Imaging the femoral cortex: Thickness, density and mass from clinical CT

There is growing evidence that focal thinning of cortical bone in the proximal femur may predispose a hip to fracture. Detecting such defects in clinical CT is challenging, since cortices may be significantly thinner than the imaging system's point spread function. We recently proposed a model-fitting technique to measure sub-millimetre cortices, an ill-posed problem which was regularized by assuming a specific, fixed value for the cortical density. In this paper, we develop the work further by proposing and evaluating a more rigorous method for estimating the constant cortical density, and extend the paradigm to encompass the mapping of cortical mass (mineral mg/cm 2) in addition to thickness. Density, thickness and mass estimates are evaluated on sixteen cadaveric femurs, with high resolution measurements from a micro-CT scanner providing the gold standard. The results demonstrate robust, accurate measurement of peak cortical density and cortical mass. Cortical thickness errors are confined to regions of thin cortex and are bounded by the extent to which the local density deviates from the peak, averaging 20% for 0.5mm cortex. © 2012 Elsevier B.V.

A clinical system for three-dimensional extended-field-of-view ultrasound.

OBJECTIVE: This work is concerned with the creation of three-dimensional (3D) extended-field-of-view ultrasound from a set of volumes acquired using a mechanically swept 3D probe. 3D volumes of ultrasound data can be registered by attaching a position sensor to the probe; this can be an inconvenience in a clinical setting. A position sensor can also cause some misalignment due to patient movement and respiratory motion. We propose a combination of three-degrees-of-freedom image registration and an unobtrusively integrated inertial sensor for measuring orientation. The aim of this research is to produce a reliable and portable ultrasound system that is able to register 3D volumes quickly, making it suitable for clinical use. METHOD: As part of a feasibility study we recruited 28 pregnant females attending for routine obstetric scans to undergo 3D extended-field-of-view ultrasound. A total of 49 data sets were recorded. Each registered data set was assessed for correct alignment of each volume by two independent observers. RESULTS: In 77-83% of the data sets more than four consecutive volumes registered. The successful registration relies on good overlap between volumes and is adversely affected by advancing gestational age and foetal movement. CONCLUSION: The development of reliable 3D extended-field-of-view ultrasound may help ultrasound practitioners to demonstrate the anatomical relation of pathology and provide a convenient way to store data.

Leadership of healthcare commissioning networks in England: a mixed-methods study on clinical commissioning groups.

To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation.

Genomic organization, gene duplication, and expression analysis of interleukin-1 beta in channel catfish (Ictalurus punctatus)

Interleukin-1 beta (IL-1 beta) is one of the pivotal early response pro-inflammatory cytokines that enables organisms to respond to infection and induces a cascade of reactions leading to inflammation. In spite of its importance and two decades of studies in the mammalian species, genes encoding IL-1 beta were not identified from non-mammalian species until recently. Recent research, particularly with genomic approaches, has led to sequencing of IL-1 beta from many species. Clinical studies also Suggested IL-1 beta as an immunoreagulatory molecule potentially useful for enhancing vaccination. However, no IL-1 beta genes have been identified from channel catfish, the primary aquaculture species from the United States. In this study, we identified two distinct cDNAs encoding catfish IL-1 beta. Their encoding genes were identified, sequenced, and characterized. The catfish IL-1 beta genes were assigned to bacterial artificial chromosome (BAC) clones. Genomic studies indicated that the IL-1 beta genes were tandemly duplicated on the same chromosome. Phylogenetic analysis of various IL-1 beta genes indicated the possibility of recent species-specific gene duplications in channel catfish, and perhaps also in swine and carp. Expression analysis indicated that both IL-1 beta genes were expressed, but exhibited distinct expression profiles in various catfish tissues, and after bacterial infection with Edwardsiella ictaluri. (c) 2005 Elsevier Ltd. All rights reserved.

Multiplex detection of mutations in clinical isolates of rifampin-resistant Mycobacterium tuberculosis by short oligonucleotide Ligation assay on DNA chips

A new approach, short-oligonucleotide-ligation assay on DNA chip (SOLAC), is developed to detect mutations in rifampin-resistant Mycobacterium tuberculosis. The method needs only four common probes to detect 15 mutational variants of the rpoB gene within 12 h. Fifty-five rifampin-resistant M. tuberculosis isolates were analyzed, resulting in 87.3% accuracy and 83.6% concordance relative to DNA sequencing.

The development of long - Term ambulatory pH monitoring system and its clinical application

This paper introduced a long-term ambulatory intragastric pH monitoring system, which is designed for prolonged ambulatory studies of Gastroesophageal Reflux Diseases. The whole system is composed of the gastric catheter with two pH sensors, a small data logger (Microdatalog), and a notebook PC. In this paper, the design of monitoring system hardware and software are described in detail. Clinical applications reveal good results.

重离子束治疗皮肤恶性肿瘤的初步临床结果；Clinical trial of carbon ion radiotherapy for malignant neoplasm of skin

目的:评价重离子束对皮肤恶性肿瘤放射治疗的近期疗效和毒副反应。方法:29例皮肤恶性肿瘤患者分6批接受重离子束放射治疗,其中恶性黑色素瘤13例,皮肤鳞癌及Bowen’s病各6例,基底细胞癌2例,其他皮肤恶性肿瘤2例。照射总剂量(50～70)GyE/(6～12)d,单次剂量5.5～11.67GyE,1f/d,连续治疗。采用RTOG标准和WHO近期疗效标准分别评价毒副反应和近期疗效。结果:截止2009-05,中位随访时间为13.5个月(1～25个月),随访率为100%。29例患者中完全缓解(CR)24例(82.8%),部分缓解(PR)5例(17.2%),有效率(RR)为100%,中位生存时间为22.8个月(95%CI:20.6～24.9)。皮肤反应0度11例(37.9%),Ⅰ度9例(31.0%),Ⅱ度6例(20.7%),Ⅲ度2例(6.9%),Ⅳ度1例(3.4%);血液毒副反应治疗前后无明显改变。结论:重离子束(12C6+)放射治疗皮肤恶性肿瘤近期疗效好,并发症轻,远期疗效、晚期副反应等尚需进一步长期全面的观察和更多的研究提供依据。

Application of probabilistic neural network in the clinical diagnosis of cancers based on clinical chemistry data

As a recently developed and powerful classification tool, probabilistic neural network was used to distinguish cancer patients from healthy persons according to the levels of nucleosides in human urine. Two datasets (containing 32 and 50 patterns, respectively) were investigated and the total consistency rate obtained was 100% for dataset 1 and 94% for dataset 2. To evaluate the performance of probabilistic neural network, linear discriminant analysis and learning vector quantization network, were also applied to the classification problem. The results showed that the predictive ability of the probabilistic neural network is stronger than the others in this study. Moreover, the recognition rate for dataset 2 can achieve to 100% if combining, these three methods together, which indicated the promising potential of clinical diagnosis by combining different methods. (C) 2002 Elsevier Science B.V. All rights reserved.

Artificial neural network classification based on high-performance liquid chromatography of urinary and serum nucleosides for the clinical diagnosis of cancer

Nucleosides in human urine and serum have frequently been studied as a possible biomedical marker for cancer, acquired immune deficiency syndrome (AIDS) and the whole-body turnover of RNAs. Fifteen normal and modified nucleosides were determined in 69 urine and 42 serum samples using high-performance liquid chromatography (HPLC). Artificial neural networks have been used as a powerful pattern recognition tool to distinguish cancer patients from healthy persons. The recognition rate for the training set reached 100%. In the validating set, 95.8 and 92.9% of people were correctly classified into cancer patients and healthy persons when urine and serum were used as the sample for measuring the nucleosides. The results show that the artificial neural network technique is better than principal component analysis for the classification of healthy persons and cancer patients based on nucleoside data. (C) 2002 Elsevier Science B.V. All rights reserved.