Breast lymphoma is a rare hematologic neoplasm that originates in the breast lymphoid tissue and includes primary breast lymphoma (PBL) and secondary breast lymphoma (SBL). PBL involves the breast ...lymphoid tissue in the absence of previously identified extramammary lymphoma and widespread disease. SBL is the most common metastasis to the breast, accounting for 17% of metastatic disease to the breast. PBL and SBL usually demonstrate imaging phenotypes that overlap with those of primary breast carcinoma, which makes a prospective diagnosis of breast lymphoma challenging. These nonspecific imaging features include an iso- to hyperdense oval mass or masses at mammography, a hypoechoic or mixed-echogenicity hypervascular mass at US, an enhancing mass with type II kinetics at MRI, and high fluorine 18-fluorodeoxyglucose avidity at PET. In cases of suspected lymphoma, reviewing the clinical history, using appropriate biopsy techniques, and evaluating for multiplicity, bilaterality, and distant disease are critical for diagnosis and management. A patient with PBL generally has an earlier clinical presentation with a palpable abnormality and a solitary imaging finding. In contrast, multiple masses in an older patient and an occult clinical presentation favor an SBL diagnosis.
RSNA, 2019.
Reporting of Claudication Does Not Differ by Race Minc, Samantha D., MD; Shah, Raj C., MD; Bennett, David A., MD ...
Journal of vascular surgery,
September 2016, Letnik:
64, Številka:
3
Journal Article
Laminar, fully developed flow through single- and double-trapezoidal (or hexagonal) ducts is modeled using a finite-difference method. A coordinate transformation is employed to map the irregular ...flow cross-section onto a rectangular computational domain. Both
H1 and
T thermal boundary conditions are considered as they represent the fundamental limiting conditions in most practical applications. Solutions for velocity and temperature variations are obtained for a wide range of duct aspect ratios and with four different trapezoidal angles. The friction factor and Nusselt number results show a strong dependence on duct geometry (aspect ratio
γ and trapezoidal angle
θ). The variations of
f
Re, Nu
H1
, and
Nu
T
with duct aspect ratio for each
θ-valued duct are presented in the form of polynomials in
γ. These equations describe the computed numerical values within ±2% for single-trapezoidal and within ±1.5% for hexagonal ducts and are of much importance to the design of compact heat exchangers.
Objectives In an effort to define the gold standard for annular sizing for transcatheter aortic valve replacement (TAVR), we sought to critically analyze and compare the predictive value of multiple ...measures of the aortic annulus for post-TAVR paravalvular (PV) regurgitation and then assess the impact of a novel cross-sectional computed tomographic (CT) approach to annular sizing. Background Recent studies have shown clear discrepancies between conventional 2-dimensional (2D) echocardiographic and CT measurements. In terms of aortic annular measurement for TAVR, such findings have lacked the outcome analysis required to inform clinical practice. Methods The discriminatory value of multiple CT annular measures for post-TAVR PV aortic regurgitation was compared with 2D echocardiographic measures. TAVR outcomes with device selection according to aortic annular sizing using a traditional 2D transesophageal echocardiography–guided or a novel CT-guided approach were also studied. Results In receiver-operating characteristic models, cross-sectional CT parameters had the highest discriminatory value for post-TAVR PV regurgitation: This was with the area under the curve for maximal cross-sectional diameter minus prosthesis size of 0.82 (95% confidence interval: 0.69 to 0.94; p < 0.001) and that for circumference-derived cross-sectional diameter minus prosthesis size of 0.81 (95% confidence interval: 0.7 to 0.94; p < 0.001). In contrast, traditional echocardiographic measures were nondiscriminatory in relation to post-TAVR PV aortic regurgitation. The prospective application of a CT-guided annular sizing approach resulted in less PV aortic regurgitation of grade worse than mild after TAVR (7.5% vs. 21.9%; p = 0.045). Conclusions Our data lend strong support to 3-dimensional cross-sectional measures, using CT as the new gold standard for aortic annular evaluation for TAVR with the Edwards SAPIEN device.
Clinically significant nonmetastatic prostate cancer (PCa) is currently treated using whole-gland therapy. This approach is effective but can have urinary, sexual, and rectal side effects.
To report ...on 5-yr PCa control following focal high-intensity focused ultrasound (HIFU) therapy to treat individual areas of cancer within the prostate.
This was a prospective study of 625 consecutive patients with nonmetastatic clinically significant PCa undergoing focal HIFU therapy (Sonablate) in secondary care centres between January 1, 2006 and December 31, 2015. A minimum of 6-mo follow-up was available for599 patients. Intermediate- or high-risk PCa was found in 505 patients (84%).
Disease was localised using multiparametric magnetic resonance imaging (mpMRI) combined with targeted and systematic biopsies, or transperineal mapping biopsies. Areas of significant disease were treated. Follow-up included prostate-specific antigen (PSA) measurement, mpMRI, and biopsies.
The primary endpoint, failure-free survival (FFS), was defined as freedom from radical or systemic therapy, metastases, and cancer-specific mortality.
The median follow-up was 56 mo (interquartile range IQR 35–70). The median age was 65 yr (IQR 61–71) and median preoperative PSA was 7.2 ng/ml (IQR 5.2–10.0). FFS was 99% (95% confidence interval CI 98–100%) at 1 yr, 92% (95% CI 90–95%) at 3 yr, and 88% (95% 85–91%) at 5 yr. For the whole patient cohort, metastasis-free, cancer-specific, and overall survival at 5 yr was 98% (95% CI 97–99%), 100%, and 99% (95% CI 97–100%), respectively. Among patients who returned validated questionnaires, 241/247 (98%) achieved complete pad-free urinary continence and none required more than 1 pad/d. Limitations include the lack of long-term follow-up.
Focal therapy for select patients with clinically significant nonmetastatic prostate cancer is effective in the medium term and has a low probability of side effects.
In this multicentre study of 625 patients undergoing focal therapy using high-intensity focused ultrasound (HIFU), failure-free survival, metastasis-free survival, cancer-specific survival, and overall survival were 88%, 98%, 100%, and 99%, respectively. Urinary incontinence (any pad use) was 2%. Focal HIFU therapy for patients with clinically significant prostate cancer that has not spread has a low probability of side effects and is effective at 5 yr.
Our study shows that at median follow-up of approximately 5 yr after focal high-intensity focused ultrasound, nine out of ten patients with predominantly intermediate- or high-risk prostate cancer are able to avoid surgery, radiotherapy, and systemic therapy. Prostate cancer–specific survival was 100%. There was a low probability of urinary incontinence (2%), erectile dysfunction (15%), and rectal side effects (rare).
The inclusive electron neutrino charged-current cross section is measured in the NOvA near detector using 8.02×10^{20} protons-on-target in the NuMI beam. The sample of GeV electron neutrino ...interactions is the largest analyzed to date and is limited by ≃17% systematic rather than the ≃7.4% statistical uncertainties. The double-differential cross section in final-state electron energy and angle is presented for the first time, together with the single-differential dependence on Q^{2} (squared four-momentum transfer) and energy, in the range 1 GeV≤E_{ν}<6 GeV. Detailed comparisons are made to the predictions of the GENIE, GiBUU, NEUT, and NuWro neutrino event generators. The data do not strongly favor a model over the others consistently across all three cross sections measured, though some models have especially good or poor agreement in the single differential cross section vs Q^{2}.
A simple objective method to quantify embryo dwarfism induced by infectious bronchitis virus in embryonated chicken eggs has been used to determine endpoints in virus titration and neutralization ...assays. The eggs and the respective embryos were weighed and embryo:egg weight (EE) ratios were calculated. The EE ratios were compared with the uninoculated control eggs and endpoints could be calculated objectively. EE indices were also calculated by dividing the EE ratios of inoculated embryonated chicken eggs by the mean EE ratio of uninoculated controls, or in the case of virus neutralization tests by the mean EE ratio of eggs inoculated with virus alone. Although this mean EE index did not reflect the dwarfing (or lack of it) in individual eggs, it served as a group indicator. This method would be useful to observe embryo lesions especially in field (non-egg adapted) infectious bronchitis virus isolates, which does not cause observable dwarfing until several embryo passages.
Optimization of fuel injection strategies can maximize the utilization of biodiesel by addressing the issues concern with fuel consumption, engine performance, and exhaust gas emission. In the midst ...of the pervasiveness of plant-based biofuel, this paper focused on maximizing the pine oil biodiesel usage in a diesel engine having common rail direct injection (CRDI) system without any engine modifications. Pine oil derived from pine tree resins, has shown impressive fuel properties such as lower viscosity, flash point, boiling point and comparable calorific value to diesel. In this study, the impact of high fuel injection pressure on the engine characteristics of a diesel engine fueled by 30% pine oil biodiesel blend (P30) was analyzed. At standard 200 bar fuel injection pressure, the brake thermal efficiency (BTE) of P30 biodiesel blend was decreased compared to sole diesel. To improve the utilization and performance of the P30 blend, fuel injection pressure increased from 200 bar to 350 bar at a step of 50 bar. The results show that BTE and combustion characteristics are improved with an increase in injection pressure. The P30 fuel exhibits maximum BTE of 26.1% at 350 bar which is 6.9% higher the BTE of diesel at 200 bar. Exhaust emissions (CO, HC & Smoke) decreased gradually with increase in fuel injection pressure due to high atomization of fuel, faster evaporation, and formation of the better air fuel mixture. At 100% load condition, the P30 blend shows a maximum decrease in CO and HC emission at 300 bar, which is 16.6% and 13.1% less respectively compared to sole diesel at 200 bar injection pressure. The NOx is increased by about 9.4% for P30 blend at 350 bar when compared to that of Diesel at 200 bar. Thus, the blending ratio of pine oil biodiesel in the diesel can be extended by increasing the fuel injection pressure.
To assess the value of exosomal miRNAs as biomarkers for Alzheimer disease (AD), the expression of microRNAs was measured in a plasma fraction enriched in exosomes by differential centrifugation, ...using Illumina deep sequencing. Samples from 35 persons with a clinical diagnosis of AD dementia were compared to 35 age and sex matched controls. Although these samples contained less than 0.1 microgram of total RNA, deep sequencing gave reliable and informative results. Twenty miRNAs showed significant differences in the AD group in initial screening (miR-23b-3p, miR-24-3p, miR-29b-3p, miR-125b-5p, miR-138-5p, miR-139-5p, miR-141-3p, miR-150-5p, miR-152-3p, miR-185-5p, miR-338-3p, miR-342-3p, miR-342-5p, miR-548at-5p, miR-659-5p, miR-3065-5p, miR-3613-3p, miR-3916, miR-4772-3p, miR-5001-3p), many of which satisfied additional biological and statistical criteria, and among which a panel of seven miRNAs were highly informative in a machine learning model for predicting AD status of individual samples with 83-89% accuracy. This performance is not due to over-fitting, because a) we used separate samples for training and testing, and b) similar performance was achieved when tested on technical replicate data. Perhaps the most interesting single miRNA was miR-342-3p, which was a) expressed in the AD group at about 60% of control levels, b) highly correlated with several of the other miRNAs that were significantly down-regulated in AD, and c) was also reported to be down-regulated in AD in two previous studies. The findings warrant replication and follow-up with a larger cohort of patients and controls who have been carefully characterized in terms of cognitive and imaging data, other biomarkers (e.g., CSF amyloid and tau levels) and risk factors (e.g., apoE4 status), and who are sampled repeatedly over time. Integrating miRNA expression data with other data is likely to provide informative and robust biomarkers in Alzheimer disease.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•PCM in metallic macro-encapsulate inside DPSAHS was investigated.•Rectangular and cylindrical metallic macro-encapsulate was tested.•Energy and cost analysis of DPSAHS with and without storage was ...conducted.•An average encapsulate efficiency of 47.2% and 67% was obtained.•Cost of heating 1 kg of hot air was $0.0074.
The present experimental work attempts to sustain the thermal response of the double-pass solar air heater system (DPSAHS) by the thermal lag of phase change material (PCM). At the same time, this analysis investigates the role of metallic macro-encapsulation on the heat storage and recovery from PCM integrated inside the DPASHS. The objectives are to investigate the influence of the geometry of encapsulation used for storage and to examine whether the discrete units allow faster charging and discharging of organic paraffin wax (PCM). In this work, an average encapsulate efficiency of 47.2% and 67% was obtained respectively for rectangular and cylindrical macro-encapsulates equipped DPSAHS. A performance comparison of DPSAHS with and without storage was presented. An overall cost analysis shows that with a small margin in constructional cost, operational time of DPSAHS was improved. The cost of heating 1 kg of hot air was 0.0074$. The overall work aims to support marginal and subsistent farmers to deal with improper drying during winter on which the potential sunshine hours are limited to 7 h/day at Calicut (11o32'N, 75o93'E) located in peninsular India.
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