Initial clinical evaluation of observer performance using a tablet computer with a 4K high-resolution display for detection of breast cancer by digital mammography

Purpose:To compare observer performance using medical‐purpose 5‐megapixel liquid crystal display monitors (5‐MP LCDs) and a tablet PC with a 4K high‐resolution display for detection of breast cancer by digital mammography. Materials and methods: Mammograms from 40 patients with primary breast cancer (18 mass, 16 microcalcifications, 3 artificial distortions, and 3 focal asymmetries) and 60 control patients were consecutively collected. Four experienced radiologists assessed 100 mammograms to rate using the BI‐RADS lexicon. The BI‐RADS assessments were subjected to receiver operating characteristic (ROC) curve analysis. Also, the observers assessed the image quality in terms of brightness, contrast, sharpness, and noise using 5‐step Likert scale. Results: The average under the curve (AUC) values for use of the 5‐MP LCDs and 4K monitors were 0.921 and 0.936; the difference between them was small and not significant. In terms of image quality, the 4K was rated better for brightness, contrast, and sharpness. Conclusion: Observer performance for detecting breast cancer on a 4K tablet PC with a high‐resolution display is similar to that using a 5‐MP LCD. This appears adequate for displaying mammograms of diagnostic quality and could be useful for patient consultations, clinical demonstrations, or educational and teaching purposes

Perineuronal Sulfated Proteoglycans, Cell Surface Glycoproteins and Dark Neurons in the Cingulate Cortex of Newborn and Adult Rats

Many neurons in the adult rat cingulate cortex possess perineuronal sulfated proteoglycans detectable with cationic iron colloid and aldehyde fuchsin, or cell surface glycoproteins reactive to lectin Vicia villosa or soybean agglutinin. The perineuronal sulfated proteoglycans develop three to four weeks after birth. The cell surface glycoproteins develop at earlier stage or two to three weeks after birth. Dark or active neurons begin to appear three to four weeks after birth. These findings indicate that the brain matures after birth or during weaning period.</p

Perineuronal Sulfated Proteoglycans in the Adult Rat Brain: Histochemical and Electron Microscopic Studies

Neurons of cerebellar nuclei in the rat brain had a marked surface coat which was stained with cationic iron colloid or aldehyde fuchsin. Neurons with a similar surface coat were also noted in the retrosplenial cortex. The surface coat was stained doubly with cationic iron colloid and aldehyde fuchsin. Digestion with hyaluronidase eliminated the stainability of the surface coat to both agents. Combined digestion with chondroitinase ABC, heparitinase and keratanase eliminated the cationic iron colloid staining but did not interfere with the aldehyde fuchsin staining. Electron microscopy of ultrathin sections revealed that the iron particles were deposited in the perineuronal tissue spaces. These findings indicate that the surface coat consists of sulfated proteoglycans which occupy, as the extracellular matrix, the perineuronal tissue spaces. Many neurons in the retrosplenial cortex were labeled with lectin Vicia villosa agglutinin. Double staining revealed that these lectin-labeled neurons are usually reactive to cationic iron colloid. Few neurons in the cerebellar nuclei were labeled with lectin V. villosa agglutinin.</p

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Human kidney glomeruli, with special reference to those in the aged person: scanning electron microscopic study of microvascular corrosion casts.

Blood vascular beds of fetal, adult and aged human kidneys were reproduced with methyl methacrylate and observed with a scanning electron microscope. The kidney glomeruli, including those from the fetal kidneys, had anastomosing capillaries. The glomeruli in the kidneys of an aged person contained many more capillaries which were much more tortuous than those of the adult and fetal kidneys. Furthermore, it was observed that the glomeruli in the kidneys of the aged person usually received tortuous afferent vessels and frequently emitted multiple efferent arterioles. The glomeruli in the juxtamedullary layer of the kidneys of the aged person were rather small in size and contained degenerative capillary networks. This observation suggests that the medulla of the kidneys of the aged is poorly supplied with blood.</p

Perineuronal sulfated proteoglycans and cell surface glycoproteins in the visual cortex of adult and newborn cats

Sections of the visual cortex of newborn (1-4 weeks after birth) and adult cats were stained with cationic iron colloid, aldehyde fuchsin or lectins (lectin Vicia villosa, soybean and Wisteria floribunda agglutinins). Many neurons in the adult cat visual cortex contained perineuronal sulfated proteoglycans detectable with cationic iron colloid and aldehyde fuchsin, or cell surface glycoproteins reactive to lectins. Double staining indicated that some of the lectin-labeled neurons were not stained with cationic iron colloid, and also that some of the cationic iron colloid-stained neurons were not labeled with lectins. The perineuronal sulfated proteoglycans and cell surface glycoproteins developed 3 weeks after birth. In the newborn cats 1-2 weeks after birth, no neurons were reactive to cationic iron colloid, aldehyde fuchsin or lectins. In the newborn cats 34 weeks after birth, it was clearly observed that the cytoplasm of the glial cells closely associated with the neurons containing the perineuronal sulfated proteoglycans showed an intense reaction to cationic iron colloid and aldehyde fuchsin, and that the Golgi complexes of the neurons with cell surface glycoproteins were intensely labeled with lectins. These findings suggest that the perineuronal sulfated proteoglycans are derived from the associated glial cells, and that the cell surface glycoproteins are produced by the associated nerve cells.</p

1989年ロマ・プリータ地震の震度分布

1989年10月17日午後5時4分(現地時間)に発生したロマ・プリータ地震(M7.1)は、サンフランシスコの南東約110kmのサンアンドレアス断層上を震度として発生した。断層の長さは約40kmで、震度の深さ約18kmとされ、断層上で右横ずれ1.7m, 縦ずれ1.3mの断層運動が確認された。震度近傍地域の市街地の建築構造物の被害はもとより、震源より約100km程度離れた近代的な都市であるサンフランシスコ市やオークランド市において海岸部の埋立地を中心に大きな被害が発生し、特にベイブリッジや高架橋構造の高速道路の崩壊による多くの死傷者やライフライン系の被害など典型的な都市型の被害が生じた市民生活に大きな影響を及ぼした。この地震による人的被害は死者62人、負傷者約3800人であった。また、倒壊建物を含む被災建物数は約3万棟で被害総額は約59億ドルと報告されている。本地震の震度分布は震源近傍の地域において修正メルカリ震度階で震度8(気象庁震度階6程度)、サンフランスコ市やオークランド市においては同震度7(同5程度)であるが、同地域内において局所的に同震度9(同7程度)の大きな震度分布を示す地域があり、大被害地域となっている。一方、地震動の強震計観測記録はUSGS(米国地質調査所)とCDMG(カリフォルニア鉱山局)が設置した観測網により多数の地点で貴重な記録が観測されている。震源近傍の地域では、地盤上の水平動成分の最大加速度値が0.64g(Corralitos)、0.54g(Capitola) と大きな値を示し、上下動成分も0.5～0.6g の値を記録している。またオークランド市周辺地域で0.26g(Emeryville)、サンフランシスコ市周辺で0.24g(Golden Gate Bridge)、0.33g(San Francisco Intl. Airport) と報告されている。しかしながら、これらの資料だけからではサンフランシスコ市やオークランド市の市内における地域的に細かな震度分布を評価することは難しい。米国では、USGSが中心となって、地震の多発するカリフォルニア州のサンフンドレアズ断層に沿う地域、特にサンフランスシコ湾岸地域を対象として、同断層および平行して走るヘイワード断層上に発生する大地震を想定した震度分布予測のためのゾーニングマップが作成されている。これは、地震断層・地質地形・地盤などを考慮して作成されたものであり、特に今回のロマ・プリータ地震でのサンフランシスコ市やオークランド市における被害発生地域は、上記のゾーニングマップにおいて、震度が相対的に高いと予測されていた地域と符合しているように思われる。本報告では、特に大都市であるサンフランシスコ市においてサイスミックマイクロゾーニングの観点から、アンケートによるミクロな震度分布調査を行い、すでにUSGSにおいて作成されている既往の地盤分類に基づいたマイクロゾーニングマップとの対応について検討を行った。その結果、サンフランシスコ市におけるUSGS による震度分布は、一部の大被害発生地域の震度を除いてMM 震度で7～6 程度であったのに対して、地域的に詳しい震度分布のコンターが得られ、表層地盤の性質に対応していることが明かとなった

Comparability of Weighed Dietary Records and a Self-Administered Diet History Questionnaire for Estimating Monetary Cost of Dietary Energy

An increasing number of studies have estimated monetary diet cost using various dietary assessment methods, based on databases on retail food prices, for investigating its association with dietary intake and health outcomes. However, information regarding the comparability of monetary diet cost across dietary assessment methods is absolutely lacking. This study compared monetary cost of dietary energy estimated from weighed dietary records (DRs) with that estimated from a self-administered diet history questionnaire (DHQ). The subjects were 92 Japanese women aged 31–69 years and 92 Japanese men aged 32–76 years. The DHQ (assessing diet during the preceding month) and 4-day DRs (one weekend day and three weekdays) were completed in each season over a 1-year period (DHQs1-4 and DRs1-4, respectively). An additional DHQ was completed at one year after completing DHQ1 (DHQ5). Monetary cost of dietary energy (Japanese yen/4184 kJ) was calculated using food intake information derived from each dietary assessment method, based on retail food prices. Pearson correlation between the mean of DRs1-4 and mean of DHQs1-4 was 0.64 for women and 0.69 for men. Pearson correlation between the mean of DRs1-4 and DHQ1 was 0.60 for women and 0.52 for men, while intraclass correlation between DHQ1 and DHQ5 was 0.64 for women and 0.51 for men. These data indicate reasonable comparability of monetary cost of dietary energy across DR and a DHQ as well as usefulness of a single administration of the DHQ for estimating monetary cost of dietary energy

The effectiveness of simulation-based education combined with peer-assisted learning on clinical performance of first-year medical residents: a case-control study

Background Simulation-based education and peer-assisted learning (PAL) are both known as useful educational methods. Previous research has reported that combining these two methods are effective for training medical residents in short-term evaluation. This study was aimed to evaluate the middle- to long-term effects of simulation-based education combined with PAL on the performance of medical residents during emergency department duties. Methods This study was designed as a case-control study and conducted over three years at Okayama University Hospital in Japan. Postgraduate-year-one medical residents were assigned to three groups: a simulation group that received simulation-based education, a lecture group that received traditional lecture-based education, and a control group that received no such prior trainings. Prior training in emergency department duties using PAL was performed as an educational intervention for the simulation and lecture groups during the clinical orientation period. The residents' medical knowledge was assessed by written examinations before and after the orientation. The performance of residents during their emergency department duties was assessed by self-evaluation questionnaires and objective-assessment checklists, following up with the residents for three months after the orientation period and collecting data on their 1st, 2nd, and 3rd emergency department duties. All the datasets collected were statistically analyzed and compared by their mean values among the three groups. Results A total of 75 residents were included in the comparative study: 27 in the simulation group, 24 in the lecture group, and 24 in the control group. The simulation and lecture groups obtained significantly higher written examination scores than the control group. From the self-evaluation questionnaires, the simulation group reported significantly higher satisfaction in their prior training than the lecture group. No significant differences were found in the emergency department performance of the residents among the three groups. However, when evaluating the improvement rate of performance over time, all three groups showed improvement in the subjective evaluation, and only the simulation and lecture groups showed improvement in the objective evaluation.ConclusionSimulation-based education combined with PAL is effective in improving the knowledge and satisfaction of medical residents, suggesting the possibility of improving work performance during their emergency department duties