Metal artifact suppression from reformatted projections in multislice helical CT using dual-front active contours.

Purpose: Large metallic implants, such as hip prosthesis and shoulder implants, can cause severe artifacts in CT exams. As such, there have been significant efforts on the design of various image- or projection-based correction methods or iterative reconstruction methods with the hope to reconstruct artifact-free images. Unfortunately, suppression of metal artifacts remains a very challenging problem, in which metal region segmentation is one of the most important steps in assuring the efficiency of artifact suppression.

Neuroanesthesiology update.

Recent literature contains many reports of value to clinicians providing anesthetic or intensive care for neurosurgical patients or patients experiencing, or at risk for, neurological impairment. We will review many of these articles, focusing on those that address intracranial hemorrhage, intracranial procedures, carotid endarterectomy, spine surgery, and the determinants of outcome in patients with evolving or new-onset neurologic disease. Additionally, we will review articles addressing neurotoxicity, neuroprotection, and nervous system monitoring.

Ultrasound machine comparison: an evaluation of ergonomic design, data management, ease of use, and image quality.

Background And Objectives: The use of ultrasound technology for vascular access and regional anesthesia is gaining widespread acceptance among anesthesia providers. As a result, many group practices and medical institutions are considering purchasing ultrasound equipment. Currently, comparative information regarding the ergonomic design, physical and adjustable features, data management, ease of use, cost, and image quality of various ultrasound machines is not available.

Progression of organ failure in patients approaching brain stem death.

We performed a retrospective cohort study to document the progression of organ dysfunction in 182 critically ill adult patients who subsequently met criteria for brain stem death (BSD). Patients were admitted to intensive care units (ICUs) of Mayo Medical Center, Rochester, MN, between January 1996 and December 2006. Daily sequential organ failure assessment (SOFA) scores were used to assess the degree of organ dysfunction.

Progress in the diagnosis and treatment of autoimmune hepatitis.

Autoimmune hepatitis has diverse clinical presentations which complicate its diagnosis and adverse outcomes which demand new treatments. The aims of this review are to indicate the progress that has been made in solving these problems and to illuminate the pathway for additional solutions. Prime source and review articles in English were selected through Medline from 1970-2008 and assimilated into a personal library spanning 31 years.

Nephrolithiasis after bariatric surgery for obesity.

Surgical intervention has become an accepted therapeutic alternative for the patient with medically complicated obesity. Multiple investigators have reported significant and sustained weight loss after bariatric surgery that is associated with improvement of many weight-related medical comorbidities, and statistically significant decreased overall mortality for surgically treated as compared with medically treated subjects. Although the Roux-en-Y gastric bypass (RYGB) is considered an acceptably safe treatment, an increasing number of patients are being recognized with nephrolithiasis after this, the most common bariatric surgery currently performed.

Aprotinin does not prolong the Sonoclot aprotinin-insensitive activated clotting time.

Study Objective: To determine whether a new Sonoclot-based, aprotinin-insensitive activated clotting time (aiACT) assay yields stable results over a broad range of aprotinin concentrations.

Design: Prospective trial conducted on in vitro blood samples.

Setting: Tertiary-care teaching medical center.

Oral and non-oral combination therapy for erectile dysfunction.

An estimated 30 million men in the United States suffer from varying degrees of erectile dysfunction. Increasing age and comorbidities are likely to increase the number of men who are initially refractory or become refractory to phosphodiesterase (PDE)-5 inhibitors, the most popular oral therapy. Combination therapy, a concept well proved in other areas of medicine, is therefore of increasing importance.

Alzheimer's disease patients' cognitive status and course years prior to symptom recognition.

This is a prospective examination of the cognitive performance and cognitive course of persons in an asymptomatic "preclinical" phase who eventually developed Alzheimer's disease (AD). We compared performances on the Mayo Cognitive Factor Scales (MCFS) of 20 persons in a neurologically normal cohort who subsequently developed AD to the performances of 60 persons who remained free of dementia symptoms. For the AD patients, exams occurred prior to the appearance of dementia symptoms (an average of 4.

Distribution of circulation-derived endothelial progenitors following systemic delivery.

Cells with an endothelial phenotype can be cultured from peripheral blood. These cells include cells of a monocytic origin with endothelial features (culture-modified mononuclear cells, CMMCs) and, at later time points, blood outgrowth endothelial cells (BOECs). Both are promising candidates for systemic cell-based cardiovascular therapies and each may have unique capabilities.

Molecular targets for therapy of hepatitis B virus-induced hepatocellular carcinoma.

Chronic hepatitis B virus (HBV) infection is the most frequent risk factor for development of hepatocellular carcinoma (HCC) worldwide. Studies of the molecular genetics and pathophysiology of HCC suggest that there are significant differences in the allelic imbalance, genome copy number, and gene expression patterns of HBV-induced HCC as compared to HCCs from other causes, which are presumably reflected to differences in the mode of presentation and outcomes of HBV-induced HCCs. Unique features of HBV-induced carcinogenesis include the role of HBV DNA integration in carcinogenesis and the powerful synergism between HBV and dietary aflatoxins in the pathogenesis of HCC.

Papillary thyroid carcinoma in children: risk factors and complications of disease recurrence.

Introduction: Optimal treatment of recurrent papillary thyroid carcinoma (PTC) in children remains controversial. We reviewed our experience with recurrent PTC to better identify children diagnosed with it.

Aims: The objective of this study was to determine the risk factors, optimal treatment, complications, and prognosis of recurrent PTC in children.

Electroconvulsive therapy in patients taking monoamine oxidase inhibitors.

Concerns have been expressed regarding the use of general anesthesia for electroconvulsive therapy (ECT) in patients taking monoamine oxidase inhibitors (MAOIs). We review the published literature and present 4 new cases and conclude that there is no evidence of a dangerous interaction between ECT and MAOI use. In general, a cautious approach would be to discontinue MAOIs before ECT if the medication has not been helpful; however, there is no need for a washout interval before starting ECT.