bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparing for and Responding to Pandemic Influenza: Implications for People With Disabilities
Authors: Campbell Vincent A. , Gilyard Jamylle A. , Sinclair Lisa , Sternberg Tom , Kailes June I.
Published: October 2009

State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath.

People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available.
Protecting Vulnerable Populations From Pandemic Influenza in the United States: A Strategic Imperative
Authors: Hutchins Sonja S. , Truman Benedict I. , Merlin Toby L. , Redd Stephen C.
Published: October 2009

Protecting vulnerable populations from pandemic influenza is a strategic imperative. The US national strategy for pandemic influenza preparedness and response assigns roles to governments, businesses, civic and community-based organizations, individuals, and families.

Because influenza is highly contagious, inadequate preparedness or untimely response in vulnerable populations increases the risk of infection for the general population. Recent public health emergencies have reinforced the importance of preparedness and the challenges of effective response among vulnerable populations.

We explore definitions and determinants of vulnerable, at-risk, and special populations and highlight approaches for ensuring that pandemic influenza preparedness includes these populations and enables them to respond appropriately. We also provide an overview of population-specific and cross-cutting articles in this theme issue on influenza preparedness for vulnerable populations.
Changes in Prescribing of Antiviral Medications for Influenza Associated With New Treatment Guidelines
Authors: Hersh Adam L. , Maselli Judith H. , Cabana Michael D.
Published: October 2009

In 2006, the Centers for Disease Control and Prevention recommended discontinuing the use of adamantanes (amantadine and rimantadine) to treat influenza because of high levels of resistance to this class of antivirals. We examined changes in prescribing practices resulting from this recommendation and found that prescribing of adamantanes declined nationwide, with these drugs accounting for approximately 40% of the antivirals prescribed for influenza from 2000 to 2005 and only 2% in 2006. This finding provides evidence of a rapid change in clinical practice associated with the dissemination of treatment guidelines. Evaluating the effectiveness with which public health recommendations are translated into practice is important given the ongoing emergence of resistance to antiviral drugs and a novel H1N1 influenza virus.
Effects of an Ongoing Epidemic on the Annual Influenza Vaccination Rate and Vaccination Timing Among the Medicare Elderly: 2000-2005
Authors: Yoo Byung-Kwang , Kasajima Megumi , Fiscella Kevin , Bennett Nancy M. , Phelps Charles E. , Szilagyi Peter G.
Published: October 2009

Objectives. We assessed short-term responsiveness of influenza vaccine demand to variation in timing and severity of influenza epidemics since 2000. We tested the hypothesis that weekly influenza epidemic activity is associated with annual and daily influenza vaccine receipt.

Methods. We conducted cross-sectional survival analyses from the 2000–2001 to 2004–2005 influenza seasons among community-dwelling elderly using the Medicare Current Beneficiary Survey (unweighted n = 2280–2822 per season; weighted n = 7.7–9.7 million per season). The outcome variable was daily vaccine receipt. Covariates included the biweekly changes of epidemic and vaccine supply at 9 census-region levels.

Results. In all 5 seasons, biweekly epidemic change was positively associated with overall annual vaccination (e.g., 2.7% increase in 2003–2004 season) as well as earlier vaccination timing (P < .01). For example, unvaccinated individuals were 5%–29% more likely to receive vaccination after a 100% biweekly epidemic increase.

Conclusions. Accounting for short-term epidemic responsiveness in predicting demand for influenza vaccination may improve vaccine distribution and the annual vaccination rate, and might assist pandemic preparedness planning.
Learning in Bayesian Games with Binary Actions
Authors: Beggs Alan
Published: October 2009

This paper considers a simple adaptive learning rule in Bayesian games with binary actions where players employ threshold strategies. Global convergence results are given for supermodular games and potential games. If there is a unique equilibrium, players' strategies converge almost surely to it. Even if there is not, in potential games and in the two-player case in supermodular games, any limit point of the learning process must be an equilibrium. In particular, if equilibria are isolated, the learning process converges to one of them almost surely.
Infection With Viruses From Several Families Triggers Autoimmune Diabetes in LEW.1WR1 Rats
Authors: Tirabassi Rebecca S. , Guberski Dennis L. , Blankenhorn Elizabeth P. , Leif Jean H. , Woda Bruce A. , Liu Zhijun , Winans Donald , Greiner Dale L. , Mordes John P.
Published: October 2009

OBJECTIVE

The contribution of antecedent viral infection to the development of type 1 diabetes in humans is controversial. Using a newer rat model of the disease, we sought to 1) identify viruses capable of modulating diabetes penetrance, 2) identify conditions that increase or decrease the diabetogenicity of infection, and 3) determine whether maternal immunization would prevent diabetes.

RESEARCH DESIGN AND METHODS

About 2% of LEW.1WR1 rats develop spontaneous autoimmune diabetes, but disease penetrance is much higher if weanling rats are exposed to environmental perturbants including Kilham rat virus (KRV). We compared KRV with other viruses for diabetogenic activity.

RESULTS

Both KRV and rat cytomegalovirus (RCMV) induced diabetes in up to 60% of LEW.1WR1 rats, whereas H-1, vaccinia, and Coxsackie B4 viruses did not. Simultaneous inoculation of KRV and RCMV induced diabetes in 100% of animals. Pretreatment of rats with an activator of innate immunity increased the diabetogenicity of KRV but not RCMV and was associated with a moderate rate of diabetes after Coxsackie B4 and vaccinia virus infection. Inoculation of LEW.1WR1 dams with both KRV and RCMV prior to pregnancy protected weanling progeny from virus-induced diabetes in a virus-specific manner.

CONCLUSIONS

Exposure to viruses can affect the penetrance of autoimmune diabetes in genetically susceptible animals. The diabetogenicity of infection is virus specific and is modified by immunomodulation prior to inoculation. Maternal immunization protects weanlings from virus-induced diabetes, suggesting that modification of immune responses to infection could provide a means of preventing islet autoimmunity.
Raised Late Pregnancy Glucose Concentrations in Mice Carrying Pups With Targeted Disruption of H19Δ13
Authors: Petry Clive J. , Evans Mark L. , Wingate Dianne L. , Ong Ken K. , Reik Wolf , Constância Miguel , Dunger David B.
Published: October 2009

OBJECTIVE

We have hypothesized that variation in imprinted growth-promoting fetal genes may affect maternal glucose concentrations in pregnancy. To test this hypothesis we evaluated the effects of fetal disruption of murine H19Δ13 on maternal glucose concentrations in pregnancy.

RESEARCH DESIGN AND METHODS

Experimental mice were pregnant females that had inherited the disrupted H19Δ13 from their fathers and were therefore phenotypically wild type due to imprinting; approximately half of their litters were null for H19Δ13 through maternal inheritance of the disrupted gene. In control mice approximately half the litter paternally inherited the disrupted H19Δ13, so the pups were either genetically wild type or phenotypically wild type due to imprinting. Blood glucose concentrations were assessed by intraperitoneal glucose tolerance tests on days 1, 16, and 18 of pregnancy.

RESULTS

There were no differences in the glucose concentrations of control and experimental pregnant mice at day 1. However, at day 16 mothers carrying H19Δ13-null pups had a significantly higher area under the glucose tolerance test curves than controls (1,845 ± 378 vs. 1,386 ± 107 mmol · min · l−1 [P = 0.01]) in association with increasing pregnancy-related insulin resistance. Although this difference lessened toward term, overall, mothers of maternally inherited H19Δ13 mutants had significantly higher glucose concentrations during the last trimester (1,602 ± 321 [n = 17] vs. 1,359 ± 147 [n = 18] mmol · min · l−1 [P = 0.009]).

CONCLUSIONS

This study provides evidence that maternal glucose concentrations in pregnant mice can be affected by targeted disruption of fetal H19Δ13. This implies that variable fetal IGF2 expression could affect risk for gestational diabetes.
Effects of high plasma fentanyl concentrations on minimum alveolar concentration of isoflurane in horses
Authors: Knych Heather K. DiMaio , Steffey Eugene P. , Mama Khursheed R. , Stanley Scott D.
Published: October 2009

Objective—To verify the isoflurane anesthetic minimum alveolar concentration (MAC)-sparing effect of a previously administered target plasma fentanyl concentration of 16 ng/mL and characterize an anticipated further sparing in isoflurane MAC associated with higher target plasma fentanyl concentrations.

Animals—8 horses.

Procedures—Horses were assigned 2 of 3 target plasma fentanyl concentrations (16, 24, and 32 ng/mL), administered in ascending order. Following determination of baseline MAC, horses received a loading dose of fentanyl followed by a constant rate infusion; MAC determination was performed in triplicate at baseline and at each fentanyl concentration. Venous blood samples were collected throughout the study for determination of actual plasma fentanyl concentrations. Recovery from anesthesia was monitored, and behaviors were rated as excellent, good, fair, or poor.

Results—Mean ± SD fentanyl plasma concentrations were 13.9 ± 2.6 ng/mL, 20.1 ± 3.6 ng/mL, and 24.1 ± 2.4 ng/mL for target concentrations of 16, 24, and 32 ng/mL, respectively. The corresponding changes in the MAC of isoflurane were −3.28%, −6.23%, and +1.14%. None of the changes were significant. Recovery behavior was variable and included highly undesirable, potentially injurious excitatory behavior.

Conclusions and Clinical Relevance—Results of the study did not verify an isoflurane-sparing effect of fentanyl at a plasma target concentration of 16 ng/mL. Furthermore, a reduction in MAC was not detected at higher fentanyl concentrations. Overall, results did not support the routine use of fentanyl as an anesthetic adjuvant in adult horses.
Analgesic effects of carprofen and liposome-encapsulated butorphanol tartrate in Hispaniolan parrots (Amazona ventralis) with experimentally induced arthritis
Authors: Paul-Murphy Joanne R. , Sladky Kurt K. , Krugner-Higby Lisa A. , Stading Ben R. , Klauer Julia M. , Keuler Nicholas S. , Brown Carolyn S. , Heath Timothy D.
Published: October 2009

Objective—To evaluate the microcrystalline sodium urate (MSU) method for inducing arthritis in parrots and to compare the analgesic efficacy of long-acting liposome-encapsulated butorphanol (LEBT), carprofen, or a combination of both.

Animals—20 Hispaniolan parrots.

Procedures—MSU was injected into a tibiotarsal-tarsometatarsal (intertarsal) joint to induce arthritis (time 0). Four treatments were compared (LEBT [15 mg/kg, SC] administered once at time 0; injections of carprofen [3 mg/kg, IM, q 12 h] starting at time 0; administration of LEBT plus carprofen; and a control treatment of saline [0.9% NaCl] solution). Weight load testing and behavioral scoring were conducted at 0, 2, 6, 26, and 30 hours.

Results—Injection of MSU into the intertarsal joint induced arthritis, which resolved within 30 hours. Treatment with LEBT or LEBT plus carprofen resulted in significantly greater weight-bearing load on the limb with induced arthritis, compared with the control treatment. Treatment with carprofen alone caused a slight but nonsignificant improvement in weight-bearing load on the arthritic limb, compared with the control treatment. Behaviors associated with motor activity and weight bearing differed between the control and analgesic treatments.

Conclusions and Clinical Relevance—Butorphanol was an effective treatment for pain associated with arthritis, but carprofen administered every 12 hours was insufficient. Injection of MSU to induce arthritis in a single joint was a good method for evaluating tonic pain in parrots, and measurement of the weight-bearing load was accurate for assessment of arthritic pain; however, behavioral changes associated with pain were subtle.
Pathogenicity of an emergent, ovine abortifacient Campylobacter jejuni clone orally inoculated into pregnant guinea pigs
Authors: Burrough Eric R. , Sahin Orhan , Plummer Paul J. , Zhang Qijing , Yaeger Michael J.
Published: October 2009

Objective—To compare pathogenicity of an emergent abortifacient Campylobacter jejuni (IA 3902) with that of reference strains after oral inoculation in pregnant guinea pigs.

Animals—58 pregnant guinea pigs.

Procedures—12 animals were challenged IP with C jejuni IA 3902 along with 5 sham-inoculated control animals to confirm abortifacient potential. Once pathogenicity was confirmed, challenge via oral inoculation was performed whereby 12 guinea pigs received IA 3902, 12 received C jejuni isolated from ovine feces (OF48), 12 received a fully sequenced human C jejuni isolate (NCTC 11168), and 5 were sham-inoculated control animals. After abortions, guinea pigs were euthanized; samples were collected for microbial culture, histologic examination, and immunohistochemical analysis.

Results—C jejuni IA 3902 induced abortion in all 12 animals following IP inoculation and 6 of 10 animals challenged orally. All 3 isolates colonized the intestines after oral inoculation, but only IA 3902 induced abortion. Evidence of infection existed for both IA 3902 and NCTC 11168; however, C jejuni was only recovered from fetoplacental units of animals inoculated with IA 3902. Immunohistochemical analysis localized C jejuni IA 3902 infection to subplacental trophoblasts, perivascular tissues, and phagocytes in the placental transitional zone.

Conclusions and Clinical Relevance—This study revealed that C jejuni IA 3902 was a unique, highly abortifacient strain with the ability to colonize the intestines, induce systemic infection, and cause abortion because of its affinity for the fetoplacental unit. Guinea pigs could be effectively used in the study of septic abortion after oral inoculation with this Campylobacter strain.
Prevalence of clinical abnormalities in cats found to have nonneoplastic middle ear disease at necropsy: 59 cases (1991–2007)
Authors: Schlicksup Michael D. , Van Winkle Thomas J. , Holt David E.
Published: October 2009

Objective—To determine the prevalence of nonneoplastic middle ear disease among cats undergoing necropsy and the prevalence of clinical abnormalities in cats in which nonneoplastic middle ear disease was identified.

Design—Retrospective case series.

Animals—59 cats that underwent necropsy between January 1991 and August 2007.

Procedures—Medical records were searched to identify cats in which nonneoplastic middle ear disease was identified at necropsy. For cats included in the study, data that were recorded included signalment, initial complaint, whether the cat had any clinical signs of middle or external ear disease, whether the cat had upper respiratory tract disease, necropsy diagnosis, gross appearance of the bullae, and reason for euthanasia. Signs of middle ear disease that were considered included unilateral peripheral vestibular disease without motor deficits, Horner syndrome, and facial nerve paralysis.

Results—Of the 3,442 cats that underwent necropsy during the study period, 59 (1.7%) had nonneoplastic middle ear disease. Six of the 59 (10%) cats, including 1 cat that was affected bilaterally, had clinical signs of middle ear disease. Of these, 5 had signs of unilateral peripheral vestibular disease, and 1 had Horner syndrome.

Conclusions and Clinical Relevance—Results suggested that most cats with nonneoplastic middle ear disease did not have associated clinical signs. Findings may be of clinical relevance for cats in which middle ear disease is identified as an incidental finding during computed tomography or magnetic resonance imaging for unrelated diseases.
Detection of a large unnamed Babesia piroplasm originally identified in dogs in North Carolina in a dog with no history of travel to that state
Authors: Holman Patricia J. , Backlund Brianna B. , Wilcox Angela L. , Stone Richard , Stricklin Andrew L. , Bardin Kendall E.
Published: October 2009

Case Description—A 12-year-old 46-kg (101.2-lb) sexually intact male Labrador Retriever was evaluated because of lymphadenomegaly. The dog resided in Texas, and its travel history included many southeastern and eastern shore states but not North Carolina.

Clinical Findings—Following evaluation of the dog, a diagnosis of stage IVa intermediate- to large-cell lymphoma was made. A cyclophosphamide-hydroxydaunorubicin (doxorubicin)-vincristine-prednisone chemotherapy protocol was initiated. One week after the first chemotherapeutic treatment, a routine blood smear evaluation revealed single and paired intraerythrocytic large piroplasms that resembled Babesia canis. Via molecular testing, the organism was identified as a Babesia sp that had been detected previously in dogs in North Carolina.

Treatment and Outcome—The dog was administered imidocarb diproprionate (7 mg/kg [3.2 mg/lb], IM) on 2 occasions (3-week interval). At 1, 4, 15, and 50 weeks after the second treatment, blood samples were analyzed specifically for the North Carolina Babesia sp via PCR assay; the result of each assay was positive.

Clinical Relevance—Because of the morphologic similarity of the large piroplasm detected in dogs in North Carolina to B canis, molecular testing of large piroplasms detected in dogs is needed to definitively identify the infective Babesia sp. In the dog of this report, the infection was not eliminated following treatment with imidocarb diproprionate, which may have been a result of the immunocompromised state of the dog or the drug's ineffectiveness against this parasite. If imidocarb diproprionate is ineffective against the North Carolina Babesia sp, treated dogs may act as reservoirs of infection.
The effects of copper and zinc on biomass and taxonomic composition of algal periphyton communities from the River Gharasou, Western Iran
Authors: Atazadeh Islam , Kelly Martyn , Sharifi Mozafar , Beardall John
Published: October 2009

The effects of copper and zinc on biomass and taxonomic composition of algal periphyton communities from the River Gharasou, Western Iran

Indoor artificial streams were used to evaluate the short-term (24 day) influence of copper and zinc, individually and in combination, on the biomass and taxonomic composition of algal periphyton communities. The effects of Cu (50 μg 1-1) and Zn (1 mg 1-1) were assessed using measurements of biomass, ash-free dry mass (AFDM), chlorophyll-a concentration, taxonomic composition and biovolume. In artificial streams with Cu, Zn and Cu+Zn, there were significant (p > 0.05) reductions of chlorophyll-a concentrations, dry mass and AFDM, and also changes in the species diversity and relative abundances of periphyton species. In artificial streams containing both Cu and Zn the taxonomic composition shifted from a Cyanophyceaen dominated community to one consisting mainly of Chlorophyceae, whilst the relative contribution of Bacillariophyceae was not significantly altered.
The dependencies between the abundance of Chironomus f. l. plumosus and bream (Abramis brama) net catches in a lowland reservoir (Zegrzyński Reservoir, central Poland)
Authors: Prus Paweł
Published: October 2009

The dependencies between the abundance of Chironomus f. l. plumosus and bream (Abramis brama) net catches in a lowland reservoir (Zegrzyński Reservoir, central Poland)

Chironomus f. l. plumosus larvae, a valuable food of bream (Abramis brama (L.)), dominate in the benthos of the extra-littoral zone of the shallow, lowland, eutrophic Zegrzyński Reservoir. Bream is the dominant fish species in this reservoir, making up to 80% of total net catches. During eight years of studies, very regular Chironomus population dynamics were noted in the lotic part of the central, broad basin of the reservoir. There were usually two peaks of the abundance: the higher one in spring, and the much lower one in late summer. Both peaks of Chironomus abundance positively correlated with commercial net catches of bream in the reservoir in particular years. The total bream catch per year in the reservoir studied also correlated positively with the average yearly abundance of Chironomus. The correlation between Chironomus abundance and bream occurrence (measured by commercial net catches) in the reservoir studied suggests that this environment is used by bream mainly as a feeding ground. In the years with a low spring Chironomus peak of abundance, the bream leave the reservoir, searching for food in its inflows - two large, lowland rivers. This corresponds to much lower catches noted in the reservoir in the years of low Chironomus abundance.
The use of the delayed luminescence method for determinations of chlorophyll a concentrations in phytoplankton
Authors: Prokowski Zdzisław
Published: October 2009

The use of the delayed luminescence method for determinations of chlorophyll a concentrations in phytoplankton

Delayed luminescence is the phenomenon of long-lived emission of light by living plants and cyanobacteria after being illuminated with light and put into darkness. This study presents uses of this phenomenon as a tool for monitoring the chlorophyll a concentration in phytoplankton. The luminescence method was used on natural phytoplankton from the surface waters in tributaries supplying Lake Miedwie and compared with the commonly used spectrophotometric method of determining chlorophyll a concentrations.
The application of photoinduced luminescence in research on humic substances of various origins
Authors: Mielnik Lilla
Published: October 2009

The application of photoinduced luminescence in research on humic substances of various origins

This paper discusses preliminary research on using photoinduced luminescence phenomena in determining the structural properties of humic acids extracted from the bottom sediments of two lakes. The lakes examined differ in the hydrochemical parameters of the water body, as well as in the drainage basins surrounding the lakes. Photoinduced luminescence of humic acids was induced with a halogen light of 1500 μmol m-2 s-1 photon flux density. The differences observed are evidence of both the variable qualitative and quantitative contribution of photoluminophors to the structure of the examined humic acids, and of their different photochemical activity. Furthermore, photoinduced luminescence intensity depends on the degree of transformation of the humic acids.
Can poor foraging habitat (an inundated opencast sulphur mine) be attractive to the great crested grebe (Podiceps cristatus)?
Authors: Gwiazda Robert
Published: October 2009

Can poor foraging habitat (an inundated opencast sulphur mine) be attractive to the great crested grebe (Podiceps cristatus)?

During investigations of an inundated opencast sulphur mine (an open, deep water habitat with a relatively small littoral area) only five species of breeding water birds were recorded. The density of breeding great crested grebes Podiceps cristatus was relatively high (c. 1.0-1.1 pairs 10 ha-1 of water, and 1.6-1.8 pairs ha-1 of the macrophyte area) although fish density was very low. High water transparency probably compensated for low prey density, because potential prey could be readily detected. Most of the fish were small and occurred in the upper layers of the water column (they could not live below 10 m where the water was anoxic), so were readily available and easily caught by the grebes.
Development of tools for ecological quality assessment in Polish marine areas according to the Water Framework Directive. Part I - Nutrients
Authors: Łysiak-Pastuszak Elżbieta , Krzymiński Włodzimierz , Lewandowski Łukasz
Published: October 2009

Development of tools for ecological quality assessment in Polish marine areas according to the Water Framework Directive. Part I - Nutrients

Assessment of the ecological status of an aquatic environment according to the European Union Water Framework Directive (WFD) requires the determination of a link between the observed status of the marine ecosystem and catchment loading as well as the establishment of criteria for ecological status definitions. This article presents the results of a study identifying links between environmental pressures in the Polish sector of the Baltic Sea and state parameters applied in the assessment of eutrophication. Strong, statistically significant correlations were found between riverine loads of nutrients and their marine concentrations even in relatively short time data series.
Development of tools for ecological quality assessment in polish marine areas according to the Water Framework Directive. Part II — Chlorophyll-a
Authors: Łysiak-Pastuszak Elżbieta , Krzymiński Włodzimierz , Lewandowski Łukasz
Published: October 2009

Development of tools for ecological quality assessment in polish marine areas according to the Water Framework Directive. Part II — Chlorophyll-a

To implement the EU Water Framework Directive (WFD) it is necessary to establish tools enabling ecological status quantification on the basis of biological indicators, and to assess reference conditions and relevant environmental pressures for the construction of response curves. This study focuses on the Polish sector of the Baltic Sea. A number of statistically significant linear correlations, linking chlorophyll-a concentrations with pressure parameters, were found. Due to the lack of historical data, reference conditions and ecological class boundaries for chlorophyll-a assessment were determined using a simplified mathematical approach.
Development of tools for ecological quality assessment in polish marine areas according to the Water Framework Directive. Part III — Secchi depth
Authors: Łysiak-Pastuszak Elżbieta , Krzymiński Włodzimierz , Lewandowski Łukasz
Published: October 2009

Development of tools for ecological quality assessment in polish marine areas according to the Water Framework Directive. Part III — Secchi depth

The implementation of the EU Water Framework Directive (WFD) requires ecological status quantification on the basis of biological and physico-chemical parameters, and an assessment of reference conditions and relevant environmental pressures for the construction of response curves. In this study the linking of water transparency, a proposed eutrophication indicator, to environmental pressure parameters was examined in the Polish sector of the Baltic Sea. Statistically significant linear correlations were detected between nutrient concentrations in sea water and Secchi depth, and between nutrient riverine loads and Secchi depth. The magnitude of acceptable deviation from reference conditions is also discussed.
Axial Loading of the Spine during CT and MR in Patients with Suspected Lumbar Spinal Stenosis
Authors: Danielson B. I. , Willén J. , Gaulitz A. , Niklason T. , Hansson T. H.
Published: October 2009

Purpose: To evaluate the effect of compressive axial loading in imaging of the lumbar spine in patients with clinically suspected spinal stenosis.

Material and Methods: A total of 84 patients were examined, 50 with CT (after intrathecal contrast administration) and 34 with MR. First the dural sac cross-sectional area (CSA) was determined with the patient in the supine psoas relaxed position (PRP). Then the CSA was determined during supine axial compression in slight extension (ACE), obtained with a specially designed loading device. A measurement error study was performed.

Results: A minimum difference in CSA of 15 mm2 between PRP and ACE was found to be significant. In 40/50 (80%) of CT-examined patients and in 26/34 (76%) of MR-examined patients a significant difference in CSA was found. In 25/84 (30%) of the patients there was a significant difference at more than one level.

Conclusion: for an adequate evaluation of the CSA, CT or MR studies should be performed with axial loading in patients who have symptoms of lumbar spinal stenosis.
Assessment of Image Post-Processing and of Measuring Assistance Tools in Computed Radiography
Authors: Sanfridsson J. , Svahn G. , Ryd L. , Ahl T. L. , Sundén P. , Jonsson K.
Published: October 2009

Purpose: A system for the examination and measurement of the weight-bearing knee was adapted to computed radiography (CR) and to a picture archiving and communication system (PACS). the examination and measurement system was developed on examination equipment used for QUESTOR precision radiography (QPR). for an easier and more standardised localisation of bony landmarks on the screen, 4 measuring assistance tools (MATs) were developed. the aim of this study was to evaluate the usefulness of the tools developed and of image post-processing, specifically as magnification (zoom) and filtering (edge enhancement), by determining intra-observer variation in the measurement of angles and distances.

Material and Methods: the original QPR measurement program, generating 19 angles and distances corrected for parallax and magnification, was converted and installed on a multi-modality workstation (Imtec Image 1200). A CR system (Fuji AC-2) was used for the generation of the related images and the measurements were made on the workstation. Four unilateral examinations of weight-bearing knees were undertaken. These examinations were measured twice under 5 different measurement conditions by 4 viewers.

Results and Conclusions: the most important factor in reducing intra-observer variation was the ability to magnify (zoom) the images. the MATs also reduced variation. Filtering (edge enhancement), however, did not affect precision.
2D Inflow MR Angiography in Severe Chronic Leg Ischemia
Authors: Eklöf H. , Smedby Ö. , Ljungman C. , Karacagil S. , Bergqvist D. , Ahlström H.
Published: October 2009

Purpose: the aim of this study was to compare 2D inflow MR angiography (MRA) with selective X-ray angiography (XRA) in patients with severe chronic leg ischemia.

Material and Methods: In a blinded prospective study, 2D inflow MRA and XRA were compared with regard to evaluation of the arteries distal to the knee in 24 patients (median age 72 years) with severe ischemia; 23 of them had either rest pain or tissue loss. Statistics were calculated with XRA as the reference method.

Results: the interpretations of 2D inflow MRA and XRA showed moderate agreement in the calf arteries but poor agreement in the foot arteries. of the discrepancies, two-thirds were observer-related and only one-third method-related. of all the comparable arteries, 9% showed method-related differences between the two methods. An assessment of MRA using only maximum intensity projections (MIP) resulted in 19% of findings being judged inconclusive whereas all the arteries could be classified when the cross-sectional images were studied on the viewing console.

Conclusion: the agreement between MRA and XRA was good in the calf but questionable in the foot.
Clinical Outcome of Stenting in Superior Vena Cava Syndrome Associated with Malignant Tumors
Authors: Tanigawa Noboru , Sawada S. , Mishima K. , Okuda Y. , Mizukawa K. , Ohmura N. , Toita T. , Ogawa K. , Kobayashi M. , Kobayashi M.
Published: October 2009

Purpose: We analyzed the clinical outcome of treatment with the expandable metallic stent (EMS) for the superior vena cava (SVC) syndrome associated with malignant tumors, and the results were compared with those of radiotherapy.

Material and Methods: of 33 patients with the SVC syndrome, 23 were treated by Gianturco EMS placement and 10 were treated by radiotherapy and/or chemotherapy alone. of the 23 EMS patients, 11 had treatment before EMS placement and 12 had no treatment before EMS placement.

Results: After stenting, the clinical symptoms disappeared in 78% (18/23) of the patients, i.e. in 50% of the patients with intraluminal tumors, and in 93% of those with extrinsic compression. the clinical symptoms improved in 80% of patients who received radiotherapy. the mean duration of survival was 145 days in patients who underwent stenting, and 146 days in those receiving radiotherapy. However, the survival period differed significantly between patients with intraluminal tumors (44.9 days) and those with extrinsic compression (198.6 days). Between patients with previous treatment and those with no previous treatment, there was no significant difference in response rate or in survival period which were 82% versus 75%, and 127 days versus 162 days, respectively.

Conclusion: the clinical symptoms showed similar improvement in patients receiving EMS placement or radiotherapy. EMS placement was effective in relieving clinical symptoms in patients who had failed to respond to radiotherapy.
Transjugular Biopsy of the Liver with an Automated Device
Authors: Gonzalez-Tutor A. , García-Valtuille R. , Cerezal L. , Bustamante M.
Published: October 2009

Purpose: To evaluate the results of transjugular liver biopsies conducted with an automated device.

Material and Methods: Transjugular liver biopsies were conducted on 37 patients. the principal indication was coagulation disorders. the biopsies were performed with a 1.3-mm automated device. Each patient underwent three biopsies: anterior, lateral and posterior. A fourth biopsy was conducted if the first three did not produce at least one core sample that was sufficient for the histologic diagnosis.

Results: Transjugular liver biopsy was successful in all 37 patients. We performed a mean of 3.06 punctures per patient (average 2.86 samples). the length of the samples varied from 5 to 23 mm (mean 13.6 mm). Biopsy specimens were useful for histologic diagnosis in 97% of the cases. No serious complications were caused by the procedure.

Conclusion: the transjugular liver biopsy technique is an efficient way of obtaining tissue samples. the procedure shows a high success ratio and a low complication rate.
Transcatheter Embolization of Celiac Artery Pseudoaneurysm following Pancreaticoduodenectomy for Pancreatic Cancer
Authors: Mori K. , Murata S. , Yoshioka H. , Michishita N. , Kuramochi M. , Oda T. , Saida Y. , Itai Y.
Published: October 2009

A case of transcatheter embolization of a celiac artery pseudoaneurysm in a 70-year-old man is reported. the pseudoaneurysm was considered to be the result of pancreatic anastomotic leakage and an intra-abdominal abscess following pancreaticoduodenectomy with irradiation of 66 Gy for pancreatic carcinoma.

To avoid recanalization of the pseudoaneurysm due to retrograde blood flow, first all branches of the celiac artery were embolized with metallic coils, and then the celiac trunk was also occluded. Hepatic arterial flow was preserved by the right hepatic artery arising from the superior mesenteric artery. After the procedure, the patient had no noticeable complications associated with the embolization nor any recurrence of the pancreatic cancer, and he achieved a 2-year survival.
3D Surface Rendering of Images from Multiple MR Pulse Sequences in the Pre-Operative Evaluation of Hepatic Lesions
Authors: Bjerner T. , Johansson L. , Haglund U. , Ahlström H.
Published: October 2009

Purpose: To develop a method for making three-dimensional (3D) reconstructions of liver vessels and hepatic lesions from different MR data sets.

Material and Methods: To reduce the time required for segmentation and reconstructions, we used T1, T2 and phase contrast angiography, optimised for liver, lesion and vessels respectively. Following segmentation and reconstruction, the different volumes were combined on the same workstation and presented to the surgeon.

Results and Conclusion: Segmentation and reconstruction took 1–2 h. To be able to combine the volumes from the different data sets, certain criteria had to be fulfilled: a) the field of view had to be constant; b) the same volume had to be scanned every time which meant that the slice thickness and the number of slices could be adjusted as long as the volume covered was the same; and c) the positioning of each volume had to be identical between every scan. the resulting 3D reconstruction gave the surgeon a clear appreciation of the different lesions and their relation to the different liver segments in the pre-operative planning of hepatic resections.
Shear Stress in Cerebral Arteries Carrying Saccular Aneurysms
Authors: Rossitti S.
Published: October 2009

Purpose: To investigate whether the branching geometry determines an underlying increase of shear stress (SS) on the vessel wall in cerebral arteries of patients with aneurysms located distally to the circle of Willis. Increased SS is regarded as a major factor in the etiology of intracranial saccular aneurysm. Aneurysms occur commonly in the Willisian arteries, where the role of hemodynamic forces are evident, but they occur also in more peripheral arteries.

Material and Methods: the ratio between SS in the branches and SS in the parent vessel at bifurcations was estimated using exponential relations of vessel caliber. the absolute difference of SS branch ratios in every bifurcation represents the SS gradient at the apex. Cerebral angiograms of 10 patients with aneurysm of the distal anterior cerebral artery were analyzed and compared with normal values from an earlier study.

Results: the branching geometry determines a relatively small but significant increase of SS in branches and of SS gradients at bifurcation apices in cerebral arteries of patients with aneurysm.

Conclusion: the results may reflect increased cerebral vessel tone after sub-arachnoidal hemorrhage, or alternatively an underlying derangement of the regulation of cerebral arterial caliber and SS in these patients.
MR Findings of Primary Central Nervous System Lymphoma in a Child
Authors: Çiftçi E. , Erden I. , Akyar S.
Published: October 2009

MR imaging of a rare case of primary central nervous system lymphoma in a 12-year-old boy with headache and seizure is presented. MR imaging showed a mass lesion located in the corpus callosum. Diagnosis was made by stereotactic biopsy. the patient was treated with radiotherapy. Early control MR imaging showed a decrease in tumor size but after 12 months an increase in tumor size was detected.
Acute Side Effects of Iopromide and Diatrizoate in Urography
Authors: Şahin H. , Bircan M. K. , Akay A. F. , Kuru A. F.
Published: October 2009

Purpose: In a prospective study, we compared the acute (0–2 h) side effects of ionic and nonionic contrast media in 767 patients undergoing intravenous urography.

Material and Methods: A nonionic contrast medium (iopromide) was compared to an ionic contrast medium (diatrizoate).

Results: Side effects occurred in 25 patients (7.9%) receiving iopromide and in 104 patients (23.1%) receiving diatrizoate ( p<0.01). the reactions in the iopromide group were mild in 11 patients, moderate in 5, and severe in 1. the reactions were 83, 19 and 2, respectively, in the diatrizoate group. the number of reactions that required treatment was equal in the two groups ( p>0.05).

Conclusion: At intravenous urography, iopromide induced fewer side effects compared to diatrizoate.
Ligaments and Tendons of the Ankle
Authors: Rand T. , Mo Ahn J. , Muhle C. , Garcia M. , Resnick D.
Published: October 2009

Purpose: To investigate the value of MR imaging using a low-field imaging unit (0.2 T) for the evaluation of ligaments and tendons of the ankle.

Material and Methods: Twelve ankle specimens were studied using low-field MR imaging (0.2 T). the Achilles tendon, the tibialis posterior tendon, and the lateral collateral ligaments were evaluated for the presence of degenerative changes and partial and complete tears. Visibility and overall image quality were analyzed by qualitative evaluation.

Results: Low-field MR images of the 24 tendons were interpreted as normal in 11 cases, showing degenerative changes in 9 cases and a partial tear in 1 case. Visualization was regarded as not sufficient for a diagnosis in 3 cases. of the 36 ligaments, 14 were regarded as normal while degenerative changes were seen in 5 cases and a tear in 2 cases. In 13 cases, no diagnosis could be established, and in 2 cases only a probable diagnosis was established. the best overall quality was obtained with the use of T1 spin-echo (680/20/4) and T2 multi-echo (3000/40/1) images.

Conclusion: Optimized protocols for examination of the ankle using low-field MR imaging may allow evaluation of the Achilles and tibialis posterior tendons, but these protocols may not be as useful for diagnosing ligamentous changes.
MR Imaging of the Liver Using an Ultrafast 3D Multi-Shot EPI Sequence
Authors: Papanikolaou N. , Karantanas A. , Lavdas E.
Published: October 2009

Purpose: To compare a 3D echo planar imaging (EPI) sequence with four other T1-weighted sequences for imaging of the liver at 1 T.

Material and Methods: Twenty volunteers were included in our imaging protocol. Spin-echo (SE), turbo SE (TSE), turbo field echo (TFE) in 2D and 3D acquisition mode, fast field echo (T1-FFE) and 3D EPI sequences were applied. Signal-to-noise (S/N) ratio of the liver, contrast-to-noise (C/N) ratio and relative contrast (ReCon) between the liver and the spleen, scanning time per slice and artifact levels were evaluated.

Results: 3D EPI provided a statistically equivalent S/N ratio of the liver with SE and T1-FFE sequences ( p > 0.05), while it provided a statistically higher S/N ratio of the liver compared to TFE sequences ( p < 0.05). The TSE technique provided a statistically higher S/N ratio of the liver compared to 3D EPI ( p < 0.05). With regard to the liver-spleen C/N ratio, 3D EPI provided statistically equivalent results compared to all sequences except T1-FFE, where 3D EPI was superior. With regard to liver-spleen ReCon, 3D EPI was statistically equivalent to SE, TSE and T1-FFE, while it provided significantly higher liver-spleen ReCon than 3D TFE and significantly lower than 2D TFE.

Conclusion: 3D EPI provided sufficient ReCon and C/N ratio and produced motion-free images in one breath-hold period. Further clinical studies are required to estimate the sensitivity, specificity and accuracy of the sequence.
Perfusion CT of the Brain in the Assessment of Flow Alterations during Brachytherapy of Meningioma
Authors: Bondestam S. , Halavaara J. T. , Jääskeläinen J. E. , Kinnuen J. J. , Hamberg L. M.
Published: October 2009

Purpose: the aim was to investigate the use of perfusion CT of the brain in the assessment of flow alterations during brachytherapy of meningiomas.

Material and Methods: Six patients with an intracranial meningioma were investigated during brachytherapy treatment by stereotactic implantation of I-125 seeds. Cerebral blood flow (CBF) in the tumour centre and the tumour periphery as well as in the normal brain parenchyma was determined by perfusion CT. Follow-up examinations were performed during the first year after the implantation. the CBF of the normal brain parenchyma was used as control.

Results: In the beginning of therapy, the mean±SEM blood flow in the tumour centre was 231.4±58.1 ml/100 g/min and in the periphery 223.5±53.8 ml/100 g/min. Within three months after the iodine seed implantation, the tumour blood flow had decreased 41%. At the one-year follow-up, the tumour blood flow in the centre had decreased to 68.7±45.9 ml/100 g/min. In the periphery of the tumour, it remained nearly unchanged (199.3±101.0 ml/100 g/min). the CBF values obtained from normal brain parenchyma did not decrease during the treatment. Throughout the study, the mean CBF for the normal grey matter was 38.5±2.9 ml/100 g/min, and 22.3±1.2 ml/100 g/min for the normal white matter.

Conclusion: Perfusion CT seems to enable accurate monitoring of the blood flow of meningiomas during brachytherapy, and could be used in clinical situations where blood flow changes in brain and tumours should be investigated.
Hypoplasia of the Sphenoid Sinuses as a Diagnostic Tool in Cystic Fibrosis
Authors: Eggesbø H. B. , Eken T. , Eiklid K. , Kolmannskog F.
Published: October 2009

Purpose: To measure and compare the size of the sphenoid sinuses in patients with cystic fibrosis (CF) to patients with inflammatory sinonasal disease, and to correlate the size with number of CF mutations in each patient.

Material and Methods: Ninety-six CF patients aged 5–47 years (median 19 years) and 130 control patients aged 7–51 years (median 32 years) were examined using coronal CT of the paranasal sinuses. In each patient, the CT image with the largest coronal area of the sphenoid sinuses was scanned into a Macintosh computer with image processing and analysis software. Largest coronal area and largest circumference of the right and left sphenoid sinuses were automatically measured. Additionally, antero-posterior extension of the sphenoid sinuses was calculated from the lateral scanograms. CF patients were grouped according to number of confirmed mutations (CF-0, CF-1, or CF-2).

Results: CF patients generally had small sphenoid sinuses. the largest differences for all parameters were observed between the CF-2 and the control groups (p<0.0001). No CF-2 patient had pneumatization beyond the presphenoid. the CF-0 and CF-1 groups consisted of two populations, one overlapping the CF-2 group and another overlapping the control group.

Conclusion: Hypoplasia of the sphenoid sinuses is a characteristic finding in CF patients. When pneumatization of the basisphenoid is present, the existing CF diagnosis should be questioned.
Evaluation of Planar Scintimammography with 99mTc-MIBI in the Detection of Axillary Lymph Node Metastases of Breast Carcinoma
Authors: Danielsson R. , Boné B. , Perbeck L. , Aspelin P.
Published: October 2009

Purpose: the aim of our prospective study was to evaluate the role of planar scintimammography with 99mTc-MIBI in detecting axillary lymph node metastases in women with primary breast carcinoma.

Material and Methods: Fifty-eight patients underwent scintimammography prior to axillary lymph node dissection. Ten minutes after injection of 700 MBq 99mTc-MIBI, two prone lateral projections were obtained, followed by a supine anterior projection. Sixty-one axillae (3 bilateral) were operated upon and the status of the lymph nodes verified with histopathology. the scintigraphic result was compared to the histopathologic findings.

Results: A sensitivity of 67% and a specificity of 80% of planar scintimammography in detecting axillary lymph node metastases were achieved.

Conclusion: Scintimammography with 99mTc-MIBI is not recommended as a routine method for the detection of axillary lymph node metastases in patients with breast carcinoma.