Web-based Diagnostic Imaging Service Using XML Forms

Traditionally, radiology has been conceived as a support department providing patient scanning services to the other clinical departments in a hospital. However, recent advancements in networking technology and related information systems such as picture archiving and communication system (PACS) and radiology information system (RIS) provide new opportunities for inventing different types of diagnostic imaging businesses such as teleradiology. In this article, we examined the business processes of currently operating imaging centers and proposed a prototype of an information system that can facilitate their workflows in a more efficient way. The principal component of our proposed system is a report management module built on extensible markup language (XML) technologies that allows much flexibility and convenience for both imaging technicians and radiologists.     

Angiotensin II and renal prostaglandin release in the dog. Interactions in controlling renal blood flow and glomerular filtration rate

The relationship between angiotensin II and renal prostaglandins, and their interactions in controlling renal blood flow (RBF) and glomerular filtration rate (GFR) were investigated in 18 anaesthetized dogs with acutely denervated kidneys. Intrarenal angiotensin II infusion increased renal PGE₂ release (veno-arterial concentration difference times renal plasma flow) from 1.7 ± 0.9 to 9.1 ±0.4 and 6-keto-PGFja release from 0.1 ±0.1 to 5.3 ± 2.1 pmol min^-1. An angiotensin II induced reduction in RBF of 20% did not measurably change GFR whereas a 30% reduction reduced GFR by 18 ± 8%. Blockade of prostaglandin synthesis approximately doubled the vasocon-strictory action of angiotensin II, and all reductions in RBF were accompanied by parallel reductions in GFR. When prostaglandin release was stimulated by infusion of arachidonic acid (46.8± 13.3 and 15.9± 5.4 pmol min^-1 for PGE₂, and 6-keto-PGFja, respectively), angiotensin II did not change prostaglandin release, but had similar effects on the relationship between RBF and GFR as during control. In an ureteral occlusion model with stopped glomerular filtration measurements of ureteral pressure and intrarenal venous pressure permitted calculations of afferent and efferent vascular resistances. Until RBF was reduced by 25–30% angiotensin II increased both afferent and efferent resistances almost equally, keeping the ureteral pressure constant. At greater reductions in RBF, afferent resistance increased more than the efferent leading to reductions in ureteral pressure. This pattern was not changed by blockade of prostaglandin synthesis indicating no influence of prostaglandins on the distribution of afferent and efferent vascular resistances during angiotensin II infusion. In this ureteral occlusion model glomerular effects of angiotensin II will not be detected, and it might well be that the shift from an effect predominantly on RBF to a combined effect on both RBF and GFR induced by inhibition of prostaglandin synthesis is located to the glomerulus. We therefore postulate that renal prostaglandins attenuate the effects of angiotensin II on glomerular surface area and the filtration barrier, and not on the afferent arterioles as previously suggested.     

A comparative study of the somato-axonal flow of protein in the feline hypoglossal and vagus nerves

Summary After ³H-lysine was applied to the X^th and XII^th cranial nuclei, radioactive protein synthesized in the nerve cell bodies of the hypoglossal and vagus nerves moved down the axons of these fibers at maximal rates of 6.3±1.2 and 16±3 mm per day, respectively. The distribution of radiolabeled protein at various periods indicated that other proteinaceous components moved at slower velocities.     

物理学在医学影像中的应用

物理学对医学的贡献是巨大的，物理学与医学等学科的交叉碰撞在医学领域中产生了许多丰硕成果，现代的医学影像就是其中的成果之一。本文阐述了物理学在现代四大医学影像中的应用。     

A Dynamic Morphometric Model of the Normal Lung for Studying Expiratory Flow Limitation in Mechanical Ventilation

A nonlinear dynamic morphometric model of breathing mechanics during artificial ventilation is described. On the basis of the Weibel symmetrical representation of the tracheobronchial tree, the model accurately accounts for the geometrical and mechanical characteristics of the conductive zone and packs the respiratory zone into a viscoelastic Voigt body. The model also accounts for the main mechanisms limiting expiratory flow (wave speed limitation and viscous flow limitation), in order to reproduce satisfactorily, under dynamic conditions, the expiratory flow limitation phenomenon occurring in normal subjects when the difference between alveolar pressure and tracheal pressure (driving pressure) is high. Several expirations characterized by different levels of driving pressure are simulated and expiratory flow limitation is detected by plotting the isovolume pressure–flow curves. The model is used to study the time course of resistance and total cross-sectional area as well as the ratio of fluid velocity to wave speed (speed index), in conductive airway generations. The results highlight that the coupling between dissipative pressure losses and airway compliance leads to onset of expiratory flow limitation in normal lungs when driving pressure is increased significantly by applying a subatmospheric pressure to the outlet of the ventilator expiratory channel; wave speed limitation becomes predominant at still higher driving pressures.     

Neural fibrolipoma of the superficial peroneal nerve in the ankle: a case report with immunohistochemical analysis

This report presents a case of neural fibrolipoma arising from the superficial peroneal nerve in the ankle. A 28-year-old woman was referred with a soft tissue mass in the anterior aspect of the right ankle, which had been gradually enlarging for the past 10 years. Magnetic resonance imaging showed a mass lesion, measuring approximately 8 x 3 x 2 cm, with high to partially low signal intensity on both T1- and T2-weighted images. A band of low signal intensity within the lesion, which is indicative of coexistence with the tumor and the superficial peroneal nerve, could be detected on both T1- and T2-weighted images. The patient underwent an excisional biopsy. The specimen microscopically consisted of nerve bundles and fibro-fatty proliferation with abundant collagen fibers. Immunoreactivity for CD34 antigen antibody was detected in fibrous spindle cells. This is the first report to present an immunohistochemical profile of neural fibrolipoma. Neural fibrolipoma should be considered as a differential diagnosis when a lipomatous lesion is encountered in the foot or ankle as well as in the upper extremities.     

Shear Rate Dependence of Ultrasound Backscattering from Blood Samples Characterized by Different Levels of Erythrocyte Aggregation

The objectives were (1) to determine the effect of the erythrocyte aggregation level (wide range of aggregation) and shear rate (which also affects aggregation) on the ultrasound backscattered power, and (2) to evaluate the reproducibility of the ultrasound method. Experiments were performed under steady flow (100–1250 ml/min) in a 12.7 mm diameter vertical tube. Doppler ultrasound at 10 MHz was used to measure simultaneously the velocity and the backscattered power across the tube. For each radial position, the shear rate was computed from the derivative of the velocity profile. The backscattered power decayed exponentially as a function of the shear rate, and for a given shear rate, the power increased monotonically with the level of aggregation measured by laser reflectometry. Using blood samples simulating hypo-, normal, and hyperaggregating erythrocytes, the power of the ultrasound signal varied respectively by –7.8, –13.2, and –16.1 dB as a function of the shear rate (from 0.4 to 50 s^–1). The reproducibility of the backscattered power was 5.5 dB, which is less than the variations observed as a function of the shear rate. In conclusion, ultrasound backscattering is sensitive to the level of erythrocyte aggregation. At a first glance, ultrasound seems less accurate when compared to laser reflectometry but it is suggested that this is because ultrasound backscattering may be sensitive to structural aggregate changes that are not detected by the laser method. © 2000 Biomedical Engineering Society. PAC00: 8718-h, 8719Tt, 8750Kk     

Evaluation of encephalic ventricular volume from the magnetic resonance imaging scans of thirty-eight human subjects

Summary Accurate volume determination of the encephalic ventricles is of importance in several clinical conditions, including Alzheimer's presenile dementia, schizophrenia, and benign intracranial hypertension. Previous studies have investigated the accuracy with which magnetic resonance imaging (MRI) can be used in clinical practice to evaluate the encephalic ventricles. However, adequate evaluation of pathological conditions depends on a sufficient amount of morphometric data from normal subjects. To begin establishing this data base for normal subjects, we evaluated the MRI scans of 38 subjects found to have no apparent pathology and calculated the ventricular volume in each case by using methods previously developed in our laboratory. The results were then compared with published volumes determined from studies that used either ventricular casts or computerized tomographic scans. The average total ventricular volume for all 38 subjects was 17.4 cm³, while that for males was 16.3 cm³ and that for females was 18.0 cm³. A small but significant correlation was found between age of subject and ventricular volume, with ventricular size increasing with age.

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Evaluation du volume des ventricules cérébraux à partir des images obtenues en résonance magnétique nucléaire chez 38 sujets humains

Résumé La détermination exacte du volume des ventricules cérébraux est importante en clinique comme par exemple dans la démence présénile d'Alzheimer, la schizophrénie et l'hypertension intracrânienne bénigne. Des études antérieures ont étudié la fiabilité de la résonance magnétique nucléaire en pratique clinique pour évaluer le volume des ventricules cérébraux. Toutefois une évaluation correcte dans les conditions pathologiques implique une bonne connaissance des données morphométriques du sujet normal. Pour établir ces données sur « le sujet normal », nous avons étudié les coupes obtenues en IRM chez 38 sujets apparemment indemnes de toute pathologie; nous avons calculé le volume ventriculaire dans chaque cas en utilisant des méthodes mises au point auparavant dans notre laboratoire. Les résultats ont été ensuite comparés avec ceux obtenus par d'autres études utilisant soit des moules ventriculaires, soit des coupes tomographiques computérisées. Le volume ventriculaire total moyen chez 38 sujets est de 17,4 cm³, mais il est chez les sujets masculins de 16,3 cm³ et chez les sujets de sexe féminin de 18 cm³. Une corrélation faible mais significative a été trouvée entre l'âge du sujet et le volume ventriculaire, étant entendu que la taille du ventricule augmente avec l'âge.

     

Minimising stimulator artefacts in electromagnetic flow signals

Simultaneous electrical stimulation of tissue with the measurement of blood flow using an electromagnetic flowmeter system almost invariably results in large flow measurement inaccuracies. These inaccuracies are because the electrical energy from stimulating artefacts is amplified along with the flow signals. The paper describes the building and use of an inexpensive circuit to remove stimulation artefacts from electromagnetic flow measurements.     

Frequency-domain analysis of cerebral autoregulation from spontaneous fluctuations in arterial blood pressure

The dynamic relationship between spontaneous fluctuations of arterial blood pressure (ABP) and corresponding changes in crebral blood flow velocity (CBFV) is studied in a population of 83 neonates. Static and dynamic methods are used to identify two subgroups showing either normal (group A, n=23) or impaired (group B, n=21) cerebral autoregulation. An FFT algorithm is used to estimate the coherence and transfer function between CBFV and ABP. The significance of the linear dependence between these two variables in demonstrated by mean values of squared coherence >0.50 for both groups in the frequency range 0.02–0.50 Hz. However, group A has significanlty smaller coherences than group B in the frequency ranges 0.02–0.10 Hz and 0.33–0.49 Hz. The phase response of group A is also significantly more positive than that of group B, with slopes of 9.3±1.05 and 1.80±1.2 rad Hz⁻¹, respectively. The amplitude frequency response is also significantly smaller for group A in relation to group B for the frequency range 0.25–0.43 Hz. These results suggest that transfer function analysis may be able to identify different components of cerebral autoregulation and also provide a deeper understanding of recent findings by other investigators.