Ethiodized oil emulsion 13 in computed tomography of hepatoma.

Six patients with biopsy-proven hepatoma were prospectively evaluated both by conventional computed tomography (CT) and by scans using ethiodized oil emulsion 13 (EOE 13) as a contrast agent. EOE 13 infusion resulted in marked improvement in the demonstration of the neoplasm in all cases and allowed more accurate definition of tumor extent than was possible with standard scanning techniques. In two cases EOE 13 enhancement was essential for complete radiographic depiction of tumor location, size, and extent. EOE 13 also proved to be of considerable value in assessment of therapeutic response in three patients, permitting more objective determination of tumor growth or regression. EOE 13--enhanced CT scanning provides a valuable means of staging patients presenting with hepatoma and is a reliable, accurate means of radiographic follow-up.

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Voluminous Intrapericardial Lipoma Mimicking Pericardial Effusion

Case Reports in Medicine ◽

10.1155/2020/6295634 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Fabíola Prado de Morais ◽

Noah Romero Nakajima ◽

Olívia Félix Marconi Andalécio ◽

Pedro de Santana Prudente ◽

Guilherme Emílio Ferreira ◽

...

Keyword(s):

Computed Tomography ◽

Pericardial Effusion ◽

Signs And Symptoms ◽

Tumor Location ◽

Pathological Examination ◽

Computed Tomography Scan ◽

Radiologic Imaging ◽

Heart Tumors ◽

Tomography Scan

Lipomas are rare primary heart tumors and may involve the endocardium, myocardium, or pericardium. Signs and symptoms depend on the tumor location and size. The intrapericardial lipoma we report has massive dimensions and mimics a pericardial effusion. A 38-year-old male complained of dyspnea and precordial pain. On physical examination, heart sounds were diminished. The patient had received extensive medication for a clinically suspected pericardial effusion due to heart failure. A voluminous mass resembling fat within the pericardial sac was revealed by transesophageal echocardiography and a computed tomography scan. The tumor was removed successfully by a subxiphoid surgical approach. The diagnosis of a 635 gram intrapericardial lipoma was confirmed by pathological examination. After surgery, the patient recovered well and was completely asymptomatic at a follow-up at 90 days. No medications were being taken since. The diagnosis of a pericardial effusion should be secured by imaging exams to avoid unnecessary medications. Cardiac lipomas can be readily recognized by their typical features on radiologic imaging. The surgical pathology examination confirms the diagnosis and rules out malignancy criteria.

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Nasal Endoscopy and the Definition and Diagnosis of Chronic Rhinosinusitis

Otolaryngology ◽

10.1067/mhn.2002.125602 ◽

2002 ◽

Vol 126 (6) ◽

pp. 623-627 ◽

Cited By ~ 86

Author(s):

James A. Stankiewicz ◽

James M. Chow

Keyword(s):

Computed Tomography ◽

Chronic Rhinosinusitis ◽

Sensitivity And Specificity ◽

Nasal Polyps ◽

Ct Scanning ◽

Current Treatment ◽

Current Definition ◽

Treatment Paradigm ◽

Definition Of ◽

High Degree

OBJECTIVES: Although endoscopy has been shown by a few authors to be a valuable tool for the diagnosis of chronic rhinosinusitis, its true role in the evaluation of the patient with chronic rhinosinusitis has not been elucidated. The current definition of chronic rhinosinusitis is a symptom-based definition, and objective testing such as endoscopy or computed tomography (CT) is not included. However, the current treatment paradigm for chronic rhinosinusitis is dependent on the definition for diagnosis. Patients are treated with 4 weeks of antibiotics and decongestant/antihistamines/steroids based on the definition. This study aims to evaluate in a prospective fashion the place of endoscopy in the diagnosis of chronic rhinosinusitis. STUDY DESIGN: A group of 78 patients meeting the definition of chronic rhinosinusitis were subjected to same-day endoscopy and CT scanning. RESULTS: Seventeen (22%) of 78 patients had positive endoscopic and CT results. There were 20 (26%) of 78 patients with negative endoscopic and positive CT results. Six (8%) patients had positive endoscopic and negative CT results, and 35 (45%) had negative endoscopic and negative CT results. Overall, 37 (47%) patients had positive CT results, and 41 (53%) patients had negative CT results. Endoscopy showing the presence of purulence, nasal polyps, or watery congested mucosa correlated well with CT results. Negative endoscopy correlated with CT results in 65% of patients. CONCLUSION: The use of endoscopy to corroborate the diagnosis in nonpolypoid or nonpurulent rhinosinusitis in previously unoperated patients is questioned. Patients who meet the subjective definition of chronic rhinosinusitis should have a high degree of sensitivity and specificity with endoscopy or CT. The fact this is not the case questions the accuracy of the definition and the treatment paradigm. SIGNIFICANCE: According to this study, positive endoscopic results correlated well with CT, and negative endoscopic results correlated in 71% of patients with negative CT results.

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Multifactorial seroprofiling dissects the contribution of pre-existing human coronaviruses responses to SARS-CoV-2 immunity

Nature Communications ◽

10.1038/s41467-021-27040-x ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Irene A. Abela ◽

Chloé Pasin ◽

Magdalena Schwarzmüller ◽

Selina Epp ◽

Michèle E. Sickmann ◽

...

Keyword(s):

Protective Immunity ◽

Rapid Development ◽

Antibody Responses ◽

Human Coronavirus ◽

Neutralization Activity ◽

Accurate Definition ◽

Human Coronaviruses ◽

Definition Of ◽

Antibody Levels

AbstractDetermination of SARS-CoV-2 antibody responses in the context of pre-existing immunity to circulating human coronavirus (HCoV) is critical for understanding protective immunity. Here we perform a multifactorial analysis of SARS-CoV-2 and HCoV antibody responses in pre-pandemic (N = 825) and SARS-CoV-2-infected donors (N = 389) using a custom-designed multiplex ABCORA assay. ABCORA seroprofiling, when combined with computational modeling, enables accurate definition of SARS-CoV-2 seroconversion and prediction of neutralization activity, and reveals intriguing interrelations with HCoV immunity. Specifically, higher HCoV antibody levels in SARS-CoV-2-negative donors suggest that pre-existing HCoV immunity may provide protection against SARS-CoV-2 acquisition. In those infected, higher HCoV activity is associated with elevated SARS-CoV-2 responses, indicating cross-stimulation. Most importantly, HCoV immunity may impact disease severity, as patients with high HCoV reactivity are less likely to require hospitalization. Collectively, our results suggest that HCoV immunity may promote rapid development of SARS-CoV-2-specific immunity, thereby underscoring the importance of exploring cross-protective responses for comprehensive coronavirus prevention.

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Determination of Tumor Location in Rectosigmoid Carcinomas: Difficulties in Preoperative Diagnostics

Gastrointestinal Disorders ◽

10.3390/gidisord1010016 ◽

2019 ◽

Vol 1 (1) ◽

pp. 210-219

Author(s):

Els Moltzer ◽

Bo Noordman ◽

Nomdo Renken ◽

Daphne Roos

Keyword(s):

Diagnostic Accuracy ◽

Anal Verge ◽

Neoadjuvant Treatment ◽

Ct Scanning ◽

Tumor Stage ◽

Flexible Endoscopy ◽

Tumor Location ◽

Index Test ◽

Diagnostic Challenge

Differentiation between rectal and sigmoid carcinomas is a diagnostic challenge with important implications for further treatment. Depending on the tumor stage, treatment for rectal carcinoma consists of preoperative (chemo)radiotherapy and surgery. Sigmoid carcinomas are treated with surgery alone. We established the diagnostic accuracy of flexible endoscopy, MRI and/or CT scan, and both modalities combined as reflected by the conclusion of our multidisciplinary team (MDT). Furthermore, we assessed the treatment consequences of misdiagnosis. Consecutive patients were included who underwent surgery from January 2012 to January 2017 for colorectal carcinoma located ≤20 cm from the anal verge as determined by flexible colonoscopy. Diagnostic accuracy of MRI/CT, flexible endoscopy and the final MDT conclusion were analyzed as index test. The location of the tumor during surgery and the type of surgery was the reference standard. We included 293 patients. Flexible endoscopy had a diagnostic accuracy of 90% and for MRI/CT scanning this was 86–87%. Combination of both modalities improved diagnostic accuracy to 96%. Due to misdiagnosis during initial staging, three patients (1%) erroneously underwent neoadjuvant treatment and in two patients neoadjuvant treatment was potentially erroneously omitted. In conclusion, the combination of both flexible endoscopy and MRI/CT (the MDT conclusion) improves diagnostic accuracy. Erroneous clinical diagnosis can lead to under- and overtreatment.

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A Framework Proposal to Assess the LARG Index of a Supply Chain in a Fuzzy Context

Research Methods ◽

10.4018/978-1-4666-7456-1.ch014 ◽

2015 ◽

pp. 299-321

Author(s):

Paulo Fazendeiro ◽

Susana G. Azevedo ◽

V. Cruz-Machado

Keyword(s):

Supply Chain ◽

Supply Chains ◽

Evaluation Model ◽

Enterprise 2.0 ◽

Assessment Tasks ◽

Consensual Definition ◽

Implementation Level ◽

Definition Of

Bearing in mind the new Supply Chain Management (SCM) paradigms, it is important that supply chains be aware of the implementation level of the main practices associated to each SCM paradigm (Lean, Agile, Resilient, and Green, hereafter referred as LARG). The main objective of this chapter is to propose a framework, based on Enterprise 2.0 approach, for global supply chains to assess their LARG index in order to evaluate the leanness, agility, resilience, and greenness of their practices. Enterprise 2.0 technologies and Fuzzy Logic techniques are used as enablers to the proposed LARG evaluation model in the following assessment tasks: 1) determination of an adequate set of Lean, Agile, Resilient, and Green practices; 2) consensual definition of the relative weights of the considered practices; 3) adjustment of the evaluation policy to the particular supply chain; and 4) effective follow-up of the assessment results.

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Frontal sinus and nasoethmoidal injuries

10.1093/med/9780199682874.003.0077 ◽

2021 ◽

pp. 821-826

Author(s):

Nabeela Ahmed ◽

Lachlan M. Carter ◽

Rabindra P. Singh

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Frontal Sinus ◽

Critical Area ◽

Associated Injuries ◽

High Resolution Computed Tomography ◽

Accurate Definition ◽

Computed Tomography Scanning ◽

Definition Of ◽

Tomography Scanning

The frontal sinus and the adjacent naso-orbitoethmoid complex of bones in the midline are vulnerable to direct trauma and significant injuries can involve the adjacent skull base, the nasofrontal duct, and the medial orbit. The anatomy of this critical area is complex. Assessment of the injury includes ocular and neurological examination for associated injuries, and high-resolution computed tomography scanning is required for accurate definition of the injury. In this chapter, the principles of management and the complications of these fractures and their management are described.

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Computed Tomography in Massive Pulmonary Embolism

Acta Radiologica ◽

10.1177/028418518903000124 ◽

1989 ◽

Vol 30 (1) ◽

pp. 105-107 ◽

Cited By ~ 2

Author(s):

P. Kälebo ◽

J. Wallin

Keyword(s):

Computed Tomography ◽

Pulmonary Embolism ◽

Massive Pulmonary Embolism ◽

Dynamic Contrast Enhanced ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Dynamic Contrast Enhanced Ct

The usefulness of computed tomography (CT) for the diagnosis of pulmonary embolism (PE) was demonstrated in two cases. Employing dynamic, contrast-enhanced CT, both direct and indirect signs of PE may be rapidly and conveniently demonstrated. Possible contraindications for therapy may be diagnosed simultaneously and follow-up examinations after therapy may be readily performed. The method serves as a good complement when PE must be verified before treatment with potent agents.

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ENGIN-X: a third-generation neutron strain scanner

Journal of Applied Crystallography ◽

10.1107/s0021889806042245 ◽

2006 ◽

Vol 39 (6) ◽

pp. 812-825 ◽

Cited By ~ 230

Author(s):

J. R. Santisteban ◽

M. R. Daymond ◽

J. A. James ◽

L. Edwards

Keyword(s):

Virtual Instrument ◽

Three Dimensional ◽

Absolute Number ◽

Simple Expression ◽

Neutron Diffractometer ◽

Accurate Definition ◽

Gauge Volume ◽

Computer Representation ◽

Definition Of

ENGIN-X, a new time-of-flight (TOF) neutron diffractometer optimized to measure elastic strains at precise locations in bulky specimens recently commissioned at the ISIS Facility in the Rutherford Laboratory, UK, is described. Fast counting times, together with a flexible and accurate definition of the instrumental gauge volume are the main requirements of neutron strain scanning and have been addressed on ENGIN-X through the design of a novel TOF diffractometer with a tuneable resolution and interchangeable radial collimators. Further, the routine operation of the instrument has been optimized by creating a virtual instrument,i.e.a three-dimensional computer representation of the diffractometer and samples, which assists in the planning and execution of experiments. On comparing ENGIN-X with its predecessor ENGIN, a 25× gain in performance is found, which has allowed the determination of stresses up to 60 mm deep in steel specimens. For comparison with constant-wavelength diffractometers, special attention has been paid to the absolute number of counts recorded during the experiments. A simple expression is presented for the estimation of counting times in TOF neutron strain scanning experiments.

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Postoperative Color Flow Duplex Scanning in Aortic Endografting

Journal of Endovascular Therapy ◽

10.1177/152660289700400305 ◽

1997 ◽

Vol 4 (3) ◽

pp. 262-271 ◽

Cited By ~ 21

Author(s):

Peter Heilberger ◽

Christian Schunn ◽

Wolfgang Ritter ◽

Sepp Weber ◽

Dieter Raithel

Keyword(s):

Contrast Agent ◽

Ultrasound Contrast Agent ◽

Ct Scanning ◽

Duplex Sonography ◽

Duplex Scanning ◽

Ultrasound Contrast ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct

Purpose: To report the feasibility and sensitivity of duplex sonography compared to computed tomography (CT) for aortic endograft follow-up surveillance. Methods: In a 26-month period, 113 aortic aneurysm patients received 79 tube and 34 bifurcated stent-grafts. Follow-up used contrast-enhanced CT scanning and duplex sonography with an intravenous ultrasound contrast agent (Levovist). Results: Eleven patients (9.7%) were converted to open repair; 1 died from hemorrhagic shock secondary to retroperitoneal hematoma. The mean follow-up time was 7.2 months (range 1 to 24), during which 5 patients died of unrelated causes. Sixteen primary (within 30 days) and 5 secondary endoleaks were detected by duplex after tube graft implantation. Among 5 endoleaks due to retrograde side-branch perfusion, 3 were detected only with contrast-enhanced duplex scanning. Iliac artery occlusion was also documented using duplex; however, 2 stent fractures could not be seen with ultrasound. Ten primary endoleaks were detected in bifurcated stent-graft patients. One endoleak originating from the distal iliac limb anchoring site was missed by duplex owing to bowel gas. Graft limb thrombosis was clearly identified by lack of a flow signal on duplex. Conclusions: Duplex sonography could be a valuable, reliable, and economical surveillance tool for endovascular aortic reconstructions. The adjunctive use of an intravenous ultrasound contrast agent increased the sensitivity for detecting endoleak to a level comparable to contrast-enhanced CT scanning. However, stent fractures may not be seen on ultrasound, and bowel gas can interfere with obtaining an adequate image.

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