| 1. |
- Winblad, B, et al.
(författare)
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Mild cognitive impairment--beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment.
- 2004
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Ingår i: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 256:3, s. 240-6
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Forskningsöversikt (refereegranskat)abstract
- The First Key Symposium was held in Stockholm, Sweden, 2-5 September 2003. The aim of the symposium was to integrate clinical and epidemiological perspectives on the topic of Mild Cognitive Impairment (MCI). A multidisciplinary, international group of experts discussed the current status and future directions of MCI, with regard to clinical presentation, cognitive and functional assessment, and the role of neuroimaging, biomarkers and genetics. Agreement on new perspectives, as well as recommendations for management and future research were discussed by the international working group. The specific recommendations for the general MCI criteria include the following: (i) the person is neither normal nor demented; (ii) there is evidence of cognitive deterioration shown by either objectively measured decline over time and/or subjective report of decline by self and/or informant in conjunction with objective cognitive deficits; and (iii) activities of daily living are preserved and complex instrumental functions are either intact or minimally impaired.
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| 2. |
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| 3. |
- Weinreb, Neal J, et al.
(författare)
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Gaucher disease type 1 : revised recommendations on evaluations and monitoring for adult patients.
- 2004
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Ingår i: Semin Hematol. - 0037-1963. ; 41:4 Suppl 5, s. 15-22
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- For patients with type 1 Gaucher disease, challenges to patient care posed by clinical heterogeneity, variable progression rates, and potential permanent disability that can result from untreated or suboptimally treated hematologic, skeletal, and visceral organ involvement dictate a need for comprehensive, serial monitoring. An updated consensus on minimum recommendations for effective monitoring of all adult patients with type 1 Gaucher disease has been developed by the International Collaborative Gaucher Group (ICGG) Registry coordinators. These recommendations provide a schedule for comprehensive and reproducible evaluation and monitoring of all clinically relevant aspects of this disease. The initial assessment should include confirmation of deficiency of beta-glucocerebrosidase, genotyping, and a complete family medical history. Other assessments to be performed initially and at regular intervals include a complete physical examination, patient-reported quality of life using the SF-36 survey, and assessment of hematologic (hemoglobin and platelet count), visceral, and skeletal involvement, and biomarkers. Specific radiologic imaging techniques are recommended for evaluating visceral and skeletal pathology. All patients should undergo comprehensive regular assessment, the frequency of which depends on treatment status and whether therapeutic goals have been achieved. Additionally, reassessment should be performed whenever enzyme therapy dose is altered, or in case of significant clinical complication.
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| 4. |
- Besjakov, Jack, et al.
(författare)
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Grading scale of radiographic findings in the pubic bone and symphysis in athletes.
- 2003
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Ingår i: Acta Radiologica. - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 44:1, s. 79-83
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes. Material and Methods: Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19-35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance. Results and Conclusion: The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely (p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.
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| 5. |
- Herrmann, C., et al.
(författare)
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Simulation of nodule-like pathology in radiographs of the lumbar spine
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1-2, s. 113-116
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Tidskriftsartikel (refereegranskat)abstract
- For the evaluation of the imaging properties of medical radiographic systems there are well-established standards for measuring techniques available, e.g. ISO 9236 for the measurement of the H/D curve. However, such measuring techniques require sophisticated equipment which is not available in a clinical environment. For a clinical routine of image evaluation, techniques like contrast-detail diagrams or the visual inspection of radiographs of grid pattern with varying contrast and spatial resolution are very common. The disadvantage of these techniques is that the corresponding results are very hard to be transferred to real patient images. Therefore, observer studies on the detection of certain pathology are commonly used to e.g. investigate the influence of different radiographic techniques on diagnostic image quality. As it is very difficult to find a sufficient number of patients with real pathologies for such studies, the pathologies are often simulated by fixing e.g. aluminium disks or other nodule-like objects to healthy volunteers when the radiograph is produced. This approach is relatively simple and rather successful in chest imaging. For lumbar spine images, however, the situation is different because nodule-like tumours cannot only consist of bony material which is increasing the X-ray absorption, but tumours can also destroy the bone material resulting in an increased transparency of the corresponding anatomical region. Such a behaviour is extremely hard to be simulated by fixing an external object to the patient. However, it can be easily simulated in a computer and applied to digital radiographic data. The current paper presents a computer model for the simulation of nodules in lumbar spine images. The model has been applied within a CEC founded research project, which was investigating the influence of MTF and noise power spectra on the diagnostic quality of radiographs of the lumbar spine.
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| 6. |
- Jacobson, Peter, 1962, et al.
(författare)
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Melanocortin 4 receptor sequence variations are seldom a cause of human obesity: the Swedish Obese Subjects, the HERITAGE Family Study, and a Memphis cohort.
- 2002
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Ingår i: The Journal of clinical endocrinology and metabolism. - 0021-972X. ; 87:10, s. 4442-6
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of mutations within and in the flanking regions of the gene encoding the melanocortin 4 receptor was investigated in severely obese and normal-weight subjects from the Swedish Obese Subjects study, the Health, Risk Factors, Exercise Training, and Genetics (HERITAGE) Family study, and a Memphis cohort. A total of 433 white and 95 black subjects (94% females) were screened for mutations by direct sequencing. Three previously described missense variants and nine novel (three missense, six silent) variants were detected. None of them showed significant association with obesity or related phenotypes. In addition, two novel deletions were found in two heterozygous obese women: a -65_-64delTG mutation within the 5' noncoding region and a 171delC frameshift mutation predicted to result in a truncated nonfunctional receptor. No pathogenic mutations were found among obese blacks or nonobese controls. Furthermore, none of the null mutations found in other populations was present in this sample. In conclusion, our results do not support the prevailing notion that sequence variation in the melanocortin 4 receptor gene is a frequent cause of human obesity.
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| 7. |
- Lanhede, B., et al.
(författare)
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The Influence of Different Technique Factors on Image Quality for Chest Radiographs: Application of the Recent CEC Image Quality Criteria
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1-2, s. 203-206
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the first this work part of the EU-project, Trial I, was to evaluate and possibly improve the CEC image criteria for radiographic chest images. Chest images of healthy volunteers were acquired using different technique factors. The image criteria were used as a tool to discriminate between the different images. The technique factors were chosen so that the image quality would differ slightly. Four different technique parameters, each with two possible settings, used in clinical practice today, were used: tube voltage - 102 and 141 kV; screen/film speed - 160 and 320; maximum optical density in the parenchyma - 1.3 and 1.8; method for scatter reduction - air gap 30/390 and moving grid40/12. The results showed that the image criteria were able to separate between different technique groups. Some conclusions can be drawn from the results Optical density 1.8 was better than 1.3 independent of the other parameters. . Among the six combinations ranked best , four used tube voltage 141 kV and four used air gap technique for scatter reduction. No difference was seen for screen/film speed. No correlation was seen between the ranking of the systems and patient dose.
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| 8. |
- Lanhede, B, et al.
(författare)
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The influence of different technique factors on image quality of chest radiographs as evaluated by modified CEC image quality criteria.
- 2002
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 75:889, s. 38-49
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Tidskriftsartikel (refereegranskat)abstract
- The Commission of the European Communities (CEC) research project "Predictivity and optimisation in medical radiation protection" addressed fundamental operational limitations in existing radiation protection mechanisms. The first part of the project aimed at investigating (1) whether the CEC image quality criteria could be used for optimization of a radiographic process and (2) whether significant differences in image quality based on these criteria could be detected in a controlled project with well known physical and technical parameters. In the present study, chest radiographs on film were produced using healthy volunteers. Four physical/technical parameters were varied in a carefully controlled manner: tube voltage (102 kVp and 141 kVp), nominal speed class (160 and 320), maximum film density (1.3 and 1.8) and method of scatter reduction (grid (R=12) and air gap). The air kerma at the entrance surface was measured for all patients and the risk-related dose H(Golem), based on calculated organ-equivalent dose conversion coefficients and the measured entrance air kerma values, was calculated. Image quality was evaluated by a group of European expert radiologists using a modified version of the CEC quality criteria. For the two density levels, density level 1.8 was significantly better than 1.3 but at the cost of a higher patient radiation exposure. The correlation between the number of fulfilled quality criteria and H(Golem) was generally poor. An air gap technique resulted in lower doses than scatter reduction with a grid but provided comparable image quality. The criteria can be used to highlight optimum radiographic technique in terms of image quality and patient dose, although not unambiguously. A recommendation for good radiographic technique based on a compromise between image quality and risk-related radiation dose to the patient is to use 141 kVp, an air gap, a screen-film system with speed 320 and an optical density of 1.8.
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| 9. |
- Tingberg, Anders, et al.
(författare)
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Comparison of two methods for evaluation of the image quality of lumbar spine radiographs
- 2000
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Ingår i: Radiation Protection Dosimetry. - 1742-3406. ; 90:1, s. 165-168
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Tidskriftsartikel (refereegranskat)abstract
- Two methods for visual evaluation of image quality of clinical radiographs have been compared. In visual grading analysis (VGA) specified anatomical structures in an image are visually compared with the same structures in a reference image, and in a free-response forced error (FFE) experiment - an extension of conventional ROC (receiver operating characteristics) analysis - the objective is to correctly localise known lesions. The spatial resolution and noise of digitised clinical radiographs of the lumbar spine were altered by image processing, and pathological structures were added to the images for the FFE experiment. The images were printed to film and evaluated by seven European expert radiologists using VGA and FFE. The results of these two different methods showed a very good agreement. In conclusion, VGA methodology can be made as solid as the FFE experiment for evaluating image quality. The simplicity of VGA makes it very suitable for implementation in clinical practice.
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| 10. |
- Tingberg, Anders, et al.
(författare)
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Evaluation of lumbar spine images with added pathology
- 2000
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Ingår i: Proceedings of SPIE. - : SPIE. - 0819435988 ; 3981, s. 34-42
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Konferensbidrag (refereegranskat)abstract
- Optimisation of radiographic procedures require solid tools for evaluation of the image quality in order to ensure that it is sufficient to answer the clinical question at the lowest possible absorbed dose to the patient. Lumbar spine radiography is an examination giving a relatively high dose and good methods for evaluation of image quality as well as dose are needed. We have developed and used a method for the addition of artificial pathological structures into clinical images. The new images were evaluated in a study of detectability (free-response forced error experiment). The results from the study showed that the methodology can be used to detect differences in the screen-film systems used to produce the images, indicating that the method can be used in a study of image quality. The results of the study of detectability were compared with the outcome of a visual grading analysis based on the structures mentioned in the European Quality Criteria. The comparison indicated that a linear correlation exists between the two methods. This means that the simpler VGA can be used in the evaluation of clinical image quality.
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| 11. |
- Tingberg, Anders, et al.
(författare)
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Influence of the characteristic curve on the clinical image quality of lumbar spine and chest radiographs.
- 2004
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Ingår i: The British journal of radiology. - : British Institute of Radiology. - 0007-1285 .- 1748-880X. ; 77:915, s. 204-15
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Tidskriftsartikel (refereegranskat)abstract
- The "European Guidelines on Quality Criteria for Diagnostic Radiographic Images" do not address the choice of the film characteristic (H&D) curve, which is an important parameter for the description of a radiographic screen-film system. The image contrast of clinical lumbar spine and chest radiographs was altered by digital image processing techniques, simulating images with different H&D curves, both steeper and flatter than the original. The manipulated images were printed on film for evaluation. Seven experienced radiologists evaluated the clinical image quality by analysing the fulfilment of the European Image Criteria (ICS) and by visual grading analysis (VGA) of in total 224 lumbar spine and 360 chest images. A parallel study of the effect of the H&D curve has also been made using a theoretical model. The contrast (DeltaOD) of relevant anatomical details was calculated, using a Monte Carlo simulation-model of the complete imaging system including a 3D voxel phantom of a patient. Correlations between the calculated contrast and the radiologists' assessment by VGA were sought. The results of the radiologists' assessment show that the quality in selected regions of lumbar spine and chest images can be significantly improved by the use of films with a steeper H&D curve compared with the standard latitude film. Significant (p<0.05) correlations were found between the VGA results and the calculations of the contrast of transverse processes and trabecular details in the lumbar spine vertebrae, and with the contrast of blood vessels in the retrocardiac area of the chest.
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| 12. |
- Tingberg, Anders, et al.
(författare)
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The influence of the characteristic curve on the clinical image quality and patient absorbed dose in lumbar spine radiography
- 2001
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Ingår i: Proceedings of SPIE. - : SPIE. - 0819440108 ; 4324, s. 41503-41503
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Konferensbidrag (refereegranskat)abstract
- The 'European Guidelines on Quality Criteria for Diagnostic Radiographic Images' do not address the choice of film characteristic (H/D) curve, which is an important parameter for the description of a radiographic screen-film system. Since it is not possible to investigate this influence by taking repeated exposures of the same patients on films with systematically varied H/D curves, patient images of lumbar spine were digitised in the current study. The image contrast was altered by digital image processing techniques, simulating images with H/D curves varying from flat over standard latitude to a film type steeper than a mammography film. The manipulated images were printed on film for evaluation. Seven European radiologists evaluated the clinical image quality of in total 224 images by analysing the fulfilment of the European Image Criteria and by visual grading analysis of the images. The results show that the local quality can be significantly improved by the application of films with a steeper film H/D curve compared to the standard latitude film. For images with an average optical density of about 1.25, the application of the steeper film results in a reduction of patient absorbed dose by about 10-15% without a loss of diagnostically relevant image information. The results also show that the patient absorbed dose reduction obtained by altering the tube voltage from 70 kV to 90 kV coincides with a loss of image information that cannot be compensated for by simply changing the shape of the H/D curve.
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| 13. |
- Tingberg, Anders, et al.
(författare)
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What is worse: Decreased spatial resolution or increased noise?
- 2002
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Ingår i: Proceedings of SPIE. - : SPIE. - 9780819444318 ; 4686, s. 338-346
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Konferensbidrag (refereegranskat)abstract
- Purpose: To investigate the relative importance of spatial resolution and noise on the image quality of clinical radiographs. Methods: The spatial resolution and noise of fifteen digitised lumbar spine radiographs were altered with image processing. Three different MTF curves and three different Wiener spectra were combined into seven different combinations of spatial resolution and noise. These seven combinations were applied to the original data set, and the resulting images were printed on film. Seven expert radiologists evaluated the clinical image quality of the resulting images with visual grading analysis (VGA) of structures based on the European Image Criteria. Results: The results show that added noise is more deteriorating than reduced spatial resolution for the clinical image quality. For a given MTF and noise level, the worst was the one with increased noise followed by the one with both reduced MTF and added noise (mimicking a faster screen-film combination). Reduced MTF only gave the highest rating. Conclusions: It is more important to find methods for removing noise than to try to improve the MTF of a radiographic system. A noisy image can sometimes be improved by reducing the spatial resolution.
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| 14. |
- Ukkola, Olavi, et al.
(författare)
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Role of ghrelin polymorphisms in obesity based on three different studies.
- 2002
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Ingår i: Obesity research. - : Wiley. - 1071-7323. ; 10:8, s. 782-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Associations between preproghrelin DNA variants and obesity-related phenotypes were studied in 3004 subjects from the Québec Family Study (QFS), the HERITAGE Family Study (HERITAGE), and the Swedish Obese Subjects (SOS) Study. RESEARCH METHODS AND PROCEDURES: Body mass index (BMI), fat mass (FM) from underwater weighing, and abdominal fat from computerized tomography were measured. The ghrelin polymorphisms were identified by polymerase chain reaction. RESULTS: Arg51Gln QFS subjects (n = 6) had lower ghrelin concentrations (p = 0.007) than Arg51Arg subjects (n = 14). White preproghrelin Met72Met subjects in HERITAGE had the lowest BMI (p = 0.020), and those in the QFS cohort had the lowest FM (p < 0.001). Met72 carrier status (Met72+) was associated with lower FM (p = 0.026) and higher insulin-like growth factor-1 levels (p = 0.019) among blacks. Met72Met QFS subjects had less visceral fat (p = 0.002) and a lower fasting respiratory quotient (p = 0.037). HERITAGE Met72+ white subjects also showed lower exercise respiratory quotient (p = 0.030) and higher maximal oxygen uptake (p = 0.023). Furthermore, the prevalence of Met72+ was higher (19.2%; p < 0.05) in SOS subjects whose BMI was < or =25 kg/m(2) than in those with BMI >25 kg/m(2) (14.8%). SOS Met72+ obese women had a lower (11.4%; p = 0.032) prevalence of hypertension than noncarriers (23.9%). DISCUSSION: Arg51Gln mutation was associated with lower plasma ghrelin levels but not with obesity. The preproghrelin Met72 carrier status seems to be protective against fat accumulation and associated metabolic comorbidities.
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| 15. |
- Yang, Xiao Lin, 1955, et al.
(författare)
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Evidence of impaired adipogenesis in insulin resistance
- 2004
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Ingår i: Biochem Biophys Res Commun. - : Elsevier BV. - 0006-291X. ; 317:4, s. 1045-51
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Tidskriftsartikel (refereegranskat)abstract
- To elucidate the roles of adipose tissue and skeletal muscle in the early development of insulin resistance, we characterized gene expression profiles of isolated adipose cells and skeletal muscle of non-diabetic insulin-resistant first-degree relatives of type 2 diabetic patients using oligonucleotide microarrays. About 600 genes and expressed sequence tags, which displayed a gene expression pattern of cell proliferation, were differentially expressed in the adipose cells. The differentially expressed genes in the skeletal muscle were mostly related to the cellular signal transduction and transcriptional regulation. To verify the microarray findings, we studied expression of genes participating in adipogenesis. The expression of Wnt signaling genes, WNT1, FZD1, DVL1, GSK3beta, beta-catenin, and TCF1, and adipogenic transcription factors, C/EBPalpha and beta and delta, PPARgamma, and SREBP-1, was reduced in the adipose tissue. The expression of adipose-specific proteins related to terminal differentiation, such as adiponectin and aP2, was reduced both in the adipose tissue and in the adipose cells isolated from portions of the biopsies. The adipose cells were enlarged in the insulin-resistant relatives and the cell size inversely correlated with the expression of the Wnt signaling genes, adiponectin, and aP2. Our findings suggest that insulin resistance is associated with an impaired adipogenesis.
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