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[PMID]:27779124
[Au] Autor:Kim Y; Bae SK; Cheng T; Tao C; Ge Y; Chapman AB; Torres VE; Yu AS; Mrug M; Bennett WM; Flessner MF; Landsittel DP; Bae KT
[Ad] Endereço:Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
[Ti] Título:Automated segmentation of liver and liver cysts from bounded abdominal MR images in patients with autosomal dominant polycystic kidney disease.
[So] Source:Phys Med Biol;61(22):7864-7880, 2016 Nov 21.
[Is] ISSN:1361-6560
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Liver and liver cyst volume measurements are important quantitative imaging biomarkers for assessment of disease progression in autosomal dominant polycystic kidney disease (ADPKD) and polycystic liver disease (PLD). To date, no study has presented automated segmentation and volumetric computation of liver and liver cysts in these populations. In this paper, we proposed an automated segmentation framework for liver and liver cysts from bounded abdominal MR images in patients with ADPKD. To model the shape and variations in ADPKD livers, the spatial prior probability map (SPPM) of liver location and the tissue prior probability maps (TPPMs) of liver parenchymal tissue intensity and cyst morphology were generated. Formulated within a three-dimensional level set framework, the TPPMs successfully captured liver parenchymal tissues and cysts, while the SPPM globally constrained the initial surfaces of the liver into the desired boundary. Liver cysts were extracted by combined operations of the TPPMs, thresholding, and false positive reduction based on spatial prior knowledge of kidney cysts and distance map. With cross-validation for the liver segmentation, the agreement between the radiology expert and the proposed method was 84% for shape congruence and 91% for volume measurement assessed by the intra-class correlation coefficient (ICC). For the liver cyst segmentation, the agreement between the reference method and the proposed method was ICC = 0.91 for cyst volumes and ICC = 0.94 for % cyst-to-liver volume.
[Mh] Termos MeSH primário: Abdome/patologia
Algoritmos
Cistos/patologia
Interpretação de Imagem Assistida por Computador/métodos
Hepatopatias/patologia
Fígado/patologia
Imagem por Ressonância Magnética/métodos
Rim Policístico Autossômico Dominante/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Automação Laboratorial
Progressão da Doença
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161027
[St] Status:MEDLINE


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[PMID]:28468689
[Au] Autor:De Silva WSL; Gamlaksha DS; Jayasekara DP; Rajamanthri SD
[Ad] Endereço:Post Graduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka. supun85@gmail.com.
[Ti] Título:A splenic artery aneurysm presenting with multiple episodes of upper gastrointestinal bleeding: a case report.
[So] Source:J Med Case Rep;11(1):123, 2017 May 03.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Splenic artery aneurysm is rare and its diagnosis is challenging due to the nonspecific nature of the clinical presentation. We report a case of a splenic artery aneurysm in which the patient presented with chronic dyspepsia and multiple episodes of minor intragastric bleeding. CASE PRESENTATION: A 60-year-old, previously healthy Sri Lankan man presented with four episodes of hematemesis and severe dyspeptic symptoms over a period of 6 months. The results of two initial upper gastrointestinal endoscopies and an abdominal ultrasound scan were unremarkable. A third upper gastrointestinal endoscopy detected a pulsatile bulge at the posterior wall of the gastric antrum. A contrast-enhanced computed tomogram of his abdomen detected a splenic artery aneurysm measuring 3 × 3 × 2.5 cm. While awaiting routine surgery, he developed a torrential upper gastrointestinal bleeding and shock, leading to emergency laparotomy. Splenectomy and en bloc resection of the aneurysm with the posterior stomach wall were performed. Histology revealed evidence for a true aneurysm without overt, acute, or chronic inflammation of the surrounding gastric mucosa. He became completely asymptomatic 2 weeks after the surgery. CONCLUSIONS: Splenic artery aneurysms can result in recurrent upper gastrointestinal bleeding. The possibility of impending catastrophic bleeding should be remembered when managing patients with splenic artery aneurysms after a minor bleeding. Negative endoscopy and ultrasonography should require contrast-enhanced computed tomography to look for the cause of recurrent upper gastrointestinal bleeding.
[Mh] Termos MeSH primário: Aneurisma Roto/complicações
Hemorragia Gastrointestinal/etiologia
Artéria Esplênica
[Mh] Termos MeSH secundário: Abdome/diagnóstico por imagem
Aneurisma Roto/diagnóstico por imagem
Aneurisma Roto/cirurgia
Endoscopia Gastrointestinal
Seres Humanos
Masculino
Meia-Idade
Esplenectomia
Artéria Esplênica/diagnóstico por imagem
Artéria Esplênica/patologia
Estômago/cirurgia
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1282-7


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[PMID]:29465604
[Au] Autor:Shen K; Cui X; Xie Z
[Ad] Endereço:Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University Changchun, Jilin, P. R. China.
[Ti] Título:Double laparoscopy assisted cylindrical abdominal-perineal resection for low rectal cancer with 4 cases report.
[So] Source:Medicine (Baltimore);97(8):e9995, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Rectal cancer is a common cancer worldwide. Low rectal cancer exhibits a tendency for recurrence. Surgical resection is an important treatment for rectal cancer. Cylindrical abdominal-perineal resection is suitable for patients with low rectal cancer and has helped improve the prognosis of these patients. However, there are some difficulties during the operation. Especially the perineal area operation cannot be performed under direct vision, which affects the quality of surgical resection. To resolve these constraints, our group designed double laparoscopy assisted cylindrical abdominal-perineal resection for low rectal cancer. CONCLUSION: The procedure effectively solved these problems and reduced the operation time with no increase in surgery complications.
[Mh] Termos MeSH primário: Abdome/cirurgia
Laparoscopia/métodos
Períneo/cirurgia
Neoplasias Retais/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Neoplasias Retais/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009995


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[PMID]:29465554
[Au] Autor:Collinge E; Tigaud I; Balme B; Gerland LM; Sujobert P; Carlioz V; Salles G; Thomas X; Paubelle E
[Ad] Endereço:Department of Hematology, CHU UCL Namur, Belgium.
[Ti] Título:Case report: Purulent transformation of granulocytic sarcoma: An unusual pattern of differentiation in acute promyelocytic leukemia.
[So] Source:Medicine (Baltimore);97(8):e9657, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Acute promyelocytic leukemia (APL) is a curable subtype of acute myeloid leukemia. APL is currently treated with combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) resulting in the induction of apoptosis and differentiation of the leukemic cells. Differentiation syndrome (so-called ATRA syndrome) is the main life-threatening complication of induction therapy with these differentiating agents. PATIENT CONCERNS: Herein, we report the case of a 49-year-old woman diagnosed with APL with, concomitantly, a bulky cutaneous lesion of 10 cm diameter with a red-to-purple background and a necrotic center, localized on her abdomen. DIAGNOSES: After 10 days of treatment, the cutaneous lesion became purulent. Fluorescence in situ hybridization (FISH) analysis performed on this pus confirmed the presence of malignant features in the involved granulocytes proving their origin from the differentiation of leukemic APL cells, as all the analyzed nuclei showed 2 promyelocytic leukemia (PML)-retinoic acid receptor-a (RARA) fusions signals. INTERVENTION: The association by ATRA and ATO was continued. OUTCOME: Eventually, the evolution was favorable with healing in three weeks. LESSONS: This case report therefore highlights the differentiation phenomenon of promyelocytic blasts within promyelocytic sarcoma with the ATRA-ATO combination and the efficacy of this drug association in resolving both the malignant sarcoma and a secondary local infection.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Arsenicais/efeitos adversos
Leucemia Promielocítica Aguda/tratamento farmacológico
Óxidos/efeitos adversos
Sarcoma Mieloide/tratamento farmacológico
Tretinoína/efeitos adversos
[Mh] Termos MeSH secundário: Abdome/patologia
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Arsenicais/administração & dosagem
Diferenciação Celular/efeitos dos fármacos
Feminino
Seres Humanos
Quimioterapia de Indução/efeitos adversos
Meia-Idade
Óxidos/administração & dosagem
Sarcoma Mieloide/induzido quimicamente
Sarcoma Mieloide/patologia
Supuração/induzido quimicamente
Tretinoína/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Arsenicals); 0 (Oxides); 5688UTC01R (Tretinoin); S7V92P67HO (arsenic trioxide)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009657


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[PMID]:29367198
[Au] Autor:Boden I; Skinner EH; Browning L; Reeve J; Anderson L; Hill C; Robertson IK; Story D; Denehy L
[Ad] Endereço:Department of Physiotherapy, Launceston General Hospital, Launceston, TAS, 7250, Australia ianthe.boden@ths.tas.gov.au.
[Ti] Título:Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial.
[So] Source:BMJ;360:j5916, 2018 01 24.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the efficacy of a single preoperative physiotherapy session to reduce postoperative pulmonary complications (PPCs) after upper abdominal surgery. DESIGN: Prospective, pragmatic, multicentre, patient and assessor blinded, parallel group, randomised placebo controlled superiority trial. SETTING: Multidisciplinary preadmission clinics at three tertiary public hospitals in Australia and New Zealand. PARTICIPANTS: 441 adults aged 18 years or older who were within six weeks of elective major open upper abdominal surgery were randomly assigned through concealed allocation to receive either an information booklet (n=219; control) or preoperative physiotherapy (n=222; intervention) and followed for 12 months. 432 completed the trial. INTERVENTIONS: Preoperatively, participants received an information booklet (control) or an additional 30 minute physiotherapy education and breathing exercise training session (intervention). Education focused on PPCs and their prevention through early ambulation and self directed breathing exercises to be initiated immediately on regaining consciousness after surgery. Postoperatively, all participants received standardised early ambulation, and no additional respiratory physiotherapy was provided. MAIN OUTCOME MEASURES: The primary outcome was a PPC within 14 postoperative hospital days assessed daily using the Melbourne group score. Secondary outcomes were hospital acquired pneumonia, length of hospital stay, utilisation of intensive care unit services, and hospital costs. Patient reported health related quality of life, physical function, and post-discharge complications were measured at six weeks, and all cause mortality was measured to 12 months. RESULTS: The incidence of PPCs within 14 postoperative hospital days, including hospital acquired pneumonia, was halved (adjusted hazard ratio 0.48, 95% confidence interval 0.30 to 0.75, P=0.001) in the intervention group compared with the control group, with an absolute risk reduction of 15% (95% confidence interval 7% to 22%) and a number needed to treat of 7 (95% confidence interval 5 to 14). No significant differences in other secondary outcomes were detected. CONCLUSION: In a general population of patients listed for elective upper abdominal surgery, a 30 minute preoperative physiotherapy session provided within existing hospital multidisciplinary preadmission clinics halves the incidence of PPCs and specifically hospital acquired pneumonia. Further research is required to investigate benefits to mortality and length of stay. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ANZCTR 12613000664741.
[Mh] Termos MeSH primário: Abdome/cirurgia
Modalidades de Fisioterapia
Complicações Pós-Operatórias/prevenção & controle
Cuidados Pré-Operatórios
Doenças Respiratórias/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Austrália
Método Duplo-Cego
Procedimentos Cirúrgicos Eletivos/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Nova Zelândia
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5916


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[PMID]:29341066
[Au] Autor:Yu Y; Zhang K; Zhang L; Zong H; Meng L; Han R
[Ad] Endereço:Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, No.6 Tiantan Xili, Beijing, China, 100050.
[Ti] Título:Cerebral near-infrared spectroscopy (NIRS) for perioperative monitoring of brain oxygenation in children and adults.
[So] Source:Cochrane Database Syst Rev;1:CD010947, 2018 Jan 17.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay). SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 12), Embase (1974 to 20 December 2016) and MEDLINE (PubMed) (1975 to 20 December 2016). We also searched the World Health Organization (WHO) International Clinical Trials Registry Platform for ongoing studies on 20 December 2016. We updated this search in November 2017, but these results have not yet been incorporated in the review. We imposed no language restriction. SELECTION CRITERIA: We included all relevant randomized controlled trials (RCTs) dealing with the use of cerebral NIRS in the perioperative setting (during the operation and within 72 hours after the operation), including the operating room, the postanaesthesia care unit and the intensive care unit. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies, assessed risk of bias and extracted data. For binary outcomes, we calculated the risk ratio (RR) and its 95% confidence interval (CI). For continuous data, we estimated the mean difference (MD) between groups and its 95% CI. As we expected clinical and methodological heterogeneity between studies, we employed a random-effects model for analyses and we examined the data for heterogeneity (I statistic). We created a 'Summary of findings' table using GRADEpro. MAIN RESULTS: We included 15 studies in the review, comprising a total of 1822 adult participants. There are 12 studies awaiting classification, and eight ongoing studies.None of the 15 included studies considered the paediatric population. Four studies were conducted in the abdominal and orthopaedic surgery setting (lumbar spine, or knee and hip replacement), one study in the carotid endarterectomy setting, and the remaining 10 studies in the aortic or cardiac surgery setting. The main sources of bias in the included studies related to potential conflict of interest from industry sponsorship, unclear blinding status or missing participant data.Two studies with 312 participants considered postoperative neurological injury, however no pooled effect estimate could be calculated due to discordant direction of effect between studies (low-quality evidence). One study (N = 126) in participants undergoing major abdominal surgery reported that 4/66 participants experienced neurological injury with blinded monitoring versus 0/56 in the active monitoring group. A second study (N = 195) in participants having coronary artery bypass surgery reported that 1/96 participants experienced neurological injury in the blinded monitoring group compared with 4/94 participants in the active monitoring group.We are uncertain whether active cerebral NIRS monitoring has an important effect on the risk of postoperative stroke because of the low number of events and wide confidence interval (RR 0.25, 95% CI 0.03 to 2.20; 2 studies, 240 participants; low-quality evidence).We are uncertain whether active cerebral NIRS monitoring has an important effect on postoperative delirium because of the wide confidence interval (RR 0.63, 95% CI 0.27 to 1.45; 1 study, 190 participants; low-quality evidence).Two studies with 126 participants showed that active cerebral NIRS monitoring may reduce the incidence of mild postoperative cognitive dysfunction (POCD) as defined by the original studies at one week after surgery (RR 0.53, 95% CI 0.30 to 0.95, I = 49%, low-quality evidence).Based on six studies with 962 participants, there was moderate-quality evidence that active cerebral oxygenation monitoring probably does not decrease the occurrence of POCD (decline in cognitive function) at one week after surgery (RR 0.62, 95% CI 0.37 to 1.04, I = 80%). The different type of monitoring equipment in one study could potentially be the cause of the heterogeneity.We are uncertain whether active cerebral NIRS monitoring has an important effect on intraoperative mortality or postoperative mortality because of the low number of events and wide confidence interval (RR 0.63, 95% CI 0.08 to 5.03, I = 0%; 3 studies, 390 participants; low-quality evidence). There was no evidence to determine whether routine use of NIRS-based cerebral oxygenation monitoring causes adverse effects. AUTHORS' CONCLUSIONS: The effects of perioperative active cerebral NIRS monitoring of brain oxygenation in adults for reducing the occurrence of short-term, mild POCD are uncertain due to the low quality of the evidence. There is uncertainty as to whether active cerebral NIRS monitoring has an important effect on postoperative stroke, delirium or death because of the low number of events and wide confidence intervals. The conclusions of this review may change when the eight ongoing studies are published and the 12 studies awaiting assessment are classified. More RCTs performed in the paediatric population and high-risk patients undergoing non-cardiac surgery (e.g. neurosurgery, carotid endarterectomy and other surgery) are needed.
[Mh] Termos MeSH primário: Encéfalo/metabolismo
Hipóxia-Isquemia Encefálica/diagnóstico
Consumo de Oxigênio/fisiologia
Espectroscopia de Luz Próxima ao Infravermelho
[Mh] Termos MeSH secundário: Abdome/cirurgia
Adulto
Artroplastia de Quadril
Artroplastia do Joelho
Criança
Transtornos Cognitivos/prevenção & controle
Seres Humanos
Vértebras Lombares/cirurgia
Monitorização Intraoperatória
Complicações Pós-Operatórias/prevenção & controle
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD010947.pub2


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[PMID]:27771340
[Au] Autor:Ambrosini A; Gracia M; Proag A; Rayer M; Monier B; Suzanne M
[Ad] Endereço:LBCMCP UMR5088, Centre de Biologie Integrative (CBI), Université de Toulouse, CNRS, UPS, France.
[Ti] Título:Apoptotic forces in tissue morphogenesis.
[So] Source:Mech Dev;144(Pt A):33-42, 2017 04.
[Is] ISSN:1872-6356
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:It is now well established that apoptosis is induced in response to mechanical strain. Indeed, increasing compressive forces induces apoptosis in confined spheroids of tumour cells, whereas releasing stress reduces apoptosis in spheroids cultivated in free suspension (Cheng et al., 2009). Apoptosis can also be induced by applying a 100 to 250MPa pressure, as shown in different cultured cells (for review, see (Frey et al., 2008)). During epithelium development, the pressure caused by a fast-growing clone can trigger apoptosis at the vicinity of the clone, mediating mechanical cell competition (Levayer et al., 2016). While the effect of strain has long been known for its role in apoptosis induction, the reciprocal mechanism has only recently been highlighted. First demonstrated at the cellular level, the effect of an apoptotic cell on its direct neighbours has been analysed in different kinds of monolayer epithelium (Gu et al., 2011; Rosenblatt et al., 2001; Kuipers et al., 2014; Lubkov & Bar-Sagi, 2014). More recently, the concept of a broader impact of apoptotic cell behaviours on tissue mechanical strain has emerged from the characterisation of tissue remodelling during Drosophila development (Toyama et al., 2008; Monier et al., 2015). In the present review, we summarize our current knowledge on the mechanical impact of apoptosis during tissue remodelling.
[Mh] Termos MeSH primário: Apoptose/genética
Drosophila melanogaster/crescimento & desenvolvimento
Células Epiteliais/citologia
Regulação da Expressão Gênica no Desenvolvimento
Morfogênese/genética
[Mh] Termos MeSH secundário: Abdome/crescimento & desenvolvimento
Animais
Divisão Celular
Proteínas de Ligação a DNA/genética
Proteínas de Ligação a DNA/metabolismo
Proteínas de Drosophila/genética
Proteínas de Drosophila/metabolismo
Drosophila melanogaster/genética
Drosophila melanogaster/metabolismo
Células Epiteliais/metabolismo
Matriz Extracelular/metabolismo
Larva/genética
Larva/crescimento & desenvolvimento
Larva/metabolismo
Modelos Biológicos
Pupa/genética
Pupa/crescimento & desenvolvimento
Pupa/metabolismo
Estresse Mecânico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (DNA-Binding Proteins); 0 (Drosophila Proteins); 0 (dwg protein, Drosophila); 0 (reaper protein, Drosophila)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:29390274
[Au] Autor:Yuan LQ; Wang JH; Zhu K; Yang M; Gu WZ; Lai C; Li HM; Shu Q; Chen X
[Ad] Endereço:Departments of Central Laboratory, Pathology, Oncology and Radiology, The Children's Hospital of Zhejiang University School of Medicine.
[Ti] Título:A highly malignant case of neuroblastoma with substantial increase of single-nucleotide variants and normal mismatch repair system: A case report.
[So] Source:Medicine (Baltimore);96(50):e8845, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Neuroblastoma is a common abdominal malignancy in children. The chemoresistant and relapsed cases have poor prognosis. The genetic background and the mechanism of resistance remain unelucidated. Next-generation sequence (NGS) is becoming a popular tool to unravel the genetic background and to guide precision medicine in oncology studies as well as in clinical practice. PATIENT CONCERNS: Here we report a neuroblastoma case of a boy aged 2 years and 8 months when first diagnosed, with multiple metastatic sites found in both lungs. The metastatic tumors were resistant to chemotherapy and the patient suffered from severe bone marrow suppression. NGS of the whole exon revealed somatic mutations including 9666 single-nucleotide variants (SNVs) from 5148 genes, 55 copy number variations (CNVs), and 140 insertion-deletion variations. The high frequency of SNVs makes it distinguished case. However, no mutation of key tumor driver genes with functional significance was identified. No abnormality was found in nucleic acid synthesis enzymes. No amplification of c-Myc and n-Myc was found by fluorescence in situ hybridization (FISH). Both NGS and immunohistochemistry (IHC) analysis indicated that DNA mismatch repair (MMR) system was intact. INTERVENTIONS: After initial diagnosis, the patient received combinational chemotherapy, which includes vindesine, an analogue of adriamycin suggested by NGS data, for 4 months. Radical section of the tumor together with the left kidney and the left adrenal gland was performed 5 months after diagnosis. Postsurgical chemotherapy protocols was similar with the previous. OUTCOMES: The patient died 2 years after initial diagnosis after 8 relapses following combinational chemotherapy. LESSONS: This case of neuroblastoma is with pronounced somatic mutations but unidentified driver gene and therapeutic target. Although NGS is a potentially powerful tool to guide precision medicine, at current stage, its application in the clinic certainly has its limits. The underlying mechanism of the substantially increased SNV number, as well as the malignant behaviors of the tumor, is yet to be revealed.
[Mh] Termos MeSH primário: Abdome
Variações do Número de Cópias de DNA
Reparo de Erro de Pareamento de DNA
Neuroblastoma/genética
Neuroblastoma/patologia
Polimorfismo de Nucleotídeo Único
[Mh] Termos MeSH secundário: Pré-Escolar
Evolução Fatal
Seres Humanos
Imuno-Histoquímica
Hibridização in Situ Fluorescente
Masculino
Mutação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008845


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[PMID]:29261334
[Au] Autor:Lv J; Yang M; Zhang J; Wang X
[Ad] Endereço:1 Academy for Advanced Interdisciplinary Studies, Peking University , Beijing , China.
[Ti] Título:Respiratory motion correction for free-breathing 3D abdominal MRI using CNN-based image registration: a feasibility study.
[So] Source:Br J Radiol;91(1083):20170788, 2018 Feb.
[Is] ISSN:1748-880X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Free-breathing abdomen imaging requires non-rigid motion registration of unavoidable respiratory motion in three-dimensional undersampled data sets. In this work, we introduce an image registration method based on the convolutional neural network (CNN) to obtain motion-free abdominal images throughout the respiratory cycle. METHODS: Abdominal data were acquired from 10 volunteers using a 1.5 T MRI system. The respiratory signal was extracted from the central-space spokes, and the acquired data were reordered in three bins according to the corresponding breathing signal. Retrospective image reconstruction of the three near-motion free respiratory phases was performed using non-Cartesian iterative SENSE reconstruction. Then, we trained a CNN to analyse the spatial transform among the different bins. This network could generate the displacement vector field and be applied to perform registration on unseen image pairs. To demonstrate the feasibility of this registration method, we compared the performance of three different registration approaches for accurate image fusion of three bins: non-motion corrected (NMC), local affine registration method (LREG) and CNN. RESULTS: Visualization of coronal images indicated that LREG had caused broken blood vessels, while the vessels of the CNN were sharper and more consecutive. As shown in the sagittal view, compared to NMC and CNN, distorted and blurred liver contours were caused by LREG. At the same time, zoom-in axial images presented that the vessels were delineated more clearly by CNN than LREG. The statistical results of the signal-to-noise ratio, visual score, vessel sharpness and registration time over all volunteers were compared among the NMC, LREG and CNN approaches. The SNR indicated that the CNN acquired the best image quality (207.42 ± 96.73), which was better than NMC (116.67 ± 44.70) and LREG (187.93 ± 96.68). The image visual score agreed with SNR, marking CNN (3.85 ± 0.12) as the best, followed by LREG (3.43 ± 0.13) and NMC (2.55 ± 0.09). A vessel sharpness assessment yielded similar values between the CNN (0.81 ± 0.03) and LREG (0.80 ± 0.04), differentiating them from the NMC (0.78 ± 0.06). When compared with the LREG-based reconstruction, the CNN-based reconstruction reduces the registration time from 1 h to 1 min. CONCLUSION: Our preliminary results demonstrate the feasibility of the CNN-based approach, and this scheme outperforms the NMC- and LREG-based methods. Advances in knowledge: This method reduces the registration time from ~1 h to ~1 min, which has promising prospects for clinical use. To the best of our knowledge, this study shows the first convolutional neural network-based registration method to be applied in abdominal images.
[Mh] Termos MeSH primário: Abdome/diagnóstico por imagem
Imagem Tridimensional/métodos
Imagem por Ressonância Magnética/métodos
Redes Neurais (Computação)
Técnicas de Imagem de Sincronização Respiratória/métodos
[Mh] Termos MeSH secundário: Adulto
Estudos de Viabilidade
Feminino
Voluntários Saudáveis
Seres Humanos
Aumento da Imagem/métodos
Interpretação de Imagem Assistida por Computador/métodos
Masculino
Movimento (Física)
Razão Sinal-Ruído
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20170788


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[PMID]:29414276
[Au] Autor:Baltimore RS; Nimkin K; Sparger KA; Pierce VM; Plotkin SA
[Ad] Endereço:From the Departments of Pediatrics and Infection Prevention, Yale New Haven Children's Hospital, and the Departments of Pediatrics and Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT (R.S.B.); the Departments of Radiology (K.N.), Pediatrics (K.A.S., V.M.P.), and
[Ti] Título:Case 4-2018: A Newborn with Thrombocytopenia, Cataracts, and Hepatosplenomegaly.
[So] Source:N Engl J Med;378(6):564-572, 2018 Feb 08.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Surdez/etiologia
Síndrome da Rubéola Congênita/diagnóstico
Trombocitopenia/etiologia
[Mh] Termos MeSH secundário: Abdome/diagnóstico por imagem
Encéfalo/diagnóstico por imagem
Catarata/etiologia
Diagnóstico Diferencial
Hepatomegalia/etiologia
Seres Humanos
Recém-Nascido
Masculino
Nigéria
Radiografia Torácica
Síndrome da Rubéola Congênita/complicações
Esplenomegalia/etiologia
Ultrassonografia
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180208
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1706110



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