Continuing report on the deterioration of x-ray fluoroscopic screens.
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Fluoroscopy↗
Biomedical subjects
K E Weaver
Publications and source records attributed to K E Weaver.
Beam quality measurements in diagnostic roentgenology.
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Absorption↗
A radiation instrument calibration system.
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Radiation↗
Factors related to low contrast resolution in CT scanners.
The concept of "low contrast resolution" in CT scanners is examined. Several questions are raised, not only about limitations to interpretation of figures of merit of low contrast resolution, such as contrast-detail diagrams; but also, interpretation of related CT physical performance parameters, such as: noise, dose, spatial resolution and slice width (or sensitivity profile). Caveats are raised concerning interpretation of contrast-detail studies and the degree to which first-order observer studies are reflective of the actual clinical situation. Particular care is suggested in interpretating contrast-detail diagrams in which sensitivity, specificity and the number of target signals may be varying.
Models, Structural↗
A new software correction approach to volume averaging artifacts in CT.
The nature of artifacts in computed tomography, due to nonlinear partial volume effects, is briefly reviewed. A methodology for correction of these artifacts proposed. This methodology utilizes a correction algorithm for post-processing the original reconstructed CT image. The algorithm utilizes local CT values to predict the probability of volume averaging of bone, air and tissue, and incorporates information from the original image on the spatial extent of the averaging, to correct the nonlinear effects. The algorithm is successfully demonstrated on mathematical phantoms, wherein volume averaging can be introduced over central targets and/or peripheral annuli of tissue, bone, and air. The algorithm is also demonstrated on actual CT brain scans but only for its qualitative effects. It is pointed out that higher order corrections, to be reported in future publications, will further correct the actual clinical scans.
Air↗
Phantoms for specifications and quality assurance of MR imaging scanners.
The accompanying paper examines the subject of NMR phantoms. The paper reports on initial experience with existing phantoms and reviews proposals from various standards groups and professional organizations. Many image tests are illustrated by existing vendor phantoms. The paper concludes that many phantoms already meet or exceed most of the suggestions for tests of classical imaging parameters, which can be pursued by first order adaptations of CT phantoms. The paper does, however, point out the limitations of existing phantoms and raise the possibility of developing phantoms that more accurately reflect human shapes and cavities, and which present more realistic resistive losses, and T1 and T2 values.
Humans↗
Zinc levels and infections in hospitalized patients with AIDS.
Impaired cellular and humoral immunity and phagocytic function have been attributed to zinc deficiency. This study examined the association between low serum zinc concentration and opportunistic infections in hospitalized patients with the acquired immune deficiency syndrome (AIDS). We examined the records from all 505 inpatient consultations performed by our Nutrition Service from May 1992 through June 1994. The medical records from all 228 patients with AIDS with known serum zinc levels (determined by atomic absorption spectrophotometry) were reviewed. The length of HIV seropositivity, most recent CD4 count, presence of diarrhea, and degree of malnutrition were noted. The principal diagnosis accounting for the admission was grouped according to the type of infection: Pneumocystis carinii pneumonia (PCP), viral, fungal, bacterial, and other. Sixty-seven patients (29%) had abnormally low serum zinc levels (LSZ < 55 micrograms/dL), 49 patients (21%) had borderline low serum zinc (BSZ > or = 55 and < or = 65 microgram/dL), and 112 (49%) patients had normal serum zinc levels (NSZ > 65 micrograms/dL). There was no significant difference among the groups in CD4 count, length of HIV seropositivity, presence of diarrhea, or severity of malnutrition. Patients with zinc deficiency (LSZ) had a significantly higher incidence of bacterial infection than did patients with normal zinc. Patients with borderline zinc levels had an intermediate incidence of bacterial infection. There were no significant differences among the three groups in the incidence of PCP, viral, or fungal infections. Severe zinc deficiency was noted in 29% and borderline levels in an additional 21% of hospitalized AIDS patients. A low zinc level was not associated with the length of HIV seropositivity, CD4 count, or degree of malnutrition. Hypozincemia was associated with an increased incidence of concomitant systemic bacterial infections.
AIDS-Related Opportunistic Infections↗
Steatorrhea: a common manifestation in patients with HIV/AIDS.
Multiple infectious causes of diarrhea are known in patients with HIV/AIDS. Maldigestion and malabsorption have been reported in patients with HIV/AIDS and may be independent of infectious etiologies. Among ambulatory patients with HIV/AIDS, we examined the prevalence of fat malabsorption (steatorrhea). Sixty-one patients with unexplained diarrhea (defined as > 2 stools/d) and/or weight loss despite adequate caloric intake (and without clinical evidence of chronic pancreatitis) were evaluated in our outpatient Gastroenterology-Nutrition Clinic between March 1, 1993, and July 1994. Patients were instructed by a dietitian to follow a > or = 100 g/d fat diet for 24 h before submitting a stool sample for qualitative (or quantitative) fecal fat determination. Forty-five patients, 32 with ongoing diarrhea and 13 without diarrhea, submitted stool samples. Twenty-two of 45 patients (49%) had qualitative or quantitative steatorrhea, 16/32 with diarrhea (50%) and 6/13 patients without diarrhea (46%). Thirty of 32 patients with diarrhea had had extensive microbiologic and/or endoscopic evaluations. Only 9 patients had a detectable intestinal pathogen, 5 patients had cytomegalovirus (4 treated), 4 patients had cryptosporidia (3 treated), and 1 patient had microsporidia. Steatorrhea, as determined by abnormal qualitative fecal fat, is detectable in nearly 50% of patients with HIV/AIDS. Fat malabsorption appears to be a primary defect in these patients independent of detectable pathogens. Assessment of fat malabsorption should be considered in patients with unexplained weight loss or diarrhea before extensive evaluation for opportunistic infections.
Acquired Immunodeficiency Syndrome↗
Serum zinc and protein levels: lack of a correlation in hospitalized patients with AIDS.
Abnormally low serum zinc levels are associated with advanced states of malnutrition. Zinc levels are thought to parallel serum albumin, and repletion of zinc has reportedly led to increased albumin. We examined the correlation between zinc deficiency and serum proteins in hospitalized patients with AIDS. Over 500 inpatient consultations were performed by our Gastroenterology-Nutrition Consult Service from May 1992 to June 1994. We reviewed the medical records from all 228 AIDS patients in whom a serum zinc level was measured (by atomic absorption spectrophotometry). The correlation between serum zinc, albumin, prealbumin, and transferrin drawn on the same hospital day was analyzed by linear regression. The patients were stratified by the level of albumin, group A albumin < 2.0 g/dL, group B albumin 2.0-2.9 g/dL, and group C albumin > 3.0 g/dL, to allow comparison of the incidence of diarrhea and mean zinc level by chi square. Thirty-four patients had more than one serum zinc and albumin determination; the change over time was compared by linear regression. Serum zinc and albumin, prealbumin, and transferrin levels did not correlate strongly (r2 < or = 0.01). Furthermore, changes in zinc over time did not correlate with parallel changes in serum albumin (r2 < or = 0.01). In patients grouped by albumin, the proportion of patients with diarrhea did not differ significantly. The mean zinc levels were also not statistically significantly different. Serum zinc levels do not strongly correlate with serum proteins in hospitalized patients with AIDS. Serial measures of zinc over time also do not correlate strongly with changes in albumin. The incidence of diarrhea was not significantly different in patients with hypoalbuminemia or hypozincemia when compared with patients with near normal albumin or zinc. The relationship between zinc and serum proteins in AIDS patients is not linear. Zinc deficiency should be assessed in patients independent of the serum albumin.
Acquired Immunodeficiency Syndrome↗
Comparative image aspects of radiography and computed tomography.
Fundamental image descriptors, including contrast, noise, and resolution, were appropriate for computed tomography. These variables were then used to predict limiting system performance as applied to a model for detection of simple tumor-like signals in a homogeneous surround. The results predict that any intrinsic physical advantages of computed tomography may be restricted to a fairly narrow range of tumor diameters, from a few millimeters to a few centimeters, depending on the relative dose levels and scatter levels present in each imaging system. The results indicate high probable yield for radiographic image manipulation involving independent or, preferably, mutual manipulation of scatter levels, contrast enhancement, kVp techniques, and subtraction techniques, where applied to reduce the highly structured backgrounds that can increase the complexity of diagnosis.
Information Theory↗