bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF ARGON PLASMA COAGULATION IN PATIENTS WITH UPPER GASTROINTESTINAL ACTIVE HEMORRHAGE
Authors: Komatsu Hirokazu , Hara Yuriko , Naito Yoshitaka , Hosaka Yoshio , Yamanaka Shigeru , Masuda Hideaki , Imamura Kiyoko
Published: December 2004

Background:  Acute upper gastrointestinal hemorrhage is a common and life‐threatening medical emergency. Despite a large number of endoscopic methods for hemostasis, active bleeding lacks an adequate therapeutic remedy. The aim of the present study was to evaluate the hemostatic effect of argon plasma coagulation on upper gastrointestinal active bleeding, especially in comparison with heater probe and pure ethanol injection therapy.

Methods:  Sixty‐eight patients with 77 lesions presenting active bleeding were treated endoscopically and divided into three groups depending on the procedures, that is, argon plasma coagulation group (27 patients with 32 lesions), heater probe group (20 patients with 22 lesions) and pure ethanol injection group (21 patients with 23 lesions). The three groups were similar with respect to all background variables. Episodes of rebleeding were retreated with the same modality as used previously.

Results:  The primary hemostatic rate in the argon plasma coagulation group was 81.3%, that in the heater probe group was 77.3%, and that in the pure ethanol injection group was 87.0%. The permanent hemostatic rate in the argon plasma coagulation group was 75.0%, that in the heater probe group was 63.6%, and that in the pure ethanol injection group was 78.3%. When examined in terms of Forrest's criteria, the argon plasma coagulation group in Forrest's type I b and the pure ethanol injection group in type I a showed the highest permanent hemostatic rate.

Conclusions:  Argon plasma coagulation is most suitable in arresting oozing hemorrhage. If pure ethanol injection therapy is possible, it is more effective than other therapies in the case of spurters.
THREE‐DIMENSIONAL ENDOSCOPIC COLOR DOPPLER ULTRASONOGRAPHY OF ESOPHAGEAL VARICES
Authors: Sato Takahiro , Yamazaki Katsu , Akaike Jun , Toyota Jouji , Karino Yoshiyasu , Ohmura Takumi , Kuwata Yasuaki , Suga Toshihiro
Published: December 2004

Background:  Endoscopic color Doppler ultrasonography (ECDUS) is a method for obtaining color flow images in blood vessels. In the present study, we evaluated the usefulness of three‐dimensional endoscopic color Doppler ultrasonography (3D‐ECDUS) using electronic radial ECDUS.

Methods:  Five patients with esophageal varices were studied. The technique of ECDUS was performed using a Pentax EG3630‐UR (forward‐view) with a distal tip diameter of 12 mm. The instrument (electronic radial array) has a curved array scanning transducer with variable frequency (5.0, 7.5, 10.0 MHz) and B mode/color Doppler/power Doppler capability. A Hitachi EUB 8500 was used for the display, which provided a 270° image. We monitored the color flow images of esophageal varices, paraesophageal veins and perforating veins. Scanning was performed from the cardiac part of the stomach to the distal esophagus by moving the instrument. After completing the examination, 3D‐ECDUS images were reconstructed.

Results:  Color flow images of esophageal varices and paraesophageal veins were obtained in five of the five patients. Color flow images of perforating veins were obtained in five of the five patients with 3D‐ECDUS. 3D‐ECDUS clearly delineated the continuity of vessels from the cardiac varices to the esophageal varices, and between the perforating veins and esophageal varices. Furthermore, 3D‐ECDUS clearly showed the continuity of vessels from the anterior branch of the left gastric vein to the esophageal varices and from the posterior branch of the left gastric vein to the paraesophageal veins.

Conclusion:  3D‐ECDUS more clearly provides visualization of vessel continuity in esophageal varices, which allows for better understanding of the hemodynamics of esophageal variceal cases.
RELATIONSHIP BETWEEN PULSE WAVE VELOCITY AND CIRCULATORY HEMODYNAMICS DURING UPPER GASTROINTESTINAL ENDOSCOPY
Authors: Uemura Eiko , Nomura Masahiro , Uehara Kohzo , Sawa Yuko , Nakaya Yutaka , Ito Susumu
Published: December 2004

Background:  Arterial stiffness has recently been proposed as a powerful independent predictor of cardiovascular disease. The aim of the present study was to establish the relationship between aortic stiffness and circulatory complications during gastrointestinal endoscopy using pulse wave velocity (PWV) as a parameter.

Methods:  We serially monitored standard 12‐lead ECGs, blood pressure, and percutaneous arterial oxygen saturation during gastrointestinal endoscopy, and performed a spectral analysis of heart rate variability and an analysis of QT dispersion. We also performed a logistic multivariate analysis of the severity of atherosclerosis and changes in the circulatory kinetics using PWV.

Results:  In the elderly group (older than 65 years), the rate of decrease in parasympathetic nervous activity and rate of change in blood pressure and QT dispersion were significantly larger than those in the non‐elderly group (younger than 65 years) (P < 0.05). However, a multivariate analysis showed that the relative risk for the grade of atherosclerosis was greater in an evaluation by PWV than by age.

Conclusions:  We conclude that the grade of atherosclerosis, as evaluated from PWV, is a stronger predictive factor for changes in circulatory kinetics during gastrointestinal endoscopy than age. PWV screening may facilitate the prevention of cardiac accidents during gastrointestinal endoscopy to some degree.
USEFULNESS OF MULTI DETECTOR ROW COMPUTED TOMOGRAPHY FOR DETECTION OF FLAT AND DEPRESSED COLORECTAL CANCER
Authors: Izumiya Takashi , Hirata Ichiro , Hamamoto Norihiro , Matsuki Mitsuru , Narabayashi Isamu , Nishiguchi Kanji , Okuda Junji , Tanigawa Nobuhiko , Katsu Ken‐ichi
Published: December 2004

Background:  Recently, the clinical usefulness of colorectal cancer screening by CT colonography has been reported in Europe and the USA. However, in Japan, the diagnosis of flat or depressed colorectal cancer lesions has been emphasized, and the question of whether CT colonography facilitates visualization of these lesions remains to be answered. In the present study, we compared the visualization of flat and depressed colorectal cancer lesions by CT colonography with that of protruding lesions.

Methods:  We investigated 33 Dukes A colorectal cancer lesions that had been examined by 3D‐CT, colonoscopy, and barium enema prior to surgery. In all patients, CT colonography was performed immediately after colonoscopy. Volume rendering was used for 3‐D rearrangement, and imaging findings were examined with respect to morphology, tumor diameter, and tumor height.

Results:  All (14/14) of the protruding‐type lesions were visualized by CT colonography, whereas 78.9% (15/19) of the flat and depressed‐type lesions were visualized. There was no significant difference in tumor diameter between protruding‐type lesions and flat and depressed‐type lesions. With respect to tumor height, 100% of the lesions measuring 2 mm or more in height were visualized, whereas only 42.9% of those measuring less than 2 mm in height were visualized; the difference was significant (P < 0.001).

Conclusions:  These results suggest that the visualization capacity of CT colonography is associated with tumor height, but not with tumor diameter. Currently, lesions measuring 2 mm or more in height can be visualized reliably by CT colonography.
PATHOLOGICAL AND MOLECULAR‐BIOLOGICAL STUDIES ON SEQUENCE FROM REFLUX ESOPHAGITIS TO DEVELOPMENT OF BARRETT's ADENOCARCINOMA
Authors: Wada Ryo , Yamaguchi Toshikazu , Tanizaki Takayuki
Published: December 2004

Background:  Barrett's adenocarcinoma is considered to develop via a dysplasia‐carcinoma sequence. However, this theory is thought to be incomplete, because the reports supporting it have been led by an investigation using relatively large‐sized neoplasias or biopsy materials. We think that the minute‐sized neoplasias and the propria mucosa adjacent to these lesions must be examined histologically to clarify the histogenesis of digestive tract carcinoma. In the present study, new findings on the histogenesis of Barrett's adenocarcinoma were revealed according to this point described above.

Methods:  First, Barrett's epithelium (in particular, specialized colmunar epithelium: SCE) was investigated histologically and immunohistochemically. Second, 28 lesions of the super‐minute tubular neoplasia within 1 mm in maximum diameter in Barrett's esophagus (SMBa) were detected by pathological examinations, and loss of heterozygosity of microsatellite markers (TP53, D17S796 and D17S786) in chromosome 17‐related p53 (p53‐LOH) in these SMBa lesions were examined by DNA extraction using microdissection and high resolution fluorescence labeled PCR primers.

Results:  Histological and immunohistochemical findings showed that the tubules of SCE had a three‐layer structure and typical SCE should be thought to be the large bowel‐type of the intestinal metaplasia (or goblet cell metaplasia) in the cardiac gland mucosa. According to the overexpression of p53 protein labeling index (p53‐LI), the SMBa lesions were divided into two groups. Three lesions with p53‐LI over 90%, which were thought to be intramucosal adenocarcinoma morphologically, showed high frequency of p53‐LOH (loss of heterozygosity) (100%), and 25 lesions with an average p53‐LI of 58%, which were thought to be benign neoplasia morphologically, also showed p53‐LOH (36%).

Conclusions:  SCE is thought to be the large bowel type of the intestinal metaplasia in the cardiac gland mucosa. Pathological and molecular‐biological findings of SMBa in SCE supports the dysplasia‐carcinoma sequence in the histogenesis of Barrett's cancer and synchronously some SMBa suggests that there is a different route, the so‐called de novo carcinoma theory.
SYNCHRONOUS MULTICENTRIC SIGNET‐RING CELL CARCINOMA OF THE STOMACH
Authors: Sakuma Takahiko , Tsukahara Yasuo , Doi Reiko , Kan Kazuomi , Fujita Junya , Kawata Junji , Kitada Masashi , Shibata Takashi , Hata Shinsuke , Hayakawa Masanobu , Sato Masayuki , Hanada Masato , Shimano Takashi
Published: December 2004

A case of simultaneous multicentric signet‐ring cell carcinoma (SRC) of stomach is presented. Initially, an early gastric cancer (IIc) was diagnosed and this was cured with distal gastrectomy. Thirty‐eight months after the operation, follow‐up endoscopy revealed a tiny mucosal discoloration lesion, which was diagnosed as a minute SRC focus with biopsy. This was successfully treated with endoscopic mucosal resection (EMR). Nine months later, gastroscopy discovered another small mucosal lesion and it was again diagnosed as a tiny SRC lesion, which was also successfully treated with EMR. After a further 2 months, endoscopy showed three small mucosal lesions (discoloration) similar to previous lesions, two of which proved to be SRC with biopsy. As these lesions distributed widely over the remnant stomach, total gastrectomy of the residual stomach was performed. Pathological examination demonstrated a total of 22 simultaneous multifocal SRC lesions, which were all very small mucosal cancer. These cancers, including previously EMR‐treated ones, seemed to develop in a multicentric manner, as they were diagnosed within 11 months. This case also indicated that even subtle endoscopic findings should vigorously be sought and, if in doubt, be biopsied in order to locate gastric cancer early enough for minimal invasive curative treatment to be feasible.
A CASE OF PEDUNCULATED POLYPOID CANCER ASSOCIATED WITH FLAT‐TYPE CANCER OF THE GALLBLADDER
Authors: Kimura Katsumi , Fujita Naotaka , Noda Yutaka , Kobayashi Go , Ito Kei , Horaguchi Jun , Takasawa Osamu
Published: December 2004

Pedunculated polypoid cancer of the gallbladder ordinarily shows cancer spread within the polyp consisting mainly of adenoma. We experienced a case of pedunculated mucosal cancer associated with flat‐type cancer of the gallbladder without an adenomatous component, the details of which are reported herein. The lesion was first detected by transabdominal ultrasonography (US) as a polypoid lesion of the gallbladder, 5 mm in size. Distinct growth of the lesion was revealed at follow‐up US after a year. Endoscopic ultrasonography showed not only a pedunculated polypoid lesion, 9 mm in size, with a solid internal echo pattern and a nodular surface, but also slight thickening of the surrounding gallbladder wall. Cholecystectomy was performed with a preoperative diagnosis of early gallbladder cancer, and a pedunculated polypoid lesion, 8 × 8 × 3 mm in size with a thin stalk and a nodular contour, surrounded by a widely spreading flat lesion with a coarse‐granular surface, was confirmed. Microscopically, the stalk was 700 µm in size, and both the pedunculated polypoid lesion and flat lesion consisted of well‐differentiated tubular adenocarcinoma limited to the mucosa, without an adenomatous component.
LAPAROSCOPIC ABLATION THERAPY FOR HEPATOCELLULAR CARCINOMA
Authors: Nagae Genta , Ido Kenichi , Isoda Norio , Sato Shin , Kita Hiroto , Sugano Kentaro
Published: December 2004

Laparoscopic ablation therapy is an attractive modality for localized hepatocellular carcinoma. It is an optimal treatment in patients with superficial tumors, tumors adjacent to other vital organs, or tumors difficult to access by percutaneous procedure. Laparoscopic access allows for easier detection and more accurate targeting of the tumor compared with percutaneous access and can minimize complications. In addition, this novel technique is favorable in terms of the length of hospital stay and cost‐effectiveness because it is completed in a single session. Characteristics and therapeutic potential of laparoscopic ablation therapy are summarized and compared with other therapeutic modalities in this review.
Employability in the Undergraduate Curriculum: some student perspectives
Authors: YORKE MANTZ
Published: December 2004

Government policy around the world is heavily influenced by a ‘human capital’ perspective. Education systems are pressed towards developing young people for their roles in the labour market: in the UK this is signalled in the term ‘employability’. Curricula differ in the ways in which they respond. Data are provided from three recent UK surveys that bear on employability and are discussed with reference to the USEM account of employability.
Students and Universities in Italy in an Age of Reform
Authors: FINOCCHIETTI GIOVANNI
Published: December 2004

Recent developments of the Italian student body are marked by an increasing diversification of prevailing student profiles. The presence of ‘new’ student groups is surveyed next to the groups which are the ‘traditional’ target of national policies for higher education and student welfare. Examples of such traditional target groups are, amongst others: males or females; students from well‐off and well‐educated families or from lower social backgrounds; resident or non‐resident students; undergraduate, graduate or postgraduate students (first, second or third cycle of university studies); students from different fields of study.

Working students are to be quoted in ‘new’ profiles. They may either work regularly or take occasional jobs during terms; in both cases they no longer seem to be full‐time students and should be considered as de facto part‐time students. Although student work is not a novelty, what has changed in recent times is its development: working students are reported to be a majority in the university student body. Their emerging needs and expectations as university customers point to inadequacies and delays in the prevailing academic attitudes and in higher education policy‐making.

The Italian Euro Student Survey is a monitoring of students’ living and study conditions in Italian universities. It is carried out in the framework of the Euro Student Report project, which involves many EU countries. Euro Student attaches great importance to the analysis of the impact of the diversification issue on the students’ living and study conditions, on their personal experiences and on their relations with academic institutions. Some of the most relevant emerging trends will be dealt with in this article, e.g. the demand for support and interaction with teachers and students (the ‘solitude’ issue), the increasing demand for better conditions in the study environment (the ‘quality’ issue), the differences in average academic achievements of different student groups (the ‘performance’ issue).

Based on the updated available data, some ideas and theories will be explained as a conclusion about the possible impacts of the most recent reforms in the higher education sector in Italy, i.e. the design of new courses according to the ‘Bologna process’ and the planning of a new student welfare system.
The Students’ Role in French Academic Deliberative Democracy
Authors: TAVERNIER FRANÇOIS
Published: December 2004

Since 1968, according to the French higher education law, elected students must participate in the different academic boards in every university. As trustees, they must formulate opinions about the institutional policy. Moreover, they must deliberate on equal terms with teachers.

According to a common discourse, this democratic activity is still considered as a nonsense because of some students’ structural weaknesses: very low turnout at the elections of their representatives, very high absenteeism rate of these miselected representatives and incapacity to formulate responsible and pragmatic proposals. This students’ uselessness in the academic participatory governance process would come from a post‐modernist air du temps: youth apathy, individualism, democratic societies’ crisis . . .

In accordance with the scientific questioning about the contemporary processes of political communication, I propose an alternative set of explanations focused on the spirit and practices which rule French academic boards. I assume that the development and improvement of student participation are also limited by endogenous factors that are closely linked with the functioning of the academic boards.

I propose an ethnographic analysis of a French university board. I compare the elected students’ absenteeism to the others members’ (teachers, staff members and guests) attendance rates. Then I study the cultural patterns which structure the interactions. Discursive freedom would be the sine qua non condition of academic autonomy and the structural explanation of weak student participation by teachers.
Should the Pre‐Notification of Mergers Be Compulsory in Australia?
Authors: Shekhar Chander , Williams Philip L.
Published: December 2004

Australia is unusual among the world's antitrust jurisdictions in not making the pre‐notification of mergers compulsory. However, if the parties are concerned that the Australian Competition and Consumer Commission (ACCC) is likely to object to the merger, there are strong incentives for them to notify the ACCC as the regulator has developed a strong reputation for imposing heavy costs on parties that fail to notify such mergers. The result is a system of quasi‐compulsory notification that creates the strongest incentives for parties to notify the ACCC of those proposals to which it is most likely to object. This study analyses data extracted from the ACCC's merger database and the empirical results are consistent with this characterisation. Mergers reported voluntarily by the parties are found to experience longer delays to completion, and are more likely to be challenged by the ACCC, when compared with a sample of all other mergers assessed by the regulator. The results suggest that non‐compulsory notification allows the parties themselves to pre‐sort the proposed merger vis‐à‐vis its interest to the ACCC.
The ‘Network Economy’ and Models of the Employment Contract
Authors: Marsden David
Published: December 2004

The development of the ‘network economy’ and the project‐based work challenge established methods of regulating employment relationships. There appears to be an unsatisfied demand for its greater use, especially among employers, and this may be blocked by the lack of suitable contractual forms. Project‐based work seeks to retain some of the open‐ended flexibility of the standard employment relationship in relation to its task content but not its duration. I argue that the success of the standard employment relationship stems from articulation of its psychological, economic/incentive, and legal aspects. As yet, this appears to be lacking for more transient forms of relationship.
Exchange Rate, Exchange Rate Volatility and Foreign Direct Investment
Authors: Kiyota Kozo , Urata Shujiro
Published: December 2004

In the light of the importance of foreign direct investment (FDI) for the promotion of economic development, this paper examines the impact of the changes in the real exchange rate and its volatility on FDI. Examining Japan's FDI by industries, we found that the depreciation of the currency of the host country attracted FDI, while the high volatility of the exchange rate discouraged FDI. Our results suggest the need to avoid over‐valuation of the exchange rate and to maintain stable but flexible exchange rate in order to attract FDI.
FDI and Industrial Restructuring in Post‐WTO Greater PRD: Implications on Regional Growth in China
Authors: Tuan Chyau , Ng Linda Fung‐Yee
Published: December 2004

This paper aims at studying the investment flows in the Greater Pearl River Delta region (Hong Kong‐PRD) in China and its impacts on industrial restructuring at the firm‐level using a business survey with the Hong Kong‐PRD entity acted as a core‐periphery economy. The critical effects of gravity distance on transaction costs in the determination of investment flows are examined statistically by a gravity model by incorporating a hypothetical infrastructural construction project. Survey findings show that the evolution of the cross‐border operations at the main core has directed the outward FDI flows and the subsequent industrial structural adjustments of the core‐periphery economy. This paper has presented a typical illustrative case for further studies of investment flows and its impacts upon industrial adjustments and performance in other regions in China especially after the WTO accession. Its implication on regional economic growth is also discussed.
EEG findings in dementia with Lewy bodies causing diagnostic confusion with sporadic Creutzfeldt–Jakob disease
Authors: Doran M. , Larner A. J.
Published: December 2004

Two patients with pathologically confirmed dementia with Lewy bodies (DLB) had electroencephalogram recordings reported to show periodic discharges suggestive or typical of Creutzfeldt–Jakob disease. These findings caused diagnostic confusion and necessitated appropriate precautions for prion disease at postmortem examination. Periodic sharp wave complexes have occasionally been reported in DLB and should not therefore dissuade one from the diagnosis when other clinical and neuropsychological features are consistent with validated diagnostic criteria.
Teaching of neuroepidemiology in Europe: time for action
Authors: Feigin V. , Brainin M. , Breteler M. M. B. , Martyn C. , Wolfe C. , Bornstein N. , Fieschi C. , Sevcik P. , Lima M. L. , Boysen G. , Beghi E. , Tzourio C. , Demarin V. , Gusev E. , López‐Pousa S. , Forsgren L.
Published: December 2004

Many epidemiological and clinical studies in Europe, especially in Eastern Europe and countries in transition, are of poor methodological quality because of lack of background knowledge in clinical epidemiology methods and study designs. The only way to improve the quality of epidemiological studies is to provide adequate undergraduate and/or postgraduate education for the health professionals and allied health professions. To facilitate this process, the European Federation of Neurological Societies (EFNS) Task Force on teaching of clinical epidemiology in Europe was set up in October 2000. Based on analyses of the current teaching and research activities in neuroepidemiology in Europe, this paper describes the Task Force recommendations aimed to improve these activities.
Clinical perspective on the Swedish version of the Assessment of Communication and Interaction Skills: stability of assessments
Authors: Haglund Lena , Thorell Lars‐Håkan
Published: December 2004

The purpose of the present study was to investigate whether ratings according to the Assessment of Communication and Interaction Skills, Swedish version (ACIS‐S) are related to the settings in which the skills are assessed, and whether the client's comprehension of the setting is related to the ACIS‐S rating scores. The ACIS‐S is an observation rating scale applied immediately after each of two to six different social sessions that the client takes part in. The selection of settings relies on the client's judgement of them as being meaningful. In total, nine occupational therapists and 16 clients participated in the study. A total of 71 ratings were made in a mean of 4.4 settings per client. The results indicate that the client's rated comprehension of the settings is not significantly related, in general, to the ACIS‐S rating scores given by the occupational therapist. However, the clients ACIS‐S scores may vary a lot over settings. In the present study, 13‐ of the 20‐items showed ratings of both the existence and the absence of problems in the same skill – but in different settings – in half or more of the client group. This may rise questions for the practitioners how to implement the ACIS‐S in clinical practice, for example, how many and which kind of settings and how many times? Further research in the field is recommended.
Violence in institutional care for elderly people from the perspective of involved care providers
Authors: Sandvide Åsa , Åström Sture , Norberg Astrid , Saveman Britt‐Inger
Published: December 2004

The aim of the present study was to describe violent events as narrated by care providers involving themselves. During a 12‐month period, care providers reported 149 violent events. Using consecutive purposive sampling with maximum variation, 61 events were further investigated using narrative interviews with involved care providers. They were involved either as victims, perpetrators or as witnesses. The narratives were analysed using a qualitative descriptive analysis. The presentation of the result includes contextual aspects and three themes: ‘misunderstanding each other’, ‘invasion of personal space’ and ‘acceptance of violence in work’. These themes represent a process of violence in the narratives. Mutual misunderstanding may be seen as an antecedent to violent events. Invasion of personal space is a theme revealing what violence is about. Acceptance of violence seems to be a natural consequence for the caregivers because the events are seen as unavoidable, impossible to solve and as a constituent of daily work.
Releasing and relieving encounters: experiences of pregnancy and childbirth
Authors: Lundgren Ingela
Published: December 2004

The experience of childbirth is an important life event for women, memories of which may follow them throughout life. The aim of the study reported here was to synthesize the results from four selected studies describing these experiences by focusing on women's and midwives’ experiences of the encounter during childbirth, as well as experiences of pregnancy from the women's perspective. The setting was the Alternative Birth Care Centre (Sahlgrenska University Hospital, Göteborg) and Karolinska Hospital (Stockholm, Sweden). A qualitative method grounded in phenomenology and hermeneutics was used as a basis for the studies and synthesis. The essential structure may be conceptualized under the heading ‘releasing and relieving encounters’, which, for the woman, constitutes an encounter with herself as well as with the midwife, and includes stillness as well as change. Stillness is expressed as presence and being one's body. Change is expressed as transition to the unknown and to motherhood. In the releasing and relieving encounter, for the midwife stillness and change equals being both anchored and a companion. To be a companion is to be an available person who listens to and follows the woman through the process of childbirth. To be anchored is to be the person who respects the limits of the woman's ability as well as her own professional limits in the transition process. A releasing and relieving encounter implies a sharing of responsibility and participation for women. This may be understood as a unique feature, which differs from other caring encounters and should be further studied.
Social class variations in schoolchildren's self‐reported outcome of the health dialogue with the school health nurse
Authors: Borup Ina , Evald Holstein Bjørn
Published: December 2004

Introduction and purpose.  School health services is an important element in many countries’ health promotion activities but little is known about the pupils’ acceptance and perception of these services and their effects. The objective of this paper was to examine the pupils’ self‐reported outcome of the health dialogue and to examine the effect of social class on this response controlled for the effect of other relevant social factors.

Material and methods.  The study is a survey. The population were all pupils in the fifth, seventh and ninth grade (11, 13 and 15 years old) in a random sample of schools in Denmark, response rate 87%, n = 5205. Data were collected by questionnaires.

Results.  The majority of the pupils had reflected about the content of the last health dialogue with the school health nurse (54%), had discussed the content with their mother (62%) and with friends (54%); 62% had followed the nurse's advice, 77% had made their own autonomous decisions based on the health dialogue, and 11% had returned to the nurse for further advice. Pupils from the lower social classes had more often followed the nurse's advice (OR = 1.16, 95% CI: 0.99–1.37) and returned to the nurse (OR = 1.46, 95% CI: 1.12–1.90). Pupils from the middle and lower social classes had more often made their own autonomous decisions (middle social classes: OR =1.23, 95% CI: 1.08–1.39, lower social classes: OR = 1.13, 95% CI: 0.95–1.34).

Conclusion.  Most pupils reported an outcome of the health dialogue with the school health nurse. Pupils from lower social classes seemed to benefit more than pupils from higher social classes.
Corporate social responsibility, partnerships, and institutional change: The case of mining companies in South Africa
Authors: Hamann Ralph
Published: December 2004

Internationally and in South Africa, mining companies are increasingly referring to corporate social responsibility (CSR) and partnerships in terms of the business case, or the expectation that being responsible and collaborating with stakeholders is good for profits. Based on a case study of platinum and chrome mining in South Africa, this article argues that the business case is circumscribed by companies’ institutional context. In the past, mining companies’ dominant interpretation of CSR has been in terms of charitable donations and support to good causes. These efforts have not alleviated the contribution of mining companies to growing social problems around the mines, primarily because they have not impacted on core business practices and have not contributed to necessary cross‐sectoral collaboration. Recently, however, there has been an important transition involving the broadening of the interpretation of CSR and increasing commitment to these issues amongst corporate leadership. Though market‐based incentives have contributed to this, the key driver has been the State's legislated transformation programme premised on State sovereignty over mineral resources. Hence, while the interrelationship between companies and their institutional context has, in the past, brought about a vicious cycle of irresponsibility and minimal collaboration, this cycle may be reversed into a virtuous one, driven in particular by the State. The broader implication is that references to a business case for CSR and partnerships cannot be relied upon independently of continued efforts at shaping the public sector context of companies.
Quasi-Three-Dimensional Analysis of Cavitation in an Inducer
Authors: Horiguchi Hironori , Arai Souhei , Fukutomi Junichiro , Nakase Yoshiyuki , Tsujimoto Yoshinobu
Published: December 2004

A method for the prediction of steady cavitation in turbopumps is proposed on the assumption that the fluid is inviscid and the stream surface is rotationally symmetric. The analysis in the meridian plane is combined with that in a blade-to-blade stream surface where a singularity method based on a closed cavity model is used. The present method is applied to a helical inducer and it is found that the influence of the three-dimensionality of the flow on cavitation mainly appears as the change of angle of attack associated with the change of meridional velocity caused by the movement of meridian streamline in radial direction.
Very Large-Scale Structures and Their Effects on the Wall Shear-Stress Fluctuations in a Turbulent Channel Flow up to Reτ=640
Authors: Abe Hiroyuki , Kawamura Hiroshi , Choi Haecheon
Published: December 2004

Direct numerical simulation of a fully developed turbulent channel flow has been carried out at three Reynolds numbers, 180, 395, and 640, based on the friction velocity and the channel half width, in order to investigate very large-scale structures and their effects on the wall shear-stress fluctuations. It is shown that very large-scale structures exist in the outer layer and that they certainly contribute to inner layer structures at high Reynolds number. Moreover, it is revealed that very large-scale structures exist even in the wall shear-stress fluctuations at high Reynolds number, which are essentially associated with the very large-scale structures in the outer layer.
Inverse Design and Optimization of a Return Channel for a Multistage Centrifugal Compressor
Authors: Veress A´rpa´d , Van den Braembussche Rene´
Published: December 2004

The design and optimization of a multistage radial compressor vaneless diffuser, cross-over and return channel is presented. An analytical design procedure for 3D blades with prescribed load distribution is first described and illustrated by the design of a 3D return channel vane with leading edge upstream of the cross-over. The analysis by means of a 3D Navier–Stokes solver shows a substantial improvement of the return channel performance in comparison with a classical 2D channel. Most of the flow separation inside and downstream of the cross-over could be avoided in this new design. The geometry is further improved by means of a 3D inverse design method to smooth the Mach number distribution along the vanes at hub and shroud. The Navier–Stokes analysis shows a rather modest impact on performance but the calculated velocity distribution indicates a more uniform flow and hence a larger operating range can be expected. The impact of vane lean on secondary flows is investigated and further performance improvements have been obtained with negative lean.
Automatic phase determination for retrospectively gated cardiac CT
Authors: Manzke R. , Köhler Th. , Nielsen T. , Hawkes D. , Grass M.
Published: December 2004

The recent improvements in CT detector and gantry technology in combination with new heart rate adaptive cone beam reconstruction algorithms enable the visualization of the heart in three dimensions at high spatial resolution. However, the finite temporal resolution still impedes the artifact‐free reconstruction of the heart at any arbitrary phase of the cardiac cycle. Cardiac phases must be found during which the heart is quasistationary to obtain outmost image quality. It is challenging to find these phases due to intercycle and patient‐to‐patient variability. Electrocardiogram (ECG) information does not always represent the heart motion with an adequate accuracy. In this publication, a simple and efficient image‐based technique is introduced which is able to deliver stable cardiac phases in an automatic and patient‐specific way. From low‐resolution four‐dimensional data sets, the most stable phases are derived by calculating the object similarity between subsequent phases in the cardiac cycle. Patient‐specific information about the object motion can be determined and resolved spatially. This information is used to perform optimized high‐resolution reconstructions at phases of little motion. Results based on a simulation study and three real patient data sets are presented. The projection data were generated using a 16‐slice cone beam CT system in low‐pitch helical mode with parallel ECG recording.
Potential third‐party radiation exposure from outpatients treated with for hyperthyroidism
Authors: Matheoud Roberta , Reschini Eugenio , Canzi Cristina , Voltini Franco , Gerundini Paolo
Published: December 2004

Thirty‐three hyperthyroid patients treated with radioiodine (mean administered activity 414 MBq, range 163–555) were studied to determine if pretreatment dosimetry could be used to give radiation protection advice that could assure compliance with the effective dose constraints suggested by the European Commission. Effective doses to travelers, co‐workers, and sleeping partners were estimated by integrating the effective dose rate‐versus‐time curve obtained by fitting the dose rates measured several times after radioiodine administration to a biexponential function. The mean estimated effective doses to travelers, co‐workers, and sleeping partners were 0.11 mSv (0.05–0.24), 0.24 mSv (0.07–0.52), and 1.8 mSv (0.6–4.1), respectively. The best correlation was found between effective dose in mSv and maximum activity in MBq taken up in the thyroid: ; ; . Private/public transports are always allowed. For the co‐workers the effective dose constraint of 0.3 mSv is met without restrictions and with 3 days off work if is lower or higher than 185 MBq, respectively. For the sleeping partners the effective dose constraint of 3 mSv is met without restriction and with 4 nights separate sleeping arrangements if is lower or higher than 185 MBq, respectively. The potential for contamination by the patients was determined from perspiration samples taken from the patient's hands, forehead, and neck and in saliva at 4, 24, and 48 h after radioiodine treatment. The mean highest activity levels for hands, forehead, neck, and saliva were , and , respectively. The results indicate that there is minimal risk of contamination from these patients.
An error‐reduction‐based algorithm for cone‐beam computed tomography
Authors: Zeng Kai , Chen Zhiqiang , Zhang Li , Wang Ge
Published: December 2004

Image reconstruction from cone‐beam projections collected along a single circular source trajectory is commonly done using the Feldkamp algorithm, which performs well only with a small cone angle. In this report, we propose an error‐reduction‐based algorithm to increase the cone angle by several folds to achieve satisfactory image quality at the same radiation dose. In our scheme, we first reconstruct the object using the Feldkamp algorithm. Then, we synthesize cone‐beam projection data from the reconstructed volume in the same geometry, and reconstruct the volume again from the synthesized projections. Finally, these two reconstruction results are combined to reduce the reconstruction error and produce a superior image volume. The merit of this algorithm is demonstrated in numerical simulation.
Dosimetric study of the ROPES eye plaque
Authors: Granero D. , Pérez‐Calatayud J. , Ballester F. , Casal E. , de Frutos J. M.
Published: December 2004

The main aim of this paper is to make a study of dose‐rate distributions obtained around the , radiation oncology physics and engineering services, Australia (ROPES) eye plaque loaded with model 6711 radioactive seeds. In this study, we have carried out a comparison of the dose‐rate distributions obtained by the algorithm used by the Plaque Simulator (PS) (BEBIG GmbH, Berlin, Germany) treatment planning system with those obtained by means of the Monte Carlo method for the ROPES eye plaque. A simple method to obtain the dose‐rate distributions in a treatment planning system via the superposition of the dose‐rate distributions of a seed placed in the eye plaque has been developed. The method uses eye plaque located in a simplified geometry of the head anatomy and distributions obtained by means of the Monte Carlo code GEANT4. The favorable results obtained in the development of this method suggest that it could be implemented on a treatment planning system to improve dose‐rate calculations. We have also found that the dose‐rate falls sharply along the eye and that outside the eye the dose‐rate is very low. Furthermore, the lack of backscatter photons from the air located outside the eye‐head phantom produces a dose reduction negligible for distances from the eye‐plaque but reaches up to 20% near the air‐eye interface. Results showed that the treatment planning system lacks accuracy around the border of the eye (in the sclera and the surrounding area) due to the simplicity of the algorithm used. The BEBIG treatment planning system uses a global attenuation factor that takes into account the effect of the eye plaque seed carrier and the lack of backscatter photons caused by the metallic cover, which in the case of a ROPES eye plaque has a default value of (no correction). In the present study, a global attenuation factor and an air‐interface correction factor which improve on treatment planning system calculations were obtained.
Automated matching of temporally sequential CT sections
Authors: Sensakovic William F. , Armato Samuel G. , Starkey Adam , Ogarek Joseph L.
Published: December 2004

In the evaluation of patient response to therapy through measurements on thoracic computed tomography (CT) scans, the selection of anatomically equivalent sections in temporally sequential scans is required. We developed an automated method based on normalized mutual information (NMI) to expedite the selection of anatomically equivalent sections. The method requires as input two temporally sequential CT scans from the same patient. A specified section from the baseline scan is then compared with the sections of a follow‐up scan. Each section in the follow‐up scan is successively translated and rotated relative to the baseline section, and NMI is calculated. The section in the follow‐up scan that yields the highest NMI with respect to the baseline section is selected as the matching section. The method was applied to a database of 22 pairs of temporally sequential CT scans from mesothelioma patients. Five observers manually selected their choice of the best anatomically matched section for each of three predetermined sections in the 22 baseline scans, and the range of selected sections was recorded. The automated method was applied to the same baseline sections to determine the computer‐based anatomically matched sections in the corresponding follow‐up scan. The automated process was performed using both original CT sections and sections automatically segmented so that only intrathoracic pixels contributed to NMI calculations. The accuracy of the automated method was quantified on a section‐by‐section basis by comparison with the range of sections selected by the observers. The automated method without segmentation selected equivalent sections within the observers' range for 54 of the 66 matching tasks (81.8%). An 11% improvement was achieved when thoracic segmentation was performed as a pre‐processing step.
Image reconstruction algorithm for a spinning strip CZT SPECT camera with a parallel slat collimator and small pixels
Authors: Zeng Gengsheng L. , Gagnon Daniel
Published: December 2004

This paper discusses the use of small pixels in a spinning CdZnTe single photon emission computed tomography (SPECT) camera that is mounted with a parallel slat collimator. In a conventional slat collimation configuration, there is a detector pixel between two adjacent collimator slats. In our design, the pixel size is halved. That is, there are two smaller pixels to replace a regular pixel between two adjacent slats while the collimator remains unchanged. It has an advantage over our older design that uses tilted slats. In order to acquire a complete data set the tilted‐slat collimator must spin 360° at each SPECT view while the proposed design requires only 180° at each SPECT view. Computer simulations and phantom experiments have been carried out to investigate the performance of the small‐pixel configuration. It is observed that this design has the potential to increase the spatial resolution of the detector while keeping photon counts the same.
Development of an integral system test for image‐guided radiotherapy
Authors: Rowbottom Carl G. , Jaffray David A.
Published: December 2004

An integral system test was developed to determine the precision and accuracy of an image‐guided radiotherapy system involving an x‐ray volumetric imaging device mounted onto the gantry of a medical linear accelerator. The test was designed to interrogate the system components as a whole without deconstructing the individual sources of error. The integral system test was based on the imaging of an unambiguous stationary object in the treatment position and so took no account of patient related errors. An array of micromosfets interspersed within slices of a tissue equivalent phantom was developed as an imaging test object. It has previously been demonstrated that micromosfets have a very small active volume, are clearly visible on CT images, and produce no significant artifacts. In addition, the active volume of the micromosfets can be accurately inferred radiographically via the use of x‐ray volumetric imaging. X‐ray volumetric imaging was performed with the object in the treatment position, then reconstructed and transferred to a treatment planning system. With the phantom remaining undisturbed in the treatment position a series of treatment fields were designed to produce a series of fields with the leaf edge sweeping across active volume of the micromosfets. The fields were delivered with a micro‐MLC to dosimetrically verify the position of the mosfets and compare with dose values produced by the treatment planning system. It was demonstrated that the systematic gantry flex could be accounted for by the imaging and delivery systems. For the delivery system small changes in leaf positions of the micro‐MLC were required to account for gantry flex. The position of the micromosfets determined by the 50% dose position was on average away from the position determined radiographically for the and axes, and for the axis. This implies that a margin of approximately in the axial plane and in the superior‐inferior plane would be required at the delineation stage to ensure coverage of a tumor volume to account purely for imprecision in the image‐guided radiotherapy system. The integral system test demonstrated that the image‐guided radiotherapy system is capable, in the absence of patient motion, of imaging an object in the treatment position and delivering dose to that object with submillimeter accuracy.