32 research outputs found

    Voiding urosonography with ultrasound contrast agents for the diagnosis of vesicoureteric reflux in children: I. Procedure

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    Voiding urosonography (VUS) encompasses examination of the urinary tract with intravesical administration of US contrast agent (UCA) for diagnosis of vesicoureteric reflux (VUR). The real breakthrough for US examination of VUR came with the availability of stabilized UCAs in the mid-1990s. This article presents a comprehensive review of various procedural aspects of VUS. Different US modalities are available for detecting the echogenic microbubbles: fundamental mode, colour Doppler US, harmonic imaging and dedicated contrast imaging with multiple display options. The reflux is graded (1 to 5) in a similar manner to the system used in voiding cystourethrography (VCUG). The most commonly used UCA for VUS, Levovist, is galactose-based and contains air-filled microbubbles. The recommended concentration is 300 mg/ml at a dose of 5–10%, or less than 5%, of the bladder filling volume when using fundamental or harmonic imaging modes, respectively. There are preliminary reports of VUS using a second-generation UCA, SonoVue. Here the UCA volume is less than 1% of the bladder filling volume. There is no specific contraindication to intravesical administration of UCA. The safety profile of intravesical Levovist is very high with no reports of side effects over a decade of use in VUS

    Intraoperative Detektion der Neuroendokrinen Tumoren mit Hilfe der Gamma Sonde

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    Intraoperative Detektion der Neuroendokrinen Tumoren mit Hilfe der Gamma Sonde

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    L. Nichols' Waltzer - A87 - no date or location

    Modeling the ocean and atmosphere during an extreme bora event in northern Adriatic using one-way and two-way atmosphere–ocean coupling

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    We have studied the performances of (a) a two-way coupled atmosphere–ocean modeling system and (b) one-way coupled ocean model (forced by the atmosphere model), as compared to the available in situ measurements during and after a strong Adriatic bora wind event in February 2012, which led to extreme air–sea interactions. The simulations span the period between January and March 2012. The models used were ALADIN (Aire LimitĂ©e Adaptation dynamique DĂ©veloppement InterNational) (4.4 km resolution) on the atmosphere side and an Adriatic setup of Princeton ocean model (POM) (1°âˆ•30 × 1°âˆ•30 angular resolution) on the ocean side. The atmosphere–ocean coupling was implemented using the OASIS3-MCT model coupling toolkit. Two-way coupling ocean feedback to the atmosphere is limited to sea surface temperature. We have compared modeled atmosphere–ocean fluxes and sea temperatures from both setups to platform and CTD (conductivity, temperature, and depth) measurements from three locations in the northern Adriatic. We present objective verification of 2 m atmosphere temperature forecasts using mean bias and standard deviation of errors scores from 23 meteorological stations in the eastern part of Italy. We show that turbulent fluxes from both setups differ up to 20 % during the bora but not significantly before and after the event. When compared to observations, two-way coupling ocean temperatures exhibit a 4 times lower root mean square error (RMSE) than those from one-way coupled system. Two-way coupling improves sensible heat fluxes at all stations but does not improve latent heat loss. The spatial average of the two-way coupled atmosphere component is up to 0.3 °C colder than the one-way coupled setup, which is an improvement for prognostic lead times up to 20 h. Daily spatial average of the standard deviation of air temperature errors shows 0.15 °C improvement in the case of coupled system compared to the uncoupled. Coupled and uncoupled circulations in the northern Adriatic are predominantly wind-driven and show no significant mesoscale differences

    Modeling the ocean and atmosphere during an extreme bora event in northern Adriatic using one-way and two-way atmosphere-ocean coupling

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    We have studied the performances of (a) a two-way coupled atmosphere-ocean modeling system and (b) one-way coupled ocean model (forced by the atmosphere model), as compared to the available in situ measurements during and after a strong Adriatic bora wind event in February 2012, which led to extreme air-sea interactions. The simulations span the period between January and March 2012. The models used were ALADIN (Aire LimiteĂ© Adaptation dynamique DĂ©veloppement InterNational) (4.4 km resolution) on the atmosphere side and an Adriatic setup of Princeton ocean model (POM) (130 × 130 angular resolution) on the ocean side. The atmosphere-ocean coupling was implemented using the OASIS3-MCT model coupling toolkit. Two-way coupling ocean feedback to the atmosphere is limited to sea surface temperature. We have compared modeled atmosphere-ocean fluxes and sea temperatures from both setups to platform and CTD (conductivity, temperature, and depth) measurements from three locations in the northern Adriatic. We present objective verification of 2 m atmosphere temperature forecasts using mean bias and standard deviation of errors scores from 23 meteorological stations in the eastern part of Italy. We show that turbulent fluxes from both setups differ up to 20 % during the bora but not significantly before and after the event. When compared to observations, two-way coupling ocean temperatures exhibit a 4 times lower root mean square error (RMSE) than those from one-way coupled system. Two-way coupling improves sensible heat fluxes at all stations but does not improve latent heat loss. The spatial average of the two-way coupled atmosphere component is up to 0.3 °C colder than the one-way coupled setup, which is an improvement for prognostic lead times up to 20 h. Daily spatial average of the standard deviation of air temperature errors shows 0.15 °C improvement in the case of coupled system compared to the uncoupled. Coupled and uncoupled circulations in the northern Adriatic are predominantly wind-driven and show no significant mesoscale differences. © 2016 Author(s)

    Gleason score at diagnosis predicts the rate of detection of 18F-choline PET/CT performed when biochemical evidence indicates recurrence of prostate cancer: experience with 1,000 patients

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    The objective of this study was to explore the ability of the initial Gleason score (GS) to predict the rate of detection of recurrent prostate cancer (PCa) with (18)F-choline PET/CT in a large cohort of patients. METHODS: Data from 1,000 patients who had undergone (18)F-choline PET/CT because of biochemical evidence of relapse of PCa between 2004 and 2013 were retrieved from databases at 4 centers. Continuous data were compared by the Student t test or ANOVA, and categoric variables were compared by the χ(2) test. Univariable and multivariable analyses were performed by logistic regression. RESULTS: The GS at diagnosis was less than or equal to 6 in 257 patients, 7 in 347 patients, and greater than 7 in 396 patients. The results of 645 PET/CT scans were positive for PCa recurrence. Eighty-one percent of the positive PET/CT results were found in patients with a PSA level of greater than or equal to 2 ng/mL, 43% were found in patients with a PSA level of 1-2 ng/mL, and 31% were found in patients with a PSA level of less than or equal to 1 ng/mL; 78.8% of patients with positive PET/CT results had a GS of greater than 7. The results of (18)F-choline PET/CT scans were negative in 300 patients; 44% had a GS of less than or equal to 6, 35% had a GS of 7, and 17% had a GS of greater than 7. PET/CT results were rated as doubtful in only 5.5% of patients (median PSA, 1.8 ng/mL). When the GS was greater than 7, the rates of detection of (18)F-choline PET/CT were 51%, 65%, and 91% for a PSA level of less than 1 ng/mL, 1-2 ng/mL, and greater than 2 ng/mL, respectively. In univariable and multivariable analyses, both a GS of 7 and a GS of greater than 7 were independent predictors for positive (18)F-choline PET/CT results (odds ratios, 0.226 and 0.330, respectively; P values for both, <0.001). CONCLUSION: A high GS at diagnosis is a strong predictive factor for positive (18)F-choline PET/CT scan results for recurrent PCa, even when the PSA level is low (i.e., ≀1 ng/mL)
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