RESUMO
AIM: To evaluate whether deep learning reconstruction (DLR) can accelerate the acquisition of magnetic resonance imaging (MRI) sequences of the knee for clinical use. MATERIALS AND METHODS: Using a 1.5-T MRI scanner, sagittal fat-suppressed T2-weighted imaging (fs-T2WI), coronal proton density-weighted imaging (PDWI), and coronal T1-weighted imaging (T1WI) were performed. DLR was applied to images with a number of signal averages (NSA) of 1 to obtain 1DLR images. Then 1NSA, 1DLR, and 4NSA images were compared subjectively, and by noise (standard deviation of intra-articular water or medial meniscus) and contrast-to-noise ratio between two anatomical structures or between an anatomical structure and intra-articular water. RESULTS: Twenty-seven healthy volunteers (age: 40.6 ± 11.9 years) were enrolled. Three 1DLR image sequences were obtained within 200 s (approximately 12 minutes for 4NSA image). According to objective evaluations, PDWI 1DLR images showed the smallest noise and significantly higher contrast than 1NSA and 4NSA images. For fs-T2WI, smaller noise and higher contrast were observed in the order of 4NSA, 1DLR, and 1NSA images. According to the subjective analysis, structure visibility, image noise, and overall image quality were significantly better for PDWI 1DLR than 1NSA images; moreover, the visibility of the meniscus and bone, image noise, and overall image quality were significantly better for 1DLR than 4NSA images. Fs-T2WI and T1WI 1DLR images showed no difference between 1DLR and 4NSA images. CONCLUSION: Compared to PDWI 4NSA images, PDWI 1DLR images were of higher quality, while the quality of fs-T2WI and T1WI 1DLR images was similar to that of 4NSA images.
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Aprendizado Profundo , Articulação do Joelho , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Adulto , Feminino , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/anatomia & histologia , Voluntários Saudáveis , Pessoa de Meia-Idade , Razão Sinal-Ruído , Interpretação de Imagem Assistida por Computador/métodosRESUMO
AIM: To evaluate 1.5 T magnetic resonance imaging (MRI) brain images with denoising procedures using deep learning-based reconstruction (dDLR) relative to the original 1.5 and 3 T images. MATERIALS AND METHODS: Eleven volunteers underwent MRI at 3 and 1.5 T. Two-dimensional fast spin-echo T2-weighted imaging (T2WI), fluid-attenuated inversion recovery (FLAIR) imaging and diffusion-weighted imaging (DWI) sequences were performed. The dDLR method was applied to the 1.5 T data (dDLR-1.5 T), then the image quality of the dDLR-1.5 T data relative to the original 1.5 T and 3 T data was qualitatively and quantitatively assessed based on the structure similarity (SSIM) index; the signal-to-noise ratios (SNRs) of the grey matter (GM) and white matter (WM); and the contrast-to-noise ratios (CNRs) between the GM and WM (CNRgm-wm) and between the striatum (ST) and WM (CNRst-wm). RESULTS: The perceived image quality, and SNRs and CNRs were significantly higher for the dDLR-1.5 T images versus the 1.5 T images for all sequences and almost comparable or even superior to those of the 3 T images. For DWI, the SNRs and CNRst-wm were significantly higher for the dDLR-1.5 T images versus the 3 T images. CONCLUSION: The dDLR technique improved the image quality of 1.5 T brain MRI images. With respect to qualitative and quantitative measurements, the denoised 1.5 T brain images were almost equivalent or even superior to the 3 T brain images.
Assuntos
Neoplasias Encefálicas , Aprendizado Profundo , Humanos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Imageamento por Ressonância Magnética/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Neoplasias Encefálicas/patologiaRESUMO
The purpose of this retrospective study was to assess the efficacy of salvage radiation therapy (RT) or chemoradiation therapy (CRT) for locoregional recurrence (LR) of esophageal cancer after curative surgery. Forty-two patients who received salvage RT or CRT for LR of esophageal cancer after curative surgery between November 2000 and May 2012 were reviewed. The intended RT regimen was 60 Gy in 30 fractions combined with concurrent platinum-based chemotherapy. Median follow-up periods were 17.9 months for all evaluable patients and 28.2 months for patients still alive (19 patients) at analysis time. The 1-, 2-, and 3-year survival rates were 81.2 ± 6.4%, 51.3 ± 8.6%, and 41.1 ± 8.7%, respectively, with a median survival time of 24.3 ± 4.1 months. Out of 41 evaluable patients, 16 patients (39%) were alive beyond 2 years from salvage therapy. However, univariate analyses for overall survival showed no significant prognostic factor. Grade 3 or higher leukocytopenia was observed in 46% of the patients. Salvage RT or CRT for LR after surgery for esophageal cancer was safe and effective. These therapies may offer long-term survival to some patients. RT or CRT should be considered for LR.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/terapia , Carcinossarcoma/terapia , Neoplasias Esofágicas/terapia , Recidiva Local de Neoplasia/terapia , Terapia de Salvação , Adulto , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinossarcoma/mortalidade , Quimiorradioterapia/métodos , Cisplatino/administração & dosagem , Estudos de Coortes , Combinação de Medicamentos , Neoplasias Esofágicas/mortalidade , Feminino , Fluoruracila/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Compostos Organoplatínicos/administração & dosagem , Ácido Oxônico/administração & dosagem , Piridinas/administração & dosagem , Radioterapia/métodos , Estudos Retrospectivos , Taxa de Sobrevida , Tegafur/administração & dosagem , Resultado do TratamentoRESUMO
Using time-series analysis, we investigated the monthly cholera incidence in Dhaka, Bangladesh during an 18-year period for its relationship to the sea surface temperature (SST) linked to El Niño, and to the sunspot number. Dominant periodic modes identified for cholera incidence were 11.0, 4.8, 3.5, 2.9, 1.6, 1.0 and 0.5 years. The majority of these modes, e.g. the 11.0-, 4.8-, 3.5-, 1.6- and 1.0-year modes, were essentially consistent with those obtained for the SST data (dominant modes: 5.1, 3.7, 2.5, 2.1, 1.5, 1.0 years) and the sunspot number data (dominant modes: 22.1, 11.1, 7.3, 4.8, 3.1 years). We confirmed that the variations of cholera incidence were synchronous with SSTs, and were inversely correlated to the sunspot numbers. These results suggest that the cholera incidence in Bangladesh may have been influenced by the occurrence of El Niño and also by the periodic change of solar activity.
Assuntos
Cólera/epidemiologia , Clima , Modelos Estatísticos , Atividade Solar , Bangladesh/epidemiologia , Humanos , Incidência , Modelos BiológicosRESUMO
AIM: Autoimmune pancreatitis (AIP) is a rare subtype of chronic pancreatitis. AIP has been suggested to be complicated by tubulointerstitial nephritis or glomerulonephritis, implying that the kidney is involved as a phenotype of IgG4-positive multi-organ lymphoproliferative syndrome; however, the clinical significance of this novel entity is not well-defined. METHODS: We conducted a retrospective cohort analysis of 47 (male, 39; female, 8) AIP patients. RESULTS: The patients (mean age, 70.3 +/- 9.5 years) had a mean observation period of 4.1 years. Before treatment, renal dysfunction with an eGFR of 30 and 15 ml/min/1.73 m2 developed only in 10.6% (5/47) and 2.1% (1/47) of the patients, respectively. Nevertheless, urinary N-acetyl-beta-D-glucosaminidase and alpha1-microglobulin levels were elevated in 78.6% (11/14) and 30.8% (4/13) of the patients, respectively. Renal involvement in contrast-enhanced CT imaging was present in 18.2% (8/44) of the patients and was associated with proteinuria (p = 0.04) and a decrease in eGFR (p < 0.01). Furthermore, a follow-up CT study (mean, 545 days) revealed improved kidney lesions in 80.0% (4/5) of the patients after oral corticosteroid administration. In contrast, first-time kidney involvements appeared newly in 3.6% (1/28) of the patients after steroid therapy for nonrenal AIP symptoms, and in 14.3% (1/7) of the patients under no specific therapy (p = 0.02). CONCLUSION: Although severe renal failure develops rarely in AIP patients, renal abnormalities have been significantly detected by biochemical and radiological tests. Oral corticosteroid administration, even when not targeting symptomatic nephropathy, can treat and prevent kidney involvements in AIP.
Assuntos
Doenças Autoimunes/patologia , Nefropatias/patologia , Rim/patologia , Pancreatite Crônica/patologia , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Estudos de Coortes , Feminino , Glucocorticoides/uso terapêutico , Humanos , Rim/diagnóstico por imagem , Nefropatias/complicações , Nefropatias/diagnóstico por imagem , Nefropatias/tratamento farmacológico , Masculino , Pancreatite Crônica/complicações , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/tratamento farmacológico , Prednisona/uso terapêutico , Radiografia , Análise de Regressão , Estudos Retrospectivos , Resultado do TratamentoRESUMO
To investigate the efficacy and toxicity of definitive chemoradiotherapy (CRT) for elderly patients with locally advanced esophageal cancer. Twenty-two patients aged over 75 that performed definitive CRT were retrospectively reviewed. The regimen included concurrent CRT consisting of two cycles of chemotherapy (CTx) of platinum and 5-fluorouracil, and radiation therapy (RT) of 50-50.4 Gy (actual range: 45.4-71.4 Gy), and additional CTx where possible. Both CTx and RT were reduced in dose and field where necessary. The disease-free survival rate and the overall survival rate at 3 years were 33.3% ± 11.4% and 25.9% ± 10.8%. Grade 4 leukocytopenia and thrombocytopenia occurred in three (14%) and four (18%) patients. Treatment-related death was suspected in up to four (18%) patients at the most. Univariate analyses for disease-free survival showed that neither total radiation dose nor number of total cycles of CTx was significant. The pattern of relapse was predominantly more frequent in the intra-RT field than outside the RT field. For elderly patients, adverse events are frequent, and decreased organ reserve may cause treatment-related death. Reduction in CTx dose or RT field, appropriate only for two cycles of CTx, and careful monitoring may help to minimize toxicity. Physicians should not be too afraid of adverse events or be negative about CRT for elderly patients, as long as comorbidities and complications are managed carefully.
Assuntos
Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Masculino , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Small-cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report clinical outcomes of limited-disease small-cell carcinoma of the esophagus from the analysis of nine patients. Between 2003 and 2006, nine consecutive patients with small-cell carcinoma of the esophagus were treated in our single institution, representing 2.8% of all esophageal malignancies treated with curative concurrent chemoradiation during this period. All the patients received four cycles of etoposide (100 mg/m(2), days 1-3), combined with cisplatin (80 mg/m(2), day 1), plus radiation therapy (50 Gy in daily doses of 2 Gy, 5 days/week). At the time of analysis, the median follow-up time was 10.8 months (range: 4.2-42.8 months) and 21.8 months in five living patients (56%). Of all the nine patients, five patients (56%) had a complete response, and the actuarial 3-year overall survival rate was 55.6%. This regimen resulted in a favorable 3-year survival rate. We conclude that the optimum treatment seems to be the same as for small-cell carcinomas of the lung, that is, a multidrug combination chemotherapy regimen used with concurrent radiation.
Assuntos
Carcinoma de Células Pequenas/tratamento farmacológico , Carcinoma de Células Pequenas/radioterapia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/radioterapia , Idoso , Carcinoma de Células Pequenas/mortalidade , Neoplasias Esofágicas/mortalidade , Feminino , Humanos , Japão , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Estudos Retrospectivos , Resultado do TratamentoRESUMO
This retrospective study was conducted to compare the treatment results between radical surgery and definitive chemoradiotherapy for resectable squamous cell carcinoma of the esophagus. Between June 2000 and May 2005, 82 consecutive patients were selected for this study in which 33 were treated with chemoradiotherapy and 49 with surgery. The patients in the chemoradiotherapy (CRT) group received 2-4 cycles of 5-fluorouracil (1000 mg/m(2)/day, day 1-4, continuous) combined with cisplatin (75 mg/m(2), day 1, bolus) plus 50.4 Gy of radiation, while those in the surgery group were treated by an esophagectomy with radical node dissection. Eighteen surgical patients received postoperative chemotherapy. The baseline clinical TNM stage was similar between the two groups. With a median follow-up period of 36 months (range: 23-84 months) with 47 survivors (57%), the 3-year overall survival rates (P = 0.22) and disease-free survival rates (P = 0.16) were 48% and 44% in the chemoradiotherapy group versus 65% and 59% in the surgery group, and lacked statistical significance. This non-randomized study on patients with resectable squamous cell carcinoma of the esophagus showed that chemoradiotherapy could result in survival comparable with conventional surgery in spite of selection bias of patients. There is a trend toward improved survival with surgery versus definitive CRT.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Carcinoma de Células Escamosas/terapia , Fracionamento da Dose de Radiação , Neoplasias Esofágicas/terapia , Esofagectomia/métodos , Recidiva Local de Neoplasia/epidemiologia , Idoso , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Quimioterapia Adjuvante , Terapia Combinada , Neoplasias Esofágicas/mortalidade , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Feminino , Seguimentos , Humanos , Japão , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Probabilidade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Análise de Sobrevida , Resultado do TratamentoRESUMO
Objective: Previous work has shown that high body mass index (BMI) is associated with low grey matter volume. However, evidence on the relationship between waist circumference (WC) and brain volume is relatively scarce. Moreover, the influence of mild obesity (as indexed by WC and BMI) on brain volume remains unclear. This study explored the relationships between WC and BMI and grey matter volume in a large sample of Japanese adults. Methods: The participants were 792 community-dwelling adults (523 men and 269 women). Brain magnetic resonance images were collected, and the correlation between WC or BMI and global grey matter volume were analysed. The relationships between WC or BMI and regional grey matter volume were also investigated using voxel-based morphometry. Results: Global grey matter volume was not correlated with WC or BMI. Voxel-based morphometry analysis revealed significant negative correlations between both WC and BMI and regional grey matter volume. The areas correlated with each index were more widespread in men than in women. In women, the total area of the regions significantly correlated with WC was slightly greater than that of the regions significantly correlated with BMI. Conclusions: Results show that both WC and BMI were inversely related to regional grey matter volume, even in Japanese adults with somewhat mild obesity. Especially in populations with less obesity, such as the female participants in current study, WC may be more sensitive than BMI as a marker of grey matter volume differences associated with obesity.
RESUMO
RATIONALE AND OBJECTIVES: To investigate the impact of random survival forest (RSF) classifier trained by radiomics features over the prediction of the overall survival of patients with resectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The dynamic computed tomography data of 127 patients (97 men, 30 women; mean age, 68 years) newly diagnosed with resectable HCC were retrospectively analyzed. After manually setting the region of interest to include the tumor within the slice at its maximum diameter, texture analyses were performed with or without a Laplacian of Gaussian filter. Using the extracted 96 histogram based texture features, RSFs were trained using 5-fold cross-validation to predict the individual risk for each patient on disease free survival (DFS) and overall survival (OS). The associations between individual risk and DFS or OS were evaluated using Kaplan-Meier analysis. The effects of the predicted individual risk and clinical variables upon OS were analyzed using a multivariate Cox proportional hazards model. RESULTS: Among the 96 histogram based texture features, RSF extracted 8 of high importance for DFS and 15 for OS. The RSF trained by these features distinguished two patient groups with high and low predicted individual risk (P=1.1×10-4 for DFS, 4.8×10-7 for OS). Based on the multivariate Cox proportional hazards model, high predicted individual risk (hazard ratio=1.06 per 1% increase, P=8.4×10-8) and vascular invasion (hazard ratio=1.74, P=0.039) were the only unfavorable prognostic factors. CONCLUSIONS: The combination of radiomics analysis and RSF might be useful in predicting the prognosis of patients with resectable HCC.
Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/mortalidade , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/mortalidade , Tomografia Computadorizada por Raios X , Idoso , Carcinoma Hepatocelular/patologia , Intervalo Livre de Doença , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Neoplasias Hepáticas/patologia , Masculino , Invasividade Neoplásica , Prognóstico , Modelos de Riscos Proporcionais , Estudos RetrospectivosRESUMO
We previously reported that p42/SETbeta is a substrate for caspase-7 in irradiated MOLT-4 cells, and that treating the cells with sodium orthovanadate (vanadate) inhibits p42/SETbeta's caspase-mediated cleavage. Here, we initially found that the inhibitory effect of vanadate was due to the suppression of caspase activation but not of caspase activity. Further investigations revealed that vanadate suppressed upstream of apoptotic events, such as the loss of mitochondrial membrane potential, the conformational change of Bax, and p53 transactivation, although the accumulation, total phosphorylation, and phosphorylation of six individual sites of p53 were not affected. Importantly, vanadate suppressed p53-dependent apoptosis, but not p53-independent apoptosis. Finally, gel-shift and chromatin immunoprecipitation assays conclusively demonstrated that vanadate inhibits the DNA-binding activity of p53. Vanadate is conventionally used as an inhibitor of protein tyrosine phosphatases (PTPs); however, we recommend that the influence of vanadate not only on PTPs but also on p53 be considered before using it.
Assuntos
Apoptose/efeitos dos fármacos , Inibidores de Caspase , Dano ao DNA/efeitos dos fármacos , Proteína Supressora de Tumor p53/antagonistas & inibidores , Vanadatos/farmacologia , Caspases/metabolismo , Linhagem Celular Tumoral , Ativação Enzimática , Humanos , Potenciais da Membrana/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/fisiologia , Proteína X Associada a bcl-2/químicaRESUMO
BACKGROUND: A growing number of studies demonstrate the utility of (18)fluoro-2-deoxyglucose positron emission tomography (FDG-PET) in the management of malignant lymphoma. The results of FDG-PET, however, have not been studied extensively for T-cell and natural killer (NK)-cell neoplasms. PATIENTS AND METHODS: We retrospectively evaluated pretreatment FDG-PET scans in 41 patients with T/NK-cell neoplasms diagnosed according to the World Health Organization (WHO) classification. Histological subtypes frequently included were peripheral T-cell lymphoma, unspecified (PTCLu, n = 11), extranodal NK/T-cell lymphoma, nasal type (ENKL, n = 8), primary cutaneous anaplastic large cell lymphoma (C-ALCL, n = 5), and angioimmunoblastic T-cell lymphoma (AILT, n = 4). RESULTS: FDG-PET detected a lymphoma lesion in at least one site in 36 out of 41 patients. The positive rate was equally high in most histological subtypes except for cutaneous lymphomas: PTCLu 91%, ENKL 100%, C-ALCL 60%, AILT 100%. All the patients without an FDG-avid lesion had lesions restricted to skin. Among patients who had cutaneous lesions, only 50% had FDG-avid cutaneous lesions, all of which were tumorous. The positive rate of FDG-PET for bone marrow involvement was only 20%. CONCLUSION: T/NK-cell neoplasms incorporated in this study were generally FDG-avid except for cutaneous lesions and bone marrow involvement.
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Medula Óssea/patologia , Fluordesoxiglucose F18 , Células Matadoras Naturais/patologia , Linfoma Anaplásico Cutâneo Primário de Células Grandes/diagnóstico por imagem , Linfoma de Células T/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Linfoma de Células T/patologia , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The purpose of this study was to evaluate the possibility of preserving ovarian function by ovarian shielding to reduce the irradiation dose in total body irradiation (TBI). The subjects in the study were females aged less than 40 years, who were undergoing allogeneic hematopoietic stem cell transplantation using a TBI-based regimen and who desired to have children after transplantation. For ovarian shielding, abdominal computed tomography (CT) and skin marking were performed in both the supine and prone positions, prior to the TBI. A pair of columnar blocks was placed just above the patient's body. Thus far three patients have been treated. The serum estradiol level decreased to an undetectable level (<8.5 pg/ml) after transplantation and the follicle-stimulating hormone (FSH) level increased above 90 mIU/ml in all patients and they became amenorrheic. However, regular menstruation recovered in patients no. 1 and 2 about 800 and 370 days after transplantation, respectively, with a decrease in the serum FSH level. Menstruation did not recover in patient no. 3, and serum estradiol was transiently detected above 20 pg/ml. The preservation of ovarian function was made possible by ovarian shielding. However, a longer follow-up is needed to know if normal pregnancy and delivery can occur.
Assuntos
Leucemia/terapia , Ovário/efeitos da radiação , Proteção Radiológica/métodos , Transplante de Células-Tronco/métodos , Irradiação Corporal Total/métodos , Adulto , Antineoplásicos/uso terapêutico , Terapia Combinada , Estradiol/sangue , Feminino , Humanos , Menstruação , Imagens de Fantasmas , Postura , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND PURPOSE: Experiences with computer-assisted detection of cerebral aneurysms in diagnosis by radiologists in real-life clinical environments have not been reported. The purpose of this study was to evaluate the usefulness of computer-assisted detection in a routine reading environment. MATERIALS AND METHODS: During 39 months in a routine clinical practice environment, 2701 MR angiograms were each read by 2 radiologists by using a computer-assisted detection system. Initial interpretation was independently made without using the detection system, followed by a possible alteration of diagnosis after referring to the lesion candidate output from the system. We used the final consensus of the 2 radiologists as the reference standard. The sensitivity and specificity of radiologists before and after seeing the lesion candidates were evaluated by aneurysm- and patient-based analyses. RESULTS: The use of the computer-assisted detection system increased the number of detected aneurysms by 9.3% (from 258 to 282). Aneurysm-based analysis revealed that the apparent sensitivity of the radiologists' diagnoses made without and with the detection system was 64% and 69%, respectively. The detection system presented 82% of the aneurysms. The detection system more frequently benefited radiologists than being detrimental. CONCLUSIONS: Routine integration of computer-assisted detection with MR angiography for cerebral aneurysms is feasible, and radiologists can detect a number of additional cerebral aneurysms by using the detection system without a substantial decrease in their specificity. The low confidence of radiologists in the system may limit its usefulness.
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Interpretação de Imagem Assistida por Computador/métodos , Aneurisma Intracraniano/diagnóstico por imagem , Angiografia por Ressonância Magnética/métodos , Humanos , Radiologistas , Sensibilidade e EspecificidadeRESUMO
The analysis of fibroin secretion-deficient 'naked-pupa' mutant silkworms has suggested that the disulfide linkage between heavy (H) and light (L) chains of fibroin, produced by the silkworm, Bombyx mori, is essential in its efficient large-scale secretion from the posterior silk gland cells. However, the site of disulfide-linkage between H- and L-chains has not been determined. In this study, cysteine residues involved in the single disulfide linkage between H- and L-chains were identified as the twentieth residue from the carboxyl terminus of H-chain (Cys-c20) and Cys-172 of L-chain by sequencing of genomic clones and peptide analysis. Furthermore, Cys-c4 (fourth residue from the carboxyl terminus) and Cys-c1 at the carboxyl terminus of H-chain were shown to form an intramolecular disulfide bond.
Assuntos
Bombyx/metabolismo , Cisteína/química , Dissulfetos/química , Fibroínas/química , Sequência de Aminoácidos , Animais , Sequência de Bases , Sítios de Ligação , Bombyx/genética , Dados de Sequência Molecular , Fragmentos de Peptídeos/química , TripsinaRESUMO
BACKGROUND: Diminished myocardial vasodilatation (MVD) in hypercholesterolemics without overt coronary stenosis has been reported. However, whether the diminished MVD of angiographically normal coronary arteries in hypercholesterolemics can be reversed after lipid-lowering therapy is not known. METHODS AND RESULTS: A total of 27 hypercholesterolemics and 16 age-matched controls were studied. All patients had >1 normal coronary artery, and those segments that were perfused by anatomically normal coronary arteries were studied. Myocardial blood flow (MBF) was measured during dipyridamole loading and at baseline using positron emission tomography and 13N-ammonia, after which MVD was calculated before and after lipid-lowering therapy. Total cholesterol was significantly higher in hypercholesterolemics (263+/-33.8) than in controls (195+/-16.6), and it normalized after lipid-lowering therapy (197+/-19.9). Baseline MBF (ml. min-1. 100 g-1) was comparable among hypercholesterolemics (both before and after therapy) and controls. MBF during dipyridamole loading was significantly lower in hypercholesterolemics before therapy (189+/-75.4) than in controls (299+/-162, P<0.01). However, MBF during dipyridamole loading significantly increased after therapy (226+/-84.7; P<0.01). MVD significantly improved after therapy in hypercholesterolemics (2.77+/-1.35 after treatment [P<0.05] versus 2. 02+/-0.68 before treatment [P<0.01]), but it remained significantly higher in controls (3.69+/-1.13, P<0.01). There was a significant relationship between the percent change of total cholesterol and the percent change of MVD before and after lipid-lowering therapy (r=-0. 61, P<0.05). CONCLUSIONS: Diminished MVD of anatomically normal coronary arteries in hypercholesterolemics can be reversed after lipid-lowering therapy.
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Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/fisiopatologia , Vasos Coronários/fisiopatologia , Hipercolesterolemia/complicações , Hipercolesterolemia/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Vasodilatação/fisiologia , Idoso , Circulação Coronária/efeitos dos fármacos , Circulação Coronária/fisiologia , Diabetes Mellitus/fisiopatologia , Dipiridamol/farmacologia , Eletrocardiografia , Feminino , Hemodinâmica/fisiologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Vasodilatadores/farmacologiaRESUMO
OBJECTIVES: The purpose of this study was to evaluate the effects of thermal balloon percutaneous transluminal coronary angioplasty using radiofrequency energy in the treatment of patients with failed coronary angioplasty and complex lesions. In addition, we evaluated restenosis after radiofrequency thermal balloon applications. BACKGROUND: The efficacy of coronary angioplasty is limited by the relatively low success rate in complex lesions and the high frequency of restenosis. Few reports have studied the combined effects of pressure and laser thermal energy. This study describes a new device for coronary angioplasty using radiofrequency thermal energy. METHODS: Thirty-two patients with failed conventional coronary angioplasty or complex lesions were treated with radiofrequency thermal balloon coronary angioplasty. Radiofrequency energy was delivered up to 11 times in exposures ranging from 30 to 60 s in duration. This combined effect allowed the vascular wall to be heated to temperatures ranging from 60 to 70 degrees C. Follow-up coronary angiography was performed, on average, 6 months after the procedure. RESULTS: Successful radiofrequency coronary angioplasty was achieved in 28 (82%) of 34 lesions. There was one abrupt coronary artery occlusion (3%) and no death, perforation or dissection. Angiographic restenosis occurred in 14 (56%) of 25 lesions. CONCLUSIONS: In patients with failed coronary angioplasty and difficult complex lesions, radiofrequency coronary angioplasty could potentially improve angioplasty success rates and may have important implications for bailout cases with abrupt occlusion. However, restenosis remains a significant problem.
Assuntos
Angioplastia Coronária com Balão/instrumentação , Doença das Coronárias/cirurgia , Ondas de Rádio , Angioplastia Coronária com Balão/métodos , Angiografia Coronária , Doença das Coronárias/diagnóstico por imagem , Doença das Coronárias/epidemiologia , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Fatores de Tempo , Resultado do TratamentoRESUMO
This study investigated treatment results and prognostic factors in radical radiotherapy for stage IIB-IVA cervical cancer. This is a retrospective analysis of 71 patients with cancer of the uterine cervix treated radically with external beam radiotherapy and high-dose-rate intracavitary brachytherapy between June 1991 and May 2004. In 47/71 (66%) of patients' chemotherapy was combined with radiotherapy. All 71 patients were retrospectively analysed. The median follow-up time was 34.8 months. The median age was 57 years (range 26-78 years) There were 21 patients (30%) in stage IIB, 3 (4%) stage IIIA, 40 (56%) stage IIIB, and 7 (10%) stage IVA. The 5-year overall survival rate was 83.5%, 77.0%, and 42.9% for stage IIB, III, and IVA, respectively. Federation Internationale de Gynocologie et d'Obstetrique (FIGO) classification stage and pelvic and para-aortic nodal status significantly affected survival in univariate analysis, but no treatment-related factor was found to be significant in multivariate analysis. In this study para-aortic nodal status was the most important prognostic factor in the radical radiotherapy of cervical cancer.
Assuntos
Adenocarcinoma/radioterapia , Carcinoma de Células Escamosas/radioterapia , Neoplasias do Colo do Útero/radioterapia , Adenocarcinoma/secundário , Adulto , Idoso , Braquiterapia/métodos , Carcinoma de Células Escamosas/secundário , Feminino , Seguimentos , Humanos , Metástase Linfática/radioterapia , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Análise de SobrevidaRESUMO
The human brain is composed of complex networks of 100 billion neurons that underlie its higher functions. The set of neural connections in the brain has recently attracted growing interest from the scientific community. It is important to identify individual differences in these neural connections to study the background of individual differences in brain function and performance. In the present study, we investigated whether the pattern of brain diffusion, reflecting neural connections, is discernibly different among individuals; i.e., whether brain diffusivity is personally identifiable information. Using diffusion tensor imaging data from 224 healthy subjects scanned twice at an interval of about 1year, we performed brain recognition by spatial normalization of fractional anisotropy maps, feature extraction based on Principal Component Analysis, and calculation of the Euclidean distances between image pairs projected into the subspace. Even with only 16 dimensions used for projection, the rank-one identification rate was 99.1%. The rank-one identification rate was 100% with ⩾32 dimensions used for projection. The genuine accept rates were 95.1% and 100% at a false accept rate of 0.001%, with 16 and ⩾32 dimensions used for projection, respectively. There were no large differences in the Euclidean distance among different combinations of scanners used or between image pairs with and without scanner upgrade. The results indicate that brain diffusivity can identify a specific individual; i.e., the pattern of brain diffusion is personally identifiable information. Individual differences in brain diffusivity will form the basis of individual differences in personality and brain function.
Assuntos
Mapeamento Encefálico , Encéfalo/fisiologia , Imagem de Tensor de Difusão , Reconhecimento Psicológico/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anisotropia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Fibras Nervosas Mielinizadas , Análise de Componente PrincipalRESUMO
OBJECTIVES: To investigate whether reproducibility of gray matter volumetry is influenced by parameter settings for VBM 8 using Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) with region-of-interest (ROI) analyses. METHODS: We prepared three-dimensional T1-weighted magnetic resonance images (3D-T1WIs) of 21 healthy subjects. All subjects were imaged with each of five MRI systems. Voxel-based morphometry 8 (VBM 8) and WFU PickAtlas software were used for gray matter volumetry. The bilateral ROI labels used were those provided as default settings with the software: Frontal Lobe, Hippocampus, Occipital Lobe, Orbital Gyrus, Parietal Lobe, Putamen, and Temporal Lobe. All 3D-T1WIs were segmented to gray matter with six parameters of VBM 8, with each parameter having between three and eight selectable levels. Reproducibility was evaluated as the standard deviation (mm³) of measured values for the five MRI systems. RESULTS: Reproducibility was influenced by 'Bias regularization (BiasR)', 'Bias FWHM', and 'De-noising filter' settings, but not by 'MRF weighting', 'Sampling distance', or 'Warping regularization' settings. Reproducibility in BiasR was influenced by ROI. Superior reproducibility was observed in Frontal Lobe with the BiasR1 setting, and in Hippocampus, Parietal Lobe, and Putamen with the BiasR3*, BiasR1, and BiasR5 settings, respectively. CONCLUSION: Reproducibility of gray matter volumetry was influenced by parameter settings in VBM 8 using DARTEL and ROI. In multi-center studies, the use of appropriate settings in VBM 8 with DARTEL results in reduced scanner effect.