Differentiating autoimmune pancreatitis from pancreatic ductal adenocarcinoma with CT radiomics features

PurposeThe purpose of this study was to determine whether computed tomography (CT)-based machine learning of radiomics features could help distinguish autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC).Materials and MethodsEighty-nine patients with AIP (65 men, 24 women; mean age, 59.7 ± 13.9 [SD] years; range: 21–83 years) and 93 patients with PDAC (68 men, 25 women; mean age, 60.1 ± 12.3 [SD] years; range: 36–86 years) were retrospectively included. All patients had dedicated dual-phase pancreatic protocol CT between 2004 and 2018. Thin-slice images (0.75/0.5 mm thickness/increment) were compared with thick-slices images (3 or 5 mm thickness/increment). Pancreatic regions involved by PDAC or AIP (areas of enlargement, altered enhancement, effacement of pancreatic duct) as well as uninvolved parenchyma were segmented as three-dimensional volumes. Four hundred and thirty-one radiomics features were extracted and a random forest was used to distinguish AIP from PDAC. CT data of 60 AIP and 60 PDAC patients were used for training and those of 29 AIP and 33 PDAC independent patients were used for testing.ResultsThe pancreas was diffusely involved in 37 (37/89; 41.6%) patients with AIP and not diffusely in 52 (52/89; 58.4%) patients. Using machine learning, 95.2% (59/62; 95% confidence interval [CI]: 89.8–100%), 83.9% (52:67; 95% CI: 74.7–93.0%) and 77.4% (48/62; 95% CI: 67.0–87.8%) of the 62 test patients were correctly classified as either having PDAC or AIP with thin-slice venous phase, thin-slice arterial phase, and thick-slice venous phase CT, respectively. Three of the 29 patients with AIP (3/29; 10.3%) were incorrectly classified as having PDAC but all 33 patients with PDAC (33/33; 100%) were correctly classified with thin-slice venous phase with 89.7% sensitivity (26/29; 95% CI: 78.6–100%) and 100% specificity (33/33; 95% CI: 93–100%) for the diagnosis of AIP, 95.2% accuracy (59/62; 95% CI: 89.8–100%) and area under the curve of 0.975 (95% CI: 0.936–1.0).ConclusionsRadiomic features help differentiate AIP from PDAC with an overall accuracy of 95.2%.     

TEN YEARS' EXPERIENCE IN LOW VISION PRACTICE

The Low Vision Clinic at the Palmerston North Hospital has now been oerating for 70 years. Over the course of these ten years a number of factors have emerged which can be as readily applied to general ophthalmological practice as to low vision practice. The philosophy of low vision care is one of which all ophthalmologists should be aware and includes factors to be taken into account when dealing with children, people in the workplace, and everyday factors involved in daily living activities, all of which are equally relevant in routine ophthalmological practice. This paper endeavours to share some thoughts on these factors and also discusses means by which the visually handicapped can be helped in areas where specialist low vision services are not readily available.     

Inhibitory effect of human blood granulocyte glycosaminoglycans on colony-forming activity of bone marrow fibroblasts

Inhibitory effect of glycosaminoglycans isolated from peripheral blood granulocytes of patients with chronic myeloleukemia and normal subjects on increment in colony-forming units of fibroblasts in monolayer cultures of rat bone marrow is determined by the degree of sulfation of their main component chondroitin-4-sulfate and by increased content of heparan sulfate. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 125, No. 3, pp. 319–322, March, 1998     

电刺激黑质对脑干伤害性单位放电的影响

本实验采用单细胞外记录神经元单位放电的方法，在Ｗｉｓｔａｒ大鼠上观察到网状巨细胞核。一区伤害性神经元５７个，其中伤害兴奋性神经元（ＮＥＮ）４２个，伤害抑制性神经元（ＮＩＮ）１５个。电刺激黑质对ＮＥＮ（２９）和ＮＩＮ（８的放电呈抑制作用，其反应百分率分别由刺激黑质第１分钟时的１．０±２．１％和－２０．４±６．２％，降到第５分钟时的－８３．６±１２．３％和－６５．４±１０．７％（Ｐ＜０．０１）。刺激黑质对少数ＮＥＮ（１３）和ＮＩＮ（７）的放电有兴奋作用，其值分别由第］分钟时的２０．５±７．３％和１．０±３．４％，升高到第５分钟时的７４．５±１０．７％和２１，５±８．６％（Ｐ＜０．０５）。氟哌啶醇注入ＰＡＧ腹外侧部可阻断刺激黑质的效应，这提示从黑质到网状巨细胞核α－区存在着一条痛调制通路，而且这种通路的递质是多巴胺能的。     

Hygiene in Operationsabteilungen – Empfehlungen des Nationalen Referenzzentrums für Krankenhaushygiene

Zusammenfassung. Viele Hygienema?nahmen in Operationsabteilungen sind durch wissenschaftliche Untersuchungen nicht belegt. Die in dieser Arbeit vom Nationalen Referenzzentrum für Krankenhaushygiene, das 1996 vom Bundesgesundheitsministerium eingerichtet wurde, zusammengestellten Empfehlungen stützen sich auf die Ergebnisse wissenschaftlicher Untersuchungen und trennen so die unbedingt notwendigen von den weniger bzw. nicht sinnvollen Ma?nahmen.

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Summary. Many hygienic procedures performed in operation units are not supported by scientific investigations. The following recommendations by the National Reference Center for Hospital Epidemiology, founded by the German Ministry of Health in 1996, are based on the scientific literature and separate necessary from less necessary and unnecessary procedures.

     

脐血抗—HPCA—2和Tük3标记的CD34阳性细胞的流式细胞仪比较分析

在标记脐血造血祖细胞表面抗原（ＨＰＣＡ），ＣＤ３４中，比较抗－ＨＰＣＡ－２－ＦＩＴＣ和Ｔｋ３（纯抗体）标记的ＣＤ（３４＋）细胞在流式细胞仪分析中的荧光特征及两种单抗标记的ＣＤ（３４＋）细胞与体外培养的粒单细胞集落形成单位（ＣＦＵ－ＧＭ），红系爆发形成单位（ＢＦＵ－Ｅ），和混合集落形成单位（ＣＦＵ－Ｍｉｘ）的相关性。结果发现脐血有核细胞中，抗ＨＰＣＡ－２阳性细胞占１．０５±０．７２％（ｎ＝１３），Ｔｋ３阳性细胞占２．０６±１．２５％（ｎ＝８），差别显著（Ｐ＜０．０５）。每毫升脐血两种抗体标记的细胞分别为９６．５６±５６．６４和２３１．４０±１６３．９３（Ｐ＜０．０５）。尽管ＨＰＣＡ－２阳性细胞与Ｔｋ３阳性细胞数量呈显著正相关（ｒ＝０．８７５，Ｐ＜０．０１），前者与ＣＦＵ－ＧＭ，ＢＦＵＥ，ＣＦＵ－Ｍｉｘ及集落总数ＣＦＵｓ均呈正相关，而后者仅与ＣＦＵ－ＧＭ，ＣＦＵｓ相关。研究提示在检测造血祖细胞时，用抗－ＨＰＣＡ－２－ＦＩＴＣ代替Ｔｋ３可降低假阳性，获得较好的ＯＤ（３４＋）细胞与ＣＦＵ间的线性关系。     

Can a clinician predict the technical equipment a patient will need during intensive care unit treatment? An approach to standardize and redesign the intensive care unit workstation

The technical equipment of today's intensive care unit (ICU) workstation has been characterized by a gradual, incremental accumulation of individual devices, whose presence is dictated by patient needs. These devices usually present differently designed controls, operate under different alarm philosophies, and cannot communicate with each other. By contrast, ICU workstations could be equipped permanently and in a standardized manner with electronically linked modules if the attending physicians could reliably predict, at the time of admission, the patient's equipment needs. Over a period of 3 1/2 months, the doctors working in our 20-bed surgical ICU made 1,000 predictions concerning outcome, equipment need, duration of artificial ventilation, and duration of hospitalization for 300 recently admitted patients. The interviews were made within the first 24 hours after admission. The doctors being interviewed were usually (i.e., in over 90% of cases) unfamiliar with the patient. Information concerning the patient's general state of health, special pre-ICU events, and complications was offered to the interviewed clinician because this information represents standard admission data. It was found that the equipment need (represented by two different setups, high tech and low tech) could be predicted most reliably (96.4% correct predictions) compared with a prediction on outcome of ICU treatment (94.5%), on duration of artificial ventilation (75.4%), and on duration of stay (43.4%). There was no significant (p>0.05) difference in the reliability of predictions between residents and consultants. Factors influencing the postoperative equipment need varied with surgical specialty. The general state of health, as indicated by the ASA classification (p<0.001), and the specific intervention (all multiple-valve replacements needed the high-level equipment standard) appeared to be most important in cardiac surgery, while a state of septicemia was important in general surgery (p<0.001). Our findings suggest that ICU workstations may be standardized into at least two types.