bluuebunny/crossref_metadata_2025 huggingface dataset:
Large Litter Rearing Improves Leptin Sensitivity and Hypothalamic Appetite Markers in Offspring of Rat Dams Fed High-Fat Diet During Pregnancy and Lactation
Authors: Sun Bo , Song Lin , Tamashiro Kellie L. K. , Moran Timothy H. , Yan Jianqun
Published: June 2014

Maternal high-fat (HF) diet has long-term consequences on the offspring's metabolic phenotype. Here, we determined the effects of large litter (LL) rearing in offspring of rat dams fed HF diet during gestation and lactation. Pregnant Sprague-Dawley rats were maintained on standard chow (CHOW) or HF diet throughout gestation and lactation. Pups were raised in normal litters (NLs) (10 pups/dam) or LLs (16 pups/dam) during lactation, resulting in 4 groups: CHOW-NL, CHOW-LL, HF-NL, and HF-LL. The offspring were weaned onto to either CHOW or HF diet on postnatal day 21. Male and female pups with maternal HF diet (HF-NL) had greater body weight and adiposity, higher plasma leptin levels, impaired glucose tolerance, abnormal hypothalamic leptin signaling pathways (lower leptin receptor-b [OB-Rb] and signal transducer and activator of transcription 3, higher suppressor of cytokine signaling 3 mRNA expression) and appetite markers (lower neuropeptide Y and Agouti-related peptide mRNA expression), and reduced phospho-signal transducer and activator of transcription 3 level in response to leptin in the arcuate nucleus at weaning, whereas LL rearing normalized these differences. When weaned onto CHOW diet, adult male offspring from HF diet-fed dams continued to have greater adiposity, higher leptin levels, and lower hypothalamic OB-Rb, and LL rearing improved them. When weaned onto HF diet, both adult male and female offspring with maternal HF diet had greater body weight and adiposity, higher leptin levels, impaired glucose tolerance, lower OB-Rb, and higher suppressor of cytokine signaling 3 in hypothalamus compared with those of CHOW dams, whereas LL rearing improved most of them except male OB-Rb expression. Our data suggest that LL rearing improves hypothalamic leptin signaling pathways and appetite markers in an age- and sex-specific manner in this model.
Larval mesenchyme cell specification in the primitive echinoid occurs independently of the double-negative gate
Authors: Yamazaki Atsuko , Kidachi Yumi , Yamaguchi Masaaki , Minokawa Takuya
Published: June 2014

Echinoids (sea urchins) are divided into two major groups – cidaroids (a ‘primitive’ group) and euechinoids (a ‘derived’ group). The cidaroids are a promising model species for understanding the ancestral developmental mechanisms in echinoids, but little is known about the molecular mechanisms of cidaroid development. In euechinoids, skeletogenic mesenchyme cell specification is regulated by the double-negative gate (DNG), in which hesC represses the transcription of the downstream mesenchyme specification genes (alx1, tbr and ets1), thereby defining the prospective mesenchyme region. To estimate the ancestral mechanism of larval mesenchyme cell specification in echinoids, the expression patterns and roles of mesenchyme specification genes in the cidaroid Prionocidaris baculosa were examined. The present study reveals that the expression pattern and function of hesC in P. baculosa were inconsistent with the DNG model, suggesting that the euechinoid-type DNG is not utilized during cidaroid mesenchyme specification. In contrast with hesC, the expression patterns and functions of alx1, tbr and ets1 were similar between P. baculosa and euechinoids. Based on these results, we propose that the roles of alx1, tbr and ets1 in mesenchyme specification were established in the common ancestor of echinoids, and that the DNG system was acquired in the euechinoid lineage after divergence from the cidaroid ancestor. The evolutionary timing of the establishment of the DNG suggests that the DNG was originally related to micromere and/or primary mesenchyme cell formation but not to skeletogenic cell differentiation.
Transcription factors involved in retinogenesis are co-opted by the circadian clock following photoreceptor differentiation
Authors: Laranjeiro Ricardo , Whitmore David
Published: June 2014

The circadian clock is known to regulate a wide range of physiological and cellular processes, yet remarkably little is known about its role during embryo development. Zebrafish offer a unique opportunity to explore this issue, not only because a great deal is known about key developmental events in this species, but also because the clock starts on the very first day of development. In this study, we identified numerous rhythmic genes in zebrafish larvae, including the key transcriptional regulators neurod and cdx1b, which are involved in neuronal and intestinal differentiation, respectively. Rhythmic expression of neurod and several additional transcription factors was only observed in the developing retina. Surprisingly, these rhythms in expression commenced at a stage of development after these transcription factors are known to have played their essential role in photoreceptor differentiation. Furthermore, this circadian regulation was maintained in adult retina. Thus, once mature photoreceptors are formed, multiple retinal transcription factors fall under circadian clock control, at which point they appear to play a new and important role in regulating rhythmic elements in the phototransduction pathway.
Nuclear to cytoplasmic shuttling of ERK promotes differentiation of muscle stem/progenitor cells
Authors: Michailovici Inbal , Harrington Heather A. , Azogui Hadar Hay , Yahalom-Ronen Yfat , Plotnikov Alexander , Ching Saunders , Stumpf Michael P. H. , Klein Ophir D. , Seger Rony , Tzahor Eldad
Published: June 2014

The transition between the proliferation and differentiation of progenitor cells is a key step in organogenesis, and alterations in this process can lead to developmental disorders. The extracellular signal-regulated kinase 1/2 (ERK) signaling pathway is one of the most intensively studied signaling mechanisms that regulates both proliferation and differentiation. How a single molecule (e.g. ERK) can regulate two opposing cellular outcomes is still a mystery. Using both chick and mouse models, we shed light on the mechanism responsible for the switch from proliferation to differentiation of head muscle progenitors and implicate ERK subcellular localization. Manipulation of the fibroblast growth factor (FGF)-ERK signaling pathway in chick embryos in vitro and in vivo demonstrated that blockage of this pathway accelerated myogenic differentiation, whereas its activation diminished it. We next examined whether the spatial subcellular localization of ERK could act as a switch between proliferation (nuclear ERK) and differentiation (cytoplasmic ERK) of muscle progenitors. A myristoylated peptide that blocks importin 7-mediated ERK nuclear translocation induced robust myogenic differentiation of muscle progenitor/stem cells in both head and trunk. In the mouse, analysis of Sprouty mutant embryos revealed that increased ERK signaling suppressed both head and trunk myogenesis. Our findings, corroborated by mathematical modeling, suggest that ERK shuttling between the nucleus and the cytoplasm provides a switch-like transition between proliferation and differentiation of muscle progenitors.
Magnetic resonance angiography.
Authors: Graves M J
Published: June 2014

Magnetic resonance angiography (MRA) permits the non-invasive visualization of blood flow through the effects of moving spins on the magnetic resonance signal. MRA techniques can be divided into two main classifications depending upon the primary effect responsible for contrast in the image. Angiograms can be produced using either the time-of-flight (TOF) or phase contrast (PC) methods. Each method has particular advantages and limitations as an angiographic imaging technique and these are reflected in their respective applications. This review article is intended to outline the scientific and technical development of MRA from its basis in the earliest in vitro nuclear magnetic resonance (NMR) experiments, through the implementation of in vivo angiographic techniques on whole body MRI systems, to the recent rapid expansion in MRA acquisition and processing techniques.
Do non-specific minimal signs in a biennial mammographic breast cancer screening programme need further diagnostic assessment?
Authors: Maes R M , Dronkers D J , Hendriks J H , Thijssen M A , Nab H W
Published: June 2014

Mammographic features such as small vague densities, indefinable microcalcifications, subtle architectural distortions, alone or in combination, are non-specific appearances for breast cancer. These features sometimes precede malignancy and a decisive strategy on how to deal with non-specific minimal signs in a breast cancer screening programme is therefore desirable. After studying the prevalence of these signs in a Dutch Breast Cancer Screening Centre and estimating the risk of participants with these signs acquiring breast cancer within 2 years, we have developed such a strategy. Non-specific minimal signs were seen on the mammograms of 53 of 500 (10.6%) participants, aged 50-70 years, in this programme. After retrospective analysis of the mammograms of 254 patients with screen-detected or interval carcinoma, non-specific minimal signs were detected in 77 cases. Combining the incidence of breast cancer with the difference between the expected number of non-specific minimal signs in the screening programme and its actual occurrence in previous mammograms of patients with breast cancer, the risk of cancer in women with these signs, additional to that of screened women in general (additional risk), is calculated as being 0.5%. Invasive breast cancer in women with previously detected non-specific minimal signs demonstrated a favourable stage at diagnosis (axillary metastasis in 23% vs 37% in cancers without these previous signs, p < or = 0.05). Our strategy for follow-up in case of non-specific minimal signs remains unchanged because of the low additional risk and favourable staging, and is restricted to an invitation for the next screening round in 2 years time.
Renal transplant evaluation with power Doppler sonography.
Authors: Hilborn M D , Bude R O , Murphy K J , Platt J F , Rubin J M
Published: June 2014

This study was performed to determine if the marked variation we had previously noted in the power Doppler sonographic appearance of renal transplants correlated with disease, 22 renal transplants were scanned with power Doppler at 5 MHz, with biopsies being taken within 1 h in 17 kidneys and within 48 h in four other kidneys. Biopsy was not performed in one kidney with distal ureteral obstruction. Biopsy results were complex with many coexistent abnormalities; classification was based upon the predominant abnormality. Cortical vascularity was subjectively evaluated as normal, decreased or markedly decreased, and graded as 0, 1 or 2, respectively, and was compared with biopsy results, serum creatinine levels and resistive index. Cortical vascularity gradings were: 0 (12 cases); 1 (7 cases); and 2 (3 cases). The large number of disease categories (cellular rejection, 11 cases; vascular rejection, 5 cases; IgA nephropathy, 1 case; cyclosporin toxicity, 3 cases; obstruction, 1 case; and lupus nephropathy, 1 case) in relation to the number of vascular grades and number of kidneys precluded statistical analysis of cortical vascularity for rejection. However, vascularity did not appear to correlate with rejection, the three severest cases of vascular rejection having normal (grade 0) vascularity. There was no statistically significant correlation of vascular grade with creatinine levels or resistive index. In conclusion, subjective analysis of the power Doppler sonographic appearance of renal transplants does not appear to aid in their evaluation.
CT measurements of capillary permeability within nodal masses: a potential technique for assessing the activity of lymphoma.
Authors: Miles K A , Kelley B B
Published: June 2014

Analysis of time-attenuation data has enabled CT to measure capillary permeability within the brain and kidney. As yet, such techniques have not been applied to nodal masses in patients with lymphoma. Tumour angiogenesis is known to produce capillaries that exhibit increased permeability and CT measurements of permeability could therefore potentially provide a marker of tumour viability. This study aims to determine the feasibility and limitations of CT measurement of capillary permeability within lymphoma nodal masses. Six patients with biopsy proven lymphoma have been studied. Time-attenuation curves from the aorta and nodal mass were generated from a single-location dynamic sequence of images acquired over 3 min following an intravenous bolus of iopamidol. A nuclear medicine data processing technique, Patlak analysis, was used to calculate capillary permeability and blood volume within the nodal mass. Renal blood vessel permeability was also determined in four patients. Median lymph node permeability to iopamidol was 88.5 microliters min-1 ml-1 (range 36.4-198.5 microliters min-1 ml-1). The correlation coefficient of the linear fit for the Patlak analysis ranged from 0.74 to 0.95 and was greater than 0.9 for regions of interest of 150 pixels or more (256 x 256 matrix). The values for renal permeability (442 microliters min-1 ml-1; range: 349-589 microliters min-1 ml-1) were comparable to those previously reported. Functional images of permeability were also obtained. The study has confirmed the feasibility of CT measurements of capillary permeability within nodal masses. The technique combines anatomical imaging and functional information within one examination and has potential application in monitoring the response of lymphoma to therapy.
A simple and reproducible method for assessing intimal-medial thickness of the common carotid artery.
Authors: Sidhu P S , Desai S R
Published: June 2014

Intimal-medial thickness (IMT) of the inner arterial wall is a marker for early changes of atherosclerosis. In order to assess the IMT of the common carotid artery (CCA), two observers (A and B) examined the far wall of both CCAs of three groups of 10 healthy volunteers on two occasions, separated by a period of 2 weeks. Each observer examined one group, then both examined a third group (A, B and interobserver groups). The distance between the two echogenic lines representing the IMT of the arterial wall of the distal CCA was measured within 1 cm proximal to the carotid bulb. The maximal IMT at this site in the right and left CCAs was measured three times on each side and a mean value calculated. The mean of the absolute value of differences between both assessments was 0.027 mm for observer A, 0.027 mm for observer B and 0.0480 mm between observers. The calculated coefficient of variation was 5.02% for observer A, 5.70% for observer B and 8.98% between observers. The coefficient of repeatability was, 0.074 mm for observer A, 0.070 mm for observer B and 0.128 mm between observers. This method for estimating the IMT provides a reproducible and reliable measurement suitable for routine practice.
Massive enterolithiasis associated with ileal dysgenesis.
Authors: Grassi R , Pinto A , Valente T , Rossi G , Catalano O , Rotondo A , Landolfi V , Del Genio A
Published: June 2014

A 20-year-old man with massive ileal enterolithiasis was investigated with plain radiography, ultrasound, computed tomography, barium follow through and double contrast barium enema. Ileocecal valve agenesis was found at surgery. The enteroliths were located in the distal ileum, which communicated with the large intestine via an ileotransverse fistula.
An audit of knee radiographs performed for general practitioners.
Authors: Morgan B , Mullick S , Harper W M , Finlay D B
Published: June 2014

The Royal College of Radiologists (RCR) has published guidelines concerning indications for imaging investigations. These include plain radiography of the knee, the indications for which are locking or signs of restricted movement. This audit consisted of 1153 knee radiographs in a 9 month period, results of a questionnaire sent to general practitioners (GPs), analysis of radiological reports and returned questionnaires (55% of cases), and subsequent comments from the GPs on receiving these results. Only 50% of cases fall within RCR guidelines, 90% of radiographs were normal or showed degenerative change. In 42% of cases, knee radiographs were requested to confirm previously expected degenerative change, and in 30% patient pressure was a significant factor. Most knee radiographs (87%) result in no significant change in management apart from continuation of symptomatic measures. Application of current guidelines, however, would miss some important diagnoses manifest clinically by persistent pain or effusion, for example loose body or Brodie's abscess. In cases of locking, where a radiograph may miss significant soft tissue abnormality, there was concern that reassurance was often gained by a normal examination. This audit shows that many knee radiographs are unnecessary. The guidelines appear appropriate with the proviso that persistent pain and effusion should be included as indications for investigation. Many GPs report medico-legal considerations as important reasons for unnecessary referrals, although the application of guidelines should be protection against this. The referral rate for knee radiographs before and after the communication of these results has not altered.
In vivo measurement method of ovarian dose during barium enema examinations.
Authors: Lavoie C , Don C
Published: June 2014

Barium enema is currently the most commonly performed fluoroscopic procedure. In general, it is not possible to measure directly gonadal dose in women during this procedure. A measurement method to allow an estimate of radiation dose to the ovaries is described. The method uses thermoluminescent dosimeters attached to the tip of the rectal tube to measure radiation dose during procedures. A series of measurements was made at a university hospital equipped with an image-intensified, camera-based X-ray system and at a private clinic with a mirror-optics X-ray system. Measurements were made on both single contrast and double contrast barium enema examinations. On the image-intensified, camera-based X-ray system, the average results of dose measurements for single and double contrast barium enema were 3.11 mGy and 6.50 mGy and the results for the mirror optics system were 1.57 mGy and 3.64 mGy, respectively.
Radiation exposure during standard and complex interventional procedures.
Authors: Vehmas T
Published: June 2014

Radiation doses given during standard and complex interventional procedures were compared. Screening times, dose-area products, and radiologists' forehead and finger doses were recorded during 28 standard percutaneous drainages and 10 complex drainages (eight combined procedures and two failed procedures). The median screening times (8.75 min) and finger doses (84 microGy) during standard drainages were less than those during complex drainages (20.5 min, p = 0.0005 and 163 microGy, p = 0.0003). Dose-area products and forehead doses were also lower, but not significantly. Previously published series on radiation measurements lack data on complex procedures. This may bias the results, since combined and failed interventions, which are common, are associated with higher radiation exposure than are standard procedures.
A survey of current in vivo radiotherapy dosimetry practice.
Authors: Edwards C R , Grieveson M H , Mountford P J , Rolfe P
Published: June 2014

A questionnaire was sent out to 57 radiotherapy physics departments in the United Kingdom to determine the type of dosemeters used for in vivo measurements inside and outside X-ray treatment fields, and whether any correction is made for energy dependence when the dose to critical organs outside the main beam is estimated. 44 responses were received. 11 centres used a semi-conductor for central axis dosimetry compared with only two centres which used thermoluminescent dosimetry (TLD). 37 centres carried out dosimetry measurements outside the main beam; 25 centres used TLD and 12 centres used a semi-conductor detector. Of the 16 centres measuring the dose at both sites. 11 used a semi-conductor for the central axis measurement, but only four of those 11 changed to TLD for critical organ dosimetry despite the latter's lower variation in energy response. None of the centres stated that they made a correction for the variation in detector energy response when making measurements outside the main beam, indicating a need for a more detailed evaluation of the energy response of these detectors and the energy spectra outside the main beam.
Retained nephrostomy thread providing a nidus for atypical renal calcification.
Authors: Ahn J , Trost D W , Topham S L , Sos T A
Published: June 2014

Percutaneous nephrostomy (PCN) is a commonly performed procedure. The indications have expanded from merely providing emergency decompression of obstruction to being the initial step of many interventional procedures including percutaneous nephrolithotomy, ureteral stenting dilation and biopsy. Nephrostomy tube design has evolved from a simple trocar to the current self-retaining loop catheters. These catheters contain a suture which, when secured, locks the loop of the catheter in order to prevent accidental removal of the catheter. We present a case where incomplete removal of the locking suture providing the nidus for calcification within the renal pelvis.
Comparing the sensitivities and specificities of two diagnostic procedures performed on the same group of patients.
Authors: Hawass N E
Published: June 2014

Studies of diagnostic accuracy are the most commonly performed diagnostic tests. These are carried out by using Decision Matrix tables in which sensitivities, specificities, predictive values and other ratios are calculated and compared. Various recoverable pitfalls and limitations of this method have been reported. This study reports additional further limitations of using this method as a statistical analytical tool. Decision protocol and formulae are presented to show how the sensitivities and specificities of tests are compared in order to make a decision. The study also shows how special tables can be constructed for the four results of comparative diagnostic tests (true positive, true negative, false positive and false negative), and cautions against the use of some 2 x 2 contingency tables. The procedures of how to use these special tables and formulae for comparing sensitivity and specificity and deriving confidence intervals for their difference are presented. It is also shown how it is possible to make a single inference from diagnostic test performance which will permit the determination of which test is better.
An audit of radiotherapy patient doses measured with in vivo semiconductor detectors.
Authors: Adeyemi A , Lord J
Published: June 2014

Uncertainties exist both in the basic data from which a radiotherapy plan is produced and in the process whereby such a plan is translated into the patient set-up during treatment. Individual parts of the radiotherapy process are subject to checks, but the overall accuracy of treatment delivery is not routinely evaluated. In vivo dosimetry by means of a semiconductor detector system can be used to measure the cumulative error in the radiotherapy treatment dose delivered. A direct patient dosimetry system was commissioned and introduced in January 1993 for the routine evaluation of the doses patients receive. Since its introduction a total of 1000 patients have been monitored for a range of radiotherapy applications, comprising 300 breast treatments (6 MV X-rays), 150 head and neck treatments (6 MV X-rays) and 550 pelvis. abdomen and thorax treatments (10 MV X-rays). The results of this audit show that less than 5% of all patients monitored gave a systematic error more than +/- 5% for a single field, or more than +/- 2.5% for the "estimated overall error" in the isocentre dose. The causes of these errors were identified and appropriate action taken where necessary. It is suggested that this method could be used routinely in radiotherapy treatment to assess the overall performance of the treatment process.
Diuretic renography findings in enterovesical fistula.
Authors: Kao P F , Tzen K Y , Chang P L , Chang-Chien C R , Tsai M F , You D L
Published: June 2014

A 73-year-old male presented with a 2 week history of gross haematuria and faecal material in the urine. Bone scan for cancer work-up showed 99T(cm)-MDP radioactivity accumulation in the transverse and descending colon. A 99T(cm)-DTPA diuretic renogram was arranged to study renal function and to determine the location of the enterovesical fistula. Diuretic renography demonstrated extraurinary tract radioactivity in the sigmoid colon in the early images, extending to the descending and transverse colon in the subsequent dynamic images. A sigmoid colon adenocarcinoma with bladder wall invasion and fistula formation was confirmed at surgical operation. The impressive dynamic diuretic renography study in this patient was helpful in determining the location of the fistula and in planning surgical management.
Computed tomography of the chest in diving-related pulmonary barotrauma.
Authors: Reuter M , Tetzlaff K , Warninghoff V , Steffens J C , Bettinghausen E , Heller M
Published: June 2014

Arterial gas embolism due to barotrauma of the lungs is a severe complication in compressed air diving. Precipitating factors are often missed on plain chest radiology. This study was conducted to detect occult lung disease predisposing to the development of pulmonary barotrauma in conditions associated with a change in ambient pressure. During the past 4 years, 11 patients who have suffered pulmonary barotrauma with or without subsequent development of cerebral or spinal arterial gas embolism underwent computed tomography of the chest several days post-injury. Examinations were conducted either using the conventional technique (n = 7) or, more recently, in the spiral mode (n = 4). Chest radiographs were available in all cases. In five patients CT revealed subpleural emphysematous blebs or cysts that were not detected by conventional radiography. Follow-up studies performed in two of these cases several months post-injury showed that the cystic lesions did not resolve. We assume that the lung cysts or blebs are preexisting conditions which caused pulmonary barotrauma. Computed tomography of the chest, preferably in the spiral mode, is recommended in any case of suspected pulmonary barotrauma in order to evaluate the possibility of pre-existing pathology and to predict future fitness to dive.
Predicting late rectal complications following prostate conformal radiotherapy using biologically effective doses and normalized dose-surface histograms.
Authors: MacKay R I , Hendry J H , Moore C J , Williams P C , Read G
Published: June 2014

A model to predict the late normal tissue complication probability (NTCP) of the rectum following conformal therapy is described. The model evaluates the biological consequence of inhomogeneities in the physical dose by computing dose histograms of the biologically effective dose to the surface of the rectum for a given fractionation scheme. A method of normalizing the surface area of the rectum is employed so that the predicted NTCP is independent of the differing cross-sectional size of sections of the rectum, ensuring the NTCP is dependent only on the dose delivered to sensitive rectal tissues. The model has been used to assess severe late rectal complications and the milder RTOG grades 2 and 3 reactions. This model was found to predict severe toxicity levels of 1.7 +/- 0.6% for an accelerated treatment of 50 Gy in 16 fractions commonly employed at this centre. This result lies between the severe toxicities predicted for 60 and 62 Gy delivered in 2 Gy fractions. The model predicts that the average NTCP for severe late effects for nine prostate patients becomes greater than 5% with a fractionation scheme of 70 Gy in 35 fractions, for the four fields treatment. The effects of not treating all fields at each therapy session on rectal toxicity were also investigated. Biologically effective dose-surface histograms show that the dose to the lower surface of the rectum is increased by not treating all fields at each therapy session, but the predicted differences in rectal NTCP are negligible.
MRI of multiple biliary hamartomas.
Authors: Cheung Y C , Tan C F , Wan Y L , Lui K W , Tsai C C
Published: June 2014

Multiple biliary hamartomas (MBH) are uncommon benign malformations of the bile ducts. A case of MBH simulating liver metastases is reported, the diagnosis having been ascertained by US-guided biopsy. US and CT showed multiple hepatic nodules scattering in both lobes of the liver. Angiography showed small hypovascular lesions as well as hypervascular nodules. Only two cases with MRI studies have previously been reported. In this case, the finding was of hepatic cysts containing intermediate signal mural nodules. Demonstrating hepatic cysts with mural nodules on imaging will considerably increase the accuracy of diagnosis.
MRI of inner ear and facial nerve pathology using 3D MP-RAGE and 3D CISS sequences.
Authors: Held P , Fellner C , Fellner F , Seitz J , Graf S , Hilbert M , Strutz J
Published: June 2014

The aim of this study was to evaluate 3D CISS, unenhanced 3D MP-RAGE and contrast enhanced 3D MP-RAGE for the diagnosis of neoplastic, vascular and inflammatory lesions of the cerebellopontine angle, the inner auditory canal, the labyrinth and the facial nerve 42 MR examinations were performed on a total of 38 patients (25 males, 13 females; aged 1-77 years, mean age 43 +/- 20 years) using a 1.5 T MR unit. A T2* weighted 3D CISS sequence (TR 14.65 ms, TE 21 ms, flip angle 65 degrees, voxel size 0.7 x 0.7 x 0.7 mm3) and a T1 weighted 3D MP-RAGE sequence (TR 12.5 ms, TE 5 ms, T1 300 ms, flip angle 15 degrees, voxel size 1.0 x 0.9 x 0.9 mm3) with and without contrast medium (gadolinium-DTPA, 0.1 mmol kg-1 body weight) were used. Results of contrast enhanced 3D MP-RAGE-pathological enhancement was found in the following lesions: schwannomas of the cerebellopontine angle (CPA) and the internal auditory canal (IAC), 4; schwannomas of the IAC, 7 and labyrinthine tumours, 3; posterior fossa lymphoma, 1; meatal meningioma, 1; acute labyrinthitis, 15 and neuritis of the seventh cranial nerve, 10. Results of 3D CISS-filling defects were found with the following lesions: schwannomas of the CPA, the IAC or labyrinth, 14; lymphoma, 1; meningioma, 1; labyrinthine fibrosis, 13 and scar in the IAC, 4. These results suggest that unenhanced and contrast enhanced 3D MP-RAGE and 3D CISS are complementary MR imaging modalities. T1 weighted 3D MP-RAGE is preferred to T1 weighted 2D (turbo) spin echo sequences because of the multiplanar reconstruction possibilities of 3D sequences, which are very useful in the case of the inner ear and facial nerve.
Serum PICP as a bone formation marker in 89Sr and external beam radiotherapy of prostatic bony metastases.
Authors: Papatheofanis F J
Published: June 2014

The clinical management of skeletal metastatic disease is problematic because of the difficulty in treating and accurately monitoring therapy impact and disease progression. This investigation measured serum procollagen type I C-terminal peptide (PICP) concentrations as a semi-quantitative index of bone turnover in patients with metastatic prostatic adenocarcinoma before and following palliative 89Sr chloride therapy. 10 patients with early stage (stage A2, B1 and B2) biopsy-confirmed prostatic adenocarcinoma were investigated (n = 10). Two groups of 10 patients each (n = 10 per group) with advanced (stage D) metastatic prostatic adenocarcinoma who had previously undergone hormonal manipulation were also investigated. One group of patients with scintigraphically documented metastatic bone disease received additional irradiation for new symptomatic bone metastases, whereas the other group received 89Sr chloride therapy. A radioimmunoassay for PICP was used to measure serum concentrations of patients in each of these groups as well as positive and negative controls. The concentration of serum PICP rose from 649 +/- 279 before treatment with external beam radiotherapy to 927 +/- 157 ng ml-1 4 months after therapy (p < 0.05). However, the results demonstrated a four-fold decrease (p < 0.001) in serum PICP in clinical responders to 89Sr chloride therapy versus baseline 4 months after the completion of treatment. The clinical non-responders demonstrated no significant change in PICP concentrations during that interval. This may be due to an increase in untreated bony metastases in the non-89Sr treated group. Although a relatively small representative group of patients was studied, these data demonstrate that serum PICP concentration correlates with clinical response to 89Sr chloride therapy. This objective laboratory technique may be useful for monitoring and predicting the need for 89Sr chloride therapy and optimizing palliative care. It may also be extremely useful in predicting a therapeutic response to such intervention.
Modification of bone marrow radiosensensitivity by medicinal plant extracts.
Authors: Ganasoundari A , Zare S M , Devi P U
Published: June 2014

Withaferin A (WA), a steroidal lactone, and Plumbagin (Pl), a naphthoquinone, from the roots of Withania somnifera and Plumbago rosea, respectively, have been shown to possess growth inhibitory and radiosensitizing effects on experimental mouse tumours. An aqueous extract of the leaves of Ocimum sanctum (OE) was found to protect mice against radiation lethality. Therefore, the radiomodifying effects of the above plant products on the bone marrow of the adult Swiss mouse was studied. Single doses of WA (30 mg kg-1) or Pl (5 mg kg-1) were injected intraperitoneally (ip) and OE (10 mg kg-1) was injected ip once daily for five consecutive days. Administration of extracts was followed by 2 Gy whole body gamma irradiation. Bone marrow stem cell survival was studied by an exogenous spleen colony unit (CFU-S) assay. The effects of WA and Pl were compared with that of cyclophosphamide (CP) and radioprotection by OE was compared with that of WR-2721 (WR). Radiation reduced the CFU-S to less than 50% of normal. WA, CP and Pl significantly enhanced this effect and reduced the CFU-S to almost the same extent (to < 20% of normal), although individually WA and Pl were less cytotoxic than CP. These results indicate that radiosensitization by WA and Pl is not tumour specific. OE significantly increased CFU-S compared with radiotherapy (RT) alone. OE+RT gave a higher stem cell survival (p < 0.05) than that produced by WR+RT. While WR alone had a toxic effect, OE treatment showed no such effect, suggesting that the latter may have an advantage over WR in clinical application.
Quality control programme in mammography: second level quality controls.
Authors: Nassivera E , Nardin L
Published: June 2014

Mammography is the most reliable method by which to detect lesions in the breast. Since contrast between normal and pathological areas in the breast is extremely low, mammographic image quality should reach high standards without exceeding acceptable exposure levels for the breast. A quality control programme in mammography has been implemented. This programme is subdivided into two levels. The first consists of simple daily checks of image quality and film processing, while the second deals with more complex checks of mammographic unit, screen-film system, darkroom, illuminators, viewing conditions and reference dose determination. The values of all the parameters undergoing measurement are compared with the limiting values given by National and International Protocols. This paper describes the second level controls carried out every 6 months by the medical physicist. The parameters described are only those which have been studied and analysed in detail since the quality control programme in mammography was implemented. Such parameters (kilovoltage, focal spot dimension, half value layer, tube output, automatic exposure control system, screen-film characteristic curve and mean glandular dose) were measured during the period 1991-1995 and the results summarised. The values obtained prove the constant correct functioning of the equipment.
Knee tumours--duration and nature of symptoms prior to investigation.
Authors: Dickinson F L , Harper W M , Finlay D B
Published: June 2014

The incidence of most musculoskeletal neoplasms is highest around the knee. Royal College of Radiologists Guidelines for diagnostic imaging state that plain radiographs are not routinely indicated for knee pain without restriction of movement or symptoms of locking. The notes of 19 patients with knee tumours presenting over a 5 year period were analysed. Irrespective of age or the grade of malignancy the majority of patients had symptoms for around 6 months prior to the initial radiograph. Only four patients had symptoms which would have merited radiological investigation under the present Guidelines. Even in these patients the symptoms prior to either pathological fracture or locking would not have come under the Guidelines. There is a case for regarding persistent, unilateral knee pain for longer than 6 weeks as an indication for imaging.
Magnetic resonance imaging of an ovarian mucinous cystadenoma immediately before and after rupture.
Authors: Mullen C J , Burd D , Reuter K L
Published: June 2014

The MRI findings are described in a case of rupture of an ovarian mucinous cystadenoma which occurred during the course of an MR scan. While the rupture was presumed to be spontaneous, possible precipitating factors are discussed.
Comparison of two Hologic DXA systems (QDR 1000 and QDR 4500/A).
Authors: Barthe N , Braillon P , Ducassou D , Basse-Cathalinat B
Published: June 2014

Bone mineral content is reliably measured by dual energy X-ray absorptiometry (DXA), if manufacturers' recommendations and quality control (QC) procedures are followed. Several phantoms (Hologic anthropomorphic spine phantom, the Groupe de Recherche et d'Informations sur les Osteoporoses (GRIO) test objects and the European semi-anthropomorphic phantoms) were used to evaluate reproducibility, linearity, accuracy and spatial resolution of two DXA devices in vitro. These parameters were also evaluated in vivo from measurements performed on 120 volunteer patients. It was found that when one device (a single beam monodetector QDR 1000) is replaced by another (a fan beam multidetector QDR 4500/A), the novel combination of procedures described here, ensures that the accuracy of DXA study results is maintained when both devices are used in succession for the same patient. To study the possible responses in clinical situations, the influence of bone environment (soft and adipose tissues) was also evaluated. In both systems, similar performances (in vitro coefficients of variation of 0.5%) were established. At extreme bone density values, slight differences in linearity were found, as well as differences in accuracy and spatial resolution. Lumbar spine and femoral neck measurements were performed with both systems in 120 volunteers, both measurements being made on the same day. The corresponding bone mineral density (BMD) values were highly correlated (r2 = 0.985 for lumbar spine and 0.948 for the femoral neck), and the mean BMD differences were 0.68% and 0.37% for each anatomical site, respectively. Although small, these differences add to the precision error of the method, which is near 1%. A calibration curve has to be obtained in order that both devices can be equally used in regular clinical study. We concluded that when a DXA system is replaced by a new one, appropriate QC procedures must be strictly observed.
Methods for transferring patient and plan data between radiotherapy treatment planning systems.
Authors: Bedford J L , Oldham M , Hoess A , Evans P M , Shentall G S , Webb S
Published: June 2014

The effectiveness of conformal radiotherapy can ultimately only be assessed by the use of clinical trials. As large multicentre clinical trials become more widespread, methods of transferring patient and plan data between radiotherapy treatment planning systems become increasingly important. In this paper, the general strategy for the transfer of data is discussed, and also illustrated with reference to two specific systems: TARGET 2 (GE Medical Systems) and VOXELPLAN (DKFZ-Heidelberg). The transfer method involves using a computer program to translate the data formats used by each of the two systems for CT scans, patient outlines, plan information and block descriptions. This paper does not address the question of transferring beam data between systems: beam data must first be entered separately into both machines. The physical concepts encountered when transferring plans are described, with specific reference to the two planning systems used. Differences in the strategies used by the two planning systems for definition of irregular field shapes are compared. The dose calculations used by the two systems are also briefly evaluated. Isodoses produced by VOXELPLAN around a circular target volume are found to be up to 3 mm different in location to those produced by TARGET 2, owing to the use of a smooth field shape contour as opposed to a stepped field shape which closely models the leaves of a multileaf collimator. In general, dose distributions generated by both systems are comparable, but some differences are found in the presence of large tissue inhomogeneities. It is concluded that the transfer of patient and plan data between two different treatment planning systems is feasible, provided that any differences in field shape definition methods or dose calculation methods between the two systems are understood.
Bare area abscess: imaging findings and potential communication with the mediastinum.
Authors: Domjan J M , Tung K T , Johnson C
Published: June 2014

The bare area of the liver is not usually visualized by standard cross-sectional imaging techniques except in patients with ascites or subphrenic collections where this area is spared of fluid. We present a case of an abscess in the bare area of the liver with imaging findings and demonstration of a communication with the mediastinum, not previously described.
Rhombencephalosynapsis associated with hand anomalies.
Authors: Aydingöz U , Cila A , Aktan G
Published: June 2014

A case of rhombencephalosynapsis, a very rare disorder characterized by agenesis or hypogenesis of the cerebellar vermis and fusion of the cerebellar hemispheres, is reported with magnetic resonance imaging features. Radiographs showed anomalies in both hands; namely phalangeal hypoplasia and occult polydactyly in the right hand and syndactyly in the left, previously unreported in association with this disorder.
Biphasic cellular repair and implications for multiple field radiotherapy treatments.
Authors: Canney P A , Millar W T
Published: June 2014

Data describing the response of several normal tissues to fractionated irradiation, in terms of a biphasic repair of sub-lethal damage, have now been published. Typical results of such analyses have been taken and applied to a conventional radiotherapy protocol of 60 Gy in 30 daily fractions. The effect of using a four field treatment plan is shown to reduce the biological effect of the radiation schedule by increments dependent upon the time interval between each field in a treatment fraction, with a 10% reduction in the extrapolated dose response (ERD) resulting from a 5 min interfield interval. When applied to tissues having the same repair characteristics as pig skin this reduction in ERD is predicted to result in an approximately 25% reduction in the probability of acute morbidity from a protocol of 60 Gy in 30 fractions. These results imply that the basic LQ model, which is unable to correct for interfield intervals, overestimates the effect on normal tissues of radical clinical protocols, most of which use more than a single field. Increasing the interfield interval could be used to reduce the normal tissue side effects from radical radiotherapy when multiple fields are used.
Tumour-to-normal uptake ratio of 90Y microspheres in hepatic cancer assessed with 99Tcm macroaggregated albumin.
Authors: Ho S , Lau W Y , Leung T W , Chan M , Chan K W , Lee W Y , Johnson P J , Li A K
Published: June 2014

The selective delivery of a high dose of radiation to malignant hepatic tumours by infusion of non-biodegradable yttrium-90 (90Y) microspheres via the hepatic artery while sparing the non-tumorous liver parenchyma depends on the tumour-to-normal uptake ratio (T/N) of the therapeutic radiopharmaceutical. Using intrahepatic arterial technetium-99m macroaggregated albumin (99Tcm-MAA), the effect of tumour type, tumour vascularity assessed by hepatic angiography (HAG), tumour size and the degree of extrahepatic shunting on the T/N was investigated in 377 patients with hepatocellular carcinoma (HCC) and 25 patients with colorectal liver metastases. HCC was shown to have a wider range of T/N (0.2-26.5) compared with liver metastases (2.3-7.2). HCC with vascularity grade 1 on HAG had significantly lower T/N but there was no significant difference in HCC with higher vascularity grades. This confirmed that vascularity on HAG does not predict T/N. Overall there was no correlation between T/N and tumour size. Large tumours (> 20 cm) had a significantly lower T/N, probably due to necrosis in the tumour centres. A decrease in mean T/N with increasing percentages of lung shunting was observed in HCC. Determination of T/N by simulation with 99Tcm-MAA is recommended before internal radiation therapy with 90Y microspheres.
The significance of hepatic lesions associated with small adrenocortical tumours in childhood.
Authors: Cameron F J , Sohaib S A , Scheimberg I , Dicks-Mireaux C
Published: June 2014

Small adrenocortical tumours in children are rarely associated with hepatic pathology. We present two case reports of children with hepatic pathology associated with small adrenal tumours on computed tomography. One child had multiple granulomatous lesions due to toxocariasis and the other had focal nodular hyperplasia. Hepatic lesions seen in association with small adrenal tumours in childhood may represent coincidental rather than metastatic pathology.
Spontaneous bilateral carotid and vertebral artery dissection presenting as a Collet-Sicard syndrome.
Authors: Rees J H , Valentine A R , Llewelyn J G
Published: June 2014

Spontaneous dissection of the internal carotid arteries usually presents with unilateral headache, neck pain, focal ipsilateral cerebral ischaemic symptoms and a Horner's syndrome. Lower cranial nerve palsies are only rarely observed. We report a case of carotid and vertebral dissections presenting as a unilateral palsy of the ninth to twelfth cranial nerves (Collet-Sicard syndrome).
MRI findings of VIIth cranial nerve involvement in sarcoidosis.
Authors: Oki M , Takizawa S , Ohnuki Y , Shinohara Y
Published: June 2014

Right facial nerve palsy in a 58-year-old woman was due to sarcoidosis demonstrated by Gd-DTPA enhanced MRI. Abnormal enhancement of the right VIIth cranial nerve in the distal internal acoustic canal was seen on MRI. The enhancing lesion was smaller after 1 month of prednisolone 50 mg day-1. This is the first report on facial nerve involvement in neurosarcoidosis examined by Gd-DTPA enhanced MRI. The use of Gd-DTPA enhanced MRI with thin slicing, e.g. 3 mm slice thickness and 1 mm interslice gap, is effective in detecting small extramedullary lesions.
Colour ultrasound imaging of blood flow and tissue motion.
Authors: Hoskins P R , McDicken W N
Published: June 2014

Recent years have seen the introduction of a high quality imaging modality which uses the Doppler shift for the study of blood flow and tissue motion. Colour ultrasound technology has now reached a level of maturity and it is, therefore, timely to review its features and consider how colour techniques may develop. This review concentrates on autocorrelator based colour systems. Recent developments are described including colour vector Doppler, contrast agents, 3D display, tissue vascularity assessment and volume flow measurement.