Ultrasound characteristics of a symptomatic and asymptomatic lymphocele after pelvic and/or paraaortic lymphadenectomy

Objective: To describe the sonographic characteristics of a lymphocele after pelvic and/or paraaortic lymphadenectomy for gynecological malignancy, analyze and identify ultrasound characteristics related to the symptomatic and asymptomatic lymphoceles. Materials and methods: This is a retrospective analysis of ultrasound examination data collected consecutively in patients after pelvic and/or paraaortic lymphadenectomy in one institution. We recorded the number of lymphoceles, localization, size; ultrasound morphology following International Ovarian Tumor Analysis group classification and symptoms. Results: We described and analyzed 227 lymphoceles (150 asymptomatic and 77 symptomatic) in 161 patients. The asymptomatic lymphocele is typically a thick-walled cystic lesion without vascularization, round and unilocular with anechoic or ground-glass content. The symptomatic lymphocele is typically an oval, or ovoid, unilocular lesion with low-level or anechoic content (ground glass content is unlikely to be present, p 1) (p = 0.005), septa (p = 0.002), and debris (p < 0.001) were independent ultrasound features correlating to symptoms development. More than one lymphocele (p = 0.047), septations (p = 0.007) and presence of debris (p < 0.001) were independent ultrasound features correlated to infection. Conclusion: Ultrasound features of symptomatic and asymptomatic lymphocele differ. The clues for lymphocele differential diagnosis are the history of lymphadenectomy and the finding cystic lesion with typically ultrasound features of lymphocele, adjacent to great pelvic vessels. Unique ultrasound features of lymphocele may help to distinguish from tumor relapse, hematoma, abscess, seroma or urinoma. Keywords: Diagnosis, Gynecologic neoplasms, Lymphadenectomy, Lymphocele, Ultrasonograph

The Diagnostic Accuracy of Ultrasound in Assessment of Myometrial Invasion in Endometrial Cancer: Subjective Assessment versus Objective Techniques

The aim of this study was to assess the diagnostic accuracy of subjective ultrasound evaluation of myometrial invasion of endometrial cancer and to compare its accuracy to objective methods. All consecutive patients with histologically proven endometrial cancer, who underwent ultrasound evaluation followed by surgical staging between January 2009 and December 2011, were prospectively enrolled. Myometrial invasion was evaluated by subjective assessment using ultrasound (<50% or ≥50%) and calculated as deepest invasion/normal myometrium ratio (Gordon’s ratio) and as tumor/uterine anteroposterior diameter ratio (Karlsson’s ratio). Histological assessment from hysterectomy was considered the gold standard. Altogether 210 patients were prospectively included. Subjective assessment and two objective ratios were found to be statistically significant predictors of the myometrial invasion (AUC = 0.65, p value < 0.001). Subjective assessment was confirmed as the most reliable method to assess myometrial invasion (79.3% sensitivity, 73.2% specificity, and 75.7% overall accuracy). Deepest invasion/normal myometrium (Gordon’s) ratio (cut-off 0.5) reached 69.6% sensitivity, 65.9% specificity, and 67.3% overall accuracy. Tumor/uterine anteroposterior diameter (Karlsson’s) ratio with the same cut-off reached 56.3% sensitivity, 76.4% specificity, and 68.1% overall accuracy. The subjective ultrasound evaluation of myometrial invasion performed better than objective methods in nearly all measures but showed statistically significantly better outcomes only in case of sensitivity

Climate-induced decline in the quality and quantity of European hops calls for immediate adaptation measures

Acknowledgements: This work was supported by the project SustES—Adaptation strategies for sustainable ecosystem services and food security under adverse environmental conditions (CZ.02.1.01/0.0/0.0/16_019/0000797) to M.T., the Technology Agency of the Czech Republic (No. SS02030040, SS02030018) to M.M.Funder: Ministry of Education, Youth and Sports of the Czech Republic - project SustES - Adaptation strategies for sustainable ecosystem services and food security under adverse environmental conditions Technology Agency of the Czech Republic - No. SS02030040, SS02030018.A recent rise in the global brewery sector has increased the demand for high-quality, late summer hops. The effects of ongoing and predicted climate change on the yield and aroma of hops, however, remain largely unknown. Here, we combine meteorological measurements and model projections to assess the climate sensitivity of the yield, alpha content and cone development of European hops between 1970 and 2050 CE, when temperature increases by 1.4 °C and precipitation decreases by 24 mm. Accounting for almost 90% of all hop-growing regions, our results from Germany, the Czech Republic and Slovenia show that hop ripening started approximately 20 days earlier, production declined by almost 0.2 t/ha/year, and the alpha content decreased by circa 0.6% when comparing data before and after 1994 CE. A predicted decline in hop yield and alpha content of 4–18% and 20–31% by 2050 CE, respectively, calls for immediate adaptation measures to stabilize an ever-growing global sector

Climate-induced decline in the quality and quantity of European hops calls for immediate adaptation measures

Acknowledgements: This work was supported by the project SustES—Adaptation strategies for sustainable ecosystem services and food security under adverse environmental conditions (CZ.02.1.01/0.0/0.0/16_019/0000797) to M.T., the Technology Agency of the Czech Republic (No. SS02030040, SS02030018) to M.M.Funder: Ministry of Education, Youth and Sports of the Czech Republic - project SustES - Adaptation strategies for sustainable ecosystem services and food security under adverse environmental conditions Technology Agency of the Czech Republic - No. SS02030040, SS02030018.A recent rise in the global brewery sector has increased the demand for high-quality, late summer hops. The effects of ongoing and predicted climate change on the yield and aroma of hops, however, remain largely unknown. Here, we combine meteorological measurements and model projections to assess the climate sensitivity of the yield, alpha content and cone development of European hops between 1970 and 2050 CE, when temperature increases by 1.4 °C and precipitation decreases by 24 mm. Accounting for almost 90% of all hop-growing regions, our results from Germany, the Czech Republic and Slovenia show that hop ripening started approximately 20 days earlier, production declined by almost 0.2 t/ha/year, and the alpha content decreased by circa 0.6% when comparing data before and after 1994 CE. A predicted decline in hop yield and alpha content of 4–18% and 20–31% by 2050 CE, respectively, calls for immediate adaptation measures to stabilize an ever-growing global sector