可疑冠心病患者核素显像与CT冠状动脉造影对比分析

Objective The aim of this study was to analyze the relationship between myocardial perfusion imaging (MPI) and computed tomography coronary artefiography (CTCA) in diagnosis of patients with suspected coronary artery disease (CAD).Methods Forty patients with suspected CAD underwent invagive coronary angiography(CAG),MPI and CTCA within 2 months.The results of myocardial perfusion imaging were classified as normal or abnormal[reversible and(or)fixed defects] ;The CTCA studies were classified as normal,non-obstructive(＜50% stenosis)CAD,or obstructive CAD.Taking the results of CAG as"gold standard",the findings of MPI and CTCA were comparatively analyzed.Concordant and discordant results between MPI and CTCA were statistically analyzed using Kappa test.P＜0.05 Was considered statistically significant.Results Aboat 90.1% patients with normal CTCA also showed normal MPI.However,only 44.8% patients with abnormal CTCA showed corresponding perfusion abnormalities on MPI.Conversely,61.5% patients with normal MPI had abnormal CTCA.Compared with CAG,the sensitivity,specificity and accuracy of CTCA were 96.4%(27/28),83.3%(10/12) and 92.5%(37/40),and those of MPI were 46.4%(13/28),91.7%(11/12)and 60.0%(24/40) respectively.Conclusions MPI and CTCA provide different but complementary information in diagnosis of patients with suspected CAD.Their clinical value and application should be practically combined.     

中国汉族正常成人第四脑室容积的高分辨率MRI测量

Objective To explore the normal range of the fourth ventricle volume of Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range= 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e., Group A (age range = 18 to 30),B (age range =31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of the fourth ventricle were measured at sagittal view by automatic trace of Midobl.2 combined with manual outlining.The difference of volumes of the fourth ventricle between male and female were analyzed by independent sample t test, and among age groups by ANOVA.Pearson's correlation coeffcient was used to characterize the relationship between volumes of the fourth ventricle and age.Results The fourth ventricle volumes of Group A-E were (2.1±0.9), (2.1±0.8), (2.2±0.8), (2.1±1.0) and (2.4±0.8) ml respectively for male; those for female were(2.0±0.7), (1.9±0.6), (18±0.6), (1.9±0.7) and (2.0±0.6) ml respectively.The fourth ventricle volumes of males were significantly larger than those of females ( t = 5.573, P =0.000 ) ; there were no significant differences among the female groups ( F = 1.788, P = 0.130 ) ; there were significant differences among the male groups ( F = 2.639, P = 0.033 ) and multiple comparison found that the 60 years old was the watershed with significant difference ( P < 0.05 ).Correlation between the change of males' volumes and the ages was not strong (r = 0.119, P = 0.008 ), and the females' volumes did not correlated with their ages ( r = 0.041,P = 0.360 ).Conclusion There are gender differences in the fourth ventricle volumes of normal Chinese adults, and changes of the fourth ventricle volume with aging are different between males and females.     

中国汉族正常成人第四脑室容积的高分辨率MRI测量

Objective To explore the normal range of the fourth ventricle volume of Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range= 18 to 70) recruited from 15 hospitals were divided into 5 groups, i.e., Group A (age range = 18 to 30),B (age range =31 to 40), C (age range =41 to 50), D (age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of the fourth ventricle were measured at sagittal view by automatic trace of Midobl.2 combined with manual outlining.The difference of volumes of the fourth ventricle between male and female were analyzed by independent sample t test, and among age groups by ANOVA.Pearson's correlation coeffcient was used to characterize the relationship between volumes of the fourth ventricle and age.Results The fourth ventricle volumes of Group A-E were (2.1±0.9), (2.1±0.8), (2.2±0.8), (2.1±1.0) and (2.4±0.8) ml respectively for male; those for female were(2.0±0.7), (1.9±0.6), (18±0.6), (1.9±0.7) and (2.0±0.6) ml respectively.The fourth ventricle volumes of males were significantly larger than those of females ( t = 5.573, P =0.000 ) ; there were no significant differences among the female groups ( F = 1.788, P = 0.130 ) ; there were significant differences among the male groups ( F = 2.639, P = 0.033 ) and multiple comparison found that the 60 years old was the watershed with significant difference ( P < 0.05 ).Correlation between the change of males' volumes and the ages was not strong (r = 0.119, P = 0.008 ), and the females' volumes did not correlated with their ages ( r = 0.041,P = 0.360 ).Conclusion There are gender differences in the fourth ventricle volumes of normal Chinese adults, and changes of the fourth ventricle volume with aging are different between males and females.     

99Tcm-MIBI显像评价非小细胞肺癌三维适形放疗疗效的临床研究

Objective To explore whether the degree of 99Tcm-methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) could be correlated with the treatment response to three-dimensional conformal radiotherapy.Methods A total of 102 patients with NSCLC were studied with 99Tcm-MIBI SPECT before radiotherapy.The patients were classified by a follow-up CT as responders (complete or partial remission) and non-responders (stable or progressive disease).After intravenous administration of 740 MBq 99Tcm-MIBI, SPECT imaging at 10-30 min (early) and 2-3 h (delayed) were performed.Region of interest (ROI) was placed over the tumors and contralateral normal lung tissue.The uptake ratio of tumor to contralateral normal lung (T/N) was obtained from both early (ER) and delayed (DR) SPECT images.The retention index (RI) was measured as:RI = (DR - ER)/ER×100%.Statistical analysis was performed by two independent-sample t-test and Mann-Whitney U test using software SPSS 13.0.Results 99Tcm-MIBI uptake was significantly higher in responders than in non-responders:2.36 ±0.17 vs 1.82 ±0.14 (ER) and 2.48 ± 0.20 vs 1.94 ± 0.16 (DR), respectively (t = - 13.1,- 12.7, both P＜ 0.05).The median RI in the responders group was also significantly higher than that in the non-responders group (6.60% vs 5.13%, z = - 6.83, P ＜ 0.05).Conclusion ER, DR and RI of 99Tcm-MIBI SPECT might be useful to estimate the treatment response to three-dimensional conformal radiotherapy in patients with NSCLC.     

99Tcm-MIBI显像评价非小细胞肺癌三维适形放疗疗效的临床研究

Objective To explore whether the degree of 99Tcm-methoxyisobutylisonitrile (MIBI) uptake in non-small cell lung cancer (NSCLC) could be correlated with the treatment response to three-dimensional conformal radiotherapy.Methods A total of 102 patients with NSCLC were studied with 99Tcm-MIBI SPECT before radiotherapy.The patients were classified by a follow-up CT as responders (complete or partial remission) and non-responders (stable or progressive disease).After intravenous administration of 740 MBq 99Tcm-MIBI, SPECT imaging at 10-30 min (early) and 2-3 h (delayed) were performed.Region of interest (ROI) was placed over the tumors and contralateral normal lung tissue.The uptake ratio of tumor to contralateral normal lung (T/N) was obtained from both early (ER) and delayed (DR) SPECT images.The retention index (RI) was measured as:RI = (DR - ER)/ER×100%.Statistical analysis was performed by two independent-sample t-test and Mann-Whitney U test using software SPSS 13.0.Results 99Tcm-MIBI uptake was significantly higher in responders than in non-responders:2.36 ±0.17 vs 1.82 ±0.14 (ER) and 2.48 ± 0.20 vs 1.94 ± 0.16 (DR), respectively (t = - 13.1,- 12.7, both P＜ 0.05).The median RI in the responders group was also significantly higher than that in the non-responders group (6.60% vs 5.13%, z = - 6.83, P ＜ 0.05).Conclusion ER, DR and RI of 99Tcm-MIBI SPECT might be useful to estimate the treatment response to three-dimensional conformal radiotherapy in patients with NSCLC.     

中国汉族正常成人颞叶体积的高分辨率MRI测量

Objective To explore the morphological features of temporal lobe of healthy Chinese Han adults on the high-resolution MRI and provide morphological data of temporal lobe for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.Three hundred healthy Chinese volunteers (male 150, and female 150) recruited from 15 hospitals were divided equally into five groups according to their age, i.e., 18-30 ( Group A ), 31-40 ( Group B ), 41-50 ( Group C ), 51-60(Group D), 61-70( Group E).All subjects were scanned using T1WI 3D MPRAGE sequence and volumes of standardized temporal lobe were collected.The bilateral volumes of standardized temporal lobe were compared by variance analysis between male and female subjects and among five age groups.Results The mean volumes of left and right temporal lobe were (97 126±15 703) mm3 and (97 015±15 545) mm3 respectively for men, and (95 123±14 564) mm3 and (96 423±13 407) mm3 for women.The difference temporal lobe volume between male and female wasn't significant on the same side (F = 1.336, 0.127 ,P =0.249, 0.722).The left temporal lobe volumes of Group A-E were (93 873±13 351 ), (95 566±11 964), (10 1890±14 511 ), (93 972±14 050) and (95 636±19 864)mm3 respectively, and those on the right side were (93 409±10 984), (98 158±16 392), (102 079±15 112), (95 448±11 123 ) and (94 658±16 928) mm3.There were significant differences among 5 groups between left and right temporal lobe volume( F = 2.940, 3.514, P = 0.021, 0.008 ).Further pairwise comparison revealed that left and right temporal lobe volume in Group C is higher than those of Group A and D(P<0.05), while there were no significant differences between the other groups ( P > 0.05 ).Conclusion High-resolution MRI could offer detailed images and precise morphological data of temporal lobe, which provides morphological data of temporal lobe for the construction of database for Chinese Standard Brain.     

中国汉族正常成人岛叶体积的高分辨率MRI测量

Objective To explore the normal range of the insula volume of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range = 18 to 70) recruited from 16 hospitals were divided into 5 groups, i.e.,Group A ( age range = 18 to 30), B ( age range = 31 to 40 ), C ( age range = 41 to 50 ), D ( age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of bilateral insula were manually measured.The volume of bilateral insula were compared by paired sample t test.The insula volumes were compared between male and female by independent sample t test, and the differences among 5 age groups were compared by one-way ANNOVA.The relationship between the volumes of insula and age,sex or cerebral volume were analyzed using bivariate correlation, respectively.Results The left snd right side volume of insula before standarized were (7764±1165) and (7387±1128) mm3 respectively, after standarized were (8413±1201 ) and (7871±1140) mm3 respectively.The left insula volume were significant larger than that of right(t = - 10.565, - 16.014,P <0.01 ).The left and fight volume of insula were (8146±1181 ) and (7735±1113) mm3 for male, and (7393±1022) mm3 and (7050±1038) mm3for female.The left and right insula volumes for male were larger than the female's(t = 10.934,9.945 ,P <0.01 ).The left and right insula volume of male after standarized were (8779±1230 ) and (8224±1081 )mm3, female were (8043±1054) and (7515±1091 ) mm3 ,the left and right insula volume of male were larger than the female's ( t = 4.858,4.632, P < 0.01 ).The left insula volumes among Group A, B, C, D,E before standarized were ( 8268±1221 ), ( 8067±1107 ), ( 7869±1109), ( 7603±1111 ), ( 6997±934 )mm3 respectively,the right were (8028±1156), (7636±1075), (7294±986), (7249±1068), (6717±916) mm3 respectively, there were significant differences among 5 groups between left and right insula volume(F= -0.361,-0.337,P <0.01 ).The left insula volume of A,B,C,D,E after standarized were ( 9093±1105 ), ( 8679±965 ), ( 8810±1136), ( 8202±980), ( 7273±940 )mm3, the right were ( 8694±1005), (8136±1100), (8034±910), (7496±990), (6989±932) mm3, there were significant differences among 5 groups between left and right insula volume(F = -0.490, -0.512,P < 0.01 ).There was significant negative correlation between the volume and age ( before standarizded:r = -0.361, -0.337, after standardized r = -0.490, -0.512, P<0.05).Before and after standardized, there was significant correlation between the volume of right and left insula and cerebral volume ( r = 0.470,0.459, P < 0.05 ).Before and after standardized, there was significant correlation between the volume of right and left insula and weight( r = 0.141, 0.092, P < 0.05 ).Conclusions 1.5 T MR scanner has high resolution, for distinguishing the white matter from the gray matter, and provide morphological data of insula for the construction of database for Chinese Standard Brain.     

中国汉族正常成人岛叶体积的高分辨率MRI测量

Objective To explore the normal range of the insula volume of Chinese adults of the Han nationality and its relationship with age, which provide morphological data for the construction of database for Chinese Standard Brain.Methods This is a clinical multi-center study.One thousand Chinese healthy volunteers (age range = 18 to 70) recruited from 16 hospitals were divided into 5 groups, i.e.,Group A ( age range = 18 to 30), B ( age range = 31 to 40 ), C ( age range = 41 to 50 ), D ( age range =51 to 60), and E (age range =61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.After three dimension data reconstruction, the volumes of bilateral insula were manually measured.The volume of bilateral insula were compared by paired sample t test.The insula volumes were compared between male and female by independent sample t test, and the differences among 5 age groups were compared by one-way ANNOVA.The relationship between the volumes of insula and age,sex or cerebral volume were analyzed using bivariate correlation, respectively.Results The left snd right side volume of insula before standarized were (7764±1165) and (7387±1128) mm3 respectively, after standarized were (8413±1201 ) and (7871±1140) mm3 respectively.The left insula volume were significant larger than that of right(t = - 10.565, - 16.014,P <0.01 ).The left and fight volume of insula were (8146±1181 ) and (7735±1113) mm3 for male, and (7393±1022) mm3 and (7050±1038) mm3for female.The left and right insula volumes for male were larger than the female's(t = 10.934,9.945 ,P <0.01 ).The left and right insula volume of male after standarized were (8779±1230 ) and (8224±1081 )mm3, female were (8043±1054) and (7515±1091 ) mm3 ,the left and right insula volume of male were larger than the female's ( t = 4.858,4.632, P < 0.01 ).The left insula volumes among Group A, B, C, D,E before standarized were ( 8268±1221 ), ( 8067±1107 ), ( 7869±1109), ( 7603±1111 ), ( 6997±934 )mm3 respectively,the right were (8028±1156), (7636±1075), (7294±986), (7249±1068), (6717±916) mm3 respectively, there were significant differences among 5 groups between left and right insula volume(F= -0.361,-0.337,P <0.01 ).The left insula volume of A,B,C,D,E after standarized were ( 9093±1105 ), ( 8679±965 ), ( 8810±1136), ( 8202±980), ( 7273±940 )mm3, the right were ( 8694±1005), (8136±1100), (8034±910), (7496±990), (6989±932) mm3, there were significant differences among 5 groups between left and right insula volume(F = -0.490, -0.512,P < 0.01 ).There was significant negative correlation between the volume and age ( before standarizded:r = -0.361, -0.337, after standardized r = -0.490, -0.512, P<0.05).Before and after standardized, there was significant correlation between the volume of right and left insula and cerebral volume ( r = 0.470,0.459, P < 0.05 ).Before and after standardized, there was significant correlation between the volume of right and left insula and weight( r = 0.141, 0.092, P < 0.05 ).Conclusions 1.5 T MR scanner has high resolution, for distinguishing the white matter from the gray matter, and provide morphological data of insula for the construction of database for Chinese Standard Brain.     

99Tcm-N-NOET负荷和延迟门控心肌灌注显像对高血压患者的临床价值

Objective To investigate clinical significance of the 99Tcm-bis (N-ethoxy-N-ethyl-dithiocarbamato) nitridotechnetium(99Tcm-N-NOET) exercise and delayed myocardial perfusion imaging (MPI) in hypertensive patients. Methods Sixty patients with hypertension and 19 normal subjects were carried out 99Tcm-N-NOET exercise and delayed MPI, and analyzed the results of MPI, exercise electrocardiography (ECG), cardiac function parameters end-diastolic volume(EDV), end-systolic volume(ESV), left ventricular ejection fraction(LVEF), △ LVEF (LV EF exercis-LVEF delay) and coronary angiography(CAG). Results ① Sixty patients with hypertension, 22 cases(36.7%)of exercise ECG were abnormal, 16 cases (26.7%)were the chest tightness in exercise, 13 cases (21.7%) were blood pressure excessive reaction in exercise; control group, 2 cases (10.5%) of exercise ECG were abnormal, 1 case (5.3%, 1/19) was chest tightness in exercise,no per-son was blood pressure response in excessive. ②The positive rate of myocardial perfusion in hyper tensive group was significantly higher than the control group (31.75％ vs.5.30％, P<0.05). ③Cardial function parameters in hypertension group [exercise EDV =(79.75 ±29.10)ml, ESV =(28.82 ± 15.73)ml, LVEF =(65.78 ±1.27)%; delay EDV=(81.42±3.47)ml, ESV=(30.62±2.05)ml, LVEF=(64.20±9.70)%] and control group[exercise EDV=(79.63 ±21.65)ml, ESV=(27.37±10.71)ml, LVEF=(66.42±1.55)%; delay EDV=(82.89±4.96)ml,ESV=(31.42±3.06)ml, LVEF=(63.16 ±7.54)%] were no statistical difference(exercise EDV: t=0.161, ESV: t=0.112, LVEF: t=0.261; delay EDV: t=0.276, ESV: t=0.197, LVEF: t=0.184, P>0.05), △ LVEF<0%, 28 cases (46.7%) in hypertension group, 4 cases (21.1%) in control group, χ2=3.929, P<0.05; 11 cases (57.9%) in MPI positive group, 12 cases (29.3％) in MPI negative group, χ2=4.501, P<0.05. ④Nineteen hypertension underwent CAG, 11 cases were abnormal, 8 cases were normal. MPI results: 9 cases were ischemia, 10 cases were normal, and they were no statistical difference (χ2=0.25, P>0.05). The sensitivity,specificity and accuracy of 99Tcm-N-NOET MPI were 72.7％, 87.5％ and 78.9％. Conclusions ①99Tcm-N-NOET exercise and delayed MPI can diagnose whether hypertension patients with myocardial ischemia or not. ② △ LVEF of hypertensive patients reduced, △ LVEF is lower in hypertensive patients of MPI-positive.     

64层螺旋CT肺动脉成像低管电压设置结合个体化对比剂应用的对照研究

Objective To investigate the feasibility of the low tube voltage setting and personalized contrast agent application in 64-row multi-slice spiral CT pulmonary angiography.Methods Ninety patients with high risk of pulmonary artery embolism were sequentially enrolled in the study and divided into 3 groups employing completely randomized design: (1) Regular group included 30 patients using 120 kV and fixed dose of 70 ml contrast agent, (2)Another 30 patients were in 120 kV group, using 120 kV and the contrast amount was determined according to the patient weight (1.0 ml/kg), (3) The remaining 30 patients were included in 100 kV group, using 100 kV and the contrast amount was also determined according to the patient weight(1.0 ml/kg).Administration of contrast agent was completed within 20 seconds for all the patients, followed by 20 ml of saline.The objective and subjective indexes for assessing CT image quality, CT dose index volume (CTDIvol) and effective received dose (ERD) were compared between 120 kV group and 100 kV group; then the contrast media volume, injection rate, objective CT image indexes and subjective indexes for image quality was compared between the 100 kV group and regular group.The variance analysis and post hoc test were employed for the statistical analysis.Results Compared with 120 kV group(3.4± 0.7), the image quality of 100 kV group(5.2±1.8)had higher noise(52.9%), but subjective index for the image quality demonstrated no differences(q=0.272 ,P=0.063)in mediastinum window while CTDIvol and ERD decreased for 34.9%[(9.5±0.0) vs (14.6±0.0) mGy]and 36.8%[(3.8±0.6) vs (2.4± 0.4) mSv].The mean CT values on pulmonary artery of 100 kV group[(269.2±54.7) HU]were 13.4% (31.8/237.4) higher than the 120 kV group[(237.4±62.9) HU], but there was no statistical differences eornpared to normal group(q=0.172,P=0.260).Conclusion Using low kV setting (100 kV) to reduce radiation dose is proved to be effective and feasible in 64-MSCT pulmonary angiography.Personalized contrast agent injection has clinical application value for specific patient group.     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Do Balance Board Training Programs Reduce the Risk of Ankle Sprains in Athletes?

Introduction Ankle sprains are the most common musculo-skeletal injury that occurs in athletes,particularly in sports that require jumping and landing on one foot such as soccer,and basketball(1-4).These injuries often result in significant time loss from participation,long-term disability,and have a major impact on health care costs and resources(5-8).     

High Intensity Interval Training:New Insights

KEY POINTS ·High-intensity interval training(HIT)is characterized by repeated sessions of relatively brief，intermittent exercise.often performed with an“a11 out”effort or at an intensity close to that which elicits peak oxygen uptake(i.e.，≥90%of VO2 peak).     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

Developmental validation of the PowerPlex(®) ESI 16 and PowerPlex(®) ESI 17 Systems: STR multiplexes for the new European standard

In response to the ENFSI and EDNAP groups’ call for new STR multiplexes for Europe, Promega^® developed a suite of four new DNA profiling kits. This paper describes the developmental validation study performed on the PowerPlex^® ESI 16 (European Standard Investigator 16) and the PowerPlex^® ESI 17 Systems. The PowerPlex^® ESI 16 System combines the 11 loci compatible with the UK National DNA Database^®, contained within the AmpFlSTR^® SGM Plus^® PCR Amplification Kit, with five additional loci: D2S441, D10S1248, D22S1045, D1S1656 and D12S391. The multiplex was designed to reduce the amplicon size of the loci found in the AmpFlSTR^® SGM Plus^® kit. This design facilitates increased robustness and amplification success for the loci used in the national DNA databases created in many countries, when analyzing degraded DNA samples. The PowerPlex^® ESI 17 System amplifies the same loci as the PowerPlex^® ESI 16 System, but with the addition of a primer pair for the SE33 locus. Tests were designed to address the developmental validation guidelines issued by the Scientific Working Group on DNA Analysis Methods (SWGDAM), and those of the DNA Advisory Board (DAB). Samples processed include DNA mixtures, PCR reactions spiked with inhibitors, a sensitivity series, and 306 United Kingdom donor samples to determine concordance with data generated with the AmpFlSTR^® SGM Plus^® kit. Allele frequencies from 242 white Caucasian samples collected in the United Kingdom are also presented. The PowerPlex^® ESI 16 and ESI 17 Systems are robust and sensitive tools, suitable for the analysis of forensic DNA samples. Full profiles were routinely observed with 62.5 pg of a fully heterozygous single source DNA template. This high level of sensitivity was found to impact on mixture analyses, where 54–86% of unique minor contributor alleles were routinely observed in a 1:19 mixture ratio. Improved sensitivity combined with the robustness afforded by smaller amplicons has substantially improved the quantity of data obtained from degraded samples, and the improved chemistry confers exceptional tolerance to high levels of laboratory prepared inhibitors.     

Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula （BSF）. Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types （A and B） of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7 （87.5%） of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple, safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. （J Intervent Radiol, 2007, 16： 253-257）     

Prevalence and severity of hip and groin pain in sub‐elite male football: a cross‐sectional cohort study of 695 players

The purpose of this study was twofold: (a) to investigate the prevalence of hip and groin pain in sub‐elite male adult football in Denmark and (b) to explore the association between prevalence and duration of hip and groin pain in the previous season with the Copenhagen Hip and Groin Outcome Score (HAGOS) in the beginning of the new season. In total 695 respondents from 40 teams (Division 1–4) were included. Players completed in the beginning of the new season (July–Sept 2011) a self‐reported paper questionnaire on hip and/or groin pain during the previous season and HAGOS. In total 49% (95% CI: 45–52%) reported hip and/or groin pain during the previous season. Of these, 31% (95% CI: 26–36%) reported pain for >6 weeks. Players with the longest duration of pain during the previous season had the lowest HAGOS scores, when assessed at the beginning of the new season, P < 0.001. This study documents that half of sub‐elite male adult football players report pain in the hip and/or groin during a football season. The football players with the longest duration of pain in previous season displayed the lowest HAGOS scores in the beginning of the new season.