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Background: The prostate stroma is a key mediator of epithelial differentiation and development, and potentially plays a role in the initiation and progression of prostate cancer. The tumor-associated stroma is marked by increased expression of CD90/THY1. Isolation and characterization of these stromal cells could provide valuable insight into the biology of the tumor microenvironment.Methods: Prostate CD90+ stromal fibromuscular cells from tumor specimens were isolated by cell-sorting and analyzed by DNA microarray. Dataset analysis was used to compare gene expression between histologically normal and tumor-associated stromal cells. For comparison, stromal cells were also isolated and analyzed from the urinary bladder.Results: The tumor-associated stromal cells were found to have decreased expression of genes involved in smooth muscle differentiation, and those detected in prostate but not bladder. Other differential expression between the stromal cell types included that of the CXC-chemokine genes.Conclusion: CD90+ prostate tumor-associated stromal cells differed from their normal counterpart in expression of multiple genes, some of which are potentially involved in organ development. [ABSTRACT FROM AUTHOR]

Introduction: Despite significant improvements in recent years, maternal and neonatal health outcomes remain poor in many regions of the world. One such area is in the remote mountainous regions of Nepal. The purpose of this study is to describe the current antenatal care practices and delivery support in a mountainous district of Nepal., Methods: This study took place in Solukhumbu District between December 2015 and February 2018. A household survey was created using evidence-based maternal and neonatal care indicators. Women who had delivered within the previous two years were surveyed regarding antenatal and delivery care they received. A standardized health facility survey was used to evaluate the operational status of health facilities. The study was approved by the Nepal Ministry of Health and the University of Utah IRB., Results: A total of 487 households and 19 facilities were surveyed. 35.7% (174/487) of deliveries occurred in a health facility (hospital, primary health care center or birthing center). 35.2% (171/486) of deliveries were attended by a skilled birth attendant. 52.8% (47/89) of women who did not deliver in a facility noted that transportation issues and not having sufficient time to travel during labor prevented them from delivering in a facility. No health posts had staff trained in obstetric and neonatal emergencies., Discussion: The majority of women in Solukhumbu District do not receive high quality antenatal and delivery care. An intervention that would make antenatal care and delivery support more accessible could improve maternal and infant outcomes in this district and other similar regions., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Aim: To assess the effect of cine frame rate on the accuracy of the detection of pulmonary nodules at computed tomography (CT)., Materials and Methods: CT images of 15 consecutive patients with (n = 13) or without (n = 2) pulmonary metastases were identified. Initial assessment by two thoracic radiologists provided the "actual" or reference reading. Subsequently, 10 radiologists [board certified radiologists (n = 4) or radiology residents (n = 6)] used different fixed cine frame rates for nodule detection. Within-subjects analysis of variance (ANOVA) was used to evaluate the data., Results: Eighty-nine nodules were identified by the thoracic radiologists (median 8, range 0-29 per patient; median diameter 9 mm, range 4-40 mm). There was a non-statistically significant trend to reduced accuracy at higher frame rates (p=0.113) with no statistically significant difference between experienced observers and residents (p = 0.79)., Conclusion: The accuracy of pulmonary nodule detection at higher cine frame rates is reduced, unrelated to observer experience., (Copyright 2009 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Vertebral artery injury may occur at the time of cervical fracture or dislocation. Congenital vertebral artery variations, especially a double vertebral artery origin, may be responsible for angiographic findings that mimic vertebral artery dissection. Two cases of cervical spine fracture with ipsilateral double vertebral artery are presented. Conventional cerebral angiography is the easiest and best way to make this diagnosis and to exclude vertebral artery dissection.

Anterior atlas clefts (AACs) are rare developmental variants that may mimic fractures. Due to the potential severe implications of craniocervical junction trauma, expeditious differentiation between a Jefferson burst fracture and a congenital cleft is essential in trauma patients. Three cases of AAC are presented. Two cases demonstrated incidental AACs; the third case was associated with a Jefferson burst injury. Computed tomography is most helpful in evaluating the integrity of the atlas; however, plain radiography or pluridirectional tomography are best for evaluating displacement of the lateral masses of C1 in relation to C2.

The hyperdense middle cerebral artery sign is a CT predictor of the development of a large cerebral infarct. The limits of detectability were tested in a blinded, then unblinded analysis of CT scans from 25 acute stroke patients. In the initial blinded analysis, sign detection exhibited the following mean values: sensitivity, 78.5%; specificity, 93.4%; positive predictive value, 66%; negative predictive value, 96.4%; accuracy, 91.3%. Kappa statistics analysis indicated poor interobserver agreement (k = .38). Results of unblinded analysis were as follows: sensitivity, 69%; specificity, 94.4%; positive predictive value, 82.8%; negative predictive value, 88.7%; accuracy, 87.3%. There was fair unblinded interobserver agreement (k = .53). Unblinded analysis had a lower false-positive frequency and did not increase the number of true-positive determinations. We conclude that detection of the hyperdense middle cerebral artery sign on CT scans by multiple observers is a sensitive, accurate, and predictive indicator of middle cerebral artery thromboembolism.

Using seven illustrative cases, the authors discuss the computerized tomographic (CT) appearance of cranial epidermoid tumors. These tumors are of low density (-2 to +10 EMI units), seldom show calcification, and do not enhance with contrast medium. Their differentiation from dermoid tumors and craniopharyngiomas is also discussed.

Two giant thrombosed aneurysms of the middle cerebral artery are reported with a review of the pertinent literature. A tortuous channel through the thrombus results in an unusual and characteristic angiogram. Mechanisms involved in the formation of this lesion are discussed.

The authors' experience using the Debrun detachable balloon catheter system in occluding surgically-created carotid-jugular fistulas is described. Useful technical points in preparing and using the system are outlined. Technical failures were encountered both in creation of the fistula model and in use of the system, and their occurrence is documented. It is concluded that, when familiarization with the system's operation is attained, the detachable balloon catheter system promises to offer a valuable method of treatment of traumatic carotid-cavernous fistulas in humans.

An example of the internal carotid artery supplying the posterior inferior cerebellar artery directly is reported. The direct PICA supply comes from a trigeminal trunk. There was no basilar artery opacification. An embryological explanation is given.

Digital subtraction angiography (DSA) with intravenous contrast injection was performed on 500 consecutive adult patients and evaluated for image quality of the carotid artery bifurcations. Diagnostic quality examinations were obtained in 974 common, 925 internal, and 904 external carotid artery segments. Sixty-two patients had standard carotid arteriography around the same time as DSA. Agreement of standard arteriograms with diagnostic quality DSA examinations was noted in 97 of 98 common, 94 of 95 internal, and 79 of 91 external carotid artery segments. All cases of complete carotid occlusion (14 of 14) were correctly interpreted by DSA. To identify a population with clinically significant stenosis, a 60% or greater reduction in diameter of the internal carotid was defined as a positive examination. Applying this criterion, the sensitivity, specificity, and accuracy of DSA as compared with standard arteriography was about 94%.

Two cases of neurofibromatosis and intracranial arterial occlusive disease are reported. The radiographic and clinical features of these and twelve previously reported cases are reivewed.

A case of iatrogenic carotid-cavernous fistula secondary to a Fogarty catheter thrombectomy is presented. The literature and seven previously reported cases are reviewed.

A method of determining intracranial blood vlot volumes from CT images data is presented. This technique avoids dependence on regular geometric volume approximations. Studies are presented on phantoms of known volume (ranging from 3.5 to 108 cm3) but with varying size, shape, and density relative to the surrounding medium. For a wide range of differential densities across the boundary, these phantom results indicate that volumes may be calculated to an accuracy generally better than +/- 2 cm3. A series of clinical cases, principally hypertensive intracranial hemorrhages, have been studied to demonstrate the technique. Three-dimensional axes, which allow clot localization relative to cerebral anatomy, are defined using the anterior/posterior falx attachment points and the dorsum sellae. Clot volume, center of mass, vector of clot expansion, and shift of anatomical structures are determined. Correlation of these data with clinical outcome and surgery is discussed.

Multiple cases of vascular abnormalities associated with the persistent trigeminal artery or a variant thereof are presented. A persistent otic artery variant is the only known such case in the literature.

A 5-F dilating catheter that has been modified with side holes is described for venous injection digital angiography. This catheter can be rapidly placed in an antecubital arm vein in most patients without fluoroscopy, even in those patients whose arm veins are inadequate for other techniques. In studies of over 100 carotid arteries that were performed using this method, images of diagnostic quality have regularly been obtained.

Extracranial carotid occlusive disease can be evaluated with either intravenous (IV) digital subtraction angiography (DSA) or standard angiography. In a prospective study, complications related to 500 IV DSA examinations occurred in 16.6% of patients, including local complications in 2.0%, systemic complications in 15.0%, and neurologic complications in 3.0%. A permanent neurologic deficit occurred in one patient. Complications related to 150 standard angiograms occurred in 7.3% of patients, including local complications in 4.0%, systemic complications in 3.4%, and neurologic complications in 0.7%. There were no permanent neurologic deficits. Serious systemic and neurologic complications occurred in 8.2% of patients during IV DSA and 2.7% of patients during standard angiography. The rapid injection of high volumes of hypertonic contrast media during IV DSA and the resultant hemodynamic and cardiac electrophysiologic changes account for the higher incidence of complications with IV DSA.

Carotid arteriograms on three patients with unilateral pulsatile tinnitus demonstrated an ipsilateral atypical trigeminal artery extending from the cavernous portion of the internal carotid artery to form the posterior inferior cerebellar artery. Illustrations and a dissection of a human fetus with a similar finding show this artery crossing the cochlear nerve near its insertion in the pons. Evidence is presented suggesting that neurovascular compression of the eighth nerve is the source of pulsatile tinnitus in these patients.

Demonstration of traumatic lumbosacral root avulsion is a rare clinical entity because the bony pelvis offers support and protection to the nerve roots against stretching and rupture. Major vehicular trauma producing unstable pelvic fractures allows lumbosacral root avulsion to occur, and the 18th well-documented case is reported. Delay in diagnosis of several months is common. Demonstration of traumatic meningoceles is important, and metrizamide offers better visualization of the root than does iodophendylate. Absence of the root in the meningocele is equated with avulsion.

Five cases of pericollicular focal hemorrhages are presented with a description of their effect on vision and consciousness. Loss of vision, loss of consciousness, extraocular muscle dysfunction, mutism, and dyslexia may result from expansive lesions near the collicular plate.

Central nervous system sarcoidosis and its varied neuroradiological manifestations are reviewed. Two cases of mechanical obstruction secondary to sarcoid granulomata at the outlet of the fourth ventricle are described.

The characteristics of various types of collimators have been studied systematically for the EMI Mark I brain scanner. The degree of collimation ranged from the 13-mm adjacent A and B slices to 3-mm separated slices. Multiple phantom studies (including variable density immiscible liquid interfaces) have been performed to evaluate the effect of collimation on (a) the line-spread function, (b) the change in effective absorption number, and (c) volume averaging. Effects associated with the technique settings involving the kVp, the mA, and the scan time were also investigated. The results of TLD dose measurements as a function of collimation are presented. The significance of collimation in specific clinical studies involving small, fairly well-circumscribed lesions is discussed.