Metal Artifact Reduction in Head CT Performed for Patients with Deep Brain Stimulation Devices: Effectiveness of a Single-Energy Metal Artifact Reduction Algorithm.

BACKGROUND AND PURPOSE: Deep brain stimulation electrodes induce massive artifacts on CT images, deteriorating the diagnostic value of examinations. We aimed to investigate the usefulness and potential limitations of a single-energy metal artifact reduction algorithm in head CT performed in patients with implanted deep brain stimulation devices. MATERIALS AND METHODS: Thirty-four patients with deep brain stimulation (bilateral, n = 28) who underwent head CT on a 320-detector row scanner and whose images were reconstructed with and without single-energy metal artifact reduction at the examinations were retrospectively included. The severity of artifacts around electrodes was assessed objectively using SDs and an artifact index. Two radiologists subjectively evaluated the severity of artifacts from electrodes, the visibility of electrode localization and surrounding structures, and overall diagnostic confidence on 4-point scales. Background image quality (GM-WM contrast and image noise) was subjectively and objectively assessed. The presence and location of artifacts newly produced by single-energy metal artifact reduction were analyzed. RESULTS: Single-energy metal artifact reduction provided lower objective and subjective metal artifacts and improved visualization of electrode localization and surrounding structures and diagnostic confidence compared with non-single-energy metal artifact reduction images, with statistical significance (all, P < .01). No significant differences were observed in GM-WM contrast and image noise (all, P ≥ .11). The new artifacts from single-energy metal artifact reduction were prominently observed in patients with bilateral deep brain stimulation at high convexity, possibly induced by deep brain stimulation leads placed under the parietal scalp. CONCLUSIONS: Single-energy metal artifact reduction substantially reduces the metal artifacts from deep brain stimulation electrodes and improves the visibility of intracranial structures without affecting background image quality. However, non-single-energy metal artifact reduction images should be simultaneously reviewed to accurately assess the entire intracranial area, particularly in patients with bilateral deep brain stimulation.

High frequency region of the snore spectra carry important information on the disease of sleep apnoea.

Snoring is the most common symptom of obstructive sleep apnoea (OSA). Several researchers have reported differences between the power spectra of non-OSA and OSA snorers. The traditional approach over the years has been to record snore sounds at a bandwidth of < 5 kHz. Narrowing of the upper airways during OSA events and the resulting upward shift of snore frequencies also lend support to the idea of examining snore sounds beyond 5 kHz. In this paper, we compute the power spectra of snores in three different bands defined as: low-frequency band (LFB: < 5 kHz); middle-frequency band (MFB: 5-10 kHz) and high-frequency band (HFB: 10-20 kHz). We illustrate that there is a significant difference between non-OSA snorers (Apnoea Hypopnoea Index (AHI) < 10) and OSA snorers (AHI > 10) in the region > 5 kHz. We then develop a feature to diagnose OSA based on the spectral differences in the high frequency region and evaluate its performance on a database of 20 subjects. Our results strongly suggest that the high-frequency region of the snore sounds carry information, hitherto disregarded, on the disease of sleep apnoea.

First demonstration of electron scattering using a novel target developed for short-lived nuclei.

We carried out a demonstrative electron scattering experiment using a novel ion-trap target exclusively developed for short-lived highly unstable nuclei. Using stable 133Cs ion as a target, this experiment completely mimicked electron scattering off short-lived nuclei. Achieving a luminosity higher than 10;{26} cm;{-2} s;{-1} with around only 10;{6} trapped ions on the electron beam, the angular distribution of elastic scattering was successfully measured. This experiment clearly demonstrates that electron scattering off rarely produced short-lived nuclei is practical with this target technique.

Novel internal target for electron scattering off unstable nuclei.

A novel internal target has been developed, which will make electron scattering off short-lived radioactive nuclei possible in an electron storage ring. An "ion trapping" phenomenon in the electron storage ring was successfully utilized for the first time to form the target for electron scattering. Approximately 7 x 10(6) stable 133Cs ions were trapped along the electron beam axis for 85 ms at an electron beam current of 80 mA. The collision luminosity between the stored electrons and trapped Cs ions was determined to be 2.4(8) x 10(25) cm(-2) s(-1) by measuring elastically scattered electrons.

Feature extraction for snore sound via neural network processing.

Snore sound (SS) is the earliest and the most common symptom of Obstructive Sleep Apnea (OSA) which is a serious disease caused by the collapse of upper airways during sleep. SS should carry vital information on the state of the upper airways and is simple to acquire and rich in features but their analysis is complicated. In this study we use neural network (NN) based method to model SS via a simple second order one-step predictor. We show that the some hidden information/feature of a SS can be conveniently captured in the connection-weight-space (CWS) of the NN, after a process of supervised training. The availability of the proposed method is investigated by performing independent component analysis (ICA) on CWS.

Tracking the states of a nonlinear and nonstationary system in the weight-space of artificial neural networks.

We propose a novel interpretation and usage of Neural Network (NN) in modeling physiological signals, which are allowed to be nonlinear and/or nonstationary. The method consists of training a NN for the k-step prediction of a physiological signal, and then examining the connection-weight-space (CWS) of the NN to extract information about the signal generator mechanism. We define a novel feature, Normalized Vector Separation (gamma(ij)), to measure the separation of two arbitrary states "i" and "j" in the CWS and use it to track the state changes of the generating system. The performance of the method is examined via synthetic signals and clinical EEG. Synthetic data indicates that gamma(ij) can track the system down to a SNR of 3.5 dB. Clinical data obtained from three patients undergoing carotid endarterectomy of the brain showed that EEG could be modeled (within a root-means-squared-error of 0.01) by the proposed method, and the blood perfusion state of the brain could be monitored via gamma(ij), with small NNs having no more than 21 connection weight altogether.

De novo uterine sarcoma with good response to neo-adjuvant chemotherapy.

We report here the extremely rare case of a 28-year-old woman with advanced stage uterine sarcoma arising soon after a cesarean section. She underwent an abdominal cesarean section because of a breech presentation. At the time of the procedure, there were no abnormal findings such as leiomyoma of the uterus in the abdominal cavity. One year later, she was referred to our hospital because of a large abdominal tumor. Transabdominal power Doppler ultrasonography and magnetic resonance imaging (MRI) showed a large hypervascular tumor in the abdominal cavity. Her serum levels, for the two tumor markers carbohydrate antigen CA125 and LDH, were elevated, at 219 U/ml (< 35 U/ml) and 862 IU/l (115 U/ml-217 U/ml), respectively. On the basis of a diagnosis of malignant tumor of gynecological origin, exploratory laparotomy was performed, and through biopsy, the tumor was found to be advanced undifferentiated uterine sarcoma. She exhibited a good response to neoadjuvant chemotherapy consisting of cisplatin, epirubicin, and dimethyltriazenoimidazole carboxamide (DTIC) every 28 days, which was successfully followed by a hysterectomy.

[Two cases of Chlamydia psittaci infection occurring in employees of the same pet shop].

We report here 2 cases of psittacosis in a pet shop. In the first case, a 44-year-old male was admitted with fever, and a chest radiograph showed an infiltration shadow in the right lower lung. One day later, a colleague of the first patient, a 42-year-old man, developed fever and was admitted. In this patient, chest radiography revealed an infiltration shadow in the left lower lung. Both patients had mild liver dysfunction. The serum titer of a complement fixation (CF) test against Chlamydia psittaci was elevated fourfold in the first case and sixteen-fold in the second on the analysis of paired acute- and convalescent-phase serum specimens. Clinical symptoms and abnormal laboratory data were attenuated by the administration of minocycline for 2 weeks. Since both patients worked in same pet shop and since some parakeets at the shop had died, we speculated that the psittacosis had originated from these birds.

A preliminary study of discrimination among the components of small pulmonary nodules by MR imaging: correlation between MR images and histologic appearance.

PURPOSE: To investigate whether magnetic resonance (MR) imaging depicts the internal characteristics of small pulmonary nodules. METHODS: We reviewed MR images of 39 surgically resected pulmonary nodules 3 cm or less and compared the components within the nodules. In 22 malignant nodules, eight histologic components were characterized by signal and enhancement patterns on MR images. RESULTS: MR images obtained from any single sequence discriminated all components in 26 (67%) nodules, whereas the combination of images from various sequences allowed discrimination in 35 (90%). Fourteen of 16 components of aggregated tumor cells showed marked early enhancement. Although fibrotic and necrotic components showed no or slight early enhancement, nine of 10 fibrotic components showed hypointensity and six of seven necrotic components showed hyperintensity on T2-weighted images. Component characterization in eight histologies by MR imaging was possible in 71-100%. CONCLUSION: Our study demonstrated that MR imaging offers the possibility of high tissue-contrast resolution in small pulmonary nodules.

Alpha 1-antichymotrypsin inhibits chymotrypsin-induced apoptosis in rat hepatoma cells.

Increased serum levels of alpha1-antichymotrypsin (alpha 1ACT) are observed in some cancer patients, especially those with hepatocellular carcinoma. A possible role of alpha 1ACT in tumour growth has been suggested, but this remains uncertain. We have demonstrated that alpha 1ACT inhibited chymotrypsin-induced apoptosis in rat hepatoma H4 cells. Even low concentrations of chymotrypsin (but not trypsin) induce apoptosis in H4 cells with a minimum effective concentration of 2.4 x 10(-2) units/ml (0.5 microg/ml), and this apoptosis was inhibited by alpha 1ACT in a concentration-dependent manner. Furthermore, the concentrations of alpha 1ACT required to inhibit the apoptosis were lower than normal serum levels. These results may indicate that alpha 1ACT plays a role in the apoptosis of rat hepatoma cells.

Observation of the strain field near the Si(111) 7 x 7 surface with a new X-ray diffraction technique.

A new X-ray diffraction technique has been developed in order to measure the strain field near a solid surface under ultrahigh vacuum (UHV) conditions. The X-ray optics use an extremely asymmetric Bragg-case bulk reflection. The glancing angle of the X-rays can be set near the critical angle of total reflection by tuning the X-ray energy. Using this technique, rocking curves for Si surfaces with different surface structures, i.e. a native oxide surface, a slightly oxide surface and an Si(111) 7 x 7 surface, were measured. It was found that the widths of the rocking curves depend on the surface structures. This technique is efficient in distinguishing the strain field corresponding to each surface structure.

Effects of amino acid replacements on cadmium binding of metallothionein alpha-fragment.

To evaluate whether only 20 cysteine residues at invariant positions are needed to bind and coordinate the metals in metallothioneins (MTs), and whether changing the positions of cysteine residues in the sequence affects the metal-binding capacity and the coordination of MTs, we examined the cadmium-binding affinities of seven mutant MT alpha s using an Escherichia coli expression system. Five mutant MT alpha s in which the constitutive amino acid residues other than cysteines of the alpha-fragment were replaced with glycine residues, and the remaining two mutant MT alpha s in which the invariant positions of the cysteine residues of the alpha-fragment were shifted, were analysed for their ability to be expressed as cadmium-binding forms and for their biochemical properties. The results showed that extreme alteration of the constitutive amino acid residues other than cysteines in the MT alpha-fragment leads to disruption of their cadmium-binding abilities and of their structure. However, mutant MT alpha s containing changes of the invariant positions of the cysteine residues were expressed in a cadmium-binding form in Escherichia coli, although the invariant positions of 20 cysteine residues in the MTs are thought to be important for their metal-binding abilities. These results suggest that the position of cysteine residues and the chemical nature of the other amino acids in the amino acid sequence of MTs are less critical than expected.

Restriction of cadmium transfer to eggs from laying hens exposed to cadmium.

The transfer of Cd to eggs of white Leghorn laying hens has been shown to be restricted. After Cd was injected ip into laying hens, the Cd concentrations in the blood, livers, ovaries, and eggs were measured. Although the Cd concentrations in the maternal blood and livers increased remarkably at certain levels of administrations, the Cd concentration in the yolks of eggs was not significantly increased, and was less than 0.04 microgram/g wet weight. After egg production stopped in the highest injected group (7.5 mg Cd/kg), Cd in the yolks of eggs had an accumulated range of 0.02-0.03 microgram/g wet weight. This was despite the high Cd accumulation in the liver. Furthermore, the Cd concentration in the follicle walls of the ovary increased and was 13- to 52-fold higher than in the follicle yolks. An additional experiment was conducted in order to estimate whether hatching success is affected by the Cd in the laid eggs of Cd-injected laying hens. The ratio of hatching success in the 0.3 or 1.2 micrograms Cd/egg-injected groups was similar to that in the saline-injected group, indicating that a small amount of Cd in the eggs might exert no marked influence on the hatching success. In conclusion, Cd transfer from laying hen to eggs was restricted after the maternal bird was exposed to Cd. Furthermore, Cd accumulates in the follicle walls of ovary. These results suggest that the follicle walls might play a role in protecting the follicle yolks against Cd toxicity.

A Case of Microangiopathic Hemolytic Anemia Associated with Breast Cancer: Improvement with Chemoendocrine Therapy.

Microangiopathic hemolytic anemia (MAHA) is a term which describes the association of hemolytic anemia with red cell fragmentation caused by microangiopathy mechanically. This paper reports a 45-year-old woman with bone metastases from breast cancer. She developed MAHA and disseminated intravascular coagulation (DIC). Although the prognosis of MAHA associated with malignant tumor has been very poor, she achieved remission of the syndrome after chemoendocrine therapy.

Simultaneous observation of endocrine and exocrine functions of the pancreas responding to somatostatin in man.

Six patients who underwent segmental autotransplantation of the caudal pancreas (SAT) following total pancreatectomy for pancreatic cancer were investigated. The graft was transplanted to the left groin, and pancreatic juice was diverted outside through a polyethylene tube indwelled into the main pancreatic duct. In these SAT patients, the responses of insulin (IRIS) in terms of plasma levels and pancreatic secretion to subcutaneous injections of somatostatin octreotide (Sandostatin: SMS201-995) were simultaneously observed. Four doses (0.039, 0.156, 0.625 and 2.5 micrograms/kg) of SMS201-995 were given on separate days. As a control, saline was injected subcutaneously. Standard liquid test meal was given 1 h after the subcutaneous injection. The basal plasma IRI were significantly decreased with doses greater than 0.156 microgram/kg. The postprandial responses of IRI was also significantly suppressed with the same doses. On the other hand, the basal pancreatic exocrine secretion was significantly suppressed with doses greater than 0.625 microgram/kg. The postprandial pancreatic exocrine secretion was also significantly suppressed with doses greater than 0.625 microgram/kg. Those suppressions were dose-dependent. The postprandial CCK secretion was also significantly suppressed in dose-dependent manner with SMS201-995. The CCK suppression was significantly correlated with the suppression of pancreatic exocrine secretion. This clinical study under the setting of SAT demonstrated not only the direct inhibitory effect of somatostatin on both the islet and acinar cells but also, probably, the indirect inhibitory effect on the acinal cells via suppression of CCK release in humans.

Independent self-assembly of cadmium-binding alpha-fragment of metallothionein in Escherichia coli without participation of beta-fragment.

We examined the independent self-assembly of the alpha- and beta-fragments of human metallothionein (MT) into cadmium-binding conformation in an Escherichia coli expression system, in addition to wild-type MT expression. The expressed alpha-fragment formed independently the structure of a metal-binding cluster without the aid of the beta-fragment. The alpha-fragment and wild-type MT expressed in E.coli were purified and analyzed for their biochemical and spectroscopic properties. The apparent cadmium binding of the alpha-fragment was approximately 12-fold greater than that for the wild-type MT, whereas in other respects the studied biochemical properties were similar. In contrast, we were unable to obtain any independently expressed beta-fragment as the cadmium-binding form in this study. Possible explanations for this phenomenon are discussed.

Roles of the conserved serines of metallothionein in cadmium binding.

The sequence of six amino acid residues -Ser-Cys-Cys-Ser-Cys-Cys- is present in all mammalian metallothionein sequences and has been highly conserved during evolution, although the metallothioneins have divergent primary sequences. To determine whether two serines in the sequence play a crucial role in metal-binding of metallothioneins, a mutant metallothionein with these two serines replaced by leucines was obtained using an Escherichia coli expression system. The expressed protein was analyzed for its chemical and spectroscopic properties. It was confirmed that the mutant metallothionein (MT) bound cadmium through a metal-thiolate complex and that there was no strong difference between the mutant and the wild-type MTs in retaining the metal-binding cluster. However, the metal-binding cluster of the mutant metallothionein was more unstable than that of the wild-type metallothionein. The two conservative serines could play a role in the stability of metal-binding ligands.

Expression of human metallothionein-2 in Escherichia coli: cadmium tolerance of transformed cells.

A genetic approach was undertaken to investigate the physiological roles of human metallothionein-2. A constructed expression plasmid, pEXPMTII, in which human metallothionein-IIA cDNA was inserted downstream of a tryptophan-lactose promoter, was used to transform Escherichia coli JM105 strain. Cadmium-binding metallothionein was successfully expressed in E. coli in the medium containing cadmium, while copper and zinc-metallothioneins were scarcely observed in copper- or zinc-containing medium. The amino acid composition and sequence of the biosynthesized cadmium-metallothionein were analyzed. The selectivity of metals bound to metallothionein and the stability of metal-binding forms of metallothionein in E. coli were discussed. In addition, cadmium, zinc, or copper resistance of the cells expressing metallothionein was examined. Cells transformed with the plasmid pEXPMTII and cultured in a medium containing cadmium exhibited tolerance only to cadmium. It was demonstrated that human metallothionein-2 functioned for cadmium detoxification in E. coli.

An effect of somatostatin on neurotensin secretion.

A somatostatin analog (SMS201-995) was administered subcutaneously to six totally pancreatectomized (TP) patients at five dose levels from 0 microgram/kg (control) to 2.5 micrograms/kg before ingestion of a liquid test meal, and plasma levels of neurotensin (NT) were measured. There were no significant differences in basal levels of NT between the doses of somatostatin. The NT levels were significantly elevated after ingestion of the test meal in the normal controls (n = 14). In the TP patients postprandial hypersecretion of NT was observed. The hypersecretion of NT in the patients was suppressed by SMS201-995 dose-dependently.