RESUMEN
AIM: To determine the feasibility of semi-quantitative haemodynamic parameters derived from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) to assess liver fibrosis. MATERIALS AND METHODS: Seventy-five patients with Child's A classification (males/females=24/51; average age, 58 years; range, 30-80 years) received DCE-MRI 3 days prior to hepatectomy. Semi-quantitative haemodynamic parameters, including the wash-in slope, wash-out slope, and time-to-peak, were calculated from DCE-MRI data. Liver fibrosis of the resected non-tumour liver was graded pathologically from F0 (no fibrosis) to F6 (cirrhosis) in the regions corresponding to those assessed by DCE-MRI. RESULTS: The wash-out slope showed higher interobserver and intra-observer reliabilities than the wash-in slope and time-to-peak. There was a significant positive correlation between the wash-out slope and pathological grade of fibrosis (Spearman's correlation coefficient: r=0.5331, p<0.0001). The area under the receiver operating characteristic curve was 0.8066 when using the wash-out slope to differentiate cirrhosis (grade F6) from non-cirrhosis (grades F0-5). Using the cut-off point that maximised specificity, the sensitivity was 62.07%, specificity was 91.30%, positive predictive value was 81.81%, negative predictive value was 79.25%, and accuracy was 80%. CONCLUSIONS: The wash-out slope derived from DCE-MRI might be potentially useful in assessing liver cirrhosis in patients with Child's A classification before hepatectomy.
Asunto(s)
Hepatectomía , Cirrosis Hepática/patología , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Medios de Contraste , Estudios de Factibilidad , Femenino , Humanos , Cirrosis Hepática/cirugía , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Cuidados Preoperatorios/métodosAsunto(s)
Vesícula/patología , Exantema/patología , Dermatosis Bullosa IgA Lineal/patología , Anciano de 80 o más Años , Antibacterianos/efectos adversos , Betametasona/administración & dosificación , Betametasona/uso terapéutico , Vesícula/inducido químicamente , Vesícula/tratamiento farmacológico , Diagnóstico Diferencial , Exantema/inducido químicamente , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulina A/metabolismo , Dermatosis Bullosa IgA Lineal/inducido químicamente , Dermatosis Bullosa IgA Lineal/diagnóstico , Dermatosis Bullosa IgA Lineal/tratamiento farmacológico , Masculino , Combinación Piperacilina y Tazobactam/efectos adversos , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Resultado del Tratamiento , Vancomicina/efectos adversosAsunto(s)
Exantema/patología , Púrpura/patología , Rickettsia typhi/aislamiento & purificación , Piel/patología , Tifus Endémico Transmitido por Pulgas/diagnóstico , Animales , Antibacterianos/uso terapéutico , Pueblo Asiatico , Exantema/microbiología , Fiebre/diagnóstico , Fiebre/etiología , Técnica del Anticuerpo Fluorescente Indirecta/métodos , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Púrpura/microbiología , Roedores , Piel/irrigación sanguínea , Resultado del Tratamiento , Tifus Endémico Transmitido por Pulgas/sangre , Tifus Endémico Transmitido por Pulgas/tratamiento farmacológicoRESUMEN
The structure-activity relationships of 25 triorganotin(IV) compounds were studied using the 4th instar A. aegypti larvae of the susceptible Liverpool Red-eye strain. The LC50 values of these compounds were compared with those of Malathion, DDT and Temephos. Maximal activities were obtained with tritolyltin chloride and its complexes with triphenyl-phosphine oxide and pyridine N-oxide, dimethyloctyltin- and diethyloctyltin acetates and tributyltin sucrose phthalate. A limited number of the triorganotin compounds was also tested with observed high activity against the 4th instar larvae of a local DDT-tolerant strain and against the 2nd instar larvae and adults of the susceptible strain. Delayed effect studies with both 2nd and 4th instar larvae showed high post-treatment mortality for the latter and, among the range of active compounds, the methyl- and aryltin compounds, in particular, were also found to exhibit high residual activities (100% kill) in laboratory tests conducted up to 10 weeks.