Predicting enteric methane emission of dairy cows with milk Fourier-transform infrared spectra and gas chromatography-based milk fatty acid profiles.

The objective of the present study was to compare the prediction potential of milk Fourier-transform infrared spectroscopy (FTIR) for CH4 emissions of dairy cows with that of gas chromatography (GC)-based milk fatty acids (MFA). Data from 9 experiments with lactating Holstein-Friesian cows, with a total of 30 dietary treatments and 218 observations, were used. Methane emissions were measured for 3 consecutive days in climate respiration chambers and expressed as production (g/d), yield (g/kg of dry matter intake; DMI), and intensity (g/kg of fat- and protein-corrected milk; FPCM). Dry matter intake was 16.3 ± 2.18 kg/d (mean ± standard deviation), FPCM yield was 25.9 ± 5.06 kg/d, CH4 production was 366 ± 53.9 g/d, CH4 yield was 22.5 ± 2.10 g/kg of DMI, and CH4 intensity was 14.4 ± 2.58 g/kg of FPCM. Milk was sampled during the same days and analyzed by GC and by FTIR. Multivariate GC-determined MFA-based and FTIR-based CH4 prediction models were developed, and subsequently, the final CH4 prediction models were evaluated with root mean squared error of prediction and concordance correlation coefficient analysis. Further, we performed a random 10-fold cross validation to calculate the performance parameters of the models (e.g., the coefficient of determination of cross validation). The final GC-determined MFA-based CH4 prediction models estimate CH4 production, yield, and intensity with a root mean squared error of prediction of 35.7 g/d, 1.6 g/kg of DMI, and 1.6 g/kg of FPCM and with a concordance correlation coefficient of 0.72, 0.59, and 0.77, respectively. The final FTIR-based CH4 prediction models estimate CH4 production, yield, and intensity with a root mean squared error of prediction of 43.2 g/d, 1.9 g/kg of DMI, and 1.7 g/kg of FPCM and with a concordance correlation coefficient of 0.52, 0.40, and 0.72, respectively. The GC-determined MFA-based prediction models described a greater part of the observed variation in CH4 emission than did the FTIR-based models. The cross validation results indicate that all CH4 prediction models (both GC-determined MFA-based and FTIR-based models) are robust; the difference between the coefficient of determination and the coefficient of determination of cross validation ranged from 0.01 to 0.07. The results indicate that GC-determined MFA have a greater potential than FTIR spectra to estimate CH4 production, yield, and intensity. Both techniques hold potential but may not yet be ready to predict CH4 emission of dairy cows in practice. Additional CH4 measurements are needed to improve the accuracy and robustness of GC-determined MFA and FTIR spectra for CH4 prediction.

International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017).

In recent years, the number of approved and investigational agents that can be safely administered for the treatment of lymphoma patients for a prolonged period of time has substantially increased. Many of these novel agents are evaluated in early-phase clinical trials in patients with a wide range of malignancies, including solid tumors and lymphoma. Furthermore, with the advances in genome sequencing, new "basket" clinical trial designs have emerged that select patients based on the presence of specific genetic alterations across different types of solid tumors and lymphoma. The standard response criteria currently in use for lymphoma are the Lugano Criteria which are based on [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography or bidimensional tumor measurements on computerized tomography scans. These differ from the RECIST criteria used in solid tumors, which use unidimensional measurements. The RECIL group hypothesized that single-dimension measurement could be used to assess response to therapy in lymphoma patients, producing results similar to the standard criteria. We tested this hypothesis by analyzing 47 828 imaging measurements from 2983 individual adult and pediatric lymphoma patients enrolled on 10 multicenter clinical trials and developed new lymphoma response criteria (RECIL 2017). We demonstrate that assessment of tumor burden in lymphoma clinical trials can use the sum of longest diameters of a maximum of three target lesions. Furthermore, we introduced a new provisional category of a minor response. We also clarified response assessment in patients receiving novel immune therapy and targeted agents that generate unique imaging situations.

Cowden disease: CT findings in three patients.

Cowden disease, also known as multiple hamartoma syndromes, is an autosomal dominant disease characterized by numerous benign mucocutaneous tumors, hamartomas of multiple organs, and malignancies of the breast and thyroid. In this report, we present the computed tomographic findings in three patients with Cowden disease. In addition to the classic findings, the patients were diagnosed with spinal neurinoma (n=1), meningioma (n=1), and hepatic hemangioma (n=3). We also review current clinical and genetic concepts that unify Cowden disease.

[Extracapsular spread of cervical lymph node metastases: diagnostic relevance of ultrasound examinations]. / Kapseldurchbrüche zervikaler Lymphknotenmetastasen: Diagnostischer Stellenwert der Sonographie.

OBJECTIVE: Assessment of the value of ultrasound examination in the determination of extracapsular neoplastic infiltration and soft tissue infiltration of cervical lymph nodes. MATERIAL AND METHODS: In a prospective study the results of ultrasound studies in 110 patients with squamous cell carcinoma in the head-neck region were compared with the findings of the histologic examination after neck dissection. RESULTS: Ultrasound examination showed a specificity of 81.8 % in the determination of extracapsular neoplastic infiltration. The sensitivity was only 78.6 % - this was mainly caused by microscopic extracapsular growth, which gave false-negative results. Infiltration of blood vessels were identified in all patients. There was only one false negative diagnosis of muscle infiltration. CONCLUSION: The specificity (81.8 %) and sensitivity (78.6 %) of ultrasound examinations in the diagnosis of extracapsular infiltration in patients with lymph nodes metastasis is promising. But the examiner has to keep in mind that especially microscopic extracapsular neoplastic infiltration cannot be seen in ultrasound.

[Value of contrast-enhanced ultrasound vs. CT and MRI in palpable enlarged lymph nodes of the head and neck]. / Wertigkeit der kontrastmittelverstärkten Sonographie von Lymphknotenvergrösserungen im Kopf-Hals-Bereich versus Computertomographie und Magnetresonanztomographie.

PURPOSE: To compare the value of B-mode-, plain and contrast enhanced color Doppler ultrasound, CT and MRI with respect to their diagnostic accuracy in palpable enlarged cervical lymph nodes. MATERIAL AND METHODS: Thirty patients (18 - 90 years old) with palpable enlarged lymph nodes of the head and neck underwent B-mode-ultrasound, plain and contrast enhanced color Doppler, CT and MRI (gold standard: histologic analysis in 22 and clinical follow up for at least six months in eight patients). The criteria of malignancy were maximal and minimal lymph node diameter, M/Q-ratio, various morphologic criteria (necrosis, hilus line, internal structure, contour, contrast enhancement), spectral Doppler indices, and vascular architecture in color Doppler. RESULTS: The highest sensitivity (= 1.00, specificity = 0.07 - 0.15) was obtained measuring the lymph node diameter independent on the used imaging modality (ultrasound, CT, MRI), the highest specificity (= 1.00, sensitivity = 0.71) analyzing the vascularity of the lymph node by plain color Doppler. The highest diagnostic (= 0.93) accuracy was delivered by contrast enhanced color Doppler analysis of the vascularity. Sensitivity (= 0.94) and specificity (= 0.92) of this imaging modality were only slightly inferior to the top values. Fisher's exact test revealed significant values in differentiating malignant from benign lymph nodes for B-mode- and MR-analysis of the M/Q-ratio (p < 0001/p < 0.05), B-mode morphology (p < 0.00005), plain and contrast enhanced color Doppler analysis of the vascularity (p < 0.0001/p < 0.000005), MR-morphology (p < 0.0001), and CT-morphology (p < 0.005). CONCLUSION: CT is inferior to MRI, B-mode-ultrasound and contrast-enhanced color Doppler in the differential diagnosis of selectively analyzed, palpably enlarged cervical lymph nodes using the criteria of our study. The analysis of the MR-morphology revealed a slightly inferior diagnostic accuracy to B-mode morphology and color Doppler analysis of the vascularity.

[Analysis of vascularity in breast tumors--comparison of high frequency ultrasound and contrast-enhanced color harmonic imaging]. / Vaskularisationsanalyse bei Mammatumoren--Vergleich von Hochfrequenzsonographie und Kontrast-Colour-Harmonic-Imaging.

PURPOSE: To compare the ability of standard power Doppler and color harmonic imaging for visualising breast tumor vascularity using ultrasound probes of various frequencies, and to evaluate the influence on diagnostic accuracy using ultrasound contrast agent. MATERIALS AND METHODS: Twenty patients (x = 43.6 +/- 11.7 years) with suspected malignancy of the breast underwent power Doppler to evaluate vascularity and to offer a differential diagnosis of the lesion. Two criteria were used for differential diagnosis: The quantitative extent of vascularity ("percentage vessel area", PVA) and the qualitative assessment of vascular architecture. The following power Doppler modes were compared in every patient: Plain and enhanced (Levovist(R)) 9 MHz and 12 MHz standard power mode and enhanced 9 MHz color harmonic imaging-(CHI). RESULTS: The PVA increased from a mean of 2.2 +/- 2.9 % (9 MHz standard plain) via 4.8 +/- 4.1 % (12 MHz standard plain), 9.7 +/- 15.3 % (9 MHz standard enhanced), 17.4 +/- 20.0 % (9 MHz CHI enhanced) up to 19.4 +/- 14.8 % (12 MHz standard enhanced). The perceptibility of the vascular structure was best using the enhanced 12 MHz standard power mode, immediately followed by the enhanced 9 MHz CHI mode. The improved detection of vascular signal did not translate into improved diagnostic accuracy. The highest diagnostic accuracy (95 %) was obtained using the enhanced 9 MHz CHI mode (criterion "PVA") and the enhanced 9 MHz standard power mode (criterion "vascular structure"), whereas the 12 MHz probes delivered insufficient diagnostic accuracy and very low specificity. CONCLUSION: Best quantitative and qualitative visualisation of the tumor vascularity was achieved using the enhanced 12 MHz standard power mode. Nevertheless, the highest diagnostic accuracy was obtained using enhanced 9 MHz standard power Doppler and enhanced 9 MHz color harmonic imaging. The visualisation of tumor vascularity and, partially, the diagnostic accuracy are improved significantly by color harmonic imaging without changing the probe frequently.

Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions.

The use of Power Doppler sonography in nodal diseases provides an improvement of early and noninvasive diagnosis of regional metastatic involvement. By using Power Doppler sonography it is possible to characterize lymph nodes as reactively enlarged, metastases, malignant lymphoma, tuberculosis and to study cervical cysts. The high diagnostic accuracy is based on perfusion-characteristics of these lymph nodes. Reactive lymph nodes show increased central perfusion of the hilum, whereas metastases tend to show increased peripheral perfusion. Affected lymph nodes in patients with by malignant lymphoma are highly perfused in the center but also peripheral. Power Doppler sonography is still not able to discriminate small (<8 mm) nonnecrotic metastasis or micrometastases from reactive lymph nodes. The purpose of this paper is to provide a summary of the current status of power Doppler and Doppler sonography in the differential diagnosis of lymph nodes.

Combined CT pulmonary angiography and venography for diagnosis of pulmonary embolism and deep vein thrombosis: radiation dose.

A major concern about combined pulmonary CT angiography (PCTA) and CT venography (CTV) refers to the additional radiation exposure to the patient. The purpose of this paper is to analyze the organ dose, the effective dose, and the gonadal dose of combined PCTA and CTV. Effective dose and gonadal dose in PCTA and CTV were calculated. Also measured was the organ doses with thermoluminescence dosimeters in six patients who underwent combined PCTA/CTV. The risk from the effective dose and gonadal dose in combined PCTA/CTV is low. Nevertheless, additional CTV increases the gonadal dose by a significant factor and use of this procedure should be limited in younger patients.

Hemorrhagic cavernoma or ruptured dermoid of the orbit: Diagnosis with MRI.

MRI is a useful tool to study space-occupying lesions of the orbit. We present two cases of intraorbital lesions that were found to be a hemorrhagic cavernous hemangioma and a ruptured dermoid, respectively. The difficulties in arriving at the diagnosis of these rare entities with MRI are discussed. In general, dermoids are characterized by a peripheral, extra-conal location in the immediate vicinity of an orbital suture, while cavernous hemangiomas tend to be intraconal. Secondary complications of both entities, such as hemorrhage or rupture, may alter the characteristic MRI signal patterns found in uncomplicated lesions. Inflammatory reactions may be observed. The signal of the fatty dermoid and the hemorrhagic part of a cavernoma are both of high intensity on the T1-weighted images, and this may lead to diagnostic difficulties.

An unusual cause of retrograde ejaculation and hypertension.

A 39-year-old man presented with a 1-year history of retrograde ejaculation and a 10-year history of drug-resistant hypertension. Diagnostic abdominal ultrasound revealed an open bladder neck during the filling phase and a retroperitoneal tumor. After surgical excision histology revealed an extra-adrenal pheochromocytoma, which should be included in the differential diagnosis of patients presenting with retrograde ejaculation and hypertension.

Uncommon metastasis of a glioblastoma multiforme in liver and spleen.

A case of a glioblastoma multiforme is presented. Craniotomy was performed with total resection of the right temporal tumor. Postoperatively, the patient received adjuvant radiotherapy, but 6 months after therapy he developed severe nausea and weight loss. Recurrence of an intracranial tumor in the right temporal region with nodules in the liver and spleen were detected by CT scan. Fine-needle biopsies of the liver confirmed the diagnosis of a glioblastoma metastasis with characteristic immunohistochemical staining for glial fibrillary acidic protein. This rare case of an intracerebral glioblastoma metastasizing to liver and spleen was managed by systemic chemotherapy.

Hepatic hemangiosarcoma: imaging findings and differential diagnosis.

Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis, Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous liver biopsy is hazardous.

[Graves ophthalmopathy and ocular myasthenia]. / Basedow-Ophthalmopathie und okuläre Myasthenie.

BACKGROUND: An 18-year-old woman presented with thyrotoxic symptoms - right sided lid retraction and exophthalmus. She complained of diplopia on lateral gaze. Laboratory investigations confirmed Grave's disease with hyperthyroidism and TSH receptor antibodies. PATIENTS AND METHODS: Her clinical symptoms improved after thyrostatic and steroid therapy. However, diplopia recurred 2 weeks after withdrawal of steroid therapy and a ptosis of the left lid appeared for the first time. RESULTS: A positive Tensilon test and electromyographic findings confirmed the diagnosis of myasthenia gravis with a predominantly ocular manifestation. Diplopia and ptosis improved with oral pyridostigmine. CONCLUSIONS: The coexistence of myasthenia gravis should be taken into consideration in the management of patients with Graves' ophthalmopathy.

Pitfall: a pseudo tumor within the left liver lobe presenting with abdominal pain, jaundice and severe weight loss.

A 51 year old male patient with a history of chronic alcohol consumption and recurrent pancreatitis was referred to our hospital with jaundice, epigastric pain, severe diarrhoea and weight loss of 28 kg within the last 12 months. A CT scan of the abdomen 4 months before admission had shown a pancreatitis with free fluid around the corpus and tail of the pancreas as well as dilated intrahepatic bile ducts and a cavernous transformation of the portal vein. Moreover, a tumor (3.5 x 3.0 x 3.6 cm) with irregular contrast enhancement was seen within the left liver lobe. The patient was referred to us for further evaluation and treatment. The initial B-Mode sonogram revealed a bull's eye like well defined lesion (8.1 x 7.5 x 7.0 cm) within the left liver lobe, consistent with a tumour or abscess. Prior to a diagnostic needle biopsy a PTCD was performed in this case presenting with dilated intrahepatic bile ducts and having a history of Billroth II operation. An additional colour coded Duplex Doppler ultrasonography demonstrated a visceral artery aneurysm and prevented us from performing the diagnostic puncture. The aneurysm was assumed to originate from a variant or a branch of the left hepatic artery. Angiography revealed a pseudoaneurysm of the pancreaticoduodenal artery and coil embolization was performed because of the increasing size and the risk of a bleeding complication. Postinterventional colour duplex ultrasound measurement showed no blood flow within the aneurysm. Retrospectively, the pseudoaneurysm must have led to a compression of the common bile duct, since the patient did not develop cholestasis after embolization and removal of the PTCD. Thus, a pseudoaneurysm of the pancreaticoduodenal artery must be included in the differential diagnosis of liver tumours in patients with chronic pancreatitis, despite its unusual localization near the liver. Therefore, we suggest that colour coded ultrasonography should be applied to any unclear, bull's eye like lesion, even though this method alone cannot exactly determine the origin of the pseudoaneurysm. Interventional angiography remains the gold standard for the diagnosis and therapy of visceral artery aneurysm.

Multiphasic analysis of xanthomonads causing bacterial spot disease on tomato and pepper in the Caribbean and central america: evidence for common lineages within and between countries.

ABSTRACT Four hundred thirty-three xanthomonad strains isolated from tomato or pepper plants from 32 different fields in four Caribbean and Central American countries were screened for the ability to hydrolyze starch and sodium polypectate and for resistance to copper and streptomycin. Of these, 95 representative strains were further characterized by various phnetic tests, and 63 of these strains were then analyzed by genomic fingerprinting. Most of the strains (>90%) were tolerant to copper. However, there was much more variability in sensitivity to streptomycin. All strains in Guadeloupe and 93% of the strains in Barbados were sensitive to streptomycin. The majority of strains were typical Xanthomonas campestris pv. vesicatoria group A strains. In Barbados, however, a unique group of strains was identified that was serologically similar to group A strains but was amylolytic. These strains were designated A1. The occurrence of X. campestris pv. vesicatoria group B strains in Central America was found to be limited to two fields in Costa Rica and one in Guatemala. No group B strains were identified in the Caribbean, in contrast to common occurrence in the central United States and in South America. T3 strains were not found in this study, despite the recent increase of such strains in Florida and Mexico. Unique strains from Costa Rica belonging to the X. gardneri group were identified. Little linkage was found among phenotypic and rep-polymerase chain reaction (rep-PCR) genomic fingerprinting profiles of the pathogens except at the species/pathovar level; strains displaying virtually identical fingerprint profiles were found to correspond to distinct races and vice versa. The rep-PCR genomic fingerprinting analyses suggest that certain lineages may have evolved or predominated in specific regions or specific countries.

Veno-occlusive disease of the colon--CT findings.

Venous occlusion is a rare cause of ischemic bowel disease and is usually brought about by thrombosis that may occur as a complication of systemic disorders like systemic lupus erythematosus. Behçet disease or Churg-Strauss syndrome. This report describes a patient with veno-occlusive disease of the colon caused by lymphocytic phlebitis. Typical CT findings included homogeneous bowel wall thickening and vascular engorgement.

[Osteosarcoma of the skull cap. Differential diagnosis and clinical considerations]. / Osteosarkom der Schädelkalotte. Differentialdiagnostik und klinische Uberlegungen.

Differential Diagnosis and Clinical Aspects: Osteosarcoma is a rare type of bone tumor that usually occurs only towards the end of a long bone. This article reports the case of a primary osteosarcoma of the skull and discusses important clinical issues. CT played an important role in the assessment of the tumor.

The effect of indomethacin-induced gastric mucosal injury on 24-h intragastric acidity and plasma gastrin concentration in healthy volunteers.

AIMS: To determine the influences of prostaglandin inhibition by indomethacin on 24-h intragastric acidity and plasma gastrin concentration, related to gastric mucosal injury. METHODS: A pre- and post-treatment study design was employed in 10 Helicobacter pylori negative healthy male subjects. All subjects underwent upper gastrointestinal endoscopy at least 3 days before and after 7 days dosing with indomethacin 50 mg t.d.s. Mucosal damage was scored according to the Lanza method, and biopsies were taken for H. pylori status and assay of mucosal concentrations of prostaglandin (PG)E2 and leukotriene (LT)B4. Before and on the last day of dosing, intragastric acidity was measured by continuous 24-h pH monitoring, and plasma gastrin levels determined by radioimmunoassay in blood samples collected over the same period. RESULTS: All subjects completed the study and no serious adverse events were reported. The mucosal injury score increased significantly from 0 (0-2) to 3.4 (0-8) (mean and range of values, P < 0.05) after dosing with indomethacin. No differences were observed in 24-h mean pH or meal stimulated plasma gastrin concentrations. Mucosal PGE2 and LTB4 were unchanged 8-10 h after the last indomethacin dose. CONCLUSIONS: Endogenous prostaglandins do not appear to alter intragastric acidity or gastrin secretion, in contrast to the PGE analogues, whose effects must be more pharmacological than physiological.