Comparative analysis of patient scatter to phantom scatter for computed tomography systems.

Current computed tomography (CT) shielding practices are largely based on calculations of scattered radiation emitted from an acrylic head or body phantom, such as the Computed Tomography Dose Index (CTDI) phantom, or anthropomorphic phantoms of these two anatomical categories. This report considers the difference in scattered air kerma or dose from phantom models, to actual patient scatter under a variety of clinical scan conditions. Empirical patient scatter measurements recorded at different positions around the gantry, for 3 different CT scanners, resulted in average patient scatter fractions per unit Dose Length Product (DLP: mGy cm) at 1 m from the isocentre of 0.09 ± 0.03 and 0.17 ± 0.04 µGy (mGy cm)-1 for head and body scans respectively. For the purposes of shielding design and scattered dose estimates to staff it is recommended that a single standard deviation be applied to these averages in the continued interest of conservatism. These values are reasonably comparative to the widely published scatter fractions by the National Council of Radiological Protection using the CTDI phantom, and the British Institute of Radiology using head and body anthropomorphic phantoms.

Phonon anharmonicities and ultrafast dynamics in epitaxial Sb2Te3.

In this study we report on the investigation of epitaxially grown Sb2Te3 by employing Fourier-Transform transmission Spectroscopy (FTS) with laser-induced Coherent Synchrotron Radiation (CSR) in the Terahertz (THz) spectral range. Static spectra in the range between 20 and 120 cm-1 highlight a peculiar softening of an in-plane IR-active phonon mode upon temperature decrease, as opposed to all Raman active modes which instead show a hardening upon temperature decrease in the same energy range. The phonon mode softening is found to be accompanied by an increase of free carrier concentration. A strong coupling of the two systems (free carriers and phonons) is observed and further evidenced by exciting the same phonon mode at 62 cm-1 within an ultrafast pump-probe scheme employing a femtosecond laser as pump and a CSR single cycle THz pulse as probe. Separation of the free carrier contribution and the phonon resonance in the investigated THz range reveals that, both damping of the phonon mode and relaxation of hot carriers in the time domain happen on the same time scale of 5 ps. This relaxation is about a factor of 10 slower than expected from the Lorentz time-bandwidth limit. The results are discussed in the framework of phonon scattering at thermal and laser induced transient free carriers.

Magneto-Optical Functions at the 3p Resonances of Fe, Co, and Ni: Ab initio Description and Experiment.

We present experimental data and a complete theoretical description of the magneto-optical contributions to the complex refractive index in the extreme ultraviolet (XUV) range covering the 3p resonances of Fe, Co, and Ni. The direct comparison of the two allows us to conclude that many-body corrections to the ground state and local field effects are crucial for an accurate description of M-edge spectra. Our results are relevant for investigation of static magnetization, via XUV spectroscopy of multielement systems, as well as the dynamics of magnetization, as needed in the study of femtomagnetism and spintronics.

Optical Writing of Magnetic Properties by Remanent Photostriction.

We present an optically induced remanent photostriction in BiFeO_{3}, resulting from the photovoltaic effect, which is used to modify the ferromagnetism of Ni film in a hybrid BiFeO_{3}/Ni structure. The 75% change in coercivity in the Ni film is achieved via optical and nonvolatile control. This photoferromagnetic effect can be reversed by static or ac electric depolarization of BiFeO_{3}. Hence, the strain dependent changes in magnetic properties are written optically, and erased electrically. Light-mediated straintronics is therefore a possible approach for low-power multistate control of magnetic elements relevant for memory and spintronic applications.

Brillouin scattering of visible and hard X-ray photons from optically synthesized phonon wavepackets.

We monitor how destructive interference of undesired phonon frequency components shapes a quasi-monochromatic hypersound wavepacket spectrum during its local real-time preparation by a nanometric transducer and follow the subsequent decay by nonlinear coupling. We prove each frequency component of an optical supercontinuum probe to be sensitive to one particular phonon wavevector in bulk material and cross-check this by ultrafast x-ray diffraction experiments with direct access to the lattice dynamics. Establishing reliable experimental techniques with direct access to the transient spectrum of the excitation is crucial for the interpretation in strongly nonlinear regimes, such as soliton formation.

Following strain-induced mosaicity changes of ferroelectric thin films by ultrafast reciprocal space mapping.

We investigate coherent phonon propagation in a thin film of ferroelectric PbZr(0.2)Ti(0.8)O(3) (PZT) by ultrafast x-ray diffraction experiments, which are analyzed as time-resolved reciprocal space mapping in order to observe the in- and out-of-plane structural dynamics, simultaneously. The mosaic structure of the PZT leads to a coupling of the excited out-of-plane expansion to in-plane lattice dynamics on a picosecond time scale, which is not observed for out-of-plane compression.

Normalization schemes for ultrafast x-ray diffraction using a table-top laser-driven plasma source.

We present an experimental setup of a laser-driven x-ray plasma source for femtosecond x-ray diffraction. Different normalization schemes accounting for x-ray source intensity fluctuations are discussed in detail. We apply these schemes to measure the temporal evolution of Bragg peak intensities of perovskite superlattices after ultrafast laser excitation.

[Thrombotic microangiopathy under an effective treatment with gemcitabine]. / Thrombotische Mikroangiopathie unter einer effektiven Therapie mit Gemcitabin.

A 67-year-old male patient with a pancreatic carcinoma and hepatic metastases was admitted with progressive dyspnea and anuria. Previously he had received five cycles of a palliative chemotherapy with gemcitabine and responded well with a reduction of the tumor mass. The laboratory results showed a distinct anemia, thrombocytopenia, an increase in creatinine and lactate dehydrogenase levels. With an additional finding of 21 per mille fragmentocytes in the periphery blood smear, we diagnosed a thrombotic microangiopathy (TMA). Until now the literature lacks well-defined therapy standards for this known but rare condition of gemcitabine. In a few case reports addressing the related microangiopathy of thrombotic thrombocytopenic purpura (TTP), which is characterised by a significant reduction of the von Willebrand factor (vWF) cleaving serum protease ADAMTS-13, encouraging results have been achieved by an immediate plasma exchange. Though ADAMTS-13 activity was not relevantly reduced in our patient, we still observed a rapid improvement of the clinical features as well as of LDH, thrombocytes and fragmentocytes under plasma exchange. The patient was discharged after one month in good clinical condition. Interestingly, during follow-up for further 21 months we found a continued stable status of the pancreatic carcinoma without any cytostatic therapy. In summary, this case provides evidence that the use of plasma exchange therapy in gemcitabine-associated TMA is justified.

Lead attenuation characteristics models.

Lead attenuation characteristic curves are often consulted in premises radiation shielding assessments employing the non-destructive testing (NDT) method. This study developed lead attenuation characteristics mathematical models for the radionuclide Co-57. These models take into account the statistical variation of the attenuation characteristics. The results are a set of equations that a NDT assessor can use to predict the range of transmission factors for the NDT measurement or, using the inverse functions, to gauge the lead equivalence (with the associated uncertainty) of a radiation barrier. This study showed that the combined effect of types of statistical variations can form an uncertainty region on the transmission characteristics such that the relative uncertainty decreases for values of lead mass per unit area up to approximately 20 kg/m2 and 15 kg/m2 for the Ludlum 18 and Ludlum 2241-2 survey meters respectively but thereafter increases.

Injuries during the 2006 Women's Rugby World Cup.

BACKGROUND: Although there have been reports of injury rates in men's World Cup rugby, there has been no research into injury rates in women's international rugby. OBJECTIVE: To determine the rate of injury at the 2006 Women's Rugby World Cup (WRWC). METHODS: All participating teams in the 2006 WRWC were enrolled prospectively in this study. Healthcare workers for each team collected data on training and game exposure and information on injuries. RESULTS: 55 players (16%) sustained at least one injury (10.0/1000 player hours); 4 players (1%) sustained two injuries. 45 injuries occurred during games (37.5/1000 player hours) and 14 injuries occurred during practice (12.5/1000 player hours), a statistically significant difference (RR = 12.5, 95% CI 6.9 to 22.8). The injury rate was 39.3/1000 player hours for the forwards and 42.2/1000 player hours for the backs (RR = 1.3, 95% CI 0.7 to 2.3). The front row had the highest injury rate (62.5/1000 player hours). 63.6% of injuries occurred during the tackle. Most injuries occurred to the neck, knee and head/face. The majority of injuries were sprains, muscle injuries and contusions. There were five fractures during the event and four reported concussions. CONCLUSION: Female players sustained a considerable rate of injury during the 2006 WRWC. Backs had a slightly higher rate of injury than forwards, but the players most often injured were in the front row. The neck/cervical spine and knee were the most commonly injured regions, followed by the head and face. This is the first study to examine injury rates in female rugby players at a World Cup and reports valuable data in this population.

[Low-MI-sonography with the contrast-agent SonoVue in the diagnosis of infarction of the spleen, kidney, liver and pancreas]. / Low-MI-Sonographie mit dem Ultraschallkontrastmittel SonoVue im Vergleich zur Computertomographie bei Organinfarkten und Nekrosen in Milz, Niere, Leber und Pankreas.

PURPOSE: The diagnosis of ischemic injury by B-mode-sonography is difficult in many cases. Aim of the pilot-study was to evaluate whether additional examination with the ultrasound contrast agent SonoVue could improve the sonographic diagnosis of ischemic injury. MATERIALS AND METHODS: In a prospective study, intra-abdominal organs (n = 12) with ischemic lesions found by CT-scan were examined. All ischemic organs were examined by native B-mode-sonography and after injection of 1.2 ml SonoVue i. v. The SonoVue-examinations were performed using the CPS-software (Siemens, Erlangen). RESULTS: Native B-mode-sonography detected demarcation of ischemic lesions in only 7 of the 12 organs. In contrast, SonoVue-enhanced sonography diagnosed ischemic lesions in all organs. In one patient with renal infarction, however, the ischemic lesion found by SonoVue-enhanced sonography was smaller compared with the CT-scan. The diagnosis "compatible with ischemia" as cause for the abnormalities in B-mode sonography was described in only 3 out of 12 organs, and none of the organs were classified as "definite diagnosis of ischemia". In contrast, the diagnosis "definite diagnosis of ischemia" was made in 10 of the 12 organs when examined with SonoVue-enhanced sonography. In two further patients, the lesion was classified as "compatible with ischemia". In these patients, the diagnosis of ischemia was verified by CT-scan, due to the accompanying subtotal splenic infarction and a partial thrombosis of the coeliac trunc. CONCLUSION: It became evident that SonoVue-enhanced sonography was more sensitive in the diagnosis of ischemic injury than native B-mode sonography.

Recommendations for a technical quality control program for diagnostic X-ray equipment.

This position paper was produced by a working party set up by the Radiology Special Interest Group of the ACPSEM in 2001. It is designed to give the consensus view of College members in Australia and New Zealand on the nature and frequency of tests which should be performed on diagnostic x-ray equipment to maintain adequate quality control of imaging performance and radiation safety. Tests on mammographic equipment have been excluded having been covered in a previous ACPSEM position paper (Australas Phys Eng Sci Med, 24(3):107-131, 2001). Detailed descriptions of test procedures are not given but it is intended that a series of workbooks should be produced giving College recommended test methods for each imaging modality. The recommendations are produced here in an easy-to-read, tabular form giving the nature and purpose of each test and the implications of non-compliance with regard to image quality and radiation safety.

The retinitis pigmentosa GTPase regulator (RPGR) interacts with novel transport-like proteins in the outer segments of rod photoreceptors.

Mutations in the retinitis pigmentosa GTPase regulator (RPGR) gene cause X-linked retinitis pigmentosa type 3 (RP3), a severe, progressive and degenerative retinal dystrophy eventually leading to complete blindness. RPGR is ubiquitously expressed, yet mutations in the RPGR gene lead to a retina-restricted phenotype. To date, all RP3 associated missense mutations that have been identified are located in the RCC1-homologous domain (RHD) of RPGR. To investigate the molecular pathogenesis of RP3, we screened retinal yeast two-hybrid libraries with the RHD of RPGR. We identified several alternatively spliced gene products, some with retina-restricted expression, that interact specifically with RPGR in vivo and in vitro. Thus, these proteins were named RPGR-interacting protein 1 (RPGRIP1) isoforms. They contain a C-terminal RPGR-interacting domain and stretches of variable coiled-coil domains homologous to proteins involved in vesicular trafficking. The interaction between RPGR and RPGRIP1 isoforms was impaired in vivo by RP3-associated mutations in RPGR. Moreover, RPGR and RPGRIP1 co-localize in the outer segment of rod photoreceptors, which is in full agreement with the retinitis pigmentosa phenotype observed in RP3 patients. The localization of RPGRIP1 at 14q11 makes it a strong candidate gene for RP16. These results provide a clue for the retina-specific pathogenesis in RP3, and hint towards the involvement of RPGR and RPGRIP1 in mediating vesicular transport-associated processes.

The zinc finger cluster domain of RanBP2 is a specific docking site for the nuclear export factor, exportin-1.

The Ran-binding protein 2 (RanBP2) is a large scaffold cyclophilin-related protein expressed in photoreceptor cells. Red/green opsin, Ran-GTPase, and the 19 S regulatory complex of the proteasome associate with specific RanBP2 structural modules. Some of these play a role in chaperoning the functional expression of opsin. RanBP2 localization at cytoplasmic fibrils emanating from the nuclear pore complex and interaction with the Ran-GTPase support also its role in nucleocytoplasmic transport processes. The degenerate nucleoporin repeat motifs FXFG, GLFG, and XXFG have been proposed to mediate the movement of nucleocytoplasmic transport factors. In particular, RanBP2 has been implicated in nuclear import processes. Here, we show the zinc fingers of RanBP2 associate with high specificity to the nuclear export factor, exportin-1 (CRM1). The bovine RanBP2 transcript contained only five of the eight zinc fingers reported in the human counterpart and are sufficient for exportin-1 association with RanBP2. In contrast to Ran interaction with RanBP2-exportin-1 complex, exportin-1 binding to the zinc finger cluster domain of RanBP2 is insensitive to leptomycin B and nucleotide-bound state of Ran-GTPase. Our results indicate that the zinc finger-rich domain of RanBP2 constitutes a docking site for exportin-1 during nuclear export. Thus, RanBP2 emerges as a key component of the nuclear export pathway.

Corrosion of lead shielding in a radiology department.

Corrosion of lead sheet used for structural radiation protection in the Princess Alexandra Hospital radiology department has been identified. The corrosion is thought to have been caused by organic acid vapours released from oregon timber wall panelling. Non-destructive testing (NDT) and X-ray transmission measurements were used to define the extent and severity of damage, and subsequently to provide the data necessary for estimation of staff and public radiation doses. Although radiation dose limits have not been exceeded, corrective actions including structural modifications and staff information sessions have been undertaken.

The cyclophilin-like domain mediates the association of Ran-binding protein 2 with subunits of the 19 S regulatory complex of the proteasome.

The combination of the Ran-binding domain 4 and cyclophilin domains of Ran-binding protein 2 selectively associate with a subset of G protein-coupled receptors, red/green opsins, upon cis-trans prolyl isomerase-dependent and direct modification of opsin followed by association of the modified opsin isoform to Ran-binding domain 4. This effect enhances in vivo the production of functional receptor and generates an opsin isoform with no propensity to self-aggregate in vitro. We now show that another domain of Ran-binding protein 2, cyclophilin-like domain, specifically associates with the 112-kDa subunit, P112, and other subunits of the 19 S regulatory complex of the 26 S proteasome in the neuroretina. This association possibly mediates Ran-binding protein 2 limited proteolysis into a smaller and stable isoform. Also, the interaction of Ran-binding protein 2 with P112 regulatory subunit of the 26 S proteasome involves still another protein, a putative kinesin-like protein. Our results indicate that Ran-binding protein 2 is a key component of a macro-assembly complex selectively linking protein biogenesis with the proteasome pathway and, thus, with potential implications for the presentation of misfolded and ubiquitin-like modified proteins to this proteolytic machinery.

Treatment of enterococcal pyelonephritis with trovafloxacin and rifampin: in vitro-in vivo contrast.

The in vitro bactericidal interaction of trovafloxacin and rifampin against Enterococcus spp. has indicated that antagonism occurs between these two antimicrobial agents. This drug combination was examined in vivo in rats with experimental pyelonephritis. The rats received trovafloxacin, rifampin, or both drugs. On the basis of the mean log10 CFU of Enterococcus faecalis from the kidneys, there was no evidence that trovafloxacin and rifampin were antagonistic in vivo.

Precision and accuracy of computed digital absorptiometry for assessment of bone density of the hand.

Widespread osteoporosis testing and diagnosis are currently limited due to the high capital cost and reduced portability of many existing bone densitometry techniques. In this study we evaluated an inexpensive, low radiation, X-ray-based technique for assessing bone density of the middle phalanx. The technique, termed computed digital absorptiometry (CDA), is similar to radiographic absorptiometry (RA), using a single-energy X-ray source, an aluminum alloy step-wedge, and a charge-coupled device (CCD) detector system to automatically compute bone mineral content (BMC, g) and bone mineral density (BMD, g/cm2) in the middle phalanx of the third finger. The potential advantage of CDA over current RA techniques is that by using a filmless detector system, no off-site processing of radiographs is required and bone density results are obtained immediately after the test. Using human cadaveric specimens we determined the accuracy and short-term precision of CDA as well as its correlation with other hand and forearm bone densitometry methods. We obtained 26 cadaveric forearms (50% female, mean age 78 years, range 52-96 years). BMC and BMD of the middle phalanx of the third finger were determined using CDA and using RA. We assessed forearm BMC and BMD using single-energy and dualenergy X-ray absorptiometry (SXA and DXA). Precision of CDA was assessed by measuring ten of the specimens five times each with repositioning between measurements. Finally, the middle phalanx was dissected and incinerated to determine ash weight. BMC estimates from CDA and from RA were strongly correlated with ash weight (r = 0.89, p < 0.001 and r = 0.93, p < 0.001, respectively). The mean coefficients of variation using CDA were 1.36% and 0.70% for phalanx BMC and BMD, respectively. BMC and BMD measured by CDA were strongly correlated with hand and forearm bone mineral measurements performed by SXA, DXA and RA (r = 0.74-0.91). These results indicate that CDA accurately and precisely predicts BMC of the middle phalanx. Thus, with further clinical verification, this technique may prove to be a useful tool for the widespread testing and assessment of osteoporotic fracture risk.

In vitro activity of the combination of trovafloxacin and other antibiotics against enterococci.

The activities of trovafloxacin and ciprofloxacin against 38 strains of non-beta-lactamase-producing enterococci, resistant to ampicillin, 34 strains susceptible to ampicillin, and 3 vancomycin-resistant enterococci were studied. Trovafloxacin was more active than ciprofloxacin against all the enterococci studied. The ampicillin-resistant strains were more susceptible than the ampicillin-susceptible strains to both agents. The effect of combining trovafloxacin with gentamicin, ampicillin-sulbactam, novobiocin, rifampin, teicoplanin, and vancomycin was determined for 17 strains by the checkerboard method. An additive effect by inhibition was seen with all antibiotics studied. The results by killing varied with the different agents studied. Gentamicin, ampicillin-sulbactam, and novobiocin produced an additive killing effect with trovafloxacin. Reduced killing was seen when rifampin, vancomycin, or teicoplanin were added to trovafloxacin.