Comparison of four methods for measuring femoral anteversion

This study evaluates the most valid and reproducible method for directly measuring anteversion (torsion) in dried femora using a commercially available measuring machine. Each femur was placed horizontally on the surface of the machine and readings were obtained from the head, the shaft distal to the lesser trochanter, and the distal end. Using computer software, four different anteversion angles were calculated: the center head-neck line to the retrocondylar line (Method 1); the center head-neck line to the transcondylar line (Method 2); the anterior head-trochanter line to the retrocondylar line (Method 3); and the anterior head-trochanter line to the transcondylar line (Method 4). The methods were applied to 20 femora, which were measured twice by one observer. The most reproducible method of measuring femoral anteversion uses the bone surfaces on the anterior aspect of the head and greater trochanter and on the posterior aspect of the condyles (Method 3.95% confidence limits of ± 0.4°). The other methods are shown to be reproducible to ±2.4°, ±3.3° and ±1.7° (Methods 1, 2, and 4, respectively, 95% confidence limits). Conversion factors between the different methods are: 12.5° + 0.8 x (anteversion angle) to change each of Method 2 to Method 1 and Method 4 to Method 3; and 8° + 0.7 x (anteversion angle) to change each of Method 1 to Method 3 and Method 2 to Method 4 (correct to within ±3°). © 1993 Wiley-Liss, Inc.     

Partial volume mapping using magnetic resonance fingerprinting

Magnetic resonance fingerprinting (MRF) is a quantitative imaging technique that maps multiple tissue properties through pseudorandom signal excitation and dictionary‐based reconstruction. The aim of this study is to estimate and validate partial volumes from MRF signal evolutions (PV‐MRF), and to characterize possible sources of error. Partial volume model inversion (pseudoinverse) and dictionary‐matching approaches to calculate brain tissue fractions (cerebrospinal fluid, gray matter, white matter) were compared in a numerical phantom and seven healthy subjects scanned at 3 T. Results were validated by comparison with ground truth in simulations and ROI analysis in vivo. Simulations investigated tissue fraction errors arising from noise, undersampling artifacts, and model errors. An expanded partial volume model was investigated in a brain tumor patient. PV‐MRF with dictionary matching is robust to noise, and estimated tissue fractions are sensitive to model errors. A 6% error in pure tissue T₁ resulted in average absolute tissue fraction error of 4% or less. A partial volume model within these accuracy limits could be semi‐automatically constructed in vivo using k‐means clustering of MRF‐mapped relaxation times. Dictionary‐based PV‐MRF robustly identifies pure white matter, gray matter and cerebrospinal fluid, and partial volumes in subcortical structures. PV‐MRF could also estimate partial volumes of solid tumor and peritumoral edema. We conclude that PV‐MRF can attribute subtle changes in relaxation times to altered tissue composition, allowing for quantification of specific tissues which occupy a fraction of a voxel.     

A comprehensive neuropsychological mapping battery for functional magnetic resonance imaging

Existing batteries for FMRI do not precisely meet the criteria for comprehensive mapping of cognitive functions within minimum data acquisition times using standard scanners and head coils. The goal was to develop a battery of neuropsychological paradigms for FMRI that can also be used in other brain imaging techniques and behavioural research. Participants were 61 healthy, young adult volunteers (48 females and 13 males, mean age: 22.25 ± 3.39 years) from the university community. The battery included 8 paradigms for basic (visual, auditory, sensory-motor, emotional arousal) and complex (language, working memory, inhibition/interference control, learning) cognitive functions. Imaging was performed using standard functional imaging capabilities (1.5-T MR scanner, standard head coil). Structural and functional data series were analysed using Brain Voyager QX2.9 and Statistical Parametric Mapping-8. For basic processes, activation centres for individuals were within a distance of 3–11 mm of the group centres of the target regions and for complex cognitive processes, between 7 mm and 15 mm. Based on fixed-effect and random-effects analyses, the distance between the activation centres was 0–4 mm. There was spatial variability between individual cases; however, as shown by the distances between the centres found with fixed-effect and random-effects analyses, the coordinates for individual cases can be used to represent those of the group. The findings show that the neuropsychological brain mapping battery described here can be used in basic science studies that investigate the relationship of the brain to the mind and also as functional localiser in clinical studies for diagnosis, follow-up and pre-surgical mapping.     

Reproducibility of whole‐brain temperature mapping and metabolite quantification using proton magnetic resonance spectroscopy

Assessing brain temperature can provide important information about disease processes (e.g., stroke, trauma) and therapeutic effects (e.g., cerebral hypothermia treatment). Whole‐brain magnetic resonance spectroscopic imaging (WB‐MRSI) is increasingly used to quantify brain metabolites across the entire brain. However, its feasibility and reliability for estimating brain temperature needs further validation. Therefore, the present study evaluates the reproducibility of WB‐MRSI for temperature mapping as well as metabolite quantification across the whole brain in healthy volunteers. Ten healthy adults were scanned on three occasions 1 week apart. Brain temperature, along with four commonly assessed brain metabolites—total N‐acetyl‐aspartate (tNAA), total creatine (tCr), total choline (tCho) and myo‐inositol (mI)—were measured from WB‐MRSI data. Reproducibility was evaluated using the coefficient of variation (CV). The measured mean (range) of the intra‐subject CVs was 0.9% (0.6%‐1.6%) for brain temperature mapping, and 4.7% (2.5%‐15.7%), 6.4% (2.4%‐18.9%) and 14.2% (4.4%‐52.6%) for tNAA, tCho and mI, respectively, with reference to tCr. Consistently larger variability was found when using H₂O as the reference for metabolite quantifications: 7.8% (3.3%‐17.8%), 7.8% (3.1%‐18.0%), 9.8% (3.7%‐31.0%) and 17.0% (5.9%‐54.0%) for tNAA, tCr, tCho and mI, respectively. Further, the larger the brain region (indicated by a greater number of voxels within that region), the better the reproducibility for both temperature and metabolite estimates. Our results demonstrate good reproducibility of whole‐brain temperature and metabolite measurements using the WB‐MRSI technique.     

Design of field-cycled magnetic resonance systems for small animal imaging

This paper presents a design study for a field-cycled magnetic resonance imaging (MRI) system directed at small animal imaging applications. A field-cycled MRI system is different from a conventional MRI system in that it uses two separate and dynamically controllable magnetic fields. A strong magnetic field is used to polarize the object, and a relatively weak magnetic field is used during signal acquisition. The potential benefits of field-cycled MRI are described. The theoretical dependences of field-cycled MRI performance on system design are introduced and investigated. Electromagnetic, mechanical and thermal performances of the system were considered in this design study. A system design for imaging 10 cm diameter objects is presented as an example, capable of producing high-duty-cycle polarizing magnetic fields of 0.5 T and readout magnetic fields corresponding to a proton Larmor frequency of 5 MHz. The specifications of the final design are presented along with its expected electromagnetic and thermal performance.     

Comparison of four serological methods for detecting antibodies toChlamydia trachomatis

The ability of four serological methods (enzyme-linked immunosorbent assay, single radial haemolysis, micro-immunofluorescence and complement fixation) to detect chlamydial antibodies was compared. Antigen was prepared fromChlamydia trachomatis serotype E. Sixty-two sera known to be positive and 12 negative reference sera were screened. The four tests yielded 71.6 % (53/74) concordant results (Chi-square=14.57,p < 0.01). Samples giving discordant results had only low levels of antibodies. Analysis of results showed a strong correlation between enzyme-linked immunosorbent assay and immunofluorescence (r=0.98), and complement fixation and single radial haemolysis (r=0.75). Antibodies were detected in 97 % of the 62 positive sera by immunofluorescence and in 91 % by enzyme-linked immunosorbent assay, whereas the results for complement fixation and single radial haemolysis were only 69.3 % and 70.9 % respectively. Extrapolation of the regression curve to the abscissae indicated a marginal superiority of immunofluorescence over enzyme-linked immunosorbent assay, although the reading of the results of the former test was more cumbersome. Good linearity was obtained between haemolytic zone diameter and reciprocal serum dilution in single radial haemolysis. Immunofluorescence was found to be the most sensitive and complement fixation the least sensitive of the four tests.     

Comparison of four different methods for detection of Cryptosporidium species.

Newly available assays offer alternatives to conventional microscopic examination for Cryptosporidium spp. We compared two enzyme immunoassays, ProSpect Cryptosporidium microtiter assay (Alexon, Inc., Mountain View, Calif.) and Color Vue Cryptosporidium assay (Serady, Indianapolis, Ind.), and a direct immunofluorescent assay, Merifluor Cryptosporidium kit (Meridian Diagnostics, Cincinnati, Ohio), with acid-fast Kinyoun-staining for the detection of Cryptosporidium spp. Examinations were performed on 129 stool specimens received from patients during a recent waterborne outbreak. A specimen was considered positive when organisms could be identified visually by acid-fast and immunofluorescent stains or if organisms could be visualized by either acid-fast or immunofluorescent stain and detected by both enzyme immunoassays. The final number of positive specimens was 55. No single procedure detected all 55 positive specimens. Of these, ProSpect and Color Vue detected 52 (sensitivity, 94.5%), and the Kinyoun stain and Merifluor detected 53 (sensitivity, 96.4%). The final number of negative specimens was 74. One false-positive result was seen with both the Kinyoun stain and the ProSpect assay. The Color Vue and ProSpect assays required the most hands-on technologist time. The ProSpect assay and Merifluor kit were easiest to perform. The acid-fast stain was difficult to interpret. The Merifluor kit was easiest to read and was adaptable to both batch and single testing. Overall, the Kinyoun stain and the Merifluor test were preferable to both of the enzyme immunoassays because of the high reagent cost and hands-on time required for the enzyme immunoassays. The difficult interpretation of the Kinyoun stain smears made the Merifluor a more desirable test despite its higher cost.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of four different methods for detection of rubella IgM antibodies

Four different tests for detection of rubella-specific IgM antibodies were compared: two Ig separation methods (centrifugation and chromatography) with subsequent haemagglutination inhibition test and two commercially available ELISA tests. The 114 sera tested had been sent to the diagnostic laboratory, mostly with insufficient clinical histories. Agreement between the centrifugation method and one of the ELISA tests was good (2 divergent results with 107 sera tested), while the other ELISA test yielded more positive (partly perhaps non-specific) results. The chromatographic method did not separate the Ig classes as reliably as the centrifugation method, but because of its simplicity it may be useful, if adequate test controls are performed. The divergent results are discussed. It is postulated that in cases with pending induced abortion, two independent tests should be performed.     

Comparison of four methods for testing high-level aminoglycoside resistance in enterococci

In a prospective study the prevalence of high-level aminoglycoside resistance (MIC 2,000 µg/ml) among 62 clinically significant enterococci was investigated. A total of 10⁵ organisms were inoculated a) onto a plate containing 2,000 µg/ml of gentamicin or streptomycin; b) into a microtube for dilution MIC determinations for gentamicin, amikacin, tobramycin and streptomycin; and c) into a single tube containing 500 µg/ml of gentamicin, amikacin, tobramycin or streptomycin in supplemented Mueller-Hinton broth. In addition, tubes containing 500 µg/ml of gentamicin, amikacin, tobramycin or streptomycin were inoculated with five enterococcal colonies (crude method). For 45 of the 62 isolates, MICs of gentamicin, amikacin and tobramycin were 500 µg/ml, while 17 (27 %) showed high-level resistance. The MICs of streptomycin were 500 µg/ml for 42 of 62 isolates, and 2,000 µg/ml for 20 (32.3 %). For 8 of the 17 (47 %) isolates showing high-level gentamicin resistance, MICs of streptomycin were 500 µg/ml. There was complete agreement between the results of the plate method, the microtube dilution MIC and the tube inoculated with 10⁵ CFU, but the crude method gave discordant results for two isolates. It is concluded that a tube containing 500 µg/ml of aminoglycoside is a simple, accurate and inexpensive method for determining high-level aminoglycoside resistance.     

Comparison of four methods for determining nitrate utilization by cryptococci.

This study evaluated the following methods for determining nitrate utilization: Wickerham broth, a special nitrate broth, Delft plate, and nitrate strip. With 236 isolates of cryptococci as test organisms, the special nitrate broth method gave 99% correct results and the Wickerham broth method gave 98%. The nitrate strip and Delft plate methods gave correct results in 94 and 86% of tests, respectively. The special nitrate broth method is judged superior because it provides accurate results within 48 h, compared to 14 days with the Wickerham broth method.     

Comparison of two methods for the estimation of subcortical volume and asymmetry using magnetic resonance imaging: a methodological study

Purpose

The subcortical brain structures are associated with other structures of nervous system; therefore, they have major influence on sensory–motor, limbic and cognitive information processing. Magnetic resonance imaging provides a detailed knowledge of normal and diseased anatomical structures for medical research. The aim of the current study was to compare the volumes of subcortical brain structures and determine the probable volumetric asymmetry in healthy subjects using stereological (point-counting) and semi-automatic segmentation methods.

Methods

MR scans were obtained from 30 subjects (17 males, 13 females) free of any psychiatric, neurological or cognitive impairment. MR images were analyzed by using stereological (point-counting) and semi-automatic segmentation methods.

Results

We did not find any significant differences among the subjects with respect to gender using both methods. This study showed no significant asymmetry in subcortical structures according to methods. Also, no significant difference was found between point-counting and semi-automated segmentation methods for the volumes of subcortical structures (p > 0.05).

Conclusion

From these results, it can be concluded that the semi-automated segmentation method and stereological technique can be used for reliable volume estimation of subcortical structures. However, the stereological method takes less time than semi-automated segmentation; it is simple, reliable and inexpensive. Further studies are required with larger samples in order to support these data.     

Comparison of four serological methods for the detection of diphtheria anti-toxin antibody

The aim of this study was to compare four serological methods for the detection of Corynebacterium diphtheriae IgG anti-toxin antibodies (IgG-DTAb) in human serum. One hundred serum samples were evaluated for C. diphtheriae IgG-DTAb by four different methods: passive haemagglutination (PHA), latex agglutination test (LA), toxoid enzyme-linked immunosorbent assay (Toxoid-ELISA), and toxin-binding inhibition enzyme-linked immunosorbent assay (ToBI-ELISA). As the external standardisation the neutralisation test for C. diphtheriae toxin in Vero cells (TN Vero) was used. For internal standardisation of IgG-DTAb titres, the WHO standard serum of human diphtheria antitoxin was used. The study revealed a poor correlation between the reference test and the PHA (r=0.34 Pearson's correlation coefficient), an acceptable correlation for the LA (r=0.74), a good correlation for the Toxoid-ELISA (r=0.81) and a very good correlation for ToBI-ELISA (r=0.93). The sensitivity measurements of PHA, LA, Toxoid-ELISA and ToBI-ELISA tests, were 14, 100, 94, 96% respectively and the corresponding specificity characteristics were 86, 76, 94, 90 respectively. Of the four evaluated methods, the ToBI-ELISA could be recommended for scientific and precise laboratory assays of diphtheria antibody levels in humans. For screening purposes the Toxoid-ELISA could be used, but the accuracy of antibody titres below 0.1 IU/ml, considered as the limits of protection, is questionable. Both tests offer very useful alternatives to the in vitro diphtheria toxin neutralisation test in Vero cells. Because of their unsatisfactory correlation and sensitivity as compared to the reference method, PHA and LA should be avoided and replaced by one of the two enzyme immunoassays.     

Comparison of four DNA-based methods for strain delineation of Candida lusitaniae.

Four methods for the accurate delineation of epidemiologically related and unrelated strains of Candida lusitaniae were compared. Three pulsed-field electrophoretic methods, including two contour-clamped homogeneous field gel electrophoresis methods (EKP-1 and EKP-2) yielding electrophoretic karyotype patterns of intact chromosomal DNA and a method in which the chromosomal DNA was macrodigested with the endonuclease SfiI prior to pulsed-field electrophoresis (MDP), and a random amplified polymorphic DNA (RAPD) assay were evaluated. A selected panel of 21 well-characterized isolated representing 13 strains of C. lusitaniae, including 7 epidemiologically related isolates of one strain (group I-A), 3 epidemiologically related isolates of another strain (group I-B), and 11 epidemiologically unrelated isolates (group II), were tested. All isolates were coded and tested in a blinded manner. All seven group I-A isolates were confirmed to be a single strain by the EKP-1 and MDP methods, and the three group I-B isolates were shown to be a single strain by the EKP-1, EKP-2, MDP, and RAPD methods. Subtle differences were noted with two of the group I-A isolates by the EKP-2 method, whereas three of these isolates were different by the RAPD method. Each group II isolate had distinct patterns by all four methods. These data support the fact that the three pulsed-field electrophoretic methods and the RAPD method can be used to delineate strains of C. lusitaniae.(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparison of four different methods for epidemiologic typing of Acinetobacter baumannii.

A set of 103 epidemiologically well-defined Acinetobacter baumannii isolates obtained from nine hospital outbreaks and 21 unrelated strains were characterized by pulsed-field gel electrophoresis (PFGE) of total genomic DNA digested with ApaI. Among outbreak strains, eight different patterns and five possible variants were identified by PFGE. Results were compared with those from traditional typing methods such as plasmid profile analysis, antimicrobial susceptibility, and biotyping. Plasmid analysis revealed six different and two related patterns; one outbreak strain lacked plasmids. A total of 16 of the 21 unrelated strains harbored plasmids and exhibited unique patterns. Epidemiologically unrelated strains were placed into only two biotypes and had similar antimicrobial susceptibility patterns but were clearly distinguished by PFGE. PFGE of A. baumannii chromosomal DNA yielded reproducible and easily readable results and showed excellent discriminatory power. However, plasmid profile analysis may provide a cost-effective first step in epidemiological typing of A. baumannii isolates obtained from well-defined hospital outbreaks.     

Comparison of four methods for assessing patient effective dose from radiological examinations

Three methods of indirect effective dose estimation were reviewed and compared to a direct effective dose determination method. An anthropomorphic phantom and thermoluminescence dosimetry were used to obtain dosimetric data associated with anterior-posterior (AP) abdominal radiography, posterior-anterior (PA) chest radiography, PA head radiography, and AP heart fluoroscopy. Effective dose was determined using: (i) organ specific dose values directly determined by thermoluminescence dosimeters, (ii) data published by National Radiological Protection Board (NRPB) and entrance surface dose (ESD), (iii) NRPB data and dose area product (DAP), (iv) energy imparted derived from DAP. The effective dose values estimated from the Rando phantom measurements were 161, 32.3, and 8.4 microSv/projection for the abdomen, chest, and head radiographs, respectively. Cardiac fluoroscopy yielded an effective dose value of 111 microSv/min. The effective dose values obtained indirectly using NRPB data and DAP were in good agreement with directly assessed values in all simulated exposures (difference <8%). The effective doses using NRPB data and ESD values differed from directly assessed values by less than 15% for the radiographic exposures and 60% for heart fluoroscopy. The energy imparted method yielded 136, 31, and 6.6 microSv/projection for the abdomen, chest, and head radiographs, respectively, and 111 microSv/min for heart fluoroscopy. Indirect patient effective dose determination using the NRPB dosimetric data and the measured value of incident radiation allows for reliable patient effective dose estimates. The use of DAP rather than ESD is recommended because it yields accurate results even for complex radiologic exposures involving fluoroscopy. The value of energy imparted may be used for the accurate determination of patient effective dose, especially when specific organ dose values are not of interest. The calculation of energy imparted with the use of EAP provides a reliable starting point for estimation of effective dose from radiologic examinations for which dosimetric data are not provided by NRPB.