Medullary thyroid carcinoma: genetic advances, treatment recommendations, and the approach to the patient with persistent hypercalcitoninemia

Medullary thyroid cancer is a tumor of the thyroid C cells that occurs in sporadic and hereditary clinical settings. Genetic testing of at-risk individuals is available and has been applied to patient management. Plasma calcitonin levels are a sensitive marker for the presence of disease. Surgery offers the best hope for cure and also is an effective modality for managing metastatic and recurrent disease.     

A Simple D 2-Sampling Based PTAS for k-Means and Other Clustering Problems

Given a set of points \(P \subset\mathbb{R}^{d}\) , the k-means clustering problem is to find a set of k centers \(C = \{ c_{1},\ldots,c_{k}\}, c_{i} \in\mathbb{R}^{d}\) , such that the objective function ∑ _x∈P e(x,C)², where e(x,C) denotes the Euclidean distance between x and the closest center in C, is minimized. This is one of the most prominent objective functions that has been studied with respect to clustering. D ²-sampling (Arthur and Vassilvitskii, Proceedings of the Eighteenth Annual ACM-SIAM Symposium on Discrete Algorithms, SODA’07, pp. 1027–1035, SIAM, Philadelphia, 2007) is a simple non-uniform sampling technique for choosing points from a set of points. It works as follows: given a set of points \(P \subset\mathbb{R}^{d}\) , the first point is chosen uniformly at random from P. Subsequently, a point from P is chosen as the next sample with probability proportional to the square of the distance of this point to the nearest previously sampled point. D ²-sampling has been shown to have nice properties with respect to the k-means clustering problem. Arthur and Vassilvitskii (Proceedings of the Eighteenth Annual ACM-SIAM Symposium on Discrete Algorithms, SODA’07, pp. 1027–1035, SIAM, Philadelphia, 2007) show that k points chosen as centers from P using D ²-sampling give an O(logk) approximation in expectation. Ailon et al. (NIPS, pp. 10–18, 2009) and Aggarwal et al. (Approximation, Randomization, and Combinatorial Optimization. Algorithms and Techniques, pp. 15–28, Springer, Berlin, 2009) extended results of Arthur and Vassilvitskii (Proceedings of the Eighteenth Annual ACM-SIAM Symposium on Discrete Algorithms, SODA’07, pp. 1027–1035, SIAM, Philadelphia, 2007) to show that O(k) points chosen as centers using D ²-sampling give an O(1) approximation to the k-means objective function with high probability. In this paper, we further demonstrate the power of D ²-sampling by giving a simple randomized (1+?)-approximation algorithm that uses the D ²-sampling in its core.     

Forensic image analysis using inconsistent noise pattern

With the advancement of image acquisition devices and social networking services, a huge volume of image data is generated. Using different image and video processing applications, these image data are manipulated, and thus, original images get tampered. These tampered images are the prime source of spreading fake news, defaming the personalities and in some cases (when used as evidence) misleading the law bodies. Hence before relying totally on the image data, the authenticity of the image must be verified. Works of the literature are reported for the verification of the authenticity of an image based on noise inconsistency. However, these works suffer from limitations of confusion between edges and noise, post-processing operation for localization and need of prior knowledge about an image. To handle these limitations, a noise inconsistency-based technique has been presented here to detect and localize a false region in an image. This work consists of three major steps of pre-processing, noise estimation and post-processing. For the experimental purpose two, publicly available datasets are used. The result is discussed in terms of precision, recall, accuracy and f1-score on the pixel level. The result of the presented work is also compared with the recent state-of-the-art techniques. The average accuracy of the proposed work on datasets is 91.70%, which is highest among state-of-the-art techniques.

     

Cell-free apoptosis in Xenopus egg extracts: inhibition by Bcl-2 and requirement for an organelle fraction enriched in mitochondria

Apoptotic cell death involves a ritual series of morphological changes, presumably reflecting a conserved molecular pathway. We now report that the nuclear events typical of apoptosis can be reproduced in "apoptotic" Xenopus egg extracts. In this cell-free system, nuclear assembly and protein import are initially normal; after 2-4 hr, however, a process of nuclear destruction ensues involving chromatin condensation and the shrinkage and fragmentation of the nuclei. This apoptotic process, which also occurs in nuclei added exogenously, is blocked by the addition of baculovirus-expressed Bcl-2 protein. To block the disintegration of nuclei that are added later, Bcl-2 must be present during this latent period. "Apoptosis" in these extracts requires a dense organelle fraction enriched in mitochondria. The cell-free system described here provides a novel tool for understanding intracellular events in apoptosis and the inhibitory function of Bcl-2.     

Autoradiographic assessment of blood flow heterogeneity in the hamster heart

OBJECTIVE: Provide regional flow measurement in the hearts of small mammals using a new, higher-resolution technique based on the deposition of a molecular marker. METHODS: We determined the instantaneous extraction and retention of the "molecular microsphere" radiolabeled desmethylimipramine in retrogradely perfused hamster hearts. In a separate series of experiments, autoradiography was used to measure regional myocardial deposition densities in hamster hearts of about 0.5 g with spatial area resolution of 16 x 16 microns. RESULTS: Radiolabeled desmethylimipramine is almost 100% extracted during a single transcapillary passage and is retained in the tissue for many minutes. Autoradiographic images demonstrated a spatial flow heterogeneity with standard deviations of 31 +/- 4% of the mean flow (N = 5) in 16 x 16 x 20-micronm3 voxels. This is equivalent to the projections made using fractal relationships from cruder observations obtained with microspheres in the hearts of baboons, sheep, and rabbits. CONCLUSIONS: Autoradiography using a molecular deposition marker provides quantitative information on myocardial flow heterogeneities with resolution at the size of cardiac myocytes. Because the regions resolved are smaller than the volume of regions supplied by single arterioles, the results must slightly exaggerate the true heterogeneity of regional flows.     

Performance of orthogonal frequency division multiplexing based M-ary quadrature amplitude modulation in asymmetrical dual-hop mixed RF-FSO transmission system

This paper investigates the performance of a dual-hop mixed relay system with radio frequency (RF) and free-space optics (FSO) communication under the effect of pointing error (PE) and atmospheric turbulence (AT). This paper considers a system where RF and FSO links are cascaded. The RF link is modeled by Nakagami-m fading, and the FSO link is modeled as gamma–gamma (G-G) fading channel. Both the channel models use orthogonal frequency division multiplexing (OFDM) with M-ary quadrature amplitude modulation (QAM). The expressions for probability density function, cumulative distribution function, signal-to-noise ratio, and ergodic capacity are derived. The moment generating function (MGF) of fading and the bit error rate (BER) of the OFDM-based M-ary QAM scheme is derived in terms of Meijer's G-function. It has been observed that, in fixed gain relay systems, the modulation scheme's BER is dominated by the SNR of the RF link. While in a variable gain relay system, the turbulence conditions of the FSO system affect the SNR and the BER of the modulation method. The feasibility of heterodyne detection and intensity modulation direct detection (IM/DD) is analyzed in terms of outage probability and ergodic capacity. The results can be used to choose the optimal modulation order and relay system for QAM-OFDM-based optical wireless systems.     

Comparison of osteoconductivity and absorbability of beta-tricalcium phosphate and hydroxyapatite in clinical scenario of opening wedge high tibial osteotomy

The purpose of this study was to compare the osteoconductivity, and absorbability of hydroxyapatite or beta-tricalcium phosphate in clinical scenario of opening wedge high tibial osteotomy Total 41 knees of 40 patients with follow up period of more than 1 year were enrolled. These patients were divided into two groups, Group I (22 knees, 21 patients) used hydroxyapatite and Group II (19 knees, 19 patients) used beta-tricalcium phosphate as a substitute in the opening gap. According to proven method, the osteoconductivity was assessed radiographically by the extent of new bone formation at osteotomy space and absorbability was evaluated by measuring the area occupied by substitute at immediate postoperative, postoperative 6 months and 1 year. Regarding preoperative demographic data, no significant differences were found between two groups. No statistically significant differences were found between two groups regarding lower limb alignment (mechanical femorotibial angle, weight-bearing line%) and posterior tibial slope at postoperative and final follow up radiographs. Concerning the osteoconductivity, there were no significant differences between two groups in any zone. However, the absorption rate was significantly greater in the Group II than in Group I at 6 months (Group I: 13.7?±?6.8, group II: 35.3?±?15.8, P?=?0.001) and 1 year (Group I: 24.2?±?6.3, Group II: 49.6?±?14.3, P?<?0.0001). The complications related to bone substitutes were not observed. Both hydroxyapatite and beta-tricalcium phosphate showed satisfactory gap healing without complications and can be successfully used as alternative healing materials in opening wedge high tibial osteotomy. Our study showed that beta-tricalcium phosphate has superior absorbability than hydroxyapatite. But osteoconductivity showed no significant difference.     

Experimental deformation analysis of an adhesively bonded multi-material joint for marine applications

The strength and deformation of full-scale adhesively bonded multi-material joints is studied in this paper. Four joints with a thick layer of methyl methacrylate adhesive (MMA) have been manufactured in shipyard conditions. In two specimens, cracks have been introduced at steel–adhesive and composite–adhesive interfaces. One cracked and one un-cracked specimen were subjected to quasi-static tensile testing; the two remaining specimens were stepwise loaded/unloaded with increasing load until failure. The strain in the adhesive layers was measured with digital image correlation (DIC). This showed a predominant shear deformation and dissimilar shear strain patterns for different bond lines. Fibre Bragg (FBG) sensors were used to monitor strains at steel and composite constituents and to detect the onset and evolution of damage in the un-cracked specimen. Strains measured by FBG sensors correspond well with DIC results at nearby regions. All specimens failed by delamination of the composite panel near the composite–adhesive interface.     

US-guided core breast biopsy: use and cost-effectiveness

OBJECTIVES: We sought to determine, using serial echocardiography, the hydrodynamic mechanisms involved in the occurrence of hemolysis after mitral valve repair. BACKGROUND: Recently, fluid dynamic simulation models have identified distinct patterns of mitral regurgitant flow disturbances in patients with mitral prosthetic hemolysis that were associated with high shear stress and may therefore produce clinical hemolysis. Rapid acceleration, fragmentation, and collision jets were associated with high shear stress and hemolysis whereas slow deceleration and free jets were not. METHODS: We reviewed serial echocardiographic studies of 13 consecutive patients with hemolytic anemia after mitral valve repair who were referred for mitral reoperation between January 1985 and December 1996 (group 1). Thirteen patients undergoing reoperation for mitral regurgitation after mitral valve repair but without hemolysis served as controls (group 2). RESULTS: The mitral regurgitant jet was central in origin in 12 group 1 patients and 9 group 2 patients (Fisher exact test, p= 0.3). The other patients had para-ring regurgitation. Group 1 patients had collision (n=11), rapid acceleration (n=2) or fragmentation (n=1) jets whereas group 2 patients had slow deceleration (n=11) or free jets (n=2) (Fisher exact test, p < 0.0001). One patient with hemolysis had both collision and rapid acceleration jets. The "culprit" jet could be identified on the postbypass transesophageal echocardiography (TEE) study in only 1 patient at the time of initial mitral repair. Twelve group 1 patients underwent reoperation, with subsequent resolution of hemolysis in all patients. At reoperation, the initial repair was found to be intact in 8 (67%) patients. CONCLUSION: Distinct patterns of flow disturbance associated with high shear stress were identified by color Doppler imaging in patients with hemolysis after mitral valve repair. The majority (92%) of these color flow disturbances were not present during intraoperative postbypass TEE study after initial mitral repair and subsequently developed in the early postoperative period.