Does shear wave ultrasound independently predict axillary lymph node metastasis in women with invasive breast cancer?

Shear wave elastography (SWE) shows promise as an adjunct to greyscale ultrasound examination in assessing breast masses. In breast cancer, higher lesion stiffness on SWE has been shown to be associated with features of poor prognosis. The purpose of this study was to assess whether lesion stiffness at SWE is an independent predictor of lymph node involvement. Patients with invasive breast cancer treated by primary surgery, who had undergone SWE examination were eligible. Data were retrospectively analysed from 396 consecutive patients. The mean stiffness values were obtained using the Aixplorer(®) ultrasound machine from SuperSonic Imagine Ltd. Measurements were taken from a region of interest positioned over the stiffest part of the abnormality. The average of the mean stiffness value obtained from each of two orthogonal image planes was used for analysis. Associations between lymph node involvement and mean lesion stiffness, invasive cancer size, histologic grade, tumour type, ER expression, HER-2 status and vascular invasion were assessed using univariate and multivariate logistic regression. At univariate analysis, invasive size, histologic grade, HER-2 status, vascular invasion, tumour type and mean stiffness were significantly associated with nodal involvement. Nodal involvement rates ranged from 7 % for tumours with mean stiffness <50 kPa to 41 % for tumours with a mean stiffness of >150 kPa. At multivariate analysis, invasive size, tumour type, vascular invasion, and mean stiffness maintained independent significance. Mean stiffness at SWE is an independent predictor of lymph node metastasis and thus can confer prognostic information additional to that provided by conventional preoperative tumour assessment and staging

Data Management for Large-Scale Scientific Computations in High Performance Distributed Systems

With the increasing number of scientific applications manipulating huge amounts of data, effective high-level data man-agement is an increasingly important problem. Unfortunately, so far the solutions to the high-level data management prob-lem either require deep understanding of specific storage architectures and file layouts (as in high-performance file storage systems) or produce unsatisfactory I/O performance in exchange for ease-of-use and portability (as in relational DBMSs). In this paper we present a novel application development environment which is built around an active meta-data manage-ment system (MDMS) to handle high-level data in an effective manner. The key components of our three-tiered architecture are user application, the MDMS, and a hierarchical storage system (HSS). Our environment overcomes the performance problems of pure database-oriented solutions, while maintaining their advantages in terms of ease-of-use and portability. The high levels of performance are achieved by the MDMS, with the aid of user-specified, performance-oriented directives. Our environment supports a simple, easy-to-use yet powerful user interface, leaving the task of choosing appropriate I/O techniques for the application at hand to the MDMS. We discuss the importance of an active MDMS and show how the three components of our environment, namely application, the MDMS, and the HSS, fit together. We also report performance numbers from our ongoing implementation and illustrate that significant improvements are made possible without undue programming effort. Keywords: 1

Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma

<p>Abstract</p> <p>Background</p> <p>In this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized.</p> <p>Methods</p> <p>A total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated.</p> <p>Results</p> <p>Vesicular changes were observed in 21 (12%) out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%). In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed.</p> <p>Conclusions</p> <p>Our findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology.</p> <p>Virtual slides</p> <p>The virtual slide(s) for this article can be found here: <url>http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474</url></p