Radio Frequency Identification Gate System to Identify Misused Personal Dosimeters.

The use of two personal dosimeters, one worn over and one worn under a protective apron, provides the best estimate of effective dose. However, inappropriate positioning of dosimeters is a common occurrence, resulting in abnormally high or low radiation exposure records. Although such incorrect positioning can be identified by radiation exposure records, doing so is time-consuming and labor-intensive for administrators. Therefore, a system that can identify incorrect locations of dosimeters without burdening administrators must be developed. In this study, we developed a radio frequency identification (RFID) gate system that can differentiate between two RFID-tagged dosimeters placed over and under a metal apron and identify misused dosimeters. To simulate the position of the RFID-tagged dosimeters, we designed four dosimeter-wearing classes, including "proper use" and three types of "misuse" (i.e., "reversed," "both under," and "both over"). When the system predicts "misuse" based on the tag reading, the worker is alerted with lights and alarms. The system performance was evaluated using a confusion matrix, with an overall accuracy of 97.75%, demonstrating high classification performance. The safety of the system against life support devices was also investigated, demonstrating that they were not affected by the electric field at 0.3 m or more from the antenna of the system under any transmit powers tested. This RFID gate system is highly capable of identifying incorrectly positioned dosimeters, enabling real-time monitoring of dosimeters to manage their positioning.

Association between Edinburgh Postnatal Depression Scale and Serum Levels of Ketone Bodies and Vitamin D, Thyroid Function, and Iron Metabolism.

Suicide due to postpartum depression is the most common perinatal-related death and is a social concern in Japan. Nutritional deficiencies during pregnancy may contribute to postpartum depression; therefore, we investigated the relationship between postpartum depression and nutritional status during pregnancy and postpartum. We focused specifically on ketone bodies because they are known to protect brain cells. The relationship between the Edinburgh Postnatal Depression Scale (EPDS) scores and the serum levels of ketone bodies and vitamin D, thyroid function, and iron metabolism was examined. Overall, 126 pregnant women were identified for the study, and 99 were eventually included in the analysis. We defined an EPDS score of ≥9 as being positive for postpartum depression, and serum ketone levels were found to be higher in the group with an EPDS score of ≥9 during the second trimester; however, there were no other significant findings. We may be able to predict postpartum depression from a pregnant woman's serum ketone levels in the second trimester. There was a positive correlation between the EPDS scores at 3 days and 1 month postpartum (r = 0.534, p < 0.001). EPDS scores assessed in the early postpartum period may be useful for the timely detection of postpartum depression.

Evaluation of Inappropriate Positioning of Dosimeters in Medical Workers Based on Dose Equivalent Hp(10).

ABSTRACT: This report presents a new method to characterize the inappropriate positioning of dosimeters based on the dose equivalent Hp(10). The Hp(10) values of medical workers were measured monthly for 12 mo using two personal dosimeters. Using the ratio between the values of Hp(10) recorded from dosimeters worn over and under protective aprons [Hp(10) over and Hp(10) under , respectively], 670 pairs of dosimeter readings were categorized into a proper use group [Hp(10) over /Hp(10) under ≥ 5] and a misuse group [Hp(10) over /Hp(10) under < 5]. Following personal interviews, the readings in the misuse group were classified into the following six subgroups: "reversed," "sometimes reversed," "both under," "both over," "without apron," and "not specified." Ultimately, the scatter plot of "Hp(10) over - Hp(10) under " vs. Hp(10) over was identified as the most promising tool for clarifying the misuse patterns of dosimeters, as individual readings were mapped to the locations of the corresponding subgroups in the obtained graphs. Our results are expected to facilitate efficient and accurate usage of dosimeters by medical workers.

Optimal timing of liver transplantation for liver cirrhosis caused by sclerosing cholangitis in a patient with Langerhans cell histiocytosis: a case report.

Liver cirrhosis due to secondary sclerosing cholangitis caused by Langerhans cell histiocytosis (LCH) has a poor prognosis, and liver transplantation is the definitive treatment. However, the optimal timing has not been established. We report a 2-year-old girl with LCH-related liver cirrhosis who successfully underwent liver transplantation before progressing to severe liver dysfunction. Physical examination revealed a tumor on her palate. Biopsy was performed, and a diagnosis of LCH was established, together with hepatomegaly, splenomegaly, and rashes. Percutaneous liver biopsy before treatment revealed extreme fibrosis and absence of LCH cells. After beginning chemotherapy, she experienced several delays in treatment and dose reductions because of unacceptable bone marrow suppression, worsening liver dysfunction, and cholangitis. However, tumor shrinkage was observed in both magnetic resonance imaging and BRAF V600E mutant allele titers in her plasma. Given the good treatment response, liver transplantation was conducted. The postoperative course was uneventful, and chemotherapy was resumed 34 days after liver transplantation. Subsequent maintenance treatment was completed with no severe adverse effects. To prevent perioperative complications due to exacerbation of liver dysfunction and possible discontinuation of chemotherapy, liver transplantation should be considered before development of end-stage liver failure, provided that the original disease is well controlled.

Baculovirus-Induced Fast-Acting Innate Immunity Kills Liver-Stage Plasmodium.

Baculovirus (BV), an enveloped insect virus with a circular dsDNA genome, possesses unique characteristics that induce strong innate immune responses in mammalian cells. In this study, we show that BV administration in BALB/c mice not only provides complete protection against a subsequent Plasmodium berghei sporozoite infection for up to 7 d after the injection but also eliminates existing liver-stage parasites completely. The elimination of sporozoites by BV was superior to that by primaquine, and this effect occurred in a TLR9-independent manner. At 6 h after BV administration, IFN-α and IFN-γ were robustly produced in the serum, and RNA transcripts of IFN-stimulated genes were markedly upregulated in the liver compared with control mice. The in vivo passive transfer of serum after BV administration effectively eliminated liver-stage parasites, and IFN-α neutralization abolished this effect, indicating that the BV liver-stage parasite-killing mechanism is downstream of the type I IFN signaling pathway. These findings provide evidence that BV-induced, fast-acting innate immunity completely kills liver-stage parasites and, thus, may lead to new malaria drug and vaccine strategies.

Effects of myocardial perfusion abnormalities on the accuracy of left ventricular volume and ejection fraction measured by thallium-201 gated single-photon emission tomography: comparison with echocardiography as the reference standard.

BACKGROUND: We assessed the accuracy of left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) using quantitative gated single-photon emission computed tomography (QGS) in comparison with echocardiography as the reference standard. We also assessed the effects of total perfusion deficit (TPD) on the accuracy of QGS measurements. METHODS: A total of 258 patients underwent single-photon emission computed tomography and transthoracic echocardiography within 4 weeks of each investigation for evaluating coronary artery disease. Patients were divided into four groups according to TPD scores. RESULTS: There were 138 patients with no/minimal TPD, 64 patients with small TPD, 35 patients with middle TPD, and 21 patients with large TPD. There were good correlations and agreements in EDV (r=0.87, 0.90, 0.71, and 0.94, respectively), ESV (r=0.92, 0.94, 0.79, and 0.94, respectively), and EF (r=0.61, 0.79, 0.61, and 0.83, respectively) between QGS and echocardiography in patients with any TPD. QGS significantly underestimated EDV and ESV in patients with no/minimal or small TPD, and significantly overestimated ESV in patients with large TPD. QGS significantly underestimated EF in patients with middle or large TPD. CONCLUSION: Our results suggest that QGS is a useful tool for assessing the left ventricular volume and function in patients with any TPD, but myocardial perfusion abnormalities should be taken into consideration when interpreting QRS measurements.

Validation of automated quantification of myocardial perfusion single-photon emission computed tomography using Heart Score View in patients with known or suspected coronary artery disease.

Heart Score View (HSV) is a free software package for automated quantification of myocardial single photon emission computed tomography (SPECT) imaging using a standard Windows computer. We compared scoring results of myocardial perfusion among visual analysis, Quantitative Perfusion SPECT (QPS), and HSV in patients with known or suspected coronary artery disease.This study included 75 consecutive patients with known or suspected coronary artery disease who underwent adenosive stress-rest Tl-201 SPECT. Analysis of myocardial perfusion SPECT was performed on a standard 17-segment model visually and using QPS and HSV.There were 54 male and 21 female patients with a mean age of 70.5 ± 10.7 years. Thirteen patients (17%) had prior myocardial infarction. Summed stress score (SSS) and summed rest score (SRS) in the mid and basal areas were significantly higher on HSV than visual analysis or QPS. There was no significant difference in SDS in the whole area among the 3 methods. Similar results were found even in patients without prior myocardial infarction. Manual setting of the left ventricular cavity improved the correlations of SSS, SRS and SDS between HSV and the other methods.Our data suggested that HSV was comparable with visual analysis or QPS in scoring myocardial perfusion when manual setting of the left ventricular cavity is applied.

[Experience of using a filmless system in dental practice at Hiroshima University Hospital, a former university dental hospital].

Our university hospital has had a policy of electronic patient recordkeeping, replacing paper-based recordkeeping, since September 1, 2008. Because the Department of Oral and Maxillofacial Radiology had already been using computed radiography for X-ray systems except for intraoral radiography and storing data in Digital Imaging and Communications in Medicine (DICOM) format, the following three conditions form the basis of the changes we made in relation to the introduction of this policy. We started 1. using imaging plates for intraoral radiography as well and storing the data in DICOM format; 2. diagnosed without the need for film; and 3. referred to past images displayed on the screen of our Radiology Information System (RIS). The introduction of digital intraoral radiography has many advantages: not only does it not require film and can all past images be referred to on the screen of the RIS, but radiation exposure times are also shorter, images can be saved electronically, and thus, film processing is redundant. The system improves efficiency and is also advantageous to patients and staff in other departments.

Relationship between vision-related quality of life in Japanese patients and methods for evaluating visual field.

PURPOSE: To investigate the relationship between methods used to evaluate the visual field (VF) and vision-related quality of life (VRQOL) in Japanese patients. METHODS: We evaluated the VRQOL of 50 patients using the National Eye Institute Visual Function Questionnaire 25 (VFQ-25). Patients meeting the following criteria were assessed: (1) a Goldmann perimetry (GP) test conducted within 3 months of the initial visit; (2) best-corrected decimal visual acuity (VA) of the better eye when VRQOL was measured was less than 0.3 but more than 0.05. The VF was estimated based on a composite measure of the V-4e isopters of both eyes, as measured by GP. We calculated the VF using the American Medical Association (AMA) score, the Esterman disability score (EDS), the functional field score (FFS), the composite VF area calculated with area measurement software, and SR, an evaluation method based on solid angles. We then studied the relationships between the VFQ-25 score and the VF scores. RESULTS: Only EDS correlated significantly with the VFQ-25 score (r = 0.34, P = 0.02); AMA scoring did not correlate with the VFQ-25 score. CONCLUSION: It is necessary to reexamine standard VF evaluation methods.

[Evaluation of quality of life characteristics and grade of legal visual impairment].

PURPOSE: To evaluate the possible correlation between quality of life (QOL) characteristics and grades of legal visual impairment. MATERIALS AND METHODS: Quality of life characteristics associated with various causes of visual loss were investigated in 237 Japanese patients in the low-vision care clinic at Tokyo University Hospital, who had been issued the official ID and handbook for the physically handicapped. The main causes of vision loss were glaucoma (87 patients), macular degeneration (35) and diabetic retinopathy (34). Using a previously developed questionnaire, we assessed the correlation between the disability index (DI) as a quality of life characteristic, and the grade of legal visual impairment. RESULTS: Total DI was 1.24 +/- 0.43, showing a very significant correlation with Handicapped Handbook grades (r = -0.44, p < .0001). The correlation coefficients were -0.63 (p < 0.0001) for diabetic retinopathy, -0.50 (p = 0.002) for macular degeneration, and -0.16 (p = 0.14) for glaucoma patients. CONCLUSION: The needs of low-vision patients correlate with the grade of legal visual impairment and it is important to understand that the needs of low vision patients differ for each disease.

Clinical study on the metastasis to the eyes from breast cancer.

In our hospital, 24 patients who underwent surgery for breast cancer during 1980 to 2001 were diagnosed with metastasis to the eye. Metastasis to the choroid was found most frequently, making the choroid the most common site of metastasis. A few patients had metastasis to the orbit. Decreased visual acuity and tunnel vision were frequently found in patients who had metastasis to the choroid, and ocular floaters and blurred vision were also found in a few patients. Patients with metastasis to the orbit showed diplopia caused by ocular dyskinesia and eyelid swelling. The mean postoperative period until the diagnosis with metastasis to the eye was 3 years and 2 months, with most cases diagnosed between 20 and 40 months postoperatively, a relatively long period. We performed radiotherapy in 21 of the 24 patients, and more than half of the patients showed improvement. The mean survival period after diagnosis with metastasis to the eye was 10 months, and some of them already had recurrence to other organs such as the bones or lungs. Examination with consideration of metastasis to the eyes is required to improve the quality of life of cancer patients,.

[Usefulness of simulation with multi-slice CT for laparoscopic nephrectomy].

In recent years, laparoscopic surgery has attracted attention as a minimally invasive type of surgery because of the small surgical wounds and early recovery it provides. We carry out this technique on the basis of volume data that we make use of in multi-slice CT imaging technology in laparoscopic nephrectomy by the retroperitoneal approach, and we have created CT virtual laparoscopy by virtual endoscopic display as an intra-operative navigatior with an image analysis system. We provide information on detailed vascular anatomy to form intra-operative images that act as similar support images. With the provision of this volume data, we consider virtual endoscopic display the most suitable method for surgery. When we perform virtual laparoscopy, we simulate the insertion point and angle, the order of vascular structures and their locations, the number of arteries and veins, and their bifurcation points and ligation points in conjunction with the surgeon prior to operation. As the branch patterns of the renal artery are varied, perioperative confusion and surgical mishaps can be avoided through the information that is provided beforehand. Thus surgery is more accurate and proceeds more smoothly, because the surgeon has accurate anatomical information. In addition, the time required for surgery is decreased, reducing risk and the possibility of complications.