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Ferdynand Hebal Elissa Port Catherine J. Hunter Bryan Malas Jared Green Marleta Reynolds 《Journal of pediatric surgery》2019,54(4):656-662
Background/purpose
Computed tomography (CT) derived Haller Index (HI) remains the standard for quantifying severity in patient with pectus excavatum (PE). Optical scanning described in literature reports optimistic results and new indices that correlate with HI. This study assessed the feasibility of a handheld White Light Scanner (WLS) to obtain 3D measurements and indices of PE deformity.Methods
From April 2015–April 2017, WLS scanning was conducted by orthotists during clinical visits. Included were children with PE up to 18?years. Analysis assessed correlation of a WLS-derived severity index, Hebal-Malas Index (HMI), with physician measured PE Depth (PED), and CT-derived HI.Results
Of 195 participants, 185(94%) patients with PE were scanned and 127(69%) had complete WLS data. For 88 patients undergoing monitoring, HMI correlated with PED (r?=?0.42, p?=?0.004). For 39 patients with pre-operative CT, HMI demonstrated strong correlation with HI (r?=?0.87, p < 0.0001).Conclusions
WLS demonstrated high feasibility of scanning PE. WLS-derived HMI best correlates with HI for patients with severe pectus deformity. Our current data is suggestive that WLS is best applied for severe deformities and yet to be established for milder deformities. Future yearly WLS will provide data on deformity progression and surgical therapy.Level of Evidence
IV.Type of Study
Diagnostic Study. 相似文献4.
Cardiac imaging in the evaluation of patients presenting to the emergency department with chest pain
Conclusions Despite the utility and benefits that each imaging modality has to offer, it is easy to see why there is still no perfect
choice for a noninvasive cardiac imaging modality to assist in the management of chest pain patients. All of the current imaging
techniques have their own significant strengths and weaknesses when compared with other modalities. SPECT and echocardiography
are wellestablished technologies that can directly assess the presence of myocardial ischemia and its functional consequence
on RF; newer and more expensive techniques such as MDCT and CMR can directly assess coronary anatomy and have just started
to be evaluated in the acute chest pain setting. There are no studies that directly compare these technologies, and more data
are clearly needed before the question of whether anatomic imaging versus perfusion/function imaging is the better approach
can be answered. Other comparisons such as relative safety, availability, logistics, and cost-effectiveness between the various
technologies are also lacking.
Of all of the imaging modalities discussed, MCE is the only portable technology. The images do not require expensive software
or other technology for offline processing before interpretation, and any trained cardiologist can read the study at the bedside
or, potentially, over the Internet, providing near-instantaneous results in the acute cardiac setting, where time is of the
essence.
MCE is also relatively cheap compared with other technologies, a potential advantage for payors but not necessarily for payees.
How reimbursement rates and fee structures eventually affect clinical practice is also unknown.
Despite these and other questions that need to be answered before any one technique will be used exclusively, the future of
noninvasive cardiac imaging remains an exciting and ever-changing field. The adaptation of any one of these techniques into
its proper role in the ED Journal of Nuclear Cardiology Wyrick and Wei 753 Volume 13, Number 6;749-55 Cardiac imaging in patients
with chest pain will take considerably more time and effort in terms of research, money, and time-tested clinical experience. 相似文献
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Pawan Kumar Dhruva Rao Deborah Clements Michael M. Davies Jared Torkington 《Surgical endoscopy》2007,21(6):1036
We present our comments on the above article. 相似文献
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Metaphase and anaphase analysis of V79 cells exposed to erionite, UICC chrysotile and UICC crocidolite 总被引:2,自引:0,他引:2
The cytogenetic effects of erionite treatment of V79 cells werecompared with those of UICC crocidolite and UICC chrysotiletreatment. A significant reduction in diploid cells with anaccompanying increase in aneuploid and polyploid cells was observedwith all three treatments. In the erionite-treated cultures,an increase in aneuploid was observedy at all dose levels rangingfrom 10 to 100 µg/ml, whereas in the crocidolite- andchrysotile-treated cultures, significant increases in aneuploidywere observed at all dose levels except the low dose, 10 µg/ml.Chromatid aberrations were observed in cultures treated withcrocidolite and chrysotile and were especially pronounced atdose 100 µg/ml of chrysotile. The clastogenic effect oferionite was weaker but statistically significant at dose 100µg/ml. An extrapolation of these cytogenetic changes overdose in number of fibers suggests that erionite was more reactivethan the other two minerals in producing aneuploidy. The numberof fibers required to produce a similar degree of cytogeneticeffects was several orders of magnitude higher for chrysotileand crocidolite than erionite. These results correlate withthe higher tumorigenic potency of erionite. In general, fewercells treated with erionite entered anaphase than those treatedwith the other two minerals. As a result, abnormal anaphasesrepresenting chromosomal mis-segregation were observed onlyin the chrysotile- and crocidolite-treated cultures. To ourknowledge, this is the first report on cytogenetic effects oferionite. 相似文献
8.
Radiotherapy has been successful in treating localized prostate cancer; however, a subset of patients will experience disease
recurrence. Determination of the recurrence location must be made using pretreatment and posttreatment clinical variables,
imaging, and postradiotherapy biopsy. Patients presumed to have local-only recurrence, optimal clinical risk factors, and
an extended life expectancy may be considered for salvage local treatment. Current options include salvage surgery, cryoablation,
and brachytherapy. Although they are associated with higher morbidity than primary therapy, salvage treatments can be effective
and can still provide patients with a good oncologic and functional outcome. As these modalities continue to improve and patient
selection is optimized, better results will evolve. 相似文献
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Our purpose was to determine the effects of six cigarette toxicants (pyridine, nicotine, 2-ethylpyridine, 3-ethylpyridine, p-cresol, and pyrazine) on three types of cultured mammalian cells (human umbilical vein endothelial cells [HUVECs], human microvascular endothelial cells [HMVECs], and NIH 3T3 cells) using a cell proliferation/survival assay. Synchronized cells were cultured in proliferation or survival medium containing various doses (10(-18)M-10(-2)M) of the tested chemicals. After 48 h, cells were counted using a hemacytometer. The no observable adverse effect level (NOAEL), lowest observable adverse effect level (LOAEL), and the efficacy were determined for each compound in the cell proliferation and survival assays. Pyridine and p-cresol did not show significant effects with any cell types, except at high doses. Derivitization of the pyridine ring altered its potency, especially when an ethyl group or nitrogen was added. In survival medium, nicotine stimulated proliferation of all three cell types at doses found in smoker's serum (10(-8)M-10(-7)M). For HUVEC and HMVEC, 2-ethylpyridine, 3-ethylpyridine, and pyrazine inhibited proliferation in proliferation medium and induced cell death in survival medium at attomolar and femtomolar doses. All chemicals, except pyridine and pyrazine, stimulated NIH 3T3 cell proliferation at low doses and induced cell death at high doses. LOAELs and efficacies revealed that endothelial cells from a developing organ (umbilical cord) were more sensitive to these chemicals than endothelial cells from an adult organ (lung). 3-Ethylpyridine and pyrazine, which induced cell death at low doses, are added to consumer products and should be subjected to further toxicological testing. 相似文献