Παρασκευή, 13 Απριλίου 2018

Age and gender differences in mechanically induced intra oral temporal summation and conditioned pain modulation in healthy subjects.

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Publication date: Available online 13 April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Junad Khan, Olga Korczeniewska, Rafael Benoliel, Mythili Kalladka, Eli Eliav, Cibelle Nasri-Heir
ObjectiveTo study intra oral Temporal Summation (TS) and Conditioned Pain Modulation (CPM) and compare the outcome to TS and CPM induced in the forearm. Also, to study the effect of age and gender on intra oral and forearm TS and CPM.Study DesignMechanical stimulation was induced with # 5.46 von Frey filament applying 26 grams of force. A single stimulus, and then a train of 30 successive stimuli were applied intra orally and to the dominant forearm. CPM was assessed with TS test as the painful stimulus and non-dominant hand immersion in hot water bath as the conditioning stimulus.ResultsGender was significantly associated with TS but not CPM measures. Females had significantly lower mean TS measured in the face and in dominant forearm than males. Age was significantly associated with CPM but not TS measures. In both sites examined, older subjects had significantly lower mean CPM when compared to younger subjects.ConclusionMechanical temporal summation elicited in the oral cavity can be used as test-stimulus for CPM testing. Intraoral modulation, both TS and CPM has a similar extent to that of the standard cutaneous extremity. TS was lower in females and CPM reduced with age.



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The effect of ovariectomy and two antiresorptive therapeutic agents on bone response in rats: a three-dimensional imaging analysis

Publication date: Available online 13 April 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Priscilla Coutinho Romualdo, Nayane Barbosa Fernandes Furlanetto Cunha, Graziela Bianchi Leoni, Manoel Damião de Sousa-Neto, Alberto Consolaro, Alexandra Mussolino de Queiroz, Raquel Assed Bezerra da Silva, Lea Assed Bezerra da Silva, Paulo Nelson-Filho
ObjectiveTo evaluate bone mineral density (BMD) and microarchitecture in femurs and maxillary bones of ovariectomized (OVX) rats treated or not treated with alendronate (ALD) or odanacatib (ODN).Study Design: Twenty rats were divided into groups: SHAM, OVX, OVX/ALD and OVX/ODN. After 12 weeks, the femurs and maxillae were removed and subjected to three-dimensional analysis by microcomputed tomography. Results were analyzed with one-way ANOVA and Tukey's test (α=0.05).ResultsOVX decreased maxillary and femoral BMD and altered femoral microarchitecture (p<0.05). The drugs increased BMD of both types of bones, but only ALD maintained the phenotype similar to the sham group. The action of ALD was limited to the femoral Tb.Sp (trabecular separation). OVX and the drugs had no effect on the microarchitecture of the maxilla (p>0.05).ConclusionsAlendronate and odanacatib therapy increased BMD in both bones after ovariectomy. Alendronate was more successful than odanacatip in preserving the morphology of bone similar to the sham group. ALD maintained the phenotype for Tb.Sp in the femur but ODN did not. In the maxillae, neither ovariectomy nor either antiresorptive drug had significant effects on microarchitecture.



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Corrigendum to “Evaluation of Texture Analysis Parameter for Response Prediction in Patients with Hepatocellular Carcinoma Undergoing Drug-Eluting Bead Transarterial Chemoembolization (DEB-TACE) Using Biphasic Contrast-Enhanced CT Image Data

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Publication date: Available online 13 April 2018
Source:Academic Radiology
Author(s): Christopher Kloth, Wolfgang Maximilian Thaiss, Rainer Kärgel, Rainer Grimmer, Jan Fritz, Sorin Dumitru Ioanoviciu, Dominik Ketelsen, Konstantin Nikolaou, Marius Horger




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Automated Breast Ultrasound Interpretation Times

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Publication date: Available online 13 April 2018
Source:Academic Radiology
Author(s): Ashley I. Huppe, Marc F. Inciardi, Mark Redick, Melissa Carroll, Jennifer Buckley, Jacqueline D. Hill, Jason B. Gatewood
Rationale and ObjectivesThis study aimed to determine the average time for breast radiologists of varied experience to interpret automated breast ultrasound (ABUS) examinations.Materials and MethodsA reader performance study was conducted on female patients, with ACR BI-RADS 4 breast density classifications of C or D, who received both an ABUS screening examination and a digital mammogram from 2013 to 2014 at an academic institution. Three faculty breast radiologists with varied levels of ABUS experience (advanced, intermediate, novice) read all ABUS examinations, with interpretation times and final impressions (categorized as "normal" or "abnormal") recorded for each examination.ResultsNinety-nine patients were included, with all readers demonstrating an average ABUS interpretation time of less than 3 minutes. Compared to the other two readers, the intermediate reader had a significantly longer mean interpretation time at 2.6 minutes (95% confidence interval 2.4–2.8; P < .001). In addition to having the shortest mean interpretation time, the novice reader also demonstrated reduced times in subsequent interpretations, with a significant decrease in interpretation times of 3.1 seconds (95% confidence interval 0.4–5.8) for every 10 ABUS examinations interpreted (P < .05).ConclusionsOverall, mean ABUS interpretation time by radiologists of all experience levels was short, at less than 3 minutes per examination, which should not deter radiologists from incorporating ABUS examinations into a busy clinical environment.



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Dynamic contrast-enhanced magnetic resonance imaging for differentiating osteomyelitis from acute neuropathic arthropathy in the complicated diabetic foot

Abstract

Objective

The main purpose of this study was to investigate the diagnostic value of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating osteomyelitis from acute neuropathic arthropathy in the diabetic foot.

Materials and Methods

This prospective study was carried out on 30 diabetic foot patients, with a mean age of 51 years. The patients all underwent clinical examinations, laboratory examinations and DCE-MRI. The DCE-MRI parameters (Ktrans, Kep and Ve) of the regions of acute neuropathic arthropathy and osteomyelitis were calculated. Receiver operating characteristic curves (ROCs) were used to identify the DCE-MRI parameters that showed the highest accuracy in differentiating the acute neuropathic arthropathy from the osteomyelitic regions. Pearson correlation coefficients were used to assess the correlations among the DCE-MRI parameters, the level of C-reactive protein (CRP) and the erythrocyte sedimentation rate (ESR).

Results

The Ktrans, Kep and Ve values of the osteomyelitic regions were higher than those of the acute neuropathic arthropathy regions, and significant differences were found between the two groups (P = 0.000, P = 0.000, P = 0.000). The ROC analysis showed that Ktrans and Ve performed best in differentiating osteomyelitis from acute neuropathic arthropathy, both with an area under the curve of 0.938. The Pearson correlation coefficients showed that the DCE-MRI parameters correlated significantly with the level of CRP and ESR (P = 0.000, P = 0.014, P = 0.000; P = 0.000, P = 0.000, P = 0.013).

Conclusions

Our results showed that DCE-MRI may provide reproducible parameters that can reliably differentiate osteomyelitis from acute neuropathic arthropathy.



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Impact of the Glymphatic System on the Kinetic and Distribution of Gadodiamide in the Rat Brain: Observations by Dynamic MRI and Effect of Circadian Rhythm on Tissue Gadolinium Concentrations

Objectives The glymphatic system is a recently hypothesized waste clearance system of the brain in which perivascular space constitutes a pathway similar to the lymphatic system in other body regions. Sleep and anesthesia are reported to influence the activity of the glymphatic system. Because rats are nocturnal animals, the glymphatic system is expected to be more active during the day. We attempted to elucidate the influence of the glymphatic system for intravenously injected gadodiamide in the rat brain by 2 experiments. One was a magnetic resonance imaging (MRI) experiment to evaluate the short-term dynamics of signal intensity changes after gadodiamide administration. The other was a quantification experiment to evaluate the concentration of retained gadolinium within the rat brain after repeated intravenous administration of gadodiamide at different times of day and levels of anesthesia. Materials and Methods The imaging experiment was performed on 6 rats that received an intravenous injection of gadodiamide (1 mmol/kg) and dynamic MRI for 3 hours at 2.4-minute intervals. The time course of the signal intensity changes was evaluated for different brain structures. The tissue quantification experiment was performed on 24 rats divided into 4 groups by injection time (morning, late afternoon) and anesthesia (none, short, long) during administration. All animals received gadodiamide (1.8 mmol/kg, 8 times over 2 weeks). Gadolinium concentration of dissected brain tissues was quantified 5 weeks after the last administration by inductively coupled plasma mass spectrometry. Results In the imaging experiment, muscle and the fourth ventricle showed an instantaneous signal intensity increase immediately after gadodiamide injection. The signal curve of the cerebral cortex and deep cerebellar nuclei reached the peak signal intensity later than the fourth ventricle but earlier than that of the prepontine cistern. In the gadolinium quantification experiment, the concentration in the group with the morning injection showed a significantly lower concentration than the late afternoon injection group. The lowest tissue gadolinium concentrations were found in the groups injected in the morning during long anesthesia. Conclusions Instantaneous transition of gadodiamide from blood to cerebrospinal fluid was indicated by dynamic MRI. The gadodiamide distribution to the cerebral cortex and deep cerebellar nuclei seemed to depend on both blood flow and cerebrospinal fluid. This confirms previous studies indicating that the cerebrospinal fluid is one potential pathway of gadolinium-based contrast agent entry into the brain. For the distribution and clearance of the gadodiamide from brain tissue, involvement of the glymphatic system seemed to be indicated in terms of the influence of sleep and anesthesia. Received for publication January 30, 2018; and accepted for publication, after revision, February 28, 2018. Conflicts of interest and sources of funding: Gregor Jost, Thomas Frenzel and Hubertus Pietsch are employees of Bayer AG. Correspondence to: Toshiaki Taoka, MD, PhD, Department of Radiology, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466–8550, Japan. E-mail: ttaoka@med.nagoya-u.ac.jp. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Brain morphological and microstructural features in cryptogenic late-onset temporal lobe epilepsy: a structural and diffusion MRI study

Abstract

Purpose

Although epilepsy in the elderly has attracted attention recently, there are few systematic studies of neuroimaging in such patients. In this study, we used structural MRI and diffusion tensor imaging (DTI) to investigate the morphological and microstructural features of the brain in late-onset temporal lobe epilepsy (TLE).

Methods

We recruited patients with TLE and an age of onset > 50 years (late-TLE group) and age- and sex-matched healthy volunteers (control group). 3-Tesla MRI scans, including 3D T1-weighted images and 15-direction DTI, showed normal findings on visual assessment in both groups. We used Statistical Parametric Mapping 12 (SPM12) for gray and white matter structural normalization and comparison and used Tract-Based Spatial Statistics (TBSS) for fractional anisotropy and mean diffusivity comparisons of DTI. In both methods, p < 0.05 (family-wise error) was considered statistically significant.

Results

In total, 30 patients with late-onset TLE (mean ± SD age, 66.8 ± 8.4; mean ± SD age of onset, 63.0 ± 7.6 years) and 40 healthy controls (mean ± SD age, 66.6 ± 8.5 years) were enrolled. The late-onset TLE group showed significant gray matter volume increases in the bilateral amygdala and anterior hippocampus and significantly reduced mean diffusivity in the left temporofrontal lobe, internal capsule, and brainstem. No significant changes were evident in white matter volume or fractional anisotropy.

Conclusions

Our findings may reflect some characteristics or mechanisms of cryptogenic TLE in the elderly, such as inflammatory processes.



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Distribution of environmental tritium in rivers, groundwater, mine water and precipitation in Goa, India

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Md. Arzoo Ansari, H.V. Mohokar, Archana Deodhar, Noble Jacob, U.K. Sinha
Tritium concentration in rivers, groundwater, precipitation and mine pits water, all over Goa state was characterized to find out spatial and temporal variability of tritium. Twenty four water samples were collected during pre-monsoon and post-monsoon and analyzed for their tritium concentration. The mean tritium concentration in surface and sub-surface hydrosphere is 2.5 (±0.6) TU. The mean concentration of tritium in rivers, groundwater, mines pits water and rain water are 2.9 (±0.5) TU, 1.95 (±0.5) TU, 2.5(±0.3) TU and 3.1(±0.1) TU respectively. The tritium distribution in all the samples shows modern precipitation (post-1950) component in surface and sub-surface hydrosphere of Goa. The HYSPLIT4.0 air mass trajectory model and atmospheric circulation pattern suggest that the moisture origin was from the Arabian Sea and this low tritium moisture is diluting the tritium concentration of surface hydrosphere near the coastal area. The tritium concentration in surface hydrosphere shows more and more enrichment as one move inland (i.e. away from the coast). Significant seasonal change is observed in the surface hydrosphere. The pre-monsoon samples showed higher tritium concentration than post-monsoon samples. This may be due to high rate of re-evaporation of water and a reduction in the supply of oceanic moisture during the summer (pre-monsoon).



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The role of ethylene–vinyl alcohol copolymer in association with other embolic agents for the percutaneous and endovascular treatment of type Ia endoleak

Abstract

Aim

To evaluate safety, technical and clinical success of embolization of type Ia endoleak (T1a EL) using ethylene–vinyl alcohol copolymer as embolic agent alone or in combination with other materials.

Materials and methods

Five patients presented T1a EL after endovascular repair of aortic aneurysms (EVAR) with radiological evidence of expanding sac size; in particular, three had contained rupture. In one patient, proximal cuff insertion was previously performed, in three patients proximal cuff was urgently inserted but T1a EL persisted; one patient, previously treated with Ovation Abdominal Stent Graft System, was directly proposed for endovascular treatment. In all cases, endovascular embolization was successfully performed and the transfemoral approach was always chosen; in one case it failed and translumbar approach by direct puncture of the sac was required. Used embolization agents were glue, ethylene–vinyl alcohol copolymer (Onyx) and coils in three cases, n-butyl cyanoacrylate and Onyx in one case, Onyx and coils in the last case.

Results

Technical success rate was 100% as well as clinical success. No major or minor complication, including non-target embolization, was registered. Clinical success was 100% until today and the sac diameter remained stable in four patients and decreased in one.

Conclusions

Onyx may be considered a suitable embolic agent in the treatment of patients with type Ia endoleaks after EVAR, after failure of conventional treatments such as prolonged balloon inflation of the aortic neck or deployment of large bare stent.



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Technical difficulties

I'm sorry to say that today we have been the subject of a bot attack that has caused significant technical headaches. The form of this attack was the attempted creation of tens of thousands of new accounts all using spam email addresses. We had to briefly suspend new account creations and introduce a rushed urgent temporary fix. 

Unfortunately, this has lead to a few bugs.

The most notable one is that all draft cases cannot be accessed and results in an error page. We are almost 100% certain that all the content is safe and sound.

We are also unable to moderate any edits to cases (both new cases and previously created cases). Again the content of these cases is almost certainly completely fine. 

We should be able to fix all of this in the near future (either over the next day or two or early next week at the latest). 

There is no indication whatsoever that there has been any attempt at breaching our security and there is no indication whatsoever that any user details have been obtained. This seems to have been purely an automated attempt to create a large number of user profiles and it is likely that we were not even a deliberate target. 

Apologies for any inconvenience. 

 

Frank Gaillard

Founder CEO/Editor in Chief. 



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Institutional Interventional Radiology Symposium Increases Medical Student Interest and Identifies Target Recruitment Candidates

Publication date: Available online 12 April 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Mina S. Makary, Anand Rajan, Rose J. Miller, Eric D. Elliott, James W. Spain, Gregory E. Guy
ObjectivesTo assess and raise medical student interest in Interventional Radiology (IR); and to evaluate student response across gender, level of training, and surgical vs non-surgical specialty interest.Materials and MethodsAll Ohio medical students were invited to an IR Symposium held by a large academic medical center in central Ohio. The program encompassed didactic lectures, hands-on simulation models, and a networking luncheon with faculty, trainees, and industry partners. All attendees completed an anonymous, 5-point-Likert scaled survey pre- and post- attending the event to assess their awareness of IR as a specialty, understanding of the current training pathways, and level of interest.ResultsA total of 46 participants (M:F 60:40%, MS1–53%, MS2–36%, MS3–11%) attended the symposium. The cohort demonstrated increased interest in pursuing a career in IR following the symposium (4.12 vs 3.70, p<.001). Students with an interest in a non-surgical specialty showed an increased interest in IR (4.20 vs 3.68, p<.001), whereas surgically-oriented students did not demonstrate a significant increase (4.00 vs 3.71, p=0.375). No statistically significant differences were noted across gender or level of training. The symposium experience significantly increased understanding of the IR training pathways (4.51 vs 2.94, p<.001). Students rated lectures (57%) and endovascular simulators (41%) as the most useful experiences.ConclusionsThis study demonstrated the role of symposia in improving medical student awareness of IR and training pathways. Findings were validated across gender and training level, and identified the subset of students with nonsurgical interests as most responsive to such intervention and potential recruitment.



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Structured Head and Neck CT Angiography Reporting Reduces Resident Revision Rates

Publication date: Available online 12 April 2018
Source:Current Problems in Diagnostic Radiology
Author(s): Tucker F. Johnson, Waleed Brinjikji, Derrick A. Doolittle, Alex A. Nagelschneider, Brian T. Welch, Amy L. Kotsenas
This resident-driven quality improvement project was undertaken to assess the effectiveness of structured reporting to reduce revision rates for afterhours reports dictated by residents. The first part of the study assessed baseline revision rates for head and neck CT angiography (CTA) exams dictated by residents during afterhours call. A structured report was subsequently created based on templates on the RSNA informatics reporting website and critical findings that should be assessed for on all CTA exams. The template was made available to residents through the speech recognition software for all head and neck CTA exams for a duration of two months. Report revision rates were then compared with and without use of the structured template. The structured template was found to reduce revision rates by approximately 50% with 10/41 unstructured reports revised and 2/17 structured reports revised. Based on our experience, we believe that structured reporting can help reduce reporting errors, particularly in term of typographical errors, train residents to evaluate complex exams in a systematic fashion, and assist them in recalling critical findings on these exams.



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