Risk and significance of endoscopic/radiological evidence of recurrent Crohn's disease

BACKGROUND & AIMS: The aim of this study was to determine the risk of endoscopic/radiological recurrence of Crohn's disease postoperatively and the long-term outcome. METHODS: A randomized placebo-controlled trial was performed to determine the effectiveness of mesalamine in preventing recurrent Crohn's disease postoperatively. Patients in the control group were examined endoscopically/radiologically before entry into and annually during the trial. Findings were classified as minimal or severe. RESULTS: There were 76 patients (49 men and 37 women; mean age, 37.1 +/- 13.2 years). Fifty (61.7%) had terminal ileal resections. Overall, 55 endoscopic/radiological recurrences were observed in 51 patients (67.1%). Expressed actuarially, the recurrence rate was 27.5% at 1 year (95% confidence interval [CI], 15.8%-37.6%), 60.8% at 2 years (95% CI, 46%-71.3%), and 77.3% at 3 years (95% CI, 62.7%-86.3%). Nineteen (37%) were symptomatic and 12 (24%) were initially asymptomatic but later became symptomatic (mean, 13.0 +/- 8.8 months), whereas 20 (39%) remained asymptomatic (mean, 16.9 +/- 17.4 months). Patients with severe endoscopic/radiological disease were significantly more likely to be or become symptomatic than those with minimal disease (23 of 32 vs. 8 of 19, respectively; P = 0.0437). CONCLUSIONS: This study suggests that postoperative endoscopic/radiological recurrences occur later than previously reported. Furthermore, many of these patients, especially with minimal disease, will remain asymptomatic. (Gastroenterology 1997 Dec;113(6):1823-7)     

利福昔明：有效维持肝性脑病缓解

肝性脑病是的一种慢性消耗性的肝硬化并发症。利福昔明（rifaximin）,一种口服的抗生素,治疗急性肝性脑病的疗效已有报道,但其预防此病疗效未知。     

Massage therapy after heart surgery: possibly pleasant,but not effective

Albert NM, Gillinov AM, Lytle BW, Feng J, Cwynar R, Blackstone EH. A randomized trial of massage therapy after heart surgery. Heart Lung 2009; 38: 480–90.     

Kinetics and 28-day test–retest repeatability and reproducibility of [11C]UCB-J PET brain imaging

[¹¹C]UCB-J is a novel radioligand that binds to synaptic vesicle glycoprotein 2A (SV2A). The main objective of this study was to determine the 28-day test–retest repeatability (TRT) of quantitative [¹¹C]UCB-J brain positron emission tomography (PET) imaging in Alzheimer’s disease (AD) patients and healthy controls (HCs). Nine HCs and eight AD patients underwent two 60 min dynamic [¹¹C]UCB-J PET scans with arterial sampling with an interval of 28 days. The optimal tracer kinetic model was assessed using the Akaike criteria (AIC). Micro-/macro-parameters such as tracer delivery (K₁) and volume of distribution (V_T) were estimated using the optimal model. Data were also analysed for simplified reference tissue model (SRTM) with centrum semi-ovale (white matter) as reference region. Based on AIC, both 1T2k_V_B and 2T4k_V_B described the [¹¹C]UCB-J kinetics equally well. Analysis showed that whole-brain grey matter TRT for V_T, DVR and SRTM BP_ND were –2.2% ± 8.5, 0.4% ± 12.0 and –8.0% ± 10.2, averaged over all subjects. [¹¹C]UCB-J kinetics can be well described by a 1T2k_V_B model, and a 60 min scan duration was sufficient to obtain reliable estimates for both plasma input and reference tissue models. TRT for V_T, DVR and BP_ND was <15% (1SD) averaged over all subjects and indicates adequate quantitative repeatability of [¹¹C]UCB-J PET.     

Magnetic resonance imaging and spectroscopy of hepatic iron overload

Experimental animals that had been given excess iron in their diet were studied by magnetic resonance (MR) imaging in vivo and by magnetic resonance (MR) spectroscopy in vitro. Hepatic iron overload in patients with transfusional iron excess was studied by MR imaging, and isolated iron protein fractions were studied in vitro by MR spectroscopy. The spin echo image intensity of livers with iron overload was decreased because of the extreme decreases in T2 compared with normal; T1 was decreased only moderately. The relaxation rates 1/T2 and 1/T1 both showed a linear relationship to hepatic iron levels. Ferritin solutions showed moderate decreases in T2 and mild decreases in T1. The T2 relaxivity of ferritin, which is due to the iron core rather than the apoferritin protein shell, does not appear sufficient to account for the extreme decrease in T2 observed in hepatic iron overload. Low molecular weight cytosol iron is present in lower concentrations than ferritin but potentially has much greater relaxivity and may contribute to the MR findings. These techniques may be useful in other studies of iron metabolism.     

Computer simulation in conjunction with medical thermography as an adjunct tool for early detection of breast cancer

Background

Mathematical modelling and analysis is now accepted in the engineering design on par with experimental approaches. Computer simulations enable one to perform several 'what-if' analyses cost effectively. High speed computers and low cost of memory has helped in simulating large-scale models in a relatively shorter time frame. The possibility of extending numerical modelling in the area of breast cancer detection in conjunction with medical thermography is considered in this work.

Methods

Thermography enables one to see the temperature pattern and look for abnormality. In a thermogram there is no radiation risk as it only captures the infrared radiation from the skin and is totally painless. But, a thermogram is only a test of physiology, whereas a mammogram is a test of anatomy. It is hoped that a thermogram along with numerical modelling will serve as an adjunct tool. Presently mammogram is the 'gold-standard' in breast cancer detection. But the interpretation of a mammogram is largely dependent on the radiologist. Therefore, a thermogram that looks into the physiological changes in combination with numerical simulation performing 'what-if' analysis could act as an adjunct tool to mammography.

Results

The proposed framework suggested that it could reduce the occurrence of false-negative/positive cases.

Conclusion

A numerical bioheat model of a female breast is developed and simulated. The results are compared with experimental results. The possibility of this method as an early detection tool is discussed.

     

Contaminant Loading in Drainage and Fresh Water Used for Wetland Management at Stillwater National Wildlife Refuge

Throughout the western United States, studies have identified various detrimental effects of contaminants to aquatic biota from the use of agricultural drainage water for management of arid wetlands. However, little is known about the relative contributions of contaminant loading from pollutants dissolved in water compared with those carried by drifting material (e.g., detritus) associated with drainage water. Consequently, we determined loading rates for contaminants dissolved in water and those incorporated by drifting material for drainage (Diagonal Drain) as well as fresh (S-Line Canal) water used for wetland management at Stillwater National Wildlife Refuge (SNWR), Nevada during the early, middle, and late periods of the irrigation season (June through mid-November) in 1993. We found loading rates for trace elements throughout the irrigation season were almost entirely (> 98%) associated with contaminants dissolved in the water rather than incorporated by drift. Although drift contributed little to the total loading for trace elements to SNWR wetlands, contaminant concentrations were much greater in drift compared with those dissolved in water. Loading rates for dissolved As, B, Hg, and total dissolved solids (TDS) differed among periods for the Diagonal Drain. Along the Diagonal Drain, loading rates for dissolved As, B, Hg, Mo, unionized ammonia (NH₃-N), TDS, and Zn differed among its three sampling sites. B was the only trace element with differences in loading rates for drift among periods from the Diagonal Drain. In contrast, loading rates for As, B, Cr, Cu, Hg, Se, and Zn in drift differed among periods for the S-Line Canal. Along Diagonal Drain, loading rates in drift for B (middle and late periods), Cr, Cu, and Zn differed among sites. Hg (xˉ ≥ 12.0 ng/L) and NH₃-N (xˉ ≥ 0.985 mg/L) dissolved in water as well as B (xˉ ≥ 97.4 μg/g DW) and Hg (xˉ ≥ 0.461 μg/g DW) in drift from the Diagonal Drain and S-Line Canal exceeded screening levels (SLs) for protection of aquatic biota throughout the irrigation season. Dissolved As (xˉ ≥ 0.0426 mg/L) in water from the Diagonal Drain during all periods exceeded the SL for protection of aquatic biota. Dissolved B (xˉ = 1.03 mg/L) in water from the Diagonal Drain during the early period exceeded the SL for protection of aquatic biota. Received: 18 September 1997/Accepted: 5 February 1998