RESUMEN
We assessed infection control efforts by comparing data collected over 20 weeks during a pandemic under a dual-track healthcare system. A decline in non-COVID-19 patients visiting the emergency department by 37.6% (P<0.01) was observed since admitting COVID-19 cases. However, patients with acute myocardial infarction (AMI), stroke, severe trauma and acute appendicitis presenting for emergency care did not decrease. Door-to-balloon time (34.3 (± 11.3) min vs 22.7 (± 8.3) min) for AMI improved significantly (P<0.01) while door-to-needle time (55.7 (± 23.9) min vs 54.0 (± 18.0) min) in stroke management remained steady (P=0.80). Simultaneously, time-sensitive care involving other clinical services, including patients requiring chemotherapy, radiation therapy and haemodialysis did not change.
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COVID-19/epidemiología , Servicios Médicos de Urgencia/estadística & datos numéricos , Hospitales/estadística & datos numéricos , Tiempo de Tratamiento/estadística & datos numéricos , Enfermedad Aguda , Apendicitis/epidemiología , Apendicitis/terapia , COVID-19/diagnóstico , COVID-19/transmisión , COVID-19/virología , Estudios Transversales , Servicio de Urgencia en Hospital/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Control de Infecciones/organización & administración , Infarto del Miocardio/epidemiología , Infarto del Miocardio/terapia , Pandemias/prevención & control , SARS-CoV-2/genética , Seúl/epidemiología , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/terapia , Tiempo de Tratamiento/tendencias , Heridas y Lesiones/epidemiología , Heridas y Lesiones/terapiaRESUMEN
BACKGROUND: There might be much benefit in xenotransplantation, however, the risk of infections across species barriers remains, especially porcine endogenous retrovirus (PERV). To date, many attempts have been made to knock down active PERVs by inhibitory RNA (RNAi) and micro RNA (miRNA), which target different genes of PERV. There are a few studies that have explored whether targeting promoter regions of PERV could exert an inhibition effect. METHODS: miRNAs were automatically selected based on an online program BLOCK-iT RNAi Designer. The inhibition efficiency between miRNAs was compared based on their inhibition of different PERV genes: long terminal repeats (LTR), gag, and pol. Both relative quantitative real-time polymerase chain reaction (PCR) and C-type reverse transcriptase activity were performed. RESULTS: The results demonstrated that miRNA targeting the LTR region degraded the target sequence, and simultaneously inhibited the mRNA expression of both gag and pol genes of PERV. The LTR1, LTR2, and dual LTR1 + LTR2 miRNA inhibited 76.2%, 22%, and 76.8% of gag gene expression, respectively. Similarly, the miRNA was found to knock down the pol gene expression of 69.8%, 25.5%, and 77.7% for single targeting miRNA (LTR1 and LTR2) and multi-targeting miRNA (LTR1 + LTR2), respectively. A stable PK15 clone constitutively expressed dual LTR1 + LTR2 miRNA and exhibited higher inhibitory up to 82.8% and 92.7% of the expressions of the gag and pol genes, respectively. Also, the result of co-cultivation of dual LTR1 + LTR2 miRNA transfected PK15 cell with a human cell line inhibited expression of LTR, gag, and pol genes of PERV. CONCLUSIONS: In conclusion, this study suggested that the LTR might be an alternative target for gene silencing of PERV, and that multi-targeting miRNA had better inhibitory effect than single- targeting miRNA. In an in vitro model, the presence of miRNA was able to reduce PERV infectivity in a human cell line.
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Retrovirus Endógenos/genética , Marcación de Gen/métodos , MicroARNs/genética , Secuencias Repetidas Terminales/genética , Trasplante Heterólogo/efectos adversos , Animales , Línea Celular , Células Cultivadas , Genes gag/genética , Genes pol/genética , Humanos , Interferencia de ARN , Reacción en Cadena en Tiempo Real de la Polimerasa , Porcinos/virología , Trasplante Heterólogo/métodosRESUMEN
OBJECTIVES: Symptomatic degenerative disc disease (DDD) is associated with neovascularization and nerve ingrowth into intervertebral discs (IVDs). Notochordal cells (NCs) are key cells that may lead to regeneration of IVDs. However, their activities under conditions of hypoxia, the real environment of IVD, are not well known. We hypothesized that NCs may inhibit neovascularization by interacting with endothelial cells (ECs) under hypoxia. DESIGN: Human IVDs were isolated and cultured to produce nucleus pulposus (NP) cell conditioned medium (NPCM). Immortalized human microvascular ECs were cultured in NPCM with notochordal cell-rich rabbit nucleus pulposus cells (rNC) under hypoxia. Vascular endothelial growth factor (VEGF), vascular cell adhesion molecule (VCAM), and interleukin-8 (IL-8) were analyzed by ELISA. Focal adhesion kinase (FAK), filamentous actin (F-actin), and platelet-derived growth factor (PDGF) were evaluated to investigate EC activity. Wound-healing migration assays were performed to examine EC migration. RESULTS: The VEGF level of EC cells cultured in NPCM was significantly higher under hypoxia compared to normoxia. VEGF expression was significantly decreased, and FAK, F-actin, PDGF expression were inhibited when ECs were cocultured with rNCs under hypoxia. ECs cocultured with rNC in NPCM showed significantly decreased migratory activity compared to those without rNC under hypoxia. CONCLUSIONS: The angiogenic capacity of ECs was significantly inhibited by NCs under hypoxia via a VEGF-related pathway. Our results suggest that NCs may play a key role in the development of IVDs by inhibiting vascular growth within the disc, and this may be a promising novel therapeutic strategy for targeting vascular ingrowth in symptomatic DDD.
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Inductores de la Angiogénesis/metabolismo , Hipoxia de la Célula/fisiología , Degeneración del Disco Intervertebral/patología , Neovascularización Patológica/patología , Notocorda/citología , Animales , Comunicación Celular/fisiología , Proliferación Celular/fisiología , Células Cultivadas , Técnicas de Cocultivo , Medios de Cultivo Condicionados , Células Endoteliales/metabolismo , Células Endoteliales/fisiología , Humanos , Disco Intervertebral/irrigación sanguínea , Degeneración del Disco Intervertebral/metabolismo , Neovascularización Patológica/metabolismo , Núcleo Pulposo/citología , Núcleo Pulposo/metabolismo , Conejos , Factor A de Crecimiento Endotelial Vascular/fisiologíaRESUMEN
AIM: To evaluate the role of ultrasound (US) following magnetic resonance imaging (MRI) and mammography in patients with newly diagnosed breast cancers by assessing the additional cancer detection rate of US. MATERIAL AND METHODS: Two hundred and twenty-five women who had undergone 225 MRI examinations followed by US were included. An US-detected additional cancer was defined as a lesion detected using breast US that had not been detected by MRI, and which was shown to be malignant at histopathology. The rate of additional cancer detection, incidence of additional malignancies, positive predictive value (PPV), and false-positive (FP) rate were analysed. Factors associated with an increase in the additional cancer detection rate were analysed. RESULTS: The additional cancer detection rate was 0% (0/225) for the ipsilateral breast and 0.9% (2/225) for the contralateral breast, and the PPVs were 0% (0/5) and 100% (2/2), respectively. The overall TP:FP ratio was 0.4 (2:5). The additional cancer detection rate was higher for cases with moderate and severe background parenchymal enhancement than cases with minimal and mild background parenchymal enhancement (p=0.003). The additional cancer detection rate for cases with moderate and severe background parenchymal enhancement was 5.7% (2/35) for the contralateral breast (p=0.003). CONCLUSION: Preoperative breast US following MRI and mammography can help clinicians screen for contralateral cancers with an additional detection rate of 0.9%. Moreover, whole-breast US might be a useful contralateral screening modality in cases with moderate or marked parenchymal enhancement on breast MRI.
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Neoplasias de la Mama/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Biopsia , Mama/diagnóstico por imagen , Mama/patología , Neoplasias de la Mama/patología , Femenino , Humanos , Mamografía/métodos , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
This study applied molecular-based method to investigate the presence of porcine deltacoronavirus (PDCoV) in 59 commercial pig farms in South Korea. The results of RT-PCR screening on a relatively large collection of faeces samples (n = 681) from January 2013 to March 2015 did not reveal the presence of PDCoV until the end of 2014. However, on March 2015, PDCoV-positive samples (SL2, SL5) were detected from SL swine farm in Gyeongbuk province. The phylogenetic trees based on the complete spike- and nucleocapsid protein-coding genes showed that SL2 and SL5 closely related to the US PDCoV strains rather than those in China. Thought Korean strains of PDCoV isolated in 2014 (KNU14.04) and in 2015 (SL2 and SL5) grouped within US PDCoV cluster, the reconstruction of ancestral amino acid changes suggested that they are different.
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Infecciones por Coronaviridae/veterinaria , Coronaviridae/aislamiento & purificación , Diarrea/veterinaria , Enfermedades de los Porcinos/epidemiología , Animales , Coronaviridae/genética , Infecciones por Coronaviridae/epidemiología , Infecciones por Coronaviridae/virología , Diarrea/epidemiología , Diarrea/virología , Heces/virología , Femenino , Proteínas de la Nucleocápside/genética , Filogenia , Reacción en Cadena de la Polimerasa/veterinaria , República de Corea/epidemiología , Análisis de Secuencia de ADN/veterinaria , Glicoproteína de la Espiga del Coronavirus/genética , Porcinos , Enfermedades de los Porcinos/virologíaRESUMEN
AIM: To evaluate whether adding magnetic resonance imaging (MRI) to ultrasound (US) and US-guided fine-needle aspiration (US-FNA) can reduce the false-negative rate (FNR) in the diagnosis of axillary lymph node metastasis (ALNM) in breast cancer patients, and to assess false-negative diagnosis of N2 and N3 disease when adding MRI to US and US-FNA. MATERIALS AND METHODS: From March 2012 to February 2013, 497 breast cancer patients were included in the study. ALNM was evaluated according to US and US-FNA prior to MRI. Second-look US was performed when MRI showed positive findings of ALNM. If second-look US also revealed a positive finding, US-FNA was performed. Diagnostic performance, including FNR, was calculated for US and US-FNA with and without MRI. The negative predictive value (NPV) of N2 and N3 disease was evaluated in negative cases based on US and US-FNA with MRI. RESULTS: A total of 159 of 497 (32.0%) patients were found to have ALNM. Among them, 92 patients were diagnosed with metastasis on US and US-FNA. When adding MRI to US and US-FNA, an additional six patients were diagnosed with metastasis. The FNR of diagnosis of ALNM was improved by the addition of MRI (42.1% versus 38.4%, p = 0.0143). The NPV for N2 and N3 disease was 98% (391/399) based on US and US-FNA with MRI. CONCLUSION: Adding MRI to US and US-FNA could reduce the FNR of the diagnosis of ALNM. Furthermore, US and US-FNA with MRI may exclude 98% of N2 and N3 disease.
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Neoplasias de la Mama , Ganglios Linfáticos , Metástasis Linfática , Imagen por Resonancia Magnética/métodos , Biopsia del Ganglio Linfático Centinela/métodos , Ultrasonografía Intervencional/métodos , Adulto , Anciano , Anciano de 80 o más Años , Axila , Biopsia con Aguja Fina/métodos , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Reacciones Falso Negativas , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática/diagnóstico por imagen , Metástasis Linfática/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto JovenRESUMEN
Porcine reproductive and respiratory syndrome virus (PRRSV) has long been an economically devastating swine viral disease. The recent emergence of a highly pathogenic type 2 PRRSV with high mobility and mortality in China, spreading in Vietnam, Laos, and Thailand has placed neighbouring countries at risk. This study applied a codon-based extension of the Bayesian relaxed clock model and the fixed effects maximum-likelihood method to investigate and compare the evolutionary dynamics of type 2 PRRSV for all of known structural envelope protein-coding genes. By comparing the highly pathogenic type 2 PRRSV clade against the typical type 2 PRRSV clade, this study demonstrated that the highly pathogenic clade evolved at high rates in all of the known structural genes but did not display rapid evolutionary dynamics compared with typical type 2 PRRSV. In contrast, the ORF3, ORF5 and ORF6 genes of the highly pathogenic clade evolved in a qualitatively different manner from the genes of the typical clade. At the population level, several codons of the sequence elements that were involved in viral neutralization, as well as codons that were associated with in vitro attenuation/over-attenuation, were predicted to be selected differentially between the typical clade and the highly pathogenic clade. The results of this study suggest that the multigenic factors of the envelope protein-coding genes contribute to diversifying the biological properties (virulence, antigenicity, etc.) of the highly pathogenic clade compared with the typical clade of type 2 PRRSV.
Asunto(s)
Evolución Molecular , Síndrome Respiratorio y de la Reproducción Porcina/virología , Virus del Síndrome Respiratorio y Reproductivo Porcino/genética , Proteínas del Envoltorio Viral/genética , Animales , Teorema de Bayes , China , Codón , Funciones de Verosimilitud , Epidemiología Molecular , Filogenia , Virus del Síndrome Respiratorio y Reproductivo Porcino/patogenicidad , PorcinosRESUMEN
AIM: To compare the penetration resistance (PR) of six thermoplastic gutta-percha (GP) materials against needle penetration at different temperatures. METHODOLOGY: The PR of the following materials based on warm gutta-percha techniques, Beefill GP Cartridge (Beefill), GP Obturator-Hard/Medium/Soft (Dia-H, Dia-M, Dia-S), Obtura (Obtura) and Tactendo Gutta (Tactendo), was measured as a function of temperature change (from 30 °C to 200 °C). The PR was measured using a force gauge, mounted on a motor-driven micrometre stage, which pushed the penetration needle against GP in a glass cylinder at the designated temperatures. Data were analysed using Kruskal-Wallis anova and Duncan's multiple range tests at 5% significance. RESULTS: The mean PR values for all assessed materials ranged from 15.55 MPa to 26.02 MPa at 30 °C, decreased to 0.18-1.61 MPa at 60 °C, and finally reached 0.02-0.12 MPa at 200 °C. The Obtura had the highest PR values at most of the measured temperatures. At 40-60 °C, Obtura had the highest PR value (P < 0.05), and Tactendo had the lowest amongst the tested materials. At 70-200 °C, both the mean PR values and melt flow temperature (MFR) of Obtura, Dia-H and Dia-M were significantly higher than those of other materials (P < 0.05). CONCLUSIONS: The PR values were changed by both the heating temperature and the brand or type of GP materials tested. Each material was associated with drastic decreases before reaching 60 °C in different degrees, and Obtura had the highest PR at most of the measured temperatures.
Asunto(s)
Gutapercha/química , Materiales de Obturación del Conducto Radicular/química , Ensayo de Materiales , Reología , TemperaturaRESUMEN
PURPOSE: The effectiveness of supplemental screening ultrasound (US) was investigated in women ≥â40 years at average risk for breast cancer regardless of breast parenchymal density. A total of 4394 women at average risk and having previously undergone screening mammography were classified as the mammography group.â MATERIALS AND METHODS: Of 4394 women, 2005 underwent screening US after a final assessment of category 1 or 2 on screening mammography, and were categorized as the US group.âCategory 0, 4, and 5 on mammography and 3, 4, and 5 on US were defined as positive. The cancer yields per 1000 women and diagnostic performance of two groups were compared. RESULTS: The total cancer and invasive cancer yields for the mammography group were 3.0 (95â% confidence interval 1.6, 5.1) and 2.0 (95â% CI, 0.9, 3.9) per 1000 women, higher than the US values of 2.0 (0.5, 5.1) and 1.0 (0.1, 3.6), not statistically significant. The specificity, accuracy, and positive predictive value (PPV) for mammography were 88.90â% (87.93, 89.81), 88.85â% (87.88, 89.76), and 2.61â% (1.39, 4.41), significantly higher than the US values of 69.07â% (66.99, 71.09), 69.13â% (67.05, 71.15), and 0.64â% (0.18, 1.64). The short-term follow-up rate of mammography was 5.51â% (4.85, 6.22), significantly lower than the rate of 26.58 (24.66, 28.58) for US.â CONCLUSION: Supplemental screening US in mammographically negative breasts can find additional carcinomas in women at average risk but is not as effective as screening mammography because of the lower cancer yield, invasive cancer yield, specificity, accuracy, PPV and a high short-term follow-up rate.
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Neoplasias de la Mama/diagnóstico , Detección Precoz del Cáncer , Mamografía , Ultrasonografía Mamaria , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
PURPOSE: The purpose of our study was to review and compare the US findings of synchronous malignant breast lesions other than the index cancer additionally detected on second-look US with those detected on initial US, and therefore to determine differing characteristics that may aid in diagnosis and essentially improve the performance of the initial US examination. MATERIALS AND METHODS: A retrospective review of 39 mammographically occult synchronous malignant lesions other than the index cancer from 38 patients was performed (21 lesions: detected on second-look US, 18 lesions: detected on initial US). All patients underwent initial mammography, bilateral whole breast US (BWBU) and breast MRI, and all lesions were confirmed pathologically by biopsy or preoperative localization. RESULTS: Additional malignant breast lesions detected on both initial US and second-look US tended to be subtle and often did not show classic malignant findings. Second-look US lesions (median, 7.0âmm; range, 3â-â22âmm) tended to be smaller than initial US lesions (median, 9.0âmm; range 3â-â45âmm), although the difference was not statistically significant (pâ=â0.134). Second-look US lesions also showed no posterior acoustic features (pâ=â0.037) and a significantly higher proportion of lesions with circumscribed or indistinct margins compared to initial US lesions (pâ=â0.042). Second-look US lesions were significantly subareolar or relatively far (>â5âcm) from the nipple than initial US lesions (pâ=â0.048). CONCLUSION: Second-look US lesions showed more subtle findings of posterior acoustic features and margins, and tended to be subareolar or relatively far from the nipple compared to initial US lesions. However, both groups showed subtle US findings and there was no significant difference in other features.
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Neoplasias de la Mama/diagnóstico , Mama/patología , Imagen por Resonancia Magnética , Neoplasias Primarias Múltiples/diagnóstico , Adulto , Anciano , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Estudios Retrospectivos , Sensibilidad y Especificidad , Carga TumoralRESUMEN
PURPOSE: To assess the risk of malignancy of thyroid incidentalomas found on 18F-FDG PET/CT by US features and cytologic results, and to evaluate the clinical usage of a combination of US features and cytology for post-FNA management of thyroid incidentalomas on 18F-FDG PET/CT. MATERIALS AND METHODS: From September 2006 to December 2008, 132 patients with 134 thyroid incidentalomas detected on 18F-FDG PET/CT who had undergone US and US-FNA were included in this study. We evaluated the malignancy rate of thyroid incidentalomas in different subgroups subdivided by US features and US-FNA cytology results. Several variables were compared between the benign and malignant group. RESULTS: The risk of malignancy was 58.2â% (78/132) in thyroid incidentalomas on 18F-FDG PET/CT. Age, gender, and tumor size were not significantly different between the malignant and benign group. âMalignancy rate of thyroid incidentalomas was significantly higher in the suspicious malignant (88.9â%) than in the probably benign group (11.3â%) on US (p <â0.001). Malignancy rates were high in thyroid nodules with "malignancy", "suspicious for malignancy", or "follicular neoplasm" on cytologic results, regardless of US features. However, malignancy rates of thyroid incidentalomas with "unsatisfactory" or "benign" results on cytology were higher in the suspicious malignant (75â%, 12.5â%, respectively) than in the probably benign (0â%) group on US.â CONCLUSIONS: This study demonstrated that the risk of malignancy was high in thyroid incidentalomas on 18F-FDG PET/CT even without suspicious US features. However, there was no malignancy in nodules with no suspicious US features and benign cytology. Based on these results, we concluded that US may not replace FNA in the diagnosis of PET incidentalomas, and that a follow-up may be considered of thyroid incidentalomas with benign cytology and no suspicious US features.
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Biopsia con Aguja Fina , Fluorodesoxiglucosa F18 , Hallazgos Incidentales , Tomografía de Emisión de Positrones , Ajuste de Riesgo , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/patología , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patología , Tomografía Computarizada por Rayos X , Adenocarcinoma Folicular/diagnóstico por imagen , Adenocarcinoma Folicular/patología , Factores de Edad , Anciano , Algoritmos , Biomarcadores de Tumor/sangre , Diagnóstico Diferencial , Detección Precoz del Cáncer , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/diagnóstico por imagen , Recurrencia Local de Neoplasia/patología , Neoplasias Primarias Secundarias/diagnóstico por imagen , Neoplasias Primarias Secundarias/patología , Factores de Riesgo , Sensibilidad y Especificidad , Factores Sexuales , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/patología , Carga Tumoral , UltrasonografíaRESUMEN
Understanding viral transmission is an important factor for the effective prevention one of the most devastating swine diseases, porcine reproductive and respiratory syndrome. Focusing on molecular epidemiology of type 1 PRRSV, this study analysed a large ORF5 dataset collected worldwide from 1991 to 2012 using a coalescent-based Bayesian Markov chain Monte Carlo approach. The results suggested that the virus diversified into unique subpopulations in Russia & Belarus and Italy approximately 100 years ago. Previously unreported consecutive diffusions of the virus were identified, which showed that some countries, such as Spain and Germany, acted as distribution sources to some extent. This study also provided statistical evidence for the existence of an ORF5-based phylogeographical structure of type 1 PRRSV, in which the virus tended to cluster by geographical locations more tightly than expected by chance. In contrast to this tight geographical structure, the evolution of the ORF5 gene, based on mapping of non-synonymous/synonymous substitutions, was best described by a non-homogeneous process that could be implicated as a mechanism for viral immune evasion.
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Síndrome Respiratorio y de la Reproducción Porcina/virología , Virus del Síndrome Respiratorio y Reproductivo Porcino , Animales , Teorema de Bayes , Europa (Continente)/epidemiología , Epidemiología Molecular , Filogenia , Filogeografía , Síndrome Respiratorio y de la Reproducción Porcina/epidemiología , Virus del Síndrome Respiratorio y Reproductivo Porcino/clasificación , Virus del Síndrome Respiratorio y Reproductivo Porcino/genética , Virus del Síndrome Respiratorio y Reproductivo Porcino/aislamiento & purificación , Porcinos , Proteínas del Envoltorio Viral/genéticaRESUMEN
OBJECTIVE: To test whether the interaction between annulus fibrosus cells (AFCs) and endothelial cells (ECs) disrupts matrix homeostasis and stimulates production of innervation mediators. METHODS: Human microvascular ECs were cultured in the conditioned media of AF cell culture derived from degenerated human surgical specimen. Matrix-metalloproteinases (MMPs) and platelet-derived growth factor (PDGF) of ECs of this culture were analyzed by qRT-PCR, Western, and immunofluorescence. Vascular endothelial growth factor (VEGF), Interleukin-8 (IL-8), and nerve growth factor (NGF) in the media of this cell culture were assayed by ELISA. To determine the effects of ECs on AFCs, qRT-PCR was performed to determine mRNA levels of collagen I, II and aggrecan in AFCs cultured in EC conditioned media. RESULTS: Compared to ECs cultured in naïve media, ECs exposed to AFC conditioned media expressed higher mRNA and protein levels of key biomarkers of invasive EC phenotype, MMP-2 (2×), MMP-13 (4×), and PDGF-B (1.5-2×), and NGF (24.9 ± 15.2 pg/mL vs 0 in naïve media). Treatment of AF cells with EC culture conditioned media decreased collagen type II expression two fold. Considerable quantities of pro-angiogenic factors IL-8 (396.7 ± 302.0 pg/mL) and VEGF (756.2 ± 375.9 pg/mL) were also detected in the conditioned media of untreated AF cell culture. DISCUSSION: AFCs from degenerated discs secreted factors which stimulated EC production of factors known to induce matrix degradation, angiogenesis, and innervation. IL-8 and VEGF maybe the secreted factors from AFCs which mediate a pro-angiogenic stimulus often implicated in the development of disc degeneration.
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Medios de Cultivo Condicionados/farmacología , Endotelio Vascular/metabolismo , Matriz Extracelular/patología , Degeneración del Disco Intervertebral/metabolismo , Disco Intervertebral/inervación , Adulto , Capilares/metabolismo , Supervivencia Celular , Células Cultivadas , Colágeno Tipo II/metabolismo , Células Endoteliales/efectos de los fármacos , Femenino , Humanos , Interleucina-8/biosíntesis , Disco Intervertebral/irrigación sanguínea , Degeneración del Disco Intervertebral/patología , Masculino , Metaloproteasas/metabolismo , Persona de Mediana Edad , Neovascularización Patológica/metabolismo , Factor de Crecimiento Nervioso/metabolismo , Factor de Crecimiento Derivado de Plaquetas/metabolismo , Factor A de Crecimiento Endotelial Vascular/biosíntesisRESUMEN
Extensive green-roof systems are expected to have a synergetic effect in mitigating urban runoff, decreasing temperature and supplying water to a building. Mitigation of runoff through rainwater retention requires the effective design of a green-roof catchment. This study identified how to improve building runoff mitigation through quantitative analysis of an extensive green-roof system. Quantitative analysis of green-roof runoff characteristics indicated that the extensive green roof has a high water-retaining capacity response to rainfall of less than 20 mm/h. As the rainfall intensity increased, the water-retaining capacity decreased. The catchment efficiency of an extensive green roof ranged from 0.44 to 0.52, indicating reduced runoff comparing with efficiency of 0.9 for a concrete roof. Therefore, extensive green roofs are an effective storm water best-management practice and the proposed parameters can be applied to an algorithm for rainwater-harvesting tank design.
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Conservación de los Recursos Naturales/métodos , Restauración y Remediación Ambiental/métodos , Inundaciones , Ciudades , Drenaje de Agua , Vivienda , Lluvia , Temperatura , Movimientos del Agua , Abastecimiento de AguaRESUMEN
PURPOSE: To evaluate the rate of the elastography-pathology discordance, and evaluate which various factors have an effect on discordant elastography images (DEI) of breast lesions. MATERIALS AND METHODS: Elastography images of 284 pathologically confirmed breast lesions of 233 patients were evaluated. Elasticity scores were compared to pathology results, and lesions were divided into 4 groups: benign concordant/discordant, and malignant concordant/discordant. The rate of DEI among benign and malignant lesions was calculated and compared. Patient, lesion factors and image adequacy were compared among the concordant and discordant groups for analysis. RESULTS: Among the 284 breast lesions, 225 (79.2%) were benign, and 59 (20.8%) were malignant. The rate of DEI among malignant lesions was significantly higher than in benign lesions, i. e., 52.5 vs. 3.1% (p < 0.001). Discordant images were more significantly seen in patients with extremely dense breasts on mammography in benign lesions, 42.9 vs. 11.9% (p = 0.034). Discordant images were more significantly seen in malignant lesions < 10 mm or ≥ 20 mm (p = 0.006), and those with inadequate images (64.5 vs. 35.5%, p < 0.001). CONCLUSION: The rate of DEI was higher in malignant lesions than in benign lesions. Dense breast parenchyma, lesion size and image adequacy showed significance in discordant images of elastography which need consideration in image acquisition and interpretation.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Diagnóstico por Imagen de Elasticidad/métodos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/patología , Carcinoma Intraductal no Infiltrante/diagnóstico por imagen , Carcinoma Intraductal no Infiltrante/patología , Femenino , Humanos , Hiperplasia/diagnóstico por imagen , Hiperplasia/patología , Glándulas Mamarias Humanas/patología , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Ultrasonografía Intervencional/métodosRESUMEN
PURPOSE: For preoperative evaluation of ALN status using various methods, axillary US and subsequent US-FNA targeting the LNs suspicious for metastasis are the most widely used methods. The purpose of our study was to assess the rate of false-negative results at preoperative ultrasonography (US) and ultrasonography guided fine needle aspiration (US-FNA) of axillary lymph nodes (ALNs) in breast cancer patients and the number of false-negative lymph nodes, and to evaluate factors related to ALN false negative results in US and/or US-FNA in patients diagnosed with invasive ductal carcinoma. MATERIALS AND METHODS: Among 317 patients who underwent surgery for invasive ductal carcinoma during 2009 in Severance hospital, 237 patients had no reported ALN metastasis on preoperative US-FNA and US.âWe retrospectively reviewed the subsequent surgical pathology and clinicopathologic findings and assessed the rate of false-negative results from US and US-FNA of ALN and the number of false-negative lymph node. We performed univariate analysis and multivariate logistic regression analysis to evaluate the relationships between variable clinicopathologic factors (T-stage, position of ALN, hormone receptors, histologic grade, lymphovascular invasion (LVI) and performance of FNA) and cytologic results (false-negative result; FNALN and true negative result; TNALN) from US and/or US-FNA of ALN. RESULTS: The rate of false-negative results was 42.4â% (59/139) in both US and US-FNA of ALN but among them, 57.6â% (34/59) showed only one metastatic ALN. Breast cancer with FNALN on US and US-FNA was significantly related to positive estrogen receptor (pâ=â0.003), positive progesterone receptor (pâ=â0.001), and the presence of LVI (pâ=â0.004) in univariate analysis. In multivariate analysis, high T stages (≥âT2, odds ratio (OR) 4.007, pâ=â0.004) and LVI (OR 7.951, pâ=â0.001) showed significant correlation with FNALN on US and US-FNA. CONCLUSION: More than half of patients with FNALN showed only one metastatic ALN. LVI and high T-stages were the most important factors attributed to FNALN on US and US-FNA in patients with invasive ductal carcinoma.
Asunto(s)
Biopsia con Aguja Fina , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/patología , Ganglios Linfáticos/diagnóstico por imagen , Ganglios Linfáticos/patología , Metástasis Linfática/diagnóstico por imagen , Metástasis Linfática/patología , Ultrasonografía Intervencional , Adulto , Anciano , Axila , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/cirugía , Reacciones Falso Negativas , Femenino , Humanos , Lactante , Persona de Mediana Edad , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Cuidados Preoperatorios , Estudios RetrospectivosRESUMEN
PURPOSE: To evaluate the interobserver variability for US assessments of thyroid nodules and analyze the diagnostic performances of US assessments in thyroid nodules according to nodule size. MATERIALS AND METHODS: This was an IRB-approved retrospective study with waiver of informed consent. A total of 400 surgically-confirmed thyroid nodules were included. Nodules were divided into 4 groups by size; group 1 (nodule size <â5âmm), group 2 (5âmm ≤ nodule size <â10âmm), group 3 (10âmm ≤ nodule size <â20âmm), and group 4 (nodule size ≥â20âmm). Three experienced (7â-â10 years) radiologists retrospectively reviewed the US images. Agreement of each US descriptor and final US assessment, and diagnostic performances were calculated in each group and compared. RESULTS: Composition represented substantial or good agreement (kâ=â0.719â-â0.89). Margin showed the lowest agreement (kâ=â0.322â-â0.365). Individual kappa values for final assessment according to nodule size were as follows: group 1 (kâ=â0.674), group 2 (kâ=â0.596), group 3 (kâ=â0.674), and group 4 (kâ=â0.673). Specificity, PPV, and accuracy were significantly different among the groups with different size (p value <â0.05) and lowest in group 1.âNPV, specificity, PPV and accuracy except PPV of observer 3 increased with nodule size (pâ<â0.05). CONCLUSION: Interobserver agreements were relatively good (kâ=â0.637) in final US assessment regardless of nodule size in experienced radiologists. High false-positive rate was observed in US assessment in nodules less than 5âmm in maximum diameter.
Asunto(s)
Neoplasias de la Tiroides/diagnóstico por imagen , Nódulo Tiroideo/diagnóstico por imagen , Adolescente , Adulto , Anciano , Biopsia con Aguja Fina , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Estudios Retrospectivos , Sensibilidad y Especificidad , Glándula Tiroides/diagnóstico por imagen , Glándula Tiroides/patología , Glándula Tiroides/cirugía , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Nódulo Tiroideo/patología , Nódulo Tiroideo/cirugía , Carga Tumoral , Ultrasonografía Intervencional , Adulto JovenRESUMEN
PURPOSE: To investigate whether ultrasound-guided 14-gauge core needle biopsy (US-CNB) is efficient in the diagnosis of probably benign lesions showing interval growth on follow-up US.â MATERIALS AND METHODS: From March 2008 to August 2009, 116 breast lesions in 113 women (mean age: 41.2 years, range: 19â-â63 years) which were initially assessed as category 3 showing interval growth on follow-up US underwent US-CNB, and subsequent US-guided vacuum-assisted excision, surgical excision or follow-up US for at least 12 months. Diagnostic performances of US-CNB were evaluated with histopathologic results and follow-up US as standard reference. Clinical features of the patient and lesions characteristics including follow-up interval (I), the most increased diameter (D), D per I, increased volume (%V) and %V per I were calculated and compared. RESULTS: Of the 116 lesions, 4 lesions were diagnosed as malignancy and 112 as benign on final pathology. Malignancy rate of probably benign lesions showing interval growth was 3.4â% (4/116). Incorrect biopsy rate was 0.9â% (1/116). Palpability or newly developed suspicious US features were more associated with malignancy, 75.0 to 13.4â% and 50.0 to 25.9â%, respectively, but without significance (pâ=â0.063 and 0.290). Significant differences were seen in average rank when comparing between benign and malignancy in D, %V, D per follow-up interval (I), and %V/I (pâ=â0.037, 0.017, 0.043 and 0.009, respectively). CONCLUSION: US-CNB is an efficient diagnostic method for probably benign lesions showing interval growth, with discordant biopsy rate of 0.9â%.
Asunto(s)
Biopsia con Aguja/métodos , Neoplasias de la Mama/patología , Enfermedad Fibroquística de la Mama/patología , Ultrasonografía Intervencional/métodos , Ultrasonografía Mamaria/métodos , Adulto , Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/patología , Carcinoma Ductal de Mama/cirugía , Diagnóstico Diferencial , Femenino , Fibroadenoma/patología , Fibroadenoma/cirugía , Enfermedad Fibroquística de la Mama/cirugía , Humanos , Persona de Mediana Edad , Tumor Filoide/patología , Tumor Filoide/cirugía , Estudios Retrospectivos , Vacio , Adulto JovenRESUMEN
OBJECTIVE: The objective of this study was to compare the underestimation rate of invasive carcinoma in cases with ductal carcinoma in situ (DCIS) at percutaneous ultrasound-guided core biopsies of breast lesions between 14-gauge automated core-needle biopsy (ACNB) and 8- or 11-gauge vacuum-assisted biopsy (VAB), and to determine the relationship between the lesion type (mass or microcalcification on radiological findings) and the DCIS underestimation rate. METHODS: We retrospectively reviewed imaging-guided biopsies of breast lesions performed from February 2003 to August 2008. 194 lesions were diagnosed as DCIS at ultrasound-guided core biopsy: 138 lesions in 132 patients by 14-gauge ACNB, and 56 lesions in 56 patients by 8- or 11-gauge VAB. The histological results of the core biopsy samples were correlated with surgical specimens. The clinical and radiological findings were also reviewed. The histological DCIS underestimation rates were compared between the two groups and were analysed for differences according to the clinical and radiological characteristics of the lesions. RESULTS: The DCIS underestimation rate was 47.8% (66/138) for 14-gauge ACNB and 16.1% (9/56) for VAB (p<0.001). According to the lesion type on sonography, DCIS underestimation was 43.4% (63/145) in masses (47.6% using ACNB and 15.8% using VAB; p=0.012) and 24.5% (12/49) in microcalcifications (50.0% using ACNB and 16.2% using VAB; p=0.047). CONCLUSION: The underestimation rate of invasive carcinoma in cases with DCIS at ultrasound-guided core biopsies was significantly higher for ACNB than for VAB. Furthermore, this difference does not change according to the lesion type on ultrasound. Therefore, ultrasound-guided VAB can be a useful method for the diagnosis of DCIS lesions presented as either mass or microcalcification.
Asunto(s)
Biopsia con Aguja/métodos , Neoplasias de la Mama/patología , Mama/patología , Carcinoma Ductal de Mama/patología , Carcinoma Intraductal no Infiltrante/patología , Adulto , Biopsia con Aguja/instrumentación , Calcinosis/patología , Diagnóstico Tardío , Femenino , Humanos , Persona de Mediana Edad , Pronóstico , Sensibilidad y Especificidad , Ultrasonografía Intervencional/métodos , VacioRESUMEN
In the past 4 years, incidences of endemic or epidemic respiratory diseases associated with canine influenza H3N2 virus in Asian dogs have been reported in countries such as South Korea and China. Canine species were considered to be the new natural hosts for this virus. However, at the beginning of 2010, influenza-like respiratory signs, such as dyspnoea, were also observed among cats as well as in dogs in an animal shelter located in Seoul, South Korea. The affected cats showed 100â% morbidity and 40â% mortality. We were able to isolate a virus from a lung specimen of a dead cat, which had suffered from the respiratory disease, in embryonated-chicken eggs. The eight viral genes isolated were almost identical to those of the canine influenza H3N2 virus, suggesting interspecies transmission of canine influenza H3N2 virus to the cat. Moreover, three domestic cats infected with intranasal canine/Korea/GCVP01/07 (H3N2) all showed elevated rectal temperatures, nasal virus shedding and severe pulmonary lesions, such as suppurative bronchopneumonia. Our study shows, for the first time, that cats are susceptible to canine influenza H3N2 infection, suggesting that cats may play an intermediate host role in transmitting the H3N2 virus among feline and canine species, which could lead to the endemic establishment of the virus in companion animals. Such a scenario raises a public health concern, as the possibility of the emergence of new recombinant feline or canine influenza viruses in companion animals with the potential to act as a zoonotic infection cannot be excluded.