Encephalic ventricular volumetry in multislice computed tomography images in adults with normal cognitive functions

Introducción: Debido a la necesidad de un diagnóstico precoz de los trastornos neurodegenerativos, se ha intentado armonizar los criterios diagnósticos mediante métodos morfométricos basados en técnicas de neuroimagen, pero aún no se han obtenido resultados concluyentes. Objetivo: Determinar el volumen ventricular debido a su amplio uso como marcador de atrofia cerebral e identificar el efecto del sexo sobre estas estructuras, según el tipo de cráneo, estimado a partir de técnicas de imagen de tomografía computarizada multicorte. Métodos: Se desarrolló un estudio observacional y descriptivo en 30 sujetos con funciones neurocognitivas y exploración neuropsiquiátrica normales, con edades comprendidas entre 45 y 54 años, a los que se les realizó una tomografía computarizada multicorte simple de cráneo. Se utilizó un método de segmentación de imágenes basado en la homogeneidad. Resultados: Los volúmenes ventriculares mostraron una correlación significativa y positiva entre ellos, excepto entre el tercer y cuarto ventrículo y el tercero y el volumen ventricular derecho. Los estadísticos del modelo lineal multivariante aplicado mostraron que sólo eran significativos en función del sexo y del tipo de cráneo. No se encontraron diferencias significativas con respecto al sexo en ningún volumen, excepto en el tercer ventrículo (p= 0,01). Lo mismo ocurrió por tipo de cráneo (p= 0,005). Conclusiones: El método de morfometría del sistema ventricular encefálico a partir de imágenes de Tomografía Computarizada / Segmentación por homogeneidad, permitió cuantificar los cambios volumétricos cerebrales asociados al envejecimiento normal y puede ser utilizado como biomarcador de la relación entre la estructura cerebral y las funciones cognitivas.

Introduction: Due to the need for an early diagnosis of neurodegenerative disorders, attempts have been made to harmonize diagnostic criteria using morphometric methods based on neuroimaging techniques, but conclusive results have not yet been obtained. Objective: To determine the ventricular volume due to its wide use as a marker of cerebral atrophy and to identify the effect of sex on these structures, according to the type of skull, estimated from multislice computed tomography imaging techniques. Methods: An observational and descriptive study was developed in 30 subjects with normal neurocognitive functions and neuropsychiatric examination, aged between 45 and 54 years, who underwent a simple multislice CT scan of the skull. An image segmentation method based on homogeneity was used. Results: The ventricular volumes showed a significant and positive correlation between them, except between the third and fourth ventricles and the third and the right ventricular volume. The statistics in the multivariate linear model applied showed that they were only significant in terms of sex and type of skull. No significant differences were found regarding sex in any volume except in the third ventricle (p= 0.01). The same occurred by type of skull (p= 0.005). Conclusions: The morphometry method of the encephalic ventricular system from Computed Tomography images / Segmentation by homogeneity, allowed to quantify the cerebral volumetric changes associated with normal aging and can be used as a biomarker of the relationship between brain structure and cognitive functions.

Determinação do período de estabilidade de soluções volumétricas rotineiramente utilizadas em laboratórios de análises químicas / Determination of the stability period of volumetric solutions routinely used in chemical analysis laboratories / Determinación del período de estabilidad de las soluciones volumétricas utilizadas habitualmente en los laboratorios de análisis químicos

As soluções volumétricas são rotineiramente utilizadas nos laboratórios, principalmente nos processos de síntese de produtos e nas análises quantitativas de matéria-prima e/ou produto acabado, entretanto poucos são os estudos que abordam a estabilidade destas soluções. Considerando que a qualidade das soluções volumétricas pode afetar os procedimentos de análises químicas e consequentemente induzir a erros, e ainda que, a Farmacopeia Brasileira (2010) não cita tempo máximo de utilização dessas soluções padronizadas, a avaliação da estabilidade das mesmas é importante. Sendo assim, o objetivo do trabalho foi avaliar a estabilidadede 10 soluções volumétricas, empregadas rotineiramente em laboratórios de análises químicas, com o intuito de estabelecer o período que essas soluções permanecem estáveis, isto é, sem sofrer alteração na concentração. As metodologias de preparo e padronização das soluções volumétricas seguiram os métodos descritos na Farmacopeia Brasileira (2010), sendo as mesmas padronizadas no momento do preparo e a cada 20 dias, por um período de 180 dias. As soluções contendo ácidos e bases, bem como as soluções de iodato de potássio e nitrato de prata, permaneceram constantes durante o período de análises. As soluções de EDTA, iodo, nitrito de sódio, permanganato de potássio e tiossulfato de sódio apresentaram estabilidade inferior a 180 dias, tornando necessária a realização de padronização periódica. As soluções volumétricas utilizadas nos laboratórios apresentam diferentes estabilidades, o que ressalta a importância da determinação do período que as mesmas se mantêmcom as concentrações estáveis, evitando possíveis alterações de resultados nas análises químicas.

Volumetric solutions are routinely used in laboratories, mainly in product synthesis processes and in quantitative analyzes of raw materials and/or finished products, however there are few studies that address the stability of these solutions. Considering that the quality of volumetric solutions can affect chemical analysis procedures and consequently induce errors, and even though the Brazilian Pharmacopoeia (2010) does not mention the maximum time for using these standardized solutions, the evaluation of their stability is important. Therefore, the aim of this work was to evaluate the stability of 10 volumetric solutions, routinely used in chemical analysis laboratories, in order to establish the period that these solutions remain stable without changing their concentrations. The methodologies for preparing and standardizing the volumetric solutions followed the methods described in the Brazilian Pharmacopoeia (2010), being standardized at the time of preparation and every 20 days, for a period of 180 days. Solutions containing acids and bases, as well as potassium iodate and silver nitrate solutions, were stable during the analysis period. The solutions of EDTA, iodine, sodium nitrite, potassium permanganate and sodium thiosulfate showed stability less than 180 days, making it necessary to carry out periodic standardization of these solutions. The volumetric solutions used in the laboratories have different stabilities, which highlights the importance of determining the period in which they remain stable, avoiding possible changes in results in chemical analyzes.

Las soluciones volumétricas se utilizan de forma rutinaria en los laboratorios, principalmente en los procesos de síntesis de productos y en el análisis cuantitativo de materias primas y/o productos acabados. Sin embargo, existen pocos estudios que aborden la estabilidad de estas soluciones. Considerando que la calidad de las soluciones volumétricas puede afectar los procedimientos de análisis químico y consecuentemente inducir a errores, y también que, la Farmacopea Brasileña (2010) no menciona el tiempo máximo de uso de estas soluciones estandarizadas, la evaluación de su estabilidad es importante. Así, el objetivo del trabajo fue evaluar la estabilidad de 10 soluciones volumétricas, utilizadas rutinariamente en los laboratorios de análisis químico, con el fin de establecer el período en que estas soluciones permanecen estables, es decir, sin sufrir alteraciones en la concentración. Las metodologías de preparación y estandarización de las soluciones volumétricas siguieron los métodos descritos en la Farmacopea Brasileña (2010), siendo las mismas estandarizadas en el momento de la preparación y cada 20 días, por un período de 180 días. Las soluciones que contienen ácidos y bases, así como las soluciones de yodato de potasio y nitrato de plata, permanecieron constantes durante el periodo de análisis. Las soluciones de EDTA, yodo, nitrito de sodio, permanganato de potasio y tiosulfato de sodio fueron estables durante menos de 180 días, por lo que fue necesario realizar estandarizaciones periódicas. Las soluciones volumétricas utilizadas en los laboratorios presentan diferentes estabilidades, lo que pone de manifiesto la importancia de determinar el periodo que permanecen con concentraciones estables, evitando posibles cambios en los resultados en los análisis químicos.

Application of stereology in liver volume measurements using computed tomography scan / Aplicación de la estereología en mediciones de volumen hepático mediante tomografía computarizada

SUMMARY: The application of stereology in hepatobiliary conditions is essential in liver volume estimation. Computerized topographic scan with contrast is a reliable method in liver scanning for precise boundaries demarcation. Liver volumetry varies in relation to different factors. Reports showed a correlation of liver volume with sex and body mass index. Steady relation between age and ethnicity is not established. This study aimed to design a protocol for liver volume measurement and apply it in the estimation of volume among the Sudanese population use stereology. Recruitment of the study population was obtained in the royal scan clinic in Khartoum by making an announcement for participation in the study. Patients with a history of hepatobiliary diseases were excluded. CT abdomen with contrast was obtained in DICOM format and transferred to computer-based software for image analysis. A protocol was designed and validated and then applied in volume estimation using software MRIcro for image display, ImageJ for volume estimation, and Onis 2.6 as image viewer. 300 apparently healthy volunteers were recruited. The protocol reliability result was 0.805. Absolute mean liver volume was 3261.32 ± 1365.313 cm3. High liver volume among females was detected than among males. A positive correlation was detected between volume and body mass index (p-value 0.001) regardless of sex. Relation with age showed a rough steady rise till the age of 50 years then it started to decline steadily. The relationship was detected in liver volume with sex and body mass index. More studies are needed to investigate the relationship between ethnicity and age groups.

RESUMEN: La aplicación de la estereología en condiciones hepatobiliares es fundamental en la estimación del volumen hepático. El escaneo topográfico computarizado con contraste es un método confiable en el escaneo del hígado para la demarcación precisa de sus límites. La volumetría hepática varía en función de diferentes factores. Los informes mostraron una correlación del volumen del hígado con el sexo y el índice de masa corporal. No se establece una relación estable entre la edad y la etnia. Este estudio tuvo como objetivo diseñar un protocolo para la medición del volumen hepático de la población sudanesa usando la estereología. El reclutamiento de la población de estudio fue realizado en la clínica de exploración real en Jartum mediante un anuncio de participación. Se excluyeron los pacientes con antecedentes de enfermedades hepatobiliares. Se obtuvo TC de abdomen con contraste en formato DICOM y se transfirió a un software informático para el análisis de imágenes. Se diseñó y validó un protocolo y luego se aplicó en la estimación de volumen utilizando el software MRIcro para la visualización de imágenes, ImageJ para la estimación de volumen y Onis 2.6 como visor de imágenes. Se reclutaron 300 voluntarios sanos. El resultado de la fiabilidad del protocolo fue 0,805. El volumen hepático medio absoluto fue 3261,32 ± 1365,313 cm3. Se detectó un volumen más elevado de hígado en las mujeres que en los hombres. Se detectó una correlación positiva entre el volumen y el índice de masa corporal (valor de p 0,001) independientemente del sexo. La relación con la edad mostró un aumento continuo y brusco hasta los 50 años, luego comenzó a disminuir de manera constante. Se detectó la relación del volumen hepático con el sexo y el índice de masa corporal. Se necesitan más estudios para investigar la relación entre la etnia y los grupos etarios.

MRI based volumetric analysis of entorhinal cortex in elderly subjects with mild cognitive impairment and in subjects with normal cognition to see effects of aging on volume of ERC

Background: MCI is a transitional period between normal ageing and clinically probable early Alzheimer’s Dementia (AD). ERC volumes show early reduction in cases of MCI in comparison to the normal ageing subjects. Early cognitive impairment can be documented with ERC atrophy on MR volumetry. Aim of the study was to evaluate the volume of entorhinal cortex in patients of MCI and  to compared the volume with patients of normal cognition. Secondarily, we studied changes in the volume of entorhinal cortex with increasing ageMethods: In this study 30 patients of 60 years and above with MCI and 30 controls of normal cognition (age and sex matched) underwent brain examination on 3T MRI. Volume of entorhinal cortex was measured on 1 mm thick T1 coronal oblique MR scans by manually tracing the boundaries defined by two widely used methods i.e. Insausti et al and Goncharova et al.Results: Patients with MCI showed 17.2% decline in the entorhinal cortex volume compared to controls (p value = 0.001). Patients of older age showed significantly more ERC volume reduction, reaching up to 30.4% in comparison to younger subjects suggesting atrophy of ERC in normal aging and in MCI both, but more so in patients with cognitive impairment.Conclusions: ERC atrophy was found in MCI cases more than controls, increase atrophy trend was noted with increasing age. MR volumetry may play a role for documentation of ERC atrophy in cases of MCI.

Cardiac CT for Measurement of Right Ventricular Volume and Function in Comparison with Cardiac MRI: A Meta-Analysis

OBJECTIVE: We performed a meta-analysis to evaluate the agreement of cardiac computed tomography (CT) with cardiac magnetic resonance imaging (CMRI) in the assessment of right ventricle (RV) volume and functional parameters.MATERIALS AND METHODS: PubMed, EMBASE, and Cochrane library were systematically searched for studies that compared CT with CMRI as the reference standard for measurement of the following RV parameters: end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), or ejection fraction (EF). Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and correlation coefficient (r) between CT and CMRI. Heterogeneity was also assessed. Subgroup analyses were performed based on the probable factors affecting measurement of RV volume: CT contrast protocol, number of CT slices, CT reconstruction interval, CT volumetry, and segmentation methods.RESULTS: A total of 766 patients from 20 studies were included. Pooled bias and LOA were 3.1 mL (−5.7 to 11.8 mL), 3.6 mL (−4.0 to 11.2 mL), −0.4 mL (5.7 to 5.0 mL), and −1.8% (−5.7 to 2.2%) for EDV, ESV, SV, and EF, respectively. Pooled correlation coefficients were very strong for the RV parameters (r = 0.87–0.93). Heterogeneity was observed in the studies (I2 > 50%, p < 0.1). In the subgroup analysis, an RV-dedicated contrast protocol, ≥ 64 CT slices, CT volumetry with the Simpson's method, and inclusion of the papillary muscle and trabeculation had a lower pooled bias and narrower LOA.CONCLUSION: Cardiac CT accurately measures RV volume and function, with an acceptable range of bias and LOA and strong correlation with CMRI findings. The RV-dedicated CT contrast protocol, ≥ 64 CT slices, and use of the same CT volumetry method as CMRI can improve agreement with CMRI.

Role of hippocampal volumetry in drug resistant epilepsy

Background: Hippocampus is a brain structure located deep in the temporal lobe. The structure is crucial for learning and memory and is a natural inhibitor of seizure activity in brain. In drug resistant epilepsy (DRE), there is shrinkage of the hippocampus leading to poor seizure control.Methods: Patients meeting the diagnostic criteria for drug resistant epilepsy between the age group of 10-60 years were enrolled in the study. Epileptic non drug resistant controls and normal healthy individuals were taken from same cohort. Selected patients underwent MRI Brain and their hippocampal volumes were estimated manually. Coronal oblique sections, perpendicular to the long axis of hippocampus were taken and hippocampal volume (HV) were calculated using region of interest approach with manual delineation . Results: There was increment in detecting hippocampal atrophy from 30% to 46.6% in DRE patients when manual hippocampal atrophy was used in addition to visual assessment. The mean right and left hippocampal volumes in drug resistant epilepsy cases were found to be 2.17+0.57 cc and 1.52+0.54 cc respectively. Left HV was found to be statistically significantly smaller than right side (p value < 0.05). DRE patients had smaller mean bilateral HV than healthy controls, the difference being 33%. The left HV loss was almost double the right HV loss among DRE cases. The hippocampal volumes were reduced in DRE patients compared to epileptic non-resistant patients; however the difference was found to be less than that of normal healthy controls.Conclusion: Manual hippocampal volumetry detected more patients with hippocampal atrophy in our study compared to visual assessment. Manual hippocampal volumetry should be routinely done in patients with Drug resistant epilepsy.

Cambios estructurales cerebrales en epilepsia generalizada idiopática identificados por análisis de imágenes de resonancia magnética automatizados / Cerebral structural changes in generalized idiopathic epilepsy identified by automated magnetic resonance imaging analysis

El objetivo de este estudio fue combinar dos métodos automatizados de análisis estructural de imágenes de resonancia magnética para identificar cambios estructurales en pacientes nacidos en Argentina con epilepsia generalizada idiopática (EGI) en comparación con un grupo control de adultos sanos. Fueron incluidos 28 pacientes con EGI y 26 controles sin diferencias demográficas significativas. El análisis de las estructuras cerebrales se realizó con dos métodos automatizados de análisis de imágenes de resonancia magnética: la morfometría basada en vóxel y con la herramienta de segmentación y registro integrada FSL (FSL-FIRST). FSL mostró una disminución del volumen en ambos tálamos en EGI en comparación con el grupo control (tálamo izquierdo: 8092 mm³ grupo control vs. 7424 mm³ EGI, p = 0.0015; tálamo derecho: 7951 mm³ grupo control vs. 7247 mm³ EGI, p = 0.0016). Se observó una reducción en el volumen de ambos núcleos caudados (izquierdo: 3612 mm³ grupo control vs. 3376 mm³ EGI, p = 0.01; derecho 3683 mm³ grupo control vs. 3459 mm³ EGI, p = 0.04). La morfometría basada en vóxel mostró una disminución del volumen en ambos núcleos caudados en EGI en comparación con el grupo control. Las otras estructuras cerebrales analizadas no mostraron diferencias significativas entre los grupos. Este estudio muestra la reducción en el volumen en las estructuras subcortical, tálamos y núcleos caudados en pacientes con EGI comparado con un grupo control.

The purpose of this study was to combine two automated methods of magnetic resonance imaging (MRI) structural analysis in order to identify structural changes in patients born in Argentina with idiopathic generalized epilepsy (IGE) compared to a healthy adult control group. Twenty-eight patients with IGE and 26 controls with no significant demographic differences were included. The analysis of the brain structures was conducted with two automated methods of magnetic resonance image analysis: voxel-based morphometry and FSL-integrated registration and segmentation toolbox (FSL-FIRST). FSL showed volume decrease in both thalamus in patients with IGE compared to the control group (left: 8092 mm³ control group vs. 7424 mm³ IGE, p = 0.0015; right: 7951 mm³ control group vs. 7247 mm³ IGE, p = 0.0016). A reduction in the volume of both caudate nuclei was also seen (left: 3612 mm³ control group vs. 3376 mm³ IGE, p = 0.01; right: 3683 mm³ control group vs. 3459 mm³ IGE, p = 0.04). Voxel-based-morphometry showed a volume decrease in both caudate nuclei in patients with IGE compared to the control group. The other cerebral structures analyzed did not show significant differences between the groups. In conclusion, this study shows the reduction in volume in the subcortical, thalamic, and caudate nuclei structures in patients with IGE in comparison to control group. This study conducted in our country delves into the analysis of brain structural changes in patients with EGI compared to healthy subjects.

Regression analysis of expected fetal lung volume on MRI / 中国医学影像技术

Objective To establish domestic expected fetal lung volume (FLV) regression formula according to gestational week (GW) with large sample and data distributed evenly. Methods Prenatal MRI of 457 fetuses from 18 to 39 gestational weeks with normal chest was collected. FLV was measured on the axial images of single shot fast spin echo sequence. All FLV data were used for regression analysis. The regression model was determined according to the degree of fitting and test results, and the expected FLV regression formula based on GW was obtained. Results The mean GW of 457 fetuses was (29.44±4.61) weeks. There were 43.11% (197/457) fetuses at 28 weeks and below. FLV based on MRI measurement ranged from 9.47 ml to 131.48 ml, mean (50.78±23.76) ml. The final regression formula was expected FLV=0.004g2.76 (g=GW, R2=0.845, P<0.001). Conclusion The final regression formula of expected FLV is simple, practical and applicable to most fetuses, and is helpful to the research on prenatal assessment of domestic fetuses lung.

Application of multi-slice spiral CT to assess vascular volume for the diagnosis and treatment of gastric varices / 中华肝脏病杂志

Objective@#To differentiate the inflow and outflow channels of gastric varices in cirrhotic portal hypertension patients using multi-slice spiral CT (MSCT), and to assess the relationship between calculable CT volume of gastric varices and the amount of tissue adhesive.@*Methods@#97 cases with cirrhotic gastric varices who were admitted from November 2013 to August 2017 were selected. The type and shape of gastric varices were observed before tissue glue injection treatment by MSCT. The correlation between CT volume of gastric varices and the amount of tissue adhesive was evaluated by Spearman rank correlation coefficient and Univariate linear regression analysis.@*Results@#MSCT showed that Le, g type had the highest proportion (54.6%), followed by Le, g, Lg (20.6%). Le, Lg and Lgf type accounted for 17.5%, and 5.2%, respectively, while Lgf+b accounted for 2.1%. On MSCT, varices of the gastric fundus were in the direction from bottom to top, and 75% of the fundus had a large curved side varices combined with gastric and renal shunt. Under the gastroscopy, varices in the small curved side of the gastric fundus from near to far were formless. In addition, varices in the large curved side of the gastric fundus when observed from different angles to the direction of blood flow (reverse gastroscope) were 72.7% (near and far) or 20.5 % (far and near). There was a positive correlation between CT volume (R = 0.97, P < 0.001) and the amount of tissue adhesive (Y1 = 0.35 + 0.65X1, Univariate linear regression equation; ρ = 0.89, P < 0.001, Spearman correlation analysis).@*Conclusion@#MSCT can recognize the vascular shape and inflow and outflow channels of gastric varices. A positive correlation between CT volume and the amount of tissue adhesive, suggested that the CT volume measurement before treatment could be used as one of the method to predict the amount of tissue adhesive.

Ultrasonographic quantification of pleural effusion: comparison of four formulae

PURPOSE: The purpose of this study was to evaluate the correlations of ultrasonographically estimated volumes of pleural fluid with the actual effusion volume in order to determine the most reliable formula. METHODS: In 32 consecutive patients with clinically diagnosed pleural effusion, an ultrasound estimation was made of the volume of effusion using four different formulae, including two in the erect position and two in the supine position. Closed-tube thoracostomy drainage using a 28-Fr chest tube was performed. The total drainage was calculated after confirmation of full lung re-expansion and complete drainage by plain chest radiographs and ultrasound. The ultrasonographically estimated volume was compared to the actual total volume drained as the gold standard. RESULTS: There were 14 female and 18 male subjects. The mean age of all subjects was 41.56±18.34 years. Fifty percent of the effusions were in the left hemithorax. Metastatic disease accounted for the plurality of effusions (31.2%). The mean total volume drained for all the subjects was 2,770±1,841 mL. The ultrasonographically estimated volumes for the erect 1, erect 2, supine 1, and supine 2 formulae were 1,816±753 mL, 1,520±690 mL, 2,491±1,855 mL, and 1,393±787 mL, respectively. The Pearson correlation coefficients (r) for the estimate of each formula were 0.75, 0.81, 0.62, and 0.63, respectively. CONCLUSION: Although both erect formulae showed similar correlations, the erect 2 formula (Goecke 2) was most closely correlated with the actual volume drained.

Clinical implication of hepatic volumetry for living donor liver transplantation

No abstract available.

Autopercepción de aumento de volumen de extremidades superiores y cuatro criterios diagnósticos para linfedema en mujeres tratadas por cáncer de mama / Self-perception of upper limbs swelling and four diagnostic criteria for lymphedema in women treated for breast cancer

La autopercepción de aumento de volumen de extremidad superior, puede ser una herramienta eficaz en la pesquisa e intervención temprana del linfedema. El objetivo del estudio fueverificar la asociación entre autopercepción de aumento de volumen de extremidad superior y criterios objetivos de uso común para linfedema en mujeres tratadas por cáncer de mama. Se evaluaron 112 mujeres con cáncer de mama, quienes tenían entre 6 y 18 meses post cirugía. Se realizó el cálculo de volumetría indirecta de extremidades superiores, a través de cuatro criterios diagnósticos basados en diferencia de volumen de extremidades (≥2 cm, ≥ 200 mL, ≥10% ≥20%). La autopercepción de volumen fue evaluada con una pregunta. Para el análisis de datos, se utilizó la prueba de chi cuadrado. La media de edad fue 56,3 años (DE=13,1). La prevalencia observada para el criterio de diferencia de volumen ≥ 200 mL fue de 13,4%, 17% para criterio ≥10%, 6,25% para criterio ≥ 20% y 33% para criterio ≥2 cm. Stemmer fue positivo en 51,8% y fóvea positiva en 17,9% de las mujeres. La autopercepción de aumento de volumen se asoció con los criterios ≥ 200 mL y ≥10% y con la presencia de Stemmer y fóvea (p<0,05). En conclusión, la información entregada por las pacientes respecto de la autopercepción del volumen de su extremidad, se asoció con los criterios diagnósticos de linfedema más conservadores, así como para la presencia de signos de Stemmer y fóvea positiva. Estos se debiera considerar dentro de la evaluación clínica.

Self-perception of upper limbs swelling can be an effective tool in diagnostic and early intervention of lymphedema. The aim of the present paper was to verify the association between self-perception of swelling of upper extremities and objective criteria commonly used for lymphedema diagnostic in women treated for breast cancer. We evaluated 112 women with breast cancer between 6- and 18-months post-surgery. Indirect calculation of the volume of upper extremities through four criteria commonly used was employed (≥2 cm, ≥ 200 mL, ≥10%, ≥20%). The self-perception of swelling was evaluated with a question. The chi square test was used for data analysis. The mean age was 56.3 years (DE=13.1). The prevalence of lymphedema according to limb volume difference ≥ 200 ml criterion was 13.4%; 17% for criterion ≥10 %; 6.25% for criterion ≥ 20%; and 33% for criterion ≥2 cm. Stemmer was positive in 51.8% and 17.9% women presented positive fovea. Self-perception of swelling was associated with the criteria ≥ 200 mL and ≥10 % and the presence of positive Stemmer and fovea (p <0.05). In conclusion, the information provided by the patient about her perception of swelling, is associated with objective diagnostic criteria and the Stemmer and fovea positive signs. Self-perception should be considered in the clinical evaluation.

Use of Cardiac Computed Tomography for Ventricular Volumetry in Late Postoperative Patients with Tetralogy of Fallot

BACKGROUND: Cardiac computed tomography (CT) has emerged as an alternative to magnetic resonance imaging (MRI) for ventricular volumetry. However, the clinical use of cardiac CT requires external validation. METHODS: Both cardiac CT and MRI were performed prior to pulmonary valve implantation (PVI) in 11 patients (median age, 19 years) who had undergone total correction of tetralogy of Fallot during infancy. The simplified contouring method (MRI) and semiautomatic 3-dimensional region-growing method (CT) were used to measure ventricular volumes. RESULTS: All volumetric indices measured by CT and MRI generally correlated well with each other, except for the left ventricular end-systolic volume index (LV-ESVI), which showed the following correlations with the other indices: the right ventricular end-diastolic volume index (RV-EDVI) (r=0.88, p<0.001), the right ventricular end-systolic volume index (RV-ESVI) (r=0.84, p=0.001), the left ventricular end-diastolic volume index (LV-EDVI) (r=0.90, p=0.001), and the LV-ESVI (r=0.55, p=0.079). While the EDVIs measured by CT were significantly larger than those measured by MRI (median RV-EDVI: 197 mL/m² vs. 175 mL/m², p=0.008; median LV-EDVI: 94 mL/m² vs. 92 mL/m², p=0.026), no significant differences were found for the RV-ESVI or LV-ESVI. CONCLUSION: The EDVIs measured by cardiac CT were greater than those measured by MRI, whereas the ESVIs measured by CT and MRI were comparable. The volumetric characteristics of these 2 diagnostic modalities should be taken into account when indications for late PVI after tetralogy of Fallot repair are assessed.

Use of morphometric analyses to assess the efficacy of the technique of resin composite bonded to cervical dentin with additional mechanical retentions / Uso de análisis morfométrico para evaluar la eficacia de la técnica de resina compuesta unida a dentina cervical con retenciones mecánicas adicionales

The structural changes and morphological derivatives of progressive dentin hypermineralization determine the bonding to its surface. A planimetric study and fracture volume estimate were conducted to assess the efficacy of resin composite bonded to hypermineralized cervical dentin with and without retentions by applying a shear test. Thirty-four premolars from adult patients were used to obtain a flat cervical dentin surface. The specimens were distributed randomly into two groups: 1) experimental, where hemispherical retentions were carved into the cervical dentin, and 2) control, where the flat dentin was maintained. Using a jig, a resin column was built into the dentin surface fitted with bonding in specimens from both groups, which were then subjected to the shear test. The morphological analysis was performed with a microscope while the percentage of remnant surface from each component of the adhesive bond was calculated planimetrically. The volume of lost tissue was determined using Scherle's method. In the planimetric study, the average remnant resin on the surface was significantly higher in the experimental group and there was less intact dentin in the control group. The volumetric assessment also showed a much higher loss of dentin substrate than the experimental group. Consequently, the complementary use of morphometric and volumetric techniques enables the evaluation of the efficacy of a technique, demonstrating that the inclusion of mechanical retentions in hypermineralized cervical dentin improves the bonding properties.

Los cambios estructurales y morfológicos derivados de la hipermineralización dentinaria progresiva determina la adhesión a su superficie. Fue realizado un estudio planimétrico y el volumen de fractura estimado para evaluar la eficacia de resina compuesta adherida a dentina cervical hipermineralizada con y sin retenciones a través de la prueba de cizalla. Treinta y cuatro premolares obtenidos de pacientes adultos fueron utilizados para obtener una superficie dentinaria cervical plana. Las muestras fueron distribuidas aleatoriamente en dos grupos: 1) experimental, donde se realizaron retenciones hemiesféricas a la dentina cervical, y 2) control, donde la dentina plana fue mantenida. Usando un dispositivo, una columna de resina fue construida en la superficie dentinaria y adaptada con adhesivos en las muestras de ambos grupos, las cuales fueron sometidas al test de cizalla. El análisis morfológico fue realizado con un microscopio mientras que el porcentaje de superficie remanente para cada componente del adhesivo fue calculado planimetricamente. El volumen del tejido perdido fue determinado utilizado el método de Scherle. En el estudio planimétrico, el promedio de resina remanente en la superficie fue significativamente mayor en el grupo experimental y con menos dentina intacta en el grupo control. El análisis volumétrico mostró una mayor perdida de sustrato dentinario en el grupo control. De esta manera, el uso de técnicas morfométricas y volumétricas permite la evaluación de la eficacia de una técnica, demostrando que la inclusión de retenciones mecánicas en la dentina hipermineralizada cervical mejora las propiedades de adhesión.

Application of liver volumetry in hepatectomy / 中华肝胆外科杂志

Liver volume can reflect the change of parenchyma volume and functional reserve of liver.Liver volumetry is commonly achieved by imaging methods such as ultrasound,CT and MRI,while CT volumetry is most commonly used in clinical practice.This article discussed the decision making among different liver volumetry methods and associated applications in hepatectomy.

Cognitive Dysfunction in Drug-induced Parkinsonism Caused by Prokinetics and Antiemetics

The use of prokinetics/antiemetics is one of the leading causes of drug-induced parkinsonism (DIP) observed in neurology clinics. Cognitive dysfunction in DIP has recently been recognized, but pathologies related with cognitive dysfunction is unknown. Among our retrospective cohort of 385 consecutive parkinsonian patients enrolled in our parkinsonism registry, 14 patients were identified who satisfied our inclusion criteria: parkinsonism caused by prokinetics/antiemetics, existing T1-weighted 3D volumetric MR images, and normal [18F]-N-3-fluoropropyl-2-beta-carboxymethoxy-3-beta-(4-iodophenyl) nortropane PET scan images. For the comparison of volumetric MR data, 30 age- and sex-matched healthy individuals were included in this study. Among 14 patients with DIP, 4 patients were diagnosed with dementia, and all other patients had mild cognitive impairment (MCI). Comparisons of MR volumetric data between DIP patients with MCI and controls show that cortical gray matter volumes are reduced bilaterally in DIP (P=0.041) without changes in either total white matter volume or total intracranial volume. Among subcortical structures, the volume of the right hippocampus is reduced in DIP patients compared with controls (P=0.011, uncorrected). In DIP, cortical thickness is reduced in the bilateral lingual (P=0.002), right fusiform (P=0.032) and part of the left lateral occipital gyri (P=0.007). Our results suggests that cognitive dysfunction in DIP caused by prokinetics/antiemetics is common. Structural changes in the brain by 3D MRI may be associated with cognitive decline in DIP.

Intra-Rater and Inter-Rater Reliability of Brain Surface Intensity Model (BSIM)-Based Cortical Thickness Analysis Using 3T MRI

PURPOSE: Brain surface intensity model (BSIM)-based cortical thickness analysis does not require complicated 3D segmentation of brain gray/white matters. Instead, this technique uses the local intensity profile to compute cortical thickness. The aim of the present study was to evaluate intra-rater and inter-rater reliability of BSIM-based cortical thickness analysis using images from elderly participants. MATERIALS AND METHODS: Fifteen healthy elderly participants (ages, 55-84 years) were included in this study. High-resolution 3D T1-spoiled gradient recalled-echo (SPGR) images were obtained using 3T MRI. BSIM-based processing steps included an inhomogeneity correction, intensity normalization, skull stripping, atlas registration, extraction of intensity profiles, and calculation of cortical thickness. Processing steps were automatic, with the exception of semiautomatic skull stripping. Individual cortical thicknesses were compared to a database indicating mean cortical thickness of healthy adults, in order to produce Z-score thinning maps. Intra-class correlation coefficients (ICCs) were calculated in order to evaluate inter-rater and intra-rater reliabilities. RESULTS: ICCs for intra-rater reliability were excellent, ranging from 0.751-0.940 in brain regions except the right occipital, left anterior cingulate, and left and right cerebellum (ICCs = 0.65-0.741). Although ICCs for inter-rater reliability were fair to excellent in most regions, poor inter-rater correlations were observed for the cingulate and occipital regions. Processing time, including manual skull stripping, was 17.07 +/- 3.43 min. Z-score maps for all participants indicated that cortical thicknesses were not significantly different from those in the comparison databases of healthy adults. CONCLUSION: BSIM-based cortical thickness measurements provide acceptable intra-rater and inter-rater reliability. We therefore suggest BSIM-based cortical thickness analysis as an adjunct clinical tool to detect cortical atrophy.

Contralateral hippocampal volume influences surgical outcome in patients with MTLE and similar degree of ipsilateral hippocampal atrophy / O volume hipocampal contralatral influencia o desfecho cirúrgico de pacientes com ELTM e grau semelhante de atrofia hipocampal ipsilateral

Objective: to investigate the relationship between hippocampal atrophy (HA) and surgical outcome in patients with mesial temporal lobe epilepsy (MTLE). Methodology: we compared 34 patients free of seizure (GroupA) with 33 patients with persistent seizures after surgery (GroupB). All had preoperative diagnosis of unilateral MTLE by EEG and MRI evidence of unilateral hippocampal sclerosis (HS) by visual analysis. We performed hippocampal volumetry using high resolution T1 MRI (1mm) in all patients and in 30 healthy controls. Results: Z-score (Mean±SD) of affected hippocampus was -2.58±1.29 in GroupA and -2.57±1.47 in Group-B (p=0.98). The Z-Score of contralateral hippocampus was significantly lower in GroupB, compared to GroupA (p=0.038). Grouping all patients, smaller hippocampal volumes in the affected side were associated with history of meningitis (p=0.049), febrile seizures (p=0.049) and absence of family history of epilepsy (p=0.049). Conclusions: Ipsilateral HA was more severe in patients who had febrile seizures and meningitis, and in those without family history of epilepsy, supporting the notion that in the absence of genetic predisposition, more severe cerebral insult is necessary to induce epileptogenesis. Less favorable surgery outcome for unilateral MTLE was associated with smaller hippocampal volumes contralateral to the operated side, suggesting that surgery is less effective when bilateral damage exists, even when it is not detectable by visual MRI analysis...

Objetivo: investigar a relação entre atrofia hipocampal (AH) e resultado cirúrgico de pacientes com epilepsia de lobo temporal mesial (ELTM). Methodology: comparamos 34 pacientes livres de crises (grupoA) com 33 pacientes que permaneceram com crises após cirurgia (GrupoB). Todos apresentavam o diagnóstico pré-operatório de ELTM unilateral por EEG e RM com sinais de atrofia hipocampal (AH) unilateral na análise visual. Realizamos volumetria do hipocampo utilizando imagens T1 de RM de alta resolução (1mm) em todos os pacientes e em 30 controles sadios. Resultados: o Z-score (Média±DP) dos hipocampos afetados foi -2.58±1.29 no GrupoA e -2.57±1.47 no GrupoB (p=0.98). O Z-score dos hipocampos contralaterais foi significativamente menor no grupoB comparado ao grupoA (p=0.038). Agrupando todos os pacientes, volumes hipocampais menores no lado afetado foram associados à história de meningite (p=0.049), crises febris (p=0.049) e ausência de história familiar de epilepsia (p=0.049). Conclusão: AH ipsilateral foi mais acentuada em pacientes com antecedente de crises febris e meningite, e naqueles sem história familiar de epilepsia, reforçando a ideia de que na ausência de predisposição genética, um maior insulto cerebral seria necessário para induzir epileptogenesis. Um resultado cirúrgico menos favorável na cirurgia para ELTM unilateral foi associado a menores volumes hipocampais no lado contralateral ao lado operado, sugerindo que a cirurgia é menos efetiva quando há dano bilateral, mesmo quando não detectado por analise visual...

Validación de los métodos para control de calidad de los ingredientes activos en Fungirex crema / Validation of the quality control methods for active ingredients of Fungirex cream

INTRODUCCIÓN: Fungirex crema es un producto que contiene dos fármacos: ácido undecilénico y undecilenato de zinc en una base adecuada. Como se trata de un producto que no aparece en las monografías oficiales de las farmacopeas, se proponen métodos analíticos sencillos capaces de cuantificar los analitos de interés en la crema, útiles para la liberación de los lotes de crema recién elaborados. OBJETIVO: validar dos métodos volumétricos para control de calidad de los ingredientes activos presentes en Fungirex crema. MÉTODOS: se propuso una volumetría de neutralización directa para cuantificar ácido undecilénico previa extracción del analito y la complejometría con EDTA para undecilenato de zinc. Atendiendo a la clasificación de ambos métodos en la categoría I, se realizó la validación de ambos métodos a través de los parámetros: especificidad, linealidad, exactitud, precisión y rango. RESULTADOS: se corroboró la ausencia de interferencia de los restantes componentes de la matriz. Los criterios de aceptación establecidos para linealidad, exactitud y precisión se cumplieron satisfactoriamente para los dos métodos en estudio, por lo que fueron válidos en el rango de 50 a 150 por ciento (método por volumetría de neutralización: 25,6-76,8 mg/g y método por complejometría: 111,1-333,3 mg/g). CONCLUSIONES: los métodos volumétricos propuestos fueron lineales, precisos, exactos y específicos para realizar el control de calidad de Fungirex crema en base al contenido de ácido undecilénico y undecilenato de zinc(AU)

INTRODUCTION: Fungirex cream is a two-drug product, that is, undecylenic acid and zinc undecylenate over a suitable basis. Since this is a product not documented in the official monographs of the pharmacopeae, simple analytical methods were suggested for quantitation of analytes of interest in the cream, which are useful for release of newly prepared cream batches. OBJECTIVE: to validate two volumetric methods for the quality control of active ingredients in Fungirex cream. METHODS: a direct neutralization volumetric method was suggested to quantitate undecylenic acid after the analyte extraction and EDTA complexometry for zinc undecylenate . According to the classification of both methods in the category I, they were validated through the parameters specificity, linearity, accuracy, precision and range. RESULTS: the non-interference of the rest of the matrix components was corroborated. The set acceptance criteria for linearity, accuracy and precision were satisfactorily met for the two study methods, so they were valid in the 50-150 percent range (neutralization volumetry method: 25.6-76.8 mg/g and complexometry method 111.1-333,3 mg/g). CONCLUSIONS: the suggested volumetric methods were linear, specific, precise, and accurate for the quality control of Fungirex cream based on the undecylenic acid and zinc undecylenate content(AU)

Validación del método para control de la calidad del nitrato de miconazol en una nueva crema al 2 % / Validation of a quality control method of a new 2 percent miconazole nitrate cream

Objetivo: validar el método para control de la calidad del nitrato de miconazol en una nueva crema al 2 por ciento. Métodos: se realizó la validación según los parámetros exigidos para la categoría I y considerando la metodología y los criterios de aceptación vigentes en Cuba. Una vez validado, se aplicó al análisis de los tres lotes elaborados a escala piloto. Resultados: los resultados fueron satisfactorios, cumpliendo en todos los parámetros los límites establecidos. El método fue lineal, exacto y preciso en el rango de 10 a 30 mg/g y no hubo interferencias de ninguno de los componentes de la nueva formulación. Los lotes presentaron correcta dosificación, sin diferencias estadísticamente significativas entre las réplicas y los lotes analizados. Conclusiones: El método evaluado resulta válido para el objetivo con el cual se propuso(AU)

Objective: to validate a quality control method for a 2 percent new miconazole nitrate cream. Methods: the validation was made following the category I parameters and taking into account the methodology and acceptance criteria in force in Cuba. Once validated, the analysis of the three batches was applied on pilot scale. Results: the results were satisfactory since they fulfilled all the set parameters. The method was linear, accurate and precise in the 10-30 mg/g range. there was no interference from any of the components of the new formulation. The batches presented correct dosing, without any statistically significant differences between replicas and analyzed batches. Conclusions: the evaluated method proved to be valid for the stated purpose(AU)