The nested dirichlet distribution and incomplete categorical data analysis

The nested Dirichlet distribution (NDD) is an important distribution defined on the closed n-dimensional simplex. It includes the classical Dirichlet distribution and is useful in incomplete categorical data (ICD) analysis. In this article, we develop the distributional properties of NDD. New large-sample likelihood and small-sample Bayesian approaches for analyzing ICD are proposed and compared with existing likelihood/Bayesian strategies. We show that the new approaches have at least three advantages over existing approaches based on the traditional Dirichlet distribution in both frequentist and conjugate Bayesian inference for ICD. The new methods possess closed-form expressions for both the maximum likelihood and Bayes estimates when the likelihood function is in NDD form; produce computationally efficient EM and data augmentation algorithms when the likelihood is not in NDD form; and provide exact sampling procedures for some special cases. The methodologies are illustrated with simulated and real data.published_or_final_versio

Dual Regulating Effect of Shaoyao-Gangcao-Tang on COX- 2 Expression in Acute and Resolution Phases of Carrageenin-Induced Pleurisy in Rats

Purpose: To investigate the effects and potential mechanisms of Shaoyao-Gangcao-Tang (SGT) on acute and resolution phases of carrageenin-induced pleurisy in rats.Methods: To determine the effects of SGT at 2 h, Sprague-Dawley rats received injection of 0.2 ml of 1 % λ-carrageenin into the pleural cavity after treatment with 4.0, 13.3 and 40.0 g/kg SGT for three days. At 2 h after pleurisy induction, exudate volume, total cell number, prostaglandin E2 (PGE2) production and cyclooxygenase-2 (COX-2) protein expression were measured. To determine the effects at 48 h, the rats were treated with SGT at 24, 36 and 46 h after injection of λ-carrageenin into the pleural cavity, and the exudate volume, total cell number, 15-deoxy-Δ12,14-PGJ2 (15d-PGJ2) production and COX-2 protein expression were evaluated.Results: At 2 h after pleurisy induction, 13.3 and 40.0 g/kg SGT significantly decreased exudate volume by 34 (p < 0.05) and b 4 0% (p < 0.01), total cell number by 27 (p < 0.05) and 41 % (p < 0.01), PGE2 production by 17 (p < 0.05) and 35 % (p < 0.01), as well as COX-2 protein expression by 21 (p < 0.01) and 43 % (p < 0.01) compared with control group treated with saline. At 48 h after pleurisy induction, 13.3 and 40 g/kg SGT also significantly decreased exudate volume by 36 (p < 0.05) and 55 % (p < 0.01), as well as total cell number by 31 (p < 0.05) and 43 % (p < 0.01), but markedly increased 15d- PGJ2 production by 26 (p < 0.05) and 51 % (p < 0.01), as well as COX-2 protein expression by 50 (p < 0.01) and 100 % (p < 0.01) compared with control group.Conclusion: The findings suggest that SGT has dual regulating effect in acute and resolution phases of inflammation, involving inhibiting acute inflammation through down-regulation of pro-inflammatory mediators, and promoting inflammatory resolution through up-regulation of pro-resolution mediators.Keywords: Shaoyao-Gangcao-Tang, Cyclooxygenase-2, Prostaglandin E2, 15-Deoxy-Δ12,14-PGJ2, Inflammatio

Breast and Axillary Lymph Nodes Metastasis five years after Radical Nephrectomy for Renal Cell Carcinoma A Case Report and Review of the Literature

Breast is an uncommon and rare site for metastasis. Primary and secondary tumors of the breast need to be differentiated as management is different. We present a 67 year old female patient with two breast lumps and an axillary lymph node, 5 years after nephrectomy for Renal Cell Carcinoma (RCC). Mammogram report showed a dense spiculated mass at right upper outer quadrant and a retroareolar mass associated with clustered micro calcifications. Fine Needle Cytology and trucut biopsy were inconclusive. Computer Topography (CT) abdomen did not show evidence of RCC recurrence. After discussion with the patient, she underwent mastectomy with axillary clearance and the final histopathology report was consistent with metastasis from RCC. The management of this case is discussed

Alemtuzumab pre-conditioning with tacrolimus monotherapy in pediatric renal transplantation

We employed antibody pre-conditioning with alemtuzumab and posttransplant immunosuppression with low-dose tacrolimus monotherapy in 26 consecutive pediatric kidney transplant recipients between January 2004 and December 2005. Mean recipient age was 10.7 ± 5.8 years, 7.7% were undergoing retransplantation, and 3.8% were sensitized, with a PRA >20%. Mean donor age was 32.8 ± 9.2 years. Living donors were utilized in 65% of the transplants. Mean cold ischemia time was 27.6 ± 6.4 h. The mean number of HLA mismatches was 3.3 ± 1.3. Mean follow-up was 25 ± 8 months. One and 2 year patient survival was 100% and 96%. One and 2 year graft survival was 96% and 88%. Mean serum creatinine was 1.1 ± 0.6 mg/dL, and calculated creatinine clearance was 82.3 ± 29.4 mL/min/1.73 m 2. The incidence of pre-weaning acute rejection was 11.5%; the incidence of delayed graft function was 7.7%. Eighteen (69%) of the children were tapered to spaced tacrolimus monotherapy, 10.5 ± 2.2 months after transplantation. The incidence of CMV, PTLD and BK virus was 0%; the incidence of posttransplant diabetes was 7.7%. Although more follow-up is clearly needed, antibody pre-conditioning with alemtuzumab and tacrolimus monotherapy may be a safe and effective regimen in pediatric renal transplantation. © 2007 The Authors

Breast-Lesion Characterization using Textural Features of Quantitative Ultrasound Parametric Maps

© 2017 The Author(s). This study evaluated, for the first time, the efficacy of quantitative ultrasound (QUS) spectral parametric maps in conjunction with texture-analysis techniques to differentiate non-invasively benign versus malignant breast lesions. Ultrasound B-mode images and radiofrequency data were acquired from 78 patients with suspicious breast lesions. QUS spectral-analysis techniques were performed on radiofrequency data to generate parametric maps of mid-band fit, spectral slope, spectral intercept, spacing among scatterers, average scatterer diameter, and average acoustic concentration. Texture-analysis techniques were applied to determine imaging biomarkers consisting of mean, contrast, correlation, energy and homogeneity features of parametric maps. These biomarkers were utilized to classify benign versus malignant lesions with leave-one-patient-out cross-validation. Results were compared to histopathology findings from biopsy specimens and radiology reports on MR images to evaluate the accuracy of technique. Among the biomarkers investigated, one mean-value parameter and 14 textural features demonstrated statistically significant differences (p < 0.05) between the two lesion types. A hybrid biomarker developed using a stepwise feature selection method could classify the legions with a sensitivity of 96%, a specificity of 84%, and an AUC of 0.97. Findings from this study pave the way towards adapting novel QUS-based frameworks for breast cancer screening and rapid diagnosis in clinic