RESUMO
Medical imaging is an essential technique for the diagnosis and treatment of diseases in modern clinics. Soft computing plays a major role in the recent advances in medical imaging. It handles uncertainties and improves the qualities of an image. Until now, various soft computing approaches have been proposed for medical applications. This paper discusses various medical imaging modalities and presents a short review of soft computing approaches such as fuzzy logic, artificial neural network, genetic algorithm, machine learning, and deep learning. We also studied and compared each approach used for other imaging modalities based on the certain parameter used for the system evaluation. Finally, based on comparative analysis, the possible research strategies for further development are proposed. As far as we know, no previous work examined this issue.
Assuntos
Algoritmos , Inteligência Artificial , Lógica Fuzzy , Humanos , Aprendizado de Máquina , Redes Neurais de ComputaçãoRESUMO
BACKGROUND: Clinicopathologic variables influence the treatment and prognosis of patients with thyroid cancer. METHODS: A retrospective analysis of public hospital thyroid cancer database and the Surveillance, Epidemiology and End Results 17 database was conducted. Demographic, clinical, and pathologic data were compared across ethnic groups. RESULTS: Within the public hospital database, Hispanics versus non-Hispanic whites were younger and had more lymph node involvement (34% vs 17%, P < .001). Median tumor size was not statistically different across ethnic groups. Similar findings were demonstrated within the Surveillance, Epidemiology and End Results database. African Americans aged <45 years had the largest tumors but were least likely to have lymph node involvement. Asians had the most stage IV disease despite having no differences in tumor size, lymph node involvement, and capsular invasion. CONCLUSIONS: There is considerable variability in the clinical presentation of thyroid cancer across ethnic groups. Such disparities persist within an equal-access health care system. These findings suggest that factors beyond socioeconomics may contribute to such differences.
Assuntos
Grupos Raciais/estatística & dados numéricos , Neoplasias da Glândula Tireoide/etnologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Carcinoma/etnologia , Carcinoma/patologia , Feminino , Hospitais Públicos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Programa de SEER , Neoplasias da Glândula Tireoide/patologia , Estados Unidos/epidemiologia , População Urbana , Adulto JovemRESUMO
OBJECTIVE: To present a case of dysphagia secondary to a progressively increasing nontoxic multinodular goiter caused by sarcoidosis. METHODS: We summarize the clinical presentation and pertinent pathology in a patient with sarcoidosis involving the thyroid gland. A review of literature regarding this topic is also presented. RESULTS: A 54-year-old man was noted to have asymptomatic nontoxic thyromegaly. Biopsy of right thyroid nodule was benign while the biopsy from the isthmus nodule was nondiagnostic. He presented with acute onset of dysphagia two months later and the work-up for gastrointestinal causes was negative. Chest imaging showed left-sided lymphadenopathy, and biopsy of a lymph node showed sarcoidosis. Two years after the initial presentation a repeat biopsy of the isthmus nodule was again reported as nondiagnostic. Because he had persistent dysphagia, he underwent total thyroidectomy with resolution of dysphagia. Histopathological examination of the thyroid revealed non necrotizing granulomas consistent with sarcoidosis. CONCLUSION: This case brings to light this uncommon etiology of a nontoxic multinodular goiter. Involvement of the thyroid gland by sarcoidosis is very rare. It has been reported in 4.2 to 4.6% of patients with sarcoidosis. In patients with pulmonary or extrapulmonary sarcoidosis and associated thyromegaly, possible involvement of the thyroid by this process should be considered.
Assuntos
Transtornos de Deglutição/etiologia , Bócio Nodular/fisiopatologia , Sarcoidose Pulmonar/fisiopatologia , Transtornos de Deglutição/prevenção & controle , Bócio Nodular/etiologia , Bócio Nodular/patologia , Bócio Nodular/cirurgia , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Sarcoidose/etiologia , Sarcoidose/patologia , Sarcoidose/fisiopatologia , Sarcoidose/cirurgia , Sarcoidose Pulmonar/diagnóstico , Glândula Tireoide/patologia , Glândula Tireoide/fisiopatologia , Glândula Tireoide/cirurgia , Tireoidectomia , Tireoidite Subaguda/etiologia , Tireoidite Subaguda/patologia , Tireoidite Subaguda/fisiopatologia , Tireoidite Subaguda/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: As many as 43% of patients will have normocalcemic intact parathyroid hormone (PTH) elevation after undergoing curative parathyroidectomy for primary hyperparathyroidism. This phenomenon may be due in part to an absolute or relative deficiency of vitamin D, which is under-recognized in patients with primary hyperparathyroidism. METHODS: From September 1, 2004, to September 30, 2005, 86 consecutive patients underwent parathyroidectomy for primary sporadic hyperparathyroidism (psHPT). The patients were segregated into 2 groups based on postoperative management. Group 1 was composed of 26 patients who received routine oral calcitriol and calcium carbonate postoperatively. The 60 patients in the second group (group 2) received calcium carbonate postoperatively at the discretion of the primary surgeon. RESULTS: A total of 85 patients (99%) achieved postoperative cure with sustained reduction in serum calcium. Within 30 days postoperatively, mean serum PTH levels normalized in both groups (41 +/- 31 vs 39 +/- 31 pg/ml; P = .91). However, at 1 to 3 months postoperatively, mean serum calcium levels remained similar (9.5 +/- 0.7 vs 9.3 +/- 0.5 mg/dl; P = .39) whereas mean serum PTH levels in groups 1 and 2 were 43 +/- 25 pg/ml and 67 +/- 45 pg/ml (P = .02), respectively. At 4 to 6 months postoperatively, mean PTH was again higher in group 2 (36 +/- 22 vs 67 +/- 35; P = .03), whereas mean serum calcium levels were normal (9.2 +/- 0.8 vs 9.6 +/- 0.4 mg/dl; P = .18). The incidence of postoperative normocalcemic PTH elevation was significantly higher in group 2 at 1 to 3 months (14% vs 39%; P = .04) and at 7 to 12 months (22% vs 83%; P = .04). CONCLUSIONS: Vitamin D supplementation following parathyroidectomy for primary hyperparathyroidism reduces the incidence of postoperative eucalcemic PTH elevation.
Assuntos
Cálcio/sangue , Hiperparatireoidismo Primário/sangue , Hiperparatireoidismo Primário/cirurgia , Hormônio Paratireóideo/sangue , Paratireoidectomia , Vitamina D/administração & dosagem , Administração Oral , Idoso , Calcitriol/uso terapêutico , Carbonato de Cálcio/uso terapêutico , Agonistas dos Canais de Cálcio/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/antagonistas & inibidores , Cuidados Pós-Operatórios , Período Pós-Operatório , Fatores de Tempo , Vitamina D/uso terapêuticoRESUMO
Functionalized erythromycin 9-oxime derivatives are 6-O-allylated under mild conditions using substituted allyl tert-butyl carbonates under palladium(0) catalysis. This allylation works well where traditional ether-forming protocols function poorly. Allyl tert-butyl carbonates provide higher yields in this reaction than lesser substituted carbonates such as ethyl or isopropyl. Aryl-substituted allyl carbonates or carbamates may be employed as well and, when used, produce trans-olefinic products.