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1.
AJR Am J Roentgenol ; : 1-9, 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31670587

RESUMO

OBJECTIVE. The purpose of this study is to evaluate the diagnostic outcome of ultrasound (US)-guided core needle biopsy (CNB) of soft-tissue tumors and to assess the factors associated with significant diagnostic failure. MATERIALS AND METHODS. We performed a retrospective analysis of biopsy specimens obtained from patients with soft-tissue tumors of the extremities and superficial trunk who underwent both US-guided CNB and surgical resection. In accordance with the World Health Organization classification, biopsy results and findings from final histologic analysis of the surgically resected specimen (hereafter known as final histologic findings) were categorized in terms of biologic potential as benign, intermediate (locally aggressive), intermediate (rarely metastasizing), or malignant. Biopsy results were considered to show a significant diagnostic failure if they resulted in incorrect classification of biologic potential compared with final histologic findings, if results were indeterminate, or if nondiagnostic specimens were obtained. World Health Organization classification categories and the biologic potential of the tumors according to final histologic findings were assessed to identify any relationship with diagnostic failure of CNB, as were other tumor- and patient-related factors. RESULTS. Significant diagnostic failure was seen for 40 of 303 biopsies (13.20%). Multivariate analysis showed a significant association between diagnostic failure and adipocytic tumors (odds ratio [OR], 9.686; p = 0.037) or vascular tumors (OR, 40.115; p = 0.005); intermediate (rarely metastasizing) biologic potential (OR, 12.279; p = 0.001), or malignant biologic potential (OR, 5.668; p < 0.001); and discordance between radiologic and final histologic findings or indeterminacy of biologic potential (OR, 2.500; p = 0.034). CONCLUSION. The World Health Organization classification categories (adipocytic or vascular), biologic potential (intermediate [rarely metastasizing] or malignant), and discordance between radiologic and final histologic findings or indeterminacy of biologic potential were found to be independent risk factors for significant diagnostic failure of CNB of soft-tissue tumors.

2.
Clin Cancer Res ; 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31573956

RESUMO

PURPOSE: The success of checkpoint blockade has led to a significant increase in the development of a broad range of immunomodulatory molecules for the treatment of cancer, including agonists against T-cell costimulatory receptors, such as OX40. Unlike checkpoint blockade, where complete and sustained receptor saturation may be required for maximal activity, the optimal dosing regimen and receptor occupancy for agonist agents is less well understood and requires further study. EXPERIMENTAL DESIGN: We integrated both preclinical and clinical biomarker data sets centered on dose, exposure, receptor occupancy, receptor engagement, and downstream pharmacodynamic changes to model the optimal dose and schedule for the OX40 agonist antibody BMS-986178 alone and in combination with checkpoint blockade. RESULTS: Administration of the ligand-blocking anti-mouse surrogate antibody OX40.23 or BMS-986178 as monotherapy or in combination with checkpoint blockade led to increased peripheral CD4+ and CD8+ T-cell activation in tumor-bearing mice and patients with solid tumors, respectively. OX40 receptor occupancy between 20% and 50% both in vitro and in vivo was associated with maximal enhancement of T-cell effector function by anti-OX40 treatment, whereas a receptor occupancy > 40% led to a profound loss in OX40 receptor expression, with clear implications for availability for repeat dosing. CONCLUSIONS: Our results highlight the value of an integrated translational approach applied during early clinical development to aggregate preclinical and clinical data in an effort to define the optimal dose and schedule for T-cell agonists in the clinic.

3.
J Food Sci ; 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31589346

RESUMO

A multilayer film containing star anise essential oil and thymol coating layers (SAEO and TH, respectively), with insect repellent and antimicrobial properties, has been developed using bar coating and adhesive lamination processes. Our previous study reported the in vitro activities of this polypropylene film (PP)/SAEO/polyethylene terephthalate film (PET)/TH/low-density polyethylene film (LDPE) multilayer film. The current study focused on demonstrating the morphological, optical, and mechanical properties of the film, and evaluating its in vivo activities when used as a bread packaging material. The developed film was 15.03% thicker and 1.86% less transparent than the control film (without active agent coating layers: PP/PET/LDPE). While the color values of the developed film were slightly different from the control film, both films appeared similar to the naked eye. The tensile strength in the developed film was somewhat lower than that of the control film, while both films had statistically comparable values for elongation at break. During storage of sliced bread packaged in the developed film, the film both deterred insects from approaching toward and impeded the growth of microorganisms in the bread. These results suggest the potential applicability of the developed film as an active food packaging material with insect repellent and antimicrobial activities. PRACTICAL APPLICATION: A multilayer film incorporated with insect repellent and antimicrobial coating layers was applied in sliced wheat bread packaging. The developed film effectively inhibited approaches of stored-product insects to packaged bread and growth of microorganisms on the bread surface. It can be used as an active food packaging material that improves the safety and shelf-life of foods.

4.
Nucleic Acids Res ; 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31665416

RESUMO

Microbial secondary metabolism is a reservoir of bioactive compounds of immense biotechnological and biomedical potential. The biosynthetic machinery responsible for the production of these secondary metabolites (SMs) (also called natural products) is often encoded by collocated groups of genes called biosynthetic gene clusters (BGCs). High-throughput genome sequencing of both isolates and metagenomic samples combined with the development of specialized computational workflows is enabling systematic identification of BGCs and the discovery of novel SMs. In order to advance exploration of microbial secondary metabolism and its diversity, we developed the largest publicly available database of predicted BGCs combined with experimentally verified BGCs, the Integrated Microbial Genomes Atlas of Biosynthetic gene Clusters (IMG-ABC) (https://img.jgi.doe.gov/abc-public). Here we describe the first major content update of the IMG-ABC knowledgebase, since its initial release in 2015, refreshing the BGC prediction pipeline with the latest version of antiSMASH (v5) as well as presenting the data in the context of underlying environmental metadata sourced from GOLD (https://gold.jgi.doe.gov/). This update has greatly improved the quality and expanded the types of predicted BGCs compared to the previous version.

5.
Sci Data ; 6(1): 207, 2019 10 16.
Artigo em Inglês | MEDLINE | ID: mdl-31619684

RESUMO

Natural sulfide rich deposits are common in coastal areas worldwide, including along the Baltic Sea coast. When artificial drainage exposes these deposits to atmospheric oxygen, iron sulfide minerals in the soils are rapidly oxidized. This process turns the potential acid sulfate soils into actual acid sulfate soils and mobilizes large quantities of acidity and leachable toxic metals that cause severe environmental problems. It is known that acidophilic microorganisms living in acid sulfate soils catalyze iron sulfide mineral oxidation. However, only a few studies regarding these communities have been published. In this study, we sampled the oxidized actual acid sulfate soil, the transition zone where oxidation is actively taking place, and the deepest un-oxidized potential acid sulfate soil. Nucleic acids were extracted and 16S rRNA gene amplicons, metagenomes, and metatranscriptomes generated to gain a detailed insight into the communities and their activities. The project will be of great use to microbiologists, environmental biologists, geochemists, and geologists as there is hydrological and geochemical monitoring from the site stretching back for many years.

6.
Korean J Gastroenterol ; 74(2): 110-114, 2019 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-31438662

RESUMO

The Chicago classification (CC) defines an esophagogastric junction outflow obstruction (EGJOO) as the presence of several instances of intact or weak peristalsis, elevated median integrated relaxation pressure above 15 mmHg, and a discrepancy from the criteria of achalasia. The revised CC addresses the potential etiology of EGJOO, including the early forms of achalasia, mechanical obstruction, esophageal wall stiffness, or manifestation of hiatal hernia. A 58-year-old woman visited the Presbyterian Medical Center with swallowing difficulty. The patient underwent a high resolution manometry (HRM) examination and was diagnosed with EGJOO. Chest CT was performed to exclude a mechanical obstruction as a cause, and CT revealed a subepithelial tumor (SET) at the upper part of the esophagogastric junction. Therefore, laparoscopic surgery was performed and eccentric muscular hypertrophy of the distal esophagus was observed. Longitudinal myotomy and Dor fundoplication were also performed. The histology findings of the surgical specimens were consistent with achalasia. This paper reports a case of early achalasia that was finally diagnosed by the histology findings, but was initially diagnosed as EGJOO using HRM and misdiagnosed as SET in the image study.

7.
Saudi Med J ; 40(8): 836-839, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31423522

RESUMO

A subcapsular hematoma of the liver is often found during autopsy in stillborn infants rather than clinically. It is usually asymptomatic unless ruptured; thus, the diagnosis is often delayed or missed. Rupture of a subcapsular hematoma in a premature neonate causes massive intraabdominal hemorrhage, which is associated with high mortality. Thus, early recognition and treatment to avoid rupture are imperative. We describe a case of life-threatening hemorrhage from a subcapsular hematoma of the liver during emergent laparotomy for mechanical obstruction in an 860 g premature neonate and discuss the appropriate preoperative preparation and anesthetic management for this case.

8.
Sci Data ; 6(1): 140, 2019 07 31.
Artigo em Inglês | MEDLINE | ID: mdl-31366912

RESUMO

The rocky, seasonally-dry and nutrient-impoverished soils of the Brazilian campos rupestres impose severe growth-limiting conditions on plants. Species of a dominant plant family, Velloziaceae, are highly specialized to low-nutrient conditions and seasonal water availability of this environment, where phosphorus (P) is the key limiting nutrient. Despite plant-microbe associations playing critical roles in stressful ecosystems, the contribution of these interactions in the campos rupestres remains poorly studied. Here we present the first microbiome data of Velloziaceae spp. thriving in contrasting substrates of campos rupestres. We assessed the microbiomes of Vellozia epidendroides, which occupies shallow patches of soil, and Barbacenia macrantha, growing on exposed rocks. The prokaryotic and fungal profiles were assessed by rRNA barcode sequencing of epiphytic and endophytic compartments of roots, stems, leaves and surrounding soil/rocks. We also generated root and substrate (rock/soil)-associated metagenomes of each plant species. We foresee that these data will contribute to decipher how the microbiome contributes to plant functioning in the campos rupestres, and to unravel new strategies for improved crop productivity in stressful environments.

9.
J Mol Diagn ; 21(6): 1053-1066, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31445211

RESUMO

Microsatellite instability (MSI) is an important biomarker for predicting response to immune checkpoint inhibitor therapy, as emphasized by the recent checkpoint inhibitor approval for MSI-high (MSI-H) solid tumors. Herein, we describe and validate a novel method for determining MSI status from a next-generation sequencing comprehensive genomic profiling assay using formalin-fixed, paraffin-embedded samples. This method is 97% (65/67) concordant with current standards, PCR and immunohistochemistry. We further apply this method to >67,000 patient tumor samples to identify genes and pathways that are enriched in MSI-stable or MSI-H tumor groups. Data show that although rare in tumors other than colorectal and endometrial carcinomas, MSI-H samples are present in many tumor types. Furthermore, the large sample set revealed that MSI-H tumors selectively share alterations in genes across multiple common pathways, including WNT, phosphatidylinositol 3-kinase, and NOTCH. Last, MSI is sufficient, but not necessary, for a tumor to have elevated tumor mutation burden. Therefore, MSI can be determined from comprehensive genomic profiling with high accuracy, allowing for efficient MSI-H detection across all tumor types, especially those in which routine use of immunohistochemistry or PCR-based assays would be impractical because of a rare incidence of MSI. MSI-H tumors are enriched in alterations in specific signaling pathways, providing a rationale for investigating directed immune checkpoint inhibitor therapies in combination with pathway-targeted therapies.

10.
Colloids Surf B Biointerfaces ; 181: 879-889, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31382336

RESUMO

In this study, a double network hydrogel of a natural polysaccharide gellan gum (GG) hydrogel and a synthetic hydrogel poloxamer-heparin (PoH) hydrogel (PoH/GG DNH) is introduced to complement disadvantages of each hydrogel and improve the microenvironment for cell delivery. The microstructure, surface morphology, gelation temperature, swelling and weight loss, sol fraction, mechanical property and thermal stability was examined. The potential of the composite hydrogel for cell vehicle was demonstrated by encapsulation of bone marrow stem cells isolated from rabbits (rBMSCs) within the PoH/GG DNH in vitro. The results showed that the DNH system supported cell survival and retained rBMSCs morphology and phenotype. Moreover, cell distribution, adherence, and ECM production were supported by PoH/GG DNH in vivo. Overall results provide a potential opportunity to apply the composite hydrogels in tissue engineering purpose.

11.
Medicine (Baltimore) ; 98(30): e16611, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348309

RESUMO

Although unilateral primary aldosteronism (PA) is the most common surgically correctable cause of hypertension, the cure rate varies widely. The predicting factors related to uncured hypertension are not completely established. This study was designed to determine predicting factors associated with resolution of hypertension after adrenalectomy for PA.The records of unilateral PA patients who had undergone retroperitoneal laparoscopic adrenalectomy were retrospectively reviewed from January 2010 to December 2017 in a single center. Patient demographics and preoperative factors were analyzed, including age, sex, smoking history, family history of hypertension, the presence of diabetes, body mass index (BMI), systolic blood pressure, diastolic blood pressure, biochemical results and tumor characteristics. Univariate and multivariate Logistic regression analysis were used for statistical assessment.126 patients with unilateral PA were enrolled, and the mean age at the time of surgery was 54.2 years. Of these patients, 74 (58.7%) were women, and the mean BMI and duration of hypertension were 26 kg/m and 61 months, respectively. Hypertension was cured in 46% patients, of the patients with uncured hypertension, 91% had improved control of hypertension. In univariate analysis, age (P = .03), BMI (P = .01), duration of hypertension >5 years (P = .03), preoperative antihypertensive agents>2 (P = .02), contralateral abnormalities (P = .03) were the main factors related to uncured hypertension after adrenalectomy. In multivariate regression analysis, uncured hypertension was independently associated with obesity (25.00-29.99: odds ratio [OR], 2.97, P < .02; ≥30: OR, 6.42, P < .01), duration of hypertension >5 years (OR, 6.25, P < .01), preoperative antihypertensive agents >2 (OR, 5.30, P < .001), and contralateral adrenal abnormalities (OR, 8.38, P < .01).The hypertension cure rate of unilateral adrenalectomy in PA is not high. Obesity, duration of hypertension >5 years, preoperative antihypertensive agents >2 and contralateral adrenal abnormalities were independently associated with uncured hypertension.


Assuntos
Adrenalectomia/estatística & dados numéricos , Hiperaldosteronismo/cirurgia , Hipertensão/epidemiologia , Adulto , Fatores Etários , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hiperaldosteronismo/complicações , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos
12.
J Appl Toxicol ; 39(10): 1470-1479, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31287177

RESUMO

With the rapid advancement and numerous applications of engineered nanomaterials (ENMs) in science and technology, their effects on animal health, environment and safety should be considered carefully. However, quick assessment of their effects on developmental and reproductive health and an understanding of how they cause such adverse toxic effects remain challenging, because of the fast-growing number of ENMs and the limitations of the different toxicity assays currently in use as well as lack of suitable animal model systems. In this study, we performed a high-throughput complex object parametric analyzer and sorter (COPAS) assay for assessing the developmental and reproductive toxicity of ENMs using Caenorhabditis elegans and provide descriptions of the data and their subsequent analysis. The results showed significant reproductive and developmental toxicity potential of different ENMs. We assessed the usefulness of this method in terms of error-free data, user-friendliness and results being consistent with those of visual, molecular and cellular studies. Moreover, the COPAS Biosort system could be used on a larger scale to screen thousands of chemicals, drugs, pharmaceuticals and ENMs. This study also indicates that the COPAS-based high-throughput screening system is highly reliable for the assessment of toxicity and health risks of NMs.

13.
Sci Data ; 6(1): 129, 2019 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-31332186

RESUMO

Metagenomic and metatranscriptomic time-series data covering a 52-day period in the fall of 2016 provide an inventory of bacterial and archaeal community genes, transcripts, and taxonomy during an intense dinoflagellate bloom in Monterey Bay, CA, USA. The dataset comprises 84 metagenomes (0.8 terabases), 82 metatranscriptomes (1.1 terabases), and 88 16S rRNA amplicon libraries from samples collected on 41 dates. The dataset also includes 88 18S rRNA amplicon libraries, characterizing the taxonomy of the eukaryotic community during the bloom. Accompanying the sequence data are chemical and biological measurements associated with each sample. These datasets will facilitate studies of the structure and function of marine bacterial communities during episodic phytoplankton blooms.

14.
J Neuroeng Rehabil ; 16(1): 99, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31358017

RESUMO

BACKGROUND: Balance impairments are common in patients with infratentorial stroke. Although robot-assisted gait training (RAGT) exerts positive effects on balance among patients with stroke, it remains unclear whether such training is superior to conventional physical therapy (CPT). Therefore, we aimed to investigate the effects of RAGT combined with CPT and compared them with the effects of CPT only on balance and lower extremity function among survivors of infratentorial stroke. METHODS: This study was a single-blinded, randomized controlled trial with a crossover design conducted at a single rehabilitation hospital. Patients (n = 19; 16 men, three women; mean age: 47.4 ± 11.6 years) with infratentorial stroke were randomly allocated to either group A (4 weeks of RAGT+CPT, followed by 4 weeks of CPT+CPT) or group B (4 weeks of CPT+CPT followed by 4 weeks of RAGT+CPT). Changes in dynamic and static balance as indicated by Berg Balance Scale scores were regarded as the primary outcome measure. Outcome measures were evaluated for each participant at baseline and after each 4-week intervention period. RESULTS: No significant differences in outcome-related variables were observed between group A and B at baseline. In addition, no significant time-by-group interactions were observed for any variables, indicating that intervention order had no effect on lower extremity function or balance. Significantly greater improvements in secondary functional outcomes such as lower extremity Fugl-Meyer assessment (FMA-LE) and scale for the assessment and rating of ataxia (SARA) were observed following the RAGT+CPT intervention than following the CPT+CPT intervention. CONCLUSION: RAGT produces clinically significant improvements in balance and lower extremity function in individuals with infratentorial stroke. Thus, RAGT may be useful for patients with balance impairments secondary to other pathologies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02680691. Registered 09 February 2016; retrospectively registered.

15.
Nat Commun ; 10(1): 2581, 2019 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-31197173

RESUMO

Despite existing reports on differential DNA methylation in type 2 diabetes (T2D) and obesity, our understanding of its functional relevance remains limited. Here we show the effect of differential methylation in the early phases of T2D pathology by a blood-based epigenome-wide association study of 4808 non-diabetic Europeans in the discovery phase and 11,750 individuals in the replication. We identify CpGs in LETM1, RBM20, IRS2, MAN2A2 and the 1q25.3 region associated with fasting insulin, and in FCRL6, SLAMF1, APOBEC3H and the 15q26.1 region with fasting glucose. In silico cross-omics analyses highlight the role of differential methylation in the crosstalk between the adaptive immune system and glucose homeostasis. The differential methylation explains at least 16.9% of the association between obesity and insulin. Our study sheds light on the biological interactions between genetic variants driving differential methylation and gene expression in the early pathogenesis of T2D.


Assuntos
Metilação de DNA/fisiologia , Diabetes Mellitus Tipo 2/genética , Glucose/metabolismo , Insulina/metabolismo , Obesidade/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Simulação por Computador , Ilhas de CpG/genética , Diabetes Mellitus Tipo 2/metabolismo , Epigênese Genética/fisiologia , Epigenômica/métodos , Feminino , Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica/genética , Estudo de Associação Genômica Ampla/métodos , Homeostase/genética , Humanos , Masculino , Redes e Vias Metabólicas/genética , Pessoa de Meia-Idade , Obesidade/metabolismo , Polimorfismo de Nucleotídeo Único/fisiologia , Adulto Jovem
16.
Cancer Res ; 79(15): 3916-3927, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31182547

RESUMO

Regulatory T cells (Treg) are immunosuppressive and negatively impact response to cancer immunotherapies. CREB-binding protein (CBP) and p300 are closely related acetyltransferases and transcriptional coactivators. Here, we evaluate the mechanisms by which CBP/p300 regulate Treg differentiation and the consequences of CBP/p300 loss-of-function mutations in follicular lymphoma. Transcriptional and epigenetic profiling identified a cascade of transcription factors essential for Treg differentiation. Mass spectrometry analysis showed that CBP/p300 acetylates prostacyclin synthase, which regulates Treg differentiation by altering proinflammatory cytokine secretion by T and B cells. Reduced Treg presence in tissues harboring CBP/p300 loss-of-function mutations was observed in follicular lymphoma. Our findings provide novel insights into the regulation of Treg differentiation by CBP/p300, with potential clinical implications on alteration of the immune landscape. SIGNIFICANCE: This study provides insights into the dynamic role of CBP/p300 in the differentiation of Tregs, with potential clinical implications in the alteration of the immune landscape in follicular lymphoma.

17.
Sci Rep ; 9(1): 6917, 2019 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-31061414

RESUMO

Precise mechanisms underlying interleukin-7 (IL-7)-mediated tumor invasion remain unclear. Thus, we investigated the role of IL-7 in tumor invasiveness using metastatic prostate cancer PC-3 cell line derivatives, and assessed the potential of IL-7 as a clinical target using a Janus kinase (JAK) inhibitor and an IL-7-blocking antibody. We found that IL-7 stimulated wound-healing migration and invasion of PC-3 cells, increased phosphorylation of signal transducer and activator of transcription 5, Akt, and extracellular signal-regulated kinase. On the other hand, a JAK inhibitor and an IL-7-blocking antibody decreased the invasiveness of PC-3 cells. IL-7 increased tumor sphere formation and expression of epithelial-mesenchymal transition (EMT) markers. Importantly, lentiviral delivery of IL-7Rα to PC-3 cells significantly increased bone metastasis in an experimental murine metastasis model compared to controls. The gene expression profile of human prostate cancer cells from The Cancer Genome Atlas revealed that EMT pathways are strongly associated with prostate cancers that highly express both IL-7 and IL-7Rα. Collectively, these data suggest that IL-7 and/or IL-7Rα are promising targets of inhibiting tumor metastasis.

18.
Nanotechnology ; 30(33): 335402, 2019 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-31026842

RESUMO

Piezoelectric materials convert external mechanical force into electrical energy, due to the breaking of the centrosymmetry of the atomic structure. Piezoelectricity-based nano-generators (PNGs) based on two-dimensional transition metal dichalcogenides (TMDs) can generate electrical energy stably by the piezoelectric effect at their nanoscale thickness. However, the commercialization of TMD-based PNGs is limited by their poor piezoelectric performance and microscale energy harvesting. Here, we present the first centimeter-scale PNGs based on molybdenum disulfide (MoS2) nanosheets with vertically grown hollow MoS2 nanoflakes (v-MoS2 NFs) obtained by chemical vapor deposition for energy harvesting from human motions. The collision of v-MoS2 NFs with a preferred odd-atomic-layer number and their 2H antiparallel phase leads to efficient electrical energy generation during the bending movement. Further, basal MoS2 films with v-MoS2 NFs are transferred onto flexible substrates via conventional polymer-assisted methods for the fabrication of attachable and wearable piezoelectric power generators.

19.
PLoS One ; 14(4): e0215737, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31026299

RESUMO

BACKGROUND: Small-for-gestational age (SGA) infants should be identified before birth because of an increased risk of adverse perinatal outcomes. The objective of this study was to assess the impact of fetal growth rate by gestational age on the prediction of SGA and to identify the optimal time to initiate intensive fetal monitoring to detect SGA in low-risk women. We also sought to determine which the ultrasonographic parameters that contribute substantially to the birthweight determination. METHODS: This was a retrospective study of 442 healthy pregnant women with singleton pregnancies. There were 328 adequate-for-gestational age (AGA) neonates and 114 SGA infants delivered between 37+0 and 41+6 weeks of gestation. We compared the biparietal diameters (BPD), head circumferences (HC), abdominal circumferences (AC), femur lengths (FL), and estimated fetal weights (EFW) obtained on each ultrasound to determine which of these parameters was the best indicator of SGA. We created receiver operating characteristic curves, calculated the areas under the curves (AUCs), and analyzed the data using multivariable logistic regressions to assess the ultrasound screening performances and identify the best predictive factor. RESULTS: Among the four ultrasonographic parameters, the AC measurement between 24+0~28+6 weeks achieved a sensitivity of 79.5% and a specificity of 71.7%, with an AUC of 0.806 in the prediction of SGA. AC showed consistently higher AUCs above 0.8 with 64~80% sensitivities as gestational age progressed. EFW measurements from 33+0~35+6 gestational weeks achieved a sensitivity of 60.6% and a specificity of 87.6%, with an AUC of 0.826. In a conditional growth model developed from the linear mixed regression, the value differences between AC and EFW in the SGA and AGA groups became even more pronounced after 33+0~35+6 weeks. CONCLUSION: Healthy low-risk women with a low fetal AC after 24 weeks' gestation need to be monitored carefully for fetal growth to identify SGA infants with a risk for adverse perinatal outcomes.

20.
Anticancer Res ; 39(4): 1875-1882, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30952728

RESUMO

BACKGROUND/AIM: We investigated the correlation between texture features on apparent diffusion coefficient (ADC) maps and histological vascular parameters of FN13762 rat breast cancers after antiangiogenic therapy. MATERIALS AND METHODS: FN13762 cancer cells were implanted into 30 rats, and bevacizumab was intraperitoneally administered to 15 (treated group). For each rat, magnetic resonance imaging (MRI) was obtained at five time points after baseline examination. Serial texture analyses were performed on ADC maps and extracted texture parameters were correlated with histological vascular parameters. RESULTS: Entropy of the ADC values correlated with microvessel density in the treated group (r=0.493, p=0.06). Hypoxia inducible factor-1 alpha showed the highest correlation coefficient with the 5th percentile ADC value (r=0.844, p<0.001). Vascular endothelial growth factor was significantly correlated with homogeneity on ADC map (r=-0.521, p=0.046). In the control group, no texture features showed significant correlations with histological vascular parameters. CONCLUSION: ADC map texture features may reflect histological vascular changes after antiangiogenic therapy.


Assuntos
Inibidores da Angiogênese/farmacologia , Bevacizumab/farmacologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador/métodos , Neovascularização Patológica , Animais , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Feminino , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Valor Preditivo dos Testes , Ratos Endogâmicos F344 , Fatores de Tempo , Carga Tumoral/efeitos dos fármacos , Fator A de Crescimento do Endotélio Vascular/metabolismo
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