Gynandroblastoma with elements resembling juvenile granulosa cell tumor

The Mammography Quality Assurance Programme, recently established by the Royal Australasian College of Radiologists, has processed the first 50 applications. This programme, which closely follows the programme of the American College of Radiology (ACR), utilizes phantom film images, thermoluminescent dosimetry measurement of mean glandular dose, processor control charts, clinical images, equipment reports and required survey information to establish that a centre conforms to a minimum standard in mammography. The present paper describes the initial results of the first phantom images, dose measurements, processor control and survey information. A film review panel of six members has been trained in phantom film reading. Their evaluation of phantom films was compared with film readings by members of the ACR and was found to be in close agreement. Fifty films have been evaluated up to the present time with a failure rate of 26%. The major causes of failure were unacceptable film artefacts and poor contrast (as indicated by reduced fibre and mass visibility). A surprising result was the high failure in processing, where 23% of units reviewed had significant problems, including failure to keep the processor within required control limits. Only one centre recorded a mean glandular dose above 2 mGy with no centre over the 3 mGy limit. A review of the frequency of the quality control testing shows that the acceptance of quality assurance in mammography, while greater than in the initial stages of the ACR programme, is less than current US practice. These initial results for the accreditation process probably reflect an initial period of adjustment, as seen by the high pass rate achieved by centres that have resubmitted material to gain accreditation.     

Towards design and comparison of World Wide Web-accessible myocardial two-dimensional gel electrophoresis protein databases

In addition to the recently published HEART-2DPAGE--a myocardial World Wide Web-accessible 2-DE gel protein database--the usage and installation of software tools are described with regard to the hard- and software environments. Further, access to the HEART-2DPAGE from other two-dimensional electrophoresis (2-DE) databases using name or accession code of a protein is now available. Moreover, database images, published in the myocardial HSC-2DPAGE and HEART-2DPAGE databases are compared. Using the warping tool of the common image processing system Khoros the database images are matched and added in order to visualize the effects of warping. The application of such image processing tools is aimed at improving the comparability of protein spot patterns of different gel images available through the net.     

Blockade of the human cardiac K+ channel Kv1.5 by the antibiotic erythromycin

The Internet, as a global computer network, provides opportunities to make available multimedia educational materials, such as teaching files and image databases, that can be accessed using "World-Wide Web" client browser to provide continuing medical education. Since August, 1995, at the Institute of Radiology-University of Palermo, we developed a World-Wide Web server on the Internet to provide a collection of interactive radiology educational resources such as teaching files and image database for continuing medical education in radiology. Our server is based on a UNIX workstation connected to the Internet via our campus Ethernet network and reachable at the uniform resource locator (URL) address: http:/(/)mbox.unipa.it/approximately radpa/ radpa.html. Digital CT and MR images for teaching files and image database are downloaded through an Ethernet local area network from a GE Advantage Windows workstation. US images will be acquired on-line through a video digitizing board. Radiographs will be digitized by means of a Charge Coupled Device (CCD) scanner. To set up teaching files, image database and all other documents, we use the standard "HyperText Markup Language" (HTML) to edit the documents, and the Graphics Interchange Format (GIF) or Joint Photographic Expert Group (JPEG) format to store the images. Nine teaching files are presently available on the server, together with 49 images in the database, a list of international radiological servers, a section devoted to the museum of radiology hosted by our Institute, the electronic version of the Journal Eido Electa. In the first 12 months of public access through the Internet, 12,280 users accessed the server worldwide: 45% of them to retrieve teaching files; 35% to retrieve images from the database; the remaining 20% to retrieve other documents. Placing teaching files and image database on a World-Wide Web server makes these cases more available to residents and radiologists to provide continuing medical education in radiology.     

Impact of differences in ultrasound and computed tomography volumes on treatment planning of permanent prostate implants

PURPOSE: Both ultrasound (US) and computerized tomography (CT) images have been used in the planning of prostate interstitial therapy. Ultrasound images more clearly define the apex and capsule of the prostate, while CT images define seed positions for postimplant dosimetry. Proper registration of the US volume with the CT volume is critical to the assessment of dosimetry. We therefore compared US and CT prostate volumes to determine if differences were significant. METHODS AND MATERIALS: Ten consecutive patients entered in an interstitial implant program were studied by pretreatment US. In addition, pretreatment CT scans were obtained and three physicians independently outlined the dimensions of the prostate on these images. The patients subsequently underwent placement of radioactive 125I or 103Pd. Postimplant CT images were obtained the next day and the postimplant prostate volumes were outlined by the same three physicians. Seven of 10 patients underwent late CT scans 9-14 months postimplant for comparison of preimplant and immediate postimplant CT studies. RESULTS: There were differences between US and CT volumes. Although the physician-to-physician variation was significant, the trends were consistent, with US prostate volume typically smaller (47%) than the preimplant CT volume and markedly smaller (120%) than the postimplant CT volume. Prostate volumes derived from late CT images did not consistently return to preimplant levels. CONCLUSIONS: Significant differences in volume of the prostate structure were found between US and CT images. The data suggests that: (a) Implants planned on CT tend to overestimate the size of the prostate and may lead to unnecessary implantation of the urogenital diaphragm and penile urethra. (b) Registration of initial US and postimplant CT prostate volumes required for accurate dosimetry is difficult due to the increased volume of prostate secondary to trauma. (c) Further study to determine the optimal time for the postimplant CT is necessary.     

Three-dimensional US and volumetric assessment of the prostate

The authors demonstrate a method for constructing three-dimensional (3D) images of the prostate based on standard two-dimensional ultrasonic (US) images. Transverse US images of the prostate in six patients (aged 61-83 years) and 10 water-filled balloon phantoms were recorded at video rates by manually withdrawing a biplane transrectal probe at a constant speed. Data acquisition time of the images was less than a minute. Typically, 50-70 scans of 0.2-0.5-mm-thick cross sections were acquired. Postprocessing of these data enabled lifelike 3D visualization of the gland and accurate measurement of its volume.     

Mid-Infrared Diode Laser Spectroscopy of X ; 1 A '' HC35 Cl

PURPOSE: Ultrasound (US)-guided permanent prostate implants typically use US prostate volumes to plan the implant procedure and CT prostate volumes for 3D dosimetric evaluation of the implant. Such a protocol requires that CT and US prostate volumes be registered. We have studied the impact of prostate volume registration on postimplant dosimetry for patients with low-grade prostate cancer treated with combined US and fluoroscopic-guided permanent implants. METHODS AND MATERIALS: A US image set was obtained with the patient in the lithotomy position to delineate the prostate volume that was subsequently used for treatment planning. Each plan was customized and optimized to ensure complete coverage of the US prostate volume. After implant, a CT scan was obtained for postimplant dosimetry with the patient lying supine. Sources were localized on CT by interactively creating orthogonal images of small cubes, whose dimensions were slightly larger than the source, to assure unique identification of each seed. Ultrasound and CT 3D surfaces were registered using either (a) the rectal surface and base of the prostate, or (b) the Foley balloon and urethra as the alignment reference. A dose distribution was assigned to the US prostate volume based on the CT source distribution, and the dose-volume histogram (DVH) was calculated. RESULT: Prostate volumes drawn from US images differ from those drawn from CT images with the CT volumes being typically larger than the US volumes. Urethral registration of the prostate volume based on aligning the prostatic urethra generates a dose distribution that best follows the preimplant plan and is geometrically the preferable choice for dosimetry. CONCLUSION: The dose distribution and the DVH for the US prostate is sensitive to the mode of registration limiting the ability to determine if acceptable dose coverage has been achieved.     

Heart rate variability as an assessment of acute rejection after heart transplantation

BACKGROUND: Orthotopic heart transplantation is currently a widely accepted treatment for end-stage heart disease. Early detection and adequate therapy of acute rejection increases the survival rate. Currently, the most reliable technique for the detection of acute cardiac rejection (ACR) is endomyocardial biopsy (EMB), which is an invasive procedure with some intrinsic problems. The purpose of this study was to assess heart rate variability (HRV) as a noninvasive procedure for frequent monitoring of ACR. METHODS: Six consecutive orthotopic cardiac transplant recipients were prospectively recruited into this study. The follow-up periods ranged from seven to 359 days (median; 146 days). A precordial electrocardiograph (ECG) of 288 seconds was recorded at 5:00 PM before the patient underwent EMB. The results from the frequency domain analysis of the ECG signals were evaluated to correlate with the findings from EMB. RESULTS: Of 48 EMBs, 42 (87.5%) showed no evidence of rejection, four showed mild focal ACR (EMB grade 1A), one mild diffuse ACR (1B) and one moderate plurifocal ACR (3A). There was no moderate focal ACR (2), severe diffuse ACR (3B) or severe ACR (4). Correlation between ACR (3A) and a significant increase in HRV with a corresponding 'broad-band' or bell-shaped pattern on the power spectrum was noted. CONCLUSIONS: Our study in consecutive cardiac transplant recipients indicates that the changes in HRV provide clinicians with a new concept for heart transplant monitoring. Further study is needed to verify clinical utility.     

特钢棒材标记方案设计与信息码识别

为了解决特钢棒材信息跟踪的问题,提高生产智能化水平,搭建了基于机器视觉的特钢棒材端面信息码识别系统。根据车间环境和特钢棒材端面特征,提出了水平双标志点的标记方案,并针对该标记方案提出了一种信息码图像识别方法。该识别方法提取了字符二值图像灰度共生矩阵与区域连通域面积两组特征,建立特征模板库,利用特征模板库对特钢棒材端面信息码进行识别。结果表明,基于水平双标志点的标记方案能够满足特钢棒材身份标记需求,信息码图像识别方法可有效解决特钢棒材端面信息码的自动识别问题,提高钢厂自动化和智能化水平。     

Unilateral spatial neglect in the late stage of Alzheimer''s disease

This paper presents a method designed to register preoperative computed tomography (CT) images to vertebral surface points acquired intraoperatively from ultrasound (US) images or via a tracked probe. It also presents a comparison of the registration accuracy achievable with surface points acquired from the entire posterior surface of the vertebra to the accuracy achievable with points acquired only from the spinous process and central laminar regions. Using a marker-based method as a reference, this work shows that submillimetric registration accuracy can be obtained even when a small portion of the posterior vertebral surface is used for registration. It also shows that when selected surface patches are used, CT slice thickness is not a critical parameter in the registration process. Furthermore, the paper includes qualitative results of registering vertebral surface points in US images to multiple CT slices. The method has been tested with US points and physical points on a plastic spine phantom and with simulated data on a patient CT scan.     

Isolation and characterization of a novel facultatively alkaliphilic Nitrobacter species, N. alkalicus sp. nov

BACKGROUND: The American College of Rheumatology (ACR) established criteria to discriminate among patients with seven types of vasculitis. Although designated as "classification criteria" for research, these criteria are often used for diagnosis. OBJECTIVE: To examine the operating characteristics of the 1990 ACR classification criteria in the diagnosis of Wegener granulomatosis, giant-cell arteritis, polyarteritis nodosa, and hypersensitivity vasculitis. DESIGN: Prospective cohort study. SETTING: University medical center and Veterans Affairs medical center. PATIENTS: 198 consecutive patients referred to rheumatologists for evaluation of possible vasculitis. Measurements: Blinded chart audits were done to classify patients according to the 1990 ACR classification criteria for Wegener granulomatosis, polyarteritis nodosa, giant-cell arteritis, and hypersensitivity vasculitis on the basis of the patients' initial presentation. Chart audits done 2 to 8 months after baseline provided the patients' final diagnoses, which were considered the gold standard, as in the development of the ACR criteria. Test operating characteristics of the ACR classification criteria were calculated according to 2 x 2 tables for the entire cohort and for only the patients with a final diagnosis of vasculitis. RESULTS: Vasculitis was diagnosed in 51 (26%) patients. Thirty-eight (75%) of 51 patients with vasculitis and 31 (21%) of 147 patients without vasculitis met ACR criteria for one or more types of vasculitis. The positive predictive values for the four vasculitides according to ACR criteria were 17% to 29% for the entire cohort and 29% to 75% for only the patients with a final diagnosis of vasculitis. CONCLUSION: The 1990 ACR classification criteria function poorly in the diagnosis of specific vasculitides.     

The status of Black males in America: A data base search.

Discusses database searching strategies for topics in psychology, using, as an example, the present authors' (1988) bibliography of research on Black males in the US, compiled from the PsycINFO database. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acylcarnitine metabolism during fasting and after refeeding

Carnitine metabolism during starvation and just after refeeding was studied by the measurement of acylcarnitine (ACR) and total carnitine (TCR) concentration in the serum and liver of mice. Starvation caused marked increases in the concentration of serum ACR, and of acid-soluble ACR in the liver. The refeeding caused the quick decrement of serum ACR with a concomitant marked increase in the level of acid-soluble TCR in the liver. Through the use of positron emission tomography in a rhesus monkey, a marked increase in [2-11C]acetyl-L-carnitine uptake in the liver was observed after the administration of glucose accompanying the decrease of serum ACR. From this study, it is clear that the mammalian liver can salvage and conserve the unused ACR when the state of energy metabolism is improved.     

Web-based digital radiology teaching file: facilitating case input at time of interpretation

OBJECTIVE: Our goal was to develop a software system that allows easy and rapid input of digital radiology images and text reports, at the time of interpretation, into an easily searchable electronic teaching file database using the Internet and the World-Wide Web protocols, servers, and browsers. CONCLUSION: Using the Internet, the World-Wide Web, and our software system, we can rapidly input digital radiology images and associated text reports into an easily searchable database accessed by privileged users. This inexpensive and simple method for building a digital teaching file database allows cross-platform access for users who have a Web browser.     

Single neurons in the medial prefrontal cortex of the rat exhibit tonic and phasic coding during trace fear conditioning.

Trace fear conditioning is a learning task that requires the association of an auditory conditioned stimulus (CS) and a shock unconditioned stimulus (US) that are separated by a 20-s trace interval. Single neuron activity was recorded from the prelimbic and infralimbic areas of the medial prefrontal cortex in rats during trace fear conditioning or nonassociative unpaired training. Prelimbic neurons showed learning-related increases in activity to the CS and US, whereas infralimbic neurons showed learning-related decreases in activity to these stimuli. A subset of prelimbic neurons exhibited sustained increases in activity during the trace interval. These sustained prelimbic responses may provide a bridging code that allows for overlapping representations of CS and US information within the trace fear conditioning circuit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The organization of automated information systems on occupational diseases and of the hygienic monitoring of working conditions

Creation of automated database "Archive of occupational diseases clinic" is an important task of informational support for occupational pathology centers. Constructing the database, the authors designed an "Accounting chart of patient with occupational disease for diagnostic survey in occupational pathology center" and a "Diagnosis of occupational disease" code book adjusted to X ICD with instruction. Analysis of the information obtained forms a basis for forecasting the course of pathologic process, for justifying a complex of treatment and prophylaxis.     

Effects of acute and chronic dieldrin administration on liver and plasma esterases of the rat

A heritable propensity to develop malignant lesions is found in individuals with familial adenomatosis of the colon an rectum (ACR) and the Gardner's syndrome variant, an autosomal dominant trait. In the present study, the growth characteristics of cultured skin fibroblasts (SF) derived from normal-appearing flat skin biopsies of ACR families, representing all phenotypes, and appropriate controls were investigated. SF were obtained from stocks between the second and fifth passages and growth to confluency in Eagle's Minimal Essential Medium (EMEM) supplemented with 15% fetal calf serum (FCS). Following trypsinization, cells were replanted in EMEM supplemented with either 1% or 15% FCS at an initial density of 4 x 10(3) cells/cm2 and counted daily for five days. Normal SF representing several age groups (both sexes) and those obtained from non-afflicted individuals of ACR families grew only in 15% FCS. In contrast, SF from ACR subjects and from embryonal skin grew both in 1% and 15% FCS. SF from several clinically asymptomatic adults, children or ACR patients, grew in 1% FCS as well. Cell cultures from ACR individuals showed regions of criss-crossed arrays and multilayered pattern. These growth properties were not observed in normal cell cultures. The SF from ACR individuals did not grow in methocel, nor did they form tumors in athymic mice. These results suggest the occurrence of previously undetected biochemical alterations in SF taken from ACR genotypes.     

A new approach to assessing rheumatoid arthritis (RA) disease activity using the American College of Rheumatology core set of disease activity measures for RA trials--a multi-center study

To characterize the American College of Rheumatology core set of disease activity measures for rheumatoid arthritis (RA) clinical trials (ACR core set measures) and the ACR definition of improvement of RA (ACR improvement definition), we studied 42 Japanese patients with active RA who were treated with DMARDs including mizoribine. Each patient's disease activity was assessed at the time of enrollment to the study and after 24 weeks using the ACR core set measures as well as the physical global assessment through the conventional measures. Twenty-five (60%) patients were discerned as showing improved by physicians through the conventional measures. This decision appeared to be based on improvement in Lansbury activity index (LAI) and C-reactive protein (CRP) value. Twelve of the 25 "improved" patients satisfied the ACR improvement definition. The 12 patients showed significant improvement in "outcome" measures including patients assessments of pain, disease activity, and physical function, compared to the 30 patients not satisfying the ACR definition. However, no significant differences were observed between these two groups in "process" measures including LAI, tender joint count, swallen joint count, or CRP value. In conclusion, the ACR core set measures including both process and outcome measures have potential to reflect clinical important changes on "real life" of patients with RA.     

Should improvement in rheumatoid arthritis clinical trials be defined as fifty percent or seventy percent improvement in core set measures, rather than twenty percent?

OBJECTIVE: To determine whether improvement of more than 20% in core set parameters should be required before patients are characterized as improved in rheumatoid arthritis (RA) clinical trials. METHODS: Data from 6 RA trials were reanalyzed to evaluate the discriminant validity (ability to differentiate active treatment from control) of 4 proposed definitions of improvement: the current American College of Rheumatology (ACR) definition (a 20% threshold for core set parameters [ACR 201), a 50% threshold (ACR 50), a 70% threshold (ACR 70), and an ordinal definition in which a patient could be classified in any of 3 categories (unimproved, ACR 20, or ACR 50). To evaluate the discriminant validity of these 4 definitions of improvement, we characterized each patient in each trial as improved or not, based on each definition, and computed a chi-square value differentiating the active treatment group from the control group, with the corresponding P value. RESULTS: With an increase in the threshold for improvement, the percentage of placebo-treated patients who were classified as experiencing response dropped dramatically in all trials, as did the percentage of patients receiving active therapy (second-line drug, combination therapy, tumor necrosis factor p75-Fc fusion protein) who were classified as experiencing response. Generally, the drop in active treatment response rates was greater than the drop in placebo response rates, leaving the difference between the 2 groups less at the higher thresholds. Therefore, chi-square values fell as the threshold for response was raised. The ordinal definition of improvement yielded chi-square values similar to those obtained using ACR 20 alone. CONCLUSION: Adopting a definition of efficacy in RA trials that requires 50% or 70% improvement in core set parameters would likely compromise statistical power and make it more difficult to distinguish between 2 treatments with different efficacy. ACR 20 should continue to be the primary measure of efficacy in RA trials, with higher thresholds for improvement being determined and reported as secondary efficacy measures.     

Computer analysis of mammography phantom images (CAMPI): an application to the measurement of microcalcification image quality of directly acquired digital images

The purpose of this investigation was to apply the recently developed CAMPI (computer analysis of mammography phantom images) method to a Fischer Mammotest Stereotactic Digital Biopsy machine. Another aim was to further elucidate the nature of the empirically introduced CAMPI measures. Images of an American College of Radiology (ACR) accreditation phantom centered on the largest two speck groups were obtained on this machine under a variety of x-ray conditions. An additional measure, alternative SNR (ASNR) is introduced which is complementary to the SNR measure. Analyses of the Mammotest images revealed that the mAs and kVp dependencies of the CAMPI measures could be understood from basic imaging physics principles. It is shown that: (1) the measures reflect the expected linearity of the digital detector and Poisson photon statistics; (2) under automatic exposure control (AEC) conditions the signal (SIG) measure is proportional to subject contrast; and (3) under AEC conditions the noise (NOI) measure is proportional to the square root of the average absorbed photon energy. Correspondence with basic imaging physics principles shows that the measures are significantly free of artifacts. Precision of the CAMPI measures exceeds that of human observers by orders of magnitude. CAMPI measures are expected to be more relevant to clinical mammography than Fourier metrics as the measurements are done on objects of arbitrary shape and size that were designed by the manufacturer to resemble various detection tasks in mammography. It is concluded that CAMPI can perform objective and highly precise evaluations of phantom image quality in mammography. It could be used as a sophisticated quality control tool, as a replacement for the current ACR/MQSA phantom evaluation program, and to evaluate the rapidly evolving digital mammography technology.     

Cellulose as a gastrointestinal US contrast agent

Ultrasound (US) imaging of the abdomen often is compromised by artifacts due to adjacent bowel gas. In an attempt to decrease gas artifacts and improve US image quality, the authors evaluated the use of cellulose preparations as gastrointestinal US contrast agents. Optimal homogeneity and reflectivity were evaluated in phantom solutions, and two suitable agents were selected for clinical trial. Ten volunteers underwent abdominal US imaging before and after contrast agent administration on three separate occasions. The volunteers drank 800 mL of freshly degassed water and two different gastrointestinal US contrast agents. US images obtained before and after administration of contrast material were evaluated by five radiologists and scored for bowel marking, visualization of abdominal anatomy, and image degradation by bowel gas. Compared with water, the orally administered US contrast agents improved visualization of bowel and abdominal anatomy, with diminished gas artifact.