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Diagnostic performance of contrast-enhanced ultrasound and enhanced magnetic resonance for breast nodules

The Journal of Biomedical Research 2018年第3期32卷 198-207页

作者： Cuiying Li Haiyan Gong Lijun Ling Liwen Du Tong Su Shui Wang Jie Wang departments of Ultrasound the First Affiliated Hospital of Nanjing Medical University general surgery the First Affiliated Hospital of Nanjing Medical University Radiology the First Affiliated Hospital of Nanjing Medical University

In the current study, we sought to evaluate the diagnostic efficacies of conventional ultrasound（US）, contrastenhanced US（CEUS）, combined US and CEUS and magnetic resonance imaging（MRI） in detecting focal solid breast lesions. Totally 117 patients with 120 BI-RADS category 4A-5 breast lesions were evaluated by conventional US and CEUS, and MRI, respectively. SonoVue was used as contrast agent in CEUS and injected as an intravenous bolus; nodule scan was performed 4 minutes after bolus injection. A specific sonographic quantification software was used to obtain color-coded maps of perfusion parameters for the investigated lesion, namely the time-intensity *** pattern of contrast enhancement and related indexes regarding the time-intensity curve were used to describe the lesions, comparatively with pathological results. Histopathologic examination revealed 46 benign and 74 malignant lesions. Sensitivity, specificity, and accuracy of US in detecting malignant breast lesions were 90.14%, 95.92%, and 92.52%, respectively. Meanwhile, CE-MRI showed sensitivity, specificity, and accuracy of 88.73%, 95.92%, and91.67%, respectively. The area under the ROC curve for combined US and CEUS in discriminating benign from malignant breast lesions was 0.936, while that of MRI was 0.923, with no significant difference between them, as well as among groups. The time-intensity curve of malignant hypervascular fibroadenoma and papillary lesions mostly showed a fast-in/fast-out pattern, with no good correlation between them（kappa 〈0.20）. In conclusion, the combined use of conventional US and CEUS displays good agreement with MRI in differentiating benign from malignant breast lesions.

关键词： conventional ultrasound contrast-enhanced ultrasound breast lesions BI-RADS magnetic resonance imaging(MRI) time-intensity curve(TIC) contrast-enhanced magnetic resonance imaging(CE-MRI)

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SURVIVAL TRENDS IN CHILDHOOD HEMATOLOGICAL MALIGNANCIES

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International Journal of Biomathematics 2012年第6期5卷 95-103页

作者： STEPHANIE RICH SHIHAB ALI GEOFFREY W. CALKINS JAMES S. MICHAELSON Laboratory of Quantitative Medicine Massachusetts general Hospital 65 Landsdowne Street Suite 200Cambridge Massachusetts 02139 USA Laboratory of Quantitative Medicine and departments of surgery and Pathology Massachusetts general Hospital 65 Landsdowne Street Suite 200Cambridge Massachusetts 02139 USA

Survival of patients with childhood hematological malignancies has increased markedly in the past decades. To examine the finescale details of how this progress has occurred, we carried out KaplanMeier causespecific survival analysis using the Surveillance Epi demiology and End Results （SEER） dataset for patients with childhood hematologi cal malignancies Hodgkin＇s Lymphoma, NonHodgkin＇s Lymphoma, Lymphoblastic Leukemia and Myeloid Leukemia diagnosed in five eras： 1983-1987; 1988-1992; 1993-1997; 1998-2002 and 2003-2007. We generated KaplanMeier estimates of survival for each of the first 24 years after diagnosis. These figures agree with previously reported five and tenyear values and attest to the remarkable increase in survival that has occurred over the past three decades of medical progress. The trend towards progres sively increasing survival shows no sign of slowing, suggesting that we may expect further increases in survival in the years ahead. Most of the increase in survival for childhood hematological malignancies has occurred by reducing the risk of death in the first two years after diagnosis. This may be largely explained by the fact that this is the time period when patients are at highest risk of death.

关键词： Childhood hematological malignancies survival trends.

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A radical scavenger edaravone and oligodendrocyte protection/regeneration

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Neural Regeneration Research 2018年第9期13卷 1550-1551页

作者： Hajime Takase Josephine Lok Ken Arai Neuroprotection Research Laboratory Departments of Radiology and NeurologyMassachusetts General Hospital and Harvard Medical School

Cerebral white matter is vulnerable to oxidative stress： Oxidative stress is one of the major harmful conditions for the central ner- vous system （CNS）. Oxidative stress is a state from an imbalance between free radical production and their removal by antioxidants, resulting in an excessive amount of reactive oxygen species （ROS） in cells and tissues. ROS causes cell damage due to oxidation of cellular components, including DNAs, proteins, and lipids. During physiological conditions, small amounts of ROS are generated in the process of normal biological activity, and ROS at physiological levels play important roles in maintaining cellular homeostasis （Chen et al., 2018）. However, during pathological conditions, ROS levels are increased and excessive ROS can lead to deleterious ef- fects on many kinds of cells.

关键词： PROLONGED CEREBRAL HYPOPERFUSION OXIDATIVE STRESS MOUSE MODEL STROKE

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Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture:A case report

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World Journal of Gastroenterology 2007年第6期13卷 970-972页

作者： Toshiaki Ichihara Tsutomu Sato Hideaki Miyazawa Satoshi Shibata Manabu Hashimoto Koichi Ishiyama Yuzo Yamamoto departments of Gastroenterological surgery and Radiology Akita University School of Medicine Hondo Akita 010-8543 Japan

To treat postoperative bleeding after hepato-pancreato-biliary surgery, interventional radiology has become essential. We report a case of coincidental pseudoan-eurysm and jejunal varices that were both successfully treated by stent-grafts. After a pancreaticoduodenec-tomy, the patient developed a pseudoaneurysm in the hepatic artery and a stenosis in its periphery. After establishing hepatic arterial flow by placing stent-grafts over both the pseudoaneurysm and the stenosis, the pseudoaneurysm was embolized with microcoils. Nine months later, the patient developed jejunal varices caused by a severe stricture in the main trunk of the portal vein. Percutaneous transhepatic portography was performed and stent-grafts were placed over the stenotic segment. A venoplasty using stent-grafts nor-malized the portal blood flow and the jejunal varices vanished. Although stenosis occurred due to scarred tissues from leakage after pancreaticoduodenectomy, stent-grafts were useful for managing jejunal bleeding post-operatively.

关键词： Extrahepatic portal vein stenosis Jejunalvarices Interventional radiology Stent-graft

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Destructive granuloma derived from a liver cyst: A case report

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World Journal of Gastroenterology 2006年第11期12卷 1798-1801页

作者： Yujo Kawashita Yukio Kamohara Junichiro Furui Fumihiko Fujita Shungo Miyamoto Mitsuhisa Takatsuki Kuniko Abe Tomayoshi Hayashi Yasuharu Ohno Takashi Kanematsu departments of Transplantation and Digestive surgery and Pathology Graduate School of Biomedical SciencesNagasaki University HospitalJapan

We herein report the case of an idiopathic liver cystic mass which aggressively infiltrated the thoracoabdominal wall. A 74-year-old woman who had a huge cystic lesion in her right hepatic lobe was transferred to our hospital for further examinations. Imaging studies revealed a simple liver cyst, and the cytological findings of intracystic fluid were negative. She was followed up periodically by computed tomography （CT） scans. Seven years later, she complained of a prominence and dull pain in her right thoraco-abdominal region. CT revealed an enlargement of the cystic lesion and infiltration into the intercostal subcutaneous tissue. We suspected the development of a malignancy inside the liver cyst such as cystadenocarcinoma, and she therefore underwent surgery. A tumor extirpation was performed, including the chest wall, from the 7th to the 10th rib, as well as a right hepatic Iobectomy. Pathologically, the lesion consisted of severe inflammatory change with epithelioid cell granuloma and bone destruction without any malignant neoplasm. No specific pathogens were evident based on further histological and molecular examinations. Therefore the lesion was diagnosed to be a destructive granuloma associated with a long-standing hepatic cyst. Since undergoing surgery, the patient has been doing well without any signs of recurrence.

关键词： Destructive granuloma Liver cyst

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Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period

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World Journal of Cardiovascular Diseases 2024年第2期14卷 99-114页

作者： Hamadou Ba Nganou-Ngnindjio Chris Nadège Tatchim Samuel Aimé Kamdem Félicité Tchoukoua Serge Honoré Ahmadou Jingi Danwe Dieudonne Kingue Samuel Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Internal Medicine Garoua General Hospital Garoua Cameroon Cardiology Department Yaoundé Central Hospital Yaoundé Cameroon Higher Institute of Health Sciences University of the Mountains Bagangté Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Internal Medicine Douala General Hospital Douala Cameroon Faculty of Health Sciences University of Bamenda Bamenda Cameroon Cardiology Department Yaoundé General Hospital Yaoundé Cameroon

Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and general Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay.

关键词： Cost Management Venous Thromboembolism Yaoundé

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Stereotactic radiosurgery for haemorrhagic cerebral cavernous malformation:a multi-institutional,retrospective study

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Stroke & Vascular Neurology 2024年第3期9卷 221-229,I0130,I0131页

作者： Chloe Dumot Georgios Mantziaris Sam Dayawansa Zhiyuan Xu Stylianos Pikis Selcuk Peker Yavuz Samanci Gokce D Ardor Ahmed M Nabeel Wael A Reda Sameh R Tawadros Khaled Abdelkarim Amr M N El-Shehaby Reem M Emad Eldin Ahmed H Elazzazi Nuria Martínez Moreno Roberto MartínezÁlvarez Roman Liscak Jaromir May David Mathieu Jean-Nicolas Tourigny Manjul Tripathi Akshay Rajput Narendra Kumar Rupinder Kaur Piero Picozzi Andrea Franzini Herwin Speckter Wenceslao Hernandez Anderson Brito Ronald E Warnick Juan Alzate Douglas Kondziolka Greg N Bowden Samir Patel Jason Sheehan Department of Neurological surgery Hospices Civils de LyonLyonFrance Department of Neurological surgery University of VirginiaCharlottesvilleVirginiaUSA Department of Neurosurgery Koc University School of MedicineIstanbulTurkey Gamma-knife Center Nasser institute HospitalCairoEgypt Neurosurgery Department Benha UniversityBenhaEgypt departments of Neurosurgery Ain Shams UniversityCairoEgypt Department of Clinical Oncology Ain Shams UniversityCairoEgypt Department of Radiation Oncology National Cancer InstituteCairo UniversityGizaEgypt Faculty of Medicine Extended Modular ProgramAin Shams UniversityCairoEgypt Department of Radiosurgery Rúber Internacional HospitalMadridSpain Department of Stereotactic and Radiation Neurosurgery Na Homolce HospitalPragueCzech Republic Neurosurgery Centre de recherche du CHUSUniversitéde SherbrookeSherbrookeQuebecCanada Neurosurgery PGIMERChandigarhChandigarhIndia Radiation Therapy PGIMERChandigarhChandigarhIndia Neurosurgery IRCCS Istituto Clinico HumanitasRozzanoMilanItaly Dominican Gamma Knife Center and Radiology Department CEDIMATSanto DomingoDominican Republic Gamma Knife Center Mayfield ClinicThe Jewish Hospital-Mercy HealthCincinnatiOhioUSA Neurosurgery NYU Langone HealthNew YorkNew YorkUSA Neurosurgery University of AlbertaEdmontonAlbertaCanada Division of Radiation Oncology Department of OncologyUniversity of AlbertaEdmontonAlbertaCanada

Background Cerebral cavernous malformations(CCMs)frequently manifest with *** radiosurgery(SRS)has been employed for CCM not suitable for *** effect on reducing haemorrhage risk is still *** aim of this study was to expand on the safety and efficacy of SRS for haemorrhagic *** This retrospective multicentric study included CCM with at least one haemorrhage treated with single-session *** annual haemorrhagic rate(AHR)was calculated before and after *** event analysis and Cox regression were used to evaluate factors associated with *** radiation effects(AREs)and occurrence of new neurological deficits were *** The study included 381 patients (median age:37.5 years(Q1–Q3:25.8–51.9))with 414 *** AHR from diagnosis to SRS excluding the first haemorrhage was 11.08 per 100 CCM-years and was reduced to 2.7 per 100 CCM-years after *** recurrent event analysis,SRS,HR 0.27(95%CI 0.17 to 0.44),p13 Gy,HR 2.27(95%CI 1.20 to 4.32),p=0.012 and the presence of DVA,HR 2.08(95%CI 1.00 to 4.31),p=0.049 were factors associated with higher probability of post-SRS ***-SRS haemorrhage was symptomatic in 22 out of 381(5.8%)patients,presenting with transient(15/381)or permanent(7/381)neurological *** occurred in 11.1%(46/414)CCM and was responsible for transient neurological deficit in 3.9%(15/381)of the patients and permanent deficit in 1.1%(4/381)of the *** doses>13 Gy and CCM volume>0.7 cc were associated with increased risk of ARE.

关键词： doses haemorrhagic diagnosis

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Effect of early stepwise cardiopulmonary rehabilitation on function and quality of life in sepsis patients

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World Journal of Clinical Cases 2024年第4期12卷 729-736页

作者： Ming-Hui Zheng Wen-Jun Liu Juan Yang Division of Cardiovascular First Ward departments of Internal Medicine Liyuan HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430077Hubei ProvinceChina Department of Respiratory Medicine PuRen Hospital Affiliated to Wuhan University of Science and Technology/Respiratory MedicineWuhan 430000Hubei ProvinceChina Department of Cardiology Huanggang Central HospitalHuanggang 438000Hubei ProvinceChina

BACKGROUND Sepsis,as a non-limiting host infection disease,can be accompanied by serious complications such as organ failure,which seriously threatens patient quality of *** To investigate the effect of early stepwise cardiopulmonary rehabilitation on cardiopulmonary function and quality of life in patients evacuated from mechanical ventilation with *** A total of 80 patients with sepsis who were hospitalized in our hospital from January 2021 to January 2022 were selected and divided into the observation group(n=40)and the control group(n=40)according to the random number table *** observation group was treated with early stepwise cardiopulmonary rehabilitation,and the control group was treated with a conventional treatment *** function indexes(central venous pressure,cardiac troponin I,B-type brain natriuretic peptide),lung function indicators(diaphragmatic mobility,changes in central venous oxygen saturation,oxygenation index),and quality of life(Quality of Life Evaluation Scale)were compared between the two groups after *** After treatment,the central venous pressure,diaphragm mobility,central venous oxygen saturation,oxygenation index,and Quality of Life Evaluation Scale scores in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The observation group was less than that of the control group for other parameters,and the differences were statistically significant(P<0.05).CONCLUSION Early stepwise cardiopulmonary rehabilitation can effectively enhance cardiac and pulmonary function and improve the quality of life in patients evacuated from mechanical ventilation with sepsis.

关键词： Stepwise cardiopulmonary rehabilitation Sepsis Evacuation of mechanical ventilation Cardiopulmonary function Quality of life

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Laparoscopic approach to Meckel's diverticulum

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World Journal of Gastroenterology 2014年第25期20卷 8173-8178页

作者： Alfonso Papparella Fabiano Nino Carmine Noviello Antonio Marte Pio Parmeggiani Ascanio Martino Giovanni Cobellis departments of Paediatrics Paediatric Surgery Faculty of Medicine Paediatric Surgery-Second University of Naples80138 NaplesItaly Paediatric surgery Unit-Salesi Children Hospital 60121 AnconaItaly

AIM: To retrospective review the laparoscopic management of Meckel Diverticulum(MD) in two Italian Pediatric surgery ***: Between January 2002 and December 2012, 19 trans-umbilical laparoscopic-assisted(TULA) procedures were performed for suspected MD. The children were hospitalized for gastrointestinal bleeding and/or recurrent abdominal pain. Median age at diagnosis was 5.4 years(range 6 mo-15 years). The study included 15 boys and 4 girls. All patients underwent clinical examination, routine laboratory tests, abdominal ultrasound and technetium-99m pertechnetate scan, and patients with bleeding underwent gastrointestinal endoscopy. The abdominal exploration was performed with a 10 mm operative laparoscope. Pneumoperitoneum was establishedbased on the body weight. Systematic overview of the peritoneal cavity allowed the ileum to be grasped with an atraumatic instrument. The complete exploration and surgical treatment of MD were performed extracorporeally, after intestinal exteriorization through the umbilicus. All patients' demographics, main clinical features, diagnostic investigations, operative time, histopathology reports, conversion rate, hospital stay and complications were registered and ***: MD was identified in 17 patients, while 1 had an ileal duplication and 1 a jejunal hemangioma. Fifteen patients had painless intestinal bleeding, while 4 had recurrent abdominal pain and exhibited cyst like structures in an ultrasound study. Eleven patients had a positive technetium-99m pertechnetate scan. In the patients with bleeding, gastrointestinal endoscopy did not name the source of hemorrhage. All patients were subjected to a TULA surgical procedure. An intestinal resection/anastomosis was performed in 14 patients, while 4 had a wedge resection of the diverticulum and 1 underwent stapling diverticulectomy. All surgical procedures were performed without conversion to open laparotomy. Mean operative time was 75 min(range 40-115 min). No m

关键词： Meckel's diverticulum Laparoscopy One trocar surgery Gastrointestinal bleeding Minimal invasive surgery Ileal duplication Jejunal hemangioma

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Do phagocytotic mechanisms regulate soluble factor secretion in microglia?

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Neural Regeneration Research 2021年第5期16卷 974-975页

作者： Gen Hamanaka Kelly K.Chung Ken Arai Neuroprotection Research Laboratory Departments of Radiology and NeurologyMassachusetts General Hospital and Harvard Medical SchoolCharlestownMAUSA

Microglia are responsible for phagocytosis in the brain:Phagocytosis,one of the major mechanisms of innate immune defense,is the process by which several types of cells in the immune system recognize,engulf,and digest large particles,such as pathogens and cell *** the brain,microglia play phagocytotic roles to regulate the micro-environment of brains under both physiological and pathological conditions.

关键词： conditions. mechanisms debris

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