Hepatic lesions: discrimination of nonsolid, benign lesions from solid, malignant lesions with heavily T2-weighted fast spin-echo MR imaging

PURPOSE: To determine whether the combined use of heavily and moderately T2-weighted fast spin-echo magnetic resonance (MR) images improves differentiation of non-solid, benign hepatic lesions from solid malignancies. MATERIALS AND METHODS: Three radiologists reviewed moderately (n = 133) and heavily (n = 133) T2-weighted and multiphasic dynamic contrast material-enhanced (n = 93) MR images in 133 patients with proved focal hepatic lesions (95 benign, 38 malignant). The radiologists used a five-point scale to rate their confidence in determination of malignancy. RESULTS: All three reviewers were statistically significantly better able to differentiate small (diameter less than 3 cm; n = 84) benignancies from small malignancies with the combination of moderately and heavily T2-weighted images (area under the receiver operating characteristic curve, 0.99 for each reader) than with moderately T2-weighted images alone (area, 0.88-0.90; P < .05). Confident diagnoses were rendered in 69 (82%) patients, with 100% accuracy for the combined use of moderately and heavily T2-weighted images. For larger lesions (diameter 3 cm or larger; n = 49), accurate differentiation was possible with moderately T2-weighted images alone. Additional use of multiphasic images did not improve the sensitivity, specificity, or accuracy of image interpretation. CONCLUSION: The combined use of moderately and heavily T2-weighted fast spin-echo MR images improves differentiation of small benign hepatic lesions from small malignant lesions.     

The traumatic anterior overbite

The position of the anterior teeth and skeletal base relationship establish many of our facial characteristics, yet these same tooth positions can result in a range of dental problems that are often specific for a particular incisal relationship. Excessive loss of tooth tissue on various surfaces may result in trauma to the soft tissue and temporomandibular joint dysfunction. A range of treatment options may be required and can often be conveniently classified by the form of incisal relationship.     

Expression and function of a recombinant endothelial nitric oxide synthase gene in porcine coronary arteries

PURPOSE: To evaluate the influence of prognostic factors in postoperative radiotherapy of NSCLC with special emphasis on the time interval between surgery and start of radiotherapy. METHODS AND MATERIALS: Between January 1976 and December 1993, 340 cases were treated and retrospectively analyzed meeting the following criteria: complete follow-up; complete staging information including pathological confirmation of resection status; maximum interval between surgery (SX) and radiotherapy (RT) of 12 weeks (median 36 days, range 18 to 84 days); minimum dose of 50 Gy (R0), and maximum dose of 70 Gy (R2). Two hundred thirty patients (68%) had N2 disease; 228 patients were completely resected (R0). One hundred six (31%) had adenocarcinoma, 172 (51%) squamous cell carcinoma. RESULTS: In univariate analysis, Karnofsky performance status (90+ >60-80%; p = 0.019 log rank), resection status stratified for nodal disease (R+ 相似文献   

Esthetic preference of the frontal and profile views of the same smile

This study has shown that orthodontists and their patients share a common pool of diffuse esthetic values of the same smile. Profile and frontal views of the same smile were not similarly rated for esthetic pleasantness: the profile views were rated higher than the frontal views of the same smile. This finding suggests that orthodontists should consider both frontal and lateral views during evaluation of their patient when planning and assessing orthodontic treatment. More research is needed to determine the generalizability of the finding that orthodontists and patients have similar facial esthetic preferences. Future studies should expand the range of smiles that are evaluated by including both genders, people of different ethnic backgrounds, and people of a variety of ages. Research is also needed to evaluate facial esthetics and smiles in dynamic motion.     

Interstitial fluid concentrations of glycerol, glucose, and amino acids in human quadricep muscle and adipose tissue. Evidence for significant lipolysis in skeletal muscle

To determine the relationship between circulating metabolic fuels and their local concentrations in peripheral tissues we measured glycerol, glucose, and amino acids by microdialysis in muscle and adipose interstitium of 10 fasted, nonobese human subjects during (a) baseline, (b) euglycemic hyperinsulinemia (3 mU/kg per min for 3 h) and, (c) local norepinephrine reuptake blockade (NOR). At baseline, interstitial glycerol was strikingly higher (P < 0.0001) in muscle (3710 microM) and adipose tissue (2760 microM) compared with plasma (87 microM), whereas interstitial glucose (muscle 3.3, fat 3.6 mM) was lower (P < 0.01) than plasma levels (4.8 mM). Taurine, glutamine, and alanine levels were higher in muscle than in adipose or plasma (P < 0.05). Euglycemic hyperinsulinemia did not affect interstitial glucose, but induced a fall in plasma glycerol and amino acids paralleled by similar changes in the interstitium of both tissues. Local NOR provoked a fivefold increase in glycerol (P < 0.001) and twofold increase in norepinephrine (P < 0.01) in both muscle and adipose tissues. To conclude, interstitial substrate levels in human skeletal muscle and adipose tissue differ substantially from those in the circulation and this disparity is most pronounced for glycerol which is raised in muscle as well as adipose tissue. In muscle, insulin suppressed and NOR increased interstitial glycerol concentrations. Our data suggest unexpectedly high rates of intramuscular lipolysis in humans that may play an important role in fuel metabolism.     

Direct cardiac and vascular actions of adrenomedullin in conscious sheep

OBJECTIVE: Patients with Kawasaki disease mount an immune response directed to their abnormally stimulated vascular endothelium, that is associated with vascular inflammation and injury and a predisposition to arterial aneurysm formation. This suggests that specific pro-inflammatory cytokines may mediate these hyperreactive responses. The selective chemoattractant and activation effects of chemokines on lymphocytes identifies them as potential candidates in mediating selective inflammatory processes in Kawasaki disease. We examined peripheral blood from patients with Kawasaki disease for chemokine gene expression. METHODS: Consecutive samples from 14 patients during the acute, subacute, and convalescent phases of their illness were collected and elaborated for RANTES, macrophage inflammatory protein-1 beta (MIP-1 beta) and monocyte chemotactic protein-1 (MCP-1) expression. RESULTS: RANTES and MCP-1 gene expression levels were significantly elevated in 12 of the 14 patients, and MIP-1 beta gene expression was elevated in 13 of the 14 patients. There was no obvious correlation between clinical phase of the disease and chemokine expression level, yet elevated expression levels were detected in all phases, including the convalescent phase, when laboratory evidence of lymphocyte activation has been shown to return to normal. Serial samples showed persistence or increased expression of chemokine genes into the convalescent phase in patients with coronary artery lesions. CONCLUSION: Chemokine mediated inflammatory events may persist in the convalescent phase of Kawasaki disease and may contribute to further risk of vascular endothelial cell injury, specifically coronary aneurysm formation.