Evaluation of automatic measurement of the intracranial volume based on quantitative MR imaging.

BACKGROUND AND PURPOSE: Brain size is commonly described in relation to ICV, whereby accurate assessment of this quantity is fundamental. Recently, an optimized MR sequence (QRAPMASTER) was developed for simultaneous quantification of T1, T2, and proton density. ICV can be measured automatically within minutes from QRAPMASTER outputs and a dedicated software, SyMRI. Automatic estimations of ICV were evaluated against the manual segmentation. MATERIALS AND METHODS: In 19 healthy subjects, manual segmentation of ICV was performed by 2 neuroradiologists (Obs1, Obs2) by using QBrain software and conventional T2-weighted images. The automatic segmentation from the QRAPMASTER output was performed by using SyMRI. Manual corrections of the automatic segmentation were performed (corrected-automatic) by Obs1 and Obs2, who were blinded from each other. Finally, the repeatability of the automatic method was evaluated in 6 additional healthy subjects, each having 6 repeated QRAPMASTER scans. The time required to measure ICV was recorded. RESULTS: No significant difference was found between reference and automatic (and corrected-automatic) ICV (P > .25). The mean difference between the reference and automatic measurement was -4.84 ± 19.57 mL (or 0.31 ± 1.35%). Mean differences between the reference and the corrected-automatic measurements were -0.47 ± 17.95 mL (-0.01 ± 1.24%) and -1.26 ± 17.68 mL (-0.06 ± 1.22%) for Obs1 and Obs2, respectively. The repeatability errors of the automatic and the corrected-automatic method were <1%. The automatic method required 1 minute 11 seconds (SD = 12 seconds) of processing. Adding manual corrections required another 1 minute 32 seconds (SD = 38 seconds). CONCLUSIONS: Automatic and corrected-automatic quantification of ICV showed good agreement with the reference method. SyMRI software provided a fast and reproducible measure of ICV.

Colonization with potentially pathogenic respiratory tract bacteria. A household study.

A group of 235 persons (180 adults and 55 children 0-15 years old) recorded symptoms of upper respiratory tract infection daily during two three-month periods (autumn 1986 and spring 1987). Samples for culture were taken from the nasopharynx and throat once during each period. Fifteen per cent of asymptomatic subjects harboured respiratory pathogens in the nasopharynx, as did 28% of those subjects with minor respiratory tract infections and 46% of those with more severe respiratory tract infections. Of children up to seven years of age, 58% were colonized with potential respiratory pathogens, which is important to keep in mind when evaluating culture reports from young children. Adults living with young children were colonized significantly more often than other adults. Branhamella catarrhalis was the most common pathogen.

Cyclosporine in treatment of corticosteroid-resistant episodes of rejection.

We used cyclosporine (formerly called cyclosporin A) to treat established episodes of kidney-transplant rejection in six patients in whom the use of corticosteroids either was ineffective or was precluded by preestablished side effects. All patients were followed up by using fine-needle aspiration biopsy and transplant aspiration cytology. In four episodes of rejection with typical blast cell--dominated inflammation, the response to cyclosporine was apparently favorable: the inflammatory cells disappeared within days and the transplant resumed its normal function. One episode of acute rejection was overcome within a week after discontinuing treatment with cyclosporine. In one episode of chronic rejection that was devoid of any distinct blastogenic component, no effect of cyclosporine could be detected. We believe that cyclosporine can be used to treat established episodes of rejection, but what type or types of inflammatory episodes are susceptible to cyclosporine must first be clarified through prerandomized clinical trials.

Attitudes concerning water fluoridation among Swedish dentists in 1975.

The purpose of the investigation was to assess the attitudes concerning water fluoridation among dentists actively engaged in the practice of dentistry in Sweden. A 25% random sample was selected from the aforementioned population of 6,669 dentists. A questionnaire was sent out by mail in 1974/75. The rate of return was 93%. A 99% confidence estimate indicated that 60-66% of Swedish dentists approved a water fluoridation; 58% would welcome fluoridation of their own community water supplies; 56% expressed a willingness to sign a petition to the Parliament requesting that water fluoridation again be permitted. Approximately 11% were not certain about the effectiveness of water fluoridation in preventing dental decay. One-third of the respondents were uncertain about the safety of the technical procedures; 20% were undecided concerning the possibility of combining procedures for topical application of fluorides with water fluoridation, and 15% stated that topical application of fluorides could not be combined with water fluoridation. More than 19% were not able to report the F-content of their own community water supplies.

Survival in idiopathic glomerulonephritis.

Actuarial survival was studied in 285 adult patients with idiopathic glomerulonephritis (GN). Minimum follow-up was 7 years. 105 patients had minimal change GN (MC), 22 membranous GN (MGN), 20 acute GN (AGN), 11 mesangial sclerosis Gn (MSGN), 28 mesangiocapillary GN (MCGN), 8 crescentic GN (RPGN), 27 unclassifiable GN, 61 focal proliferative GN (FGN), and 3 focal segmental glomerular sclerosis and hyalinosis (FSGSH). Ten year survival was best in FGN (91%), and progressively poorer in MC (90%), AGN (85%), MSGN (83%), MGN (82%), MCGN (62%), unclassifiable GN (37%), and RPGN (16%). One of the three patients with FSGSH died during follow-up. At 10 years, survival differed significantly (p less than 0.01) from expected only in MCGN, RPGN and unclassifiable GN. Our results suggest that -- because survival was not significantly different from expected in most types of GN -- the current classification of GN is only a crude guide to prognosis. The nephrotic syndrome was found to worsen prognosis in MGN and MCGN.

Attitudes concerning water fluoridation among graduating Swedish dentists.

The purpose of the investigation was to assess the attitudes concerning water fluoridation among Swedish dentists just having completed their dental education. All senior dental students (168) at the four Swedish dental schools were handed a questionnaire during the last week of November 1974. By the end of February 1975, 98% of the respondents, now dentists, had returned their questionnaires. Water fluoridation was considered by the average respondent to be quite economical and effective but only slightly advisable; 72% expressed approval and support of water fluoridation; 15% expressed indecisiveness; 12% expressed negative views. The negative attitudes were associated with misconceptions concerning economy, technical efficiency, safety and effectiveness. Many respondents, even those who expressed support of water fluoridation, displayed misconceptions concerning the effectiveness of water fluoridation in relation to topical application of fluorides and to the administration of fluoride tablets.