[Research Study on the Effects of Disinfectants on Medical Images and Medical Equipment in Infection Control Measures].

In this study, we investigated the effects of various disinfectants used to prevent infectious diseases on medical images and medical equipment. First, we investigated the effect of residual disinfectant on medical images in CT, mammography (MMG), and general imaging systems. Acrylic discs with various disinfectants attached were photographed using each imaging device, and visual evaluation and changes in image signal values were evaluated. We also conducted a questionnaire survey of each manufacturer regarding cleaning methods for medical devices. With CT/MMG, residual disinfectant could be visually confirmed on the image. Although this could not be confirmed with the general imaging system, a significant difference was confirmed in the image signal values of the general imaging system through statistical analysis. This is thought to be largely due to the influence of nonlinearity in the short-time imaging range of general imaging equipment. In addition, from the responses to a questionnaire survey of each medical device manufacturer, we were able to understand detailed cleaning methods that are not covered in medical device instruction manuals.

Effect of Polyphenols in Sea Buckthorn Berry on Chemical Mediator Release from Mast Cells.

Sea buckthorn (Hippophae rhamnoides L.) is a deciduous shrub of the Elaeagnaceae family and is widely distributed in northern Eurasia. Sea buckthorn berry (SBB) has attracted attention for its use in many health foods, although its physiological function remains unknown. In this study, we investigated the inhibitory effect of SBB extract and its fractions on Type-I allergy using mast cell lines. Among these fractions, SBB fraction with the highest amount of antioxidant polyphenols significantly inhibited the release of chemical mediators such as histamine and leukotriene B4 (LTB4) from the stimulated mast cells. This fraction also inhibited the influx of calcium ions (Ca2+) and the phosphorylation of tyrosine residues in proteins, including spleen tyrosine kinase, which is associated with signal transduction during the release of chemical mediators. The active SBB fraction contained isorhamnetin as its major flavonol aglycon. Isorhamnetin inhibited histamine and LTB4 release from the stimulated cells and suppressed intracellular Ca2+ influx. These results indicate that isorhamnetin is the primary substance responsible for the antiallergic activity in SBB. In conclusion, SBB may alleviate Type-I allergy by inhibiting the release of chemical mediators from mast cells, and polyphenols may contribute to this effect.

Development of a new body weight estimation method using head CT scout images.

BACKGROUND: Imaging examinations are crucial for diagnosing acute ischemic stroke, and knowledge of a patient's body weight is necessary for safe examination. To perform examinations safely and rapidly, estimating body weight using head computed tomography (CT) scout images can be useful. OBJECTIVE: This study aims to develop a new method for estimating body weight using head CT scout images for contrast-enhanced CT examinations in patients with acute ischemic stroke. METHODS: This study investigates three weight estimation techniques. The first utilizes total pixel values from head CT scout images. The second one employs the Xception model, which was trained using 216 images with leave-one-out cross-validation. The third one is an average of the first two estimates. Our primary focus is the weight estimated from this third new method. RESULTS: The third new method, an average of the first two weight estimation methods, demonstrates moderate accuracy with a 95% confidence interval of ±14.7 kg. The first method, using only total pixel values, has a wider interval of ±20.6 kg, while the second method, a deep learning approach, results in a 95% interval of ±16.3 kg. CONCLUSIONS: The presented new method is a potentially valuable support tool for medical staff, such as doctors and nurses, in estimating weight during emergency examinations for patients with acute conditions such as stroke when obtaining accurate weight measurements is not easily feasible.

Verification of Qfix Encompass™ couch modeling using the Acuros XB algorithm and HypeArc™ using a high-spatial-resolution two-dimensional diode array.

We modeled the Qfix Encompass™ immobilization system and further verified the calculated dose distribution of the AcurosXB (AXB) dose calculation algorithm using SRS MapCHECKⓇ (SRSMC) in the HyperArc™ (HA) clinical plan. An Encompass system with a StereoPHAN™ QA phantom was scanned by SOMATOM go.Sim and imported to an Eclipse™ treatment planning system to create a treatment plan for Encompass modeling. The Encompass modeling was performed in the StereoPHAN with a pinpoint ion chamber for 6 MV and 6 MV flattening filter free (6 MV FFF), and 2 × 2 cm2, 4 × 4 cm2, and 6 × 6 cm2 irradiation field sizes. The dose calculation algorithm used was AXB ver. 15.5 with a 1.0 mm calculation grid size. The Hounsfield unit (HU) values of the Encompass modeling were set to 400, -100, -200, and -300 for Encompass, and -400, -600, -700, and -800 for the Encompass base. We evaluated the dose distribution after Encompass modeling by SRSMC using gamma analysis in 12 patients. We adopted HU values of -200 for Encompass, -800 for Encompass base for 6 MV, and -200 for Encompass and -700 for Encompass. Base for 6 MV FFF was adopted as the HU values for the Encompass modeling based on the measurement results. The proposed Encompass modeling resulted in a mean pass rate evaluation >98% for both 6 MV and 6 MV FFF when the 1%/1 mm criterion was used, demonstrating that the proposed HU value can be adopted to calculate more accurate dose distributions.

U-Net-based image segmentation of the whole heart and four chambers on pediatric X-ray computed tomography.

This study aimed to determine whether a U-Net-based segmentation method could be used to automatically extract regions of the whole heart and atrioventricular regions from pediatric cardiac computed tomography images with high accuracy. Pediatric cardiac contrast computed tomography images with no abnormalities (n = 20; patient age, 0-13 years; mean 5 years) were used for segmentation of the whole heart and each atrioventricular region using U-Net. Segmentation accuracy was evaluated using the Dice similarity coefficient. The mean Dice similarity coefficient for the whole-heart segmentation was high at 0.95. There were no significant differences between age categories. The median Dice similarity coefficients for segmentation of the atria and ventricles were good (> 0.86). There were significant differences between age categories at some sites. Differences in the Dice similarity coefficient may have occurred because the target diseases and examination procedures differed according to subject age. There was no clear tendency for similar values between subjects of school age, close to adulthood, and newborns; good agreement was obtained in all age categories. These results suggest that U-Net-based segmentation may be useful for automatic extraction of the whole heart and atrioventricular regions from pediatric computed tomography images.

[Evaluation of a Bone Coordinate System Constructed Using MR Image Composing].

PURPOSE: To evaluate the accuracy of a bone coordinate system constructed using MR image composing. METHOD: A femoral coordinate system constructed using image composing of MR images of a whole bovine femur was evaluated using CT images. The MR images were acquired by moving the table and were processed with 3D distortion correction and composing. To evaluate the reproducibility of the measurements, the same operator repeated the construction of the femoral coordinate system. In addition, distortions in the MR images were evaluated in comparison with those in the CT images. RESULT: The center position of the femoral coordinate system constructed using the MR image composing was 1.6±0.9 mm on the X-axis, 1.5±0.8 mm on the Y-axis, and 0.2±0.3 mm on the Z-axis, and the rotation of each axis was 1° or less. The distortion of the composed MR image was about 0.3%. CONCLUSION: The femoral coordinate system constructed using MR image composing had the same accuracy as a system constructed with CT images. The effect of MR image composing on the construction of the femoral coordinate system was small.

[A Method for Evaluating the T2∗-weighting Effect in MRI].

PURPOSE: To propose a method for evaluating the T2*-weighting effect in MRI. METHODS: Multiple solutions with different concentrations of a superparamagnetic iron oxide contrast agent were made and their signal intensities on T2*-weighted images were measured. The relationship between iron concentration and signal intensity was determined, and we simulated an iron concentration map representing a simplified model of a brain microbleed and converted the pixel values in the map to signal intensity based on the determined relationship, generating a simulated T2*-weighted image. An 'S-value' parameter was defined to evaluate the low-intensity regions in the simulated image. S-values were obtained using T2*-weighted sequences acquired with different echo time (TE) values on three MRI scanners (Philips 1.5 T, GE 3.0 T, and Siemens 3.0 T). Another parameter (A-value) defined by the American Society for Testing and Materials (ASTM-F2119) for assessing artifacts was applied to evaluate the weighting effect in the T2*-weighted image of a laboratory-made susceptibility-effect phantom. RESULTS: With all three scanners, the S-values increased as the TE increased, indicating enhancement of the T2*-weighting effect. For every TE, the S-values obtained for the Philips scanner were the largest, followed by those for the GE and Siemens scanners. The results of this comparative evaluation were similar to those obtained using A-values. CONCLUSION: Comparisons with the established A-value parameter showed our proposed method for the quantitative evaluation of the T2*-weighting effect using S-values to be valid. The proposed method has the advantage that the S-values do not depend on a specific susceptibility-effect phantom.

Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals.

BACKGROUND AND AIM: Considering the increasing prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH), the development of an effective screening and follow-up system that enables the recognition of etiological changes by primary physicians in clinics and specialists in hospitals is required. METHODS: Chronic hepatitis B (HBV) and C (HCV), NASH, and alcoholic steatohepatitis (ASH) patients who were assayed for Mac-2-binding protein glycosylation isomer (M2BPGi) (n = 272) and underwent magnetic resonance elastography (MRE) (n = 119) were enrolled. Patients who underwent MRE were also tested by ultrasound elastography (USE) (n = 80) and for M2BPGi (n = 97), autotaxin (ATX) (n = 62), and platelet count (n = 119), and their fibrosis-4 (FIB-4) index was calculated (n = 119). RESULTS: FIB-4 index >2, excluding HBV-infected patients, M2BPGi >0.5, ATX >0.5, and platelet count <20 × 104/µL were the benchmark indices, and we took into consideration other risk factors, such as diabetes mellitus and age, to recommend further examinations, such as USE, based on the local situation to avoid overlooking hepatocellular carcinoma (HCC) in the clinic. During specialty care in the hospital, MRE exhibited high diagnostic ability for fibrosis stages >F3 or F4; it could efficiently predict collateral circulation with high sensitivity, which can replace USE. We also identified etiological features and found that collateral circulation in NASH/ASH patients tended to exceed high-risk levels; moreover, these patients exhibited more variation in HCC-associated liver stiffness than the HBV and HCV patients. CONCLUSIONS: Using appropriate markers and tools, we can establish a stepwise, practical, noninvasive, and etiology-based screening and follow-up system in primary and specialty care.

Improved wedge method for the measurement of sub-millimeter slice thicknesses in magnetic resonance imaging.

The standard method for measuring the slice thickness of magnetic resonance images uses the inclined surface of a wedge (wedge method); it is sensitive to small increases in noise because of the differentiation of the edge response function (ERF) required. The purpose of this study was to improve the wedge method by fitting a curve to the ERF. The curve-fit function was obtained by convolving an ideal ERF (a ramp function) with a Gaussian function to represent ERF blurring. Measurements of 5- and 3-mm slice thicknesses were performed on a 3T scanner using the conventional wedge method, the improved wedge method, and another standard method using an inclined slab (slab method). Subsequently, 0.5- and 0.25-mm slice thicknesses from multiple slices acquired using a three-dimensional sequence were measured using the improved wedge method. When measuring 5-mm slices, the differences in measurements obtained using the improved wedge method and the conventional slab and wedge methods were very small: <0.6% of the 5-mm slice thickness. The difference was ≤1.7% for 3-mm slices. For 0.5- and 0.25-mm slices, the mean values obtained using the improved wedge method were 0.543 ± 0.007 mm and 0.247 ± 0.015 mm, with a 1.2 and 5.9% coefficient of variation across slices, respectively. The improved wedge method is valid and potentially applicable to the measurement of sub-millimeter slice thicknesses.

Flavonol glycosides in the petal of Rosa species as chemotaxonomic markers.

Thirteen flavonol glycosides were isolated from the petals of Rosa species belonging to the section Gallicanae, and their structures were identified from their spectroscopic data. These flavonol glycosides, along with two flavonol glycosides isolated from Rosa rugosa, in the petals of 31 Rosa species belonging to sections Gallicanae, Cinnamomeae, Caninae, and Synstylae were quantitatively analyzed by UPLC. The results indicated that the species belonging to these sections could be classified into four types (Type A, B, C and D) based on the pattern of flavonol glycoside contents, whereas the R. rugosa flavonol glycosides were detected only in section Cinnamomeae. A principal components analysis (PCA) calculated from the 15 flavonol glycosides contained in these samples supported the presence of four types. The distribution of the species in Type D (a group of Cinnamomeae) was shown to reflect close interrelationships, but species in Type B (one group of Gallicanae) could be subdivided into two groups, one of which contained species in section Synstylae. Moreover, the flavonol glycosides were grouped by sugar moieties: a disaccharide composed of two hexoses (S1), a hexose (S2), including a hexose with galloyl group, a pentose (S3), and a disaccharide composed of a hexose and a pentose (S4). The ratios of the amounts of S1-S4 to total flavonol glycoside content indicated that differences among the four sections were more distinctive than the amounts of the 15 flavonol glycosides. The 31 samples were divided into Type B, composed of one type of Gallicanae and Synstylae, Type A+C, composed of another type of Gallicanae and Caninae, and Type D, composed of Cinnamomeae. The R. rugosa flavonol glycosides were shown to be important chemotaxonomic markers for the classification of species in Cinnamomeae, and this method of using flavonol glycosides as chemotaxonomic markers could be useful for the identification of Rosa species belonging to sections Gallicanae, Cinnamomeae, Caninae, and Synstylae.

[Preparation of water in oil type cream with high content of water containing Kochia scoparia fruit and Cnidium monnieri fruit].

Kikisui is a herbal lotion containing Kochia scoparia Fruit and Cnidium monnieri Fruit that is clinically used as an antipruritic for itchy dry skin. However, this formulation is unsuitable for inducing a prolonged effect. Here, we attempted to change the formulation from a lotion to a cream. The cream we chose was a water-in-oil (W/O) type emulsion for enhancing skin compatibility. In addition, the high water content imparts a sensation of coolness. However, it is difficult to prepare a stable W/O type cream with high water content using a mechanical mixing method. Instead, we prepared the W/O type emulsion using liquid crystals. Water containing cocamidopropyl betaine was added to a dispersed phase comprising an oil phase of oleic acid and liquid paraffin that was constantly stirred. Addition of an aqueous solution containing Kochia scoparia Fruit and Cnidium monnieri Fruit decreased the stability of the cream. However, addition of glycerin as a humectant, and ethyl p-hydroxybenzoate/n-butyl p-hydroxybenzoate as preservatives enhanced the stability of the cream. The stability of the emulsion was correlated with the apparent viscosity of the cream. The final W/O type cream had a water content of 83% and was stable for more than 6 months at 4°C. Furthermore, ostol, which is one of the main biologically active herbal compounds, was also stable for more than 6 months.

Botanical origin of mei-gui hua (petal of a Rosa species).

Mei-gui hua has been used as a crude drug in traditional medicine and as herbal tea in China. The scientific name of Mei-gui is Rosa rugosa thunb. However, the morphological characteristics and botanical ecology of Mei-gui were different from those of R. rugosa. Since the botanical origins of Mei-gui cultivated in China have not yet been clarified, we compared Mei-gui and R. rugosa in terms of their morphological characteristics, phylogenetic analysis, and phytochemical studies. Our research suggested that Mei-gui cultivated around Tarim Basin in Xinjiang Province showed homology to Rosa gallica, while those cultivated in the northeastern parts of China are considered to be hybrids of R. rugosa.

Simultaneous determination of hydrolysable tannins in the petals of Rosa rugosa and allied plants.

The petals of Rosa rugosa and allied plants for medicinal use contain abundant hydrolysable tannins, and they show remarkable biological activities. The activities are dependent on the structures of the hydrolysable tannins, so their contents and compositions are essential for evaluation of medicinal potency. Therefore, we optimized the simultaneous quantitative determination of the hydrolysable tannins using ultra-performance liquid chromatography. A column of ethylene bridged hybrid (BEH) phenyl (C(6) alkyl phenyl group as solid-phase modification) was shown to be most effective for the separation of hydrolysable tannins isolated from R. rugosa and related compounds when the column temperature was kept under 25 degrees C. The efficacy of the BEH phenyl column might be due to the interaction between solid phase and phenolic ester groups of hydrolysable tannins such as galloyl, hexahydroxydiphenoyl and valoneoyl groups. The relation between the retention times on the BEH phenyl column and the column temperature was demonstrated to depend on the structural characteristics of hydrolysable tannins.

Inhibitory effects of Rosa gallica on the digestive enzymes.

The 50% aqueous ethanol extracts of petals of Rosa gallica collected in Xinjiang province, China, exhibited potent inhibitory effects against alpha-amylase and alpha-glucosidase. As the active principles, seven hydrolysable tannins were isolated from this species for the first time and elucidated by NMR and ESI-TOF-MS analysis. Quantitative analysis by ultra-performance liquid chromatography demonstrated that the contents of these hydrolysable tannins were 3-5% of the dry weight of the petals, and the hydrolysable tannins must be related to the medicinal utilization of this species.

Diffusion-perfusion mismatch in symptomatic vasospasm after subarachnoid hemorrhage.

Diffusion-weighted and perfusion-weighted magnetic resonance (MR) imaging were investigated as a method to detect diffusion-perfusion mismatch in the early stages of vasospasm in 17 patients with acute subarachnoid hemorrhage after aneurysm clipping. Single photon emission computed tomography (SPECT) with N-isopropyl-p-[(123)I]iodoamphetamine was also performed. Diffusion-perfusion mismatch was clearly identified in the 3 patients who manifested clinical deterioration. Perfusion-weighted imaging showed increased mean transit time, normal cerebral blood flow, and increased or normal cerebral blood volume. SPECT revealed no earlier signs of vasospasm. Diffusion-perfusion mismatch was clearly demonstrated in the early stages of vasospasm, so may be useful for early identification of ischemia in vasospasm and initiating appropriate treatment.

Effects of Rosa rugosa petals on intestinal bacteria.

The effects of pulverized petal of Rosa rugosa on the growth of 10 species of intestinal and pathogenic bacteria were investigated. Growth of bifidobacteria and lactobacilli was not affected by the addition of the petal in plate cultivation. However, the growth of Bacteroides vulgatus, Escherichia coli, Staphylococcus aureus, and Bacillus cereus was completely inhibited by the addition of 0.1, 0.5, 0.1, and 0.05% (w/v) of the petal respectively. In liquid cultivation, the addition of the petal (0.5%) stimulated the growth of Bifidobacterium breve and slightly inhibited the growth of Lactobacillus salivarius. But the growth of E. coli, S. aureus, B. cereus, and Salmonella sp. was inhibited by nearly 50%. Hydrolyzable tannins isolated from R. rugosa, rugosin D, and tellimagradin II showed antibacterial activities against E. coli, S. aureus, B. cereus, and Salmonella sp., but little or no effect against Bif. breve and L. salivarius. R. rugosa petal showed selective antibacterial activities against intestinal and pathogenic bacteria, and the selectivity resembled that of prebiotics such as oligosaccharides and dietary fiber. Hydrolyzable tannins in R. rugosa, such as rugosin D and tellimagradin II, must be active constituents.

[Detailed magnetic resonance imaging of abducens nerve by 3D-CISS].

Although abducens nerve palsy is a relatively common disease, the abducens nerve has been almost impossible to identify, because it is one of the finest cranial nerves and runs three-dimensionally in the prepontine cistern. Three-dimensional constructive interference in steady state (3D-CISS) is helpful in visualizing fine structural elements in the central nervous system because of its higher spatial resolution and fewer artifacts from cerebrospinal fluid. In this study, we successfully visualized the abducens nerve using 3D-CISS. The procedures were as follows: first, Dorello's canal and the ponto-medullary sulcus were identified as visible landmarks, and then the abducens nerve was followed to the root exit zone; second, the gray scale of the original image was inverted to clearly visualize the cisternal course of the nerve and the neighboring small vessels; and, finally, the entire cisternal course of the nerve was visualized in the same images in both oblique axial and oblique sagittal planes by a multi-planar reconstruction method. This reliable technique can be performed for the diagnosis of abducens nerve palsy.