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Superiority of Digital Subtraction for Analysis of Simultaneously-Acquired Dual-Radiopharmaceutical Parathyroid Scintigraphy

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open Journal of Medical Imaging 2015年第2期5卷 42-48页

作者： Matthieu Pelletier-Galarneau oyebola o. Sogbein Laurent Dinh Lionel S. Zuckier Division of Nuclear Medicine University of Ottawa Ottawa Canada

With dual-radiopharmaceutical (DR) parathyroid scintigraphy, imaging with 99mTco4-or 123I-NaI is combined with 99mTc-sestamibi scintigraphy for localization of parathyroid adenomas. The set images are then either visually compared or digitally subtracted to aid in interpretation. While both EANM and SNMMI guidelines recommend use of digital subtraction over visual interpretation alone, to date, the few formal comparisons performed have not demonstrated superiority. The purpose of this investigation is to rigorously assess the added value of digital subtraction over visual interpretation alone using simultaneously-acquired 123I-NaI and 99mTc-sestamibi images. Materials: 90 consecutive patients with DR parathyroid scintigraphy for primary hyperparathyroidism who underwent successful parathyroidectomy were included. DR planar acquisition was performed 15 minutes post injection using 10% dual energy windows. Digital subtraction was subsequently performed using commercially available software. Images were independently reviewed by 3 nuclear medicine trainees and 2 experienced nuclear medicine physicians with and without digital subtraction. Results were compared with surgical and histopathologic findings, which served as ground truth. Results: 90 patients had a total of 91 confirmed parathyroid lesions. All 5 readers had significantly greater sensitivity with digital subtraction compared with visual interpretation alone while specificity was not significantly diminished. Area under the roc curve was significantly greater with digital subtraction in 3 of 5 readers. Agreement was greater among trainees and experienced physicians when using digital subtraction. Conclusion: Using an optimized DR planar co-imaging technique, digital subtraction significantly improved inter-observer agreement and confidence of interpretation and increased sensitivity, without diminishing specificity.

关键词： Parathyroid Scintigraphy Dual-Isotope Dual-Radiopharmaceutical Digital Subtraction Visual

神经干/祖细胞移植对脑损伤导致的胶质细胞活化有调节作用并有助于移植细胞与宿主胶质细胞间缝隙连接的建立

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神经损伤与功能重建 2014年第2期9卷 F0003-F0003页

作者： rocío Talaverón Esperanza R.Matarredona Rosa R.de la Cruz David Macías Victoria Gálvez and Angel M. Pastor Departamento de Fisiología Facultad de Biología Universidad de Sevilla Avenida Reina Mercedes

移植神经干/祖细胞有助于受损脑组织形态和功能的恢复。移植部位的微环境及移植细胞与宿主细胞间的通讯在神经干/祖细胞移植的神经保护机制中有重要意义。笔者既往研究显示,对中枢轴索损伤动物进行神经干/祖细胞移植有助于恢复损伤神经... 详细信息

移植神经干/祖细胞有助于受损脑组织形态和功能的恢复。移植部位的微环境及移植细胞与宿主细胞间的通讯在神经干/祖细胞移植的神经保护机制中有重要意义。笔者既往研究显示,对中枢轴索损伤动物进行神经干/祖细胞移植有助于恢复损伤神经元的电活动及突触联系,并可增加神经营养因子的释放。本研究拟观察移植的神经干/祖细胞与宿主胶质细胞间的解剖关系,以探讨神经干/祖细胞移植的神经保护作用的可能机制。从新生大鼠的脑室下区提取神经干/祖细胞移植到内侧纵束横断伤模型大鼠脑内。移植后8周取脑进行相关检测。免疫组化检测结果显示,与未移植神经干/祖细胞的大鼠相比,移植了神经干/祖细胞的大鼠脑内更多的小胶质细胞被激活。移植的神经干/祖细胞聚集在激活的小胶质细胞和星形胶质细胞附近。缝隙连接蛋白CX-43表达在损伤部位的神经干/祖细胞和胶质细胞上,且较多的存在于移植细胞和胶质细胞相连接的部位。移植的神经干/祖细胞和宿主胶质细胞及宿主小胶质细胞间均形成了缝隙连接,但移植的神经干/祖细胞和宿主胶质细胞间的缝隙连接较多。本研究结果显示,神经干/祖细胞移植对脑损伤导致的胶质细胞活化有调节作用,并可能通过在移植细胞和宿主细胞间建立缝隙连接来调节细胞间的通讯,这可能是细胞移植的神经保护作用的机制之一。

关键词：星形胶质细胞轴索断裂缝隙连接蛋白-43 小胶质细胞脑室下区

Frequency and severity of oSAHS in Mexican adolescents. The role of BMI and neck circumference

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Health 2013年第8期5卷 1-8页

作者： Armando Partida-Gaytán Arturo Berber Blanca Estela del Río-Navarro Reyes Haro-Valencia Chief of Sleep Breathing Disorders Clinic Universidad Nacional Autónoma de México Hospital General de México Secretaria de Salud Distrito Federal México Departamento de Alergia e Inmunología Clínica Pediátrica Hospital Infantil de México Federico Gómez Instituto Nacional de Salud Secretaria de Salud Distrito Federal México

Background: overweight and obesity are major public-health issues in Mexico. Sleep breathing disorders directly impact the health of affected subjects. The aim of this study was to describe the frequency and severity of obstructive sleep apnea/hypopnea syndrome (oSAHS) in Mexican adolescents grouped by weight status. Secondary objectives were to describe the influence of body mass index (BMI) and neck circumference (NC) as predictive factors of oSAH. Method: Somatometric, demographic data and full-night polysomnography were done. Linear and logistic regression models described the relationship between BMI and NC with oSAHS presence and severity. Receiver-operating-Characteristics (roc) curves showed different sensitivity and specificity performances of BMI and NC cutoff-values. Results: oSAHS frequency and severity were significantly greater in obese and extremely-obese adolescents (8% vs 22% vs 67%;p on showed an AHI increase of 0.940 events/hour for every centimeter-increase in NC and 0.696 events/hour for every1 kg/m2-increase in BMI. Logistic-regression showed extreme-obesity as the main risk factor (oR 9.9) for diagnosis of oSAHS. roc curves showed an area under the curve (AUC) of 0.83 for BMI defined cutoff-values, and of 0.80 for BMI percentile-for-age cutoff-values. The AUC of NC roc curve was 0.8043. Conclusion: This is the largest study made on Latin-American population evaluating the frequency and severity of oSAHS with full-night polysomnography. We showed that obese and extremely-obese Mexican-adolescents are at highest risk for oSAHS. Increasing BMI and NC showed positive correlation with AHI. Different BMI cut-off values showed similar diagnostic performance. Extreme-obesity increases 8 times the risk association for oSAHS.

关键词： obesity obstructive Sleep Apnea Hyopopnea Syndrome (oSAHS) obstructive Sleep Apnea Sleep Apnea Syndromes Polysomnography Body Mass Index (BMI) Neck Circumference Adolescents

HER2 in gastric cancer: Comparative analysis of three different antibodies using whole-tissue sections and tissue microarrays

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World Journal of Gastroenterology 2013年第38期19卷 6438-6446页

作者： Lucas Faria Abraho-Machado Alexandre Andrade dos Anjos Jácome Durval Renato Wohnrath José Sebastio dos Santos Estela Cristina Carneseca José Humberto Tavares Guerreiro Fregnani Cristovam Scapulatempo-Neto Department of Pathology Barretos Cancer HospitalBarretosSao Paulo 14784-400Brazil Department of Clinical oncology Mater Dei HospitalBelo HorizonteMinas Gerais 30140-092Brazil Department of Gastrointestinal Surgical oncology Barretos Cancer HospitalBarretosSao Paulo 14784-400Brazil Department of Surgery and Anatomy University of S o Paulo-Ribeir o Preto School of MedicineRibeir o PretoSao Paulo 14049-900Brazil Biostatistician at Cancer Registry Department Barretos Cancer HospitalBarretosSao Paulo 14784-400Brazil Researcher Support Center Barretos Cancer HospitalBarretosSao Paulo 14784-400Brazil

AIM:To compare the performance of three commercially available anti-human epidermalgrowth factor receptor 2(HER2)antibodies in whole-tissue sections and tissue microarrays(TMAs)of a series of gastric ***:We present a comparative analysis of three anti-HER2 antibodies(HercepTest,4B5 and SP3)using TMA and whole-tissue sections prepared from the same paraffin blocks of 199 gastric adenocarcinomas operated upon between January 2004 and December2008 at a Brazilian cancer *** data on the patients’age,sex,the anatomical location of the tumor and the Lauren’s histological classification were collected from clinical and pathological *** immunohistochemical(IHC)results were examined by two pathologists and the cases were classified as positive(3+),equivocal(2+)and negative(0 or 1+),according to the criteria of the IHC scoring system of gastric *** and whole-tissue sections were evaluated separately and *** cases yielding discordant IHC results and/or scored as 2+were subjected to dual-color in situ hybridization in order to determine the final HER2 *** determining the sensitivity and predictive value for HER2-positive status,we measured the accuracy of each antibody by calculating the area under the receiver operating characteristic(roc)*** agreement between the results obtained using the TMAs and those obtained using the whole-tissue sections was assessed by means of Kappa ***:Intratumoral heterogeneity of HER2 expression was observed with all ***2-positive expression(3+)in the whole-tissue sections was observed in 23 cases(11.6%)using the 4B5 antibody,in 18 cases(9.1%)using the SP3 antibody and in 10 cases(5.1%)using the HercepTest *** the TMAs,11 positive cases(5.6%)were identified using SP3 antibody,9(4.6%)using the 4B5 antibody and 6(3%)using the HercepTest *** sensitivity using whole-tissue sections and TMA,respectively,was 95.2%and 42.9%with 4B5,90.5%and 66.7%

关键词： Gastric cancer Human epidermalgrowth factor receptor 2 Immunohistochemistry Whole-tissue sections Tissue microarray Trastuzumab

HIV阳性神经认知损害患者的尾状核血流和体积减少

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世界核心医学期刊文摘(神经病学分册) 2006年第10期 47-47页

作者： Ances B.M. roc A.C. 郭俊 HIV Neurobehavioral Research Center 150 W. Washington San Diego CA 92119 United States Dr.

objective: To evaluate the effects of HIV- associated neurocognitive impairment on caudate blood flow and volume. Methods: The authors performed continuous arterial spin labeled MRI on 42 HIV+ patients (23 subsyndromic and 19 HIV neurosymptomatic) on highly active antiretroviral therapy and 17 seronegative controls. They compared caudate blood flow and volume among groups. Results: A stepwise decrease in both caudate blood flow and volume was observed with increasing HIV- associated neurocognitive impairment. Compared with seronegative controls, baseline caudate blood flow was reduced in HIV+ neurosymptomatic patients (p = 0.001) with a similar decreasing trend for subsyndromic HIV+ patients (p = 0.070). Differences in caudate volume were observed only for neurosymptomatic HIV+ patients compared with controls (p = 0.010). A Jonckheere- Terpstra test for trends was significant for both caudate blood flow and volume for each of the three subgroups. Pearson product moment correlation coefficients were not significant between caudate blood flow and volume for each group. Conclusions: Decreasing trends in caudate blood flow and volume were associated with significantly increasing HIV- associated neurocognitive impairment (HNCI), with the greatest decreases observed for more severely impaired patients. However, reductions in caudate blood flow and volume were poorly correlated. Changes in residual caudate blood flow may act as a surrogate biomarker for classifying the degree of HNCI.

关键词：尾状核纹状体血流神经认知患者阳性

经闭孔尿道悬吊术后妊娠的病例报道和文献回顾(法)

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世界核心医学期刊文摘（妇产科学分册） 2006年第12期2卷 62-62页

作者： Le roc'h A. Debodinance P. 朱磊 Service de Gynécologie-obstétrique CH de Dunkerque43rue des Pinsons59430 Saint-Pol-sur-Mer

Rare cases of pregnancy occur after surgical treatment of an urinary incontinence. We report the case of a 37-year-old patient became pregnant 5 months after trans-obturator insertion of asuburethral sling (Monarc). The pregnancy was monitored regularly and no sign of urinary incontinence was *** delivery was decided at 40 weeks gestation. The patient has remained quite continent,one year after *** appropriate mode of delivery is discussed.

关键词：文献回顾悬吊术

Coronary physiology assessment in the catheterization laboratory

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World Journal of Cardiology 2015年第9期7卷 525-538页

作者： Felipe Díez-delhoyo Enrique Gutiérrez-Ibanes Gerard Loughlin Ricardo Sanz-Ruiz María Eugenia Vázquez-álvarez Fernando Sarnago-Cebada rocío Angulo-Llanos Ana Casado-Plasencia Jaime Elízaga Francisco Fernández Avilés Diáz Instituto de Investigación Sanitaria Gregorio Maranón Servicio de CardiologíaDepartamento de MedicinaUniversidad Complutense de Madrid

Physicians cannot rely solely on the angiographic appearance of epicardial coronary artery stenosis when evaluating patients with myocardial ischemia. Instead, sound knowledge of coronary vascular physiology and of the methods currently available for its characterization can improve the diagnostic and prognostic accuracy of invasive assessment of the coronary circulation, and help improve clinical decision-making. In this article we summarize the current methods available for a thorough assessment of coronary physiology.

关键词： Coronary heart disease Coronary physiology Endothelial dysfunction Microvascular dysfunction Fractional flow reserve Coronary flow reserve Index of microcirculatory resistance

Prediction of Intraoperative Trifecta Achievement during Laparoscopic Partial Nephrectomy

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open Journal of Urology 2021年第1期11卷 6-16页

作者： ovidiu-Spiru Barnoiu F. J. Baron T. Sæ ter A. o. Tysland A. Andersen Department of Urology Sorlandet Hospital Kristiansand Norway Department of Biostatistics University of Malaga Malaga Spain Department of Clinical and Molecular Medicine Norwegian University of Science and Technology Trondheim Norway Department of Urology Sorlandet Hospital Arendal Norway

Purpose: We introduce the concept of intraoperative Trifecta during laparoscopic partial nephrectomy (LPN) as the simultaneous achievement of estimated blood loss (EBL) Methods: We retrospectively evaluated 122 patien... 详细信息

ong>Purpose:ong> We introduce the concept of intraoperative Trifecta during laparoscopic partial nephrectomy (LPN) as the simultaneous achievement of estimated blood loss (EBL) of the intraoperative course. The study’s aim was to find preoperative factors that could predict the likelihood of achieving intraoperative Trifecta and build a surgical nomogram. ong>Methods:ong> We retrospectively evaluated 122 patients who underwent LPN. Preoperative factors like age, sex, body-mass index (BMI), kidney function, tumor characteristics (R.E.N.A.L. score) and Charlson-Comorbidity-Index (CCI) were recorded. Intraoperative complication (IoC) was graded according to the Rosenthal classification. R software was used to find a predicting model for achievement of Trifecta using preoperative variables and a nomogram was built. ong>Results: ong>The surgical features include median EBL of 100 ml having 6.5% bleed > 500 ml, median WIT of 12 minutes having 7.3% more than 20 minutes. There was recorded a 12.3% IoC with a mean Rosenthal’s grade of 0.2. Intraoperative Trifecta was achieved in 105 patients (86%) and three preoperative factors were chosen for the predictive model: BMI (p = 0.041), CCI (p = 0.037) and RENAL score (p = 0.002). A nomogram was generated and the roc-AUC of the model was 75.8%. ong>Conclusion:ong> We have defined an intraoperative Trifecta concept as the achievement of EBL of the intraoperative course. A nomogram was developed from preoperative factors like BMI, CCI and R.E.N.A.L. score. It can be used to estimate the probability of Trifecta achievement in patients treated with LPN.

关键词： Intraoperative Complications Laparoscopic Partial Nephrectomy Prediction Trifecta

Celiac disease serology in patients with different pretest probabilities: Is biopsy avoidable?

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World Journal of Gastroenterology 2010年第25期16卷 3144-3152页

作者： Emilia Sugai María L Moreno Hui J Hwang Ana Cabanne Adriana Crivelli Fabio Nach-man Horacio Vázquez Sonia Niveloni Julio Argonz Roberto Mazure Graciela La Motta María E Caniggia Edgardo Smecuol Néstor Chopita Juan C Gómez Eduardo Maurińo Julio C Bai Small Bowel Section Department of Medicine Gastroenterology Hospital "Dr. C. Bonorino Udaondo" Caseros 2061 Ciudad de Buenos Aires Argentina Pathology Service Hospital de Gastroenter-ología "Dr. C. Bonorino Udaondo" Av. Caseros 2061 Ciudad de Buenos Aires Argentina USNMA HIGA "San Martín" La Plata B1900 Provincia de Buenos Aires Argentina Endoscopy Service Hospital de Gastroenter-ología "Dr. C. Bonorino Udaondo" Av. Caseros 2061 Ciudad de Buenos Aires Argentina Endoscopy Service HIGA "San Martín" La Plata

AIM: To establish the diagnostic performance of sev-eral serological tests, individually and in combination, for diagnosing celiac disease (CD) in patients with different pretest probabilities, and to explore potential se- rological algorithms to reduce the necessity for biopsy. METHoDS: We prospectively performed duodenal biopsy and serology in 679 adults who had either high risk (n = 161) or low risk (n = 518) for CD. Blood samples were tested using six assays (enzyme-linked immunosorbent assay) that detected antibodies to tissue transglutaminase (tTG) and deamidated gliadin peptide (DGP). RESULTS: CD prevalence was 39.1% in the high-risk population and 3.3% in the low-risk group. In high-risk patients, all individual assays had a high diagnostic efficacy [area under receiving operator characteristic curves (AU roc): 0.968 to 0.999]. In contrast, assays had a lower diagnostic efficacy (AU roc: 0.835 to 0.972) in the low-risk group. Using assay combinations, it would be possible to reach or rule out diagnosis of CD without biopsy in 92% of cases in both pretest populations. We observed that the new DGP/tTG Screen assay resulted in a surplus compared to more conventional assays in any clinical situation. CoNCLUSIoN: The DGP/tTG Screen assay could be considered as the best initial test for CD. Combinations of two tests, including a DGP/tTG Screen, might be able to diagnose CD accurately in different clinical scenarios making biopsy avoidable in a high proportion of subjects.

关键词： Celiac disease Serology Gliadin peptide antibodies Tissue transglutaminase Antigliadin antibodies Small bowel biopsy Diagnostic accuracy