[Results of a year's use of the turn-table for successive examination of several patients].
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Tables are provided for estimation of the risk of open spina bifida in patients who have elevated maternal serum alpha-fetoprotein levels but normal results on detailed anatomy ultrasonographic scan. Risks are provided for various prior population risks, for various levels of elevated maternal serum alpha-fetoprotein, and for various assumptions about the sensitivity of ultrasonographic examination. The formula used is based on sequential multiplication of odds with the use of Bayes' theorem, but an arbitrary reduction (to the power of 0.5) in the degree to which ultrasonographic information modifies the odds has been made to allow for the nonindependence of ultrasonography and maternal serum alpha-fetoprotein tests. The wide range of resulting risks shows that the decision to offer amniocentesis after a negative scan should be individualized.
Ratio imaging in fluorescence microscopy is used in measuring parameters such as pH, pCa, cytoplasmic porosity, and the relative concentration of fluorescent analogs within single cells. The fastest method for ratio imaging is to use lookup tables on special-purpose image processors. Since lookup tables store integers in integer addresses, using a lookup table will generate rounding errors. The magnitude of the error will depend on the transformation performed and on the number of levels used in the lookup table. We examined ratio imaging by lookup table and computed the errors generated by both inversion and log subtraction methods. Both uniformly fluorescing fields and fluorescing cell images were employed to provide data for use in confirming our calculations and illustrating both the magnitude and spatial incidence of errors. It is shown that, through proper design of lookup tables, a significant reduction can be made in the errors generated in comparison with common methods available in most image processors.
The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.
Magnetic resonance angiography (MRA) is increasingly used as a non-invasive alternative to digital subtraction angiography (DSA). Besides plain time-of-flight (TOF) and phase contrast (PC) MRA a new MRA technique using positive contrast agent has been introduced recently. A fast 3D gradient-echo sequence is applied to reach a significant reduction of measurement time for acquisition of the MRA within the first pass of the contrast agent, thereby avoiding venous overlap. A significant progress was yielded by MR systems allowing manual table movement for examination of the pelvis and the lower limbs in one examination with a single contrast agent bolus. However, in this case it is necessary to have a coworker in the examination room moving the table manually. In this paper we report a prototype system which allows automatic table movement ("floating table"). Using this novel system we examined a patient with an aneurysm of the abdominal aorta and peripheral arterial occlusive disease (PAOD). Diagnostic results of contrast enhanced MRA and DSA were equivalent. In summary, the automatic floating table system introduced in this paper allows comfortable non-invasive examination of pelvic and lower limb arteries. The value of this technique in comparison to DSA has to be determined in future studies.
The digital imaging and communications in medicine (DICOM) standard includes parts regarding nonimage data information, such as image study ordering data and performed procedure data, and is used for sharing information between HIS/RIS and modality systems, which is essential for IHE. To bring such parts of the DICOM standard into force in Japan, a joint committee of JIRA and JAHIS established the JJ1017 management guideline, specifying, for example, which items are legally required in Japan, while remaining optional in the DICOM standard. In Japan, the contents of orders from referring physicians for radiographic examinations include details of the examination. Such details are not used typically by referring physicians requesting radiographic examinations in the United States, because radiologists in the United States often determine the examination protocol. The DICOM standard has code tables for examination type, region, and direction for image examination orders. However, this investigation found that it does not include items that are detailed sufficiently for use in Japan, because of the above-mentioned reason. To overcome these drawbacks, we have generated the JJ1017 code for these 3 codes for use based on the JJ1017 guidelines. This report introduces the JJ1017 code. These codes (the study type codes in particular) must be expandable to keep up with technical advances in equipment. Expansion has 2 directions: width for covering more categories and depth for specifying the information in more detail (finer categories). The JJ1017 code takes these requirements into consideration and clearly distinguishes between the stem part as the common term and the expansion. The stem part of the JJ1017 code partially utilizes the DICOM codes to remain in line with the DICOM standard. This work is an example of how local requirements can be met by using the DICOM standard and extending it.
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