Resting-state functional magnetic resonance imaging indices are related to electrophysiological dysfunction in degenerative cervical myelopathy.

The age-related degenerative pathologies of the cervical spinal column that comprise degenerative cervical myelopathy (DCM) cause myelopathy due spinal cord compression. Functional neurological assessment of DCM can potentially reveal the severity and pathological mechanism of DCM. However, functional assessment by conventional MRI remains difficult. This study used resting-state functional MRI (rs-fMRI) to investigate the relationship between functional connectivity (FC) strength and neurophysiological indices and examined the feasibility of functional assessment by FC for DCM. Preoperatively, 34 patients with DCM underwent rs-fMRI scans. Preoperative central motor conduction time (CMCT) reflecting motor functional disability and intraoperative somatosensory evoked potentials (SEP) reflecting sensory functional disability were recorded as electrophysiological indices of severity of the cervical spinal cord impairment. We performed seed-to-voxel FC analysis and correlation analyses between FC strength and the two electrophysiological indices. We found that FC strength between the primary motor cortex and the precuneus correlated significantly positively with CMCT, and that between the lateral part of the sensorimotor cortex and the lateral occipital cortex also showed a significantly positive correlation with SEP amplitudes. These results suggest that we can evaluate neurological and electrophysiological severity in patients with DCM by analyzing FC strengths between certain brain regions.

Clinical application of biological fingerprints extracted from averaged chest radiographs and template-matching technique for preventing left-right flipping mistakes in chest radiography.

We aimed to evaluate the identification performance achieved using biological fingerprints extracted from averaged chest radiographs and template-matching techniques for the prevention of left-right flipping mistakes. We produced averaged chest radiographs for each sex by averaging 100 posteroanterior chest radiographs. Further, 400 and 566 chest radiographs were used in consistency and validation tests, respectively, and they were flipped horizontally to produce flipped chest radiographs under the assumption that the left-right flipping mistake occurred. The correlation values obtained with chest radiographs and those obtained with flipped chest radiographs were calculated. When we used correlation indices calculated from the correlation values from four biological fingerprints except for the lung apex, 96.5% (386/400) and 95.8% (542/566) of the left or right sides were identified correctly in the consistency and validation tests, respectively. This result indicates that our proposed method would be promising for the prevention of left-right flipping mistakes.

Evaluation of the depiction ability of similar subtraction images using digital chest radiographs of different patients.

The temporal subtraction (TS) technique requires the same patient's chest radiographs (CXRs) acquired on different dates, whereas the similar subtraction (SS) technique can be used in patients who have no previous CXR, using similar CXRs from different patients. This study aimed to examine the depiction ability of SS images with simulated nodules in comparison with that of TS images with 2- and 7-year acquisition intervals. One hundred patients were randomly selected from our image database. The most recently acquired images of the patients were used as target images for subtraction. The simulated nodule was superimposed on each target image to examine the usefulness of the SS technique. The most (Top 1) and ten most (Top 10) similar images for each target image were identified in the 24,254-image database using a template-matching technique, and used for the SS technique. SS and TS images were obtained using a previously developed nonlinear image-warping technique. The depiction ability of SS and TS images was evaluated using the contrast-to-noise ratio (CNR). The proportion of Top 1 SS images showing higher CNR than that of the TS images with 2- and 7-year acquisition intervals was 28% (28/100) and 33% (33/100), respectively. Moreover, the proportion of cases that had any of the Top 10 SS images with higher CNRs than those of TS images with 2- and 7-year acquisition intervals was 56% (56/100) and 72% (72/100), respectively. Our study indicates that the SS technique can potentially be used to detect lung nodules on CXRs.

Crystal structure analysis and enzymatic characterization of γ-glutamyltranspeptidase from Pseudomonas nitroreducens.

Theanine (γ-glutamylethylamide) is an amino acid analog that reduces blood pressure and improves immune responses. The ϒ-glutamyltranspeptidase (GGT) from Pseudomonas nitroreducens IFO12694 (PnGGT) has a unique preference for primary amines as ϒ-glutamyl acceptors over standard L-amino acids and peptides. This characteristic is useful for the synthesis of theanine. We used X-ray crystallographic analysis to understand the structural basis of PnGGT's hydrolysis and transpeptidation reactions and to characterize its previously unidentified acceptor site. Structural studies of PnGGT have shown that key interactions between three residues (Trp385, Phe417, and Trp525) distinguish PnGGT from other GGTs. We studied the roles of these residues in the distinct biochemical properties of PnGGT using site-directed mutagenesis. All mutants showed a significant decrease in hydrolysis activity and an increase in transpeptidase activity, suggesting that the aromatic side chains of Trp385, Phe417, and Trp525 were involved in the recognition of acceptor substrates. Abbreviations: ϒ-glutamyl peptide, theanine, X-ray crystallography.

[Usefulness of Biological Fingerprints and Template Matching Techniques in Bedside Chest Radiography for Patient Identification and Preventing Filing Mistakes].

The purpose of this study was to investigate whether patients can be identified by using biological fingerprints extracted from bedside chest radiographs and template matching techniques for preventing filing mistakes in a picture archiving and communication system (PACS) server. A total of 400 bedside chest radiographs from 100 male and 100 female patients with current and previous images were used for evaluating patient identification performance. Five biological fingerprints were extracted from 200 previous images using the averaged bedside chest radiographs, produced for each sex and detector size. The correlation values of 200 same patients and 39,800 different patients were calculated as a similarity index, and used for the receiver operating characteristic (ROC) analysis. The patient identification performance was examined by using the correlation index calculated by the summation of correlation values obtained from five biological fingerprints. The sensitivity at 90.0% specificity was calculated using the correlation index. The correlation index for same patients was higher than that for different patients. The area under the ROC curve was 0.974. The patient identification performance was 76.0% (152/200), and the sensitivity at 90.0% specificity was 93.4% (37168/39800). Our results suggest that the proposed method may potentially be useful for preventing filing mistakes in bedside chest radiographs on a PACS server.

Improving image quality around subtle lung nodules by reducing artifacts in similar subtraction imaging.

Similar subtraction imaging is useful for the detection of lung nodules; however, some artifacts on similar subtraction images reduce their utility. The authors attempted to improve the image quality of similar subtraction images by reducing artifacts caused by differences in image contrast and sharpness between two images used for similar subtraction imaging. Image contrast was adjusted using the histogram specification technique. The differences in image sharpness were compensated for using a pixel matching technique. The improvement in image quality was evaluated objectively based on the degree of artifacts and the contrast-to-noise ratio (CNR) of the lung nodules. The artifacts in similar subtraction images were reduced in 94% (17/18) of cases, and CNR was improved in 83% (15/18) of cases. The results indicate that the combination of histogram specification and pixel matching techniques is potentially useful in improving image quality in similar subtraction imaging.

Development of a method of automated extraction of biological fingerprints from chest radiographs as preprocessing of patient recognition and identification.

This paper describes the development of an automated method of extraction of biological fingerprints (BFs), including detection of image orientation in chest radiographs. The image orientation of a target image was recognized and modified by examination of normalized cross-correlation values between a target image and averaged male and female images with correct image orientation. Templates of BFs were extracted from averaged images. Then, each BF in the target image was extracted from locations that showed the highest cross-correlation value between the template of BF in the averaged image and the corresponding BF in the target image. With our method, 100% (200/200) of image orientations were recognized correctly. If the orientation was recognized as inappropriate, our algorithm modified it into the appropriate chest image orientation. In addition, the BFs automatically extracted from target images were improved. This method would be useful in a preprocessing system for patient recognition and identification.

Evaluation of the usefulness of modified biological fingerprints in chest radiographs for patient recognition and identification.

We have been developing an image-searching method to identify misfiled images in a PACS server. Developing new biological fingerprints (BFs) that would reduce the influence of differences in positioning and breathing phases to improve the performance of recognition is desirable. In our previous studies, the whole lung field (WLF) that included the shadows of the body and lungs was affected by differences in positioning and/or breathing phases. In this study, we showed the usefulness of a circumscribed lung with a rectangular region of interest and the upper half of a chest radiograph as modified BFs. We used 200 images as hypothetically misfiled images. The cross-correlation identifies the resemblance between the BFs in the misfiled images and the corresponding BFs in the database images. The modified BFs indicated better results than did WLF in a receiver operating characteristic analysis; therefore, they could be used as identifiers for patient recognition and identification.

Effect of X-ray beam quality on determination of exposure index.

We investigated the effect of X-ray beam qualities RQA3, 5, 7, and 9 on the exposure index (EI) as defined by International Electrotechnical Commission guideline 62494-1. Half-value layers (HVLs) of RQA5 X-rays passing through anti-scatter grids (grid ratios 6:1, 8:1, 10:1, and 12:1) were also evaluated because grids are frequently used in clinical situations. The maximum percent differences in the EIs for RQA3, 7, and 9 with respect to RQA5 were 35.0, 11.6, and 38.7 %, respectively. The range of HVLs for RQA5-7 beams was 7.10-9.10 mm of aluminum (mm Al). This was wider than the range of HVLs when grids were used (6.94-7.29 mm Al). The effect of variations in X-ray beam qualities in the RQA series on the EI was significantly greater than the effect of grids. This study indicated that, in clinical settings, the EI should be used carefully in X-ray examinations with different X-ray beam qualities.