3D detection and extraction of bladder tumors via MR virtual cystoscopy

Purpose

This paper proposes a pipeline for the detection and extraction of 3D regions of bladder tumors via MR virtual cystoscopy.

Methods

After the acquisition of volumetric bladder images with a high-resolution T2-weighted 3D sequence, the inner and outer surfaces of the bladder wall were segmented simultaneously by a coupled directional level-set method. Based on the Laplacian method, a potential field was built up between two surfaces so that the thickness of each voxel within the bladder wall was estimated. To detect bladder abnormalities, four volume-based morphological features, including bent rate, shape index, wall thickness, and a novel morphological feature, which reflects bent rate difference between the inner and outer surfaces, were extracted. The combination of these four features was used to detect seeds on the inner surface by using selected filtering criterion. Then all points on streamlines started from detected seeds formed 3D candidate regions. Finally the fuzzy c-means clustering with spatial information (sFCM) was used to extract tumors from surrounding bladder wall tissues in candidate regions.

Results

The proposed pipeline was evaluated by a database of MR bladder images acquired from ten patients with bladder cancer. To find an optimal feature combination for tumor detection, the performance of different combinations of these features was evaluated with different filtering criteria. With the combination of all four features, the computer-aided detection pipeline shows a high performance of 100 % sensitivity with 2.3 FPs/case. Comparing with tumor regions delineated by radiological experts, the average overlap ratio of tumor regions extracted by sFCM is 86.3 %.

Conclusions

The experimental result demonstrates the feasibility of the proposed pipeline on the detection and extraction of bladder tumors. It may provide an effective way to achieve the goal of evaluating the whole bladder for tumor detection and local staging.

     

Can utility-weighted health-related quality-of-life estimates capture health effects of quality improvement for depression?

BACKGROUND: Utility methods that are responsive to changes in desirable outcomes are needed for cost-effectiveness (CE) analyses and to help in decisions about resource allocation. OBJECTIVES: Evaluated is the responsiveness of different methods that assign utility weights to subsets of SF-36 items to average improvements in health resulting from quality improvement (QI) interventions for depression. DESIGN: A group level, randomized, control trial in 46 primary care clinics in six managed care organizations. Clinics were randomized to one of two QI interventions or usual care. SUBJECTS: One thousand one hundred thirty-six patients with current depressive symptoms and either 12-month, lifetime, or no depressive disorder identified through screening 27,332 consecutive patients. MEASURES: Utility weighted SF-12 or SF-36 measures, probable depression, and physical and mental health-related quality of life scores. RESULTS: Several utility-weighted measures showed increases in utility values for patients in one of the interventions, relative to usual care, that paralleled the improved health effects for depression and emotional well being. However, QALY gains were small. Directly elicited utility values showed a paradoxical result of lower utility during the first year of the study for intervention patients relative to controls. CONCLUSIONS: The results raise concerns about the use of direct single-item utility measures or utility measures derived from generic health status measures in effectiveness studies for depression. Choice of measure may lead to different conclusions about the benefit and CE of treatment. Utility measures that capture the mental health and non-health outcomes associated with treatment for depression are needed.     

Diagnosis and follow-up study of carotid cavernous fistulas with color Doppler ultrasonography: analysis of 33 cases.

OBJECTIVE: The purpose of this study was to observe image characteristics and hemodynamic changes of carotid-cavernous sinus fistulas (CCFs) and to evaluate the efficacy of interventional treatment for CCFs by color Doppler ultrasonography (CDUS). METHODS: Thirty-three patients with suspected CCFs were studied with CDUS. Forty-six volunteers took part in this study as controls. Scanning was performed through temporal, orbital, and occipital windows to measure the blood flow parameters of the internal carotid artery (ICA) and related vessels. All results were confirmed by cerebral angiography. Nineteen patients were followed after interventional treatment. RESULTS: Thirty-two patients (97%) were found to have CCFs by CDUS. Irregular mosaic flashes were observed in the cavernous sinus region, the cross-section areas of which were significantly larger than those of the normal intracranial ICA (1.7-5.2 versus 0.2-0.5 cm(2); P < .01). A lower resistive index of the ICA in the affected side was revealed with spectral analysis of relevant vessels. The peak velocity of vessels distal to the fistula was significantly lower than that of the healthy side and control group (P < .05). Superior ophthalmic veins had a reversed arterialized flow pattern with a mean velocity of 34.5 cm/s and an average resistive index +/- SD of 0.31 +/- 0.08. In follow-up study, the mosaic flashes and turbulence flow disappeared in 14 patients and remained in 5 after the interventional operation. CONCLUSIONS: Combined with the direct sign of an irregular mosaic flash in the cavernous sinus region, hemodynamic changes in relevant branch vessels, and a reversed arterialized flow pattern in superior ophthalmic veins, CDUS has great value in confirming diagnosis and follow-up study of CCFs.     

电视胸腔镜在小儿心脏手术中的应用

目的 :探讨胸壁打孔电视胸腔镜心脏手术方法在小儿先天性心脏病手术中的应用效果。方法 :62例先天性心脏病患儿 ,房间隔缺损 1 6例 ,室间隔缺损 46例膜周部室间隔缺损患者 ,采用胸壁打孔经股动脉、股静脉和上腔静脉插管后股动脉 ,股静脉插管建立体外循环 ,完全在胸腔镜下行房间隔和室间隔缺损修补。结果 :62例患儿体外循环时间 (78.5± 2 3)min ,主动脉阻闭时间 (2 8.5± 1 2 .7)min ,开放升主动脉后心脏均自动复跳。除 1例患者因术后残余漏而再次体外循环外手术外 ,其他患者手术顺利 ,术后无并发症并痊愈出院。结论 :胸壁打孔电视胸腔镜下心脏手术方法在小儿心脏病体外循环下行房间隔和室间隔缺损修补术安全可靠     

转化生长因子β1基因修饰成骨细胞复合仿生基质材料治疗骨缺损

背景:通过分子生物学技术与组织工程技术相结合以修复骨缺损,是骨科当前重要的研究方向之一。转化生长因子β1作为重要的骨形成因子,在骨代谢和骨损伤修复中发挥着极为重要的作用。目的:观察转化生长因子β1基因修饰的成骨细胞复合仿生基质材料修复鼠胫骨骨缺损的治疗效果。设计:随机对照实验。单位:华中科技大学同济医学院附属协和医院骨科。材料:实验于2003-03/08在华中科技大学同济医学院附属协和医院完成。选用健康SD大鼠20只,雌雄不限,由华中科技大学同济医学院实验动物中心提供。方法:将转化生长因子β1基因转染的成骨细胞与涂覆多聚赖氨酸的聚DL乳酸仿生基质材料复合,植入鼠胫骨骨缺损模型,术后摄X射线片和组织学检查观察修复情况。主要观察指标:术后4,8周X线摄片和组织学检查情况。结果:20只SD大鼠均进如结果分析,无脱失。①实验组:4周时X线片可见骨痂形成,组织学观察有类骨组织和新骨形成,成骨细胞贴附于基质材料表面。8周时缺损基本修复,新骨密度与自体骨接近。②对照组:4周时X线片未见骨痂形成,组织学观察没有类骨组织形成,基质材料表面成骨细胞贴附较少,材料腔隙中有大量淋巴细胞浸润。8周时植入材料基本吸收,为纤维组织替代。结论:将分子生物学和组织工程学结合修复骨缺损,获得理想的治疗效果。     

对流行性出血热病人入量指导及饮食干预的效果观察

流行性出血热又称肾综合征出血热,是由汉坦病毒引起的以鼠类为传染源的自然疫源性疾病。典型病例有发热、出血和肾脏损害三大主征和发热期、低血压休克期、少尿期、多尿期、恢复期“五期”特点,病人各期对入量和饮食的要求均不相同。我院对120例住院病人进行了入量指导及饮食干     

依达拉奉对深低温保存大鼠断肢再植后缺血再灌注损伤的影响

目的:观察依达拉奉对深低温保存大鼠断肢再植后出现缺血再灌注损伤时的保护作用。方法:实验于2006-04/11在山东省立医院手足外科低温医学实验室完成。①选取健康成年Wistar大鼠36只,随机分为对照组、冷冻组和依达拉奉组3组,每组12只。②对照组只显露股动静脉而不结扎,其他2组大鼠截断右后肢,对断肢进行深低温冷冻保存处理(自结扎股动静脉至深低温保存约2h)。③1个月后,将冷冻保存的断肢复温、灌洗液洗脱,依达拉奉组所用灌洗液中含依达拉奉0.5mg/kg,行自体肢体回植(自液氮中取出肢体至恢复血供约2h),恢复肢体血供4h后取材,骨骼肌丙二醛含量,超氧化物歧化酶活性以及线粒体ATP酶活性,测定胫前肌含水量,光镜观察各组骨骼肌肌组织的结构改变。结果:36只全部进入结果分析。①骨骼肌丙二醛含量:依达拉奉组低于冷冻组[(10.37±1.25),(15.36±1.28)μmol/g,P<0.01]。②骨骼肌ATP酶和超氧化物歧化酶活性:依达拉奉组高于冷冻组[(206.2±45.2),(72.7±32.5)μkat/g;(83.9±5.2),(70.5±8.0)mkat/g;P均<0.01]。③胫前肌湿/干质量比值:依达拉奉组低于冷冻组(4.89±0.82,6.38±0.63,P<0.01)。④光镜结果显示依达拉奉组骨骼肌损伤程度明显轻于冷冻组。结论:依达拉奉可以降低肢体再灌注后肌肉组织中的氧自由基水平,减轻缺血再灌注对骨骼肌造成的损伤,对缺血再灌注骨骼肌具有保护作用。     

Genome Analysis of Cytochrome in Dinotefuran-Treated Apolygus lucorum (Meyer-Dür)

Bulletin of Environmental Contamination and Toxicology - In this study, two CYP genes, CYP395G1 and CYP4EY1, were analyzed in Apolygus lucorum (Hemiptera: Miridae). The expression pattern in...     

The complete mitochondrial genomes of two globally invasive ants,the Argentine ant <Emphasis Type="Italic">Linepithema</Emphasis><Emphasis Type="Italic">humile</Emphasis> and the little fire ant <Emphasis Type="Italic">Wasmannia auropunctata</Emphasis>

Ants are among the most widespread and damaging of invasive alien species. Here, we report the complete mitochondrial genomes for two globally invasive ants: the Argentine ant Linepithema humile and the little fire ant Wasmannia auropunctata. The circular genomes of L. humile and W. auropunctata are 15,929 and 16,362 bp in length, respectively, and encode the same typical set of 37 mitochondrial genes (i.e. 13 PCGs, 22 tRNAs and two rRNAs) and one control region. The mitochondrial genome of W. auropunctata harbors a unique gene arrangement (‘rrnS-trnV-CR-trnM-trnI-trnQ-nad2-trnW-trnC-trnY’; the underlines indicate inverted genes) between rrnL and cox1. Phylogenetic analysis largely corroborated the traditional taxonomy, except for L. humile which was found to be more related to those taxa of the subfamilies Formicinae and Myrmicinae than to the consubfamilial Leptomyrmex pallens. Our genomic data can be readily used for genetic assays of these two globally invasive ants.     

早孕期筛查唐氏综合征或18-三体综合征不同风险值与胎儿染色体异常及妊娠结局分析

目的探讨孕妇早孕期筛查结果为唐氏综合征(DS)或18-三体综合征高风险、临界风险与低风险的胎儿染色体异常率及其妊娠结局。 方法选择2017年1至12月,于南方医科大学附属深圳市妇幼保健院接受早孕期筛查,并获得明确妊娠结局的14 598例单胎孕妇为研究对象。对其妊娠结局随访,分别采取查询本院产前诊断中心、深圳市妇幼保健信息管理系统或电话随访受试者本人的方式完成,对其随访截止时间设定为活产儿1岁,或胎儿自然流产/死胎发生时。其中,接受早孕期血清学筛查孕妇为6 825例,接受早孕期血清学联合胎儿超声颈项透明层(NT)筛查为7 773例;早孕期筛查结果为DS或18-三体综合征高风险、临界风险、低风险的孕妇分别为1 082例、1 903例及11 613例;高龄(预产年龄≥35岁)孕妇为2 223例(15.23%,2 223/14 598)。采用回顾性研究方法,收集所有孕妇早孕期筛查与胎儿染色体异常结果及其妊娠结局。对于预产年龄<35岁与≥35岁孕妇的胎儿DS、18-三体综合征筛查阳性率(SPR)比较,早孕期筛查结果为胎儿DS或18-三体综合征高风险、临界风险、低风险的胎儿染色体异常率及不良妊娠结局发生率比较,采用χ²检验。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。 结果①高龄孕妇的胎儿DS与18-三体综合征SPR分别为22.22%(494/2 223)与1.30%(29/2 223),均显著高于预产年龄<35岁孕妇的4.00%(495/12 375)与0.52%(649/12 375),并且差异均有统计学意义(χ²＝990.737、18.456,P<0.001)。②本研究14 598例孕妇中,经产前诊断确诊为胎儿染色体异常者为49例,经新生儿外周血核型分析确诊为胎儿染色体异常者为2例,胎儿染色体异常率为0.35%(51/14 598)。51例异常染色体胎儿中,26例为DS胎儿。其中,早孕期筛查结果为胎儿DS高风险为22例,临界风险及低风险为4例,DS胎儿检出率为84.62%(22/26),胎儿DS发生率为0.18%(26/14 598);胎儿18-三体综合征为3例,早孕期筛查结果均为胎儿18-三体综合征高风险,胎儿18-三体综合征检出率为100.00%(3/3);胎儿性染色体异常为15例,胎儿性染色体异常率为0.10%(15/14 598);2例为13-三体综合征胎儿,5例为染色体结构异常胎儿。③早孕期筛查结果为胎儿DS或18-三体综合征高风险、临界风险、低风险孕妇中,确诊胎儿为染色体异常者分别为31例、7例及13例,胎儿染色体异常率分别为2.87%(31/1 082)、0.37%(7/1 903)及0.11%(13/11 613)。在胎儿DS或18-三体综合征临界风险和低风险孕妇中,确诊胎儿为DS或18-三体综合征者共计20例,其中19例经产前诊断确诊,包括17例无创产前检测(NIPT)结果显示异常、1例孕妇为高龄及1例为胎儿NT增厚;1例为产后确诊胎儿染色体异常。④排除51例胎儿染色体异常的孕妇之外,其余14 547例孕妇中,早孕期筛查结果为高风险孕妇,因胎儿超声结构异常而终止妊娠、自然流产/死胎、早产、伴出生缺陷等不良妊娠结局发生率为9.32%(98/1 051),临界风险孕妇为5.17%(98/1 896),低风险孕妇为4.19%(486/11 600),3者比较,差异有统计学意义(χ²＝57.989,P<0.001)。 结论早孕期筛查对DS和18-三体综合征胎儿具有较高检出率,但是不能检出所有的染色体异常胎儿。在早孕期筛查结果为临界风险、低风险孕妇中,其胎儿仍然存在染色体异常可能,对此类孕妇进一步进行NIPT,有助于检出染色体异常胎儿。早孕期筛查结果为高风险孕妇,除胎儿染色体异常率高外,因胎儿超声结构异常而终止妊娠、自然流产/死胎、早产、伴出生缺陷等不良妊娠结局发生率亦较高。