Medicine Format Research Articles

A Subadult Specimen of Rubeosaurus ovatus (Dinosauria: Ceratopsidae), with Observations on Other Ceratopsids from the Two Medicine Formation

BackgroundCentrosaurine ceratopsids are well known from the middle Campanian Upper Two Medicine Formation of Montana. Four taxa have been named: Brachyceratops montanensis, Rubeosaurus ovatus, Einiosaurus procurvicornis, and Achelousaurus horneri. Rubeosaurus has been historically the most enigmatic of these taxa; only two specimens, the holotype caudal parietal bar and a referred incomplete skull, have been assigned to Rubeosaurus.Methodology/Principal FindingsA revised interpretation of the parietal processes of USNM 14765, the partial skeleton of a subadult centrosaurine formerly referred to Brachyceratops, indicates that it shares a P5 spike with the holotype of Rubeosaurus ovatus and should therefore be referred to that taxon. Brachyceratops is considered a nomen dubium.Conclusions/SignificanceUSNM 14765 provides additional anatomical information for Rubeosaurus ovatus. These new data are incorporated into a recent phylogenetic analysis of centrosaurine relationships; Rubeosaurus appears as the sister taxon of a clade composed of Einiosaurus, Achelousaurus, and Pachyrhinosaurus.

New unadorned hadrosaurine hadrosaurid (Dinosauria, Ornithopoda) from the Campanian of North America

ABSTRACT A new hadrosaurid dinosaur, Acristavus gagslarsoni, is here named on the basis of several autapomorphic characteristics of the frontal, postorbital, and dentary. Acristavus is a member of the newly erected clade Brachylophosaurini, which along with its other members, Brachylophosaurus and Maiasaura, constitutes the earliest hadrosaurine hadrosaurid clade. The new taxon occurred approximately 79 million years ago and has been recovered from the Two Medicine Formation of western Montana and nearly simultaneously in the Wahweap Formation of southern Utah. Corresponding with its age and relationship to the other members of the Brachylophosaurini, it is not surprising that Acristavus possesses traits seen in both Brachylophosaurus and Maiasaura, but not necessarily shared between them. One of the most interesting morphological features of Acristavus is the lack of cranial osteological ornamentation, which is in stark contrast to every other hadrosaurid dinosaur except Edmontosaurus. Combining stratigraphic and phylogenetic data from Acristavus yields support for the hypothesis that the hadrosaurid ancestor did not possess cranial ornamentation, and that the subfamilies Hadrosaurinae and Lambeosaurinae each independently developed display structures.

Quantitative analysis of elastography images in the detection of breast cancer

The aim of this study was to develop a quantitative method for breast cancer diagnosis based on elastosonography images in order to reduce whenever possible unnecessary biopsies. The proposed method was validated by correlating the results of quantitative analysis with the diagnosis assessed by histopathologic exam. 109 images of breast lesions (50 benign and 59 malignant) were acquired with the traditional B-mode technique and with elastographic modality. Images in Digital Imaging and COmmunications in Medicine format (DICOM) were exported into a software, written in Visual Basic, especially developed to perform this study. The lesion was contoured and the mean grey value and softness inside the region of interest (ROI) were calculated. The correlations between variables were investigated and receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of the proposed method. Pathologic results were used as standard reference. Both the mean grey value and the softness inside the ROI resulted statistically different at the t test for the two populations of lesions (i.e., benign versus malignant): p<0.0001. The area under the curve (AUC) was 0.924 (0.834-0.973) and 0.917 (0.826-0.970) for the mean grey value and for the softness respectively. Quantitative elastosonography is a promising ultrasound technique in the detection of breast cancer but large prospective trials are necessary to determine whether quantitative analysis of images can help to overcome some pitfalls of the methodic.

A remote desktop-based telemedicine system

We describe the construction of an almost cost-free telemedicine system using a remote desktop and the public internet system. Using this system, real-time images in Digital Imaging and Communication in Medicine (DICOM) format were observed with their original spatial resolution without any delay. The system is secure for the protection of personal information. There is no risk of viral infection to either the host or the viewer’s computer. No specific license, contract or initial investment is necessary. This system may partially alleviate the present shortage of specialists.

Paleoecological utility of insect trace fossils in dinosaur nesting sites of the Two Medicine Formation (Campanian), Choteau, Montana

Insect trace fossils, such as burrows, pupation chambers and nests, can provide broad paleoecological insights by helping to define paleohydrology, effects of seasonality or conditions of associated paleosols. Insect traces adjacent to nesting sites of the dinosaur Troodon formosus in the Cretaceous (Campanian) Two Medicine Formation near Choteau, Montana, demonstrate such paleoecological utility. One outcrop in particular contains an abundance of insect burrows and pupation chambers in a calcareous paleosol. Most trace fossils are interpreted as apocritan (wasps and bees) burrows, brooding chambers and cocoons. Apocritans prefer to construct burrows and brooding chambers in well-drained soils during relatively dry conditions (avoiding wet seasons). Their trace fossils are consistent with previous inferences of semi-arid conditions and seasonality for the Two Medicine Formation. Moreover, apocritan nesting is likely to have occurred in the same places and conditions as dinosaur nests: well above the local water table and during dry seasons. Such trace fossils hold the potential for more precise definitions of paleoecological factors in dinosaur nest sites. For example, within the Two Medicine Formation, the Celliforma ichnofacies is commonly associated with eggs of T. formosus and Continuoolithus, but not with those of Maiasaura peeblesorum, perhaps indicative of subtle nesting site preferences.

広島大学病院（旧歯学部附属病院）の歯科領域におけるフィルムレス化の経験

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.

TAPHONOMY OF A JUVENILE LAMBEOSAURINE BONEBED FROM THE TWO MEDICINE FORMATION (CAMPANIAN) OF MONTANA, UNITED STATES

The Sun River Bonebed is a monodominant assemblage of late juvenile lambeosaurine elements from the Upper Cretaceous Two Medicine Formation of north-central Montana, United States. Detailed excavation revealed an unusual paleobiologic and depositional signature. Although the bonebed occurs in a succession of beds representing anastomosing stream deposits in a seasonal paleoenvironment, the assemblage consists of a conglomerate of bone and calcareous clasts in a matrix of silty mud and free-floating sand grains. Internally, the bed exhibits normal grading of bone and calcareous clasts, poor sediment sorting, and preferred orientation of elongate elements, all characteristics common to debris flow deposits. The mud-rich matrix, poor sorting, and graded clasts of the bonebed suggest the assemblage was entrained and deposited by a cohesive debris flow, perhaps initiated through entrainment of fine overbank sediment by a seasonal flood. Nearly complete skeletal disarticulation and weathering of some bones indicate a brief period of postmortem exposure prior to debris flow entrainment. Fracture styles suggesting fresh breaks and frequent abrasion may reflect pre-flow trampling or chaotic flow transport. A significant number of elements also exhibit wet rot. The uniformity in taphonomic effects among elements suggests a mass mortality event, a rarity for debris-flow-hosted bonebeds, though the specific cause of death is uncertain. The age class dominance is interpreted to reflect original paleobiology, rather than abiotic postmortem selection, and establishes the Sun River Bonebed as the first bonebed of predominantly late juvenile material, with no adult material, in the Two Medicine Formation.

Assessment of Myocardial Deformation in Children Using Digital Imaging and Communications in Medicine (DICOM) Data and Vendor Independent Speckle Tracking Software

Analysis of myocardial deformation from data stored in Digital Imaging and Communications in Medicine format using vendor-independent software may be useful for clinical and research purposes but has not been evaluated in children. Grayscale images were prospectively acquired on Vivid 7 (GE Healthcare) and iE33 (Philips Medical Systems) ultrasound systems in 49 children. Digital Imaging and Communications in Medicine and raw data were analyzed using vendor-independent software (Cardiac Performance Analysis, Tomtec Imaging Systems) and vendor-specific software (EchoPAC and QLAB) and results compared. In addition, vendor-independent software using images at 30 frames/sec were compared with images at the higher acquisition frame rate. Measurement of short-axis radial and circumferential strain (ε) and apical four-chamber longitudinal εby vendor-independent software was possible in >92% of the children. Intraobserver and interobserver coefficients of variation for global circumferential and longitudinal ε ranged from 7.1% to 15.3% and for radial ε from 23.9% to 30.2%. Strain values were somewhat higher when using GE images at acquisition frame rates compared with ε values using GE images stored at 30 frames/sec. Strain values obtained by vendor-independent software were comparable with those obtained by vendor-specific software for longitudinal εand higher for circumferential ε. Radial ε values obtained by vendor-independent software were lower than ε values by EchoPAC and higher than ε values by QLAB. Vendor-independent software-derived ε is feasible and potentially valuable for measuring myocardial deformation in research and in multicenter studies using images from different ultrasound systems, especially for longitudinal deformation. However, a systematic bias for circumferential ε and a high variability in radial ε measurements remain concerns.

Overall anatomical features and clinical value of the sacral nerve in high resolution computed tomography reconstruction

Sacral nerve injury is a common complication of pelvic or sacral fractures. As the sacral nerve courser within the sacrum and has a complex relationship with the surrounding tissues, different parts of the sacral plexus injury have similar clinical symptoms and signs. Since lack of specific imaging technique in the diagnosis of sacral nerve injury, especially on multi-segment, multi-site, how to determine the preoperative location and extent of the sacral nerve injury accurately becomes a concern of the general orthopaedic and images practitioners. This study was conducted to gain an insight into the overall anatomical features of the sacral nerve (SN) on the same slice in high resolution computed tomography (HRCT) reconstruction and to determine the value of this information for the clinical diagnosis of related diseases. Fifty healthy volunteers and 30 patients (40 sides) with SN lesions confirmed by surgery were scanned using a 16-slice helical CT scanner (Light Speed, GE, USA). Among the patients, 6 with intervertebral disk hernia (6 sides), 8 with spinal stenosis (12 sides), 11 with pelvic trauma (14 sides), 4 with pelvic malignancies (6 sides), and 1 with sacral vertebral tuberculosis (2 sides). The SN multiplanar reconstruction was performed using a UNIX-based SCD4.1 workstation where the image was set on the same slice. All images were stored in the Digital Imaging and Communications in Medicine format. The display of nerves in different sections was analyzed using a five-graded scale with coordinate curves of each individual score. The overall anatomic features visible on the slice were analyzed and the abnormalities of the lesions were studied. The image of the same slice clearly revealed the shape, running direction, thickness, tension and adjacent anatomy of the S1-S4 nerves. The rank of display rates in different sections was: outward-rotated oblique sagittal > outward-rotated oblique coronal > oblique coronal plane > coronal > sagittal > transverse section. The S5 nerve was partially displayed from the starting point to the segment around the posterior sacral foramen. The overall anatomy of the triangular sacral plexus was only revealed in the oblique outward-rotated sagittal section, while 100% of its individual rami, as well as two or three of the adjacent rami, were displayed from their starting points to the anterior border of the piriformis. The abnormalities included 39 sides of morphological change (97.5%), 38 sides of compression (95.0%), 35 sides of adhesion (87.5%), 32 sides of displacement (80.0%), 34 sides of shrinkage (85.0%), 6 sides of thickening (15.0%), and 2 sides of abruption (5.0%). The 16-slice CT multiplanar reconstruction was able to reveal the overall anatomic features of the SN on the same slice. The section of reconstruction was a crucial factor in determining the display capability of various sacral nerves. This technology was valuable in the diagnosis and management of related diseases.

Creation and Storage of Standards-based Pre-scanning Patient Questionnaires in PACS as DICOM Objects

Radiology departments around the country have completed the first evolution to digital imaging by becoming filmless. The next step in this evolution is to become truly paperless. Both patient and non-patient paperwork has to be eliminated in order for this transition to occur. A paper-based set of patient pre-scanning questionnaires were replaced with web-based forms for use in an outpatient imaging center. We discuss this process by which questionnaire elements are converted into SNOMED-CT terminology concepts, stored for future use, and sent to PACS in Digital Imaging and Communications in Medicine (DICOM) format to be permanently stored with the relevant study in the DICOM image database.

View of heaven in Neijing and health cultivation of chronic liver diseases

Neijing was a early medical classic existing in China and had a deep influence on the formation of traditional Chinese medicine. Besides, Neijing was also an ancient philosophic works, in which the severe view of heaven was recorded, laying a sound basis for the development of TCM. It would have great significance for health cultivation of patients with chronic liver diseases to analyze the theory on relation between human and nature recorded in Neijing and to absorb its rational contents. Key words: Neijing; View of heaven; Relation between human and nature; Chronic liver diseases; Health cultivation

Expediency and coincidence in re-engineering a health system: an interpretive approach to formation of family medicine in Iran

Analysing the evidence generated over decades, the World Health Report 2008 recommended the expansion of primary health care (PHC) to achieve better population health, higher equity and lower costs. Over the last two decades, the Iranian model of PHC has resulted in population health indices that match the best in the region. Despite the extensive PHC networks in rural areas, there was an expansion of private outpatient care and hospital-based services. This model has been inadequate to meet the evolving health needs of the population and increasingly difficult to afford. In response, a family medicine (FM) programme has been implemented since August 2005, funded through Behbar, a model of social insurance. In this paper, we aim to identify facilitators of and barriers to implementation of FM in Iran. Data were collected between November 2006 and May 2007 through semi-structured interviews at national (19 interviews), provincial (9) and local (43) levels, and through a purposive document analysis. The framework approach was used for analysing interviews. Document analysis followed a narrative contextual framework. We interpreted data using an interpretive framework consisting of multiple streams and network theories. The introduction of Behbar provided FM advocates with the opportunity to place FM on the policy agenda. They skillfully coupled the two policies and defined FM as the only solution to fulfill Behbar. However, the manner in which policy was formed was the main obstacle to desired FM implementation. The interpretive framework links the concept of outreach to the poor and enhancing equity to rationing health services at a particularly opportune moment in Iran. However, using windows of opportunity to implement a major policy change, if it results in sacrifices in planning and preparedness, may harm the policy and the future success in achieving its objectives.

Magnetic Resonance Imaging Research in Sub-Saharan Africa: Challenges and Satellite-Based Networking Implementation

As part of an NIH-funded study of malaria pathogenesis, a magnetic resonance (MR) imaging research facility was established in Blantyre, Malaŵi to enhance the clinical characterization of pediatric patients with cerebral malaria through application of neurological MR methods. The research program requires daily transmission of MR studies to Michigan State University (MSU) for clinical research interpretation and quantitative post-processing. An intercontinental satellite-based network was implemented for transmission of MR image data in Digital Imaging and Communications in Medicine (DICOM) format, research data collection, project communications, and remote systems administration. Satellite Internet service costs limited the bandwidth to symmetrical 384 kbit/s. DICOM routers deployed at both the Malaŵi MRI facility and MSU manage the end-to-end encrypted compressed data transmission. Network performance between DICOM routers was measured while transmitting both mixed clinical MR studies and synthetic studies. Effective network latency averaged 715 ms. Within a mix of clinical MR studies, the average transmission time for a 256 × 256 image was ~2.25 and ~6.25 s for a 512 × 512 image. Using synthetic studies of 1,000 duplicate images, the interquartile range for 256 × 256 images was [2.30, 2.36] s and [5.94, 6.05] s for 512 × 512 images. Transmission of clinical MRI studies between the DICOM routers averaged 9.35 images per minute, representing an effective channel utilization of ~137% of the 384-kbit/s satellite service as computed using uncompressed image file sizes (including the effects of image compression, protocol overhead, channel latency, etc.). Power unreliability was the primary cause of interrupted operations in the first year, including an outage exceeding 10 days.

Ultrasonic attenuation estimation of the pregnant cervix: a preliminary report

Estimates of ultrasonic attenuation (the loss of energy as an ultrasonic wave propagates through tissue) have been used to evaluate the structure and function of tissues in health and disease. The purpose of this research was to develop a method to estimate ultrasonic cervical attenuation during human pregnancy using a clinical ultrasound system. Forty women underwent a cervical scan once during pregnancy with the Zonare z.one clinical ultrasound system using a 4-9-MHz endovaginal transducer. This ultrasound system provides access to radiofrequency (RF) image data for processing and analysis. In addition, a scan of a tissue-mimicking phantom with a known attenuation coefficient was acquired and used as a reference. The same settings and transducer used in the clinical scan were used in the reference scan. Digital data of the beam-formed image were saved in Digital Imaging and Communications in Medicine (DICOM) format on a flash drive and converted to RF data on a personal computer using a Matlab program supplied by Zonare. Attenuation estimates were obtained using an algorithm that was independently validated using tissue-mimicking ultrasonic phantoms. RF data were acquired and analyzed to estimate attenuation of the human pregnant cervix. Regression analysis revealed that attenuation was: a predictor of the interval from ultrasound examination to delivery (beta = 0.43, P = 0.01); not a predictor of gestational age at time of examination (beta = - 0.23, P = 0.15); and not a predictor of cervical length (beta = 0.077, P = 0.65). Ultrasonic attenuation estimates have the potential to be an early and objective non-invasive method to detect interval between examination and delivery. We hypothesize that a larger sample size and a longitudinal study design will be needed to detect gestational age-associated changes in cervical attenuation.

Fossil eggs and eggshell from the lowermost Two Medicine Formation of western Montana, Sevenmile Hill locality

ABSTRACT In the last 30 years, the Two Medicine Formation of western Montana has provided a wealth of information about dinosaur reproductive biology. Here, we describe a fossil egg-bearing stratum that occurs approximately 105 m above the base of the formation. This site in the Sevenmile Hill outcrops south of Choteau, Montana, lies immediately above a volcanic tuff and bentonite, dated as 80.0 Ma. Spherulitic eggshells from a quarry at this locality are similar to Spheruprismatoolithus candensusBray, 1999, which were assigned to the oofamily Prismatoolithidae. However, we refer this eggshell to the Spheroolithidae Zhao, 1979, as Spheroolithus choteauensis, oosp. nov. The quarry also produced Triprismatoolithus stephensi, oogen. et oosp. nov. These symmetrical 30 mm × 75 mm prismatic eggs exhibit three structural layers of calcite and round tubercles on the shell surface. Four additional ootaxa occurred at the First Find Microsite (OTM 99-19): Prismatoolithus hirschi, oosp. nov.; Tubercuoolithus tetonensis, oogen. et oosp. nov.; Continuoolithus canadensisZelenitsky et al., 1996; and KrokolithesHirsch, 1985. Spheroolithus choteauensis, T. stephensi, P. hirschi, T. tetonensis, and Krokolithes are unique to the lowermost Two Medicine Formation, whereas C. canadensis may occur elsewhere in the middle and upper strata of the Two Medicine and Oldman formations of Montana and Alberta, respectively. Although poorly represented by dinosaur osteological remains, the lower Two Medicine Formation locality yields egg types that suggest a significant difference in faunal composition compared to the middle and upper portions of the formation.

Glishades ericksoni, a new hadrosauroid (Dinosauria: Ornithopoda) from the Late Cretaceous of North America

A new genus and species of hadrosauroid dinosaur, Glishades ericksoni, is described based on paired partial premaxillae collected from the Upper Cretaceous Two Medicine Formation of Montana, in the Western Interior of the United States of America. This taxon is diagnosed on the basis of a unique combination of characters: absence of everted oral margin, arcuate oral margin with wide and straight, obliquely oriented, and undeflected anterolateral corner, grooved transversal thickening on ventral surface of premaxilla posterior to denticulate oral margin, and foramina on anteromedial surface above oral edge and adjacent to proximal end of narial bar. Maximum parsimony analysis positioned G. ericksoni as a derived hadrosauroid. Exclusion of G. ericksoni from Hadrosauridae was unambiguously supported by the lack in AMNH 27414 of a dorsomedially reflected premaxillary oral margin. Furthermore, the maximum agreement subtree positioned G. ericksoni as the sister taxon to Bactrosaurus johnsoni. This position was unambiguously supported by posteroventral thickening on the ventral surface of the premaxilla (independently derived in saurolophid hadrosaurids and Ouranosaurus nigeriensis) and having foramina on each premaxilla on the anterior surface, adjacent to the parasagittal plane of the rostrum (reconstructed as independently derived in Brachylophosaurus canadensis, Maiasaura peeblesorum, and Edmontosaurus annectens).

A Comparison of Cone-Beam Computed Tomography and Direct Measurement in the Examination of the Mandibular Canal and Adjacent Structures

Introduction The purpose of this investigation was to assess the ability of cone-beam computed tomography (CBCT) scanning to measure distances from the apices of selected posterior teeth to the mandibular canal. Measurements were taken from the apices of all posterior teeth that were superior to the mandibular canal. Methods A pilot study was performed to determine the scanning parameters that produced the most diagnostic image and the best dissection technique. Twelve human hemimandibles with posterior teeth were scanned at .20 voxels on an I-CAT Classic CBCT device (Imaging Sciences International, Hatfield, PA), and the scans were exported in Digital Imaging and Communications in Medicine (DICOM) format. The scans were examined in InVivo Dental software (Anatomage, San Jose, CA), and measurements were taken from the apex of each root along its long axis to the upper portion of the mandibular canal. The specimens were dissected under a dental operating microscope, and analogous direct measurements were taken with a Boley gauge. All measurements were taken in triplicate at least 1 week apart by one individual (TSK). The results were averaged and the data separated into matching pairs for statistical analysis. Results There was no statistical difference (α = .05) between the methods of measurement according to the Wilcoxon matched pairs test (p = 0.676). For the anatomic measurements, the intra-rater correlation coefficient (ICC) was .980 and for the CBCT it was .949, indicating that both methods were highly reproducible. Both measurement methods were highly predictive of and highly correlated to each other according to regression and correlation analysis, respectively. Conclusions Based on the results of this study, the I-CAT Classic can be used to measure distances from the apices of the posterior teeth to the mandibular canal as accurately as direct anatomic dissection.

Formation and development of toxicity theoryof traditional Chinese medicine

The basic situation of formation and development of toxicity theory of traditional Chinese medicine in China was systematically summarized in this paper. A new "Network regulation theory" hypothesis about of toxicity of traditional Chinese medicine was firstly proposed and provided scientific bases for the clinic application of toxic traditional Chinese medicine.

Role of O.G. Gazenko in formation and advancement of space biology and medicine

Oleg G. Gazenko belongs to the noble cohort of pupils of well-known Russian physiologist L.A. Orbeli. He was one of the fathers of space biology and medicine, discipline in which he displayed his brilliant talents of experimenter and thinker. He was acknowledged for the investigations of spaceflight effects on living systems, the concept of medical operations system to support long-term piloted missions and implementation of biological researches that fostered the advance of space and gravitational biology. The analytical works of Oleg G. Gazenko are of imperishable significance for future researches to the benefit of space biomedicine.

平成２０年度 一般撮影領域のＤＩＣＯＭ画像における付帯情報および画像特性の現状調査班報告

平成２０年度 一般撮影領域のＤＩＣＯＭ画像における付帯情報および画像特性の現状調査班報告