Comparison of SPECT bone scintigraphy with MRI for diagnosis of meniscal tears

Background

Scintigraphy has been considered as competitive to MRI, but limited data are available on the accuracy of single photon emission tomography (SPECT) compared with MRI for the assessment of meniscal tears. Our objective was to assess the value of SPECT in comparison to MRI.

Methods

Between January 2003 and March 2004, sixteen patients were studied with both modalities and the accuracy rates of SPECT scan results, and MRI findings in the diagnosis of meniscal tears were compared. Arthroscopy was the gold standard.

Results

The respective sensitivity rate, specificity rate, and positive and negative predictive accuracies of MRI were 89%, 94%, 93%, and 79% and for SPECT those were 78%, 94%, 94%, and 88%. There was good agreement on the presence or absence of tears between two modalities (κ statistic = 0.699).

Conclusion

SPECT and MRI are both valuable imaging techniques. SPECT is a useful alternative when MRI is unavailable or unsuitable and it is beneficial when more possible accuracy is desired (such as when MRI results are either inconclusive or conflict with other clinical data).     

Expression of CD4 on peripheral blood granulocytes. a novel finding in a case of myelodysplastic syndrome in association with t(5;12)

Myelodysplastic syndromes (MDS) are associated with cell maturation defects that can manifest as abnormal surface antigen expression. We describe a patient with refractory anemia with excess blasts, who presented with infection and extensive dysplastic features in peripheral blood granulocytes. The granulocytes expressed CD11b, CD13, CD15, CD33, and CD43. The granulocytes also expressed CD4 antigen. Cytogenetic analysis showed a clonal t(5;12)(q33;p13). The patient improved on antibiotics with partial improvement in the dysplastic features. However, shortly after, the patient experienced paravertebral extramedullary blast transformation followed by a leukemia phase of acute monoblastic leukemia. The patient died a few days later. This is the first report describing anomalous expression of CD4 on granulocytes in MDS. Since the breakpoint on chromosome 12 is near the CD4 gene, which is mapped to 12p12, we hypothesize that dysregulation of the CD4 gene may have occurred resulting in its persistent expression on mature and maturing granulocytes.     

Evaluation of {beta}-endorphin and interleukin-6 in seminal plasma of patients with certain andrological diseases

Human semen contains large amounts of opioid peptides and cytokines.We have measured the concentrations of interleukin (IL)-6 in140 semen samples and of -endorphinin 77 semen samples. Themedian concentration of endorphinin seminal plasma from normozoospermicmen(n = 23) was 154.7 pg/ml (10th—90th percentiles, 42.0—774.6),and there was no significant difference in the -endorphin concentrationamong normozoospermic, oligozoospermic (n= 28), asthenozoospermic(n= 15), azoospermic(n= 4) and post-vasectomy (n= 7) samples.There was no correlation between -endorphin concentration andsperm characteristics, nor with blood hormones. Endorphinconcentration was lower in cases with immunelogical infertility,as revealed by a positive direct mixedantiglobulin reactiontest (n = 12) ( > 0.01), than inmatched controls. The medianconcentration of IL-6 insamples with normal sperm concentration,motility andmorphology with or without white blood cells (n=39) was 26.1 pg/ml (10th–90th percentiles, 7.3–172.3),and there was no significant difference in the IL-6 concentrationamong normozoospermic, oligozoospermic (n= 46),asthenozoospermic(n= 32), azoospermic (n= 13) and post-vasectomy (n= 10) samples.The IL-6 concentration was significantly higher in cases ofvaricocele (n= 22)without white blood cells in semen (P <0.001) than in matched controls without varicocele (n= 23).In addition, the IL-6 concentration was elevated (P < 0.0001)in cases with accessory sex gland inflammation (n= 40). IL-6concentration was positively correlated with white blood cellsin semen (n= 60, r = 0.59, P < 0.0001), but there was nocorrelation with -endorphin concentration. The IL-6 concentrationchosen to differentiate between cases with and without accessorygland inflammation was 45.3 pg/ml, with a specificity of 80.6%and a sensitivity of 92.5%. It is concluded that -endorphinin seminal plasma playsan immune suppressive role, and thatincreased IL-6 concentration may be related to testicular dysfunctionincases with varicocele. Furthermore, IL-6 is an accurate markerof accessory sex gland inflammation.     

Synthèse de macromères à base de chlorures de vinyle et de vinylidène au moyen de télomères

New macromers 4, 8, and 10, containing ester, alcohol, or acid functions, were prepared starting with vinyl chloride (CV) or vinylidene dichloride (CV₂). The telomer 1, resulting from CV₂ and CCI₄ was telomerized with allyl acetate and the product was transformed into the acrylate 4 by hydrolysis of the reaction product and subsequent esterification. Macromers 8 and 10 were prepared from CV by radical telomerization with thioglycolic acid (7) and 2-mercaptoethanol (9), respectively. Reactive double bonds were introduced into these macromers by reaction with acrylic acid, Vinyl chloroformate, methacryloyl chloride, or 2,3 -epoxypropyle methacrylate, leading to new macromers 12, 13, 14, and 15, respectively.     

The therapeutic effect of cerium oxide nanoparticle on ischaemia/reperfusion injury in rat testis

Testicular torsion is a dangerous urogenital disorder which is caused by twisting of spermatic cord, and unless immediate treatments happen at a proper time, oxidative stress, occurred during ischaemia reperfusion, finally leads to irreversible disintegration of testicular tissue. One of the first preventive lines is to administrate antioxidant factors. In the present study, we investigate the therapeutic effect of cerium oxide nanoparticle on the injury. We divided 45 rats into nine groups, subjected eight groups to testicular torsion–detorsion, injected different doses of cerium oxide nanoparticle into the peritoneum of six groups and analysed all the groups regarding spermatogenetic indices including sperm count, sperm viability and Johnson mean. Our results showed that cerium oxide nanoparticle can alleviate oxidative stress in testis, and this alleviation promotes the reproductive indices as the concentration of cerium oxide nanoparticles increases. The catalase-mimetic and superoxide dismutase-mimetic activities of cerium oxide nanoparticle are the most probable theories to explain the antioxidant effect of the nanoparticle.     

Outcomes of patients older than 55 years undergoing abdominoplasty after bariatric surgery

BackgroundBariatric surgery has become widely performed for treating patients with morbid obesity, and the age limits are being pushed further and further as the procedure proves safe. After massive weight loss, many of those patients seek body-contouring surgery for excess skin and fat.ObjectivesTo analyze the feasibility and the safety of abdominoplasty in patients older than 55 years old after bariatric surgery.SettingUniversity hospital medical center.MethodsWe performed a retrospective review of prospectively collected data from patients aged older than 55 years who had undergone abdominoplasty following massive weight loss due to a bariatric surgery at a single institution from 2004 to 2017. The data analyzed included age, gender, preoperative body mass index, associated interventions, co-morbidities, and postoperative complications.ResultsWe retrieved records for 104 patients; 85.6% percent of them were female, and the mean age was 60.1 ± 3.9 years old. Of the 104 patients, 21 (20.2%) underwent a sleeve gastrectomy and 77 (74%) underwent a Roux-en-Y gastric bypass. The mean interval between the bariatric surgery and the abdominoplasty was 33.6 ± 26.9 months. The mean preoperative weight and body mass index were 76.1 ± 14.5 kg and 28.9 ± 4.5 kg/m², respectively. A total complication rate of 20% was observed. The only factor significantly associated with postoperative morbidity was the associated procedure (P = .03), when we performed another procedure at the same time as the abdominoplasty. Complications included postoperative bleeding in 5 patients (4.8%), seromas in 5 patients (4.8%), surgical site infections in 12 patients (11.5%), and wound dehiscence or ischemia in 2 patients (1.9%). No mortality occurred.ConclusionAbdominoplasty can be safely performed in carefully selected patients older than 55 years old after weight loss surgery, and does not present increased morbidity or mortality. We recommend that surgeons avoid adding concomitant procedures when possible, to decrease the risk of complications. It is also important to look at the patient’s previous maximum BMI levels, as a higher maximum BMI can predict higher postoperative risks and longer hospital stays.     

Kidney recipients with allograft failure,transition of kidney care (KRAFT): A survey of contemporary practices of transplant providers

Kidney allograft failure and return to dialysis carry a high risk of morbidity. A practice survey was developed by the AST Kidney Pancreas Community of Practice workgroup and distributed electronically to the AST members. There were 104 respondents who represented 92 kidney transplant centers. Most survey respondents were transplant nephrologists at academic centers. The most common approach to immunosuppression management was to withdraw the antimetabolite first (73%), while only 12% responded they would withdraw calcineurin inhibitor (CNI) first. More than 60% reported that the availability of a living donor is the most important factor in their decision to taper immunosuppression, followed by risk of infection, risk of sensitization, frailty, and side effects of medications. More than half of respondents reported that embolization was either not available or offered to less than 10% as an option for surgical intervention. Majority reported that ≤50% of failed allograft patients were re-listed before dialysis, and less than a quarter of transplant nephrologists performed frequent visits with their patients with failed kidney allograft after they return to dialysis. This survey demonstrates heterogeneity in the care of patients with a failing allograft and the need for more evidence to guide improvements in clinical practice related to transition of care.     

Does the type of cryoprobe affect oncological and functional outcomes in men with clinically localized prostate cancer treated with primary whole gland prostate cryoablation?

Background:This study aimed to compare the oncological and functional outcomes of primary whole gland cryoablation of the prostate using the variable ice cryoprobe (V-Probe^®) and the conventional fixed-size ice probe.Materials and methods:We reviewed the Cryo On-Line Data Registry for men who were treated with primary whole gland prostate cryoablation from 2000 through 2017. A multivariate Cox proportional hazards model was used to compare timing to biochemical recurrence between the V-Probe^® and fixed-size ice probe after adjusting for preoperative prostate-specific antigen (PSA), neoadjuvant androgen deprivation therapy, preoperative Gleason score, and preoperative T stage.Results:A total of 1124 men were included. Median age, Gleason score, and pretreatment PSA were 70 years (interquartile range [IQR]: 65–74 years), 7 (IQR: 6–7) and 5.9 ng/mL (IQR: 4.6–8.1 ng/mL), respectively. The median follow-up time was 25.0 months (IQR: 11.2–48.6 months). V-Probes^® were used in 269 (23.9%) cases and fixed-size ice probes in 858 (76.1%) cases. After adjusting for clinical T stage, PSA, neoadjuvant androgen deprivation therapy and preoperative Gleason score, on the multivariate Cox regression model, we found that there was no significant difference between the type of probe and timing to biochemical recurrence (p = 0.35). On multivariate logistic regression, using the V-Probe^® was associated with a 91% increase in postoperative urinary retention compared to the fixed-size ice probe (p = 0.003).Conclusions:The use of the V-Probe^® versus conventional fixed-size ice probe was not associated with a difference in biochemical recurrence in patients undergoing primary cryoablation of the prostate.     

Natural Convection Heat Transfer in a Porous Cavity with Sinusoidal Temperature Distribution Using Cu/Water Nanofluid: Double MRT Lattice Boltzmann Method

In this study, natural convection flow in a porous cavity with sinusoidal temperature distribution has been analyzed by a new double multi relaxation time (MRT) Lattice Boltzmann method (LBM). We consider a copper/water nanofluid filling a porous cavity. For simulating the temperature and flow fields, D2Q5 and D2Q9 lattices are utilized respectively, and the effects of different Darcy numbers (Da) (0.001-0.1) and various Rayleigh numbers (Ra) ($10^3$-$10^5$) for porosity ($ε$) between 0.4 and 0.9 have been considered. Phase deviation ($θ$) changed from 0 to $π$ and the volume fraction of nanoparticles (Ø) varied from 0 to 6%. The present results show a good agreement with the previous works, thus confirming the reliability the new numerical method proposed in this paper. It is indicated that the heat transfer rate increases at increasing Darcy number, porosity, Rayleigh number, the volume fraction of nanoparticles and phase deviation. However, the most sensitive parameter is the Rayleigh number. The maximum Nusselt deviation is 10%, 32% and 33% for Ra=$10^3$, $10^4$ and $10^5$, respectively, with $ε = 0.4$ to $ε = 0.9$. It can be concluded that the effect of Darcy number on the heat transfer rate increases at increasing Rayleigh number, yielding a maximum enhancement of the average Nusselt number around 12% and 61% for Ra=$10^3$ and Ra=$10^5$, respectively.