Multimedia

Transthoracic Echocardiograms of a Study Patient With Typical Bicuspid Aortic Valve

Interactive feature for Michelena HI, Khanna AD, Mahoney D, et al. Incidence of Aortic Complications in Patients With Bicuspid Aortic Valves. JAMA. 2011;306(10):1104-1112.

Interactive videos of parasternal short- and long-axis echocardiograms of a study patient with typical bicuspid aortic valve (BAV).

Cardiovascular Magnetic Resonance Cine Imaging of Ventricular Ballooning Patterns in Stress Cardiomyopathy

Interactive feature for Eitel I, von Knobelsdorff-Brenkenhoff F, Bernhardt P, et al. Clinical Characteristics and Cardiovascular Magnetic Resonance Findings in Stress (Takotsubo) Cardiomyopathy. JAMA. 2011;306(3):277-286.

Interactive cardiovascular magnetic resonance cine images from representative patients with stress cardiomyopathy demonstrate the 4 distinct patterns of regional ventricular ballooning.

Mechanism of Synthetic Lethality by PARP Inhibition in Cancer Cells With BRCA Mutation

Interactive figure for Tung N. Management of Women With BRCA Mutations: A 41-Year-Old Woman With a BRCA Mutation and a Recent History of Breast Cancer. JAMA. 2011;305(21):2211-2220.

This interactive figure demonstrates how poly (ADP-ribose) polymerase 1 (PARP) inhibitors selectively target cancer cells with BRCA mutations by synthetic lethality.

Major Muscles and Nerves of the Lower Extremity Involved in Testing Neural Control of a Virtual Prosthesis for Individuals With Transfemoral Amputation

Interactive feature for Hargrove LJ, Simon AM, Lipschutz RD, et al. Real-Time Myoelectric Control of Knee and Ankle Motions for Transfemoral Amputees. JAMA. 2011;305(15):1542-1544.

This interactive illustration demonstrates the thigh muscles and their innervation used to achieve myoelectric control of a virtual prosthesis in transfemoral amputees based on motion-specific electromyogram patterns.

DICER1 Mutations in Familial Multinodular Goiter With and Without Ovarian Sertoli-Leydig Cell Tumors

Interactive feature for Frio TR, Bahubeshi A, and Kanellopoulou C, et al. DICER1 Mutations in Familial Multinodular Goiter With and Without Ovarian Sertoli-Leydig Cell Tumors. JAMA. 2011;305(1):68-77.

Use this interactive feature to view and rotate the predicted structures of the PAZ domain of wild-type DICER1 and of 2 mutant DICER1 proteins from affected families.

Association Between Macroeconomic Factors and Hematopoietic Stem Cell Transplant Rates in 71 Countries

Interactive graphs for Gratwohl A, Baldomero H, Aljurf M, et al. Hematopoietic Stem Cell Transplantation: A Global Perspective. JAMA. 2010;303(16):1617-1624.

Use interactive graphs to view the association between macroeconomic factors and hematopoietic stem cell transplant rates in 71 participating countries of the Worldwide Network for Blood and Marrow Transplantation.

Country-Specific Mortality and Growth Failure in Infancy and Young Children and Association With Maternal Stature

Interactive information graphic for Özaltin E, Hill K, and Subramanian SV. Association of Maternal Stature With Offspring Mortality, Underweight, and Stunting in Low- To Middle-Income Countries. JAMA. 2010;303(15):1507-1516.

Use interactive graphs and maps to view and sort country-specific infant and early childhood mortality and growth failure data and their association with maternal stature.

Spoken Language Comprehension and Expression Scores During 3 Years of Follow-up After Cochlear Implantation in Young Children

Interactive graphs for Niparko JK, Tobey EA, Thal DJ, et al. Spoken Language Development in Children Following Cochlear Implantation. JAMA. 2010;303(5):1498-1506.

Use interactive graphs to view and compare Reynell Developmental Language Scales Scores of comprehension and expression during 3 years of follow-up in children after cochlear implantation at different ages and in children with normal hearing.

Kinship and Pathology in King Tutankhamun's Family

Interactive feature for Hawass Z, Gad YZ, Ismail S, et al. Ancestry and Pathology in King Tutankhamun's Family. JAMA. 2010;303(7):638-647.

In this interactive feature, view the royal mummies of the New Kingdom in ancient Egypt included in this study of King Tutankhamun's ancestry and explore the molecular evidence used to construct a pedigree of Tutankhamun's lineage.

Computed Tomographic Angiogram of Abdominal Aortic Aneurysm

Interactive figure for Schermerhorn M. A 66-Year-Old Man With an Abdominal Aortic Aneurysm JAMA. 2009;302(18):2015-2022.

This interactive figure displays computed tomographic angiogram images that demonstrate the presence of an abdominal aortic aneurysm from the patient case, Mr F.

Transport Service Areas for US Burn Centers

Interactive figure for Klein MB, Kramer CB, Nelson J, et al. Geographic Access to Burn Center Hospitals JAMA. 2009;302(16):1774-1781.

These interactive maps display the locations of verified and self-reported US burn centers and the geographic regions within 1, 2, and 4 hours by ground transport and 1 and 2 hours by rotary air transport.

Distribution of Cerebrospinal Fluid Aβ42:P-Tau Ratio and T-Tau Levels in Healthy Controls, Patients With Alzheimer Disease, and Patients With Mild Cognitive Impairment

Interactive figure for Mattsson N, Zetterberg H, Hansson O, et al. CSF Biomarkers and Incipient Alzheimer Disease in Patients With Mild Cognitive Impairment. JAMA. 2009;302(4):385-393.

The 3 panels of this interactive figure show the distribution of cerebrospinal fluid (CSF) Aβ42:P-Tau Ratio and T-Tau Levels in healthy controls, patients with Alzheimer disease, and patients with mild cognitive impairment relative to an 85% sensitivity cutoff for diagnosis of incipient Alzheimer disease among patients with mild cognitive impairment.

Co-occurrence of Chromosomal Alterations and Tumor-Promoting Gene Interactions in Gliomas

Interactive figures for Bredel M, Scholtens DM, Harsh GR, et al. A Network Model of a Cooperative Genetic Landscape in Brain Tumors. JAMA. 2009;302(3):261-275.

Interactive figure 1 displays chromosomal maps showing (A) the associations between chromosomal territories that displayed co-occurrence of gene dosage alterations in gliomas in discovery and validation sets (validated genetic landscape) and (B) the network of highly connected genes with cooperatively tumorigenic relationships in the validated genetic landscape.

Interactive figure 2 displays the complete network model of 214 cooperatively tumorigenic glioma genes and their functionality and alterations in expression.

Distribution of Oseltamivir-Resistant Influenza A(H1N1) Viruses Identified in the United States, 2007-2008

Interactive figure for Dharan NJ. Infections With Oseltamivir-Resistant Influenza A(H1N1) Virus in the United States. JAMA. 2009;301(10):1034-1041.

This interactive map displays the number of oseltamivir-resistant influenza A(H1N1) viruses identified in each state.

Normal Upper Extremity and Chest Anatomy and Examples of Targeted Muscle Reinnervation

Interactive figure for Kuiken T, et al. Targeted Muscle Reinnervation for Real-time Myoelectric Control of Multifunction Artificial Arms. JAMA. 2009;301(6):619-628.

This interactive figure displays the normal muscular anatomy and innervation of the major muscles of the chest, shoulder, back, and arm, and examples of targeted muscle reinnervation surgery for patients with shoulder-disarticulation and transhumeral amputation.

Targeted Muscle Reinnervation for Advanced Prosthetic Arms

Multimedia feature for Kuiken T, et al. Targeted Muscle Reinnervation for Real-time Myoelectric Control of Multifunction Artificial Arms. JAMA. 2009;301(6):619-628.

This multimedia feature explains how targeted muscle reinnervation (TMR) is used to control advanced prosthetic arms. Three patients who underwent TMR surgery demonstrate this technology.

Computed Tomography Angiography for Detection of Peripheral Arterial Disease

Interactive figure for Met R. Diagnostic Performance of Computed Tomography Angiography in Peripheral Arterial Disease. JAMA. 2009;301(4):415-424.

This interactive figure displays the anatomy underlying a computed tomography angiogram in an individual with peripheral arterial disease. The image demonstrates total occlusion of the left common iliac artery with severe calcification.

Abdominal Ultrasound of a Woman with Uterine Fibroids

Interactive figure for Van Voorhis B. A 41-Year-Old Woman with Menorrhagia, Anemia, and Fibroids. JAMA. 2009;301(1):82-93.

This interactive figure displays the anatomy underlying an abdominal ultrasound of a woman with uterine fibroids. The large fibroids distort the shape of the uterus.

MRI of Individual With Mild Cognitive Impairment

Interactive figure for Ellison JM. A 60-Year-Old Woman With Mild Memory Impairment. JAMA. 2008;300(13):1566-1574.

This interactive figure displays the anatomy underlying a T2-weighted fluid attenuated inversion recovery magnetic resonance image in a case patient with mild cognitive impairment. The image demonstrates bilateral subcortical and periventricular discrete and confluent T2-enhancing white matter lesions with no significant cortical atrophy.

Serial Magnetic Resonance Imaging of a Brainstem Hemagioblastoma Demonstrating Peritumoral Cyst Formation in a Patient with von Hippel-Lindau Disease

Interactive figure for Butman JA, Lineham WM, and Lonser RR. Neurologic Manifestations of von Hippel-Lindau Disease. JAMA. 2008;300(11):1334-1342.

This interactive figure displays the anatomy underlying serial MRIs of a brainstem hemangioblastoma that demonstrate formation of a peritumoral cyst in a patient with von Hippel-Lindau disease.

Anatomy of the L4-L5 Functional Spinal Unit and Associated Neural Structures

Interactive feature for Rathmell JP. A 50-Year-Old Man With Chronic Low Back Pain. JAMA. 2008;299(17):2066-2077.

This multimedia feature includes an interactive model of the normal L4-L5 functional spinal unit and demonstrates the progression from early to late degenerative changes.

Model of Influenza B Neuraminidase Monomer

Interactive figure for Hatakeyama S, Sugaya N, Ito M. Emergence of Influenza B Viruses With Reduced Sensitivity to Neuraminidase Inhibitors. JAMA. 2007;297:1435-1442.

This interactive feature is a rotatable model of an influenza B neuraminidase monomer that demonstrates the location of mutations associated with reduced sensitivity to neuraminidase inhibitors.

3D Model of Basal Ganglia

Interactive figure for Voelker R. Scientists Use Neuroimaging, Genetic Studies to Probe Biology of Tourette Syndrome. JAMA. 2004;292:909-911.

This interactive feature is a rotatable 3-dimensional computer model of the caudate, putamen, and globus pallidus, in which surface structures were extracted automatically from magnetic resonance imaging data.

Ligamentous and Meniscal Injuries of the Knee: Basic Anatomy and Functional Examination

Interactive feature for Solomon DH, Simel DL, Bates DW, Katz JN, Schaffer JL. Does This Patient Have a Torn Meniscus or Ligament of the Knee? JAMA. 2001;286:1610-1620.

This interactive feature illustrates knee anatomy and demonstrates maneuvers used to perform a thorough functional examination of the knee.

Development and Testing of Myoelectric Control of a Virtual Lower Limb Prosthesis for Individuals With Transfemoral Amputation

Video for Hargrove LJ, Simon AM, Lipschutz RD, et al. Real-Time Myoelectric Control of Knee and Ankle Motions for Transfemoral Amputees. JAMA. 2011;305(15):1542-1544.

This video demonstrates how electromyogram (EMG) patterns from residual thigh muscles in a patient with a transfemoral amputation are used to control virtual knee and ankle motions.

Contrast Angiography of Mr C's Left and Right Coronary Arteries

Video for Pinto DS. A 43-Year-Old Man With Angina, Elevated Troponin, and Lateral ST Depression: Management of Acute Coronary Syndromes. JAMA. 2010;303(1):54-63.

This video includes 4 angiographic views of the left coronary artery and a single view of the right coronary artery. The angiogram shows disease at the origin of the left anterior descending artery (LAD) and proximal disease in a large diagonal branch, occlusion and diffuse disease in the mid portion of the LAD, and collateral filling of the distal LAD. The angiogram of the right coronary artery shows an area of severe stenosis in the mid portion of the vessel.

Simulation of Floaters

Video for Hollands H, Johnson D, Brox AC, et al. Acute-Onset Floaters and Flashes: Is This Patient at Risk for Retinal Detachment? JAMA. 2009;302(20):2243-2249.

This video simulates the appearance of floaters as experienced by an individual scanning an open landscape.

Open and Endovascular Repair of Abdominal Aortic Aneurysm

Video for Schermerhorn M. A 66-Year-Old Man With an Abdominal Aortic Aneurysm: Review of Screening and Treatment. JAMA. 2009;302(18):2015-2022.

This video explains local anatomy and key steps in both open and endovascular repair of an abdominal aortic aneurysm.

Tubular Diskectomy vs Conventional Diskectomy for Treatment of Sciatica

Video for Arts MP, Brand R, van den Akker ME, et al. Tubular Diskectomy vs Conventional Microdiskectomy for Sciatica: A Randomized Controlled Trial. JAMA. 2009;302(2):149-158.

These videos demonstrate representative cases of the 2 surgical techniques compared in this randomized trial among patients with sciatica due to lumbar disk herniation.

Intramyocardial Bone Marrow Cell Injection in a Patient With Chronic Myocardial Ischemia

Video for van Ramshorst J, Bax JJ, Beeres SLMA, et al. Intramyocardial Bone Marrow Injection for Chronic Myocardial Ischemia. JAMA. 2009;301(19):1997-2004.

This video explains how intramyocardial bone marrow cell injection is performed and shows a patient with chronic myocardial ischemia undergoing this procedure.

Nasal Endoscopy

Video for Hwang PH. A 51-Year-Old Woman With Acute Onset of Facial Pressure, Rhinorrhea, and Tooth Pain. JAMA. 2009;301(17):1798-1807.

Video of a normal nasal endoscopy.

Rotating 3-dimensional Fluorodeoxyglucose F18-Positron Emission Tomography Whole-Body Maximal Intensity Projection Image

Video for Masciari S, Van den Abbeele AD, Diller LR, et al. F18-Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography Screening in Li-Fraumeni Syndrome. JAMA. 2008;299(11):1315-1319.

This video displays a rotating whole-body maximal intensity projection image of an individual with Li-Fraumeni Syndrome and gastroesophageal junction cancer.

A 74-Year-Old Man With Memory Loss and Neuropathy Who Enjoys Alcoholic Beverages

Video for Brust, J. A 74-Year-Old Man With Memory Loss and Neuropathy Who Enjoys Alcoholic Beverages. JAMA. 2008;299(9):1046-1054.

In this video, Mr E describes the loss of strength and function he has experienced in his hands and demonstrates atrophy of the intrinsic muscles of his hands and claw deformities of his fourth and fifth fingers. The video also shows the examination of Mr E's gait.

Use of Indigo Carmine Solution in Endoscopic Identification and Resection of Nonpolypoid Colorectal Neoplasms

Video for Soetikno RM, Kaltenbach T, Rouse RV et al. Prevalence of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Asymptomatic and Symptomatic Adults. JAMA. 2008;299(9):1027-1035.

This video supplement demonstrates the use of indigo carmine solution to identify a flat, nonpolypoid adenoma followed by endoscopic mucosal resection of the lesion.

Transthoracic Echocardiogram of a Patient With Sickle Cell Disease and Pulmonary Hypertension

Video for Barnett CF, Hsue PY, and Machado RF. Pulmonary Hypertension: An Increasingly Recognized Complication of Hereditary Hemolytic Anemias and HIV Infection. JAMA. 2008;299(3):324-331.

This video supplement includes the 2-dimensional and color doppler echocardiograms of the case patient with sickle cell disease and pulmonary hypertension presented in the companion JAMA article.

Pulmonary Vein Radiofrequency Catheter Ablation Therapy for Atrial Fibrillation

Video for Marine JE. Catheter Ablation Therapy for Supraventricular Arrhythmias. JAMA. 2007;298(23):2768-2778.

This video provides an overview of the technique of circumferential pulmonary vein catheter ablation for the treatment of atrial fibrillation. This example demonstrates the integration of a patient's pre-acquired computed tomography or magnetic resonance cardiac images with a 3-dimensional electroanatomical mapping system during the procedure to guide the ablation, including catheter manipulation and identification of ablation sites.

Overview of Reverse Cholesterol Transport and High Density Lipoprotein Metabolism

Video for Singh IM, Shishehbor MH, Ansell BJ. High-Density Lipoprotein as a Therapeutic Target: A Systematic Review. JAMA. 2007;298(7):786-798.

This video provides an overview of how high-density lipoprotein may protect against cardiovascular disease through the mechanism of reverse cholesterol transport.

Echocardiogram of a Patient With Cardiac Tamponade

Video for Roy CL, Minor MA, Brookhart MA, Choudhry NK. Does This Patient With a Pericardial Effusion Have Cardiac Tamponade? JAMA. 2007;297:1810-1818.

In this video, a large circumferential pericardial effusion compressing the heart is visualized by transthoracic echocardiography in a patient with cardiac tamponade.

Detection of Patent Foramen Ovale Using Contrast Transesophageal Echocardiography

Video for Allemann Y, Hutter D, Ernst L, et al. Patent Foramen Ovale and High-Altitude Pulmonary Edema. JAMA. 2006;296:2954-2958.

This video demonstrates the detection of a patent foramen ovale using contrast transesophageal echocardiography in the long axis view.

3D Imaging of Head and Neck Vasculature

Video for Zeller JL. New 3D Imaging Software Opens New Vistas. JAMA. 2006;296:2908-2913.

This video shows a capture of 3D imaging of the vasculature of the head and neck created from noncontrast magnetic resonance imaging data.

Doppler Auscultation of the Posterior Tibial Artery

Video for Khan NA, Rahim SA, Anand SS, Simel DL, Panju A. Does the Clinical Examination Predict Lower Extremity Peripheral Arterial Disease? JAMA. 2006;295:536-546.

This video displays the anatomy, technique, and sound characteristics of Doppler auscultation of the posterior tibial artery of a healthy individual.

Intravascular Ultrasound to Measure Progression of Atherosclerosis

Video for Nissen SE, Tuzcu EM, Schoenhagen P. Effect of Intensive Compared With Moderate Lipid-Lowering Therapy on Progression of Coronary Atherosclerosis. JAMA. 2004;291:1071-1080.

This video demonstrates the technique of intravascular ultrasound imaging and determination of atheroma area before and after lipid-lowering therapy.

Use of Augmented Reality for Laparoscopic Adrenalectomy

Video for Marescaux J. Augmented-Reality�Assisted Laparoscopic Adrenalectomy. JAMA. 2004;292:2214-2215.

This video demonstrates the preoperative and intraoperative use of augmented reality for laparoscopic adrenalectomy in a patient with Conn adenoma.

Mitochondrial Movement in a Cortical Neuron

Video for Friedrich MJ. Scientists Probe Roles of Mitochondria in Neurological Disease and Injury. JAMA. 2004;291:679-681.

This time-lapse video shows mitochondria moving along the cytoskeleton of a single cortical neuron transfected with mitochondrially targeted yellow fluorescent protein.