Handcrafted firearm suicide: About the unusual use of a mole gun

The body of a man was found in a workshop at the back of his home, a metal pipe embedded in his chest. In the immediate vicinity of the body, among various tools, was a machine containing a holster hit of lead shot evoking a mole-trap-type “taupe gun” (mole gun).The findings at the scene and the presence of a metal tube, sinkers, and a flock in the chest are in favour of the use of a homemade firearm. The autopsy and CT scan revealed atypical ballistic thoracic trauma responsible for a dilaceration of both the heart and thoracic aorta that caused the death. The autopsy also found a contused wound at the back of the skull without intracranial lesion, which may be due to the fall of the victim after the thoracic trauma. There is no other traumatic lesion and in particular no lesion of seizure, constraint, or defense. Toxicological analyses revealed the presence of alcoholic impregnation at the time of death. These findings, confronted with the expertise of a balistician, made it possible to understand how the victim used a mole gun to cause these lesions. A metal tube was used as a cannon to aim more surely at the heart but also as a means of triggering the propulsion mechanism of the trap without having to stretch out the arm. The tube, thinner than the barrel, had disengaged from its tip to be embedded with the lead shot in the chest of the victim.     

Integrated active tracking detector for MRI-guided interventions

We present a fully integrated detector suitable for active tracking of interventional devices in MR-guided interventions. The single-chip microsystem consists of a detection coil, a tuning capacitor, an intermediate frequency downconversion receiver, and a phase-locked-loop-based frequency synthesizer. Thanks to the integrated mixer, the chip output stage delivers an analog frequency-downconverted NMR signal in the frequency range from 0 to 200 kHz. The microchip, realized in a standard complementary metal oxide semiconductor technology, has a size of 1 × 2 × 0.74 mm(3) and operates at a frequency of 63 MHz (i.e., in 1.5 T clinical scanners). Tests in a standard clinical scanner demonstrate the compatibility of the complementary metal oxide semiconductor microchip with clinical MRI systems. Using a solid sample of cis-polyisoprene having a size of 1 × 1.9 × 0.8 mm(3) as internal signal source, the detector achieves a three-dimensional isotropic spatial resolution of 0.15 mm in a measuring time of 100 ms.     

Suicide by a rifle with a muzzle brake: a particular entrance wound

The authors describe a case in which a 21-year-old male committed suicide using a rifle equipped with a muzzle brake, placed in contact with his head. A muzzle brake for firearms is a device positioned at the mouth of a weapon, which dissipates the gases, that are generated subsequent to the gun being discharged. Generally, when a gun is pressed against an anatomical region, where the skin lies on the bone surface without interposition of other soft parts, the entrance wound consists of many lacerated branches, originating from a central lack of tissue. In this case report, the use of a rifle with a muzzle brake generated an unexpected wound, circular in shape, with a diameter of 0.8 cm. This lesion was surrounded by a bruised area, circular in shape, and an abrasion collar of the height of 0.5 cm. In addition, a muzzle imprint mark consisting of intradermal bruises, composed of a narrow red line concentrically encircling the entrance hole, was found. In order to analyze in detail if this particular entrance wound could be associated with a weapon equipped with the muzzle brake, ballistic tests – with weapons compatible with that used by the victim – were performed.     

Rheological modelling of cardiorespiratory kinetics during sub-maximal exercise

Rheological modelling of cardiorespiratory kinetics during submaximal exercise. With a view to quantify the kinetic evolution of cardiorespiratory variables during a physical exercise the concept of the viscoelastic behaviour of materials is extended to the physiological context. The method is investigated by executing a curve fitting of the observations of five groups of young adult males performing each a 60 minutes submaximal ergometry at constant intensity levels equal to 10%, 25%, 40%, 50% and 75% of their maximal work load Wmax, respectively. The rheological model consists of a fast exponential adjustment, followed by a slow linear regulation and is in accordance with the physiological concept of the non-existence of an ergometric steady state. The linear relationship between the logarithm of the rheological parameters and the work intensity allows a relatively accurate prediction of the time course of the physiological variables during sub-maximal work. Choosing a reference physiological variable (eg, heart rate) at a specific work load level (eg, 25% of Wmax) the dynamic evolution of any of the cardiorespiratory variables at any sub-maximal work load can be estimated. The ratio of the retardation time to the relaxation time of the rheological Burgers model is proposed as a quantitative index to measure the dissipated power when a subject performs a prolonged effort of constant intensity.     

再论急救白金十分钟

急救“白金十分钟”理念提出后,逐步形成了狭义和广义的概念,在专业领域和社会上受到广泛关注并被同行接受.在“白金十分钟”内存在着救护的“急救盲区”,包括“救护空白时间”和“医疗空白时间”两个时段.急救时效性是应急救援决策及实践的出发点和归宿,应从时间、空间和人员三方面来把握最佳抢救时效值,救援的决策应该指向具有最佳时效值的“白金十分钟”.人民大众是自救互救的核心力量,是填补“救护空白时间”的主力军.从“白金十分钟”时效值角度对自救互救进行新的定义认为,自救互救是一切急救的开始和基础,具有比专业救护更高的救治时效值,不仅不能被专业救治所替代,还为专业救治提供了基础,是与专业救治相统一并同等重要的一个急救阶段,是抢救、救援链上独立的一环,这个初始环节的优劣直接决定后续救治的效果.“白金十分钟”是一面时效性旗帜,它指向急救链上最薄弱且义具有最佳时效的大众自救互救,其成功实施可以最大程度挖掘救治时效潜力,新形势下新概念的自救互救应该成为国家战略.     

Traumatic Neuroma around the Celiac Trunk after Gastrectomy Mimicking a Nodal Metastasis: A Case Report

Traumatic neuroma is a well-known disorder that occurs after trauma or surgery involving the peripheral nerve and develops from a nonneoplastic proliferation of the proximal end of a severed, partially transected, or injured nerve. We present a case of traumatic neuroma around the celiac trunk after gastrectomy in a 56-year-old man, which was confirmed by pathology. CT demonstrated the presence of a lobulated, homogeneous, hypoattenuating mass around the celiac trunk, mimicking a nodal metastasis.     

Pulmonary Venous Malformation in a 4-Year-Old Boy: a Case Report

We report a case of a pulmonary venous malformation in a 4-year-old boy who presented with recurrent pneumonia. A radiograph revealed a right infrahilar mass and a hyperlucent right lung. Computed tomography (CT) demonstrated a mass containing intensely enhancing areas and multiple phleboliths located in the right lower lobe and encasing the right bronchus and right inferior pulmonary vein. Magnetic resonance imaging (MRI) precisely revealed the mass demarcation. A right lower lobectomy was performed and a pathological examination confirmed the diagnosis of a venous malformation. To the best of our knowledge, a venous malformation in pulmonary tissue has not been reported in the English literature. Herein, we report a case of a pulmonary venous malformation, with the radiograph, CT, MRI, and blood pool scan findings, along with its pathologic correlation.     

Techniques in facial identification: Computer-aided facial reconstruction using a laser scanner and video superimposition

A facial image was reconstructed from the skull, part of a complete skeleton found in woodland, of a male person who had hanged himself from a tree. In addition, video superimposition was carried out with antemortem photographs of a person suspected of being the victim, and a good match was obtained. In a further case, a cheaper video-transparency superimposition was carried out, with identity later being confirmed on the basis of dental records. The techniques and the problems encountered are discussed. According to our experience, 3D computer reconstruction and video superimposition have a useful role in the process of identification, particularly in the early stages of an investigation and when other more definitive methods may not be available.     

Multilobulated popliteal cyst after a failed total knee arthroplasty

Popliteal cyst is a rare finding after total knee arthroplasty (TKA), but when present, it might indicate a malfunction of the TKA related to generation of wear-particles, or loosening. We present a case of a multilobulated popliteal cyst developing in a patient 8 years after primary TKA. The cyst was associated with a mechanical prosthetic loosening. The primary complaint of the patient was pain in the posterior region of the knee. A two-stage procedure consisting of cyst excision at first, followed after 5 months by a revision TKA was performed. Intraoperatively, a darkish, multilobulated cyst with a well-defined thick wall filled with fluid containing polyethylene debris, communicating with the knee joint was found. After 3 years of follow-up, the patient was satisfied and walked without the support of a cane. The patient presented a satisfactory knee range of motion. Clinical, radiological and ultrasound investigations ruled out popliteal cyst recurrence. A dissecting popliteal cyst associated with a failed TKA should be excised because it contains polyethylene debris that constitutes an induced factor for prosthetic loosening. A two-stage procedure with quite a long time in-between, as presented in this paper, can be a useful alternative to manage such a problem, in particular in very old patients associated with other medical problems.     

Schwannoma of the brachial plexus: cross-sectional imaging diagnosis using CT,sonography, and MR imaging

Primary brachial plexus tumors are rare, usually benign, and in general have a good prognosis after surgical excision. We present a case of a schwannoma in which sonography enabled the correct diagnosis of a probably benign brachial plexus tumor. Key to the diagnosis was the demonstration of a smooth-bordered, longish, and well-defined nodule along a brachial plexus nerve root. Cross-sectional imaging modalities that provide a high degree of soft tissue contrast and spatial resolution, such as sonography and MR imaging, were suitable methods to establish the correct preoperative diagnosis. Findings at CT, sonography, MR imaging, and surgery are discussed.     

中国农作物航空航天诱变育种的进展及其前景

１９８７年以来,中国先后将３００多个品种５０多种农作物种子,塔载返回卫星和高空气球。德育出的品（系）种主要有：丰产、抗病、优势的水稻新品系,能恢复灿稻不孕系的粳稻恢复系材料,果大５００ｇ以上的青椒新品,抗病、优质的番茄新品系,大英型油菜新类型,果大一倍的白莲种子和百合鳞。空间特殊条件能够引起材中子后代众多的变异,是农作物诱变育种的一个新的途径。     

A 16-plex Y-SNP typing system based on allele-specific PCR for the genotyping of Chinese Y-chromosomal haplogroups

Y-chromosomal SNP (Y-SNP), with its stable inheritance and low mutation, can provide Supplementary information in forensic investigation. While commonly used Y-chromosomal STR haplotypes show their limitations, typing of Y-SNP would become a powerful complement. In this study, a 16-plex Y-SNP typing system based on allele-specific PCR (AS-PCR) was developed to discriminate four dominant Y-chromosomal haplogroups (C-M130, D-CTS3946, N-M231, and O-M175) and 12 predominant sub-haplogroups of O-M175 (O1a-M119, O1a1a1a-CTS3265, O1b-M268, O1b1a2-Page59, O2-M122, O2a1-L127.1, O2a1b-F240, O2a1b1a1-CTS5820, O2a2-P201, O2a2b1a1-M177, O2a2b1a1a1a-Y17728, O2a2b1a2-F114). A series of experimental validation studies including sensitivity, species specificity, male-female mixture and inhibition were performed. The discrimination of the typing system was preliminarily proved with a haplogroup diversity of 0.9239. Altogether, the Y-SNP typing system based on AS-PCR should be capable of distinguishing China’s dominant Y-chromosomal haplogroups in a rapid and reliable manner, thus can be employed as a useful complement in forensic casework.     

Segmental anatomy of the liver: a review and a proposal for an international working nemenclature

The segmental anatomy of the human liver has become a field of increasing interest to radiologists during the past the past few years. The number of different terminologies which have been used since the topic has been systematically investigated is, however, a source of serious confusion. The present paper describes the reasons why the authors plead for an international working nomenclature which distinguishes a right hemiliver consisting of a right posterior and a right anterior segment, formed by subsegments 6 and 7, and 5 and 8, respectively, and a left hemiliver consisting of a left medial and a left lateral segment, the former corresponding to segment 4, and the latter to subsegments 2 and 3. This basic concept, however, must be carefully tailored to the highly variable individual anatomy of each patient. Furthermore, some aspects of hepatic segmentation are not yet understood and require additional anatomical investigation.Correspondence to: J. H. D. Fasel     

Imaging of neuropathies about the hip

Neuropathies about the hip may be cause of chronic pain and disability. In most cases, these conditions derive from mechanical or dynamic compression of a segment of a nerve within a narrow osteofibrous tunnel, an opening in a fibrous structure, or a passageway close to a ligament or a muscle. Although the evaluation of nerve disorders primarily relies on neurological examination and electrophysiology, diagnostic imaging is currently used as a complement to help define the site and aetiology of nerve compression and exclude other disease possibly underlying the patient’ symptoms. Diagnosis of entrapment neuropathies about the hip with US and MR imaging requires an in-depth knowledge of the normal imaging anatomy and awareness of the anatomic and pathologic factors that may predispose or cause a nerve injury. Accordingly, the aim of this article is to provide a comprehensive review of hip neuropathies with an emphasis on the relevant anatomy, aetiology, clinical presentation, and their imaging appearance. The lateral femoral cutaneous neuropathy (meiralgia paresthetica), femoral neuropathy, sciatic neuropathy, obturator neuropathy, superior and inferior gluteal neuropathies and pudendal neuropathy will be discussed.     

Fluctuation of adenosine concentration by modes of intravenous infusion based on mathematical simulation and experiments

OBJECTIVE: Adenosine, which has been used for a myocardial perfusion scan, shows rapid clearance from blood because of its short half-life of <10 seconds. This simulation study evaluates influences of modes of radionuclide injection on ventricular adenosine concentration when one intravenous injection line is used. METHODS: Assuming that radionuclide injection is a unit impulse, time-activity curves were measured in the left ventricle (LV) and fitted by a gamma function. Typical patterns of concentration fluctuation when adenosine infusion was temporarily modified were calculated by the convolution integral of input function and unit impulse response. Variation of concentration was measured by experiments using continuous 99mTc injection and co-infusion of water via a three-way stopcock. Modes of co-infusion with various infusion speeds and volumes were examined. RESULTS: Intermission of adenosine infusion and rapid displacement by radionuclide co-injection significantly influenced the adenosine concentration in LV. Intermission of adenosine infusion for 2 seconds caused a 15% decrease in the adenosine concentration in the left ventricle. When a square-shaped input was assumed, a three-fold higher concentration of adenosine for 3 seconds created by radionuclide injection resulted in a +42% increase in the LV concentration. Based on a measured input function, radionuclide injection using three-way stopcock through one route caused a two- to three-fold increase in the steady concentration in the vein just after injection. When 0.5 ml of radionuclide was slowly co-injected, with three ways opened, it caused a relatively low fluctuation, creating a +34% to -47% change in concentration of LV. A flush of radionuclide with physiological saline significantly increased the adenosine concentration in LV, when short half-lives were assumed. CONCLUSION: An intravenous adenosine and radiopharmaceutical injection in the same line is feasible. However, the fluctuation of concentration depends significantly on the mode of injection. To minimize the fluctuation, a slow injection of a small volume of a myocardial imaging agent via a co-injection route, with three ways opened, is recommended.     

Reengineering the Radiology Enterprise: A Summary of the 2014 Intersociety Committee Summer Conference

The current initiative to reform health care from both a quality and a cost perspective has already had a profound impact on the radiology enterprise. We have seen a decrease in the utilization of imaging studies, a reduction in reimbursement, a declining payer mix, shrinking incomes, a proliferation of performance indices, creation of radiology mega-groups, growth of national radiology companies, and increasing turf incursions. Our cheese is clearly on the move, and we must take action to reengineer the radiology enterprise. In keeping with general health care reform, we must be patient-centric, data driven, and outcome based. We must create a radiology enterprise that adheres to the value equation of providing the highest quality health care, for the lowest possible cost, for all citizens.     

Bourdieu’s field theory applied to the story of the UK radiography profession: A discussion paper

ObjectivesThere are many suggestions offered within the literature to decide if a job type is a profession, some using tick box type trait and characteristics analyses to compare the actions and qualities of individuals to a predefined list. However, there is no specific way to resolve what makes or defines a profession. Writers in many disciplines, including radiography, have used these different models, sometimes with conflicting results. This paper explores the use of Bourdieu’s replacement of the concept of profession with that of a ‘field’, meaning a network of occupants with common attributes, in this case radiographers, in an attempt to resolve this issue.FindingsIn the UK, radiography practitioners and professional bodies generally use the term profession to describe radiography, and this paper explores a defence of the term for radiography. Using Bourdieu’s field theory not only helps define a profession, but also explains the difficulties at the boundaries of professions, and the work needed to protect a profession as a credible entity.ConclusionThis paper supports the argument that radiography is a profession when using Bourdieu’s field theory. Radiography continues to work to maintain its status by increasing its symbolic capital by increasing the research output and evidence base of the profession and through role extension.Implications for practiceRadiographers can perhaps be assured that radiography is a profession when using Bourdieu’s field theory. This paper shows how theoretical frameworks and concepts from outside radiography can be used to support new ways of thinking within the profession.     

Pseudotumoral appearance of a ruptured epidermal cyst in the foot

We present a case of keratin granuloma due to a ruptured epidermal cyst, occurring in the foot, in a 52-year-old woman. The patient presented with a history of a slow-growing lump in the web space of the foot that had been present for over a year. Imaging appearances suggested a soft tissue neoplasm. Clinical presentation, radiological features and histopathological findings are described, and the relevant literature is reviewed.     

Segmentation and Feature Extraction Techniques,with Applications to MRI Head Studies

To obtain a three-dimensional reconstruction of the hippocampus from a volumetric MRI head study, it is necessary to separate that structure not only from the surrounding white matter, but also from contiguous areas of gray matter–the amygdala and cerebral cortex. At present it is necessary for a physician to manually segment the hippocampus on each slice of the volume to obtain such a reconstruction. This process is time consuming, and is subject to inter- and intra-operator variation as well as large discontinuities between slices. We propose a novel technique, making use of a combination of gray scale and edge-detection algorithms and some a priori knowledge, by which a computer may make an unsupervised identification of a given structure through a series of contiguous images. This technique is applicable even if the structure includes so-called false contours or missing contours. Applications include three-dimensional reconstruction of difficult-to-segment regions of the brain, and volumetric measurements of structures from series of two-dimensional images.     

Active microcoil tracking in the lungs using a semisolid rubber as signal source

A new method to localize and track medical devices in air‐filled body cavities is proposed that uses active microcoils with a semisolid filling. In air spaces, e.g., the lung, microcoils require an independent signal source, which should be made of a biocompatible, solid and sterilizable material with a long shelf time. In a measurement of the T₁ and T*₂ and the relative spin density of several semisolid materials, latex was identified as a suitable material from which a prototype catheter was constructed with a microcoil at its tip. In a dual‐echo tracking pulse sequence, the very short T*₂ of the rubber material allowed suppressing the background signal from surrounding tissue with a subtraction technique and additional dephasing gradients. With a roadmapping reconstruction, the microcoil's trajectory could be visualized on a previously acquired reference image set with a tracking rate of up to 60 Hz at a spatial resolution of better than 2mm. In a real‐time tracking implementation, an image update rate of 4 Hz was achieved by combining the tracking with a fast real‐time imaging sequence. Both methods were successfully applied in vivo to track the catheter in the lung of a pig. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.