Patient-centric comparative analysis of experiences in open upright and conventional closed MRI scanners.

INTRODUCTION: MRI often induces anxiety, leading to incomplete scans and claustrophobia-related distress. Open MRI systems aim to enhance patient comfort. This study examines how prior MRI experiences impact subsequent encounters in an open upright MRI scanner. METHODS: In this cross-sectional study, 118 adult patients completed a self-administered questionnaire from August 2022 to October 2023. It covered previous MRI experiences, including questions about claustrophobia, premature scan terminations, sedative medication usage, general MRI experiences, and interactions with radiology technologists. RESULTS: Patients in open upright MRI reported less claustrophobia compared to closed MRI systems (18.4% vs. 58.3%), fewer premature scan terminations (5.3% vs. 31.0%), and less sedative use (5.3% vs. 46.9%). Moderate positive correlations were found between past and current claustrophobic events and premature scan terminations. Effective communication with radiology technologists was essential for patient comfort and reduced claustrophobia. Scan duration and noise triggered discomfort in 26.1% and 21.6% of study participants respectively. Persons without prior MRI experience were more satisfied with the examination and expressed no clear preference for future MRI settings, contrasting those with previous exposure favoring the open MRI setup. CONCLUSION: The study emphasizes the benefits of open upright MRI for high-risk claustrophobic patients. It identifies the lasting impact of negative MRI experience on future examinations and highlights the crucial role of radiology technologists. IMPLICATIONS FOR PRACTICE: Integrating open MRI scanners in medical facilities and prioritizing effective communication with radiology technologists enhances patient comfort. Positive experiences with open MRI may improve patient compliance and offer greater flexibility for future examinations.

[Radiation exposure and image sharpness of mammographic units in bavaria with respect to the European guidelines]. / Strahlenexposition und Abbildungsschärfe an bayerischen Mammographie--Einrichtungen im Hinblick auf die Europäischen Leitlinien.

In a survey including all mammography units in Bavaria, entrance doses in air and other quality-relevant parameters were measured with standard settings and under comparable conditions. The study was aimed to discover discrepancies between practical mammographic imaging techniques and the demands established in the European Guidelines. Test images were made by the operators themselves with phantoms used for constancy checks. Entrance dose values were measured with official film dosimeters. The survey showed that more than 95 % of all mammographic units in Bavaria comply with the European guidelines with respect to radiation exposure and imaging sharpness.

[Progress in mammography technics. Bimetal anode tubes and selective filtration technic]. / Fortschritte in der Mammographietechnik. Bimetall-Anodenröhre und selektive Filtertechnik.

The use of molybdenum (Mo) as material for anodes and filters in mammography has been a result of contrast optimisation for breasts of low to medium radiation absorption. To penetrate denser breasts the kV must be increased, thus increasing the fraction of the harder radiation component and deteriorating image contrast. Besides this an increased radiation exposure to the patient must be accepted. In these cases the flexible use of rhodium (Rh) as anode and filter material is promising. A newly developed mammographic equipment (Senographe DMR, General Electric-CGR) offers these features. With selective rhodium filtering and anode material our measurements confirm a reduced radiation exposure (less than 50%) in dense breasts with significantly improved image contrast compared with the conventional molybdenum technique.

Activation and enhanced contact of human T-lymphocytes with autologous red blood cells are required for their stable adherence at 37 degrees.

The adherence of human red blood cells (RBC) to autologous T-cells does not occur in the body, and in vitro is elicited at 4 degrees. Autologous E-rosetting at 37 degrees has not previously been described. In this work, lymphocyte-RBC adherence has been studied in mixed leukocyte-RBC cultures and in whole blood from healthy donors. Vital, cytochemical and electron microscopic studies have shown that T-cells may form stable E-rosettes with autologous RBC at 37 degrees. As in the previously reported cold-dependent reversible rosetting, stable rosetting is mediated by the erythrocyte LFA3 and lymphocyte CD2 molecules. Uniquely, this phenomenon requires both T-cell activation and an enhanced contact between the T-cell and RBC membranes. These requirements were met by exposure of cell cultures to: (1) PHAE, the erythroagglutinating component of PHAP, or (2) to either non-erythroagglutinating mitogens, PHAL, Con A, OKT3 or SEA, or to antigens of typhus group rickettsiae or salmonellae, provided that the RBC membrane was desialyted. Cultures derived from individuals seropositive to rickettsiae or vaccinated with salmonellae demonstrated the adherence phenomenon after antigen exposure when neuraminidase was present in the culture medium. The system 2 described here can be used as a diagnostic tool for defining activated T-cells and T-cell clones with the memory to antigens capable of inducing cell-mediated immunity.

[Focal spot sizes and the geometric unsharpness of mammographic equipment]. / Fokusabmessung und geometrische Unschärfe bei Mammographiegeräten.

The visibility of microcalcifications in mammography is limited, inter alia, by the dimensions of the focal spot of the x-ray tube. The user should be able to evaluate a given nominal value of the focal spot and to assess the effective size of the focal spot in his x-ray tube. Determination of the resolution with the help of the mammographic phantom suggested by the German DIN standards specifications requires special care. In the framework of the German Mammography Study, 45 mammography devices at different locations were tested with regard to their focal spot sizes. All devices complied with the acceptance test without any adverse comment, although--if judged objectively--only half of them have the resolution demanded by DIN standards. Consequently, in most of the cases the users are unaware of this, and the negative effects on the visibility of possibly present microcalcifications are often underestimated. The diagnostic importance of microcalcifications for the detection of breast cancer suggests, however, to abstain from devices which are only of limited usefulness in relevant mammography screening.

Absence of neutralizing antibodies to interferon in condyloma acuminata and cancer patients treated with natural human leukocyte interferon.

Human leukocyte-derived interferon-alpha (IFN-alpha n3) was used to treat condyloma acuminata patients in a double-blind placebo-controlled clinical study. The incidence of antibody formation to IFN-alpha was evaluated in matched patient sera from the control placebo and the IFN-alpha n3 treatment groups. Sera from IFN-alpha n3-treated phase I cancer patients and untreated healthy donors were also evaluated. Three sensitive assay methods (ELISA, competitive immunoradiometric, and antiviral neutralization) were used in these evaluations. The overall levels of detectable binding anti-IFN-alpha antibodies in the patients were similar to those of the normal donors. No neutralizing antibodies were generated in the patients after repeated treatment with natural IFN-alpha n3.

Trace amounts of murine immunoglobulin in affinity purified leukocyte interferon alpha are not immunogenic.

Human leukocyte-derived interferon alfa-n3 (Alferon N Injection) is purified to very high specific activity over a murine immunoaffinity column specific for human interferon alpha. Trace amounts of murine immunoglobulin copurify with the interferon alfa-n3. Three populations of individuals were studied for the development of human anto-murine antibodies (HAMA), that is, normal donors, Condylomata acuminata patients receiving interferon alfa-n3, and Condylomata acuminata patients receiving placebo. High and variable endogenous levels of HAMA were observed in all three populations. The same relative increase in HAMA was seen in the placebo as in the interferon alfa-n3 treatment groups. The data demonstrate that intralesional injection of the interferon alfa-n3 did not induce the development of HAMA.

Lymphocyte emperipolesis into autologous monocytes in leukocyte cultures exposed to mitogenic lectins.

Lymphocyte-monocyte synergistic interaction in cooperative response to mitogens and antigens is well established. This paper describes a less known--antagonistic (effector-target)--lymphocyte-monocyte interaction that came into existence in a leukocyte culture after the commencement of cellular response to concanavalin A, phytohemagglutinin and Wistaria floribunda mitogen. An invasion of lymphocytes into monocytes and monocyte polykaryons has been found 24-48 h after exposure to mitogens. The invasion is not followed by lysosome fusion with lymphocyte-bearing vacuoles, but is associated with a sequential destruction of the vacuole wall, and eventual disintegration of some affected cells. The expression of pan-T-cell surface antigens, staining patterns for nonspecific esterase and acid phosphatase as well as ultrastructural features show that the lymphocytes entering into and those located within monocytes and polykaryons represent activated T-cells. The presence of developed Golgi complexes associated with coated and smooth vesicles, and lysosomal bodies with microvesicles, tubular arrays or dense cores suggest that these T-cells belong to subpopulations which possess cytolytic activities. The lymphocyte invasion is considered cytolytic emperipolesis directed towards some autologous cells of the mononuclear phagocyte series. Its extent depends upon the mitogen concentration, and density of cell population in the culture. It also shows individual variability. The relationship of cytolytic emperipolesis to phagocytosis, and its possible significance as a mechanism of cell-mediated elimination of undesirable cells is discussed.