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Sample records for suspicious lns us-guided

  1. SUSPICIOUS POST

    CERN Multimedia

    Relations with the Host States Service

    2001-01-01

    If you receive a suspicious letter or package in the post, please do not open it and contact the Fire Brigade Tel. 74444. They will contact the CERN Medical Service. This is especially important in today's current situation with regard to the Anthrax scare. For further information, the Permanent Mission of Switzerland to the International Organisations in Geneva recommends the following web sites:   http://www.admin.ch/ch/f/cf/brennpunkt/03.html http://www.who.int/emc-documents/zoonoses/whoemczdi986c.html

  2. The NUMEN project @ LNS: Status and perspectives

    Science.gov (United States)

    Cappuzzello, F.; Agodi, C.; Acosta, L.; Auerbach, N.; Bellone, J.; Bijker, R.; Bonanno, D.; Bongiovanni, D.; Borello-Lewin, T.; Boztosun, I.; Branchina, V.; Bussa, M. P.; Calabrese, S.; Calabretta, L.; Calanna, A.; Carbone, D.; Cavallaro, M.; Calvo, D.; Lomelí, E. R. Chávez; Coban, A.; Colonna, M.; D'Agostino, G.; Degeronimo, G.; Delaunay, F.; Deshmukh, N.; de Faria, P. N.; Ferraresi, C.; Ferreira, J. L.; Fisichella, M.; Foti, A.; Finocchiaro, P.; Gallo, G.; Garcia, U.; Giraudo, G.; Greco, V.; Hacisalihoglu, A.; Kotila, J.; Iazzi, F.; Introzzi, R.; Lanzalone, G.; Lavagno, A.; Via, F. La; Lay, J. A.; Lenske, H.; Linares, R.; Litrico, G.; Longhitano, F.; Presti, D. Lo; Lubian, J.; Medina, N.; Mendes, D. R.; Muoio, A.; Oliveira, J. R. B.; Pakou, A.; Pandola, L.; Petrascu, H.; Pinna, F.; Reito, S.; Rifuggiato, D.; Rodrigues, M. R. D.; Russo, A. D.; Russo, G.; Santagati, G.; Santopinto, E.; Sgouros, O.; Solakcı, S. O.; Souliotis, G.; Soukeras, V.; Spatafora, A.; Torresi, D.; Tudisco, S.; Vsevolodovna, R. I. M.; Wheadon, R. J.; Yildirin, A.; Zagatto, V.

    2017-10-01

    The NUMEN project aims at accessing experimentally driven information on Nuclear Matrix Elements (NME) involved in the half-life of the neutrinoless double beta decay (0νββ), by high-accuracy measurements of the cross sections of Heavy Ion (HI) induced Double Charge Exchange (DCE) reactions. Particular attention is given to the (18O,18Ne) and (20Ne,20O) reactions as tools for β+β+ and β-β-decays, respectively. First evidence about the possibility to get quantitative information about NME from experiments is found for both kind of reactions. In the experiments, performed at INFN - Laboratory Nazionali del Sud (LNS) in Catania, the beams are accelerated by the Superconducting Cyclotron (CS) and the reaction products are detected the MAGNEX magnetic spectrometer. The measured cross sections are challengingly low, limiting the present exploration to few selected isotopes of interest in the context of typically low-yield experimental runs. A major upgrade of the LNS facility is foreseen in order to increase the experimental yield of at least two orders of magnitude, thus making feasible a systematic study of all the cases of interest. Frontiers technologies are going to be developed, to this purpose, for the accelerator and the detection systems. In parallel, advanced theoretical models will be developed in order to extract the nuclear structure information from the measured cross sections.

  3. Use of fragmentation beams at LNS with CHIMERA detector

    Directory of Open Access Journals (Sweden)

    Gianí R.

    2012-07-01

    Full Text Available The recent intensity upgrade of the LNS fragmentation beam is discussed. The available beams, the tagging procedures and details on the beam quality are reported. The experimental program started with the CHIMERA detector using such beams is also discussed with preliminary results and future perspectives.

  4. Using CHIMERA detector at LNS for gamma-particle coincidences

    Directory of Open Access Journals (Sweden)

    Cardella G.

    2016-01-01

    Full Text Available We have recently evaluated the quality of γ-ray angular distributions that can be extracted in particle-gamma coincidence measurements using the CHIMERA detector at LNS. γ-rays have been detected using the CsI(Tl detectors of the spherical part of the CHIMERA array. Very clean γ-rays angular distributions were extracted in reactions induced by different stable beams impinging on 12C thin targets. The results evidenced an effect of projectile spin flip on the γ-rays angular distributions. γ-particle coincidence measurements were also performed in reactions induced by neutron rich exotic beams produced through in-flight fragmentation at LNS. In recent experiments also the Farcos array was used to improve energy and angular resolution measurements of the detected charged particles. Results obtained with both stable and radioactive beams are reported.

  5. Acceptability of lipid-based nutrient supplements (LNS) among Ghanaian infants and pregnant or lactating women.

    Science.gov (United States)

    Adu-Afarwuah, Seth; Lartey, Anna; Zeilani, Mamane; Dewey, Kathryn G

    2011-10-01

    Inadequate micronutrient intake during pregnancy, lactation and infancy is a major problem in many developing countries. Lipid-based nutrient supplements (LNS) can improve micronutrient status, growth and development of infants, and also have potential to improve nutritional status of pregnant and lactating women. The objective of the study was to test the acceptability of LNS designed for infants (LNS-20gM) and pregnant or lactating women (LNS-P&L). Participants were infants (n = 22, mean age = 8 months) and pregnant or lactating women (n = 24) attending routine services at a hospital in Ghana. Infants consumed 45 g of a test meal consisting of one part LNS-20gM and three parts fermented maize porridge, while women consumed 50 g of a similar test meal containing LNS-P&L instead. Participants also used their respective LNS at home for 14 days. Primary outcome was the proportion of the test meal consumed. On average, infants consumed 76.2% of the test meal [95% (confidence interval) CI: 65.7, 86.7], while women consumed 87.1% (95% CI: 82.6, 91.6). During the 14-day period, median daily consumption of LNS-20gM was 19.3 g, very close to the recommended 20 g d(-1), while that of LNS-P&L was one sachet, as recommended. We conclude that LNS-20gM and LNS-P&L were well accepted. © 2010 Blackwell Publishing Ltd.

  6. The value of preoperative ultrasound guided fine-needle aspiration cytology of radiologically suspicious axillary lymph nodes in breast cancer

    Directory of Open Access Journals (Sweden)

    Torill Sauer

    2014-01-01

    Full Text Available Background: Preoperative ultrasound (US and eventually US-guided fine-needle aspiration cytology (FNAC of suspicious axillary lymph nodes (ALN is a standard procedure in the work-up of suspicious breast lesions. Preoperative US FNAC may prevent sentinel node biopsy (SNB procedure in 24-30% of patients with early stage breast carcinoma. The aim of this study was to evaluate the institutional results of this preoperative diagnostic procedure. Materials and Methods: A total of 182 cases of preoperative FNAC of suspicious ALN where retrieved from the pathology files. The results were compared with the final histology and staging. False negative (FN FNAC cases were reviewed and possibly missed metastatic cases (2 were immunostained with the epithelial marker AE1/AE3. Results: There were no false positives, whereas 16 cases were FN. In all but one case the FN′s represented sampling error. Half of the 16 FN cases in this series were macrometastases. Discussion: About 83% of the preoperatively aspirated cases were N+, indicating that a radiologically suspicious ALN has a very high risk of being metastatic. Preoperative US guided FNAC from radiologically suspicious ALN is highly efficient in detecting metastases. Depending on national guidelines, a preoperative, positive ALN FNAC might help to stratify the patients as to SNB and/or ALN dissection.

  7. Recent progress in plasma modelling at INFN-LNS

    Science.gov (United States)

    Neri, L.; Castro, G.; Torrisi, G.; Galatà, A.; Mascali, D.; Celona, L.; Gammino, S.

    2016-02-01

    At Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS), the development of intense ion and proton sources has been supported by a great deal of work on the modelling of microwave generated plasmas for many years. First, a stationary version of the particle-in-cell code was developed for plasma modelling starting from an iterative strategy adopted for the space charge dominated beam transport simulations. Electromagnetic properties of the plasma and full-waves simulations are now affordable for non-homogenous and non-isotropic magnetized plasma via "cold" approximation. The effects of Coulomb collisions on plasma particles dynamics was implemented with the Langevin formalism, instead of simply applying the Spitzer 90° collisions through a Monte Carlo technique. A wide database of different cross sections related to reactions occurring in a hydrogen plasma was implemented. The next step consists of merging such a variety of approaches for retrieving an "as-a-whole" picture of plasma dynamics in ion sources. The preliminary results will be summarized in the paper for a microwave discharge ion source designed for intense and high quality proton beams production, proton source for European Spallation Source project. Even if the realization of a predictive software including the complete processes involved in plasma formation is still rather far, a better comprehension of the source behavior is possible and so the simulations may support the optimization phase.

  8. Recent progress in plasma modelling at INFN-LNS

    Energy Technology Data Exchange (ETDEWEB)

    Neri, L., E-mail: neri@lns.infn.it; Castro, G.; Mascali, D.; Celona, L.; Gammino, S. [INFN-Laboratori Nazionali del Sud, Via S. Sofia 62, 95125 Catania (Italy); Torrisi, G. [INFN-Laboratori Nazionali del Sud, Via S. Sofia 62, 95125 Catania (Italy); Università Mediterranea di Reggio Calabria, Via Graziella, 89100 Reggio Calabria (Italy); Galatà, A. [INFN-Laboratori Nazionali di Legnaro, Viale dell’Università 2, 35020 Legnaro, Padova (Italy)

    2016-02-15

    At Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS), the development of intense ion and proton sources has been supported by a great deal of work on the modelling of microwave generated plasmas for many years. First, a stationary version of the particle-in-cell code was developed for plasma modelling starting from an iterative strategy adopted for the space charge dominated beam transport simulations. Electromagnetic properties of the plasma and full-waves simulations are now affordable for non-homogenous and non-isotropic magnetized plasma via “cold” approximation. The effects of Coulomb collisions on plasma particles dynamics was implemented with the Langevin formalism, instead of simply applying the Spitzer 90° collisions through a Monte Carlo technique. A wide database of different cross sections related to reactions occurring in a hydrogen plasma was implemented. The next step consists of merging such a variety of approaches for retrieving an “as-a-whole” picture of plasma dynamics in ion sources. The preliminary results will be summarized in the paper for a microwave discharge ion source designed for intense and high quality proton beams production, proton source for European Spallation Source project. Even if the realization of a predictive software including the complete processes involved in plasma formation is still rather far, a better comprehension of the source behavior is possible and so the simulations may support the optimization phase.

  9. (aspiration cytology and mammography) of clinically suspicious ...

    African Journals Online (AJOL)

    Combined assessment. (aspiration cytology and mammography) of clinically suspicious breast masses. W. F. van Wyk, D. M. Dent, E. Anne Hacking,. Genevieve Learmonth, R. E. Kottler,. C. Anne Gudgeon, A. Tiltman. We examined the safety and utility of the combined assessment of aspiration cytology and mammography ...

  10. Unattended Monitoring of Suspicious Behaviour for Route Surveillance

    NARCIS (Netherlands)

    Schoemaker, R.M.; Sandbrink, R.D.J.; Voorthuijsen, G.P. van

    2010-01-01

    A priori information on suspicious behaviour is extremely valuable for countering threats involving improvised explosive devices (IEDs). Suspicious activities along routes during expeditionary operations can be monitored by unattended networks using simple sensing nodes that can gather data for

  11. An LNS Approach for Container Stowage Multi-port Master Planning

    DEFF Research Database (Denmark)

    Pacino, Dario

    2013-01-01

    The generation of competitive stowage plans have become a priority for the shipping industry. Stowage planning is NP-hard and is a challenging optimization problem in practice. Two-phase decomposition approaches have proved to give viable solutions. We propose a large neighborhood search (LNS...

  12. Preventative lipid-based nutrient supplements (LNS) and young child feeding practices: findings from qualitative research in Haiti.

    Science.gov (United States)

    Lesorogol, Carolyn; Jean-Louis, Sherlie; Green, Jamie; Iannotti, Lora

    2015-12-01

    To prevent undernutrition in an urban slum in Haiti, a lipid-based nutrient supplement (LNS) was introduced through a randomised control trial. Food supplementation for young child nutrition has a long history in Haiti, but there is little empirical information regarding the effects of supplementation on young child feeding practices. One of the concerns raised by supplementation is that it may disrupt other positive feeding practices such as breastfeeding and use of other complementary foods, with negative consequences for child nutrition. We conducted 29 in-depth interviews with mother-baby pairs from the three comparison groups: control, 3-month LNS supplementation and 6-month LNS supplementation. Findings from those in the LNS groups indicated high acceptance and satisfaction with LNS and perceptions that it positively affects child health and development. LNS was integrated into and enhanced ongoing complementary feeding practices. The effects of LNS use on duration and perceived quantity of breastfeeding were variable, but generally, breastfeeding was maintained during and after the intervention. Interviews generated insights into beliefs regarding infant and young child feeding practices such as introduction and use of complementary foods, and breastfeeding duration, exclusivity and cessation. Implications for the use of LNS in public health nutrition programmes are discussed. © 2014 John Wiley & Sons Ltd.

  13. Pulse-by-pulse variation of energy spectra on the LNS linac

    Energy Technology Data Exchange (ETDEWEB)

    Miyamoto, A.; Oyamada, M.; Kurihara, A.; Shinto, K.; Mutoh, M. [Tohoku Univ., Sendai (Japan). Lab. of Nuclear Science

    2000-07-01

    The 300MeV Linac at LNS is driven with a maximum repetition rate of 300 Hz generated horn the six harmonics of the 50Hz electricity power line. We have constructed a new system that measures respective beam energy spectra by dividing pulses into 6 periodic groups. Results suggest differences in 6 energy spectra, are caused by periodic variation of klystron RF power. We tried to stabilize it by applying an external reference voltage for the de'Qing circuits in the klystron pulser. (author)

  14. High-intensity extraction from the Superconducting Cyclotron at LNS-INFN

    Science.gov (United States)

    Calanna, A.

    2017-03-01

    The LNS Superconducting Cyclotron (CS) has successfully worked for more than 20 years, with an extracted beam power limited to 100W. Its peculiarity is to provide a broad range of ion species from hydrogen to lead in the energy range between 10 and 80AMeV. Recently, the demand for higher beam intensities came from the experiment NUMEN, which investigates the nuclear matrix element of the neutrinoless double beta decay through double exchange reactions. Also, the in-flight radioactive beams produced at FRIBs@LNS are interested in the high intensity primary beams. Both activities deal with low cross section reactions and require an increase in beam intensities for light ions up to a factor 100. Nevertheless, other experiments will take advantage of the upgrade and there will be even the possibility to produce medical radioisotopes. The solution proposed in this study makes use of extraction by stripping to provide high-intensity beams up to 10^{14} pps. Major machine modifications, including the cryostat and the superconducting coils, are mandatory to guarantee these new performance. However, heavier ions acceleration will be guaranteed, maintaining the extraction by electrostatic deflectors. An overview of the studies carried out is here presented.

  15. Beam imaging in the injection line of the INFN-LNS superconducting cyclotron.

    Science.gov (United States)

    Nicolosi, Dario; Cosentino, Luigi; Mascali, David; Pappalardo, Alfio; Castro, Maurizio; Celona, Luigi; Marchetta, Carmelo; Marletta, Salvatore; Maugeri, Antonio; Rifuggiato, Danilo; Seminara, Angelo; Gammino, Santo

    2016-02-01

    A cheap and efficient diagnostic system for beam monitoring has been recently developed at INFN-LNS in Catania. It consists of a high sensitivity CCD camera detecting the light produced by an ion beam hitting the surface of a scintillating screen and a frame grabber for image acquisition. A scintillating screen, developed at INFN-LNS and consisting of a 2 μm BaF2 layer evaporated on an aluminium plate, has been tested by using (20)Ne and (40)Ar beams in the keV energy range. The CAESAR ECR ion source has been used for investigating the influence of the frequency and magnetic field tuning effects, the impact of the microwave injected power, and of the focusing solenoids along the low energy beam transport on the beam shape and current. These tests will allow to better understand the interplay between the plasma and beam dynamics and, moreover, to improve the transport efficiency along the low energy beam line and the matching with the superconducting cyclotron, particularly relevant in view of the expected upgrade of the machine.

  16. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  17. Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy.

  18. Actinomyces israelii May Produce Vulvar Lesions Suspicious for Malignancy

    Science.gov (United States)

    McElroy, Jennifer Y.; Gorens, Marsha E.; Jackson, Lisa N.; Stigger, Danielle; Becker, Teresa; Sheiner, Eyal

    2006-01-01

    Background. We present a case of Actinomyces israelii causing vulvar mass suspicious for malignancy in a postmenopausal woman. Case. A 60 year-old woman presented due to a firm, nonmobile, 10 cm vulvar mass, which had been rapidly enlarging for 5 months. The mass was painful, with localized pruritus and sinus tracts oozing of serosanguinous fluid. Biopsy and cultures revealed a ruptured epidermal inclusion cyst containing granulation tissue and Actinomyces israelii. Conclusion. Actinomyces israelii may produce vulvar lesions that are suspicious for malignancy. Thus, biopsies and cultures are both mandatory while evaluating vulvar masses suspicious for malignancy. PMID:17093351

  19. Differing growth responses to nutritional supplements in neighboring health districts of Burkina Faso are likely due to benefits of small-quantity lipid-based nutrient supplements (LNS).

    Science.gov (United States)

    Hess, Sonja Y; Peerson, Janet M; Becquey, Elodie; Abbeddou, Souheila; Ouédraogo, Césaire T; Somé, Jérôme W; Yakes Jimenez, Elizabeth; Ouédraogo, Jean-Bosco; Vosti, Stephen A; Rouamba, Noël; Brown, Kenneth H

    2017-01-01

    Of two community-based trials among young children in neighboring health districts of Burkina Faso, one found that small-quantity lipid-based nutrient supplements (LNS) increased child growth compared with a non-intervention control group, but zinc supplementation did not in the second study. We explored whether the disparate growth outcomes were associated with differences in intervention components, household demographic variables, and/or children's morbidity. Children in the LNS study received 20g LNS daily containing different amounts of zinc (LNS). Children in the zinc supplementation study received different zinc supplementation regimens (Z-Suppl). Children in both studies were visited weekly for morbidity surveillance. Free malaria and diarrhea treatment was provided by the field worker in the LNS study, and by a village-based community-health worker in the zinc study. Anthropometric assessments were repeated every 13-16 weeks. For the present analyses, study intervals of the two studies were matched by child age and month of enrollment. The changes in length-for-age z-score (LAZ) per interval were compared between LNS and Z-Suppl groups using mixed model ANOVA or ANCOVA. Covariates were added to the model in blocks, and adjusted differences between group means were estimated. Mean ages at enrollment of LNS (n = 1716) and Z-Suppl (n = 1720) were 9.4±0.4 and 10.1±2.7 months, respectively. The age-adjusted change in mean LAZ per interval declined less with LNS (-0.07±0.44) versus Z-Suppl (-0.21±0.43; pgrowth in children who received LNS could not be explained by known cross-trial differences in baseline characteristics or morbidity burden, implying that the observed difference in growth response was partly due to LNS.

  20. Primary malignant tumours of the bony pelvis: US-guided high intensity focused ultrasound ablation.

    Science.gov (United States)

    Wang, Yang; Wang, Wei; Tang, Jie

    2013-11-01

    The aim of this review is to evaluate the value of ultrasound (US)-guided high intensity focused ultrasound (HIFU) ablation in the treatment of primary malignant tumours of the bony pelvis. Eleven patients with primary malignant tumours of the bony pelvis received US-guided HIFU ablation. The maximum tumour size ranged from 5.6 to 25.0 cm (median 10.5 cm). Treatment was curative in four patients and palliative in seven patients. During follow-up, the effectiveness of HIFU ablation was assessed by contrast-enhanced magnetic resonance (MR). Significant coagulative necrosis was obtained in all patients after scheduled HIFU ablations; the volume ablation ratio was 86.7% ± 12.5% (range 65-100%). Complete tumour necrosis was achieved in all patients receiving curative HIFU ablation. No major complications were encountered. No patients died of local tumour progression during follow-up. US-guided HIFU ablation may be a safe and effective minimally invasive technique for the local treatment of primary malignant tumours of the bony pelvis.

  1. Usefulness of US-guided automated gun biopsy of nonpalpable breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Sook; Kim, Hak Soo; Lee, Han Kyung; Koh, Sung Hye; O, Eun Young; Yoon, Myung Hwan; Yang, Dal Mo; Kim, Hyung Sik [Chungang Gil Hospital, Incheon (Korea, Republic of)

    1997-11-01

    To evaluate the clinical usefulness of ultrasonography(US)-guided automated gun biopsy of nonpalpable breast lesions. In 30 nonpalpable breast lesions over 0.6cm and detected on US, we performed US-guided biopsy using an 18-gauge automated biopsy gun. Two to four specimens were obtained from each lesion. We analyzed the site, size and depth of the lesions, and the length and histopathologic results of the specimens. In four lesions, surgical biopsy and gun biopsy results were compared. In 29 of 30 lesions(96.7%), specimens were adequate for histopathologic diagnosis, and this was as follows : one case of infiltrating ductal carcinoma, 13 of fibrocystic disease, 10 of fibrocystic disease versus fibroadenoma and one of fibrodenoma. There was also one reactive hyperplasia of LN, and one fatty one and two normal tissues, and in these four lesions, agreement between gun and surgical biopsy results was 100%. The only complication was minor bleeding, which was controlled by compression. US-guided automated gun biopsy is a clinically useful and safe procedure for evaluating nonpalpable breast lesions detected on US.

  2. Overview of the future upgrade of the INFN-LNS superconducting cyclotron

    Science.gov (United States)

    Calabretta, Luciano; Calanna, Alessandra; Cuttone, Giacomo; D'Agostino, Grazia; Rifuggiato, Danilo; Domenico Russo, Antonio

    2017-06-01

    The LNS Superconducting Cyclotron, named “Ciclotrone Superconduttore” (CS), has been in operation for more than 20 years. A wide range of ion species from hydrogen to lead, with energy in the range 10 to 80 AMeV, have been delivered to users. The maximum beam power is limited to 100 W due to the beam dissipation on the electrostatic deflectors. To fulfil the demand of users aiming at studying rare processes in nuclear physics, an upgrade of the cyclotron is necessarily intended to increase the intensity of ion beams with mass lower than 40 a.m.u. up to a power 10 kW. This will be achieved by means of extraction by stripping. This solution needs to replace the cryostat including the superconducting coils. The present capability of the cyclotron will be maintained, i.e. all the ion species allowed by the operating diagram will be available, being extracted by electrostatic extraction. In addition to the high power beams for nuclear physics, it will be possible to produce medical radioisotopes like 211At using an internal target.

  3. An integrated framework for detecting suspicious behaviors in video surveillance

    Science.gov (United States)

    Zin, Thi Thi; Tin, Pyke; Hama, Hiromitsu; Toriu, Takashi

    2014-03-01

    In this paper, we propose an integrated framework for detecting suspicious behaviors in video surveillance systems which are established in public places such as railway stations, airports, shopping malls and etc. Especially, people loitering in suspicion, unattended objects left behind and exchanging suspicious objects between persons are common security concerns in airports and other transit scenarios. These involve understanding scene/event, analyzing human movements, recognizing controllable objects, and observing the effect of the human movement on those objects. In the proposed framework, multiple background modeling technique, high level motion feature extraction method and embedded Markov chain models are integrated for detecting suspicious behaviors in real time video surveillance systems. Specifically, the proposed framework employs probability based multiple backgrounds modeling technique to detect moving objects. Then the velocity and distance measures are computed as the high level motion features of the interests. By using an integration of the computed features and the first passage time probabilities of the embedded Markov chain, the suspicious behaviors in video surveillance are analyzed for detecting loitering persons, objects left behind and human interactions such as fighting. The proposed framework has been tested by using standard public datasets and our own video surveillance scenarios.

  4. 75 FR 75586 - Confidentiality of Suspicious Activity Reports

    Science.gov (United States)

    2010-12-03

    ... FinCEN and the OCC, the OTS proposed to modify the general introduction in its rules to state that....'' The introduction also would indicate that SAR information may not be disclosed, except as authorized... ordinary course of the banks' business, on which the report of suspicious activity was based''); Cotton v...

  5. Interpersonal hostility and suspicious thinking in obsessive-compulsive disorder.

    Science.gov (United States)

    Tellawi, Ghazel; Williams, Monnica T; Chasson, Gregory S

    2016-09-30

    Individuals with obsessive-compulsive disorder (OCD) may struggle with hostility and suspicious thinking, but this has not been the subject of much research. The purpose of this study is to examine the relationship between hostility, suspicious thinking, and OCD severity. Participants included 66 outpatients in treatment for OCD, 27 in treatment for other disorders, and 68 students (n=161). All completed the Inventory of Hostility and Suspicious Thinking (IHS), a measure of psychotic thinking/paranoia, the Obsessive Compulsive Inventory-Revised (OCI-R), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). As expected, the IHS was significantly positively correlated with the BAI and BDI-II. Additionally, regression analyses revealed that individuals with OCD have higher levels of hostility than students. Hostility was also significantly positively associated with increased OCD severity. Hostility and suspicious thoughts are prominent in anxiety disorders in general, and thus necessitate continued research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Money laundering: correlation between risk assessment and suspicious transactions

    Directory of Open Access Journals (Sweden)

    Sonja Cindori

    2013-06-01

    Full Text Available The risk assessment system was introduced in the Republic of Croatia in 2009, as a result of harmonization with international standards, especially the Directive 2005/60/EC on the prevention of the use of the financial system for the purpose of money laundering and terrorist financing. Risk assessment is an extensive concept which requires not only a legislative framework, but also the application of numerous criteria for its effective implementation in practice. Among these criteria are suspicious transactions, closely related to the assessment of the customer, transaction, product or service.The undeniable contribution of suspicious transactions to the quality of the risk assessment system will be confirmed by a statistical analysis of a number of West and East European countries. A combination of strict, but sufficiently flexible legal provisions governing the system for prevention of money laundering and terrorist financing and a statistical analysis of reported suspicious transactions will lead to conclusions that either support or represent criticism of the efficiency of application of the risk assessment system in practice.The aforementioned statistical analysis will show whether suspicious transactions are a reliable criterion for the risk assessment analysis, and whether they can be considered the only such criterion. There is a possibility that the findings of the analysis will be contradictory to those of some international studies.

  7. Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: A minimum of 2-year follow-up retrospective comparative study.

    Science.gov (United States)

    Alessio-Mazzola, Mattia; Repetto, Ilaria; Biti, Besmir; Trentini, Roberto; Formica, Matteo; Felli, Lamberto

    2018-01-01

    To compare the efficacy of two independent groups of patients treated with ultrasound (US)-guided extracorporeal shock wave (ESW) therapy and with US-guided injection of platelet-rich plasma (PRP) for chronic lateral epicondylitis (LE) with a minimum of 2-year follow-up. We retrospectively evaluated 63 patients treated for chronic LE (31 patients with autologous US-guided PRP injection and 32 patients with US-guided focal ESW therapy) from 2009 to 2014. All the patients were evaluated by means of Roles-Maudsley (RM) score, quick Disabilities of Arm, Shoulder, and Hand (QuickDASH) score, visual analogic scale (VAS) and patient-rated tennis elbow evaluation (PRTEE) to retrospectively assess the pain relief, level of activity, the self-reported function and subjective satisfaction at minimum of 2-year follow-up. Both US-guided autologous PRP injection and US-guided focal ESW administration proved effective in chronic LE with significant improvement in the QuickDASH, VAS, RM and PRTEE scores ( p 0.05). The mean time between treatment and symptom resolution was significantly shorter for the PRP treatment ( p = 0.0212); furthermore, the mean time to return to the normal activities was quicker for PRP group ( p = 0.0119). Both PRP injection and ESW therapy are feasible and safe options for the treatment of chronic LE with low risk of complications and with good long-term follow-up results. US-guided PRP injection has quick efficacy when compared with US-guided focal ESW therapy.

  8. Use of 70 MeV proton beam for medical applications at INFN-LNS: CATANA project

    Science.gov (United States)

    Sabini, M. G.; Cirrone, G. A. P.; Tonghi, L. Barone; Bartolotta, A.; Brai, M.; Cuttone, G.; Nigro, S. Lo; Marano, F.; Nicoletti, G. A.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Romeo, N.; Rovelli, A.; Salamone, V.; Teri, G.

    2000-04-01

    The project CATANA (Centro di Adro Terapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of protontherapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations.

  9. Use of 70 MeV Proton Beam for Medical Applications at INFN-LNS: CATANA Project

    Energy Technology Data Exchange (ETDEWEB)

    Sabini, M.G.; Cirrone, G.A.P.; Barone Tonghi, L.; Bartolotta, A.; Brai, M.; Cuttone, G.; Lo Nigro, S.; Marano, F.; Nicoletti, G.A.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Romeo, N.; Rovelli, A.; Salamone, V.; Teri, G.

    2000-12-31

    The project CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of proton therapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations.

  10. US-guided percutaneous liver biopsy in pediatric liver transplant recipients.

    Science.gov (United States)

    Mandal, Soma; Miraglia, Roberto; Maruzzelli, Luigi; Liotta, Rosa; Tuzzolino, Fabio; Spada, Marco; Riva, Silvia; Luca, Angelo

    2014-06-01

    The present study assesses the safety of ultrasound (US)-guided percutaneous liver biopsies (PLBs) within pediatric liver allograft recipients, describes the pathological results according to early (≤12 months) and late (>12 months) posttransplantation periods, and analyzes the value of liver function tests (LFTs) and Doppler US variables in determining these results. A total of 219 US-guided PLBs in 85 pediatric patients with liver transplant (mean age 7 ± 5 years, range: 6 months to 18 years) performed between March 2005 and May 2012 were retrospectively evaluated at a single institution. Doppler US and LFT evaluation (including total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, alkaline phosphatase) occurred within 1 day of early (n = 92, 42%) and late term (n = 127, 58%) posttransplantation biopsies. The rate of major complications (hemorrhage requiring blood transfusion) was 0.91% (n = 2). The early versus late term biopsy results, respectively, included: cholestasis at 36% versus 18% (P = 0.003), minimal changes 16% versus 24% (not significant [NS]), acute rejection 13% versus 5% (P = 0.027), inflammatory diseases 15% versus 15% (NS), indeterminate acute rejection 11% versus 7% (NS), chronic rejection 4% versus 14% (P = 0.017), fibrotic diseases 4% versus 12% (NS), and other 0% versus 5% (NS). Neither LFT nor US variables were correlated with pathological outcomes. The rate of complications in pediatric patients after US-guided liver biopsy is low. A range of pathological results exists between early and late posttransplantation liver biopsies. LFT and Doppler US findings are not predictors of pathological results.

  11. US-guided transcutaneous tru-cut biopsy of laryngo-hypopharyngeal lesions

    Energy Technology Data Exchange (ETDEWEB)

    Preda, Lorenzo; De Fiori, Elvio; Rampinelli, Cristiano; Petralia, Giuseppe; Bonello, Luke [European Institute of Oncology, Department of Radiology, Milan (Italy); Ansarin, Mohssen; Chiesa, Fausto [European Institute of Oncology, Department of Head and Neck Surgery, Milan (Italy); Maffini, Fausto [European Institute of Oncology, Patology Division, Laboratory of Anatomy, Milan (Italy); Alterio, Daniela [European Institute of Oncology, Radiotherapy Division, Milan (Italy); Bellomi, Massimo [European Institute of Oncology, Department of Radiology, Milan (Italy); University of Milan, School of Medicine, Milan (Italy)

    2010-06-15

    To evaluate the feasibility and performance of ultrasound-guided transcutaneous tru-cut biopsy (USGTCB) in selected patients (with stenosis of airways or difficult intubation or contraindication to general anaesthesia) with untreated or previously treated suspicious laryngo-hypopharyngeal masses. Biopsies were performed with a free-hand technique by a single radiologist. Thirty-six USGTCBs were scheduled in 34 patients (24 males, 10 females; age range 47-95 years). Two USGTCBs were not performed, as lesions were not detectable: therefore, 16 USGTCBs were performed for an untreated mass suspicious for malignancy and 18 were performed for a mass suspicious for recurrence after radiotherapy alone, or associated with endoscopic laser surgery or chemotherapy. USGTCB diagnosed 25 squamous cell carcinomas (73.5%) and nine benign lesions (26.5%); no false positives and two false negatives were reported, both in patients previously treated with radiotherapy. The sensitivity, specificity, positive and negative predictive value of the technique was 92.5%, 100%, 100% and 77.7% respectively, with no major complications. Although biopsy under microlaryngoscopy remains the ''gold-standard'' technique, USGTCB is feasible, carries the advantages of avoiding general anaesthesia, is suitable for outpatients and is cost-effective. If applied to selected patients, it could be considered for the histological diagnosis of both primary and recurrent laryngo-hypopharyngeal masses. (orig.)

  12. US-guided diffuse optical tomography for breast lesions: the reliability of clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Min Jung; Kim, Ji Youn; Youn, Jung Hyun; Kim, Myung Hyun; Koo, Hye Ryoung; Kim, Soo Jin; Sohn, Yu-Mee; Moon, Hee Jung; Kim, Eun-Kyung [Yonsei University College of Medicine, Institute of Radiological Science, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2011-07-15

    To prospectively assess the reliability of US-guided diffuse optical tomography (US-DOT) using interobserver agreement for the diagnosis of breast lesions with individual real-time imaging and to assess the interobserver agreement of conventional sonography (US) combined with US-DOT for differentiation between benignity and malignancy breast lesions. An Institutional Review Board approved this study, and all subjects provided written informed consent. 122 breast lesions in 111 patients evaluated with US-guided core biopsy were included. Assessments with US and US-DOT for cases subjected to biopsy were obtained by two radiologists using individual real-time imaging prior to biopsy and were prospectively recorded by each performer. With DOT, the total haemoglobin concentration (THC) for each breast lesion was measured. Histopathological results from US-guided biopsies were used as a reference standard. To assess measurement interobserver agreement, the intraclass correlation coefficient (ICC) and the Bland-Altman plot were used for THC in US-DOT and the kappa values and ROC analysis were used to evaluate the diagnostic performances of the US BI-RADS final assessment in US and combined US and US-DOT. Of 122 US-guided core biopsied lesions, 83 (68.0%) were diagnosed as benign, and 39 (32.0%) as malignant. Excellent correlation was seen in the THC in US-DOT (ICC score 0.796; 95% confidence interval, 0.708-0.857). The interobserver agreement in BI-RADS final assessment with US and US-DOT (almost perfect; {kappa} = 0.8618) was improved compared with that of US (substantial agreement, {kappa} = 0.6574). However, the overall areas under the ROC curve did not show significant differences between US and combined US and US-DOT, 0.8894 and 0.8975, respectively (P = 0.981). The reliability of THC in US-DOT showed excellent correlation in overall real-time performance. Although the inter-observer agreement for BI-RADS final assessment of US was improved by using US-DOT, the

  13. Photoelectron spectra of the late rare-earth misfit layer compounds (LnS)(1+x)TS2 (Ln=Tb, Dy, Ho; T=Nb, Ta)

    NARCIS (Netherlands)

    Fang, CM; Wiegers, GA; Haas, C

    Photoemission spectra (XPS and UPS) are presented for the valence band of misfit layer compounds (LnS)(1+x)TS2 with Ln = Dy, Ho or Tb; T = Nb or Ta. The Nb 4d(x)2 (or Ta 5d(x)2) conduction band is almost filled, which indicates a charge transfer of slightly less than one electron per T from the LnS

  14. Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators

    Directory of Open Access Journals (Sweden)

    Elena Antonova

    2016-09-01

    Full Text Available Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males from the Buddhist tradition (meditators and 24 meditation-naïve individuals (all males. Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males. All participants completed the Schizotypal Personality Questionnaire (Raine, 1991, a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness. Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe, describing (Describe, acting with awareness (Awareness, non-judging of (Non-judgment and non-reactivity to inner experience (Non-reactivity facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

  15. Schizotypy and mindfulness: Magical thinking without suspiciousness characterizes mindfulness meditators.

    Science.gov (United States)

    Antonova, Elena; Amaratunga, Kavitha; Wright, Bernice; Ettinger, Ulrich; Kumari, Veena

    2016-09-01

    Despite growing evidence for demonstrated efficacy of mindfulness in various disorders, there is a continuous concern about the relationship between mindfulness practice and psychosis. As schizotypy is part of the psychosis spectrum, we examined the relationship between long-term mindfulness practice and schizotypy in two independent studies. Study 1 included 24 experienced mindfulness practitioners (19 males) from the Buddhist tradition (meditators) and 24 meditation-naïve individuals (all males). Study 2 consisted of 28 meditators and 28 meditation-naïve individuals (all males). All participants completed the Schizotypal Personality Questionnaire (Raine, 1991), a self-report scale containing 9 subscales (ideas of reference, excessive social anxiety, magical thinking, unusual perceptual experiences, odd/eccentric behavior, no close friends, odd speech, constricted affect, suspiciousness). Participants of study 2 also completed the Five-Facet Mindfulness Questionnaire which assesses observing (Observe), describing (Describe), acting with awareness (Awareness), non-judging of (Non-judgment) and non-reactivity to inner experience (Non-reactivity) facets of trait mindfulness. In both studies, meditators scored significantly lower on suspiciousness and higher on magical thinking compared to meditation-naïve individuals and showed a trend towards lower scores on excessive social anxiety. Excessive social anxiety correlated negatively with Awareness and Non-judgment; and suspiciousness with Awareness, Non-judgment and Non-reactivity facets across both groups. The two groups did not differ in their total schizotypy score. We conclude that mindfulness practice is not associated with an overall increase in schizotypal traits. Instead, the pattern suggests that mindfulness meditation, particularly with an emphasis on the Awareness, Non-judgment and Non-reactivity aspects, may help to reduce suspiciousness and excessive social anxiety.

  16. Neural Correlates of Suspiciousness and Interactions with Anxiety during Emotional and Neutral Word Processing

    Directory of Open Access Journals (Sweden)

    Joscelyn E Fisher

    2014-06-01

    Full Text Available Suspiciousness is usually classified as a symptom of psychosis, but it also occurs in depression and anxiety disorders. Though how suspiciousness overlaps with depression is not obvious, suspiciousness does seem to overlap with anxious apprehension and anxious arousal (e.g., verbal iterative processes and vigilance about environmental threat. However, suspiciousness also has unique characteristics (e.g., concern about harm from others and vigilance about social threat. Given that both anxiety and suspiciousness have been associated with abnormalities in emotion processing, it is unclear whether it is the unique characteristics of suspiciousness or the overlap with anxiety that drive abnormalities in emotion processing.. Event-related brain potentials were obtained during an emotion-word Stroop task. Results indicated that suspiciousness interacts with anxious apprehension to modulate initial stimulus perception processes. Suspiciousness is associated with attention to all stimuli regardless of emotion content. In contrast, anxious arousal is associated with a later response to emotion stimuli only. These results suggest that suspiciousness and anxious apprehension share overlapping processes, but suspiciousness alone is associated with a hyperactive early vigilance response. Depression did not interact with suspiciousness to predict response to emotion stimuli. These findings suggest that it may be informative to assess suspiciousness in conjunction with anxiety in order to better understand how these symptoms interact and contribute to dysfunctional emotion processing.

  17. Treatment of benign cold thyroid nodule: efficacy and safety of US-guided percutaneous ethanol injection

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Kon; Lee, Ho Kyu; Lee, Myung Joon; Choi, Choong Gon; Suh, Dae Chul [Ulsan Univ., College of Medicine, Seoul (Korea, Republic of); Ahn, Il Min [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    The purpose of this study was to evaluate the efficacy and safety of US-guided percutaneous ethanol injection for the treatent of benign cold thyroid nodules. Twenty-five patients with benign cold thyroid nodules (volume of each at least 2ml proven by PCNA to be adenomatous hyperplasia, and cold nodule by thyroid scan) underwent a total of one to three percutaneous ethanol injections (PEI) at intervals of one or two months. The mean amount of ethanol used was 6.2(range, 1.5-8)ml, depending on the volume of the nodule. Follow up ultrasonography was performed one to four months after the final session. The initial volume of nodules was 11.4{+-}4.1(range, 2.5-41.4)ml, and in all cases this fell by 56.1{+-}22.3%(range, 10.9-92.1%);in all cases, follow-up ultrasonography showed that echogeneity was lower and its pattern was heterogeneous. There were no important longstanding complications;the most common side effect was acute pain at the injection site(n=3D9), and in one case, transient vocal cord palsy occurred. Our results show that US-guided percutaneous injection of ethanol is an effective and a safe procedure for the treatment of benign cold thyroid nodules, and is thus an alternative to surgery or hormone therapy.=20.

  18. Usefulness of the coaxial technique in US-guided breast core biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hyun; Lee, Jeong Hwa; Ha, Jeon Ju; Lee, Keon; Kim, Won Ho; Kwon, Jung Hyeok [Dongkang general hospital, Seoul (Korea, Republic of); Ham, Soo Youn [Ulsan Univ. Hospital, Ulsan (Korea, Republic of)

    1999-05-01

    To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40 patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion. Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We used an 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens were obtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and their rate were evaluated. For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, and the findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 of fibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12 lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. The procedure time was about 15 minutes and no significant complications were noted. In breast core biopsy, the coaxial technique is simple and time-saving, and compared with standard breast core biopsy, may also be less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.

  19. The nuclear matrix elements of 0νββ decay and the NUMEN project at INFN-LNS

    Directory of Open Access Journals (Sweden)

    Cappuzzello F.

    2016-01-01

    Full Text Available An innovative technique to access the nuclear matrix elements entering the expression of the life time of the double beta decay by relevant cross sections measurements of double charge exchange reactions is proposed. A key aspect of the project is the use of the MAGNEX large acceptance magnetic spectrometer, for the detection of the ejectiles, and of the LNS K800 Superconducting Cyclotron (CS, for the acceleration of the required high resolution and low emittance heavyion beams, already in operation at INFN Laboratory Nazionali del Sud in Catania (Italy.

  20. Biopharmaceutical evaluation of epigallocatechin gallate-loaded cationic lipid nanoparticles (EGCG-LNs): In vivo, in vitro and ex vivo studies.

    Science.gov (United States)

    Fangueiro, Joana F; Calpena, Ana C; Clares, Beatriz; Andreani, Tatiana; Egea, Maria A; Veiga, Francisco J; Garcia, Maria L; Silva, Amélia M; Souto, Eliana B

    2016-04-11

    Cationic lipid nanoparticles (LNs) have been tested for sustained release and site-specific targeting of epigallocatechin gallate (EGCG), a potential polyphenol with improved pharmacological profile for the treatment of ocular pathologies, such as age-related macular edema, diabetic retinopathy, and inflammatory disorders. Cationic EGCG-LNs were produced by double-emulsion technique; the in vitro release study was performed in a dialysis bag, followed by the drug assay using a previously validated RP-HPLC method. In vitro HET-CAM study was carried out using chicken embryos to determine the potential risk of irritation of the developed formulations. Ex vivo permeation profile was assessed using rabbit cornea and sclera isolated and mounted in Franz diffusion cells. The results show that the use of cationic LNs provides a prolonged EGCG release, following a Boltzmann sigmoidal profile. In addition, EGCG was successfully quantified in both tested ocular tissues, demonstrating the ability of these formulations to reach both anterior and posterior segment of the eye. The pharmacokinetic study of the corneal permeation showed a first order kinetics for both cationic formulations, while EGCG-cetyltrimethylammonium bromide (CTAB) LNs followed a Boltzmann sigmoidal profile and EGCG-dimethyldioctadecylammonium bromide (DDAB) LNs a first order profile. Our studies also proved the safety and non-irritant nature of the developed LNs. Thus, loading EGCG in cationic LNs is recognised as a promising strategy for the treatment of ocular diseases related to anti-oxidant and anti-inflammatory pathways. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. US-guided injection of the upper and lower extremity joints

    Energy Technology Data Exchange (ETDEWEB)

    Collins, James M.P., E-mail: j.collins@znb.nl [Department of Radiology, Medical Center Leeuwarden, H. Dunantweg 2, AD Leeuwarden (Netherlands); Smithuis, Robin [Department of Radiology, Rijnland Hospital, Leiderdorp (Netherlands); Rutten, Matthieu J.C.M. [Department of Radiology, Jeroen Bosch Hospital, ‘s-Hertogenbosch (Netherlands)

    2012-10-15

    There is a growing interest in the application of ultrasound (US) guidance for diagnostic and therapeutic joint injections. US provides direct visualization of soft tissues and the outer borders of bony structures. With real-time needle guidance the success rate of intra-articular injections improves and iatrogenic damage to anatomic structures can be avoided. An US machine is more readily available, transferrable and more affordable than a fluoroscopy machine or CT scanner and lacks the risk of radiation. These factors make US a valuable alternative to procedures performed either blind or under fluoroscopic or CT guidance. This article focuses on the rationale for injections in the upper and lower extremity joints and describes and illustrates the different US-guided injection techniques.

  2. "Suspicious" salivary gland FNA: Risk of malignancy and interinstitutional variability.

    Science.gov (United States)

    Maleki, Zahra; Miller, James Adam; Arab, Seyedeh Elham; Fadda, Guido; Bo, Ping; Wise, Olga; Rossi, Esther Diana; Jhala, Nirag; Ashish, Chandra; Ali, Syed Z; Wang, He

    2018-02-01

    Fine-needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimally invasive, and cost-effective method for the diagnosis of salivary gland lesions. Salivary gland neoplasms are often difficult to diagnose because of morphologic heterogeneity and a variety of epithelial metaplastic changes. Hence, a number of salivary gland FNA specimens yield indeterminate results. For indeterminate FNA specimens, the suspicious-for-malignancy (SFM) category is used when a specific neoplasm falls short in quantity or quality for the criteria for malignancy. Therefore, the findings are not sufficient for a conclusive diagnosis of malignancy. This study was designed to evaluate the risk of malignancy (ROM) for the SFM group at 5 tertiary medical centers worldwide with the aforementioned criteria. Among 12,606 salivary gland FNA cases between 1997 and 2014, 276 (2.2%) were reported to be SFN. Specifically, 114 suspicious cases (41%) had histological follow-up. Histological follow-up of the 114 suspicious cases showed 95 malignant tumors indicating a risk of malignancy (ROM) of 83.3%. The ROM varied between 74% and 88% for the 5 participating institutions, and a Fisher's exact test with significance set to p<.05 showed no significant difference in ROM among the institutions (p = .78). Overall, 83.3% of SFM salivary gland FNA specimens turned out to be malignant; there was no significant interinstitutional variability in the ROMs. The SFM category for salivary gland FNA is very homogeneous, and the ROMs are quite similar worldwide. Cancer Cytopathol 2018;126:94-100. © 2017 American Cancer Society. © 2017 American Cancer Society.

  3. US guided corticosteroid injection into the subacromial-subdeltoid bursa: Technique and approach.

    Science.gov (United States)

    Molini, L; Mariacher, S; Bianchi, S

    2012-02-01

    Local injection of cortisone derivatives, sometimes combined with local anesthetics, is frequently administered in rheumatology as the treatment of choice in para-articular diseases or as an adjuvant to systemic therapy in the treatment of arthritis.One of the most frequent local corticosteroid injections administered in daily clinical practice by rheumatologists, orthopedic surgeons, physiatrists, sports medicine doctors and general practitioners is injection into the subacromialsubdeltoid bursa in the treatment of bursitis and anterior superior impingement syndrome of the shoulder.Before local corticosteroid injection is administered, it is important to identify possible contraindications and to examine the documentation provided by the patient. Absolute contraindications or those related to the procedure should be evaluated by the prescribing physician but also the physician performing the corticosteroid injection should evaluate possible contraindications to make sure that corticosteroid injection is feasible. The present paper describes the ultrasound (US) guided local corticosteroid injection procedure with particular attention to the equipment required, the position of the patient and the examiner as well as the approach. The main advantage of US guidance during corticosteroid injection is the possibility to identify vascular structures, nerves and tendons situated in the needle path in order to avoid these structures and be sure to inject the drug into the appropriate location. When all rules are complied with and the corticosteroid injection is carried out by an experienced physician, it is virtually painless and is performed in just a few minutes.

  4. Percutaneous Drainage of Postoperative Pelvic Abscess: Fluoroscopic and US-Guided Transgluteal Approach

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Hyo Jin; Hong, Hyun Pyo; Lee, Hyung Geun; Choi, Yoon Jung; Lee, Young Rae; Lee, Ji Young; Park, Hae Won [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Sam Soo [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

    2010-08-15

    To retrospectively review the effectiveness and safety of fluoroscopic and US-guided percutaneous transgluteal drainage of postoperative pelvic abscesses. From January 2002 to December 2007, 594 patients underwent surgery at our institution due to rectosigmoid cancer. A retrospective analysis revealed that percutaneous drainage of a postoperative pelvic abscess was performed in 19 out of the 594 patients (3.19%) that underwent surgery (13 male, 6 female; mean age, 57.9 years; age range, 40-82 years). The transgluteal and other methods were used for percutaneous drainage and the success rate, duration of therapy, and complication rate were evaluated. The transgluteal approach was performed with fluoroscopic and US-guidance in 10 patients (52.6%). A catheter was inserted through a preexisting surgical drain in 5 patients (26.3%). The transabdominal approach was performed under US-guidance in 4 patients (21.0%). Technical success was achieved in all patients. The catheter was removed after a mean of 14 days. In 2 patients, who were treated by the transgluteal approach, subsequent surgery was performed due to incomplete resolution of the abscess (10.5%). The mean duration of catheter drainage using the transgluteal approach (16.5 days) was longer than other methods (11.2 days). Furthermore, no procedure-related major complications or mortality was observed in all methods. The percutaneous transgluteal approach to a postoperative pelvic abscess with US and fluoroscopic guidance is relatively safe and effective.

  5. US guided corticosteroid injection into the subacromial-subdeltoid bursa: Technique and approach

    Science.gov (United States)

    Molini, L.; Mariacher, S.; Bianchi, S.

    2012-01-01

    Local injection of cortisone derivatives, sometimes combined with local anesthetics, is frequently administered in rheumatology as the treatment of choice in para-articular diseases or as an adjuvant to systemic therapy in the treatment of arthritis. One of the most frequent local corticosteroid injections administered in daily clinical practice by rheumatologists, orthopedic surgeons, physiatrists, sports medicine doctors and general practitioners is injection into the subacromialsubdeltoid bursa in the treatment of bursitis and anterior superior impingement syndrome of the shoulder. Before local corticosteroid injection is administered, it is important to identify possible contraindications and to examine the documentation provided by the patient. Absolute contraindications or those related to the procedure should be evaluated by the prescribing physician but also the physician performing the corticosteroid injection should evaluate possible contraindications to make sure that corticosteroid injection is feasible. The present paper describes the ultrasound (US) guided local corticosteroid injection procedure with particular attention to the equipment required, the position of the patient and the examiner as well as the approach. The main advantage of US guidance during corticosteroid injection is the possibility to identify vascular structures, nerves and tendons situated in the needle path in order to avoid these structures and be sure to inject the drug into the appropriate location. When all rules are complied with and the corticosteroid injection is carried out by an experienced physician, it is virtually painless and is performed in just a few minutes. PMID:23396761

  6. Beam commission of the high intensity proton source developed at INFN-LNS for the European Spallation Source

    Science.gov (United States)

    Neri, L.; Celona, L.; Gammino, S.; Miraglia, A.; Leonardi, O.; Castro, G.; Torrisi, G.; Mascali, D.; Mazzaglia, M.; Allegra, L.; Amato, A.; Calabrese, G.; Caruso, A.; Chines, F.; Gallo, G.; Longhitano, A.; Manno, G.; Marletta, S.; Maugeri, A.; Passarello, S.; Pastore, G.; Seminara, A.; Spartà, A.; Vinciguerra, S.

    2017-07-01

    At the Istituto Nazionale di Fisica Nucleare - Laboratori Nazionali del Sud (INFN-LNS) the beam commissioning of the high intensity Proton Source for the European Spallation Source (PS-ESS) started in November 2016. Beam stability at high current intensity is one of the most important parameter for the first steps of the ongoing commissioning. Promising results were obtained since the first source start with a 6 mm diameter extraction hole. The increase of the extraction hole to 8 mm allowed improving PS-ESS performances and obtaining the values required by the ESS accelerator. In this work, extracted beam current characteristics together with Doppler shift and emittance measurements are presented, as well as the description of the next phases before the installation at ESS in Lund.

  7. US-guided placement of central vein catheters in patients with disorders of hemostasis

    Energy Technology Data Exchange (ETDEWEB)

    Tercan, Fahri [Baskent University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)], E-mail: ftercan@yahoo.com; Ozkan, Ugur; Oguzkurt, Levent [Baskent University, Faculty of Medicine, Department of Radiology, Ankara (Turkey)

    2008-02-15

    Objective: To prospectively evaluate the technical success and immediate complication rates of temporary central catheter placement in a homogenous patient population with disorders of hemostasis. Materials and methods: One hundred and thirty three temporary central vein catheters inserted under ultrasound guidance in 119 patients with bleeding disorders were analyzed over a 4-year period. Patients were males (n = 51; 43%) and females (n = 68; 57%) with a mean age of 56.6 years (age range 18-95 years). A catheter was inserted in IJV in 129 (97%) procedures, subclavian vein in 2 (1.5%) procedures and femoral vein in 2 (1,5%) procedures. Thirty-three (24.8%) procedures were performed on bedside. Of 119 patients, 106 (89%) had only one catheter placement and the rest had had more than one catheter placement (range 1-3). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.01 (range 1-2). One hundred and nineteen insertions (89.5%) were single-wall punctures, whereas 14 insertions were double-wall punctures. Eight (6%) minor complications occurred including oozing of blood around the catheter in five (3.8%) procedures, small hematoma in two (1.5%) procedure and both in one patient. There was no inadvertent arterial puncture or major complications like hemothorax or pneumothorax in any patients. Conclusion: US-guided placement of central vein catheters in patients with disorder of hemostasis is safe with high technical success and low complication rates. US guidance for central venous catheterization should be the preferred method in this group of patients, if available in the hospital setting.

  8. US-Guided Vacuum-Assisted Biopsy of Microcalcifications in Breast Lesions and Long-Term Follow-Up Results

    Science.gov (United States)

    Kim, Hua Sun; Kim, Eun-Kyung; Kwak, Jin Young; Son, Eun Ju; Oh, Ki Keun

    2008-01-01

    Objective To evaluate the diagnostic accuracy of the use of an ultrasonography (US)-guided vacuum-assisted biopsy for microcalcifications of breast lesions and to evaluate the efficacy of the use of US-guided vacuum-assisted biopsy with long-term follow-up results. Materials and Methods US-guided vacuum-assisted biopsy cases of breast lesions that were performed between 2002 and 2006 for microcalcifications were retrospectively reviewed. A total of 62 breast lesions were identified where further pathological confirmation was obtained or where at least two years of mammography follow-up was obtained. These lesions were divided into the benign and malignant lesions (benign and malignant group) and were divided into underestimated group and not-underestimated lesions (underestimated and not-underestimated group) according to the diagnosis after a vacuum-assisted biopsy. The total number of specimens that contained microcalcifications was analyzed and the total number of microcalcification flecks as depicted on specimen mammography was analyzed to determine if there was any statistical difference between the groups. Results There were no false negative cases after more than two years of follow-up. Twenty-nine lesions were diagnosed as malignant (two invasive carcinomas and 27 carcinoma in situ lesions). Two of the 27 carcinoma in situ lesions were upgraded to invasive cancers after surgery. Among three patients diagnosed with atypical ductal hyperplasia, the diagnosis was upgraded to a ductal carcinoma in situ after surgery in one patient. There was no statistically significant difference in the number of specimens with microcalcifications and the total number of microcalcification flecks between the benign group and malignant group of patients and between the underestimated group and not-underestimated group of patients. Conclusion US-guided vacuum-assisted biopsy can be an effective alternative to stereotactic-guided vacuum-assisted biopsy in cases where

  9. US-guided percutaneous transhepatic biliary drainage: comparative study of right-sided and left-sided approach

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Hwan; Cha, Soon Joo [College of Medicine, Inje Univ., Kimhae (Korea, Republic of)

    2002-02-01

    To compare the feasibility and safety of US-guided right and left percutaneous transhepatic biliary drainage (PTBD). Between March 1998 and May 1999, 32 patients underwent 36 US-guided right or left PTBD in referred order, alternatively. The causes of biliary obstruction were bile duct stone (n=2), bile duct carcinoma (n=10), carcinoma of the pancreas (n=9), GB carcinoma (n=7), metastasis to the porta hepatis (n=3), and carcinoma of the ampulla of vater (n=1). Technical success, procedure time, fluoroscopic time, and complications were evaluated. PTBD was successful in 94% of both right and left approach. The average procedure time was 9.7 {+-}3.8 min. in the right approach and 9.6 {+-}3.1 min. in the left approach, respectively (p=0.794). The average fluoroscopic time were 3.9{+-}2.4 min. in the right approach and 3.8{+-}2.2 min. in the left approach (p=0.892). A major complication, bile peritonitis, occurred in one of 16 patient with right-sided approach. Minor complications occurred in six right (2 hemobilia, 3 tube malfunction, 1 cholangitis) and three left (1 hemobilia, 1 fever, 1cholangitis) PTBD. There were no significant difference in the complication rates between right and left PTBD (p=0.729). There were no significant differences in feasibility and safety in US-guided right and left PTBD.

  10. Minimising bias in the forensic evaluation of suspicious paediatric injury.

    Science.gov (United States)

    Skellern, Catherine

    2015-08-01

    In the rules of evidence in all legal jurisdictions, medical experts are required to maintain objectivity when providing opinions. When interpreting medical evidence, doctors must recognise, acknowledge and manage uncertainties to ensure their evidence is reliable to legal decision-makers. Even in the forensic sciences such as DNA analysis, implicit bias has been shown to influence how results are interpreted from cognitive and contextual biases unconsciously operating. In cases involving allegations of child abuse there has been significant exposure in the media, popular magazines, legal journals and in the published medical literature debating the reliability of medical evidence given in these proceedings. In these cases judges have historically been critical of experts they perceived had sacrificed objectivity for advocacy by having an investment in a 'side'. This paper firstly discusses the issue of bias then describes types of cognitive biases identified from psychological research applied to forensic evidence including adversarial bias, context bias, confirmation bias and explains how terminology can influence the communication of opinion. It follows with previously published guidelines of how to reduce the risk of bias compromising objectivity in forensic practices then concludes with my own recommendations of practices that can be used by child protection paediatricians and within an organisation when conducting forensic evaluations of suspicious childhood injury to improve objectivity in formulation of opinion evidence. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  11. Suspiciousness and low self-esteem as predictors of misattributions of anger in schizophrenia spectrum disorders.

    Science.gov (United States)

    Lysaker, Paul Henry; Davis, Louanne Whitman; Tsai, Jack

    2009-04-30

    While it is widely recognized that many with schizophrenia have significant difficulties in correctly identifying the emotions of others, less is known about the causes and correlates of particular forms of misattribution, including mistakenly seeing anger in others. One possibility is that persons with high levels of suspiciousness and low levels of self-esteem are at risk to attribute their poor feelings about themselves to the malice of others. To explore this possibility, we identified 52 persons with a schizophrenia spectrum disorder who made significant numbers of errors on the Bell-Lysaker Emotional Recognition Test. We then performed a cluster analysis based on measures of suspiciousness from the Positive and Negative Syndrome Scale and self-esteem from the Rosenberg Self-Esteem Schedule, and found the following four groups: a) High Suspiciousness/High Self-Esteem; b) Mild Suspiciousness/High Self-Esteem; c) High Suspiciousness/Low Self-Esteem; and d) Minimal Suspiciousness/Low Self-Esteem. Comparisons between groups revealed that as predicted the High Suspiciousness/Low Self-Esteem group made significantly more misattributions of anger than other groups, even when levels of depression were controlled for statistically. Implications for addressing the misattributions of anger in schizophrenia are discussed.

  12. Fine-needle aspiration of the thyroid: correlating suspicious cytology results with histological outcomes.

    Science.gov (United States)

    Baynes, Andrea L; Del Rio, Andres; McLean, Catriona; Grodski, Simon; Yeung, Meei J; Johnson, William R; Serpell, Jonathan W

    2014-05-01

    Fine-needle aspiration cytology (FNAC) assists the diagnosis of thyroid malignancy. A 'suspicious for malignancy' on FNAC creates a management dilemma. The aims of this study were to investigate the malignancy rate for patients with suspicious cytology, and to describe a management approach for those with a suspicious result. A retrospective review of prospectively collected data in an endocrine surgery database was undertaken. Patients undergoing thyroidectomy with preoperative FNAC from 1992 to 2012 were analysed. Preoperative FNAC was undertaken in 2,692 patients, and the FNAC result was 'suspicious for malignancy' in 94 (3.5 %) patients. Of these, 53 (56.4 %) were malignant, with the majority 44 (83.0 %) being papillary thyroid cancer. 48 patients went straight to total thyroidectomy, 40 patients had an initial diagnostic hemithyroidectomy, and 1 patient had a diagnostic isthmusectomy. 5 patients required reoperative total thyroidectomy as an initial procedure. Of the 94 suspicious cases, 55 were reported by an unknown, presumably non-expert, thyroid cytopathologist. 38 of these cases were available for review and re-reporting by an experienced cytopathologist. On review, 28 (73.7 %) were reclassified as cytologically malignant, and all of these were confirmed as malignant on subsequent histopathology. Suspicious cytology has a high risk of malignancy. Expert thyroid cytopathology can improve diagnostic accuracy and a preoperative malignant diagnosis should be pursued to enable one-stage surgery where possible.

  13. Effectiveness of Fluoroscopic and US - Guided Percutaneous Catheter Drainage for Iliopsoas Abscess through the Anterolateral Transabdominal Approach

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Ho Cheol; Shin, Tae Beom; Park, Mee Jung; Kim, Ji Eun; Choi, Hye Young; Bae, Kyung Soo; Choi, Dae Seob; Na, Jae Boem; Jeong, Seong Hoon [Gyeongsang National University Hospital, College of Medicine, Jinju (Korea, Republic of)

    2011-02-15

    We evaluated the effectiveness of performing fluoroscopic and ultrasonography guided percutaneous catheter drainage (PCD) through the anterolateral transabdominal approach for treating iliopsoas abscess. From January 2008 to December 2009, fluoroscopic and US-guided PCD through the anterolateral transabdominal approach was performed on sixteen iliopsoas abscesses of fourteen patients (7 males and 7 females; mean age: 63 years; age range: 30-87 years). Six abscesses were on the right side and ten abscesses were on the left side. The location of the abscesses were the psoas muscle (n=7), the iliacus muscle (n=7) and the iliopsoas muscle (n=2). All the procedures were performed under fluoroscopy and US guidance in the angiography room. The clinical findings before and after the procedure, the duration of catheter insertion and the procedure-related complications were evaluated. 15 out of the 16 iliopsoas abscesses were effectively treated. The duration of catheter insertion was 5- 27 days (mean: 14.6) days. No patient had significant complications during or after drainage. One patient died of uncontrolled diabetes complications and shock on the 9th day after percutaneous catheter drainage. One recurrence was noted 5 months after removal of the catheter. This patient underwent aspiration and antibiotic treatment for this lesion and the patient improved. Fluoroscopic and US-guided PCD for iliopsoas abscess through the anterolateral transabdominal approach is an effective and safe procedure

  14. US-guided percutaneous laser ablation of refractory metastatic retroperitoneal lesions: A care-compliant case report.

    Science.gov (United States)

    Tian, Guo; Jiang, Tian'an

    2017-04-01

    Retroperitoneal metastatic lymph node is rare but severe, which has important structures like the gastrointestinal tract and large blood vessels around and may challenge excision, inducing serious complications like hemorrhage, intestinal adhesion, and even death after injury. We described the case of a 60-year-old man with a history of right liver resection in 2010, pulmonary wedge resection in 2012, and transarterial chemoembolization twice in 2014, in which the postoperative pathology suggested the mixed liver cancer, and poorly differentiated lung cancer from liver metastasis. Preoperative magnetic resonance (MR) imaging scan showed a refractory retroperitoneal metastatic lymph node. Then this patient repeatedly received 4 ablations with US-guided laser ablation within a month. After 4 ablations due to residual tumor, MR, and CT images of 5-month follow-up showed the partial response. No obvious side effects were discovered in this case during these procedures. This suggested US-guided laser ablation appears to be a useful technique for retroperitoneal metastatic lymph node with poor general condition or those refusing surgical therapy.

  15. Natural History of Pathologically Benign Cancer Suspicious Regions on Multiparametric Magnetic Resonance Imaging Following Targeted Biopsy.

    Science.gov (United States)

    Bryk, Darren J; Llukani, Elton; Huang, William C; Lepor, Herbert

    2015-11-01

    We determined the natural history of pathologically benign cancer suspicious regions on multiparametric magnetic resonance imaging following targeted biopsy. Between January 2012 and September 2014, 330 men underwent prostate multiparametric magnetic resonance imaging. A total of 533 cancer suspicious regions were identified and scored on a Likert scale of 1 to 5 based on suspicion for malignancy with 5 indicating the highest suspicion level. Following multiparametric magnetic resonance imaging all men underwent magnetic resonance imaging-ultrasound fusion targeted prostate biopsy using ProFuse software and the ei-Nav|Artemis system (innoMedicus, Cham, Switzerland), and a computer generated 12-core random biopsy. We analyzed a cohort of 34 men with a total of 51 cancer suspicious regions who had benign prostate biopsies and underwent repeat multiparametric magnetic resonance imaging and prostate specific antigen testing at 1 year. Changes in the greatest linear measurement, the suspicion score and serum prostate specific antigen were ascertained. During 1 year the suspicion score distribution and the mean greatest linear measurement of the cancer suspicious regions decreased significantly (p resonance imaging at 1 year in men with pathologically benign cancer suspicious regions should be discouraged since it is unlikely to influence management decisions. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

    Energy Technology Data Exchange (ETDEWEB)

    Visser, Roelant; Schuur, Klaas H. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Veldkamp, Wouter J.H.; Bun, Petra A.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Centre/Mid-West, Utrecht (Netherlands); Imhof-Tas, Mechli W.; Snoeren, Miranda M.; Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Academical Medical Center Amsterdam, Department of Radiology, Amsterdam (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, P.O. Box 6873, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands)

    2012-04-15

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was available twice, once processed with a tissue equalisation (TE) algorithm and once with local contrast optimisation (PV). All cases had digitised previous mammograms. For both algorithms, the probability of malignancy of each finding was scored independently by six screening radiologists. Perceived case suspiciousness was defined as the highest probability of malignancy of all findings of a radiologist within a case. Differences in diagnostic accuracy of the processing algorithms were analysed by comparing the areas under the receiver operating characteristic curves (A{sub z}). Differences in perceived case suspiciousness were analysed using sign tests. There was no significant difference in A{sub z} (TE: 0.909, PV 0.917, P = 0.46). For all radiologists, perceived case suspiciousness using PV was higher than using TE more often than vice versa (ratio: 1.14-2.12). This was significant (P <0.0083) for four radiologists. Optimisation of local contrast by image processing may increase perceived case suspiciousness, while diagnostic accuracy may remain similar. (orig.)

  17. Lipid based nutrient supplements (LNS) for treatment of children (6 months to 59 months) with moderate acute malnutrition (MAM): A systematic review

    Science.gov (United States)

    Pena-Rosas, Juan Pablo; Boy-Mena, Evelyn; Sachdev, Harshpal S.

    2017-01-01

    Background Moderate acute malnutrition is a major public health problem affecting children from low- and middle-income countries. Lipid nutrient supplements have been proposed as a nutritional intervention for its treatment. Objectives To evaluate the effectiveness and safety of LNS for the treatment of MAM in infants and children 6 to 59 months of age. Study design Systematic review of randomized-controlled trials and controlled before-after studies. Results Data from nine trials showed that use of LNS, in comparison to specially formulated foods, improved the recovery rate (RR 1.08; 95% CI 1.02–1.14, 8 RCTs, 8934 participants, low quality evidence); decreased the chances of no recovery (RR 0.70; 95% CI 0.58–0.85, 7 RCTs, 8364 participants, low quality evidence) and the risk of deterioration into severe acute malnutrition (RR 0.87; 95% CI 0.73–1.03, 6 RCTs, 6788 participants, low quality evidence). There was little impact on mortality (RR 0.94, 95% CI 0.54–1.52, 8 RCTs, 8364 participants, very-low- quality evidence) or default rate (RR 1.32; 95% CI 0.73–2.4, 7 studies, 7570 participants, low quality evidence). There was improvement in weight gain, weight-for-height z-scores, height-for-age z-scores and mid-upper arm circumference. Subset analyses suggested higher recovery rates with greater amount of calories provided and with ready-to-use therapeutic foods, in comparison to ready-to-use supplementary foods. One study comparing LNS with nutritional counselling (very low quality evidence) showed higher chance of recovery, lower risk of deteriorating into severe acute malnutrition and lower default rate, with no impact on mortality, and no recovery. Conclusions Evidence restricted to the African regions suggests that LNS may be slightly more effective than specially formulated fortified foods or nutritional counselling in recovery from MAM, lowering the risk of deterioration into SAM, and improving weight gain with little impact on mortality or default

  18. A novel statistical approach for detection of suspicious regions in digital mammogram

    Directory of Open Access Journals (Sweden)

    Z.A. Abo-Eleneen

    2013-07-01

    Full Text Available In this paper, we propose a novel algorithm to detect the suspicious regions on digital mammograms that based on the Fisher information measure. The proposed algorithm is tested different types and categories of mammograms (fatty, fatty-glandular and dense glandular within mini-MIAS database (Mammogram Image Analysis Society database (UK. The proposed method is compared with a different segmentation based information theoretical methods to demonstrate their effectiveness. The experimental results on mammography images showed the effectiveness in the detection of suspicious regions. This study can be a part of developing a computer-aided decision (CAD system for early detection of breast cancer.

  19. 31 CFR 103.20 - Reports by money services businesses of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... immediate attention, such as ongoing money laundering schemes, the money services business shall immediately... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Reports by money services businesses of suspicious transactions. 103.20 Section 103.20 Money and Finance: Treasury Regulations Relating to...

  20. 31 CFR 103.15 - Reports by mutual funds of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... FINANCIAL RECORDKEEPING AND REPORTING OF CURRENCY AND FOREIGN TRANSACTIONS Reports Required To Be Made § 103.15 Reports by mutual funds of suspicious transactions. (a) General. (1) Every investment company (as... pursuant to that Act (for purposes of this section, a “mutual fund”), shall file with the Financial Crimes...

  1. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography

    NARCIS (Netherlands)

    Visser, Roelant; Veldkamp, Wouter J. H.; Beijerinck, David; Bun, Petra A. M.; Deurenberg, Jan J. M.; Imhof-Tas, Mechli W.; Schuur, Klaas H.; Snoeren, Miranda M.; den Heeten, Gerard J.; Karssemeijer, Nico; Broeders, Mireille J. M.

    2012-01-01

    To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal). Each case was

  2. Increase in perceived case suspiciousness due to local contrast optimisation in digital screening mammography.

    NARCIS (Netherlands)

    Visser, R.; Veldkamp, W.J.H.; Beijerinck, D.; Bun, P.A.; Deurenberg, J.J.; Imhof-Tas, M.W.; Schuur, K.H.; Snoeren, M.M.; Heeten, G.J. den; Karssemeijer, N.; Broeders, M.J.M.

    2012-01-01

    OBJECTIVES: To determine the influence of local contrast optimisation on diagnostic accuracy and perceived suspiciousness of digital screening mammograms. METHODS: Data were collected from a screening region in the Netherlands and consisted of 263 digital screening cases (153 recalled,110 normal).

  3. Anomaly detection driven active learning for identifying suspicious tracks and events in WAMI video

    Science.gov (United States)

    Miller, David J.; Natraj, Aditya; Hockenbury, Ryler; Dunn, Katherine; Sheffler, Michael; Sullivan, Kevin

    2012-06-01

    We describe a comprehensive system for learning to identify suspicious vehicle tracks from wide-area motion (WAMI) video. First, since the road network for the scene of interest is assumed unknown, agglomerative hierarchical clustering is applied to all spatial vehicle measurements, resulting in spatial cells that largely capture individual road segments. Next, for each track, both at the cell (speed, acceleration, azimuth) and track (range, total distance, duration) levels, extreme value feature statistics are both computed and aggregated, to form summary (p-value based) anomaly statistics for each track. Here, to fairly evaluate tracks that travel across different numbers of spatial cells, for each cell-level feature type, a single (most extreme) statistic is chosen, over all cells traveled. Finally, a novel active learning paradigm, applied to a (logistic regression) track classifier, is invoked to learn to distinguish suspicious from merely anomalous tracks, starting from anomaly-ranked track prioritization, with ground-truth labeling by a human operator. This system has been applied to WAMI video data (ARGUS), with the tracks automatically extracted by a system developed in-house at Toyon Research Corporation. Our system gives promising preliminary results in highly ranking as suspicious aerial vehicles, dismounts, and traffic violators, and in learning which features are most indicative of suspicious tracks.

  4. Clinical experiences with photoacoustic breast imaging: the appearance of suspicious lesions

    NARCIS (Netherlands)

    Heijblom, M.

    2014-01-01

    This thesis describes photoacoustic (PA) imaging of suspicious breast lesions. In PA imaging, the tissue of interest is illuminated by short pulses of laser light, usually in the near infrared (NIR) regime. Upon absorption by primarily the tumor vasculature, the light causes a small temperature

  5. 75 FR 63545 - Proposed Collection; Comment Request; Bank Secrecy Act Suspicious Activity Report Database...

    Science.gov (United States)

    2010-10-15

    ... derived through third party data as enhanced data if not provided and Country is US, Mexico or Canada and... corruption (domestic) h. Suspected public/private corruption (foreign) i. Suspicious use of informal value... Country is US, Mexico or Canada and ZIP/Postal Code is provided * 57. ZIP/Postal Code a. (check if...

  6. Comparison of US-Guided Catheterization of the Right Internal Jugular Vein Using Medial-Oblique and Short Axis Techniques

    Directory of Open Access Journals (Sweden)

    Hamid Kamalipour

    2014-09-01

    Full Text Available Background: Although some investigations have shown higher rates of successful first attempt and fewer attempts by using ultrasound-guided Internal Jugular Vein (IJV catheterization, arterial puncture is still common.. Objectives: The present study aimed to investigate US-guided catheterization of the right IJV via medial-oblique technique and also compare this technique to short-axis technique in open-heart surgery patients.. Patients and Methods: In this randomized clinical trial, 80 patients referred to cardiac operating room of Namazi hospital, Shiraz, Iran from March to July 2014 were selected using census method. Block randomization with website was also done. Then, the patients were divided into two groups of 40, Short Axis Group (SAG and Medial-Oblique Group (M-OG. For short-axis technique, patient’s head was positioned at zero degree angulation with his trunk. For medial-oblique technique, on the other hand, patient’s head was tilted to left to 45 degrees between the head and trunk. Sex, age, Body Mass Index (BMI, access time, guidewire time, cannulation time, total attempts for catheterization, first, second, and third attempt success, arterial puncture, hematoma, bleeding, and catheter malposition were recorded. The overlap between the carotid artery and IJV in zero- and 45-degree angulation was estimated through ultrasound print. After all, Kolmogorov-Smirnov test was used to assess normal distribution of the data. Then, the data were analyzed through Student’s t-test, Mann-Whitney U test, and chi-square test. P < 0.05 was considered as statistically significant.. Results: The results showed no significant differences between the two groups regarding the duration of different catheterization steps (P = 0.376. In all the cases in both groups, accessing the vein was successful with three attempts or less. There were no clinical complications of catheterization in the two groups. The mean of overlap was 23.60 ± 33.47 in zero

  7. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, B., E-mail: belarmino.goncalves@gmail.com [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Ambrosio, C.; Serra, S. [Department of Rheumatology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F. [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal)

    2011-09-15

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  8. Clinical and Research Activities at the CATANA Facility of INFN-LNS: From the Conventional Hadrontherapy to the Laser-Driven Approach

    Directory of Open Access Journals (Sweden)

    Giuseppe A. P. Cirrone

    2017-09-01

    Full Text Available The CATANA proton therapy center was the first Italian clinical facility making use of energetic (62 MeV proton beams for the radioactive treatment of solid tumors. Since the date of the first patient treatment in 2002, 294 patients have been successful treated whose majority was affected by choroidal and iris melanomas. In this paper, we report on the current clinical and physical status of the CATANA facility describing the last dosimetric studies and reporting on the last patient follow-up results. The last part of the paper is dedicated to the description of the INFN-LNS ongoing activities on the realization of a beamline for the transport of laser-accelerated ion beams for future applications. The ELIMED (ELI-Beamlines MEDical and multidisciplinary applications project is introduced and the main scientific aspects will be described.

  9. Anti-tumoral effect of recombinant vaccinia virus through US guided injection in a rabbit model of hepatic VX2 carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jong Young; Park, Byeong Ho; Kang, Myong Jin; Cho, Jin Han; Choi, Jong Cheol; Choi, Sun Seob; Nam, Kyung Jin; Hwang, Tae Ho; Jeong, Jin Sook [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2006-02-15

    The purpose of this study was to evaluate the anti-tumoral effect of recombinant vaccinia virus (rVV) (Thymidine kinase (-)/GM-CSF (+)) that was administered as a US guided intratumoral injection in a rabbit model of hepatic VX2 carcinoma. VX2 carcinoma was implanted in the livers of 12 rabbits. US was performed at every week interval to detect hepatic mass after the implantation of VX2 carcinoma. The accurate tumor size and volume was evaluated with CT when the tumor was detected on US. US guided injection of rVV (10{sup 9} pfu/ml) was preformed in three rabbits, intravenous injection of the same dose of rVV was done in two rabbits and another seven rabbits that were without any treatment were selected as a control group. We evaluated the change of the hepatic tumor size and extrahepatic metastasis on serial CT. Tumor specimens were harvested from rabbits that were killed at 8 weeks after VX2 implantation. These tissues were histoimmuopathologically compared to each other (the virus injection group and the control group). The differences between these groups were statistically assessed with student t-tests. Tumor growth was significantly suppressed in the US guided injection group compared with the intravenous injection group or the control group ({rho} < 0.01). The intravenous injection group showed statistically significant tumor suppression compared to the control group ({rho} < 0.01) until 2 weeks after virus injection. Quantification of the pulmonary metastatic nodules was performed in view of both the number and volume. The average number or volume of the pulmonary metastatic nodules in the US injection group was much smaller than these in the control group. Histopathologically, the tumors of the US guided injection group showed less extensive necrosis than those of the control group. Immunohistochemically, the tumor of the US guided injection group showed more prominent infiltration of CD4 (+) and CD8 (+) lymphocytes than did the tumors of the other group

  10. Punch 'scoring': a technique that facilitates melanoma diagnosis of clinically suspicious pigmented lesions.

    Science.gov (United States)

    Grogan, Judith; Cooper, Caroline L; Dodds, Tristan J; Guitera, Pascale; Menzies, Scott W; Scolyer, Richard A

    2017-08-10

    Early recognition and accurate diagnosis underpins melanoma survival. Identifying early melanomas arising in association with pre-existing lesions is often challenging. Clinically suspicious foci, however small, must be identified and examined histologically. This study assessed the accuracy of punch biopsy 'scoring' of suspicious foci in excised atypical pigmented skin lesions to identify early melanomas. Forty-one excised pigmented skin lesions with a clinically/dermoscopically focal area of concern for melanoma, with the suspicious focus marked prior to excision with a punch biopsy 'score' (a partial incision into the skin surface), were analysed. Melanoma was diagnosed in nine of 41 cases (22%). In eight of nine cases (89%) the melanoma was associated with a naevus, and in seven of nine (88%) cases the melanoma was identified preferentially by the scored focus. In six of nine cases (67%), the melanoma was entirely encompassed by the scored focus. In one case of melanoma in situ, the diagnostic material was identified only on further levelling through the scored focus. In 28 of 32 of non-melanoma cases (88%), the scored focus identified either diagnostic features of a particular lesion or pathological features that correlated with the clinical impression of change/atypia including altered architecture or distribution of pigmentation, features of irritation or regression. The 'punch scoring technique' allows direct clinicopathological correlation and facilitates early melanoma diagnosis by focusing attention on clinically suspicious areas. Furthermore, it does not require special expertise in ex-vivo clinical techniques for implementation. Nevertheless, in some cases examination of the lesion beyond the scored focus is also necessary to make a diagnosis of melanoma. © 2017 John Wiley & Sons Ltd.

  11. Sonographic scoring of solid thyroid nodules: effects of nodule size and suspicious cervical lymph node.

    Science.gov (United States)

    Unsal, Ozlem; Akpinar, Meltem; Turk, Bilge; Ucak, Irmak; Ozel, Alper; Kayaoglu, Semra; Uslu Coskun, Berna

    Ultrasound is the most frequently used imaging method to evaluate thyroid nodules. Sonographic characteristics of thyroid nodules which are concerning for malignancy are important to define the need for fine needle aspiration biopsy or open surgery. To evaluate malignancy risk of solid thyroid nodules through sonographic scoring. The effects of nodule size ≥2cm and associated pathologic cervical lymph node in scoring were examined in addition to generally excepted suspicious features. Medical data of 123 patients underwent thyroid surgery were reviewed, and 89 patients (58 females, 31 males) were included in the study. The presence and absence of each suspicious sonographic feature of thyroid nodules were scored as 1 and 0, respectively. Total ultrasound score was obtained by adding the positive ultrasound findings. Differently from the literature, nodule size ≥2cm and associated pathologic cervical node were added in scoring criteria. The diagnostic performance of nodule characteristics for malignancy and the effect of total US score to discriminate malignant and benign disease were calculated. A significant relationship was found between malignancy and hypoechogenity, border irregularity, intranodular vascularity, and microcalcification (p<0.05). Pathologic cervical node was observed predominantly in association with malignant nodules. Positive predictive value of suspicious cervical node for malignancy was 67%, similar to microcalcification. Nodule size ≥2cm was not distinctive for diagnosis of malignancy. The number of suspicious sonographic features obtained with receiver operating characteristic analysis to discriminate between malignant and benign disease was three. Sonographic scoring of thyroid nodules is an effective method for predicting malignancy. The authors suggest including associated pathologic node in the scoring criteria. Further studies with larger cohorts will provide more evidence about its importance in sonographic scoring. Copyright

  12. Utilizing Social Media to Further the Nationwide Suspicious Activity Reporting Initiative

    Science.gov (United States)

    2012-09-01

    Initiative NYPD New York Police Department OSINT Open Source Intelligence P2P Peer to Patent SAR Suspicious Activity Report SMS Short Message (or...Media as an Open-Source Intelligence Tool Several government documents outline the use of social media as an Open Source intelligence tool ( OSINT ...social media to be an OSINT tool that federal, state, and local law enforcement agencies should use to develop timely, relevant, and actionable

  13. Acceleration of tendon healing using US guided intratendinous injection of bevacizumab: First pre-clinical study on a murine model

    Energy Technology Data Exchange (ETDEWEB)

    Dallaudière, Benjamin, E-mail: bendallau64@hotmail.fr [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Inserm U698, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Lempicki, Marta [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Pesquer, Lionel [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Louedec, Liliane [Inserm U698, Hôpital universitaire Bichat, Paris (France); Preux, Pierre Marie [Laboratoire de Biostatistiques, Faculté de médecine, Limoges (France); Meyer, Philippe [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Hess, Agathe [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Université de Médecine Paris Diderot (France); Durieux, Marie Hèlène Moreau [Centre d’Imagerie Ostéo Articulaire, Clinique du Sport de Bordeaux-Mérignac (France); Hummel, Vincent; Larbi, Ahmed [Service de Radiologie, Hôpital universitaire Bichat, Paris (France); Deschamps, Lydia [Service d’ Anatomopathologie, Hôpital universitaire Bichat, Paris (France); and others

    2013-12-01

    Purpose: Tendinopathy shows early disorganized collagen fibers with neo-angiogenesis on histology. Peri-tendinous injection of corticosteroid is the commonly accepted strategy despite the abscence of inflammation in tendinosis. The aim of our study was to assess the potential of intratendinous injection of an anti-angiogenic drug (bevacizumab, AA) to treat tendinopathy in a murine model of patellar and Achilles tendinopathy, and to evaluate its local toxicity. Materials and method: Forty rats (160 patellar and Achilles tendons) were used for this study. We induced tendinosis (T+) in 80 tendons by injecting under ultrasonography (US) guidance Collagenase 1{sup ®} (day 0 = D0, patellar = 40 and Achilles = 40). Clinical examination and tendon US were performed at D3, immediately followed by either AA (AAT+, n = 40) or physiological serum (PST+, n = 40, control) US-guided intratendinous injection. Follow-up at D6 and D13 using clinical, US and histology, and comparison between the 2 groups were performed. To study AA toxicity we compared the 80 remaining normal tendons (T−) after injecting AA in 40 (AAT−). Results: All AAT+ showed a better joint mobilization compared to PST+ at D6 (p = 0.004) with thinner US tendon diameters (p < 0.004), and less disorganized collagen fibers and neovessels on histology (p < 0.05). There was no difference at D13 regarding clinical status, US tendon diameter and histology (p > 0.05). Comparison between AAT− and T− showed no AA toxicity on tendon (p = 0.18). Conclusion: Our study suggests that high dose mono-injection of AA in tendinosis, early after the beginning of the disease, accelerates tendon's healing, with no local toxicity.

  14. Usefulness of preoperative breast MRI in breast cancer patients diagnosed with tumor removal using a US-guided mammotome

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Hyun Woo; Kang, Doo Kyung; Yim, Hyun Ee [Ajou University, School of Medicine, Suwon (Korea, Republic of); Park, Hee Boong [Park Breast Clinic, Suwon (Korea, Republic of)

    2007-10-15

    We evaluated the MRI findings that suggested the presence of a residual cancer after a mammotome biopsy in pathologically proven breast cancer patients and the usefulness of MRI to diagnose a residual cancer and additional lesions. We reviewed 41 breast cancer patients that underwent an ultrasonography-guided mammotome biopsy for complete resection of a breast lesion. MRI was performed for preoperative assessment and MRI findings suggestive of a residual cancer at the procedure site were analyzed and correlated to the pathological findings. Additional enhancements on breast MRI were analyzed, and the diagnostic accuracy of MRI for occult additional lesions was calculated. A total of 32 (78.0%) patients had a residual tumor. A mass was the most common MRI finding that suggested a residual cancer. Thick rim enhancement or a mass with a non-mass like enhancement were the most suspicious findings that suggested the presence of a residual cancer. The sensitivity, specificity and accuracy of MRI for the detection of a residual cancer were 81.3%, 66.7% and 78.0%, respectively. Additional malignant lesions were found in 7 cases. The sensitivity, specificity and accuracy of MRI for the detection of additional lesions were 100%, 60.0% and 76.5%, respectively. Further complete surgery should be performed, as residual tumors are found in 50% of the negative MRI examinations, whereas preoperative MRI is helpful to evaluate occult additional lesions.

  15. Separating Facts from Fiction: Linguistic Models to Classify Suspicious and Trusted News Posts on Twitter

    Energy Technology Data Exchange (ETDEWEB)

    Volkova, Svitlana; Shaffer, Kyle J.; Jang, Jin Yea; Hodas, Nathan O.

    2017-07-30

    Pew research polls report 62 percent of U.S. adults get news on social media (Gottfried and Shearer, 2016). In a December poll, 64 percent of U.S. adults said that “made-up news” has caused a “great deal of confusion” about the facts of current events (Barthel et al., 2016). Fabricated stories spread in social media, ranging from deliberate propaganda to hoaxes and satire, contributes to this confusion in addition to having serious effects on global stability. In this work we build predictive models to classify 130 thousand news tweets as suspicious or verified, and predict four subtypes of suspicious news – satire, hoaxes, clickbait and propaganda. We demonstrate that neural network models trained on tweet content and social network interactions outperform lexical models. Unlike previous work on deception detection, we find that adding syntax and grammar features to our models decreases performance. Incorporating linguistic features, including bias and subjectivity, improves classification results, however social interaction features are most informative for finer-grained separation between our four types of suspicious news posts.

  16. Diffusion-weighted magnetic resonance imaging in the assessment of ovarian masses with suspicious features: Strengths and challen

    Directory of Open Access Journals (Sweden)

    Sahar Mansour

    2015-12-01

    Conclusion: DWI supported by conventional MRI data can confirm or exclude malignancy in suspicious ovarian masses. The combined analysis of quantitative and qualitative criteria and knowledge of the sequence pitfalls are required.

  17. Phishing suspiciousness in older and younger adults: The role of executive functioning.

    Directory of Open Access Journals (Sweden)

    Brandon E Gavett

    Full Text Available Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger, sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3] accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27 and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12 and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07. Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid

  18. Phishing suspiciousness in older and younger adults: The role of executive functioning

    Science.gov (United States)

    Zhao, Rui; John, Samantha E.; Bussell, Cara A.; Roberts, Jennifer R.; Yue, Chuan

    2017-01-01

    Phishing is the spoofing of Internet websites or emails aimed at tricking users into entering sensitive information, with such goals as financial or identity theft. The current study sought to determine whether age is associated with increased susceptibility to phishing and whether tests of executive functioning can predict phishing susceptibility. A total of 193 cognitively intact participants, 91 younger adults and 102 older adults, were primarily recruited through a Psychology department undergraduate subject pool and a gerontology research registry, respectively. The Executive Functions Module from the Neuropsychological Assessment Battery and the Iowa Gambling Task were the primary cognitive predictors of reported phishing suspiciousness. Other predictors included age group (older vs. younger), sex, education, race, ethnicity, prior knowledge of phishing, prior susceptibility to phishing, and whether or not browsing behaviors were reportedly different in the laboratory setting versus at home. A logistic regression, which accounted for a 22.7% reduction in error variance compared to the null model and predicted phishing suspiciousness with 73.1% (95% CI [66.0, 80.3]) accuracy, revealed three statistically significant predictors: the main effect of education (b = 0.58, SE = 0.27) and the interactions of age group with prior awareness of phishing (b = 2.31, SE = 1.12) and performance on the Neuropsychological Assessment Battery Mazes test (b = 0.16, SE = 0.07). Whether or not older adults reported being suspicious of the phishing attacks used in this study was partially explained by educational history and prior phishing knowledge. This suggests that simple educational interventions may be effective in reducing phishing vulnerability. Although one test of executive functioning was found useful for identifying those at risk of phishing susceptibility, four tests were not found to be useful; these results speak to the need for more ecologically valid tools in

  19. Informing cancer patient based on his type of personality: the suspicious (paranoid) patient.

    Science.gov (United States)

    Kallergis, G

    2013-01-01

    Imparting bad news had always been an unpleasant task for the physician, as shown from ancient years to our days. In the healthcare sector and as far as the cancer patient is concerned, the imparting of bad news is performed by the patient's doctor within a therapeutic relationship of course. The fundamental question is how a therapist could tailor the information to any patient and if "Is it possible to determine who should be told what, when and how ?". The aim of this paper was to describe the suspicious character or type of personality thoroughly so that any physician can make a diagnosis and tailor the information strategy to the patient's needs. As method of research was used the qualitative method through groups with doctors and nurses, while research within groups lasted for 5 years. The degree of informing of the suspicious personality in the range "minimal - small - medium - large - very large" is : the degree of denial varies between large and very large. The degree of informing varies between medium and small and sometimes minimal. Informing the Family: The hardest family to deal with. Pay attention to litigious mania. Avoid confrontation or be drawn into agreeing with the family views.

  20. Automated linking of suspicious findings between automated 3D breast ultrasound volumes

    Science.gov (United States)

    Gubern-Mérida, Albert; Tan, Tao; van Zelst, Jan; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    Automated breast ultrasound (ABUS) is a 3D imaging technique which is rapidly emerging as a safe and relatively inexpensive modality for screening of women with dense breasts. However, reading ABUS examinations is very time consuming task since radiologists need to manually identify suspicious findings in all the different ABUS volumes available for each patient. Image analysis techniques to automatically link findings across volumes are required to speed up clinical workflow and make ABUS screening more efficient. In this study, we propose an automated system to, given the location in the ABUS volume being inspected (source), find the corresponding location in a target volume. The target volume can be a different view of the same study or the same view from a prior examination. The algorithm was evaluated using 118 linkages between suspicious abnormalities annotated in a dataset of ABUS images of 27 patients participating in a high risk screening program. The distance between the predicted location and the center of the annotated lesion in the target volume was computed for evaluation. The mean ± stdev and median distance error achieved by the presented algorithm for linkages between volumes of the same study was 7.75±6.71 mm and 5.16 mm, respectively. The performance was 9.54±7.87 and 8.00 mm (mean ± stdev and median) for linkages between volumes from current and prior examinations. The proposed approach has the potential to minimize user interaction for finding correspondences among ABUS volumes.

  1. Validation of the EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis.

    Science.gov (United States)

    Burgers, Leonie E; Siljehult, Filip; Ten Brinck, Robin M; van Steenbergen, Hanna W; Landewé, Robert B M; Rantapää-Dahlqvist, Solbritt; van der Helm-van Mil, Annette H M

    2017-12-01

    Recently a EULAR-taskforce defined arthralgia suspicious for progression to RA, in order to allow inclusion of homogeneous sets of arthralgia patients in clinical studies. This longitudinal study aimed (i) to validate this definition in arthralgia patients in whom rheumatologists felt that imminent RA was more likely than other arthralgias [clinically suspect arthralgia (CSA)], that is, the target population fulfilling the entry criterion, and (ii) to explore the performance in arthralgia patients who were referred to secondary care prior to rheumatological evaluation, hence ignoring the entry criterion. The definition was assessed in 241 Dutch patients identified with CSA by rheumatologists and 113 patients referred to the Umeå university hospital with recent-onset arthralgia in small joints. The external reference was arthritis development definition (⩾3/7 parameters present) had an increased risk for developing arthritis compared with definition-negative CSA patients (hazard ratio = 2.1, 95% CI: 0.9, 4.7). The sensitivity was 84% and the positive predictive value 30%. In arthralgia patients in whom the definition was applied before rheumatological evaluation, a positive definition was neither sensitive (10%) nor predictive (positive predictive value 3%). The EULAR definition of arthralgia suspicious for progression to RA is sensitive when used to support the rheumatologist's opinion on imminent RA. This validation study shows that the definition, when used as designed, further homogenizes patients that rheumatologists consider at risk for RA. To arrive at a high specificity, the clinical definition needs to be combined with biomarkers.

  2. Ductal carcinoma in situ diagnosed at US-guided 14-gauge core-needle biopsy for breast mass: Preoperative predictors of invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Park, Ah Young; Gweon, Hye Mi; Son, Eun Ju; Yoo, Miri; Kim, Jeong-Ah; Youk, Ji Hyun, E-mail: jhyouk@yuhs.ac

    2014-04-15

    Objectives: To identify preoperative features that could be used to predict invasive breast cancer in women with a diagnosis of ductal carcinoma in situ (DCIS) at ultrasound (US)-guided 14-gauge core needle biopsy (CNB). Methods: A total of 86 DCIS lesions that were diagnosed at US-guided 14-gauge CNB and excised surgically in 84 women were assessed. We retrospectively reviewed the patients’ medical records, mammography, US, and MR imaging. We compared underestimation rates of DCIS for the collected clinical and radiologic variables and determined the preoperative predictive factors for upstaging to invasive cancer. Results: Twenty-seven (31.4%) of 86 DCIS lesions were upgraded to invasive cancer. Preoperative features that showed a significantly higher underestimation of DCIS were palpability or nipple discharge (p = 0.040), number of core specimens less than 5 (p = 0.011), mammographic maximum lesion size of 25 mm or larger (p = 0.022), mammographic mass size of 40 mm or larger (p = 0.046), sonographic mass size of 32 mm or larger (p = 0.009), lesion size of 30 mm on MR (p = 0.004), lower signal intensity (SI) on fat-saturated T2-weighted MR images (FS-T2WI) (p = 0.005), heterogeneous or rim enhancement on MR images (p = 0.009), and apparent diffusion coefficient (ADC) values lower than 1.04 × 10{sup −3} mm{sup 2}/s on diffusion-weighted MR imaging (DWI) (p < 0.001). Conclusion: Clinical symptom of palpability or nipple discharge, number of core specimen, mammographic maximum lesion or mass size, SI on FS-T2WI, heterogeneous or rim enhancement on MR, and ADC value may be helpful in predicting the upgrade to invasive breast cancer for DCIS diagnosed at US-guided 14-gauge CNB.

  3. Preoperative US-guided hook-needle insertion in recurrent lymph nodes of papillary thyroid cancer: A help for the surgeon

    Energy Technology Data Exchange (ETDEWEB)

    Duprez, Raphaelle [Radiology department, Hopital Porte-Madeleine, CHR Orleans, BP 2439, 45032 Orleans Cedex 1 (France)], E-mail: raphaelle.duprez@wanadoo.fr; Lebas, Patrick [Radiology department, Hopital Porte-Madeleine, CHR Orleans, BP 2439, 45032 Orleans Cedex 1 (France); Marc, Olivier Saint [General Surgery department, Hopital La Source, CHR Orleans, BP 6709, 45067 Orleans Cedex 2 (France); Mongeois, Elise; Emy, Philippe [Endocrinology department, Hopital La Source, CHR Orleans, BP 6709, 45067 Orleans Cedex 2 (France); Michenet, Patrick [Pathology department, Hopital La Source, CHR Orleans, BP 6709, 45067 Orleans Cedex 2 (France)

    2010-01-15

    Objective: The objective of this study is to investigate whether preoperative ultrasound guided insertion of a hook-needle is useful in reoperations for cervical recurrent lymph node metastases of papillary thyroid cancer. Patients and methods: 8 patients with operated papillary thyroid cancer were included in this study. They all had suspicious nonpalpable cervical lymph nodes discovered during follow-up. These lymph nodes were identified by ultrasound imaging and their metastatic nature was confirmed by fine needle aspiration cytology and measurement of in situ thyroglobulin. In all cases, surgical excision of these lymph nodes was decided. All 8 patients had a hook-needle inserted in the suspicious lymph node(s) preoperatively and under ultrasound guidance. Results and conclusion: In all 8 patients, the suspicious lymph nodes were removed and their metastatic nature was confirmed by the final pathological examination. This localization technique is very helpful for the surgeon during the excision of small and nonpalpable lymph nodes, especially in previously operated area.

  4. Thyroid nodules with highly suspicious ultrasonographic features, but with benign cytology on two occasions: is malignancy still possible?

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley; Calsolari, Maria Regina, E-mail: pedrowsrosario@gmail.com [Santa Casa de Belo Horizonte, MG (Brazil)

    2016-11-01

    There is no information about the frequency of malignancy specifically in the case of thyroid nodules with highly suspicious sonographic features, but with two fine needle aspiration (FNA) showing benign cytology. This was the objective of the study. Subjects and methods: We report the results of 105 patients with thyroid nodules considered 'highly suspicious' according to the ultrasonographic classification of American Thyroid Association, in whom FNA revealed benign cytology on two occasions (interval of 6 months). Results: Thyroidectomy was performed in 11 cases due to desire of the patient or significant growth of the nodule. In these patients, cytology continued to be benign in 9, was non-diagnostic in 1, and suspicious in 1. Histology revealed papillary carcinoma in only one nodule. In patients in whom a third FNA was obtained for this study (n = 94), cytology continued to be benign in 86, became non-diagnostic in 5, indeterminate in 2, and suspicious in 1. The last 8 patients (with non-benign cytology) were submitted to thyroidectomy and histology revealed malignancy in only one nodule. Conclusion: The rate of malignancy found here for nodules with highly suspicious sonographic features, even after two FNA showing benign cytology, was 2%. We believe that in these cases, the continuation of follow-up consisting of ultrasound at intervals of 2 years may still be adequate. (author)

  5. Crossover trial to test the acceptability of a locally produced lipid-based nutrient supplement (LNS) for children under 2 years in Cambodia: a study protocol.

    Science.gov (United States)

    Borg, Bindi; Mihrshahi, Seema; Griffin, Mark; Chamnan, Chhoun; Laillou, Arnaud; Wieringa, Frank T

    2017-09-06

    The acceptability and efficacy of existing ready-to-use supplementary and therapeutic foods has been low in Cambodia, thus limiting success in preventing and treating malnutrition among Cambodian children. In that context, UNICEF and IRD have developed a locally produced, multiple micronutrient fortified lipid-based nutrient supplement. This food is innovative, in that it uses fish instead of milk as the animal source food. Very few supplementary foods have non-milk animal source foods, and in addition they have not been widely tested. This trial will assess the novel food's acceptability to children and caregivers. This is a cluster-randomised, incomplete block, 4×4 crossover design with no blinding. It will take place in four sites in a community setting in periurban Phnom Penh. Healthy children aged 9-23 months (n=100) will eat each of four foods for 3 days at a time. The amount they consume will be measured, and at the end of each 3-day set, caregivers will assess how well their child liked the food. After 12 days, caregivers themselves will do a sensory test of the 4 foods and will rank them in terms of preference. Ethical clearance was received from the University of Queensland Medical Research Ethics Committee (2014001070) and from Cambodia's National Ethics Committee for Health Research (03/8 NECHR). ClinicalTrials.gov, identifier: LNS-CAMB-INFANTS; NCT02257437. Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Visualization of suspicious lesions in breast MRI based on intelligent neural systems

    Science.gov (United States)

    Twellmann, Thorsten; Lange, Oliver; Nattkemper, Tim Wilhelm; Meyer-Bäse, Anke

    2006-05-01

    Intelligent medical systems based on supervised and unsupervised artificial neural networks are applied to the automatic visualization and classification of suspicious lesions in breast MRI. These systems represent an important component of future sophisticated computer-aided diagnosis systems and enable the extraction of spatial and temporal features of dynamic MRI data stemming from patients with confirmed lesion diagnosis. By taking into account the heterogenity of the cancerous tissue, these techniques reveal the malignant, benign and normal kinetic signals and and provide a regional subclassification of pathological breast tissue. Intelligent medical systems are expected to have substantial implications in healthcare politics by contributing to the diagnosis of indeterminate breast lesions by non-invasive imaging.

  7. Student Perceptions of Auditor Responses to Evidence of Suspicious Activities: An Experimental Assessment

    Directory of Open Access Journals (Sweden)

    David S Murphy

    2015-12-01

    Full Text Available This study assessed student perceptions of auditor responses to evidence that a client failed to respond appropriately to suspicious activities that could indicate money laundering. Subjects were presented with a series of randomized cases in which partner type (new vs. experienced, firm type (regional vs. international and audit fee materiality (not material, material to the local office only, material to the firm were manipulated asked to indicate their perceptions of the likelihood that an audit partner would discuss such evidence with the client, and the likelihood that the issue would be disclosed by the auditor. Both partner type and audit fee materiality was found to have significant effects on perceived likelihoods.

  8. Introducing a Model for Suspicious Behaviors Detection in Electronic Banking by Using Decision Tree Algorithms

    Directory of Open Access Journals (Sweden)

    Rohulla Kosari Langari

    2014-02-01

    Full Text Available Change the world through information technology and Internet development, has created competitive knowledge in the field of electronic commerce, lead to increasing in competitive potential among organizations. In this condition The increasing rate of commercial deals developing guaranteed with speed and light quality is due to provide dynamic system of electronic banking until by using modern technology to facilitate electronic business process. Internet banking is enumerate as a potential opportunity the fundamental pillars and determinates of e-banking that in cyber space has been faced with various obstacles and threats. One of this challenge is complete uncertainty in security guarantee of financial transactions also exist of suspicious and unusual behavior with mail fraud for financial abuse. Now various systems because of intelligence mechanical methods and data mining technique has been designed for fraud detection in users’ behaviors and applied in various industrial such as insurance, medicine and banking. Main of article has been recognizing of unusual users behaviors in e-banking system. Therefore, detection behavior user and categories of emerged patterns to paper the conditions for predicting unauthorized penetration and detection of suspicious behavior. Since detection behavior user in internet system has been uncertainty and records of transactions can be useful to understand these movement and therefore among machine method, decision tree technique is considered common tool for classification and prediction, therefore in this research at first has determinate banking effective variable and weight of everything in internet behaviors production and in continuation combining of various behaviors manner draw out such as the model of inductive rules to provide ability recognizing of different behaviors. At least trend of four algorithm Chaid, ex_Chaid, C4.5, C5.0 has compared and evaluated for classification and detection of exist

  9. Diagnostic Accuracy of Radiologic Scoring System for Evaluation of Suspicious Hirschsprung Disease in Children

    Science.gov (United States)

    Alehossein, Mehdi; Roohi, Ahad; Pourgholami, Masoud; Mollaeian, Mansour; Salamati, Payman

    2015-01-01

    Background: In 1996, Donovan and colleagues represented a scoring system for better prediction of Hirschsprung disease (HD). Objectives: Our objective was to devise another scoring system that uses a checklist of radiologic and clinical signs to determine the probability of HD in suspicious patients. Patients and Methods: In a diagnostic accuracy study, 55 children with clinical manifestations of HD that referred to a training hospital from 1998 to 2011 were assessed. A checklist was used to evaluate the items proposed by contrast enema (CE), based on six subscales, including transitional zone, rectosigmoid index (RSI), irregular contractions in aganglionic region, cobblestone appearance, filling defect due to fecaloid materials and lack of meconium defecation during the first 48 hours after birth. The patients were classified as high score and low score. Sensitivity, specificity, positive predictive value and negative predictive value of our scoring system were calculated for identifying HD, in comparison with pathologically proved or ruled out HD. Results: Of the 55 patients, 36 (65.4%) cases had HD and 19 (34.6%) cases were without HD. In the HD group, 32 patients showed high scores and four patients had low scores. The sensitivity and specificity of our diagnostic scoring system were 88.9% (95% CI: 78.6% - 99.1%) and 84.2% (95% CI: 68.7% - 100%), respectively. Moreover, positive predictive value (PPV) and negative predictive value (NPV) were 91.4% (95% CI: 82.1% - 100%) and 80% (95% CI: 62.5% - 97.5%), respectively. Conclusions: Our new scoring system of CE is a useful diagnostic method in HD. If a patient’s score is high, that patient is highly suspicious to HD and reversely, when one’s score is low, the patient presents a reduced probability to be diagnosed with HD. PMID:25901256

  10. The Role of Conventional Bronchoscopy in the Workup of Suspicious CT Scan Screen-Detected Pulmonary Nodules

    NARCIS (Netherlands)

    van't Westeinde, Susan C.; Horeweg, Nanda; Vernhout, Rene M.; Groen, Harry J. M.; Lammers, Jan-Willem J.; Weenink, Carla; Nackaerts, Kristiaan; Oudkerk, Matthijs; Mali, Willem; Thunnissen, Frederik B.; de Koning, Harry J.; van Klaveren, Rob J.

    Background: Up to 50% of the participants in CT scan lung cancer screening trials have at least one pulmonary nodule. To date, the role of conventional bronchoscopy in the workup of suspicious screen-detected pulmonary nodules is unknown. If a bronchoscopic evaluation could be eliminated, the

  11. The role of conventional bronchoscopy in the workup of suspicious CT scan screen-detected pulmonary nodules

    NARCIS (Netherlands)

    S.C. van 't Westeinde (Susan); N. Horeweg (Nanda); R. Vernhout (Rene); H.J.M. Groen (Henk); J.-W.J. Lammers (Jan-Willem); C. Weenink (Carla); K. Nackaerts (Kristiaan); M. Oudkerk (Matthijs); W.P. Mali (Willem); F.B.J.M. Thunnissen (Frederik); H.J. de Koning (Harry); R.J. van Klaveren (Rob)

    2012-01-01

    textabstractBackground: Up to 50% of the participants in CT scan lung cancer screening trials have at least one pulmonary nodule. To date, the role of conventional bronchoscopy in the workup of suspicious screen-detected pulmonary nodules is unknown. If a bronchoscopic evaluation could be

  12. US-guided percutaneous treatment of chronic calcific tendinitis of the shoulder; Trattamento percutaneo eco-guidato della tendinite calcifica cronica della spalla

    Energy Technology Data Exchange (ETDEWEB)

    Giacomoni, P. [Ospedale S. Camillo, Trient (Italy). Servizio di Radiologia; Siliotto, R. [Ospedale S. Camillo, Trient (Italy). Fisiatria e Riabilitazione

    1999-11-01

    The purpose of this work is to report on the personal technique and the results of US-guided percutaneous treatment of chronic calcific tendinitis. January 1997 to March 1999, 70 patients with known chronic calcific supraspinatus tendinitis were submitted to the US-guided treatment. All patients had undergone plain radiography, US, and physical and psychiatric examination. Plain radiography and aspiration biopsy demonstrated hard and radiopaque calcification in 59 patients and soft and faintly milky calcification in 11 cases; calcification diameter ranged 6-30 mm. US showed tendon thickening, with bulging of the outer tendon surface; 10 patients also had moderate dilatation of the subacromial bursa. Physiatric examination revealed chronic pain exacerbated at night, which was always associated with motion impairment. The selection criteria for treatment were calcification diameter >6 mm, integrity of the tendon, and chronic pain. After superficial planes were anesthetized, a 16 G needle was positioned inside the calcification under US guidance and the calcific deposits were fragmented and aspirated. Then, 0.5-1 mL triamcinolone acetonide (40 mg) was injected in the soft tissues or subacromial bursa. The US-guided technique always allowed easy location of calcific deposits and complete aspiration of all soft calcifications. Splintering of hard calcifications helped migration of residual deposits to vascularized soft tissues, which accelerated the - frequently complete - resorption process. It has been privileged extensive and prolonged fragmentation of the calcifications using a single needle, versus the technique using a second needle, saline lavage and aspiration of residual deposits. US-guided percutaneous treatment with aspiration and splintering of chronic calcific supraspinatus tendinitis is a conservative, simple, well-tolerated procedure which can be considered the method of choice after the failure of medical treatment. [Italian] Vengono presentati la

  13. SU-F-R-25: Automatic Identification of Suspicious Recurrent/residual Disease Regions After Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Parra, N A; Abramowitz, M; Pollack, A; Stoyanova, R [University of Miami, Miami, FL (United States)

    2016-06-15

    Purpose: To automatically identify and outline suspicious regions of recurrent or residual disease in the prostate bed using Dynamic Contrast Enhanced-MRI (DCE-MRI) in patients after prostatectomy. Methods: Twenty-two patients presenting for salvage radiotherapy and with identified Gross Tumor Volume (GTV) in the prostate bed were retrospectively analyzed. The MRI data consisted of Axial T2weighted-MRI (T2w) of the pelvis: resolution 1.25×1.25×2.5 mm; Field of View (FOV): 320×320 mm; slice thickness=2.5mm; 72 slices; and Dynamic Contrast Enhanced MRI (DCE-MRI)–12 series of T1w with identical spatial resolution to T2w and at 30–34s temporal resolution. Unsupervised pattern recognition was used to decompose the 4D DCE data as the product W.H of weights W of k patterns H. A well-perfused pattern Hwp was identified and the weight map Wwp associated to Hwp was used to delineate suspicious volumes. Threshold of Wwp set at mean(Wwp)+S*std(Wwp), S=1,1.5,2 and 2.5 defined four volumes labeled as DCE1.0 to DCE2.5. These volumes were displayed on T2w and, along with GTV, were correlated with the highest pre-treatment PSA values, and with pharmacokinetic analysis constants. Results: GTV was significantly correlated with DCE2.0(ρ= 0.60, p<0.003), and DCE 2.5 (ρ=0.58, p=0.004)). Significant correlation was found between highest pre-treatment PSA and GTV(ρ=0.42, p<0.049), DCE2.0(ρ= 0.52, p<0.012), and DCE 2.5 (ρ=0.67, p<<0.01)). Kruskal-Wallis analysis showed that Ktrans median value was statistically different between non-specific prostate bed tissue NSPBT and both GTV (p<<0.001) and DCE2.5 (p<<0.001), but while median Ve was statistically different between DCE2.5 and NSPBT (p=0.002), it was not statistically different between GTV and NSPBT (p=0.054), suggesting that automatic volumes capture more accurately the area of malignancy. Conclusion: Software developed for identification and visualization of suspicions regions in DCE-MRI from post-prostatectomy patients has

  14. Automatic detection of suspicious behavior of pickpockets with track-based features in a shopping mall

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; Burghouts, Gertjan J.; Eendebak, Pieter T.; van Huis, Jasper R.; Dijk, Judith; van Rest, Jeroen H. C.

    2014-10-01

    Proactive detection of incidents is required to decrease the cost of security incidents. This paper focusses on the automatic early detection of suspicious behavior of pickpockets with track-based features in a crowded shopping mall. Our method consists of several steps: pedestrian tracking, feature computation and pickpocket recognition. This is challenging because the environment is crowded, people move freely through areas which cannot be covered by a single camera, because the actual snatch is a subtle action, and because collaboration is complex social behavior. We carried out an experiment with more than 20 validated pickpocket incidents. We used a top-down approach to translate expert knowledge in features and rules, and a bottom-up approach to learn discriminating patterns with a classifier. The classifier was used to separate the pickpockets from normal passers-by who are shopping in the mall. We performed a cross validation to train and evaluate our system. In this paper, we describe our method, identify the most valuable features, and analyze the results that were obtained in the experiment. We estimate the quality of these features and the performance of automatic detection of (collaborating) pickpockets. The results show that many of the pickpockets can be detected at a low false alarm rate.

  15. [Establishment of confirmatory test for suspicious hepatitis B surface antigen positive samples].

    Science.gov (United States)

    Chen, Lin; Rong, Yang; Liu, Jia; Xu, Jun; Guo, Jing-Xia; Song, Yong-Ji; Zhao, Jing; Liu, Ai-Xia; Yang, Li-Hua; Li, Bo-An; Mao, Yuan-Li

    2012-08-01

    Establish a confirmatory test based on ELISA, and use to verify the authenticity of HBsAg weak positive samples, pick and get rid of the false result, and avoid the mistake diagnosis. The particles (reagent A) coated by streptavidin and biotinylated HBsAb (reagent B) were mixed in different proportions, then neutralized with serum whose the COI of HBsAg > 20 by ELISA in order to identify the activity of HBsAb in confirmatory reagent. 30 pieces of HBsAg weak positive serum neutralized with the confirmatory reagent, the serum were considered to be positive if rate of decline of HBsAg COI > 50%. The results were compared to Roche confirmatory Kit. Confirmatory reagent was able to neutralized with HBsAg. 24 of 30 pieces of HBsAg weak positive samples were judged to be positive, while 6 poeces were negative. The ELISA comfirm method is fully consistent with Roche confirmatory Kit. The ELISA confirmatory test for suspicious HBsAg positive samples is a simple, accurate and low cost initial validation method, After further clinical trials, should be widely applied.

  16. Adaptive Suspicious Prevention for Defending DoS Attacks in SDN-Based Convergent Networks.

    Science.gov (United States)

    Dao, Nhu-Ngoc; Kim, Joongheon; Park, Minho; Cho, Sungrae

    2016-01-01

    The convergent communication network will play an important role as a single platform to unify heterogeneous networks and integrate emerging technologies and existing legacy networks. Although there have been proposed many feasible solutions, they could not become convergent frameworks since they mainly focused on converting functions between various protocols and interfaces in edge networks, and handling functions for multiple services in core networks, e.g., the Multi-protocol Label Switching (MPLS) technique. Software-defined networking (SDN), on the other hand, is expected to be the ideal future for the convergent network since it can provide a controllable, dynamic, and cost-effective network. However, SDN has an original structural vulnerability behind a lot of advantages, which is the centralized control plane. As the brains of the network, a controller manages the whole network, which is attractive to attackers. In this context, we proposes a novel solution called adaptive suspicious prevention (ASP) mechanism to protect the controller from the Denial of Service (DoS) attacks that could incapacitate an SDN. The ASP is integrated with OpenFlow protocol to detect and prevent DoS attacks effectively. Our comprehensive experimental results show that the ASP enhances the resilience of an SDN network against DoS attacks by up to 38%.

  17. Adaptive Suspicious Prevention for Defending DoS Attacks in SDN-Based Convergent Networks.

    Directory of Open Access Journals (Sweden)

    Nhu-Ngoc Dao

    Full Text Available The convergent communication network will play an important role as a single platform to unify heterogeneous networks and integrate emerging technologies and existing legacy networks. Although there have been proposed many feasible solutions, they could not become convergent frameworks since they mainly focused on converting functions between various protocols and interfaces in edge networks, and handling functions for multiple services in core networks, e.g., the Multi-protocol Label Switching (MPLS technique. Software-defined networking (SDN, on the other hand, is expected to be the ideal future for the convergent network since it can provide a controllable, dynamic, and cost-effective network. However, SDN has an original structural vulnerability behind a lot of advantages, which is the centralized control plane. As the brains of the network, a controller manages the whole network, which is attractive to attackers. In this context, we proposes a novel solution called adaptive suspicious prevention (ASP mechanism to protect the controller from the Denial of Service (DoS attacks that could incapacitate an SDN. The ASP is integrated with OpenFlow protocol to detect and prevent DoS attacks effectively. Our comprehensive experimental results show that the ASP enhances the resilience of an SDN network against DoS attacks by up to 38%.

  18. Effectiveness of autofluorescence to identify suspicious oral lesions--a prospective, blinded clinical trial.

    Science.gov (United States)

    Koch, Felix Peter; Kaemmerer, Peer W; Biesterfeld, Stefan; Kunkel, Martin; Wagner, Wilfried

    2011-12-01

    Regular screening through white light inspection of the entire oral mucosa is the most important examination method to identify precancerous lesions and early oral carcinoma. Additionally, the physiologic autofluorescence of the oral mucosa has been described as a novel screening method for the detection of mucosal lesions that are not visible by white light. This study aimed to evaluate the sensitivity and specificity of the autofluorescence examination. Seventy-eight patients were examined in this study. All of them suffered from suspicious oral mucosal lesions. Two different investigation methods were applied: the standard examination by white light and an examination by a novel light source of 400 nm that evoked a green light emission (>500 nm) in normal mucosa. It was proposed that malignant oral mucosal lesions show different autofluorescence characteristics than the green autofluorescence of healthy mucosa. Red autofluorescence indicated SCC with a sensitivity of 20% and a specificity of 98%. The results showed that dysplasia and carcinoma could be identified with a sensitivity of 96% and a specificity of 18% by using the autofluorescence method. The sensitivity decreased according to the grade of mucosal keratosis and was influenced by the localisation of the lesion. In conclusion, benign as well as malignant oral lesions could not be distinguished by a diminished autofluorescence signal. A red autofluorescence signal, however, could indicate cancerous processes of the oral mucosa.

  19. Typing the atypical: Diagnostic issues and predictive markers in suspicious prostate lesions.

    Science.gov (United States)

    Sanguedolce, Francesca; Cormio, Antonella; Musci, Giovanni; Troiano, Francesco; Carrieri, Giuseppe; Bufo, Pantaleo; Cormio, Luigi

    2017-08-01

    As much as 5% of prostate biopsies yield findings equivocal for malignancy even for skilled uropathologist; such "grey zone" lesions have been addressed in many ways, although the acronym ASAP (atypical small acinar proliferation) is the most widely used when referring to an atypical focus suspicious, but not diagnostic, for malignancy. Since the introduction of this diagnostic category more than 20 years ago, debate has ensued over its histological characterization and clinical significance. Pathology reporting of ASAP, commonly based on strict morphological criteria and traditional immunohistochemical markers such as basal cell antibodies, has been improved by recent availability of novel immunohistochemical markers such as AMACR and ERG. Further pathological issues, such as the role of pre-analytical variables, number of tissue levels, interobserver variability, and association with prostatic intraepithelial neoplasia also play a role in the optimal assessment of ASAP. Apart from diagnostic issues, a major issue is ASAP predictive value for prostate cancer on repeat biopsy. Therefore, attempts have been made to identify clinical and biological parameters that could predict subsequent diagnosis of malignancy as well as define time and modality of repeat biopsy. Finally, pathological features of cancers detected after a previous ASAP diagnosis are compared with those diagnosed at first prostate biopsy.

  20. Anomaly and signature filtering improve classifier performance for detection of suspicious access to EHRs.

    Science.gov (United States)

    Kim, Jihoon; Grillo, Janice M; Boxwala, Aziz A; Jiang, Xiaoqian; Mandelbaum, Rose B; Patel, Bhakti A; Mikels, Debra; Vinterbo, Staal A; Ohno-Machado, Lucila

    2011-01-01

    Our objective is to facilitate semi-automated detection of suspicious access to EHRs. Previously we have shown that a machine learning method can play a role in identifying potentially inappropriate access to EHRs. However, the problem of sampling informative instances to build a classifier still remained. We developed an integrated filtering method leveraging both anomaly detection based on symbolic clustering and signature detection, a rule-based technique. We applied the integrated filtering to 25.5 million access records in an intervention arm, and compared this with 8.6 million access records in a control arm where no filtering was applied. On the training set with cross-validation, the AUC was 0.960 in the control arm and 0.998 in the intervention arm. The difference in false negative rates on the independent test set was significant, P=1.6×10(-6). Our study suggests that utilization of integrated filtering strategies to facilitate the construction of classifiers can be helpful.

  1. FDG PET and other imaging modalities in the primary diagnosis of suspicious breast lesions

    Energy Technology Data Exchange (ETDEWEB)

    Scheidhauer, K.; Seemann, M.D. [Department of Nuclear Medicine, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Ismaninger Strasse 22, 81675, Munich (Germany); Walter, C. [Department of Diagnostic Radiology, Krankenhaus der Barmherzigen Brueder, Trier (Germany)

    2004-06-01

    Mammography is the primary imaging modality for screening of breast cancer and evaluation of breast lesions (T staging). Ultrasonography is an adjunctive tool for mammographically suspicious lesions, in patients with mastopathy and as guidance for reliable histological diagnosis with percutaneous biopsy. Dynamic enhanced magnetic resonance mammography (MRM) has a high sensitivity for the detection of breast cancer, but also a high false positive diagnosis rate. In the literature, MRM is reported to have a sensitivity of 86-96%, a specificity of 64-91%, an accuracy of 79-93%, a positive predictive value (PPV) of 77-92% and a negative predictive value (NPV) of 75-94%. In unclarified cases, metabolic imaging using fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) can be performed. In the literature, FDG PET is reported to have a sensitivity of 64-96%, a specificity of 73-100%, an accuracy of 70-97%, a PPV of 81-100% and an NPV of 52-89%. Furthermore, PET or PET/CT using FDG has an important role in the assessment of N and M staging of breast cancer, the prediction of tumour response in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy, and the differentiation of scar and cancer recurrence. Other functional radionuclide-based diagnostic tools, such as scintimammography with sestamibi, peptide scintigraphy or immunoscintigraphy, have a lower accuracy than FDG PET and, therefore, are appropriate only for exceptional indications. (orig.)

  2. Diagnostic Value of Nucleolar Organizer Regions (AgNORs in Brush Biopsies of Suspicious Lesions of the Oral Cavity

    Directory of Open Access Journals (Sweden)

    Torsten W. Remmerbach

    2003-01-01

    Full Text Available Objective: The aim of this retrospective study was to report on the diagnostic accuracy of AgNOR‐analysis as an adjunctive diagnostic tool of conventional oral exfoliative cytology taken from suspicious lesions in our clinic. Study design: Cytological diagnoses obtained from brush biopsies of macroscopically suspicious lesions of the oral mucosa from 75 patients (final diagnoses: 53 histologically proven squamous cell carcinomas, 11 leukoplakias and other inflammatory oral lesions and from 11 patients with normal mucosa as a negative control group were compared with histological and/or clinical follow‐ups. Five smears were doubtful and seven suspicious for tumor cells in the cytologic report. Number of AgNOR's were counted in 100 squamous epithelial cell‐nuclei per slide after silver‐restaining. Results: Sensitivity of our cytological diagnosis alone on oral smears for the detection of squamous carcinomas was 92.5%, specificity 100%, positive predictive value was 100% and negative 84.6%. The best cut‐off value of the mean number of AgNOR dots per nucleus distinguishing benign from malignant cells was 4.8. The percentage of nuclei with more than three AgNORs had a cut‐off level of 70%. Applying these methods to twelve doubtful or suspicious cytological diagnoses we were able to correctly establish the diagnosis of malignancy in ten cases of histologically proven cancers and to reveal benignity in two histologically proven cases. Thus we achieved a positive and negative predictive value of 100% each. Conclusions: Smears from brushings of visible oral lesions, if clinically considered as suspicious for cancer, are an easily practicable, non‐invasive, painless, safe and accurate screening method for detection of oral cancerous lesions. We conclude that AgNOR‐analysis may be a useful adjunct to other methods in routine cytological diagnosis of oral cancer that can help to solve cytologically suspicious or doubtful cases. Colour

  3. Error in laboratory report data for platelet count assessment in patients suspicious for dengue: a note from observation

    Directory of Open Access Journals (Sweden)

    Somsri Wiwanitkit

    2016-08-01

    Full Text Available Dengue is a common tropical infection that is still a global health threat. An important laboratory parameter for the management of dengue is platelet count. Platelet count is an useful test for diagnosis and following up on dengue. However, errors in laboratory reports can occur. This study is a retrospective analysis on laboratory report data of complete blood count in cases with suspicious dengue in a medical center within 1 month period during the outbreak season on October, 2015. According to the studied period, there were 184 requests for complete blood count for cases suspected for dengue. From those 184 laboratory report records, errors can be seen in 12 reports (6.5%. This study demonstrates that there are considerable high rate of post-analytical errors in laboratory reports. Interestingly, the platelet count in those erroneous reports can be unreliable and ineffective or problematic when it is used for the management of dengue suspicious patients.

  4. Malignancy rate of biopsied suspicious bone lesions identified on FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Hugo J.A.; Kwee, Thomas C. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Klerk, John M.H. de [Meander Medical Center, Department of Nuclear Medicine, Amersfoort (Netherlands); Heggelman, Ben G.F. [Meander Medical Center, Department of Radiology, Amersfoort (Netherlands); Dubois, Stefan V. [Meander Medical Center, Department of Pathology, Amersfoort (Netherlands)

    2016-07-15

    To determine the malignancy rate of bone lesions identified on FDG PET/CT in patients who have undergone CT-guided biopsy because of the suspicion of malignancy. This single-centre retrospective study spanned eight consecutive years and included all patients who underwent both FDG PET/CT and CT-guided bone biopsy because of the suspicion of malignancy. The positive predictive value (PPV) for malignancy was calculated, and different patient and imaging characteristics were compared between malignant and benign bone lesions. Of 102 included patients with bone lesions that all showed FDG uptake exceeding mediastinal uptake, bone biopsy showed a malignant lesion in 91 patients, yielding a PPV for malignancy of 89.2 % (95 % CI 81.7 - 93.9 %). In the 94 patients with bone lesions that showed FDG uptake exceeding liver uptake, bone biopsy showed a malignant lesion in 83 patients, yielding a PPV for malignancy of 88.3 % (95 % CI 80.1 - 93.5 %). Higher age, bone marrow replacement of the lesion seen on CT, expansion of the lesion seen on CT, and presence of multifocal lesions on FDG PET/CT were significantly more frequent in patients with malignant lesions than in those with benign bone lesions (P = 0.044, P = 0.009, P = 0.015, and P = 0.019, respectively). Furthermore, there was a trend towards a higher incidence of cortical destruction (P = 0.056) and surrounding soft tissue mass (P = 0.063) in patients with malignant bone lesions. The PPV for malignancy of suspicious bone lesions identified on FDG PET/CT is not sufficiently high to justify changes in patient management without histopathological confirmation. Nevertheless, ancillary patient and imaging characteristics may increase the likelihood of a malignant bone lesion. (orig.)

  5. Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

    Science.gov (United States)

    Vigneswaran, Nadarajah

    2011-03-01

    Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

  6. Revaluation of breast cytology with pathologist on-site of lesions with suspicious sonographic features

    Energy Technology Data Exchange (ETDEWEB)

    Capalbo, Emanuela, E-mail: emanuelacapalbo@tiscalinet.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Sajadidehkordi, Farideh, E-mail: faridehit@yahoo.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Colombi, Claudio; Ticha, Vladimira; Moretti, Angela, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy); Peli, Michela, E-mail: peli.michela@gmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Cosentino, Maria, E-mail: maria-cosentino@tiscali.it [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Lovisatti, Maria, E-mail: marialovisatti@hotmail.com [Scuola di Specializzazione di Radiologia Diagnostica ed Interventistica, Università degli Studi di Milano Via Di Rudinì, Milano, 20142 Italy (Italy); Berti, Elisabetta, E-mail: eliberti@hotmail.it [Dipartimento di Scienze Diagnostiche, UOC di Anatomia Patologica, A.O San Carlo Borromeo. Via Pio II, 3, Milano 20153 (Italy); Cariati, Maurizio, E-mail: info.radiologia@sancarlo.mi.it [Dipartimento di Scienze Diagnostiche, UOC di Radiologia Diagnostica ed Interventistica, A.O San Carlo Borromeo. Via Pio II, 3, 20153 Milano (Italy)

    2013-09-15

    Objective: Evaluating correlation estimation between diagnostic ultrasound (U.S.) of breast lesions and fine needle aspiration cytology (FNAC), and the correlation between cytology and histology (I) of these lesions undergo surgery. Materials and methods: In 2010 we performed 1589 ultrasound breast. We identified 210 suspicious lesions to be subjected to FNAC, which was performed with pathologist on site, and extemporaneous analysis of the sample to assess their appropriateness. We classified the lesions in 5 ultrasound (U) classes according to the criteria defined by Echographic BIRADS Lexicon. The results of cytology were classified in 5 classes (C) according to the guidelines of F.O.N.Ca.M. Then we evaluated the diagnostic correlation between U.S. and FNAC, and between FNAC and Histology. Results: The distribution of lesions in U classes was: 57U2, 55U3, 36U4 and 62U5. The diagnostic concordance between U and FNAC was 96.7%, with a sensitivity of 98%, specificity 93%, negative and positive predictive value respectively of 94.9% and 97.3%, and diagnostic accuracy of 96.6%. The 98 patients with C4-C5 lesions were subjected to surgery and the histology confirmed high-grade malignancy of lesions with a concordance of 99.7%. Conclusions: Having achieved high diagnostic concordance between U and FNAC, and then between FNAC and histology, we may say that the FNAC, less invasive and traumatic for the patient than needle biopsy (CB), may be still a valid method when performed with pathologist on-site to assess the adequacy of the sample taken.

  7. Transnasal Flexible Fiberoptic in-office Laryngeal Biopsies—Our Experience with 117 Patients with Suspicious Lesions

    Directory of Open Access Journals (Sweden)

    Jacob T. Cohen

    2014-04-01

    Full Text Available Objective: To compare pathologic results obtained via in-office transnasal fiberoptic laryngoscopy (TFL to those of subsequent direct laryngoscopy in order to assess the accuracy of TFL as a diagnostic tool. Patients: One hundred and seventeen patients with suspicious laryngeal lesions. Methods: All patients underwent in-office biopsies. All patients with malignant diagnosis were referred to treatment. All patients with benign diagnosis or carcinoma in situ were referred to direct laryngoscopy for definitive diagnosis. The pathological results of the specimens from both procedures were compared. Results: Adequate tissue for diagnostic purposes was obtained in 110 of 117 in-office transnasal fiberoptic laryngoscopy biopsies (94.0%. The biopsy results revealed invasive carcinoma in 42 patients (38.2%, carcinoma in situ (CIS in 17 patients (15.4%, and benign lesions in 51 patients (46.4%. All patients with benign pathologies and carcinoma in situ were referred to biopsy under direct laryngoscopy (five patients refused and were removed from the statistics. The final pathologies identified from the biopsies on direct laryngoscopy revealed that there was an underestimation of the transnasal fiberoptic laryngoscopy results in 33 patients (a false negative rate of 31.4%, 33/105 and an overestimation in one patient. The sensitivity of transnasal fiberoptic laryngoscopy biopsy compared with direct laryngoscopy biopsy was 70.6% and the specificity was 96.7%. Conclusions: TFL with biopsy is easy, safe, and cost-effective but raises serious doubts about its clinical value due to its low sensitivity rate for diagnosing suspicious lesions of the larynx. As such, it is recommended that all patients with a suspicious lesion diagnosed by TFL biopsy as being benign or CIS should be referred to direct laryngoscopy for verification of the findings.

  8. {sup 99m}Tc sestamibi scintimammography. Screening mammographic non-palpable suspicious breast lesions: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Bekis, R.; Derebek, E.; Degirmenci, B.; Durak, H. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Nuclear Medicine; Balci, P. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Radiology; Kocdor, M.A. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Surgery; Canda, T. [Dokuz Eyluel Univ., Izmir (Turkey). Dept. of Pathology

    2004-02-01

    Aim: Investigation of the diagnostic role of technetium-99m methoxyisobutylisonitrile ({sup 99m}Tc estamibi) scintimammography in non-palpable, suspicious breast lesions described as microcalcification, mass and increased density using mammography. Patients, method: 35 women with non-palpable breast lesions were enrolled in the study. Anterior, left and right lateral, ipsilateral posterior oblique images were obtained 15 min after the injection of 740 MBq of {sup 99m}Tc sestamibi. All scintigraphic images were evaluated visually and focal increased {sup 99m}Tc sestamibi uptake was accepted as malignant lesion. Breast lesions were classified as microcalcification (13 women), mammographic mass (16 women) and increased density (6 women). Excisional biopsy was performed in all of them irrespective of the scintigraphic results: Results: The focally increased {sup 99m}Tc sestamibi uptake was seen in 11 breast lesions with malignant lesions and in 4 breast lesions with benign lesions. The diffuse uptake of {sup 99m}Tc sestamibi was seen in 18 breast lesions with benign lesions and 2 breast lesions with malignant lesions. There was no false positive result of {sup 99m}Tc sestamibi in microcalcification group and three was no false negative result of the mammographic mass and increased density groups. Conclusion: Scintimammography might be a complementary method in decision making for the non-palpable, suspicious breast lesions that were evaluated as microcalcification, mass and increased density mammograpically. (orig.)

  9. Predictive performance of BI-RADS magnetic resonance imaging descriptors in the context of suspicious (category 4 findings

    Directory of Open Access Journals (Sweden)

    João Ricardo Maltez de Almeida

    2016-06-01

    Full Text Available Abstract Objective: To determine the positive predictive value (PPV and likelihood ratio for magnetic resonance imaging (MRI characteristics of category 4 lesions, as described in the Breast Imaging Reporting and Data System (BI-RADS® lexicon, as well as to test the predictive performance of the descriptors using multivariate analysis and the area under the curve derived from a receiver operating characteristic (ROC curve. Materials and Methods: This was a double-blind review study of 121 suspicious findings from 98 women examined between 2009 and 2013. The terminology was based on the 2013 edition of the BI-RADS. Results: Of the 121 suspicious findings, 53 (43.8% were proven to be malignant lesions, with no significant difference between mass and non-mass enhancement (p = 0.846. The PPVs were highest for masses with a spiculated margin (71% and round shape (63%, whereas segmental distribution achieved a high PPV (80% for non-mass enhancement. Kinetic analyses performed poorly, except for type 3 curves applied to masses (PPV of 73%. Logistic regression models were significant for both patterns, although the results were better for masses, particularly when kinetic assessments were included (p = 0.015; pseudo R2 = 0.48; area under the curve = 90%. Conclusion: Some BI-RADS MRI descriptors have high PPV and good predictive performance-as demonstrated by ROC curve and multivariate analysis-when applied to BI-RADS category 4 findings. This may allow future stratification of this category.

  10. Can positron emission mammography help to identify clinically significant breast cancer in women with suspicious calcifications on mammography?

    Energy Technology Data Exchange (ETDEWEB)

    Bitencourt, Almir G.V.; Lima, Eduardo N.P.; Macedo, Bruna R.C.; Conrado, Jorge L.F.A.; Marques, Elvira F.; Chojniak, Rubens [A C Camargo Cancer Center-Department of Imaging, Sao Paulo, SP (Brazil)

    2017-05-15

    To evaluate the diagnostic accuracy of positron emission mammography (PEM) for identifying malignant lesions in patients with suspicious microcalcifications detected on mammography. A prospective, single-centre study that evaluated 40 patients with suspicious calcifications at mammography and indication for percutaneous or surgical biopsy, with mean age of 56.4 years (range: 28-81 years). Patients who agreed to participate in the study underwent PEM with 18F-fluorodeoxyglucose before the final histological evaluation. PEM findings were compared with mammography and histological findings. Most calcifications (n = 34; 85.0 %) were classified as BIRADS 4. On histology, there were 25 (62.5 %) benign and 15 (37.5 %) malignant lesions, including 11 (27.5 %) ductal carcinoma in situ (DCIS) and 4 (10 %) invasive carcinomas. On subjective analysis, PEM was positive in 15 cases (37.5 %) and most of these cases (n = 14; 93.3 %) were confirmed as malignant on histology. There was one false-positive result, which corresponded to a fibroadenoma, and one false negative, which corresponded to an intermediate-grade DCIS. PEM had a sensitivity of 93.3 %, specificity of 96.0 % and accuracy of 95 %. PEM was able to identify all invasive carcinomas and high-grade DCIS (nuclear grade 3) in the presented sample, suggesting that this method may be useful for further evaluation of patients with suspected microcalcifications. (orig.)

  11. A comparisonof lymphocytic thyroiditis with papillary thyroid carcinoma showing suspicious ultrasonographic findings in a background of heterogeneous parenchyma

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Sang Yu; Shin, Jung Hee; Ko, Eun Young; Hahn, Soo Yeon [Dept. of Radiology, Samsung Medicine Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2015-01-15

    The aim of this study was to compare ultrasonographic features in patients with lymphocytic thyroiditis (LT) and papillary thyroid carcinoma (PTC) having suspicious thyroid nodule(s) in a background of heterogeneous parenchyma and to determine the clinical and radiological predictors of malignancy. We reviewed the cases of 100 patients who underwent ultrasonography between April 2011 and October 2012, and showed suspicious thyroid nodule(s) in a background of heterogeneous parenchyma. Eight patients who did not undergo ultrasonography-guided fineneedle aspiration cytology (FNAC) and 34 cases of follow-up ultrasonography after initial FNAC were excluded. We compared the benign and malignant nodules in terms of their clinical and radiological factors. For the 58 nodules including 31 LTs (53.4%) and 27 PTCs (46.6%), the mean tumor sizes of the two groups were 0.96 cm for LT and 0.97 cm for PTC. A univariate analysis revealed that PTCs were more frequent in patients younger than 45 years and having microcalcifications than was LT. An independent predictor of PTC after adjustment was an age of <45 years. LT mimics malignancy in a background of heterogeneous parenchyma on ultrasonography. A young age of <45 years is the most important predictor of malignancy in this condition.

  12. Prostate needle biopsies containing prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma: implications for patient care.

    Science.gov (United States)

    Epstein, Jonathan I; Herawi, Mehsati

    2006-03-01

    We identified information critical for patient treatment on prostate needle biopsies diagnosed with prostatic intraepithelial neoplasia or atypical foci suspicious for carcinoma. A search was performed using the MEDLINE database and referenced lists of relevant studies to obtain articles addressing the significance of finding PIN or atypical foci suspicious for carcinoma on needle biopsy. There were certain results concerning PIN. 1) Low grade PIN should not be documented in pathology reports due to poor interobserver reproducibility and a relatively low risk of cancer following re-biopsy. 2) The expected incidence of HGPIN on needle biopsy is between 5% and 8%. 3) Although the diagnosis of HGPIN is subjective, interobserver reproducibility for its diagnosis is fairly high among urological pathologists, and yet only moderate among pathologists without special expertise in prostate pathology. 4) The median risk recorded in the literature for cancer following the diagnosis of HGPIN on needle biopsy is 24.1%, which is not much higher than the risk reported in the literature for repeat biopsy following a benign diagnosis. 5) The majority of publications that compared the risk of cancer in the same study following a needle biopsy diagnosis of HGPIN to the risk of cancer following a benign diagnosis on needle biopsy show no differences between the 2 groups. 6) Clinical and pathological parameters do not help stratify which men with HGPIN are at increased risk for a cancer diagnosis. 7) A major factor contributing to the decreased incidence of cancer following a diagnosis of HGPIN on needle biopsy in the contemporary era is related to increased needle biopsy core sampling, which detects many associated cancers on initial biopsy, such that re-biopsy, even with good sampling, does not detect many additional cancers. 8) It is recommended that men do not need routine repeat needle biopsy within the first year following the diagnosis of HGPIN, while further studies are needed

  13. Hybrid ANN optimized artificial fish swarm algorithm based classifier for classification of suspicious lesions in breast DCE-MRI

    Science.gov (United States)

    Janaki Sathya, D.; Geetha, K.

    2017-12-01

    Automatic mass or lesion classification systems are developed to aid in distinguishing between malignant and benign lesions present in the breast DCE-MR images, the systems need to improve both the sensitivity and specificity of DCE-MR image interpretation in order to be successful for clinical use. A new classifier (a set of features together with a classification method) based on artificial neural networks trained using artificial fish swarm optimization (AFSO) algorithm is proposed in this paper. The basic idea behind the proposed classifier is to use AFSO algorithm for searching the best combination of synaptic weights for the neural network. An optimal set of features based on the statistical textural features is presented. The investigational outcomes of the proposed suspicious lesion classifier algorithm therefore confirm that the resulting classifier performs better than other such classifiers reported in the literature. Therefore this classifier demonstrates that the improvement in both the sensitivity and specificity are possible through automated image analysis.

  14. Comparison of the accuracy of US-guided biopsy of breast masses performed with 14-gauge, 16-gauge and 18-gauge automated cutting needle biopsy devices, and review of the literature.

    Science.gov (United States)

    Huang, Monica L; Hess, Kenneth; Candelaria, Rosalind P; Eghtedari, Mohammad; Adrada, Beatriz E; Sneige, Nour; Fornage, Bruno D

    2017-07-01

    To compare the diagnostic accuracy of ultrasound (US)-guided core needle biopsy (CNB) of breast masses performed with 14-gauge, 16-gauge and 18-gauge needles. We retrospectively reviewed the charts of 1,112 patients who underwent US-guided breast CNB with 14-gauge, 16-gauge and 18-gauge needles. Cases with surgical excision or a minimum of 2 years of imaging follow-up were included. Rates of sample inadequacy, discordance with surgical or imaging findings and upgrade of DCIS to invasive cancer or high-risk lesion to in situ or invasive cancer were computed for each needle size. The study included 703 CNBs: 203 performed with 14-gauge, 235 with 16-gauge and 265 with 18-gauge needles. There were no significant differences between 14-gauge, 16-gauge and 18-gauge needles in rates of specimen inadequacy (0 %, 0.4 % and 1.9 %, respectively) (p = 0.084); surgical discordance (2.6 %, 2.9 % and 3.8 %) (p = 0.76); imaging discordance (0 %, 0 % and 2 %) (p = 1.0); DCIS upgrade (43 %, 43 % and 36 %) (p = 1.00) or high-risk lesion upgrade (38 %, 25 % and 55 %) (p = 0.49). There was no statistically significant difference in diagnostic accuracy of US-guided CNB of breast masses performed with 14-gauge, 16-gauge and 18-gauge needles. • Percutaneous image-guided breast core needle biopsy (CNB) is the standard of care. • Breast CNB with 14-gauge, 16-gauge and 18-gauge needles has similar diagnostic accuracy. • Smaller gauge needles can be confidently used for ultrasound-guided breast CNB.

  15. Combination therapy of three-dimensional (3D) visualisation operative treatment planning system and US-guided percutaneous microwave ablation in larger renal cell carcinomas (D ≥ 4 cm): preliminary results.

    Science.gov (United States)

    Li, Xin; Yu, Jie; Liang, Ping; Yu, Xiaoling; Cheng, Zhigang; Han, Zhiyu; Huang, Hui; Duan, Shaobo; Zheng, Jiasheng

    2016-12-07

    To analyse the clinical outcomes of combination therapy of three-dimensional (3D) visualisation operative treatment planning system and US-guided percutaneous microwave ablation (PMWA) in larger renal cell carcinomas (RCCs) (D ≥ 4 cm). The results from 20 patients with 20 larger RCCs treated with a 3D visualisation operative treatment planning system and US-guided PMWA were reviewed retrospectively. The patients were followed up by contrast-enhanced images at 1, 3, and 6 months and every 6 months thereafter. The outcomes of overall survival and local tumour progression rate were statistically analysed. The median follow-up period was 26 months. The mean time of ablation for one tumour was 1.1 ± 0.3 sessions. The average number of ablation points of one tumour was 4.5 ± 0.9. The mean output power of ablation was 50.50 ± 2.2 W. The mean time of ablation for one tumour was 1374.4 ± 391.1 s. Artificial ascites was used in 12 (60%) tumours adjacent to the intestinal tract, and thermal monitoring system was used in all tumours (100%). Technical effectiveness and metastasis-free status were achieved in all tumours. The 1- and 2-year local tumour progression rates were both 5%. The cancer-specific survival rate and 2-year overall survival rates were both 100%. No severe major complications occurred. There was no significant difference in creatinine or urea nitrogen before or 3 days after ablation. Combination therapy of 3D visualisation operative treatment planning system and US-guided PMWA appeared to be a safe and effective technique for the management of larger RCCs, which could improve clinical efficacy.

  16. Anxiety/Depression and Hostility/Suspiciousness in Adolescent Boys: Testing Adherence to Honor Code as Mediator of Callousness and Attachment Insecurity

    Science.gov (United States)

    Somech, Lior Y.; Elizur, Yoel

    2012-01-01

    Research of psychological distress (PD) needs to differentiate between anxiety/depression and hostility/suspiciousness, which are associated with different motivational systems. In this study, structural equation modeling was used to test two hypothesized models for the prediction of each facet of PD. Hypotheses were proposed about the effects of…

  17. Rapid identification of bacillus anthracis spores in suspicious powder samples by using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)

    NARCIS (Netherlands)

    Dybwad, M.; Laaken, A.L. van der; Blatny, J.M.; Paauw, A.

    2013-01-01

    Rapid and reliable identification of Bacillus anthracis spores in suspicious powders is important to mitigate the safety risks and economic burdens associated with such incidents. The aim of this study was to develop and validate a rapid and reliable laboratory- based matrix-assisted laser

  18. Correspondence of cytological and histopathological diagnoses in diagnostic category V of the Bethesda system: “suspicious for malignancy”

    Directory of Open Access Journals (Sweden)

    Agata Stanek-Widera

    2016-05-01

    Full Text Available The progress in imaging methods enables fine needle aspiration (FNA biopsy to be performed on smaller and smaller lesions, including malignant ones (papillary microcarcinomas. The follicular variant predominates in this group, with cytological features often not permitting an unbiased interpretation. The aim of the study was to determine the degree of reliability of the “suspicious for malignancy” (SM diagnosis in material from the Institute of Oncology in Gliwice (IO. 290 primary SM diagnoses were established from 2010 to 2015 in the IO, including the consultations. None of the patients was treated surgically after the first FNA resulting in diagnostic category V (DC V. After the second FNA 80 patients underwent surgery, after the third 58, and after subsequent FNA 10. Together, 148 surgical resections were performed. Among 148 patients treated surgically, 111 were diagnosed with malignant lesions, which constitutes 75%. Predominantly – in 91 cases – the histopathological outcome was papillary carcinoma. The others were: 16 medullary carcinomas, 2 follicular carcinomas, and 2 poorly differentiated carcinoma cases. Moreover, 8 follicular adenomas and 28 nonneoplastic lesions were found. The high positive predictive value (PPV = 75% of SM diagnosis established in the IO testifies to the high reliability of this test. Diagnostic category V in FNA should be an indication for surgical treatment.

  19. The Usefulness of the Transabdominal Ultrasonography as a Screening Examination in the Evaluation of the Patient with Suspicious Gastric Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Cheol; Shin, Hyeong Cheol; Kim, Hyung Hwan; Park, Seong Jin; Nam, Deok Ho; Bae, Won Kyung; Kim, Il Young; Jeong, Du Shin; Chung, Il Kwun [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of)

    2005-03-15

    To evaluate the usefulness of transabdominal ultrasonography as a screening examination in patients with suspicious gastric disease. We selected 141 patients with epigastric pain and who were found to have antral gastric wall thickening of more than 5 mm in transabdominal ultrasonography, and who underwent gastroscopy immediately following the ultrasonography examination, because we suspected that these patients had gastric disease. We measured the full thickness of the five layers of the gastric wall and evaluated the preservation of this five layered structure. We respectively compared the gastric wall thickness and the preservation of gastric layers in 26 normal, 91 gastritis, 12 gastric ulcer, and 12 gastric cancer patients, who were classified based on the gastroscopy results. The mean thicknesses of the gastric wall in the normal, gastritis, gastric ulcer and gastric cancer patients were 5.13{+-}0.14 mm, 6.71{+-}1.33 mm, 8.08{+-}2.80 mm, and 12.45{+-}3.70 mm, respectively. The gastric walls in the gastritis, gastric ulcer and gastric cancer patients were significantly thicker than that in the normal patients (p < 0.01). The gastric wall in the gastric cancer patients was significantly thicker than those in the gastritis and gastric ulcer patients (p < 0.01). However, the difference in the gastric wall thickness between the gastritis and gastric ulcer patients was not statistically significant (p > 0.01). Except for two patients with gastritis and three patients with gastric ulcer, the stratification of the gastric wall was preserved in all of the normal, gastritis and gastric ulcer patients, whereas it was disrupted in all of the patients with gastric cancer. Transabdominal ultrasonography in the fasting state may be a helpful and convenient modality, which can serve as a screening examination in the evaluation of gastric disease. Therefore, careful attention and effort are needed to evaluate the gastric wall during transabdominal ultrasonography

  20. Agreement among RTOG Sarcoma Radiation Oncologists in Contouring Suspicious Peritumoral Edema for Pre-operative Radiotherapy of Soft Tissue Sarcoma of the Extremity

    Science.gov (United States)

    Bahig, Houda; Roberge, David; Bosch, Walter; Levin, William; Petersen, Ivy; Haddock, Michael; Freeman, Carolyn; DeLaney, Thomas F.; Abrams, Ross A.; Indelicato, Danny J.; Baldini, Elizabeth H.; Hitchcock, Ying; Kirsch, David G.; Kozak, Kevin R.; Wolfson, Aaron; Wang, Dian

    2013-01-01

    Purpose Peritumoral edema may potentially harbor sarcoma cells. The extent of suspicious edema (SE) included in the treatment volume is subject to clinical judgment, balancing the risk of missing tumor cells with excess toxicity. Our goal was to determine variability in SE delineation by sarcoma radiation oncologists (RO). Material and Method Twelve expert ROs were provided with T1 Gadolinium and T2-weighted MR images of 10 patients with high-grade extremity soft tissue sarcoma. Gross tumor volume, CTV3cm (3cm longitudinal and 1.5cm radial margin) and CTV2cm (2cm longitudinal and 1cm radial margin) were contoured by a single observer. Suspicious peritumoral edema, defined as abnormal signal on T2 images, was independently delineated by all 12 ROs. Contouring agreement was analyzed using the Simultaneous Truth and Performance Level Estimation (STAPLE) algorithm and kappa statistics. Results The mean volumes of GTV, CTV2cm and CTV3cm were respectively 130 cm3 (7–413 cm3), 280cm3 and 360cm3. The mean consensus volume computed using the STAPLE algorithm at 95% confidence interval was 188cm3 (24–565cm3) with a substantial overall agreement corrected for chance (mean kappa =0.71; range: 0.32–0.87). The minimum, maximum and mean volume of suspicious edema (excluding the GTV) were 4cm3, 182cm3 and 58 cm3 (representing a median of 29% of the GTV volume). The median volume of suspicious edema not included in the CTV2cm and in the CTV3cm was 5 cm3 and 0.3cm3 respectively. There were 3 large tumors with >30cm3 of suspicious edema not included in the CTV3cm volume. Conclusion Despite the fact that SE would empirically seem to be a more subjective volume, a substantial or near-perfect inter-observer agreement was observed in SE delineation in most cases with high-grade STS of the extremity. A median of 97% of the consensus SE is within the CTV2cm (99.8% within the CTV3cm). In a minority of cases, however, significant expansion of the CTVs is required to cover SE. PMID

  1. Clinical decision-making in atypical and suspicious categories in fine-needle aspiration cytology of the breast.

    Science.gov (United States)

    Gipponi, Marco; Fregatti, Piero; Garlaschi, Alessandro; Calabrese, Massimo; Baccini, Paola; Gallo, Maurizio; Murelli, Federica; Margarino, Cecilia; Bobbio, Carolina; Friedman, Daniele

    2015-04-01

    Fine-needle aspiration cytology (FNAC) is a simple and reliable technique to assess breast lesions, although a definitive differential diagnosis (benignity vs. cancer) is achieved approximately in 60-70% of cases because an inadequate (C1), atypical (C3) or suspicious (C4) category is otherwise reported. A retrospective analysis of 763 cases with C3 or C4 reports was performed to define their positive predictive value (PPV), as well as the practical implications of clinical and imaging findings as for clinical decision-making. FNACs were collected from January 2003 to September 2012 at the Breast Unit of IRCCS "A.O.U. San Martino-IST" Genoa, with each being received later to definitive histology. The PPV for cancer of C3/C4 categories were computed to measure the accuracy of FNAC; moreover, the PPV was also stratified according to clinical, mammography and sonography data alone or by their combination. The PPV of C3 and C4 was 21.1% (80/380) and 84.1 % (322/383), respectively. Within each C3/C4 category, a significant direct correlation (p<0.001) between the suspicion index of clinical, mammography and sonography data and cancer detection rate was always observed. The PPV of C3/C4 stratified by the combination of clinical and imaging findings showed satisfactory values in the C3 category only when there was an agreement between clinical and imaging findings, whereas the PPV of the C4 category was always remarkably high (ranging from 92.3% to 100%). the diagnostic work-up in C4 reports or in patients with a C3 report but with an high suspicion index at clinical or imaging examination should be preferably implemented by means of a core biopsy to optimize the therapeutic planning; given a C3 report with dubious clinical and/or imaging findings, an excisional biopsy (or in alternative vacuum-assisted breast biopsy with complete removal of the nodule) should be preferably performed in order to reach a definitive histological dia gnosis with no further delay. Copyright

  2. Eyes with Suspicious Appearance of the Optic Disc and Normal Intraocular Pressure: Using Clinical and Epidemiological Characteristics to Differentiate Those with and without Glaucoma.

    Directory of Open Access Journals (Sweden)

    Diego T Dias

    Full Text Available Among all glaucoma suspects, eyes with optic nerve head features suspicious or suggestive of early glaucoma are probably those that offer the greatest challenge for clinicians. In contrast with the robust longitudinal data published on ocular hypertension, there is no specific management guideline for these patients. Therefore, evaluating eyes with suspicious optic disc appearance and normal intraocular pressure (IOP, we sought to investigate potential differences in clinical and epidemiological characteristics to differentiate those with normal-tension glaucoma (NTG from those with presumed large physiological optic disc cups (pLPC. In this observational case-control study, we consecutively enrolled individuals with pLPC and NTG. All eyes had vertical cup-to-disc ratio (VCDR≥0.6 and untreated IOP<21 mmHg. Glaucomatous eyes had reproducible visual field defects. Eyes with pLPC required normal visual fields and ≥30 months of follow-up with no evidence of glaucomatous neuropathy. Clinical and epidemiological parameters were compared between groups. Eighty-four individuals with pLPC and 40 NTG patients were included. Regarding our main results, NTG patients were significantly older and with a higher prevalence of Japanese descendants (p<0.01. Not only did pLPC eyes have smaller mean VCDR, but also larger optic discs (p≤0.04. There were no significant differences for gender, central corneal thickness, and spherical equivalent (p≥0.38. Significant odds ratios (OR were found for race (OR = 2.42; for Japanese ancestry, age (OR = 1.05, VCDR (OR = 5.03, and disc size (OR = 0.04; p≤0.04. In conclusion, in patients with suspicious optic disc and normal IOP, those with older age, Japanese ancestry, smaller optic discs, and larger VCDR are more likely to have NTG, and therefore, deserve deeper investigation and closer monitoring.

  3. Applicability and discriminative value of a semiautomatic three-dimensional spherical volume for the assessment of the apparent diffusion coefficient in suspicious breast lesions-feasibility study.

    Science.gov (United States)

    Hering, Jan; Laun, Frederik Bernd; Lederer, Wolfgang; Daniel, Heidi; Kuder, Tristan Anselm; Stieber, Anne; Delorme, Stefan; Maier-Hein, Klaus H; Schlemmer, Heinz-Peter; Bickelhaupt, Sebastian

    To evaluate the feasibility and accuracy of a semiautomatic, three-dimensional volume of interest (3D sphere) for measuring the apparent diffusion coefficient (ADC) in suspicious breast lesions compared to conventional single-slice two-dimensional regions of interest (2D ROIs). This institutional-review-board-approved study included 56 participants with Breast Imaging Reporting and Data System 4/5 lesion. All received diffusion-weighted imaging magnetic resonance imaging prior to biopsy (b=0-1500 s/mm(2)). ADC values were measured in the lesions with both methods. Reproducibility and accuracies were compared. Area under the curve was 0.93 [95% confidence interval (CI) 0.86-0.99] for the 3D sphere and 0.91 (95% CI 0.84-0.98) for the 2D ROIs without significantly differing reproducibility (P=.45). A semiautomatic 3D sphere could reliably estimate ADC values in suspicious breast lesions without significant difference compared to conventional 2D ROIs. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Migrant workers’ occupation and healthcare-seeking preferences for TB-suspicious symptoms and other health problems: a survey among immigrant workers in Songkhla province, southern Thailand

    Directory of Open Access Journals (Sweden)

    Naing Tinzar

    2012-10-01

    Full Text Available Abstract Background Much of the unskilled and semi-skilled workforce in Thailand comprises migrant workers from neighbouring countries. While, in principle, healthcare facilities in the host country are open to those migrants registered with the Ministry of Labour, their actual healthcare-seeking preferences and practices, as well as those of unregistered migrants, are not well documented. This study aimed to describe the patterns of healthcare-seeking behaviours of immigrant workers in Thailand, emphasizing healthcare practices for TB-suspicious symptoms, and to identify the role of occupation and other factors influencing these behaviours. Methods A survey was conducted among 614 immigrant factory workers (FW, rubber tappers (RT and construction workers (CW, in which information was sought on socio-demography, history of illness and related healthcare-seeking behaviour. Mixed effects logistic regression modeling was employed in data analysis. Results Among all three occupations, self-medication was the most common way of dealing with illnesses, including the development of TB-suspicious symptoms, for which inappropriate drugs were used. Only for GI symptoms and obstetric problems did migrant workers commonly seek healthcare at modern healthcare facilities. For GI illness, FW preferred to attend the in-factory clinic and RT a private facility over government facilities owing to the quicker service and greater convenience. For RT, who were generally wealthier, the higher cost of private treatment was not a deterrent. CW preferentially chose a government healthcare facility for their GI problems. For obstetric problems, including delivery, government facilities were utilized by RT and CW, but most FW returned to their home country. After adjusting for confounding, having legal status in the country was associated with overall greater use of government facilities and being female and being married with use of both types of modern healthcare

  5. A comparative analysis of core needle biopsy and fine-needle aspiration cytology in the evaluation of palpable and mammographically detected suspicious breast lesions.

    Science.gov (United States)

    Garg, Shailja; Mohan, Harsh; Bal, Amanjit; Attri, A K; Kochhar, Suman

    2007-11-01

    The present study was undertaken to compare the efficacy of needle core biopsy (NCB) of the breast with fine-needle aspiration cytology (FNAC) in breast lesions (palpable and non-palpable) in the Indian set-up, along with the assessment of tumor grading with both the techniques. Fifty patients with suspicious breast lesions were subjected to simultaneous FNAC and ultrasound-guided NCB following an initial mammographic evaluation. Cases were categorized into benign, benign with atypia, suspicious and malignant groups. In cases of infiltrating duct carcinomas, grading was performed on cytological smears as well as on NCB specimens. Both the techniques were compared, and findings were correlated with radiological and excision findings. Out of 50 cases, 18 were found to be benign and 32 malignant on final pathological diagnosis. Maximum number of patients with benign diagnosis was in the fourth decade (42.11%) and malignant diagnosis in the fourth as well as fifth decade (35.48% each). Sensitivity and specificity of mammography for the diagnosis of malignancy was 84.37% and 83.33%, respectively. Sensitivity and specificity of FNAC for malignant diagnosis was 78.15% and 94.44%, respectively, and of NCB was 96.5% and 100%, respectively. But NCB had a slightly higher specimen inadequacy rate (8%). NCB improved diagnostic categorization over FNAC by 18%. Tumor grading in cases of IDC showed high concordance rate between NCB and subsequent excision biopsy (94.44%) but low concordance rate between NCB and FNAC (59.1%). NCB is superior to FNAC in the diagnosis of breast lesions in terms of sensitivity, specificity, correct histological categorization of the lesions as well as tumor grading. (c) 2007 Wiley-Liss, Inc.

  6. The clinical impact of 18F-FDG PET/CT to detect suspicious recurred thyroid cancer with differentiated type before high dose radioactive iodine therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bom Sahn; Kang, Won Jun; Lee, Dong Soo; Chang, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    The purpose of this study was to evaluate the usefulness of 18F-FDG PET/CT (PET/CT) in suspicious recurred thyroid cancer before high dose of radioactive iodine therapy (RAI therapy). PET/CT was performed after injecting 370-555MBq of 18F-FDG in 23 patients prior to RAI therapy. RAI therapy (212 58 mCi) was performed, and thyroglobulin (Tg) and anti-thyroglobulin antibody (anti-TG ab) during TSH stimulation was measured. The interval between PET/CT and RAI scan was 41 50 day. 15 patients were confirmed as recurred thyroid cancer (pathologic diagnosis: 10), whereas 8 patients were diagnosed as remission status (pathologic diagnosis: 3). PET/CT had 80.0% (12/15) of sensitivity and 75.0% (6/8) of specificity. TG and RAI scan had 80.0% (12/15) and 75% (6/8), 80% (12/15) and 37.5% (3/8) of sensitivity and specificity, respectively. Combination of PET/CT and TG increased the sensitivity (93.3%; 14/15) and specificity (87.5%; 7/8). There was 25 suspicious lesions (19 malignant lesion, 6 benign lesion) in lesion-based study. PET/CT had 84.5% and 83.3% of sensitivity and specificity but RAI scan had 89.5% and 16.7%, respectively. Five false positive sites of RAI scan were diagnosed as fungus ball of lung, calcified mediastinal LN, and post op induced change such as suture granuloma. PET/CT revealed 80% (3/5) of them as benign lesions. Even though PET/CT had similar sensitivity with high dose of RAI scan, it had a better discriminating nature to detect benign lesion. We could diminish the unnecessary high dose of RAI therapy using FDG PET/CT.

  7. Analysis of stereotactic biopsies performed on suspicious calcifications identified within 24 months after completion of breast conserving surgery and radiation therapy for early breast cancer: Can biopsy be obviated?

    Science.gov (United States)

    Candelaria, Rosalind P; Hansakul, Palita; Thompson, Alastair M; Le-Petross, Huong; Valero, Vicente; Bassett, Roland; Huang, Monica L; Santiago, Lumarie; Adrada, Beatriz E

    2017-07-01

    To determine the cancer yield of stereotactic biopsy of suspicious calcifications identified within 24 months after breast conservation therapy (BCT). Retrospective review of stereotactic biopsies performed during 2009-2013 for suspicious calcifications in the ipsilateral breast of patients who completed BCT. 94/2773 (3.4%) had stereotactic biopsies for suspicious calcifications in the ipsilateral breast; 7/94 (7.4%) had DCIS (6) or invasive (1) cancer; 5/7 occurred in the same breast quadrant as the primary. All 7 originally had negative surgical margins (≥2 mm); 6 received whole breast irradiation, and 2 received adjuvant chemotherapy + endocrine therapy. Median time to detection was 11 months (range, 6-20 months). There was a strong association between calcification morphology (particularly pleomorphic) and likelihood of malignancy (p = 0.008). Stereotactic biopsy of calcifications identified within 24 months post-BCT has a 7% cancer yield. Tissue biopsy should be performed rather than imaging followup alone when breast calcifications have suspicious morphology. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Agreement Among RTOG Sarcoma Radiation Oncologists in Contouring Suspicious Peritumoral Edema for Preoperative Radiation Therapy of Soft Tissue Sarcoma of the Extremity

    Energy Technology Data Exchange (ETDEWEB)

    Bahig, Houda [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montréal, Montreal, QC (Canada); Roberge, David, E-mail: david.roberge.chum@ssss.gouv.qc.ca [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montréal, Montreal, QC (Canada); Bosch, Walter [Department of Radiation Oncology, Washington University, St Louis, Missouri (United States); Levin, William [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Petersen, Ivy; Haddock, Michael [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Freeman, Carolyn [Division of Radiation Oncology, McGill University Health Centre, Montreal, QC (Canada); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Indelicato, Danny J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Baldini, Elizabeth H. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Hitchcock, Ying [Department of Radiation Oncology, University of Utah Medical Center, Salt Lake City, Utah (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Kozak, Kevin R. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Wolfson, Aaron [Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, Florida (United States); and others

    2013-06-01

    Purpose: Peritumoral edema may harbor sarcoma cells. The extent of suspicious edema (SE) included in the treatment volume is subject to clinical judgment, balancing the risk of missing tumor cells with excess toxicity. Our goal was to determine variability in SE delineation by sarcoma radiation oncologists (RO). Methods and Materials: Twelve expert ROs were provided with T1 gadolinium and T2-weighted MR images of 10 patients with high-grade extremity soft-tissue sarcoma. Gross tumor volume, clinical target volume (CTV)3cm (3 cm longitudinal and 1.5 cm radial margin), and CTV2cm (2 cm longitudinal and 1 cm radial margin) were contoured by a single observer. Suspicious peritumoral edema, defined as abnormal signal on T2 images, was independently delineated by all 12 ROs. Contouring agreement was analyzed using the simultaneous truth and performance level estimation (STAPLE) algorithm and kappa statistics. Results: The mean volumes of GTV, CTV2cm, and CTV3cm were, respectively, 130 cm{sup 3} (7-413 cm{sup 3}), 280 cm{sup 3} and 360 cm{sup 3}. The mean consensus volume computed using the STAPLE algorithm at 95% confidence interval was 188 cm{sup 3} (24-565 cm{sup 3}) with a substantial overall agreement corrected for chance (mean kappa = 0.71; range: 0.32-0.87). The minimum, maximum, and mean volume of SE (excluding the GTV) were 4, 182, and 58 cm{sup 3} (representing a median of 29% of the GTV volume). The median volume of SE not included in the CTV2cm and in the CTV3cm was 5 and 0.3 cm{sup 3}, respectively. There were 3 large tumors with >30 cm{sup 3} of SE not included in the CTV3cm volume. Conclusion: Despite the fact that SE would empirically seem to be a more subjective volume, a substantial or near-perfect interobserver agreement was observed in SE delineation in most cases with high-grade soft-tissue sarcomas of the extremity. A median of 97% of the consensus SE is within the CTV2cm (99.8% within the CTV3cm). In a minority of cases, however, significant

  9. Comprehensive Laboratory Evaluation of a Highly Specific Lateral Flow Assay for the Presumptive Identification of Bacillus anthracis Spores in Suspicious White Powders and Environmental Samples.

    Science.gov (United States)

    Ramage, Jason G; Prentice, Kristin W; DePalma, Lindsay; Venkateswaran, Kodumudi S; Chivukula, Sruti; Chapman, Carol; Bell, Melissa; Datta, Shomik; Singh, Ajay; Hoffmaster, Alex; Sarwar, Jawad; Parameswaran, Nishanth; Joshi, Mrinmayi; Thirunavkkarasu, Nagarajan; Krishnan, Viswanathan; Morse, Stephen; Avila, Julie R; Sharma, Shashi; Estacio, Peter L; Stanker, Larry; Hodge, David R; Pillai, Segaran P

    2016-01-01

    We conducted a comprehensive, multiphase laboratory evaluation of the Anthrax BioThreat Alert(®) test strip, a lateral flow immunoassay (LFA) for the rapid detection of Bacillus anthracis spores. The study, conducted at 2 sites, evaluated this assay for the detection of spores from the Ames and Sterne strains of B. anthracis, as well as those from an additional 22 strains. Phylogenetic near neighbors, environmental background organisms, white powders, and environmental samples were also tested. The Anthrax LFA demonstrated a limit of detection of about 10(6) spores/mL (ca. 1.5 × 10(5) spores/assay). In this study, overall sensitivity of the LFA was 99.3%, and the specificity was 98.6%. The results indicated that the specificity, sensitivity, limit of detection, dynamic range, and repeatability of the assay support its use in the field for the purpose of qualitatively evaluating suspicious white powders and environmental samples for the presumptive presence of B. anthracis spores.

  10. Comprehensive laboratory evaluation of a highly specific lateral flow assay for the presumptive identification of ricin in suspicious white powders and environmental samples.

    Science.gov (United States)

    Hodge, David R; Prentice, Kristin Willner; Ramage, Jason G; Prezioso, Samantha; Gauthier, Cheryl; Swanson, Tanya; Hastings, Rebecca; Basavanna, Uma; Datta, Shomik; Sharma, Shashi K; Garber, Eric A E; Staab, Andrea; Pettit, Denise; Drumgoole, Rahsaan; Swaney, Erin; Estacio, Peter L; Elder, Ian A; Kovacs, Gerald; Morse, Brenda S; Kellogg, Richard B; Stanker, Larry; Morse, Stephen A; Pillai, Segaran P

    2013-12-01

    Ricin, a heterodimeric toxin that is present in the seeds of the Ricinus communis plant, is the biothreat agent most frequently encountered by law enforcement agencies in the United States. Even in untrained hands, the easily obtainable seeds can yield a highly toxic product that has been used in various types of threats, including "white-powder" letters. Although the vast majority of these threats are hoaxes, an impediment to accurate hazard assessments by first responders is the unreliability of rapid detection assays for ricin, such as lateral flow assays (LFAs). One of the complicating factors associated with LFAs is the incorporation of antibodies of poor specificity that cross-react with near-neighbors or with plant lectins that are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the compelling and critical need to promote the interests of public safety and public health, the Department of Homeland Security conducted a comprehensive laboratory evaluation study of a commercial LFA for the rapid detection of ricin. This study was conducted using comprehensive inclusivity and exclusivity panels of ricin and near-neighbor plant materials, along with panels of lectins and "white-powders," to determine the specificity, sensitivity, limits of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples in the field.

  11. Comprehensive laboratory evaluation of a specific lateral flow assay for the presumptive identification of abrin in suspicious white powders and environmental samples.

    Science.gov (United States)

    Ramage, Jason G; Prentice, Kristin Willner; Morse, Stephen A; Carter, Andrew J; Datta, Shomik; Drumgoole, Rahsaan; Gargis, Shaw R; Griffin-Thomas, Latoya; Hastings, Rebecca; Masri, Heather P; Reed, Matthew S; Sharma, Shashi K; Singh, Ajay K; Swaney, Erin; Swanson, Tanya; Gauthier, Cheryl; Toney, Denise; Pohl, Jan; Shakamuri, Priyanka; Stuchlik, Olga; Elder, Ian A; Estacio, Peter L; Garber, Eric A E; Hojvat, Sally; Kellogg, Richard B; Kovacs, Gerald; Stanker, Larry; Weigel, Linda; Hodge, David R; Pillai, Segaran P

    2014-01-01

    Abrin is a heterodimeric toxin present in the seeds of the Abrus precatorius plant. The easily obtainable seeds can yield a highly toxic product that can be used in various types of biocrimes and terrorism-related activities, including "white-powder" letters. Although the vast majority of these threats are hoaxes, the lack of rapid and reliable detection assays for abrin, such as lateral flow assays (LFAs), can be an impediment to accurate and rapid hazard assessment. One of the complicating factors associated with LFAs is the use of antibodies of poor affinity and specificity that cross-react with near neighbors or that bind to plant lectins, which are capable of nonspecifically cross-linking the capture and detector antibodies. Because of the critical need to promote public safety and public health, we conducted a comprehensive laboratory evaluation of a commercial LFA for the rapid detection of abrin. This study was conducted using comprehensive inclusivity and exclusivity panels of abrin and near-neighbor plant materials, along with panels of lectins, related proteins, white powders, and environmental background material, to determine the sensitivity, specificity, limit of detection, dynamic range, and repeatability of the assay for the specific intended use of evaluating suspicious white powders and environmental samples for the presumptive presence of abrin.

  12. Prenatal diagnosis of Prader-Willi syndrome and Angelman syndrome for fetuses with suspicious deletion of chromosomal region 15q11-q13.

    Science.gov (United States)

    Chang, Chia-Wei; Hsu, Hui-Kuo; Kao, Chiu-Ching; Huang, Jyun-Yuan; Kuo, Pao-Lin

    2014-04-01

    To identify Prader-Willi syndrome (PWS) and Angelman syndrome (AS) among fetuses with suspicious deletion of the chromosomal region 15q11-q13. In a retrospective study, data were assessed from fetuses missing chromosomal band 15q12 that underwent molecular diagnosis at the National Chen-Kung University Hospital, Tainan, Taiwan, between January 2001 and December 2012. Amniocytes were subjected to molecular testing, including fluorescence in situ hybridization (FISH) analysis, methylation-specific PCR (M-PCR), and methylation-specific multiplex-ligation-dependent probe amplification (MS-MLPA). During the 12-year study period, 26 041 amniocyte samples were analyzed at the study center and 27 (0.1%) were found to have a missing 15q12 band. A further 16 samples with a missing 15q12 band were received from other cytogenetic laboratories; as a result, 43 amniocyte samples lacking chromosomal band 15q12 underwent further molecular testing. Among these samples, 3 fetuses (7.0%) were found to have PWS (n=1) or AS (n=2). A minority of cases with missing 15q12 had deletion of the PWS/AS critical region. This finding draws attention to the subtle structural rearrangements that occur on 15q11-q13 and provides useful information for prenatal diagnosis of PWS and AS. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  13. Jumping to Conclusions Is Associated with Paranoia but Not General Suspiciousness: A Comparison of Two Versions of the Probabilistic Reasoning Paradigm

    Directory of Open Access Journals (Sweden)

    Steffen Moritz

    2012-01-01

    Full Text Available Theoretical models ascribe jumping to conclusions (JTCs a prominent role in the pathogenesis of paranoia. While many earlier studies corroborated this account, some newer investigations have found no or only small associations of the JTC bias with paranoid symptoms. The present study examined whether these inconsistencies in part reflect methodological differences across studies. The study was built upon the psychometric high-risk paradigm. A total of 1899 subjects from the general population took part in an online survey and were administered the Paranoia Checklist as well as one of two different variants of the probabilistic reasoning task: one variant with a traditional instruction (a and one novel variant that combines probability estimates with decision judgments (b. Factor analysis of the Paranoia Checklist yielded an unspecific suspiciousness factor and a psychotic paranoia factor. The latter was significantly associated with scores indicating hasty decision making. Subjects scoring two standard deviations above the mean of the Paranoia Checklist showed an abnormal data-gathering style relative to subjects with normal scores. Findings suggest that the so-called decision threshold parameter is more sensitive than the conventional JTC index. For future research the specific contents of paranoid beliefs deserve more consideration in the investigation of decision making in schizophrenia as JTC seems to be associated with core psychosis-prone features of paranoia only.

  14. Evaluation of Criteria for Requesting Brain CT Scan before Performing Lumbar Puncture for the Children Suspicious to Meningitis in Rasul Akram Hospital, Tehran

    Directory of Open Access Journals (Sweden)

    A.R. Nateghian

    2005-04-01

    Full Text Available Lumbar puncture (LP is the only way to diagnose meningitis, however some concerning points regarding its complication especially brain herniation are usually noted. Several factors including difficulties of neurologic examination especially in infants, absence of cooperation when performing the LP, incorrect myths and legal issues as well as unavailability of CT equipment , X-ray exposure and charges; makes evaluation of such requests reasonable .One hundred infants and children, 2 months to 12 years old who were suspicious to have meningitis were enrolled in this cross-sectional, descriptive study. Two groups were formed based on requesting a B.CT (Brain CT scan before LP or performing the procedure directly. Demographic and clinical parameters were analyzed among two groups using a questionnaire and CT results were recorded. Chi-square test was used for statistical analysis; P value<0.05 was considered as significant.B.CT was requested for 21 patients (case group in which the results led to postponing the procedure in 14%( 3 of cases. Toxic appearance, poor general condition, bulging fontanel and impaired consciousness (GCS score<8 were significantly related to such a decision making. There was also a trend toward ordering B.CT for those patients with recent cardiopulmonary arrest, focal signs, papilledema, hemiparesis and bradycardia. Two cases of brain herniation were identified in the control group, both had severe irritability and projectile vomiting at presentation.According to other studies, severe impairment of consciousness and presence of focal signs and symptoms are acceptable criteria for such a request, however ordering B.CT solely based on general condition or presence of a bulge fontanel seems to be unreasonable for which we couldn’t identify any supportive study. Larger scale studies considering the pediatric differential diagnosis and characteristics are required to generate proper, scientific and supportive protocols in this

  15. Multi-probe-based resonance-frequency electrical impedance spectroscopy for detection of suspicious breast lesions: improving performance using partial ROC optimization

    Science.gov (United States)

    Lederman, Dror; Zheng, Bin; Wang, Xingwei; Wang, Xiao Hui; Gur, David

    2011-03-01

    We have developed a multi-probe resonance-frequency electrical impedance spectroscope (REIS) system to detect breast abnormalities. Based on assessing asymmetry in REIS signals acquired between left and right breasts, we developed several machine learning classifiers to classify younger women (i.e., under 50YO) into two groups of having high and low risk for developing breast cancer. In this study, we investigated a new method to optimize performance based on the area under a selected partial receiver operating characteristic (ROC) curve when optimizing an artificial neural network (ANN), and tested whether it could improve classification performance. From an ongoing prospective study, we selected a dataset of 174 cases for whom we have both REIS signals and diagnostic status verification. The dataset includes 66 "positive" cases recommended for biopsy due to detection of highly suspicious breast lesions and 108 "negative" cases determined by imaging based examinations. A set of REIS-based feature differences, extracted from the two breasts using a mirror-matched approach, was computed and constituted an initial feature pool. Using a leave-one-case-out cross-validation method, we applied a genetic algorithm (GA) to train the ANN with an optimal subset of features. Two optimization criteria were separately used in GA optimization, namely the area under the entire ROC curve (AUC) and the partial area under the ROC curve, up to a predetermined threshold (i.e., 90% specificity). The results showed that although the ANN optimized using the entire AUC yielded higher overall performance (AUC = 0.83 versus 0.76), the ANN optimized using the partial ROC area criterion achieved substantially higher operational performance (i.e., increasing sensitivity level from 28% to 48% at 95% specificity and/ or from 48% to 58% at 90% specificity).

  16. Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis.

    Science.gov (United States)

    Campanella, Paolo; Ianni, Francesca; Rota, Carlo Antonio; Corsello, Salvatore Maria; Pontecorvi, Alfredo

    2014-05-01

    In order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies. We did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes. The meta-analysis included 41 studies, for a total of 29678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size ≥4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22). Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas. The current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.

  17. PCA3 sensitivity and specificity for prostate cancer detection in patients with abnormal PSA and/or suspicious digital rectal examination. First Latin American experience.

    Science.gov (United States)

    Ramos, Christian G; Valdevenito, Raul; Vergara, Ivonne; Anabalon, Patricio; Sanchez, Catherine; Fulla, Juan

    2013-11-01

    Prostate Cancer Gene 3 (PCA3) is a recently described and highly specific urinary marker for prostate cancer (CaP). Its introduction in clinical practice to supplement low specificity of prostate specific antigen (PSA) can improve CaP diagnosis and follow-up. However, before its introduction, it is necessary to validate the method of PCA3 detection in distinct geographic populations. Our aim was to describe for the first time in Latin America, the application of the PROGENSA PCA3 assay for PCA3 detection in urine in Chilean men and its utility for CaP diagnosis in men with an indication of prostate biopsy. Sixty-four Chilean patients (mean age, 64 years) with indication of prostate biopsy because of elevated PSA and/or suspicious digital rectal examination (DRE) were prospectively recruited. PCA3 scores were assessed from urine samples obtained after DRE, before biopsy, and compared with PSA levels and biopsy outcome. The median PSA value and mean PCA3 score were 5.8 ng/ml and 31.7, respectively. Using a cutoff PCA3 score of 35, the sensitivity and specificity for detecting CaP were 52% and 87%, respectively. The receiver operating characteristic (ROC) curve analysis showed an area under the curve of 0.77 for PCA3 and 0.57 for PSA, for the same group of patients. In patients with previous negative biopsy, PCA3 specificity increased by 2.2%. This is the first report in Latin America on the use of PCA3 in diagnosing CaP. Our results are comparable to those reported in other populations in the literature, demonstrating the reproducibility of the test. PCA3 score was highly specific and we specially recommend its use in patients with persistent elevated PSA and prior negative biopsies. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions: Findings from The National Dental Practice-Based Research Network.

    Science.gov (United States)

    Makhija, Sonia K; Shugars, Daniel A; Gilbert, Gregg H; Litaker, Mark S; Bader, James D; Schaffer, Rebecca; Gordan, Valeria V; Rindal, D Brad; Pihlstrom, Daniel J; Mungia, Rahma; Meyerowitz, Cyril

    2017-12-01

    A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ 2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P = .03), luster (P = .04), and roughness (P = .01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P = .07). Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives. Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  19. The use of clinical guidelines for referral of patients with lesions suspicious for oral cancer may ease early diagnosis and improve education of healthcare professionals.

    Science.gov (United States)

    Seoane, Juan; Corral-Lizana, Cesar; González-Mosquera, Antonio; Cerero, Rocío; Esparza, Germán; Sanz-Cuesta, Teresa; Varela-Centelles, Pablo

    2011-11-01

    Early diagnosis and referral of oral cancer is essential. Successful implementation of clinical guidelines must include current practitioners and students. To evaluate the diagnostic accuracy of students at oral cancer screening and to assess the effectiveness of clinical referral guidelines. Fifth year dental students were randomly allocated to either control (n=19) or experimental groups (n = 18). Both received the customary training in oral diagnosis. The experimental group underwent a 2 hour workshop where the guidelines for the referral of suspicious lesions were discussed. Three months later, a set of 51 clinical cases including benign, malignant, and precancerous conditions/lesions were used to assess the screening ability of each subject. All 37 students entered the study. Sensitivity (control group) ranged from 16.7% to 66.7%; the experimental group scored from 16.7% to 83.3%. Fifty percent of the experimental students reached sensitivity values ≥ 62.5% (p = 0.01). Diagnostic specificity (control group) spanned from 80% to 93.3% (median = 50%); amongst experimental group it ranged from 82.2% to 97.8% (median = 92.8%); (p = 0.003). Concordance -control group- was X = 82.5 (SD = 3.2), and X = 88.2 (SD = 4.3) for the experimental, (p > 0.001). Cohen's kappa test was poor (K cancers urgently (p = 0.002) and left less unreferred cancers (0.04). This group also referred more precancerous lesions/conditions urgently (p = 0.02). The implementation of a clinical referral guideline at undergraduate level has proved valuable, under experimental conditions, to significantly increase diagnostic abilities of the examiners and thus to improve screening for oral cancer.

  20. {sup 99m}Tc-MDP and {sup 99m}Tc-MIBI scintimammography in patients with clinically suspicious breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Moon Sun; Park, Chan H.; Kim, Su Zy; Yoon, Suk Nam; Park, Hee Boong [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    {sup 99m}Tc-MDP scintimammography(SM) was performed at the time of the preoperative bone scan in patients with suspicious breast cancer. These patients also had {sup 99m}Tc-MIBI scintimammography before or after the bone scan. The purpose of this report is to compare {sup 99m}Tc-MDP SM and {sup 99m}Tc-MIBI SM with the surgical results. Scintimammography with {sup 99m}Tc-MDP was performed in 20 patients with palpable mass and radiologic suspicion or proven diagnosis of breast cancer preoperatively. Patients ranged in age from 34 to 72. No male patient was included. Both prone lateral and supine anterior views were obtained for 10 min each 10-15min after IV administration of 740 MBq of {sup 99m}Tc-MDP. The {sup 99m}Tc-MIBI scintimammography was also performed before surgery. {sup 99m}Tc-MIBI SM began in 5 min. postinjection of 740MBq of {sup 99m}Tc-MIBI with prone lateral views for 10 min. Scintimammography was evaluated as positive or negative for presence or absence of focal localization of the tracers and the results were compared to histological findings. Breast cancer was histologically diagnosed in all patients ( 16 infiltrating ductal carcinoma, 2 comedocarcinoma, 1 phyllodes tumor, 1 paget disease). The size of tumor mass ranged 1.5-3 cm. Lymph node metastasis was found in 4 patients by the histologic examination. The uptake of {sup 99m}Tc-MDP in breast cancer was noted in all patients except two. One of the two patients was in post excisional biopsy state and the other was also negative in the MIBI scan. There was MDP axillary node uptake in 5 patients. Two of 5 patients with axillary lymph node uptake were false positive but they were all positive with {sup 99m}Tc-MIBI scintimammography. Two masses found in MIBI scan of a patients cannot be separated o the MDP scan. It showed more diffuse uptake than MIBI scan. The concordance between MDP-SM with MIBI-SM(similar pattern of uptake) was 45% and the remaining cases showed not focal but more diffuse uptake

  1. Diagnosis of Cervical Metastatic Lymph Nodes in Papillary Thyroid Carcinoma: Is CT Enhancement Useful for Diagnosing Lymph Node Metastasis?

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hyun Joo; Kim, Eun Kyung; Moon, Hee Jung; Kwak, Jin Young [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-09-15

    We wanted to determine the utility of CT enhancement for diagnosing metastatic lymphadenopathy in patients with papillary thyroid carcinoma (PTC), and especially in the lymph nodes (LNs) of the lateral neck level and that are not suspicious for metastasis on ultrasonography (US). Our study population included 34 consecutive LNs of 31 patients (25 females and 6 males, mean age: 46.7 yrs) with PTC and who had no suspicious metastatic lateral cervical LN on preoperative US, but enhancement of the lateral cervical LNs was seen on CT. To objectify the degree of enhancement, the difference of Hounsfield units between the suspicious LN and that of the ipsilateral SCM muscle was calculated. For the node-by-node analysis, marking of the corresponding LN with CT enhancement on the second look US was performed. The final assessment was attained by surgical dissection of the marked LNs. The medical records were reviewed for the patients' age and gender and the size of the LNs. Among the 34 LNs, 17 LNs were diagnosed as metastasis and 17 were benign. There was no difference in the size of the LNs between two the groups (benign and metastatic). The patients who had metastatic LNs were younger than those patients with benign LNs (p = 0.037). The incidence of metastatic LN was higher in the male patients than in the female patients (F:M = 38.5%:100%, p = 0.018). There was no statistical difference between the metastatic LNs and benign LNs according to the degree of enhancement (p = 0.953). The degree of CT enhancement is not feasible to use for diagnosing metastatic LNs in the lateral neck level in patients with PTC

  2. Status report of LNS accelerator complex in 2001

    Energy Technology Data Exchange (ETDEWEB)

    Hama, H.; Hinode, F.; Kurihara, A.; Mutoh, M.; Nanao, M.; Shibasaki, Y.; Shinto, K.; Takahashi, S. [Tohoku Univ., Sendai (Japan). Lab. of Nuclear Science

    2002-11-01

    The electron accelerator complex at the Laboratory of Nuclear Science, Tohoku University has been operated for various fields of science. A 35-year-old 300 MeV electron linac is still working well. However troubles due to aging is rapidly getting serious. In addition, because of multi-purpose use of the linac many different beam characteristics are requested by the users, so that the operation mode has been complicate. In this report, the operation status of the accelerator complex including major troubles experience in the fiscal year 2001 is described and future plan is shortly discussed by showing the present machine operation. (author)

  3. Status report of LNS accelerator complex in 2001

    CERN Document Server

    Hama, H; Kurihara, A; Mutoh, M; Nanao, M; Shibasaki, Y; Shinto, K; Takahashi, S

    2002-01-01

    The electron accelerator complex at the Laboratory of Nuclear Science, Tohoku University has been operated for various fields of science. A 35-year-old 300 MeV electron linac is still working well. However troubles due to aging is rapidly getting serious. In addition, because of multi-purpose use of the linac many different beam characteristics are requested by the users, so that the operation mode has been complicate. In this report, the operation status of the accelerator complex including major troubles experience in the fiscal year 2001 is described and future plan is shortly discussed by showing the present machine operation. (author)

  4. Status report of LNS accelerator complex in 2000

    Energy Technology Data Exchange (ETDEWEB)

    Hama, H.; Hinode, F.; Kurihara, A.; Mutoh, M.; Nanao, M.; Oyamada, M.; Shibasaki, Y.; Shinto, K.; Takahashi, S. [Tohoku Univ., Sendai (Japan). Lab. of Nuclear Science

    2001-11-01

    The accelerator complex at the Laboratory of Nuclear Science, Tohoku University consists of a 300 MeV electron linac that has been operational for 34 years and a stretcher-booster synchrotron (STB ring) constructed for multipurpose use whose operation was started in 1997. In this report, major tasks of those accelerators are introduced, and operation experiences in the fiscal year 2000 are presented. In addition, improvement and replacement of devices are described. (author)

  5. Is there any additional benefit of contrast-enhanced CT as part of routine PET/CT protocols for the differentiation of suspicious incidental gastrointestinal 2-deoxy-{sup 18}F-FDG uptake?

    Energy Technology Data Exchange (ETDEWEB)

    Brendle, Cornelia Bettina; Aschoff, Phillip; Kratt, Thomas; Schraml, Christina; Reimold, Matthias; Claussen, Claus Detlef; Pfannenberg, Christina Anna [University Hospital Tuebingen, Tuebingen (Germany)

    2013-12-15

    Suspicious incidental gastrointestinal FDG uptake during positron-emission tomography/computed tomography (PET/CT) examinations can be caused by different diseases, including malignancies. However, differentiation with PET alone is difficult. The aim of this study was to investigate the potential of PET alone, contrast-enhanced CT (ceCT), and low-dose CT (ldCT) in routine PET/CT protocols for differentiation of incidental gastrointestinal lesions. Sixty patients with incidental gastrointestinal lesions who underwent a routine PET/CT protocol with ldCT and ceCT were retrospectively analysed. The PET lesions were evaluated regarding their FDG uptake patterns and the standard uptake value. The anatomical correlates in both CT protocols were compared in regard to the correct lesion classification with the reference standard endoscopy. Sixty-two lesions were found in 60 patients (17 malignant, 10 premalignant, 5 benign, 13 inflammatory, 17 physiological). The differentiation of the FDG uptake patterns did not enable reliable lesion classification. The positive predictive value for pathology was 0.81 for ceCT in PET/CT and 0.70 for ldCT. Malignancies were detected in 100% of the patients by ceCT vs. 29.4% by ldCT. The false negative rate of ceCT for all pathologies was 31.1%, vs. 68.9% for ldCT. False positive results (17/62) could not be excluded sufficiently by either CT protocol. PET/ceCT protocols provide additional benefit especially in detecting gastrointestinal malignancies as a cause of suspicious incidental gastrointestinal FDG uptake. However, since follow-up endoscopy cannot be forgone due to the considerable false negative rate even with ceCT, the addition of ceCT to a routine PET/ldCT protocol cannot be recommended for this purpose.

  6. A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model.

    Directory of Open Access Journals (Sweden)

    Zeshu Zhang

    Full Text Available Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG-fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting.

  7. THE RESULTS OF PARATHYROID HORMONE ASSAY IN PARATHYROID ASPIRATES IN PRE-OPERATIVE LOCALIZATION OF PARATHYROID ADENOMAS FOR FOCUSED PARATHYROIDECTOMY IN PATIENTS WITH NEGATIVE OR SUSPICIOUS TECHNETIUM-99M-SESTAMIBI SCANS.

    Science.gov (United States)

    Ozderya, Aysenur; Temizkan, Sule; Cetin, Kenan; Ozugur, Sule; Gul, Aylin Ege; Aydin, Kadriye

    2017-09-01

    This study aimed to evaluate the results of parathyroid hormone (PTH) assay in parathyroid aspirates to determine uniglandular disease by an endocrinologist-performed ultrasound (US) in patients with discordant or negative technetium-sestamibi scans and to evaluate whether this procedure increases the number of focused parathyroidectomies (FPs). We analyzed the data of 65 patients who underwent an endocrinologist-performed US-guided parathyroid fine-needle aspiration (FNA) with PTH wash-out, retrospectively. The results of PTH wash-out procedure and the reports of parathyroid surgery and pathology were reviewed. Of 65 patients, 54 had positive PTH wash-out results. The median serum PTH level of patients with positive and negative PTH wash-out results was 143 (25 and 75% interquartile range [IQR], 114 to 197) versus 154 (IQR, 115 to 255) pg/mL (P = .45), and the median PTH in FNA was 3,533 (IQR, 1,481 to 3,534) versus 6.0 (IQR, 1 to 6) pg/mL (P<.001), respectively. Forty-five patients underwent surgery. Of the operated patients, 42 had positive PTH wash-out results and had successful FP. Four patients with redo surgery had positive PTH wash-out results and were successfully re-operated with FP. Of 11 patients with negative PTH wash-out results, 3 had bilateral neck exploration (BNE) surgery and 2 patients were successfully operated, while surgery was unsuccessful in 1 patient, despite BNE. Our study results suggest that endocrinologist-performed US and parathyroid FNA with PTH wash-out increases the number and success of FPs. In particular, patients with redo surgery may benefit from this procedure. 4D-CT = four-dimensional computed tomography BNE = bilateral neck exploration FNA = fine-needle aspiration FNAB = fine-needle aspiration biopsy FP = focused parathyroidectomy IQR = 25 and 75% inter-quartile range PHPT = primary hyperparathyroidism PPV = positive predictive value PTH = parathyroid hormone (99m)Tc = technetium US = ultrasound.

  8. Propensity to Click on Suspicious Links

    DEFF Research Database (Denmark)

    Sudzina, Frantisek; Pavlicek, Antonin

    2017-01-01

    There already exists a certain, not huge, body of knowledge about impact of personality traits on susceptibility to phishing. But there is a gap when it comes specifically to phishing with links pretending to lead to deal sites. The paper analyzes if gender, age and personality traits influence.......1. Openness to experience was linked positively linked to responsible behavior, narcissism was negatively linked....

  9. Comparative analysis of {sup 99m}Tc-MDP three-phase bone scan with SPECT/CT and {sup 99m}Tc-HMPAO-labeled WBC SPECT/CT in the differential diagnosis of clinically suspicious post-traumatic osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    KIm, Chan Woo; Lee, Soo Jin; Kim, Ji Young; Hwang, Kyu Tae; Choi, Yun Young [Hanyang University Medical CenterSeoul (Korea, Republic of)

    2017-03-15

    To identify differences between three-phase bone scan and SPECT/CT (TBS) and WBC SPECT/CT (WS) and compare diagnostic accuracies of each modality in patients with suspicious post-traumatic osteomyelitis (OM). Twenty-one patients with suspicious post-traumatic OM were enrolled. All patients performed TBS and WS within 1 week. Foci of MDP and WBC accumulation were divided into three categories: bone (OM), soft tissue (soft tissue inflammation; STI), negative for inflammation (NI). Confirmative diagnosis was made upon operative pathology or long-term clinical follow-up. Of 21 patients, four OM, eight STI, nine NI were finally diagnosed. TBS diagnosis was correct in three of four positive cases and nine of 17 negative cases. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of TBS were 75 %, 52.9 %, 57.1 %, 27.3 %, 90 %. WS diagnosis was correct in two of four positive cases and 17 of 17 negative cases. Sensitivity, specificity, accuracy, PPV, NPV were 50 %, 100 %, 81.0 %, 100 %, 89.5 %. Twelve of 21 cases showed agreement between TBS and WS. TBS misdiagnosed nine cases (six STI and two NI as eight OM; one OM as one STI), while WS misdiagnosed four cases (two OM as two STI; two STI as two NI). Combining results from TBS and WS led to better diagnostic accuracy (91.7 %) than either TBS or WS alone. TBS and WS showed moderate agreement in assessment of clinically suspected post-traumatic OM. WS better evaluated inflammation than TBS. WS tended to underestimate inflammation whereas TBS tended to overestimate inflammation. Combining TBS and WS enhanced diagnostic accuracy.

  10. SPECT/spiral CT and bone scintigraphy in cancer patients: Impact of a low dose CT acquisitions in indeterminate or suspicious solitary focus; TEMP/TDM et scintigraphie osseuse en cancerologie: impact d'une acquisition scannographique basse dose chez les patients avec foyer isole suspect ou de nature indeterminee

    Energy Technology Data Exchange (ETDEWEB)

    Franson, T.; Bardet, S.; Switsers, O.; Aide, N. [CRLCC Francois-Baclesse, 14 - Caen (France); CHU Lyon-Sud, Pierre-Benite, Service de Medecine Nucleaire, 69 - Lyon (France); Loiseau, C. [CRLCC Francois-Baclesse, Unite de Biophysique, 14 - Caen (France); Allouache, D.; Gunzer, K. [CRLCC Francois-Baclesse, Oncologie Medicale, 14 - Caen (France); Allouache, N. [CRLCC Francois-Baclesse, Radiotherapie, 14 - Caen (France)

    2008-05-15

    Aim: To evaluate the usefulness of a low dose SPECT/CT and the added value of an additional 'diagnostic' centred CT-scan in cancer patients with a solitary focus observed on planar whole-body bone scintigraphy (P.W.B.S.) and classified as indeterminate or suspicious. Material and methods Sixty consecutive patients underwent a low dose SPECT/CT acquisition (120 kV, 30 m As, 3 mm slice thickness) followed by a 'diagnostic' CT-scan (120 kV, 100 m As, 1.25 mm slice thickness) centred on the focus. The first observer considered prospectively W.B.S., low-dose SPECT/CT and finally the centred SPECT/CT. A blinded review was performed by a second observer. Results P.W.B.S. depicted solitary indeterminate or suspicious foci in 38 and 22 patients, respectively. SPECT/CT acquisitions clarified 73% (44/60) of the foci. Additional diagnostic CT-scan altered low-dose SPECT/CT results in nine patients. Additional foci (not found by P.W.B.S.) located outside the scanning area of the centred diagnostic CT-scan were found in 20 patients. Inter observer agreement for P.W.B.S., low-dose SPECT/CT and diagnostic SPECT/CT was equal to 0.542, 0.68 and 0.694, respectively. R.O.C. analysis showed no difference between low-dose SPECT/CT and diagnostic SPECT/CT for observer 1 and observer 2. Conclusion This study shows that a conventional low-dose SPECT/CT in patients presenting with a solitary focus on P.W.B.S. is sufficient to improve both accuracy and inter observer variability of bone scanning. A CT volume session should not be limited to the area of the solitary focus since additional foci located outside the centred CT-scan frequently occurred. (authors)

  11. US-Guided Femoral and Sciatic Nerve Blocks for Analgesia During Endovenous Laser Ablation

    Energy Technology Data Exchange (ETDEWEB)

    Yilmaz, Saim, E-mail: ysaim@akdeniz.edu.tr; Ceken, Kagan; Alimoglu, Emel; Sindel, Timur [Akdeniz University School of Medicine, Department of Radiology (Turkey)

    2013-02-15

    Endovenous laser ablation may be associated with significant pain when performed under standard local tumescent anesthesia. The purpose of this study was to investigate the efficacy of femoral and sciatic nerve blocks for analgesia during endovenous ablation in patients with lower extremity venous insufficiency. During a 28-month period, ultrasound-guided femoral or sciatic nerve blocks were performed to provide analgesia during endovenous laser ablation in 506 legs and 307 patients. The femoral block (n = 402) was performed at the level of the inguinal ligament, and the sciatic block at the posterior midthigh (n = 124), by injecting a diluted lidocaine solution under ultrasound guidance. After the blocks, endovenous laser ablations and other treatments (phlebectomy or foam sclerotherapy) were performed in the standard fashion. After the procedures, a visual analogue pain scale (1-10) was used for pain assessment. After the blocks, pain scores were 0 or 1 (no pain) in 240 legs, 2 or 3 (uncomfortable) in 225 legs, and 4 or 5 (annoying) in 41 legs. Patients never experienced any pain higher than score 5. The statistical analysis revealed no significant difference between the pain scores of the right leg versus the left leg (p = 0.321) and between the pain scores after the femoral versus sciatic block (p = 0.7). Ultrasound-guided femoral and sciatic nerve blocks may provide considerable reduction of pain during endovenous laser and other treatments, such as ambulatory phlebectomy and foam sclerotherapy. They may make these procedures more comfortable for the patient and easier for the operator.

  12. On the significance of density-induced speed of sound variations on US-guided radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fontanarosa, Davide; Meer, Skadi van der; Verhaegen, Frank [Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands) and Medical Physics Unit, Oncology Department, McGill University, Montreal, Quebec H3G 1A4 (Canada)

    2012-10-15

    Purpose: To show the effect of speed of sound (SOS) aberration on ultrasound guided radiotherapy (US-gRT) as a function of implemented workflow. US systems assume that SOS is constant in human soft tissues (at a value of 1540 m/s), while its actual nonuniform distribution produces small but systematic errors of up to a few millimeters in the positions of scanned structures. When a coregistered computerized tomography (CT) scan is available, the US image can be corrected for SOS aberration. Typically, image guided radiotherapy workflows implementing US systems only provide a CT scan at the simulation (SIM) stage. If changes occur in geometry or density distribution between SIM and treatment (TX) stage, SOS aberration can change accordingly, with a final impact on the measured position of structures which is dependent on the workflow adopted. Methods: Four basic scenarios were considered of possible changes between SIM and TX: (1) No changes, (2) only patient position changes (rigid rotation-translation), (3) only US transducer position changes (constrained on patient's surface), and (4) patient tissues thickness changes. Different SOS aberrations may arise from the different scenarios, according to the specific US-gRT workflow used: intermodality (INTER) where TX US scans are compared to SIM CT scans; intramodality (INTRA) where TX US scans are compared to SIM US scans; and INTERc and INTRAc where all US images are corrected for SOS aberration (using density information provided by SIM CT). For an experimental proof of principle, the effect of tissues thickness change was simulated in the different workflows: a dual layered phantom was filled with layers of sunflower oil (SOS 1478 m/s), water (SOS 1482 m/s), and 20% saline solution (SOS 1700 m/s). The phantom was US scanned, the layer thicknesses were increased and the US scans were repeated. The errors resulting from the different workflows were compared. Results: Theoretical considerations show that workflows implementing SOS correction based on SIM-CT scan (INTERc, INTRAc) give null errors in all scenarios except when tissues thickness changes, where an error proportional to the degree of change in SOS maps between SIM and TX ({Delta}SOS) occurs. An uncorrected workflow such as INTER produces in all scenarios a pure SOS error, while uncorrected INTRA produces a null error for rotation-translation of the patient, a {Delta}SOS error for changing tissues thickness and an error proportional to the degree of SOS distribution change along the different lines of view when shifting the transducer. The dual layered phantom demonstrated experimentally that the effect of SOS change between SIM and TX is clinically nonrelevant, being less than the intrinsic resolution of imaging systems, even when a substantial change in thicknesses is applied, provided that a SIM-CT-based SOS aberration correction is applied. Noncorrected workflows produce errors up to 4 mm for INTER and to 3 mm for INTRA in the phantom test. Conclusions: A SOS correction is advantageous for all US-gRT workflows and clinical cases, where the effect of SOS change can be considered a second order effect.

  13. [The treatment of venous malformations in adult patients: the role of US-guided sclerotherapy].

    Science.gov (United States)

    Fresa, Marco; Erdmann, Andreas; El Ezzi, Oumama; De Buys, Anthony; Depairon, Michele; Dabiri, Amin; Ney, Barbara; Mazzolai, Lucia

    2017-12-06

    Venous malformations are slow flow dysplastic lesions, constituted by a vascular nest without arterial or capillary connections, more or less independent of the normal venous anatomy and circulation. In certain cases a treatment is required for symptom relief or for natural complications management. The percutaneous sclerotherapy under ultrasound guidance is increasingly used as an effective and mini-invasive option, allowing obtaining very good results with minor side effects. Several substances have been used with different efficacy and side effects rate. We review the literature and present some cases.

  14. EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis.

    Science.gov (United States)

    van Steenbergen, Hanna W; Aletaha, Daniel; Beaart-van de Voorde, Liesbeth J J; Brouwer, Elisabeth; Codreanu, Catalin; Combe, Bernard; Fonseca, João E; Hetland, Merete L; Humby, Frances; Kvien, Tore K; Niedermann, Karin; Nuño, Laura; Oliver, Sue; Rantapää-Dahlqvist, Solbritt; Raza, Karim; van Schaardenburg, Dirkjan; Schett, Georg; De Smet, Liesbeth; Szücs, Gabriella; Vencovský, Jirí; Wiland, Piotr; de Wit, Maarten; Landewé, Robert L; van der Helm-van Mil, Annette H M

    2017-03-01

    During the transition to rheumatoid arthritis (RA) many patients pass through a phase characterised by the presence of symptoms without clinically apparent synovitis. These symptoms are not well-characterised. This taskforce aimed to define the clinical characteristics of patients with arthralgia who are considered at risk for RA by experts based on their clinical experience. The taskforce consisted of 18 rheumatologists, 1 methodologist, 2 patients, 3 health professionals and 1 research fellow. The process had three phases. In phase I, a list of parameters considered characteristic for clinically suspect arthralgia (CSA) was derived; the most important parameters were selected by a three-phased Delphi approach. In phase II, the experts evaluated 50 existing patients on paper, classified them as CSA/no-CSA and indicated their level of confidence. A provisional set of parameters was derived. This was studied for validation in phase III, where all rheumatologists collected patients with and without CSA from their outpatient clinics. The comprehensive list consisted of 55 parameters, of which 16 were considered most important. A multivariable model based on the data from phase II identified seven relevant parameters: symptom duration <1 year, symptoms of metacarpophalangeal (MCP) joints, morning stiffness duration ≥60 min, most severe symptoms in early morning, first-degree relative with RA, difficulty with making a fist and positive squeeze test of MCP joints. In phase III, the combination of these parameters was accurate in identifying patients with arthralgia who were considered at risk of developing RA (area under the receiver operating characteristic curve 0.92, 95% CI 0.87 to 0.96). Test characteristics for different cut-off points were determined. A set of clinical characteristics for patients with arthralgia who are at risk of progression to RA was established. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Passive Smoking and Breast Cancer - a Suspicious Link.

    Science.gov (United States)

    Malik, Abhidha; Jeyaraj, Pamela Alice; Shankar, Abhishek; Rath, Goura Kishore; Mukhopadhyay, Sandip; Kamal, Vineet Kumar

    2015-01-01

    Breast cancer is the most common malignancy of women in the world. The disease is caused by infectious and non-infectious, environmental and lifestyle factors. Tobacco smoke has been one of the most widely studied environmental factors with possible relevance to breast cancer. The purpose of this study was to assess the impact of tobacco smoking in breast cancer patients in a hospital based cohort and to establish prognostic implications if any. A retrospective audit of 100 women with pathological diagnosis of invasive breast cancer was included in this study. The verbal questionnaire elicited information on current and previous history of exposure to smoking in addition to active smoking. All analyses were adjusted for potential confounders, including stage at presentation, alcohol intake, hormonal replacement therapy, oral contraceptive intake, obesity and menopausal status. The mean age at presentation of breast cancer was 51.4 ± 10.86 years. Mean age of presentation was 53.1±11.5 and 45.7±11.9 years in never smokers and passive smokers, respectively. Age at presentation varied widely in patients exposed to tobacco smoke for >10 years in childhood from 40.3± 12.0 years to 47.7± 13.9 in patients exposed for > 20 years as adults. Among passive smokers, 60.9% were premenopausal and 39.1% of patients were postmenopausal. In never smokers, 71.4% were post menopausal. Expression of receptors in non-smokers vs passive smokers was comparable with no significant differences. Metastatic potential in lung parenchyma was slightly elevated in passive smokers as compared to never smokers although statistically non-significant. An inverse relationship exists between the intensity and duration of smoking and the age at presentation and poor prognostic factors. The results strongly suggest efforts should be taken to prevent smoking, encourage quitting and restrict exposure to second hand smoke in India.

  16. Heterotopic pancreas presenting as suspicious mass in the gallbladder.

    Science.gov (United States)

    Foucault, Amélie; Veilleux, Hubert; Martel, Guillaume; Lapointe, Réal; Vandenbroucke-Menu, Franck

    2012-11-10

    Heterotopic pancreas is a rare entity. Thirty-three cases in the gallbladder have been reported. We describe the first case of heterotopic pancreas mimicking a gallbladder cancer, identified within a calcified lesion in the thickened posterior wall of the gallbladder. A 72-year-old woman with right upper quadrant pain was referred with a suspicion of gallbladder neoplasia. A CT scan demonstrated a 1 cm thickened posterior wall of the gallbladder with a 2 mm punctate calcification. An open cholecystectomy was carried out without complication. The frozen section demonstrated pancreatic tissue. Heterotopic pancreas of the gallbladder is highly uncommon. It can mimic a neoplastic process in the gallbladder, particularly in the context of calcification. Its malignant potential in the gallbladder is unknown, in contrast to previously described neoplastic transformation with gastric heterotopic pancreas.

  17. Cavitary lung lesion suspicious for malignancy reveals Mycobacterium xenopi.

    Science.gov (United States)

    Fogla, Sumit; Pansare, Vaishali M; Camero, Luis G; Syeda, Uzma; Patil, Naveen; Chaudhury, Arun

    2018-01-01

    We report the case of a 68-year-old gentleman who presented with musculoskeletal chest pain which appeared suddenly when he bent over with his dog. The chest pain was localized to the left lower chest and increased with movement and deep breathing. The patient did not complain weight loss, night sweat, fever or chill. He complained of mild cough, with expectoration of whitish mucus. Imaging revealed cavitary chest lesion in the right upper lobe, which was initially suspected to be lung cancer. The patient had a 50-year-old history of smoking 2 packs per day. PET CT imaging did not reveal any specific activity. Needle biopsy and bronchoalveolar lavage, however, did not reveal any malignant cells. Rather, necrotic tissues were observed. A wedge resection of the lung mass was performed. No common organisms or fungi could be grown. However, acid fast bacilli were observed in clumps. The morphology hinted towards non-tuberculous mycobacterial organism(s). Molecular studies revealed infection with Mycobacterium xenopi. The patient was started on an anti-tuberculous regimen of INH, rifampicin, ethambutol and PZA, with pyridoxine. The patient is a Vietnam veteran and complained of exposure to dust from a bird's nest and asbestos exposure in childhood, but no specific exposure to tuberculosis. The patient had an uneventful recovery post-surgery. He complained of some nausea after initiation of the antituberculous medications, but his pain subsided with time. The patient had diabetes, though specific reasons of compromise of immune status could not be pinpointed as causative of his nontuberculous mycobacterial lung infection.

  18. Managing Suspicious Activity Reporting Systems at Small Agency Police Departments

    Science.gov (United States)

    2012-09-01

    X 65,129 64 Placentia X X 49,938 65 Pleasanton X X 68,755 66 Rancho Santa Margarita -OCSD X X 49,458 67 Redding X 90,521...Montebello Napa Novato Perris Pittsburg Rancho Santa Margarita Redondo Beach Rosemead San Mateo Santa

  19. 75 FR 75576 - Confidentiality of Suspicious Activity Reports

    Science.gov (United States)

    2010-12-03

    ... introduction in its rules to ] state that confidential treatment also must be afforded to ``any information that would reveal the existence of a SAR.'' The introduction also would indicate that SAR information... based''); Cotton v. Private Bank and Trust Co., 235 F. Supp. 2d 809, 815 (N.D. Ill. 2002) (holding that...

  20. Yellow fever vaccine-associated neurological disease, a suspicious case.

    Science.gov (United States)

    Beirão, Pedro; Pereira, Patrícia; Nunes, Andreia; Antunes, Pedro

    2017-03-02

    A 70-year-old man with known cardiovascular risk factors, presented with acute onset expression aphasia, agraphia, dyscalculia, right-left disorientation and finger agnosia, without fever or meningeal signs. Stroke was thought to be the cause, but cerebrovascular disease investigation was negative. Interviewing the family revealed he had undergone yellow fever vaccination 18 days before. Lumbar puncture revealed mild protein elevation. Cultural examinations, Coxiella burnetti, and neurotropic virus serologies were negative. Regarding the yellow fever virus, IgG was identified in serum and cerebrospinal fluid (CSF), with negative IgM and virus PCR in CSF. EEG showed an encephalopathic pattern. The patient improved gradually and a week after discharge was his usual self. Only criteria for suspect neurotropic disease were met, but it's possible the time spent between symptom onset and lumbar puncture prevented a definite diagnosis of yellow fever vaccine-associated neurological disease. This gap would have been smaller if the vaccination history had been collected earlier. 2017 BMJ Publishing Group Ltd.

  1. EULAR definition of arthralgia suspicious for progression to rheumatoid arthritis

    DEFF Research Database (Denmark)

    van Steenbergen, Hanna W; Aletaha, Daniel; Beaart-van de Voorde, Liesbeth J J

    2017-01-01

    BACKGROUND: During the transition to rheumatoid arthritis (RA) many patients pass through a phase characterised by the presence of symptoms without clinically apparent synovitis. These symptoms are not well-characterised. This taskforce aimed to define the clinical characteristics of patients wit...

  2. 12 CFR 21.11 - Suspicious Activity Report.

    Science.gov (United States)

    2010-01-01

    ... transaction has no business or apparent lawful purpose or is not the sort in which the particular customer... pursuant to the reporting requirements of 17 CFR 240.17f-1. (g) Retention of records. A national bank shall...

  3. B-Flow Twinkling Sign in Preoperative Evaluation of Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Giuseppina Napolitano

    2013-01-01

    Full Text Available Papillary thyroid cancer (PTC is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs. The ultrasonography (US is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI, recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS, within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high values ​​of specificity (99.7% and sensitivity (80.9%. The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.

  4. Causas do retardo na confirmação diagnóstica de lesões mamárias em mulheres atendidas em um centro de referência do Sistema Único de Saúde no Rio de Janeiro Factors leading to delay in obtaining definitive diagnosis of suspicious lesions for breast cancer in a dedicated health unit in Rio de Janeiro

    Directory of Open Access Journals (Sweden)

    Magda Côrtes Rodrigues Rezende

    2009-02-01

    Full Text Available OBJETIVO: avaliar os fatores que levam ao retardo na confirmação diagnóstica de lesões mamárias suspeitas de câncer. MÉTODOS: foi realizado um estudo observacional de corte transversal. Foram incluídas 104 mulheres que procuraram um hospital de câncer, com diagnóstico ou suspeita de câncer de mama. Foi aplicado um questionário semiestruturado com perguntas referentes às características demográficas, clínicas e de utilização de serviços. As variáveis foram comparadas pelos testes t de Student, Mann-Whitney, χ2 de Pearson ou exato de Fisher, conforme a indicação. A fim de identificar as variáveis associadas ao retardo na confirmação diagnóstica do câncer de mama, foram calculadas as Odds Ratio (OR com intervalo com 95% de confiança (IC95% e um modelo de regressão logística foi elaborado. RESULTADOS: a média de idade foi de 54 anos (±12,6, predominando mulheres brancas (48,1%, casadas (63,5%, residentes no Município do Rio de Janeiro (57,7% e com baixo grau de escolaridade (60,6%. O tempo mediano entre o primeiro sinal ou sintoma da doença e a primeira consulta foi de um mês, e desta última até a confirmação diagnóstica de 6,5 meses. Em 51% das mulheres o diagnóstico foi tardio (estádios II a IV. Presença de sintomas, longo intervalo de tempo entre o início dos sintomas e a primeira avaliação e entre o início dos sintomas e a confirmação diagnóstica, mostraram-se fatores significantes (pPURPOSE: to evaluate the factors leading to delays in obtaining definitive diagnosis of suspicious lesions for breast cancer. METHODS: a cross-sectional, observational study was carried out with 104 women attending a cancer hospital with a diagnosis or suspected diagnosis of breast cancer. A semistructured questionnaire on the patients' demographic, clinical characteristics and the use of services was applied.Variables were compared using t-Student test, Mann-Whitney test, Pearson's χ2 test or Fisher's exact test

  5. Postoperative pain management of liver transplantation in cystic fibrosis: Is it time to start US-guided neuraxial blocks?

    Science.gov (United States)

    Piazza, M; Martucci, G; Arcadipane, A

    2016-01-01

    Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy. There is a growing evidence that thoracic epidural anesthesia is feasible in pediatric patients. Concerns about coagulopathy and immunosuppression have limited its use in liver transplantation. Ultrasonography is becoming an adjunct tool in neuraxial blocks, allowing faster and easier recognition of the epidural space, and reducing vertebral touch and number of attempts. In pediatric patients, it is still debated whether anesthesia has detrimental effects on cognitive development. Efforts to make regional techniques easier and safer by ultrasonography are ongoing. We report the first case of continuous thoracic epidural analgesia after pediatric liver transplantation in a 10-year-old boy affected with CF with macronodular cirrhosis. Despite a challenging coagulation profile, the echo-assisted procedure was safely performed and allowed extubation in the odds ratio, postoperative awakening and comfort, and quick resumption of respiratory physiotherapy.

  6. Postoperative pain management of liver transplantation in cystic fibrosis: Is it time to start US-guided neuraxial blocks?

    Directory of Open Access Journals (Sweden)

    M Piazza

    2016-01-01

    Full Text Available Cystic fibrosis (CF is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy. There is a growing evidence that thoracic epidural anesthesia is feasible in pediatric patients. Concerns about coagulopathy and immunosuppression have limited its use in liver transplantation. Ultrasonography is becoming an adjunct tool in neuraxial blocks, allowing faster and easier recognition of the epidural space, and reducing vertebral touch and number of attempts. In pediatric patients, it is still debated whether anesthesia has detrimental effects on cognitive development. Efforts to make regional techniques easier and safer by ultrasonography are ongoing. We report the first case of continuous thoracic epidural analgesia after pediatric liver transplantation in a 10-year-old boy affected with CF with macronodular cirrhosis. Despite a challenging coagulation profile, the echo-assisted procedure was safely performed and allowed extubation in the odds ratio, postoperative awakening and comfort, and quick resumption of respiratory physiotherapy.

  7. Perfil clínico-epidemiológico dos casos suspeitos de Dengue em um bairro da zona sul de Teresina, PI, Brasil Perfíl clinico-epidemiológico de los casos sospechosos de Dengue en un distrito de la zona sur de Teresina, PI, Brasil Clinical-epidemiologic profile of Dengue suspicious cases in a district in the south zone of Teresina, PI, Brazil

    Directory of Open Access Journals (Sweden)

    Polyana da Costa Ribeiro

    2008-04-01

    Full Text Available O objetivo foi traçar o perfil clínico-epidemiológico dos casos suspeitos de Dengue em um bairro da zona sul de Teresina. Realizou-se um estudo descritivo-exploratório, por meio de inquérito domiciliar mediante aplicação de formulário com 28 pessoas. 88,9% tinham coleta de lixo 3 vezes por semana; 57,1% dos depósitos encontrados foram material de construção/peças de carro; 75% destinam as águas servidas a céu aberto; 60,7% desenvolveram primo-infecção, 75% realizaram sorologia, com 33,3% confirmados. Faltou uma maior efetividade de ações de saneamento por parte do poder público e um envolvimento da população no desenvolvimento de medidas preventivas no combate à dengue.El un objetivo del estudio fue establecer un perfil clínico-epidemiológico de los casos sospechosos de Dengue en un distrito de la zona sur de la cuidad de Teresina, PI, Brasil. Tratase de un estudio descriptivo-exploratorio en lo cual se aplicó un cuestionario a 28 residentes del área del estudio. 88,9% tenían colección de basura 3 veces por la semana; 57,1% de los depósitos analizados tenían material de construcción o piezas de auto; 75% de las casas tenían el escoto con destino a áreas libres; 60,7% tuvieron prima-infección, 75% fueron sometidos a serología, con 33,3% confirmaciones. Mayor efectividad de acciones sanitarias por el gobierno y un envolvimiento de la población en el desarrollo de programas preventivos de combate a la Dengue son necesarios.The objective of the study was to establish a clinical-epidemiologic profile of Dengue suspicious cases in a district in the south zone of Teresina, PI, Brazil. This study is a descriptive-exploratory survey in which it was applied a questionnaire to 28 residents of the mentioned district. 88.9% had garbage collection 3 times per week; 57.1% of the deposits had construction material or car parts; 75% destine served waters to opencast; 60.7% had developed first-infection, 75% were submitted to

  8. Crossover trial to test the acceptability of a locally produced lipid-based nutrient supplement (LNS) for children under 2 years in Cambodia: a study protocol

    National Research Council Canada - National Science Library

    Borg, Bindi; Mihrshahi, Seema; Griffin, Mark; Chamnan, Chhoun; Laillou, Arnaud; Wieringa, Frank T

    2017-01-01

    IntroductionThe acceptability and efficacy of existing ready-to-use supplementary and therapeutic foods has been low in Cambodia, thus limiting success in preventing and treating malnutrition among Cambodian children...

  9. The FARCOS project. First characterization of CsI(Tl crystals of the FARCOS array using charged particle beams at LNS

    Directory of Open Access Journals (Sweden)

    Quattrocchi L.

    2014-03-01

    Full Text Available The construction of a new array to study femtoscopy and multi-particle correlations in heavy ion collisions at intermediate energies (E=20-1000 AMeV has been started at the INFN. The project, named FARCOS (Femtoscope ARray for COrrelations and Spectroscopy is aimed at developing of a detection system with high pixelation capabilities in order to perform precision measurements of particle correlations for nuclear dynamics and spectroscopy. We present first detection simulations for FARCOS and first results related to the commissioning of CsI(T1 crystals, an important detection stage of each telescope.

  10. Clinical and research activities at the CATANA facility of INFN-LNS: fom the conventional hadrontherapy to the laser-driven approach

    Czech Academy of Sciences Publication Activity Database

    Cirrone, G.A.P.; Cuttone, G.; Raffaele, L.; Salamone, S.; Avitabile, T.; Privitera, G.; Spatola, C.; Margarone, Daniele; Patti, V.; Petringa, G.; Romano, F.; Russo, A.; Russo, An.; Sabini, M.G.; Scuderi, Valentina; Schillaci, F.; Valastro, L.

    2017-01-01

    Roč. 7, Sep (2017), 1-13, č. článku 223. ISSN 2234-943X R&D Projects: GA MŠk EF15_008/0000162 Grant - others:ELI Beamlines(XE) CZ.02.1.01/0.0/0.0/15_008/0000162 Institutional support: RVO:68378271 Keywords : proton therapy * dosimetry * clinical follow-up * Monte Carlo * laser-driven * ELIMED Subject RIV: BL - Plasma and Gas Discharge Physics

  11. Evaluation of a simulation procedure designed to recognize shape and contour of suspicious masses in mammography

    Science.gov (United States)

    Sousa, Maria A. Z.; Siqueira, Paula N.; Schiabel, Homero

    2015-03-01

    A large number of breast phantoms have been developed for conducting quality tests, characterization of imaging systems and computer aided diagnosis schemes, dosimetry and image perception. The realism of these phantoms is important for ensuring the accuracy of results and a greater range of applications. In this work, a developed phantom is considered proposing the use of PVC films for simulation of nodules inserted in the breast parenchyma designed for classification between malignant and benign signals according to the BI-RADS® standard. The investigation includes analysis of radiographic density, mass shape and its corresponding contour outlined by experienced radiologists. The material was cut based on lesions margins found in 44 clinical cases, which were divided between circumscribed and spiculated structures. Tests were performed to check the ability of the specialists in distinguishing the contour compared to actual cases while the shapes accuracy was determined quantitatively by evaluation metrics. Results showed the applicability of the chosen material creating image radiological patterns very similar to the actual ones.

  12. Logistic regression function for detection of suspicious performance during baseline evaluations using concussion vital signs.

    Science.gov (United States)

    Hill, Benjamin David; Womble, Melissa N; Rohling, Martin L

    2015-01-01

    This study utilized logistic regression to determine whether performance patterns on Concussion Vital Signs (CVS) could differentiate known groups with either genuine or feigned performance. For the embedded measure development group (n = 174), clinical patients and undergraduate students categorized as feigning obtained significantly lower scores on the overall test battery mean for the CVS, Shipley-2 composite score, and California Verbal Learning Test-Second Edition subtests than did genuinely performing individuals. The final full model of 3 predictor variables (Verbal Memory immediate hits, Verbal Memory immediate correct passes, and Stroop Test complex reaction time correct) was significant and correctly classified individuals in their known group 83% of the time (sensitivity = .65; specificity = .97) in a mixed sample of young-adult clinical cases and simulators. The CVS logistic regression function was applied to a separate undergraduate college group (n = 378) that was asked to perform genuinely and identified 5% as having possibly feigned performance indicating a low false-positive rate. The failure rate was 11% and 16% at baseline cognitive testing in samples of high school and college athletes, respectively. These findings have particular relevance given the increasing use of computerized test batteries for baseline cognitive testing and return-to-play decisions after concussion.

  13. A Location Prediction-Based Helper Selection Scheme for Suspicious Eavesdroppers

    Directory of Open Access Journals (Sweden)

    Yan Huo

    2017-01-01

    Full Text Available This paper aims to improve security performance of data transmission with a mobile eavesdropper in a wireless network. The instantaneous channel state information (CSI of the mobile eavesdropper is unknown to legitimate users during the communication process. Different from existing work, we intend to reduce power consumption of friendly jamming signals. Motivated by the goal, this work presents a location-based prediction scheme to predict where the eavesdropper will be later and to decide whether a friendly jamming measure should be selected against the eavesdropper. The legitimate users only take the measure when the prediction result shows that there will be a risk during data transmission. According to the proposed method, system power can be saved to a large degree. Particularly, we first derive the expression of the secrecy outage probability and set a secrecy performance target. After providing a Markov mobile model of an eavesdropper, we design a prediction scheme to predict its location, so as to decide whether to employ cooperative jamming or not, and then design a power allocation scheme and a fast suboptimal helper selection method to achieve targeted and efficient cooperative jamming. Finally, numerical simulation results demonstrate the effectiveness of the proposed schemes.

  14. 75 FR 75593 - Financial Crimes Enforcement Network; Confidentiality of Suspicious Activity Reports

    Science.gov (United States)

    2010-12-03

    ... reports from civil liability in connection with the report. In 2001, the USA PATRIOT Act clarified that... government agency and expanded the scope of the limit on liability to cover any civil liability that may....\\12\\ \\12\\ For example, a private litigant may serve a discovery request on a bank in civil litigation...

  15. Diagnosis and Treatment of a Neck Node Swelling Suspicious for a Malignancy: An Algorithmic Approach

    Directory of Open Access Journals (Sweden)

    A. J. M. Balm

    2010-01-01

    Full Text Available Aim. To present an up-to-date algorithm incorporating recent advances regarding its diagnosis and treatment. Method. A Medline/Pubmed search was performed to identify relevant studies published in English from 1990 until 2008. Only clinical studies were identified and were used as basis for the diagnostic algorithm. Results. The eligible literature provided only observational evidence. The vast majority of neck nodes from occult primaries (>90% represent SCC with a high incidence among middle aged man. Smoking and alcohol abuse are important risk factors. Asiatic and North African patients with neck node metastases are at risk of harbouring an occult nasopharyngeal carcinoma. The remainder are adenocarcinoma, undifferentiated carcinoma, melanoma, thyroid carcinoma and Merkel cell carcinoma. Fine needle aspiration cytology (FNAC reaches sensitivity and specificity percentages of 81% and 100%, respectively and plays an important role as the second diagnostic step after routine ENT mirror and/or endoscopic examination. FDG-PET/CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases. Conclusion. Although reports on the diagnostic process offer mainly descriptive studies, current information seems sufficient to formulate a diagnostic algorithm to contribute to a more systematic diagnostic approach preventing unnecessary steps.

  16. Diagnosis and treatment of a neck node swelling suspicious for a malignancy: an algorithmic approach.

    Science.gov (United States)

    Balm, A J M; van Velthuysen, M L F; Hoebers, F J P; Vogel, W V; van den Brekel, M W M

    2010-01-01

    Aim. To present an up-to-date algorithm incorporating recent advances regarding its diagnosis and treatment. Method. A Medline/Pubmed search was performed to identify relevant studies published in English from 1990 until 2008. Only clinical studies were identified and were used as basis for the diagnostic algorithm. Results. The eligible literature provided only observational evidence. The vast majority of neck nodes from occult primaries (>90%) represent SCC with a high incidence among middle aged man. Smoking and alcohol abuse are important risk factors. Asiatic and North African patients with neck node metastases are at risk of harbouring an occult nasopharyngeal carcinoma. The remainder are adenocarcinoma, undifferentiated carcinoma, melanoma, thyroid carcinoma and Merkel cell carcinoma. Fine needle aspiration cytology (FNAC) reaches sensitivity and specificity percentages of 81% and 100%, respectively and plays an important role as the second diagnostic step after routine ENT mirror and/or endoscopic examination. FDG-PET/CT has proven to be helpful in identifying occult primary carcinomas of the head and neck, especially when applied as a guiding tool prior to panendoscopy, and may induce treatment related clinical decisions in up to 60% of cases. Conclusion. Although reports on the diagnostic process offer mainly descriptive studies, current information seems sufficient to formulate a diagnostic algorithm to contribute to a more systematic diagnostic approach preventing unnecessary steps.

  17. Clinical heterogeneity and chromosome breakage in Iranian patients suspicious of Fanconi anemia

    Directory of Open Access Journals (Sweden)

    Ghasemi Firoozabadi S

    2007-10-01

    Full Text Available Background: Fanconi anemia (FA is a rare autosomal recessive disorder characterized by short stature, skeletal anomalies, increased incidence of solid tumors and leukemia, and bone marrow failure (aplastic anemia. FA has been reported in all races and ethnic groups and affects men and women in an equal proportion. The frequency of FA has been estimated at approximately 1 per 360,000 live births. In some populations, including Ashkenazi Jews, Turks, Saudi Arabians and Iranians, this frequency appears to be higher, probably as a result of the founder effect and consanguineous marriage. Because of extensive genetic and clinical heterogeneity (the age of onset, clinical manifestations and survival, diagnosis of FA on the basis of clinical data alone is unreliable and its molecular diagnosis is difficult. The diagnosis of FA exploits the hypersensitivity of FA lymphocytes and fibroblasts to bifunctional alkylating agents such as mitomycin C (MMC, diepoxybutane (DEB and nitrogen mustard and differentiates it from idiopathic aplastic anemia. In this study, in addition to the patients' clinical profiles, a cytogenetic test using MMC was implemented for an accurate diagnosis of Fanconi anemia.Methods: In this study, the lymphocytes of 20 patients referred for FA, and those of their normal sex-matched controls, were treated with three different concentrations of mitomycin C (20, 30, 40 ng/ml. Slides were prepared and solid stained. In order to determine the number and kind of chromosome abnormalities, 50 metaphase spreads from each culture were analyzed. Clinical information was obtained from patient files.Results: Five patients manifested increased chromosome breakage with MMC, confirming the FA diagnosis. Two different concentrations of MMC (30, 40 ng/ml were most effective.Conclusion: The chromosomal breakage test is important for the accurate diagnosis of Fanconi anemia. DNA crosslinking agents used to treat idiopathic aplastic anemia may be lethal for patients with FA. Thus, aplastic anemia patients with unknown etiology, infants with congenital abnormalities involved in FA and siblings of FA patients should also be cytogenetically tested."n 

  18. Identifying compromised systems through correlation of suspicious traffic from malware behavioral analysis

    Science.gov (United States)

    Camilo, Ana E. F.; Grégio, André; Santos, Rafael D. C.

    2016-05-01

    Malware detection may be accomplished through the analysis of their infection behavior. To do so, dynamic analysis systems run malware samples and extract their operating system activities and network traffic. This traffic may represent malware accessing external systems, either to steal sensitive data from victims or to fetch other malicious artifacts (configuration files, additional modules, commands). In this work, we propose the use of visualization as a tool to identify compromised systems based on correlating malware communications in the form of graphs and finding isomorphisms between them. We produced graphs from over 6 thousand distinct network traffic files captured during malware execution and analyzed the existing relationships among malware samples and IP addresses.

  19. 31 CFR 103.16 - Reports by insurance companies of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    .... (1) Each insurance company shall file with the Financial Crimes Enforcement Network, to the extent... product that is relevant to a possible violation of law or regulation. An insurance company may also file... company is not required to file a SAR-IC to report the submission to it of false or fraudulent information...

  20. Real-Time Label-Free Detection of Suspicious Powders Using Noncontact Optical Methods

    Science.gov (United States)

    2013-11-05

    Systems, Inc. 1512 Industrial Park Street Covina, CA 91722 -3417 ABSTRACT Number of Papers published in peer-reviewed journals: Number of Papers published...AUTHORS William F. Hug, Ray D. Reid, Rohit Bhartia 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Photon Systems 1512 Industrial Park St. Covina...baking powder, baking soda, aspirin , Aleve, and acetaminophen, as well as inorganic Army Phase I SBIR W911NF-13-C-005 Final Report Photon Systems

  1. Communicating climate science to a suspicious public: How best to explain what we know?

    Science.gov (United States)

    Conway, E. M.; Jackson, R.

    2014-12-01

    In 2007, the Jet Propulsion Laboratory decided to establish a climate science website aimed at explaining what scientists know about climate science, and what they don't, to the English-speaking public. Because of my prior work in the history of atmospheric and climate sciences, I was asked to help choose the data that would be displayed on the site and to write the basic text. Our site went "live" in 2008, and quickly attracted both widespread media attention and sponsorship from NASA, which funded us to expand it into the NASA Climate Change website, climate.nasa.gov. It's now generally the 3rd or 4th ranked climate change website in Google rankings. A perusal of the NASA Climate Change website will reveal that the word "uncertainty" does not appear in its explanatory essays. "Uncertainty," in science, is a calculated quantity. To calculate it, one must know quite a bit about the phenomenon in question. In vernacular use, "uncertainty" means something like "stuff we don't know." These are radically different meanings, and yet scientists and their institutions routinely use both meanings without clarification. Even without the deliberate disinformation campaigns that Oreskes and Conway have documented in Merchants of Doubt, scientists' own misuse of this one word would produce public confusion. We chose to use other words to overcome this one communications problem. But other aspects of the climate communications problem cannot be so easily overcome in a context of Federal agency communications. In this paper, we'll review recent research on ways to improve public understanding of science, and set it against the restrictions that exist on Federal agency communications—avoidance of political statements and interpretation, focusing on fact over storytelling, narrowness of context—to help illuminate the difficulty of improving public understanding of complex, policy-relevant phenomenon like climate change.

  2. 75 FR 75583 - Standards Governing the Release of a Suspicious Activity Report

    Science.gov (United States)

    2010-12-03

    ... against international terrorism.'' \\9\\ This standard will permit disclosures responsive to a grand jury... is not required if the agency certifies that the rule will not have a significant economic impact on... 605(b) of the RFA, the OTS hereby certifies that this rule will not have a significant economic impact...

  3. High throughput image cytometry for detection of suspicious lesions in the oral cavity

    Science.gov (United States)

    MacAulay, Calum; Poh, Catherine F.; Guillaud, Martial; Michele Williams, Pamela; Laronde, Denise M.; Zhang, Lewei; Rosin, Miriam P.

    2012-08-01

    The successful management of oral cancer depends upon early detection, which relies heavily on the clinician's ability to discriminate sometimes subtle alterations of the infrequent premalignant lesions from the more common reactive and inflammatory conditions in the oral mucosa. Even among experienced oral specialists this can be challenging, particularly when using new wide field-of-view direct fluorescence visualization devices clinically introduced for the recognition of at-risk tissue. The objective of this study is to examine if quantitative cytometric analysis of oral brushing samples could facilitate the assessment of the risk of visually ambiguous lesions. About 369 cytological samples were collected and analyzed: (1) 148 samples from pathology-proven sites of SCC, carcinoma in situ or severe dysplasia; (2) 77 samples from sites with inflammation, infection, or trauma, and (3) 144 samples from normal sites. These were randomly separated into training and test sets. The best algorithm correctly recognized 92.5% of the normal samples, 89.4% of the abnormal samples, 86.2% of the confounders in the training set as well as 100% of the normal samples, and 94.4% of the abnormal samples in the test set. These data suggest that quantitative cytology could reduce by more than 85% the number of visually suspect lesions requiring further assessment by biopsy.

  4. A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma

    DEFF Research Database (Denmark)

    Jarjis, Reem Dina; Hansen, Lone Bak; Matzen, Steen Henrik

    2016-01-01

    in the FTRS.  Methods. Patients referred to the Department of Plastic Surgery and Breast Surgery in Zealand University Hospital were registered prospectively over a 1-year period in 2014. A cross-sectional study was performed analyzing referral patterns, including patient and tumor characteristics.  Results...

  5. 75 FR 75607 - Notice of Availability of Final Interpretative Guidance-Sharing Suspicious Activity Reports by...

    Science.gov (United States)

    2010-12-03

    ... organizational structure for purposes consistent with Title II of the BSA, as determined by regulation or... of usefulness in criminal, tax, or regulatory investigations or proceedings, or for intelligence or counter-intelligence activities to protect against international terrorism. In particular, the BSA and its...

  6. Pendulous Heart with Alternating Axis: A Suspicious Clue for Diagnosis of a Rare Disease

    Directory of Open Access Journals (Sweden)

    Abbas Ali Rafighdoust

    2015-03-01

    Full Text Available Absence of pericardium is a rare type of pericardial disorders. Left sided pericardial absence is more common than the right one. This disorder may present with a variety of signs and symptoms or abnormalities in electrocardiography and echocardiography. In this report, we discussed diagnosis of partial absence of pericardium in a 52-year-old man presented with a dull left-sided chest pain from 4 months ago with special electrocardiographic features. The axis deviations in his serial electrocardiograms led us to further evaluations with possible diagnosis of pericardial absence. His echocardiography and Magnetic Resonance Imaging (MRI confirmed the suspicion of pericardial absence. Suspicion of potentially life-threatening cardiac abnormalities should remain even while facing atypical chest pain or other non-specific symptoms. In this case, abnormal electrocardiographic and chest X-Ray findings together with echocardiography were all helpful in referring the patient for cardiac MRI as the imaging modality of choice in such cases.

  7. Performance and role of the breast lesion excision system (BLES) in small clusters of suspicious microcalcifications.

    Science.gov (United States)

    Scaperrotta, Gianfranco; Ferranti, Claudio; Capalbo, Emanuela; Paolini, Biagio; Marchesini, Monica; Suman, Laura; Folini, Cristina; Mariani, Luigi; Panizza, Pietro

    2016-01-01

    To assess the diagnostic performance of the BLES as a biopsy tool in patients with ≤ 1 cm clusters of BIRADS 4 microcalcifications, in order to possibly avoid surgical excision in selected patients. This is a retrospective study of 105 patients undergone to stereotactic breast biopsy with the BLES. It excises a single specimen containing the whole mammographic target, allowing better histological assessment due to preserved architecture. Our case series consists of 41 carcinomas (39%) and 64 benign lesions (61%). Cancer involved the specimen margins in 20/41 cases (48.8%) or was close to them (≤ 1 mm) in 14 cases (34.1%); margins were disease-free in only 7 DCIS (17.1%). At subsequent excision of 39/41 malignant cases, underestimation occurred for 5/32 DCIS (15.6%), residual disease was found in 15/39 cancers (38.5%) and no cancer in 19/39 cases (48.7%). For DCIS cases, no residual disease occurred for 66.7% G1-G2 cases and for 35.3% G3 cases (P=0.1556) as well as in 83.3%, 40.0% and 43.8% cases respectively for negative, close and positive BLES margins (P=0.2576). The BLES is a good option for removal of small clusters of breast microcalcifications, giving better histological interpretation, lower underestimation rates and possibly reducing the need of subsequent surgical excision in selected patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. 76 FR 69204 - Anti-Money Laundering Program and Suspicious Activity Reporting Requirements for Housing...

    Science.gov (United States)

    2011-11-08

    ..., or in the conduct of intelligence or counterintelligence activities, including analysis, to protect..., competitive, and resilient national housing finance markets. Where FHFA has not acted with superseding...

  9. 75 FR 76677 - Financial Crimes Enforcement Network: Anti-Money Laundering Program and Suspicious Activity...

    Science.gov (United States)

    2010-12-09

    ... examples of red flags associated with existing or potential customers are referenced in previous FinCEN... related to mortgage fraud.\\13\\ \\13\\ See Mortgage Fraud (a listing of FinCEN's mortgage fraud related..., U.S. Department of the Treasury, on ``The Financial Fraud Enforcement Task Force'', Nov. 17, 2009...

  10. 77 FR 8148 - Anti-Money Laundering Program and Suspicious Activity Report Filing Requirements for Residential...

    Science.gov (United States)

    2012-02-14

    ... incorporation or tax laws. An exception for sole proprietorships likely would perpetuate, to some degree, the... reports that the Secretary determines ``have a high degree of usefulness in criminal, tax, or regulatory... consequences that undermine the effectiveness of a comprehensive, risk-based AML and SAR program regime. Such...

  11. The study of suspicious cases to body smuggling in Loghman Hospital 1999-2000

    Directory of Open Access Journals (Sweden)

    Hoseinian Moghadam H

    2001-11-01

    Full Text Available One method of drug smuggling is body packing or body stuffing, placement of narcotics (opium, heroin, hashish, … inside intestinal tract for transfer from city to city or country to country. Estimating of the methods for transferring, content of packets, packaging, cause of death and results of diagnostic and therapeutic methods can effectively decrease the number of body packer and law execution. This study is case series by randomized sampling. Several parameters such as sex, age, marital status, addiction, job, level of education, type of opioids and their weight and number of packets, result of abdominal X-ray, surgery needs, were collected from April 1999 to December 2000. Through this period of time, 32 male smuggler who had swallowed drug packets were detained. The average age was 41 years (max=62, min=20. The minimum weight of the opium carried by this smugglers was below 20 gram and maximum weight was 1000 grams (median=360 grams. The minimum number of packets were one packet and maximum number of packets were 54 (median=10 packets. In 84 percent of body smugglers the content of packets was opium, 13 percent was heroin and 3 percent was hashish. From the cases, 81 percent of smugglers were addicts themselves. Death occurred in 7 cases from which 3 were after surgery.

  12. Life-Threatening and Suspicious Lesions Caused by Mechanical Cardiopulmonary Resuscitation

    DEFF Research Database (Denmark)

    Milling, Louise; Leth, Peter Mygind; Astrup, Birgitte Schmidt

    2017-01-01

    , between the scapulae, and in the lumbar region. Investigation of internal organs showed injuries to the lung, spleen, and kidney. The extension of the injuries gave rise to suspicion of homicide by smothering, which police investigation subsequently did not support. The pattern of injury could...

  13. 12 CFR 563.180 - Suspicious Activity Reports and other reports and statements.

    Science.gov (United States)

    2010-01-01

    ... notify its bond company and file a proof of loss under the procedures provided by its bond, concerning.... For the purposes of this paragraph (d): (i) FinCEN means the Financial Crimes Enforcement Network of...' license or social security numbers, addresses and telephone numbers, must be reported. (iii) Violations...

  14. 77 FR 552 - Proposed Collection; Comment Request; Renewal of Suspicious Activity Reporting by the Securities...

    Science.gov (United States)

    2012-01-05

    ... matters, or in the conduct of intelligence or counter-intelligence activities, to protect against... Secretary to administer the Bank Secrecy Act has been delegated to the Director of FinCEN. \\4\\ Language expanding the scope of the Bank Secrecy Act to intelligence or counter-intelligence activities to protect...

  15. 31 CFR 103.18 - Reports by banks of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... transaction has no business or apparent lawful purpose or is not the sort in which the particular customer... 17 CFR 240.17f-1. (d) Retention of records. A bank shall maintain a copy of any SAR filed and the...

  16. 31 CFR 103.21 - Reports by casinos of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... in which the particular customer would normally be expected to engage, and the casino knows of no... reported to appropriate law enforcement authorities. (d) Retention of records. A casino shall maintain a...

  17. 31 CFR 103.19 - Reports by brokers or dealers in securities of suspicious transactions.

    Science.gov (United States)

    2010-07-01

    ... purpose or is not the sort in which the particular customer would normally be expected to engage, and the... Securities and Exchange Commission under such laws. (d) Retention of records. A broker-dealer shall maintain...

  18. Usefulness of Ultrasound and Ultrasound-guided Fine-Needle Aspiration Biopsy for Axillary Staging in Breast Cancer: Analysis of 327 patients at a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Mi Jung; Kim, Sun Mi; Lyou, Chae Yeon; Kang, Eun Young; Kim, Sung Won; Park, So Yeon; Kim, Jee Hyun; Kim, Yu Jung [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Moon, Woo Kyung; Cho, Nariya [Seoul National University Hospital, Seoul (Korea, Republic of)

    2010-12-15

    Aspiration biopsy (FNAB) for the diagnosis of metastasis in the axillary lymph node (LN) of patients with breast cancer. A retrospective review of the data was performed on 327 breast cancer patients that underwent axillary US from Jun 2006 to July 2008. US guided FNAB was performed when a LN indicated suspicious findings. Results of FNAB were compared with those of subsequent surgery. Of the 327 patients, 111 showed suspicious findings on US and underwent FNAB. Among the 111 cases, 73 (66%) were positive for cancer, while 38 (34%) were negative results. A Total of 254 patients who had normal findings on US (n=216) and negative results on FNAB (n=38) underwent SNB, of which 56 (22%) were proven to have metastasis. Sensitivity and specificity of US were 61.9% and 81.8%, respectively, with a positive predictive value (PPV) of 65.8% and negative predictive value (NPV) of 79.2%. Sensitivity and specificity of US-guided FNAB were 86.9% and 100%, respectively, with a PPV of 100% and a NPV of 71.7%. US and US-guided FNAB performed for axillary staging are useful methods with a high specificity and positive predictive value in invasive breast cancer patients

  19. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES - 2016 UPDATE

    DEFF Research Database (Denmark)

    Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R

    2016-01-01

    as diagnostic cornerstones. The key issues discussed in these guidelines are as follows: (1) US-based categorization of the malignancy risk and indications for US-guided FNA (henceforth, FNA), (2) cytologic classification of FNA samples, (3) the roles of immunocytochemistry and molecular testing applied...... for relapsing, benign cystic lesions, while US-guided thermal ablation treatments may be considered for solid or mixed symptomatic benign thyroid nodules. Surgery remains the treatment of choice for malignant or suspicious nodules. The present document updates previous guidelines released in 2006 and 2010...... by the American Association of Clinical Endocrinologists (AACE), American College of Endocrinology (ACE) and Associazione Medici Endocrinologi (AME). ABBREVIATIONS: AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology AME = Associazione Medici Endocrinologi BEL = best...

  20. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    Energy Technology Data Exchange (ETDEWEB)

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Kara, Gulcan [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Center, Department of Nephrology, Adana (Turkey); Kizilkilic, Osman [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Yildirim, Tulin [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)

    2005-07-01

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein.

  1. Hematoma in Retzius' space following US-guided prostate biopsy: evidence of the diagnostic accuracy using transrectal end-fire probe in the anterior prostate gland.

    Science.gov (United States)

    Dell'atti, Lucio

    2014-03-01

    We report a rare case of hematoma in Retzius' space in a 62-year-old man who underwent transrectal prostate biopsy using an endocavitary, end-fire, convex probe. Clinical symptoms resolved spontaneously after catheter placement and appropriate antibiotic therapy. Transrectal ultrasound 1 month later showed partial resolution of the hematoma. Based on the analysis of this unusual complication, we demonstrate the effectiveness of transrectal biopsy as compared to transperineal biopsy in detecting cancer of the anterior prostate. We have also analyzed the various factors that may be the reason why core biopsy harvested in this "hidden" area may be inadequate.

  2. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    National Research Council Canada - National Science Library

    Dobrosavljević, Aleksandar; Rakić, Snezana; Nikoli, Branka; Raznatović, Svetlana Janković; Dikić, Svetlana Dragojević; Milosević, Zorica; Jurisić, Aleksandar; Skrobić, Milica

    2016-01-01

    Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant...

  3. Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

    Directory of Open Access Journals (Sweden)

    Dobrosavljević Aleksandar

    2016-01-01

    Full Text Available Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%, fibroadenoma (26.7%, fibrocystic dysplasia with/without atypia (10%, lipoma (3.3% and intramammary lymph node (3.3%. Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05. All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05. Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C and BI-RADS 5 lesions should be worked-up with biopsy.

  4. Evaluation of the MoleMateTM training program for assessment of suspicious pigmented lesions in primary care

    Directory of Open Access Journals (Sweden)

    Annabel Wood

    2008-05-01

    Conclusion The MoleMateTM training program is a potentially effective and acceptable informatics tool to teach practitioners to recognise the features of SPLs identified by the MoleMateTM system. It will be used as part of the intervention in a randomised controlled trial to compare the diagnostic accuracy and appropriate referral rates of practitioners using the MoleMateTM system with best practice in primary care.

  5. Light microscopy can reveal the consumption of a mixture of psychotropic plant and fungal material in suspicious death.

    Science.gov (United States)

    Wiltshire, Patricia E J; Hawksworth, David L; Edwards, Kevin J

    2015-08-01

    Light microscopical examination of plant and fungal remains in the post mortem gut may be capable of demonstrating the ingestion of unexpected natural psychotropic materials. This is demonstrated here in a case in which a 'shaman' was accused of causing the death of a young man. The deceased had participated in a ceremony which involved the drinking of ayahuasca in order to induce a psychotropic experience. Ayahuasca is an infusion of Banisteriopsis caapi (ayahuasca vine), which produces a monoamine oxidase inhibitor, and one or more additional tropical plants, generally Psychotria viridis (chacruna) which produces dimethyltryptamine (DMT). The monoamine oxidase inhibitor prevents DMT from being broken down in the gut, so enabling its passage into the bloodstream and across the blood/brain barrier. Toxicological tests for DMT demonstrated the presence of this compound in the body. The deceased was reported to be in the habit of using Psilocybe semilanceata (liberty cap). This fungus (popularly called magic mushroom) contains psilocybin which is hydrolysed in the gut to psilocin; this compound mimics a serotonin uptake inhibitor, and also invokes psychotropic experiences. Microscopical examination established that the ileum and colon contained spores of Psilocybe and, in addition, pollen of Cannabis sativa and seeds of Papaver cf. somniferum (opium poppy). Both the plant species yield psychotropic substances. Palynological and mycological analysis of containers from the deceased person's dwelling also yielded abundant trace evidence of pertinent pollen and spores. The police had requested analysis for DMT but there was no screening for other psychotropic substances. Investigators were surprised that a mixture of hallucinogenic materials had been consumed by the deceased. The charge was modified from manslaughter to possession of a 'Class A' drug as the deceased had been consuming psychotropic substances not administered by the 'shaman'. Where death involving drugs from plants or fungi is suspected, microscopical examination of samples from the gut can provide a rapid and effective method for assessing, in a temporal context, the presence of ingested materials that may not have been previously suspected. The example presented here also demonstrates the need for caution in interpreting toxicological results where screening for unusual compounds has been limited. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  6. Predictive value of biopsy specimens suspicious for melanoma: support for 6-mm criterion in the ABCD rule.

    Science.gov (United States)

    Soltani-Arabshahi, Razieh; Sweeney, Carol; Jones, Benjamin; Florell, Scott R; Hu, Nan; Grossman, Douglas

    2015-03-01

    Clinical detection of melanoma can be challenging. The number of biopsy specimens performed to diagnose 1 melanoma is a measure of efficiency of skin cancer detection, but few data are available to describe this measure from US health care. We studied the diagnosis of melanoma among biopsy specimens of clinically concerning pigmented lesions at an academic dermatology department. We searched for all biopsy specimens that were performed because of clinical suspicion of melanoma in 2013. Characteristics of the patient, lesion, and clinician performing the biopsy, and the final pathology diagnosis were recorded. A total of 2643 biopsy specimens from 2213 patients submitted by 43 providers were included. Melanoma was diagnosed in 165 cases (positive predictive value 6.4%, 95% confidence interval 5.5%-7.4%). Older age (P < .001), male gender (P = .045), and nontrunk location (P < .001) were predictors of higher probability of melanoma detection. Lesions larger than 6 mm in size had higher positive predictive value 11.5% (8.8%-14.1%) than smaller lesions 2.6% (1.6%-3.6%). Factors influencing the decision to biopsy a lesion may be difficult to evaluate retrospectively. At an academic medical center, 16 clinically concerning lesions were biopsied to diagnose 1 melanoma. Biopsy specimens of clinically concerning pigmented lesions larger than 6 mm on older men had the highest yield. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  7. 99mTc MIBI prone scintimammography in patients with suspicious breast cancer: relationship with mammography and tumor size.

    Science.gov (United States)

    Scopinaro, F; Mezi, S; Ierardi, M; De Vincentis, G; Tiberio, N S; David, V; Maggi, S; Sallusti, E; Modesti, M

    1998-03-01

    99mTc MIBI prone scintimammography (PSM) is reported to be a specific examination in order to assess the nature of breast lesions. Fifty-three patients whose mammography was stratified according to the breast imaging reporting and data system (BI-RADS), the five category classification of mammography approved by the American college of radiology, were studied with prone scintimammography, with the aim of assessing the accuracy of this exam and its usefulness in clinical practice. Thirty-five out of forty-one patients with BI-RADS category V (high probability of cancer) showed cancer at histology. Thirty-one of them had positive PSM. Three out of the six patients with mammo-graphic features of category IV indicated malignancy. PSM was positive in all of them and negative in the three benign lesions. One of the five patients with category III mammography showed cancer and positive PSM. The PSM was negative in 12/13 patients with benign patology (specificity 92.3%). When the cancers were stratified for T-category significant differences were found between the sensitivity for tumors larger or smaller than 1 cm. The sensitivity was 50% for the cancers smaller than 1 cm and 96.9% for those larger than 1 cm. PSM is a very specific method to determine the nature of breast lesions. Its sensitivity is also high but has to be improved when tumors smaller than 1 cm have to be detected. From a clinical point of view PSM can at the moment be considered as an accurate method for the study of borderline lesions of IV and also of III BI-RADS category. In this case a positive PSM indicates an impact in clinical decision making.

  8. Fast Screening Technology for Drug Emergency Management: Predicting Suspicious SNPs for ADR with Information Theory-based Models.

    Science.gov (United States)

    Liang, Zhaohui; Liu, Jun; Huang, Jimmy Xiangji; Zeng, Xing

    2018-01-14

    The genetic polymorphism of Cytochrome P450 (CYP 450) is considered as one of the main causes for adverse drug reactions (ADRs). In order to explore the latent correlations between ADRs and potentially corresponding single-nucleotide polymorphism (SNPs) in CYP450, three algorithms based on information theory are used as the main method to predict the possible relation. The study uses a retrospective case-control study to explore the potential relation of ADRs to specific genomic locations and single-nucleotide polymorphism (SNP). The genomic data collected from 53 healthy volunteers are applied for the analysis, another group of genomic data collected from 30 healthy volunteers excluded from the study are used as the control group. The SNPs respective on five loci of CYP2D6*2,*10,*14 and CYP1A2*1C, *1F are detected by the Applied Biosystem 3130xl. The raw data is processed by ChromasPro to detected the specific alleles on the above loci from each sample. The secondary data are reorganized and processed by R combined with the reports of ADRs from clinical reports. Three information theory based algorithms are implemented for the screening task: JMI, CMIM, and mRMR. If a SNP is selected by more than two algorithms, we are confident to conclude that it is related to the corresponding ADR. The selection results are compared with the control decision tree + LASSO regression model. In the study group where ADRs occur, 10 SNPs are considered relevant to the occurrence of a specific ADR by the combined information theory model. In comparison, only 5 SNPs are considered relevant to a specific ADR by the decision tree + LASSO regression model. In addition, the new method detects more relevant pairs of SNP and ADR which are affected both by SNP and dosage. This implies that the new information theory based model is effective to discover correlations of ADRs and CYP 450 SNPs and is helpful to predict the potential vulnerable genotype for some ADRs. The newly proposed information theory based model has superiority performance in detecting the relation between SNP and ADR compared to the decision tree + LASSO regression model. The new model is more sensitive to detect ADRs compared to the old method, while the old method is more reliable. Therefore, the selection criteria for selecting algorithms should depend on the pragmatic needs. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Day surgery and recovery in women with a suspicious breast lesion: evaluation of a psychoeducational nursing intervention.

    Science.gov (United States)

    Allard, Nicole

    2006-01-01

    The study assessed whether a nursing intervention based on self-regulation theory, the Attentional Focus and Symptom Management Intervention (AFSMI), could help women who underwent day surgery for breast cancer to achieve better pain management and decreased emotional distress. The sample consisted of 117 patients with breast cancer who were outpatients and undergoing surgery as part of the initial treatment for their cancer. All subjects were interviewed at three different occasions. The subjects were randomized into the experimental group (n = 61) or the usual care group (control, n = 56). The subjects in the experimental group received the intervention in two sessions, 3-4 days and 10-11 days after surgery. The outcomes were the subjects' pain and emotional distress. Results showed significant differences between the experimental and control group at post-test on home management, total mood disturbance, confusion and tension scores implying that the intervention was effective in achieving these outcomes. Clinical significance has illustrated that a nursing intervention applied during immediate recovery of breast cancer surgery is quite clinically relevant to reduce emotional distress. Self-regulation theory could effectively be used as a guide in developing nursing intervention programs in practice for patients with cancer undergoing day surgery as a primary treatment.

  10. 31 CFR 103.17 - Reports by futures commission merchants and introducing brokers in commodities of suspicious...

    Science.gov (United States)

    2010-07-01

    ... purpose or is not the sort in which the particular customer would normally be expected to engage, and the... for the purposes of this paragraph (c)(2). (d) Retention of records. An FCM or IB-C shall maintain a...

  11. An analysis of of the ultrasound findings of false negative cases for an initial ultrasound-guided fine needle aspiration biopsy (FNAB)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jee Young; Jung, So Lyung; Kim, Bum Soo; Ahn, Kook Jin; Hahn, Seong Tae [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-09-15

    To analyze the ultrasonographic (US) findings of thyroid nodules that yielded false negative results after an initial ultrasound-guided fine needle aspiration biopsy (FNAB). Between August 2003 and February 2006, 389 patients with 405 thyroid nodules received a repeat US-guided FNAB. We retrospectively reviewed the US findings, cytology results and postsurgical pathological results. The cytology diagnoses were classified as benign, a suspicious malignancy, a follicular neoplasm, a papillary carcinoma, and a non-diagnostic result. The US findings of the thyroid nodules were analyzed with regard to size, internal content, shape, margin, echogenecity, and calcification pattern. Of the 405 thyroid nodules, 17 nodules were false negative. The major US findings of these nodules were a solid internal component in 16 nodules, hypoechogenicity or marked hypoechogenicity in 14 nodules, microcalcifications in 12 nodules, an ovoid to round shape in 9 nodules and a well-defined smooth margin in 9 nodules. An repeat US-guided FNAB should be performed if the thyroid nodules have one of the malignant US features such as hypoechogenecity or marked hypoechogenecity, a microcalcification, a taller than wide shape or a well-defined spiculate margin although the cytology results indicated a benign lesion. In addition, thyroid nodules with findings of a well-defined smooth margin, ovoid to round shape, and solid internal component might also be subject to a repeat US-guided FNAB to exclude a malignancy.

  12. Target volume definition in high-risk prostate cancer patients using sentinel node SPECT/CT and 18 F-choline PET/CT

    Directory of Open Access Journals (Sweden)

    Vees Hansjörg

    2012-08-01

    Full Text Available Abstract Background To assess the influence of sentinel lymph nodes (SNs SPECT/CT and 18 F-choline (18 F-FCH PET/CT in radiotherapy (RT treatment planning for prostate cancer patients with a high-risk for lymph node (LN involvement. Methods Twenty high-risk prostate cancer patients underwent a pelvic SPECT acquisition following a transrectal ultrasound guided injection of 99mTc-Nanocoll into the prostate. In all patients but one an 18 F-FCH PET/CT for RT treatment planning was performed. SPECT studies were coregistered with the respective abdominal CTs. Pelvic SNs localized on SPECT/CT and LN metastases detected by 18 F-FCH PET/CT were compared to standard pelvic clinical target volumes (CTV. Results A total of 104 pelvic SNs were identified on SPECT/CT (mean 5.2 SNs/patient; range 1–10. Twenty-seven SNs were located outside the standard pelvic CTV, 17 in the proximal common iliac and retroperitoneal regions above S1, 9 in the pararectal fat and 1 in the inguinal region. SPECT/CT succeeded to optimize the definition of the CTV and treatment plans in 6/20 patients due to the presence of pararectal SNs located outside the standard treatment volume. 18 F-FCH PET/CT identified abnormal tracer uptake in the iliac LN region in 2/19 patients. These abnormal LNs were negative on SPECT/CT suggesting a potential blockade of lymphatic drainage by metastatic LNs with a high tumour burden. Conclusions Multimodality imaging which combines SPECT/CT prostate lymphoscintigraphy and 18 F-FCH PET/CT identified SNs outside standard pelvic CTVs or highly suspicious pelvic LNs in 40% of high-risk prostate cancer patients, highlighting the potential impact of this approach in RT treatment planning.

  13. The InKiIsSy experiment at LNS: A study of size vs. isospin effects with 124Xe + 64Zn , 64Ni reactions at 35 A MeV

    Science.gov (United States)

    Norella, S.; Acosta, L.; Auditore, L.; Baran, V.; Cap, T.; Cardella, G.; Colonna, M.; De Filippo, E.; Dell'Aquila, D.; De Luca, S.; Francalanza, L.; Gnoffo, B.; Lanzalone, G.; Lombardo, I.; Maiolino, C.; Martorana, N. S.; Minniti, T.; Pagano, A.; Pagano, E. V.; Papa, M.; Piasecki, E.; Pirrone, S.; Politi, G.; Porto, F.; Quattrocchi, L.; Rizzo, F.; Rosato, E.; Russotto, P.; Siwek-Wilczynska, K.; Trifirò, A.; Trimarchi, M.; Verde, G.; Vigilante, M.; Wilczyński, J.

    2017-11-01

    In previous experiments, performed by CHIMERA Collaboration, a strong difference in the cross sections of "dynamical" PLF binary decay between neutron-poor 112Sn (35 A MeV)+ 58Ni and neutron-rich 124Sn (35 A MeV)+ 64Ni colliding systems has been reported. The same effect was not seen in the "statistical" binary decay. The observed difference was related to the different N/ Z content between the two systems. However, size effects could not be excluded. In order to disentangle Isospin effects from size ones, the systems 124Xe (35 A MeV)+ 64Zn ( 64Ni were studied in the InKiIsSy (Inverse Kinematic Isobaric Systems) experiment, carried out at Laboratori Nazionali del Sud on April 2013, using the multi-detector CHIMERA and 4 prototype-modules of FARCOS array. We will report preliminary results on the binary PLF splitting mechanism.

  14. Likelihood of malignancy in thyroid nodules according to a proposed Thyroid Imaging Reporting and Data System (TI-RADS) classification merging suspicious and benign ultrasound features.

    Science.gov (United States)

    Delfim, Ricardo Luiz Costantin; Veiga, Leticia Carrasco Garcez da; Vidal, Ana Paula Aguiar; Lopes, Flávia Paiva Proença Lobo; Vaisman, Mário; Teixeira, Patrícia de Fatima Dos Santos

    2017-01-01

    The aim of this study was to describe the ultrasound features of benign and malignant thyroid nodules and evaluate the likelihood of malignancy associated with each feature according to the Bethesda System for Reporting Thyroid Cytopathology and histopathology. With this analysis, we propose a new TI-RADS classification system. The likelihood of malignancy from ultrasound features were assessed in 1413 thyroid nodules according to the Bethesda System for Reporting Thyroid Cytopathology and histopathological findings. A score was established by attributing different weights to each ultrasound feature evaluated. Features positively associated with malignancy in bivariate analysis received a score weight of +1. We attributed a weight of +2 to features which were independently associated with malignancy in a multivariate analysis and +3 for those associated with the highest odds ratio for malignancy (> 10.0). Hence, hypoechogenicity (graded as mild, moderate or marked, according to a comparison with the overlying strap muscle), microcalcification and irregular/microlobulated margin received the highest weights in our scoring system. Features that were negatively associated with malignancy received weights of -2 or -1. In the proposed system a cutoff score of 2 (sensitivity 97.4% and specificity 51.6%) was adopted as a transition between probably benign (TI-RADS 3) and TI-RADS 4a nodules. Overall, the frequency of malignancy in thyroid nodules according to the categories was 1.0% for TI-RADS 3, 7.8% for TI-RADS 4a, 35.3% for TI-RADS 4b, and 84.7% for TI-RADS 5. A newly proposed TI-RADS classification adequately assessed the likelihood of malignancy in thyroid nodules.

  15. Comprehensive laboratory evaluation of a highly specific lateral flow assay for the presumptive identification of ricin in suspicious white powders and environmental samples

    Science.gov (United States)

    Ricin, a heterodimeric toxin that is present in the seeds of the Ricinus communis plant, is the most frequently encountered biothreat agent by law enforcement agencies in the United States. Even in untrained hands, the easily obtainable seeds can yield a highly toxic product that has been used in v...

  16. Technical note: Evaluation of the uncertainties in (choline+creatine)/citrate ratios measured by proton MR spectroscopic imaging in patients suspicious for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zbyn, S.; Krssak, M.; Memarsadeghi, M.; Gholami, B.; Haitel, A.; Weber, M.; Helbich, T.H.; Trattnig, S.; Moser, E.; Gruber, S.

    2014-07-15

    The presented evaluation of the relative uncertainty (δ'CCC) of the (choline + creatine)/citrate (CC/C) ratios can provide objective information about the quality and diagnostic value of prostate MR spectroscopic imaging data. This information can be combined with the numeric values of CC/C ratios and provides metabolic-quality maps enabling accurate cancer detection and user-independent data evaluation. In addition, the prostate areas suffering most from the low precision of CC/C ratios (e. g., prostate base) were identified.

  17. Assessment of Feasibility to Use Computer Aided Texture Analysis Based Tool for Parametric Images of Suspicious Lesions in DCE-MR Mammography

    Directory of Open Access Journals (Sweden)

    Mehmet Cemil Kale

    2013-01-01

    Full Text Available Our aim was to analyze the feasibility of computer aided malignant tumor detection using the traditional texture analysis applied on two-compartment-based parameter pseudoimages of dynamic contrast-enhanced magnetic resonance (DCE-MR breast image data. A major contribution of this research will be the through-plane assessment capability. Texture analysis was performed on two-compartment-based pseudo images of DCE-MRI datasets of breast data of eight subjects. The resulting texture parameter pseudo images were inputted to a feedforward neural network classification system which uses the manual segmentations of a primary radiologist as a gold standard, and each voxel was assigned as malignant or nonmalignant. The classification results were compared with the lesions manually segmented by a second radiologist. Results show that the mean true positive fraction (TPF and false positive fraction (FPF performance of the classifier vs. primary radiologist is statistically as good as the mean TPF and FPF performance of the second radiologist vs. primary radiologist with a confidence interval of 95% using a one-sample -test with . In the experiment implemented on all of the eight subjects, all malignant tumors marked by the primary radiologist were classified to be malignant by the computer classifier. Our results have shown that neural network classification using the textural parameters for automated screening of two-compartment-based parameter pseudo images of DCE-MRI as input data can be a supportive tool for the radiologists in the preassessment stage to show the possible cancerous regions and in the postassessment stage to review the segmentations especially in analyzing complex DCE-MRI cases.

  18. The Use of Social Media Networks and Mobile Phone Applications for Reporting Suspicious and Criminal Activities to Mass Transit Law Enforcement Agencies

    Science.gov (United States)

    2013-12-01

    success in fighting crime by implementing social media and smartphone applications. Social Media networks such as Facebook , Twitter, YouTube, Instagram ...technologies are a first in measurments of success in terms of effectiveness. The number of Facebook “Likes” and “Followers” on Twitter and Instagram are...54 E . SANTA CLARA VALLEY TRANSPORTATION AUTHORITY ...........55 F. NIAGARA FRONTIER TRANSPORTATION

  19. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta

    2015-01-01

    in all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (p Gleason score....... MATERIAL AND METHODS: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI...... upgrade of at least one grade based on the mp-MRI-bx. Secondary PCa lesions not visible on mp-MRI were detected by TRUS-bx in six out of 39 PCa patients. The secondary foci were all Gleason 6 (3 + 3) in 5-10% of the biopsy core. According to the Epstein criteria, 37 out of 39 cancer patients were...

  20. Non-Bayesian noun generalization in 3- to 5-year-old children: Probing the role of prior knowledge in the suspicious coincidence effect

    Science.gov (United States)

    Jenkins, Gavin W.; Samuelson, Larissa K.; Smith, Jodi R.; Spencer, John P.

    2014-01-01

    It is unclear how children learn labels for multiple overlapping categories such as “Labrador,” “dog,” and “animal.” Xu and Tenenbaum (2007a) suggested that learners infer correct meanings with the help of Bayesian inference. They instantiated these claims in a Bayesian model, which they tested with preschoolers and adults. Here, we report data testing a developmental prediction of the Bayesian model—that more knowledge should lead to narrower category inferences when presented with multiple subordinate examples. Two experiments did not support this prediction. Children with more category knowledge showed broader generalization when presented with multiple subordinate examples, compared to less knowledgeable children and adults. This implies a U-shaped developmental trend. The Bayesian model was not able to account for these data, even with inputs that reflected the similarity judgments of children. We discuss implications for the Bayesian model including a combined Bayesian/morphological knowledge account that could explain the demonstrated U-shaped trend. PMID:24961497

  1. Non-Bayesian Noun Generalization in 3-to 5-Year-Old Children: Probing the Role of Prior Knowledge in the Suspicious Coincidence Effect

    Science.gov (United States)

    Jenkins, Gavin W.; Samuelson, Larissa K.; Smith, Jodi R.; Spencer, John P.

    2015-01-01

    It is unclear how children learn labels for multiple overlapping categories such as "Labrador," "dog," and "animal." Xu and Tenenbaum (2007a) suggested that learners infer correct meanings with the help of Bayesian inference. They instantiated these claims in a Bayesian model, which they tested with preschoolers and…

  2. The B-mode Sonography and Sonoelastographic Features of Sclerosing Adenosis of the Breast

    Energy Technology Data Exchange (ETDEWEB)

    Myong, Joo Hwa; Kim, Sung Hun; Kang, Bong Joo; Ahn, Young I; Yoon, Soo Kyoung; Lee, A Won; Yim, Kwang Il; Kim, Tae Eun; Song, Byung Joo [Seoul St. Mary' s Hospital, The Catholic University, Seoul (Korea, Republic of)

    2011-06-15

    The purpose of this study was to evaluate the B-mode sonographic and sonoelastographic features of high risk lesions of the breast. From April 2009 to February 2010, 1390 patients with breast lesions underwent US-guided core-biopsy. Among them, 13 lesions were confirmed to be pure sclerosing adenosis by subsequent surgical excision or on imaging follow-up of more than 1 year. Two radiologists retrospectively analyzed the B-mode sonography according to the Breast Imaging Reporting and Data System classification. The sonoelastographic images were classified into 5 elasticity scores according to the Itoh classification and the strain ratio between the mass and the surrounding fat tissue was reviewed. We considered the sonoelastographic patterns to be suspicious for the case with a score of 4 and 5 and a strain ratio of more than a 2.24. The common B-mode sonographic features of sclerosing adenosis were an irregular shape (69.2%, 9 of 13), an indistinct margin (92.3%, 12 of 13), hypoechogenicity (76.9%, 10 of 13) and category 4A, a low suspicion of malignancy (61.5%, 8 of 13). The common sonoelastographic features were a score of 2 (42%, 6 of 13) and a strain ratio < 2.24 (69.2%, 9 of 13). Sclerosing adenosis showed suspicious B-mode sonographic findings, but it had benign sonolastographic features

  3. Comparison of hybrid {sup 68}Ga-PSMA PET/MRI and {sup 68}Ga-PSMA PET/CT in the evaluation of lymph node and bone metastases of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freitag, Martin T.; Roethke, Matthias; Schlemmer, Heinz-Peter [German Cancer Research Center, Department of Radiology, Heidelberg (Germany); Radtke, Jan P. [German Cancer Research Center, Department of Radiology, Heidelberg (Germany); University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Hadaschik, Boris A. [University Hospital Heidelberg, Department of Urology, Heidelberg (Germany); Kopp-Schneider, A. [German Cancer Research Center, Department of Bioinformatics and Statistics, Heidelberg (Germany); Eder, Matthias; Kopka, Klaus [German Cancer Research Center, Division of Radiopharmaceutical Chemistry, Heidelberg (Germany); Haberkorn, Uwe [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany); German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Afshar-Oromieh, Ali [University Hospital Heidelberg, Department of Nuclear Medicine, Heidelberg (Germany)

    2016-01-15

    To evaluate the reproducibility of the combination of hybrid PET/MRI and the {sup 68}Ga-PSMA-11 tracer in depicting lymph node (LN) and bone metastases of prostate cancer (PC) in comparison with that of PET/CT. A retrospective analysis of 26 patients who were subjected to {sup 68}Ga-PSMA PET/CT{sub low-dose} (1 h after injection) followed by PET/MRI (3 h after injection) was performed. MRI sequences included T1-w native, T1-w contrast-enhanced, T2-w fat-saturated and diffusion-weighted sequences (DWI{sub b800}). Discordant PET-positive and morphological findings were evaluated. Standardized uptake values (SUV) of PET-positive LNs and bone lesions were quantified and their morphological size and conspicuity determined. Comparing the PET components, the proportion of discordant PSMA-positive suspicious findings was very low (98.5 % of 64 LNs concordant, 100 % of 28 bone lesions concordant). Two PET-positive bone metastases could not be confirmed morphologically using CT{sub low-dose}, but could be confirmed using MRI. In 12 of 20 patients, 47 PET-positive LNs (71.9 %) were smaller than 1 cm in short axis diameter. There were significant linear correlations between PET/MRI SUVs and PET/CT SUVs in the 64 LN metastases (p < 0.0001) and in the 28 osseous metastases (p < 0.0001) for SUV{sub mean} and SUV{sub max}, respectively. The LN SUVs were significantly higher on PET/MRI than on PET/CT (p{sub SUVmax} < 0.0001; p{sub SUVmean} < 0.0001) but there was no significant difference between the bone lesion SUVs (p{sub SUVmax} = 0.495; p{sub SUVmean} = 0.381). Visibility of LNs was significantly higher on MRI using the T1-w contrast-enhanced fat-saturated sequence (p = 0.013), the T2-w fat-saturated sequence (p < 0.0001) and the DWI sequence (p < 0.0001) compared with CT{sub low-dose}. For bone lesions, only the overall conspicuity was higher on MRI compared with CT{sub low-dose} (p < 0.006). Nodal and osseous metastases of PC are accurately and reliably depicted by hybrid PET

  4. Is Visual Registration Equivalent to Semiautomated Registration in Prostate Biopsy?

    Directory of Open Access Journals (Sweden)

    Jin Tae Kwak

    2015-01-01

    Full Text Available In magnetic resonance iimaging- (MRI- ultrasound (US guided biopsy, suspicious lesions are identified on MRI, registered on US, and targeted during biopsy. The registration can be performed either by a human operator (visual registration or by fusion software. Previous studies showed that software registration is fairly accurate in locating suspicious lesions and helps to improve the cancer detection rate. Here, the performance of visual registration was examined for ability to locate suspicious lesions defined on MRI. This study consists of 45 patients. Two operators with differing levels of experience (<1 and 18 years performed visual registration. The overall spatial difference by the two operators in 72 measurements was 10.6 ± 6.0 mm. Each operator showed a spatial difference of 9.4 ± 5.1 mm (experienced; 39 lesions and 12.1 ± 6.6 mm (inexperienced; 33 lesions, respectively. In a head-to-head comparison of the same 16 lesions from 12 patients, the spatial differences were 9.7 mm ± 4.9 mm (experienced and 13.4 mm ± 7.4 mm (inexperienced. There were significant differences between the two operators (unpaired, P value = 0.042; paired, P value = 0.044. The substantial differences by the two operators suggest that visual registration could improperly and inaccurately target many tumors, thereby potentially leading to missed diagnosis or false characterization on pathology.

  5. Second-look US examination of MR-detected breast lesions.

    Science.gov (United States)

    Candelaria, Rosalind; Fornage, Bruno D

    2011-01-01

    To review our institutional experience in using second-look ultrasound (SLUS) to identify breast lesions initially detected on MR imaging that were indeterminate or suspicious for malignancy. This Health Insurance Portability and Accountability Act compliant retrospective review included 83 women with 131 lesions initially identified as indeterminate or suspicious for malignancy on MR imaging from February 1, 2008 through July 31, 2009. An SLUS correlate was confirmed on the basis of concordant location, size, and morphologic features. The detection rate of SLUS was determined. Patients' demographics, lesion size, and MR imaging morphologic features (focus, mass, non-masslike) were reviewed to identify which factors led to successful detection on SLUS. Likelihood ratio χ(2) tests were used for statistical analysis. SLUS correlates were found for 88 of 131 (67%) lesions initially detected on MR imaging; 27 of 88 (31%) were malignant. SLUS detected foci (67%) and masses (73%) more frequently than it did non-masslike lesions (54%). The detection rate of SLUS was independent of lesion size on MR imaging. Malignant lesions were not more likely than benign lesions to be detected on SLUS (61% versus 70%). SLUS provides value in the clinical workup of breast lesions that are indeterminate or suspicious for malignancy. It identified two thirds of the MR-detected lesions evaluated and permitted performance of US-guided needle biopsy on 70 of 88lesions. The likelihood of finding MR-detected lesions on SLUS was significantly higher for foci and masses than for non-masslike lesions (P < 0.05). Copyright © 2010 Wiley Periodicals, Inc.

  6. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Energy Technology Data Exchange (ETDEWEB)

    Eun, Na Lae; Chang, Hang Seok; Gweon, Hye Mi; Kim, Jeong Ah; Youk, Ji Hyun; Son, Eun Jun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoo, Mi Ri [Dept. of Radiology, Dongjak Kyunghee Hospital, Seoul (Korea, Republic of); Park, Ah Young [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Moon, Hee Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

  7. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ASSOCIAZIONE MEDICI ENDOCRINOLOGI MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE DIAGNOSIS AND MANAGEMENT OF THYROID NODULES--2016 UPDATE.

    Science.gov (United States)

    Gharib, Hossein; Papini, Enrico; Garber, Jeffrey R; Duick, Daniel S; Harrell, R Mack; Hegedüs, Laszlo; Paschke, Ralf; Valcavi, Roberto; Vitti, Paolo

    2016-05-01

    Thyroid nodules are detected in up to 50 to 60% of healthy subjects. Most nodules do not cause clinically significant symptoms, and as a result, the main challenge in their management is to rule out malignancy, with ultrasonography (US) and fine-needle aspiration (FNA) biopsy serving as diagnostic cornerstones. The key issues discussed in these guidelines are as follows: (1) US-based categorization of the malignancy risk and indications for US-guided FNA (henceforth, FNA), (2) cytologic classification of FNA samples, (3) the roles of immunocytochemistry and molecular testing applied to thyroid FNA, (4) therapeutic options, and (5) follow-up strategy. Thyroid nodule management during pregnancy and in children are also addressed. On the basis of US features, thyroid nodules may be categorized into 3 groups: low-, intermediate-and high-malignancy risk. FNA should be considered for nodules ≤10 mm diameter only when suspicious US signs are present, while nodules ≤5 mm should be monitored rather than biopsied. A classification scheme of 5 categories (nondiagnostic, benign, indeterminate, suspicious for malignancy, or malignant) is recommended for the cytologic report. Indeterminate lesions are further subdivided into 2 subclasses to more accurately stratify the risk of malignancy. At present, no single cytochemical or genetic marker can definitely rule out malignancy in indeterminate nodules. Nevertheless, these tools should be considered together with clinical data, US signs, elastographic pattern, or results of other imaging techniques to improve the management of these lesions. Most thyroid nodules do not require any treatment, and levothyroxine (LT4) suppressive therapy is not recommended. Percutaneous ethanol injection (PEI) should be the first-line treatment option for relapsing, benign cystic lesions, while US-guided thermal ablation treatments may be considered for solid or mixed symptomatic benign thyroid nodules. Surgery remains the treatment of choice for

  8. The role of 18F-FDG PET/CT in the detection of osteosarcoma recurrence.

    Science.gov (United States)

    Angelini, Andrea; Ceci, Francesco; Castellucci, Paolo; Graziani, Tiziano; Polverari, Giulia; Trovarelli, Giulia; Palmerini, Emanuela; Ferrari, Stefano; Fanti, Stefano; Ruggieri, Pietro

    2017-09-01

    The aim of this study was to investigate the diagnostic accuracy of 18F-FDG-PET/CT in osteosarcoma patients suspicious for disease recurrence after adequate surgical therapy. Inclusion criteria were: a) adequate surgical treatment for proven osteosarcoma and documented complete remission after therapy; b) 18F-FDG-PET/CT performed during follow-up for clinical/diagnostic suspicion of relapse; c) new surgical treatment with excision of the suspected lesions; d) histological validation of 18F-FDG-PET/CT findings. Thirty-seven patients matching all inclusion criteria were retrospectively enrolled (20 men and 17 female). Primary surgical treatment consists of resection (31 cases) or amputation (six cases). 18F-FDG-PET/CT performance was assessed with a per-patient and per-site evaluation of sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV). The sites of relapse were classified as local, lung, lymphnodes (LNs), and distant (other skeletal segments and/or distant soft tissue). The disease-free survival (DFS) and the overall survival (OS) after 18F-FDG PET/CT were evaluated. 18F-FDG-PET/CT was positive in 89.2% (33/37) of patients. Local uptake only was observed in 35.1% patients (13/37); lung uptake only in 18.9% (7/37); distant uptake only in 2.7% (1/37) case; multiple sites of uptake in 32.4% (12/37). Histology resulted positive in 92% (34/37) of patients. A total of 51 pathologic lesions were evaluated (22 local relapse, 11 lung metastasis, 10 metastatic LNs, eight distant metastatic lesions). On a per-patient analysis 18F-FDG-PET/CT showed a sensitivity, specificity, accuracy, PPV, and NPV of 91%, 75%, 89%, 97%, 50%. On a per-site analysis the performance for local relapse was 96%, 100%, 97%, 100%, 93%, while for lung relapse detection was 80%, 100%, 92%, 100%, 88%. The mean follow-up after 18F-FDG-PET/CT was 21.5 months. At the last follow-up, 19% (7/37) of patients were death with disease, 38% (14/37) were alive

  9. The role of {sup 18}F-FDG PET/CT in the detection of osteosarcoma recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Angelini, Andrea; Trovarelli, Giulia; Ruggieri, Pietro [University of Padova, Department of Orthopedics and Orthopedic Oncology, Padova (Italy); Ceci, Francesco; Castellucci, Paolo; Graziani, Tiziano; Polverari, Giulia; Fanti, Stefano [University of Bologna, Service of Nuclear Medicine, S.Orsola-Malpighi Hospital, Bologna (Italy); Palmerini, Emanuela; Ferrari, Stefano [Istituto Ortopedico Rizzoli, Department of Chemotherapy, Bologna (Italy)

    2017-09-15

    The aim of this study was to investigate the diagnostic accuracy of {sup 18}F-FDG-PET/CT in osteosarcoma patients suspicious for disease recurrence after adequate surgical therapy. Inclusion criteria were: a) adequate surgical treatment for proven osteosarcoma and documented complete remission after therapy; b) {sup 18}F-FDG-PET/CT performed during follow-up for clinical/diagnostic suspicion of relapse; c) new surgical treatment with excision of the suspected lesions; d) histological validation of {sup 18}F-FDG-PET/CT findings. Thirty-seven patients matching all inclusion criteria were retrospectively enrolled (20 men and 17 female). Primary surgical treatment consists of resection (31 cases) or amputation (six cases). {sup 18}F-FDG-PET/CT performance was assessed with a per-patient and per-site evaluation of sensitivity, specificity, accuracy, positive predicting value (PPV), and negative predicting value (NPV). The sites of relapse were classified as local, lung, lymphnodes (LNs), and distant (other skeletal segments and/or distant soft tissue). The disease-free survival (DFS) and the overall survival (OS) after 18F-FDG PET/CT were evaluated. {sup 18}F-FDG-PET/CT was positive in 89.2% (33/37) of patients. Local uptake only was observed in 35.1% patients (13/37); lung uptake only in 18.9% (7/37); distant uptake only in 2.7% (1/37) case; multiple sites of uptake in 32.4% (12/37). Histology resulted positive in 92% (34/37) of patients. A total of 51 pathologic lesions were evaluated (22 local relapse, 11 lung metastasis, 10 metastatic LNs, eight distant metastatic lesions). On a per-patient analysis {sup 18}F-FDG-PET/CT showed a sensitivity, specificity, accuracy, PPV, and NPV of 91%, 75%, 89%, 97%, 50%. On a per-site analysis the performance for local relapse was 96%, 100%, 97%, 100%, 93%, while for lung relapse detection was 80%, 100%, 92%, 100%, 88%. The mean follow-up after {sup 18}F-FDG-PET/CT was 21.5 months. At the last follow-up, 19% (7/37) of patients were

  10. Muon identification and pion rejection in the 4th concept

    Indian Academy of Sciences (India)

    ] Alexander Mikhailichenko has described a similar iron-free magnetic field system in his internal notes 'Do detectors need a yoke', Cornell LNS, CBN 01-20, 6 October 2001; and, 'Detectors for linear collider', Cornell LNS, 8 March 2002.

  11. Lipid-based nanosystem of edaravone: development, optimization, characterization and in vitro/in vivo evaluation.

    Science.gov (United States)

    Parikh, Ankit; Kathawala, Krishna; Tan, Chun Chuan; Garg, Sanjay; Zhou, Xin-Fu

    2017-11-01

    Edaravone (EDR) is a well-recognized lipophilic free radical scavenger for diseases including neurodegenerative disease, cardiovascular disease, and cancer. However, its oral use is restricted due to poor oral bioavailability (BA). The aim of present research was to enable its oral use by developing a lipid-based nanosystem (LNS). The components of LNS including oil, surfactants, and co-surfactants were selected based on their potential to maximize the solubilization in gastrointestinal (GI) fluids, reduce its glucuronidation and improve transmembrane permeability. The liquid LNS (L-LNS) with Capryol™ PGMC (Oil), Cremophor® RH 40:Labrasol®:TPGS 1000 (1:0.8:0.2) (Surfactant) and Transcutol P® (Co-surfactant) were optimized to form microemulsion having droplet size (16.25 nm), polydispersity index (0.039), % Transmittance (99.85%), and self-emulsification time (32 s). It significantly improved the EDR loading as well as its metabolism and permeability profile during transport across the GI tract. To overcome the possible drawbacks of L-LNS, Aerosil® 200 was used to formulate solid LNS (S-LNS), and its concentration was optimized based on flow properties. S-LNS possessed all quality attributes of L-LNS confirmed by solid-state characterization, reconstitution ability, and stability study. The dissolution rate of EDR was significantly enhanced with L-LNS and S-LNS in simulated gastric, and intestinal fluids. The pharmacokinetic study revealed significant improvement in relative BA, Cmax, and t1/2 with L-LNS and S-LNS against EDR suspension. Moreover, S-LNS showed superior cellular uptake and neuroprotective effect compared to EDR in SH-SY5Y695 cell line. An appropriate selection of the components of LNS could enable effective oral delivery of challenging therapeutics that are conventionally used by the parenteral administration.

  12. Predictive Value of the Number of Harvested Lymph Nodes and Cut-Off for Lymph Node Ratio in the Prognosis of Stage II and III Colorectal Cancer Patients.

    Science.gov (United States)

    Li Destri, Giovanni; Barchitta, Martina; Pesce, Antonio; Latteri, Saverio; Bosco, Dorotea; Di Cataldo, Antonio; Agodi, Antonella; Puleo, Stefano

    2017-10-03

    Purpose/aim: The appropriate staging of colorectal cancer requires at least 12 lymph nodes to be sampled. We evaluated whether lymph node sampling (LNS) and lymph node ratio (LNR) can predict the prognosis of stage II-III patients. This is a retrospective study on 432 patients classified in LNS ≥12 and LNS test, p < 0.001). In the patients with LNS ≥ 12, the cut-off of 0.257 could predict recurrence (specificity 86%). Stage II patients with LNS < 12 tend to have shorter DFS than stage II patients with LNS ≥ 12. In stage III patients, an appropriate LNR cut-off is a better prognostic predictor than LNR quartile, especially in patients with LNS ≥ 12.

  13. Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients.

    Science.gov (United States)

    Tsai, Hsiang-Lin; Huang, Ching-Wen; Yeh, Yung-Sung; Ma, Cheng-Jen; Chen, Chao-Wen; Lu, Chien-Yu; Huang, Ming-Yii; Yang, I-Ping; Wang, Jaw-Yuan

    2016-04-14

    To identify factors affecting the harvest of lymph nodes (LNs) and to investigate the association between examining a minimum of 12 LNs and clinical outcomes in stage I-III colorectal cancer (CRC) patients. The clinicopathologic features and the number of examined LNs for 1167 stage I-III CRC patients were analyzed to identify factors affecting the number of LNs harvested and the correlations between clinical outcomes and high harvests (≧12 LNs) and low harvests (cancer and that tumor size (P = 0.015) was the only independent factor in rectal cancer. Patients with low harvests had poorer overall survival with stage II and stage III CRC (stage II: P number of examined LNs (≧12) is associated with a survival benefit. Removal of at least 12 LNs will determine the lymph node status reliably.

  14. Radiologists' performance in the detection of benign and malignant masses with 3D automated breast ultrasound (ABUS)

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jung Min [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Moon, Woo Kyung, E-mail: moonwk@radcom.snu.ac.kr [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Cho, Nariya [Department of Radiology and Clinical Research Institute, Seoul National University Hospital and the Institute of Radiation Medicine, Seoul National University Medical Research Center (Korea, Republic of); Park, Jeong Seon [Department of Radiology, Hanyang University College of Medicine, Hanyang University Hospital (Korea, Republic of); Kim, Seung Ja [Department of Radiology, Seoul National Universtiy Boramea Hospital (Korea, Republic of)

    2011-04-15

    Objectives: To retrospectively evaluate the detection performance of benign and malignant breast masses using 3D volume data obtained by ABUS and to determine lesion variables which affect detectability. Methods: Between November and December of 2007, bilateral whole breast US images were obtained using ABUS in 67 consecutive women who were scheduled to undergo US-guided needle biopsy due to suspicious breast masses. Twenty-four invasive ductal cancers in 23 breasts, 46 benign breast lesions in 44 breasts and 38 normal breasts were included. Three breast radiologists (experience range, 8-16 years) who did not perform the examinations and were blinded to the histology independently reviewed the ABUS data of the 105 breasts to detect suspicious solid masses with pathology as the standard of reference. Sensitivity and specificity in detecting benign and malignant masses were calculated, and lesion characteristics affecting detectability were analyzed. Results: Sensitivities for benign and malignant mass detections were 65.2% (30/46), 95.8% (23/24) for reader 1 (p = 0.007), 66.7% (31/46), 87.5% (21/24) for reader 2 (p = 0.087), and 56.3% (24/46), 91.7% (22/24), for reader 3 (p = 0.001), respectively. Logistic analysis showed that mass size (odds ratio, 95% CI; 1.12, 1.02-1.24), surrounding tissue changes (odds ratio, 95% CI; 0.11, 0.02-0.47), and shape of the mass (odds ratio, 95% CI; 3.12, 1.02-9.55) were the variables associated with detectability at ABUS. Conclusion: In reader studies using ABUS data, significantly higher sensitivity was noted for malignant breast masses than for benign masses.

  15. Hyalinizing trabecular tumor of the thyroid: Diagnosed of a rare tumor using ultrasonography, cytology, and intraoperative frozen sections

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Hyun Sik; Kim, Eun Kyung; Kwak, Jin Young; Moon, Hee Jung; Yoon, Jung Hyun [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Park, Cheol Keun; Son, Eun Ju [Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to evaluate the clinicopathological and imaging features of thyroid nodules surgically diagnosed as hyaline trabecular tumor (HTT), and to assess the role of cytology and frozen sections (FS) in the diagnosis of HTT. This study included 21 thyroid nodules in 21 patients treated from August 2005 to March 2015 (mean age, 53.3 years) who were either diagnosed as HTT or had HTT suggested as a possible diagnosis based on cytology, FS, or the final pathology report. Patients' medical records were retrospectively reviewed for cytopathologic results and outcomes during the course of follow-up. Sonograms were reviewed and categorized. Twelve nodules from 12 patients were surgically confirmed as HTT. Ultrasonography (US)-guided fine needle aspiration (FNA) was performed on 11 nodules, of which six (54.5%) were papillary thyroid carcinoma (PTC) or suspicious for PTC and three (27.3%) were HTT or suspicious for HTT. Intraoperative FS suggested the possibility of HTT in seven nodules, of which four (57.1%) were confirmed as HTT. US-FNA suggested the diagnosis of HTT in 10 nodules, of which three (30.0%) were confirmed as HTT. Common US features of the 12 pathologically confirmed cases of HTT were hypoechogenicity or marked hypoechogenicity (83.4%), absence of calcifications (91.7%), parallel shape (100.0%), presence of vascularity (75.0%), and probable benignity (58.3%). HTT should be included in the differential diagnosis of solid tumors with hypoechogenicity or marked hypoechogenicity and otherwise benign US features that have been diagnosed as PTC through cytology.

  16. The absence of cutaneous lymph nodes results in a Th2 response and increased susceptibility to Leishmania major infection in mice.

    Science.gov (United States)

    Ehrchen, Jan M; Roth, Johannes; Roebrock, Kirsten; Varga, Georg; Domschke, Wolfram; Newberry, Rodney; Sorg, Clemens; Müller-Tidow, Carsten; Sunderkötter, Cord; Kucharzik, Torsten; Spahn, Thomas W

    2008-09-01

    Lymph nodes (LNs) are important sentinel organs where antigen-presenting cells interact with T cells to induce adaptive immune responses. In cutaneous infection of mice with Leishmania major, resistance depends on the induction of a T-helper-cell-1 (Th1)-mediated cellular immune response in draining, peripheral LNs. We investigated whether draining, peripheral LNs are absolutely required for resistance against L. major infection. We investigated the course of experimental leishmaniasis in wild-type (wt) mice lacking peripheral LNs (pLNs), which we generated by in utero blockade of membrane-bound lymphotoxin, and in mice lacking pLNs or all LNs due to genetic deletion of lymphotoxin ligands or receptors. wt mice of the resistant C57BL/6 strain without local skin-draining LNs were still able to generate specific T-cell responses, but this yielded Th2 cells. This switch to a Th2 response resulted in severe systemic infection. We also confirmed these results with mice lacking pLNs due to genetic depletion of lymphotoxin-beta. The complete absence of LNs due to a genetic depletion of the lymphotoxin-beta receptor also resulted in a marked deterioration of disease and a Th2 response. Thus, in the absence of pLNs, an L. major-specific Th2 response is induced in the remaining secondary lymphoid organs, such as the spleen and non-skin-draining LNs. This indicates a critical requirement for pLNs to induce protective Th1 immunity and suggests that whether Th1 or Th2 priming to the same antigen occurs depends on the site of the primary antigen recognition.

  17. Target detection: Magnetic resonance imaging-ultrasound fusion–guided prostate biopsy

    Science.gov (United States)

    Sonn, Geoffrey A.; Margolis, Daniel J.; Marks, Leonard S.

    2014-01-01

    Recent advances in multiparametric magnetic resonance imaging (MRI) have enabled image-guided detection of prostate cancer. Fusion of MRI with real-time ultrasound (US) allows the information from MRI to be used to direct biopsy needles under US guidance in an office-based procedure. Fusion can be performed either cognitively or electronically, using a fusion device. Fusion devices allow superimposition (coregistration) of stored MRI images on real-time US images; areas of suspicion found on MRI can then serve as targets during US-guided biopsy. Currently available fusion devices use a variety of technologies to perform coregistration: robotic tracking via a mechanical arm with built-in encoders (Artemis/Eigen, BioJet/Geoscan); electromagnetic tracking (UroNav/Philips-Invivo, Hi-RVS/Hitachi); or tracking with a 3D US probe (Urostation/Koelis). Targeted fusion biopsy has been shown to identify more clinically significant cancers and fewer insignificant cancers than conventional biopsy. Fusion biopsy appears to be a major advancement over conventional biopsy because it allows (1) direct targeting of suspicious areas not seen on US and (2) follow-up biopsy of specific cancerous sites in men undergoing active surveillance. PMID:24239473

  18. Multi-parametric MRI findings of transitional zone prostate cancers: correlation with 3-dimensional transperineal mapping biopsy.

    Science.gov (United States)

    Pokharel, Sajal S; Patel, Nayana U; Garg, Kavita; La Rosa, Francisco G; Arangua, Paul; Jones, Clifford; Crawford, E David

    2015-01-01

    A preliminary project to correlate MR findings with mapping prostate biopsy to help differentiate malignant transitional zone lesions form benign prostatic hyperplasia (BPH) nodules. Institutional IRB approved retrospective study with 14 patients suspected of having prostate cancer who underwent both prostate 3T MRI using endorectal coil and 3D transperineal mapping prostate biopsy. MR exams were independently reviewed by two abdominal radiologists blinded to pathology with disagreement resolved by consensus. An MRI lesion was defined as having hypointense T2 signal subjectively without corresponding T1 high signal intensity and low signal on ADC maps in the central gland. Mapping biopsy consisted of systematic transperineal US guided biopsy with 55-108 cores per patient. Twenty-nine lesions were detected on MRI. Of these, 13 correlated with Gleason 6 or higher biopsy samples. 16 were biopsy negative. Among the various MRI characteristics assessed, lack of T2 hypointense rim demonstrated the highest specificity (93%) and positive predictive value (89%). Highest sensitivity (85%) and negative predictive value (78%) were seen with ill-defined nodules. When suspicious MR characteristics were combined, the specificity and PPV rose to 100% while sensitivity decreased to 45% and NPV decreased to 73%. Preliminary study indicates MR findings which can help differentiate a BPH nodule from transitional zone prostate cancers which could help direct biopsy in the large and growing number of people suspected of having prostate cancer. Further work will be needed for validation.

  19. Efficient convex optimization approach to 3D non-rigid MR-TRUS registration.

    Science.gov (United States)

    Sun, Yue; Yuan, Jing; Rajchl, Martin; Qiu, Wu; Romagnoli, Cesare; Fenster, Aaron

    2013-01-01

    In this study, we propose an efficient non-rigid MR-TRUS deformable registration method to improve the accuracy of targeting suspicious locations during a 3D ultrasound (US) guided prostate biopsy. The proposed deformable registration approach employs the multi-channel modality independent neighbourhood descriptor (MIND) as the local similarity feature across the two modalities of MR and TRUS, and a novel and efficient duality-based convex optimization based algorithmic scheme is introduced to extract the deformations which align the two MIND descriptors. The registration accuracy was evaluated using 10 patient images by measuring the TRE of manually identified corresponding intrinsic fiducials in the whole gland and peripheral zone, and performance metrics (DSC, MAD and MAXD) for the apex, mid-gland and base of the prostate were also calculated by comparing two manually segmented prostate surfaces in the registered 3D MR and TRUS images. Experimental results show that the proposed method yielded an overall mean TRE of 1.74 mm, which is favorably comparable to a clinical requirement for an error of less than 2.5 mm.

  20. Impact of Hashimoto's thyroiditis, TSH levels, and anti-thyroid antibody positivity on differentiated thyroid carcinoma incidence.

    Science.gov (United States)

    Gabalec, Filip; Srbova, Libuse; Nova, Marketa; Hovorkova, Eva; Hornychova, Helena; Jakubikova, Iva; Ryska, Ales; Cap, Jan

    2016-01-01

    The relationship between Hashimoto's thyroiditis (HT) and thyroid cancer (TC) is controversial. While most surgical studies report a high incidence of malignancy among patients with HT, cytological studies do not. The role of autoantibodies in the incidence of malignancy is unclear. A single-centre retrospective observational study was conducted in patients evaluated for thyroid nodules by US-guided fine-needle aspiration cytology (FNAC) and, if indicated, by surgery. The levels of thyroid-stimulating hormone (TSH) and anti-thyroid antibodies were measured at the time of FNAC. Of 4947 patients, 599 (12.1%) were diagnosed with HT. A malignant/suspicious cytological result was found in 14.2% of the patients with HT and in 15.2% of the others. The odds ratio (OR) for malignancy in HT was 0.921 (0.716-1.183, p = 0.51). Of 1603 patients who underwent surgery, differentiated thyroid carcinoma was found in 29.5% of the HT patients and in 15.2% of the others (OR 2.33, 95% confidence interval CI, 1.403-3.854, p thyroid peroxidase (ATP) or thyroglobulin (ATG) and malignancy rate. No association between HT and thyroid cancer was observed cytologically; a positive relationship in histological series was caused by selection bias. Low TSH levels decreased the risk of TC in patients with nodular goitre, but this has not been proven in patients with HT.

  1. Cytological diagnosis of thyroid nodules in Hashimoto thyroiditis in elderly patients.

    Science.gov (United States)

    Caleo, Alessia; Vigliar, Elena; Vitale, Mario; Di Crescenzo, Vincenzo; Cinelli, Mariapia; Carlomagno, Chiara; Garzi, Alfredo; Zeppa, Pio

    2013-01-01

    Long standing Hashimoto Thyroiditis (HT) causes shrinking and atrophy of the thyroid, but may also lead to diffuse enlargement of the gland and/or formation of nodules. These nodules should be differentiated from papillary thyroid carcinoma (PTC) and primary thyroidal non-Hodgkin lymphoma (PTL), which are possible complications of HT, and require pre-surgical diagnoses and different treatments. Thirty-four elderly patients (≥ 65 yrs) with HT and diffuse or nodular enlargement of the thyroid underwent ultrasound (US)-guided FNC. Smears were routinely stained and evaluated; additional passes were used for flow cytometry (FC) assessment of lymphoid infiltrate in 6 cases. The cytological diagnosis was HT in 12 cases with prevalence of Hurtle cells in 2 cases, PTC in 1 case and PTL in 2 cases. FC assessed the reactive, non-lymphomatous nature of the lymphoid infiltrate in 5 cases and demonstrated light chain restriction, hence the lymphomatous nature of the lymphoid infiltrate in 2 cases of PTL. FNC plays a key role in the clinical surveillance and pre-surgical diagnosis of diffuse enlargement and nodular presentation of HT in elderly patients. FNC can correctly diagnose HT, PTC and PTL indicating the need for surgery and its extension in suspicious or neoplastic cases, leaving other cases to the medical treatment and clinical surveillance.

  2. Confirmatory study for the congenital hypothyroidism diagnostic in newborns with suspicious neonatal sieve;Estudio confirmatorio para el diagnostico de hipotiroidismo congenito en recien nacidos con tamiz neonatal sospechoso

    Energy Technology Data Exchange (ETDEWEB)

    Murillo V, D.; Badillo A, V.; Villasana R, A. P., E-mail: black_dany87@hotmail.co [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Laboratorio de Radioinmunoanalisis, Calle Cipres No. 10, Fracc. La Penuela, 98068 Zacatecas (Mexico)

    2009-10-15

    The congenital hypothyroidism is an endocrine illness knows from the X V century. It is caused by the anatomical or functional absence of the thyroid gland, what causes a deficiency in the thyroid hormones production. These hormones are indispensable for an appropriate physical and mental development from the first moments of the life. This illness is the more frequent cause of avoidable mental retardation in the child. In Mexico, is considered that 1 of each 2,537 newborns present congenital hypothyroidism, this frequency is extraordinarily high in relation to other countries. For the opportune confirmation of this illness is carried out by means of the radio immuno analysis that is a competitive type technique which is based on the antigen-antibody reaction. To the present antigen in the sample problem, is go to add a constant and known quantity of labelled antigen (hot antigen). The labelled antigens are formed substituting some of the normal atoms of the antigen for the corresponding radioactive isotope I{sup 125} in the molecule. The two types of antigens, cold and hot will compete, in equality of conditions, to unite with the available antibody. The concentrations of labelled antigen and antibody not change, the only variable of the system is the non labelled antigen (cold antigen) concentration. As much as more it is the quantity of cold antigen in the sample problem, it is displaced at the hot antigen and therefore they are fixed to the antibody smaller quantities of labelled antigen. Therefore, the formation of radioactive complexes (Ag-Ac) it varies in function of the non labelled antigen concentration: to major non labelled antigen concentration, major formation of non labelled antigen-antibody complexes, and minor formation of radioactive complexes and vice versa. 29 cases were analyzed with suspicion of congenital hypothyroidism therefore the T4 neonatal and TSH neonatal were quantified by the radio immuno analysis technique giving the confirmation of a single positive case as result. In this way it is contributed to the opportune confirmation of the results provided by the neonatal sieve for the detection and opportune treatment in order to avoid the congenital hypothyroidism consequences. (Author)

  3. Logical Framework for Normative Systems

    OpenAIRE

    Nakayama, Yasuo

    2010-01-01

    In this paper, I propose a new logical framework that can be used to analyze normative phenomena in general. I call this framework a Logic for Normative Systems (LNS). I also demonstrate how to solve some paradoxes of Standard Deontic Logic (SDL). A characteristic of LNS is its dynamic behavior. LNS is flexible, hence it can be applied to describe complex normative problems including ethical problems.

  4. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer.

    Science.gov (United States)

    Shanmugam, Chandrakumar; Hines, Robert B; Jhala, Nirag C; Katkoori, Venkat R; Zhang, Bin; Posey, James A; Bumpers, Harvey L; Grizzle, William E; Eltoum, Isam E; Siegal, Gene P; Manne, Upender

    2011-05-28

    Although evaluation of at least 12 lymph nodes (LNs) is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91), but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64), examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87) and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26) decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p < 0.0001). For Stage II and III colon cancers, there was improved survival and a decreased risk of recurrence with an increased number of LNs examined, regardless of the cutoff-points. Examination of ≥7 or ≥12 LNs had similar outcomes, but there were significant outcome benefits at the ≥20 cutoff-point only for Stage II patients. For Stage III patients, examination of 6 additional LNs detected one additional positive LN. Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  5. Prognostic Significance of the Number of Positive Lymph Nodes in Women With T1-2N1 Breast Cancer Treated With Mastectomy: Should Patients With 1, 2, and 3 Positive Lymph Nodes Be Grouped Together?

    Energy Technology Data Exchange (ETDEWEB)

    Dai Kubicky, Charlotte, E-mail: charlottedai@gmail.com [Department of Radiation Medicine and Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States); Mongoue-Tchokote, Solange [Biostatistics Shared Resource, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon (United States)

    2013-04-01

    Purpose: To determine whether patients with 1, 2, or 3 positive lymph nodes (LNs) have similar survival outcomes. Methods and Materials: We analyzed the Surveillance, Epidemiology, and End Results registry of breast cancer patients diagnosed between 1990 and 2003. We identified 10,415 women with T1-2N1M0 breast cancer who were treated with mastectomy with no adjuvant radiation, with at least 10 LNs examined and 6 months of follow-up. The Kaplan-Meier method and log–rank test were used for survival analysis. Multivariate analysis was performed using the Cox proportional hazard model. Results: Median follow-up was 92 months. Ten-year overall survival (OS) and cause-specific survival (CSS) were progressively worse with increasing number of positive LNs. Survival rates were 70%, 64%, and 60% (OS), and 82%, 76%, and 72% (CSS) for 1, 2, and 3 positive LNs, respectively. Pairwise log–rank test P values were <.001 (1 vs 2 positive LNs), <.001 (1 vs 3 positive LNs), and .002 (2 vs 3 positive LNs). Multivariate analysis showed that number of positive LNs was a significant predictor of OS and CSS. Hazard ratios increased with the number of positive LNs. In addition, age, primary tumor size, grade, estrogen receptor and progesterone receptor status, race, and year of diagnosis were significant prognostic factors. Conclusions: Our study suggests that patients with 1, 2, and 3 positive LNs have distinct survival outcomes, with increasing number of positive LNs associated with worse OS and CSS. The conventional grouping of 1-3 positive LNs needs to be reconsidered.

  6. Inhibition of lanthanide nanocrystal-induced inflammasome activation in macrophages by a surface coating peptide through abrogation of ROS production and TRPM2-mediated Ca(2+) influx.

    Science.gov (United States)

    Yao, Han; Zhang, Yunjiao; Liu, Liu; Xu, Youcui; Liu, Xi; Lin, Jun; Zhou, Wei; Wei, Pengfei; Jin, Peipei; Wen, Long-Ping

    2016-11-01

    Lanthanide-based nanoparticles (LNs) hold great promise in medicine. A variety of nanocrystals, including LNs, elicits potent inflammatory response through activation of NLRP3 inflammasome. We have previously identified an LNs-specific surface coating peptide RE-1, with the sequence of 'ACTARSPWICG', which reduced nanocrystal-cell interaction and abrogated LNs-induced autophagy and toxicity in both HeLa cells and liver hepatocytes. Here we show that RE-1 coating effectively inhibited LNs-induced inflammasome activation, mostly mediated by NLRP3, in mouse bone marrow derived macrophage (BMDM) cells, human THP-1 cells and mouse peritoneal macrophages and also reduced LNs-elicited inflammatory response in vivo. RE-1 coating had no effect on cellular internalization of LNs in BMDM cells, in contrast to the situation in HeLa cells where cell uptake of LNs was significantly inhibited by RE-1. To elucidate the molecular mechanism underlying the inflammasome-inhibiting effect of RE-1, we assessed several parameters known to influence nanocrystal-induced NLRP3 inflammasome activation. RE-1 coating did not reduce potassium efflux, which occurred after LNs treatment in BMDM cells and was necessary but insufficient for LNs-induced inflammasome activation. RE-1 did decrease lysosomal damage induced by LNs, but the inhibitor of cathepsin B did not affect LNs-elicited caspase 1 activation and IL-1β release, suggesting that lysosomal damage was not critically important for LNs-induced inflammasome activation. On the other hand, LNs-induced elevation of intracellular reactive oxygen species (ROS), critically important for inflammasome activation, was largely abolished by RE-1 coating, with the reduction on NADPH oxidase-generated ROS playing a more prominent role for RE-1's inflammasome-inhibiting effect than the reduction on mitochondria-generated ROS. ROS generation further triggered Ca(2+) influx, an event that was mediated by Transient Receptor Potential M2 (TRPM2) and was

  7. Tumor-Associated Macrophages Extend Along Lymphatic Flow in the Pre-metastatic Lymph Nodes of Human Gastric Cancer.

    Science.gov (United States)

    Go, Yukie; Tanaka, Hiroaki; Tokumoto, Mao; Sakurai, Katsunobu; Toyokawa, Takahiro; Kubo, Naoshi; Muguruma, Kazuya; Maeda, Kiyoshi; Ohira, Masaichi; Hirakawa, Kosei

    2016-02-01

    Tumor-associated macrophages (TAMs) correlate with lymphangiogenesis in primary lesions and with lymph node (LN) metastasis of several cancers. However, the association of TAMs in regional LNs with lymphatic spread of cancer remains unclear. The purpose of this study was to evaluate the distribution of TAMs in draining LNs and the impact of TAMs on the establishment of LN metastasis of gastric cancer. The number and distribution of TAMs in regional LNs that were obtained from 49 patients who underwent radical surgery for gastric cancer at Osaka City University Hospital in 2011 were assessed. TAMs were defined as immunohistochemically CD163 positive cells. The association of the TAM density with lymph node metastasis and the lymphatic drainage route of the stomach were investigated. A high density of TAMs was significantly associated with pathologically positive lymph nodes and pathological TNM stage. The density of TAMs was increased in LNs with micro metastasis compared with those without metastasis. There was a significant, positive correlation between TAM number and lymphatic vessel density in LNs. In nonmetastatic LNs, TAMs were likely to accumulate in the neighborhood of the primary lesion. In addition, the density of TAMs in distant LNs was significantly increased in patients in whom LN metastasis was observed in perigastric LNs. Accumulated TAMs may induce lymphangiogenesis and prepare an environment that facilitates cancer proliferation in LNs. Our findings might provide a conceptual framework for understanding the lymphatic spreading of cancer and for designing future therapeutic strategies for gastric cancer.

  8. The Structure of Neurexin 1[alpha] Reveals Features Promoting a Role as Synaptic Organizer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Fang; Venugopal, Vandavasi; Murray, Beverly; Rudenko, Gabby (Michigan)

    2014-10-02

    {alpha}-Neurexins are essential synaptic adhesion molecules implicated in autism spectrum disorder and schizophrenia. The {alpha}-neurexin extracellular domain consists of six LNS domains interspersed by three EGF-like repeats and interacts with many different proteins in the synaptic cleft. To understand how {alpha}-neurexins might function as synaptic organizers, we solved the structure of the neurexin 1{alpha} extracellular domain (n1{alpha}) to 2.65 {angstrom}. The L-shaped molecule can be divided into a flexible repeat I (LNS1-EGF-A-LNS2), a rigid horseshoe-shaped repeat II (LNS3-EGF-B-LNS4) with structural similarity to so-called reelin repeats, and an extended repeat III (LNS5-EGF-B-LNS6) with controlled flexibility. A 2.95 {angstrom} structure of n1{alpha} carrying splice insert SS3 in LNS4 reveals that SS3 protrudes as a loop and does not alter the rigid arrangement of repeat II. The global architecture imposed by conserved structural features enables {alpha}-neurexins to recruit and organize proteins in distinct and variable ways, influenced by splicing, thereby promoting synaptic function.

  9. Impact of Neoadjuvant Chemoradiation on Lymph Node Status in Esophageal Cancer Post hoc Analysis of a Randomized Controlled Trial

    NARCIS (Netherlands)

    Talsma, Koen; Wijnhoven, Bas; van Lanschot, Jan; van Berge Henegouwen, Mark

    2015-01-01

    Objective: The study objectives were to analyze the impact of the number of lymph nodes (LNs) reported as resected (NLNr) and the number of LNs invaded (NLNi) on the prognosis of esophageal cancer (EC) after neoadjuvant chemoradiotherapy. Background: Pathological LN status is a major disease

  10. Prognostic implications of the number of retrieved lymph nodes of patients with rectal cancer treated with preoperative chemoradiotherapy.

    Science.gov (United States)

    Park, In Ja; Yu, Chang Sik; Lim, Seok-Byung; Yoon, Yong Sik; Kim, Chan Wook; Kim, Tae Won; Kim, Jong Hoon; Kim, Jin Cheon

    2014-10-01

    The impact of the number of retrieved lymph nodes (LNs) on oncological outcomes in patients with rectal cancer remains unclear. This study was designed to evaluate the prognostic implications of the number of retrieved LNs in patients with rectal cancer receiving preoperative chemoradiotherapy (CRT). The study cohort consisted of 859 patients with locally advanced (cT3-4 or cN+) mid to low rectal cancer that had been treated with preoperative CRT and radical resection between 2000 and 2009. Multivariate analysis and the Kaplan-Meier method were used to evaluate the influence of the number of retrieved LNs on disease-free survival (DFS). The median number of LNs retrieved from included patients was 13 (interquartile range [IQR] 9-17). Multivariate analysis confirmed the independent prognostic importance of the number of retrieved LNs on DFS (hazard ratio = 0.97, 95% confidence interval = 0.95-0.99, p = 0.029). The 3-year DFS rate in patients with yp stage II rectal cancer was associated with the total number of retrieved LNs. DFS was associated with the number of LNs retrieved from patients with rectal cancer who received preoperative CRT, especially among patients with ypT3-4 N0 stage tumors. The oncological importance of the number of retrieved LNs should be considered when treating these patients.

  11. Axillary lymph node characterization in breast cancer patients using magnetic resonance mammography: A prospective comparative study with FDG PET-CT and healthy women

    Energy Technology Data Exchange (ETDEWEB)

    Krammer, J., E-mail: Julia.Krammer@medma.uni-heidelberg.de; Wasser, K.; Schnitzer, A.; Henzler, T.; Schoenberg, S.O.; Kaiser, C.G.

    2013-12-01

    Objective: The aim of this study was to evaluate the capability of dynamic contrast enhanced MR-mammography (MRM) for the interpretation of axillary lymph nodes (LNs) in patients with breast cancer. Material and methods: 25 patients with breast cancer preoperatively underwent both FDG positron emission computed tomography (PET-CT) and dynamic contrast enhanced MRM. The maximum signal increase (SI{sub max}) and curve shape (types I–III) of contrast enhanced LNs ≥0.5 cm (short-axis) were analyzed in MRM and correlated to the maximum standard uptake value (SUV{sub max}) of FDG PET-CT. 29 healthy women with MRM served as control group. Enhancement kinetics of all malignant LNs were compared to LN findings of the healthy control group. Results: Overall 33 contrast enhanced LNs on preoperative MRM had a corresponding FDG uptake on PET-CT. 30 of the PET positive LNs were classified as surely malignant (mean SUV{sub max} 7.3 (±5.4)). The mean SI{sub max} of these LNs was not significantly different to the control group (222% vs 197%), but malignant LNs had a significantly higher rate of type III curves with rapid washout (93% vs 66%, p = 0.008). Conclusion: The maximum signal increase is not capable of differentiating malignant from benign axillary LNs. However, since malignant LNs showed a higher frequency of rapid washout curves (type III curves) on corresponding MRM future studies should concentrate on the analysis of this parameter. In clinical routine the curve shape still should be taken with care as there is a high overlap with benign LNs.

  12. The size of retrieved lymph nodes correlates with the number of retrieved lymph nodes and is an independent prognostic factor in patients with stage II colon cancer.

    Science.gov (United States)

    Okada, Kazutake; Sadahiro, Sotaro; Suzuki, Toshiyuki; Tanaka, Akira; Saito, Gota; Masuda, Shinobu; Haruki, Yasuo

    2015-12-01

    In stage II colon cancer, patients with many retrieved lymph nodes (LNs) have been reported to have better oncological outcomes. We tested the hypothesis that the greater number of retrieved LNs is related to a larger LN size. The subjects comprised 320 patients with stage II colon cancer who underwent curative resection. All operations were elective and were performed by the same surgeons. The maximum long axis and short axis diameters of LNs were measured on hematoxylin-eosin-stained specimens. A total of 4,744 LNs were evaluated. The number of retrieved LNs was 14.8 ± 10.1 (mean ± SD). The long axis diameter was 4.8 ± 2.6 mm, with a median value of 4.3 mm, a maximum value of 20.4 mm, and a minimum value of 0.6 mm. The corresponding short axis diameters were 3.4 ± 1.7, 3.0, 15.1, and 0.5 mm, respectively. The highest correlation coefficient for the association with the number of LNs was obtained for the maximum value of the long axis diameter (0.59). Multivariate analysis revealed that age, tumor location, pathological T stage, and the maximum long axis diameter were independent prognostic factors. The number of LNs was not a significant factor. Patients with less than 12 LNs and a maximum long axis diameter of less than 10 mm had significantly poorer outcomes (p patients with stage II colon cancer, the maximum long axis diameter of LNs correlated with the number of LNs and was an independent prognostic factor.

  13. Differential diagnosis of idiopathic granulomatous mastitis and breast cancer using acoustic radiation force impulse imaging.

    Science.gov (United States)

    Teke, Memik; Teke, Fatma; Alan, Bircan; Türkoğlu, Ahmet; Hamidi, Cihad; Göya, Cemil; Hattapoğlu, Salih; Gumus, Metehan

    2017-01-01

    Differentiation of idiopathic granulomatous mastitis (IGM) from carcinoma with routine imaging methods, such as ultrasonography (US) and mammography, is difficult. Therefore, we evaluated the value of a newly developed noninvasive technique called acoustic radiation force impulse imaging in differentiating IGM versus malignant lesions in the breast. Four hundred and eighty-six patients, who were referred to us with a presumptive diagnosis of a mass, underwent Virtual Touch tissue imaging (VTI; Siemens) and Virtual Touch tissue quantification (VTQ; Siemens) after conventional gray-scale US. US-guided percutaneous needle biopsy was then performed on 276 lesions with clinically and radiologically suspicious features. Malignant lesions (n = 122) and IGM (n = 48) were included in the final study group. There was a statistically significant difference in shear wave velocity marginal and internal values between the IGM and malignant lesions. The median marginal velocity for IGM and malignant lesions was 3.19 m/s (minimum-maximum 2.49-5.82) and 5.05 m/s (minimum-maximum 2.09-8.46), respectively (p < 0.001). The median internal velocity for IGM and malignant lesions was 2.76 m/s (minimum-maximum 1.14-4.12) and 4.79 m/s (minimum-maximum 2.12-8.02), respectively (p < 0.001). The combination of VTI and VTQ as a complement to conventional US provides viscoelastic properties of tissues, and thus has the potential to increase the specificity of US.

  14. Diagnostic Accuracy of Detecting Hashimoto's Thyroiditis in Thyroid Cancer Patients Who Underwent Thyroid Surgery: Comparison of Ultrasonography, Positron Emission Tomography/CT, Contrast Enhanced CT, and Anti-Thyroid Antibody

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Gyun; Lee, Tae Hyun; Park, Dong Hee; Nam, Sang Been [Dept. of Radiology, Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2012-11-15

    To compare the diagnostic accuracy of ultrasonography (US), F18-fluorodeoxyglucose positron emission tomography/CT (PET/CT), contrast enhanced CT (CECT), serum anti-thyroid antibody for detecting Hashimoto's thyroiditis in thyroid cancer patients who underwent neck surgery. A total of 150 patients with suspicious for thyroid cancer, who had previously undergone US guided needle aspiration of thyroid, were evaluated with the use of US, PET/CT, CECT and serum anti-thyroid antibody. The four studies were performed within two months before neck surgery. Hashimoto's thyroiditis was confirmed by histopathological results. The diagnostic accuracy of US, PET/CT, CECT and serum anti-thyroid antibody were calculated statistically. Hashimoto's thyroiditis was diagnosed in 51 out of the 150 patients, following neck surgery. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US were 76.5%, 92.9%, 84.8%, 88.5%, and 87.3%, respectively. The corresponding values of PET/CT were 37.3%, 96.0%, 82.6%, 74.8%, and 76.0%, and CECT were 62.7%, 89.9%, 76.2%, 82.4%, and 80.7%, and serum anti-thyroid antibody level were 90.2%, 93.9%, 88.5%, 94.9%, and 92.7%, respectively. McNemar test revealed significant difference among PET/CT and others, but no significant differences among US, CECT and serum anti-thyroid antibody. Overall, serum anti-thyroid antibody showed most accurate diagnostic performance. In detecting Hashimoto's thyroiditis, serum anti-thyroid antibody showed higher diagnostic accuracy than others. US also showed relatively high diagnostic accuracy.

  15. Diabetic mastopathy: Imaging features and the role of image-guided biopsy in its diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Hyeon; Kim, Eun Kyung; Kim, Min Jung; Moon, Hee Jung; Yoon, Jung Hyun [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-03-15

    The goal of this study was to evaluate the imaging features of diabetic mastopathy (DMP) and the role of image-guided biopsy in its diagnosis. Two experienced radiologists retrospectively reviewed the mammographic and sonographic images of 19 pathologically confirmed DMP patients. The techniques and results of the biopsies performed in each patient were also reviewed. Mammograms showed negative findings in 78% of the patients. On ultrasonography (US), 13 lesions were seen as masses and six as non-mass lesions. The US features of the mass lesions were as follows: irregular shape (69%), oval shape (31%), indistinct margin (69%), angular margin (15%), microlobulated margin (8%), well-defined margin (8%), heterogeneous echogenicity (62%), hypoechoic echogenicity (38%), posterior shadowing (92%), parallel orientation (100%), the absence of calcifications (100%), and the absence of vascularity (100%). Based on the US findings, 17 lesions (89%) were classified as Breast Imaging Reporting and Data System category 4 and two (11%) as category 3. US-guided core biopsy was performed in 18 patients, and 10 (56%) were diagnosed with DMP on that basis. An additional vacuum-assisted biopsy was performed in seven patients and all were diagnosed with DMP. The US features of DMP were generally suspicious for malignancy, whereas the mammographic findings were often negative or showed only focal asymmetry. Core biopsy is an adequate method for initial pathological diagnosis. However, since it yields non-diagnostic results in a considerable number of cases, the evaluation of correlations between imaging and pathology plays an important role in the diagnostic process.

  16. Breast mass evaluation: factors influencing the quality of US elastography.

    Science.gov (United States)

    Chang, Jung Min; Moon, Woo Kyung; Cho, Nariya; Kim, Seung Ja

    2011-04-01

    To investigate factors influencing the quality of ultrasonographic (US) elastography in the evaluation of suspicious breast masses. This prospective study was conducted with institutional review board approval; written informed consent was obtained. Between January 2009 and February 2009, real-time US elastography of 312 breast masses (245 benign, 67 malignant) was performed in 268 consecutive patients (mean age, 45.7 years ± 10.2 [standard deviation]) prior to US-guided core biopsy. Five breast radiologists who had performed the examinations assessed the quality of elasticity images as inadequate, low, or high without histologic information. Age, body mass index (BMI), mammographic density, lesion size, lesion depth, and breast thickness at US were analyzed for their association with image quality by using the χ(2) test, Student t test, and multivariate analysis. Sensitivities and specificities for the differentiation of benign from malignant masses on the basis of elastography were calculated and compared between groups of quality scores by using the logistic regression method. The quality of elasticity images was assessed as inadequate in 21 (6.7%) cases, low in 134 (42.9%), and high in 157 (50.3%). According to univariate analysis, smaller lesion size (P = .001), shallower lesion depth (P = .005), less breast thickness where the lesion was located (P image quality. There was no correlation of image quality with age (P = .213), BMI (P = .191), mammographic density (P = .091), or distance from the nipple (P = .100). Multivariable analysis showed that breast thickness at the location of target lesions was the most important factor influencing elasticity image quality (P = .001). There were significant differences in sensitivity between higher-quality and lower-quality images (87.0% vs 56.8%, respectively; P = .015) in the differentiation of benign from malignant masses. Breast thickness at the location of the lesion was the most important factor influencing

  17. Repeatability of a planning target volume expansion protocol for radiation therapy of regional lymph nodes in canine and feline patients with head tumors.

    Science.gov (United States)

    Yoshikawa, Hiroto; Harmon, Joseph F; Custis, James T; Larue, Susan M

    2012-01-01

    For canine and feline patients with head tumors, simultaneous irradiation of the primary tumor and mandibular and retropharyngeal lymph nodes (LNs) is often indicated. The purpose of this study was to assess the repeatability of a planning target volume (PTV) expansion protocol for these LNs. Two CT image sets from 44 dogs and 37 cats that underwent radiation therapy for head tumors were compared to determine LN repositioning accuracy and precision; planning-CT (for radiation therapy planning) and cone-beam CT (at the time of actual treatment sessions). Eleven percent of dogs and 65% of cats received treatment to their LNs. In dogs, the mandibular LNs were positioned more caudally (P = 0.0002) and the right mandibular and right retropharyngeal LNs were positioned more to the left side of the patient (P = 0.00015 and P = 0.003, respectively). In cats, left mandibular LN was positioned higher (toward roof) than the planning-CT (P = 0.028). In conclusion, when the patient immobilization devices and bony anatomy matching are used to align the primary head target and these LNs are treated simultaneously, an asymmetrical PTV expansion that ranges 4-9 mm (dogs) and 2-4 mm (cats), depending on the directions of couch movement, should be used to include the LNs within the PTV at least 95% of the time. © 2012 Veterinary Radiology & Ultrasound.

  18. The diagnostic ability of {sup 18}F-FDG PET/CT for mediastinal lymph node staging using {sup 18}F-FDG uptake and volumetric CT histogram analysis in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won [Catholic Kwandong University College of Medicine, Department of Nuclear Medicine, International St. Mary' s Hospital, Incheon (Korea, Republic of); Kim, Eun Young [Yonsei University College of Medicine, Division of Pulmonology, Department of Internal Medicine, Seoul (Korea, Republic of); Kim, Dae Joon [Yonsei University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul (Korea, Republic of); Lee, Jae-Hoon [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Nuclear Medicine, Gangnam Severance Hospital, Seoul (Korea, Republic of); Kang, Won Jun; Yun, Mijin [Yonsei University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Lee, Jong Doo [Catholic Kwandong University College of Medicine, Department of Radiology, International St. Mary' s Hospital, Incheon (Korea, Republic of)

    2016-12-15

    To evaluate the clinical implications of lymph node (LN) density on {sup 18}F-FDG PET/CT for mediastinal LN characterization in non-small cell lung cancer (NSCLC). One hundred and fifty-two patients with 271 mediastinal LNs who underwent PET/CT and endobronchial ultrasound-guided transbronchial needle aspiration for staging were enrolled. Maximum standardized uptake value (SUVmax), short axis diameter, LN-to-primary cancer ratio of SUVmax, and median Hounsfield unit (HU) based on CT histogram were correlated to histopathology. Of 271 nodes, 162 (59.8 %) were malignant. SUVmax, short axis diameter, and LPR of malignant LNs were higher than those of benign nodes. Among malignant LNs, 71.0 % had median HU between 25 and 45, while 78.9 % of benign LNs had values <25 HU or >45 HU. Using a cutoff value of 4.0, SUVmax showed the highest diagnostic ability for detecting malignant LNs with a specificity of 94.5 %, but showing a sensitivity of 70.4 %. Using additional density criteria (median HU 25-45) in LNs with 2.0< SUVmax ≤4.0, the sensitivity increased to 88.3 % with the specificity of 82.6 %. LN density is useful for the characterization of LNs with mild {sup 18}F-FDG uptake. The risk of mediastinal LN metastasis in NSCLC patients could be further stratified using both {sup 18}F-FDG uptake and LN density. (orig.)

  19. Number of mediastinal lymph nodes in non-small cell lung cancer: a Gaussian curve, not a prognostic factor.

    Science.gov (United States)

    Riquet, Marc; Legras, Antoine; Mordant, Pierre; Rivera, Caroline; Arame, Alex; Gibault, Laure; Foucault, Christophe; Dujon, Antoine; Le Pimpec Barthes, Françoise

    2014-07-01

    It has been proposed that examining a greater number of lymph nodes (LNs) in patients with non-small-cell lung cancer (NSCLC) treated by surgical resection may increase the likelihood of proper staging and affect outcome. Our purpose was to evaluate the interindividual variability and prognostic relevance of the number of LNs harvested during complete pulmonary and mediastinal lymphadenectomy performed for NSCLC. We prospectively collected and retrospectively reviewed the data from 1,095 patients who underwent lung cancer resection in association with systematic lymphadenectomy and pulmonary and mediastinal LN counts from 2004 to 2009. We analyzed the interindividual variability and prognostic impact of the number of LNs on overall survival (OS). The mean number of harvested pulmonary and mediastinal LNs was 17.4±7.3 (range, 1-65) and was higher in male patients, right lung surgical procedures, lobectomy and pneumonectomy, N2 disease, and pIII stage. The mean number of harvested mediastinal LNs was 10.7±5.6 and was normally distributed (range, 0-49; median, 10). The 5-year survival rate was 53.8%. Overall survival was influenced by the number of involved stations (single-station versus multi-station disease, 5-year survival rates 31.5% versus 16.9%, respectively; p=0.041) but not by the number of harvested LNs, the number of harvested mediastinal LNs, or the number of positive mediastinal LNs. After lung cancer resection and complete lymphadenectomy, the number of LNs is subject to normally distributed interindividual variability, with no significant impact on OS. Recommending an optimal number of nodes is therefore arbitrary. Instead, our recommendation is to perform a complete systematic pulmonary and mediastinal lymphadenectomy following established anatomical boundaries. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Evaluation of lymph node numbers for adequate staging of Stage II and III colon cancer

    Directory of Open Access Journals (Sweden)

    Bumpers Harvey L

    2011-05-01

    Full Text Available Abstract Background Although evaluation of at least 12 lymph nodes (LNs is recommended as the minimum number of nodes required for accurate staging of colon cancer patients, there is disagreement on what constitutes an adequate identification of such LNs. Methods To evaluate the minimum number of LNs for adequate staging of Stage II and III colon cancer, 490 patients were categorized into groups based on 1-6, 7-11, 12-19, and ≥ 20 LNs collected. Results For patients with Stage II or III disease, examination of 12 LNs was not significantly associated with recurrence or mortality. For Stage II (HR = 0.33; 95% CI, 0.12-0.91, but not for Stage III patients (HR = 1.59; 95% CI, 0.54-4.64, examination of ≥20 LNs was associated with a reduced risk of recurrence within 2 years. However, examination of ≥20 LNs had a 55% (Stage II, HR = 0.45; 95% CI, 0.23-0.87 and a 31% (Stage III, HR = 0.69; 95% CI, 0.38-1.26 decreased risk of mortality, respectively. For each six additional LNs examined from Stage III patients, there was a 19% increased probability of finding a positive LN (parameter estimate = 0.18510, p Conclusions Thus, the 12 LN cut-off point cannot be supported as requisite in determining adequate staging of colon cancer based on current data. However, a minimum of 6 LNs should be examined for adequate staging of Stage II and III colon cancer patients.

  1. National Cancer Database Report of Lymphadenectomy Trends in Endometrial Cancer.

    Science.gov (United States)

    Cripe, James; Handorf, Elizabeth; Brown, Jennifer; Jain, Angela; Rubin, Stephen; Mantia-Smaldone, Gina

    2017-09-01

    Lymph node involvement has a significant impact on prognosis that may direct adjuvant therapy. The role of routine lymph node staging (LNS) is controversial given conflicting results in multiple studies. Our aims are to describe treatment patterns of LNS, identify factors impacting LNS, and quantify the contemporary trends. The National Cancer Data Base was queried for patients undergoing hysterectomy for endometrioid and serous uterine carcinomas from 2003 to 2012. For endometrioid tumors, LNS was considered indicated if at least 1 of 4 criteria was met. Multivariate logistic regression and Cox proportional hazards model were used. A total of 161,683 patients were identified who received hysterectomy for 155,893 (96.4%) endometrioid and 5790 (3.6%) serous carcinomas. Receipt of LNS was significantly associated with greater than 50% myometrial invasion (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.55-1.73), grades 3 to 4 (OR, 3.03; 95% CI, 2.83-3.25), and tumor size greater than 2 cm (OR, 1.17; 95% CI, 1.28-1.26). Of the 97,152 patients with endometrioid carcinoma who met criteria for comprehensive staging, 73,268 (75.4%) underwent LNS. Patients with endometrioid carcinoma meeting criteria for LNS were less likely to receive LNS if they were of African American race (OR, 0.92; 95% CI, 0.86-0.98), had Medicaid insurance status (OR, 0.75; 95% CI, 0.69-0.81), had Medicare insurance (OR, 0.82; 95% CI, 0.79-0.86), or received care at a community program (OR, 0.39; 95% CI, 0.33-0.46). Nationally, most patients with greater than 50% myometrial invasion, grades 3 to 4, and/or tumor size greater than 2 cm receive LNS, but this was significantly impacted by insurance status, demographic characteristics, and facility location/type.

  2. Mapping the distinctive populations of lymphatic endothelial cells in different zones of human lymph nodes.

    Directory of Open Access Journals (Sweden)

    Saem Mul Park

    Full Text Available The lymphatic sinuses in human lymph nodes (LNs are crucial to LN function yet their structure remains poorly defined. Much of our current knowledge of lymphatic sinuses derives from rodent models, however human LNs differ substantially in their sinus structure, most notably due to the presence of trabeculae and trabecular lymphatic sinuses that rodent LNs lack. Lymphatic sinuses are bounded and traversed by lymphatic endothelial cells (LECs. A better understanding of LECs in human LNs is likely to improve our understanding of the regulation of cell trafficking within LNs, now an important therapeutic target, as well as disease processes that involve lymphatic sinuses. We therefore sought to map all the LECs within human LNs using multicolor immunofluorescence microscopy to visualize the distribution of a range of putative markers. PROX1 was the only marker that uniquely identified the LECs lining and traversing all the sinuses in human LNs. In contrast, LYVE1 and STAB2 were only expressed by LECs in the paracortical and medullary sinuses in the vast majority of LNs studied, whilst the subcapsular and trabecular sinuses lacked these molecules. These data highlight the existence of at least two distinctive populations of LECs within human LNs. Of the other LEC markers, we confirmed VEGFR3 was not specific for LECs, and CD144 and CD31 stained both LECs and blood vascular endothelial cells (BECs; in contrast, CD59 and CD105 stained BECs but not LECs. We also showed that antigen-presenting cells (APCs in the sinuses could be clearly distinguished from LECs by their expression of CD169, and their lack of expression of PROX1 and STAB2, or endothelial markers such as CD144. However, both LECs and sinus APCs were stained with DCN46, an antibody commonly used to detect CD209.

  3. Evaluation of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Huanhuan [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Department of Radiology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine (China); Yan, Fuhua; Pan, Zilai; Lin, Xiaozhu; Luo, Xianfu; Shi, Cen [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Chen, Xiaoyan [Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Wang, Baisong [Department of Biomedical Statistics, Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China); Zhang, Huan, E-mail: huanzhangy@126.com [Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025 (China)

    2015-02-15

    Highlights: • Colorectal cancer is the third most prevalent cancer and the status of the regional lymph nodes in rectal cancer is considered to be one of the most powerful prognostic factor in the absence of distant metastatic disease. Detecting LNs metastasis is still a challenging problem due to the presence of microscopic metastasis or inflammatory swelling of LNs. • We investigated the value of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Our study demonstrated that the quantitative normalized iodine concentration (nIC) could be useful for differentiating metastatic and non-metastatic lymph nodes. The combination of nIC in portal venous phase and conventional size criterion could improve the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of rectal cancer. - Abstract: Objectives: To investigate the value of dual energy spectral CT (DEsCT) imaging in differentiating metastatic from non-metastatic lymph nodes in rectal cancer. Methods: Fifty-five patients with rectal cancer underwent the arterial phase (AP) and portal venous phase (PP) contrast-enhanced DEsCT imaging. The virtual monochromatic images and iodine-based material decomposition images derived from DEsCT imaging were interpreted for lymph nodes (LNs) measurement. The short axis diameter and the normalized iodine concentration (nIC) of metastatic and non-metastatic LNs were measured. The two-sample t test was used to compare the short axis diameters and nIC values of metastatic and non-metastatic LNs. ROC analysis was performed to assess the diagnostic performance. Results: One hundred and fifty two LNs including 92 non-metastatic LNs and 60 metastatic LNs were matched using the radiological-pathological correlation. The mean short axis diameter of metastatic LNs was significantly larger than that of the non-metastatic LNs (7.28 ± 2.28 mm vs. 4.90 ± 1.64 mm, P < 0.001). The mean n

  4. Contrast-enhanced sonography for detection of secondary lymph nodes in a melanoma tumor animal model.

    Science.gov (United States)

    Liu, Ji-Bin; Merton, Daniel A; Berger, Adam C; Forsberg, Flemming; Witkiewicz, Agnieszka; Zhao, Hongjia; Eisenbrey, John R; Fox, Traci B; Goldberg, Barry B

    2014-06-01

    To investigate the use of contrast-enhanced ultrasound imaging (US) for detection of secondary lymph nodes (LNs) in a naturally occurring melanoma swine model compared to surgery and pathologic assessment. Twenty-seven Sinclair swine were studied. The perfluorobutane microbubble contrast agent Sonazoid (GE Healthcare, Oslo, Norway) was administered (1.0 mL total dose) around the melanoma, and contrast-enhanced US was used to localize contrast-enhanced sentinel lymph nodes (SLNs). Then Sonazoid (dose, 0.25-1.0 mL) was injected into the SLNs to detect contrast-enhanced efferent lymphatic channels and secondary LNs. After peritumoral injection of blue dye, a surgeon (blinded to the contrast-enhanced US results) performed a radical LN dissection. Contrast-enhanced US was used to guide removal of any enhanced secondary LNs left after radical LN dissection. Clustered conditional logistic regression analyzed the benefit of contrast-enhanced US-directed secondary LN dissection over radical LN dissection using pathologic findings as the reference standard. A total of 268 secondary LNs were resected, with 59 (22%) containing metastases. Contrast-enhanced US detected 92 secondary LNs; 248 were identified by radical LN dissection; and 68 were identified by both methods. Metastases were detected in 20% (51 of 248) and 40% (37 of 92) of the secondary LNs identified by radical LN dissection and contrast-enhanced US, respectively. Thus, secondary LNs detected by contrast-enhanced US were nearly 5 times more likely to contain metastases than secondary LNs removed by radical LN dissection (odds ratio, 4.8; P < .0001). Twenty-two of the 180 secondary LNs (12%) identified only by radical LN dissection contained metastases, whereas contrast-enhanced US identified 20 secondary LNs after the surgeon completed the radical LN dissection, of which 8 (40%) contained metastases. Secondary LNs can be detected by using contrast-enhanced US after injection of Sonazoid into SLNs. Secondary LNs

  5. Thyroid cancer & sarcoidosis.

    Science.gov (United States)

    Ergin, Ahmet Bahadir; Nasr, Christian E

    2014-10-20

    The association of thyroid cancer and SA has been previously described in individual case reports. We are describing 4 patients with co-existence of papillary thyroid cancer (PTC) and SA who presented a diagnostic and management challenge. One patient (Patient 1) with known history of SA was referred for thyroid nodules and cervical adenopathies; Fine needle aspiration (FNA) showed PTC.  At surgery, he was found to have non-necrotizing granulomatous inflammation (NNGI) in lymph nodes in addition to PTC. Another patient (Patient 2) with known history of PTC presented with a palpable LN.  FNA showed NNGI.  She was subsequently found to have diffuse lymphadenopathies from SA. A third patient (Patient 3) who was totally asymptomatic, without history of PTC or SA, presented with a right thyroid nodule and a right lateral neck adenopathy both of which were positive for PTC. Pathology showed extensive NNGI and PTC in 4 LNs. Subsequent work up revealed diffuse lymphadenopahies throughout the body on positron-emitting tomography/computed tomography with elevated serum angiotensin converting enzyme level.  The last patient (Patient 4) who did not have any history of SA or PTC presented with systemic symptoms. Work up revealed a large goiter with substernal extension that required a thyroidectomy.  At surgery, suspicious adenopathies were resected and were found to contain NNGI.  The thyroid specimen contained PTC. Clinicians should be wary of this association/co-existence of SA and PTC to avoid mismanagement of neck lymphadenopathies in patients with current or history of SA. Although 4% of thyroid cancers may induce a sarcoid reaction in the thyroid gland, SA as a disease may coexist with PTC although causality remains uncertain. Being aware of this association is important in the differential diagnosis of a thyroid mass and/or a LN in a patient with SA. Therefore, patients with known SA who are found to have cervical adenopathies or thyroid nodules should have a

  6. The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

    Directory of Open Access Journals (Sweden)

    Hossam Eldin Mohamed

    2016-01-01

    Conclusion: ECLN are associated with an increased likelihood of thyroid malignancy in the patients undergoing evaluation of a suspicious nodule. The risk of malignancy in thyroid nodules increases with the presence of suspicious ultrasonographic features on cervical lymph nodes.

  7. 78 FR 48501 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Science.gov (United States)

    2013-08-08

    ... information collection: Suspicious Activity Reporting Using the Protected Web Server (PWS). 2. Current OMB... licensees voluntarily report information on suspicious incidents on an ad-hoc basis, as these incidents...

  8. 78 FR 71673 - Agency Information Collection Activities: Submission for the Office of Management and Budget (OMB...

    Science.gov (United States)

    2013-11-29

    ... title of the information collection: Suspicious Activity Reporting using the Protected Web Server (PWS.... Abstract: The NRC licensees voluntarily report information on suspicious incidents on an ad-hoc basis, as...

  9. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

    OpenAIRE

    José L. Arias-Buría; Sebastián Truyols-Domínguez; Raquel Valero-Alcaide; Jaime Salom-Moreno; María A. Atín-Arratibel; César Fernández-de-las-Peñas

    2015-01-01

    Objective. To compare effects of ultrasound- (US-) guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n = 17) group or exercise (n = 19) group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous ele...

  10. 76 FR 79114 - Privacy Act of 1974: Implementation of Exemptions; DOT/ALL 23-Information Sharing Environment...

    Science.gov (United States)

    2011-12-21

    ...-- Information Sharing Environment (ISE) Suspicious Activity Reporting (SAR) Initiative System of Records AGENCY... established system of records titled, ``DOT/ALL 23--Information Sharing Environment (ISE) Suspicious Activity... Department exempts portions of the ``DOT/ALL 23--Information Sharing Environment (ISE) Suspicious Activity...

  11. One-pot synthesis of dextran-coated iron oxide nanoclusters for real-time regional lymph node mapping.

    Science.gov (United States)

    Fu, Chaoping; Zhou, Haipeng; Wang, Yanan; Liu, Dong; Li, Junmeng; Deng, Haijun; Qi, Xiaolong; Chen, Tao; Zhang, Li-Ming; Li, Guoxin

    2017-01-01

    The intraoperative precision cleaning of lymph nodes (LNs) is an essential component of treating neoplastic disease. To develop efficient probes for the targeted detection of LNs that could act as carriers for the specific diagnosis and treatment of metastatic LNs in the future, dextran-coated iron oxide nanoclusters (DIONs) were synthesized using a one-pot coprecipitation procedure. These modified DIONs have good water dispersibility, cytocompatibility, an optimum size, and a stable, dark brown color for LN imaging. In this study, cytotoxicity was evaluated using lymphatic endothelial cells (LECs) to predict biosafety and biocompatibility. Most importantly, the effectiveness of DIONs in mapping perigastric LNs in Sprague Dawley rats following injection into the gastric submucosal layer was demonstrated. In addition, a long-term tracing in vivo (from 4 days to 3 months) indicated that the DIONs had good biosafety and biocompatibility according to an evaluation of the behavior and blood biochemistry of the rat and a histopathological examination of the important organs.

  12. Tuberculous lymphadenitis in the left axillary misdiagnosed as metastasis: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Hui Li

    2017-03-01

    Conclusion: The TB LNs could show some performances similar to metastasis such as hypoechoic, tending to round and rich in blood. But there are some differences between TB and metastatic LN. 1 The hypo echoic TB LNs were homogenous with clear border and smooth edge. The metastatic ones usually have unsmooth edge with spicular or process. 2 Some lymph nodes with collapse and strip shaped hyper echoic areas could be detected in TB patient, that could coexistent with hypoechoic round LNs. 3 The distribution of the rich blood flow in the TB nodes was not distorted, but with branch-like shaped and distributed smoothly. It must be considered about some particular infections during the ultrasonic examinations of swelling LNs in axillary, especially there is no significant lump in the breasts.

  13. Acceptability of Supplementary Foods for Children with Moderate Acute Malnutrition and Feeding Behaviours During Home-Based Treatment

    DEFF Research Database (Denmark)

    Iuel-Brockdorff, Ann-Sophie Julie D

    group discussions, home visits and interviews. Results The pilot study showed that both CSB and LNS were equally well-accepted and there were no indication that the level of milk or the quality of soy had an impact on the organoleptic properties of the foods in healthy children. Nevertheless, more...... with medicine. During the TreatFOOD trial, we found that although all products received good ratings, LNS was more appreciated as was both LNS and CSB with high content of milk. In terms of organoleptic parameters such as taste, texture and odour, the content of milk and quality of soy did not affect......Background Moderate acute malnutrition (MAM) affects around 33 million children and is a major global health problem, causing increased morbidity and mortality and delayed cognitive development. Despite the development of lipid-based nutrient supplement (LNS) and enhanced versions of corn-soy blend...

  14. Design of a Group Decision Support System Prioritizing Air Force Logistics Needs

    Science.gov (United States)

    1990-03-01

    vii Abstract .............................................. viii I. Introduction ...Qualifications ........... 38 Criteria for Prioritizing LNs ........ 39 LN Information ......................... 40 MCDM Model...59 Test of the MCDM Model ..................... 61 Consistency of TOPSIS Model .......... 62 Design of a GDSS

  15. Extraction, quantification and degree of polymerization of yacon ...

    African Journals Online (AJOL)

    Extraction, quantification and degree of polymerization of yacon (Smallanthus sonchifolia) fructans. EWN da Fonseca Contado, E de Rezende Queiroz, DA Rocha, RM Fraguas, AA Simao, LNS Botelho, A de Fatima Abreu, MABCMP de Abreu ...

  16. Lunar Navigator - A Miniature, Fully Autonomous, Lunar Navigation, Surveyor, and Range Finder System Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Microcosm will use existing hardware and software from related programs to create a prototype Lunar Navigation Sensor (LNS) early in Phase II, such that most of the...

  17. Nuclear matter equation of state and σ-meson parameters

    Indian Academy of Sciences (India)

    Author Affiliations. A B Santra1 U Lambardo2. Nuclear Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India; Dipartimento di Fisica, Universita di Catania and INFN-LNS, Via S. Sofia 44, I-95123 Catania, Italy ...

  18. Production of krypton and xenon isotopes in thick stony and iron targets isotropically irradiated with 1600 MeV protons

    National Research Council Canada - National Science Library

    Gilabert, E; Lavielle, B; Michel, R; Leya, I; Neumann, S; Herpers, U

    2002-01-01

    Abstract— Two spherical targets made of gabbro with a radius of 25 cm and of steel with a radius of 10 cm were irradiated isotropically with 1600 MeV protons at the SATURNE synchrotron at Laboratoire National Saturne (LNS...

  19. Syndromic surveillance: etiologic study of acute febrile illness in dengue suspicious cases with negative serology. Brazil, Federal District, 2008 Vigilância sindrômica: estudo etiológico de doenças febris agudas a partir dos casos suspeitos de dengue com sorologia não reagente. Distrito Federal, Brasil, 2008

    Directory of Open Access Journals (Sweden)

    Ailton Domicio da Silva

    2010-10-01

    Full Text Available With the aim of identifying the etiology of acute febrile illness in patients suspected of having dengue, yet with non reagent serum, a descriptive study was conducted with 144 people using secondary serum samples collected during convalescence. The study was conducted between January and May of 2008. All the exams were re-tested for dengue, which was confirmed in 11.8% (n = 17; the samples that remained negative for dengue (n = 127 were tested for rubella, with 3.9% (n = 5 positive results. Among those non reactive for rubella (n = 122, tests were made for leptospirosis and hantavirus. Positive tests for leptospirosis were 13.9% (n = 17 and none for hantavirus. Non reactive results (70.8% were considered as Indefinite Febrile Illness (IFI. Low schooling was statistically associated with dengue, rubella and leptospirosis (p = 0.009, dyspnea was statistically associated with dengue and leptospirosis (p = 0.012, and exanthem/petechia with dengue and rubella (p = 0.001. Among those with leptospirosis, activities in empty or vacant lots showed statistical association with the disease (p = 0.013. Syndromic surveillance was shown to be an important tool in the etiologic identification of IFI in the Federal District of Brazil.Com o objetivo de identificar a etiologia de doenças febris agudas, em suspeitos de dengue com sorologia não reagente, realizou-se estudo descritivo com 144 pessoas utilizando amostras de soro coletados na convalescença, entre janeiro e março de 2008. Todos os exames foram re-testados para dengue, sendo as amostras negativas, processadas para rubéola (n = 127. Dentre as não reagentes para rubéola, submeteu-se ao teste para leptospirose (n = 122, e em se permanecendo sem diagnóstico, testou-se para hantavirose. Confirmou-se dengue em 11,8% (n = 17, rubéola em 3,9% (n = 5 e leptospirose em 13,9% (n = 17. Os resultados não reagentes foram considerados como doença febril aguda indiferenciada (DFI em 70.8% dos casos. Verificou-se associação estatística em baixa escolaridade nos casos de dengue, rubéola e leptospirose (p = 0,009, assim como dispnéia para dengue e leptospirose (p = 0,012, e exantema/petéquias para dengue e rubéola (p = 0,001. Dentre os doentes com leptospirose, as atividades em terreno baldio mostraram-se com diferença estatística significante (p = 0,013. A vigilância sindrômica demonstrou-se como importante ferramenta na identificação de doenças febris agudas no Distrito Federal.

  20. O uso da biópsia aspirativa com agulha fina (BAAF no diagnóstico de lesão iriana suspeita: relato de caso Fine needle aspiration biopsy (FNAB in the diagnosis of a suspicious iris lesion: case report

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2001-08-01

    Full Text Available Relatar o caso de um paciente que apresentou massa intra-ocular sólida no segmento anterior do olho direito e a investigação diagnóstica escolhida pelos autores. A dúvida diagnóstica e a recusa do paciente em aceitar o tratamento levaram os autores a realizar uma biópsia aspirativa com agulha fina da lesão. A biópsia foi realizada por meio de punção por via corneana, através do humor aquoso até a lesão tumoral. A citologia do material coletado na biópsia determinou a estratégia terapêutica neste caso. O diagnóstico citológico foi melanoma maligno primário da coróide do tipo misto. Sugeriu-se a enucleação do globo ocular devido à localização do tumor e seu potencial para metástases à distância. Após a enucleação, o exame anatomopatológico apresentou resultado concordante com a citologia. O paciente está sendo acompanhado clinicamente, sem sinais de metástases 2 anos após enucleação.To report the case of a patient who presented with a solid anterior segment intraocular mass in his right eye, and the diagnostic investigation chosen by the authors. Diagnostic uncertainty and patient's refusal to agree with the treatment caused the authors to perform a fine needle aspiration biopsy of the lesion. Biopsy was performed by corneal puncture, through the aqueous and the tumor. Cytology of the specimen obtained by the biopsy determined the therapeutic strategy for this case. Cytology diagnosis was consistent with primary malignant melanoma of the choroid of mixed cell type. Enucleation of the eye was suggested due to the position of the tumor and its potential to spread distant metastases. After enucleation, anatomopathological examination of the eye presented a similar result to cytology. The patient is currently been followed, with no signs of metastasis 2 years after enucleation.

  1. Lipid-based nutrient supplements containing vitamins and minerals attenuate renal electrolyte loss in HIV/AIDS patients starting antiretroviral therapy: A randomized controlled trial in Zambia.

    Science.gov (United States)

    Munkombwe, D; Muungo, T L; Michelo, C; Kelly, P; Chirwa, S; Filteau, S

    2016-06-01

    Advanced HIV infection combined with undernutrition and antiretroviral therapy (ART) places HIV/AIDS patients at high risk of electrolyte abnormalities and increased morbidity and mortality. Here, in a sub-study of a large published randomized trial, we evaluated if nutritional supplements will help curtail renal electrolyte loss in HIV/AIDS patients starting ART. 130 malnourished HIV-positive patients referred for ART received lipid-based nutrient supplements alone (LNS, n = 63) or together with vitamins and minerals (LNS-VM, n = 67). Serum and spot urine samples were collected and assayed for creatinine, potassium, magnesium and phosphate concentrations at baseline and after 12 weeks of ART, and fractional excretion and reabsorption were calculated using standard equations. Eighteen (28.6%) patients from the LNS and 16 (23.9%) from LNS-VM groups died, most during the referral interval before starting ART. Phosphate excretion at baseline, was high in both LNS (mean ± SD: 1.2 ± 0.6 mg/mg creatinine) and LNS-VM (1.1 ± 0.8 mg/mg creatinine) groups relative to normal physiological ranges. Phosphate excretion remained high in the LNS group (1.1 ± 0.41 mg/mg creatinine) but significantly decreased in the LNS-VM group (0.6 ± 0.28 mg/mg creatinine; p 6.4%) reflecting renal potassium wasting. However, FEK was significantly lowered in the LNS-VM group (6.2 ± 3.4%) but not in the LNS group (12.8 ± 4.7%) after 12 weeks of ART (p < 0.001). Finally, the fractional excretion of magnesium was not significantly different between the two groups at baseline (p = 0.68) and remained unchanged within normal physiological ranges at 12 weeks of ART (p = 0.82) in both groups. The LNS-VM regimen appeared to offer protection against phosphate and potassium loss during HIV/AIDS treatment. This offers potential opportunities to improve care and support of poorly nourished HIV-infected patients in resource-limited settings. www.pactr.org ID number: PACTR

  2. Three-dimensional quantitative ultrasound for detecting lymph node metastases.

    Science.gov (United States)

    Saegusa-Beecroft, Emi; Machi, Junji; Mamou, Jonathan; Hata, Masaki; Coron, Alain; Yanagihara, Eugene T; Yamaguchi, Tadashi; Oelze, Michael L; Laugier, Pascal; Feleppa, Ernest J

    2013-07-01

    Detection of metastases in lymph nodes (LNs) is critical for cancer management. Conventional histological methods may miss metastatic foci. To date, no practical means of evaluating the entire LN volume exists. The aim of this study was to develop fast, reliable, operator-independent, high-frequency, quantitative ultrasound (QUS) methods for evaluating LNs over their entire volume to effectively detect LN metastases. We scanned freshly excised LNs at 26 MHz and digitally acquired echo-signal data over the entire three-dimensional (3D) volume. A total of 146 LNs of colorectal, 26 LNs of gastric, and 118 LNs of breast cancer patients were enrolled. We step-sectioned LNs at 50-μm intervals and later compared them with 13 QUS estimates associated with tissue microstructure. Linear-discriminant analysis classified LNs as metastatic or nonmetastatic, and we computed areas (Az) under receiver-operator characteristic curves to assess classification performance. The QUS estimates and cancer probability values derived from discriminant analysis were depicted in 3D images for comparison with 3D histology. Of 146 LNs of colorectal cancer patients, 23 were metastatic; Az = 0.952 ± 0.021 (95% confidence interval [CI]: 0.911-0.993); sensitivity = 91.3% (specificity = 87.0%); and sensitivity = 100% (specificity = 67.5%). Of 26 LNs of gastric cancer patients, five were metastatic; Az = 0.962 ± 0.039 (95% CI: 0.807-1.000); sensitivity = 100% (specificity = 95.3%). A total of 17 of 118 LNs of breast cancer patients were metastatic; Az = 0.833 ± 0.047 (95% CI: 0.741-0.926); sensitivity = 88.2% (specificity = 62.5%); sensitivity = 100% (specificity = 50.5%). 3D cancer probability images showed good correlation with 3D histology. These results suggest that operator- and system-independent QUS methods allow reliable entire-volume LN evaluation for detecting metastases. 3D cancer probability images can help pathologists identify metastatic foci that could be missed using conventional

  3. 3D quantitative ultrasound for detecting lymph-node metastases

    Science.gov (United States)

    Saegusa-Beecroft, Emi; Machi, Junji; Mamou, Jonathan; Hata, Masaki; Coron, Alain; Yanagihara, Eugene T.; Yamaguchi, Tadashi; Oelze, Michael L.; Laugier, Pascal; Feleppa, Ernest

    2013-01-01

    BACKGROUND Detection of metastases in lymph nodes (LNs) is critical for cancer management. Conventional histological methods may miss metastatic foci. Currently, no practical means of entire LN-volume evaluation exists. The aim of this study is to develop fast, reliable, operator-independent, high-frequency, quantitative-ultrasound (QUS) methods for evaluating LNs over their entire volumes for effectively detecting LN metastases. MATERIALS AND METHODS Freshly excised LNs were scanned at 26 MHz and echo-signal data were digitally acquired over the entire three-dimensional (3D) volume. 146 LNs of colorectal-, 26 LNs of gastric-, and 118 LNs of breast-cancer patients were enrolled. LNs were step-sectioned at 50-μm intervals and later compared to 13 QUS estimates associated with tissue microstructure. Linear-discriminant analysis classified LNs as metastatic or non-metastatic, and areas (Az) under receiver-operator characteristic (ROC) curves were computed to assess classification performance. QUS-estimates and cancer-probability values derived from discriminant analysis were depicted in 3D images for comparison with 3D histology. RESULTS 23/146 LNs of colorectal-cancer patients were metastatic; Az = 0.952 ± 0.021 (95% CI: 0.911 to 0.993); sensitivity 91.3% (specificity 87.0%); sensitivity 100% (specificity 67.5%). 5/26 LNs of gastric-cancer patients were metastatic; Az = 0.962 ± 0.039 (95% CI: 0.807 to 1.000); sensitivity 100% (specificity 95.3%). 17/118 LNs of breast-cancer patients were metastatic; Az = 0.833 ± 0.047 (95% CI: 0.741 to 0.926); sensitivity 88.2% (specificity 62.5%); sensitivity 100% (specificity 50.5%). 3D cancer-probability images showed good correlation with 3D histology. CONCLUSIONS These results suggest that operator- and system-independent QUS methods will allow reliable entire-volume LN evaluation for detecting metastases. 3D cancer-probability images can help pathologists identify metastatic foci that could be missed using conventional

  4. Biodistribution and Efficacy of Human Adipose-Derived Mesenchymal Stem Cells Following Intranodal Administration in Experimental Colitis

    Directory of Open Access Journals (Sweden)

    Mercedes Lopez-Santalla

    2017-06-01

    Full Text Available Mesenchymal stem cells (MSCs have a large potential in cell therapy for treatment of inflammatory and autoimmune diseases, thanks to their immunomodulatory properties. The encouraging results in animal models have initiated the translation of MSC therapy to clinical trials. In cell therapy protocols with MSCs, administered intravenously, several studies have shown that a small proportion of infused MSCs can traffic to the draining lymph nodes (LNs. This is accompanied with an increase of different types of regulatory immune cells in the LNs, suggesting the importance of migration of MSCs to the LNs in order to contribute to immunomodulatory response. Intranodal (IN, also referred as intralymphatic, injection of cells, like dendritic cells, is being proposed in the clinic for the treatment of cancer and allergy, showing that this route of administration is clinically safe and efficient. In this study, we investigated, for the first time, the biodistribution and the efficacy of Luciferase+ adipose-derived MSCs (Luci-eASCs, infused through the inguinal LNs (iLNs, in normal mice and in inflamed mice with colitis. Most of the Luci-eASCs remain in the iLNs and in the adipose tissue surrounding the inguinal LNs. A small proportion of Luci-eASCs can migrate to other locations within the lymphatic system and to other tissues and organs, having a preferential migration toward the intestine in colitic mice. Our results show that the infused Luci-eASCs protected 58% of the mice against induced colitis. Importantly, a correlation between the response to eASC treatment and a higher accumulation of eASCs in popliteal, parathymic, parathyroid, and mesenteric LNs were found. Altogether, these results suggest that IN administration of eASCs is feasible and may represent an effective strategy for cell therapy protocols with human adipose-derived MSCs in the clinic for the treatment of immune-mediated disorders.

  5. A Methylene Blue–assisted Technique for Harvesting Lymph Nodes After Radical Surgery for Gastric Cancer

    Science.gov (United States)

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S.; Morita, Satoshi

    2015-01-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue–assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy. PMID:25356528

  6. A methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer: a prospective, randomized, controlled study.

    Science.gov (United States)

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S; Morita, Satoshi; Yoshikawa, Takaki

    2015-02-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue-assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy.

  7. Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases.

    Science.gov (United States)

    Wojcinski, Sebastian; Dupont, Jennifer; Schmidt, Werner; Cassel, Michael; Hillemanns, Peter

    2012-12-19

    To determine the general appearance of normal axillary lymph nodes (LNs) in real-time tissue sonoelastography and to explore the method's potential value in the prediction of LN metastases. Axillary LNs in healthy probands (n=165) and metastatic LNs in breast cancer patients (n=15) were examined with palpation, B-mode ultrasound, Doppler and sonoelastography (assessment of the elasticity of the cortex and the medulla). The elasticity distributions were compared and sensitivity (SE) and specificity (SP) were calculated. In an exploratory analysis, positive and negative predictive values (PPV, NPV) were calculated based upon the estimated prevalence of LN metastases in different risk groups. In the elastogram, the LN cortex was significantly harder than the medulla in both healthy (p=0.004) and metastatic LNs (p=0.005). Comparing healthy and metastatic LNs, there was no difference in the elasticity distribution of the medulla (p=0.281), but we found a significantly harder cortex in metastatic LNs (p=0.006). The SE of clinical examination, B-mode ultrasound, Doppler ultrasound and sonoelastography was revealed to be 13.3%, 40.0%, 14.3% and 60.0%, respectively, and SP was 88.4%, 96.8%, 95.6% and 79.6%, respectively. The highest SE was achieved by the disjunctive combination of B-mode and elastographic features (cortex >3mm in B-mode or blue cortex in the elastogram, SE=73.3%). The highest SP was achieved by the conjunctive combination of B-mode ultrasound and elastography (cortex >3mm in B-mode and blue cortex in the elastogram, SP=99.3%). Sonoelastography is a feasible method to visualize the elasticity distribution of LNs. Moreover, sonoelastography is capable of detecting elasticity differences between the cortex and medulla, and between metastatic and healthy LNs. Therefore, sonoelastography yields additional information about axillary LN status and can improve the PPV, although this method is still experimental.

  8. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T.; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge

    2015-01-01

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. PMID:26077718

  9. Enhanced Antibody Responses in a Novel NOG Transgenic Mouse with Restored Lymph Node Organogenesis

    Directory of Open Access Journals (Sweden)

    Takeshi Takahashi

    2018-01-01

    Full Text Available Lymph nodes (LNs are at the center of adaptive immune responses. Various exogenous substances are transported into LNs and a series of immune responses ensue after recognition by antigen–specific lymphocytes. Although humanized mice have been used to reconstitute the human immune system, most lack LNs due to deficiency of the interleukin (IL-2Rγ gene (cytokine common γ chain, γc. In this study, we established a transgenic strain, NOG-pRORγt-γc, in the NOD/shi-scid-IL-2Rγnull (NOG background, in which the γc gene was expressed in a lymph-tissue inducer (LTi lineage by the endogenous promoter of RORγt. In this strain, LN organogenesis was normalized and the number of human T cells substantially increased in the periphery after reconstitution of the human immune system by human hematopoietic stem cell transplantation. The distribution of human T cells differed between NOG-pRORγt-γc Tg and NOG-non Tg mice. About 40% of human T cells resided in LNs, primarily the mesenteric LNs. The LN-complemented humanized mice exhibited antigen-specific immunoglobulin G responses together and an increased number of IL-21+–producing CD4+ T cells in LNs. This novel mouse strain will facilitate recapitulation of human immune responses.

  10. Random migration and signal integration promote rapid and robust T cell recruitment.

    Science.gov (United States)

    Textor, Johannes; Henrickson, Sarah E; Mandl, Judith N; von Andrian, Ulrich H; Westermann, Jürgen; de Boer, Rob J; Beltman, Joost B

    2014-08-01

    To fight infections, rare T cells must quickly home to appropriate lymph nodes (LNs), and reliably localize the antigen (Ag) within them. The first challenge calls for rapid trafficking between LNs, whereas the second may require extensive search within each LN. Here we combine simulations and experimental data to investigate which features of random T cell migration within and between LNs allow meeting these two conflicting demands. Our model indicates that integrating signals from multiple random encounters with Ag-presenting cells permits reliable detection of even low-dose Ag, and predicts a kinetic feature of cognate T cell arrest in LNs that we confirm using intravital two-photon data. Furthermore, we obtain the most reliable retention if T cells transit through LNs stochastically, which may explain the long and widely distributed LN dwell times observed in vivo. Finally, we demonstrate that random migration, both between and within LNs, allows recruiting the majority of cognate precursors within a few days for various realistic infection scenarios. Thus, the combination of two-scale stochastic migration and signal integration is an efficient and robust strategy for T cell immune surveillance.

  11. Preoperative computed tomography of the chest in lung cancer patients: the predictive value of calcified lymph nodes for the perioperative outcomes of video-assisted thoracoscopic surgery lobectomy

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Kwang Nam; Lee, Youkyung; Wi, Jae Yeon [Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Moon, Hyeon-Jong; Sung, Yong Won [Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Department of Cardiothoracic Surgery, Seoul (Korea, Republic of)

    2013-12-15

    To determine the predictive value of identifying calcified lymph nodes (LNs) for the perioperative outcomes of video-assisted thoracoscopic surgery (VATS). Fifty-six consecutive patients who underwent VATS lobectomy for lung cancer were included. We evaluated the number and location of calcified LNs on computed tomography (CT). We investigated clinical parameters, including percentage forced expiratory volume in 1 s (FEV{sub 1}%), surgery duration, chest tube indwelling duration, and length of hospital stay. We performed linear regression analysis and multiple comparisons of perioperative outcomes. Mean number of calcified LNs per patient was 0.9 (range, 0-6), mostly located in the hilar-interlobar zone (43.8 %). For surgery duration (mean, 5.0 h), FEV{sub 1}% and emphysema severity were independent predictors (P = 0.010 and 0.003, respectively). The number of calcified LNs was an independent predictor for chest tube indwelling duration (P = 0.030) and length of hospital stay (P = 0.046). Mean duration of chest tube indwelling and hospital stay was 8.8 days and 12.7 days in no calcified LN group; 9.2 and 13.2 in 1 calcified LN group; 12.8 and 19.7 in {>=}2 calcified LNs group, respectively. The presence of calcified LNs on CT can help predict more complicated perioperative course following VATS lobectomy. (orig.)

  12. In vitro-in vivo study of CoQ10-loaded lipid nanoparticles in comparison with nanocrystals.

    Science.gov (United States)

    Piao, Hongyu; Ouyang, Mei; Xia, Dengning; Quan, Peng; Xiao, Wenhua; Song, Yanzhi; Cui, Fude

    2011-10-31

    The present work described the effect of CoQ10 dissolution characteristics in nanocrystals and lipid nanoparticles (LNs) on its oral absorption in rats. Nanocrystals and LNs were prepared by melt-high pressure homogenization and sucrose monolaurate was used as a stabilizer in all formulations. Witepsol(®)W35 and medium-chain triglycerides (MCT) were selected as lipid additives to form LN(CoQ10+W35) and LN(CoQ10+MCT), respectively. From the results obtained, the particle size of CoQ10 nanocrystals was 285 nm, while it was reduced to 150 nm by mixture with an equal amount of lipid additives due to their lower melting points. In vitro dissolution results indicated that the drug release from two LNs was delayed compared with that from nanocrystals, and LN(CoQ10+W35) exhibited the highest drug release over 4h. Finally, in vivo evaluation demonstrated that the oral absorption of CoQ10 was markedly increased by using nanocrystals and LNs compared with a coarse suspension. A good relationship was found between the in vitro dissolution and in vivo evaluation. The enhanced oral absorption of CoQ10 by nanocrystals and LNs was due to improved dissolution. In conclusion, Witepsol(®)W35 was shown to be a better lipid additive for the preparation of LNs to increase the oral absorption of CoQ10. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Linear growth increased in young children in an urban slum of Haiti: a randomized controlled trial of a lipid-based nutrient supplement.

    Science.gov (United States)

    Iannotti, Lora L; Dulience, Sherlie Jean Louis; Green, Jamie; Joseph, Saminetha; François, Judith; Anténor, Marie-Lucie; Lesorogol, Carolyn; Mounce, Jacqueline; Nickerson, Nathan M

    2014-01-01

    Haiti has experienced rapid urbanization that has exacerbated poverty and undernutrition in large slum areas. Stunting affects 1 in 5 young children. We aimed to test the efficacy of a daily lipid-based nutrient supplement (LNS) for increased linear growth in young children. Healthy, singleton infants aged 6-11 mo (n = 589) were recruited from an urban slum of Cap Haitien and randomly assigned to receive: 1) a control; 2) a 3-mo LNS; or 3) a 6-mo LNS. The LNS provided 108 kcal and other nutrients including vitamin A, vitamin B-12, iron, and zinc at ≥80% of the recommended amounts. Infants were followed monthly on growth, morbidity, and developmental outcomes over a 6-mo intervention period and at one additional time point 6 mo postintervention to assess sustained effects. The Bonferroni multiple comparisons test was applied, and generalized least-squares (GLS) regressions with mixed effects was used to examine impacts longitudinally. Baseline characteristics did not differ by trial arm except for a higher mean age in the 6-mo LNS group. GLS modeling showed LNS supplementation for 6 mo significantly increased the length-for-age z score (±SE) by 0.13 ± 0.05 and the weight-for-age z score by 0.12 ± 0.02 compared with in the control group after adjustment for child age (P growth of young children in this urban setting. The trial was registered at clinicaltrials.gov as NCT01552512.

  14. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease. © 2015 Aspelund et al.

  15. Prognostic indicators for radiotherapy of abdominal lymph node metastases from hepatocellular carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Doo Yeul; Park, Joong-Won; Kim, Tae Hyun; Lee, Ju Hee; Kim, Bo Hyun; Woo, Sang Myung; Kim, Sang Soo; Lee, Woo Jin; Kim, Dae Yong; Kim, Chang-Min [National Cancer Center, Center for Liver Cancer, Research Institute and Hospital, Goyang (Korea, Republic of)

    2015-11-15

    To identify prognostic indicators in patients treated with radiotherapy (RT) for metastases from hepatocellular carcinoma (HCC) in abdominal lymph nodes (LNs). RT was used to treat 65 patients for metastases from HCC in abdominal LNs. Total radiation dose was 30-60 Gy (median 52.8 Gy), with fraction size 1.8-3 Gy. RT was administered five times per week to an equivalent dose in 2-Gy fractions (EQD2; Gy{sub 10}) of 32.5-65 Gy{sub 10} (median 54 Gy{sub 10}) and an α/β ratio for tumor and acute effects of normal tissue of 10. Median overall survival (OS) in all patients was 8.1 months. LN responders had significantly higher median OS than nonresponders (14.5 vs. 3.7 months, p < 0.05). Multivariate analysis showed that Child-Pugh classification, status of intrahepatic tumor, number of metastatic LNs, and LN response were independently predictive of OS (p < 0.05 each). Based on results of multivariate analysis, patients were prognostically stratified according to pretreatment risk factors, including Child-Pugh classification, intrahepatic tumor status, and number of metastatic LNs; with the expected median OS in patients with ≥ 2, 1, and 0 risk factors being 2.9, 9.8, and 27.6 months, respectively (p < 0.05). Our data showed that LN response to RT was an independent prognostic factor for OS in advanced HCC patients with abdominal LN metastases, and suggested that RT for metastatic LNs might improve OS in these patients. In addition, our data suggest that Child-Pugh classification, intrahepatic tumor status, and number of metastatic LNs may be useful prognostic and therapeutic indicators for selecting treatment strategies. (orig.) [German] Identifikation von Prognoseindikatoren fuer die Strahlentherapie (RT) von Metastasten in abdominalen Lymphknoten (LN) bei Patienten mit einem Leberzellkarzinom (HCC). Bei 65 Patienten wurden HCC-Metastasen in abdominalen LNs mit einer RT behandelt. Die Gesamtdosis betrug 30-60 Gy (Mittelwert 52,8 Gy), mit Einzeldosen zwischen 1

  16. Clinically misinterpreted melanoma metastases can correctly be diagnosed by ultrasound-guided fine needle aspiration cytology

    NARCIS (Netherlands)

    G. Schaefer-Hesterberg (Gregor); A.C.J. van Akkooi (Alexander); A. Letsch (Anne); J. Roewert (Joachim); U. Blume-Peytavi (Ulrike); U. Keilholz (Ulrich); C. Voit (Christiane)

    2011-01-01

    textabstractUltrasound-guided fine needle aspiration cytology (US-guided FNAC) of regional nodal basins is increasingly incorporated into the national follow-up schemes of high risk melanoma patients. In this paper we describe an additional added value of US-guided FNAC in the detection and

  17. EUS – Fine- Needle Aspiration Biopsy (FNAB in the Diagnosis of Pancreatic Adenocarcinoma: A Review

    Directory of Open Access Journals (Sweden)

    Kalogeraki Alexandra

    2016-03-01

    Full Text Available Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS is a relatively new technology that employs endoscopy and high-frequency ultrasound (US. EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP brushing, CT-guided biopsies, and transabdominal ultrasound (US have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities

  18. Metabolomics of Breast Cancer Using High-Resolution Magic Angle Spinning Magnetic Resonance Spectroscopy: Correlations with 18F-FDG Positron Emission Tomography-Computed Tomography, Dynamic Contrast-Enhanced and Diffusion-Weighted Imaging MRI.

    Directory of Open Access Journals (Sweden)

    Haesung Yoon

    Full Text Available Our goal in this study was to find correlations between breast cancer metabolites and conventional quantitative imaging parameters using high-resolution magic angle spinning (HR-MAS magnetic resonance spectroscopy (MRS and to find breast cancer subgroups that show high correlations between metabolites and imaging parameters.Between August 2010 and December 2013, we included 53 female patients (mean age 49.6 years; age range 32-75 years with a total of 53 breast lesions assessed by the Breast Imaging Reporting and Data System. They were enrolled under the following criteria: breast lesions larger than 1 cm in diameter which 1 were suspicious for malignancy on mammography or ultrasound (US, 2 were pathologically confirmed to be breast cancer with US-guided core-needle biopsy (CNB 3 underwent 3 Tesla MRI with dynamic contrast-enhanced (DCE and diffusion-weighted imaging (DWI and positron emission tomography-computed tomography (PET-CT, and 4 had an attainable immunohistochemistry profile from CNB. We acquired spectral data by HR-MAS MRS with CNB specimens and expressed the data as relative metabolite concentrations. We compared the metabolites with the signal enhancement ratio (SER, maximum standardized FDG uptake value (SUV max, apparent diffusion coefficient (ADC, and histopathologic prognostic factors for correlation. We calculated Spearman correlations and performed a partial least squares-discriminant analysis (PLS-DA to further classify patient groups into subgroups to find correlation differences between HR-MAS spectroscopic values and conventional imaging parameters.In a multivariate analysis, the PLS-DA models built with HR-MAS MRS metabolic profiles showed visible discrimination between high and low SER, SUV, and ADC. In luminal subtype breast cancer, compared to all cases, high SER, ADV, and SUV were more closely clustered by visual assessment. Multiple metabolites were correlated with SER and SUV in all cases. Multiple metabolites

  19. Toxoplasmic Lymphadenitis Mimicking a Metastatic Thyroid Carcinoma at {sup 18}F-FDG-PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Treglia, Giorgio; Bongiovanni, Massimo; Ceriani, Luca; Paone, Gaetano; Giovanella, Luca [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2013-12-15

    A 28-year-old woman underwent total thyroidectomy for a papillary thyroid carcinoma in the right thyroid lobe (pTx, pN1b). Subsequently a {sup 131}I-ablation (4.4 GBq) was performed. Four years later the patient presented increased thyroglobulin (Tg) serum levels (8.4 μg/l) during thyroxine treatment. Furthermore, enlarged hypoechoic and round-shaped bilateral cervical lymph nodes were detected at cervical ultrasonography (US). Based on laboratory and US findings suspicious for lymph nodal recurrence of thyroid carcinoma, the patient underwent an {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG-PET/CT) to check for distant metastases (Fig. 1). The patient underwent a US-guided fine-needle aspiration cytology on an {sup 18}F-FDG-avid cervical lymph-node. The smears were hypercellulated and consisted of numerous small- to medium-sized lymphocytes, macrophages, dendritic cells and tingible body macrophages. The cytological diagnosis was consistent with that of reactive lymphadenitis. Serological test revealed elevated IgM and IgG anti-Toxoplasma antibodies with a very low IgG-avidity, indicating an acute toxoplasmosis. Serum Tg was then measured by using heterophilic antibody blocking tubes, as previously reported, and serum value dropped to <0.2 μg/l. It is well known that antibody interference may falsely increase serum Tg; in particular, increased anti-Toxoplasma antibodies likely interfered to the Tg measurement in our case. Additionally, activated granulocytes and macrophages may display significantly increased glucose consumption, giving false-positive results at {sup 18}F-FDG-PET/CT in oncological patients. Few reports have described toxoplasmic infection mimicking malignancy at {sup 18}F-FDG-PET/CT; these findings were found mainly in immunodepressive patients or with history of lymphoma. Conversely, we described here a case of toxoplasmosis inducing false-positive Tg measurement, neck US and {sup 18}F

  20. Central zone lesions on magnetic resonance imaging: Should we be concerned?

    Science.gov (United States)

    Tan, Wei Phin; Mazzone, Andrew; Shors, Stephanie; Antoine, Nency; Ekbal, Shahid; Khare, Narendra; McKiel, Charles; Pessis, Dennis; Deane, Leslie

    2017-01-01

    The Prostate Imaging Reporting and Data System (PI-RADS) score was developed to evaluate lesions in the peripheral and transition zone on multiparametric magnetic resonance imaging (mpMRI) of the prostate. We aim to determine if the PI-RADS scoring system can be used to evaluate central zone lesions on mpMRI. A retrospective review of 73 patients who underwent mpMRI/ultrasound (US) fusion-guided biopsy of 143 suspicious lesions between February 2014 and October 2015 was performed. All patients underwent a 3T mpMRI. Indications for mpMRI included an abnormal digital rectal examination, PSA velocity >0.75ng/dl/y, and patients on active surveillance. The mpMRI sequence involved T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast enhancement. Using 3-dimensional model software (Invivo Corporation, Gainesville, FL, USA), a minimum of 3 magnetic resonance imaging (MRI)/US fusion-guided biopsy samples were taken from each prostate lesion seen on mpMRI irrespective of PI-RADS score, using local anesthesia in an outpatient clinic setting. A total of 73 patients underwent MRI/US fusion-guided biopsy of 85 peripheral zone lesions, 31 transitional zone lesions, and 27 central zone lesions. Only 2 (7%) of central zone lesions were positive for prostate cancer. Both patients had lesions which were graded as PI-RADS 3. Both the patients had multifocal lesions that encompassed≥50% of the central and transition zones on the sagittal view MRI images. Both patients previously had transrectal US-guided biopsy of the prostate which was negative for cancer. Both patients underwent a robotic-assisted laparoscopic prostatectomy, each revealing high-grade cancer. Lesions involving only the central gland/zone seen on MRI are less concerning for malignancy and should not be given equal weight as peripheral zone lesions. In this series, no lesions involving solely the central gland/zone, regardless of PI-RADS score, was positive for malignancy on MRI/US fusion

  1. Responsive feeding and child interest in food vary when rural Malawian children are fed lipid-based nutrient supplements or local complementary food.

    Science.gov (United States)

    Flax, Valerie L; Mäkinen, Samppa; Ashorn, Ulla; Cheung, Yin Bun; Maleta, Kenneth; Ashorn, Per; Bentley, Margaret E

    2013-07-01

    Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Malawian children receiving 50 g/day of supplementary LNS for 12 weeks were videotaped during LNS (n = 32) and local complementary feeding (n = 28) episodes. Behaviours were coded at the level of the intended bite (1674 total bites). The analysis used regression models adjusted for within-subject correlation. Caregivers were less likely to allow children to self-feed and more likely to use physical pressure during LNS vs. complementary food bites. Positive caregiver verbalization was infrequent and did not differ by type of food. Higher odds of accepting a bite were associated with the bite containing LNS, odds ratio (OR) 3.05; 90% confidence interval (CI) (1.98, 4.71), the child self-feeding, OR 5.70; 90% CI (2.77, 11.69), and positive caregiver verbalization, OR 2.46; 90% CI (1.26, 4.80), while lower odds of acceptance were associated with negative child verbalization during feeding, OR 0.27; 90% CI (0.17, 0.42). In this sample, caregivers used more responsive feeding practices during bites of local complementary food and were more controlling when feeding LNS. Responsive caregiver behaviours predicted child acceptance of food. These results could be used to design interventions in Malawi to improve responsive feeding practices in general and during LNS use. © 2011 John Wiley & Sons Ltd.

  2. O-(2-[{sup 18}F]Fluoroethyl)-L-tyrosine (FET): a tracer for differentiation of tumour from inflammation in murine lymph nodes

    Energy Technology Data Exchange (ETDEWEB)

    Rau, Friederike C.; Weber, Wolfgang A.; Wester, Hans-Juergen; Herz, Michael; Schwaiger, Markus; Senekowitsch-Schmidtke, Reingard [Nuklearmedizinische Klinik der Technischen Universitaet Muenchen, Ismaninger Strasse 22, 81675 Muenchen (Germany); Becker, Ingrid [Institut fuer Pathologie der Technischen Universitaet Muenchen (Germany); Krueger, Achim [Institut fuer Experimentelle Onkologie und Therapieforschung der Technischen Universitaet Muenchen (Germany)

    2002-08-01

    The aim of this study was to investigate quantitatively the uptake of FDG, [{sup 3}H]methyl-L-methionine (MET) and O-2-([{sup 18}F]fluoroethyl)-L-tyrosine (FET) in tumour-infiltrated and immunologically stimulated LNs. Popliteal LNs of Balb/c and DBA/2 mice were stimulated by injection into the right posterior foot pad of mice of either streptozotocin (STZ), causing chronic lymphadenitis, or concanavalin A (Con A), resulting in acute lymphadenitis. Tumour-infiltrated popliteal LNs were induced by inoculation of 2 x 10{sup 5} lacZ-tagged T cell mouse lymphoma cells into the right posterior foot pad of syngeneic mice. Twenty-one days post inoculation of tumour cells or at various time points after STZ or Con A injection, mice were simultaneously injected intravenously with MET and FDG or MET and FET. After 30 min, mice were sacrificed and tracer uptake was determined in popliteal LNs. Contralateral LNs and LNs of untreated mice served as controls. Histopathological and immunohistochemical analysis demonstrated typical signs of chronic inflammation (non-specific sinus hyperplasia with macrophages) in STZ-treated animals and acute inflammatory changes (accumul ation of neutrophilic granulocytes, vascular dilation, follicular hyperplasia) in Con A-treated animals. X-Gal staining confirmed the presence of tumour cells in the LNs of the injected side of tumour-inoculated mice. In the chronic lymphadenitis model, FDG uptake increased 3.0{+-}0.1 fold [from 2.7{+-}0.2 to 8.2{+-}1.2 percent of injected dose per gram tissue (%ID/g)] and MET uptake 2.0{+-}0.01 fold (from 4.5{+-}0.6 to 9.2{+-}1.1 %ID/g). In the acute lymphadenitis model, FDG uptake increased 3.9{+-}0.3 fold (from 2.7{+-}0.2 to 10.6{+-}2.4 %ID/g) and MET uptake 1.9{+-}0.1 fold (from 4.5{+-}0.6 to 8.5{+-}1.4 %ID/g). In contrast, FET uptake in both lymphadenitis models (1.0{+-}0.03 and 1.2{+-}0.04 fold) was not significantly different from that in controls (from 4.2{+-}0.3 to 4.7{+-}0.7 and to 5.1{+-}0.4 %ID

  3. Small-quantity lipid-based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young burkinabe children: a cluster-randomized trial.

    Directory of Open Access Journals (Sweden)

    Sonja Y Hess

    Full Text Available Small-quantity lipid-based nutrient supplements (SQ-LNS are promising home fortification products, but the optimal zinc level needed to improve growth and reduce morbidity is uncertain. We aimed to assess the impact of providing SQ-LNS with varied amounts of zinc, along with illness treatment, on zinc-related outcomes compared with standard care. In a placebo-controlled, cluster-randomized trial, 34 communities were stratified to intervention (IC or non-intervention cohorts (NIC. 2435 eligible IC children were randomly assigned to one of four groups:1 SQ-LNS without zinc, placebo tablet; 2 SQ-LNS containing 5mg zinc, placebo tablet; 3 SQ-LNS containing 10mg zinc, placebo tablet; or 4 SQ-LNS without zinc and 5mg zinc tablet from 9–18 months of age. During weekly morbidity surveillance, oral rehydration salts were provided for reported diarrhea and antimalarial therapy for confirmed malaria. Children in NIC (n = 785 did not receive SQ-LNS, tablets, illness surveillance or treatment. At 9 and 18 months, length, weight and hemoglobin were measured in all children. Reported adherence was 97 ± 6% for SQ-LNS and tablets. Mean baseline hemoglobin was 89 ± 15g/L. At 18 months, change in hemoglobin was greater in IC than NIC (+8 vs -1g/L, p<0.0001, but 79.1% of IC were still anemic (vs. 91.1% in NIC. Final plasma zinc concentration did not differ by group. During the 9-month observation period, the incidence of diarrhea was 1.10 ± 1.03 and of malaria 0.54 ± 0.50 episodes per 100 child-days, and did not differ by group. Length at 18 months was significantly greater in IC compared to NIC (77.7 ± 3.0 vs. 76.9 ± 3.4 cm; p<0.001 and stunting prevalence was significantly lower in IC (29.3% than NIC (39.3%; p<0.0001, but did not differ by intervention group within IC. Wasting prevalence was also significantly lower in IC (8.7% than in NIC (13.5%; p = 0.0003. Providing SQ-LNS daily with or without zinc, along with malaria and diarrhea treatment

  4. Tuberculous lymphadenitis: FDG PET and CT findings in responsive and nonresponsive disease

    Energy Technology Data Exchange (ETDEWEB)

    Sathekge, Mike [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); University of Pretoria, Steve Biko Academic Hospital, Private Bag X169, Pretoria (South Africa); Maes, Alex [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); University Hospital Leuven, Department of Morphology and Medical Imaging, Leuven (Belgium); D' Asseler, Yves [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium); Vorster, Mariza [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); Gongxeka, Harlem [University of Pretoria, Department of Radiology, Pretoria (South Africa); Wiele, Christophe van de [University of Pretoria, Department of Nuclear Medicine, Pretoria (South Africa); University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium)

    2012-07-15

    No data is available on the different FDG PET and CT findings in the lymph nodes (LN) of patients with HIV and tuberculosis (TB) who respond compared with those who do not respond to anti-TB treatment by 4 months after initiation of TB treatment. These findings were the focus of our study. PET/CT scans performed at 4 months after initiation of TB treatment in 20 consecutive HIV patients were analysed. SUVmax values were obtained for all regions of LN involvement. The diameter of the LNs was measured and the CT enhancement (LNs showing peripheral rim enhancement with central low attenuation, PRECLO, in comparison with homogeneously involved LNs) and the calcification patterns of involved LNs assessed. The relationship between the PET and CT findings and the clinical outcome, response or nonresponse, was evaluated. FDG PET identified 91 sites of LN involvement, 20 of which were not identified by CT. SUVmax values were significantly higher in nonresponders (8 patients, SUVmax 11.2 {+-} 4.0, mean {+-} SD) when compared to responders (12 patients, SUVmax 2.6 {+-} 2.3; p = 0.0001). In ROC analysis (AUC 0.952) a cut-off value of 4.5 for SUVmax yielded a sensitivity and specificity of 95 % and 85 % for discriminating nonresponding from responding LNs. LNs were significantly larger in nonresponders (1.9 {+-} 0.4 cm) than in responders (1.4 {+-} 0.4 cm; p = 0.0001); the AUC in the ROC analysis was 0.76. PRECLO LNs were significantly larger (2.2 {+-} 0.3 cm) than homogeneous involved LN basins (1.5 {+-} 0.4 cm) and LN basins with calcification (1.4 {+-} 0.5 cm; p = 0.001). Using the presence of at least one LN basin with PRECLO as a criterion for nonresponse, responders could be separated from nonresponders with a sensitivity of 88 % and a specificity of 66 %. LNs responding to TB treatment could be differentiated from nonresponding LNs with a sensitivity and specificity of 95 % and 85 % using a SUVmax cut-off value of 4.5 and a sensitivity and specificity of 88 % and 66

  5. Effect of visceral fat area on outcomes of laparoscopyassisted distal gastrectomy for gastric cancer: subgroup analysis by gender and parameters of obesity.

    Science.gov (United States)

    Go, Ji-Eon; Kim, Min-Chan; Kim, Ki-Han; Oh, Jong-Young; Kim, Yoo-Min

    2015-06-01

    The aim of this study was to investigate the impact of the visceral fat area (VFA) of patients with gastric cancer undergoing laparoscopic surgery on operative outcomes such as number of retrieved lymph nodes (LNs) and operative time. We retrospectively reviewed the medical records and the CT scans of 597 patients with gastric cancer who underwent laparoscopy assisted distal gastrectomy (LADG) with partial omentectomy and LN dissection (>D1 plus beta). Patients were stratified by gender, VFA, and body mass index (BMI), and the clinicopathologic characteristics and operative outcomes were evaluated. Multiple linear regression analysis was used to assess the effects of VFA and BMI on the number of retrieved LNs and operative time in male and female patients. The mean number of retrieved LNs was significantly decreased for both male and female patients with high VFA. The operative time was significantly longer for both male and female patients with high VFA. The number of retrieved LNs had a statistically significant negative correlation with VFA in both men and women, but not with BMI. The operative time had a statistically significant positive correlation with VFA in men, whereas the operative time had a statistically significant positive correlation with BMI in women. The preoperative VFA of male patients with gastric cancer who undergo LADG may affect the number of retrieved LNs and operative time. VFA was more useful than BMI for predicting outcomes of LADG.

  6. Development and Physico-Chemical Characterization of a Shea Butter-Containing Lipid Nutrition Supplement for Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Elizabeth M. Sloffer

    2017-11-01

    Full Text Available Lipid-based nutrient supplements (LNS are used to prevent and treat moderate and severe acute malnutrition, a leading cause of mortality in children-under-five. The physical and chemical changes of two new LNS products were evaluated before and after accelerated shelf life testing (ASLT according to protocols suggested by the U.S. Agency for International Development (USAID and Doctors without Borders and compared against USAID’s A-20 paste as a control. LNS formulas containing Shea butter from the Shea nut tree (Vitellaria paradoxa, a common fat source in parts of Sub-Saharan Africa, with and without flax-seed oil, as a source of omega-3 fatty acids, were developed. LNS formulas were batched (0.8 kg in a wet grinder, sealed under nitrogen in three-layer mini-pouches (20 g, and underwent ASLT at 40 ± 2 °C for six months with sampling every eight weeks. At each time point, water activity, moisture, peroxide value, oil separation, vitamin C content, and hardness were evaluated. Results showed comparable stability among all formulas with an increase in Aw (p < 0.05 but no change in vitamin C, oil separation, or peroxide value. Addition of Shea butter improved the LNS’s hardness, which remained stable over time. Modifying fat profile in LNS can improve its texture and essential fatty acid content without affecting its storage stability.

  7. Laboratory for Nuclear Science. High Energy Physics Program

    Energy Technology Data Exchange (ETDEWEB)

    Milner, Richard [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2014-07-30

    High energy and nuclear physics research at MIT is conducted within the Laboratory for Nuclear Science (LNS). Almost half of the faculty in the MIT Physics Department carry out research in LNS at the theoretical and experimental frontiers of subatomic physics. Since 2004, the U.S. Department of Energy has funded the high energy physics research program through grant DE-FG02-05ER41360 (other grants and cooperative agreements provided decades of support prior to 2004). The Director of LNS serves as PI. The grant supports the research of four groups within LNS as “tasks” within the umbrella grant. Brief descriptions of each group are given here. A more detailed report from each task follows in later sections. Although grant DE-FG02-05ER41360 has ended, DOE continues to fund LNS high energy physics research through five separate grants (a research grant for each of the four groups, as well as a grant for AMS Operations). We are pleased to continue this longstanding partnership.

  8. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition

    DEFF Research Database (Denmark)

    Fabiansen, Christian; Yaméogo, Charles W; Iuel-Brockdorf, Ann-Sophie

    2017-01-01

    BACKGROUND: Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplement (LNS) or corn-soy blend (CSB). We assessed the effectiveness of (a) matrix, i.e., LNS or CSB, (b) soy quality, i.e., soy isolate (SI) or dehulled soy (DS), and (c) percentage of total prot...... rehabilitated. Nevertheless, LNS yields more fat-free tissue and higher recovery rates than CSB. Moreover, current LNSs with DS may be improved by shifting to SI. The role of milk relative to soy merits further research. TRIAL REGISTRATION: ISRCTN registry ISRCTN42569496.......BACKGROUND: Children with moderate acute malnutrition (MAM) are treated with lipid-based nutrient supplement (LNS) or corn-soy blend (CSB). We assessed the effectiveness of (a) matrix, i.e., LNS or CSB, (b) soy quality, i.e., soy isolate (SI) or dehulled soy (DS), and (c) percentage of total...... protein from dry skimmed milk, i.e., 0%, 20%, or 50%, in increasing fat-free tissue accretion. METHODS AND FINDINGS: Between September 9, 2013, and August 29, 2014, a randomised 2 × 2 × 3 factorial trial recruited 6- to 23-month-old children with MAM in Burkina Faso. The intervention comprised 12 weeks...

  9. Manganese Oxide-Coated Carbon Nanotubes As Dual-Modality Lymph Mapping Agents for Photothermal Therapy of Tumor Metastasis.

    Science.gov (United States)

    Wang, Sheng; Zhang, Qin; Yang, Peng; Yu, Xiangrong; Huang, Li-Yong; Shen, Shun; Cai, Sanjun

    2016-02-17

    Lymph node (LN) status is a major indicator of stage and survival of lung cancer patients. LN dissection is a primary option for lung cancer LN metastasis; however, this strategy elicits adverse effects and great trauma. Therefore, developing a minimally invasive technique to cure LN metastasis of lung cancer is desired. In this study, multiwalled carbon nanotubes (MWNTs) coated with manganese oxide (MnO) and polyethylene glycol (PEG) (namely MWNTs-MnO-PEG) was employed as a lymphatic theranostic agent to diagnose and treat metastatic LNs. After single local injection and lymph drainage were performed, regional LNs were clearly mapped by T1-weighted magnetic resonance (MR) of MnO and dark dye imaging of MWNTs. Meanwhile, metastatic LNs could be simultaneously ablated by near-infrared (NIR) irradiation under the guidance of dual-modality mapping. The excellent result was obtained in mice bearing LNs metastasis models, showing that MWNTs-MnO-PEG as a multifunctional theranostic agent was competent for dual-modality mapping guided photothermal therapy of metastatic LNs.

  10. Reduced number of CD169+macrophages in pre-metastatic regional lymph nodes is associated with subsequent metastatic disease in an animal model and with poor outcome in prostate cancer patients.

    Science.gov (United States)

    Strömvall, Kerstin; Sundkvist, Kristoffer; Ljungberg, Börje; Halin Bergström, Sofia; Bergh, Anders

    2017-11-01

    Tumor-derived antigens are captured by CD169 + (SIGLEC1 + ) sinus macrophages in regional lymph nodes (LNs), and are presented to effector cells inducing an anti-tumor immune response. Reduced CD169 expression in pre-metastatic regional LNs is associated with subsequent metastatic disease and a poor outcome in several tumor types, but if this is the case in prostate cancer has not been explored. CD169 expression was measured with immunohistochemistry in metastasis-free regional LNs from 109 prostate cancer patients treated with prostatectomy (January 1996 to April 2002). Possible associations of CD169 expression with PSA-relapse, prostate cancer death, Gleason score, and other clinical data were assessed using Kaplan-Meier survival- and Cox regression analysis. In addition, the Dunning rat prostate tumor model was used to examine CD169 expression in pre-metastatic LNs draining either highly metastatic MatLyLu- or poorly metastatic AT1-tumors. In patients with low CD169 immunostaining in metastasis-free regional LNs, 8 of the 27 patients died from prostate cancer compared with only three of the 82 patients with high immunostaining (P cancer aggressiveness. © 2017 The Authors. The Prostate Published by Wiley Periodicals, Inc.

  11. Rationale for a Minimum Number of Lymph Nodes Removed with Non-Small Cell Lung Cancer Resection: Correlating the Number of Nodes Removed with Survival in 98,970 Patients.

    Science.gov (United States)

    Samayoa, Andres X; Pezzi, Todd A; Pezzi, Christopher M; Greer Gay, E; Asai, Megumi; Kulkarni, Nandini; Carp, Ned; Chun, Stephen G; Putnam, Joe B

    2016-12-01

    The benefit of thoracic lymphadenectomy in the treatment of resectable non-small cell lung cancer (NSCLC) continues to be debated. We hypothesized that the number of lymph nodes (LNs) removed for patients with pathologic node-negative NSCLC would correlate with survival. The National Cancer Data Base (NCDB) was queried for resected, node-negative, NSCLC patients treated between 2004 and 2014. Patients were grouped according to the number of LNs removed (1-4, 5-8, 9-12, 13-16, and ≥17). Patients with patients with NSCLC reported to the NCDB during the study period, 98,970 (9.0 %) underwent resection without evidence of pathologic nodal involvement. Lobectomy was performed in 83.9 %, sublobar resection was performed in 12.7 % and pneumonectomy was performed in 2.8 % of patients. The number of LNs removed correlated with increasing tumor size and extent of resection. On multivariate analysis, increasing age, male sex, white ethnicity, high tumor grade, larger tumor size, pneumonectomy, and positive surgical margins were all negatively correlated with overall survival. The number of LNs removed and lobectomy/bi-lobectomy correlated with improved survival. The removal of patients is associated with the number of LNs removed. The surgical management of early-stage NSCLC should include thoracic lymphadenectomy of at least 10 nodes.

  12. Sono-elastography for differentiating benign and malignant cervical lymph nodes: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Mahsa Ghajarzadeh

    2014-01-01

    Full Text Available We did this systematic review to determine diagnostic accuracy of sono-elastography in evaluating cervical lymph nodes (LNs. A highly sensitive search for sono-elastography and LNs was performed in MEDLINE, Cochrane Library, ACP Journal Club, EMBASE, Health Technology assessment, and ISI web of knowledge for studies published prior to December 2012. SPSS version 18 (SPSS Inc., Chicago, IL, USA used for descriptive analysis and meta-disk version 1.4 applied for meta-analysis. Forest plots for pooled estimates and summery of receiver operating characteristic plots for different cut-offs were produced. The literature and manual search yielded 69 articles, of which 10 were eligible to include. A total of 578 individuals with a total number of 936 cervical LNs was evaluated (502 malignant and 434 benign. The summary sensitivity of the scoring and strain ratio (SR measurements for the differentiation of benign and malignant LNs were 0.76 (95% CI: 0.71-0.8 and 0.83 (95% CI: 0.78-0.87. The summary specificities were 0.8 (95% confidence interval [CI]: 0.75-0.84 and 0.84 (95% CI: 0.79-0.88, respectively. Area under the curve for scoring system was 0.86 (standard error [SE] = 0.03 and 0.95 (SE = 0.02 for SR measurement. Sono-elastograohy has high accuracy in differentiating benign and malignant cervical LNs.

  13. Visualization of fluid drainage pathways in lymphatic vessels and lymph nodes using a mouse model to test a lymphatic drug delivery system.

    Science.gov (United States)

    Kodama, Tetsuya; Hatakeyama, Yuriko; Kato, Shigeki; Mori, Shiro

    2015-01-01

    Curing/preventing micrometastasis to lymph nodes (LNs) located outside the surgically resected area is essential for improving the morbidity and mortality associated with breast cancer and head and neck cancer. However, no lymphatic therapy system exists that can deliver drugs to LNs located outside the dissection area. Here, we demonstrate proof of concept for a drug delivery system using MXH10/Mo-lpr/lpr mice that exhibit systemic lymphadenopathy, with some peripheral LNs being as large as 10 mm in diameter. We report that a fluorescent solution injected into the subiliac LN (defined as the upstream LN within the dissection area) was delivered successfully to the proper axillary LN (defined as the downstream LN outside the dissection area) through the lymphatic vessels. Our results suggest that this approach could be used before surgical resection to deliver drugs to downstream LNs outside the dissection area. We anticipate that our methodology could be applied clinically, before surgical resection, to cure/prevent micrometastasis in LNs outside the dissection area, using techniques such as ultrasound-guided internal jugular vein catheterization.

  14. Effects on anthropometry and appetite of vitamins and minerals given in lipid nutritional supplements for malnourished HIV-infected adults referred for antiretroviral therapy: results from the NUSTART randomized controlled trial.

    Science.gov (United States)

    Rehman, Andrea M; Woodd, Susannah; PrayGod, George; Chisenga, Molly; Siame, Joshua; Koethe, John R; Heimburger, Douglas C; Kelly, Paul; Friis, Henrik; Filteau, Suzanne

    2015-04-01

    The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. We hypothesized that both vitamin and mineral deficiencies and poor appetite limit weight gain in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. The randomized controlled Nutritional Support for Africans Starting Antiretroviral Therapy trial was conducted in Mwanza, Tanzania, and Lusaka, Zambia. ART-naive adults referred for ART and with body mass index vitamins and minerals (LNS-VM), beginning before ART initiation. Participants were given 30 g/d LNS from recruitment until 2 weeks after starting ART and 250 g/d from weeks 2 to 6 of ART. Of 1815 patients recruited, 365 (20%) died during the study and 813 (45%) provided data at 12 weeks. Controlling for baseline values, anthropometric measures were consistently higher at 12-week ART in the LNS-VM than in the LNS group but statistically significant only for calf and mid-upper arm circumferences and triceps skinfold. Appetite did not differ between groups. Using piecewise mixed-effects quadratic models including all patients and time points, the main effects of LNS-VM were seen after starting ART and were significant for weight, body mass index, and mid-upper arm circumference. Provision of high levels of vitamins and minerals to patients referred for ART, delivered with substantial macronutrients, increased nutritional recovery but did not seem to act through treatment group differences in appetite.

  15. A case report of gastric lymphocytic phlebitis, a rare mimic for malignancy

    Directory of Open Access Journals (Sweden)

    Daniel L. Chan

    2017-01-01

    Conclusion: If clinical history and endoscopic findings are suspicious for malignancy, despite normal biopsies, an aggressive surgical resection remains reasonable given the rarity gastric lymphocytic phlebitis.

  16. Ultrasonographic features of metastatic lymph nodes in papillary thyroid microcarinomas and macrocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Young Gyung; Kang, Hee; Joh, Young Doc; Jeong, Kyung Soon; Kim, Beom Su [Dept. of Radiology, Kosin University Gospel Hospital, Busan(Korea, Republic of)

    2015-02-15

    To analyze ultrasonographic (US) features of metastatic lymph nodes (LNs) in papillary thyroid microcarcinomas (PTMC) and in papillary thyroid macrocarcinomas. The study reviewed US findings of 273 patients with pathologically confirmed papillary thyroid carcinoma (PTC) and metastatic LNs based on the US examination. Patients were divided into two groups: PTMC and papillary thyroid macrocarcinomas. The 273 patients with PTC included 87 with PTMC and 186 with papillary thyroid macrocarcinoma. No significant difference of US features in patients with lateral neck node metastasis was found between PTMC (n = 96) and macrocarcinoma (n = 29). In central neck node metastasis, round shape was the most frequent findings in both groups (p < 0.001). There was no significant difference in US features of metastatic LNs between PTMC and papillary thyroid macrocarcinomas. Therefore, careful evaluation of the whole neck should be made.

  17. The effect of nutritional supplementation on quality of life in people living with HIV

    DEFF Research Database (Denmark)

    Tesfaye Woldeyohannes, Markos; Kæstel, Pernille; Olsen, Mette Frahm

    2016-01-01

    OBJECTIVE: To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART), and to investigate the effects of timing of supplementation by comparing with supplementation during...... the subsequent 3 months. METHODS: Randomized controlled trial in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17kg/m(2) and given daily supplements of 200 grams of LNS containing whey or soy either during the first 3...... quality of life score between the early and delayed supplementation groups [β=3.0, 95% confidence interval: -0.4: 6.4]. However, the early supplementation group showed higher scores on the social and spirituality domains than the delayed group. CONCLUSIONS: LNS given during the first 4 months of ART...

  18. Lesch-nyhan syndrome in an Indian child

    Directory of Open Access Journals (Sweden)

    Priyanka Chandekar

    2015-01-01

    Full Text Available Hypoxanthine guanine phosphoribosyl transferase-1 (HGPRT-1 leading to Lesch-Nyhan syndrome (LNS is one of the important causes of self-mutilation. Hereby, we report a case of LNS in a three and half-year-old male child, who presented with characteristic self-mutilating behavior. He had history of developmental delay, difficulty in social interaction, attention deficit and features of autism. His serum blood biochemistry was normal except for low hemoglobin levels and raised serum uric acid levels. With a diagnosis of LNS, the child was treated with allopurinol. With various modalities of physical restraint, his self-mutilating behavior came under control and currently the patient is being followed up.

  19. Math anxiety differentially affects WAIS-IV arithmetic performance in undergraduates.

    Science.gov (United States)

    Buelow, Melissa T; Frakey, Laura L

    2013-06-01

    Previous research has shown that math anxiety can influence the math performance level; however, to date, it is unknown whether math anxiety influences performance on working memory tasks during neuropsychological evaluation. In the present study, 172 undergraduate students completed measures of math achievement (the Math Computation subtest from the Wide Range Achievement Test-IV), math anxiety (the Math Anxiety Rating Scale-Revised), general test anxiety (from the Adult Manifest Anxiety Scale-College version), and the three Working Memory Index tasks from the Wechsler Adult Intelligence Scale-IV Edition (WAIS-IV; Digit Span [DS], Arithmetic, Letter-Number Sequencing [LNS]). Results indicated that math anxiety predicted performance on Arithmetic, but not DS or LNS, above and beyond the effects of gender, general test anxiety, and math performance level. Our findings suggest that math anxiety can negatively influence WAIS-IV working memory subtest scores. Implications for clinical practice include the utilization of LNS in individuals expressing high math anxiety.

  20. A Low-Power Two-Digit Multi-dimensional Logarithmic Number System Filterbank Architecture for a Digital Hearing Aid

    Directory of Open Access Journals (Sweden)

    William Miller

    2005-11-01

    Full Text Available This paper addresses the implementation of a filterbank for digital hearing aids using a multi-dimensional logarithmic number system (MDLNS. The MDLNS, which has similar properties to the classical logarithmic number system (LNS, provides more degrees of freedom than the LNS by virtue of having two, or more, orthogonal bases and the ability to use multiple MDLNS components or digits. The logarithmic properties of the MDLNS also allow for reduced complexity multiplication and large dynamic range, and a multiple-digit MDLNS provides a considerable reduction in hardware complexity compared to a conventional LNS approach. We discuss an improved design for a two-digit 2D MDLNS filterbank implementation which reduces power and area by over two times compared to the original design.

  1. Botulinum toxin: treatment of self-mutilation in patients with Lesch-Nyhan syndrome.

    Science.gov (United States)

    Gutierrez, Cristiam; Pellene, Alejandro; Micheli, Federico

    2008-01-01

    Lesch-Nyhan syndrome (LNS) is a rare X-linked recessive disorder involving purine metabolism caused by the congenital absence of hypoxanthine guanine phosphoribosyl transferase. A characteristic feature of LNS is the appearance of intractable self-injurious behavior, usually in the form of severe lip and finger biting. The mechanism behind this severe self-mutilating behavior is unknown, and is one of the main challenges in the management of this condition. We here report the case of a 30-year-old man with a confirmed diagnosis of LNS who was successfully treated for self-mutilation of his lips with repeated botulinum toxin A (BTX-A) injections in the facial perioral muscles. Our findings suggest that treatment with BTX-A helped reduce self-abusive behavior in this patient. Our case illustrates that BTX-A injections can be a useful therapeutic approach in patients with self-abusive behavior.

  2. Novel molecular tumor cell markers in regional lymph nodes and blood samples from patients undergoing surgery for non-small cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Oddmund Nordgård

    Full Text Available Recent evidence suggests that microscopic lymph node metastases and circulating tumor cells may have clinical importance in lung cancer. The purpose of this study was to identify new molecular markers for tumor cells in regional lymph nodes (LNs and peripheral blood (PB from patients with non-small cell lung cancer (NSCLC.Candidate markers were selected based on digital transcript profiling and previous literature. KRT19, CEACAM5, EPCAM, DSG3, SFTPA, SFTPC and SFTPB mRNA levels were initially validated by real-time reverse transcription PCR-based quantification in 16 NSCLC tumors and 22 LNs and 12 PB samples from individuals without known cancer. Five of the candidate markers were selected for secondary validation by quantification in parallel tumor biopsies, regional LNs and PB samples from 55 patients undergoing surgery for NSCLC. LN and PB marker status were compared to clinicopathological patient data.All selected markers except DSG3 were present at high levels in the primary tumors and at very low or non-detectable levels in normal LNs and PB in the first round of validation, indicating a potential for detecting tumor cells in NSCLC patients. The expression profiles of KRT19, CEACAM5, DSG3, SFTPA and SFTPC mRNA were confirmed in the larger group during the secondary validation. Using the highest normal LN level of each marker as threshold, 39 (71% of the 55 patients had elevated levels of at least one marker in regional LNs. Similarly, 26 (47% patients had elevated levels of at least one marker in PB. A significantly higher number of patients with adenocarcinomas had positive LN status for these markers, compared with other histological types (P = 0.004.Several promising molecular tumor cell markers in regional LNs and PB were identified, including the new SFTPA and SFTPC mRNAs. Clinical follow-up in a larger cohort is needed to elucidate their prognostic value.

  3. Can calcification predict {sup 131}I accumulation on metastatic lymph nodes in papillary thyroid carcinoma patients receiving {sup 131}I therapy? Comparison of CT, {sup 131}I WBS and {sup 18}F-FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, Koichiro; Abe, Koichiro; Baba, Shingo; Tanabe, Yoshitaka; Yabuuchi, Hidetake; Hatakenaka, Masamitsu; Honda, Hiroshi [Kyushu University, Department of Clinical Radiology, Graduate School of Medical Sciences, Fukuoka (Japan); Sasaki, Masayuki [Kyushu University, Department of Health Sciences, School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka (Japan)

    2010-02-15

    The aim of this study was to clarify the predictive significance of nodal calcification in terms of the therapeutic option of {sup 131}I therapy in papillary thyroid carcinoma (PTC) patients. We reviewed 19 computed tomography (CT) examinations of PTC patients on receiving {sup 131}I therapy for the presence of nodal calcification, and compared the {sup 131}I whole-body scintigraphy and {sup 18}F-2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/CT findings. The metastatic lymph nodes (mLNs) were divided into three groups: A, those with calcification; B, those without calcification but belonging to patients who had calcified mLNs; C, those without calcification and belonging to patients who had no calcified mLNs. The incidences of {sup 131}I accumulation and maximum standardised uptake values (SUV max) in the three groups were compared. A total of 70 mLNs were evaluated. Twelve mLNs belonged to group A, 13 to group B and 45 to group C. The incidences of {sup 131}I accumulation were significantly higher in groups A (100%) and B (100%) than in group C (11.1%) (p < 0.0001 for both). The SUVmax was significantly lower in groups A (4.1 {+-} 1.9) and B (3.9 {+-} 1.4) than in group C (7.1 {+-} 4.4) (p = 0.01, p = 0.002, respectively). Our results indicated that calcification in mLNs related to the ability of {sup 131}I accumulation and less dedifferentiation. (orig.)

  4. Providing lipid-based nutrient supplements does not affect developmental milestones among Malawian children.

    Science.gov (United States)

    Mangani, Charles; Cheung, Yin Bun; Maleta, Kenneth; Phuka, John; Thakwalakwa, Chrissie; Dewey, Kathryn; Manary, Mark; Puumalainen, Taneli; Ashorn, Per

    2014-01-01

    To assess whether using lipid-based nutrient supplements (LNS) to complement the diets of infants and young children affected when they achieved selected developmental milestones. In rural Malawi, 840 6-month-old healthy infants were enrolled to a randomised trial. Control participants received no supplements, others were provided with milk-containing LNS, soy-containing LNS or corn-soy blend (CSB) for 12 months. Outcomes were the age at which they achieved key milestone: motor (walking with assistance, standing and walking alone, running), social (drinking from a cup and eating by themselves) and language (saying single comprehensible words and waving goodbye). The mean age at which the subjects walked with assistance was 42.5, 42.3, 42.7 and 43.2 weeks in the control, milk-LNS, soy-LNS and CSB groups, respectively (p = 0.748). There were also no significant differences in the mean age at standing alone (45.0, 44.9, 45.1 and 46.3 weeks), walking alone (54.6, 55.1, 55.3, 56.5 weeks), running (64.6, 63.7, 64.8, 65.9 weeks) or any other social or language milestones (each p > 0.10). The findings do not support a hypothesis that providing tested formulations and doses of micronutrient-fortified LNS or CSB would have an impact on when young children in rural Malawi achieved selected developmental milestones. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  5. Effect of supplementation with a lipid-based nutrient supplement on the micronutrient status of children aged 6-18 months living in the rural region of Intibucá, Honduras.

    Science.gov (United States)

    Siega-Riz, Anna M; Estrada Del Campo, Yaniré; Kinlaw, Alan; Reinhart, Gregory A; Allen, Lindsay H; Shahab-Ferdows, Setareh; Heck, Jeff; Suchindran, Chirayath M; Bentley, Margaret E

    2014-05-01

    Lipid-based nutrient supplements (LNS) have been effective in the treatment of acute malnutrition among children. We evaluated the use of LNS supplementation for improving the micronutrient status of young children. A 12-month randomised controlled trial was conducted among children aged 6-18 months living in Intibucá, Honduras. Communities (n = 18) were randomised into clusters matched by poverty indicators (9 intervention, n = 160 and 9 controls, n = 140). Intervention participants received LNS. All children received food vouchers and nutrition education. Primary outcomes included measures of micronutrient status: at baseline, 6 and 12 months' blood were collected for assessment of folate, iron, zinc, riboflavin, and vitamin B12 status; haemoglobin was measured every 3 months; and dietary and anthropometry collected monthly. Longitudinal analyses were based on intent to treat and LNS adherence. Generalised estimating equations were used in the estimation of generalised linear regression models specified for the data. At 6-month follow-up, children in the intervention group had a lower proportion classified as deficient for B12 (43.6%) compared with the control (67.7%; P = 0.03). The intervention group had a higher mean concentration for folate at 6 months (P = 0.06), and improvements continued through 12 months for folate (P = 0.002) and vitamin A deficiency (P = 0.03). This pattern of results, with improved significance, remained in subanalysis based on LNS adherence. These data demonstrate that LNS improved select micronutrient status in young non-malnourished Honduran children. © 2014 John Wiley & Sons Ltd.

  6. [Comparison study of CT indicators and pathological N staging in lymph node metastasis of gastric cancer].

    Science.gov (United States)

    Tang, Lei; Zhang, Xiao-peng; Sun, Ying-shi; Li, Jie; Wang, Ning; Cao, Kun; Ji, Jia-fu; Li, Zi-yu

    2008-11-01

    To explore the CT criteria for evaluating lymph node (LN) metastasis and preoperative N-staging of gastric cancer through the comparison of CT signs and surgical pathology. Eighty-nine patients with gastric cancer underwent CT examinations before radical resections. A soft-reading method on PACS workstation was employed to evaluate the detection of LNs. The size and number of LNs were registered, and the accumulated size of LNs was calculated in every case. The pathological N-staging (pN(0-3)) was considered on the basis of pathological examination of excised specimens according to UICC TNM-staging system (6th edition, 2002). The relationships between LN metastases and CT findings were analyzed by SPSS using t test and one-way ANOVA analysis. The distribution of maximal size, CT detection number and accumulated size were significantly different among different pN stages (P0.05), while significant difference could be found in CT detection number between pN1 and pN3 (P<0.01), pN2 and pN3 (P<0.01), and in accumulated size between pN1 and pN3 (P<0.01), pN1 and pN2 (P<0.01). The involvement of LNs in gastric cancer and pN staging are associated with size, number, and accumulated size of CT detection. CT detection number is more valuable in the evaluation of N staging than LNs size. CT detection number combined with accumulated size of LNs can provide meaningful information for preoperative N-staging.

  7. Apparent diffusion coefficient for discriminating metastatic from non-metastatic lymph nodes in primary rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Een Young, E-mail: seirosera@naver.com; Kim, Seung Ho, E-mail: radiresi@gmail.com; Yoon, Jung-Hee, E-mail: radyjh@hanmail.net; Lee, Yedaun, E-mail: chosai@hanmail.net; Lim, Yun-Jung, E-mail: iihiye@hanmail.net; Kim, Seon-Jeong, E-mail: bluesingirl@naver.com; Baek, Hye Jin, E-mail: sartre81@gmail.com; Eun, Choong Ki, E-mail: ilovegod@chollian.net

    2013-11-01

    Objective: To investigate whether the apparent diffusion coefficient (ADC) could be used to discriminate metastatic from non-metastatic lymph nodes (LNs) in patients with primary rectal cancer. Methods: This study investigated 34 patients (male: 12, female: 22, mean: 62.7, range: 37–82) who underwent 1.5-T MRI with diffusion-weighted imaging (DWI) and subsequent surgical resection. A blinded radiologist measured the ADC value in each regional LN after referring to the T2-weighted images and DWI. The t-test was used to compare the mean ADC values of the metastatic and non-metastatic LNs. A ROC analysis was performed to calculate the diagnostic performance and obtain the optimal cut-off. The histopathological results were used as the reference standard. Results: 114 LNs (46 metastatic and 68 non-metastatic) were matched and analyzed. The mean ADC of the metastatic LNs was significantly lower than that of the non-metastatic LNs (0.9 ± 0.15 × 10{sup −3} mm{sup 2}/s; 1.1 ± 0.22 × 10{sup −3} mm{sup 2}/s, P < 0.0001). The area under the ROC curve was 0.734 (95% confidence interval, 0.644–0.812). When an ADC value of 1.0 × 10{sup −3} mm{sup 2}/s was used as the cut-off, a maximum accuracy of 72% was calculated (sensitivity, 78%; specificity, 67%). Conclusions: Although ADC could be used to discriminate metastatic from non-metastatic LNs, the diagnostic accuracy is approximately 70%.

  8. CD169 Expressing Macrophage, a Key Subset in Mesenteric Lymph Nodes Promotes Mucosal Inflammation in Dextran Sulfate Sodium-Induced Colitis

    Directory of Open Access Journals (Sweden)

    Qiuting Li

    2017-06-01

    Full Text Available Inflammatory bowel disease (IBD including Crohn’s disease (CD and ulcerative colitis is a relapsing-remitting illness. Patients with long-standing extensive colitis are easy to develop colorectal cancer (CRC. The increasing incidence of IBD and a substantial increase in the risk of CRC make the necessity to pay more attention on the regulation of inflammation especially by specific macrophages subset. The present study reported that a key subset of sinus macrophage expressing CD169 in mesenteric lymph nodes (mLNs played an essential role in promoting mucosal inflammation. The results revealed that the subset expressing CD169 in mLNs increased significantly during the dextran sulfate sodium (DSS-induced colitis. The colitic symptoms were alleviated in CD169-diphtheria toxin receptor (DTR mice at least partially due to the deletion of CD169+ macrophages in mLNs. In addition, the levels of inflammatory cytokines as well as the percentage of Th17 cells in mLNs from CD169-DTR mice were much lower than those from WT mice with DSS-induced colitis. Further experiment in vitro demonstrated that the supernatant from whole cells of mLNs or colon tissues could promote the production of inflammatory factors by mLN cells or colon tissues from CD169-DTR mice. These results could be explained by the cell sorting result that CD11b+CD169+ macrophages expressed higher level of inflammatory factors directly. All these data indicated that CD169+ sinus macrophage in mLNs played an essential role on regulating mucosal inflammation.

  9. CD169 Expressing Macrophage, a Key Subset in Mesenteric Lymph Nodes Promotes Mucosal Inflammation in Dextran Sulfate Sodium-Induced Colitis

    Science.gov (United States)

    Li, Qiuting; Wang, Dan; Hao, Shengyu; Han, Xiaolei; Xia, Yuan; Li, Xiangzhi; Chen, Yaoxing; Tanaka, Masato; Qiu, Chun-Hong

    2017-01-01

    Inflammatory bowel disease (IBD) including Crohn’s disease (CD) and ulcerative colitis is a relapsing-remitting illness. Patients with long-standing extensive colitis are easy to develop colorectal cancer (CRC). The increasing incidence of IBD and a substantial increase in the risk of CRC make the necessity to pay more attention on the regulation of inflammation especially by specific macrophages subset. The present study reported that a key subset of sinus macrophage expressing CD169 in mesenteric lymph nodes (mLNs) played an essential role in promoting mucosal inflammation. The results revealed that the subset expressing CD169 in mLNs increased significantly during the dextran sulfate sodium (DSS)-induced colitis. The colitic symptoms were alleviated in CD169-diphtheria toxin receptor (DTR) mice at least partially due to the deletion of CD169+ macrophages in mLNs. In addition, the levels of inflammatory cytokines as well as the percentage of Th17 cells in mLNs from CD169-DTR mice were much lower than those from WT mice with DSS-induced colitis. Further experiment in vitro demonstrated that the supernatant from whole cells of mLNs or colon tissues could promote the production of inflammatory factors by mLN cells or colon tissues from CD169-DTR mice. These results could be explained by the cell sorting result that CD11b+CD169+ macrophages expressed higher level of inflammatory factors directly. All these data indicated that CD169+ sinus macrophage in mLNs played an essential role on regulating mucosal inflammation. PMID:28694804

  10. A new method (the "Pincers maneuver") for lymphadenectomy along the right recurrent laryngeal nerve during thoracoscopic esophagectomy in the prone position for esophageal cancer.

    Science.gov (United States)

    Oshikiri, Taro; Nakamura, Tetsu; Miura, Yukiko; Yamamoto, Masashi; Kanaji, Shingo; Yamashita, Kimihiro; Matsuda, Takeru; Sumi, Yasuo; Suzuki, Satoshi; Kakeji, Yoshihiro

    2017-03-01

    In esophageal squamous cell carcinoma, the number of dissected lymph nodes (LNs), including those along the recurrent laryngeal nerves (RLNs), influences prognosis and nodal staging accuracy. However, dissection of LNs along the RLN increases the risk of complications, especially RLN palsy. Therefore, complete dissection of these LNs with prevention of RLN palsy is recommended. We present herein a new method for lymphadenectomy along the right RLN, named the Pincers maneuver, during thoracoscopic esophagectomy in the prone position (TEP). The fundamental concept in this new method is to first exfoliate the two-dimensional membrane (lateral pedicle), which includes the right RLN, LNs along the right RLN, and the primary esophageal artery, from the right side of the trachea toward the neck. Using a Pincers strategy, closing in from the inner and outer sides of the two-dimensional membrane (lateral pedicle), lymphadenectomy along the right RLN toward the right inferior thyroid artery should be easy. This technique was evaluated in 30 consecutive cases of TEP for squamous cell cancer. There were 15 patients who underwent the new method (Pincers maneuver; Pm) and 15 patients who underwent the conventional method (Cm). There were no significant differences between the two groups in the duration of the thoracic procedure and dissection along the right RLN. No intraoperative and postoperative morbidity related to the right RLN was observed in either group. The Pm group had a higher number of dissected LNs along the right RLN than the Cm group (6.3 vs 3.1, p = 0.044). The Pincers maneuver for lymphadenectomy along the right RLN during TEP is technically safe and feasible. It increases the number of dissected LNs along the right RLN.

  11. Gut microbiota in Malawian infants in a nutritional supplementation trial.

    Science.gov (United States)

    Cheung, Yin Bun; Xu, Ying; Mangani, Charles; Fan, Yue-Mei; Dewey, Kathryn G; Salminen, Seppo Jaakko; Maleta, Kenneth; Ashorn, Per

    2016-02-01

    To examine whether two forms of lipid-based nutrient supplements (LNS) or a micronutrient-fortified corn-soya blend were associated with development of the gut microbiota in Malawian infants, to assess the microbiota profiles at the age of 6 and 18 months and to follow the changes during the 12-month period. This was a substudy of a 4-arm randomised controlled trial conducted in rural Malawi. Infants at the age of 6 months were randomised to receive no supplement during the primary follow-up period (control), 54 g/day of micronutrient-fortified LNS with milk protein base (milk LNS), 54 g/day of micronutrient-fortified LNS with soya protein base (soya LNS), or 71 g/day of micronutrient-fortified corn-soya blend for 12 months. Stool samples were collected at baseline (6 months) and end of trial (18 months). The 16S rRNA gene was amplified and subjected to multiplex sequencing. A total of 213 infants had paired microbiota data at 6 and 18 months of age. The Dirichlet-multinomial test showed no significant difference in microbiota profile between the four intervention groups at either age (each P > 0.10). Bifidobacterium longum was most abundant at both ages. Lactobacillus ruminis, Shigella and Salmonella were present. The abundance of Prevotella and Faecalibacterium increased with age (each P < 0.001), while Bifidobacteriaceae and Enterobacteriaceae exhibited significant decrease (each P < 0.001). Nutritional supplementation by LNS or corn-soya blend for twelve months did not affect the gut microbiota profile in the rural Malawian context. © 2015 John Wiley & Sons Ltd.

  12. Extensively re-organized systemic lymph nodes provide a feasible environment for self-reactivity in lupus-prone NZB × NZW F1 mice.

    Science.gov (United States)

    Kurosawa, Yoichi; Ozawa, Madoka; Kanda, Yasuhiro; Takeuchi, Arata; Kawamura, Toshihiko; Narita, Ichiei; Katakai, Tomoya

    2017-12-31

    Lymphadenopathy is a frequently observed symptom in systemic lupus erythematosus, although the immunological role of lymph nodes (LNs) in systemic autoimmunity remains largely unknown. Here, we performed comprehensive and systematic analyses of LNs in lupus-prone NZB × NZW F1 (BWF1) mice, demonstrating extensive tissue re-organization of the systemic LNs with follicular expansion, hyper germinal center (GC) formation, atrophy of the paracortical T-cell area and expansion of the medulla in aged BWF1 mice bearing glomerulonephritis. The proportion of B cells was significantly increased in these reactive LNs but not in the spleen, and lymphocyte subsets involved in antibody production, i.e. GC B cells, follicular helper T cells and plasma cells, were elevated. Draining LNs of the affected organs, such as the renal and cervical nodes, showed enhanced tissue re-organization and accumulation of effector lymphocytes, suggesting the presence of a positive feedback loop of regional responses. LN cells isolated from disease-bearing animals produced anti-DNA antibody, indicating activation of autoreactive lymphocytes in situ. The substantial development of disease and LN alterations in mice that received a splenectomy at a young age points to the importance of other secondary lymphoid organs, most likely LNs, for the progression of autoimmune responses independent of the spleen. Taken together, our findings highlight the value of taking LN alterations and activities into consideration for understanding the pathogenesis of systemic autoimmunity. © The Japanese Society for Immunology. 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Analysis of the prognostic factors for low rectal cancer with the pT1-2NxM0 stage after abdominoperineal resection.

    Science.gov (United States)

    Zhang, Xing-mao; Ma, Chao; Sun, Da-yong; Wang, Zheng; Zhou, Zhi-xiang

    2015-01-01

    This study was designed to explore the factors influencing local recurrence and survival for low rectal cancer with pT1-2NxM0 stage after an abdominoperineal resection (APR). Data of 429 patients confirmed to have pT1-2NxM0 after APR were reviewed. The recurrence rate in patients with intraoperative perforation, less than 12 lymph nodes (LNs) harvested, T2 staging, and positive circumferential resection margin (CRM) was 25.1, 19.9, 9.5, and 26.1% compared with 6.9, 7.0, 0, and 5.8% in patients with no perforation, 12 or more LNs harvested, T1, and negative CRM. The 5-year survival rate in patients with age of at least 70, perforation, less than 12 LNs harvested, T2, and positive CRM was 71.1, 60.8, 58.8, 69.9, and 46.0%, but 73.4, 73.5, 73.8, 89.4, and 75.0% in patients with age less than 70, no perforation, 12 or more LNs harvested, T1, and negative CRM. Meanwhile, patients with N0, N1, and N2 had a survival rate of 90.7, 69.9, and 63.9%. Multivariate analysis showed that perforation (PCRM status (P=0.002) were associated with local recurrence, whereas age of the patients (P=0.023), N staging (PCRM status (P=0.004) were associated with survival. APR was affected by patients' age, operation performer, perforation, number of LNs harvested, T staging, N staging, differentiation, and CRM status. Perforation, number of LNs harvested, T staging, differentiation, and CRM status were independent factors for recurrence; meanwhile, age of the patients, N staging, differentiation, and CRM status were independent factors influencing survival.

  14. Role of axillary lymph node ultra-sound and large core biopsy in the preoperative assessment of patients selected for sentinel node biopsy; Ruolo dell'ecografia e della microbiopsia istologica nella valutazione del cavo ascellare in pazienti candidate a biopsia del linfonodo sentinella

    Energy Technology Data Exchange (ETDEWEB)

    Nori, Jacopo; Boeri, Cecilia; Vanzi, Ermanno; Nori Bufalini, Filippo; Masi, Andrea [Azienda Ospedaliero-Universitaria Careggi, Firenze (Italy). Diagnostica senologica; Bazzocchi, Massimo; Londero, Viviana [Udine Univ., Udine (Italy). Istituto di radiologia universitaria; Mangialavori, Giuseppe [Ospedale di Merano, Bolzano (Italy). Servizio di radiologia; Distante, Vito; Simoncini, Roberta [Firenze Univ., Firenze (Italy). Clinica chirurgica I

    2005-04-01

    Purpose: To aim of this study was to evaluate the diagnostic accuracy of axillary lymph node sonography, if necessary in collaboration with US-guided large core biopsy, in the preoperative evaluation of breast cancer patients scheduled for quadrantectomy and sentinel lymph node excision. Materials and methods: From July 2001 to December 2002, we evaluated 117 breast cancer patients with ultrasound and, where indicated, FNAB. Breast lesions has diameters between 4 and 26 mm (mean diameter 11 mm). Fifteen (13%) of the 117 patients were excluded from the series as they did not found fulfil the criteria for preliminary sonography of the axilla: in 9 patients fewer than 4 nodes were detected and in 6 patients the breast lesions were intraoperatively found to be benign. Eleven patients (10.7%) with sonographically suspicious axillary nodes were sampled by US-guided core biopsy using a 14 or 16 Gauge Tru-Cut needle. Results: The ultrasound study aims to evaluate the dimensions and morphology of the breast lesion as well as detect and assess at least 4 axillary nodes. These were evaluated for hilar and cortical thickening and radio between the sinus diameter and the total longitudinal diameter. Lymph nodes with hilar diameters equal to or greater than 50% of the longitudinal diameter were considered normal. Of the 102 patients evaluated, 77 (75.7%) had normal axillary nodes according to the US criteria adopted. Negativity was confirmed by histology in 56 cases (72.7%, true negative); 21 (27.3%, false negative) were found to be positive, in contrast with the sonographic appearance. The false negative cases were due to lymph node micrometastasis which probably did not cause morphologic alterations perceptible at ultrasound. The remaining 25 patients (24.5%) had axillary lymph nodes classified as suspicious. In 13 cases of (52%, true positive) there was agreement with histology, whereas in 12 cases (48%, false positive) the US suspicion was not confirmed at surgery. The most

  15. Long-lasting insecticidal mosquito nets: effects of washing processes on pesticide residues, and human and environmental exposure

    OpenAIRE

    Ouattara, Jean Pierre Nabléni

    2014-01-01

    Malaria is one of the public health problems in the world. More than 3.3 billion people are at risk of malaria. Children under the age of five year, and pregnant women are most severely affected. The disease is transmitted to human through the bite of an infected female mosquito of the genus Anopheles. Nowadays Long-Lasting Insecticidal Mosquito Nets (LNs) are the most popular and useful tools for malaria control. At the same time LNs face some challenges as the need for reliable methods to c...

  16. Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood

    DEFF Research Database (Denmark)

    Herndon, Thomas M; Chen, Shih-Ann; Saba, Nakhle S

    2017-01-01

    of active cell proliferation remains to be definitively determined. Based on findings that CLL cells in LNs have increased expression of B-cell activation genes, we tested the hypothesis that the fraction of 'newly born' cells would be highest in the LNs. Using a deuterium oxide ((2)H) in vivo labeling...... method in which patients consumed deuterated (heavy) water ((2)H2O), we determined CLL cell kinetics in concurrently obtained samples from LN, PB and BM. The LN was identified as the anatomical site harboring the largest fraction of newly born cells, compared to PB and BM. In fact, the calculated birth...

  17. Evaluation of the acceptability of improved supplementary foods for the treatment of moderate acute malnutrition in Burkina Faso using a mixed method approach

    DEFF Research Database (Denmark)

    Iuel-Brockdorff, Ann-Sophie Julie D; Dræbel, Tania; Ritz, Christian

    2016-01-01

    The objective of this study was to evaluate, within the context of a randomized controlled trial of product effectiveness, the acceptability of new formulations of six corn-soy blended flours (CSB) and six lipid-based nutrient supplements (LNS) with different quantities of milk and qualities of soy...... products were well accepted in terms of organoleptic qualities and received good ratings. However, LNS were more appreciated by caretakers and children. Additionally, an effect of soy isolate was detected on child appreciation where products with high milk content also received better ratings. CSB were...

  18. Lymph node pooling: a feasible and efficient method of lymph node molecular staging in colorectal carcinoma.

    Science.gov (United States)

    Rakislova, Natalia; Montironi, Carla; Aldecoa, Iban; Fernandez, Eva; Bombi, Josep Antoni; Jimeno, Mireya; Balaguer, Francesc; Pellise, Maria; Castells, Antoni; Cuatrecasas, Miriam

    2017-01-14

    Pathologic lymph node staging is becoming a deficient method in the demanding molecular era. Nevertheless, the use of more sensitive molecular analysis for nodal staging is hampered by its high costs and extensive time requirements. Our aim is to take a step forward in colon cancer (CC) lymph node (LN) pathology diagnosis by proposing a feasible and efficient molecular method in routine practice using reverse transcription loop-mediated isothermal amplification (RT-LAMP). Molecular detection of tumor cytokeratin 19 (CK19) mRNA with RT-LAMP was performed in 3206 LNs from 188 CC patients using two methods: individual analysis of 1449 LNs from 102 patients (individual cohort), and pooled LN analysis of 1757 LNs from 86 patients (pooling cohort). A median of 13 LNs (IQR 10-18) per patient were harvested in the individual cohort, and 18 LNs (IQR 13-25) per patient in the pooling cohort (p ≤ 0.001). The median of molecular assays performed in the pooling cohort was 2 per patient (IQR 1-3), saving a median of 16 assays/patient. The number of molecular assays performed in the individual cohort was 13 (IQR 10-18), corresponding to the number of LNs to be analyzed. The sensitivity and specificity of the pooling method for LN involvement (assessed by hematoxylin and eosin) were 88.9% (95% CI 56.5-98.0) and 79.2% (95% CI 68.9-86.8), respectively; concordance, 80.2%; PPV, 33.3%; NPV, 98.4%. The individual method had 100% sensitivity (95% CI 72.2-100), 44.6% specificity (95% CI 34.8-54.7), 50% concordance, 16.4% PPV, and 100% NPV. The amount of tumor burden detected in all LNs of a case, or total tumor load (TTL) was similar in both cohorts (p = 0.228). LN pooling makes it possible to analyze a high number of LNs from surgical colectomies with few molecular tests per patient. This approach enables a feasible means to integrate LN molecular analysis from CC specimens into pathology diagnosis and provides a more accurate LN pathological staging with potential prognostic

  19. Serological markers of sand fly exposure to evaluate insecticidal nets against visceral leishmaniasis in India and Nepal: a cluster-randomi trial

    DEFF Research Database (Denmark)

    Gidwani, K; Picado, A; Rijal, S

    2011-01-01

    Background: Visceral leishmaniasis is the world’ second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs) are a low cost proven vector intervention method for malaria control; however, their effectiveness...... against visceral leishmaniasis (VL) is unknown. This study quantified the effect of LNs on exposure to the sand fly vector of VL in India and Nepal during a two year community intervention trial. Methods: As part of a paired-cluster randomized controlled clinical trial in VL-endemic regions of India...

  20. Real-time ultrasound elastography in 180 axillary lymph nodes: elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases

    Directory of Open Access Journals (Sweden)

    Wojcinski Sebastian

    2012-12-01

    Full Text Available Abstract Background To determine the general appearance of normal axillary lymph nodes (LNs in real-time tissue sonoelastography and to explore the method′s potential value in the prediction of LN metastases. Methods Axillary LNs in healthy probands (n=165 and metastatic LNs in breast cancer patients (n=15 were examined with palpation, B-mode ultrasound, Doppler and sonoelastography (assessment of the elasticity of the cortex and the medulla. The elasticity distributions were compared and sensitivity (SE and specificity (SP were calculated. In an exploratory analysis, positive and negative predictive values (PPV, NPV were calculated based upon the estimated prevalence of LN metastases in different risk groups. Results In the elastogram, the LN cortex was significantly harder than the medulla in both healthy (p=0.004 and metastatic LNs (p=0.005. Comparing healthy and metastatic LNs, there was no difference in the elasticity distribution of the medulla (p=0.281, but we found a significantly harder cortex in metastatic LNs (p=0.006. The SE of clinical examination, B-mode ultrasound, Doppler ultrasound and sonoelastography was revealed to be 13.3%, 40.0%, 14.3% and 60.0%, respectively, and SP was 88.4%, 96.8%, 95.6% and 79.6%, respectively. The highest SE was achieved by the disjunctive combination of B-mode and elastographic features (cortex >3mm in B-mode or blue cortex in the elastogram, SE=73.3%. The highest SP was achieved by the conjunctive combination of B-mode ultrasound and elastography (cortex >3mm in B-mode and blue cortex in the elastogram, SP=99.3%. Conclusions Sonoelastography is a feasible method to visualize the elasticity distribution of LNs. Moreover, sonoelastography is capable of detecting elasticity differences between the cortex and medulla, and between metastatic and healthy LNs. Therefore, sonoelastography yields additional information about axillary LN status and can improve the PPV, although this method is still

  1. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    2011-06-15

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various ...

  2. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  3. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation, in Europe: results of a survey of experts and scientific societies.

    LENUS (Irish Health Repository)

    Mandl, Peter

    2012-01-01

    To document the practice and training opportunities of US-guided arthrocentesis and joint injection (UGAJ) among rheumatologists in the member countries of the European League Against Rheumatism (EULAR).

  4. Non-Invasive Targeted Peripheral Nerve Ablation Using 3D MR Neurography and MRI-Guided High-Intensity Focused Ultrasound (MR-HIFU) : Pilot Study in a Swine Model

    NARCIS (Netherlands)

    Huisman, Merel; Staruch, Robert M; Ladouceur-Wodzak, Michelle; van den Bosch, Maurice A; Burns, Dennis K; Chhabra, Avneesh; Chopra, Rajiv

    2015-01-01

    PURPOSE: Ultrasound (US)-guided high intensity focused ultrasound (HIFU) has been proposed for noninvasive treatment of neuropathic pain and has been investigated in in-vivo studies. However, ultrasound has important limitations regarding treatment guidance and temperature monitoring. Magnetic

  5. Role of Ultrasound Guided Platelet-Rich Plasma (PRP Injection in Treatment of Lateral Epicondylitis

    Directory of Open Access Journals (Sweden)

    Enass M. Khattab

    2017-06-01

    Conclusion: We concluded that US-guided platelet-rich plasma (PRP injection for treatment of lateral epicondylitis was a safe, minimally invasive and effective procedure in improving the sonographic and pathological changes of common extensor tendon (CET.

  6. Endoscopy Ultra- Sonography -guided biliary drainage in the surgical -endoscopy era

    National Research Council Canada - National Science Library

    Artifon, Everson L A; Pinhata Otoch, Jose; Yábar, Alejandro; Poli-de-Figueiredo, Luiz F; Sakai, Paulo; Rasslan, Samir

    2011-01-01

    US-guided hepatico - gastrostomy, choledocho-duodenostomy and choledocho-antrostomy are advanced procedures on biliary and pancreatic endoscopy and together make up the echo-guided biliary drainage...

  7. Fine Needle Aspiration Biopsy in a Rural Family Practice | O'Mahony ...

    African Journals Online (AJOL)

    Background: Fine Needle Aspiration Biopsy (FNAB) is a safe economic method of obtaining tissue from a suspicious mass for diagnostic purposes. This study describes the results of FNAB in a family practice in a poor rural community. Methods: Any patient with a suspicious mass that the family practitioner considered could ...

  8. Quantitative classification of breast fine needle aspirates using the ...

    African Journals Online (AJOL)

    Fine needle aspiration cytology is useful in the pre-operative assessment of patients with breast lumps. Lesions are reported as benign, suspicious or malignant. The number of suspicious categories is high in inexperienced hands thus limiting this useful diagnostic tool. The aim was to evaluate quantitative methods of ...

  9. 12 CFR 748.1 - Filing of reports.

    Science.gov (United States)

    2010-01-01

    ... criminal violations and suspicious activities to law enforcement and financial institution supervisory... damage to the credit union or causing an interruption in vital member services, as defined in § 749.1 of...(ies). (c) Suspicious Activity Report. A credit union must file a report if it knows, suspects, or has...

  10. 82-IJBCS-Article-Dr O Nnodu

    African Journals Online (AJOL)

    RHUMSIKI

    Fine needle aspiration cytology is useful in the pre-operative assessment of patients with breast lumps. Lesions are reported as benign, suspicious or malignant. The number of suspicious categories is high in inexperienced hands thus limiting this useful diagnostic tool. The aim was to evaluate quantitative methods of.

  11. A RATIONALE FOR PROSTATE CANCER DETECTION IN A ...

    African Journals Online (AJOL)

    Organ confined cancer was detected in 41.7% of them (15 patients). In group 2, 75 men were biopsied (69 for high PSA± suspicious DRE and 6 for suspicious DRE alone).The cancer detection rate was 2.2% (19 patients) and the rate of organ confined disease was 37.87 (7 patients). There was no significant statistical ...

  12. Efficacy of Ultrasound-Guided Axillary Brachial Plexus Block for Analgesia During Percutaneous Transluminal Angioplasty for Dialysis Access

    Energy Technology Data Exchange (ETDEWEB)

    Chiba, Emiko, E-mail: chibaemi23@comet.ocn.ne.jp; Hamamoto, Kohei, E-mail: hkouhei917@gmail.com [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan); Nagashima, Michio, E-mail: nagamic00@gmail.com [Asahikawa Medical University, Department of Emergency Medicine (Japan); Matsuura, Katsuhiko, E-mail: kmatsur@gmail.com; Okochi, Tomohisa, E-mail: t-shachi@dj8.so-net.ne.jp; Tanno, Keisuke, E-mail: tankichi1974@gmail.com; Tanaka, Osamu, E-mail: otanaka@omiya.jichi.ac.jp [Jichi Medical University, Department of Radiology, Saitama Medical Center (Japan)

    2016-10-15

    PurposeTo evaluate the efficacy and safety of ultrasound (US)-guided axillary brachial plexus block (ABPB) for analgesia during percutaneous transluminal angioplasty (PTA) for dialysis access.Subjects and MethodsTwenty-one patients who underwent PTA for stenotic dialysis access shunts and who had previous experience of PTA without sedation, analgesia, and anesthesia were included. The access type in all patients was native arteriovenous fistulae in the forearm. Two radiologists performed US-guided ABPB for the radial and musculocutaneous nerves before PTA. The patients’ pain scores were evaluated using a visual analog scale (VAS) after PTA, and these were compared with previous sessions without US-guided ABPB. The patient’s motor/sensory paralysis after PTA was also examined.ResultsThe mean time required to achieve US-guided ABPB was 8 min. The success rate of this procedure was 100 %, and there were no significant complications. All 21 patients reported lower VAS with US-guided ABPB as compared to without the block (p < 0.01). All patients expressed the desire for an ABPB for future PTA sessions, if required. Transient motor paralysis occurred in 8 patients, but resolved in all after 60 min.ConclusionUS-guided ABPB is feasible and effective for analgesia in patients undergoing PTA for stenotic dialysis access sites.Level of EvidenceLevel 4 (case series).

  13. 76 FR 67760 - National Register of Historic Places; Notification of Pending Nominations and Related Actions

    Science.gov (United States)

    2011-11-02

    ..., 11000845 Squires, Frederick, House, 1003 W. Church St., Champaign, 11000846 Cook County Building at 2440 N... Washington, Margaret Murray, School, (Public School Buildings of Washington, DC MPS) 27 O St., NW... Historic District, Portions of Morattico Rd., Riverside, & Saltwater Drs., Church, & Sea Shell Lns...

  14. Acceptability of new formulations of corn-soy blends and lipid-based nutrient supplements in Province du Passoré, Burkina Faso

    DEFF Research Database (Denmark)

    Iuel-Brockdorff, Ann-Sophie Julie D; Dræbel, Tania; Fabiansen, Christian

    2015-01-01

    The objective of this study was to evaluate the acceptability of new formulations of six corn-soy blended flours (CSB) and six lipid-based nutrient supplements (LNS) with different quantities of milk and qualities of soy to be used for the treatment of moderate acute malnutrition (MAM). Furthermo...

  15. Dimensions of working memory dysfunction in schizophrenia.

    NARCIS (Netherlands)

    Pukrop, R.; Matuschek, E.; Ruhrmann, S.; Brockhaus, A.; Tendolkar, I.; Bertsch, A.; Klosterkötter, J.

    2003-01-01

    The aim of this study was to investigate the underlying structure of eight working memory tests used to assess prefrontal dysfunction in schizophrenia research [Letter-Number Span (LNS), Digit-Symbol Test (DST), Trail-Making Test B (TMT-B), Delayed Response Task (DRT) for spatial working memory,

  16. Detection of sentinel nodes by a novel red-fluorescent dye, ATX-S10Na (II), in an orthotopic xenograft rat model of human gastric carcinoma.

    Science.gov (United States)

    Koyama, Tomoki; Tsubota, Akihito; Nariai, Koichi; Yoshikawa, Tetsuya; Mitsunaga, Makoto; Sumi, Makoto; Nimura, Hiroshi; Yanaga, Katsuhiko; Yumoto, Yoko; Mabashi, Yasuo; Takahashi, Hiroshi

    2007-01-01

    We developed a new imaging system to detect sentinel nodes (SNs) using a novel fluorescent tracer, ATX-S10Na(II), and investigated its usefulness in an animal model. Human gastric carcinoma cells were implanted orthotopically into nude rats. ATX-S10Na(II) was injected subserosally into the primary tumor lesion, and visualized by a fluorescence spectro-laparoscope. Presence of tumor cells in lymph nodes (LNs) was determined by RT-PCR specific for human beta-actin. Injection of ATX-S10Na(II) was successful in 27 tumor-bearing rats. A red fluorescence was incorporated into the left gastric and hepatic LNs in 25 and 2 rats, respectively. Of note, human beta-actin was detected in most of these LNs. Fluorescence was not detected in LNs that did not contain cancer. ATX-S10Na(II) is useful for the detection of cancer-containing SNs in an animal model of gastric carcinoma, and may serve as a novel tracer in SN navigation surgery. (c) 2006 Wiley-Liss, Inc.

  17. PALNS - A software framework for parallel large neighborhood search

    DEFF Research Database (Denmark)

    Røpke, Stefan

    2009-01-01

    This paper propose a simple, parallel, portable software framework for the metaheuristic named large neighborhood search (LNS). The aim is to provide a framework where the user has to set up a few data structures and implement a few functions and then the framework provides a metaheuristic where...

  18. Acceptability of different lipid-based nutrient supplements for adults ...

    African Journals Online (AJOL)

    Lipid-based Nutrient Supplements (LNS) can provide nutritional support and can be adapted to the needs of adults infected with HIV. However, consumption of these products may be limited by monotony or by an unacceptably strong taste of highly concentrated micronutrients. This study investigated the acceptability of ...

  19. ISSN 2073 ISSN 2073-9990 East Cent. Afr. J. surg. (Online) 90 East ...

    African Journals Online (AJOL)

    DELL

    2005-04-12

    Apr 12, 2005 ... and lower ureters, by lymphatics to the regional LNs and by haematogenous spread via pelvic veins to the lower spine, other bones, lungs, brain and ... False elevations occur after urethral instrumentations, DRE, prostatic biopsy, urinary retention, prostatitis and acute prostatic infarction. PSA is prostate ...

  20. Lymphadenectomy prior to rat hind limb allotransplantation prevents graft-versus-host disease in chimeric hosts

    NARCIS (Netherlands)

    Brouha, PCR; Perez-Abadia, G; Francois, CG; Laurentin-Perez, LA; Gorantla, [No Value; Vossen, M; Tai, C; Pidwell, D; Anderson, GL; Stadelmann, WK; Hewitt, CW; Kon, M; Barker, JH; Maldonado, C

    In previous rat studies, the use of mixed allogeneic chimerism (MAC) to induce host tolerance to hind limb allografts has resulted in severe graft-versus-host disease (GVHD). The purpose of this study was to determine if immunocompetent cells in bone marrow (BM) and/or lymph nodes (LNs) of

  1. Adsorption of Lanthanides by A{sub y}Mo{sub x}W{sub 1-x}O{sub 3} Hexagonal Tungsten Bronzes and Prospects for their Potential Use as Recyclable Inert Matrix Fuels

    Energy Technology Data Exchange (ETDEWEB)

    Luca, Vittorio; Yang, Bin; Yaman, Ilkay; Griffith, Christopher S.; Scales, Nicholas; Sizgek, Erden [Australian Nuclear Science and Technology Organisation (ANSTO), Institute of Materials Engineering, New Illawarra Road, Lucas Heights, New South Wales, 2234 (Australia)

    2008-07-01

    The hexagonal tungsten bronze (HTB) based adsorbents of general formula A{sub y}M{sub x}W{sub 1-x}O{sub 3}.ZH{sub 2}O have been a particular focus of attention in our laboratory for some time. In the context of a potential partition and transmutation strategy our interest in these HTB materials has been stimulated by their particularly high affinity for lanthanide (LN) and minor actinide (MA). In addition to partitioning operations the materials can also be contemplated for mop-up and decontamination applications. With Cs{sup +} as the target species, HTBs can be converted to very effective waste form materials with performances comparable to the best Cs-containing ceramics such as hollandite. However, their excellent affinity for LNs and MAs suggest their use for MA recycling. When granular variants of the HTB adsorbents are loaded with LNs and are heated in air to relatively modest temperatures these elements preferentially partition into relatively soluble phases imbedded within a durable WO{sub 3} matrix. Since the LN-containing phase is relatively soluble, efficient recovery of the LNs or potentially MAs is feasible. This, together with potentially favorable irradiation properties, suggests they may have uses as recyclable inert matrix fuels. In this communication, we discuss LN and MA adsorption and thermal properties of HTB materials with variable x, as well as resistance to {gamma}-radiation and heavy ion bombardment. Finally, recoverability of the LNs is considered. (authors)

  2. Limitations of lymph node ratio, evidence-based benchmarks, and the importance of a thorough lymph node dissection in melanoma.

    Science.gov (United States)

    Grotz, Travis E; Huebner, Marianne; Pockaj, Barbara A; Perkins, Sarah; Jakub, James W

    2013-12-01

    Stage III melanoma is currently stratified by number of lymph nodes (LNs) involved. However, given the variability of LN retrieval counts we hypothesize that lymph node ratio (LNR) may also provide prognostic information. Retrospective cohort study of 411 patients with stage III melanoma were divided into two groups based on LNR (analysis N stage (N3 vs. N1, hazard ratio [HR] = 2.13, p 8 inguinal, >15 axillary, or >20 cervical LNs examined had fewer same nodal basin recurrences (26 [8 %] vs. 20 [20 %], p = 0.0009) and for N1 patients an improved OS (3-year OS 84 % vs. 76 %, 10-year OS 53 % vs. 34 %, p = 0.06) compared with N1 patients who had fewer LNs examined. LNR is an important prognostic factor in stage III melanoma; however, it was not independent over the current AJCC TNM staging system. Diligence by the surgeon and pathologist to retrieve and examine >8 inguinal, >15 axillary, or >20 cervical LNs is associated with fewer same nodal basin recurrences and improved survival and is critical to reliable prognostication.

  3. Characterization, electrical transport and magnetic properties of the rare earth misfit layer compounds (TbS)(1.21)NbS2, (TbS)(1.20)TaS2, (DyS)(1.22)NbS2 and (DyS)(1.21)TaS2

    NARCIS (Netherlands)

    Zhou, W.Y.; Meetsma, A.; deBoer, J.L.; Wiegers, G.A

    1996-01-01

    X-ray powder and single-crystal X-ray diffraction of the title compounds showed that they are planar intergrowth compounds, built of alternating sandwiches TS2 (T=Nb, Ta) and double layers LnS (Ln=Tb, Dy), present in three orientational variants related by rotations of 120 degrees around the c axis

  4. Effects of Cannabinoid Exposure during Adolescence on the Conditioned Rewarding Effects of WIN 55212-2 and Cocaine in Mice: Influence of the Novelty-Seeking Trait

    Directory of Open Access Journals (Sweden)

    M. Rodríguez-Arias

    2016-01-01

    Full Text Available Adolescent exposure to cannabinoids enhances the behavioural effects of cocaine, and high novelty-seeking trait predicts greater sensitivity to the conditioned place preference (CPP induced by this drug. Our aim was to evaluate the influence of novelty-seeking on the effects of adolescent cannabinoid exposure. Adolescent male mice were classified as high or low novelty seekers (HNS and LNS in the hole-board test. First, we evaluated the CPP induced by the cannabinoid agonist WIN 55212-2 (0.05 and 0.075 mg/kg, i.p. in HNS and LNS mice. Then, HNS and LNS mice were pretreated i.p. with vehicle, WIN 55212-2 (0.1 mg/kg, or cannabinoid antagonist rimonabant (1 mg/kg and were subsequently conditioned with WIN 55212-2 (0.05 mg/kg, i.p. or cocaine (1 or 6 mg/kg, i.p.. Only HNS mice conditioned with the 0.075 mg/kg dose acquired CPP with WIN 55212-2. Adolescent exposure to this cannabinoid agonist increased the rewarding effects of 1 mg/kg of cocaine in both HNS and LNS mice, and in HNS mice it also increased the reinstating effect of a low dose of cocaine. Our results endorse a role for individual differences such as a higher propensity for sensation-seeking in the development of addiction.

  5. Adjuvant chemotherapy is not associated with improved survival for all high-risk factors in stage II colon cancer

    NARCIS (Netherlands)

    Verhoeff, S.R.; Erning, F.N. van; Lemmens, V.E.; Wilt, J.H.W. de; Pruijt, J.F.

    2016-01-01

    Adjuvant chemotherapy can be considered in high-risk stage II colon cancer comprising pT4, poor/undifferentiated grade, vascular invasion, emergency surgery and/or <10 evaluated lymph nodes (LNs). Adjuvant chemotherapy administration and its effect on survival was evaluated for each known risk

  6. 7254 ACCEPTABILITY OF DIFFERENT LIPID-BASED NUTRIENT ...

    African Journals Online (AJOL)

    Marlène Hébié

    2013-01-01

    Jan 1, 2013 ... (Chocolate, Chocolate-Banana and Unflavoured) and “salty or non-sweet” formulations also with three different flavours (Tomato, Tomato-Onion and. Unflavoured). Therefore, there were four different sets of LNS for the study (Table 1). The acceptability of all the formulations was investigated both raw and ...

  7. Variation in Lymph Node Evaluation in Rectal Cancer : A Dutch Nationwide Population-Based Study

    NARCIS (Netherlands)

    Elferink, M. A. G.; Siesling, S.; Lemmens, V. E. P. P.; Visser, O.; Rutten, H. J.; van Krieken, J. H. J. M.; Tollenaar, R. A. E. M.; Langendijk, J. A.

    For adequate staging and subsequent accurate estimation of prognosis, a sufficient number of lymph nodes (LNs) has to be evaluated. This study aimed to identify factors associated with adequate nodal evaluation and to determine its relationship with survival. Data from all patients with stage I to

  8. Supine MRI for regional breast radiotherapy: imaging axillary lymph nodes before and after sentinel-node biopsy

    Science.gov (United States)

    van Heijst, Tristan C. F.; Eschbach-Zandbergen, Debora; Hoekstra, Nienke; van Asselen, Bram; Lagendijk, Jan J. W.; Verkooijen, Helena M.; Pijnappel, Ruud M.; de Waard, Stephanie N.; Witkamp, Arjen J.; van Dalen, Thijs; Desirée van den Bongard, H. J. G.; Philippens, Marielle E. P.

    2017-08-01

    Regional radiotherapy (RT) is increasingly used in breast cancer treatment. Conventionally, computed tomography (CT) is performed for RT planning. Lymph node (LN) target levels are delineated according to anatomical boundaries. Magnetic resonance imaging (MRI) could enable individual LN delineation. The purpose was to evaluate the applicability of MRI for LN detection in supine treatment position, before and after sentinel-node biopsy (SNB). Twenty-three female breast cancer patients (cTis-3N0M0) underwent 1.5 T MRI, before and after SNB, in addition to CT. Endurance for MRI was monitored. Axillary levels were delineated. LNs were identified and delineated on MRI from before and after SNB, and on CT, and compared by Wilcoxon signed-rank tests. LN locations and LN-based volumes were related to axillary delineations and associated volumes. Although postoperative effects were visible, LN numbers on postoperative MRI (median 26 LNs) were highly reproducible compared to preoperative MRI when adding excised sentinel nodes, and higher than on CT (median 11, p  <  0.001). LN-based volumes were considerably smaller than respective axillary levels. Supine MRI of LNs is feasible and reproducible before and after SNB. This may lead to more accurate RT target definition compared to CT, with potentially lower toxicity. With the MRI techniques described here, initiation of novel MRI-guided RT strategies aiming at individual LNs could be possible.

  9. Poorly-differentiated colorectal neuroendocrine tumour: CT differentiation from well-differentiated neuroendocrine tumour and poorly-differentiated adenocarcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Ji Hee [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Se Hyung [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Han, Joon Koo [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea, Republic of)

    2017-09-15

    The differentiation of poorly-differentiated neuroendocrine tumours (PD-NETs), well-differentiated NETs (WD-NETs), and adenocarcinomas (ADCs) is important due to different management options and prognoses. This study is to find the differential CT features of colorectal PD-NETs from WD-NETs and ADCs. CT features of 25 colorectal WD-NETs, 36 PD-NETs, and 36 ADCs were retrospectively reviewed. Significant variables were assessed using univariate and multivariate analyses. Receiver operating characteristics analysis determined the optimal cut-off value of tumour and lymph node (LN) size. Large size, rectum location, ulceroinfiltrative morphology without intact overlying mucosa, heterogeneous attenuation with necrosis, presence of ≥3 enlarged LNs, and metastasis were significant variables to differentiate PD-NETs from WD-NETs (P < 0.05). High attenuation on arterial phase, persistently high enhancement pattern, presence of ≥6 enlarged LNs, large LN size, and wash-in/wash-out enhancement pattern of liver metastasis were significant variables to differentiate PD-NETs from ADCs (P < 0.05). Compared to WD-NETs, colorectal PD-NETs are usually large, heterogeneous, and ulceroinfiltrative mass without intact overlying mucosa involving enlarged LNs and metastasis. High attenuation on arterial phase, presence of enlarged LNs with larger size and greater number, and wash-in/wash-out enhancement pattern of liver metastasis can be useful CT discriminators of PD-NETs from ADCs. (orig.)

  10. Lymph Nodes and Cancer Metastasis: New Perspectives on the Role of Intranodal Lymphatic Sinuses

    Directory of Open Access Journals (Sweden)

    Rui-Cheng Ji

    2016-12-01

    Full Text Available The lymphatic system is essential for transporting interstitial fluid, soluble antigen, and immune cells from peripheral tissues to lymph nodes (LNs. Functional integrity of LNs is dependent on intact lymphatics and effective lymph drainage. Molecular mechanisms that facilitate interactions between tumor cells and lymphatic endothelial cells (LECs during tumor progression still remain to be identified. The cellular and molecular structures of LNs are optimized to trigger a rapid and efficient immune response, and to participate in the process of tumor metastasis by stimulating lymphangiogenesis and establishing a premetastatic niche in LNs. Several molecules, e.g., S1P, CCR7-CCL19/CCL21, CXCL12/CXCR4, IL-7, IFN-γ, TGF-β, and integrin α4β1 play an important role in controlling the activity of LN stromal cells including LECs, fibroblastic reticular cells (FRCs and follicular dendritic cells (DCs. The functional stromal cells are critical for reconstruction and remodeling of the LN that creates a unique microenvironment of tumor cells and LECs for cancer metastasis. LN metastasis is a major determinant for the prognosis of most human cancers and clinical management. Ongoing work to elucidate the function and molecular regulation of LN lymphatic sinuses will provide insight into cancer development mechanisms and improve therapeutic approaches for human malignancy.

  11. Light sheet fluorescence microscopy for in situ cell interaction analysis in mouse lymph nodes.

    Science.gov (United States)

    Abe, Jun; Ozga, Aleksandra J; Swoger, Jim; Sharpe, James; Ripoll, Jorge; Stein, Jens V

    2016-04-01

    Reactive lymph nodes (LNs) are sites where pMHC-loaded dendritic cells (DCs) interact with rare cognate T cells, leading to their clonal expansion. While DC interactions with T cell subsets critically shape the ensuing immune response, surprisingly little is known on their spatial orchestration at physiologically T cell low precursor frequencies. Light sheet fluorescence microscopy and one of its implementations, selective plane illumination microscopy (SPIM), is a powerful method to obtain precise spatial information of entire organs of 0.5-10mm diameter, the size range of murine LNs. Yet, its usefulness for immunological research has thus far not been comprehensively explored. Here, we have tested and defined protocols that preserve fluorescent protein function during lymphoid tissue clearing required for SPIM. Reconstructions of SPIM-generated 3D data sets revealed that calibrated numbers of adoptively transferred T cells and DCs are successfully detected at a single cell level within optically cleared murine LNs. Finally, we define parameters to quantify specific interactions between antigen-specific T cells and pMHC-bearing DCs in murine LNs. In sum, our studies describe the successful application of light sheet fluorescence microscopy to immunologically relevant tissues. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Antiretroviral therapy provided to HIV-infected Malawian women in a randomized trial diminishes the posiitive effect of lipid-based nutrient supplements on breast milk B-vitamins

    Science.gov (United States)

    Background: There is little information on B-vitamin concentrations in human milk or how they are affected by maternal B-vitamin deficiencies, antiretroviral (ARV) therapy or maternal supplementation. Objective: To evaluate effects of ARV therapy and/or lipid-based nutrient supplements (LNS) on B-v...

  13. Targeting of 111In-Labeled Dendritic Cell Human Vaccines Improved by Reducing Number of Cells

    NARCIS (Netherlands)

    Aarntzen, Erik H. J. G.; Srinivas, Mangala; Bonetto, Fernando; Cruz, Luis J.; Verdijk, Pauline; Schreibelt, Gerty; van de Rakt, Mandy; Lesterhuis, W. Joost; van Riel, Maichel; Punt, Cornelius J. A.; Adema, Gosse J.; Heerschap, Arend; Figdor, Carl G.; Oyen, Wim J.; de Vries, I. Jolanda M.

    2013-01-01

    PURPOSE: Anticancer dendritic cell (DC) vaccines require the DCs to relocate to lymph nodes (LN) to trigger immune responses. However, these migration rates are typically very poor. Improving the targeting of ex vivo generated DCs to LNs might increase vaccine efficacy and reduce costs. We

  14. Lymphoid Aggregates Remodel Lymphatic Collecting Vessels that Serve Mesenteric Lymph Nodes in Crohn Disease.

    Science.gov (United States)

    Randolph, Gwendalyn J; Bala, Shashi; Rahier, Jean-François; Johnson, Michael W; Wang, Peter L; Nalbantoglu, ILKe; Dubuquoy, Laurent; Chau, Amélie; Pariente, Benjamin; Kartheuser, Alex; Zinselmeyer, Bernd H; Colombel, Jean-Frederic

    2016-12-01

    Early pathological descriptions of Crohn disease (CD) argued for a potential defect in lymph transport; however, this concept has not been thoroughly investigated. In mice, poor healing in response to infection-induced tissue damage can cause hyperpermeable lymphatic collecting vessels in mesenteric adipose tissue that impair antigen and immune cell access to mesenteric lymph nodes (LNs), which normally sustain appropriate immunity. To investigate whether analogous changes might occur in human intestinal disease, we established a three-dimensional imaging approach to characterize the lymphatic vasculature in mesenteric tissue from controls or patients with CD. In CD specimens, B-cell-rich aggregates resembling tertiary lymphoid organs (TLOs) impinged on lymphatic collecting vessels that enter and exit LNs. In areas of creeping fat, which characterizes inflammation-affected areas of the bowel in CD, we observed B cells and apparent innate lymphoid cells that had invaded the lymphatic vessel wall, suggesting these cells may be mediators of lymphatic remodeling. Although TLOs have been described in many chronic inflammatory states, their anatomical relationship to preestablished LNs has never been revealed. Our data indicate that, at least in the CD-affected mesentery, TLOs are positioned along collecting lymphatic vessels in a manner expected to affect delivery of lymph to LNs. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  15. Maternal cortisol and stress are associated with birth outcomes, but are not affected by lipid-based micronutrient supplements during pregnancy: an analysis of data from a randomized controlled trial in rural Malawi

    Science.gov (United States)

    Background: Prenatal micronutrient supplements have been found to increase birth weight, but mechanisms for increased growth are poorly understood. Our hypotheses were that 1) women who receive lipid-based micronutrient supplements (LNS) during pregnancy would have lower salivary cortisol concentrat...

  16. Plasma and breastmilk selenium in HIV-infected Malawian mothers are positively associated with infant selenium status but are not associated with maternal supplementations: Breastfeeding, Antiretrovirals, and Nutrition Study

    Science.gov (United States)

    Background: Low dietary selenium (Se) intake coupled with low plasma Se concentrations in HIV infection could result in inadequate breastmilk Se intake by exclusively breastfed infants of HIV-infected women. Objective: To test the effect of lipid-based nutrient supplements (LNS) containing 1.3 R...

  17. The effects of a lipid-based nutrient supplement and antiretroviral therapy in a randomized controlled trial on iron, copper, and zinc in milk from HIV+ Malawian mothers and associations with maternal and infant biomarkers

    Science.gov (United States)

    We evaluated effects of antiretroviral (ARV) therapy and lipid-based nutrient supplements (LNS) on iron, copper and zinc in milk of exclusively breastfeeding HIV-infected Malawian mothers, and their correlations with maternal and infant biomarkers. Breast milk at 2, 6, and 24 weeks (wk) postpartum a...

  18. The SINQ data acquisition environment

    Energy Technology Data Exchange (ETDEWEB)

    Maden, D. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1996-11-01

    The data acquisition environment for the neutron scattering instruments supported by LNS at SINQ is described. The intention is to provide future users with the necessary background to the computing facilities on site rather than to present a user manual for the on-line system. (author) 5 figs., 6 refs.

  19. Small submucosal tumors of the stomach: differentiation of gastric schwannoma from gastrointestinal stromal tumor with CT.

    Science.gov (United States)

    Choi, Jin Wook; Choi, Dongil; Kim, Kyoung-Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin

    2012-01-01

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  20. Small Submucosal Tumors of the Stomach: Differentiation of Gastric Schwannoma from Gastrointestinal Stromal Tumor with CT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Wook; Choi, Dong Gil; Kim, Kyoung Mee; Sohn, Tae Sung; Lee, Jun Haeng; Kim, Hee Jung; Lee, Soon Jin [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2012-07-15

    To identify the CT features that help differentiate gastric schwannomas (GS) from small (5 cm or smaller) gastrointestinal stromal tumors (GIST) and to assess the growth rates of both tumors. We included 16 small GSs and 56 GISTs located in the stomach. We evaluated the CT features including size, contour, surface pattern, margins, growth pattern, pattern and degree of contrast enhancement, and the presence of intralesional low attenuation area, hemorrhage, calcification, surface dimpling, fistula, perilesional lymph nodes (LNs), invasion to other organs, metastasis, ascites, and peritoneal seeding. We also estimated the tumor volume doubling time. Compared with GISTs, GSs more frequently demonstrated a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs (each p < 0.05). The intralesional low attenuation area was more common in GISTs than GSs (p < 0.05). Multivariate analyses indicated that a homogeneous enhancement pattern, exophytic or mixed growth pattern, and the presence of perilesional LNs were statistically significant (p < 0.05). Tumor volume doubling times for GSs (mean, 1685.4 days) were significantly longer than that of GISTs (mean, 377.6 days) (p = 0.004). Although small GSs and GISTs show similar imaging findings, GSs more frequently show an exophytic or mixed growth pattern, homogeneous enhancement pattern, perilesional LNs and grow slower than GISTs.

  1. Intravital and whole-organ imaging reveals capture of melanoma-derived antigen by lymph node subcapsular macrophages leading to widespread deposition on follicular dendritic cells.

    Science.gov (United States)

    Moalli, Federica; Proulx, Steven T; Schwendener, Reto; Detmar, Michael; Schlapbach, Christoph; Stein, Jens V

    2015-01-01

    Aberrant antigens expressed by tumor cells, such as in melanoma, are often associated with humoral immune responses, which may in turn influence tumor progression. Despite recent data showing the central role of adaptive immune responses on cancer spread or control, it remains poorly understood where and how tumor-derived antigen (TDA) induces a humoral immune response in tumor-bearing hosts. Based on our observation of TDA accumulation in B cell areas of lymph nodes (LNs) from melanoma patients, we developed a pre-metastatic B16.F10 melanoma model expressing a fluorescent fusion protein, tandem dimer tomato, as a surrogate TDA. Using intravital two-photon microscopy (2PM) and whole-mount 3D LN imaging of tumor-draining LNs in immunocompetent mice, we report an unexpectedly widespread accumulation of TDA on follicular dendritic cells (FDCs), which were dynamically scanned by circulating B cells. Furthermore, 2PM imaging identified macrophages located in the subcapsular sinus of tumor-draining LNs to capture subcellular TDA-containing particles arriving in afferent lymph. As a consequence, depletion of macrophages or genetic ablation of B cells and FDCs resulted in dramatically reduced TDA capture in tumor-draining LNs. In sum, we identified a major pathway for the induction of humoral responses in a melanoma model, which may be exploitable to manipulate anti-TDA antibody production during cancer immunotherapy.

  2. Effectiveness of food supplements in increasing fat-free tissue accretion in children with moderate acute malnutrition: A randomised 2 × 2 × 3 factorial trial in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Christian Fabiansen

    2017-09-01

    Full Text Available Children with moderate acute malnutrition (MAM are treated with lipid-based nutrient supplement (LNS or corn-soy blend (CSB. We assessed the effectiveness of (a matrix, i.e., LNS or CSB, (b soy quality, i.e., soy isolate (SI or dehulled soy (DS, and (c percentage of total protein from dry skimmed milk, i.e., 0%, 20%, or 50%, in increasing fat-free tissue accretion.Between September 9, 2013, and August 29, 2014, a randomised 2 × 2 × 3 factorial trial recruited 6- to 23-month-old children with MAM in Burkina Faso. The intervention comprised 12 weeks of food supplementation providing 500 kcal/day as LNS or CSB, each containing SI or DS, and 0%, 20%, or 50% of protein from milk. Fat-free mass (FFM was assessed by deuterium dilution technique. By dividing FFM by length squared, the primary outcome was expressed independent of length as FFM index (FFMI accretion over 12 weeks. Other outcomes comprised recovery rate and additional anthropometric measures. Of 1,609 children, 4 died, 61 were lost to follow-up, and 119 were transferred out due to supplementation being switched to non-experimental products. No children developed allergic reaction. At inclusion, 95% were breastfed, mean (SD weight was 6.91 kg (0.93, with 83.5% (5.5 FFM. In the whole cohort, weight increased 0.90 kg (95% CI 0.88, 0.93; p 0.05. LNS compared to CSB resulted in 128 g (95% CI 67, 190; p < 0.01 greater weight gain if both contained SI, but there was no difference between LNS and CSB if both contained DS (mean difference 22 g; 95% CI -40, 84; p = 0.49 (interaction p = 0.017. Accordingly, SI compared to DS increased weight by 89 g (95% CI 27, 150; p = 0.005 when combined with LNS, but not when combined with CSB. A limitation of this and other food supplementation trials is that it is not possible to collect reliable data on individual adherence.Based on this study, children with MAM mainly gain fat-free tissue when rehabilitated. Nevertheless, LNS yields more fat-free tissue and

  3. Phase III evaluation of the insecticidal efficacy and durability of a deltamethrin-treated polypropylene long-lasting net LifeNet®, in comparison with long-lasting nets made from polyester and polyethylene: study protocol.

    Science.gov (United States)

    Tungu, Patrick; Messenger, Louisa A; Kirby, Matthew J; Sudi, Wema; Kisinza, William; Rowland, Mark

    2016-01-01

    Universal coverage of long-lasting insecticidal nets (LNs) made from polyester or polyethylene fibres has been adopted as the standard of care to control malaria among at-risk populations. To obtain a WHO recommendation, LNs must undergo prospective monitoring of insecticidal efficacy against mosquito vectors over 3 years of household use. The retention of bioefficacy and physical durability of a LN is influenced by net usage practices, textile polymer material and insecticide treatment technology. Fabric durability is the critical factor which determines the interval required between LN replacement campaigns. To investigate factors known to affect LN durability and bioefficacy, we describe a three-arm WHO Pesticide Evaluation Scheme (WHOPES) Phase III evaluation of a LN made uniquely from polypropylene (LifeNet®, Bayer CropScience) compared to standard LNs made from polyester and polyethylene, all treated with deltamethrin, over 3 years of use. This is a prospective three-arm household randomized, equivalence trial of LNs in Tanzania, with nets as the unit of observation. Equal numbers of houses will be randomized to receive deltamethrin-treated polypropylene, polyester or polyethylene LNs; all sleeping spaces in a given household will be provided with one type of net. Bioefficacy (insecticidal activity against mosquitoes), insecticide content of net fibres, and fabric integrity (number, location and size of holes) will be measured every 6 months, using WHO cone or tunnel bioassays, chemical analysis and calculation of hole index, respectively. A cohort of LNs will be surveyed annually to assess survivorship (median LN survival time) and cumulative loss of fabric integrity. Field durability outcomes will be compared with laboratory strength tests. This is the first trial to compare the relative durability of three LNs each made from a different textile polymer, treated with the same insecticide, in the same community side-by-side over 3 years of use. Trial

  4. Heterogeneity Analysis of {sup 18}F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting

    Energy Technology Data Exchange (ETDEWEB)

    Budiawan, Hendra; Cheon, Gi Jeong; Im, Hyungjun; Lee, Soo Jin; Paeng, Keon Wook; Chung, Junekey; Lee, Dong Soo [Seoul National Univ. Hospital, Seoul (Korea, Republic of)

    2013-12-15

    Lymph node (LN) characterization is crucial in determining the stage and treatment decisions in patient with lung cancer. Although {sup 18}F-fluorodeoxyglucose positron emission tomography/computed tomography ({sup 18}F-FDG PET/CT) has a higher diagnostic accuracy in LN characterization than anatomical imaging, differentiating between metastatic and inflammatory LNs is still challenging because both could show high {sup 18}F-FDG uptake. The purpose of this study was to assess if the heterogeneity of the {sup 18}F-FDG uptake could help in differentiating between inflammatory and metastatic LNs in lung cancer, and to compare with other parameters. A total of 44 patients with adenocarcinoma of the lung, who underwent preoperative {sup 18}F-FDG PET/CT without having any previous treatments and were revealed to have {sup 18}F-FDG-avid LNs, were enrolled. There were 52 pathology-proven metastatic lymph nodes in 26 subjects. The pathology-proven metastatic LNs were compared with 42 pathology-proven inflammatory/benign LNs in 18 subjects. The coefficient of variation (CV) was used to assess the heterogeneity of {sup 18}F-FDG uptake by dividing the standard deviation of standardized uptake value (SUV) by mean SUV. The volume of interest was manually drawn based on the combined CT images of {sup 18}F-FDG PET/CT (no threshold is used). Comparisons were made with the maximum standardized uptake values (SUV{sub max}), visual assessment of {sup 18}F-FDG uptake, longest diameter, and maximum Hounsfield units (HUmax). Metastatic lymph nodes tended to have higher CVs than the inflammatory LNs. The mean CV of metastatic LNs (0.30±0.08; range: 0.08.0.55) was higher than that of inflammatory LNs (0.17+0.06; range, 0.07.0.32; P<0.0001). On receiver operating characteristic (ROC) curve analysis, the area under curve was 0.901, and using 0.20 as cut-off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 88.5 %, 76.2 %, 82

  5. The effect of nutritional supplementation on quality of life in people living with HIV: a randomised controlled trial.

    Science.gov (United States)

    Tesfaye, Markos; Kaestel, Pernille; Olsen, Mette Frahm; Girma, Tsinuel; Yilma, Daniel; Abdissa, Alemseged; Ritz, Christian; Michaelsen, Kim F; Hanlon, Charlotte; Friis, Henrik

    2016-06-01

    To determine the effects of lipid-based nutrient supplements (LNS) on the quality of life of people living with HIV (PLHIV) during the first 3 months of antiretroviral treatment (ART) and to investigate the effects of timing of supplementation by comparing with supplementation during the subsequent 3 months. A randomised controlled trial was conducted in three ART clinics within public health facilities in Jimma, Ethiopia. Participants were PLHIV eligible to start ART with body mass index >17 kg/m(2) and given daily supplements of 200 g of LNS containing whey or soya either during the first 3 months or the subsequent months of ART. The outcome was measured in terms of total quality-of-life scores on the adapted version of the WHOQOL-HIV-BREF assessed at baseline, three and six months. Of the 282 participants, 186 (66.0%) were women. The mean age (SD) was 32.8 (±9.0) years, and the mean (SD) total quality-of-life score was 82.0 (±14.8) at baseline assessment. At 3 months, participants who received LNS showed better quality of life than those who only received ART without LNS (β = 6.2, 95% CI: 2.9: 9.6). At 6 months, there was no difference in total quality-of-life score between the early and delayed supplementation groups (β = 3.0, 95% CI: -0.4: 6.4). However, the early supplementation group showed higher scores on the social and spirituality domains than the delayed group. LNS given during the first three months of ART improves the quality of life of PLHIV. © 2016 John Wiley & Sons Ltd.

  6. The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota (United States); Brinkmann, Debra H.; Ward, Shelly B. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Durski, Jolanta [Department of Radiology, Nuclear Medicine Program, Mayo Clinic, Rochester, Minnesota (United States); Laack, Nadia N.; Yan, Elizabeth; Schomberg, Paula J.; Garces, Yolanda I. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Suman, Vera J. [Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota (United States); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2013-03-15

    Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.

  7. Low NO{sub x}/SO{sub x} Burner retrofit for utility cyclone boilers. Quarterly technical progress report, June--September 1990

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    The objective of this project is to demonstrate the LNS Burner as retrofitted to the host cyclone boiler for effective low-cost control of NO{sub x} and SO{sub x} emissions while firing a bituminous coal. The LNS Burner employs a simple, innovative combustion process to burn pulverized coal at high temperatures and provides effective, low-cost control of sulfur dioxide (SO{sub 2}) and nitrogen oxides (NO{sub x}) emissions. The coal ash contains sulfur and is removed in the form of molten slag and flyash. Cyclone-fired boiler units are typically older units firing high-sulfur bituminous coals at very high temperatures which results in very high NO{sub x} and SO{sub x} emissions. The addition of conventional emission control equipment, such as wet scrubbers, to these older cyclone units in order to meet current and future environmental regulations is generally not economic. Further, the units are generally not compatible with low sulfur coal switching for S0{sub 2} control or selective catalytic reduction technologies for NO{sub x} control. Because the LNS Burner operates at the same very high temperatures as a typical cyclone boiler and produces a similar slag product, it may offer a viable retrofit option for cyclone boiler emission control. This was confirmed by the Cyclone Boiler Retrofit Feasibility Study carried out by TransAlta and an Operating Committee formed of cyclone boiler owners in 1989. An existing utility cyclone boiler, was then selected for the evaluation of the cost and performance study. It was concluded that the LNS Burner retrofit would be a cost-effective option for control of cyclone boiler emissions. A full-scale demonstration of the LNS Burner retrofit was selected in October 1988 as part of the DOE`s Clean Coal Technology Program Round II.

  8. Low NO sub x /SO sub x Burner retrofit for utility cyclone boilers

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    The objective of this project is to demonstrate the LNS Burner as retrofitted to the host cyclone boiler for effective low-cost control of NO{sub x} and SO{sub x} emissions while firing a bituminous coal. The LNS Burner employs a simple, innovative combustion process to burn pulverized coal at high temperatures and provides effective, low-cost control of sulfur dioxide (SO{sub 2}) and nitrogen oxides (NO{sub x}) emissions. The coal ash contains sulfur and is removed in the form of molten slag and flyash. Cyclone-fired boiler units are typically older units firing high-sulfur bituminous coals at very high temperatures which results in very high NO{sub x} and SO{sub x} emissions. The addition of conventional emission control equipment, such as wet scrubbers, to these older cyclone units in order to meet current and future environmental regulations is generally not economic. Further, the units are generally not compatible with low sulfur coal switching for S0{sub 2} control or selective catalytic reduction technologies for NO{sub x} control. Because the LNS Burner operates at the same very high temperatures as a typical cyclone boiler and produces a similar slag product, it may offer a viable retrofit option for cyclone boiler emission control. This was confirmed by the Cyclone Boiler Retrofit Feasibility Study carried out by TransAlta and an Operating Committee formed of cyclone boiler owners in 1989. An existing utility cyclone boiler, was then selected for the evaluation of the cost and performance study. It was concluded that the LNS Burner retrofit would be a cost-effective option for control of cyclone boiler emissions. A full-scale demonstration of the LNS Burner retrofit was selected in October 1988 as part of the DOE's Clean Coal Technology Program Round II.

  9. Prognosis of patients with pelvic lymph node (LN) metastasis after radical prostatectomy: value of extranodal extension and size of the largest LN metastasis.

    Science.gov (United States)

    Passoni, Niccolo M; Fajkovic, Harun; Xylinas, Evanguelos; Kluth, Luis; Seitz, Christian; Robinson, Brian D; Rouprêt, Morgan; Chun, Felix K; Lotan, Yair; Roehrborn, Claus G; Crivelli, Joseph J; Karakiewicz, Pierre I; Scherr, Douglas S; Rink, Michael; Graefen, Markus; Schramek, Paul; Briganti, Alberto; Montorsi, Francesco; Tewari, Ashutosh; Shariat, Shahrokh F

    2014-10-01

    To assess the prognostic role of extranodal extension (ENE) and the size of the largest lymph node (LN) metastasis in predicting early biochemical relapse (eBCR) in patients with LN metastasis after radical prostatectomy (RP). We evaluated BCR-free survival in men with LN metastases after RP and pelvic LN dissection performed in six high-volume centres. Multivariable Cox regression tested the role of ENE and diameter of largest LN metastasis in predicting eBCR after adjusting for clinicopathological variables. We compared the discrimination of multivariable models including ENE, the size of largest LN metastasis and the number of positive LNs. Overall, 484 patients were included. The median (interquartile range, IQR) follow-up was 16.1 (6-27.5) months. The median (IQR) number of removed LNs was 10 (4-14), and the median (IQR) number of positive LNs was 1 (1-2). ENE was present in 280 (58%) patients, and 211 (44%) had their largest metastasis >10 mm. Patients with ENE and/or largest metastasis of >10 mm had significantly worse eBCR-free survival (all P 2) and the diameter of LN metastasis (≤10 vs >10 mm), but not ENE, were significant predictors of eBCR (all P model (0.663) by 0.016 points. The diameter of the largest LN metastasis and the number of positive LNs are independent predictors of eBCR. Considered together, ENE and the diameter of the largest LN metastasis have less discrimination than the number of positive LNs. © 2013 The Authors. BJU International © 2013 BJU International.

  10. Comparison of different lymph node staging systems in prognosis of gastric cancer: a bi-institutional study from Hungary.

    Science.gov (United States)

    Tóth, Dezső; Bíró, Adrienn; Varga, Zsolt; Török, Miklós; Árkosy, Péter

    2017-08-01

    The Union for International Cancer Control (UICC) Node (N) classification is the most common used staging method for the prognosis of gastric cancer. It demands adequate, at least 16 lymph nodes (LNs) to be dissected; therefore different staging systems were invented. Between March 2005 and March 2010, 164 patients were evaluated at the Department of General Surgery in the Kenézy Gyula Hospital and at the Department of General, Thoracic and Vascular Surgery in the Kaposi Mór Hospital. The 6th, 7th and 8th UICC N-staging systems, the number of examined LNs, the number of harvested negative LNs, the metastatic lymph node ratio (MLR) and the log odds of positive LNs (LODDS) were determined to measure their 5-year survival rates and to compare them to each other. The overall 5-year survival rate for all patients was 55.5% with a median overall survival time of 102 months. The tumor stage, gender, UICC N-stages, MLR and the LODDS were significant prognostic factors for the 5-year survival with univariate analysis. The 6th UICC N-stage did not follow the adequate risk in comparing N2 vs . N0 and N3 vs . N0 with multivariate investigation. Comparison of performances of the residual N classifications proved that the LODDS system was first in the prediction of prognosis during the evaluation of all patients and in cases with less than 16 harvested LNs. The MLR gave the best prognostic prediction when adequate (more than or equal to 16) lymphadenectomy was performed. We suggest the application of LODDS system routinely in western patients and the usage of MLR classification in cases with extended lymphadenectomy.

  11. Primary simian immunodeficiency virus SIVmnd-2 infection in mandrills (Mandrillus sphinx).

    Science.gov (United States)

    Onanga, Richard; Souquière, Sandrine; Makuwa, Maria; Mouinga-Ondeme, Augustin; Simon, François; Apetrei, Cristian; Roques, Pierre

    2006-04-01

    Mandrills are the only nonhuman primate (NHP) naturally infected by two types of simian immunodeficiency virus (SIV): SIVmnd-1 and SIVmnd-2. We have already reported that the high SIVmnd-1 replication during primary infection contrasts with only transient changes in CD4+ and CD8+ cell counts. Since early virus-host interactions predict viral control and disease progression in human immunodeficiency virus-infected patients, we investigated the dynamics of SIVmnd-2 primary infection in mandrills to examine the impact on immune effectors in blood and lymph nodes (LNs). To avoid in vitro strain selection, all mandrills in this study received plasma from SIVmnd-2-infected mandrills. SIVmnd-2 plasma viremia peaked at 10(7) to 10(8) RNA copies/ml between days 7 and 10. This peak was followed in all four monkeys by a decline in virus replication, with a set point level of 10(5) to 10(6) RNA copies/ml at day 42 postinfection (p.i.). Viral DNA load in PBMC and LNs also peaked between days 7 and 10 (10(5) to 10(6) DNA copies/10(6) cells) and stabilized at 10(3) to 10(4) DNA copies/10(6) cells during the chronic phase. Anti-SIVmnd-2 antibodies were detected starting from days 28 to 32. A transitory decline of CD3+ CD4+ cells in the LNs occurred in animals with high peak VLs. CD4+ and CD8+ T-cell activation in blood and LNs was noted between days 5 and 17 p.i., surrounding the peak of viral replication. This was most significant in the LNs. Activation markers then returned to preinfection values despite continuous and active viral replication during the chronic infection. The dynamics of SIVmnd-2 infection in mandrills showed a pattern similar to that of SIVmnd-1 infection. This might be a general feature of nonpathogenic SIV natural African NHP models.

  12. Efficient fluorescence detection of protoporphyrin IX in metastatic lymph nodes of murine colorectal cancer stained with indigo carmine.

    Science.gov (United States)

    Matsuo, Hisataka; Harada, Yoshinori; Minamikawa, Takeo; Kato, Yoshiyuki; Murayama, Yasutoshi; Otsuji, Eigo; Takamatsu, Tetsuro; Tanaka, Hideo

    2017-09-01

    Protoporphyrin IX (PpIX), a biochemical converted from 5-aminolevulinc acid (5-ALA) in living cells, is useful for intraoperative fluorescent detection of cancer metastasis in lymph nodes (LNs). However, unknown is whether the fluorescence of PpIX can be detected in the LNs when they coexist with indigo carmine, a blue dye commonly used for identification of sentinel LNs during surgery. To address this issue, we sought to evaluate the diagnostic usefulness of PpIX fluorescence in the presence of indigo carmine in a mouse LN metastasis model of rectal cancer after administration of 5-ALA. Spectral analysis of pure chemicals revealed that the absorption spectrum of indigo carmine widely overlapped with the fluorescence spectrum of PpIX specifically at the peak of 632nm, a common emission wavelength for detecting PpIX, but not at the other peak of 700nm. Due to such spectral overlap, the PpIX fluorescence intensity was significantly attenuated by mixture with indigo carmine at 632nm, but not at 700nm. Accordingly, fluorescent measurements of the mouse metastatic LN revealed more intense presentation of PpIX at 700nm than at 632nm, indicating that the diagnostic usefulness is greater at 700nm than at 632nm for the indigo carmine-dyed LNs after administration of 5-ALA. From these observations, we propose that the fluorescence measurement is more efficient at 700nm than at 632nm for detection of PpIX in metastatic LNs stained with indigo carmine. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Serological markers of sand fly exposure to evaluate insecticidal nets against visceral leishmaniasis in India and Nepal: a cluster-randomized trial.

    Directory of Open Access Journals (Sweden)

    Kamlesh Gidwani

    2011-09-01

    Full Text Available Visceral leishmaniasis is the world' second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs are a low cost proven vector intervention method for malaria control; however, their effectiveness against visceral leishmaniasis (VL is unknown. This study quantified the effect of LNs on exposure to the sand fly vector of VL in India and Nepal during a two year community intervention trial.As part of a paired-cluster randomized controlled clinical trial in VL-endemic regions of India and Nepal we tested the effect of LNs on sand fly biting by measuring the antibody response of subjects to the saliva of Leishmania donovani vector Phlebotomus argentipes and the sympatric (non-vector Phlebotomus papatasi. Fifteen to 20 individuals above 15 years of age from 26 VL endemic clusters were asked to provide a blood sample at baseline, 12 and 24 months post-intervention.A total of 305 individuals were included in the study, 68 participants provided two blood samples and 237 gave three samples. A random effect linear regression model showed that cluster-wide distribution of LNs reduced exposure to P. argentipes by 12% at 12 months (effect 0.88; 95% CI 0.83-0.94 and 9% at 24 months (effect 0.91; 95% CI 0.80-1.02 in the intervention group compared to control adjusting for baseline values and pair. Similar results were obtained for P. papatasi.This trial provides evidence that LNs have a limited effect on sand fly exposure in VL endemic communities in India and Nepal and supports the use of sand fly saliva antibodies as a marker to evaluate vector control interventions.

  14. The impact of maternal diet fortification with lipid-based nutrient supplements on postpartum depression in rural Malawi: a randomised-controlled trial.

    Science.gov (United States)

    Stewart, Robert C; Ashorn, Per; Umar, Eric; Dewey, Kathryn G; Ashorn, Ulla; Creed, Francis; Rahman, Atif; Tomenson, Barbara; Prado, Elizabeth L; Maleta, Ken

    2017-04-01

    Perinatal depression is highly prevalent in low-and-middle-income countries and has been linked to poor child health. Suboptimal maternal nutrition may be a risk factor for perinatal depression. In this randomised-controlled trial conducted in rural Malawi, we set out to test the hypothesis that women taking a fatty acid-rich lipid-based nutrient supplement (LNS) would have fewer depressive symptoms postpartum than those taking iron-folate (IFA) or multiple-micronutrient (MMN) capsules. Women were recruited from antenatal clinics and randomised to receive LNS or MMN during pregnancy and for 6 months postpartum, or IFA during pregnancy only. Maternal depressive symptoms were measured using validated translations of the Self Reporting Questionnaire (SRQ) and Edinburgh Postnatal Depression Scale (EPDS), antenatally (SRQ only) and at 6 months postpartum (SRQ and EPDS). Analysis was by modified intention to treat. One thousand three hundred and ninety one women were randomised (LNS = 462, MMN = 466, IFA = 463). The groups were similar across a range of baseline variables. At 6 months postpartum, 1078 (77.5%) had SRQ completed; mean (SD) scores were LNS 1.76(2.73), MMN 1.92(2.75), IFA 1.71(2.66), P = 0.541. One thousand and fifty seven (76.0%) had EPDS completed; mean (SD) scores were LNS 5.77(5.53), MMN 5.43(4.97), IFA 5.52(5.18), P = 0.676. There were no statistically significant differences between the groups on SRQ or EPDS scores (continuous or dichotomised) in unadjusted or adjusted models. In conclusion, fortification of maternal diet with LNS compared with MMN or IFA did not reduce postnatal depressive symptoms in this study. © 2016 John Wiley & Sons Ltd.

  15. Oxazolone-induced contact hypersensitivity reduces lymphatic drainage but enhances the induction of adaptive immunity.

    Directory of Open Access Journals (Sweden)

    David Aebischer

    Full Text Available Contact hypersensitivity (CHS induced by topical application of haptens is a commonly used model to study dermal inflammatory responses in mice. Several recent studies have indicated that CHS-induced skin inflammation triggers lymphangiogenesis but may negatively impact the immune-function of lymphatic vessels, namely fluid drainage and dendritic cell (DC migration to draining lymph nodes (dLNs. On the other hand, haptens have been shown to exert immune-stimulatory activity by inducing DC maturation. In this study we investigated how the presence of pre-established CHS-induced skin inflammation affects the induction of adaptive immunity in dLNs. Using a mouse model of oxazolone-induced skin inflammation we observed that lymphatic drainage was reduced and DC migration from skin to dLNs was partially compromised. At the same time, a significantly stronger adaptive immune response towards ovalbumin (OVA was induced when immunization had occurred in CHS-inflamed skin as compared to uninflamed control skin. In fact, immunization with sterile OVA in CHS-inflamed skin evoked a delayed-type hypersensitivity (DTH response comparable to the one induced by conventional immunization with OVA and adjuvant in uninflamed skin. Striking phenotypic and functional differences were observed when comparing DCs from LNs draining uninflamed or CHS-inflamed skin. DCs from LNs draining CHS-inflamed skin expressed higher levels of co-stimulatory molecules and MHC molecules, produced higher levels of the interleukin-12/23 p40 subunit (IL-12/23-p40 and more potently induced T cell activation in vitro. Immunization experiments revealed that blockade of IL-12/23-p40 during the priming phase partially reverted the CHS-induced enhancement of the adaptive immune response. Collectively, our findings indicate that CHS-induced skin inflammation generates an overall immune-stimulatory milieu, which outweighs the potentially suppressive effect of reduced lymphatic vessel function.

  16. Landmark-Guided and Ultrasound-Guided Approaches for Trochanteric Bursa Injection: A Cadaveric Study.

    Science.gov (United States)

    Mu, Alex; Peng, Philip; Agur, Anne

    2017-03-01

    Trochanteric bursa (TB) injection with local anesthetic and corticosteroid is a treatment for patients suffering from greater trochanteric pain syndrome. Both landmark (LM)-guided and ultrasound (US)-guided methods have been used, but their accuracies have not been determined. This study examined the accuracy of these injections with cadaveric dissection. Twenty-four hip specimens were randomized to receive TB injections with methylene blue under either LM-guided or US-guided approach. After dissection, the locations of the dye were classified into 3 categories: intrabursal, extrabursal, or combined intrabursal and extrabursal. The presence of dye in the intrabursal space with or without extrabursal leak was considered a successful injection. Accuracy was defined as the percentage of successful injection. The accuracies of the LM-guided and US-guided injection were 0.67 (95% confidence interval 0.35-0.90) and 0.92 (95% confidence interval 0.62-1.00), respectively, with no significant difference. This is the first cadaveric study examining the accuracy of both the US-guided and LM-guided techniques for TB injection. Future clinical studies are required to compare the outcomes of LM-guided and US-guided greater trochanteric pain syndrome injection.

  17. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    José L. Arias-Buría

    2015-01-01

    Full Text Available Objective. To compare effects of ultrasound- (US- guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n=17 group or exercise (n=19 group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions. Shoulder pain (NPRS and disability (DASH were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P<0.01: individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

  18. Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children.

    Science.gov (United States)

    Unger, Stefan A; Drammeh, Saikou; Hasan, Jahid; Ceesay, Kabiru; Sinjanka, Edrisa; Beyai, Sainey; Sonko, Bakary; Dondeh, Bai Lamin; Fulford, Anthony J; Moore, Sophie E; Prentice, Andrew M

    2017-08-01

    Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed. We undertook a double-blind randomised controlled trial of small-quantity lipid-based nutrient supplements (SQ-LNS) fortified with 23 micronutrients in children aged 6 months (mo) to 5 years (y) presenting with an illness at a rural primary healthcare centre in The Gambia. Primary outcomes were repeat clinic presentations and growth over 24 wk. Participants were randomly assigned to receive 1 of 3 interventions: (1) supplementation with micronutrient-fortified SQ-LNS for 12 wk (MMN-12), (2) supplementation with micronutrient-fortified SQ-LNS for 6 wk followed by unfortified SQ-LNS for 6 wk (MMN-6), or (3) supplementation with unfortified SQ-LNS for 12 wk (MMN-0) to be consumed in daily portions. Treatment masking used 16 letters per 6-wk block in the randomisation process. Blinded intention-to-treat analysis based on a prespecified statistical analysis plan included all participants eligible and correctly enrolled. Between December 2009 and June 2011, 1,101 children (age 6-60 mo, mean 25.5 mo) were enrolled, and 1,085 were assessed (MMN-0 = 361, MMN-6 = 362, MMN-12 = 362). MMN supplementation was associated with a small increase in height-for-age z-scores 24 wk after recruitment (effect size for MMN groups combined: 0.084 SD/24 wk, 95% CI: 0.005, 0.168; p = 0.037; equivalent to 2-5 mm depending on age). No significant difference in frequency of morbidity measured by the

  19. Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children.

    Directory of Open Access Journals (Sweden)

    Stefan A Unger

    2017-08-01

    Full Text Available Multiple micronutrients (MMN are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed.We undertook a double-blind randomised controlled trial of small-quantity lipid-based nutrient supplements (SQ-LNS fortified with 23 micronutrients in children aged 6 months (mo to 5 years (y presenting with an illness at a rural primary healthcare centre in The Gambia. Primary outcomes were repeat clinic presentations and growth over 24 wk. Participants were randomly assigned to receive 1 of 3 interventions: (1 supplementation with micronutrient-fortified SQ-LNS for 12 wk (MMN-12, (2 supplementation with micronutrient-fortified SQ-LNS for 6 wk followed by unfortified SQ-LNS for 6 wk (MMN-6, or (3 supplementation with unfortified SQ-LNS for 12 wk (MMN-0 to be consumed in daily portions. Treatment masking used 16 letters per 6-wk block in the randomisation process. Blinded intention-to-treat analysis based on a prespecified statistical analysis plan included all participants eligible and correctly enrolled. Between December 2009 and June 2011, 1,101 children (age 6-60 mo, mean 25.5 mo were enrolled, and 1,085 were assessed (MMN-0 = 361, MMN-6 = 362, MMN-12 = 362. MMN supplementation was associated with a small increase in height-for-age z-scores 24 wk after recruitment (effect size for MMN groups combined: 0.084 SD/24 wk, 95% CI: 0.005, 0.168; p = 0.037; equivalent to 2-5 mm depending on age. No significant difference in frequency of morbidity measured by

  20. Preventing acute malnutrition among young children in crises: a prospective intervention study in Niger.

    Science.gov (United States)

    Langendorf, Céline; Roederer, Thomas; de Pee, Saskia; Brown, Denise; Doyon, Stéphane; Mamaty, Abdoul-Aziz; Touré, Lynda W-M; Manzo, Mahamane L; Grais, Rebecca F

    2014-09-01

    Finding the most appropriate strategy for the prevention of moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in young children is essential in countries like Niger with annual "hunger gaps." Options for large-scale prevention include distribution of supplementary foods, such as fortified-blended foods or lipid-based nutrient supplements (LNSs) with or without household support (cash or food transfer). To date, there has been no direct controlled comparison between these strategies leading to debate concerning their effectiveness. We compared the effectiveness of seven preventive strategies-including distribution of nutritious supplementary foods, with or without additional household support (family food ration or cash transfer), and cash transfer only-on the incidence of SAM and MAM among children aged 6-23 months over a 5-month period, partly overlapping the hunger gap, in Maradi region, Niger. We hypothesized that distributions of supplementary foods would more effectively reduce the incidence of acute malnutrition than distributions of household support by cash transfer. We conducted a prospective intervention study in 48 rural villages located within 15 km of a health center supported by Forum Santé Niger (FORSANI)/Médecins Sans Frontières in Madarounfa. Seven groups of villages (five to 11 villages) were allocated to different strategies of monthly distributions targeting households including at least one child measuring 60 cm-80 cm (at any time during the study period whatever their nutritional status): three groups received high-quantity LNS (HQ-LNS) or medium-quantity LNS (MQ-LNS) or Super Cereal Plus (SC+) with cash (€38/month [US$52/month]); one group received SC+ and family food ration; two groups received HQ-LNS or SC+ only; one group received cash only (€43/month [US$59/month]). Children 60 cm-80 cm of participating households were assessed at each monthly distribution from August to December 2011. Primary endpoints were SAM

  1. Extranodal extension is a powerful prognostic factor in bladder cancer patients with lymph node metastasis.

    Science.gov (United States)

    Fajkovic, Harun; Cha, Eugene K; Jeldres, Claudio; Robinson, Brian D; Rink, Michael; Xylinas, Evanguelos; Chromecki, Thomas F; Breinl, Eckart; Svatek, Robert S; Donner, Gerhard; Tagawa, Scott T; Tilki, Derya; Bastian, Patrick J; Karakiewicz, Pierre I; Volkmer, Bjoern G; Novara, Giacomo; Joual, Abdennabi; Faison, Talia; Sonpavde, Guru; Daneshmand, Siamak; Lotan, Yair; Scherr, Douglas S; Shariat, Shahrokh F

    2013-11-01

    Lymph node metastasis (LNM) is the most powerful pathologic predictor of disease recurrence after radical cystectomy (RC). However, the outcomes of patients with LNM are highly variable. To assess the prognostic value of extranodal extension (ENE) and other lymph node (LN) parameters. A retrospective analysis of 748 patients with urothelial carcinoma of the bladder and LNM treated with RC and lymphadenectomy without neoadjuvant therapy at 10 European and North American centers (median follow-up: 27 mo). All subjects underwent RC and bilateral pelvic lymphadenectomy. Each LNM was microscopically evaluated for the presence of ENE. The number of LNs removed, number of positive LNs, and LN density were recorded and calculated. Univariable and multivariable analyses addressed time to disease recurrence and cancer-specific mortality after RC. A total of 375 patients (50.1%) had ENE. The median number of LNs removed, number of positive LNs, and LN density were 15, 2, and 15, respectively. The rate of ENE increased with advancing pT stage (pCox regression analyses that adjusted for the effects of established clinicopathologic features and LN parameters, ENE was associated with disease recurrence (hazard ratio [HR]: 1.89; 95% confidence interval [CI], 1.55-2.31; pmodel that included pT stage, tumor grade, age, gender, lymphovascular invasion, surgical margin status, LN density, number of LNs removed, number of positive LNs, and adjuvant chemotherapy improved predictive accuracy for disease recurrence and cancer-specific mortality from 70.3% to 77.8% (p<0.001) and from 71.8% to 77.8% (p=0.007), respectively. The main limitation of the study is its retrospective nature. ENE is an independent predictor of both cancer recurrence and cancer-specific mortality in RC patients with LNM. Knowledge of ENE status could help with patient counseling, clinical decision making regarding inclusion in clinical trials of adjuvant therapy, and tailored follow-up scheduling after RC. Copyright

  2. Maternal and Child Supplementation with Lipid-Based Nutrient Supplements, but Not Child Supplementation Alone, Decreases Self-Reported Household Food Insecurity in Some Settings.

    Science.gov (United States)

    Adams, Katherine P; Ayifah, Emmanuel; Phiri, Thokozani E; Mridha, Malay K; Adu-Afarwuah, Seth; Arimond, Mary; Arnold, Charles D; Cummins, Joseph; Hussain, Sohrab; Kumwenda, Chiza; Matias, Susana L; Ashorn, Ulla; Lartey, Anna; Maleta, Kenneth M; Vosti, Stephen A; Dewey, Kathryn G

    2017-12-01

    Background: It is unknown whether self-reported measures of household food insecurity change in response to food-based nutrient supplementation.Objective: We assessed the impacts of providing lipid-based nutrient supplements (LNSs) to women during pregnancy and postpartum and/or to their children on self-reported household food insecurity in Malawi [DOSE and DYAD trial in Malawi (DYAD-M)], Ghana [DYAD trial in Ghana (DYAD-G)], and Bangladesh [Rang-Din Nutrition Study (RDNS) trial].Methods: Longitudinal household food-insecurity data were collected during 3 individually randomized trials and 1 cluster-randomized trial testing the efficacy or effectiveness of LNSs (generally 118 kcal/d). Seasonally adjusted Household Food Insecurity Access Scale (HFIAS) scores were constructed for 1127 DOSE households, 732 DYAD-M households, 1109 DYAD-G households, and 3671 RDNS households. The impact of providing LNSs to women during pregnancy and the first 6 mo postpartum and/or to their children from 6 to 18-24 mo on seasonally adjusted HFIAS scores was assessed by using negative binomial models (DOSE, DYAD-M, and DYAD-G trials) and mixed-effect negative binomial models (RDNS trial).Results: In the DOSE and DYAD-G trials, seasonally adjusted HFIAS scores were not different between the LNS and non-LNS groups. In the DYAD-M trial, the average household food-insecurity scores were 14% lower (P = 0.01) in LNS households than in non-LNS households. In the RDNS trial, compared with non-LNS households, food-insecurity scores were 17% lower (P = 0.02) during pregnancy and the first 6 mo postpartum and 15% lower (P = 0.02) at 6-24 mo postpartum in LNS households.Conclusions: The daily provision of LNSs to mothers and their children throughout much of the "first 1000 d" may improve household food security in some settings, which could be viewed as an additional benefit that may accrue in households should policy makers choose to invest in LNSs to promote child growth and development. These

  3. Mammographic CAD: Correlation of regions in ipsilateral views - a pilot study

    National Research Council Canada - National Science Library

    Padayachee, J; Alport, M J; Rae, W ID

    2009-01-01

    ...: The aim of this study was to develop image-processing algorithms that can be used to match a suspicious feature from one mammographic view to the same feature in another mammographic view of the same breast...

  4. Medline Plus

    Full Text Available ... cancer. Examine skin regularly for development of suspicious growths or changes in an existing skin lesion. Early detection and treatment are key in increasing the cure rate for skin cancer.

  5. Design of a software architecture supporting business-to-government information sharing to improve public safety and security : Combining business rules, Events and blockchain technology

    NARCIS (Netherlands)

    van Engelenburg, S.H.; Janssen, M.F.W.H.A.; Klievink, A.J.

    2017-01-01

    Toensurepublicsafetyandsecurity,itisvitallyimportantforgovernmentstocol- lect information from businesses and analyse it. Such information can be used to determine whether transported goods might be suspicious and therefore require physical inspection. Although businesses are obliged to report some

  6. A Ranking Approach to Source Retrieval of Plagiarism Detection

    National Research Council Canada - National Science Library

    KONG, Leilei; LU, Zhimao; HAN, Zhongyuan; QI, Haoliang

    2017-01-01

    This paper addresses the issue of source retrieval in plagiarism detection. The task of source retrieval is retrieving all plagiarized sources of a suspicious document from a source document corpus whilst minimizing retrieval costs...

  7. Intelligent route surveillance

    NARCIS (Netherlands)

    Schoemaker, R.M.; Sandbrink, R.D.J.; Voorthuijsen, G.P. van

    2009-01-01

    Intelligence on abnormal and suspicious behaviour along roads in operational domains is extremely valuable for countering the IED (Improvised Explosive Device) threat. Local sensor networks at strategic spots can gather data for continuous monitoring of daily vehicle activity. Unattended intelligent

  8. Needle Biopsy

    Science.gov (United States)

    ... Procedures Needle biopsy Sections About Print Overview Thyroid biopsy Thyroid biopsy During a thyroid biopsy, your doctor uses a ... the needle to the suspicious area. Core needle biopsy Core needle biopsy A core needle biopsy uses ...

  9. Ricin

    Science.gov (United States)

    ... on Facebook Tweet Share Compartir 2013 Ricin Event FBI Response to Reports of Suspicious Letters Received at ... Word file Microsoft Excel file Audio/Video file Apple Quicktime file RealPlayer file Text file Zip Archive ...

  10. Children's (Pediatric) Magnetic Resonance Imaging

    Medline Plus

    Full Text Available ... who will share the results with you. Follow-up examinations may be necessary, and your doctor will ... why another exam is needed. Sometimes a follow-up exam is done because a suspicious or questionable ...

  11. Primary low-grade endometrial stromal sarcoma of the omentum

    OpenAIRE

    Kiran Clair; Juliet Wolford; Sonia Veran-Taguibao; Grace Kim; Eskander, Ramez N.

    2017-01-01

    Highlights ? Extra-uterine endometrial stromal sarcoma may arise in endometriosis. ? Abdominal exploration for extra pelvic endometriosis is warranted. ? Representative endometriotic implants should be resected and/or biopsied if clinically suspicious.

  12. Severe trachea compression caused by Riedel's thyroiditis: A case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Ren Chong Xi

    2016-12-01

    Conclusions: Clinicians should be aware of RT. It is important to differentiate this condition from other thyroid disorders, especially malignant lesions. Thyroidectomy is indicated for patients with compressive symptoms, suspicious malignancy and failure of conservative management.

  13. Combined assessment (aspiration cytology and mammography) of ...

    African Journals Online (AJOL)

    Combined assessment (aspiration cytology and mammography) of clinically suspicious breast masses. W.F. van Wyk, D Dent, E Anne Hacking, Genevieve Learmonth, R.E. Kottler, C Anne Gudgeon, A Tiltman ...

  14. Aggravating conditions: Cynical hostility and neighborhood ambient stressors

    Science.gov (United States)

    This study is the first to investigate neighborhood clustering of a personality trait e cynical hostility (a sense of mistrust of others amplified by suspicious antagonism.) Cynical hostility increases physiological reactivity by influencing appraisal and coping when stressful ev...

  15. Computer-Aided Diagnosis of Malignant Mammograms using Zernike Moments and SVM

    National Research Council Canada - National Science Library

    Sharma, Shubhi; Khanna, Pritee

    This work is directed toward the development of a computer-aided diagnosis (CAD) system to detect abnormalities or suspicious areas in digital mammograms and classify them as malignant or nonmalignant...

  16. Using Neural Networks in Diagnosing Breast Cancer

    National Research Council Canada - National Science Library

    Fogel, David

    1997-01-01

    .... In the current study, evolutionary programming is used to train neural networks and linear discriminant models to detect breast cancer in suspicious and microcalcifications using radiographic features and patient age...

  17. Dexmethylphenidate

    Science.gov (United States)

    ... arm or leg changes in vision or blurred vision seizures believing things that are not true feeling unusually suspicious of others aggressive behavior hallucinations (seeing things or hearing voices that do not ...

  18. Security, Fraud Detection

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Secure. Secure. Server – Intruder prevention/detection; Network – Encryption, PKI; Client - Secure. Fraud detection based on audit trails. Automatic alerts like credit-card alerts based on suspicious patterns.

  19. Pathologically Benign Lymph Nodes Can Mimic Malignancy on Imaging in Patients With Angiomatoid Fibrous Histiocytoma

    National Research Council Canada - National Science Library

    Ulaner, Gary A; Healey, John H; Athanasian, Edward A

    2017-01-01

    .... We found that several of our patients with AFH presented with radiologically suspicious local lymph nodes that were sampled because of their imaging characteristics, but the nodes proved to be benign...

  20. The 2nd international veterinary poultry congress of Iran

    African Journals Online (AJOL)

    ehsan

    2012-07-24

    quarters and bird keepers indicate that most of the young pigeons die with suspicious infection to parasites. In addition, the pigeon owners were complaining of skin itching on their head. Thus, this research was conducted.

  1. Prostate Ultrasound

    Medline Plus

    Full Text Available ... are obtained from different angles to get the best view of the prostate gland. If a suspicious ... over time. Follow-up examinations are sometimes the best way to see if treatment is working or ...

  2. 9 CFR 310.9 - Anthrax; carcasses not to be eviscerated; disposition of affected carcasses; hides, hoofs, horns...

    Science.gov (United States)

    2010-01-01

    ... boots to protect the hands and feet, and goggles to protect the eyes, should be taken by those engaged... promptly any suspicious condition (sore or carbuncle) or symptom to a physician, in order that anti-anthrax...

  3. Ultrasound-guided genitourinary interventions: principles and techniques

    Directory of Open Access Journals (Sweden)

    Byung Kwan Park

    2017-10-01

    Full Text Available Ultrasound (US is often used to guide various interventional procedures in the genitourinary (GU tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  4. Ultrasound-guided genitourinary interventions: principles and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-10-15

    Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  5. Testing the performances of different image representations for mass classification in digital mammograms

    OpenAIRE

    Angelini, Enrico; Campanini, Renato; Iampieri, Emiro; Lanconelli, Nico; Masotti, Matteo; Roffilli, Matteo

    2006-01-01

    The classification of tumoral masses and normal breast tissue is targeted. A mass detection algorithm which does not refer explicitly to shape, border, size, contrast or texture of mammographic suspicious regions is evaluated. In the present approach, classification features are embodied by the image representation used to encode suspicious regions. Classification is performed by means of a support vector machine (SVM) classifier. To investigate whether improvements can be achieved with respe...

  6. Implementasi Intrusion Detection System (Ids)di Jaringan Universitas Bina Darma

    OpenAIRE

    Ulfa, Maria

    2012-01-01

    Computer Security systems, in recent years has become a major focus in the world of computer networks, this is due to the high threat of suspicious (Suspicious Threat) and attacks from the internet. Bina Darma University is one of the agencies which activities using the internet network services, ranging from the processing of existing data, including the KRS online system, mail server and web portal in each unit and others. Bina Darma University network manager for this building system is a ...

  7. Simultaneous Retzius-sparing robot-assisted radical prostatectomy and partial nephrectomy

    Directory of Open Access Journals (Sweden)

    Ali Abdel Raheem

    2016-03-01

    Full Text Available We present a 61-year-old man who was diagnosed with synchronous prostate cancer and suspicious renal cell carcinoma of the right kidney, treated with combined Retzius-sparing robot-assisted radical prostatectomy (RS-RARP and robot-assisted partial nephrectomy (RAPN. The combined approach using RS-RARP and RAPN is technically feasible and safe surgical option for treatment of concomitant prostate cancer and suspicious renal cell carcinoma.

  8. Accuracy of ultrasound-guided versus unguided pes anserinus bursa injections.

    Science.gov (United States)

    Finnoff, Jonathan T; Nutz, David J; Henning, Philip T; Hollman, John H; Smith, Jay

    2010-08-01

    To compare the accuracy of ultrasound (US)-guided versus unguided pes anserinus bursa injections in a cadaveric model. Single blind, prospective study. Academic institution procedural skills laboratory. Twenty-four unembalmed, unpaired adult cadaveric lower extremity specimens. A single investigator performed 12 US-guided and 12 unguided pes anserinus bursa injections using colored liquid latex into 24 unembalmed adult cadaveric lower extremity specimens. The order of the injection techniques was randomized. The specimens were subsequently dissected by a co-investigator blinded to the injection technique used for each injection. The injections were graded for accuracy as follows: accurate (all injectate contained within the pes anserinus bursa), accurate with overflow (injectate within the pes anserinus bursa, but also located in adjacent structures), or inaccurate (injectate not within the pes anserinus bursa). The accuracy of the 2 approaches was compared using Pearson chi(2) test with Williams' correction for the small sample size (P = .05). The accuracy rate was 92% (11 of 12 specimens) in the US-guided condition and 17% (2 of 12 specimens) in the unguided condition. One US-guided injection was considered accurate with overflow, whereas 4 unguided injections were accurate with overflow. The US-guided injection technique was significantly more accurate than the unguided technique (Williams-corrected chi(2) = 12.528, P bursa injections rarely place the injectate within the pes anserinus bursa, whereas US-guided pes anserinus bursa injections have a high degree of accuracy. Therefore, clinicians should consider using US-guidance for diagnostic or therapeutic pes anserinus bursa injections when indicated. Copyright © 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  9. The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions

    Science.gov (United States)

    Lopes, Pedro Marinho; Sepúlveda, Luís; Ramos, Rui; Sousa, Pedro

    2015-01-01

    Objective The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies. Materials and Methods Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers). Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done. Results In a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%). The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032). No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172). Conclusion The high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule). PMID:25798001

  10. The role of transrectal ultrasound in the diagnosis of prostate cancer: new contributions

    Directory of Open Access Journals (Sweden)

    Pedro Marinho Lopes

    2015-02-01

    Full Text Available Objective: The present study was aimed at evaluating the contribution of transrectal prostate ultrasound in the screening for prostate neoplasias and in the guidance of prostate biopsies. Materials and Methods: Prospective study developed over a one-year period. All the patients with indication for prostate biopsy were evaluated. Regardless of PSA values, the patients underwent ultrasound in order to identify suspicious nodules (confirmed by two observers. Sextant biopsy was subsequently performed. In cases of finding suspicious nodules, an additional puncture directed to such nodules was done. Results: In a total of 155 cases the prevalence of malignancy was of 53%. Suspicious nodules were detected in 34 patients, and 25 where malignant (positive predictive value of 74%. The specificity and sensitivity for suspicious nodules were 88% and 31% respectively. Comparatively with the randomly obtained sextant specimens, the rate of findings of neoplasia was higher in the specimens obtained with puncture directed to the nodule (p = 0.032. No statistically significant difference was observed in the Gleason score for both types of specimens (p = 0.172. Conclusion: The high positive predictive value and the high rate of findings of neoplasia in specimens of suspicious nodules should be taken into consideration in the future. The authors suggest a biopsy technique similar to the one described in the present study (sextant biopsy plus puncture directed to the suspicious nodule.

  11. Automatic segmentation of lesion from breast DCE-MR image using artificial fish swarm optimization algorithm

    Science.gov (United States)

    Janaki, Sathya D.; Geetha, K.

    2017-06-01

    Interpreting Dynamic Contrast-Enhanced (DCE) MR images for signs of breast cancer is time consuming and complex, since the amount of data that needs to be examined by a radiologist in breast DCE-MRI to locate suspicious lesions is huge. Misclassifications can arise from either overlooking a suspicious region or from incorrectly interpreting a suspicious region. The segmentation of breast DCE-MRI for suspicious lesions in detection is thus attractive, because it drastically decreases the amount of data that needs to be examined. The new segmentation method for detection of suspicious lesions in DCE-MRI of the breast tissues is based on artificial fishes swarm clustering algorithm is presented in this paper. Artificial fish swarm optimization algorithm is a swarm intelligence algorithm, which performs a search based on population and neighborhood search combined with random search. The major criteria for segmentation are based on the image voxel values and the parameters of an empirical parametric model of segmentation algorithms. The experimental results show considerable impact on the performance of the segmentation algorithm, which can assist the physician with the task of locating suspicious regions at minimal time.

  12. Ultrasound and ultrasound guided biopsy, CT and lymphography in the diagnosis of retroperitoneal metastases in testicular cancer

    DEFF Research Database (Denmark)

    Damgaard-Pedersen, K; von der Maase, H

    1991-01-01

    A retrospective study of bipedal lymphography (BL), computed tomography (CT) and ultrasonography (US) of retroperitoneal lymph nodes has been carried out in 95 patients with newly diagnosed testicular cancer. Twenty-one patients had abnormal lymph nodes at the time of staging. The diagnostic...... findings and 5 verified benign lesions. US represents a cheap and accurate alternative to CT in the detection of metastatic retroperitoneal lymph nodes. US and US-guided biopsy is indicated supplementary to CT in cases with borderline enlarged nodes on CT. Furthermore, US-guided biopsy should always...

  13. Bilateral sciatic nerve block after orthopedic surgery in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Levent Şahin

    2011-09-01

    Full Text Available Early postoperative pain is one of the most important problems in pediatric orthopedic surgery. Introduction of the use of ultrasound (US has led to very important developments in pediatric regional anesthesia. We aimed to present with the literature data about that we applied the bilateral US-guided sciatic nerve block to the patient who was operated under bilateral knee disarticulation because of congenital tibia agenesis and talipes equinovarus. In conclusion we entertain that US-guided peripheral nerve blocks are effective and safety for postoperative pain in pediatric orthopedic surgery.

  14. Clinical outcome and imaging changes after intraarticular (IA) application of etanercept or methylprednisolone in rheumatoid arthritis: Magnetic resonance imaging and ultrasound-Doppler show no effect of IA injections in the wrist after 4 weeks

    DEFF Research Database (Denmark)

    Boesen, M.; Boesen, L.; Jensen, K.E.

    2008-01-01

    Objective. To assess the magnetic resonance imaging (MRI) and ultrasound (US) changes in the wrist of patients with rheumatoid arthritis (RA) 4 weeks after an US guided intraarticular (IA) injection. Methods. Contrast enhanced MRI and US-Doppler were performed at baseline and 4 weeks after IA...... injection of either 40 mg methylprednisolone (n = 12) or 25 mg etanercept (n = 13) in 25 patients with RA taking disease modifying antirheumatic drugs with a therapy-resistant wrist joint. All injections were US guided. Results. There was an improvement in swollen target joint score (p

  15. Kaposi sarcoma and lymphadenopathy syndrome: limitations of abdominal CT in acquired immunodeficiency syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Moon, K.L. Jr.; Federle, M.P.; Abrams, D.I.; Volberding, P.; Lewis, B.J.

    1984-02-01

    Abdominal computed tomography (CT) was performed in 31 patients with Kaposi sarcoma (KS) related to acquired immunodeficiency syndrome (AIDS), three patients with classic KS, and 12 patients with the newly described lymphadenopathy syndrome (LNS). The frequency, distribution, and appearance of lymphadenopathy and splenomegaly were similar in the AIDS-related KS and LNS groups. Rectal and perirectal disease was identified in 86% of homosexual men studied; rectal KS could not be distinguished from proctitis on CT criteria alone. No CT abnormalities were seen in patients with classic KS. The CT demonstration of retroperitoneal, mesenteric, or pelvic adenopathy or of rectal or perirectal disease in patients with AIDS-related KS is not necessarily indicative of widespread involvement with the disease.

  16. Context-Dependent Development of Lymphoid Stroma from Adult CD34+ Adventitial Progenitors

    DEFF Research Database (Denmark)

    Sitnik, Katarzyna Maria; Wendland, Kerstin; Weishaupt, Holger

    2016-01-01

    Despite the key role of primary and secondary lymphoid organ stroma in immunity, our understanding of the heterogeneity and ontogeny of these cells remains limited. Here, we identify a functionally distinct subset of BP3-PDPN+PDGFRβ+/α+CD34+ stromal adventitial cells in both lymph nodes (LNs......) and thymus that is located within the vascular niche surrounding PDPN-PDGFRβ+/α-Esam-1+ITGA7+ pericytes. CD34+ adventitial cells developed in late embryonic thymus and in postnatal LNs and in the thymus originated, along with pericytes, from a common anlage-seeding progenitor population. Using lymphoid organ...... re-aggregate grafts, we demonstrate that adult CD34+ adventitial cells are capable of differentiating into multiple lymphoid stroma-like subsets including pericyte-, FRC-, MRC-, and FDC-like cells, the development of which was lymphoid environment-dependent. These findings extend the current...

  17. Significant Mismatch between FDG Uptake and Size after Chemotherapy in a Patient with Non-small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Seong Young; Jeong, Shin Young; Seo, Young Soon; Ha, Jung Min; Chong, A Ri; Oh, Jong Ryool; Song, Ho Chun; Min, Jung Joon; Bom, Hee Seung [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2008-12-15

    A 75-year-old man with non-small cell lung cancer (NSCLC) underwent F-18 fluorodeoxyglucose (FDG) PET/CT for staging. PET/CT showed distant metastases to intra-abdominal lymph nodes (LNs) as well as bilateral mediastinal LNs (stage IV). He underwent PET/CT (restaging PET/CT) 1 week after the completion of first-line chemotherapy (docetaxel + carboplatin). It showed markedly increased FDG uptake in primary tumor, whereas tumor size decreased significantly, compared to prior PET/CT. This lesion was aggravated on follow-up CT 3 months after the completion of chemotherapy. Although there are several reports that FDG PET has potential to evaluate early response to chemotherapy and prognosis, there are a few cases to show mismatch between FDG uptake and size on PET/CT. Thus we report a case of NSCLC showed increased FDG uptake of primary tumor while decreased tumor size on restaging PET/CT.

  18. Effects on mortality of a nutritional intervention for malnourished HIV-infected adults referred for antiretroviral therapy

    DEFF Research Database (Denmark)

    Filteau, Suzanne; PrayGod, George; Kasonka, Lackson

    2015-01-01

    BACKGROUND: Malnourished HIV-infected African adults are at high risk of early mortality after starting antiretroviral therapy (ART). We hypothesized that short-course, high-dose vitamin and mineral supplementation in lipid nutritional supplements would decrease mortality. METHODS: The study...... was an individually-randomised phase III trial conducted in ART clinics in Mwanza, Tanzania, and Lusaka, Zambia. Participants were 1,815 ART-naïve non-pregnant adults with body mass index (BMI) ART based on CD4 count ... was a lipid-based nutritional supplement either without (LNS) or with additional vitamins and minerals (LNS-VM), beginning prior to ART initiation; supplement amounts were 30 g/day (150 kcal) from recruitment until 2 weeks after starting ART and 250 g/day (1,400 kcal) from weeks 2 to 6 after starting ART...

  19. Season-independent cognitive deficits in seasonal affective disorder and their relation to depressive symptoms

    DEFF Research Database (Denmark)

    Hjordt, Liv Vadskjær; Stenbæk, Dea Siggaard; Ozenne, Brice

    2017-01-01

    with Seasonal Affective Disorder (SAD), to study depression-related cognition, longitudinally. Twenty-nine medication-free individuals diagnosed with winter-SAD and 30 demographically matched healthy controls with no seasonality symptoms completed the Letter-number Sequencing task (LNS), the Symbol Digit...... Modalities Test (SDMT) and the Simple Reaction Time (SRT) twice; in summer and in winter. Compared to controls, SAD individuals showed significant season-independent impairments in tasks measuring working memory (LNS), cognitive processing speed (SDMT) and motor speed (SRT). In SAD individuals, cognitive...... processing speed was significantly negatively associated with the seasonal change in SAD depressive symptoms. We present novel evidence that in SAD individuals, working memory, cognitive processing- and motor speed is not only impaired in the winter but also in the summer. This suggests that certain...

  20. A lipid-based nano-regulator for cancer immunotherapy (Conference Presentation)

    Science.gov (United States)

    Qian, Yuan; Qiao, Sha; Zhang, Zhihong

    2017-02-01

    In the application of nanotechnology in cancer immunotherapy, antigen presenting cells (APCs, dendritic cells and macrophages) are preferable target due to their endocytic capacity and suppressed phenotype. Recently, we developed a lipid-based core-shell nanocarrier, which is stabilized by changeable fusion peptides and possesses a sub-30 diameter. With the different peptides, the nanoparticles (NPs) could either target to dendritic cells (DCs) in lymph nodes (LNs) or tumor associated macrophages (TAMs) in tumor environment. After subcutaneous injection, the NPs could targeted deliver the encapsulated antigen peptides (APs) and adjuvants (CpG-ODN) to dendritic cells in LNs, and lead to the antigen presenting and activation of cytotoxic T lymphocytes against tumor. In other case, after systemic administration, the immune regulatory molecules were carried by NPs and targeting delivered to specific immunocytes in tumor microenvironment resulting in the immunosuppressive state broken and tumor growth inhibition.

  1. Pesquisa do linfonodo sentinela em pacientes com melanoma: experiência com fitato marcado com Tecnécio-99m e revisão da literatura The role of sentinel node mapping in malignant melanoma: experience with 99mTc-phytate and a review of the literature

    Directory of Open Access Journals (Sweden)

    Marcelo T. Sapienza

    2004-04-01

    Full Text Available FUNDAMENTOS: A progressão linfática do melanoma maligno habitualmente se inicia pelo linfonodo sentinela (LNS, cuja análise histopatológica permite predizer o acometimento de toda a cadeia. OBJETIVO: O trabalho tem por objetivo descrever a utilização do 99mTc-Fitato na detecção do LNS em pacientes com melanoma maligno, revisando as indicações e informações fornecidas por sua biópsia. MÉTODO: A pesquisa de LNS foi realizada por meio da linfocintilografia com 99mTc-Fitato em 92 pacientes com melanoma (54,0±14,3 anos. Após 18-24 horas, 88 pacientes foram submetidos à localização intra-operatória com detector portátil, seguida da ressecção e análise histopatológica do LNS. RESULTADOS: A linfocintilografia permitiu a identificação do LNS em todos os estudos, havendo detecção intra-operatória em 98,8% dos casos. O LNS estava acometido em 23 pacientes (26%. O valor preditivo negativo foi de 100% e não se observaram reações adversas pelo uso do 99mTc-Fitato. CONCLUSÃO: A detecção do LNS pode ser realizada com diferentes radiofármacos, incluindo o 99mTc-Fitato, que apresenta vantagens de custo e disponibilidade no Brasil. A pesquisa de LNS resulta em maior acurácia e menor morbidade no estadiamento de pacientes com melanoma malignoBACKGROUND: Sentinel lymph node (SLN, corresponding to the first lymph node draining the tumor, is usually the first one to receive its metastasis, and its biopsy is used to define the status of the whole lymphatic basin. OBJECTIVE: The aim of this paper is to describe the use 99mTc-Fitato in SLN localization in malignant melanoma patients, and to review the main indications and information provided by SLN biopsy. METHOD: A total of 92 patients with malignant melanoma was studied. Lymph node scintigraphy was carried out after the subdermal injection of 99mTc-Phytate. After 18-24 hours, intra-operative SLN localization was carried out using the gamma-probe and lymph node dissection was then

  2. Reprogramming the Local Lymph Node Microenvironment Promotes Tolerance that Is Systemic and Antigen Specific

    Directory of Open Access Journals (Sweden)

    Lisa H. Tostanoski

    2016-09-01

    Full Text Available Many experimental therapies for autoimmune diseases, such as multiple sclerosis (MS, aim to bias T cells toward tolerogenic phenotypes without broad suppression. However, the link between local signal integration in lymph nodes (LNs and the specificity of systemic tolerance is not well understood. We used intra-LN injection of polymer particles to study tolerance as a function of signals in the LN microenvironment. In a mouse MS model, intra-LN introduction of encapsulated myelin self-antigen and a regulatory signal (rapamycin permanently reversed paralysis after one treatment during peak disease. Therapeutic effects were myelin specific, required antigen encapsulation, and were less potent without rapamycin. This efficacy was accompanied by local LN reorganization, reduced inflammation, systemic expansion of regulatory T cells, and reduced T cell infiltration to the CNS. Our findings suggest that local control over signaling in distinct LNs can promote cell types and functions that drive tolerance that is systemic but antigen specific.

  3. Effects on anthropometry and appetite of vitamins and minerals given in lipid nutritional supplements for malnourished HIV-infected adults referred for antiretroviral therapy

    DEFF Research Database (Denmark)

    Rehman, Andrea M; Woodd, Susannah; PrayGod, George

    2015-01-01

    BACKGROUND:: The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. OBJECTIVE:: We hypothesised that both vitamin and mineral deficiencies and poor appetite limit weight gain in malnouris......BACKGROUND:: The evidence base for effects of nutritional interventions for malnourished HIV-infected patients starting antiretroviral therapy (ART) is limited and inconclusive. OBJECTIVE:: We hypothesised that both vitamin and mineral deficiencies and poor appetite limit weight gain...... in malnourished patients starting ART and that vitamin and mineral supplementation would improve appetite and permit nutritional recovery. DESIGN:: The randomised controlled Nutritional Support for Africans Starting Antiretroviral Therapy (NUSTART) trial was conducted in Mwanza, Tanzania and Lusaka, Zambia. ART......-naïve adults referred for ART and with body mass index (BMI)vitamins and minerals (LNS-VM), beginning prior to ART initiation. Participants were given 30 g/day LNS from recruitment until 2 weeks after starting ART...

  4. Difference in the performances of ECR ion sources when they are fed by klystron-based generator or travelling-wave-tube-based generator

    CERN Document Server

    Gammino, S; Celona, L

    2002-01-01

    During recent experiments, a different behaviour of the electron cyclotron resonance (ECR) ion source CAESAR was observed at INFN-LNS, when it was operated by means of a travelling-wave-tube-based generator with respect to the standard operation by means of a klystron-based generator. The current available for argon-high charge states was significantly higher in the former case. The same test was repeated with the other source available at LNS, i.e. the superconducting ECR ion source SERSE, with oxygen in place of argon, and the results were similar. A description of the experimental set-up and of the results obtained in the two cases is given in the following.

  5. Determination of the half-life of 213Fr with high precision

    Science.gov (United States)

    Fisichella, M.; Musumarra, A.; Farinon, F.; Nociforo, C.; Del Zoppo, A.; Figuera, P.; La Cognata, M.; Pellegriti, M. G.; Scuderi, V.; Torresi, D.; Strano, E.

    2013-07-01

    High-precision measurement of half-life and Qα value of neutral and highly charged α emitters is a major subject of investigation currently. In this framework, we recently pushed half-life measurements of neutral emitters to a precision of a few per mil. This result was achieved by using different techniques and apparatuses at Istituto Nazionale di Fisica Nucleare Laboratori Nazionali del Sud (INFN-LNS) and GSI Darmstadt. Here we report on 213Fr half-life determination [T1/2(213Fr) = 34.14±0.06 s] at INFN-LNS, detailing the measurement protocol used. Direct comparison with the accepted value in the literature shows a discrepancy of more than three sigma. We propose this new value as a reference, discussing previous experiments.

  6. Comparison of abdominal ultrasound and magnetic resonance imaging for detection of abdominal lymphadenopathy in dogs with metastatic apocrine gland adenocarcinoma of the anal sac.

    Science.gov (United States)

    Anderson, C L; MacKay, C S; Roberts, G D; Fidel, J

    2015-06-01

    Imaging studies in humans with anal and rectal cancer indicate that magnetic resonance imaging (MRI) is a more sensitive technique than abdominal ultrasound (AUS) for the detection of abdominal lymphadenopathy. The purpose of this retrospective study was to directly compare the efficacy of these two techniques in detecting abdominal lymphadenopathy in dogs with apocrine gland adenocarcinoma of the anal sac (AGAAS). Six dogs with histologically confirmed AGAAS and histopathologic confirmation of metastasis to abdominal lymph nodes (LNs) had AUS and abdominal MRI. AUS identified lymphadenopathy in two of six dogs, whereas MRI identified lymphadenopathy in all the six dogs. Lymphadenopathy was predominantly sacral in location, with involvement of the medial iliac and hypogastric LNs in only two cases. These data suggest that MRI is more sensitive than AUS for detecting sacral abdominal lymphadenopathy in dogs with AGAAS. As such, MRI could be considered in any patient with AGAAS for initial staging of this disease. © 2013 Blackwell Publishing Ltd.

  7. Ovarian mass mimicking malignancy: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Il; Kim, Seok Ki; Lee, Jeong Won; Lee, Sang Mi; Kim, Tae Sung [National Cancer Center, Goyang (Korea, Republic of)

    2010-12-15

    A 32-year-old female who suffered from abdominal pain underwent {sup 18}F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the diagnostic workup of pelvic mass lesions. Cystic mass lesions in the bilateral ovaries showed wall thickening and intense hypermetabolism along the rim. In addition, multifocal intense hypermetabolic lymphadenopathies were seen in the left paraaortic lymph node (LN), aortocaval LN, and both common iliac LNs. We interpreted these findings as bilateral ovarian cancer with retroperitoneal metastatic lymphadenopathies rather than endometriosis with reactive lymphadenopathies rather than endometriosis with reactive lymphadenopathies. However, Histopathological examination confirmed the ovarian mass lesions as tubo-ovarian abscesses. We report a case that even if simultaneous hypermetabolic retroperitoneal LNs are seen, intense hypermetabolic lesions in both ovaries can be in consequence of inflammatory change

  8. Infection Programs Sustained Lymphoid Stromal Cell Responses and Shapes Lymph Node Remodeling upon Secondary Challenge

    Directory of Open Access Journals (Sweden)

    Julia L. Gregory

    2017-01-01

    Full Text Available Lymph nodes (LNs are constructed of intricate networks of endothelial and mesenchymal stromal cells. How these lymphoid stromal cells (LSCs regulate lymphoid tissue remodeling and contribute to immune responses remains poorly understood. We performed a comprehensive functional and transcriptional analysis of LSC responses to skin viral infection and found that LSC subsets responded robustly, with different kinetics for distinct pathogens. Recruitment of cells to inflamed LNs induced LSC expansion, while B cells sustained stromal responses in an antigen-independent manner. Infection induced rapid transcriptional responses in LSCs. This transcriptional program was transient, returning to homeostasis within 1 month of infection, yet expanded fibroblastic reticular cell networks persisted for more than 3 months after infection, and this altered LN composition reduced the magnitude of LSC responses to subsequent heterologous infection. Our results reveal the complexity of LSC responses during infection and suggest that amplified networks of LN stromal cells support successive immune responses.

  9. Corneal Tissue From Dry Eye Donors Leads to Enhanced Graft Rejection.

    Science.gov (United States)

    Inomata, Takenori; Hua, Jing; Nakao, Takeshi; Shiang, Tina; Chiang, Homer; Amouzegar, Afsaneh; Dana, Reza

    2018-01-01

    To assess the effect of dry eye disease (DED) in graft donors on dendritic cell (DC) maturation, host T-cell sensitization, and corneal allograft rejection. Corneas of control (healthy donor) and DED mice (C57BL/6) were transplanted onto fully allogeneic naive BALB/c recipients (n = 10 mice/group). Long-term allograft survival was evaluated for 8 weeks. Corneas and draining lymph nodes (dLNs) were harvested at posttransplantation day 14 (n = 5 mice/group). The frequencies of MHCII CD11c DCs in the donor corneas and host dLNs and the frequencies of interferon (IFN)-γ and IL-17 CD4 T cells and Foxp3 expression by Tregs in host dLNs were investigated using flow cytometry. The enzyme-linked immunospot assay was used to assess host T-cell allosensitization through direct and indirect pathways (n = 3/group). Recipients of DED donor corneas showed significantly reduced graft survival (10%) compared with control mice (50% survival, P = 0.022), and had significantly increased frequencies of mature DCs in the grafted cornea (DED donor 44.0% ± 0.36% vs. healthy donor 35.4 ± 0.5%; P donor 25.1% ± 0.66% vs. healthy donor 13.7% ± 1.6%; P = 0.005). Frequencies of IFN-γ and IL-17 T cells were increased in the dLNs of recipients of DED corneas, whereas the expression (mean fluorescence intensity) of Foxp3 in Tregs was decreased significantly in these mice (DED donor 6004 ± 193 vs. healthy donor 6806 ± 81; P = 0.0002). Enzyme-linked immunospot analysis showed that the direct pathway of allosensitization was significantly amplified in recipients of grafts with DED (P = 0.0146). Our results indicate that DED in the donor is a significant risk factor for subsequent corneal allograft rejection.

  10. Characterization of cervical lymph-nodes using a multi-parametric and multi-modal approach for an early prediction of tumor response to chemo-radiotherapy.

    Science.gov (United States)

    Scalco, Elisa; Marzi, Simona; Sanguineti, Giuseppe; Vidiri, Antonello; Rizzo, Giovanna

    2016-12-01

    In the treatment of Head-and-Neck Squamous Cell Carcinoma (HNSCC), the early prediction of residual malignant lymph nodes (LNs) is currently required. Here, we investigated the potential of a multi-modal characterization (combination of CT, T2w-MRI and DW-MRI) at baseline and at mid-treatment, based on texture analysis (TA), for the early prediction of LNs response to chemo-radiotherapy (CRT). 30 patients with pathologically confirmed HNSCC treated with CRT were considered. All patients underwent a planning CT and two serial MR examinations (including T2w and DW images), one before and one at mid-CRT. For each patient the largest malignant LN was selected and within each LN, morphological and textural features were estimated from T2w-MRI and CT, besides a quantification of the apparent diffusion coefficient (ADC) from DW-MRI. After a median follow-up time of 26.6months, 19 LNs showed regional control, while 11 LNs showedregional failure at a median time of 4.6months. Linear discriminant analysis was used to test the accuracy of the image-based features in predicting the final response. Pre-treatment features showed higher predictive power than mid-CRT features, the ADC having the highest accuracy (80%); CT-based indices were found not predictive. When ADC was combined with TA, the classification performance increased (accuracy=82.8%). If only T2w-MRI features were considered, the best combination of pre-CRT indices and their variation reached an equivalent accuracy (81.8%). Our results may suggest that TA on T2w-MRI and ADC can be combined together to obtain a more accurate prediction of response to CRT. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  11. Feasibility and reliability of pancreatic cancer staging using fiberoptic confocal fluorescence microscopy in rats.

    Science.gov (United States)

    Ignat, Mihaela; Aprahamian, Marc; Lindner, Veronique; Altmeyer, Anaïs; Perretta, Silvana; Dallemagne, Bernard; Mutter, Didier; Marescaux, Jacques

    2009-11-01

    Surgical management of pancreatic cancer depends on tumor resectability and staging. This study evaluated a new in vivo technique, fiberoptic confocal fluorescence microscopy (FCFM), for detection and staging of pancreatic tumors in rats. FCFM was used with a protease-activated fluorescent marker (ProSense; VisEn Medical Inc, Woburn, MA) for in vivo imaging of solid organs (1.8-microm resolution) in a rat model of pancreatic ductal adenocarcinoma. A preliminary study described the FCFM rendering of normal and pathologic tissues. Subsequently, 2 double-blind studies compared FCFM to standard histology in (1) detection of tumors in rat models of cancer and controls and (2) detection of nodal involvement (splenic, celiac, mesenteric, and colic) 4, 5, and 6 weeks after tumor induction vs controls. Tumor cells displayed a fluorescent ductal pattern compared with non-fluorescent normal pancreas or normal follicular pattern of lymph nodes (LNs). FCFM detected all the pancreatic tumors (1.7-mm mean diameter) and identified 23 LNs that contained metastases of 99 LNs examined. Standard histologic analyses resulted in 1 false-negative result in tumor detection and 2 false negatives in LN detection, whereas FCFM produced no false-negative results. Additional serial sectioning confirmed all tumors and 16 metastatic LNs; FCFM had a negative predictive value of 100% and a positive predictive value of 69.6%. Real-time "virtual biopsy" using FCFM detects tumors and LN metastases with 100% sensitivity and 92.2% specificity in rats, making it a reliable technique for detection and staging of pancreatic cancer.

  12. Characterization of Gd loaded chitosan-TPP nanohydrogels by a multi-technique approach combining dynamic light scattering (DLS), asymetrical flow-field-flow-fractionation (AF4) and atomic force microscopy (AFM) and design of positive contrast agents for molecular resonance imaging (MRI)

    Science.gov (United States)

    Rigaux, G.; Gheran, C. V.; Callewaert, M.; Cadiou, C.; Voicu, S. N.; Dinischiotu, A.; Andry, M. C.; Vander Elst, L.; Laurent, S.; Muller, R. N.; Berquand, A.; Molinari, M.; Huclier-Markai, S.; Chuburu, F.

    2017-02-01

    Chitosan CS—tripolyphosphate TPP/hyaluronic acid HA nanohydrogels loaded with gadolinium chelates (GdDOTA ⊂ CS-TPP/HA NGs) synthesized by ionic gelation were designed for lymph node (LN) MRI. In order to be efficiently drained to LNs, nanogels (NGs) needed to exhibit a diameter ϕ TPP ratio (2 TPP TPP/HA nanohydrogels which, in turn, allowed to select formulations leading to NGs of suitable mean sizes showing good MRI efficiency and negligible toxicity.

  13. In vivo Tracking of Dendritic Cell using MRI Reporter Gene, Ferritin.

    Directory of Open Access Journals (Sweden)

    Hoe Suk Kim

    Full Text Available The noninvasive imaging of dendritic cells (DCs migrated into lymph nodes (LNs can provide helpful information on designing DCs-based immunotherapeutic strategies. This study is to investigate the influence of transduction of human ferritin heavy chain (FTH and green fluorescence protein (GFP genes on inherent properties of DCs, and the feasibility of FTH as a magnetic resonance imaging (MRI reporter gene to track DCs migration into LNs. FTH-DCs were established by the introduction of FTH and GFP genes into the DC cell line (DC2.4 using lentivirus. The changes in the rate of MRI signal decay (R2* resulting from FTH transduction were analyzed in cell phantoms as well as popliteal LN of mice after subcutaneous injection of those cells into hind limb foot pad by using a multiple gradient echo sequence on a 9.4 T MR scanner. The transduction of FTH and GFP did not influence the proliferation and migration abilities of DCs. The expression of co-stimulatory molecules (CD40, CD80 and CD86 in FTH-DCs was similar to that of DCs. FTH-DCs exhibited increased iron storage capacity, and displayed a significantly higher transverse relaxation rate (R2* as compared to DCs in phantom. LNs with FTH-DCs exhibited negative contrast, leading to a high R2* in both in vivo and ex vivo T2*-weighted images compared to DCs. On histological analysis FTH-DCs migrated to the subcapsular sinus and the T cell zone of LN, where they highly expressed CD25 to bind and stimulate T cells. Our study addresses the feasibility of FTH as an MRI reporter gene to track DCs migration into LNs without alteration of their inherent properties. This study suggests that FTH-based MRI could be a useful technique to longitudinally monitor DCs and evaluate the therapeutic efficacy of DC-based vaccines.

  14. MRI sequences for the detection of individual lymph nodes in regional breast radiotherapy planning.

    Science.gov (United States)

    van Heijst, Tristan C F; van Asselen, Bram; Pijnappel, Ruud M; Cloos-van Balen, Marissa; Lagendijk, Jan J W; van den Bongard, Desirée; Philippens, Mariëlle E P

    2016-07-01

    In regional radiotherapy (RT) for patients with breast cancer, lymph node (LN) targets are delineated on CT, defined by anatomical boundaries. By identifying individual LNs, MRI-based delineations may reduce target volumes and thereby toxicity. We optimized MRI sequences for this purpose. Our aim was to evaluate the techniques for LN delineation in RT planning. Supine MRI was explored at 1.5 T in RT position (arms in abduction). 5 MRI techniques were optimized in 10 and evaluated in 12 healthy female volunteers. The scans included one T1 weighted (T1w), three T2 weighted (T2w) and a diffusion-weighted imaging (DWI) technique. Quantitative evaluation was performed by scoring LN numbers per volunteer and per scan. Qualitatively, scans were assessed on seven aspects, including LN contrast, anatomical information and insensitivity to motion during acquisition. Two T2w fast spin-echo (FSE) methods showed the highest LN numbers (median 24 axillary), high contrast, excellent fat suppression and relative insensitivity to motion during acquisition. A third T2w sequence and DWI showed significantly fewer LNs (14 and 10) and proved unsuitable due to motion sensitivity and geometrical uncertainties. T1w MRI showed an intermediate number of LNs (17), provided valuable anatomical information, but lacked LN contrast. Explicit LN imaging was achieved, in supine RT position, using MRI. Two T2w FSE techniques had the highest detection rates and were motion insensitive. T1w MRI showed anatomical information. MRI enables direct delineation of individual LNs. Our optimized MRI scans enable accurate target definition in MRI-guided regional breast RT and development of personalized treatments.

  15. Relationship between intraprostatic tracer deposits and sentinel lymph node mapping in prostate cancer patients.

    Science.gov (United States)

    Buckle, Tessa; Brouwer, Oscar R; Valdés Olmos, Renato A; van der Poel, Henk G; van Leeuwen, Fijs W B

    2012-07-01

    Intraprostatic injection of the hybrid tracer indocyanine green (ICG)-(99m)Tc-nanocolloid enables both preoperative sentinel node (SN) identification and intraoperative visualization of the SN. Relating the fluorescence deposits in embedded prostate tissue specimens to the preoperatively detected SNs also provides the opportunity to study the influence of their placement on lymphatic drainage pattern. Nineteen patients with prostate carcinoma scheduled for robot-assisted laparoscopic prostatectomy and lymph node (LN) dissection were included. ICG-(99m)Tc-nanocolloid was injected intraprostatically, guided by ultrasound. SN biopsy was performed using a combination of radioguidance and fluorescence guidance. Tracer distribution was visualized in paraffin-embedded prostate samples using ex vivo fluorescence imaging. This distribution was correlated to the number and location of the SNs identified on preoperative lymphoscintigraphy and SPECT/CT. ICG-(99m)Tc-nanocolloid helped guide surgical excision of the SNs. Ex vivo fluorescence imaging revealed a large variation in the locations of intraprostatic tracer deposits among patients. Tracer deposits in the peripheral zone correlated with a higher number of visualized LNs than deposits in the central zone (on average, 4.7 vs. 2.4 LNs per patient). Furthermore, tracer deposits in the mid gland correlated with a higher number of visualized LNs than deposits near the base or apex of the prostate (on average, 6 vs. 3.5 LNs per patient). The hybrid nature of the tracer not only enables surgical guidance but also provides an opportunity to study the correlation between the location of tracer deposits within the prostate and the number and location of preoperatively visualized SNs. These data suggest that the location at which a tracer deposit is placed influences the lymphatic drainage pattern.

  16. Nutrient supplementation may adversely affect maternal oral health--a randomised controlled trial in rural Malawi.

    Science.gov (United States)

    Harjunmaa, Ulla; Järnstedt, Jorma; Dewey, Kathryn G; Ashorn, Ulla; Maleta, Kenneth; Vosti, Stephen A; Ashorn, Per

    2016-01-01

    Nutritional supplementation during pregnancy is increasingly recommended especially in low-resource settings, but its oral health impacts have not been studied. Our aim was to examine whether supplementation with multiple micronutrients (MMN) or small-quantity lipid-based nutrient supplements affects dental caries development or periodontal health in a rural Malawian population. The study was embedded in a controlled iLiNS-DYAD trial that enrolled 1391 pregnant women micronutrients (MMN) or one sachet of lipid-based nutrient supplements (LNS) containing protein, carbohydrates, essential fatty acids and 21 micronutrients. Oral examination of 1024 participants was conducted and panoramic X-ray taken within 6 weeks after delivery. The supplement groups were similar at baseline in average socio-economic, nutritional and health status. At the end of the intervention, the prevalence of caries was 56.7%, 69.1% and 63.3% (P = 0.004), and periodontitis 34.9%, 29.8% and 31.2% (P = 0.338) in the IFA, MMN and LNS groups, respectively. Compared with the IFA group, women in the MMN group had 0.60 (0.18-1.02) and in the LNS group 0.59 (0.17-1.01) higher mean number of caries lesions. In the absence of baseline oral health data, firm conclusions on causality cannot be drawn. However, although not confirmatory, the findings are consistent with a possibility that provision of MMN or LNS may have increased the caries incidence in this target population. Because of the potential public health impacts, further research on the association between gestational nutrient interventions and oral health in low-income settings is needed. © 2015 John Wiley & Sons Ltd.

  17. Assessment of Risk Reduction for Lymphedema Following Sentinel Lymph Noded Guided Surgery for Primary Breast Cancer

    Science.gov (United States)

    2006-10-01

    technical error rather than true absence of LNs. None of the three patients experienced arm, breast, or axillary swelling. Level I nodes were...scintigraphy. Such manual approaches are labor intensive and prone to error . Modern imaging technologies may identify these lymphatics and allow the...opportunity for substantial medico -economic savings. (also, cover LN’s when clinically indicated and necessary based on status of disease) 40 The ability

  18. Sentinel Lymph Node Biopsy: Quantification of Lymphedema Risk Reduction

    Science.gov (United States)

    2006-10-01

    visualized in 3 patients (8.1%). We suspect this may reflect a technical error rather than true absence of LNs. None of the three patients experienced arm...the lymphatics that were deemed occult from scintigraphy. Such manual approaches are labor intensive and prone to error . Modern imaging...related quality of life (HRQOL), and society the opportunity for substantial medico -economic savings. (also, cover LN’s when clinically indicated and

  19. Dosimetric evaluation of the feasibility of stereotactic body radiotherapy for primary lung cancer with lobe-specific selective elective nodal irradiation.

    Science.gov (United States)

    Komatsu, Tetsuya; Kunieda, Etsuo; Kitahara, Tadashi; Akiba, Takeshi; Nagao, Ryuta; Fukuzawa, Tsuyoshi

    2016-01-01

    More than 10% of all patients treated with stereotactic body radiotherapy (SBRT) for primary lung cancer develop regional lymph node recurrence. We evaluated the dosimetric feasibility of SBRT with lobe-specific selective elective nodal irradiation (ENI) on dose-volume histograms. A total of 21 patients were treated with SBRT for Stage I primary lung cancer between January 2010 and June 2012 at our institution. The extents of lobe-specific selective ENI fields were determined with reference to prior surgical reports. The ENI fields included lymph node stations (LNS) 3 + 4 + 11 for the right upper lobe tumors, LNS 7 + 11 for the right middle or lower lobe tumors, LNS 5 + 11 for the left upper lobe tumors, and LNS 7 + 11 for the left lower lobe tumors. A composite plan was generated by combining the ENI plan and the SBRT plan and recalculating for biologically equivalent doses of 2 Gy per fraction, using a linear quadratic model. The V20 of the lung, D(1cm3) of the spinal cord, D(1cm3) and D(10cm3) of the esophagus and D(10cm3) of the tracheobronchial wall were evaluated. Of the 21 patients, nine patients (43%) could not fulfill the dose constraints. In all these patients, the distance between the planning target volume (PTV) of ENI (PTVeni) and the PTV of SBRT (PTVsrt) was ≤2.0 cm. Of the three patients who developed regional metastasis, two patients had isolated lymph node failure, and the lymph node metastasis was included within the ENI field. When the distance between the PTVeni and PTVsrt is >2.0 cm, SBRT with selective ENI may therefore dosimetrically feasible. © The Author 2015. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  20. Comparison of the diagnostic efficacy and perioperative outcomes of limited versus extended pelvic lymphadenectomy during robot-assisted radical prostatectomy: a multi-institutional retrospective study in Japan.

    Science.gov (United States)

    Morizane, Shuichi; Honda, Masashi; Fukasawa, Satoshi; Komaru, Atsushi; Inokuchi, Junichi; Eto, Masatoshi; Shimbo, Masaki; Hattori, Kazunori; Kawano, Yoshiaki; Takenaka, Atsushi

    2017-12-11

    We conducted a retrospective study to compare the perioperative course and lymph node (LN) counts of patients undergoing limited pelvic lymphadenectomy (lPLND) or extended pelvic lymphadenectomy (ePLND) during robot-assisted radical prostatectomy in an initial Japanese series. The cohort included 1333 patients who underwent either lPLND (n = 902) or ePLND (n = 431) during robot-assisted radical prostatectomy at five institutions in Japan. All complications within 28 days of surgery were recorded, and clinical data were collected retrospectively. The outcomes and complications were compared relative to the extent of lymphadenectomy, and we conducted univariate and multivariate logistic regression analyses to assess the predictors of the major complications. On multivariate analysis for evaluating the associations between major complications and perioperative characteristics, console time (p = 0.001) was significantly associated with major complications, although the extent of lymphadenectomy (p = 0.272) was not significantly associated with major complications. In the distribution of positive LNs removed in the extended pelvic lymphadenectomy cohort, 60.4% of patients had positive LNs only in the obturator/internal iliac region. However, 22.6% of the patients with positive LNs had no positive LNs in the obturator/internal iliac region, but only in the external/common iliac region. ePLND, which significantly increased the console time and blood loss but nearly quadrupled the lymph node yield, is considered a relatively safe and acceptable procedure. Moreover, the results of this study suggest that ePLND improves staging and removes a greater number of metastatic nodes.

  1. Association of prenatal lipid?based nutritional supplementation with fetal growth in rural Gambia

    OpenAIRE

    Johnson, William; Darboe, Momodou K.; Sosseh, Fatou; Nshe, Patrick; Prentice, Andrew M.; Moore, Sophie E.

    2016-01-01

    Abstract Prenatal supplementation with protein?energy (PE) and/or multiple?micronutrients (MMNs) may improve fetal growth, but trials of lipid?based nutritional supplements (LNSs) have reported inconsistent results. We conducted a post?hoc analysis of non?primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, par...

  2. Association of prenatal lipid-based nutritional supplementation with fetal growth in rural Gambia.

    Science.gov (United States)

    Johnson, William; Darboe, Momodou K; Sosseh, Fatou; Nshe, Patrick; Prentice, Andrew M; Moore, Sophie E

    2017-04-01

    Prenatal supplementation with protein-energy (PE) and/or multiple-micronutrients (MMNs) may improve fetal growth, but trials of lipid-based nutritional supplements (LNSs) have reported inconsistent results. We conducted a post-hoc analysis of non-primary outcomes in a trial in Gambia, with the aim to test the associations of LNS with fetal growth and explore how efficacy varies depending on nutritional status. The sample comprised 620 pregnant women in an individually randomized, partially blinded trial with four arms: (a) iron and folic acid (FeFol) tablet (usual care, referent group), (b) MMN tablet, (c) PE LNS, and (d) PE + MMN LNS. Analysis of variance examined unadjusted differences in fetal biometry z-scores at 20 and 30 weeks and neonatal anthropometry z-scores, while regression tested for modification of intervention-outcome associations by season and maternal height, body mass index, and weight gain. Despite evidence of between-arm differences in some fetal biometry, z-scores at birth were not greater in the intervention arms than the FeFol arm (e.g., birth weight z-scores: FeFol -0.71, MMN -0.63, PE -0.64, PE + MMN -0.62; group-wise p = .796). In regression analyses, intervention associations with birth weight and head circumference were modified by maternal weight gain between booking and 30 weeks gestation (e.g., PE + MMN associations with birth weight were +0.462 z-scores (95% CI [0.097, 0.826]) in the highest quartile of weight gain but -0.099 z-scores (-0.459, 0.260) in the lowest). In conclusion, we found no strong evidence that a prenatal LNS intervention was associated with better fetal growth in the whole sample. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

  3. Accuracy and Significance of Polymerase Chain Reaction Detection of Sentinel Node Metastases in Breast Cancer Patients

    Science.gov (United States)

    2000-10-01

    III LNs not dissected) 10%-90% from lymphedema to dysesthesias ? these patients, the axillary nodes are removed.11 In patients undergoing... supplement ): 93. (6) Bedrosian, I.; Reynolds, C; Mick, R; al, e. Accuracy of Sentinel Lymph Node Biopsy in Patients with Large Primary Breast Tumors. Cancer... Supplement ): 87. (22) Burak, W., Jr.; Walker, M. J.; Yee, L. D.; Kim, J. A; Saha, S.; Hinkle, G.; Olsen, J. O.; Pozderac, R; Farrar, W. B. Routine

  4. Influence of sporting activity and smoking on peripheral lymph nodes in patients with melanoma analyzed by high-resolution ultrasound.

    Science.gov (United States)

    Hinz, Torsten; Hoeller, Tobias; Bieber, Thomas; Blum, Andreas; Schmid-Wendtner, Monika-H

    2012-11-01

    The sonographic examination of peripheral lymph nodes (LNs) plays an important role in the preoperative treatment and in the follow-up of patients with melanoma. A prospective study including 200 consecutive patients with a history of invasive cutaneous melanoma was performed at the Department of Dermatology and Allergy, University of Bonn, Germany, to examine the influence of sporting activity, physical workload, interferon alfa therapy, smoking habits, and infections of the upper respiratory tract on morphology and number of LNs analyzed by high-resolution ultrasound. Between May 2010 and June 2011, 106 men and 94 women (mean age 51.1 ± 12.8 years) were included in this study. During their follow-up visits for cutaneous melanoma, high-resolution ultrasound examination of cervical, axillary, and inguinal LN regions were performed. LN diameters and volumes were measured and correlated with the above given factors. Sports-active patients had more LNs in inguinal regions, a higher volume and a larger LN diameter, and a higher maximum width of the hypoechoic LN margin in comparison with the nonactive patients. Patients with a hard physical workload in their occupations had a significantly higher volume of the biggest LN. Compared with nonsmoking patients smokers presented higher values in the total quantity of the LNs, in the greatest volume of LN, and in the greatest diameter of LN in the cervical regions. The other factors had no significant influence on the LN parameters. Our study population was too small to comment on influencing factors in more detail especially the influences of different sporting activities or smoking habits. Sporting activity, physical workload, and smoking habits as associated cofactors influencing sonomorphologic aspects in patients with cutaneous melanoma should always be considered. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  5. 6-Thioguanine-loaded polymeric micelles deplete myeloid-derived suppressor cells and enhance the efficacy of T cell immunotherapy in tumor-bearing mice

    OpenAIRE

    Jeanbart, Laura; Kourtis, Iraklis C.; van der Vlies, Andr? J.; Swartz, Melody A.; Hubbell, Jeffrey A.

    2015-01-01

    Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature myeloid cells that suppress effector T cell responses and can reduce the efficacy of cancer immunotherapies. We previously showed that ultra-small polymer nanoparticles efficiently drain to the lymphatics after intradermal injection and target antigen-presenting cells, including Ly6chi Ly6g? monocytic MDSCs (Mo-MDSCs), in skin-draining lymph nodes (LNs) and spleen. Here, we developed ultra-small polymer micell...

  6. Olyset Duo® (a Pyriproxyfen and Permethrin Mixture Net): An Experimental Hut Trial against Pyrethroid Resistant Anopheles gambiae and Culex quinquefasciatus in Southern Benin.

    OpenAIRE

    Ngufor, C; N'Guessan, R; Fagbohoun, J; Odjo, A; Malone, D.; Akogbeto, M.; Rowland, M

    2014-01-01

    Background Alternative compounds which can complement pyrethroids on long-lasting insecticidal nets (LN) in the control of pyrethroid resistant malaria vectors are urgently needed. Pyriproxyfen (PPF), an insect growth regulator, reduces the fecundity and fertility of adult female mosquitoes. LNs containing a mixture of pyriproxyfen and pyrethroid could provide personal protection through the pyrethroid component and reduce vector abundance in the next generation through the sterilizing effect...

  7. Non-linear blend coding in the moth antennal lobe emerges from random glomerular networks

    Directory of Open Access Journals (Sweden)

    Alberto eCapurro

    2012-04-01

    Full Text Available Neural responses to odor blends often interact at different stages of the olfactory pathway. The first olfactory processing center in insects, the antennal lobe (AL, exhibits a complex network connectivity. We attempt to determine if non-linear blend interactions can arise purely as a function of the AL network connectivity itself, without necessitating additional factors such as competitive ligand binding at the periphery or intrinsic cellular properties. To assess this, we compared blend interactions among responses from single neurons recorded intracellularly in the AL of the moth M. sexta with those generated using a population-based computational model constructed from the morphologically-based connectivity pattern of projection neurons (PNs and local interneurons (LNs with randomized connection probabilities, from which we excluded detailed intrinsic neuronal properties. The model accurately predicted most of the proportions of blend interaction types observed in the physiological data. Our simulations also indicate that input from LNs is important in establishing both the type of blend interaction and the nature of the neuronal response (excitation or inhibition exhibited by AL neurons. For LNs, the only input that significantly impacted the blend interaction type was received from other LNs, while for PNs the input from olfactory sensory neurons (OSNs and other PNs contributed agonistically with the LN input to shape the AL output. Our results demonstrate that non-linear blend interactions can be a natural consequence of AL connectivity, and highlight the importance of lateral inhibition as a key feature of blend coding to be addressed in future experimental and computational studies.

  8. Nuclear astrophysics measurements with ELISSA at ELI-NP

    Science.gov (United States)

    Matei, C.; Balabanski, D. L.; Tesileanu, O.; Xu, Y.; La Cognata, M.; Spitaleri, C.

    2017-09-01

    ELISSA is a new silicon-strip detector array under development at the Extreme Light Infrastructure - Nuclear Physics facility in collaboration with INFN-LNS, Catania. ELI-NP will provide very intense, brilliant gamma beams, tunable from 200keV to 19.5MeV. Several reactions important for the astrophysical p-process, Big Bang Nucleosynthesis and supernova explosion have been selected for the first measurement campaigns starting in 2019.

  9. Molecular hydrodynamics: Vortex formation and sound wave propagation.

    Science.gov (United States)

    Han, Kyeong Hwan; Kim, Changho; Talkner, Peter; Karniadakis, George Em; Lee, Eok Kyun

    2018-01-14

    In the present study, quantitative feasibility tests of the hydrodynamic description of a two-dimensional fluid at the molecular level are performed, both with respect to length and time scales. Using high-resolution fluid velocity data obtained from extensive molecular dynamics simulations, we computed the transverse and longitudinal components of the velocity field by the Helmholtz decomposition and compared them with those obtained from the linearized Navier-Stokes (LNS) equations with time-dependent transport coefficients. By investigating the vortex dynamics and the sound wave propagation in terms of these field components, we confirm the validity of the LNS description for times comparable to or larger than several mean collision times. The LNS description still reproduces the transverse velocity field accurately at smaller times, but it fails to predict characteristic patterns of molecular origin visible in the longitudinal velocity field. Based on these observations, we validate the main assumptions of the mode-coupling approach. The assumption that the velocity autocorrelation function can be expressed in terms of the fluid velocity field and the tagged particle distribution is found to be remarkably accurate even for times comparable to or smaller than the mean collision time. This suggests that the hydrodynamic-mode description remains valid down to the molecular scale.

  10. Dendritic Cell Interactions with Lymphatic Endothelium

    Science.gov (United States)

    Russo, Erica; Nitschké, Maximilian

    2013-01-01

    Abstract Afferent lymphatic vessels fulfill essential immune functions by transporting leukocytes and lymph-borne antigen to draining lymph nodes (dLNs). An important cell type migrating through lymphatic vessels are dendritic cells (DCs). DCs reside in peripheral tissues like the skin, where they take up antigen and transport it via the lymphatic vascular network to dLNs for subsequent presentation to T cells. As such, DCs play a key role in the induction of adaptive immune responses during infection and vaccination, but also for the maintenance of tolerance. Although the migratory pattern of DCs has been known for long time, interactions between DCs and lymphatic vessels are only now starting to be unraveled at the cellular level. In particular, new tools for visualizing lymphatic vessels in combination with time-lapse microscopy have recently generated valuable insights into the process of DC migration to dLNs. In this review we summarize and discuss current approaches for visualizing DCs and lymphatic vessels in tissues for imaging applications. Furthermore, we review the current state of knowledge about DC migration towards, into and within lymphatic vessels, particularly focusing on the cellular interactions that take place between DCs and the lymphatic endothelium. PMID:24044757

  11. Lipid-based Nutrient Supplements Do Not Affect Gut Bifidobacterium Microbiota in Malawian Infants: A Randomized Trial.

    Science.gov (United States)

    Aakko, Juhani; Grześkowiak, Łukasz; Asukas, Tiia; Päivänsäde, Eerika; Lehto, Kirsi-Maarit; Fan, Yue-Mei; Mangani, Charles; Maleta, Kenneth; Ashorn, Per; Salminen, Seppo

    2017-04-01

    The aim of the study was to assess the effect of nutritional supplementation with lipid-based nutrient supplements (LNS) and corn-soy blend flour on Bifidobacterium and Staphylococcus aureus gut microbiota composition in Malawian infants. In addition, the microbiota changes over time were characterized in the study infants. Healthy 6-month-old Malawian infants were randomly assigned to 1 of 4 intervention schemes for a 6-month period. Infants in the control group were not provided with any supplementary food. Infants in other 3 groups received either micronutrient-fortified corn-soy blend, micronutrient-fortified LNS with milk protein base, or micronutrient-fortified LNS with soy protein base between 6 and 12 months of age. Fecal bifidobacteria and S aureus gut microbiota at 6 and 12 months of age were analyzed by quantitative real-time polymerase chain reaction method. There was no difference in change in bacterial prevalence or counts between the intervention groups during the 6-month study period. When looking at the total study population, higher counts of total bacteria (P = 0.028), Bifidobacterium genus (P = 0.027), B catenulatum (P = 0.031), and lower counts of B infantis (P Bifidobacterium and S aureus microbiota composition of the study infants. The fecal bifidobacterial diversity of the infants, however, changed toward a more adult-like microbiota profile within the observed time.

  12. Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II-III breast cancer? A multicentre retrospective study (KROG 12-05).

    Science.gov (United States)

    Noh, J M; Park, W; Suh, C-O; Keum, K C; Kim, Y B; Shin, K H; Kim, K; Chie, E K; Ha, S W; Kim, S S; Ahn, S D; Shin, H S; Kim, J H; Lee, H-S; Lee, N K; Huh, S J; Choi, D H

    2014-03-18

    To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II-III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT). We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated. After a median follow-up period of 66.2 months (range, 15.6-127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0-is vs 1 vs 2-4) and the number of LNs sampled (ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled. ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials.

  13. Is elective nodal irradiation beneficial in patients with pathologically negative lymph nodes after neoadjuvant chemotherapy and breast-conserving surgery for clinical stage II–III breast cancer? A multicentre retrospective study (KROG 12-05)

    Science.gov (United States)

    Noh, J M; Park, W; Suh, C-O; Keum, K C; Kim, Y B; Shin, K H; Kim, K; Chie, E K; Ha, S W; Kim, S S; Ahn, S D; Shin, H S; Kim, J H; Lee, H-S; Lee, N K; Huh, S J; Choi, D H

    2014-01-01

    Background: To evaluate the effects of elective nodal irradiation (ENI) in clinical stage II–III breast cancer patients with pathologically negative lymph nodes (LNs) (ypN0) after neoadjuvant chemotherapy (NAC) followed by breast-conserving surgery (BCS) and radiotherapy (RT). Methods: We retrospectively analysed 260 patients with ypN0 who received NAC followed by BCS and RT. Elective nodal irradiation was delivered to 136 (52.3%) patients. The effects of ENI on survival outcomes were evaluated. Results: After a median follow-up period of 66.2 months (range, 15.6–127.4 months), 26 patients (10.0%) developed disease recurrence. The 5-year locoregional recurrence-free survival and disease-free survival (DFS) for all patients were 95.5% and 90.5%, respectively. Pathologic T classification (0−is vs 1 vs 2–4) and the number of LNs sampled (ENI. Elective nodal irradiation also did not affect survival outcomes in any of the subgroups according to pathologic T classification or the number of LNs sampled. Conclusions: ENI may be omitted in patients with ypN0 breast cancer after NAC and BCS. But until the results of the randomised trials are available, patients should be put on these trials. PMID:24481403

  14. LIGHT regulates inflamed draining lymph node hypertrophy

    Science.gov (United States)

    Zhu, Mingzhao; Yang, Yajun; Wang, Yugang; Wang, Zhongnan; Fu, Yang-Xin

    2011-01-01

    Lymph node (LN) hypertrophy, the increased cellularity of LNs, is the major indication of the initiation and expansion of the immune response against infection, vaccination, cancer or autoimmunity. The mechanisms underlying LN hypertrophy remain poorly defined. Here, we demonstrate that LIGHT (TNFSF14) is a novel factor essential for LN hypertrophy after CFA immunization. Mechanistically, LIGHT is required for the influx of lymphocytes into but not egress out of LNs. In addition, LIGHT is required for DC migration from the skin to draining LNs. Compared with WT mice, LIGHT−/− mice express lower levels of chemokines in skin and addressins in LN vascular endothelial cells after CFA immunization. We unexpectedly observed that LIGHT from radioresistant rather than radiosensitive cells, likely Langerhans cells, is required for LN hypertrophy. Importantly, antigen-specific T cell responses were impaired in DLN of LIGHT−/− mice, suggesting the importance of LIGHT regulation of LN hypertrophy in the generation of an adaptive immune response. Collectively, our data reveal a novel cellular and molecular mechanism for the regulation of LN hypertrophy and its potential impact on the generation of an optimal adaptive immune response. PMID:21572030

  15. The association between serum creatine kinase, mood and psychosis in inpatients with schizophrenia, bipolar and schizoaffective disorders.

    Science.gov (United States)

    Hollander, Sarah; Hochman, Eldar; Shoval, Gal; Taler, Michal; Trommer, Sharon; Hermesh, Haggai; Weizman, Abraham; Krivoy, Amir

    2016-04-30

    Previous studies demonstrated levels of serum CK (sCK) in the majority of patients undergoing acute psychosis. Records of 1054 patients hospitalized in Geha Mental Health Center during the study period were analyzed. Of them, 743 have been diagnosed with schizophrenia (Sz), 170 with schizoaffective disorder (SzA), and 158 with bipolar disorder (BP-I). Baseline sCK and PANSS values were obtained from each patient upon admission. Our results show that LnsCK is higher in patients with BP-I in comparison with patients with SZ, but not significantly different compared to patients with SzA. A multivariate analysis using linear regression model in which LnsCK was predicted by factors such as PANSS-total and sub-scores, IM injection, BMI, gender, and age among patients at each admission, revealed that PANSS-depression was inversely associated with LnsCK level in SzA and BP-I and not in SZ. A positive association was found between PANSS-total and sCK in SzA and BP-I; however, PANSS-positive scores correlated with sCK only in SzA. After controlling for confounders, it seems that sCK level is associated with the both affective and psychotic components. Serum CK may serve as a biomarker for affective exacerbation rather than psychosis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Molecular hydrodynamics: Vortex formation and sound wave propagation

    Science.gov (United States)

    Han, Kyeong Hwan; Kim, Changho; Talkner, Peter; Karniadakis, George Em; Lee, Eok Kyun

    2018-01-01

    In the present study, quantitative feasibility tests of the hydrodynamic description of a two-dimensional fluid at the molecular level are performed, both with respect to length and time scales. Using high-resolution fluid velocity data obtained from extensive molecular dynamics simulations, we computed the transverse and longitudinal components of the velocity field by the Helmholtz decomposition and compared them with those obtained from the linearized Navier-Stokes (LNS) equations with time-dependent transport coefficients. By investigating the vortex dynamics and the sound wave propagation in terms of these field components, we confirm the validity of the LNS description for times comparable to or larger than several mean collision times. The LNS description still reproduces the transverse velocity field accurately at smaller times, but it fails to predict characteristic patterns of molecular origin visible in the longitudinal velocity field. Based on these observations, we validate the main assumptions of the mode-coupling approach. The assumption that the velocity autocorrelation function can be expressed in terms of the fluid velocity field and the tagged particle distribution is found to be remarkably accurate even for times comparable to or smaller than the mean collision time. This suggests that the hydrodynamic-mode description remains valid down to the molecular scale.

  17. Neurotransmitter and their metabolite concentrations in different areas of the HPRT knockout mouse brain.

    Science.gov (United States)

    Tschirner, Sarah K; Gutzki, Frank; Schneider, Erich H; Seifert, Roland; Kaever, Volkhard

    2016-06-15

    Lesch-Nyhan syndrome (LNS) is characterized by uric acid overproduction and severe neurobehavioral symptoms, such as recurrent self-mutilative behavior. To learn more about the pathophysiology of the disease, we quantified neurotransmitters and their metabolites in the cerebral hemisphere, cerebellum and the medulla oblongata of HPRT knockout mice, an animal model for LNS, in comparison to the corresponding wild-type. Our analyses included l-glutamate, 4-aminobutanoic acid (GABA), acetylcholine, serotonin, 5-hydroxyindoleacetic acid (5-HIAA), norepinephrine, l-normetanephrine, epinephrine and l-metanephrine and were conducted via high performance liquid chromatography (HPLC) coupled to tandem mass spectrometry (MS/MS). Among these neurotransmitter systems, we did not find any abnormalities in the HPRT knockout mouse brains. On one side, this might indicate that HPRT deficiency most severely affects dopamine signaling, while brain functioning based on other neurotransmitters is more or less spared. On the other hand, our findings may reflect a compensating mechanism for impaired purine salvage that protects the brain in HPRT-deficient mice but not in LNS patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Normal Uricemia in Lesch–Nyhan Syndrome and the Association with Pulmonary Embolism in a Young Child—A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Jeng-Dau Tsai

    2014-08-01

    Full Text Available Deficiency of hypoxanthine phosphoribosyltransferase activity is a rare inborn error of purine metabolism with subsequent uric acid overproduction and neurologic presentations. The diagnosis of Lesch–Nyhan syndrome (LNS is frequently delayed until self-mutilation becomes evident. We report the case of a boy aged 1 year and 10 months who was diagnosed with profound global developmental delay, persistent chorea, and compulsive self-mutilation since the age of 1 year. Serial serum uric acid levels showed normal uric acid level, and the spot urine uric acid/creatinine ratio was >2. The hypoxanthine phosphoribosyltransferase cDNA showed the deletion of exon 6, and the boy was subsequently diagnosed to have LNS. He also had respiratory distress due to pulmonary embolism documented by chest computed tomography scan. This report highlights the need to determine the uric acid/creatinine ratio caused by increased renal clearance in LNS in young children. The presence of pulmonary embolism is unusual and may be the consequence of prolonged immobilization.

  19. Normal uricemia in Lesch-Nyhan syndrome and the association with pulmonary embolism in a young child-a case report and literature review.

    Science.gov (United States)

    Tsai, Jeng-Dau; Chen, Shan-Ming; Lin, Chien-Heng; Ku, Min-Sho; Tsao, Teng-Fu; Sheu, Ji-Nan

    2014-08-01

    Deficiency of hypoxanthine phosphoribosyltransferase activity is a rare inborn error of purine metabolism with subsequent uric acid overproduction and neurologic presentations. The diagnosis of Lesch-Nyhan syndrome (LNS) is frequently delayed until self-mutilation becomes evident. We report the case of a boy aged 1 year and 10 months who was diagnosed with profound global developmental delay, persistent chorea, and compulsive self-mutilation since the age of 1 year. Serial serum uric acid levels showed normal uric acid level, and the spot urine uric acid/creatinine ratio was >2. The hypoxanthine phosphoribosyltransferase cDNA showed the deletion of exon 6, and the boy was subsequently diagnosed to have LNS. He also had respiratory distress due to pulmonary embolism documented by chest computed tomography scan. This report highlights the need to determine the uric acid/creatinine ratio caused by increased renal clearance in LNS in young children. The presence of pulmonary embolism is unusual and may be the consequence of prolonged immobilization. Copyright © 2013. Published by Elsevier B.V.

  20. Prognostic classifications of lymph node involvement in lung cancer and current International Association for the Study of Lung Cancer descriptive classification in zones.

    Science.gov (United States)

    Riquet, Marc; Arame, Alex; Foucault, Christophe; Le Pimpec Barthes, Françoise

    2010-09-01

    The lymphatic drainage of solid organ tumors crosses through the lymph nodes (LNs) whose tumoral involvement may still be considered as local disease. Concerning lung cancer, LN involvement may be intrapulmonary (N1), and mediastinal and/or extra-thoracic. More than 30 years ago, mediastinal involved LNs were all considered as N2, and outside the scope of surgery. In 1978, Naruke presented an original article entitled 'Lymph node mapping and curability at various levels of metastasis in resected lung cancer', demonstrating that N2 was not a contraindication to surgery in all patients. The map permitted to localize the favorable N2 on the lung cancer ipsilateral side of the mediastinum. Several maps ensued aiming to discriminate between right and left involvement (1983), and to distinguish N2 (ipsilateral) and N3 (contralateral) mediastinal LN involvement (1983, 1986). The last map (1997 regional LN classification) was recently replaced by a descriptive classification in anatomical zones. This new LN map of the TNM classification for lung cancer is a step toward using anatomical view points which might be the best way to better understand lung cancer lymphatic spread. Nowadays, the LNs are easily identified by current radiological imaging, and their resectability may be anticipated. Each LN chain may be removed by en-bloc lymphadenectomy performed during radical lung resection, a safe procedure which seems to be more oncological based than sampling, and which avoids the source of discrepancies pointed out during the labeling of LN stations by surgeons.

  1. Lipid nanoparticles based on butyl-methoxydibenzoylmethane: in vitro UVA blocking effect

    Science.gov (United States)

    Niculae, G.; Lacatusu, I.; Badea, N.; Meghea, A.

    2012-08-01

    The aim of the present study was to obtain efficient lipid nanoparticles loaded with butyl-methoxydibenzoylmethane (BMDBM) in order to develop cosmetic formulations with enhanced UVA blocking effect. For this purpose, two adequate liquid lipids (medium chain triglycerides and squalene) have been used in combination with two solid lipids (cetyl palmitate and glyceryl stearate) in order to create appropriate nanostructured carriers with a disordered lipid network able to accommodate up to 1.5% BMDBM. The lipid nanoparticles (LNs) were characterized in terms of particle size, zeta potential, entrapment efficiency, loading capacity and in vitro UVA blocking effect. The efficiency of lipid nanoparticles in developing some cosmetic formulations has been evaluated by determining the in vitro erythemal UVA protection factor. In order to quantify the photoprotective effect, some selected cream formulations based on BMDBM-LNs and a conventional emulsion were exposed to photochemical UV irradiation at a low energy to simulate the solar energy during the midday. The results obtained demonstrated the high ability of cream formulations based on BMDBM-LNs to absorb more than 96% of UVA radiation. Moreover, the developed cosmetic formulations manifest an enhanced UVA blocking effect, the erythemal UVA protection factor being four times higher than those specific to conventional emulsions.

  2. Homeostatic NF-κB Signaling in Steady-State Migratory Dendritic Cells Regulates Immune Homeostasis and Tolerance.

    Science.gov (United States)

    Baratin, Myriam; Foray, Chloe; Demaria, Olivier; Habbeddine, Mohamed; Pollet, Emeline; Maurizio, Julien; Verthuy, Christophe; Davanture, Suzel; Azukizawa, Hiroaki; Flores-Langarica, Adriana; Dalod, Marc; Lawrence, Toby

    2015-04-21

    Migratory non-lymphoid tissue dendritic cells (NLT-DCs) transport antigens to lymph nodes (LNs) and are required for protective immune responses in the context of inflammation and to promote tolerance to self-antigens in steady-state. However, the molecular mechanisms that elicit steady-state NLT-DC maturation and migration are unknown. By comparing the transcriptome of NLT-DCs in the skin with their migratory counterparts in draining LNs, we have identified a novel NF-κB-regulated gene network specific to migratory DCs. We show that targeted deletion of IKKβ in DCs, a major activator of NF-κB, prevents NLT-DC accumulation in LNs and compromises regulatory T cell conversion in vivo. This was associated with impaired tolerance and autoimmunity. NF-κB is generally considered the prototypical pro-inflammatory transcription factor, but this study describes a role for NF-κB signaling in DCs for immune homeostasis and tolerance that could have implications in autoimmune diseases and immunity. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Fluorescence imaging of lymphatic outflow of cerebrospinal fluid in mice.

    Science.gov (United States)

    Kwon, Sunkuk; Janssen, Christopher F; Velasquez, Fred Christian; Sevick-Muraca, Eva M

    2017-10-01

    Cerebrospinal fluid (CSF) is known to be reabsorbed by the lymphatic vessels and drain into the lymph nodes (LNs) through peripheral lymphatic vessels. In the peripheral lymphatics, the contractile pumping action of lymphangions mediates lymph drainage; yet it is unknown whether lymphatic vessels draining cranial and spinal CSF show similar function. Herein, we used non-invasive near-infrared fluorescence imaging (NIRFI) to image (i) indocyanine green (ICG) distribution along the neuraxis and (ii) routes of ICG-laden CSF outflow into the lymphatics following intrathecal lumbar administration. We demonstrate lymphatic contractile function in peripheral lymphatics draining from the nasal lymphatics to the mandibular LNs. In addition, we observed afferent sciatic lymphatic vessels, which also show contractile activity and transport spinal CSF into the sciatic LNs. This drainage pattern was also visualized by NIRFI following intrathecal thoracic injection. In situ intravital imaging following intrathecal lumbar injection of blue dye shows similar distributions to that seen in vivo with ICG. NIRFI could be used as a tool to probe CSF pathology including neurological disorders by imaging CSF outflow dynamics to lymphatics. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Non-invasive mapping of deep-tissue lymph nodes in live animals using a multimodal PET/MRI nanoparticle

    Science.gov (United States)

    Thorek, Daniel L. J.; Ulmert, David; Diop, Ndeye-Fatou M.; Lupu, Mihaela E.; Doran, Michael G.; Huang, Ruimin; Abou, Diane S.; Larson, Steven M.; Grimm, Jan

    2014-01-01

    The invasion status of tumour-draining lymph nodes (LNs) is a critical indicator of cancer stage and is important for treatment planning. Clinicians currently use planar scintigraphy and single-photon emission computed tomography (SPECT) with 99mTc-radiocolloid to guide biopsy and resection of LNs. However, emerging multimodality approaches such as positron emission tomography combined with magnetic resonance imaging (PET/MRI) detect sites of disease with higher sensitivity and accuracy. Here we present a multimodal nanoparticle, 89Zr-ferumoxytol, for the enhanced detection of LNs with PET/MRI. For genuine translational potential, we leverage a clinical iron oxide formulation, altered with minimal modification for radiolabelling. Axillary drainage in naive mice and from healthy and tumour-bearing prostates was investigated. We demonstrate that 89Zr-ferumoxytol can be used for high-resolution tomographic studies of lymphatic drainage in preclinical disease models. This nanoparticle platform has significant translational potential to improve preoperative planning for nodal resection and tumour staging.

  5. pMHC affinity controls duration of CD8+ T cell-DC interactions and imprints timing of effector differentiation versus expansion.

    Science.gov (United States)

    Ozga, Aleksandra J; Moalli, Federica; Abe, Jun; Swoger, Jim; Sharpe, James; Zehn, Dietmar; Kreutzfeldt, Mario; Merkler, Doron; Ripoll, Jorge; Stein, Jens V

    2016-11-14

    During adaptive immune responses, CD8+ T cells with low TCR affinities are released early into the circulation before high-affinity clones become dominant at later time points. How functional avidity maturation is orchestrated in lymphoid tissue and how low-affinity cells contribute to host protection remains unclear. In this study, we used intravital imaging of reactive lymph nodes (LNs) to show that T cells rapidly attached to dendritic cells irrespective of TCR affinity, whereas one day later, the duration of these stable interactions ceased progressively with lowering peptide major histocompatibility complex (pMHC) affinity. This correlated inversely BATF (basic leucine zipper transcription factor, ATF-like) and IRF4 (interferon-regulated factor 4) induction and timing of effector differentiation, as low affinity-primed T cells acquired cytotoxic activity earlier than high affinity-primed ones. After activation, low-affinity effector CD8+ T cells accumulated at efferent lymphatic vessels for egress, whereas high affinity-stimulated CD8+ T cells moved to interfollicular regions in a CXCR3-dependent manner for sustained pMHC stimulation and prolonged expansion. The early release of low-affinity effector T cells led to rapid target cell elimination outside reactive LNs. Our data provide a model for affinity-dependent spatiotemporal orchestration of CD8+ T cell activation inside LNs leading to functional avidity maturation and uncover a role for low-affinity effector T cells during early microbial containment. © 2016 Ozga et al.

  6. Extended Salvage Pelvic Lymph Node Dissection in Patients with Recurrent Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Daniar K. Osmonov

    2014-01-01

    Full Text Available Background. Treatment of patients with a biochemical recurrence (BCR of prostate cancer (PCa is generally difficult and without valid treatment options. Since 2004 we have been developing therapeutic possibilities for these patients. Methods. We retrospectively analyzed a cohort of 41 patients with a BCR of PCa and a mean followup of 40.3±20.8 months. Group 1 (n=10: salvage radical prostatectomy (sRP with SePLND (salvage extended pelvic lymph nodes dissection (initial treatment: combined brachytherapy. Group 2 (n=22: SePLND (initial treatment: radical prostatectomy (RP. Group 3 (n=9: SePLND (initial treatment: RP and adjuvant radiation therapy (RT. We observed PSA, PSA-velocity, localization of LNs and LNs+, BCR-free period, and BR (biochemical response. Results. Group 1: 60% with BCR-freedom (mean 27.2 months. Group 2: 63.6% with BCR-freedom (mean 17.5 months. Group 3: 33.3% with BCR-freedom (mean 17.6 months. In total, BCR-freedom was observed in 23 of 41 patients (56.1% after salvage surgery. 75.6% of all patients showed a BR. 765 LNs were removed and 14.8% of these were LN+. Conclusions. The BCR-free period and BR are comparable in all three groups. Sensibility to ADT can be reestablished and prolonged as a result of SePLND. Multicenter studies are needed for a reliable output.

  7. CCR4 and CXCR3 play different roles in the migration of T cells to inflammation in skin, arthritic joints, and lymph nodes.

    Science.gov (United States)

    Al-Banna, Nadia A; Vaci, Maria; Slauenwhite, Drew; Johnston, Brent; Issekutz, Thomas B

    2014-06-01

    CCR4 and CXCR3 are expressed on several T-cell subsets in inflamed tissues, yet their role in tissue-specific recruitment is unclear. We examined the contributions of CCR4 and CXCR3 to T-cell recruitment into inflamed joints in collagen-induced arthritis, antigen-draining lymph nodes (LNs) and dermal inflammatory sites (poly I:C, LPS, concanavalin A, and delayed type hypersensitivity), using labeled activated T cells from CXCR3(-/-), CCR4(-/-), and WT mice. Both CXCR3 and CCR4 deficiency reduced the development of arthritis, but did not affect Th1-cell recruitment to the inflamed joints. Accumulation in inflamed LNs was highly CXCR3 dependent. In contrast, CCR4-deficient Th1 cells had an increased accumulation in these LNs. Migration to all four dermal inflammatory sites by activated Th1 and T cytotoxic cells and memory CD4(+) T cells was partially CXCR3-dependent, but Treg-cell migration was independent of CXCR3. The subset of cells expressing CCR4 has skin-migrating properties, but CCR4 itself is not required for the migration. Thus, migration into these inflamed tissues is CCR4-independent, and partially dependent on CXCR3, except for Treg cells, which require neither receptor. CCR4 may therefore affect retention of T cells in different tissues rather than trafficking out of the blood. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Clinical impact of lymphadenectomy extent in resectable gastric cancer of advanced stage.

    Science.gov (United States)

    Schwarz, Roderich E; Smith, David D

    2007-02-01

    Advanced, but potentially still curable gastric cancer (stages IIIA, IIIB, or stage IV M0) is associated with very high recurrence rates after gastrectomy. The value of an extended lymph node dissection (ELND) remains unclear in this setting. A resected gastric cancer data set was created through structured queries to the SEER 1973-2000 database. Relationships between the number of lymph nodes (LNs) examined and survival outcomes were analyzed for the stage subgroups characterized by the N categories N2 or N3, and transmural tumor extension (T categories T2b or T3). The study group encompassed 1,377 patients, including T2b/3N2 (n = 1,076) and T2b/3N3 stage subgroups (n = 301). Total LN count (or number of negative LNs examined; P transmural or serosa-positive gastric cancer with advanced nodal involvement, more extensive LN dissection and analysis influences survival. Stage-based survival prediction depends on total LN number and number of negative LNs. The mechanism remains uncertain, but is not limited to stage migration. ELND during potentially curative gastrectomy is recommended even for advanced gastric cancer.

  9. A real-time prediction model for post-irradiation malignant cervical lymph nodes.

    Science.gov (United States)

    Lo, W-C; Cheng, P-W; Shueng, P-W; Hsieh, C-H; Chang, Y-L; Liao, L-J

    2017-10-05

    To establish a real-time predictive scoring model based on sonographic characteristics for identifying malignant cervical lymph nodes (LNs) in cancer patients after neck irradiation. One-hundred forty-four irradiation-treated patients underwent ultrasonography and ultrasound-guided fine-needle aspirations (USgFNAs), and the resultant data were used to construct a real-time and computerised predictive scoring model. This scoring system was further compared with our previously proposed prediction model. A predictive scoring model, 1.35 × (L axis) + 2.03 × (S axis) + 2.27 × (margin) + 1.48 × (echogenic hilum) + 3.7, was generated by stepwise multivariate logistic regression analysis. Neck LNs were considered to be malignant when the score was ≥ 7, corresponding to a sensitivity of 85.5%, specificity of 79.4%, posi