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1.
Emerg Radiol ; 31(3): 391-403, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38530436

RESUMO

Artificial Intelligence (AI) has emerged as a transformative force within medical imaging, making significant strides within emergency radiology. Presently, there is a strong reliance on radiologists to accurately diagnose and characterize foreign bodies in a timely fashion, a task that can be readily augmented with AI tools. This article will first explore the most common clinical scenarios involving foreign bodies, such as retained surgical instruments, open and penetrating injuries, catheter and tube malposition, and foreign body ingestion and aspiration. By initially exploring the existing imaging techniques employed for diagnosing these conditions, the potential role of AI in detecting non-biological materials can be better elucidated. Yet, the heterogeneous nature of foreign bodies and limited data availability complicates the development of computer-aided detection models. Despite these challenges, integrating AI can potentially decrease radiologist workload, enhance diagnostic accuracy, and improve patient outcomes.


Assuntos
Inteligência Artificial , Corpos Estranhos , Humanos , Corpos Estranhos/diagnóstico por imagem
2.
Emerg Radiol ; 29(4): 691-696, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35503393

RESUMO

PURPOSE: The purpose of our study was to analyze the change in water and fat density within the bone marrow using the GE Revolution dual-energy computed tomography (DECT) platform using two-material decomposition analyses at extremity, spine, and pelvic fracture sites compared to normal bone marrow at equivalent anatomic sites in adult patients who sustained blunt trauma. METHODS: This retrospective study included 26 consecutive adults who sustained blunt torso trauma and an acute fracture of the thoracolumbar vertebral body, pelvis, or upper and lower extremities with a total of 32 fractures evaluated. Two-material decomposition images were analyzed for quantitative analysis. Statistical analysis was performed using the paired t-test and Shapiro-Wilk test for normality. RESULTS: There were statistically significant differences in the water and fat densities in the bone marrow at the site of an extremity, vertebral body, or pelvic fracture when compared to the normal anatomic equivalent (p < 0.01). CONCLUSION: In this preliminary study, DECT basis material images, using water (calcium) and fat (calcium) decomposition illustrated significant differences in water and fat content between fracture sites and normal bone in a variety of anatomical sites.


Assuntos
Doenças da Medula Óssea , Fraturas Ósseas , Adulto , Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/diagnóstico por imagem , Cálcio , Edema , Fraturas Ósseas/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X/métodos , Água
3.
Mol Biol Evol ; 37(9): 2584-2600, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32359138

RESUMO

Gene families underlie genetic innovation and phenotypic diversification. However, our understanding of the early genomic and functional evolution of tandemly arranged gene families remains incomplete as paralog sequence similarity hinders their accurate characterization. The Drosophila melanogaster-specific gene family Sdic is tandemly repeated and impacts sperm competition. We scrutinized Sdic in 20 geographically diverse populations using reference-quality genome assemblies, read-depth methodologies, and qPCR, finding that ∼90% of the individuals harbor 3-7 copies as well as evidence of population differentiation. In strains with reliable gene annotations, copy number variation (CNV) and differential transposable element insertions distinguish one structurally distinct version of the Sdic region per strain. All 31 annotated copies featured protein-coding potential and, based on the protein variant encoded, were categorized into 13 paratypes differing in their 3' ends, with 3-5 paratypes coexisting in any strain examined. Despite widespread gene conversion, the only copy present in all strains has functionally diverged at both coding and regulatory levels under positive selection. Contrary to artificial tandem duplications of the Sdic region that resulted in increased male expression, CNV in cosmopolitan strains did not correlate with expression levels, likely as a result of differential genome modifier composition. Duplicating the region did not enhance sperm competitiveness, suggesting a fitness cost at high expression levels or a plateau effect. Beyond facilitating a minimally optimal expression level, Sdic CNV acts as a catalyst of protein and regulatory diversity, showcasing a possible evolutionary path recently formed tandem multigene families can follow toward long-term consolidation in eukaryotic genomes.


Assuntos
Dineínas do Axonema/genética , Evolução Biológica , Variações do Número de Cópias de DNA , Proteínas de Drosophila/genética , Drosophila melanogaster/genética , Família Multigênica , Animais , Feminino , Conversão Gênica , Masculino , Seleção Genética , Espermatozoides/fisiologia
4.
Skeletal Radiol ; 49(5): 699-705, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31781788

RESUMO

OBJECTIVE: The purposes of this study was to determine the prevalence of the accessory anterolateral talar facet (AALTF); to evaluate the relationship between AALTF, focal abutting bone marrow edema (FABME), and sinus tarsi edema; and to study the prevalence of tarsal coalitions in patients with the AALTF utilizing ankle MR images. MATERIALS AND METHODS: 5-T ankle MR images were reviewed for the presence of AALTF, FABME, sinus tarsi edema, tarsal coalition, and location and type of coalition (cartilaginous, fibrous, and osseous). Multivariate analysis was performed to examine the correlation between AALTF and the other variables. RESULTS: Three hundred ninety-one consecutive patients were included (age range 5-86 years; mean age 45 years). An AALTF was present in 3.6% (14/391) of patients. The AALTF prevalence was 2% in women and 6.6% in men. There was a significantly association between AALTF and FABME (9/14, p < 0.05), sinus tarsi edema (13/14, p < 0.05), and tarsal coalition (4/14, p < 0.05). CONCLUSION: AALTF is relatively often detected on MRI of the ankle and significantly associated with BME, sinus tarsi edema, and subtalar coalition. Patients with a tarsal coalition should be evaluated for the concurrent presence of an AALTF.


Assuntos
Medula Óssea/patologia , Edema/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Articulação Talocalcânea/anormalidades , Articulação Talocalcânea/diagnóstico por imagem , Coalizão Tarsal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/diagnóstico por imagem , Criança , Pré-Escolar , Edema/complicações , Edema/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Coalizão Tarsal/complicações , Adulto Jovem
5.
Proc Natl Acad Sci U S A ; 109(6): 2043-8, 2012 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-22308475

RESUMO

In many species, both morphological and molecular traits related to sex and reproduction evolve faster in males than in females. Ultimately, rapid male evolution relies on the acquisition of genetic variation associated with differential reproductive success. Many newly evolved genes are associated with novel functions that might enhance male fitness. However, functional evidence of the adaptive role of recently originated genes in males is still lacking. The Sperm dynein intermediate chain multigene family, which encodes a Sperm dynein intermediate chain presumably involved in sperm motility, originated from complex genetic rearrangements in the lineage that leads to Drosophila melanogaster within the last 5.4 million years since its split from Drosophila simulans. We deleted all the members of this multigene family resident on the X chromosome of D. melanogaster by chromosome engineering and found that, although the deletion does not result in a reduction of progeny number, it impairs the competence of the sperm in the presence of sperm from wild-type males. Therefore, the Sperm dynein intermediate chain multigene family contributes to the differential reproductive success among males and illustrates precisely how quickly a new gene function can be incorporated into the genetic network of a species.


Assuntos
Drosophila melanogaster/genética , Evolução Molecular , Genes de Insetos/genética , Espermatozoides/fisiologia , Animais , Feminino , Fertilidade/genética , Masculino , Família Multigênica/genética , Especificidade de Órgãos/genética , Reprodutibilidade dos Testes
6.
Case Rep Oncol ; 14(1): 56-61, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33776682

RESUMO

Hepatocellular carcinoma commonly metastasizes to organs, but there are few reports of vertebral metastases causing cord compression. Here, we present a case of thoracic cord compression in a patient with advanced hepatocellular carcinoma. Providers' and patient's awareness of this risk is important, as this is an oncological emergency.

7.
Exp Clin Transplant ; 17(1): 111-114, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-28447926

RESUMO

Posttransplant lymphoproliferative disorder is a serious complication of solid-organ transplant. Extranodal involvement is common; however, isolated involvement of the central nervous system is extremely rare and represents a particularly difficult therapeutic challenge with no current consensus on optimal treatment. Here, we describe a 70-year-old woman who developed Epstein-Barr virus-related primary central nervous system lymphoma 19 months after kidney transplant. Immunosuppression was reduced, and the patient was started on high-dose methotrexate, which was complicated by acute kidney injury and discontinued. She then received a rituximab and temozolomide chemotherapeutic regimen and achieved complete clinical response. Seventeen months after diagnosis, she is alive and has not developed any other posttransplant lymphoproliferative disorder. We review the current literature and discuss treatment options for patients with primary central nervous system posttransplant lymphoproliferative disorder following kidney transplant.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Sistema Nervoso Central/tratamento farmacológico , Infecções por Vírus Epstein-Barr/virologia , Transplante de Rim/efeitos adversos , Linfoma/tratamento farmacológico , Rituximab/administração & dosagem , Temozolomida/administração & dosagem , Idoso , Biópsia , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias do Sistema Nervoso Central/virologia , Imagem de Difusão por Ressonância Magnética , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Imuno-Histoquímica , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Linfoma/diagnóstico , Linfoma/virologia , Resultado do Tratamento
8.
Commun Integr Biol ; 5(5): 462-5, 2012 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-23181161

RESUMO

In many animal species, traits associated with male fitness evolve rapidly. Intersexual conflict and male-male competition have been suggested to drive this rapid evolution. These fast evolutionary dynamics result in elevated rates of amino acid replacement and modification of gene expression attributes. Gene acquisition is another mechanism that might contribute to fitness differences among males. However, empirical evidence of fitness effects associated with newly evolved genes is scarce. The Sdic multigene family originated within the last 5.4 myr in the lineage that leads to D. melanogaster and encodes a sperm dynein intermediate chain presumably involved in sperm motility. The silencing of the Sdic multigene family, followed by the screening of relevant phenotypes, supports the role of the Sdic multigene family in sperm competition. The case of the Sdic multigene family illustrates the flexibility of genetic networks in incorporating lineage-specific gene novelties that can trigger an evolutionary arms race between males.

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