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Sample records for functional diagnostic work-up

  1. Anorectal function testing and anal endosonography in the diagnostic work-up of patients with primary pelvic organ prolapse

    NARCIS (Netherlands)

    A.G. Groenendijk (Annette); E. Birnie (Erwin); G.E. Boeckxstaens (Guy); J-P.W. Roovers (Jan-Paul); G.J. Bonsel (Gouke)

    2009-01-01

    textabstractAIM: To study the pathophysiology of defecation disorders in patients with primary pelvic organ prolapse (POP) and the diagnostic potential of anorectal function testing (AFT) including endosonography in the work-up of these patients. METHODS: 59 Patients were evaluated with a validated

  2. Anorectal function testing and anal endosonography in the diagnostic work-up of patients with primary pelvic organ prolapse

    NARCIS (Netherlands)

    Groenendijk, Annette G.; Birnie, Erwin; Boeckxstaens, Guy E.; Roovers, Jan-Paul W.; Bonsel, Gouke J.

    2009-01-01

    AIM: To study the pathophysiology of defecation disorders in patients with primary pelvic organ prolapse (POP) and the diagnostic potential of anorectal function testing (AFT) including endosonography in the work-up of these patients. METHODS: 59 Patients were evaluated with a validated

  3. Cost-effectiveness of functional cardiac imaging in the diagnostic work-up of coronary heart disease.

    Science.gov (United States)

    Pletscher, Mark; Walker, Simon; Moschetti, Karine; Pinget, Christophe; Wasserfallen, Jean-Blaise; Greenwood, John P; Schwitter, Juerg; Girardin, François R

    2016-07-01

    The aim of this study was to assess the cost-effectiveness of eight common diagnostic work-up strategies for coronary heart disease (CHD) in patients with stable angina symptoms in Switzerland. A decision analytical model was used to perform a cost-effectiveness comparison of eight common multitest strategies to diagnose CHD using combinations of four diagnostic techniques: exercise treadmill test (ETT), single-photon emission computed tomography (SPECT), cardiac magnetic resonance imaging (CMR), and coronary angiography (CA). We used a Markov state transition model to extrapolate the results over a life-time horizon, from a third-party payer perspective. We used a CHD prevalence rate of 39% in patients and a base-case scenario with 60-year-old male patients with intermediate symptom severity Canadian Cardiovascular Society grading of angina pectoris 2 and at least one cardiovascular (CV) risk factor but without a history of myocardial infarction and without need for revascularization. Among the eight work-up strategies, one strategy was dominant, i.e. least costly and most effective: ETT followed by CMR if the ETT result was inconclusive and then CA if the CMR result was positive or inconclusive. The CMR features a favourable balance between false-negative diagnoses, associated with an elevated risk of CV events, and false-positive diagnoses, leading to unnecessary CA and related mortality. Key parameters guiding the diagnostic strategy are the prevalence of CHD in patients with angina symptoms and the diagnostic costs of CA and CMR. Cardiac magnetic resonance imaging appears to be a cost-effective work-up strategy compared with other regimens using SPECT or direct CA. Cardiac magnetic resonance imaging should be more widely recommended as a diagnostic procedure for patients with suspected angina symptoms.

  4. Diagnostic work-up in cardiomyopathies

    DEFF Research Database (Denmark)

    Rapezzi, Claudio; Arbustini, Eloisa; Caforio, Alida L P

    2013-01-01

    In 2008, The ESC Working Group on Myocardial and Pericardial Diseases proposed an updated classification of cardiomyopathies based on morphological and functional phenotypes and subcategories of familial/genetic and non-familial/non-genetic disease. In this position statement, we propose a framew...... conventional cardiological assessment with non-cardiac and molecular parameters increases diagnostic accuracy and thus improves advice and treatment for patients and families....... a framework for the clinical approach to diagnosis in cardiomyopathies based on the recognition of diagnostic 'red flags' that can be used to guide rational selection of specialized tests including genetic analysis. The basic premise is that the adoption of a cardiomyopathy-specific mindset which combines...

  5. The diagnostic work-up of women with postmenopausal bleeding

    NARCIS (Netherlands)

    van Hanegem, N.

    2015-01-01

    In this thesis we describe the diagnostic work-up that can be used to diagnose or exclude endometrial cancer in women with postmenopausal bleeding. Despite the many studies investigating this, there is no consensus in literature. The diagnostic steps vary in different guidelines, depending on the

  6. Splenomegaly - Diagnostic validity, work-up, and underlying causes

    DEFF Research Database (Denmark)

    Curovic Rotbain, Emelie; Lund Hansen, Dennis; Schaffalitzky de Muckadell, Ove

    2017-01-01

    to an internal medical department and can be caused by a large spectrum of diseases, including haematological diseases and liver cirrhosis. However, some patients remain without a causal diagnosis, despite extensive medical work-up. PATIENTS AND METHODS: We identified 129 patients through the DNRP, that had been...... given the ICD-10 splenomegaly diagnosis code in 1994-2013 at Odense University Hospital, Denmark, excluding patients with prior splenomegaly, malignant haematological neoplasia or liver cirrhosis. Medical records were reviewed for validity of the splenomegaly diagnosis, diagnostic work...

  7. GPs' perspectives on the diagnostic work-up in patients with shoulder pain: a qualitative study.

    Science.gov (United States)

    Ottenheijm, Ramon P G; Hesselmans, Nicolle J J M; Kemper, Anouk; Moser, Albine; de Bie, Rob A; Dinant, Geert-Jan; Cals, Jochen W L

    2014-06-01

    The diagnostic work-up of patients with shoulder pain in general practice is complex. General practitioners' (GPs) guidelines advise a pragmatic diagnostic work-up in which additional imaging has a limited role. However, diagnostic ultrasounds are increasingly ordered by GPs, which seems to reflect complexity in management of shoulder pain. This study aimed to explore GPs' perspectives on the diagnostic work-up of patients with shoulder pain. This study has a qualitative exploratory design with an inductive approach and was carried out in Dutch general practice. The study population consisted of 18 Dutch GPs who were sampled purposefully with a spread in clinical experience and ordering diagnostic ultrasound. Data were gathered by means of semi-structured interviews and analysed following principles of the constant comparative method. Three main categories with subcategories emerged that captured the diagnostic work-up of shoulder pain: variety in diagnostic classifications [(non-)specific diagnosis and interdisciplinary differences], establishing strategies for diagnostic work-up (use of existing tools and motives to deviate from existing tools), and strategies dealing with diagnostic uncertainties (accepting diagnostic uncertainties, diagnostic imaging tests, and interdisciplinary consultation and referral). Despite the availability of evidence-based shoulder guidelines, GPs experience uncertainties during diagnostic work-up and apply different strategies when dealing with these uncertainties. At some point, GPs as well as patients seem to have a need for a specific diagnosis. Currently, there appears to be little agreement if, or in which phase of shoulder pain, diagnostic ultrasound is useful or indicated. © 2014 John Wiley & Sons, Ltd.

  8. Effects of Diagnostic Work-Up on Medical Decision-Making for Canine Urinary Tract Infection

    DEFF Research Database (Denmark)

    Sørensen, T M; Bjørnvad, C R; Cordoba, G

    2018-01-01

    dipstick (99%), microscopic examination of urine (80%) and bacterial culture (56%). Fifty-one percent of dogs had urinary tract infection (UTI) based on reference QBC. Appropriate DTT was made for 62% of the dogs, while 36% were over-prescribed and 2% under-prescribed. Inappropriate use of second......BACKGROUND: Clinical signs of urinary tract disease in dogs often lead to prescription of antibiotics. Appropriate diagnostic work-up could optimize treatment and reduce the risk of inappropriate use of antibiotics. HYPOTHESIS/OBJECTIVES: To describe and evaluate the impact of diagnostic work......-up on decision to treat (DTT) and choice of antibiotic treatment (COT) for dogs presenting with clinical signs of urinary tract disease. ANIMALS: One hundred and fifty-one dogs presenting to 52 Danish veterinary practices. METHODS: Prospective, observational study. Clinical signs, diagnostic work...

  9. Improving the existing diagnostic strategy by accounting for characteristics of the women in the diagnostic work up for postmenopausal bleeding

    NARCIS (Netherlands)

    Opmeer, B. C.; van Doorn, H. C.; Heintz, A. P. M.; Burger, C. W.; Bossuyt, P. M. M.; Mol, B. W. J.

    2007-01-01

    OBJECTIVES: The aim of this study was to evaluate whether the efficiency of the current diagnostic work up following postmenopausal bleeding could be improved by diagnostic strategies that take into account characteristics of the women in addition to the currently recommended transvaginal

  10. The diagnostic work up of growth failure in secondary health care; An evaluation of consensus guidelines

    Directory of Open Access Journals (Sweden)

    Dekker Friedo W

    2008-05-01

    Full Text Available Abstract Background As abnormal growth might be the first manifestation of undetected diseases, it is important to have accurate referral criteria and a proper diagnostic work-up. In the present paper we evaluate the diagnostic work-up in secondary health care according to existing consensus guidelines and study the frequency of underlying medical disorders. Methods Data on growth and additional diagnostic procedures were collected from medical records of new patients referred for short stature to the outpatient clinics of the general paediatric departments of two hospitals (Erasmus MC – Sophia Children's Hospital, Rotterdam and Spaarne Hospital, Haarlem between January 1998 and December 2002. As the Dutch Consensus Guideline (DCG is the only guideline addressing referral criteria as well as diagnostic work-up, the analyses were based on its seven auxological referral criteria to determine the characteristics of children who are incorrectly referred and the adequacy of workup of those who are referred. Results Twenty four percent of children older than 3 years were inappropriately referred (NCR. Of the correctly referred children 74–88% were short corrected for parental height, 40–61% had a height SDS Conclusion Existing guidelines for workup of children with suspected growth failure are poorly implemented. Although poorly implemented the DCG detects at least 5% pathologic causes of growth failure in children referred for short stature. New guidelines for referral are required with a better sensitivity and specificity, wherein distance to target height should get more attention. The general diagnostic work up for short stature should include testing for celiac disease in all children and for Turner syndrome in girls.

  11. Non-traumatic cortical subarachnoid haemorrhage: diagnostic work-up and aetiological background

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    Spitzer, C.; Kosinski, C.M. [University Hospital of RWTH Aachen, Department of Neurology, Aachen (Germany); Mull, M. [University Hospital of RWTH Aachen, Department of Neuroradiology, Aachen (Germany); Rohde, V. [University Hospital of RWTH Aachen, Department of Neurosurgery, Aachen (Germany)

    2005-07-01

    Only 15% of all subarachnoid haemorrhages (SAHs) are not of aneurysmal origin. Among those, circumscribed SAHs along the cortical convexity are rare and have only been described in singular case reports so far. Here, we present a collection of 12 cases of SAH along the convexity, of non-traumatic origin. Over a period of 10 years, 12 cases of circumscribed SAH along the convexity were identified at our clinic. The clinical presentations, neuroradiological SAH characteristics, further diagnostic work-up to identify the underlying aetiologies, the therapy and clinical outcome were analysed. The patients' chief complaints were unspecific cephalgia, focal or generalised seizures and focal neurological deficits. Typical signs of basal SAH, such as nuchal rigidity, thunderclap-headache or alteration of consciousness, were rare. Magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) revealed different aetiologies, namely postpartal posterior encephalopathy (three), cerebral vasculitis (two), dural sinus thrombosis (two), cortical venous thrombosis (one), intracerebral abscesses (one) and cerebral cavernoma (one). Two cases remained unresolved. Treatment of the underlying disease and symptomatic medication led to good clinical outcome in almost all cases. On the basis of these findings, we demonstrate that the clinical presentation, localisation and aetiology of cortical SAH differ clearly from other SAHs. A diagnostic work-up with MRI and eventually DSA is essential. Mostly, the causative disease can be identified, and specific treatment allows a favourable outcome. (orig.)

  12. TU-D-209-01: Dosimetry of Diagnostic Work Up Mammography

    Energy Technology Data Exchange (ETDEWEB)

    Jallow, N [Emory University, Atlanta, GA (United States); Sechopoulos, I [Radboud University Medical Centre, Nijmegen (Netherlands)

    2016-06-15

    Purpose: To investigate patient average glandular dose (AGD) characteristics of diagnostic mammography. Methods: The techniques used to image 14420 patients who received diagnostic work up mammography from October 2008 to December 2014 at one academic hospital were retrospectively collected. The most common diagnostic views and the techniques used for each according to compressed breast thickness were determined. For all techniques, 1st half value layer and air kerma output per tube current-exposure time product were measured; then the incident air kerma for each acquisition was calculated. The values for normalized glandular dose (DgN) were obtained with a validated Monte Carlo simulation of mammographic acquisition. The mono-energetic DgN results were combined according to relative fluence using the TASMICS model to obtain DgN coefficients for each spectrum. The spectral DgN and calculated incident air kerma were used to estimate AGD of patients with breast thickness ranging from 2 to 8 cm. Results: The most common views utilized during diagnostic mammography were magnification craniocaudal (24%), magnification mediolateral (19%), spot craniocaudal (28%), and spot mediolateral oblique (24%). The AGD increased with increasing breast thickness for both the magnification and spot views. The AGD for a 5.5 cm thick breast was approximately 6.8 mGy and 2.2 mGy for the magnification and spot views, respectively. The AGD ranged from 3.6 mGy to 6.8 mGy for the magnification views and from 1.0 mGy to 3.1 mGy for spot views. The difference in AGD between the two magnification views or the two spot views was not significant. Conclusion: These results provide information on breast dose to which screening recalled women are exposed to. In addition to understanding the dose used for common clinical imaging tests, this data could be used when comparing use of mammography for diagnostic workup to other potential modalities, such as breast tomosynthesis and breast CT.

  13. The Appropriate Use of Neuroimaging in the Diagnostic Work-Up of Dementia

    Science.gov (United States)

    2014-01-01

    Background Diagnosis of dementia is challenging and requires both ruling out potentially treatable underlying causes and ruling in a diagnosis of dementia subtype to manage patients and suitably plan for the future. Objectives This analysis sought to determine the appropriate use of neuroimaging during the diagnostic work-up of dementia, including indications for neuroimaging and comparative accuracy of alternative technologies. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published between 2000 and 2013. Review Methods Data on diagnostic accuracy and impact on clinical decision making were abstracted from included studies. Quality of evidence was assessed using GRADE. Results The search yielded 5,374 citations and 15 studies were included. Approximately 10% of dementia cases are potentially treatable, though less than 1% reverse partially or fully. Neither prediction rules nor clinical indications reliably select the subset of patients who will likely benefit from neuroimaging. Clinical utility is highest in ambiguous cases or where dementia may be mixed, and lowest for clinically diagnosed Alzheimer disease or clinically excluded vascular dementia. There is a lack of evidence that MRI is superior to CT in detecting a vascular component to dementia. Accuracy of structural imaging is moderate to high for discriminating different types of dementia. Limitations There was significant heterogeneity in estimates of diagnostic accuracy, which often prohibited a statistical summary of findings. The quality of data reported by studies prohibited calculation of likelihood ratios in the present analysis. No studies from primary care were found; thus, generalizability beyond tertiary care settings may be limited. Conclusions A diagnosis of reversible dementia is rare. Imaging has the most

  14. Feasibility of dynamic MR-hysterosalpingography for the diagnostic work-up of infertile women

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    Winter, Leopold; Gluecker, Thomas; Steinbrich, Wolfgang; Pegios, Wassilios (Dept. of Radiology, Univ. Hospital Basel (Switzerland)), e-mail: winterl@uhbs.ch; Steimann, Sabine; De Geyter, Christian (Women' s Hospital, Univ. Hospital Basel (Switzerland)); Froehlich, Johannes M. (Guerbet AG, Zuerich (Switzerland))

    2010-07-15

    Background: Tubal disturbances often contribute to infertility. Conventional hysterosalpingography (HSG) is considered as standard in the assessment of the patency of the fallopian tubes, but requires ionizing radiation and is restricted to the imaging of endoluminal structures. Purpose: To evaluate dynamic magnetic resonance-HSG (dMR-HSG) in the diagnostic work-up in patients with infertility. Material and Methods: Thirty-seven consecutive infertile women underwent dMR-HSG: 20 ml of gadolinium-polyvidone solution (18.4 mM Dotarem 1:20 with polyvidone) were injected intracervically through a 5-Charriere balloon catheter while acquiring five consecutive flash-3D T1-weighted MR sequences with fat saturation. Two experienced readers assessed image quality and anatomic-pathologic correlations prospectively. The relevance of results was evaluated in the clinical context of each patient. Patient comfort was evaluated with a standardized questionnaire. Results: dMR-HSG was successfully completed in 33/37 patient with an average study time of 45 min. In 4 of 37 patients the catheter became dislodged during the examination, resulting in two complete diagnostic failures. Failure in another two patients was due to preliminary termination because of excessive pain and discomfort during the application of the contrast solution. The uterine cavity was completely visualized and bilateral fallopian tube patency was confirmed by dMR-HSG in 27 of 33 patients. Bilateral tubal occlusion was diagnosed in one of the remaining six patients and was confirmed by laparoscopy. Successful selective tubal catheterization was performed in one additional patient with unilateral and one patient with bilateral fallopian tube occlusion. In three cases, the catheter became dislocated at the end of the examination without demonstration of tubal patency. Since all three patients refused diagnostic laparoscopy and conventional HSG, possible bilateral occlusions of the fallopian tubes could not be

  15. Near-infrared spectroscopy in the routine diagnostic work-up of patients with leg ischaemia

    NARCIS (Netherlands)

    Ubbink, D. T.; Koopman, B.

    2006-01-01

    OBJECTIVE: To examine the reproducibility and clinical applicability of near-infrared spectroscopy (NIRS) in patients with leg ischaemia. DESIGN: Prospective comparative diagnostic study. MATERIALS AND METHODS: Routinely measured peripheral blood pressure and microcirculatory parameters were

  16. International survey and surgeon's preferences in diagnostic work-up towards treatment of anterior shoulder instability

    NARCIS (Netherlands)

    Weel, Hanneke; Tromp, Wouter; Krekel, Peter R.; Randelli, Pietro; van den Bekerom, Michel P. J.; van Deurzen, Derek F. P.

    2016-01-01

    Recurrent anterior shoulder instability after surgical treatment can be caused by bony defects. Several diagnostic tools have been designed to measure the extent of these bony lesions. Currently, there is no consensus which measurement tool to use and decide which type of surgery is most

  17. Cetrorelix suppression test in the diagnostic work-up of severe hyperandrogenism in adolescence.

    NARCIS (Netherlands)

    Man, M de; Derksen, E.; Pieters, G.; Boer, H. de

    2008-01-01

    Conventional diagnostic procedures failed to provide a definitive diagnosis in a 15 year-old girl presenting with severe hirsutism, oligomenorrhea, and markedly elevated serum testosterone levels. To examine whether androgen overproduction was luteinizing hormone (LH) dependent and thus likely of

  18. Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain

    DEFF Research Database (Denmark)

    Wewer, Anne Vibeke; Strandberg, C; Pærregaard, Anders

    1997-01-01

    We report on our experience with routine abdominal ultrasonography in 120 children (aged 3-15 years) with recurrent abdominal pain, in order to determine the diagnostic value of this investigation. Eight children (7%) revealed sonographic abnormalities: gallbladder stone (n = 2), splenomegaly (n...... = 1) and urogenital abnormalities (n = 5). The recurrent abdominal pain could be explained by these findings in only two (may be three) cases. CONCLUSION: The diagnostic value of abdominal ultrasonography in unselected children with recurrent abdominal pain is low. However, the direct visualization...... of the abdominal structures as being normal may be helpful to the parents and the child in their understanding and acceptance of the benign nature of recurrent abdominal pain....

  19. Planning diagnostic imaging work-up strategies using case-based reasoning.

    OpenAIRE

    Kahn, C. E.

    1994-01-01

    ISIS is a developmental decision support system that helps physicians select diagnostic imaging procedures. It uses case-based reasoning, an artificial-intelligence approach that emphasizes reasoning and planning from prior experience. The development, training, and evaluation of a prototype system were used to guide the development of ISIS. To realize a clinically useful system, particular emphasis has been placed on increasing the depth and breadth of case-based knowledge, enhancing the exp...

  20. Molecular biomarkers have the potential to improve the diagnostic work-up of pancreatic cystic lesions

    DEFF Research Database (Denmark)

    Plougmann, Julie Isabelle; Klausen, Pia; Karstensen, John Gásdal

    2017-01-01

    of diagnostic tools are used to predict the malignant potential of these cysts, but specificity and sensitivity are limited. Thus, many patients undergo unnecessary operations for benign cysts. Balancing the risks of watchful waiting with those of operative management is key in managing these lesions. During...... the last decade, genetic changes of pancreatic cysts have been examined extensively to estimate their malignant potential. In this review, we provide an overview of the latest molecular and genetic aspects of pancreatic cysts and how they may contribute to the differential diagnosis in patients...

  1. Role of 3.0 Tesla magnetic resonance hysterosalpingography in the diagnostic work-up of female infertility.

    Science.gov (United States)

    Cipolla, Valentina; Guerrieri, Daniele; Pietrangeli, Daniela; Santucci, Domiziana; Argirò, Renato; de Felice, Carlo

    2016-09-01

    Imaging evaluation plays a crucial role in the diagnostic work-up of female infertility. In recent years, the possibility to evaluate tubal patency using 1.5 Tesla magnetic resonance (1.5T MR) has been studied. To assess the feasibility of 3.0 Tesla magnetic resonance (3.0T MR) hysterosalpingography and its role in the diagnostic work-up of female infertility and to evaluate if this fast "one-stop-shop" imaging approach should be proposed as a first-line examination. A total of 116 infertile women were enrolled in this prospective study; all underwent 3.0T MR hysterosalpingography. After standard imaging of the pelvis, tubal patency was assessed by acquiring 3D dynamic time-resolved T1-weighted (T1W) sequences during manual injection of 4-5 mL of contrast solution consisting of gadolinium and normal sterile saline. Images were evaluated by two radiologists with different experience in MR imaging (MRI). The examination was successfully completed in 96.5% of cases, failure rate was 3.5%. Dynamic sequences showed bilateral tubal patency in 64.3%, unilateral tubal patency in 25.9%, and bilateral tubal occlusion in 9.8%. Extratubal abnormalities were found in 69.9% of patients. Comprehensive analysis of morphological and dynamic sequences showed extratubal abnormalities in 43.1% of patients with bilateral tubal patency. 3.0T MR hysterosalpingography is a feasible, simple, fast, safe, and well-tolerated examination, which allows evaluation of tubal patency and other pelvic causes of female infertility in a single session, and it may thus represent a "one-stop-shop" solution in female infertility diagnostic work-up. © The Foundation Acta Radiologica 2015.

  2. Diagnostic work-up of neurological syndromes in a rural African setting: knowledge, attitudes and practices of health care providers.

    Directory of Open Access Journals (Sweden)

    Alain Mpanya

    Full Text Available BACKGROUND: Neurological disorders of infectious origin are common in rural sub-Saharan Africa and usually have serious consequences. Unfortunately, these syndromes are often poorly documented for lack of diagnostic tools. Clinical management of these diseases is a major challenge in under-equipped rural health centers and hospitals. We documented health care provider knowledge, attitudes and practices related to this syndrome in two rural health zones in Bandundu Province, Democratic Republic of Congo. METHODS: We used a qualitative research approach combining observation, in-depth interviews and focus group discussions. We observed 20 patient-provider contacts related to a neurological syndrome, conducted 12 individual interviews and 4 focus group discussions with care providers. All interviews were audiotaped and the transcripts were analyzed with the software ATLAS.ti. RESULTS: Care providers in this region usually limit their diagnostic work-up to clinical examination primarily because of the financial hurdles in this entirely out-of-pocket payment system. The patients prefer to purchase drugs rather than diagnostic tests. Moreover the general lack of diagnostic tools and the representation of the clinician as a "diviner" do not enhance any use of laboratory or other diagnostic methods. CONCLUSION: Innovation in diagnostic technology for neurological disorders is badly needed in Central-Africa, but its uptake in clinical practice will only be a success if tools are simple, affordable and embedded in a patient-centered approach.

  3. Diagnostic work up for language testing in patients undergoing awake craniotomy for brain lesions in language areas.

    Science.gov (United States)

    Bilotta, Federico; Stazi, Elisabetta; Titi, Luca; Lalli, Diana; Delfini, Roberto; Santoro, Antonio; Rosa, Giovanni

    2014-06-01

    Awake craniotomy is the technique of choice in patients with brain tumours adjacent to primary and accessory language areas (Broca's and Wernicke's areas). Language testing should be aimed to detect preoperative deficits, to promptly identify the occurrence of new intraoperative impairments and to establish the course of postoperative language status. Aim of this case series is to describe our experience with a dedicated language testing work up to evaluate patients with or at risk for language disturbances undergoing awake craniotomy for brain tumour resection. Pre- and intra operative testing was accomplished with 8 tests. Intraoperative evaluation was accomplished when patients were fully cooperative (Ramsey language testings were normal in 9 patients (45%), showed mild to moderate language deficit in 8 (40%) and severe language deficit or aphasic disorders in 3 (15%). Broca's area was identified in 15 patients, in all cases by counting arrest during stimulation and in 12 cases by naming arrest. In this article we describe our experience using a language testing work up to evaluate - pre, intra and postoperatively - patients undergoing awake craniotomy for brain tumour resection with preoperative language disturbances or at risk for postoperative language deficits. This approach allows a systematic evaluation and recording of language function status and can be accomplished even when a neuropsychologist or speech therapist are not involved in the operation crew.

  4. Diagnostic work-up of an elderly patient with unilateral head and neck pain. A case report.

    Science.gov (United States)

    De Hertogh, Willem; Vaes, Peter; Versijpt, Jan

    2013-12-01

    Headache patients frequently contact physiotherapists and manual therapists. In case of elderly patients with unilateral headache, neck and facial pain clinical practice guidelines recommend further referral for medical investigation to exclude red flags. The present patient was seen in a multidisciplinary headache clinic. He was referred by the neurologist (headache specialist) for physiotherapeutic assessment after screening for red flags, including giant cell arteritis (GCA). After first assessment, GCA was considered unlikely, since the sedimentation rate, as a marker for inflammation, was only slightly elevated. The purpose of the referral was to exclude cervicogenic headache (CEH) and to explore physical treatment as a therapeutic option. Physiotherapeutic assessment consisted of a history taking on CEH signs (Sjaastad criteria, 1998), followed by cervical spine assessment including tests for neck mobility, joint pain, and endurance of the short neck flexors. The patient's history revealed no specific signs of CEH and cervical spine assessment was negative. In consultation with the neurologist, the diagnosis of CEH was abandoned. Since palpation of the temporal artery proved to be painful, laboratory examination and biopsy of the temporal artery were thereafter performed, this time revealing GCA. Appropriate treatment (high dose steroids) was initiated promptly, with a good clinical evolution. The presented case shows the potential of a multidisciplinary collaboration in the clinical diagnostic work-up of patients with head and neck pain. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. The use of 4D-CTA in the diagnostic work-up of brain arteriovenous malformations

    International Nuclear Information System (INIS)

    Willems, Peter W.A.; Taeshineetanakul, Patamintita; Terbrugge, Karel G.; Krings, Timo; Schenk, Barry; Brouwer, Patrick A.

    2012-01-01

    We aimed to evaluate the use of time-resolved whole-head CT angiography (4D-CTA) in patients with an untreated arteriovenous malformation of the brain (bAVM), as demonstrated by catheter angiography (DSA). Seventeen patients with a DSA-proven bAVM were enrolled. These were subjected to 4D-CTA imaging using a 320 detector row CT scanner. Using a standardized scoring sheet, all studies were analyzed by a panel of three readers. This panel was blind to the DSA results at the time of reading the 4D-CTA. 4D-CTA detected all bAVMs. With regard to the Spetzler-Martin grade, 4D-CTA disagreed with DSA in only one case, where deep venous drainage was missed. Further discrepancies between 4D-CTA and DSA analyses included underestimation of the nidus size in small lesions (four cases), misinterpretation of a feeding vessel (one case), misinterpretation of indirect feeding through pial collaterals (three cases) and oversight of mild arterial enlargement (two cases). 4D-CTA correctly distinguished low-flow from high-flow lesions and detected dural/transosseous feeding (one case), venous narrowing (one case) and venous pouches (nine cases). In this series, 4D-CTA was able to detect all bAVMs. Although some angioarchitectural details were missed or misinterpreted when compared to DSA, 4D-CTA evaluation was sufficiently accurate to diagnose the shunt and classify it. Moreover, 4D-CTA adds cross-sectional imaging and perfusion maps, helpful in treatment planning. 4D-CTA appears to be a valuable new adjunct in the non-invasive diagnostic work-up of bAVMs and their follow-up when managed conservatively. (orig.)

  6. Fecal lactoferrin and intestinal permeability are effective non-invasive markers in the diagnostic work-up of chronic diarrhea.

    Science.gov (United States)

    Caccaro, Roberta; D'Incà, Renata; Martinato, Matteo; Pont, Elisabetta Dal; Pathak, Surajit; Frigo, Anna Chiara; Sturniolo, Giacomo Carlo

    2014-10-01

    Non-invasive markers able to identify patients with chronic diarrhea at risk of organic disease are missing. Aim of the study was to assess the diagnostic ability of intestinal permeability (IP) test and fecal lactoferrin (FL) in distinguishing functional from organic disease in patients with chronic diarrhea. We retrospectively enrolled patients referring to the gastroenterology outpatient clinic for chronic diarrhea. Among the 103 patients included, 40 % had an organic disease, with IP and FL levels significantly higher compared to those with a functional disorder (p chronic diarrhea patients. Together these tests could recognize both the presence of intestinal damage and its site.

  7. The use of a rapid D-dimer blood test in the diagnostic work-up for pulmonary embolism: a management study

    NARCIS (Netherlands)

    de Groot, M. R.; van Marwijk Kooy, M.; Pouwels, J. G.; Engelage, A. H.; Kuipers, B. F.; Büller, H. R.

    1999-01-01

    D-dimer assays have a potential to rule out pulmonary embolism in case of a normal test result. We studied the clinical utility of incorporating the SimpliRED D-dimer test result and clinical probability in the routine diagnostic work-up of patients with suspected acute pulmonary embolism. In a

  8. The value of FDG-PET/CT in the diagnostic work-up of extra cardiac infectious manifestations in infectious endocarditis

    DEFF Research Database (Denmark)

    Ozcan, C; Asmar, A; Gill, S

    2013-01-01

    method to standard work-up in evaluating primary and distant infective foci. A retrospective cohort study of 72 IE patients admitted from 2008 to 2010, which had an (18)F-FDG-PET/CT performed. Findings were assessed in relation to the routine work-up, which served as the "gold standard". One hundred......-uptake/secretion, the corresponding values increased to 87 and 52 %, respectively. (18)F-FDG-PET/CT may be an important diagnostic tool in detecting extra cardiac infections in patients with IE, particularly in organs with low physiological glucose uptake....

  9. Non-invasive diagnostic work-up of patients with clinically suspected pulmonary embolism; results of a management study

    NARCIS (Netherlands)

    ten Wolde, M.; Hagen, P. J.; Macgillavry, M. R.; Pollen, I. J.; Mairuhu, A. T. A.; Koopman, M. M. W.; Prins, M. H.; Hoekstra, O. S.; Brandjes, D. P. M.; Postmus, P. E.; Büller, H. R.

    2004-01-01

    Background: Clinicians often deviate from the recommended algorithm for the diagnosis of pulmonary embolism consisting of ventilation-perfusion scintigraphy and pulmonary angiography. Objectives: To assess the safety and feasibility of a diagnostic algorithm which reduces the need for lung

  10. Tailoring Stress Incontinence Surgery : “How to install proper diagnostic work-up and individualised treatment”

    NARCIS (Netherlands)

    Houwert, R.M.|info:eu-repo/dai/nl/292579632

    2009-01-01

    In this thesis a different principle to determine the value of diagnostic parameters and to install the proper, individualized, surgical treatment for stress urinary incontinence is presented. The aim of the first part of this thesis was to evaluate the value of urodynamic investigation (UDI) in the

  11. Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

    Directory of Open Access Journals (Sweden)

    Mehrdad Bakhshayeshkaram

    2016-01-01

    Full Text Available Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women, PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation.

  12. Prospective evaluation of diagnostic work-up in syncope patients: results of the PL-US registry.

    Science.gov (United States)

    Kulakowski, Piotr; Lelonek, Malgorzata; Krynski, Tomasz; Bacior, Bogumila; Kowalczyk, Jacek; Malkowska, Beata; Tokarczyk, Monika; Stypula, Pawel; Pawlik, Tomasz; Stec, Sebastian M

    2010-02-01

    Syncope is a common problem. Demographic and clinical characteristics of patients admitted to different types of centres may vary, physician's adherence to the guidelines has been examined only in a few studies, and the requirements for implantable loop recorders (ILR) have not been well defined. The aim of this study was to (i) compare demographic and clinical characteristics of patients with syncope diagnosed and treated in tertiary electrophysiology cardiac centres and those attending syncope units or general hospitals, (ii) assess how physicians adhere to the published guidelines, and (iii) calculate the requirement for ILR insertion. In total, 669 consecutive patients with syncope, admitted to 18 electrophysiological cardiac tertiary centres over a mean of 3 months (range 1-10 months), entered a special Internet database called the PL-US (Polish patients with Unexplained Syncope) registry. Detailed demographic and clinical characteristics of the patients, including the results of all diagnostic tests performed, were analysed. Adherence to the guidelines was assessed, based on the published recommendations. The ILR implantation was indicated when (i) all other tests were inconclusive (unexplained syncope) and (ii) syncope associated with injury or presence of organic heart disease or past medical history and ECG suggesting arrhythmic syncope. Syncope of cardiac/arrhythmic origin was the most frequent diagnosis (53%), followed by reflex syncope (33%). Adherence to the guidelines was less than satisfactory-measurement of blood pressure in an upright position, carotid sinus massage, exercise testing, and electrophysiological study were underused, whereas prolonged ECG monitoring and neurological consultations were overused. Unexplained syncope had 58 (9%) patients, and 42 (72%) of them had indication for ILR which accounts for 6% of the whole study population. The calculated need for ILR was 222 implants/million inhabitants/year. Patients with syncope admitted to

  13. The Added Diagnostic Value of 18F-Fluorodihydroxyphenylalanine PET/CT in the Preoperative Work-Up of Small Bowel Neuroendocrine Tumors.

    Science.gov (United States)

    Addeo, Pietro; Poncet, Gilles; Goichot, Bernard; Leclerc, Loic; Brigand, Cécile; Mutter, Didier; Romain, Benoit; Namer, Izzie-Jacques; Bachellier, Philippe; Imperiale, Alessio

    2018-04-01

    The precise localization of the primary tumor and/or the identification of multiple primary tumors improves the preoperative work-up in patients with small bowel (SB) neuroendocrine tumor (NET). The present study assesses the diagnostic value of 18 F-fluorodihydroxyphenylalanine ( 18 F-FDOPA) positron emission tomography/computed tomography (PET/CT) during the preoperative wok-up of SB NETs. Between January 2010 and June 2017, all consecutive patients with SB NETs undergoing preoperative 18 F-FDOPA PET/CT and successive resection were analyzed. Preoperative work-up included computed tomography (CT), somatostatin receptor scintigraphy (SRS), and 18 F-FDOPA PET/CT. Sensitivity and accuracy ratio for primary and multiple tumor detection were compared with data from surgery and pathology. There were 17 consecutive patients with SB NETs undergoing surgery. Nine patients (53%) had multiple tumors, 15 (88%) metastatic lymph nodes, 3 (18%) peritoneal carcinomatosis, and 9 patients (53%) liver metastases. A total of 70 SB NETs were found by pathology. Surgery identified the primary in 17/17 (100%) patients and recognized seven of 9 patients (78%) with multiple synchronous SB. Preoperatively, 18 F-FDOPA PET/CT displayed a statistically significant higher sensitivity for primary tumor localization (100 vs. 23.5 vs. 29.5%) and multiple tumor detection (78 vs. 22 vs. 11%) over SRS and CT. Compared with pathology, 18 F-FDOPA PET/CT displayed the highest accuracy ratio for number of tumor detected over CT and SRS (2.0 ± 2.2 vs. 0.4 ± 0.7 vs. 0.6 ± 1.5, p = 0.0003). 18 F-FDOPA PET/CT significantly increased the sensitivity and accuracy for primary and multiple SB NET identification. 18 F-FDOPA PET/CT should be included systematically in the preoperative work-up of SB NET.

  14. The Challenge of Prenatal Diagnostic Work-Up of Maternally Inherited X-Linked Opitz G/BBB: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Marialuigia Spinelli

    2015-01-01

    Full Text Available Background. Prenatal diagnosis of Optiz G/BBB syndrome (OS is challenging because the characteristic clinical features, such as facial and genitourinary anomalies, may be subtle at sonography and rather unspecific. Furthermore, molecular testing of the disease gene is not routinely performed, unless a specific diagnosis is suggested. Method. Both familial and ultrasound data were used to achieve the diagnosis of X-linked OS (XLOS, which was confirmed by molecular testing of MID1 gene (Xp22.3 at birth. Results. Sequencing of MID1 gene disclosed the nucleotide change c.1285 +1 G>T, previously associated with XLOS. Conclusions. This case illustrates current challenges of the prenatal diagnostic work-up of XLOS and exemplifies how clinical investigation, including family history, and accurate US foetal investigations can lead to the correct diagnosis.

  15. NON-INVASIVE METHODS OF THE WORK-UP FOR ASSESSMENT OF MORPHOLOGIC AND FUNCTIONAL STATE OF THE SIGMOID WALL

    Directory of Open Access Journals (Sweden)

    A. E. Mashkov

    2015-01-01

    Full Text Available Background: Prolonged colonic congestion in children with chronic constipation and dolichosigma are characterized  by a permanent imbalance of gut microflora, secondary inflammation and degeneration of the sigmoid wall. There is plenty of research papers on the optic non-invasive diagnostics in medicine, based on spectrophotometry and laser spectral analysis. Aim: To study morphologic and functional state  of the sigmoid wall for detection of inflammation  and  degeneration in the  sigmoid  wall and  optimization  of treatment of children with dolichosigma  and long-standing constipation. Materials and methods: From 2009 to 2014, 30 children with dolichosigma  were seen in the Department of Pediatric surgery of MONIKI. All patients  were  hospitalized  after unsuccessful conservative  treatment in in-patient  clinics of the Moscow Region. The children underwent a set of investigations  for objective assessment of degree of the secondary  inflammatory and degenerative abnormalities  in the sigmoid wall, such as microbiological assessment, cytological assessment and fluorescent  diagnostics.  Results:  There  was  no   caused  by dolichosigma. It maintains  chronic inflammation  and  may play an indirect  role in abnormalities  of gut  motor  function. Inflammatory and  degenerative abnormalities  were  confirmed by a cytological investigation  of wall-adjacent biopsy of the  sigma. The results of the  complex assessment showed  moderate inflammation  and degeneration in the  sigmoid wall in 20 children; subsequent conservative treatment of chronic colostasis was effective. Ten children had advanced secondary inflammatory and degenerative abnormalities of the  sigmoid  wall, with high  levels of elastin and collagen in the colon wall. Surgery was performed in 6 children with the highest degree of fibrous transformation of the sigma. Conclusion: Complex assessment of the sigmoid wall, including

  16. Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Lahaye, M.J.; Lambregts, D.M.J.; Mutsaers, E.; Beets-Tan, R.G.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Essers, B.A.B. [Maastricht University Medical Centre, Department of Epidemiology and Medical Technology, Maastricht (Netherlands); Breukink, S.; Beets, G.L. [Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Cappendijk, V.C. [Jeroen Bosch Hospital, Department of Radiology, ' s Hertogenbosch (Netherlands)

    2015-05-01

    To evaluate whether mandatory imaging is an effective strategy in suspected appendicitis for reducing unnecessary surgery and costs. In 2010, guidelines were implemented in The Netherlands recommending the mandatory use of preoperative imaging to confirm/refute clinically suspected appendicitis. This retrospective study included 1,556 consecutive patients with clinically suspected appendicitis in 2008-2009 (756 patients/group I) and 2011-2012 (800 patients/group II). Imaging use (none/US/CT and/or MRI) was recorded. Additional parameters were: complications, medical costs, surgical and histopathological findings. The primary study endpoint was the number of unnecessary surgeries before and after guideline implementation. After clinical examination by a surgeon, 509/756 patients in group I and 540/800 patients in group II were still suspected of having appendicitis. In group I, 58.5% received preoperative imaging (42% US/12.8% CT/3.7% both), compared with 98.7% after the guidelines (61.6% US/4.4% CT/ 32.6% both). The percentage of unnecessary surgeries before the guidelines was 22.9%. After implementation, it dropped significantly to 6.2% (p<0.001). The surgical complication rate dropped from 19.9% to 14.2%. The average cost-per-patient decreased by 594 EUR from 2,482 to 1,888 EUR (CL:-1081; -143). Increased use of imaging in the diagnostic work-up of patients with clinically suspected appendicitis reduced the rate of negative appendectomies, surgical complications and costs. (orig.)

  17. Is there an added value of faecal calprotectin and haemoglobin in the diagnostic work-up for primary care patients suspected of significant colorectal disease? A cross-sectional diagnostic study

    NARCIS (Netherlands)

    Elias, Sjoerd G.; Kok, Liselotte; de Wit, NJ; Witteman, Ben J. M.; Goedhard, Jelle G.; Romberg-Camps, Marielle J. L.; Muris, Jean W. M.; Moons, Karel G. M.

    2016-01-01

    Background The majority of primary care patients referred for bowel endoscopy do not have significant colorectal disease (SCD), and are – in hindsight – unnecessarily exposed to a small but realistic risk of severe endoscopy-associated complications. We developed a diagnostic strategy to better

  18. Diagnostic Approach to Functional Recovery

    DEFF Research Database (Denmark)

    Havsteen, Inger; Madsen, Kristoffer H; Christensen, Hanne Krarup

    2013-01-01

    available and does not pose any adverse effects, repeated fMRI measurements provide unprecedented possibilities to prospectively assess the time course of reorganization in functional neural networks after stroke and relate the temporospatial dynamics of reorganization at the systems level to functional...

  19. The Diagnostic Work-Up of Eating Disorders

    DEFF Research Database (Denmark)

    Sjögren, Magnus

    2015-01-01

    Background: The mortality of Anorexia Nervosa (AN) is the highest among all psychiatric disorders, and Eating Disorders (ED) overall pose serious health threats to a significant proportion of the population. In spite of an increasing recognition of the clinical impact of ED, often, the general...

  20. Diagnostic work-up of acute myeloid leukemia.

    Science.gov (United States)

    Weinberg, Olga K; Sohani, Aliyah R; Bhargava, Parul; Nardi, Valentina

    2017-03-01

    Acute myeloid leukemia (AML) is characterized by a clonal expansion of undifferentiated myeloid precursors resulting in impaired hematopoiesis and bone marrow failure. In 2016, the World Health Organization (WHO) published revisions to the classification of myeloid neoplasms and acute leukemias. Similar to the 2008 classification, the updated classification incorporates clinical features, morphology, immunophenotyping, and cytogenetics, with greater emphasis on molecular genetics, to define disease entities. This brief review addresses the various components of pathologic assessment to establish a diagnosis of AML and to help risk stratify patients, with an emphasis on newer techniques used in the detection of mutations with prognostic significance, as well as assays employed in the evaluation of minimal residual disease following treatment. © 2017 Wiley Periodicals, Inc.

  1. Neuroradiologic work-up of brain tumors

    International Nuclear Information System (INIS)

    Fishbein, D.S.

    1988-01-01

    The presence of an intracranial tumor may be suspected or deduced from the clinical history and examination, or it may be discovered incidentally during investigation of another disorder. Once the suggestion is raised, a variety of neuroradiologic techniques are available to define the extent and nature of the lesion. The studies performed may allow a tissue diagnosis to be presumed, may serve as a guide to proposed surgical therapy, or may allow the course of a previously diagnosed lesion to be followed. This chapter discusses the utility of common neuroradiologic techniques and their specific indications in the work-up of intracranial tumors. Emphasis is placed upon tests that are most frequently utilized and have the greatest value

  2. PET scan as a functional diagnostic tool

    International Nuclear Information System (INIS)

    Kyogoku, Shinsuke; Ogawa, Shoichi; Amano, Maki

    2007-01-01

    Morphological diagnostic imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI) have undergone rapid development of hardware and imaging technique. However, these imaging modalities have some limitations in determining whether lymph node swelling is malignant or benign. It is difficult for the radiologist and physician to differentiate malignant lesion from benign lesion based solely on lymph node size. Mass media has sensationalized the efficacy of positron emission tomography (PET) scan. PET scans have now become a well-known medical examination among the general public. The ministry of health, labor and welfare approved F-18 fluorodeoxyglucose (FDG) as a commercially available isotope in 2005 and PET centers have rapidly spread in Japan. PET scan is considered a breakthrough in cancer detection, as a functional diagnostic tool. This article discusses simple methods and isotopes for PET scan and the diseases for which FDG-PET scan is covered by the medical insurance system. The preparation and workflow of FDG-PET examination are also discussed. Finally, I describe the usefulness of FDG-PET scan using an illustrative case presentation. (author)

  3. Nanoparticle functionalization for brain targeting drug delivery and diagnostic

    DEFF Research Database (Denmark)

    Gomes, Maria João; Mendes, Bárbara; Martins, Susana

    2016-01-01

    carriers to cross the BBB and achieve brain, and their functionalization strategies are described; and finally the delivery of nanoparticles to the target moiety, as diagnostics or therapeutics. Therefore, this chapter is focused on how the nanoparticle surface may be functionalized for drug delivery......-mediated drug transport across the BBB, where nanoparticles take advantage of physiological receptor-mediated transport processes....

  4. Technique and diagnostic value of functional myelography in lumbar discopathy

    International Nuclear Information System (INIS)

    Thron, A.; Bockenheimer, S.

    1979-01-01

    A standard myelogram using water soluble contrast with additional functional examinations were carried out on 72 patients with suspected disc prolapse. Diagnostic accuracy can be significantly improved by the functional examination and, in some cases, the diagnosis can only be made in this way. There are no false positives. The advantages and limitations of the method are enumerated and its morphological significance is discussed. (orig.) [de

  5. Fluidized bed reactor for working up carbon coated particles

    International Nuclear Information System (INIS)

    Marschollek, M.; Simon, W.; Walter, C.

    1981-01-01

    A fluidized bed reactor is described for working up carbon coated particles, particularly nuclear fuel particles or fertile material particles consisting essentially of a cylindrical portion connected to a conical portion. Gas supply pipes, gas distribution space and gas distribution heads are provided within the conical reactor lower portion, the gas distribution members being arranged in at least two superimposed planes and distributed symmetrically over the cross-section of the reactor

  6. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    , all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...... and barriers, stating important differences between multidisciplinary and interdisciplinary processes. Checklists and assessment scales may be very useful when performing a geriatric work-up, but they should be used with caution. Specific scales covering different functional areas of the geriatric patient...

  7. Diagnostic functional MRI: illustrated clinical applications and decision-making.

    Science.gov (United States)

    Bartsch, Andreas Joachim; Homola, György; Biller, Armin; Solymosi, László; Bendszus, Martin

    2006-06-01

    Functional magnetic resonance imaging (fMRI) has become a popular research tool, yet its use for diagnostic purposes and actual treatment planning has remained less widespread. The literature yields rather sparse evidence-based data on clinical fMRI applications and accordant decision-making. Notwithstanding, blood oxygenation level dependent (BOLD)- and arterial spin labeling (ASL)-fMRI can be judiciously combined with perfusion measurements, electroencephalographic (EEG) recordings, diffusion-weighted imaging (DWI), and fiber tractographies to assist clinical decisions. In this article we provide an overview of clinical fMRI applications based on illustrative examples. Assessment of cochlear implant candidates by fMRI is covered in some detail, and distinct reference is made to particular challenges imposed by brain tumors, other space-occupying lesions, cortical dysplasias, seizure disorders, and vascular malformations. Specific strategies, merits, and pitfalls of analyzing and interpreting diagnostic fMRI studies in individual patients are highlighted. Copyright 2006 Wiley-Liss, Inc.

  8. Biomarkers of renal injury and function : diagnostic, prognostic and therapeutic implications in heart failure

    NARCIS (Netherlands)

    van Veldhuisen, Dirk J.; Ruilope, Luis M.; Maisel, Alan S.; Damman, Kevin

    2016-01-01

    Heart failure guidelines suggest evaluating renal function as a routine work-up in every patient with heart failure. Specifically, it is advised to calculate glomerular filtration rate and determine blood urea nitrogen. The reason for this is that renal impairment and worsening renal function (WRF)

  9. Usage of analytical diagnostics when evaluating functional surface material defects

    Directory of Open Access Journals (Sweden)

    R. Frischer

    2015-10-01

    Full Text Available There are occurring defects due to defects mechanisms on parts of production devices surfaces. Outer defects pronouncement is changing throw the time with unequal speed. This variability of defect’s mechanism development cause that is impossible to evaluate technical state of the device in any moment, without the necessary underlying information. Proposed model is based on analytical diagnostics basis. Stochastic model with usage of Weibull probability distribution can assign probability of function surface defect occurrence on the operational information in any moment basis. The knowledge of defect range limiting moment, then enable when and in what range will be necessary to make renewal.

  10. 21 CFR 870.1435 - Single-function, preprogrammed diagnostic computer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Single-function, preprogrammed diagnostic computer... Single-function, preprogrammed diagnostic computer. (a) Identification. A single-function, preprogrammed diagnostic computer is a hard-wired computer that calculates a specific physiological or blood-flow parameter...

  11. [Anorectal functional diagnostics. Therapy algorithm for obstruction and incontinence].

    Science.gov (United States)

    Kim, M; Isbert, C

    2013-01-01

    The surgical therapy of pelvic floor insufficiency is mainly focused on two functional disorders, outlet obstruction and fecal incontinence. Surgery becomes of special significance after ineffectiveness of conservative treatment options. The indications for surgical interventions should be based on a precise preoperative evaluation. The dimension of functional impairment will be primarily assessed by an accurate anamnesis, application of disease-specific scoring systems and the clinical proctological basic examination that includes digital rectal examination and proctoscopy/rectoscopy. Imaging procedures (anorectal endosonography and dynamic defecography) are carried out as adjuncts and contribute to a visualization of morphological changes. Severity and manifestation of morphological symptoms are essential for the therapeutic algorithm due to increasingly differentiated surgical strategies. Only a thorough diagnostic investigation and patient selection enable a targeted therapy of obstruction and fecal incontinence.

  12. Undescended testis: how extensive should the work up be?

    Science.gov (United States)

    Shera, Altaf Hussain; Baba, Aejaz Ahsan; Gupta, Shyam Kumar; Gupta, Geetanjali; Sherwani, Afak Yusuf

    2010-01-01

    The aim of this study was to highlight various anomalies associated with undescended testis and to determine how much work up is necessary for this condition. The study was conducted in the department of Pediatric Surgery SKIMS Srinagar, Kashmir. All patients between 0-14 years of age who attended out patient department (OPD) from January 2002 to December 2003 with maldescent of testes were included in the study. Detailed relevant history and physical examination findings were recorded in all the cases. Baseline investigations were performed along with ultrasonography of the abdomen. In relevant cases other investigations like intravenous urography, micturating cystourethrography, CT scan and laparoscopy were performed as and when indicated. A total of 250 cases of undescended testis were registered during this period. Maximum number of cases were in the age group of 5-10 years. In 130 (52%) cases the right testis was undescended while 75 (30%) had left sided undescended testis and 45 (18%) had bilateral undescended testis. Maldescended testis comprised 11% of the admissions. The majority of cases were having gestational age of 37 weeks or more. The associated anomalies picked up on investigations included duplication of upper urinary tract (3.2%), hydronephrosis and polycystic kidney (0.8% each), horseshoe kidney, ectopic kidney, crossed renal ectopia (0.4% each) Posterior urethral valves, Prune belly syndrome (0.4%) and spina bifida (0.4%). On detailed clinical examination of genitalia several abnormalities were picked which included hydrocele, hypospadias, hernia, chordee, micropenis and ambiguous genitalia. We recommend ultrasonography to be done in all cases of undescended testis in addition to a thorough history and physical examination. Intravenous pyelography, micturating cystourethrogram, CT scan and other investigations should be performed selectively based on history, physical examination or ultrasound findings.

  13. Undesended testis: How extensive should the work up be?

    Directory of Open Access Journals (Sweden)

    Shera Altaf

    2010-01-01

    Full Text Available Aim: The aim of this study was to highlight various anomalies associated with undescended testis and to determine how much work up is necessary for this condition. Material and Methods: The study was conducted in the department of Pediatric Surgery SKIMS Srinagar, Kashmir. All patients between 0-14 years of age who attended out patient department (OPD from January 2002 to December 2003 with maldescent of testes were included in the study. Detailed relevant history and physical examination findings were recorded in all the cases. Baseline investigations were performed along with ultrasonography of the abdomen. In relevant cases other investigations like intravenous urography, micturating cystourethrography, CT scan and laparoscopy were performed as and when indicated. Results: A total of 250 cases of undescended testis were registered during this period. Maximum number of cases were in the age group of 5-10 years. In 130 (52% cases the right testis was undescended while 75 (30% had left sided undescended testis and 45 (18% had bilateral undescended testis. Maldescended testis comprised 11% of the admissions. The majority of cases were having gestational age of 37 weeks or more. The associated anomalies picked up on investigations included duplication of upper urinary tract (3.2%, hydronephrosis and polycystic kidney (0.8% each, horseshoe kidney, ectopic kidney, crossed renal ectopia (0.4% each Posterior urethral valves, Prune belly syndrome (0.4% and spina bifida (0.4%. On detailed clinical examination of genitalia several abnormalities were picked which included hydrocele, hypospadias, hernia, chordee, micropenis and ambiguous genitalia. Conclusion: We recommend ultrasonography to be done in all cases of undescended testis in addition to a thorough history and physical examination. Intravenous pyelography, micturating cystourethrogram, CT scan and other investigations should be performed selectively based on history, physical examination or

  14. SYNTHESIS OF INFORMATION MODEL FOR ALTERNATIVE FUNCTIONAL DIAGNOSTICS PROCEDURE

    OpenAIRE

    P. F. Shchapov; R. P. Miguschenko

    2014-01-01

    Probabilistic approaches in information theory and information theory of measurement, allowing to calculate and analyze the amount expected to models measuring conversions and encoding tasks random measurement signals were considered. A probabilistic model of diagnostic information model transformation and diagnostic procedures was developed. Conditions for obtaining the maximum amount of diagnostic information were found out.

  15. [Magnetoencephalography: a new functional diagnostic technique for the neurosciences].

    Science.gov (United States)

    Maestú, C; Gómez-Utrero, E; Piñeiro, R; Sola, R G

    We present a review on the technical, methodological and clinical advances in the functional study of the brain by means of magneto-encephalography. We look back the milestones of its historical development, through the work of the major research groups on this field and through our group's works and database (including doctoral thesis). Discussion on the neurophysiological and biomagnetism basis is provided as well as description of technical developments in superconducting detectors (SQUID, Superconducting Quantum Interference Device), signal processing, enhancement of noise-signal ratio and dipole modeling. The need for brain functional studies has led to newer imaging procedures (functional magnetic resonance, PET, SPECT, etc.). Their spatial and temporal resolution and invasivity are compared to that of magneto-encephalography. Current equipment, up to 306 whole-head channels, may accurately detect cortical and subcortical activity. Apart from the physiological activity, it may be applied to a number of conditions: epilepsy (ictal, interictal and presurgical); dementia, movement disorders, stroke, eloquent cortex delimitation prior to tumour or lesion resection; learning disabilities and foetal studies. Magnetoencephalography provides with an excellent temporal, very good spatial resolution, acquires in real-time, without references and minimal interference. It entails a great advance in the diagnostic approach in neurosciences.

  16. [Cognitive functions, their development and modern diagnostic methods].

    Science.gov (United States)

    Klasik, Adam; Janas-Kozik, Małgorzata; Krupka-Matuszczyk, Irena; Augustyniak, Ewa

    2006-01-01

    provided a theory. The psychometric approach concentrates on studying the differences in intelligence. The aim of this approach is to test intelligence by means of standardized tests (e.g. WISC-R, WAIS-R) used to show the individual differences among humans. Human cognitive functions determine individuals' adaptation capabilities and disturbances in this area indicate a number of psychopathological changes and are a symptom enabling to differentiate or diagnose one with a disorder. That is why the psychological assessment of cognitive functions is an important part of patients' diagnosis. Contemporary neuropsychological studies are to a great extent based computer tests. The use of computer methods has a number of measurement-related advantages. It allows for standardized testing environment, increasing therefore its reliability and standardizes the patient assessment process. Special attention should be paid to the neuropsychological tests included in the Vienna Test System (Cognitron, SIGNAL, RT, VIGIL, DAUF), which are used to assess the operational memory span, learning processes, reaction time, attention selective function, attention continuity as well as attention interference resistance. It also seems justified to present the CPT id test (Continuous Performance Test) as well as Free Recall. CPT is a diagnostic tool used to assess the attention selective function, attention continuity of attention, attention interference resistance as well as attention alertness. The Free Recall test is used in the memory processes diagnostics to assess patients' operational memory as well as the information organization degree in operational memory. The above mentioned neuropsychological tests are tools used in clinical assessment of cognitive function disorders.

  17. System diagnostics using qualitative analysis and component functional classification

    Science.gov (United States)

    Reifman, J.; Wei, T.Y.C.

    1993-11-23

    A method for detecting and identifying faulty component candidates during off-normal operations of nuclear power plants involves the qualitative analysis of macroscopic imbalances in the conservation equations of mass, energy and momentum in thermal-hydraulic control volumes associated with one or more plant components and the functional classification of components. The qualitative analysis of mass and energy is performed through the associated equations of state, while imbalances in momentum are obtained by tracking mass flow rates which are incorporated into a first knowledge base. The plant components are functionally classified, according to their type, as sources or sinks of mass, energy and momentum, depending upon which of the three balance equations is most strongly affected by a faulty component which is incorporated into a second knowledge base. Information describing the connections among the components of the system forms a third knowledge base. The method is particularly adapted for use in a diagnostic expert system to detect and identify faulty component candidates in the presence of component failures and is not limited to use in a nuclear power plant, but may be used with virtually any type of thermal-hydraulic operating system. 5 figures.

  18. Functional diagnostics of the cervical spine by using computer tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dvorak, J.; Hayek, J.; Grob, D.; Penning, L.; Panjabi, M.M.; Zehnder, R.

    1988-04-01

    35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7/sup 0/, and C1/C2 more than 54/sup 0/ could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29/sup 0/ to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast.

  19. Functional diagnostics of the cervical spine by using computer tomography

    International Nuclear Information System (INIS)

    Dvorak, J.; Hayek, J.; Grob, D.

    1988-01-01

    35 healthy adults and 137 patients after cervical spine injury were examined by functional CT. The range of axial rotation at the level occiput/atlas, atlas/axis and the segment below were measured in all subjects. A rotation occiput/atlas of more than 7 0 , and C1/C2 more than 54 0 could refer to segmental hypermobility, a rotation at the segment C1/C2 less than 29 0 to hypomobility. According to the postulated normal values based upon a 98% confidence level, out of 137 patients examined after cervical spine injury and with therapy-resistant neck pain, 45 showed signs of segmental hypermobility of the upper cervical spine, 17 showed hyper- or hypomobility at different levels, 10 patients presented segmental hypomobility at C1/C2 level alone. In all patients, according to the clinical assessment, functional pathology was suspected in the upper cervical spine. Surgical correction of rotatory instability should be considered as a possible therapeutic procedure after successful diagnostic stabilisation of the cervical spine by minerva cast. (orig.)

  20. System diagnostics using qualitative analysis and component functional classification

    International Nuclear Information System (INIS)

    Reifman, J.; Wei, T.Y.C.

    1993-01-01

    A method for detecting and identifying faulty component candidates during off-normal operations of nuclear power plants involves the qualitative analysis of macroscopic imbalances in the conservation equations of mass, energy and momentum in thermal-hydraulic control volumes associated with one or more plant components and the functional classification of components. The qualitative analysis of mass and energy is performed through the associated equations of state, while imbalances in momentum are obtained by tracking mass flow rates which are incorporated into a first knowledge base. The plant components are functionally classified, according to their type, as sources or sinks of mass, energy and momentum, depending upon which of the three balance equations is most strongly affected by a faulty component which is incorporated into a second knowledge base. Information describing the connections among the components of the system forms a third knowledge base. The method is particularly adapted for use in a diagnostic expert system to detect and identify faulty component candidates in the presence of component failures and is not limited to use in a nuclear power plant, but may be used with virtually any type of thermal-hydraulic operating system. 5 figures

  1. How to work up a patient with polyneuropathy?

    LENUS (Irish Health Repository)

    Renganathan, R

    2009-01-01

    Undiagnosed and untreated neuropathy may lead to disability and poor quality of life. Ordering every possible test to find the cause of polyneuropathy can waste time and resources. In this study, we investigated what could be used as a routine neuropathy screen. A retrospective audit of all charts of patients diagnosed to have polyneuropathy by nerve conduction studies from November 2001 to November 2002 were carried out. Demographics, background history, type of neuropathy and investigations done were documented. The charts of 61 patients were audited. 12 patients had a background history of diabetes mellitus. 2 patients had history of alcohol abuse. 23 patients presented with paraesthesia and 33 with weakness of limbs. We found a cause of polyneuropathy in 79% of cases. In most patients with polyneuropathy where a cause can be identified, this can be achieved by the medical history, neurological examination, nerve conduction studies and the baseline blood tests. We suggest a 3-step approach to the diagnostic workup of polyneuropathy.

  2. Evaluation of the Diagnostic Work-Up in Children with Myocarditis and Idiopathic Dilated Cardiomyopathy

    NARCIS (Netherlands)

    S.L. den Boer (Susanna); R.P.J. Meijer; G.G. van Iperen (Gabrielle); A.D.J. ten Harkel (Arend); G.J. Du Marchie Sarvaas (Gideon); B. Straver; L. Rammeloo (Lukas); R. Tanke (Ronald); J.J.A. van Kampen (Jeroen); M. Dalinghaus (Michiel)

    2015-01-01

    textabstractThe underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14–22 % is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, ‘a clinical diagnosis of myocarditis’ has been frequently used because the gold standard

  3. Evaluation of the diagnostic work-up in children with myocarditis and idiopathic dilated cardiomyopathy

    NARCIS (Netherlands)

    den Boer, S. L.; Meijer, R. P. J.; van Iperen, G. G.; ten Harkel, A. D. J.; du Marchie Sarvaas, G. J.; Straver, B.; Rammeloo, L. A. J.; Tanke, R. B.; van Kampen, J. J. A.; Dalinghaus, M.

    2015-01-01

    The underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14-22 % is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, 'a clinical diagnosis of myocarditis' has been frequently used because the gold standard [endomyocardial

  4. Evaluation of the Diagnostic Work-Up in Children with Myocarditis and Idiopathic Dilated Cardiomyopathy

    NARCIS (Netherlands)

    den Boer, S. L.; Meijer, R. P. J.; van Iperen, G. G.; ten Harkel, A. D. J.; Sarvaas, G. J. du Marchie; Straver, B.; Rammeloo, L. A. J.; Tanke, R. B.; van Kampen, J. J. A.; Dalinghaus, M.

    The underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14-22 % is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, 'a clinical diagnosis of myocarditis' has been frequently used because the gold standard [endomyocardial

  5. Evaluation of the diagnostic work-up in children with myocarditis and idiopathic dilated cardiomyopathy

    NARCIS (Netherlands)

    Boer, S.L. den; Meijer, R.P.; Iperen, G.G. van; Harkel, A.D. Ten; Sarvaas, G.J.; Straver, B.; Rammeloo, L.A.; Tanke, R.B.; Kampen, J.J. van; Dalinghaus, M.

    2015-01-01

    The underlying etiology of dilated cardiomyopathy (DCM) in children varies, 14-22% is secondary to myocarditis, and the majority remains idiopathic. Etiology has prognostic value; however, 'a clinical diagnosis of myocarditis' has been frequently used because the gold standard [endomyocardial biopsy

  6. Volumetric capnography: In the diagnostic work-up of chronic thromboembolic disease

    Directory of Open Access Journals (Sweden)

    Marcos Mello Moreira

    2010-05-01

    Full Text Available Marcos Mello Moreira1, Renato Giuseppe Giovanni Terzi1, Laura Cortellazzi2, Antonio Luis Eiras Falcão1, Heitor Moreno Junior2, Luiz Cláudio Martins2, Otavio Rizzi Coelho21Department of Surgery, 2Department of Internal Medicine, State University of Campinas, School of Medical Sciences, Campinas, Sao Paulo, BrazilAbstract: The morbidity and mortality of pulmonary embolism (PE have been found to be related to early diagnosis and appropriate treatment. The examinations used to diagnose PE are expensive and not always easily accessible. These options include noninvasive examinations, such as clinical pretests, ELISA D-dimer (DD tests, and volumetric capnography (VCap. We report the case of a patient whose diagnosis of PE was made via pulmonary arteriography. The clinical pretest revealed a moderate probability of the patient having PE, and the DD result was negative; however, the VCap associated with arterial blood gases result was positive. The patient underwent all noninvasive exams following admission to hospital and again eight months after discharge. Results gained from invasive tests were similar to those produced by image exams, highlighting the importance of VCap as an important noninvasive tool.Keywords: pulmonary embolism, pulmonary hypertension, volumetric capnography, d-dimers, pretest probability

  7. Superficial artery aneurysms underlying nummular headache--2 cases and proposed diagnostic work-up.

    Science.gov (United States)

    López-Ruiz, Pedro; Cuadrado, María-Luz; Aledo-Serrano, Angel; Alonso-Oviés, Almudena; Porta-Etessam, Jesús; Ganado, Tomás

    2014-01-01

    Nummular headache, considered a primary headache in the 3rd edition of the International Classification of Headache Disorders, has nonetheless been attributed in several occasions to underlying epicranial anomalies. Vascular imaging of the head in 2 patients with nummular headache revealed fusiform aneurysms of the scalp vessel in close relation to the painful area. One of the patients underwent surgical resection of the aneurysm with excellent response. A response to triptans was noted in both. In selected patients with nummular headache, vascular imaging of the scalp may reveal anomalies amenable to surgical treatment or triptan administration, sometimes resulting in disappearance of the pain. © 2014 American Headache Society.

  8. Diagnostics

    DEFF Research Database (Denmark)

    Donné, A.J.H.; Costley, A.E.; Barnsley, R.

    2007-01-01

    In order to support the operation of ITER and the planned experimental programme an extensive set of plasma and first wall measurements will be required. The number and type of required measurements will be similar to those made on the present-day large tokamaks while the specification...... of the measurements—time and spatial resolutions, etc—will in some cases be more stringent. Many of the measurements will be used in the real time control of the plasma driving a requirement for very high reliability in the systems (diagnostics) that provide the measurements. The implementation of diagnostic systems......&D is needed to prepare the systems. In some cases the environmental difficulties are so severe that new diagnostic techniques are required. The starting point in the development of diagnostics for ITER is to define the measurement requirements and develop their justification. It is necessary to include all...

  9. Diagnostic agreement of schizophrenia spectrum disorders among chronic patients with functional psychoses

    DEFF Research Database (Denmark)

    Jakobsen, K D; Frederiksen, J N; Parnas, J

    2006-01-01

    diagnostic systems were identified. Diagnostic agreement was assessed using unweighted kappa-statistics and pairwise concordance rates (CR). RESULTS: High diagnostic agreement of schizophrenia was observed across the ICD-10 and DSM systems (CR >0.70, kappa >0.70), which all had a significantly lower...... function previous to the onset of illness. Similarly high pairwise CR were observed for schizophrenia spectrum disorders across all diagnostic systems. CONCLUSIONS: This study demonstrates that diagnostic agreement is higher among chronic patients than that observed in subjects with a recent onset......BACKGROUND: To investigate whether diagnostic agreement across different diagnostic systems improves in a sample of chronic patients suffering from functional psychosis compared to first-admitted patients. SAMPLING AND METHODS: Among 353 patients with a history of functional psychosis, a subset...

  10. Study of an electrocyclone working up to 600 0C

    International Nuclear Information System (INIS)

    Daniel, F.; Pourprix, M.; Vendel, J.

    1986-01-01

    An electrocyclone is studied and spectral efficiency is determined for a particle size range from 0.3 micron to 10 microns in function of gas temperature and speed. Possible applications include prefiltration of gaseous effluents from the dismantling of nuclear facilities or radioactive waste incinerators. 18 refs [fr

  11. 21 CFR 868.1900 - Diagnostic pulmonary-function interpretation calculator.

    Science.gov (United States)

    2010-04-01

    ... calculator. 868.1900 Section 868.1900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND... Diagnostic pulmonary-function interpretation calculator. (a) Identification. A diagnostic pulmonary-function interpretation calculator is a device that interprets pulmonary study data to determine clinical significance of...

  12. Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Shu-Hang [Chang Gung Memorial Hospital Linkou Medical Center, Molecular Imaging Center and Department of Diagnostic Radiology, Kueishan (China)]|[Chang Gung Memorial Hospital, Linkou Medical Center, Department of Diagnostic Radiology, Kueishan, Taoyuan (China); Chan, Sheng-Chieh; Yen, Tzu-Chen; Liu, Feng-Yuan [Chang Gung Memorial Hospital Linkou Medical Center, Department of Nuclear Medicine, Kueishan (China); Chang, Joseph Tung-Chieh; Fan, Kang-Hsing [Chang Gung Memorial Hospital Linkou Medical Center, Department of Radiation Oncology, Kueishan (China); Liao, Chun-Ta [Chang Gung Memorial Hospital Linkou Medical Center, Department of Otorhinolaryngology, Kueishan (China); Ko, Sheung-Fat; Chin, Shu-Chyn [Chang Gung Memorial Hospital Linkou Medical Center, Molecular Imaging Center and Department of Diagnostic Radiology, Kueishan (China); Hsu, Cheng-Lung [Chang Gung Memorial Hospital Linkou Medical Center, Department of Medical Oncology, Kueishan (China)

    2009-01-15

    We prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC). A total of 111 patients with histologically proven NPC were investigated with PET/CT and conventional imaging (head-and-neck MRI, chest X-ray, abdominal ultrasound, and bone scan) before treatment. The respective findings were reviewed independently and then compared with each other. With regard to T staging, PET/CT showed a discrepancy with head-and-neck MRI in 36 (32.4%) of the study subjects. With regard to N staging, PET/CT showed a discrepancy with head-and-neck MRI in 15 (13.5%) patients. Among the discordant cases, MRI was superior in demonstrating tumor involvement in the parapharyngeal space, skull base, intracranial area, sphenoid sinus, and retropharyngeal nodes while PET/CT was superior in demonstrating neck nodal metastasis. PET/CT disclosed 13 of 16 patients with distant malignancy compared with four patients disclosed by conventional imaging work-up. The false-positive rate of PET/CT was 18.8%. PET/CT correctly modified M staging in eight patients (7.2%) and disclosed a second primary lung malignancy in one patient (0.9%). In NPC patients, MRI appears to be superior to PET/CT for the assessment of locoregional invasion and retropharyngeal nodal metastasis. PET/CT is more accurate than MRI for determining cervical nodal metastasis and should be the better reference for the neck status. PET/CT has an acceptable diagnostic yield and a low false-positive rate for the detection of distant malignancy and can replace conventional work-up to this aim. PET/CT and head-and-neck MRI are suggested for the initial staging of NPC patients. (orig.)

  13. Diagnostic probability function for acute coronary heart disease garnered from experts' tacit knowledge.

    Science.gov (United States)

    Steurer, Johann; Held, Ulrike; Miettinen, Olli S

    2013-11-01

    Knowing about a diagnostic probability requires general knowledge about the way in which the probability depends on the diagnostic indicators involved in the specification of the case at issue. Diagnostic probability functions (DPFs) are generally unavailable at present. Our objective was to illustrate how diagnostic experts' case-specific tacit knowledge about diagnostic probabilities could be garnered in the form of DPFs. Focusing on diagnosis of acute coronary heart disease (ACHD), we presented doctors with extensive experience in hospitals' emergency departments a set of hypothetical cases specified in terms of an inclusive set of diagnostic indicators. We translated the medians of these experts' case-specific probabilities into a logistic DPF for ACHD. The principal result was the experts' typical diagnostic probability for ACHD as a joint function of the set of diagnostic indicators. A related result of note was the finding that the experts' probabilities in any given case had a surprising degree of variability. Garnering diagnostic experts' case-specific tacit knowledge about diagnostic probabilities in the form of DPFs is feasible to accomplish. Thus, once the methodology of this type of work has been "perfected," practice-guiding diagnostic expert systems can be developed. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Strongly lateralized activation in language fMRI of atypical dominant patients-implications for presurgical work-up.

    NARCIS (Netherlands)

    Wellmer, J.; Weber, B.; Weis, S.; Klaver, P.; Urbach, H.; Reul, J.; Fernandez, G.S.E.; Elger, C.E.

    2008-01-01

    PURPOSE: Functional magnetic resonance imaging (fMRI) is being used increasingly for language dominance assessment in the presurgical work-up of patients with pharmacoresistant epilepsy. However, the interpretation of bilateral fMRI-activation patterns is difficult. Various studies propose

  15. Functional hypothalamic amenorrhoea — diagnostic challenges, monitoring, and treatment.

    Science.gov (United States)

    Sowińska-Przepiera, Elżbieta; Andrysiak-Mamos, Elżbieta; Jarząbek-Bielecka, Grażyna; Walkowiak, Aleksandra; Osowicz-Korolonek, Lilianna; Syrenicz, Małgorzata; Kędzia, Witold; Syrenicz, Anhelli

    2015-01-01

    Functional hypothalamic amenorrhoea (FHA) is associated with functional inhibition of the hypothalamic-pituitary-ovarian axis. Causes of FHA can be classified into the three groups: 1) stress-related factors, 2) consequences of weight loss and/or underweight, and 3) consequences of physical exercise or practicing sports. Diagnosis of FHA should be based on a history of menstrual disorders. During physical examination, patients with FHA present with secondary and tertiary sex characteristics specific for the pubertal stage preceding development of the condition and with the signs of hypoestrogenism. Laboratory results determine further management of patients with amenorrhea, and thus their correct interpretation is vital for making appropriate therapeutic decisions. Treatment of chronic anovulation, menstrual disorders, and secondary amenorrhea resulting from hypothalamic disorders should be aimed at the elimination of the primary cause, i.e. a decrease in psycho-emotional strain, avoidance of chronic stressors, reduction of physical exercise level, or optimisation of BMI in patients who lose weight. If menses do not resume after a period of six months or primary causative treatment is not possible, neutralisation of hypoestrogenism consequences, especially unfavourable effects on bone metabolism, become the main issue. Previous studies have shown that oestroprogestagen therapy is useful in both the treatment of menstrual disorders and normalisation of bone mineral density. Hormonal preparations should be introduced into therapeutic protocol on an individualised basis.

  16. Diagnostic stability among chronic patients with functional psychoses: an epidemiological and clinical study

    Directory of Open Access Journals (Sweden)

    Jakobsen Klaus D

    2007-08-01

    Full Text Available Abstract Background Diagnostic stability and illness course of chronic non-organic psychoses are complex phenomena and only few risk factors or predictors are known that can be used reliably. This study investigates the diagnostic stability during the entire course of illness in patients with non-organic psychoses and attempts to identify non-psychopathological risk factors or predictors. Method 100 patients with functional psychosis were initially characterised using the Operational Criteria Checklist for Psychotic Illness and Affective Illness (OPCRIT, medical records and health registers. To study the stability of diagnoses (i.e. shifts per time, we used registry data to define four measures of diagnostic variation that were subsequently examined in relation to four possible measures of time (i.e. observation periods or hospitalisation events. Afterwards, we identified putative co-variables and predictors of the best measures of diagnostic stability. Results All four measures of diagnostic variation are very strongly associated with numbers-of-hospitalisations and less so with duration-of-illness, duration-of-hospitalisation and with year-of-first-admission. The four measures of diagnostic variation corrected for numbers-of-hospitalisations were therefore used to study the diagnostic stability. Conventional predictors of illness course – e.g. age-of-onset and premorbid-functioning – are not significantly associated with stability. Only somatic-comorbidity is significantly associated with two measures of stability, while family-history-of-psychiatric-illness and global-assessment-of-functioning (GAF scale score show a trend. However, the traditional variables age-of-first-admission, civil-status, first-diagnosis-being-schizophrenia and somatic-comorbidity are able to explain two-fifth of the variation in numbers-of-hospitalisations. Conclusion Diagnostic stability is closely linked with the contact between patient and the healthcare system

  17. Renal failure and occupational exposure to organic solvents: what work-up should be performed?

    Science.gov (United States)

    Mediouni, Zakia; Potherat, Guillaume; Barrere, Xavier; Debure, Alain; Descatha, Alexis

    2011-01-01

    The etiological work-up of a disease with an occupational component, such as renal failure associated with exposure to organic solvents, may include several complementary investigations. The authors discussed certain elements of the etiological work-up in the light of a clinical case, particularly the individual and collective advantages and disadvantages of this work-up. Further investigations would not have provided the patient with any individual or collective benefit and were therefore not performed, whereas other investigations (environmental studies, screening of fellow workers) may provide collective rather than individual benefits, but must be decided by a multidisciplinary approach. A multidisciplinary study (general practitioner, nephrologist, occupational health physician, and specialist in toxicology) is necessary to discuss the appropriate etiological work-up, taking into account the individual and collective benefit-risk balance. Copyright © 2011 Taylor & Francis Group, LLC

  18. Diagnostic Profiles of Patients Differentially Failing Executive Functioning Measures.

    Science.gov (United States)

    Hammers, Dustin; Ramirez, Gabriela; Persad, Carol; Heidebrink, Judith; Barbas, Nancy; Giordani, Bruno

    2016-05-01

    Limited research exists to explain differential executive functioning impairment in clinical populations, particularly between the Wisconsin Card Sorting Task (WCST) and the Trail Making Test (TMT). The distribution of clinical diagnoses was examined in patients failing none, one, or both tasks, and executive task performance was compared among dementia-related diagnoses. Two hundred and sixty-six participants received evaluations through an Alzheimer's Disease Research Center, which included executive tasks. Dementia-related diagnoses were established through consensus. Chi-square analyses indicated that TMT failure, with or without WCST failure, possessed higher associations with dementia diagnoses. Repeated measures analysis of variance similarly indicated that participants with dementia, especially mild and moderate severity, performed worse on TMT. Executive dysfunction was observed in dementia-related diagnoses, and TMT failure was implicated in dementia in higher proportions than WCST impairment. Trail Making Test appears more sensitive than WCST for assessing executive impairment across diagnoses, especially when time and resources are limited in screening and clinical settings. © The Author(s) 2015.

  19. Advanced radiological work-up as an adjunct to decision in early reconstructive surgery in brachial plexus injuries

    Directory of Open Access Journals (Sweden)

    Björkman Anders

    2010-07-01

    Full Text Available Abstract Background As neurophysiologic tests may not reveal the extent of brachial plexus injury at the early stage, the role of early radiological work-up has become increasingly important. The aim of the study was to evaluate the concordance between the radiological and clinical findings with the intraoperative findings in adult patients with brachial plexus injuries. Methods Seven consecutive male patients (median age 33; range 15-61 with brachial plexus injuries, caused by motor cycle accidents in 5/7 patients, who underwent extensive radiological work-up with magnetic resonance imaging (MRI, computed tomography myelography (CT-M or both were included in this retrospective study. A total of 34 spinal nerve roots were evaluated by neuroradiologists at two different occasions. The degree of agreement between the radiological findings of every individual nerve root and the intraoperative findings was estimated by calculation of kappa coefficient (К-value. Using the operative findings as a gold standard, the accuracy, sensitivity, specificity, positive predictive value (PPV and negative predictive value (NPV of the clinical findings and the radiological findings were estimated. Results The diagnostic accuracy of radiological findings was 88% compared with 65% for the clinical findings. The concordance between the radiological findings and the intraoperative findings was substantial (К = 0.76 compared with only fair (К = 0.34 for the clinical findings. There were two false positive and two false negative radiological findings (sensitivity and PPV of 0.90; specificity and NPV of 0.87. Conclusions The advanced optimized radiological work-up used showed high reliability and substantial agreement with the intraoperative findings in adult patients with brachial plexus injury.

  20. Neuropsychological functioning in early-onset first-episode psychosis: comparison of diagnostic subgroups.

    Science.gov (United States)

    Zabala, Arantzazu; Rapado, Marta; Arango, Celso; Robles, Olalla; de la Serna, Elena; González, Cristina; Rodríguez-Sánchez, José Manuel; Andrés, Patricia; Mayoral, María; Bombín, Igor

    2010-04-01

    The aims of this study were to examine the nature and extent of cognitive impairment in first-episode early-onset psychosis (FE-EOP) soon after their stabilisation and to search for potential differences according to specific diagnostic sub-groups of patients. As part of a Spanish multicentre longitudinal study, 107 FE-EOP patients and 98 healthy controls were assessed on the following cognitive domains: attention, working memory, executive functioning, and verbal learning and memory. Three diagnostic categories were established in the patient sample: schizophrenia (n = 36), bipolar disorder (n = 19), and other psychosis (n = 52). Patients performed significantly worse than controls in all cognitive domains. The three diagnostic sub-groups did not differ in terms of impaired/preserved cognitive functions or degree of impairment. FE-EOP patients show significant cognitive impairment that, during this early phase, seems to be non-specific to differential diagnosis.

  1. The role of PET in initial work-up and evaluation after therapy in patients with carcinoma of unknown primary

    Energy Technology Data Exchange (ETDEWEB)

    Ryoo, Baek Yeol; Kang, Yoon Koo

    1998-12-01

    The carcinoma of unknown primary occupied 5 - 10 % of all malignancies. It is heterogenous in origin and has poor prognosis. The indentification of primary site and definition of involved area are more helpful in the management. The efficacy of positron emission tomography (PET) with fluorine-18- fluorodeoxyglucose (F18-FDG) positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors such as breast, pancreas and head and neck cancers. In carcinoma of unknown primary, it was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG may be much helpful in identifying primary site and defining involved area. The authors evaluated the usefulness of PET with F18-FDG in initial work-up and in evaluation after radical therapy for the patients with carcinoma of unknown primary. The visual analysis of FDG-PET would be helpful in identifying primary site and defining involved area. In detecting recurrent of residual lesions, FDG-PET seemed to be less helpful than conventional diagnostic work-up. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in carcinoma of unknown primary.

  2. Diagnostic nerve ultrasonography; Diagnostische Nervensonographie

    Energy Technology Data Exchange (ETDEWEB)

    Baeumer, T. [Universitaet zu Luebeck CBBM, Haus 66, Institut fuer Neurogenetik, Luebeck (Germany); Grimm, A. [Universitaetsklinikum Tuebingen, Klinik und Poliklinik fuer Neurologie, Tuebingen (Germany); Schelle, T. [Staedtisches Klinikum Dessau, Neurologische Klinik, Dessau (Germany)

    2017-03-15

    For the diagnostics of nerve lesions an imaging method is necessary to visualize peripheral nerves and their surrounding structures for an etiological classification. Clinical neurological and electrophysiological investigations provide functional information about nerve lesions. The information provided by a standard magnetic resonance imaging (MRI) examination is inadequate for peripheral nerve diagnostics; however, MRI neurography is suitable but on the other hand a resource and time-consuming method. Using ultrasonography for peripheral nerve diagnostics. With ultrasonography reliable diagnostics of entrapment neuropathies and traumatic nerve lesions are possible. The use of ultrasonography for neuropathies shows that a differentiation between different forms is possible. Nerve ultrasonography is an established diagnostic tool. In addition to the clinical examination and clinical electrophysiology, structural information can be obtained, which results in a clear improvement in the diagnostics. Ultrasonography has become an integral part of the diagnostic work-up of peripheral nerve lesions in neurophysiological departments. Nerve ultrasonography is recommended for the diagnostic work-up of peripheral nerve lesions in addition to clinical and electrophysiological investigations. It should be used in the clinical work-up of entrapment neuropathies, traumatic nerve lesions and spacy-occupying lesions of nerves. (orig.) [German] Fuer die Diagnostik von Nervenlaesionen ist ein bildgebendes Verfahren zur Darstellung des peripheren Nervs und seiner ihn umgebenden Strukturen fuer eine aetiologische Einordnung erforderlich. Mit der klinisch-neurologischen Untersuchung und Elektrophysiologie ist eine funktionelle Aussage ueber die Nervenlaesion moeglich. In der Standard-MRT-Untersuchung wird der periphere Nerv nur unzureichend gut dargestellt. Die MRT-Neurographie ist ein sehr gutes, aber auch zeit- und ressourcenintensives Verfahren. Nutzung des Ultraschalls fuer die

  3. The diagnostic and therapeutic aspects of loss-of-function cardiac sodium channelopathies in children

    NARCIS (Netherlands)

    Chockalingam, Priya; Clur, Sally-Ann B.; Breur, Johannes M. P. J.; Kriebel, Thomas; Paul, Thomas; Rammeloo, Lukas A.; Wilde, Arthur A. M.; Blom, Nico A.

    2012-01-01

    BACKGROUND Loss-of-function sodium channelopathies manifest as a spectrum of diseases including Brugada syndrome (BrS) and cardiac conduction disease. OBJECTIVE To analyze the diagnostic and therapeutic aspects of these disorders in children. METHODS Patients aged <= 16 years with genetically

  4. 78 FR 21128 - Molecular Diagnostic Instruments With Combined Functions; Draft Guidance for Industry and Food...

    Science.gov (United States)

    2013-04-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2013-D-0258] Molecular Diagnostic Instruments With Combined Functions; Draft Guidance for Industry and Food and Drug Administration Staff; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food...

  5. Geriatric work-up in the Nordic countries. The Nordic approach to comprehensive geriatric assessment

    DEFF Research Database (Denmark)

    Sletvold, O; Tilvis, R; Jonsson, A

    1996-01-01

    A group established by the Nordic professors of geriatrics has developed a position document presenting a shared and updated review of geriatric work-up as a way of comprehensive geriatric assessment in the Nordic countries. The main intention is that the document will serve as support and help......, the background for developing a Nordic version of geriatric work-up is shared attitudes and principally the same organization of the health care system, and collaboration within geriatrics for many years. Several trials on comprehensive geriatric assessment and management performed in different settings have......, all being modified by extra- and intraindividual factors. Handicap is defined as the disability gap. Different health professionals have varying responsibilities in the geriatric team-work, but all should be dedicated to establish common goals. The geriatric work-up is presented with success factors...

  6. Safety and Yield of Diagnostic ERCP in Liver Transplant Patients with Abnormal Liver Function Tests

    Directory of Open Access Journals (Sweden)

    Jayapal Ramesh

    2014-01-01

    Full Text Available Background. Abnormal liver enzymes postorthotopic liver transplant (OLT may indicate significant biliary pathology or organ rejection. There is very little known in the literature regarding the current role of diagnostic ERCP in this scenario. Aim. To review the utility of diagnostic ERCP in patients presenting with abnormal liver function tests in the setting of OLT. Methods. A retrospective review of diagnostic ERCPs in patients with OLT from 2002 to 2013 from a prospectively maintained, IRB approved database. Results. Of the 474 ERCPs performed in OLT patients, 210 (44.3%; 95% CI 39.8–48.8 were performed for abnormal liver function tests during the study period. Majority of patients were Caucasian (83.8%, male (62.4% with median age of 55 years (IQR 48–62 years. Biliary cannulation was successful in 99.6% of cases and findings included stricture in 45 (21.4 %; biliary stones/sludge in 23 (11%; biliary dilation alone in 31 (14.8%; and normal in 91 (43.3%. Three (1.4% patients developed mild, self-limiting pancreatitis; one patient (0.5% developed cholangitis and two (1% had postsphincterotomy bleeding. Multivariate analyses showed significant association between dilated ducts on imaging with a therapeutic outcome. Conclusion. Diagnostic ERCP in OLT patients presenting with liver function test abnormalities is safe and frequently therapeutic.

  7. Influence of environmental tobacco smoke on morphology and functions of cardiovascular system assessed using diagnostic imaging.

    Science.gov (United States)

    Gać, Paweł; Poręba, Małgorzata; Pawlas, Krystyna; Sobieszczańska, Małgorzata; Poręba, Rafał

    Exposure to tobacco smoke is a significant problem of environmental medicine. Tobacco smoke contains over one thousand identified chemicals including numerous toxicants. Cardiovascular system diseases are the major cause of general mortality. The recent development of diagnostic imaging provided methods which enable faster and more precise diagnosis of numerous diseases, also those of cardiovascular system. This paper reviews the most significant scientific research concerning relationship between environmental exposure to tobacco smoke and the morphology and function of cardiovascular system carried out using diagnostic imaging methods, i.e. ultrasonography, angiography, computed tomography and magnetic resonance imaging. In the forthcoming future, the studies using current diagnostic imaging methods should contribute to the reliable documentation, followed by the wide-spreading knowledge of the harmful impact of the environmental tobacco smoke exposure on the cardiovascular system.

  8. Efficiency of Staging Work-Ups in the Evaluation of Carcinoma of the Uterine Cervix

    International Nuclear Information System (INIS)

    Kim, Jae Sung; Ha, Sung Whan

    1991-01-01

    A series of 510 patients with carcinoma of the uterine cervix given the curative radiation therapy from March 1979 through December 1986 was evaluated to determine the value of intravenous pyelography(IVP), cystoscopy, sigmoidoscopy, and abdomino-pelvic CT as staging work-up prior to treatment. On IVP and cystoscopy, 10.7%(49/456) and 5/3%(24/452) showed abnormality, respectively, but only 0.7% (3/413) did on signoidoscopy. As a result of these work-ups prerequisite to FIGO staging, twenty six (5.1%) out of 510 patients were upstaged from the stage determined by the findings of physical examination alone. The proportions of upstaging in each stage were as follows none in stage IB(35), IIA (89) and IIIA(8), 7.9%(20/252) in stage IIB(14 patients to FIGO Stage IIIB, 6 patients to FIGO stage IVA), and 4.8% (6/126) in stage IIIB (all to FIGO stage IVA). Positive findings of staging work-ups were found only in patients with advanced stages of stage IIB or over determined by physical examination alone but not in those with earlier stages. CT was performed in 337 patients. CT detected pelvic lymph node (LN) enlargement in 25.2% (85/337) and paraaortic LN enlargement in 7.4% (25/337). Pelvic LN positivity was well correlated with increasing stage but paraaortic LN positivity was not. In the evaluation of parametrial involvement, CT findings were in accordance with those of physical examination only in 65.6%(442/674). When compared with endoscopic studies, CT had much lower positive predictive value than negative predictive value in the evaluation of adjacent organ invasion. The staging work-ups should be individualized by the disease extent of each patient, and then the efficiency of work-ups may be increased without compromising the appropriate FIGO staging and treatment

  9. Diagnostic classification based on functional connectivity in chronic pain: model optimization in fibromyalgia and rheumatoid arthritis.

    Science.gov (United States)

    Sundermann, Benedikt; Burgmer, Markus; Pogatzki-Zahn, Esther; Gaubitz, Markus; Stüber, Christoph; Wessolleck, Erik; Heuft, Gereon; Pfleiderer, Bettina

    2014-03-01

    The combination of functional magnetic resonance imaging (fMRI) of the brain with multivariate pattern analysis (MVPA) has been proposed as a possible diagnostic tool. Goal of this investigation was to identify potential functional connectivity (FC) differences in the salience network (SN) and default mode network (DMN) between fibromyalgia syndrome (FMS), rheumatoid arthritis (RA), and controls (HC) and to evaluate the diagnostic applicability of derived pattern classification approaches. The resting period during an fMRI examination was retrospectively analyzed in women with FMS (n = 17), RA (n = 16), and HC (n = 17). FC was calculated for SN and DMN subregions. Classification accuracies of discriminative MVPA models were evaluated with cross-validation: (1) inferential test of a single method, (2) explorative model optimization. No inferentially tested model was able to classify subjects with statistically significant accuracy. However, the diagnostic ability for the differential diagnostic problem exhibited a trend to significance (accuracy: 69.7%, P = .086). Optimized models in the explorative analysis reached accuracies up to 73.5% (FMS vs. HC), 78.8% (RA vs. HC), and 78.8% (FMS vs. RA) whereas other models performed at or below chance level. Comparable support vector machine approaches performed above average for all three problems. Observed accuracies are not sufficient to reliably differentiate between FMS and RA for diagnostic purposes. However, some indirect evidence in support of the feasibility of this approach is provided. This exploratory analysis constitutes a fundamental model optimization effort to be based on in further investigations. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

  10. Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI

    International Nuclear Information System (INIS)

    Furtner, J.; Prayer, D.; Sachs, G.

    2010-01-01

    Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [de

  11. Diagnostic work-up of 449 consecutive girls who were referred to be evaluated for precocious puberty

    DEFF Research Database (Denmark)

    Mogensen, Signe Sloth; Aksglaede, Lise; Mouritsen, Annette

    2011-01-01

    A decrease in age at pubertal onset has been observed internationally. The aim of this study was to describe a large cohort of Caucasian girls referred with signs of early puberty according to etiology and compare biochemical characteristics....

  12. A proposed evidence-based neonatal work-up to confirm or refute allegations of intrapartum asphyxia.

    Science.gov (United States)

    Muraskas, Jonathan K; Morrison, John C

    2010-08-01

    To propose a clinical work-up in term and near-term newborns to address the nine American College of Obstetricians and Gynecologists (the College) and American Academy of Pediatrics criteria to define an acute intrapartum event sufficient to cause cerebral palsy. We examined our experience as neonatal expert witnesses in 103 closed claims of alleged intrapartum asphyxia with poor newborn outcome over a 21-year period from 1987 to 2008. We estimated how often the clinical components of this proposed work-up were not obtained or recorded in the medical record. Cord arterial blood gases and placental pathology were not obtained or sent in 38% and 32% of the 103 cases, respectively. Routine neonatal laboratory tests, including a complete blood count with differential, nucleated red blood cells, electrolytes, calcium, coagulation profile, and renal and liver function tests, were frequently absent. Cranial imaging in ultrasonograms, computed tomography, and magnetic resonance imaging were absent in more than 50% of the cases reviewed and were often not scheduled at optimal times. The medical record of newborns with poor outcomes frequently has a paucity of objective, evidence-based data. This leads to speculation and unethical expert testimony. The protocol will assist in confirming or refuting allegations of intrapartum asphyxia. III.

  13. About the Big Graphs Arising when Forming the Diagnostic Models in a Reconfigurable Computing Field of Functional Monitoring and Diagnostics System of the Spacecraft Onboard Control Complex

    Directory of Open Access Journals (Sweden)

    L. V. Savkin

    2015-01-01

    Full Text Available One of the problems in implementation of the multipurpose complete systems based on the reconfigurable computing fields (RCF is the problem of optimum redistribution of logicalarithmetic resources in growing scope of functional tasks. Irrespective of complexity, all of them are transformed into an orgraph, which functional and topological structure is appropriately imposed on the RCF based, as a rule, on the field programmable gate array (FPGA.Due to limitation of the hardware configurations and functions realized by means of the switched logical blocks (SLB, the abovementioned problem becomes even more critical when there is a need, within the strictly allocated RCF fragment, to realize even more complex challenge in comparison with the problem which was solved during the previous computing step. In such cases it is possible to speak about graphs of big dimensions with respect to allocated RCF fragment.The article considers this problem through development of diagnostic algorithms to implement diagnostics and control of an onboard control complex of the spacecraft using RCF. It gives examples of big graphs arising with respect to allocated RCF fragment when forming the hardware levels of a diagnostic model, which, in this case, is any hardware-based algorithm of diagnostics in RCF.The article reviews examples of arising big graphs when forming the complicated diagnostic models due to drastic difference in formation of hardware levels on closely located RCF fragments. It also pays attention to big graphs emerging when the multichannel diagnostic models are formed.Three main ways to solve the problem of big graphs with respect to allocated RCF fragment are given. These are: splitting the graph into fragments, use of pop-up windows with relocating and memorizing intermediate values of functions of high hardware levels of diagnostic models, and deep adaptive update of diagnostic model.It is shown that the last of three ways is the most efficient

  14. Differential Item Functioning Assessment in Cognitive Diagnostic Modeling: Application of the Wald Test to Investigate DIF in the DINA Model

    Science.gov (United States)

    Hou, Likun; de la Torre, Jimmy; Nandakumar, Ratna

    2014-01-01

    Analyzing examinees' responses using cognitive diagnostic models (CDMs) has the advantage of providing diagnostic information. To ensure the validity of the results from these models, differential item functioning (DIF) in CDMs needs to be investigated. In this article, the Wald test is proposed to examine DIF in the context of CDMs. This study…

  15. Functional imaging - a new tool for X-ray functional diagnostics

    International Nuclear Information System (INIS)

    Boehm, M.; Erbe, W.; Sonne, B.; Hoehne, K.H.; Nicolae, G.C.; Pfeiffer, G.

    1978-05-01

    The method of functional imaging is applied to X-ray angiograms. Functional images are generated by inserting at each point of an X-ray image a computed grey value proportional to a dynamic parameter (such as blood velocity) instead of the recorded X-ray absorption value. For this purpose a new system for angiographic image processing has been developed. First results show that the method is a tool to extract more information about the blood dynamics in organs in an easier and faster way than with the conventional angiographic technique. (orig.)

  16. Automation of scheduling and file room functions of a Diagnostic Radiology Department. Volume I

    International Nuclear Information System (INIS)

    Lazarus, C.B.; Poitras, J.W.; Mitchell, W.P.; Knowlton, R.H.; Kaley, M.E.; Ianello, J.M.; Arenson, R.L.; Taveras, J.M.; Barnett, G.O.

    1975-02-01

    The automation of patient scheduling and file room functions of a diagnostic radiology department has been successfully accomplished at the Massachusetts General Hospital. Carried out under contract from the Bureau of Radiological Health, the pilot system includes scheduling, file room, and registration modules. The system has resulted in a reduction in delays in obtaining examinations and reports, and reduction in unnecessary radiation by allowing for the detection of possible duplicate, similar, or conflicting examinations. Film tracking ensures knowledge of the location of a master folder at all times

  17. How doctors generate diagnostic hypotheses: a study of radiological diagnosis with functional magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Marcio Melo

    Full Text Available In medical practice, diagnostic hypotheses are often made by physicians in the first moments of contact with patients; sometimes even before they report their symptoms. We propose that generation of diagnostic hypotheses in this context is the result of cognitive processes subserved by brain mechanisms that are similar to those involved in naming objects or concepts in everyday life.To test this proposal we developed an experimental paradigm with functional magnetic resonance imaging (fMRI using radiological diagnosis as a model. Twenty-five radiologists diagnosed lesions in chest X-ray images and named non-medical targets (animals embedded in chest X-ray images while being scanned in a fMRI session. Images were presented for 1.5 seconds; response times (RTs and the ensuing cortical activations were assessed. The mean response time for diagnosing lesions was 1.33 (SD ±0.14 seconds and 1.23 (SD ±0.13 seconds for naming animals. 72% of the radiologists reported cogitating differential diagnoses during trials (3.5 seconds. The overall pattern of cortical activations was remarkably similar for both types of targets. However, within the neural systems shared by both stimuli, activation was significantly greater in left inferior frontal sulcus and posterior cingulate cortex for lesions relative to animals.Generation of diagnostic hypotheses and differential diagnoses made through the immediate visual recognition of clinical signs can be a fast and automatic process. The co-localization of significant brain activation for lesions and animals suggests that generating diagnostic hypotheses for lesions and naming animals are served by the same neuronal systems. Nevertheless, diagnosing lesions was cognitively more demanding and associated with more activation in higher order cortical areas. These results support the hypothesis that medical diagnoses based on prompt visual recognition of clinical signs and naming in everyday life are supported by similar

  18. Functional brain imaging with SPECT in normal again and dementia. Methodological, pathophysiological, and diagnostic aspects

    International Nuclear Information System (INIS)

    Waldemar, G.

    1996-03-01

    New developments in instrumentation, radiochemistry, and data analysis, particularly the introduction of 99m Tc-labeled brain-retained tracers for perfusion studies, have opened up a new era of single photon emission computed tomography (SPECT). In this review critical methodological issues relating to the SPECT instrument, the radioactive tracers, the scanning procedure, the data analysis and interpretation of data, and subject selection are discussed together with the changes in regional cerebral blood flow (rCBF) observed in normal aging. An overview is given of the topography and the pathophysiological and diagnostic significance of focal rCBF deficits in Alzheimer's disease and in other dementia disorders, in which SPECT is capable of early or preclinical disease detection. In Alzheimer's disease, the diagnostic sensitivity and specificity of focal rCBF deficits measured with SPECT and brain-retained tracers are very high, in particular when combined with medial temporal lob atrophy on CT. Together with neuropsychological testing, SPECT serves to map the topography of brain dysfunction. Thus, in the clinical setting, SPECT provides information that is supplemental to that obtained in other studies. Future applications include neuroreceptor studies and treatment studies, in which SPECT may serve as a diagnostic aid in the selection of patients and as a potential mean for monitoring treatment effects. Although positron emission tomography is the best characterized tool for addressing some of these clinical and research issues in dementia, only the less expensive and technically simpler SPECT technique will have the potential of being available as a screening diagnostic instrument in the clinical setting. It is concluded that, properly approached, functional brain imaging with SPECT represents an important tool in the diagnosis, management, and research of dementia disorders. (au) 251 refs

  19. 3D-diagnostics of function of electron distribution in plasma

    Directory of Open Access Journals (Sweden)

    А. С. Мустафаев

    2017-08-01

    Full Text Available The paper gives further development of the method of a plate single-sided probe, which makes it possible to reconstruct the total electron velocity distribution function in an axially symmetric nonequilibrium plasma with an arbitrary degree of anisotropy. The method is improved for plasma diagnostics without the assumption of any symmetry. The theory of the method is developed and analytical relations are obtained connecting the Legendre components of the second-order derivative of the probe current with respect to the potential of the probe and the electron distribution function. The method is experimentally tested in the plasma of a positive column of a helium glow discharge. New possibilities of the method for investigating plasma near the boundaries are demonstrated and non-traditional information is obtained on the processes of escape of charged particles from the plasma volume on the walls.

  20. How should we work up a patient with chronic diarrhea and are ...

    African Journals Online (AJOL)

    This review addresses two clinical situations medical practitioners see frequently; in the first scenario an appropriate cost-efficient diagnostic approach is described and in the second situation the uncertainty regarding a therapeutic choice is elucidated.

  1. Diagnosis and diagnostic tests for fibromyalgia (syndrome).

    Science.gov (United States)

    Häuser, W; Wolfe, F

    2012-09-28

    To present diagnostic criteria for the clinical diagnosis of fibromyalgia syndrome (FMS) and to offer a scheme for diagnostic work-up in clinical practice. Narrative review of the literature, consensus documents by the American College of Rheumatology (ACR), evidence-based interdisciplinary German guidelines on the diagnosis and management of FMS. The ACR 1990 classification criteria emphasized tender points and widespread pain as the key features of FMS. In 2010, the ACR proposed preliminary diagnostic criteria for fibromyalgia that abandoned the tender point count and placed increased emphasis of patient symptoms. A later modification of the ACR 2010 criteria for use in surveys employed a self-report questionnaire (Fibromyalgia Survey Questionnaire FSQ) to assess patient symptoms. The FSQ can be used to assist physician's diagnosis of FMS. We recommend a stepwise diagnostic work-up of patients with chronic widespread pain (CWP) in primary care: Complete medical history including medication, complete medical examination, basic laboratory tests to screen for inflammatory or endocrinology diseases, referral to specialists only in case of suspected somatic diseases, assessment of limitations of daily functioning, screening for other functional somatic symptoms and mental disorders, and referring to mental health specialists in case of mental disorder. The diagnosis of FMS is easy in most patients with CWP and does not ordinarily require a rheumatologist. A rheumatologist's expertise might be needed to exclude difficult to diagnose or concomitant inflammatory rheumatic diseases. In the presence of mental illness referral to a mental health specialist for evaluation is recommended.

  2. Diagnostic Accuracy, Sensitivity, and Specificity of Executive Function Tests in Moderate Traumatic Brain Injury in Ghana.

    Science.gov (United States)

    Adjorlolo, Samuel

    2016-04-27

    The sociocultural differences between Western and sub-Saharan African countries make it imperative to standardize neuropsychological tests in the latter. However, Western-normed tests are frequently administered in sub-Saharan Africa because of challenges hampering standardization efforts. Yet a salient topical issue in the cross-cultural neuropsychology literature relates to the utility of Western-normed neuropsychological tests in minority groups, non-Caucasians, and by extension Ghanaians. Consequently, this study investigates the diagnostic accuracy, sensitivity, and specificity of executive function (EF) tests (The Stroop Test, Trail Making Test, and Controlled Oral Word Association Test), and a Revised Quick Cognitive Screening Test (RQCST) in a sample of 50 patients diagnosed with moderate traumatic brain injury and 50 healthy controls in Ghana. The EF test scores showed good diagnostic accuracy, with area under the curve (AUC) values of the Trail Making Test scores ranging from .746 to .902. With respect to the Stroop Test scores, the AUC values ranged from .793 to .898, while Controlled Oral Word Association Test had AUC value of .787. The RQCST scores discriminated between the groups, with AUC values ranging from .674 to .912. The AUC values of composite EF score and a neuropsychological score created from EF and RQCST scores were .936 and. 942, respectively. Additionally, the Stroop Test, Trail Making Test, EF composite score, and RQCST scores showed good to excellent sensitivities and specificities. In general, this study has shown that commonly used EF tests in Western countries have diagnostic accuracy, sensitivity, and specificity when administered in Ghanaian samples. The findings and implications of the study are discussed. © The Author(s) 2016.

  3. Psychophysiological methods for the diagnostics of human functional states: New approaches and perspectives

    Directory of Open Access Journals (Sweden)

    Chernorizov A.M.

    2016-12-01

    Full Text Available L. S. Vygotsky in his famous methodological essay “The historical meaning of psychological crisis” (1928 emphasized the importance of studying any psychological process or state as a “whole” — that is, as characterized from the subjective and objective sides at the same time. This position is fully relevant for studying the human functional states (FSes. Today the objective psychophysiological diagnostics of human FSes in activities associated with a high risk of technological disasters (in nuclear-power plants, transportation, the chemical industry are extremely relevant and socially important. This article reviews some new psychophysiological methods of FS assessment that are being developed in Russia and abroad and discusses different aspects of developing integral psychophysiological FS assessment. The emphasis is on distant methods of FS diagnostics: the bioradiolocation method, laser Doppler vibrometry, eye tracking, audio and video recordings, infrared thermography. The possibilities and limitations of the most popular emotion atlases — the Facial Affect Scoring Technique (FAST and the Facial Action Coding System (FACS — in developing distant visual-range and infrared-range systems for automated classification of facial expressions are analyzed. A special section of the article concentrates on the problem of constructing an integral psychophysiological FS index. Mathematical algorithms that provide a partition of FS indicators into different FS types are based on various methods of machine learning. We propose the vector approach for construction of complex estimations of the human FSes.

  4. New proposal on the development of machine protection functions for ITER diagnostics control

    International Nuclear Information System (INIS)

    Yamamoto, Tsuyoshi; Yatsuka, Eiichi; Hatae, Takaki; Takeuchi, Masaki; Kitazawa, Sin-iti; Ogawa, Hiroaki; Kawano, Yasunori; Itami, Kiyoshi; Ota, Kazuya; Hashimoto, Yasunori; Nakamura, Kitaru; Sugie, Tatsuo

    2016-01-01

    There is a need to develop ITER instrumentation and control (I and C) systems with high reliabilities. Interlock systems that activate machine protection functions are implemented on robust wired-logic systems such as programmable logic controllers (PLCs). We herein propose a software tool that generates program code templates for the control systems using PLC logic. This tool decreases careless mistakes by developers and increases reliability of the program codes. A large-scale engineering database has been implemented in the ITER project. To derive useful information from this database, we propose adding semantic data to it using the Resource Description Framework format. In our novel proposal for the ITER diagnostic control system, a guide words generator that analyzes the engineering data by inference is applied to the hazard and operability study. We validated the methods proposed in this paper by applying them to the preliminary design for the I and C system of the ITER edge Thomson scattering system. (author)

  5. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

    Science.gov (United States)

    2012-01-01

    Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA). In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications. PMID:22731684

  6. Psychiatric comorbidities in asperger syndrome and high functioning autism: diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Mazzone Luigi

    2012-06-01

    Full Text Available Abstract Several psychiatric conditions, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS and High Functioning Autism (HFA. In this review we examine the interplay between psychiatric comorbidities and AS/HFA. In particular, we will focus our attention on three main issues. First, we examine which psychiatric disorders are more frequently associated with AS/HFA. Second, we review which diagnostic tools are currently available for clinicians to investigate and diagnose the associated psychiatric disorders in individuals with AS/HFA. Third, we discuss the challenges that clinicians and researchers face in trying to determine whether the psychiatric symptoms are phenotypic manifestations of AS/HFA or rather they are the expression of a distinct, though comorbid, disorder. We will also consider the role played by the environment in the manifestation and interpretation of these symptoms. Finally, we will propose some strategies to try to address these issues, and we will discuss therapeutic implications.

  7. Surface functionalized nanofibrillar cellulose (NFC) film as a platform for immunoassays and diagnostics.

    Science.gov (United States)

    Orelma, Hannes; Filpponen, Ilari; Johansson, Leena-Sisko; Osterberg, Monika; Rojas, Orlando J; Laine, Janne

    2012-12-01

    We introduce a new method to modify films of nanofibrillated cellulose (NFC) to produce non-porous, water-resistant substrates for diagnostics. First, water resistant NFC films were prepared from mechanically disintegrated NFC hydrogel, and then their surfaces were carboxylated via TEMPO-mediated oxidation. Next, the topologically functionalized film was activated via EDS/NHS chemistry, and its reactivity verified with bovine serum albumin and antihuman IgG. The surface carboxylation, EDC/NHS activation and the protein attachment were confirmed using quartz crystal microbalance with dissipation, contact angle measurements, conductometric titrations, X-ray photoelectron spectroscopy and fluorescence microscopy. The surface morphology of the prepared films was investigated using confocal laser scanning microscopy and atomic force microscopy. Finally, we demonstrate that antihuman IgG can be immobilized on the activated NFC surface using commercial piezoelectric inkjet printing.

  8. Multi-Site Diagnostic Classification of Schizophrenia Using Discriminant Deep Learning with Functional Connectivity MRI.

    Science.gov (United States)

    Zeng, Ling-Li; Wang, Huaning; Hu, Panpan; Yang, Bo; Pu, Weidan; Shen, Hui; Chen, Xingui; Liu, Zhening; Yin, Hong; Tan, Qingrong; Wang, Kai; Hu, Dewen

    2018-03-23

    A lack of a sufficiently large sample at single sites causes poor generalizability in automatic diagnosis classification of heterogeneous psychiatric disorders such as schizophrenia based on brain imaging scans. Advanced deep learning methods may be capable of learning subtle hidden patterns from high dimensional imaging data, overcome potential site-related variation, and achieve reproducible cross-site classification. However, deep learning-based cross-site transfer classification, despite less imaging site-specificity and more generalizability of diagnostic models, has not been investigated in schizophrenia. A large multi-site functional MRI sample (n = 734, including 357 schizophrenic patients from seven imaging resources) was collected, and a deep discriminant autoencoder network, aimed at learning imaging site-shared functional connectivity features, was developed to discriminate schizophrenic individuals from healthy controls. Accuracies of approximately 85·0% and 81·0% were obtained in multi-site pooling classification and leave-site-out transfer classification, respectively. The learned functional connectivity features revealed dysregulation of the cortical-striatal-cerebellar circuit in schizophrenia, and the most discriminating functional connections were primarily located within and across the default, salience, and control networks. The findings imply that dysfunctional integration of the cortical-striatal-cerebellar circuit across the default, salience, and control networks may play an important role in the "disconnectivity" model underlying the pathophysiology of schizophrenia. The proposed discriminant deep learning method may be capable of learning reliable connectome patterns and help in understanding the pathophysiology and achieving accurate prediction of schizophrenia across multiple independent imaging sites. Copyright © 2018. Published by Elsevier B.V.

  9. [Work-up and treatment of iron deficiency anaemia after bariatric surgery with gastric bypass].

    Science.gov (United States)

    Gribsholt, Sigrid Bjerge; Nielsen, Joan Bach; Melén, Charlotte-Joséphine Ström; Richelsen, Bjørn

    2014-06-09

    Treatment of severe obesity with Roux-en-Y gastric bypass (RYGB) results in pronounced weight loss but also in various nutritional complications. Iron deficiency anaemia is one of the most common nutritional complications due to reduced uptake of iron after this operation. Premenopausal women are particularly at risk of developing iron deficiency anaemia because of menstruation. In the present article the pathophysiology, diagnostic considerations, and treatment of iron deficiency anaemia after RYGB are discussed.

  10. DVA as a Diagnostic Test for Vestibulo-Ocular Reflex Function

    Science.gov (United States)

    Wood, Scott J.; Appelbaum, Meghan

    2010-01-01

    The vestibulo-ocular reflex (VOR) stabilizes vision on earth-fixed targets by eliciting eyes movements in response to changes in head position. How well the eyes perform this task can be functionally measured by the dynamic visual acuity (DVA) test. We designed a passive, horizontal DVA test to specifically study the acuity and reaction time when looking in different target locations. Visual acuity was compared among 12 subjects using a standard Landolt C wall chart, a computerized static (no rotation) acuity test and dynamic acuity test while oscillating at 0.8 Hz (+/-60 deg/s). In addition, five trials with yaw oscillation randomly presented a visual target in one of nine different locations with the size and presentation duration of the visual target varying across trials. The results showed a significant difference between the static and dynamic threshold acuities as well as a significant difference between the visual targets presented in the horizontal plane versus those in the vertical plane when comparing accuracy of vision and reaction time of the response. Visual acuity increased proportional to the size of the visual target and increased between 150 and 300 msec duration. We conclude that dynamic visual acuity varies with target location, with acuity optimized for targets in the plane of rotation. This DVA test could be used as a functional diagnostic test for visual-vestibular and neuro-cognitive impairments by assessing both accuracy and reaction time to acquire visual targets.

  11. A bead-based assay in the work-up of suspected platelet alloimmunization.

    Science.gov (United States)

    Cooper, Nina; Bein, Gregor; Heidinger, Kathrin; Santoso, Sentot; Sachs, Ulrich J

    2016-01-01

    Alloantibodies against human platelet antigens (HPAs) are of clinical significance in immune-mediated thrombocytopenia such as fetal/neonatal alloimmune thrombocytopenia (FNAIT), posttransfusion purpura, and platelet (PLT) transfusion refractoriness. The gold standard for the detection of these antibodies is the monoclonal antibody immobilization of PLT antigens (MAIPA) assay. Both requirement of typed donor PLT panels and technical expertise often restrict its use to reference laboratories. An easy-to-use, bead-based assay (BBA) has been introduced recently. In this study, we compared MAIPA and BBA test results for 126 serum samples from women who gave birth to a child with FNAIT including rare HPA specificities (n = 111) and from patients with PLT transfusion refractoriness (n = 15). For sera with defined allospecificities, the number of BBA false-negatives was 12 of 126, or 9.5%, and the number of BBA false-positives (i.e., detection of additional specificities) was two of 126, or 1.6%. BBA had major problems in detecting antibodies against HPA-3a (3/15 undetected = 20% failure rate) and HPA-3b (5/6 undetected = 83.3% failure rate), but performed well in detecting typical FNAIT- or PLT transfusion refractoriness-associated antibodies including HPA-1a (35/35 = 100%), HPA-1b (15/15 = 100%), HPA-5b (22/24 = 91.6%), and glycoprotein IV (6/6 = 100%). BBA might be a useful and time-saving tool in the initial laboratory work-up of suspected PLT alloimmunization when an appropriate algorithm ensures follow-up investigation of BBA-negative sera. © 2015 AABB.

  12. Strongly lateralized activation in language fMRI of atypical dominant patients-implications for presurgical work-up.

    Science.gov (United States)

    Wellmer, Jörg; Weber, Bernd; Weis, Susanne; Klaver, Peter; Urbach, Horst; Reul, Jürgen; Fernandez, Guillen; Elger, Christian E

    2008-07-01

    Functional magnetic resonance imaging (fMRI) is being used increasingly for language dominance assessment in the presurgical work-up of patients with pharmacoresistant epilepsy. However, the interpretation of bilateral fMRI-activation patterns is difficult. Various studies propose fMRI-lateralization index (LI) thresholds between +/-0.1 and +/-0.5 for discrimination of atypical from typical dominant patients. This study examines if these thresholds allow identifying atypical dominant patients with sufficient safety for presurgical settings. 65 patients had a tight comparison, fully controlled semantic decision fMRI-task and a Wada-test for language lateralization. According to Wada-test, 22 were atypical language dominant. In the remaining, Wada-test results were compatible with unilateral left dominance. We determined fMRI-LI for two frontal and one temporo-parietal functionally defined, protocol-specific volume of interest (VOI), and for the least lateralized of these VOIs ("low-VOI") in each patient. We find large intra-individual LI differences between functionally defined VOIs irrespective of underlying type of language dominance (mean LI difference 0.33+/-0.35, range 0-1.6; 15% of patients have inter-VOI-LI differences >1.0). Across atypical dominant patients fMRI-LI in the Broca's and temporo-parietal VOI range from -1 to +1, in the "remaining frontal" VOI from -0.93 to 1. The highest low-VOI-LI detected in atypical dominant patients is 0.84. Large intra-individual inter-VOI-LI differences and strongly lateralized fMRI-activation in patients with Wada-test proven atypical dominance question the value of the proposed fMRI-thresholds for presurgical language lateralization. Future studies have to develop strategies allowing the reliable identification of atypical dominance with fMRI. The low-VOI approach may be useful.

  13. The diagnostic and therapeutic aspects of loss-of-function cardiac sodium channelopathies in children.

    Science.gov (United States)

    Chockalingam, Priya; Clur, Sally-Ann B; Breur, Johannes M P J; Kriebel, Thomas; Paul, Thomas; Rammeloo, Lukas A; Wilde, Arthur A M; Blom, Nico A

    2012-12-01

    Loss-of-function sodium channelopathies manifest as a spectrum of diseases including Brugada syndrome (BrS) and cardiac conduction disease. To analyze the diagnostic and therapeutic aspects of these disorders in children. Patients aged ≤ 16 years with genetically confirmed loss-of-function sodium channelopathies (SCN5A mutation), presenting with cardiac symptoms, positive family history, and/or abnormal electrocardiogram (ECG), were included. Abnormal ECG consisted of type 1 BrS ECG and/or prolonged conduction intervals (PR interval/QRS duration > 98th percentile for age). Among the cohort (n = 33, age 6 ± 5 years, 58% male subjects, 30% probands), 14 (42%) patients were symptomatic, presenting with syncope (n = 5), palpitations (n = 1), supraventricular arrhythmias (n = 3), aborted cardiac arrest (n = 3), and sudden cardiac death (n = 2). Heart rate was 91 ± 26 beats/min, PR interval 168 ± 35 ms, QRS duration 112 ± 20 ms, and heart-rate corrected QT interval 409 ± 26 ms. Conduction intervals were prolonged in 28 (85%) patients; 6 of these patients also had spontaneous type 1 BrS ECG. Eight fever-associated events occurred in 6 patients; 2 of these were vaccination-related fever episodes. Treatment included aggressive antipyretics during fever in all patients; antiarrhythmic treatment included implantable cardioverter-defibrillator (n = 4), pacemaker (n = 2), and beta-blockers, either alone (n = 3) or in combination with device (n = 2). During follow-up (4 ± 4 years), 2 previously symptomatic patients had monomorphic ventricular tachycardia; there were no deaths. Diagnosis of loss-of-function sodium channelopathies in children relies on cardiac symptoms, family history, and ECG. Fever and vaccination are potential arrhythmia triggers; conduction delay is the commonest finding on ECG. Beta-blockers have a role in preventing tachycardia-induced arrhythmias; implantable cardioverter-defibrillator should probably be reserved for severe cases. Copyright © 2012

  14. Recent Advances of Individual BODIPY and BODIPY-Based Functional Materials in Medical Diagnostics and Treatment.

    Science.gov (United States)

    Marfin, Yuriy S; Solomonov, Alexey V; Timin, Alexander S; Rumyantsev, Evgeniy V

    2017-01-01

    The group of fluorophores on boron dipyrrin platform (4,4- difluoro-4-bora3a,4a-diaza-s-indacene, also known as BODIPY) has attracted much attention in the field of molecular sensorics, including sensing of biomolecules and bioprocesses. Structural diversity of existing BODIPY with ample opportunities of directed modification of compounds makes this class of fluorophores attractive for medical and biological purposes. The recent progress in the design and functionalization of BODIPY allows using them for modification of drug micro- and nanocarriers in order to improve their therapeutic effect in cancer treatment. At the same time, integration of BODIPY into drug carriers provides the possibility of in vitro and in vivo real time imaging of used drug carriers. The high fluorescent intensity and low toxicity of BODIPY granted for conjugation with different biomolecules. The present review focuses on the recent advances for application of individual BODIPY in medical diagnostics, antimicrobial activity, as well as establishing the role of BODIPY in labeling of biomolecules (e.g. proteins, hormones and DNA). Also the review highlights the potential of BODIPY in functionalization of drug micro- and nanocarriers in order to achieve better therapeutic efficiency compared with non-modified materials. The advantages derived from the use of BODIPY for preparation and modification of drug carriers are critically evaluated and potential for future challenges, especially concerning the design of innovative multi-functional BODIPY-based nanocarriers, is discussed in detail using representative examples from literature. Our objective was to show that BODIPY are powerful tools for bioimaging, labeling of biomolecules and construction of new multifunctional drug carriers. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  15. Calculation of the nonlinear relativistic Thomson scattering fields and Its application to electron distribution function diagnostic

    Science.gov (United States)

    Guasp, J.; Pastor, I.; Álvarez-Estrada, R. F.; Castejón, F.

    2015-02-01

    Analytical results obtained recently of the ab-initio classical incoherent Thomson Scattering (TS) spectrum from a single-electron (Alvarez-Estrada et al 2012 Phys. Plasmas 19 062302) have been numerically implemented in a paralelized code to efficiently compute the TS emission from a given electron distribution function, irrespective of its characteristics and/or the intensity of the incoming radiation. These analytical results display certain differences, when compared with other authors, in the general case of incoming linearly and circularly polarized radiation and electrons with arbitrary initial directions. We regard such discrepancies and the ubiquitous interest in TS as motivations for this work. Here, we implement some analytical advances (like generalized Bessel functions for incoming linearly polarized radiation) in TS. The bulk of this work reports on the efficient computation of TS spectra (based upon our analytical approach), for an electron population having an essentially arbitrary distribution function and for both incoming linearly and circularly polarized radiation. A detailed comparison between the present approach and a previous Monte Carlo one (Pastor et al 2011 Nuclear Fusion 51 043011), dealing with the ab-initio computation of TS spectra, is reported. Both approaches are shown to fully agree with each other. As key computational improvements, the analytical technique yields a × 30 to × 100 gain in computation time and is a very flexible tool to compute the scattered spectrum and eventually the scattered electromagnetic fields in the time domain. The latter are computed explicitly here for the first time, as far as we know. Scaling laws for the power integrated over frequency versus initial kinetic energy are studied for the case of isotropic and monoenergetic electron distribution functions and their potential application as diagnostic tools for high-energy populations is briefly discussed. Finally, we discuss the application of these

  16. Emotion Perception in Asperger's Syndrome and High-Functioning Autism: The Importance of Diagnostic Criteria and Cue Intensity

    Science.gov (United States)

    Mazefsky, Carla A.; Oswald, Donald P.

    2007-01-01

    This study compared emotion perception accuracy between children with Asperger's syndrome (AS) and high-functioning autism (HFA). Thirty children were diagnosed with AS or HFA based on empirically supported diagnostic criteria and administered an emotion perception test consisting of facial expressions and tone of voice cues that varied in…

  17. [The functional tests in clinical diagnostic laboratory: the detection of magnesium deficiency in the loading test].

    Science.gov (United States)

    Kondakov, A V; Kobylianskiĭ, A G; Tishchenkov, V G; Titov, V N

    2012-06-01

    The article deals with the value and role of functional tests in practice of clinical diagnostic laboratories. The possibilities of evaluation of biological function of homeostasis according the changes of magnesium ions or calcium concentration in urine or blood hence reflecting the deficiency of these ions in vivo. The magnesium tolerant test is described It is demonstrated that it can be applied both in curative preventive institutions and ambulatories. In the examined group of patients, 78% had physiologic parameters of magnesium concentration, 17% suffered from hypermagnesiumuria and 5%--from hypermagnesiumuria. The magnesium deficiency of different degree was detected in 87% of patients. In the most part of patients with magnesium deficiency normomagnesiumuria was detected. Only in one case with normomagnesiumuria the magnesium deficiency was absent. In 30% of patients with magnesium deficiency the concentration of cation in day urine decreased up to 2.2 times after load dose. In absence of deficiency the monotony of cation's excretion was noted. Under the magnesium deficiency the character of process changed but velocity of excretion of magnesium after load probe slightly decreased relative to values before the load. The impact of alcohol under established magnesium deficiency results in increasing of velocity of excretion of this analyte. In patient with diabetes mellitus type II six months before the diagnosis of this disease the hidden deficiency of magnesium was detected. The magnesium deficiency was not detected after the antidiabetic treatment was applied The results permit to postulate the possibility of application oral load test with magnesium to assess the impact of various stress, physical, emotional and psychological factors. The detection of magnesium deficiency permit to broad the complex treatment, to accelerate and to enhance the results of treatment of diseases. Besides, the evaluation of patient's condition according the reaction of the

  18. Beam control and diagnostic functions in the NIF transport spatial filter

    International Nuclear Information System (INIS)

    Holdener, F.R.; Ables, E.; Bliss, E.S.

    1996-10-01

    Beam control and diagnostic systems are required to align the National Ignition Facility (NIF) laser prior to a shot as well as to provide diagnostics on 192 beam lines at shot time. A design that allows each beam's large spatial filter lenses to also serve as objective lenses for beam control and diagnostic sensor packages helps to accomplish the task at a reasonable cost. However, this approach also causes a high concentration of small optics near the pinhole plane of the transport spatial filter (TSF) at the output of each beam. This paper describes the optomechanical design in and near the central vacuum vessel of the TSF

  19. Diagnostics of cognitive functions of treated clients with an anamnesis of long-term drug use

    Directory of Open Access Journals (Sweden)

    Ondřej Krupčík

    2014-12-01

    Full Text Available Clients in treatment and aftercare programmes with a history of long-term abuse of substances like alcohol, cannabis, methamphetamine or heroin often exhibit serious problems while coming back to the working process and managing complex responsibilities and difficulties. It is very important to find a job in the aftercare process for many reasons. It is a source of living, it enables clients to plan their own housing, and it makes repayment of debts possible. Job is also important for establishing new social relations which are not connected with problematic drug environment. Last but not least employment contributes to a reconstruction of a healthy rhythm of life and meaningful spending of time. Thus it is very important for decreasing a probability of a relapse. This process can be disrupted by the deteriorated cognitive functioning. These problems may not be evident in an everyday life routine while talking with friends or performing automatic activities, but can be evident in demanding working tasks, because the job usually requires concentration, memory, decision making etc. The Goal of this study is an evaluation of potential benefits an individual cognitive performance assessment can have in treatment and aftercare. The paper summarizes pilot research in which a complete Neuro-psychological battery of diagnostic methods such as Auditory Verbal Learning Test (AVLT, Verbal fluency Test (FAS, Trail Making Test (TMT, Rey-Osterrieth Complex Figure (ROCF, Benton Visual Retention Test (BVRT, Stroop Colour Word Test (SCWT and Numeric square is used for assessment of cognitive functions of a small sample of treated clients (N=24. We present two case histories with detailed results. In some cases, in line with the expectations, the worsened cognitive functioning is evident. We recommend a cognitive training focused on attention and memory for three clients. In other cases, surprisingly, we can find normal cognitive functions quality, but another

  20. Peptide release, side-chain deprotection, work-up, and isolation

    DEFF Research Database (Denmark)

    Pedersen, Søren Ljungberg; Jensen, Knud Jørgen

    2013-01-01

    After having successfully synthesized a peptide, it has to be released from the solid support, unless it is being used for on-resin display. The linker and, in some cases, the cleavage mixture determine the C-terminal functionality of the released peptide. In most cases, the peptide is released...... types providing a variety of different C-terminal functionalities, including acids, amides, amines, and aldehydes. Moreover, suggestions for determination of peptide Purities and for storage conditions are provided....

  1. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Defensive Functioning Scale: a validity study.

    Science.gov (United States)

    Porcerelli, John H; Cogan, Rosemary; Markova, Tsveti; Miller, Kristen; Mickens, Lavonda

    2011-01-01

    We assess the convergent and predictive validity of the Defensive Functioning Scale (DFS) with measures of life events, including childhood abuse and adult partner victimization; dimensions of psychopathology, including axis I (depressive) and axis II (borderline personality disorder) symptoms; and quality of object relations. One hundred and ten women from a university-based urban primary care clinic completed a research interview from which defense mechanisms were assessed. The quality of object relations was also assessed from interview data. The women completed self-report measures assessing depression, borderline personality disorder symptoms, childhood physical and sexual abuse, and adult partner physical and sexual victimization. Inter-rater reliability of the scoring of the DFS levels was good. High adaptive defenses were positively correlated with the quality of object relations and pathological defenses were positively correlated with childhood and adult victimization and symptom measures. Although major image distorting defenses were infrequently used, they were robustly correlated with all study variables. In a stepwise multiple regression analysis, major image distorting defenses, depressive symptoms, and minor image distorting defenses significantly predict childhood victimization, accounting for 37% of the variance. In a second stepwise multiple regression analysis, borderline personality disorder symptoms and disavowal defenses combined to significantly predict adult victimization, accounting for 16% of the variance. The DFS demonstrates good convergent validity with axis I and axis II symptoms, as well as with measures of childhood and adult victimization and object relations. The DFS levels add nonredundant information to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition beyond axis I and axis II. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. [News in the work-up of deep vein thrombosis (DVT)].

    Science.gov (United States)

    Wautrecht, J-C

    2015-09-01

    Deep vein thrombosis (DVT) is a component of venous thromboembolism (VTE), the other being pulmonary embolism (PE). Its incidence is 1 to 2/1.000/year and nearly 1/100/year after 80 years. The major complication of DVT is PE which occurs in about 1/3 of cases, is often asymptomatic but can be fatal. Another common complication, occurring in 20-50 % of cases is the post-thrombotic syndrome (PTS) which is likely to alter the quality of life. Several issues remain unanswered when considering DVT. The optimal management of distal DVT versus proximal DVT is not well codified. The diagnostic approach to DVT is essential : it is based on the estimation of clinical probability, the possible use of D-dimer test and compression ultrasonography. The new direct oral anticoagulants (NOACs) have been proven effective in the phase 3 studies but when to use them and which to choose in the real life ? Wearing compression stockings to prevent the SPT is recommended: what is the definition of compression stockings and is there some evidence of their efficacy ? The purpose of this article is to provide some useful information to primary care physicians to address a DVT.

  3. Is thyroid hormones evaluation of clinical value in the work-up of males of infertile couples?

    Science.gov (United States)

    Lotti, F; Maseroli, E; Fralassi, N; Degl'Innocenti, S; Boni, L; Baldi, E; Maggi, M

    2016-03-01

    Is thyroid hormones (TH) evaluation of clinical value in the work-up of males of infertile couples? Our results suggest that TH evaluation is not mandatory in the work-up of male infertility. A few previous studies performed on a limited series of subjects reported a negative impact of hyper- and hypo-thyroidism on semen volume, sperm concentration, progressive motility and normal morphology. No previous study has systematically evaluated associations between TH variation, semen parameters and ultrasound characteristics of the male genital tract. Cross-sectional analysis of a consecutive series of 172 subjects seeking medical care for couple infertility from September 2010 to November 2014. Of the entire cohort, 163 men (age 38.9 ± 8.0 years) free of genetic abnormalities were studied. All subjects underwent a complete andrological and physical examination, biochemical and hormonal assessment, scrotal and transrectal colour-Doppler ultrasound (CDUS) and semen analysis (including seminal interleukin 8 levels, sIL-8) evaluation within the same day. Among the patients studied, 145 (88.9%) showed euthyroidism, 6 (3.7%) subclinical hyper- and 12 (7.4%) subclinical hypo-thyroidism. No subjects showed overt hyper- or hypo-thyroidism. At univariate analysis, no associations among thyroid-stimulating hormone (TSH) or TH levels and sperm parameters were observed. Conversely, we observed positive associations among free triiodothyronine (fT3) and free thyroxine (fT4) levels, ejaculate volume and seminal fructose levels. In a multivariate model, after adjusting for confounders such as age, body mass index, smoking habit, sexual abstinence, calculated free testosterone, prolactin and sIL-8 levels, only the associations found for fT3 levels were confirmed. When CDUS features were investigated, using the same multivariate model, we found positive associations between fT3 levels and seminal vesicles (SV) volume, both before and after ejaculation (adj. r = 0.354 and adj. r = 0

  4. The importance of masticatory functional analysis in the diagnostic finding and treatment planning for prosthodontic rehabilitation

    Directory of Open Access Journals (Sweden)

    Harry Laksono

    2012-06-01

    Full Text Available Background: The masticatory system as a biologic system is subjected to harmful influences of varying severity. Almost half of routine patients requesting prosthodontic treatment indicated at least one sign or symptom of temporomandibular disorders. Analysis of the masticatory system often neglected by dentist. Untreated temporomandibular disorders may significantly implicated in the perpetuation of the disorder and may interfere with routine prosthodontic clinical procedures. It would be resulted unsuccessful long term goal of prosthodontic rehabilitation because of the uncompleted diagnoses and treatment plan. Purpose: The purpose of this case report was to give the information of the importance of masticatory functional analysis in the diagnostic finding for treatment planning in the prosthodontic rehabilitation. Case: A 45 year - old male patient, partial dentate with reduced chewing efficiency, mild pain in right preauricular region in function, left click in opening mouth, severe attrition on all anterior lower teeth with vertical dimension of occlusion decreased due to loss of posterior support. He wanted to make a new denture. Case management: Record and analyze of active and passive mandibular movement, opening pathway, muscle and temporomandibular joints palpation, load testing, and vertical dimension of occlusion with manual functional analysis (MFA, occlusal condition and radiographic examination. Treatment plan was formulated into 3 phases: stabilization of the masticatory system, definitive treatment and periodical control. The result of this treatment excellent for 1 year evaluation after permanent cementation. Conclusion: Masticatory functional analysis is very important and must be done in the diagnosis finding for treatment planning in every case of prosthodontic rehabilitation.Latar belakang: Sistem pengunyahan sebagai sistem biologis sewaktu-waktu dapat terjadi gangguan dengan berbagai derajat keparahan. Hampir setengah dari

  5. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale

    NARCIS (Netherlands)

    Laméris, Wytze; van Randen, Adrienne; Dijkgraaf, Marcel G. W.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

    2007-01-01

    ABSTRACT: BACKGROUND: The acute abdomen is a frequent entity at the Emergency Department (ED), which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US), computed tomography (CT) and even diagnostic laparoscopy.

  6. Magnetic capture from blood rescues molecular motor function in diagnostic nanodevices.

    Science.gov (United States)

    Kumar, Saroj; Ten Siethoff, Lasse; Persson, Malin; Albet-Torres, Nuria; Månsson, Alf

    2013-05-03

    Introduction of effective point-of-care devices for use in medical diagnostics is part of strategies to combat accelerating health-care costs. Molecular motor driven nanodevices have unique potentials in this regard due to unprecedented level of miniaturization and independence of external pumps. However motor function has been found to be inhibited by body fluids. We report here that a unique procedure, combining separation steps that rely on antibody-antigen interactions, magnetic forces applied to magnetic nanoparticles (MPs) and the specificity of the actomyosin bond, can circumvent the deleterious effects of body fluids (e.g. blood serum). The procedure encompasses the following steps: (i) capture of analyte molecules from serum by MP-antibody conjugates, (ii) pelleting of MP-antibody-analyte complexes, using a magnetic field, followed by exchange of serum for optimized biological buffer, (iii) mixing of MP-antibody-analyte complexes with actin filaments conjugated with same polyclonal antibodies as the magnetic nanoparticles. This causes complex formation: MP-antibody-analyte-antibody-actin, and magnetic separation is used to enrich the complexes. Finally (iv) the complexes are introduced into a nanodevice for specific binding via actin filaments to surface adsorbed molecular motors (heavy meromyosin). The number of actin filaments bound to the motors in the latter step was significantly increased above the control value if protein analyte (50-60 nM) was present in serum (in step i) suggesting appreciable formation and enrichment of the MP-antibody-analyte-antibody-actin complexes. Furthermore, addition of ATP demonstrated maintained heavy meromyosin driven propulsion of actin filaments showing that the serum induced inhibition was alleviated. Detailed analysis of the procedure i-iv, using fluorescence microscopy and spectroscopy identified main targets for future optimization. The results demonstrate a promising approach for capturing analytes from serum for

  7. Cognitive Function as a Trans-Diagnostic Treatment Target in Stimulant Use Disorders

    Science.gov (United States)

    Sofuoglu, Mehmet; DeVito, Elise E.; Waters, Andrew J.; Carroll, Kathleen M.

    2016-01-01

    Stimulant use disorder is an important public health problem, with an estimated 2.1 million current users in the United States alone. No pharmacological treatments are approved by the U.S. Food and Drug Administration (FDA) for stimulant use disorder and behavioral treatments have variable efficacy and limited availability. Most individuals with stimulant use disorder have other comorbidities, most with overlapping symptoms and cognitive impairments. The goal of this article is to present a rationale for cognition as a treatment target in stimulant use disorder, and to outline potential treatment approaches. Rates of lifetime comorbid psychiatric disorders among people with stimulant use disorders are estimated at 65% - 73%, with the most common being mood disorders (13% - 64%) and anxiety disorders (21% - 50%), as well as non-substance induced psychotic disorders (under 10%). There are several models of addictive behavior, but the dual process model particularly highlights the relevance of cognitive impairments and biases to the development and maintenance of addiction. This model explains addictive behavior as a balance between automatic processes and executive control, which in turn are related to individual (genetics, comorbid disorders, psychosocial factors) and other (craving, triggers, drug use) factors. Certain cognitive impairments, such as attentional bias and approach bias, are most relevant to automatic processes, while sustained attention, response inhibition, and working memory are primarily related to executive control. These cognitive impairments and biases are also common in disorders frequently comorbid with stimulant use disorder, and predict poor treatment retention and clinical outcomes. As such, they may serve as feasible trans-diagnostic treatment targets. There are promising pharmacological, cognitive, and behavioral approaches that aim to enhance cognitive function. Pharmacotherapies target cognitive impairments associated with executive

  8. Is Whole-Body Computed Tomography the Standard Work-up for Severely-Injured Children? Results of a Survey among German Trauma Centers.

    Science.gov (United States)

    Bayer, J; Reising, K; Kuminack, K; Südkamp, N P; Strohm, P C

    2015-01-01

    Whole-body computed tomography is accepted as the standard procedure in the primary diagnostic of polytraumatised adults in the emergency room. Up to now there is still controversial discussion about the same algorithm in the primary diagnostic of children. The aim of this study was to survey the participation of German trauma-centres in the care of polytraumatised children and the hospital dependant use of whole-body computed tomography for initial patient work-up. A questionnaire was mailed to every Department of Traumatology registered in the DGU (German Trauma Society) databank. We received 60,32% of the initially sent questionnaires and after applying exclusion criteria 269 (53,91%) were applicable to statistical analysis. In the three-tiered German hospital system no statistical difference was seen in the general participation of children polytrauma care between hospitals of different tiers (p = 0.315). Even at the lowest hospital level 69,47% of hospitals stated to participate in polytrauma care for children, at the intermediate and highest level hospitals 91,89% and 95,24% stated to be involved in children polytrauma care, respectively. Children suspicious of multiple injuries or polytrauma received significantly fewer primary whole-body CTs in lowest level compared to intermediate level hospitals (36,07% vs. 56,57%; p = 0.015) and lowest level compared to highest level hospitals (36,07% vs. 68,42%; p = 0.001). Comparing the use of whole-body CT in intermediate to highest level hospitals a not significant increase in its use could be seen in highest level hospitals (56,57% vs. 68,42%; p = 0.174). According to our survey, taking care of polytraumatised children in Germany is not limited to specialised hospitals or a defined hospital level-of-care. Additionally, there is no established radiologic standard in work-up of the polytraumatised child. However, in higher hospital care -levels a higher percentage of hospitals employs whole-body CTs for primary

  9. Diagnosis and diagnostic tests for fibromyalgia (syndrome

    Directory of Open Access Journals (Sweden)

    F. Wolfe

    2012-09-01

    Full Text Available Objectives: To present diagnostic criteria for the clinical diagnosis of fibromyalgia syndrome (FMS and to offer a scheme for diagnostic work-up in clinical practice. Methods: Narrative review of the literature, consensus documents by the American College of Rheumatology (ACR, evidence-based interdisciplinary German guidelines on the diagnosis and management of FMS. Results: The ACR 1990 classification criteria emphasized tender points and widespread pain as the key features of FMS. In 2010, the ACR proposed preliminary diagnostic criteria for fibromyalgia that abandoned the tender point count and placed increased emphasis of patient symptoms. A later modification of the ACR 2010 criteria for use in surveys employed a self-report questionnaire (Fibromyalgia Survey Questionnaire FSQ to assess patient symptoms. The FSQ can be used to assist physician’s diagnosis of FMS. We recommend a stepwise diagnostic work-up of patients with chronic widespread pain (CWP in primary care: Complete medical history including medication, complete medical examination, basic laboratory tests to screen for inflammatory or endocrinology diseases, referral to specialists only in case of suspected somatic diseases, assessment of limitations of daily functioning, screening for other functional somatic symptoms and mental disorders, and referring to mental health specialists in case of mental disorder. Conclusions: The diagnosis of FMS is easy in most patients with CWP and does not ordinarily require a rheumatologist. A rheumatologist’s expertise might be needed to exclude difficult to diagnose or concomitant inflammatory rheumatic diseases. In the presence of mental illness referral to a mental health specialist for evaluation is recommended.

  10. Non-immediate hypersensitivity reactions to beta-lactam antibiotics in children - our 10-year experience in allergy work-up.

    Science.gov (United States)

    Atanaskovic-Markovic, Marina; Gaeta, Francesco; Medjo, Biljana; Gavrovic-Jankulovic, Marija; Cirkovic Velickovic, Tanja; Tmusic, Vladimir; Romano, Antonino

    2016-08-01

    Non-immediate reactions to beta-lactam antibiotics (BL) occur more than one hour after drug administration, and the most common manifestations are maculopapular exanthemas and delayed-appearing urticaria and/or angioedema. Infections can lead to skin eruptions and mimic drug hypersensitivity reactions (DHR), if a drug is taken at the same time. The most of children are labeled as 'drug allergic' after considering only the clinical history. To diagnose/detect a hypersensitivity or an infection which mimic DHR in children with non-immediate reactions to BL METHODS: A prospective survey was conducted in a group of 1026 children with histories of non-immediate reactions to BL by performing patch tests, skin tests, and in case of negative results, drug provocation tests (DPTs). In 300 children, a study was performed to detect infections by viruses or Mycoplasma pneumoniae. Urticaria and maculopapular exanthemas were the most reported non-immediate reactions. Only 76 (7.4%) of 1026 children had confirmed non-immediate hypersensitivity reactions to BL. Fifty-seven children had positive delayed-reading intradermal tests (18 of these with a positive patch test). Nineteen children had positive DPT. Sixty-six of 300 children had positive tests for viruses or Mycoplasma pneumoniae and 2 of them had a positive allergy work-up. A diagnostic work-up should be performed in all children with non-immediate reactions to BL, to remove a false label of hypersensitivity. Even though only 57 (5.5%) of 1026 children displayed positive responses to delayed-reading intradermal tests to BL, such tests appear to be useful in order to reduce the risk for positive DPTs. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Cost-Saving Early Diagnosis of Functional Pain in Nonmalignant Pain: A Noninferiority Study of Diagnostic Accuracy.

    Science.gov (United States)

    Cámara, Rafael J A; Merz, Christian; Wegmann, Barbara; Stauber, Stefanie; von Känel, Roland; Egloff, Niklaus

    2016-01-01

    Objectives. We compared two index screening tests for early diagnosis of functional pain: pressure pain measurement by electronic diagnostic equipment, which is accurate but too specialized for primary health care, versus peg testing, which is cost-saving and more easily manageable but of unknown sensitivity and specificity. Early distinction of functional (altered pain perception; nervous sensitization) from neuropathic or nociceptive pain improves pain management. Methods. Clinicians blinded for the index screening tests assessed the reference standard of this noninferiority diagnostic accuracy study, namely, comprehensive medical history taking with all previous findings and treatment outcomes. All consenting patients referred to a university hospital for nonmalignant musculoskeletal pain participated. The main analysis compared the receiver operating characteristic (ROC) curves of both index screening tests. Results. The area under the ROC curve for peg testing was not inferior to that of electronic equipment: it was at least 95% as large for finger measures (two-sided p = 0.038) and at least equally as large for ear measures (two-sided p = 0.003). Conclusions. Routine diagnostic testing by peg, which is accessible for general practitioners, is at least as accurate as specialized equipment. This may shorten time-to-treatment in general practices, thereby improving the prognosis and quality of life.

  12. [Anatomo-functional aspects and diagnostic algorithm (of the upper limb pathologies secondary to repeated trauma)].

    Science.gov (United States)

    Bazzini, G

    2001-01-01

    The epidemiology of work-related musculo-skeletal pathologies of the upper limbs has become significantly relevant in the last years, and a sharp increasing trend can be observed. This paper mainly focuses on the chronic inflammatory and degenerative conditions, which are more complex and difficult to accurately diagnose and treat. A synthesis of the diagnostic picture of the different types, involving the joints, muscles and tendons, and peripheral nerves is provided, with mention of the sensitivity and specificity of the main diagnostic tests. The possible entrapments of the radial, median and ulnar nerves are described in detail. Finally, a brief critical review on the principal movements of the upper limbs which are responsible of the onset of such conditions is presented.

  13. On limitations of laser-induced fluorescence diagnostics for xenon ion velocity distribution function measurements in Hall thrusters

    Science.gov (United States)

    Romadanov, I.; Raitses, Y.; Diallo, A.; Hara, K.; Kaganovich, I. D.; Smolyakov, A.

    2018-03-01

    Hall thruster operation is characterized by strong breathing oscillations of the discharge current, the plasma density, the temperature, and the electric field. Probe- and laser-induced fluorescence (LIF) diagnostics were used to measure temporal variations of plasma parameters and the xenon ion velocity distribution function (IVDF) in the near-field plasma plume in regimes with moderate (reducing the production of metastable ions. Because the residence time of ions in the channel is generally shorter than the time scale of breathing oscillations, the density of the excited ions outside the thruster is low and they cannot be detected. In the range of temperature of oscillations, the ionization cross-section of xenon atoms remains sufficiently large to sustain the discharge. This finding suggests that the commonly used LIF diagnostic of xenon IVDF can be subject to large uncertainties in the regimes with significant oscillations of the electron temperature, or other plasma parameters.

  14. Improving work-up of the abnormal mammogram through organized assessment: results from the ontario breast screening program.

    Science.gov (United States)

    Quan, May Lynn; Shumak, Rene S; Majpruz, Vicky; Holloway, Claire M D; O'Malley, Frances P; Chiarelli, Anna M

    2012-03-01

    Women with an abnormal screening mammogram should ideally undergo an organized assessment to attain a timely diagnosis. This study evaluated outcomes of women undergoing work-up after abnormal mammogram through a formal breast assessment affiliate (BAA) program with explicit care pathways compared with usual care (UC) using developed quality indicators for screening mammography programs. Between January 1 and December 31, 2007, a total of 320,635 women underwent a screening mammogram through the Ontario Breast Screening Program (OBSP), of whom 25,543 had an abnormal result requiring further assessment. Established indicators assessing timeliness, appropriateness of follow-up, and biopsy rates were compared between women who were assessed through either a BAA or UC using χ(2) analysis. Work-up of the abnormal mammogram for patients screened through a BAA resulted in a greater proportion of women attaining a definitive diagnosis within the recommended time interval when a histologic diagnosis was required. In addition, use of other quality measures including specimen radiography for both core biopsies and surgical specimens and preoperative core needle biopsy was greater in BAA facilities. These findings support future efforts to increase the number of BAAs within the OBSP, because the pathways and reporting methods associated with them result in improvements in our ability to provide timely and appropriate care for women requiring work-up of an abnormal mammogram.

  15. Differential Item Functioning Assessment in Cognitive Diagnostic Modeling: Applying the Wald Test to Investigate DIF in the Generalized DINA Model Framework

    Science.gov (United States)

    Hou, Likun

    2013-01-01

    Analyzing examinees' responses using cognitive diagnostic models (CDMs) have the advantages of providing richer diagnostic information. To ensure the validity of the results from these models, differential item functioning (DIF) in CDMs needs to be investigated. In this dissertation, the model-based DIF detection method, Wald-CDM procedure is…

  16. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness

    DEFF Research Database (Denmark)

    Stender, Johan; Gosseries, Olivia; Bruno, Marie-Aurélie

    2014-01-01

    BACKGROUND: Bedside clinical examinations can have high rates of misdiagnosis of unresponsive wakefulness syndrome (vegetative state) or minimally conscious state. The diagnostic and prognostic usefulness of neuroimaging-based approaches has not been established in a clinical setting. We did a va...... Funds for Scientific Research (FNRS), Fonds Léon Fredericq, the European Commission, the James McDonnell Foundation, the Mind Science Foundation, the French Speaking Community Concerted Research Action, the University of Copenhagen, and the University of Liège....

  17. Diagnostic function of the neuroinflammatory biomarker YKL-40 in Alzheimer's disease and other neurodegenerative diseases.

    Science.gov (United States)

    Baldacci, Filippo; Lista, Simone; Cavedo, Enrica; Bonuccelli, Ubaldo; Hampel, Harald

    2017-04-01

    Neuroinflammation is a crucial mechanism in the pathophysiology of neurodegenerative diseases pathophysiology. Cerebrospinal fluid (CSF) YKL-40 - an indicator of microglial activation - has recently been identified by proteomic studies as a candidate biomarker for Alzheimer's disease (AD). Areas covered: We review the impact of CSF YKL-40 as a pathophysiological biomarker for AD and other neurodegenerative diseases. CSF YKL-40 concentrations have been shown to predict progression from prodromal mild cognitive impairment to AD dementia. Moreover, a positive association between CSF YKL-40 and other biomarkers of neurodegeneration - particularly total tau protein - has been reported during the asymptomatic preclinical stage of AD and other neurodegenerative diseases. Albeit preliminary, current data do not support an association between APOE-ε4 status and CSF YKL-40 concentrations. When interpreting the diagnostic/prognostic significance of CSF YKL-40 concentrations in neurodegenerative diseases, potential confounders - including age, metabolic and cardiovascular risk factors, diagnostic criteria for selecting cases/controls - need to be considered. Expert opinion/commentary: CSF YKL-40 represents a pathophysiological biomarker reflecting immune/inflammatory mechanisms in neurodegenerative diseases, associated with tau protein pathology. Besides being associated with tau pathology, CSF YKL-40 adds to the growing array of biomarkers reflecting distinct molecular brain mechanisms potentially useful for stratifying individuals for biomarker-guided, targeted anti-inflammatory therapies emerging from precision medicine.

  18. Gender-related differential item functioning in DSM-IV/DSM-5-III (alternative model) diagnostic criteria for borderline personality disorder.

    Science.gov (United States)

    Benson, Kathryn T; Donnellan, M Brent; Morey, Leslie C

    2017-01-01

    A number of studies have evaluated the possibility of bias in the diagnostic criteria in borderline personality disorder as an explanation of gender differences in prevalence. Previous studies have used both regression and latent trait approaches but the results have been inconsistent. The current study extended prior investigations in testing differential function of Borderline diagnostic criteria using both regression and latent-trait methods in the same sample, examining both Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) and DSM-5 alternative model criteria for borderline personality. Data were obtained from a national sample of 337 clinicians providing diagnostic information on 1 of their target patients. Chronic feelings of emptiness was the only criterion that demonstrated consistent evidence of potential differential functioning across methods and diagnostic models. Implications of these results for the conceptualization of borderline personality are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Genetic and Diagnostic Biomarker Development in ASD Toddlers Using Resting State Functional MRI

    Science.gov (United States)

    2016-09-01

    2008;3(2):177-190. 31. von dem Hagen EA, Stoyanova RS, Baron -Cohen S, Calder AJ. Reduced functional connectivity within and between ’ social ’ resting...widespread disruptions in functional networks in ASD that are crucial for social , communication, cognitive, attention and salience functions. These are...mean of 26.5 months (SD=8.9 months) in All subjects received a battery of psychological tests and final diagnoses were confirmed by licensed clinical

  20. Clinical value of measurement of pulmonary radioaerosol mucociliary clearance in the work up of primary ciliary dyskinesia

    DEFF Research Database (Denmark)

    Munkholm, Mathias; Nielsen, Kim Gjerum; Mortensen, Jann

    2015-01-01

    BACKGROUND: We aimed to evaluate and define the general clinical applicability and impact of pulmonary radioaerosol mucociliary clearance (PRMC) on the work up of patients suspected of having primary ciliary dyskinesia (PCD). In addition, we wanted to evaluate the accuracy of the reference values...... of the entire lung. Its greatest strength is its ability to reject a suspected PCD diagnosis with great certainty. In our material, this accounted for 2/3 of referred patients. In addition, the test has a high rate of conclusive results. According to our analyses, reference equations on children would benefit...

  1. State-of-art application of near infrared spectroscopy for functional diagnostics in neonatology

    International Nuclear Information System (INIS)

    Wolf, M.; Paiziev, A.

    2013-01-01

    The present brief review is devoted to application of near infra-red spectroscopy (NIRS) for early diagnostics of human brain injury. The number of commercially accessible NIRS instruments, and accordingly their users, increases but the precision of measurements and their reproducibility from the clinical point of view essentially depend on used algorithms, a kind of the NIRS-instrument, sensors, which frequently leads to the different values of the measurable parameters of blood oxygen saturation (StO 2 ). We present some commercially accessible NIRS instruments for control of an oxygen saturation degree in human blood, first of all in neonatology, on the basis of absorption and scattering of near infra-red light at human tissue chromophores. The results of clinical investigations of different NIRS-spectrometers for measurements of in-vivo new-born child' blood saturation are presented as well. (authors)

  2. THE MAKE BREAK TEST AS A DIAGNOSTIC-TOOL IN FUNCTIONAL WEAKNESS

    NARCIS (Netherlands)

    VANDERPLOEG, RJO; OOSTERHUIS, HJGH

    Strength was measured in four major muscle groups with a hand-held dynamometer. The "make" and "break" technique was used with and without encouragement, and fatiguability was tested in patients with organic weakness and patients with functional weakness. Patients with functional weakness could be

  3. Functional scintiscanning with sup(99m)technetium-diethyl-HIDA as a nuclear diagnostical means in hepatobiliary diseases

    International Nuclear Information System (INIS)

    Hummel, G.

    1982-01-01

    The study aimed to delimit the value of sequential hepatobiliary scintiscanning with the aid of sup(99m)technetium-diethyl-HIDA as a diagnostical method in functional or morphological disorders of the gall bladder and bile ducts. The most frequent indications to carry through the investigation therefore were inflammations calculosis in the biliary system, suspected intrahepatic icterus or conditions following biliodigestive anastomoses. Special attention was directed to the question in how far the results were in accordance with those of x-ray cholecystography/cholangiography. Furthermore the possibility for semiquantitative evaluation of serial functional scintiscanning was looked into and clearance determinations were carried through in part of the patients investigated. (orig./MG) [de

  4. Genetic and Diagnostic Biomarker Development in ASD Toddlers Using Resting State Functional MRI

    Science.gov (United States)

    2016-09-01

    imagining ,  and   functional  connectivity,  typically  measured...Toddlers  Using  Resting-­‐State   Functional  MRI   PRINCIPAL  INVESTIGATOR:      David  C.  Glahn CONTRACTING  ORGANIZATION...Yale  University   New Haven, CT 06520-8047 REPORT  DATE:   September 2016   TYPE  OF  REPORT:        Annual

  5. METHODS FOR LOCAL CHANGES IN THE PLASTIC DEFORMATION DIAGNOSTICS ON THE WORK FUNCTION

    Directory of Open Access Journals (Sweden)

    K. V. Panteleyev

    2015-01-01

    Full Text Available The paper describes the electronic work function measurements by the contact potential difference technique, and experimental demonstration of the possibility of these methods application for the stress-strain state of the surface layer of the metals and alloys. The techniques end examples of their application of localization of plastic deformation studies using the Kelvin probe are developed and present. The study topology of work function the deformed surface possible to determine the type of deformation and dynamics of

  6. Genetic and Diagnostic Biomarker Development in ASD Toddlers Using Resting State Functional MRI

    Science.gov (United States)

    2017-11-01

    All subjects received a battery of psychological tests and final diagnoses were confirmed by licensed clinical psychologists at the Courchesne lab...analyses of intrinsic functional networks are powerful tools for characterizing functional networks in pediatric and clinical populations. In control...first-ever studies of the intrinsic connectivity patterns in infants and toddlers with ASD at the age of first clinical identification. The knowledge

  7. Cross-diagnostic validity in a generic instrument: an example from the Functional Independence Measure in Scandinavia

    Directory of Open Access Journals (Sweden)

    Grimby G

    2006-08-01

    Full Text Available Abstract Background To analyse the cross-diagnostic validity of the Functional Independence Measure (FIM™ motor items in patients with spinal cord injury, stroke and traumatic brain injury and the comparability of summed scores between these diagnoses. Methods Data from 471 patients on FIM™ motor items at admission (stroke 157, spinal cord injury 157 and traumatic brain injury 157, age range 11–90 years and 70 % male in nine rehabilitation facilities in Scandinavia, were fitted to the Rasch model. A detailed analysis of scoring functions of the seven categories of the FIM™ motor items was made prior to testing fit to the model. Categories were re-scored where necessary. Fit to the model was assessed initially within diagnosis and then in the pooled data. Analysis of Differential Item Functioning (DIF was undertaken in the pooled data for the FIM™ motor scale. Comparability of sum scores between diagnoses was tested by Test Equating. Results The present seven category scoring system for the FIM™ motor items was found to be invalid, necessitating extensive rescoring. Despite rescoring, the item-trait interaction fit statistic was significant and two individual items showed misfit to the model, Eating and Bladder management. DIF was also found for Spinal Cord Injury, compared with the other two diagnoses. After adjustment, it was possible to make appropriate comparisons of sum scores between the three diagnoses. Conclusion The seven-category response function is a problem for the FIM™ instrument, and a reduction of responses might increase the validity of the instrument. Likewise, the removal of items that do not fit the underlying trait would improve the validity of the scale in these groups. Cross-diagnostic DIF is also a problem but for clinical use sum scores on group data in a generic instrument such as the FIM™ can be compared with appropriate adjustments. Thus, when planning interventions (group or individual, developing

  8. Neurocognitive Functioning in Schizophrenia and Bipolar Disorder: Clarifying Concepts of Diagnostic Dichotomy vs. Continuum.

    Science.gov (United States)

    Kuswanto, Carissa N; Sum, Min Y; Sim, Kang

    2013-01-01

    The Kraepelinian dichotomy posits that patients with schizophrenia (SCZ) and bipolar disorder (BD) present as two separate psychotic entities such that they differ in terms of clinical severity including neurocognitive functioning. Our study aimed to specifically compare and contrast the level of neurocognitive functioning between SCZ and BD patients and identify predictors of their poor neurocognitive functioning. We hypothesized that patients with SCZ had a similar level of neurocognitive impairment compared with BD. About 49 healthy controls (HC), 72 SCZ, and 42 BD patients who were matched for age, gender, and premorbid IQ were administered the Brief Assessment of Cognition battery (BAC). Severity of psychopathology and socio-occupational functioning were assessed for both patients groups. Both BD and SCZ groups demonstrated similar patterns of neurocognitive deficits across several domains (verbal memory, working memory, semantic fluency, processing speed) compared with HC subjects. However, no significant difference was found in neurocognitive functioning between BD and SCZ patients, suggesting that both patient groups suffer the same degree of neurocognitive impairment. Patients with lower level of psychosocial functioning [F (1,112) = 2.661, p = 0.009] and older age [F (1,112) = -2.625, p = 0.010], not diagnosis or doses of psychotropic medications, predicted poorer overall neurocognitive functioning as measured by the lower BAC composite score. Our findings of comparable neurocognitive impairments between SCZ and BD affirm our hypothesis and support less the Kraepelinian concept of dichotomy but more of a continuum of psychotic spectrum conditions. This should urge clinicians to investigate further the underlying neural basis of these neurocognitive deficits, and be attentive to the associated socio-demographic and clinical profile in order to recognize and optimize early the management of the widespread neurocognitive deficits in patients

  9. Neurocognitive functioning in schizophrenia and bipolar disorder: Clarifying concepts of diagnostic dichotomy versus continuum

    Directory of Open Access Journals (Sweden)

    Carissa Nadia Kuswanto

    2013-12-01

    Full Text Available The Kraepelinian dichotomy posits that patients with schizophrenia (SCZ and bipolar disorder (BD present as two separate psychotic entities such that they differ in terms of clinical severity including neurocognitive functioning. Our study aimed to specifically compare and contrast the level of neurocognitive functioning between SCZ and BD patients and identify predictors of their poor neurocognitive functioning. We hypothesized that patients with SCZ had a similar level of neurcognitive impairment compared with BD. Forty-nine healthy controls (HC, 72 SCZ and 42 BD patients who were matched for age, gender, and premorbid IQ were administered the Brief Assessment of Cognition battery (BAC. Severity of psychopathology and socio-occupational functioning were assessed for both patients groups. Both BD and SCZ groups demonstrated similar patterns of neurocognitive deficits across several domains (verbal memory, working memory, semantic fluency, processing speed compared with HC subjects. However, no significant difference was found in neurocognitive functioning between BD and SCZ patients, suggesting that both patient groups suffer the same degree of neurocognitive impairment. Patients with lower level of psychosocial functioning (F(1,112 = 2.661, p = 0.009 and older age (F(1,112 = -2.625, p = 0.010, not diagnosis or doses of psychotropic medications, predicted poorer overall neurocognitive functioning as measured by the lower BAC composite score. Our findings of comparable neurocognitive impairments between SCZ and BD affirm our hypothesis and support less the Kraepelinian concept of dichotomy but more of a continuum of psychotic spectrum conditions. This should urge clinicians to investigate further the underlying neural basis of these neurocognitive deficits, and be attentive to the associated socio-demographic and clinical profile in order to recognize and optimize early the management of the widespread neurocognitive deficits in patients with

  10. The Technologist Function in Fields Related to Radiology: Tasks in Radiation Therapy and Diagnostic Ultrasound. Research Report No. 9; Relating Technologist Tasks in Diagnostic Radiology, Ultrasound and Radiation Therapy. Research Report No. 10.

    Science.gov (United States)

    Gilpatrick, Eleanor

    The two research reports included in this document describe the application of the Health Services Mobility Study (HSMS) task analysis method to two technologist functions and examine the interrelationships of these tasks with those in diagnostic radiology. (The HSMS method includes processes for using the data for designing job ladders, for…

  11. Mucins as diagnostic and prognostic biomarkers in a fish-parasite model: transcriptional and functional analysis.

    Directory of Open Access Journals (Sweden)

    Jaume Pérez-Sánchez

    Full Text Available Mucins are O-glycosylated glycoproteins present on the apex of all wet-surfaced epithelia with a well-defined expression pattern, which is disrupted in response to a wide range of injuries or challenges. The aim of this study was to identify mucin gene sequences of gilthead sea bream (GSB, to determine its pattern of distribution in fish tissues and to analyse their transcriptional regulation by dietary and pathogenic factors. Exhaustive search of fish mucins was done in GSB after de novo assembly of next-generation sequencing data hosted in the IATS transcriptome database (www.nutrigroup-iats.org/seabreamdb. Six sequences, three categorized as putative membrane-bound mucins and three putative secreted-gel forming mucins, were identified. The transcriptional tissue screening revealed that Muc18 was the predominant mucin in skin, gills and stomach of GSB. In contrast, Muc19 was mostly found in the oesophagus and Muc13 was along the entire intestinal tract, although the posterior intestine exhibited a differential pattern with a high expression of an isoform that does not share a clear orthologous in mammals. This mucin was annotated as intestinal mucin (I-Muc. Its RNA expression was highly regulated by the nutritional background, whereas the other mucins, including Muc2 and Muc2-like, were expressed more constitutively and did not respond to high replacement of fish oil (FO by vegetable oils (VO in plant protein-based diets. After challenge with the intestinal parasite Enteromyxum leei, the expression of a number of mucins was decreased mainly in the posterior intestine of infected fish. But, interestingly, the highest down-regulation was observed for the I-Muc. Overall, the magnitude of the changes reflected the intensity and progression of the infection, making mucins and I-Muc, in particular, reliable markers of prognostic and diagnostic value of fish intestinal health.

  12. Overactive pelvic floor muscles (OPFM): improving diagnostic accuracy with clinical examination and functional studies.

    Science.gov (United States)

    Aw, Hau Choong; Ranasinghe, Weranja; Tan, Philip Huang Min; O'Connell, Helen E

    2017-07-01

    To identify the functional correlation of overactive pelvic floor muscles (OPFM) with cystoscopic and fluoroscopic urodynamic studies (FUDS), including urethral pressure measurements. Patients refractory to conservative therapy including bladder retraining, medications and pelvic muscle exercises for a variety of gamut of storage and voiding disorders were evaluated. Prospective data for 201 patients across both genders who underwent flexible cystoscopy and urodynamics for lower urinary tract symptoms (LUTS) refractory to conservative management between 01 Jan 2014 and 01 Jan 2016 was collected. Factors studied included history of LUTS, voiding patterns, physical examination, cystoscopic findings and functional studies, with maximum urethral closing pressure (MUCP). A total of 201 were patients recruited. The 85 were diagnosed with OPFM based on clinical presentation and presence of pelvic floor tenderness on examination. Significant differences were noted on functional studies with FUDS and urethral pressure measurement. Subjects with pelvic floor tenderness were found to have a higher (MUCP) at 93.1 cm H2O compared to 80.6 cm H2O (P=0.015). There are distinct characteristics of OPFM on clinical examination and functional studies, in particular MUCP. In patients refractory to conservative treatments, specific urodynamics tests are useful in sub-categorising patients. When OPFM is diagnosed, the impact on patient management is significant, and targeted intervention with pelvic floor physiotherapy is central in the multimodal approach of this complex condition.

  13. Methods to determine fast-ion distribution functions from multi-diagnostic measurements

    DEFF Research Database (Denmark)

    Jacobsen, Asger Schou; Salewski, Mirko

    Understanding the behaviour of fast ions in a fusion plasma is very important, since the fusion-born alpha particles are expected to be the main source of heating in a fusion power plant. Preferably, the entire fast-ion velocity-space distribution function would be measured. However, no fast-ion ...

  14. A single-centre experience of the implementation of adrenal vein sampling procedure: the impact on the diagnostic work-up in primary aldosteronism

    NARCIS (Netherlands)

    Kadziela, J.; Prejbisz, A.; Michalowska, I.; Kolodziejczyk-Kruk, S.; Schultze Kool, L.J.; Kabat, M.; Janaszek-Sitkowska, H.; Toutounchi, S.; Galazka, Z.; Ambroziak, U.; Bednarczuk, T.; Ptasinska-Wnuk, D.; Hoffmann, M.; Januszewicz, M.; Januszewicz, A.; Witkowski, A.

    2017-01-01

    BACKGROUND: Primary aldosteronism is one of the most common causes of secondary hypertension. Adrenal vein sampling (AVS) remains a "gold standard" procedure in differentiation between unilateral (adenoma) and bilateral (hyperplasia) disease. AIM: The aim of this study was to present our

  15. Diagnostic management of patients with SAPHO syndrome: use of MR imaging to guide bone biopsy at CT for microbiological and histological work-up

    International Nuclear Information System (INIS)

    Kirchhoff, Timm; Rosenthal, Herbert; Prokop, Mathias; Chavan, Ajay; Galanski, Michael; Merkesdal, Sonja; Wagner, Annette; Zeidler, Henning; Mai, Uwe; Hammer, Michael

    2003-01-01

    Propionibacterium acnes (P. acnes) is suspected to be involved in the pathophysiology of SAPHO syndrome, since it has been isolated repeatedly through open surgical bone biopsy. This study demonstrates the role of MRI in identifying inflamed bone areas in patients with SAPHO syndrome and the role of CT-guided bone biopsies in obtaining samples from these areas for microbiological and histopathological investigations, thus obviating open surgery. Fourteen consecutive patients with SAPHO syndrome were investigated by MRI to identify acute inflammatory changes in hyperostotic periarticular bone. The CT-guided biopsies for microbiological investigations were taken from the areas identified. Patients positive for P. acnes were started on long-term antibiotic therapy according to antibiotic susceptibility. On MRI the inflammatory changes appeared as hyperintense areas on fat-saturated T2 fast-spin-echo (FSE) images and showed signal increase on fat-saturated T1 SE images after Gd-DTPA. With MR localization CT-guided bone biopsies yielded P. acnes in 8 patients. No bacteria could be isolated from the remaining 6 patients. Acute inflammatory bone changes in SAPHO syndrome are well localized by MRI. With MR localization, CT-guided bone biopsies offer a minimally invasive alternative to open surgery in the detection of. P. acnes leading to the institution of a specific antibiotic therapy. (orig.)

  16. Core Noise Diagnostics of Turbofan Engine Noise Using Correlation and Coherence Functions

    Science.gov (United States)

    Miles, Jeffrey H.

    2009-01-01

    Cross-correlation and coherence functions are used to look for periodic acoustic components in turbofan engine combustor time histories, to investigate direct and indirect combustion noise source separation based on signal propagation time delays, and to provide information on combustor acoustics. Using the cross-correlation function, time delays were identified in all cases, clearly indicating the combustor is the source of the noise. In addition, unfiltered and low-pass filtered at 400 Hz signals had a cross-correlation time delay near 90 ms, while the low-pass filtered at less than 400 Hz signals had a cross-correlation time delay longer than 90 ms. Low-pass filtering at frequencies less than 400 Hz partially removes the direct combustion noise signals. The remainder includes the indirect combustion noise signal, which travels more slowly because of the dependence on the entropy convection velocity in the combustor. Source separation of direct and indirect combustion noise is demonstrated by proper use of low-pass filters with the cross-correlation function for a range of operating conditions. The results may lead to a better idea about the acoustics in the combustor and may help develop and validate improved reduced-order physics-based methods for predicting direct and indirect combustion noise.

  17. Physical and Cognitive Functioning After 3 Years Can Be Predicted Using Information From the Diagnostic Process in Recently Diagnosed Multiple Sclerosis

    NARCIS (Netherlands)

    de Groot, V.; Beckerman, H.; Uitdehaag, B.M.J.; Hintzen, R.Q.; Minneboo, A.; Heymans, M.W.; Lankhorst, G.J.; Polman, C.H.; Bouter, L.M.

    2009-01-01

    de Groot V, Beckerman H, Uitdehaag BM, Hintzen RQ, Minneboo A, Heymans MW, Lankhorst GJ, Polman CH, Bouter LM, on behalf of the Functional Prognostication and Disability (FuPro) Study Group. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic

  18. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  19. Diagnostics of Cognitive Function in Women of Menopausal Period at Level of Primary Health Care

    Directory of Open Access Journals (Sweden)

    N. Zhilgeldina

    2014-12-01

    Full Text Available Introduction. In the medical community, there is no consensus on whether or not climacteric changes are pathologic and require treatment. One of the main problems related to menopause is misperception of menopause; consequently, there is no consensus on treatments for psychological dysfunction and cognitive deficits in menopausal women. Timely diagnosis and adequate treatment of psychological disorders and cognitive dysfunction are imperative and complicated. The purpose of this study was to evaluate physician perceptions of cognitive and psychological deficits in menopausal women in outpatient settings.Methods. 215 obstetricians-gynecologists working in out-patient services were surveyed using a multiple choice questionnaire assessing perceptions and knowledge of menopausal transition.Results. Of total respondents, 42.0% ± 2.5 of physicians found it hard to define menopausal period, and 67.5% ± 3.2 could not give a clear definition of hormone replacement therapy. On the question “cognitive function includes…,” 62.5% ± 2.1 of physicians selected “memory,” 32.3% ± 1.8 selected attention, 77.5% ± 3.2 selected mood and/or imagination, 37.4% selected intellect, 36.3% ± 3.1 of respondents selected character traits, and 6.2% ± 1.7 selected speech. Regarding the question “how do you study memory status function?” it was estimated that 71.2% ± 2.5 of study participants have studied the memory only on the basis of subjective complaints, and none of the respondents (100% have ever used neuropsychological tests.Conclusion. The survey allows us to ascertain that primary medical care services lack the ability to appropriately recognize and diagnose cognitive deficits in women of menopausal age. Based on these data, we can assume that proper mental care is not provided. Thus, the study indicates a need to create training programs for general practitioners and other specialists (cardiologists, neurologists, and endocrinologists to fulfill

  20. Diagnostic radiology for functional analysis of the cervical vertebral column. Roentgenfunktionsdiagnostik der Halswirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Kamieth, H.

    1986-01-01

    The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement. The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc., the causes of each, and with the clinical relevance of spondylochondrosis and arthrosis, and with the pain. With 171 figs..

  1. [Neurogenic bladder function disorders in patients with meningomyelocele: S2k guidelines on diagnostics and therapy].

    Science.gov (United States)

    Stein, R; Assion, C; Beetz, R; Bürst, M; Cremer, R; Ermert, A; Goepel, M; Kuwertz-Bröking, E; Ludwikowski, B; Michael, T; Pannek, J; Peters, H; Rohrmann, D; Rübben, I; Schröder, A; Trollmann, R; Thüroff, J W; Wagner, W

    2015-02-01

    The treatment of children and adolescents with meningomyelocele has experienced a clear change in the last 30 years. The establishment of pharmacotherapy, clean intermittent catheterization (CIC) and infection prophylaxis have improved the prognosis for patients and have led to new therapeutic strategies. The interdisciplinary cooperation between neonatologists, neurosurgeons, pediatric neurologists, pediatric urologists, pediatric nephrologists, pediatric orthopedists and pediatric surgeons leads to optimization of individualized therapy. These guidelines present definitions and classifications, investigations and timing which are described in detail. The conservative and operative therapy options for neurogenic bladder function disorders are described and discussed with reference to the current literature. The brief overview provides in each case assistance for the treating physician in the care of this patient group and facilitates the interdisciplinary cooperation.

  2. A study of shear sprays using probability density function techniques and laser-based diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Gitahi, A.; Kioni, P.N. [Jomo Kenyatta University of Agriculture and Technology (Kenya). Department of Mechanical Engineering

    2009-07-01

    Presented in this paper are preliminary experimental results from investigations carried out on a two-dimensional shear spray. These results are part of ongoing research of combustion in shear flows. Among the objectives is to include the effects of droplet-droplet interactions and turbulent dispersion. In the numerical work, use is made of Probability Density Function (pdf) techniques owing to the large dimensionality of the spray problem. For the experimental work, a burner has been developed and laser-based experiments carried out on it to characterize the spray. The results capture velocity evolution and droplet size distributions. At this stage a water spray is used, to bring out the quality of the burner as a precursor to spray combustion investigations in the ongoing research. (orig.)

  3. Lung function studies in diagnostics and follow-up of pulmonary sarcoidosis

    International Nuclear Information System (INIS)

    Braadvik, I.

    1994-06-01

    In 66 patients the relationship between lung volumes and lung mechanics in pulmonary sarcoidosis was investigated. Lung volumes, static lung mechanics, lung resistance, dynamic lung mechanics and arterial blood gases at rest and during exercise were obtained. Fifteen functionally compromised patients received steroids during one year. They were re-investigated during the treatment and at a follow-up after an average of 7 years. In another 41 patients with newly diagnosed sarcoidosis, the kinetics of the lung clearance of 99m Tc-DTPA measured over 180 minutes was explored, and compared to kinetics in healthy smokers. The relationship between lung clearance and lung volumes, lung mechanics, arterial blood gases and disease activity assessed with serum angiotensin-converting enzyme and 67 Ga scintigraphy was studied. Reducing lung volumes and compliance, increased resistance and arterial oxygen tension were common. Vital capacity (VC), and changes of VC at follow-up, corresponded to the slope of the static elastic pressure/volume curve, and to the variation of it. Other static lung volumes reflected rather the position of the curve along the volume axis. Reduced VC also reflected obstruction. Forced expiratory volume in one second revealed to equal extent lung stiffness and obstruction. Lung mechanics showed abnormalities not always evident from spirometry.In 50% of the patients lung clearance of 99m Tc-DTPA disclosed an abnormally fast mono-exponential clearance or a bi-exponential clearance, which however differed from that in smokers. Lung clearance more readily detected abnormal function than did spirometry. Clearance did nor correlate with other investigations. 67 Ga lung activity was higher in patients with a pathologic lung clearance

  4. Is there a role for capsule endoscopy in the staging work-up of patients with gastric marginal zone B-cell lymphoma of MALT?

    Science.gov (United States)

    Al-Taie, O; Dietrich, C G; Flieger, D; Katzenberger, T; Fischbach, W

    2013-08-01

    In earlier studies, involvement of the small intestine was reported in patients with gastrointestinal lymphoma. Prospective data on the involvement of the small intestine in patients suffering from gastric extranodal MZBCL of MALT do not exist so far. In this study, we investigated the frequency of the involvement of the small intestine and the role of capsule endoscopy in patients with gastrointestinal extranodal MZBCL of MALT and of follicular lymphoma. 40 consecutive patients with gastrointestinal extranodal MZBCL of MALT (26 men, 14 women, aged 27 - 80 years), and 7 patients with known follicular lymphoma of the small intestine (5 men, 2 women, aged 34 - 63 years) underwent capsule endoscopy. Involvement of the small intestine was identified by capsule endoscopy in all 7 patients with known follicular lymphoma of the small intestine. In 6 of 40 patients with gastric extranodal MZBCL of MALT abnormal findings could be observed, three of these findings indicative for lymphoma involvement of the small intestine. However, in each of these 3 cases, intestinal involvement had been already diagnosed by conventional GI endoscopy before capsule endoscopy. Capsule endoscopy is able to detect involvement of the small intestine in patients with gastrointestinal lymphoma. However, involvement of the small intestine seems to be rare in patients with gastric extranodal MZBCL of MALT. In summary, routine diagnostic work-up of the small intestine, e. g. by capsule endoscopy seems unnecessary because of the rare involvement of the small intestine and an excellent long-term outcome irrespective of a possible intestinal manifestation. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Patterns of anaphylaxis after diagnostic workup

    DEFF Research Database (Denmark)

    Oropeza, Athamaica Ruiz; Bindslev-Jensen, Carsten; Broesby-Olsen, Sigurd

    2017-01-01

    BACKGROUND: Most published studies on anaphylaxis are retrospective or register based. Data on subsequent diagnostic work-up are sparse. We aimed to characterize patients seen with suspected anaphylaxis at the emergency care setting (ECS), after subsequent diagnostic work-up at our Allergy Center...... patient with clinical suspicion but not fulfilling the WAO/EAACI criteria at the ECS. The estimated incidence rate of anaphylaxis was 26 cases per 100,000 person years and the one year period prevalence was 0.04%. The most common elicitor was drugs (41.1%) followed by venom (27.4%) and food (20.6%). In 13...

  6. Enhancing the functionality of reactor protection systems to provide diagnostic and monitoring information: The ISATTM approach

    International Nuclear Information System (INIS)

    Baldwin, J.A.; Rowe, B.J.; Jones, C.D.

    1996-01-01

    The ISAT TM architecture has been successfully implemented as the Single Channel Trip System (SCTS), part of the primary protection system of Nuclear Electric's Dungeness 'B' Advanced Gas-Cooled Reactors. The system is the first computer-based protection system licensed on a UK civil nuclear reactor. The system provides protection against single channel faults resulting in high coolant gas outlet temperature. The SCTS was designed to output data at several points in the system to an Ethernet to allow checks to be made on the operation of parts of the protection system and the system as a whole. In order to monitor the performance of this shutdown system a PC based monitoring system was developed to take input as data from the Ethernet, check its integrity and then analyze the data to provide information of the state of the system and subsystems. The SCTS monitor was basically intended to alert the operator to any fault on the safety system and indicate its source, provide a diagnosis of the cause of any trip initiated by the safety system, and log the occurrences of these incidents for later inspection. The intention was also to provide accurate real-time information on the thermocouple readings and to decrease the effort required to maintain the safety system. This paper will describe briefly the development of the ISAT TM monitoring system: how its requirements were arrived at, and how the design, code and testing were carried out to ensure approval for this application. It will then go on to report how the ISAT TM monitor has performed during its time in service: how more functionality has been added over and above its original requirements. Features of additional monitors for the SCTS and other ISAT TM systems will also be described. (author). 2 refs, 5 figs

  7. Pipe leak diagnostic using high frequency piezoelectric pressure sensor and automatic selection of intrinsic mode function

    Science.gov (United States)

    Yusop, Hanafi M.; Ghazali, M. F.; Yusof, M. F. M.; Remli, M. A. Pi; Kamarulzaman, M. H.

    2017-10-01

    In a recent study, the analysis of pressure transient signals could be seen as an accurate and low-cost method for leak and feature detection in water distribution systems. Transient phenomena occurs due to sudden changes in the fluid’s propagation in pipelines system caused by rapid pressure and flow fluctuation due to events such as closing and opening valves rapidly or through pump failure. In this paper, the feasibility of the Hilbert-Huang transform (HHT) method/technique in analysing the pressure transient signals in presented and discussed. HHT is a way to decompose a signal into intrinsic mode functions (IMF). However, the advantage of HHT is its difficulty in selecting the suitable IMF for the next data postprocessing method which is Hilbert Transform (HT). This paper reveals that utilizing the application of an integrated kurtosis-based algorithm for a z-filter technique (I-Kaz) to kurtosis ratio (I-Kaz-Kurtosis) allows/contributes to/leads to automatic selection of the IMF that should be used. This technique is demonstrated on a 57.90-meter medium high-density polyethylene (MDPE) pipe installed with a single artificial leak. The analysis results using the I-Kaz-kurtosis ratio revealed/confirmed that the method can be used as an automatic selection of the IMF although the noise level ratio of the signal is low. Therefore, the I-Kaz-kurtosis ratio method is recommended as a means to implement an automatic selection technique of the IMF for HHT analysis.

  8. MFP scanner diagnostics using a self-printed target to measure the modulation transfer function

    Science.gov (United States)

    Wang, Weibao; Bauer, Peter; Wagner, Jerry; Allebach, Jan P.

    2014-01-01

    In the current market, reduction of warranty costs is an important avenue for improving profitability by manufacturers of printer products. Our goal is to develop an autonomous capability for diagnosis of printer and scanner caused defects with mid-range laser multifunction printers (MFPs), so as to reduce warranty costs. If the scanner unit of the MFP is not performing according to specification, this issue needs to be diagnosed. If there is a print quality issue, this can be diagnosed by printing a special test page that is resident in the firmware of the MFP unit, and then scanning it. However, the reliability of this process will be compromised if the scanner unit is defective. Thus, for both scanner and printer image quality issues, it is important to be able to properly evaluate the scanner performance. In this paper, we consider evaluation of the scanner performance by measuring its modulation transfer function (MTF). The MTF is a fundamental tool for assessing the performance of imaging systems. Several ways have been proposed to measure the MTF, all of which require a special target, for example a slanted-edge target. It is unacceptably expensive to ship every MFP with such a standard target, and to expect that the customer can keep track of it. To reduce this cost, in this paper, we develop new approach to this task. It is based on a self-printed slanted-edge target. Then, we propose algorithms to improve the results using a self-printed slanted-edge target. Finally, we present experimental results for MTF measurement using self-printed targets and compare them to the results obtained with standard targets.

  9. The clinical value of 201Tl per rectum scintigraphy in the work-up of patients with alcoholic liver disease

    International Nuclear Information System (INIS)

    Urbain, D.; Reding, P.; Georges, B.; Thys, O.; Ham, H.R.; Vrije Univ., Brussels

    1986-01-01

    The clinical value of thallium 201 per rectum scintigraphy in the work-up of patients with alcoholic liver disease was evaluated using data obtained in 104 patients. The 25th min ratio of heart to liver activities was used as an index of portal systemic shunting. This ratio was found to be normal in alcoholic patients with normal liver biopsy and also in those presenting only steatosis. It was slightly higher in patients with liver fibrosis and significantly higher values were observed in patients with liver cirrhosis. High values of the ratio were associated with a higher risk of portal systemic encephalopathy and/or gastrointestinal bleeding. The prognostic value of the test was supported by the fact that good correlations were observed between the ratio and widely accepted prognostic scores such as the Child score or the Orrego index. Moreover, high ratios were associated with an increased mortality risk at one year. We conclude that this simple test is interesting in the screening of cirrhotics at risk of encephalopathy, gastrointestinal hemorrhage, or early death. (orig.)

  10. The role of PET in staging work-up and evaluation after therapy in patients with malignant lymphoma

    International Nuclear Information System (INIS)

    Kang, Yoon Koo; Ryoo, Baek Yeol

    1998-12-01

    The stage of disease in patients with malignant lymphoma in important in decision of treatment modality and in prediction of prognosis. The authors evaluated the usefulness of PET with F18-FDG in initial staging, in reevaluation after radical therapy and in diagnosis of recurrence or disease progression of malignant lymphoma, compared with conventional imaging studies. The efficacy of positron emission tomography (PET) with fluorine-18-fluorodeoxyglucose (F18-FDG) was evaluated in several tumors. In malignant lymphoma. It was reported that the concentration of FDG was increased in tumor tissues, and that PET with F18-FDG was more sensitive and specific in staging evaluation compared with CT scan. The visual analysis of FDG-PET would be helpful in initial staging work-up, in reevaluation of residual disease after radical therapy and in suspicious recurrence or disease progression, determining the residual disease of lymphoma after radical therapy. But more studies with larger number of cases and longer follow-up were required. The results of this study can be bases for the direction of future studies for the usefulness of PET in malignant lymphoma

  11. Antisense oligodeoxynucleotide inhibition as a potent diagnostic tool for gene function in plant biology

    Energy Technology Data Exchange (ETDEWEB)

    Jansson, Christer; Sun, Chuanxin; Ghebramedhin, Haile; Hoglund, Anna-Stina; Jansson, Christer

    2008-01-15

    Antisense oligodeoxynucleotide (ODN) inhibition emerges as an effective means for probing gene function in plant cells. Employing this method we have established the importance of the SUSIBA2 transcription factor for regulation of starch synthesis in barley endosperm, and arrived at a model for the role of the SUSIBAs in sugar signaling and source-sink commutation during cereal endosperm development. In this addendum we provide additional data demonstrating the suitability of the antisense ODN technology in studies on starch branching enzyme activities in barley leaves. We also comment on the mechanism for ODN uptake in plant cells. Antisense ODNs are short (12-25 nt-long) stretches of single-stranded ODNs that hybridize to the cognate mRNA in a sequence-specific manner, thereby inhibiting gene expression. They are naturally occurring in both prokaryotes and eukaryotes where they partake in gene regulation and defense against viral infection. The mechanisms for antisense ODN inhibition are not fully understood but it is generally considered that the ODN either sterically interferes with translation or promotes transcript degradation by RNase H activation. The earliest indication of the usefulness of antisense ODN technology for the purposes of molecular biology and medical therapy was the demonstration in 1978 that synthetic ODNs complementary to Raos sarcoma virus could inhibit virus replication in tissue cultures of chick embryo fibroblasts. Since then the antisense ODN technology has been widely used in animal sciences and as an important emerging therapeutic approach in clinical medicine. However, antisense ODN inhibition has been an under-exploited strategy for plant tissues, although the prospects for plant cells in suspension cultures to take up single-stranded ODNs was reported over a decade ago. In 2001, two reports from Malho and coworker demonstrated the use of cationic-complexed antisense ODNs to suppress expression of genes encoding pollen

  12. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students

    Science.gov (United States)

    2016-01-01

    Background and Aims Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Methods Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. Results The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms and further intervention studies focusing on treatment recommendation in improving the symptoms are essential. PMID:27997551

  13. Evaluation of the diagnostic accuracy of ultra-miniaturized pocket ultrasound device on cardiac function in critically ill patients

    Directory of Open Access Journals (Sweden)

    Li WANG

    2016-09-01

    Full Text Available Objective  To compare the diagnostic accuracy of a new ultra-miniaturized pocket ultrasound device (PUD (VscanTM, GE Healthcare, Wauwatosa, WI and conventional high-quality echocardiography system (Vivid qTM, GE Healthcare for a cardiac focused ultrasonography in critical patients. Methods  The patients admitted to our hospital and receiving transthoracic echocardiography (TTE using a PUD and a conventional echocardiography system were included in this study during the 10 months from December 2013 to October 2014. Each examination was performed independently by an intensive care unit (ICU physician and an experienced ultrasound doctor, unaware of the results found by the alternative device. The following parameters were assessed: global cardiac systolic function, identification of ventricular size, whether or not accompanying enlargement or hypertrophy, assessment for the morphology of cardiac valves and its function, pericardial effusion and estimation of the inferior vena cava (IVC diameter. The time-consuming of each device were recorded. Results  One hundred and twenty-eight patients were included in the study. Their left ventricular wall motion abnormalities, global left ventricular systolic dysfunction, pericardial effusion, IVC dilation were assessed by PUD and the assessment results were highly consistent with those by Vivid q (κ>0.84. The consistency was slightly lower in evaluating the left and right ventricular size. For evaluating the cardiac valves function, the agreement of two devices were relatively low (κ=0.69-0.84. Compared with Vivid q, PUD took less time (4.7±1.4min vs 6.3±2.6min; P<0.05. Conclusion  PUD can provide fast, reliable cardiac examination, thus being an effective method for ICU physicians to assess the cardiac f unction in critical patients. DOI: 10.11855/j.issn.0577-7402.2016.08.10

  14. Comparison of a gene expression profiling strategy to standard clinical work-up for determination of tumour origin in cancer of unknown primary (CUP)

    DEFF Research Database (Denmark)

    Ades, Felipe; de Azambuja, Evandro; Daugaard, Gedske

    2013-01-01

    for this trial. The clinical work-up and gene expression profiling on a biopsy from a metastatic site were started at the same time. The study was planned using a one-stage Fleming design. Patients in whom no primary site was diagnosed by the clinical work-up were excluded. Out of the 67 patients registered......, the primary site was identified by clinical work-up in 36 patients, and diagnosis with CupPrint was obtained in 53. There were 31 evaluable patients with both clinical and CupPrint diagnoses, and out of these a similar diagnosis was obtained in 11 patients, i.e. the concordance rate was 35% (95% confidence...... interval: 19-55%). The median time to diagnosis through the clinical work-up was 48 days, and 10 days with CupPrint (P...

  15. Improved Diagnostic Accuracy of Alzheimer's Disease by Combining Regional Cortical Thickness and Default Mode Network Functional Connectivity: Validated in the Alzheimer's Disease Neuroimaging Initiative Set.

    Science.gov (United States)

    Park, Ji Eun; Park, Bumwoo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Chai; Oh, Joo Young; Lee, Jae-Hong; Roh, Jee Hoon; Shim, Woo Hyun

    2017-01-01

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal ( p Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease.

  16. Validating the Modified Drug Adherence Work-Up (M-DRAW Tool to Identify and Address Barriers to Medication Adherence

    Directory of Open Access Journals (Sweden)

    Sun Lee

    2017-09-01

    Full Text Available Barriers to medication adherence stem from multiple factors. An effective and convenient tool is needed to identify these barriers so that clinicians can provide a tailored, patient-centered consultation with patients. The Modified Drug Adherence Work-up Tool (M-DRAW was developed as a 13-item checklist questionnaire to identify barriers to medication adherence. The response scale was a 4-point Likert scale of frequency of occurrence (1 = never to 4 = often. The checklist was accompanied by a GUIDE that provided corresponding motivational interview-based intervention strategies for each identified barrier. The current pilot study examined the psychometric properties of the M-DRAW checklist (reliability, responsiveness and discriminant validity in patients taking one or more prescription medication(s for chronic conditions. A cross-sectional sample of 26 patients was recruited between December 2015 and March 2016 at an academic medical center pharmacy in Southern California. A priming question that assessed self-reported adherence was used to separate participants into the control group of 17 “adherers” (65.4%, and into the intervention group of nine “unintentional and intentional non-adherers” (34.6%. Comparable baseline characteristics were observed between the two groups. The M-DRAW checklist showed acceptable reliability (13 item; alpha = 0.74 for identifying factors and barriers leading to medication non-adherence. Discriminant validity of the tool and the priming question was established by the four-fold number of barriers to adherence identified within the self-selected intervention group compared to the control group (4.4 versus 1.2 barriers, p < 0.05. The current study did not investigate construct validity due to small sample size and challenges on follow-up with patients. Future testing of the tool will include construct validation.

  17. Predicting Cognitive, Functional, and Diagnostic Change over 4 Years Using Baseline Subjective Cognitive Complaints in the Sydney Memory and Ageing Study.

    Science.gov (United States)

    Slavin, Melissa J; Sachdev, Perminder S; Kochan, Nicole A; Woolf, Claudia; Crawford, John D; Giskes, Katrina; Reppermund, Simone; Trollor, Julian N; Draper, Brian; Delbaere, Kim; Brodaty, Henry

    2015-09-01

    There is limited understanding of the usefulness of subjective cognitive complaint(s) (SCC) in predicting longitudinal outcome because most studies focus solely on memory (as opposed to nonmemory cognitive) complaints, do not collect data from both participants and informants, do not control for relevant covariates, and have limited outcome measures. Therefore the authors investigate the usefulness of participant and informant SCCs in predicting change in cognition, functional abilities, and diagnostic classification of mild cognitive impairment or dementia in a community-dwelling sample over 4 years. Nondemented participants (N = 620) in the Sydney Memory and Ageing Study aged between 70 and 90 years completed 15 memory and 9 nonmemory SCC questions. An informant completed a baseline questionnaire that included 15 memory and 4 nonmemory SCC questions relating to the participant. Neuropsychological, functional, and diagnostic assessments were carried out at baseline and again at 4-year follow-up. Cross-sectional and longitudinal analyses were carried out to determine the association between SCC indices and neuropsychological, functional, and diagnostic data while controlling for psychological measures. Once participant characteristics were controlled for, participant complaints were generally not predictive of cognitive or functional decline, although participant memory-specific complaints were predictive of diagnostic conversion. Informant-related memory questions were associated with global cognitive and functional decline and with diagnostic conversion over 4 years. Informant memory complaint questions were better than participant complaints in predicting cognitive and functional decline as well as diagnoses over 4 years. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Distribution of phytoplankton functional types in high-nitrate, low-chlorophyll waters in a new diagnostic ecological indicator model

    Directory of Open Access Journals (Sweden)

    A. P. Palacz

    2013-11-01

    Full Text Available Modeling and monitoring plankton functional types (PFTs is challenged by the insufficient amount of field measurements of ground truths in both plankton models and bio-optical algorithms. In this study, we combine remote sensing data and a dynamic plankton model to simulate an ecologically sound spatial and temporal distribution of phyto-PFTs. We apply an innovative ecological indicator approach to modeling PFTs and focus on resolving the question of diatom–coccolithophore coexistence in the subpolar high-nitrate and low-chlorophyll regions. We choose an artificial neural network as our modeling framework because it has the potential to interpret complex nonlinear interactions governing complex adaptive systems, of which marine ecosystems are a prime example. Using ecological indicators that fulfill the criteria of measurability, sensitivity and specificity, we demonstrate that our diagnostic model correctly interprets some basic ecological rules similar to ones emerging from dynamic models. Our time series highlight a dynamic phyto-PFT community composition in all high-latitude areas and indicate seasonal coexistence of diatoms and coccolithophores. This observation, though consistent with in situ and remote sensing measurements, has so far not been captured by state-of-the-art dynamic models, which struggle to resolve this "paradox of the plankton". We conclude that an ecological indicator approach is useful for ecological modeling of phytoplankton and potentially higher trophic levels. Finally, we speculate that it could serve as a powerful tool in advancing ecosystem-based management of marine resources.

  19. Web-based platform for patient dose surveys in diagnostic and interventional radiology in Bulgaria: Functionality testing and optimisation.

    Science.gov (United States)

    Simeonov, F; Palov, N; Ivanova, D; Kostova-Lefterova, D; Georgiev, E; Zagorska, A; Madzharova, R; Vassileva, J

    2017-09-01

    In the period 2013-2016 the National Centre of Radiobiology and Radiation Protection (NCRRP) at the Ministry of Health of Bulgaria has developed a web based platform for performing national patient dose surveys and establishing Diagnostic Reference Levels (DRLs). It is accessible via internet browser, allowing the users to submit data remotely. Electronic questionnaires, specific for radiography, fluoroscopy, image guided interventional procedures, mammography and CT, were provided. Short and clear manuals were added to guide users and minimise human errors. The web-based data collection platform is functional and is currently being used for performing the third national dose survey in Bulgaria, launched in 2016. Data analysis is facilitated due to the standardisation of collected data and their storing. Using the platform, the participating facilities can establish their typical dose levels based on the median value, and compare them to DRLs. A disadvantage of the platform is the need to enter data manually, but it is opened for future upgrades for automatic data harvesting and analysis. Various practical approaches were used to overcome the lack of qualified human resources and insufficient understanding of the DRL and dose tracking concept and to motivate facilities to submit data. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. Diagnostic value of semi-quantitative and quantitative analysis of functional parameters in multiparametric MRI of the prostate.

    Science.gov (United States)

    Hauth, Elke; Halbritter, Daniela; Jaeger, Horst; Hohmuth, Horst; Beer, Meinrad

    2017-10-01

    To determine the diagnostic value of semi-quantitative and quantitative parameters of three functional techniques in multiparametric (mp)-MRI of the prostate. Mp-MRI was performed in 110 patients with suspicion of prostate cancer (PCA) before transrectal ultrasound (TRUS)-guided core biopsy. Peak-enhancement, initial and post-initial enhancement, initial area under gadolinium curve, Ktrans (forward rate constant), Kep (efflux rate constant), Ve (extracellular volume), ADC (apparent diffusion coefficient) and MR spectroscopy ratio were obtained for malignant and benign lesions. For iAUGC, Ktrans, Kep and Ve we evaluated median, mean and the difference (Diff) between mean and median. For ADC we evaluated mean, median, Diff between mean and median, and min. In addition, we evaluated these parameters in dependence of Gleason score in PCA. Receiver operating characteristic analysis and area under curve (AUC) were determined. ADC min and Kep Diff were the best predictors of malignancy in all lesions (AUC: 0.765). ADC min was the best predictor of malignancy for lesions in peripheral zone (PZ) (AUC: 0.7506) and Kep Diff was the best predictor of malignancy for lesions in transitional zone (AUC: 0.7514). Peak enhancement was the best parameter in differentiation of low-grade PCA with Gleason score 6 from high-grade PCA with Gleason score ≥ 7 (AUC: 0.7692). ADC min can differentiate PCA from benign prostate lesions in PZ. Kep Diff could possibly improve prostate cancer detection in. Peak enhancement might be able to differentiate low grade from high-grade PCA. Semi-quantitative and quantitative parameters may be useful for the functional techniques in mp-MRI. Advances in knowledge: ADC min can differentiate PCA from benign prostate lesions in PZ. Peak enhancement might be able to differentiate low grade from high-grade PCA.

  1. Platelet Function Analyzed by Light Transmission Aggregometry

    DEFF Research Database (Denmark)

    Hvas, Anne-Mette; Favaloro, Emmanuel J

    2017-01-01

    Analysis of platelet function is widely used for diagnostic work-up in patients with increased bleeding tendency. During the last decades, platelet function testing has also been introduced for evaluation of antiplatelet therapy, but this is still recommended for research purposes only. Platelet...... function can also be assessed for hyper-aggregability, but this is less often evaluated. Light transmission aggregometry (LTA) was introduced in the early 1960s and has since been considered the gold standard. This optical detection system is based on changes in turbidity measured as a change in light...

  2. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students.

    Science.gov (United States)

    Lim, Ying Jye; Rosita, Jamaluddin; Chieng, Jin Yu; Hazizi, Abu Saad

    2016-01-01

    Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06-2.06) and age group (odds ratio: 1.34, 95% CI: 1.01-1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08-2.17, P < 0.05). Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among the female respondents. Early detection of symptoms

  3. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students.

    Directory of Open Access Journals (Sweden)

    Ying Jye Lim

    Full Text Available Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future.Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis.The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4% than men (12.5%. Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%. Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06-2.06 and age group (odds ratio: 1.34, 95% CI: 1.01-1.79 with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08-2.17, P < 0.05.Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%, with significantly more prevalence among the female respondents. Early detection of

  4. Additive value of amyloid-PET in routine cases of clinical dementia work-up after FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Brendel, Matthias; Schnabel, Jonas; Wagner, Leonie; Brendel, Eva; Meyer-Wilmes, Johanna; Unterrainer, Marcus [University Hospital, LMU Munich, Department of Nuclear Medicine, Munich (Germany); Schoenecker, Sonja; Prix, Catharina; Ackl, Nibal [University Hospital, LMU Munich, Department of Neurology, Munich (Germany); Schildan, Andreas; Patt, Marianne; Barthel, Henryk; Sabri, Osama [University of Leipzig, Department of Nuclear Medicine, Leipzig (Germany); Catak, Cihan [Klinikum der Universitaet Muenchen, Institute for Stroke and Dementia Research, Munich (Germany); Pogarell, Oliver [University Hospital, LMU Munich, Department of Psychiatry, Munich (Germany); Levin, Johannes; Danek, Adrian [University Hospital, LMU Munich, Department of Neurology, Munich (Germany); DZNE - German Center for Neurodegenerative Diseases, Munich (Germany); Buerger, Katharina [Klinikum der Universitaet Muenchen, Institute for Stroke and Dementia Research, Munich (Germany); DZNE - German Center for Neurodegenerative Diseases, Munich (Germany); Bartenstein, Peter; Rominger, Axel [University Hospital, LMU Munich, Department of Nuclear Medicine, Munich (Germany); Munich Cluster for Systems Neurology (SyNergy), Munich (Germany)

    2017-12-15

    In recent years, several [{sup 18}F]-labeled amyloid-PET tracers have been developed and have obtained clinical approval. Despite their widespread scientific use, studies in routine clinical settings are limited. We therefore investigated the impact of [{sup 18}F]-florbetaben (FBB)-PET on the diagnostic management of patients with suspected dementia that was still unclarified after [{sup 18}F]-fluordeoxyglucose (FDG)-PET. All subjects were referred in-house with a suspected dementia syndrome due to neurodegenerative disease. After undergoing an FDG-PET exam, the cases were discussed by the interdisciplinary dementia board, where the most likely diagnosis as well as potential differential diagnoses were documented. Because of persistent diagnostic uncertainty, the patients received an additional FBB-PET exam. Results were interpreted visually and classified as amyloid-positive or amyloid-negative, and we then compared the individual clinical diagnoses before and after additional FBB-PET. A total of 107 patients (mean age 69.4 ± 9.7y) were included in the study. The FBB-PET was rated as amyloid-positive in 65/107. In 83% of the formerly unclear cases, a final diagnosis was reached through FBB-PET, and the most likely prior diagnosis was changed in 28% of cases. The highest impact was observed for distinguishing Alzheimer's dementia (AD) from fronto-temporal dementia (FTLD), where FBB-PET altered the most likely diagnosis in 41% of cases. FBB-PET has a high additive value in establishing a final diagnosis in suspected dementia cases when prior investigations such as FDG-PET are inconclusive. The differentiation between AD and FTLD was particularly facilitated by amyloid-PET, predicting a considerable impact on patient management, especially in the light of upcoming disease-modifying therapies. (orig.)

  5. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; O' Neill, Siobhan B.; O' Donovan, Joanne P.; McWilliams, Sebastian [Cork University Hospital, Department of Radiology, Cork (Ireland); Murphy, Kevin P.; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); University College Cork, Department of Radiology, Cork (Ireland); Desmond, Alan N. [Cork University Hospital, Department of Medicine, Cork (Ireland); Shanahan, Fergus; Quigley, Eamonn M. [Cork University Hospital, Department of Medicine, Cork (Ireland); University College Cork, Alimentary Pharmabiotic Center, Cork (Ireland)

    2014-12-15

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %. Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. (orig.)

  6. Memory functions and rCBF-99mTc-HMPAO-SPECT: Developing diagnostics in Alzheimer's Disease

    International Nuclear Information System (INIS)

    Sundstroem, T.; Riklund Ahlstroem, K.; Elgh, E.; Naesman, B.; Nyberg, L.

    2002-01-01

    Alzheimer's disease (AD) is a primary degenerative disease of the brain. The prevalence increases with age with devastating consequences for the individual and for the society. The aim of this study was to evaluate if patients with early AD show an altered regional cerebral blood flow (rCBF) compared to control persons. The aim was furthermore to investigate the correlation between rCBF in sub-lobar volumes of the brain and performance on memory tests. Memory tests were chosen to evaluate episodic and semantic memory. Fourteen patients (75.2±8.8 yrs) with early AD, and 15 control persons (71.4±3.2 yrs) were included. rCBF measurements with single photon emission computerized tomography (SPECT) using 99m Tc-hexamethyl propylenamine oxime (HMPAO) were performed. The rCBF- 99m Tc-HMPAO-SPECT images were spatially transformed to fit a brain atlas and normalized for differences in rCBF (Computerized Brain Atlas software). Cortical and sub-cortical volumes of interests (VOI) were analyzed and compared. Compared to the controls, AD-patients showed a significantly lower rCBF ratio in temporoparietal regions including left hippocampus. The diagnostic sensitivity and specificity for AD were high in temporoparietal regions. AD-patients had significantly reduced performance on semantic and, in particular, episodic memory tests compared to age matched normative data, and their performance on several episodic tests correlated with rCBF ratios in parietal and temporal regions including left hippocampus. The correlation between rCBF ratio and level of episodic memory performance suggests that abnormalities in rCBF pattern underlie impaired episodic memory functioning in AD

  7. Memory functions and rCBF 99mTc-HMPAO SPET: developing diagnostics in Alzheimer's disease

    International Nuclear Information System (INIS)

    Elgh, Eva; Naesman, Birgitta; Sundstroem, Torbjoern; Aahlstroem, Katrine Riklund; Nyberg, Lars

    2002-01-01

    Alzheimer's disease (AD) is a primary degenerative disease of the brain. The prevalence increases with age, with devastating consequences for the individual and society. The aim of this study was to evaluate whether patients with early AD show an altered regional cerebral blood flow (rCBF) compared with control persons. Furthermore, we aimed to investigate the correlation between rCBF in sublobar volumes of the brain and performance on memory tests. Memory tests were chosen to evaluate episodic and semantic memory. Fourteen patients (aged 75.2±8.8 years) with early AD and 15 control persons (aged 71.4±3.2 years) were included. rCBF measurements with single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO) were performed. The rCBF 99m Tc-HMPAO SPET images were spatially transformed to fit a brain atlas and normalised for differences in rCBF (Computerised Brain Atlas software). Cortical and subcortical volumes of interest (VOIs) were analysed and compared. Compared with the controls, AD patients showed a significantly lower rCBF ratio in temporoparietal regions, including the left hippocampus. The diagnostic sensitivity and specificity for AD were high in temporoparietal regions. AD patients had significantly reduced performance on semantic and, in particular, episodic memory tests compared with age-matched normative data, and their performance on several episodic tests correlated with rCBF ratios in parietal and temporal regions, including the left hippocampus. The correlation between rCBF ratio and level of episodic memory performance suggests that abnormalities in rCBF pattern underlie impaired episodic memory functioning in AD. (orig.)

  8. Evaluation of diagnostic thresholds dependability for tribologic signals received in the environment disturbed by vibroacoustic and functional signals

    Directory of Open Access Journals (Sweden)

    Lindstedt Paweł

    2015-12-01

    Full Text Available Determination of dependable diagnostic thresholds for tribologic signals received e.g. from antifriction bearings (in particular for insufficient number of measurements, only 4÷5 is a really difficult task due to complexity of working environment where such bearings are operated. Typical working environment for such objects must take account for operation time under various working conditions and accompanying (and disturbing signals, e.g. vibroacoustic ones. The sought assessment of the relationship between diagnostic signals and environmental noise can be determined from convolution of both diagnostic and environments signals that make up the complete set of received information. The convolution of these two series of signals can be obtained from an algorithm based on the Cauchy product. Then one has to find the coherence factor and the square of amplitude gain for the set of diagnostic signals with reference to various sets of signals received from environment, which makes it possible to evaluate cohesion of the investigated series of signals, thus their suitability to determine diagnostic threshold for tribologic signals intended for the analysis.

  9. LUNG FUNCTION TESTING IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Matjaž Fležar

    2004-03-01

    Full Text Available Background. Lung function testing in children above five years old is standardised similarly as is in adult population (1. Nevertheless bronchial provocation testing can be more hazardous since the calibre and reactivity of childhood airway is different. We analysed the frequency of different lung function testing procedures and addressed the safety issues of bronchial provocation testing in children.Methods. We analysed lung function testing results in 517 children, older than 5 years, tested in our laboratory in threeyear period. Spirometry was done in every patient, metacholine provocation test was used as a part of diagnostic work-up in suspected asthma. In case of airway obstruction, bronchodilator test with salbutamol was used instead of a metacholine provocation test.Results. The most common procedure in children was spirometry with bronchial provocation test as a part of diagnostic work-up of obstructive syndrome (mostly asthma. 291 children required metacholine test and 153 tests were interpreted as positive. The decline in expiratory flows (forced expiratory flow in first second – FEV1 in positive tests was greater than in adult population as was the dose of metacholine, needed to induce bronchoconstriction. The compliance of children was better than in adults.Conclusions. Lung function testing in children is reliable and safe and can be done in a well-standardised laboratory that follows the regulations of such testing in adults.

  10. The diagnostic accuracy and outcomes after coronary computed tomography angiography vs. conventional functional testing in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Ortner, Nino; Nørgaard, Bjarne L

    2014-01-01

    suspected of stable coronary artery disease (CAD). METHODS AND RESULTS: We systematically searched for studies published from January 2002 to February 2013 examining the diagnostic accuracy (defined as at least ≥50% luminal obstruction on invasive coronary angiography) and outcomes of coronary CTA (≥16......AIMS: To systematically review and perform a meta-analysis of the diagnostic accuracy and post-test outcomes of conventional exercise electrocardiography (XECG) and single-photon emission computed tomography (SPECT) compared with coronary computed tomography angiography (coronary CTA) in patients...... slice) in comparison with XECG and SPECT. The search revealed 11 eligible studies (N = 1575) comparing the diagnostic accuracy and 7 studies (N = 216.603) the outcomes of coronary CTA vs. XECG or/and SPECT. The per-patient sensitivity [95% confidence interval (95% CI)] to identify significant CAD was 98...

  11. Estimation of the shielding ability of a tungsten functional paper for diagnostic x-rays and gamma rays.

    Science.gov (United States)

    Monzen, Hajime; Kanno, Ikuo; Fujimoto, Takahiro; Hiraoka, Masahiro

    2017-09-01

    Tungsten functional paper (TFP) is a novel paper-based radiation-shielding material. We measured the shielding ability of TFP against x-rays and gamma rays. The TFP was supplied in 0.3-mm-thick sheets that contained 80% tungsten powder and 20% cellulose (C 6 H 10 O 5 ) by mass. In dose measurements for x-rays (60, 80, 100, and 120 kVp), we measured doses after through 1, 2, 3, 5, 10, and 12 TFP sheets, as well as 0.3 and 0.5 mm of lead. In lead equivalence measurements, we measured doses after through 2 and 10 TFP sheets for x-rays (100 and 150 kVp), and 0, 7, 10, 20, and 30 TFP sheets for gamma rays from cesium-137 source (662 keV). And then, the lead equivalent thicknesses of TFP were determined by comparison with doses after through standard lead plates (purity >99.9%). Additionally, we evaluated uniformity of the transmitted dose by TFP with a computed radiography image plate for 50 kVp x-rays. A single TFP sheet was found to have a shielding ability of 65%, 53%, 48%, and 46% for x-rays (60, 80, 100, and 120 kVp), respectively. The lead equivalent thicknesses of two TFP sheets were 0.10 ± 0.02, 0.09 ± 0.02 mmPb, and of ten TFP sheets were 0.48 ± 0.02 and 0.51 ± 0.02 mmPb for 100 and 150 kVp x-rays, respectively. The lead equivalent thicknesses of 7, 10, 20, and 30 sheets of TFP for gamma rays from cesium-137 source were estimated as 0.28, 0.43, 0.91, and 1.50 mmPb with an error of ± 0.01 mm. One TFP sheet had nonuniformity, however, seven TFP sheets provided complete shielding for 50 kVp x-rays. TFP has adequate radiation shielding ability for x-rays and gamma rays within the energy range used in diagnostic imaging field. © 2017 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  12. Diagnostic Implementation of Fast and Selective Integrin-Mediated Adhesion of Cancer Cells on Functionalized Zeolite L Monolayers.

    Science.gov (United States)

    Greco, Arianna; Maggini, Laura; De Cola, Luisa; De Marco, Rossella; Gentilucci, Luca

    2015-09-16

    The rapid and exact identification and quantification of specific biomarkers is a key technology for always achieving more efficient diagnostic methodologies. We present the first application of a nanostructured device constituted of patterned self-assembled monolayers of disk-shaped zeolite L coated with the cyclic integrin ligand c[RGDfK] via isocyanate linker, to the rapid detection of cancer cells. With its high specificity toward HeLa and Glioma cells and fast adhesion ability, this biocompatible monolayer is a promising platform for implementation in diagnostics and personalized therapy formulation devices.

  13. Diagnostic accuracy of cardiovascular magnetic resonance imaging of right ventricular morphology and function in the assessment of suspected pulmonary hypertension results from the ASPIRE registry

    Directory of Open Access Journals (Sweden)

    Swift Andrew J

    2012-06-01

    Full Text Available Abstract Background Cardiovascular Magnetic Resonance (CMR imaging is accurate and reproducible for the assessment of right ventricular (RV morphology and function. However, the diagnostic accuracy of CMR derived RV measurements for the detection of pulmonary hypertension (PH in the assessment of patients with suspected PH in the clinic setting is not well described. Methods We retrospectively studied 233 consecutive treatment naïve patients with suspected PH including 39 patients with no PH who underwent CMR and right heart catheterisation (RHC within 48hours. The diagnostic accuracy of multiple CMR measurements for the detection of mPAP ≥ 25 mmHg was assessed using Fisher’s exact test and receiver operating characteristic (ROC analysis. Results Ventricular mass index (VMI was the CMR measurement with the strongest correlation with mPAP (r = 0.78 and the highest diagnostic accuracy for the detection of PH (area under the ROC curve of 0.91 compared to an ROC of 0.88 for echocardiography calculated mPAP. Late gadolinium enhancement, VMI ≥ 0.4, retrograde flow ≥ 0.3 L/min/m2 and PA relative area change ≤ 15% predicted the presence of PH with a high degree of diagnostic certainty with a positive predictive value of 98%, 97%, 95% and 94% respectively. No single CMR parameter could confidently exclude the presence of PH. Conclusion CMR is a useful alternative to echocardiography in the evaluation of suspected PH. This study supports a role for the routine measurement of ventricular mass index, late gadolinium enhancement and the use of phase contrast imaging in addition to right heart functional indices in patients undergoing diagnostic CMR evaluation for suspected pulmonary hypertension.

  14. Can value for money be improved by changing the sequence of our donor work-up in the living kidney donor programme?

    DEFF Research Database (Denmark)

    Larsen, J.; Sorensen, S.S.; Feldt-Rasmussen, B.

    2009-01-01

    was the procedure identifying most subjects who were unsuited for kidney donation. A rearrangement of the present donor work-up programme could potentially reduce the costs from euro6911 to euro5292 per donor--saving 23% of the costs. By changing the sequence of examinations, it might be possible to cut down...

  15. Functional neuroimaging correlates of thinking flexibility and knowledge structure in memory: Exploring the relationships between clinical reasoning and diagnostic thinking

    NARCIS (Netherlands)

    Durning, S.J.; Costanzo, M.E.; Beckman, T.J.; Artino, A.R.; Roy, M.J.H.M. van; Vleuten, C.P.M. van der; Holmboe, E.S.; Lipner, R.S.; Schuwirth, L.

    2016-01-01

    BACKGROUND: Diagnostic reasoning involves the thinking steps up to and including arrival at a diagnosis. Dual process theory posits that a physician's thinking is based on both non-analytic or fast, subconscious thinking and analytic thinking that is slower, more conscious, effortful and

  16. Comparison of exercise perfusion and ventricular function imaging: an analysis of factors affecting the diagnostic accuracy of each technique

    International Nuclear Information System (INIS)

    Osbakken, M.D.; Okada, R.D.; Boucher, C.A.; Strauss, H.W.; Pohost, G.M.

    1984-01-01

    Exercise thallium-201 perfusion scans and gated equilibrium blood pool scans were performed in 120 catheterized patients with a chest pain syndrome. Eighty-six patients had coronary artery disease and 34 patients did not. The effects of gender, propranolol, exercise level, exercise ischemia, history of typical angina, history of previous myocardial infarction, electrocardiographic Q waves, number of diseases vessels and extent of coronary artery obstruction on diagnostic accuracy were evaluated. Thallium scans and anginal history were less sensitive for detecting coronary disease in women (men: thallium 79%; angina 77%; women: 54 and 46%, respectively; p less than 0.05). Exercise level did not significantly affect the diagnostic accuracy of either scan. Thallium and gated scans were both highly sensitive (95%) in detecting disease in 20 patients with a prior myocardial infarction, angina and a positive electrocardiogram. The sensitivity of the thallium scan significantly decreased as the number of diseased vessels decreased. Both thallium and gated scans were less frequently positive in patients with atypical angina or no Q waves, but were not significantly influenced by electrocardiographic ischemia. The sensitivity and specificity of both scans were low in 57 patients with the combination of atypical angina, no history of infarction and equivocal stress electrocardiogram thallium. When stress thallium scan evaluation included the electrocardiogram and thallium scan interpretation, the diagnostic accuracy was 81%. When all the information from gated scans (wall motion, ejection fraction, pulmonary blood volume) was combined for final gated scan evaluation, the diagnostic accuracy was 83%. When electrocardiographic data were added to all three gated scan variables, diagnostic accuracy was 77%

  17. Investigação da trombose venosa na gravidez Deep vein thrombosis during pregnancy work up

    Directory of Open Access Journals (Sweden)

    Jorge Agle Kalil

    2008-03-01

    the disease developed in the third trimester of pregnancy (64.3%. Of the 42 patients diagnosed with DVT, 18 (42.8% occurred in infrapatellar veins. There was a case of pulmonary thromboembolism in a 37-year-old patient, who had been submitted to in vitro fecundation, with twin pregnancy and a diagnostic of DVT (no thrombophilia after a cesarean section. Of the 42 patients, 16 (38.1% had the cause of their DVT determined, with a prevalence of heterozygous mutation of factor V Leiden in six patients (14.2%, followed by phospholipid syndrome and other causes. Most patients were treated with low-molecular-weight heparin. CONCLUSION: DVT during pregnancy, despite having low frequency, is a major cause of increased maternal-fetal morbidity. Investigation of thrombophilia should be conducted in selected cases, such as personal or family history of thrombotic phenomena and/or thrombophilia. Twin pregnancy, cesarean birth and artificial insemination were also found as factors leading to DVT.

  18. [The potential of the modern methods for clinical diagnostics applied in the forensic medical assessment of functional disturbances of the ankle joint in the case of its injury].

    Science.gov (United States)

    Khabova, Z S; Fetisov, V A

    2012-01-01

    The present paper is focused on the problems of clinical diagnostics of the functional disturbances in the locomotor apparatus as exemplified by the injuries to the ankle joint. The results of analysis of the entire range of up-to-date diagnostic tools for the purpose suggest the necessity of revision of obsolete methodological principles still adopted in forensic medicine as regards the problem being condidered. It is proposed based on the recent progress achieved by the specialists in traumatology, orthopedics, medicosocial expertise, and the related areas that a forensic medical expert should not confine oneself to the consideration of the sole criterion, such as "the range of articular movements", for the estimation of the severity of harm to health in the patients presenting with a joint injury.

  19. Diagnostic accuracy and functional parameters of myocardial perfusion scintigraphy using accelerated cardiac acquisition with IQ SPECT technique in comparison to conventional imaging.

    Science.gov (United States)

    Pirich, Christian; Keinrath, Peter; Barth, Gabriele; Rendl, Gundula; Rettenbacher, Lukas; Rodrigues, Margarida

    2017-03-01

    IQ SPECT consists of a new pinhole-like collimator, cardio-centric acquisition, and advanced 3D iterative SPECT reconstruction. The aim of this paper was to compare diagnostic accuracy and functional parameters obtained with IQ SPECT versus conventional SPECT in patients undergoing myocardial perfusion scintigraphy with adenosine stress and at rest. Eight patients with known or suspected coronary artery disease underwent [99mTc] tetrofosmin gated SPECT. Acquisition was performed on a Symbia T6 equipped with IQ SPECT and on a conventional gamma camera system. Gated SPECT data were used to calculate functional parameters. Scores analysis was performed on a 17-segment model. Coronary angiography and clinical follow-up were considered as diagnostic reference standard. Mean acquisition time was 4 minutes with IQ SPECT and 21 minutes with conventional SPECT. Agreement degree on the diagnostic accuracy between both systems was 0.97 for stress studies, 0.91 for rest studies and 0.96 for both studies. Perfusion abnormalities scores obtained by using IQ SPECT and conventional SPECT were not significant different: SSS, 9.7±8.8 and 10.1±6.4; SRS, 7.1±6.1 and 7.5±7.3; SDS, 4.0±6.1 and 3.9±4.3, respectively. However, a significant difference was found in functional parameters derived from IQ SPECT and conventional SPECT both after stress and at rest. Mean LVEF was 8% lower using IQ SPECT. Differences in LVEF were found in patients with normal LVEF and patients with reduced LVEF. Functional parameters using accelerated cardiac acquisition with IQ SPECT are significantly different to those obtained with conventional SPECT, while agreement for clinical interpretation of myocardial perfusion scintigraphy with both techniques is high.

  20. Economic evaluation of diagnostic localization following biochemical prostate cancer recurrence.

    Science.gov (United States)

    Barocas, Daniel A; Bensink, Mark E; Berry, Kristin; Musa, Zahra; Bodnar, Carolyn; Dann, Robert; Ramsey, Scott D

    2014-10-01

    The aim of this study was to assess potential cost-effectiveness of using a prostate cancer specific functional imaging technology capable of identifying residual localized disease versus small volume metastatic disease for asymptomatic men with low but detectable prostate specific antigen (PSA) elevation following radical prostatectomy. Markov modeling was used to estimate the incremental impact on healthcare system costs (2012 USD) and quality-adjusted life-years (QALYs) of two alternative strategies: (i) using the new diagnostic to guide therapy versus (ii) current usual care-using a combination of computed tomography, magnetic resonance imaging, and bone scan to guide therapy. Costs were based on estimates from literature and Medicare reimbursement. Prostate cancer progression, survival, utilities, and background risk of all-cause mortality were obtained from literature. Base-case diagnostic sensitivity (75 percent), specificity (90 percent), and cost (USD 2,500) were provided by our industry partner GE Healthcare. The new diagnostic strategy provided an average gain of 1.83 (95 percent uncertainty interval [UI]: 1.24-2.64) QALYs with added costs of USD 15,595 (95 percent UI: USD -6,330-44,402) over 35 years. The resulting incremental cost-effectiveness ratio was USD 8,516/QALY (95 percent UI: USD -2,947-22,372). RESULTS were most influenced by the utility discounting rate and test performance characteristics; however, the new diagnostic provided clinical benefits over a wide range of sensitivity and specificity. This analysis suggests a diagnostic technology capable of identifying whether men with biochemical recurrence after radical prostatectomy have localized versus metastatic disease would be a cost-effective alternative to current standard work-up. The results support additional investment in development and validation of such a diagnostic.

  1. Pragmatic approach to the clinical work-up of patients with putative allergic disease to metallic orthopaedic implants before and after surgery

    DEFF Research Database (Denmark)

    Thyssen, J P; Menné, T; Schalock, P C

    2011-01-01

    on in the work-up of patients with putative allergic complications following surgery. Few studies have investigated whether subjects with metal contact allergy have increased risk of developing complications following orthopaedic implant insertion. Metal allergy might in a minority increase the risk...... testing prior to surgery unless the patient has already had implant surgery with complications suspected to be allergic or has a history of clinical metal intolerance of sufficient magnitude to be of concern to the patient or a health provider. The clinical work-up of a patient suspected of having......Allergic complications following insertion of metallic orthopaedic implants include allergic dermatitis reactions but also extracutaneous complications. As metal-allergic patients and/or surgeons may ask dermatologists and allergologists for advice prior to planned orthopaedic implant surgery...

  2. The value of the abdominal radiograph in children with functional gastrointestinal disorders

    Energy Technology Data Exchange (ETDEWEB)

    Bongers, Marloes E.J. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)]. E-mail: mbongers@uva.amc.nl; Voskuijl, Wieger P. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Rijn, Rick R. van [Department of Pediatric Radiology, Emma Children' s Hospital/Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands); Benninga, Marc A. [Department of Pediatric Gastroenterology and Nutrition, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam (Netherlands)

    2006-07-15

    Functional gastrointestinal disorder is a common problem in childhood. The symptoms vary from a relative mild gastrointestinal problem such as abdominal pain or infrequent defecation to severe problems with fecal impaction and fecal incontinence. The aim of this review is to describe and evaluate the value of the different existing methods to assess fecal loading on an abdominal radiograph with or without the use of radio-opaque markers in the diagnosis of functional abdominal pain, functional constipation and functional non-retentive fecal incontinence. In our opinion, the abdominal radiograph has limited value in the diagnostic work-up of children with functional gastrointestinal disorders.

  3. The value of the abdominal radiograph in children with functional gastrointestinal disorders

    International Nuclear Information System (INIS)

    Bongers, Marloes E.J.; Voskuijl, Wieger P.; Rijn, Rick R. van; Benninga, Marc A.

    2006-01-01

    Functional gastrointestinal disorder is a common problem in childhood. The symptoms vary from a relative mild gastrointestinal problem such as abdominal pain or infrequent defecation to severe problems with fecal impaction and fecal incontinence. The aim of this review is to describe and evaluate the value of the different existing methods to assess fecal loading on an abdominal radiograph with or without the use of radio-opaque markers in the diagnosis of functional abdominal pain, functional constipation and functional non-retentive fecal incontinence. In our opinion, the abdominal radiograph has limited value in the diagnostic work-up of children with functional gastrointestinal disorders

  4. Coupling gene-based and classic veterinary diagnostics improves interpretation of health and immune function in the Agassiz’s desert tortoise (Gopherus agassizii)

    Science.gov (United States)

    Drake, Karla K.; Bowen, Lizabeth; Lewison, Rebecca L.; Esque, Todd C.; Nussear, Kenneth E.; Braun, Josephine; Waters, Shannon C.; Miles, A. Keith

    2017-01-01

    The analysis of blood constituents is a widely used tool to aid in monitoring of animal health and disease. However, classic blood diagnostics (i.e. hematologic and plasma biochemical values) often do not provide sufficient information to determine the state of an animal’s health. Field studies on wild tortoises and other reptiles have had limited success in drawing significant inferences between blood diagnostics and physiological and immunological condition. However, recent research using gene transcription profiling in the threatened Mojave desert tortoise (Gopherus agassizii) has proved useful in identifying immune or physiologic responses and overall health. To improve our understanding of health and immune function in tortoises, we evaluated both standard blood diagnostic (body condition, hematologic, plasma biochemistry values, trace elements, plasma proteins, vitamin A levels) and gene transcription profiles in 21 adult tortoises (11 clinically abnormal; 10 clinically normal) from Clark County, NV, USA. Necropsy and histology evaluations from clinically abnormal tortoises revealed multiple physiological complications, with moderate to severe rhinitis or pneumonia being the primary cause of morbidity in all but one of the examined animals. Clinically abnormal tortoises had increased transcription for four genes (SOD, MyD88, CL and Lep), increased lymphocyte production, biochemical enzymes and organics, trace elements of copper, and decreased numbers of leukocytes. We found significant positive correlations between increased transcription for SOD and increased trace elements for copper, as well as genes MyD88 and Lep with increased inflammation and microbial insults. Improved methods for health assessments are an important element of monitoring tortoise population recovery and can support the development of more robust diagnostic measures for ill animals, or individuals directly impacted by disturbance.

  5. The impacts of thyroid function on the diagnostic accuracy of cystatin C to detect acute kidney injury in ICU patients: a prospective, observational study.

    Science.gov (United States)

    Wang, Feilong; Pan, Wenzhi; Wang, Hairong; Zhou, Yu; Wang, Shuyun; Pan, Shuming

    2014-01-09

    Cystatin C (Cysc) could be affected by thyroid function both in vivo and in vitro and thereby may have limited ability to reflect renal function. We aimed to assess the association between Cysc and thyroid hormones as well as the effect of thyroid function on the diagnostic accuracy of Cysc to detect acute kidney injury (AKI). A total of 446 consecutive intensive care unit (ICU) patients were screened for eligibility in this prospective AKI observational study. Serum Cysc, thyroid hormones and serum creatinine (Scr) were measured upon entry to the ICU. We also collected each patient's baseline characteristics including the Acute Physiology and Chronic Health Evaluation II (APACHE-II) score. The diagnostic performance of Cysc was assessed from the area under the receiver operator characteristic curve (AUC) in each quartile of thyroid hormone(s). A total of 114 (25.6%) patients had a clinical diagnosis of AKI upon entry to the ICU. The range of free thyroxine (FT4) value was 4.77 to 39.57 pmol/L. Multivariate linear regression showed that age (standardized beta = 0.128, P Patients were divided into four quartiles based on FT4 levels. The AUC for Cysc in detecting AKI in each quartile were as follows: 0.712 in quartile I, 0.754 in quartile II, 0.829 in quartile III and 0.797 in quartile IV. There was no significant difference in the AUC between any two groups (all P > 0.05). The optimal cut-off value of Cysc for diagnosing AKI increased across FT4 quartiles (1.15 mg/L in quartile I, 1.15 mg/L in quartile II, 1.35 mg/L in quartile III and 1.45 mg/L in quartile IV). There was no significant impact of thyroid function on the diagnostic accuracy of Cysc to detect AKI in ICU patients. However, the optimal cut-off value of Cysc to detect AKI could be affected by thyroid function.

  6. Atherosclerotic renal artery stenosis in the post-CORAL era part 1: the renal penumbra concept and next-generation functional diagnostic imaging.

    Science.gov (United States)

    Sag, Alan Alper; Inal, Ibrahim; Okcuoglu, John; Rossignol, Patrick; Ortiz, Alberto; Afsar, Baris; Sos, Thomas A; Kanbay, Mehmet

    2016-04-01

    After three neutral trials in which renal artery stenting failed to improve renal function or reduce cardiovascular and renal events, the controversy surrounding diagnosis and treatment of atherosclerotic renal artery stenosis and renovascular hypertension has led to paradigm shifts in the diagnostic algorithm. Noninvasive determination of earlier events (cortex hypoxia and renal artery hemodynamic changes) will supersede late sequelae (calcific stenosis, renal cortical thinning). Therefore, this review proposes the concept of renal penumbra in defining at-risk ischemic renal parenchyma. The complex field of functional renal magnetic resonance imaging will be reviewed succinctly in a clinician-directed fashion. Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  7. The usefulness of sup(99m)Tc-DTPA renogram in the functional and diagnostic evaluations of chronic renal insufficiency in children

    International Nuclear Information System (INIS)

    Matsueda, Yoriko; Hiraiwa, Mikio; Meguro, Hidenori; Fujii, Ryochi

    1980-01-01

    As there are some difficulties in the performance of renal biopsy and intravenous pyelography is of little use in children with chronic renal insufficiency, we evaluated the usefulness of sup(99m)Tc-DTPA renogram in two children. The causes of the renal insufficiency presented were obstructive congenital anomalies and chronic pyelonephritis in one patient and polycystic kidneys in the other. As expected, intravenous pyelography poorly visualized in the upper urinary tracts of both the cases examined. sup(99m)Tc-DTPA renogram gave us distinct image for the diagnosis of the kidneys and urinary tracts, and the individual renal functions were clarified as well. It was apparently superior to the combined use of sup(99m)Tc-DMSA renoscintigram and 131 I-Hippuran renogram in both the imaging and functional evaluations. In such cases as are reported herein, sup(99m)Tc-DTPA renogram might be a useful alternative to several other diagnostic tests. (author)

  8. Comparison of roll-to-roll replication approaches for microfluidic and optical functions in lab-on-a-chip diagnostic devices

    Science.gov (United States)

    Brecher, Christian; Baum, Christoph; Bastuck, Thomas

    2015-03-01

    Economically advantageous microfabrication technologies for lab-on-a-chip diagnostic devices substituting commonly used glass etching or injection molding processes are one of the key enablers for the emerging market of microfluidic devices. On-site detection in fields of life sciences, point of care diagnostics and environmental analysis requires compact, disposable and highly functionalized systems. Roll-to-roll production as a high volume process has become the emerging fabrication technology for integrated, complex high technology products within recent years (e.g. fuel cells). Differently functionalized polymer films enable researchers to create a new generation of lab-on-a-chip devices by combining electronic, microfluidic and optical functions in multilayer architecture. For replication of microfluidic and optical functions via roll-to-roll production process competitive approaches are available. One of them is to imprint fluidic channels and optical structures of micro- or nanometer scale from embossing rollers into ultraviolet (UV) curable lacquers on polymer substrates. Depending on dimension, shape and quantity of those structures there are alternative manufacturing technologies for the embossing roller. Ultra-precise diamond turning, electroforming or casting polymer materials are used either for direct structuring or manufacturing of roller sleeves. Mastering methods are selected for application considering replication quality required and structure complexity. Criteria for the replication quality are surface roughness and contour accuracy. Structure complexity is evaluated by shapes producible (e.g. linear, circular) and aspect ratio. Costs for the mastering process and structure lifetime are major cost factors. The alternative replication approaches are introduced and analyzed corresponding to the criteria presented. Advantages and drawbacks of each technology are discussed and exemplary applications are presented.

  9. Clinical impact of 18F-FDG-PET/CT in the extra cardiac work-up of patients with infective endocarditis

    DEFF Research Database (Denmark)

    Asmar, Ali; Ozcan, Cengiz; Diederichsen, Axel C P

    2014-01-01

    , the prognosis relies crucially on the presence of systemic infectious embolism. METHODS: Seventy-two patients (71% males and mean age 63 ± 17 years) with IE were evaluated with (18)F-FDG-PET/CT in addition to standard work-up including patient history, physical examination, conventional imaging modalities......, and weekly interdisciplinary conferences. When previous unknown lesions detected by (18)F-FDG-PET/CT were confirmed by succeeding examinations, they were considered true positive new findings and were further assessed for their clinical importance. Number needed to investigate was calculated as the number...

  10. Congenital diarrheal disorders: an updated diagnostic approach.

    Science.gov (United States)

    Terrin, Gianluca; Tomaiuolo, Rossella; Passariello, Annalisa; Elce, Ausilia; Amato, Felice; Di Costanzo, Margherita; Castaldo, Giuseppe; Canani, Roberto Berni

    2012-01-01

    Congenital diarrheal disorders (CDDs) are a group of inherited enteropathies with a typical onset early in the life. Infants with these disorders have frequently chronic diarrhea of sufficient severity to require parenteral nutrition. For most CDDs the disease-gene is known and molecular analysis may contribute to an unequivocal diagnosis. We review CDDs on the basis of the genetic defect, focusing on the significant contribution of molecular analysis in the complex, multistep diagnostic work-up.

  11. Congenital Diarrheal Disorders: An Updated Diagnostic Approach

    Directory of Open Access Journals (Sweden)

    Giuseppe Castaldo

    2012-03-01

    Full Text Available Congenital diarrheal disorders (CDDs are a group of inherited enteropathies with a typical onset early in the life. Infants with these disorders have frequently chronic diarrhea of sufficient severity to require parenteral nutrition. For most CDDs the disease-gene is known and molecular analysis may contribute to an unequivocal diagnosis. We review CDDs on the basis of the genetic defect, focusing on the significant contribution of molecular analysis in the complex, multistep diagnostic work-up.

  12. Neuropsychopharmacology and Neurogenetic Aspects of Executive Functioning: Should Reward Gene Polymorphisms Constitute a Diagnostic Tool to Identify Individuals at Risk for Impaired Judgment?

    Science.gov (United States)

    Bowirrat, Abdalla; Chen, Thomas JH; Oscar-Berman, Marlene; Madigan, Margaret; Chen, Amanda LH; Bailey, John A.; Braverman, Eric R.; Kerner, Mallory; Giordano, John; Morse, Siohban; Downs, B. William; Waite, Roger L.; Fornari, Frank; Armaly, Zaher; Blum, Kenneth

    2013-01-01

    Executive functions are processes that act in harmony to control behaviors necessary for maintaining focus and achieving outcomes. Executive dysfunction in neuropsychiatric disorders is attributed to structural or functional pathology of brain networks involving prefrontal cortex (PFC) and its connections with other brain regions. The PFC receives innervations from different neurons associated with a number of neurotransmitters, especially dopamine (DA). Here we review findings on the contribution of PFC DA to higher-order cognitive and emotional behaviors. We suggest examination of multifactorial interactions of an individual’s genetic history, along with environmental risk factors, can assist in the characterization of executive functioning for that individual. Based upon the results of genetic studies we also propose genetic mapping as a probable diagnostic tool serving as a therapeutic adjunct for augmenting executive functioning capabilities. We conclude that preservation of the neurological underpinnings of executive functions requires the integrity of complex neural systems including the influence of specific genes and associated polymorphisms to provide adequate neurotransmission. PMID:22371275

  13. [Diagnostic workup of fragrance allergy].

    Science.gov (United States)

    Geier, J; Uter, W

    2015-09-01

    The diagnostic workup of contact allergy to fragrances must not be limited to patch testing with the two well-established fragrance mixes. False-positive reactions to these mixes occur in up to 50 % of the patch tested patients. For the diagnostic work-up of positive reactions, and in cases of suspected fragrance allergy, patch testing with the single mix components and additional fragrances is mandatory. Frequently sensitizing fragrance materials are the 14 components of the two fragrance mixes and tree moss (Evernia furfuracea), ylang ylang oil (I + II; Cananga odorata), lemongrass oil (Cymbopogon schoenanthus), sandalwood oil (Santalum album), jasmine absolute (Jasminum spp.), and, less frequently, clove oil (Eugenia caryophyllus), cedarwood oil (Cedrus atlantica/deodara, Juniperus virginiana), Neroli oil (Citrus aurantium amara flower oil), salicylaldehyde, narcissus absolute (Narcissus spp.), and patchouli oil (Pogostemon cablin).

  14. In-Depth Functional Diagnostics of Mouse Models by Single-Flash and Flicker Electroretinograms without Adapting Background Illumination.

    Science.gov (United States)

    Tanimoto, Naoyuki; Michalakis, Stylianos; Weber, Bernhard H F; Wahl-Schott, Christian A; Hammes, Hans-Peter; Seeliger, Mathias W

    2016-01-01

    Electroretinograms (ERGs) are commonly recorded at the cornea for an assessment of the functional status of the retina in mouse models. Full-field ERGs can be elicited by single-flash as well as flicker light stimulation although in most laboratories flicker ERGs are recorded much less frequently than singleflash ERGs. Whereas conventional single-flash ERGs contain information about layers, i.e., outer and inner retina, flicker ERGs permit functional assessment of the vertical pathways of the retina, i.e., rod system, cone ON-pathway, and cone OFF-pathway, when the responses are evoked at a relatively high luminance (0.5 log cd s/m(2)) with varying frequency (from 0.5 to 30 Hz) without any adapting background illumination. Therefore, both types of ERGs complement an in-depth functional characterization of the mouse retina, allowing for a discrimination of an underlying functional pathology. Here, we introduce the systematic interpretation of the single-flash and flicker ERGs by demonstrating several different patterns of functional phenotype in genetic mouse models, in which photoreceptors and/or bipolar cells are primarily or secondarily affected.

  15. Diagnostic accuracy of cardiovascular magnetic resonance imaging for assessment of right ventricular morphology and function in pulmonary artery hypertension

    Directory of Open Access Journals (Sweden)

    Eman Ramzy Ali

    2017-07-01

    Conclusions: CMR imaging is likely to increase in importance as the optimal reference method for assessment of early structural (morphological and functional parameters of the right ventricle for evaluation of patients with suspected PH valuable for assessment of treatment response, follow up and prognosis.

  16. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study.

    LENUS (Irish Health Repository)

    Breen, Micheal

    2014-07-25

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs.

  17. [Using diagnostic software module for monitoring the functional reserves of the organism for the estimation of the efficacy of health-improving and rehabilitative programs].

    Science.gov (United States)

    Iakovlev, M Iu; Bobrovnitskiĭ, I P; Lebedeva, O D

    2012-01-01

    The social implications of the estimation of health reserves and their monitoring becomes increasingly important for early diagnostics of dysfunctional problems associated with the social and occupational activities as well as for the prevention of the development of pathological processes. Taking this fact into consideration, we have designed a diagnostic technology called "health reserves" for the identification of subjects with risk factors of the development of the most widespread diseases that enables the users to perform qualitative assessment of the risks, evaluate functional reserves of the organism, and prognosticate the efficacy of application of non-medicamental technologies for the improvement of the patients' health status. We studied 79 patients aged from 18 to 73 years including 33 (42.8%) men and 44 (57.2%) women at their admittance to the clinic and within 2-3 days after discharge. The patients were treated using non-medicamental rehabilitative techniques, such as remedial gymnastics, massage, iodine-bromine baths. The results of the treatment were subjected to the mathematical analysis. The study permitted to determine predictors of efficacy of the non-medicamental treatment and individualized rehabilitation programs.

  18. A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients.

    Science.gov (United States)

    Pan, Pan; Binjie, Hu; Min, Li; Lipei, Fan; Yanli, Ni; Junwen, Zhou; Xianghua, Shi

    2014-12-01

    This meta-analysis aimed to perform a systematic review on comparing the diagnostic value of serum cystatin C and creatinine for glomerular filtration rate in renal transplant patients. The data was extracted into 2×2 table after the articles were assessed by the tool of QUADAS and heterogeneity analysis. The SROC curve and meta-analysis were performed by MetaDisc1.4. Meta-analysis showed that the serum cystatin C had no heterogeneity (P=0.418, I2=2.2%, DOR=25.03), while creatinine heterogeneity was high (P=0.109, I2=37.5%, DOR=9.11). The values of SEN, SPE and SAUC were calculated as 0.86, 0.70 and 0.9015 for cystatin C, and 0.78, 0.73 and 0.8285 for creatinine individually. This study utilized GFR detection and subgroups analysis by cutoff. The PLR was 6.13 and the NLR was 0.12 for cystatin C, compared to SCr (3.72, 0.32). There was homogeneity among these studies using PENIA testing for cystatin C (χ2=2.61, P=0.4560, I2=0.0%. There were significant correlations among cystatin C , creatinine and glomerular filtration rate (GFR). Cystatin C had more sensitivity but less specificity than creatinine for evaluation of GFR. Cystatin C had strong ability in diagnosing renal function after renal transplant and ruling out diagnostic efficacy.

  19. Contribution of age and balance confidence to functional mobility test performance: diagnostic accuracy of L test and normal-paced timed up and go.

    Science.gov (United States)

    Medley, Ann; Thompson, Mary

    2015-01-01

    Falls are a public health priority. Contribution of age and balance confidence to functional mobility is unknown. Appropriate cutoff scores for normal-paced Timed Up and Go (TUG) and L test may improve ability to determine fall risk. Purposes were to determine the contribution of age and balance confidence to functional mobility, determine the association between balance confidence and fall risk, and propose cutoffs. A prospective, descriptive study was conducted in the community with 105 apparently healthy adults at the age of 60 to 96 years. Participants provided fall history. Examiners administered the Activities-Specific Balance Confidence Scale, Dynamic Gait Index (DGI), Functional Gait Assessment, TUG, and L test. Linear regression determined the balance confidence contribution. Multivariate analysis of covariance determined differences between participants with high and low confidence. Sensitivity, specificity, overall diagnostic accuracy, and receiver operating characteristics curves were used to estimate cutoffs. Performance across functional mobility tests declined with age. A total of 46 participants had low balance confidence. Depending on the outcome measure, 16% to 30% of participants' balance confidence and physical performance did not match. Regression analysis revealed that the best model combines age and balance confidence. Regardless of age, participants with high and low balance confidence differed on the basis of multivariate analysis of covariance. Receiver operating characteristics curves supported the diagnostic accuracy of 12 or more seconds (normal-paced TUG) and 25.5 or more seconds (L test) cutoffs. We confirmed that functional mobility, as measured by the L test, declines with age similar to other outcome measures. Balance confidence contributes to functional mobility performance, and the 2 constructs do not match about 25% of the time. Because these constructs may not match, the need to formally assess balance confidence is warranted

  20. [Diagnostic value and functional correlations of the ADAS-Cog scale in Alzheimer's disease: data on NORMACODEM project].

    Science.gov (United States)

    Monllau, A; Pena-Casanova, J; Blesa, R; Aguilar, M; Bohm, P; Sol, J M; Hernandez, G

    2007-10-01

    The aims of this study were to assess the criterion validity of Alzheimer's Disease Assessment Scale (ADAS) and its cognitive subscale (ADAS-Cog) for the diagnosis of Alzheimer's disease (AD), and to determine their different cut-off scores and sensitivity and specificity values. In addition, we also attempted to study the possible correlations between cognitive scores (ADAS) and functional measures. 451 subjects were studied (254 controls, 86 subjects with mild cognitive impairment and 111 patients with AD). ADAS total score was obtained by adding the cognitive (ADAS-Cog) and non-cognitive (ADAS-Nocog) scales. Scores were adjusted for age and formal education. For assessing the possible correlation between cognitive and functional measures, the following instruments were administered: Rapid Disability Rating Scale-2 (RDRS-2), Blessed Dementia Rating Scale (BDRS) and the Interview for the Deterioration of Daily Living in Dementia (IDDD). ROC curves and Pearson correlation coefficient. ADAS best cut-off score for dementia was > or = 17 providing sensitivity and specificity values of 90.09% and 85.88 % respectively, while for the ADAS-Cog best cut-off score was > or = 12 with sensitivity and specificity values of 89.19 % and 88.53 % respectively. In both cases scores were adjusted for age and formal education. The area under the ROC curve was 0.95 and 0.94 respectively. Highly significant correlations were found for ADAS and 19 ADAS-Cog with the functional scales studied. Both, ADAS and ADAS-Cog report good validity in terms of sensitivity, specificity and as predictive value for AD. Moreover, significant correlations were found between the functional impairment observed in patients with AD and the overall scores achieved in the ADAS and ADAS-Cog.

  1. In-vitro diagnostics of Hymenoptera venom allergy

    NARCIS (Netherlands)

    Rueff, F.; Vos, B.; Przybilla, B.

    In-vitro diagnostics of Hymenoptera venom allergy Patients with a history of anaphylactic sting reactions require an allergological work-up (history, in-vitro tests, and skin tests) to clarify indications on venom immunotherapy and on the type of venom to be used. To demonstrate a venom

  2. Diagnostic laparoscopy

    Science.gov (United States)

    ... cavity. These complications could lead to immediate open surgery ( laparotomy ). Diagnostic laparoscopy may not be possible if you have a swollen bowel, fluid in the abdomen (ascites), or you have had a past surgery.

  3. Companion diagnostics

    DEFF Research Database (Denmark)

    Jørgensen, Jan Trøst; Hersom, Maria

    2016-01-01

    . Despite having discussed personalized medicine for more than a decade, we still see that most drug prescriptions for severe chronic diseases are largely based on 'trial and error' and not on solid biomarker data. However, with the advance of molecular diagnostics and a subsequent increased understanding...... of disease mechanisms, things are slowly changing. Within the last few years, we have seen an increasing number of predictive biomarker assays being developed to guide the use of targeted cancer drugs. This type of assay is called companion diagnostics and is developed in parallel to the drug using the drug-diagnostic...... co-development model. The development of companion diagnostics is a relatively new discipline and in this review, different aspects will be discussed including clinical and regulatory issues. Furthermore, examples of drugs, such as the ALK and PD-1/PD-L1 inhibitors, that have been approved recently...

  4. Can value for money be improved by changing the sequence of our donor work-up in the living kidney donor programme?

    DEFF Research Database (Denmark)

    Larsen, Jesper; Sørensen, Søren Schwartz; Feldt-Rasmussen, Bo

    2009-01-01

    The aim of the study was to identify procedures of maximum importance for acceptance or rejection of kidney donation from a living donor as well as making the process more cost-effective. We identified all potential living related donors who were examined during the period between January 2002...... and December 2006 at our department. The cost in euro (euro) for the programme was estimated using the Danish diagnosis-related group-system (DRG). The donor work-up programme was described. One hundred and thirty-three potential donors were identified; 66 male- and 67 female subjects, median age of 52 years...... (range 22-69). Sixty-four participants were rejected as donors. Abdominal CT-scan with angiography and urography ruled out 22 of the above 64 potential organ donors; thus, 48% of the volunteers for living kidney donation were unsuited for donation. Abdominal CT-scan with angiography and urography...

  5. Value of computed tomography arthrography with delayed acquisitions in the work-up of ganglion cysts of the tarsal tunnel: report of three cases

    International Nuclear Information System (INIS)

    Omoumi, Patrick; Gheldere, Antoine de; Leemrijse, Thibaut; Galant, Christine; Van den Bergh, Peter; Malghem, Jacques; Simoni, Paolo; Berg, Bruno C.V.; Lecouvet, Frederic E.

    2010-01-01

    Ganglion cysts are a common cause of tarsal tunnel syndrome. As in other locations, these cysts are believed to communicate with neighboring joints. The positive diagnosis and preoperative work-up of these cysts require identification and location of the cyst pedicles so that they may be excised and the risk of recurrence decreased. This can be challenging with ultrasonography and magnetic resonance (MR) imaging. We present three cases of symptomatic ganglion cysts of the tarsal tunnel, diagnosed by MR imaging, where computed tomography (CT) arthrography with delayed acquisitions helped to confirm the diagnosis and identify precisely the topography of the communication with the subtalar joint. These cases provide new evidence of the articular origin of ganglion cysts developing in the tarsal tunnel. (orig.)

  6. Can value for money be improved by changing the sequence of our donor work-up in the living kidney donor programme?

    DEFF Research Database (Denmark)

    Larsen, J.; Sorensen, S.S.; Feldt-Rasmussen, B.

    2009-01-01

    (range 22-69). Sixty-four participants were rejected as donors. Abdominal CT-scan with angiography and urography ruled out 22 of the above 64 potential organ donors; thus, 48% of the volunteers for living kidney donation were unsuited for donation. Abdominal CT-scan with angiography and urography......The aim of the study was to identify procedures of maximum importance for acceptance or rejection of kidney donation from a living donor as well as making the process more cost-effective. We identified all potential living related donors who were examined during the period between January 2002...... and December 2006 at our department. The cost in euro (euro) for the programme was estimated using the Danish diagnosis-related group-system (DRG). The donor work-up programme was described. One hundred and thirty-three potential donors were identified; 66 male- and 67 female subjects, median age of 52 years...

  7. Follicular Variant of Papillary Thyroid Cancer with Bilateral Renal Metastases Discovered Incidentally During Work-Up of Primary Endometrial Cancer: A Rare Occurrence.

    Science.gov (United States)

    Lubana, Sandeep Singh; Singh, Navdeep; Tuli, Sandeep S; Bashir, Tayyaba; Sachmechi, Issac; Kemeny, Margaret M

    2015-07-16

    Follicular variant of papillary thyroid cancer (FV-PTC) is the second most common subtype of papillary thyroid cancer (PTC) after classic PTC. FV-PTC is characterized by nuclear features consistent with classic PTC but has a follicular architecture that lacks classic papillary morphology. Thyroid cancer rarely metastasizes to the kidney. Only 6 cases of FV-PTC metastasizing to the kidney have been reported in the English literature. We are reporting a case of FV-PTC with bilateral renal metastases discovered incidentally during work-up of primary endometrial cancer. A 70-year-old woman presented with post-menopausal bleeding secondary to endometrial cancer. Staging work-up showed multiple bilateral lung nodules, bilateral soft tissue kidney masses, and multinodular goiter. The pathological and immnohistochemical profile of the lung biopsy was consistent with primary well-differentiated lung adenocarcinoma. Follow-up computerized tomography scan showed stable lung nodules and enlarging renal masses, which was suggestive of bilateral renal cancer. While the histologic features of the renal biopsy were not typical, the immunohistochemical staining of renal biopsy was positive for Paired box 8, thyroid transcription factor-1, thyroglobulin, and cytokeratin 7, suggesting the thyroid as the primary cancer site. The final histopathology on surgical specimen of total thyroidectomy revealed follicular variant of papillary thyroid cancer. The presence of pulmonary nodules and kidney masses does not always suggest the lung or the kidney as primary tumor sites. The clinician should be aware of the possibility of metastasis and look for the primary source, which in the present case was FV-PTC. Immunohistochemistry plays an important role in determining the primary site of origin. In case of multiple-organ metastases, each metastatic lesion should be biopsied as soon as possible for definitive diagnosis and appropriate treatment.

  8. Contrast-enhanced spectral mammography as work-up tool in patients recalled from breast cancer screening has low risks and might hold clinical benefits.

    Science.gov (United States)

    Houben, I P L; Van de Voorde, P; Jeukens, C R L P N; Wildberger, J E; Kooreman, L F; Smidt, M L; Lobbes, M B I

    2017-09-01

    Contrast-enhanced spectral mammography (CESM) is a reliable problem solving tool in the work-up of women recalled from breast cancer screening. We evaluated additional findings caused by CESM alone and outweighed them against the disadvantages of this technique. From December 2012 to December 2015, all women recalled from screening who underwent CESM were considered for this study. Radiation exposure and number of adverse contrast reactions were analysed. An experienced breast radiologist reviewed all exams and identified cases with lesions detected by CESM alone and scored their conspicuity. From these cases, data on breast density and final diagnosis were collected. For malignant cases, tumour grade and receptor characteristics were also collected. During this study, 839 women underwent CESM after a screening recall, in which five minor adverse contrast reactions were observed. Median radiation dose per exam was 6.0mGy (0.9-23.4mGy). Seventy CESM-only lesions were detected in 65 patients. Of these 70 lesions, 54.3% proved to be malignant, most commonly invasive ductal carcinomas. The remaining CESM-only lesions were benign, predominantly fibroadenomas. No complications were observed during biopsy of these lesions. Retrospectively, the majority of the lesions were either occult or a 'minimal sign' on low-energy CESM images or the screening mammogram. Using CESM as a work-up tool for women recalled from screening carries low risk for the patient, while additionally detected tumour foci might hold important clinical implications which need to be further studied in large, randomized controlled trials. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. AUTOMATED PEDAGOGICAL DIAGNOSTICS IN MODERN UNIVERSITY

    Directory of Open Access Journals (Sweden)

    Oleksandr H. Kolhatin

    2010-08-01

    Full Text Available Realisation of the pedagogical assessment functions at using of automated pedagogical diagnostics systems in university instruction process is considered. Pedagogical diagnostics software requirements are determined on the base of automated pedagogical diagnostics systems classifications analysis according to didactical aim of the diagnostics.

  10. Fever of unknown origin in the elderly is a diagnostic challenge

    DEFF Research Database (Denmark)

    Zajworoniuk-Wlodarczyk, Jolanta; Drozdowska, Joanna; Pedersen, Hanne

    2013-01-01

    with lack of fever. Co-morbidities may complicate, dominate, and confuse the clinical impression. In the diagnostic work-up it is important to consider other co-morbidities and overall frailty. Patients should be informed and their wishes taken into account in the early phase of planning diagnostic work...

  11. Inadequate Diagnostic Evaluation in Young Patients Registered with a Diagnosis of Dementia

    DEFF Research Database (Denmark)

    Salem, Lise Cronberg; Andersen, Birgitte Bo; Nielsen, T Rune

    2014-01-01

    BACKGROUND: Establishing a diagnosis of dementia in young patients may be complex and have significant implications for the patient. The aim of this study was to evaluate the quality of the diagnostic work-up in young patients diagnosed with dementia in the clinical routine. METHODS: Two hundred...... patients were randomly selected from 891 patients aged ≤65 years registered with a diagnosis of dementia for the first time in 2008 in Danish hospitals, and 159 medical records were available for review. Three raters evaluated their medical records for the completeness of the diagnostic work-up on which...... the diagnosis of dementia had been based, using evidence-based guidelines for the diagnostic evaluation of dementia as reference standards. RESULTS: According to the rater review, only 111 (70%) patients met the clinical criteria for dementia. An acceptable diagnostic work-up including all items of recommended...

  12. Distribution of phytoplankton functional types in high-nitrate low-chlorophyll waters in a new diagnostic ecological indicator model

    DEFF Research Database (Denmark)

    Palacz, Artur; St. John, Michael; Brevin, R.J.W.

    2013-01-01

    Modeling and monitoring plankton functional types (PFTs) is challenged by insufficient amount of field measurements to ground-truth both plankton models and bio-optical algorithms. In this study, we combine remote sensing data and a dynamic plankton model to simulate an ecologically-sound spatial...... and temporal distribution of phyto-PFTs. We apply an innovative ecological indicator approach to modeling PFTs, and focus on resolving the question of diatom-coccolithophore co-existence in the subpolar high-nitrate and low-chlorophyll regions. We choose an artificial neural network as our modeling framework...... and remote sensing measurements, was so far not captured by state-of-the-art dynamic models which struggle to resolve this "paradox of the plankton". We conclude that an ecological indicator approach is useful for ecological modeling of phytoplankton and potentially higher trophic levels. Finally, we...

  13. Cable Diagnostic Focused Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Hartlein, R.A.; Hampton, R.N.

    2010-12-30

    This report summarizes an extensive effort made to understand how to effectively use the various diagnostic technologies to establish the condition of medium voltage underground cable circuits. These circuits make up an extensive portion of the electric delivery infrastructure in the United States. Much of this infrastructure is old and experiencing unacceptable failure rates. By deploying efficient diagnostic testing programs, electric utilities can replace or repair circuits that are about to fail, providing an optimal approach to improving electric system reliability. This is an intrinsically complex topic. Underground cable systems are not homogeneous. Cable circuits often contain multiple branches with different cable designs and a range of insulation materials. In addition, each insulation material ages differently as a function of time, temperature and operating environment. To complicate matters further, there are a wide variety of diagnostic technologies available for assessing the condition of cable circuits with a diversity of claims about the effectiveness of each approach. As a result, the benefits of deploying cable diagnostic testing programs have been difficult to establish, leading many utilities to avoid the their use altogether. This project was designed to help address these issues. The information provided is the result of a collaborative effort between Georgia Tech NEETRAC staff, Georgia Tech academic faculty, electric utility industry participants, as well as cable system diagnostic testing service providers and test equipment providers. Report topics include: •How cable systems age and fail, •The various technologies available for detecting potential failure sites, •The advantages and disadvantages of different diagnostic technologies, •Different approaches for utilities to employ cable system diagnostics. The primary deliverables of this project are this report, a Cable Diagnostic Handbook (a subset of this report) and an online

  14. Neurocognitive functioning in children with developmental dyslexia and attention-deficit/hyperactivity disorder: Multiple deficits and diagnostic accuracy.

    Science.gov (United States)

    Moura, Octávio; Pereira, Marcelino; Alfaiate, Cláudia; Fernandes, Eva; Fernandes, Boavida; Nogueira, Susana; Moreno, Joana; Simões, Mário R

    2017-04-01

    This study aimed to investigate the neurocognitive functioning of children with developmental dyslexia (DD) and attention-deficit/hyperactivity disorder (ADHD). Four groups of children between the ages of 8 and 10 years participated in the study: typically developing children (TDC; N = 34), children with DD-only (N = 32), children with ADHD-only (N = 32), and children with DD+ADHD (N = 18). Children with DD and ADHD exhibited significant weaknesses on almost all neurocognitive measures compared with TDC. Large effect sizes were observed for naming speed and phonological awareness. The comorbid group showed deficits consistent with both DD and ADHD without additional impairments. Results from binary logistic regression and receiver-operating characteristic (ROC) curve analyses suggested that some neurocognitive measures revealed an adequate sensitivity for the clinical diagnosis of both neurodevelopmental disorders. Specifically, naming speed and phonological awareness were the strongest predictors to correctly discriminate both disorders. Taken together, the results lend support to the multiple cognitive deficit hypothesis showing a considerable overlap of neurocognitive deficits between both disorders.

  15. [Acute and chronic renal insufficiency. Diagnostics and practical implications].

    Science.gov (United States)

    Nitschke, Martin; Meier, Markus; Steinhoff, Jürgen

    2008-07-15

    A newly diagnosed renal insufficiency should be investigated thoroughly, since even slight elevations of renal retention parameters reflect a relevant loss of renal function. Acute creatinine elevations above 0.3 mg/dl are considered an acute kidney injury. Renal failure can be classified according to different criteria. Generally, an acute kidney injury should be separated from chronic renal failure leading to different diagnostic and therapeutic consequences. In most cases, some easy procedures (history, ultrasound, blood tests) help to differentiate between acute and chronic failure. While adequate therapy results in restitution of acute kidney injury in most cases, the aim in chronic renal failure is to minimize complications and to delay renal replacement therapy. Therefore, it is mandatory to involve renal specialists as it has been shown that early referral to nephrologists can ameliorate renal morbidity and mortality. Except for postrenal causes of renal deterioration the diagnostic and therapeutic work-up should be done by nephrologists to avoid unnecessary complications and expenses.

  16. Diagnostic development

    International Nuclear Information System (INIS)

    Barnett, C.F.; Brisson, D.A.; Greco, S.E.

    1978-01-01

    During the past year the far-infrared or submillimeter diagnostic research program resulted in three major developments: (1) an optically pumped 0.385-μm D 2 O-laser oscillator-amplifier system was operated at a power level of 1 MW with a line width of less than 50 MHz; (2) a conical Pyrex submillimeter laser beam dump with a retention efficiency greater than 10 4 was developed for the ion temperature Thompson scattering experiment; and (3) a new diagnostic technique was developed that makes use of the Faraday rotation of a modulated submillimeter laser beam to determine plasma current profile. Measurements of the asymmetric distortion of the H/sub α/ (6563 A) spectral line profile show that the effective toroidal drift velocity, dv/sub two vertical bars i/dT/sub i/, may be used as an indicator of plasma quality and as a complement to other ion temperature diagnostics

  17. Fungal diagnostics.

    Science.gov (United States)

    Kozel, Thomas R; Wickes, Brian

    2014-04-01

    Early diagnosis of fungal infection is critical to effective treatment. There are many impediments to diagnosis such as a diminishing number of clinical mycologists, cost, time to result, and requirements for sensitivity and specificity. In addition, fungal diagnostics must meet the contrasting needs presented by the increasing diversity of fungi found in association with the use of immunosuppressive agents in countries with high levels of medical care and the need for diagnostics in resource-limited countries where large numbers of opportunistic infections occur in patients with AIDS. Traditional approaches to diagnosis include direct microscopic examination of clinical samples, histopathology, culture, and serology. Emerging technologies include molecular diagnostics and antigen detection in clinical samples. Innovative new technologies that use molecular and immunoassay platforms have the potential to meet the needs of both resource-rich and resource-limited clinical environments.

  18. [Diagnostics in osteology].

    Science.gov (United States)

    Jakob, F; Genest, F; Seefried, L; Tsourdi, E; Lapa, C; Hofbauer, L C

    2016-07-01

    Clinical diagnostics in metabolic bone diseases cover a broad spectrum of conventional and state of the art methods ranging from the medical history and clinical examination to molecular imaging. Patient treatment is carried out in an interdisciplinary team due to the multiple interactions of bone with other organ systems. Diagnosis of osteoporosis is supported by high level national guidelines. A paradigm shift concerning the clinical relevance of bone mineral density measurement renders this now to be a strong risk factor rather than a diagnostic parameter, while strengthening the value of other clinical factors for risk assessment. The impact of parameters for muscle mass, structure and function is steadily increasing in all age groups. In order to identify underlying diseases that influence bone metabolism a panel of general laboratory diagnostic parameters is recommended. Markers for bone formation and resorption and specific parameters for the regulation of calcium and phosphate metabolism should be evaluated by specialists because they require diligence in preanalytics and experience in interpretation. Genetic diagnosis is well established for rare bone diseases while diagnostic panels are not yet available for routine diagnostics in polygenetic diseases such as osteoporosis. Conventional radiology is still very important to identify, e. g. fractures, osteolytic and osteoblastic lesions and extraosseous calcifications; however tomography-based methods which combine, e. g. scintigraphy or positron emission technologies with anatomical imaging are of increasing significance. Clinical diagnostics in osteology require profound knowledge and are subject to a dynamic evolution.

  19. Should PET/CT be implemented in the routine imaging work-up of locally advanced head and neck squamous cell carcinoma? A prospective analysis

    Energy Technology Data Exchange (ETDEWEB)

    Cacicedo, Jon; Bilbao, Pedro [Cruces University Hospital, Radiation Oncology Department, Barakaldo, Bizkaia (Basque Country) (Spain); BioCruces Health Research Institute, Bizkaia, Basque Country (Spain); Fernandez, Iratxe [Cruces University Hospital, Nuclear Medicine Department, Barakaldo (Spain); Hoyo, Olga del; Hortelano, Eduardo [Cruces University Hospital, Radiation Oncology Department, Barakaldo, Bizkaia (Basque Country) (Spain); Dolado, Ainara [Cruces University Hospital, Radiodiagnostic and Medical Imaging Department, Barakaldo (Spain); Gomez-Suarez, Javier [Cruces University Hospital, Otolaryngology Department, Barakaldo (Spain); Sancho, Aintzane [Cruces University Hospital, Medical Oncology Department, Barakaldo (Spain); Pijoan, Jose I. [BioCruces Health Research Institute, Bizkaia, Basque Country (Spain); Cruces University Hospital, Clinical Epidemiology Unit, Barakaldo (Spain); CIBER de Epidemiologia y Salud Publica (CIBERESP), Madrid (Spain); Alvarez, Julio [Cruces University Hospital, Oral and Maxillofacial Surgery Department, Barakaldo (Spain); Espinosa, Jose M. [Cruces University Hospital, Medical Physics Department, Barakaldo (Spain); Gaafar, Ayman [Cruces University Hospital, Department of Pathology, Barakaldo (Spain)

    2015-08-15

    The objective of this study was to determine the incremental staging information provided by positron emission tomography/computed tomography (PET/CT) and its impact on management plans in patients with untreated stage III-IV head and neck squamous cell carcinoma (HNSCC). We prospectively studied, between September 2011 and February 2013, 84 consecutive patients [median age 63.5 years (39-84); 73 men] with histologically confirmed HNSCC. First, based on a conventional work-up (physical examination, CT imaging of the head, neck and chest), the multidisciplinary Head and Neck Tumour Board documented the TNM stage and a management plan for each patient, outlining the modalities to be used, including surgery, radiation therapy (RT), chemotherapy or a combination. After release of the PET/CT results, new TNM staging and management plans were agreed on by the multidisciplinary Tumour Board. Any changes in stage or intended management due to the PET/CT findings were then analysed. The impact on patient management was classified as: low (treatment modality, delivery and intent unchanged), moderate (change within the same treatment modality: type of surgery, radiation technique/dose) or high (change in treatment intent and/or treatment modality → curative to palliative, or surgery to chemoradiation or detection of unknown primary tumour or a synchronous second primary tumour). TNM stage was validated by histopathological analysis, additional imaging or follow-up. Accuracy of the conventional and PET/CT-based staging was compared using McNemar's test. Conventional and PET/CT stages were discordant in 32/84 (38 %) cases: the T stage in 2/32 (6.2 %), the N stage in 21/32 (65.7 %) and the M stage 9/32 (28.1 %). Patient management was altered in 22/84 (26 %) patients, with a moderate impact in 8 (9.5 %) patients and high impact in 14 (16.6 %) patients. PET/CT TNM classification was significantly more accurate (92.5 vs 73.7 %) than conventional staging with a p value < 0

  20. Should PET/CT be implemented in the routine imaging work-up of locally advanced head and neck squamous cell carcinoma? A prospective analysis

    International Nuclear Information System (INIS)

    Cacicedo, Jon; Bilbao, Pedro; Fernandez, Iratxe; Hoyo, Olga del; Hortelano, Eduardo; Dolado, Ainara; Gomez-Suarez, Javier; Sancho, Aintzane; Pijoan, Jose I.; Alvarez, Julio; Espinosa, Jose M.; Gaafar, Ayman

    2015-01-01

    The objective of this study was to determine the incremental staging information provided by positron emission tomography/computed tomography (PET/CT) and its impact on management plans in patients with untreated stage III-IV head and neck squamous cell carcinoma (HNSCC). We prospectively studied, between September 2011 and February 2013, 84 consecutive patients [median age 63.5 years (39-84); 73 men] with histologically confirmed HNSCC. First, based on a conventional work-up (physical examination, CT imaging of the head, neck and chest), the multidisciplinary Head and Neck Tumour Board documented the TNM stage and a management plan for each patient, outlining the modalities to be used, including surgery, radiation therapy (RT), chemotherapy or a combination. After release of the PET/CT results, new TNM staging and management plans were agreed on by the multidisciplinary Tumour Board. Any changes in stage or intended management due to the PET/CT findings were then analysed. The impact on patient management was classified as: low (treatment modality, delivery and intent unchanged), moderate (change within the same treatment modality: type of surgery, radiation technique/dose) or high (change in treatment intent and/or treatment modality → curative to palliative, or surgery to chemoradiation or detection of unknown primary tumour or a synchronous second primary tumour). TNM stage was validated by histopathological analysis, additional imaging or follow-up. Accuracy of the conventional and PET/CT-based staging was compared using McNemar's test. Conventional and PET/CT stages were discordant in 32/84 (38 %) cases: the T stage in 2/32 (6.2 %), the N stage in 21/32 (65.7 %) and the M stage 9/32 (28.1 %). Patient management was altered in 22/84 (26 %) patients, with a moderate impact in 8 (9.5 %) patients and high impact in 14 (16.6 %) patients. PET/CT TNM classification was significantly more accurate (92.5 vs 73.7 %) than conventional staging with a p value < 0

  1. Diagnostic accuracy of common clinical tests for assessing abdominal muscle function after motor-complete spinal cord injury above T6.

    Science.gov (United States)

    Bjerkefors, A; Squair, J W; Malik, R; Lam, T; Chen, Z; Carpenter, M G

    2015-02-01

    Diagnostic study. The objective of this study was to compare patterns of electromyography (EMG) recordings of abdominal muscle function in persons with motor-complete spinal cord injury (SCI) above T6 and in able-bodied controls, and to determine whether manual examination or ultrasound measures of muscle activation can be accurate alternatives to EMG. Research center focused on SCI and University laboratory, Vancouver, Canada. Thirteen people with SCI (11 with American Spinal Injury Association Impairment Scale (AIS) A and 2 AIS B; C4-T5), and 13 matched able-bodied participants volunteered for the study. Participants completed trunk tasks during manual examination of the abdominal muscles and then performed maximal voluntary isometric contractions, while EMG activity and muscle thickness changes were recorded. The frequency of muscle responses detected by manual examination and ultrasound were compared with detection by EMG (sensitivity and specificity). All individuals with SCI were able to elicit EMG activity above resting levels in at least one abdominal muscle during one task. In general, the activation pattern was task specific, confirming voluntary control of the muscles. Ultrasound, when compared with EMG, showed low sensitivity but was highly specific in its ability to detect preserved abdominal muscle function in persons with SCI. Conversely, manual examination was more sensitive than ultrasound but showed lower specificity. The results from this study confirm preserved voluntary abdominal muscle function in individuals classified with motor-complete SCI above T6 and highlight the need for further research in developing more accurate clinical measures to diagnose the level of trunk muscle preservation in individuals with SCI.

  2. Diagnostic formulation

    OpenAIRE

    Kuruvilla, K.; Kuruvilla, Anju

    2010-01-01

    Writing a ?Diagnostic Formulation? is a skill expected of candidates in the post-graduate examinations in psychiatry in most universities in India. However there is ambiguity regarding what the term means and how it should be written. This article is an attempt to provide some guidelines on this topic.

  3. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    International Nuclear Information System (INIS)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun; Lee, Jae Hong; Roh, Jee Hoon

    2017-01-01

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease

  4. Improved diagnostic accuracy of Alzheimer's disease by combining regional cortical thickness and default mode network functional connectivity: Validated in the Alzheimer's disease neuroimaging initiative set

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ji Eun; Park, Bum Woo; Kim, Sang Joon; Kim, Ho Sung; Choi, Choong Gon; Jung, Seung Jung; Oh, Joo Young; Shim, Woo Hyun [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, Jae Hong; Roh, Jee Hoon [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2017-11-15

    To identify potential imaging biomarkers of Alzheimer's disease by combining brain cortical thickness (CThk) and functional connectivity and to validate this model's diagnostic accuracy in a validation set. Data from 98 subjects was retrospectively reviewed, including a study set (n = 63) and a validation set from the Alzheimer's Disease Neuroimaging Initiative (n = 35). From each subject, data for CThk and functional connectivity of the default mode network was extracted from structural T1-weighted and resting-state functional magnetic resonance imaging. Cortical regions with significant differences between patients and healthy controls in the correlation of CThk and functional connectivity were identified in the study set. The diagnostic accuracy of functional connectivity measures combined with CThk in the identified regions was evaluated against that in the medial temporal lobes using the validation set and application of a support vector machine. Group-wise differences in the correlation of CThk and default mode network functional connectivity were identified in the superior temporal (p < 0.001) and supramarginal gyrus (p = 0.007) of the left cerebral hemisphere. Default mode network functional connectivity combined with the CThk of those two regions were more accurate than that combined with the CThk of both medial temporal lobes (91.7% vs. 75%). Combining functional information with CThk of the superior temporal and supramarginal gyri in the left cerebral hemisphere improves diagnostic accuracy, making it a potential imaging biomarker for Alzheimer's disease.

  5. High resolution MRI for preoperative work-up of neonates with an anorectal malformation: a direct comparison with distal pressure colostography/fistulography

    Energy Technology Data Exchange (ETDEWEB)

    Thomeer, Maarten G. [Erasmus MC, Department of Radiology, Rotterdam (Netherlands); Devos, Annick; Lequin, Maarten; Graaf, Nanko de; Meradji, Morteza [Erasmus MC, Department of Pediatric Radiology, Rotterdam (Netherlands); Meeussen, Conny J.H.M.; Blaauw, Ivo de; Sloots, Cornelius E.J. [Erasmus MC, Department of Pediatric Surgery, Rotterdam (Netherlands)

    2015-12-15

    To compare MRI and colostography/fistulography in neonates with anorectal malformations (ARM), using surgery as reference standard. Thirty-three neonates (22 boys) with ARM were included. All patients underwent both preoperative high-resolution MRI (without sedation or contrast instillation) and colostography/fistulography. The Krickenbeck classification was used to classify anorectal malformations, and the level of the rectal ending in relation to the levator muscle was evaluated. Subjects included nine patients with a bulbar recto-urethral fistula, six with a prostatic recto-urethral fistula, five with a vestibular fistula, five with a cloacal malformation, four without fistula, one with a H-type fistula, one with anal stenosis, one with a rectoperineal fistula and one with a bladderneck fistula. MRI and colostography/fistulography predicted anatomy in 88 % (29/33) and 61 % (20/33) of cases, respectively (p = 0.012). The distal end of the rectal pouch was correctly predicted in 88 % (29/33) and 67 % (22/33) of cases, respectively (p = 0.065). The length of the common channel in cloacal malformation was predicted with MRI in all (100 %, 5/5) and in 80 % of cases (4/5) with colostography/fistulography. Two bowel perforations occurred during colostography/fistulography. MRI provides the most accurate evaluation of ARM and should be considered a serious alternative to colostography/fistulography during preoperative work-up. (orig.)

  6. Diagnostic approach to functional recovery

    DEFF Research Database (Denmark)

    Raffin, Estelle; Dyrby, Tim B

    2013-01-01

    There is evidence showing that white matter changes are clinically relevant and can be associated with cognitive disorders, slower mental processing speed or motor impairment. The complex structural organization of the white matter can be depicted in vivo in great detail with advanced diffusion......-weighted imaging (DWI). From the simplest and most commonly used technique (e.g. the mapping of apparent diffusion coefficient values) to more advanced techniques (e.g. diffusion tensor imaging), it is now possible to visualize white matter fibers of the brain in a noninvasive way. This chapter will first provide...

  7. Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up.

    Science.gov (United States)

    Brusamolino, Ercole; Bacigalupo, Andrea; Barosi, Giovanni; Biti, Giampaolo; Gobbi, Paolo G; Levis, Alessandro; Marchetti, Monia; Santoro, Armando; Zinzani, Pier Luigi; Tura, Sante

    2009-04-01

    The Italian Society of Hematology (SIE), the Italian Society of Experimental Haematology (SIES) and the Italian Group for Bone Marrow Transplantation (GITMO) commissioned a project to develop practice guidelines for the initial work-up, therapy and follow-up of classical Hodgkin's lymphoma. Key questions to the clinical evaluation and treatment of this disease were formulated by an Advisory Committee, discussed and approved by an Expert Panel (EP) composed of senior hematologists and one radiotherapist. After a comprehensive and systematic literature review, the EP recommendations were graded according to their supporting evidence. An explicit approach to consensus methodologies was used for evidence interpretation and for producing recommendations in the absence of a strong evidence. The EP decided that the target domain of the guidelines should include only classical Hodgkin's lymphoma, as defined by the WHO classification, and exclude lymphocyte predominant histology. Distinct recommendations were produced for initial work-up, first-line therapy of early and advanced stage disease, monitoring procedures and salvage therapy, including hemopoietic stem cell transplant. Separate recommendations were formulated for elderly patients. Pre-treatment volumetric CT scan of the neck, thorax, abdomen, and pelvis is mandatory, while FDG-PET is recommended. As to the therapy of early stage disease, a combined modality approach is still recommended with ABVD followed by involved-field radiotherapy; the number of courses of ABVD will depend on the patient risk category (favorable or unfavorable). Full-term chemotherapy with ABVD is recommended in advanced stage disease; adjuvant radiotherapy in patients without initial bulk who achieved a complete remission is not recommended. In the elderly, chemotherapy regimens more intensive than ABVD are not recommended. Early evaluation of response with FDG-PET scan is suggested. Relapsed or refractory patients should receive high

  8. Irritable bowel syndrome: diagnostic approaches in clinical practice

    Directory of Open Access Journals (Sweden)

    Eugene J Burbige

    2010-09-01

    Full Text Available Eugene J BurbigeDivision of Gastroenterology, Gastrointestinal and Liver Research, John Muir Medical Center, Concord, CA, USABackground: Irritable bowel syndrome (IBS, a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.Methods: The peer-reviewed literature (PubMed was searched for primary reports and reviews using the limiters of date (1999–2009 and English language and the search terms irritable bowel syndrome, diagnosis, gastrointestinal disease, symptom-based criteria, outcome, serology, and fecal markers. Abstracts from Digestive Disease Week 2008–2009 and reference lists of identified articles were reviewed.Results: A disconnect is apparent between practice guidelines and clinical practice. The American Gastroenterological Association and American College of Gastroenterology recommend diagnosing IBS in patients without alarm features of organic disease using symptom-based criteria (eg, Rome. However, physicians report confidence in a symptom-based diagnosis without further testing only up to 42% of the time; many order laboratory tests and perform sigmoidoscopies or colonoscopies despite good evidence showing no utility for this work-up in uncomplicated cases. In the absence of diagnostic criteria easily usable in a busy practice, newer diagnostic methods, such as stool-form examination, fecal inflammatory markers, and serum biomarkers, have been proposed as adjunctive tools to aid in an IBS diagnosis by increasing physicians

  9. Periodontal diagnostics.

    Science.gov (United States)

    Kinane, D F

    2000-10-01

    Periodontitis affects a subset of the population and our current thinking is that progression of periodontal disease may be either continuous or cyclical (burst hypothesis). These features make screening and diagnostic tools desirable in the management of this disease. Although many potential markers exist, several difficulties hamper our ability to declare them diagnostic tests with proven utility. The 'gold standard' for active periodontal disease is not available and inflammation due to gingivally confined lesions (gingivitis) and periodontal inflammation which results in attachment loss is a potential confounder of any test based on assessing the host response elements of the disease. The current absence of proof for the progression of periodontal disease i.e., whether or not the burst hypothesis is correct, is a further problem. Although much is written about the need for markers of current or future disease which will prevent us from overtreating pockets, the time, effort and cost involved in testing these sites has to be balanced against the relative ease and speed of routine therapy such as root planing. In addition, we are still some way from the development and validation of reliable host or microbial testing methods. In terms of screening tests for diseases such as the early-onset forms of periodontitis, the research and development on diagnostic tools involving genetic polymorphisms, specific genes, systemic antibodies or leucocyte cell surface markers of the patients, may become a clinical reality in time. One could envisage chairside tests using blood from thumb pricks being capable of determining a young individual's risk of developing disease at a later age, and thus the need for a timely prevention programme. Before applying any test we should reconsider what treatment planning effects a positive or negative result will have, and any test which does not influence the treatment plan is redundant. Whether periodontal diagnostic tests will be

  10. Factors associated with the decision of the rheumatologist to order sacroiliac joints magnetic resonance imaging (SI-MRI) or HLA-B27 testing in the diagnostic work-up of patients with spondyloarthritis in clinical practice

    NARCIS (Netherlands)

    Bautista-Molano, Wilson; Landewé, Robert B. M.; Serna, Cesar; Valle-Oñate, Rafael; van der Heijde, Désirée

    2017-01-01

    To evaluate the patients' characteristics associated with the clinical decision to request SI-MRI and/or HLA-B27 in patients with SpA in daily practice. Patients referred to a rheumatology outpatient-clinic in a national referral-centre were selected. Patients with a clinical diagnosis of SpA

  11. Ultrasound techniques in the evaluation of the mediastinum, part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography

    NARCIS (Netherlands)

    Jenssen, Christian; Annema, Jouke Tabe; Clementsen, Paul; Cui, Xin-Wu; Borst, Mathias Maximilian; Dietrich, Christoph Frank

    2015-01-01

    Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node (MLN) staging affects the management of patients with both operable

  12. Whole-body-MR imaging including DWIBS in the work-up of patients with head and neck squamous cell carcinoma: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Noij, Daniel P., E-mail: d.noij@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Boerhout, Els J., E-mail: e.boerhout@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Pieters-van den Bos, Indra C., E-mail: i.pieters@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Comans, Emile F., E-mail: efi.comans@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Oprea-Lager, Daniela, E-mail: d.oprea-lager@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Reinhard, Rinze, E-mail: r.reinhard@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Hoekstra, Otto S., E-mail: os.hoekstra@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Bree, Remco de, E-mail: r.debree@vumc.nl [Department Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Graaf, Pim de, E-mail: p.degraaf@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands); Castelijns, Jonas A., E-mail: j.castelijns@vumc.nl [Department of Radiology and Nuclear Medicine, VU University Medical Center, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam (Netherlands)

    2014-07-15

    Objectives: To assess the feasibility of whole-body magnetic resonance imaging (WB-MRI) including diffusion-weighted whole-body imaging with background-body-signal-suppression (DWIBS) for the evaluation of distant malignancies in head and neck squamous cell carcinoma (HNSCC); and to compare WB-MRI findings with {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) and chest-CT. Methods: Thirty-three patients with high risk for metastatic spread (26 males; range 48–79 years, mean age 63 ± 7.9 years (mean ± standard deviation) years) were prospectively included with a follow-up of six months. WB-MRI protocol included short-TI inversion recovery and T1-weighted sequences in the coronal plane and half-fourier acquisition single-shot turbo spin-echo T2 and contrast-enhanced-T1-weighted sequences in the axial plane. Axial DWIBS was reformatted in the coronal plane. Interobserver variability was assessed using weighted kappa and the proportion specific agreement (PA). Results: Two second primary tumors and one metastasis were detected on WB-MRI. WB-MRI yielded seven clinically indeterminate lesions which did not progress at follow-up. The metastasis and one second primary tumor were found when combining {sup 18}F-FDG-PET/CT and chest-CT findings. Interobserver variability for WB-MRI was κ = 0.91 with PA ranging from 0.82 to 1.00. For {sup 18}F-FDG-PET/CT κ could not be calculated due to a constant variable in the table and PA ranged from 0.40 to 0.99. Conclusions: Our WB-MRI protocol with DWIBS is feasible in the work-up of HNSCC patients for detection and characterization of distant pathology. WB-MRI can be complementary to {sup 18}F-FDG-PET/CT, especially in the detection of non {sup 18}F-FDG avid second primary tumors.

  13. Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI; Funktionelle MRT bei Schizophreniepatienten. Diagnostik und Therapiemonitoring kognitiver Defizite schizophrener Patienten mittels funktioneller MRT

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Sachs, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Psychiatrie und Psychotherapie, Wien (Austria)

    2010-02-15

    Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [German] Kognitive Defizite sind ein zentraler Bestandteil der Symptomatik schizophrener Patienten. Diese Defizite betreffen v. a. die Aufmerksamkeit, exekutive Funktionen sowie das Gedaechtnis. Der vorliegende Beitrag zeigt den Stellenwert der funktionellen Magnetresonanztomographie (fMRT) in Hinblick auf Diagnostik und Therapiemonitoring der unterschiedlichen kognitiven Teilbereiche auf. Darueber hinaus werden die Unterschiede in Bezug auf die Aktivierung der einzelnen Gehirnareale zwischen schizophrenen Patienten und gesunden Kontrollpersonen dargestellt. Diese Informationen sollen helfen, in der Praxis ein Profil der kognitiven Leistungsreduktionen sowie ein darauf angepasstes Therapiekonzept zu erstellen. (orig.)

  14. Memory functions and rCBF {sup 99m}Tc-HMPAO SPET: developing diagnostics in Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Elgh, Eva; Naesman, Birgitta [Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeaa University, 901 85 Umeaa (Sweden); Sundstroem, Torbjoern; Aahlstroem, Katrine Riklund [Department of Radiation Sciences, Diagnostic Radiology, Umeaa University, Umeaa (Sweden); Nyberg, Lars [Department of Psychology, Umeaa University, Umeaa (Sweden)

    2002-09-01

    Alzheimer's disease (AD) is a primary degenerative disease of the brain. The prevalence increases with age, with devastating consequences for the individual and society. The aim of this study was to evaluate whether patients with early AD show an altered regional cerebral blood flow (rCBF) compared with control persons. Furthermore, we aimed to investigate the correlation between rCBF in sublobar volumes of the brain and performance on memory tests. Memory tests were chosen to evaluate episodic and semantic memory. Fourteen patients (aged 75.2{+-}8.8 years) with early AD and 15 control persons (aged 71.4{+-}3.2 years) were included. rCBF measurements with single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO) were performed. The rCBF {sup 99m}Tc-HMPAO SPET images were spatially transformed to fit a brain atlas and normalised for differences in rCBF (Computerised Brain Atlas software). Cortical and subcortical volumes of interest (VOIs) were analysed and compared. Compared with the controls, AD patients showed a significantly lower rCBF ratio in temporoparietal regions, including the left hippocampus. The diagnostic sensitivity and specificity for AD were high in temporoparietal regions. AD patients had significantly reduced performance on semantic and, in particular, episodic memory tests compared with age-matched normative data, and their performance on several episodic tests correlated with rCBF ratios in parietal and temporal regions, including the left hippocampus. The correlation between rCBF ratio and level of episodic memory performance suggests that abnormalities in rCBF pattern underlie impaired episodic memory functioning in AD. (orig.)

  15. Ambient diagnostics

    CERN Document Server

    Cai, Yang

    2014-01-01

    Part I. FundamentalsIntroductionWhat is Ambient Diagnostics?Diagnostic ModelsMultimedia IntelligenceCrowd SourcingSoft SensorsScience of SimplicityPersonal DiagnosesBasic AlgorithmsBasic ToolsSummaryProblemsTransformationEarly Discoveries of Heartbeat PatternsTransforms, Features, and AttributesSequential FeaturesSpatiotemporal FeaturesShape FeaturesImagery FeaturesFrequency Domain FeaturesMulti-Resolution FeaturesSummaryProblemsPattern RecognitionSimilarities and DistancesClustering MethodsClassification MethodsClassifier Accuracy MeasuresSummaryProblemsPart II. Multimedia IntelligenceSound RecognitionMicrophone AppsModern Acoustic Transducers (Microphones)Frequency Response CharacteristicsDigital Audio File FormatsHeart Sound SensingLung Sound SensingSnore MeterSpectrogram (STFT)Ambient Sound AnalysisSound RecognitionRecognizing Asthma SoundPeak ShiftFeature CompressionRegroupingNoise IssuesFuture ApplicationsSummaryProblemsColor SensorsColor SensingHuman Color VisionColor SensorsColor Matching ExperimentsC...

  16. The emerging age of endovascular treatment of acute ischaemic stroke and the role of CT angiography in patient work-up: a guide for the radiologist

    International Nuclear Information System (INIS)

    Loughborough, W.; Mahady, K.; Bradley, M.D.; Renowden, S.A.; Mortimer, A.M.

    2016-01-01

    Recent trial evidence suggests that for patients suffering large-vessel occlusive stroke, endovascular therapy based on the stent-retriever technique is associated with superior clinical outcomes when compared to intravenous thrombolysis alone. The challenge now is how this service is to be delivered. This may involve both centralisation of services around large cities and development of robust networks to receive patients from district general hospitals situated further afield. Both diagnostic and interventional neuroradiology will need to expand. Furthermore, we suggest that it would be advantageous for radiology departments in those hospitals receiving hyperacute stroke patients to perform computed tomography (CT) angiography in addition to non-contrast CT, which also has implications for service delivery in these units. This could swiftly aid identification of patients who might benefit from thrombectomy and improve decision-making through demonstration of occlusive thrombus and of collateral status.

  17. Diagnostic accuracy of organ electrodermal diagnostics | Szopinski ...

    African Journals Online (AJOL)

    Objective. To estimate the diagnostic accuracy as well as the scope of utilisation of a new bio-electronic method of organ diagnostics. Design. Double-blind comparative study of the diagnostic results obtained by means of organ electrodermal diagnostics (OED) and clinical diagnoses, as a criterion standard. Setting.

  18. The level of diagnostic assessment in severe asthma

    DEFF Research Database (Denmark)

    von Bülow, Anna; Backer, Vibeke; Bodtger, Uffe

    2017-01-01

    INTRODUCTION: Systematic assessment of patients with severe asthma is pivotal to decide which patients are eligible to new biological therapies. However, the level of diagnostic work-up in patients with severe asthma is only poorly investigated. AIMS & OBJECTIVES: To describe the diagnostic work......-up in a complete population of patients with severe asthma including: objective confirmation of the asthma diagnosis, and identification of potential treatment barriers, such as poor adherence and poor inhaler technique. METHODS: A retrospective cross-sectional multicenter study was performed in 2013. We evaluated...... patient record forms of all patients (aged 18-65 years) consecutively referred with asthma to one of five respiratory outpatient clinics over two years. Patients were included in the study, if they fulfilled ERS/ATS guidelines for having severe asthma. RESULTS: Among 1563 patients with asthma, 98 (6...

  19. Radiologic diagnostics of dementia; Radiologische Demenzdiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Essig, M. [Radiologie, Deutsches Krebsforschungszentrum Heidelberg (Germany); Radiologie, Deutsches Krebsforschungszentrum Heidelberg, Im Neuenheimer Feld 280, 69120, Heidelberg (Germany); Schoenberg, S.O. [Institut fuer klinische Radiologie, Ludwig-Maximilians-Universitaet Muenchen (Germany)

    2003-07-01

    Dementia is one of the most common diseases in the elderly population and is getting more and more important with the ageing of the population. A radiologic structural examination with CT or MRI is meanwhile a standard procedure in the diagnostic work up of patients with dementia syndrome. Radiology enables an early diagnosis and a differential diagnosis between different causes of dementia. Because structural changes occur only late in the disease process, a more detailed structural analysis using volumetric techniques or the use of functional imaging techniques is mandatory. These days, structural imaging uses MRI which enables to detect early atrophic changes at the medial temporal lobe with focus on the amygdala hippocampal complex. These changes are also present in the normal ageing process. In patients with Alzheimer's disease, however, they are more rapid and more pronounced. The use of functional imaging methods such as perfusion MRI, diffusion MRI or fMRI allow new insights into the pathophysiologic changes of dementia. The article gives an overview of the current status of structural imaging and an outlook into the potential of functional imaging methods. Detailed results of structural and functional imaging are presented in other articles of this issue. (orig.) [German] Demenzielle Syndrome gehoeren zu den haeufigsten Erkrankungen im hoeheren Lebensalter und werden mit einer Zunahme der Ueberalterung in der Bevoelkerung volkswirtschaftlich immer bedeutender. Die radiologische Untersuchung mittels struktureller CT oder MRT gehoert mittlerweile zur Standardabklaerung jeder demenziellen Symptomatik. Sie dient der Frueherkennung und der Differenzialdiagnostik der verschiedenen Ursachen einer Demenz. Dies gilt insbesondere in Hinblick auf zu erwartende und bereits vorhandene Therapiemoeglichkeiten. Da jedoch strukturelle Veraenderungen erst relativ spaet im Fortschreiten der Erkrankung visualisiert werden koennen, sind detaillierte strukturelle

  20. Whole-body magnetic resonance imaging: an essential tool for diagnosis and work up of non-oncological systemic diseases in children.

    Science.gov (United States)

    Korchi, A M; Hanquinet, S; Anooshiravani, M; Merlini, L

    2014-06-01

    Whole-body MRI (WBMRI) is a non-irradiating imaging technique, suitable to investigate the extent of multisystemic diseases in pediatric patients. However its real impact on diagnosis and management of non-oncological pediatric diseases remains unclear. We present our experience of pediatric WBMRI in various pathologies. We retrospectively reviewed medical files of all non- oncologic patients who underwent WBMRI from January 2008 to November 2012. The MRI protocol included T1 weighted and 3D SPACE Inversion Recovery (IR) and fat saturated diffusion weighted (DWI) sequence. We reviewed medical records in order to determine if performing WBMRI added useful information for diagnostic purposes and/or changed clinical management. Forty-two children were included in the study (19 F, 23 M) (median age 4.7 years). Twenty-one children underwent general anesthesia. WBMRI was a useful tool to provide correct diagnosis in chronic recurrent multifocal osteomyelitis (CRMO), and to identify the origin of fever or arthralgia of unknown etiology. WBMRI allowed to determine the extent of disease in juvenile idiopathic arthritis (JIA), chronic granulomatous disorder, enchondromatosis, Langerhans cell histiocytosis, and in the assessment of tumor burden in neurofibromatosis type I. For the battered child syndrome, the influence on management was rather minimal. For each of these pathologies we performed a review of recent literature. WBMRI is easy to perform in children and allows the assessment of systemic diseases or discovery of lesions ignored by clinical examination. WBMRI influenced the decisional process and clinical management of various pathologies in our series.

  1. Mitigation diagnostics

    International Nuclear Information System (INIS)

    Hall, S.T.

    1990-01-01

    This paper reports that experience in the remediation of schools and other large buildings has shown the importance of the effects of both the location of geologic sources and HVAC-induced distribution of indoor radon. In general, elevated radon in areas of schools with evenly distributed HVAC pressures are correlated with maximum soil radon emanations. However, strong or unequal HVAC effects can redistribute indoor radon to areas away from the direct source. Effective remediation required a complete understanding of both contributions. In some schools, highest indoor radon levels were located near large return ducts and were attributed to proximity to negative HVAC pressure. Successful sub-slab depressurization systems were installed, however, in rooms with lower indoor but greatest sub-slab radon levels, closest to the source. This shows the inadequacy of using indoor radon levels alone as a basis for remediation. Wings of two other schools with radon problems have equivalent window fan coil units in rooms of equal size and no central HVAC system. Highest indoor radon levels correlated well with highest sub-slab radon levels due to the equivalent effects of the window units. Diagnostic tests in other schools have revealed: blockwall radon transport to upper floors; high blockwall radon adjacent to sub-slab sources; and elevated indoor radon over crawlspace being drawn upward by HVAC-induced negative pressure, determined from indoor to outdoor micromanometer measurements

  2. Evaluation of the Criterion and Convergent Validity of the Diagnostic Interview for Social and Communication Disorders in Young and Low-Functioning Children

    Science.gov (United States)

    Maljaars, Jarymke; Noens, Ilse; Scholte, Evert; van Berckelaer-Onnes, Ina

    2012-01-01

    The Diagnostic Interview for Social and Communication Disorders (DISCO; Wing, 2006) is a standardized, semi-structured and interviewer-based schedule for diagnosis of autism spectrum disorder (ASD). The objective of this study was to evaluate the criterion and convergent validity of the DISCO-11 ICD-10 algorithm in young and low-functioning…

  3. Social Communication Disorder outside Autism? A Diagnostic Classification Approach to Delineating Pragmatic Language Impairment, High Functioning Autism and Specific Language Impairment

    Science.gov (United States)

    Gibson, Jenny; Adams, Catherine; Lockton, Elaine; Green, Jonathan

    2013-01-01

    Background: Developmental disorders of language and communication present considerable diagnostic challenges due to overlapping of symptomatology and uncertain aetiology. We aimed to further elucidate the behavioural and linguistic profile associated with impairments of social communication occurring outside of an autism diagnosis. Methods: Six to…

  4. Research on Fault Diagnostic System in CVT Based on UDS

    Directory of Open Access Journals (Sweden)

    Jiande Wang

    2015-01-01

    Full Text Available A communication model of diagnostic network and implementation of unified diagnostic services (UDS based on controller area network (CAN bus are presented in this paper, and fault diagnostic function of transmission control unit (TCU, USB- (universal serial bus- CAN hardware and software modules, and fault diagnostic software based on personal computer (PC are designed. Model diagnostic method is applied on ratio control, and fault diagnostic system is tested in vehicle.

  5. Importance of nuclear medicine diagnostics in CUP syndrome

    International Nuclear Information System (INIS)

    Winter, M.C.; Haberkorn, U.; Kratochwil, C.

    2014-01-01

    The diagnostic work-up in patients with carcinoma of unknown primary (CUP) syndrome is extensive, highly time-consuming and cost-intensive and ultimately often fails to detect a primary site. In this context chest X-ray and computed tomography (CT) have been used as standard imaging modalities in CUP syndrome. Since the introduction of positron emission tomography (PET) evaluation of tumor vitality has become possible. Furthermore, PET-CT hybrid scanners allow the combination of functional and morphological imaging. Several meta-analyses have reported an additional overall detection rate between 24.5 % and 44 % by either PET or PET-CT. Metastatic localization (cervical versus extracervical) did not influence the performance. The sensitivity was usually high (> 80 %) but specificity was moderate ranging from 68 % to 88 % at best. If mentioned, the results obtained by fluorodeoxyglucose (FDG)-PET significantly changed the clinical management in approximately one third of the patients studied. In a direct comparison with PET alone, PET-CT did not depict significantly more primary tumors but was able to reduce false positive findings. To determine the real additional value of PET-CT in the diagnosis of CUP syndrome large prospective studies with more uniform inclusion criteria are needed. Despite the capabilities of FDG-PET-CT there is as yet no evidence that a potentially improved diagnostic algorithm is translated into a better patient outcome. Nevertheless, FDG-PET-CT should be performed in all CUP patients where conventional imaging failed to detect a primary site or the results are equivocal. In CUP patients with cervical lymph node metastases PET-CT should be carried out prior to panendoscopy to reduce the number of false negative biopsies. (orig.) [de

  6. Proposed Diagnostic Criteria for Smartphone Addiction.

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  7. Quality and diagnostic perspectives in laboratory diagnostics

    OpenAIRE

    Müller, Mathias M.

    2010-01-01

    Laboratory diagnostics is a medical discipline playing an important part in patient management. In laboratory medicine meaningful, accurate and precise routine measurements are essential for diagnosis, risk assessment, treatment and follow-up of patients. The contribution of the diagnostic laboratory in the overall diagnostic process is app. 40-60%, depending on the kind of disease status investigated. The diagnostic laboratory uses nowadays more than 1.000 different tests mostly provided by ...

  8. What Is Diagnostic Testing?

    Science.gov (United States)

    ... you want to learn. Search form Search Diagnostic testing You are here Home Testing & Services Testing for ... help you make the decision. What Is Diagnostic Testing? Diagnostic genetic testing can usually work out if ...

  9. Dermatoglyphics: A Diagnostic Aid?

    Science.gov (United States)

    Fuller, I. C.

    1973-01-01

    Dermatoglyphics of patients suffering from diabetes, schizophrenia, duodenal ulcer, asthma, and various cancers have been contrasted and significant differences in the digital ridge counts, maximum atd angles, and distal palmar loop ridge counts have been found. A discriminant analysis of the digital ridge counts was performed and the function was used to attempt differential diagnosis between these conditions on dermatoglyphic evidence alone. This diagnostic trial failed, and possible reasons for its failure are discussed. Attention is drawn to the possibility that prognostic implications of dermatoglyphics might be relevant to screening techniques. PMID:4714584

  10. Recent diagnostic developments on LHD

    International Nuclear Information System (INIS)

    Sudo, S; Ozaki, T; Ashikawa, N; Emoto, M; Goto, M; Hamada, Y; Ida, K; Ido, T; Iguchi, H; Inagaki, S; Isobe, M; Kawahata, K; Khlopenkov, K; Kobuchi, T; Liang, Y; Masuzaki, S; Minami, T; Morita, S; Muto, S; Nagayama, Y; Nakanishi, H; Narihara, K; Nishizawa, A; Ohdachi, S; Osakabe, M; Peterson, B J; Sakakibara, S; Sasao, M; Sato, K; Shoji, M; Tamura, N; Tanaka, K; Toi, K; Tokuzawa, T; Watanabe, K; Watanabe, T; Yamada, I; Goncharov, P; Ejiri, A; Okajima, S; Mase, A; Tsuji-Iio, S; Akiyama, T; Lyon, J F; Vyacheslavov, L N; Sanin, A

    2003-01-01

    The recent diagnostic developments on the large helical device (LHD) are described briefly. LHD is the largest helical machine with all superconducting coils, and its purpose is to prove the ability of a helical system to confine a fusion-relevant plasma in steady state. According to the missions of LHD research, the diagnostic devices are categorized as follows: diagnostics for (i) high nτ E T plasmas and transport physics; (ii) magnetohydrodynamic stability; (iii) long pulse operation and divertor function; and (iv) energetic particles. These are briefly described focusing on the recent developments of the devices. Since the LHD experiment started in March 1998, five series of experimental campaigns have been carried out. The LHD diagnostics during these periods were operated successfully, and contributed to the analysis of the experimental results

  11. Recent diagnostic developments on LHD

    Energy Technology Data Exchange (ETDEWEB)

    Sudo, S; Ozaki, T; Ashikawa, N; Emoto, M; Goto, M; Hamada, Y; Ida, K; Ido, T; Iguchi, H; Inagaki S; Isobe, M; Kawahata, K; Khlopenkov, K; Kobuchi, T; Liang, Y; Masuzaki, S; Minami, T; Morita, S; Muto, S; Nagayama, Y; Nakanishi, H; Narihara, K; Nishizawa, A; Ohdachi, S; Osakabe, M; Peterson, BJ; Sakakibara, S; Sasao, M; Sato, K; Shoji, M; Tamura, N; Tanaka, K; Toi, K; Tokuzawa, T; Watanabe, K; Watanabe, T; Yamada, I [National Institute for Fusion Science, Toki 509-5292 (Japan); Goncharov, P [Grad. Univ. Advanced Studies, Oroshi-cho 322-6, Toki 509-5292 (Japan); Ejiri, A [University of Tokyo, Tokyo 113-0033 (Japan); Okajima, S [Chubu University, Kasugai-shi, 487-8501 (Japan); Mase, A [Kyushu University, Kasuga, 816-8580 (Japan); Tsuji-Iio, S [Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550 (Japan); Akiyama, T [Tokyo Institute of Technology, Meguro-ku, Tokyo 152-8550 (Japan); Lyon, J F [Oak Ridge National Laboratory, Oak Ridge, TN 37831-8072 (United States); Vyacheslavov, L N [Budker Institute of Nuclear Physics, 630090, Novosibirsk (Russian Federation); Sanin, A [Budker Institute of Nuclear Physics, 630090, Novosibirsk (Russian Federation)

    2003-07-01

    The recent diagnostic developments on the large helical device (LHD) are described briefly. LHD is the largest helical machine with all superconducting coils, and its purpose is to prove the ability of a helical system to confine a fusion-relevant plasma in steady state. According to the missions of LHD research, the diagnostic devices are categorized as follows: diagnostics for (i) high n{tau}{sub E}T plasmas and transport physics; (ii) magnetohydrodynamic stability; (iii) long pulse operation and divertor function; and (iv) energetic particles. These are briefly described focusing on the recent developments of the devices. Since the LHD experiment started in March 1998, five series of experimental campaigns have been carried out. The LHD diagnostics during these periods were operated successfully, and contributed to the analysis of the experimental results.

  12. Diagnostic accuracy of pre-bronchodilator FEV1/FEV6 from microspirometry to detect airflow obstruction in primary care: a randomised cross-sectional study

    NARCIS (Netherlands)

    Bemt, L. van den; Wouters, B.C.; Grootens, J.; Denis, J.; Poels, P.J.P.; Schermer, T.R.J.

    2014-01-01

    BACKGROUND: Forced expiratory volume in 1s/forced expiratory volume in 6 s ( FEV1/FEV6) assessment with a microspirometer may be useful in the diagnostic work up of subjects who are suspected of having COPD in primary care. AIM: To determine the diagnostic accuracy of a negative pre-bronchodilator

  13. Diagnostic accuracy of pre-bronchodilator FEV1/FEV6 from microspirometry to detect airflow obstruction in primary care: a randomised cross-sectional study.

    NARCIS (Netherlands)

    Bemt, L. van den; Wouters, B.C.W.; Grootens, J.; Denis, J.; Poels, P.; Schermer, T.R.

    2014-01-01

    Background: Forced expiratory volume in 1s/forced expiratory volume in 6 s ( FEV1/FEV6) assessment with a microspirometer may be useful in the diagnostic work up of subjects who are suspected of having COPD in primary care. Aim: To determine the diagnostic accuracy of a negative pre-bronchodilator

  14. Diagnostic yield of 24-hour esophageal manometry in non-cardiac chest pain.

    Science.gov (United States)

    Barret, M; Herregods, T V K; Oors, J M; Smout, A J P M; Bredenoord, A J

    2016-08-01

    In the past, ambulatory 24-h manometry has been shown useful for the evaluation of patients with non-cardiac chest pain (NCCP). With the diagnostic improvements brought by pH-impedance monitoring and high-resolution manometry (HRM), the contribution of ambulatory 24-h manometry to the diagnosis of esophageal hypertensive disorders has become uncertain. Our aim was to assess the additional diagnostic yield of ambulatory manometry to HRM and ambulatory pH-impedance monitoring in this patient population. All patients underwent 24-h ambulatory pressure-pH-impedance monitoring and HRM. Patients had retrosternal pain as a predominant symptom and no explanation after cardiologic and digestive endoscopic evaluations. Diagnostic measurements were analyzed by two independent physicians. Fifty-nine patients met the inclusion criteria; 37.3% of the patients had their symptoms explained by abnormalities on pH-impedance monitoring and 6.8% by ambulatory manometry. Functional chest pain was diagnosed in 52.5% of the patients. High-resolution manometry, using the Chicago Classification v3.0 criteria alone, did not identify any of the four patients with esophageal spasm on ambulatory manometry. However, taking into account other abnormalities, such as simultaneous (rapid) or repetitive contractions, HRM had a sensitivity of 75% and a specificity of 98.2% for the diagnosis of esophageal spasm. In the work-up of NCCP, ambulatory 24-h manometry has a low additional diagnostic yield. However, it remains the best technique to identify esophageal spasm as the cause of symptoms. This is particularly useful when an unequivocal diagnosis is needed before treatment. © 2016 John Wiley & Sons Ltd.

  15. Improving the Sensitivity and Functionality of Mobile Webcam-Based Fluorescence Detectors for Point-of-Care Diagnostics in Global Health

    Directory of Open Access Journals (Sweden)

    Reuven Rasooly

    2016-05-01

    Full Text Available Resource-poor countries and regions require effective, low-cost diagnostic devices for accurate identification and diagnosis of health conditions. Optical detection technologies used for many types of biological and clinical analysis can play a significant role in addressing this need, but must be sufficiently affordable and portable for use in global health settings. Most current clinical optical imaging technologies are accurate and sensitive, but also expensive and difficult to adapt for use in these settings. These challenges can be mitigated by taking advantage of affordable consumer electronics mobile devices such as webcams, mobile phones, charge-coupled device (CCD cameras, lasers, and LEDs. Low-cost, portable multi-wavelength fluorescence plate readers have been developed for many applications including detection of microbial toxins such as C. Botulinum A neurotoxin, Shiga toxin, and S. aureus enterotoxin B (SEB, and flow cytometry has been used to detect very low cell concentrations. However, the relatively low sensitivities of these devices limit their clinical utility. We have developed several approaches to improve their sensitivity presented here for webcam based fluorescence detectors, including (1 image stacking to improve signal-to-noise ratios; (2 lasers to enable fluorescence excitation for flow cytometry; and (3 streak imaging to capture the trajectory of a single cell, enabling imaging sensors with high noise levels to detect rare cell events. These approaches can also help to overcome some of the limitations of other low-cost optical detection technologies such as CCD or phone-based detectors (like high noise levels or low sensitivities, and provide for their use in low-cost medical diagnostics in resource-poor settings.

  16. Cross-diagnostic validity of the SF-36 physical functioning scale in patients with stroke, multiple sclerosis and amyotrophic lateral sclerosis: a study using Rasch analysis

    NARCIS (Netherlands)

    Dallmeijer, Annet J.; de Groot, Vincent; Roorda, Leo D.; Schepers, Vera P. M.; Lindeman, Eline; van den Berg, Leonard H.; Beelen, Anita; Dekker, Joost

    2007-01-01

    The aim of this study was to investigate unidimensionality and differential item functioning of the SF-36 physical functioning scale (PF10) in patients with various neurological disorders. Patients: Patients post-stroke (n = 198), with multiple sclerosis (n = 151) and amyotrophic lateral sclerosis

  17. Planetary Transmission Diagnostics

    Science.gov (United States)

    Lewicki, David G. (Technical Monitor); Samuel, Paul D.; Conroy, Joseph K.; Pines, Darryll J.

    2004-01-01

    This report presents a methodology for detecting and diagnosing gear faults in the planetary stage of a helicopter transmission. This diagnostic technique is based on the constrained adaptive lifting algorithm. The lifting scheme, developed by Wim Sweldens of Bell Labs, is a time domain, prediction-error realization of the wavelet transform that allows for greater flexibility in the construction of wavelet bases. Classic lifting analyzes a given signal using wavelets derived from a single fundamental basis function. A number of researchers have proposed techniques for adding adaptivity to the lifting scheme, allowing the transform to choose from a set of fundamental bases the basis that best fits the signal. This characteristic is desirable for gear diagnostics as it allows the technique to tailor itself to a specific transmission by selecting a set of wavelets that best represent vibration signals obtained while the gearbox is operating under healthy-state conditions. However, constraints on certain basis characteristics are necessary to enhance the detection of local wave-form changes caused by certain types of gear damage. The proposed methodology analyzes individual tooth-mesh waveforms from a healthy-state gearbox vibration signal that was generated using the vibration separation (synchronous signal-averaging) algorithm. Each waveform is separated into analysis domains using zeros of its slope and curvature. The bases selected in each analysis domain are chosen to minimize the prediction error, and constrained to have the same-sign local slope and curvature as the original signal. The resulting set of bases is used to analyze future-state vibration signals and the lifting prediction error is inspected. The constraints allow the transform to effectively adapt to global amplitude changes, yielding small prediction errors. However, local wave-form changes associated with certain types of gear damage are poorly adapted, causing a significant change in the

  18. Metaanalysis of Diagnostic Performance of Computed Coronary Tomography Angiography, Computed Tomography Perfusion and Computed Tomography-Fractional Flow Reserve in Functional Myocardial Ischemia Assessment versus Invasive Fractional Flow Reserve

    Science.gov (United States)

    Gonzalez, Jorge A.; Lipinski, Michael J.; Flors, Lucia F.; Shaw, Peter; Kramer, Christopher M.; Salerno, Michael

    2015-01-01

    We sought to compare the diagnostic performance of computed coronary tomography angiography (CCTA), computed tomography perfusion (CTP) and computed tomography fractional flow reserve (CT-FFR) for assessing the functional significance of coronary stenosis as defined by invasive fractional flow reserve (FFR), in patients with known or suspected coronary artery disease. CCTA has proven clinically useful for excluding obstructive CAD due to its high sensitivity and negative predictive value (NPV), however the ability of CTA to identify functionally significant CAD has remained challenging. We searched PubMed/Medline for studies evaluating CCTA, CTP or CT-FFR for the non-invasive detection of obstructive CAD as compared to catheter-derived FFR as the reference standard. Pooled sensitivity, specificity, PPV, NPV, likelihood ratios (LR), odds ratio (OR) of all diagnostic tests were assessed. Eighteen studies involving a total of 1535 patients were included. CTA demonstrated a pooled sensitivity of 0.92, specificity 0.43, PPV of 0.56 and NPV of 0.87 on a per-patient level. CT-FFR and CTP increased the specificity to 0.72 and 0.77 respectively (P=0.004 and P=0.0009)) resulting in higher point estimates for PPV 0.70 and 0.83 respectively. There was no improvement in the sensitivity. The CTP protocol involved more radiation (3.5 mSv CCTA VS 9.6 mSv CTP) and a higher volume of iodinated contrast (145 mL). In conclusion, CTP and CT-FFR improve the specificity of CCTA for detecting functionally significant stenosis as defined by invasive FFR on a per-patient level; both techniques could advance the ability to non-invasively detect the functional significance of coronary lesions. PMID:26347004

  19. Diagnostic accuracy of organ electrodermal diagnostics

    African Journals Online (AJOL)

    ll Diagnostic methods based upon measurements of electrical potential, resistance and impedance of these zones have been proposed; however, their diagnostic accuracy has not been proven and reproducibility has not been consistent. Some of these methods utilise specific bio-electrical properties of acupuncture points.

  20. Working up a lactofermented vegetable product

    NARCIS (Netherlands)

    Nagy-Gasztonyi, M.; Biekman, E.S.A.; Krebbers, B.

    2002-01-01

    The combination of lactofermentation and enzyme-treatment (Rohament-PL as endo-polygalacturonase and the mixture of Rohament-PL and Rohalase 7069 as cellulase) of sliced carrot and orange juice resulted in a homogeneous product, with pleasant organoleptic features, after 18 h fermentation period.

  1. Update on diagnostics of metabolic myopathies.

    Science.gov (United States)

    Toscano, Antonio; Barca, Emanuele; Musumeci, Olimpia

    2017-10-01

    This review aims to highlight the most relevant clinical and laboratory findings, regarding acute and progressive metabolic myopathies, and to develop an algorithm addressing clinicians to clinical practice. Although diagnosis of metabolic myopathies remains still challenging, the recent identification of new disorders has increased the number of patients requiring specific investigations. Nowadays, a more detailed characterization of the clinical spectrum of metabolic myopathies improved awareness as well as a deeper knowledge on their natural history or multisystem involvement. Diagnostic procedures, as first-line screening tests are necessary for an earlier and more accurate diagnostic work up, not only in infantile cases, but also in adults with suspected metabolic myopathies. New generation diagnostic techniques such as NGS (Next Generation Sequencing) and whole exome/genome sequencing have emerged as innovative tools to extensively evaluate either known genes variants or new candidate genes as possible causes of metabolic myopathies. Diagnosis of metabolic myopathies is still challenging for clinicians because of rarity and clinical heterogeneity which is often overlapping with other neuromuscular disorders. Detailed algorithms supported by advanced laboratory investigations may be helpful to timely reach a diagnosis, so allowing an earlier therapeutic decision.

  2. Far infrared fusion plasma diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Luhmann, N.C. Jr.; Peebles, W.A.

    1990-01-01

    Over the last several years, reflectometry has grown in importance as a diagnostic for both steady-state density Profiles as well as for the investigation of density fluctuations and turbulence. As a diagnostic for density profile measurement, it is generally believed to be well understood in the tokamak environment. However, its use as a fluctuation diagnostic is hampered by a lack of quantitative experimental understanding of its wavenumber sensitivity and spatial resolution. Several researchers, have theoretically investigated these questions. However, prior to the UCLA laboratory investigation, no group has experimentally investigated these questions. Because of the reflectometer's importance to the world effort in understanding plasma turbulence and transport, UCLA has, over the last year, made its primary Task IIIA effort the resolution of these questions. UCLA has taken the lead in a quantitative experimental understanding of reflectometer data as applied to the measurement of density fluctuations. In addition to this, work has proceeded on the design, construction, and installation of a reflectometer system on UCLA's CCT tokamak. This effort will allow a comparison between the improved confinement regimes (H-mode) observed on both the DIII-D and CCT machines with the goal of achieving a physics understanding of the phenomena. Preliminary investigation of a new diagnostic technique to measure density profiles as a function of time has been initiated at UCLA. The technique promises to be a valuable addition to the range of available plasma diagnostics. Work on advanced holographic reflectometry technique as applied to fluctuation diagnostics has awaited a better understanding of the reflectometer signal itself as discussed above. Efforts to ensure the transfer of the diagnostic developments have continued with particular attention devoted to the preliminary design of a multichannel FIR interferometer for MST.

  3. Image diagnostic of colonic diseases - controversial questions

    International Nuclear Information System (INIS)

    Pomakov, P.; Rizov, A.; Stancheva, I.

    2013-01-01

    In the system of colonic diseases' diagnostic algorithm, fibrocolonoscopy (FCS) is defined as 'Golden Standard'. By this reason some X-ray diagnostic methods - irrigography, etc. are currently not being used in a number of health institutions. The aim of this study is a comparative analysis of FCS and irrigography diagnostic efficacy in various colonic diseases. For 10-years period, in cooperation with a gastroenterologist-gastroscopist, 2151 patients with various colonic diseases were evaluated by FCS and irrigography with pharmaco-diagnostics/when necessary. Advantage of FCS was established in diagnosing diseases with patho-morfologic changes on the inner surface of the colon - benign and malignant neoplastic processes, chronic inflammatory diseases, etc. At the same time functional changes - irritated colon syndrome, changes in defecation act, etc., are not an object of diagnosis through FCS. Correction in colonic diseases diagnostic algorithm is necessary. FCS should be mandatory. If result is negative - irrigography with pharmaco-diagnostics should be done. (authors)

  4. Thioaptamer Diagnostic System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — AM Biotechnologies (AM) will develop a diagnostic system in response to SBIR Topic X10.01 Reusable Diagnostic Lab Technology that will simultaneously detect and...

  5. Imprecision of urinary iothalamate clearance as a gold-standard measure of GFR decreases the diagnostic accuracy of kidney function estimating equations.

    Science.gov (United States)

    Kwong, Yuen-Ting Diana; Stevens, Lesley A; Selvin, Elizabeth; Zhang, Yaping Lucy; Greene, Tom; Van Lente, Frederick; Levey, Andrew S; Coresh, Josef

    2010-07-01

    Evaluating the accuracy of estimated glomerular filtration rate (eGFR) derived from serum creatinine (SCr) and serum cystatin C (SCysC) equations requires gold-standard measures of GFR. However, the influence of imprecise measured GFRs (mGFRs) on estimates of equation error is unknown. Diagnostic test study. 1,995 participants from the Modification of Diet in Renal Disease (MDRD) Study and African American Study of Kidney Disease and Hypertension (AASK) with at least 2 baseline mGFRs from iodine 125-iothalamate urinary clearances, 1 standardized SCr value, and 1 SCysC value. eGFRs calculated using the 4-variable isotope-dilution mass spectrometry (IDMS)-traceable MDRD Study equation, the Chronic Kidney Disease (CKD) Epidemiology Collaboration (CKD-EPI) SCysC equation, the CKD-EPI SCr-SCysC equation, and mGFRs collected from another prerandomization visit. A single reference mGFR, average of 2, and average of 3 mGFRs; additional analysis limited to consistent mGFRs (difference gold standard (1 - P(30)). However, improving the precision of the reference test from a single mGFR to the average of 3 consistent mGFRs decreased these error estimates (1 - P(30)) to 8.0%, 12.5%, and 3.9%, respectively. Study population limited to those with CKD. Imprecision in gold-standard measures of GFR contribute to an appreciable proportion of the cases in which eGFR and mGFR differ by >30%. Reducing and quantifying errors in gold-standard measurements of GFR is critical to fully estimating the accuracy of GFR estimates.

  6. Lactulose:Mannitol Diagnostic Test by HPLC and LC-MSMS Platforms: Considerations for Field Studies of Intestinal Barrier Function and Environmental Enteropathy

    Science.gov (United States)

    Lee, Gwenyth O.; Kosek, Peter; Lima, Aldo A.M.; Singh, Ravinder; Yori, Pablo P.; Olortegui, Maribel P.; Lamsam, Jesse L.; Oliveira, Domingos B.; Guerrant, Richard L.; Kosek, Margaret

    2014-01-01

    ABSTRACT Objectives: The lactulose:mannitol (L:M) diagnostic test is frequently used in field studies of environmental enteropathy (EE); however, heterogeneity in test administration and disaccharide measurement has limited the comparison of results between studies and populations. We aim to assess the agreement between L:M measurement between high-performance liquid chromatography with pulsed amperometric detection (HPLC-PAD) and liquid chromatography-tandem mass spectrometry (LC-MSMS) platforms. Methods: The L:M test was administered in a cohort of Peruvian infants considered at risk for EE. A total of 100 samples were tested for lactulose and mannitol at 3 independent laboratories: 1 running an HPLC-PAD platform and 2 running LC-MSMS platforms. Agreement between the platforms was estimated. Results: The Spearman correlation between the 2 LC-MSMS platforms was high (ρ ≥ 0.89) for mannitol, lactulose, and the L:M ratio. The correlation between the HPLC-PAD platform and LC-MSMS platform was ρ = 0.95 for mannitol, ρ = 0.70 for lactulose, and ρ = 0.43 for the L:M ratio. In addition, the HPLC-PAD platform overestimated the lowest disaccharide concentrations to the greatest degree. Conclusions: Given the large analyte concentration range, the improved accuracy of LC-MSMS has important consequences for the assessment of lactulose and mannitol following oral administration in populations at risk for EE. We recommend that researchers wishing to implement a dual-sugar test as part of a study of EE use an LC-MSMS platform to optimize the accuracy of results and increase comparability between studies. PMID:24941958

  7. Mycobacterium tuberculosis DosR Regulon Gene Rv2004c Encodes a Novel Antigen with Pro-inflammatory Functions and Potential Diagnostic Application for Detection of Latent Tuberculosis

    Directory of Open Access Journals (Sweden)

    Sankara Narayana Doddam

    2017-06-01

    Full Text Available Approximately 1.7 billion people in the world harbor latent Mycobacterium tuberculosis (Mtb with a substantial risk of progression to clinical outcome. Containment of these seed beds of Mtb is essential to eliminate tuberculosis completely in high burden settings such as India. Hence, there is an urgent need for the identification of new serological markers for detection or vaccine candidates to prevent latent tuberculosis infection (LTBI. DosR regulon antigens of Mtb might serve as attractive targets for LTBI diagnosis or vaccine development as they are specifically expressed and are upregulated during latent phase. In this study, we investigated the role of Rv2004c, a member of DosR regulon (exclusive to Mtb complex, in host–pathogen interaction and its immunogenic potential in LTBI, active TB, and healthy control cohorts. Rv2004c elicited strong antibody response in individuals with LTBI compared to active TB patients and healthy cohorts. Recombinant Rv2004c induced pro-inflammatory cytokine response in human peripheral blood mononuclear cells and THP-1 cells via NF-κB phosphorylation. Interaction of Rv2004c with toll-like receptor (TLR-2 was confirmed using HEK-Blue hTLR-2 and pull-down assays. Rv2004c enhanced the surface expression of TLR-2 at mRNA and protein levels in THP-1 cells. Our findings revealed that Rv2004c induces strong humoral and cell mediated immune responses. Given these observations, we propose Rv2004c to be a potential diagnostic marker or an attractive vaccine candidate that can be useful against LTBI.

  8. Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis

    NARCIS (Netherlands)

    de Groot, Vincent; Beckerman, Heleen; Uitdehaag, Bernard M.; Hintzen, Rogier Q.; Minneboo, Arjan; Heymans, Martijn W.; Lankhorst, Gustaaf J.; Polman, Chris H.; Bouter, Lex M.; IJzerman, Maarten Joost

    2009-01-01

    Objective To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS). Design Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI). Setting

  9. Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement (II): Applications in spine diagnostics and assessment of crohn's disease

    NARCIS (Netherlands)

    van Schie, Jeroen J. N.; Lavini, Cristina; van Vliet, Lucas J.; Kramer, Gem; Pieters-van den Bos, Indra; Marcus, J. T.; Stoker, Jaap; Vos, Frans M.

    2017-01-01

    Pharmacokinetic (PK) models can describe microvascular density and integrity. An essential component of PK models is the arterial input function (AIF) representing the time-dependent concentration of contrast agent (CA) in the blood plasma supplied to a tissue. To evaluate a novel method for

  10. Comparison of diagnostic capability of macular ganglion cell complex and retinal nerve fiber layer among primary open angle glaucoma, ocular hypertension, and normal population using Fourier-domain optical coherence tomography and determining their functional correlation in Indian population

    Directory of Open Access Journals (Sweden)

    Nabanita Barua

    2016-01-01

    Full Text Available Context: Analysis of diagnostic ability of macular ganglionic cell complex and retinal nerve fiber layer (RNFL in glaucoma. Aim: To correlate functional and structural parameters and comparing predictive value of each of the structural parameters using Fourier-domain (FD optical coherence tomography (OCT among primary open angle glaucoma (POAG and ocular hypertension (OHT versus normal population. Setting and Design: Single centric, cross-sectional study done in 234 eyes. Materials and Methods: Patients were enrolled in three groups: POAG, ocular hypertensive and normal (40 patients in each group. After comprehensive ophthalmological examination, patients underwent standard automated perimetry and FD-OCT scan in optic nerve head and ganglion cell mode. The relationship was assessed by correlating ganglion cell complex (GCC parameters with mean deviation. Results were compared with RNFL parameters. Statistical Analysis: Data were analyzed with SPSS, analysis of variance, t-test, Pearson′s coefficient, and receiver operating curve. Results: All parameters showed strong correlation with visual field (P 0.5 when compared with other parameters. None of the parameters showed significant diagnostic capability to detect OHT from normal population. In diagnosing early glaucoma from OHT and normal population, only inferior GCC had statistically significant AUC value (0.715. Conclusion: In this study, GCC and RNFL parameters showed equal predictive capability in perimetric versus normal group. In early stage, inferior GCC was the best parameter. In OHT population, single day cross-sectional imaging was not valuable.

  11. Dacryoscintigraphy: A survey of diagnostic applications

    Energy Technology Data Exchange (ETDEWEB)

    De Rossi, G.; Salvatori, M.; Giordano, A.; Focosi, F.; Dickmann, A.; Melchiorri, M.

    1984-04-01

    A survey of clinical applications of dacryoscintigraphy is presented. Dacryocystorhinostomy is specifically described. Radioisotope studies showed a more rapid tear flow in intubated patients as compared with normal cases when good surgical results were achieved. In any case dacryocystoscintigraphy was able to reflect the functional state of polyethylene prosthesis better than any other diagnostic tool. In the authors' opinion radioisotope methods reliably support other diagnostic procedures, providing very useful quantitative functional parameters.

  12. The role of functional imaging techniques in the dementia

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Young Hoon [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2004-06-01

    Evaluation of dementia in patients with early symptoms of cognitive decline is clinically challenging, but the need for early, accurate diagnosis has become more crucial, since several medication for the treatment of mild to moderate Alzheimer' disease are available. Many neurodegenerative diseases produce significant brain function alteration even when structural imaging (CT of MRI) reveal no specific abnormalities. The role of PET and SPECT brain imaging in the initial assessment and differential diagnosis of dementia is beginning to evolve rapidly and growing evidence indicates that appropriate incorporation of PET into the clinical work up can improve diagnostic and prognostic accuracy with respect to Alzheimer's disease, the most common cause of dementia in the geriatric population. In the fast few years, studies comparing neuropathologic examination with PET have established reliable and consistent accuracy for diagnostic evaluations using PET - accuracies substantially exceeding those of comparable studies of diagnostic value of SPECT or of both modalities assessed side by side, or of clinical evaluations done without nuclear imaging. This review deals the role of functional brian imaging techniques in the evaluation of dementias and the role of nuclear neuroimaging in the early detection and diagnosis of Alzheimer's disease.

  13. Proposed Diagnostic Criteria for Smartphone Addiction.

    Directory of Open Access Journals (Sweden)

    Yu-Hsuan Lin

    Full Text Available Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria.We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist's structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists' clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy.Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1 six symptom criteria, (2 four functional impairment criteria and (3 exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%, while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use.The diagnostic criteria of smartphone addiction demonstrated the core symptoms "impaired control" paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment.

  14. Proposed Diagnostic Criteria for Smartphone Addiction

    Science.gov (United States)

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han

    2016-01-01

    Background Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. Methods We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist’s structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists’ clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Results Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. Conclusion The diagnostic criteria of smartphone addiction demonstrated the core symptoms “impaired control” paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment. PMID:27846211

  15. Diagnostic imaging of shoulder impingement

    International Nuclear Information System (INIS)

    Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

    1996-01-01

    Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

  16. Executive functions as a potential neurocognitive endophenotype in anxiety disorders: A systematic review considering DSM-IV and DSM-5 diagnostic criteria classification

    Directory of Open Access Journals (Sweden)

    Juliana de Lima Muller

    Full Text Available Evidence in the literature indicates that neurocognitive impairments may represent endophenotypes in psychiatric disorders.Objective:This study aimed to conduct a systematic review on executive functions as a potential neurocognitive endophenotype in anxiety disorder diagnosis according to the DSM-IV and DSM-5 classifications.Methods:A literature search of the LILACS, Cochrane Library, Index Psi Periódicos Técnico-Científicos, PubMed and PsycInfo databases was conducted, with no time limits. Of the 259 studies found, 14 were included in this review.Results:Only studies on obsessive-compulsive disorder (OCD were found. The executive function components of decision-making, planning, response inhibition, behavioral reversal/alternation, reversal learning and set-shifting/cognitive flexibility were considered to be a neurocognitive endophenotypes in OCD.Conclusion:Further studies on executive functions as a neurocognitive endophenotype in other anxiety disorders are needed since these may have different neurocognitive endophenotypes and require other prevention and treatment approaches.

  17. Inventive activity of the Department of Protein Structure and Function of the Palladin Institute of Biochemistry of NAS of Ukraine. Part I. Development of the diagnostic methods for detection of hemostasis disorders and characterization of certain blood coagulation factors

    Directory of Open Access Journals (Sweden)

    V. M. Danilova

    2016-04-01

    Full Text Available The practical aspects of inventive activity of the Department of Protein Structure and Function of the Palladin Institute of Biochemistry, NAS of Ukraine are highlighted in this article. Through years of fundamental and applied researches of blood coagulation system proteins, initiated by luminaries of the world biochemistry O. V. Palladin and V. O. Belitser, the Department staff have developed a considerable number of methods, techniques and tests for the assessment of the state of the hemostasis system, which were approved in many clinics. In the first part of this work the authors describe the development of the diagnostic methods for identifying the homeostasis system disorders in detail, as well as characterize certain coagulation factors.

  18. Calibration issues for neutron diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Sadler, G.J. [JET Joint Undertaking, Abingdon (United Kingdom); Adams, J.M. [AEA Technology, Harwell (United Kingdom); Barnes, C.W. [Los Alamos National Lab., NM (United States)] [and others

    1997-12-01

    The performance of diagnostic systems are limited by their weakest constituents, including their calibration issues. Neutron diagnostics are notorious for problems encountered while determining their absolute calibrations, due mainly to the nature of the neutron transport problem. In order to facilitate the determination of an accurate and precise calibration, the diagnostic design should be such as to minimize the scattered neutron flux. ITER will use a comprehensive set of neutron diagnostics--comprising radial and vertical neutron cameras, neutron spectrometers, a neutron activation system and internal and external fission chambers--to provide accurate measurements of fusion power and power densities as a function of time. The calibration of such an important diagnostic system merits careful consideration. Some thoughts have already been given to this subject during the conceptual design phase in relation to the time-integrated neutron activation and time-dependent neutron yield monitors. However, no overall calibration strategy has been worked out so far. This paper represents a first attempt to address this vital issue. Experience gained from present large tokamaks (JET, TFTR and JT60U) and proposals for ITER are reviewed. The need to use a 14-MeV neutron generator as opposed to radioactive sources for in-situ calibration of D-T diagnostics will be stressed. It is clear that the overall absolute determination of fusion power will have to rely on a combination of nuclear measuring techniques, for which the provision of accurate and independent calibrations will constitute an ongoing process as ITER moves from one phase of operation to the next.

  19. Towards trans-diagnostic mechanisms in psychiatry: neurobehavioral profile of rats with a loss-of-function point mutation in the dopamine transporter gene

    Directory of Open Access Journals (Sweden)

    Valentina Vengeliene

    2017-04-01

    Full Text Available The research domain criteria (RDoC matrix has been developed to reorient psychiatric research towards measurable behavioral dimensions and underlying mechanisms. Here, we used a new genetic rat model with a loss-of-function point mutation in the dopamine transporter (DAT gene (Slc6a3_N157K to systematically study the RDoC matrix. First, we examined the impact of the Slc6a3_N157K mutation on monoaminergic signaling. We then performed behavioral tests representing each of the five RDoC domains: negative and positive valence systems, cognitive, social and arousal/regulatory systems. The use of RDoC may be particularly helpful for drug development. We studied the effects of a novel pharmacological approach metabotropic glutamate receptor mGluR2/3 antagonism, in DAT mutants in a comparative way with standard medications. Loss of DAT functionality in mutant rats not only elevated subcortical extracellular dopamine concentration but also altered the balance of monoaminergic transmission. DAT mutant rats showed deficits in all five RDoC domains. Thus, mutant rats failed to show conditioned fear responses, were anhedonic, were unable to learn stimulus-reward associations, showed impaired cognition and social behavior, and were hyperactive. Hyperactivity in mutant rats was reduced by amphetamine and atomoxetine, which are well-established medications to reduce hyperactivity in humans. The mGluR2/3 antagonist LY341495 also normalized hyperactivity in DAT mutant rats without affecting extracellular dopamine levels. We systematically characterized an altered dopamine system within the context of the RDoC matrix and studied mGluR2/3 antagonism as a new pharmacological strategy to treat mental disorders with underlying subcortical dopaminergic hyperactivity.

  20. Identifying diagnostically-relevant resting state brain functional connectivity in the ventral posterior complex via genetic data mining in autism spectrum disorder.

    Science.gov (United States)

    Baldwin, Philip R; Curtis, Kaylah N; Patriquin, Michelle A; Wolf, Varina; Viswanath, Humsini; Shaw, Chad; Sakai, Yasunari; Salas, Ramiro

    2016-05-01

    Exome sequencing and copy number variation analyses continue to provide novel insight to the biological bases of autism spectrum disorder (ASD). The growing speed at which massive genetic data are produced causes serious lags in analysis and interpretation of the data. Thus, there is a need to develop systematic genetic data mining processes that facilitate efficient analysis of large datasets. We report a new genetic data mining system, ProcessGeneLists and integrated a list of ASD-related genes with currently available resources in gene expression and functional connectivity of the human brain. Our data-mining program successfully identified three primary regions of interest (ROIs) in the mouse brain: inferior colliculus, ventral posterior complex of the thalamus (VPC), and parafascicular nucleus (PFn). To understand its pathogenic relevance in ASD, we examined the resting state functional connectivity (RSFC) of the homologous ROIs in human brain with other brain regions that were previously implicated in the neuro-psychiatric features of ASD. Among them, the RSFC of the VPC with the medial frontal gyrus (MFG) was significantly more anticorrelated, whereas the RSFC of the PN with the globus pallidus was significantly increased in children with ASD compared with healthy children. Moreover, greater values of RSFC between VPC and MFG were correlated with severity index and repetitive behaviors in children with ASD. No significant RSFC differences were detected in adults with ASD. Together, these data demonstrate the utility of our data-mining program through identifying the aberrant connectivity of thalamo-cortical circuits in children with ASD. Autism Res 2016, 9: 553-562. © 2015 International Society for Autism Research, Wiley Periodicals, Inc. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  1. BSA-Bioinspired Gadolinium Hybrid-Functionalized Hollow Gold Nanoshells for NIRF/PA/CT/MR Quadmodal Diagnostic Imaging-Guided Photothermal/Photodynamic Cancer Therapy.

    Science.gov (United States)

    You, Qing; Sun, Qi; Yu, Meng; Wang, Jinping; Wang, Siyu; Liu, Li; Cheng, Yu; Wang, Yidan; Song, Yilin; Tan, Fengping; Li, Nan

    2017-11-22

    Multimodal imaging-guided synergistic therapy promises a more accurate diagnosis and higher therapeutic efficiency than single imaging modality or their simple "mechanical" combination. In this research, we have constructed an innovative multifunctional drug delivery platform by gadolinium (Gd)-based bovine serum albumin (BSA) hybrid-coated hollow gold nanoshells (Au@BSA-Gd). The obtained nanoparticles exhibited excellent photothermal effect and computed tomography (CT)/photoacoustic (PA) activity. Besides, the BSA-bioinspired gadolinium complex endowed the nanoparticles with an excellent T 1 contrast agent for magnetic resonance imaging (MRI). In addition, the near-infrared (NIR) absorbing phototherapeutic agent [indocyanine green (ICG)] was loaded into the Au@BSA-Gd nanoparticles because of their unique, hollow, and porous structures, thus possessing photodynamic/photothermal property and near-infrared fluorescence (NIRF)/PA imaging capability. As a result, a combined cancer therapy containing the photothermal therapy of Au@BSA-Gd and the synchronous photodynamic/photothermal therapy of ICG was constructed. Furthermore, the well-designed nanocomposites with multiple integrated modalities enabled them to be an ideal nanotheranostic agent for NIRF/PA/CT/MR quadmodal imaging. Therefore, the ICG-loaded albumin-bioinspired gadolinium hybrid-functionalized hollow gold nanoshells (ICG-Au@BSA-Gd) hold great promise as a theranostic platform for simultaneous therapeutic monitoring and precise cancer therapy.

  2. Use of Liver Function Tests as First-line Diagnostic Tools for Predicting Common Bile Duct Stones in Acute Cholecystitis Patients.

    Science.gov (United States)

    Ahn, Keun Soo; Yoon, Yoo-Seok; Han, Ho-Seong; Cho, Jai Young

    2016-08-01

    Prior studies have examined the use of liver function tests (LFT) for predicting the presence of common bile duct (CBD) stones in chronic cholecystitis (CC) patients. It is currently unclear whether LFT are also useful for predicting CBD stones in patients with acute cholecystitis (AC). Of 1059 patients who visited an emergency room with gallbladder-related symptoms between March 2004 and December 2009, 854 patients were analyzed, and were divided into three groups (556 AC patients without CBD stones (AC - CBD), 98 AC patients with CBD stones (AC + CBD), and 200 CC patients without CBD stones). We compared the LFT values at admission and the changes in LFT values over time following admission among the three groups. The LFT values were significantly greater in the AC + CBD group than in the AC - CBD groups. Of all the LFT variables analyzed, γ-glutamyl transpeptidase was the most reliable variable for predicting the presence of CBD stones, with a sensitivity of 80.6 % and a specificity of 75.3 % at the cut-off level of 224 IU/L. The elevated LFT values decreased significantly from the start of the follow-up assessment to before cholecystectomy in the AC - CBD group, but were unchanged before stone removal in the AC + CBD group. The LFT values on initial admission and the changes in LFT values over time are reliable predictors of CBD stones in patients with AC.

  3. Diagnostic value of electron-beam computed tomography (EBT). I. cardiac applications

    International Nuclear Information System (INIS)

    Enzweiler, C.N.H.; Lembcke, A.; Rogalla, P.; Taupitz, M.; Wiese, T.H.; Hammm, B.; Becker, C.R.; Reiser, M.F.; Felix, R.; Knollmann, F.D.; Georgi, M.; Weisser, G.; Lehmann, K.J.

    2004-01-01

    Electron beam tomography (EBT) directly competes with other non-invasive imaging modalities, such as multislice computed tomography, magnetic resonance imaging, and echocardiography, in the diagnostic assessment of cardiac diseases. EBT is the gold standard for the detection and quantification of coronary calcium as a preclinical sign of coronary artery disease (CAD). Its standardized examination protocols and the broad experience with this method favor EBT. First results with multislice CT indicate that this new technology may be equivalent to EBT for coronary calcium studies. The principal value of CT-based coronary calcium measurements continues to be an issue of controversy amongst radiologists and cardiologists due to lack of prospective randomized trials. Coronary angiography with EBT is characterized by a high negative predictive value and, in addition, may be indicated in some patients with manifest CAD. It remains to be shown whether coronary angiography with multislice CT is reliable and accurate enough to be introduced into the routine work-up, to replace some of the many strictly diagnostic coronary catheterizations in Germany and elsewhere. Assessment of coronary stent patency with EBT is associated with several problems and in our opinion cannot be advocated as a routine procedure. EBT may be recommended for the evaluation of coronary bypasses to look for bypass occlusions and significant stenoses, which, however, can be equally well achieved with multislice CT. Quantification of myocardial perfusion with EBT could not replace MRI or other modalities in this field. EBT has proven to be accurate, reliable and in some instances equivalent to MRI, which is the gold standard for the quantitative and qualitative evaluation of cardiac function. Some disadvantages not the least of which is the limited distribution of electron beam scanners, favor MRI for functional assessment of the heart. (orig.) [de

  4. Exosomal proteins as potential diagnostic markers in advanced non-small cell lung carcinoma

    DEFF Research Database (Denmark)

    Jakobsen, Kristine Raaby; Paulsen, Birgitte Sandfeld; Bæk, Rikke

    2015-01-01

    Background: Lung cancer is one of the leading causes of cancer-related death. At the time of diagnosis, more than half of the patients will have disseminated disease and, yet, diagnosing can be challenging. New methods are desired to improve the diagnostic work-up. Exosomes are cell-derived vesic......Background: Lung cancer is one of the leading causes of cancer-related death. At the time of diagnosis, more than half of the patients will have disseminated disease and, yet, diagnosing can be challenging. New methods are desired to improve the diagnostic work-up. Exosomes are cell...... analysis was capable of detecting and phenotyping exosomes in all samples from only 10 µL of unpurified plasma. Multivariate analysis using the Random Forests method produced a combined 30-marker model separating the two patient groups with an area under the curve of 0.83, CI: 0.77–0.90. The 30-marker...

  5. Diagnostic issues in pediatric drug allergy.

    Science.gov (United States)

    Caubet, Jean-Christoph; Eigenmann, Philippe A

    2012-08-01

    The serious health hazards posed by drug allergies have long been recognized and are commonly encountered in daily pediatric practice. Our general lack of knowledge of the pathomechanims greatly hampers our ability to correctly diagnose allergic drug reactions. The present review addresses the most recent literature regarding the diagnosis of allergy for the most commonly implicated drugs in children, that is, antibiotics, nonsteroidal anti-inflammatory drugs (NSAID) and vaccines. Systematic approaches have been proposed and, if implemented, will likely reduce the number of children being inappropriately labeled as 'drug allergic'. In case of suspicion of an allergy, a complete allergy work-up should always be performed. This evaluation based on carefully selected diagnostic tests will differ according to the drug involved and the mechanisms suspected. The drug provocation test remains the gold standard and has gained in importance, particularly in children presenting with a benign rash while taking antibiotic treatment. Several new diagnostic tools are currently under investigation and provide promising results. Accurate diagnosis of drug allergy is important not only to prevent serious or even life-threatening reactions, but also to avoid unnecessary drug restriction associated with increased resistance and healthcare costs.

  6. A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders: a report of the Rome Foundation Working Team on cross-cultural, multinational research.

    Science.gov (United States)

    Schmulson, M; Corazziari, E; Ghoshal, U C; Myung, S-J; Gerson, C D; Quigley, E M M; Gwee, K-A; Sperber, A D

    2014-10-01

    Variations in healthcare provision around the world may impact how patients with functional gastrointestinal disorder (FGIDs) are investigated, diagnosed, and treated. However, these differences have not been reviewed. The Multinational Working Team of the Rome Foundation, established to make recommendations on the conduct of multinational, cross-cultural research in FGIDs, identified seven key issues that are analyzed herein: (i) coverage afforded by different healthcare systems/providers; (ii) level of the healthcare system where patients with FGIDs are treated; (iii) extent/types of diagnostic procedures typically undertaken to diagnose FGIDs; (iv) physicians' familiarity with and implementation of the Rome diagnostic criteria in clinical practice; (v) range of medications approved for FGIDs and approval process for new agents; (vi) costs involved in treating FGIDs; and (vii) prevalence and role of complementary/alternative medicine (CAM) for FGIDs. Because it was not feasible to survey all countries around the world, we compared a selected number of countries based on their geographical and ethno-cultural diversity. Thus, we included Italy and South Korea as representative of nations with broad-based coverage of healthcare in the population and India and Mexico as newly industrialized countries where there may be limited provision of healthcare for substantial segments of the population. In light of the paucity of formal publications on these issues, we included additional sources from the medical literature as well as perspectives provided by local experts and the media. Finally, we provide future directions on healthcare issues that should be taken into account and implemented when conducting cross-cultural and multinational research in FGIDs. © 2014 John Wiley & Sons Ltd.

  7. Estimating the arterial input function from dynamic contrast-enhanced MRI data with compensation for flow enhancement (II): Applications in spine diagnostics and assessment of crohn's disease.

    Science.gov (United States)

    van Schie, Jeroen J N; Lavini, Cristina; van Vliet, Lucas J; Kramer, Gem; Pieters-van den Bos, Indra; Marcus, J T; Stoker, Jaap; Vos, Frans M

    2018-05-01

    Pharmacokinetic (PK) models can describe microvascular density and integrity. An essential component of PK models is the arterial input function (AIF) representing the time-dependent concentration of contrast agent (CA) in the blood plasma supplied to a tissue. To evaluate a novel method for subject-specific AIF estimation that takes inflow effects into account. Retrospective study. Thirteen clinical patients referred for spine-related complaints; 21 patients from a study into luminal Crohn's disease with known Crohn's Disease Endoscopic Index of Severity (CDEIS). Dynamic fast spoiled gradient echo (FSPGR) at 3T. A population-averaged AIF, AIFs derived from distally placed regions of interest (ROIs), and the new AIF method were applied. Tofts' PK model parameters (including v p and K trans ) obtained with the three AIFs were compared. In the Crohn's patients K trans was correlated to CDEIS. The median values of the PK model parameters from the three methods were compared using a Mann-Whitney U-test. The associated variances were statistically assessed by the Brown-Forsythe test. Spearman's rank correlation coefficient was computed to test the correlation of K trans to CDEIS. The median v p was significantly larger when using the distal ROI approach, compared to the two other methods (P < 0.05 for both comparisons, in both applications). Also, the variances in v p were significantly larger with the ROI approach (P < 0.05 for all comparisons). In the Crohn's disease study, the estimated K trans parameter correlated better with the CDEIS (r = 0.733, P < 0.001) when the proposed AIF was used, compared to AIFs from the distal ROI method (r = 0.429, P = 0.067) or the population-averaged AIF (r = 0.567, P = 0.011). The proposed method yielded realistic PK model parameters and improved the correlation of the K trans parameter with CDEIS, compared to existing approaches. 3 Technical Efficacy Stage 1 J. Magn. Reson. Imaging 2018;47:1197-1204. © 2017

  8. Psychologists' Diagnostic Processes during a Diagnostic Interview

    NARCIS (Netherlands)

    Groenier, M.; Beerthuis, R.J.; Pieters, J.M.; Witteman, C.L.M.; Swinkels, J.A.

    2011-01-01

    In mental health care, psychologists assess clients’ complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists’ diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common

  9. Psychologists' diagnostic processes during a diagnostic interview

    NARCIS (Netherlands)

    Groenier, Marleen; Beerthuis, Vos R.J.; Pieters, Julius Marie; Witteman, C.L.M.; Witteman, Cilia L.M.; Swinkels, Jan A.

    2011-01-01

    In mental health care, psychologists assess clients’ complaints, analyze underlying problems, and identify causes for these problems, to make treatment decisions. We present a study on psychologists’ diagnostic processes, in which a mixed-method approach was employed. We aimed to identify a common

  10. INTEGRATED DIAGNOSTIC TECHNIQUE FOR NUCLEAR POWER PLANTS

    Directory of Open Access Journals (Sweden)

    AKIO GOFUKU

    2014-12-01

    Full Text Available It is very important to detect and identify small anomalies and component failures for the safe operation of complex and large-scale artifacts such as nuclear power plants. Each diagnostic technique has its own advantages and limitations. These facts inspire us not only to enhance the capability of diagnostic techniques but also to integrate the results of diagnostic subsystems in order to obtain more accurate diagnostic results. The article describes the outline of four diagnostic techniques developed for the condition monitoring of the fast breeder reactor “Monju”. The techniques are (1 estimation technique of important state variables based on a physical model of the component, (2 a state identification technique by non-linear discrimination function applying SVM (Support Vector Machine, (3 a diagnostic technique applying WT (Wavelet Transformation to detect changes in the characteristics of measurement signals, and (4 a state identification technique effectively using past cases. In addition, a hybrid diagnostic system in which a final diagnostic result is given by integrating the results from subsystems is introduced, where two sets of values called confidence values and trust values are used. A technique to determine the trust value is investigated under the condition that the confidence value is determined by each subsystem.

  11. Paradigm Shifts in Ophthalmic Diagnostics.

    Science.gov (United States)

    Sebag, J; Sadun, Alfredo A; Pierce, Eric A

    2016-08-01

    Future advances in ophthalmology will see a paradigm shift in diagnostics from a focus on dysfunction and disease to better measures of psychophysical function and health. Practical methods to define genotypes will be increasingly important and non-invasive nanotechnologies are needed to detect molecular changes that predate histopathology. This is not a review nor meant to be comprehensive. Specific topics have been selected to illustrate the principles of important paradigm shifts that will influence the future of ophthalmic diagnostics. It is our impression that future evaluation of vision will go beyond visual acuity to assess ocular health in terms of psychophysical function. The definition of disease will incorporate genotype into what has historically been a phenotype-centric discipline. Non-invasive nanotechnologies will enable a paradigm shift from disease detection on a cellular level to a sub-cellular molecular level. Vision can be evaluated beyond visual acuity by measuring contrast sensitivity, color vision, and macular function, as these provide better insights into the impact of aging and disease. Distortions can be quantified and the psychophysical basis of vision can be better evaluated than in the past by designing tests that assess particular macular cell function(s). Advances in our understanding of the genetic basis of eye diseases will enable better characterization of ocular health and disease. Non-invasive nanotechnologies can assess molecular changes in the lens, vitreous, and macula that predate visible pathology. Oxygen metabolism and circulatory physiology are measurable indices of ocular health that can detect variations of physiology and early disease. This overview of paradigm shifts in ophthalmology suggests that the future will see significant improvements in ophthalmic diagnostics. The selected topics illustrate the principles of these paradigm shifts and should serve as a guide to further research and development. Indeed

  12. Intelligent diagnostics systems

    Science.gov (United States)

    Mcquiston, Barbara M.; Dehoff, Ronald L.

    1992-01-01

    Intelligent systems have been applied to today's problems and could also be applied to space operations integrity. One of these systems is the XMAN tool designed for 'troubleshooting' jet engines. XMAN is the eXpert MAiNtenance tool developed to be an expert information analysis tool which stores trending and diagnostic data on Air Force engines. XMAN operates with a 'network topology' which follows a flow chart containing engine management information reports required by the governments technical order procedures. With XMAN technology, the user is able to identify engine problems by presenting the assertions of the fault isolation logic and attempting to satisfy individual assertions by referring to the databases created by an engine monitoring system. The troubleshooting process requires interaction between the technician and the computer to acquire new evidence form auxiliary maintenance tests corroboration of analytical results to accurately diagnose equipment malfunctions. This same technology will be required for systems which are functioning in space either with an onboard crew, or with an unmanned system. The technology and lessons learned developing this technology while suggesting definite applications for its use with developing space systems are addressed.

  13. Beam diagnostics and control for SLC

    International Nuclear Information System (INIS)

    Ross, M.C.

    1987-02-01

    Construction of the SLAC Linear Collider has posed some new problems in beam diagnostic device design. Typical beam sizes are small when compared with conventional storage rings, orbit tolerances are tighter and the pulsed nature of the machine means that signal to noise enhancement by averaging is not always possible. Thus the diagnostics must have high resolution, high absolute accuracy and must deliver data from a single pulse. In practice the required performance level depends on the function and dynamics of a given region in the collider. This paper reviews the major beam diagnostic systems and then discusses the global data acquisition schemes. Each system is described only in a very cursory fashion

  14. Bangladesh Jobs Diagnostic

    OpenAIRE

    Farole, Thomas; Cho, Yoonyoung

    2017-01-01

    This Jobs Diagnostic presents the characteristics and constraints of the labor market in Bangladesh, identifies the objectives of the jobs agenda, and proposes a policy framework to progress toward them. This multisectoral diagnostic assesses the relationships between supply- and demand-side factors that interact to determine job creation, quality, and inclusion outcomes. Understanding the...

  15. Reliability and diagnostic of modular systems

    Directory of Open Access Journals (Sweden)

    J. Kohlas

    2014-01-01

    Full Text Available Reliability and diagnostic are in general two problems discussed separately. Yet the two problems are in fact closely related to each other. Here, this relation is considered in the simple case of modular systems. We show, how the computation of reliability and diagnostic can efficiently be done within the same Bayesian network induced by the modularity of the structure function of the system.

  16. Proposed Diagnostic Criteria for Smartphone Addiction

    OpenAIRE

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han; Lin, Sheng-Hsuan

    2016-01-01

    Background Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. Methods We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each parti...

  17. MR diagnostics after Ross procedure

    International Nuclear Information System (INIS)

    Steffens, J.C.; Link, J.; Harringer, W.; Haverich, A.; Heller, M.

    1996-01-01

    Purpose: To determine the ability of MRI to diagnose morphological and functional changes in patients after Ross procedure. Material and methods: During one year, 5 patients after Ross procedure were studied by MRI. T 1 -weighted spin-echo sequences in different orientations as well as cine sequences and a VENC-sequence were used. Results: In all patients the morphology including the postoperative changes could be visualised by MRI. The cine sequences provided functional information on valvular and ventricular function. VENC-MR yielded an exact quantification of the regurgitant fraction. Conclusion: MRI is capable of providing all important diagnostic information in patients after Ross procedure such as valvular and ventricular function and valvular and outflow tract morphology in a single examination. (orig.) [de

  18. Noninvasive diagnostic tools for pelvic congestion syndrome: a systematic review.

    Science.gov (United States)

    Steenbeek, Miranda P; van der Vleuten, Carine J M; Schultze Kool, Leo J; Nieboer, Theodoor E

    2018-01-30

    In the work-up of patients with suspected pelvic congestion syndrome, venography is currently the gold standard. Yet if non-invasive diagnostic tools are found to be accurate, invasive venography might no longer be indicated as necessary. A literature search in Pubmed and EMBASE was performed from inception until May 6th 2017. Studies comparing non-invasive diagnostic tools to a reference standard in the work-up of patients with (suspected) pelvic congestion syndrome were included. Relevant data were extracted and methodological quality of individual included studies was assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Nine studies matched our inclusion criteria. Six studies compared ultrasonography to venography and three studies described a magnetic resonance imaging technique. In using transvaginal ultrasonography, the occurrence of a vein greater than five mm crossing the uterine body had a specificity of 91% (95% CI; 77-98%) and occurrence of pelvic varicoceles a sensitivity and specificity of 100% (95% CI; 89-100%) and 83-100% (95% CI; 66-93%), respectively. In transabdominal ultrasonography, reversed caudal flow in the ovarian vein accounted for a sensitivity of 100% (95% CI; 84-100%). Detection of pelvic congestion syndrome with magnetic resonance imaging techniques resulted in a sensitivity varying from 88 to 100%. The sensitivity of ultrasonography and magnetic resonance imaging seem to be adequate, which indicates a role for both tests in an early stage of the diagnostic workup. However, due to methodological flaws and diversity in outcome parameters, more high standard research is necessary to establish a clear advice for clinical practice. © 2018 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

  19. CIT diagnostic computer interface studies

    International Nuclear Information System (INIS)

    Rauch, W.; Hayes, S.; Lowrance, J.; Oliaro, G.; Sauthoff, N.; Sichta, P.; Stark, W.

    1987-01-01

    This paper presents the on-going work performed in proposing instrumentation equipment and communications networks for the Diagnostic Data Acquisition and Diagnostic Instrumentation and Control System for the Compact Ignition Torus (CIT), which will begin operation in 1993. Consideration is given to the system criteria and requirements and their influence on the appropriate application of instrumentation and communication technologies to the system. This paper concentrates on the investigation of the bus communication technologies as they apply to the CIT data acquisition system. It compares CAMAC, VME, and FASTBUS as standards for data acquisition. The paper describes the connectivity between VAX equipment and CAMAC and VME instrumentation systems. Instrumentation and communication functionality and performance levels are presented as factors important to the overall data acquisition system performance

  20. Decisions to withhold diagnostic investigations in nursing home patients with a clinical suspicion of venous thromboembolism.

    Directory of Open Access Journals (Sweden)

    Henrike J Schouten

    Full Text Available This study aimed to gather insights in physicians' considerations for decisions to either refer for- or to withhold additional diagnostic investigations in nursing home patients with a suspicion of venous thromboembolism.Our study was nested in an observational study on diagnostic strategies for suspected venous thromboembolism in nursing home patients. Patient characteristics, bleeding-complications and mortality were related to the decision to withhold investigations. For a better understanding of the physicians' decisions, 21 individual face-to-face in-depth interviews were performed and analysed using the grounded theory approach.Referal for additional diagnostic investigations was forgone in 126/322 (39.1% patients with an indication for diagnostic work-up. 'Blind' anticoagulant treatment was initiated in 95 (75.4% of these patients. The 3 month mortality rates were higher for patients in whom investigations were withheld than in the referred patients, irrespective of anticoagulant treatment (odds ratio 2.45; 95% confidence interval 1.40 to 4.29 but when adjusted for the probability of being referred (i.e. the propensity score, there was no relation of non-diagnosis decisions to mortality (odds ratio 1.75; 0.98 to 3.11. In their decisions to forgo diagnostic investigations, physicians incorporated the estimated relative impact of the potential disease; the potential net-benefits of diagnostic investigations and whether performing investigations agreed with established management goals in advance care planning.Referral for additional diagnostic investigations is withheld in almost 40% of Dutch nursing home patients with suspected venous thromboembolism and an indication for diagnostic work-up. We propose that, given the complexity of these decisions and the uncertainty regarding their indirect effects on patient outcome, more attention should be focused on the decision to either use or withhold additional diagnostic tests.

  1. Diagnostics on Z (invited)

    International Nuclear Information System (INIS)

    Nash, T. J.; Derzon, M. S.; Chandler, G. A.; Fehl, D. L.; Leeper, R. J.; Porter, J. L.; Spielman, R. B.; Ruiz, C.; Cooper, G.; McGurn, J.

    2001-01-01

    The 100 ns, 20 MA pinch-driver Z is surrounded by an extensive set of diagnostics. There are nine radial lines of sight set at 12 o above horizontal and each of these may be equipped with up to five diagnostic ports. Instruments routinely fielded viewing the pinch from the side with these ports include x-ray diode arrays, photoconducting detector arrays, bolometers, transmission grating spectrometers, time-resolved x-ray pinhole cameras, x-ray crystal spectrometers, calorimeters, silicon photodiodes, and neutron detectors. A diagnostic package fielded on axis for viewing internal pinch radiation consists of nine lines of sight. This package accommodates virtually the same diagnostics as the radial ports. Other diagnostics not fielded on the axial or radial ports include current B-dot monitors, filtered x-ray scintillators coupled by fiber optics to streak cameras, streaked visible spectroscopy, velocity interferometric system for any reflector, bremsstrahlung cameras, and active shock breakout measurement of hohlraum temperature. The data acquisition system is capable of recording up to 500 channels and the data from each shot is available on the Internet. A major new diagnostic presently under construction is the BEAMLET backlighter. We will briefly describe each of these diagnostics and present some of the highest-quality data from them

  2. Technical diagnostics functioning machines and mechanisms

    Science.gov (United States)

    Kiselev, M. I.; Pronyakin, V. I.; Tulekbaeva, A. K.

    2018-02-01

    Article discusses the machines and mechanisms technical state monitoring problem. Approaches for estimating mechanical systems current technical state, defects detection and evaluation of mechanical elements degradation levels are considered. The paper analyzes the traditional methods offered in international and national standards, especially vibrodiagnostics. An advanced phase method is presented which is based on registration the kinematic parameters of the mechanism running cycle. The result of coupling the phase method and mathematical modeling is shown, and simulation comparison with the experimental data is presented.

  3. Muscle diseases with prominent joint contractures: Main entities and diagnostic strategy.

    Science.gov (United States)

    Eymard, B; Ferreiro, A; Ben Yaou, R; Stojkovic, T

    2013-01-01

    Muscle diseases may have various clinical manifestations including muscle weakness, atrophy or hypertrophy and joint contractures. A spectrum of non-muscular manifestations (cardiac, respiratory, cutaneous, central and peripheral nervous system) may be associated. Few of these features are specific. Limb joint contractures or spine rigidity, when prevailing over muscle weakness in ambulant patients, are of high diagnostic value for diagnosis orientation. Within this context, among several disorders, four groups of diseases should systematically come to mind including the collagen VI-related myopathies, the Emery-Dreifuss muscular dystrophies, the SEPN1 and FHL1 related myopathies. More rarely other genetic or acquired myopathies may present with marked contractures. Diagnostic work-up should include a comprehensive assessment including family history, neurological, cardiologic and respiratory evaluations. Paraclinical investigations should minimally include muscle imaging and electromyography. Muscle and skin biopsies as well as protein and molecular analyses usually help to reach a precise diagnosis. We will first describe the main muscle and neuromuscular junction diseases where contractures are typically a prominent symptom of high diagnostic value for diagnosis orientation. In the following chapters, we will present clues for the diagnostic strategy and the main measures to be taken when, at the end of the diagnostic work-up, no definite muscular disease has been identified. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  4. A landslide-quake detection algorithm with STA/LTA and diagnostic functions of moving average and scintillation index: A preliminary case study of the 2009 Typhoon Morakot in Taiwan

    Science.gov (United States)

    Wu, Yu-Jie; Lin, Guan-Wei

    2017-04-01

    Since 1999, Taiwan has experienced a rapid rise in the number of landslides, and the number even reached a peak after the 2009 Typhoon Morakot. Although it is proved that the ground-motion signals induced by slope processes could be recorded by seismograph, it is difficult to be distinguished from continuous seismic records due to the lack of distinct P and S waves. In this study, we combine three common seismic detectors including the short-term average/long-term average (STA/LTA) approach, and two diagnostic functions of moving average and scintillation index. Based on these detectors, we have established an auto-detection algorithm of landslide-quakes and the detection thresholds are defined to distinguish landslide-quake from earthquakes and background noises. To further improve the proposed detection algorithm, we apply it to seismic archives recorded by Broadband Array in Taiwan for Seismology (BATS) during the 2009 Typhoon Morakots and consequently the discrete landslide-quakes detected by the automatic algorithm are located. The detection algorithm show that the landslide-detection results are consistent with that of visual inspection and hence can be used to automatically monitor landslide-quakes.

  5. The size of the thymus: an important immunological diagnostic tool?

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth

    2003-01-01

    of the thymus relevant to its function and could measurement of the thymus be a useful immunological diagnostic tool in the investigation of thymic function in humans with a depressed immune system? Conclusion: Studies using the size of the thymus as an immunological diagnostic tool should be encouraged....

  6. Melioidosis Diagnostic Workshop, 20131

    Science.gov (United States)

    AuCoin, David; Baccam, Prasith; Baggett, Henry C.; Baird, Rob; Bhengsri, Saithip; Blaney, David D.; Brett, Paul J.; Brooks, Timothy J.G.; Brown, Katherine A.; Chantratita, Narisara; Cheng, Allen C.; Dance, David A.B.; Decuypere, Saskia; Defenbaugh, Dawn; Gee, Jay E.; Houghton, Raymond; Jorakate, Possawat; Lertmemongkolchai, Ganjana; Limmathurotsakul, Direk; Merlin, Toby L.; Mukhopadhyay, Chiranjay; Norton, Robert; Peacock, Sharon J.; Rolim, Dionne B.; Simpson, Andrew J.; Steinmetz, Ivo; Stoddard, Robyn A.; Stokes, Martha M.; Sue, David; Tuanyok, Apichai; Whistler, Toni; Wuthiekanun, Vanaporn; Walke, Henry T.

    2015-01-01

    Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions. PMID:25626057

  7. Melioidosis diagnostic workshop, 2013.

    Science.gov (United States)

    Hoffmaster, Alex R; AuCoin, David; Baccam, Prasith; Baggett, Henry C; Baird, Rob; Bhengsri, Saithip; Blaney, David D; Brett, Paul J; Brooks, Timothy J G; Brown, Katherine A; Chantratita, Narisara; Cheng, Allen C; Dance, David A B; Decuypere, Saskia; Defenbaugh, Dawn; Gee, Jay E; Houghton, Raymond; Jorakate, Possawat; Lertmemongkolchai, Ganjana; Limmathurotsakul, Direk; Merlin, Toby L; Mukhopadhyay, Chiranjay; Norton, Robert; Peacock, Sharon J; Rolim, Dionne B; Simpson, Andrew J; Steinmetz, Ivo; Stoddard, Robyn A; Stokes, Martha M; Sue, David; Tuanyok, Apichai; Whistler, Toni; Wuthiekanun, Vanaporn; Walke, Henry T

    2015-02-01

    Melioidosis is a severe disease that can be difficult to diagnose because of its diverse clinical manifestations and a lack of adequate diagnostic capabilities for suspected cases. There is broad interest in improving detection and diagnosis of this disease not only in melioidosis-endemic regions but also outside these regions because melioidosis may be underreported and poses a potential bioterrorism challenge for public health authorities. Therefore, a workshop of academic, government, and private sector personnel from around the world was convened to discuss the current state of melioidosis diagnostics, diagnostic needs, and future directions.

  8. Laser fusion diagnostics

    International Nuclear Information System (INIS)

    Coleman, L.W.

    1978-01-01

    High temporal and spatial resolution optical diagnostics of laser performance, energy balance, and applicable plasma probing techniques are reviewed. A variety of spatially, temporally and spectrally resolved x-ray diagnostics techniques and instruments as discussed. Particular emphasis is on high spatial resolution imaging techniques and applications and on high temporal resolution x-ray streak camera applications to exploding pusher target experiments. Finally, particle diagnostics and systems designed to diagnose target performance via yield and temperature measurements and techniques designed to determine the characteristics of compressed targets are discussed

  9. DIAGNOSTIC VALUE OF SEROLOGICAL MARKERS OF RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    Aleksei Leonidovich Maslaynski

    2012-01-01

    Full Text Available Rheumatoid arthritis (RA is a classic autoimmune disease associated with the production of wide range of autoantibodies, and their detection has diagnostic and prognostic implication. The objective of this study was to estimate the diagnostic value of antibodies against modified citrullinated vimentin (AMCV and nuclear antigen RA33 of the IgA rheumatoid factor (RF versus the value of routinely used profile of autoantibodies in diagnostic work-up of RA. Material and methods. 253 patients with RA prehistory of varying duration were included into the study group. The control group was comprised of 92 patients, including patients with seronegative spondyloarthropathies and diffuse connective tissue diseases, as well as sex and age matched healthy controls. Serum levels of IgM and IgA RF, antibodies against cyclic citrullinated peptide (ACCP, ACMV, anti-keratin antibodies (AKA, antibodies against RA33 antigen (ARA33 and antinuclear factor (ANF were measured in all patients and controls. Results and discussion. Diagnostic sensitivity of AMCV equaled 78%, ACCP — 77%, IgM RF — 71%, IgA RF — 43%, AKA — 43%, ARA33 — 31% and ANF — 31%. All anti-citrullinic antibodies (AKA, ACCP, ACMV were significantly more commonly associated with IgM RF. Among RF and ACCP seronegative patients ACMV were found in 24% cases with 20 IU/Ml detection threshold, and in 21% — with 30 IU/Ml, allowing to increase diagnostic specificity of the test up to 91% with the increment of diagnostic threshold. Incidence of ARA33 was not significantly different among the RF and ACCP positive or negative subgroups, thus making ARA33 an independent RA marker. Specificity of this marker was 87,9%, thus making it inferior to RF and ACCP by a composite of diagnostic characteristics. Conclusions. Integrated measurement of ACMV and ARA33 is a rational approach at the second stage of serologic testing work-up in suspected cases of RA onset, when initial RF and ACCP tests were negative.

  10. Functional

    Directory of Open Access Journals (Sweden)

    Fedoua Gandia

    2014-07-01

    Full Text Available The study was carried out to investigate the effects of inhaled Mg alone and associated with F in the treatment of bronchial hyperresponsiveness. 43 male Wistar rats were randomly divided into four groups and exposed to inhaled NaCl 0.9%, MeCh, MgSO4 and MgF2. Pulmonary changes were assessed by means of functional tests and quantitative histological examination of lungs and trachea. Results revealed that delivery of inhaled Mg associated with F led to a significant decrease of total lung resistance better than inhaled Mg alone (p < 0.05. Histological examinations illustrated that inhaled Mg associated with F markedly suppressed muscular hypertrophy (p = 0.034 and bronchoconstriction (p = 0.006 in MeCh treated rats better than inhaled Mg alone. No histological changes were found in the trachea. This study showed that inhaled Mg associated with F attenuated the main principle of the central components of changes in MeCh provoked experimental asthma better than inhaled Mg alone, potentially providing a new therapeutic approach against asthma.

  11. [Results from a general training hospital for the implementation of a diagnostic workup for pulmonary embolism according to the Dutch Institute for Health Care Improvement

    NARCIS (Netherlands)

    Kamphuisen, P.W.; Jacobs, E.M.G.; Mol, J.J.; Rijnders, A.J.; Ullmann, E.F.

    2002-01-01

    OBJECTIVE: To evaluate the active implementation of the Dutch Institute for Healthcare Improvement's guideline for the diagnostic work-up for pulmonary embolism in a general training hospital, and to analyse reasons for not following the guideline strategy. DESIGN: Partly retrospective and partly

  12. A systematic review on the accuracy of diagnostic procedures for infravesical obstruction in boys.

    Directory of Open Access Journals (Sweden)

    Pauline M L Hennus

    Full Text Available BACKGROUND: Infravesical obstruction leads to kidney and bladder dysfunction in a significant proportion of boys. The aim of this review is to determine the value of diagnostic tests for ascertainment of infravesical obstruction in boys. METHODOLOGY: We searched PubMed and EMBASE databases until January 1, 2013, to identify papers that described original diagnostic accuracy research for infravesical obstruction in boys. We extracted information on (1 patient characteristics and clinical presentation of PUV and (2 diagnostic pathway, (3 diagnostic accuracy measures and (4 assessed risk of bias. PRINCIPAL FINDINGS: We retrieved 15 studies describing various diagnostic pathways in 1,189 boys suspected for infravesical obstruction. The included studies reflect a broad clinical spectrum of patients, but all failed to present a standardised approach to confirm the presence and severity of obstruction. The risk of bias of included studies is rather high due to work-up bias and missing data. CONCLUSIONS: As a consequence of low quality of methods of the available studies we put little confidence in the reported estimates for the diagnostic accuracy of US, VCUG and new additional tests for ruling in or ruling out infravesical obstruction. To date, firm evidence to support common diagnostic pathways is lacking. Hence, we are unable to draw conclusions on diagnostic accuracy of tests for infravesical obstruction. In order to be able to standardise the diagnostic pathway for infravesical obstruction, adequate design and transparent reporting is mandatory.

  13. [Comparison of Diagnostic Values of Instantaneous Wave-Free R atio and Fractional Flow R eserve With Noninvasive Methods for Evaluating Myocardial Ischemia in Assessment of the Functional Significance of Intermediate Coronary Stenoses in Patients With Chronic Ischemic Heart Disease].

    Science.gov (United States)

    Ansheles, A A; Sergienko, B V; Darenskiy, I D; Gramovich, V V; Zharova, A E; Mitroshkin, G M; Matchin, G Y; Atanesyan, V R

    2017-08-01

    To compare the diagnostic accuracy of instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) with noninvasive methods in assessment of the functional significance of moderate coronary stenoses in patients with chronic ischemic heart disease (IHD). We included in this study 50 patients with chronic or suspected IHD and moderate coronary stenoses (50-70%; 74 stenoses). Values of iFR and FFR were determined within 10 days after noninvasive stress tests (combination of stress-echo and SPECT). The values of iFR and FFR were compared with the results of noninvasive methods by ROC-analysis. Coronary artery stenosis was considered functionally important if at least one of noninvasive tests (stress-echo or SPECT) demonstrated positive result. The results of noninvasive stress-tests were positive in 14 patients (28%). ROC area under the curve (AUC) for iFR - 0.961±0.019 (95%CI 0.888-0.992). The best cut-off point for iFR is 0.92 (sensitivity 100, specificity 84%). ROC AUC for FFR - 0.893±0.041 (95%CI 0.79-0.96). The best cut-off point for FFR is 0.81 (sensitivity 100% and specificity 69%). There was no significant difference between iFR and FFR ROC-curves (р=0.0845). The values of iFR and FFR have equivalent agreement with the results of noninvasive tests commonly used to detect myocardial ischemia in patients with moderate coronary stenoses.

  14. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

    Tao, Ran; Huang, Xiuqin; Wang, Jinan; Zhang, Huimin; Zhang, Ying; Li, Mengchen

    2010-03-01

    The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

  15. Prenatal Genetic Diagnostic Tests

    Science.gov (United States)

    ... are available for many inherited disorders. The main disadvantage is that diagnostic testing carries a very small ... chromosomes, arranged in order of size. Microarray: A technology that examines all of a person’s genes to ...

  16. National Convective Weather Diagnostic

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Current convective hazards identified by the National Convective Weather Detection algorithm. The National Convective Weather Diagnostic (NCWD) is an automatically...

  17. Rotorcraft Diagnostics, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Under this SBIR program, Ridgetop will introduce the first low-cost, low-power, and lightweight data monitoring solution for rotorcraft diagnostics. The solution is...

  18. Diagnostic interventions in nuclear medicine

    International Nuclear Information System (INIS)

    Thrall, J.H.; Swanson, D.P.

    1989-01-01

    Diagnostic interventions in nuclear medicine may be defined as the coadministration of a nonradioactive drug or application of a physical stimulus or physiologic maneuver to enhance the diagnostic utility of a nuclear medicine test. The rationale for each interventional maneuver follows from the physiology or metabolism of the particular organ or organ system under evaluation. Diagnostic inference is drawn from the pattern of change in the biodistribution of the tracer in response to the intervention-induced change in metabolism or function. In current practice, the most commonly performed interventional maneuvers are aimed at studies of the heart, genitourinary system, hepatobiliary system, and gastrointestinal tract. The single most commonly performed interventional study in the United States is the stress Thallium-201 myocardial perfusion scan aimed at the diagnosis of coronary artery disease. The stress portion of the study is accomplished with dynamic leg exercise on a treadmill and is aimed at increasing myocardial oxygen demands. Areas of myocardium distal to hemodynamically significant lesions in the coronary arteries become ischemic at peak stress due to the inability of the stenotic vessel to respond to the oxygen demand/blood flow needs of the myocardium. Ischemic areas are readily recognized as photopenic defects on scans obtained immediately after exercise, with normalization upon delayed imaging. Diuresis renography is aimed at the differential diagnosis of hydroureteronephrosis. By challenging the urinary tract collecting structures with an augmented urine flow, dilated, unobstructed systems can be differentiated from systems with significant mechanical obstruction. 137 references

  19. DIAGNOSTIC KARATE TESTS

    Directory of Open Access Journals (Sweden)

    Dragan Doder

    2006-06-01

    Full Text Available The basic condition of a successful process of karate training is making diagnosis of any sportsman. Assessment is usually done by a coach and it is a part of technical process; quantity measurements are also a part of the evaluation which contains these tests. The suggested diagnostic karate tests are based on the knowledge of the specific karate characteristics and on the research which was done so far (Zulić 1985, Milošević and Zulić 1988, Jovanović 1981, 1988, Mudrić 1994, Doder 1998, 2000, 2005, Babiak, Doder, Savić, Golik2001, Savić, Doder, Babiak 2002. Karate as a type of sport demands diagnosis of many relevant characteristics, abilities and features that are thought to be predominant in the analysis of this kind of sport. Knowing all relevant anthropologic karate dimensions it is possible to select necessary instruments for measuring and to test those dimensions that karate results depend on. Considering all scientific knowledge and achievements in this field the fallowing tests are suggested: Morphologic measures: body height, arm span, arm length, pelvis width, hand ankle diameter, knees diameter, elbow diameter, body weight, parameters of one’s chest, stomach, the upper and lower part of one’s arm and legs, then to examine the skin fold of any sportsman’s arms, back, stomach and legs. Functional diagnosis: measuring of the maximum amount of oxygen breathed in. Mobility tests: the speed of simple movements, the speed of karate technique, deep bow on the bench, shoulders capability of moving, the static strength of hands, legs, shoulders and middle part of a body, jump height, an average jump, and the percentage of maximum achievement in jumping.

  20. Spectrum analysis in beam diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, S.Y.; Weng, W.T.

    1993-04-23

    In this article, we discuss fundamentals of the spectrum analysis in beam diagnostics, where several important particle motions in a circular accelerator are considered. The properties of the Fourier transform are presented. Then the coasting and the bunched beam motion in both longitudinal and transverse are studied. The discussions are separated for the signal particle, multiple particle, and the Schottky noise cases. To demonstrate the interesting properties of the beam motion spectrum, time domain functions are generated, and then the associated spectra are calculated and plotted. In order to show the whole picture in a single plot, some data have been scaled, therefore they may not be realistic in an accelerator.

  1. Optics/Optical Diagnostics Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The Optics/Optical Diagnostics Laboratory supports graduate instruction in optics, optical and laser diagnostics and electro-optics. The optics laboratory provides...

  2. Adverse Food Reaction and Functional Gastrointestinal Disorders: Role of the Dietetic Approach.

    Science.gov (United States)

    Pasqui, Francesca; Poli, Carolina; Colecchia, Antonio; Marasco, Giovanni; Festi, Davide

    2015-09-01

    Bloating, abdominal discomfort or pain, disturbed bowel habits are very common symptoms, frequently reported by the patients soon after food ingestion. These symptoms may occur in different clinical conditions, such as functional bowel disorders, food adverse reactions, gluten-related syndromes, which frequently are interrelated. Consequently, in clinical practice, it is necessary to perform a correct diagnosis in order to identify, for the single patient, the most appropriate therapeutic strategy, which may include not only specific drugs, but also, and mainly, life style changes (healthy nutritional behavior and constant physical activity). The aim of this review is to provide to the general physician, according to the available evidence, the most appropriate diagnostic work-ups for recognizing the different clinical scenarios (i.e. food allergy and intolerance, functional bowel diseases, gluten-related syndromes), to identify their clinical interrelationships and to suggest the most appropriate management. In fact, as far as food intolerances are concerned, it is well known that the number of patients who believe that their symptoms are related to food intolerance is increasing and consequently they restrict their diet, possibly causing nutritional deficiencies. Furthermore, there is an increasing use of unconventional diagnostic tests for food intolerance which lack accurate scientific evidence; the application of their results may induce misdiagnosis and unhealthy therapeutic choices. Consequently the recognition of food intolerance has to be performed on the basis of reliable tests within an agreed diagnostic workup.

  3. Unified information system for diagnostics of nuclear equipment

    International Nuclear Information System (INIS)

    Babula, J.

    1989-01-01

    The conceptual principles and partial results of modeling selected information functions of an automated diagnostic system for light-water reactor nuclear power plants are summarized. A brief description is given of the (two-level) architecture of this system, requirements put on the structure and operation of databases of the diagnostic stations of the unit as well as of the central diagnostic station of the plant. The basis of the automated diagnostic system is the distributed information system for each unit represented by a computer network, in the nodes of which specialized object-oriented local diagnostic stations are located. Superior to the unit level is the whole-plant level with its own computer network. The computer networks are of the ETHERNET type. The main diagnostic station is based on an SM 52/12 computer, whereas multiprocessor units of the Intel iAPX-432 type are considered to be used as the local diagnostic stations. The automated diagnostic system operates in two basic modes: in the normal mode, all diagnostic stations evaluate the diagnostic signals and information data and transmit their outputs to the unit or central control room of the nuclear power plant, whereas in the diagnostic mode the failure states of the subsystems of the automated diagnostic system are tested at the two levels involved. (Z.M.). 1 fig., 3 refs

  4. Best combination of multiple diagnostic tests for screening purposes.

    Science.gov (United States)

    Qin, Jing; Zhang, Biao

    2010-12-10

    In a medical diagnostic testing problem, multiple diagnostic tests are often available in distinguishing between diseased and nondiseased subjects. Different diagnostic tests are usually sensitive to different aspects of the disease. A desirable approach is to combine multiple diagnostic tests so as to obtain an optimal composite diagnostic test with higher sensitivity and specificity that detects the presence of the disease more accurately. To accomplish this, it has been observed via signal detection theory developed in the 1950s and 1960s, that the optimal combination of different diagnostic variables (i.e. the diagnostic test results) is determined by the likelihood ratio function for the diseased and nondiseased groups. The conventional approach is to fit parametric models for the diseased and nondiseased groups separately and then to use the fitted likelihood ratio function for the best combination of test results. However, this approach is not so robust if the underlying distribution functions are misspecified. Since the optimal combination depends only on the likelihood ratio function, it would be more appropriate to model this function directly. A two-sample semiparametric inference technique is applied to the model for the likelihood ratio function. We consider the best combination of multiple diagnostic tests, and study semiparametric likelihood estimation of the optimal receiver operating characteristic curve and the area under the curve. We present a bootstrap procedure along with some results on simulation and on analysis of two real data sets.

  5. THE DIAGNOSTIC VALUE OF PULSED WAVE TISSUE DOPPLER IMAGING IN ASYMPTOMATIC BETA- THALASSEMIA MAJOR CHILDREN AND YOUNG ADULTS ; RELATION TO CHEMICAL BIOMARKERS OF LEFT VENTRICULAR FUNCTION AND IRON OVERLOAD .

    Directory of Open Access Journals (Sweden)

    Seham Ragab

    2015-08-01

    Full Text Available Background: Cardiac iron toxicity is the leading cause of death among  β-halassaemia major (TM  patients.  Once  heart failure becomes overt , it will be  difficult to reverse . Objectives: To investigate non overt cardiac dysfunctions  in TM patients using  pulsed wave Tissue Doppler  Imaging (TD I and its relation to the iron overload and brain natruritic peptide (BNP. Methods: Thorough  clinical , conventional echo and  pulsed  wave TDI  parameters were compared between  asymtomatic 25 β-TM  patients  and 20 age and gender matched individuals. Serum ferritin and plasma BNP  levels were assayed by  ELISA .  Results: TM patients had significant higher mitral inflow early diastolic (E wave and  non significant other conventional echo  parameters. Pulsed wave TDI revealed systolic and diastolic dysfunctions in the form of significant higher  isovolumetric contraction time (ICT , ejection time ( E T and  isovolumetric relaxation time (IRT with significantly lower  mitral annulus  early diastolic velocity E` (12.07 ±2.06 vs 15.04±2.65 ,P= 0.003  in patients compared to  controls. Plasma BNP was higher in patients compared to the controls.  Plasma BNP and serum ferritin had significant correlation with each other and with pulsed wave conventional and TDI indices of systolic and diastolic functions.  Patients with E/E` ≥ 8 had  significant higher  serum ferritin  and plasma BNP levels compared to those with E/E` ratio < 8 without difference in Hb levels .Conclusion:  Pulsed wave TDI  is an  important diagnostic tool for latent cardiac dysfunction in iron loaded TM patients and is related to iron overload and BNP .

  6. Pitfalls in diagnostic radiology

    Energy Technology Data Exchange (ETDEWEB)

    Peh, Wilfred C.G. (ed.) [Khoo Teck Puat Hospital (Singapore). Dept. of Diagnostic Radiology

    2015-04-01

    Only textbook to focus primarily on the topic of pitfalls in diagnostic radiology. Highlights the pitfalls in a comprehensive and systematic manner. Written by experts in different imaging modalities and subspecialties from reputable centers across the world. The practice of diagnostic radiology has become increasingly complex, with the use of numerous imaging modalities and division into many subspecialty areas. It is becoming ever more difficult for subspecialist radiologists, general radiologists, and residents to keep up with the advances that are occurring year on year, and this is particularly true for less familiar topics. Failure to appreciate imaging pitfalls often leads to diagnostic error and misinterpretation, and potential medicolegal problems. Diagnostic errors may be due to various factors such as inadequate imaging technique, imaging artifacts, failure to recognize normal structures or variants, lack of correlation with clinical and other imaging findings, and poor training or inexperience. Many, if not most, of these factors are potentially recognizable, preventable, or correctable. This textbook, written by experts from reputable centers across the world, systematically and comprehensively highlights the pitfalls that may occur in diagnostic radiology. Both pitfalls specific to different modalities and techniques and those specific to particular organ systems are described with the help of numerous high-quality illustrations. Recognition of these pitfalls is crucial in helping the practicing radiologist to achieve a more accurate diagnosis.

  7. Pitfalls in diagnostic radiology

    International Nuclear Information System (INIS)

    Peh, Wilfred C.G.

    2015-01-01

    Only textbook to focus primarily on the topic of pitfalls in diagnostic radiology. Highlights the pitfalls in a comprehensive and systematic manner. Written by experts in different imaging modalities and subspecialties from reputable centers across the world. The practice of diagnostic radiology has become increasingly complex, with the use of numerous imaging modalities and division into many subspecialty areas. It is becoming ever more difficult for subspecialist radiologists, general radiologists, and residents to keep up with the advances that are occurring year on year, and this is particularly true for less familiar topics. Failure to appreciate imaging pitfalls often leads to diagnostic error and misinterpretation, and potential medicolegal problems. Diagnostic errors may be due to various factors such as inadequate imaging technique, imaging artifacts, failure to recognize normal structures or variants, lack of correlation with clinical and other imaging findings, and poor training or inexperience. Many, if not most, of these factors are potentially recognizable, preventable, or correctable. This textbook, written by experts from reputable centers across the world, systematically and comprehensively highlights the pitfalls that may occur in diagnostic radiology. Both pitfalls specific to different modalities and techniques and those specific to particular organ systems are described with the help of numerous high-quality illustrations. Recognition of these pitfalls is crucial in helping the practicing radiologist to achieve a more accurate diagnosis.

  8. ORION laser target diagnostics

    International Nuclear Information System (INIS)

    Bentley, C. D.; Edwards, R. D.; Andrew, J. E.; James, S. F.; Gardner, M. D.; Comley, A. J.; Vaughan, K.; Horsfield, C. J.; Rubery, M. S.; Rothman, S. D.; Daykin, S.; Masoero, S. J.; Palmer, J. B.; Meadowcroft, A. L.; Williams, B. M.; Gumbrell, E. T.; Fyrth, J. D.; Brown, C. R. D.; Hill, M. P.; Oades, K.

    2012-01-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  9. ORION laser target diagnostics.

    Science.gov (United States)

    Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

    2012-10-01

    The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

  10. Nova diagnostics summary

    International Nuclear Information System (INIS)

    Slivinsky, V.W.; Drake, R.P.

    1985-01-01

    The authors intend that Nova be the best diagnosed ICF research facility in operation today. The authors experience in providing advanced diagnostics for previous laser systems will be extended at Nova, and will be challenged by the development of new instrumentation to diagnose the more advanced targets made possible by this powerful laser. Previous experience has shown that to understand target performance, the authors must have as complete a set of diagnostics as possible. The Nova diagnostics are divided into two sets: the basic set required for the initial Nova experiments and the more advanced set for later, generally more complex, experiments. The basic set will be operational for the first Nova shots; it was a Nova line item funded with Nova construction money. This basic set is presented in a table

  11. [Cytology in uropathological diagnostics].

    Science.gov (United States)

    Gaisa, N T; Lindemann-Docter, K

    2015-11-01

    Cytology in uropathological diagnostics is mainly performed for oncological purposes. The assessment of malignancy by urothelial cell morphology is therefore decisive; however, cytology is only sensitive enough to detect high-grade tumor cells and the different low-grade tumors cannot be reliably diagnosed. Thus, the four-tier classification system of cytological findings (i.e. negative, atypical cells but significance uncertain, suspicious and positive) refers to high-grade tumor cells only. Furthermore, for valid cytological diagnostics not only the cytological specimen but also clinical information on cystoscopy findings and, if applicable, a biopsy should be evaluated together. In difficult differential diagnostic settings, e.g. differentiation between reactive versus neoplastic atypia or difficult to access lesions in the upper urinary tract, additional fluorescence in situ hybridization of cytological preparations might be helpful. At the moment there are no indications for further immunocytology or additional biomarker tests.

  12. Laser diagnostics of biofractals

    International Nuclear Information System (INIS)

    Ushenko, A G

    1999-01-01

    An optical approach to the problem of modeling and diagnostics of the structures of biofractal formations was considered in relation to human bone tissue. A model was proposed for the optical properties of this tissue, including three levels of fractal organisation: microcrystaline, macrocrystallne, and architectural. The studies were based on laser coherent polarrimetry ensuring the retrieval of the fullest information about the optical and polarisation properties of bone tissue. A method was developed for contactless noninvasive diagnostics of the orientational and mineralogical structure of bone tissue considered as a biofractal. (lasers in medicine)

  13. Diagnostic Imaging Workshop

    International Nuclear Information System (INIS)

    Sociedad Argentina de Fisica Medica

    2012-01-01

    The American Association of Physicist in Medicine (AAPM), the International Organization for Medical Physics (IOMP) and the Argentina Society of Medical Physics (SAFIM) was organized the Diagnostic Imaging Workshop 2012, in the city of Buenos Aires, Argentina. This workshop was an oriented training and scientific exchange between professionals and technicians who work in medical physics, especially in the areas of diagnostic imaging, nuclear medicine and radiotherapy, with special emphasis on the use of multimodal imaging for radiation treatment, planning as well of quality assurance associates.

  14. Diagnostic Imaging for Implants

    Directory of Open Access Journals (Sweden)

    Sanjay M Mallya

    2004-01-01

    Full Text Available Dental implants are a popular modality for permanent tooth replacement. The key to successful implant placement, its subsequent osseointegration and the final prosthetic rehabilitation is proper preoperative assessment. Diagnostic imaging plays an important role in the pre- and post-surgical evaluation process. Imaging is used to evaluate suitability of implant sites, aid in selection of appropriate implants, and finally evaluate implant placement and osseointegration. This article reviews the role of diagnostic imaging in the various phases and the advantages and limitations of the numerous imaging modalities.

  15. Designing high speed diagnostics

    Science.gov (United States)

    Veliz Carrillo, Gerardo; Martinez, Adam; Mula, Swathi; Prestridge, Kathy; Extreme Fluids Team Team

    2017-11-01

    Timing and firing for shock-driven flows is complex because of jitter in the shock tube mechanical drivers. Consequently, experiments require dynamic triggering of diagnostics from pressure transducers. We explain the design process and criteria for setting up re-shock experiments at the Los Alamos Vertical Shock Tube facility, and the requirements for particle image velocimetry and planar laser induced fluorescence measurements necessary for calculating Richtmeyer-Meshkov variable density turbulent statistics. Dynamic triggering of diagnostics allows for further investigation of the development of the Richtemeyer-Meshkov instability at both initial shock and re-shock. Thanks to the Los Alamos National Laboratory for funding our project.

  16. Differentiating cerebral ischemia from functional neurological symptom disorder: a psychosomatic perspective

    Science.gov (United States)

    2014-01-01

    Background The differential diagnosis of pseudo-neurological symptoms often represents a clinical challenge. The Diagnostic and Statistical Manual of Mental Disorders, DSM-5, made an attempt to improve diagnostic criteria of conversion disorder (functional neurological symptom disorder). Incongruences of the neurological examination, i.e. positive neurological signs, indicate a new approach - whereas psychological factors are not necessary anymore. As the DSM-5 will influence the International Classification of Diseases, ICD-11, this is of importance. In the case presented, a history of psychological distress and adverse childhood experiences coexisted with a true neurological disorder. We discuss the relevance of an interdisciplinary assessment and of operationalized diagnostic criteria. Case presentation A 32-year-old man presented twice with neurological symptoms without obvious pathological organic findings. A conversion disorder was considered early on at the second admission by the neurology team. Sticking to ICD-10, this diagnosis was not supported by a specialist for psychosomatic medicine, due to missing hints of concurrent psychological distress in temporal association with neurological symptoms. Further investigations then revealed a deep vein thrombosis (though D-dimers had been negative), which had probably resulted in a crossed embolus. Conclusion The absence of a clear proof of biological dysfunction underlying neurological symptoms should not lead automatically to the diagnosis of a conversion disorder. In contrast, at least in more complex patients, the work-up should include repeated psychological and neurological assessments in close collaboration. According to ICD-10 positive signs of concurrent psychological distress are required, while DSM-5 emphasizes an incongruity between neurological symptoms and neurophysiological patterns of dysfunction. In the case presented, an extensive medical work-up was initially negative, and neither positive

  17. Radiological diagnostics in CUP syndrome

    International Nuclear Information System (INIS)

    Kazmierczak, P.M.; Nikolaou, K.; Graser, A.; Reiser, M.F.; Cyran, C.C.; Rominger, A.

    2014-01-01

    Imaging plays an essential role in the therapeutic management of cancer of unknown primary (CUP) patients for localizing the primary tumor, for the identification of tumor entities for which a dedicated therapy regimen is available and for the characterization of clinicopathological subentities that direct the subsequent diagnostic and therapeutic strategy. Modalities include conventional x-ray, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound as well as positron emission tomography (PET)-CT and MRI-PET. In whole body imaging CT has a high sensitivity for tumor entities which frequently present as a metastasized cancer illness. According to the current literature CT is diagnostic in 86% of patients with pancreatic carcinoma, in 36% of patients with colon carcinoma and in 74% of patients with lung carcinoma. Additionally a meta-analysis showed that for patients with squamous cell carcinoma and cervical lymph node metastases a positive diagnosis was possible in 22% of the cases using CT, in 36% using MRI and in 28-57% using 18F-fluorodeoxyglucose PET-CT ( 18 F-FDG PET-CT). In addition, MRI plays an important role in the localization of primary occult tumors (e.g. breast and prostate) because of its high soft tissue contrast and options for functional imaging. At the beginning of the diagnostic algorithm stands the search for a possible primary tumor and CT of the neck, thorax and abdomen is most frequently used for whole body staging. Subsequent organ-specific imaging examinations follow, e.g. mammography in women with axillary lymphadenopathy. For histological and immunohistochemical characterization of tumor tissue, imaging is also applied to identify the most accessible and representative tumor manifestation for biopsy. Tumor biopsy may be guided by CT, MRI or ultrasound and MRI also plays a central role in the localization of primary occult tumors because of superior soft tissue contrast and options for functional imaging (perfusion

  18. Structural redundance of NPPs and diagnostics

    International Nuclear Information System (INIS)

    Znyshev, V.V.; Sabaev, E.F.

    1988-01-01

    A new approach to functional diagnosis of NPP state based on structural redundance, owing to which in major of the facilities there are elements identical as to the structure and operational conditions, is suggested. The difference from zero by the given value for one parameter measured for various identical elements is an indicator of a failed element and a signal for diagnostic analysis

  19. Protein nanomedicines for cancer diagnostics and therapy

    International Nuclear Information System (INIS)

    Nair, Shantikumar

    2012-01-01

    New results and applications of the work on anti-cancer therapy using nanomedicines at the Amrita Centre for Nanosciences are presented. Proteins have been selected as having good potential for clinical translation and are excellent carriers for drugs, provide good release kinetics and are also amenable for fluorescent tagging with multiple functionalities for diagnostic purposes. (author)

  20. Feasibility and Diagnostic Value of Cardiovascular Magnetic Resonance Imaging After Acute Ischemic Stroke of Undetermined Origin.

    Science.gov (United States)

    Haeusler, Karl Georg; Wollboldt, Christian; Bentheim, Laura Zu; Herm, Juliane; Jäger, Sebastian; Kunze, Claudia; Eberle, Holger-Carsten; Deluigi, Claudia Christina; Bruder, Oliver; Malsch, Carolin; Heuschmann, Peter U; Endres, Matthias; Audebert, Heinrich J; Morguet, Andreas J; Jensen, Christoph; Fiebach, Jochen B

    2017-05-01

    Etiology of acute ischemic stroke remains undetermined (cryptogenic) in about 25% of patients after state-of-the-art diagnostic work-up. One-hundred and three patients with magnetic resonance imaging (MRI)-proven acute ischemic stroke of undetermined origin were prospectively enrolled and underwent 3-T cardiac MRI and magnetic resonance angiography of the aortic arch in addition to state-of-the-art diagnostic work-up, including transesophageal echocardiography (TEE). We analyzed the feasibility, diagnostic accuracy, and added value of cardiovascular MRI (cvMRI) compared with TEE for detecting sources of stroke. Overall, 102 (99.0%) ischemic stroke patients (median 63 years [interquartile range, 53-72], 24% female, median NIHSS (National Institutes of Health Stroke Scale) score on admission 2 [interquartile range, 1-4]) underwent cvMRI and TEE in hospital; 89 (86.4%) patients completed the cvMRI examination. In 93 cryptogenic stroke patients, a high-risk embolic source was found in 9 (8.7%) patients by cvMRI and in 11 (11.8%) patients by echocardiography, respectively. cvMRI and echocardiography findings were consistent in 80 (86.0%) patients, resulting in a degree of agreement of κ=0.24. In 82 patients with cryptogenic stroke according to routine work-up, including TEE, cvMRI identified stroke etiology in additional 5 (6.1%) patients. Late gadolinium enhancement consistent with previous myocardial infarction was found in 13 (14.6%) out of 89 stroke patients completing cvMRI. Only 2 of these 13 patients had known coronary artery disease. Our study demonstrated that cvMRI was feasible in the vast majority of included patients with acute ischemic stroke. The diagnostic information of cvMRI seems to be complementary to TEE but is not replacing echocardiography after acute ischemic stroke. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01917955. © 2017 American Heart Association, Inc.

  1. Diagnostic studies in amyloidosis

    NARCIS (Netherlands)

    Hazenberg, Bouke Pier Cornelis

    2007-01-01

    In this thesis two diagnostic techniques are studied in amyloidosis. Systemic amyloidosis is characterized by deposition of amyloid fibrils (tiny fibres) throughout the body resulting in damage of vital organs. Amyloid can be detected in a tissue specimen stained with Congo red: red-stained amyloid

  2. Angiography in renal diagnostics

    International Nuclear Information System (INIS)

    Schreyer, H.; Justich, E.; Graz Univ.

    1982-01-01

    The angiographic symptoms of kidney vessels diseases are described as well as traumas and growing and displacing processes of the kidneys. The diagnostic value of angiography in kidney traumas and growing and displacing processes of the kidney is discussed and compared with other techniques, e.g. urography, sonography and computed tomography. (orig.) [de

  3. Electron beam diagnostics study

    International Nuclear Information System (INIS)

    Garganne, P.

    1989-08-01

    This paper summarizes the results of a study on beam diagnostics, using carbon wire scanners and optical transition radiation (DTR) monitors. The main consideration consists in the material selection, taking their thermal properties and their effect on the beam into account [fr

  4. Diagnostics for pellet experiments

    International Nuclear Information System (INIS)

    Johnson, R.R.

    1978-01-01

    The target diagnostics which are being used and planned in current laser driven ICF Experiments are described. Most of these diagnostics can be easily applied to future ion-beam fusion experiments. The status of laser fusion diagnostics has been much improved in the last 5 years and further improvements can be expected and should be available when the first ICF experiments using ion beams are performed. As an example, x-ray temporal and spatial resolutions are now approximately 5 psec and 3 μm, which is approximately a factor of 4 better than the resolution reported in the first implosion experiments. As one plans ahead for ion-beam fusion experiments it should be emphasized that high yield experiments are easier to diagnose provided adequate shielding is employed. However, in the event that the first high yield experiments fail it will be necessary to have diagnostics available to determine where the problems lie. In laser fusion it is interesting to note that higher laser powers are required now for breakeven experiments than first anticipated, mainly because some aspects of the laser-interaction physics were not recognized until the experiments were carefully diagnosed. Thus as has been pointed out, it may be necessary to increase the energy of the ion-beam driver to enable us to do breakeven experiments with high confidence

  5. 1968 Prototype Diagnostic Test.

    Science.gov (United States)

    Veterans Administration Hospital, Bedford, MA.

    This true-false diagnostic test was used for pretesting of employees at a Veterans Administration Hospital. The test is comprised of 20 items. An alternate test--Classification Questionnaire--was used for testing after remedial training. (For related document, see TM 002 334.) (DB)

  6. Diagnostic and interventional radiology

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie

    2016-08-01

    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  7. It's diagnostics, stupid.

    Science.gov (United States)

    Bernards, René

    2010-04-02

    To stem the spiraling cost of cancer treatment, a concerted effort is urgently needed to develop molecular diagnostics to better identify the patients that respond to expensive targeted therapies. Opportunities and obstacles in the development of such drug response biomarkers are discussed here. Copyright 2010 Elsevier Inc. All rights reserved.

  8. Serbia : Systematic Country Diagnostic

    OpenAIRE

    World Bank Group

    2015-01-01

    This Systematic Country Diagnostic (SCD) aims to identify the major constraints on and opportunities for sustaining poverty reduction and shared prosperity in Serbia. The SCD serves as the analytic foundation on which the World Bank Group and the Government of Serbia will define a new Country Partnership Framework for FY2016 to FY2020. It is based on the best possible analysis, drawing on ...

  9. Diagnostic Vacuum Curettage

    African Journals Online (AJOL)

    1974-04-17

    Apr 17, 1974 ... A trial of the Vabra aspirator, a sterile disposable suction curette, was carried out on 136 outpatients. The apparatus is designed to allow full curettage of the uterine cavity. Adequate specimens for diagnostic histology were ob- tained in' all but 10 cases. Of these, no specimen was obtained in 4 cases.

  10. PDR diagnostics study with CLOUDY

    International Nuclear Information System (INIS)

    Xue Rui; Huang Maohai

    2009-01-01

    A series of plane-parallel photodissociation region (PDR) models are calculated using the spectral synthesis code CLOUDY. These models span a wide range of physical conditions, with gas densities of n = 10 2 - 10 6 cm -3 and incident far-ultraviolet (FUV) fields of G 0 = 10 0 - 10 6 (where G 0 is the FUV flux in units of the local interstellar value), which are comparable with various astrophysical environments from interstellar diffuse clouds to the dense neutral gas around galactic compact H II regions. Based on the calculated results, we study the thermal balance of PDR gas and the emissions of [C II], [C I] and [O I] fine-structure lines under different physical conditions. The intensities and strength ratios of the studied lines, which are frequently used as PDR diagnostics, are presented using contour diagrams as functions of n and G 0 . We compare the calculated PDR surface gas temperatures T s with those from Kaufman et al. and find that T s from our models are systematically higher over most of the adopted n-G 0 parameter space. The predicated line intensities and ratios from our work and those from Kaufman et al. can be different by a factor greater than 10, and such large differences usually occur near the border of our parameter space. The different methods of treating the dust grain physics, the change of H 2 formation and dissociation rates, and the improvement in the radiation transfer of line emissions in our CLOUDY models are likely to be the major reasons for the divergences. Our models represent an up-to-date treatment of PDR diagnostic calculations and can be used to interpret observational data. Meanwhile, the uncertainties in the treatment of microphysics and chemical processes in PDR models have significant effects on PDR diagnostics.

  11. Primary Sjögren's syndrome: oral aspects on pathogenesis, diagnostic criteria, clinical features and approaches for therapy

    DEFF Research Database (Denmark)

    Pedersen, A.M.; Nauntofte, Birgitte

    2001-01-01

    diagnostic criteria, labial salivary gland histopathology, primary Sjögren's syndrome, salivary gland function, therapy, xerostomia......diagnostic criteria, labial salivary gland histopathology, primary Sjögren's syndrome, salivary gland function, therapy, xerostomia...

  12. Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators

    Directory of Open Access Journals (Sweden)

    M. Campanini

    2013-05-01

    Full Text Available BACKGROUND Pulmonary embolism (PE is a potentially fatal disease. Diagnosis is challenging for clinicians because clinical presentation is variable and there is no diagnostic test that combines sufficiently high sensitivity and specificity to be used alone in clinically suspected PE. AIM OF THE STUDY PIOPED II investigators have formulated recommendations for the diagnostic approach to patients with suspected PE based on randomized trials. METHODS Diagnostic work-up recommendations were formulated based on the results of the Prospective Investigation of Pulmonary Embolism Diagnosis II and outcomes studies. RESULTS In many patients that present the combination of low or moderate clinical probability with negative D-dimer PE can be safely excluded. In other patients with suspected PE and positive D-dimer a CT angiography in combination with CT venography is recommended. PIOPED II investigators have also formulated recommendations for patients with suspected PE and allergy to iodinated contrast medium, with impaired renal function, and for women at fertile age and during pregnancy. In patients with discordant findings between clinical assessment and CTA o CTA/CTV, and with segmental or sub-segmental EP, further evaluation may be necessary and the diagnosis should be re-assessed. DISCUSSION AND CONCLUSIONS PIOPED II recommendations are of particular interest because consider, after the right clinical evaluation necessary for risk stratification of PE, the most recent, sensitive and specific imaging techniques for definitive diagnosis, such as CTA and CTV. D-dimer evaluation is recommended but, however, its low specificity is not underlined. The importance of combining CTA and CTV for a complete evaluation of the deep venous system is stated, but the difficulties of a routinary similar approach are not considered and alternative techniques, like compressive ultrasound and Colour Doppler ultrasound, are not proposed. The study faces also the issue of

  13. Diagnostic Evaluation of Nontraumatic Chest Pain in Athletes.

    Science.gov (United States)

    Moran, Byron; Bryan, Sean; Farrar, Ted; Salud, Chris; Visser, Gary; Decuba, Raymond; Renelus, Deborah; Buckley, Tyler; Dressing, Michael; Peterkin, Nicholas; Coris, Eric

    This article is a clinically relevant review of the existing medical literature relating to the assessment and diagnostic evaluation for athletes complaining of nontraumatic chest pain. The literature was searched using the following databases for the years 1975 forward: Cochrane Database of Systematic Reviews; CINAHL; PubMed (MEDLINE); and SportDiscus. The general search used the keywords chest pain and athletes. The search was revised to include subject headings and subheadings, including chest pain and prevalence and athletes. Cross-referencing published articles from the databases searched discovered additional articles. No dissertations, theses, or meeting proceedings were reviewed. The authors discuss the scope of this complex problem and the diagnostic dilemma chest pain in athletes can provide. Next, the authors delve into the vast differential and attempt to simplify this process for the sports medicine physician by dividing potential etiologies into cardiac and noncardiac conditions. Life-threatening causes of chest pain in athletes may be cardiac or noncardiac in origin, which highlights the need for the sports medicine physician to consider pathology in multiple organ systems simultaneously. This article emphasizes the importance of ruling out immediately life threatening diagnoses, while acknowledging the most common causes of noncardiac chest pain in young athletes are benign. The authors propose a practical algorithm the sports medicine physician can use as a guide for the assessment and diagnostic work-up of the athlete with chest pain designed to help the physician arrive at the correct diagnosis in a clinically efficient and cost-effective manner.

  14. The use of MR in cardiological diagnostics

    International Nuclear Information System (INIS)

    Smith, Hans-Joergen

    2004-01-01

    Image diagnostics is playing an important role in cardiology, and magnetic resonance tomography (MR) is one of many methods used in examinations of the heart. Based on studies of the literature and his own experience the author surveys the potential of MR in today's and tomorrow's diagnostics of heart diseases. Among the image diagnostic methods MR is the one that can give the most extensive information about the heart's anatomy and function. In a non-invasive way and without the use of ionizing radiation, MR can represent the anatomy in selectable planes, visualize and quantify the heart's pumping function and functioning of the cardiac valves, and give detailed information about the regional contractility, blood flow and viability of myocard. MR is capable of giving important and to some extent unique contributions to heart diseases, both congenital and contracted heart disease. Because of failing availability and competence MR is still little used in cardiological diagnostics, but the method undoubtedly has the potential to play a very important role in the future

  15. The dilemma of diagnostic testing for Prader-Willi syndrome

    Science.gov (United States)

    Hung, Dorothy

    2017-01-01

    Although Prader-Willi syndrome (PWS) is a well-described clinical dysmorphic syndrome, DNA testing is required for a definitive diagnosis. A definitive diagnosis can be made in approximately 99% of cases using DNA testing; there are a number of DNA tests that can be used for this purpose, although there is no set standard algorithm of testing. The dilemma arises because of the complex genetic mechanisms at the basis of PWS, which need to be elucidated. To establish the molecular mechanism with a complete work up, involves at least 2 tests. Here we discuss the commonly used tests currently available and suggest a cost—effective approach to diagnostic testing. PMID:28164030

  16. FEL components and diagnostics

    International Nuclear Information System (INIS)

    Carr, R.

    1997-01-01

    FEL hardware includes undulators, alignment systems, electron beam diagnostics, and mechanical and vacuum systems. While most FEL close-quote s employ conventional undulators, there is some interest in novel types, particularly where conventional designs cannot be used, as at very short periods and high fields. For these areas, superconducting technology is indicated. The most serious issue facing long FEL undulators is that of alignment; mechanical techniques may not be accurate enough, and beam-based strategies must be considered. To maintain alignment and control the electron trajectory, beam position monitors with micron precision are required. Beam size monitors are also required to assure control of emittance. The talks given in the working group sessions touch on undulators, alignment, and electron beam diagnostics, and they are summarized here. copyright 1997 American Institute of Physics

  17. Bunched beam diagnostics

    International Nuclear Information System (INIS)

    Siemann, R.H.

    1989-01-01

    There is a remarkable diversity in the field of accelerator physics. Look at the proceedings of any conference. Papers range from Hamiltonian dynamics to the latest improvements of performance in accelerator X to the engineering of specialized equipment. Beam diagnostics is somewhere in the middle of this. Diagnostic instruments make the connection between theories and observations, and the capabilities of these instruments influence strongly our ability to improve performance. The gave a series of lectures in 1987 on the general topic of Principles of Beam Observation. The emphasis was on frequency domain analysis of beam generated signals in storage rings, and that is the subject of this paper. The goal is to connect spectrum analyzer observations to what the beam is doing. In addition, understanding beam spectra is essential for understanding coherent effects and instabilities in storage rings, and this is discussed extensively. 23 figures, 4 tables

  18. Nanobiosensors in diagnostics

    Directory of Open Access Journals (Sweden)

    Alejandro Chamorro-Garcia

    2016-11-01

    Full Text Available Medical diagnosis has been greatly improved thanks to the development of new techniques capable of performing very sensitive detection and quantifying certain parameters. These parameters can be correlated with the presence of specific molecules and their quantity. Unfortunately, these techniques are demanding, expensive, and often complicated. On the other side, progress in other fields of science and technology has contributed to the rapid growth of nanotechnology. Although being an emerging discipline, nanotechnology has raised huge interest and expectations. Most of the enthusiasm comes from new possibilities and properties of nanomaterials. Biosensors (simple, robust, sensitive, cost-effective combined with nanomaterials, also called nanobiosensors, are serving as bridge between advanced detection/diagnostics and daily/routine tests. Here we review some of the latest applications of nanobiosensors in diagnostics field.

  19. Nanodevices in diagnostics

    Science.gov (United States)

    Hu, Ye; Fine, Daniel H.; Tasciotti, Ennio; Bouamrani, Ali; Ferrari, Mauro

    2010-01-01

    The real-time, personalized and highly sensitive early-stage diagnosis of disease remains an important challenge in modern medicine. With the ability to interact with matter at the nanoscale, the development of nanotechnology architectures and materials could potentially extend subcellular and molecular detection beyond the limits of conventional diagnostic modalities. At the very least, nanotechnology should be able to dramatically accelerate biomarker discovery, as well as facilitate disease monitoring, especially of maladies presenting a high degree of molecular and compositional heterogeneity. This article gives an overview of several of the most promising nanodevices and nanomaterials along with their applications in clinical practice. Significant work to adapt nanoscale materials and devices to clinical applications involving large interdisciplinary collaborations is already underway with the potential for nanotechnology to become an important enabling diagnostic technology. PMID:20229595

  20. Diagnostic orientation in control of disturbance situations

    International Nuclear Information System (INIS)

    Hukki, K.; Norros, L.

    1993-01-01

    The object of the study is diagnostic judgement in the control of dynamic processes. The starting point was the known difficulty process operators have in utilizing knowledge of process dynamics in disturbance situations that require both diagnostic and prognostic actions. A model of the diagnostic judgement process as a construction of coherent interpretation of the situation is outlined, and comprehensive data from simulated disturbance handling by 6 crews of a PWR type nuclear power plant was analysed. The phase of analysis included evaluation of the adequacy of task performance, utilization of available process information, and evaluation of the interpretation of disturbance situations. The results suggest that a functional orientation towards task performance allows a more coherent and comprehensive interpretation of the situation and more adequate task performance. Coherence of interpretation seems to be reflected in a higher subjective certainty compared with crews with an incoherent interpretation. (author). 15 refs, 2 figs, 2 tabs

  1. [Diagnostic imaging in pregraduate integrated curricula].

    Science.gov (United States)

    Kainberger, F; Kletter, K

    2007-11-01

    Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula.

  2. Diagnostic imaging in pregraduate integrated curricula

    International Nuclear Information System (INIS)

    Kainberger, F.; Kletter, K.

    2007-01-01

    Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula. (orig.)

  3. Multi-method automated diagnostics of rotating machines

    Science.gov (United States)

    Kostyukov, A. V.; Boychenko, S. N.; Shchelkanov, A. V.; Burda, E. A.

    2017-08-01

    The automated machinery diagnostics and monitoring systems utilized within the petrochemical plants are an integral part of the measures taken to ensure safety and, as a consequence, the efficiency of these industrial facilities. Such systems are often limited in their functionality due to the specifics of the diagnostic techniques adopted. As the diagnostic techniques applied in each system are limited, and machinery defects can have different physical nature, it becomes necessary to combine several diagnostics and monitoring systems to control various machinery components. Such an approach is inconvenient, since it requires additional measures to bring the diagnostic results in a single view of the technical condition of production assets. In this case, we mean by a production facility a bonded complex of a process unit, a drive, a power source and lines. A failure of any of these components will cause an outage of the production asset, which is unacceptable. The purpose of the study is to test a combined use of vibration diagnostics and partial discharge techniques within the diagnostic systems of enterprises for automated control of the technical condition of rotating machinery during maintenance and at production facilities. The described solutions allow you to control the condition of mechanical and electrical components of rotating machines. It is shown that the functionality of the diagnostics systems can be expanded with minimal changes in technological chains of repair and operation of rotating machinery. Automation of such systems reduces the influence of the human factor on the quality of repair and diagnostics of the machinery.

  4. RFQ1 diagnostic devices

    International Nuclear Information System (INIS)

    Chidley, B.G.; Arbique, G.M.; de Jong, M.S.; McMichael, G.E.; Michel, W.L.; Smith, B.H.

    1991-01-01

    The diagnostic devices in use on RFQ1 will be described. They consist of a double-slit emittance-measuring unit, a 45 degree deflection energy-analysis magnet, parametric current transformers, optical beam sensors, beam-stop current monitors, and an x-ray end-point analyzer. All of these devices are able to operate up to the full output current of RFQ1 (75 mA cw at 0.6 MeV)

  5. Volumetric Combustion Diagnostics

    Science.gov (United States)

    2017-01-03

    Force Office of Scientific Research Submitted by: Lin Ma, PhD Professor Department of Aerospace and Ocean Engineering Department of Mechanical ...established PLIF (planar LIF [11, 12]) to volumetric measurement of species concentration, and have demonstrated single- shot VLIF measurements in both...Ikeda, J., Xu, W., Carter, C.D. Single Shot 3D Flame Diagnostic Based on Volumetric Laser Induced Fluorescence (VLIF), Proceedings of the

  6. Radiological diagnostics in hyperparathyroidism

    International Nuclear Information System (INIS)

    Moedder, U.; Kuhn, F.P.; Gruetzner, G.

    1991-01-01

    The most important radiologically detectable effects of the primary and secondary hyperparathyroidism of the skeletal system and the periarticular soft tissue structures are presented. In the following sensitivity and specificity of radiological imaging - sonography, scintigraphy, computed tomography, magnetic resonance imaging, arteriography and selective venous sampling - in the preoperative diagnostic of the parathyroid adenomas are discussed. Therefore, radiological imaging can be omitted before primary surgery. It was only in secondary surgery that radiological process proved useful and a guide during surgical intervention. (orig.) [de

  7. The sleepy teenager - diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Anne-Marie eLandtblom

    2014-08-01

    Full Text Available The sleepy teenager is a diagnostic challenge because the problems may be physiological or pathological, with behavioural, social and pychological expressions. It is of great importance that health staff that encounter young people with sleep disturbance have good knowledge about the diseases that must be excluded. Narcolepsy, periodic hypersomnia like Kleine Levin syndrome, delayed sleep phase syndrome and obstructive sleep apnoea syndrome, depression and substance use as well as fatigue from chronic disease like multiple sclerosis should be investigated. Clinical assessment, neurophysiological and laboratory investigations constitute important support in these investigations. Functional methods, for example fMRI, are being developed. The role of computer gaming and use of social media in the night is discussed in relation to these diseases. Cognitive dysfunction may develop with several of the conditions. There is need for increased awareness of how to investigate sleep disturbance in children and young people.

  8. Spark gap produced plasma diagnostics

    International Nuclear Information System (INIS)

    Chang, H.Y.

    1990-01-01

    A Spark Gap (Applied voltage : 2-8KV, Capacitor : 4 Micro F. Dia of the tube : 1 inch, Electrode distance : .3 ∼.5 inch) was made to generate a small size dynamic plasma. To measure the plasma density and temperature as a function of time and position, we installed and have been installing four detection systems - Mach-Zehnder type Interferometer for the plasma refractivity, Expansion speed detector using two He-Ne laser beams, Image Processing using Lens and A Optical-Fiber Array for Pointwise Radiation Sensing, Faraday Rotation of a Optical Fiber to measure the azimuthal component of B-field generated by the plasma drift. These systems was used for the wire explosion diagnostics, and can be used for the Laser driven plasma also

  9. Radiation effects in IFMIF Li target diagnostic systems

    International Nuclear Information System (INIS)

    Molla, J.; Vila, R.; Shikama, T.; Horiike, H.; Simakov, S.; Ciotti, M.; Ibarra, A.

    2009-01-01

    Diagnostics for the lithium target will be crucial for the operation of IFMIF. Several parameters as the lithium temperature, target thickness or wave pattern must be monitored during operation. Radiation effects may produce malfunctioning in any of these diagnostics due to the exposure to high radiation fields. The main diagnostic systems proposed for the operation of IFMIF are reviewed in this paper from the point of view of radiation damage. The main tools for the assessment of the performance of these diagnostics are the neutronics calculations by using specialised codes and the information accumulated during the last decades on the radiation effects in functional materials, components and diagnostics for ITER. This analysis allows to conclude that the design of some of the diagnostic systems must be revised to assure the high availability required for the target system.

  10. SNS Diagnostics Timing Integration

    CERN Document Server

    Long, Cary D; Murphy, Darryl J; Pogge, James; Purcell, John D; Sundaram, Madhan

    2005-01-01

    The Spallation Neutron Source (SNS) accelerator systems will deliver a 1.0 GeV, 1.4 MW proton beam to a liquid mercury target for neutron scattering research. The accelerator complex consists of a 1 GeV linear accelerator, an accumulator ring and associated transport lines. The SNS diagnostics platform is PC-based running Windows XP Embedded for its OS and LabVIEW as its programming language. Coordinating timing among the various diagnostics instruments with the generation of the beam pulse is a challenging task that we have chosen to divide into three phases. First, timing was derived from VME based systems. In the second phase, described in this paper, timing pulses are generated by an in house designed PCI timing card installed in ten diagnostics PCs. Using fan-out modules, enough triggers were generated for all instruments. This paper describes how the Timing NAD (Network Attached Device) was rapidly developed using our NAD template, LabVIEW's PCI driver wizard, and LabVIEW Channel Access library. The NAD...

  11. XML Diagnostics Description Standard

    International Nuclear Information System (INIS)

    Neto, A.; Fernandes, H.; Varandas, C.; Lister, J.; Yonekawa, I.

    2006-01-01

    A standard for the self-description of fusion plasma diagnostics will be presented, based on the Extensible Markup Language (XML). The motivation is to maintain and organise the information on all the components of a laboratory experiment, from the hardware to the access security, to save time and money when problems arises. Since there is no existing standard to organise this kind of information, every Association stores and organises each experiment in different ways. This can lead to severe problems when the organisation schema is poorly documented or written in national languages. The exchange of scientists, researchers and engineers between laboratories is a common practice nowadays. Sometimes they have to install new diagnostics or to update existing ones and frequently they lose a great deal of time trying to understand the currently installed system. The most common problems are: no documentation available; the person who understands it has left; documentation written in the national language. Standardisation is the key to solving all the problems mentioned. From the commercial information on the diagnostic (component supplier; component price) to the hardware description (component specifications; drawings) to the operation of the equipment (finite state machines) through change control (who changed what and when) and internationalisation (information at least in the native language and in English), a common XML schema will be proposed. This paper will also discuss an extension of these ideas to the self-description of ITER plant systems, since the problems will be identical. (author)

  12. An Ecological Diagnostic Classification Plan.

    Science.gov (United States)

    Hurst, James C.; McKinley, Donna L.

    1988-01-01

    Discusses the value of diagnostic classification systems to counseling professionals. Describes the Ecological Diagnostic Classification Plan, an approach to diagnosis that includes the environment as a possible cause of pathology and target of intervention. (Author/KS)

  13. Thioaptamer Diagnostic System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — AM Biotechnologies (AM) will develop a diagnostic system in response to SBIR Topic X10.01 Reusable Diagnostic Lab Technology that will simultaneously detect and...

  14. 2012 HIV Diagnostics Conference: the molecular diagnostics perspective.

    Science.gov (United States)

    Branson, Bernard M; Pandori, Mark

    2013-04-01

    2012 HIV Diagnostic Conference Atlanta, GA, USA, 12-14 December 2012. This report highlights the presentations and discussions from the 2012 National HIV Diagnostic Conference held in Atlanta (GA, USA), on 12-14 December 2012. Reflecting changes in the evolving field of HIV diagnostics, the conference provided a forum for evaluating developments in molecular diagnostics and their role in HIV diagnosis. In 2010, the HIV Diagnostics Conference concluded with the proposal of a new diagnostic algorithm which included nucleic acid testing to resolve discordant screening and supplemental antibody test results. The 2012 meeting, picking up where the 2010 meeting left off, focused on scientific presentations that assessed this new algorithm and the role played by RNA testing and new developments in molecular diagnostics, including detection of total and integrated HIV-1 DNA, detection and quantification of HIV-2 RNA, and rapid formats for detection of HIV-1 RNA.

  15. Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience.

    Science.gov (United States)

    Montella, Silvia; Corcione, Adele; Santamaria, Francesca

    2017-01-29

    Recurrent pneumonia (RP), i.e., at least two episodes of pneumonia in one year or three episodes ever with intercritical radiographic clearing of densities, occurs in 7.7%-9% of children with community-acquired pneumonia. In RP, the challenge is to discriminate between children with self-limiting or minor problems, that do not require a diagnostic work-up, and those with an underlying disease. The aim of the current review is to discuss a reasoned diagnostic approach to RP in childhood. Particular emphasis has been placed on which children should undergo a diagnostic work-up and which tests should be performed. A pediatric case series is also presented, in order to document a single centre experience of RP. A management algorithm for the approach to children with RP, based on the evidence from a literature review, is proposed. Like all algorithms, it is not meant to replace clinical judgment, but it should drive physicians to adopt a systematic approach to pediatric RP and provide a useful guide to the clinician.

  16. Diagnostic strategies in spinal trauma

    Energy Technology Data Exchange (ETDEWEB)

    Heinemann, Uwe [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany); Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de

    2006-04-15

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed.

  17. Diagnostic strategies in spinal trauma

    International Nuclear Information System (INIS)

    Heinemann, Uwe; Freund, Michael

    2006-01-01

    Spinal injuries may result in severe neurological deficits, especially if nerve roots or even the spinal cord are affected. Besides presenting the important anatomical and technical basis underlying the imaging findings of spinal injuries, the trauma mechanisms and the resulting injuries are discussed. Based on the current literature and recommendations of scientific organizations, an approach is provided to the radiologic work up of spinal trauma. The different imaging modalities are presented. Advantages and disadvantages of the methods are discussed

  18. MAST magnetic diagnostics

    Science.gov (United States)

    Edlington, T.; Martin, R.; Pinfold, T.

    2001-01-01

    The mega-ampere spherical tokamak (MAST) experiment is a new, large, low aspect ratio device (R=0.7-0.8 m, a=0.5-0.65 m, maximum BT˜0.63 T at R=0.7 m) operating its first experimental physics campaign. Designed to study a wide variety of plasma shapes with up to 2 MA of plasma current with an aspect ratio down to 1.3, the poloidal field (PF) coils used for plasma formation, equilibrium and shaping are inside the main vacuum vessel. For plasma control and to investigate a wide range of plasma phenomena, an extensive set of magnetic diagnostics have been installed inside the vacuum vessel. More than 600 vacuum compatible, bakeable diagnostic coils are configured in a number of discrete arrays close to the plasma edge with about half the coils installed behind the graphite armour tiles covering the center column. The coil arrays measure the toroidal and poloidal variation in the equilibrium field and its high frequency fluctuating components. Internal coils also measure currents in the PF coils, plasma current, stored energy and induced currents in the mechanical support structures of the coils and graphite armour tiles. The latter measurements are particularly important when halo currents are induced following a plasma termination, for example, when the plasma becomes vertically unstable. The article describes the MAST magnetic diagnostic coil set and their calibration. The way in which coil signals are used to control the plasma equilibrium is described and data from the first MAST experimental campaign presented. These coil data are used as input to the code EFIT [L. Lao et al., Nucl. Fusion 25, 1611 (1985)], for measurement of halo currents in the vacuum vessel structure and for measurements of the structure of magnetic field fluctuations near the plasma edge.

  19. Bouveret's Syndrome: diagnostic considerations

    International Nuclear Information System (INIS)

    Cooper, S.G.; Sherman, S.B.; Steinhardt, J.E.; Wilson, J.M. Jr.; Richman, A.H.

    1987-01-01

    Bouveret's syndrome is a rare disease entity manifested by the formation of a cholecystoduodenal or choledochoduodenal fistula with passage of a gallstone into the duodenal bulb and subsequent obstruction of the gastric outlet. To date, no report of this entity using computed tomographic (CT) imaging is available. This article presents a case of Bouveret's syndrome with the classic findings on upper gastrointestinal (GI) tract series and a description of the CT manifestations. The literature is reviewed with discussion of the diagnostic approach to patients with Bouveret's syndrome

  20. COMPLEX RENAL MASSES DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    M.L. Chekhonatskaya

    2008-03-01

    Full Text Available Saratov State Medical University Research Institute for Fundamental and Clinical Urology Nephrology Renal masses are widespread pathology with high mortality and morbidity rate. Early diagnostics is a possibility of nephron-spearing surgery. Ultrasonography is screening imaging modality for renal lesions, Doppler investigation provide possibility for vascularity of these masses evaluation. CT with and without contrast enhancement can be used as a marker of malignancy. Magnetic resonance imaging has been proposed for the evaluation of renal lesions, especially in cases in which ultrasonography (US and/or CT results are not definitive.

  1. FASTBUS Snoop Diagnostic Module

    International Nuclear Information System (INIS)

    Walz, H.V.; Downing, R.

    1980-11-01

    Development of the FASTBUS Snoop Module, undertaken as part of the prototype program for the new interlaboratory data bus standard, is described. The Snoop Module resides on a FASTBUS crate segment and provides diagnostic monitoring and testing capability. Communication with a remote host computer is handled independent of FASTBUS through a serial link. The module consists of a high-speed ECL front-end to monitor and single-step FASTBUS cycles, a master-slave interface, and a control microprocessor with serial communication ports. Design details and performance specifications of the prototype module are reported. 9 figures, 1 table

  2. Isotope diagnostics apparatus

    International Nuclear Information System (INIS)

    Herrschaft, H.

    1976-01-01

    The invention relates to a measuring probe for an isotope diagnostics apparatus to determine the distribution of radioactive substances in a body by measuring the radiation emanating from this body by means of a multiplicity of measuring probes directed simultaneously towards areas of measuring surfae and carried in guidances of a holding block. The measuring results of the individual probes are recorded separately, thus allowing the possibility of being evaluated separately, too. Measuring probes of this kind are used in multi-channel measuring objects and are useful particularly for determining the regional cerebral blood flow. (orig./ORU) [de

  3. Diagnostic radiology 1987

    International Nuclear Information System (INIS)

    Margulis, A.R.; Gooding, C.A.

    1987-01-01

    This is the latest version of the continuing education course on diagnostic radiology given yearly by the Department of Radiology at the University of California, San Francisco. The lectures are grouped into sections on gastrointestinal radiology, mammography, uroradiology, magnetic resonance, hepatobiliary radiology, pediatric radiology, ultrasound, interventional radiology, chest radiology, nuclear medicine, cardiovascular radiology, and skeletal radiology. Each section contains four to eight topics. Each of these consists of text that represents highlights in narrative form, selected illustrations, and a short bibliography. The presentation gives a general idea of what points were made in the lecture

  4. Algorithm for the Diagnosis of Scleroderma. Early Systemic Sclerosis: Definitions and diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Domenico Galasso

    2013-04-01

    Full Text Available Introduction: The term scleroderma derives from the Greek words skleros, which means hard, and derma, which means skin. It refers to an acquired systemic inflammatory disease of the connective tissue –also known as systemic sclerosis (SSc– characterized by excessive collagen deposition in the skin and the internal organs that results in fibrosis. The typical vascular lesion in SSc leads to narrowing of the vessel lumen, intimal thickening, medial hypotrophy, and adventitial fibrosis of small muscular vessels, collagen deposition in the other matrix components of interstice, and the Raynaud phenomenon secondary to these widespread microvascular abnormalities. All these characteristics lead to a connective tissue re-modeling. Discussion: Several clinical studies utilize the American Rheumatology Association’s 1980 classification. However, these diagnostic criteria are unsatisfactory because they fail to take into consideration part of the disease spectrum. Early-phase SSc is characterized by the Raynaud phenomenon (in 90% of all patients, sclerodactyly, and positivity for SSc-specific autoantibodies (antinuclear antibodies, anti-topoisomerase I antibodies, anti-RNA polymerase I and III antibodies, anti-centromere antibodies, anti-fibrillarin antibodies, anti-PM-SCL antibodies.. It is necessary to reduce delays in the diagnosis of SSc. Conclusions: Patients with red-flag positivity (Raynaud phenomenon and digital edema require Phase I SSc screening, which consists in capillaroscopic assessment of possible microvascular abnormalities. The work-up will then focus on inflammatory indices, renal function tests, and internal organ involvement (echocardiography, high-resolution computed tomography of the chest, diffusing capacity of the lungs for carbon monoxide.

  5. The Improvements of Enterprise Anti-Crisis Management Diagnostics in the System of Managerial Diagnostics

    Directory of Open Access Journals (Sweden)

    Ruslan Skrynkovskyy

    2017-11-01

    Full Text Available The purpose of the article is to substantiate the theoretical positions and to develop practical recommendations for improving the diagnostics of anti-crisis management of the enterprise in the system of managerial diagnostics. It is revealed that the specificity of crisis management of the enterprise (as a special diagnostic purpose of the system of management diagnostic purposes is related to: 1 the strategy of anti-crisis management, which includes the prevention of crisis and the strategy to overcome the crisis; 2 the need for complex management decisions (functioning, development in the conditions of limited financial and informational resources, high general level of uncertainty of the environment (displaying various events and aspects and risk, etc. It is established that the diagnostics of anti-crisis management in the enterprise in the system of managerial diagnostics should include: 1 the study of basic business indicators (parameters of production and economic activity of the enterprise; 2 comprehensive in-depth analysis of the influence of factors (internal, external on the state of the enterprise (financial and economic, technical and technological; 3 expert valuation of the developed measures and prospects for financial rehabilitation and preventive sanation, as well as an assessment of the achievement of forecasting goals. The prospect of further research in this field is the development of a system of goals of economic diagnosis (diagnostics of activity of the enterprise (institution, organization taking into account the presented results of the study and the graphical interpretation of the improvement of the effectiveness of the anti-crisis management enterprise in the system of managerial diagnostics.

  6. Diagnostic Technologies in Practice

    Science.gov (United States)

    Steinberg, Malcolm; Kwag, Michael; Chown, Sarah A.; Doupe, Glenn; Trussler, Terry; Rekart, Michael; Gilbert, Mark

    2015-01-01

    Diagnosing HIV-positive gay men through enhanced testing technologies that detect acute HIV infection (AHI) or recent HIV infection provides opportunities for individual and population health benefits. We recruited 25 men in British Columbia who received an acute (n = 13) or recent (n = 12) HIV diagnosis to engage in a longitudinal multiple-methods study over one year or longer. Our thematic analysis of baseline qualitative interviews revealed insights within men’s accounts of technologically mediated processes of HIV discovery and diagnosis. Our analysis illuminated the dialectic of new HIV technologies in practice by considering the relationship between advances in diagnostics (e.g., nucleic acid amplification tests) and the users of these medical technologies in clinical settings (e.g., clients and practitioners). Technological innovations and testing protocols have shifted experiences of learning of one’s HIV-positive status; these innovations have created new diagnostic categories that require successful interpretation and translation to be rendered meaningful, to alleviate uncertainty, and to support public health objectives. PMID:25201583

  7. Radiation hardening of diagnostics

    International Nuclear Information System (INIS)

    Siemon, R.E.

    1991-01-01

    The world fusion program has advanced to the stage where it is appropriate to construct a number of devices for the purpose of burning DT fuel. In these next-generation experiments, the expected flux and fluence of 14 MeV neutrons and associated gamma rays will pose a significant challenge to the operation and diagnostics of the fusion device. Radiation effects include structural damage to materials such as vacuum windows and seals, modifications to electrical properties such as electrical conductivity and dielectric strength and impaired optical properties such as reduced transparency and luminescence of windows and fiber optics during irradiation. In preparation for construction and operation of these new facilities, the fusion diagnostics community needs to work with materials scientists to develop a better understanding of radiation effects, and to undertake a testing program aimed at developing workable solutions for this multi-faceted problem. A unique facility to help in this regard is the Los Alamos Spallation Radiation Effects Facility, a neutron source located at the beam stop of the world's most powerful accelerator, the Los Alamos Meson Physics Facility (LAMPF). The LAMPF proton beam generates 10 16 neutrons per second because of ''spallation'' reactions when the protons collide with the copper nuclei in the beam stop

  8. Reflectometry diagnostics on TCV

    Science.gov (United States)

    Molina Cabrera, Pedro; Coda, Stefano; Porte, Laurie; Offeddu, Nicola; Tcv Team

    2017-10-01

    Both profile reflectometer and Doppler back-scattering (DBS) diagnostics are being developed for the TCV Tokamak using a steerable quasi-optical launcher and universal polarizers. First results will be presented. A pulse reflectometer is being developed to complement Thomson Scattering measurements of electron density, greatly increasing temporal resolution and also effectively enabling fluctuation measurements. Pulse reflectometry consists of sending short pulses of varying frequency and measuring the roundtrip group-delay with precise chronometers. A fast arbitrary waveform generator is used as a pulse source feeding frequency multipliers that bring the pulses to V-band. A DBS diagnostic is currently operational in TCV. DBS may be used to infer the perpendicular velocity and wave number spectrum of electron density fluctuations in the 3-15 cm-1 wave-number range. Off-the-shelf transceiver modules, originally used for VNA measurements, are being used in a Doppler radar configuration. See author list of S. Coda et al., 2017 Nucl. Fusion 57 102011.

  9. Shiva optical diagnostics

    International Nuclear Information System (INIS)

    Rienecker, F.; Kobierecki, M.; Ozarski, R.; Seppala, L.; Manes, K.; Merritt, B.

    1977-01-01

    In the laser fusion program at Lawrence Livermore Laboratory, no target experiment is complete unless it is complemented by careful measurements of the laser pulse that irradiates the target. For this purpose, an incident beam diagnostics (IBD) package has been designed for the Shiva laser. The package will furnish data on items such as the total energy and the focusable energy out of the laser chain, and the spatial and temporal energy and power distribution at the target plane. Understanding laser-plasma interactions requires knowledge of the amount of 1.06 μm light energy that is scattered in various directions from the target. The light energy that is scattered toward the beam focusing lens is analyzed by a reflected beam diagnostic (RBD) package containing a calorimeter, a multiple image camera and a TV camera. This paper describes the detailed design and operation of the IBD and RBD packages as tools to align spatial filters and targets, as well as to diagnose the laser beams and target reflectivity

  10. Encyclopedia of diagnostic imaging

    International Nuclear Information System (INIS)

    Baert, A.L.

    2008-01-01

    The simple A to Z format provides easy access to relevant information in the field of imaging. Extensive cross references between keywords and related articles enable efficient searches in a user-friendly manner. Fully searchable and hyperlinked electronic online edition. The aim of this comprehensive encyclopedia is to provide detailed information on diagnostic radiology contributing to the broad field of imaging. The wide range of entries are written by leading experts. They will provide basic and clinical scientists in academia, practice and industry with valuable information about the field of diagnostic imaging. Those in related fields, students, teachers, and interested laypeople will also benefit from the important and relevant information on the most recent developments. Please note that this publication is available as print only or online only or print + online set. Save 75% of the online list price when purchasing the bundle. For more information on the online version please type the publication title into the search box above, then click on the eReference version in the results list. (orig.)

  11. Radiation hardening of diagnostics

    Science.gov (United States)

    Siemon, R. E.

    The world fusion program has advanced to the stage where it is appropriate to construct a number of devices for the purpose of burning DT fuel. In these next-generation experiments, the expected flux and fluence of 14 MeV neutrons and associated gamma rays will pose a significant challenge to the operation and diagnostics of the fusion device. Radiation effects include structural damage to materials such as vacuum windows and seals, modifications to electrical properties such as electrical conductivity and dielectric strength and impaired optical properties such as reduced transparency and luminescence of windows and fiber optics during irradiation. In preparation for construction and operation of these new facilities, the fusion diagnostics community needs to work with materials scientists to develop a better understanding of radiation effects, and to undertake a testing program aimed at developing workable solutions for this multi-faceted problem. A unique facility to help in this regard is the Los Alamos Spallation Radiation Effects Facility, a neutron source located at the beam stop of the world's most powerful accelerator, the Los Alamos Meson Physics Facility (LAMPF). The LAMPF proton beam generates 10(exp 16) neutrons per second because of spallation'reactions when the protons collide with the copper nuclei in the beam stop.

  12. Laser fusion diagnostics

    International Nuclear Information System (INIS)

    Coleman, L.W.

    1978-01-01

    The current status of the capability of laser fusion diagnostics is reviewed. Optical and infrared streak cameras provide one time resolution measurement capability of less than 10 ps, while x-ray streak cameras provide 15 ps time resolution in the range of about 1--30 keV presently. Time integrated spatial resolutions of 1 μm are provided with a variety of optical techniques. Ultraviolet holographic interferometry has measured electron densities above 10 21 cm -3 with 1 μm spatial resolution and 15 ps temporal resolution. X-ray microscopes provide 3 μm time integrated resolution and the x-ray streak pinhole camera has 6 μm spatial resolution. Development of the framing camera has thus far provided 50 μm spatial resolution with 125 ps frame duration and the third order reconstruction of zone plate images has provided 3 μm resolutions for alpha particles. Time integrated measurements of x-rays span the range shown. Finally, the new Shiva neutron spectrometer increases the energy resolution capability of that technique to 25 keV for 14-MeV neutrons. These combined capabilities provide a unique set of diagnostics for the detailed measurement of the interaction of laser light with targets and a subsequent performance of those targets

  13. Instrumentation and diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Nakaishi, C.V.; Bedick, R.C.

    1990-12-01

    This Technology Status Report describes research and accomplishments for the Instrumentation and Diagnostics (I D) Projects within the Advanced Research and Technology Development (AR TD) Program of the United States Department of Energy (DOE) Office of Fossil Energy (FE). Process understanding and control can be improved through the development of advanced instrumentation and diagnostics. The thrust of the I D Projects is to further develop existing measurement and control techniques for application to advanced coal-based technologies. Project highlights are: an inductively coupled plasma (ICP) instrument has been developed to analyze trace elements in gasification and combustion process streams. An in situ two-color Mie scattering technique with LSS can simultaneously measure the size, velocity, and elemental composition of coal particles during combustion. A high-temperature, fluorescence thermometry technique has accurately measured gas temperatures during field testing in combustion and gasification environments. Expert systems have been developed to improve the control of advanced coal-based processes. Capacitance flowmeters were developed to determine the mass flowrate, solid volume fraction, and particle velocities of coal slurries. 32 refs., 9 figs.

  14. Diagnostic algorithm for syncope.

    Science.gov (United States)

    Mereu, Roberto; Sau, Arunashis; Lim, Phang Boon

    2014-09-01

    Syncope is a common symptom with many causes. Affecting a large proportion of the population, both young and old, it represents a significant healthcare burden. The diagnostic approach to syncope should be focused on the initial evaluation, which includes a detailed clinical history, physical examination and 12-lead electrocardiogram. Following the initial evaluation, patients should be risk-stratified into high or low-risk groups in order to guide further investigations and management. Patients with high-risk features should be investigated further to exclude significant structural heart disease or arrhythmia. The ideal currently-available investigation should allow ECG recording during a spontaneous episode of syncope, and when this is not possible, an implantable loop recorder may be considered. In the emergency room setting, acute causes of syncope must also be considered including severe cardiovascular compromise due to pulmonary, cardiac or vascular pathology. While not all patients will receive a conclusive diagnosis, risk-stratification in patients to guide appropriate investigations in the context of a diagnostic algorithm should allow a benign prognosis to be maintained. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Graphene-based nanoprobes for molecular diagnostics.

    Science.gov (United States)

    Chen, Shixing; Li, Fuwu; Fan, Chunhai; Song, Shiping

    2015-10-07

    In recent years, graphene has received widespread attention owing to its extraordinary electrical, chemical, optical, mechanical and structural properties. Lately, considerable interest has been focused on exploring the potential applications of graphene in life sciences, particularly in disease-related molecular diagnostics. In particular, the coupling of functional molecules with graphene as a nanoprobe offers an excellent platform to realize the detection of biomarkers, such as nucleic acids, proteins and other bioactive molecules, with high performance. This article reviews emerging graphene-based nanoprobes in electrical, optical and other assay methods and their application in various strategies of molecular diagnostics. In particular, this review focuses on the construction of graphene-based nanoprobes and their special advantages for the detection of various bioactive molecules. Properties of graphene-based materials and their functionalization are also comprehensively discussed in view of the development of nanoprobes. Finally, future challenges and perspectives of graphene-based nanoprobes are discussed.

  16. An ontology-driven, diagnostic modeling system.

    Science.gov (United States)

    Haug, Peter J; Ferraro, Jeffrey P; Holmen, John; Wu, Xinzi; Mynam, Kumar; Ebert, Matthew; Dean, Nathan; Jones, Jason

    2013-06-01

    To present a system that uses knowledge stored in a medical ontology to automate the development of diagnostic decision support systems. To illustrate its function through an example focused on the development of a tool for diagnosing pneumonia. We developed a system that automates the creation of diagnostic decision-support applications. It relies on a medical ontology to direct the acquisition of clinic data from a clinical data warehouse and uses an automated analytic system to apply a sequence of machine learning algorithms that create applications for diagnostic screening. We refer to this system as the ontology-driven diagnostic modeling system (ODMS). We tested this system using samples of patient data collected in Salt Lake City emergency rooms and stored in Intermountain Healthcare's enterprise data warehouse. The system was used in the preliminary development steps of a tool to identify patients with pneumonia in the emergency department. This tool was compared with a manually created diagnostic tool derived from a curated dataset. The manually created tool is currently in clinical use. The automatically created tool had an area under the receiver operating characteristic curve of 0.920 (95% CI 0.916 to 0.924), compared with 0.944 (95% CI 0.942 to 0.947) for the manually created tool. Initial testing of the ODMS demonstrates promising accuracy for the highly automated results and illustrates the route to model improvement. The use of medical knowledge, embedded in ontologies, to direct the initial development of diagnostic computing systems appears feasible.

  17. Diagnostic value of CD103 expression in bronchoalveolar lymphocytes in sarcoidosis.

    Science.gov (United States)

    Mota, Patrícia Caetano; Morais, António; Palmares, Carmo; Beltrão, Marília; Melo, Natália; Santos, Ana Cristina; Delgado, Luís

    2012-07-01

    Pulmonary sarcoidosis is frequently characterized by a CD4(+)/CD8(+) ratio ≥3.5 in bronchoalveolar lavage fluid (BALF), although up to 40% of the cases present a normal or even decreased ratio, pointing out its variability and limitation as a diagnostic marker for sarcoidosis. Lung lymphocytes within the bronchial epithelium, the alveolar walls, and BALF express the integrin CD103. Our aim was to compare the expression of CD103 in BALF T-lymphocytes between sarcoidosis and other interstitial lung diseases (ILD) and to evaluate its relevance as a BALF diagnostic marker for sarcoidosis. A total of 86 patients with ILD (mean age ± standard deviation, 42.6 ± 16.6 years; 60.5% female), who underwent BALF as part of their initial diagnostic work-up, were enrolled into 2 groups: sarcoidosis (n = 41) and other ILD (n = 45). Area under the receiver operating characteristic (ROC) curve (AUC) was used to describe the performance of CD103 for sarcoidosis diagnosis. Sarcoidosis patients presented a significantly reduced CD103 expression in BALF T-lymphocytes, more pronounced in the CD4(+) subset. The BALF CD103(+)CD4(+)/CD4(+) ratio for a cutoff point of 0.45 was associated with a better diagnostic performance for sarcoidosis (AUC: 0.86 [95% confidence interval (95% CI): 0.78-0.94]; sensitivity: 81%; specificity: 78%), even for those with a CD4(+)/CD8(+) ratio <3.5 (AUC: 0.79 [95% CI: 0.64-0.93]; sensitivity: 75%; specificity: 78%). Assessment of CD103 expression in BALF CD4(+) T-lymphocytes may be a reliable tool for sarcoidosis diagnosis, independently of CD4(+)/CD8(+) ratio, pointing out the relevance of evaluating the CD103(+)CD4(+)/CD4(+) ratio in the ILD diagnostic work-up. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. Autonomous functioning of the goitre

    International Nuclear Information System (INIS)

    Emrich, D.

    1994-01-01

    The article summarizes the status of knowledge on functional autonomy of the thyroid gland from the standpoint of definition, pathogenesis, pathophysiology, epidemiology, diagnostics and treatment. (orig.) [de

  19. Diagnostic Challenges at SNS

    CERN Document Server

    Plum, M A

    2003-01-01

    The Spallation Neutron Source now being built in Oak Ridge, Tennessee, USA, accelerates an H- ion beam to 1000 MeV with an average power of 1.4 MW. The H- beam is then stripped to H+, compressed in a storage ring to a pulse length of 695 ns, and then directed onto a mercury neutron spallation target. Most of the acceleration is accomplished with superconducting rf cavities. The presence of these cavities, the high average beam power, and the large range of beam intensity in the storage ring, provide unique challenges to the beam diagnostics systems. In this talk we will discuss these challenges and some of our solutions, including the laser profile monitor system, the residual gas ionization profile monitors, and network attached devices. Measurements performed using prototype instrumentation will also be presented.

  20. Laboratory Diagnostics for Histoplasmosis.

    Science.gov (United States)

    Azar, Marwan M; Hage, Chadi A

    2017-06-01

    The diagnosis of histoplasmosis is based on a multifaceted approach that includes clinical, radiographic, and laboratory evidence of disease. The gold standards for laboratory diagnosis include demonstration of yeast on pathological examination of tissue and isolation of the mold in the culture of clinical specimens; however, antigen detection has provided a rapid, noninvasive, and highly sensitive method for diagnosis and is a useful marker of treatment response. Molecular methods with improved sensitivity on clinical specimens are being developed but are not yet ready for widespread clinical use. This review synthesizes currently available laboratory diagnostics for histoplasmosis, with an emphasis on complexities of testing and performance in various clinical contexts. Copyright © 2017 American Society for Microbiology.

  1. Challenges of ITER diagnostic electrical services

    Energy Technology Data Exchange (ETDEWEB)

    Encheva, A., E-mail: anna.encheva@iter.org [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Omran, H. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); Pérez-Lasala, M. [The European Joint Undertaking for ITER and the Development of Fusion Energy, c/Josep Pla, n° 2, Torres Diagonal Litoral, Edificio B3, 08019 Barcelona (Spain); Alekseev, A. [Efremov Institute, Metallostroy, Doroga na Metallostroy, 3 bld., Saint-Petersburg 196641 (Russian Federation); Arshad, S. [The European Joint Undertaking for ITER and the Development of Fusion Energy, c/Josep Pla, n° 2, Torres Diagonal Litoral, Edificio B3, 08019 Barcelona (Spain); Bede, O. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); Bender, S. [Efremov Institute, Metallostroy, Doroga na Metallostroy, 3 bld., Saint-Petersburg 196641 (Russian Federation); Bertalot, L.; Direz, M.-F.; Drevon, J.-M.; Jakhar, S.; Kaschuk, Y.; Komarov, V.; Lebarbier, R. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Lucca, F. [L.T. Calcoli SaS, Piazza Prinetti 26/B, 23807 Merate (Italy); Macklin, B.; Maquet, P. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Marin, A. [L.T. Calcoli SaS, Piazza Prinetti 26/B, 23807 Merate (Italy); Martin, A. [ITER Organization, Route de Vinon sur Verdon, 13115 St Paul-Lez-Durance (France); Mills, S. [Oxford Technologies Ltd, 7 Nuffield Way, Abingdon OX14 1RL (United Kingdom); and others

    2013-10-15

    Highlights: • A brief description of all major components part of diagnostic electrical services has been given. • The integration challenges have been presented. • Design assumptions and requirements for the components have been described. • The design of the conduit/loom and the relevant analysis has been highlighted. -- Abstract: Diagnostic electrical services provide the electrical infrastructure to serve diagnostic components installed on the ITER tokamak. This infrastructure is composed of cables, connectors, cable tails, looms, conduits and feedthroughs. The diagnostic services offer as well a shelter for various instrumentations – vacuum vessel (VV), blanket and divertor. The diagnostic sensors are located on the inner and outer VV wall, on blanket shield modules, divertor cassettes and in port plugs. They require electrical cabling to extract the measurement and, in some cases, to supply electrical power to the sensors. These cables run from the sensors to feedthroughs on the VV and the port interspace or cryostat. The design and integration of all components that are part of diagnostic electrical services is an important engineering activity that is being challenged by the multiple requirements and constraints which have to be satisfied while at the same time delivering the required diagnostic performance. The positioning of the components must correlate not only with their functional specifications but also with the design of the major ITER components. This is a particular challenge because not all systems have reached the same level of design maturity. This paper outlines the engineering challenges of ITER diagnostics electrical services. The environmental conditions inside the VV will have an important impact. Leading risks to these components include poor electrical contact at connectors, the effects of exposure to nuclear irradiation, such as material transmutation, heating, and generation of spurious electrical signals etc., failure due to

  2. Oral vs. salivary diagnostics

    Science.gov (United States)

    Marques, Joana; Corby, Patricia M.; Barber, Cheryl A.; Abrams, William R.; Malamud, Daniel

    2015-05-01

    The field of "salivary diagnostics" includes studies utilizing samples obtained from a variety of sources within the oral cavity. These samples include; whole unstimulated saliva, stimulated whole saliva, duct saliva collected directly from the parotid, submandibular/sublingual glands or minor salivary glands, swabs of the buccal mucosa, tongue or tonsils, and gingival crevicular fluid. Many publications state "we collected saliva from subjects" without fully describing the process or source of the oral fluid. Factors that need to be documented in any study include the time of day of the collection, the method used to stimulate and collect the fluid, and how much fluid is being collected and for how long. The handling of the oral fluid during and post-collection is also critical and may include addition of protease or nuclease inhibitors, centrifugation, and cold or frozen storage prior to assay. In an effort to create a standard protocol for determining a biomarker's origin we carried out a pilot study collecting oral fluid from 5 different sites in the mouth and monitoring the concentrations of pro- and anti-inflammatory cytokines detected using MesoScaleDiscovery (MSD) electrochemiluminesence assays. Our data suggested that 3 of the cytokines are primarily derived from the submandibular gland, while 7 of the cytokines come from a source other than the major salivary glands such as the minor salivary glands or cells in the oral mucosae. Here we review the literature on monitoring biomarkers in oral samples and stress the need for determining the blood/saliva ratio when a quantitative determination is needed and suggest that the term oral diagnostic be used if the source of an analyte in the oral cavity is unknown.

  3. Molecular diagnostic PCR handbook

    International Nuclear Information System (INIS)

    Viljoen, G.J.; Crowther, J.R.; Nel, L.H.

    2005-01-01

    The uses of nucleic acid-directed methods have increased significantly in the past five years and have made important contributions to disease control country programmes for improving national and international trade. These developments include the more routine use of PCR as a diagnostic tool in veterinary diagnostic laboratories. However, there are many problems associated with the transfer and particularly, the application of this technology. These include lack of consideration of: the establishment of quality-assured procedures, the required set-up of the laboratory and the proper training of staff. This can lead to a situation where results are not assured. This book gives a comprehensive account of the practical aspects of PCR and strong consideration is given to ensure its optimal use in a laboratory environment. This includes the setting-up of a PCR laboratory; Good Laboratory Practice and standardised PCR protocols to detect animal disease pathogens. Examples of Standard Operating Procedures as used in individual specialist laboratories and an outline of training materials necessary for PCR technology transfer are presented. The difficulties, advantages and disadvantages in PCR applications are explained and placed in context with other test systems. Emphasis is placed on the use of PCR for detection of pathogens, with a particular focus on diagnosticians and scientists from the developing world. It is hoped that this book will enable readers from various disciplines and levels of expertise to better judge the merits of PCR and to increase their skills and knowledge in order to assist in a more logical, efficient and assured use of this technology

  4. Nova target diagnostics control system

    International Nuclear Information System (INIS)

    Severyn, J.R.

    1985-01-01

    During the past year the Nova target diagnostics control system was finished and put in service. The diagnostics loft constructed to the north of the target room provides the environmental conditions required to collect reliable target diagnostic data. These improvements include equipment cooling and isolation of the power source with strict control of instrumentation grounds to eliminate data corruption due to electromagnetic pulses from the laser power-conditioning system or from target implosion effects

  5. Diagnostics of Factors of Enterprise Innovation Development

    Directory of Open Access Journals (Sweden)

    Skrynkovskyy Ruslan M.

    2017-03-01

    Full Text Available The aim of the article is the formation and development of theoretical and methodological foundations for diagnosing the factors of innovation development of an enterprise within the framework of theory and practice of economics and enterprise management. It was found out that the presented diagnostics should be understood as the process of identification, analysis and determination of the degree of influence of certain factors (positive, negative on the processes of innovative development of an enterprise in order to identify and solve problems (available, possible of hindering its innovation activity (introduction of new technological processes, innovative types of products, etc. in the context of ensuring an effective functioning and development of the enterprise. It is determined that the key business indicators of the system for diagnosing the factors of innovation development of an enterprise are indicators that reflect main factors of innovation development: indicator of innovation development; indicator of innovation activity of personnel; indicator of provision of the enterprise with intangible assets; indicator of the property required for innovative development; indicator of promotion of innovative products to the market. The prospect for further research in this scientific direction is developing a system of partial diagnostic purposes of a multicriteria system for diagnosing activities of enterprises with consideration for diagnostics of innovative development factors of the enterprise as a partial diagnostic purpose.

  6. [Metastazation into the seminal vesicles due to primary goblet cell carcinoid of the vermiform appendix. An unusual diagnostic procedure of a seminal vesicle tumor].

    Science.gov (United States)

    Gramann, T; Matter, L; Pfofe, D; Flury, R; Jaeger, P

    2009-11-01

    We report on a remarkable diagnostic work up of suspect rectal palpation results in a 54-year-old patient. According to a transrectal ultrasound-guided punch biopsy the patient was suspected of having a carcinoma of the seminal vesicles and an aggressive operational approach was considered. After a median laparotomy a generalized peritoneal carcinomatosis was found. A goblet cell carcinoid of the vermiform appendix was identified as the primary tumor. This case report deals with metastazation of a primary goblet cell carcinoma into the seminal vesicles on both sides as an extremely rare reason for suspicious rectal palpation results. The tumor valency, diagnostic work up, therapy and further differential diagnoses are described.

  7. Hepatic Epithelioid Hemangioendothelioma - a Rare Tumor and Diagnostic Dilemma.

    Science.gov (United States)

    Treska, Vladislav; Daum, Ondrej; Svajdler, Martin; Liska, Vaclav; Ferda, Jiri; Baxa, Jan

    2017-01-01

    Hepatic epithelioid haemangio-endothelioma (HEHE) is a very rare malignant tumor of vascular origin and uncertain biological behaviour that is difficult to diagnose using preoperative radiology diagnostic techniques. The authors present here two patients with HEHE of different extent. The first patient had a generalised form of disease, with involvement of the liver, lungs and bones and was treated with a combination of bevacizumab and capecitabine. The second patient had a localised form of disease involving the liver and this was resolved using a combination of liver resection and radiofrequency ablation. In both patients, the radiology work-up before surgery was non-specific and metastases of another malignant process were considered. The definitive histological diagnosis was made by the pathologist on the basis of immunohistochemical analysis that demonstrated the presence of CD31, CD34 and calmodulin-binding transcription activator 1 (CAMTA 1). Both patients remain in an overall good condition 27 and 5 months respectively following treatment for HEHE. Preoperative radiological diagnosis of HEHE is difficult and immunohistochemical examination of the tumor tissue sample remains the key diagnostic tool. Radical surgical resection or liver transplantation is the method of choice in patients with localised liver involvement. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  8. Team building and diagnostic training

    International Nuclear Information System (INIS)

    Bulmer, S.

    1987-01-01

    While developing a commercial training program to improve teamwork in control room crews, General Electric's Nuclear Training Services made an important discovery. Traditional training methods for developing teamwork and enhancing diagnostics capabilities are incomplete. Traditional methods generally help, but fail to fulfill the long-term needs of most teams. Teamwork has been treated as a short-term performance problem. Traditional diagnostic training suffers from a similar problem. Too often, it covers only the basic principles of decision-making, ignoring the development of expert diagnostic capabilities. In response to this discovery, they have developed comprehensive training in Team Building and Diagnostics

  9. Amelanotic melanoma masquerading as a superficial small round cell tumor: A diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Archana Shetty

    2014-01-01

    Full Text Available Malignant melanoma poses a remarkable capacity for morphological diversity and often presents as a diagnostic challenge due to its wide clinical presentation. We present a case of a 73-year-old lady, with a large superficial ulcerative nodular mass on the flexor aspect of the right upper arm. On fine needle aspiration poorly differentiated round cell tumor was suggested, with histopathology also supporting the same diagnosis. A final diagnosis of amelanotic melanoma was given following immunohistochemical work-up using a panel of relevant markers. We are presenting this case, not only for its rare clinical presentation, but also for the diagnostic difficulties encountered by us in cytology and histopathology to reach the final diagnosis.

  10. Neuropsychological diagnostics of neurosarcoidosis

    Directory of Open Access Journals (Sweden)

    Vera B. Nikishina

    2018-02-01

    Full Text Available This article presents the results of neuropsychological studies of the patients with neurosarcoidosis. The obtained results show that typical manifestations of neurosarcoidosis are disorders of motor functions. They appear in the speed reduction of actions and their accuracy, which prove peripheral neuropathy and myopathy at the functional level as clinical signs of neurosarcoidosis. Specific manifestations of neurosarcoidosisare determinedby topographical localization of granulomatoma.

  11. COAGULATION ASSESSMENT: UNDERUTILIZED DIAGNOSTIC TOOLS IN ZOO AND AQUATIC ANIMAL MEDICINE.

    Science.gov (United States)

    Gerlach, Trevor J; Barratclough, Ashley; Conner, Bobbi

    2017-12-01

    Veterinarians specializing in nondomestic species are faced with unique challenges regarding research and diagnostic capabilities given the wild and frequently dangerous nature of their patients. Standard diagnostic techniques used in small or large animal practice are not always possible due to anatomical constraints, size, tractability, or the inherent risk of anesthesia in highly valued, rare species. Diagnostic modalities that utilize simple, relatively noninvasive techniques show promise in evaluating nondomestic species and elucidating the pathophysiology behind poorly characterized disease processes in both wild and captive populations. Coagulation profiles, which may include prothrombin time (PT), partial thromboplastin time (PTT), D-dimer concentration, platelet count, and thromboelastography (TEG) are frequently used in domestic species but often overlooked in exotic medicine due to lack of normal reference values and/or availability. Whenever possible, coagulation profiles should be utilized in the evaluation of various disease processes including neoplasia, sepsis, trauma, inflammation, toxin exposure, and envenomation. There are several reports of coagulopathies in both wild and captive species; however, few studies on coagulation profiles have been published on nondomestic species. Clinicians should consider coagulation testing as part of the diagnostic work-up in nondomestic species. A review of available coagulation diagnostic tests is provided here in addition to summarizing the pertinent coagulation disorders currently established in the literature.

  12. The diagnostic management of upper extremity deep vein thrombosis: A review of the literature.

    Science.gov (United States)

    Kraaijpoel, Noémie; van Es, Nick; Porreca, Ettore; Büller, Harry R; Di Nisio, Marcello

    2017-08-01

    Upper extremity deep vein thrombosis (UEDVT) accounts for 4% to 10% of all cases of deep vein thrombosis. UEDVT may present with localized pain, erythema, and swelling of the arm, but may also be detected incidentally by diagnostic imaging tests performed for other reasons. Prompt and accurate diagnosis is crucial to prevent pulmonary embolism and long-term complications as the post-thrombotic syndrome of the arm. Unlike the diagnostic management of deep vein thrombosis (DVT) of the lower extremities, which is well established, the work-up of patients with clinically suspected UEDVT remains uncertain with limited evidence from studies of small size and poor methodological quality. Currently, only one prospective study evaluated the use of an algorithm, similar to the one used for DVT of the lower extremities, for the diagnostic workup of clinically suspected UEDVT. The algorithm combined clinical probability assessment, D-dimer testing and ultrasonography and appeared to safely and effectively exclude UEDVT. However, before recommending its use in routine clinical practice, external validation of this strategy and improvements of the efficiency are needed, especially in high-risk subgroups in whom the performance of the algorithm appeared to be suboptimal, such as hospitalized or cancer patients. In this review, we critically assess the accuracy and efficacy of current diagnostic tools and provide clinical guidance for the diagnostic management of clinically suspected UEDVT. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Statefinder diagnostic for coupled quintessence

    International Nuclear Information System (INIS)

    Zhang Xin

    2005-01-01

    The problem of the cosmic coincidence is a longstanding puzzle. This conundrum may be solved by introducing a coupling between the two dark sectors. In this Letter, we study two cases of the coupled quintessence scenario. (a) Assume that the mass of dark matter particles depends exponentially on the scalar field associated to dark energy and meanwhile the scalar field evolves in an exponential potential; (b) Assume that the mass of dark matter particles depends on a power law function of the scalar field and meanwhile the scalar field evolves in a power law potential. Since the dynamics of this system is dominated by an attractor solution, the mass of dark matter particles is forced to change with time as to ensure that the ratio between the energy densities of dark matter and dark energy becomes a constant at late times, and one thus solve the cosmic coincidence problem naturally. We perform a statefinder diagnostic to both cases of this coupled quintessence scenario. It is shown that the evolving trajectory of this scenario in the s-r diagram is quite different from those of other dark energy models

  14. Technical diagnostics of steam turbines

    International Nuclear Information System (INIS)

    Vlckova, B.; Drahy, J.

    1987-01-01

    This paper deals with practical experience in application of technical diagnostics methods to steam turbines, in particular using pedestal and shaft vibration measurements as well as estimation of bearing metal temperature and ultrasound emission signals. An estimation of effectiveness of the diagnostics methods used is given on the basis of experimental investigations made on a 30-MW turbine. (author)

  15. Imaging diagnostics of the foot

    International Nuclear Information System (INIS)

    Szeimies, Ulrike; Staebler, Axel; Walther, Markus

    2012-01-01

    The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

  16. Dual Processing and Diagnostic Errors

    Science.gov (United States)

    Norman, Geoff

    2009-01-01

    In this paper, I review evidence from two theories in psychology relevant to diagnosis and diagnostic errors. "Dual Process" theories of thinking, frequently mentioned with respect to diagnostic error, propose that categorization decisions can be made with either a fast, unconscious, contextual process called System 1 or a slow, analytical,…

  17. Psychometric perspectives on diagnostic systems

    NARCIS (Netherlands)

    Borsboom, D.

    2008-01-01

    The author identifies four conceptualizations of the relation between symptoms and disorders as utilized in diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994): A constructivist perspective, which holds

  18. Plasma diagnostics discharge parameters and chemistry

    CERN Document Server

    Auciello, Orlando

    1989-01-01

    Plasma Diagnostics, Volume 1: Discharge Parameters and Chemistry covers seven chapters on the important diagnostic techniques for plasmas and details their use in particular applications. The book discusses optical diagnostic techniques for low pressure plasmas and plasma processing; plasma diagnostics for electrical discharge light sources; as well as Langmuir probes. The text also describes the mass spectroscopy of plasmas, microwave diagnostics, paramagnetic resonance diagnostics, and diagnostics in thermal plasma processing. Electrical engineers, nuclear engineers, microwave engineers, che

  19. Moyamoya disease: Diagnostic imaging

    International Nuclear Information System (INIS)

    Tarasów, Eugeniusz; Kułakowska, Alina; Łukasiewicz, Adam; Kapica-Topczewska, Katarzyna; Korneluk-Sadzyńska, Alicja; Brzozowska, Joanna; Drozdowski, Wiesław

    2011-01-01

    Moyamoya disease is a progressive vasculopathy leading to stenosis of the main intracranial arteries. The incidence of moyamoya disease is high in Asian countries; in Europe and North America, the prevalence of the disease is considerably lower. Clinically, the disease may be of ischaemic, haemorrhagic and epileptic type. Cognitive dysfunction and behavioral disturbance are atypical symptoms of moyamoya disease. Characteristic angiographic features of the disease include stenosis or occlusion of the arteries of the circle of Willis, as well as the development of collateral vasculature. Currently, magnetic resonance angiography and CT angiography with multi-row systems are the main imaging methods of diagnostics of the entire range of vascular changes in moyamoya disease. The most common surgical treatment combines the direct arterial anastomosis between the superficial temporal artery and middle cerebral, and the indirect synangiosis involving placement of vascularised tissue in the brain cortex, in order to promote neoangiogenesis. Due to progressive changes, correct and early diagnosis is of basic significance in selecting patients for surgery, which is the only effective treatment of the disease. An appropriate qualification to surgery should be based on a comprehensive angiographic and imaging evaluation of brain structures. Despite the rare occurrence of moyamoya disease in European population, it should be considered as one of causes of ischaemic or haemorrhagic strokes, especially in young patients

  20. Laboratory diagnostics of malaria

    Science.gov (United States)

    Siahaan, L.

    2018-03-01

    Even now, malaria treatment should only be administered after laboratory confirmation. There are several principal methods for diagnosing malaria. All these methods have their disadvantages.Presumptive treatment of malaria is widely practiced where laboratory tests are not readily available. Microscopy of Giemsa-stained thick and thin blood films remains the gold standard for the diagnosis of malaria infection. The technique of slide preparation, staining and reading are well known and standardized, and so is the estimate of the parasite density and parasite stages. Microscopy is not always available or feasible at primary health services in limited resource settings due to cost, lack of skilled manpower, accessories and reagents required. Rapid diagnostic tests (RDTs) are potential tools for parasite-based diagnosis since the tests are accurate in detecting malaria infections and are easy to use. The test is based on the capture of parasite antigen that released from parasitized red blood cells using monoclonal antibodies prepared against malaria antigen target. Polymerase Chain Reaction (PCR), depend on DNA amplification approaches and have higher sensitivity than microscopy. PCR it is not widely used due to the lack of a standardized methodology, high costs, and the need for highly-trained staff.

  1. Chorioamnionitis: a diagnostic approach

    Directory of Open Access Journals (Sweden)

    Yeni Arroyave

    2013-09-01

    Full Text Available Introduction: Chorioamnionitis has been defined as inflammation of the amnion and chorion membranes in response to microbial invasion or other pathological process. May be clinical when clinical manifestations of local and systemic inflammation is present, subclinical when no clinical signs; histological if there is microscopic evidence of infection or inflammation in placental examination. The frequency of chorioamnionitis is highly variable, depending on the risk factors of the population studied, the criteria used for diagnosis (clinical or histological and gestational age. This clinical entity is important because results in maternal, fetal and neonatal aftermath such as postpartum endometritis, pelvic abscess and high risk of caesarean section in the mother. In the fetus, Prematurity, perinatal death, pneumonia, sepsis, intraventricular hemorrhage and cerebral palsy. Make an early and accurate diagnosis is essential to prevent these aftermath. Objective: Carry out a literature review on the diagnosis of chorioamnionitis. Methods: A search of the literature published during the last 5 years in Pubmed, Tripdatabase, Science direct and Embase biomedical was made, selecting the most relevant literature on chorioamnionitis. Conclusions: Despite medical advances in diagnostic methods, unify parameters for early diagnosis of chorioamnionitis is still a challenge, as shown by the variability of the evidence found in this review.

  2. Diagnostic evaluation of rhabdomyolysis.

    Science.gov (United States)

    Nance, Jessica R; Mammen, Andrew L

    2015-06-01

    Rhabdomyolysis is characterized by severe acute muscle injury resulting in muscle pain, weakness, and/or swelling with release of myofiber contents into the bloodstream. Symptoms develop over hours to days after an inciting factor and may be associated with dark pigmentation of the urine. Serum creatine kinase and urine myoglobin levels are markedly elevated. Clinical examination, history, laboratory studies, muscle biopsy, and genetic testing are useful tools for diagnosis of rhabdomyolysis, and they can help differentiate acquired from inherited causes of rhabdomyolysis. Acquired causes include substance abuse, medication or toxic exposures, electrolyte abnormalities, endocrine disturbances, and autoimmune myopathies. Inherited predisposition to rhabdomyolysis can occur with disorders of glycogen metabolism, fatty acid β-oxidation, and mitochondrial oxidative phosphorylation. Less common inherited causes of rhabdomyolysis include structural myopathies, channelopathies, and sickle-cell disease. This review focuses on the differentiation of acquired and inherited causes of rhabdomyolysis and proposes a practical diagnostic algorithm. Muscle Nerve 51: 793-810, 2015. © 2015 Wiley Periodicals, Inc.

  3. Bayesian modelling of fusion diagnostics

    Science.gov (United States)

    Fischer, R.; Dinklage, A.; Pasch, E.

    2003-07-01

    Integrated data analysis of fusion diagnostics is the combination of different, heterogeneous diagnostics in order to improve physics knowledge and reduce the uncertainties of results. One example is the validation of profiles of plasma quantities. Integration of different diagnostics requires systematic and formalized error analysis for all uncertainties involved. The Bayesian probability theory (BPT) allows a systematic combination of all information entering the measurement descriptive model that considers all uncertainties of the measured data, calibration measurements, physical model parameters and measurement nuisance parameters. A sensitivity analysis of model parameters allows crucial uncertainties to be found, which has an impact on both diagnostic improvement and design. The systematic statistical modelling within the BPT is used for reconstructing electron density and electron temperature profiles from Thomson scattering data from the Wendelstein 7-AS stellarator. The inclusion of different diagnostics and first-principle information is discussed in terms of improvements.

  4. Recent diagnostic developments on LHD

    International Nuclear Information System (INIS)

    Sudo, S.; Nagayama, Y.; Peterson, B.J.

    2003-01-01

    Standard diagnostics for fundamental plasma parameters and for plasma physics are routinely utilized for daily operation and physics study in the large helical device (LHD) with high reliability. Diagnostics for steady state plasma are intensively developed, especially for T e , n e (YAG laser Thomson, CO 2 laser polarimeter), data acquisition in steady state, heat resistant probes. To clarify the plasma property of the helical structure, 2-D or 3-D diagnostics are intensively developed: Tangential cameras (Fast SX TV, Photon counting CCD, H α TV); Tomography (Tangential SX CCD, Bolometer); Imaging (Bolometer, ECE, Reflectometer). Divertor and edge physics are one of important key issues for steady state operation. Diagnostics for neutral flux (H α array, Zeeman spectroscopy) and n e (Fast scanning probe, Li beam probe, Pulsed radar reflectometer). In addition to these, advanced diagnostics are being intensively developed with national and international collaborations in LHD. (author)

  5. Microfluidic Sensing Platforms for Medicine and Diagnostics

    DEFF Research Database (Denmark)

    Kiilerich-Pedersen, Katrine

    for decentralized clinical applications in medicine and diagnostics. In this PhD project, low cost electrochemical plastic sensors for basic research, diagnosis of viral infections or drug discovery were developed and evaluated. In the developed biosensor chip, early signs of virus infection in cell culture could...... and specificity. Influenza virus in saliva specimen was detectable within fifteen minutes at a clinically relevant concentration. The device has potential for miniaturization into a cost effective field ready point of care diagnostic system, where the majority of established techniques fail to function outside...... the specialized laboratory. Microfluidic cell migration devices, imitating in vivo conditions were developed with success, improving the in vitro experimental setup for basic research and drug discovery. Polymer biosensors have reached a new level of maturity, and pathogen detection could benefit from...

  6. ITER diagnostic system: Vacuum interface

    International Nuclear Information System (INIS)

    Patel, K.M.; Udintsev, V.S.; Hughes, S.; Walker, C.I.; Andrew, P.; Barnsley, R.; Bertalot, L.; Drevon, J.M.; Encheva, A.; Kashchuk, Y.; Maquet, Ph.; Pearce, R.; Taylor, N.; Vayakis, G.; Walsh, M.J.

    2013-01-01

    Diagnostics play an essential role for the successful operation of the ITER tokamak. They provide the means to observe control and to measure plasma during the operation of ITER tokamak. The components of the diagnostic system in the ITER tokamak will be installed in the vacuum vessel, in the cryostat, in the upper, equatorial and divertor ports, in the divertor cassettes and racks, as well as in various buildings. Diagnostic components that are placed in a high radiation environment are expected to operate for the life of ITER. There are approx. 45 diagnostic systems located on ITER. Some diagnostics incorporate direct or independently pumped extensions to maintain their necessary vacuum conditions. They require a base pressure less than 10 −7 Pa, irrespective of plasma operation, and a leak rate of less than 10 −10 Pa m 3 s −1 . In all the cases it is essential to maintain the ITER closed fuel cycle. These directly coupled diagnostic systems are an integral part of the ITER vacuum containment and are therefore subject to the same design requirements for tritium and active gas confinement, for all normal and accidental conditions. All the diagnostics, whether or not pumped, incorporate penetration of the vacuum boundary (i.e. window assembly, vacuum feedthrough etc.) and demountable joints. Monitored guard volumes are provided for all elements of the vacuum boundary that are judged to be vulnerable by virtue of their construction, material, load specification etc. Standard arrangements are made for their construction and for the monitoring, evacuating and leak testing of these volumes. Diagnostic systems are incorporated at more than 20 ports on ITER. This paper will describe typical and particular arrangements of pumped diagnostic and monitored guard volume. The status of the diagnostic vacuum systems, which are at the start of their detailed design, will be outlined and the specific features of the vacuum systems in ports and extensions will be described

  7. Costs of diagnostic and preoperative workup with and without breast MRI in older women with a breast cancer diagnosis.

    Science.gov (United States)

    Onega, Tracy; Tosteson, Anna N A; Weiss, Julie; Alford-Teaster, Jennifer; Hubbard, Rebecca A; Henderson, Louise M; Kerlikowske, Karla; Goodrich, Martha E; O'Donoghue, Cristina; Wernli, Karen J; DeMartini, Wendy B; Virnig, Beth A

    2016-02-27

    Breast cancer in the U.S. - estimated at 232,670 incident cases in 2014 - has the highest aggregate economic burden of care relative to other female cancers. Yet, the amount of cost attributed to diagnostic/preoperative work up has not been characterized. We examined the costs of imaging and biopsy among women enrolled in Medicare who did and did not receive diagnostic/preoperative Magnetic Resonance Imaging (MRI). Using Surveillance, Epidemiology and End Results (SEER)- Medicare data, we compared the per capita costs (PCC) based on amount paid, between diagnosis date and primary surgical treatment for a breast cancer diagnosis (2005-2009) with and without diagnostic/preoperative MRI. We compared the groups with and without MRI using multivariable models, adjusting for woman and tumor characteristics. Of the 53,653 women in the cohort, within the diagnostic/preoperative window, 20 % (N = 10,776) received diagnostic/preoperative MRI. Total unadjusted median costs were almost double for women with MRI vs. without ($2,251 vs. $1,152). Adjusted costs were higher among women receiving MRI, with significant differences in total costs ($1,065), imaging costs ($928), and biopsies costs ($138). Costs of diagnostic/preoperative workups among women with MRI are higher than those without. Using these cost estimates in comparative effectiveness models should be considered when assessing the benefits and harms of diagnostic/preoperative MRI.

  8. Plasma diagnostics for tokamaks and stellarators

    Energy Technology Data Exchange (ETDEWEB)

    Stott, P. E.; Sanchez, J.

    1994-07-01

    A collection of papers on plasma diagnostics is presented. The papers show the state of the art developments in a series of techniques: Magnetic diagnostics, Edge diagnostics, Langmuir probes, Spectroscopy, Microwave and FIR diagnostics as well as Thomson Scattering. Special interest was focused on those diagnostics oriented to fluctuations measurements in the plasma. (Author) 451 refs.

  9. Plasma diagnostics for tokamaks and stellarators

    International Nuclear Information System (INIS)

    Stott, P.E.; Sanchez, J.

    1994-01-01

    A collection of papers on plasma diagnostics is presented. The papers show the state of the art developments in a series of techniques: magnetic diagnostics, Edge diagnostics, Langmuir probes, Spectroscopy, Microwave and FIR diagnostics as well as Thomson Sattering. Special interest was focused on those diagnostics oriented to fluctuations measurements in the plasma

  10. Clinical relevance of nuclear medicine in diagnostics and therapy of the thyroid

    International Nuclear Information System (INIS)

    1982-01-01

    50 papers divided into 7 interrelated topics including the corresponding discussions are reported. The papers deal with diagnostics and therapy of thyroid diseases by means of radiopharmaceuticals. Carcinomas and functional disorders of the thyroid are discussed in the same way as problems of thyroiditis and thyroid immunology as well as morphological diagnostics of the thyroid and thyroid function related to other internal diseases

  11. [Diagnostic laparoscopy in acute abdomen].

    Science.gov (United States)

    Keller, R; Kleemann, M; Hildebrand, P; Roblick, U J; Bruch, H-P

    2006-11-01

    Acute abdomen is not a disease in itself but a description of a complex of symptoms combined with severe abdominal pain developed within a time frame of less than 24 h. All strategies for the management of acute abdomen underline the need for an interdisciplinary approach to diagnosis and therapy. This requires focused and intelligent use of efficient diagnostic procedures. Diagnostic laparoscopy may be a key to solving the diagnostic dilemma of unspecific acute abdomen. Furthermore, it allows not only direct inspection of the abdominal cavity but also surgical intervention, if needed. In particular the rate of negative laparotomies can be reduced.

  12. [DIAGNOSTIC ERRORS IN INTERNAL MEDICINE].

    Science.gov (United States)

    Schattner, Ami

    2017-02-01

    Diagnostic errors remain an important target in improving the quality of care and achieving better health outcomes. With a relatively steady rate estimated at 10-15% in many settings, research aiming to elucidate mechanisms of error is highly important. Results indicate that not only cognitive mistakes but a number of factors acting together often culminate in a diagnostic error. Far from being 'unpreventable', several methods and techniques are suggested that may show promise in minimizing diagnostic errors. These measures should be further investigated and incorporated into all phases of medical education.

  13. Mammary carcinoma diagnostics and therapy

    International Nuclear Information System (INIS)

    Fischer, Uwe; Baum, Friedemann

    2014-01-01

    The book on mammary carcinoma diagnostics and therapy covers the following issues: development, anatomy and physiology of the mammary glands, pathology of benign and malign mammary gland changes, non-imaging diagnostics; mammography; ultrasonic mammography; magnetic resonance tomography of the mammary glands; imaging diagnostics findings; mammary interventions; examination concepts; operative therapy of the mammary carcinoma; chemotherapy of the mammary carcinoma; radio-oncological therapy of the mammary carcinoma; logistics in a medical center for mammary gland diseases; logistics in an interdisciplinary center for mammary diseases; dialogue conduction and psycho-social attendance.

  14. Development of the Model of the System of Managerial Diagnostics of the Enterprise on the Basis of Improvement of Diagnostic Purposes

    Directory of Open Access Journals (Sweden)

    Grzegorz Pawlowski

    2017-11-01

    Full Text Available The purpose of the article is to develop a model of the system of managerial diagnostics of the enterprise on the basis of the improvement of diagnostic purposes. The developed model of the system of managerial diagnostics of the enterprise is a set of subjects (owners, managers, investors, specialists, etc., objects (management system, resources, technology, methods (a set of methods and means, business indicators and criteria (parameters that, when interacting, provide the achievement (efficient and effective of the diagnostic objectives of the system of the objectives of managerial diagnostics of the enterprise, taking into account the compliance of its competitive strategy of the state of the environment function of direct action (competitors, customers, suppliers, mediators, and other contact audiences in the context of improving the efficiency and developing the management. It is determined that the system of goals of the model of the system of managerial diagnostics of the enterprise (taking into account the ensuring of the compliance of the system of management with strategic goals and tactical tasks form the following key diagnostic objectives that require improvement on the basis of business indicators (parameters, namely: 1 diagnostics of the effectiveness of controlling the internal business processes of the enterprise; 2 diagnostics of the effectiveness of the typical organizational structure of enterprise management; 3 diagnostics of the efficiency of standardization of the work of linear and functional managers and specialists at the enterprise; 4 diagnostics of the enterprise in the areas of vocational education, labor activity and motivation, innovation work and social development; 5 diagnostics of the level of conflict in the team at the enterprise; 6 diagnostics of efficiency of use of information technologies in the management of the enterprise. The prospect of further research in this area is to improve the complex system of

  15. Diagnostics for the National Compact Stellarator Experiment

    International Nuclear Information System (INIS)

    Stratton, B.C.; Johnson, D.; Feder, R.; Fredrickson, E.; Neilson, H.; Takahashi, H.; Zarnstorf, M.; Cole, M.; Goranson, P.; Lazarus, E.; Nelson, B.

    2003-01-01

    The status of planning of the National Compact Stellarator Experiment (NCSX) diagnostics is presented, with the emphasis on resolution of diagnostics access issues and on diagnostics required for the early phases of operation

  16. Thioaptamer Diagnostic System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — AM Biotechnologies (AM) in partnership with Sandia National Laboratories will develop a Thioaptamer Diagnostic System (TDS) in response to Topic X10.01 Reusable...

  17. Cyclotron radiation as Tokamak diagnostics

    International Nuclear Information System (INIS)

    Fiedler-Ferrari, N.

    1985-01-01

    A brief introduction to the use of Electron Cyclotron Emission as diagnostics in tokamaks is made. The utilization feasibility of this dignostics in the TBR-1 and TTF2A tokamaks is discussed. (L.C.) [pt

  18. Diagnostics and Instrumentation for FEL

    CERN Document Server

    Couprie, M E

    2001-01-01

    Free Electron Laser are coherent sources of radiation based on the interaction of a relativistic electron beam in an undulator field. According to the energy of the accelerator, they presently cover a wide spectral range, from the infra-red to the VUV. FELs combine the diagnostics of typical laser systems (for the measurement of spectral and temporal characteristics, the transverse mode pattern, the polarisation) and the diagnostics of relativistic electron beams. The electron beam is characterised in order to evaluate and control the FEL performances, but also in order to measure the effect of the FEL on the electron beam. The FEL characteristics are monitored with various types of detectors, depending mainly on the spectral range. Diagnostics for Linac based Infra Red FELs and storage ring FELs in the UV-VUV will be described. Particular instrumentation, required for FEL operation, such as the optical resonator, possible diagnostics inside the undulator will also be analysed.

  19. Microfluidic technology for molecular diagnostics.

    Science.gov (United States)

    Robinson, Tom; Dittrich, Petra S

    2013-01-01

    Molecular diagnostics have helped to improve the lives of millions of patients worldwide by allowing clinicians to diagnose patients earlier as well as providing better ongoing therapies. Point-of-care (POC) testing can bring these laboratory-based techniques to the patient in a home setting or to remote settings in the developing world. However, despite substantial progress in the field, there still remain many challenges. Progress in molecular diagnostics has benefitted greatly from microfluidic technology. This chapter aims to summarise the more recent advances in microfluidic-based molecular diagnostics. Sections include an introduction to microfluidic technology, the challenges of molecular diagnostics, how microfluidic advances are working to solve these issues, some alternative design approaches, and detection within these systems.

  20. Calibration issues for neutron diagnostics

    International Nuclear Information System (INIS)

    Sadler, G.J.; Adams, J.M.; Barnes, C.W.

    1997-10-01

    In order for ITER to meet its operational and programmatic goals, it will be necessary to measure a wide range of plasma parameters. Some of the required parameters e.g., neutron yield, fusion power and power density, ion temperature profile in the core plasma, and characteristics of confined and escaping alpha particle populations are best measured by fusion product diagnostic techniques. To make these measurements, ITER will have dedicated diagnostic systems, including radial and vertical neutron cameras, neutron and gamma ray spectrometers, internal and external fission chambers, a neutron activation system, and diagnostics for confined and escaping alpha particles. Engineering integration of many of these systems is in progress, and other systems are under investigation. This paper summarizes the present state of design of fusion product diagnostic systems for ITER and discusses expected measurement capability

  1. Laser Diagnostics for Spacecraft Propulsion

    Science.gov (United States)

    MacDonald-Tenenbaum, Natalia

    2015-09-01

    Over the past several decades, a variety of laser diagnostic techniques have been developed and applied to diagnose spacecraft propulsion devices. Laser diagnostics are inherently non-intrusive, and provide the opportunity to probe properties such as temperature, concentration or number density of plume species, and plume velocities in the harsh environments of combustion and plasma discharges. This presentation provides an overview of laser diagnostic capabilities for spacecraft propulsion devices such as small monopropellant thrusters, arcjets, ion engines and Hall thrusters. Particular emphasis is placed on recent developments for time-resolved ion velocity measurements in Hall thruster plumes. Results are presented for one such diagnostic method, a time-synchronized CW-laser induced fluorescence (LIF) technique based on a sample hold scheme. This method is capable of correlating measured fluorescence excitation lineshapes with high frequency current fluctuations in the plasma discharge of a Hall thruster and is tolerant of natural drifting in the current oscillation frequency.

  2. Molecular diagnostics and therapeutics for ectopic pregnancy.

    Science.gov (United States)

    Tong, Stephen; Skubisz, Monika M; Horne, Andrew W

    2015-02-01

    Ectopic pregnancies are a serious gynaecological emergency that can be fatal. As such, prompt diagnosis and safe timely treatment is essential. Here, we review the literature on the development of molecularly targeted diagnostics and therapeutics for ectopic pregnancy. A blood-based biomarker that accurately identifies an ectopic pregnancy could be used to offer early diagnostic certainty in cases where ultrasound cannot determine the location of the embryo ('a pregnancy of unknown location'). Molecules examined so far can be broadly grouped into biological themes of relevance to reproduction: (i) Fallopian tube (dys)function, (ii) embryo/trophoblast growth, (iii) corpus luteum function, (iv) inflammation, (v) uterine function and (vi) angiogenesis. While a sensitive and specific biomarker for ectopic pregnancy has yet to be identified, it is possible that improvements in platform technologies or a multi-modal biomarker approach may yield an accurate diagnostic biomarker test. Furthermore, with the advent of better imaging technology, the need for a blood-based biomarker test may be superseded by improvements in ultrasound or magnetic resonance imaging technology. There have been some recent preclinical studies describing molecularly targeted therapeutic approaches for ectopic pregnancy. Notably, bench-to-bedside studies have examined the use of combination gefitinib (orally available epidermal growth factor receptor inhibitor) and methotrexate. Preclinical studies suggest that combination gefitinib and methotrexate is highly effective in inducing placental cell death, and is significantly more effective than methotrexate alone. In early human trials, encouraging preliminary efficacy data have shown that combination gefitinib and methotrexate can rapidly resolve tubal ectopic pregnancies, and large extra-tubal ectopic pregnancies. If a large clinical randomized controlled trial confirms these findings, combination gefitinib and methotrexate could become a new

  3. Advantages of digital imaging for radiological diagnostic

    International Nuclear Information System (INIS)

    Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

    2006-01-01

    The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

  4. Working up a Debt: Students as Vulnerable Consumers

    Science.gov (United States)

    Robson, Julie; Farquhar, Jillian Dawes; Hindle, Christopher

    2017-01-01

    Students are recognized as vulnerable consumers where financial matters are concerned, particularly with reference to indebtedness. This study examines student indebtedness in order to initiate wider debate about student vulnerability. We consider vulnerability as dynamic and temporal, linked to an event that renders the consumer susceptible to…

  5. Processes for working-up an aqueous fluosilicic acid solution

    Directory of Open Access Journals (Sweden)

    Alpha O. Toure

    2012-11-01

    Full Text Available Aqueous fluosilicic acid solutions were once considered to be only adverse by-products of phosphoric acid production, which required treatment to prevent ecosystem destruction when discharged into the sea. However, a range of chemicals can be generated by the transformation of this industrial waste product. Through experiments undertaken in the laboratory, we have shown the possibility of caustic soda production. Volumetric analysis showed caustic soda to be present as a 6%– 7%solution with yields of about 70% – 80%by weight. Two processes were investigated for the caustification of sodium fluoride, using different precipitates: sodium chloride and ethanol and are described by modelling caustification curves. The activation energies of precipitation determined by semi-empirical correlations showed that precipitation by ethanol (EA = 933.536 J/mol was more successful than precipitation by sodium chloride (EA = 7452.405 J/mol. Analyses performed on the precipitates highlighted compositions that are essential and useful constituents in the cement industry.

  6. Time response measurements of LASL diagnostic detectors

    International Nuclear Information System (INIS)

    Hocker, L.P.

    1970-07-01

    The measurement and data analysis techniques developed under the Los Alamos Scientific Laboratory's detector improvement program were used to characterize the time and frequency response of selected LASL Compton, fluor-photodiode (NPD), and fluor-photomultiplier (NPM) diagnostic detectors. Data acquisition procedures and analysis methods presently in use are summarized, and detector time and frequency data obtained using the EG and G/AEC electron linear accelerator fast pulse (approximately 50 psec FWHM) as the incident radiation driving function are presented. (U.S.)

  7. Novel uses of detonator diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Gibson, John R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wilde, Zakary Robert [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Tasker, Douglas George [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Francois, Elizabeth Green [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Nakamoto, Teagan Kanakanui Junichi [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Smith, Dalton Kay [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Trujillo, Christopher J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-09-15

    A novel combination of diagnostics is being used to research the physics of detonator initiation. The explosive PETN (Pentaerythritol tetranitrate) commonly used in detonators, is also a piezo-electric material that, when sufficiently shocked, emits an electromagnetic field in the radio frequency (RF) range, along crystal fracture planes. In an effort to capture this RF signal, a new diagnostic was created. A copper foil, used as an RF antenna, was wrapped around a foam fixture encompassing a PETN pellet. Rogowski coils were used to obtain the change in current with respect to time (di/dt) the detonator circuit, in and polyvinylidene difluoride (PVDF) stress sensors were used to capture shockwave arrival time. The goal of these experiments is to use these diagnostics to study the reaction response of a PETN pellet of known particle size to shock loading with various diagnostics including an antenna to capture RF emissions. Our hypothesis is that RF feedback may signify the rate of deflagration to detonation transition (DDT) or lack thereof. The new diagnostics and methods will be used to determine the timing of start of current, bridge burst, detonator breakout timing and RF generated from detonation. These data will be compared to those of currently used diagnostics in order to validate the accuracy of these new methods. Future experiments will incorporate other methods of validation including dynamic radiography, optical initiation and use of magnetic field sensors.

  8. Diagnostic indices for vertiginous diseases

    Directory of Open Access Journals (Sweden)

    Warninghoff Jan-Christian

    2010-10-01

    Full Text Available Abstract Background Vertigo and dizziness are symptoms which are reported frequently in clinical practice. We aimed to develop diagnostic indices for four prevalent vertiginous diseases: benign paroxysmal positional vertigo (BPPV, Menière's disease (MD, vestibular migraine (VM, and phobic postural vertigo (PPV. Methods Based on a detailed questionnaire handed out to consecutive patients presenting for the first time in our dizziness clinic we preselected a set of seven questions with desirable diagnostic properties when compared with the final diagnosis after medical workup. Using exact logistic regression analysis diagnostic scores, each comprising of four to six items that can simply be added up, were built for each of the four diagnoses. Results Of 193 patients 131 questionnaires were left after excluding those with missing consent or data. Applying the suggested cut-off points, sensitivity and specificity were 87.5 and 93.5% for BPPV, 100 and 87.4% for MD, 92.3 and 83.7% for VM, 73.7 and 84.1% for PPV, respectively. By changing the cut-off points sensitivity and specificity can be adjusted to meet diagnostic needs. Conclusions The diagnostic indices showed promising diagnostic properties. Once further validated, they could provide an ease to use and yet flexible tool for screening vertigo in clinical practice and epidemiological research.

  9. Diagnostic indices for vertiginous diseases

    Science.gov (United States)

    2010-01-01

    Background Vertigo and dizziness are symptoms which are reported frequently in clinical practice. We aimed to develop diagnostic indices for four prevalent vertiginous diseases: benign paroxysmal positional vertigo (BPPV), Menière's disease (MD), vestibular migraine (VM), and phobic postural vertigo (PPV). Methods Based on a detailed questionnaire handed out to consecutive patients presenting for the first time in our dizziness clinic we preselected a set of seven questions with desirable diagnostic properties when compared with the final diagnosis after medical workup. Using exact logistic regression analysis diagnostic scores, each comprising of four to six items that can simply be added up, were built for each of the four diagnoses. Results Of 193 patients 131 questionnaires were left after excluding those with missing consent or data. Applying the suggested cut-off points, sensitivity and specificity were 87.5 and 93.5% for BPPV, 100 and 87.4% for MD, 92.3 and 83.7% for VM, 73.7 and 84.1% for PPV, respectively. By changing the cut-off points sensitivity and specificity can be adjusted to meet diagnostic needs. Conclusions The diagnostic indices showed promising diagnostic properties. Once further validated, they could provide an ease to use and yet flexible tool for screening vertigo in clinical practice and epidemiological research. PMID:20973968

  10. THE PROBLEMS OF EARLY CLINICAL DEFECTOLOGICAL DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    Aleksandar CORDIC

    1997-06-01

    Full Text Available Clinical defectological diagnostics, related to diagnostics of each individual's impairment of his cognitive and socializing abilities, has been applied in our country for a long time. Since it is a new area in the clinical defectological work and a new form of research in defectology, it poses a series of problems which have not been met so far. We shall to recognize some of them in this paper and to aim at their solution.This time we shall consider only the most prominent problems towards which we direct our interventions:· When does defectological diagnostics take part in diagnosis as treatment of impairments of the handicapped person? When does it function in the process of rehabilitation? For example, is working with a dyslexic child treatment or rehabilitation?· When does the early diagnostics reveal a problem arising from inappropriate intersection of different development courses, which can sometimes be solved without any particular treatment (early stuttering, various convulsions, and when does it reveal actual condition, such as oligophrenia or autism. Thereby we ask ourselves if early stimulative treatment of oligophrenic children or children with early childhood psychosis is treatment or rehabilitation.We tried to classify end explain the problems of diagnostics in the context of treatment and rehabilitation and to define the theoretical grounds for our standpoints.We wanted to point out the unity of the process of any impairment of the handicapped person from early childhood to the end of his life. Treatment and rehabilitation should be a united process and follow the course of development of early disorders which sometimes end up as handicaps, and sometimes, thanks to the treatment, may end up in successful socialization, for example, persons with impaired hearing or sight.We establish defectology as a complete theoretical standpoint and expert procedure which is parallel to and complementary with medicine. The only difference we

  11. Climate Model Diagnostic Analyzer Web Service System

    Science.gov (United States)

    Lee, S.; Pan, L.; Zhai, C.; Tang, B.; Kubar, T. L.; Li, J.; Zhang, J.; Wang, W.

    2015-12-01

    Both the National Research Council Decadal Survey and the latest Intergovernmental Panel on Climate Change Assessment Report stressed the need for the comprehensive and innovative evaluation of climate models with the synergistic use of global satellite observations in order to improve our weather and climate simulation and prediction capabilities. The abundance of satellite observations for fundamental climate parameters and the availability of coordinated model outputs from CMIP5 for the same parameters offer a great opportunity to understand and diagnose model biases in climate models. In addition, the Obs4MIPs efforts have created several key global observational datasets that are readily usable for model evaluations. However, a model diagnostic evaluation process requires physics-based multi-variable comparisons that typically involve large-volume and heterogeneous datasets, making them both computationally- and data-intensive. In response, we have developed a novel methodology to diagnose model biases in contemporary climate models and implementing the methodology as a web-service based, cloud-enabled, provenance-supported climate-model evaluation system. The evaluation system is named Climate Model Diagnostic Analyzer (CMDA), which is the product of the research and technology development investments of several current and past NASA ROSES programs. The current technologies and infrastructure of CMDA are designed and selected to address several technical challenges that the Earth science modeling and model analysis community faces in evaluating and diagnosing climate models. In particular, we have three key technology components: (1) diagnostic analysis methodology; (2) web-service based, cloud-enabled technology; (3) provenance-supported technology. The diagnostic analysis methodology includes random forest feature importance ranking, conditional probability distribution function, conditional sampling, and time-lagged correlation map. We have implemented the

  12. The size of the thymus: an important immunological diagnostic tool?

    DEFF Research Database (Denmark)

    Jeppesen, Dorthe Lisbeth

    2003-01-01

    The report on the influence of seasonal factors on thymic size in early life describes a pattern of ultrasonographically measured thymic growth in Gambian infants including the finding of a smaller thymus in the hungry season. These factors raise a number of important questions: Is the size...... of the thymus relevant to its function and could measurement of the thymus be a useful immunological diagnostic tool in the investigation of thymic function in humans with a depressed immune system? Conclusion: Studies using the size of the thymus as an immunological diagnostic tool should be encouraged....

  13. A Perspective on Middle-Aged and Older Men With Functional Hypogonadism: Focus on Holistic Management.

    Science.gov (United States)

    Grossmann, Mathis; Matsumoto, Alvin M

    2017-03-01

    Middle-aged and older men (≥50 years), especially those who are obese and suffer from comorbidities, not uncommonly present with clinical features consistent with androgen deficiency and modestly reduced testosterone levels. Commonly, such men do not demonstrate anatomical hypothalamic-pituitary-testicular axis pathology but have functional hypogonadism that is potentially reversible. Literature review from 1970 to October 2016. Although definitive randomized controlled trials are lacking, evidence suggests that in such men, lifestyle measures to achieve weight loss and optimization of comorbidities, including discontinuation of offending medications, lead to clinical improvement and a modest increase in testosterone. Also, androgen deficiency-like symptoms and end-organ deficits respond to targeted treatments (such as phosphodiesterase-5 inhibitors for erectile dysfunction) without evidence that hypogonadal men are refractory. Unfortunately, lifestyle interventions remain difficult and may be insufficient even if successful. Testosterone therapy should be considered primarily for men who have significant clinical features of androgen deficiency and unequivocally low testosterone levels. Testosterone should be initiated either concomitantly with a trial of lifestyle measures, or after such a trial fails, after a tailored diagnostic work-up, exclusion of contraindications, and appropriate counseling. There is modest evidence that functional hypogonadism responds to lifestyle measures and optimization of comorbidities. If achievable, these interventions may have demonstrable health benefits beyond the potential for increasing testosterone levels. Therefore, treatment of underlying causes of functional hypogonadism and of symptoms should be used either as an initial or adjunctive approach to testosterone therapy.

  14. Clinical presentation and diagnostic workup for community-acquired pneumonia: the Gulf Corporation Council CAP Working Group consensus statement.

    Science.gov (United States)

    Memish, Z A; Arabi, Y M; Ahmed, Q A; Al Jahdali, H; Shibl, A M; Niederman, M S

    2007-10-01

    Community-acquired pneumonia (CAP) is diagnosed on the basis of a suggestive history and compatible physical findings and new infiltrates on a chest radiograph. No criteria or combination of criteria based on history and physical examination have been found to be gold standard. With the rise in elderly Gulf Cooperation Council (GCC) residents, CAP is likely to present with non-classical manifestations such as somnolence, new anorexia, and confusion and carries a worse outcome than CAP in their younger counterparts. Tuberculosis should be considered in the differential diagnosis of unresolving CAP in the GCC region. Diagnostic work up depends on severity of CAP, clinical course and underlying risk factors.

  15. Whole-Exome Sequencing as a diagnostic tool in a child with Atypical Episodic Muscle Weakness

    Science.gov (United States)

    Magoulas, Pilar L.; Bainbridge, Matthew; Muzny, Donna; Wu, YuanQing; Wang, Min; Lupski, James R.; Gibbs, Richard A.; Brown, Chester W.

    2014-01-01

    The advent of whole-exome next-generation sequencing (WES) has been pivotal for the molecular characterization of Mendelian disease; however, the clinical application of WES has remained relatively unexplored. We describe our experience with WES as a diagnostic tool in a three-year old female patient with a two-year history of episodic muscle weakness and paroxysmal dystonia who presented following a previous extensive but unrevealing diagnostic work-up. WES was performed on the proband and her two parents. Parental exome data was used to filter de novo genomic events in the proband and suspected mutations were confirmed using di-deoxy sequencing. WES revealed a de novo non-synonymous mutation in exon 21 of the calcium channel gene CACNA1S that has been previously reported in a single patient as a rare cause of atypical hypokalemic periodic paralysis. This was unexpected, as the proband’s original differential diagnosis had included hypokalemic periodic paralysis, but clinical and laboratory features were equivocal, and standard clinical molecular testing for hypokalemic periodic paralysis and related disorders was negative. This report highlights the potential diagnostic utility of WES in clinical practice, with implications for the approach to similar diagnostic dilemmas in the future. PMID:22901280

  16. Saliva as a diagnostic medium.

    Science.gov (United States)

    Pink, Richard; Simek, Jiri; Vondrakova, Jana; Faber, Edgar; Michl, Petr; Pazdera, Jindrich; Indrak, Karel

    2009-06-01

    This is a review of current knowledge on the use of saliva, gingival cervical fluid and mucosal transudate in the detection of some oral and systemic diseases as well as drugs. Oral fluid is a diagnostic medium that can be easily collected and with minimal invasion but it has been neglected in the past. Today, saliva is being used more often to diagnose: HIV virus, oro-facial and systemic tumors, cardiovascular disease and in detecting addictive substances. Neutropil levels in saliva may also indicate successful bone marrow transplant. Oral fluid is now systematically being researched and oral fluid analysis is being compared with the analysis of other diagnostic media such as blood and urine. A number of recent studies have focused on oncogenic marker detection and its monitoring in saliva. The latest clinical and laboratory findings on diagnostic markers of oropharyngeal carcinoma in oral fluid could be the beginning of their wider use as a diagnostic medium. Oral fluid can also be also used to diagnose other malignancies such as breast cancer which was one of the first malignant tumors to be detected using genetic protein biomarkers. Raised levels of CA15-3 and the epidermal growth factor (EGF) receptor have been found in patients with breast cancer and elevated levels of CA 125 and the glycoprotein complex in the saliva of ovarian cancer patients. Doubtless, the diagnostic value of saliva, aided by current technological development will increase rapidly in the near future.

  17. Diagnostic peptide discovery: prioritization of pathogen diagnostic markers using multiple features.

    Directory of Open Access Journals (Sweden)

    Santiago J Carmona

    Full Text Available The availability of complete pathogen genomes has renewed interest in the development of diagnostics for infectious diseases. Synthetic peptide microarrays provide a rapid, high-throughput platform for immunological testing of potential B-cell epitopes. However, their current capacity prevent the experimental screening of complete "peptidomes". Therefore, computational approaches for prediction and/or prioritization of diagnostically relevant peptides are required. In this work we describe a computational method to assess a defined set of molecular properties for each potential diagnostic target in a reference genome. Properties such as sub-cellular localization or expression level were evaluated for the whole protein. At a higher resolution (short peptides, we assessed a set of local properties, such as repetitive motifs, disorder (structured vs natively unstructured regions, trans-membrane spans, genetic polymorphisms (conserved vs. divergent regions, predicted B-cell epitopes, and sequence similarity against human proteins and other potential cross-reacting species (e.g. other pathogens endemic in overlapping geographical locations. A scoring function based on these different features was developed, and used to rank all peptides from a large eukaryotic pathogen proteome. We applied this method to the identification of candidate diagnostic peptides in the protozoan Trypanosoma cruzi, the causative agent of Chagas disease. We measured the performance of the method by analyzing the enrichment of validated antigens in the high-scoring top of the ranking. Based on this measure, our integrative method outperformed alternative prioritizations based on individual properties (such as B-cell epitope predictors alone. Using this method we ranked [Formula: see text]10 million 12-mer overlapping peptides derived from the complete T. cruzi proteome. Experimental screening of 190 high-scoring peptides allowed the identification of 37 novel epitopes with

  18. Recent applications of nuclear medicine in diagnostics: II part

    Directory of Open Access Journals (Sweden)

    Giorgio Treglia

    2013-04-01

    Full Text Available Introduction: Positron-emission tomography (PET and single photon emission computed tomography (SPECT are effective diagnostic imaging tools in several clinical settings. The aim of this article (the second of a 2-part series is to examine some of the more recent applications of nuclear medicine imaging techniques, particularly in the fields of neurology, cardiology, and infection/inflammation. Discussion: A review of the literature reveals that in the field of neurology nuclear medicine techniques are most widely used to investigate cognitive deficits and dementia (particularly those associated with Alzheimer disease, epilepsy, and movement disorders. In cardiology, SPECT and PET also play important roles in the work-up of patients with coronary artery disease, providing accurate information on the state of the myocardium (perfusion, metabolism, and innervation. White blood cell scintigraphy and FDG-PET are widely used to investigate many infectious/inflammatory processes. In each of these areas, the review discusses the use of recently developed radiopharmaceuticals, the growth of tomographic nuclear medicine techniques, and the ways in which these advances are improving molecular imaging of biologic processes at the cellular level.

  19. [Acute myeloid leukemia. Genetic diagnostics and molecular therapy].

    Science.gov (United States)

    Schlenk, R F; Döhner, K; Döhner, H

    2013-02-01

    Acute myeloid leukemia (AML) is a genetically heterogeneous disease. The genetic diagnostics have become an essential component in the initial work-up for disease classification, prognostication and prediction. More and more promising molecular targeted therapeutics are becoming available. A prerequisite for individualized treatment strategies is a fast pretherapeutic molecular screening including the fusion genes PML-RARA, RUNX1-RUNX1T1 and CBFB-MYH11 as well as mutations in the genes NPM1, FLT3 and CEBPA. Promising new therapeutic approaches include the combination of all- trans retinoic acid and arsentrioxid in acute promyelocytic leukemia, the combination of intensive chemotherapy with KIT inhibitors in core-binding factor AML and FLT3 inhibitors in AML with FLT3 mutation, as well as gemtuzumab ozogamicin therapy in patients with low and intermediate cytogenetic risk profiles. With the advent of the next generation sequencing technologies it is expected that new therapeutic targets will be identified. These insights will lead to a further individualization of AML therapy.

  20. Intrarenal neuroblastoma - a diagnostic dilemma: A report of three cases

    Directory of Open Access Journals (Sweden)

    Anupam Lall

    2001-01-01

    Full Text Available Differentiation between the Wilms′ tumor (WT and the intrarenal neuroblastoma (IRNB is imperative, as the prognosis and the treatment are different for these condi-tions. It may pose a diagnostic challenge to distinguish them pre-operatively. Over the period of last 10 years (1990-1999, 3 children aged 2 months to 4 years were diagnosed to have IRNB. 2 cases were operated with a provisional diagnosis of WT, but on histology were found to have neuroblastoma. Taking benefit from our previous experience, the third case we encountered with a renal lump and bony metastasis with clinical features not con-sistent with the diagnosis of Wilms′ tumor was further investigated. Urinary catecholamines were significantly elevated and there was bone marrow involvement and positive bone scan for multiple bony metastasis. 2 pa-tients are on chemotherapy and follow-up for last 6 months, while 1 died 6 years back after a follow-up of 2 years. Patients who have a renal mass on imaging, with clinical features of rapid deterioration in general condi-tion and evidence of bony secondaries, should undergo work-up for neuroblastoma pre-operatively to confirm the diagnosis.

  1. Diagnostics for the ATA beam propagation experiments

    International Nuclear Information System (INIS)

    Fessenden, T.J.; Atchison, W.L.; Barletta, W.A.

    1981-11-01

    This report contains a discussion of the diagnostics required for the beam propagation experiment to be done with the ATA accelerator. Included are a list of the diagnostics needed; a description of the ATA experimental environment; the status of beam diagnostics available at Livermore including recent developments, and a prioritized list of accelerator and propagation diagnostics under consideration or in various stages of development

  2. Diagnostics for the ATA beam propagation experiments

    Energy Technology Data Exchange (ETDEWEB)

    Fessenden, T.J.; Atchison, W.L.; Barletta, W.A.

    1981-11-01

    This report contains a discussion of the diagnostics required for the beam propagation experiment to be done with the ATA accelerator. Included are a list of the diagnostics needed; a description of the ATA experimental environment; the status of beam diagnostics available at Livermore including recent developments, and a prioritized list of accelerator and propagation diagnostics under consideration or in various stages of development.

  3. Contribution of multiparameter flow cytometry immunophenotyping to the diagnostic screening and classification of pediatric cancer.

    Science.gov (United States)

    Ferreira-Facio, Cristiane S; Milito, Cristiane; Botafogo, Vitor; Fontana, Marcela; Thiago, Leandro S; Oliveira, Elen; da Rocha-Filho, Ariovaldo S; Werneck, Fernando; Forny, Danielle N; Dekermacher, Samuel; de Azambuja, Ana Paula; Ferman, Sima Esther; de Faria, Paulo Antônio Silvestre; Land, Marcelo G P; Orfao, Alberto; Costa, Elaine S

    2013-01-01

    Pediatric cancer is a relatively rare and heterogeneous group of hematological and non-hematological malignancies which require multiple procedures for its diagnostic screening and classification. Until now, flow cytometry (FC) has not been systematically applied to the diagnostic work-up of such malignancies, particularly for solid tumors. Here we evaluated a FC panel of markers for the diagnostic screening of pediatric cancer and further classification of pediatric solid tumors. The proposed strategy aims at the differential diagnosis between tumoral vs. reactive samples, and hematological vs. non-hematological malignancies, and the subclassification of solid tumors. In total, 52 samples from 40 patients suspicious of containing tumor cells were analyzed by FC in parallel to conventional diagnostic procedures. The overall concordance rate between both approaches was of 96% (50/52 diagnostic samples), with 100% agreement for all reactive/inflammatory and non-infiltrated samples as well as for those corresponding to solid tumors (n = 35), with only two false negative cases diagnosed with Hodgkin lymphoma and anaplastic lymphoma, respectively. Moreover, clear discrimination between samples infiltrated by hematopoietic vs. non-hematopoietic tumor cells was systematically achieved. Distinct subtypes of solid tumors showed different protein expression profiles, allowing for the differential diagnosis of neuroblastoma (CD56(hi)/GD2(+)/CD81(hi)), primitive neuroectodermal tumors (CD271(hi)/CD99(+)), Wilms tumors (>1 cell population), rhabdomyosarcoma (nuMYOD1(+)/numyogenin(+)), carcinomas (CD45(-)/EpCAM(+)), germ cell tumors (CD56(+)/CD45(-)/NG2(+)/CD10(+)) and eventually also hemangiopericytomas (CD45(-)/CD34(+)). In summary, our results show that multiparameter FC provides fast and useful complementary data to routine histopathology for the diagnostic screening and classification of pediatric cancer.

  4. Contribution of multiparameter flow cytometry immunophenotyping to the diagnostic screening and classification of pediatric cancer.

    Directory of Open Access Journals (Sweden)

    Cristiane S Ferreira-Facio

    Full Text Available Pediatric cancer is a relatively rare and heterogeneous group of hematological and non-hematological malignancies which require multiple procedures for its diagnostic screening and classification. Until now, flow cytometry (FC has not been systematically applied to the diagnostic work-up of such malignancies, particularly for solid tumors. Here we evaluated a FC panel of markers for the diagnostic screening of pediatric cancer and further classification of pediatric solid tumors. The proposed strategy aims at the differential diagnosis between tumoral vs. reactive samples, and hematological vs. non-hematological malignancies, and the subclassification of solid tumors. In total, 52 samples from 40 patients suspicious of containing tumor cells were analyzed by FC in parallel to conventional diagnostic procedures. The overall concordance rate between both approaches was of 96% (50/52 diagnostic samples, with 100% agreement for all reactive/inflammatory and non-infiltrated samples as well as for those corresponding to solid tumors (n = 35, with only two false negative cases diagnosed with Hodgkin lymphoma and anaplastic lymphoma, respectively. Moreover, clear discrimination between samples infiltrated by hematopoietic vs. non-hematopoietic tumor cells was systematically achieved. Distinct subtypes of solid tumors showed different protein expression profiles, allowing for the differential diagnosis of neuroblastoma (CD56(hi/GD2(+/CD81(hi, primitive neuroectodermal tumors (CD271(hi/CD99(+, Wilms tumors (>1 cell population, rhabdomyosarcoma (nuMYOD1(+/numyogenin(+, carcinomas (CD45(-/EpCAM(+, germ cell tumors (CD56(+/CD45(-/NG2(+/CD10(+ and eventually also hemangiopericytomas (CD45(-/CD34(+. In summary, our results show that multiparameter FC provides fast and useful complementary data to routine histopathology for the diagnostic screening and classification of pediatric cancer.

  5. Contribution of Multiparameter Flow Cytometry Immunophenotyping to the Diagnostic Screening and Classification of Pediatric Cancer

    Science.gov (United States)

    Ferreira-Facio, Cristiane S.; Milito, Cristiane; Botafogo, Vitor; Fontana, Marcela; Thiago, Leandro S.; Oliveira, Elen; da Rocha-Filho, Ariovaldo S.; Werneck, Fernando; Forny, Danielle N.; Dekermacher, Samuel; de Azambuja, Ana Paula; Ferman, Sima Esther; de Faria, Paulo Antônio Silvestre; Land, Marcelo G. P.; Orfao, Alberto; Costa, Elaine S.

    2013-01-01

    Pediatric cancer is a relatively rare and heterogeneous group of hematological and non-hematological malignancies which require multiple procedures for its diagnostic screening and classification. Until now, flow cytometry (FC) has not been systematically applied to the diagnostic work-up of such malignancies, particularly for solid tumors. Here we evaluated a FC panel of markers for the diagnostic screening of pediatric cancer and further classification of pediatric solid tumors. The proposed strategy aims at the differential diagnosis between tumoral vs. reactive samples, and hematological vs. non-hematological malignancies, and the subclassification of solid tumors. In total, 52 samples from 40 patients suspicious of containing tumor cells were analyzed by FC in parallel to conventional diagnostic procedures. The overall concordance rate between both approaches was of 96% (50/52 diagnostic samples), with 100% agreement for all reactive/inflammatory and non-infiltrated samples as well as for those corresponding to solid tumors (n = 35), with only two false negative cases diagnosed with Hodgkin lymphoma and anaplastic lymphoma, respectively. Moreover, clear discrimination between samples infiltrated by hematopoietic vs. non-hematopoietic tumor cells was systematically achieved. Distinct subtypes of solid tumors showed different protein expression profiles, allowing for the differential diagnosis of neuroblastoma (CD56hi/GD2+/CD81hi), primitive neuroectodermal tumors (CD271hi/CD99+), Wilms tumors (>1 cell population), rhabdomyosarcoma (nuMYOD1+/numyogenin+), carcinomas (CD45−/EpCAM+), germ cell tumors (CD56+/CD45−/NG2+/CD10+) and eventually also hemangiopericytomas (CD45−/CD34+). In summary, our results show that multiparameter FC provides fast and useful complementary data to routine histopathology for the diagnostic screening and classification of pediatric cancer. PMID:23472067

  6. Highly biocompatible and water-dispersible, amine functionalized magnetite nanoparticles, prepared by a low temperature, air-assisted polyol process: a new platform for bio-separation and diagnostics

    Science.gov (United States)

    Das, Manasmita; Dhak, Prasanta; Gupta, Satyajit; Mishra, Debasish; Maiti, Tapas K.; Basak, Amit; Pramanik, Panchanan

    2010-03-01

    A low temperature polyol process, based on glycolaldehyde mediated partial reduction of FeCl3·6H2O at 120 °C in the presence of sodium acetate as an alkali source and 2, 2'-(ethylenedioxy)-bis-(ethylamine) as an electrostatic stabilizer has been used for the gram-scale preparation of biocompatible, water-dispersible, amine functionalized magnetite nanoparticles (MNPs) with an average diameter of 6 ± 0.75 nm. With a reasonably high magnetization (37.8 e.m.u.) and amine groups on the outer surface of the nanoparticles, we demonstrated the magnetic separation and concentration implications of these ultrasmall particles in immunoassay. MRI studies indicated that these nanoparticles had the desired relaxivity for T2 contrast enhancement in vivo. In vitro biocompatibility, cell uptake and MR imaging studies established that these nanoparticles were safe in clinical dosages and by virtue of their ultrasmall sizes and positively charged surfaces could be easily internalized by cancer cells. All these positive attributes make these functional nanoparticles a promising platform for further in vitro and in vivo evaluations.

  7. Highly biocompatible and water-dispersible, amine functionalized magnetite nanoparticles, prepared by a low temperature, air-assisted polyol process: a new platform for bio-separation and diagnostics.

    Science.gov (United States)

    Das, Manasmita; Dhak, Prasanta; Gupta, Satyajit; Mishra, Debasish; Maiti, Tapas K; Basak, Amit; Pramanik, Panchanan

    2010-03-26

    A low temperature polyol process, based on glycolaldehyde mediated partial reduction of FeCl(3).6H(2)O at 120 degrees C in the presence of sodium acetate as an alkali source and 2, 2(')-(ethylenedioxy)-bis-(ethylamine) as an electrostatic stabilizer has been used for the gram-scale preparation of biocompatible, water-dispersible, amine functionalized magnetite nanoparticles (MNPs) with an average diameter of 6 +/- 0.75 nm. With a reasonably high magnetization (37.8 e.m.u.) and amine groups on the outer surface of the nanoparticles, we demonstrated the magnetic separation and concentration implications of these ultrasmall particles in immunoassay. MRI studies indicated that these nanoparticles had the desired relaxivity for T(2) contrast enhancement in vivo. In vitro biocompatibility, cell uptake and MR imaging studies established that these nanoparticles were safe in clinical dosages and by virtue of their ultrasmall sizes and positively charged surfaces could be easily internalized by cancer cells. All these positive attributes make these functional nanoparticles a promising platform for further in vitro and in vivo evaluations.

  8. Highly biocompatible and water-dispersible, amine functionalized magnetite nanoparticles, prepared by a low temperature, air-assisted polyol process: a new platform for bio-separation and diagnostics

    International Nuclear Information System (INIS)

    Das, Manasmita; Dhak, Prasanta; Gupta, Satyajit; Basak, Amit; Pramanik, Panchanan; Mishra, Debasish; Maiti, Tapas K

    2010-01-01

    A low temperature polyol process, based on glycolaldehyde mediated partial reduction of FeCl 3 ·6H 2 O at 120 deg. C in the presence of sodium acetate as an alkali source and 2, 2 ' -(ethylenedioxy)-bis-(ethylamine) as an electrostatic stabilizer has been used for the gram-scale preparation of biocompatible, water-dispersible, amine functionalized magnetite nanoparticles (MNPs) with an average diameter of 6 ± 0.75 nm. With a reasonably high magnetization (37.8 e.m.u.) and amine groups on the outer surface of the nanoparticles, we demonstrated the magnetic separation and concentration implications of these ultrasmall particles in immunoassay. MRI studies indicated that these nanoparticles had the desired relaxivity for T 2 contrast enhancement in vivo. In vitro biocompatibility, cell uptake and MR imaging studies established that these nanoparticles were safe in clinical dosages and by virtue of their ultrasmall sizes and positively charged surfaces could be easily internalized by cancer cells. All these positive attributes make these functional nanoparticles a promising platform for further in vitro and in vivo evaluations.

  9. The computer diagnostic program (DIAG 2) for identifying states of complex technical objects

    Science.gov (United States)

    Duer, Stanisław; Bernatowicz, Dariusz

    2017-10-01

    This paper presents a method to control an operation process of a complex technical object, with the use of trivalent diagnostic information. Also, a general diagram of the complex technical object was presented, and its internal structure was described. A diagnostic analysis was conducted, as a result of which sets of the functional elements of the object and its diagnostic signals were determined. Also, the methodology of the diagnostic examination of the technical system was presented. The result was a functional and diagnostic model, which constituted the basis for initial diagnostic information, which is provided by the sets of information concerning the elements of the basic modules and their output signals. The theoretical results obtained in the present study were verified in practice on the example of a complex and reparable technical object. It belongs to the group of technical equipment for which a short time of shutdowns is required (an ineffective use of the object).

  10. Development of ITER diagnostic window assemblies

    International Nuclear Information System (INIS)

    Maquet, Ph.; Walker, C.I.; Barnsley, R.; Bertalot, L.; Encheva, A.; Pitcher, C.S.; Reichle, R.; Vayakis, G.; Veshchev, E.; Udintsev, V.S.; Walsh, M.J.; Watts, C.; Patel, K.M.; Giacomin, T.; Hughes, Shaun; Taylor, Neill; Pearce, Robert; Okayama, Katsumi

    2013-01-01

    Highlights: • The concepts chosen for ITER Diagnostic Windows are given. • The description of the main components of the window assemblies is presented. • An overview of the R and D related to the window assemblies is given. • The process for their development is briefly explained. -- Abstract: Most of ITER's diagnostics will be provided with viewing lines (optical, microwave, spectroscopic) for the monitoring of key characteristics of the plasma or for the achievement of physical measurements inside the vacuum vessel. For many of them the nature of the physical signal transmitted through the viewing lines requires the implementation of window assemblies incorporating either Glass/Ceramic or Beryllium window. The main requirements of the Diagnostic Window Assemblies are the transmission of the signals without attenuation or disturbances, the containment of vacuum, the confinement of in-vessel radioactive materials. Although they are generally not in direct viewing of the plasma, they are exposed to severe environmental conditions in normal and accidental conditions. The concept chosen for ITER Diagnostic Window Assemblies is based on a system of two windows with a monitored interspace, largely inspired from previous large machine solutions. Such a system is able to satisfy the transmission and vacuum requirements. Although this capability has previously proven a high reliability level, ITER conditions, which are more stringent, impose the requirement for improvement of existing designs and even the development of novel solutions, in particular to assure the radioactive material confinement function, which must be met in all circumstances including all off-normal conditions. Moreover the qualification of these concepts shall meet the nuclear safety requirements, although non metallic and beryllium components are not covered by existing codes and standards. This paper presents designs of window assemblies for different diagnostics. It gives an update of the

  11. Diagnostic accuracy in virtual dermatopathology

    DEFF Research Database (Denmark)

    Mooney, E.; Kempf, W.; Jemec, G.B.E.

    2012-01-01

    Background Virtual microscopy is used for teaching medical students and residents and for in-training and certification examinations in the United States. However, no existing studies compare diagnostic accuracy using virtual slides and photomicrographs. The objective of this study was to compare...... diagnostic accuracy of dermatopathologists and pathologists using photomicrographs vs. digitized images, through a self-assessment examination, and to elucidate assessment of virtual dermatopathology. Methods Forty-five dermatopathologists and pathologists received a randomized combination of 15 virtual...... slides and photomicrographs with corresponding clinical photographs and information in a self-assessment examination format. Descriptive data analysis and comparison of groups were performed using a chi-square test. Results Diagnostic accuracy in dermatopathology using virtual dermatopathology...

  12. Fetal exposure in diagnostic radiology

    International Nuclear Information System (INIS)

    Baker, M.L.; Vandergrift, J.F.; Dalrymple, G.V.

    1979-01-01

    The problem of possible radiation damage to the fetus or embryo as a result of diagnostic radiography during pregnancy, particularly in the early stages, is discussed. Recommendations of therapeutic abortion after fetal exposure require an adequate knowledge of the doses involved. In the absence of actual dose measurements or estimates, approximate exposure levels may be determined from the literature. A summary of published values for radiography involving the lower abdomen is given. Data is also presented from a series of fetal exposures resulting mostly from routine diagnostic radiography when pregnancy was not known at the time but was established later. Results of actual dose measurements using a phantom and of dose calculations based on published values are in reasonable agreement indicating that literature values of dose provide a satisfactory alternative to measurement. These data suggest that diagnostic radiography rarely, if ever, results in fetal exposures high enough to justify therapeutic abortion. (author)

  13. Enhanced NIF neutron activation diagnostics.

    Science.gov (United States)

    Yeamans, C B; Bleuel, D L; Bernstein, L A

    2012-10-01

    The NIF neutron activation diagnostic suite relies on removable activation samples, leading to operational inefficiencies and a fundamental lower limit on the half-life of the activated product that can be observed. A neutron diagnostic system measuring activation of permanently installed samples could remove these limitations and significantly enhance overall neutron diagnostic capabilities. The physics and engineering aspects of two proposed systems are considered: one measuring the (89)Zr/(89 m)Zr isomer ratio in the existing Zr activation medium and the other using potassium zirconate as the activation medium. Both proposed systems could improve the signal-to-noise ratio of the current system by at least a factor of 5 and would allow independent measurement of fusion core velocity and fuel areal density.

  14. CT guided diagnostic foot injections

    International Nuclear Information System (INIS)

    Saifuddin, A.; Abdus-Samee, M.; Mann, C.; Singh, D.; Angel, J.C.

    2005-01-01

    AIM: To describe a CT technique for guiding diagnostic and therapeutic injections in the hind- and mid-foot. MATERIALS AND METHODS: Over a period of 50 months, 28 individuals were referred for diagnostic and therapeutic hind- and mid-foot injections before possible arthrodesis. A CT technique was developed that allowed entry into the various joints using a vertical approach. Numbers of joints injected were as follows: posterior subtalar, 21; talonavicular, 4; calcaneonavicular, calcaneocuboid, navicular-cuneiform and 5th metatarsocuboid joints, 1 each. RESULTS: All injections but one were technically successful. Significant relief of symptoms was noted by 16 participants, whereas for 9 there was no improvement and for 3 a partial response was achieved. CONCLUSION: CT is a simple and safe alternative to fluoroscopy for guiding diagnostic and therapeutic foot injections, and may be the technique of choice in cases of disordered anatomy

  15. Molecular diagnostics of neurodegenerative disorders.

    Science.gov (United States)

    Agrawal, Megha; Biswas, Abhijit

    2015-01-01

    Molecular diagnostics provide a powerful method to detect and diagnose various neurological diseases such as Alzheimer's and Parkinson's disease. The confirmation of such diagnosis allows early detection and subsequent medical counseling that help specific patients to undergo clinically important drug trials. This provides a medical pathway to have better insight of neurogenesis and eventual cure of the neurodegenerative diseases. In this short review, we present recent advances in molecular diagnostics especially biomarkers and imaging spectroscopy for neurological diseases. We describe advances made in Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD), and finally present a perspective on the future directions to provide a framework for further developments and refinements of molecular diagnostics to combat neurodegenerative disorders.

  16. Integration of diagnostics in ITER buildings

    Energy Technology Data Exchange (ETDEWEB)

    Arumugam, Arun Prakash, E-mail: arun.prakash@iter.org [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France); Walker, Chris; Mita, Y.; Patisson, L.; Kuehn, I.; Cantone, B. [ITER Organization, CS 90 046, 13067 St Paul Lez Durance Cedex (France)

    2011-10-15

    ITER Diagnostic systems extend from plasma to the various diagnostic areas where they are controlled and acquired data is processed. Diagnostic equipment is found at three levels of the Tokamak Building, within 21 port cells, the gallery and also at three levels of Diagnostic Area. Diagnostic equipment is also located in other buildings, such as the Hot Cell Facility for neutron testing and port plug receipt and preparation. This paper describes the relationship of the ITER Diagnostics with the Buildings and highlights the design requirement and solutions of satisfying this interface acceptably to diagnostic and building performance.

  17. SveDem, the Swedish Dementia Registry - a tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice.

    Directory of Open Access Journals (Sweden)

    Dorota Religa

    Full Text Available The Swedish Dementia Registry (SveDem was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden.SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se. The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes.The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden.SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.

  18. An edge over diagnostic setup

    Directory of Open Access Journals (Sweden)

    Sridhar Kannan

    2017-01-01

    Full Text Available Diagnostic setup proposed by H.D. Kingsley serves as a practical aid in treatment planning and diagnosis. These setups have some inherent shortcomings. A simple technique of duplication of the setups in dental stone can solve problems encountered before as well as provide many other advantages over the conventional procedure. The diagnostic setup is prepared by the conventional method [Figure 1]. An alginate impression is then taken of the setups and poured in dental stone to obtain the derived treatment model [Figure 2]. The same setup can now be further modified for alternate lines of treatment. Subsequently models could then be obtained as required [Figure 3].

  19. Diagnostic imaging in internal medicine

    International Nuclear Information System (INIS)

    Eisenberg, R.L.

    1985-01-01

    This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

  20. Differential diagnostics of bullous dermatoses

    Directory of Open Access Journals (Sweden)

    A. A. Kubanov

    2016-01-01

    Full Text Available Bullous dermatoses are the diseases characterized by vesication and erosion of skin and/or mucos coats, production of autoantibodies against the structural components of epidermis and/or derma. The most frequent diseases of these disorders are pemphigus, bullous pemphigoid, dermatitis herpetiformis, beningn familial chronic pemphigus (Gougerot Hailey-Hailey disease.Diagnostics of bullous dermatoses is based on assessement of clinical signs, results of cytological and histological studies and immunological tests. However none of the current diagnostic methods allows to reveal bullous dermatosis severally and with absolute certainty. Consequently it is necessary to perform wide range of clinical and laboratory tests for early diagnosis and treatment order.