Scanning wedge

F. 1 Conparison of the characteristic grey scale transmission of a) the IP scanner BAS2000 and b) the film scanner NOT Scan n(DBA Systems) for a step wedge exposure. 

Visualization of Wedge-Shaped Lesions by Bone Scan with MDP and MRI... 

This patient, who had autosomal dominant polycystic kidney disease (ADPKD), almost drowned and then developed ALPE. On July 20, 1990, he nearly drowned in the sea at 1500 hours, and was brought to our hospital by ambulance for dyspnea and severe loin pain at 1620 hours. On admission, metabolic acidosis was observed. His CRP, serum creatinine, CPK, amylase, and urinary protein levels were 1+, 1.5mg/dl, 116 U/l, 592IU/1 (derived from the salivary gland), and 2+, respectively. His body temperature was 37.7°C, and his blood pressure was 110/60 mmHg. His pulse and respiratory rate were 120/min and 22/min, respectively. Delayed CT 6h after the administration of contrast medium showed wedge-shaped contrast enhancement in the noncystic renal parenchyma (Fig. 34). On July 24, a bone scan with MDP revealed patchy lesions (Fig. 35). His serum creatinine level was 1.3 mg/dl, which had decreased to 1.0 mg/dl on July 27. The patient was then discharged. 

MRI and a bone scan with MDP showed wedge-shaped contrast enhancement in some patients, although these procedures were less sensitive than CT. Patchy lesions could be visualized by a bone scan with MDP in Patients 5 (Fig. 18), 12 (Fig. 33), 13 (Fig. 35), and 16 (Fig. 40). This visualization was achieved by MRI in Patients 6 [35] (Fig. 26), 16 (Fig. 22 and Fig. 39), and 21 (Fig. 45). In the future, ultrasonography with Levovist will facilitate the visualization of lesions. 

On June 6, this patient developed severe loin pain after he participated in two 150-m sprints at a town athletics meeting. After 5 days, he was referred to the outpatient clinic of our department. His serum creatinine and uric acid levels and FEUA, were 2.9mg/dl, 2.1 mg/dl, and 49.7%, respectively. His creatine phosphokinase (CPK) level was normal. When his serum creatinine level decreased to 1.58 mg/dl, a contrast medium was administered. A delayed computed tomography (CT) scan after 24 and 48 h confirmed patchy wedge-shaped contrast enhancement (Fig. 58). Under a diagnosis of ALPE, his body water balance (hydration) was controlled. In this patient, recovery was achieved 4 weeks after onset, and his serum creatinine and uric acid levels were then 1.0 mg/dl and 0.6 mg/dl, respectively. Furthermore, load tests with a uric acid reabsorption inhibitor (benzbromarone) and a uric acid excretion inhibitor (pyrazinamide) suggested presecretory reabsorption defect-related renal hypouricemia. A kidney biopsy 16 days after onset confirmed the recovery from acute tubular necrosis. 

Delayed CT scan after Patchy wedge-shaped Diffuse enhancement... 

In the patients with ALPE, plain CT of the kidney (delayed CT) a few hours, 24 h, and 48 h after the administration of 40 ml contrast medium showed wedge-shaped contrast enhancement. When physicians hesitate to administer a contrast medium, patchy accumulation can be sometimes detected by magnetic resonance imaging (MRI) with gadolinium-diethylenetriaminopentoacetic acid (Gd-DTPA), bone scan with MDP, or ultrasonography with Levovist. 

Ishii H, Saitoh T, Ishikawa I (1997) Wedge-shaped enhancement on delayed CT scan during vasopressin infusion in rats (in Japanese with English abstract). J Kanazawa Med Univ 22 15-25... 

The Brinkman Model 2010 analyzer (figure 9.16) scans the sample with a shaped and focused laser beam using a rotating wedge prism. The time... 

A third group of calibration procedures, the (3) direct (single step) [23-25] techniques avoids (many of) these problems. In particular, the so-called improved wedge-calibration method, in which a tip/cantilever is scanned across a calibration sample with two well-defined slopes (see Fig. 2.31), allows one to calculate the calibration factors with an error of ca. 5% [18]. 

In the wedge calibration method, a cantilever is scanned across a calibration sample with two well-defined slopes. The friction signal is recorded as a function of the applied load. At a given load L, friction and normal forces (normal force = load + adhesion A) depend on the direction of motion (Fig. 2.32). 

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