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PubMed2004

Transitions: noninvasive coronary angiography using electron beam computed tomography: technique, clinical application, future prospective.

Electron beam computed tomography has been available clinically for 20 years. It is the only computed tomography scanner specifically developed for cardiac imaging. Over the past decade, with improvements in methodology and computer software, electron beam computed tomography has been shown to provide an excellent method to perform noninvasive coronary angiography. This article looks at the historical aspects of electron beam computed tomography and comments on how to perform and interpret electron beam angiography studies. The expanding development of noninvasive coronary and peripheral angiography methods using computed tomography will have a significant influence on cardiovascular specialists and their practices.

Coronary Angiography↗
PubMed1986

Basic principles of computer technology.

This article explains the functions of the different components of computer systems and how they work together. Covered are computer central processors, various peripheral accessories, and the types of software that control them.

Computers↗
PubMed2005

Objective radiologic analysis of ground-glass opacity aimed at curative limited resection for small peripheral non-small cell lung cancer.

OBJECTIVE: The aim of this study was to evaluate the efficacy of the objective radiologic analysis of high-resolution computed tomographic images of small peripheral non-small cell lung cancer and to select the candidates for curative limited resection. METHODS: High-resolution computed tomographic images of 146 surgically resected T1 N0 M0 peripheral non-small cell lung cancers were analyzed by using National Institutes of Health image software and classified on the basis of the percentage of ground-glass opacity within the tumor. RESULTS: Eighty-seven percent of tumors with ground-glass opacity ratios of 90% to 100% (type I) were diagnosed as noninvasive bronchioloalveolar carcinoma, whereas 55.6% of tumors with ground-glass opacity ratios of 50% to 89% (type II) consisted of adenocarcinoma. Tumors with ground-glass opacity ratios of 50% or more (type I/II) had no nodal involvement, whereas nodal metastases were identified in 20.0% of tumors with ground-glass opacity ratios of 10% to 49% (type III) and 24.4% of tumors with ground-glass opacity ratios of less than 10% (type IV). No tumors with ground-glass opacity ratios of 50% or more showed vessel infiltration, except for one lesion with a ground-glass opacity ratio of 50%. The 3-year disease-free survival was 97.7% for type I/II, 86.1% for type III, and 78.5% for type IV tumors. CONCLUSIONS: The objective quantitative radiologic analysis with National Institutes of Health image software exhibited a good correlation with the histologic classification, pathologic invasiveness, and postoperative outcome of small peripheral lung cancer. Patients with tumors that have ground-glass opacity ratios of greater than 50% are considered to be possible candidates for limited pulmonary resection.

Aged↗
PubMed2005

Quantification of intravenously administered contrast medium transit through the peripheral arteries: implications for CT angiography.

PURPOSE: To prospectively determine the range of aortopopliteal bolus transit times in patients with moderate-to-severe peripheral arterial occlusive disease (PAOD) as a guideline for developing injection strategies for computed tomographic (CT) angiography of peripheral arteries. MATERIALS AND METHODS: The study protocol was approved by the local ethics board, and informed consent was obtained. Twenty patients with PAOD referred for CT angiography of the lower extremities were categorized into two groups, Fontaine stage IIb (group 1) and stage III or IV (group 2), and demographic information was collected. In all patients, a 16-mL test bolus was injected intravenously, and single-level dynamic acquisitions were obtained at the level of the abdominal aorta. After injection of a second 16-mL test bolus, dynamic acquisitions were obtained at the level of the knee (popliteal arteries). Aortopopliteal bolus transit times were calculated by subtracting the time to peak enhancement in the popliteal arteries from that in the aorta. Aortopopliteal transit speeds also were derived. Transit times and speeds were compared graphically between clinical stage groups. The time required for the contrast medium to enhance the entire peripheral arterial tree in patients with PAOD was estimated by using linear extrapolation. RESULTS: Sixteen men and four women with a mean age of 69 years (range, 49-86 years) were included. Twelve patients were included in group 1, and eight patients, in group 2. Aortopopliteal bolus transit times ranged from 4 to 24 seconds (median, 8 seconds) in all subjects, which corresponded to bolus transit speeds of 177 and 29 mm/sec, respectively. Wide overlap of transit times and transit speeds was observed between clinical stage groups. The estimated time needed for the bolus to enhance the entire peripheral arterial tree was 6-39 seconds. CONCLUSION: Aortopopliteal bolus transit times differ widely among patients and may be substantially delayed in all patients with PAOD. Empirical injection protocols should include an injection duration of 35 seconds or more, as well as an increased scanning delay, with table speeds of more than 30 mm/sec.

Aged↗
PubMed2005

Peripheral solitary pulmonary nodule: CT findings in patients with pulmonary emphysema.

PURPOSE: To analyze retrospectively the computed tomographic (CT) features of peripheral noncalcified solitary pulmonary nodules in patients with and those without emphysema. MATERIALS AND METHODS: The authors' institutional review board required neither its approval nor patient informed consent for this retrospective study. The authors retrospectively reviewed 2-mm-thick CT images of 41 nodules (21 malignant, 20 benign) in 41 patients with emphysema (age range, 58-88 years; mean, 71.9 years) and 40 nodules (20 malignant, 20 benign) in 40 patients without emphysema (age range, 50-85 years; mean, 69.2 years). Two radiologists who were unaware of the diagnosis independently evaluated the shape and margin of the nodule, recorded the presence of ground-glass opacities and air bronchograms, and classified nodules into two diagnostic categories: malignant and benign. Final decisions were reached by consensus. For quantitative assessment of the nodules, the fractal dimensions of the nodule interfaces and circularity of the nodule shape were calculated with an image-processing program, and the percentage of the nodule surrounded by emphysema was obtained. Statistical comparisons were made with a chi(2) or Fisher exact test and the Mann-Whitney U test. RESULTS: In patients with emphysema, there were no significant differences in fractal dimension, circularity, or frequency of lobulation or spiculation between malignant and benign nodules. Of the 41 nodules in patients with emphysema, 26 (63%) were correctly diagnosed. Thirteen benign nodules (65%) were diagnosed as malignant in patients with emphysema. Of the 40 nodules in nonemphysematous lungs, 37 (93%) were correctly diagnosed. The mean percentage of emphysema around the nodule was greater for misdiagnosed nodules than for correctly diagnosed nodules (P = .003). CONCLUSION: Malignant and benign nodules associated with emphysema exhibited considerably more overlap in CT features than did nodules in nonemphysematous lungs.

Aged↗
PubMed2000

[Role of transthoracic fine-needle aspiration in the diagnosis of peripheral lung cancer].

The efficacy of transthoracic fine-needle aspiration guided by roentgenotelevision (86 cases) and computed tomography (106 cases) for peripheral lung cancer was studied. Special needles Nos. 18-20G (dia. 1-1.2 mm) and Nos. 22-25G (dia. 0.5-0.7 mm) were used depending on size and site of tumor. Roentgenotelevision imaging proved more informative for small-size tumors (less than 2 cm). Computed tomography offered more advantage in imaging medium- and large-size tumors because it allowed to avoid repeated aspiration and, therefore, reduce the risk of complications.

Adenocarcinoma↗
PubMed1987

Evaluation of peripheral vascular disease by intravenous digital subtraction angiography with the Fuji computed radiography (FCR) system.

Intravenous digital subtraction angiography using Fuji computed radiography system (FCR-DSA) was used to evaluate 57 preoperative patients with clinical manifestations of peripheral vascular disease of lower extremity. With its high contrast resolution and good special resolution, image of FCR-DSA could offer optimal information of vascular abnormality in lower extremity distal to midfoot for the diagnosis and the choice of management.

Adult↗
PubMed1990

The use of selective inhibitors and computer modelling to evaluate the role of specific high affinity cyclic AMP phosphodiesterases in the hormonal regulation of hepatocyte intracellular cyclic AMP concentrations.

Using experimentally derived data for the activities and kinetic constants of hepatocyte cyclic AMP phosphodiesterase isoenzymes together with the derived changes in adenylate cyclase activity, due to stimulation and subsequent desensitization by glucagon, a computer model was established to simulate hepatocyte cyclic AMP metabolism. The established ability of glucagon to activate the 'dense-vesicle' cyclic AMP phosphodiesterase by eliciting its cyclic AMP-dependent phosphorylation was shown on the model to be capable of eliciting a profound reduction in the glucagon-stimulated increase in intracellular cyclic AMP. This was consistent with experimentally derived observations using the compound ICI 118233 which was used to inactivate the 'dense-vesicle' enzyme selectively. The non-hydrolysable adenosine agonist N6 (phenylisopropyl)-adenosine (PIA), which prevents glucagon pre-treatment of hepatocytes blocking the ability of insulin to stimulate the peripheral plasma membrane cyclic AMP phosphodiesterase, is shown here to accentuate the ability of insulin to decrease glucagon-elevated intracellular cyclic AMP concentrations. This effect was obliterated using the compound ICI 63197, a selective inhibitor of the peripheral plasma membrane phosphodiesterase. Computer modelling studies, taking into account experimentally derived actions in insulin in activating the peripheral plasma membrane phosphodiesterase, confirmed the potential of this enzyme to decrease intracellular cyclic AMP concentrations. Modelling of the putative effect of an insulin 'mediator' in activating the two cyclic GMP-stimulated cyclic AMP phosphodiesterase isoenzymes was shown to elicit a decrease in intracellular cyclic AMP concentrations which was comparable to that caused by insulin's action on intact hepatocytes. The relative contribution of each phosphodiesterase form to the metabolism of hepatocyte intracellular cyclic AMP, together with an assessment of the potential effect of inhibition and activation of specific species, was evaluated using the computer model. These experimental and stimulation studies indicate that alterations in the phosphodiesterase activity of the 'dense-vesicle' enzyme, the peripheral plasma membrane enzyme, the cyclic GMP-stimulated cyclic AMP isoforms and the IBMX-insensitive PDE-MQ-II can elicit profound effects upon hepatocyte intracellular cyclic AMP concentrations.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2005

Measurement of peripheral muscle resistance in rats with chronic ischemia-induced paraplegia or morphine-induced rigidity using a semi-automated computer-controlled muscle resistance meter.

In experimental and clinical studies, an objective assessment of peripheral muscle resistance represents one of the key elements in determining the efficacy of therapeutic manipulations (e.g. pharmacological, surgical) aimed to ameliorate clinical signs of spasticity and/or rigidity. In the present study, we characterize a newly developed limb flexion resistance meter which permits a semi-automated, computer-controlled measurement of peripheral muscle resistance (PMR) in the lower extremities during a forced flexion of the ankle in the awake rat. Ischemic paraplegia was induced in Sprague-Dawley rats by transient aortic occlusion (10 min) in combination with systemic hypotension (40 mm Hg). After ischemia the presence of spasticity component was determined by the presence of an exaggerated EMG activity recorded from gastrocnemius muscle after nociceptive or proprioceptive afferent activation and by velocity-dependent increase in muscle resistance. Rigidity was induced by high dose (30 mg/kg, i.p.) of morphine. Animals with defined ischemic spasticity or morphine-induced rigidity were then placed into a plastic restrainer and a hind paw attached by a tape to a metal plate driven by a computer-controlled stepping motor equipped with a resistance transducer. The resistance of the ankle to rotation was measured under several testing paradigms: (i) variable degree of ankle flexion (40 degrees, 50 degrees, and 60 degrees), (ii) variable speed/rate of ankle flexion (2, 3, and 4 sec), (iii) the effect of inhalation anesthesia, (iv) the effect of intrathecal baclofen, (v) the effect of dorsal L2-L5 rhizotomy, or (vi) systemic naloxone treatment. In animals with ischemic paraplegia an increased EMG response after peripheral nociceptive or proprioceptive activation was measured. In control animals average muscle resistance was 78 mN and was significantly increased in animals with ischemic spasticity (981-7900 mN). In ischemic-spastic animals a significant increase in measured muscle resistance was seen after increased velocity (4 > 3 > 2 sec) and the angle (40 degrees > 50 degrees > 60 degrees) of the ankle rotation. In spastic animals, deep halothane anesthesia, intrathecal baclofen or dorsal rhizotomy decreased muscle resistance to 39-80% of pretreatment values. Systemic treatment with morphine induced muscle rigidity and corresponding increase in muscle resistance. Morphine-induced increase in muscle resistance was independent on the velocity of the ankle rotation and was reversed by naloxone. These data show that by using this system it is possible to objectively measure the degree of peripheral muscle resistance. The use of this system may represent a simple and effective experimental tool in screening new pharmacological compounds and/or surgical manipulations targeted to modulate spasticity and/or rigidity after a variety of neurological disorders such as spinal cord traumatic or ischemic injury, multiple sclerosis, cerebral palsy, or Parkinson's disease.

Anesthetics, Inhalation↗
PubMed1987

Mesencephalic hemorrhage and third nerve palsy.

We report the clinical and computed tomography findings in two patients with small mesencephalic hematomas. Both patients presented with unilateral oculomotor paralysis and minor associated neurological symptoms. One patient had pupillary involvement suggestive of a peripheral third nerve lesion. Computed tomography evaluation disclosed small unilateral anterior mesencephalic hematomas involving the oculomotor fascicle. Angiography in both cases and surgery in the first case disclosed no evidence of an arteriovenous malformation or neoplasm. Both patients showed significant clinical improvement within 3 months.

Adolescent↗
PubMed2003

Sclerosing stromal tumor of the ovary: color Doppler findings.

The sclerosing stromal tumor (SST) of the ovary is a distinct benign neoplasm that differs from fibromas, thecomas, luteinized tumors and lipoid cell tumors. It accounts for 6% of ovarian stromal tumors and tends to occur at an earlier age. On gray-scale ultrasound examination, SSTs of the ovary are solid or cystic and multilocular. We describe here, we believe for the first time, the findings on color Doppler imaging of an SST of the ovary. A 29-year-old woman presented with an organic ovarian mass. She underwent a transvaginal ultrasound examination that revealed an echogenic cyst with acoustic shadowing. Color Doppler demonstrated marked peripheral vascularization. Findings on computed tomography and magnetic resonance imaging strongly suggested the preoperative diagnosis of SST of the ovary, which was confirmed at pathology. Association of an echogenic ovarian mass with acoustic shadowing and a high degree of peripheral vascularization may strongly suggest the diagnosis of SST of the ovary.

Adult↗
PubMed2004

A computational study of the binding of propidium to the peripheral anionic site of human acetylcholinesterase.

Combined docking and molecular dynamics (MD) simulations were carried out in order to investigate the binding mode of propidium at the human acetylcholinesterase (HuAChE) peripheral site. Two different docking protocols followed by cluster analyses were performed, allowing the identification of five high-populated and low-energy configuration families. To dynamically explore the behavior of the ligand at the peripheral HuAChE binding site, six complexes (five low-energy and one high-energy) were submitted to 2.5 ns of MD simulations. The representative propidium/HuAChE binding modes were chosen on the basis of both the docking energy score and the dynamic stability of the complexes throughout the MD simulations. The most stable poses of propidium at HuAChE PAS were similar to those experimentally determined with the murine enzyme. We therefore suggest that the present modeling protocol might be used in the dynamic investigation of the interactions of a small-molecule inhibitor with a surface-like binding site of a protein. Finally, because of the biological relevance of the target studied here, the present results can be of interest for the rational design of molecules potentially useful in the treatment of the Alzheimer's disease.

Acetylcholinesterase↗
PubMed1982

[Studies of peripheral nerve conduction velocities in vibrating tool operators].

Vibrating tools such as chain-saws, rock-drills, grinders and tie-tampers have been widely used in many kinds of industries in Japan, causing vibration syndrome among the operators. As is well-known, the syndrome includes disorders of the peripheral circulation in the hands, e.g. Raynaud's phenomenon, and of the peripheral and central nervous systems. As the result of preventive countermeasures to the syndrome during the last decade, the picture of the syndrome has been partly changing especially for the patients among the state forestry workers; for example, the prevalence of the peripheral nerve disorders has been relatively increasing compared with that of Raynaud's phenomenon. Peripheral nerve disorders such as numbness, paresthesia and hypesthesia in the upper limbs tend to be usually cumulative and irreversible. The disorders are very important problem of vibration syndrome from the standpoint of treatment and prevention, though there are only a few reports of the study on the disorders using electrophysiological methods. In order to make objectively clear the peripheral nerve disorders, 236 male vibrating tool operators (= Group V) were examined. The following nerve conduction velocities were measured: (1) Maximal motor nerve conduction velocities (MCV) of the median and ulnar nerves in the forearm. (2) Sensory nerve conduction velocities (SCV) of the median and ulnar nerves in the forearm and palm. (3) Residual latency (RL) of the median and ulnar nerves. Besides, working conditions and complaints relevant to vibration syndrome were examined by using questionnaires. MCVs, SCVs and RLs that were outside of mean +/- 2 S.D. of the control group (= Group C), consisting of 30 healthy men, were evaluated as abnormal. The obtained results led to the following conclusions: (1) All MCVs, SCVs and RLs of Group V were significantly less than those of the control group. In Group V, prevalence of the abnormality in each of forearm SCVs was higher than that in each of MCVs of the corresponding nerves. (2) The difference between the median and ulnar SCV in the palm and the respective SCV in the forearm of each subject was significantly greater for Group V than Group C. (Palm-forearm difference) (3) The difference between the forearm and palmar SCV of the ulnar nerve and the respective velocities of the median nerve was statistically greater for Group V than for Group C. (Ulnar-median difference) (4) Ulnar SCV in the palm of Group V was significantly related to the total operating hours of vibrating tools. (5) There was no significant relation between all the nerve conduction velocities and the white finger attack. But a significant relation was noticed between the prevalence of the abnormal values of ulnar SCV in the palm and the peripheral circulatory function score computed from the data of nail press test and cold immersion test.

Adult↗
PubMed1997

Preliminary results achieved by a computer-assisted system for controlled balloon dilatation of coronary and peripheral arteries.

In percutaneous balloon angioplasty the extent of trauma to the vessel as determined by slope of balloon inflation, peak pressure, and inflation time is crucial to the success of the intervention. These parameters are still not standardized and hence open to the operator. To elucidate this problem, a computer-assisted PTCA system (CAPS) was developed. CAPS is composed of a motor driven unit, a central processing and power unit, and a notebook. A syringe is clamped onto the motor unit and connected to a pressure gauge. CAPS may be linked to all types of balloon catheters. The notebook allows for preselection of peak pressure, slope of pressure increase, and inflation time. During balloon inflation, adjustments are made in a closed-loop system. On a screen, the inflation process is supervised in digital numbers and analogous curves. After the procedure, patient data and inflation curves may be recalled for analysis. In conclusion, CAPS by controlled inflation theoretically may reduce the mechanical trauma to the arteries. Further refinements should aim at gaining information on the lesions' characteristics and on the dilatation process itself.

Angioplasty, Balloon, Coronary↗
PubMed2003

[Oval window canal and CT-diagnosis of peripheral pareses of the facial nerve].

Computed tomography (CT) has examined 200 patients (400 temporal bones) at the age of 0-74 with unaffected facial nerve and 28 patients with symptoms of peripheral paresis or paralysis of the facial nerve of different genesis. Polyposition CT of the temporal bone is an intravital noninvasive method of the Fallopius' canal visualization. The canal is visualized on the tomograms in 100% cases irrespective of the patients' age. The following causes of n. facialis paresis were revealed: neurinoma of the facial nerve, sarcoma of the temporal bone, destruction of the tympanic canal wall in chronic otitis media, fractures of the temporal bone, malformations of the Fallopius' canal in malformations of the temporal bone, stenosis of the canal in fibrous dysplasia. The above alterations of n. facialis canal determine further therapeutic policy.

Brain Injuries↗
PubMed2004

A computational solution of mathematical model for oxygen transport in peripheral nerve.

Time-dependent transport of oxygen in a peripheral nerve by simulating oxygen release, diffusion, chemical reactions and consumption in capillaries and surrounding peripheral nerve tissue using Krogh cylinder symmetry has been studied. Radial diffusion of oxygen is from a capillary to a surrounding cylinder tissue and axial diffusion to arterial distance to veins. A monoexponential or bioexponential function characterizes the approach of the oxygen tension to a new value. The time-dependent transport of oxygen in peripheral nerve with forward and backward reactions has been considered in this mathematical model which makes it different from earlier-studied models. A numerical technique has been used to find the solution.

Blood Flow Velocity↗