrasound (US) examination demonstrated an 8 × 5 cm hematoma within the right rectus muscle. Follow-up US examination revealed that the hematoma had enlarged and a computed tomography (CT) examination of the lower abdomen was performed. CT scan showed a smooth-shaped mass within the layers of the anterolateral abdominal wall leading to enlargement of the right rectus abdominis muscle without signs of active bleeding. A conservative management was considered. Result: The clinical course was uneventful with a stable hemodynamic state. The patient was discharged 12 days later and was doing well at the 2 week follow-up. Conclusion: Spontaneous rectus sheath hematoma is an unusual complication of a patient on anticoagulant therapy during EVAR. A prompt radiological investigation may prevent unnecessary surgical procedures in this unusual complication. PMID:23555371
Tabassum, Sumera; Haider, Shahbaz
2016-01-01
Objective: To determine frequencies of different MRI patterns of tuberculous spondylitisin a public sector hospital in Karachi. Methods: This descriptive multidisciplinary case series study was done from October 25, 2011 to May 28, 2012 in Radiology Department and Department of Medicine in the Jinnah Postgraduate Medical Center Karachi. MRI scans (dorsal / lumbosacral spine) of the Patients presenting with backache in Medical OPD, were performed in Radiology Department. Axial and sagittal images of T1 weighted, T2 weighted and STIR sequences of the affected region were taken. A total of 140 patients who were diagnosed as having tuberculous spondylitis were further evaluated and analyzed for having different patterns of involvement of the spine and compared with similar studies. Results: Among frequencies of different MRI pattern of tuberculous spondylitis, contiguous vertebral involvement was 100%, discal involvement 98.6%, paravertebral abscess 92.1% cases, epidural abscess 91.4%, spinal cord / thecal sac compression 89.3%, vertebral collapse 72.9%, gibbus deformity 42.9% and psoas abscess 36.4%. Conclusion: Contiguous vertebral involvement was commonest MRI pattern, followed by disk involvement, paravertebral & epidural abscesses, thecal sac compression and vertebral collapse. PMID:27022369
Financial ratios in diagnostic radiology practices: variability and trends.
Hogan, Christopher; Sunshine, Jonathan H
2004-03-01
To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yeo, E.; Chen, D.C.; Siegel, M.E.
1989-02-01
Gallbladder perforation is an unusual condition with a high mortality rate. Early detection with prompt surgical intervention can increase the survival rate. Hepatobiliary imaging using Technetium-99m-labeled iminodiacetic acid has been used for the diagnosis of gallbladder perforation. However, the results vary and are somewhat confusing. The authors report a case of gallbladder perforation with hepatobiliary imaging and an unusual gallium image; review the literature; and propose a classification of three different imaging patterns: (1) visualization of the gallbladder with bile leakage, (2) nonvisualization of the gallbladder with a photopenic fluid collection, and (3) nonvisualization of the gallbladder with bile leakage.more » These patterns may provide pathophysiologic information for the surgeon. 27 references.« less
Unusual Configurations of Personality Traits Indicate Multiple Patterns of Their Coalescence
Allik, Jüri; Hřebíčková, Martina; Realo, Anu
2018-01-01
It is widely accepted that the Five Factor Model (FFM) is a satisfactory description of the pattern of covariations among personality traits, which supposedly fits, more or less adequately, every individual. As an amendment to the FFM, we propose that the customary five-factor structure is only a near-universal, because it does not fit all individuals but only a large majority of them. Evidences reveal a small minority of participants who have an unusual configuration of personality traits, which is clearly recognizable, both in self- and observer-ratings. We identified three types of atypical configurations of personality traits, characterized mainly by a scatter of subscale scores within each of the FFM factors. How different configurations of personality traits are formed, persist, and function needs further investigation. PMID:29515499
Women as radiologists: are there barriers to entry and advancement?
Baker, Stephen R; Barry, Maureen; Chaudhry, Hamaira; Hubbi, Basil
2006-02-01
In consideration of the fact that women constitute only 25% of radiology residents, even though they constitute 45% of medical students, this study was conducted to determine if the trend of women choosing radiology as a career differs from that for other medical specialties and if there are differences on the basis of the gender of program directors or geographic location. The authors also wished to determine if constraints exist that prevent women from advancing into positions of leadership in radiology. The percentage of women in each of the 186 radiology residency programs was compiled to determine the mean and standard deviation of women represented and from those data to examine if there were patterns of exclusion related to program size, location, or the gender of program directors. The membership and committee lists of the ACR and the Radiological Society of North America (RSNA) were examined to gauge the participation of women as leaders in these 2 organizations, as were the mastheads of Radiology and the American Journal of Roentgenology. The number of female chairs of academic departments was also examined. Over the past decade, the percentage of women in diagnostic radiology residencies has remained remarkably constant at or slightly above 25%. There was no discernable prejudice against women applicants by program size, location, or program director gender. In both the ACR and the RSNA, women are represented in positions of leadership approximately in proportion to their percentage in the general membership. Journal mastheads have fewer women than might be expected given the participation of women in academic radiology. There are a small but increasing number of women chairing academic radiology departments. The relatively low percentage of women in diagnostic radiology residencies is not a reflection of the gender of program directors. Women are represented in positions of influence and authority in major organizations in American radiology in proportion to the overall number of women in the organization. However, women continue to be underrepresented in radiology chair positions. Explanations must be sought for the relative unattractiveness of radiology to prospective women residents and barriers to the advancement of women in academic radiology.
Dadlani, Ravi; Sadanand, Venkatraman; Ghosal, Nandita; Hegde, Alangar S
2013-11-01
Giant plexiform neurofibroma (GPNF) of the scalp is an extremely rare lesion reported in association with neurofibromatosis. Occipital location of GPNF is even more infrequent, especially in association with occipital dysplasia (OD). The authors report 2 pediatric cases of GPNF associated with OD. The first case had an associated meningoencephalocele, and the second had large vascular channels within the lesion and the dominant ipsilateral transverse sinus lying in the center of the calvarial defect. The authors present these 2 unusual cases with a review of literature and discuss the radiological findings, theories of etiopathogenesis of the OD, and management dilemmas.
Kadota, Yoshihisa; Fukui, Eriko; Kitahara, Naoto; Okura, Eiji; Ohta, Mitsunori
2016-07-01
We report a patient with vascular-type Ehlers-Danlos syndrome (vEDS) who developed pneumothorax and was treated with a total pleural covering technique (TPC). A 24-year-old man developed repeat pneumothorax with intermittent hemo-sputum. Based on unusual radiological manifestations of lung lesions and physical findings, EDS was suspected as an underlying cause of the pneumothorax. Surgical treatment was performed using a mediastinal fat pad and TPC, and no relapse was seen up to 2 years after surgery. TPC is a less invasive surgical approach for selected patients with vEDS. Accurate underlying diagnosis of vEDS and systemic evaluation of vascular complications are necessary before planning surgery.
Infrasellar craniopharyngioma of the posterior nasal septum: a rare entity.
Chiun, Kian Chai; Tang, Ing Ping; Vikneswaran, Tharumalingam; Nurshaline Pauline, H Kipli
2012-02-01
To report an unusual location of infrasellar craniopharyngioma in a peadiatric patient. A six-year-old boy presented with persistent bilateral nasal obstruction for one year. Clinical examination revealed a posterior choanal mass arising from septum and the finding was confirmed by paranasal sinuses computed tomography scan. He then underwent wide local excision. Histopathological examination confirmed the diagnosis of craniopharyngioma (adamantinomatous type). There were no signs and symptoms of recurrence after a year of followup. Infracranial craniopharyngioma without sellar involvement is extremely rare. Persistent nasal obstruction without endocrine dysfunction is the common presentation. Radiological imaging is important to diagnose and assess the extent. The mainstay of treatment for infrasellar craniopharyngioma is surgery. Regular follow up is mandatory.
Tanwar, Parul; Gandhi, Jatin S; Sharma, Anila; Gupta, Manoj; Choudhary, Partha S
2018-01-01
Breast metastases are a relatively rare condition and account for approximately 0.5–2% of all breast tumors. Recognition of metastatic tumors in the breast is important because it would prevent unnecessary mutilating surgery and would lead to appropriate treatment of the primary tumor. Breast metastases from medullary thyroid cancer (MTC) are very rare with only 21 reported cases in the literature. Some MTCs mimic primary invasive lobular carcinoma of the breast histopathologically and radiologically, making the distinction between the two diagnostically challenging. We present the case of a 45-year-old female presenting with a lump breast, which was later found out to be metastasis from medullary carcinoma thyroid. PMID:29643661
When Absence of Evidence Is Evidence of Absence: Rational Inferences From Absent Data.
Hsu, Anne S; Horng, Andy; Griffiths, Thomas L; Chater, Nick
2017-05-01
Identifying patterns in the world requires noticing not only unusual occurrences, but also unusual absences. We examined how people learn from absences, manipulating the extent to which an absence is expected. People can make two types of inferences from the absence of an event: either the event is possible but has not yet occurred, or the event never occurs. A rational analysis using Bayesian inference predicts that inferences from absent data should depend on how much the absence is expected to occur, with less probable absences being more salient. We tested this prediction in two experiments in which we elicited people's judgments about patterns in the data as a function of absence salience. We found that people were able to decide that absences either were mere coincidences or were indicative of a significant pattern in the data in a manner that was consistent with predictions of a simple Bayesian model. Copyright © 2016 Cognitive Science Society, Inc.
Guria, Amit K.; Dey, Koushik; Sarkar, Suresh; Patra, Biplab K.; Giri, Saurav; Pradhan, Narayan
2014-01-01
Programming the reaction chemistry for superseding the formation of Sm2O3 in a competitive process of formation and dissolution, the crystal growth patterns are varied and two different nanostructures of Sm2O3 in 2D confinement regime are designed. Among these, the regular and self-assembled square platelets nanostructures exhibit paramagnetic behavior analogous to the bulk Sm2O3. But, the other one, 2D flower like shaped nanostructure, formed by irregular crystal growth, shows superparamagnetism at room temperature which is unusual for bulk paramagnet. It has been noted that the variation in the crystal growth pattern is due to the difference in the binding ability of two organic ligands, oleylamine and oleic acid, used for the synthesis and the magnetic behavior of the nanostructures is related to the defects incorporated during the crystal growth. Herein, we inspect the formation chemistry and plausible origin of contrasting magnetism of these nanostructures of Sm2O3. PMID:25269458
ERIC Educational Resources Information Center
Randell, Jordan; Searle, Rob; Reed, Phil
2012-01-01
Schedules of reinforcement typically produce reliable patterns of behaviour, and one factor that can cause deviations from these normally reliable patterns is schizotypy. Low scorers on the unusual experiences subscale of the Oxford-Liverpool Inventory of Feelings and Experiences performed as expected on a yoked random-ratio (RR), random-interval…
Arcadu, Antonella; Byrne, Suzanne C; Pirina, Pietro; Hartman, Thomas E; Bartholmai, Brian J; Moua, Teng
2017-08-01
Little is known about presenting 'inconsistent' or 'possible' usual interstitial pneumonia (UIP) computed tomography (CT) patterns advancing to 'consistent' UIP as disease progresses in idiopathic pulmonary fibrosis (IPF). We hypothesized that if 'consistent' UIP represented more advanced disease, such a pattern on presentation should also correlate with more severe pulmonary function test (PFT) abnormalities. Consecutive IPF patients (2005-2013) diagnosed by international criteria with baseline PFT and CT were included. Presenting CTs were assessed by three expert radiologists for consensus UIP pattern ('consistent', 'possible', and 'inconsistent'). Approximation of individual and combined interstitial abnormalities was also performed with correlation of interstitial abnormalities and UIP CT pattern made with PFT findings and survival. Three-hundred and fifty patients (70% male) were included with a mean age of 68.3 years. Mean percent predicted forced vital capacity (FVC%) and diffusion capacity (DLCO%) was 64% and 45.5% respectively. Older age and male gender correlated more with 'consistent' UIP CT pattern. FVC% was not associated with any UIP pattern but did correlate with total volume of radiologist assessed interstitial abnormalities. DLCO% was lower in those with 'consistent' UIP pattern. A 'consistent' UIP CT pattern was also not independently predictive of survival after correction for age, gender, FVC%, and DLCO%. PFT findings appear to correlate with extent of radiologic disease but not specific morphologic patterns. Whether such UIP patterns represent different stages of disease severity or radiologic progression is not supported by coinciding pulmonary function decline. Copyright © 2017 Elsevier Ltd. All rights reserved.
Pathologic and Radiologic Correlation of Adult Cystic Lung Disease: A Comprehensive Review
Parimi, Vamsi; Taddonio, Michale; Kane, Joshua Robert; Yeldandi, Anjana
2017-01-01
The presence of pulmonary parenchymal cysts on computed tomography (CT) imaging presents a significant diagnostic challenge. The diverse range of possible etiologies can usually be differentiated based on the clinical setting and radiologic features. In fact, the advent of high-resolution CT has facilitated making a diagnosis solely on analysis of CT image patterns, thus averting the need for a biopsy. While it is possible to make a fairly specific diagnosis during early stages of disease evolution by its characteristic radiological presentation, distinct features may progress to temporally converge into relatively nonspecific radiologic presentations sometimes necessitating histological examination to make a diagnosis. The aim of this review study is to provide both the pathologist and the radiologist with an overview of the diseases most commonly associated with cystic lung lesions primarily in adults by illustration and description of pathologic and radiologic features of each entity. Brief descriptions and characteristic radiologic features of the various disease entities are included and illustrative examples are provided for the common majority of them. In this article, we also classify pulmonary cystic disease with an emphasis on the pathophysiology behind cyst formation in an attempt to elucidate the characteristics of similar cystic appearances seen in various disease entities. PMID:28270943
STS-43 Earth observation of a colorful sunrise
1991-08-11
STS-43 Earth observation taken aboard Atlantis, Orbiter Vehicle (OV) 104, captures the Earth's limb at sunrise with unusual cloud patterns silhouetted by the sunlight and rising into the terminator lines.
Ros-Pérez, Purificación; Regidor, Francisco J; Colino, Esmeralda; Martínez-Payo, Cristina; Barroso, Eva; Heath, Karen E
2012-06-29
The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected.
2012-01-01
Background The association of achondroplasia and Klinefelter syndrome is extremely rare. To date, five cases have been previously reported, all of them diagnosed beyond the postnatal period, and only one was molecularly characterized. We describe the first case of this unusual association diagnosed in the neonatal period, the clinical findings and the molecular studies undertaken. Case presentation The boy was born at term with clinical and radiological features indicating the diagnosis of achondroplasia or hypochondroplasia combined with the prenatal karyotype of Klinefelter syndrome (47,XXY). Neonatal FGFR3 mutation screening showed that the newborn was heterozygous for the classic achondroplasia G340R mutation. Microsatellite marker analysis showed that the sex chromosome aneuploidy had arisen from a non-disjunction error in paternal meiosis I, with a recombination event in the pseudoautosomal region 1 (PAR1). Conclusion Specific mutation analysis is appropriate to confirm the clinical diagnosis of achondroplasia for appropriate diagnosis, prognosis, and genetic counseling, especially when the karyotype does not explain the abnormal prenatal sonographic findings. In the present case, a recombination event was observed in the PAR1 region, although recombinational events in paternally derived Klinefelter syndrome cases are much rarer than expected. PMID:22747519
Arai, Atsushi; Sasayama, Takashi; Koyama, Junji; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji
2010-01-01
A 27-year-old woman presented with headache and occasional numbness over her right face. Computed tomography revealed a hypodense mass in the middle cranial fossa and another adjacent hyperdense mass in the posterior fossa with erosion of the right petrous apex. Magnetic resonance imaging revealed the lesion in the middle cranial fossa as iso- to hypointense on T(1)-weighted and hyperintense on T(2)-weighted imaging, with peripheral enhancement after gadolinium administration, and the adjacent lesion in the posterior fossa as hyperintense on T(1)-weighted and hypointense on T(2)-weighted imaging. During surgery, these lesions mimicking two adjacent distinct tumors were revealed to connect through Meckel's cave. The hypodense lesion in the middle cranial fossa consisted of pearly-like solid contents, and the hyperdense lesion in the posterior cranial fossa consisted of viscid dark-green materials. The tumors were gross totally resected with endoscopic assistance. Histological examination confirmed that the tumor was an epidermoid cyst. The present case cyst indicates that although the diffusion-weighted imaging sequence is useful for detection of intracranial epidermoid cysts, epidermoid cysts including viscous materials with unusual radiological findings could complicate the preoperative diagnosis.
Female-patterned alopecia in teenage brothers with unusual histologic features.
Carlson, J Andrew; Malysz, Jozef; Schwartz, Joseph
2006-11-01
Patterned hair loss, follicular miniaturization, and increased telogen hair counts characterize androgenic alopecia (AGA). Follicular inflammation in AGA has been associated with treatment resistance and progressive hair loss. Brothers, 15 and 18 years old, presented with frontal and mid-scalp hair loss with an intact frontal hairline noted over a 1-year period. The elder reported past use of androgenic steroids. Laboratory assessment for metabolic and hormonal abnormalities was unrevealing, and hair pull test was negative. Scalp biopsies revealed decreased terminal hairs, marked diameter variation of anagen hairs, decreased terminal to vellus hair ratios (3.7:1/3.4:1, older/younger), and increased telogen counts (23%/21%). Infrabulbar and peri-isthmic (follicular bulge region) lymphocytic infiltrates were present. Hair loss has progressed, unabated by daily topical 0.5% clobetasol (for 6 months), daily 5% minoxidil (1 year), and latter, daily oral finasteride (2 years - older brother only). Based on patterned hair loss and miniaturized hairs, these brothers have AGA. The female pattern of hair loss (diffuse hair loss affecting the central scalp with preservation of frontal hair line) coupled with follicular isthmic lymphocytic inflammation represents an unusual presentation, possibly a treatment resistant, inflammatory variant of AGA. The differential diagnosis includes exogenous androgen-mediated hair loss, cicatricial pattern hair loss, or the superimposition of alopecia areata.
Calcified gallstone fissures: the reversed Mercedes Benz sign.
Strijk, S P
1987-01-01
This article describes the occurrence of an unusual radiating pattern of calcification in the center of large radiolucent gallstones. The radiographic findings are attributed to calcium deposition within the fissures of biliary calculi.
Aspiration cytology of mammary analogue secretory carcinoma of the salivary gland.
Jung, Min Jung; Kim, Sang Yoon; Nam, Soon Yuhl; Roh, Jong-Lyel; Choi, Seung-Ho; Lee, Jeong Hyun; Baek, Jung Hwan; Cho, Kyung-Ja
2015-04-01
Aspiration cytologic findings of mammary analogue secretory carcinoma (MASC), a newly established salivary gland neoplasm defined by a t(12;15)(p13;q25) ETV6-NTRK3 translocation, are not fully characterized to date. We report cytologic descriptions of nine cases of molecularly confirmed MASC, including two with unusual findings. Aspiration smears from nine MASCs of the salivary glands were retrospectively reviewed and analyzed according to the cellular and structural features of the corresponding surgical specimens. Aspiration smears of MASC generally reflected the histologic diversity of the tumors. Among usual histologic findings, a micropapillary pattern was associated with a predominance of vacuolated individual cells on aspiration smears, a papillary-cystic pattern with a predominance of thin branching papillary structures, and a microcystic pattern with a predominance of irregular sheets of eosinophilic cells. There were two unusual cases, one with three-dimensional groups of high-grade atypical cells, and one with epithelial clusters floating in a notably mucinous background. These cases represented MASC with high-grade transformation and MASC with cystadenocarcinoma-like features, respectively. The secretory activity of MASC was not prominent in the aspiration specimens. Although unusual cases were present, most MASC cases showed characteristic cytologic findings, which could aid the cytologic diagnosis of MASC. And knowledge of the histologic spectrum of MASC, including high-grade transformation, could be valuable for cytological differential diagnoses of salivary gland tumors, and the management of patients with MASC. © 2014 Wiley Periodicals, Inc.
Donnadieu, Anne Claire; Deffieux, Xavier; Le Ray, Camille; Mordefroid, Marie; Frydman, René; Fernandez, Hervé
2006-12-01
A large ovarian cyst was diagnosed at 22 weeks' of gestation in a 32-year-old woman. The ultrasonographic appearance of the ovarian cyst was unusual with multiple mobile, spherical echogenic structures floating in the cystic mass, called intracystic "fat balls." Right adnexectomy was performed by laparotomy at 28 weeks' of gestation, because of rapid growth and overall size exceeding 20 cm. Pathological examination confirmed ovarian cystic teratoma. Usually, dermoid cysts are slow-growing, even in premenopausal women. The exact mechanism related to the fast growth during pregnancy is unknown. It could be related to an unusual pattern of estrogen (E)/P receptors expression in the cystic teratoma. This case shows that a fast-growing, mature ovarian cystic teratoma may occur during pregnancy.
Behr, Gerald G; Berdon, Walter E; Griscom, N Thorne
2012-06-01
An infant with complex cyanotic congenital heart disease was recently encountered whose radiographs seemed to show enhancement of pericardium, peritoneal mesothelium and body wall fascial planes without enhancement of the liver or spleen after very large doses of intravenous contrast. Although patterns of postcontrast enhancement have been described previously, this pattern seems to be unique. We report the unusual postcontrast opacification pattern and speculate about its underlying mechanism.
Carretta, A; Canneto, B; Calori, G; Ceresoli, G L; Campagnoli, E; Arrigoni, G; Vagani, A; Zannini, P
2001-08-01
The incidence of adenocarcinoma and bronchoalveolar carcinoma has increased in recent years. The aim of this study was to retrospectively evaluate radiological and pathological factors affecting survival in patients with bronchoalveolar carcinoma (BAC) or BAC associated with adenocarcinoma who underwent surgical treatment. From May 1988 to September 1999, 49 patients with BAC or BAC and adenocarcinoma underwent surgical treatment. Complete resection was performed in 42 patients. In these patients the impact of the following factors on survival was evaluated: stage, TNM status, radiological and pathological findings (percentage of bronchoalveolar carcinoma in the tumour, presence or absence of sclerosing and mucinous patterns, vascular invasion and lymphocytic infiltration). Twenty-nine patients were male and 20 female. Mean age was 63 years. Five-year survival was 54%. Univariate analysis of the patients who underwent complete resection demonstrated a favourable impact on survival in stages Ia and Ib (P = 0.01) and in the absence of nodal involvement (P = 0.02) and mucinous patterns (P = 0.02). Mucinous pattern was also prognostically relevant at multivariate analysis (P = 0.02). In the 27 patients with stage Ia and Ib disease, univariate analysis demonstrated that the absence of mucinous pattern (P = 0.006) and a higher percentage of BAC (P = 0.01) favourably influenced survival. The latter data were also confirmed by multivariate analysis (P = 0.01). Surgical treatment of early-stage BAC and combined BAC and adenocarcinoma is associated with favourable results. However, the definition of prognostic factors is of utmost importance to improve the results of the treatment. In our series tumours of the mucinous subtype and with a lower percentage of BAC had a worse prognosis.
Jian, Yu-Qing; Huang, Xiao-Jun; Zhang, Dong-Mei; Jiang, Ren-Wang; Chen, Min-Feng; Zhao, Bing-Xin; Wang, Ying; Ye, Wen-Cai
2015-06-15
A novel sesquiterpene-based Psidium meroterpenoid, possessing an unusual coupling pattern, and two new monoterpene-based meroterpenoids with unprecedented skeletons were isolated from the leaves of Psidium guajava. Their structures and absolute configurations were elucidated by spectroscopic, X-ray diffraction, and computational methods. The plausible biosynthetic pathway of these meroterpenoids as well as their cytotoxicities toward HepG2 and HepG2/ADM cells were also discussed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Chiba, Sahoko; Tsuchiya, Kimitake; Akashi, Takumi; Ishizuka, Masahiro; Okamoto, Tsukasa; Furusawa, Haruhiko; Tateishi, Tomoya; Kishino, Mitsuhiro; Miyazaki, Yasunari; Tateishi, Ukihide; Takemura, Tamiko; Inase, Naohiko
2016-06-01
Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by the inhalation of environmental antigens. The relationship between clinical, radiologic, and histopathologic findings of chronic HP remains unclear. Sixteen patients with proven chronic bird-related HP with a usual interstitial pneumonia-like pattern were analyzed retrospectively. Histopathologic findings were semiquantitatively assessed and compared with clinical and radiologic findings. We also evaluated the histopathologic findings affecting prognosis. The extent of centrilobular fibrosis was negatively correlated with Pao2 (r = -0.55, P = .03). The extent of bridging fibrosis was positively correlated with the ratio of maximal expiratory flow at 50% of forced vital capacity to that at 25% (r = 0.60, P = .02). Patients with a greater extent of fibroblastic foci (FF) had more radiologic reticulation (P = .01), honeycombing (P = .01), and traction bronchiectasis (P = .02), and had significantly shorter survival time (P = .01) than patients with a lesser extent of FF. Multivariate analysis showed that the extent of FF was a significant prognostic factor (hazard ratio, 2.36; 95% confidence interval, 1.02-5.48; P = .04). Our findings demonstrated that the extent of FF was significantly associated with reticulation, honeycombing, and traction bronchiectasis on high-resolution CT scanning. Moreover, the extent of FF could be a useful predictor of mortality in chronic HP with a usual interstitial pneumonia-like pattern. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Unusually cold and dry winters increase mortality in Australia.
Huang, Cunrui; Chu, Cordia; Wang, Xiaoming; Barnett, Adrian G
2015-01-01
Seasonal patterns in mortality have been recognised for decades, with a marked excess of deaths in winter, yet our understanding of the causes of this phenomenon is not yet complete. Research has shown that low and high temperatures are associated with increased mortality independently of season; however, the impact of unseasonal weather on mortality has been less studied. In this study, we aimed to determine if unseasonal patterns in weather were associated with unseasonal patterns in mortality. We obtained daily temperature, humidity and mortality data from 1988 to 2009 for five major Australian cities with a range of climates. We split the seasonal patterns in temperature, humidity and mortality into their stationary and non-stationary parts. A stationary seasonal pattern is consistent from year-to-year, and a non-stationary pattern varies from year-to-year. We used Poisson regression to investigate associations between unseasonal weather and an unusual number of deaths. We found that deaths rates in Australia were 20-30% higher in winter than summer. The seasonal pattern of mortality was non-stationary, with much larger peaks in some winters. Winters that were colder or drier than a typical winter had significantly increased death risks in most cities. Conversely summers that were warmer or more humid than average showed no increase in death risks. Better understanding the occurrence and cause of seasonal variations in mortality will help with disease prevention and save lives. Copyright © 2014 Elsevier Inc. All rights reserved.
Chow, Daniel S; Ha, Richard; Filippi, Christopher G
2015-01-01
OBJECTIVE; There is evidence in academic medicine that the number of authors per paper has increased over time. The goal of this study was to quantitatively analyze authorship trends in the field of radiology over 20 years. A search of the National Library of Medicine MEDLINE database was conducted to identify articles published by radiology departments between 1991 and 2012. Country of origin, article study design, and journal impact factor were recorded. The increase in number of authors per paper was assessed by linear and nonlinear regression. Pearson correlation was used to assess the relation between journal impact factor and number of authors. A total of 142,576 articles and 699,257 authors were identified during the study period. The mean number of authors per paper displayed linear growth from 3.9 to 5.7 (p < 0.0001). The proportion of single authors declined from 11% in 1991 to 4.4% in 2012. The number of clinical trials increased in a linear pattern, review articles in an exponential pattern, and case reports in a logistic pattern (p < 0.0001 for each). Countries with the highest number of authors per paper were Japan, Italy, and Germany. The number of articles funded by the U.S. National Institutes of Health (NIH) displayed exponential growth and of non-NIH-funded articles displayed linear growth (p < 0.0001 for each). A negligible relation was observed between journal impact factor and number of authors (Pearson r = 0.1066). Radiology has had a steady increase in mean number of authors per paper since the early 1990s that has varied by study design. The increase is probably multi-factorial and includes components of author inflation and increasing complexity of research. Findings support the need for reemphasis of authorship criteria to preserve authorship value and accountability.
Bette, Stefanie; Barz, Melanie; Huber, Thomas; Straube, Christoph; Schmidt-Graf, Friederike; Combs, Stephanie E; Delbridge, Claire; Gerhardt, Julia; Zimmer, Claus; Meyer, Bernhard; Kirschke, Jan S; Boeckh-Behrens, Tobias; Wiestler, Benedikt; Gempt, Jens
2018-03-14
Recent studies suggested that postoperative hypoxia might trigger invasive tumor growth, resulting in diffuse/multifocal recurrence patterns. Aim of this study was to analyze distinct recurrence patterns and their association to postoperative infarct volume and outcome. 526 consecutive glioblastoma patients were analyzed, of which 129 met our inclusion criteria: initial tumor diagnosis, surgery, postoperative diffusion-weighted imaging and tumor recurrence during follow-up. Distinct patterns of contrast-enhancement at initial diagnosis and at first tumor recurrence (multifocal growth/progression, contact to dura/ventricle, ependymal spread, local/distant recurrence) were recorded by two blinded neuroradiologists. The association of radiological patterns to survival and postoperative infarct volume was analyzed by uni-/multivariate survival analyses and binary logistic regression analysis. With increasing postoperative infarct volume, patients were significantly more likely to develop multifocal recurrence, recurrence with contact to ventricle and contact to dura. Patients with multifocal recurrence (Hazard Ratio (HR) 1.99, P = 0.010) had significantly shorter OS, patients with recurrent tumor with contact to ventricle (HR 1.85, P = 0.036), ependymal spread (HR 2.97, P = 0.004) and distant recurrence (HR 1.75, P = 0.019) significantly shorter post-progression survival in multivariate analyses including well-established prognostic factors like age, Karnofsky Performance Score (KPS), therapy, extent of resection and patterns of primary tumors. Postoperative infarct volume might initiate hypoxia-mediated aggressive tumor growth resulting in multifocal and diffuse recurrence patterns and impaired survival.
Bilateral Breast Metastases from Vulvar Carcinoma: A Case Report and Literature Review
Kalogerakos, K.; Dimopoulos, Johannes Carl Athanasios; Kalinoglou, N.
2017-01-01
Vulvar carcinoma is a rare disease that accounts for 3–5% of all gynecologic malignancies. Breast represents an unusual site of metastasis and only a few cases are reported. We describe the first case of bilateral metastatic breast carcinoma of vulvar origin, at an 80-year-old female patient. Six months after treatment of her primary disease, she presented with bilateral metastatic squamous cell breast carcinoma. Diagnosis was based on clinical, radiological, and histological facts. Breast although rare is another potential site of metastasis in vulvar cancer and thus mammary gland examination should be considered in the follow-up of these patients. Differential diagnosis between primary and metastatic lesions is of utmost importance for appropriate management. PMID:28487793
Walters, Matthew P; Baynes, Keith; Carrera, Guillermo F; King, David M; Wang, Dian; Charlson, John; Zambrano, Eduardo
2011-10-01
Adamantinoma is a rare neoplasm that characteristically involves the tibia. In many instances, typical location within the tibia, very slow course, and a typical radiographic appearance can strongly suggest the correct diagnosis. We present a case that has both unusual radiographic findings and uncharacteristic histology. In this case, radiologic imaging showed a poorly defined lytic lesion within the distal, lateral tibia extending to the joint with central necrosis, overlying periosteal reaction and possible tumor spread into soft tissue. The histology of this lesion showed pronounced vascularity and surrounding large neoplastic cells with plasmacytoid morphology. The combination of these features led to an initial misdiagnosis as metastatic carcinoma from unknown primary. Copyright © 2011 Elsevier Inc. All rights reserved.
Poliosis of eyelashes as an unusual sign of a halo nevus.
Kay, Kyu Mee; Kim, Joong Hun; Lee, Tae Soo
2010-08-01
A 39-year-old man with poliosis of his lower eyelid lashes visited our clinic. He reported that his symptoms began with a few central lashes and then spread along the adjacent lashes during the ensuing 2 weeks. A pigmented nevus, approximately 4 mm in diameter, was identified just above the white lashes without surrounding skin depigmentation. No specific findings were identified with regard to the patient's general health or serologic and radiologic testing. Excisional biopsy of the pigmented nevus was performed. On histopathologic examination, infiltration of the dermis by numerous lymphocytes and melanophages was observed. The poliosis was ultimately diagnosed as a presenting sign of the halo phenomenon in the regressive stage of a melanocytic nevus.
Poliosis of Eyelashes as an Unusual Sign of a Halo Nevus
Kim, Joong Hun; Lee, Tae Soo
2010-01-01
A 39-year-old man with poliosis of his lower eyelid lashes visited our clinic. He reported that his symptoms began with a few central lashes and then spread along the adjacent lashes during the ensuing 2 weeks. A pigmented nevus, approximately 4 mm in diameter, was identified just above the white lashes without surrounding skin depigmentation. No specific findings were identified with regard to the patient's general health or serologic and radiologic testing. Excisional biopsy of the pigmented nevus was performed. On histopathologic examination, infiltration of the dermis by numerous lymphocytes and melanophages was observed. The poliosis was ultimately diagnosed as a presenting sign of the halo phenomenon in the regressive stage of a melanocytic nevus. PMID:20714388
Recurrent Obstructive Giant Inflammatory Polyposis of the Colon
Budhraja, Vikram
2016-01-01
Inflammatory polyps are relatively common in patients with inflammatory bowel disease. The term giant inflammatory polyposis is used to describe inflammatory polyps greater than 1.5 cm in any dimension. Their clinical presentation can be varied, ranging from asymptomatic, with incidental detection on radiological or endoscopic testing, to symptomatic, with rectal bleeding and colonic obstruction. Although giant inflammatory polyposis is a rare finding, it is of clinical importance, since it is easily mistaken for colon cancer, with patients sometimes undergoing radical surgeries. We describe an unusual case of giant inflammatory polyposis causing recurrent symptomatic obstruction despite multiple segmental colectomies in a patient with indeterminate colitis. This is the first such reported case in English literature to the best of our knowledge. PMID:27807551
Recurrent Obstructive Giant Inflammatory Polyposis of the Colon.
Syal, Gaurav; Budhraja, Vikram
2016-08-01
Inflammatory polyps are relatively common in patients with inflammatory bowel disease. The term giant inflammatory polyposis is used to describe inflammatory polyps greater than 1.5 cm in any dimension. Their clinical presentation can be varied, ranging from asymptomatic, with incidental detection on radiological or endoscopic testing, to symptomatic, with rectal bleeding and colonic obstruction. Although giant inflammatory polyposis is a rare finding, it is of clinical importance, since it is easily mistaken for colon cancer, with patients sometimes undergoing radical surgeries. We describe an unusual case of giant inflammatory polyposis causing recurrent symptomatic obstruction despite multiple segmental colectomies in a patient with indeterminate colitis. This is the first such reported case in English literature to the best of our knowledge.
Poland's syndrome with unusual hand and chest anomalies: a rare case report.
Yadav, G K; Lal, S; Dange, N; Marwah, K G; Singh, J P
2014-01-01
Poland's syndrome is a rare congenital anomaly consisting of a unilateral absence of the pectoralis major, ipsilateral muscle, hand anomaly and occasionally associated other malformations of the chest wall and breast. Many structural and functional abnormalities have been described in association with this syndrome. We report an incidentally diagnosed case in a 27-year-old male patient who presented to us with symbrachydactyly. In addition to this, anterior depression of 2nd, 3rd and 4th ribs and bifid (forked) 5th rib was present on radiological investigations. The body of sternum was short and deformed on the right side with absence of xiphoid process. All middle phalanges were absent on righthand. It is a rare variant of Poland's syndrome.
An unusual cause of recurrent spontaneous pneumothorax: the Mounier-Kuhn syndrome.
Unlu, Elif Nisa; Annakkaya, Ali Nihat; Balbay, Ege Gulec; Aydın, Leyla Yilmaz; Safcı, Sinem; Boran, Mertay; Guclu, Derya
2016-01-01
We present a case of 63-year-old man who was referred to the emergency department with a right-sided pneumothorax. He had a history of spontaneous pneumothorax for 2 times. The chest computed tomographic scan showed tracheobronchomegaly with an increase in the diameter of the trachea and right and left main bronchus. Fiberoptic bronchoscopy revealed enlarged trachea and both main bronchus with diverticulas. These findings are consistent with a diagnosis of Mounier-Kuhn syndrome. Mounier-Kuhn syndrome is a rare clinical and radiologic condition. It is characterized by a tracheal and bronchial dilation. Diagnosis is made by computed tomography and bronchoscopy. Mounier-Kuhn syndrome should be kept in mind in the differential diagnosis of recurrent spontaneous pneumothorax.
Singhi, Pratibha; Saini, Arushi Gahlot; Sankhyan, Naveen; Gupta, Pankaj; Vyas, Sameer
2015-01-01
A 4-year-old girl presented with acute visual loss followed 2 weeks later with loss of speech and audition, fulminant neuroregression, and choreo-athetoid movements of extremities. Fundus showed bilateral chorioretinitis. Electroencephalography showed periodic complexes. Measles antibody titers were elevated in both serum and cerebrospinal fluid, consistent with subacute sclerosing panencephalitis. Neuroimaging showed discontiguous involvement of splenium of the corpus callosum and ventral pons with sparing of cortical white matter. Our case highlights the atypical clinical and radiologic presentations of subacute sclerosing panencephalitis. Pediatricians need to be aware that necrotizing chorioretinitis in a child and/or atypical brain stem changes could be the heralding feature of this condition in endemic countries. © The Author(s) 2014.
ERIC Educational Resources Information Center
Titilope, Afolayan Oluyinka
2014-01-01
Mobile phone addiction is now a common phenomenon in the 21st century, especially among teenagers due to the unusual cravings in the use of technological devices. In view of this phenomenon, the study examined the socio-psychological dimensions of mobile phone addiction and usage patterns amongst teenagers in three Higher Institutions of Learning…
Climate Shocks and Migration: An Agent-Based Modeling Approach.
Entwisle, Barbara; Williams, Nathalie E; Verdery, Ashton M; Rindfuss, Ronald R; Walsh, Stephen J; Malanson, George P; Mucha, Peter J; Frizzelle, Brian G; McDaniel, Philip M; Yao, Xiaozheng; Heumann, Benjamin W; Prasartkul, Pramote; Sawangdee, Yothin; Jampaklay, Aree
2016-09-01
This is a study of migration responses to climate shocks. We construct an agent-based model that incorporates dynamic linkages between demographic behaviors, such as migration, marriage, and births, and agriculture and land use, which depend on rainfall patterns. The rules and parameterization of our model are empirically derived from qualitative and quantitative analyses of a well-studied demographic field site, Nang Rong district, Northeast Thailand. With this model, we simulate patterns of migration under four weather regimes in a rice economy: 1) a reference, 'normal' scenario; 2) seven years of unusually wet weather; 3) seven years of unusually dry weather; and 4) seven years of extremely variable weather. Results show relatively small impacts on migration. Experiments with the model show that existing high migration rates and strong selection factors, which are unaffected by climate change, are likely responsible for the weak migration response.
Climate Shocks and Migration: An Agent-Based Modeling Approach
Entwisle, Barbara; Williams, Nathalie E.; Verdery, Ashton M.; Rindfuss, Ronald R.; Walsh, Stephen J.; Malanson, George P.; Mucha, Peter J.; Frizzelle, Brian G.; McDaniel, Philip M.; Yao, Xiaozheng; Heumann, Benjamin W.; Prasartkul, Pramote; Sawangdee, Yothin; Jampaklay, Aree
2016-01-01
This is a study of migration responses to climate shocks. We construct an agent-based model that incorporates dynamic linkages between demographic behaviors, such as migration, marriage, and births, and agriculture and land use, which depend on rainfall patterns. The rules and parameterization of our model are empirically derived from qualitative and quantitative analyses of a well-studied demographic field site, Nang Rong district, Northeast Thailand. With this model, we simulate patterns of migration under four weather regimes in a rice economy: 1) a reference, ‘normal’ scenario; 2) seven years of unusually wet weather; 3) seven years of unusually dry weather; and 4) seven years of extremely variable weather. Results show relatively small impacts on migration. Experiments with the model show that existing high migration rates and strong selection factors, which are unaffected by climate change, are likely responsible for the weak migration response. PMID:27594725
Maxillary and Mandibular First Premolars Showing Three-Cusp Pattern: An Unusual Presentation
Kotrashetti, Vijayalakshmi; Nayak, Aarati; Patil, Viraj; Kulkarni, Mayuri; Somannavar, Pradeep
2013-01-01
Dental anatomy is the study of morphology of various teeth in human dentitions. The application of dental anatomy in clinical practice is important, and dentist should have a thorough knowledge regarding the morphology of the teeth. At times as a result of genetic variation, environmental factors, diet of an individual and race, variations in the morphology of the teeth can be observed. These variations have been extensively studied by the researcher in the field of anthropology to define a particular race. The most commonly observed changes include peg-shaped laterals, shovel-shaped incisors, and extra cusp on molar. Common variations documented with regard to maxillary and mandibular first premolars are the variation in the number of roots. But the variations with respect to crown morphology are few. We report a first documented unusual presentation of maxillary and mandibular first premolars with three-cusps pattern in a female patient. PMID:23476817
Van Etten, Hannah M; Kaur, Maninderjit; Srinivasan, Sudha M; Cohen, Shereen J; Bhat, Anjana; Dobkins, Karen R
2017-11-01
The current study investigated the prevalence and pattern of unusual sensory behaviors (USBs) in teens with Autism Spectrum Disorder (ASD) and infants (3-36 months) at risk for ASD. From two different sites (UCSD and UConn), caregivers of infants at high (n = 32) and low risk (n = 33) for ASD, and teenagers with (n = 12) and without ASD (n = 11), completed age-appropriate Sensory Profile questionnaires (Infant/Toddler Sensory Profile; Dunn 2002; Adolescent/Adult Sensory Profile; Brown and Dunn 2002). The results show that high-risk infants and teenagers with ASD exhibit higher-than-typical prevalence of USBs. Results of our distribution analyses investigating the direction of sensory atypicalities (greater-than-typical vs. less-than-typical) revealed a fair degree of consistency amongst teens, however, USB patterns were more varied in high-risk infants.
Entrance, exit, and reentrance of one shot with a shotgun.
Gulmann, C; Hougen, H P
1999-03-01
The case being reported is one of a homicidal shotgun fatality with an unusual wound pattern. A 34-year-old man was shot at close range with a 12-gauge shotgun armed with No. 5 birdshot ammunition. The shot entered the left axillary region, exited through the left infraclavicular region, and thereafter penetrated the left side of the neck, causing tearing of the left common carotid artery and the right internal carotid artery. The entrance wound in the axilla was larger than the other wounds, and before autopsy it was believed that the shotgun had been fired twice, causing one wound in the neck and one wound perforating the infraclavicular region and exiting through the left axillary region. Thus, this case shows that unusual wound patterns in shotgun fatalities can easily lead to incorrect assumptions with regard to number and direction of shots fired unless thorough investigation is carried out postmortem.
Modeling of workflow-engaged networks on radiology transfers across a metro network.
Camorlinga, Sergio; Schofield, Bruce
2006-04-01
Radiology metro networks bear the challenging proposition of interconnecting several hospitals in a region to provide a comprehensive diagnostic imaging service. Consequences of a poorly designed and implemented metro network could cause delays or no access at all when health care providers try to retrieve medical cases across the network. This could translate into limited diagnostic services to patients, resulting in negative impacts to the patients' medical treatment. A workflow-engaged network (WEN) is a new network paradigm. A WEN appreciates radiology workflows and priorities in using the network. A WEN greatly improves the network performance by guaranteeing that critical image transfers experience minimal delay. It adjusts network settings to ensure the application's requirements are met. This means that high-priority image transfers will have guaranteed and known delay times, whereas lower-priority traffic will have increased delays. This paper introduces a modeling to understand the benefits that WEN brings to a radiology metro network. The modeling uses actual data patterns and flows found in a hospital metro region. The workflows considered are based on the Integrating the Healthcare Enterprise profiles. This modeling has been applied to metropolitan workflows of a health region. The modeling helps identify the kind of metro network that supports data patterns and flows in a metro area. The results of the modeling show that a 155-Mb/s metropolitan area network (MAN) with WEN operates virtually equal to a normal 622-Mb/s MAN without WEN, with potential cost savings for leased line services measured in the millions of dollars per year.
Hiraishi, Hirotoshi; Kikuchi, Mitsuru; Yoshimura, Yuko; Kitagawa, Sachiko; Hasegawa, Chiaki; Munesue, Toshio; Takesaki, Natsumi; Ono, Yasuki; Takahashi, Tsutomu; Suzuki, Michio; Higashida, Haruhiro; Asada, Minoru; Minabe, Yoshio
2015-03-01
Autism spectrum disorder (ASD) is often described as comprising an unusual brain growth pattern and aberrant brain lateralization. Although it is important to study the pathophysiology of the developing ASD cortex, examples of physiological brain lateralization in young children with ASD have yet to be well examined. Thirty-eight boys with ASD (aged 3-7 years) and 38 typically developing (TD) boys (aged 3-8 years) concentrated on video programs and their brain activities were measured non-invasively. We employed a customized child-sized magnetoencephalography system in which the sensors were located as close to the brain as possible for optimal recording in young children. To produce a credible laterality index of the brain oscillations, we defined two clusters of sensors corresponding to the right and left hemispheres. We focused on the laterality index ([left - right]/[left+right]) of the relative power band in seven frequency bands. The TD group displayed significantly rightward lateralized brain oscillations in the theta-1 frequency bands compared to the ASD group. This is the first study to demonstrate unusual brain lateralization of brain oscillations measured by magnetoencephalography in young children with ASD. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.
Lee, Ming-Che; Chuang, Kei-Shih; Hsu, Tien-Cheng; Lee, Chien-Ding
2016-11-01
Collection of radiation dose derived from radiological examination is necessary not only for radiation protection, but also for fulfillment of structured reports. However, the material regarding of radiation dose cannot be directly utilized by the Radiological Information System (RIS) since it is generated and only stored in the Picture Archiving and Communication System (PACS). In this paper, an integration reporting module is proposed to facilitate handling of dose information and structured reporting by providing two functionalities. First, a gateway is established to automatically collect the related information from PACS for further analyzing and monitoring the accumulated radiation. Second, the designated structured reporting patterns with corresponding radiation dose measurements can be acquired by radiologists as necessary. In the design, the radiation dose collection gateway and the well-established pattern are collocated to achieve that there is no need to do manual entry for structured reporting, thus increasing productivity and medical quality.
Gungor, O Erken; Nur, B Guzel; Yalcin, H; Karayilmaz, H; Mihci, E
2015-01-01
Hallermann-Streiff syndrome (HSS) is a genetic disorder characterized by proportionate dwarfism, birdlike facies, hypotrichosis, skin atrophy, dyscephaly, bilateral microphthalmia, congenital cataracts, a narrow, weak, beaked nose, a hypoplastic mandible, and orodental anomalies. Occurrence is sporadic and distinct patterns of inheritance have not been found. This case report describes the dental management of a 3-year-old girl patient with HSS, who had unusual radiographic appearance of teeth. Furthermore, dental treatments and a 30-month follow-up period of the patient with this rare tooth structure malformation have been presented.
Sevilla, Julián; Fernández-Plaza, Sandra; Lassaletta, Alvaro; González-Vicent, Marta; Contra, Trinidad; Madero, Luis
2007-12-01
Myelodysplastic syndromes (MDS) in childhood are rare hematologic diseases. MDS with t(3;5) (NPM/MLF1) is an unusual subtype without a well-defined clinical and prognostic pattern. A poor outcome has been reported, suggesting that hematopoietic transplantation is the only treatment option. Here in we described a 2-year-old child diagnosed with the disease, without a suitable hematopoietic donor, treated early in the disease with chemotherapy. He is alive and well 4 years after the end of treatment. This unusual MDS needs further studies to better understand the disease.
Spondylotic myelopathy mimicking myelitis: diagnostic clues by magnetic resonance imaging.
Rua, Adriana; Blanco, Yolanda; Sepúlveda, María; Sola-Valls, Núria; Martínez-Hernández, Eugenia; Llufriu, Sara; Berenguer, Joan; Graus, Francesc; Saiz, Albert
2015-12-01
Spondylotic myelopathy is the commonest cause of nontraumatic myelopathy. Radiological features of spondylotic myelopathy can often overlap with inflammatory myelopathies which may lead to a delayed or incorrect diagnosis and therapy. A distinctive gadolinium enhancement pattern recently described may help to differentiate spondylotic from inflammatory myelopathy. Case 1: a 38-years-old man presented with a 2-year history of paresthesias in the upper extremities, and one year later cramps on the right limbs and numbness over right C5 and C6 dermatomes, related to movement of the neck. Case 2: a 44-year-old man presented with a 1-year history of progressive gait difficulties and sensory disturbance in the hands, and a recent onset of bladder dysfunction. In both cases, spinal cord MRI identified a longitudinal cervical T2-signal hyperintensity associated with a pancakelike transverse band of gadolinium enhancement just below the site of maximum spinal stenosis, and circumferential or hemicord enhancement on axial images. The radiological features of spondylotic myelopathy may resemble those of inflammatory origin. The recognition of a transverse pancakelike gadolinium enhancement immediately below the site of maximal compression as a typical radiological pattern of spondylotic myelopathy is important to reduce the risk of misdiagnosis and to help in the management of these patients.
Modeling Temporal Behavior in Large Networks: A Dynamic Mixed-Membership Model
DOE Office of Scientific and Technical Information (OSTI.GOV)
Rossi, R; Gallagher, B; Neville, J
Given a large time-evolving network, how can we model and characterize the temporal behaviors of individual nodes (and network states)? How can we model the behavioral transition patterns of nodes? We propose a temporal behavior model that captures the 'roles' of nodes in the graph and how they evolve over time. The proposed dynamic behavioral mixed-membership model (DBMM) is scalable, fully automatic (no user-defined parameters), non-parametric/data-driven (no specific functional form or parameterization), interpretable (identifies explainable patterns), and flexible (applicable to dynamic and streaming networks). Moreover, the interpretable behavioral roles are generalizable, computationally efficient, and natively supports attributes. We applied ourmore » model for (a) identifying patterns and trends of nodes and network states based on the temporal behavior, (b) predicting future structural changes, and (c) detecting unusual temporal behavior transitions. We use eight large real-world datasets from different time-evolving settings (dynamic and streaming). In particular, we model the evolving mixed-memberships and the corresponding behavioral transitions of Twitter, Facebook, IP-Traces, Email (University), Internet AS, Enron, Reality, and IMDB. The experiments demonstrate the scalability, flexibility, and effectiveness of our model for identifying interesting patterns, detecting unusual structural transitions, and predicting the future structural changes of the network and individual nodes.« less
Anomalous sylvian fissure morphology in Williams syndrome.
Eckert, Mark A; Galaburda, Albert M; Karchemskiy, Asya; Liang, Alyssa; Thompson, Paul; Dutton, Rebecca A; Lee, Agatha D; Bellugi, Ursula; Korenberg, Julie R; Mills, Debra; Rose, Fredric E; Reiss, Allan L
2006-10-15
The unusual sensitivity and attraction to auditory stimuli in people with Williams syndrome (WS) has been hypothesized to be the consequence of atypical development of brain regions surrounding the Sylvian fissure. Planum temporale surface area, which is determined in part by Sylvian fissure patterning, was examined in 42 WS and 40 control participants to determine if anomalous Sylvian fissure morphology is present in WS. WS participants had significantly reduced leftward asymmetry of the planum temporale compared to control participants, due to a significant expansion in the size of the right planum temporale. The increased right planum temporale size was largely due to WS participants (24%) who had a right hemisphere Sylvian fissure that coursed horizontally and failed to ascend into the parietal lobe. This sulcal pattern is unusual in the right hemisphere and is more commonly found in the left hemisphere of typically developing individuals. There were no control participants with this type of right hemisphere Sylvian fissure pattern. The right hemisphere Sylvian fissure sulcal patterns were also related to a measure of cortical complexity and the amount of right hemisphere occipital lobe volume, suggesting that intrinsic genetic influences leading to anomalous visual system development in WS have widespread influences on cortical morphology that are similar in manner to extrinsic embryonic visual system lesions.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gluck, Iris; Ibrahim, Mohannad; Popovtzer, Aron
2009-05-01
Purpose: To analyze patterns of failure in patients with head-and-neck cutaneous squamous cell carcinoma (HNCSCC) and clinical/radiologic evidence of perineural invasion (CPNI), in order to define neural clinical target volume (CTV) for treatment planning. Methods and Materials: Patients treated with three-dimensional (3D) conformal or intensity-modulated radiotherapy (IMRT) for HNCSCC with CPNI were included in the study. A retrospective review of the clinical charts, radiotherapy (RT) plans and radiologic studies has been conducted. Results: Eleven consecutive patients with HNCSCCs with CPNI were treated from 2000 through 2007. Most patients underwent multiple surgical procedures and RT courses. The most prevalent failure patternmore » was along cranial nerves (CNs), and multiple CNs were ultimately involved in the majority of cases. In all cases the involved CNs at recurrence were the main nerves innervating the primary tumor sites, as well as their major communicating nerves. We have found several distinct patterns of disease spread along specific CNs depending on the skin regions harboring the primary tumors, including multiple branches of CN V and VII. These patterns and the pertinent anatomy are detailed in the this article. Conclusions: Predictable disease spread patterns along cranial nerves supplying the primary tumor sites were found in this study. Awareness of these patterns, as well as knowledge of the relevant cranial nerve anatomy, should be the basis for CTV definition and delineation for RT treatment planning.« less
Adenoid cystic carcinoma of the larynx presenting with unusual subglottic mass: Case report.
Kashiwagi, Takashi; Kanaya, Hiroaki; Konno, Wataru; Goto, Kazutaka; Hirabayashi, Hideki; Haruna, Shin-Ichi
2016-10-01
A 33-year-old woman presented with an unusual subglottic bulging mass accompanied by prolonged cough and wheeze. Laryngeal endoscopy revealed a bilateral, symmetrical mass immediately below the vocal cords with marked airway obstruction. Chronic subglottic laryngitis with inflammation or another condition such as amyloidosis was initially suspected. Cervicothoracic computed tomography revealed an obvious reduction of laryngeal caliber caused by an engulfing mass extending from just under the vocal cords to the cricoid ring, which was associated with thyroid, arytenoid, and cricoid cartilage destruction. Histopathological diagnosis of a biopsy specimen collected via a tracheotomy revealed that the lesion was a cT4aN0M0 adenoid cystic carcinoma (ACC) originating from the laryngeal minor salivary glands. The patient was treated by total laryngectomy with elective bilateral neck dissection under general anesthesia. Gross inspection of resected tissue confirmed yellowish-white, solid tumor mainly circumferentially encompassing the lumina of the cricoid ring. The histopathological findings confirmed typical ACC accompanied by a predominant cribriform appearance with no evidence of lymph node metastasis. The patient remains well and free of recurrence or metastasis. We herein describe laryngeal ACC and discuss radiological images and the surgical pathology. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
32 CFR Appendix B to Part 651 - Categorical Exclusions
Code of Federal Regulations, 2010 CFR
2010-07-01
... disturbance. Examples include topographic surveys, bird counts, wetland mapping, and other resources... existing land-use patterns. (4) Modification, product improvement, or configuration engineering design... original product design and there are no unusual disposal requirements. The development and use by the...
32 CFR Appendix B to Part 651 - Categorical Exclusions
Code of Federal Regulations, 2013 CFR
2013-07-01
... disturbance. Examples include topographic surveys, bird counts, wetland mapping, and other resources... existing land-use patterns. (4) Modification, product improvement, or configuration engineering design... original product design and there are no unusual disposal requirements. The development and use by the...
32 CFR Appendix B to Part 651 - Categorical Exclusions
Code of Federal Regulations, 2011 CFR
2011-07-01
... disturbance. Examples include topographic surveys, bird counts, wetland mapping, and other resources... existing land-use patterns. (4) Modification, product improvement, or configuration engineering design... original product design and there are no unusual disposal requirements. The development and use by the...
32 CFR Appendix B to Part 651 - Categorical Exclusions
Code of Federal Regulations, 2012 CFR
2012-07-01
... disturbance. Examples include topographic surveys, bird counts, wetland mapping, and other resources... existing land-use patterns. (4) Modification, product improvement, or configuration engineering design... original product design and there are no unusual disposal requirements. The development and use by the...
Lumbar Discitis Caused by Clostridium perfringens
Popoff, M. R.; Degand, Nicolas; Lotte, Laurene; Bouvet, Philippe; Baudin, Guillaume; Cua, Eric; Roger, Pierre-Marie; Ruimy, Raymond
2014-01-01
We report here a rare case of chronic lumbar discitis caused by Clostridium perfringens in an elderly patient that was treated with a combination of β-lactams and clindamycin. Molecular analysis performed on the strain revealed an unusual toxin gene pattern. PMID:25056327
Safety evaluation of new roads.
DOT National Transportation Integrated Search
2002-09-01
The primary objective of this research study was to evaluate the crash history of bypass routes to determine if there were unusual patterns or changes in the crash history on these routes over the first years of operation. The focus of the evaluation...
Zhang, Shuo; Feng, Juan; Shi, Yifang
2016-01-01
Infection with Epstein-Barr virus (EBV) is very common and usually occurs in childhood or early adulthood. Encephalitis/encephalopathy is an uncommon but serious neurological complication of EBV. A case of EBV-associated encephalitis/encephalopathy with involvement of reversible widespread cortical and splenial lesions is presented herein. An 8-year-old Chinese girl who presented with fever and headache, followed by seizures and drowsiness, was admitted to the hospital. Magnetic resonance imaging revealed high signal intensities on diffusion-weighted imaging in widespread cortical and splenial lesions. The clinical and laboratory examination results together with the unusual radiology findings suggested acute encephalitis/encephalopathy due to primary EBV infection. After methylprednisolone pulse therapy together with ganciclovir, the patient made a full recovery without any brain lesions. The hallmark clinical-radiological features of this patient included severe encephalitis/encephalopathy at onset, the prompt and complete recovery, and rapidly reversible widespread involvement of the cortex and splenium. Patients with EBV encephalitis/encephalopathy who have multiple lesions, even with the widespread involvement of cortex and splenium of the corpus callosum, may have a favorable outcome with complete disappearance of all brain lesions. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Metastatic Breast Cancer in Medication-Related Osteonecrosis Around Mandibular Implants.
Favia, Gianfranco; Tempesta, Angela; Limongelli, Luisa; Crincoli, Vito; Piattelli, Adriano; Maiorano, Eugenio
2015-09-15
Many authors have considered dental implants to be unrelated to increased risk of medication-related osteonecrosis of the jaw (MRONJ). Nevertheless, more recently, more cases of peri-implant MRONJ (PI-MRONJ) have been described, thus becoming a challenging health problem. Also, metastatic cancer deposits are not infrequently found at peri-implant sites and this may represent an additional complication for such treatments. We present the case of a breast cancer patient with PI-MRONJ, presenting a clinically and radiologically undetected metastasis within the necrotic bone, and highlight the necessity of an accurate histopathological analysis. A 66-year-old female patient, who had received intravenous bisphosphonates for bone breast cancer metastases, came to our attention for a non-implant surgery-triggered PI-MRONJ. After surgical resection of the necrotic bone, conventional and immunohistochemical examinations were performed, which showed breast cancer deposits within the necrotic bone. Cancer patients with metastatic disease, who are undergoing bisphosphonate treatment, may develop unusual complications, including MRONJ, which is a site at risk for hosting additional metastatic deposits that may be clinically and radiologically overlooked. Such risk is increased by previous or concomitant implant procedures. Consequently, clinicians should be prudent when performing implant surgery in cancer patients with advanced-stage disease and consider the possible occurrence of peri-implant metastases while planning adequate treatments in such patients.
An unusual characteristic “flower-like” pattern: flash suppressor burns
Gurcan, Altun
2012-01-01
The case on contact shots from firearms with a flash suppressor is rare. When a rifle fitted with a flash suppressor is fired, the emerging soot-laden gas in the barrel escapes from the slits of the flash suppressor. If the shot is contact or near contact, the flash suppressor will produce a characteristic “flower-like” pattern of seared, blackened zones around the entrance. This paper presents the injury pattern of the flash suppressor in a 29-year-old man who committed suicide with a G3 automatic infantry rifle. PMID:23935280
An unusual characteristic "flower-like" pattern: flash suppressor burns.
Gurcan, Altun
2012-04-01
The case on contact shots from firearms with a flash suppressor is rare. When a rifle fitted with a flash suppressor is fired, the emerging soot-laden gas in the barrel escapes from the slits of the flash suppressor. If the shot is contact or near contact, the flash suppressor will produce a characteristic "flower-like" pattern of seared, blackened zones around the entrance. This paper presents the injury pattern of the flash suppressor in a 29-year-old man who committed suicide with a G3 automatic infantry rifle.
Unusual coexistence of extramedullary plasmacytoma and nasopharyngeal carcinoma in nasopharynx.
Du, Ri-Chang; Li, Hai-Nan; Huang, Wei; Tian, Xiao-Ying; Li, Zhi
2015-09-17
Nasopharyngeal carcinoma (NPC) is an EBV-associated malignant tumor of nasopharynx. As extremely rare condition, the second primary cancer of nasopharynx can occur in NPC patients synchronously or subsequently. Extramedullary plasmacytoma (EMP) is a rare tumor and commonly originates in the head and neck region. However, there is no report to describe a collision tumor of NPC and EMP occurring in the same nasopharyngeal mass. We report here an unusual case of synchronous coexistence of NPC and EMP occurring in the nasopharynx of an old male patient. A 63-year-old male patient presented with a 3-month history of right-sided nasal obstruction and recently intermittent epistaxis without enlargement of cervical lymph nodes. The solitary mass of nasopharynx was found by radiological and nasopharyngeal examination. Histologically, the mass contained two separated portions and displayed typically histological features of NPC and EMP, respectively. In EMP portion, the tumor was composed of monomorphic plasmacytoid-appearing cells with immuno-positive to CD79a, CD138, CD38, MUM-1 and CD56, but lack immunoreactivity to pan-CK (AE1/AE3), CD20, CD21 and EBERs. In NPC portion, the tumor cells formed irregular-shaped islands with diffusely immuno-positive to pan-CK (AE1/AE3), EMA and EBERs, but lack expressions of lymphoplasmacytic markers. A diagnosis of simultaneous occurrence of EMP and NPC in nasopharynx was made. There was no evidence of tumor recurrence or metastasis 18-month follow-up after radiotherapy. To our knowledge, it may be the first case of coexistence of EMP and NPC synchronously. In addition, the histological differential diagnosis and relevant potential mechanism of this unusual collision tumor were also discussed.
Artificial intelligence in radiology.
Hosny, Ahmed; Parmar, Chintan; Quackenbush, John; Schwartz, Lawrence H; Aerts, Hugo J W L
2018-05-17
Artificial intelligence (AI) algorithms, particularly deep learning, have demonstrated remarkable progress in image-recognition tasks. Methods ranging from convolutional neural networks to variational autoencoders have found myriad applications in the medical image analysis field, propelling it forward at a rapid pace. Historically, in radiology practice, trained physicians visually assessed medical images for the detection, characterization and monitoring of diseases. AI methods excel at automatically recognizing complex patterns in imaging data and providing quantitative, rather than qualitative, assessments of radiographic characteristics. In this Opinion article, we establish a general understanding of AI methods, particularly those pertaining to image-based tasks. We explore how these methods could impact multiple facets of radiology, with a general focus on applications in oncology, and demonstrate ways in which these methods are advancing the field. Finally, we discuss the challenges facing clinical implementation and provide our perspective on how the domain could be advanced.
Kharat, Amit T; Singh, Amarjit; Kulkarni, Vilas M; Shah, Digish
2014-01-01
Data mining facilitates the study of radiology data in various dimensions. It converts large patient image and text datasets into useful information that helps in improving patient care and provides informative reports. Data mining technology analyzes data within the Radiology Information System and Hospital Information System using specialized software which assesses relationships and agreement in available information. By using similar data analysis tools, radiologists can make informed decisions and predict the future outcome of a particular imaging finding. Data, information and knowledge are the components of data mining. Classes, Clusters, Associations, Sequential patterns, Classification, Prediction and Decision tree are the various types of data mining. Data mining has the potential to make delivery of health care affordable and ensure that the best imaging practices are followed. It is a tool for academic research. Data mining is considered to be ethically neutral, however concerns regarding privacy and legality exists which need to be addressed to ensure success of data mining. PMID:25024513
Active Monitoring of a Humeral Osteoblastoma in a 52-Year-Old Male: A Case Report
Bouchet, Juliette; Lassoued, Donia; Boussier, Nathalie; Birebent, Jordan; Oustric, Stephane; Rouge-Bugat, Marie-Eve
2015-01-01
An osteoblastoma is an uncommon benign but painful tumor, typically found on the axial skeleton or on long bones in the case of young patients. Some cases of humeral osteoblastomas have been described in literature but not in men older than 30. We report the case of a painless bone tumor on the humerus of a 52-year-old patient. The CT scan shows a 30 mm hypodense lacunar formation, surrounded by thickened cortical bone resembling an osteoid osteoma. The anatomopathological and immunohistological analyses support the thesis of an osteoblastoma. A course of radiological monitoring without surgical resection was adopted. This unusual case introduces the possibility of carrying out a differential diagnosis with an osteosarcoma and raises the question of the treatment that should be adopted. PMID:29147426
Za, Tay; Antonowicz, Stefan; Menon, Madhav
2012-03-27
An 81-year-old man on warfarin was admitted to hospital after 3 days of constipation, straining and mild rectal bleeding. A large, boggy mass was felt posteriorly on direct rectal examination. Investigations revealed a normocytic anaemia and a supratherapeutic international normalised ratio (INR). Fearing a late presentation of malignancy, an urgent CT of abdomen and pelvis was arranged which showed a homogeneous mass arising between the sacrum and the rectum. Given the anaemia in the presence of anticoagulation, and subsequent widespread perineal and scrotal ecchymosis, the patient was diagnosed with atraumatic presacral haematoma. Following resuscitation, the patient was managed non-operatively and was discharged several days later following stabilisation of the haemoglobin and INR. At 3 months, he had complete clinical and radiological resolution of this haematoma.
Za, Tay; Antonowicz, Stefan; Menon, Madhav
2012-01-01
An 81-year-old man on warfarin was admitted to hospital after 3 days of constipation, straining and mild rectal bleeding. A large, boggy mass was felt posteriorly on direct rectal examination. Investigations revealed a normocytic anaemia and a supratherapeutic international normalised ratio (INR). Fearing a late presentation of malignancy, an urgent CT of abdomen and pelvis was arranged which showed a homogeneous mass arising between the sacrum and the rectum. Given the anaemia in the presence of anticoagulation, and subsequent widespread perineal and scrotal ecchymosis, the patient was diagnosed with atraumatic presacral haematoma. Following resuscitation, the patient was managed non-operatively and was discharged several days later following stabilisation of the haemoglobin and INR. At 3 months, he had complete clinical and radiological resolution of this haematoma. PMID:22605821
Pneumatocele during sorafenib therapy: first report of an unusual complication
Sangro, Paloma; Bilbao, Idoia; Fernández-Ros, Nerea; Iñarrairaegui, Mercedes; Zulueta, Javier; Bilbao, JI; Sangro, Bruno
2018-01-01
Sorafenib is a multi-kinase inhibitor and a vascular endothelial growth factor (VEGF) inhibitor approved to treat patients with advanced hepatocellular carcinoma, renal cell carcinoma and differentiated thyroid carcinoma. Its most common side effects are asthenia/fatigue, skin toxicity, diarrhea and arterial hypertension. Reported respiratory adverse reactions include dyspnea, cough, pleural effusion and hoarseness. The aim of this report is to describe for the first time the occurrence of pneumatocele in two patients treated with Sorafenib. Patients had no respiratory symptoms and alternative diagnoses were ruled out. Primary tumors were different (liver metastases from a pancreatic neuroendocrine tumor and hepatocellular carcinoma) but both patients had been treated with yttrium 90 radioembolization 9 and 17 months before starting on Sorafenib, respectively. No complications occurred and Sorafenib withdrawal was followed by radiologic improvement. PMID:29464101
Dyke-Davidoff-Masson Syndrome. An unusual cause of status epilepticus.
Zawar, Ifrah; Khan, Ashfa A; Sultan, Tipu; Rathore, Ahsan W
2015-10-01
The Dyke-Davidoff-Masson Syndrome (DDMS) results from an insult to the growing brain in utero or early infancy, which lead to loss of neurons compromising the growth of the brain. Clinical presentation includes seizures, hemiparesis, facial asymmetry, and learning disability. Radiological findings include cerebral atrophy on one side. Here, we present a case with status epilepticus who had underlying DDMS. It is a rare syndrome and uncommon cause for status epilepticus. Infections of CNS, hypoxic ischemic encephalopathy, intracranial bleed, trauma, congenital vascular malformations are the common causes of this syndrome. Diagnosis is established after clinical history, examination, and MRI. Intractable seizures can be controlled with appropriate anticonvulsants. Subsequently, these children may require physiotherapy, speech therapy, and occupational therapy in addition to the anticonvulsant medication. Outcome is better if the seizures are controlled.
Base of coracoid process fracture with acromioclavicular dislocation in a child
2010-01-01
Fracture of the coracoid process is a rare injury. It can be easily missed when associated with other injuries to the shoulder girdle, for instance, acromioclavicular joint (ACJ) dislocation. Clinical attention is easily drawn to the more obvious ACJ dislocation, hence, the need for further radiological evaluation. We report an unusual case of fracture of the base of coracoid process associated with a true acromioclavicular joint dislocation in a 12 year old boy, with no separation of the epiphyseal plate, as one might expect. Treatment also remains controversial. Our patient underwent open reduction internal fixation of the acromioclavicular joint and coracoid process. He subsequently made an uneventful progress with pain free full range of shoulder movement at 5 months, and was discharged at 9 months. PMID:20955595
Khan, Sana; Waqar Elahi, Muhammad; Ullah, Waqas; Ahmad, Ejaz; Al Mohajer, Mayar; Majeed, Aneela
2017-01-01
Mucor and Rhizopus cause life-threatening infections primarily involving the lungs and sinuses, which disseminate very rapidly by necrosis and infarction of the contiguous tissues. We present a case of a 64-year-old African American posttransplant patient who presented with a productive cough and weight loss. He had a past surgical history of renal transplant for renal cell carcinoma and was on dual immunosuppressive therapy, that is, mycophenolate and tacrolimus. During his hospital stay, he developed a pneumopericardium due to the direct extension of a lung lesion. The diagnosis was made by radiological imaging and PCR result which was consistent with Mucor species. He was treated with antifungal therapy. The purpose of this report is to highlight the unusual association of mucormycosis with pneumopericardium. PMID:28596926
Cumulative radiation dose caused by radiologic studies in critically ill trauma patients.
Kim, Patrick K; Gracias, Vicente H; Maidment, Andrew D A; O'Shea, Michael; Reilly, Patrick M; Schwab, C William
2004-09-01
Critically ill trauma patients undergo many radiologic studies, but the cumulative radiation dose is unknown. The purpose of this study was to estimate the cumulative effective dose (CED) of radiation resulting from radiologic studies in critically ill trauma patients. The study group was composed of trauma patients at an urban Level I trauma center with surgical intensive care unit length of stay (LOS) greater than 30 days. The radiology records were reviewed. A typical effective dose per study for each type of plain film radiograph, computed tomographic scan, fluoroscopic study, and nuclear medicine study was used to calculate CED. Forty-six patients met criteria. The mean surgical intensive care unit and hospital LOS were 42.7 +/- 14.0 and 59.5 +/- 28.5 days, respectively. The mean Injury Severity Score was 32.2 +/- 15.0. The mean number of studies per patient was 70.1 +/- 29.0 plain film radiographs, 7.8 +/- 4.1 computed tomographic scans, 2.5 +/- 2.6 fluoroscopic studies, and 0.065 +/- 0.33 nuclear medicine study. The mean CED was 106 +/- 59 mSv per patient (range, 11-289 mSv; median, 104 mSv). Among age, mechanism, Injury Severity Score, and LOS, there was no statistically significant predictor of high CED. The mean CED in the study group was 30 times higher than the average yearly radiation dose from all sources for individuals in the United States. The theoretical additional morbidity attributable to radiologic studies was 0.78%. From a radiobiologic perspective, risk-to-benefit ratios of radiologic studies are favorable, given the importance of medical information obtained. Current practice patterns regarding use of radiologic studies appear to be acceptable.
Resident iPad use: has it really changed the game?
Berkowitz, Seth J; Kung, Justin W; Eisenberg, Ronald L; Donohoe, Kevin; Tsai, Leo L; Slanetz, Priscilla J
2014-02-01
The purpose of this study was to assess residents' usage patterns and opinions of the iPad as a tool for radiology education and clinical practice at an academic medical center. All 38 radiology residents in our radiology program (postgraduate years 2 to 5) were provided with iPad 2 tablets and subscriptions to e-Anatomy and STATdx. After 6 months of device use, residents were surveyed to assess their opinions regarding the technology as a tool for education and clinical practice. A total of 36 residents (95%) completed the survey. Eighty-six percent reported daily iPad use. Radiology-specific applications, particularly e-Anatomy, were used weekly or daily by 88% of respondents. Most preferred to read journal articles on the iPad (70%), but the number of respondents preferring to read textbooks on the iPad (48.5%) compared with the traditional bound form (48.5%) was evenly divided. Residents were also divided on the clinical utility of the iPad. Most had not used the iPad to view radiologic examinations (75%). Fewer than half (47%) used their iPads during readout. Finally, only 12% had used the iPad to edit dictated reports. The iPad has generated excitement within the radiology community, particularly among resident educators, who are increasingly recognizing the unique needs of "millennial learners." This study showed that the majority of residents at the authors' institution have incorporated the iPad as an educational tool and use it as a learning aid. Incorporation of the iPad into clinical workflow has been less pronounced. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Wei, Youhua; Low, Albert
2017-01-01
In most large-scale programs of tests that aid in making high-stakes decisions, such as the "TOEIC"® family of products and service, it is not unusual for a significant portion of test takers to retake the test at multiple times.The study reported here used multilevel growth modeling to explore the score change patterns of nearly 20,000…
Emergency Radiology Practice Patterns: Shifts, Schedules, and Job Satisfaction.
Hanna, Tarek N; Shekhani, Haris; Lamoureux, Christine; Mar, Hanna; Nicola, Refky; Sliker, Clint; Johnson, Jamlik-Omari
2017-03-01
To assess the practice environment of emergency radiologists with a focus on schedule, job satisfaction, and self-perception of health, wellness, and diagnostic accuracy. A survey drawing from prior radiology and health care shift-work literature was distributed via e-mail to national societies, teleradiology groups, and private practices. The survey remained open for 4 weeks in 2016, with one reminder. Data were analyzed using hypothesis testing and logistic regression modeling. Response rate was 29.6% (327/1106); 69.1% of respondents (n = 226) were greater than 40 years old, 73% (n = 240) were male, and 87% (n = 284) practiced full time. With regard to annual overnight shifts (NS): 36% (n = 118) did none, 24.9% (n = 81) did 182 or more, and 15.6% (n = 51) did 119. There was a significant association between average NS worked per year and both perceived negative health effects (P < .01) and negative impact on memory (P < .01). There was an inverse association between overall job enjoyment and number of annual NS (P < .05). The odds of agreeing to the statement "I enjoy my job" for radiologists who work no NS is 2.21 times greater than for radiologists who work at least 119 NS, when shift length is held constant. Radiologists with 11+ years of experience who work no NS or 1 to 100 NS annually have lower odds of feeling overwhelmed when compared with those working the same number of NS with <10 years' experience. There is significant variation in emergency radiology practice patterns. Annual NS burden is associated with lower job satisfaction and negative health self-perception. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Langenberg, Rick van de, E-mail: rickvandelangenberg@hotmail.com; Dohmen, Amy J.C.; Bondt, Bert J. de
2012-10-01
Purpose: The purpose of this study was to evaluate the control rate of vestibular schwannomas (VS) after treatment with linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) or radiotherapy (SRT) by using a validated volumetric measuring tool. Volume-based studies on prognosis after LINAC-based SRS or SRT for VS are reported scarcely. In addition, growth patterns and risk factors predicting treatment failure were analyzed. Materials and Methods: Retrospectively, 37 VS patients treated with LINAC based SRS or SRT were analyzed. Baseline and follow-up magnetic resonance imaging scans were analyzed with volume measurements on contrast enhanced T1-weighted magnetic resonance imaging. Absence of intervention aftermore » radiotherapy was defined as 'no additional intervention group, ' absence of radiological growth was defined as 'radiological control group. ' Significant growth was defined as a volume change of 19.7% or more, as calculated in a previous study. Results: The cumulative 4-year probability of no additional intervention was 96.4% {+-} 0.03; the 4-year radiological control probability was 85.4% {+-} 0.1). The median follow-up was 40 months. Overall, shrinkage was seen in 65%, stable VS in 22%, and growth in 13%. In 54% of all patients, transient swelling was observed. No prognostic factors were found regarding VS growth. Previous treatment and SRS were associated with transient swelling significantly. Conclusions: Good control rates are reported for LINAC based SRS or SRT in VS, in which the lower rate of radiological growth control is attributed to the use of the more sensitive volume measurements. Transient swelling after radiosurgery is a common phenomenon and should not be mistaken for treatment failure. Previous treatment and SRS were significantly associated with transient swelling.« less
A dominantly inherited form of arthrogryposis multiplex congenita with unusual dermatoglyphics.
Sack, G H
1978-12-01
A father and daughter with arthrogryposis multiplex congenita and similar dermatoglyphic patterns are described. No evidence was found of chromosomal abnormality, neuropathy or myopathy, and there were no other affected family members. The findings are compatible with autosomal dominant inheritance.
A case of multicentric low-grade neuroendocrine breast tumor with an unusual histological pattern.
D'Antonio, Antonio; Addesso, Maria; Memoli, Domenico; Cascone, Annamaria; Cremone, Luigi
2016-01-01
Neuroendocrine features are detectable in carcinomas of the breast either as scattered cells, that are recognized by their expression of neuroendocrine cell markers. Instead, pure breast carcinomas with neuroendocrine features (NEBC) are very rare and represent <1% of all breast cancer. Usually NEBC may be well or poorly differentiated and more frequent in older woman. These tumors showed variable histological pattern but a common feature is represented by expression of neuroendocrine markers. Here we report a case of a primary multicentric low-grade neuroendocrine carcinoma of the breast presented because of its rarity and for the unusual tubular and cribriform pattern resembling a well-differentiated conventional breast carcinoma. The tumor was treated with left quadrantectomy with concomitant wide excisional biopsy of other two nodules and lymph node sentinel biopsy. No recurrence was observed during 1-year follow-up. Because of its rarity and variability of morphologic features, there exist diagnostic challenges for pathologists to differentiate primary NEBC to some conventional breast carcinomas and to the breast metastasis from neuroendocrine tumor of the lung or gastrointestinal tract. It is important to be able recognize this tumor in order to avoid potential misdiagnosis and improper management of afflicted patients.
Investigation occurrences of turing pattern in Schnakenberg and Gierer-Meinhardt equation
NASA Astrophysics Data System (ADS)
Nurahmi, Annisa Fitri; Putra, Prama Setia; Nuraini, Nuning
2018-03-01
There are several types of animals with unusual, varied patterns on their skin. The skin pigmentation system influences this in the animal. On the other side, in 1950 Alan Turing formulated the mathematical theory of morphogenesis, where this model can bring up a spatial pattern or so-called Turing pattern. This research discusses the identification of Turing's model that can produce animal skin pattern. Investigations conducted on two types of equations: Schnakenberg (1979), and Gierer-Meinhardt (1972). In this research, parameters were explored to produce Turing's patter on that both equation. The numerical simulation in this research done using Neumann Homogeneous and Dirichlet Homogeneous boundary condition. The investigation of Schnakenberg equation yielded poison dart frog (Andinobates dorisswansonae) and ladybird (Coccinellidae septempunctata) pattern while skin fish pattern was showed by Gierer-Meinhardt equation.
Unusual Intron Conservation near Tissue-Regulated Exons Found by Splicing Microarrays
Sugnet, Charles W; Srinivasan, Karpagam; Clark, Tyson A; O'Brien, Georgeann; Cline, Melissa S; Wang, Hui; Williams, Alan; Kulp, David; Blume, John E; Haussler, David; Ares, Manuel
2006-01-01
Alternative splicing contributes to both gene regulation and protein diversity. To discover broad relationships between regulation of alternative splicing and sequence conservation, we applied a systems approach, using oligonucleotide microarrays designed to capture splicing information across the mouse genome. In a set of 22 adult tissues, we observe differential expression of RNA containing at least two alternative splice junctions for about 40% of the 6,216 alternative events we could detect. Statistical comparisons identify 171 cassette exons whose inclusion or skipping is different in brain relative to other tissues and another 28 exons whose splicing is different in muscle. A subset of these exons is associated with unusual blocks of intron sequence whose conservation in vertebrates rivals that of protein-coding exons. By focusing on sets of exons with similar regulatory patterns, we have identified new sequence motifs implicated in brain and muscle splicing regulation. Of note is a motif that is strikingly similar to the branchpoint consensus but is located downstream of the 5′ splice site of exons included in muscle. Analysis of three paralogous membrane-associated guanylate kinase genes reveals that each contains a paralogous tissue-regulated exon with a similar tissue inclusion pattern. While the intron sequences flanking these exons remain highly conserved among mammalian orthologs, the paralogous flanking intron sequences have diverged considerably, suggesting unusually complex evolution of the regulation of alternative splicing in multigene families. PMID:16424921
Failure of a vagus nerve stimulator following a nearby lightning strike.
Terry, Garth E; Conry, Joan A; Taranto, Eleanor; Yaun, Amanda
2011-01-01
We recently reported our experience with implanted vagus nerve stimulators (VNS) in 62 children over a 7-year period. Here, we present a case of a VNS that successfully reduced the number and severity of seizures in a patient with an unusual seizure pattern, and failed to function shortly after a lightning storm. To our knowledge, the failure of VNS or any implantable electrical devices by lightning has not been reported in the literature. This mechanism of electrical interference, while unusual, may require more attention as these devices are expected to be used more frequently. Copyright © 2011 S. Karger AG, Basel.
Macchi, Veronica; Picardi, Edgardo; Inferrera, Antonino; Porzionato, Andrea; Crestani, Alessandro; Novara, Giacomo; De Caro, Raffaele; Ficarra, Vincenzo
2018-02-01
The aim of the present anatomic and radiologic study was to evaluate the location, extension, and characteristics of the Brödel's plane and eventually define its different patterns. We evaluated 15 human normal kidneys sampled from unembalmed cadavers without clinical history or anatomical evidence of renal diseases. Kidneys with the surrounding perirenal fat tissue were removed en bloc with the abdominal segment of the aorta. The renal artery was injected with acrylic and radiopaque resins. A CT examination of the injected kidneys was performed. After the imaging acquisition, the specimens were treated with sodium hydroxide for removal of the parenchyma to obtain the vascular casts. All the CT images were elaborated using dedicated three-dimensional (3D) software with the aim to improve the possibility to identify the Brödel's plane. The avascular plane was identified directly on the vascular casts and confirmed on the corresponding 3D images. The avascular plane was located in all cases medially to the lateral convex border of the kidneys. The recorded mean distance was 2.04 cm (range 1.8-2.4 cm). Three patterns of distribution of the Brödel's line were identified. In five (33.3%) cases the avascular plane was extended from the apical to the inferior segment of the kidneys (type 1); in six (40%) from the superior to the inferior segment (type 2); and in four (26.7%) from the apical to the middle segment (type 3). Fourth and fifth order vessels crossing the Brödel's line were detected in all the analyzed cases. The renal avascular plane showed a different extension allowing us to cluster three different patterns. Preoperative identification of the Brödel's line patterns could help surgeons to minimize hemorrhagic complications during percutaneous and surgical procedures requiring an incision of the renal parenchyma such as traditional or robot-assisted nephrolithotomy or partial nephrectomy for endophytic renal tumors. Radiologic studies validated that the described patterns in the clinical practice are strongly needed.
NASA Astrophysics Data System (ADS)
Sylwester, Barbara; Sylwester, Janusz; Siarkowski, Marek; Gburek, Szymon; Phillips, Kenneth
Very high sensitivity of SphinX soft X-ray spectrophotometer aboard Coronas-Photon allows to observe spectra of small X-ray brightenings(microflares), many of them with maximum intensities well below the GOES or RHESSI sensitivity thresholds. Hundreds of such small flare-like events have been observed in the period between March and November 2009 with energy resolution better than 0.5 keV. The spectra have been measured in the energy range extending above 1 keV. In this study we investigate the time variability of basic plasma parameters: temperature T and emission measure EM for a number of these weak flare-like events and discuss respective evolutionary patterns on the EM-T diagnostic diagrams. For some of these events, unusual behavior is observed, different from this characteristic for a "normal" flares of higher maximum intensities. Physical scenarios providing possible explanation of such unusual evolutionary patterns will be discussed.
Ingram, G C; Goodrich, J; Wilkinson, M D; Simon, R; Haughn, G W; Coen, E S
1995-09-01
The unusual floral organs (ufo) mutant of Arabidopsis has flowers with variable homeotic organ transformations and inflorescence-like characteristics. To determine the relationship between UFO and previously characterized meristem and organ identity genes, we cloned UFO and determined its expression pattern. The UFO gene shows extensive homology with FIMBRIATA (FIM), a gene mediating between meristem and organ identity genes in Antirrhinum. All three UFO mutant alleles that we sequenced are predicted to produce truncated proteins. UFO transcripts were first detected in early floral meristems, before organ identity genes had been activated. At later developmental stages, UFO expression is restricted to the junction between sepal and petal primordia. Phenotypic, genetic, and expression pattern comparisons between UFO and FIM suggest that they are cognate homologs and play a similar role in mediating between meristem and organ identity genes. However, some differences in the functions and genetic interactions of UFO and FIM were apparent, indicating that changes in partially redundant pathways have occurred during the evolutionary divergence of Arabidopsis and Antirrhinum.
Vortex arrays and ciliary tangles underlie the feeding-swimming tradeoff in starfish larvae
NASA Astrophysics Data System (ADS)
Gilpin, William; Prakash, Vivek N.; Prakash, Manu
2016-11-01
Many marine invertebrates have larval stages covered in linear arrays of beating cilia, which propel the animal while simultaneously entraining planktonic prey. These bands are strongly conserved across taxa spanning four major superphyla, and they are responsible for the unusual morphologies of many invertebrates. However, few studies have investigated their underlying hydrodynamics. Here, we study the ciliary bands of starfish larvae, and discover a beautiful pattern of slowly-evolving vortices that surrounds the swimming animals. Closer inspection of the bands reveals unusual ciliary "tangles" analogous to topological defects that break-up and re-form as the animal adjusts its swimming stroke. Quantitative experiments and modeling demonstrate that these vortices create a physical tradeoff between feeding and swimming in heterogenous environments, which manifests as distinct flow patterns or "eigenstrokes" representing each behavior-potentially implicating neuronal control of cilia. This quantitative interplay between larval form and hydrodynamic function generalizes to other invertebrates, and illustrates the potential effects of active boundary conditions in other biological and synthetic systems.
Brain injury patterns in hypoglycemia in neonatal encephalopathy.
Wong, D S T; Poskitt, K J; Chau, V; Miller, S P; Roland, E; Hill, A; Tam, E W Y
2013-07-01
Low glucose values are often seen in term infants with NE, including HIE, yet the contribution of hypoglycemia to the pattern of neurologic injury remains unclear. We hypothesized that MR features of neonatal hypoglycemia could be detected, superimposed on the predominant HIE injury pattern. Term neonates (n = 179) with NE were prospectively imaged with day-3 MR studies and had glucose data available for review. The predominant imaging pattern of HIE was recorded as watershed, basal ganglia, total, focal-multifocal, or no injury. Radiologic hypoglycemia was diagnosed on the basis of selective edema in the posterior white matter, pulvinar, and anterior medial thalamic nuclei. Clinical charts were reviewed for evidence of NE, HIE, and hypoglycemia (<46 mg/dL). The predominant pattern of HIE injury imaged included 17 watershed, 25 basal ganglia, 10 total, 42 focal-multifocal, and 85 cases of no injury. A radiologic diagnosis of hypoglycemia was made in 34 cases. Compared with laboratory-confirmed hypoglycemia, MR findings had a positive predictive value of 82% and negative predictive value of 78%. Sixty (34%) neonates had clinical hypoglycemia before MR imaging. Adjusting for 5-minute Apgar scores and umbilical artery pH with logistic regression, clinical hypoglycemia was associated with a 17.6-fold higher odds of MR imaging identification (P < .001). Selective posterior white matter and pulvinar edema were most predictive of clinical hypoglycemia, and no injury (36%) or a watershed (32%) pattern of injury was seen more often in severe hypoglycemia. In term infants with NE and hypoglycemia, specific imaging features for both hypoglycemia and hypoxia-ischemia can be identified.
Hoverboards: spectrum of injury and association with an uncommon fracture.
Schapiro, Andrew H; Lall, Neil U; Anton, Christopher G; Trout, Andrew T
2017-04-01
Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. The purpose of this study is to determine the spectrum of radiologically apparent injuries associated with hoverboard use. We retrospectively reviewed all imaging studies interpreted at our institution for hoverboard-related injuries during an 8-month period. We recorded patient demographics and injury characteristics. Thirty-two of the 47 pediatric patients imaged for hoverboard-related injury had radiologically detectable injuries, all fractures. Fifty percent of these 32 patients were female and 50% were male, with a mean age of 12.4 years. There were 42 fractures total, all involving the appendicular skeleton, with 74% in the upper extremities and 26% in the lower extremities. Thirty-eight percent of the fractures involved the physis. A distinct injury pattern was seen in three patients who sustained open distal phalanx juxta-epiphyseal fractures. Most of the fractures sustained during hoverboard use are commonly seen in everyday pediatric radiology practice, with an overall pattern paralleling that reported in association with skateboard use. However an otherwise uncommon fracture, the distal phalanx juxta-epiphyseal fracture, was identified in association with hoverboard use, and this finding has important treatment implications including need for irrigation and debridement, antibiotic therapy, and potential surgical fixation.
Las Heras, Alfonso; Vela, Ana I.; Fernández, Elena; Legaz, Emilio; Domínguez, Lucas; Fernández-Garayzábal, Jose F.
2002-01-01
This work describes an outbreak of clinical mastitis affecting 13 of 58 lactating ewes due to Streptococcus equi subsp. zooepidemicus. S. equi subsp. zooepidemicus was isolated in pure culture from all milk samples. All the clinical isolates had identical biochemical profiles and antimicrobial susceptibility patterns and also exhibited indistinguishable macrorestriction patterns by pulsed-field gel electrophoresis, indicating that all cases of mastitis were produced by a single strain. PMID:11880454
Treatment of pulmonary brucellosis: a systematic review.
Solera, Javier; Solís García Del Pozo, Julián
2017-01-01
Pulmonary involvement is a rare, focal complication of human brucellosis. The aim of this review is to describe clinical and radiologic features, treatment administered and clinical course of these patients. Areas covered: We conducted a systematic search of scientific reports of brucellosis with pulmonary involvement published from January 1985 to July 2016. Four main patterns of disease were observed: pneumonia, pleural effusion, nodules and interstitial pattern. Cough and fever were the most common symptoms. Brucella spp. culture was obtained from blood (50%) or pleural fluid. Treatment is based on the same antibiotics and combinations of antibiotics as for patients with acute no complicated brucellosis. The most frequent antimicrobial combination was doxycycline and rifampin for six weeks. The clinical course was favorable in most reports, and mortality was remarkably low (<1%). Expert commentary: Non-specific clinical and radiological manifestations were the main reason for the delay in proper treatment. Difficulty in distinguishing Brucellosis from other pulmonary infections, such as tuberculosis, sometimes posed an added diagnostic challenge.
Jordan, Andrew; Lyne, Jonathan; Wong, Tom
2010-04-01
A case of cardiomyopathy and ventricular tachycardia previously assumed to be idiopathic in origin is described. Investigation with cardiac magnetic resonance imaging prompted the diagnosis and successful treatment of an underlying disorder based on typical scarring patterns seen with late gadolinium enhancement. The present report suggests that clinicians should have a low threshold for actively excluding this condition in patients presenting with cardiomyopathy, even in the absence of other disease features, particularly if typical scarring patterns are found on cardiac magnetic resonance imaging because disease-specific therapy appears to significantly improve both symptoms and prognosis.
An unusual metastasis of a papillary thyroidian carcinoma with follicular pattern.
Coconu, M; Berdan, G; Roşculescu, I; Herlea, V
1998-01-01
The case of a 67-year-old man is presented. He was admitted for the presence of a left parietal tumour with progressive growing, without any other objective or subjective symptomatology. CT-scan detects a left parietal osteolytic area. The histopathological aspect suggested an adenocarcinomatous metastasis with papillary pattern, moderately differentiated. With the purpose of diagnosing the original tumour, immunnohistochemical techniques were performed, which led to a diagnosis of a thyroidian carcinoma. At the histological examination of the surgical extirpated thyroid, it was proved to be a papillary carcinoma (Chan, 1990, Hay, 1990), the follicular pattern.
Unusual hydrogen bonding patterns in AF (aminofluorene) and AAF (acetylaminofluorene) modified DNA
DOE Office of Scientific and Technical Information (OSTI.GOV)
Broyde, S.; Hingerty, B.E.; Shapiro, R.
1989-01-01
New structures are presented for AF and AAF modified DNAs that place the carcinogen in the minor groove of a B-DNA helix. These structures employ non-Watson-Crick base pairing schemes with syn guanine at the modification site. 32 refs., 9 figs.
Understanding Williams Syndrome: Behavioral Patterns and Interventions.
ERIC Educational Resources Information Center
Semel, Eleanor; Rosner, Sue R.
This guide to Williams syndrome (WS), a congenital disorder characterized by developmental/cognitive limitations but relatively high verbal and social skills, explains the strengths, difficulties and variations found among individuals with the condition and offers guidelines for intervention in the unusual properties of the WS behavioral profile.…
Coexistent Superscan and Lincoln Sign on Bone Scintigraphy.
Kulkarni, Mukta; Soni, Atul; Shetkar, Shubhangi; Amer, Momin; Mulavekar, Amruta; Joshi, Prathamesh
2017-08-01
A 70-year-old man underwent Tc-methylene diphosphonate scintigraphy for staging of adenocarcinoma prostate. Scintigraphy revealed diffuse increased tracer uptake in skeletal system along with faint renal visualization, a pattern compatible with metastatic superscan. The scintigraphy also revealed increased radiotracer uptake in the body of the mandible-Lincoln sign or black beard sign. Radiological imaging revealed sclerotic lesions throughout the skeleton including the mandible, confirming widespread skeletal metastases. Lincoln sign is previously described in monostotic Paget disease of the mandible and in contiguous spread of oral malignancy. We describe this pattern in distant metastatic involvement from carcinoma prostate with coexistent superscan pattern.
Bouali, Sofiene; Said, Imed Ben; Yedeas, Mohamed Dahmani; Abderrahmen, Khansa; Maatar, Nidhal; Boubaker, Adnen; Kallel, Jalel; Jemel, Hafedh
2016-03-01
Involvement of the orbit with Burkitt's lymphoma is a very rare presentation of extra-nodal lymphoma. We report a case of a 2-year-old female presented an unusual location of sporadic Burkitt's lymphoma arising in the orbital region. Diagnostic magnetic resonance imagining identified an oval-shaped mass on the lateral rectus of the right orbit that caused dislocation of eyeball, for which she underwent a biopsy from the periorbital swellings. The mass was histologically confirmed as Burkitt's lymphoma, and postoperative aggressive chemotherapy was initiated. We describe clinical diagnosis, histological aspects, radiological features, and current management of this rapidly growing malignant tumor. Because of the rapid progression of Burkitt lymphoma, and considering that it responds well to treatment, early recognition and appropriate management are important factors for survival and to preserve visual function.
Abdulkadir, Kocer; Buket, Sanlisoy; Dilek, Agircan; Munevver, Okay; Ayse, Aralasmak
2015-04-01
Otitis media is a well-known condition and its infra-temporal and intracranial complications are extremely rare because of the widespread usage of antibiotic treatment. We report a case of 63-year-old female with complaints of right-sided facial pain and diplopia. She had a history of acute otitis media before 4 months of admission to our neurology unit. Neurological examination showed that total ophthalmoplegia with ptosis, mydriasis, decreased vision and loss of pupil reflex on the right side. In addition, there was involvement of 5th and 7th cranial nerves. Neurological and radiological follow-up examinations demonstrated Jacod's Syndrome with unusual facial nerve damage and infection in aetiology. Sinusitis is the most common aetiology, but there are a few cases reported Jacod's Syndrome originating from otitis media.
Aspergillus infection of the neck with an extradural component: an unusual presentation.
Lin, M B; Chee, S G
1995-12-01
A 66-year-old Chinese male, diabetic and hypertensive for more than 10 years, had excision of right cerebellar abscess in 1985. Histology then was suggestive of Aspergillus colonies. He presented to the ENT Department 7 years later, in September 1992, with complaints of a left-sided neck lump and fullness for 3 months which was shown on histology and culture to be Aspergillosis. CT scan findings revealed extradural involvement with erosions of parts of the cervical vertebrae. The patient, however, did not show any signs of spinal cord involvement. This case illustrates the long indolent period which Aspergillus infection can take. It also highlights the fact that it can mimic the radiological features of a highly malignant lesion. Follow-up CT scans of the patient revealed resolution of the lesion with itraconazole therapy.
A Case of Masson's Tumor of the Penis Presenting as Chronic Pelvic Pain Syndrome.
Yanev, Krasimir; Krastanov, Aleksander; Georgiev, Marincho; Tonev, Andrian; Timev, Alexander; Elenkov, Angel
2018-03-17
The intravascular papillary endothelial hyperplasia (IPEH) or Masson's tumor is an unusual and rare benign disease.It is histologically characterized by papillary and anastomosing channel-like structures lined by proliferating e n dothelium. Radiologically, it is usually presented as a heterogenic solid mass with contrast enhancement, withareas resembling necrosis and thrombosis. These signs can easily be attributed to malignancy. The urogenital tractis extremely rarely affected with only 8 cases described in the kidneys and one of the penis. We present a rarecase of IPEH at the base of the penis, visible only on MRI, causing chronic pelvic pain and erectile dysfunction.According to available English literature our case is the first in this pelvic location and only the second to affect thepenis. Radical excision of the formation cured the condition.
An unusual case of concurrent insulinoma and nesidioblastosis.
Bright, Elizabeth; Garcea, Giuseppe; Ong, Seok L; Madira, Webster; Berry, David P; Dennison, Ashley R
2008-09-02
Endogenous hyperinsulinaemic hypoglycaemia in adults is most commonly caused by an insulinoma. Adult nesidioblastosis is rarely reported. To the best of our knowledge the presence of both insulinoma and nesidioblastosis has not been reported before. We report a case of a 35-year-old female presenting with neuroglycaemic symptoms. A supervised 72-hour fast confirmed hypoglycaemia in the presence of hyperinsulinaemia. Thorough pre-operative biochemical and radiological investigations, including selective splenic, superior mesenteric and portal venous sampling inferred a tentative diagnosis of adult nesidioblastosis. However, a grossly elevated insulin level within the splenic vein on a second set of venous sampling produced a high index of suspicion for the presence of an insulinoma. At surgical exploration both an insulinoma and nesidioblastosis were identified and confirmed by histological examination. We report an even rarer entity of concurrent insulinoma and nesidioblastosis.
Shiraishi, Wataru; Hayashi, Shintaro; Iwanaga, Yasutaka; Murai, Hiroyuki; Yamamoto, Akifumi; Kira, Jun-ichi
2015-02-15
A 43-year-old woman with a 3-year history of headache, fever, and swelling of the forehead, presented to our hospital. A general examination revealed palmar and plantar pustules. Blood analyses showed an elevated white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Brain MRI revealed a partially thickened cranial bone with gadolinium enhancement, and also abnormally enhanced dura mater. Bone scintigraphy showed involvement of the cranial bone and bilateral sternoclavicular joints. Palmar skin biopsy indicated palmoplantar pustulosis. From these results, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome with associated hypertrophic pachymeningitis was diagnosed. After corticosteroid therapy and tonsillectomy, the clinical symptoms and radiological abnormalities were improved. Clinicians should be aware of SAPHO as a potential unusual cause of hypertrophic pachymeningitis. Copyright © 2014 Elsevier B.V. All rights reserved.
Subhadarshani, Sweta; Gupta, Vishal; Chahal, Anurag; Verma, Kaushal K
2017-06-15
We report a young female who presented with saddle-nose and bilateral cauliflower ear deformities along with pyoderma gangrenosum-like ulcers, digital gangrene and pulselessness. Subsequently, she was found to have bilateral conductive hearing loss, a corneal opacity, mild aortic regurgitation and radiological evidence of cavitary changes in lungs and aortoarteritis. Our patient had a constellation of symptoms which posed a diagnostic challenge. Finally, a diagnosis of relapsing polychondritis with several unusual features was made. Overlap with Takayasu's arteritis and granulomatosis with polyangitis, which has been reported rarely in the literature, cannot be excluded. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Visual Neuroscience: A Retinal Ganglion Cell to Report Image Focus?
Baden, Tom; Schaeffel, Frank; Berens, Philipp
2017-02-20
A recent study describes a mouse neuron projecting from the retina to the brain that exhibits exquisitely high sensitivity to high spatial frequency patterns presented over an unusually large receptive field: could this cell be a (de)focus detector? Copyright © 2017 Elsevier Ltd. All rights reserved.
Human Performance in Continuous Operations: Volume 1. Human Performance Guidelines
1979-12-01
seemingly capable of enduring unusual degrees of stress and fatigue when nec- essary. When a soldier is driven by the motivation to survive, by exemplary...Vulnerabilities to degradation --Artillery 470 PS4 -?--- -. Armor Task Vulnerabilit.y The pattern of vulnurabihlties Ior tank platoon personnel (tl’Fiure 8. 2
Language and Development in FG Syndrome with Callosal Agenesis.
ERIC Educational Resources Information Center
McCardle, Peggy; Wilson, Bruce
1993-01-01
The FG syndrome is characterized by unusual facies; sudden infant death; developmental delay; and abnormalities of the cardiac, gastrointestinal, and central nervous systems. Serial evaluations of one case with isolated agenesis of the corpus callosum found consistent patterns over time in specific language impairments in syntactic and…
Angioma serpiginosum: report of an unusual acral case and review of the literature*
Freites-Martinez, Azael; Martinez-Sanchez, Diego; Moreno-Torres, Amalia; Huerta-Brogeras, Maria; Núñez, Almudena Hernández; Borbujo, Jesus
2015-01-01
We report the case of a 35-year-old woman with deep-red asymptomatic macules on the plantar and dorsal skin of the right great toe. Histopathologic fi ndings were compatible with Angioma serpiginosum. Immunohistochemical stains for estrogens and progesterone receptors were negative. Dermoscopy showed an erythematous parallel ridge pattern with double rows of irregular dots and globules. We report an unusual case of angioma serpiginosum with acral volar skin involvement. The dermoscopic features described may aid in the diagnosis of AS in this specifi c skin area. Acral volar skin involvement must be included in the clinical spectrum of Angioma serpiginosum and in the differential diagnosis of acral vascular lesions. PMID:26312666
Erdem, Guliz; Ford, Jacqueline M.; Kanenaka, Rebecca Y.; Abe, Lucienne; Yamaga, Karen; Effler, Paul V.
2006-01-01
Two clusters of necrotizing fasciitis (NF) due to group A streptococcus (GAS) were identified on the Hawaiian islands of Kauai and Maui during 1997 and 2002, respectively. The emm gene sequence types and the pulsed-field gel electrophoresis patterns were determined for 6 isolates recovered from patients with NF and for 116 isolates recovered from patients with temporally associated community-acquired GAS infection. No predominant emm type was identified, and the emm types of 64 (52.5%) of the isolates were considered to be uncommon in the continental United States. These findings suggest that unusual emm types might be responsible for invasive GAS infections in patients from Hawaii. PMID:15909276
Myxomatosis on the Western Plains of Victoria.
Tighe, F. G.; Edmonds, J. W.; Nolan, I. F.; Shepherd, R. C.; Gocs, A.
1977-01-01
Myxomatosis on the Western Plains is an enzootic disease in contrast with the epizootic pattern which is general in eastern Australia. The most unusual aspects are the presence of significant numbers of diseased rabbits throughout the winter and the continuously low percentage of rabbits with antibodies to myxoma virus. Climatic and topographic conditions are unsuited to the production of the high densities of mosquitoes necessary for widespread epizootics. Under these conditions the effects of less efficient methods of myxomatosis transmission are apparent. The unusual epidemiology of myxomatosis has resulted in selection for virulence of the virus similar to that which has occurred under summer epizootic conditions. All field strains are now in the mid range of virulence. PMID:20473
Myxomatosis on the Western Plains of Victoria.
Tighe, F G; Edmonds, J W; Nolan, I F; Shepherd, R C; Gocs, A
1977-10-01
Myxomatosis on the Western Plains is an enzootic disease in contrast with the epizootic pattern which is general in eastern Australia. The most unusual aspects are the presence of significant numbers of diseased rabbits throughout the winter and the continuously low percentage of rabbits with antibodies to myxoma virus. Climatic and topographic conditions are unsuited to the production of the high densities of mosquitoes necessary for widespread epizootics. Under these conditions the effects of less efficient methods of myxomatosis transmission are apparent. The unusual epidemiology of myxomatosis has resulted in selection for virulence of the virus similar to that which has occurred under summer epizootic conditions. All field strains are now in the mid range of virulence.
Thakar, Sumit; Dadlani, Ravi; Tawari, Manish; Hegde, Alangar S
2014-01-01
Symptomatic cerebellar slump (CS) and external hydrocephalus (EH) are amongst the rarer complications of foramen magnum decompression (FMD) for Chiari I malformation (CM). CS typically presents with delayed onset headache related to dural traction or with neurological deficit offsetting the benefit of FMD. EH, consisting of ventriculomegaly along with subdural fluid collection(s) (SFCs), has been related to cerebrospinal fluid egress from a tiny breach in an otherwise intact arachnoid. We describe the case of a 21-year-old man with CM and syringomyelia who presented with impaired gag, spastic quadriparesis, and raised intracranial pressure 1 week following an uneventful FMD during which the arachnoid had been widely fenestrated. Magnetic resonance imaging (MRI) showed an infratentorial SFC, dilated aqueduct and triventriculomegaly, features of CS, and a residual but resolving syrinx. His symptoms resolved following a high pressure ventriculo-peritoneal shunt. At a 6-month follow-up visit, he was asymptomatic and demonstrated partial resolution of the syrinx, with no recurrence of the SFC. The unusual features in the clinical course of this patient were an atypical CS syndrome presenting with concomitantly resolving syringomyelia, and the development of EH after a wide arachnoidal fenestration. This is the first case in indexed literature describing such a combination of unusual postoperative complications of a FMD. A hypothesis is presented to explain the clinico-radiological findings of the case.
THAKAR, Sumit; DADLANI, Ravi; TAWARI, Manish; HEGDE, Alangar S
2014-01-01
Symptomatic cerebellar slump (CS) and external hydrocephalus (EH) are amongst the rarer complications of foramen magnum decompression (FMD) for Chiari I malformation (CM). CS typically presents with delayed onset headache related to dural traction or with neurological deficit offsetting the benefit of FMD. EH, consisting of ventriculomegaly along with subdural fluid collection(s) (SFCs), has been related to cerebrospinal fluid egress from a tiny breach in an otherwise intact arachnoid. We describe the case of a 21-year-old man with CM and syringomyelia who presented with impaired gag, spastic quadriparesis, and raised intracranial pressure 1 week following an uneventful FMD during which the arachnoid had been widely fenestrated. Magnetic resonance imaging (MRI) showed an infratentorial SFC, dilated aqueduct and triventriculomegaly, features of CS, and a residual but resolving syrinx. His symptoms resolved following a high pressure ventriculo-peritoneal shunt. At a 6-month follow-up visit, he was asymptomatic and demonstrated partial resolution of the syrinx, with no recurrence of the SFC. The unusual features in the clinical course of this patient were an atypical CS syndrome presenting with concomitantly resolving syringomyelia, and the development of EH after a wide arachnoidal fenestration. This is the first case in indexed literature describing such a combination of unusual postoperative complications of a FMD. A hypothesis is presented to explain the clinico-radiological findings of the case. PMID:24257499
Radiomics: a new application from established techniques
Parekh, Vishwa; Jacobs, Michael A.
2016-01-01
The increasing use of biomarkers in cancer have led to the concept of personalized medicine for patients. Personalized medicine provides better diagnosis and treatment options available to clinicians. Radiological imaging techniques provide an opportunity to deliver unique data on different types of tissue. However, obtaining useful information from all radiological data is challenging in the era of “big data”. Recent advances in computational power and the use of genomics have generated a new area of research termed Radiomics. Radiomics is defined as the high throughput extraction of quantitative imaging features or texture (radiomics) from imaging to decode tissue pathology and creating a high dimensional data set for feature extraction. Radiomic features provide information about the gray-scale patterns, inter-pixel relationships. In addition, shape and spectral properties can be extracted within the same regions of interest on radiological images. Moreover, these features can be further used to develop computational models using advanced machine learning algorithms that may serve as a tool for personalized diagnosis and treatment guidance. PMID:28042608
Methamphetamine-induced toxic leukoencephalopathy: clinical, radiological and autopsy findings.
Mu, Jiao; Li, Meiyu; Guo, Ying; Lv, Bin; Qiu, Mingjie; Dong, Hongmei
2017-09-01
Toxic leukoencephalopathy represents a process of structural alteration of the white matter. It is caused by substance abuse including drugs such as heroin, cocaine, toluene and ethanol. We reported the clinical, radiological and autopsy findings of a rare case of toxic leukoencephalopathy following chronic methamphetamine (MA) usage. A 34-year-old man with a 3-year history of MA abuse experienced progressive sluggish state, limb weakness, inability to stand and eating disorders, followed by rapid progression to coma and death. Imaging revealed hypodense CT and long T1 and T2 signals in MRI in the white matter of the bilateral periventricular and centrum semiovale regions. Histologically, white matter rarefaction, loss of myelin and axonal injury were observed. This pattern of clinical presentation, radiological manifestations and histological findings show a certain degree of particularity in toxic leukoencephalopathy. Clinically, the condition may be easily misdiagnosed as withdrawal symptoms. In suspected cases, MRI is recommended for diagnosis. The case reported here reminds clinicians and forensic pathologist of the possibility of toxic leukoencephalopathy related to MA abuse.
[Cryptorchidism with didymo-epididymal dissociation and Robinow's syndrome: 2 case reports].
Fabbro, M A; D'Agostino, S; Costa, L; Musi, L; Cappellari, F
1997-01-01
Two brothers of normal not consanguineous parents, with bilateral intrabdominal cryptorchidism, were admitted to our Institution. Both children had short stature, limb and hand malformations and craniofacial patterns of Robinow syndrome. During the orchidopexy, bilateral epididymal and vasal abnormalities were found in both of them. This anomaly associated with Robinow syndrome has never been reported before. These two cases provides the Authors with the opportunity of reviewing clinical features, genetics and radiological patterns of this rare syndrome.
Kim, Sanghee; Lim, Byung-Jin; Min, Gi-Sik; Choi, Han-Gu
2013-05-10
Copepoda is the most diverse and abundant group of crustaceans, but its phylogenetic relationships are ambiguous. Mitochondrial (mt) genomes are useful for studying evolutionary history, but only six complete Copepoda mt genomes have been made available and these have extremely rearranged genome structures. This study determined the mt genome of Calanus hyperboreus, making it the first reported Arctic copepod mt genome and the first complete mt genome of a calanoid copepod. The mt genome of C. hyperboreus is 17,910 bp in length and it contains the entire set of 37 mt genes, including 13 protein-coding genes, 2 rRNAs, and 22 tRNAs. It has a very unusual gene structure, including the longest control region reported for a crustacean, a large tRNA gene cluster, and reversed GC skews in 11 out of 13 protein-coding genes (84.6%). Despite the unusual features, comparing this genome to published copepod genomes revealed retained pan-crustacean features, as well as a conserved calanoid-specific pattern. Our data provide a foundation for exploring the calanoid pattern and the mechanisms of mt gene rearrangement in the evolutionary history of the copepod mt genome. Copyright © 2012 Elsevier B.V. All rights reserved.
Han, Daniel Seung Youl; Han, Yea Sik; Park, Jin Hyung
2011-11-01
A radiologic examination is required in the treatment of nasal bone fracture to determine the fracture condition. Thus, there is an increasing need for radiologic classification of nasal bone fractures that can be applied to clinical practice. Computed tomography was performed in 125 patients with nasal bone fractures to determine which axial view best showed the entire nasal view. The obtained axial view was then used as a reference for classification. The length from the top to the base of the nasal bone was divided into upper, middle, and lower levels, after which the fracture location was determined. If the fracture spanned the boundaries of these levels, it was classified as the total level. Subsequently, the fracture was subclassified based on the fracture direction and pattern and the concurrent fracture. Radiologic examination of patients with nasal bone fracture showed that nasal bone fracture was frequently found at the total, middle, upper, and lower levels, in that order. Nasal bone fractures at the upper level showed lower frequencies of complication and reoperation than the fractures at the other levels, whereas nasal bone fractures at the total level showed the highest frequencies of complication and reoperation. Radiologic classification can be useful for preoperative and postoperative evaluations of nasal bone fractures and can be helpful in understanding such fractures because it can efficiently predict the prognosis of a fracture. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Coordinating patient care within radiology and across the enterprise.
McEnery, Kevin W
2014-12-01
For the practice of radiology, the transition to filmless imaging operations has resulted in a fundamental transition to more efficient clinical operations. In addition, the electronic delivery of diagnostic studies to the bedside has had a great impact on the care process throughout the health care enterprise. The radiology information system (RIS) has been at the core of the transition to filmless patient care. In a similar manner, the electronic medical record (EMR) is fundamentally and rapidly transforming the clinical enterprise into paperless/digital coordination of care. The widespread availability of EMR systems can be predicted to continue to increase the level of coordination of clinical care within the EMR framework. For the radiologist, readily available clinical information at the point of interpretation will continue to drive the evolution of the interpretation process, leading to improved patient outcomes. Regardless of practice size, efficient workflow processes are required to best leverage the functionality of IT systems. The radiologist should be aware of the scope of the RIS capabilities that allow for maximizing clinical benefit, and of the EMR system capabilities for improving = clinical imaging practice and care coordination across the enterprise. Radiology departments should be actively involved in forming practice patterns that allow efficient EMR-based clinical practice. This summary article is intended to assist radiologists in becoming active participants in the evolving role of both the RIS and EMR systems in coordinating efficient and effective delivery across the clinical enterprise. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Vasu, Tajender S; Cavallazzi, Rodrigo; Hirani, Amyn; Sharma, Dinesh; Weibel, Sandra B; Kane, Gregory C
2009-08-01
Bronchiolitis obliterans organizing pneumonia (BOOP) is a distinct pattern of reaction of the lung to injury. It may be idiopathic or secondary to a variety of injuries. The term cryptogenic organizing pneumonia (COP) is used for patients with idiopathic BOOP. In this study we describe clinical and radiologic features of patients with BOOP. The medical records of 33 patients with diagnosis of BOOP on surgical lung biopsy over a 10-year time period were reviewed retrospectively. We obtained data on clinical and radiologic manifestations, etiology, and outcome of these patients. Dyspnea was the most common symptom, followed by dry cough and fever. Crackles was the most common physical finding. Mean age at diagnosis of BOOP was 59 years, and 42% were females. The main radiologic manifestation was bilateral patchy consolidation. Most patients had favorable prognosis; however, 17% did not respond to treatment. Female sex was more common in COP than in secondary BOOP (P = .004). Patients with COP had longer symptom duration before the diagnosis than secondary BOOP (P = .01). Patients with secondary BOOP reported fever more frequently, compared to COP (P = .005). Pleural effusion was present in 60% of patients with secondary BOOP, whereas none of the patients with COP had effusion (P = .004). COP and secondary BOOP have diverse clinical and radiologic manifestations. Patients with secondary BOOP are more symptomatic. Both COP and secondary BOOP patients have good prognosis, and most respond to treatment with corticosteroids or by discontinuing the injurious drug.
Thali, Michael J; Braun, Marcel; Wirth, Joachim; Vock, Peter; Dirnhofer, Richard
2003-11-01
A main goal of forensic medicine is to document and to translate medical findings to a language and/or visualization that is readable and understandable for judicial persons and for medical laymen. Therefore, in addition to classical methods, scientific cutting-edge technologies can and should be used. Through the use of the Forensic, 3-D/CAD-supported Photogrammetric method the documentation of so-called "morphologic fingerprints" has been realized. Forensic, 3-D/CAD-supported Photogrammetry creates morphologic data models of the injury and of the suspected injury-causing instrument allowing the evaluation of a match between the injury and the instrument. In addition to the photogrammetric body surface registration, the radiological documentation provided by a volume scan (i.e., spiral, multi-detector CT, or MRI) registers the sub-surface injury, which is not visible to Photogrammetry. The new, combined method of merging Photogrammetry and Radiology data sets creates the potential to perform many kinds of reconstructions and postprocessing of (patterned) injuries in the realm of forensic medical case work. Using this merging method of colored photogrammetric surface and gray-scale radiological internal documentation, a great step towards a new kind of reality-based, high-tech wound documentation and visualization in forensic medicine is made. The combination of the methods of 3D/CAD Photogrammetry and Radiology has the advantage of being observer-independent, non-subjective, non-invasive, digitally storable over years or decades and even transferable over the web for second opinion.
Abbritti, M; Mazzei, M A; Bargagli, E; Refini, R M; Penza, F; Perari, M G; Volterrani, L; Rottoli, P
2012-08-01
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease that occurs almost exclusively in smokers, generally young adults between 20 and 40 years old. Prognostic biomarkers of the disease are lacking. This study describes the clinical-radiological features of a group of PLCH patients and applies a semi-quantitative CT score of the chest to verify the prognostic value of radiological findings in this disease. Clinical-radiological and immunological data from 12 Caucasian patients (6M, 7 smokers and 5 ex-smokers, mean age 36±8 years) were recorded at onset and after a follow-up period of 4 years. Application of the semi-quantitative CT score revealed a prevalently cystic pattern at onset and follow-up in the majority of the patients. Patients with a prevalently nodular pattern developed cystic lesions during follow-up. Interestingly, significant correlations were found between the extent of cystic lesions and DLCO values at onset (time 0: p<0.05) and at the end of follow-up (time 1, p<0.05) and with FEV1 values at time 0 (p<0.05) and time 1 (p<0.05). Patients with progressive functional decline were those with CT evidence of severe cystic alterations. The results suggest that high resolution CT scan of the chest is mandatory for characterizing PLCH patients at diagnosis and during follow-up. The proposed CT score of the chest showed potential prognostic value. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Chitnavis, J; Sinsheimer, J S; Suchard, M A; Clipsham, K; Carr, A J
2000-06-01
To determine and compare the aetiological background, clinical patterns and radiological features of idiopathic osteoarthritis (OA) of the hip and the knee warranting arthroplasty. A total of 402 Caucasians consecutively undergoing total hip replacement (THR) or total knee replacement (TKR) for idiopathic OA at a major centre was surveyed. Previous joint injury was more common in the TKR group (P < 0.0001). However, both groups manifested a mixed occupational background, body mass indices similar to the general population and a predominance of females (F:M = 1.3-1.4:1). The TKR group had a significantly younger age of symptom onset (56 yr) than the THR group (61 yr) but both groups had a tendency to bilateral arthroplasty (33%), nodal involvement (54-59%), a significant excess of right-sided replacements (1.8:1, THR; 2.2:1, TKR) and similar levels of pre-operative pain and disability. Up to 40% of hips manifested acetabular dysplasia and 10% possible previous slipped upper femoral epiphyses. Eighty-five per cent with end-stage coxarthrosis or gonarthrosis had an identical pattern of radiographic disease contralaterally. Our data suggest the importance of a constitutional tendency to idiopathic, end-stage OA, a disorder traditionally associated with environmental factors leading to 'wear and tear'.
Giuffrè, G; Lodato, G
1986-01-01
We describe three siblings presenting unusual pigmented dystrophic lesions of the fovea. The first sibling showed macroreticular dystrophy associated with butterfly shaped dystrophy in one eye and associated with vitelliform cyst in the other eye. The second showed the atrophic outcome of a vitelliform cyst with development of subretinal neovascular membrane in one eye and a radial pigmented macular dystrophy in the other eye. The third sibling had bilateral macular vitelliform lesions. This vitelliform patterned dystrophy of the retinal pigment epithelium may represent a new form that should be classified near Best's disease and the pattern dystrophies. Images PMID:3718916
Quantitative Stratification of Diffuse Parenchymal Lung Diseases
Raghunath, Sushravya; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Maldonado, Fabien; Peikert, Tobias; Moua, Teng; Ryu, Jay H.; Bartholmai, Brian J.; Robb, Richard A.
2014-01-01
Diffuse parenchymal lung diseases (DPLDs) are characterized by widespread pathological changes within the pulmonary tissue that impair the elasticity and gas exchange properties of the lungs. Clinical-radiological diagnosis of these diseases remains challenging and their clinical course is characterized by variable disease progression. These challenges have hindered the introduction of robust objective biomarkers for patient-specific prediction based on specific phenotypes in clinical practice for patients with DPLD. Therefore, strategies facilitating individualized clinical management, staging and identification of specific phenotypes linked to clinical disease outcomes or therapeutic responses are urgently needed. A classification schema consistently reflecting the radiological, clinical (lung function and clinical outcomes) and pathological features of a disease represents a critical need in modern pulmonary medicine. Herein, we report a quantitative stratification paradigm to identify subsets of DPLD patients with characteristic radiologic patterns in an unsupervised manner and demonstrate significant correlation of these self-organized disease groups with clinically accepted surrogate endpoints. The proposed consistent and reproducible technique could potentially transform diagnostic staging, clinical management and prognostication of DPLD patients as well as facilitate patient selection for clinical trials beyond the ability of current radiological tools. In addition, the sequential quantitative stratification of the type and extent of parenchymal process may allow standardized and objective monitoring of disease, early assessment of treatment response and mortality prediction for DPLD patients. PMID:24676019
Using photoshop filters to create anatomic line-art medical images.
Kirsch, Jacobo; Geller, Brian S
2006-08-01
There are multiple ways to obtain anatomic drawings suitable for publication or presentations. This article demonstrates how to use Photoshop to alter digital radiologic images to create line-art illustrations in a quick and easy way. We present two simple to use methods; however, not every image can adequately be transformed and personal preferences and specific changes need to be applied to each image to obtain the desired result. There are multiple ways to obtain anatomic drawings suitable for publication or to prepare presentations. Medical illustrators have always played a major role in the radiology and medical education process. Whether used to teach a complex surgical or radiologic procedure, to define typical or atypical patterns of the spread of disease, or to illustrate normal or aberrant anatomy, medical illustration significantly affects learning (). However, if you are not an accomplished illustrator, the alternatives can be expensive (contacting a professional medical illustrator or buying an already existing stock of digital images) or simply not necessarily applicable to what you are trying to communicate. The purpose of this article is to demonstrate how using Photoshop (Adobe Systems, San Jose, CA) to alter digital radiologic images we can create line-art illustrations in a quick, inexpensive, and easy way in preparation for electronic presentations and publication.
Activities for Babies and Toddlers with Down Syndrome: A Physiotherapy Approach.
ERIC Educational Resources Information Center
Kelso, Rose-Anne; Price, Sue
Children with Down Syndrome have the potential for the development of a large range and variety of postures, balance reactions, movements, and skills. Sometimes this potential remains relatively untapped resulting in unusual, inefficient, or even detrimental patterns of movement. By handling and playing with the child, he or she becomes more aware…
Eye Movements when Looking at Unusual/Weird Scenes: Are There Cultural Differences?
ERIC Educational Resources Information Center
Rayner, Keith; Castelhano, Monica S.; Yang, Jinmian
2009-01-01
Recent studies have suggested that eye movement patterns while viewing scenes differ for people from different cultural backgrounds and that these differences in how scenes are viewed are due to differences in the prioritization of information (background or foreground). The current study examined whether there are cultural differences in how…
1999-01-01
The past few years have witnessed unusually warm weather, as evidenced by both mild winters and hot summers. The analysis shows that the 30-year norms--the basis of weather-related energy demand projections--do not reflect the warming trend or its regional and seasonal patterns.
USDA-ARS?s Scientific Manuscript database
Alternate pathways of RNA processing play an important role in the expression of the secreted (S) and membrane (Mb) forms of immunoglobulin (Ig) heavy (H) chain isotypes in all vertebrates. Interestingly, while the differential splicing mechanism and the splice sites that generate the two forms of I...
AN UNUSUAL PATTERN OF GENE FLOW BETWEEN THE TWO SOCIAL FORMS OF THE FIRE ANT SOLENOPSIS INVICTA.
Ross, Kenneth G; Shoemaker, D DeWayne
1993-10-01
Uncertainty over the role of shifts in social behavior in the process of speciation in social insects has stimulated interest in determining the extent of gene flow between conspecific populations differing in colony social organization. Allele and genotype frequencies at 12 neutral polymorphic protein markers, as well as the numbers of alleles at the sex-determining locus (loci), are shown here to be consistent with significant ongoing gene flow between two geographically adjacent populations of Solenopsis invicta that differ in colony queen number. Data from a thirteenth protein marker that is under strong differential selection in the two social forms confirm that such gene flow occurs. Data from this selected locus, combined with knowledge of the reproductive biology of the two social forms, further suggest that interform gene flow is largely unidirectional and mediated through males only. This unusual pattern of gene flow results from the influence of the unique social enviroments of the two forms on the behavior of workers and on the reproductive physiology of sexuals. © 1993 The Society for the Study of Evolution.
Tokat, Fatma; Zeren, Handan; Barut, Pinar; Tansan, Sualp; Ince, Umit
2017-01-01
Non-small cell lung cancer (NSCLC) is a frequent tumor entity with high mortality. Although several newly discovered chromosomal translocations and mutations opened new horizons for targeted therapy, literature still lacks large series of NSCLC with chromosomal abberations and their correlations with histological and clinical features. We present a case of echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) translocation positive adenocarcinoma of the lung with an unusual metastatic pattern in a 29-year-old young woman. Young adult non-smoker female patients with an unexplained pleural effusion and signs of metastatic disease should alert the physicians straight away for all types of malignancies including lung cancer. Any skin lesions should be evaluated carefully, biopsies should be done to exclude metastasis in urgency. On the other hand, an uncommon clinical presentation of a lung cancer requires corresponding molecular testing rapidly in order to offer the best treatment option.
Vortex arrays and ciliary tangles underlie the feeding-swimming trade-off in starfish larvae
NASA Astrophysics Data System (ADS)
Gilpin, William; Prakash, Vivek N.; Prakash, Manu
2017-04-01
Many marine invertebrates have larval stages covered in linear arrays of beating cilia, which propel the animal while simultaneously entraining planktonic prey. These bands are strongly conserved across taxa spanning four major superphyla, and they are responsible for the unusual morphologies of many invertebrate larvae. However, few studies have investigated their underlying hydrodynamics. Here, we study the ciliary bands of starfish larvae, and discover a beautiful pattern of slowly evolving vortices that surrounds the swimming animals. Closer inspection of the bands reveals unusual ciliary `tangles' analogous to topological defects that break up and re-form as the animal adjusts its swimming stroke. Quantitative experiments and modelling demonstrate that these vortices create a physical trade-off between feeding and swimming in heterogeneous environments, which manifests as distinct flow patterns or `eigenstrokes' representing each behaviour--potentially implicating neuronal control of cilia. This quantitative interplay between larval form and hydrodynamic function may generalize to other invertebrates with ciliary bands, and illustrates the potential effects of active boundary conditions in other biological and synthetic systems.
Infertility in Women: Hysterosalpingographic Assessment of the Fallopian Tubes in Lagos, Nigeria
ERIC Educational Resources Information Center
Akinola, R. A.; Akinola, O. I.; Fabamwo, A. O.
2009-01-01
Tubal disease constitutes a major factor in infertility especially in developing countries. This study was undertaken to assess the hysterosalpingographic patterns seen in infertile patients in an urban centre in Lagos. Two hundred and twenty patients who reported from the gynaecology clinic to the radiology department of Lagos State University…
Bandeira, Teresa; Negreiro, Filipa; Ferreira, Rosário; Salgueiro, Marisa; Lobo, Luísa; Aguiar, Pedro; Trindade, J C
2011-06-01
Few reports have compared chronic obstructive lung diseases (OLDs) starting in childhood. To describe functional, radiological, and biological features of obliterative bronchiolitis (OB) and further discriminate to problematic severe asthma (PSA) or to diagnose a group with overlapping features. Patients with OB showed a greater degree of obstructive lung defect and higher hyperinflation (P < 0.001). The most frequent high-resolution computed tomography (HRCT) features (increased lung volume, inspiratory decreased attenuation, mosaic pattern, and expiratory air trapping) showed significantly greater scores in OB patients. Patients with PSA have shown a higher frequency of atopy (P < 0.05). ROC curve analysis demonstrated discriminative power for the LF variables, HRCT findings and for atopy between diagnoses. Further analysis released five final variables more accurate for the identification of a third diagnostic group (FVC%t, post-bronchodilator ΔFEV(1) in ml, HRCT mosaic pattern, SPT, and D. pteronyssinus-specific IgE). We found that OB and PSA possess identifiable characteristic features but overlapping values may turn them undistinguishable. Copyright © 2011 Wiley-Liss, Inc.
[Study on the indexes of forensic identification by the occlusal-facial digital radiology].
Gao, Dong; Wang, Hu; Hu, Jin-liang; Xu, Zhe; Deng, Zhen-hua
2006-02-01
To discuss the coding of full dentition with 32 locations and measure the characteristics of some bony indexes in occlusal-facial digital radiology (DR). To select randomly three hundred DR orthopantomogram and code the full dentition, then analyze the diversity of dental patterns. To select randomly one hundred DR lateral cephalogram and measure six indexes (N-S,N-Me,Cd-Gn,Cd-Go,NP-SN,MP-SN) separately by one odontologist and one trained forensic graduate student, then calculate the coefficient variation (CV) of every index and take a correlation analysis for the consistency between two measurements. (1) The total diversity of 300 dental patterns was 75%.It was a very high value. (2)All six quantitative variables had comparatively high CV value.(3) After the linear correlation analysis between two measurements, all six coefficient correlations were close to 1. This indicated that the measurements were stable and consistent. The method of coding full dentition in DR orthopantomogram and measuring six bony indexes in DR lateral cephalogram can be used to forensic identification.
Acute transverse colon volvulus with secondary gastric isquemia. Case report.
Sala-Hernández, Ángela; Pous-Serrano, Salvador; Lucas-Mera, Elí; Carvajal-Amaya, Nicolás
2016-03-01
Acute colonic volvulus accounts for 10% of all intestinal obstructions being the transverse colon volvulus an exceptional localization (2-4%). Late diagnosis is made as there are no pathognomonic clinical or radiological findings for this pathology. We present the case of an 81 year-old male with acute transverse colon volvulus that involved the gastric antrum causing irreversible ischemia. Subtotal gastrectomy, subtotal colectomy and reconstruction with Y en Roux gastrojejunostomy and ileosigmoid anastomosis was performed given the good overall status of the patient. Decompressive colonoscopy is not advised given the high probability of ischemic lesions in these cases; surgical exploration is mandatory in these circumstances. Surgical detortion with or without colopexia carries important recurrence rates. Treatment of choice includes colectomy with or without primary anastomosis. There are no reports on gastric ischemic necrosis in the setting of a transverse colon volvulus making this case unusual and unique.
Imaging findings of juvenile xanthogranuloma of the penis.
Bradford, Ray K; Choudhary, Arabinda K
2009-02-01
Juvenile xanthogranuloma (JXG) is a rare benign self-limiting lesion presenting in early childhood. It is the commonest variant of non-Langerhans cell histiocytosis and usually presents as a cutaneous mass. It might have a systemic component and also might be associated with other conditions, notably neurofibromatosis and juvenile chronic myelogenous leukemia. Penile masses are unusual in childhood and we describe a case of JXG involving the penis. Although four cases of JXG of the penis have been reported in the literature, this is the first with imaging of the penile lesion. We discuss the clinical and radiological findings, differential diagnosis and management of these cases. High awareness of these lesions in the differential diagnosis of penile masses presenting in early childhood is important to avoid potentially unnecessary ablative genital surgery. Careful assessment should also be made for any systemic involvement and for associated pathologies.
Clinical Aspects of Idiopathic Inflammatory Bowel Disease: A Review for Pathologists.
Lee, Hwajeong; Westerhoff, Maria; Shen, Bo; Liu, Xiuli
2016-05-01
-Idiopathic inflammatory bowel disease manifests with different clinical phenotypes showing varying behavior and risk for neoplasia. The clinical questions that are posed to pathologists differ depending on phase of the disease and the clinical circumstances. Understanding the clinical aspects of the dynamic disease process will enhance the role of pathology in optimizing the care of patients with inflammatory bowel disease. -To review clinical and surgical aspects of inflammatory bowel disease that are relevant to practicing pathologists. -The literature was reviewed. -Diagnosis and management of inflammatory bowel disease require an integrated evaluation of clinical, endoscopic, radiologic, and pathologic features. Therefore, close interaction between clinicians and pathologists is crucial. Having this team approach improves understanding of the pertinent clinical and surgical aspects of the disease and assists in the recognition of unusual presentation of variants, as well as mimics of idiopathic inflammatory bowel disease, by pathologists.
Case of a strangulated right paraduodenal fossa hernia in a malrotated gut.
Ong, Michelle; Roberts, Matthew; Perera, Marlon; Pretorius, Casper
2017-07-24
We report an unusual case of a strangulated internal hernia resulting from a right paraduodenal fossa hernia (PDH) in the context of bowel malrotation. There are few documented cases of PDHs associated with a concomitant gut malrotation. Emergency laparotomy was performed based on clinical and radiological. Intraoperatively, the proximal jejunum was seen to enter a hernia sac formed by an aberrant duodenojejunal flexure located to the right of the aorta. This was presumed to be a strangulated internal hernia of the paraduodenal recess in a malrotated gut. The hernia neck was widened and the sac obliterated to allow reduction of the contents. On reduction and warming, the insulted small bowel appeared viable and returned to the abdominal cavity without resection. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
[Sinus histiocytosis (Destombes-Rosai-Dorfman disease) revealed by extranodal spinal involvement].
Bernard, F; Sarran, N; Serre, I; Baldet, P; Callamand, P; Margueritte, G; Astruc, J
1999-02-01
Sinus histiocytosis with massive cervical lymphadenopathy (Rosai-Dorfman disease) is a non-neoplastic lymphoproliferative disorder. Extranodal involvement, especially of the nervous system, is unusual. We report a case revealed by neurological symptoms. A 10-year-old girl presented with paraparesis due to a dural extramedullary mass on magnetic resonance imaging. Massive cervical lymphadenopathy appeared secondarily. Radiological investigations showed mediastinal, paranasal sinus and lower eyelid involvement. The diagnosis of Rosai-Dorfman disease was established histologically and by immunohistochemical studies of nodal lesions by the demonstration of characteristic sinus histiocytosis with sheets of S-100 protein and CD-68 positive large histiocytes displaying lymphocyte phagocytosis. A dramatic response occurred with complete resolution of all clinical findings after treatment with corticosteroids and etoposide, although neurological lesions were unchanged on magnetic resonance imaging. Despite its rarity, this case underlines the unknown pathogenesis of this disease (immune dysfunction?) and the difficulties of treatment (choice of chemotherapeutic agents, duration).
Gil, Rui; Cunha, Teresa Margarida; Rolim, Ines
2017-07-01
We describe a case of a mature cystic teratoma of the ovary with high proportion of solid thyroid tissue (< 50% of the entire tumor) in a childbearing woman. The patient presented with non-specific abdominal bloating. Pelvic ultrasound and magnetic resonance imaging revealed a complex cystic-solid tumor confined to the left ovary with an anterior fat-containing locus compatible with mature cystic teratoma and a posterior predominantly solid component with low signal intensity on T2-weighted images that was histopatologically diagnosed as benign thyroid tissue. Thyroglobulin levels were in normal range. Although thyroid tissue is present in up to 20% of mature cystic teratomas, with exception of struma ovarii, it is not usually macroscopically nor radiologically identified. The differential diagnosis should include T2-hypointense adnexal lesions associated with mature cystic teratoma, malignant transformation of mature teratoma, and immature teratoma.
Penetrating skull fracture by a wooden object: Management dilemmas and literature review
Arifin, Muhammad Zafrullah; Gill, Arwinder Singh; Faried, Ahmad
2012-01-01
Most penetrating skull injuries are caused by gun shot wounds or missiles. The compound depressed skull fracture represents an acute neurosurgical emergency. Management and diagnosis of such cases have been described, but its occurence following a fall onto a piece of wood is quite unusual. A 75-year-old female fell onto a piece of wood that penetrated her skull on the left frontal region and was treated in our department. The patient had no neurological deficits during presentation. She was managed surgically and removal of the wooden object was performed to prevent early or late infection complications. Wooden foreign bodies often pose a different set of challenges as far as penetrating injuries to the brain are concerned. Radiological difficulties and increased rates of infection due to its porous nature make these types of injuries particularly interesting. Their early diagnosis and appropriate treatment can minimize the risk of complications. PMID:23293668
Itchins, Malinda; Hayes, Sarah A; Gill, Anthony J; Cooper, Wendy; O'Connell, Rachel; Howell, Viive M; Clarke, Stephen J; Pavlakis, Nick
2018-04-19
To report on the pattern of care and survival of anaplastic lymphoma kinase rearranged non-small cell lung cancer (ALK+NSCLC) in a real-world retrospective cohort from an Australian tertiary referral center. Individuals with a pathological diagnosis of ALK+NSCLC via immunohistochemistry and fluorescence in situ hybridization and a radiological diagnosis of stage IV disease were eligible. Patients were identified via the Pathology Department specimen database and electronic patient chart review. Data were collected and analyzed for baseline demographics, radiological pattern of disease and response to treatment, treatment sequencing, toxicity and survival. Thirty-five patients were identified over a 7-year period from 2010 to 2016 and followed for a median of 23 months. Median overall survival (OS) in the entire cohort was immature at data cut, 46.0 months (95% confidence interval [CI], 22.53-69.47 months), with the longest surviving patient was alive 62.1 months since diagnosis. Objective radiological response rate overall across six potential treatments and six treatment lines (range 1-6) was 58.2%. Almost 50% received at-least two lines of ALK inhibitor therapy with median OS in this group estimated to be 53.4 months (95% CI, 35.1 months-not reached). Toxicity was manageable with a low rate of ≥ grade 3 toxicity (n = 7). Forty-eight percent relapsed within the CNS and 43% overall died due to CNS progression. In those with CNS diagnosis at baseline and/or progression within the CNS (n = 32), median OS was also 46.0 months (95% CI, 24.22-66.78 months). This retrospective cohort analysis of a single tertiary institution experience in treating ALK+NSCLC demonstrates impressive OS and the importance and impact of careful management of CNS disease in this patient population. © 2018 John Wiley & Sons Australia, Ltd.
Graham, R N J
2012-01-01
With the increasing tempo of military conflicts in the last decade, much has been learnt about imaging battlefield casualties in the acute setting. Ultrasound in the form of focused abdominal sonography in trauma (FAST) has proven invaluable in emergency triage of patients for immediate surgery. Multidetector CT allows accurate determination of battlefield trauma injuries. It permits the surgeons and anaesthetists to plan their interventions more thoroughly and to be made aware of clinically occult injuries. There are common injury patterns associated with blast injury, gunshot wounds and blunt trauma. While this body of knowledge is most applicable to the battlefield, there are parallels with peacetime radiology, particularly in terrorist attacks and industrial accidents. This pictorial review is based on the experiences of a UK radiologist deployed in Afghanistan in 2010. PMID:22806621
Idiopathic pulmonary fibrosis in a Christmas Island nuclear test veteran
Parfrey, H; Babar, J; Fiddler, CA; Chilvers, ER
2010-01-01
We describe the case of a 71-year-old man with idiopathic pulmonary fibrosis (usual interstitial pneumonia (UIP) pattern) diagnosed on clinical, radiological and lung function criteria, in accordance with the American Thoracic Society/European Respiratory Society consensus criteria (2000), who had been in close proximity to three atmospheric nuclear bomb blasts during military service in 1957. He does not have clubbing and clinically and radiologically his lung disease is stable. He also has bladder carcinoma and carotid arteriosclerosis, both recognised consequences of radiation injury. This is the first reported case of UIP in a nuclear test veteran. Awareness of this potential association is important given the current attempts of the British Nuclear Test Veterans Association to gain compensation for claimed injuries. PMID:22797205
Non-squamous cell neoplasms of the larynx: radiologic-pathologic correlation.
Becker, M; Moulin, G; Kurt, A M; Dulgerov, P; Vukanovic, S; Zbären, P; Marchal, F; Rüfenacht, D A; Terrier, F
1998-01-01
A variety of benign and malignant non-squamous cell neoplasms may affect the larynx. Most of these uncommon laryngeal neoplasms are located beneath an intact mucosa, making diagnosis difficult with endoscopy alone, and sampling errors may occur if only traditional superficial biopsies are performed. In some laryngeal neoplasms, radiologic evaluation allows the correct diagnosis. Hemangiomas have very high signal intensity at T2-weighted magnetic resonance (MR) imaging and strong enhancement at both computed tomography (CT) and MR imaging after administration of contrast material. Phleboliths, which are pathognomonic for hemangiomas, are easily identified at CT. Chondrogenic tumors typically manifest with coarse or stippled calcifications at CT. Because of their high water content, chondrogenic tumors have very high signal intensity on T2-weighted MR images, whereas only moderate enhancement is observed after administration of contrast material. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. They are isoattenuating to subcutaneous fat at CT and isointense relative to subcutaneous fat with all MR pulse sequences. Metastases from renal adenocarcinoma typically demonstrate strong contrast enhancement and flow voids at MR imaging, and metastases from melanotic melanoma usually have high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images owing to the paramagnetic properties of melanin. Although radiologic findings are nonspecific in most other non-squamous cell neoplasms of the larynx (eg, Kaposi sarcoma, hematopoietic tumors, tumors of the minor salivary glands, metastases from amelanotic melanoma), cross-sectional imaging can play an important role in the diagnostic work-up of these unusual tumors by delineating the extent of submucosal tumor spread and directing the endoscopist to the appropriate site for the deep, transmucosal biopsies needed to establish the diagnosis. In addition, CT and MR imaging are crucial for posttherapeutic monitoring and early detection of local recurrence.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Boe, Timothy; Lemieux, Paul; Schultheisz, Daniel
2013-07-01
Management of debris and waste from a wide-area radiological incident would probably constitute a significant percentage of the total remediation cost and effort. The U.S. Environmental Protection Agency's (EPA's) Waste Estimation Support Tool (WEST) is a unique planning tool for estimating the potential volume and radioactivity levels of waste generated by a radiological incident and subsequent decontamination efforts. The WEST was developed to support planners and decision makers by generating a first-order estimate of the quantity and characteristics of waste resulting from a radiological incident. The tool then allows the user to evaluate the impact of various decontamination/demolition strategies onmore » the waste types and volumes generated. WEST consists of a suite of standalone applications and Esri{sup R} ArcGIS{sup R} scripts for rapidly estimating waste inventories and levels of radioactivity generated from a radiological contamination incident as a function of user-defined decontamination and demolition approaches. WEST accepts Geographic Information System (GIS) shape-files defining contaminated areas and extent of contamination. Building stock information, including square footage, building counts, and building composition estimates are then generated using the Federal Emergency Management Agency's (FEMA's) Hazus{sup R}-MH software. WEST then identifies outdoor surfaces based on the application of pattern recognition to overhead aerial imagery. The results from the GIS calculations are then fed into a Microsoft Excel{sup R} 2007 spreadsheet with a custom graphical user interface where the user can examine the impact of various decontamination/demolition scenarios on the quantity, characteristics, and residual radioactivity of the resulting waste streams. (authors)« less
Bronchoalveolar carcinoma: clinical, radiologic, and pathologic factors and survival.
Okubo, K; Mark, E J; Flieder, D; Wain, J C; Wright, C D; Moncure, A C; Grillo, H C; Mathisen, D J
1999-10-01
The principal feature of bronchoalveolar carcinoma is that it spreads along airways or aerogenously with multifocality, but many issues are unresolved. We studied 119 patients with pathologically confirmed bronchoalveolar carcinoma. Symptoms, smoking status, radiologic findings, the size of tumor, operative procedures, and complications were reviewed. We studied the pathologic features: presence or absence of aerogenous spread, patterns of growth, cell type, nuclear grade, mitosis, rate of bronchoalveolar carcinoma in adenocarcinoma, and lymphocyte infiltration. The correlation among clinical, radiologic, and pathologic findings was examined, and the factors affecting survival were analyzed. Symptomatic patients had more infiltrative radiographic features, and asymptomatic patients tended to have more mass-like features (P <.0001). Tumors with radiographically infiltrating lesions tended to have mucinous histologic features (P =.006). Tumors with mass lesions by radiograph tended to have nonmucinous and sclerosing histologic features (P =.003). Aerogenous spread was seen in 94% of specimens. The presence of a variety of cell types suggested multiple clonal origin. The overall survival in those patients undergoing resection was 69.1% at 5 years and 56.5% at 10 years. The significant factors affecting survival were radiologic presence of a mass or infiltrate, pathologic findings of the presence of sclerosis, association with a scar, the rate of bronchoalveolar carcinoma in adenocarcinoma, lymphocyte infiltration grade, nodal involvement, and status of complete resection. Mitosis or nuclear grade of tumor cells did not correlate with survival. Bronchoalveolar carcinoma showed good overall survival with appropriate surgical procedures. Certain radiologic or pathologic findings correlated with survival. These findings may enhance the ability to predict long-term survival.
Woodings, S
2004-09-01
Iodine-131 patients pose a radiation risk to their family members, carers and colleagues. Doses from thyrotoxicosis and thyroid cancer patients undergoing standard treatments have been well characterised in the literature. However the resulting precautions cannot be easily adapted to circumstances where the patient has an unusual affliction, or an atypical family or occupational environment. In this study, a model for calculating dose from an I-131 patient is derived from first principles. The model is combined with existing results from the literature to determine a distance weighting factor between patients and family members. This technique reduces the uncertainty in the dose calculations by removing the need to guess the unknown patterns of close contact, a problem common to all previous dose calculation techniques. Data is presented for four unusual I-131 treatments; a child thyroid cancer patient, two thyroid cancer dialysis patients and a phaeochromocytoma patient. The model is used to calculate appropriate periods of restricted contact for these patients. The recommendations provide a useful guide for future unusual I-131 treatments.
Phase coherent transport in hybrid superconductor-topological insulator devices
NASA Astrophysics Data System (ADS)
Finck, Aaron
2015-03-01
Heterostructures of superconductors and topological insulators are predicted to host unusual zero energy bound states known as Majorana fermions, which can robustly store and process quantum information. Here, I will discuss our studies of such heterostructures through phase-coherent transport, which can act as a unique probe of Majorana fermions. We have extensively explored topological insulator Josephson junctions through SQUID and single-junction diffraction patterns, whose unusual behavior give evidence for low-energy Andreev bound states. In topological insulator devices with closely spaced normal and superconducting leads, we observe prominent Fabry-Perot oscillations, signifying gate-tunable, quasi-ballistic transport that can elegantly interact with Andreev reflection. Superconducting disks deposited on the surface of a topological insulator generate Aharonov-Bohm-like oscillations, giving evidence for unusual states lying near the interface between the superconductor and topological insulator surface. Our results point the way towards sophisticated interferometers that can detect and read out the state of Majorana fermions in topological systems. This work was done in collaboration with Cihan Kurter, Yew San Hor, and Dale Van Harlingen. We acknowledge funding from Microsoft Project Q.
Havird, Justin C; Vaught, Rebecca C; Weeks, Jeffrey R; Fujita, Yoshihisa; Hidaka, Michio; Santos, Scott R; Henry, Raymond P
2014-12-01
Crustaceans generally act as oxy-regulators, maintaining constant oxygen uptake as oxygen partial pressures decrease, but when a critical low level is reached, ventilation and aerobic metabolism shut down. Cave-adapted animals, including crustaceans, often show a reduced metabolic rate possibly owing in part to the hypoxic nature of such environments. However, metabolic rates have not been thoroughly explored in crustaceans from anchialine habitats (coastal ponds and caves), which can experience variable oxygenic regimes. Here, an atypical oxy-conforming pattern of oxygen uptake is reported in the Hawaiian anchialine atyid Halocaridina rubra, along with other unusual metabolic characteristics. Ventilatory rates are near-maximal in normoxia and did not increase appreciably as PO₂ declined, resulting in a decline in VO₂ during progressive hypoxia. Halocaridina rubra maintained in anoxic waters survived for seven days (the duration of the experiment) with no measureable oxygen uptake, suggesting a reliance on anaerobic metabolism. Supporting this, lactate dehydrogenase activity was high, even in normoxia, and oxygen debts were quickly repaid by an unusually extreme increase in oxygen uptake upon exposure to normoxia. In contrast, four related anchialine shrimp species from the Ryukyu Islands, Japan, exhibited physiological properties consistent with previously studied crustaceans. The unusual respiratory patterns found in H. rubra are discussed in the context of a trade-off in gill morphology for osmoregulatory ion transport vs. diffusion of respiratory gasses. Future focus on anchialine species may offer novel insight into the diversity of metabolic responses to hypoxia and other physiological challenges experienced by crustaceans. Published by Elsevier Inc.
Probed Serial Recall in Williams Syndrome: Lexical Influences on Phonological Short-Term Memory
ERIC Educational Resources Information Center
Brock, Jan; McCormack, Teresa; Boucher, Jill
2005-01-01
Williams syndrome is a genetic disorder that, it has been claimed, results in an unusual pattern of linguistic strengths and weaknesses. The current study investigated the hypothesis that there is a reduced influence of lexical knowledge on phonological short-term memory in Williams syndrome. Fourteen children with Williams syndrome and 2…
In-Situ Subsurface Coating of Corroded Steel Sheet Pile Structures: Final Report on Project F08-AR06
2017-09-01
scraped the sheet pile wall with an excavator. After scraping the out-pans with a flat edge bucket, the contractor welded a blade on the bucket...unusual striations were parallel grooves running at 30 – 45 degrees from the vertical. Some patterns cross each other symmetrically. The stria- tions
Winter injury among white fir seedlings...unusual pattern in seed source study
M. Thompson Conkle; W. J. Libby; J. L. Hamrick
1967-01-01
White fir seeds collected from 43 sources were sown at the Institute of Forest Genetics, Placerville, Calif. in 1963. Observations made 3 years later showed that seedlings from northern sources sustained more winter injury than did southern origin seedlings. Seedlings from low elevations were less severely damaged than seedlings from higher elevations in the same...
Embracing E-Books: Increasing Students' Motivation to Read and Write
ERIC Educational Resources Information Center
Siegle, Del
2012-01-01
In his keynote address at the "New York Times" Schools for Tomorrow 2011 Fall Conference, Dr. Larry Summers (2011) suggested that technology implementations have an unusual growth pattern. New technology innovations usually require more time to "catch on" than one might expect, but once they catch on, their use spreads more quickly than anyone can…
ERIC Educational Resources Information Center
Harrison, Allyson G.; Rosenblum, Yoni; Currie, Shannon
2010-01-01
Methods of identifying poor test-related motivation using the Wechsler Adult Intelligence Scale Digit Span subtest are based on identification of performance patterns that are implausible if the test taker is investing full effort. No studies to date, however, have examined the specificity of such measures, particularly when evaluating persons…
Ingressive Speech Errors: A Service Evaluation of Speech-Sound Therapy in a Child Aged 4;6
ERIC Educational Resources Information Center
Hrastelj, Laura; Knight, Rachael-Anne
2017-01-01
Background: A pattern of ingressive substitutions for word-final sibilants can be identified in a small number of cases in child speech disorder, with growing evidence suggesting it is a phonological difficulty, despite the unusual surface form. Phonological difficulty implies a problem with the cognitive process of organizing speech into sound…
Heather Lessig; William J. McShea; Jeffrey R. Walters
2010-01-01
The southern Appalachians support a unique forest ecosystem at higher elevations in which the breeding distribution of several bird species of conservation concern extends to unusually southern latitudes. The dual threats of rising global temperatures and potential wind energy development may impact these forests by reducing or fragmenting preferred habitat.
Impact of PACS On The Organization Of Radiology Departments
NASA Astrophysics Data System (ADS)
Zielonka, Jason S.
1983-05-01
The radiologist serves as a consultant to other physicians in the practice of clinical medicine; the image obtained and the reported interpretation of that image represent the service rendered and are therefore of major importance (medically, legally and economically) to the radiologist. Because many radiology departments are organized along subspecialty lines or (in the case of a single department serving several institutions) along combined institutional and subspecialty lines, many patients may undergo diagnostic evaluation sequences in which several studies are performed and multiple simultaneous consultations may result. In the past, the lack of availability of multiple copies of the study (for multiple interested parties) has prevented the effective tailoring of subsequent examinations until the prior exam results were available; the advent of digital networks for PACS may result in a significant change in this procedure and, accordingly, in the pattern of interpretation, internal referral and organization of radiology departments. In addition, since clinicians may have access to studies directly and, possibly, prior to official interpretation, the nature of the relationship between the clinician and the radiologist may be altered by PACS.
Toxicological and radiological safety of chicken meat irradiated with 7.5 MeV X-rays
NASA Astrophysics Data System (ADS)
Song, Beom-Seok; Lee, Yunjong; Park, Jong-Heum; Kim, Jae-Kyung; Park, Ha-Young; Kim, Dong-Ho; Kim, Chang-Jong; Kang, Il-Jun
2018-03-01
This study was conducted to evaluate the toxicological and radiological safety of chicken meat that had been irradiated at 30 kGy with 7.5 MeV X-rays. In a sub-chronic toxicity study, ICR mice were fed X-ray-irradiated chicken meat at 2500 mg/kg body weight daily for 90 days, and no mortality or abnormal clinical signs were observed throughout the study period. However, several hematological and serum biochemical parameters of the ICR mice differed significantly from those in the control group; nevertheless, the observed values were all within the normal range for the respective parameters. In addition, no toxicological effects were determined in male or female mice. Furthermore, no differences in gamma-ray spectrometric patterns were detected between the non-irradiated and irradiated samples, indicating that the radioactivity induced by 7.5 MeV X-ray irradiation was below the detection limit. These results tentatively suggest that chicken meat irradiated with 7.5 MeV X-rays would be safe for human consumption in terms of toxicology and radiology.
Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je
2014-01-01
Objectives The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. Methods We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Results Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Conclusion Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy. PMID:25177439
Joo, Yeon Hee; Kim, Jin Pyeong; Park, Jung Je; Woo, Seung Hoon
2014-09-01
The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.
ERIC Educational Resources Information Center
Hall, L. O.; Soderstrom, T.; Ahlqvist, J.; Nilsson, T.
2011-01-01
This article is about collaborative learning with educational computer-assisted simulation (ECAS) in health care education. Previous research on training with a radiological virtual reality simulator has indicated positive effects on learning when compared to a more conventional alternative. Drawing upon the field of Computer-Supported…
Peris-Celda, M; Giannini, C; Diehn, F E; Eckel, L J; Neff, B A; Van Gompel, J J
2018-04-03
Vestibular schwannomas and meningiomas account for the great majority of lesions arising in the cerebellopontine angle (CPA). In this report, we present a case of glioneuronal heterotopia, also known as glioneuronal hamartoma, arising from the VIII cranial nerve, which is an extremely uncommon lesion. Important radiologic and surgical aspects are reviewed, which may help in early recognition and intraoperative decision making when these lesions are encountered. A healthy 29-year-old female presented with intermittent right facial numbness. Magnetic resonance imaging (MRI) showed an incidental minimally enhancing cerebellopontine angle lesion on the right VII-VIII cranial nerve complex. The patient declined serial observation and opted for operative intervention for resection. Intraoperatively, the lesion resembled neural tissue and was continuous with the VIII cranial nerve. Pathological analysis demonstrated mature glioneuronal tissue consistent with hamartomatous brain tissue. The patient maintained normal hearing and facial nerve function after surgery. Radiologic, surgical and pathological characteristics are described. Ectopic glioneuronal tissue of the VIII cranial nerve is a rare non-neoplastic lesion, and should be considered in the differential diagnosis of unusual appearing intracanalicular and cerebellopontine angle lesions. The congenital and benign nature of this entity makes observation a valid option for these cases, although they are so infrequent that they are often presumptively managed as vestibular schwannomas. Attempts to radically resect these lesions may result in higher rates of hearing loss or facial palsy due to their continuity with the cranial nerves. Copyright © 2018 Elsevier Inc. All rights reserved.
The significance of Bartonella henselae bacterias for oncological diagnosis in children.
Mazur-Melewska, Katarzyna; Jończyk-Potoczna, Katarzyna; Mania, Anna; Kemnitz, Paweł; Szydłowski, Jarosław; Służewski, Wojciech; Figlerowicz, Magdalena
2015-01-01
Cat-scratch disease (CSD) is a common infection in children; however, the wide spectrum of its clinical picture may lead to delayed diagnosis. An unusual presentation of CSD includes in the differential diagnosis malignant diseases, Epstein-Barr and cytomegalovirus infections, tuberculosis, and mycobacterioses. The diagnostic procedure is difficult, and it is important to consider CSD as the etiology of untypical lesion. We present the analysis of 22 immunocompetent children treated with the clinical diagnosis of CSD in our hospital. Their ages were 2 to 16 years (mean 9.15 ± 2.2 years). Four of them presented classical papulas at admission time. Asymmetric, local lymphadenopathy was present in 16 patients. Five children, who presented an untypical course of CSD mimicking the oncological process, were analysed carefully. There were 3 patients with skull osteomyelitis, 1 with inflammation of the parotid gland, and 1 with an extra peripharyngeal mass. The diagnosis in these children was based on epidemiological, radiological, serological, and histological factors. About 25 % of children with bartonellosis present an untypical spectrum of symptoms, including the lack of documented cat contact, primary lesions, or peripheral lymphadenopathy. Radiological methods like USG, CT, MRI present the unspecific masses, but they are not enough to distinguish the Bartonella inflammatory and oncological process. The final diagnosis was based on a histological method with additional polymerase chain reaction test. CSD should be considered in differential diagnosis of any patient with untypical lesions located on the head, neck, and upper extremities.
Desmoplastic fibroma of the rib with cystic change: a case report and literature review.
Okubo, Taketo; Saito, Tsuyoshi; Takagi, Tatsuya; Suehara, Yoshiyuki; Kaneko, Kazuo
2014-05-01
Desmoplastic fibroma (DF) is a rare, locally aggressive, solitary tumor microscopically composed of well-differentiated myofibroblasts with abundant dense collagen deposition. The most common sites are the long tubular bones and mandible. To our knowledge, only five cases of DF in the ribs have been reported. Here, we report a case of DF in this rare location with unusual radiological findings. A 40-year-old man presented with a 4-year history of swelling of the right chest wall. Radiographs revealed a mass at the right 9th rib, and computed tomography demonstrated a mass of 14 × 12 × 8 cm at the right 9th rib with expanded cystic change and marked calcification that appeared to have arisen from the bone. Open biopsy suggested DF. Total excision was performed, and the chest wall was reconstructed. The surgical specimen was a yellowish tumor with multilocular cystic change containing a viscous liquid. The tumor was composed of a proliferation of less-atypical spindle-shaped cells in a collagenous background. The cystic change was observed in the extra-osseous lesion. No β-catenin cytoplasmic/nuclear accumulation was detected, and no β-catenin or GNAS genetic mutations were detected. A final diagnosis of DF was made on the basis of the pathological and radiological findings. The patient was successfully treated with total excision of the tumor with no evidence of recurrence 6 months after surgery.
Pérez-Guzmán, Carlos; Vargas, Mario H; Torre-Bouscoulet, Luis
2008-01-01
To describe clinical and radiological features of patients with pleural mesothelioma, according to main histological types. Clinical records of inpatients admitted with diagnosis of pleural mesothelioma to the Instituto Nacional de Enfermedades Respiratorias in the last 11 years, were reviewed. We analyzed 85 cases confirmed by immunohistochemistry. The most frequent histological type was epithelial (84.7 %), followed by sarcomatous (12.9 %) and mixed (2.4 %) types. Comparison between epithelial and sarcomatous types showed no differences in age (53.7 +/- 13.1 vs. 55.9 +/- 11.0 years, respectively), male : female ratio (2.3 : 1 vs. 1.8 : 1), history of asbestos exposure (34.7 vs. 27.2 %), tobacco habit (54.2 vs 45.4 %), occupation, evolution time (4.8 +/- 3.3 vs. 4.4 +/- 3.7 months), pain, dyspnea and cough, right-side predominance (55.6 vs. 81.8 %), radiological image with pleural effusion (59.7 vs. 36.4 %) or pleural thickening (38.9 vs. 63.6 %), and diagnostic efficiency of closed pleural biopsy (58.3 vs. 27.2 %). Our results suggest that clinical and radiological features of epithelial and sarcomatous histological types are very similar. Additionally, we found a high frequency of epithelial mesothelioma, which contrasts with findings from other countries, suggesting that the type of asbestos or other factors involved in the development of pleural mesothelioma differ from those existing in other regions of the world.
NASA Astrophysics Data System (ADS)
Ummenhofer, Caroline C.; Seo, Hyodae; Kwon, Young-Oh; Parfitt, Rhys; Brands, Swen; Joyce, Terrence M.
2017-08-01
Dominant European winter precipitation patterns over the past century, along with their associated extratropical North Atlantic circulation changes, are evaluated using cluster analysis. Contrary to the four regimes traditionally identified based on daily wintertime atmospheric circulation patterns, five distinct seasonal precipitation regimes are detected here. Recurrent precipitation patterns in each regime are linked to changes in atmospheric blocking, storm track, and sea surface temperatures across the North Atlantic region. Multidecadal variability in the frequency of the precipitation patterns reveals more (fewer) winters with wet conditions in northern (southern) Europe in recent decades and an emerging distinct pattern of enhanced wintertime precipitation over the northern British Isles. This pattern has become unusually common since the 1980s and is associated with changes in moisture transport and more frequent atmospheric river events. The observed precipitation changes post-1950 coincide with changes in storm track activity over the central/eastern North Atlantic toward the northern British Isles.
Usual interstitial pneumonia: typical, possible, and “inconsistent” patterns
Torres, Pedro Paulo Teixeira e Silva; Rabahi, Marcelo Fouad; Moreira, Maria Auxiliadora Carmo; Meirelles, Gustavo de Souza Portes; Marchiori, Edson
2017-01-01
ABSTRACT Idiopathic pulmonary fibrosis is a severe and progressive chronic fibrosing interstitial lung disease, a definitive diagnosis being established by specific combinations of clinical, radiological, and pathological findings. According to current international guidelines, HRCT plays a key role in establishing a diagnosis of usual interstitial pneumonia (UIP). Current guidelines describe three UIP patterns based on HRCT findings: a typical UIP pattern; a pattern designated “possible UIP”; and a pattern designated “inconsistent with UIP”, each pattern having important diagnostic implications. A typical UIP pattern on HRCT is highly accurate for the presence of histopathological UIP, being currently considered to be diagnostic of UIP. The remaining patterns require further diagnostic investigation. Other known causes of a UIP pattern include drug-induced interstitial lung disease, chronic hypersensitivity pneumonitis, occupational diseases (e.g., asbestosis), and connective tissue diseases, all of which should be included in the clinical differential diagnosis. Given the importance of CT studies in establishing a diagnosis and the possibility of interobserver variability, the objective of this pictorial essay was to illustrate all three UIP patterns on HRCT. PMID:29160385
Annual radiological environmental operating report, Browns Ferry Nuclear Plant, 1991
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1992-04-01
This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant in 1991. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiation levels.more » Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations.« less
Discreet charm of the GABAergic bourgeoisie: superconnected cells conduct developmental symphonies.
Case, Marianne; Soltesz, Ivan
2009-12-24
In an exciting study in the December 4(th) issue of Science, Bonifazi and colleagues demonstrated the existence and importance of exceedingly rare but unusually richly connected cells in the developing hippocampus. Manipulating the activity of single GABAergic hub cells modulated network activity patterns, demonstrating their importance for coordinating synchronous activity. 2009 Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Karmel, Tom; Mark, Kevin; Mlotkowski, Peter
2009-01-01
This technical paper examines some large and unusual movements for data in the 2007 VET (Vocational Education Training) Provider Collection by comparison with 2006. Changes in the patterns of courses undertaken explain most of the divergence between students, enrolments and hours. Appendices include: (1) Derivation of the decomposition; (2) Tables…
Spatial Disorientation in Flight: Current Problems
1980-10-01
intimately involved with various sensory, cognitive , and emotional processes of habituation (Guedry,1971). While repeated exposure to patterns of...stimuli normally involved in orientation and the failure of a learned cognitive skill to compensate for mismatched signals. Recently, a new concept has...It is well known that under atypical stimulation, unusual environmental conditions, or stress, the first abilities to be impaired are learned cognitive
New Evidence against a Causal Marriage Wage Premium
Killewald, Alexandra; Lundberg, Ian
2017-01-01
Recent research shows that men’s wages rise more rapidly than expected prior to marriage, but diverges on whether this indicates selection or a causal effect of anticipating marriage. We seek to adjudicate this debate by bringing together literatures on: (1) the male marriage wage premium, (2) selection into marriage based on men’s economic circumstances, and (3) the transition to adulthood, during which both union formation and unusually rapid improvements in work outcomes often occur. Using data from the NLSY79, we evaluate these perspectives. We show that wage declines predate rather than follow divorce, indicating no evidence that staying married benefits men’s wages. We find that older grooms experience no unusual wage patterns at marriage, suggesting that the observed marriage premium may simply reflect co-occurrence with the transition to adulthood for younger grooms. We show that men entering shotgun marriages experience similar premarital wage gains as other grooms, casting doubt on the claim that anticipation of marriage drives wage increases. We conclude that the observed wage patterns are most consistent with men marrying when their wages are already rising more rapidly than expected and divorcing when their wages are already falling, with no additional causal effect of marriage on wages. PMID:28332136
New Evidence Against a Causal Marriage Wage Premium.
Killewald, Alexandra; Lundberg, Ian
2017-06-01
Recent research has shown that men's wages rise more rapidly than expected prior to marriage, but interpretations diverge on whether this indicates selection or a causal effect of anticipating marriage. We seek to adjudicate this debate by bringing together literatures on (1) the male marriage wage premium; (2) selection into marriage based on men's economic circumstances; and (3) the transition to adulthood, during which both union formation and unusually rapid improvements in work outcomes often occur. Using data from the National Longitudinal Survey of Youth 1979, we evaluate these perspectives. We show that wage declines predate rather than follow divorce, indicating no evidence that staying married benefits men's wages. We find that older grooms experience no unusual wage patterns at marriage, suggesting that the observed marriage premium may simply reflect co-occurrence with the transition to adulthood for younger grooms. We show that men entering shotgun marriages experience similar premarital wage gains as other grooms, casting doubt on the claim that anticipation of marriage drives wage increases. We conclude that the observed wage patterns are most consistent with men marrying when their wages are already rising more rapidly than expected and divorcing when their wages are already falling, with no additional causal effect of marriage on wages.
A very small and super strong zebra pattern burst at the beginning of a solar flare
DOE Office of Scientific and Technical Information (OSTI.GOV)
Tan, Baolin; Tan, Chengming; Zhang, Yin
2014-08-01
Microwave emission with spectral zebra pattern structures (ZPs) is frequently observed in solar flares and the Crab pulsar. The previous observations show that ZP is a structure only overlapped on the underlying broadband continuum with slight increments and decrements. This work reports an unusually strong ZP burst occurring at the beginning of a solar flare observed simultaneously by two radio telescopes located in China and the Czech Republic and by the EUV telescope on board NASA's satellite Solar Dynamics Observatory on 2013 April 11. It is a very short and super strong explosion whose intensity exceeds several times that ofmore » the underlying flaring broadband continuum emission, lasting for just 18 s. EUV images show that the flare starts from several small flare bursting points (FBPs). There is a sudden EUV flash with extra enhancement in one of these FBPs during the ZP burst. Analysis indicates that the ZP burst accompanying an EUV flash is an unusual explosion revealing a strong coherent process with rapid particle acceleration, violent energy release, and fast plasma heating simultaneously in a small region with a short duration just at the beginning of the flare.« less
Dermatoglyphics in childhood leukemia
Berka, Ludmila; McClure, P. D.; Sonley, Marilyn J.; Thompson, Margaret W.
1971-01-01
The dermatoglyphics of 54 leukemic children do not differ significantly from those of 25 mothers and 592 unrelated controls with respect to frequency of digital pattern types, position of axial triradius, or type of palmar flexion creases. These findings do not support the hypothesis that children with leukemia have an increased frequency of unusual dermal patterns, but suggest that the dermatoglyphics of leukemic children are not distinctive and therefore have no practical value in the diagnosis of childhood leukemia. Whatever factors are responsible for the development of leukemia in children, these factors do not appear regularly to affect the differentiation of the dermal ridges. PMID:5112119
Two unusual anatomic variations create a diagnostic dilemma in distal ulnar nerve compression.
Kiehn, Mark W; Derrick, Allison J; Iskandar, Bermans J
2008-09-01
Diagnosis of peripheral neuropathies is based upon patterns of functional deficits and electrodiagnostic testing. However, anatomic variations can lead to confounding patterns of physical and electrodiagnostic findings. Authors present a case of ulnar nerve compression due to a rare combination of anatomic variations, aberrant branching pattern, and FCU insertion at the wrist, which posed a diagnostic and therapeutic dilemma. The literature related to isolated distal ulnar motor neuropathy and anatomic variations of the ulnar nerve and adjacent structures is also reviewed. This case demonstrates how anatomic variations can complicate the interpretation of clinical and electrodiagnostic findings and underscores the importance of thorough exploration of the nerve in consideration for possible variations. (c) 2008 Wiley-Liss, Inc.
NASA Technical Reports Server (NTRS)
Johnson, Jay K.
1991-01-01
Data recovered as the result of a recent field project designed to test a model of the distribution of protohistoric settlement in an unusual physiographic zone in eastern Mississippi are examined using GIS based techniques to manipulate soil and stream distance information. Significant patterning is derived. The generally thin soils and uniform substratum of the Black Prairie in combination with a distinctive settlement pattern offer a promising opportunity for the search for site specific characteristics within airborne imagery. Landsat TM data provide information on modern ground cover which is used as a mask to select areas in which a multivariate search for archaeological site signatures within a TIMS image is most likely to prove fruitful.
A single institution's 1-year experience with uterine fibroid embolization marketing.
Ciacci, Joseph; Taussig, Jacob; Kouri, Brian; Bettmann, Michael
2011-09-01
To assess the impact of various marketing techniques on the referral pattern for uterine fibroid embolization (UFE) at an academic interventional radiology practice over a 1-year period. All referrals to the interventional radiology clinic for UFE from January 1, 2009, to December 31, 2009, were retrospectively reviewed. A standard intake sheet was completed by the interventional clinic secretary at the time of initial patient contact that included the source of the referral (radio, television, newspaper, mailing, Internet, physician, friend, other). All patients who proceeded to consultation were seen in the interventional radiology clinic by attending interventional radiologists in a university-based academic center. The referral pattern was analyzed with respect to the number of patients who contacted the clinic, the number of actual clinic visits, the number of magnetic resonance (MR) imaging examinations performed before and after the procedure, the total number of embolization cases performed, and the subsequent downstream revenue. During the 1-year period, 344 patients contacted the interventional radiology clinic regarding UFE resulting in 171 consultations and 100 pelvic MR imaging examinations performed before the procedure. Sixty-two patients proceeded to UFE, and 32 patients underwent follow-up pelvic MR imaging. These results show a significant increase from eight cases the previous year and are presumably attributable almost entirely to the directed marketing campaign. The marketing initiative consisted primarily of print and radio advertisements, with the latter being the most effective. The total advertising cost for the year was approximately $24,706, of which $20,520 was for radio advertisements. The radio advertisements generated 69% (237 of 344) of the referrals and 69% (43 of 62) of the UFE procedures. Using Medicare reimbursement rates, the radio advertisements generated $281,994 in UFE technical fees and $50,329 in MR imaging technical fees. Direct patient marketing techniques can promote significant growth for a fibroid embolization practice. In our market, radio advertisements proved to be the most cost-effective strategy. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.
Lower extremity endovascular interventions: can we improve cost-efficiency?
O'Brien-Irr, Monica S; Harris, Linda M; Dosluoglu, Hasan H; Dayton, Merril; Dryjski, Maciej L
2008-05-01
Management of lower extremity arterial disease with endovascular intervention is on the rise. Current practice patterns vary widely across and within specialty practices that perform endovascular intervention. This study evaluated reimbursement and costs of different approaches for offering endovascular intervention and identified strategies to improve cost-efficiency. The medical records of all patients admitted to a university health system during 2005 for an endovascular intervention were retrospectively reviewed. Procedure type, setting, admission status, and financial data were recorded. Groups were compared using analysis of variance, Student t test for independent samples, and chi2. A total of 296 endovascular interventions were completed, and 184 (62%) met inclusion criteria. Atherectomy and stenting were significantly more costly when performed in the operating room than in the radiology suite: atherectomy, dollars 6596 vs dollars 4867 (P = .002); stent, dollars 5884 vs dollars 3292, (P < .001); angioplasty, dollars 2251 vs dollars 1881 (P = .46). Reimbursement was significantly higher for inpatient vs ambulatory admissions (P < .001). Costs were lowest when the endovascular intervention was done in the radiology suite on an ambulatory basis and highest when done as an inpatient in the operating room (dollars 5714 vs dollars 12,278; P < .001). Contribution margins were significantly higher for inpatients. Net profit was appreciated only for interventions done as an inpatient in the radiology suite. Reimbursement, contribution margins, and net profit were significantly lower among private pay patients in both the ambulatory and inpatient setting. The 30-day hospital readmission after ambulatory procedures was seven patients (6%). Practice patterns for endovascular interventions differ considerably. Costs vary by procedure and setting, and reimbursement depends on admission status and accurate documentation; these dynamics affect affordability. Organizing vascular services within a hub will ensure that care is delivered in the most cost-efficient manner. Guidelines may include designating the radiology suite as the primary venue for endovascular interventions because it is less costly than the operating room. Selective stenting policies should be considered. Contracts with private insurers must include carve-outs for stent costs and commensurate reimbursement for ambulatory procedures, and Current Procedural Terminology (CPT; American Medical Association, Chicago, Ill) coding must be proficient to make ambulatory endovascular interventions fiscally acceptable.
Climate, not conflict, explains extreme Middle East dust storm
Parolari, Anthony J.; Li, Dan; Bou-Zeid, Elie; ...
2016-11-08
The recent dust storm in the Middle East (Sepember 2015) was publicized in the media as a sign of an impending 'Dust Bowl.' Its severity, demonstrated by extreme aerosol optical depth in the atmosphere in the 99th percentile compared to historical data, was attributed to the ongoing regional conflict. However, surface meteorological and remote sensing data, as well as regional climate model simulations, support an alternative hypothesis: the historically unprecedented aridity played a more prominent role, as evidenced by unusual climatic and meteorological conditions prior to and during the storm. Remotely sensed normalized difference vegetation index demonstrates that vegetation covermore » was high in 2015 relative to the prior drought and conflict periods, suggesting that agricultural activity was not diminished during that year, thus negating the media narrative. Instead, meteorological simulations using the Weather Research and Forecasting (WRF) model show that the storm was associated with a cyclone and 'Shamal' winds, typical for dust storm generation in this region, that were immediately followed by an unusual wind reversal at low levels that spread dust west to the Mediterranean Coast. These unusual meteorological conditions were aided by a significant reduction in the critical shear stress due to extreme dry and hot conditions, thereby enhancing dust availability for erosion during this storm. Concluding, unusual aridity, combined with unique synoptic weather patterns, enhanced dust emission and westward long-range transport across the region, thus generating the extreme storm.« less
Anhøj, Jacob
2015-01-01
Run charts are widely used in healthcare improvement, but there is little consensus on how to interpret them. The primary aim of this study was to evaluate and compare the diagnostic properties of different sets of run chart rules. A run chart is a line graph of a quality measure over time. The main purpose of the run chart is to detect process improvement or process degradation, which will turn up as non-random patterns in the distribution of data points around the median. Non-random variation may be identified by simple statistical tests including the presence of unusually long runs of data points on one side of the median or if the graph crosses the median unusually few times. However, there is no general agreement on what defines “unusually long” or “unusually few”. Other tests of questionable value are frequently used as well. Three sets of run chart rules (Anhoej, Perla, and Carey rules) have been published in peer reviewed healthcare journals, but these sets differ significantly in their sensitivity and specificity to non-random variation. In this study I investigate the diagnostic values expressed by likelihood ratios of three sets of run chart rules for detection of shifts in process performance using random data series. The study concludes that the Anhoej rules have good diagnostic properties and are superior to the Perla and the Carey rules. PMID:25799549
Climate, not conflict, explains extreme Middle East dust storm
DOE Office of Scientific and Technical Information (OSTI.GOV)
Parolari, Anthony J.; Li, Dan; Bou-Zeid, Elie
The recent dust storm in the Middle East (Sepember 2015) was publicized in the media as a sign of an impending 'Dust Bowl.' Its severity, demonstrated by extreme aerosol optical depth in the atmosphere in the 99th percentile compared to historical data, was attributed to the ongoing regional conflict. However, surface meteorological and remote sensing data, as well as regional climate model simulations, support an alternative hypothesis: the historically unprecedented aridity played a more prominent role, as evidenced by unusual climatic and meteorological conditions prior to and during the storm. Remotely sensed normalized difference vegetation index demonstrates that vegetation covermore » was high in 2015 relative to the prior drought and conflict periods, suggesting that agricultural activity was not diminished during that year, thus negating the media narrative. Instead, meteorological simulations using the Weather Research and Forecasting (WRF) model show that the storm was associated with a cyclone and 'Shamal' winds, typical for dust storm generation in this region, that were immediately followed by an unusual wind reversal at low levels that spread dust west to the Mediterranean Coast. These unusual meteorological conditions were aided by a significant reduction in the critical shear stress due to extreme dry and hot conditions, thereby enhancing dust availability for erosion during this storm. Concluding, unusual aridity, combined with unique synoptic weather patterns, enhanced dust emission and westward long-range transport across the region, thus generating the extreme storm.« less
Factors associated with smoking among tuberculosis patients in Spain.
Jiménez-Fuentes, María Ángeles; Rodrigo, Teresa; Altet, María Neus; Jiménez-Ruiz, Carlos A; Casals, Martí; Penas, Antón; Mir, Isabel; Solano Reina, Segismundo; Riesco-Miranda, Juan Antonio; Caylá, Joan A
2016-09-14
To determine the prevalence of smoking and analyze associated factors in a cohort of patients diagnosed with tuberculosis (TB) in Spain between 2006 and 2013. Multicenter, cross-sectional, descriptive, observational study using a national database of TB patients, using logistic regression to calculate odds ratios (OR) and confidence intervals (CI). We analyzed 5,846 cases (62 % men, mean age 39 years, 33 % foreigners). 23.4 % were alcohol abuser, 1.3 % were injected drug users (IDU), 4.6 % were co-infected with HIV, and 7.5 % had a history of TB treatment. 6.6 % and 0.8 % showed resistance to one and multiple drugs, respectively. The predominant clinical presentation was pulmonary (71 %) with a cavitary radiological pattern in 32.8 % of cases. 82 % of cases were confirmed microbiologically, and 54 % were smear-positive microscopy. 2,300 (39.3 %) patients were smokers. The following factors were associated with smoking: male sex (OR = 2.26;CI:1.97;2.60), Spanish origin (OR = 2.79;CI:2.40-3.24), alcoholism (OR = 2.85;CI:2.46;3.31), IDU (OR = 2.78;CI:1.48;5.52), homelessness (OR = 1.99;CI:1.14-3.57), pulmonary TB (OR = 1.61;CI:1.16;2.24), cavitary radiological pattern (OR = 1.99;CI:1.43;2.79) and a smear-positive microscopy at the time of diagnosis (OR = 1.39;CI:1.14;1.17). The prevalence of smoking among TB patients is high. Smokers with TB have a distinct sociodemographic, clinical, radiological and microbiological profile to non-smokers.
Milk of calcium stones: radiological signs and management outcome.
El-Shazly, M
2015-06-01
Milk of calcium (MOC) is a rare type of stone that was first described in 1940 by Ludin and Howald who reported MOC in renal cysts. Milk of calcium is a viscous colloidal suspension of calcium salts. Stasis, obstruction and infection are important predisposing factors. Due to a layering effect, characteristic radiological signs especially in CT can help in diagnosis to avoid unsuccessful shock wave lithotripsy. This is the largest reported case series, in which radiological signs by CT scan to predict renal MOC stones, clinical picture and management outcome are described in detail. Cases with suspected renal milk of calcium stones were studied over 7 years (2008-2015). All cases were diagnosed preoperatively by non-contrast CT. Urine cultures were performed in all patients preoperatively. Intra-operative and postoperative findings were reported. Stones retrieved were sent for chemical analysis using an infrared method. Seven cases of milk of calcium renal stones were included in this study. These stones were faint radio-opaque in two cases and radiolucent in five cases. All cases were diagnosed preoperatively with non-contrast CT. Their Hounsfield units (HU) ranged from 114 to 612. All stones were located in a dependent position (gravitational effect) in the posterior aspect of dilated calyces. Five cases exhibited the typical fluid level and two cases demonstrated semilunar (half moon) pattern in the anterior surface of the stones. All cases underwent PCNL with suction and retrieval of soft stones without the need for disintegration. When stones demonstrate a low Hounsfield unit, are arranged in dependent positions within dilated calyces and exhibit fluid level or semilunar pattern on non-contrast CT, milk of calcium stones should be considered. PCNL is an effective modality for management of renal milk of calcium stones.
Radiologic-pathologic correlation of renal cell carcinoma associated with Xp11.2 translocation.
Koo, Hyun Jung; Choi, Hyuck Jae; Kim, Mi-hyun; Cho, Kyoung-Sik
2013-09-01
The prognosis of translocation RCCs in adult patients is relatively poor compared to that of other subtypes of RCCs. Although there have been several reports regarding radiologic findings of translocation RCC, studies with histologic correlation could help to understand the imaging features. To explore the correlation between radiologic and pathologic findings in Xp11.2 translocation renal cell carcinoma (RCC) and provide clues for translocation RCC diagnosis. CT scans of six patients (one man and five women; age range, 8-71 years; mean age, 34 years) with histologically-proven Xp11.2 translocation RCCs were retrospectively evaluated in consensus by two radiologists. Tumor size, presence of necrosis, hemorrhage, fat or calcification, enhancement patterns of the tumor, presence of lymphadenopathy, and distant metastases were evaluated. The average size of the tumors was 6 cm (range, 2.7-12 cm). All six tumors appeared as well-defined masses with areas of low attenuation representing hemorrhage or necrosis. Four tumors contained high attenuating solid portions, compared to the surrounding renal cortex seen on unenhanced images, where representing dense cellular component on microscopic examination. Peripheral rim enhancement pattern that correlated with histologic finding of a fibrous capsule was seen in five cases. In two patients who underwent kidney MR, the masses showed low signal intensity on T2-weighted images. One patient had lymphadenopathy. No distant metastasis was noted in any patient. Translocation RCC appeared as a well-defined mass that contain high attenuating solid portions on unenhanced images and low attenuating necrotic or hemorrhagic foci; the tumor also showed gradual peripheral rim enhancement due to a fibrous capsule surrounding the tumor.
Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip
2014-09-01
The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p < 0.05) and no significant change in coracoclavicular distance (10.4 ± 0.9 vs. 10.0 ± 0.8 mm). According to the Rockwood classification only type I and II lesions occurred. After additional coracoclavicular ligament cut, the acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p < 0.05. The mean coracoclavicular distance increased to 20.6 ± 2.1 mm resulting in type III-V lesions concerning the Rockwood classification. Trauma with intact coracoclavicular ligaments did not result in acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.
Workforce Effects and the Evolution of Complex Sociality in Wild Damaraland Mole Rats.
Young, Andrew J; Jarvis, Jennifer U M; Barnaville, James; Bennett, Nigel C
2015-08-01
Explaining the evolution of eusocial and cooperatively breeding societies demands that we understand the effects of workforce size on the reproductive success of breeders. This challenge has yet to be addressed in the family that arguably exhibits the most extreme outcomes of vertebrate social evolution, the African mole rats (Bathyergidae), leaving the ultimate causes of their many unusual adaptations open to debate. Here we report-using a 14-year field study of wild Damaraland mole rats, Fukomys damarensis-that workers appear to have strong but unusual effects on offspring. Groups with larger workforces exhibited substantially higher rates of offspring recruitment while maintaining high juvenile survival rates, relationships that may have favored the evolution of the delayed dispersal, cooperation, morphological specialization, and unusual patterns of longevity that characterize such societies. Offspring reared by larger workforces also showed slower growth, however. That reduced offspring growth in larger groups has also been documented under ad lib. food conditions in the laboratory raises the possibility that this reflects socially induced growth restraint rather than simple constraints on resource availability. Our findings shed new light on the evolution of complex sociality in this enigmatic clade and highlight further departures from the norms reported for other cooperative vertebrates.
Wang, Tao; Stadler, Zsofia K; Zhang, Liying; Weiser, Martin R; Basturk, Olca; Hechtman, Jaclyn F; Vakiani, Efsevia; Saltz, Lenard B; Klimstra, David S; Shia, Jinru
2018-04-01
Microsatellite instability, a well-established driver pathway in colorectal carcinogenesis, can develop in both sporadic and hereditary conditions via different molecular alterations in the DNA mismatch repair (MMR) genes. MMR protein immunohistochemistry (IHC) is currently widely used for the detection of MMR deficiency in solid tumors. The IHC test, however, can show varied staining patterns, posing challenges in the interpretation of the staining results in some cases. Here we report a case of an 80-year-old female with a colonic adenocarcinoma that exhibited an unusual "null" IHC staining pattern with complete loss of all four MMR proteins (MLH1, MSH2, MSH6, and PMS2). This led to subsequent MLH1 methylation testing and next generation sequencing which demonstrated that the loss of all MMR proteins was associated with concurrent promoter hypermethylation of MLH1 and double somatic truncating mutations in MSH2. These molecular findings, in conjunction with the patient's age being 80 years and the fact that the patient had no personal or family cancer history, indicated that the MMR deficiency was highly likely sporadic in nature. Thus, the stringent Lynch syndrome type surveillance programs were not recommended to the patient and her family members. This case illustrates a rare but important scenario where a null IHC phenotype signifies complex underlying molecular alternations that bear clinical management implications, highlighting the need for recognition and awareness of such unusual IHC staining patterns.
Emotion and style in an English translation of the Quran.
Whissell, Cynthia
2004-04-01
An English translation of the Quran was studied in terms of word use patterns, emotionality of words, and style. Variables were assessed with the help of computer programs and the Dictionary of Affect in Language. On the basis of words used at unusually high frequencies, the translation of the Quran was seen to be emphatically about Allah, his Prophets and Message, and believers. The translation of the Quran was slightly less Pleasant and Active in emotional tone than everyday English and also less concrete. It contained an unusual number of negatives and was repetitive but did not contain many rare or long words. Significant differences were noted between chronologically Early and Late suras (chapters) in terms of emotion, style, and word use. An inflection point was identified in the time-line partway through the Meccan suras of the Quran.
Intellectual disability, unusual facial morphology and hand anomalies in sibs.
Sousa, Sérgio B; Venâncio, Margarida; Chanudet, Estelle; Palmer, Rodger; Ramos, Lina; Beales, Philip L; Moore, Gudrun E; Saraiva, Jorge M; Hennekam, Raoul C
2013-10-01
Here we report on a Portuguese family with three sisters who shared moderate intellectual disability, unusual facial morphology (short palpebral fissures; broad nasal tip; thin upper and lower vermillion; broad and pointed chin) and hand anomalies in two of them (short left third and fifth right metacarpals in one case; marked syndactyly between the third and fourth fingers in another). One of the sisters had microcephaly and short stature, and the other two were obese. Obesity and somewhat similar facial features were also present in the otherwise healthy mother. Despite the overlap with several known syndromes (Albright osteodystrophy; Filippi syndrome; Rubinstein-Taybi syndrome; microdeletion 2q37), we suggest this condition is previously unreported, and most likely displays an autosomal recessive pattern of inheritance. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.
From coffee ring to spherulites ring of poly(ethylene oxide) film from drying droplet
NASA Astrophysics Data System (ADS)
Hu, Yinchun; Zhang, Xuerong; Qiu, Maibo; Wei, Yan; Zhou, Qiong; Huang, Di
2018-03-01
We discuss how the "spherulites ring" morphology and "coffee ring" profile of PEO film formed by the drying droplet at glass substrate with different heating rate. Upon increasing the heating rate of substrate, it is found that deposited PEO film from drying droplet shows the unusually observed "coffee ring" profile and "spherulites ring" morphology. The main mechanism for this phenomenon is proposed to be an enhanced Marangoni convection which is induced by the increased solute concentration gradient and reduced viscous force above 70 °C. A simple formation mechanism of the unusually observed "coffee ring" profile and "spherulites ring" morphology is proposed. These findings can be exploited to trace the center of Marangoni convection, with potential applications in designing the spherulite patterns of crystalline polymer films in ink-jet printing and self-assembly fields.
Unusual injury pattern in a case of postmortem animal depredation by a domestic German shepherd.
Tsokos, M; Schulz, F; Püschel, K
1999-09-01
A case is presented of a 38-year-old woman with skeletization of the head, neck, and collar region and a circumscribed 26-cm x 19-cm defect on the left chest with sole removal of the heart through the opened pericardium but undamaged mediastinum and lungs. The injuries showed V-shaped puncture wounds and superficial claw-induced scratches adjacent to the wound margins that have been described as typical for postmortem animal depredation of carnivore origin and derived from postmortem animal damage by the woman's domestic German shepherd. The circumscribed destruction of the left chest with unusual opening of the pericardium is explained by the physiognomy of the muzzle of the German shepherd and differs from previous reports. Any case presented as postmortem animal mutilation should be viewed with skepticism and undergo a full autopsy.
Vision and benefits of a virtual radiology environment for the U.S. Army
NASA Astrophysics Data System (ADS)
Chacko, Anna K.; Griffin, Robert; Cook, Jay F.; Martinez, Ralph; Lollar, H. William; Perez, Guadalupe
1998-07-01
The changes that have overtaken the U.S. healthcare industry in the last five years could be best characterized as tectonic shifts. Every aspect of the healthcare market has been affected by the changes in Government policy and the attitude of society to issues in Healthcare. Most of these changes have been viewed as adversarial both to the health care provider and to the consumer. Healthcare reform was to have made healthcare more affordable and more available. Although healthcare reform was not passed, attempts have been made nationwide to address the ills of the system. These attempts have been largely half-hearted and weak-kneed. In most instances, only half a solution has been provided. There has been no improvement in the quality of care. In fact, in many instances, there has been degradation in quality and it has not become more available. We are faced with seemingly conflicting mandates -- providing quality care making it more available working under severe capitation constraints and attracting and retaining a quality workforce. How do we address these problems? We have to change. We have to adopt the military paradigm of agility, adaptability and flexibility applicable to military science to our field of endeavor. We have to consider achieving all our goals without sacrificing any aspect. The most obvious step is to improve efficiency. This can be done best by incorporating the advantages that information technology has bestowed on other fields of endeavor. Properly applied information technology will provide the answer to improving efficiency in the Healthcare field. In the Department of Defense (DoD), we are now embarking on an extremely exciting new idea -- rendering the entire Virtual Radiology Environment (VRE). The business of radiology in the military therefore, is being re-engineered on several fronts. This is achieved in several sequential steps: (1) Equipping every radiology department to become digital and PACS-network capable. (2) Information Retrieval, Routing and Archiving -- developing a network. (3) Relook at staffing patterns and intelligent management of those patterns. (4) Arming ourselves for the future -- learning to enjoy chaos. In this paper, we then formulate a master plan for developing large hospital PAC Systems that will service the entire Regional Medical Command (RMC) and Medical Treatment Facilities (MTFs). The systems engineering methodology is presented, as well as some important characteristics of the VRE. The resulting Virtual Radiology Environment will enable to improve access and quality and reduce cost in the Army.
Soheili, Arash; Tambar, Uttam K
2013-10-04
A formal total synthesis of (±)-amathaspiramide F through a tandem palladium-catalyzed allylic amination/[2,3]-Stevens rearrangement is reported. The unexpected diastereoselectivity of the [2,3]-Stevens rearrangement was controlled by the substitution patterns of an aromatic ring. This discovery represents a new stereocontrolling element for [2,3]-sigmatropic rearrangements in complex molecular settings.
Vanacker, Peter; Matias, Gonçalo; Hagmann, Patric; Michel, Patrik
2015-01-01
PRES is a reversible neurotoxic state presenting with headache, altered mental status, visual loss, and seizures. Delayed diagnosis can be avoided if radiological patterns could distinguish PRES from cerebral ischemia. Clinical and radiological data were collected on all hospitalized patients who had (1) discharge diagnosis of PRES and (2) acute CTP/CTA. Data were compared with 10 TIA patients with proven cytotoxic edema on MRI. Of the four PRES patients found, three were correlated with acute blood pressure and one with chemotherapy. At the radiological level, quantitative analyses of the CTP parameters showed that 2 out of 4 patients had bilaterally reduced CBF-values (23.2-47.1 ml/100g/min) in occipital regions, as seen in the pathological regions of TIA patients (27.3 ± 13.5 ml/100g/min). When compared with TIA patients, the pathological ROI's demonstrated decreased CBV-values (3.4-5.6 ml/100g). Vasogenic edema on MRI FLAIR imaging was seen in only one PRES patient, and cytotoxic edema on DWI-imaging was never found. CT angiography showed in one PRES patient a vasospasm-like unilateral posterior cerebral artery. If confirmed by other groups, CTP and CTA imaging in patients with acute visual loss and confusion may help to distinguish PRES from bi-occipital ischemia. These radiological parameters may identify PRES patients at risk for additional tissue infarction. Copyright © 2014 by the American Society of Neuroimaging.
Data Science in Radiology: A Path Forward.
Aerts, Hugo J W L
2018-02-01
Artificial intelligence (AI), especially deep learning, has the potential to fundamentally alter clinical radiology. AI algorithms, which excel in quantifying complex patterns in data, have shown remarkable progress in applications ranging from self-driving cars to speech recognition. The AI application within radiology, known as radiomics, can provide detailed quantifications of the radiographic characteristics of underlying tissues. This information can be used throughout the clinical care path to improve diagnosis and treatment planning, as well as assess treatment response. This tremendous potential for clinical translation has led to a vast increase in the number of research studies being conducted in the field, a number that is expected to rise sharply in the future. Many studies have reported robust and meaningful findings; however, a growing number also suffer from flawed experimental or analytic designs. Such errors could not only result in invalid discoveries, but also may lead others to perpetuate similar flaws in their own work. This perspective article aims to increase awareness of the issue, identify potential reasons why this is happening, and provide a path forward. Clin Cancer Res; 24(3); 532-4. ©2017 AACR . ©2017 American Association for Cancer Research.
Semi-Automatic Terminology Generation for Information Extraction from German Chest X-Ray Reports.
Krebs, Jonathan; Corovic, Hamo; Dietrich, Georg; Ertl, Max; Fette, Georg; Kaspar, Mathias; Krug, Markus; Stoerk, Stefan; Puppe, Frank
2017-01-01
Extraction of structured data from textual reports is an important subtask for building medical data warehouses for research and care. Many medical and most radiology reports are written in a telegraphic style with a concatenation of noun phrases describing the presence or absence of findings. Therefore a lexico-syntactical approach is promising, where key terms and their relations are recognized and mapped on a predefined standard terminology (ontology). We propose a two-phase algorithm for terminology matching: In the first pass, a local terminology for recognition is derived as close as possible to the terms used in the radiology reports. In the second pass, the local terminology is mapped to a standard terminology. In this paper, we report on an algorithm for the first step of semi-automatic generation of the local terminology and evaluate the algorithm with radiology reports of chest X-ray examinations from Würzburg university hospital. With an effort of about 20 hours work of a radiologist as domain expert and 10 hours for meetings, a local terminology with about 250 attributes and various value patterns was built. In an evaluation with 100 randomly chosen reports it achieved an F1-Score of about 95% for information extraction.
Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey.
Yazgan, Cisel; Aksu, Nalan M
2016-06-01
To present the radiological features of blast-related injuries in the victims of the 10 October 2015 Ankara bombing and emphasize the importance of imaging. This retrospective descriptive study included a total of 28 patients who underwent CT scan or radiographic imaging within 6 h after the bombing on 10 October 2015. CT scans and plain radiographs were evaluated regarding mechanisms of injuries. Injuries were categorized as primary, secondary, tertiary and quaternary. The number of shrapnel and distribution of injuries were noted. Injury Severity Score (ISS) was used to rank the severity of the injury. Primary blast injuries consisted of only tympanic membrane rupture. A high rate of patients (21/28 patients) in the study group suffered from secondary blast injuries. Tertiary injuries were detected in only three patients. Of the severely injured patients, five had abdominal injuries, three had thoracic injuries and six had extremity injuries. ISS was significantly higher in patients with thoracic and abdominal injuries. Our results after the suicide bomb attacks showed that the most common injury pattern was secondary blast injury. The torso was the most commonly injured body region, followed by the extremities. This specific injury pattern requires the use of immense radiological imaging. Hence, radiologists should be aware of the mechanisms and spectrums of blast-related injuries. Both the unique injury pattern and the following chaos make blast-related injuries a challenge in terms of triage, diagnosis and management. Radiologists should be familiar with the wide spectrum of these unique injuries.
Peyre, Matthieu; Goutagny, Stephane; Imbeaud, Sandrine; Bozorg-Grayeli, Alexis; Felce, Michele; Sterkers, Olivier; Kalamarides, Michel
2011-01-01
Surgical management of bilateral vestibular schwannomas (VS) in neurofibromatosis type 2 (NF2) is often difficult, especially when both tumors threaten the brainstem. When the largest tumor has been removed, the management of the contralateral VS may become puzzling. To give new insights into the growth pattern of these tumors and to determine the best time point for treatment (surgery or medical treatment), we studied radiological growth in 11 VS (11 patients with NF2) over a long period (mean duration, 7.6 years), before and after removal of the contralateral tumor while both were threatening the brainstem. We used a quantitative approach of the radiological velocity of diametric expansion (VDE) on consecutive magnetic resonance images. Before first surgery, growth patterns of both tumors were similar in 9 of 11 cases. After the first surgery, VDE of the remaining VS was significantly elevated, compared with the preoperative period (2.5 ± 2.2 vs 4.4 ± 3.4 mm/year; P = .01, by Wilcoxon test). Decrease in hearing function was associated with increased postoperative growth in 3 cases. Growth pattern of coexisting intracranial meningiomas was not modified by VS surgery on the first side. In conclusion, removal of a large VS in a patient with NF2 might induce an increase in the growth rate of the contralateral medium or large VS. This possibility should be integrated in NF2 patient management to adequately treat the second VS. PMID:21798887
Pérez de San Román-Mena, Laila; Simal-Julián, Juan Antonio; Miranda-Lloret, Pablo; Sanromán-Álvarez, Pablo; Botella-Asunción, Carlos
2017-08-01
The surgical approach to the petrous apex (PA) and petroclival junction (PCJ) remains a challenge. The carotid-clival window (CCW) represents the widest window available to approach the PCJ from a mediolateral endoscopic route. Here we define the CCW radiologically in nonpathological conditions, to establish the anatomic variability of the PCJ, relate this variability to pneumatization patterns, and evaluate some technical concerns conditioned by the CCW. This was an analytical study of 10 multislice computed tomography scans from patients without SB pathology. Bilateral measures were taken at the roof and floor levels of the lacerum canal (LC) and its posterior projection over the PCJ (segments DE and QR). All measures were compared across different pneumatization patterns. The DE and QR lengths were found to be the most important measures affecting the width of the CCW. Wide variability was observed, with a mean DE length of 8.52 mm (range, 2.4-12.8 mm) at the LC floor level and a mean QR length of 9.11 mm (range, 4.3-13.1 mm) at the LC roof level. The presence of retrocarotid pneumatization was statistically significantly associated with longer DE and QR segments. No differences were found among other pneumatization patterns. The CCW varies widely among individuals. The presence of pneumatization behind the paraclival carotid represents an advantageous characteristic when planning an endoscopic approach to the PCJ. Copyright © 2017 Elsevier Inc. All rights reserved.
Neuropareidolia: diagnostic clues apropos of visual illusions.
Maranhão-Filho, Péricles; Vincent, Maurice B
2009-12-01
Diagnosis in neuroimaging involves the recognition of specific patterns indicative of particular diseases. Pareidolia, the misperception of vague or obscure stimuli being perceived as something clear and distinct, is somewhat beneficial for the physician in the pursuit of diagnostic strategies. Animals may be pareidolically recognized in neuroimages according to the presence of specific diseases. By associating a given radiological aspect with an animal, doctors improve their diagnostic skills and reinforce mnemonic strategies in radiology practice. The most important pareidolical perceptions of animals in neuroimaging are the hummingbird sign in progressive supranuclear palsy, the panda sign in Wilson's disease, the panda sign in sarcoidosis, the butterfly sign in glioblastomas, the butterfly sign in progressive scoliosis and horizontal gaze palsy, the elephant sign in Alzheimer's disease and the eye-of-the-tiger sign in pantothenate kinase-associated neurodegenerative disease.
2014-01-01
As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic mucoepidermoid carcinoma misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive jaundice, epigastric discomfort, and weight loss with slightly increased carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod carcinoma of liver by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060 PMID:24475740
Brown-Sequard syndrome associated with unusual spinal cord injury by a screwdriver stab wound
Beer-Furlan, André Luiz; Paiva, Wellingson Silva; Tavares, Wagner Malagó; de Andrade, Almir Ferreira; Teixeira, Manoel Jacobsen
2014-01-01
Introduction: Stab wounds resulting in spinal cord injuries are very rare. In direct central back stabbings, the layers of muscles and the spinal column tends to deflect blades, rarely causing injuries to the spinal cord. We report an unusual case of traumatic spinal cord injury by a screwdriver stab, presented as Brown-Séquard syndrome and discuss possible pitfalls on the surgical treatment. Case report: A 34 year-old man was brought to the emergency department after a group assault with a single screwdriver stab wound on the back. Neurological examination revealed an incomplete Brown-Sequard syndrome, with grade IV motor deficit on the left leg and contralateral hemihypoalgesia below T9 level. Radiological evaluation showed a retained 9 cm screwdriver that entered and trespassed the spinal canal at T6 level, reaching the posterior mediastinum with close relation to the thoracic aorta. Vascular injury could not be excluded. The joint decision between the neurosurgery and the vascular surgery teams was the surgical removal of the screwdriver under direct visualization. A left mini-thoracotomy was performed. Simultaneously, a careful dissection was done and screwdriver was firmly pulled back on the opposite path of entry under direct visualization of the aorta. The neurological deficit was maintained immediately after the surgical procedure. Follow-up visit after 1 year showed minor motor deficit and good healing. Conclusions: It is important to consider all aspects of secondary injury on the surgical planning of penetrating spinal cord injury. The secondary injury can be minimized with multidisciplinary planning of the surgical procedure. PMID:24482724
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nishimuri, Gen; Fukushima, Yoshimitsu; Ohashi, Hirofumi
1995-11-20
The recent discovery of mutations in the FGFR-3 (fibroblast growth factor receptor-3) gene (FGFR3) as the cause of achondroplasia has provided new insight into understanding genetic diseases. It was surprising from the viewpoint of molecular genetics that most patients with achondroplasia showed the same mutation at nucleotide 1138, leading to a single amino acid substitution from glycine to arginine at codon 380 (Gly380Arg). All 39 patients examined by two groups had the Gly380Arg; 38 patients and the other demonstrated a G to A and a G to C transition at nucleotide 1138, respectively. Subsequently another group disclosed a G tomore » A transition at the same nucleotide 1138 in 21/23 patients of diverse ethnic origin, although mutations were not identified in two patients. To date, a total of 193 patients with the mutation of the G380Arg have been reported; a single patient with another mutation resulting in a substitution from glycine to cysteine at codon 375 (Gly375Cys) has been described. The presence of this common mutation is consistent with the clinical fact that achondroplastic individuals show less phenotypic variability than is unusual for autosomal dominant diseases. We encountered a Japanese boy with the Gly375Cys. His mother with achondroplasia has the same mutation. The molecular investigation of these patients was reported elsewhere. Here we report the clinical and radiological findings in this boy who demonstrated some atypical manifestations from those of typical achondroplasia. 8 refs., 1 fig.« less
Kim, Sung Han; Yuk, Heong Dong; Park, Weon Seo; Kim, Sun Ho; Joung, Jae Young; Seo, Ho Kyung; Lee, Kang Hyun; Chung, Jinsoo
2016-01-01
Mucinous cystadenocarcinoma (MC) of the kidney is a rare epithelial tumor originating from the renal pelvic urothelium and few study cases have been reported. Because of the rarity of these tumors and their unknown histogenesis, its diagnosis is difficult until surgical exploration. We report here on a 55-year-old man referred to the urology department from the hepatology department because of a cystic renal mass measuring approximately 5 cm in size, which was detected incidentally under ultrasonography during the routine examination of liver. The renal mass was finally diagnosed as MC originating from kidney after partial nephrectomy and the patient still showed no evidence of recurrence until 12 months postoperatively. This is the first report on a case of renal MC in a patient who underwent partial nephrectomy. The aim of this report is to present our unusual case of MC and also review the previous literature on the pathological and radiological aspects of MC of kidney. PMID:25687861
Intrauterine midgut volvulus without malrotation: Diagnosis from the ‘coffee bean sign’
Park, Jun Seok; Cha, Seong Jae; Kim, Beom Gyu; Kim, Yong Seok; Choi, Yoo Shin; Chang, In Taik; Kim, Gwang Jun; Lee, Woo Seok; Kim, Gi Hyeon
2008-01-01
Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, during the gestation period. This 2.79 kg, 33-wk infant was born via a spontaneous vaginal delivery caused by preterm labor. Prenatal ultrasound showed dilated bowel loops with the appearance of a ‘coffee bean sign’. This patient had an unusual presentation with a distended abdomen showing skin discoloration. An emergency laparotomy revealed a midgut volvulus and a twisted small bowel, caused by complicated meconium ileus. Such nonspecific prenatal radiological signs and a low index of suspicion of a volvulus during gestation might delay appropriate surgical management and result in ischemic necrosis of the bowel. Preterm labor, specific prenatal sonographic findings (for example, the coffee bean sign) and bluish discoloration of the abdominal wall could suggest intrauterine midgut volvulus requiring prompt surgical intervention. PMID:18322966
Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8)
Lirio, Francisco; Sesma, Julio; Baschwitz, Benno; Bolufer, Sergio
2017-01-01
Unusual anatomical segmentectomies are technically demanding procedures that require a deep knowledge of intralobar anatomy and surgical skill. In the other hand, these procedures preserve more normal lung parenchyma for lesions located in specific anatomical segments, and are indicated for benign lesions, metastasis and also early stage adenocarcinomas without nodal involvement. A 32-year-old woman was diagnosed of a benign pneumocytoma in the anterior segment of the left-lower lobe (S8, LLL), so we performed a single-incision video-assisted thoracoscopic surgery (SI-VATS) anatomical S8 segmentectomy in 140 minutes under intercostal block. There were no intraoperative neither postoperative complications, the chest tube was removed at 24 hours and the patient discharged at 5th postoperative day with low pain on the visual analogue scale (VAS). Final pathologic exam reported a benign sclerosant pneumocytoma with free margins. The patient has recovered her normal activities at 3 months completely with radiological normal controls at 1 and 3 months. PMID:29078674
Single-incision video-assisted thoracoscopic surgery left-lower lobe anterior segmentectomy (S8).
Galvez, Carlos; Lirio, Francisco; Sesma, Julio; Baschwitz, Benno; Bolufer, Sergio
2017-01-01
Unusual anatomical segmentectomies are technically demanding procedures that require a deep knowledge of intralobar anatomy and surgical skill. In the other hand, these procedures preserve more normal lung parenchyma for lesions located in specific anatomical segments, and are indicated for benign lesions, metastasis and also early stage adenocarcinomas without nodal involvement. A 32-year-old woman was diagnosed of a benign pneumocytoma in the anterior segment of the left-lower lobe (S8, LLL), so we performed a single-incision video-assisted thoracoscopic surgery (SI-VATS) anatomical S8 segmentectomy in 140 minutes under intercostal block. There were no intraoperative neither postoperative complications, the chest tube was removed at 24 hours and the patient discharged at 5 th postoperative day with low pain on the visual analogue scale (VAS). Final pathologic exam reported a benign sclerosant pneumocytoma with free margins. The patient has recovered her normal activities at 3 months completely with radiological normal controls at 1 and 3 months.
de Foucher, Tiphaine; Roussel, Hélène; Hivelin, Mikael; Rossi, Léa; Cornou, Caroline; Bats, Anne-Sophie; Deloménie, Myriam; Lécuru, Fabrice; Ngô, Charlotte
2017-01-01
Malignant phyllodes tumors (MPT) are rare breast neoplasms. Preoperative diagnosis is often challenging due to the unspecific clinical, radiological, and histological characteristics of the tumor. Dissemination pathways are local with chest wall invasion, regional with lymph nodes metastasis, and distant, hematogenous, mostly to the lungs, bones, and brain. Distant metastasis (DM) can be synchronous or appear months to years after the diagnosis and initial management. The current report describes the case of a 57-year-old woman presenting with a giant/neglected MPT of the breast, with no DM at initial staging, treated by radical modified mastectomy. Motor disorders due to medullar compression by a paravertebral mass appeared at short follow-up, also treated surgically. The patient died from several DM of rapid evolution. To our knowledge, this is the only case described of MPT with metastases to soft tissue causing medullar compression. We present a literature review on unusual metastatic localizations of MPT.
Line intensity measurements and analysis in the ν3 band of ruthenium tetroxide
NASA Astrophysics Data System (ADS)
Vander Auwera, J.; Reymond-Laruinaz, S.; Boudon, V.; Doizi, D.; Manceron, L.
2018-01-01
Ruthenium tetroxide (RuO4) is a heavy tetrahedral molecule characterized by an unusual volatility near ambient temperature. Because of its chemical toxicity and the radiological impact of its 103Ru and 106Ru isotopologues, the possible remote sensing of this compound in the atmosphere has renewed interest in its spectroscopic properties. The present contribution is the first investigation dealing with high-resolution line-by-line intensity measurements for the strong fundamental band observed near 10 μm, associated with the excitation of the infrared active stretching mode ν3. It relies on new, high resolution FTIR spectra recorded at room temperature, using a specially constructed cell and an isotopically pure sample of 102Ru16O4. Relying on an effective Hamiltonian and associated effective dipole moment [S Reymond-Laruinaz et al, J Mol Spectrosc 2015;315:46-54], the measured line intensities were assigned and dipole moment parameters determined. A HITRAN-formatted frequency and intensity line list was generated.
Mladenović, Marko; Micić, Ivan; Andjelković, Zoran; Mladenović, Desimir; Stojiljković, Predrag
2015-12-01
Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.
Unusual case of acute appendicitis with left upper quadrant abdominal pain.
Tawk, Charbel M; Zgheib, Rana R; Mehanna, Seba
2012-01-01
Acute appendicitis is one of the most frequent causes of surgical abdominal pain presenting to the Emergency Department. The diagnosis is confirmed by a set of clinical signs, blood tests and imaging. The typical presentation consists of periumbilical pain radiating to the right lower quadrant with peritoneal reaction on palpation (Mac Burney). In this article, we report a case of acute appendicitis presenting with a left upper quadrant pain due to intestinal malrotation and we describe the radiologic findings on computed tomography. With an Alvarado score of 4 and a nonconclusive abdominal U/S, the diagnosis of acute appendicitis was a long shot. Persistence of pain and increasing inflammatory parameters in her blood exams pushed the medical team to further investigate and a CT scan revealed intestinal malrotation with acute appendicitis. An examining physician should not be mislead by the atypical presentation of acute appendicitis and should bear in mind the diagnosis to avoid serious complications. Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
Rebahi, H; El Adib, A G; Mouaffak, Y; El Hattaoui, M; Chaara, A; Sadek, H; Khouchani, M; Mahmal, L; Younous, S
2015-01-01
Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.
Emergent Rotational Symmetries in Disordered Magnetic Domain Patterns
NASA Astrophysics Data System (ADS)
Su, Run; Seu, Keoki A.; Parks, Daniel; Kan, Jimmy J.; Fullerton, Eric E.; Roy, Sujoy; Kevan, Stephen D.
2011-12-01
Uniaxial systems often form labyrinthine domains that exhibit short-range order but are macroscopically isotropic and would not be expected to exhibit precise symmetries. However, their underlying frustration results in a multitude of metastable configurations of comparable energy, and driving such a system externally might lead to pattern formation. We find that soft x-ray speckle diffraction patterns of the labyrinthine domains in CoPd/IrMn heterostructures reveal a diverse array of hidden rotational symmetries about the magnetization axis, thereby suggesting an unusual form of emergent order in an otherwise disordered system. These symmetries depend on applied magnetic field, magnetization history, and scattering wave vector. Maps of rotational symmetry exhibit intriguing structures that can be controlled by manipulating the applied magnetic field in concert with the exchange bias condition.
Emergent rotational symmetries in disordered magnetic domain patterns.
Su, Run; Seu, Keoki A; Parks, Daniel; Kan, Jimmy J; Fullerton, Eric E; Roy, Sujoy; Kevan, Stephen D
2011-12-16
Uniaxial systems often form labyrinthine domains that exhibit short-range order but are macroscopically isotropic and would not be expected to exhibit precise symmetries. However, their underlying frustration results in a multitude of metastable configurations of comparable energy, and driving such a system externally might lead to pattern formation. We find that soft x-ray speckle diffraction patterns of the labyrinthine domains in CoPd/IrMn heterostructures reveal a diverse array of hidden rotational symmetries about the magnetization axis, thereby suggesting an unusual form of emergent order in an otherwise disordered system. These symmetries depend on applied magnetic field, magnetization history, and scattering wave vector. Maps of rotational symmetry exhibit intriguing structures that can be controlled by manipulating the applied magnetic field in concert with the exchange bias condition. © 2011 American Physical Society
Acute fibrinous and organising pneumonia.
Guimarães, Catarina; Sanches, Inês; Ferreira, Catarina
2012-03-20
Acute fibrinous and organising pneumonia (AFOP) was recently described as an unusual pattern of diffuse lung disease. Particular characteristics make the differential diagnosis with the well recognised clinical patterns of diffuse alveolar damage, cryptogenic organising pneumonia or eosinophilic pneumonia. The lack of hyaline membranes, the presence of intra-alveolar fibrin, absence of noticeable eosinophils and patchy distribution suggests that AFOP define a distinct histological pattern. The authors describe the case of a woman diagnosed with AFOP after surgical lung biopsy, in association with primary biliary cirrhosis. The patient presented dyspnoea, fatigue, dry cough and thoracic pain. The CT scan showed bilateral patchy infiltrates predominantly in the lower lobes. Flexible bronchoscopy and subsidiary techniques were inconclusive and biopsy through video-assisted thoracoscopic surgery led to anatomopathological diagnosis of AFOP. The patient is having a good clinical response to prednisone.
Recording In Vivo Human Colonic Motility: What Have We Learnt Over the Past 100 Years?
Dinning, Phil G
To understand the abnormalities that underpin functional gut disorders we must first gain insight into the normal patterns of gut motility. While detailed information continually builds on the motor patterns (and mechanisms that control them) of the human esophagus and anorectum, our knowledge of normal and abnormal motility in the more inaccessible regions of the gut remains poor. This particularly true of the human colon. Investigation of in vivo colonic motor patterns is achieved through measures of transit (radiology, scintigraphy and, more recently, "smart pills") or by direct real-time recording of colonic contractility (intraluminal manometry). This short review will provide an overview of findings from the past and present and attempt to piece together the complex nature of colonic motor patterns. In doing so it will build a profile of human colonic motility and determine the likely mechanisms that control this motility.
Boyette, Jennings R
2014-10-01
Facial trauma in children differs from adults. The growing facial skeleton presents several challenges to the reconstructive surgeon. A thorough understanding of the patterns of facial growth and development is needed to form an individualized treatment strategy. A proper diagnosis must be made and treatment options weighed against the risk of causing further harm to facial development. This article focuses on the management of facial fractures in children. Discussed are common fracture patterns based on the development of the facial structure, initial management, diagnostic strategies, new concepts and old controversies regarding radiologic examinations, conservative versus operative intervention, risks of growth impairment, and resorbable fixation. Copyright © 2014 Elsevier Inc. All rights reserved.
Unusual staphylococcal toxic shock syndrome presenting as a scarlet-like fever.
Andrey, D O; Ferry, T; Siegenthaler, N; Fletcher, C; Calmy, A; Lina, G; Emonet, S
2015-11-01
Diagnosis of nonmenstrual staphylococcal toxic shock syndrome (TSS) is often challenging. A female medical colleague had a rare entity, a staphylococcal pharyngitis complicated by TSS. The diagnosis was confirmed by isolation of tst-positive Staphylococcus aureus in throat culture and by identification of a specific Vβ2 expansion pattern of her T lymphocytes. Recent improvements in microbiology can be of great help for the diagnosis of nonmenstrual TSS.
Purtscher-like retinopathy: A rare complication of peribulbar anesthesia.
Narendran, Siddharth; Saravanan, V R; Pereira, Merlyn
2016-06-01
Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion.
Testing the item-order account of design effects using the production effect.
Jonker, Tanya R; Levene, Merrick; Macleod, Colin M
2014-03-01
A number of memory phenomena evident in recall in within-subject, mixed-lists designs are reduced or eliminated in between-subject, pure-list designs. The item-order account (McDaniel & Bugg, 2008) proposes that differential retention of order information might underlie this pattern. According to this account, order information may be encoded when a common form of processing is used alone in a list (e.g., reading), but not when an unusual form of processing is used (e.g., generation) or when a common form and an unusual form are mixed within a list. The production effect--better memory for words said aloud than for words read silently--shows this same design-contingent pattern. In 2 experiments, we investigated whether differential order retention might underlie the production effect. Consistent with the item-order account, we found that retention of order information was better in pure silent lists than in either pure aloud lists or mixed lists, as measured using an order reconstruction test. Moreover, in Experiment 2, order was better preserved in free recall of pure silent lists than of either pure aloud or mixed lists. Thus, production joins the set of tasks identified by McDaniel and Bugg (2008), and our findings suggest a role for order processing in explaining the production effect.
Emoticon-Based Ambivalent Expression: A Hidden Indicator for Unusual Behaviors in Weibo.
Hu, Yue; Zhao, Jichang; Wu, Junjie
2016-01-01
Recent decades have witnessed online social media being a big-data window for testifying conventional social theories quantitatively and exploring much detailed human behavioral patterns. In this paper, by tracing the emoticon use in Weibo, a group of hidden "ambivalent users" are disclosed for frequently posting ambivalent tweets containing both positive and negative emotions. Further investigation reveals that this ambivalent expression could be a novel indicator of many unusual social behaviors. For instance, ambivalent users with the female as the majority like to make a sound in midnights and at weekends. They mention their close friends frequently in ambivalent tweets, which attract more replies and serve as a more private communication way. Ambivalent users also respond differently to public affairs from others and demonstrate more interests in entertainment and sports events. Moreover, the sentiment shift in ambivalent tweets is more evident than usual and exhibits a clear "negative to positive" pattern. The above observations, though being promiscuous seemingly, actually point to the self-regulation of negative mood in Weibo, which could find its basis from the traditional emotion management theories in sociology but makes an important extension to the online environment in this study. Finally, as an interesting corollary, ambivalent users are found connected with compulsive buyers and turn out to be perfect targets for online marketing.
Castro-Villabón, Diana; Barrera-Herrera, Luis E; Rodríguez-Urrego, Paula A; Hudacko, Rachel; Vera, Alonso; Álvarez, Johanna; Andrade, Rafael; López, Rocío
2015-01-01
Fibrolamellar carcinoma (FLC) is an uncommon form of primary liver malignancy with unique clinical, histological, and biological characteristics. It is usually seen in young adults without underlying liver disease. Histologically, it shows large cells with abundant eosinophilic cytoplasm, large vesicular nuclei, prominent nucleoli, and lamellar type fibrosis. In contrast, classical hepatocellular carcinoma (HCC) is typically present in elderly male patients with cirrhosis. It is the most common histological subtype, and it is characterized by its resemblance to the normal liver, both in its growth pattern and its cytology. The unusual case of a liver carcinoma that presented with histological features of both FLC and classical HCC is herein reported. This was the case of a 37-year-old female complaining of diffuse abdominal discomfort and epigastric pain for two months. She was referred to us for further management after she was diagnosed with HCC in a noncirrhotic liver. She underwent a left-sided hepatectomy. A yellow nodular mass with well-defined borders and a necrotic center was present in the resection specimen. The morphological features and immunohistochemical studies were consistent with a diagnosis of FLC mixed with classical HCC. The patient was followed up for five months, and no signs of recurrence were evident.
Labial ankyloglossia: A rare case report
Bahadure, Rakesh Namdeo; Jain, Eesha; Singh, Parul; Pandey, Rameshkumar; Chuk, Rakeshkumar
2016-01-01
Tongue-tie or ankyloglossia is the congenital short thick lingual frenulum resulting in reduced mobility of the tongue. It limits the possibilities of the extension such as the protrusion and elevation of the tip of the tongue due to either the short of frenulum or genioglossus muscle or both. It can be observed at different ages with specific indications for treatment for each group and cause problems in the feeding, dental hygiene, speech, appearance, and self-esteem of affected patients. Although various degrees of the tongue-tie are mostly observed from the tip of tongue to the base of tongue, sometimes it may present unusually. The present article reports an unusual unique pattern of ankyloglossia where lingual frenum was exceptionally extended and merged with mandibular labium frenum. Reported case is one of the rarest types of ankyloglossia and emphasizes on its clinical implications, need for modifying diagnostic criteria, surgical management, and postoperative exercises. PMID:27994428
Xe-129 - Xe-128 and Ar-40 - Ar-39 chronology of two Antarctic enstatite meteorites
NASA Technical Reports Server (NTRS)
Honda, M.; Bernatowicz, T. J.; Podosek, F. A.
1983-01-01
Xe-129 - Xe-128 and Ar-40 - Ar-39 analyses has been performed on two Antarctic enstatite meteorites, the chondrite Y-691 and the aubrite (enstatite achondrite) ALH-78113. Both meteorites have complex Ar-40 - Ar-39 release patterns to which no unambiguous age assignment is possible. Both give apparently satisfactory Xe-129 - Xe-128 correlations corresponding to unusual ages. The I-Xe age of the chondrite Y-691 is 16 Ma after Bjurbole, not unusual for chondrites in general but 10 Ma later than previously known ages for enstatite chondrites. The I-Xe age of the aubrite ALH-78113 is 210 Ma after Bjurbole, the latest age (rather than a limit) so far observed by the I-Xe technique, but this age assignment must be considered tentative because of the possibility that it is significantly influenced by terrestrial I contamination.
Unusually loud ambient noise in tidewater glacier fjords: a signal of ice melt
Pettit, Erin C.; Lee, Kevin M.; Brann, Joel P.; Nystuen, Jeffrey A.; Wilson, Preston S.; O'Neel, Shad
2015-01-01
In glacierized fjords, the ice-ocean boundary is a physically and biologically dynamic environment that is sensitive to both glacier flow and ocean circulation. Ocean ambient noise offers insight into processes and change at the ice-ocean boundary. Here we characterize fjord ambient noise and show that the average noise levels are louder than nearly all measured natural oceanic environments (significantly louder than sea ice and non-glacierized fjords). Icy Bay, Alaska has an annual average sound pressure level of 120 dB (re 1 μPa) with a broad peak between 1000 and 3000 Hz. Bubble formation in the water column as glacier ice melts is the noise source, with variability driven by fjord circulation patterns. Measurements from two additional fjords, in Alaska and Antarctica, support that this unusually loud ambient noise in Icy Bay is representative of glacierized fjords. These high noise levels likely alter the behavior of marine mammals.
Multipole Superconductivity in Nonsymmorphic Sr_{2}IrO_{4}.
Sumita, Shuntaro; Nomoto, Takuya; Yanase, Youichi
2017-07-14
Discoveries of marked similarities to high-T_{c} cuprate superconductors point to the realization of superconductivity in the doped J_{eff}=1/2 Mott insulator Sr_{2}IrO_{4}. Contrary to the mother compound of cuprate superconductors, several stacking patterns of in-plane canted antiferromagnetic moments have been reported, which are distinguished by the ferromagnetic components as -++-, ++++, and -+-+. In this paper, we clarify unconventional features of the superconductivity coexisting with -++- and -+-+ structures. Combining the group theoretical analysis and numerical calculations for an effective J_{eff}=1/2 model, we show unusual superconducting gap structures in the -++- state protected by nonsymmorphic magnetic space group symmetry. Furthermore, our calculation shows that the Fulde-Ferrell-Larkin-Ovchinnikov superconductivity is inevitably stabilized in the -+-+ state since the odd-parity magnetic -+-+ order makes the band structure asymmetric by cooperating with spin-orbit coupling. These unusual superconducting properties are signatures of magnetic multipole order in nonsymmorphic crystal.
Sometimes two arms are enough--an unusual life-stage in brittle stars (Echinodermata: Ophiuroidea).
Stöhr, Sabine; Alme, Øydis
2015-08-03
Off West Africa (Angola-Morocco), benthos samples were collected in the years 2005-2012. These contained 124 specimens of brittle stars with two long arms and three extremely short or absent arms and an elongated, narrow disc. These unusual brittle stars, as well as 33 specimens with five fully developed arms, were identified as Amphiura ungulata. The specimens with unequal arms were juvenile stages, whereas adults had five equal arms. The large number of specimens with unequal arms suggests that this condition is not the result of damage and regeneration, but a normal growth pattern in this species. This study documents the morphology by SEM, amends the species description, and discusses possible explanations for the evolution of this condition. Although brittle star species with unequal arm growth have been reported, this is an extreme case that was unknown before this study.
Isentropic mixing in the Artic stratosphere during the 1992-1993 and 1993-1994 winters
DOE Office of Scientific and Technical Information (OSTI.GOV)
Dahlberg, S.P.; Bowman, K.P.
1995-05-15
Dynamic isolation of the winter Arctic circumpolar vortex during 1992-1993 and 1993-1994 (the second and third northern hemisphere winters of the UARS mission) is studied using quasi-horizontal isentropic trajectories. Ejection of vortex air and entrainment of mid-latitude air into the vortex are quantified and compared with climatological values obtained from the analysis of 16 Arctic winters. A number of unusual features of both winters are discussed. The most notable features are the anomalous isolation experienced by the vortex during December 1992 and the unusual degree of isolation and persistence of the vortex during February and March of both years. Themore » 1992-1993 winter season is the most consistently isolated vortex on record. Only during January 1993, when entrainment is large, is this pattern of extreme isolation broken. 14 refs., 3 tabs.« less
Multipole Superconductivity in Nonsymmorphic Sr2IrO4
NASA Astrophysics Data System (ADS)
Sumita, Shuntaro; Nomoto, Takuya; Yanase, Youichi
2017-07-01
Discoveries of marked similarities to high-Tc cuprate superconductors point to the realization of superconductivity in the doped Jeff=1 /2 Mott insulator Sr2IrO4. Contrary to the mother compound of cuprate superconductors, several stacking patterns of in-plane canted antiferromagnetic moments have been reported, which are distinguished by the ferromagnetic components as -++-, ++++, and -+-+ . In this paper, we clarify unconventional features of the superconductivity coexisting with -++- and -+-+ structures. Combining the group theoretical analysis and numerical calculations for an effective Jeff=1 /2 model, we show unusual superconducting gap structures in the -++- state protected by nonsymmorphic magnetic space group symmetry. Furthermore, our calculation shows that the Fulde-Ferrell-Larkin-Ovchinnikov superconductivity is inevitably stabilized in the -+-+ state since the odd-parity magnetic -+-+ order makes the band structure asymmetric by cooperating with spin-orbit coupling. These unusual superconducting properties are signatures of magnetic multipole order in nonsymmorphic crystal.
Kumar, Rahul
2014-01-01
Introduction: Coronal anatomic variations in permanent maxillary molars are unusual; conversely variations involving the number of root canals or number of roots are more common. Methods and Materials: This case report presents a successful nonsurgical endodontic therapy of left maxillary first molar with three roots and seven root canals. This unusual morphology was diagnosed using a dental operating microscope (DOM) and confirmed with the help of cone-beam computed tomography (CBCT) images. Results: CBCT axial images showed that both of the palatal and distobuccal roots had Vertucci type II canal pattern, whereas the mesiobuccal root canal showed a Sert and Bayirli’s type XV configuration. Conclusion: The use of a DOM and CBCT imaging in endodontically challenging cases can facilitate a better understanding of the complex root canal anatomy, which ultimately enables the clinician to explore the root canal system, and therefore treat it far more efficiently. PMID:24688587
Preschoolers' encoding of rational actions: the role of task features and verbal information.
Pfeifer, Caroline; Elsner, Birgit
2013-10-01
In the current study, we first investigated whether preschoolers imitate selectively across three imitation tasks. Second, we examined whether preschoolers' selective imitation is influenced by differences in the modeled actions and/or by the situational context. Finally, we investigated how verbal cues given by the model affect preschoolers' imitation. Participants (3- to 5-year-olds) watched an adult performing an unusual action in three imitation tasks (touch light, house, and obstacle). In two conditions, the model either was or was not restricted by situational constraints. In addition, the model verbalized either the goal that was to be achieved, the movement, or none of the action components. Preschoolers always acted on the objects without constraints. Results revealed differences in preschoolers' selective imitation across the tasks. In the house task, they showed the selective imitation pattern that has been interpreted as rational, imitating the unusual action more often in the no-constraint condition than in the constraint condition. In contrast, in the touch light task, preschoolers imitated the unusual head touch irrespective of the model's constraints or of the verbal cues that had been presented. Finally, in the obstacle task, children mostly emulated the observed goal irrespective of the presence of the constraint, but they increased their imitation of the unusual action when the movement had been emphasized. Overall, our data suggest that preschoolers adjust their imitative behavior to context-specific information about objects, actions, and their interpretations of the model's intention to teach something. Copyright © 2012 Elsevier Inc. All rights reserved.
Sargsyan, M. A.; Voskanyan, H. E.; Karalova, E. M.; Hakobyan, L. H.; Karalyan, Z. A.
2018-01-01
Aim: First cases of clinically uncommon African swine fever (ASF), caused by virus genotype II are described in this article. These cases occurred in Armenia, Tavush region, Dilijan municipality in 2011. The aim of this study was to identify and describe the new pathogenic forms of ASF in Armenia. Materials and Methods: The isolation and identification of ASF virus (ASFV) were carried out using conventional techniques. Clinical signs of infection were recorded daily. Gross anatomical pathology characteristics were observed during routine postmortem examinations. Blood and serum were obtained by puncture of the jugular vein using a vacutainer system. Results: The presence of ASFV DNA in the spleens was confirmed by polymerase chain reaction. Sequenced sections of p72 showed phylogenetic identity to genotype 2. The pathology exhibits unusual manifestations of the main disease. The unusual form of ASF demonstrates characteristics of a subacute form of the disease, with the possibility of conversion to a chronic form. Decreased lethality, low level of hemorrhages, and absence of severe pancytopenia in smears from spleen, lymph nodes, and blood are common features of the new form of ASF. Unlike severe thrombocytopenia in the typical ASF, the unusual form exhibited moderate or minor decrease of this feature. Despite a moderate decrease in hemadsorption titers, the unusual pattern of the disease was characterized by viremia and the presence of the virus in the visceral organs, including the brain. Conclusion: Our data allow assuming that new nosological form of ASF (genotype II) may present as a transitional form of the disease with the possibility of chronization. PMID:29479149
An, Jin-kyu; Ono, Takashi
2017-01-01
Objective The objective of this study is to investigate the eruption pattern and root resorption of the bovine anterior dentition in relation to growth-related parameters based on dental maturity. Methods A cross-sectional study was conducted on 110 bovine anterior mandibles by using standard radiography, cone-beam computed tomography (CBCT), and actual measurements. We determined the relationships between the stages of dental maturity by using a modification of Demirjian's method and various growth-related parameters, such as the activity of the root-resorbing tissue and mobility of the deciduous teeth. The correlation of growth-related parameters with interdental spacing and distal unusual root resorption (DRR) of the deciduous fourth incisor was assessed. The cause of mesial unusual root resorption (MRR) of the deciduous fourth incisor was determined on the basis of the arrangement of the permanent third incisor. Results An independent t-test and chi-square test indicated significant differences in growth-related parameters associated with dental arch length discrepancy and factors related to the shedding of deciduous teeth between the low and high dental maturity groups. The samples with interdental spacing and DRR showed a larger sum of mesiodistal permanent crown widths and higher dental maturity than did the respective controls. Samples with MRR tended to show a lingually rotated distal tip of the adjacent tooth crown. Conclusions Dental maturity has relevance to the interdental spaces and unusual root resorption of mixed dentition. The position of the adjacent tooth crown on CBCT may be correlated with the occurrence of unusual root resorption of the incisor. PMID:29090124
Diagnostic workstation for digital hand atlas in bone age assessment
NASA Astrophysics Data System (ADS)
Cao, Fei; Huang, H. K.; Pietka, Ewa; Gilsanz, Vicente; Ominsky, Steven
1998-06-01
Bone age assessment by a radiological examination of a hand and wrist image is a procedure frequently performed in pediatric patients to evaluate growth disorders, determine growth potential in children and monitor therapy effects. The assessment method currently used in radiological diagnosis is based on atlas matching of the diagnosed hand image with the reference set of atlas patterns, which was developed in 1950s and is not fully applicable for children of today. We intent to implement a diagnostic workstation for creating a new reference set of clinically normal images which will serve as a digital atlas and can be used for a computer-assisted bone age assessment. In this paper, we present the initial data- collection and system setup phase of this five-year research program. We describe the system design, user interface implementation and software tool development for collection, visualization, management and processing of clinically normal hand and wrist images.
Common celiacomesenteric trunk: a computed tomography radiological study.
Özgökçe, Mesut; Ayyıldız, Veysel Atilla; Oğul, Hayri; Arslan, Harun; Batur, Abdussamet; Yavuz, Alpaslan; İnce, Suat; Yüce, Deniz
2018-03-03
There is an increasing trend for administration of invasive radiological interventions, laparoscopic surgery, and transplantation procedures in recent years, and determining the vascular variations prior to these procedures is crucially important. Celiacomesenteric trunk (CMT) is among these variations. This study aimed to retrospectively evaluate this rare anomaly by computed tomography (CT). A total of 1000 CT angiography images were analyzed retrospectively, and the patients with mesenteric and celiac arteries arising from the abdominal aorta with a single root were identified. The level that CMT arose, and its branching patterns were determined individually for all patients. Ten patients (6 males and 4 females) with a mean age of 50.2 years (17-87 years) had CMT in CT images. The knowledge of variations in the CMT prior to vascular or laparoscopic interventions will contribute to early intervention in case of a complication, or to avoid from a potential damage.
Radiologic findings in late-onset systemic lupus erythematosus
DOE Office of Scientific and Technical Information (OSTI.GOV)
Braunstein, E.M.; Weissman, B.N.; Sosman, J.L.
1983-03-01
Systemic lupus erythematosus in the elderly has a different clinical and serologic course from that in young patients. Radiographic findings in patients in whom the diagnosis was made after age 50 were compared with findings in younger patients to see if the radiologic patterns are also different. The only significant radiographic difference between the two groups was that the older group had a greater incidence of soft-tissue swelling of the hands and wrists (p < 0.001). There was no significant difference in osteopenia, erosion, soft-tissue calcification, alignment abnormalities, or intrathoracic findings. Of 24 patients over age 50, two developed lymphomamore » and another developed multiple myeloma. The data agree with clinical observations that there is a higher incidence of arthritis in late-onset lupus, but clinical findings of increased incidence of pleuropericardial disease are not confirmed radiographically. The coincidence of hematologic malignancy with late-onset lupus in this series is noteworthy.« less
Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette
2017-03-20
In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr -1 . The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.
Maxwell, Anthony J; Clements, Karen; Dodwell, David J; Evans, Andrew J; Francis, Adele; Hussain, Monuwar; Morris, Julie; Pinder, Sarah E; Sawyer, Elinor J; Thomas, Jeremy; Thompson, Alastair
2016-06-01
To investigate the radiological features, diagnosis and management of screen-detected lobular neoplasia (LN) of the breast. 392 women with pure LN alone were identified within the prospective UK cohort study of screen-detected non-invasive breast neoplasia (the Sloane Project). Demography, radiological features and diagnostic and therapeutic procedures were analysed. Non-pleomorphic LN (369/392) was most frequently diagnosed among women aged 50-54 and in 53.5% was at the first screen. It occurred most commonly on the left (58.0%; p = 0.003), in the upper outer quadrant and confined to one site (single quadrant or retroareolar region). No bilateral cases were found. The predominant radiological feature was microcalcification (most commonly granular) which increased in frequency with increasing breast density. Casting microcalcification as a predominant feature had a significantly higher lesion size compared to granular and punctate patterns (p = 0.034). 326/369 (88.3%) women underwent surgery, including 17 who underwent >1 operation, six who had mastectomy and six who had axillary surgery. Two patients had radiotherapy and 15 had endocrine treatment. Pleomorphic lobular carcinoma in situ (23/392) presented as granular microcalcification in 12; four women had mastectomy and six had radiotherapy. Screen-detected LN occurs in relatively young women and is predominantly non-pleomorphic and unilateral. It is typically associated with granular or punctate microcalcification in the left upper outer quadrant. Management, including surgical resection, is highly variable and requires evidence-based guideline development. Copyright © 2016 Elsevier Ltd. All rights reserved.
Patterson, Emily S.; Rayo, Mike; Gill, Carolina; Gurcan, Metin N.
2011-01-01
Background: Adoption of digital images for pathological specimens has been slower than adoption of digital images in radiology, despite a number of anticipated advantages for digital images in pathology. In this paper, we explore the factors that might explain this slower rate of adoption. Materials and Method: Semi-structured interviews on barriers and facilitators to the adoption of digital images were conducted with two radiologists, three pathologists, and one pathologist's assistant. Results: Barriers and facilitators to adoption of digital images were reported in the areas of performance, workflow-efficiency, infrastructure, integration with other software, and exposure to digital images. The primary difference between the settings was that performance with the use of digital images as compared to the traditional method was perceived to be higher in radiology and lower in pathology. Additionally, exposure to digital images was higher in radiology than pathology, with some radiologists exclusively having been trained and/or practicing with digital images. The integration of digital images both improved and reduced efficiency in routine and non-routine workflow patterns in both settings, and was variable across the different organizations. A comparison of these findings with prior research on adoption of other health information technologies suggests that the barriers to adoption of digital images in pathology are relatively tractable. Conclusions: Improving performance using digital images in pathology would likely accelerate adoption of innovative technologies that are facilitated by the use of digital images, such as electronic imaging databases, electronic health records, double reading for challenging cases, and computer-aided diagnostic systems. PMID:21383925
Personal Branding: A Primer for Radiology Trainees and Radiologists.
Kalia, Vivek; Patel, Amy K; Moriarity, Andrew K; Canon, Cheri L
2017-07-01
A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care. It is no longer sufficient to only practice excellent clinical radiology; one's service experience to clinical providers, report quality, and digital presence must all be robust and compelling. Defining your brand and promoting your vision and quality standards have become as important to radiologists' future as keeping up with advancements in radiologic technology. One must select the proper platforms and types of interactions in which to engage from available social media options. Developing a consistent brand and presence in the work setting, on social media accounts, and in professional organizations at the local, national, and international levels is the ultimate goal. At present, very little, if any, formal training is provided on personal branding skills such as these in current residency curricula, and it is critical for radiologists to fill their gaps in knowledge through additional means. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Rabbitfish ("aras"): an unusual source of ciguatera poisoning.
Raikhlin-Eisenkraft, Bianca; Bentur, Yedidia
2002-01-01
Ciguatera poisoning is the commonest fish-borne seafood intoxication. It is endemic to warm water tropical areas and is caused by consumption of bottom-dwelling shore reef fish, mostly during spring and summer. The causative agent, ciguatoxin, is a heat-stable ester complex that becomes concentrated in fish feeding on toxic dinoflagellates. The common clinical manifestations are a combination of gastrointestinal and neurologic symptoms. Severe poisoning may be associated with seizures and respiratory paralysis. To describe a series of patients who sustained ciguatera poisoning in an uncommon region and from an unexpected source. Two families complained of a sensation of "electrical currents," tremors, muscle cramps, nightmares, hallucinations, agitation, anxiety and nausea of varying severity several hours after consuming rabbitfish ("aras"). These symptoms lasted between 12 and 30 hours and resolved completely. The temporal relationship to a summer fish meal, the typical clinical manifestations along with the known feeding pattern of the rabbitfish suggested ciguatera poisoning. The Eastern Mediterranean basin is an unusual region and the rabbitfish an unusual source for ciguatera poisoning. There are no readily available and reliable means for detecting ciguatoxin in humans. A high index of suspicion is needed for diagnosis and a thorough differential diagnosis is essential to eliminate other poisonings, decompression sickness and encephalitis. Supportive therapy is the mainstay of treatment.
Extreme Magnetosphere-Ionosphere Coupling at the Plasmapause: a - In-A Bright SAR Arc
NASA Astrophysics Data System (ADS)
Baumgardner, J.; Wroten, J.; Semeter, J.; Mendillo, M.; Kozyra, J.
2007-05-01
Heat conduction from the ring current - plasmapause interaction region generates high electron temperature within the ionosphere that drive stable auroral red (SAR) arc emission at 6300 A. On the night of 29 October 1991, a SAR arc was observed using an all-sky imager and meridional imaging spectrograph at Millstone Hill. At xxxx UT, the SAR arc was south of Millstone at approximate L = 2 and reached emission levels of 13,000 rayleighs (R). Over two solar cycle of imaging observations have been made at Millstone Hill, and SAR arc brightness levels (excluding this event) averaged ~ 500 R. Simultaneous observations using the incoherent scatter radar (ISR), a DMSP satellite pass, the MSIS neutral atmosphere and SAR arc modeling using the Rees and Roble formalism succeeded in simulations of the observed emission. The reason for the unusual brightness was not the extreme temperatures achieved (and therefore heat conduction input), but the fact that the end of the plasmapause field line where the elevated Te values were measured did not occur in the ionospheric trough, but equatorward of it, thereby having far more ambient electrons to heat and subsequently collide with atomic oxygen. This unusual spatial geometry probably resulted from unusual convection patterns early in a superstorm scenario.
Franceschi, Ana M; Rosenkrantz, Andrew B
2017-09-01
This study aimed to characterize recent National Institutes of Health (NIH) funding for diagnostic radiology departments at US medical schools. This retrospective study did not use private identifiable information and thus did not constitute human subjects research. The public NIH Research Portfolio Online Reporting Tools Expenditure and Results system was used to extract information regarding 887 NIH awards in 2015 to departments of "Radiation-Diagnostic/Oncology." Internet searches were conducted to identify each primary investigator (PI)'s university web page, which was used to identify the PI's departmental affiliation, gender, degree, and academic rank. A total of 649 awards to diagnostic radiology departments, based on these web searches, were included; awards to radiation oncology departments were excluded. Characteristics were summarized descriptively. A total of 61 unique institutions received awards. The top five funded institutions represented 33.6% of all funding. The most common institutes administering these awards were the National Cancer Institute (29.0%) and the National Institute of Biomedical Imaging and Bioengineering (21.6%). Women received 15.9% of awards and 13.3% of funding, with average funding per award of $353,512 compared to $434,572 for men. PhDs received 77.7% of all awards, with average funding per award of $457,413 compared to $505,516 for MDs. Full professors received 51.2% of awards (average funding per award of $532,668), compared to assistant professors who received 18.4% of awards ($260,177). Average funding was $499,859 for multiple-PI awards vs. $397,932 for single-PI awards. Common spending categories included "neurosciences," "cancer," "prevention," and "aging." NIH funding for diagnostic radiology departments has largely been awarded to senior-ranking male PhD investigators, commonly at large major academic medical centers. Initiatives are warranted to address such disparities and promote greater diversity in NIH funding among diagnostic radiology investigators. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey
DOE Office of Scientific and Technical Information (OSTI.GOV)
Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.
Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived frommore » a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are used in the United States. Trends toward making interventional radiology a clinical specialty are evident, with 51% of respondents having day case beds, and 30% having inpatient beds.« less
Hassanpour, Saeed; Langlotz, Curtis P; Amrhein, Timothy J; Befera, Nicholas T; Lungren, Matthew P
2017-04-01
The purpose of this study is to evaluate the performance of a natural language processing (NLP) system in classifying a database of free-text knee MRI reports at two separate academic radiology practices. An NLP system that uses terms and patterns in manually classified narrative knee MRI reports was constructed. The NLP system was trained and tested on expert-classified knee MRI reports from two major health care organizations. Radiology reports were modeled in the training set as vectors, and a support vector machine framework was used to train the classifier. A separate test set from each organization was used to evaluate the performance of the system. We evaluated the performance of the system both within and across organizations. Standard evaluation metrics, such as accuracy, precision, recall, and F1 score (i.e., the weighted average of the precision and recall), and their respective 95% CIs were used to measure the efficacy of our classification system. The accuracy for radiology reports that belonged to the model's clinically significant concept classes after training data from the same institution was good, yielding an F1 score greater than 90% (95% CI, 84.6-97.3%). Performance of the classifier on cross-institutional application without institution-specific training data yielded F1 scores of 77.6% (95% CI, 69.5-85.7%) and 90.2% (95% CI, 84.5-95.9%) at the two organizations studied. The results show excellent accuracy by the NLP machine learning classifier in classifying free-text knee MRI reports, supporting the institution-independent reproducibility of knee MRI report classification. Furthermore, the machine learning classifier performed well on free-text knee MRI reports from another institution. These data support the feasibility of multiinstitutional classification of radiologic imaging text reports with a single machine learning classifier without requiring institution-specific training data.
Pattern-histogram-based temporal change detection using personal chest radiographs
NASA Astrophysics Data System (ADS)
Ugurlu, Yucel; Obi, Takashi; Hasegawa, Akira; Yamaguchi, Masahiro; Ohyama, Nagaaki
1999-05-01
An accurate and reliable detection of temporal changes from a pair of images has considerable interest in the medical science. Traditional registration and subtraction techniques can be applied to extract temporal differences when,the object is rigid or corresponding points are obvious. However, in radiological imaging, loss of the depth information, the elasticity of object, the absence of clearly defined landmarks and three-dimensional positioning differences constraint the performance of conventional registration techniques. In this paper, we propose a new method in order to detect interval changes accurately without using an image registration technique. The method is based on construction of so-called pattern histogram and comparison procedure. The pattern histogram is a graphic representation of the frequency counts of all allowable patterns in the multi-dimensional pattern vector space. K-means algorithm is employed to partition pattern vector space successively. Any differences in the pattern histograms imply that different patterns are involved in the scenes. In our experiment, a pair of chest radiographs of pneumoconiosis is employed and the changing histogram bins are visualized on both of the images. We found that the method can be used as an alternative way of temporal change detection, particularly when the precise image registration is not available.
NASA Astrophysics Data System (ADS)
Mazurowski, Maciej A.; Tourassi, Georgia D.
2011-03-01
In this study we investigate the hypothesis that there exist patterns in erroneous assessment of BI-RADS image features among radiology trainees when performing diagnostic interpretation of mammograms. We also investigate whether these error making patterns can be captured by individual user models. To test our hypothesis we propose a user modeling algorithm that uses the previous readings of a trainee to identify whether certain BI-RADS feature values (e.g. "spiculated" value for "margin" feature) are associated with higher than usual likelihood that the feature will be assessed incorrectly. In our experiments we used readings of 3 radiology residents and 7 breast imaging experts for 33 breast masses for the following BI-RADS features: parenchyma density, mass margin, mass shape and mass density. The expert readings were considered as the gold standard. Rule-based individual user models were developed and tested using the leave one-one-out crossvalidation scheme. Our experimental evaluation showed that the individual user models are accurate in identifying cases for which errors are more likely to be made. The user models captured regularities in error making for all 3 residents. This finding supports our hypothesis about existence of individual error making patterns in assessment of mammographic image features using the BI-RADS lexicon. Explicit user models identifying the weaknesses of each resident could be of great use when developing and adapting a personalized training plan to meet the resident's individual needs. Such approach fits well with the framework of adaptive computer-aided educational systems in mammography we have proposed before.
Imaging features of blast injuries: experience from 2015 Ankara bombing in Turkey
Aksu, Nalan M
2016-01-01
Objective: To present the radiological features of blast-related injuries in the victims of the 10 October 2015 Ankara bombing and emphasize the importance of imaging. Methods: This retrospective descriptive study included a total of 28 patients who underwent CT scan or radiographic imaging within 6 h after the bombing on 10 October 2015. CT scans and plain radiographs were evaluated regarding mechanisms of injuries. Injuries were categorized as primary, secondary, tertiary and quaternary. The number of shrapnel and distribution of injuries were noted. Injury Severity Score (ISS) was used to rank the severity of the injury. Results: Primary blast injuries consisted of only tympanic membrane rupture. A high rate of patients (21/28 patients) in the study group suffered from secondary blast injuries. Tertiary injuries were detected in only three patients. Of the severely injured patients, five had abdominal injuries, three had thoracic injuries and six had extremity injuries. ISS was significantly higher in patients with thoracic and abdominal injuries. Conclusion: Our results after the suicide bomb attacks showed that the most common injury pattern was secondary blast injury. The torso was the most commonly injured body region, followed by the extremities. This specific injury pattern requires the use of immense radiological imaging. Hence, radiologists should be aware of the mechanisms and spectrums of blast-related injuries. Advances in knowledge: Both the unique injury pattern and the following chaos make blast-related injuries a challenge in terms of triage, diagnosis and management. Radiologists should be familiar with the wide spectrum of these unique injuries. PMID:26959613
Patterns of contrast enhancement in the brain and meninges.
Smirniotopoulos, James G; Murphy, Frances M; Rushing, Elizabeth J; Rees, John H; Schroeder, Jason W
2007-01-01
Contrast material enhancement for cross-sectional imaging has been used since the mid 1970s for computed tomography and the mid 1980s for magnetic resonance imaging. Knowledge of the patterns and mechanisms of contrast enhancement facilitate radiologic differential diagnosis. Brain and spinal cord enhancement is related to both intravascular and extravascular contrast material. Extraaxial enhancing lesions include primary neoplasms (meningioma), granulomatous disease (sarcoid), and metastases (which often manifest as mass lesions). Linear pachymeningeal (dura-arachnoid) enhancement occurs after surgery and with spontaneous intracranial hypotension. Leptomeningeal (pia-arachnoid) enhancement is present in meningitis and meningoencephalitis. Superficial gyral enhancement is seen after reperfusion in cerebral ischemia, during the healing phase of cerebral infarction, and with encephalitis. Nodular subcortical lesions are typical for hematogenous dissemination and may be neoplastic (metastases) or infectious (septic emboli). Deeper lesions may form rings or affect the ventricular margins. Ring enhancement that is smooth and thin is typical of an organizing abscess, whereas thick irregular rings suggest a necrotic neoplasm. Some low-grade neoplasms are "fluid-secreting," and they may form heterogeneously enhancing lesions with an incomplete ring sign as well as the classic "cyst-with-nodule" morphology. Demyelinating lesions, including both classic multiple sclerosis and tumefactive demyelination, may also create an open ring or incomplete ring sign. Thick and irregular periventricular enhancement is typical for primary central nervous system lymphoma. Thin enhancement of the ventricular margin occurs with infectious ependymitis. Understanding the classic patterns of lesion enhancement--and the radiologic-pathologic mechanisms that produce them--can improve image assessment and differential diagnosis.
Taghian, Alphonse; Jagsi, Reshma; Makris, Andreas; Goldberg, Saveli; Ceilley, Elizabeth; Grignon, Laurent; Powell, Simon
2004-11-01
To examine the self-reported practice patterns of radiation oncologists in North America and Europe regarding radiotherapy to the internal mammary lymph node chain (IMC) in breast cancer patients. A survey questionnaire was sent in 2001 to physician members of the American Society for Therapeutic Radiology and Oncology and European Society for Therapeutic Radiology and Oncology regarding their management of breast cancer. Respondents were asked whether they would treat the IMC in several clinical scenarios. A total of 435 responses were obtained from European and 702 responses from North American radiation oncologists. Respondents were increasingly likely to report IMC irradiation in scenarios with greater axillary involvement. Responses varied widely among different European regions, the United States, and Canada (p < 0.01). European respondents were more likely to treat the IMC (p < 0.01) than their North American counterparts. Academic physicians were more likely to treat the IMC than those in nonacademic positions (p < 0.01). The results of this study revealed significant international variation in attitudes regarding treatment of the IMC. The international patterns of variation mirror the divergent conclusions of studies conducted in the different regions, indicating that physicians may rely preferentially on evidence from local studies when making difficult treatment decisions. These variations in self-reported practice patterns indicate the need for greater data in this area, particularly from international cooperative trials. The cultural predispositions documented in this study are important to recognize, because they may continue to affect physician attitudes and practices, even as greater evidence accumulates.
Lacz, N L; Schwartz, R A; Kapila, R
2006-04-01
Rocky Mountain spotted fever (RMSF) is an unusual but important dermatological condition to identify without hesitation. The classic triad of headache, fever, and a rash that begins on the extremities and travels proximally to involve the trunk is found in a majority of patients. The cutaneous centripetal pattern is a result of cell to cell migration by the causative organism Rickettsia rickettsii. Such individuals should receive prompt antimicrobial therapy and supportive care to avoid serious and potentially fatal complications.
Unusual Thermal Stability of High-Entropy Alloy Amorphous Structure
2012-06-20
incident angle X - ray diffractometer (GIAXRD, RIGAKU D/MAX2500) with Cu Kα radiation and at the incident angle of 1°. The surface morphology and...microanalyzer (EPMA, JEOL JAX-8800). The crystallographic structures of as-deposited and annealed metallic films were characterized utilizing a glancing ...field image and selected-area- diffraction (SAD) patterns of (a) 800 °C-, (b) 850 °C- and (c) 900 °C-annealed alloy thin films, respectively. Both
Purtscher-like retinopathy: A rare complication of peribulbar anesthesia
Narendran, Siddharth; Saravanan, V R; Pereira, Merlyn
2016-01-01
Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion. PMID:27488158
Emergent structures in reaction-advection-diffusion systems on a sphere.
Krause, Andrew L; Burton, Abigail M; Fadai, Nabil T; Van Gorder, Robert A
2018-04-01
We demonstrate unusual effects due to the addition of advection into a two-species reaction-diffusion system on the sphere. We find that advection introduces emergent behavior due to an interplay of the traditional Turing patterning mechanisms with the compact geometry of the sphere. Unidirectional advection within the Turing space of the reaction-diffusion system causes patterns to be generated at one point of the sphere, and transported to the antipodal point where they are destroyed. We illustrate these effects numerically and deduce conditions for Turing instabilities on local projections to understand the mechanisms behind these behaviors. We compare this behavior to planar advection which is shown to only transport patterns across the domain. Analogous transport results seem to hold for the sphere under azimuthal transport or away from the antipodal points in unidirectional flow regimes.
Emergent structures in reaction-advection-diffusion systems on a sphere
NASA Astrophysics Data System (ADS)
Krause, Andrew L.; Burton, Abigail M.; Fadai, Nabil T.; Van Gorder, Robert A.
2018-04-01
We demonstrate unusual effects due to the addition of advection into a two-species reaction-diffusion system on the sphere. We find that advection introduces emergent behavior due to an interplay of the traditional Turing patterning mechanisms with the compact geometry of the sphere. Unidirectional advection within the Turing space of the reaction-diffusion system causes patterns to be generated at one point of the sphere, and transported to the antipodal point where they are destroyed. We illustrate these effects numerically and deduce conditions for Turing instabilities on local projections to understand the mechanisms behind these behaviors. We compare this behavior to planar advection which is shown to only transport patterns across the domain. Analogous transport results seem to hold for the sphere under azimuthal transport or away from the antipodal points in unidirectional flow regimes.
A general natural-language text processor for clinical radiology.
Friedman, C; Alderson, P O; Austin, J H; Cimino, J J; Johnson, S B
1994-01-01
OBJECTIVE: Development of a general natural-language processor that identifies clinical information in narrative reports and maps that information into a structured representation containing clinical terms. DESIGN: The natural-language processor provides three phases of processing, all of which are driven by different knowledge sources. The first phase performs the parsing. It identifies the structure of the text through use of a grammar that defines semantic patterns and a target form. The second phase, regularization, standardizes the terms in the initial target structure via a compositional mapping of multi-word phrases. The third phase, encoding, maps the terms to a controlled vocabulary. Radiology is the test domain for the processor and the target structure is a formal model for representing clinical information in that domain. MEASUREMENTS: The impression sections of 230 radiology reports were encoded by the processor. Results of an automated query of the resultant database for the occurrences of four diseases were compared with the analysis of a panel of three physicians to determine recall and precision. RESULTS: Without training specific to the four diseases, recall and precision of the system (combined effect of the processor and query generator) were 70% and 87%. Training of the query component increased recall to 85% without changing precision. PMID:7719797
Newly diagnosed multiple sclerosis in state of Qatar.
Akhtar, N; Elsetouhy, A; Deleu, D; Kamran, S; AlHail, H; Elalamy, O; Mesraoua, B; Sokrab, T; Kamil, H; Melikyan, G; D'souza, A; Osman, Y; Imam, Y
2013-08-01
Epidemiologic studies on multiple sclerosis (MS) are well-documented in the western population but to a lesser extent in Arab world. To study the demographics, clinical aspects, radiologic and laboratory features along with the degree of disability inflicted, and factors affecting disease progression and outcome of newly diagnosed MS patients at our institution. Data from all newly diagnosed MS patients fulfilling McDonald criteria from January 01, 2005 to December 31, 2010 were collected and analyzed. A total of 142 patients were identified, in which 82 (58%) were Qataris, and 90 (64%) females. Mean age was 31 years, and mean duration of symptoms was 24 days (median 15 days). Most common symptoms were sensory (63%), followed by visual (45%) and motor (43%). Mean EDSS was 2.3 at presentation. Treatment was given to 127 (89%), and relapse observed in 49%. Gadolinium enhancing lesions on follow-up MRI brain and relapsing remitting MS were associated with increased radiologic disease burden, while weakness at onset, EDSS of ≥2.5 and ≥3 clinical relapse was associated with clinical disease progression. MS in Qatar is an emerging disorder especially in the native population. The pattern of disease differs from other Middle Eastern countries by its milder clinical and aggressive radiologic disease presentation. Copyright © 2013 Elsevier B.V. All rights reserved.
Role of Radiologic Imaging in Genetic and Acquired Neuromuscular Disorders.
Ortolan, Paolo; Zanato, Riccardo; Coran, Alessandro; Beltrame, Valeria; Stramare, Roberto
2015-03-11
Great technologic and clinical progress have been made in the last two decades in identifying genetic defects of several neuromuscular diseases, as Spinal Muscular Atrophy, genetic muscular dystrophies and other genetic myopathies. The diagnosis is usually challenging, due to great variability in genetic abnormalities and clinical phenotypes and the poor specificity of complementary analyses, i.e., serum creatine kinase (CK) and electrophysiology. Muscle biopsy represents the gold standard for the diagnosis of genetic neuromuscular diseases, but clinical imaging of muscle tissue is an important diagnostic tool to identify and quantifyies muscle damage. Radiologic imaging is, indeed, increasingly used as a diagnostic tool to describe patterns and the extent of muscle involvement, thanks to modern techniques that enable to definethe definition of degrees of muscle atrophy and changes in connective tissue. They usually grade the severity of the disease process with greater accuracy than clinical scores. Clinical imaging is more than complementary to perform muscle biopsy, especially as ultrasound scans are often mandatory to identify the muscle to be biopsied. We will here detail and provideWe will herein provide detailed examples of the radiologic methods that can be used in genetic and acquired neuromuscular disorders, stressing pros and cons. Muscle Imaging, MRI, CT, genetic muscle disorders, myopathies, dystrophies.
Role of Radiologic Imaging in Genetic and Acquired Neuromuscular Disorders
Zanato, Riccardo; Coran, Alessandro; Beltrame, Valeria; Stramare, Roberto
2015-01-01
Great technologic and clinical progress have been made in the last two decades in identifying genetic defects of several neuromuscular diseases, as Spinal Muscular Atrophy, genetic muscular dystrophies and other genetic myopathies. The diagnosis is usually challenging, due to great variability in genetic abnormalities and clinical phenotypes and the poor specificity of complementary analyses, i.e., serum creatine kinase (CK) and electrophysiology. Muscle biopsy represents the gold standard for the diagnosis of genetic neuromuscular diseases, but clinical imaging of muscle tissue is an important diagnostic tool to identify and quantifyies muscle damage. Radiologic imaging is, indeed, increasingly used as a diagnostic tool to describe patterns and the extent of muscle involvement, thanks to modern techniques that enable to definethe definition of degrees of muscle atrophy and changes in connective tissue. They usually grade the severity of the disease process with greater accuracy than clinical scores. Clinical imaging is more than complementary to perform muscle biopsy, especially as ultrasound scans are often mandatory to identify the muscle to be biopsied. We will here detail and provideWe will herein provide detailed examples of the radiologic methods that can be used in genetic and acquired neuromuscular disorders, stressing pros and cons. Key Words: Muscle Imaging, MRI, CT, genetic muscle disorders, myopathies, dystrophies PMID:26913153
Thali, M J; Kneubuehl, B P; Dirnhofer, R; Zollinger, U
2001-11-15
Forensic science uses substitutes to reconstruct injury patterns in order to answer questions regarding the dynamic formation of unusual injuries. Using a case study, an experimental simulation of a finger was designed, for the first time with a combination of hard wood and glycerin soap. With this model as an intermediate target simulation, it was possible not only to demonstrate the "bullet-body (finger) interaction", but also to recreate the wound pattern found in the victim. This case demonstrates that by using ballistic models and body-part substitutes, gunshot cases can be reproduced simply and economically, without coming into conflict with ethical guidelines.
Congenital absence of dermatoglyphs.
Límová, M; Blacker, K L; LeBoit, P E
1993-08-01
Congenital absence or unusual patterns of human dermatoglyphs (fingerprints) occur in several syndromes that are rare and poorly understood. The abnormalities of dermatoglyphs fall into four categories: complete absence, ridge hypoplasia, ridge dissociation, and ridges-off-the-end. Complete congenital absence of ridges is an exceedingly rare syndrome that consists of neonatal blisters and milia, adult traumatic blistering and fissuring, absence of sweating, contracture of digits, and absence of dermatoglyphs on the hands and feet. The syndrome is inherited in an autosomal dominant pattern, and only two kindreds have been described in the literature. We describe a newly identified patient and kindred with findings similar to the previously reported cases and review the clinical and histopathologic findings of this syndrome.
Norman, J A; Christidis, L; Joseph, L; Slikas, B; Alpers, D
2002-10-22
Molecular analysis of two Australo-Papuan rainforest birds exhibiting correlated 'leapfrog' patterns were used to elucidate the evolutionary origin of this unusual pattern of geographical differentiation. In both sooty owls (Tyto) and logrunners (Orthonyx), phenotypically similar populations occupy widely disjunct areas (central-eastern Australia and upland New Guinea) with a third, highly distinctive population, occurring between them in northeastern Queensland. Two mechanisms have been proposed to explain the origin of leapfrog patterns in avian distributions: recent shared ancestry of terminal populations and unequal rates or phenotypic change among populations. As the former should generate correlated patterns of phenotypic and genetic differentiation, we tested for a sister relationship between populations from New Guinea and central-eastern Australia using nuclear and mitochondrial DNA sequences. The resulting phylogenies not only refute recent ancestry as an explanation for the leapfrog pattern, but provide evidence of vastly different spatio-temporal histories for sooty owls and logrunners within the Australo-Papuan rainforests. This incongruence indicates that the evolutionary processes responsible for generating leapfrog patterns in these co-distributed taxa are complex, possibly involving a combination of selection and drift in sooty owls and convergence or retention of ancestral characteristics in logrunners.
Source Evolution After Subduction Initiation as Recorded in the Izu-Bonin-Mariana Fore-arc Crust
NASA Astrophysics Data System (ADS)
Shervais, J. W.; Reagan, M. K.; Pearce, J. A.; Shimizu, K.
2015-12-01
Drilling in the Izu-Bonin-Mariana (IBM) fore-arc during IODP Expedition 352 and DSDP Leg 60 recovered consistent stratigraphic sequences of volcanic rocks reminiscent of those found in many ophiolites. The oldest lavas in these sections are "fore-arc basalts" (FAB) with ~51.5 Ma ages. Boninites began eruption approximately 2-3 m.y. later (Ishizuka et al., 2011, EPSL; Reagan et al., 2013, EPSL) and further from the trench. First results from IODP Expedition 352 and preliminary post-cruise data suggest that FAB at Sites U1440 and U1441 were generated by decompression melting during near-trench sea-floor spreading, and that fluids from the subducting slab were not involved in their genesis. Temperatures appear to have been unusually high and pressures of melting appear to have been unusually low compared to mid-ocean ridges. Spreading rates at this time appear to have been robust enough to maintain a stable melt lens. Incompatible trace element abundances are low in FAB compared to even depleted MORB. Nd and Hf Isotopic compositions published before the expedition suggest that FAB were derived from typical MORB source mantle. Thus, their extreme deletion resulted from unusually high degrees of melting immediately after subduction initiation. The oldest boninites from DSDP Site 458 and IODP Sites U1439 and U1442 have relatively high concentrations of fluid-soluble elements, low concentrations of REE, and light depleted REE patterns. Younger boninites, have even lower REE concentrations, but have U-shaped REE patterns. Our first major and trace element compositions for the FAB through boninite sequence suggests that melting pressures and temperatures decreased through time, mantle became more depleted though time, and spreading rates waned during boninite genesis. Subduction zone fluids involved in boninite genesis appear to have been derived from progressively higher temperatures and pressures over time as the subducting slab thermally matured.
Carmichael, Ruth H; Graham, William M; Aven, Allen; Worthy, Graham; Howden, Stephan
2012-01-01
An unusual number of near term and neonatal bottlenose dolphin (Tursiops truncatus) mortalities occurred in the northern Gulf of Mexico (nGOM) in 2011, during the first calving season after two well documented environmental perturbations; sustained cold weather in 2010 and the Deepwater Horizon oil spill (DWHOS). Preceding the stranding event, large volumes of cold freshwater entered the nGOM due to unusually large snowmelt on the adjacent watershed, providing a third potential stressor. We consider the possibility that this extreme cold and freshwater event contributed to the pattern of perinatal dolphin strandings along the nGOM coast. During the 4-month period starting January 2011, 186 bottlenose dolphins, including 46% perinatal calves (nearly double the percentage for the same time period from 2003-2010) washed ashore from Louisiana to western Florida. Comparison of the frequency distribution of strandings to flow rates and water temperature at a monitoring buoy outside Mobile Bay, Alabama (the 4(th) largest freshwater drainage in the U.S.) and along the nGOM coast showed that dolphin strandings peaked in Julian weeks 5, 8, and 12 (February and March), following water temperature minima by 2-3 weeks. If dolphin condition was already poor due to depleted food resources, bacterial infection, or other factors, it is plausible that the spring freshet contributed to the timing and location of the unique stranding event in early 2011. These data provide strong observational evidence to assess links between the timing of the DWHOS, other local environmental stressors, and mortality of a top local predator. Targeted analyses of tissues from stranded dolphins will be essential to define a cause of death, and our findings highlight the importance of considering environmental data along with biological samples to interpret stranding patterns during and after an unusual mortality event.
Late-onset Rasmussen Encephalitis: A literature appraisal.
Dupont, Sophie; Gales, Ana; Sammey, Serge; Vidailhet, Marie; Lambrecq, Virginie
2017-08-01
Rasmussen Encephalitis (RE) is classically described as a childhood encephalopathy due to a unilateral inflammation of the cerebral cortex with a presumed immune-mediated pathophysiological basis. Unusual variant forms, including adolescent and adult-onset RE have been described but there is still a doubt whether these atypical cases correspond to classical RE patients. To review evidence, a systematic PubMed search was conducted to retrieve papers addressing late onset RE to assess (i) the positivity rate of classical childhood-onset diagnostic criteria for RE in late-onset RE, (ii) the specific clinical and radiological features that could help earlier diagnosis and therapeutic interventions, (iii) the arguments for an autoimmune pathophysiology including (iiia) the association with autoimmune markers or diseases and (iiib) the effects of immunomodulatory or immunosuppressive treatments. A total of 50 papers were considered. We identified 102 late-onset RE patients with a sex ratio of 8 women for 2 men. 67% fulfilled the consensus diagnostic criteria for RE. As compared to classical RE, the late-onset RE patients exhibited: i) more frequent focal complex partial seizures, ii) less frequent epilepsia partialis continua throughout evolution, iii) a slower evolution with a delayed occurrence of cortical deficit, iv) less cognitive deterioration and v) a better outcome. A specific association with autoimmune markers or diseases was not found. Immunomodulatory therapies, even performed in a late stage, improved late-onset RE patients in 61% of cases. This review proves that late-onset RE is a reality with specific clinical and radiological features. The good response to immunomodulatory treatments brings further arguments for an immune-regulated process. Copyright © 2017 Elsevier B.V. All rights reserved.
Spennato, Pietro; Chiaramonte, Carmela; Cicala, Domenico; Donofrio, Vittoria; Barbarisi, Manlio; Nastro, Anna; Mirone, Giuseppe; Trischitta, Vincenzo; Cinalli, Giuseppe
2016-11-01
OBJECTIVE Intraventricular choroid plexus cysts are unusual causes of acute hydrocephalus in children. Radiological diagnosis of intraventricular choroid plexus cysts is difficult because they have very thin walls and fluid contents similar to CSF and can go undetected on routine CT studies. METHODS This study reports the authors' experience with 5 patients affected by intraventricular cysts originating from the choroid plexus. All patients experienced acute presentation with rapid neurological deterioration, sometimes associated with hypothalamic dysfunction, and required urgent surgery. In 2 cases the symptoms were intermittent, with spontaneous remission and sudden clinical deteriorations, reflecting an intermittent obstruction of the CSF pathway. RESULTS Radiological diagnosis was difficult in these cases because a nonenhanced CT scan revealed only triventricular hydrocephalus, with slight lateral ventricle asymmetry in all cases. MRI with driven-equilibrium sequences and CT ventriculography (in 1 case) allowed the authors to accurately diagnose the intraventricular cysts that typically occupied the posterior part of the third ventricle, occluding the aqueduct and at least 1 foramen of Monro. The patients were managed by urgent implantation of an external ventricular drain in 1 case (followed by endoscopic surgery, after completing a diagnostic workup) and by urgent endoscopic surgery in 4 cases. Endoscopic surgery allowed the shrinkage and near-complete removal of the cysts in all cases. Use of neuronavigation and a laser were indispensable. All procedures were uneventful, resulting in restoration of normal neurological conditions. Long-term follow-up (> 2 years) was available for 2 patients, and no complications or recurrences occurred. CONCLUSIONS This case series emphasizes the necessity of an accurate and precise identification of the possible causes of triventricular hydrocephalus. Endoscopic surgery can be considered the ideal treatment of choroid plexus cysts in children.
Carceller, Fernando; Bautista, Francisco J; Fowkes, Lucy A; Marshall, Lynley V; Sirvent, Sara I; Chisholm, Julia C; Pearson, Andrew D J; Koh, Dow-Mu; Moreno, Lucas
2016-08-01
RECIST guidelines constitute the reference for radiological response assessment in most paediatric trials of anticancer agents. However, these criteria have not been validated in children. We evaluated the outcomes and patterns of progression of children/adolescents enrolled in phase I trials in two paediatric drug development units. Patients aged ≤21 assessed with RECIST (v1.0 or v1.1) were eligible. Clinico-radiological data were analysed using Mann-Whitney U and log-rank tests to correlate response categories and sum of longest diameters (SLD) with time-to-event variables and overall survival (OS). Sixty-one patients (71 enrolments) were evaluated; median age: 12.7 years (range, 3.1-20.9). Overall, 7% achieved complete/partial response (n = 5) and 31% disease stabilisation (n = 22). Median (95% CI) OS (in months) was 29.1 (27.6-30.6) with complete/partial response, 8.9 (2.0-15.8) with stable disease and 2.8 (2.3-3.3) with disease progression (P < 0.001); 32.6% patients with measurable disease presented exclusive progression of existing non-target lesions and/or new lesions. The change in SLD at best response showed a linear correlation with duration of response (r = -0.605; P = 0.004) and time on trial (r = -0.61; P = 0.003), but the change in SLD at progression did not correlate with time to progression (r = -0.219; P = 0.206). Response assessment according to RECIST correlated with OS in children/adolescents treated on phase I trials. The reduction in SLD at best response correlated with more prolonged responses. Tumour size did not constitute an optimal method to assess disease progression in one third of patients with measurable disease. Further refinement of current response assessment guidelines will enable the development of paediatric-specific radiological criteria. © 2016 Wiley Periodicals, Inc.
Chow, Daniel S; Itagaki, Michael W
2010-11-01
To establish the characteristics of published interventional oncology (IO) research, including the volume, growth, geographic distribution, type of research, and funding patterns, and to determine how IO research compares with overall radiology research. This retrospective bibliometric analysis of public data was exempt from Institutional Review Board approval. IO articles published between 1996 and 2008 were identified in the National Library of Medicine MEDLINE database. Country of origin, article methodology, study topic, and source of funding were recorded. Growth was analyzed by using linear and nonlinear regression. Total journal articles numbered 3801, including 847 (22.3%) from the United States, 722 (19.0%) from Japan, and 390 (10.3%) from China. World publications grew with a sigmoid (logistic) pattern (predicted maximum of 586.8 articles per year, P < .001). The United States and China also had logistic and slowing growth (maximums of 111.0 and 48.1 articles per year, respectively; both P < .001). Growth was linear in Japan (growth of 3.0 articles per year, P < .001) and exponential and accelerating in Germany, Italy, South Korea, France, and the United Kingdom. The United States produced 187 (36.9%) review articles but only 52 (13.1%) clinical trials. Japan (75, 18.8%) and China (71, 17.8%) both produced more clinical trials than other countries. U.S. IO articles were less likely than general radiology articles to receive funding from government (12.5% vs 23.7%) and nongovernment (15.0% vs 17.0%) sources. Liver cancer articles constituted 2388 (62.8%) of all IO articles. IO research is slowing in the United States but growing elsewhere. Japan and China are leaders in clinical trial research. U.S. IO research receives less funding than does overall radiology research. IO research focuses primarily on liver cancer. © RSNA, 2010.
Localized conductive patterning via focused electron beam reduction of graphene oxide
NASA Astrophysics Data System (ADS)
Kim, Songkil; Kulkarni, Dhaval D.; Henry, Mathias; Zackowski, Paul; Jang, Seung Soon; Tsukruk, Vladimir V.; Fedorov, Andrei G.
2015-03-01
We report on a method for "direct-write" conductive patterning via reduction of graphene oxide (GO) sheets using focused electron beam induced deposition (FEBID) of carbon. FEBID treatment of the intrinsically dielectric graphene oxide between two metal terminals opens up the conduction channel, thus enabling a unique capability for nanoscale conductive domain patterning in GO. An increase in FEBID electron dose results in a significant increase of the domain electrical conductivity with improving linearity of drain-source current vs. voltage dependence, indicative of a change of graphene oxide electronic properties from insulating to semiconducting. Density functional theory calculations suggest a possible mechanism underlying this experimentally observed phenomenon, as localized reduction of graphene oxide layers via interactions with highly reactive intermediates of electron-beam-assisted dissociation of surface-adsorbed hydrocarbon molecules. These findings establish an unusual route for using FEBID as nanoscale lithography and patterning technique for engineering carbon-based nanomaterials and devices with locally tailored electronic properties.
Isolated scaphoid dislocation associated with axial carpal dissociation: an unusual injury report.
Horton, Todd; Shin, Alexander Y; Cooney, William P
2004-11-01
We present a report of a patient with an isolated scaphoid dislocation associated with a hyperextension and axial loading injury of the carpus required a careful and extensive clinical and radiographic evaluation leading to surgical intervention to reduce and stabilize the scaphoid and to reduce and hold internally the axial carpal injury. Knowledge of the anatomy and the potential injury patterns of the carpus will aid the hand surgeon with injury recognition and proper treatment.
2004-06-15
therefore should be the subject of additional due diligence . Independent Task Force on Terrorist Financing 47 • Cooperate fully with any multilateral...unusually talented group who brought enthusiasm, diligence , and strong analytical skills to this project. We are especially appreciative of the hard...State Department’s latest Patterns of Global Terrorism report, continue to give praise where praise is due but too often go to lengths to avoid
A minimally invasive vertebral hemangioma.
Van den Broeck, S; Mailleux, P; Joris, J P
2010-01-01
We describe a very unusual vertebral hemangioma presenting with a mixture of aggressive-like pattern (epidural extension, T1 hyposignal) and quiescent, inactive lesion (fatty infiltration), in association with a spiculated calcified epidural component.This paper emphasizes that CT and/or MR findings are accurate enough to make formal assessment of vertebral hemangioma, preventing patient's anguish and moreover unnecessary treatment. Furthermore this attractive case proposes a poorly known characteristic of vertebral hemangioma which is usually encountered and described only in skull hemangiomas.
Shakespeare, William A.; Davie, Daniel; Tonnerre, Claude; Rubin, Michael A.; Strong, Michael; Petti, Cathy A.
2005-01-01
We report an unusual case of Salmonella enterica serotype Typhi presenting as a primary psoas abscess. The isolate tested susceptible to ciprofloxacin but resistant to nalidixic acid in vitro, a pattern associated with fluoroquinolone therapeutic failures. We review the literature for serovar Typhi psoas abscess in the absence of bacteremia and discuss the importance of identifying isolates with reduced susceptibility to fluoroquinolones. PMID:15695728
Emoticon-Based Ambivalent Expression: A Hidden Indicator for Unusual Behaviors in Weibo
Hu, Yue; Zhao, Jichang; Wu, Junjie
2016-01-01
Recent decades have witnessed online social media being a big-data window for testifying conventional social theories quantitatively and exploring much detailed human behavioral patterns. In this paper, by tracing the emoticon use in Weibo, a group of hidden “ambivalent users” are disclosed for frequently posting ambivalent tweets containing both positive and negative emotions. Further investigation reveals that this ambivalent expression could be a novel indicator of many unusual social behaviors. For instance, ambivalent users with the female as the majority like to make a sound in midnights and at weekends. They mention their close friends frequently in ambivalent tweets, which attract more replies and serve as a more private communication way. Ambivalent users also respond differently to public affairs from others and demonstrate more interests in entertainment and sports events. Moreover, the sentiment shift in ambivalent tweets is more evident than usual and exhibits a clear “negative to positive” pattern. The above observations, though being promiscuous seemingly, actually point to the self-regulation of negative mood in Weibo, which could find its basis from the traditional emotion management theories in sociology but makes an important extension to the online environment in this study. Finally, as an interesting corollary, ambivalent users are found connected with compulsive buyers and turn out to be perfect targets for online marketing. PMID:26800119
An unusual stress fracture: Bilateral posterior longitudinal stress fracture of tibia.
Malkoc, Melih; Korkmaz, Ozgur; Ormeci, Tugrul; Oltulu, Ismail; Isyar, Mehmet; Mahirogulları, Mahir
2014-01-01
Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral. This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for last one month and after imaging studies posterior longitudinal tibial stress fracture was detected on his left tibia. After six months the patient was admitted to our clinic with the same type of complaints in his right leg. All imaging modalities and blood counts were performed and as a result longitudinal posterior tibial stress fractures were detected on his right tibia. Treatment of tibial stress fracture includes rest and modified activity, followed by a graded return to activity commensurate with bony healing. We have applied the same treatment protocol and our results were acceptable but our follow up time short for this reason our study is restricted for separate stress fractures of the posterior tibia. Although the main localization of tibial stress fractures were unilateral, anterior and transverse pattern, rarely, like in our case, the unusual bilateral posterior localization and longitudinal pattern can be seen. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.
Samach, A; Klenz, J E; Kohalmi, S E; Risseeuw, E; Haughn, G W; Crosby, W L
1999-11-01
Genetic and molecular studies have suggested that the UNUSUAL FLORAL ORGANS (UFO) gene, from Arabidopsis thaliana, is expressed in all shoot apical meristems, and is involved in the regulation of a complex set of developmental events during floral development, including floral meristem and floral organ identity. Results from in situ hybridization using genes expressed early in floral development as probes indicate that UFO controls growth of young floral primordia. Transgenic constructs were used to provide evidence that UFO regulates floral organ identity by activating or maintaining transcription of the class B organ-identity gene APETALA 3, but not PISTILLATA. In an attempt to understand the biochemical mode of action of the UFO gene product, we show here that UFO is an F-box protein that interacts with Arabidopsis SKP1-like proteins, both in the yeast two-hybrid system and in vitro. In yeast and other organisms both F-box proteins and SKP1 homologues are subunits of specific ubiquitin E3 enzyme complexes that target specific proteins for degradation. The protein selected for degradation by the complex is specified by the F-box proteins. It is therefore possible that the role of UFO is to target for degradation specific proteins controlling normal growth patterns in the floral primordia, as well as proteins that negatively regulate APETALA 3 transcription.
Friedman, E; Bale, A E; Carson, E; Boson, W L; Nordenskjöld, M; Ritzén, M; Ferreira, P C; Jammal, A; De Marco, L
1994-01-01
Nephrogenic diabetes insipidus is a rare hereditary disorder, most commonly transmitted in an X chromosome-linked recessive manner and characterized by the lack of renal response to the action of antidiuretic hormone [Arg8]vasopressin. The vasopressin type 2 receptor (V2R) has been suggested to be the gene that causes the disease, and its role in disease pathogenesis is supported by mutations within this gene in affected individuals. Using the PCR, denaturing gradient gel electrophoresis, and direct DNA sequencing, we examined the V2R gene in four unrelated kindreds. In addition, linkage analysis with chromosome Xq28 markers was done in one large Brazilian kindred with an apparent unusual X chromosome-linked dominant inheritance pattern. In one family, a mutation in codon 280, causing a Tyr-->Cys substitution in the sixth transmembrane domain of the receptor, was found. In the other three additional families with nephrogenic diabetes insipidus, the V2R-coding region was normal in sequence. In one large Brazilian kindred displaying an unusual X chromosome-linked dominant mode of inheritance, the disease-related gene was localized to the same region of the X chromosome as the V2R, but no mutations were found, thus raising the possibility that this disease is caused by a gene other than V2R. Images PMID:8078903
Case report: value of gene expression profiling in the diagnosis of atypical neuroblastoma.
Harttrampf, Anne C; Chen, Qingrong; Jüttner, Eva; Geiger, Julia; Vansant, Gordon; Khan, Javed; Kontny, Udo
2017-08-17
Nephroblastoma and neuroblastoma belong to the most common abdominal malignancies in childhood. Similarities in the initial presentation may provide difficulties in distinguishing between these two entities, especially if unusual variations to prevalent patterns of disease manifestation occur. Because of the risk of tumor rupture, European protocols do not require biopsy for diagnosis, which leads to misdiagnosis in some cases. We report on a 4½-year-old girl with a renal tumor displaying radiological and laboratory characteristics supporting the diagnosis of nephroblastoma. Imaging studies showed tumor extension into the inferior vena cava and bilateral lung metastases while urine catecholamines and MIBG-scintigraphy were negative. Preoperative chemotherapy with vincristine, actinomycine D and adriamycin according to the SIOP2001/GPOH protocol for the treatment of nephroblastoma was initiated and followed by surgical tumor resection. Histopathology revealed an undifferentiated tumor with expression of neuronal markers, suggestive of neuroblastoma. MYCN amplification could not be detected. DNA-microarray analysis was performed using Affymetrix genechip human genome U133 plus 2.0 and artificial neural network analysis. Results were confirmed by multiplex RT-PCR. Principal component analysis using 84 genes showed that the patient sample was clearly clustering with neuroblastoma tumors. This was confirmed by hierarchical clustering of the multiplex RT-PCR data. The patient underwent treatment for high-risk neuroblastoma comprising chemotherapy including cisplatin, etoposide, vindesine, dacarbacine, ifosfamide, vincristine, adriamycine and autologous stem cell transplantation followed by maintenance therapy with 13-cis retinoic acid (GPOH NB2004 High Risk Trial Protocol) and is in complete long-term remission. The use of gene expression profiling in an individual patient strongly contributed to clarification in a diagnostic dilemma which finally led to a change of diagnosis from nephroblastoma to neuroblastoma. This case underlines the importance of gene-expression profiling in the correct diagnosis of childhood neoplasms with atypical presentation to ensure that adequate treatment regimens can be applied.
Defining the abdominal radiologist based on the current U.S. job market.
Hoffman, David H; Rosenkrantz, Andrew B
2018-03-24
The purpose of the study is to characterize current practice patterns of abdominal radiologists based on work descriptions within job postings on numerous national radiology specialty websites. Job postings for either "abdominal" or "body" radiologists were searched weekly on five society websites (SAR, SCBT-MR, ARRS, ACR, RSNA) over a 1-year period. Postings were reviewed for various characteristics. Nine hundred and sixteen total ads for 341 unique abdominal radiologist positions were reviewed (34.6% academic, 64.2% private practice, 1.2% other). Postings occurred most commonly in March (12.3%) and least commonly in November (4.8%). States with most positions were Florida (27), California (26), and New York (24). Of postings delineating expectations of specific abdominal modalities, 67.4% mentioned MRI, 58.5% ultrasound, 41.1% fluoroscopy, 14.3% PET, and 54.0% interventions. Additional non-abdominal expectations included general radiology (28.7%), breast imaging (21.1%), and general nuclear medicine (9.7%). Additional skills included prostate MRI (7.0%), OBGYN ultrasound (5.0%), and CT colonoscopy (2.6%). 79.2% required an abdominal imaging fellowship (specifically a body MRI fellowship in 4.1%). By using job postings for abdominal radiologists, we have taken a practical approach to characterizing the current status of this subspecialty, reflecting recent job expectations and requirements. The large majority of positions required a body fellowship, and the positions commonly entailed a variety of skills beyond non-invasive diagnostic abdominal imaging. Of note, expectations of considerable minorities of positions included abdominal interventions, general radiology, and breast imaging. These insights may guide the development of abdominal radiology fellowships and mini-fellowships, as well as assist radiologists entering or returning to the job market.
Kattimani, Vivekanand S; Chakravarthi, Srinivas P; Neelima Devi, K Naga; Sridhar, Meka S; Prasad, L Krishna
2014-01-01
Bone grafts are frequently used in the treatment of bone defects. Bone harvesting can cause postoperative complications and sometimes does not provide a sufficient quantity of bone. Therefore, synthetic biomaterials have been investigated as an alternative to autogenous bone grafts. The aim of this study was to evaluate and compare bovine derived hydroxyapatite (BHA) and synthetic hydroxyapatite (SHA) graft material as bone graft substitute in maxillary cystic bony defects. Patients were analyzed by computerized densitometric study and digital radiography. In this study, 12 patients in each group were included randomly after clinical and radiological evaluation. The integration of hydroxyapatite was assessed with mean bone density, surgical site margin, and radiological bone formation characteristics, of the successful graft cases using computer densitometry and radio-visiograph. Statistical analysis was carried out using Mann-Whitney U-test, Wilcoxon matched pairs test and paired t-test. By the end of 24 th week, the grafted defects radiologically and statistically showed similar volumes of bone formation. However, the significant changes observed in the formation of bone and merging of material and surgical site margin at 1 st week to 1 st month. The results were significant and correlating with all the parameters showing the necessity of the grafting for early bone formation. However, the bone formation pattern is different in both BHA and SHA group at 3 rd month interval with significant P value. Both BHA and SHA graft materials are biocompatible for filling bone defects, showing less resorption and enhanced bone formation with similar efficacy. Our study showed maximum bone healing within 12 weeks of grafting of defects. The BHA is economical; however, price difference between the two is very nominal.
Reddington, Amanda R; Egli, Amy J; Schmuck, Heather M
2018-05-01
Health professions students are often unaware of other health care providers' roles or professional expertise due to most education taking place within their single profession. This pattern may be even more prevalent for baccalaureate and associate degree programs since most interprofessional education (IPE) occurs in predoctoral programs and, when IPE is incorporated into allied health professions education, it often utilizes simulation instead of live patient experiences. The aim of this study was to determine if radiologic technology and dental assisting students' perceptions changed regarding interprofessional practice and teamwork after an IPE activity with actual patients. The participants were students in the University of Southern Indiana (USI) radiologic technology and dental assisting programs. This mixed-methods pilot study conducted in 2017 collected quantitative and qualitative data from pre and post surveys, the researchers' observations of student interactions during live patient assessment and acquisition of panoramic images, and large-group discussion. Twenty-five of the 26 students who participated in the IPE program completed both pre and post surveys, for a 96% response rate. The results showed significant differences in the participants' perceptions from the pre to post surveys on a wide variety of survey items. Most notable were the positive changes in perceptions related to trust in judgment of others within their profession (p=0.001), relationships with other professions (p=0.002), and thinking highly of other professions (p=0.002). Overall, this study found that incorporating the IPE activity with a live patient into these radiologic technology and dental assisting programs improved the students' perceptions of other allied health professionals. Future research should include more participants to increase sample size and add quantitative data collection.
Tuberculosis of the hip in children: A retrospective analysis of 27 patients.
Agarwal, Anil; Suri, Tarun; Verma, Indereshwar; Kumar, Shashi Kant; Gupta, Neeraj; Shaharyar, Abbas
2014-09-01
We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria. The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial "triradiate" and normal types and worst with posttreatment atrophic and "ankylosed" types. The Shanmugasundaram radiological types accurately predict prognosis only in normal types and "triradiate" pattern. The functional outcome is independent of radiological morphology of the hip in smaller children.
Tuberculosis of the hip in children: A retrospective analysis of 27 patients
Agarwal, Anil; Suri, Tarun; Verma, Indereshwar; Kumar, Shashi Kant; Gupta, Neeraj; Shaharyar, Abbas
2014-01-01
Background: We retrospectively evaluated the pretreatment radiological presentation and the clinicoradiological outcome at the completion of 1 year chemotherapy in osteoarticular tuberculosis of hip in children to prognosticate correlation between them. Materials and Methods: We retrospectively analyzed the clinical and plain radiographic findings in 27 patients with an age of 12 years or younger in whom hip tuberculosis was diagnosed and treated between 2006 and 2010. The diagnosis was based on histopathology in 14 and clinicoradiological basis in 13 patients. The pre and post treatment plain radiographs were evaluated according to Shanmugasundaram radiological classification and our observations regarding unclassified cases which were not fit in this classification were suggested. The functional outcome at the completion of chemotherapy was assessed using modified Moon's criteria. Results: The male female ratio was 11:16. The left hip was involved more frequently than the right (17:10). The average age was 7.37 years (range, 2-12 years). In the pretreatment radiographs, 9 hips were normal, 6 traveling, 4 dislocating, 1 protrusio acetabuli, 3 atrophic and 4 unclassified types (3 triradiate; 1 pseudarthrosis coxae). There were no Perthes and mortar pestle at the initial presentation. Posttreatment, the types changed to 9 normal, 3 Perthes, 1 protrusio acetabuli, 1 atrophic, 4 mortar pestle and 9 unclassified types (3 triradiate, 3 pseudarthrosis coxae and 3 ankylosed). There were 37% excellent, 18.5% good, 26% fair and 18.5% poor results. The prognosis was best with initial “triradiate” and normal types and worst with posttreatment atrophic and “ankylosed” types. Conclusions: The Shanmugasundaram radiological types accurately predict prognosis only in normal types and “triradiate” pattern. The functional outcome is independent of radiological morphology of the hip in smaller children. PMID:25298552
DOE Office of Scientific and Technical Information (OSTI.GOV)
Teshima, Teruki; Numasaki, Hodaka; Shibuya, Hitoshi
2008-09-01
Purpose: To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. Methods and Materials: A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. Results: The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765more » linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 {sup 60}Co remote-controlled after-loading systems, and 119 {sup 192}Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload. Conclusions: The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control.« less
`Blame' Hawaii for Extreme Cold Air Outbreaks on the US West Coast?
NASA Astrophysics Data System (ADS)
Grotjahn, R.; Zhang, R.
2017-12-01
Short term extreme cold events punctuate the climate record. Though not always captured by monthly or seasonal means, they can have impacts lasting months. Extreme cold air outbreaks affecting the US West Coast are associated with a specific large scale meteorological pattern (LSMP). The LSMP has large meridional displacements of warm and cold air that create a ridge over and south of western Alaska, then a trough downstream moving with the cold air of the CAO, and finally another ridge over the southeastern US. These three features form in that order over several days leading up to the CAO onset. The warm advection creating the Alaskan ridge displaces cold air which is then advected southward along the North American west coast. Our recent work shows that both advections are driven by a lower level highly unusual high pressure center near the Gulf of Alaska. The cold air advection includes a continental interior portion (which sets up an offshore pressure gradient) and a portion off the west coast (air parcels high enough to be little modified before sinking over the US West Coast). In the mid to upper troposphere there are additional cyclonic centers to the south of the Alaskan ridge. Depending on the region compared, the LSMP has notable pattern correlation (up to 0.7) with the Pacific-North American teleconnection (PNA) negative phase pattern. (Others have shown a link between the PNA negative phase and unusual cold over northwestern North America on longer time scales. Here we find a higher frequency LSMP having centers offset from corresponding centers in the negative phase PNA loading pattern.) Even earlier before onset, we find a connection to a stream function structure straddling the equator that shares properties with slow moving equatorial Rossby waves; this pattern includes a trough near Hawaii that appears linked to the Alaskan ridge building that initiates the CAO. Hence, we arrive at our provocative title. All these features in the geopotential and stream function fields are highly significant from bootstrap statistics. The presentation will emphasize the time evolution of these significant features.
Dense Deposit Disease Mimicking a Renal Small Vessel Vasculitis
Singh, Lavleen; Bhardwaj, Swati; Sinha, Aditi; Bagga, Arvind; Dinda, Amit
2016-01-01
Dense deposit disease is caused by fluid-phase dysregulation of the alternative complement pathway and frequently deviates from the classic membranoproliferative pattern of injury on light microscopy. Other patterns of injury described for dense deposit disease include mesangioproliferative, acute proliferative/exudative, and crescentic GN. Regardless of the histologic pattern, C3 glomerulopathy, which includes dense deposit disease and C3 GN, is defined by immunofluorescence intensity of C3c two or more orders of magnitude greater than any other immune reactant (on a 0–3 scale). Ultrastructural appearances distinguish dense deposit disease and C3 GN. Focal and segmental necrotizing glomerular lesions with crescents, mimicking a small vessel vasculitis such as ANCA-associated GN, are a very rare manifestation of dense deposit disease. We describe our experience with this unusual histologic presentation and distinct clinical course of dense deposit disease, discuss the pitfalls in diagnosis, examine differential diagnoses, and review the relevant literature. PMID:26361799
Patterned piezo-, pyro-, and ferroelectricity of poled polymer electrets
DOE Office of Scientific and Technical Information (OSTI.GOV)
Qiu, Xunlin
2010-07-01
Polymers with strong piezo-, pyro-, and ferroelectricity are attractive for a wide range of applications. In particular, semicrystalline ferroelectric polymers are suitable for a large variety of piezo- and pyroelectric transducers or sensors, while amorphous polymers containing chromophore molecules are particularly interesting for photonic devices. Recently, a new class of polymer materials has been added to this family: internally charged cellular space-charge polymer electrets (so-called “ferroelectrets”), whose piezoelectricity can be orders of magnitude higher than that of conventional ferroelectric polymers. Suitable patterning of these materials leads to improved or unusual macroscopic piezo-, pyro-, and ferroelectric or nonlinear optical properties thatmore » may be particularly useful for advanced transducer or waveguide applications. In the present paper, the piezo-, pyro-, and ferroelectricity of poled polymers is briefly introduced, an overview on the preparation of polymer electrets with patterned piezo-, pyro-, and ferroelectricity is provided and a survey of selected applications is presented.« less
A historical case of beaten-copper cranium.
Rühli, Frank J; Nicklisch, Nicole; Alt, Kurt W
2007-01-01
The authors present the oldest historical case of a so-called beaten-copper cranium. The typical pattern was identified on a skull from a child, probably a boy, who died at approximately 6 years of age and was buried in a provisional cemetery used during the siege of Hanau, Germany, in 1635 and 1636. Morphological and radiological analyses of the severe digitate impressions ubiquitous on the child's endocranium support the diagnosis of chronically elevated intracranial pressure due to hydrocephalus.
NASA Astrophysics Data System (ADS)
Georgiou, Harris
2009-10-01
Medical Informatics and the application of modern signal processing in the assistance of the diagnostic process in medical imaging is one of the more recent and active research areas today. This thesis addresses a variety of issues related to the general problem of medical image analysis, specifically in mammography, and presents a series of algorithms and design approaches for all the intermediate levels of a modern system for computer-aided diagnosis (CAD). The diagnostic problem is analyzed with a systematic approach, first defining the imaging characteristics and features that are relevant to probable pathology in mammo-grams. Next, these features are quantified and fused into new, integrated radio-logical systems that exhibit embedded digital signal processing, in order to improve the final result and minimize the radiological dose for the patient. In a higher level, special algorithms are designed for detecting and encoding these clinically interest-ing imaging features, in order to be used as input to advanced pattern classifiers and machine learning models. Finally, these approaches are extended in multi-classifier models under the scope of Game Theory and optimum collective deci-sion, in order to produce efficient solutions for combining classifiers with minimum computational costs for advanced diagnostic systems. The material covered in this thesis is related to a total of 18 published papers, 6 in scientific journals and 12 in international conferences.
Kajbafzadeh, Abdol-Mohammad; Payabvash, Seyedmehdi; Karimian, Golnar
2007-08-01
To retrospectively review a series of children with anterior urethral valves (AUV), with emphasis on patterns of urodynamic change and long-term outcome of endoscopic treatment. We reviewed the medical records of eight patients who had undergone thorough radiological and urodynamic exams before and after treatment. The diagnosis of AUV was based on radiological imaging and confirmed by urethrocystoscopy. The valves were ablated through either transurethral fulguration or resection. The upper urinary tracts were studied by renal scan and ultrasonography before and after the procedure. Bladder function was assessed urodynamically 3 months after surgery. Uroflowmetry was performed as soon as the children were toilet trained. Endoscopic ablation of AUV was successful in all cases and no surgical complications occurred. The initial symptoms resolved in all boys. VUR disappeared in two out of three patients, and five children had bladder trabeculation that was resolved after surgery. The final outcome was successful in seven patients (88%). The major urodynamic dysfunction was bladder hypercontractility that resolved following valve ablation. The mean maximum voiding detrusor pressure (P(detmax)) decreased from 213.2+/-17.9 cmH(2)O to 80.7+/-9.9 cmH(2)O, 6 months after treatment (P<0.001). None of the patients had low-compliant bladder, detrusor instability or myogenic failure. The voiding pattern in all toilet-trained patients was staccato and of an interrupted shape prior to surgery, but changed to a normal bell-shaped voiding pattern following valve ablation. AUV should be considered in the differential diagnosis of patients presenting with infravesical obstruction. We recommend endoscopic valve ablation as the treatment of choice.
Raghavendra, U; Gudigar, Anjan; Maithri, M; Gertych, Arkadiusz; Meiburger, Kristen M; Yeong, Chai Hong; Madla, Chakri; Kongmebhol, Pailin; Molinari, Filippo; Ng, Kwan Hoong; Acharya, U Rajendra
2018-04-01
Ultrasound imaging is one of the most common visualizing tools used by radiologists to identify the location of thyroid nodules. However, visual assessment of nodules is difficult and often affected by inter- and intra-observer variabilities. Thus, a computer-aided diagnosis (CAD) system can be helpful to cross-verify the severity of nodules. This paper proposes a new CAD system to characterize thyroid nodules using optimized multi-level elongated quinary patterns. In this study, higher order spectral (HOS) entropy features extracted from these patterns appropriately distinguished benign and malignant nodules under particle swarm optimization (PSO) and support vector machine (SVM) frameworks. Our CAD algorithm achieved a maximum accuracy of 97.71% and 97.01% in private and public datasets respectively. The evaluation of this CAD system on both private and public datasets confirmed its effectiveness as a secondary tool in assisting radiological findings. Copyright © 2018 Elsevier Ltd. All rights reserved.
Liu, Shuo; Cui, Tie Jun; Zhang, Lei; Xu, Quan; Wang, Qiu; Wan, Xiang; Gu, Jian Qiang; Tang, Wen Xuan; Qing Qi, Mei; Han, Jia Guang; Zhang, Wei Li; Zhou, Xiao Yang; Cheng, Qiang
2016-10-01
The concept of coding metasurface makes a link between physically metamaterial particles and digital codes, and hence it is possible to perform digital signal processing on the coding metasurface to realize unusual physical phenomena. Here, this study presents to perform Fourier operations on coding metasurfaces and proposes a principle called as scattering-pattern shift using the convolution theorem, which allows steering of the scattering pattern to an arbitrarily predesigned direction. Owing to the constant reflection amplitude of coding particles, the required coding pattern can be simply achieved by the modulus of two coding matrices. This study demonstrates that the scattering patterns that are directly calculated from the coding pattern using the Fourier transform have excellent agreements to the numerical simulations based on realistic coding structures, providing an efficient method in optimizing coding patterns to achieve predesigned scattering beams. The most important advantage of this approach over the previous schemes in producing anomalous single-beam scattering is its flexible and continuous controls to arbitrary directions. This work opens a new route to study metamaterial from a fully digital perspective, predicting the possibility of combining conventional theorems in digital signal processing with the coding metasurface to realize more powerful manipulations of electromagnetic waves.
On the Influence of North Pacific Sea Surface Temperature on the Arctic Winter Climate
NASA Technical Reports Server (NTRS)
Hurwitz, Margaret M.; Newman, P. A.; Garfinkel, C. I.
2012-01-01
Differences between two ensembles of Goddard Earth Observing System Chemistry-Climate Model simulations isolate the impact of North Pacific sea surface temperatures (SSTs) on the Arctic winter climate. One ensemble of extended winter season forecasts is forced by unusually high SSTs in the North Pacific, while in the second ensemble SSTs in the North Pacific are unusually low. High Low differences are consistent with a weakened Western Pacific atmospheric teleconnection pattern, and in particular, a weakening of the Aleutian low. This relative change in tropospheric circulation inhibits planetary wave propagation into the stratosphere, in turn reducing polar stratospheric temperature in mid- and late winter. The number of winters with sudden stratospheric warmings is approximately tripled in the Low ensemble as compared with the High ensemble. Enhanced North Pacific SSTs, and thus a more stable and persistent Arctic vortex, lead to a relative decrease in lower stratospheric ozone in late winter, affecting the April clear-sky UV index at Northern Hemisphere mid-latitudes.
Synthetic biology meets tissue engineering
Davies, Jamie A.; Cachat, Elise
2016-01-01
Classical tissue engineering is aimed mainly at producing anatomically and physiologically realistic replacements for normal human tissues. It is done either by encouraging cellular colonization of manufactured matrices or cellular recolonization of decellularized natural extracellular matrices from donor organs, or by allowing cells to self-organize into organs as they do during fetal life. For repair of normal bodies, this will be adequate but there are reasons for making unusual, non-evolved tissues (repair of unusual bodies, interface to electromechanical prostheses, incorporating living cells into life-support machines). Synthetic biology is aimed mainly at engineering cells so that they can perform custom functions: applying synthetic biological approaches to tissue engineering may be one way of engineering custom structures. In this article, we outline the ‘embryological cycle’ of patterning, differentiation and morphogenesis and review progress that has been made in constructing synthetic biological systems to reproduce these processes in new ways. The state-of-the-art remains a long way from making truly synthetic tissues, but there are now at least foundations for future work. PMID:27284030
Atypical Teratoid Rhabdoid Tumor in a Teenager with Unusual Infiltration Into the Jugular Foramen.
Udaka, Yoko T; Yoon, Janet M; Malicki, Denise M; Khanna, Paritosh C; Levy, Michael L; Crawford, John R
2015-12-01
Atypical teratoid rhabdoid tumor is a rare malignant neoplasm that represents 1%-2% of all pediatric central nervous system tumors. Immunohistochemistry plays an important role in establishing the diagnosis with a loss of INI-1 staining in tumor cells. In this case report, we describe a teenager with an unusual presentation and pattern of infiltration of the tumor. A 13-year-old boy presented with a history over several months of progressive nausea, weight loss, and hoarseness of voice associated with multiple lower cranial nerve palsies on neurologic examination. Magnetic resonance imaging revealed a large heterogeneously enhancing extra-axial neoplasm with extension and bony expansion of the jugular foramen. After near total resection, neuropathology demonstrated the absence of INI-1 expression consistent with a diagnosis of atypical teratoid rhabdoid tumor. This case highlights the diverse clinical presentation and infiltrative potential of atypical teratoid rhabdoid tumors, thus expanding the differential diagnosis of extra-axial tumors invading the jugular foramen. Copyright © 2015 Elsevier Inc. All rights reserved.
Remote Linkages to Anomalous Winter Atmospheric Ridging over the Northeastern Pacific
NASA Technical Reports Server (NTRS)
Swain, Daniel L.; Singh, Deepti; Horton, Daniel E.; Mankin, Justin S.; Ballard, Tristan C.; Diffenbaugh, Noah S.
2017-01-01
Severe drought in California between 2013 and 2016 has been linked to the multiyear persistence of anomalously high atmospheric pressure over the northeastern Pacific Ocean, which deflected the Pacific storm track northward and suppressed regional precipitation during California's winter 'rainy season.' Multiple hypotheses have emerged regarding why this high pressure ridge near the west coast of North America was so resilient-including unusual sea surface temperature patterns in the Pacific Ocean, reductions in Arctic sea ice, random atmospheric variability, or some combination thereof. Here we explore relationships between previously documented atmospheric conditions over the North Pacific and several potential remote oceanic and cryospheric influences using both observational data and a large ensemble of climate model simulations. Our results suggest that persistent wintertime atmospheric ridging similar to that implicated in California's 2013-2016 drought can at least partially be linked to unusual Pacific sea surface temperatures, and that Pacific Ocean conditions may offer some degree of cool-season foresight in this region despite the presence of substantial internal variability.
Remote Linkages to Anomalous Winter Atmospheric Ridging Over the Northeastern Pacific
NASA Astrophysics Data System (ADS)
Swain, Daniel L.; Singh, Deepti; Horton, Daniel E.; Mankin, Justin S.; Ballard, Tristan C.; Diffenbaugh, Noah S.
2017-11-01
Severe drought in California between 2013 and 2016 has been linked to the multiyear persistence of anomalously high atmospheric pressure over the northeastern Pacific Ocean, which deflected the Pacific storm track northward and suppressed regional precipitation during California's winter "rainy season." Multiple hypotheses have emerged regarding why this high pressure ridge near the west coast of North America was so resilient—including unusual sea surface temperature patterns in the Pacific Ocean, reductions in Arctic sea ice, random atmospheric variability, or some combination thereof. Here we explore relationships between previously documented atmospheric conditions over the North Pacific and several potential remote oceanic and cryospheric influences using both observational data and a large ensemble of climate model simulations. Our results suggest that persistent wintertime atmospheric ridging similar to that implicated in California's 2013-2016 drought can at least partially be linked to unusual Pacific sea surface temperatures and that Pacific Ocean conditions may offer some degree of cool-season foresight in this region despite the presence of substantial internal variability.
Ling, Ming-Xing; Liu, Yu-Long; Williams, Ian S.; Teng, Fang-Zhen; Yang, Xiao-Yong; Ding, Xing; Wei, Gang-Jian; Xie, Lu-Hua; Deng, Wen-Feng; Sun, Wei-Dong
2013-01-01
Rare Earth Elements (REE) are essential to modern society but the origins of many large REE deposits remain unclear. The U-Th-Pb ages, chemical compositions and C, O and Mg isotopic compositions of Bayan Obo, the world's largest REE deposit, indicate a protracted mineralisation history with unusual chemical and isotopic features. Coexisting calcite and dolomite are in O isotope disequilibrium; some calcitic carbonatite samples show highly varied δ26Mg which increases with increasing Si and Mg; and ankerite crystals show decreases in Fe and REE from rim to centre, with highly varied REE patterns. These and many other observations are consistent with an unusual mineralisation process not previously considered; protracted fluxing of calcitic carbonatite by subduction-released high-Si fluids during the closure of the Palaeo-Asian Ocean. The fluids leached Fe and Mg from the mantle wedge and scavenged REE, Nb and Th from carbonatite, forming the deposit through metasomatism of overlying sedimentary carbonate.
Guntapong, Ratigorn; Tacharoenmuang, Ratana; Singchai, Phakapun; Upachai, Sompong; Sutthiwarakom, Karun; Komoto, Satoshi; Tsuji, Takao; Tharmaphornpilas, Piyanit; Yoshikawa, Tetsushi; Sangkitporn, Somchai; Taniguchi, Koki
2017-04-01
Of 2,754 stool specimens collected from children with acute gastroenteritis during 2013-2014 in Sukhothai and Phetchaboon provinces, Thailand, 666 (24.2%) were positive for rotavirus A (RVA) in polyacrylamide gel electrophoresis (PAGE). The G and P types of all RVA-positive specimens were determined by semi-nested RT-PCR. G1P[8] (56.5%) was most prevalent, followed by G2P[4] (22.1%). Unusual G8P[8] human RVAs (HuRVAs) were detected at a high frequency (20.0%). Interestingly, 171 of the 376 G1P[8] HuRVAs and all of the 133 G8P[8] HuRVAs showed a short RNA pattern in PAGE. Thus, it was shown that the properties of HuRVAs have been markedly unusual in recent years in Thailand. J. Med. Virol. 89:615-620, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
The changing of the guard: Molecular diversity and rapid evolution of beta-defensins.
Semple, Colin A; Gautier, Phillipe; Taylor, Karen; Dorin, Julia R
2006-11-01
Defensins are small cationic peptides involved in innate immunity and are components of the first line of defence against invading pathogens. beta-defensins are a subgroup of the defensin family that display a particular cysteine spacing and pattern of intramolecular bonding. These molecules are produced mostly by epithelia lining exposed surfaces and appear to have both antimicrobial and cell signalling functions. The unusually high degree of sequence variation in the mature peptide produced by the paralogous and in some cases orthologous genes implies extensive specialisation and species specific adaptation. Here we review recent functional data that are an important addition to our knowledge of the innate immune response and novel antibiotic design. We also consider the organisation and evolution of the genomic loci harbouring these genes where radical and rapid changes in beta-defensin sequences have been shown to result from the interplay of both positive and negative selection. Consequently these genes provide some unusually clear glimpses of the processes of duplication and specialisation that have shaped the mammalian genome.
Khan, M S; Khan, M S; Hasan, R; Godfrey-Faussett, P
2013-09-01
In developing countries, only one-third of new tuberculosis cases notified are from women. It is not clear whether tuberculosis incidence is lower in women than men, or whether notification figures reflect under-detection of tuberculosis in women. Pakistan, however, presents an unusual pattern of sex differences in tuberculosis notifications. While 2 of the 4 provinces (Sindh and Punjab) report more notifications from men (female to male ratios 0.81 and 0.89 respectively in 2009), the other 2 provinces (Khyber-Pakhtunkhwa and Balochistan) consistently report higher numbers of smear-positive tuberculosis notifications from women than men (1.37 and 1.40). No other country is known to have such a large variation in the sex ratios of notifications across regions. Large variations in female to male smear-positive notification ratios in different settings across a single country may indicate that environmental factors, rather than endogenous biological factors, are important in influencing the observed sex differences in tuberculosis notifications.
Hwang, Kyusung; Kim, Yong Baek
2016-01-01
We theoretically investigate emergent quantum phases in the thin film geometries of the pyrochore iridates, where a number of exotic quantum ground states are proposed to occur in bulk materials as a result of the interplay between electron correlation and strong spin-orbit coupling. The fate of these bulk phases as well as novel quantum states that may arise only in the thin film platforms, are studied via a theoretical model that allows layer-dependent magnetic structures. It is found that the magnetic order develop in inhomogeneous fashions in the thin film geometries. This leads to a variety of magnetic metal phases with modulated magnetic ordering patterns across different layers. Both the bulk and boundary electronic states in these phases conspire to promote unusual electronic properties. In particular, such phases are akin to the Weyl semimetal phase in the bulk system and they would exhibit an unusually large anomalous Hall effect. PMID:27418293
NASA Astrophysics Data System (ADS)
Hess, Andrew; Liu, Qingkun; Smalyukh, Ivan
A promising approach in designing composite materials with unusual physical behavior combines solid nanostructures and orientationally ordered soft matter at the mesoscale. Such composites not only inherit properties of their constituents but also can exhibit emergent behavior, such as ferromagnetic ordering of colloidal metal nanoparticles forming mesoscopic magnetization domains when dispersed in a nematic liquid crystal. Here we demonstrate the optical patterning of domain structures and topological defects in such ferromagnetic liquid crystal colloids which allows for altering their response to magnetic fields. Our findings reveal the nature of the defects in this soft matter system which is different as compared to non-polar nematic and ferromagnetic systems alike. This research was supported by the NSF Grant DMR-1420736.
Ball, Hope C; Stavarz, Madeline; Oldaker, Jonathan; Usip, Sharon; Londraville, Richard L; George, John C; Thewissen, Johnannes G M; Duff, Robert Joel
2015-08-01
Cetacean evolution was shaped by an extraordinary land-to-sea transition in which the ancestors of whales became fully aquatic. As part of this transition, these mammals evolved unusually thick blubber which acts as a metabolic reservoir as well as an insulator and provides buoyancy and streamlining. This study describes blubber stratification and correlates it to seasonal variation, feeding patterns, and ontogeny in an arctic-adapted mysticete, the bowhead whale (Balaena mysticetus). Bowheads are unique among mammals for possessing the largest known blubber stores. We found that adipocyte numbers in bowheads, like other mammals, do not vary with season or feeding pattern but that adipocyte size and structural fiber densities do vary with blubber depth. © 2015 Wiley Periodicals, Inc.
Hemosuccus Pancreaticus following a Puestow Procedure in a Patient with Chronic Pancreatitis
Okamoto, Hirotaka; Miura, Kazuo; Fujii, Hideki
2011-01-01
Hemosuccus pancreaticus is an unusual cause of gastrointestinal bleeding that occurs as a complication of chronic or acute pancreatitis. We report a case of extremely acute-onset hemosuccus pancreaticus occurring in a patient with chronic pancreatitis over a long-term follow-up after a Puestow procedure (side-to-side pancreaticojejunostomy). The patient was admitted to our hospital due to severe anemia and tarry stools indicative of gastrointestinal bleeding. Emergent endoscopy, including gastrointestinal fiberscopy and colon fiberscopy, showed no abnormal findings. Abdominal contrast-enhanced computed tomography and hemorrhagic scintigraphy did not detect a hemorrhagic lesion. Although interventional radiology was considered for diagnosis and treatment, conservative therapy seemed sufficient to affect hemostasis. Two weeks later, however, acute intestinal bleeding with hemodynamic shock occurred, and exploration was performed without delay. Intraoperative endoscopy through an incision of the reconstructed jejunal loop in the close proximal end revealed a site of active bleeding from the side-to-side anastomotic pancreatic duct. Following a longitudinal incision of the jejunal loop, a bleeding point was sutured and ligated on direct inspection. The patient showed a good postoperative course. PMID:21960948
Hemosuccus Pancreaticus following a Puestow Procedure in a Patient with Chronic Pancreatitis.
Okamoto, Hirotaka; Miura, Kazuo; Fujii, Hideki
2011-05-01
Hemosuccus pancreaticus is an unusual cause of gastrointestinal bleeding that occurs as a complication of chronic or acute pancreatitis. We report a case of extremely acute-onset hemosuccus pancreaticus occurring in a patient with chronic pancreatitis over a long-term follow-up after a Puestow procedure (side-to-side pancreaticojejunostomy). The patient was admitted to our hospital due to severe anemia and tarry stools indicative of gastrointestinal bleeding. Emergent endoscopy, including gastrointestinal fiberscopy and colon fiberscopy, showed no abnormal findings. Abdominal contrast-enhanced computed tomography and hemorrhagic scintigraphy did not detect a hemorrhagic lesion. Although interventional radiology was considered for diagnosis and treatment, conservative therapy seemed sufficient to affect hemostasis. Two weeks later, however, acute intestinal bleeding with hemodynamic shock occurred, and exploration was performed without delay. Intraoperative endoscopy through an incision of the reconstructed jejunal loop in the close proximal end revealed a site of active bleeding from the side-to-side anastomotic pancreatic duct. Following a longitudinal incision of the jejunal loop, a bleeding point was sutured and ligated on direct inspection. The patient showed a good postoperative course.
An unusual case of Y-shaped right renal vein.
Lavy, M; Martin, L; Eouzan, D; Turco, C; Heyd, B; Mantion, G; Parratte, B; Tatu, L
2015-01-01
Vascular renal anomalies are frequent, multiple and well described and result from errors in vessel embryogenesis between the 6th and 10th week of gestation. Historically, variations are described in anatomic dissection and currently mostly in image interpretation. We report an anatomic variation concerning the right renal vein which, to our knowledge, has never been described in the literature either by dissection or by radiological examination. This variation was discovered during the routine dissection of an embalmed male body. It consists of a Y-shaped right renal vein and is associated with multiple retroperitoneal variations: a bilateral accessory renal artery, a trident ending of the right renal artery and a left testicular vein variation. Venous and arterial renal anatomy and its variations are fundamentally important in renal surgery, especially concerning living donor renal grafts. These variations may be diagnosed thanks to injected tomodensitometry which has a good sensitivity and specificity for anomalies. Preoperative diagnosis of an anatomic vascular renal variation may reduce morbidity during surgery, which is why precise examination of injected tomography should be mandatory.
Silent diabetes mellitus, periodontitis and a new case of thalamic abscess
Karageorgiou, Ioannis; Chandler, Christopher; Whyte, Martin Brunel
2014-01-01
Brain abscess is an unusual complication of uncontrolled diabetes. A solitary thalamic abscess is an uncommon type of brain abscess. We report a case of thalamic abscess, whereupon diabetes mellitus and periodontitis were diagnosed. The diagnosis and management of thalamic abscess, and the interplay of type 2 diabetes and periodontitis are discussed. A 56-year-old, Caucasian, man with no medical or travel history, presented with 5-day symptoms of meningeal irritation. Body mass index 30.6 kg/m2. CT demonstrated a solitary midline lesion with neoplasia as a differential diagnosis. It was biopsied and cultures grew Streptococcus milleri. He was treated by stereotactic puncture, external drainage and targeted intrathecal and systemic antibiotic therapy. HIV negative but glycated haemoglobin (HbA1c) 10.7% (93 mmol/mol). Dental examination revealed a small molar abscess. Radiological resolution of the thalamic abscess occurred within 2 months. Diabetes improved with 7 weeks of insulin, and maintained on metformin, HbA1c 6.9% (51 mmol/mol). There was no residual neurological disability. PMID:25053670
Oral manifestations of Fanconi's anaemia: a case report.
Saleh, A; Stephen, L X G
2008-02-01
Fanconi's anaemia (FA) is a rare, inherited autosomal recessive genetic disease characterized by progressive bone marrow failure, congenital abnormalities, and high predisposition to malignancies. The incidence of the disease is unusually high in the Afrikaner population of South Africa with calculated heterozygote prevalence being approximately 1 in 77. This report describes the oral clinical and radiological findings in a 16 year old male with FA. Medical and dental history was noted, the oral mucosa was examined and the teeth were screened for fillings and caries. Periodontal examination consisted of: measurement of probing depths, recession, mobility of teeth, furcation involvement, plaque index and gingival index. An orthopantomograph was taken. There was a generalized black hyper-pigmentation on the buccal mucosa, tongue and palate. The patient had generalized gingival recession and most of the periodontal pockets were deeper than 5mm. Several teeth were mobile and the orthopantomograph showed loss of alveolar bone in the furcation areas of most posterior teeth. A diagnosis of severe generalized periodontitis associated with systemic disease was made. Patients with Fanconi's anaemia are susceptible to severe dental and periodontal diseases.
An unusual presentation of osteogenesis imperfecta type I
Rebelo, Marta; Lima, Jandira; Vieira, José Diniz; Costa, José Nascimento
2011-01-01
Osteogenesis imperfecta (OI) is a rare inherited disorder with a broad spectrum of clinical and genetic variability. The genetic diversity involves, in the majority of the cases, mutations in one of the genes that encodes the type 1 collagen protein (COL1 A1 and COL1 A2), but it is not a requirement for the diagnosis. The most benign form is OI type I. The authors present a case report of a 25-year-old woman who had severe low back pain associated with incapacity to walk and breast-feed post-partum. Symptoms developed 2 weeks after delivery. The radiological examination revealed severe osteoporosis with no abnormalities in the laboratory findings. The clinical signs and a positive personal and family history of multiple fractures in childhood suggested OI type I, although other diagnosis, such as pregnancy-associated osteoporosis, was also considered. The atypical presentation of this rare disorder in adulthood calls attention to the need for early diagnosis for prompt treatment. Treatment of OI is never curative, but it improves the quality of the patient’s life. PMID:23754901
Xiphoid syndrome: an uncommon occupational disorder.
Yapici Ugurlar, O; Ugurlar, M; Ozel, A; Erturk, S M
2014-01-01
We report a case of a 45-year-old man, complaining of swelling and pain in his epigastric region for the last 3 years. According to his medical history, he had undergone various investigations and treatments for gastro-oesophageal reflux, without relief. He had had a history of chronic repeated microtraumas to his sternum during 9 years of working as a carpenter, as a result of placing wood against his anterior chest wall and pushing the former into a plank cutting machine. On examination, a tender swelling was palpable as an immobile, hard mass showing minimal protrusion under the skin on the xiphoid process. He was diagnosed as having xiphoid syndrome. We prescribed anti-inflammatory medication and advised him to avoid pressure on his anterior chest wall, especially on the sternum, while cutting wood. At follow-up, the symptoms were relieved. Xiphoid syndrome may be seen in people performing hard physical work who incur sustained pressure or friction on their anterior chest wall. The case emphasizes the importance of the occupational history as well as clinical and radiological investigation of unusual conditions as mentioned above.
Fatal lawn mower related projectile injury.
Colville-Ebeling, Bonnie; Lynnerup, Niels; Banner, Jytte
2014-06-01
Fatal lawn mower related injuries are a relatively rare occurrence. In a forensic setting, the primary aim is to reconstruct the injury mechanism and establish the cause of death. A relatively rare, but characteristic type of injury is a so-called projectile or missile injury. This occurs when the operator or a bystander is impacted by an object mobilized from the grass by the rotating mower blades. This type of injury often leaves only modest external trauma, which increases the risk of overlooking an entry wound. In this paper we present a case of a fatal lawn mower related projectile injury which was initially overlooked, later interpreted as a possible gunshot homicide, and finally identified as a lawn mower related projectile injury when autopsy revealed a piece of metal thread in the main bronchus to the right middle lobe, hemopericardium, and right-sided hemothorax. To our knowledge, this injury mechanism has not previously been reported as a cause of death. This case illustrates the importance of postmortem radiological imaging and interdisciplinary cooperation when establishing manner and cause of death in unusual cases.
Pituitary tumors. Current concepts in diagnosis and management.
Aron, D C; Tyrrell, J B; Wilson, C B
1995-01-01
Diagnostic advances have resulted in earlier and more frequent recognition of pituitary tumors. Pituitary tumors cause problems owing to the hormones they secrete or the effects of an expanding sellar mass--hypopituitarism, visual field abnormalities, and neurologic deficits. Prolactin-secreting tumors (prolactinomas), which cause amenorrhea, galactorrhea, and hypogonadism, constitute the most common type of primary pituitary tumors, followed by growth hormone-secreting tumors, which cause acromegaly, and corticotropin-secreting tumors, which cause Cushing's syndrome. Hypersecretion of thyroid-stimulating hormone, the gonadotrophins, or alpha-subunits is unusual. Nonfunctional tumors currently represent only 10% of all clinically diagnosed pituitary adenomas, and some of these are alpha-subunit-secreting adenomas. Insights into the pathogenesis and biologic behavior of these usually benign tumors have been gained from genetic studies. We review some of the recent advances and salient features of the diagnosis and management of pituitary tumors, including biochemical and radiologic diagnosis, transsphenoidal surgery, radiation therapy, and medical therapy. Each type of lesion requires a comprehensive but individualized treatment approach, and regardless of the mode of therapy, careful follow-up is essential. Images PMID:7747500
Song, Won Seok; Jeon, Dae-Geun; Cho, Wan Hyeong; Kong, Chang-Bae; Cho, Sang Hyun; Lee, Jung Wook; Lee, Soo-Yong
2014-06-01
We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.
[The clinicopathological features of acute fibrinous and organizing pneumonia].
Qiu, Yu-ying; Miao, Li-yun; Cai, Hou-rong; Xiao, Yong-long; Ye, Qing; Meng, Fan-qing; Feng, An-ning
2013-06-01
To improve understanding of the clinical, radiological and pathological characteristics of acute fibrinous and organizing pneumonia (AFOP). The clinical data of 5 AFOP patients were retrospectively analyzed. AFOP was diagnosed via percutaneous lung biopsy guided by chest computerized tomography (CT) in the Affiliated Drum Tower Hospital of Nanjing University Medical School during March 2011 to June 2012. The clinical, radiological and pathological characteristics of those patients were summarized. Among the 5 patients, 2 were male and 3 were female, aging 43-61 years. They were all subacute onset. The main clinical manifestations were dyspnea, productive cough, fever and chest pain with hypoxemia via blood gas analysis. Bilateral infiltrates with diffuse and pathy distribution were the predominant features in chest HRCT. The pathological examination revealed slightly widened alveolar septa, 1ymphocyte and plasma cell infiltration and the presence of intra-alveolar fibrin in the form of fibrin "balls" (organization) within the alveolar spaces. No neutrophil, and eosinophil infiltration and hyaline membrane formation were detected, which was different from other well-recognized histologic patterns of acute lung injury, such as diffuse alveolar damage, cryptogenic organizing pneumonia and eosinophilic pneumonia. All patients were treated by corticosteroids and showed significant clinical and radiological improvement. AFOP has nospecific features, and its diagnosis depends on pathological examination. Treatment with corticosteroids is optimal. However, whether it is a unique interstitial disease needs to be further clinically investigated.
[E-Learning in radiology; the practical use of the content management system ILIAS].
Schütze, B; Mildenberger, P; Kämmerer, M
2006-05-01
Due to the possibility of using different kinds of visualization, e-learning has the advantage of allowing individualized learning. A check should be performed to determine whether the use of the web-based content management system ILIAS simplifies the writing and production of electronic learning modules in radiology. Internet-based e-learning provides access to existing learning modules regardless of time and location, since fast Internet connections are readily available. Web Content Management Systems (WCMS) are suitable platforms for imparting radiology-related information (visual abilities like the recognition of patterns as well as interdisciplinary specialized knowledge). The open source product ILIAS is a free WCMS. It is used by many universities and is accepted by both students and lecturers. Its modular and object-oriented software architecture makes it easy to adapt and enlarge the platform. The employment of e-learning standards such as LOM and SCORM within ILIAS makes it possible to reuse contents, even if the platform has to be changed. ILIAS renders it possible to provide students with texts, images, or files of any other kind within a learning context which is defined by the lecturer. Students can check their acquired knowledge via online testing and receive direct performance feedback. The significant interest that students have shown in ILIAS proves that e-learning can be a useful addition to conventional learning methods.
Legionnaire's pneumonia: is there really an interstitial disease?
Godet, C; Frat, J P; Le Moal, G; Roblot, F; Michalakis, G; Cabon, E; Tasu, J P
2007-01-01
Legionella pneumonia is usually classified as "atypical pneumonia", which suggests a predominance of interstitial patterns in chest X-rays. Based on a selection of recent clinical cases and a brief review of the literature, the aim of the study is to clarify, how far the actual radiological findings would be consistent with these expectations. A retrospective analysis of 18 epidemic personal cases and a review of the literature data were performed to describe the chest X-ray findings of Legionella pneumophila (LP) community acquired pneumonia. X-ray review was performed simultaneously and in consensus by two radiologists (J.P.T., E.C.) and a physician (C.G.). From our series, 17 patients had an abnormal chest X-ray on admission. Among these pathological X-ray cases, infiltrates were more often confluent (n=16), or patchy (n=7), rather than interstitial (n=1). Fifteen patients had infiltrates involving the lower lung fields. Bilateral distribution of abnormalities and pleural effusion were each observed in three cases. Radiological findings deteriorated between the second and seventh days following admission, particularly in the form of patchy infiltrates with pleural effusion. The review of the literature is consistent with these findings, by reporting prevalent confluent or patchy infiltrates. These findings are consistent with the physiopathological particularity of this affection and incite us to avoid the classification "atypical pneumonia" in radiologic terminology. This term is more appropriate for clinical and microbiological use.
White Paper: Curriculum in Interventional Radiology.
Mahnken, Andreas H; Bücker, Arno; Hohl, Christian; Berlis, Ansgar
2017-04-01
Purpose Scope and clinical importance of interventional radiology markedly evolved over the last decades. Consequently it was acknowledged as independent subspecialty by the "European Union of Medical Specialists" (UEMS). Based on radiological imaging techniques Interventional Radiology is an integral part of Radiology. Materials und Methods In 2009 the German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a structured training in Interventional Radiology. In cooperation with the German Society of Neuroradiology (DGNR) this training was extended to also cover Interventional Neuroradiology in 2012. Tailored for this training in Interventional Radiology a structured curriculum was developed, covering the scope of this modular training. Results The curriculum is based on the DeGIR/DGNR modular training concept in Interventional Radiology. There is also an European Curriculum and Syllabus for Interventional Radiology developed by the "Cardiovascular and Interventional Radiological Society of Europe" (CIRSE). The presented curriculum in Interventional Radiology is designed to provide a uniform base for the training in Interventional Radiology in Germany, based on the competencies obtained during residency. Conclusion This curriculum can be used as a basis for training in Interventional Radiology by all training sites. Key Points: · Interventional Radiology is an integral part of clinical radiology. · The German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a curriculum in Interventional Radiology. · This curriculum is an integrative basis for the training in interventional. Citation Format · Mahnken AH, Bücker A, Hohl C et al. White Paper: Curriculum in Interventional Radiology. Fortschr Röntgenstr 2017; 189: 309 - 311. © Georg Thieme Verlag KG Stuttgart · New York.
Plaisant, Catherine; Lam, Stanley; Shneiderman, Ben; Smith, Mark S.; Roseman, David; Marchand, Greg; Gillam, Michael; Feied, Craig; Handler, Jonathan; Rappaport, Hank
2008-01-01
As electronic health records (EHR) become more widespread, they enable clinicians and researchers to pose complex queries that can benefit immediate patient care and deepen understanding of medical treatment and outcomes. However, current query tools make complex temporal queries difficult to pose, and physicians have to rely on computer professionals to specify the queries for them. This paper describes our efforts to develop a novel query tool implemented in a large operational system at the Washington Hospital Center (Microsoft Amalga, formerly known as Azyxxi). We describe our design of the interface to specify temporal patterns and the visual presentation of results, and report on a pilot user study looking for adverse reactions following radiology studies using contrast. PMID:18999158
NASA Technical Reports Server (NTRS)
Baily, N. A.
1973-01-01
The radiological implications of statistical variations in energy deposition by ionizing radiation were investigated in the conduct of the following experiments: (1) study of the production of secondary particles generated by the passage of the primary radiation through bone and muscle; (2) the study of the ratio of nonreparable to reparable damage in DNA as a function of different energy deposition patterns generated by X rays versus heavy fast charged particles; (3) the use of electronic radiography systems for direct fluoroscopic tomography and for the synthesis of multiple planes and; (4) the determination of the characteristics of systems response to split fields having different contrast levels, and of minimum detectable contrast levels between the halves under realistic clinical situations.
Palisaded Encapsulated (Solitary Circumscribed) Neuroma of the Buccal Mucosa: a Rare Case.
Atarbashi-Moghadam, Saede; Lotfi, Ali; Salehi Zalani, Saman; Mokhtari, Sepideh
2017-12-01
The rarity of oral soft tissue spindle cell tumors combined with overlapping microscopic patterns can make challenges in their diagnosis and treatment. Oral cavity palisaded encapsulated neuroma is an uncommon lesion which occurs often on the hard palate. It is essential for oral pathologists to be familiar with its histopathology of this lesion is essential since many lesions are probably diagnosed microscopically as neurofibroma or schwannoma. Here, we report a case of oral palisaded encapsulated (solitary circumscribed) neuroma in an unusual site.
Joint Workshop on Aspects of Halophilism Held in Jerusalem, March 23-28, 1986. Program/Abstracts.
1986-04-30
different proteins. The sulfate residues are not reduced, but rather incorporated into glycoconjugates as sulfuric acid esters ( 1 ). In vivo studies with...References: 1 . Gupta, R. and C. R. Woese. 1980. Unusual modification patterns in the transfer ribonuclel acids of arohaebacteria. Curr. 4icrobiol. 4:245-249...of large amounts of rain floods in the winter of 1979- 1 )60, diluting the upper water layers by up to 1 ( 1 %. The bacerial bloom consisted for 80% of
Case report. Pediatric carpal fracture dislocation.
DeCoster, T A; Faherty, S; Morris, A L
1994-01-01
Transcarpal fractures in children are rare in the orthopaedic literature. This is a case report of a 10-year-old boy who sustained fractures across the distal radius, scaphoid, lunate, and triquetrum with gross displacement. Treatment consisted of open reduction with internal fixation of the fractures and ligamentous repair through a combined dorsal and palmar approach. The injury healed with good wrist function but abnormal carpal development. This unusual pattern of injury is described so that it may be more readily appreciated in the future.
Hepatic venous connection to a persistent inferior caval vein in left isomerism.
Guenthard, J; Carvalho, J S; Anderson, R H; Rigby, M L
1990-09-01
In 22 cases of left atrial isomerism studied at the Brompton Hospital, four cases were found to have an unusual arrangement of the abdominal vessels. There was persistence of an inferior caval vein, partially anomalous hepatic venous connection and additional continuation of part of the venous return from the lower body through the azygos venous system. This venous pattern had surgical implications in our index case, since redirection of the inferior caval venous return was necessary.
NASA Astrophysics Data System (ADS)
Kaya, Ismet I.; Eberl, Karl
2007-05-01
A three-terminal device formed by two electrostatic barriers crossing an asymmetrically patterned two-dimensional electron gas displays an unusual potential depression at the middle contact, yielding absolute negative resistance. The device displays momentum and current transfer ratios that far exceed unity. The observed reversal of the current or potential in the middle terminal can be interpreted as the analog of Bernoulli’s effect in a Fermi liquid. The results are explained by directional scattering of electrons in two dimensions.
Diabetes insipidus, diabetes mellitus, optic atrophy and deafness. A clinical and genetic study.
Nagi, N. A.
1979-01-01
Two Iraqi sisters and a female cousin developed diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy (OA), and deafness (D), (the 'DIDMOAD' syndrome) before the age of 12 years. One girl exhibited all the features of this disease complex only 3 months after an unusually late onset of recognizable symptoms at 11 years 9 months. Another girl died suddenly and unexpectedly. This family study illustrates the recessive inheritance pattern of the syndrome. Images Fig. 2 Fig. 3 PMID:482181
Imaging of the meninges and the extra-axial spaces.
Kirmi, Olga; Sheerin, Fintan; Patel, Neel
2009-12-01
The separate meningeal layers and extraaxial spaces are complex and can only be differentiated by pathologic processes on imaging. Differentiation of the location of such processes can be achieved using different imaging modalities. In this pictorial review we address the imaging techniques, enhancement and location patterns, and disease spread that will promote accurate localization of the pathology, thus improving accuracy of diagnosis. Typical and unusual magnetic resonance (MR), computed tomography (CT), and ultrasound imaging findings of many conditions affecting these layers and spaces are described.
Evaluation of secondary hyperparathyroidism in patients undergoing hemodialysis.
Rahimian, Mohammad; Sami, Ramin; Behzad, Fariba
2008-01-01
Renal osteodystrophy is a complication of chronic kidney disease (CKD) that present in low and high turnover patterns. This disorder has a key role in the disability of CKD patients in whom early diagnosis and treatment can result in better outcome. We studied hyperparathyroidism prevalence and its relationship with renal osteodystrophy in our advanced CKD population. We included 80 patients (of whom 44 (55%) were diabetic) during 6 months period. The patients answered a questionnaire about symptoms related to bone disease and blood levels of parathormone (PTH), calcium, phosphorus, and alkaline phosphatase were obtained, in addition to hand and skull radiographs in all the study patients. Prevalence of clinically evident hyperparathyroidism in our patients was 45%. Hyperparathyroidism had significant relationship with alkaline phosphatase and radiological findings, but did not have a significant relationship with dialysis duration, age, sex, familial history, diabetes mellitus, or hypertension. We conclude that secondary hyperparathyroidism is prevalent in our dialysis population and has high correlation with serum alkaline phosphatase levels and radiological changes.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1993-04-01
This report describes the environmental radiological monitoring program conducted by TVA in the vicinity of Browns Ferry Nuclear Plant (BFN) in 1992. The program includes the collection of samples from the environment and the determination of the concentrations of radioactive materials in the samples. Samples are taken from stations in the general area of the plant and from areas not influenced by plant operations. Station locations are selected after careful consideration of the weather patterns and projected radiation doses to the various areas around the plant. Material sampled includes air, water, milk, foods, vegetation, soil, fish, sediment, and direct radiationmore » levels. Results from stations near the plant are compared with concentrations from control stations and with preoperational measurements to determine potential impacts of plant operations. Small amounts of Co-60 and Cs-134 were found in sediment samples downstream from the plant. This activity in stream sediment would result in no measurable increase over background in the dose to the general public.« less
Kanna, Rishi M; Shetty, Ajoy Prasad; Rajasekaran, S
2014-02-01
Existing research on lumbar disc degeneration has remained inconclusive regarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated. To analyze the patterns of lumbar disc degeneration in patients with chronic back pain and DDD and those with acute DP. Prospective, magnetic resonance imaging-based radiological study. Two groups of patients (aged 20-50 years) were prospectively studied. Group 1 included patients requiring a single level microdiscectomy for acute DP. Group 2 included patients with chronic low back pain and DDD. Discs were assessed by magnetic resonance imaging through Pfirmann grading, Schmorl nodes, Modic changes, and the total end-plate damage score for all the five lumbar discs. Group 1 (DP) had 91 patients and group 2 (DDD) had 133 patients. DP and DDD patients differed significantly in the number, extent, and severity of degeneration. DDD patients had a significantly higher number of degenerated discs than DP patients (p<.000). The incidence of multilevel and pan-lumbar degeneration was also significantly higher in DDD group. The pattern of degeneration also differed in both the groups. DDD patients had predominant upper lumbar involvement, whereas DP patients had mainly lower lumbar degeneration. Modic changes were more common in DP patients, especially at the prolapsed level. Modic changes were present in 37% of prolapsed levels compared with 9.9% of normal discs (p<.00). The total end-plate damage score had a positive correlation with disc degeneration in both the groups. Further the mean total end-plate damage score at prolapsed level was also significantly higher. The results suggest that patients with disc prolapse, and those with back pain with DDD are clinically and radiologically different groups of patients with varying patterns, severity, and extent of disc degeneration. This is the first study in literature to compare and identify significant differences in these two commonly encountered patient groups. In patients with single-level DP, the majority of the other discs are nondegenerate, the lower lumbar spine is predominantly involved and the end-plate damage is higher. Patients with back pain and DDD have larger number of degenerate discs, early multilevel degeneration, and predominant upper lumbar degeneration. The knowledge that these two groups of patients are different clinically and radiologically is critical for our improved understanding of the disease and for future studies on disc degeneration and disc prolapse. Copyright © 2014 Elsevier Inc. All rights reserved.
Norman, J A; Christidis, L; Joseph, L; Slikas, B; Alpers, D
2002-01-01
Molecular analysis of two Australo-Papuan rainforest birds exhibiting correlated 'leapfrog' patterns were used to elucidate the evolutionary origin of this unusual pattern of geographical differentiation. In both sooty owls (Tyto) and logrunners (Orthonyx), phenotypically similar populations occupy widely disjunct areas (central-eastern Australia and upland New Guinea) with a third, highly distinctive population, occurring between them in northeastern Queensland. Two mechanisms have been proposed to explain the origin of leapfrog patterns in avian distributions: recent shared ancestry of terminal populations and unequal rates or phenotypic change among populations. As the former should generate correlated patterns of phenotypic and genetic differentiation, we tested for a sister relationship between populations from New Guinea and central-eastern Australia using nuclear and mitochondrial DNA sequences. The resulting phylogenies not only refute recent ancestry as an explanation for the leapfrog pattern, but provide evidence of vastly different spatio-temporal histories for sooty owls and logrunners within the Australo-Papuan rainforests. This incongruence indicates that the evolutionary processes responsible for generating leapfrog patterns in these co-distributed taxa are complex, possibly involving a combination of selection and drift in sooty owls and convergence or retention of ancestral characteristics in logrunners. PMID:12396487
What is a wiki, and how can it be used in resident education?
Kohli, Marc D; Bradshaw, John K
2011-02-01
Training as a radiology resident is a complex task. Residents frequently encounter multiple hospital systems, each with unique workflow patterns and heterogenous information systems. We identified an opportunity to ease some of the resulting anxiety and frustration by centralizing high-quality resources using a wiki. In this manuscript, we describe our choice of wiki software, give basic information about hardware requirements, detail steps for configuration, outline information included on the wiki, and present the results of a resident acceptance survey.
Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...
Kalele, Ketki P; Patil, Kaustubh P; Nayyar, Abhishek Singh; Sasane, Rutuparna S
2016-04-01
Lymphocytes are often termed to be isomorphic, having a monotonous light microscopic appearance. Morphological aspects of lymphocytes in tissue sections thereby are not routinely taken notice of as their morphology seems to vary only in case of lymphoid malignancies, hematological malignancies apart from certain viral infections. Atypical lymphocytes are the lymphocytes with unusual shape, size or overall structure. These are more commonly known as reactive lymphocytes. The unusual histomorphological feature of these cells include larger size than normal lymphocytes; in some cells the size exceeds even 30 microns. The large size is the result of antigenic stimulation of the cell. Alongwith these, the other rare feature which is recently coming under light is "Cellular Cannibalism" which is defined as a large cell enclosing a slightly smaller one within its cytoplasm. Previously, this feature was noted only in cases of malignant tumors. The objectives of this study were to determine the proportion of atypical lymphocytes in chronic periapical granulomas and cysts; to determine the proportionate cellular cannibalism in these periapical lesions. This was a descriptive, observational study conducted in the Department of Oral Medicine and Radiology and Oral Pathology and Microbiology. Haematoxylin and eosin stained 30 slides of chronic periapical granulomas and 20 slides of cysts reported in the year 2014-15 and the clinical proformas of the patients were retrieved from the files of the Department of Oral Medicine and Radiology and Oral Pathology and Microbiology. These slides were evaluated by 3 experts from the specialization of Oral Pathology and Microbiology to determine the presence of atypical lymphocytes and cellular cannibalism under high power magnification (400X). Out of the 30 slides of chronic periapical granulomas, about 12 slides (40%) revealed presence of atypical lymphocytes. In case of slides of chronic periapical cysts, however, only 4 out of the 20 slides (20%) examined histopathologically showed presence of atypical lymphocytes. An interesting feature of cellular cannibalism was noted in tissues with atypical cells. Cannibalistic cells were present in 12 out of the 30 slides of chronic periapical granulomas (40%). None of the cysts, however, revealed cannibalistic cells (0%). In the present study, we have quoted our observations on the unique cellular composition that was seen in histopathological sections of chronic periapical lesions. As also it was noted that those cases in which atypical cells & cellular cannibalism was evident the lesion clinically showed size more than 5cm. The question arises that whether presence of atypical cells from the tissue sections in these lesions denotes an aggressive clinical behavior and should be given a due consideration in deciding the treatment protocols for such cases to provide an optimum patient care.
Pawar, Uday M; Kundnani, Vishal; Agashe, Vikas; Nene, Amita; Nene, Abhay
2009-10-15
Prospective cohort study. We report the first study of multidrug-resistant tuberculosis (MDR-TB) in the spine. The aim was to determine the clinical, radiologic, and drug resistance profile as well as the factors associated with treatment outcome of MDR-TB in the spine. Tuberculosis of the spine is the most common extrapulmonary form of tuberculosis in the Asian subcontinent. The disease in few cases is resistant to the primary anti-Koch's medications and the number of cases detected is on the rise. Multidrug resistant form of tuberculosis of the spine is ill reported in the literature. The diagnosis, management thus remains a challenge to the treating surgeon. This study tries to assess these critical issues of this "new" disease. Described here are the clinical characteristics of 25 MDR-TB spine patients identified in the study and their drug susceptibility patterns. They were followed up clinically, radiologically after a biopsy, culture, and Drug Susceptibility Testing. According to their Drug Susceptibility Testing pattern and previous history of Anti-Tubercular Treatment (ATT), individualized treatment regimens were tailored for each patient by an expert physician. Majority of the patients seen in the present study were in the productive years of their life. (Males (9) mean age: 38.5 years and females (16) mean age: 34.3 years. Four patients were defaulters of the ATT. The average number of drugs used was 6, including 4 second line drugs. Average treatment duration was 24 months. Almost 50% of the patients had adverse drug effects. Of the 25 patients, 19 achieved healed status and 6 are still on treatment. Four patients required surgery for mechanical instability of the spine. Radiologic improvement was observed in all the cases after a mean treatment of 6 months. Five predictors were identified for successful outcome of MDR-TB. They include progressive clinical improvement at 6 months, radiologic improvement during treatment and disease with Mycobacterium tuberculosis strains exhibiting resistance to less than or up to 3 antitubercular drugs, use of less than or up to 4 second-line drugs in treatment, and no change of regimen during treatment. MDR-TB of the spine is a different disease and is here to stay. There is an urgent need to include culture and drug susceptibility testing in the protocol for the treatment of tuberculosis of the spine.
Behavior of Aberrant Chromosome Configurations in Drosophila melanogaster Female Meiosis I
Gilliland, William D.; Colwell, Eileen M.; Lane, Fiona M.; Snouffer, Ashley A.
2014-01-01
One essential role of the first meiotic division is to reduce chromosome number by half. Although this is normally accomplished by segregating homologous chromosomes from each other, it is possible for a genome to have one or more chromosomes that lack a homolog (such as compound chromosomes), or have chromosomes with multiple potential homologs (such as in XXY females). These configurations complete meiosis but engage in unusual segregation patterns. In Drosophila melanogaster females carrying two compound chromosomes, the compounds can accurately segregate from each other, a process known as heterologous segregation. Similarly, in XXY females, when the X chromosomes fail to cross over, they often undergo secondary nondisjunction, where both Xs segregate away from the Y. Although both of these processes have been known for decades, the orientation mechanisms involved are poorly understood. Taking advantage of the recent discovery of chromosome congression in female meiosis I, we have examined a number of different aberrant chromosome configurations. We show that these genotypes complete congression normally, with their chromosomes bioriented at metaphase I arrest at the same rates that they segregate, indicating that orientation must be established during prometaphase I before congression. We also show that monovalent chromosomes can move out on the prometaphase I spindle, but the dot 4 chromosomes appear required for this movement. Finally, we show that, similar to achiasmate chromosomes, heterologous chromosomes can be connected by chromatin threads, suggesting a mechanism for how heterochromatic homology establishes these unusual biorientation patterns. PMID:25491942
Behavior of aberrant chromosome configurations in Drosophila melanogaster female meiosis I.
Gilliland, William D; Colwell, Eileen M; Lane, Fiona M; Snouffer, Ashley A
2014-12-09
One essential role of the first meiotic division is to reduce chromosome number by half. Although this is normally accomplished by segregating homologous chromosomes from each other, it is possible for a genome to have one or more chromosomes that lack a homolog (such as compound chromosomes), or have chromosomes with multiple potential homologs (such as in XXY females). These configurations complete meiosis but engage in unusual segregation patterns. In Drosophila melanogaster females carrying two compound chromosomes, the compounds can accurately segregate from each other, a process known as heterologous segregation. Similarly, in XXY females, when the X chromosomes fail to cross over, they often undergo secondary nondisjunction, where both Xs segregate away from the Y. Although both of these processes have been known for decades, the orientation mechanisms involved are poorly understood. Taking advantage of the recent discovery of chromosome congression in female meiosis I, we have examined a number of different aberrant chromosome configurations. We show that these genotypes complete congression normally, with their chromosomes bioriented at metaphase I arrest at the same rates that they segregate, indicating that orientation must be established during prometaphase I before congression. We also show that monovalent chromosomes can move out on the prometaphase I spindle, but the dot 4 chromosomes appear required for this movement. Finally, we show that, similar to achiasmate chromosomes, heterologous chromosomes can be connected by chromatin threads, suggesting a mechanism for how heterochromatic homology establishes these unusual biorientation patterns. Copyright © 2015 Gilliland et al.
Lim, Huat C; Montesion, Meagan; Botton, Thomas; Collisson, Eric A; Umetsu, Sarah E; Behr, Spencer C; Gordan, John D; Stephens, Phil J; Kelley, Robin K
2018-04-05
Biliary tract cancers such as cholangiocarcinoma represent a heterogeneous group of cancers that can be difficult to diagnose. Recent comprehensive genomic analyses in large cholangiocarcinoma cohorts have defined important molecular subgroups within cholangiocarcinoma that may relate to anatomic location and etiology [1-4] and may predict responsiveness to targeted therapies in development [5-7]. These emerging data highlight the potential for tumor genomics to inform diagnosis and treatment options in this challenging tumor type. We report the case of a patient with a germline BRCA1 mutation who presented with a cholangiocarcinoma driven by the novel YWHAZ-BRAF fusion. Hybrid capture-based DNA sequencing and copy number analysis performed as part of clinical care demonstrated that two later-occurring tumors were clonally derived from the primary cholangiocarcinoma rather than distinct new primaries, revealing an unusual pattern of late metachronous metastasis. We discuss the clinical significance of these genetic alterations and their relevance to therapeutic strategies. Hybrid capture-based next-generation DNA sequencing assays can provide diagnostic clarity in patients with unusual patterns of metastasis and recurrence in which the pathologic diagnosis is ambiguous.To our knowledge, this is the first reported case of a YWHAZ-BRAF fusion in pancreaticobiliary cancer, and a very rare case of cholangiocarcinoma in the setting of a germline BRCA1 mutation.The patient's BRCA1 mutation and YWHAZ-BRAF fusion constitute potential targets for future therapy. © AlphaMed Press 2018.
Usual and unusual development of the dicot leaf: involvement of transcription factors and hormones.
Fambrini, Marco; Pugliesi, Claudio
2013-06-01
Morphological diversity exhibited by higher plants is essentially related to the tremendous variation of leaf shape. With few exceptions, leaf primordia are initiated postembryonically at the flanks of a group of undifferentiated and proliferative cells within the shoot apical meristem (SAM) in characteristic position for the species and in a regular phyllotactic sequence. Auxin is critical for this process, because genes involved in auxin biosynthesis, transport, and signaling are required for leaf initiation. Down-regulation of transcription factors (TFs) and cytokinins are also involved in the light-dependent leaf initiation pathway. Furthermore, mechanical stresses in SAM determine the direction of cell division and profoundly influence leaf initiation suggesting a link between physical forces, gene regulatory networks and biochemical gradients. After the leaf is initiated, its further growth depends on cell division and cell expansion. Temporal and spatial regulation of these processes determines the size and the shape of the leaf, as well as the internal structure. A complex array of intrinsic signals, including phytohormones and TFs control the appropriate cell proliferation and differentiation to elaborate the final shape and complexity of the leaf. Here, we highlight the main determinants involved in leaf initiation, epidermal patterning, and elaboration of lamina shape to generate small marginal serrations, more deep lobes or a dissected compound leaf. We also outline recent advances in our knowledge of regulatory networks involved with the unusual pattern of leaf development in epiphyllous plants as well as leaf morphology aberrations, such as galls after pathogenic attacks of pests.
Radiology Undergraduate and Resident Curricula: A Narrative Review of the Literature
Linaker, Kathleen L.
2015-01-01
Objective The purpose of this study was to examine the literature regarding radiology curricula for both undergraduates and residents. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 142 were found to be relevant to the purpose of this study. Undergraduate radiology education, radiology curriculum, and radiology pedagogy vary widely between disciplines and between colleges within disciplines. Formal radiology education is not taught at all medical programs and little radiology training is incorporated into non-radiology residencies. This results in some medical graduates not being taught how to interpret basic radiology images and not learning contraindications and indications for ordering diagnostic imaging tests. There are no definitive studies examining how to incorporate radiology into the curriculum, how to teach radiology to either undergraduates or residents, or how to assess this clinical competency. Conclusions This review shows that radiology education is perceived to be important in undergraduate and residency programs. However, some programs do not include radiology training, thus graduates from those programs do not learn radiology essentials. PMID:26770172
Rosenkrantz, Andrew B; Ayoola, Abimbola
2016-06-01
The aim of this study was to evaluate the trends in the impact factor (IF) of radiological journals over a recent 12-year period, including associations between IF and journal topic. Journal Citation Reports (JCR) was used to identify all biomedical journals and all radiological journals (assigned a JCR category of "Radiology, Nuclear Medicine, & Medical Imaging"), along with journal IF, in 2003 and 2014. Radiological journals were manually classified by topic. Trends in median IF (mIF) were assessed. The number of radiological journals increased from 83 (2003) to 125 (2014) (all biomedical journals: 5907 to 8718, respectively). mIF of radiological journals increased from 1.42 (2003) to 1.75 (2014) (all biomedical journals: 0.93 to 1.46, respectively). The most common topic among new radiological journals was general (nonspecialized) radiology (8). Five new radiological journals in 2014 were in topics (cancer imaging and molecular imaging) having no journals in 2003. mIF of general radiological journals was 1.49. Topics having highest mIF were cardiac imaging (2.94), optics (2.86), molecular imaging (2.77), radiation oncology (2.60), and neuroradiology (2.25). Topics with lowest mIF were ultrasound (1.19) and interventional radiology (1.44). Topics with the largest increase in mIF were cardiac imaging (from 1.17 to 2.94) and neuroradiology (from 1.07 to 2.25). Radiological journals exhibited higher mIF than biomedical journals overall. Among radiological journals, subspecialty journals had highest mIF. While a considerable number of new radiological journals since 2003 were general radiology journals having relatively low IF, there were also new journal topics representing emerging areas of subspecialized radiological research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
Núñez, Rafael E; Sweetser, Eve
2006-05-06
Cognitive research on metaphoric concepts of time has focused on differences between moving Ego and moving time models, but even more basic is the contrast between Ego- and temporal-reference-point models. Dynamic models appear to be quasi-universal cross-culturally, as does the generalization that in Ego-reference-point models, FUTURE IS IN FRONT OF EGO and PAST IS IN BACK OF EGO. The Aymara language instead has a major static model of time wherein FUTURE IS BEHIND EGO and PAST IS IN FRONT OF EGO; linguistic and gestural data give strong confirmation of this unusual culture-specific cognitive pattern. Gestural data provide crucial information unavailable to purely linguistic analysis, suggesting that when investigating conceptual systems both forms of expression should be analyzed complementarily. Important issues in embodied cognition are raised: how fully shared are bodily grounded motivations for universal cognitive patterns, what makes a rare pattern emerge, and what are the cultural entailments of such patterns? 2006 Lawrence Erlbaum Associates, Inc.
Metastatic patterns of myxoid/round cell liposarcoma: a review of a 25-year experience.
Asano, Naofumi; Susa, Michiro; Hosaka, Seiichi; Nakayama, Robert; Kobayashi, Eisuke; Takeuchi, Katsuhito; Horiuchi, Keisuke; Suzuki, Yoshihisa; Anazawa, Ukei; Mukai, Makio; Toyama, Yoshiaki; Yabe, Hiroo; Morioka, Hideo
2012-01-01
Myxoid/round cell liposarcoma (MRCL), unlike other soft tissue sarcomas, has been associated with unusual pattern of metastasis to extrapulmonary sites. In an attempt to elucidate the clinical features of MRCL with metastatic lesions, 58 cases, from the medical database of Keio University Hospital were used for the evaluation. 47 patients (81%) had no metastases, whereas 11 patients (11%) had metastases during their clinical course. Among the 11 patients with metastatic lesions, 8 patients (73%) had extrapulmonary metastases and 3 patients (27%) had pulmonary metastases. Patients were further divided into three groups; without metastasis, with extrapulmonary metastasis, and with pulmonary metastasis. When the metastatic patterns were stratified according to tumor size, there was statistical significance between the three groups (P = 0.028). The 8 cases with extrapulmonary metastases were all larger than 10 cm. Similarly, histological grading had a significant impact on metastatic patterns (P = 0.027). 3 cases with pulmonary metastatic lesions were all diagnosed as high grade. In conclusion, large size and low histological grade were significantly associated with extrapulmonary metastasis.
Weather chains during the 2013/2014 winter and their significance for seasonal prediction
NASA Astrophysics Data System (ADS)
Davies, Huw C.
2015-11-01
Day-to-day weather forecasting has improved substantially over the past few decades. In contrast, progress in seasonal prediction outside the tropics has been meagre and mixed. On seasonal timescales, the constraining influence of the initial atmospheric state is weak, and the internal variability associated with transient weather systems tends to be large compared with the nuanced influence of anomalies in external forcing. Current research and operational activities focus on exploring and exploiting potential links between external anomalies and seasonal-mean climate patterns. Here I examine reanalysed meteorological data sets for the unusual winter 2013/2014, with drought and freezing conditions juxtaposed over North America and severe wet and stormy weather over parts of Europe, to study the role of weather systems and their transient upper-tropospheric flow patterns. I find that the amplitude, recurrence and location of these transient patterns account directly for the corresponding anomalous seasonal-mean patterns. They occurred episodically and sequentially, were linked dynamically, and exhibited some circumpolar connectivity. I conclude that the upper-tropospheric components of transient weather systems are significant for understanding and predicting seasonal weather patterns, whereas the role of external factors is more subtle.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hanson, P.J.; Isebrands, J.G.; Dickson, R.E.
1988-03-01
Oak (Quercus) seedlings exhibit a pattern of shoot growth known to place demands on carbohydrate and nutrient reserves. This study was designed to determine ontogenetic patterns in CO{sub 2} exchanges properties of red oak leaves, and to determine if individual leaf CO{sub 2} exchange rates (CER) increase in response to the assimilate demand placed on a seedling during flushing. Northern red oak (Q. rubra L.) seedlings were grown in environments favorable for multiple flushes of shoot growth. Measurements of CER on single, attached, median leaves from each flush were made over a range of photosynthetic photon flux densities on plantsmore » at nine stages of seedling development through three flushes of growth. Carbon dioxide exchange rate of red oak leaves increased during leaf development up to and beyond full leaf expansion before decreasing an unusual pattern of photosynthesis during leaf ontogeny. Furthermore, first- and second-flush leaf CER initially decreased and then increased in conjunction with the third flush of shoot growth. These patterns indicate that red oak leaves have a capacity for CER adjustment in response to increase sink demand.« less
Kim, Ho Sung; Choi, Jung-Ah
2018-01-01
According to the reports presented at the second Asian Radiology Forum (ARF) 2016, organized by the Korean Society of Radiology (KSR) during the Korean Congress of Radiology (KCR) in September 2016 in Seoul, there is an increasing need for the Asian-Oceanian Society of Radiology (AOSR) and its member societies to promote radiology together in the Asian-Oceanian region. In ARF 2016, the national delegates of the Asian-Oceanian radiological partner societies primarily discussed their societies' activities and contributions in international and regional societies including AOSR, expectations for AOSR, recommendations and suggestions for AOSR, and their societies' support of AOSR. PMID:29520175
Chin, Jung Yeon; Yi, Jeong Eun; Youn, Ho-Joong
2013-10-01
Cardiac involvement in Churg-Strauss syndrome (CSS) is a major cause of mortality. Here we report a case of a 75-year-old woman with eosinophilic endomyocarditis due to CSS. An electrocardiogram showed intraventricular conduction delay, and echocardiography showed an impaired relaxation pattern and biventricular apical thickening. Magnetic resonance imaging revealed subendocardial delayed enhancement with biventricular apical thrombi. Endomyocardial biopsy showed perivascular eosinophilic infiltration. Despite resolution of the hypereosinophilia after steroid therapy, her left ventricular (LV) diastolic function worsened into a restrictive pattern and she died with a ventricular escape rhythm on her 14th day in the hospital. This case is unusual in that there was rapid progression of the LV diastolic dysfunction and conduction disturbance due to CSS. © 2013, Wiley Periodicals, Inc.
Whittington, Camilla M; Papenfuss, Anthony T; Kuchel, Philip W; Belov, Katherine
2008-09-15
The platypus, as an egg-laying mammal, displays an unusual mixture of reptilian and mammalian characteristics. It is also venomous, and further investigations into its little-studied venom may lead to the development of novel pharmaceuticals and drug targets and provide insights into the origins of mammalian venom. Here we investigate the expression patterns of antimicrobial genes called defensins, and also the venom peptides called defensin-like peptides (OvDLPs). We show, in the first expression study on any platypus venom gene, that the OvDLPs are expressed in a greater range of tissues than would be expected for genes with specific venom function, and thus that they may have a wider role than previously suspected.
Control of cell nucleus shapes via micropillar patterns.
Pan, Zhen; Yan, Ce; Peng, Rong; Zhao, Yingchun; He, Yao; Ding, Jiandong
2012-02-01
We herein report a material technique to control the shapes of cell nuclei by the design of the microtopography of substrates to which the cells adhere. Poly(D,L-lactide-co-glycolide) (PLGA) micropillars or micropits of a series of height or depth were fabricated, and some surprising self deformation of the nuclei of bone marrow stromal cells (BMSCs) was found in the case of micropillars with a sufficient height. Despite severe nucleus deformation, BMSCs kept the ability of proliferation and differentiation. We further demonstrated that the shapes of cell nuclei could be regulated by the appropriate micropillar patterns. Besides circular and elliptoid shapes, some unusual nucleus shapes of BMSCs have been achieved, such as square, cross, dumbbell, and asymmetric sphere-protrusion. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.
Nassar, Lara; Atweh, Lamya Ann; Jurjus, Abdo; Al Kutoubi, Aghiad
2012-07-01
Anatomical variations of the digestive system arteries are important due to their clinical significance. However, anomalies in the inferior mesenteric artery (IMA) are the least common compared with the celiac trunk and superior mesenteric artery. This report describes the case of a 67-year-old man with an extremely rare variant in which the IMA arises from the left common iliac artery, and the ipsilateral external iliac artery has a corkscrew pattern. These findings were depicted during computed tomography angiography of the abdomen and pelvis. This case is the first report of such a variation associated with a left external iliac artery turning into a double loop before forming the femoral artery. The embryological and clinical significance of such an anomaly are discussed.
Marschallinger, Robert; Golaszewski, Stefan M; Kunz, Alexander B; Kronbichler, Martin; Ladurner, Gunther; Hofmann, Peter; Trinka, Eugen; McCoy, Mark; Kraus, Jörg
2014-01-01
In multiple sclerosis (MS) the individual disease courses are very heterogeneous among patients and biomarkers for setting the diagnosis and the estimation of the prognosis for individual patients would be very helpful. For this purpose, we are developing a multidisciplinary method and workflow for the quantitative, spatial, and spatiotemporal analysis and characterization of MS lesion patterns from MRI with geostatistics. We worked on a small data set involving three synthetic and three real-world MS lesion patterns, covering a wide range of possible MS lesion configurations. After brain normalization, MS lesions were extracted and the resulting binary 3-dimensional models of MS lesion patterns were subject to geostatistical indicator variography in three orthogonal directions. By applying geostatistical indicator variography, we were able to describe the 3-dimensional spatial structure of MS lesion patterns in a standardized manner. Fitting a model function to the empirical variograms, spatial characteristics of the MS lesion patterns could be expressed and quantified by two parameters. An orthogonal plot of these parameters enabled a well-arranged comparison of the involved MS lesion patterns. This method in development is a promising candidate to complement standard image-based statistics by incorporating spatial quantification. The work flow is generic and not limited to analyzing MS lesion patterns. It can be completely automated for the screening of radiological archives. Copyright © 2013 by the American Society of Neuroimaging.
Anil, Gopinathan; Zhang, Junwei; Al Hamar, Nawal Ebrahim; Nga, Min En
2017-01-01
We aimed to evaluate the imaging features of solid pseudopapillary neoplasm (SPN) of the pancreas with an emphasis on radiologic-pathologic correlation. Ten patients (all female; mean age, 32 years) with histologic or cytologic diagnosis of SPN encountered between January 2007 and December 2013 were included in this study. Preoperative computed tomography (CT) images were reviewed for location, attenuation, enhancement pattern, margin, shape, size, morphology, presence of capsule and calcification. CT appearances were correlated with histopathologic findings. Tumors in the distal pancreatic body and tail had a tendency to be larger (mean size 12.6 cm vs. 4.0 cm). Six of the nine tumors that were resected had a fibrous pseudocapsule at histology, five of which could be identified on CT scan. Eight lesions had mixed hypoenhancing solid components and cystic areas corresponding to tumor necrosis and hemorrhage. The two smallest lesions were purely solid and nonencapsulated. Varied patterns of calcification were seen in four tumors. Three of the four pancreatic tail tumors invaded the spleen. At a median follow-up of 53 months, there was no evidence of recurrence in the nine patients who underwent surgical resection of the tumor. A mixed solid and cystic pancreatic mass in a young woman is suggestive of SPN. However, smaller lesions may be completely solid. Splenic invasion can occur in pancreatic tail SPNs; however, in this series it did not adversely affect the long-term outcome.
Comprehensive Health Care Economics Curriculum and Training in Radiology Residency.
Keiper, Mark; Donovan, Timothy; DeVries, Matthew
2018-06-01
To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers' influence in the practice of radiology. A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers' role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.
Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S
2017-05-01
Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.
Comparison between ultrasonographic and clinical findings in 43 dogs with gallbladder mucoceles.
Choi, Jihye; Kim, Ahyoung; Keh, Seoyeon; Oh, Juyeon; Kim, Hyunwook; Yoon, Junghee
2014-01-01
Cholecystectomy is the current standard recommended treatment for dogs with gallbladder mucoceles. However, medical management with monitoring has also been recommended for asymptomatic dogs. The purpose of this retrospective study was to compare ultrasonographic patterns of gallbladder mucoceles with clinical disease status in a group of dogs. For each included dog, the ultrasonographic pattern of the mucocele was classified into one of six types: type 1, immobile echogenic bile; type 2, incomplete stellate pattern; type 3, typical stellate pattern; type 4, kiwi like pattern and stellate combination; type 5, kiwi like pattern with residual central echogenic bile; and type 6, kiwi like pattern. A total of 43 dogs were included. Twenty-four dogs, including 11 dogs with gallbladder rupture, were symptomatic. Nineteen dogs were asymptomatic. Cholecystectomy (n = 19), medical therapy (n = 17), or monitoring (n = 6) treatments were applied according to clinical signs and owners' requests. One dog suspected of having gallbladder rupture was euthanized. Frequencies of gallbladder mucocele patterns were as follows: type 1 = 10 (23%), type 2 = 13 (30%), type 3 = 5 (12%), type 4 = 11 (26%), type 5 = 4 (9%), and type 6 = 0. In dogs with gallbladder rupture, type 2 (8/13) was the most common. No significant correlations were found between ultrasonographic patterns of gallbladder mucoceles and clinical disease status or gallbladder rupture. Findings indicated that ultrasonographic patterns of gallbladder mucoceles may not be valid bases for treatment recommendations in dogs. © 2013 American College of Veterinary Radiology.
Model for collaboration: a rural medicine and academic health center teleradiology project
NASA Astrophysics Data System (ADS)
Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said
1996-05-01
A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology services. The primary value for the referring sites was the added confidence provided by the subspecialty overreads. An educational value was recognized by all. In conclusion, the networking of rural health care sites to an AHC subspecialty radiology practice was successful primarily in increasing the diagnostic confidence at the rural site. Other benefits included: education; increased rural imaging and an opportunity to provide primary interpretation when the rural radiologist is not available. However, the rate of rural generated consultation was low (17%) and is unlikely to support the costs of a high speed network. To support, rather than replace, rural radiology requires a lower cost network and a mechanism for payment for these services.
Marshall Islands: a study of diet and living patterns
DOE Office of Scientific and Technical Information (OSTI.GOV)
Naidu, J. R.; Greenhouse, N. A.; Knight, G.
1980-07-01
This study summarizes information on diet and living patterns for the Marshallese. The data was derived from literature, answers to questionnaires, personal observations while living with the Marshallese for periods extending from months to years, and from direct participation in their activities. The results reflect the complex interactions of many influences, such as, the gathering of local foods the receipt of food aid through programs, such as, school-lunch, typhoon-relief, food distributed to populations displaced as a result of nuclear testing, and in recent times the availability of cash for the purchase of imported foods. The results identify these influences andmore » are therefore restricted to local food diets while recognizing that the living patterns are changing as local food gathering is replaced by other food supplies. The data will therefore provide the necessary information for input into models that will assess the radiological impacts attributable to the inhabitation of the Marshall Islands. It is recommended that this study should be continued for at least two to three years in order to more accurately identify trends in local food consumption and living patterns.« less
Fractal Analysis of Radiologists Visual Scanning Pattern in Screening Mammography
DOE Office of Scientific and Technical Information (OSTI.GOV)
Alamudun, Folami T; Yoon, Hong-Jun; Hudson, Kathy
2015-01-01
Several investigators have investigated radiologists visual scanning patterns with respect to features such as total time examining a case, time to initially hit true lesions, number of hits, etc. The purpose of this study was to examine the complexity of the radiologists visual scanning pattern when viewing 4-view mammographic cases, as they typically do in clinical practice. Gaze data were collected from 10 readers (3 breast imaging experts and 7 radiology residents) while reviewing 100 screening mammograms (24 normal, 26 benign, 50 malignant). The radiologists scanpaths across the 4 mammographic views were mapped to a single 2-D image plane. Then,more » fractal analysis was applied on the derived scanpaths using the box counting method. For each case, the complexity of each radiologist s scanpath was estimated using fractal dimension. The association between gaze complexity, case pathology, case density, and radiologist experience was evaluated using 3 factor fixed effects ANOVA. ANOVA showed that case pathology, breast density, and experience level are all independent predictors of the visual scanning pattern complexity. Visual scanning patterns are significantly different for benign and malignant cases than for normal cases as well as when breast parenchyma density changes.« less
Unilateral or bilateral punctate hippocampal hyperintensities on DW-MRI: seizures, amnesia, or both?
Bocos-Portillo, Jone; Escalza-Cortina, Inés; Gómez-Beldarrain, Marian; Rodriguez-Sainz, Aida; Garcia-Monco, Juan Carlos
2018-06-02
The presence of small hippocampal hyperintense lesions on diffusion-weighted (DW) MRI can respond to different etiologies and represents a challenge where clinical judgment is imperative, since therapeutic approach may be quite different.We here report three patients with similar neuroradiological findings, i.e., hyperintense punctate hippocampal lesions on diffusion-weighted MRI sequences, yet of different origin. The first one presented with isolated amnesia (transient global amnesia), the second one with amnesia and seizures, and the third one with seizures.Thus, hippocampal punctate lesions appear after transient global amnesia, but the same pattern may be present after seizures, either focal-onset or generalized seizures. This peculiar radiological MRI pattern could indicate a pathogenic link between transient global amnesia (TGA) and seizures which should be further studied.
[Hypersensitivity pneumonitis. A series of nine cases with surgical lung biopsy].
Gómez Tejada, Ricardo A; Legarreta, Cora G; Enghelmayer, Juan Ignacio; Dianti, Milagros; Acuña, Silvana; Olmedo, Gloria
2017-01-01
In a series of nine patients with histopathological diagnosis of hypersensitivity pneumonitis, we retrospectively evaluated clinical data, exposure related factors, pulmonary function tests and chest computed tomography scans. A restrictive abnormality with reduction of diffusion capacity for carbon monoxide was mainly found. Chest scans showed fibrotic patterns in most cases; ground glass attenuation areas with mosaic pattern and consolidation in the rest. Exposure to avian antigens, cereal grains and air conditioners contaminated with fungi yeasts and bacteria, were suspected from clinical data in two-thirds of the cases. Since there are no unique features that allow differentiation from other interstitial lung diseases, a high clinical suspicion is required and a careful search of environmental exposure to possible antigens is needed that, together with clinical, radiological and pathological data, may lead to diagnosis.