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Abstract Background Our objective was to assess the histological changes in mammary glands of the female Wistar-Furth rat as a result of low dose exposure to N-nitrosomethylurea (NMU). Methods Groups of 30–40 virgin female rats of between 49–58 days old received a single injection of 10, 20, 30 or 50 mg NMU/kg body weight (BW). A group of 10 control rats received 0.9% NaCl solution only. The formation of palpable mammary gland tumors was assessed weekly and, upon sacrifice at 12, 22 and 25–30 weeks after treatment, we performed a comprehensive histological analysis of all mammary gland lesions and tumors. Results Alongside the predicted increase in tumor number and decrease in tumor latency with increasing NMU dose, we observed a number of microscopic lesions and other epithelial abnormalities in the mammary glands for all NMU doses. Two types of non-neoplastic histological changes were observed in rats exposed to 10 or 20 mg NMU/kg BW: namely, (i) an increase in the number of acinar structures often accompanied by secretion into the lumen which is normally associated with pregnancy and lactation, and (ii) an increase in the number of epithelial cells sloughed into the lumen of the epithelial ducts. Conclusion This study establishes a baseline for low-dose exposure and defines the histological features in the mammary gland resulting from NMU exposure. Furthermore, this system provides an ideal platform for evaluating the relative susceptibility of animals protected from, or predisposed to, developing cancer through environmental influences.

Peripheral nerve imaging is a powerful tool in evaluating peripheral neuropathy. This review aims to provide an overview of the anatomy, clinical significance and pathologies of small peripheral nerves, typically less than 2 mm in diameter. High frequency ultrasound probes offer the best assessment of these nerves whilst permitting real-time clinical correlation, while the role of MRI is inherently limited by spatial resolution constraints and the lack of patient contact. This review discusses techniques for sonographic identification, strategies for optimal visualization and common ultrasound-guided procedures., Competing Interests: Declarations: Informed consent for publication and presentation was obtained from the subjects described in this article. Ethical approval was not warranted for presentation of this review article. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to International Skeletal Society (ISS).)

Invasive vectors can induce dramatic changes in disease epidemiology. While viral emergence following geographical range expansion of a vector is well known, the influence a vector can have at the level of the host's pathobiome is less well understood. Taking advantage of the formerly heterogeneous spatial distribution of the ectoparasitic mite Varroa destructor that acts as potent virus vector among honeybees Apis mellifera , we investigated the impact of its recent global spread on the viral community of honeybees in a retrospective study of historical samples. We hypothesized that the vector has had an effect on the epidemiology of several bee viruses, potentially altering their transmissibility and/or virulence, and consequently their prevalence, abundance, or both. To test this, we quantified the prevalence and loads of 14 viruses from honeybee samples collected in mite-free and mite-infested populations in four independent geographical regions. The presence of the mite dramatically increased the prevalence and load of deformed wing virus, a cause of unsustainably high colony losses. In addition, several other viruses became more prevalent or were found at higher load in mite-infested areas, including viruses not known to be actively varroa-transmitted, but which may increase opportunistically in varroa-parasitized bees., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Authors.)

The "carpal boss" is a variant present in 19% of the population according to cadaveric studies but becomes symptomatic in only 1% of cases. With the rising popularity of "yoga," which includes prolonged hyperextension at the wrist joint with weight bearing, an increasing number of individuals with silent carpal boss present with dorsal wrist pain due to impingement over the dorsal soft tissues by this innocuous bony protuberance. This warrants the attention of radiologists and clinicians while dealing with wrist pain. It can be challenging to identify this bossing on routine radiographs, necessitating special views. We describe the use of dynamic ultrasound in diagnosing "symptomatic" carpal boss, the effects of which become even more evident on imaging during hyperextension-the triggering movement., Competing Interests: Conflict of Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Microglia are the resident immune cells of the brain which regulate both the innate and adaptive neuroimmune responses in health and disease. In response to specific endogenous and exogenous stimuli, microglia transition to one of their reactive states characterized by altered morphology and function, including their secretory profile. A component of the microglial secretome is cytotoxic molecules capable of causing damage and death to nearby host cells, thus contributing to the pathogenesis of neurodegenerative disorders. Indirect evidence from secretome studies and measurements of mRNA expression using diverse microglial cell types suggest different stimuli may induce microglia to secrete distinct subsets of cytotoxins. We demonstrate the accuracy of this hypothesis directly by challenging murine BV-2 microglia-like cells with eight different immune stimuli and assessing secretion of four potentially cytotoxic molecules, including nitric oxide (NO), tumor necrosis factor α (TNF), C-X-C motif chemokine ligand 10 (CXCL10), and glutamate. Lipopolysaccharide (LPS) and a combination of interferon (IFN)-γ plus LPS induced secretion of all toxins studied. IFN-β, IFN-γ, polyinosinic:polycytidylic acid (poly I:C), and zymosan A upregulated secretion of subsets of these four cytotoxins. LPS and IFN-γ, alone or in combination, as well as IFN-β induced toxicity of BV-2 cells towards murine NSC-34 neuronal cells, while ATP, N-formylmethionine-leucyl-phenylalanine (fMLP), and phorbol 12-myristate 13-acetate (PMA) did not affect any parameters studied. Our observations contribute to a growing body of knowledge on the regulation of the microglial secretome, which may inform future development of novel therapeutics for neurodegenerative diseases, where dysregulated microglia are key contributors to pathogenesis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Cardiolipin is a mitochondrial phospholipid that is also detected in serum inferring its extracellular release; however, this process has not been directly demonstrated for any of the brain cell types. Nevertheless, extracellular cardiolipin has been shown to modulate several neuroimmune functions of microglia and astrocytes, including upregulation of their endocytic activity. Low cardiolipin levels are associated with brain aging, and may thus hinder uptake of amyloid-β (Αβ) in Alzheimer's disease. We hypothesized that glial cells are one of the sources of extracellular cardiolipin in the brain parenchyma where this phospholipid interacts with neighboring cells to upregulate the endocytosis of Αβ. Liquid chromatography-mass spectrophotometry identified 31 different species of cardiolipin released from murine BV-2 microglial cells and revealed this process was accelerated by exposure to Aβ42. Extracellular cardiolipin upregulated internalization of fluorescently-labeled Aβ42 by primary murine astrocytes, human U118 MG astrocytic cells, and murine BV-2 microglia. Increased endocytic activity in the presence of extracellular cardiolipin was also demonstrated by studying uptake of Aβ42 and pHrodo™ Bioparticles™ by human induced pluripotent stem cells (iPSCs)-derived microglia, as well as iPSC-derived human brain organoids containing microglia, astrocytes, oligodendrocytes and neurons. Our observations indicate that Aβ42 augments the release of cardiolipin from microglia into the extracellular space, where it can act on microglia and astrocytes to enhance their endocytosis of Aβ42. Our observations suggest that the reduced glial uptake of Aβ due to the decreased levels of cardiolipin could be at least partially responsible for the extracellular accumulation of Aβ in aging and Alzheimer's disease., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2022. Published by Elsevier Inc.)

Astrocytes are the main support cells of the central nervous system. They also participate in neuroimmune reactions. In response to pathological and immune stimuli, astrocytes transform to reactive states characterized by increased release of inflammatory mediators. Some of these molecules are neuroprotective and inflammation resolving while others, including reactive oxygen species (ROS), nitric oxide (NO), matrix metalloproteinase (MMP)- 9, L-glutamate, and tumor necrosis factor α (TNF), are well-established toxins known to cause damage to surrounding cells and tissues. We hypothesized that similar to microglia, the brain immune cells, reactive astrocytes can release a broader set of diverse molecules that are potentially neurotoxic. A literature search was conducted to identify such molecules using the following two criteria: 1) evidence of their expression and secretion by astrocytes and 2) direct neurotoxic action. This review describes 14 structurally diverse molecules as less-established astrocyte neurotoxins, including C-X-C motif chemokine ligand (CXCL)10, CXCL12/CXCL12(5-67), FS-7-associated surface antigen ligand (FasL), macrophage inflammatory protein (MIP)- 2α, TNF-related apoptosis inducing ligand (TRAIL), pro-nerve growth factor (proNGF), pro-brain-derived neurotrophic factor (proBDNF), chondroitin sulfate proteoglycans (CSPGs), cathepsin (Cat)B, group IIA secretory phospholipase A 2 (sPLA 2 -IIA), amyloid beta peptides (Aβ), high mobility group box (HMGB)1, ceramides, and lipocalin (LCN)2. For some of these molecules, further studies are required to establish either their direct neurotoxic effects or the full spectrum of stimuli that induce their release by astrocytes. Only limited studies with human-derived astrocytes and neurons are available for most of these potential neurotoxins, which is a knowledge gap that should be addressed in the future. We also summarize available evidence of the role these molecules play in select neuropathologies where reactive astrocytes are a key feature. A comprehensive understanding of the full spectrum of neurotoxins released by reactive astrocytes is key to understanding neuroinflammatory diseases characterized by the adverse activation of these cells and may guide the development of novel treatment strategies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Alzheimer's disease (AD) is characterized by chronic neuroinflammation, which is partially mediated by dysregulated functions of glial cells. Cardiolipin (CL) is a phospholipid normally confined to the inner mitochondrial membrane; however, it has been detected in human sera, indicating that it can exist in the extracellular space where it may interact with nearby cells. Although CL has been shown to modulate several functions of microglia in a toll-like receptor (TLR) 4-dependent manner, the effects of extracellular CL on astrocytes are unknown. In addition to their homeostatic functions, astrocytes participate in neuroimmune responses of the brain and express TLR 4. Therefore, we hypothesized that extracellular CL (1) modulates the secretion of cytokines and cytotoxins by astrocytes, as well as their phagocytic activity, and (2) acts by interacting with astrocyte TLR 4. We demonstrate that CL inhibits the lipopolysaccharide- (LPS-) induced secretion of cytotoxins and expression of glial fibrillary acidic protein (GFAP) by human U118 MG astrocytic cells. CL alone upregulates the phagocytic activity of human astrocytic cells and primary murine astrocytes. CL in combination with LPS upregulates secretion of interleukin (IL)-1 β by astrocytic cells. Furthermore, CL alone increases the secretion of monocyte chemoattractant protein (MCP)-1 by astrocytic cells, which is blocked by the TLR 4-specific antagonist TAK-242. We demonstrate that CL upregulates MCP-1 secretion in the absence of its natural carrier protein, β 2-glycoprotein 1, indicating that CL may be bioactive in the brain where this protein is not present. Lastly, we show that CL downregulates the expression of astrocytic TLR 4, implying that CL engages this receptor, as its activation has been shown to lead to its degradation. Overall, our study extends the list of cell type functions of which CL modulates and provides evidence that CL, or liposomes containing this phospholipid can be used to modulate specific neuroimmune functions of astrocytes., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Taryn E. Murray et al.)

Microglia are the professional immune cells of the brain, which support numerous physiological processes. One of the defensive functions provided by microglia involves secretion of cytotoxins aimed at destroying invading pathogens. It is also recognized that the adverse activation of microglia in diseased brains may lead to secretion of cytotoxic molecules, which could be damaging to the surrounding cells, including neurons. Several of these toxins, such as reactive oxygen and nitrogen species, L-glutamate, and quinolinic acid, are widely recognized and well-studied. This review is focused on a structurally diverse group of less-established microglia neurotoxins, which were selected by applying the two criteria that these molecules 1) can be released by microglia, and 2) have the potential to be directly harmful to neurons. The following 11 molecules are discussed in detail: amyloid beta peptides (Aβ); cathepsin (Cat)B and CatD; C-X-C motif chemokine ligand (CXCL)10 and CXCL12 (5-67); high mobility group box (HMGB)1; lymphotoxin (LT)-α; matrix metalloproteinase (MMP)-2 and MMP-9; platelet-activating factor (PAF); and prolyl endopeptidase (PEP). Molecular mechanisms of their release by microglia and neurotoxicity, as well as available evidence implicating their involvement in human neuropathologies are summarized. Further studies on several of the above molecules are warranted to confirm either their microglial origin in the brain or direct neurotoxic effects. In addition, investigations into the differential secretion patterns of neurotoxins by microglia in response to diverse stimuli are required. This research could identify novel therapeutic targets for neurological disorders involving adverse microglial activation., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Transarterial radioembolization with yttrium-90 microspheres is an established therapy for hepatocellular carcinoma. Post-procedural imaging is important for the assessment of both treatment response and procedural complications. A variety of challenging treatment-specific imaging phenomena complicate imaging assessment, such as changes in tumoral size, tumoral and peritumoral enhancement, and extrahepatic complications. A review of the procedural steps, emerging variations, and timelines for post-treatment tumoral and extra-tumoral imaging changes are presented, which may aid the reporting radiologist in the interpretation of post-procedural imaging. Furthermore, a description of post-procedural complications and their significance is provided., (© 2021. Crown.)

Background: Young adults are increasingly using electronic nicotine delivery systems (ENDS). The standard ENDS device involves an electric coil that heats a wick to vaporize an e-liquid solution. "Dripping" is another method that involves applying e-liquid directly to the coil. Dripping increases risk of harmful toxic compounds in vapor aerosols. Despite evidence of high levels of dripping among adolescents, young adult prevalence is unknown., Methods: Young adults aged 18 to 24 completed an online survey assessing vaping and dripping status, type of devices used, tobacco use, and vaping expectancies. Among ever-vapers, univariate and multivariate logistic regression models assessed whether demographics predicted dripping and use of dripping devices. Multivariate Analysis of Variance compared never- and ever-drippers on expectancies for vaping outcomes., Results: Over 2 in 5 young adult ever-vapers (43.7%) reported dripping. A multivariate regression model found that male gender (AOR = 1.83), identifying as White (AOR = 2.37), and use of other tobacco products (hookah; AOR = 1.91; cigars; AOR = 2.26; cigarettes; AOR = 2.51) were associated with dripping. E-cigarette users who reported lifetime dripping were more likely to consider vaping stimulating, socially facilitating, and flavorful. They ascribed lower health risks to vaping and felt it could reduce negative affect, weight gain, nicotine cravings, and boredom (all P  < .05)., Conclusion: Dripping was a highly prevalent behavior among this sample of young adults, particularly among White males. These findings point to the importance of gaining a greater understanding of the drivers and consequences of vaping and dripping behavior., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Alzheimer's disease (AD) is a neurodegenerative disorder without a known cure or effective treatment. Research has identified several modifiable risk factors and suggested preventative measures to reduce the risk of developing AD, including alterations in diet. Polyunsaturated fatty acids (PUFAs) have been shown to regulate inflammatory responses in the central nervous system (CNS), the main site of inflammation in AD. In the CNS, microglia are immune cells responsible for the maintenance of homeostasis. However, in AD, microglia can become adversely activated, causing them to release increased levels of cytotoxins and inflammatory mediators, including nitric oxide (NO) and monocyte-chemoattractant protein (MCP)-1. We assessed the effects of two PUFAs, α-linolenic acid (ALA) and linoleic acid (LA), on select microglial immune functions, since the effects of these dietary fatty acids on neuroimmune responses are not well characterized. In BV-2 mouse microglia activated with lipopolysaccharide (LPS), exposure to LA reduced NO secretion and inducible nitric oxide synthase (iNOS) levels, whereas exposure to ALA reduced NO without a corresponding reduction of iNOS. Neither ALA nor LA altered MCP-1 levels or cytotoxins released by THP-1 human microglia-like cells stimulated with a combination of LPS and interferon (IFN)-γ. Specific receptor antagonists were used to demonstrate that the inhibitory effect of LA on NO secretion did not depend on the free fatty acid receptor (FFAR) 1 or FFAR4. Furthermore, gas chromatography with a flame ionization detector (GC-FID) revealed that exposure to LA or ALA did not alter the fatty acid composition of BV-2 microglia. Our data indicate that regulation of select microglial immune functions by ALA and LA could be one of the mechanisms underlying the observed link between certain dietary patterns and AD, such as reduced risk of cognitive decline and dementia associated with the Mediterranean diet., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objectives: Same-day CT colonography (CTC) following incomplete optical colonoscopy allows patients to avoid both a delayed diagnosis and the need for repeat bowel preparation. The aim of our study is to establish the diagnostic quality of same-day CT colonography following an incomplete optical colonoscopy., Methods: We performed a retrospective review of patients undergoing same-day CT colonography following an incomplete colonoscopy at our center between July 2015 and December 2017 (N = 245). We divided the large bowel into thirteen subsegments in each patient. Using a semiquantitative scoring system, the quality of bowel preparation, adequacy of fecal tagging, and luminal distension were assessed in each subsegment on all views performed. A combined score for each subsection was obtained., Results: Ninety-nine percent of studies did not require a repeat CTC or optical colonoscopy. Median values for bowel preparation and fecal tagging were satisfactory across the bowel segments for the cohort and luminal distension was acceptable in all but three patients., Conclusions: Same-day CTC should be considered in centers with capacity, following an incomplete optical colonoscopy. Same-day completion CTCs are of high diagnostic quality and this approach allows patients to avoid repeat bowel cleansing or a delayed diagnosis., Key Points: • Same-day CT colonography is a high-quality examination that can be performed following incomplete optical colonoscopy. • Same-day CT colonography should be considered for patients with incomplete optical colonoscopy in centers with the capacity to offer this service. • Same-day CTC can avoid a delay in diagnosis and avoids repeat bowel preparation.

Urbanisation is an important global driver of biodiversity change, negatively impacting some species groups whilst providing opportunities for others. Yet its impact on ecosystem services is poorly investigated. Here, using a replicated experimental design, we test how Central European cities impact flying insects and the ecosystem service of pollination. City sites have lower insect species richness, particularly of Diptera and Lepidoptera, than neighbouring rural sites. In contrast, Hymenoptera, especially bees, show higher species richness and flower visitation rates in cities, where our experimentally derived measure of pollination is correspondingly higher. As well as revealing facets of biodiversity (e.g. phylogenetic diversity) that correlate well with pollination, we also find that ecotones in insect-friendly green cover surrounding both urban and rural sites boost pollination. Appropriately managed cities could enhance the conservation of Hymenoptera and thereby act as hotspots for pollination services that bees provide to wild flowers and crops grown in urban settings.

Magnetic resonance imaging provides detailed visualisation, identification and extent assessment of many anal disorders. While many studies are performed in the evaluation of malignant processes such as anorectal carcinoma, the primary focus of this pictorial review is benign lesions, which involve the anal canal and perianal spaces. This pictorial review will illustrate the MRI appearances of a variety of benign conditions, which predominantly affect the anal canal, including abscess, fistulae, lipomas, developmental cysts and inflammatory conditions. MRI aids in the identification and characterisation of these abnormalities, of coexisting complications and differentiation from other perineal abnormalities. This pictorial review highlights the spectrum of non-malignant processes involving the perianal region., (© 2019 The Royal Australian and New Zealand College of Radiologists.)

Background: Osteoarthritis (OA) is the most common cause of disability in people older than 65 years. Readability of online OA information has never been assessed. A 2003 study found the quality of online OA information to be poor., Objective: The aim of this study was to review the readability and quality of current online information regarding OA., Methods: The term osteoarthritis was searched across the three most popular English language search engines. The first 25 pages from each search engine were analyzed. Duplicate pages, websites featuring paid advertisements, inaccessible pages (behind a pay wall, not available for geographical reasons), and nontext pages were excluded. Readability was measured using Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Website quality was scored using the Journal of the American Medical Association (JAMA) benchmark criteria and the DISCERN criteria. Presence or absence of the Health On the Net Foundation Code of Conduct (HONcode) certification, age of content, content producer, and author characteristics were noted., Results: A total of 37 unique websites were found suitable for analysis. Readability varied by assessment tool from 8th to 12th grade level. This compares with the recommended 7th to 8th grade level. Of the 37, 1 (2.7%) website met all 4 JAMA criteria. Mean DISCERN quality of information for OA websites was "fair," compared with the "poor" grading of a 2003 study. HONcode-endorsed websites (43%, 16/37) were of a statistically significant higher quality., Conclusions: Readability of online health information for OA was either equal to or more difficult than the recommended level., (©Kieran Edward Murray, Timothy Eanna Murray, Anna Caroline O'Rourke, Candice Low, Douglas James Veale. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 16.09.2019.)

OBJECTIVE. Autonomic dysreflexia (AD) is a potentially life-threatening condition that occurs in patients with cervical and high thoracic spinal cord injury (SCI). AD is not completely understood and has a high incidence that increases proportional to the level and severity of the SCI. The signs and symptoms can vary, but severe hypertension is a dominant feature and may be fatal. This condition can be precipitated by a wide range of triggers occurring below the level of the injury, several of which are common to both diagnostic and interventional radiology, such as manipulation or distention of the genitourinary or gastrointestinal tract, patient positioning, or the use of certain anesthetic techniques. There is little guidance in the radiology literature specific to risk stratification or the use of premedication in this population. The incidence and pathophysiology of AD are discussed, along with pragmatic tips to aid the radiologist in selecting patients who may require a higher level of care or anesthesiologist involvement, with instructions for the conservative and medical management of acute episodes of AD. CONCLUSION. Awareness of AD is essential for all health care practitioners involved in the care of patients with SCI. A variety of procedures in the radiology department, both diagnostic and interventional, may precipitate AD. Planning, monitoring procedures, knowledge of the relevant pathophysiology and pharmacology, and communication with clinical colleagues are essential to ensure safe practice. Clinicians ordering procedures and radiologists selecting protocols for those procedures should identify at-risk patients before booking a procedure to ensure appropriate supervision and anesthesiology support. Education of radiologists, interventional nursing staff, and technical staff can assist in prevention, early recognition, and successful management of AD.

Introduction: Trends in medical technology patents provide an objective comparison of research and development between countries and over time. An analysis of these trends can benchmark innovation within Ireland in a worldwide context. By identifying and examining leading countries, domestic educational, infrastructural, regulatory and fiscal planning may be optimised., Materials and Methods: Published data filing and granting reports from the two major patent offices (United States Patent and Trademark Office (USPTO) and European Patent Office (EPO)) were analysed., Results: USPTO statistics demonstrated an 83.1% decrease in the overall number of medical device patents filed over the 10-year period, from 2005 (n = 1092) to 2015 (n = 185). Conversely, there was a 166% increase in the number of medical device patents granted over the same period. EPO applications in the field of medical technology represented the single largest industry category. The proportion of patents granted of Irish origin have increased from 0.7 (n = 22) to 0.9% (n = 73) over 10 years. Switzerland ranks first for medical device patents granted per head of population by the EPO, with Ireland ranking 5th. Ireland's medical device patents have increased dramatically per head of population, from 4.1 per million in 2012, to 15.3 in 2016. Israel has the highest number of USPTO patents granted per head of population, with Ireland ranking 5th., Conclusions: Ireland demonstrates high levels of medical technology patent filing per head of population, reflecting the importance of this industry. However, both Switzerland and Israel demonstrate dominance amongst smaller nations, and serving as benchmarks for national planning.

Purpose: Thermoresponsive hydrogels are gels which have different properties at varying temperatures. The objective of this study was to assess the material characteristics, imaging properties and chemotherapeutic drug release profile of a novel radiopaque thermoresponsive hydrogel in vitro, which is liquid at room temperature but solidifies at body temperature, to determine potential suitability for intratumoural delivery., Materials and Methods: An iodinated radiopaque thermoresponsive hydrogel was formulated using iodixanol at a range of concentrations and assessed for sol-gel transition, radiopacity and imaging using CT and US. A lead formulation containing iodixanol at a concentration of 9.22% weight by weight (w/w, g of iodixanol per g of hydrogel) was evaluated in vitro for injectability, disintegration and dual drug release of cisplatin and paclitaxel from the hydrogel formulation., Results: Radiopacity of the hydrogel increased in a concentration-dependent manner, but the highest concentration of iodixanol evaluated in this study (13.83% w/w) adversely affected the sol-gel transition of the hydrogel; therefore, 9.22% w/w iodixanol hydrogel was identified as the lead formulation. This formulation was readily visible on both CT and US. The formulation was hand injectable through a range of clinically relevant devices, had a sustained disintegration profile for up to 28 days and was able to deliver a sustained release of chemotherapeutic drug for up to 10 days., Conclusions: Favourable in vitro and ex vivo imaging and material characteristics of this thermoresponsive gel are demonstrated, suggesting potential interventional oncology applications for image-guided intratumoural delivery of sustained-release chemotherapy.

Purpose: To describe a single skin puncture technique combining subcutaneous injection of anesthetic to the depth of the vessel wall with venipuncture in the same movement., Technique: Using ultrasound guidance, controlled anesthetic instillation along the needle tract and outer vessel wall with a 21-G vascular access needle can be combined with vessel puncture. This technique reduces the number of skin punctures and ensures accurate anesthetic instillation. The maximum inadvertent intravascular dose of commercial local anesthetic preparations that can be delivered with a small syringe is far below toxicity thresholds., Conclusion: A technique for combining anesthetic administration and vascular access with a 21-G needle and ultrasound guidance is feasible.

Aim: To determine whether obesity information obtained via imaging techniques is desirable for clinicians and patients, and to investigate whether it impacts clinical decision-making., Materials and Methods: Parallel surveys were designed to assess patient and clinician attitudes to the medical utility and social stigma of reporting obesity on radiology reports performed for other reasons., Results: Where obesity was noted at medical imaging performed for any reason, clinicians and patients strongly agreed that it should be included in the radiology report (5.9 and 5.8, respectively, on a seven-point preference score ranging from strongly disagree [1] to strongly agree [7]). Clinicians and patients indicated a preference for a quantitative report. Clinicians somewhat disagreed and patients disagreed that a radiology report describing obesity would be considered insulting (3 and 2.1, respectively). Clinicians and patients agreed that they would be more likely to discuss overweight/obesity if it was described in a radiology report (5.3 and 6.1 respectively). Clinicians and patients agreed that radiology reports describing obesity would influence future management/behaviour (4.5 and 6.2, respectively). Clinicians strongly disagreed that they would avoid sending patients for scans if obesity was reported (1.3). Patients also disagreed that including such information on a report would result in imaging avoidance (1.9)., Conclusion: Both clinicians and patients indicate a clear preference for obesity-related information on radiology reports for examinations performed for any reason. Surveyed attitudes suggest including such information is not considered insulting, and is unlikely to result in avoidance of imaging., (Copyright © 2018 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

Rationale and Objectives: Investigators aimed to assess online information describing uterine artery embolization (UAE) to examine the quality and readability of websites patients are accessing., Materials and Methods: A list of applicable, commonly used searchable terms was generated, including "Uterine Artery Embolization," "Fibroid Embolization," "Uterine Fibroid Embolization," and "Uterine Artery Embolisation." Each possible term was assessed across the five most-used English language search engines to determine the most commonly used term. The most common term was then investigated across each search engine, with the first 25 pages returned by each engine included for analysis. Duplicate pages, nontext content such as video or audio, and pages behind paywalls were excluded. Pages were analyzed for quality and readability using validated tools including DISCERN score, JAMA Benchmark Criteria, HONcode Certification, Flesch Reading Ease Score, Flesch-Kincaid Grade Level, and Gunning-Fog Index. Secondary features such as age, rank, author, and publisher were recorded., Results: The most common applicable term was "Uterine Artery Embolization" (492,900 results). Mean DISCERN quality of information provided by UAE websites is "fair"; however, it has declined since comparative 2012 studies. Adherence to JAMA Benchmark Criteria has reduced to 6.7%. UAE website readability remains more difficult than the World Health Organization-recommended 7-8th grade reading levels. HONcode-certified websites (35.6%) demonstrated significantly higher quality than noncertified websites., Conclusions: Quality of online UAE information remains "fair." Adherence to JAMA benchmark criteria is poor. Readability is above recommended 7-8th grade levels. HONcode certification was predictive of higher website quality, a useful guide to patients requesting additional information., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Renal angiomyolipoma (AML) are benign tumours composed of fat, muscle, and disorganised blood vessels. Historic treatment algorithms for sporadic AML based on size fail to consider additional risk factors such as tumour vascularity and pseudoaneurysm formation. As AML is now predominantly incidental, rupture is rare and its mortality low. The recent publication of the largest longitudinal series to date also suggest that growth is uncommon, challenging existing surveillance paradigms. The evidence assessing treatment strategies in AML are reviewed, with particular emphasis on incidental sporadic AML. The relative merits of various AML treatments are discussed, and areas of clinical uncertainty highlighted.

Aims: Both fluoroscopic water-soluble contrast swallow (FWSCS) and CT water-soluble contrast swallow (CTWSCS) are widely performed as a routine in the post-esophagectomy patient to assess for anastomotic leak. Several prospective studies have compared FWSCS and CTWSCS; however, no synthesis of the data exists., Materials and Methods: Systematic review and meta-analysis of diagnostic test accuracy studies comparing FWSCS and CTWSCS in the adult patient following esophagectomy for malignancy was performed in accordance with PRISMA guidelines., Results: Three diagnostic test accuracy studies met the inclusion criteria, directly comparing FWSCS and CTWSCS in 185 patients. FWSCS demonstrated high specificity (98%), but low sensitivity (64%). CTWSCS can be categorized as normal, mediastinal gas without contrast leak, or leakage of oral contrast. Visible leakage of oral contrast demonstrated high specificity (98%) but low sensitivity (56%). The presence of mediastinal gas increased sensitivity (84%), but reduced specificity (85%). The higher sensitivity of CTWSCS over FWSCS failed to reach significance ( P = 0.125)., Conclusion: CTWSCS shares the high specificity of FWSCS. Its higher sensitivity increases its utility as a rule-out test in the postoperative period. Additional factors that may influence decision-making are described., Competing Interests: There are no conflicts of interest.

There is international and national variation in the location of diagnostic imaging centres relative to hospitals. Diagnostic cross-sectional imaging has traditionally been performed within a hospital, catering for both inpatient and outpatients. The resulting two-tiered system caters for emergent and complex inpatients, in addition to typically ambulatory outpatients. These outpatients are less complex, and often attend an acute hospital for the specific purpose of diagnostic imaging. In both the UK and the Republic of Ireland, outpatient radiology is often provided on-campus in state-funded hospitals, reflecting the allocation of resources nationally. In many other countries, hospitals provide acute and high-level care, with community centres addressing outpatients' clinical and diagnostic needs. Mixing inpatients and outpatients introduces variability into the scanning process, and many institutions struggle to provide for the very different needs of outpatients. Current strategies of mixing these two fundamentally different groups should be reassessed, and either in-hospital segregation or dedicated outpatient diagnostic imaging centres merit serious consideration in any future healthcare planning.

Traditional tropical agriculture often entails a form of slash-and-burn land management that may adversely affect ecosystem services such as pollination, which are required for successful crop yields. The Yucatán Peninsula of Mexico has a >4000 year history of traditional slash-and-burn agriculture, termed 'milpa'. Hot 'Habanero' chilli is a major pollinator-dependent crop that nowadays is often grown in monoculture within the milpa system.We studied 37 local farmers' chilli fields (sites) to evaluate the effects of landscape composition on bee communities. At 11 of these sites, we undertook experimental pollination treatments to quantify the pollination of chilli. We further explored the relationships between landscape composition, bee communities and pollination service provision to chilli.Bee species richness, particularly species of the family Apidae, was positively related to the amount of forest cover. Species diversity decreased with increasing proportion of crop land surrounding each sampling site. Sweat bees of the genus Lasioglossum were the most abundant bee taxon in chilli fields and, in contrast to other bee species, increased in abundance with the proportion of fallow land, gardens and pastures which are an integral part of the milpa system.There was an average pollination shortfall of 21% for chilli across all sites; yet the shortfall was unrelated to the proportion of land covered by crops. Rather, chilli pollination was positively related to the abundance of Lasioglossum bees, probably an important pollinator of chilli, as well indirectly to the proportion of fallow land, gardens and pastures that promote Lasioglossum abundance. Synthesis and applications . Current, low-intensity traditional slash-and-burn ( milpa ) agriculture provides Lasioglossum spp. pollinators for successful chilli production; fallow land, gardens and pasture therefore need to be valued as important habitats for these and related ground-nesting bee species. However, the negative impact of agriculture on total bee species diversity highlights how agricultural intensification is likely to reduce pollination services to crops, including chilli. Indeed, natural forest cover is vital in tropical Yucatán to maintain a rich assemblage of bee species and the provision of pollination services for diverse crops and wild flowers.

Rigid inflatable gastrostomy (RIG) tubes are widely used in contemporary clinical practice for a variety of indications. Insertion of RIG tubes is associated with a high technical success rate and low incidence of mortality. In this case report, a procedural pitfall associated with intraperitoneal-extragastric malposition is described. Rigorous assessment of abdominal radiographs, as well as awareness of the expected appearance of the RIG tube and gastropexy T-fasteners, allows the abdominal radiologist to detect early RIG position in the early postprocedural period. Abdominal radiography is a widely available and inexpensive technique. The high spatial resolution it provides makes it a valuable tool in determining hardware position.

Animal-mediated pollination is required for the reproduction of the majority of angiosperms, and pollinators are therefore essential for ecosystem functioning and the economy. Two major threats to insect pollinators are anthropogenic land-use change and the spread of pathogens, whose effects may interact to impact pollination. Here, we investigated the relative effects on the ecosystem service of pollination of (i) land-use change brought on by agriculture and urbanization as well as (ii) the prevalence of pollinator parasites, using experimental insect pollinator-dependent plant species in natural pollinator communities. We found that pollinator habitat (i.e. availability of nesting resources for ground-nesting bees and local flower richness) was strongly related to flower visitation rates at the local scale and indirectly influenced plant pollination success. At the landscape scale, pollination was positively related to urbanization, both directly and indirectly via elevated visitation rates. Bumblebees were the most abundant pollinator group visiting experimental flowers. Prevalence of trypanosomatids, such as the common bumblebee parasite Crithidia bombi, was higher in urban compared with agricultural areas, a relationship which was mediated through higher Bombus abundance. Yet, we did not find any top-down, negative effects of bumblebee parasitism on pollination. We conclude that urban areas can be places of high transmission of both pollen and pathogens., (© 2016 The Author(s).)

Introduction: Transarterial embolization is increasingly used in the management of renal angiomyolipoma. The level of evidence establishing the safety and efficacy of transarterial embolization has not increased in parallel., Materials and Methods: Using the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) criteria a systematic review of transarterial embolization of angiomyolipoma was performed to establish procedural safety and efficacy. A MEDLINE® PubMed® search revealed 1,739 publications, of which 31 studies met eligibility criteria., Results: A total of 524 cases of transarterial embolization of angiomyolipoma were included in analysis. Self-limiting post-embolization syndrome developed following 35.9% of embolizations and further morbidity developed in 6.9%. No procedural mortality was reported. At a mean followup of 39 months the mean size reduction was 3.4 cm (-38.3% of angiomyolipoma diameter). Unplanned repeat embolization or surgery was required in 20.9% of cases during this period. The most frequent indications for repeat procedures included angiomyolipoma revascularization in 30.0% of cases, unchanged or increasing size in 22.6%, refractory or recurring symptoms in 16.7% and representation with acute retroperitoneal hemorrhage in 14.3%. Treatment included a combination of 2 or more embolic agents in 46.8% of cases, ethanol monotherapy in 41.7%, coil monotherapy in 6.2% and foam or microparticle monotherapy in 5.2%., Conclusions: Transarterial embolization of angiomyolipoma demonstrates low rates of mortality and serious complications. Re-treatment rates and size reduction at a mean followup of 39 months are presented. Longitudinal data assessing long-term size reduction and re-treatment rates are lacking. Recommendations guiding the indications for transarterial embolization and clear followup require further longitudinal data., (Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)

The genetic structure of the earth bumblebee (Bombus terrestris L.) was examined across 22 wild populations and two commercially reared populations using eight microsatellite loci and two mitochondrial genes. Our study included wild bumblebee samples from six populations in Ireland, one from the Isle of Man, four from Britain and 11 from mainland Europe. A further sample was acquired from New Zealand. Observed levels of genetic variability and heterozygosity were low in Ireland and the Isle of Man, but relatively high in continental Europe and among commercial populations. Estimates of Fst revealed significant genetic differentiation among populations. Bayesian cluster analysis indicated that Irish populations were highly differentiated from British and continental populations, the latter two showing higher levels of admixture. The data suggest that the Irish Sea and prevailing south westerly winds act as a considerable geographical barrier to gene flow between populations in Ireland and Britain; however, some immigration from the Isle of Man to Ireland was detected. The results are discussed in the context of the recent commercialization of bumblebees for the European horticultural industry., (© 2015 John Wiley & Sons Ltd.)

The worldwide spread of diseases is considered a major threat to biodiversity and a possible driver of the decline of pollinator populations, particularly when novel species or strains of parasites emerge. Previous studies have suggested that populations of introduced European honeybee (Apis mellifera) and bumblebee species (Bombus terrestris and Bombus ruderatus) in Argentina share the neogregarine parasite Apicystis bombi with the native bumblebee (Bombus dahlbomii). In this study we investigated whether A. bombi is acting as an emergent parasite in the non-native populations. Specifically, we asked whether A. bombi, recently identified in Argentina, was introduced by European, non-native bees. Using ITS1 and ITS2 to assess the parasite's intraspecific genetic variation in bees from Argentina and Europe, we found a largely unstructured parasite population, with only 15% of the genetic variation being explained by geographic location. The most abundant haplotype in Argentina (found in all 9 specimens of non-native species) was identical to the most abundant haplotype in Europe (found in 6 out of 8 specimens). Similarly, there was no evidence of structuring by host species, with this factor explaining only 17% of the genetic variation. Interestingly, parasites in native Bombus ephippiatus from Mexico were genetically distant from the Argentine and European samples, suggesting that sufficient variability does exist in the ITS region to identify continent-level genetic structure in the parasite. Thus, the data suggest that A. bombi from Argentina and Europe share a common, relatively recent origin. Although our data did not provide information on the direction of transfer, the absence of genetic structure across space and host species suggests that A. bombi may be acting as an emergent infectious disease across bee taxa and continents.

Background and Aims: Riparian systems are prone to invasion by alien plant species. The spread of invasive riparian plants may be facilitated by hydrochory, the transport of seeds by water, but while ecological studies have highlighted the possible role of upstream source populations in the establishment and persistence of stands of invasive riparian plant species, population genetic studies have as yet not fully addressed the potential role of hydrochoric dispersal in such systems., Methods: A population genetics approach based on a replicated bifurcate sampling design is used to test hypotheses consistent with patterns of unidirectional, linear gene flow expected under hydrochoric dispersal of the invasive riparian plant Impatiens glandulifera in two contrasting river systems., Key Results: A significant increase in levels of genetic diversity downstream was observed, consistent with the accumulation of propagules from upstream source populations, and strong evidence was found for organization of this diversity between different tributaries, reflecting the dendritic organization of the river systems studied., Conclusions: These findings indicate that hydrochory, rather than anthropogenic dispersal, is primarily responsible for the spread of I. glandulifera in these river systems, and this is relevant to potential approaches to the control of invasive riparian plant species.

Worldwide, wild bumble bees ( Bombus spp.) are experiencing marked declines, with potentially up to 11% of species currently under threat. Recent studies from North America suggest that disease transmission from commercially reared bumble bees to wild populations has led to marked range contractions in some species. In Europe, data on the prevalence of pathogen spillover from commercial to wild bumble bee populations is lacking, despite the widespread production and transport of hives within the EU since the early 1980s. We determined the permeability of cropping systems to commercial bumble bees, and quantified the prevalence of four pathogens in commercial Bombus terrestris hives and adjacent conspecific populations at increasing distances from greenhouses in Ireland. Commercial bumble bees collected from 31% to 97% of non-crop pollen, depending on the cropping system, and hives had markedly higher frequencies of two gut parasites, Crithidia spp. and Nosema bombi , compared to adjacent populations, but were free of tracheal mites. The highest prevalence of Crithida was observed within 2 km of greenhouses and the probability of infection declined in a host sex- and pathogen-specific manner up to 10 km. We suggest implementing measures that prevent the interaction of commercially reared and wild bumble bees by integrating the enforcement of national best management practices for users of commercial pollinators with international legislation that regulates the sanitation of commercial hives in production facilities., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Cryptic diversity within bumblebees (Bombus) has the potential to undermine crucial conservation efforts designed to reverse the observed decline in many bumblebee species worldwide. Central to such efforts is the ability to correctly recognise and diagnose species. The B. lucorum complex (Bombus lucorum, B. cryptarum and B. magnus) comprises one of the most abundant and important group of wild plant and crop pollinators in northern Europe. Although the workers of these species are notoriously difficult to diagnose morphologically, it has been claimed that queens are readily diagnosable from morphological characters. Here we assess the value of colour-pattern characters in species identification of DNA-barcoded queens from the B. lucorum complex. Three distinct molecular operational taxonomic units were identified each representing one species. However, no uniquely diagnostic colour-pattern character state was found for any of these three molecular units and most colour-pattern characters showed continuous variation among the units. All characters previously deemed to be unique and diagnostic for one species were displayed by specimens molecularly identified as a different species. These results presented here raise questions on the reliability of species determinations in previous studies and highlights the benefits of implementing DNA barcoding prior to ecological, taxonomic and conservation studies of these important key pollinators.

Globally, there is concern over the decline of bees, an ecologically important group of pollinating insects. Genetic studies provide insights into population structure that are crucial for conservation management but that would be impossible to obtain by conventional ecological methods. Yet conservation genetic studies of bees have primarily focussed on social species rather than the more species-rich solitary bees. Here, we investigate the population structure of Colletes floralis, a rare and threatened solitary mining bee, in Ireland and Scotland using nine microsatellite loci. Genetic diversity was surprisingly as high in Scottish (Hebridean island) populations at the extreme northwestern edge of the species range as in mainland Irish populations further south. Extremely high genetic differentiation among populations was detected; multilocus F(ST) was up to 0.53, and and D(est) were even higher (maximum: 0.85 and 1.00, respectively). A pattern of isolation by distance was evident for sites separated by land. Water appears to act as a substantial barrier to gene flow yet sites separated by sea did not exhibit isolation by distance. C. floralis populations are extremely isolated and probably not in regional migration-drift equilibrium. GIS-based landscape genetic analysis reveals urban areas as a potential and substantial barrier to gene flow. Our results highlight the need for urgent site-specific management action to halt the decline of this and potentially other rare solitary bees., (© 2010 Blackwell Publishing Ltd.)

This article documents the addition of 512 microsatellite marker loci and nine pairs of Single Nucleotide Polymorphism (SNP) sequencing primers to the Molecular Ecology Resources Database. Loci were developed for the following species: Alcippe morrisonia morrisonia, Bashania fangiana, Bashania fargesii, Chaetodon vagabundus, Colletes floralis, Coluber constrictor flaviventris, Coptotermes gestroi, Crotophaga major, Cyprinella lutrensis, Danaus plexippus, Fagus grandifolia, Falco tinnunculus, Fletcherimyia fletcheri, Hydrilla verticillata, Laterallus jamaicensis coturniculus, Leavenworthia alabamica, Marmosops incanus, Miichthys miiuy, Nasua nasua, Noturus exilis, Odontesthes bonariensis, Quadrula fragosa, Pinctada maxima, Pseudaletia separata, Pseudoperonospora cubensis, Podocarpus elatus, Portunus trituberculatus, Rhagoletis cerasi, Rhinella schneideri, Sarracenia alata, Skeletonema marinoi, Sminthurus viridis, Syngnathus abaster, Uroteuthis (Photololigo) chinensis, Verticillium dahliae, Wasmannia auropunctata, and Zygochlamys patagonica. These loci were cross-tested on the following species: Chaetodon baronessa, Falco columbarius, Falco eleonorae, Falco naumanni, Falco peregrinus, Falco subbuteo, Didelphis aurita, Gracilinanus microtarsus, Marmosops paulensis, Monodelphis Americana, Odontesthes hatcheri, Podocarpus grayi, Podocarpus lawrencei, Podocarpus smithii, Portunus pelagicus, Syngnathus acus, Syngnathus typhle,Uroteuthis (Photololigo) edulis, Uroteuthis (Photololigo) duvauceli and Verticillium albo-atrum. This article also documents the addition of nine sequencing primer pairs and sixteen allele specific primers or probes for Oncorhynchus mykiss and Oncorhynchus tshawytscha; these primers and assays were cross-tested in both species., (© 2009 Blackwell Publishing Ltd.)

Background: Low educational attainment is a marker of socioeconomic status that correlates strongly with higher death rates from many conditions. No previous studies have analyzed national data to measure the number of deaths associated with lower education among working-aged adults (25-64 years) by race or ethnicity. Furthermore, no previous studies have examined comprehensively the relationship of education to cause-specific and all-cause mortality in the three largest racial or ethnic groups in the United States using national data., Methods: Age-standardized, race/ethnicity-specific death rates from all causes and the 15 leading causes were measured among men and women aged 25-64 years by level of education based on U.S. national mortality data in 2001. The total number of deaths that potentially could be avoided among people aged 25-64 years was estimated by applying the mortality rates among college graduates (within each 5-year category of age, gender, and race/ethnicity) to each of the less-educated subpopulations. All analyses were performed in 2007., Results: Nearly half (48%) of all deaths among men aged 25-64 years (white, black, and Hispanic), and 38% of all deaths in women would not have occurred in this age range if all segments of the population experienced the death rates of college graduates. Black men and women had the highest death rates from all causes combined and from many specific causes at nearly all levels of education, and the largest average life years lost before age 65 years. However, the total number of deaths associated with low education status was not confined to any single racial group. About 161,280 deaths in whites, 40,840 deaths in blacks, and 13,162 deaths in Hispanics in this age range were associated with educational disparity., Conclusions: Potentially avoidable factors associated with lower educational status account for almost half of all deaths among working-aged adults in the U.S.; these deaths are not confined to any single racial or ethnic group. These findings highlight the need for greater attention to social determinants of health.

A World Conservation Union (IUCN) regional red list is an objective assessment of regional extinction risk and is not the same as a list of conservation priority species. Recent research reveals the widespread, but incorrect, assumption that IUCN Red List categories represent a hierarchical list of priorities for conservation action. We developed a simple eight-step priority-setting process and applied it to the conservation of bees in Ireland. Our model is based on the national red list but also considers the global significance of the national population; the conservation status at global, continental, and regional levels; key biological, economic, and societal factors; and is compatible with existing conservation agreements and legislation. Throughout Ireland, almost one-third of the bee fauna is threatened (30 of 100 species), but our methodology resulted in a reduced list of only 17 priority species. We did not use the priority species list to broadly categorize species to the conservation action required; instead, we indicated the individual action required for all threatened, near-threatened, and data-deficient species on the national red list based on the IUCN's conservation-actions template file. Priority species lists will strongly influence prioritization of conservation actions at national levels, but action should not be exclusive to listed species. In addition, all species on this list will not necessarily require immediate action. Our method is transparent, reproducible, and readily applicable to other taxa and regions.

Alexandrium tamarensis is a toxigenic dinoflagellate found in coastal waters worldwide. A critical factor in alleviating the health and economic threats posed by this species is the development of a rapid and reliable method for detection. This study stream-lined a labor- and resource-intensive protocol for the isolation of A. tamarensis ribosomal DNA (rDNA). Subcultures of A. tamarensis were established in water samples from several coastal Atlantic sites. A commercial DNA isolation kit protocol for cultured cells was used for isolation of the dinoflagellate DNA. Samples were amplified by PCR using primers specific for a 700-bp sequence of A. tamarensis rDNA. It was determined that this method facilitated the detection of 10(-4) ng/microL of A. tamarensis DNA. Furthermore, the kit enabled A. tamarensis to be isolated from the water sources with little signal degradation. This is a valuable technique for the rapid detection of A. tamarensis, even before cell numbers are large enough for morphological identification.

The definite diagnosis of osteoid osteoma relies on the demonstration of the nidus, best shown by CT, which also provides precise preoperative localization of the nidus. While bone-block excision to remove the nidus is feasible in the long bones, there may be unacceptable sequelae in the vertebral column and small bones of the hands. By precisely localizing the nidus, radionuclide scintimetry permits excellent therapeutic results, with minimal morbidity.