Looking back,moving forward: 1988–2013. The first 25 years of the American Society of Emergency Radiology

The American Society of Emergency Radiology (ASER) was founded in 1988 and is celebrating its 25th Anniversary. ASER is thriving and emergency radiology has never enjoyed greater popularity than at present. This history describes the genesis of the Society, its growth and current state of affairs. It is based on the recollections and personal files of the authors, one Founder and both former ASER Presidents and Gold Medalists, the ASER archives, and interviews and correspondence with many ASER members. It is hoped that this brief review will be interesting to the reader, provide some insight into ASER evolution over the years, and hold some lessons moving forward.     

Loop mediated isothermal amplification combined with nucleic acid lateral flow strip for diagnosis of cyprinid herpes virus-3

An improved loop mediated isothermal amplification (LAMP) assay for rapid, sensitive and specific detection of cyprinid herpes virus-3 (CyHV-3), also known as koi herpes virus (KHV), was developed. The lower detection limit of the CyHV-3-LAMP assay is 10 fg DNA which equivalent to 30 copies of CyHV-3 genome. Nucleic acid lateral flow assay was used for visual detection of the LAMP products. The LAMP- nucleic acid lateral flow assay relies on DNA hybridization technology and antigen–antibody reactions in combination with LAMP. For application of this assay, the biotinylated LAMP product was hybridized with a FITC-labelled specific probe for 5 min. The resulting DNA complex could be visualised as purple band at the strip test line within 5 min of sample exposure. The nucleic acid lateral flow analysis of the LAMP product was equivalent in sensitivity but more rapid than the conventional agarose gel electrophoresis. The combination of LAMP assay with the nucleic acid lateral flow analysis can simplify the diagnosis and screening of CyHV-3 as it is simple, requires very little training, does not require specialized equipment such as a thermal cycler, the results are read visually with no need to run a gel and has a high sensitivity and specificity.     

Carotid Sinus Massage in the Echocardiography Laboratory

Proper interpretation of the spectral Doppler signal and elucidation of the underlying hemodynamics can at times be problematic due to confounding factors, one of them being a rapid heart rate. In this article, we discuss the use of carotid sinus massage (CSM) in the echocardiography laboratory as a maneuver to reduce the resting heart rate and thus render the transmitral Doppler signal more amenable to analysis. We provide examples of the value of the CSM in the assessment of left ventricular filling pressure.     

Quantitative blood oxygenation level‐dependent (BOLD) response of the left ventricular myocardium to hyperoxic respiratory challenge at 1.5 and 3.0 T

The aim of this study was to quantify the response of the myocardial transverse relaxation times (ΔT₂*) to hyperoxic respiratory challenge (HRC) at different field strengths in an intra‐individual comparison of healthy volunteers and in a patient with coronary artery disease. Blood oxygenation level‐dependent (BOLD) cardiovascular MR (CMR) data were acquired in 10 healthy volunteers (five women, five men; mean age, 29 ± 3 years; range, 22–35 years) at 1.5 and 3.0 T. Medical air (21% O₂), pure oxygen and carbogen (95% O₂, 5% CO₂) were administered in a block‐design temporal pattern to induce normoxia, hyperoxia and hyperoxic hypercapnia, respectively. Average T₂* times were derived from measurements by two independent and blind readers in 16 standard myocardial segments on three short‐axis slices per patient. Inter‐ and intra‐reader correlations of T₂* measurements were good [intra‐class correlation coefficient (ICC) = 0.75 and ICC = 0.79, both p < 0.001]. During normoxia, the mean T₂* times were 29.9 ± 6.1 ms at 1.5 T and 27.1 ± 6.6 ms at 3.0 T. Both hyperoxic gases induced significant (all p < 0.01) T₂* increases (?T₂* hyperoxia: 1.5 T, 12.7%; 3.0 T, 11.2%; hyperoxic hypercapnia: 1.5 T, 13.1%; 3.0 T, 17.7%). Analysis of variance (ANOVA) results indicated a significant (both p < 0.001) effect of the inhaled gases on the T₂* times at both 1.5 T (F = 17.74) and 3.0 T (F = 39.99). With regard to the patient imaged at 1.5 T, HRC induced significant T₂* increases during hyperoxia and hyperoxic hypercapnia in normal myocardial segments, whereas the T₂* response was not significant in ischemic segments (p > 0.23). The myocardial ?T₂* response to HRC can reliably be imaged and quantified with BOLD CMR at both 1.5 and 3.0 T. During HRC, hyperoxia and hyperoxic hypercapnia induce a significant increase in T₂*, with ?T₂* being largest at 3.0 T and during hyperoxic hypercapnia in normal myocardial segments. Copyright © 2014 John Wiley & Sons, Ltd.     

The Effect of Smoking on Myocardial Performance Index in Middle‐Aged Males after First Acute Myocardial Infarction

Background: Cigarette smoking is associated with increased rates of coronary artery disease and acute myocardial infarction (MI). Paradoxically, smokers had lower mortality after MI. The purpose of this study was to evaluate the effect of chronic smoking on myocardial performance index (MPI) in middle‐aged men after an acute MI. Material and methods: A total of 429 patients (325 smokers vs. 104 nonsmokers) presenting with acute ST elevation MI were enrolled in this study. Thrombolysis in myocardial infarction (TIMI) flow of the infarct related artery was measured before and after the primary percutaneous coronary intervention (PCI), and Gensini score was also calculated. Conventional echocardiography and tissue Doppler echocardiography (TDI) were performed within 48–72 hours after onset of chest pain. Peak early (Em) and late (Am) diastolic velocities, peak systolic (Sm) mitral annular velocities and time intervals were recorded with TDI. The MPI, ratio of Em/Am, and E/Em were calculated. Results: Baseline demographic and angiographic characteristics such as Gensini score, pre and, post PCI TIMI flow were similar in 2 groups. In contrast, LV MPI was preserved among smokers (0.59 ± 0.15 vs. 0.66 ± 0.14, P = 0.01), and Em/Am values were also higher in smokers (0.84 ± 0.28 vs. 0.75 ± 0.31, P = 0.01). Independent predictors of impaired MPI (≥0.60) were determined as nonsmoking status (odds ratio 2.940, 95% CI 0.98–5.83, P = 0.05), left anterior descending artery stenosis (odds ratio 3.196, 95% CI 1.73–5.91 P = 0.001), and, age (odds ratio 1.12, 95% CI 1.03–1.22, P = 0.01). Conclusions: Despite similar demographic and angiographic characteristics, smoker males had a paradoxically better MPI after acute MI.     

Technique and short-term results of ankle arthrodesis using anterior plating

Clinical and biomechanical trials have shown that rigid internal fixation during ankle arthrodesis leads to increased rates of union and is associated with a reduced infection rate, union time, discomfort and earlier mobilisation compared with other methods. We describe our technique of ankle arthrodesis using anterior plating with a narrow dynamic compression plate (DCP). Between 2004 and 2007, 29 patients with a mean age of 24.4 years (range 18–42) had ankle arthrodesis using an anteriorly placed narrow DCP. Twenty-two patients were post-traumatic and seven were paralytic (five after spine fracture and two after common peroneal nerve injury). Follow-up was between 12 and 18 months (average 14 months). A rate of fusion of 100% was achieved at an average of 12.2 weeks. According to the Mazur ankle score, 65.5% had excellent, 20.7% good and 13.8% fair results. Ankle arthrodesis using an anteriorly placed narrow DCP is a good method to achieve ankle fusion in many types of ankle arthropathies.