Intracranial pressure and intracranial volume in children with craniosynostosis.

Intracranial volume and intracranial pressure have been measured in 66 children with craniosynostosis, 48 boys and 18 girls. The premature fusion of skull sutures is assumed to restrict skull growth and predispose to elevated intracranial pressure. Thirteen children (20 percent) had raised intracranial pressure and demonstrated a significant restriction of skull growth. In this series, volume measurement alone, however, did not serve as a reliable predictor that the intracranial pressure was raised.     

Orbital volume measurements in enophthalmos using three-dimensional CT imaging

The purpose of this study was to investigate enophthalmos by measuring the volume of various orbital structures using off-line computer techniques on images generated by a CT scanner. Eleven patients with enophthalmos had CT scans of the orbits consisting of 30 to 40 adjacent 1.5-mm slices. The data from the scans were analyzed on a Nova 830 stand-alone computer system using software programs that allowed measurement of total bony orbital volume, total soft-tissue volume, globe volume, orbital fat volume, neuromuscular tissue volume, and apex-to-globe distance in the horizontal plane. These data were analyzed comparing the volumes in the normal eye with the volumes in the enophthalmic eye in each patient. The analysis demonstrated a statistically significant increase in bony orbital volume in the enophthalmic eye, but the total soft-tissue volume, fat volume, neuromuscular tissue volume, and globe volume were the same as in the normal eye. The apex-to-globe distance, a measure of the degree of enophthalmos, was less in the enophthalmic eye than in the normal eye. These results suggest that in the majority of patients, the cause of posttraumatic enophthalmos is increased bony orbital volume rather than by soft-tissue loss or fat necrosis. (Several patients showed no volume discrepancies, and it is likely that cicatricial contracture is responsible for the enophthalmos in these cases.) This study suggests that the objective of surgery for correction of enophthalmos in patients with a volume discrepancy should be to decrease the volume of the bony orbit and to increase the anterior projection of the globe.     

Nocturnal ultrasound measurements of optic nerve sheath diameter correlate with intracranial pressure in children with craniosynostosis

Children with craniosynostosis are at risk for increased intracranial pressure, and additional possibilities to screen for increased intracranial pressure are required. The authors' aim was to use ultrasound measurements of the optic nerve sheath to understand and express the variability of intracranial pressure in syndromic craniosynostosis. Therefore, five pediatric patients with craniosynostosis underwent invasive 24-hour intracranial pressure monitoring and simultaneous optic nerve sheath measurements. In three patients, the intracranial pressure was abnormal, and during the second half of the night, the optic nerve sheath was increased in all three patients. The optic nerve sheath diameter changes during the night and is as dynamic as the intracranial pressure. To the best of their knowledge, the authors are the first to describe a real-time relationship of the optic nerve sheath with increased intracranial pressure in children.     

Contactless passive diagnosis for brain intracranial applications: A study using dielectric matching materials

A prototype system for passive intracranial monitoring using microwave radiometry is proposed. It comprises an ellipsoidal conductive wall cavity to achieve beamforming and focusing, in conjunction with sensitive multiband receivers for detection. The system has already shown the capability to provide temperature and/or conductivity variations in phantoms and biological tissue. In this article, a variant of the initially constructed modality is theoretically and experimentally investigated. Specifically, dielectric matching materials are used in an effort to improve the system's focusing attributes. The theoretical study investigates the effect of dielectric matching materials on the system's detection depth, whereas measurements with phantoms focus on the investigation of the system's detection level and spatial resolution. The combined results suggest that the dielectric matching layers lead to the improvement of the system's detection depth and temperature detection level. Also, the system's spatial resolution is explored at various experimental setups. Theoretical and experimental results conclude that with the appropriate combination of operation frequencies and dielectric layers, it is possible to monitor areas of interest inside human head models with a variety of detection depths and spatial resolutions. Bioelectromagnetics 31:335–349, 2010. © 2010 Wiley‐Liss, Inc.     

From CT scans of embedded Ivanovia to models using rapid prototyping

A limestone cube from Tunisia with embedded thalli of the Permian, coenocytic, cyathiform green alga, Ivanovia tebagaensis , was CT (computed tomography) scanned as a nondestructive method to study some of its morphological features. Two sets of scans were used to make three physical three-dimensional models of Ivanovia structures by rapid prototyping stereolithography or layer manufacturing: (1) an asexual reproductive bud using the initial medical CT scans; (2) a cyathiform thallus with an attached bud and a second cup fused to the bottom of the first; and (3) about ten per cent of the total rock volume. A set of high resolution scans was used to construct (2) and (3). Study of the models suggested new information on developmental stages of budding and the great extent of membrane connections.     

Virtual structural analysis of tibial fracture healing from low-dose clinical CT scans

Quantitative assessment of bone fracture healing remains a significant challenge in orthopaedic trauma research. Accordingly, we developed a new technique for assessing bone healing using virtual mechano-structural analysis of computed tomography (CT) scans. CT scans from 19 fractured human tibiae at 12 weeks after surgery were segmented and prepared for finite element analysis (FEA). Boundary conditions were applied to the models to simulate a torsion test that is commonly used to access the structural integrity of long bones in animal models of fracture healing. The output of each model was the virtual torsional rigidity (VTR) of the healing zone, normalized to the torsional rigidity of each patient’s virtually reconstructed tibia. This provided a structural measure to track the percentage of healing each patient had undergone. Callus morphometric measurements were also collected from the CT scans. Results showed that at 12 weeks post-op, more than 75% of patients achieved a normalized VTR (torsional rigidity relative to uninjured bone) of 85% or above. The predicted intact torsional rigidities compared well with published cadaveric data. Across all patients, callus volume and density were weakly and non-significantly correlated with normalized VTR and time to clinical union. Conversely, normalized VTR was significantly correlated with time to union (R² = 0.383, p = 0.005). This suggests that fracture scoring methods based on the visual appearance of callus may not accurately predict mechanical integrity. The image-based structural analysis presented here may be a useful technique for assessment of bone healing in orthopaedic trauma research.     

Non-destructive tree-ring measurements using a clinical 3T-MRI for archaeology

For dendrochronology, both high spatial resolution and a wide imaging area are required. However, there has been no study to satisfy these two requirement for a tree-ring measurement method using magnetic resonance imaging (MRI). In this study, we developed a ring-width measurement method (ultra-high-resolution T2 weighted imaging: uHR-T2WI) using clinical MRI that can scan images at high resolution and over a wide sample area for waterlogged wood, by repeating small fields of view (FOV).Incidentally, until now, the method using X-ray computed tomography (X-CT) has been developed for non-destructive ring-width measurement for analysis of wooden cultural heritage and excavated wooden artifacts, and is mainly successful for dried samples with a low moisture content. However, the contrast of X-CT images tends to reduce as the water content increases, and it has been reported that the attempts to visualize waterlogged and PEG-impregnated archaeological oak wood were unsuccessful owing to a low degree of contrast between the water/PEG and the preserved wood (Bill et al., 2012).Actually, the archaeologically excavated wood generally has very high moisture content (400%–800%), thereby reducing the suitability of X-CT for tree-ring analysis.On the other hand, MRI equipment images the density and state of hydrogen nuclei, and so the expected quality of MRI improves as the moisture content of the wood increases.With these factors, to use both modality complementary will be very useful for dendroarchaeology. However, direct comparison of the suitable range of each modality has not been reported. Therefore, we examined the difference between X-CT and MRI related to moisture content of wood, and examined the range of adaptation for each modality as a function of moisture content.By using the proposed method, we then obtained a tree-ring width series and evaluated the usefulness of the proposed method. The uHR-T2WI method was able to obtain tree-ring width series comparable to those of an optical scanner from images acquired at a spatial resolution of 0.05 mm in high moisture content wood. The results show that wood with a high moisture content (e.g., waterlogged wood measured immediately after excavation, or high-water-content lacquered wooden cultural property) can now be successfully analyzed as non-destructive methods with MRI.In conclusion, the complementarity of both MRI and X-CT will be very useful as non-destructive inspection methods for dendroarchaeology. Although further research should consider more wood species, our study suggests that the proposed method will significantly advance the field of dendrochronology, particularly when related to dendroarchaeology.     

Antiandrogens: clinical applications

Antiandrogens, preventing androgen action at target tissue level, are used in the treatment of various androgen-dependent diseases. Pharmacologically these substances have either a steroidal structure, like cyproterone acetate (CPA) and spironolactone (SPL), or a non-steroidal structure, like flutamide (FLU). In women with hyperandrogenism (PCO syndrome, idiopathic hirsutism, acne), clinical benefit may be obtained with CPA, which also displays a progestational activity and an antigonadotropic effect. CPA (25-50 mg/day) is used in combination with ethinyl-estradiol (EE) (20-30 micrograms/day) in reversed sequential regimen. SPL, less effective than CPA may be employed in moderate hirsutism and acne at dosages of 100-200 mg/day. During SPL treatment menstrual irregularities are frequent: in this case an association with oral contraceptives is indicated. SPL + bromocriptine (2.5-5 mg/day) has been experienced with success in PCO syndrome. The pure antiandrogen FLU, inducing progressive increase in LH and testosterone secretion, may be used only in combination with oral contraceptives. In men antiandrogens have been tested in BPH and prostatic carcinoma. In BPH the decrease in nuclear receptors and DHT nuclear content during CPA or FLU may represent the rational base of the medical treatment. An improvement in urinary obstructive manifestation has been observed with CPA alone or associated with tamoxifen (100 mg + 100 mg day). In advanced prostatic carcinoma antiandrogens represent a good alternative to estrogen therapy with less side effects and in combination with surgical or medical castration (LH-RH analogues) achieve a complete androgen blockade. An increase in the percentage of remissions and survival has been reported.     

The correction factors for sucrose gap measurements and their practical applications.

The distribution of extracellular and intracellular potential in the sucrose gap apparatus, previously established for a single fiber using the cable equations for a core conductor model (Jirounek and Straub, Biophys. J., 11:1, 1971), is obtained for a multifiber preparation. The exact equation is derived relating the true membrane potential change to the measured potential differences across the sucrose gap, the junction potentials between sucrose and physiological solution, the membrane potential in the sucrose region, and the electrical parameters of the preparation in each region of the sucrose gap. The extracellular potential distribution has been measured using a modified sucrose gap apparatus for the frog sciatic nerve and the rabbit vagus nerve. The results indicate a hyperpolarization of the preparations in the sucrose region, of 60--75 mV. The hyperpolarization is independent of the presence of junction potentials. The calculation of the correction terms in the equation relating the actual to the measured potential change is illustrated for the case of complete depolarization by KC1 on one side of the sucrose gap. The correction terms in the equation are given for various experimental conditions, and a number of nomographic charts are presented, by means of which the correction factors can be rapidly evaluated.     

A method for estimating cell volume of amoebae based on measurements of cell length of motile forms: physiological and ecological applications

A novel method of estimating the cell volume of non-testate, free-living amoebae is presented. Measurements of the length (L) of motile forms of some amoebae, obtained by applying some basic rules, can be used to calculate diameter (D) using a relatively simple formula, derived from regression analysis (N=39): D=0.6L. Important physiological and ecological variables, including carbon content and respiratory rate, can then be easily calculated using this estimated cell volume.     

Three-dimensional surface imaging from CT scans for the study of craniofacial dysmorphology

Computer-assisted medical imaging technologies provide new tools for the study of congenital craniofacial deformities. Three-dimensional surface reconstructions have been developed to simplify the interpretation and improve the utility of CT scans of the head. While 3-D reconstructions initially were applied to assist clinical management of craniofacial deformities, these images now are finding utility in the study of unique anomalies, the definition of group characteristics for dysmorphic heads, the differentiation of similar phenotypes, and the documentation of the effects of cranial surgery on craniofacial growth. These findings should assist the formulation and evaluation of hypotheses regarding mechanisms of congenital malformation and deformation.     

Nestorone: clinical applications for contraception and HRT

The 19-nor derivatives of progesterone are referred to as "pure" progestational molecules as they bind almost exclusively to the progesterone receptor (PR) without interfering with receptors of other steroids. In this category is Nestorone, which has strong progestational activity and antiovulatory potency with no androgenic or estrogenic activity in vivo. These properties make it highly suitable for use in contraception and hormonal therapy (HT). Due to its high potency, very low doses of Nestorone may be delivered via long-term sustained-release delivery systems. Nestorone, 75 or 100 microg per day, released by vaginal ring has suppressed ovulation in women, with inhibition of follicular maturation. A vaginal ring releasing both 150 microg of Nestorone and 15 microg of ethinyl estradiol per day has effectively suppressed ovulation for 13 consecutive cycles. Nestorone has also been used effectively in a single implant for contraception in breastfeeding women and shows promise for use in transdermal systems as a contraceptive or for HT when combined with estrogen.     

True and false positive peaks in genomewide scans: applications of length-biased sampling to linkage mapping.

Disease-susceptibility loci are now being mapped via genomewide scans in which a linkage statistic is computed at each of a large number of markers. Such disease-susceptibility loci may be identified via a peak in the test statistic when the latter is plotted against the genetic map. In this paper we establish, by appealing to renewal theory, that true positive peaks are expected to be longer than false positive peaks. These results are verified by a realistic simulation of a genomewide linkage study based on the affected-sib-pair design. Since longer peaks are more likely to contain a gene of interest than are shorter peaks, these differences may aid in linkage mapping, justifying assignment of lower priority to shorter peaks. However, since these differences are generally small, statistics based on both peak length and height may not be much more powerful than those based on height alone. The results presented here also provide a theoretical framework for methods that use the length of shared haplotypes in populations to map disease genes.     

Radiation dose and cancer risks from radiation exposure during abdominopelvic computed tomography (CT) scans: comparison of diagnostic and radiotherapy treatment planning CT scans

In the present study, radiation doses and cancer risks resulting from abdominopelvic radiotherapy planning computed tomography (RP-CT) and abdominopelvic diagnostic CT (DG-CT) examinations are compared. Two groups of patients who underwent abdominopelvic CT scans with RP-CT (n = 50) and DG-CT (n = 50) voluntarily participated in this study. The two groups of patients had approximately similar demographic features including mass, height, body mass index, sex, and age. Radiation dose parameters included CTDI_vol, dose–length product, scan length, effective tube current, and pitch factor, all taken from the CT scanner console. The ImPACT software was used to calculate the patient-specific radiation doses. The risks of cancer incidence and mortality were estimated based on the BEIR VII report of the US National Research Council. In the RP-CT group, the mean ± standard deviation of cancer incidence risk for all cancers, leukemia, and all solid cancers was 621.58 ± 214.76, 101.59 ± 27.15, and 516.60 ± 189.01 cancers per 100,000 individuals, respectively, for male patients. For female patients, the corresponding risks were 742.71 ± 292.35, 74.26 ± 20.26, and 667.03 ± 275.67 cancers per 100,000 individuals, respectively. In contrast, for DG-CT cancer incidence risks were 470.22 ± 170.07, 78.23 ± 18.22, and 390.25 ± 152.82 cancers per 100,000 individuals for male patients, while they were 638.65 ± 232.93, 62.14 ± 13.74, and 575.73 ± 221.21 cancers per 100,000 individuals for female patients. Cancer incidence and mortality risks were greater for RP-CT than for DG-CT scans. It is concluded that the various protocols of abdominopelvic CT scans, especially the RP-CT scans, should be optimized with respect to the radiation doses associated with these scans.