Validez diagnóstica del sistema vesical imaging-reporting and data system (VI-RADS): estudio con datos de la vida real / Diagnostic validity of the vesical imaging-reporting and data system (VI-RADS): A real-world study

Objetivo: Recientemente se ha generalizado el uso del sistema vesical imaging-reporting and data (VI-RADS). Nos propusimos validar el rendimiento diagnóstico del VI-RADS para diferenciar el cáncer vesical músculo-iinvasivo (CVMI) del cáncer vesical no músculo-invasivo (CVNMI) en un contexto de práctica clínica real. Métodos Entre diciembre de 2019 y febrero de 2022 se revisaron los pacientes con sospecha de cáncer vesical primario. Se incluyeron los pacientes con un protocolo de RM multiparamétrica adecuado para VI-RADS antes de cualquier tratamiento invasivo. La estadificación local de los pacientes se realizó mediante resección transuretral, segunda resección o cistectomía radical como tratamiento de referencia. Dos expertos en radiología genitourinaria cegados a los datos clínicos e histopatológicos evaluaron las imágenes de RM multiparamétrica de forma independiente y retrospectiva. Se analizó el rendimiento diagnóstico de ambos radiólogos y la concordancia entre lectores. Resultados De los 96 pacientes, 20 (20,8%) tenían CVMI y 76 (79,2%) tenían CVNMI. La exactitud diagnóstica del CVMI fue alta para los dos radiólogos. El primer radiólogo tenía un área bajo la curva (ABC) de 0,83 y 0,84, una sensibilidad de 85% y 80% y una especificidad de 80,3% y 88,2% para VI-RADS≥3 y≥4, respectivamente. El segundo radiólogo tenía un área bajo la curva (ABC) de 0,79 y 0,77, una sensibilidad del 85% y el 65% y una especificidad del 73,7% y el 89,5% para VI-RADS≥3 y≥4, respectivamente. La concordancia de la puntuación VI-RADS global entre los dos radiólogos fue moderada (K=0,45). Conclusión El sistema VI-RADS tiene un alto poder diagnóstico para diferenciar el CVMI de CVNMI antes de la resección transuretral. La concordancia entre los radiólogos es moderada. (AU)

Objective: Preoperative Vesical Imaging-Reporting and Data System (VI-RADS) becomes widespread. We aimed to validate the diagnostic performance of VI-RADS in differentiating muscle-invasive (MIBC) from non-muscle-invasive bladder cancer (NMIBC) in a real-world setting. Methods Between December 2019 and February 2022 suspected primary bladder cancer patients were reviewed. Those with proper multiparametric MRI (mpMRI) protocol for VI-RADS before any invasive treatment were included. Patients were locally staged according to transurethral resection, second resection, or radical cystectomy as the reference standard. Two experienced genitourinary radiologists who were blinded to clinical and histopathological data evaluated the mpMRI images independently and retrospectively. The diagnostic performance of both radiologists and the interreader agreement were analyzed. Results Among 96 patients, 20 (20.8%) had MIBC, and 76 (79.2%) had NMIBC. Both radiologists had great diagnostic performance in diagnosing MIBC. The first radiologist had an area under curve (AUC) of 0.83 and 0.84, the sensitivity of 85% and 80%, and the specificity of 80.3% and 88.2% for VI-RADS≥3 and≥4, respectively. The second radiologist had an area under curve (AUC) of 0.79 and 0.77, the sensitivity of 85% and 65%, and the specificity of 73.7% and 89.5% for VI-RADS≥3 and≥4, respectively. The overall VI-RADS score agreement between the two radiologists was moderate (K=0.45). Conclusion VI-RADS is diagnostically powerful in differentiating MIBC from NMBIC prior to transurethral resection. The agreement between radiologists is moderate. (AU)

Diagnostic validity of the vesical imaging-reporting and data system (VI-RADS): a real-world study.

OBJECTIVES: Preoperative Vesical Imaging-Reporting and Data System (VI-RADS) becomes widespread. We aimed to validate the diagnostic performance of VI-RADS in differentiating muscle-invasive (MIBC) from non-muscle-invasive bladder cancer (NMIBC) in a real-world setting. METHODS: Between December 2019 and February 2022 suspected primary bladder cancer patients were reviewed. Those with proper multiparametric MRI (mpMRI) protocol for VI-RADS before any invasive treatment were included. Patients were locally staged according to transurethral resection, second resection, or radical cystectomy as the reference standard. Two experienced genitourinary radiologists who were blinded to clinical and histopathological data evaluated the mpMRI images independently and retrospectively. The diagnostic performance of both radiologists and the interreader agreement were analyzed. RESULTS: Among 96 patients, 20 (20.8%) had MIBC, and 76 (79.2%) had NMIBC. Both radiologists had great diagnostic performance in diagnosing MIBC. The first radiologist had an area under curve (AUC) of 0.83 and 0.84, the sensitivity of 85% and 80%, and the specificity of 80.3% and 88.2% for VI-RADS ≥3 and ≥4, respectively. The second radiologist had an area under curve (AUC) of 0.79 and 0.77, the sensitivity of 85% and 65%, and the specificity of 73.7% and 89.5% for VI-RADS ≥3 and ≥4, respectively. The overall VI-RADS score agreement between the two radiologists was moderate (κ = 0.45). CONCLUSION: VI-RADS is diagnostically powerful in differentiating MIBC from NMBIC prior to transurethral resection. The agreement between radiologists is moderate.

The effects of the breeder index value on the microscopic structure of egg shells, hatching results, and hybrid performance.

The quality of egg shell and bone properties of hen are important for hen welfare, consumers, and producers. Parameters of the genetic selection have both desirable and undesirable effects among themselves. Until recently, it has been stated that the concept of shell quality is not only about breaking strength, thickness, and weight of shell, but also microscopic properties of the shell. In this study, the effect of index selection including age and weight at sexual maturity, number of eggs and egg weight on eggshell structures, hatching results, and hybrid performance was determined. Ninety Barred Rock 1 (BAR-1) and ninety Rhode Island Red 1 (RIR-1) hens and twenty RIR-1 cocks (46 weeks old) were used. BAR-1 and RIR-1 were classified according to the breeder index value as low and high. Egg quality characteristics, embryo development and hatching results were examined in eggs obtained from these lines. In the hybrid eggs with high breeder index, the thickness of the palisade layer, breaking strength, ash, and Ca level of the shell were lower and cone similarity and egg weight were higher than that with low breeder index. The breaking strength of the egg shell had a significantly positive correlation with the palisade layer thickness of the shell. In addition, the tibia weight of the high breeder index group was lower than that of the low breeder index group. Differences in femur and tibia weights in hybrids with low and high breeder index increased with age. A negative correlation was observed between hatchability and the thickness of the palisade layer. Further studies are needed to determine which selection programs positively affect the thickness of the palisade layer, the Ca level and the breaking strength of the shell, the number of broken eggs, and the tibia weight in layer hybrids.

Persistent left superior vena cava in patient with right atrial myxoma undergoing open heart surgery. A case report and review of literature.

Persistent left superior vena cava (PLSVC) is a rare and asymptomatic congenital cardiovascular anomaly. Being asymptomatic, PLSVC was usually discovered while performing interventions (such as insertion of central lines, Swan-Ganz catheters, or placing pacemakers) through the left internal jugular vein or left subclavian veins. Commonly, PLSVC is detected not only as an isolated congenital anomaly, but also it can be associated with many other cardiac anomalies. Also, presence of a dilated coronary sinus on echocardiography should raise the suspicion of PLSVC. The diagnosis should be confirmed by contrast venography or computed tomography angiography. The present case is a female patient, 29 year old, who was undergoing elective excision of a right atrial mass, with closure of patent foramen ovale, and she had end-stage renal failure on regular hemodialysis three times weekly through a permicath inserted in the right subclavian vein.

Anatomical and histological analysis of the salpinx and ovary in Anatolian wild goat (Capra aegagrus aegagrus).

BACKGROUND: This study determined the anatomical and histological structure of the salpinx and ovary of the Anatolian wild goat (C. aegagrus aegagrus). MATERIALS AND METHODS: The salpinges and ovaries from four wild goats of similar ages were used. These goats were brought to the Kafkas University Wildlife Rescue and Rehabilitation Centre (Kars, Turkey) for various reasons such as traffic accidents or firearm injury, but either could not be saved or were euthanased. RESULTS: The mean length of the ovary was 13.22 ± 1.27 mm, width was 8.46 ± 0.88 mm, thickness was 5.67 ± 0.79 mm, and weight was 0.59 ± 0.17 g. The mean length of the salpinx was 58.11 ± 14.02 mm, width was 0.80 ± 0.22 mm, thickness was 0.41 ± 0.01 mm, and weight was 0.30 ± 0.08 g. The salpinx consisted of three different regions (infundibulum, ampulla, and isthmus). These regions consisted of tunica mucosa, tunica muscularis, and tunica serosa. Prismatic epithelial cells were observed in the lamina epithelialis of the tunica mucosa in every region. CONCLUSIONS: The data resulting from this study regarding anatomical and histological structures of the salpinx and ovary in the genital system organs of Anatolian wild goat will support other studies seeking to improve reproductive efficiency and eliminate the danger of extinction of this species.

Hong-Ou-Mandel interference between independent III-V on silicon waveguide integrated lasers.

The versatility of silicon photonic integrated circuits has led to a widespread usage of this platform for quantum information-based applications, including quantum key distribution (QKD). However, the integration of simple high-repetition-rate photon sources is yet to be achieved. The use of weak-coherent pulses (WCPs) could represent a viable solution. For example, measurement device independent QKD (MDI-QKD) envisions the use of WCPs to distill a secret key immune to detector side channel attacks at large distances. Thus, the integration of III-V lasers on silicon waveguides is an interesting prospect for quantum photonics. Here we report the experimental observation of Hong-Ou-Mandel interference with 46±2% visibility between WCPs generated by two independent III-V on silicon waveguide integrated lasers. This quantum interference effect is at the heart of many applications, including MDI-QKD. This Letter represents a substantial first step towards an implementation of MDI-QKD fully integrated in silicon and could be beneficial for other applications such as standard QKD and novel quantum communication protocols.

Immunohistochemical examination of effects of kefir, koumiss and commercial probiotic capsules on platelet derived growth factor-c and platelet derived growth factor receptor-alpha expression in mouse liver and kidney.

We investigated using immunohistochemistry the effects of kefir, koumiss and commercial probiotic capsules on the expression of platelet derived growth factor-c (PDGF-C) and platelet derived growth factor receptor-alpha (PDGFR-α) in mouse liver and kidney. Mice were assigned to four groups: group 1 was given commercial probiotic capsules, group 2 was given kefir, group 3 was given koumiss and group 4 was untreated. After oral administration for 15 days, body weights were recorded and liver and kidney tissue samples were obtained. Hematoxylin and eosin staining was used to examine histology. PDGF-C and PDGFR-α in liver and kidney were localized using the streptavidin-biotin peroxidase complex method (ABC). We found that the weights of the mice in the kefir, koumiss and commercial probiotic capsules groups increased compared to the control group. No differences in liver and kidney histology were observed in any of the experimental groups. Kefir, koumiss and the commercial probiotic preparation increased PDGF-C and PDGFR-α expression.

The effects of kefir, koumiss, yogurt and commercial probiotic formulations on PPARα and PPAR-ß/δ expressions in mouse kidney.

Commercial probiotic capsules that contain probiotic bacteria, kefir, koumiss and yogurt contain beneficial microorganisms that affect cholesterol levels and immune response, and are used for treatment of some diseases. We investigated using immunohistochemistry the effects of kefir, koumiss, yogurt and a commercial probiotic formulation on the expression levels of peroxisome proliferator-activated receptor-α (PPARα) and peroxisome proliferator-activated receptor-ß/δ (PPAR-ß/δ), which are members of the nuclear steroid hormone receptor superfamily in mouse kidney. Mice were assigned to five groups: group 1, commercial probiotic capsules; group 2, kefir; group 3, koumiss; group 4, yogurt; group 5, control. After oral administration for 15 days, body weights were recorded and kidney tissue samples were obtained. Hematoxylin & eosin staining and the streptavidin-biotin peroxidase complex (ABC) method were applied to tissue sections to examine histology and to determine the localization of PPARα and PPAR-ß/δ in the kidneys. We found that the weights of the mice in the kefir, koumiss, yogurt and commercial probiotic capsules groups were increased compared to controls. No differences in kidney histology were observed in any of the experimental groups. Kefir, koumiss, yogurt and the commercial probiotic preparation increased PPARα and PPAR-ß/δ expressions.

The effect of a structured empathy course on the students of a medical and a nursing school.

AIM: The study aims to determine the effect of an empathy course for medical and nursing school students in one university in Turkey. Being able to relate to others empathetically is important for health professionals who need to develop therapeutic relationships with people who are sick, weak, sensitive and vulnerable. Professionals need empathic communication skills and professionalism not only for patients and their families but also for colleagues and other members of the health team. METHOD: All first year students (257) from a medical and a nursing school in one Turkish university in 2008-2009 and 2009-2010 were enrolled to the study. The course included 10 h of lectures on empathy and communication skills given through five consecutive weeks with 2 h in a week in the first year of both schools. Data were collected by using the Empathic Communication Skills Scale (ECSS), and the Empathic Tendency Scale (ETS) before and after the course. There were 143 medical students and 83 nursing students (total: 226, 88%) who completed the ECSS and ETS in a pre-/post-test study. FINDINGS: Results demonstrated that all students received significantly higher scores for the final application than for initial scores on both scales. This implied that the targeted educational programme could have a positive effect on learning empathy and gaining empathy skills and tendency. CONCLUSION: Effective educational programmes might facilitate and improve empathic skills and empathic tendency of medical and nursing students, and both male and female students benefitted from the empathy course.

Amorphous silicon nanowires combining high nonlinearity, FOM and optical stability.

We demonstrate optically stable amorphous silicon nanowires with both high nonlinear figure of merit (FOM) of ~5 and high nonlinearity Re(γ) = 1200W(-1)m(-1). We observe no degradation in these parameters over the entire course of our experiments including systematic study under operation at 2 W coupled peak power (i.e. ~2GW/cm(2)) over timescales of at least an hour.

Electrically driven hybrid Si/III-V Fabry-Pérot lasers based on adiabatic mode transformers.

We report the first demonstration of an electrically driven hybrid silicon/III-V laser based on adiabatic mode transformers. The hybrid structure is formed by two vertically superimposed waveguides separated by a 100-nm-thick SiO2 layer. The top waveguide, fabricated in an InP/InGaAsP-based heterostructure, serves to provide optical gain. The bottom Si-waveguides system, which supports all optical functions, is constituted by two tapered rib-waveguides (mode transformers), two distributed Bragg reflectors (DBRs) and a surface-grating coupler. The supermodes of this hybrid structure are controlled by an appropriate design of the tapers located at the edges of the gain region. In the middle part of the device almost all the field resides in the III-V waveguide so that the optical mode experiences maximal gain, while in regions near the III-V facets, mode transformers ensure an efficient transfer of the power flow towards Si-waveguides. The investigated device operates under quasi-continuous wave regime. The room temperature threshold current is 100 mA, the side-mode suppression ratio is as high as 20 dB, and the fiber-coupled output power is ~7 mW.

Diffusion-weighted imaging of solid or predominantly solid gynaecological adnexial masses: is it useful in the differential diagnosis?

OBJECTIVES: This study investigated whether diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values provide specific information that allows the diagnosis of solid or predominantly solid gynaecological adnexial lesions, especially whether they can discriminate benign and malignant lesions. METHODS: DWI was performed in 37 patients with histologically proven solid or predominantly solid adnexial lesions (22 malignant and 15 benign neoplasms). The lesions in our data set were divided into two groups, all adnexial lesions or lesions of ovarian origin, for evaluation. The areas of the highest signal intensity on DWI (b = 800 s mm(-2)) and the lowest ADC values within the lesions were evaluated. RESULTS: On DWI, high signal intensity was observed more often in malignant than in benign lesions (p<0.0001). There was no significant difference between the ADC values of the malignant and benign lesions in either the adnexial (0.88±0.16 vs 0.84±0.42; p = 0.96) or the ovarian (0.85±0.14 vs 1.05±0.2; p = 0.133) lesions. When signal intensities on DWI were compared, however, malignant lesions had higher values than the benign lesions in both the adnexial (0.69±0.21 vs 0.29±0.13; p<0.0001) and the ovarian lesions (0.75±0.14 vs 0.37±0.24; p = 0.003). CONCLUSION: On DWI, high signal intensity was observed more frequently with the malignant lesions.

Expression of the NR2B-NMDA receptor trafficking complex in prefrontal cortex from a group of elderly patients with schizophrenia.

Dysregulated glutamate neurotransmission has been implicated in the pathophysiology of schizophrenia. In particular, hypofunction of the NMDA glutamate receptor has been proposed to play an important role in mediating cognitive deficits in patients. The two NMDA receptor subunits, NR2A and NR2B, are distinctly regulated during development and are associated with different intracellular pathways and functions, which suggest that these receptors play separate roles in the control of higher cognitive functions such as learning and memory. Trafficking of the NR2B subunit-containing receptor is regulated by a microtubule-associated trafficking complex consisting of the KIF17, APBA1, CASK, and mLin7 proteins. Several studies have demonstrated an integrated functional regulation of this trafficking complex with NR2B receptor subunit expression, which in turn has been linked to higher cognitive functions. In the present work, we investigated whether expression of this NR2B-associated trafficking complex might be abnormal in schizophrenia. We analyzed the expression of KIF17, APBA1, CASK, mLin7A and mLin7C in postmortem brain from patients with schizophrenia a comparison group. Analysis of transcripts for all of these proteins revealed particularly prominent expression in cortical layer III and layer IV, which overlapped with NR2B but not NR2A transcripts. We found altered expression of transcripts for the CASK, ABPA1, and mLin7 molecules and the CASK, mLin7 proteins, suggesting that NR2B-containing NMDA receptor transport could be selectively compromised in schizophrenia, and that these changes likely involve altered NR2B function in a subset of cortical neurons.

Comparison of fibrin glue and suture in the healing of teat incisions in lactating goats.

The aims of this study were to investigate whether fibrin glue can be used to close experimentally induced incisions of the teat (mammary papillae) in lactating goats and to compare the healing of the glued with the sutured incisions. Four clinically healthy lactating dairy goats, namely 8 mammary papillae were used. After surgical preparation of the papillae, a 3.5 cm long incision of each papilla was made through skin, muscular layer and mucosa into the papillary sinus. The wounds in the right papillae in all goats were closed with U-shaped uninterrupted 00 chromic catgut sutures. The wounds in the left papillae in all goats were closed, using fibrin glue. One incision was seen to be dehisced and fistulous one day after in fibrin glued teats. The animals were slaughtered 8 days after surgical manipulation. The mammary papillae were removed and examined in the viewpoint on gross and microscopic findings. The healing of wounds was slower and feeble in glued mammary papillary incisions, however faster and stronger in sutured incisions on day 8 after operations. But, available outcomes like less tissue thickness and positive cosmetic results could be obtained byfibrin glue used on mammary papillary incisions, which are very important for teats to be milked by hand and milking machine. Results suggest that it is advisable to use only one or two simple interrupted sutures in teat incisions glued with fibrin to prevent the dehiscence but with a more reliable healing than the sutured incisions.

Technetium-99m 2-methoxy-isobutyl-isonitrile uptake scintigraphy in detection of the bone marrow infiltration in multiple myeloma: correlation with MRI and other prognostic factors.

Whole-body scintigraphy with Technetium-99m 2-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) has been proposed as a useful method for demonstrating the areas of active bone marrow infiltration in multiple myeloma (MM). In this study, we compared the (99m)Tc-MIBI scan with magnetic resonance imaging (MRI), skeletal X-ray survey, and biochemical markers of disease activity in MM to determine its potential in predicting the extension of the disease. Twenty-four myeloma patients had undergone to the (99m)Tc-MIBI scan. Only two patients showed negative results in the (99m)Tc-MIBI scan; one had clinically active disease, and the other was on remission. MRI was performed to 18 clinically active patients, and 16 of them showed positive myelomatous bone marrow involvement. No significant difference was found between the (99m)Tc-MIBI scan and MRI in predicting the extension of bone marrow infiltration in MM (p = 0.11). (99m)Tc-MIBI scores were correlated with bone marrow neoplastic plasma cell ratio (p = 0.005), serum paraprotein level (p < 0.001), serum lactate dehydrogenase (p = 0.031), and beta-2 microglobulin (p = 0.045). The (99m)Tc-MIBI scan showed disease activity better than the skeletal X-ray survey (x2 = 5.299, p = 0.021). A significant decrease was found in posttreatment (99m)Tc-MIBI scores of the patients with positive overall response (p = 0.016). The (99m)Tc-MIBI scan is a noninvasive test that can show the extension of the disease in MM. It seems that the (99m)Tc-MIBI scan and MRI show extension and intensity of the myelomatous bone marrow infiltration equally well. The (99m)Tc-MIBI scan can be an alternative to MRI when it is not available or if there is any limitations for its usage.

Fast thermo-optical excitability in a two-dimensional photonic crystal.

We experimentally demonstrate excitability in a semiconductor two-dimensional photonic crystal. Excitability is a nonlinear dynamical mechanism underlying pulselike responses to small perturbations in systems possessing one stable state. We show that a band-edge photonic crystal resonator exhibits class II excitability, resulting from the nonlinear coupling between the high-Q optical mode, the charge-carrier density, and the fast (sub-micros) thermal dynamics. In this context, the critical slowing down of the electro-optical dynamics close to the excitable threshold can delay the optical response by an amount comparable to the duration of the output pulse (5 ns). The latter results from a short thermal dynamical excursion along a high local intensity manifold of the phase space.

Highly selective and compact tunable MOEMS photonic crystal Fabry-Perot filter.

The authors report a compact and highly selective tunable filter using a Fabry-Perot resonator combining a bottom micromachined 3-pair-InP/air-gap Bragg reflector with a top photonic crystal slab mirror. It is based on the coupling between radiated vertical cavity modes and waveguided modes of the photonic crystal. The full-width at half maximum (FWHM) of the resonance, as measured by microreflectivity experiments, is close to 1.5nm (around 1.55 microm). The presence of the photonic crystal slab mirror results in a very compact resonator, with a limited number of layers. The demonstrator was tuned over a 20nm range for a 4V tuning voltage, the FWHM being kept below 2.5nm. Bending of membranes is a critical issue, and better results (FWHM=0.5nm) should be obtained on the same structure if this technological point is fixed.

Acute torsion of a wandering spleen: imaging findings.

Wandering spleen is a rare entity characterized by incomplete fixation of the spleen by lienorenal and gastrosplenic ligaments. It can migrate to the lower abdomen or pelvis and can be congenital or acquired. We report a case of torsion of a wandering spleen for which there was correlative imaging by ultrasonography, Doppler ultrasonography, computed tomography, magnetic resonance imaging, and angiography. To our knowledge, this is the first reported case in which all these modalities were used in the diagnostic evaluation.

Utilising an ileal segment in the posterior urethral replacement procedures using anal sphincter to provide continence in dogs.

We aimed to replace an ileal segment in the place of posterior urethra using the anal sphincter as a continence mechanism. The experiment was carried on three male street dogs. In the first stage, only urethral replacement with an ileal segment was done and pulled through the anal sphincter in a male dog to see if anal sphincter would do any help for continence. A protruding stoma was created on the perineum. Perineal end of the ileal segment was sutured to the bulbous urethra in the other two male dogs to provide urethral patency in the second step of the operation. The dog in which the first operation was made gained continence on the 12th postoperative day. The other two male dogs, in which ileourethral anastomosis were made, became continent on the postoperative 12th and 15th days. No residual urine was found by catheterisation performed after urination. In controls, neither the stoma nor the anastomosis sites developed stenosis. This procedure may be applied in patients with complete incontinence who can not be corrected by any other surgical procedures, and a very good cosmetic result may be obtained.