Comparison between chest digital tomosynthesis and CT as a screening method to detect artificial pulmonary nodules: a phantom study

OBJECTIVES

The objective of this study was to evaluate the imaging capabilities of chest digital tomosynthesis (DT) as a screening method for the detection of artificial pulmonary nodules, and to compare its efficiency with that of CT.

METHODS

DT and CT were used to detect artificial pulmonary nodules (5 mm and 8 mm in diameter, ground-glass opacities) placed in a chest phantom. Using a three-dimensional filtered back-projection algorithm at acquisition angles of 8°, 20°, 30° and 40°, DT images of the desired layer thicknesses were reconstructed from the image data acquired during a single tomographic scan. Both standard and sharp CT reconstruction kernels were used, and the detectability index (DI) valves computed for both the DT scan acquisition angles and CT reconstruction kernel types were considered. For the observer study, we examined 50 samples of artificial pulmonary nodules using both DT and CT imaging. On the basis of evaluations made by five thoracic radiologists, a jackknife free-response receiver operating characteristic (JAFROC) study was performed to compare and assess the differences in detection accuracy between CT and DT imaging.

RESULTS

For each increased acquisition angle, DI obtained by DT imaging was similar to that obtained by CT imaging. The difference in the observer-averaged JAFROC figure of merit for the five readings was 0.0363 (95% confidence interval: -0.18, 0.26; F=0.101; p=0.75).

CONCLUSION

With the advantages of a decreased radiation dose and the practical accessibility of examination, DT may be a useful alternative to CT for the detection of artificial pulmonary nodules.

Changes in chest wall thickness during four-dimensional CT in particle lung treatment planning

Four-dimensional (4D) CT images for charged particle lung therapy were acquired using a 256 multislice CT without couch movement. The thickness of the posterior right chest wall changed with respiration with a water equivalent path length (WEL) of more than 5 mm over the mid-exhalation phase but the thickness of the left chest wall did not vary.

Non-thermal hot electrons ultrafastly generating hot optical phonons in graphite

Investigation of the non-equilibrium dynamics after an impulsive impact provides insights into couplings among various excitations. A two-temperature model (TTM) is often a starting point to understand the coupled dynamics of electrons and lattice vibrations: the optical pulse primarily raises the electronic temperature T(el) while leaving the lattice temperature T(l) low; subsequently the hot electrons heat up the lattice until T(el) = T(l) is reached. This temporal hierarchy owes to the assumption that the electron-electron scattering rate is much larger than the electron-phonon scattering rate. We report herein that the TTM scheme is seriously invalidated in semimetal graphite. Time-resolved photoemission spectroscopy (TrPES) of graphite reveals that fingerprints of coupled optical phonons (COPs) occur from the initial moments where T(el) is still not definable. Our study shows that ultrafast-and-efficient phonon generations occur beyond the TTM scheme, presumably associated to the long duration of the non-thermal electrons in graphite.

Ultrafast time domain demonstration of bulk magnetization precession at zero magnetic field ferromagnetic resonance induced by terahertz magnetic field

We report the first observation of sub-terahertz bulk-magnetization precession, using terahertz time-domain spectroscopy. The magnetization precession in gallium-substituted epsilon-iron oxide nano-ferromagnets under zero magnetic field is induced by the impulsive magnetic field of the THz wave through the gyromagnetic effect. Just at the resonance frequency, the linear to circular polarized wave conversion is realized. This is understood as the free induction decay signal radiated from a rotating magnetic dipole corresponding to the natural resonance. Furthermore, this demonstration reveals that the series of gallium-substituted epsilon-iron oxide nano-ferromagnets is very prospective for magneto-optic devices, which work at room temperature without external magnetic field, in next-generation wireless communication.

A pilot case-control study on the alveolar bone density measurement in risk assessment for bisphosphonate-related osteonecrosis of the jaw

Alveolar bone mineral density (BMD) measured by radiography standardized by aluminum step wedge pasted on the film and digitized by a computer system was significantly higher around osteonecrosis lesions than in control cases in a pilot case-control study. High alveolar bone density appears useful as a local risk factor for bisphosphonate-related osteonecrosis of the jaw (BRONJ).

INTRODUCTION

In an attempt to find a reliable test method predicting the occurrence of BRONJ in addition to various risk factors suggested, an increase of alveolar bone density near the necrotic lesions was found by computerized radiogrammetry using dental films pasted with an aluminum step wedge (Bone Right, Dentalgraphic.Com Company, Himeji) in six cases of BRONJ.

METHODS

The bone mineral density surrounding the osteonecrosis lesions showed distinctly higher density in BRONJ cases compared with age-matched controls. In one subject on bisphosphonate treatment in whom two extractions were simultaneously carried out, BRONJ occurred only at the location with extremely high alveolar bone density, but not at the other site with normal density.

CONCLUSION

This method may be useful in detecting a rise of alveolar BMD frequently occurring near the necrotic lesion in subjects with impending risk for BRONJ.

An autopsy report on multiple system atrophy diagnosed immunohistochemically despite severe ischaemic damage: a new approach for investigation of medical practice associated deaths in Japan

A 60-year old man with a 10-year history of multiple system atrophy (MSA) was found in respiratory arrest. After 4 months of respiratory support with two episodes of septic shock, he died. Autopsy disclosed severe atrophy of the mesencephalon, brainstem, medulla oblongata and cerebellum. Gallyas–Braak, α-synuclein and ubiquitin-positive inclusions in the cytoplasm of glial cells were evident, despite the severe ischaemic damage due to respiratory arrest and subsequent respiratory support for 4 months. The cause of respiratory arrest was not identified, but could be explained by the natural history of MSA. The bereaved family, who had suspected malpractice, was satisfied with the explanation based on the investigation performed by eight expert doctors, one expert nurse, two coordinator nurses and two lawyers in the model project promoted by the Japanese government.

Comparison between treatment of kitchen-sink wastewater and a mixture of kitchen-sink and washing-machine wastewaters

In this paper, a submerged membrane bioreactor was used to treat 'higher-load' grey water: (a) kitchen-sink wastewater only, and (b) a mixture of kitchen-sink wastewater and washing-machine wastewater. For each type of wastewater, three systems operated at different hydraulic retention times (HRTs) were investigated. In the mixture of kitchen-sink wastewater and washing-machine wastewater, the reactor with a short HRT of four hours was stopped due to foaming. It has been observed that for both types of wastewater, an HRT of eight hours or longer can be used for the treatment. However, it has been observed that a higher COD in the permeate of the mixture can be obtained compared with that of the kitchen-sink wastewater only. This indicated that washing-machine wastewater has some component that is not easily biodegradable. The total linear akylbenzene sulfonate (LAS) removal was > 99% even at a concentration of 10-23 mg 1(-1).

[Surgical treatment of thoracic aortic disease combined with coronary artery bypass grafting operation]

We evaluated the early outcome of surgical treatment of thoracic aortic disease combined with coronary artery bypass grafting (CABG). Between January 2001 and December 2007, a total of 22 patients underwent thoracic aortic surgery with CABG. Four patients had an emergency operation performed for acute type A aortic dissection (group D). Three patients with a dissection of the right coronary artery (RCA) and 1 patient with cardiac ischemia during operation underwent CABG. One of the 18 patients with non-dissecting aneurysm (group N) underwent CABG due to injury of RCA. A comparative study was made between the study groups and a control group of 68 patients (group S) who underwent thoracic aortic replacement without CABG. Hospital mortality was 4.5% (1/22 patients) due to low output syndrome. There were significant differences in operation time, total cardiopulmonary bypass time and cardiac arrest time between groups D and N, and between groups N and S. There was also a significant difference in ventilation time and the duration of stay in the intensive care unit between groups D and N. However, there were no significant differences in postoperative complications among all the groups. This operation provides satisfactory early clinical outcomes. Thoracic aortic surgery combined with CABG can be carried out safely in elderly patients.

In vivoinduction of human cytochrome P450 3A4 by rifabutin in chimeric mice with humanized liver

The induction of human cytochrome P450 enzymes (CYPs) often poses a serious problem in clinical practice. The induction of CYP3A leads to a decrease in the pharmacological potency of drugs, since many drugs are substrates of CYP3A. The present study examined the in vivo induction potency of human CYP3A in chimeric mice with humanized liver, recently established in Japan, by a specific inducer of human CYP3A enzyme activity in this experimental condition, rifabutin, which is an analogue of rifampicin. The chimeric mice were treated intraperitoneally daily for 4 days with rifabutin (50 mg kg(-1) day(-1)). The mRNA, protein and enzyme activity in liver of the chimeric mice were measured by reverse-transcriptase polymerase chain reaction, Western blot analysis and high-performance liquid chromatography, respectively. In the chimeric mice, the human CYP3A4 mRNA expression, CYP3A4 protein content, testosterone 6ss-hydroxylase activity and dexamethasone 6-hydroxylase activity were increased 7.4-, 3.0-, 2.4- and 1.9-fold, respectively, by treatment with rifabutin. The mRNA expression of other human CYPs, transporters and nuclear receptors was not significantly changed by rifabutin. On the other hand, rifabutin was demonstrated not to increase the murine Cyp3a enzyme activities in the control mice. It was demonstrated that human CYP3A4 expressed in the chimeric mice with humanized liver was induced by rifabutin, suggesting that human CYP3A4 in the chimeric mice had induction potency. This chimeric mouse model may be a useful animal model to estimate and predict the in vivo induction of CYPs in human.