Clinical utility of Pandy test in the face of quantitative CSF total protein and albumin: A retrospective study and literature review.

INTRODUCTION: Qualitative Pandy test has long been used to indicate raised globulins in the cerebrospinal fluid (CSF). Despite its shortfalls and the availability of quantitative CSF protein assays, Pandy test continues to be performed in clinical laboratories across Malaysia. OBJECTIVES: (1) Compare diagnostic performance of Pandy test to CSF total protein and albumin; (2) Conduct literature review on clinical utility of Pandy test. MATERIALS AND METHODS: This is a retrospective, cross-sectional study involving 890 inpatients of all ages with CSF biochemistry analysed in Hospital Pulau Pinang over a period of 7 months. Patient demographics, clinical diagnosis and CSF total protein, albumin and Pandy results were collected and analysed using Mann-Whitney U test, Spearman rank-order correlation coefficient, Chi Square test and receiver operating characteristic (ROC) curve analysis. RESULTS: CSF total protein, CSF albumin, CSF protein-albumin difference and age showed significantly higher median values in patients with positive Pandy compared to negative Pandy. Significant associations were found between positive Pandy test with clinical diagnosis (Cramers V 0.443, p<0.01), sample haemolysis (Phi 0.326, p<0.01), CSF protein-albumin difference (Spearman 0.727, p<0.001), CSF total protein (Spearman 0.710, p<0.001) and CSF albumin (Spearman 0.662, p<0.01). All three quantified CSF parameters showed comparably good sensitivity and specificity in determining positive Pandy. DISCUSSION AND CONCLUSION: Good correlation with CSF proteins, analytical issues and reagent hazards indicate no added clinical value of Pandy test in the face of quantified CSF total protein and albumin. Abolishing the test saves resources, reduces occupational hazards and shortens turnaround time without compromising diagnosis.

A contrast stretching bilateral closing top-hat Otsu threshold technique for crack detection in images.

Detection of cracks from stainless steel pipe images is done using contrast stretching technique. The technique is based on an image filter technique through mathematical morphology that can expose the cracks. The cracks are highlighted and noise removal is done efficiently while still retaining the edges. An automated crack detection system with a camera platform has been successfully implemented. We compare crack extraction in terms of quality measures with those of Otsu's threshold technique and the another technique (Iyer and Sinha, 2005). The algorithm shown is able to achieve good results and perform better than these other techniques.

Reducing charging effects in scanning electron microscope images by Rayleigh contrast stretching method (RCS).

To reduce undesirable charging effects in scanning electron microscope images, Rayleigh contrast stretching is developed and employed. First, re-scaling is performed on the input image histograms with Rayleigh algorithm. Then, contrast stretching or contrast adjustment is implemented to improve the images while reducing the contrast charging artifacts. This technique has been compared to some existing histogram equalization (HE) extension techniques: recursive sub-image HE, contrast stretching dynamic HE, multipeak HE and recursive mean separate HE. Other post processing methods, such as wavelet approach, spatial filtering, and exponential contrast stretching, are compared as well. Overall, the proposed method produces better image compensation in reducing charging artifacts.

Lagrange time delay estimation for scanning electron microscope image magnification.

Interpolation techniques that are used for image magnification to obtain more useful details of the surface such as morphology and mechanical contrast usually rely on the signal information distributed around edges and areas of sharp changes and these signal information can also be used to predict missing details from the sample image. However, many of these interpolation methods tend to smooth or blur out image details around the edges. In the present study, a Lagrange time delay estimation interpolator method is proposed and this method only requires a small filter order and has no noticeable estimation bias. Comparing results with the original scanning electron microscope magnification and results of various other interpolation methods, the Lagrange time delay estimation interpolator is found to be more efficient, more robust and easier to execute.

Improvement to the scanning electron microscope image colorization by adaptive tuning.

An improvement to the previously proposed Canny optimization technique for scanning electron microscope image colorization is reported. The additional process is adaptive tuning, where colour tuning is performed adaptively, based on comparing the original luminance values with calculated luminance values. The complete adaptive Canny optimization technique gives significantly better mechanical contrast on scanning electron microscope grey-scale images than do existing methods.

Canny optimization technique for electron microscope image colourization.

Images of scanning electron microscope are usually in the monochrome mode. A simple and user-friendly approach is proposed to improve the mechanical contrast of the scanning electron microscope grey images. Also, most colourization techniques involve image segmentation or region tracking, which tend to degrade the image with fuzzy or complex region boundaries. A technique is proposed, which is a hybrid between the Canny edge detection technique and the optimization technique. Compared with existing methods, the new Canny optimization technique gives satisfactory results for scanning electron microscope images.

Prevalence of Peyronie's disease in men over 50-y-old from Southern Brazil.

The pathogenesis of Peyronie's disease still remains an enigma and few epidemiological studies are available. The purpose of this study was to determine the prevalence of Peyronie's disease in males older than 50 y. From 26 to 30 July 1998, 1071 men attended the 'Prostate Cancer Awareness Week of Santa Casa Hospital, Porto Alegre, Brazil'. In the prostate exam they also consented to be screened for Peyronie's disease. They underwent the 5-item International Index of Erectile Function (IIEF-5) questionnaire for evaluation of the erectile condition. The presence of a well-defined plaque in the penis was the diagnostic criterion for Peyronie's disease. The men were examined by five senior residents, under supervision by the staff Urologist. Men younger than 50 y as well as patients under intracavernous injection therapy for erectile dysfunction were excluded from the study. Chi2 test was used for statistical analysis. Nine hundred and fifty-four (89.1%) out of the 1071 men with a mean age of 62 y (ranging from 52 to 77) were included in the study. Peyronie's disease plaques were found in 35 men (3.67%). Eight hundred and forty-five (88.6%) were Caucasians. There was no significant statistical difference regarding age (P > 0.05). The presence of erectile dysfunction in the men with Peyronie's disease and without this condition, was 68.6% and 53.5%, respectively (P > 0.05). From this data we can conclude that the prevalence of Peyronie's disease is higher than in formerly reported studies. Further observations should be carried out in different communities and in other groups of patients in order to confirm our results.

Experience with early catheter removal after radical retropubic prostatectomy.

PURPOSE: We tested the hypothesis that early catheter removal may be accomplished safely after radical prostatectomy. MATERIALS AND METHODS: Cystography on postoperative day 4 or 5 in 42 of 67 consecutive patients who underwent radical retropubic prostatectomy revealed no extravasation in 30 and the urethral catheter was removed (group 1). The control group included 25 patients who did not undergo cystography, and the catheter was removed 14 days postoperatively (group 2). RESULTS: Immediate and late continence was achieved in 14 (46.7%) and 25 (83.3%) cases in group 1, and in 8 (32%) and 22 (88%) cases in group 2, respectively (p>0.05). Catheterization was performed easily without any endoscopic or surgical procedure in 2 patients (6.7%) in group 1 who presented in urinary retention after catheter removal. Wound infection and pelvic abscess developed in 1 case (3.3%). There were no late complications. In group 2 urinary retention developed in 1 patient (4%), wound infection in 1 (4%) and hematuria in 1 (4%). Two patients (8%) had late vesical neck contracture at 4 and 10 months, respectively, which required urethrotomy in 1. In 1 patient (4%) a stricture in the anterior urethra was dilated. CONCLUSIONS: Our study shows that early catheter removal may be accomplished safely in most patients after radical retropubic prostatectomy, and was not associated with a higher complication rate.

Is there any association between Peyronie's disease and serum collagen markers?

Several theories regarding the pathogenesis of Peyronie's disease have been investigated under many clinical conditions. We have investigated the association of Peyronie's disease with the most common markers of collagen disease. Several serum markers of collagen disease (mucoproteins, C-reactive protein, antinuclear antibody, rheumatoid factor, lupus erythematosus cells, proteinograms) of 30 patients with Peyronie's disease were compared with those obtained from 30 patients, matched for age, with other urological conditions unrelated to the penis. Mucoproteins were altered in 66.7% of patients of the Peyronie's disease group and in 46.7% of the control patients (P>0.05). C-reactive protein was altered in 23.3% of the Peyronie's disease patients and in 13.3% of the control patients (P>0.05). Antinuclear antibody (ANA) was reactive in 16.7% of the tested group and in 6.7% of the control group (P>0.05). The rheumatoid factor was elevated in 6.7% of the patients from both groups (P>0.05). LE cells were normal in all the patients in our study. No statistical significance between the two groups was found in the protein electrophoresis test. Only the Waaler-Rose test (rheumatoid hemagglutination test) was statistically significant in our study (P<0.05). We have not found any significant association between the serum markers of collagen diseases in patients with Peyronie's disease, except the rheumatoid hemagglutination test (Waaler-Rose).