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Background Volumetric high-resolution computed tomography (HRCT) of the chest has recently replaced incremental CT in the diagnostic workup of idiopathic pulmonary fibrosis (IPF). Concomitantly, visual and quantitative scores have been proposed for disease extent assessment to ameliorate disease management. Purpose To compare the performance of density histograms (mean lung attenuation, skewness, and kurtosis) and visual scores, along with lung function correlations, in IPF patients submitted to incremental or volumetric thorax HRCT. Material and methods Clinical data and CT scans of 89 newly diagnosed and therapy-naive IPF patients were retrospectively evaluated. Results Forty-six incremental and 43 volumetric CT scans were reviewed. No differences of density histograms and visual scores estimates were found by comparing two HRCT techniques, with an optimal inter-operator agreement (concordance correlation coefficient >0.90 in all instances). Single-breath diffusing lung capacity for carbon monoxide (DLCOsb) was inversely related with the Best score (r = −00.416; p = 0.014), the Kazerooni fibrosis extent (r = −0.481; p = 0.004) and the mean lung attenuation (r = −0.382; p = 0.026), while a positive correlation was observed with skewness (r = 0.583; p = 0.001) and kurtosis (r = 0.543; p = 0.001) in the incremental HRCT sub-group. Similarly, in the volumetric CT sub-cohort, DLCOsb was significantly associated with skewness (r = 0.581; p = 0.007) and kurtosis (r = 0.549; p = 0.018). Correlations with visual scores were not confirmed. Forced vital capacity significantly related to all density indices independently on HRCT technique. Conclusions Density histograms and visual scores similarly perform in incremental and volumetric HRCT. Density quantification displays an optimal reproducibility and proves to be superior to visual scoring as more strongly correlated with lung function.

Tc-99m pyrophosphate (PYP) SPECT is recommended for indeterminate findings on planar imaging. We aimed to compare the findings on planar PYP scintigraphy alone to that of routinely performed PYP SPECT. PYP scintigraphy data of 133 patients (53% men; mean age 76 years) were evaluated. SPECT was routinely performed following 1-hour planar imaging, in all cases. Semiquantitative visual score and heart-to-contralateral (H/CL) ratio were determined in all patients as recommended. PYP images from 35 patients (26%) were considered to be positive based on SPECT myocardial uptake. Among them, 20 (57%) had a H/CL ratio ≥1.5 and 34 had a visual score ≥ 2. SPECT identified myocardial uptake in one patient with a visual score < 2 and refuted the presence of myocardial uptake in two patients with a visual score ≥ 2. Visual score correlated well with SPECT (r = 0.94; P < .0001) and had an accuracy of 98% for tomographic myocardial uptake. Addition of H/CL ratio reduced the diagnostic performance of visual score. Planar-derived visual score has an excellent accuracy for tomographic myocardial uptake, though it misclassifies a small proportion of patients. H/CL ratio decreases the diagnostic certainty of planar imaging. Tomographic imaging prevents misdiagnoses and should always be performed.

Background Lung cancer is a frequent comorbidity of chronic obstructive pulmonary disease (COPD). However, the local risk of developing lung cancer related to regional emphysema distribution and clinical outcome has not been investigated. Our aim was to evaluate the impact of regional emphysema score (RES) on tumor location and prognosis in non-small cell lung cancer (NSCLC) patients. Methods We enrolled 457 patients who underwent curative surgery for NSCLC at seven hospitals at The Catholic University of Korea from 2014 to 2018. Emphysema was visually assessed for each lobe, with the lingula as a separate lobe. Semi-quantitative emphysema scoring was classified as follows: 0 = none, 0.5 = 1 to 10%, 1 = 11 to 25%, 2 = 26 to 50%, 3 = 51 to 75%, and 4 = 76 to 100%. An RES was given to each of the six lung zone: the upper, middle, and lower lobes in the right and left lungs. Results There were 145 patients in the high RES (≥ 3) group and 312 in the low RES (P P P = 0.04), pathologic stage ≥ III (OR = 2.23; 95% CI: 1.28–3.89; P P Conclusions The regional severity of emphysema by visual qualification was associated with the location of lung cancer, and was an independently poor prognostic factor for tumor recurrence in completely resected NSCLC patients.

Background and Aims: Water Sanitation and Hygiene (WASH) within the context of Sustainable Development Goal (SDG) is well debated; however, WASH in health care sector is still in nascent phase, especially for maternity units. Although there are studies on WASH in maternity units, least are focused towards the microbiological safety. The objective of present study is to compare the visual assessment with microbiological assessment of selected maternity units of Gujarat (India) and to document microbiological contamination and drug resistance. Methods: A cross-sectional study was carried out in 10 selected maternity units of Sabarkantha and Gandhinagar district of Gujarat, India, during Feb-March 2018. Two steps of Tool Box Plus were used for documentation: visual and microbiological assessment. Antimicrobial Resistance (AMR) patterns amongst positive microorganisms were also documented. Results: Although the majority of the studied maternity units were visually clean, the microbiological findings contraindicated the same. The overall visual score across all facilities was close to 50% indicating good visual cleanliness. Out of 195 samples collected, 18% (35) samples were positive for pathogenic organisms and the majority were identified from mops and labour table. 1/3rd of organisms were resistant to > 5 antibiotics. Pathogenic organism identified includes Acitenobacter, Klebsilla, MR CONS, E coli, Psudomonas Aeruginosa and Pseudomonas species. Conclusions: Visual assessment alone which is currently used for assessment of hygiene is not a proxy for safety. It should be validated by the microbiological method. Microbiology surveillance should be explored to get valuable insights on the effectiveness of cleaning practices of the maternity units.

Objectives: Develop and validate a new and simplified score for evaluating the lower urinary tract symptoms in men. Materials and methods: We modified the existing visual prostate symptom score, including changes in the images, sequence, and new alternatives, resulting in a new visual score (LUTS visual score-LUTS-V). For the validation of the new tool, we used the International Prostatic Symptom Score as the gold-standard and the new LUTS-V to 306 men. The total IPSS score and the total LUTS-V score of each subject were evaluated to determine the agreement between the two instruments. ROC curve was used to evaluate the diagnostic accuracy and best cut-off of LUTS-V. Sensitivity, specificity, and diagnostic odds ratios were used to describe the diagnostic properties. Results: The mean age of the participants was 59 [52-87] years. There was a significant correlation between LUTS-V and IPSS. (r=0.72 (p 4 was the best threshold, with a sensitivity of 74% and specificity of 78%. Conclusions: LUTS-V is a simple, self-administered tool with a significant discriminatory power to identify subjects with moderate to severe LUTS and may represent a useful instrument for the diagnosis and follow-up of men with urinary symptoms.

To evaluate the usefulness of applying computed tomography (CT) images reconstructed by a deep learning super-resolution method to the clinical scenario of planning a real bronchoscopy procedure. We trained a super-resolution generative adversarial network (SRGAN) to reconstruct CT images to high-resolution (SRGANrc). We tasked three pulmonologists with evaluating the quality of the CT images and the derived virtual bronchoscopies. We also compared the number of bronchi that were segmented by an automatic commercial program with the number of bronchi segmented in different processed thin-sectioned CT images. Regarding the human visual score, the original thin-sectioned CT images received more votes than the reconstructed CT images (SRGANrc) (29 votes versus eight votes). As for the human classification of four high-resolution CT images, the majority of images (83.7%) were classified correctly. Four out of 23 virtual bronchoscopies derived from super-resolution CT images were considered superior. The number of automatically segmented bronchi in super-resolution CT images was on average 1.5 less than that in the original thin-sliced CT images (mean bronchi: 15.1 vs. 16.6). The reconstruction of super-resolution CT images through the SRGAN may have limited applications in the clinical scenarios of our study. In addition to improving the deep-learning algorithm, we need more clinical implementation tests to discover its value.

Purpose The aim is to implement Utrecht Cranial Shape Quantificator (UCSQ) for quantification of severity of scaphocephaly and compare UCSQ with the most used quantification method, cranial index (CI). Additionally, severity is linked to intracranial volume (ICV). Methods Sinusoid curves of 21 pre-operative children (age Results Mean UCSQ was 22.00 (2.00–42.00). Mean traditional CI was 66.01 (57.36–78.58), and mean visual score was 9.1 (7–12). Correlations between both traditional CI and CI of UCSQ and overall visual scores were moderate and high (r = − 0.59; p = 0.005 vs. r = − 0.81; p r = 0.26; p > 0.05) and between ICV and CI and visual score (r = − 0.30; p > 0.05 and r = 0.17; p > 0.05, respectively). Conclusion Our current advice is to use traditional CI in clinical practice; it is easy to use and minimally invasive. However, UCSQ is more precise and objective and captures whole skull shape. Therefore, UCSQ is preferable for research. Additionally, more severe scaphocephaly does not result in more deviant skull volumes.

Introduction Ground-glass nodules may be the expression of benign conditions, pre-invasive lesions or malignancies. The aim of our study was to evaluate the capability of chest digital tomosynthesis (DTS) in detecting pulmonary ground-glass opacities (GGOs). Methods An anthropomorphic chest phantom and synthetic nodules were used to simulate pulmonary ground-glass nodules. The nodules were positioned in 3 different regions (apex, hilum and basal); then the phantom was scanned by multi-detector CT (MDCT) and DTS. For each set (nodule-free phantom, nodule in apical zone, nodule in hilar zone, nodule in basal zone) seven different scans (n = 28) were performed varying the following technical parameters: Cu-filter (0.1–0.3 mm), dose rateo (10–25) and X-ray tube voltage (105–125 kVp). Two radiologists in consensus evaluated the DTS images and provided in agreement a visual score: 1 for unidentifiable nodules, 2 for poorly identifiable nodules, 3 for nodules identifiable with fair certainty, 4 for nodules identifiable with absolute certainty. Results Increasing the dose rateo from 10 to 15, GGOs located in the apex and in the basal zone were better identified (from a score = 2 to a score = 3). GGOs located in the hilar zone were not visible even with a higher dose rate. Intermediate density GGOs had a good visibility score (score = 3) and it did not improve by varying technical parameters. A progressive increase of voltage (from 105 kVp to 125 kVp) did not provide a better nodule visibility. Conclusion DTS with optimized technical parameters can identify GGOs, in particular those with a diameter greater than 10 mm. Implications for practice DTS could have a role in the follow-up of patients with known GGOs identified in lung apex or base region.

The aim of this study was to evaluate the image quality and the quantification accuracy of Biograph Vision PET/CT scanner as a SiPM-PET in comparison to the conventional PMT-PET, Biograph mCT PET/CT scanner. This study consisted of a phantom study and a retrospective clinical analysis where patients underwent 18F-FDG PET/CT in both PET systems. The body phantom of the NEMA IEC with 10–37 mm diameter spheres were filled with an 18F-FDG solution. The root mean square error (RMSE) of SUV, the detectability of 10-mm sphere, NECphantom, the background variability (N10mm) and the contrast-noise-ratio (QH,10 mm/N10mm) were calculated based on the phantom analysis. We also examined the quality of the acquired clinical images using the NECpatient, NECdensity, SNRliver, SUVliver and SUVlesion. In the phantom study on Vision scanner, RMSE was relatively lower when the iteration number was 2, 3 or 4. To satisfy a visual score of 1.5 and the reference range of QH,10 mm/N10mm, a 60-s or longer acquisition was required. Our clinical findings show that NECpatient averaged 17.4 ± 1.72 Mcounts/m in mCT and 29.1 ± 2.83 Mcounts/m in Vision. Furthermore, NECdensity averaged 0.29 ± 0.05 kcounts/cm3 in mCT and 0.53 ± 0.09 kcounts/cm3 in Vision, respectively, whereas SNRliver averaged 14.6 ± 3.77% in mCT and 21.3 ± 1.69% in Vision (P = 0.0156), respectively. Finally, SUVliver averaged 2.82 ± 0.28 and 2.55 ± 0.30, SUVlesion ranged 1.6–17.6 and 1.9–22.9 in mCT and Vision, respectively. SiPM-PET/CT provides superior image quality and quantification accuracy compared to PMT-PET/CT.

Bladder involvement is rare in endometriosis. The prevalence is estimated to be ∼1% in patients with endometriosis. However, this figure seems to be an underestimation. The diagnosis of bladder endometriosis might be missed during laparoscopy. The aim of this study was to determine an intraoperative visual score of pelvic lesions that help the surgeon suspect bladder endometriosis. Design, Design Classification: A retrospective analysis was performed on the intraoperative photographs and videos of 69 patients with histological confirmation of bladder endometriosis.A tertiary referral center.Sixty-nine patients with bladder endometriosis were operated on in our center over a 9-year period.Evaluation and analysis of intraoperative laparoscopic findings.We found three subtypes of laparoscopic findings that can assist with diagnosing bladder endometriosis. The most prominent sign was named "kissing round ligaments" (Type K), in which the right and left round ligaments appear closer to each other than usual or even touching one another. This sign is strongly associated with full-thickness invasion of the bladder. Other laparoscopic findings that indicated bladder endometriosis were anatomical distortion (Type A) and proximal occlusion of the tubes (Type B). We further define a scoring system for the lesion that correlates with the severity of the bladder endometriosis from superficial lesions to full thickness.Bladder endometriosis is a rare condition and often remains undiagnosed. Indeed, even during surgery, bladder endometriosis can be missed if the operator is not aware of the suggestive signs. Operative laparoscopic findings may help the surgeon to diagnose bladder endometriosis, and these signs correlate with the severity of the disease.

The point-of-care strip assay for the detection of the schistosome Circulating Cathodic Antigen (POC-CCA) in urine has shown to be a user-friendly and sensitive alternative to stool microscopy for the diagnosis of Schistosoma mansoni infections. However, visual scoring of the test is by definition observer dependent and leads to discussion about the qualitative interpretation, in particular in low intensity infections when test lines tend to be weak. In order to standardise visual scoring, an innovative approach for semi-quantitative interpretation of the POC-CCA cassettes, called G-scores, was developed and evaluated. Urines (n = 110) from a S. mansoni endemic area were used to evaluate this new approach. Test lines of the POC-CCA were visually compared against the G-scores, i.e. a series of artificial cassettes containing inkjet-printed strips of different intensities in order to grade the POC-CCA test line on a scale of 1 to 10. A significant positive correlation (Spearman 0.660, p

Purpose Quantification of calretinin-stained mucosal nerve fibers by image processing and analysis (IPA) may objectively define the transition zone (TZ) of Hirschsprung disease (HD). We tested the utility of IPA as an adjunctive tool in HD. Materials and Methods Calretinin immunostain was performed on 15 HD pull-through specimens, and multiple images were captured from the proximal aganglionic zone, TZ, and probable normal zone (NZ). Pixel count (PC), defined as the percentage of brown-stained pixels in the mucosa, was quantified and plotted against distance from the rectal distal end. To validate the method, PCs from 45 images were compared with three-tiered visual scoring by five pathologists. Results were correlated against pertinent variables, which were retrieved from the clinical record. Results The PC gradually increased in the TZ toward the proximal resection margin in 10/13 (77%) cases. The PC variation in the probable NZ and around the circumference was substantial by the coefficient of variation. The mean PC of images with a visual score of 1 was less than scores of 2 and 3 by all five (100%) pathologists (p Conclusion While the mucosal calretinin staining gradually increases in the TZ, for now, the boundaries of the TZ cannot be accurately defined by mucosal biopsies given the substantial variation of staining around the circumference at the same distance and in the NZ. However, the IPA technique does provide a continuous variable and warrants further utility in HD studies.

Objective: To evaluate whether a simple semi-quantitative method aided by software enhanced visualization can be reliable enough for the quantification of emphysema during the daily workload. Patients and methods: Thirty patients with COPD were included. Patients had a standard non enhanced MDCT study of the chest using a 16 slice machine. The images were evaluated visually and scored. This scoring was repeated after applying a density mask. Three radiologists evaluated the images on separate occasions. Repeatability was also tested. The CT emphysema index and the mean lung attenuation were calculated. The extent of airway disease was not assessed. Results: Kappa test between the 3 readers revealed slight agreement (k = 0.122, p = 0.001) before the density mask and substantial agreement (k = 0.75, p

Objective The Lund–Mackay system (L–M system) is widely used for computed tomography (CT) evaluation of chronic rhinosinusitis (CRS). However, a major drawback of the L–M system is its insufficiency of gradation. To avoid this deficiency, a new staging system proposed by American societies and the Zinreich system were reported as modifications of the L–M system. The aim of this study was to investigate the efficiency of gradation and the accuracy of the visual quantification of these modified staging systems. Methods Preoperative CT scanning was performed on 20 adult patients with CRS. A computer workstation was used to measure the volume of each sinus and the volume of inflammatory disease in each sinus. Then the soft tissue density rate (STDR) and objective scores, which were adapted to each system, were calculated. Visual evaluation of the CT images was performed using these systems. The visual score with each staging system and STDR value were evaluated for a correlation, and the rate of agreement was determined between the visual and objective scores obtained with each staging system. Results The correlation between the visual scores and the STDR values was shown with all staging system including L–M system. The coefficients of correlation between the visual scores and the STDR values with these modified systems were higher than with the L–M system. While the agreement rates with these modified systems were significantly lower than with the L–M system, differences of 2 or greater between the subjective and objective scores were rare. Conclusion We cannot conclude that one of these three staging systems is superior to the other. With this study, the simple grading system such L–M staging score was considered easy and accurate method to use the clinical level. The modified staging systems showed more efficient ability to gradate in evaluating rhinosinusitis inflammation compared with the L–M system and also showed acceptable accuracy.

Purpose To determine the value of cardiac MRI for the monitoring and the prognosis of patients with acute myocarditis. Cardiac MRI plays an increasingly important role in the diagnosis of acute myocarditis. However, it is less established as a prognostic tool, which requires specific postprocessing of images. Materials and Methods In a prospective pilot study, we assessed the prognostic value of the evolution in a simplified visual quantitative score (SQS) of late gadolinium enhancement (LGE) between initial hospitalization and 3 months later. The prognostic value was assessed at 1 year using a combination of death, heart transplant, and confirmed recurrence as main outcome. Results Twenty-eight patients were included in this study. A significant correlation was found between LGE measured by SQS and planimetry (r = 0.95, P

Although dual-energy (DE) acquisition with conventional 201Tl myocardial perfusion SPECT has several advantages such as improved attenuation of the inferior wall and increased acquisition counts, the characteristics of IQ-SPECT have not been fully evaluated. We evaluate the difference of characteristics between single-energy (SE) and dual-energy (DE) imaging using 201Tl myocardial IQ-SPECT. Two myocardial phantoms were created simulating normal myocardium and infarction of the inferior wall. Energy windows were set at 70 keV ± 10% for SE, and an additional 167 keV ± 7.5% for DE. SPECT images were reconstructed using the ordered subset conjugates gradient minimizer (OSCGM) method. We visually and quantitatively compared short-axis images of correction for no (NC), for attenuation (AC) or for both AC and scatter (ACSC) images. The average counts of SE and DE projection data were 17.5 and 20.3 counts/pixel, respectively. The DE data increased acquisition counts by approximately 16% compared with the SE data. The average visual score of normal myocardium did not differ significantly between the SE and DE images. However, the DE image of defective myocardium showed a significantly lower score in AC than SE images. The % uptake values of DE image with both NC and AC were significantly higher than those of SE images. The DE images of the inferior defective areas (segments 4 and 10) showed approximately 5–10% higher uptake compared with the SE images. The DE image with NC improved attenuation of the inferior wall. However, DE image with AC showed low defect detectability. Thus, AC should be used with SE rather than DE. Furthermore, while the SE image with ACSC can be used to detect perfusion defects, it must be interpreted carefully including the possibility of artificial inhomogeneity even in the normal myocardium.

Justificación: La flebitis es una de las complicaciones mas frecuentes de los Catéteres Centrales de Inserción Periférica. La evidencia científica sobre la utilidad de las escalas de medición para el diagnostico de flebitis es escasa. Objetivos: Comparar la incidencia de flebitis antes y después de la implementación de un protocolo. Material y métodos: Estudio de cohortes retrospectivo en 159 pacientes ingresados en UCI, a los que se les ha colocado un PICC, en dos periodos equivalentes de dos años consecutivos, Periodo 1 (n=59); frente a un grupo del Periodo 2 (n=100) en el que se aplicó un nuevo protocolo para el diagnóstico y manejo de flebitis (definición de flebitis, aplicación de la Visual Infusion Phlebitis Score y valoración continua). Resultados: El riesgo de ser diagnosticado de flebitis fue significativamente menor en el P2 (OR: 0.09, I.C.95% 0.01-0.52) Conclusiones: La incorporación del protocolo redujo un 90% los diagnósticos de flebitis. ABSTRACT: Phlebitis incidence related to peripherally inserted central catheters (PICCs): New nursing protocol application. Phlebitis is one of the most common complications of peripherally inserted central catheters (PICCs). The scientific evidence about the utility of measuring scales to phlebitis diagnosis is very limited. Objectives: To compare phlebitis incidence rate before and after the introduction of a new protocol. Materials and Methods: Retrospective cohort study in 159 patients admitted to the intensive care unit (ICU) for two years. First we assess phlebitis in 59 patients (group 1). After that we apply a new protocol to identify phlebitis with visual score and continuous evaluation to 100 patients (group 2) Results: The probability of being diagnosed of phlebitis is significantly smaller in intervention group (OR: 0.09; 95% C.I.: 0.02-0.57). Conclusions: Protocol application reduced the diagnosis of phlebitis in 90%

To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa). Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0–800 s/mm2) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA. Choice of b values had a highly (P

Background: For quantitative evaluation of masticatory ability of the elderly patients, there should be a simple and reliable method without special techniques and instruments. Objective: The purpose of this study was to examine the validity and reliability of a visual scoring method for assessing masticatory performance. Materials and Methods: A 10-stage scale for visually scoring was rated based on the range of the glucose concentration dissolved from comminuted jelly. Photographic images of comminuted jellies were produced as a standard material for each score. Fifty subjects were recruited as raters who graded the visual score for 50 photographic images of comminuted jellies on the screen of a lap-top three times in random order. Results: There were strong correlations (rs = 0.911– 0.981, Spearman’s rank coefficient) between the actual scores determined from the glucose concentration and the visual scores graded by subjects in all three measurements. The intraclass correlation coefficients (ICCs) of the inter-rater reliability and the ICCs of the intra-rater reliability of the visual scoring ranged from 0.946 to 0.947 and from 0.860 to 0.987 in three measurements, respectively. Conclusions: These results indicated that the visual scoring method was valid and reliable for evaluation of masticatory performance.

ObjectivesCam morphology is not completely understood. The aim of this study was threefold: (1) to investigate if cam morphology development is associated with growth plate status; (2) to examine whether cam morphology continues to develop after growth plate closure; and (3) to qualitatively describe cam morphology development over 5-year follow-up.MethodsAcademy male football players (n=49) participated in this prospective 5-year follow-up study (baseline 12–19 years old). Anteroposterior and frog-leg lateral views were obtained at baseline (142 hips), 2.5-year (126 hips) and 5-year follow-up (98 hips). Cam morphology on these time points was defined as: (A) visual scores of the anterior head-neck junction, classified as: (1) normal, (2) flattening, and (3) prominence; and (B) alpha angle ≥60°. Proximal femoral growth plates were classified as open or closed. Cam morphology development was defined as every increase in visual score and/or increase in alpha angle from ResultsCam morphology development was significantly associated with open growth plates based on visual score (OR: 10.03, 95% CI 3.49 to 28.84, pConclusionCam morphology of the hip is more likely to develop with an open growth plate.

Refractive findings are reported in a follow-up study comprising 88 children aged 7-10 years, who were submitted to regular control for retinopathy of prematurity (ROP) in the first months after their pre-term delivery 1982-84 (mean birthweight 1467 g, mean gestational age 31 weeks). The refractive range was -13 to +6.75 D. In four subjects with fully-blown ROP both eyes were left blind and dysmorphic. Twenty-four had had ROP with regression; myopia of prematurity (MOP) appeared in six (25%). At follow-up the myopia frequency in the remaining 60 without ROP was 5%. Out of the 9 subjects with uni- or bilateral myopia of prematurity three had no evidence of early ROP. With a median corrected acuity of 0.5 only, the eyes with MOP had a lower corrected visual score than in the rest of the material (median monocular acuity 0.9). The latter value is even a little lower than what was previously reported in full-terms of a similar age (median acuity above 1.0). Obviously, as a sequel to the pre-term delivery we are dealing not only with early myopia in some subjects; further, the potential for developing full vision appears influenced and reduced. This applies to the total group of ex-prematures, but in particular it is valid for myopia of prematurity.

PURPOSE To analyze computed tomography (CT) characteristics of adrenal adenomas with hypercortisolism on adrenal CT compared to adenomas with hyperaldosteronism. MATERIALS AND METHODS Thirty-two adrenal adenomas, consisting of group A (hypercortisolism, n = 16) and group B (hyperaldosteronism, n = 16), were evaluated with adrenal CT. Thirty-four patients without adrenal nodule on CT and hormonal abnormality (group C) were selected for comparison. In adenomas, lesion size, attenuation value, and absolute and relative washout were compared between groups A and B. The mean adrenal thickness was compared quantitatively and qualitatively between groups. RESULTS All of adenomas satisfied absolute (≥60%) or relative (≥40%) washout criteria of adrenal CT. The mean adrenal thickness was 1.6 ± 0.3 mm in group A, 2.9 ± 0.5 mm in group B, and 3.0 ± 0.4 mm in group C (group A versus B or C, P < 0.001; group B versus C, P = 0.775). For differentiating group A from B, the area under the curve of quantitative and qualitative analyses for contralateral adrenal thickness was 0.982 and 0.934, respectively. Both sensitivity and specificity with cutoff of 2.0 mm or less in thickness and probably thin or more in visual score were 93.7% and 93.7%, and 87.5% and 93.7%, respectively, for predicting group A. CONCLUSIONS Contralateral adrenal thinning on CT helps predict adrenal adenomas with hypercortisolism.

A 71-year-old African man without history of cardiac disease was referred to our center for dyspnea. Transthoracic echocardiogram and cardiac MRI were suggestive of cardiac amyloidosis (CA). The diagnosis of the light-chain cardiac amyloidosis (AL-CA) was made after a first endomyocardial biopsy. Accordingly chemotherapy was started. Systematic 99mTc-HMDP scintigraphy showed moderate cardiac uptake (visual score of 2), unusual for AL-CA, and permitted to rectify the diagnosis. Hereditary transthyretin cardiac amyloidosis was confirmed by a second endomyocardial biopsy with a positive Congo-red and anti-transthyretin antibody stainings, mass spectrometry and genetic analysis (Val122Ile mutation).

The general aim of this experiment was to investigate the processes involved in reading musical notation and to study the relationship between written music and its auditory representation. Our main interest was to determine if musicians can develop expectancies for plausible or implausible auditory events on the sole basis of the visual score. Results showed that musicians can clearly expect auditory endings on the basis of visual information. These findings enliven the discussion on the question of whether music reading is actually music perception.

Clean wool colour (CWC) is an important wool price determinant and has been related to suint characteristics, i.e. sudoriparous and sebaceous gland secretions, such as suint percentage and suint K content. In this work heritability, phenotypic and genetic correlations among wool colour and skin traits were examined. The genetic estimates were assessed by Restricted Maximum Likelihood (REML) procedures using average information algorithm (AIREML) in a Corriedale flock. The traits analysed were wool colour traits (CWC), yellow predictive colour (YPC), and Visual Score; suint traits such as suint percentage and potassium and sodium concentrations in suint, and physiological traits such as potassium and sodium concentrations in the skin, including plasma and red blood cells. The objectives of this study were to assess phenotypic and genetic correlations between wool colour and skin traits, and to find the suitability of these traits as indirect selection criteria for clean wool colour. Suint traits were highly genetically correlated to YPC. Suint K, but not suint percentage, was found to have a high genetic correlation with CWC. Skin K, Visual Score, YPC and suint K were amongst the best indirect selection criteria for clean wool colour. However, selection using these traits was expected to reduce CWC from 52% to 49% of that estimated under direct selection.

Objective The purpose of this study was to investigate the relationship between visual score of emphysema and homology-based emphysema quantification (HEQ) and evaluate whether visual score was accurately predicted by machine learning and HEQ. Materials and methods A total of 115 anonymized computed tomography images from 39 patients were obtained from a public database. Emphysema quantification of these images was performed by measuring the percentage of low-attenuation lung area (LAA%). The following values related to HEQ were obtained: nb0 and nb1. LAA% and HEQ were calculated at various threshold levels ranging from −1000 HU to −700 HU. Spearman’s correlation coefficients between emphysema quantification and visual score were calculated at the various threshold levels. Visual score was predicted by machine learning and emphysema quantification (LAA% or HEQ). Random Forest was used as a machine learning algorithm, and accuracy of prediction was evaluated by leave-one-patient-out cross validation. The difference in the accuracy was assessed using McNemar’s test. Results The correlation coefficients between emphysema quantification and visual score were as follows: LAA% (−950 HU), 0.567; LAA% (−910 HU), 0.654; LAA% (−875 HU), 0.704; nb0 (−950 HU), 0.552; nb0 (−910 HU), 0.629; nb0 (−875 HU), 0.473; nb1 (−950 HU), 0.149; nb1 (−910 HU), 0.519; and nb1 (−875 HU), 0.716. The accuracy of prediction was as follows: LAA%, 55.7% and HEQ, 66.1%. The difference in accuracy was statistically significant (p = 0.0290). Conclusion LAA% and HEQ at −875 HU showed a stronger correlation with visual score than those at −910 or −950 HU. HEQ was more useful than LAA% for predicting visual score.

The study analysed the effect of frozen storage duration (FSD) on lamb sensory quality. Trained panel evaluated Longissimus lumborum aged for 1d in unfrozen carcass plus 3d in modified atmosphere packaging on thawed (1, 9, 15 or 21 month FSD) or refrigerated (0 month FSD) meat. Consumer acceptability test was performed on leg chops (Semimembranosus) kept in the same conditions but those chops for the visual test were retail displayed up to 10d from packaging. FSD differed on texture variables and fresh meat showed intermediate values among thawed meats for trained evaluators. Consumers gave the lowest acceptability to 21 months FSD and preferred 1 month FSD, being all meats 'acceptable'. A third of the population scored fresh meat with the lowest acceptance after consumption, although its visual score remained 'acceptable' 3d longer than most of thawed meats. As thawed and fresh meats were equally preferred at short display, consumer concerns about thawed meat might be reconsidered.

Background/Purpose Nasolabial lines (NL) and wrinkles of the face are major features of aging. Wrinkles have been studied widely by morphological methods using 3-dimensional (3D) photographic analysis instrument, but NL were evaluated by visual scoring usually. To evaluate NL quantitatively, another method is needed. This study is purposed to find out quantitative method for evaluation of NL. Method One hundred Korean female subjects aged 20 to 60 were recruited in this study. Facial image was taken using light source adjusted VISIA-CR® and 3-dimensional wrinkle depth on the NL area was evaluated by Phase shift rapid in vivo measuring of human skin (PRIMOS®). The pixel number of NL area and the angle were obtained using processed images. The severity of NL was assessed by visual score. Skin elasticity was measured by Cutometer®MPA580. Statistical significance was determined at P

Background/aims: During the last decade several new bioengineering methods have been proposed for evaluation of patch test reactions in a more objective manner. The aim of the present study was to investigate the usefulness of erythema index (DermaSpectrometer) in a clinical setting, i.e., reading of allergic patch tests. Methods: Twenty patients with known allergy to formaldehyde participated in the study. Each patient had patch tests for 2 days with formaldehyde solutions from 0 to 10,000 p.p.m. applied. Clinical reading of the test sites and measurement of the erythema index by the DermaSpectrometer were done 24 h after removal. A control group of 20 volunteers with no allergy to formaldehyde were tested in a similar way. Results: Erythema indices were significantly higher for visually rated positive patch tests than for negative tests (P

The aim of this analysis was to evaluate a new visual scoring scale developed to facilitate the qualitative appraisal of lesion uptake on (18)F-fluorothymidine PET ((18)F-FLT-PET).Sixty-two patients with a pulmonary lesion of unknown aetiology who had undergone an F-fluorodeoxyglucose-PET/computed tomography (CT) suspicious for malignancy prospectively underwent an (18)F-FLT-PET/CT. Three nuclear medicine physicians independently reviewed each (18)F-FLT-PET/CT scan with knowledge of the location of the pulmonary lesion but blinded to the final diagnosis. They scored the lesion (18)F-FLT uptake as follows: (0) no visible uptake; (1)spleen; (2) ≥ spleen, butboth liver and marrow; (3) between liver and marrow; (4)liver andmarrow. Lesion mean (SUV(mean)) and maximum (SUV(max)) standardized uptake values were measured in a separate session.In all, 35 lesions were malignant and 27 were benign, as assessed on the basis of surgery, biopsy or follow-up of at least 12 months. Visual score, SUV(mean) and SUV(max) were statistically different between benign and malignant lesions. The visual scoring scale showed substantial to almost-perfect interobserver agreement with a weighted κ value of 0.84, 0.67 and 0.65 for each observer pair. The visual score was highly correlated to SUV(mean) and SUV(max) (r=0.83 and 0.87, respectively) and described a logarithmic pattern in relation to SUV(mean) and SUV(max) (r =0.67 and 0.72, respectively). The area under the receiver-operating characteristic curve for the visual score was 0.86 and was statistically different from that for SUV(mean) (0.77; P=0.026) and SUV(max) (0.79; P=0.047).The (18)F-FLT scoring scale we propose is easy to use with high interobserver agreement and a significantly better discriminative capacity compared with SUV measurements. It has the potential to harmonize the qualitative interpretation of (18)F-FLT-PET/CT in lung cancer diagnosis.

The aim of the current study was to evaluate the application of two advanced noise-reduction algorithms for dental micro-CT images and to implement a comparative analysis of the performance of new and current denoising algorithms.Denoising was performed using gaussian and median filters as the current filtering approaches and the block-matching and three-dimensional (BM3D) method and total variation method as the proposed new filtering techniques. The performance of the denoising methods was evaluated quantitatively using contrast-to-noise ratio (CNR), edge preserving index (EPI) and blurring indexes, as well as qualitatively using the double-stimulus continuous quality scale procedure.The BM3D method had the best performance with regard to preservation of fine textural features (CNREdge), non-blurring of the whole image (blurring index), the clinical visual score in images with very fine features and the overall visual score for all types of images. On the other hand, the total variation method provided the best results with regard to smoothing of images in texture-free areas (CNRTex-free) and in preserving the edges and borders of image features (EPI).The BM3D method is the most reliable technique for denoising dental micro-CT images with very fine textural details, such as shallow enamel lesions, in which the preservation of the texture and fine features is of the greatest importance. On the other hand, the total variation method is the technique of choice for denoising images without very fine textural details in which the clinician or researcher is interested mainly in anatomical features and structural measurements.

OBJECTIVE: To determine the prevalence of white spot lesions (WSLs) in orthodontic patients at 6 and 12 months into treatment using the visual examination method. MATERIALS AND METHODS: Patients 6 and 12 months into treatment were examined for the presence of WSLs. The control group consisted of patients who were examined for WSLs immediately after bonding. Upon clinical evaluation, teeth were given a visual score based on the extent of demineralization. RESULTS: The percentages of individuals having at least one WSL were 38%, 46%, and 11% for the 6-month, 12-month, and control groups, respectively. The 6-month (P = .021) and 12-month groups (P = .005) were significantly different from the control group but were not significantly different from each other (P = .50). Of subjects in the study who had at least one visible WSL, 76% were males and 24% were females (P = .009). CONCLUSIONS: This clinical study showed a sharp increase in the number of WSLs during the first 6 months of treatment that continued to rise at a slower rate to 12 months. Clinicians should evaluate the oral hygiene status of patients during the initial months of treatment and, if necessary, should implement extra measures to prevent demineralization.

In the contemporary information jungle, it keeps getting harder for advertisers to be noticed. Advertisements that fail to attract even the lowest levels of the attention cannot be effective. Therefore, advertisers try to find clever ways to catch the eye of the consumer. Especially in magazines, advertisers need to come up with new ideas as the clutter of brands is high and advertisements have to compete with the editorial content surrounding them.

The use of computer-assisted diagnosis has become widespread in cardiac nuclear medicine. Quantitative programs are commercially available for ventriculography, phase analysis, and thallium 201 perfusion studies. The goal of these programs is to eliminate interobserver variability by objectively analyzing the studies without causing a loss of accuracy. In addition, by using quantitative data not apparent on visual inspection, some programs attempt to increase sensitivity for disease above that possible by the visual reading of images. Programs that analyze perfusion studies to detect coronary artery disease have received the most interest. Results have varied, but sensitivities as high as 95% have been reported. This review discusses the techniques of computer-assisted diagnosis for thallium 201 myocardial-perfusion studies. The circumferential and washout profile methods are discussed in detail.

Thermographic imaging is a noninvasive diagnostic tool used to document the inflammatory process in many species and may be useful in the detection of subclinical bumblefoot and other inflammatory diseases. Bumblefoot is a chronic inflammation of the plantar metatarsal or digital pads of the foot (pododermatitis), or both. It is one of the major health problems in birds including chickens and is responsible for significant economic losses in commercial poultry operations. Early diagnosis of bumblefoot is essential for the prevention of economical loss and the improvement of animal well-being. The object of this study was to determine the suitability of thermography for the identification of subclinical bumblefoot in chickens. Experiment 1 was designed to validate thermography as a tool for screening avian populations for bumblefoot. The plantar surface of the feet of 150 randomly selected hens was imaged using a thermal camera. The thermal images were identified as suspect, positive, or negative for bumblefoot based on thermal patterns of the plantar surface. Visual inspection of the feet identified as suspect followed 14 d later. A visual score of clinical, mildly clinical, or negative for bumblefoot was assigned, based on gross pathological changes in the plantar surface. A correlation between initial thermal images identified as suspect for bumblefoot and a visual score of positive 14 d later was 83% (P < 0.01). In experiment 2, hens whose feet were free of lesions were inoculated in the metatarsal foot pad with Staphylococcus aureus. Thermal images and visual clinical scores were taken, prechallenge and 1, 2, 3, 4, and 7 d postchallenge. The correlation between thermal images classified as clinical and a visual score of clinical for bumblefoot was 86.7% (P < 0.001). However, the correlation between the thermal images classified as mild (subclinical) and a visual score of mild was only 26.7%, suggesting that thermography is a more sensitive indicator of subclinical infection than visual appraisal. Thermography may thus provide a useful tool for screening avian populations for signs of bumblefoot, early in the course of the disease, which will improve recovery percentages and bird well-being.

The objective of this study was to determine the worst case levels of organic soil on surgical instruments and whether the commercially available TOSI((R)) provided a clinically relevant organic challenge to an instrument washer. Our data showed that protein and haemoglobin levels (374 and 111microg/cm(2), respectively) from the instruments evaluated correlated with those on a TOSI that had a visual score of 2-3 (267 and 60microg/cm(2), respectively). However, the regular TOSI (without the plastic cover) and the TOSI Lum-Chek do not present difficult cleaning challenges; therefore, a visual TOSI score of 1-5 after processing in an automated washer represents a serious cleaning problem. Our results showed that surgical instruments may have high post-cleaning levels of carbohydrate (up to 352microg/cm(2)) and endotoxin (up to 25 373EU/cm(2)), suggesting unrecognised issues with the quality of water used for the final rinse. The average carbohydrate and endotoxin levels post procedure and before cleaning were 138.9microg/cm(2) and 18.14EU/cm(2), respectively. The average protein and haemoglobin levels both showed >99% reduction in levels post cleaning. Our data support the need to monitor the water quality used in instrument washers. In addition, there is an urgent need for establishment of standardised criteria for rapid cleaning indicators for instrument washers to ensure that they provide a clinically relevant method for monitoring washers used in healthcare facilities.

A new method for assessment of dermal exposure to pesticides in subsistence farmers by use of determinants of dermal exposure is described. The method, called the determinants of dermal exposure ranking method (DERM), is a combination of checklists and expert rating assessment. Thus, determinants are listed in a form, which is used to check their presence and to assess them using a simple algorithm based on two factors, the type of transport process (T value) and the area of body surface exposed (A value). In addition, the type of clothing worn during applications is included as a protection factor. We applied the DERM to real pesticide applications, characterizing dermal exposure and comparing DERM estimates with earlier developed semiquantitative visual scores based on fluorescent tracer, the total visual score (TVS) and contaminated body area (CBA). DERM showed a very good level of agreement with both the TVS (r = 0.69; P = 0.000) and the CBA (r = 0.67; P = 0.000). DERM allowed identification of the determinants that had the highest effect on exposure and the farmers with the highest exposure. In conclusion, DERM provided information on the determinants responsible for dermal exposure in a group of subsistence farmers. This can be useful to design monitoring and preventive programs, define priorities for intervention and prioritize and select most adequate measurement strategies. DERM promises to be a low-cost easy-to-use method to assess dermal exposure to pesticides in developing country conditions.

Eight parents and 28 F1s excluding reciprocals were tested for three salinity tolerance traits viz., Na + concentration, Na/K ratio and visual score at EC 9.0-9.5 dS/m to know the genetic information and the nature of combining ability of the parents and their performances in F1 hybrids. Mean values of F1s for shoot Na + , Na/K ratio, and visual score were lower compared to parents indicated dominance of tolerance. Significant GCA and SCA effects in all the traits suggest the importance of both additive and non-additive gene actions. Much higher GCA effects than SCA effects indicated preponderance of additive gene action for salinity tolerance. Pokkali, Nonabokra, and Binnatoa were the good general combiners. Most of the best crosses were obtained from susceptible parents crossed with tolerant parents. Transfer of salinity tolerant traits from these varieties to modern varieties may offer potential for increasing the level of salinity tolerance in rice. Bangladesh J. Agril. Res. 32(2) 2007: 183-189.

Background/purpose: The intensity of steroid-induced skin blanching is usually evaluated subjectively by a trained observer using a visual score although a few methods have been described for doing this objectively. In this study we wished to establish whether the effects of topical steroids can be detected by measuring the electrical impedance of the skin. Methods: Ten healthy volunteers were treated with three concentrations of clobetasol propionate (0.005, 0.05, and 0.5 mg/mL) on the forearm covered by a dressing overnight. On the following morning, we assessed dermal blanching using a visual score, laser Doppler flowmetry and electrical impedance. Results: Using the visual score, we found dose–response blanching at all concentrations of clobetasol propionate. The laser Doppler flow values declined significantly after the application of clobetasol propionate (0.005 mg/mL (P

SummaryThis study was to examine the clinical differences between Stage 0 and normal subjects, using low-dose chest computed tomography (CT) and pulmonary function tests. Enrolled subjects performed as a health check for lung cancer screening including low-dose CT and pulmonary function tests. Subjects were divided into Stage 0, chronic obstructive pulmonary disease according to pulmonary function tests, and normal subjects. The severity of emphysema (visual score) was calculated on three low-dose CT slices. Low-dose CT and pulmonary function tests were performed in 1359 men and 888 women. The numbers and percentages of men and women smokers were 1076 (79.2%), and 107 (12.0%), respectively. A total of 722 individuals had one or more respiratory symptoms, such as cough (69.8%), sputum (75.8%), or shortness of breathing (0.83%). Of the 722 subjects, 71 (9.8%) individuals satisfied the criteria of chronic respiratory symptoms. Among the normal subjects, smoking caused differences in airflow limitation as a result of pulmonary function tests. The proportion of smokers and the visual score were significantly higher in Stage 0 than those in the normal subjects. The percentages of the maximal mid-expiratory flow (%MMF) and of the peak expiratory flow rate were significantly lower in Stage 0 than in the normal subjects. %MMF and the proportion of visual score were significantly lower in the smoking Stage 0 than in the nonsmoking Stage 0 subjects. Smoking would indicate early signs of emphysematous change between Stage 0 and normal subjects in comparison of pulmonary function tests and visual score of low-dose CT.

Objectives: To evaluate the utility of 3D-FASE for the visualization of salivary gland ducts for use in MR sialographic sequences. Methods: We compared MR sialographic images and virtual endoscopic views from 3D-FASE with those from three kinds of sequences described by previous reports in a 3D parotid gland duct model and volunteer. The four sequences were two-dimension fast spin-echo (2D-FSE), three-dimension fast spin-echo (3D-FSE), two-dimension fast asymmetric spin-echo (2D-FASE), and three-dimension fast asymmetric spin-echo (3D-FASE). Results: In the 3D parotid gland duct model, image visibility on visual score was clearest with 3D-FSE, followed by 3D-FASE (P = 0.028). In the volunteers, the visualization of images improved in the following order: 3D-FASE > 3D-FSE > 2D-FSE > 2D-FASE. Conclusions: The technique of 3D-FASE sequencing is more suitable and useful for MR sialography with an appropriate acquisition time.

The severity of psoriasis has been traditionally assessed by measures, such as the psoriasis area and severity index (PASI), the psoriasis severity scores, and the lesional severity scores. As a result, even experienced dermatologists show variations when attempting to determine the severity of psoriasis. Therefore, a better non-invasive and objective measurement of clinical signs is needed. In this study, an instrument, a so-called 'stereoimage optical topometer' (SOT), based on a new concept of 'stereoimaging' was used to measure the three-dimensional skin surface. The aim of this study was to compare the results obtained by the SOT with the visual score of psoriasis lesion. Thirty psoriatic patients were enrolled in this study. Initially, the severity of the infiltration and the scale of 134 psoriatic lesions were assessed by using a visual scoring system (0: none, 1: mild, 2: moderate, 3: severe, and 4: very severe), as scored by five dermatologists. The SOT was then used to quantify the severity of each psoriatic lesion using four three-dimensional SOT parameters (Sa, SL, SA, and SV). Secondly, the involved skin-surface area in the psoriasis cases was scored by the naked eye by the five dermatologists and by image analysis. Statistically significant differences were observed between grades 0, 1, 2, and 3 in terms of the severity measurements of the individual psoriatic lesions by SOT when using the parameters Sa, SL, SA, and SV. Therefore, it was concluded that there is a strong correlation between the results measured by visual scoring and by SOT in psoriasis.

Available techniques for diagnosis and evaluation of right ventricular (RV) function are limited. In patients with arrhythmogenic right ventricular dysplasia (ARVD) it is of great importance to assess RV wall motion and function for diagnosis, prognosis and treatment. Contrast echocardiography and videodensitometry can be used to illustrate regional and global RV hemodynamics. The authors investigated patients with ARVD and healthy volunteers by this method. An off-line analysis system was used for calculation of time intervals and indices of contrast dynamics in different regions of the right ventricle. The data were also color-coded to illustrate, in one single image, the dynamic process of the contrast. The RV wall motion was also assessed by a visual score system. The patient group showed longer time intervals for the processing of the contrast in the right ventricle than the healthy group. The color pattern for the whole process showed regional disturbances in the patient group which corresponded to the wall motion abnormalities as compared to the normals. Color-coded contrast echocardiography with videodensitometry quickly and easily demonstrated disturbances in filling and elimination patterns as signs of abnormal RV function, both regional and global, in patients with ARVD compared to healthy controls.

The effect of a protective cream was tested in a new tandem repeated irritation test with tandem application of 0.5% sodium lauryl sulphate (SLS) and undiluted toluene. The irritants were applied twice daily for 30 min to the ventral forearms of 20 volunteers. Irritant cutaneous reactions were quantified by a visual score, transepidermal water loss, chromametry and skin capacitance. Concurrent application of SLS/toluene induced stronger reactions than those caused by twice daily application of each irritant on its own. A protective effect of the protective cream was obtained against all treatment combinations and was significant for SLS/SLS (p < or = 0.01) and SLS/ toluene (p < or = 0.05). Our results indicate that the tandem repetitive irritation test has great potential in the evaluation of skin care products to prevent irritant contact dermatitis.

Skin-compatible hand cleansing is crucial for the prevention of occupational dermatitis. In this article we give an overview of skin-cleansing products and their ingredients and investigate whether solvents or abrasives could be avoided in cleansers for severely soiled skin. Comparison of skin compatibility, cleansing power and effectiveness of different formulations of skin cleansers was performed via Duhring chamber tests [visual score, trans-epidermal water loss (TEWL)] and standard hand-wash tests. The results show that, dependent on the grade of contamination, a range of skin cleansers that allow adequate skin cleansing, is necessary. Solvents could be avoided, by the use of powerful cleansing systems based on tenside/oil mixtures. Only for special contaminations may solvents be useful. Powerful cleansing activity could be performed without abrasives. The worker must be able to choose the skin cleanser that is adequate for the contamination that is present. Therefore, information and education of the workers are crucial for skin-compatible skin cleansing.