Bilateral pyogenic psoas abscesses with inferior vena cava thrombosis.

Psoas abscess is a rare clinical entity. Rarely, it is associated with thrombosis of the inferior vena cava. This report is of a 36-year-old woman with bilateral pyogenic psoas abscesses with spondylodiscitis complicated by thrombosis of the inferior vena cava. The pathogenesis and imaging features of this condition are discussed

Optimal beam quality selection based on contrast-to-noise ratio and mean glandular dose in digital mammography

The performance of a digital mammography system (Siemens Mammomat Novation) using different target/filter combinations and tube voltage has been assessed. The objective of this study is to optimize beam quality selection based on contrast-to-noise ratio (CNR) and mean glandular dose (MGD). Three composition of breast were studied with composition of glandular/adipose of 30/70, 50/50, and 70/30. CNR was measured using 2, 4 and 6 cm-thick simulated breast phantoms with an aluminium sheet of 0.1 mm thickness placed on top of the phantom. Three target/filter combinations, namely molybdenum/molybdenum (Mo/Mo), molybdenum/rhodium (Mo/Rh) and tungsten/rhodium (W/Rh) with various tube voltage and mAs were tested. MGD was measured for each exposure. For 50/50 breast composition, Mo/Rh combination with tube voltage 26 kVp is optimal for 2 cm-thick breast. W/Rh combination with tube voltage 27 and 28 kVp are optimal for 4 and 6 cm-thick breast, respectively. For both 30/70 and 70/30 breast composition, W/Rh combination is optimal with tube voltage 25, 26 and 27 kVp, respectively. From our study it was shown that there are potential of dose reduction up to 11 for a set CNR of 3.0 by using beam quality other than that are determined by AEC selection. Under the constraint of lowest MGD, for a particular breast composition, calcification detection is optimized by using a softer X-ray beam for thin breast and harder X-ray beam for thick breast. These experimental results also indicate that for breast with high fibroglandular tissues (70/30), the use of higher beam quality does not always increase calcification detection due to additional structured noise caused by the fibroglandular tissues itself

Development of a Tissue Equivalent Gelatine Phantom for Accuracy Verification of Tissue Elasticity Measurement Using Shear Wave Elastography Ultrasound

Background Shearwave elastography ultrasound (SWE) has been increasing used in the recent decade to quantify tissue stiffness and viscoelastic properties correlate to a disease condition. Aims This study aimed to develop a low cost and reproducible gelatine phantom to verify the accuracy of tissue elasticity measurement using shear wave elastography (SWE). The effect of lesion’s size, stiffness and depth from the surface on the tissue elasticity measurement were also investigated. Methods A breast tissue-equivalent phantom embedded with spherical inclusions of different sizes, stiffness and depth from surface was constructed using gelatine. The elasticity of the spherical inclusions was determined using a commercial SWE system and compared to the elasticity determined using a high precision electromechanical microtester (gold standard for elasticity measurements). Results Statistically significant difference (p < 0.05) was found between the elasticity measured using SWE and electromechanical microtester, whereby the SWE overestimated the tissue elasticity by a mean value of 22.8 ± 15.0 kPa. The size and depth of the spherical inclusions have not imposed any effect on the elasticity measured by SWE, but the depth of shear wave detection was found limited to 8 cm from the surface. Conclusion The gelatine phantom constructed in this study could be used to verify the accuracy of the elasticity measured using SWE. The tissue elasticity measured by the SWE appeared to be overestimated compared to the gold standard. Further research would need to be carried out to determine the offset from the SWE measurement and to account for these differences

A safety evaluation of intravenous administration of ex vivo expanded human peripheral blood-derived NK cells : a preclinical study

The use of natural killer (NK) cells in the treatment of various cancers is emerging as a promising approach in adoptive immunotherapy. However, the safety of ex vivo activated and expanded cells in in vivo conditions remain unknown. In this study, the toxicity of NK cells was evaluated at different doses, with 5 × 106, 20 × 106 and 50 × 106 cells injected intravenously into pre-irradiated (30Gy) immunodeficient mice twice a week for three weeks and the mice were followed-up on for 90 days. Throughout the study, no mortality, abnormal clinical signs, or behavioural changes related to the testing material were observed in either the treated or control groups of mice. There were no significant variations in food and water consumption between both genders in the NK cell treated and control groups. However, certain significant changes were observed between the groups in the clinical biochemistry and urine analysis reports. As autopsy showed no significant variations in absolute and relative organ weights between the groups, except for the livers of the treated mice. The histopathological analysis also demonstrated that there were no significant abnormalities in most of the organs of both genders, except for the liver. Some necrotic lesions were observed in the livers of both the treated and control mice, and these lesions may be due to the effects of irradiation or could be common in NOD.SCID mice. The findings of this study indicate that intravenous administration of NK cells is safe and does not cause any adverse effects up to the dose of 50 × 106 cells/mouse

Fluoroscopy Assisted Minimally Invasive Transplantation of Allogenic Mesenchymal Stromal Cells Embedded in HyStem Reduces the Progression of Nucleus Pulposus Degeneration in the Damaged Interverbal Disc: A Preliminary Study in Rabbits

This study was conducted to develop a technique for minimally invasive and accurate delivery of stem cells to augment nucleus pulposus (NP) in damaged intervertebral discs (IVD). IVD damage was created in noncontiguous discs at L4-L5 level; rabbits (N=12) were randomly divided into three groups: group I treated with MSCs in HyStem hydrogel, group II treated with HyStem alone, and group III received no intervention. MSCs and hydrogel were administered to the damaged disc under guidance of fluoroscopy. Augmentation of NP was assessed through histological and MRI T2 mapping of the NP after eight weeks of transplantation. T2 weighted signal intensity was higher in group I than in groups II and III (P<0.05). Disc height index showed maximum disc height in group I compared to groups II and III. Histological score of the degenerative index was significantly (P<0.05) lower in group I (8.6 ± 1.8) than that in groups II (11.6 ± 2.3) and III (18.0 ± 5.7). Immunohistochemistry staining for collagen type II and aggrecan staining were higher in group I as compared to other groups. Our results demonstrate that the minimally invasive administration of MSCs in hyaluronan hydrogel (HyStem) augments the repair of NP in damaged IVD

A survey of chest radiographs of migrant workers in Malaysia

A survey was done to assess the chest radiographs of a selected group of immigrants. The objective is to ascertain the presence of abnormalities especially the presence of tuberculosis. Five hundred and eleven (511) chest radiographs (PA view) were evaluated. Majority of the chest radiographs were normal, except for two cases of hilar lymphadenopathy, four cases of scoliosis and cervical rib, an old case of fracture of the clavicle and a case of cardiomegaly. Only two cases of TB were detected

The birth of an open access multidisciplinary online journal

[No abstract available

Tunnelled peripherally inserted central catherer-how we do them

In the current study, we report a new technique to place a tunnelled peripherally inserted central catheter (PICC) at the upper arm of patient under real-time ultrasound-guided venipuncture using disposal equipment provided within a standard PICC set. The tunnelling of the PICC required an extra time of 5 minutes but was well tolerated by all patients involved in the study. The tunnelled PICC was applied on 50 patients and the infection rate as well its catheter dwell time were compared to another 50 patients with conventional PICC. The rate of patients who developed infection decreased from 34% for conventional PICC to 16% in tunnelled PICC patients. The central line-associated blood stream infections rate was also decreased from 4.4 per 1000 catheter-days for conventional PICC to 1.3 per 1000 catheter-days for tunnelled PICC. The mean time to infection development for tunnelled PICC (24 days) was longer than those observed with conventional PICC (19 days). Tunnelled PICC has also increased the mean catheter dwell time from 27 days (for conventional PICC) to 47 days. Tunnelling a PICC has the potential to reduce the infection rate while increase the catheter dwell time. © 2018, Faculty of Medicine, University of Malaya. All rights reserved

Safety considerations in magnetic resonance imaging (MRI)

MRI is now an important diagnostic tool in medical management. There are numerous safety issues to be considered by the clinicians prior to requesting an MRI examination for their patients. These include those related to the magnetic field, gradient magnetic fields, the patient and contrast medium. This paper discusses the dangers and necessary precautions essential to reduce the risk of untoward complications from MRI