To evaluate role of multiparametric-MRI as comprehensive technique for determining local staging of UB cancer and predicting histological grading of lymphadenopathy.
Materials and methods
Fifty patients diagnosed as cancer bladder prospectively included and mp-MRI data were interpreted. Multiparametric techniques included added role of high resolution T2 weighted images (HR T2WI), diffusion weighted MRI (DW-MRI) and dynamic contrast enhanced MRI (DCE-MRI). Accuracy of these techniques separately and in conjunction were evaluated using histopathological findings as reference gold standard. Diagnosis of bladder cancer was performed either clinically, through urine cytology or using other radiologic investigations including ultrasonography or computed tomography.
Results
Histopathological confirmation for local T staging done in 40 patients (80%) using cystoscopy/biopsy or from transurethral resection of bladder tumors (TURT) and in 10 patients (20%) from radical cystectomy. Metastatic lymphadenopathy was histopatholgically proved after radical cystectomy in 5 patients (10%), of them 3 were stage N1 and 2 were stage N2. Diagnostic accuracy of mp-MRI (88%) was superior to DW-MRI (82%), DCE-MRI (74%) and high resolution T2W-MRI (52%) in differentiating non-muscle invasive from muscle invasive and in differentiating organ-confined from non organ-confined tumors respectively. The agreement between the mp-MRI and histopathological staging were greater than DW-MRI (κ = 0.679), DCE-MRI (κ = 0.566) and high resolution T2W-MRI (κ = 0.274). Over staging decreased from (48%) using high resolution T2W or (26%) using DCE-MRI, or (18%) using DW to (12%) using multiparametric-MRI. Low ADC values and time-intensity curve were compared with histological grades and showed significant correlation. Size criteria of the lymph nodes, their restriction and low ADC values in DW-MRI suggest their metastatic nature.
Conclusion
Mp-MRI is comprehensive & effective tool for determining local T stages, and the histological grades of urinary bladder cancers. Also, it predicts nature & stages of local lymph nodes, exhibiting high diagnostic performance with excellent objectivity. 相似文献
Wolbachiae are bacterial endosymbionts of insects and many filarial nematodes whose products trigger inflammation in filarial infections. The dependence of the parasites on their endosymbionts has also led to the use of antibiotics directed against the Wolbachiae, therapy that has been demonstrated to have a profound salutary effect on filarial infections. The identification of Wolbachiae in Mansonella species has been conclusively shown for Mansonella ozzardi (Mo), but not for Mansonella perstans (Mp). Using primers known to amplify the 16S ribosomal DNA of other filarial Wolbachiae, an identical 1393bp band was found in all samples tested. Sequence analysis of these samples demonstrated a single consensus sequence for Mp Wolbachia 16S rDNA that was most similar to Wolbachia sequences from other filarial nematodes. When aligned with the only other Mansonella Wolbachia sequence (Mo) there were only 8 nucleotide differences in the 1369bp overlapping sequence. Phylogenetic dendrograms, examining the relationship of the Mp Wolbachia to other Wolbachia 16S rDNA, showed that the Wolbachia tracked almost identically to the 5S rRNA of their parasite host. Wolbachia surface protein (WSP) was also demonstrated in protein extracted from Mp-containing whole blood. In advance of a treatment trial of Mp, a method for the quantitation of Mp Wolbachia was developed and used to demonstrate not only a relationship between microfilarial numbers and Wolbachia copy numbers, but also to demonstrate the effect of antibiotic on ridding Mp of Wolbachia. 相似文献
There is increasing evidence supporting the notion that the contribution of sleep to consolidation of motor skills depends
on the nature of the task used in practice. We compared the role of three post-training conditions in the expression of delayed
gains on two different motor skill learning tasks: finger tapping sequence learning (FTSL) and visuomotor adaptation (VMA).
Subjects in the DaySleep and ImmDaySleep conditions were trained in the morning and at noon, respectively, afforded a 90-min nap early in the afternoon and were re-tested
12 h post-training. In the NightSleep condition, subjects were trained in the evening on either of the two learning paradigms and re-tested 12 h later following
sleep, while subjects in the NoSleep condition underwent their training session in the morning and were re-tested 12 h later without any intervening sleep. The
results of the FTSL task revealed that post-training sleep (day-time nap or night-time sleep) significantly promoted the expression
of delayed gains at 12 h post-training, especially if sleep was afforded immediately after training. In the VMA task, however,
there were no significant differences in the gains expressed at 12 h post-training in the three conditions. These findings
suggest that “off-line” performance gains reflecting consolidation processes in the FTSL task benefit from sleep, even a short
nap, while the simple passage of time is as effective as time in sleep for consolidation of VMA to occur. They also imply
that procedural memory consolidation processes differ depending on the nature of task demands.
J. Doyon and M. Korman contributed equally. 相似文献
Background/objective: The purpose of this study is to investigate the use of a more biologic parameter for evaluation of the effect of nuchal cord tightness; the study of blood flow in the umbilical arteries of nuchal cord using Doppler ultrasonography.
Methods: This prospective cohort study was conducted at Ain Shams University Maternity Hospital, Cairo, Egypt in the period between August 2015 and August 2017. Hundred primigravidas were recruited with nuchal cord diagnosed by Doppler ultrasonography; whereas the rest of the study population was included in the “Control group”. Doppler velocimetry study was then performed on a free-floating loop of the umbilical cord and Doppler indices were calculated. Both groups were followed up during labor: intrapartum events, mode of delivery, and neonatal outcome were recorded.
Results: Intrapartum fetal heart rate abnormalities were significantly more common in the nuchal cord group compared to the control group. The overall cardiotocography category was significantly more commonly reflecting abnormal fetal heart rate patterns in the nuchal cord group compared to the control group with 46.74% of the nuchal group patients falling within the “suspicious – pathological – need urgent intervention” categories. Intervention rate was significantly higher in the nuchal cord group than the control group (33.69 versus 21.84%). Moreover, incidence of intrapartum fetal heart rate abnormalities and intervention rate were significantly higher in the nuchal cord with abnormal Doppler subgroup compared to both nuchal cord with normal Doppler subgroup and the control group; with a calculated number needed to harm of 2.11.
Conclusions: In view of these results, it might be concluded that umbilical cord tightness affecting fetal hemodynamics (expressed by changes in umbilical artery Doppler) might be a determinate factor affecting the intrapartum course. 相似文献
Trains of electrical stimulations were applied to the dorsal or ventral part of the inferior colliculus (IC) of audiogenic seizure susceptible rats from the AGSR strain. Threshold and duration of wild running (WR), were evaluated in the first experiment. All stimulation sites elicited WR, even in normal control rats. Stimulation of the IC of AGSR rats required a lower quantity of current, i.e., such brain sites were more sensitive to the current, than normal controls. The duration of post-stimulus WR was shorter in AGSR rats. Lower quantities of current applied to the ventral IC were needed to elicit WR than to the dorsal IC in AGSR rats. In a second experiment, using the same stimulations sites in the same rats, the emotional effect of the stimulation was tested through an instrumental learning procedure (switch-off paradigm) in which the rat was trained to press a bar to put an end to the stimulation. Both dorsal and ventral IC stimulation sites sustained switch-off behavior in AGSR rats, but only ventral IC stimulation sites sustained switch-off learning in control rats. 相似文献
This study reports on the regulation and remodeling role of endothelin-1 (ET-1) and its receptor subtypes, ET(A)-Rs/ET(B)-Rs, at the coronary endothelium (CE) and cardiomyocyte (CM) sites. It is carried out in normal and normotensive rats with streptozotocin-induced diabetes mellitus receiving different treatment modalities. Normal rats were divided into two groups, namely a placebo (N) and a losartan-treated (NL), and diabetic rats into four groups receiving placebo (D), insulin-treated (DI), losartan-treated (DL), and insulin/losartan-treated (DIL) respectively. Binding kinetics of ET-1 to ET(A)-Rs/ET(B)-Rs on CE and CMs were assessed in the above groups to try to explain the effect of therapeutic doses of an angiotensin II receptor subtype-1 blocker on the dynamics of this ligand and its receptor in insulin supplemented diabetic animals. Each group was divided into two subgroups: CHAPS-untreated and CHAPS-treated rat hearts perfused with [125I]ET-1 to respectively estimate ET-1 binding affinity (tau = 1/k-n) to its receptor subtype(s) on CE and CMs using mathematical modeling describing a 1:1 reversible binding stoichiometry. Heart perfusion results revealed that insulin treatment significantly decreased tau on CE but not on CMs in diabetic rats. In diabetics treated with losartan, an increase in tau value on CE but not on CMs was noted. Cotreatment of diabetic rats with insulin and losartan normalized tau on CE but decreased it on CMs. Western blot, using snap-frozen heart tissues, revealed increase in ET(A)-R density in all diabetic groups. However, significant decrease in ET(B)-R density was observed in all groups compared to the normal, and was reconfirmed by immunohistochemical analysis. In conclusion, coadministration of insulin and losartan in nonhypertensive animals suffering from diabetes type 1 may offer new cardiac protection benefits by improving coronary blood flow and cardiomyocyte contractility through modulating ET-1 receptor subtypes density and affinity at CE and CM sites. 相似文献