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The experience with the EMI 5005 body scanner in the neuroradiological diagnosis of about 500 cerebral and 30 spinal examinations is reported. The advantages and disadvantages of this machine are discussed.
Frontal tomograms of the orbits can be obtained with the EMI CT 1010 head scanner, retaining the fine matrix (320 X 320) and thin slice options. Only minor modifications are required.
It is shown-taking in consideration the local circumstances-that the EMI scanning of the brain is less expensive than pneumoencephalography percutaneus carotid angiography or cerebral four vessel angiography.
A comparison is made of the results of computer-assisted X-ray tomography (EMI scan) and those of radionuclide brain scan supplemented by computer-assisted isotope tomography. The X-ray examination shows a wider range of positive diagnosis, but the radionuclide examination is complementary in the detection of supratentorial gliomas. A similar comparative value of the isotope tomogram is noted in the detection of cerebral infarcts.
The responses to movement of shaped stimuli and diffuse illumination were studied for 300 neurons in three thalamic regions of the bog turtle Emys orbicularis L.' characteristics of their receptive fields (RF) were also studied. According to their responses to stimuli of various sizes, neurons were divided into two types. Neurons of Type I (85%) were activated by stimuli of any size and has large, small or medium RF. Weak or medium adaptive changes were found more often (63%) than strong changes (37%). Some of the neurons (33%) did not react to diffuse light; the remainder gave responses of various types. 57% of the neurons exhibited spontaneous activity, and 9% of the units were direction sensitive. Neurons of Type II (15%) responded only to presentation of stimuli of large sizes and were characterized by large RF, strong adaptation (89%) and weak reactivity to diffuse light (46%). 35% of the neurons exhibited spontaneous activity, and 20% were direction sensitive.
The turtle shell forms by extensive ossification of dermis ventrally and dorsally. The carapacial ridge (CR) controls early dorsal shell formation and is thought to play a similar role in shell growth as the apical ectodermal ridge during limb development. However, the molecular mechanisms underlying carapace development are still unknown. Msx genes are involved in the development of limb mesenchyme and of various skeletal structures. In particular, precocious Msx expression is recorded in skeletal precursors that develop close to the ectoderm, such as vertebral spinous processes or skull. Here, we have studied the embryonic expression of Msx genes in the European pond turtle, Emys orbicularis. The overall Msx expression in head, limb, and trunk is similar to what is observed in other vertebrates. We have focused on the CR area and pre-skeletal shell condensations. The CR expresses Msx genes transiently, in a pattern similar to that of fgf10. In the future carapace domain, the dermis located dorsal to the spinal cord expresses Msx genes, as in other vertebrates, but we did not see expansion of this expression in the dermis located more laterally, on top of the dermomyotomes. In the ventral plastron, although the dermal osseous condensations form in the embryonic Msx-positive somatopleura, we did not observe enhanced Msx expression around these elements. These observations may indicate that common mechanisms participate in limb bud and CR early development, but that pre-differentiation steps differ between shell and other skeletal structures and involve other gene activities than that of Msx genes.
The Caspian region and specifically the Apsheron peninsula of Azerbaijan are known to be polluted with a variety of environmental contaminants. These complex mixtures of contaminants make risk assessment difficult. We used the flow cytometry method (FCM) and the micronucleus assay (MN) to assess chromosomal damage in aquatic turtles (Emys orbicularis, the European pond turtle; and Mauremys caspica, the Caspian turtle) inhabiting contaminated wetlands in Azerbaijan. Evidence of genetic damage was found for two sites, Neftchala and Sumgayit, relative to a reference site, Ali Bairamly. Sediment samples from each site were analyzed for PAHs and mercury to evaluate potential contaminant associations with genetic damage. A significant positive correlation was documented between three-ring PAH sediment concentrations and FCM estimates of chromosomal damage in E. orbicularis. These data combine to show that the contaminated wetlands in Sumgayit and Neftchala are genotoxic and that three-ring PAHs are likely a significant influence on observed genotoxicity.
Twelve patients with 13 cerebrovascular incidents presenting with atypical clincial patterns where thecombination of CSF spectrophotometry (CSF-SPE) and computerized transverse axialtomogrpahy(CTAT, "EMI-scanning") showed cerebral haematomas, with or without haemorrhage into the CSFare reported. The high diagnostic significance of SDF-SPE as well as the value of using a combination of CSF-SPE and CTAT examinations in cerebrovascular disease has preveiouslybeen established by the authors. The present patient group comprised some 10% of a totalseries of patients with cerebrovascular disease hitherto studied in this fashion. Conclusive findings were found in only 1 fo the 5 cases examined by angiography and in none of the5 cases studied by isotope scan. Since many cerebral haemorrhages obviosly haveatypical clincalfeatures as compared with the "classical" pattern, the combined use of CSF-SPE and CTAT examinations in the diagnosis of cerebral haematomas is a prereguisite for rational therapy.
Thirty-three cases with malignant disease due mainly to lymphoma and testicular tumours were evaluated by computerised tomography (CT) scanning on the EMI general purpose scanner. In many cases there were either more lymph nodes demonstrated than on lymphography or more disease shown in bone or the thorax than was suspected. CT scanning is particularly valuable in showing mesenteric, retrosternal, axillary and para-aortic lymph node enlargement. Bone, liver and pulmonary metastases were shown when not demonstrated by other methods as well as showing the extent of recurrence of malignant disease. In testicular tumours metastatic spread to paravertebral soft tissues behind the diaphragm was clearly demonstrated. This cannot be seen on lymphography. CT scanning appears to be the most accurate method to date of showing the extent of malignant disease, particularly in cases of lymphoma and testicular tumours.
BACKGROUND: There is doubt about the value of training in dementia care in U.K. nursing homes. We decided to estimate the association between nursing staff's attitudes to dementia and dementia care and their recognition of cognitive impairment in residents and other indicators of care practice in nonspecialist nursing homes derived from a probability sample of 445 residents in South-East England, and to relate this to previous training. METHODS: Prospective survey. The most senior nurse on duty was interviewed about each resident sampled, about their own training and experience, their attitude to restriction of egress and covert medication use, and asked to complete the Attitudes to Dementia Questionnaire (ADQ) and the dementia Care Styles Questionnaire (CSQ). Nurses were also asked about care practices in relation to restriction of egress and covert medication use in the home. Residents were interviewed using the Mini-mental State Examination (MMSE). RESULTS: One hundred and fifty-eight nurses were interviewed. Increased person-centered attitudes seem to be associated with better recognition of cognitive impairment independent of training and experience. The espousal of restrictive practices was also associated with better recognition, but only when analysis included nurses reporting on only one impaired resident. CONCLUSIONS: More person-centered attitudes are associated with better recognition of cognitive impairment, despite perverse U.K. regulatory incentives; the need for training and support in developing person-centered dementia care for staff in "non-Elderly Mentally Infirm" ("non-EMI") care homes is supported by these results.
Emys orbicularis is a turtle with temperature-dependent sex determination. The thermosensitive period (TSP) lies between embryonic stages 16 and 22. Gonadal differentiation begins during this period involving oestrogens. Treatment with oestrogens during TSP results in the differentiation of ovaries at a male-producing temperature (25 degrees C), whereas treatment with an antioestrogen (tamoxifen) or with nonsteroidal aromatase inhibitors results in gonadal masculinization at a female-producing temperature (30 degrees C). The present study examines the effects on the ovary of inhibiting aromatase activity after TSP. Eggs of E. orbicularis incubated at 30 degrees C were given five or seven applications of 10 micrograms aromatase inhibitor Letrozole (CGS 20267) in ethanol, between stages 22+ and 24-25 when ovarian aromatase activity strongly increases. Individuals which received five applications were sacrificed at stages 24(+)-25. Those which received seven applications were sacrificed either at stage 25+ (close to hatching), or 34-36 days after hatching. Gonadal aromatase activity and related gonadal structure were studied in each individual. In the three series, the gonadal aromatase activity in individuals treated with Letrozole varied from similar or close to that in controls to much lower, and the gonadal structure varied from ovary-like to ovotestis. Ovotestes had the lowest levels of aromatase activity, under 4 fmoles/h/gonad, close to testis levels. They were found in 7 out of 26 individuals given Letrozole. Besides ovotestes, gonads presenting various degrees of masculinization, with enlarged epithelial cords and lacunae in the medulla, were found. Therefore, by inhibiting aromatase activity and thus estrogen synthesis, we were able to obtain the differentiation of testis-like cords or tubes in ovaries of E. orbicularis, after the period of temperature sensitivity. These results show that the ovary retains male potential after this period. Thus, besides their implication during the critical embryonic period for gonadal sex differentiation, oestrogens play a role in maintaining the ovarian structure after this period. A decrease in oestrogen levels could explain some other cases of ovarian masculinization known in vertebrates.
The results of transverse axial computerized tomography in EMI scan (transverse CAT) in 2 000 examinations are reviewed. The method was shown to enlarge significantly the diagnostic possibilities in cerebral disease. A correct identification of intracranial tumour was made in 98% of 250 cases. Cerebral haemorrhage, infarction and contusional oedema could be differentiated. Various forms and extensions of cerebral oedema were visualized as never before. Postoperative changes and the course of vascular disease, tumour or hydrocephalus after shunt were demonstrated at an early stage. The indications for pneumo-encephalography have been reduced to a few very special situations. On the other hand, angiography is still of decisive value in vascular cerebral disease and should be performed before surgery in case of space-occupying lesions.
EMILIN (elastin microfibril interfase located Protein) is an elastic fiber-associated glycoprotein consisting of a self-interacting globular C1q domain at the C terminus, a short collagenous stalk, an extended region of potential coiled-coil structure, and an N-terminal cysteine-rich domain (EMI domain). Using the globular C1q domain as a bait in the yeast two-hybrid system, we have isolated a cDNA encoding a novel protein. Determination of the entire primary structure demonstrated that this EMILIN-binding polypeptide is highly homologous to EMILIN. The domain organization is superimposable, one important difference being a proline-rich (41%) segment of 56 residues between the potential coiled-coil region and the collagenous domain absent in EMILIN. The entire gene (localized on chromosome 18p11.3) was isolated from a BAC clone, and it is structurally almost identical to that of EMILIN (8 exons, 7 introns with identical phases at the exon/intron boundaries) but much larger (about 40 versus 8 kilobases) than that of EMILIN. Given these findings we propose to name the novel protein EMILIN-2 and the prototype member of this family EMILIN-1 (formerly EMILIN). The mRNA expression of EMILIN-2 is more restricted compared with that of EMILIN-1; highest levels are present in fetal heart and adult lung, whereas, differently from EMILIN-1, adult aorta, small intestine, and appendix show very low expression, and adult uterus and fetal kidney are negative. Finally, the EMILIN-2 protein is secreted extracellularly by in vitro-grown cells, and in accordance with the partial coexpression in fetal and adult tissues, the two proteins shown extensive but not absolute immunocolocalization in vitro.
Non-linearities in projection values on computed tomography (CT) scanners cause corresponding errors in derived Hounsfield unit attenuation measurements. Existing commercial machines have been refined for clinical usefulness but not necessarily for quantitative accuracy. In this report the results of measurements on the EMI 7070 fourth-generation scanner are presented and compared with theory with particular attention being paid to the scatter artefact and fan-beam energy profile. It is concluded that, irrespective of any quality assurance protocol, interpatient and interslice errors can be expected to range from 3 to 10% for water-equivalent materials and the intraslice positional dependence of the CT number can vary up to 5% for dense bone-like materials in a uniform phantom. It seems as though the principal cause of this variation is an increase in the effective x-ray energy in the fan beam with increasing distance from the central ray.
The slice geometry of the EMI head scanner is investigated. It is shown that the slice thickness is positionally dependent. The slice is thinner in the central part than on the periphery and also thinner on the tube side than on the detector side. It is also shown that there is a missing region between slices A and B.
A modified water box for the EMI brain scanner is described. The modified box permits parts of the body other than the brain to be scanned. The patient setup for brain scans is simplified, and motion artifacts have almost disappeared.
The importance of clear and complete annotation of computed tomograms is emphasized. The presence of an "L" on the right side of EMI brain scans displayed with the newer viewer equipment indicates the need for attention to this problem.
A new 6 mm collimator for the EMI CT5000/5005 scanner is described. It consists of a narrower tube side and detector side collimator that can be set up in less than 5 min. The applications are primarily for the orbit and parasellar area. Future applications with the aid of new software include coronal reconstruction.