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An interactive, computer-based atlas of neurologic positron emission tomographic studies for use in teaching.

Recent developments in personal computer hardware and software allow the manipulation of radiologic images. We developed an interactive, computer-based atlas of clinical neurologic positron emission tomographic studies for use as an educational resource. A personal computer and multimedia software were used to assemble the clinical case studies. For each clinical case, the user had available the clinical history, positron emission tomographic and correlative anatomic images, study interpretation, discussion, and references. The clinical cases were selected for their educational value, either as a representative example of an abnormality or for their ability to illustrate a common pitfall in positron emission tomographic imaging of the brain.

Central Nervous System Diseases↗

A spatially resolved genomic-molecular atlas of human white-matter microstructure.

Human white matter has been linked to inherited variation, circulating molecular state and brain disease, but these layers have rarely been mapped onto the same tract anatomy. Here we measured genetic effects along 6,090 atlas-aligned fiber pathways sampled at 609,000 locations in 72,185 UK Biobank participants, and integrated proteomic and metabolomic profiles within the same anatomical frame. Genetic effects were not whole-tract properties: each locus formed a spatial footprint along fiber trajectories, ranging from single locations to broad multi-tract patterns and reflecting regional polygenicity rather than tract heritability. This map identified 258, 186 and 298 previously unreported loci for fractional anisotropy, mean diffusivity and axial diffusivity; spatial patterns replicated in adults and 157 of 315 FA loci replicated in adolescence in ABCD. Mendelian randomization linked localized genetic effects to neurodegenerative and psychiatric traits, with Alzheimer's disease showing directional effects across 12 of 17 tracts. Multi-omic analyses identified 97 proteomic and 161 metabolomic associations, with the broadest signals from lipid metabolites including linoleic acid and phosphatidylcholines. The strongest lipid-metabolite and genetic signals converged in the corpus callosum, placing inherited variation, disease risk and systemic lipid metabolism on the same localized tract segments.

Journal Article↗

3D and 4D atlas system of living human body structure.

A reference system for accessing anatomical information from a complete 3D structure of the whole body "living human", including 4D cardiac dynamics, was reconstructed with 3D and 4D data sets obtained from normal volunteers. With this system, we were able to produce a human atlas in which sectional images can be accessed from any part of the human body interactively by real-time image generation.

Anatomy, Cross-Sectional↗

Creation and use of a Talairach-compatible atlas for accurate, automated, nonlinear intersubject registration, and analysis of functional imaging data.

Spatial normalization in functional imaging can encompass various processes, including nonlinear warping to correct for intersubject differences, linear transformations to correct for identifiable head movements, and data detrending to remove residual motion correlated artifacts. We describe the use of AIR to create a custom, site-specific, normal averaged brain atlas that can be used to map T2 weighted echo-planar images and coplanar functional images directly into a Talairach-compatible space. We also discuss extraction of characteristic descriptors from sets of linear transformation matrices describing head movements in a functional imaging series. Scores for these descriptors, derived using principal components analysis with singular value decomposition, can be treated as confounds associated with each individual image in the series and systematically removed prior to voxel-by-voxel statistical analysis.

Anatomy, Artistic↗

[Clinical study of the month. The ATLAS study].

The Atlas Study was set up to compare the efficacy and safety of low doses and high doses of ACE inhibition by lisinopril on the risk of death and hospitalization in chronic heart failure. Three thousand one hundred sixty-four patients with class II to IV heart failure and an ejection fraction below 30% were randomly assigned to double blind treatment with either low doses (2.5-5 mg/daily, n = 1596) or high doses (32.5-35 mg/daily, n = 1568) of the ACE inhibitor lisinopril for 39 to 58 months while background therapy for heart failure was continued. Patients in the high dose group had a non significant 8% lower risk of death (p = 0.128), but a significant 12% lower risk of death or hospitalizations for any reason (p = 0.002) and 24% fewer hospitalizations for heart failure (p = 0.002). Side-effects such as dizziness and renal insufficiency were more frequently encountered in the high dose group, but there was no difference between the two groups in terms of number of patients requiring discontinuation of study medication. These findings indicate that patients with heart failure should not, as too frequently is, be maintained on very low dose of an ACE inhibitor unless this is the only dose that can be tolerated. The patients are expected to benefit more if they receive higher doses close to those used in the large clinical trials which have demonstrated a reduction by ACE inhibition in morbidity and mortality in heart failure.

Angiotensin-Converting Enzyme Inhibitors↗

Atlantoaxial dislocation associated with stenosis of canal at atlas.

Three rare cases of stenosis of spinal canal at the level of atlas associated with atlantoaxial dislocation are presented. An atlantoaxial lateral mass fixation with plate and screws after posterior midline bony decompression was successfully performed in these cases.

Adult↗

[Food photography atlas: its suitability for quantifying food and nutrient consumption in nutritional epidemiological research in Córdoba, Argentina].

UNLABELLED: Food pictures are suitable visual tools for quantize food and nutrient consumption avoiding bias due to self-assessments. OBJECTIVE: To determine the perception of food portion size and to establish the efficacy of food pictures for dietaries assessments. MATERIAL AND METHODS: A food frequency questionnaire (FFQ) including 118 food items of daily consumption was applied to 30 adults representative of Córdoba, Argentina, population. Among several food models (paper maché, plastics) and pictures, those which more accurately filled the purpose were selected. 3 small, median and large standard portion size were determined. Data were evaluated with descriptive statistics tools and Chi square adherence test. RESULTS: The assessment of 51 percent of the food was assayed in concordance with the reference size. In general, the remainder was overestimated. The 90 percent of volunteers concluded that the pictures were the best visual resource. CONCLUSIONS: The photographic atlas of food is an useful material for quantize the dietary consumption, suitable for many types of dietaries assessments. In conclusion, comparison among pictures of three portions previously standardized for each food is highly recommendable.

Adult↗

Functional specializations in human cerebral cortex analyzed using the Visible Man surface-based atlas.

We used surface-based representations to analyze functional specializations in the human cerebral cortex. A computerized reconstruction of the cortical surface of the Visible Man digital atlas was generated and transformed to the Talairach coordinate system. This surface was also flattened and used to establish a surface-based coordinate system that respects the topology of the cortical sheet. The linkage between two-dimensional and three-dimensional representations allows the locations of published neuroimaging activation foci to be stereotaxically projected onto the Visible Man cortical flat map. An analysis of two activation studies related to the hearing and reading of music and of words illustrates how this approach permits the systematic estimation of the degree of functional segregation and of potential functional overlap for different aspects of sensory processing.

Anatomy, Cross-Sectional↗

[Study on digitized atlas of the human brain].

Digitized Human Brain Atlas is an important tool for visualization of medical images and investigation of brain science. This paper describes its fundamentals, development, construction and applications in surgical planning, model-driven segmentation and neuroanatomy teaching.

Algorithms↗

[An computerized fundus atlas system].

This paper presented an computerized fundus atlas system for WINDOWS. The classical normal and abnormal fundus photoes were digitalized and saved in real color image format. The graphics technology was used to label the area and the feature of the abnormal section with WINDOWS atom functions. When these functions run, the graphics and the texts, which label the area of the selected section and describe their features, were displayed in a carton mode background funds image.

Fluorescein Angiography↗

[Current validation of the Greulich and Pyle atlas for the determination of skeletal age].

The radiological atlas of Greulich and Pyle published in 1959 has been validated for the modern measurement of skeletal development in a population of white school-age children from Rotterdam. This is a useful study result. Although contemporary children grow to become much taller than in previous generations, this increased growth potential is apparently realised within the same time span.

Age Determination by Skeleton↗

Hemiarthroplasty for complex fractures of the proximal humerus: surgical technique and results with the Atlas trimodular prosthesis.

The use of the Atlas trimodular prosthesis (Biomet, Inc., Warsaw, Indiana) to treat complex proximal humeral fractures in the acute and chronic setting is described. This prosthesis comprises an independent shaft, neck and head; its high degree of modularity allows the surgeon to match the local anatomy more precisely when sizing the prosthesis. The indications and contraindications for hemiarthroplasty for acute proximal humerus fractures are discussed, together with surgical technique for these fractures and for chronic proximal humerus fractures. Also addressed are chronic posterior fracture-dislocations and the results of arthroplasty for chronic complex fractures of the proximal humerus. Satisfactory results are dependent on proper surgical technique, compliance of the patient with rehabilitation and the absence of postoperative complications.

Arthroplasty, Replacement↗

Budget and financing of mental health services: baseline information on 89 countries from WHO's project atlas.

BACKGROUND: Very little information is available on budget and financing of mental health services in the world. AIMS OF THE STUDY: During year 2001, WHO collected information from all countries on resources available for mental health care as a part of Project Atlas. The present report seeks to describe the situation regarding federal budgets and financing of mental health care at the country level. It also examines the association between relative allocation of health budget to mental health and mental health policy, programme and resource indicators in 89 countries. METHOD: The information was collected through a questionnaire (with an accompanying glossary) that was sent to the mental health focal point in the Ministry of Health of each country. Eighty nine countries provided information on their mental health budget as a proportion of health budget. In addition, information was obtained on policy, programme and mental health resource indicators (beds, personnel, services to special population and availability of drugs). RESULTS: The results showed that 32% of 191 countries did not have a specified budget for mental health. Of the 89 countries that supplied the requisite information 36% spent less than 1% of their total health budget on mental health. Many countries from Africa (79%) and the South East Asia (63%) were in this subgroup. Comparison with the Global Burden of Disease data showed a marked disparity between burden and resources. Lower income countries allocated a lesser proportion of their health budget on mental health in comparison to higher income countries. The primary method of financing mental health care in most countries was tax-based (60.2%), but many low-income countries depended on out-of-pocket expenditure (16.4%). The presence of mental health policies and programmes in general was not associated with the proportion of health budget allocated to mental health. Counties categorized based on the proportion of mental health budget to health budget, differed significantly in terms of policy on disability benefits and mental health resource indicators (beds, personnel, services for special populations and availability of drugs). DISCUSSION AND LIMITATIONS: Federal allocation for mental health care in most countries is low compared to the burden of these disorders. There is also a large disparity among countries and regions. Limitations of the study were, an exclusive reliance on government sources and the difficulty some governments faced in providing accurate information on federal mental health budget as it was not identified separately. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: To use resources more efficiently and judiciously, countries should support integration of services, reallocation of mental health beds, training in mental health to providers and services for special populations. IMPLICATIONS FOR HEALTH POLICIES: Most countries need to increase their mental health budgets in order to provide necessary services. Countries with out-of-pocket payment as the primary method of mental health financing should seek to establish social insurance mechanisms. IMPLICATIONS FOR FURTHER RESEARCH: More research needs to be conducted to gather specific information on mental health financing in relation to policy and service planning.

Budgets↗

A stereotaxic atlas of the monkey frontal lobes.

A stereotaxic atlas of the frontal lobes of M. Arctoides is presented as a consecutive series of line drawings. It is based on six animals. Alternating serial coronal sections stained with cresyl violet or Luxol Fast Blue were produced for each brain. Representative sections were used to prepare line drawings at one-millimeter intervals at a magnification of 4x. The stereotaxic anterior to posterior range is +43 to +20. This line drawing format can be use to recorded electrode placement or document the extent of lesions.

Animals↗

The compilation and edition of the first color atlas of dermatology by Robert Willan (1757-1812), Thomas Bateman (1778-1821), and Ashby Smith (?-1831) from 1790 to 1817.

An account is given of the development of early dermatologic iconography, mostly in watercolors and copper prints, as a consequence of late Enlightenment perspectives and the development of a visually-dependent concept in a text-dominated discipline of dermatology. The first great atlases in the field of dermatology by Robert Willan (1757-1812) and Jean-Louis Alibert (1768-1837), and by M. N. Devergie (1784-1842) in venereology, are addressed and Willan's work is elaborated in detail.

Anatomy, Artistic↗

Creating a statistical atlas of the cranium.

Normative data is very important for simulation procedures in craniofacial surgery. While treating e.g. a malformed skull the surgeon seeks to reconstruct its natural and harmonic shape. Atlas or normative data of the skull could support the surgeon in this effort, as it would provide a standard model of the skull which gives an idea of the natural shape. We create a standard skull by averaging regularly formed skulls in a shape space spanned by spherical harmonics. While state-of-the-art methods use landmarks to define the shape and mean shapes, this method is deterministic, i.e. it manages averaging without landmarks and it provides a complete description of the shape. In addition the shape space can be used to classify shapes to identify different types of an anatomy.

Cephalometry↗

Is the subthalamic nucleus hypointense on T2-weighted images? A correlation study using MR imaging and stereotactic atlas data.

BACKGROUND AND PURPOSE: Although the subthalamic nucleus is the most frequently used target for surgical treatment of Parkinson's disease, the criteria on which it can be identified on T2-weighted images have never been clearly defined. This study was conducted to characterize the precise anatomic distribution of T2-weighted hyposignal in the subthalamic region and to correlate this hyposignal with iron content in the subthalamic nucleus. METHODS: The T2-weighted MR imaging acquisitions of 15 patients with Parkinson's disease were fused with a digitized version of the Schaltenbrand and Wahren anatomic atlas. The MR signal intensity within the anatomic limits of the subthalamic nucleus was evaluated. An anatomic specimen obtained at autopsy was used to evaluate iron content. RESULTS: In all patients, the subthalamic nucleus was hypointense on both sides in the anterior half of the nucleus. At more posterior levels of the nucleus, hypointensity was less frequently observed (20-80%). Hypointensity was never observed at the most posterior pole. Iron was present in the anteromedial part of the nucleus but absent at the most posterior levels. CONCLUSION: The hypointense signal intensity located lateral to the red nucleus and dorsolateral to the substantia nigra correlates with the presence of iron and corresponds anatomically to the subthalamic nucleus. It can therefore be used as a landmark for electrode implantation in patients with Parkinson's disease. It should, however, be emphasized that although hypointensity was always present in the anterior half of the subthalamic nucleus, the posterior part of the nucleus was not visible in most cases.

Adult↗

Histopathological atlas of renal diseases: ANCA-associated vasculitis (Second part).

In the first part of Histopathological Atlas of Renal Diseases we described the typical morphological features of Anca-associated vasculitis. The histological features in Wegener's granulomatosis, Micropolyarteritis and its renal-limited variant, are characterized by "pauci immune" necrotizing extracapillary glomerulonephritis. The cellular composition of glomerular crescent and the mechanisms underlying crescent formation are still incompletely understood. The recent availability of monoclonal antibodies directed against epithelial cells and leucocytes allowed a more precise identification of the crescent cells. In this chapter we will describe the prevalent presence of monocytes in the crescents, the possible mechanisms of recruitment of these cells and the morphological consequences of this glomerular infiltration for the chronic progression of lesions.

Antibodies, Antineutrophil Cytoplasmic↗