Suboptimal patient positioning with panoramic and CBCT imaging: effects on dose.

Objective: This study examined the effects of changes in patient positioning on radiation exposure for panoramic and cone beam computed tomography (CBCT) radiographic examinations by measuring effective dose (E) and equivalent doses.

Study Design: Simulated radiographic examinations with optimal and suboptimal positioning-anterior shift by 1 centimeter (cm), posterior shift by 1 cm, chin lowered by 10 degrees (°), chin elevated by 10°, rotation by 10°, and lateral shift by 1 cm-were conducted using a tissue-equivalent phantom and optically-stimulated luminescent dosimeters. Exposures were made with the RAYSCAN Alpha Plus 160 X-ray unit using the following exposure parameters: panoramic, 80 kVp, 14 mA, and 13.

Analyses and Utilization of Selectively Tuned Human Adipose-Derived Stromal/Stem Cell Exosomes.

We have developed a hollow fiber bioreactor-based production system for manufacturing large quantities of extracellular vesicles (EVs) containing exosomes from adult human adipose-derived stromal/stem cells (ASCs). By manipulating the cellular bioreactor environment, we have found that we can alter ASC EV production, secretion, and surface protein composition. The aims of this chapter are to describe the methodology for culturing and tuning of adipose ASCs in a bioreactor, along with the collection and isolation of the EVs containing exosomes demonstrating increased HSP70 content.

A 78-Year-Old Woman with Sudden Onset of Left-Sided Hemiballismus.

BACKGROUND Hemiballismus is the most severe form of chorea and is a hyperkinetic disorder characterized by involuntary, high-amplitude movements of the ipsilateral arm and leg, due to lesions of the contralateral side of the central nervous system. Ischemic or hemorrhagic strokes and nonketotic hyperglycemia are predominant etiologies of hemiballismus. Case reports highlighting hemiballismus associated with temporal and parietal lobe infarcts have been published, although research of frontal lobe involvement is limited.

Radiation doses in extraoral bitewing radiography compared with intraoral bitewing and panoramic radiography.

Objectives: We compared the effective dose (E) and thyroid equivalent dose of 2 extraoral bitewing (EOBW) units and compared E with their respective panoramic (PAN) modes and with intraoral bitewing radiography (IOBW).

Study Design: Child and adult anthropomorphic phantoms with dosimeters were used to evaluate Orthophos SL, Rayscan α+, and 1 intraoral unit using rectangular and circular collimation. Extraoral bitewing thyroid equivalent dose was assessed without and with thyroid shielding.

Bitewing radiography dosimetry of the PORTRAY stationary-intraoral tomosynthesis imaging system.

Objective: This study measured effective (E) and equivalent doses from adult and child 3-dimensional (3D) and 2D posterior bitewing (PBW) examinations using the PORTRAY stationary-intraoral tomosynthesis radiography system.

Study Design: Adult and child phantoms and optically stimulated luminescent dosimeters were used to measure doses for adult-4 and child-2 projection PBW examinations acquired without (W/O) and with (W) a direct digital sensor in the beam path. Child doses without and with thyroid shielding were measured.

Renal Autologous Cell Therapy to Stabilize Function in Diabetes-Related Chronic Kidney Disease: Corroboration of Mechanistic Action With Cell Marker Analysis.

Introduction: Chronic kidney disease (CKD) is a worldwide disease without cure. Selected renal cells (SRCs) can augment kidney function in animal models. This study correlates the phenotypical characteristics of autologous homologous SRCs (formulated product called Renal Autologous Cell Therapy [REACT]) injected into patients' kidneys with advanced type 2 diabetes-related CKD (D-CKD) to clinical and laboratory findings.

Opioid-Free Discharge is Not Associated With Increased Unplanned Healthcare Encounters After Ureteroscopy: Results From a Statewide Quality Improvement Collaborative.

Objectives: To evaluate patient factors associated with post-ureteroscopy opioid prescriptions, provider-level variation in opioid prescribing, and the relationship between opioid-free discharges and ED visits.

Methods: This is a retrospective analysis of a prospective cohort study of adults age 18 years and older who underwent primary ureteroscopy for urinary stones from June 2016 to September 2019 within the Michigan Urological Surgery Improvement Collaborative (MUSIC) Reducing Operative Complications from Kidney Stones (ROCKS) quality improvement initiative. Postoperative opioid prescription trends and variation among practices and surgeons were examined.

Comparative dosimetry of radiography device, MSCT device and two CBCT devices in the elbow region.

The aim of the study was to estimate and to compare effective doses in the elbow region resulting from four different x-ray imaging modalities. Absorbed organ doses were measured using 11 metal oxide field effect transistor (MOSFET) dosimeters that were placed in a custom-made anthropomorphic elbow RANDO phantom. Examinations were performed using Shimadzu FH-21 HR radiography device, Siemens Sensation Open 24-slice MSCT-device, NewTom 5G CBCT device, and Planmed Verity CBCT device, and the effective doses were calculated according to ICRP 103 recommendations.

Ureteral Stent Placement following Ureteroscopy Increases Emergency Department Visits in a Statewide Surgical Collaborative.

Purpose: Ureteral stents are commonly placed after ureteroscopy. Although studies indicate that stents are associated with patient discomfort, their impact on downstream health services use is unclear. We examined patterns of stent utilization in Michigan and their association with unplanned health care encounters.

Intraoral radiographs: A comparison of dose and risk reduction with collimation and thyroid shielding.

Background: The National Commission on Radiation Protection and Measurements has reinforced its recommendation for the use of rectangular collimation for intraoral radiography in its Report No. 177 published in 2019. This study compared effective dose (E) using circular and rectangular collimator (RC) modalities.

Bitewing radiography dosimetry of a stationary intraoral tomosynthesis imaging system.

Objectives: This study assessed effective doses (E) from conventional and stationary intraoral tomosynthesis (s-IOT) radiography for posterior bitewing (PBW) examinations and evaluated the effect of sensor attenuation.

Study Design: An adult human tissue-equivalent phantom and optically stimulated luminescent dosimeters were used. Series of 4 PBW radiographs were acquired with circular and rectangular collimation.

Initial Assessment of Variability of Responses to Toxicants in Donor-Specific Endothelial Colony Forming Cells.

There is increased interest in using high throughput assays to characterize human population variability in response to toxicants and drugs. Utilizing primary human endothelial colony-forming cells (ECFCs) isolated from blood would be highly useful for this purpose because these cells are involved in neonatal and adult vasculogenesis. We characterized the cytotoxicity of four known toxic chemicals (NaAsO, CdCl, tributyltin [TBT], and menadione) and their four relatively nontoxic counterparts (NaHAsO, ZnCl, SnCl, and phytonadione, respectively) in eight ECFC clones representing four neonatal donors (2 male and 2 female donors, 2 clones per donor).

Estimation of effective doses from MDCT and CBCT imaging of extremities.

Little research has been published on the radiation burden of cone beam computed tomography (CBCT) in comparison with multi-row detector computed tomography (MDCT) for extremity imaging. This manuscript reports effective doses produced by standard and reduced dose imaging protocols for a 128-slice MDCT unit and a dedicated extremity imaging device using CBCT technology. Anthropomorphic phantoms with x-ray attenuation characteristics simulating adult hand-wrist, foot-ankle, and knee areas were modified to receive optically stimulated luminescent dosimeters (OSL).

Hand-wrist, knee, and foot-ankle dosimetry and image quality measurements of a novel extremity imaging unit providing CBCT and 2D imaging options.

Purpose: Radiation dose is a general concern in diagnostic imaging and a special concern for children who are at greater risk from radiation effects. This study evaluates effective doses (E) produced during 2D and volume imaging with a novel cone beam computed tomography (CBCT) based extremity imaging device. The device's compact size and protocol options offer image choices that enhance the potential for reduced dose and improved diagnostics when evaluating sports injuries.

Recognizing the Continuous Nature of Expression Heterogeneity and Clinical Outcomes in Clear Cell Renal Cell Carcinoma.

Clear cell renal cell carcinoma (ccRCC) has been previously classified into putative discrete prognostic subtypes by gene expression profiling. To investigate the robustness of these proposed subtype classifications, we evaluated 12 public datasets, together with a new dataset of 265 ccRCC gene expression profiles. Consensus clustering showed unstable subtype and principal component analysis (PCA) showed a continuous spectrum both within and between datasets.

Pediatric Phantom Dosimetry of Kodak 9000 Cone-beam Computed Tomography.

Purpose: The purpose of the study was to evaluate the radiation dose of the Kodak 9000 cone-beam computed tomography (CBCT) device for different anatomical areas using a pediatric phantom.

Methods: Absorbed doses resulting from maxillary and mandibular region three by five cm CBCT volumes of an anthropomorphic 10-year-old child phantom were acquired using optical stimulated dosimetry. Equivalent doses were calculated for radiosensitive tissues in the head and neck area, and effective dose for maxillary and mandibular examinations were calculated following the 2007 recommendations of the International Commission on Radiological Protection (ICRP).

Exosomes for repair, regeneration and rejuvenation.

Introduction: Application of regenerative medicine strategies for repair of organs/tissue impacted by chronic disease is an active subject for product development. Such methodologies emphasize the role of stem cells as the active biological ingredient. However, recent developments in elucidating mechanisms of action of these therapies have focused on the role of paracrine, 'action-at-a-distance' modus operandi in mediating the ability to catalyze regenerative outcomes without significant site-specific engraftment.

Characterization of a primary brown adipocyte culture system derived from human fetal interscapular fat.

Brown fat has gained widespread attention as a potential therapeutic target to treat obesity and associated metabolic disorders. Indeed, the anti-obesity potential of multiple targets to stimulate both brown adipocyte differentiation and recruitment have been verified in rodent models. However, their therapeutic potential in humans is unknown due to the lack of a human primary brown adipocyte cell culture system.

Technical Performance of Universal and Enhanced Intraoral Imaging Rectangular Collimators.

Purpose: The purpose of this study was to compare the number and type of technical errors between 2 rectangular collimators, time/motion effort and radiographer preference.

Methods: Subjects (n=17) were recruited to expose an 18 projection full mouth series (FMX) using Tru-Align™ (enhanced) and Rinn® (universal) collimator devices. Both FMXs were exposed using photostimulable phosphor (PSP) digital sensors on a DXTTR manikin with an intraoral x-ray unit.

Isolation, culturing, and characterization of cardiac muscle cells from nonhuman primate heart tissue.

Cardiac safety pharmacology requires in vitro testing of all drug candidates before clinical trials in order to ensure they are screened for cardiotoxic effects which may result in severe arrhythmias and, ultimately, cardiomyopathy (Chi, Nat Rev Drug Discov 12:565-567, 2013). Given the physiological similarities between nonhuman primates and humans, isolated primate cardiac muscle cells are an ideal animal model for such in vitro testing. The aims of this chapter are to describe two methods for isolating and culturing primate cardiac muscle cells.

Cell-based therapeutic products: potency assay development and application.

Potency is a critical quality attribute of biological products, defined by the US FDA as the specific ability or capacity of the product, as indicated by appropriate laboratory tests or by adequately controlled clinical data obtained through the administration of the product in the manner intended, to effect a given result. Ideally, a potency assay will leverage the product's mechanism of action. Alternatively, the assay may focus on a therapeutically relevant biological activity.

Reducing the risk of intraoral radiographic imaging with collimation and thyroid shielding.

The 2007 modification by the International Commission on Radiation Protection of the calculation of effective dose from ionizing radiation has renewed interest in the concept of As Low As Reasonably Achievable exposure, and the technical approaches for reducing doses. This intraoral imaging study compared effective doses from circular and rectangular collimator modalities. A total of 18-image adult and 12-image child full mouth series were exposed using a 6 cm diameter circular collimator, a universal rectangular collimator, and an enhanced rectangular device for both adult and child phantoms.