Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI

PubMed Central

Yi, Ji Sook; Han, Jong Kyu; Kim, Hyun-Joo

2015-01-01

Objective To assess inter-modality variability when evaluating cervical intervertebral disc herniation using 64-slice multidetector-row computed tomography (MDCT) and magnetic resonance imaging (MRI). Materials and Methods Three musculoskeletal radiologists independently reviewed cervical spine 1.5-T MRI and 64-slice MDCT data on C2-3 though C6-7 of 51 patients in the context of intervertebral disc herniation. Interobserver and inter-modality agreements were expressed as unweighted kappa values. Weighted kappa statistics were used to assess the extents of agreement in terms of the number of involved segments (NIS) in disc herniation and epicenter measurements collected using MDCT and MRI. Results The interobserver agreement rates upon evaluation of disc morphology by the three radiologists were in fair to moderate agreement (k = 0.39-0.53 for MDCT images; k = 0.45-0.56 for MRIs). When the disc morphology was categorized into two and four grades, the inter-modality agreement rates were moderate (k-value, 0.59) and substantial (k-value, 0.66), respectively. The inter-modality agreements for evaluations of the NIS (k-value, 0.78) and the epicenter (k-value, 0.79) were substantial. Also, the interobserver agreements for the NIS (CT; k-value, 0.85 and MRI; k-value, 0.88) and epicenter (CT; k-value, 0.74 and MRI; k-value, 0.70) evaluations by two readers were substantial. MDCT tended to underestimate the extent of herniated disc lesions compared with MRI. Conclusion Multidetector-row computed tomography and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI. PMID:26175589

Liquid biopsy of PIK3CA mutations in cervical cancer in Hong Kong Chinese women.

PubMed

Chung, Tony K H; Cheung, Tak Hong; Yim, So Fan; Yu, Mei Yun; Chiu, Rossa W K; Lo, Keith W K; Lee, Ida P C; Wong, Raymond R Y; Lau, Kitty K M; Wang, Vivian W; Worley, Michael J; Elias, Kevin M; Fiascone, Stephen J; Smith, David I; Berkowitz, Ross S; Wong, Yick Fu

2017-08-01

Cervical cancer is the fourth most common female cancer worldwide. The prognosis for women with advanced-stage or recurrent cervical cancer remains poor and response to treatment is variable. Standardized management protocols leave little room for individualization. We report on a novel blood-based liquid biopsy for specific PIK3CA mutations as a clinically useful biomarker in patients with invasive cervical cancer. One hundred seventeen Hong Kong Chinese women with primary invasive cervical cancer and their pre-treatment plasma samples were investigated. Two PIK3CA mutations, p.E542K and p.E545K were measured in cell free DNA (cfDNA) extracted from plasma using droplet digital PCR. This liquid biopsy of PIK3CA in cervical cancer was correlated to clinico-pathological features to verify the potential of PIK3CA as a clinically useful molecular biomarker for predicting disease prognosis and monitoring for progression. PIK3CA mutations, either p.E542K or p.E545K, were detected in plasma cfDNA from 22.2% of the patients. PIK3CA mutation status was significantly correlated to median tumor size (p<0.01). PIK3CA mutations detected in the plasma were significantly associated with decreased disease-free survival and overall survival (p<0.05). As a liquid molecular biopsy, analysis of circulating PIK3CA mutations shows promise as a way to refine risk stratification of individual patients with cervical cancer, and provides a platform for further research to offer individualized therapy with the purpose of improving outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Automation-assisted cervical cancer screening in manual liquid-based cytology with hematoxylin and eosin staining.

PubMed

Zhang, Ling; Kong, Hui; Ting Chin, Chien; Liu, Shaoxiong; Fan, Xinmin; Wang, Tianfu; Chen, Siping

2014-03-01

Current automation-assisted technologies for screening cervical cancer mainly rely on automated liquid-based cytology slides with proprietary stain. This is not a cost-efficient approach to be utilized in developing countries. In this article, we propose the first automation-assisted system to screen cervical cancer in manual liquid-based cytology (MLBC) slides with hematoxylin and eosin (H&E) stain, which is inexpensive and more applicable in developing countries. This system consists of three main modules: image acquisition, cell segmentation, and cell classification. First, an autofocusing scheme is proposed to find the global maximum of the focus curve by iteratively comparing image qualities of specific locations. On the autofocused images, the multiway graph cut (GC) is performed globally on the a* channel enhanced image to obtain cytoplasm segmentation. The nuclei, especially abnormal nuclei, are robustly segmented by using GC adaptively and locally. Two concave-based approaches are integrated to split the touching nuclei. To classify the segmented cells, features are selected and preprocessed to improve the sensitivity, and contextual and cytoplasm information are introduced to improve the specificity. Experiments on 26 consecutive image stacks demonstrated that the dynamic autofocusing accuracy was 2.06 μm. On 21 cervical cell images with nonideal imaging condition and pathology, our segmentation method achieved a 93% accuracy for cytoplasm, and a 87.3% F-measure for nuclei, both outperformed state of the art works in terms of accuracy. Additional clinical trials showed that both the sensitivity (88.1%) and the specificity (100%) of our system are satisfyingly high. These results proved the feasibility of automation-assisted cervical cancer screening in MLBC slides with H&E stain, which is highly desirable in community health centers and small hospitals. © 2013 International Society for Advancement of Cytometry.

Detection and Genotyping of Human Papillomavirus in Self-Obtained Cervicovaginal Samples by Using the FTA Cartridge: New Possibilities for Cervical Cancer Screening ▿

PubMed Central

Lenselink, Charlotte H.; de Bie, Roosmarie P.; van Hamont, Dennis; Bakkers, Judith M. J. E.; Quint, Wim G. V.; Massuger, Leon F. A. G.; Bekkers, Ruud L. M.; Melchers, Willem J. G.

2009-01-01

This study assesses human papillomavirus (HPV) detection and genotyping in self-sampled genital smears applied to an indicating FTA elute cartridge (FTA cartridge). The study group consisted of 96 women, divided into two sample sets. All samples were analyzed by the HPV SPF10-Line Blot 25. Set 1 consisted of 45 women attending the gynecologist; all obtained a self-sampled cervicovaginal smear, which was applied to an FTA cartridge. HPV results were compared to a cervical smear (liquid based) taken by a trained physician. Set 2 consisted of 51 women who obtained a self-sampled cervicovaginal smear at home, which was applied to an FTA cartridge and to a liquid-based medium. DNA was obtained from the FTA cartridges by simple elution as well as extraction. Of all self-obtained samples of set 1, 62.2% tested HPV positive. The overall agreement between self- and physician-obtained samples was 93.3%, in favor of the self-obtained samples. In sample set 2, 25.5% tested HPV positive. The overall agreement for high-risk HPV presence between the FTA cartridge and liquid-based medium and between DNA elution and extraction was 100%. This study shows that HPV detection and genotyping in self-obtained cervicovaginal samples applied to an FTA cartridge is highly reliable. It shows a high level of overall agreement with HPV detection and genotyping in physician-obtained cervical smears and liquid-based self-samples. DNA can be obtained by simple elution and is therefore easy, cheap, and fast. Furthermore, the FTA cartridge is a convenient medium for collection and safe transport at ambient temperatures. Therefore, this method may contribute to a new way of cervical cancer screening. PMID:19553570

[Effectiveness of FTA Elute® indicating cartridge in combination with hybrid capture 2 for cervical cancer screening].

PubMed

Chen, Feng; Zhang, Xi; Wang, Shaoming; Hu, Shangying; Chen, Wen; Zhao, Fanghui; He, Wei; Zhang, Yuqing; Qiao, Youlin

2015-02-01

To evaluate the effectiveness of FTA Elute® Cartridge (GE healthcare, Kent, UK) in combination with hybrid capture 2 (HC2) testing for cervical cancer screening. From May to June 2012, 412 women aged 25 to 65 years in Jiangxi Tonggu were enrolled in the study. We used pathological outcome as the gold standard, and the accuracy of the FTA card in combination with HC2 testing was investigated from both physician- and self-sampling, respectively. Physician sampling using the FTA card in combination with HC2 testing showed a comparable sensitivity (12/13) with the liquid based medium, but a higher specificity 69.5% (266/383) vs (77.8%, 298/383) (P < 0.001).When self sampling method was used, the sensitivity and specificity of using the FTA card in combination with HC2 testing with liquid based medium was 10/13 vs 8/13(P = 0.625) and (62.3%, 238/382) vs (75.7%, 289/382) (P < 0.001). The agreement of detection results for HC2 between FTA and liquid-based sampling medium was 86.1% (340/395) and 79.5% (314/395). For physician-collected samples used for HC2 testing to detect CIN2+, the accuracy of the FTA card was superior to that of the liquid-based medium (area under the receiver operating characteristic curve (AUC) = 0.898, 95%CI:0.838-0.958). FTA Elute® cartridge in combination with HC2 testing is a promising method of specimen transport for cervical cancer screening programs with a good precision.With further optimization, it could become an effective method for cervical cancer screening in various economic levels of areas.

Detection and genotyping of human papillomavirus in self-obtained cervicovaginal samples by using the FTA cartridge: new possibilities for cervical cancer screening.

PubMed

Lenselink, Charlotte H; de Bie, Roosmarie P; van Hamont, Dennis; Bakkers, Judith M J E; Quint, Wim G V; Massuger, Leon F A G; Bekkers, Ruud L M; Melchers, Willem J G

2009-08-01

This study assesses human papillomavirus (HPV) detection and genotyping in self-sampled genital smears applied to an indicating FTA elute cartridge (FTA cartridge). The study group consisted of 96 women, divided into two sample sets. All samples were analyzed by the HPV SPF(10)-Line Blot 25. Set 1 consisted of 45 women attending the gynecologist; all obtained a self-sampled cervicovaginal smear, which was applied to an FTA cartridge. HPV results were compared to a cervical smear (liquid based) taken by a trained physician. Set 2 consisted of 51 women who obtained a self-sampled cervicovaginal smear at home, which was applied to an FTA cartridge and to a liquid-based medium. DNA was obtained from the FTA cartridges by simple elution as well as extraction. Of all self-obtained samples of set 1, 62.2% tested HPV positive. The overall agreement between self- and physician-obtained samples was 93.3%, in favor of the self-obtained samples. In sample set 2, 25.5% tested HPV positive. The overall agreement for high-risk HPV presence between the FTA cartridge and liquid-based medium and between DNA elution and extraction was 100%. This study shows that HPV detection and genotyping in self-obtained cervicovaginal samples applied to an FTA cartridge is highly reliable. It shows a high level of overall agreement with HPV detection and genotyping in physician-obtained cervical smears and liquid-based self-samples. DNA can be obtained by simple elution and is therefore easy, cheap, and fast. Furthermore, the FTA cartridge is a convenient medium for collection and safe transport at ambient temperatures. Therefore, this method may contribute to a new way of cervical cancer screening.

A Systematic Evaluation of Collagen Crosslinks in the Human Cervix

PubMed Central

Zork, Noelia M; Myers, Kristin Marie; Yoshida, Ms. Kyoko; Cremers, Serge; Jiang, Hongfeng; Ananth, Cande V; Wapner, Ronald; Kitajewski, Jan; Vink, Joy

2014-01-01

Objective The mechanical strength of the cervix relies on crosslinking of the tissue’s collagen network. Clinically, the internal os is functionally distinct from the external os. We sought to detect specific collagen crosslinks in human cervical tissue and determine if crosslink profiles were similar at the internal and external os. Study Design Transverse slices of cervical tissue were obtained at the internal and external os from 13 non-pregnant, premenopausal women undergoing a benign hysterectomy. To understand how crosslinks were distributed throughout the entire cervix and at the internal and external os, biopsies were obtained from three circumferential zones in four quadrants from each slice. Biopsies were pulverized, lyophilized, reduced with sodium borohydride, hydrolyzed with hydrochloric acid and reconstituted in heptafluorobutyric acid buffer. Hydroxyproline was measured by ultra-performance liquid chromatography-electrospray ionization tandem mass spectrometry (UPLC-ESI-MS/MS), converted to total collagen, and normalized by dry weight. Collagen crosslinks pyridinoline (PYD), deoxypyridinoline (DPD), dihydroxylysinonorleucine (DHLNL), and the nonenzymatic advanced glycation end product pentosidine [PEN] were measured by UPLC-ESI-MS/MS and reported as crosslink density ratio (crosslink:total collagen). Generalized estimated equation analysis was used to compare results between the internal and external os and to compare quadrants and zones within slices from the internal and external os to determine if crosslink profiles were similar. Results 592 samples from 13 patients were analyzed. Collagen crosslinks are detectable in the human cervix by UPLC-ESI-MS/MS. When comparing all samples from the internal and external os, similar levels of collagen content, PYD, DHLNL and DPD were found but PEN density was higher at the external os (0.005 vs 0.004, P=0.001). When comparing all internal os samples, significant heterogeneity was found in collagen content and crosslink densities across zones and quadrants. The external os exhibited heterogeneity only across zones. Conclusion Collagen crosslinks (PYD, DPD, DHLNL, and PEN) are detectable by UPLC-ESI-MS/MS in the human cervix. The internal os exhibits significant collagen crosslink heterogeneity compared to the external os. Further studies are needed to evaluate how collagen crosslink heterogeneity correlates to the mechanical strength and function of the human cervix. PMID:25281365

Assessment of skeletal maturation based on cervical vertebrae in CBCT.

PubMed

Shim, Jocelyne J; Heo, Giseon; Lagravère, Manuel O

2012-12-01

Diagnosis of skeletal age in adolescents helps orthodontists select and time treatments. Currently this is done using lateral cephalometric radiographs. This study evaluates the application of the conventional method in cone-beam computer tomographic (CBCT) images to bring forth assessment of skeletal maturation in three-dimensions. Ninety-eight lateral cephalometric radiographs and CBCT scans were collected from orthodontic patients between 11 to 17 years of age over an 18-month period. CBCT scans were examined in seven sagittal slices based on cervical vertebral maturation staging (CVMS). Collected CVMS values were compared with those from corresponding lateral cephalometric radiograph. CVMS measured from CBCT and lateral cephalometric radiographs were the same on average. However, they were not consistent with each other and scored interclass correlation coefficient of 0.155 in validity test. Interoperator reliability was weak (0.581). Adaptation of cervical vertebrae maturation staging in CBCT requires further clarifications or modifications to become consistent with lateral cephalometric examinations and to become a reliable method. Alternatively, a completely new method may be developed consisting of maturational indicators or landmarks unique to CBCT imaging. Copyright © 2012. Published by Elsevier Masson SAS.

Evaluation of a low-cost liquid-based Pap test in rural El Salvador: a split-sample study.

PubMed

Guo, Jin; Cremer, Miriam; Maza, Mauricio; Alfaro, Karla; Felix, Juan C

2014-04-01

We sought to test the diagnostic efficacy of a low-cost, liquid-based cervical cytology that could be implemented in low-resource settings. A prospective, split-sample Pap study was performed in 595 women attending a cervical cancer screening clinic in rural El Salvador. Collected cervical samples were used to make a conventional Pap (cell sample directly to glass slide), whereas residual material was used to make the liquid-based sample using the ClearPrep method. Selected samples were tested from the residual sample of the liquid-based collection for the presence of high-risk Human papillomaviruses. Of 595 patients, 570 were interpreted with the same diagnosis between the 2 methods (95.8% agreement). There were comparable numbers of unsatisfactory cases; however, ClearPrep significantly increased detection of low-grade squamous intraepithelial lesions and decreased the diagnoses of atypical squamous cells of undetermined significance. ClearPrep identified an equivalent number of high-grade squamous intraepithelial lesion cases as the conventional Pap. High-risk human papillomavirus was identified in all cases of high-grade squamous intraepithelial lesion, adenocarcinoma in situ, and cancer as well as in 78% of low-grade squamous intraepithelial lesions out of the residual fluid of the ClearPrep vials. The low-cost ClearPrep Pap test demonstrated equivalent detection of squamous intraepithelial lesions when compared with the conventional Pap smear and demonstrated the potential for ancillary molecular testing. The test seems a viable option for implementation in low-resource settings.

[The effect of root canal re-wetting on push-out bond strength and durability of fiber post].

PubMed

Yao, Ke; Song, Jie-wen; Li, Yan

2011-02-01

To analyze the push-out bond strength of fiber post and the durability of interface between dentin and composite resin during over drying and re-wetting of root canal. Thirty-six extracted human maxillary central incisors were randomly divided into three groups: Group A for the process of over drying, Group B for re-wetting, Group C for control. All teeth were sliced into several thin discs with thickness of 1.0 mm for micro push-out test and scanning electron microscope(SEM) observation. Push-out shear strengths of fiber post immediately after bonding in group A, B and C were (5.97 ± 1.97), (7.67 ± 2.19) and (8.46 ± 2.35) MPa. Push-out strengths of fiber post two months after water storage were (2.08 ± 1.67), (2.99 ± 1.48) and (3.22 ± 1.43) MPa. There was significantly difference in push-out strength between Group A and Group B (P < 0.05). Significantly difference in push-out strength was also found between Group A and Group C. In the condition of immediate testing, there was also significantly difference between push-out strength of cervical slice and middle slice, and between cervical slice and apical slice (P < 0.05). The water storage time has significant effect on the push-out bond strength of fiber posts (P < 0.05). Inappropriate condensation air blowing operation can cause extracted teeth root canal dentin over dry. Dehydration can destroy the formation of general structure of interface between composite resin and dentin. The over dry dentin can be turned back to wetting stage by water pouring, which can help fiber-reinforced composite post regain its normal retention strength and original adhesive durability.

Short-scan-time multi-slice diffusion MRI of the mouse cervical spinal cord using echo planar imaging.

PubMed

Callot, Virginie; Duhamel, Guillaume; Cozzone, Patrick J; Kober, Frank

2008-10-01

Mouse spinal cord (SC) diffusion-weighted imaging (DWI) provides important information on tissue morphology and structural changes that may occur during pathologies such as multiple sclerosis or SC injury. The acquisition scheme of the commonly used DWI techniques is based on conventional spin-echo encoding, which is time-consuming. The purpose of this work was to investigate whether the use of echo planar imaging (EPI) would provide good-quality diffusion MR images of mouse SC, as well as accurate measurements of diffusion-derived metrics, and thus enable diffusion tensor imaging (DTI) and highly resolved DWI within reasonable scan times. A four-shot diffusion-weighted spin-echo EPI (SE-EPI) sequence was evaluated at 11.75 T on a group of healthy mice (n = 10). SE-EPI-derived apparent diffusion coefficients of gray and white matter were compared with those obtained using a conventional spin-echo sequence (c-SE) to validate the accuracy of the method. To take advantage of the reduction in acquisition time offered by the EPI sequence, multi-slice DTI acquisitions were performed covering the cervical segments (six slices, six diffusion-encoding directions, three b values) within 30 min (vs 2 h for c-SE). From these measurements, fractional anisotropy and mean diffusivities were calculated, and fiber tracking along the C1 to C6 cervical segments was performed. In addition, high-resolution images (74 x 94 microm(2)) were acquired within 5 min per direction. Clear delineation of gray and white matter and identical apparent diffusion coefficient values were obtained, with a threefold reduction in acquisition time compared with c-SE. While overcoming the difficulties associated with high spatially and temporally resolved DTI measurements, the present SE-EPI approach permitted identification of reliable quantitative parameters with a reproducibility compatible with the detection of pathologies. The SE-EPI method may be particularly valuable when multiple sets of images from the SC are needed, in cases of rapidly evolving conditions, to decrease the duration of anesthesia or to improve MR exploration by including additional MR measurements. Copyright (c) 2008 John Wiley & Sons, Ltd.

Quantitative mass spectrometry imaging of emtricitabine in cervical tissue model using infrared matrix-assisted laser desorption electrospray ionization

PubMed Central

Bokhart, Mark T.; Rosen, Elias; Thompson, Corbin; Sykes, Craig; Kashuba, Angela D. M.; Muddiman, David C.

2015-01-01

A quantitative mass spectrometry imaging (QMSI) technique using infrared matrix-assisted laser desorption electrospray ionization (IR-MALDESI) is demonstrated for the antiretroviral (ARV) drug emtricitabine in incubated human cervical tissue. Method development of the QMSI technique leads to a gain in sensitivity and removal of interferences for several ARV drugs. Analyte response was significantly improved by a detailed evaluation of several cationization agents. Increased sensitivity and removal of an isobaric interference was demonstrated with sodium chloride in the electrospray solvent. Voxel-to-voxel variability was improved for the MSI experiments by normalizing analyte abundance to a uniformly applied compound with similar characteristics to the drug of interest. Finally, emtricitabine was quantified in tissue with a calibration curve generated from the stable isotope-labeled analog of emtricitabine followed by cross-validation using liquid chromatography tandem mass spectrometry (LC-MS/MS). The quantitative IR-MALDESI analysis proved to be reproducible with an emtricitabine concentration of 17.2±1.8 μg/gtissue. This amount corresponds to the detection of 7 fmol/voxel in the IR-MALDESI QMSI experiment. Adjacent tissue slices were analyzed using LC-MS/MS which resulted in an emtricitabine concentration of 28.4±2.8 μg/gtissue. PMID:25318460

Aspergillus in liquid-based cervicovaginal cytology in a postmenopausal patient: A case report.

PubMed

Garza-Guajardo, Raquel; Canales-Martínez, Luis Carlos; Rodríguez-Sánchez, Irám Pablo; Sánchez-Chaparro, María Marisela; Gómez-Macías, Gabriela Sofía; Vilches-Cisneros, Natalia; Barboza-Quintana, Oralia

2017-10-01

Aspergillus is an opportunistic fungus present in humid environments, whose natural environment is in soil, hay and compost. It is a frequent contaminant in the clinical laboratory. Because of this, the fungus is often inhaled, affecting those with an underlying pulmonary disease or immune deficiency. Fungal genitourinary tract infections are relatively common. A rare Aspergillus spp cervical infection diagnosed via liquid-based cytology is presented in the current study. The 57-year-old woman attended her annual check-up without any relevant medical history. The result of a gynecological examination by Papanicolaou smear was normal and routine liquid-based cytology was performed. The specimen exhibited fungal organisms characterized by septate hyphae branching at acute angles, most consistent with the Aspergillus species. Subsequent cytology demonstrated the same results. Antifungal treatment was initiated and a second post-treatment smear only exhibited atrophy. The cytomorphological features of Aspergillus spp. are discussed in the current study and a brief review of the few reported cases of a primary cervical infection in the literature is provided. In addition, the liquid-based cytology was established as a tool to diagnose the rare Aspergillus infection.

Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial.

PubMed

Ronco, Guglielmo; Segnan, Nereo; Giorgi-Rossi, Paolo; Zappa, Marco; Casadei, Gian Piero; Carozzi, Francesca; Dalla Palma, Paolo; Del Mistro, Annarosa; Folicaldi, Stefania; Gillio-Tos, Anna; Nardo, Gaetano; Naldoni, Carlo; Schincaglia, Patrizia; Zorzi, Manuel; Confortini, Massimo; Cuzick, Jack

2006-06-07

Although testing for human papillomavirus (HPV) has higher sensitivity and lower specificity than cytology alone for detecting cervical intraepithelial neoplasia (CIN), studies comparing conventional and liquid-based cytology have had conflicting results. In the first phase of a two-phase multicenter randomized controlled trial, women aged 35-60 years in the conventional arm (n = 16,658) were screened using conventional cytology, and women in the experimental arm (n = 16,706) had liquid-based cytology and were tested for high-risk HPV types using the Hybrid Capture 2 assay. Women in the conventional arm were referred to colposcopy with atypical cells of undetermined significance (ASCUS) or higher and those in the experimental arm were referred with ASCUS or higher cytology or with a positive (> or = 1 pg/mL) HPV test. Sensitivity and positive predictive value (PPV) for detection of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) were calculated. The screening methods and referral criterion applied in the experimental arm had higher sensitivity than that in the conventional arm (relative sensitivity = 1.47; 95% confidence interval [CI] = 1.03 to 2.09) but a lower PPV (relative PPV = 0.40; 95% CI = 0.23 to 0.66). With HPV testing alone at > or = 1 pg/mL and at > or = 2 pg/mL, the gain in sensitivity compared with the conventional arm remained similar (relative sensitivity = 1.43, 95% CI = 1.00 to 2.04 and relative sensitivity = 1.41, 95% CI = 0.98 to 2.01, respectively) but PPV progressively improved (relative PPV = 0.58, 95% CI = 0.33 to 0.98 and relative PPV = 0.75, 95% CI = 0.45 and 1.27, respectively). Referral based on liquid-based cytology alone did not increase sensitivity compared with conventional cytology (relative sensitivity = 1.06; 95% CI = 0.72 to 1.55) but reduced PPV (relative PPV = 0.57; 95% CI = 0.39 to 0.82). HPV testing alone was more sensitive than conventional cytology among women 35-60 years old. Adding liquid-based cytology improved sensitivity only marginally but increased false-positives. HPV testing using Hybrid Capture 2 with a 2 pg/mL cutoff may be more appropriate than a 1 pg/mL cutoff for primary cervical cancer screening.

Proteomic identification of potential biomarkers for cervical squamous cell carcinoma and human papillomavirus infection.

PubMed

Qing, Song; Tulake, Wuniqiemu; Ru, Mingfang; Li, Xiaohong; Yuemaier, Reziwanguli; Lidifu, Dilare; Rouzibilali, Aierken; Hasimu, Axiangu; Yang, Yun; Rouziahong, Reziya; Upur, Halmurat; Abudula, Abulizi

2017-04-01

It is known that high-risk human papillomavirus infection is the main etiological factor in cervical carcinogenesis. However, human papillomavirus screening is not sufficient for early diagnosis. In this study, we aimed to identify potential biomarkers common to cervical carcinoma and human papillomavirus infection by proteomics for human papillomavirus-based early diagnosis and prognosis. To this end, we collected 76 cases of fresh cervical tissues and 116 cases of paraffin-embedded tissue slices, diagnosed as cervical squamous cell carcinoma, cervical intraepithelial neoplasia II-III, or normal cervix from ethnic Uighur and Han women. Human papillomavirus infection by eight oncogenic human papillomavirus types was detected in tissue DNA samples using a quantitative polymerase chain reaction. The protein profile of cervical specimens from human papillomavirus 16-positive squamous cell carcinoma and human papillomavirus-negative normal controls was analyzed by proteomics and bioinformatics. The expression of candidate proteins was further determined by quantitative reverse transcriptase-polymerase chain reaction and immunohistochemistry. We identified 67 proteins that were differentially expressed in human papillomavirus 16-positive squamous cell carcinoma compared to normal cervix. The quantitative reverse transcriptase-polymerase chain reaction analysis verified the upregulation of ASAH1, PCBP2, DDX5, MCM5, TAGLN2, hnRNPA1, ENO1, TYPH, CYC, and MCM4 in squamous cell carcinoma compared to normal cervix ( p < 0.05). In addition, the transcription of PCBP2, MCM5, hnRNPA1, TYPH, and CYC was also significantly increased in cervical intraepithelial neoplasia II-III compared to normal cervix. Immunohistochemistry staining further confirmed the overexpression of PCBP2, hnRNPA1, ASAH1, and DDX5 in squamous cell carcinoma and cervical intraepithelial neoplasia II-III compared to normal controls ( p < 0.05). Our data suggest that the expression of ASAH1, PCBP2, DDX5, and hnRNPA1, and possibly MCM4, MCM5, CYC, ENO1, and TYPH, is upregulated during cervical carcinogenesis and potentially associated with human papillomavirus infection. Further validation studies of the profile will contribute to establishing auxiliary diagnostic markers for human papillomavirus-based cancer prognosis.

Experience of Combined Liquid Based Cervical Cytology and High-Risk HPV mRNA for Cervical Cancer Screening in Thammasat University Hospital.

PubMed

Muangto, Teerapat; Chanthasenanont, Athita; Lertvutivivat, Supapen; Nanthakomon, Tongta; Pongrojpaw, Densak; Bhamarapravatana, Kornkarn; Suwannarurk, Komsun

2016-01-01

Cervical cancer is the second most common of malignancy found in Thai women. Human papillomavirus (HPV) infection is a major cause. The objective of the present study was to evaluate the prevalence of HPV infection and association with abnormal cervical cytology in Thai women. This study was conducted at the Gynecologic Clinic, Thammasat University, Pathum Thani, Thailand. A total of 2,144 cases who underwent annual cervical cancer screening by co-testing (liquid based cytology and HPV testing, DNA versus mRNA) during the priod from July 2013 to June 2016 were recruited in this study. Prevalence of positive high risk (HR) HPV DNA and mRNA test were 19.7 and 8.4%, respectively with a statistically significant difference. Majority of cases of abnormal cytology in this study were atypical squamous cells of undetermined significance (ASC-US). In patients with ASC-US, positive HR HPV DNA was greater than in the mRNA group (10.1 and 4.5%, p<0.001). Nonetheless, there was no significant difference in participants with cervical intraepithelial neoplasia (CIN). HPV mRNA test had slightly lower sensitivity but higher negative predictive value (NPV) than the DNA test to detect abnormal cytology during cervical cancer screening (p<0.001). Both HPV test (DNA and mRNA) had equally efficacy to detect high grade precancerous lesion or higher (CIN 2+). Prevalence of HR HPV DNA and mRNA were 19.7 and 8.4 percent, respectively. NPV of HPV mRNA was higher than DNA test. Both tests had equal efficacy to detect CIN 2+ with sensitivity and specificity of 63% vs 55.7% and 83% vs 92%, respectively.

Primary screening for cervical cancer based on high-risk human papillomavirus (HPV) detection and HPV 16 and HPV 18 genotyping, in comparison to cytology.

PubMed

Agorastos, Theodoros; Chatzistamatiou, Kimon; Katsamagkas, Taxiarchis; Koliopoulos, George; Daponte, Alexandros; Constantinidis, Theocharis; Constantinidis, Theodoros C

2015-01-01

The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. The study, conducted by the "HEllenic Real life Multicentric cErvical Screening" (HERMES) study group, involved the recruitment of 4,009 women, aged 25-55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25-29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18 genotyping could represent a more accurate methodology for primary cervical cancer screening in comparison to liquid-based cytology, especially in older women.

Gardnerella vaginalis and Lactobacillus sp in liquid-based cervical samples in healthy and disturbed vaginal flora using cultivation-independent methods.

PubMed

Klomp, Johanna M; Verbruggen, Banut-Sabine M; Korporaal, Hans; Boon, Mathilde E; de Jong, Pauline; Kramer, Gerco C; van Haaften, Maarten; Heintz, A Peter M

2008-05-01

Our objective was to determine the morphotype of the adherent bacteria in liquid-based cytology (LBC) in smears with healthy and disturbed vaginal flora. And to use PCR technology on the same fixed cell sample to establish DNA patterns of the 16S RNA genes of the bacteria in the sample. Thirty samples were randomly selected from a large group of cervical cell samples suspended in a commercial coagulant fixative "(BoonFix)." PCR was used to amplify DNA of five bacterial species: Lactobacillus acidophilus, Lactobacillus crispatus, Lactobacillus jensenii, Gardnerella vaginalis, and Mycoplasma hominis. The LBC slides were then analyzed by light microscopy to estimate bacterial adhesion. DNA of lactobacilli was detected in all cell samples. Seventeen smears showed colonization with Gardnerella vaginalis (range 2.6 x 10(2)-3.0 x 10(5) bacteria/mul BoonFix sample). Two cases were identified as dysbacteriotic with high DNA values for Gardnerella vaginalis and low values for Lactobacillus crispatus. The sample with the highest concentration for Gardnerella vaginalis showed an unequivocal Gardnerella infection. This study indicates that the adherence pattern of a disturbed flora in liquid-based cervical samples can be identified unequivocally, and that these samples are suitable for quantitative PCR analysis. This cultivation independent method reveals a strong inverse relationship between Gardnerella vaginalis and Lactobacillus crispatus in dysbacteriosis and unequivocal Gardnerella infection.

Monitoring the Secretory Behavior of the Rat Adrenal Medulla by High-Performance Liquid Chromatography-Based Catecholamine Assay from Slice Supernatants

PubMed Central

De Nardi, Frédéric; Lefort, Claudie; Bréard, Dimitri; Richomme, Pascal; Legros, Christian; Guérineau, Nathalie C.

2017-01-01

Catecholamine (CA) secretion from the adrenal medullary tissue is a key step of the adaptive response triggered by an organism to cope with stress. Whereas molecular and cellular secretory processes have been extensively studied at the single chromaffin cell level, data available for the whole gland level are much scarcer. We tackled this issue in rat by developing an easy to implement experimental strategy combining the adrenal acute slice supernatant collection with a high-performance liquid chromatography-based epinephrine and norepinephrine (NE) assay. This technique affords a convenient method for measuring basal and stimulated CA release from single acute slices, allowing thus to individually address the secretory function of the left and right glands. Our data point that the two glands are equally competent to secrete epinephrine and NE, exhibiting an equivalent epinephrine:NE ratio, both at rest and in response to a cholinergic stimulation. Nicotine is, however, more efficient than acetylcholine to evoke NE release. A pharmacological challenge with hexamethonium, an α3-containing nicotinic acetylcholine receptor antagonist, disclosed that epinephrine- and NE-secreting chromaffin cells distinctly expressed α3 nicotinic receptors, with a dominant contribution in NE cells. As such, beyond the novelty of CA assays from acute slice supernatants, our study contributes at refining the secretory behavior of the rat adrenal medullary tissue, and opens new perspectives for monitoring the release of other hormones and transmitters, especially those involved in the stress response. PMID:28993760

An Evaluation of the Cobas4800 HPV Test on Cervico-Vaginal Specimens in Liquid versus Solid Transport Media.

PubMed

Luo, Hongxue; Du, Hui; Maurer, Kathryn; Belinson, Jerome L; Wang, Guixiang; Liu, Zhihong; Zhang, Lijie; Zhou, Yanqiu; Wang, Chun; Tang, Jinlong; Qu, Xinfeng; Wu, Ruifang

2016-01-01

Determine the ability of the Cobas 4800 assay to detect high-risk human papillomavirus (HrHPV) and high-grade cervical lesions when using cervico-vaginal samples applied to liquid medium and solid media cards compared to a direct cervical sample. Two cervico-vaginal specimens (pseudo self-collected) were obtained from 319 women. One was applied to an iFTA Card (FTA) then the brush placed in liquid-based medium (LSELF); the other was applied to a new solid media: POI card (POI). The clinical performance of Cobas4800 assay using the three aforementioned specimens was compared to direct collected endocervical specimens in liquid media (LDOC). The overall agreements of HrHPV detection were 84.2% (LSELF vs. LDOC), 81.0% (FTA vs. LDOC), and 82.3% (POI vs. LDOC). LSELF, FTA and POI identified 98.0%, 79.6%, and 97.5% positive cases of LDOC. Sensitivity to identify CIN2+ were 98.4% (LSELF), 73.8% (FTA), 95.1% (POI), and 93.4% (LDOC) respectively. FTA had 78.1% and 90.4% agreement with the LSELF samples for all HrHPV and HPV16/18 detection respectively, while POI had 91.6% for both. Cobas4800 HPV test combined with cervico-vaginal specimens applied to both liquid media and POI solid card are accurate to detect HrHPV infection and high-grade cervical lesions as compared with direct endocervical samples in liquid media.

An Evaluation of the Cobas4800 HPV Test on Cervico-Vaginal Specimens in Liquid versus Solid Transport Media

PubMed Central

Luo, Hongxue; Du, Hui; Maurer, Kathryn; Belinson, Jerome L.; Wang, Guixiang; Liu, Zhihong; Zhang, Lijie; Zhou, Yanqiu; Wang, Chun; Tang, Jinlong; Qu, Xinfeng; Wu, Ruifang

2016-01-01

Objectives Determine the ability of the Cobas 4800 assay to detect high-risk human papillomavirus (HrHPV) and high-grade cervical lesions when using cervico-vaginal samples applied to liquid medium and solid media cards compared to a direct cervical sample. Methods Two cervico-vaginal specimens (pseudo self-collected) were obtained from 319 women. One was applied to an iFTA Card (FTA) then the brush placed in liquid-based medium (LSELF); the other was applied to a new solid media: POI card (POI). The clinical performance of Cobas4800 assay using the three aforementioned specimens was compared to direct collected endocervical specimens in liquid media (LDOC). Results The overall agreements of HrHPV detection were 84.2% (LSELF vs. LDOC), 81.0% (FTA vs. LDOC), and 82.3% (POI vs. LDOC). LSELF, FTA and POI identified 98.0%, 79.6%, and 97.5% positive cases of LDOC. Sensitivity to identify CIN2+ were 98.4% (LSELF), 73.8% (FTA), 95.1% (POI), and 93.4% (LDOC) respectively. FTA had 78.1% and 90.4% agreement with the LSELF samples for all HrHPV and HPV16/18 detection respectively, while POI had 91.6% for both. Conclusions Cobas4800 HPV test combined with cervico-vaginal specimens applied to both liquid media and POI solid card are accurate to detect HrHPV infection and high-grade cervical lesions as compared with direct endocervical samples in liquid media. PMID:26828360

Dual p16 and Ki-67 Expression in Liquid-Based Cervical Cytological Samples Compared to Pap Cytology Findings, Biopsies, and HPV Testing in Cervical Cancer Screening: A Diagnostic Accuracy Study.

PubMed

Prigenzi, Karla Calaça Kabbach; Heinke, Thaís; Salim, Rafael Calil; Focchi, Gustavo Rubino de Azevedo

2018-01-01

Our objective was to verify the sensitivity and specificity of dual immunocytochemistry staining for p16 and Ki-67 in liquid-based samples (the "dual" assay) for cervical lesion screening, compared to biopsy findings and human papillomavirus (HPV) DNA molecular detection. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for the "dual immunocytochemistry assay" were calculated and compared to histopathological results and to high-risk HPV DNA detection in adult women or teenagers submitted to cervical cancer screening. A total of 151 women were included. The majority (96.2%) of those with negative dual assay results had lower biopsy grades (p < 0.001). Women with cytology results suggestive of cervical cancer had positive dual immunocytochemistry assay results more frequently (p < 0.001), and these positive results were also significantly associated with biopsy findings (p < 0.001) and with high-risk genotype HPV infection (p = 0.007). Specificity and PPV for the dual assay were 0.972 (0.855-0.999) and 0.800 (0.284-0.995), respectively, and 1.000 (0.590-1.000) and 1.000 (0.631-1.000) for HPV detection. The dual immunocytochemistry assay had high specificity and PPV. It reveals a persistent HPV infection, avoiding the need for new tissue collections for biopsies or hybrid capture. © 2018 S. Karger AG, Basel.

Primary Screening for Cervical Cancer Based on High-Risk Human Papillomavirus (HPV) Detection and HPV 16 and HPV 18 Genotyping, in Comparison to Cytology

PubMed Central

Constantinidis, Theocharis; Constantinidis, Theodoros C.

2015-01-01

Objectives The objective of the present study is to assess the performance of a high-risk human papillomavirus (HR-HPV) DNA test with individual HPV-16/HPV-18 genotyping as a method for primary cervical cancer screening compared with liquid-based cytology (LBC) in a population of Greek women taking part in routine cervical cancer screening. Methods The study, conducted by the “HEllenic Real life Multicentric cErvical Screening” (HERMES) study group, involved the recruitment of 4,009 women, aged 25–55, who took part in routine cervical screening at nine Gynecology Departments in Greece. At first visit cervical specimens were collected for LBC and HPV testing using the Roche Cobas 4800 system. Women found positive for either cytology or HPV were referred for colposcopy, whereas women negative for both tests will be retested after three years. The study is ongoing and the results of the first screening round are reported herein. Results Valid results for cytology and HPV testing were obtained for 3,993 women. The overall prevalence of HR-HPV was 12.7%, of HPV-16 2.7% and of HPV-18 1.4%. Of those referred for colposcopy, cervical intraepithelial neoplasia grade 2 or worse (CIN2+) was detected in 41 women (1.07%). At the threshold of CIN2+, cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] and HPV testing showed a sensitivity of 53.7% and 100% respectively, without change between age groups. Cytology and HPV testing showed specificity of 96.8% and 90.3% respectively, which was increased in older women (≥30) in comparison to younger ones (25–29). Genotyping for HPV16/18 had similar accuracy to cytology for the detection of CIN2+ (sensitivity: 58.5%; specificity 97.5%) as well as for triage to colposcopy (sensitivity: 58.5% vs 53.7% for cytology). Conclusion HPV testing has much better sensitivity than cytology to identify high-grade cervical lesions with slightly lower specificity. HPV testing with individual HPV-16/HPV-18 genotyping could represent a more accurate methodology for primary cervical cancer screening in comparison to liquid-based cytology, especially in older women. PMID:25793281

Metabolic Characterization of Acutely Isolated Hippocampal and Cerebral Cortical Slices Using [U-13C]Glucose and [1,2-13C]Acetate as Substrates.

PubMed

McNair, Laura F; Kornfelt, Rasmus; Walls, Anne B; Andersen, Jens V; Aldana, Blanca I; Nissen, Jakob D; Schousboe, Arne; Waagepetersen, Helle S

2017-03-01

Brain slice preparations from rats, mice and guinea pigs have served as important tools for studies of neurotransmission and metabolism. While hippocampal slices routinely have been used for electrophysiology studies, metabolic processes have mostly been studied in cerebral cortical slices. Few comparative characterization studies exist for acute hippocampal and cerebral cortical slices, hence, the aim of the current study was to characterize and compare glucose and acetate metabolism in these slice preparations in a newly established incubation design. Cerebral cortical and hippocampal slices prepared from 16 to 18-week-old mice were incubated for 15-90 min with unlabeled glucose in combination with [U- 13 C]glucose or [1,2- 13 C]acetate. Our newly developed incubation apparatus allows accurate control of temperature and is designed to avoid evaporation of the incubation medium. Subsequent to incubation, slices were extracted and extracts analyzed for 13 C-labeling (%) and total amino acid contents (µmol/mg protein) using gas chromatography-mass spectrometry and high performance liquid chromatography, respectively. Release of lactate from the slices was quantified by analysis of the incubation media. Based on the measured 13 C-labeling (%), total amino acid contents and relative activity of metabolic enzymes/pathways, we conclude that the slice preparations in the current incubation apparatus exhibited a high degree of metabolic integrity. Comparison of 13 C-labeling observed with [U- 13 C]glucose in slices from cerebral cortex and hippocampus revealed no significant regional differences regarding glycolytic or total TCA cycle activities. On the contrary, results from the incubations with [1,2- 13 C]acetate suggest a higher capacity of the astrocytic TCA cycle in hippocampus compared to cerebral cortex. Finally, we propose a new approach for assessing compartmentation of metabolite pools between astrocytes and neurons using 13 C-labeling (%) data obtained from mass spectrometry. Based on this approach we suggest that cellular metabolic compartmentation in hippocampus and cerebral cortex is very similar.

The process of moving from a regionally based cervical cytology biobank to a national infrastructure.

PubMed

Perskvist, Nasrin; Norlin, Loreana; Dillner, Joakim

2015-04-01

This article addresses the important issue of the standardization of the biobank process. It reports on i) the implementation of standard operating procedures for the processing of liquid-based cervical cells, ii) the standardization of storage conditions, and iii) the ultimate establishment of nationwide standardized biorepositories for cervical specimens. Given the differences in the infrastructure and healthcare systems of various county councils in Sweden, these efforts were designed to develop standardized methods of biobanking across the nation. The standardization of cervical sample processing and biobanking is an important and widely acknowledged issue. Efforts to address these concerns will facilitate better patient care and improve research based on retrospective and prospective collections of patient samples and cohorts. The successful nationalization of the Cervical Cytology Biobank in Sweden is based on three vital issues: i) the flexibility of the system to adapt to other regional systems, ii) the development of the system based on national collaboration between the university and the county councils, and iii) stable governmental financing by the provider, the Biobanking and Molecular Resource Infrastructure of Sweden (BBMRI.se). We will share our experiences with biorepository communities to promote understanding of and advances in opportunities to establish a nationalized biobank which covers the healthcare of the entire nation.

Basic in vitro experiment on the adhesive effects of sheet-type hemostatic agents used in combination with a liquid fibrin sealant.

PubMed

Ishii, Keiichi; Kawashima, Hideki; Hayama, Takuma; Mayabashira, Sumika; Oka, Shiro; Sugimoto, Toshikado

2011-11-01

Various hemostatic agents have been used quite effectively for hemostasis, as well as for providing effective adhesion during laparoscopic partial nephrectomies. In this study, we investigated the adhesiveness to the renal tissue of some sheet-type hemostatic agents used in combination with a liquid fibrin sealant. In Experiment A, component solutions of the fibrin glue (liquid fibrin sealant) were dripped onto a kite string placed annularly on a porcine kidney slice. Then, one of the sheet-type hemostats--namely, the collagen, gelatin, or cellulose hemostat--was placed on the slices, and a string scale was used to measure the force needed to pull the string apart vertically from the kidney slice. Twelve slices were used for each group, and the weight data were analyzed statistically. The tissue adhering to each sheet-type hemostatic agent was fixed in formalin and sliced and then examined by light microscopy after hematoxylin and eosin staining. In Experiment B, the solutions were dripped onto the sheet-type hemostatic agent placed first on the slice, and the force needed for pulling apart the hemostat sheet from the slice was similarly examined. The combination of fibrin glue plus a collagen hemostat was clearly superior in Experiment A, but the hemostat and renal tissue could be pulled apart more easily in Experiment B. These results showed that fibrin glue could not exert its expected adhesive effect unless it is used in combination with another hemostatic agent or is directly applied to renal tissue. It is important to obtain further comparative data among agents and select the appropriate agents, taking into consideration the type of surgery.

Pilot Study of an Open-source Image Analysis Software for Automated Screening of Conventional Cervical Smears.

PubMed

Sanyal, Parikshit; Ganguli, Prosenjit; Barui, Sanghita; Deb, Prabal

2018-01-01

The Pap stained cervical smear is a screening tool for cervical cancer. Commercial systems are used for automated screening of liquid based cervical smears. However, there is no image analysis software used for conventional cervical smears. The aim of this study was to develop and test the diagnostic accuracy of a software for analysis of conventional smears. The software was developed using Python programming language and open source libraries. It was standardized with images from Bethesda Interobserver Reproducibility Project. One hundred and thirty images from smears which were reported Negative for Intraepithelial Lesion or Malignancy (NILM), and 45 images where some abnormality has been reported, were collected from the archives of the hospital. The software was then tested on the images. The software was able to segregate images based on overall nuclear: cytoplasmic ratio, coefficient of variation (CV) in nuclear size, nuclear membrane irregularity, and clustering. 68.88% of abnormal images were flagged by the software, as well as 19.23% of NILM images. The major difficulties faced were segmentation of overlapping cell clusters and separation of neutrophils. The software shows potential as a screening tool for conventional cervical smears; however, further refinement in technique is required.

Molecular tests potentially improving HPV screening and genotyping for cervical cancer prevention

PubMed Central

Gradíssimo, Ana

2018-01-01

INTRODUCTION Human papillomavirus (HPV)-related cancers can be averted by type-specific vaccination (primary prevention) and/or through detection and ablation of precancerous cervical lesions (secondary prevention). This review presents current challenges to cervical cancer screening programs, focusing on recent molecular advances in HPV testing and potential improvements on risk stratification. AREAS COVERED High-risk (HR)-HPV DNA detection has been progressively incorporated into cervix cancer prevention programs based on its increased sensitivity. Advances in next-generation sequencing (NGS) are being rapidly applied to HPV typing. However, current HPV DNA tests lack specificity for identification of cervical precancer (CIN3). HPV typing methods were reviewed based on published literature, with a focus on these applications for screening and risk stratification in the emerging complex clinical scenario post-vaccine introduction. In addition, the potential for NGS technologies to increase specificity is discussed in regards to reflex testing of specimens for emerging biomarkers for cervix precancer/cancer. EXPERT COMMENTARY Integrative multi-disciplinary molecular tests accurately triaging exfoliated cervical specimens will improve cervical cancer prevention programs while simplifying healthcare procedures in HPV-infected women. Hence, the concept of a “liquid-biopsy” (i.e., “molecular” Pap test) highly specific for early identification of cervical precancerous lesions is of critical importance in the years to come. PMID:28277144

Bilateral vertebral artery lesion after dislocating cervical spine trauma. A case report.

PubMed

Wirbel, R; Pistorius, G; Braun, C; Eichler, A; Mutschler, W

1996-06-01

This case report illustrates the problems associated with diagnosis and management of vertebral artery injuries resulting from dislocating cervical spine trauma. Treatment involved the principles of anterior stabilization of dislocating cervical spine fracture as well as the diagnostic procedures and therapeutic modalities appropriate for vertebral artery lesions. Because vertebral artery injuries with cervical spine trauma are rarely symptomatic, they can easily be overlooked. Bilateral or dominant vertebral artery occlusion, however, may cause fatal ischemic damage to the brain stem and cerebellum. Cervical spine dislocation was stabilized immediately after admission using internal fixation by ventral plate and corticocancellous bone graft. Immediate angiography was performed when brain stem neurologic dysfunction manifested 36 hours after surgery. The patient was treated with anticoagulation, osmotherapy, and controlled hypertension. A fatal outcome resulted in this case of dominant left vertebral artery occlusion. Necropsy even revealed bilateral vertebral artery damage at the level of the osseous lesion. The possibility of the complication of a vertebral artery lesion should be kept in mind when examining patients with cervical spine trauma, especially in patients with fracture-dislocation. Immediate identification by vertebral angiography, magnetic resonance imaging, or thin-slice computed tomography scan is necessary for optimal management of this injury.

Evaluation of candidate methylation markers to detect cervical neoplasia.

PubMed

Shivapurkar, Narayan; Sherman, Mark E; Stastny, Victor; Echebiri, Chinyere; Rader, Janet S; Nayar, Ritu; Bonfiglio, Thomas A; Gazdar, Adi F; Wang, Sophia S

2007-12-01

Studies of cervical cancer and its immediate precursor, cervical intraepithelial neoplasia 3 (CIN3), have identified genes that often show aberrant DNA methylation and therefore represent candidate early detection markers. We used quantitative PCR assays to evaluate methylation in five candidate genes (TNFRSF10C, DAPK1, SOCS3, HS3ST2 and CDH1) previously demonstrated as methylated in cervical cancer. In this analysis, we performed methylation assays for the five candidate genes in 45 invasive cervical cancers, 12 histologically normal cervical specimens, and 23 liquid-based cervical cytology specimens confirmed by expert review as unequivocal demonstrating cytologic high-grade squamous intraepithelial lesions, thus representing the counterparts of histologic CIN3. We found hypermethylation of HS3ST2 in 93% of cancer tissues and 70% of cytology specimens interpreted as CIN3; hypermethylation of CDH1 was found in 89% of cancers and 26% of CIN3 cytology specimens. Methylation of either HS3ST2 or CDH1 was observed in 100% of cervical cancer tissues and 83% of CIN3 cytology specimens. None of the five genes showed detectable methylation in normal cervical tissues. Our data support further evaluation of HS3ST2 and CDH1 methylation as potential markers of cervical cancer and its precursor lesions.

Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study

PubMed Central

d'Assuncao, Jefferson; Irwig, Les; Macaskill, Petra; Chan, Siew F; Richards, Adele; Farnsworth, Annabelle

2007-01-01

Objective To compare the accuracy of liquid based cytology using the computerised ThinPrep Imager with that of manually read conventional cytology. Design Prospective study. Setting Pathology laboratory in Sydney, Australia. Participants 55 164 split sample pairs (liquid based sample collected after conventional sample from one collection) from consecutive samples of women choosing both types of cytology and whose specimens were examined between August 2004 and June 2005. Main outcome measures Primary outcome was accuracy of slides for detecting squamous lesions. Secondary outcomes were rate of unsatisfactory slides, distribution of squamous cytological classifications, and accuracy of detecting glandular lesions. Results Fewer unsatisfactory slides were found for imager read cytology than for conventional cytology (1.8% v 3.1%; P<0.001). More slides were classified as abnormal by imager read cytology (7.4% v 6.0% overall and 2.8% v 2.2% for cervical intraepithelial neoplasia of grade 1 or higher). Among 550 patients in whom imager read cytology was cervical intraepithelial neoplasia grade 1 or higher and conventional cytology was less severe than grade 1, 133 of 380 biopsy samples taken were high grade histology. Among 294 patients in whom imager read cytology was less severe than cervical intraepithelial neoplasia grade 1 and conventional cytology was grade 1 or higher, 62 of 210 biopsy samples taken were high grade histology. Imager read cytology therefore detected 71 more cases of high grade histology than did conventional cytology, resulting from 170 more biopsies. Similar results were found when one pathologist reread the slides, masked to cytology results. Conclusion The ThinPrep Imager detects 1.29 more cases of histological high grade squamous disease per 1000 women screened than conventional cytology, with cervical intraepithelial neoplasia grade 1 as the threshold for referral to colposcopy. More imager read slides than conventional slides were satisfactory for examination and more contained low grade cytological abnormalities. PMID:17604301

Improved segmentation of abnormal cervical nuclei using a graph-search based approach

NASA Astrophysics Data System (ADS)

Zhang, Ling; Liu, Shaoxiong; Wang, Tianfu; Chen, Siping; Sonka, Milan

2015-03-01

Reliable segmentation of abnormal nuclei in cervical cytology is of paramount importance in automation-assisted screening techniques. This paper presents a general method for improving the segmentation of abnormal nuclei using a graph-search based approach. More specifically, the proposed method focuses on the improvement of coarse (initial) segmentation. The improvement relies on a transform that maps round-like border in the Cartesian coordinate system into lines in the polar coordinate system. The costs consisting of nucleus-specific edge and region information are assigned to the nodes. The globally optimal path in the constructed graph is then identified by dynamic programming. We have tested the proposed method on abnormal nuclei from two cervical cell image datasets, Herlev and H and E stained liquid-based cytology (HELBC), and the comparative experiments with recent state-of-the-art approaches demonstrate the superior performance of the proposed method.

Inhibition of Listeria monocytogenes by propionic acid-based ingredients in cured deli-style Turkey.

PubMed

Glass, Kathleen A; McDonnell, Lindsey M; Von Tayson, Roxanne; Wanless, Brandon; Badvela, Mani

2013-12-01

Listeria monocytogenes growth can be controlled on ready-to-eat meats through the incorporation of antimicrobial ingredients into the formulation or by postlethality kill steps. However, alternate approaches are needed to provide options that reduce sodium content but maintain protection against pathogen growth in meats after slicing. The objective of this study was to determine the inhibition of L. monocytogenes by propionic acid-based ingredients in high-moisture, cured turkey stored at 4 or 7°C. Six formulations of sliced, cured (120 ppm of NaNO2 ), deli-style turkey were tested, including control without antimicrobials, 3.2% lactate-diacetate blend (LD), 0.4% of a liquid propionate-benzoate-containing ingredient, or 0.3, 0.4, and 0.5% of a liquid propionate-containing ingredient. Products were inoculated with 5 log CFU L. monocytogenes per 100-g package (3 log CFU/ml rinsate), vacuum-sealed, and stored at 4 or 7°C for up to 12 weeks; and populations were enumerated by plating on modified Oxford agar. As expected, the control without antimicrobials supported rapid growth, with >2 log average per ml rinsate increase within 4 weeks of storage at 4°C, whereas growth was observed at 6 weeks for the LD treatment. For both replicate trials, all treatments that contained liquid propionate or propionate-benzoate limited L. monocytogenes growth to an increase of <1 log through 9 weeks storage at 4°C. Sporadic growth (>1-log increase) was observed in individual samples for all propionate-containing treatments at weeks 10, 11, and 12. As expected, L. monocytogenes grew more rapidly when products were stored at 7°C, but trends in relative inhibition were similar to those observed at 4°C. These results verify that propionate-based ingredients inhibit growth of L. monocytogenes on sliced, high-moisture, cured turkey and can be considered as an alternative to reduce sodium-based salts while maintaining food safety.

Application of Fourier transform-second-harmonic generation imaging to the rat cervix.

PubMed

Lau, T Y; Sangha, H K; Chien, E K; McFarlin, B L; Wagoner Johnson, A J; Toussaint, K C

2013-07-01

We present the application of Fourier transform-second-harmonic generation (FT-SHG) imaging to evaluate the arrangement of collagen fibers in five nonpregnant rat cervices. Tissue slices from the mid-cervix and near the external orifice of the cervix were analyzed in both two-dimensions (2D) and three-dimensions (3D). We validate that the cervical microstructure can be quantitatively assessed in three dimensions using FT-SHG imaging and observe collagen fibers oriented both in and out-of-plane in the outermost and the innermost layers, which cannot be observed using 2D FT-SHG analysis alone. This approach has the potential to be a clinically applicable method for measuring progressive changes in collagen organization during cervical remodeling in humans. © 2013 The Authors Journal of Microscopy © 2013 Royal Microscopical Society.

Post-traumatic Unilateral Avulsion of the Abducens Nerve with Damage to Cranial Nerves VII and VIII: Case Report.

PubMed

Yamasaki, Fumiyuki; Akiyama, Yuji; Tsumura, Ryu; Kolakshyapati, Manish; Adhikari, Rupendra Bahadur; Takayasu, Takeshi; Nosaka, Ryo; Kurisu, Kaoru

2016-07-01

Traumatic injuries of the abducens nerve as a consequence of facial and/or head trauma occur with or without associated cervical or skull base fracture. This is the first report on unilateral avulsion of the abducens nerve in a 29-year-old man with severe right facial trauma. In addition, he exhibited mild left facial palsy, and moderate left hearing disturbance. Magnetic resonance imaging (MRI) using fast imaging employing steady-state acquisition (FIESTA) revealed avulsion of left sixth cranial nerve. We recommend thin-slice MR examination in patients with abducens palsy after severe facial and/or head trauma.

HPV infection in women with and without cervical cancer in Conakry, Guinea.

PubMed

Keita, N; Clifford, G M; Koulibaly, M; Douno, K; Kabba, I; Haba, M; Sylla, B S; van Kemenade, F J; Snijders, P J F; Meijer, C J L M; Franceschi, S

2009-07-07

Cervical cancer incidence in western Africa is among the highest in the world. To investigate human papillomavirus (HPV) infection in Guinea, we obtained cervical specimens from 831 women aged 18-64 years from the general population of the capital Conakry and from 77 locally diagnosed invasive cervical cancers (ICC). Human papillomavirus was detected using a GP5+/6+ PCR-based assay. Among the general population, the prevalence of cervical abnormalities was 2.6% by visual inspection and 9.5% by liquid-based cytology. Fourteen of 15 high-grade squamous intraepithelial lesions were visual inspection-negative. Human papillomavirus prevalence was 50.8% (32.1% for high-risk types) and relatively constant across all age groups. Being single or reporting > or =3 sexual partners was significantly associated with HPV positivity. HPV16 was the most common type, both among the general population (7.3%) and, notably in ICC (48.6%). HPV45 (18.6%) and HPV18 (14.3%), the next most common types in ICC, were also more common in ICC than in HPV-positive women with normal cytology from the general population. The heavy burden of HPV infection and severe cervical lesions in Guinean women calls for new effective interventions. Sixty-three per cent of cervical cancers are theoretically preventable by HPV16/18 vaccines in Guinea; perhaps more if some cross-protection exists with HPV45.

HPV infection in women with and without cervical cancer in Conakry, Guinea

PubMed Central

Keita, N; Clifford, G M; Koulibaly, M; Douno, K; Kabba, I; Haba, M; Sylla, B S; van Kemenade, F J; Snijders, P J F; Meijer, C J L M; Franceschi, S

2009-01-01

Background: Cervical cancer incidence in western Africa is among the highest in the world. Methods: To investigate human papillomavirus (HPV) infection in Guinea, we obtained cervical specimens from 831 women aged 18–64 years from the general population of the capital Conakry and from 77 locally diagnosed invasive cervical cancers (ICC). Human papillomavirus was detected using a GP5+/6+ PCR-based assay. Results: Among the general population, the prevalence of cervical abnormalities was 2.6% by visual inspection and 9.5% by liquid-based cytology. Fourteen of 15 high-grade squamous intraepithelial lesions were visual inspection-negative. Human papillomavirus prevalence was 50.8% (32.1% for high-risk types) and relatively constant across all age groups. Being single or reporting ⩾3 sexual partners was significantly associated with HPV positivity. HPV16 was the most common type, both among the general population (7.3%) and, notably in ICC (48.6%). HPV45 (18.6%) and HPV18 (14.3%), the next most common types in ICC, were also more common in ICC than in HPV-positive women with normal cytology from the general population. Conclusion: The heavy burden of HPV infection and severe cervical lesions in Guinean women calls for new effective interventions. Sixty-three per cent of cervical cancers are theoretically preventable by HPV16/18 vaccines in Guinea; perhaps more if some cross-protection exists with HPV45. PMID:19536089

Cost analysis of different cervical cancer screening strategies in Mexico.

PubMed

Beal, Christyn M; Salmerón, Jorge; Flores, Yvonne N; Torres, Leticia; Granados-García, Víctor; Dugan, Ellen; Lazcano-Ponce, Eduardo

2014-01-01

To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS) in Mexico. We estimated the costs and outcomes of the following CCSS: a) conventional Papanicolaou smear (Pap) alone; b) high-risk human papilloma virus testing (HR-HPV) as primary screening with Pap as reflex triage; c) HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC) and immunostaining for p16/Ki67 testing as reflex triage, and d) co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico.

Technologic advances for evaluation of cervical cytology: is newer better?

PubMed

Hartmann, K E; Nanda, K; Hall, S; Myers, E

2001-12-01

Among those women who have cervical cancer and have been screened, 14% to 33% of the cases represent failure to detect abnormalities that existed at the time of screening. New technologies intended to improve detection of cytologic abnormalities include liquid-based, thin-layer cytology (ThinPrep, AutoCyte), computerized rescreening (PAPNET), and algorithm-based computer rescreening (AutoPap). This report combines evidence reviews conducted for the U.S. Preventive Services Task Force and the Agency for Healthcare Research and Quality, in which we systematically identified articles on cervical neoplasia, cervical dysplasia, and screening published between January 1966 and March 2001. We note the challenges for improving screening methods, providing an overview of methods for collecting and evaluating cytologic samples, and examining the evidence about the diagnostic performance of new technologies for detecting cervical lesions. Using standard criteria for evaluation of the diagnostic tests, we determined that knowledge about the sensitivity, specificity, and predictive values of new technologies is meager. Only one study of liquid-based cytology used a reference standard of colposcopy, with histology as indicated, to assess participants with normal screening results. Lack of an adequate reference standard is the overwhelming reason that test characteristics cannot be properly assessed or compared. Most publications compare results of screening using the new technology with expert panel review of the cytologic specimen. In that case, the tests are not independent measures and do nothing to relate the screening test findings to the true status of the cervix, making determination of false-negatives, and thus sensitivity, specificity, and negative predictive value, impossible. We did not identify any literature about health outcomes or cost effectiveness of using these tools in a system of screening. For the purposes of guiding decision making about choice of screening tools, the current evidence is inadequate to gauge whether new technologies are "better" than conventional cytology..

Frequency of unsatisfactory cervical cytology smears in cancer screening of Japanese women: A systematic review and meta-analysis.

PubMed

Hosono, Satoyo; Terasawa, Teruhiko; Katayama, Takafumi; Sasaki, Seiju; Hoshi, Keika; Hamashima, Chisato

2018-04-01

The Bethesda system (TBS) has been used for cervical cytological diagnosis in Japan since 2008. Evaluation of specimen adequacy is the most important aspect of quality assurance and for precise diagnosis in TBS. A systematic review and meta-analysis were carried out to assess the unsatisfactory specimen rate in the primary cervical cancer screening setting in Japan. Ovid Medline and Ichushi-Web databases were searched from inception through to May 2017. Prospective and retrospective studies that reported the proportion of unsatisfactory specimens in healthy asymptomatic Japanese women in a cervical cancer screening program were eligible for inclusion; 17 studies were included in the meta-analysis. The random-effects model meta-analysis calculated summary estimates of the unsatisfactory rate of 0.60% (95% confidence interval [CI], 0.18-1.96%; I 2 = 99%) for conventional cytology and 0.04% (95% CI, 0.00-0.35%; I 2 = 99%) for liquid-based cytology (LBC). However, comparative results between conventional and liquid-based cytology, based on four direct and nine comparative studies, showed no significant difference (summary odds ratio = 3.5 × 10 -2 favoring LBC [95% CI, 6.9 × 10 -4 -1.7]; I 2 = 98%). In the subgroup analyses and meta-regressions, use of non-cotton devices for conventional cytology and use of a particular platform for LBC were associated with lower unsatisfactory rates. Meta-regression also suggested chronological improvement in unsatisfactory rates for both tests. In Japanese cervical cancer screening programs, conventional cytology remains prevalent. Future research needs to focus on evaluating the impact of screening programs using LBC by comparing the accuracy, performance, and cost-effectiveness with conventional cytology in the Japanese population. © 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Clinical evaluation of high-risk HPV detection on self-samples using the indicating FTA-elute solid-carrier cartridge.

PubMed

Geraets, D T; van Baars, R; Alonso, I; Ordi, J; Torné, A; Melchers, W J G; Meijer, C J L M; Quint, W G V

2013-06-01

High-risk human papillomavirus (hrHPV) testing in cervical screening is usually performed on physician-taken cervical smears in liquid-based medium. However, solid-state specimen carriers allow easy, non-hazardous storage and transportation and might be suitable for self-collection by non-responders in screening and in low-resource settings. We evaluated the adequacy of self-collected cervicovaginal (c/v) samples using a Viba-brush stored on an Indicating FTA-elute cartridge (FTA-based self-sampling) for hrHPV testing in women referred to a gynecology clinic due to an abnormal smear. 182 women accepted to self-collect a c/v sample. After self-sampling, a physician obtained a conventional liquid-based cervical smear. Finally, women were examined by colposcopy and a biopsy was taken when clinically indicated. Self-samples required only simple DNA elution, and DNA was extracted from physician-obtained samples. Both samples were tested for 14 hrHPVs by GP5+/6+-EIA-LQ Test and SPF(10)-DEIA-LiPA(25). Both assays detected significantly more hrHPV in physician-collected specimens than in self-collected samples (75.3% and 67.6% by SPF(10); 63.3% and 53.3% by GP5+/6+, respectively). The combination of physician-collected specimen and GP5+/6+ testing demonstrated the optimal balance in sensitivity (98.0%) and specificity (48.1%) for CIN2+ detection in this referral population. A test system of FTA-based self-collection and SPF(10) hrHPV detection approached this sensitivity (95.9%) and specificity (42.9%). These results show that the clinical performance of hrHPV detection is determined by both the sample collection system and the test method. FTA-based self-collection with SPF(10) testing might be valuable when a liquid-based medium cannot be used, but requires further investigation in screening populations. Copyright © 2013 Elsevier B.V. All rights reserved.

Primary cervical cancer screening with HPV testing compared with liquid-based cytology: results of round 1 of a randomised controlled trial -- the HPV FOCAL Study.

PubMed

Ogilvie, G S; Krajden, M; van Niekerk, D J; Martin, R E; Ehlen, T G; Ceballos, K; Smith, L W; Kan, L; Cook, D A; Peacock, S; Stuart, G C E; Franco, E L; Coldman, A J

2012-12-04

Round 1 data of human papillomavirus (HPV) FOCAL, a three-arm, randomised trial, which aims to establish the efficacy of HPV DNA testing as a primary screen for cervical cancer, are presented. The three arms are: Control arm - liquid based cytology with atypical squamous cells of unknown significance (ASC-US) triage with hrHPV testing; Intervention Arm - hrHPV at entry with liquid-based cytology (LBC) triage of hrHPV positives, with exit screen at 4 years; Safety check arm - hrHPV at entry with LBC triage of hrHPV positives with exit screen at 2 years. A total of 6154 women were randomised to the control arm and 12 494 to the HPV arms (intervention and safety check). In the HPV arm, the baseline cervical intraepithelial neoplasia (CIN)2+ and CIN3+ rate was 9.2/1000 (95%CI; 7.4, 10.9) and 4.8/1000 (95%CI; 3.6, 6.1), which increased to 16.1/1000 (95%CI 13.2, 18.9) for CIN2+ and to 8.0/1000 (95%CI; 5.9, 10.0) for CIN3+ after subsequent screening of HPV-DNA-positive/cytology-negative women. Detection rate in the control arm remained unchanged after subsequent screening of ASC-US-positive/hrHPV DNA-negative women at 11.0/1000 for CIN2+ and 5.0/1000 for CIN3+. After subsequent screening of women who were either hrHPV positive/cytology negative or ASC-US positive/HPV negative, women randomised to the HPV arms had increased CIN2+ detection compared with women randomised to the cytology arm.

Agreement for HPV genotyping detection between self-collected specimens on a FTA cartridge and clinician-collected specimens

PubMed Central

Guan, YaoYao; Gravitt, Patti E.; Howard, Roslyn; Eby, Yolanda J.; Wang, Shaoming; Li, Belinda; Feng, Changyan; Qiao, You-Lin; Castle, Philip E.

2016-01-01

The current method of transporting self-collected cervicovaginal specimen for HPV DNA testing relies on liquid based medium, which is challenging and expensive to transport. A novel, dry storage and transportation device, Whatman indicating FTA™ Elute Cartridge, avoids some of the pitfalls of liquid-based medium. This method has been shown to be comparable to liquid-based collection medium, but relative performance of self-collected (SC) and clinician-collected (CC) samples onto FTA cards has not been reported. The objective of this study is to compare the analytic performance of self- and clinician-collected samples onto FTA cartridges for the detection of carcinogenic HPV using Linear Array. There was a 91% agreement, 69% positive agreement, and kappa of 0.75 between the clinician-collected and self-collected specimens for detection of any carcinogenic HPV genotype. When the HPV results were categorized hierarchically according to cervical cancer risk, there was no difference in the distribution of the HPV results for the clinician- and self-collected specimens (p = 0.7). This study concludes that FTA elute cartridge is a promising method of specimen transport for cervical cancer screening programs considering using self-collected specimen and HPV testing. Larger studies with clinical endpoints are now needed to assess the clinical performance. PMID:23370404

Age Specific Cytological Abnormalities in Women Screened for Cervical Cancer in the Emirate of Abu Dhabi.

PubMed

Al Zaabi, Muna; Al Muqbali, Shaikha; Al Sayadi, Thekra; Al Ameeri, Suhaila; Coetsee, Karin; Balayah, Zuhur; Ortashi, Osman

2015-01-01

Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 270,000 deaths each year. Globally, it is estimated that over one million women currently have cervical cancer, most of whom have not been diagnosed, or have no access to treatment that could cure them or prolong their lives. In the United Arab Emirates (UAE) cervical cancer is the third most common cancer in women. A population-based cross-sectional retrospective survey of cervical smear abnormalities was conducted in the Emirate of Abu Dhabi, UAE, from January 2013 to December 2013 by collecting consecutive liquid-based cytology samples from the Department of Pathology at the SKMC Hospital in Abu Dhabi city. The total number of women screened for cervical cancer for the year 2013 at SKMC was 4,593, with 225 (4.89%) abnormal smears. The majority of the abnormal smear results were atypical squamous cells of undetermined significance (ASCUS) 114 (2.48%). This study showed 60% increase in the rate of abnormal cervical smears in the UAE over the last 10 years. In this study the highest incidence of high grade abnormalities were seen in women above the age of 61 years (1.73%), this might be due to the fact that this group of women missed the chance of screening of cervical cancer earlier in their lives or could be explained by the well-known second peak of HPV infection seen in many prevalence studies. We conclude that the rate of abnormal cervical smear in the screened Abu Dhabi women is not different from the rate in developed countries. A notable increase in both low and high grade abnormalities has occurred within the last decade.

Three-dimensional printing-based electro-millifluidic devices for fabricating multi-compartment particles.

PubMed

Chen, Qiu Lan; Liu, Zhou; Shum, Ho Cheung

2014-11-01

In this work, we demonstrate the use of stereolithographic 3D printing to fabricate millifluidic devices, which are used to engineer particles with multiple compartments. As the 3D design is directly transferred to the actual prototype, this method accommodates 3D millimeter-scaled features that are difficult to achieve by either lithographic-based microfabrication or traditional macrofabrication techniques. We exploit this approach to produce millifluidic networks to deliver multiple fluidic components. By taking advantage of the laminar flow, the fluidic components can form liquid jets with distinct patterns, and each pattern has clear boundaries between the liquid phases. Afterwards, droplets with controlled size are fabricated by spraying the liquid jet in an electric field, and subsequently converted to particles after a solidification step. As a demonstration, we fabricate calcium alginate particles with structures of (1) slice-by-slice multiple lamellae, (2) concentric core-shells, and (3) petals surrounding the particle centers. Furthermore, distinct hybrid particles combining two or more of the above structures are also obtained. These compartmentalized particles impart spatially dependent functionalities and properties. To show their applicability, various ingredients, including fruit juices, drugs, and magnetic nanoparticles are encapsulated in the different compartments as proof-of-concepts for applications, including food, drug delivery, and bioassays. Our 3D printed electro-millifluidic approach represents a convenient and robust method to extend the range of structures of functional particles.

Establishment and characterization of a differentiated epithelial cell culture model derived from the porcine cervix uteri

PubMed Central

2012-01-01

Background Cervical uterine epithelial cells maintain a physiological and pathogen-free milieu in the female mammalian reproductive tract and are involved in sperm-epithelium interaction. Easily accessible, differentiated model systems of the cervical epithelium are not yet available to elucidate the underlying molecular mechanisms within these highly specialized cells. Therefore, the aim of the study was to establish a cell culture of the porcine cervical epithelium representing in vivo-like properties of the tissue. Results We tested different isolation methods and culture conditions and validated purity of the cultured cells by immunohistochemistry against keratins. We could reproducibly culture pure epithelial cells from cervical tissue explants. Based on a morphology score and the WST-1 Proliferation Assay, we optimized the growth medium composition. Primary porcine cervical cells performed best in conditioned Ham's F-12, containing 10% FCS, EGF and insulin. After cultivation in an air-liquid interface for three weeks, the cells showed a discontinuously multilayered phenotype. Finally, differentiation was validated via immunohistochemistry against beta catenin. Mucopolysaccharide production could be shown via alcian blue staining. Conclusions We provide the first suitable protocol to establish a differentiated porcine epithelial model of the cervix uteri, based on easily accessible cells using slaughterhouse material. PMID:22429795

Metal artifact reduction in MRI-based cervical cancer intracavitary brachytherapy

NASA Astrophysics Data System (ADS)

Rao, Yuan James; Zoberi, Jacqueline E.; Kadbi, Mo; Grigsby, Perry W.; Cammin, Jochen; Mackey, Stacie L.; Garcia-Ramirez, Jose; Goddu, S. Murty; Schwarz, Julie K.; Gach, H. Michael

2017-04-01

Magnetic resonance imaging (MRI) plays an increasingly important role in brachytherapy planning for cervical cancer. Yet, metal tandem, ovoid intracavitary applicators, and fiducial markers used in brachytherapy cause magnetic susceptibility artifacts in standard MRI. These artifacts may impact the accuracy of brachytherapy treatment and the evaluation of tumor response by misrepresenting the size and location of the metal implant, and distorting the surrounding anatomy and tissue. Metal artifact reduction sequences (MARS) with high bandwidth RF selective excitations and turbo spin-echo readouts were developed for MRI of orthopedic implants. In this study, metal artifact reduction was applied to brachytherapy of cervical cancer using the orthopedic metal artifact reduction (O-MAR) sequence. O-MAR combined MARS features with view angle tilting and slice encoding for metal artifact correction (SEMAC) to minimize in-plane and through-plane susceptibility artifacts. O-MAR improved visualization of the tandem tip on T2 and proton density weighted (PDW) imaging in phantoms and accurately represented the diameter of the tandem. In a pilot group of cervical cancer patients (N  =  7), O-MAR significantly minimized the blooming artifact at the tip of the tandem in PDW MRI. There was no significant difference observed in artifact reduction between the weak (5 kHz, 7 z-phase encodes) and medium (10 kHz, 13 z-phase encodes) SEMAC settings. However, the weak setting allowed a significantly shorter acquisition time than the medium setting. O-MAR also reduced susceptibility artifacts associated with metal fiducial markers so that they appeared on MRI at their true dimensions.

Drying characteristics of pumpkin ( Cucurbita moschata) slices in convective and freeze dryer

NASA Astrophysics Data System (ADS)

Caliskan, Gulsah; Dirim, Safiye Nur

2017-06-01

This study was intended to determine the drying and rehydration kinetics of convective and freeze dried pumpkin slices (0.5 × 3.5 × 0.5 cm). A pilot scale tray drier (at 80 ± 2 °C inlet temperature, 1 m s-1 air velocity) and freeze drier (13.33 kPa absolute pressure, condenser temperature of -48 ± 2 °C) were used for the drying experiments. Drying curves were fitted to six well-known thin layer drying models. Nonlinear regression analysis was used to evaluate the parameters of the selected models by using statistical software SPSS 16.0 (SPSS Inc., USA). For the convective and freeze drying processes of pumpkin slices, the highest R2 values, and the lowest RMSE as well as χ2 values were obtained from Page model. The effective moisture diffusivity (Deff) of the convective and freeze dried pumpkin slices were obtained from the Fick's diffusion model, and they were found to be 2.233 × 10-7 and 3.040 × 10-9 m2s-1, respectively. Specific moisture extraction rate, moisture extraction rate, and specific energy consumption values were almost twice in freeze drying process. Depending on the results, moisture contents and water activity values of pumpkin slices were in acceptable limits for safe storage of products. The rehydration behaviour of [at 18 ± 2 and 100 ± 2 °C for 1:25, 1:50, 1:75, 1:100, and 1:125 solid:liquid ratios (w:w)] dried pumpkin slices was determined by Peleg's model with the highest R2. The highest total soluble solid loss of pumpkin slices was observed for the rehydration experiment which performed at 1:25 solid: liquid ratio (w:w). Rehydration ratio of freeze dried slices was found 2-3 times higher than convective dried slices.

Agreement for HPV genotyping detection between self-collected specimens on a FTA cartridge and clinician-collected specimens.

PubMed

Guan, Yaoyao; Gravitt, Patti E; Howard, Roslyn; Eby, Yolanda J; Wang, Shaoming; Li, Belinda; Feng, Changyan; Qiao, You-Lin; Castle, Philip E

2013-04-01

The current method of transporting self-collected cervicovaginal specimen for HPV DNA testing relies on liquid based medium, which is challenging and expensive to transport. A novel, dry storage and transportation device, Whatman indicating FTA™ Elute Cartridge, avoids some of the pitfalls of liquid-based medium. This method has been shown to be comparable to liquid-based collection medium, but relative performance of self-collected (SC) and clinician-collected (CC) samples onto FTA cards has not been reported. The objective of this study is to compare the analytic performance of self- and clinician-collected samples onto FTA cartridges for the detection of carcinogenic HPV using Linear Array. There was a 91% agreement, 69% positive agreement, and kappa of 0.75 between the clinician-collected and self-collected specimens for detection of any carcinogenic HPV genotype. When the HPV results were categorized hierarchically according to cervical cancer risk, there was no difference in the distribution of the HPV results for the clinician- and self-collected specimens (p=0.7). This study concludes that FTA elute cartridge is a promising method of specimen transport for cervical cancer screening programs considering using self-collected specimen and HPV testing. Larger studies with clinical endpoints are now needed to assess the clinical performance. Copyright © 2012 Elsevier B.V. All rights reserved.

Investigation of Vapor Cooling Enhancements for Applications on Large Cryogenic Systems

NASA Technical Reports Server (NTRS)

Ameen, Lauren; Zoeckler, Joseph

2017-01-01

The need to demonstrate and evaluate the effectiveness of heat interception methods for use on a relevant cryogenic propulsion stage at a system level has been identified. Evolvable Cryogenics (eCryo) Structural Heat Intercept, Insulation and Vibration Evaluation Rig (SHIIVER) will be designed with vehicle specific geometries (SLS Exploration Upper Stage (EUS) as guidance) and will be subjected to simulated space environments. One method of reducing structure-born heat leak being investigated utilizes vapor-based heat interception. Vapor-based heat interception could potentially reduce heat leak into liquid hydrogen propulsion tanks, increasing potential mission length or payload capability. Due to the high number of unknowns associated with the heat transfer mechanism and integration of vapor-based heat interception on a realistic large-scale skirt design, a sub-scale investigation was developed. The sub-project effort is known as the Small-scale Laboratory Investigation of Cooling Enhancements (SLICE). The SLICE aims to study, design, and test sub-scale multiple attachments and flow configuration concepts for vapor-based heat interception of structural skirts. SLICE will focus on understanding the efficiency of the heat transfer mechanism to the boil-off hydrogen vapor by varying the fluid network designs and configurations. Various analyses were completed in MATLAB, Excel VBA, and COMSOL Multiphysics to understand the optimum flow pattern for heat transfer and fluid dynamics. Results from these analyses were used to design and fabricate test article subsections of a large forward skirt with vapor cooling applied. The SLICE testing is currently being performed to collect thermal mechanical performance data on multiple skirt heat removal designs while varying inlet vapor conditions necessary to intercept a specified amount of heat for a given system. Initial results suggest that applying vapor-cooling provides a 50 heat reduction in conductive heat transmission along the skirt to the tank. The information obtained by SLICE will be used by the SHIIVER engineering team to design and implement vapor-based heat removal technology into the SHIIVER forward skirt hardware design.

Histology Verification Demonstrates That Biospectroscopy Analysis of Cervical Cytology Identifies Underlying Disease More Accurately than Conventional Screening: Removing the Confounder of Discordance

PubMed Central

Gajjar, Ketan; Ahmadzai, Abdullah A.; Valasoulis, George; Trevisan, Júlio; Founta, Christina; Nasioutziki, Maria; Loufopoulos, Aristotelis; Kyrgiou, Maria; Stasinou, Sofia Melina; Karakitsos, Petros; Paraskevaidis, Evangelos; Da Gama-Rose, Bianca; Martin-Hirsch, Pierre L.; Martin, Francis L.

2014-01-01

Background Subjective visual assessment of cervical cytology is flawed, and this can manifest itself by inter- and intra-observer variability resulting ultimately in the degree of discordance in the grading categorisation of samples in screening vs. representative histology. Biospectroscopy methods have been suggested as sensor-based tools that can deliver objective assessments of cytology. However, studies to date have been apparently flawed by a corresponding lack of diagnostic efficiency when samples have previously been classed using cytology screening. This raises the question as to whether categorisation of cervical cytology based on imperfect conventional screening reduces the diagnostic accuracy of biospectroscopy approaches; are these latter methods more accurate and diagnose underlying disease? The purpose of this study was to compare the objective accuracy of infrared (IR) spectroscopy of cervical cytology samples using conventional cytology vs. histology-based categorisation. Methods Within a typical clinical setting, a total of n = 322 liquid-based cytology samples were collected immediately before biopsy. Of these, it was possible to acquire subsequent histology for n = 154. Cytology samples were categorised according to conventional screening methods and subsequently interrogated employing attenuated total reflection Fourier-transform IR (ATR-FTIR) spectroscopy. IR spectra were pre-processed and analysed using linear discriminant analysis. Dunn’s test was applied to identify the differences in spectra. Within the diagnostic categories, histology allowed us to determine the comparative efficiency of conventional screening vs. biospectroscopy to correctly identify either true atypia or underlying disease. Results Conventional cytology-based screening results in poor sensitivity and specificity. IR spectra derived from cervical cytology do not appear to discriminate in a diagnostic fashion when categories were based on conventional screening. Scores plots of IR spectra exhibit marked crossover of spectral points between different cytological categories. Although, significant differences between spectral bands in different categories are noted, crossover samples point to the potential for poor specificity and hampers the development of biospectroscopy as a diagnostic tool. However, when histology-based categories are used to conduct analyses, the scores plot of IR spectra exhibit markedly better segregation. Conclusions Histology demonstrates that ATR-FTIR spectroscopy of liquid-based cytology identifies the presence of underlying atypia or disease missed in conventional cytology screening. This study points to an urgent need for a future biospectroscopy study where categories are based on such histology. It will allow for the validation of this approach as a screening tool. PMID:24404130

Polar POLICRYPS diffractive structures generate cylindrical vector beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alj, Domenico; Caputo, Roberto, E-mail: roberto.caputo@fis.unical.it; Umeton, Cesare

2015-11-16

Local shaping of the polarization state of a light beam is appealing for a number of applications. This can be achieved by employing devices containing birefringent materials. In this article, we present one such enables converting a uniformly circularly polarized beam into a cylindrical vector beam (CVB). This device has been fabricated by exploiting the POLICRYPS (POlymer-LIquid CRYstals-Polymer-Slices) photocuring technique. It is a liquid-crystal-based optical diffraction grating featuring polar symmetry of the director alignment. We have characterized the resulting CVB profile and polarization for the cases of left and right circularly polarized incoming beams.

Ezrin and E-cadherin expression profile in cervical cytology: a prognostic marker for tumor progression in cervical cancer.

PubMed

Zacapala-Gómez, Ana E; Navarro-Tito, Napoleón; Alarcón-Romero, Luz Del C; Ortuño-Pineda, Carlos; Illades-Aguiar, Berenice; Castañeda-Saucedo, Eduardo; Ortiz-Ortiz, Julio; Garibay-Cerdenares, Olga L; Jiménez-López, Marco A; Mendoza-Catalán, Miguel A

2018-03-27

Cervical cancer (CC) is the fourth cause of mortality by neoplasia in women worldwide. The use of immunomarkers is an alternative tool to complement currently used algorithms for detection of cancer, and to improve selection of therapeutic schemes. Aberrant expression of Ezrin and E-cadherin play an important role in tumor invasion. In this study we analyzed Ezrin and E-cadherin expression in liquid-based cervical cytology samples, and evaluated their potential use as prognostic immunomarkers. Immunocytochemical staining of Ezrin and E-cadherin was performed in cervical samples of 125 patients. The cytological or histological diagnostic was performed by Papanicolaou staining or H&E staining, respectively. HPV genotyping was determined using INNO-LIPA Genotyping Extra kit and the HPV physical status by in situ hybridization. Ezrin expression in HaCaT, HeLa and SiHa cell lines was determined by immunocytochemistry, immunofluorescence and Western blot. High Ezrin expression was observed in cervical cancer samples (70%), samples with multiple infection by HR-HPV (43%), and samples with integrated viral genome (47%). High Ezrin expression was associated with degree of SIL, viral genotype and physical status. In contrast, low E-cadherin expression was found in cervical cancer samples (95%), samples with multiple infection by HR-HPV/LR-HPV (87%) and integrated viral genome (72%). Low E-cadherin expression was associated with degree of SIL and viral genotype. Interestingly, Ezrin nuclear staining was associated with degree of SIL and viral genotype. High Ezrin expression, high percent of nuclear Ezrin and low E-cadherin expression behaved as risk factors for progression to HSIL and cervical cancer. Ezrin and E-cadherin expression profile in cervical cytology samples could be a potential prognostic marker, useful for identifying cervical lesions with a high-risk of progression to cervical cancer.

Long-term storage and safe retrieval of human papillomavirus DNA using FTA elute cards.

PubMed

Barth, Heidi; Morel, Adrien; Mougin, Christiane; Averous, Gerlinde; Legrain, Michèle; Fender, Muriel; Risch, Simone; Fafi-Kremer, Samira; Velten, Michel; Oudet, Pierre; Baldauf, Jean-Jacques; Stoll-Keller, Françoise

2016-03-01

Biobanking or collection and storage of specimens for future research purposes have become an essential tool in many fields of biomedical research and aims to provide a better understanding of disease mechanisms as well as the identification of disease-specific biomarkers that can navigate in complex diseases. In this study, we assessed the use of Flinders Technology Associates (FTA) cards as a long-term storage device for cervical specimens with suspected human papillomavirus (HPV) infections. HPV detection and genotyping results in liquid-based transport media were compared to HPV results from FTA cards. The overall agreement for the presence of any HPV infection between liquid-based medium and FTA cards stored for 1 year at ambient temperature was 100%. Reproducibility analysis of HPV detection and genotyping from FTA cards demonstrated that FTA cards are a reliable medium to store and preserve viral nucleic acids. Biobanking of cervical cells on FTA cards may provide a key resource for epidemiological and retrospective HPV studies. Copyright © 2015 Elsevier B.V. All rights reserved.

DeepPap: Deep Convolutional Networks for Cervical Cell Classification.

PubMed

Zhang, Ling; Le Lu; Nogues, Isabella; Summers, Ronald M; Liu, Shaoxiong; Yao, Jianhua

2017-11-01

Automation-assisted cervical screening via Pap smear or liquid-based cytology (LBC) is a highly effective cell imaging based cancer detection tool, where cells are partitioned into "abnormal" and "normal" categories. However, the success of most traditional classification methods relies on the presence of accurate cell segmentations. Despite sixty years of research in this field, accurate segmentation remains a challenge in the presence of cell clusters and pathologies. Moreover, previous classification methods are only built upon the extraction of hand-crafted features, such as morphology and texture. This paper addresses these limitations by proposing a method to directly classify cervical cells-without prior segmentation-based on deep features, using convolutional neural networks (ConvNets). First, the ConvNet is pretrained on a natural image dataset. It is subsequently fine-tuned on a cervical cell dataset consisting of adaptively resampled image patches coarsely centered on the nuclei. In the testing phase, aggregation is used to average the prediction scores of a similar set of image patches. The proposed method is evaluated on both Pap smear and LBC datasets. Results show that our method outperforms previous algorithms in classification accuracy (98.3%), area under the curve (0.99) values, and especially specificity (98.3%), when applied to the Herlev benchmark Pap smear dataset and evaluated using five-fold cross validation. Similar superior performances are also achieved on the HEMLBC (H&E stained manual LBC) dataset. Our method is promising for the development of automation-assisted reading systems in primary cervical screening.

New approach to evaluate rotation of cervical vertebrae

NASA Astrophysics Data System (ADS)

Hahn, Matthias

2001-07-01

Functional deficits after whiplash injury can be analyzed with a quite novel radiologic method by examination of joint-blocks in C0/1 and C1/2. Thereto the movability of C0, C1 and C2 is determined with three spiral CT-scans of the patient's cervical spine. One series in neutral and one in maximal active lateral right and left rotation each. Previous methods were slice based and time consuming when manually evaluated. We propose a new approach to a computation of these angles in 3D. After a threshold segmentation of bone tissue, a rough 2D classification takes place for C0, C1 and C2 in each rotation series. The center of an axial rotation for each vertebra is gained from the approximation of its center of gravity. The rotation itself is estimated by a cross-correlation of the radial distance functions. From the previous rotation the results are taken to initialize a 3D matching algorithm based on the sum of squared differences in intensity. The optimal match of the vertebrae is computed by means of the multidimensional Powell minimization algorithm. The three translational and three rotational components build a six-dimensional search-space. The vertebrae detection and rotation computation is done fully automatic.

Performance of a new HPV and biomarker assay in the management of hrHPV positive women: Subanalysis of the ongoing multicenter TRACE clinical trial (n > 6,000) to evaluate POU4F3 methylation as a potential biomarker of cervical precancer and cancer.

PubMed

Kocsis, Adrienn; Takács, Tibor; Jeney, Csaba; Schaff, Zsuzsa; Koiss, Róbert; Járay, Balázs; Sobel, Gábor; Pap, Károly; Székely, István; Ferenci, Tamás; Lai, Hung-Cheng; Nyíri, Miklós; Benczik, Márta

2017-03-01

The ongoing Triage and Risk Assessment of Cervical Precancer by Epigenetic Biomarker (TRACE) prospective, multicenter study aimed to provide a clinical evaluation of the CONFIDENCE™ assay, which comprises a human papillomavirus (HPV) DNA and a human epigenetic biomarker test. Between 2013 and 2015 over 6,000 women aged 18 or older were recruited in Hungary. Liquid-based cytology (LBC), high-risk HPV (hrHPV) DNA detection and single target host gene methylation test of the promoter sequence of the POU4F3 gene by quantitative methylation-specific polymerase chain reaction (PCR) were performed from the same liquid-based cytology sample. The current analysis is focused on the baseline cross-sectional clinical results of 5,384 LBC samples collected from subjects aged 25 years or older. The performance of the CONFIDENCE HPV™ test was found to be comparable to the cobas® HPV test with good agreement. When applying the CONFIDENCE Marker™ test alone in hrHPV positives, it showed significantly higher sensitivity with matching specificity compared to LBC-based triage. For CIN3+ histological endpoint in the age group of 25-65 and 30-65, the methylation test of POU4F3 achieved relative sensitivities of 1.74 (95% CI: 1.25-2.33) and 1.64 (95% CI: 1.08-2.27), respectively, after verification bias adjustment. On the basis of our findings, POU4F3 methylation as a triage test of hrHPV positives appears to be a noteworthy method. We can reasonably assume that its quantitative nature offers the potential for a more objective and discriminative risk assessment tool in the prevention and diagnostics of high-grade cervical intraepithelial neoplasia (CIN) lesions and cervical cancer. © 2016 UICC.

SU-E-I-26: The CT Compatibility of a Novel Direction Modulated Brachytherapy (DMBT) Tandem Applicator for Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Elzibak, A; Safigholi, H; Soliman, A

2015-06-15

Purpose: To examine CT metal image artifact from a novel direction-modulated brachytherapy (DMBT) tandem applicator (95% tungsten) for cervical cancer using a commercially available orthopedic metal artifact reduction (O-MAR) algorithm. Comparison to a conventional stainless steel applicator is also performed. Methods: Each applicator was placed in a water-filled phantom resembling the female pelvis and scanned in a Philips Brilliance 16-slice CT scanner using two pelvis protocols: a typical clinical protocol (120kVp, 16×0.75mm collimation, 0.692 pitch, 1.0s rotation, 350mm field of view (FOV), 600mAs, 1.5mm slices) and a protocol with a higher kVp and mAs setting useful for larger patients (140kVp,more » 16×0.75mm collimation, 0.688 pitch, 1.5s rotation, 350mm FOV, 870mAs, 1.5mm slices). Images of each tandem were acquired with and without the application of the O-MAR algorithm. Baseline scans of the phantom (no applicator) were also collected. CT numbers were quantified at distances from 5 to 30 mm away from the applicator’s edge (in increments of 5mm) using measurements at eight angles around the applicator, on three consecutive slices. Results: While the presence of both applicators degraded image quality, the DMBT applicator resulted in larger streaking artifacts and dark areas in the image compared to the stainless steel applicator. Application of the O-MAR algorithm improved all acquired images, both visually and quantitatively. The use of low and high kVp and mAs settings (120 kVp/600mAs and 140 kVp/870mAs) in conjunction with the O-MAR algorithm lead to similar CT numbers in the vicinity of the applicator and a similar reduction of the induced metal artifact. Conclusion: This work indicated that metal artifacts induced by the DMBT and the stainless steel applicator are greatly reduced when using the O-MAR algorithm, leading to better quality phantom images. The use of a high dose protocol provided similar improvements in metal artifacts compared to the clinical protocol.« less

Automated Cervical Screening and Triage, Based on HPV Testing and Computer-Interpreted Cytology.

PubMed

Yu, Kai; Hyun, Noorie; Fetterman, Barbara; Lorey, Thomas; Raine-Bennett, Tina R; Zhang, Han; Stamps, Robin E; Poitras, Nancy E; Wheeler, William; Befano, Brian; Gage, Julia C; Castle, Philip E; Wentzensen, Nicolas; Schiffman, Mark

2018-04-11

State-of-the-art cervical cancer prevention includes human papillomavirus (HPV) vaccination among adolescents and screening/treatment of cervical precancer (CIN3/AIS and, less strictly, CIN2) among adults. HPV testing provides sensitive detection of precancer but, to reduce overtreatment, secondary "triage" is needed to predict women at highest risk. Those with the highest-risk HPV types or abnormal cytology are commonly referred to colposcopy; however, expert cytology services are critically lacking in many regions. To permit completely automatable cervical screening/triage, we designed and validated a novel triage method, a cytologic risk score algorithm based on computer-scanned liquid-based slide features (FocalPoint, BD, Burlington, NC). We compared it with abnormal cytology in predicting precancer among 1839 women testing HPV positive (HC2, Qiagen, Germantown, MD) in 2010 at Kaiser Permanente Northern California (KPNC). Precancer outcomes were ascertained by record linkage. As additional validation, we compared the algorithm prospectively with cytology results among 243 807 women screened at KPNC (2016-2017). All statistical tests were two-sided. Among HPV-positive women, the algorithm matched the triage performance of abnormal cytology. Combined with HPV16/18/45 typing (Onclarity, BD, Sparks, MD), the automatable strategy referred 91.7% of HPV-positive CIN3/AIS cases to immediate colposcopy while deferring 38.4% of all HPV-positive women to one-year retesting (compared with 89.1% and 37.4%, respectively, for typing and cytology triage). In the 2016-2017 validation, the predicted risk scores strongly correlated with cytology (P < .001). High-quality cervical screening and triage performance is achievable using this completely automated approach. Automated technology could permit extension of high-quality cervical screening/triage coverage to currently underserved regions.

Analysis of Cervical Supernatant Samples Luminescence Using 355 nm Laser

NASA Astrophysics Data System (ADS)

Vaitkuviene, A.; Gegzna, V.; Kurtinaitiene, R.; Stanikunas, R.; Rimiene, J.; Vaitkus, J.

2010-05-01

The biomarker discovery for accurate detection and diagnosis of cervical carcinoma and its malignant precursors represents one of the current challenges in clinical medicine. Laser induced autofluorescence spectra in cervical smear content were fitted to predict the cervical epithelium diagnosis as a lab off "optical biopsy" method. Liquid PAP supernatant sediment dried on Quartz plate spectroscopy was performed by 355 nm Nd YAG microlaser STA-1 (Standa, Ltd). For comparison a liquid supernatant spectroscopy was formed by laboratory "Perkin Elmer LS 50B spetrometer at 290, 300, 310 nm excitations. Analysis of spectrum was performed by approximation using the multi-peaks program with Lorentz functions for the liquid samples and with Gaussian functions for the dry samples. Ratio of spectral components area to the area under whole experimental curve (SPP) was calculated. The spectral components were compared by averages of SPP using Mann-Whitney U-test in histology groups. Results. Differentiation of Normal and HSIL/CIN2+ cases in whole supernatant could be performed by stationary laboratory lamp spectroscopy at excitation 290 nm and emission >379 nm with accuracy AUC 0,69, Sens 0,72, Spec 0,65. Differentiation Normal versus HSIL/CIN2+ groups in dried enriched supernatant could be performed by 355 nm microlaser excitation at emission 405-424 nm with accuracy (AUC 0,96, Sens 0,91, Spec 1.00). Diagnostic algorithm could be created for all histology groups differentiation under 355 nm excitation. Microlaser induced "optical biopsy "looks promising method for cervical screening at the point of care.

[Primary cervical cancer screening].

PubMed

Vargas-Hernández, Víctor Manuel; Vargas-Aguilar, Víctor Manuel; Tovar-Rodríguez, José María

2015-01-01

Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

New technologies in cervical cancer precursor detection.

PubMed

Soler, M E; Blumenthal, P D

2000-09-01

The current literature reflects three routes toward improving cervical cancer screening. The first is to improve the test qualities of cytology-based screening. The use of liquid-based cytology and computerized analysis of Papanicolaou tests are examples of attempts at this approach. Secondly, through various combinations of parallel or sequential tests, either the sensitivity or the specificity of a given test could be improved depending on the tests chosen and the order in which they were performed (eg, Papanicolaou test followed by human papillomavirus [HPV] or vice versa). Several excellent studies have been published this year on the use of HPV DNA testing as a primary screening modality and as an adjunct to the triage of mildly abnormal cytologic findings. The recent literature also reflects increasing interest in visual inspection of the cervix and self-collected samples for HPV testing as an equally effective and viable alternative to cytology in low-resource settings. A third possibility is to make use of advances in digital and spectroscopic techniques. In these cost-conscious times, a significant number of articles address the cost-effectiveness of these technologies and the real value of cervical cancer screening. This article reviews the current literature concerning both the advent of new cervical cancer screening technologies and the rediscovery of old ones.

Objective Diagnosis of Cervical Cancer by Tissue Protein Profile Analysis

NASA Astrophysics Data System (ADS)

Patil, Ajeetkumar; Bhat, Sujatha; Rai, Lavanya; Kartha, V. B.; Chidangil, Santhosh

2011-07-01

Protein profiles of homogenized normal cervical tissue samples from hysterectomy subjects and cancerous cervical tissues from biopsy samples collected from patients with different stages of cervical cancer were recorded using High Performance Liquid Chromatography coupled with Laser Induced Fluorescence (HPLC-LIF). The Protein profiles were subjected to Principle Component Analysis to derive statistically significant parameters. Diagnosis of sample types were carried out by matching three parameters—scores of factors, squared residuals, and Mahalanobis Distance. ROC and Youden's Index curves for calibration standards were used for objective estimation of the optimum threshold for decision making and performance.

Cervical cytology biobanking in Europe.

PubMed

Arbyn, Marc; Van Veen, Evert-Ben; Andersson, Kristin; Bogers, Johannes; Boulet, Gaëlle; Bergeron, Christine; von Knebel-Doeberitz, Magnus; Dillner, Joakim

2010-01-01

A cervical cytology biobank (CCB) is an extension of current cytopathology laboratory practice consisting in the systematic storage of Pap smears or liquid-based cytology samples from women participating in cervical cancer screening with the explicit purpose to facilitate future scientific research and quality audit of preventive services. A CCB should use an internationally agreed uniform cytology terminology, be integrated in a national or regional screening registry, and be linked to other registries (histology, cancer, vaccination). Legal and ethical principles concerning personal integrity and data safety must be respected strictly. Biobank-based studies require approval of ethical review boards. A CCB is an almost inexhaustible resource for fundamental and applied biological research. In particular, it can contribute to answering questions on the natural history of HPV infection and HPV-induced lesions and cancers, screening effectiveness, exploration of new biomarkers, and surveillance of the short- and long-term effects of the introduction of HPV vaccination. To understand the limitations of CCB, more studies are needed on the quality of samples in relation to sample type, storage procedures, and duration of storage.

Foreign Food Technology of Military Significance. Volume 5, Number 1,

DTIC Science & Technology

1981-12-18

of Simple Solar Dehydrators for Drying Fruit and Vegetable Products Researchers at the Central Mango Research Station, Indian Institute of...dehydration, (raw) slices 4 to 5 mm thick, 30 to 40 mm slices were long. Immersed for 10 minutes in 0.2% powdered. potassium metabisulfite (KMS) solution...years for liquids, primarily milk products and fruit juices , and for products no more viscous than pudding. Further development of aseptic canning

A study of cellular counting to determine minimum thresholds for adequacy for liquid-based cervical cytology using a survey and counting protocol.

PubMed

Kitchener, Henry C; Gittins, Matthew; Desai, Mina; Smith, John H F; Cook, Gary; Roberts, Chris; Turnbull, Lesley

2015-03-01

Liquid-based cytology (LBC) for cervical screening would benefit from laboratory practice guidelines that define specimen adequacy for reporting of slides. The evidence base required to define cell adequacy should incorporate both ThinPrep™ (TP; Hologic, Inc., Bedford, MA, USA) and SurePath™ (SP; BD Diagnostics, Burlington, NC, USA), the two LBC systems used in the UK cervical screening programmes. The objectives of this study were to determine (1) current practice for reporting LBC in England, Wales and Scotland, (2) a reproducible method for cell counting, (3) the cellularity of slides classified as inadequate, negative or abnormal and (4) the impact of varying cellularity on the likelihood of detecting cytological abnormalities. The study involved four separate arms to pursue each of the four objectives. (1) A questionnaire survey of laboratories was conducted. (2) A standard counting protocol was developed and used by three experienced cytopathologists to determine a reliable and reproducible cell counting method. (3) Slide sets which included a range of cytological abnormalities were each sent to three laboratories for cell counting to study the correlation between cell counts and reported cytological outcomes. (4) Dilution of LBC samples by fluid only (unmixed) or by dilution with a sample containing normal cells (mixed) was performed to study the impact on reporting of reducing either the total cell count or the relative proportion of abnormal to normal cells. The study was conducted within the cervical screening programmes in England, Wales and Scotland, using routinely obtained cervical screening samples, and in 56 participating NHS cervical cytology laboratories. The study involved only routinely obtained cervical screening samples. There was no clinical intervention. The main outcome measures were (1) reliability of counting method, (2) correlation of reported cytology grades with cellularity and (3) levels of detection of abnormal cells in progressively diluted cervical samples. Laboratory practice varied in terms of threshold of cellular adequacy and of morphological markers of adequacy. While SP laboratories generally used a minimum acceptable cell count (MACC) of 15,000, the MACC employed by TP laboratories varied between 5000 and 15,000. The cell counting study showed that a standard protocol achieved moderate to strong inter-rater reproducibility. Analysis of slide reporting from laboratories revealed that a large proportion of the samples reported as inadequate had cell counts above a threshold of 15,000 for SP, and 5000 and 10,000 for TP. Inter-rater unanimity was greater among more cellular preparations. Dilution studies demonstrated greater detection of abnormalities in slides with counts above the MACC and among slides with more than 25 dyskaryotic cells. Variation in laboratory practice demonstrates a requirement for evidence-based standards for designating a MACC. This study has indicated that a MACC of 15,000 and 5000 for SP and TP, respectively, achieves a balance in terms of maintaining sensitivity and low inadequacy rates. The findings of this study should inform the development of laboratory practice guidelines. The National Institute for Health Research Health Technology Assessment programme.

Evaluation of a new APTIMA specimen collection and transportation kit for high-risk human papillomavirus E6/E7 messenger RNA in cervical and vaginal samples.

PubMed

Chernesky, Max; Jang, Dan; Gilchrist, Jodi; Elit, Laurie; Lytwyn, Alice; Smieja, Marek; Dockter, Janel; Getman, Damon; Reid, Jennifer; Hill, Craig

2014-06-01

An APTIMA specimen collection and transportation (SCT) kit was developed by Hologic/Gen-Probe. To compare cervical SCT samples to PreservCyt and SurePath samples and self-collected vaginal samples to physician-collected vaginal and cervical SCT samples. To determine ease and comfort of self-collection with the kit. Each woman (n = 580) self-collected a vaginal SCT, then filled out a questionnaire (n = 563) to determine ease and comfort of self-collection. Colposcopy physicians collected a vaginal SCT and cervical PreservCyt, SCT, and SurePath samples. Samples were tested by APTIMA HPV (AHPV) assay. Agreement between testing of cervical SCT and PreservCyt was 91.1% (κ = 0.82), and that of SurePath samples was 86.7% (κ = 0.72). Agreement of self-collected vaginal SCT to physician-collected SCT was 84.7% (κ = 0.68), and that of self-collected vaginal to cervical SCT was 82.0% (κ = 0.63). For 30 patients with CIN2+, AHPV testing of cervical SCT was 100% sensitive and 59.8% specific compared with PreservCyt (96.6% and 66.2%) and SurePath (93.3% and 70.9%). Vaginal SCT sensitivity was 86.7% for self-collection and 80.0% for physician collection. Most patients found that vaginal self-collection was easy, 5.3% reported some difficulty, and 87.6% expressed no discomfort. Cervical samples collected with the new SCT kit compared well to traditional liquid-based samples tested by AHPV. Although there was good agreement between self-collected and physician-collected samples with the SCT, in a limited number of 30 women, vaginal sampling identified fewer with CIN2+ precancerous cervical lesions than cervical SCT sampling. Comfort, ease of use, and detection of high-risk HPV demonstrated that the kit could be used for cervical and vaginal sampling.

Development of a method to evaluate glutamate receptor function in rat barrel cortex slices.

PubMed

Lehohla, M; Russell, V; Kellaway, L; Govender, A

2000-12-01

The rat is a nocturnal animal and uses its vibrissae extensively to navigate its environment. The vibrissae are linked to a highly organized part of the sensory cortex, called the barrel cortex which contains spiny neurons that receive whisker specific thalamic input and distribute their output mainly within the cortical column. The aim of the present study was to develop a method to evaluate glutamate receptor function in the rat barrel cortex. Long Evans rats (90-160 g) were killed by cervical dislocation and decapitated. The brain was rapidly removed, cooled in a continuously oxygenated, ice-cold Hepes buffer (pH 7.4) and sliced using a vibratome to produce 0.35 mm slices. The barrel cortex was dissected from slices corresponding to 8.6 to 4.8 mm anterior to the interaural line and divided into rostral, middle and caudal regions. Depolarization-induced uptake of 45Ca2+ was achieved by incubating test slices in a high K+ (62.5 mM) buffer for 2 minutes at 35 degrees C. Potassium-stimulated uptake of 45Ca2+ into the rostral region was significantly lower than into middle and caudal regions of the barrel cortex. Glutamate had no effect. NMDA significantly increased uptake of 45Ca2+ into all regions of the barrel cortex. The technique is useful in determining NMDA receptor function and will be applied to study differences between spontaneously hypertensive rats (SHR) that are used as a model for attention deficit disorder and their normotensive control rats.

Serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women.

PubMed

Zhang, Yuan-Yuan; Lu, Ling; Abliz, Guzalnur; Mijit, Fatima

2015-01-01

Despite many epidemiological studies on the effects of dietary antioxidant micronutrients on risk of cervical cancer, the findings remain uncertain and little evidence is available for serum nutrient markers. The present study aimed to examine the relationship between serum carotenoid, retinol and tocopherol concentrations and risk of cervical cancer among Chinese women. We conducted a hospital-based case- control study in which 358 adults (158 incident cases and 200 controls) were recruited from Xinjiang, China. Serum levels of carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lycopene and lutein/zeaxanthin), retinol, and tocopherols (α-tocopherol and γ-tocopherol) were assessed by reverse-phase high-performance liquid chromatography. We found inverse associations between serum carotenoid (α-carotene, β-carotene, and lutein/zeaxanthin) and tocopherol (α-tocopherol) concentrations and the risk of cervical cancer after adjusting for potential confounders, but a null association for retinol. The ORs for 1-SD increase were 0.71 (95% CI: 0.56- 0.92; p=0.003) for total carotenoids and 0.75 (95% CI: 0.60-0.94; p=0.008) for total tocopherols. These results show that higher serum concentrations of some carotenoids and tocopherols are associated with a lower risk of cervical cancer among Chinese women.

Fluorescence Spectrum and Decay Measurement for Hsil VS Normal Cytology Differentiation in Liquid Pap Smear Supernatant

NASA Astrophysics Data System (ADS)

Vaitkuviene, A.; Gegzna, V.; Juodkazis, S.; Jursenas, S.; Miasojedovas, S.; Kurtinaitiene, R.; Rimiene, J.; Vaitkus, J.

2009-06-01

Cervical smear material contains endo and exocervical cells, mucus and inflammative, immune cells in cases of pathology. Just not destroyed keratinocytes lay on the glass for microscopy. Liquid cytology supernatant apart other diagnostics could be used for photodiagnostic. The spectroscopic parameters suitable for Normal and HSIL cytology groups supernatant differentiation are demonstrated. The dried liquid PAP supernatant fractions—sediment and liquid were investigated. Excitation and emission matrices (EEM), supernatant fluorescence decay measured under 280 nm diode short pulse excitation and fluorescence spectroscopy by excitation with 355 nm laser light were analyzed. The differences between Normal and HSIL groups were statistically proven in the certain spectral regions. Fluorescence decay peculiarities show spectral regions consisting of few fluorophores. Obtained results on fluorescence differences in Normal and HSIL groups' supernatant shows the potency of photodiagnosis application in cervical screening.

Accuracy and Cost-Effectiveness of Cervical Cancer Screening by High-Risk HPV DNA Testing of Self-Collected Vaginal Samples

PubMed Central

Balasubramanian, Akhila; Kulasingam, Shalini L.; Baer, Atar; Hughes, James P.; Myers, Evan R.; Mao, Constance; Kiviat, Nancy B.; Koutsky, Laura A.

2010-01-01

Objective Estimate the accuracy and cost-effectiveness of cervical cancer screening strategies based on high-risk HPV DNA testing of self-collected vaginal samples. Materials and Methods A subset of 1,665 women (18-50 years of age) participating in a cervical cancer screening study were screened by liquid-based cytology and by high-risk HPV DNA testing of both self-collected vaginal swab samples and clinician-collected cervical samples. Women with positive/abnormal screening test results and a subset of women with negative screening test results were triaged to colposcopy. Based on individual and combined test results, five screening strategies were defined. Estimates of sensitivity and specificity for cervical intraepithelial neoplasia grade 2 or worse were calculated and a Markov model was used to estimate the incremental cost-effectiveness ratios (ICERs) for each strategy. Results Compared to cytology-based screening, high-risk HPV DNA testing of self-collected vaginal samples was more sensitive (68%, 95%CI=58%-78% versus 85%, 95%CI=76%-94%) but less specific (89%, 95%CI=86%-91% versus 73%, 95%CI=67%-79%). A strategy of high-risk HPV DNA testing of self-collected vaginal samples followed by cytology triage of HPV positive women, was comparably sensitive (75%, 95%CI=64%-86%) and specific (88%, 95%CI=85%-92%) to cytology-based screening. In-home self-collection for high-risk HPV DNA detection followed by in-clinic cytology triage had a slightly lower lifetime cost and a slightly higher quality-adjusted life expectancy than did cytology-based screening (ICER of triennial screening compared to no screening was $9,871/QALY and $12,878/QALY, respectively). Conclusions Triennial screening by high-risk HPV DNA testing of in-home, self-collected vaginal samples followed by in-clinic cytology triage was cost-effective. PMID:20592553

DOE Office of Scientific and Technical Information (OSTI.GOV)

Denton, T; Howe, J; Spalding, A

Purpose: Occipital neuralgia is a condition wherein pain is transmitted by the occipital nerves. Non-invasive therapies generally alleviate symptoms; however, persistent or recurring pain may require invasive procedures. Repeated invasive procedures upon failure are considered higher risk and are often contraindicated due to compounding inherent risk. SRS has not been explored as a treatment option largely due to the extracranial nature of the target (as opposed to the similar, more established trigeminal neuralgia), but advances in linear-accelerator frameless-based SRS now present an opportunity to evaluate the novel potential of this modality for this application. Methods: Patient presented with severe occipitalmore » pain following decompression and fusion of the cervical vertebrae with prior intervention attempted via radiofrequency ablation yielding temporary pain cessation. A 0.6 mm slice spacing CT was obtained for treatment planning, and a cervical spine oriented 1.0 mm slice spacing CT myelogram was obtained for the purpose of defining the targeted C2 occipital dorsal root ganglion (to receive 80 Gy to the isocenter) and spinal cord. Results: The spinal cord was most proximally 12.0 mm from the isocenter receiving a maximum dose of 3.36 Gy, and doses to 0.35 and 1.2 cc of 1.84 Gy and 0.79 Gy, respectively. The brain maximum dose was 2.29 Gy. The treatment was successfully performed with a NovalisTX (Varian) equipped with ExacTrac stereoscopic x-ray image guidance (BrainLAB). Treatment time was 59 minutes for 18,323 MUs. Imaging was performed prior to each arc delivery resulting in twenty-one imaging sessions (twelve requiring positional corrections with the remaining verified within tolerance). The average deviation magnitude requiring a positional or rotational correction was 0.96±0.25 mm, 0.8±0.41° while the average deviation magnitude deemed within tolerance was 0.41±0.12 mm, 0.57±0.28°. Conclusion: Linear accelerator-based frameless radiosurgery provides an accurate, non-invasive alternative for treating occipital neuralgia where an invasive procedure is contraindicated.« less

Using channelized Hotelling observers to quantify temporal effects of medical liquid crystal displays on detection performance

NASA Astrophysics Data System (ADS)

Platiša, Ljiljana; Goossens, Bart; Vansteenkiste, Ewout; Badano, Aldo; Philips, Wilfried

2010-02-01

Clinical practice is rapidly moving in the direction of volumetric imaging. Often, radiologists interpret these images in liquid crystal displays at browsing rates of 30 frames per second or higher. However, recent studies suggest that the slow response of the display can compromise image quality. In order to quantify the temporal effect of medical displays on detection performance, we investigate two designs of a multi-slice channelized Hotelling observer (msCHO) model in the task of detecting a single-slice signal in multi-slice simulated images. The design of msCHO models is inspired by simplifying assumptions about how humans observe while viewing in the stack-browsing mode. For comparison, we consider a standard CHO applied only on the slice where the signal is located, recently used in a similar study. We refer to it as a single-slice CHO (ssCHO). Overall, our results confirm previous findings that the slow response of displays degrades the detection performance of the observers. More specifically, the observed performance range of msCHO designs is higher compared to the ssCHO suggesting that the extent and rate of degradation, though significant, may be less drastic than previously estimated by the ssCHO. Especially, the difference between msCHO and ssCHO is more significant for higher browsing speeds than for slow image sequences or static images. This, together with their design criteria driven by the assumptions about humans, makes the msCHO models promising candidates for further studies aimed at building anthropomorphic observer models for the stack-mode image presentation.

Use of FTA card for dry collection, transportation and storage of cervical cell specimen to detect high-risk HPV.

PubMed

Gustavsson, Inger; Lindell, Monica; Wilander, Erik; Strand, Anders; Gyllensten, Ulf

2009-10-01

The FTA elute micro card, which enable the collection, transport, and archiving of DNA could be an attractive alternative to a liquid based collection system for detection of human papillomavirus (HPV). To develop a method based on the FTA elute micro card for dry collection of cervical epithelial cell samples, suitable for subsequent PCR-based HPV testing. The method was evaluated by a comparison of the DNA collected by cytobrush and the regular FTA elute micro card from 50 cervical cell samples. The method was then used to estimate the DNA amount in 1040 samples applied to the indicating FTA elute micro card. The agreement in HPV positivity between the cytobrush and FTA samples (94%) was excellent (kappa=0.88, 95% CI 0.748-1). All the 1040 samples on the indicating FTA card had sufficient amounts of genomic DNA (>10 copies of a single copy gene) to be suitable for HPV typing. In 53 of the 1040 women the day in the menstrual cycle was noted, and the copy number during follicular phase day 9-13 was found to be statistically significantly lower than for the other three stages in the menstrual cycle (day 4-8, 14, >14) and during menopause. The indicating FTA elute micro card represents a suitable medium for collection of cervical cell samples, although follow-up studies are needed to verify the detection of low frequency HPV types.

Comparative effectiveness of using computed tomography alone to exclude cervical spine injuries in obtunded or intubated patients: meta-analysis of 14,327 patients with blunt trauma.

PubMed

Panczykowski, David M; Tomycz, Nestor D; Okonkwo, David O

2011-09-01

The current standard of practice for clearance of the cervical spine in obtunded patients suffering blunt trauma is to use CT and an adjuvant imaging modality (such as MR imaging). The objective of this study was to determine the comparative effectiveness of multislice helical CT alone to diagnose acute unstable cervical spine injury following blunt trauma. The authors performed a meta-analysis of studies comparing modern CT with adjunctive imaging modalities and required that studies present acute traumatic findings as well as treatment for unstable injuries. Study quality, population characteristics, diagnostic protocols, and outcome data were extracted. Positive disease status included all injuries necessitating surgical or orthotic stabilization identified on imaging and/or clinical follow-up. Seventeen studies encompassing 14,327 patients met the inclusion criteria. Overall, the sensitivity and specificity for modern CT were both > 99.9% (95% CI 0.99-1.00 and 0.99-1.00, respectively). The negative likelihood ratio of an unstable cervical injury after a CT scan negative for acute injury was < 0.001 (95% CI 0.00-0.01), while the negative predictive value of a normal CT scan was 100% (95% CI 0.96-1.00). Global severity of injury, CT slice thickness, and study quality did not significantly affect accuracy estimates. Modern CT alone is sufficient to detect unstable cervical spine injuries in trauma patients. Adjuvant imaging is unnecessary when the CT scan is negative for acute injury. Results of this meta-analysis strongly show that the cervical collar may be removed from obtunded or intubated trauma patients if a modern CT scan is negative for acute injury.

Prevalence of human papillomavirus infection among Iranian women using COBAS HPV DNA testing.

PubMed

Jamdar, Farzane; Farzaneh, Farah; Navidpour, Fariba; Younesi, Sarang; Balvayeh, Payam; Hosseini, Maryamsadat; Ghodssi-Ghasemabadi, Robabeh

2018-01-01

Persistent infection with High Risk Human Papillomavirus (HR HPV) typesplaysamajor role in the development of cervical cancer. Therefore, the detection of HR HPV types is an essential part of cervical cancer screening. The aim of this study was to estimate the prevalence of HR HPV infection among healthy women undergoing routine cervical cancer screening in Iran. In this cross-sectional study,the results of HPV DNA typing in 2453 normal Iranian womenwhowere referred for routine cervical cancer screening from September 2015 to March 2017 were analyzed. Participants were screened using COBAS assay for HPV DNA typing and liquid based cytology. A total of 2453 healthy sexually active women were included in this study. The mean age was 35.1 ± 8.08 years. The overall prevalence of HR HPV infection was 10.3%. HPV16 was found in 73 (3%) women. The prevalence of HPV18 and other HR HPV typeswere 16(0.7%) and166 (8.2%),respectively. Approximately, 5% of the study population had an abnormal cervical cytology (ASCUS or worse), of whom 34% were infected by HR HPV. The prevalence of HR HPV infection among Iranian women has increased in the recent years which indicates the need for public education and health planning toprevent this cancer through vaccination and early diagnosis using screening tests.HPV DNA typing, diagnosisand the distribution of prevalent genotypes should be considered in the development of comprehensive cervical cancer prevention programs in Iran.

Human Papillomavirus Prevalence and Herd Immunity after Introduction of Vaccination Program, Scotland, 2009–2013

PubMed Central

Kavanagh, Kimberley; Pan, Jiafeng; Love, John; Cuschieri, Kate; Robertson, Chris; Ahmed, Syed; Palmer, Timothy; Pollock, Kevin G.J.

2016-01-01

In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009–2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level. PMID:26692336

Human Papillomavirus Prevalence and Herd Immunity after Introduction of Vaccination Program, Scotland, 2009-2013.

PubMed

Cameron, Ross L; Kavanagh, Kimberley; Pan, Jiafeng; Love, John; Cuschieri, Kate; Robertson, Chris; Ahmed, Syed; Palmer, Timothy; Pollock, Kevin G J

2016-01-01

In 2008, a national human papillomavirus (HPV) immunization program using a bivalent vaccine against HPV types 16 and 18 was implemented in Scotland along with a national surveillance program designed to determine the longitudinal effects of vaccination on HPV infection at the population level. Each year during 2009-2013, the surveillance program conducted HPV testing on a proportion of liquid-based cytology samples from women undergoing their first cervical screening test for precancerous cervical disease. By linking vaccination, cervical screening, and HPV testing data, over the study period we found a decline in HPV types 16 and 18, significant decreases in HPV types 31, 33, and 45 (suggesting cross-protection), and a nonsignificant increase in HPV 51. In addition, among nonvaccinated women, HPV types 16 and 18 infections were significantly lower in 2013 than in 2009. Our results preliminarily indicate herd immunity and sustained effectiveness of the bivalent vaccine on virologic outcomes at the population level.

Evaluation of sub-surface penetration and bonding durability of self-etching primer systems to Er:YAG laser treated cervical dentin.

PubMed

He, Zhengdi; Chen, Lingling; Shimada, Yasushi; Tagami, Junji; Ruan, Shuangchen

2017-03-31

This study aimed to investigate self-etching bonding systems penetrating in sub-surface dentin layer after Er:YAG laser irradiation and micro-shear bonding durability over a period of 1 year. Dentin slices obtained from extracted human third molars were prepared. Two self-etching adhesive systems were evaluated: Clearfil SE Bond and Clearfil Tri-S Bond. Specimens were tested for micro-shear bond strength with one of the following treatments: Er:YAG laser irradiation and 600-grit silicon paper polishing at 24 h, 7 days, 6 months and 1 year. The adhesive interfaces between bonding agents and lased cervical dentin were studied. No hybrid layer could be observed for lased dentin. The slim resin tags could be seen penetrating through the lased subsurface layer. Bond strength to lased dentin after 6 months and 1 year were significantly decreased (p<0.05).

Uncertainties in Assesment of the Vaginal Dose for Intracavitary Brachytherapy of Cervical Cancer using a Tandem-ring Applicator

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berger, Daniel; Dimopoulos, Johannes; Georg, Petra

2007-04-01

Purpose: The vagina has not been widely recognized as organ at risk in brachytherapy for cervical cancer. No widely accepted dose parameters are available. This study analyzes the uncertainties in dose reporting for the vaginal wall using tandem-ring applicators. Methods and Materials: Organ wall contours were delineated on axial magnetic resonance (MR) slices to perform dose-volume histogram (DVH) analysis. Different DVH parameters were used in a feasibility study based on 40 magnetic resonance imaging (MRI)-based treatment plans of different cervical cancer patients. Dose to the most irradiated, 0.1 cm{sup 3}, 1 cm{sup 3}, 2 cm{sup 3}, and at defined pointsmore » on the ring surface and at 5-mm tissue depth were reported. Treatment-planning systems allow different methods of dose point definition. Film dosimetry was used to verify the maximum dose at the surface of the ring applicator in an experimental setup. Results: Dose reporting for the vagina is extremely sensitive to geometrical uncertainties with variations of 25% for 1 mm shifts. Accurate delineation of the vaginal wall is limited by the finite pixel size of MRI and available treatment-planning systems. No significant correlation was found between dose-point and dose-volume parameters. The DVH parameters were often related to noncontiguous volumes and were not able to detect very different situations of spatial dose distributions inside the vaginal wall. Deviations between measured and calculated doses were up to 21%. Conclusions: Reporting either point dose values or DVH parameters for the vaginal wall is based on high inaccuracies because of contouring and geometric positioning. Therefore, the use of prospective dose constraints for individual treatment plans is not to be recommended at present. However, for large patient groups treated within one protocol correlation with vaginal morbidity can be evaluated.« less

Cervical specimens collected in liquid buffer are suitable for both cytologic screening and ancillary human papillomavirus testing.

PubMed

Sherman, M E; Schiffman, M H; Lorincz, A T; Herrero, R; Hutchinson, M L; Bratti, C; Zahniser, D; Morales, J; Hildesheim, A; Helgesen, K; Kelly, D; Alfaro, M; Mena, F; Balmaceda, I; Mango, L; Greenberg, M

1997-04-25

Several new techniques have been developed to improve the sensitivity of cervical carcinoma screening and reduce equivocal cytologic diagnoses referred to as atypical squamous cells of undetermined significance (ASCUS). This study evaluates the effectiveness of combining two newly introduced diagnostic techniques: preparation of thin-layer cytologic slides from ThinPrep liquid buffer and selected Hybrid Capture testing for human papillomavirus (HPV) DNA. Because HPV DNA detection has been strongly associated with the presence of a cervical carcinoma precursor ("squamous intraepithelial lesion," or SIL), HPV testing might be useful for identifying women with ASCUS who have an underlying SIL. Two hundred specimens demonstrating diverse cervical abnormalities were selected from a prospective population-based study of 9174 women conducted in Costa Rica. The entire cohort had been screened with conventional cervical smears; ThinPrep slides made from liquid buffer, PAPNET, a computerized slide reading system; and Cervicography. Patients with any abnormal screening test were referred for colposcopy, punch biopsy, and loop excision of cases with high grade cytologic abnormalities not explained by punch biopsy. For this investigation, the results of ThinPrep cytology and HPV testing alone and in combination were compared with the final diagnoses, with an emphasis on the detection of carcinoma and high grade SIL. The 200 subjects studied included 7 women with a final diagnosis of carcinoma, 44 with high grade SIL, 34 with low grade SIL, 51 with a variety of equivocal diagnoses, and 64 with normal diagnoses. A ThinPrep cytologic diagnosis of SIL or carcinoma was made in 39 (76%) of the 51 women with final diagnoses of high grade SIL or carcinoma. Hybrid Capture testing detected carcinoma-associated types of HPV DNA in 100% of women with carcinoma, 75% with high grade SIL, 62% with low grade SIL, 20% with equivocal final diagnoses, and 12% of normal women. If colposcopy referral had been limited to women with a ThinPrep diagnosis of SIL or a diagnosis of ASCUS associated with the detection of carcinoma-associated HPV DNA from the same vial, 100% of women with carcinoma and 80% with high grade SIL would have been examined. To achieve this high sensitivity in the entire population of 9174 women would have required the referral of about 7% of the population. The combined screening strategy would have performed marginally better than optimized conventional screening with referral of any abnormal cytology (ASCUS and above). A cervical carcinoma screening technique which uses a single sample for cytopathology and HPV testing to triage equivocal diagnoses may be promising if it proves to be cost-effective.

Performance and cost analysis of Siriraj liquid-based cytology: a direct-to-vial study.

PubMed

Laiwejpithaya, Somsak; Benjapibal, Mongkol; Laiwejpithaya, Sujera; Wongtiraporn, Weerasak; Sangkarat, Suthi; Rattanachaiyanont, Manee

2009-12-01

To compare the cytological diagnoses, specimen adequacy, and cost of the Siriraj liquid-based cytology (LBC) with those of the conventional smear technique. An observational study with historical comparison was conducted in a tertiary university hospital. Cytological reports of 23,676 Siriraj-LBC specimens obtained in 2006 were compared with those of 25,510 conventional smears obtained in 2004. Overall prevalence of abnormal cervical cytology detected by conventional smear was 1.76% and by Siriraj-LBC was 3.70%. Compared with the conventional method, the Siriraj-LBC yielded a significantly higher overall detection rate of abnormal cervical cytology, with a 110.23% increase in the detection rate (P<0.001), mainly due to the increase in diagnosis of squamous intraepithelial lesions (SIL), both low and high grade, together with atypical squamous cells of undetermined significance, "atypical squamous cells cannot exclude HSIL", and malignancies, but not atypical glandular cells. The Siriraj-LBC had a smaller proportion of unsatisfactory slides (4.94% vs. 18.60%, P<0.001) and a higher negative predictive value (96.33% vs. 92.74%, P=0.001), but no difference in positive predictive value (83.03% vs. 86.83%, P=0.285). The cost of Siriraj-LBC was approximately 67% higher than that of the conventional cytology used in Siriraj Hospital and 50-70% lower than that of the commercially available LBC techniques in Thailand. The Siriraj-LBC increases the detection rate of abnormal cytology, improves specimen adequacy, and enhances the negative predictive value without compromising the positive predictive value. For centers where conventional Pap smear does not perform well, the introduction of a low cost Siriraj-LBC might help to improve performance and it may be an economical alternative to the commercially available liquid-based cytology.

Human papillomavirus-related content in state and tribal comprehensive cancer control plans.

PubMed

Steele, C Brooke; Thomas, Christopher N; Richardson, Lisa C

2008-01-01

Oncogenic types of the human papillomavirus (HPV) are firmly established as etiological agents for most premalignant and malignant epithelial lesions of the cervical mucosa. Genital infection with HPV is the most common sexually transmitted infection (STI) in the United States. Although most women infected with the virus become HPV negative within 2 years, women with persistent high-risk HPV infections are at greatest risk for developing cervical cancer. Since the development of the Papanicolau (Pap) test more than 60 years ago to screen for cervical cancer, technological advances have occurred in cervical cytology screening and HPV vaccine research. For example, in 2001, high-risk HPV DNA testing was recommended for the management of women whose Pap smears (collected by a liquid-based method) reveal atypical squamous cells of undetermined significance. In 2006, the Food and Drug Administration licensed a quadrivalent HPV vaccine for females aged 9-26 years to prevent cervical cancer, precancerous lesions, and genital warts associated with HPV types in the vaccine. New and emerging technologies in cancer diagnosis, management, and prevention are often addressed in comprehensive cancer control (CCC) plans developed by states, tribes, and territories. CCC is a collaborative process through which a community and its partners pool resources to reduce the burden of cancer. To assess whether CCC plans include HPV-related content, particularly regarding cervical cancer screening and prevention, we reviewed the most current plans available between October 2006 and January 2007 on an interactive Internet site for CCC programs (n = 53). This paper describes the contexts in which HPV-related content occurs in the plans.

Aberrant Promoter Methylation and Expression of UTF1 during Cervical Carcinogenesis

PubMed Central

Deplus, Rachel; Lampe, Xavier; Krusy, Nathalie; Calonne, Emilie; Delbecque, Katty; Kridelka, Frederic; Fuks, François; Ennaji, My Mustapha; Delvenne, Philippe

2012-01-01

Promoter methylation profiles are proposed as potential prognosis and/or diagnosis biomarkers in cervical cancer. Up to now, little is known about the promoter methylation profile and expression pattern of stem cell (SC) markers during tumor development. In this study, we were interested to identify SC genes methylation profiles during cervical carcinogenesis. A genome-wide promoter methylation screening revealed a strong hypermethylation of Undifferentiated cell Transcription Factor 1 (UTF1) promoter in cervical cancer in comparison with normal ectocervix. By direct bisulfite pyrosequencing of DNA isolated from liquid-based cytological samples, we showed that UTF1 promoter methylation increases with lesion severity, the highest level of methylation being found in carcinoma. This hypermethylation was associated with increased UTF1 mRNA and protein expression. By using quantitative RT-PCR and Western Blot, we showed that both UTF1 mRNA and protein are present in epithelial cancer cell lines, even in the absence of its two main described regulators Oct4A and Sox2. Moreover, by immunofluorescence, we confirmed the nuclear localisation of UTF1 in cell lines. Surprisingly, direct bisulfite pyrosequencing revealed that the inhibition of DNA methyltransferase by 5-aza-2′-deoxycytidine was associated with decreased UTF1 gene methylation and expression in two cervical cancer cell lines of the four tested. These findings strongly suggest that UTF1 promoter methylation profile might be a useful biomarker for cervical cancer diagnosis and raise the questions of its role during epithelial carcinogenesis and of the mechanisms regulating its expression. PMID:22880087

Analysis of Mammalian Sphingolipids by Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS) and Tissue Imaging Mass Spectrometry (TIMS)

PubMed Central

Sullards, M. Cameron; Liu, Ying; Chen, Yanfeng; Merrill, Alfred H.

2011-01-01

Sphingolipids are a highly diverse category of molecules that serve not only as components of biological structures but also as regulators of numerous cell functions. Because so many of the structural features of sphingolipids give rise to their biological activity, there is a need for comprehensive or “sphingolipidomic” methods for identification and quantitation of as many individual subspecies as possible. This review defines sphingolipids as a class, briefly discusses classical methods for their analysis, and focuses primarily on liquid chromatography tandem mass spectrometry (LC-MS/MS) and tissue imaging mass spectrometry (TIMS). Recently, a set of evolving and expanding methods have been developed and rigorously validated for the extraction, identification, separation, and quantitation of sphingolipids by LC-MS/MS. Quantitation of these biomolecules is made possible via the use of an internal standard cocktail. The compounds that can be readily analyzed are free long-chain (sphingoid) bases, sphingoid base 1-phosphates, and more complex species such as ceramides, ceramide 1-phosphates, sphingomyelins, mono- and di-hexosylceramides sulfatides, and novel compounds such as the 1-deoxy- and 1-(deoxymethyl)-sphingoid bases and their N-acyl-derivatives. These methods can be altered slightly to separate and quantitate isomeric species such as glucosyl/galactosylceramide. Because these techniques require the extraction of sphingolipids from their native environment, any information regarding their localization in histological slices is lost. Therefore, this review also describes methods for TIMS. This technique has been shown to be a powerful tool to determine the localization of individual molecular species of sphingolipids directly from tissue slices. PMID:21749933

Validity of combined cytology and human papillomavirus (HPV) genotyping with adjuvant DNA-cytometry in routine cervical screening: results from 31031 women from the Bonn-region in West Germany.

PubMed

Bollmann, Reinhard; Bankfalvi, Agnes; Griefingholt, Harald; Trosic, Ante; Speich, Norbert; Schmitt, Christoph; Bollmann, Magdolna

2005-05-01

Our aim was to improve the accuracy of routine cervical screening by a risk-adapted multimodal protocol with special focus on possible reduction and prognostic assessment of false positive results. A cohort of 31031 women from the Bonn-region in West Germany, median age 36 years, were screened by cytology (conventional or liquid-based), followed by PCR-based HVP detection with genotyping and adjuvant DNA image cytometry, if indicated, in a sequential manner. The true prevalence of high-grade cervical intraepithelial neoplasia and carcinoma (>/=CIN2) was 0.32% in the population as projected from cervical biopsies of 123 women (0.4%), of whom 100 showed >/=CIN2. Sensitivity of the cytology screening program at PapIIID/HSIL threshold for detecting histologically confirmed >/=CIN2 cases was 81%, with specificity, positive predictive value (PPV) and negative predictive value (NPV) of 99, 20.9 and 99.9%, respectively. Of 38 women receiving the complete screening protocol, all the 31 >/=CIN2 cases were correctly detected by cytology alone, 30 by positive high-risk HPV genotype and 30 by aneuploid DNA profile. The combination of the three methods resulted in an up to 6.9% increase in PPV for >/=CIN2 at practically unchanged detection rate with the additional benefit of being able to predict the probable outcome of CIN1 lesions detected as false positives with any single test. Multimodal cervical screening might permit identification of those women with low-grade squamous intraepithelial lesions likely to progress at an earlier and curable stage of disease and lengthen the screening interval in those with transient minor lesions caused by productive HPV infection.

Modular electronics packaging system

NASA Technical Reports Server (NTRS)

Hunter, Don J. (Inventor)

2001-01-01

A modular electronics packaging system includes multiple packaging slices that are mounted horizontally to a base structure. The slices interlock to provide added structural support. Each packaging slice includes a rigid and thermally conductive housing having four side walls that together form a cavity to house an electronic circuit. The chamber is enclosed on one end by an end wall, or web, that isolates the electronic circuit from a circuit in an adjacent packaging slice. The web also provides a thermal path between the electronic circuit and the base structure. Each slice also includes a mounting bracket that connects the packaging slice to the base structure. Four guide pins protrude from the slice into four corresponding receptacles in an adjacent slice. A locking element, such as a set screw, protrudes into each receptacle and interlocks with the corresponding guide pin. A conduit is formed in the slice to allow electrical connection to the electronic circuit.

Thick Slice and Thin Slice Teaching Evaluations

ERIC Educational Resources Information Center

Tom, Gail; Tong, Stephanie Tom; Hesse, Charles

2010-01-01

Student-based teaching evaluations are an integral component to institutions of higher education. Previous work on student-based teaching evaluations suggest that evaluations of instructors based upon "thin slice" 30-s video clips of them in the classroom correlate strongly with their end of the term "thick slice" student evaluations. This study's…

Application of full-scale three-dimensional models in patients with rheumatoid cervical spine.

PubMed

Mizutani, Jun; Matsubara, Takeshi; Fukuoka, Muneyoshi; Tanaka, Nobuhiko; Iguchi, Hirotaka; Furuya, Aiharu; Okamoto, Hideki; Wada, Ikuo; Otsuka, Takanobu

2008-05-01

Full-scale three-dimensional (3D) models offer a useful tool in preoperative planning, allowing full-scale stereoscopic recognition from any direction and distance with tactile feedback. Although skills and implants have progressed with various innovations, rheumatoid cervical spine surgery remains challenging. No previous studies have documented the usefulness of full-scale 3D models in this complicated situation. The present study assessed the utility of full-scale 3D models in rheumatoid cervical spine surgery. Polyurethane or plaster 3D models of 15 full-sized occipitocervical or upper cervical spines were fabricated using rapid prototyping (stereolithography) techniques from 1-mm slices of individual CT data. A comfortable alignment for patients was reproduced from CT data obtained with the patient in a comfortable occipitocervical position. Usefulness of these models was analyzed. Using models as a template, appropriate shape of the plate-rod construct could be created in advance. No troublesome Halo-vests were needed for preoperative adjustment of occipitocervical angle. No patients complained of dysphasia following surgery. Screw entry points and trajectories were simultaneously determined with full-scale dimensions and perspective, proving particularly valuable in cases involving high-riding vertebral artery. Full-scale stereoscopic recognition has never been achieved with any existing imaging modalities. Full-scale 3D models thus appear useful and applicable to all complicated spinal surgeries. The combination of computer-assisted navigation systems and full-scale 3D models appears likely to provide much better surgical results.

A shape-based statistical method to retrieve 2D TRUS-MR slice correspondence for prostate biopsy

NASA Astrophysics Data System (ADS)

Mitra, Jhimli; Srikantha, Abhilash; Sidibé, Désiré; Martí, Robert; Oliver, Arnau; Lladó, Xavier; Ghose, Soumya; Vilanova, Joan C.; Comet, Josep; Meriaudeau, Fabrice

2012-02-01

This paper presents a method based on shape-context and statistical measures to match interventional 2D Trans Rectal Ultrasound (TRUS) slice during prostate biopsy to a 2D Magnetic Resonance (MR) slice of a pre-acquired prostate volume. Accurate biopsy tissue sampling requires translation of the MR slice information on the TRUS guided biopsy slice. However, this translation or fusion requires the knowledge of the spatial position of the TRUS slice and this is only possible with the use of an electro-magnetic (EM) tracker attached to the TRUS probe. Since, the use of EM tracker is not common in clinical practice and 3D TRUS is not used during biopsy, we propose to perform an analysis based on shape and information theory to reach close enough to the actual MR slice as validated by experts. The Bhattacharyya distance is used to find point correspondences between shape-context representations of the prostate contours. Thereafter, Chi-square distance is used to find out those MR slices where the prostates closely match with that of the TRUS slice. Normalized Mutual Information (NMI) values of the TRUS slice with each of the axial MR slices are computed after rigid alignment and consecutively a strategic elimination based on a set of rules between the Chi-square distances and the NMI leads to the required MR slice. We validated our method for TRUS axial slices of 15 patients, of which 11 results matched at least one experts validation and the remaining 4 are at most one slice away from the expert validations.

Collagen Fiber Orientation and Dispersion in the Upper Cervix of Non-Pregnant and Pregnant Women

PubMed Central

Myers, Kristin M.; Vink, Joy Y.; Wapner, Ronald J.; Hendon, Christine P.

2016-01-01

The structural integrity of the cervix in pregnancy is necessary for carrying a pregnancy until term, and the organization of human cervical tissue collagen likely plays an important role in the tissue’s structural function. Collagen fibers in the cervical extracellular matrix exhibit preferential directionality, and this collagen network ultrastructure is hypothesized to reorient and remodel during cervical softening and dilation at time of parturition. Within the cervix, the upper half is substantially loaded during pregnancy and is where the premature funneling starts to happen. To characterize the cervical collagen ultrastructure for the upper half of the human cervix, we imaged whole axial tissue slices from non-pregnant and pregnant women undergoing hysterectomy or cesarean hysterectomy respectively using optical coherence tomography (OCT) and implemented a pixel-wise fiber orientation tracking method to measure the distribution of fiber orientation. The collagen fiber orientation maps show that there are two radial zones and the preferential fiber direction is circumferential in a dominant outer radial zone. The OCT data also reveal that there are two anatomic regions with distinct fiber orientation and dispersion properties. These regions are labeled: Region 1—the posterior and anterior quadrants in the outer radial zone and Region 2—the left and right quadrants in the outer radial zone and all quadrants in the inner radial zone. When comparing samples from nulliparous vs multiparous women, no differences in these fiber properties were noted. Pregnant tissue samples exhibit an overall higher fiber dispersion and more heterogeneous fiber properties within the sample than non-pregnant tissue. Collectively, these OCT data suggest that collagen fiber dispersion and directionality may play a role in cervical remodeling during pregnancy, where distinct remodeling properties exist according to anatomical quadrant. PMID:27898677

Precision cut lung slices as an efficient tool for in vitro lung physio-pharmacotoxicology studies.

PubMed

Morin, Jean-Paul; Baste, Jean-Marc; Gay, Arnaud; Crochemore, Clément; Corbière, Cécile; Monteil, Christelle

2013-01-01

1.We review the specific approaches for lung tissue slices preparation and incubation systems and the research application fields in which lung slices proved to be a very efficient alternative to animal experimentation for biomechanical, physiological, pharmacological and toxicological approaches. 2.Focus is made on air-liquid interface dynamic organ culture systems that allow direct tissue exposure to complex aerosol and that best mimic in vivo lung tissue physiology. 3.A compilation of research applications in the fields of vascular and airway reactivity, mucociliary transport, polyamine transport, xenobiotic biotransformation, chemicals toxicology and complex aerosols supports the concept that precision cut lung slices are a very efficient tool maintaining highly differentiated functions similar to in vivo lung organ when kept under dynamic organ culture. They also have been successfully used for lung gene transfer efficiency assessment, for lung viral infection efficiency assessment, for studies of tissue preservation media and tissue post-conditioning to optimize lung tissue viability before grafting. 4.Taken all together, the reviewed studies point to a great interest for precision cut lung slices as an efficient and valuable alternative to in vivo lung organ experimentation.

Human papillomavirus genotypes distribution by cervical cytologic status among women attending the General Hospital of Loandjili, Pointe-Noire, Southwest Congo (Brazzaville).

PubMed

Boumba, Luc Magloire Anicet; Qmichou, Zineb; Mouallif, Mustapha; Attaleb, Mohammed; El Mzibri, Mohammed; Hilali, Lahoucine; Donatien, Moukassa; Ennaji, Moulay Mustapha

2015-10-01

HPV infection is associated with cervical cancer, one of the major public health problems in developing countries. In the Republic of Congo, despite of the high age-standardized incidence rate estimated at 25.2 per 100,000 women, molecular epidemiology data on HPV infections are very limited. We investigated HPV genotypes distribution in cervical smears among patients attending the General Hospital of Loandjili, Southwest Congo. A cross-sectional hospital-based study was conducted on 321 women. Liquid-based cytology samples were collected for cytological diagnosis and HPV detection. Nested-PCR was performed using MY09/MY11 and GP5+/GP6+ primers with genotyping by direct sequencing. Type-specific PCR for HPV-6, -11, -16, -18, -31 and -33 was also used to assess multiple infections. Out of 321 women examined, 189 (58.8%) had normal cytology, 16 (5.0%) had ASCUS and 116 (36.1%) had cytological abnormalities. HPV-DNA was detected in 22 (11.6%), 6 (37.5%), and 104 (89.6%) normal cytology, ASCUS and cytological abnormalities respectively. HPV16 was the most prevalent genotype regardless of cytological status followed by HPV70 in women without lesions and HPV33 among those with lesions. HR-HPV prevalence varied significantly according to the cervical cytology (P = 0.000). Among women without lesions, two peaks of HPV infections were observed in age group less than 30 years (60.0%) and in age group 50-59 years (7.1%). Age, age of first sex, multiple sexual partners and pregnancies were the risk factors for HPV infection in women without lesions. Our findings could be used as evidence data base for future epidemiological monitoring in this region. © 2015 Wiley Periodicals, Inc.

Evaluation of a new solid media specimen transport card for high risk HPV detection and cervical cancer prevention.

PubMed

Maurer, Kathryn; Luo, Hongxue; Shen, Zhiyong; Wang, Guixiang; Du, Hui; Wang, Chun; Liu, Xiaobo; Wang, Xiamen; Qu, Xinfeng; Wu, Ruifang; Belinson, Jerome

2016-03-01

Solid media transport can be used to design adaptable cervical cancer screening programs but currently is limited by one card with published data. To develop and evaluate a solid media transport card for use in high-risk human papillomavirus detection (HR-HPV). The Preventative Oncology International (POI) card was constructed using PK 226 paper(®) treated with cell-lysing solution and indicating dye. Vaginal samples were applied to the POI card and the indicating FTA (iFTA) elute card. A cervical sample was placed in liquid media. All specimens were tested for HR-HPV. Color change was assessed at sample application and at card processing. Stability of the POI card and iFTA elute card was tested at humidity. 319 women were enrolled. Twelve women had at least one insufficient sample with no difference between media (p=0.36). Compared to liquid samples, there was good agreement for HR-HPV detection with kappa of 0.81 (95% CI 0.74-0.88) and 0.71 (95% CI 0.62-0.79) for the POI and iFTA elute card respectively. Sensitivity for ≥CIN2 was 100% (CI 100-100%), 95.1% (CI 92.7-97.6%), and 93.5% (CI 90.7-96.3%) for the HR-HPV test from the liquid media, POI card, and iFTA elute card respectively. There was no color change of the POI card noted in humidity but the iFTA elute card changed color at 90% humidity. The POI card is suitable for DNA transport and HR-HPV testing. This card has the potential to make cervical cancer screening programs more affordable worldwide. Copyright © 2015 Elsevier B.V. All rights reserved.

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine

PubMed Central

Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

2017-01-01

Purpose Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Methods Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. Results A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. Conclusion The individualized 3D printing navigation template for pedicle screw fixation is easy and safe, with a high success rate in the upper cervical spine surgery. PMID:28152039

Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine.

PubMed

Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

2017-01-01

Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. The individualized 3D printing navigation template for pedicle screw fixation is easy and safe, with a high success rate in the upper cervical spine surgery.

Swallowing in children with neurologic disorders: clinical and videofluoroscopic evaluations.

PubMed

Marrara, Jamille Lays; Duca, Ana Paula; Dantas, Roberto Oliveira; Trawitzki, Luciana Vitaliano Voi; Lima, Raquel Aparecida Cardozo de; Pereira, José Carlos

2008-01-01

swallowing in children with neurologic disorders. to relate the data obtained in the clinical and in the videofluoroscopic evaluations of swallowing in children with neurologic disorders. a retrospective analysis of 24 protocols of speech-language evaluation and of medical records of children, of both genders, referred to clinical and videofluoroscopic evaluations of swallowing at the School of Medicine of Ribeirão Preto - University of São Paulo, from January 2001 to June 2005. The following aspects were analyzed in the clinical evaluation: diet consistency, functional aspects of the swallowing mechanism and results of the cervical auscultation. Videofluoroscopic evaluation was performed to determine the dynamic aspects of the oral and pharyngeal phases. during the clinical evaluation of the oral phase, for both liquid and pasty consistencies, a greater occurrence of inadequate bolus control was observed (n = 15 e n = 14, respectively). In the pharyngeal phase, also for both consistencies, an adequate cervical auscultate was more frequently observed before swallowing (n = 16 e n = 13) followed by the inadequate cervical auscultation during swallowing (n = 15 e n = 12). In the videofluoroscopic evaluation, during the oral phase, for both consistencies, the presence of inadequate food propulsion was the most frequent finding (n = 13 e n = 13) and, in the pharyngeal phase, the most frequent finding was the absence of laryngotracheal aspiration (n = 12 e n = 17). There was a statistically significant correlation between the cervical auscultate and the excursion of the hyoid and the larynx, and between the cervical auscultate and laryngotracheal aspiration of liquid and pasty consistencies. both procedures are important and complementary in the diagnosis of dysphagia.

A statistical analysis of cervical auscultation signals from adults with unsafe airway protection.

PubMed

Dudik, Joshua M; Kurosu, Atsuko; Coyle, James L; Sejdić, Ervin

2016-01-22

Aspiration, where food or liquid is allowed to enter the larynx during a swallow, is recognized as the most clinically salient feature of oropharyngeal dysphagia. This event can lead to short-term harm via airway obstruction or more long-term effects such as pneumonia. In order to non-invasively identify this event using high resolution cervical auscultation there is a need to characterize cervical auscultation signals from subjects with dysphagia who aspirate. In this study, we collected swallowing sound and vibration data from 76 adults (50 men, 26 women, mean age 62) who underwent a routine videofluoroscopy swallowing examination. The analysis was limited to swallows of liquid with either thin (<5 cps) or viscous (≈300 cps) consistency and was divided into those with deep laryngeal penetration or aspiration (unsafe airway protection), and those with either shallow or no laryngeal penetration (safe airway protection), using a standardized scale. After calculating a selection of time, frequency, and time-frequency features for each swallow, the safe and unsafe categories were compared using Wilcoxon rank-sum statistical tests. Our analysis found that few of our chosen features varied in magnitude between safe and unsafe swallows with thin swallows demonstrating no statistical variation. We also supported our past findings with regard to the effects of sex and the presence or absence of stroke on cervical ausculation signals, but noticed certain discrepancies with regards to bolus viscosity. Overall, our results support the necessity of using multiple statistical features concurrently to identify laryngeal penetration of swallowed boluses in future work with high resolution cervical auscultation.

Measuring relief of dysphagia in locally advanced esophageal carcinoma patients submitted to high-dose-rate brachytherapy.

PubMed

Grazziotin Reisner, Rachele; Reisner, Márcio Lemberg; Ferreira, Maria Aparecida; Rosa, Arthur Accioly; Veras, Igor Moreira; Carneiro, Túlio Meneses; Wolff, Bettina; Viégas, Célia Maria Pais; Mendonça de Araújo, Carlos Manoel; Marchiori, Edson

2015-01-01

Esophageal neoplasm has a poor prognosis, and palliative care remains an important goal of treatment. The purpose of this study was to assess the ability of high-dose-rate brachytherapy (HDRB) to improve dysphagia in 115 patients treated at our institution. Patients previously submitted to external beam radiotherapy that at least, 1 month after, presented with residual disease and persistent dysphagia, were given HDRB as palliative treatment. Patients with tumors extending to the level of cardia and those with cervical esophageal lesions were also eligible. HDRB consisted of three fractions of 500 cGy given weekly. Dysphagia was assessed using a food texture-based scale classified according to the type of food patients were able to swallow (absent, solid, pasty, or liquid). At the end of treatment, a single-category shift in dysphagia classification was scored as +1 (e.g., liquid to pasty) or -1 (e.g., solid to pasty), and a dual-category shift was scored as +2 (e.g., liquid to solid) or -2 (e.g., absent to pasty). Most patients (51.1%) had improvement of dysphagia, and 55.3% of this group experienced one-point improvement. Procedural complications included stricture (38.2%), bleeding (7%), and fistula (8.7%). In the present study, 13 patients with cervical esophageal lesions underwent HDRB without fistula formation. Esophageal HDRB effectively reduces dysphagia. Tumor location was not related to development of complications. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Utility of spatially-resolved atmospheric pressure surface sampling and ionization techniques as alternatives to mass spectrometric imaging (MSI) in drug metabolism.

PubMed

Blatherwick, Eleanor Q; Van Berkel, Gary J; Pickup, Kathryn; Johansson, Maria K; Beaudoin, Marie-Eve; Cole, Roderic O; Day, Jennifer M; Iverson, Suzanne; Wilson, Ian D; Scrivens, James H; Weston, Daniel J

2011-08-01

Tissue distribution studies of drug molecules play an essential role in the pharmaceutical industry and are commonly undertaken using quantitative whole body autoradiography (QWBA) methods. The growing need for complementary methods to address some scientific gaps around radiography methods has led to increased use of mass spectrometric imaging (MSI) technology over the last 5 to 10 years. More recently, the development of novel mass spectrometric techniques for ambient surface sampling has redefined what can be regarded as "fit-for-purpose" for MSI in a drug metabolism and disposition arena. Together with a review of these novel alternatives, this paper details the use of two liquid microjunction (LMJ)-based mass spectrometric surface sampling technologies. These approaches are used to provide qualitative determination of parent drug in rat liver tissue slices using liquid extraction surface analysis (LESA) and to assess the performance of a LMJ surface sampling probe (LMJ-SSP) interface for quantitative assessment of parent drug in brain, liver and muscle tissue slices. An assessment of the utility of these spatially-resolved sampling methods is given, showing interdependence between mass spectrometric and QWBA methods, in particular there emerges a reason to question typical MSI workflows for drug metabolism; suggesting the expedient use of profile or region analysis may be more appropriate, rather than generating time-intensive molecular images of the entire tissue section.

Stability Study of Cervical Specimens Collected by Swab and Stored Dry Followed by Human Papillomavirus DNA Detection Using the cobas 4800 Test.

PubMed

Lin, Chun-Qing; Zeng, Xi; Cui, Jian-Feng; Liao, Guang-Dong; Wu, Ze-Ni; Gao, Qian-Qian; Zhang, Xun; Yu, Xiu-Zhang; Chen, Wen; Xi, Ming-Rong; Qiao, You-Lin

2017-02-01

Safer, more convenient methods for cervical sample collection and storage are necessary to facilitate human papillomavirus (HPV) DNA testing in low-resource settings. Our study aimed to evaluate the stability of cervical specimens collected with dry swabs and stored dry, compared to liquid-based cytology (LBC) samples, as detected by HPV DNA testing. Women with abnormal cytological findings or HPV-positive results at colposcopy were recruited from the West China Second University Hospital, Sichuan University, between October 2013 and March 2014. From each woman, physicians collected cervical specimens with a swab placed into a Sarstedt tube and a CytoBrush placed into LBC medium. Samples were randomly assigned to be stored at uncontrolled ambient temperature for 2, 7, 14, or 28 days and then were tested for 14 high-risk HPV (HR-HPV) types using the cobas HPV test. The rates of agreement between dry swab and LBC samples for any HR-HPV type, HPV16, HPV18, and the 12 pooled HR-HPV types were 93.8%, 97.8%, 99.4%, and 93.2%, respectively, with kappa values of 0.87 (95% confidence interval [CI], 0.83 to 0.91), 0.94 (95% CI, 0.91 to 0.97), 0.94 (95% CI, 0.87 to 1.00), and 0.86 (95% CI, 0.82 to 0.90). The performance of swab samples for detection of cervical precancerous lesions by means of cobas HPV testing was equal to that of LBC samples, even with stratification by storage time. Dry storage of swab-collected cervical samples can last for 1 month without loss of test performance by cobas HPV testing, compared to LBC samples, which may offer a simple inexpensive approach for cervical cancer screening in low-resource settings. Copyright © 2017 American Society for Microbiology.

1064-nm Nd:YAG and 980-nm Diode Laser EDTA Agitation on the Retention of an Epoxy-Based Sealer to Root Dentin.

PubMed

Macedo, Helena Suleiman de; Messias, Danielle Cristine Furtado; Rached-Júnior, Fuad Jacob; Oliveira, Ligia Teixeira de; Silva-Sousa, Yara Teresinha Correa; Raucci-Neto, Walter

2016-01-01

Root canal irrigants are used to minimize the negative effects of smear layer on endodontic sealer retention. The aim of this study was to evaluate the efficacy of agitation of 17% ethylenediaminetetraacetic acid (EDTA) with ultrasonic, 1064-nm Nd:YAG and 980-nm diode laser on the retention of an epoxy-based sealer to the root canal walls. Forty single-rooted bovine teeth were instrumented with ProTaper rotary system and divided into four groups according to the final irrigation protocol (n = 10): (1) 17% EDTA (control); (2) 17% EDTA with 50-s ultrasonic agitation; (3) 17% EDTA with 50-s diode laser (2-W) agitation; and (4) 17% EDTA with 50-s Nd:YAG (1.5-W) laser agitation. After endodontic filling with gutta-percha F5 master cone and Sealer 26, the roots were sectioned at the cervical, middle, and apical root thirds to obtain 1.5-mm slices. Push-out tests were performed using a universal testing machine at a 1 mm/min crosshead speed. Data were analyzed using two-way ANOVA and Tukey's tests (α=0.05). Apical root thirds had significant higher retention values than cervical and middle thirds (p < 0.05). EDTA with 1064-nm Nd:YAG or 980-nm diode laser presented the highest retention values and was significantly different from EDTA with ultrasonic agitation and EDTA only (p < 0.05). Adhesive failures were predominant to EDTA only group. Mixed failures were predominant to all agitation groups. 1064-nm Nd:YAG and 980-nm diode laser EDTA agitation enhanced the retention of the epoxy-based sealer to the root canal walls compared with that due to EDTA only or EDTA with ultrasonic agitation.

Automatic 3D segmentation of spinal cord MRI using propagated deformable models

NASA Astrophysics Data System (ADS)

De Leener, B.; Cohen-Adad, J.; Kadoury, S.

2014-03-01

Spinal cord diseases or injuries can cause dysfunction of the sensory and locomotor systems. Segmentation of the spinal cord provides measures of atrophy and allows group analysis of multi-parametric MRI via inter-subject registration to a template. All these measures were shown to improve diagnostic and surgical intervention. We developed a framework to automatically segment the spinal cord on T2-weighted MR images, based on the propagation of a deformable model. The algorithm is divided into three parts: first, an initialization step detects the spinal cord position and orientation by using the elliptical Hough transform on multiple adjacent axial slices to produce an initial tubular mesh. Second, a low-resolution deformable model is iteratively propagated along the spinal cord. To deal with highly variable contrast levels between the spinal cord and the cerebrospinal fluid, the deformation is coupled with a contrast adaptation at each iteration. Third, a refinement process and a global deformation are applied on the low-resolution mesh to provide an accurate segmentation of the spinal cord. Our method was evaluated against a semi-automatic edge-based snake method implemented in ITK-SNAP (with heavy manual adjustment) by computing the 3D Dice coefficient, mean and maximum distance errors. Accuracy and robustness were assessed from 8 healthy subjects. Each subject had two volumes: one at the cervical and one at the thoracolumbar region. Results show a precision of 0.30 +/- 0.05 mm (mean absolute distance error) in the cervical region and 0.27 +/- 0.06 mm in the thoracolumbar region. The 3D Dice coefficient was of 0.93 for both regions.

Clinical significance of hTERC gene amplification detection by FISH in the screening of cervical lesions.

PubMed

Zhang, Yuan; Wang, Xiaobei; Ma, Ling; Wang, Zehua; Hu, Lihua

2009-06-01

This study evaluated the clinical significance of hTERC gene amplification detection by fluorescence in situ hybridization (FISH) in the screening of cervical lesions. Cervical specimens of 50 high risk patients were detected by thin liquid-based cytology. The patients whose cytological results were classified as ASCUS or above were subjected to the subsequent colposcopic biopsies. Slides prepared from these 50 cervical specimens were analyzed for hTERC gene amplification using interphase FISH with the two-color hTERC probe. The results of the cytological analysis and those of subsequent biopsies, when available, were compared with the FISH-detected hTERC abnormalities. It was found that the positive rates of hTERC gene amplification in NILM, ASCUS, LSIL, HSIL, and SCC groups were 0.00, 28.57%, 57.14%, 100%, and 100%, respectively. The positive rates of hTERC gene amplification in HSIL and SCC groups were significantly higher than those in NILM, ASCUS and LSIL groups (all P<0.05). The mean percentages of cells with hTERC gene amplification in NILM, ASCUS, LSIL, HSIL, and SCC groups were 0.00, 10.50%, 36.00%, 79.00%, and 96.50%, respectively. Patients with HSIL or SCC cytological diagnoses had significantly higher mean percentages of cells with hTERC gene amplification than did patients with NILM, ASCUS or LSIL cytological diagnoses (all P<0.05). It was concluded that two-color interphase FISH could detect hTERC gene amplification to accurately distinguish HSIL and ISIL of cervical cells. It may be an adjunct to cytology screening, especially high-risk patients.

Prevalence of high-risk human papilloma virus types and cervical smear abnormalities in female sex workers in Chandigarh, India.

PubMed

Singh, M P; Kaur, M; Gupta, N; Kumar, A; Goyal, K; Sharma, A; Majumdar, M; Gupta, M; Ratho, R K

2016-01-01

Cervical cancer is the most common cancer among women in developing nations. Nearly 90% of the cases have been linked to the presence of high-risk human papillomavirus (hrHPV) types 16 and 18. The risk of cervical cancer may be high in female sex workers (FSWs) due to multiple sexual partners. This study aimed to determine the prevalence of cytological abnormalities and hrHPV types 16 and 18 in FSWs in Chandigarh, North India using the liquid-based cytology (LBC) approach. The cervical brush samples were collected from 120 FSW and 98 age-matched healthy controls (HCs). These were subjected to pap smear using conventional method, LBC and the detection of hrHPV types 16 and 18 was carried out using polymerase chain reaction. The LBC samples showed better cytological details and also reduced the number of unsatisfactory smears from 11% in Pap to 1.5% in the LBC. A significantly higher number of inflammatory smears were reported in FSWs (51.7% vs. 34.7%, P = 0.01). The hrHPV types 16/18 were detected in 33/120 (27.5%) FSW versus 23/98 (23.5%) HCs. The risk of acquiring hrHPV was higher in FSWs, who had age at first sex ≤25 years, higher income and the habit of smoking. The high prevalence of hrHPV among FSWs and HCs suggests the need for the implementation of effective National Screening Programme for early detection of hrHPV types to decrease the burden of cervical cancer, especially in high-risk population.

Ultra-sensitive high performance liquid chromatography-laser-induced fluorescence based proteomics for clinical applications.

PubMed

Patil, Ajeetkumar; Bhat, Sujatha; Pai, Keerthilatha M; Rai, Lavanya; Kartha, V B; Chidangil, Santhosh

2015-09-08

An ultra-sensitive high performance liquid chromatography-laser induced fluorescence (HPLC-LIF) based technique has been developed by our group at Manipal, for screening, early detection, and staging for various cancers, using protein profiling of clinical samples like, body fluids, cellular specimens, and biopsy-tissue. More than 300 protein profiles of different clinical samples (serum, saliva, cellular samples and tissue homogenates) from volunteers (normal, and different pre-malignant/malignant conditions) were recorded using this set-up. The protein profiles were analyzed using principal component analysis (PCA) to achieve objective detection and classification of malignant, premalignant and healthy conditions with high sensitivity and specificity. The HPLC-LIF protein profiling combined with PCA, as a routine method for screening, diagnosis, and staging of cervical cancer and oral cancer, is discussed in this paper. In recent years, proteomics techniques have advanced tremendously in life sciences and medical sciences for the detection and identification of proteins in body fluids, tissue homogenates and cellular samples to understand biochemical mechanisms leading to different diseases. Some of the methods include techniques like high performance liquid chromatography, 2D-gel electrophoresis, MALDI-TOF-MS, SELDI-TOF-MS, CE-MS and LC-MS techniques. We have developed an ultra-sensitive high performance liquid chromatography-laser induced fluorescence (HPLC-LIF) based technique, for screening, early detection, and staging for various cancers, using protein profiling of clinical samples like, body fluids, cellular specimens, and biopsy-tissue. More than 300 protein profiles of different clinical samples (serum, saliva, cellular samples and tissue homogenates) from healthy and volunteers with different malignant conditions were recorded by using this set-up. The protein profile data were analyzed using principal component analysis (PCA) for objective classification and detection of malignant, premalignant and healthy conditions. The method is extremely sensitive to detect proteins with limit of detection of the order of femto-moles. The HPLC-LIF combined with PCA as a potential proteomic method for the diagnosis of oral cancer and cervical cancer has been discussed in this paper. This article is part of a Special Issue entitled: Proteomics in India. Copyright © 2015 Elsevier B.V. All rights reserved.

Vaginal Enterobius vermicularis diagnosed on liquid-based cytology during Papanicolaou test cervical cancer screening: A report of two cases and a review of the literature.

PubMed

Tsai, Chun-Yi; Junod, Rachel; Jacot-Guillarmod, Martine; Beniere, Charles; Ziadi, Sonia; Bongiovanni, Massimo

2018-02-01

Enterobiasis is one of the most common human parasitic infections. It is considered an intestinal parasite, but cases of extra-intestinal affections exist, notably infections of the female genital tract. Enterobius vermicularis (EV) eggs (or ova) have been found in the cervical smears of two patients in our institute during the last 16 years. No gynaecological or gastrointestinal symptoms were reported, and there was no known intestinal infection in these two cases. A review of the available literature revealed rare cases of vaginal enterobiasis, with a wide range of clinical presentations, many patients being asymptomatic. The diagnosis may sometimes be difficult, mainly because of the lack of clinical suspicion. However, cytological identification of EV in cervico-vaginal smears is important, especially when considering the risk of ascending infections of the genital tract associated with severe complications. © 2017 Wiley Periodicals, Inc.

First-void urine: A potential biomarker source for triage of high-risk human papillomavirus infected women.

PubMed

Van Keer, Severien; Pattyn, Jade; Tjalma, Wiebren A A; Van Ostade, Xaveer; Ieven, Margareta; Van Damme, Pierre; Vorsters, Alex

2017-09-01

Great interest has been directed towards the use of first-void urine as a liquid biopsy for high-risk human papillomavirus DNA testing. Despite the high correlations established between urinary and cervical infections, human papillomavirus testing is unable to distinguish between productive and transforming high-risk infections that have the tendency to progress to cervical cancer. Thus far, investigations have been primarily confined to the identification of biomarkers for triage of high-risk human papillomavirus-positive women in cervicovaginal specimens and tissue biopsies. This paper reviews urinary biomarkers for cervical cancer and triage of high-risk human papillomavirus infections and elaborates on the opportunities and challenges that have emerged regarding the use of first-void urine as a liquid biopsy for the analysis of both morphological- (conventional cytology and novel immunohistochemical techniques) and molecular-based (HPV16/18 genotyping, host/viral gene methylation, RNA, and proteins) biomarkers. A literature search was performed in PubMed and Web of Science for studies investigating the use of urine as a biomarker source for cervical cancer screening. Five studies were identified reporting on biomarkers that are still in preclinical exploratory or clinical assay development phases and on assessments of non-invasive (urine) samples. Although large-scale validation studies are still needed, we conclude that methylation of both host and viral genes in urine has been proven feasible for use as a molecular cervical cancer triage and screening biomarker in phase two studies. This is especially promising and underscores our hypothesis that human papillomavirus DNA and candidate human and viral biomarkers are washed away with the initial, first-void urine, together with exfoliated cells, debris and impurities that line the urethra opening. Similar to the limitations of self-collected cervicovaginal samples, first-void urine will likely not fulfil the high-quality cellularity standards required for morphological biomarkers. Molecular biomarkers will likely overcome this issue to yield high-throughput, objective, and reproducible results. When using proper sampling, transport, storage, preanalytical biomarker concentration techniques, and clinically validated assays, first-void urine is expected to be a valuable source of molecular biomarkers for cervical cancer screening. Furthermore, as first-void urine can be easily and non-invasively collected, it is a highly preferred technique among women and offers the ability to test both primary high-risk human papillomavirus and biomarkers in the same sample. In addition, the use of first-void urine confers opportunities to reduce loss-to follow-up and non-adherence to screening subjects. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Randomized Comparison of Two Vaginal Self-Sampling Methods for Human Papillomavirus Detection: Dry Swab versus FTA Cartridge

PubMed Central

Catarino, Rosa; Vassilakos, Pierre; Bilancioni, Aline; Vanden Eynde, Mathieu; Meyer-Hamme, Ulrike; Menoud, Pierre-Alain; Guerry, Frédéric; Petignat, Patrick

2015-01-01

Background Human papillomavirus (HPV) self-sampling (self-HPV) is valuable in cervical cancer screening. HPV testing is usually performed on physician-collected cervical smears stored in liquid-based medium. Dry filters and swabs are an alternative. We evaluated the adequacy of self-HPV using two dry storage and transport devices, the FTA cartridge and swab. Methods A total of 130 women performed two consecutive self-HPV samples. Randomization determined which of the two tests was performed first: self-HPV using dry swabs (s-DRY) or vaginal specimen collection using a cytobrush applied to an FTA cartridge (s-FTA). After self-HPV, a physician collected a cervical sample using liquid-based medium (Dr-WET). HPV types were identified by real-time PCR. Agreement between collection methods was measured using the kappa statistic. Results HPV prevalence for high-risk types was 62.3% (95%CI: 53.7–70.2) detected by s-DRY, 56.2% (95%CI: 47.6–64.4) by Dr-WET, and 54.6% (95%CI: 46.1–62.9) by s-FTA. There was overall agreement of 70.8% between s-FTA and s-DRY samples (kappa = 0.34), and of 82.3% between self-HPV and Dr-WET samples (kappa = 0.56). Detection sensitivities for low-grade squamous intraepithelial lesion or worse (LSIL+) were: 64.0% (95%CI: 44.5–79.8) for s-FTA, 84.6% (95%CI: 66.5–93.9) for s-DRY, and 76.9% (95%CI: 58.0–89.0) for Dr-WET. The preferred self-collection method among patients was s-DRY (40.8% vs. 15.4%). Regarding costs, FTA card was five times more expensive than the swab (~5 US dollars (USD)/per card vs. ~1 USD/per swab). Conclusion Self-HPV using dry swabs is sensitive for detecting LSIL+ and less expensive than s-FTA. Trial Registration International Standard Randomized Controlled Trial Number (ISRCTN): 43310942 PMID:26630353

Randomized Comparison of Two Vaginal Self-Sampling Methods for Human Papillomavirus Detection: Dry Swab versus FTA Cartridge.

PubMed

Catarino, Rosa; Vassilakos, Pierre; Bilancioni, Aline; Vanden Eynde, Mathieu; Meyer-Hamme, Ulrike; Menoud, Pierre-Alain; Guerry, Frédéric; Petignat, Patrick

2015-01-01

Human papillomavirus (HPV) self-sampling (self-HPV) is valuable in cervical cancer screening. HPV testing is usually performed on physician-collected cervical smears stored in liquid-based medium. Dry filters and swabs are an alternative. We evaluated the adequacy of self-HPV using two dry storage and transport devices, the FTA cartridge and swab. A total of 130 women performed two consecutive self-HPV samples. Randomization determined which of the two tests was performed first: self-HPV using dry swabs (s-DRY) or vaginal specimen collection using a cytobrush applied to an FTA cartridge (s-FTA). After self-HPV, a physician collected a cervical sample using liquid-based medium (Dr-WET). HPV types were identified by real-time PCR. Agreement between collection methods was measured using the kappa statistic. HPV prevalence for high-risk types was 62.3% (95%CI: 53.7-70.2) detected by s-DRY, 56.2% (95%CI: 47.6-64.4) by Dr-WET, and 54.6% (95%CI: 46.1-62.9) by s-FTA. There was overall agreement of 70.8% between s-FTA and s-DRY samples (kappa = 0.34), and of 82.3% between self-HPV and Dr-WET samples (kappa = 0.56). Detection sensitivities for low-grade squamous intraepithelial lesion or worse (LSIL+) were: 64.0% (95%CI: 44.5-79.8) for s-FTA, 84.6% (95%CI: 66.5-93.9) for s-DRY, and 76.9% (95%CI: 58.0-89.0) for Dr-WET. The preferred self-collection method among patients was s-DRY (40.8% vs. 15.4%). Regarding costs, FTA card was five times more expensive than the swab (~5 US dollars (USD)/per card vs. ~1 USD/per swab). Self-HPV using dry swabs is sensitive for detecting LSIL+ and less expensive than s-FTA. International Standard Randomized Controlled Trial Number (ISRCTN): 43310942.

Silent High Grade Cervical Intraepithelial Neoplasia in Atypical Smears from Liquid Based Cervical Cytology - Three Years Experience in Thammasat University Hospital.

PubMed

Lertvutivivat, Supapen; Chanthasenanont, Athita; Chanthasenanont, Athita; Muangto, Teerapat; Nanthakomon, Tongta; Pongrojpaw, Densak; Bhamarapravatana, Kornkarn; Suwannarurk, Komsun

2016-01-01

To study the prevalence of CIN2+ diagnosis in women with atypical Papaniculoau (Pap) smears to suggest appropriate management option for Thai health care. Data from all patients with liquid based cytology with human papillomavirus (HPV) testing between May 2013 - May 2016 were collected from medical records. Women with atypical cervical Pap smears were recruited. Results for age, HPV testing, HPV 16, 18, 45 and other genotypes tested, colposcopic examination and histopathological assessment were all collected. Atypical smears were defined as atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells cannot be exclude high grade squamous intraepithelial lesion (ASC-H). A total of 2,144 cases were recruited. Twenty six women with ASC-US on cytology had high risk (HR) HPV detection while eight cases with ASC-H had HR-HPV (40.0% VS 72.7%, p=0.005). Among the 26 women with ASC-US cytology and positive HR-HPV, HPV type 16 (n=8, 30.8%), type 18 (n=1, 3.8%), type 45 (n=1, 3.8%) and other HPV types (n=17, 65.4%) were found. Eight women with ASC-H and positive HR-HPV demonstrated type 16 (n=6, 75%) and other HPV types (n=2, 25%). Fifty seven women with ASC-US had normal colposcopy, CIN1 and CIN2+ at percentages of 80.7 (46/57), 14.0 (8/57) and 5.3 (3/57), respectively. In the ASC-H group, 7 out of 10 women had normal colposcopy and three (30%) had CIN2+ results. In women with ASC-US cytology, immediate colposcopy is highly recommended. HPV testing can be performed if colposcopy is not an available option because there was high prevalence (5.3%) of CIN2+ in our findings. ASCCP recommendations for ASC-H that colposcopy should be performed on all ASC-H cases regardless of HPV result are thereby supported by the findings of this investigation.

[Clinical significance of HPV L1 capsid protein detection in cervical exfoliated cells in high-risk HPV positive women].

PubMed

Wang, Jiajian; Tian, Qifang; Zhang, Su; Lyu, Liping; Dong, Jie; Lyu, Weiguo

2015-04-01

To explore the clinical significance of human papillomavirus L1 capsid protein detection in cervical exfoliated cells in high-risk HPV positive women. From November 2012 to June 2013, 386 high-risk HPV positive (detected by hybrid capture II) cases were enrolled as eligible women from Huzhou Maternity & Child Care Hospital and Women's Hospital, School of Medicine, Zhejiang University. All eligible women underwent liquid-based cytology (ThinPrep) followed by colposcopy. Biopsies were taken if indicated. Cervical exfoliated cells were collected for HPV L1 capsid protein detection by immunocytochemistry. Expression of HPV L1 capsid protein in groups with different histological diagnosis were compared, and the role of HPV L1 capsid protein detection in cervical exfoliated cells in cervical lesions screening was accessed. Total 386 enrolled eligible women were finally diagnosed histologically as follwed: 162 normal cervix, 94 low-grade squamous intraepithelial lesion (LSIL), 128 high-grade squamous intraepithelial lesion (HSIL) and 2 squamous cervical cancer (SCC). The positive expression rate of HPV L1 in HSIL+ (HSIL or worse) group was significantly lower than that in LSIL- (LSIL or better) group (19.2% vs 66.4%, P=0.000). While identifying HSIL+ in HPV positive cases and compared with cytology, HPV L1 detection resulted in significant higher sensitivity (80.77% vs 50.77%, P=0.000) and negative predictive value (NPV; 87.18% vs 76.47%, P=0.004), significant lower specificity (66.41% vs 81.25%, P=0.000), and comparable positive predictive value (PPV; 54.97% vs 57.89%, P=0.619). To identify HSIL+ in HPV-positive/cytology-negative women, the sensitivity, specificity, PPV, and NPV of HPV L1 detection were 87.50%, 61.54%, 41.18%, and 94.12% respectively, while 80.00%, 86.36%, 80.00% and 86.36% respectively in HPV-positive/atypical squamous cell of undetermined significance (ASCUS) women. HPV L1 capsid detection in cervical exfoliated cells have a role in cervical lesions screening in high-risk HPV positive women, and may be a promising triage for high-risk HPV-positive/cytology-negative or ASCUS women.

Triage of HR-HPV positive women with minor cytological abnormalities: a comparison of mRNA testing, HPV DNA testing, and repeat cytology using a 4-year follow-up of a population-based study.

PubMed

Persson, Maria; Elfström, K Miriam; Brismar Wendel, Sophia; Weiderpass, Elisabete; Andersson, Sonia

2014-01-01

Expression of the viral E6/E7 oncogenes of high-risk human papillomaviruses (HR-HPV) is necessary for malignant conversion and maintenance in cervical tissue. In order to determine whether HR-HPV E6/E7 mRNA testing more effectively predicts precancerous lesions and invasive cervical cancer than HR-HPV DNA testing, we aimed to compare triage using HR-HPV E6/E7 mRNA testing by APTIMA HPV Assay (APTIMA) to HPV16 DNA testing, HPV16/18 DNA testing, and repeat cytology. Liquid-based (PreservCyt) cell samples were obtained from HR-HPV-positive women diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) within the framework of the population-based cervical cancer screening program in Stockholm, Sweden. Samples were tested for HR-HPV E6/E7 mRNA by APTIMA (Gene-Probe Inc., San Diego, CA, USA). Women were followed up for 4 years after the index cytology via medical and laboratory records, and the Stockholm Oncology Center. Nine of 25 (36%) women in the ASCUS group, and 64 of 180 (36%) women in the LSIL group developed cervical intraepithelial neoplasia (CIN) grade 2 or worse during 4 years of follow-up. 162 (74%) women were APTIMA-positive, and APTIMA had the highest sensitivity to predict CIN2 or worse and CIN3 or worse in the ASCUS (77.8% and 100%) and LSIL (78.1 and 75.8%) groups, although specificity was insufficient (<50%). HPV16 DNA testing and repeat cytology were more specific than APTIMA. The results of this population-based study with comprehensive follow-up support the use of APTIMA as a triage test for women with ASCUS. More focused investigation is required for women with LSIL.

Triage of HR-HPV Positive Women with Minor Cytological Abnormalities: A Comparison of mRNA Testing, HPV DNA Testing, and Repeat Cytology Using a 4-Year Follow-Up of a Population-Based Study

PubMed Central

Persson, Maria; Elfström, K. Miriam; Brismar Wendel, Sophia; Weiderpass, Elisabete; Andersson, Sonia

2014-01-01

Objective Expression of the viral E6/E7 oncogenes of high-risk human papillomaviruses (HR-HPV) is necessary for malignant conversion and maintenance in cervical tissue. In order to determine whether HR-HPV E6/E7 mRNA testing more effectively predicts precancerous lesions and invasive cervical cancer than HR-HPV DNA testing, we aimed to compare triage using HR-HPV E6/E7 mRNA testing by APTIMA HPV Assay (APTIMA) to HPV16 DNA testing, HPV16/18 DNA testing, and repeat cytology. Methods Liquid-based (PreservCyt) cell samples were obtained from HR-HPV-positive women diagnosed with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) within the framework of the population-based cervical cancer screening program in Stockholm, Sweden. Samples were tested for HR-HPV E6/E7 mRNA by APTIMA (Gene-Probe Inc., San Diego, CA, USA). Women were followed up for 4 years after the index cytology via medical and laboratory records, and the Stockholm Oncology Center. Results Nine of 25 (36%) women in the ASCUS group, and 64 of 180 (36%) women in the LSIL group developed cervical intraepithelial neoplasia (CIN) grade 2 or worse during 4 years of follow-up. 162 (74%) women were APTIMA-positive, and APTIMA had the highest sensitivity to predict CIN2 or worse and CIN3 or worse in the ASCUS (77.8% and 100%) and LSIL (78.1 and 75.8%) groups, although specificity was insufficient (<50%). HPV16 DNA testing and repeat cytology were more specific than APTIMA. Conclusion The results of this population-based study with comprehensive follow-up support the use of APTIMA as a triage test for women with ASCUS. More focused investigation is required for women with LSIL. PMID:24587193

Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis.

PubMed

de Bekker-Grob, Esther W; de Kok, Inge M C M; Bulten, Johan; van Rosmalen, Joost; Vedder, Judith E M; Arbyn, Marc; Klinkhamer, Paul J J M; Siebers, Albertus G; van Ballegooijen, Marjolein

2012-08-01

Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening. The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values. Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing. Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than 3.2 more costly per test than CP, if the sensitivity of LBC is at least 3-5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %. Regarding test characteristics and costs of LBC and CP, only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost-effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost-effectiveness. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.

Type-specific detection of high-risk human papillomavirus (HPV) in self-sampled cervicovaginal cells applied to FTA elute cartridge.

PubMed

Gustavsson, Inger; Sanner, Karin; Lindell, Monica; Strand, Anders; Olovsson, Matts; Wikström, Ingrid; Wilander, Erik; Gyllensten, Ulf

2011-08-01

Most procedures for self-sampling of cervical cells are based on liquid-based media for transportation and storage. An alternative is to use a solid support, such as dry filter paper media. To evaluate if self-sampling of cervicovaginal fluid using a cytobrush (Viba-brush; Rovers Medical Devices B.V., Oss, The Netherlands) and a solid support such as the Whatman Indicating FTA Elute cartridge (GE Healthcare, United Kingdom) can be used for reliable typing of human papillomavirus (HPV), as compared to cervical samples obtained by a physician using a cytobrush and the indicating FTA Elute Micro card and biopsy analysis. A total of 50 women with a previous high-risk (HR) HPV positive test were invited to perform self-sampling using the Viba-brush and the FTA cartridge and thereafter a physician obtained a cervical sample using the cytobrush and a FTA card, together with a cervical biopsy for histology and HPV typing. Detection of HR-HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59 was performed using three multiplex real-time polymerase chain reaction (PCR) assays. All samples contained sufficient amounts of genomic DNA and the self-samples yielded on average 3.5 times more DNA than those obtained by the physician. All women that were positive for HR-HPV in the biopsy sample also typed positive both by self-sampling and physician-obtained sampling. For women with a histological diagnosis of cervical intraepithelial neoplasia grades 2-3 (CIN 2-3) all three HPV samples showed 100% concordance. A higher number of women were HPV positive by self-sampling than by physician-obtained sampling or by biopsy analysis. The Viba-brush and the FTA cartridge are suitable for self-sampling of vaginal cells and subsequent HR-HPV typing. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparative study of a novel application of automated HR HPV assay and stability in a previously untested Preservative media.

PubMed

Morel, Mike E; McBride, Simon E; Gomez, Maria P

2017-12-01

The suitability and stability of cervical cells in Novaprep media (NHQ) for certain HPV assays is unknown. We evaluated the accuracy of an automated HPV assay (Abbott RealTime HR HPV) for cervical cells prepared in NHQ and NHQ with a pre-treatment to mimic a worst case clinical use, compared to the assay manufacturers media; repeatability and reproducibility of HPV results and the stability of detectable HPV in NHQ over time compared to CE marked liquid based cytology preservatives. Cell lines were used to simulate patient samples. Cells stored in NHQ produced accurate, repeatable and reproducible results. Stability in NHQ was comparable to the best performing LBC, with at least 7 months' stability at 18-25°C, 2-8°C, -20°C and -80°C; and at least 3 months' stability at 40°C. Similar results were obtained for pre-treated NHQ except only 3.5 months' stability at 18-25°C. Cell line samples in all media and concentrations tested were detected appropriately by the assay. Based on this first stage validation analytical study, cervical cells stored in NHQ are suitable for the Realtime HPV assay. There should be no reservations for inclusion of NHQ in any further validation and clinical performance evaluation of this assay. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Improved removal of blood contamination from ThinPrep cervical cytology samples for Raman spectroscopic analysis.

PubMed

Traynor, Damien; Duraipandian, Shiyamala; Martin, Cara M; O'Leary, John J; Lyng, Fiona M

2018-05-01

There is an unmet need for methods to help in the early detection of cervical precancer. Optical spectroscopy-based techniques, such as Raman spectroscopy, have shown great potential for diagnosis of different cancers, including cervical cancer. However, relatively few studies have been carried out on liquid-based cytology (LBC) pap test specimens and confounding factors, such as blood contamination, have been identified. Previous work reported a method to remove blood contamination before Raman spectroscopy by pretreatment of the slides with hydrogen peroxide. The aim of the present study was to extend this work to excessively bloody samples to see if these could be rendered suitable for Raman spectroscopy. LBC ThinPrep specimens were treated by adding hydrogen peroxide directly to the vial before slide preparation. Good quality Raman spectra were recorded from negative and high grade (HG) cytology samples with no blood contamination and with heavy blood contamination. Good classification between negative and HG cytology could be achieved for samples with no blood contamination (sensitivity 92%, specificity 93%) and heavy blood contamination (sensitivity 89%, specificity 88%) with poorer classification when samples were combined (sensitivity 82%, specificity 87%). This study demonstrates for the first time the improved potential of Raman spectroscopy for analysis of ThinPrep specimens regardless of blood contamination. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

Accuracy of dry vaginal self-sampling for detecting high-risk human papillomavirus infection in cervical cancer screening: a cross-sectional study.

PubMed

Haguenoer, K; Giraudeau, B; Gaudy-Graffin, C; de Pinieux, I; Dubois, F; Trignol-Viguier, N; Viguier, J; Marret, H; Goudeau, A

2014-08-01

Cervical cancer screening coverage remains insufficient in most countries. Testing self-collected samples for high-risk human papillomavirus (HR-HPV) could be an alternative to the Pap smear, but costs, sampling methods and transport issues hamper its wide use. Our objective was to compare diagnostic accuracy of 2 vaginal self-collection methods, a dry swab (vsc-DRY) or swab in liquid medium (vsc-LIQ), for detecting HR-HPV cervical infection assessed by a cervical clinician-collected sample in liquid medium (ccc-LIQ). Women 20 to 65 years attending a Pap smear were recruited between September, 2009 and March, 2011. Each sample (3 per woman) underwent HPV DNA testing. Samples were classified as HR-HPV+ with detection of at least one HR-HPV or probable HR-HPV type. Of 734 women included, 722 had complete HPV data. HR-HPV was detected in 20.9% of ccc-LIQ samples. Estimated sensitivity and specificity to detect HR-HPV in vsc-DRY samples were 88.7% and 92.5%, respectively, and in vsc-LIQ samples, 87.4% and 90.9%. Cytology findings were abnormal for 79 women (10.9%): among 27 samples of low-grade squamous intraepithelial lesions, 25 were HR-HPV+ in vsc-DRY, vsc-LIQ and ccc-LIQ samples. Among 6 samples of high-grade squamous intraepithelial lesions, all were HR-HPV+ in vsc-DRY samples, 1 was HR-HPV- in vsc-LIQ samples and 1 was HR-HPV- in ccc-LIQ samples. Vaginal self-sampling with a dry swab is accurate to detect HR-HPV infection as compared with cervical clinician-collection and accurate as compared with cytology results. This cheap and easy-to-ship sampling method could be widely used in a cervical cancer screening program. Copyright © 2014 Elsevier Inc. All rights reserved.

Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing.

PubMed

Gomes de Oliveira, Geilson; Eleutério, Renata Mirian Nunes; Silveira Gonçalves, Ana Katherine; Giraldo, Paulo César; Eleutério, José

2018-01-01

The aim of this study was to assess the correlation between atypical squamous cells (ASC) and inflammatory infiltrate and vaginal microbiota using cervical liquid-based cytological (SurePath®) and high-risk human papillomavirus (HR-HPV) tests. A cross-sectional study was conducted using a 6-year database from a laboratory in Fortaleza (Brazil). Files from 1,346 ASC cases were divided into subgroups and results concerning inflammation and vaginal microorganisms diagnosed by cytology were compared with HR-HPV test results. An absence of specific microorganisms (ASM) was the most frequent finding (ASC of undetermined significance, ASC-US = 74%; ASC - cannot exclude high-grade squamous intraepithelial lesion, ASC-H = 68%), followed by bacterial vaginosis (ASC-US = 20%; ASC- H = 25%) and Candida spp. (ASC-US = 6%; ASC-H = 5%). Leukocyte infiltrate was present in 71% of ASC-US and 85% of ASC-H (p = 0.0040), and in these specific cases HR-HPV tests were positive for 65 and 64%, respectively. A positive HR-HPV test was relatively more frequent when a specific microorganism was present, and Candida spp. was associated with HR-HPV-positive results (p = 0.0156), while an ASM was associated with negative HR-HPV results (p = 0.0370). ASC-US is associated with an absence of inflammation or vaginosis, while ASC-H smears are associated with Trichomonas vaginalis and inflammatory infiltrate. A positive HR-HPV is associated with Candida spp. in ASC cytology. © 2017 S. Karger AG, Basel.

Modeling Musical Context With Word2Vec

NASA Astrophysics Data System (ADS)

Herremans, Dorien; Chuan, Ching-Hua

2017-05-01

We present a semantic vector space model for capturing complex polyphonic musical context. A word2vec model based on a skip-gram representation with negative sampling was used to model slices of music from a dataset of Beethoven's piano sonatas. A visualization of the reduced vector space using t-distributed stochastic neighbor embedding shows that the resulting embedded vector space captures tonal relationships, even without any explicit information about the musical contents of the slices. Secondly, an excerpt of the Moonlight Sonata from Beethoven was altered by replacing slices based on context similarity. The resulting music shows that the selected slice based on similar word2vec context also has a relatively short tonal distance from the original slice.

Do health care providers have a lower prevalence of abnormal pap smears than the general public?

PubMed

Suwannarurk, Komsun; Bhamarapravatana, Konkarn; Kheolamai, Pakpoom; Thaweekul, Yuttadej; Mairaing, Karicha; Poomtavorn, Yenrudee; Pattaraarchachai, Junya

2010-12-01

Most Thai people believe that health care providers have a lower risk of any disease than their patients. This belief may lull Thai health care providers into accepting the false belief that they are at a lower risk of having the precancerous conditions that lead to cervical cancer. This study compares the prevalence of abnormal Pap smears from health care providers (HC) and non health care providers (NHC) by using the standard liquid-based Pap smear processing at Thammasat University Hospital's pathology department, Thailand. Both health care providers (HC) and non health care providers (NHC) were patients at the outpatient clinic, Thammasat University Hospital. They were screened for cervical cancer by using liquid-based Pap smear (LBP). Cytological diagnoses and specimen adequacy were classified using the Bethesda system 2001. All subjects who had abnormal cytology more than atypical squamous cells or atypical glandular cells were counseled to have performed a colposcopic directed biopsy for confirmation of pathology. A total of 250 liquid-base Pap smears were processed and evaluated at the Gynecology clinic, Thammasat University Hospital from April 2008 to May 2008. The groups of HC and NHC consisted of 122 and 128 women, respectively. In general, both the HC and NHC groups were similar in their age, religion, income and education level distributions. The range of ages was between 16 and 75 years, with the mean age equal to 40.2 +/- 10.5 years. Prevalence of abnormal Pap smears was 9.8% in HC and 9.4% in NHC (p-value = 0.90). HC showed atypical change (ASC, AGC), low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) at 0.8%, 1.6% and 7.4%, respectively. NHC had an incidence of atypical change, LSIL and HSIL at 0.8%, 0.8% and 7.8%. HC had an equal incidence of abnormal Pap smears prevalence to NHC. Further, the percentage of HC and NHC groups with histological confirmed cervical intraepithelial neoplasia (CIN) 1 were not significantly different (4.92% vs. 6.25%, p-value = 0.70), likewise CIN 2/3 (1.64% vs. 1.56%, p-value = 1.00). According to our study the rate of abnormal Pap smears observed in both health care providers and clients was essentially the same. The prevalence of abnormal Pap smears in health care providers was statistically equivalent to that in their clients.

A comparison of protein profiles of cervical tissue homogenate, exfoliated cells from cervix and serum in normal and cervical malignancy conditions.

PubMed

Bhat, Sujatha; Kartha, Vasudevan Bhaskaran; Rai, Lavanya; Chidangil, Santhosh

2015-01-01

Cervical cancer, the second most common cancer in women, progresses silently over long periods before producing any clinical manifestation. Research in early detection of this condition using proteomic techniques is of very recent origin. We used high-performance liquid chromatography combined with laser-induced fluorescence method in our lab to record the protein profiles of tissue homogenate, cell lysate and serum samples of normal and different stages of malignant conditions of the cervix. Information on protein markers in the protein profiles was derived using various data processing methods including curve resolution. The variations in relative intensities of different peaks with respect to peak height, width and area under the curve from different sample types were compared to get information regarding the concentration of the various proteins and their significance in the induction and metastasis of cervical cancer. The method can be used in diagnosis, follow-up with respect to the progression, remission and effective therapy, in cervical malignancy. © The Author [2014]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Ideal Strategy for Cervical Cancer Screening in Japan: Result from the Fukui Cervical Cancer Screening Study.

PubMed

Kurokawa, T; Onuma, T; Shinagawa, A; Chino, Y; Kobayashi, M; Yoshida, Y

2018-05-16

The aims of the Fukui Cervical Cancer Screening (FCCS) study are to determine the frequency of women with high-risk HPV (hrHPV), whether HPV16 or HPV18 (HPV16/18), in the Japanese cancer screening population for the first time and to identify the best strategy for cervical cancer screening in Japan. This study enrolled 7,584 women ≥25 years of age who were undergoing routine screening. All women underwent liquid-based cytology and cobas HPV tests. Women with abnormal cytology, whether hrHPV positive or negative; women with hrHPV positivity with either normal or abnormal cytology; and women randomly selected from women with normal cytology and negative hrHPV negative were referred for colposcopy. The prevalences of hrHPV positivity and HPV16/18 positivity were 6.8% and 1.7%, respectively. The baseline data from the FCCS study showed that the combination of HPV tests and cytology was more sensitive than cytology with respect to the detection of intraepithelial neoplasia grade 2 or worse. However, the specificity (94.1%) of the co-testing strategy that required all women with abnormal cytology or hrHPV positivity to be referred for colposcopy was much lower than that (97.8%) of cytology. The sensitivity and specificity of the co-testing strategy that required only women with abnormal cytology or HPV16/18 positivity to undergo colposcopy were 85.5% and 97.0%, respectively. The baseline data from the FCCS study suggest that a cervical cancer screening strategy in which only women with abnormal cytology or HPV16/18 positivity undergo colposcopy offers a more balanced sensitivity and specificity than other strategies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

HPV testing in routine cervical screening: cross sectional data from the ARTISTIC trial

PubMed Central

Kitchener, H C; Almonte, M; Wheeler, P; Desai, M; Gilham, C; Bailey, A; Sargent, A; Peto, J

2006-01-01

To evaluate the effectiveness of human papillomavirus (HPV) testing in primary cervical screening. This was a cross-sectional study from the recruitment phase of a prospective randomised trial. Women were screened for HPV in addition to routine cervical cytology testing. Greater Manchester, attendees at routine NHS Cervical Screening Programme. In all, 24 510 women aged 20–64 screened with liquid-based cytology (LBC) and HPV testing at entry. HPV testing in primary cervical screening. Type-specific HPV prevalence rates are presented in relation to age as well as cytological and histological findings at entry. In all, 24 510 women had adequate cytology and HPV results. Cytology results at entry were: 87% normal, 11% borderline or mild, 1.1% moderate and 0.6% severe dyskaryosis or worse. Prevalence of HPV decreased sharply with age, from 40% at age 20–24 to 12% at 35–39 and 7% or less above age 50. It increased with cytological grade, from 10% of normal cytology and 31% of borderline to 70% mild, 86% moderate, and 96% of severe dyskaryosis or worse. HPV 16 or HPV 18 accounted for 64% of infections in women with severe or worse cytology, and one or both were found in 61% of women with severe dyskaryosis but in only 2.2% of those with normal cytology. The majority of young women in Greater Manchester have been infected with a high-risk HPV by the age of 30. HPV testing is practicable as a primary routine screening test, but in women aged under 30 years, this would lead to a substantial increase in retesting and referral rates. HPV 16 and HPV 18 are more predictive of underlying disease, but other HPV types account for 30% of high-grade disease. PMID:16773068

Evaluation of low-cost computer monitors for the detection of cervical spine injuries in the emergency room: an observer confidence-based study.

PubMed

Brem, M H; Böhner, C; Brenning, A; Gelse, K; Radkow, T; Blanke, M; Schlechtweg, P M; Neumann, G; Wu, I Y; Bautz, W; Hennig, F F; Richter, H

2006-11-01

To compare the diagnostic value of low-cost computer monitors and a Picture Archiving and Communication System (PACS) workstation for the evaluation of cervical spine fractures in the emergency room. Two groups of readers blinded to the diagnoses (2 radiologists and 3 orthopaedic surgeons) independently assessed-digital radiographs of the cervical spine (anterior-posterior, oblique and trans-oral-dens views). The radiographs of 57 patients who arrived consecutively to the emergency room in 2004 with clinical suspicion of a cervical spine injury were evaluated. The diagnostic values of these radiographs were scored on a 3-point scale (1 = diagnosis not possible/bad image quality, 2 = diagnosis uncertain, 3 = clear diagnosis of fracture or no fracture) on a PACS workstation and on two different liquid crystal display (LCD) personal computer monitors. The images were randomised to avoid memory effects. We used logistic mixed-effects models to determine the possible effects of monitor type on the evaluation of x ray images. To determine the overall effects of monitor type, this variable was used as a fixed effect, and the image number and reader group (radiologist or orthopaedic surgeon) were used as random effects on display quality. Group-specific effects were examined, with the reader group and additional fixed effects as terms. A significance level of 0.05 was established for assessing the contribution of each fixed effect to the model. Overall, the diagnostic score did not differ significantly between standard personal computer monitors and the PACS workstation (both p values were 0.78). Low-cost LCD personal computer monitors may be useful in establishing a diagnosis of cervical spine fractures in the emergency room.

[Cervical screening: toward a new paradigm?].

PubMed

Lavoué, V; Bergeron, C; Riethmuller, D; Daraï, E; Mergui, J-L; Baldauf, J-J; Gondry, J; Douvier, S; Lopès, P; de Reilhac, P; Quéreux, C; Letombe, B; Marchetta, J; Boulanger, J-C; Levêque, J

2010-04-01

Analysis of the trials which compare the virologic testing (HPV testing) and the cytology in the cervical screening. The MedLine database was consulted using the Keywords: "cervical screening", "pap smear", "liquid based cytology", "HPV testing", "adults", "adolescents", "cervical intraepithelial neoplasia (CIN)", "uterine cervix cancer". Articles were selected according their concern about the debate of the uterine cervix cancer screening in France. The HPV testing seems interesting allowing a decreasing delay in the diagnosis of CIN (more diagnosis of CIN2+ in the first round and less during the second one). But, when the two rounds are added, the number of CIN2+ are identical in the two arms (cytology and HPV testing) in all the trials (except the Italian NTCC trial). A negative HPV testing protects the women much longer than cytology can do: a delay of five years between two rounds seems ideal. The HPV testing alone increases the detection rate of cervical lesions, which could regress spontaneously and may induce an overtreatment, especially in the youngest population: a triage is necessary and the cytology appears to be the best way to select the candidates for colposcopy in case of positive HPV testing and cytology. The HPV infection presents some particularities in adolescent females: for this reason, the HPV testing should not be used in this special population. In vaccinated women, a consensus for the screening is necessary. The health care providers in France have to understand the characteristics of the HPV testing: its advantages compared to the cytologic screening are only evident in case of an organization of the screening in France and even in Europe. (c) 2010 Elsevier Masson SAS. All rights reserved.

Danish method study on cervical screening in women offered HPV vaccination as girls (Trial23): a study protocol.

PubMed

Thamsborg, Lise Holst; Andersen, Berit; Larsen, Lise Grupe; Christensen, Jette; Johansen, Tonje; Hariri, Jalil; Christiansen, Sanne; Rygaard, Carsten; Lynge, Elsebeth

2018-05-26

The first birth cohorts of women offered human papillomavirus (HPV) vaccination as girls are now entering cervical screening. However, there is no international consensus on how to screen HPV vaccinated women. These women are better protected against cervical cancer and could therefore be offered less intensive screening. Primary HPV testing is more sensitive than cytology, allowing for a longer screening interval. The aim of Trial23 is to investigate if primary HPV testing with cytology triage of HPV positive samples is a reasonable screening scheme for women offered HPV vaccination as girls. Trial23 is a method study embedded in the existing cervical screening programme in four out of five Danish regions. Without affecting the screening programme, women born in 1994 are randomised to present screening with liquid-based cytology every third year (present programme arm) or present screening plus an HPV test (HPV arm). The study started 1 February 2017 and will run over three screening rounds corresponding to 7-8 years. The primary endpoint is cervical intraepithelial neoplasia grade 3 or above. The trial is undertaken as a non-inferiority study including intention-to-treat and per-protocol analyses. The potential effect of primary HPV screening with a 6-year interval will be calculated from the observed data. The study protocol has been submitted to the ethical committee and deemed a method study. All women are screened according to routine guidelines. The study will contribute new evidence on the future screening of HPV vaccinated birth cohorts of women. All results will be published in open-access journal. NCT03049553; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Differentiating between endocervical glandular neoplasia and high grade squamous intraepithelial lesions in endocervical crypts: cytological features in ThinPrep and SurePath cervical cytology samples.

PubMed

Thiryayi, Sakinah A; Marshall, Janet; Rana, Durgesh N

2009-05-01

A recent audit at our institution revealed a higher number of cases diagnosed as endocervical glandular neoplasia on ThinPrep (TP) cervical cytology samples (9 cases) as opposed to SurePath (SP) (1 case), which on histology showed only high-grade cervical intraepithelial neoplasia (CIN) with endocervical crypt involvement (CI). We attempted to ascertain the reasons for this finding by reviewing the available slides of these cases, as well as slides of cases diagnosed as glandular neoplasia on cytology and histology; cases diagnosed as high-grade squamous intraepithelial lesions (HSIL) on cytology which had CIN with CI on histology and cases with mixed glandular and squamous abnormalities diagnosed both cytologically and histologically. Single neoplastic glandular cells and short pseudostratified strips were more prevalent in SP than TP with the cell clusters in glandular neoplasia 3-4 cells thick, in contrast to the dense crowded centre of cell groups in HSIL with CI. The cells at the periphery of groups can be misleading. Cases with HSIL and glandular neoplasia have a combination of the features of each entity in isolation. The diagnosis of glandular neoplasia remains challenging and conversion from conventional to liquid based cervical cytology requires a period of learning and adaptation, which can be facilitated by local audit and review of the cytology slides in cases with a cytology-histology mismatch. (c) 2009 Wiley-Liss, Inc.

Alpha-tocopherol and alpha-tocopheryl quinone levels in cervical intraepithelial neoplasia and cervical cancer.

PubMed

Palan, Prabhudas R; Woodall, Angela L; Anderson, Patrick S; Mikhail, Magdy S

2004-05-01

alpha-Tocopherol is a potent antioxidant that protects cell membranes against oxidative damage. Red blood cell alpha-tocopherol levels reflect membrane alpha-tocopherol concentrations, and altered levels may suggest membrane damage. The objective of this study was to determine the levels of alpha-tocopherol and alpha-tocopheryl quinone, the oxidized product of alpha-tocopherol, in plasma and red blood cells that were obtained from control subjects and patients with cervical intraepithelial neoplasia and cervical cancer. In this cross-sectional study, 72 women, (32 African American and 40 Hispanic) were recruited. Among these subjects, 37 women had cervical intraepithelial neoplasia; 14 women had cervical cancer, and 21 women were considered control subjects, who had normal Papanicolaou test results. alpha-Tocopherol and alpha-tocopheryl quinone levels were determined in red blood cell and plasma by high-pressure liquid chromatography. Plasma levels of alpha-tocopherol and alpha-tocopheryl quinone were decreased significantly (P=.012 and=.005, respectively, by Kruskal-Wallis test) in study groups compared with the control group; red blood cell levels of alpha-tocopherol and alpha-tocopheryl quinone were not altered significantly. The lower alpha-tocopherol level that was observed in this study is consistent with our previous reports of decreased antioxidant concentrations and increased oxidative stress in women with cervical intraepithelial neoplasia. Unaltered red blood cell alpha-tocopherol and alpha-tocopheryl quinone levels suggest undamaged cell membrane. Further studies are needed to investigate the potential role of oxidative stress in cervical intraepithelial neoplasia.

Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study

PubMed Central

2012-01-01

Background Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain. Methods The CLEOPATRE Spain study enrolled 3 261 women aged 18–65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection. Results A lifetime number of two or more sexual partners, young age (18–25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01). Conclusion This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection. PMID:22734435

Characteristic findings of cervical Papanicolaou tests from transgender patients on androgen therapy: Challenges in detecting dysplasia.

PubMed

Adkins, B D; Barlow, A B; Jack, A; Schultenover, S J; Desouki, M M; Coogan, A C; Weiss, V L

2018-02-28

The characteristic features of Papanicolaou (Pap) tests collected from female-to-male (FTM) transgender patients on androgen therapy have not been well defined in the literature. FTM transgender patients require cervical cancer screening with the same recommended frequency as cis-gender females. Dysplasia remains challenging to differentiate from atrophy. Without pertinent history, the atrophic findings in younger transgender patients can be misinterpreted as high-grade dysplasia. A review of all cervical Pap tests of transgender patients receiving androgen therapy (2010-2017) was performed. Bethesda diagnosis, cytomorphological features, HPV testing and cervical biopsy results were reviewed. Eleven transgender patients receiving androgen therapy were identified with 23 cervical Pap tests, 11 HPV tests and five cervical biopsies performed. A review of the Pap tests demonstrated: 57% negative for intraepithelial lesion; 13% unsatisfactory; 13% atypical squamous cells of undetermined significance; 13% atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion; and 4% high-grade squamous intraepithelial lesion. The rates of abnormal tests were higher than our age-matched cis-gender atrophic cohort rates of unsatisfactory (0.5%), atypical squamous cells of undetermined significance (7%), atypical squamous cells-cannot exclude high-grade squamous intraepithelial lesion (0%) and high-grade squamous intraepithelial lesion (0.5%). The cytological findings from liquid-based preparations included dispersed and clustered parabasal-type cells, scattered degenerated cells, smooth evenly dispersed chromatin, and occasional mild nuclear enlargement and irregularity. Dysplastic cells had larger nuclei, hyperchromatic clumped chromatin, and more irregular nuclear contours. The evaluation of dysplasia can be challenging on Pap tests from transgender patients on androgen therapy. The cohort evaluated had higher rates of unsatisfactory and abnormal Pap tests. Pathologists should be familiar with the distinctive cytomorphological changes in the Pap tests from patients on androgen therapy to evaluate them appropriately. © 2018 John Wiley & Sons Ltd.

Predictors of human papillomavirus infection in women undergoing routine cervical cancer screening in Spain: the CLEOPATRE study.

PubMed

Roura, Esther; Iftner, Thomas; Vidart, José Antonio; Kjaer, Susanne Krüger; Bosch, F Xavier; Muñoz, Nubia; Palacios, Santiago; Rodriguez, Maria San Martin; Morillo, Carmen; Serradell, Laurence; Torcel-Pagnon, Laurence; Cortes, Javier; Castellsagué, Xavier

2012-06-26

Human papillomavirus (HPV) is a sexually transmitted infection that may lead to development of precancerous and cancerous lesions of the cervix. The aim of the current study was to investigate socio-demographic, lifestyle, and medical factors for potential associations with cervical HPV infection in women undergoing cervical cancer screening in Spain. The CLEOPATRE Spain study enrolled 3 261 women aged 18-65 years attending cervical cancer screening across the 17 Autonomous Communities. Liquid-based cervical samples underwent cytological examination and HPV testing. HPV positivity was determined using the Hybrid Capture II assay, and HPV genotyping was conducted using the INNO-LiPA HPV Genotyping Extra assay. Multivariate logistic regression was used to identify putative risk factors for HPV infection. A lifetime number of two or more sexual partners, young age (18-25 years), a history of genital warts, and unmarried status were the strongest independent risk factors for HPV infection of any type. Living in an urban community, country of birth other than Spain, low level of education, and current smoking status were also independent risk factors for HPV infection. A weak inverse association between condom use and HPV infection was observed. Unlike monogamous women, women with two or more lifetime sexual partners showed a lower risk of infection if their current partner was circumcised (P for interaction, 0.005) and a higher risk of infection if they were current smokers (P for interaction, 0.01). This is the first large-scale, country-wide study exploring risk factors for cervical HPV infection in Spain. The data strongly indicate that variables related to sexual behavior are the main risk factors for HPV infection. In addition, in non-monogamous women, circumcision of the partner is associated with a reduced risk and smoking with an increased risk of HPV infection.

Home-Based or Clinic-Based Human Papillomavirus (HPV) Screening

ClinicalTrials.gov

2018-04-16

Atypical Squamous Cell of Undetermined Significance; Cervical Carcinoma; Cervical Intraepithelial Neoplasia Grade 2/3; Health Status Unknown; Human Papillomavirus Infection; Low Grade Cervical Squamous Intraepithelial Neoplasia; Stage 0 Cervical Cancer

Reoperation Rates After Anterior Cervical Discectomy and Fusion for Cervical Spondylotic Radiculopathy and Myelopathy: A National Population-based Study.

PubMed

Park, Moon Soo; Ju, Young-Su; Moon, Seong-Hwan; Kim, Tae-Hwan; Oh, Jae Keun; Makhni, Melvin C; Riew, K Daniel

2016-10-15

National population-based cohort study. To compare the reoperation rates between cervical spondylotic radiculopathy and myelopathy in a national population of patients. There is an inherently low incidence of reoperation after surgery for cervical degenerative disease. Therefore, it is difficult to sufficiently power studies to detect differences between reoperation rates of different cervical diagnoses. National population-based databases provide large, longitudinally followed cohorts that may help overcome this challenge. We used the Korean Health Insurance Review and Assessment Service national database to select our study population. We included patients with the diagnosis of cervical spondylotic radiculopathy or myelopathy who underwent anterior cervical discectomy and fusion from January 2009 to June 2014. We separated patients into two groups based on diagnosis codes: cervical spondylotic radiculopathy or cervical spondylotic myelopathy. Age, sex, presence of diabetes, osteoporosis, associated comorbidities, number of operated cervical disc levels, and hospital types were considered potential confounding factors. The overall reoperation rate was 2.45%. The reoperation rate was significantly higher in patients with cervical spondylotic myelopathy than in patients with cervical radiculopathy (myelopathy: P = 0.0293, hazard ratio = 1.433, 95% confidence interval 1.037-1.981). Male sex, presence of diabetes or associated comorbidities, and hospital type were noted to be risk factors for reoperation. The reoperation rate after anterior cervical discectomy and fusion was higher for cervical spondylotic myelopathy than for cervical spondylotic radiculopathy in a national population of patients. 3.

The preliminary exploration of 64-slice volume computed tomography in the accurate measurement of pleural effusion.

PubMed

Guo, Zhi-Jun; Lin, Qiang; Liu, Hai-Tao; Lu, Jun-Ying; Zeng, Yan-Hong; Meng, Fan-Jie; Cao, Bin; Zi, Xue-Rong; Han, Shu-Ming; Zhang, Yu-Huan

2013-09-01

Using computed tomography (CT) to rapidly and accurately quantify pleural effusion volume benefits medical and scientific research. However, the precise volume of pleural effusions still involves many challenges and currently does not have a recognized accurate measuring. To explore the feasibility of using 64-slice CT volume-rendering technology to accurately measure pleural fluid volume and to then analyze the correlation between the volume of the free pleural effusion and the different diameters of the pleural effusion. The 64-slice CT volume-rendering technique was used to measure and analyze three parts. First, the fluid volume of a self-made thoracic model was measured and compared with the actual injected volume. Second, the pleural effusion volume was measured before and after pleural fluid drainage in 25 patients, and the volume reduction was compared with the actual volume of the liquid extract. Finally, the free pleural effusion volume was measured in 26 patients to analyze the correlation between it and the diameter of the effusion, which was then used to calculate the regression equation. After using the 64-slice CT volume-rendering technique to measure the fluid volume of the self-made thoracic model, the results were compared with the actual injection volume. No significant differences were found, P = 0.836. For the 25 patients with drained pleural effusions, the comparison of the reduction volume with the actual volume of the liquid extract revealed no significant differences, P = 0.989. The following linear regression equation was used to compare the pleural effusion volume (V) (measured by the CT volume-rendering technique) with the pleural effusion greatest depth (d): V = 158.16 × d - 116.01 (r = 0.91, P = 0.000). The following linear regression was used to compare the volume with the product of the pleural effusion diameters (l × h × d): V = 0.56 × (l × h × d) + 39.44 (r = 0.92, P = 0.000). The 64-slice CT volume-rendering technique can accurately measure the volume in pleural effusion patients, and a linear regression equation can be used to estimate the volume of the free pleural effusion.

Effectiveness of several solutions to prevent the formation of precipitate due to the interaction between sodium hypochlorite and chlorhexidine and its effect on bond strength of an epoxy-based sealer.

PubMed

Magro, M G; Kuga, M C; Aranda-Garcia, A J; Victorino, K R; Chávez-Andrade, G M; Faria, G; Keine, K C; Só, M V R

2015-05-01

To evaluate the effectiveness of isopropyl alcohol, saline or distilled water to prevent the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and its effect on the bond strength of an epoxy-based sealer in radicular dentine. The root canals of 50 extracted human canines (n = 10) were instrumented. In G1, root canals were irrigated with 17% EDTA and 2.5% NaOCl; G2, as G1, except that 2% CHX was used as the final irrigant. In the other groups, intermediate flushes with isopropyl alcohol (G3), saline (G4) or distilled water (G5) were used between NaOCl and CHX. The specimens were submitted to SEM analysis to evaluate the presence of debris and smear layer, in the apical and cervical segments. In sequence, fifty extracted human canines were distributed into five groups (n = 10), similar to the SEM study. After root filling, the roots were sectioned transversally to obtain dentine slices, in the cervical, middle and apical thirds. The root filling was submitted to a push-out bond strength test using an electromechanical testing machine. Statistical analysis was performed using Kruskal-Wallis and Dunn's tests (α = 5%). All groups had similar amounts of residue precipitated on the canal walls (P > 0.05). The push-out bond strength values were similar for all groups, independently of the root third evaluated (P > 0.05). Isopropyl alcohol, saline and distilled water failed to prevent the precipitation of residues on canal walls following the use of NaOCl and CHX. The residues did not interfere with the push-out bond strength of the root filling. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Prevalence and genotype distribution of human papillomavirus infection of the cervix in Spain: the CLEOPATRE study.

PubMed

Castellsagué, Xavier; Iftner, Thomas; Roura, Esther; Vidart, José Antonio; Kjaer, Susanne K; Bosch, F Xavier; Muñoz, Nubia; Palacios, Santiago; San Martin Rodriguez, Maria; Serradell, Laurence; Torcel-Pagnon, Laurence; Cortes, Javier

2012-06-01

Human papillomavirus (HPV) infection is a necessary cause of cervical cancer. The aim of this study was to estimate the prevalence of cervical HPV infection and HPV type-specific distribution among women attending cervical cancer screening in Spain during 2007 and 2008. Women aged 18-65 years were recruited according to an age-stratified sampling method. Liquid-based cervical samples were collected and analyzed for cytology, HPV detection, and genotyping. HPV genotyping was determined using the INNO-LiPA HPV Genotyping Extra Reverse Hybridization Line Probe Assay. Prevalence estimates were age-standardized using 2001 Spanish census data. The present study included 3,261 women. Age-standardized HC2-based HPV prevalence was 14.3% (95% CI, 13.1-15.5) among women aged 18-65 years, and 28.8% (26.6-31.1) among women aged 18-25 years. High-risk HPV types were detected in 12.2% (95% CI, 11.1-13.4) of HPV-tested women, representing 84.0% of HPV-positive samples. Multiple infections were present in 4.1% (95% CI, 3.4-4.8) of HPV-tested women (25.0% of HPV-positive samples). The most common high-risk HPV-types among HPV-tested women were 16 (2.9%), 52 (1.8%), 51 (1.6%), 31 (1.3%), and 66 (1.2%). HPV-type 16 was present in 16.9% of HPV-positive samples. One or more of the HPV vaccine types 6/11/16/18 were detected in 3.8% of HPV-tested women (22.1% of HPV-positive samples). Though not a true population-based survey, this study provides valuable baseline data for future assessment of the impact of current HPV vaccination programs in Spain. The high prevalence of HPV infection among young women may reflect recent changes in sexual behavior. Copyright © 2012 Wiley Periodicals, Inc.

A randomized controlled trial of Human Papillomavirus (HPV) testing for cervical cancer screening: trial design and preliminary results (HPV FOCAL Trial)

PubMed Central

2010-01-01

Background In the HPV FOCAL trial, we will establish the efficacy of hr-HPV DNA testing as a stand-alone screening test followed by liquid based cytology (LBC) triage of hr-HPV-positive women compared to LBC followed by hr-HPV triage with ≥ CIN3 as the outcome. Methods/Design HPV-FOCAL is a randomized, controlled, three-armed study over a four year period conducted in British Columbia. It will recruit 33,000 women aged 25-65 through the province's population based cervical cancer screening program. Control arm: LBC at entry and two years, and combined LBC and hr-HPV at four years among those with initial negative results and hr-HPV triage of ASCUS cases; Two Year Safety Check arm: hr-HPV at entry and LBC at two years in those with initial negative results with LBC triage of hr-HPV positives; Four Year Intervention Arm: hr-HPV at entry and combined hr-HPV and LBC at four years among those with initial negative results with LBC triage of hr-HPV positive cases Discussion To date, 6150 participants have a completed sample and epidemiologic questionnaire. Of the 2019 women enrolled in the control arm, 1908 (94.5%) were cytology negative. Women aged 25-29 had the highest rates of HSIL (1.4%). In the safety arm 92.2% of women were hr-HPV negative, with the highest rate of hr-HPV positivity found in 25-29 year old women (23.5%). Similar results were obtained in the intervention arm HPV FOCAL is the first randomized trial in North America to examine hr-HPV testing as the primary screen for cervical cancer within a population-based cervical cancer screening program. Trial Registration International Standard Randomised Controlled Trial Number Register, ISRCTN79347302 PMID:20334685

Slice regular functions of several Clifford variables

NASA Astrophysics Data System (ADS)

Ghiloni, R.; Perotti, A.

2012-11-01

We introduce a class of slice regular functions of several Clifford variables. Our approach to the definition of slice functions is based on the concept of stem functions of several variables and on the introduction on real Clifford algebras of a family of commuting complex structures. The class of slice regular functions include, in particular, the family of (ordered) polynomials in several Clifford variables. We prove some basic properties of slice and slice regular functions and give examples to illustrate this function theory. In particular, we give integral representation formulas for slice regular functions and a Hartogs type extension result.

3D model of filler melting with micro-beam plasma arc based on additive manufacturing technology

NASA Astrophysics Data System (ADS)

Chen, Weilin; Yang, Tao; Yang, Ruixin

2017-07-01

Additive manufacturing technology is a systematic process based on discrete-accumulation principle, which is derived by the dimension of parts. Aiming at the dimension mathematical model and slicing problems in additive manufacturing process, the constitutive relations between micro-beam plasma welding parameters and the dimension of part were investigated. The slicing algorithm and slicing were also studied based on the dimension characteristics. By using the direct slicing algorithm according to the geometric characteristics of model, a hollow thin-wall spherical part was fabricated by 3D additive manufacturing technology using micro-beam plasma.

Dispersion-based Fresh-slice Scheme for Free-Electron Lasers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Guetg, Marc

The Fresh-slice technique improved the performance of several Self-Amplified Spontaneous Emission Free-Electron laser schemes by granting selective control on the temporal lasing slice without spoiling the other electron bunch slices. So far, the implementation required a special insertion device to create the beam yaw, called dechirper. We demonstrate a novel scheme to enable Freshslice operation based on electron energy chirp and orbit dispersion that can be implemented at any free-electron laser facility without additional hardware.

Optical microwave filter based on spectral slicing by use of arrayed waveguide gratings.

PubMed

Pastor, Daniel; Ortega, Beatriz; Capmany, José; Sales, Salvador; Martinez, Alfonso; Muñoz, Pascual

2003-10-01

We have experimentally demonstrated a new optical signal processor based on the use of arrayed waveguide gratings. The structure exploits the concept of spectral slicing combined with the use of an optical dispersive medium. The approach presents increased flexibility from previous slicing-based structures in terms of tunability, reconfiguration, and apodization of the samples or coefficients of the transversal optical filter.

A rare cause of dysphagia: compression of the esophagus by an anterior cervical osteophyte due to ankylosing spondylitis.

PubMed

Albayrak, Ilknur; Bağcacı, Sinan; Sallı, Ali; Kucuksen, Sami; Uğurlu, Hatice

2013-09-01

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatological disease affecting the axial skeleton with various extra-articular complications. Dysphagia due to a giant anterior osteophyte of the cervical spine in AS is extremely rare. We present a 48-year-old male with AS suffering from progressive dysphagia to soft foods and liquids. Esophagography showed an anterior osteophyte at C5-C6 resulting in esophageal compression. The patient refused surgical resection of the osteophyte and received conservative therapy. However, after 6 months there was no improvement in dysphagia. This case illustrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS and should be included in the diagnostic workup in early stages of the disease.

Clinical application of DNA ploidy to cervical cancer screening: A review.

PubMed

Garner, David

2014-12-10

Screening for cervical cancer with DNA ploidy assessment by automated quantitative image cytometry has spread throughout China over the past decade and now an estimated 1 million tests per year are done there. Compared to conventional liquid based cytology, DNA ploidy has competitive accuracy with much higher throughput per technician. DNA ploidy has the enormous advantage that it is an objective technology that can be taught in typically 2 or 3 wk, unlike qualitative cytology, and so it can enable screening in places that lack sufficient qualified cytotechnologists and cytopathologists for conventional cytology. Most papers on experience with application of the technology to cervical cancer screening over the past decade were published in the Chinese language. This review aims to provide a consistent framework for analysis of screening data and to summarize some of the work published from 2005 to the end of 2013. Of particular interest are a few studies comparing DNA ploidy with testing for high risk human papilloma virus (hrHPV) which suggest that DNA ploidy is at least equivalent, easier and less expensive than hrHPV testing. There may also be patient management benefits to combining hrHPV testing with DNA ploidy. Some knowledge gaps are identified and some suggestions are made for future research directions.

Clinical application of DNA ploidy to cervical cancer screening: A review

PubMed Central

Garner, David

2014-01-01

Screening for cervical cancer with DNA ploidy assessment by automated quantitative image cytometry has spread throughout China over the past decade and now an estimated 1 million tests per year are done there. Compared to conventional liquid based cytology, DNA ploidy has competitive accuracy with much higher throughput per technician. DNA ploidy has the enormous advantage that it is an objective technology that can be taught in typically 2 or 3 wk, unlike qualitative cytology, and so it can enable screening in places that lack sufficient qualified cytotechnologists and cytopathologists for conventional cytology. Most papers on experience with application of the technology to cervical cancer screening over the past decade were published in the Chinese language. This review aims to provide a consistent framework for analysis of screening data and to summarize some of the work published from 2005 to the end of 2013. Of particular interest are a few studies comparing DNA ploidy with testing for high risk human papilloma virus (hrHPV) which suggest that DNA ploidy is at least equivalent, easier and less expensive than hrHPV testing. There may also be patient management benefits to combining hrHPV testing with DNA ploidy. Some knowledge gaps are identified and some suggestions are made for future research directions. PMID:25493231

Evaluation of nuclear chromatin using grayscale intensity and thresholded percentage area in liquid-based cervical cytology.

PubMed

Lee, Hyekyung; Han, Myungein; Yoo, Taejo; Jung, Chanho; Son, Hyun-Jin; Cho, Migyung

2018-05-01

Development of computerized image analysis techniques has opened up the possibility for the quantitative analysis of nuclear chromatin in pathology. We hypothesized that the features extracted from digital images could be used to determine specific cytomorphological findings for nuclear chromatin that may be applicable for establishing a medical diagnosis. Three parameters were evaluated from nuclear chromatin images obtained from the liquid-based cervical cytology samples of patients with biopsy-proven high-grade squamous intraepithelial lesion (HGSIL), and compared between non-neoplastic squamous epithelia and dysplastic epithelia groups: (1) standard deviation (SD) of the grayscale intensity; (2) difference between the maximum and minimum grayscale intensity (M-M); and (3) thresholded area percentage. Each parameter was evaluated at the mean, mean-1SD, and mean-2SD thresholding intensity levels. Between the mean and mean-1SD levels, the thresholded nuclear chromatin pattern was most similar to the chromatin granularity of the unthresholded grayscale images. The SD of the gray intensity and the thresholded area percentage differed significantly between the non-neoplastic squamous epithelia and dysplastic epithelia of HGSIL images at all three thresholding intensity levels (mean, mean-1SD, and mean-2SD). However, the M-M significantly differed between the two sample types for only two of the thresholding intensity levels (mean-1SD and mean-2SD). The digital parameters SD and M-M of the grayscale intensity, along with the thresholded area percentage could be useful in automated cytological evaluations. Further studies are needed to identify more valuable parameters for clinical application. © 2018 Wiley Periodicals, Inc.

Analysis of HPV distribution in patients with cervical precancerous lesions in Western China.

PubMed

Li, Kemin; Yin, Rutie; Li, Qingli; Wang, Danqing

2017-07-01

Cervical human papillomavirus (HPV) infection is a dangerous disease, whose subtypes exhibit different distribution patterns in particular countries, regions, and races. In this study, the HPV distribution in patients with cervical precancerous lesions in Western China was investigated to assess a probability for prevention of cervical cancer and the clinical application of an HPV vaccine in China. The retrospective study of patients with different HPV subtypes and cervical precancerous lesions, who have undergone loop eelectrosurgical excision procedure, cold knife conization, or a total hysterectomy in our hospital from January 2016 to August 2016, was performed. All patients were tested for 27 HPV subtypes via the liquid suspension chip technology (Luminex 200). A total of 3393 cases of cervical intraepithelial neoplasia (CIN) were investigated, including 1098 cases of CIN I, 762 cases of CIN II, and 1533 cases of CIN III. The overall HPV infection rate was 82.58%. The high-risk HPV infection rate was 76.61%, and the low-risk rate was 9.88%. The most common 5 subtypes were HPV16, HPV52, HPV58, HPV33, and HPV18. The patients were grouped into 6 age groups: ≤20, 21 to 30, 31 to 40, 41 to 50, 50 to 64, and ≥65. The HPV subtypes' distribution varied across different age groups. In patients with cervical precancerous lesions in Western China, the top 5 HPV subtypes with the highest infection rates were HPV16, HPV52, HPV58, HPV33, and HPV18. The rate of cervical precancerous lesions unrelated to HPV was 17.42%. Thus, HPV screening with no cytology may leave unobserved about 20% of cervical precancerous lesions, which is worth of significant clinical attention.

Asymmetric Outer Bow Length and Cervical Headgear Force System: 3D Analysis Using Finite Element Method.

PubMed

Geramy, Allahyar; Hassanpour, Mehdi; Emadian Razavi, Elham Sadat

2015-03-01

This study sought to assess distal and lateral forces and moments of asymmetric headgears by variable outer bow lengths. Four 3D finite element method (FEM) models of a cervical headgear attached to the maxillary first molars were designed in SolidWorks 2010 software and transferred to ANSYS Workbench ver. 11 software. Models contained the first molars, their periodontal ligament (PDL), cancellous and cortical bones, a mesiodistal slice of the maxillae and the headgear. Models were the same except for the outer bow length in headgears. The headgear was symmetric in model 1. In models 2 to 4, the headgears were asymmetric in length with differences of 5mm, 10mm and 15mm, respectively. A 2.5 N force in horizontal plane was applied and the loading manner of each side of the outer bow was calculated trigonometrically using data from a volunteer. The 15mm difference in outer bow length caused the greatest difference in lateral (=0.21 N) and distal (= 1.008 N) forces and also generated moments (5.044 N.mm). As the difference in outer bow length became greater, asymmetric effects increased. Greater distal force in the longer arm side was associated with greater lateral force towards the shorter arm side and more net yawing moment. A difference range of 1mm to 15 mm of length in cervical headgear can be considered as a safe length of outer bow shortening in clinical use.

Frequency of Root Canal Isthmi in Human Permanent Teeth Determined by Cone-beam Computed Tomography.

PubMed

Estrela, Carlos; Rabelo, Luiz Eduardo G; de Souza, João Batista; Alencar, Ana Helena G; Estrela, Cyntia R A; Sousa Neto, Manoel Damião; Pécora, Jesus Djalma

2015-09-01

This study evaluated the frequency of root canal isthmi (RCIs) in human permanent teeth by using cone-beam computed tomography. A sample of 1400 teeth of 618 patients (394 women; mean age, 43.4 years) was selected. RCIs were detected longitudinally on 0.1-mm/0.1-mm axial slices of cone-beam computed tomography images of roots scanned from the pulp orifice to the apex, and findings were classified into 7 categories according to RCIs beginning and end: (1) both in the cervical third, (2) begin in the cervical third and end in the middle third, (3) begin in the cervical third and end in the apical third, (4) both in the middle third, (5) begin in the middle third and end in the apical third, (6) both in the apical third, or (7) no isthmus. A χ(2) test with Yates correction or the Fisher exact test was used to analyze categorical variables, described as frequencies (%). The Student t test was used to compare quantitative variables. RCI is a common anatomic structure in human permanent teeth, except in maxillary anterior teeth. The higher frequencies of RCIs (87.9%) were found in mandibular first molars. The frequencies of RCIs according to mean age and tooth group were not significantly different (P > .05), except in mandibular central incisors. RCIs were less frequent among older patients. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Rapid myelin water imaging in human cervical spinal cord.

PubMed

Ljungberg, Emil; Vavasour, Irene; Tam, Roger; Yoo, Youngjin; Rauscher, Alexander; Li, David K B; Traboulsee, Anthony; MacKay, Alex; Kolind, Shannon

2017-10-01

Myelin water imaging (MWI) using multi-echo T 2 relaxation is a quantitative MRI technique that can be used as an in vivo biomarker for myelin in the central nervous system. MWI using a multi-echo spin echo sequence currently takes more than 20 min to acquire eight axial slices (5 mm thickness) in the cervical spinal cord, making spinal cord MWI impractical for implementation in clinical studies. In this study, an accelerated gradient and spin echo sequence (GRASE), previously validated for brain MWI, was adapted for spinal cord MWI. Ten healthy volunteers were scanned with the GRASE sequence (acquisition time 8.5 min) and compared with the multi-echo spin echo sequence (acquisition time 23.5 min). Using region of interest analysis, myelin estimates obtained from the two sequences were found to be in good agreement (mean difference = -0.0092, 95% confidence interval =  - 0.0092 ± 0.061; regression slope = 1.01, ρ = 0.9). MWI using GRASE was shown to be highly reproducible with an average coefficient of variation of 6.1%. The results from this study show that MWI can be performed in the cervical spinal cord in less than 10 min, allowing for practical implementation in multimodal clinical studies. Magn Reson Med 78:1482-1487, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Effect of punch and orifice base sizes in different push-out test setups: stress distribution analysis.

PubMed

Zanatta, Rayssa Ferreira; Barreto, Bruno de Castro Ferreira; Xavier, Tathy Aparecida; Versluis, Antheunis; Soares, Carlos José

2015-02-01

This study evaluated the influence of punch and base orifice diameters on push-out test results by means of finite element analysis (FEA). FEA was performed using 3D models of the push-out test with 3 base orifice diameters (2.5, 3.0, and 3.5 mm) and 3 punch diameters (0.5, 1.0, and 1.5 mm) using MARC/MENTAT (MSC.Software). The image of a cervical slice from a root restored with a fiberglass post was used to construct the models. The mechanical properties of dentin, post, and resin cement were obtained from the literature. Bases and punches were constructed as rigid bodies. A 10-N force was applied by the punch in the center of the post in a nonlinear contact analysis. Modified von Mises stress, maximum principal stress, as well as shear and normal stress components were calculated. Both punch and base orifice sizes influenced the stress distribution of the push-out test. Bases with larger diameters and punches with smaller diameters caused higher stress in dentin and at the dentin/cement interface. FEA showed that the diameter of the orifice base had a more significant influence on the stress distribution than did the punch diameter. For this reason, both factors should be taken into account during push-out experimental tests.

Registration-based interpolation applied to cardiac MRI

NASA Astrophysics Data System (ADS)

Ólafsdóttir, Hildur; Pedersen, Henrik; Hansen, Michael S.; Lyksborg, Mark; Hansen, Mads Fogtmann; Darkner, Sune; Larsen, Rasmus

2010-03-01

Various approaches have been proposed for segmentation of cardiac MRI. An accurate segmentation of the myocardium and ventricles is essential to determine parameters of interest for the function of the heart, such as the ejection fraction. One problem with MRI is the poor resolution in one dimension. A 3D registration algorithm will typically use a trilinear interpolation of intensities to determine the intensity of a deformed template image. Due to the poor resolution across slices, such linear approximation is highly inaccurate since the assumption of smooth underlying intensities is violated. Registration-based interpolation is based on 2D registrations between adjacent slices and is independent of segmentations. Hence, rather than assuming smoothness in intensity, the assumption is that the anatomy is consistent across slices. The basis for the proposed approach is the set of 2D registrations between each pair of slices, both ways. The intensity of a new slice is then weighted by (i) the deformation functions and (ii) the intensities in the warped images. Unlike the approach by Penney et al. 2004, this approach takes into account deformation both ways, which gives more robustness where correspondence between slices is poor. We demonstrate the approach on a toy example and on a set of cardiac CINE MRI. Qualitative inspection reveals that the proposed approach provides a more convincing transition between slices than images obtained by linear interpolation. A quantitative validation reveals significantly lower reconstruction errors than both linear and registration-based interpolation based on one-way registrations.

Total Alkaloids of Sophora alopecuroides Inhibit Growth and Induce Apoptosis in Human Cervical Tumor HeLa Cells In vitro.

PubMed

Li, Jian-Guang; Yang, Xiao-Yi; Huang, Wei

2016-05-01

Uygur females of Xinjiang have the higher incidence of cervical tumor in the country. Alkaloids are the major active ingredients in Sophora alopecuroides, and its antitumor effect was recognized by the medical profession. Xinjiang is the main site of S. alopecuroides production in China so these plants are abundant in the region. Studies on the antitumor properties of total alkaloids of S. alopecuroides (TASA) can take full use of the traditional folk medicine in antitumor unique utility. To explore the effects of TASA on proliferation and apoptosis of human cervical tumor HeLa cells in vitro. TASA was extracted, purified, and each monomer component was analyzed by high-performance liquid chromatography. The effect of TASA at different concentrations on the survival of HeLa cells was determined after 24 h using the Cell Counting Kit-8. In addition, cells were photographed using an inverted microscope to document morphological changes. The effect of TASA on apoptotic rate of HeLa cells was assessed by flow cytometry. Monomers of TASA were found to be sophoridine, matrine, and sophocarpine. On treatment with 8.75 mg/ml of TASA, more than 50% of HeLa cells died, and cell death rate increased further with longer incubation. The apoptotic rates of HeLa cells in the experimental groups were 16.0% and 33.3% at concentrations of 6.25 mg/ml and 12.50 mg/ml, respectively. TASA can induce apoptosis in cervical tumor HeLa cells, and it has obvious inhibitory effects on cell growth. Total alkaloids of Sophora alopecuroides (TASA) exhibits anti-human cervical tumor propertiesMonomer component of TASA was analyzed by high-performance liquid chromatography, and its main effect component are sophoridine, matrine, and sophocarpineTASA inhibits growth and induces apoptosis in HeLa cells. Abbreviations used: TASA: Total alkaloids of S. alopecuroides, CCK-8: Cell Counting Kit-8, FBS: Fetal bovine serum, PBS: Phosphate buffered saline, DMEM: Dulbecco's modified Eagle medium.

Identification and quantitative evaluation of the fiber structure in the pathological tissue using Mueller matrix microscope

NASA Astrophysics Data System (ADS)

Zhou, Jialing; He, Honghui; Wang, Ye; Ma, Hui

2017-02-01

Fiber structure changes in the various pathological processes, such as the increase of fibrosis in liver diseases, the derangement of fiber in cervical cancer and so on. Currently, clinical pathologic diagnosis is regarded as the golden criterion, but different doctors with discrepancy in knowledge and experience may obtain different conclusions. Up to a point, quantitative evaluation of the fiber structure in the pathological tissue can be of great service to quantitative diagnosis. Mueller matrix measurement is capable of probing comprehensive microstructural information of samples and different wavelength of lights can provide more information. In this paper, we use a Mueller matrix microscope with light sources in six different wavelength. We use unstained, dewaxing liver tissue slices in four stages and the pathological biopsy of the filtration channels from rabbit eyes as samples. We apply the Mueller matrix polar decomposition (MMPD) parameter δ which corresponds to retardance to liver slices. The mean value of abnormal region get bigger when the level of fibrosis get higher and light in short wavelength is more sensitive to the microstructure of fiber. On the other hand, we use the Mueller matrix transformation (MMT) parameter Φ which is associated to the angel of fast axis in the analysis of the slices of the filtration channels from rabbit eyes. The value of kurtosis and the value of skewness shows big difference between new born region and normal region and can reveal the arrangement of fiber. These results indicate that the Mueller matrix microscope has great potential in auxiliary diagnosis.

Vertebral osteoporosis: perfused animal cadaver model for testing new vertebroplastic agents.

PubMed

Hoell, Thomas; Huschak, Gerald; Beier, Andre; Holzhausen, Hans-Juergen; Meisel, Hans-Joerg; Emmrich, Frank

2010-12-01

Experimental study. It was aimed to establish a cadaver model to imitate osteoporotic perfused vertebral bone and to allow for transpedicular transfer of bone cement and various new materials into vertebrae. The model was perfused to simulate vertebroplasty in the presence of transvertebral blood flow. The injection of bone cement into vertebrae bears the risk of irreversible discharge of material into the venous system of the spinal canal. The bovine cadaver model studied allows visual studies of material distribution in a vertebral bone, the potential spill-out of material, and quantification of washout and disintegration phenomena. Thoracic and lumbar vertebrae from 1-year-old calves were cut transversally into 5 mm slices, macerated, and decalcified. The softened bone slices were compressed between 2 transparent plastic discs. A standard vertebroplasty cannula (outer diameter 3.5 mm, inner diameter 2.5 mm) was inserted into the vertebral body via the pedicle to transfer the different vertebroplasty materials. Arterial blood flow was simulated by means of liquid irrigation via 2 needles in the ventral part of the vertebral body slice. Metal powder was mixed with the solution to indicate the blood flow in the bone. The model was evaluated with the vertebroplasty cement polymethylmethacrylate. The model permitted visualization of the insertion and distribution of vertebroplasty materials. Liquid bone cement was effused into the spinal canal as in the clinical situation. Higher modulus cement acted in the same way as in clinical vertebroplasty. Rigid vertebroplasty agents led to trabecular fractures and stable mechanical interactions with the bone and eventually moved dorsal bone fragments into the spinal canal. Sedimentation of the metal powder indicated regions of perfusion. The model simulated the clinical behavior of liquid and higher modulus vertebroplasty agents in the presence of blood flow. It enabled safe ex vivo testing of the mechanical and physical properties of alternative vertebroplasty materials under flow conditions.

Simple Estimation of the Endolymphatic Volume Ratio after Intravenous Administration of a Single-dose of Gadolinium Contrast

PubMed Central

NAGANAWA, Shinji; KANOU, Mai; OHASHI, Toshio; KUNO, Kayao; SONE, Michihiko

2016-01-01

Purpose: To evaluate the feasibility of a simple estimation for the endolymphatic volume ratio (endolymph volume/total lymph volume = %ELvolume) from an area ratio obtained from only one slice (%EL1slice) or from three slices (%EL3slices). The %ELvolume, calculated from a time-consuming measurement on all magnetic resonance (MR) slices, was compared to the %EL1slice and the %EL3slices. Methods: In 40 ears of 20 patients with a clinical suspicion of endolymphatic hydrops, MR imaging was performed 4 hours after intravenous administration of a single dose of gadolinium-based contrast material (IV-SD-GBCM). Using previously reported HYDROPS2-Mi2 MR imaging, the %ELvolume values in the cochlea and the vestibule were measured separately by two observers. The correlations between the %EL1slice or the %EL3slices and the %ELvolume values were evaluated. Results: A strong linear correlation was observed between the %ELvolume and the %EL3slices or the %EL1slice in the cochlea. The Pearson correlation coefficient (r) was 0.968 (3 slices) and 0.965 (1 slice) for observer A, and 0.968 (3 slices) and 0.964 (1 slice) for observer B (P < 0.001, for all). A strong linear correlation was also observed between the %ELvolume and the %EL3slices or the %EL1slice in the vestibule. The Pearson correlation coefficient (r) was 0.980 (3 slices) and 0.953 (1 slice) for observer A, and 0.979 (3 slices) and 0.952 (1 slice) for observer B (P < 0.001, for all). The high intra-class correlation coefficients (0.991–0.997) between the endolymph volume ratios by two observers were observed in both the cochlea and the vestibule for values of the %ELvolume, the %EL3slices and the %EL1slice. Conclusion: The %ELvolume might be easily estimated from the %EL3slices or the %EL1slice. PMID:27001396

Simple Estimation of the Endolymphatic Volume Ratio after Intravenous Administration of a Single-dose of Gadolinium Contrast.

PubMed

Naganawa, Shinji; Kanou, Mai; Ohashi, Toshio; Kuno, Kayao; Sone, Michihiko

2016-10-11

To evaluate the feasibility of a simple estimation for the endolymphatic volume ratio (endolymph volume/total lymph volume = %EL volume ) from an area ratio obtained from only one slice (%EL 1slice ) or from three slices (%EL 3slices ). The %EL volume, calculated from a time-consuming measurement on all magnetic resonance (MR) slices, was compared to the %EL 1slice and the %EL 3slices . In 40 ears of 20 patients with a clinical suspicion of endolymphatic hydrops, MR imaging was performed 4 hours after intravenous administration of a single dose of gadolinium-based contrast material (IV-SD-GBCM). Using previously reported HYDROPS2-Mi2 MR imaging, the %EL volume values in the cochlea and the vestibule were measured separately by two observers. The correlations between the %EL 1slice or the %EL 3slices and the %EL volume values were evaluated. A strong linear correlation was observed between the %EL volume and the %EL 3slices or the %EL 1slice in the cochlea. The Pearson correlation coefficient (r) was 0.968 (3 slices) and 0.965 (1 slice) for observer A, and 0.968 (3 slices) and 0.964 (1 slice) for observer B (P < 0.001, for all). A strong linear correlation was also observed between the %EL volume and the %EL 3slices or the %EL 1slice in the vestibule. The Pearson correlation coefficient (r) was 0.980 (3 slices) and 0.953 (1 slice) for observer A, and 0.979 (3 slices) and 0.952 (1 slice) for observer B (P < 0.001, for all). The high intra-class correlation coefficients (0.991-0.997) between the endolymph volume ratios by two observers were observed in both the cochlea and the vestibule for values of the %EL volume , the %EL 3slices and the %EL 1slice . The %EL volume might be easily estimated from the %EL 3slices or the %EL 1slice .

Towards a Property-Based Testing Environment With Applications to Security-Critical Software

DTIC Science & Technology

1994-01-01

4 is a slice of the MINIX [Tan87] login program with respect to the setuid system call. The original program contains 337 lines, the slice only 20...demonstrat- ing the e ectiveness of slicing in this case5. The mapping of the abstract concept of au- thentication to source code in the MINIX login...Slice of MINIX login with respect to setuid(). occurs. If no incorrect execution occurs, slices of the program are examined for their data ow coverage

Parametric Trace Slicing

NASA Technical Reports Server (NTRS)

Rosu, Grigore (Inventor); Chen, Feng (Inventor); Chen, Guo-fang; Wu, Yamei; Meredith, Patrick O. (Inventor)

2014-01-01

A program trace is obtained and events of the program trace are traversed. For each event identified in traversing the program trace, a trace slice of which the identified event is a part is identified based on the parameter instance of the identified event. For each trace slice of which the identified event is a part, the identified event is added to an end of a record of the trace slice. These parametric trace slices can be used in a variety of different manners, such as for monitoring, mining, and predicting.

Animation of in vitro biomechanical tests.

PubMed

Cripton, P A; Sati, M; Orr, T E; Bourquin, Y; Dumas, G A; Nolte, L P

2001-08-01

Interdisciplinary communication of three-dimensional kinematic data arising from in vitro biomechanical tests is challenging. Complex kinematic representations such as the helical axes of motion (HAM) add to the challenge. The difficulty increases further when other quantities (i.e. load or tissue strain data) are combined with the kinematic data. The objectives of this study were to develop a method to graphically replay and animate in vitro biomechanical tests including HAM data. This will allow intuitive interpretation of kinematic and other data independent of the viewer's area of expertise. The value of this method was verified with a biomechanical test investigating load-sharing of the cervical spine. Three 3.0 mm aluminium spheres were glued to each of the two vertebrae from a C2-3 segment of a human cervical spine. Before the biomechanical tests, CT scans were made of the specimen (slice thickness=1.0 mm and slice spacing=1.5 mm). The specimens were subjected to right axial torsion moments (2.0 Nm). Strain rosettes mounted to the anterior surface of the C3 vertebral body and bilaterally beneath the facet joints on C3 were used to estimate the force flow through the specimen. The locations of the aluminium spheres were digitised using a space pointer and the motion analysis system. Kinematics were measured using an optoelectronic motion analysis system. HAMs were calculated to describe the specimen kinematics. The digitised aluminium sphere locations were used to match the CT and biomechanical test data (RMS errors between the CT and experimental points were less than 1.0 mm). The biomechanical tests were "replayed" by animating reconstructed CT models in accordance with the recorded experimental kinematics, using custom software. The animated test replays allowed intuitive analysis of the kinematic data in relation to the strain data. This technique improves the ability of experts from disparate backgrounds to interpret and discuss this type of biomechanical data.

Decalcifying capability of irrigating solutions on root canal dentin mineral content

PubMed Central

Poggio, Claudio; Dagna, Alberto; Vinci, Andrea; Beltrami, Riccardo; Cucca, Lucia; Giardino, Luciano

2015-01-01

Background: Chelating agents are believed to aid root canal irrigation and to be able to remove the inorganic smear layer. Aims: The purpose of the present study was to evaluate and to compare the decalcifying capability of different irrigating solutions (Tubuliclean, Largal Ultra, ethylenediaminetetraacetic acid 17%, Tetraclean, Tetraclean NA). Materials and Methods: Sixty maxillary central incisors were used. Root canals were instrumented and irrigated. From each root, four comparable slices of cervical dentin were obtained. At three successive 5-min interval immersion times, the concentration of calcium extracted from root canal dentin was assessed with an inductively coupled plasma-atomic emission spectrometer. Statistical Analysis Used: Data were analyzed by means of Kruskal Wallis and Mann–Whitney tests. Significance was predetermined at P < 0.05. Results and Conclusions: For all irrigating solutions, the maximum amount of Ca2+ extracted from root canal dentin samples was reached after 10 min contact time except for citric acid-based agents (Tetraclean and Tetraclean NA) which induced a higher and still increasing calcium release even after 10 min contact time. In order to obtain an efficient decalcifying action on dentin and to facilitate the biomechanical procedures, citric acid-based irrigants can be applied. PMID:26097355

Association of head trauma with cervical spine injury, spinal cord injury, or both.

PubMed

Iida, H; Tachibana, S; Kitahara, T; Horiike, S; Ohwada, T; Fujii, K

1999-03-01

Links between cervical spine and/or spinal cord injuries and head trauma have not been reported in detail. 188 patients with cervical spine and/or spinal cord injury were divided into two groups, i.e., with upper cervical and mid-lower cervical injury, and compared for head injury. Associated head trauma was investigated in 188 patients with cervical spine and/or spinal cord injuries; 35% had moderate or severe injuries. Brain damage was more frequently observed in patients with upper cervical injury than in those with mid to lower cervical injury. Those patients with upper cervical injury appeared to have an elevated risk of suffering skull base fractures, traumatic subarachnoid hemorrhage, and contusional hemotoma. Approximately one third of patients with cervical spine and/or spinal cord injuries had moderate or severe head injuries. Brain damage was more frequently associated with upper cervical injury. Those patients with upper cervical injury are at greater risk of suffering from skull base fractures and severe intracranial hematomas than those with mid to lower cervical injury.

A novel solution configuration on liquid-based endometrial cytology

PubMed Central

Wang, Qi; Han, Lu; Tuo, Xiaoqian; Hou, Huilian; Liu, Yu; Shi, Zan; Wang, Qing; Li, Yan; Sun, Chao; Xue, Xue

2018-01-01

Objective Early detection and diagnosis of endometrial carcinoma and precancerous change would undoubtedly become the most alluring part for researchers. With the emergence of endometrial brush samplers, a new upsurge in endometrial cytology is in the making. But endometrial specimens obtained by the endometrial brush samplers require special preservation solution. The objective of this study is to develop a new kind of endometrial-cell preservation solution and to test the availability compared with a patented liquid-based cell preservation solution. Methods In this controlled study, we had 5 endometrial cases collected with Li Brush from the First Affiliated Hospital of Xi'an Jiaotong University (09/2016 to 12/2016). The samples of each case were collected 2 times separately and perserved in different perservation solutions. One was a kind of novel endometrial cell preservation solution and the other was a kind of patented liquid-based cell (LBC) preservation solution. The endometrial cells were smeared on slides by using the ZP-C automated slide preparation system and stained with Papanicolaou stain. A semi-quantitative scoring system was used to analyze the quality of slides. Statistical analysis was performed using the Wilcoxon signed rank test on the SPSS program (SPSS 18.0). In all LBC preparations, endometrial cells from the novel endometrial cells preservation solution had more cell quantity, less red blood cell fragments, and the background was cleaner compared with control group. Although the novel endometrial-cell preservation solution showed cellularity and absence of blood and debris expressed by no statistically significant differences (p = 0.063 and 0.102 respectively). The preservation period of the two kinds of liquids was equivalent. Conclusions The novel endometrial-cell preservation solution is superior to the liquid-base cell preservation solution for cervical cells, with clear background, diagnostic cells and low cost. PMID:29401497

Clinical implication of voltage-dependent anion channel 1 in uterine cervical cancer and its action on cervical cancer cells.

PubMed

Wu, Chih-Hsien; Lin, Yu-Wen; Wu, Tzu-Fan; Ko, Jiunn-Liang; Wang, Po-Hui

2016-01-26

Two-dimensional gel electrophoresis and liquid chromatography-tandem mass spectrometry were performed to investigate the influence of human nonmetastatic clone 23 type 1 (nm23-H1), a metastasis-associated gene on proteomic alterations in cancer cells of the uterine cervix. It was validated by RT-PCR and Western blot analysis. The expression of voltage-dependent anion channel 1 (VDAC1) was increased in nm23-H1 gene silenced SiHa or CaSki cervical cancer cells. The clinical implication was shown that cervical cancer tissues with positive VDAC1 immunoreactivity exhibited deep stromal invasion (>10 mm in depth) and large tumor size (> 4 cm in diameter). Cervical cancer patients with positive VDAC1 immunoreactivity displayed higher recurrence and poorer overall survival than those with negative VDAC1. Silencing of VDAC1 reduced cell proliferation and migratory ability. Mitochondrial membrane potential was decreased and reactive oxygen species generation was increased in the VDAC1 gene-silenced cervical cancer cells. Cell cycle progression and autophagy were not changed in VDAC1 silencing cells. The cytotoxicity of cisplatin was significantly enhanced by knockdown of cellular VDAC1 and the compounds that interfere with hexokinase binding to VDAC. Therapeutic strategies may be offered using VDAC1 as a target to reduce cell growth and migration, enhance the synergistic therapeutic efficacy of cisplatin and reduce cisplatin dose-limiting toxicity.

Prevalence of human papillomavirus infection in women in Portugal: the CLEOPATRE Portugal study.

PubMed

Pista, Angela; de Oliveira, Carlos Freire; Cunha, Maria João; Paixao, Maria Teresa; Real, Odete

2011-08-01

Human papillomavirus (HPV) is responsible for a range of diseases, including cervical cancer. The primary objectives of the CLEOPATRE Portugal study were to estimate the overall and age-stratified prevalence of cervical HPV infection and to assess HPV prevalence and type-specific distribution by cytological results among women aged 18 to 64 years, who reside in mainland Portugal. This cross-sectional population-based study recruited women aged 18 to 64 years, according to an age-stratified sampling strategy, who attended gynecology/obstetrics or sexually transmitted disease clinics across the 5 regional health administrations in mainland Portugal between 2008 and 2009. Liquid-based cytology samples were collected and analyzed centrally for HPV genotyping (clinical array HPV 2 assay) and cytology. Prevalence estimates were adjusted for age using 2007 Portuguese census data. A total of 2326 women were included in the study. The overall prevalence of HPV infection in the study was 19.4% (95% confidence interval, 17.8%-21.0%), with the highest prevalence in women aged 18 to 24 years. High-risk HPV types were detected in 76.5% of infections, of which 36.6% involved multiple types. The commonest high-risk type was HPV-16. At least 1 of the HPV types 6/11/16/18 was detected in 32.6% of infections. The HPV prevalence in normal cytology samples was 16.5%. There was a statistically significant association between high-risk infection and cytological abnormalities (P < 0.001). This is the first population-based study to quantify and describe cervical HPV infection in mainland Portugal. This study provides baseline data for future assessment of the impact of HPV vaccination programs.

Association between cervical screening and prevention of invasive cervical cancer in Ontario: a population-based case-control study.

PubMed

Vicus, Danielle; Sutradhar, Rinku; Lu, Yan; Kupets, Rachel; Paszat, Lawrence

2015-01-01

The aim of this study was to estimate the effect of cervical screening in the prevention of invasive cervical cancer among age groups, using a population-based case-control study in the province of Ontario, Canada. Exposure was defined as cervical cytology history greater than 3 months before the diagnosis date of cervical cancer (index date). Cases were women who were diagnosed with cervical cancer between January 1, 1998, and December 31, 2008. Controls were women without a diagnosis of cervical cancer on, or before, December 31, 2008. Two controls were matched to each case on year of birth and income quintile, as of the index date. Conditional logistic regression was used to estimate the odds ratio for having been screened among those with cervical cancer. Cervical cancer screening performed between 3 and 36 months before the index date was protective against invasive cervical cancer in women aged 40 through 69 years. In women younger than 40 years, cervical cancer screening performed 3 to 36 months before the index date was not protective. Cervical screening is associated with a reduced risk for invasive cervical cancer among women older than 40 years. Cervical cancer resources should be focused on maximizing the risk reduction.

DNA methylation in human papillomavirus-infected cervical cells is elevated in high-grade squamous intraepithelial lesions and cancer.

PubMed

Kim, Mi-Kyung; Lee, In-Ho; Lee, Ki-Heon; Lee, Yoo Kyung; So, Kyeong A; Hong, Sung Ran; Hwang, Chang-Sun; Kee, Mee-Kyung; Rhee, Jee Eun; Kang, Chun; Hur, Soo Young; Park, Jong Sup; Kim, Tae-Jin

2016-03-01

DNA methylation has been shown to be a potential biomarker for early cancer detection. The aim of this study was to evaluate DNA methylation profiles according to liquid-based Pap (LBP) test results and to assess their diagnostic value in a Korean population. A total of 205 patients with various Papanicolaou test results were enrolled to this study (negative, 26; atypical squamous cells of undetermined significance, 39; low grade squamous intraepithelial lesion, 44; high grade squamous intraepithelial lesion (HSIL), 48; and cancer, 48). DNA methylation analysis of four genes, ADCYAP1, PAX1, MAL, and CADM1, was performed on residual cervical cells from LBP samples using a quantitative bisulfite pyrosequencing method. To evaluate the diagnostic performance of the four methylated genes for cancer detection, receiver operating characteristic (ROC) curves were drawn. Sensitivities and specificities were also tested at cutoffs determined from the ROC curves. Cervical cancer cells showed dramatically increased methylation levels for the four genes analyzed. ADCYAP1 and PAX1 also trended toward elevated methylation levels in HSIL samples, although the levels were much lower than those in cancer cells. The sensitivities of methylated ADCYAP1, PAX1, MAL, and CADM1 for the detection of cancer were 79.2%, 75.0%, 70.8%, and 52.1%, and the specificities were 92.0%, 94.0%, 94.7%, and 94.0%, respectively. Methylated ADCYAP1 and PAX1 demonstrated relatively better discriminatory ability than did methylated MAL and CADM1 (area under the curves 0.911 and 0.916 vs. 0.854 and 0.756, respectively). DNA methylation status, especially in the ADCYAP1 and PAX1 genes, showed relatively good specificity, ranging from 90% to 94%. The possible additive and complementary roles of DNA methylation testing with respect to conventional cervical cancer screening programs will need to be validated in prospective population-based studies.

DNA methylation in human papillomavirus-infected cervical cells is elevated in high-grade squamous intraepithelial lesions and cancer

PubMed Central

Lee, Ki-Heon; So, Kyeong A; Hong, Sung Ran; Hwang, Chang-Sun; Kee, Mee-Kyung; Rhee, Jee Eun; Kang, Chun; Hur, Soo Young; Park, Jong Sup

2016-01-01

Objective DNA methylation has been shown to be a potential biomarker for early cancer detection. The aim of this study was to evaluate DNA methylation profiles according to liquid-based Pap (LBP) test results and to assess their diagnostic value in a Korean population. Methods A total of 205 patients with various Papanicolaou test results were enrolled to this study (negative, 26; atypical squamous cells of undetermined significance, 39; low grade squamous intraepithelial lesion, 44; high grade squamous intraepithelial lesion (HSIL), 48; and cancer, 48). DNA methylation analysis of four genes, ADCYAP1, PAX1, MAL, and CADM1, was performed on residual cervical cells from LBP samples using a quantitative bisulfite pyrosequencing method. To evaluate the diagnostic performance of the four methylated genes for cancer detection, receiver operating characteristic (ROC) curves were drawn. Sensitivities and specificities were also tested at cutoffs determined from the ROC curves. Results Cervical cancer cells showed dramatically increased methylation levels for the four genes analyzed. ADCYAP1 and PAX1 also trended toward elevated methylation levels in HSIL samples, although the levels were much lower than those in cancer cells. The sensitivities of methylated ADCYAP1, PAX1, MAL, and CADM1 for the detection of cancer were 79.2%, 75.0%, 70.8%, and 52.1%, and the specificities were 92.0%, 94.0%, 94.7%, and 94.0%, respectively. Methylated ADCYAP1 and PAX1 demonstrated relatively better discriminatory ability than did methylated MAL and CADM1 (area under the curves 0.911 and 0.916 vs. 0.854 and 0.756, respectively). Conclusion DNA methylation status, especially in the ADCYAP1 and PAX1 genes, showed relatively good specificity, ranging from 90% to 94%. The possible additive and complementary roles of DNA methylation testing with respect to conventional cervical cancer screening programs will need to be validated in prospective population-based studies. PMID:26768780

A Single-Arm, Proof-Of-Concept Trial of Lopimune (Lopinavir/Ritonavir) as a Treatment for HPV-Related Pre-Invasive Cervical Disease.

PubMed

Hampson, Lynne; Maranga, Innocent O; Masinde, Millicent S; Oliver, Anthony W; Batman, Gavin; He, Xiaotong; Desai, Minaxi; Okemwa, Parmenas M; Stringfellow, Helen; Martin-Hirsch, Pierre; Mwaniki, Alex M; Gichangi, Peter; Hampson, Ian N

2016-01-01

Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC-ThinPrep®). HIV negative women diagnosed as high-risk HPV positive with high grade squamous intraepithelial lesions (HSIL) were examined by colposcopy and given a 2 week course of 1 capsule of Lopimune (CIPLA) twice daily, to be self-applied as a vaginal pessary. Colposcopy, HPV testing and LBC were repeated at 4 and 12 weeks post-start of treatment with a final punch biopsy at 3 months for histology. Primary outcome measures were acceptability of treatment with efficacy as a secondary consideration. A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6-73.2%). Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6-82.8%) had no dysplasia and 4/22 (18.2%, 95%CI: 9.9-65.1%) were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions. These results demonstrate the potential of Lopimune as a self-applied therapy for HPV infection and related cervical lesions. Since there were no serious adverse events or detectable post-treatment morbidity, this study indicates that further trials are clearly justified to define optimal regimes and the overall benefit of this therapy. ISRCTN Registry 48776874.

A Single-Arm, Proof-Of-Concept Trial of Lopimune (Lopinavir/Ritonavir) as a Treatment for HPV-Related Pre-Invasive Cervical Disease

PubMed Central

Masinde, Millicent S.; Oliver, Anthony W.; Batman, Gavin; He, Xiaotong; Desai, Minaxi; Okemwa, Parmenas M.; Stringfellow, Helen; Martin-Hirsch, Pierre; Mwaniki, Alex M.; Gichangi, Peter; Hampson, Ian N.

2016-01-01

Background Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. Methods Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC -ThinPrep®). HIV negative women diagnosed as high-risk HPV positive with high grade squamous intraepithelial lesions (HSIL) were examined by colposcopy and given a 2 week course of 1 capsule of Lopimune (CIPLA) twice daily, to be self-applied as a vaginal pessary. Colposcopy, HPV testing and LBC were repeated at 4 and 12 weeks post-start of treatment with a final punch biopsy at 3 months for histology. Primary outcome measures were acceptability of treatment with efficacy as a secondary consideration. Results A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6–73.2%). Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6–82.8%) had no dysplasia and 4/22 (18.2%, 95%CI: 9.9–65.1%) were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions. Conclusions These results demonstrate the potential of Lopimune as a self-applied therapy for HPV infection and related cervical lesions. Since there were no serious adverse events or detectable post-treatment morbidity, this study indicates that further trials are clearly justified to define optimal regimes and the overall benefit of this therapy. Trial Registration ISRCTN Registry 48776874 PMID:26824902

Evaluation of p16/Ki-67 dual staining in detection of cervical precancer and cancers: a multicenter study in China

PubMed Central

Yu, Lu-Lu; Chen, Wen; Lei, Xiao-Qin; Qin, Yu; Wu, Ze-Ni; Pan, Qin-Jing; Zhang, Xun; Chang, Bai-Feng; Zhang, Shao-Kai; Guo, Hui-Qin; Qiao, You-Lin

2016-01-01

Purpose To analyze the clinical performance of p16/Ki-67 dual-stained cytology identifying high-grade cervical intraepithelial neoplasia (CIN2+) in Chinese women. Methods 1079 women attending ongoing cervical cancer screening and 211 “enriched” women aged ≥30yrs with biopsy-confirmed CIN2+ from five Chinese hospitals were enrolled during year 2014-2015. Cervical specimens were collected for high-risk human papillomavirus (HR-HPV) DNA analysis, Liquid-based cytology (LBC) and p16/Ki-67 dual staining. Colposcopy and biopsy were performed on women with any abnormal result. Results p16/Ki-67 positivity increased with histologic severity. It was 18.4%(183/996) in normal histology, 54.0%(34/63) in CIN1, 81.0%(34/42) in CIN2, 93.3%(111/119) in CIN3, 71.4% (5/7) in adenocarcinoma and 95.2%(60/63) in squamous cell carcinoma. Compared with the HR-HPV negatives, p16/Ki-67 expression was significantly higher in the HPV16/18 positive (OR: 35.45(95%CI: 23.35-53.84)) and other 12 HR-HPV types positive group (OR: 8.01(95%CI: 5.81-11.05). The sensitivity and specificity of p16/Ki-67 to detect CIN2+ in the entire population were 90.9% and 79.5%, respectively. In women with ASC-US and LSIL, sensitivity and specificity for detection of CIN2+ were 87.5% and 66.4%, respectively, with a referral rate of 43.8%. In women who tested positive for HR-HPV, sensitivity and specificity of dual-staining for detection of CIN2+ were 92.7% and 52.7%, respectively, and the referral rate was 68.7%. Conclusions p16/Ki-67 dual-stained cytology provided a high sensitivity and moderate specificity to detect underlying cervical precancer and cancers in various settings, and might be considered as an efficient screening tool in China. PMID:27029033

The theory of interface slicing

NASA Technical Reports Server (NTRS)

Beck, Jon

1993-01-01

Interface slicing is a new tool which was developed to facilitate reuse-based software engineering, by addressing the following problems, needs, and issues: (1) size of systems incorporating reused modules; (2) knowledge requirements for program modification; (3) program understanding for reverse engineering; (4) module granularity and domain management; and (5) time and space complexity of conventional slicing. The definition of a form of static program analysis called interface slicing is addressed.

Slice profile effects in 2D slice-selective MRI of hyperpolarized nuclei.

PubMed

Deppe, Martin H; Teh, Kevin; Parra-Robles, Juan; Lee, Kuan J; Wild, Jim M

2010-02-01

This work explores slice profile effects in 2D slice-selective gradient-echo MRI of hyperpolarized nuclei. Two different sequences were investigated: a Spoiled Gradient Echo sequence with variable flip angle (SPGR-VFA) and a balanced Steady-State Free Precession (SSFP) sequence. It is shown that in SPGR-VFA the distribution of flip angles across the slice present in any realistically shaped radiofrequency (RF) pulse leads to large excess signal from the slice edges in later RF views, which results in an undesired non-constant total transverse magnetization, potentially exceeding the initial value by almost 300% for the last RF pulse. A method to reduce this unwanted effect is demonstrated, based on dynamic scaling of the slice selection gradient. SSFP sequences with small to moderate flip angles (<40 degrees ) are also shown to preserve the slice profile better than the most commonly used SPGR sequence with constant flip angle (SPGR-CFA). For higher flip angles, the slice profile in SSFP evolves in a manner similar to SPGR-CFA, with depletion of polarization in the center of the slice. Copyright 2009 Elsevier Inc. All rights reserved.

Cytomegalovirus (CMV) in cervical cancer screening tests: A series of 8 cases and review of the literature.

PubMed

Elgert, Paul A; Yee-Chang, Melissa; Simsir, Aylin

2018-04-26

Cytomegalovirus (CMV) is a ubiquitous infection typically affecting over 50% of the US population by age 40. We report 8 cases of CMV infections detected in cervical cancer screening tests, the largest series of cases thus far reported in gynecologic cytology specimens. A retrospective review of our pathology archival computer database was performed from January 1, 1994 through December 31, 2016 for CMV infections reported in cervical cytology specimens. The slides were retrieved for review if available. The eight patients ranged in age from 21-46 years, with a median age of 27 years and average age of 29.5 years. Two patients were significantly immunocompromised with one patient having AIDS and one patient diagnosed with autoimmune disease. The remaining six patients are considered immunocompetent. Cases were identified most often in the fall and winter months (6 of 8 cases). Seven cases were found using Surepath Pap (SP) liquid-based processing and one case was reported in a classic Papanicolaou smear (CPS). There was no correlation of cytologic presentation of CMV with a distinct cytohormonal pattern or inflammatory constituents. Rare diagnostic cells with changes of CMV infection were seen in 75% of the cases. The presence of CMV did not usually result in adverse patient outcome, except where CMV was one of the multiple opportunistic infections detected in the patient with AIDS. © 2018 Wiley Periodicals, Inc.

The Cytotoxicity Mechanism of 6-Shogaol-Treated HeLa Human Cervical Cancer Cells Revealed by Label-Free Shotgun Proteomics and Bioinformatics Analysis.

PubMed

Liu, Qun; Peng, Yong-Bo; Qi, Lian-Wen; Cheng, Xiao-Lan; Xu, Xiao-Jun; Liu, Le-Le; Liu, E-Hu; Li, Ping

2012-01-01

Cervical cancer is one of the most common cancers among women in the world. 6-Shogaol is a natural compound isolated from the rhizome of ginger (Zingiber officinale). In this paper, we demonstrated that 6-shogaol induced apoptosis and G2/M phase arrest in human cervical cancer HeLa cells. Endoplasmic reticulum stress and mitochondrial pathway were involved in 6-shogaol-mediated apoptosis. Proteomic analysis based on label-free strategy by liquid chromatography chip quadrupole time-of-flight mass spectrometry was subsequently proposed to identify, in a non-target-biased manner, the molecular changes in cellular proteins in response to 6-shogaol treatment. A total of 287 proteins were differentially expressed in response to 24 h treatment with 15 μM 6-shogaol in HeLa cells. Significantly changed proteins were subjected to functional pathway analysis by multiple analyzing software. Ingenuity pathway analysis (IPA) suggested that 14-3-3 signaling is a predominant canonical pathway involved in networks which may be significantly associated with the process of apoptosis and G2/M cell cycle arrest induced by 6-shogaol. In conclusion, this work developed an unbiased protein analysis strategy by shotgun proteomics and bioinformatics analysis. Data observed provide a comprehensive analysis of the 6-shogaol-treated HeLa cell proteome and reveal protein alterations that are associated with its anticancer mechanism.

The Cytotoxicity Mechanism of 6-Shogaol-Treated HeLa Human Cervical Cancer Cells Revealed by Label-Free Shotgun Proteomics and Bioinformatics Analysis

PubMed Central

Liu, Qun; Peng, Yong-Bo; Qi, Lian-Wen; Cheng, Xiao-Lan; Xu, Xiao-Jun; Liu, Le-Le; Liu, E-Hu; Li, Ping

2012-01-01

Cervical cancer is one of the most common cancers among women in the world. 6-Shogaol is a natural compound isolated from the rhizome of ginger (Zingiber officinale). In this paper, we demonstrated that 6-shogaol induced apoptosis and G2/M phase arrest in human cervical cancer HeLa cells. Endoplasmic reticulum stress and mitochondrial pathway were involved in 6-shogaol-mediated apoptosis. Proteomic analysis based on label-free strategy by liquid chromatography chip quadrupole time-of-flight mass spectrometry was subsequently proposed to identify, in a non-target-biased manner, the molecular changes in cellular proteins in response to 6-shogaol treatment. A total of 287 proteins were differentially expressed in response to 24 h treatment with 15 μM 6-shogaol in HeLa cells. Significantly changed proteins were subjected to functional pathway analysis by multiple analyzing software. Ingenuity pathway analysis (IPA) suggested that 14-3-3 signaling is a predominant canonical pathway involved in networks which may be significantly associated with the process of apoptosis and G2/M cell cycle arrest induced by 6-shogaol. In conclusion, this work developed an unbiased protein analysis strategy by shotgun proteomics and bioinformatics analysis. Data observed provide a comprehensive analysis of the 6-shogaol-treated HeLa cell proteome and reveal protein alterations that are associated with its anticancer mechanism. PMID:23243437

A low-cost, durable, combined ultrasound and fluoroscopic phantom for cervical transforaminal injections.

PubMed

Lerman, Imanuel R; Souzdalnitski, Dmitri; Narouze, Samer

2012-01-01

This technical report describes a durable, low-cost, anatomically accurate, and easy-to-prepare combined ultrasound (US) and fluoroscopic phantom of the cervical spine. This phantom is meant to augment training in US- and fluoroscopic-guided pain medicine procedures. The combined US and fluoroscopic phantom (CUF-P) is prepared from commercially available liquid plastic that is ordinarily used to prepare synthetic fishing lures. The liquid plastic is heated and then poured into a metal canister that houses an anatomical cervical spine model. Drops of dark purple dye are added to make the phantom opaque. After cooling, tubing is attached to the CUF-P to simulate blood vessels. The CUF-P accurately simulates human tissue by imitating both the tactile texture of skin and the haptic resistance of human tissue as the needle is advanced. This phantom contains simulated fluid-filled vertebral arteries that exhibit pulsed flow under color Doppler US. Under fluoroscopic examination, the CUF-P-simulated vertebral arteries also exhibit uptake of contrast dye if mistakenly injected. The creation of a training phantom allows the pain physician to practice needle positioning technique while simultaneously visualizing both targeted and avoidable vascular structures under US and fluoroscopic guidance. This low-cost CUF-P is easy to prepare and is reusable, making it an attractive alternative to current homemade and commercially available phantom simulators.

Novel active contour model based on multi-variate local Gaussian distribution for local segmentation of MR brain images

NASA Astrophysics Data System (ADS)

Zheng, Qiang; Li, Honglun; Fan, Baode; Wu, Shuanhu; Xu, Jindong

2017-12-01

Active contour model (ACM) has been one of the most widely utilized methods in magnetic resonance (MR) brain image segmentation because of its ability of capturing topology changes. However, most of the existing ACMs only consider single-slice information in MR brain image data, i.e., the information used in ACMs based segmentation method is extracted only from one slice of MR brain image, which cannot take full advantage of the adjacent slice images' information, and cannot satisfy the local segmentation of MR brain images. In this paper, a novel ACM is proposed to solve the problem discussed above, which is based on multi-variate local Gaussian distribution and combines the adjacent slice images' information in MR brain image data to satisfy segmentation. The segmentation is finally achieved through maximizing the likelihood estimation. Experiments demonstrate the advantages of the proposed ACM over the single-slice ACM in local segmentation of MR brain image series.

[Health technology assessment report. Use of liquid-based cytology for cervical cancer precursors screening].

PubMed

Ronco, Guglielmo; Confortini, Massimo; Maccallini, Vincenzo; Naldoni, Carlo; Segnan, Nereo; Sideri, Mario; Zappa, Marco; Zorzi, Manuel; Calvia, Maria; Giorgi Rossi, Paolo

2012-01-01

OBJECTIVE OF THE PROJECT: Purpose of this Report is to evaluate the impact of the introduction of liquid-based cytology (LBC) in cervical cancer screening in terms of efficacy, undesired effects, costs and implications for organisation. EFFICACY AND UNDESIRED EFFECTS: LBC WITH MANUAL INTERPRETATION: The estimates of cross-sectional accuracy for high-grade intraepithelial neoplasia (CIN2 or more severe and CIN3 or more severe) obtained by a systematic review and meta-analysis published in 2008 were used. This review considered only studies in which all women underwent colposcopy or randomised controlled trials (RCTs) with complete verification of test positives. A systematic search of RCTs published thereafter was performed. Three RCTs were identified. One of these studies was conducted in 6 Italian regions and was of large size (45,174 women randomised); a second one was conducted in another Italian region (Abruzzo) and was of smaller size (8,654 women randomised); a third RCT was conducted in the Netherlands and was of large size (89,784 women randomised). No longitudinal study was available. There is currently no clear evidence that LBC increases the sensitivity of cytology and even less that its introduction increases the efficacy of cervical screening in preventing invasive cancers. The Italian randomised study NTCC showed a decrease in specificity, which was not observed in the other two RCTs available. In addition, the 2008 meta-analysis observed a reduction - even if minimal - in specificity just at the ASC-US cytological cut-off, but also a remarkable heterogeneity between studies. These results suggest that the effect of LBC on specificity is variable and plausibly related to the local style of cytology interpretation. There is evidence that LBC reduces the proportion of unsatisfactory slides, although the size of this effect varies remarkably. LBC WITH COMPUTER-ASSISTED INTERPRETATION: An Australian study, based on double testing, showed a statistically significant increase of the sensitivity for CIN2 or more of LBC with computer-assisted interpretation vs. conventional cytology with manual interpretation. However, an English RCT estimated that LBC with computer-assisted interpretation has a lower sensitivity than LBC with manual interpretation. COST AND ECONOMIC EVALUATION: In the current Italian situation the use of liquid-based cytology for primary screening is estimated to increase the costs of cytological screening. Liquid-based cytology needs shorter time for interpretation than conventional cytology. However, in the Italian situation, savings obtained from this time reduction and from the decreased number of repeats due to unsatisfactory slides are not currently sufficient to compensate the cost increase due to the prices currently applied by producers and to a possible greater number of colposcopies caused by LBC. In any case, at current prices, cost is estimated to increase even when assuming a referral rate to colposcopy with LBC similar or slightly lower than that with conventional cytology. For the costs of computer-assisted interpretation of liquid-based cytology, readers are referred to the relative HTA report (Epidemiol Prev 2012;36(5) Suppl 3:e1-43). ORGANISATIONAL AND ETHICAL ASPECTS: Ethical, legal and communication problems are judged to remain unchanged when compared to screening with conventional cytology. After having used the test for some time, interpreters prefer liquid-based to conventional cytology. Reduced time for interpretation makes the adoption of LBC a possible approach to deal with shortenings of cytology interpreters which is happening in Italy. However, alternative solutions, such as computer-assisted interpretation of cytology and the use of HPV as primary screening test, should be considered. Liquid-based cytology allows performing molecular tests, in particular the HPV test. This property allows triaging women with borderline or mild cytology by "reflex" molecular or immunocytochemical tests with no need to recall them. LBC sampling can be used also if HPV is applied as the primary screening test, allowing "reflex" triaging of HPV positive women by cytology with no need to recall them nor to take two samples, one for HPV testing and one for conventional cytology. This represents a remarkable advantage in terms of organization. However, costs are high because only 5-7% of women screened with this approach need interpretation of cytology. In addition, HPV testing with the Hybrid Capture assay on material preserved in LBC transport media needs a preliminary conversion phase, which limits the use of LBC for triaging HPV positive women. It is advisable that in the near future industry develops sampling/transport systems that allow performing both the HPV test and cytology or other validated triage tests without additional manipulations and at sustainable costs.

Nationwide prevalence of human papillomavirus infection and viral genotype distribution in 37 cities in China.

PubMed

Wang, Rong; Guo, Xiao-Lei; Wisman, G Bea A; Schuuring, Ed; Wang, Wen-Feng; Zeng, Zheng-Yu; Zhu, Hong; Wu, Shang-Wei

2015-07-04

Type-specific high-risk HPV (hrHPV) infection is related to cervical carcinogenesis. The prevalence of hrHPV infection varies geographically, which might reflect the epidemiological characteristics of cervical cancer among different populations. To establish a foundation for HPV-based screening and vaccination programs in China, we investigated the most recent HPV prevalence and genotypic distributions in different female age groups and geographical regions in China. In 2012, a total of 120,772 liquid-based cytological samples from women enrolled for population- or employee-based cervical screening in 37 Chinese cities were obtained by the Laboratory of Molecular Infectious Diseases of Guangzhou KingMed. A total of 111,131 samples were tested by Hybrid Capture II and the other 9,641 were genotyped using the Tellgenplex™ HPV DNA Assay. The total positive rate for hrHPV was 21.07 %, which ranged from 18.42 % (Nanchang) to 31.94 % (Haikou) and varied by region. The regions of Nanchang, Changsha, Hangzhou, Chengdu, Fuzhou, Guangdong, and Guiyang could be considered the low prevalence regions. Age-specific prevalence showed a "two-peak" pattern, with the youngest age group (15-19 years) presenting the highest hrHPV infection rate (30.55 %), followed by a second peak for the 50-60-year-old group. Overall, the most prevalent genotypes were HPV16 (4.82 %) and HPV52 (4.52 %), followed by HPV58 (2.74 %). Two genotypes HPV6 (4.01 %) and HPV11 (2.29 %) were predominant in the low-risk HPV (lrHPV) type, while the mixed genotypes HPV16 + 52 and HPV52 + 58 were most common in women with multiple infections. This study shows that HPV infection in China has increased to the level of an "HPV-heavy-burden" zone in certain regions, with prevalence varying significantly among different ages and regions. Data from this study represent the most current survey of the nationwide prevalence of HPV infection in China, and can serve as valuable reference to guide nationwide cervical cancer screening and HPV vaccination programs.

Asymmetric Outer Bow Length and Cervical Headgear Force System: 3D Analysis Using Finite Element Method

PubMed Central

Geramy, Allahyar; Hassanpour, Mehdi; Emadian Razavi, Elham sadat

2015-01-01

Objectives: This study sought to assess distal and lateral forces and moments of asymmetric headgears by variable outer bow lengths. Materials and Methods: Four 3D finite element method (FEM) models of a cervical headgear attached to the maxillary first molars were designed in SolidWorks 2010 software and transferred to ANSYS Workbench ver. 11 software. Models contained the first molars, their periodontal ligament (PDL), cancellous and cortical bones, a mesiodistal slice of the maxillae and the headgear. Models were the same except for the outer bow length in headgears. The headgear was symmetric in model 1. In models 2 to 4, the headgears were asymmetric in length with differences of 5mm, 10mm and 15mm, respectively. A 2.5 N force in horizontal plane was applied and the loading manner of each side of the outer bow was calculated trigonometrically using data from a volunteer. Results: The 15mm difference in outer bow length caused the greatest difference in lateral (=0.21 N) and distal (= 1.008 N) forces and also generated moments (5.044 N.mm). Conclusion: As the difference in outer bow length became greater, asymmetric effects increased. Greater distal force in the longer arm side was associated with greater lateral force towards the shorter arm side and more net yawing moment. Clinical Relevance: A difference range of 1mm to 15 mm of length in cervical headgear can be considered as a safe length of outer bow shortening in clinical use. PMID:26622275

Comparison of Human Papillomavirus Detections in Urine, Vulvar, and Cervical Samples from Women Attending a Colposcopy Clinic

PubMed Central

Gravitt, Patti E.; Dunn, S. Terence; Brown, David; Allen, Richard A.; Eby, Yolanda J.; Smith, Katie; Zuna, Rosemary E.; Zhang, Roy R.; Gold, Michael A.; Schiffman, Mark; Walker, Joan L.; Castle, Philip E.; Wentzensen, Nicolas

2014-01-01

While urine-based sampling for human papillomavirus (HPV) is being explored as a simple and noninvasive approach for cervical cancer screening, data comparing HPV genotyping in urine and those in cellular sampling of the cervix and vulva, and their correlation with rigorously confirmed cervical disease status, are sparse. We performed HPV genotyping on voided-urine and clinician-collected vulvar and cervical samples from 72 women undergoing colposcopy. Although urine-based HPV carcinogenic HPV detection was lower (58.3%) than cervical (73.6%) and vulvar (72.1%) detection (P = 0.05 and 0.07, respectively), the agreement of urine HPV with cervical and vulvar HPV was moderate (kappa = 0.55) and substantial (kappa = 0.62), respectively. Urine-based carcinogenic HPV detection had a clinical sensitivity of 80.8% (95% confidence interval [CI] = 60.7 to 93.5) and a specificity of 53.3% (95% CI = 37.9 to 68.3) for diagnosing cervical intraepithelial neoplasia grades 2/3 (CIN2/3) on histology; 90.0% of CIN3 was positive for urine HPV. The corresponding sensitivity and specificity values for vulvar sampling were 92% (95% CI = 74 to 99) and 40.5% (95% CI = 25.6 to 56.7), and those for cervical sampling were 96.2% (95% CI = 80.4 to 99.9) and 40% (95% CI = 25.7 to 55.7), respectively. HPV16 was the most common carcinogenic genotype detectable in 25% of urine, 33.8% of vulvar, and 31.9% of cervical samples overall, with prevalence increasing with cervical disease grade, regardless of the sampling method. Stronger cervical HPV PCR signal strengths were associated with increased frequency of urine HPV detection. In summary, the relatively lower detection rates but comparable clinical performance of urine-based HPV sampling underscore the need for larger studies to evaluate urine-based sampling for cervical cancer screening, epidemiologic studies, and postvaccination HPV disease surveillance. PMID:24197879

Cervical precancerous changes and selected cervical microbial infections, Kiambu County, Kenya, 2014: a cross sectional study.

PubMed

Kanyina, Evalyne Wambui; Kamau, Lucy; Muturi, Margaret

2017-09-25

Cervical cancer is the predominant cancer among women in Kenya and second most common in women in developing regions. Population-based cytological screening and early treatment reduces morbidity and mortality associated with the cancer. We determined the occurrence of cervical precancerous changes and cervical microbial infections (Trichomonas vaginalis, Candida albicans, Neisseria gonorrhea and Actinomyces) among women attending Family Health Option Kenya (FHOK) clinic in Thika. This was a hospital based cross sectional study among women attending reproductive health screening clinic from November 2013 to January 2014. Cervical Intraepithelial Neoplasia (CIN) I, II, III, cervical cancer and microbial infection (Actinomyces, Trichomonas vaginalis and Yeast cells) diagnosis was based on Pap smear screening test and High Vaginal Swab wet preparation microscopy. Neisseria gonorrhea was diagnosed through Gram staining. Socio-demographic and reproductive health data was collected using a structured questionnaire administered to the study participants and analyzed using Epi Info version 3.5.1. Of the 244 women screened, 238 (97.5%) presented with cervical inflammation, 80 (32.8%) cervical microbial infections and 12 (4.9%) cervical precancerous changes; 10 (83.3%) with CIN I and 2 (16.7%) CIN II. Of the 80 cervical microbial infections, 62 (77.5%) were yeast cell and 18 (22.5%) T. vaginalis. One thirty four (55%) participants had no history of Pap smear screening of which 84 (62.7%) were 20-40 years. Use of IUCDs (OR: 2.47, 95% CI 1.3-4.6) was associated with cervical inflammation. CIN I was the predominant cervical precancerous change. There is need to scale up cervical screening test to capture all categories of women.

[Comparison of screening performance between primary high-risk HPV screening and high-risk HPV screening plus liquid-based cytology cotesting in diagnosis of cervical precancerous or cancerous lesions].

PubMed

Zhao, X L; Remila, Rezhake; Hu, S Y; Zhang, L; Xu, X Q; Chen, F; Pan, Q J; Zhang, X; Zhao, F H

2018-05-06

Objective: To evaluate and compare the screening performance of primary high-risk HPV(HR-HPV) screening and HR-HPV screening plus liquid-based cytology (LBC) cotesting in diagnosis of cervical cancer and precancerous lesions (CIN2+). Methods: We pooled 17 population-based cross-sectional studies which were conducted across China from 1999 to 2008. After obtaining informed consent, all women received liquid-based cytology(LBC)testing, HR-HPV DNA testing. Totally 28 777 women with complete LBC, HPV and biopsy results were included in the final analysis. Screening performance of primary HR-HPV DNA screening and HPV screening plus LBC co-testing in diagnosis of CIN2+ were calculated and compared among different age groups. Results: Among the whole population, the detection rates of primary HR-HPV screening and HR-HPV screening plus LBC co-testing are 3.05% (879 CIN2+) and 3.13%(900 CIN2+), respectively. The sensitivity were 96.4% and 98.7% (χ(2)=19.00, P< 0.001), and the specificity were 86.2% and 78.8% (χ(2)=2 067.00, P< 0.001), respectively. Areas under the receiver operating characteristic (ROC) curve (AUC) showed that the primary HR-HPV screening performed better than co-testing (AUC were 0.913 and 0.888; Z= 6.16, P< 0.001). Compared with primary HR-HPV screening, co-testing showed significantly higher colposcopy referral rates (16.5% and 23.6%, respectively, χ(2)=132.00, P< 0.001) and the number of colposcopy examination for detecting per CIN2+ (5.4 and 7.6, respectively).In the group aged 25-29, the colposcopy referral rates was 8.7 (10.9%(199 cases) vs 1.3%(23 cases)) times as much as the detection rate of primary HR-HPV screening in diagnosis of CIN2+, and was 12.5 (15.7%(288 cases) vs 1.3%(23 cases)) times as much as the detection rate of HR-HPV screening plus cytology contesting. Conclusion: Compared with primary HR-HPV screening, HR-HPV screening plus cytology co-testing does not show better results in the screening performance for CIN2+ detection, and the cost-effectiveness is not good enough, especially in younger age group.

Diagnostic accuracy of high-risk HPV DNA genotyping for primary cervical cancer screening and triage of HPV-positive women, compared to cytology: preliminary results of the PIPAVIR study.

PubMed

Chatzistamatiou, Kimon; Moysiadis, Theodoros; Angelis, Eleftherios; Kaufmann, Andreas; Skenderi, Alkmini; Jansen-Duerr, Pidder; Lekka, Irini; Kilintzis, Vasilis; Angelidou, Stamatia; Katsiki, Evangelia; Hagemann, Ingke; Tsertanidou, Athena; Koch, Isabel; Boecher, Oliver; Soutschek, Erwin; Maglaveras, Nikolaos; Agorastos, Theodoros

2017-05-01

The purpose of the presented PIPAVIR (persistent infections with human papillomaviruses; http://www.pipavir.com ) subanalysis is to assess the performance of high-risk (hr) HPV-DNA genotyping as a method of primary cervical cancer screening and triage of HPV positive women to colposcopy compared to liquid-based cytology (LBC) in an urban female population. Women, aged 30-60, provided cervicovaginal samples at the Family-Planning Centre, Hippokratio Hospital of Thessaloniki, Greece, and the Department of Gynecology and Obstetrics in Mare Klinikum, Kiel, Germany. Cytology and HPV genotyping was performed using LBC and HPV Multiplex Genotyping (MPG), respectively. Women positive for cytology [atypical squamous cells of undetermined significance (ASC-US) or worse] or hrHPV were referred for colposcopy. Among 1723/1762 women included in the final analysis, hrHPV and HPV16/18 prevalence was 17.7 and 9.6%, respectively. Cytology was ASCUS or worse in 7.6%. Cervical Intraepithelial Neoplasia grade 2 or worse (CIN2+) was detected in 28 women (1.6%). Sensitivity of cytology (ASCUS or worse) and HPV DNA testing for the detection of CIN2+ was 50.0 and 100%, and specificity was 94.49 and 85.49%, respectively. The screening approach according to which only women positive for HPV16/18 and for hrHPV(non16/18) with ASCUS or worse were referred to colposcopy presented 78.57% sensitivity and 13.17% positive predictive value (PPV). HPV testing represents a more sensitive methodology for primary cervical cancer screening compared to cytology. For triage of HPV positive women to colposcopy, partial HPV genotyping offers better sensitivity than cytology, at the cost of higher number of colposcopies.

Automation of the linear array HPV genotyping test and its application for routine typing of human papillomaviruses in cervical specimens of women without cytological abnormalities in Switzerland.

PubMed

Dobec, Marinko; Bannwart, Fridolin; Kaeppeli, Franz; Cassinotti, Pascal

2009-05-01

There is a need for reliable, automated high throughput HPV detection and genotyping methods for pre- and post-prophylactic vaccine intervention analyses. To optimize the linear array (LA) HPV genotyping test (Roche Diagnostics, Rotkreuz) in regard to possible automation steps for the routine laboratory diagnosis of HPV infections and to analyze the HPV genotype distribution in cervical specimens of women without cytological abnormalities in Switzerland. 680 cervical cell specimens with normal cytology, obtained from women undergoing routine cervical screening by liquid-based Pap smear, were analyzed by the LA HPV genotyping test for HPV-DNA. The automation of the LA HPV genotyping test resulted in a total hands-on time reduction of 255 min (from 480 to 225 min; 53%). Any of 37 HPV genotypes were detected in 117 (17.2%) and high-risk (HR) HPV in 55 (8.1%) of 680 women with normal cytology. The highest prevalence of any HPV (28.1%) and HR-HPV (15.1%) was observed in age-group 21-30 and showed a continuous decrease in older age-groups. The most common HR-HPV genotypes were HPV-16 (12%), HPV-31 (9.4%), HPV-52 (6%), HPV-51 (5.1%), HPV-45 (4.3%), HPV-58 (4.3%) and HPV-59 (4.3%). The optimization and automation of the LA HPV genotyping test makes it suited for high throughput HPV detection and typing. The epidemiological data provides information about distribution of HPV genotypes in women without cytological abnormalities in Switzerland and may be important for determining the future impact of vaccines and potential changes in the country's epidemiological HPV profile.

Serial measurement of type-specific human papillomavirus load enables classification of cervical intraepithelial neoplasia lesions according to occurring human papillomavirus-induced pathway.

PubMed

Verhelst, Stefanie; Poppe, Willy A J; Bogers, Johannes J; Depuydt, Christophe E

2017-03-01

This retrospective study examined whether human papillomavirus (HPV) type-specific viral load changes measured in two or three serial cervical smears are predictive for the natural evolution of HPV infections and correlate with histological grades of cervical intraepithelial neoplasia (CIN), allowing triage of HPV-positive women. A cervical histology database was used to select consecutive women with biopsy-proven CIN in 2012 who had at least two liquid-based cytology samples before the diagnosis of CIN. Before performing cytology, 18 different quantitative PCRs allowed HPV type-specific viral load measurement. Changes in HPV-specific load between measurements were assessed by linear regression, with calculation of coefficient of determination (R) and slope. All infections could be classified into one of five categories: (i) clonal progressing process (R≥0.85; positive slope), (ii) simultaneously occurring clonal progressive and transient infection, (iii) clonal regressing process (R≥0.85; negative slope), (iv) serial transient infection with latency [R<0.85; slopes (two points) between 0.0010 and -0.0010 HPV copies/cell/day], and (v) transient productive infection (R<0.85; slope: ±0.0099 HPV copies/cell/day). Three hundred and seven women with CIN were included; 124 had single-type infections and 183 had multiple HPV types. Only with three consecutive measurements could a clonal process be identified in all CIN3 cases. We could clearly demonstrate clonal regressing lesions with a persistent linear decrease in viral load (R≥0.85; -0.003 HPV copies/cell/day) in all CIN categories. Type-specific viral load increase/decrease in three consecutive measurements enabled classification of CIN lesions in clonal HPV-driven transformation (progression/regression) and nonclonal virion-productive (serial transient/transient) processes.

Carcinogenic HPV prevalence and age-specific type distribution in 40,382 women with normal cervical cytology, ASCUS/LSIL, HSIL, or cervical cancer: what is the potential for prevention?

PubMed

Kjær, Susanne K; Munk, Christian; Junge, Jette; Iftner, Thomas

2014-02-01

Assessment of the prevaccination type-specific prevalence of human papillomavirus (HPV) in the general population is important for the prediction of the impact of HPV vaccination. We collected consecutively residual specimens from liquid-based cytology samples from 40,382 women from the general population in Copenhagen, Denmark, during 2002-2005. All samples were tested for high-risk HPV using the Hybrid Capture 2 technique, and genotyping was done using LiPa (Innogenetics). Through linkage with the Pathology Data Bank, we obtained information on the cytology result, and histology if any, on all women. The participants were 14-95 years of age (median age 37 years) at enrollment. The overall prevalence of HR HPV was 20.6 % ranging from 46.0 % in 20-23-year-old women to 5.7 % in women 65 years or older. Independently of cytology/histology, HPV16 was the most prevalent type. For virtually all HPV types, the occurrence of CIN3+ was higher when the specific HPV type was present together with HPV16 than it was together with other high-risk HPV types than HPV16 or if the HPV type occurred as a single infection. The prevalence of HPV16 and/or HPV18 was 74 % in cervical cancer and the corresponding prevalence of HPV16/18/31/33/45/52/58 was 89 %. This study forms a valuable starting point for monitoring the effect of HPV vaccination in Denmark. In addition, the particular carcinogenic role of HPV16 and 18 is confirmed and may support a role of genotyping for HPV16 and 18 in cervical cancer screening.

A new method for spatial structure detection of complex inner cavities based on 3D γ-photon imaging

NASA Astrophysics Data System (ADS)

Xiao, Hui; Zhao, Min; Liu, Jiantang; Liu, Jiao; Chen, Hao

2018-05-01

This paper presents a new three-dimensional (3D) imaging method for detecting the spatial structure of a complex inner cavity based on positron annihilation and γ-photon detection. This method first marks carrier solution by a certain radionuclide and injects it into the inner cavity where positrons are generated. Subsequently, γ-photons are released from positron annihilation, and the γ-photon detector ring is used for recording the γ-photons. Finally, the two-dimensional (2D) image slices of the inner cavity are constructed by the ordered-subset expectation maximization scheme and the 2D image slices are merged to the 3D image of the inner cavity. To eliminate the artifact in the reconstructed image due to the scattered γ-photons, a novel angle-traversal model is proposed for γ-photon single-scattering correction, in which the path of the single scattered γ-photon is analyzed from a spatial geometry perspective. Two experiments are conducted to verify the effectiveness of the proposed correction model and the advantage of the proposed testing method in detecting the spatial structure of the inner cavity, including the distribution of gas-liquid multi-phase mixture inside the inner cavity. The above two experiments indicate the potential of the proposed method as a new tool for accurately delineating the inner structures of industrial complex parts.

Development and characterization of an ex-vivo brain slice culture model of chronic wasting disease

USDA-ARS?s Scientific Manuscript database

Prion diseases have long incubation times in vivo, therefore, modeling the diseases ex-vivo will advance the development of rationale-based therapeutic strategies. An organotypic slice culture assay (POSCA) was recently developed for scrapie prions by inoculating mouse cerebellar brain slices with R...

Adaptation of Microplate-based Respirometry for Hippocampal Slices and Analysis of Respiratory Capacity

PubMed Central

Schuh, Rosemary A.; Clerc, Pascaline; Hwang, Hyehyun; Mehrabian, Zara; Bittman, Kevin; Chen, Hegang; Polster, Brian M.

2011-01-01

Multiple neurodegenerative disorders are associated with altered mitochondrial bioenergetics. Although mitochondrial O2 consumption is frequently measured in isolated mitochondria, isolated synaptic nerve terminals (synaptosomes), or cultured cells, the absence of mature brain circuitry is a remaining limitation. Here we describe the development of a method that adapts the Seahorse Extracellular Flux Analyzer (XF24) for the microplate-based measurement of hippocampal slice O2 consumption. As a first evaluation of the technique, we compared whole slice bioenergetics to previous measurements made with synaptosomes or cultured neurons. We found that mitochondrial respiratory capacity and O2 consumption coupled to ATP synthesis could be estimated in cultured or acute hippocampal slices with preserved neural architecture. Mouse organotypic hippocampal slices oxidizing glucose displayed mitochondrial O2 consumption that was well-coupled, as determined by the sensitivity to the ATP synthase inhibitor oligomycin. However stimulation of respiration by uncoupler was modest (<120% of basal respiration) compared to previous measurements in cells or synaptosomes, although enhanced slightly (to ~150% of basal respiration) by the acute addition of the mitochondrial complex I-linked substrate pyruvate. These findings suggest a high basal utilization of respiratory capacity in slices and a limitation of glucose-derived substrate for maximal respiration. The improved throughput of microplate-based hippocampal respirometry over traditional O2 electrode-based methods is conducive to neuroprotective drug screening. When coupled with cell type-specific pharmacology or genetic manipulations, the ability to efficiently measure O2 consumption from whole slices should advance our understanding of mitochondrial roles in physiology and neuropathology. PMID:21520220

Effect of Anatomical Customization of the Fiber Post on the Bond Strength of a Self-Adhesive Resin Cement.

PubMed

Rocha, Adricyla Teixeira; Gonçalves, Leticia Machado; Vasconcelos, Ana Júlia de Carvalho; Matos Maia Filho, Etevaldo; Nunes Carvalho, Ceci; De Jesus Tavarez, Rudys Rodolfo

2017-01-01

The aim of the study was to evaluate, by means of the push-out test, the effect of the anatomical customization of the fiber post on the bond strength of a self-adhesive resin cement. Twelve endodontically treated, human, upper central incisors were randomly divided into two groups ( n = 6): control (glass fiber posts cemented with Relyx® U200) and customized (glass fiber posts anatomically customized with translucent composite resin cemented with Relyx U200). The roots were sectioned into three slices, cervical, middle, and apical, and photographed with a digital camera attached to a stereomicroscopic loupe. The images were analyzed by software, for evaluation of the cement line. The slices were subsequently submitted to the push-out test until the post had completely extruded, and the fracture mode was analyzed with a stereomicroscopic loupe. The results showed significant differences between the groups in the different root thirds in relation to the area occupied by air bubbles ( p < 0.05). Bond strength, when all the thirds are considered, was 8.77 ± 4.89 MPa for the control group and 16.96 ± 4.85 MPa for the customized group. The customized group showed greater bond resistance than the control group and a more uniform cement layer.

Cervical Cancer—Patient Version

Cancer.gov

Cervical cancer is the fourth most common cancer in women worldwide. The primary risk factor for cervical cancer is human papillomavirus (HPV) infection. Start here to find evidence-based information on cervical cancer treatment, causes and prevention, screening, research, and statistics.

Nanotechnology in the management of cervical cancer.

PubMed

Chen, Jiezhong; Gu, Wenyi; Yang, Lei; Chen, Chen; Shao, Renfu; Xu, Kewei; Xu, Zhi Ping

2015-03-01

Cervical cancer is a major disease with high mortality. All cervical cancers are caused by infection with human papillomaviruses (HPV). Although preventive vaccines for cervical cancer are successful, treatment of cervical cancer is far less satisfactory because of multidrug resistance and side effects. In this review, we summarize the recent application of nanotechnology to the diagnosis and treatment of cervical cancer as well as the development of HPV vaccines. Early detection of cervical cancer enables tumours to be efficiently removed by surgical procedures, leading to increased survival rate. The current method of detecting cervical cancer by Pap smear can only achieve 50% sensitivity, whereas nanotechnology has been used to detect HPVs with greatly improved sensitivity. In cervical cancer treatment, nanotechnology has been used for the delivery of anticancer drugs to increase treatment efficacy and decrease side effects. Nanodelivery of HPV preventive and therapeutic vaccines has also been investigated to increase vaccine efficacy. Overall, these developments suggest that nanoparticle-based vaccine may become the most effective way to prevent and treat cervical cancer, assisted or combined with some other nanotechnology-based therapy. Copyright © 2015 John Wiley & Sons, Ltd.

Simulation of the planetary interior differentiation processes in the laboratory.

PubMed

Fei, Yingwei

2013-11-15

A planetary interior is under high-pressure and high-temperature conditions and it has a layered structure. There are two important processes that led to that layered structure, (1) percolation of liquid metal in a solid silicate matrix by planet differentiation, and (2) inner core crystallization by subsequent planet cooling. We conduct high-pressure and high-temperature experiments to simulate both processes in the laboratory. Formation of percolative planetary core depends on the efficiency of melt percolation, which is controlled by the dihedral (wetting) angle. The percolation simulation includes heating the sample at high pressure to a target temperature at which iron-sulfur alloy is molten while the silicate remains solid, and then determining the true dihedral angle to evaluate the style of liquid migration in a crystalline matrix by 3D visualization. The 3D volume rendering is achieved by slicing the recovered sample with a focused ion beam (FIB) and taking SEM image of each slice with a FIB/SEM crossbeam instrument. The second set of experiments is designed to understand the inner core crystallization and element distribution between the liquid outer core and solid inner core by determining the melting temperature and element partitioning at high pressure. The melting experiments are conducted in the multi-anvil apparatus up to 27 GPa and extended to higher pressure in the diamond-anvil cell with laser-heating. We have developed techniques to recover small heated samples by precision FIB milling and obtain high-resolution images of the laser-heated spot that show melting texture at high pressure. By analyzing the chemical compositions of the coexisting liquid and solid phases, we precisely determine the liquidus curve, providing necessary data to understand the inner core crystallization process.

Simulation of the Planetary Interior Differentiation Processes in the Laboratory

PubMed Central

Fei, Yingwei

2013-01-01

A planetary interior is under high-pressure and high-temperature conditions and it has a layered structure. There are two important processes that led to that layered structure, (1) percolation of liquid metal in a solid silicate matrix by planet differentiation, and (2) inner core crystallization by subsequent planet cooling. We conduct high-pressure and high-temperature experiments to simulate both processes in the laboratory. Formation of percolative planetary core depends on the efficiency of melt percolation, which is controlled by the dihedral (wetting) angle. The percolation simulation includes heating the sample at high pressure to a target temperature at which iron-sulfur alloy is molten while the silicate remains solid, and then determining the true dihedral angle to evaluate the style of liquid migration in a crystalline matrix by 3D visualization. The 3D volume rendering is achieved by slicing the recovered sample with a focused ion beam (FIB) and taking SEM image of each slice with a FIB/SEM crossbeam instrument. The second set of experiments is designed to understand the inner core crystallization and element distribution between the liquid outer core and solid inner core by determining the melting temperature and element partitioning at high pressure. The melting experiments are conducted in the multi-anvil apparatus up to 27 GPa and extended to higher pressure in the diamond-anvil cell with laser-heating. We have developed techniques to recover small heated samples by precision FIB milling and obtain high-resolution images of the laser-heated spot that show melting texture at high pressure. By analyzing the chemical compositions of the coexisting liquid and solid phases, we precisely determine the liquidus curve, providing necessary data to understand the inner core crystallization process. PMID:24326245

Epidemiology of cervical cancer and human papilloma virus infection among Iranian women - analyses of national data and systematic review of the literature.

PubMed

Khorasanizadeh, Faezeh; Hassanloo, Jaleh; Khaksar, Nafiseh; Mohammad Taheri, Somayeh; Marzaban, Maryam; H Rashidi, Batool; Akbari Sari, Ali; Zendehdel, Kazem

2013-02-01

Few studies have evaluated the epidemiology of cervical cancer in low risk Muslim countries, where the prognosis of cervical cancer is poor and which lack an organized cervical screening program. We studied incidence and mortality rates of cervical cancer and the prevalence of high risk human papilloma virus (HPV) infection in the Islamic Republic (I.R.) of Iran. We analyzed national cancer and mortality registration data and estimated age-standardized incidence (ASR) and mortality (ASMR) rates and age-specific patterns of cervical cancer. Furthermore, based on a systematic review we estimated prevalence of HPV infection in Iran. The mean cervical cancer ASR was 2.5 per 100,000 in pathology-based cancer registries. However, ASRs were almost double in the population-based cancer registry and reached 6 per 100,000. The mean cervical cancer ASMR for Iran was 1.04 per 100,000. The mortality to incidence ratio was 42%. The cervical cancer incidence rate increased after age 30 and peaked between ages 55 and 65. The prevalence of HPV infection was 76% in cervical cancer patients and 7% among healthy Iranian women. Of the HPV types isolated, HPV 16 (54%), 18 (14%), and 31 (6%) were the most commonly detected in Iranian cervical cancer patients. An organized prevention program is needed to fight against cervical cancer in Iran and other low incidence countries. We suggest a screening program starting after age 30 and with at least three screenings tests over each woman's lifetime. With a reservation on cost-effectiveness issue, available HPV vaccine will prevent HPV infection and cervical cancer in Iran. Copyright © 2012 Elsevier Inc. All rights reserved.

Assessment of Present State-of-the-art Sawing Technology of Large Diameter Ingots for Solar Sheet Material

NASA Technical Reports Server (NTRS)

Yoo, H. I.

1978-01-01

Work is reported on: (1) slicing of the ingots with the multiblade slurry saw, the multiwire slurry saw and the I.D. saw, (2) characterization of the sliced wafers, and (3) analysis of add-on slicing cost based on Solar Array Manufacturing Industry Costing Standard.

Cervical cancer screening in adolescents: an evidence-based internet education program for practice improvement among advanced practice nurses.

PubMed

Choma, Kim; McKeever, Amy E

2015-02-01

The literature reports great variation in the knowledge levels and application of the recent changes of cervical cancer screening guidelines into clinical practice. Evidence-based screening guidelines for the prevention and early detection of cervical cancer offers healthcare providers the opportunity to improve practice patterns among female adolescents by decreasing psychological distress as well as reducing healthcare costs and morbidities associated with over-screening. The purpose of this pilot intervention study was to determine the effects of a Web-based continuing education unit (CEU) program on advanced practice nurses' (APNs) knowledge of current cervical cancer screening evidence-based recommendations and their application in practice. This paper presents a process improvement project as an example of a way to disseminate updated evidence-based practice guidelines among busy healthcare providers. This Web-based CEU program was developed, piloted, and evaluated specifically for APNs. The program addressed their knowledge level of cervical cancer and its relationship with high-risk human papillomavirus. It also addressed the new cervical cancer screening guidelines and the application of those guidelines into clinical practice. Results of the study indicated that knowledge gaps exist among APNs about cervical cancer screening in adolescents. However, when provided with a CEU educational intervention, APNs' knowledge levels increased and their self-reported clinical practice behaviors changed in accordance with the new cervical cancer screening guidelines. Providing convenient and readily accessible up-to-date electronic content that provides CEU enhances the adoption of clinical practice guidelines, thereby decreasing the potential of the morbidities associated with over-screening for cervical cancer in adolescents and young women. © 2014 Sigma Theta Tau International.

Cardiac tissue slices: preparation, handling, and successful optical mapping.

PubMed

Wang, Ken; Lee, Peter; Mirams, Gary R; Sarathchandra, Padmini; Borg, Thomas K; Gavaghan, David J; Kohl, Peter; Bollensdorff, Christian

2015-05-01

Cardiac tissue slices are becoming increasingly popular as a model system for cardiac electrophysiology and pharmacology research and development. Here, we describe in detail the preparation, handling, and optical mapping of transmembrane potential and intracellular free calcium concentration transients (CaT) in ventricular tissue slices from guinea pigs and rabbits. Slices cut in the epicardium-tangential plane contained well-aligned in-slice myocardial cell strands ("fibers") in subepicardial and midmyocardial sections. Cut with a high-precision slow-advancing microtome at a thickness of 350 to 400 μm, tissue slices preserved essential action potential (AP) properties of the precutting Langendorff-perfused heart. We identified the need for a postcutting recovery period of 36 min (guinea pig) and 63 min (rabbit) to reach 97.5% of final steady-state values for AP duration (APD) (identified by exponential fitting). There was no significant difference between the postcutting recovery dynamics in slices obtained using 2,3-butanedione 2-monoxime or blebistatin as electromechanical uncouplers during the cutting process. A rapid increase in APD, seen after cutting, was caused by exposure to ice-cold solution during the slicing procedure, not by tissue injury, differences in uncouplers, or pH-buffers (bicarbonate; HEPES). To characterize intrinsic patterns of CaT, AP, and conduction, a combination of multipoint and field stimulation should be used to avoid misinterpretation based on source-sink effects. In summary, we describe in detail the preparation, mapping, and data analysis approaches for reproducible cardiac tissue slice-based investigations into AP and CaT dynamics. Copyright © 2015 the American Physiological Society.

Cardiac tissue slices: preparation, handling, and successful optical mapping

PubMed Central

Wang, Ken; Lee, Peter; Mirams, Gary R.; Sarathchandra, Padmini; Borg, Thomas K.; Gavaghan, David J.; Kohl, Peter

2015-01-01

Cardiac tissue slices are becoming increasingly popular as a model system for cardiac electrophysiology and pharmacology research and development. Here, we describe in detail the preparation, handling, and optical mapping of transmembrane potential and intracellular free calcium concentration transients (CaT) in ventricular tissue slices from guinea pigs and rabbits. Slices cut in the epicardium-tangential plane contained well-aligned in-slice myocardial cell strands (“fibers”) in subepicardial and midmyocardial sections. Cut with a high-precision slow-advancing microtome at a thickness of 350 to 400 μm, tissue slices preserved essential action potential (AP) properties of the precutting Langendorff-perfused heart. We identified the need for a postcutting recovery period of 36 min (guinea pig) and 63 min (rabbit) to reach 97.5% of final steady-state values for AP duration (APD) (identified by exponential fitting). There was no significant difference between the postcutting recovery dynamics in slices obtained using 2,3-butanedione 2-monoxime or blebistatin as electromechanical uncouplers during the cutting process. A rapid increase in APD, seen after cutting, was caused by exposure to ice-cold solution during the slicing procedure, not by tissue injury, differences in uncouplers, or pH-buffers (bicarbonate; HEPES). To characterize intrinsic patterns of CaT, AP, and conduction, a combination of multipoint and field stimulation should be used to avoid misinterpretation based on source-sink effects. In summary, we describe in detail the preparation, mapping, and data analysis approaches for reproducible cardiac tissue slice-based investigations into AP and CaT dynamics. PMID:25595366

Cervical Cancer—Health Professional Version

Cancer.gov

The primary risk factor for cervical cancer is human papillomavirus (HPV) infection. Most cases of cervical cancer are preventable by routine screening and by treatment of precancerous lesions. Find evidence-based information on cervical cancer treatment, causes and prevention, screening, research, and statistics.

An Investigation of Fat Infiltration of the Multifidus Muscle in Patients With Severe Neck Symptoms Associated With Chronic Whiplash-Associated Disorder.

PubMed

Karlsson, Anette; Leinhard, Olof Dahlqvist; Åslund, Ulrika; West, Janne; Romu, Thobias; Smedby, Örjan; Zsigmond, Peter; Peolsson, Anneli

2016-10-01

Study Design Cross-sectional study. Background Findings of fat infiltration in cervical spine multifidus, as a sign of degenerative morphometric changes due to whiplash injury, need to be verified. Objectives To develop a method using water/fat magnetic resonance imaging (MRI) to investigate fat infiltration and cross-sectional area of multifidus muscle in individuals with whiplash-associated disorders (WADs) compared to healthy controls. Methods Fat infiltration and cross-sectional area in the multifidus muscles spanning the C4 to C7 segmental levels were investigated by manual segmentation using water/fat-separated MRI in 31 participants with WAD and 31 controls, matched for age and sex. Results Based on average values for data spanning C4 to C7, participants with severe disability related to WAD had 38% greater muscular fat infiltration compared to healthy controls (P = .03) and 45% greater fat infiltration compared to those with mild to moderate disability related to WAD (P = .02). There were no significant differences between those with mild to moderate disability and healthy controls. No significant differences between groups were found for multifidus cross-sectional area. Significant differences were observed for both cross-sectional area and fat infiltration between segmental levels. Conclusion Participants with severe disability after a whiplash injury had higher fat infiltration in the multifidus compared to controls and to those with mild/moderate disability secondary to WAD. Earlier reported findings using T1-weighted MRI were reproduced using refined imaging technology. The results of the study also indicate a risk when segmenting single cross-sectional slices, as both cross-sectional area and fat infiltration differ between cervical levels. J Orthop Sports Phys Ther 2016;46(10):886-893. Epub 2 Sep 2016. doi:10.2519/jospt.2016.6553.

TU-EF-204-11: Impact of Using Multi-Slice Training Sets On the Performance of a Channelized Hotelling Observer in a Low-Contrast Detection Task in CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Favazza, C; Yu, L; Leng, S

2015-06-15

Purpose: To investigate using multiple CT image slices from a single acquisition as independent training images for a channelized Hotelling observer (CHO) model to reduce the number of repeated scans for CHO-based CT image quality assessment. Methods: We applied a previously validated CHO model to detect low contrast disk objects formed from cross-sectional images of three epoxy-resin-based rods (diameters: 3, 5, and 9 mm; length: ∼5cm). The rods were submerged in a 35x 25 cm2 iodine-doped water filled phantom, yielding-15 HU object contrast. The phantom was scanned 100 times with and without the rods present. Scan and reconstruction parameters include:more » 5 mm slice thickness at 0.5 mm intervals, 120 kV, 480 Quality Reference mAs, and a 128-slice scanner. The CHO’s detectability index was evaluated as a function of factors related to incorporating multi-slice image data: object misalignment along the z-axis, inter-slice pixel correlation, and number of unique slice locations. In each case, the CHO training set was fixed to 100 images. Results: Artificially shifting the object’s center position by as much as 3 pixels in any direction relative to the Gabor channel filters had insignificant impact on object detectability. An inter-slice pixel correlation of >∼0.2 yielded positive bias in the model’s performance. Incorporating multi-slice image data yielded slight negative bias in detectability with increasing number of slices, likely due to physical variations in the objects. However, inclusion of image data from up to 5 slice locations yielded detectability indices within measurement error of the single slice value. Conclusion: For the investigated model and task, incorporating image data from 5 different slice locations of at least 5 mm intervals into the CHO model yielded detectability indices within measurement error of the single slice value. Consequently, this methodology would Result in a 5-fold reduction in number of image acquisitions. This project was supported by National Institutes of Health grants R01 EB017095 and U01 EB017185 from the National Institute of Biomedical Imaging and Bioengineering.« less

Prevalence, Genotype Distribution and Risk Factors for Cervical Human Papillomavirus Infection in the Grand Tunis Region, Tunisia.

PubMed

Ardhaoui, Monia; Ennaifer, Emna; Letaief, Hajer; Salsabil, Rejaibi; Lassili, Thalja; Chahed, Karim; Bougatef, Souha; Bahrini, Asma; El Fehri, Emna; Ouerhani, Kaouther; Paez Jimenez, Adela; Guizani, Ikram; Boubaker, Med Samir; Ben Alaya, Nissaf Bouafif Ép

2016-01-01

Implementation of Human Papillomavirus (HPV) vaccination should be considered a key cervical cancer prevention strategy in Tunisia, where Pap smear screening is not efficient. This study aims to estimate the prevalence and to identify risk factors associated with HPV infection among women from Grand Tunis, Tunisia. We conducted a cross-sectional study, between December 2012 and May 2013. Eligible women for this study were those aged 18-65 years, sexually active, who sought medical attention at their primary health care centre or clinic in Grand Tunis, Tunisia and who gave written consent. A liquid-based Pap smear sample was obtained from all women using a cervical brush. Only women with betaglobin positive test were further analysed for HPV detection and typing. A nested-PCR of the L1 region was performed followed by reverse line blot hybridization to facilitate the specific detection of 31 HPV genotypes. Multiple logistic regression modeling was used for the analysis of associations between variables with some considered possible confounders after checking for interactions. A total of 391 women were enrolled in this study and 325 out of the 391 cervical samples were positive for the betaglobin test. Overall HPV prevalence was 13.2% [9.8%-17.5%], with the following most prevalent HPV genotypes: HPV6 (40%), HPV40 (14%), HPV16 (12%), HPV52 (9%), HPV31 and HPV59 (7%), followed by HPV68 (4%). Mean age of HPV positive women was 40.7±0.92 years. Independently associated risk factors of HPV infection were smoking (OR:2.8 [0.8-9.6]), low income (OR:9.6 [1.4-63.4), bad housing type (OR:2.5 [1-6.8]), partner with multiple sexual relationship (OR:4.5 [0.9-22.9]) and single women (widowed, divorced, separated, never married) (OR:6.9 [1.1-42.2]). This study provides the first national-based estimate of HPV prevalence in Tunisia. Our findings contribute to the evidence on the current burden of HPV infection, the critical role of sexual behaviour and socioeconomic status and call for increased support for the screening program in Tunisia to prevent cervical cancer. These results allow us to evaluate the cost-effectiveness of vaccine program implementation in Tunisia in future.

Multi-slice ultrasound image calibration of an intelligent skin-marker for soft tissue artefact compensation.

PubMed

Masum, M A; Pickering, M R; Lambert, A J; Scarvell, J M; Smith, P N

2017-09-06

In this paper, a novel multi-slice ultrasound (US) image calibration of an intelligent skin-marker used for soft tissue artefact compensation is proposed to align and orient image slices in an exact H-shaped pattern. Multi-slice calibration is complex, however, in the proposed method, a phantom based visual alignment followed by transform parameters estimation greatly reduces the complexity and provides sufficient accuracy. In this approach, the Hough Transform (HT) is used to further enhance the image features which originate from the image feature enhancing elements integrated into the physical phantom model, thus reducing feature detection uncertainty. In this framework, slice by slice image alignment and calibration are carried out and this provides manual ease and convenience. Copyright © 2016 Elsevier Ltd. All rights reserved.

Towards early detection of cervical cancer: Fractal dimension of AFM images of human cervical epithelial cells at different stages of progression to cancer.

PubMed

Guz, Nataliia V; Dokukin, Maxim E; Woodworth, Craig D; Cardin, Andrew; Sokolov, Igor

2015-10-01

We used AFM HarmoniX modality to analyse the surface of individual human cervical epithelial cells at three stages of progression to cancer, normal, immortal (pre-malignant) and carcinoma cells. Primary cells from 6 normal strains, 6 cancer, and 6 immortalized lines (derived by plasmid DNA-HPV-16 transfection of cells from 6 healthy individuals) were tested. This cell model allowed for good control of the cell phenotype down to the single cell level, which is impractical to attain in clinical screening tests (ex-vivo). AFM maps of physical (nonspecific) adhesion are collected on fixed dried cells. We show that a surface parameter called fractal dimension can be used to segregate normal from both immortal pre-malignant and malignant cells with sensitivity and specificity of more than 99%. The reported method of analysis can be directly applied to cells collected in liquid cytology screening tests and identified as abnormal with regular optical methods to increase sensitivity. Despite cervical smear screening, sometimes it is very difficult to differentiate cancers cells from pre-malignant cells. By using AFM to analyze the surface properties of human cervical epithelial cells, the authors were able to accurately identify normal from abnormal cells. This method could augment existing protocols to increase diagnostic accuracy. Copyright © 2015. Published by Elsevier Inc.

Liquid-based cytology for primary cervical cancer screening: a multi-centre study

PubMed Central

Monsonego, J; Autillo-Touati, A; Bergeron, C; Dachez, R; Liaras, J; Saurel, J; Zerat, L; Chatelain, P; Mottot, C

2001-01-01

The aim of this six-centre, split-sample study was to compare ThinPrep fluid-based cytology to the conventional Papanicolaou smear. Six cytopathology laboratories and 35 gynaecologists participated. 5428 patients met the inclusion criteria (age > 18 years old, intact cervix, informed consent). Each cervical sample was used first to prepare a conventional Pap smear, then the sampling device was rinsed into a PreservCyt vial, and a ThinPrep slide was made. Screening of slide pairs was blinded (n = 5428). All non-negative concordant cases (n = 101), all non-concordant cases (n = 206), and a 5% random sample of concordant negative cases (n = 272) underwent review by one independent pathologist then by the panel of 6 investigators. Initial (blinded) screening results for ThinPrep and conventional smears were correlated. Initial diagnoses were correlated with consensus cytological diagnoses. Differences in disease detection were evaluated using McNemar's test. On initial screening, 29% more ASCUS cases and 39% more low-grade squamous intraepithelial lesions (LSIL) and more severe lesions (LSIL+) were detected on the ThinPrep slides than on the conventional smears (P = 0.001), including 50% more LSIL and 18% more high-grade SIL (HSIL). The ASCUS:SIL ratio was lower for the ThinPrep method (115:132 = 0.87:1) than for the conventional smear method (89:94 = 0.95:1). The same trend was observed for the ASCUS/AGUS:LSIL ratio. Independent and consensus review confirmed 145 LSIL+ diagnoses; of these, 18% more had been detected initially on the ThinPrep slides than on the conventional smears (P = 0.041). The ThinPrep Pap Test is more accurate than the conventional Pap test and has the potential to optimize the effectiveness of primary cervical cancer screening. © 2001 Cancer Research Campaign http://www.bjcancer.com PMID:11161401

[Analysis of chondroitin sulfate content of Cervi Cornu Pantotrichum with different processing methods and different parts].

PubMed

Gong, Rui-Ze; Wang, Yan-Hua; Sun, Yin-Shi

2018-02-01

The differences and the variations of chondroitin sulfate content in different parts of Cervi Cornu Pantotrichum(CCP) with different processing methods were investigated. The chondroitin sulfate from velvet was extracted by dilute alkali-concentrated salt method. Next， the chondroitin sulfate was digested by chondroitinase ABC.The contents of total chondroitin sulfate and chondroitin sulfate A， B and C in the samples were determined by high performance liquid chromatography(HPLC).The content of chondroitin sulfate in wax，powder，gauze，bone slices of CCP with freeze-drying processing is 14.13，11.99，1.74，0.32 g·kg⁻¹， respectively. The content of chondroitin sulfate in wax，powder，gauze，bone slices of CCP with boiling processing is 10.71，8.97，2.21，1.40 g·kg⁻¹， respectively. The content of chondroitin sulfate in wax，powder，gauze，bone slices of CCP without blood is 12.47，9.47，2.64，0.07 g·kg⁻¹， respectively. And the content of chondroitin sulfate in wax，powder，gauze，bone slices of CCP with blood is 8.22，4.39，0.87，0.28 g·kg⁻¹ respectively. The results indicated that the chondroitin sulfate content in different processing methods was significantly different.The content of chondroitin sulfate in CCP with freeze-drying is higher than that in CCP with boiling processing.The content of chondroitin sulfate in CCP without blood is higher than that in CCP with blood. The chondroitin sulfate content in differerent paris of the velvet with the same processing methods was arranged from high to low as： wax slices， powder， gauze slices， bone slices. Copyright© by the Chinese Pharmaceutical Association.

A novel CaV2.2 channel inhibition by piracetam in peripheral and central neurons.

PubMed

Bravo-Martínez, Jorge; Arenas, Isabel; Vivas, Oscar; Rebolledo-Antúnez, Santiago; Vázquez-García, Mario; Larrazolo, Arturo; García, David E

2012-10-01

No mechanistic actions for piracetam have been documented to support its nootropic effects. Voltage-gated calcium channels have been proposed as a promising pharmacological target of nootropic drugs. In this study, we investigated the effect of piracetam on Ca(V)2.2 channels in peripheral neurons, using patch-clamp recordings from cultured superior cervical ganglion neurons. In addition, we tested if Ca(V)2.2 channel inhibition could be related with the effects of piracetam on central neurons. We found that piracetam inhibited native Ca(V)2.2 channels in superior cervical ganglion neurons in a dose-dependent manner, with an IC(50) of 3.4 μmol/L and a Hill coefficient of 1.1. GDPβS dialysis did not prevent piracetam-induced inhibition of Ca(V)2.2 channels and G-protein-coupled receptor activation by noradrenaline did not occlude the piracetam effect. Piracetam altered the biophysical characteristics of Ca(V)2.2 channel such as facilitation ratio. In hippocampal slices, piracetam and ω-conotoxin GVIA diminished the frequency of excitatory postsynaptic potentials and action potentials. Our results provide evidence of piracetam's actions on Ca(V)2.2 channels in peripheral neurons, which might explain some of its nootropic effects in central neurons.

A deep learning model integrating FCNNs and CRFs for brain tumor segmentation.

PubMed

Zhao, Xiaomei; Wu, Yihong; Song, Guidong; Li, Zhenye; Zhang, Yazhuo; Fan, Yong

2018-01-01

Accurate and reliable brain tumor segmentation is a critical component in cancer diagnosis, treatment planning, and treatment outcome evaluation. Build upon successful deep learning techniques, a novel brain tumor segmentation method is developed by integrating fully convolutional neural networks (FCNNs) and Conditional Random Fields (CRFs) in a unified framework to obtain segmentation results with appearance and spatial consistency. We train a deep learning based segmentation model using 2D image patches and image slices in following steps: 1) training FCNNs using image patches; 2) training CRFs as Recurrent Neural Networks (CRF-RNN) using image slices with parameters of FCNNs fixed; and 3) fine-tuning the FCNNs and the CRF-RNN using image slices. Particularly, we train 3 segmentation models using 2D image patches and slices obtained in axial, coronal and sagittal views respectively, and combine them to segment brain tumors using a voting based fusion strategy. Our method could segment brain images slice-by-slice, much faster than those based on image patches. We have evaluated our method based on imaging data provided by the Multimodal Brain Tumor Image Segmentation Challenge (BRATS) 2013, BRATS 2015 and BRATS 2016. The experimental results have demonstrated that our method could build a segmentation model with Flair, T1c, and T2 scans and achieve competitive performance as those built with Flair, T1, T1c, and T2 scans. Copyright © 2017 Elsevier B.V. All rights reserved.

Target recognition for ladar range image using slice image

NASA Astrophysics Data System (ADS)

Xia, Wenze; Han, Shaokun; Wang, Liang

2015-12-01

A shape descriptor and a complete shape-based recognition system using slice images as geometric feature descriptor for ladar range images are introduced. A slice image is a two-dimensional image generated by three-dimensional Hough transform and the corresponding mathematical transformation. The system consists of two processes, the model library construction and recognition. In the model library construction process, a series of range images are obtained after the model object is sampled at preset attitude angles. Then, all the range images are converted into slice images. The number of slice images is reduced by clustering analysis and finding a representation to reduce the size of the model library. In the recognition process, the slice image of the scene is compared with the slice image in the model library. The recognition results depend on the comparison. Simulated ladar range images are used to analyze the recognition and misjudgment rates, and comparison between the slice image representation method and moment invariants representation method is performed. The experimental results show that whether in conditions without noise or with ladar noise, the system has a high recognition rate and low misjudgment rate. The comparison experiment demonstrates that the slice image has better representation ability than moment invariants.

Bone pain caused by swelling of mouse ear capsule static xylene and effects on rat models of cervical spondylosis

NASA Astrophysics Data System (ADS)

Zhang, Xuhui; Xia, Lei; Hao, Shaojun; Chen, Weiliang; Guo, Junyi; Ma, Zhenzhen; Wang, Huamin; Kong, Xuejun; Wang, Hongyu; Zhang, Zhengchen

2018-04-01

To observe the effect of intravenous bone pain Capsule on the ear of mice induced by xylene, swelling of rat models of cervical spondylosis. Weighing 18 ˜ 21g 50 mice, male, were randomly divided into for five groups, which were fed with service for bone pain static capsule suspension, Jingfukang granule suspension 0.5%CMC liquid and the same volume of. Respectively to the mice ear drop of xylene 0.05 ml, 4h after cervical dislocation, the mice were sacrificed and the cut two ear, rapid analytical balance weighing, and calculate the ear swelling degree and the other to take the weight of 200 - 60 250g male SD rats, were randomly divided into for 6 groups, 10 rats in each group, of which 5 groups made cervical spondylosis model. Results: with the blank group than bone pain static capsule group and Jingfukang granule group can significantly reduce mouse auricular dimethylbenzene swelling, significantly reduce ear swelling degree (P < 0.01); the successful establishment of the rat model of cervical spondylosis. With the model group ratio, large, medium and small dose of bone pain static capsule group, Jingfukang granule group (P < 0.01) angle of swash plate of rats increased significantly, the high and middle dose of bone pain static capsule group, Jingfukang granule group can significantly reduce the rat X-ray scores (P < 0.05). Bone pain static capsule can significantly reduce mouse auricular dimethylbenzene swelling. The bone pain capsule has a good effect on the rat model of cervical spondylosis.

Do cervical collars and cervicothoracic orthoses effectively stabilize the injured cervical spine? A biomechanical investigation.

PubMed

Ivancic, Paul C

2013-06-01

In vitro biomechanical study. Our objective was to determine the effectiveness of cervical collars and cervicothoracic orthoses for stabilizing clinically relevant, experimentally produced cervical spine injuries. Most previous in vitro studies of cervical orthoses used a simplified injury model with all ligaments transected at a single spinal level, which differs from real-life neck injuries. Human volunteer studies are limited to measuring only sagittal motions or 3-dimensional motions only of the head or 1 or 2 spinal levels. Three-plane flexibility tests were performed to evaluate 2 cervical collars (Vista Collar and Vista Multipost Collar) and 2 cervicothoracic orthoses (Vista TS and Vista TS4) using a skull-neck-thorax model with 8 injured cervical spine specimens (manufacturer of orthoses: Aspen Medical Products Inc, Irvine, CA). The injuries consisted of flexion-compression at the lower cervical spine and extension-compression at superior spinal levels. Pair-wise repeated measures analysis of variance (P < 0.05) and Bonferroni post hoc tests determined significant differences in average range of motions of the head relative to the base, C7 or T1, among experimental conditions. RESULTS.: All orthoses significantly reduced unrestricted head/base flexion and extension. The orthoses allowed between 8.4% and 25.8% of unrestricted head/base motion in flexion/extension, 57.8% to 75.5% in axial rotation, and 53.8% to 73.7% in lateral bending. The average percentages of unrestricted motion allowed by the Vista Collar, Vista Multipost Collar, Vista TS, and Vista TS4 were: 14.0, 9.7, 6.1, and 4.7, respectively, for middle cervical spine extension and 13.2, 11.8, 3.3, and 0.4, respectively, for lower cervical spine flexion. Successive increases in immobilization were observed from Vista Collar to Vista Multipost Collar, Vista TS, and Vista TS4 in extension at the injured middle cervical spine and in flexion at the injured lower cervical spine. Our results may assist clinicians in selecting the most appropriate orthosis based upon patient-specific cervical spine injuries.

Internet-Based Cervical Cytology Screening System

DTIC Science & Technology

2007-04-01

approaches to cervical cancer screening possible. In addition, advances in information technology have facilitated the Internet transmission and archival...processes in the clinical laboratory. Recent technological advances in specimen preparation and computerized primary screening make automated...AD_________________ Award Number: W81XWH-04-C-0083 TITLE: Internet -Based Cervical Cytology

Optimizing secondary prevention of cervical cancer: Recent advances and future challenges.

PubMed

Ogilvie, Gina; Nakisige, Carolyn; Huh, Warner K; Mehrotra, Ravi; Franco, Eduardo L; Jeronimo, Jose

2017-07-01

Although human papillomavirus (HPV) vaccines offer enormous promise for the ultimate control and possible elimination of cervical cancer, barriers to uptake and coverage of the vaccine both in high- and low/middle-income settings mean that advances in secondary prevention continue to be essential to prevent unnecessary deaths and suffering from cervical cancer for decades to come. While cytology (the Pap smear) has reduced cervical cancer incidence and prevalence in jurisdictions where it has been systematically implemented in population-based programs-mainly in high-income settings-limitations inherent to this method, and to program delivery, leave many women still vulnerable to cervical cancer. Recent evidence has confirmed that screening based on HPV testing prevents more invasive cervical cancer and precancerous lesions, and offers innovative options such as self-collection of specimens to improve screening uptake broadly. In this paper, we review key advances, future opportunities, and ongoing challenges for secondary prevention of cervical cancer using HPV-based testing. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Recent developments in multi-wire fixed abrasive slicing technique (FAST). [for low cost silicon wafer production from ingots

NASA Technical Reports Server (NTRS)

Schmid, F.; Khattak, C. P.; Smith, M. B.; Lynch, L. D.

1982-01-01

Slicing is an important processing step for all technologies based on the use of ingots. A comparison of the economics of three slicing techniques shows that the fixed abrasive slicing technique (FAST) is superior to the internal diameter (ID) and the multiblade slurry (MBS) techniques. Factors affecting contact length are discussed, taking into account kerf width, rocking angle, ingot size, and surface speed. Aspects of blade development are also considered. A high concentration of diamonds on wire has been obtained in wire packs usd for FAST slicing. The material removal rate was found to be directly proportional to the pressure at the diamond tips.

Low cost monocrystalline silicon sheet fabrication for solar cells by advanced ingot technology

NASA Technical Reports Server (NTRS)

Fiegl, G. F.; Bonora, A. C.

1980-01-01

The continuous liquid feed (CLF) Czochralski furnace and the enhanced I.D. slicing technology for the low-cost production of monocrystalline silicon sheets for solar cells are discussed. The incorporation of the CLF system is shown to improve ingot production rate significantly. As demonstrated in actual runs, higher than average solidification rates (75 to 100 mm/hr for 150 mm 1-0-0 crystals) can be achieved, when the system approaches steady-state conditions. The design characteristics of the CLF furnace are detailed, noting that it is capable of precise control of dopant impurity incorporation in the axial direction of the crystal. The crystal add-on cost is computed to be $11.88/sq m, considering a projected 1986 25-slice per cm conversion factor with an 86% crystal growth yield.

First application of liquid-metal-jet sources for small-animal imaging: high-resolution CT and phase-contrast tumor demarcation.

PubMed

Larsson, Daniel H; Lundström, Ulf; Westermark, Ulrica K; Arsenian Henriksson, Marie; Burvall, Anna; Hertz, Hans M

2013-02-01

Small-animal studies require images with high spatial resolution and high contrast due to the small scale of the structures. X-ray imaging systems for small animals are often limited by the microfocus source. Here, the authors investigate the applicability of liquid-metal-jet x-ray sources for such high-resolution small-animal imaging, both in tomography based on absorption and in soft-tissue tumor imaging based on in-line phase contrast. The experimental arrangement consists of a liquid-metal-jet x-ray source, the small-animal object on a rotating stage, and an imaging detector. The source-to-object and object-to-detector distances are adjusted for the preferred contrast mechanism. Two different liquid-metal-jet sources are used, one circulating a Ga∕In∕Sn alloy and the other an In∕Ga alloy for higher penetration through thick tissue. Both sources are operated at 40-50 W electron-beam power with ∼7 μm x-ray spots, providing high spatial resolution in absorption imaging and high spatial coherence for the phase-contrast imaging. High-resolution absorption imaging is demonstrated on mice with CT, showing 50 μm bone details in the reconstructed slices. High-resolution phase-contrast soft-tissue imaging shows clear demarcation of mm-sized tumors at much lower dose than is required in absorption. This is the first application of liquid-metal-jet x-ray sources for whole-body small-animal x-ray imaging. In absorption, the method allows high-resolution tomographic skeletal imaging with potential for significantly shorter exposure times due to the power scalability of liquid-metal-jet sources. In phase contrast, the authors use a simple in-line arrangement to show distinct tumor demarcation of few-mm-sized tumors. This is, to their knowledge, the first small-animal tumor visualization with a laboratory phase-contrast system.

Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

PubMed Central

Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

2013-01-01

Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative-based performance initiatives for cervical cancer screening minimizes differences in provider practices and maximizes performance of screening while containing cervical cancer screening costs. PMID:21959573

Effect of desensitizing agents on dentin permeability.

PubMed

Ishihata, Hiroshi; Kanehira, Masafumi; Nagai, Tomoko; Finger, Werner J; Shimauchi, Hidetoshi; Komatsu, Masashi

2009-06-01

To investigate the in vitro efficacy of two dentin desensitizing products at reducing liquid permeability through human dentin discs. The tested hypothesis was that the products, in spite of different chemical mechanisms were not different at reducing or eliminating flow through dentin discs. Dentin slices (1 mm thick) were prepared from 16 extracted human third molars and their permeability was indirectly recorded in a split chamber model, using a chemiluminescence technique, after EDTA treatment (control), after soaking with albumin, and after desensitizer application. Two products were studied: MS Coat, a self-curing resin-containing oxalate product, and Gluma Desensitizer, a glutaraldehyde/HEMA-based agent without initiator. The dentin slices were mounted between an upper chamber, filled with an aqueous solution of 1% potassium ferricyanide and 0.3% hydrogen peroxide, and a lower chamber filled with 1% sodium hydroxide solution and 0.02% luminol. The upper solution was pressurized, and upon contact with the luminol solution a photochemical signal was generated and recorded as a measure of permeability throughout two consecutive pressurizing cycles at 2.5 and 13 kPa (26 and 133 cm H2O), respectively. The permeability of the control and albumin-soaked samples was similarly high. After application of the desensitizing agents, dentin permeability was reduced to virtually zero at both pressure levels (P < 0.001).

A prospective study of risk-based colposcopy demonstrates improved detection of cervical precancers.

PubMed

Wentzensen, Nicolas; Walker, Joan; Smith, Katie; Gold, Michael A; Zuna, Rosemary; Massad, L Stewart; Liu, Angela; Silver, Michelle I; Dunn, S Terence; Schiffman, Mark

2018-06-01

Sensitivity for detection of precancers at colposcopy and reassurance provided by a negative colposcopy are in need of systematic study and improvement. We sought to evaluate whether selecting the appropriate women for multiple targeted cervical biopsies based on screening cytology, human papillomavirus testing, and colposcopic impression could improve accuracy and efficiency of cervical precancer detection. In all, 690 women aged 18-67 years referred to colposcopy subsequent to abnormal cervical cancer screening results were included in the study (ClinicalTrials.gov: NCT00339989). Up to 4 cervical biopsies were taken during colposcopy to evaluate the incremental benefit of multiple biopsies. Cervical cytology, human papillomavirus genotyping, and colposcopy impression were used to establish up to 24 different risk strata. Outcomes for the primary analysis were cervical precancers, which included p16 + cervical intraepithelial neoplasia 2 and all cervical intraepithelial neoplasia 3 that were detected by colposcopy-guided biopsy during the colposcopy visit. Later outcomes in women without cervical intraepithelial neoplasia 2 + at baseline were abstracted from electronic medical records. The risk of detecting precancer ranged from 2-82% across 24 strata based on colposcopy impression, cytology, and human papillomavirus genotyping. The risk of precancer in the lowest stratum increased only marginally with multiple biopsies. Women in the highest-risk strata had risks of precancer consistent with immediate treatment. In other risk strata, multiple biopsies substantially improved detection of cervical precancer. Among 361 women with cervical intraepithelial neoplasia <2 at baseline, 195 (54%) had follow-up cytology or histology data with a median follow-up time of 508 days. Lack of detection of precancer at initial colposcopy that included multiple biopsies predicted low risk of precancer during follow-up. Risk assessment at the colposcopy visit makes identification of cervical precancers more effective and efficient. Not finding precancer after a multiple-biopsy protocol provides high reassurance and allows releasing women back to regular screening. Published by Elsevier Inc.

Local T1-T2 distribution measurements in porous media

NASA Astrophysics Data System (ADS)

Vashaee, S.; Li, M.; Newling, B.; MacMillan, B.; Marica, F.; Kwak, H. T.; Gao, J.; Al-harbi, A. M.; Balcom, B. J.

2018-02-01

A novel slice-selective T1-T2 measurement is proposed to measure spatially resolved T1-T2 distributions. An adiabatic inversion pulse is employed for slice-selection. The slice-selective pulse is able to select a quasi-rectangular slice, on the order of 1 mm, at an arbitrary position within the sample. The method does not employ conventional selective excitation in which selective excitation is often accomplished by rotation of the longitudinal magnetization in the slice of interest into the transverse plane, but rather a subtraction based on CPMG data acquired with and without adiabatic inversion slice selection. T1 weighting is introduced during recovery from the inversion associated with slice selection. The local T1-T2 distributions measured are of similar quality to bulk T1-T2 measurements. The new method can be employed to characterize oil-water mixtures and other fluids in porous media. The method is beneficial when a coarse spatial distribution of the components is of interest.

Whole-Lesion Apparent Diffusion Coefficient-Based Entropy-Related Parameters for Characterizing Cervical Cancers: Initial Findings.

PubMed

Guan, Yue; Li, Weifeng; Jiang, Zhuoran; Chen, Ying; Liu, Song; He, Jian; Zhou, Zhengyang; Ge, Yun

2016-12-01

This study aimed to develop whole-lesion apparent diffusion coefficient (ADC)-based entropy-related parameters of cervical cancer to preliminarily assess intratumoral heterogeneity of this lesion in comparison to adjacent normal cervical tissues. A total of 51 women (mean age, 49 years) with cervical cancers confirmed by biopsy underwent 3-T pelvic diffusion-weighted magnetic resonance imaging with b values of 0 and 800 s/mm 2 prospectively. ADC-based entropy-related parameters including first-order entropy and second-order entropies were derived from the whole tumor volume as well as adjacent normal cervical tissues. Intraclass correlation coefficient, Wilcoxon test with Bonferroni correction, Kruskal-Wallis test, and receiver operating characteristic curve were used for statistical analysis. All the parameters showed excellent interobserver agreement (all intraclass correlation coefficients  > 0.900). Entropy, entropy(H) 0 , entropy(H) 45 , entropy(H) 90 , entropy(H) 135 , and entropy(H) mean were significantly higher, whereas entropy(H) range and entropy(H) std were significantly lower in cervical cancers compared to adjacent normal cervical tissues (all P <.0001). Kruskal-Wallis test showed that there were no significant differences among the values of various second-order entropies including entropy(H) 0, entropy(H) 45 , entropy(H) 90 , entropy(H) 135 , and entropy(H) mean. All second-order entropies had larger area under the receiver operating characteristic curve than first-order entropy in differentiating cervical cancers from adjacent normal cervical tissues. Further, entropy(H) 45 , entropy(H) 90 , entropy(H) 135 , and entropy(H) mean had the same largest area under the receiver operating characteristic curve of 0.867. Whole-lesion ADC-based entropy-related parameters of cervical cancers were developed successfully, which showed initial potential in characterizing intratumoral heterogeneity in comparison to adjacent normal cervical tissues. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Secondary prevention of cervical cancer part 3: evidence-based management of women with cervical intraepithelial neoplasia.

PubMed

Guido, Richard; Lonky, Neal M; Diedrich, Justin

2014-06-01

The management of cervical intraepithelial neoplasia has evolved over the last 20 years. Observation has replaced aggressive therapy in many cases. Evidence based guidelines now guide therapy. This chapter presents an overview of various treatment options, as well as the most recent guidelines of therapy.

Application of machine learning methodology for pet-based definition of lung cancer

PubMed Central

Kerhet, A.; Small, C.; Quon, H.; Riauka, T.; Schrader, L.; Greiner, R.; Yee, D.; McEwan, A.; Roa, W.

2010-01-01

We applied a learning methodology framework to assist in the threshold-based segmentation of non-small-cell lung cancer (nsclc) tumours in positron-emission tomography–computed tomography (pet–ct) imaging for use in radiotherapy planning. Gated and standard free-breathing studies of two patients were independently analysed (four studies in total). Each study had a pet–ct and a treatment-planning ct image. The reference gross tumour volume (gtv) was identified by two experienced radiation oncologists who also determined reference standardized uptake value (suv) thresholds that most closely approximated the gtv contour on each slice. A set of uptake distribution-related attributes was calculated for each pet slice. A machine learning algorithm was trained on a subset of the pet slices to cope with slice-to-slice variation in the optimal suv threshold: that is, to predict the most appropriate suv threshold from the calculated attributes for each slice. The algorithm’s performance was evaluated using the remainder of the pet slices. A high degree of geometric similarity was achieved between the areas outlined by the predicted and the reference suv thresholds (Jaccard index exceeding 0.82). No significant difference was found between the gated and the free-breathing results in the same patient. In this preliminary work, we demonstrated the potential applicability of a machine learning methodology as an auxiliary tool for radiation treatment planning in nsclc. PMID:20179802

Cervical cancer patterns with automation-assisted and conventional cytological screening: a randomized study.

PubMed

Anttila, Ahti; Pokhrel, Arun; Kotaniemi-Talonen, Laura; Hakama, Matti; Malila, Nea; Nieminen, Pekka

2011-03-01

The purpose was to evaluate alternative cytological screening methods in population-based screening for cervical cancer up to cancer incidence and mortality outcome. Automation-assisted screening was compared to conventional cytological screening in a randomized design. The study was based on follow-up of 503,391 women invited in the Finnish cervical cancer screening program during 1999-2003. The endpoints were incident cervical cancer, severe intraepithelial neoplasia and deaths from cervical cancer. One third of the women had been randomly allocated to automation-assisted screening and two thirds to conventional cytology. Information on cervical cancer and severe neoplasia were obtained through 1999-2007 from a linkage between screening and cancer registry files. There were altogether 3.2 million woman-years at risk, and the average follow-up time was 6.3 years. There was no difference in the risk of cervical cancer between the automation-assisted and conventional screening methods; the relative risk (RR) of cervical cancer between the study and control arm was 1.00 (95% confidence interval [CI] = 0.76-1.29) among all invited and 1.08 (95% CI = 0.76-1.51) among women who were test negative at entry. Comparing women who were test negative with nonscreened, RR of cervical cancer incidence was 0.26, 95% CI = 0.19-0.36 and of mortality 0.24 (0.13-0.43). Both methods were valid for screening. Because cervical cancer is rare in our country, we cannot rule out small differences between methods. Evidence on alternative methods for cervical cancer screening is increasing and it is thus feasible to evaluate new methods in large-scale population-based screening programs up to cancer outcome. Copyright © 2010 UICC.

Injectable silk-based biomaterials for cervical tissue augmentation: an in vitro study.

PubMed

Brown, Joseph E; Partlow, Benjamin P; Berman, Alison M; House, Michael D; Kaplan, David L

2016-01-01

Cerclage therapy is an important treatment option for preterm birth prevention. Several patient populations benefit from cerclage therapy including patients with a classic history of cervical insufficiency; patients who present with advanced cervical dilation prior to viability; and patients with a history of preterm birth and cervical shortening. Although cerclage is an effective treatment option in some patients, it can be associated with limited efficacy and procedure complications. Development of an alternative to cerclage therapy would be an important clinical development. Here we report on an injectable, silk protein-based biomaterial for cervical tissue augmentation. The rationale for the development of an injectable biomaterial is to restore the native properties of cervical tissue. While cerclage provides support to the tissue, it does not address excessive tissue softening, which is a central feature of the pathogenesis of cervical insufficiency. Silk protein-based hydrogels, which are biocompatible and naturally degrade in vivo, are suggested as a platform for restoring the native properties of cervical tissue and improving cervical function. We sought to study the properties of an injectable, silk-based biomaterial for potential use as an alternative treatment for cervical insufficiency. These biomaterials were evaluated for mechanical tunability, biocompatibility, facile injection, and in vitro degradation. Silk protein solutions were cross-linked by an enzyme catalyzed reaction to form elastic biomaterials. Biomaterials were formulated to match the native physical properties of cervical tissue during pregnancy. The cell compatibility of the materials was assessed in vitro using cervical fibroblasts, and biodegradation was evaluated using concentrated protease solution. Tissue augmentation or bulking was demonstrated using human cervical tissue from nonpregnant hysterectomy specimens. Mechanical compression tests measured the tissue stiffness as a function of the volume of injected biomaterial. Silk protein concentration, molecular weight, and concentration of cross-linking agent were varied to generate biomaterials that functioned from hard gels to viscous fluids. Biomaterials that matched the mechanical features of cervical tissues were chosen for further study. Cervical fibroblasts cultured on these biomaterials were proliferative and metabolically active over 6 days. Biomaterials were degraded in protease solution, with rate of mass loss dependent on silk protein molecular weight. Injection of cervical tissue samples with 100 μL of the biomaterial resulted in a significant volume increase (22.6% ± 8.8%, P < .001) with no significant change in tissue stiffness. Cytocompatible, enzyme cross-linked silk protein biomaterials show promise as a tissue bulking agent. The biomaterials were formulated to match the native mechanical properties of human cervical tissue. These biomaterials should be explored further as a possible alternative to cerclage for providing support to the cervix during pregnancy. Copyright © 2016 Elsevier Inc. All rights reserved.

Robust watermarking scheme for binary images using a slice-based large-cluster algorithm with a Hamming Code

NASA Astrophysics Data System (ADS)

Chen, Wen-Yuan; Liu, Chen-Chung

2006-01-01

The problems with binary watermarking schemes are that they have only a small amount of embeddable space and are not robust enough. We develop a slice-based large-cluster algorithm (SBLCA) to construct a robust watermarking scheme for binary images. In SBLCA, a small-amount cluster selection (SACS) strategy is used to search for a feasible slice in a large-cluster flappable-pixel decision (LCFPD) method, which is used to search for the best location for concealing a secret bit from a selected slice. This method has four major advantages over the others: (a) SBLCA has a simple and effective decision function to select appropriate concealment locations, (b) SBLCA utilizes a blind watermarking scheme without the original image in the watermark extracting process, (c) SBLCA uses slice-based shuffling capability to transfer the regular image into a hash state without remembering the state before shuffling, and finally, (d) SBLCA has enough embeddable space that every 64 pixels could accommodate a secret bit of the binary image. Furthermore, empirical results on test images reveal that our approach is a robust watermarking scheme for binary images.

Potent anti-proliferative effects against oral and cervical cancers of Thai medicinal plants selected from the Thai/Lanna medicinal plant recipe database "MANOSROI III".

PubMed

Manosroi, Aranya; Akazawa, Hiroyuki; Pattamapun, Kassara; Kitdamrongtham, Worapong; Akihisa, Toshihiro; Manosroi, Worapaka; Manosroi, Jiradej

2015-07-01

Thai/Lanna medicinal plant recipes have been used for the treatment of several diseases including oral and cervical cancers. To investigate anti-proliferative activity on human cervical (HeLa) and oral (KB) cancer cell lines of medicinal plants selected from Thai/Lanna medicinal plant recipe database "MANOSROI III". Twenty-three methanolic plant crude extracts were tested for phytochemicals and anti-proliferative activity on HeLa and KB cell lines for 24 h by the sulforhodamine B (SRB) assay at the doses of 1 × 10(1)-1 × 10(-6 )mg/ml. The nine extracts with the concentrations giving 50% growth inhibition (GI50) lower than 100 µg/ml were further semi-purified by liquid/liquid partition in order to evaluate and enhance the anti-proliferative potency. All extracts contained steroids/triterpenoids, but not xanthones. The methanolic extracts of Gloriosa superba L. (Colchinaceae) root and Albizia chinensis (Osbeck) Merr. (Leguminosae-Mimosoideae) wood gave the highest anti-proliferative activity on HeLa and KB cell lines with the GI50 values of 0.91 (6.0- and 0.31-fold of cisplatin and doxorubicin) and 0.16 µg/ml (28.78- and 82.29-fold of cisplatin and doxorubicin), respectively. Hexane and methanol-water fractions of G. superba exhibited the highest anti-proliferative activity on HeLa and KB cell lines with the GI50 values of 0.15 (37- and 1.9-fold of cisplatin and doxorubicin) and 0.058 µg/ml (77.45- and 221.46-fold of cisplatin and doxorubicin), respectively. This study has demonstrated the potential of plants selected from MANOSROI III database especially G. superba and A. chinensis for further development as anti-oral and cervical cancer agents.

Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach

PubMed Central

Setiawan, Didik; Kotsopoulos, Nikolaos; Wilschut, Jan C.; Postma, Maarten J.; Connolly, Mark P.

2016-01-01

Background Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. Methods A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Results Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I$2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). Conclusion In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality. PMID:27490258

The German cervical cancer screening model: development and validation of a decision-analytic model for cervical cancer screening in Germany.

PubMed

Siebert, Uwe; Sroczynski, Gaby; Hillemanns, Peter; Engel, Jutta; Stabenow, Roland; Stegmaier, Christa; Voigt, Kerstin; Gibis, Bernhard; Hölzel, Dieter; Goldie, Sue J

2006-04-01

We sought to develop and validate a decision-analytic model for the natural history of cervical cancer for the German health care context and to apply it to cervical cancer screening. We developed a Markov model for the natural history of cervical cancer and cervical cancer screening in the German health care context. The model reflects current German practice standards for screening, diagnostic follow-up and treatment regarding cervical cancer and its precursors. Data for disease progression and cervical cancer survival were obtained from the literature and German cancer registries. Accuracy of Papanicolaou (Pap) testing was based on meta-analyses. We performed internal and external model validation using observed epidemiological data for unscreened women from different German cancer registries. The model predicts life expectancy, incidence of detected cervical cancer cases, lifetime cervical cancer risks and mortality. The model predicted a lifetime cervical cancer risk of 3.0% and a lifetime cervical cancer mortality of 1.0%, with a peak cancer incidence of 84/100,000 at age 51 years. These results were similar to observed data from German cancer registries, German literature data and results from other international models. Based on our model, annual Pap screening could prevent 98.7% of diagnosed cancer cases and 99.6% of deaths due to cervical cancer in women completely adherent to screening and compliant to treatment. Extending the screening interval from 1 year to 2, 3 or 5 years resulted in reduced screening effectiveness. This model provides a tool for evaluating the long-term effectiveness of different cervical cancer screening tests and strategies.

Assessment of the Broader Economic Consequences of HPV Prevention from a Government-Perspective: A Fiscal Analytic Approach.

PubMed

Setiawan, Didik; Kotsopoulos, Nikolaos; Wilschut, Jan C; Postma, Maarten J; Connolly, Mark P

2016-01-01

Cervical cancer poses a substantial burden in terms of morbidity, mortality, and economic losses, especially in low/middle-income countries. HPV vaccination and/or cervical cancer screening among females may reduce the burden of HPV-related diseases, including cervical cancer. However, limited funds may impede the implementation of population-based programmes. Governmental investments in the prevention of infectious disease may have broader economic and fiscal benefits, which are not accounted in conventional economic analyses. This study estimates the broader economic and fiscal impacts of implementing HPV vaccination and/or cervical cancer screening in Indonesia from the perspective of the government. A government-perspective quantitative analytic framework was applied to assess the Net Present Value (NPV) of investment on cervical cancer prevention strategies including HPV vaccination, cervical screening and its combination in Indonesia. All monetary values were presented in International Dollars (I$). Based on a cohort of 10,000,000 Indonesian 12-year-old females, it was estimated that HPV vaccination and/or cervical cancer screening result in a positive NPV for the Indonesian government. The combination of cervical screening and HPV vaccination generated a substantial reduction of cervical cancer incidence and HPV-related mortality of 87,862 and 19,359, respectively. It was estimated that HPV vaccination in combination with cervical screening is the most favorable option for cervical cancer prevention (NPV I$2.031.786.000), followed by HPV vaccination alone (NPV I$1.860.783.000) and cervical screening alone (NPV I$375.244.000). In addition to clinical benefits, investing in HPV vaccination and cervical screening may yield considerable fiscal benefits for the Indonesian governments due to lifelong benefits resulting from reduction of cervical cancer-related morbidity and mortality.

Organic monolith frits encased in polyether ether ketone tubing with improved durability for liquid chromatography.

PubMed

Park, Sin Young; Cheong, Won Jo

2015-09-01

This study introduces a preparation method for polymer-encased monolith frits with improved durability for liquid chromatography columns. The inner surface of the polyether ether ketone tubing is pretreated with sulfuric acid in the presence of catalysts (vanadium oxide and sodium sulfate). The tubing was rinsed with water and acetone, flushed with nitrogen, and treated with glycidyl methacrylate. After washing, the monolith reaction mixture composed of lauryl methacrylate, ethylene glycol dimethacrylate, initiator, and porogenic solvent was filled in the tubing and subjected to in situ polymerization. The tubing was cut into thin slices and used as frits for microcolumns. To check their durability, the frit slices were placed in a vial and a heavy impact was applied on the vial by a vortex mixer for various periods. The frits made in the presence of catalysts were found to be more durable than those made without catalysts. Furthermore, when the monolith-incorporated tubing was used as a chromatography column, the column prepared in the presence of catalysts resulted in a better separation efficiency. The separation performance of the columns installed with the polyether ether ketone encased monolith frits was comparable to that of the columns installed with the commercial stainless-steel screen frits. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Ripple artifact reduction using slice overlap in slice encoding for metal artifact correction.

PubMed

den Harder, J Chiel; van Yperen, Gert H; Blume, Ulrike A; Bos, Clemens

2015-01-01

Multispectral imaging (MSI) significantly reduces metal artifacts. Yet, especially in techniques that use gradient selection, such as slice encoding for metal artifact correction (SEMAC), a residual ripple artifact may be prominent. Here, an analysis is presented of the ripple artifact and of slice overlap as an approach to reduce the artifact. The ripple artifact was analyzed theoretically to clarify its cause. Slice overlap, conceptually similar to spectral bin overlap in multi-acquisition with variable resonances image combination (MAVRIC), was achieved by reducing the selection gradient and, thus, increasing the slice profile width. Time domain simulations and phantom experiments were performed to validate the analyses and proposed solution. Discontinuities between slices are aggravated by signal displacement in the frequency encoding direction in areas with deviating B0. Specifically, it was demonstrated that ripple artifacts appear only where B0 varies both in-plane and through-plane. Simulations and phantom studies of metal implants confirmed the efficacy of slice overlap to reduce the artifact. The ripple artifact is an important limitation of gradient selection based MSI techniques, and can be understood using the presented simulations. At a scan-time penalty, slice overlap effectively addressed the artifact, thereby improving image quality near metal implants. © 2014 Wiley Periodicals, Inc.

The Effect of Temperature on Photoluminescence Enhancement of Quantum Dots in Brain Slices.

PubMed

Zhao, Fei; Kim, Jongsung

2017-04-01

In this paper, we investigated the effect of temperature on photoluminescence of quantum dots immobilized on the surface of an optical fiber in a rat brain slice. The optical fiber was silanized with 3-aminopropyl trimethoxysilane (APTMS), following which quantum dots with carboxyl functional group were immobilized on the optical fiber via amide bond formation. The effect of temperature on the fluorescence intensity of the quantum dots in rat brain slices was studied. This report shows that the fluorescence intensity of quantum dots increases with the increase of temperature of the brain slice. The fluorescence enhancement phenomenon appears to take place via electron transfer related to pH increase. With the gradual increase of temperature, the fluorescence intensity of quantum dots in solution decreased, while that in the brain slice increased. This enhanced thermal performance of QDs in brain slice makes suggestion for the study of QDs-based brain temperature sensors.

Preparation of positional renal slices for study of cell-specific toxicity.

PubMed

Ruegg, C E; Gandolfi, A J; Nagle, R B; Krumdieck, C L; Brendel, K

1987-04-01

To reduce structural complexity, rabbit kidneys were sliced perpendicular to their cortical-papillary axis to isolate four distinct cell groupings. This positional orientation allows identification of each renal cell type based on its location within the slice. A mechanical slicer was used to make several precision-cut slices rapidly from an oriented cylindrical core of renal tissue, with minimal tissue trauma. Slices were then submerged under a gently circulating oxygenated media in a fritted glass support system that maintains viability (intracellular K+/DNA ratio) and structural integrity (histology) for at least 30 h. A high dose of mercuric chloride (10(-3) M) was used to demonstrate the structural and biochemical changes of intoxicated slices. This method provides a controlled subchronic in vitro system for the study of the individual cell types involved in cell-specific renal toxicities and may also be a useful tool for addressing other pharmacological and physiological research questions.

Inter-slice bidirectional registration-based segmentation of the prostate gland in MR and CT image sequences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khalvati, Farzad, E-mail: farzad.khalvati@uwaterloo.ca; Tizhoosh, Hamid R.; Salmanpour, Aryan

Purpose: Accurate segmentation and volume estimation of the prostate gland in magnetic resonance (MR) and computed tomography (CT) images are necessary steps in diagnosis, treatment, and monitoring of prostate cancer. This paper presents an algorithm for the prostate gland volume estimation based on the semiautomated segmentation of individual slices in T2-weighted MR and CT image sequences. Methods: The proposedInter-Slice Bidirectional Registration-based Segmentation (iBRS) algorithm relies on interslice image registration of volume data to segment the prostate gland without the use of an anatomical atlas. It requires the user to mark only three slices in a given volume dataset, i.e., themore » first, middle, and last slices. Next, the proposed algorithm uses a registration algorithm to autosegment the remaining slices. We conducted comprehensive experiments to measure the performance of the proposed algorithm using three registration methods (i.e., rigid, affine, and nonrigid techniques). Results: The results with the proposed technique were compared with manual marking using prostate MR and CT images from 117 patients. Manual marking was performed by an expert user for all 117 patients. The median accuracies for individual slices measured using the Dice similarity coefficient (DSC) were 92% and 91% for MR and CT images, respectively. The iBRS algorithm was also evaluated regarding user variability, which confirmed that the algorithm was robust to interuser variability when marking the prostate gland. Conclusions: The proposed algorithm exploits the interslice data redundancy of the images in a volume dataset of MR and CT images and eliminates the need for an atlas, minimizing the computational cost while producing highly accurate results which are robust to interuser variability.« less

Inter-slice bidirectional registration-based segmentation of the prostate gland in MR and CT image sequences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khalvati, Farzad, E-mail: farzad.khalvati@uwaterloo.ca; Tizhoosh, Hamid R.; Salmanpour, Aryan

2013-12-15

Purpose: Accurate segmentation and volume estimation of the prostate gland in magnetic resonance (MR) and computed tomography (CT) images are necessary steps in diagnosis, treatment, and monitoring of prostate cancer. This paper presents an algorithm for the prostate gland volume estimation based on the semiautomated segmentation of individual slices in T2-weighted MR and CT image sequences. Methods: The proposedInter-Slice Bidirectional Registration-based Segmentation (iBRS) algorithm relies on interslice image registration of volume data to segment the prostate gland without the use of an anatomical atlas. It requires the user to mark only three slices in a given volume dataset, i.e., themore » first, middle, and last slices. Next, the proposed algorithm uses a registration algorithm to autosegment the remaining slices. We conducted comprehensive experiments to measure the performance of the proposed algorithm using three registration methods (i.e., rigid, affine, and nonrigid techniques). Results: The results with the proposed technique were compared with manual marking using prostate MR and CT images from 117 patients. Manual marking was performed by an expert user for all 117 patients. The median accuracies for individual slices measured using the Dice similarity coefficient (DSC) were 92% and 91% for MR and CT images, respectively. The iBRS algorithm was also evaluated regarding user variability, which confirmed that the algorithm was robust to interuser variability when marking the prostate gland. Conclusions: The proposed algorithm exploits the interslice data redundancy of the images in a volume dataset of MR and CT images and eliminates the need for an atlas, minimizing the computational cost while producing highly accurate results which are robust to interuser variability.« less

Developing the Evidence Base to Inform Best Practice: A Scoping Study of Breast and Cervical Cancer Reviews in Low- and Middle-Income Countries

PubMed Central

Demment, Margaret M.; Peters, Karen; Dykens, J. Andrew; Dozier, Ann; Nawaz, Haq; McIntosh, Scott; Smith, Jennifer S.; Sy, Angela; Irwin, Tracy; Fogg, Thomas T.; Khaliq, Mahmooda; Blumenfeld, Rachel; Massoudi, Mehran; De Ver Dye, Timothy

2015-01-01

Background Breast and cervical cancers have emerged as major global health challenges and disproportionately lead to excess morbidity and mortality in low- and middle-income countries (LMICs) when compared to high-income countries. The objective of this paper was to highlight key findings, recommendations, and gaps in research and practice identified through a scoping study of recent reviews in breast and cervical cancer in LMICs. Methods We conducted a scoping study based on the six-stage framework of Arskey and O’Malley. We searched PubMed, Cochrane Reviews, and CINAHL with the following inclusion criteria: 1) published between 2005-February 2015, 2) focused on breast or cervical cancer 3) focused on LMIC, 4) review article, and 5) published in English. Results Through our systematic search, 63 out of the 94 identified cervical cancer reviews met our selection criteria and 36 of the 54 in breast cancer. Cervical cancer reviews were more likely to focus upon prevention and screening, while breast cancer reviews were more likely to focus upon treatment and survivorship. Few of the breast cancer reviews referenced research and data from LMICs themselves; cervical cancer reviews were more likely to do so. Most reviews did not include elements of the PRISMA checklist. Conclusion Overall, a limited evidence base supports breast and cervical cancer control in LMICs. Further breast and cervical cancer prevention and control studies are necessary in LMICs. PMID:26325181

Effect of Anatomical Customization of the Fiber Post on the Bond Strength of a Self-Adhesive Resin Cement

PubMed Central

Rocha, Adricyla Teixeira; Vasconcelos, Ana Júlia de Carvalho; Nunes Carvalho, Ceci

2017-01-01

Aim The aim of the study was to evaluate, by means of the push-out test, the effect of the anatomical customization of the fiber post on the bond strength of a self-adhesive resin cement. Methods Twelve endodontically treated, human, upper central incisors were randomly divided into two groups (n = 6): control (glass fiber posts cemented with Relyx® U200) and customized (glass fiber posts anatomically customized with translucent composite resin cemented with Relyx U200). The roots were sectioned into three slices, cervical, middle, and apical, and photographed with a digital camera attached to a stereomicroscopic loupe. The images were analyzed by software, for evaluation of the cement line. The slices were subsequently submitted to the push-out test until the post had completely extruded, and the fracture mode was analyzed with a stereomicroscopic loupe. Results The results showed significant differences between the groups in the different root thirds in relation to the area occupied by air bubbles (p < 0.05). Bond strength, when all the thirds are considered, was 8.77 ± 4.89 MPa for the control group and 16.96 ± 4.85 MPa for the customized group. Conclusion The customized group showed greater bond resistance than the control group and a more uniform cement layer. PMID:28785281

A propeller flap based on the thoracoacromial artery for reconstruction of a skin defect in the cervical region: a case report.

PubMed

Okada, Mitsuhiro; Ikeda, Mikinori; Uemura, Takuya; Takada, Jun; Nakamura, Hiroaki

2013-05-01

A propeller flap is useful for coverage of an adjacent skin defect without dissection back to source vessels and harvesting muscle tissues. The thoracoacromial artery is one of the vascular pedicles of the flaps for reconstruction in the cervical region. Use of a propeller flap based on the thoracoacromial artery has not previously been reported for reconstruction in the cervical region. We report a case in which a propeller flap based on the thoracoacromial artery was used for skin coverage after tumour resection in the cervical region together with an anatomical investigation. The propeller flap based on the thoracoacromial artery was harvested in the supine position, requiring no change in position after tumour resection. The skin defect was successfully reconstructed using the propeller flap based on the thoracoacromial artery with linear closure of the donor site. The propeller flap based on the thoracoacromial artery offers an alternative for reconstruction in the cervical region. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Combined texture feature analysis of segmentation and classification of benign and malignant tumour CT slices.

PubMed

Padma, A; Sukanesh, R

2013-01-01

A computer software system is designed for the segmentation and classification of benign from malignant tumour slices in brain computed tomography (CT) images. This paper presents a method to find and select both the dominant run length and co-occurrence texture features of region of interest (ROI) of the tumour region of each slice to be segmented by Fuzzy c means clustering (FCM) and evaluate the performance of support vector machine (SVM)-based classifiers in classifying benign and malignant tumour slices. Two hundred and six tumour confirmed CT slices are considered in this study. A total of 17 texture features are extracted by a feature extraction procedure, and six features are selected using Principal Component Analysis (PCA). This study constructed the SVM-based classifier with the selected features and by comparing the segmentation results with the experienced radiologist labelled ground truth (target). Quantitative analysis between ground truth and segmented tumour is presented in terms of segmentation accuracy, segmentation error and overlap similarity measures such as the Jaccard index. The classification performance of the SVM-based classifier with the same selected features is also evaluated using a 10-fold cross-validation method. The proposed system provides some newly found texture features have an important contribution in classifying benign and malignant tumour slices efficiently and accurately with less computational time. The experimental results showed that the proposed system is able to achieve the highest segmentation and classification accuracy effectiveness as measured by jaccard index and sensitivity and specificity.

A laminar optical tomography system for the early cervical cancer diagnosis

NASA Astrophysics Data System (ADS)

Cui, Shanshan; Jia, Mengyu; Chen, Xueying; Meng, Wei; Gao, Feng; Zhao, Huijuan

2014-03-01

Laminar optical tomography (LOT) is a new mesoscopic functional optical imaging technique, which is an extension of a confocal microscope and diffuse optical tomography to acquire both the coaxial and off-axis scattered light at the same time. In this paper, a LOT system with a larger detection area aiming at the in vivo detection of early cervical cancer is developed. The field of view of our system is 10 mm x 10 mm. In order to improve the image quality of the system, two methods were performed: the correction of image distortion and the restriction of returning light. The performance of the system with aperture stop was assessed by liquid phantom experiments. Comparing with the Monte Carlo simulation, the measurement results show that the average relative errors of eight different source-detector distances corresponding to 4 source points are lower than the errors of the system taking the frame of objective lens as the aperture stop by 5.7%, 4.8%, 6.1%, 6.1% respectively. Moreover, the experiment based on the phantom with specified structure and optical parameters to simulate the cervix demonstrates that the system perform well for the cervix measurement.

Cytology versus HPV testing for cervical cancer screening in the general population.

PubMed

Koliopoulos, George; Nyaga, Victoria N; Santesso, Nancy; Bryant, Andrew; Martin-Hirsch, Pierre Pl; Mustafa, Reem A; Schünemann, Holger; Paraskevaidis, Evangelos; Arbyn, Marc

2017-08-10

Cervical cancer screening has traditionally been based on cervical cytology. Given the aetiological relationship between human papillomavirus (HPV) infection and cervical carcinogenesis, HPV testing has been proposed as an alternative screening test. To determine the diagnostic accuracy of HPV testing for detecting histologically confirmed cervical intraepithelial neoplasias (CIN) of grade 2 or worse (CIN 2+), including adenocarcinoma in situ, in women participating in primary cervical cancer screening; and how it compares to the accuracy of cytological testing (liquid-based and conventional) at various thresholds. We performed a systematic literature search of articles in MEDLINE and Embase (1992 to November 2015) containing quantitative data and handsearched the reference lists of retrieved articles. We included comparative test accuracy studies if all women received both HPV testing and cervical cytology followed by verification of the disease status with the reference standard, if positive for at least one screening test. The studies had to include women participating in a cervical cancer screening programme who were not being followed up for previous cytological abnormalities. We completed a 2 x 2 table with the number of true positives (TP), false positives (FP), true negatives (TN), and false negatives for each screening test (HPV test and cytology) used in each study. We calculated the absolute and relative sensitivities and the specificities of the tests for the detection of CIN 2+ and CIN 3+ at various thresholds and computed sensitivity (TP/(TP + TN) and specificity (TN/ (TN + FP) for each test separately. Relative sensitivity and specificity of one test compared to another test were defined as sensitivity of test-1 over sensitivity of test-2 and specificity of test-1 over specificity of test-2, respectively. To assess bias in the studies, we used the Quality Assessment of Diagnostic test Accuracy Studies (QUADAS) tool. We used a bivariate random-effects model for computing pooled accuracy estimates. This model takes into account the within- and between-study variability and the intrinsic correlation between sensitivity and specificity. We included a total of 40 studies in the review, with more than 140,000 women aged between 20 and 70 years old. Many studies were at low risk of bias. There were a sufficient number of included studies with adequate methodology to perform the following test comparisons: hybrid capture 2 (HC2) (1 pg/mL threshold) versus conventional cytology (CC) (atypical squamous cells of undetermined significance (ASCUS)+ and low-grade squamous intraepithelial lesions (LSIL)+ thresholds) or liquid-based cytology (LBC) (ASCUS+ and LSIL+ thresholds), other high-risk HPV tests versus conventional cytology (ASCUS+ and LSIL+ thresholds) or LBC (ASCUS+ and LSIL+ thresholds). For CIN 2+, pooled sensitivity estimates for HC2, CC and LBC (ASCUS+) were 89.9%, 62.5% and 72.9%, respectively, and pooled specificity estimates were 89.9%, 96.6%, and 90.3%, respectively. The results did not differ by age of women (less than or greater than 30 years old), or in studies with verification bias. Accuracy of HC2 was, however, greater in European countries compared to other countries. The results for the sensitivity of the tests were heterogeneous ranging from 52% to 94% for LBC, and 61% to 100% for HC2. Overall, the quality of the evidence for the sensitivity of the tests was moderate, and high for the specificity.The relative sensitivity of HC2 versus CC for CIN 2+ was 1.52 (95% CI: 1.24 to 1.86) and the relative specificity 0.94 (95% CI: 0.92 to 0.96), and versus LBC for CIN 2+ was 1.18 (95% CI: 1.10 to 1.26) and the relative specificity 0.96 (95% CI: 0.95 to 0.97). The relative sensitivity of HC2 versus CC for CIN 3+ was 1.46 (95% CI: 1.12 to 1.91) and the relative specificity 0.95 (95% CI: 0.93 to 0.97). The relative sensitivity of HC2 versus LBC for CIN 3+ was 1.17 (95% CI: 1.07 to 1.28) and the relative specificity 0.96 (95% CI: 0.95 to 0.97). Whilst HPV tests are less likely to miss cases of CIN 2+ and CIN 3+, these tests do lead to more unnecessary referrals. However, a negative HPV test is more reassuring than a negative cytological test, as the cytological test has a greater chance of being falsely negative, which could lead to delays in receiving the appropriate treatment. Evidence from prospective longitudinal studies is needed to establish the relative clinical implications of these tests.

Human Papillomavirus Testing in the Prevention of Cervical Cancer

PubMed Central

Wentzensen, Nicolas; Wacholder, Sholom; Kinney, Walter; Gage, Julia C.; Castle, Philip E.

2011-01-01

Strong evidence now supports the adoption of cervical cancer prevention strategies that explicitly focus on persistent infection with the causal agent, human papillomavirus (HPV). To inform an evidence-based transition to a new public health approach for cervical cancer screening, we summarize the natural history and cervical carcinogenicity of HPV and discuss the promise and uncertainties of currently available screening methods. New HPV infections acquired at any age are virtually always benign, but persistent infections with one of approximately 12 carcinogenic HPV types explain virtually all cases of cervical cancer. In the absence of an overtly persistent HPV infection, the risk of cervical cancer is extremely low. Thus, HPV test results predict the risk of cervical cancer and its precursors (cervical intraepithelial neoplasia grade 3) better and longer than cytological or colposcopic abnormalities, which are signs of HPV infection. The logical and inevitable move to HPV-based cervical cancer prevention strategies will require longer screening intervals that will disrupt current gynecologic and cytology laboratory practices built on frequent screening. A major challenge will be implementing programs that do not overtreat HPV-positive women who do not have obvious long-term persistence of HPV or treatable lesions at the time of initial evaluation. The greatest potential for reduction in cervical cancer rates from HPV screening is in low-resource regions that can implement infrequent rounds of low-cost HPV testing and treatment. PMID:21282563

Ultra high performance liquid chromatography coupled to quadruple time-of-flight with MS(E) technology used for qualitative analysis of non-volatile oxidation markers in sliced packed mushrooms (Agaricus Bisporus).

PubMed

Wrona, Magdalena; Pezo, Davinson; Canellas, Elena; Nerín, Cristina

2016-02-05

61 different non-volatile compounds were determined in Agaricus Bisporus sliced mushrooms using UHPLC/Q-TOF with MS(E) technology. Both positive and negative electrospray ionization were applied. Chemical profile of three parts of mushroom was created: cap, gills and stipe. The analysed mushrooms were oxidized to identify the non-volatile markers in their parts. MarkerLynx(®) was proposed as a powerful tool to distinguish mushrooms purchased in different countries (Spain and Portugal) by determining their non-volatile markers. Some metabolites were identified. Surprisingly a mix of polyethylene glycols (PEGs) was detected in cap and gills of mushrooms. Whole mushrooms were considered as vegetable resistant to migration from packaging compounds. Additionally migration tests were performed to determine the source of migrating compounds. Copyright © 2016 Elsevier B.V. All rights reserved.

Imaging quality analysis of computer-generated holograms using the point-based method and slice-based method

NASA Astrophysics Data System (ADS)

Zhang, Zhen; Chen, Siqing; Zheng, Huadong; Sun, Tao; Yu, Yingjie; Gao, Hongyue; Asundi, Anand K.

2017-06-01

Computer holography has made a notably progress in recent years. The point-based method and slice-based method are chief calculation algorithms for generating holograms in holographic display. Although both two methods are validated numerically and optically, the differences of the imaging quality of these methods have not been specifically analyzed. In this paper, we analyze the imaging quality of computer-generated phase holograms generated by point-based Fresnel zone plates (PB-FZP), point-based Fresnel diffraction algorithm (PB-FDA) and slice-based Fresnel diffraction algorithm (SB-FDA). The calculation formula and hologram generation with three methods are demonstrated. In order to suppress the speckle noise, sequential phase-only holograms are generated in our work. The results of reconstructed images numerically and experimentally are also exhibited. By comparing the imaging quality, the merits and drawbacks with three methods are analyzed. Conclusions are given by us finally.

The Development of a Brief Jail-Based Cervical Health Promotion Intervention

PubMed Central

Ramaswamy, Megha; Simmons, Rebekah; Kelly, Patricia J.

2015-01-01

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women’s cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities. PMID:25063589

The development of a brief jail-based cervical health promotion intervention.

PubMed

Ramaswamy, Megha; Simmons, Rebekah; Kelly, Patricia J

2015-05-01

The primary objective of this article was to describe the development and pilot implementation of a brief jail-based cervical health promotion intervention. The intervention was guided by a preliminary study of incarcerated women's cervical health knowledge, awareness, and health literacy, as well as a social and feminist approach to intervention development. We developed and conducted a pilot implementation of the Sexual Health Empowerment Project to increase cervical health knowledge, reduce barriers related to beliefs about cervical cancer, and improve self-efficacy and confidence in navigating health systems. This article offers a framework for how empirically and theory-based interventions are developed and tailored for a jail setting. Future work should include the evaluation of the long-term effects of such a disease-specific program on health behaviors and outcomes among high-risk and vulnerable groups of women as they leave jails and enter communities. © 2014 Society for Public Health Education.

Improve definition of titanium tandems in MR-guided high dose rate brachytherapy for cervical cancer using proton density weighted MRI

PubMed Central

2013-01-01

Background For cervical cancer patients treated with MR-guided high dose rate brachytherapy, the accuracy of radiation delivery depends on accurate localization of both tumors and the applicator, e.g. tandem and ovoid. Standard T2-weighted (T2W) MRI has good tumor-tissue contrast. However, it suffers from poor uterus-tandem contrast, which makes the tandem delineation very challenging. In this study, we evaluated the possibility of using proton density weighted (PDW) MRI to improve the definition of titanium tandems. Methods Both T2W and PDW MRI images were obtained from each cervical cancer patient. Imaging parameters were kept the same between the T2W and PDW sequences for each patient except the echo time (90 ms for T2W and 5.5 ms for PDW) and the slice thickness (0.5 cm for T2W and 0.25 cm for PDW). Uterus-tandem contrast was calculated by the equation C = (Su-St)/Su, where Su and St represented the average signal in the uterus and the tandem, respectively. The diameter of the tandem was measured 1.5 cm away from the tip of the tandem. The tandem was segmented by the histogram thresholding technique. Results PDW MRI could significantly improve the uterus-tandem contrast compared to T2W MRI (0.42±0.24 for T2W MRI, 0.77±0.14 for PDW MRI, p=0.0002). The average difference between the measured and physical diameters of the tandem was reduced from 0.20±0.15 cm by using T2W MRI to 0.10±0.11 cm by using PDW MRI (p=0.0003). The tandem segmented from the PDW image looked more uniform and complete compared to that from the T2W image. Conclusions Compared to the standard T2W MRI, PDW MRI has better uterus-tandem contrast. The information provided by PDW MRI is complementary to those provided by T2W MRI. Therefore, we recommend adding PDW MRI to the simulation protocol to assist tandem delineation process for cervical cancer patients. PMID:23327682

Evaluation of the FTA carrier device for human papillomavirus testing in developing countries.

PubMed

Gonzalez, Paula; Cortes, Bernal; Quint, Wim; Kreimer, Aimée R; Porras, Carolina; Rodríguez, Ana Cecilia; Jimenez, Silvia; Herrero, Rolando; Struijk, Linda; Hildesheim, Allan; Melchers, Willem

2012-12-01

Liquid-based methods for the collection, transportation, and storage of cervical cells are cumbersome and expensive and involve laborious DNA extraction. An FTA cartridge is a solid carrier device, easier to handle and allowing simple DNA elution for human papillomavirus (HPV) testing. HPV-DNA results from cervical specimens collected in PreservCyt medium (Hologic, Inc.) and the indicating FTA elute cartridge were compared in an area where transportation and storage may affect the performance of the test. Cervical cells from 319 young adult women enrolled in the Costa Rica Vaccine Trial were collected by a nurse using a Cervex brush (Roberts), which was placed on the FTA cartridge and subsequently rinsed in 20 ml of PreservCyt medium. Two 0.5-ml PreservCyt aliquots were frozen for HPV-PCR testing; the FTA cartridges were kept at room temperature. HPV-DNA detection and typing was performed using SPF(10) PCR/DEIA (DNA enzyme immunoassay detection of amplimers)/LiPA(25) system. The percent agreement, agreement among positives, and kappas were estimated. Positivity was higher for FTA compared to PreservCyt specimens (54.5% versus 45.8%, P < 0.001). For oncogenic types, the overall agreement was 0.92, the agreement between positives was 0.74, and the kappa was 0.79. For individual HPV types, the overall agreement ranged from 0.97 to 1.00. We did not observe reduced cytology adequacy when specimen collection for cytology was preceded by FTA collection for HPV testing. HPV-DNA detection from FTA cartridges is broadly comparable to detection from PC medium. The higher HPV detection observed for FTA-collected specimens should be explored further. FTA cartridges could provide a simpler and more cost-effective method for cervical cell collection, storage, and transportation for HPV-DNA detection in research settings in developing countries.

Evaluation of the FTA Carrier Device for Human Papillomavirus Testing in Developing Countries

PubMed Central

Cortes, Bernal; Quint, Wim; Kreimer, Aimée R.; Porras, Carolina; Rodríguez, Ana Cecilia; Jimenez, Silvia; Herrero, Rolando; Struijk, Linda; Hildesheim, Allan; Melchers, Willem

2012-01-01

Liquid-based methods for the collection, transportation, and storage of cervical cells are cumbersome and expensive and involve laborious DNA extraction. An FTA cartridge is a solid carrier device, easier to handle and allowing simple DNA elution for human papillomavirus (HPV) testing. HPV-DNA results from cervical specimens collected in PreservCyt medium (Hologic, Inc.) and the indicating FTA elute cartridge were compared in an area where transportation and storage may affect the performance of the test. Cervical cells from 319 young adult women enrolled in the Costa Rica Vaccine Trial were collected by a nurse using a Cervex brush (Roberts), which was placed on the FTA cartridge and subsequently rinsed in 20 ml of PreservCyt medium. Two 0.5-ml PreservCyt aliquots were frozen for HPV-PCR testing; the FTA cartridges were kept at room temperature. HPV-DNA detection and typing was performed using SPF10 PCR/DEIA (DNA enzyme immunoassay detection of amplimers)/LiPA25 system. The percent agreement, agreement among positives, and kappas were estimated. Positivity was higher for FTA compared to PreservCyt specimens (54.5% versus 45.8%, P < 0.001). For oncogenic types, the overall agreement was 0.92, the agreement between positives was 0.74, and the kappa was 0.79. For individual HPV types, the overall agreement ranged from 0.97 to 1.00. We did not observe reduced cytology adequacy when specimen collection for cytology was preceded by FTA collection for HPV testing. HPV-DNA detection from FTA cartridges is broadly comparable to detection from PC medium. The higher HPV detection observed for FTA-collected specimens should be explored further. FTA cartridges could provide a simpler and more cost-effective method for cervical cell collection, storage, and transportation for HPV-DNA detection in research settings in developing countries. PMID:22993174

An automated quantitative DNA image cytometry system detects abnormal cells in cervical cytology with high sensitivity.

PubMed

Wong, O G; Ho, M W; Tsun, O K; Ng, A K; Tsui, E Y; Chow, J N; Ip, P P; Cheung, A N

2018-03-26

To evaluate the performance of an automated DNA-image-cytometry system as a tool to detect cervical carcinoma. Of 384 liquid-based cervical cytology samples with available biopsy follow-up were analyzed by both the Imager System and a high-risk HPV test (Cobas). The sensitivity and specificity of Imager System for detecting biopsy proven high-grade squamous intraepithelial lesion (HSIL, cervical intraepithelial neoplasia [CIN]2-3) and carcinoma were 89.58% and 56.25%, respectively, compared to 97.22% and 23.33% of HPV test but additional HPV 16/18 genotyping increased the specificity to 69.58%. The sensitivity and specificity of the Imager System for predicting HSIL+ (CIN2-3+) lesions among atypical squamous cells of undetermined significance samples were 80.00% and 70.53%, respectively, compared to 100% and 11.58% of HPV test whilst the HPV 16/18 genotyping increased the specificity to 77.89%. Among atypical squamous cells-cannot exclude HSIL, the sensitivity and specificity of Imager System for predicting HSIL+ (CIN2-3+) lesions upon follow up were 82.86% and 33.33%%, respectively, compared to 97.14% and 4.76% of HPV test and the HPV 16/18 genotyping increased the specificity to 19.05%. Among low-grade squamous intraepithelial lesion cases, the sensitivity and specificity of the Imager System for predicting HSIL+ (CIN2-3+) lesions were 66.67% and 35.71%%, respectively, compared to 66.67% and 29.76% of HPV test while HPV 16/18 genotyping increased the specificity to 79.76%. The overall results of imager and high-risk HPV test agreed in 69.43% (268) of all samples. The automated imager system and HPV 16/18 genotyping can enhance the specificity of detecting HSIL+ (CIN2-3+) lesions. © 2018 John Wiley & Sons Ltd.

Development of Multi-slice Analytical Tool to Support BIM-based Design Process

NASA Astrophysics Data System (ADS)

Atmodiwirjo, P.; Johanes, M.; Yatmo, Y. A.

2017-03-01

This paper describes the on-going development of computational tool to analyse architecture and interior space based on multi-slice representation approach that is integrated with Building Information Modelling (BIM). Architecture and interior space is experienced as a dynamic entity, which have the spatial properties that might be variable from one part of space to another, therefore the representation of space through standard architectural drawings is sometimes not sufficient. The representation of space as a series of slices with certain properties in each slice becomes important, so that the different characteristics in each part of space could inform the design process. The analytical tool is developed for use as a stand-alone application that utilises the data exported from generic BIM modelling tool. The tool would be useful to assist design development process that applies BIM, particularly for the design of architecture and interior spaces that are experienced as continuous spaces. The tool allows the identification of how the spatial properties change dynamically throughout the space and allows the prediction of the potential design problems. Integrating the multi-slice analytical tool in BIM-based design process thereby could assist the architects to generate better design and to avoid unnecessary costs that are often caused by failure to identify problems during design development stages.

Performance characteristics of visualising the cervix in symptomatic young females: a review of primary care records in females with and without cervical cancer.

PubMed

Lim, Anita Wey Wey; Hamilton, Willie; Hollingworth, Antony; Stapley, Sally; Sasieni, Peter

2016-03-01

The current strategy for timely detection of cervical cancer in young females centres on visualising the cervix when females present with gynaecological symptoms, but is based on expert opinion without an evidence base. To assess visualising the cervix in primary care in young females with gynaecological symptoms. A review of primary care records for females in England aged 20-29 years with cervical cancer (nationwide interview-based study) and in the general population (Clinical Practice Research Datalink database). From primary care records the proportion of females was identified with gynaecological symptoms who had documented cervical examination in the year before diagnosis (cancers) and in 1-year age bands (general population). Of these, the proportion was identified that was then referred for suspected malignancy. Only 39% of young females with cervical cancer had documented examination at symptomatic presentation. Visualisation resulted in referral for suspected malignancy for 18% of those examined (95% confidence interval = 5% to 40%). Very few (<1.7%) symptomatic females in the general population had documented cervical examination. None were referred for suspected malignancy at the time. The sensitivity of cervical examination to detect cancer is very low, highlighting the need for better triage tools for primary care. Until such tools are identified GPs should continue to consider cervical cancer when symptoms persist and the cervix is not obviously abnormal on clinical examination. Further research on additional triage tools such as cervical cytology used as a diagnostic aid is needed urgently. © British Journal of General Practice 2016.

Development of a slicing device for Apollo-Soyuz Test Project (ASTP) electrophoresis technology experiment MA-011

NASA Technical Reports Server (NTRS)

Nerren, B. H.

1977-01-01

The electrophoresis of six columns was accomplished on the Apollo-Soyuz test Project. After separation, these columns were frozen in orbit and were returned for ground-based analyses. One major goal of the MA-011 experiment was the assessment of the separation achieved in orbit by slicing these frozen columns. The slicing of the frozen columns required a new device. The development of that device is described.

Integrative review of cervical cancer screening in Western Asian and Middle Eastern Arab countries.

PubMed

Ali, Suhailah; Skirton, Heather; Clark, Maria T; Donaldson, Craig

2017-12-01

Population-based screening programs have resulted in minimizing mortality and morbidity from cervical cancer. The aim of this integrative review was to explore the factors influencing access of women from Western Asian and Middle Eastern Arab countries to cervical cancer screening. A systematic search for studies conducted in Arab countries in those regions, and published in English between January 2002 and January 2017, was undertaken. Thirteen papers were selected and subjected to quality appraisal. A three step analysis was used, which involved a summary of the evidence, analysis of both quantitative and qualitative data, and integration of the results in narrative form. Few population-based cervical cancer screening programs had been implemented in the relevant countries, with low knowledge of, and perceptions about, cervical screening among Arab women, the majority of whom are Muslim. Factors affecting the uptake of cervical cancer screening practices were the absence of organized, systematic programs, low screening knowledge among women, healthcare professionals' attitudes toward screening, pain and embarrassment, stigma, and sociocultural beliefs. Policy changes are urgently needed to promote population-based screening programs. Future research should address the promotion of culturally-sensitive strategies to enable better access of Arab Muslim women to cervical cancer screening. © 2017 John Wiley & Sons Australia, Ltd.

Assessing the acceptability, feasibility, and effectiveness of a tablet-based cervical cancer educational intervention

PubMed Central

Caster, MM; Norris, AH; Butao, C; Carr Reese, P; Chemey, E; Phuka, J; Turner, AN

2016-01-01

Cervical cancer is a common and deadly disease, especially in developing countries. We developed and implemented an interactive, tablet-based educational intervention to improve cervical cancer knowledge among women in rural Malawi. Chichewa-speaking adult women in six rural villages participated. Each woman took a pre-test, participated in the lesson, and then took a post-test. The lesson included information on cervical cancer symptoms, causes, risk factors, prevention, and treatment. Over the 6-month study period, 243 women participated. Women ranged in age from 18 to 77 years. Only 15% had education beyond primary school. Nearly half of participants (48%) had heard of cervical cancer prior to viewing the lesson. For these women, the median number of correct responses on the pre-test was 11 out of 20; after the lesson, they had a median of 18 correct responses (p<0.001). After the intervention, 93% of women indicated a desire for cervical cancer screening. Despite lack of familiarity with computers (96%), most women (94%) found the tablet easy to use. A tablet-based educational program was an effective, feasible and acceptable strategy to disseminate cervical cancer information to women with low education in rural Malawi. This method may be appropriate to distribute health information about other health topics in low-resource settings. PMID:26637473

Get Vaccinated! and Get Tested! Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-Speaking Audience.

PubMed

Frett, Brigitte; Aquino, Myra; Fatil, Marie; Seay, Julia; Trevil, Dinah; Fièvre, Michèle Jessica; Kobetz, Erin

2016-05-01

Although routine screening reduces cervical cancer rates between 60% and 90%, thousands of women worldwide are diagnosed with the disease on an annual basis because of inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer, with disease rates 4 times higher than the average for women in Miami. An ongoing community-based participatory research initiative to assess and reduce this burden has revealed that a complex interplay of factors contributes to a lack of access to screening in this community, including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, 2 videos on cervical cancer prevention were created using a community-based participatory research framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus disease and vaccination, Papanicolaou testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggested that the films are engaging; feature relatable characters; and impact knowledge about human papillomavirus, cervical cancer development, and current prevention recommendations.

Clinical Practice Guidelines on the Screening and Treatment of Precancerous Lesions for Cervical Cancer Prevention in Saudi Arabia.

PubMed

Al-Mandeel, Hazem Mahmoud; Sagr, Emad; Sait, Khalid; Latifah, Hassan Mohamed; Al-Obaid, Abdulaziz; Al-Badawi, Ismail A; Alkushi, Abdulmohsen O; Salem, Hany; Massoudi, Nada S; Schunemann, Holger; Mustafa, Reem A; Brignardello-Petersen, Romina

2016-01-01

Cervical cancer is the third most common gynecological malignancy in Saudi women with an estimated incidence rate of 1.9 cases per 100 000 women-years. More than 40% of cervical cancer cases are diagnosed at advanced stages due to lack of a routine screening program in Saudi Arabia. Thus, national guidelines for routine screening and treatment of precancerous cervical lesions are needed. The Saudi Centre for Evidence-Based Healthcare invited a panel of local experts and partnered them with a team from McMaster University in Canada for methodological support, to develop national clinical practice guidelines on the screening and treatment of precancerous lesions for cervical cancer. After the panel identified key clinical questions, the McMaster University working group updated existing systematic reviews that had been used for the 2013 WHO Guidelines for screening and treatment of precancerous lesions for cervical cancer prevention. Recommendations were based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. Those recommendations took into account the available evidence, patient values and preferences, and resource use in the Saudi context. The panel provided recommendations on two major issues: screening for precancerous lesions (cervical intraepithelial neoplasia 2 & 3) and treatment of those lesions to prevent cervical cancer in women who tested positive after screening. The Saudi expert panel recommends using the HPV DNA test followed by colposcopy or cytology (Pap test) followed by colposcopy to screen for CIN2+ in women at risk of cervical cancer. The panel recommends cryotherapy or loop excision electrosurgery procedure (LEEP) over cold knife cone biopsy to treat women at risk of cervical cancer that tests positive for CIN2+. Universal screening for precancerous cervical dysplasia in women in Saudi Arabia is recommended using HPV testing and or cytology. Either cryotherapy or LEEP are preferred for treatment. National studies on cervical cancer screening modalities and treatment of precancerous cervical lesions, including HPV prevalence and its association with cervical cancer, are scarce.

Cost-effectiveness of liquid-based cytology with or without hybrid-capture II HPV test compared with conventional Pap smears: a study by the French Society of Clinical Cytology.

PubMed

Cochand-Priollet, Béatrix; Cartier, Isabelle; de Cremoux, Patricia; Le Galès, Catherine; Ziol, Marianne; Molinié, Vincent; Petitjean, Alain; Dosda, Anne; Merea, Estelle; Biaggi, Annonciade; Gouget, Isabelle; Arkwright, Sylviane; Vacher-Lavenu, Marie-Cécile; Vielh, Philippe; Coste, Joël

2005-11-01

Many articles concerning conventional Pap smears, ThinPrep liquid-based cytology (LBC) and Hybrid-Capture II HPV test (HC II) have been published. This study, carried out by the French Society of Clinical Cytology, may be conspicuous for several reasons: it was financially independent; it compared the efficiency of the conventional Pap smear and LBC, of the conventional Pap smear and HC II, and included an economic study based on real costs; for all the women, a "gold standard" reference method, colposcopy, was available and biopsies were performed whenever a lesion was detected; The conventional Pap smear, the LBC (split-sample technique), the colposcopy, and the biopsies were done at the same time. This study included 2,585 women shared into two groups: a group A of a high-risk population, a group B of a screening population. The statistical analysis of the results showed that conventional Pap smears consistently had superior or equivalent sensitivity and specificity than LBC for the lesions at threshold CIN-I (Cervical Intraepithelial Neoplasia) or CIN-II or higher. It underlined the low specificity of the HC II. Finally, the LBC mean cost was never covered by the Social Security tariff.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larsson, Daniel H.; Lundstroem, Ulf; Burvall, Anna

Purpose: Small-animal studies require images with high spatial resolution and high contrast due to the small scale of the structures. X-ray imaging systems for small animals are often limited by the microfocus source. Here, the authors investigate the applicability of liquid-metal-jet x-ray sources for such high-resolution small-animal imaging, both in tomography based on absorption and in soft-tissue tumor imaging based on in-line phase contrast. Methods: The experimental arrangement consists of a liquid-metal-jet x-ray source, the small-animal object on a rotating stage, and an imaging detector. The source-to-object and object-to-detector distances are adjusted for the preferred contrast mechanism. Two different liquid-metal-jetmore » sources are used, one circulating a Ga/In/Sn alloy and the other an In/Ga alloy for higher penetration through thick tissue. Both sources are operated at 40-50 W electron-beam power with {approx}7 {mu}m x-ray spots, providing high spatial resolution in absorption imaging and high spatial coherence for the phase-contrast imaging. Results: High-resolution absorption imaging is demonstrated on mice with CT, showing 50 {mu}m bone details in the reconstructed slices. High-resolution phase-contrast soft-tissue imaging shows clear demarcation of mm-sized tumors at much lower dose than is required in absorption. Conclusions: This is the first application of liquid-metal-jet x-ray sources for whole-body small-animal x-ray imaging. In absorption, the method allows high-resolution tomographic skeletal imaging with potential for significantly shorter exposure times due to the power scalability of liquid-metal-jet sources. In phase contrast, the authors use a simple in-line arrangement to show distinct tumor demarcation of few-mm-sized tumors. This is, to their knowledge, the first small-animal tumor visualization with a laboratory phase-contrast system.« less

Fractures of the cervical spine

PubMed Central

Marcon, Raphael Martus; Cristante, Alexandre Fogaça; Teixeira, William Jacobsen; Narasaki, Douglas Kenji; Oliveira, Reginaldo Perilo; de Barros Filho, Tarcísio Eloy Pessoa

2013-01-01

OBJECTIVES: The aim of this study was to review the literature on cervical spine fractures. METHODS: The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed. RESULTS: Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents. The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures. CONCLUSIONS: Fractures of the cervical spine are potentially serious and devastating if not properly treated. Achieving the correct diagnosis and classification of a lesion is the first step toward identifying the most appropriate treatment, which can be either surgical or conservative. PMID:24270959

Cytotoxic and Immunomodulatory Potential Activity of Physalis peruviana Fruit Extracts on Cervical Cancer (HeLa) and Fibroblast (L929) Cells.

PubMed

Mier-Giraldo, Helen; Díaz-Barrera, Luis Eduardo; Delgado-Murcia, Lucy Gabriela; Valero-Valdivieso, Manuel Fernando; Cáez-Ramírez, Gabriela

2017-10-01

It was purposed to evaluate the biological potential of ethanol and isopropanol crude extracts of ripe Physalis peruviana fruits. Cytotoxic and immunomodulatory effects of the expression of interleukin-6, interleukin-8, and monocyte chemoattractant protein-1 (MCP-1) were evaluated on human cervical cancer (HeLa) and murine fibroblast (L929) cells. The composition was evaluated by high-performance liquid chromatography diode-array detection and high-performance liquid chromatography ultraviolet/visible detection. The presence of ursolic acid and rosmarinic acid was found in both solvents. However, gallic acid, quercetin, and epicatechin were higher in isopropanol extracts ( P < .05). The results indicated a relationship among the total polyphenol content, antioxidant activity, and cytotoxic activity that was dependent on the solvent used. Isopropanol extracts presented a half-maximal inhibition concentration value (IC 50 ) of 60.48 ± 3.8 μg/mL for HeLa cells and 66.62 ± 2.67 μg/mL for L929 fibroblasts. The extracts reduced the release of interleukin-6, interleukin-8, and MCP-1 in a dose-dependent manner. Extracts showed anticancer and immunomodulatory potential for new complementary pharmaceutical products development.

Cytotoxic and Immunomodulatory Potential Activity of Physalis peruviana Fruit Extracts on Cervical Cancer (HeLa) and Fibroblast (L929) Cells

PubMed Central

Mier-Giraldo, Helen; Díaz-Barrera, Luis Eduardo; Delgado-Murcia, Lucy Gabriela; Valero-Valdivieso, Manuel Fernando; Cáez-Ramírez, Gabriela

2017-01-01

It was purposed to evaluate the biological potential of ethanol and isopropanol crude extracts of ripe Physalis peruviana fruits. Cytotoxic and immunomodulatory effects of the expression of interleukin-6, interleukin-8, and monocyte chemoattractant protein-1 (MCP-1) were evaluated on human cervical cancer (HeLa) and murine fibroblast (L929) cells. The composition was evaluated by high-performance liquid chromatography diode-array detection and high-performance liquid chromatography ultraviolet/visible detection. The presence of ursolic acid and rosmarinic acid was found in both solvents. However, gallic acid, quercetin, and epicatechin were higher in isopropanol extracts (P < .05). The results indicated a relationship among the total polyphenol content, antioxidant activity, and cytotoxic activity that was dependent on the solvent used. Isopropanol extracts presented a half-maximal inhibition concentration value (IC50) of 60.48 ± 3.8 μg/mL for HeLa cells and 66.62 ± 2.67 μg/mL for L929 fibroblasts. The extracts reduced the release of interleukin-6, interleukin-8, and MCP-1 in a dose-dependent manner. Extracts showed anticancer and immunomodulatory potential for new complementary pharmaceutical products development. PMID:28719984

Unilateral Outer Bow Expanded Cervical Headgear Force System: 3D Analysis Using Finite Element Method.

PubMed

Geramy, Allahyar; Mortezai, Omid; Esmaily, Masomeh; Darvishpour, Hojat

2015-04-01

Headgears are among the effective orthodontic appliances to achieve treatment goals. Unilateral molar distal movement is sometimes needed during an orthodontic treatment, which can be achieved by an asymmetric headgear. Different unilateral headgears have been introduced. The main goal of this study was to analyze the force system of unilateral expanded outer bow asymmetric headgears by the finite element method (FEM). Six 3D finite element models of a mesiodistal slice of the maxilla containing upper first molars, their periodontal ligaments (PDLs), cancellous bone, cortical bone, and a cervical headgear with expanded outer bow attached to maxillary first molars were designed in SolidWorks 2010 and meshed in ANSYS Workbench ver. 12.1. The models were the same except for the degree of outer bow expansion. The outer bow ends were loaded with 2 N force. The distal driving force and the net moment were evaluated. A decrease in the distalizing force in the normal side molar from 1.69 N to 1.37 N was shown by increasing the degree of unilateral expansion. At the same time, the force increased from 2.19 N to 2.49 N in the expanded side molar. A net moment increasing from 2.26 N.mm to 4.64 N.mm was also shown. Unilateral outer bow expansion can produce different distalizing forces in molars, which increase by increasing the expansion.

The effect of surgical titanium rods on proton therapy delivered for cervical bone tumors: experimental validation using an anthropomorphic phantom

NASA Astrophysics Data System (ADS)

Dietlicher, Isabelle; Casiraghi, Margherita; Ares, Carmen; Bolsi, Alessandra; Weber, Damien C.; Lomax, Antony J.; Albertini, Francesca

2014-12-01

To investigate the effect of metal implants in proton radiotherapy, dose distributions of different, clinically relevant treatment plans have been measured in an anthropomorphic phantom and compared to treatment planning predictions. The anthropomorphic phantom, which is sliced into four segments in the cranio-caudal direction, is composed of tissue equivalent materials and contains a titanium implant in a vertebral body in the cervical region. GafChromic® films were laid between the different segments to measure the 2D delivered dose. Three different four-field plans have then been applied: a Single-Field-Uniform-Dose (SFUD) plan, both with and without artifact correction implemented, and an Intensity-Modulated-Proton-Therapy (IMPT) plan with the artifacts corrected. For corrections, the artifacts were manually outlined and the Hounsfield Units manually set to an average value for soft tissue. Results show a surprisingly good agreement between prescribed and delivered dose distributions when artifacts have been corrected, with > 97% and 98% of points fulfilling the gamma criterion of 3%/3 mm for both SFUD and the IMPT plans, respectively. In contrast, without artifact corrections, up to 18% of measured points fail the gamma criterion of 3%/3 mm for the SFUD plan. These measurements indicate that correcting manually for the reconstruction artifacts resulting from metal implants substantially improves the accuracy of the calculated dose distribution.

Cervical cancer screening in Bulgaria--past and present experience.

PubMed

Valerianova, Zdravka; Panayotova, Yulia; Amati, Camilla; Baili, Paolo

2010-01-01

In Bulgaria the previously (1970-1985) existing population based cervical cancer screening was replaced in the early 1990s with an opportunistic model due to political and socioeconomic reasons. As a result, in the last 20 years, cervical cancer incidence and mortality rates steady increased. The objective of the EUROCHIP project in Bulgaria was to evaluate the readiness of the health system as well as health providers' attitudes to implementation in the country of a population based screening program for cervical cancer. Using a structured questionnaire, a convenience sample of medical specialists representing different actors involved in cervical cancer prevention, treatment, financing and policy were interviewed. The majority of interviewed practitioners worried that organization and implementation of an effective population-based cervical cancer screening program is not possible in the current unstable health system. A nostalgic attitude to the cervical cancer screening, performed in the past and pessimistic view on the capability of the current health system to cope are strong. As main barriers to implementation of an effective program were pointed financial and organizational ones. Motivation for gynecologists to perform smear test should include better information, organization and payment. Medical specialists in Bulgaria are aware of the alarming rates of cervical cancer incidence and mortality in the country. However, due to the insufficient communication and interaction between policy makers and front-line health care staff, they do not have enough information on the ongoing programs. Absence of health policy regarding screening is considered as main barrier for implementation of an effective screening program.

Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study.

PubMed

Pratt, Rebekah; Mohamed, Sharif; Dirie, Wali; Ahmed, Nimo; VanKeulen, Michael; Ahmed, Huda; Raymond, Nancy; Okuyemi, Kola

2017-03-20

Screening rates for breast and cervical cancer for Muslim women in the United States are low, particularly for first-generation immigrants. Interpretations of the Muslim faith represent some of the barriers for breast and cervical cancer screening. Working to understand how faith influences breast and cervical screening for Somali women, and working with the community to identify and utilize faith-based assets for promoting screening, may lead to life-saving changes in screening behaviors. We partnered with an Imam to develop faith-based messages addressing the concerns of modesty and predetermination and promoting cancer testing and screening. A total of five focus groups were convened, with 34 Somali women (three groups) and 20 Somali men (two groups). Each focus group first discussed participant views of breast and cervical cancer screening in general and then viewed and discussed video clips of the Imam delivering the faith-based messages. Both Somali women and men had an overwhelmingly positive response to the faith-based messages promoting breast and cervical cancer screening. The faith-based messages appeared to reinforce the views of those who were already inclined to see screening positively, with participants describing increased confidence to engage in screening. For those who had reservations about screening, there was feedback that the faith-based messages had meaningfully influenced their views. Somali immigrant women and men found faith-based messages addressing topics of predestination and modesty and encouraging the use of screening and treatment to be both acceptable and influential. Faith can play an important role as an asset to promote breast and cervical cancer screening, and there may be substantial benefits to adding faith-based messaging to other interventions that focus on improving screening uptake. This may help to address health disparities for Somali women in this area.

Generation of K14-E7/∆N87βcat double transgenic mice as a model of cervical cancer.

PubMed

Bulut, Gülay; Üren, Aykut

2015-01-01

Nearly all cervical cancers are initiated by a subset of high-risk human papilloma viruses (HPVs). However, cervical cancers develop only in a small fraction of women who are infected with these viruses. HPV is required, but not sufficient for developing cervical cancer. Activation of complementary signaling pathways appears to be necessary for malignant transformation of cervical epithelial cells that are immortalized by HPV. Here, we describe the creation and maintenance of a double transgenic mouse model that is based on constitutively active Wnt/β-catenin signaling in cervical epithelial cells expressing the HPV oncoprotein E7. These mice develop invasive cervical squamous carcinomas within 6 months with an average penetrance of 94 %.

On-demand rendering of an oblique slice through 3D volumetric data using JPEG2000 client-server framework

NASA Astrophysics Data System (ADS)

Joshi, Rajan L.

2006-03-01

In medical imaging, the popularity of image capture modalities such as multislice CT and MRI is resulting in an exponential increase in the amount of volumetric data that needs to be archived and transmitted. At the same time, the increased data is taxing the interpretation capabilities of radiologists. One of the workflow strategies recommended for radiologists to overcome the data overload is the use of volumetric navigation. This allows the radiologist to seek a series of oblique slices through the data. However, it might be inconvenient for a radiologist to wait until all the slices are transferred from the PACS server to a client, such as a diagnostic workstation. To overcome this problem, we propose a client-server architecture based on JPEG2000 and JPEG2000 Interactive Protocol (JPIP) for rendering oblique slices through 3D volumetric data stored remotely at a server. The client uses the JPIP protocol for obtaining JPEG2000 compressed data from the server on an as needed basis. In JPEG2000, the image pixels are wavelet-transformed and the wavelet coefficients are grouped into precincts. Based on the positioning of the oblique slice, compressed data from only certain precincts is needed to render the slice. The client communicates this information to the server so that the server can transmit only relevant compressed data. We also discuss the use of caching on the client side for further reduction in bandwidth requirements. Finally, we present simulation results to quantify the bandwidth savings for rendering a series of oblique slices.

Fast parallel algorithm for slicing STL based on pipeline

NASA Astrophysics Data System (ADS)

Ma, Xulong; Lin, Feng; Yao, Bo

2016-05-01

In Additive Manufacturing field, the current researches of data processing mainly focus on a slicing process of large STL files or complicated CAD models. To improve the efficiency and reduce the slicing time, a parallel algorithm has great advantages. However, traditional algorithms can't make full use of multi-core CPU hardware resources. In the paper, a fast parallel algorithm is presented to speed up data processing. A pipeline mode is adopted to design the parallel algorithm. And the complexity of the pipeline algorithm is analyzed theoretically. To evaluate the performance of the new algorithm, effects of threads number and layers number are investigated by a serial of experiments. The experimental results show that the threads number and layers number are two remarkable factors to the speedup ratio. The tendency of speedup versus threads number reveals a positive relationship which greatly agrees with the Amdahl's law, and the tendency of speedup versus layers number also keeps a positive relationship agreeing with Gustafson's law. The new algorithm uses topological information to compute contours with a parallel method of speedup. Another parallel algorithm based on data parallel is used in experiments to show that pipeline parallel mode is more efficient. A case study at last shows a suspending performance of the new parallel algorithm. Compared with the serial slicing algorithm, the new pipeline parallel algorithm can make full use of the multi-core CPU hardware, accelerate the slicing process, and compared with the data parallel slicing algorithm, the new slicing algorithm in this paper adopts a pipeline parallel model, and a much higher speedup ratio and efficiency is achieved.

Age-dependent changes of presynaptic neuromodulation via A1-adenosine receptors in rat hippocampal slices.

PubMed

Sperlágh, B; Zsilla, G; Baranyi, M; Kékes-Szabó, A; Vizi, E S

1997-10-01

The presynaptic neuromodulation of stimulation-evoked release of [3H]-acetylcholine by endogenous adenosine, via A1-adenosine receptors, was studied in superfused hippocampal slices taken from 4-, 12- and 24-month-old rats. 8-Cyclopentyl-1,3-dimethylxanthine (0.25 microM), a selective A1-receptor antagonist, increased significantly the electrical field stimulation-induced release of [3H]-acetylcholine in slices prepared from 4- and 12-month-old rats, showing a tonic inhibitory action of endogenous adenosine via stimulation of presynaptic A1-adenosine receptors. In contrast, 8-cyclopentyl-1,3-dimethylxanthine had no effect in 24-month-old rats. 2-Chloroadenosine (10 microM), an adenosine receptor agonist decreased the release of [3H]-acetylcholine in slices taken from 4- and 12-month-old rats, and no significant change was observed in slices taken from 24-month-old rats. In order to show whether the number/or affinity of the A1-receptors was affected in aged rats, [3H]-8-cyclopentyl-1,3-dimethylxanthine binding was studied in hippocampal membranes prepared from rats of different ages. Whereas the Bmax value was significantly lower in 2-year-old rats than in younger counterparts, the dissociation constant (Kd) was not affected by aging, indicating that the density rather than the affinity of adenosine receptors was altered. Endogenous adenosine levels present in the extracellular space were also measured in the superfusate by high performance liquid chromatography (HPLC) coupled with ultraviolet detection, and an age-related increase in the adenosine level was found. In summary, our results indicate that during aging the level of adenosine in the extracellular fluid is increased in the hippocampus. There is a downregulation and reduced responsiveness of presynaptic adenosine A1-receptors, and it seems likely that these changes are due to the enhanced adenosine level in the extracellular space.

Behavior of Listeria monocytogenes on Mortadella Formulated Using a Natural, Clean-Label Antimicrobial Agent during Extended Storage at 4 or 12°C.

PubMed

Porto-Fett, Anna C S; Campano, Stephen G; Rieker, Marcus; Stahler, Laura J; McGEARY, Lianna; Shane, Laura E; Shoyer, Bradley A; Osoria, Manuela; Luchansky, John B

2018-05-01

All-pork mortadella, an Italian-style deli meat, was produced by a local artisanal meat producer with or without 1.0 or 1.5% liquid buffered vinegar (LBV), 0.4, 0.6, or 1.0% dry buffered vinegar (DBV), or a 2.5% blend of potassium lactate and sodium diacetate (KLac). In each of three trials, mortadella was sliced (ca. 1.5 cm thick, ca. 30 g) and surface inoculated with 250 μL per side of a five-strain mixture of Listeria monocytogenes (ca. 3.8 log CFU per slice). The packages were vacuum sealed and then stored at 4 or 12°C. In the absence of antimicrobials, L. monocytogenes levels increased by ca. 2.6 and 6.0 log CFU per slice after up to 120 or 28 days at 4 or 12°C, respectively. With inclusion of 1.0 or 1.5% LBV, 1.0% DBV, or 2.5% KLac as ingredients, pathogen levels decreased by ca. 0.3 to 0.7 log CFU per slice after 120 days at 4°C, whereas with inclusion of 0.4 or 0.6% DBV, L. monocytogenes levels increased by ca. 1.2 and 0.8 log CFU per slice, respectively. After 28 days at 12°C, inclusion of 2.5% KLac, 1.0 or 1.5% LBV, or 0.4 or 0.6% DBV resulted in a ca. 1.4- to 5.7-log increase in L. monocytogenes levels. When 1.0% DBV was included in the formulation, pathogen levels remained unchanged after 28 days at 12°C. However, product quality was lessened at this abusive storage temperature (12°C) for all treatments by the end of storage. Thus, inclusion of LBV or DBV, as clean-label ingredients, in mortadella is equally effective as KLac for controlling L. monocytogenes during storage at 4°C without adversely affecting product quality.

Cervical motion assessment using virtual reality.

PubMed

Sarig-Bahat, Hilla; Weiss, Patrice L; Laufer, Yocheved

2009-05-01

Repeated measures of cervical motion in asymptomatic subjects. To introduce a virtual reality (VR)-based assessment of cervical range of motion (ROM); to establish inter and intratester reliability of the VR-based assessment in comparison with conventional assessment in asymptomatic individuals; and to evaluate the effect of a single VR session on cervical ROM. Cervical ROM and clinical issues related to neck pain is frequently studied. A wide variety of methods is available for evaluation of cervical motion. To date, most methods rely on voluntary responses to an assessor's instructions. However, in day-to-day life, head movement is generally an involuntary response to multiple stimuli. Therefore, there is a need for a more functional assessment method, using sensory stimuli to elicit spontaneous neck motion. VR attributes may provide a methodology for achieving this goal. A novel method was developed for cervical motion assessment utilizing an electromagnetic tracking system and a VR game scenario displayed via a head mounted device. Thirty asymptomatic participants were assessed by both conventional and VR-based methods. Inter and intratester repeatability analyses were performed. The effect of a single VR session on ROM was evaluated. Both assessments showed non-biased results between tests and between testers (P > 0.1). Full-cycle repeatability coefficients ranged between 15.0 degrees and 29.2 degrees with smaller values for rotation and for the VR assessment. A single VR session significantly increased ROM, with largest effect found in the rotation direction. Inter and intratester reliability was supported for both the VR-based and the conventional methods. Results suggest better repeatability for the VR method, with rotation being more precise than flexion/extension. A single VR session was found to be effective in increasing cervical motion, possibly due to its motivating effect.

A comparison between swallowing sounds and vibrations in patients with dysphagia

PubMed Central

Movahedi, Faezeh; Kurosu, Atsuko; Coyle, James L.; Perera, Subashan

2017-01-01

The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. The aim of this study is to present a broad comparison of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who underwent videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5ml spoon was given to the participants. A comprehensive set of features was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies. PMID:28495001

Establishment of a cervical cancer bio-bank for the Chinese population: from project-based sample collection to routine management.

PubMed

Yang, Ru; Li, Xiong; Zhou, Hang; Jia, Yao; Zhou, Jin; Huang, Kecheng; Tang, Fangxu; Hu, Ting; Shen, Jian; Chen, Zhilan; Wang, Shaoshuai; Sun, Haiying; Guo, Lili; Wang, Lin; Wang, Hui; Ma, Ding; Li, Shuang

2015-08-01

There is an increasing need for the establishment of a cervical cancer bio-bank that will facilitate both clinical and basic research. The cervical cancer bio-bank was first established in January 1999 and included two stages. First, a GWAS-based sample collection was conducted with special emphasis on the diagnosis and the retrieval of the corresponding bio-specimens, especially blood samples. Second, clinical data and their corresponding bio-specimens were routinely collected and handled. Notably, these bio-specimens also included samples from Wufeng Tujia Autonomous County, which has the highest incidence of cervical cancer in China. The specimens were collected from patients with cervical cancer and those with cervical intraepithelial neoplasia, while the control samples were collected from normal individuals. With special emphasis on clinical data and blood samples for the GWAS analysis, the collection of other bio-specimens was slow, and the pairing of specimens and clinical data was poor during the first stage. However, in the second stage, the pairing of the clinical data and its corresponding bio-specimens improved. At present, the samples procured and preserved in the bio-bank cover most regions of China and different ethnic groups for both the normal controls and cervical cancer patients of different pathological categories. This bio-bank of cervical cancer specimens from the Chinese population will greatly promote the studies of cervical cancer in China.

Enhancement of the cervical cancer screening program in Malaysia: a qualitative study.

PubMed

Abdullah, Fauziah; Su, Tin Tin

2010-01-01

Cervical cancer has long been known as a preventable disease. Yet it still is a prime women's health issue globally. In Malaysia, the current cervical cancer screening program, introduced in the 1960s, has been found to be unsuccessful in terms of Pap smear coverage. The aim of this study is to determine providers perceptives on the program and the feasibility of practicing an organized cervical screening program in Malaysia. 11 key informant interviews were conducted with policy makers and health care providers from the Ministry of Health in Malaysia from October 2009 to May 2010. Interviewees' perceptions were explored on current and organized cervical screening program based on their expertise and experience. The results highlighted that the existing cervical screening program in Malaysia faced flaws at all levels that failed to reduce cervical cancer morbidity and mortality. The identified weaknesses were poor acceptance by women, lack of commitment by health care providers, nature of the program, an improper follow-up system, limited resources and other competing needs. Complementarily, all interviewees perceived an organized cervical screening program as an alternative approach both feasible and acceptable by women and government to practice in Malaysia. Better screening coverage depends on an effective screening program that incorporates a behaviour-based strategy. A new program should be focused in the policy-making context to improve screening coverage and to effectively combat cervical cancer.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Xiaoming; Nan, Zhaodong, E-mail: zdnan@yzu.edu.cn

Graphical abstract: Glass-slices were used as a template to induce formation and assembly of aragonite. Different morphologies, such as hemisphere, twinborn hemisphere and flower-shaped particles, were produced by direction of the glass-slices. Highlights: {yields} Glass-slices were used as a template to induce formation and assembly of aragonite. {yields} Hemisphere, twinborn hemisphere and flower-shaped particles were produced by direction of the glass-slices. {yields} Planes were always appeared in these as-synthesized samples. {yields} Thermodynamic theory was applied to explain the production of the aragonite. -- Abstract: A glass-slice was used as a template to induce formation and assembly of aragonite. Thermodynamic theorymore » was applied to explain the production of the aragonite. Transformation of three-dimensional nucleation to template-based two-dimensional surface nucleation caused the production of aragonite. Hemisphere, twinborn hemisphere and flower-shaped particles were produced by direction of the glass-slices. Planes were always appeared in these as-synthesized samples because the nucleation and the growth of these samples were adsorbed at the surfaces of the glass-slices. The formation mechanism of the as-formed sample was proposed. Compared with organic template, the present study provides a facile method to apply inorganic template to prepare functional materials.« less

Tectonic slicing of subducting oceanic crust along plate interfaces: Numerical modeling

NASA Astrophysics Data System (ADS)

Ruh, J. B.; Le Pourhiet, L.; Agard, Ph.; Burov, E.; Gerya, T.

2015-10-01

Multikilometer-sized slivers of high-pressure low-temperature metamorphic oceanic crust and mantle are observed in many mountain belts. These blueschist and eclogite units were detached from the descending plate during subduction. Large-scale thermo-mechanical numerical models based on finite difference marker-in-cell staggered grid technique are implemented to investigate slicing processes that lead to the detachment of oceanic slivers and their exhumation before the onset of the continental collision phase. In particular, we investigate the role of the serpentinized subcrustal slab mantle in the mechanisms of shallow and deep crustal slicing. Results show that spatially homogeneous serpentinization of the sub-Moho slab mantle leads to complete accretion of oceanic crust within the accretionary wedge. Spatially discontinuous serpentinization of the slab mantle in form of unconnected patches can lead to shallow slicing of the oceanic crust below the accretionary wedge and to its deep slicing at mantle depths depending on the patch length, slab angle, convergence velocity and continental geothermal gradient. P-T paths obtained in this study are compared to natural examples of shallow slicing of the Crescent Terrane below Vancouver Island and deeply sliced crust of the Lago Superiore and Saas-Zermatt units in the Western Alps.

Innovative approaches to cervical cancer screening for sex trade workers: an international scoping review.

PubMed

Thulien, Naomi S

2014-03-01

Female sex trade workers are among those at highest risk for developing and dying of cervical cancer, and yet many-particularly the most marginalized-are less likely than other women to be screened. This review summarizes global findings on innovative approaches to cervical cancer screening for female sex trade workers, highlights current gaps in the delivery of cervical cancer screening for female sex trade workers globally, and suggests areas for future research and policy development. A scoping review of peer-reviewed publications and grey literature was conducted. Medline (OVID), PubMed, EMBASE, and SCOPUS were searched for relevant studies written in English. There were no limitations placed on dates. Grey literature was identified by hand searching and through discussion with health care providers and community outreach workers currently working with sex trade workers. Twenty-five articles were deemed suitable for review. Articles detailing innovative ways for female sex trade workers to access cervical cancer screening were included. Articles about screening for sexually transmitted infections were also included if the findings could be generalized to screening for cervical cancer. Articles limited to exploring risk factors, knowledge, awareness, education, prevalence, and incidence of cervical cancer among sex trade workers were excluded from the review. Successful screening initiatives identified in the studies reviewed had unconventional hours of operation, understood the difference between street-based and venue-based sex trade workers, and/or used peers for outreach. Two significant gaps in health care service delivery were highlighted in this review: the limited use of unorthodox hours and the nearly exclusive practice of providing sexually transmitted infection screening for female sex trade workers without cervical cancer screening. In addition, although street-based (as opposed to venue-based) sex trade workers are likely at higher risk for developing cervical cancer, they are much less likely than other eligible women to participate in screening programs, meaning traditional outreach methods are unlikely to be successful.

[High-risk HPV genotyping PCR testing as a means of cervical cancer and precancerous lesions early screening].

PubMed

Ma, Li; Cong, Xiao; Bian, Meilu; Shi, Mai; Wang, Xiuhong; Liu, Jun; Liu, Haiyan

2015-04-01

To explored high-risk HPV genotyping PCR testing whether as a feasible means for the early screening of cervical cancer and precancerous lesions. From January 2013 to June 2014, 15,192 outpatients in China-Japan Friendship Hospital voluntary were tested by high-risk type HPV genotyping PCR. The average age of them were (33±8) years old. High-risk HPV types genotyping PCR tested by fluorescence PCR technology, in which 13 kinds of high-risk HPV subtypes were detected, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. A total of 4,315 cases of them were tested by the liquid-based cytology (LCT), among them with positive of high-risk HPV genotyping tested by PCR (n=2,366) were biopsy under colposcope (648 cases) in those LCT results were positive or LCT negative but HPV16 positive or LCT negative but had the clear clinical symptoms or and non-HPV16 positive but with clear clinical symptoms. (1) Analysis high-risk HPV infection status of 15 192 women. (2) As the pathological diagnosis was the gold standard in the diagnosis of cervical lesions, analysis of the relationship among high-risk HPV infection, virus loads and cervical lesions. (3) To evaluated the value of high-risk HPV genotyping PCR tested method in screening of cervical cancer and precancerous lesions. ⑴ Of 15,192 cases tested by high-risk HPV genotyping PCR, 2,366 cases were HPV positive (HPV infection), the overall infection rate was 15.57% (2,366/15,192), in which a single subtype of HPV infection in 1,767 cases, infection rate was 11.63% (1,767/15,192), and multiple subtypes of HPV infection (two and more subtypes HPV infection) in 599 cases, infection rate was 3.94% (599/15,192). The HPV16, 52 and 58 infections were the most common HPV subtypes in 13 subtypes, the infection rate was 3.95% (600/15,192), 2.86% (435/15,192) and 2.67% (406/15,192), respectively. (2) The most relevant subtypes with cervical intraepithelial neoplasia (CIN) II and even higher lesion were HPV16, 52 and 58, accounted for 57.7% (154/267) of all above CIN II lesions. The most relevant subtype with the cervical glandular intraepithelial neoplasia (CGIN) II or above lesions was HPV18, 3 cases with CGIN II or above lesions were all single HPV18 infection. The pathologic examination positive percentage of patients which HPV virus loads≤10(3) copys/10(4) cells was 18.2% (25/137), while the pathologic examination positive proportion was 33.3% (247/742) which HPV virus loads≥10(4) copys/10(4) cells, there was statistically significant difference between them (χ2=27.06, P=0.000). (3) Sensitivity, specificity, positive predictive value and negative predictive value for detection of CIN II or above using HPV genotyping PCR were 96.11%, 85.76%, 30.94% and 99.70%, respectively. There were a guiding significance for high-risk HPV genotyping PCR tested in screening of cervical cancer and precancerous lesion. HPV16, 52 and 58 were related to the severe cervical squamous epithelial lesions, while HPV18 was related to cervical severe glandular cell pathological changes. HPV genotyping is feasible and economical as the first choice of opportunistic screening in tertiary hospitals.

The nanoaquarium: A nanofluidic platform for in situ transmission electron microscopy in liquid media

NASA Astrophysics Data System (ADS)

Grogan, Joseph M.

There are many scientifically interesting and technologically relevant nanoscale phenomena that take place in liquid media. Examples include aggregation and assembly of nanoparticles; colloidal crystal formation; liquid phase growth of structures such as nanowires; electrochemical deposition and etching for fabrication processes and battery applications; interfacial phenomena; boiling and cavitation; and biological interactions. Understanding of these fields would benefit greatly from real-time, in situ transmission electron microscope (TEM) imaging with nanoscale resolution. Most liquids cannot be imaged by traditional TEM due to evaporation in the high vacuum environment and the requirement that samples be very thin. Liquid-cell in situ TEM has emerged as an exciting new experimental technique that hermetically seals a thin slice of liquid between two electron transparent membranes to enable TEM imaging of liquid-based processes. This work presents details of the fabrication of a custom-made liquid-cell in situ TEM device, dubbed the nanoaquarium. The nanoaquarium's highlights include an exceptionally thin sample cross section (10s to 100s of nm); wafer scale processing that enables high-yield mass production; robust hermetic sealing that provides leak-free operation without use of glue, epoxy, or any polymers; compatibility with lab-on-chip technology; and on-chip integrated electrodes for sensing and actuation. The fabrication process is described, with an emphasis on direct wafer bonding. Experimental results involving direct observation of colloid aggregation using an aqueous solution of gold nanoparticles are presented. Quantitative analysis of the growth process agrees with prior results and theory, indicating that the experimental technique does not radically alter the observed phenomenon. For the first time, in situ observations of nanoparticles at a contact line and in an evaporating thin film of liquid are reported, with applications for techniques such as dip-coating and drop-casting, commonly used for depositing nanoparticles on a surface via convective-capillary assembly. Theoretical analysis suggests that the observed particle motion and aggregation are caused by gradients in surface tension and disjoining pressure in the thin liquid film.

Time efficient whole-brain coverage with MR Fingerprinting using slice-interleaved echo-planar-imaging.

PubMed

Rieger, Benedikt; Akçakaya, Mehmet; Pariente, José C; Llufriu, Sara; Martinez-Heras, Eloy; Weingärtner, Sebastian; Schad, Lothar R

2018-04-27

Magnetic resonance fingerprinting (MRF) is a promising method for fast simultaneous quantification of multiple tissue parameters. The objective of this study is to improve the coverage of MRF based on echo-planar imaging (MRF-EPI) by using a slice-interleaved acquisition scheme. For this, the MRF-EPI is modified to acquire several slices in a randomized interleaved manner, increasing the effective repetition time of the spoiled gradient echo readout acquisition in each slice. Per-slice matching of the signal-trace to a precomputed dictionary allows the generation of T 1 and T 2 * maps with integrated B 1 + correction. Subsequent compensation for the coil sensitivity profile and normalization to the cerebrospinal fluid additionally allows for quantitative proton density (PD) mapping. Numerical simulations are performed to optimize the number of interleaved slices. Quantification accuracy is validated in phantom scans and feasibility is demonstrated in-vivo. Numerical simulations suggest the acquisition of four slices as a trade-off between quantification precision and scan-time. Phantom results indicate good agreement with reference measurements (Difference T 1 : -2.4 ± 1.1%, T 2 *: -0.5 ± 2.5%, PD: -0.5 ± 7.2%). In-vivo whole-brain coverage of T 1 , T 2 * and PD with 32 slices was acquired within 3:36 minutes, resulting in parameter maps of high visual quality and comparable performance with single-slice MRF-EPI at 4-fold scan-time reduction.

Disposal of metal fragments released during polycrystalline slicing by multi-wire saw

NASA Astrophysics Data System (ADS)

Boutouchent-Guerfi, N.; Drouiche, N.; Medjahed, S.; Ould-Hamou, M.; Sahraoui, F.

2016-08-01

The environmental and economic impacts linked with solar systems are largely based on discharges of slurry generated during the various stages of sawing and cutting ingots. These discharges into the environment are subject to the general regulations on hazardous and special industrial waste disposal. Therefore, they should not be abandoned or burned in open air. The cutting of Silicon ingots leads to the production of Silicon wafers additional costs, losing more than 30% of Silicon material. Abrasive grains (Silicon Carbide) trapped between the wire and the block of Silicon need to be removed by various mechanisms to be later evacuated by slurry fragments. In the interest of decreasing operational costs during polycrystalline ingot slicing at Semiconductors Research Center, and, avoid environmental problems; it is necessary to recover the solar grade Silicon from the Silicon sawing waste. For this reason, the removal of metal fragments has become a preliminary requirement to regenerate the slurry; in addition, the solid phase needs to be separated from the liquid phase after the dissolution PEG with the solvent. In the present study, magnetic separation and centrifugation methods were adopted for metals removal, followed by the analysis of some operating parameters such as: washing time, pH, and initial concentration of Silicon. Finally, analytical, morphological and basic methods were performed in order to evaluate the efficiency of the process undertaken.

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates

PubMed Central

Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Odhner, Dewey; Wu, Caiyun; Pednekar, Gargi; Palmer, Scott; Rozenshtein, Anna; Shirk, Melissa A.; Newell, John D.; Porteous, Mary; Diamond, Joshua M.

2017-01-01

Purpose Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI) does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT) imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh) versus a volumetric CT, which have not been addressed in the literature. Methods Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2), 16 with chronic obstructive pulmonary disease (COPD), 16 with idiopathic pulmonary fibrosis (IPF), and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU) distributions) were determined from each chest slice and from the whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh) to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC) analysis. Results The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97) and at the T7 level for VAT (0.86), and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively). However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively), and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively). These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT) were significantly different between COPD and IPF groups. Conclusions This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume. PMID:28046024

Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

PubMed

Tong, Yubing; Udupa, Jayaram K; Torigian, Drew A; Odhner, Dewey; Wu, Caiyun; Pednekar, Gargi; Palmer, Scott; Rozenshtein, Anna; Shirk, Melissa A; Newell, John D; Porteous, Mary; Diamond, Joshua M; Christie, Jason D; Lederer, David J

2017-01-01

Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI) does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT) imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh) versus a volumetric CT, which have not been addressed in the literature. Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2), 16 with chronic obstructive pulmonary disease (COPD), 16 with idiopathic pulmonary fibrosis (IPF), and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU) distributions) were determined from each chest slice and from the whole chest volume separately for SAT and VAT components. The same parameters were also computed from the single abdominal and thigh slices. The ability of the slice at each anatomic location in the chest (and abdomen and thigh) to act as a marker of the measures derived from the whole chest volume was assessed via Pearson correlation coefficient (PCC) analysis. The SAS approach correctly identified slice locations in different subjects in terms of vertebral levels. PCC between chest fat volume and chest slice fat area was maximal at the T8 level for SAT (0.97) and at the T7 level for VAT (0.86), and was modest between chest fat volume and abdominal slice fat area for SAT and VAT (0.73 and 0.75, respectively). However, correlation was weak for chest fat volume and thigh slice fat area for SAT and VAT (0.52 and 0.37, respectively), and for chest fat volume for SAT and VAT and BMI (0.65 and 0.28, respectively). These same single slice locations with maximal PCC were found for SAT and VAT within both COPD and IPF groups. Most of the attenuation properties derived from the whole chest volume and single best chest slice for VAT (but not for SAT) were significantly different between COPD and IPF groups. This study demonstrates a new way of optimally selecting slices whose measurements may be used as markers of similar measurements made on the whole chest volume. The results suggest that one or two slices imaged at T7 and T8 vertebral levels may be enough to estimate reliably the total SAT and VAT components of chest fat and the quality of chest fat as determined by attenuation distributions in the entire chest volume.

Cervical degenerative disease: systematic review of economic analyses.

PubMed

Alvin, Matthew D; Qureshi, Sheeraz; Klineberg, Eric; Riew, K Daniel; Fischer, Dena J; Norvell, Daniel C; Mroz, Thomas E

2014-10-15

Systematic review. To perform an evidence-based synthesis of the literature assessing the cost-effectiveness of surgery for patients with symptomatic cervical degenerative disc disease (DDD). Cervical DDD is a common cause of clinical syndromes such as neck pain, cervical radiculopathy, and myelopathy. The appropriate surgical intervention(s) for a given problem is controversial, especially with regard to quality-of-life outcomes, complications, and costs. Although there have been many studies comparing outcomes and complications, relatively few have compared costs and, more importantly, cost-effectiveness of the interventions. We conducted a systematic search in PubMed/MEDLINE, EMBASE, the Cochrane Collaboration Library, the Cost-Effectiveness Analysis registry database, and the National Health Service Economic Evaluation Database for full economic evaluations published through January 16, 2014. Identification of full economic evaluations that were explicitly designed to evaluate and synthesize the costs and consequences of surgical procedures or surgical intervention with nonsurgical management in patients with cervical DDD were considered for inclusion, based on 4 key questions. Five studies were included, each specific to 1 or more of our focus questions. Two studies suggested that cervical disc replacement may be more cost-effective compared with anterior cervical discectomy and fusion. Two studies comparing anterior with posterior surgical procedures for cervical spondylotic myelopathy suggested that anterior surgery was more cost-effective than posterior surgery. One study suggested that posterior cervical foraminotomy had a greater net economic benefit than anterior cervical discectomy and fusion in a military population with unilateral cervical radiculopathy. No studies assessed the cost-effectiveness of surgical intervention compared with nonoperative treatment of cervical myelopathy or radiculopathy, although it is acknowledged that existing studies demonstrate the cost-effectiveness of surgical intervention for these 2 clinical entities. A paucity of high-quality economic literature exists regarding cost-effectiveness of surgical intervention for cervical DDD. Future research is necessary to validate the findings of the few studies that do exist to guide decisions for surgery by the physician and patient with respect to cost-effectiveness. 2.

Variability in Treatment for Patients with Cervical Spine Fracture and Dislocation: An Analysis of 107,152 Patients.

PubMed

Wang, Jing; Eltorai, Adam E M; DePasse, J Mason; Durand, Wesley; Reid, Daniel; Daniels, Alan H

2018-06-01

Cervical spine injuries are a common cause of morbidity and mortality; however, the optimal treatment of many of these injuries is debated, and previous studies have shown substantial variation in treatment. We sought to examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients over a 12-year period. Data from the Healthcare Cost and Utilization Project National Inpatient Sample, from 2000 to 2011, were used for this study. Patients were identified with a cervical vertebral facture or dislocation based on the International Classification of Diseases, 9th Revision codes. Using χ 2 analysis, spinal arthrodesis rates and halo/tong placement rates were compared between hospitals based on teaching status for patients with and without spinal cord injury (SCI). The records of 107,152 patients with cervical fractures were examined. From 2000 to 2011, the overall arthrodesis rates fell from 25.2% to 20.6% (P < 0.001), and halo/tong placement rates fell from 13.2% to 3.6% (P < 0.001). In patients with cervical fracture without SCI, arthrodesis rates fell from 17.6% to 13.9% (P < 0.001), in cervical fracture patients with SCI, arthrodesis rates rose from 50.0% to 58.9% (P < 0.001), and in cervical dislocation patients, arthrodesis rates rose from 47.6% to 57.5% (P < 0.001). During the 12-year period, teaching hospitals had higher arthrodesis rates compared with nonteaching hospitals for patients with cervical fractures with SCI (57.3% vs. 53.4%, P = 0.001) and higher halo/tong placement rates for patients with cervical dislocations (2.7% vs. 1.7%, P = 0.004). Individual hospital variation showed a 3.5-fold variation in arthrodesis rates in 2000 to 2002, which fell to 3.0-fold by 2009 to 2011. Arthrodesis rates for cervical fracture patients significantly decreased, and arthrodesis rates for cervical dislocation and SCI patients increased from 2000 to 2011, with variability in treatment based on hospital teaching status. Rates of halo/tong placement rapidly decreased for cervical spine trauma at both teaching and nonteaching hospitals. Individual hospital treatment variation also decreased over the study period. Further clinical studies examining the optimal treatment for spine trauma may lead to continued decreases in treatment variability. Copyright © 2018 Elsevier Inc. All rights reserved.

Slice-to-Volume Nonrigid Registration of Histological Sections to MR Images of the Human Brain

PubMed Central

Osechinskiy, Sergey; Kruggel, Frithjof

2011-01-01

Registration of histological images to three-dimensional imaging modalities is an important step in quantitative analysis of brain structure, in architectonic mapping of the brain, and in investigation of the pathology of a brain disease. Reconstruction of histology volume from serial sections is a well-established procedure, but it does not address registration of individual slices from sparse sections, which is the aim of the slice-to-volume approach. This study presents a flexible framework for intensity-based slice-to-volume nonrigid registration algorithms with a geometric transformation deformation field parametrized by various classes of spline functions: thin-plate splines (TPS), Gaussian elastic body splines (GEBS), or cubic B-splines. Algorithms are applied to cross-modality registration of histological and magnetic resonance images of the human brain. Registration performance is evaluated across a range of optimization algorithms and intensity-based cost functions. For a particular case of histological data, best results are obtained with a TPS three-dimensional (3D) warp, a new unconstrained optimization algorithm (NEWUOA), and a correlation-coefficient-based cost function. PMID:22567290

Pulmonary parenchyma segmentation in thin CT image sequences with spectral clustering and geodesic active contour model based on similarity

NASA Astrophysics Data System (ADS)

He, Nana; Zhang, Xiaolong; Zhao, Juanjuan; Zhao, Huilan; Qiang, Yan

2017-07-01

While the popular thin layer scanning technology of spiral CT has helped to improve diagnoses of lung diseases, the large volumes of scanning images produced by the technology also dramatically increase the load of physicians in lesion detection. Computer-aided diagnosis techniques like lesions segmentation in thin CT sequences have been developed to address this issue, but it remains a challenge to achieve high segmentation efficiency and accuracy without much involvement of human manual intervention. In this paper, we present our research on automated segmentation of lung parenchyma with an improved geodesic active contour model that is geodesic active contour model based on similarity (GACBS). Combining spectral clustering algorithm based on Nystrom (SCN) with GACBS, this algorithm first extracts key image slices, then uses these slices to generate an initial contour of pulmonary parenchyma of un-segmented slices with an interpolation algorithm, and finally segments lung parenchyma of un-segmented slices. Experimental results show that the segmentation results generated by our method are close to what manual segmentation can produce, with an average volume overlap ratio of 91.48%.

SU-E-J-240: Development of a Novel 4D MRI Sequence for Real-Time Liver Tumor Tracking During Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhuang, L; Burmeister, J; Ye, Y

2015-06-15

Purpose: To develop a Novel 4D MRI Technique that is feasible for realtime liver tumor tracking during radiotherapy. Methods: A volunteer underwent an abdominal 2D fast EPI coronal scan on a 3.0T MRI scanner (Siemens Inc., Germany). An optimal set of parameters was determined based on image quality and scan time. A total of 23 slices were scanned to cover the whole liver in the test scan. For each scan position, the 2D images were retrospectively sorted into multiple phases based on breathing signal extracted from the images. Consequently the 2D slices with same phase numbers were stacked to formmore » one 3D image. Multiple phases of 3D images formed the 4D MRI sequence representing one breathing cycle. Results: The optimal set of scan parameters were: TR= 57ms, TE= 19ms, FOV read= 320mm and flip angle= 30°, which resulted in a total scan time of 14s for 200 frames (FMs) per slice and image resolution of (2.5mm,2.5mm,5.0mm) in three directions. Ten phases of 3D images were generated, each of which had 23 slices. Based on our test scan, only 100FMs were necessary for the phase sorting process which may lower the scan time to 7s/100FMs/slice. For example, only 5 slices/35s are necessary for a 4D MRI scan to cover liver tumor size ≤ 2cm leading to the possibility of tumor trajectory tracking every 35s during treatment. Conclusion: The novel 4D MRI technique we developed can reconstruct a 4D liver MRI sequence representing one breathing cycle (7s/ slice) without an external monitor. This technique can potentially be used for real-time liver tumor tracking during radiotherapy.« less

Multi-Spatiotemporal Patterns of Residential Burglary Crimes in Chicago: 2006-2016

NASA Astrophysics Data System (ADS)

Luo, J.

2017-10-01

This research attempts to explore the patterns of burglary crimes at multi-spatiotemporal scales in Chicago between 2006 and 2016. Two spatial scales are investigated that are census block and police beat area. At each spatial scale, three temporal scales are integrated to make spatiotemporal slices: hourly scale with two-hour time step from 12:00am to the end of the day; daily scale with one-day step from Sunday to Saturday within a week; monthly scale with one-month step from January to December. A total of six types of spatiotemporal slices will be created as the base for the analysis. Burglary crimes are spatiotemporally aggregated to spatiotemporal slices based on where and when they occurred. For each type of spatiotemporal slices with burglary occurrences integrated, spatiotemporal neighborhood will be defined and managed in a spatiotemporal matrix. Hot-spot analysis will identify spatiotemporal clusters of each type of spatiotemporal slices. Spatiotemporal trend analysis is conducted to indicate how the clusters shift in space and time. The analysis results will provide helpful information for better target policing and crime prevention policy such as police patrol scheduling regarding times and places covered.

Knowledge, attitude, and practice toward cervical cancer among women attending Obstetrics and Gynecology Department: A cross-sectional, hospital-based survey in South India.

PubMed

Narayana, G; Suchitra, M Jyothi; Sunanda, G; Ramaiah, J Dasaratha; Kumar, B Pradeep; Veerabhadrappa, K V

2017-01-01

Cervical cancer-related deaths among women in India are often due to late diagnosis of disease. Knowledge about disease and early screening is the most effective measure for cervical cancer prevention. Lack of awareness, negative attitude, and poor practice about cervical cancer and screening are the major causes to increase the incidence of disease. The study is designed to assess knowledge, attitude, and practice (KAP) toward cervical cancer, screening, and prevention. A cross-sectional, hospital-based survey was conducted in women attending Obstetrics and Gynecology Department of a secondary care referral hospital. A total of 403 subjects were enrolled and subjected for interview using prevalidated KAP questionnaire on cervical cancer. Descriptive statistics were used to represent the sociodemographic characteristics and KAP levels. Association of sociodemographic variables with KAP levels is determined using Chi-square test. Most of (301; 74.6%) the respondents had heard about cervical cancer and majority of them are heard from media (168; 41.6%) and friends (83; 20.5%). Most women knew symptoms (259; 64.2%), risk factors (253; 62.7%), screening methods (310; 76.9%), and preventive measures (249; 61.7%) for cervical cancer. More than half of the women (252; 62.5%) having positive attitude toward screening. More than three-fourth of women (349; 86.6%) are not having practice toward cervical cancer screening. Sociodemographic characteristics are strongly associated with KAP levels. Although women are having good knowledge, positive attitude toward cervical cancer screening and prevention still there is a gap to transform it into practice. There is a need for more educational programs to connect identified knowledge slits and uplift of regular practice of cervical cancer screening.

TU-A-12A-07: CT-Based Biomarkers to Characterize Lung Lesion: Effects of CT Dose, Slice Thickness and Reconstruction Algorithm Based Upon a Phantom Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, B; Tan, Y; Tsai, W

2014-06-15

Purpose: Radiogenomics promises the ability to study cancer tumor genotype from the phenotype obtained through radiographic imaging. However, little attention has been paid to the sensitivity of image features, the image-based biomarkers, to imaging acquisition techniques. This study explores the impact of CT dose, slice thickness and reconstruction algorithm on measuring image features using a thorax phantom. Methods: Twentyfour phantom lesions of known volume (1 and 2mm), shape (spherical, elliptical, lobular and spicular) and density (-630, -10 and +100 HU) were scanned on a GE VCT at four doses (25, 50, 100, and 200 mAs). For each scan, six imagemore » series were reconstructed at three slice thicknesses of 5, 2.5 and 1.25mm with continuous intervals, using the lung and standard reconstruction algorithms. The lesions were segmented with an in-house 3D algorithm. Fifty (50) image features representing lesion size, shape, edge, and density distribution/texture were computed. Regression method was employed to analyze the effect of CT dose, slice of thickness and reconstruction algorithm on these features adjusting 3 confounding factors (size, density and shape of phantom lesions). Results: The coefficients of CT dose, slice thickness and reconstruction algorithm are presented in Table 1 in the supplementary material. No significant difference was found between the image features calculated on low dose CT scans (25mAs and 50mAs). About 50% texture features were found statistically different between low doses and high doses (100 and 200mAs). Significant differences were found for almost all features when calculated on 1.25mm, 2.5mm, and 5mm slice thickness images. Reconstruction algorithms significantly affected all density-based image features, but not morphological features. Conclusions: There is a great need to standardize the CT imaging protocols for radiogenomics study because CT dose, slice thickness and reconstruction algorithm impact quantitative image features to various degrees as our study has shown.« less

Quantitative skeletal maturation estimation using cone-beam computed tomography-generated cervical vertebral images: a pilot study in 5- to 18-year-old Japanese children.

PubMed

Byun, Bo-Ram; Kim, Yong-Il; Yamaguchi, Tetsutaro; Maki, Koutaro; Ko, Ching-Chang; Hwang, Dea-Seok; Park, Soo-Byung; Son, Woo-Sung

2015-11-01

The purpose of this study was to establish multivariable regression models for the estimation of skeletal maturation status in Japanese boys and girls using the cone-beam computed tomography (CBCT)-based cervical vertebral maturation (CVM) assessment method and hand-wrist radiography. The analyzed sample consisted of hand-wrist radiographs and CBCT images from 47 boys and 57 girls. To quantitatively evaluate the correlation between the skeletal maturation status and measurement ratios, a CBCT-based CVM assessment method was applied to the second, third, and fourth cervical vertebrae. Pearson's correlation coefficient analysis and multivariable regression analysis were used to determine the ratios for each of the cervical vertebrae (p < 0.05). Four characteristic parameters ((OH2 + PH2)/W2, (OH2 + AH2)/W2, D2, AH3/W3), as independent variables, were used to build the multivariable regression models: for the Japanese boys, the skeletal maturation status according to the CBCT-based quantitative cervical vertebral maturation (QCVM) assessment was 5.90 + 99.11 × AH3/W3 - 14.88 × (OH2 + AH2)/W2 + 13.24 × D2; for the Japanese girls, it was 41.39 + 59.52 × AH3/W3 - 15.88 × (OH2 + PH2)/W2 + 10.93 × D2. The CBCT-generated CVM images proved very useful to the definition of the cervical vertebral body and the odontoid process. The newly developed CBCT-based QCVM assessment method showed a high correlation between the derived ratios from the second cervical vertebral body and odontoid process. There are high correlations between the skeletal maturation status and the ratios of the second cervical vertebra based on the remnant of dentocentral synchondrosis.

Cervical cancer: A global health crisis.

PubMed

Small, William; Bacon, Monica A; Bajaj, Amishi; Chuang, Linus T; Fisher, Brandon J; Harkenrider, Matthew M; Jhingran, Anuja; Kitchener, Henry C; Mileshkin, Linda R; Viswanathan, Akila N; Gaffney, David K

2017-07-01

Cervical cancer is the fourth most common malignancy diagnosed in women worldwide. Nearly all cases of cervical cancer result from infection with the human papillomavirus, and the prevention of cervical cancer includes screening and vaccination. Primary treatment options for patients with cervical cancer may include surgery or a concurrent chemoradiotherapy regimen consisting of cisplatin-based chemotherapy with external beam radiotherapy and brachytherapy. Cervical cancer causes more than one quarter of a million deaths per year as a result of grossly deficient treatments in many developing countries. This warrants a concerted global effort to counter the shocking loss of life and suffering that largely goes unreported. This article provides a review of the biology, prevention, and treatment of cervical cancer, and discusses the global cervical cancer crisis and efforts to improve the prevention and treatment of the disease in underdeveloped countries. Cancer 2017;123:2404-12. © 2017 American Cancer Society. © 2017 American Cancer Society.

[Design and research progress of zero profile cervical Interbody cage].

PubMed

Zhu, Jia; Wang, Song; Liao, Zhenhua; Liu, Weiqiang

2017-02-01

Zero profile cervical interbody cage is an improvement of traditional fusion products and necessary supplement of emerging artificial intervertebral disc products. When applied in Anterior Cervical Decompression Fusion(ACDF), zero profile cervical interbody cage can preserve the advantages of traditional fusion and reduce the incidence of postoperative complications. Moreover, zero profile cervical interbody cage can be applied under the tabu symptoms of Artificial Cervical Disc Replacement(ACDR). This article summarizes zero profile interbody cage products that are commonly recognized and widely used in clinical practice in recent years, and reviews the progress of structure design and material research of zero profile cervical interbody cage products. Based on the latest clinical demands and research progress, this paper also discusses the future development directions of zero profile interbody cage.

Assessing the Acceptability, Feasibility, and Effectiveness of a Tablet-Based Cervical Cancer Educational Intervention.

PubMed

Caster, M M; Norris, A H; Butao, C; Carr Reese, P; Chemey, E; Phuka, J; Turner, A N

2017-03-01

Cervical cancer is a common and deadly disease, especially in developing countries. We developed and implemented an interactive, tablet-based educational intervention to improve cervical cancer knowledge among women in rural Malawi. Chichewa-speaking adult women in six rural villages participated. Each woman took a pretest, participated in the lesson, and then took a posttest. The lesson included information on cervical cancer symptoms, causes, risk factors, prevention, and treatment. Over the 6-month study period, 243 women participated. Women ranged in age from 18 to 77 years. Only 15 % had education beyond primary school. Nearly half of participants (48 %) had heard of cervical cancer prior to viewing the lesson. For these women, the median number of correct responses on the pretest was 11 out of 20; after the lesson, they had a median of 18 correct responses (p < 0.001). After the intervention, 93 % of women indicated a desire for cervical cancer screening. Despite lack of familiarity with computers (96 %), most women (94 %) found the tablet easy to use. A tablet-based educational program was an effective, feasible, and acceptable strategy to disseminate cervical cancer information to women with low education in rural Malawi. This method may be appropriate to distribute health information about other health topics in low-resource settings.

Using pullulan-based edible coatings to extend shelf-life of fresh-cut 'Fuji' apples.

PubMed

Wu, Shengjun; Chen, Jinhua

2013-04-01

Pullulan is a thickener that can form semipermeable films, and glutathione is an effective reducing agent, while chitooligosaccharide has antibacterial activity. In this study, effect of pullulan-based coatings in combination with antibrowning and antibacterial agents (1% pullulan; 0.8% glutathione+1% chitooligosaccharides; and 0.8% glutathione+1% chitooligosaccharides+1% pullulan) on apple slices was investigated during hypothermia storage. Pullulan-coating treatments effectively retarded enzymatic browning, maintained firmness, decreased weight loss, and inhibited microbial growth and respiration rate of apple slices during hypothermia storage compared with that of the control (p<0.05). Results indicate that using pullulan-based coatings in combination with glutathione and chitooligosaccharides is a promising way to extend the shelf-life of apple slices. Copyright © 2013 Elsevier B.V. All rights reserved.

Awareness of cervical cancer risk factors and symptoms: cross-sectional community survey in post-conflict northern Uganda.

PubMed

Mwaka, Amos D; Orach, Christopher G; Were, Edward M; Lyratzopoulos, Georgios; Wabinga, Henry; Roland, Martin

2016-08-01

Lack of awareness of risk factors and symptoms for cancer may lead to late diagnosis and poor prognosis. We assessed community awareness about cervical cancer risk factors and symptoms and perceptions about prevention and cure of cervical cancer in order to contribute data to inform interventions to improve cervical cancer survival. Cross-sectional population-based survey. We conducted this study in Gulu, a post-conflict district in Uganda in 2012. The sample included 448 persons aged 18 years and above, selected through a multi-stage stratified cluster sampling process. We collected data using a pretested structured questionnaire. Logistic regressions were used to determine magnitudes of associations between socio-demographic and outcome variables. Most participants (444/448) had heard about cervical cancer. Known risk factors including multiple sexual partners, human papillomavirus infection, and early onset of sexual activity, were recognized by 88%, 82%, and 78% of respondents respectively. 63% of participants believed that prolonged use of family planning pills and injections caused cervical cancer. The majority of participants recognized symptoms of cervical cancer including inter-menstrual bleeding (85%), post-menopausal bleeding (84%), and offensive vaginal discharge (83%). 70% of participants believed that cervical cancer is preventable and 92% believed that it could be cured if diagnosed at an early stage. Recognition of cervical cancer risk factors and symptoms was high among study participants. Targeted interventions including increasing availability of HPV vaccination, population-based cervical screening and diagnostic services can translate high awareness into actual benefits. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Vertebral pneumatocyst. A case report.

PubMed

Laufer, L; Schulman, H; Hertzanu, Y

1996-02-01

This study illustrates intraosseous pneumatocyst of the vertebral body, a benign lesion. To review the incidence and location of this benign lesion during a 1-year period. Intraosseous pneumatocyst is a rare benign condition, commonly seen in iliac bone or sacrum. The etiology of this entity is unclear. Other locations of these lesions are very rare, and only a few isolated cases are reported in the literature. In the last year (1994-1995), vertebral pneumatocyst was incidentally found in four patients who underwent computed tomography examination for presumptive discal lesion. Axial computed tomography with 2- and 4-mm slice thickness was performed. The typical computed tomography patterns of intraosseous pneumatocyst involving the cervical, dorsal, or lumbar spine were found. The bony structure and joints were normal. To the best of our knowledge, intraosseous pneumatocyst located in the spinal process has not been reported. Intraosseous pneumatocyst is a benign lesion. Biopsy and follow-up are unnecessary.

[MR myelography: analysis of 126 cases].

PubMed

Wang, W; Zhang, X; Lu, Y

2000-03-01

To investigate the value and limitation of MR myelography (MRM) in depicting the spinal canal obstruction. Heavily T2-weighted coronal MR myelography was performed with 3D fast-spin-echo (FSE) and fat-suppression sequence in 126 cases, including 6 cerebellomedullary cistern, 18 cervical, 19 thoracic and 83 lumbar cases. The resulting slice were then projected into a composite image using a standard maxium intensity projection (MIP) algorithm. 90.5% (114/126) of MRM yielded reproducible high-quality image of the spinal thecal sac. 106 lesions (extradural, intradural, intramedullary) were detected in 101 cases (80.2%). The level and degree of spinal canal obstruction were visualized and confirmed by operation in 66 cases with a high sensitivity of 100%, and a diagnostic accuracy of 91.3%. Heavily T2 FSE MR myelography is a noninvasive and reliable method. MRM surpasses conventional and CT myelography and could replace them in some degree.

Cervical Spine Clearance in Pediatric Trauma Centers: The Need for Standardization and an Evidence-based Protocol.

PubMed

Pannu, Gurpal S; Shah, Mitesh P; Herman, Marty J

Cervical spine clearance in the pediatric trauma patient represents a particularly challenging task. Unfortunately, standardized clearance protocols for pediatric cervical clearance are poorly reported in the literature and imaging recommendations demonstrate considerable variability. With the use of a web-based survey, this study aims to define the methods utilized by pediatric trauma centers throughout North America. Specific attention was given to the identification of personnel responsible for cervical spine care, diagnostic imaging modalities used, and the presence or absence of a written pediatric cervical spine clearance protocol. A 10-question electronic survey was given to members of the newly formed Pediatric Cervical Spine Study Group, all of whom are active POSNA members. The survey was submitted via the online service SurveyMonkey (https://www.surveymonkey.com/r/7NVVQZR). The survey assessed the respondent's institution demographics, such as trauma level and services primarily responsible for consultation and operative management of cervical spine injuries. In addition, respondents were asked to identify the protocols and primary imaging modality used for cervical spine clearance. Finally, respondents were asked if their institution had a documented cervical spine clearance protocol. Of the 25 separate institutions evaluated, 21 were designated as level 1 trauma centers. Considerable variation was reported with regards to the primary service responsible for cervical spine clearance. General Surgery/Trauma (44%) is most commonly the primary service, followed by a rotating schedule (33%), Neurosugery (11%), and Orthopaedic Surgery (8%). Spine consults tend to be seen most commonly by a rotating schedule of Orthopaedic Surgery and Neurosurgery. The majority of responding institutions utilize computed tomographic imaging (46%) as the primary imaging modality, whereas 42% of hospitals used x-ray primarily. The remaining institutions reported using a combination of x-ray and computed tomographic imaging. Only 46% of institutions utilize a written, standardized pediatric cervical spine clearance protocol. This study demonstrates a striking variability in the use of personnel, imaging modalities and, most importantly, standardized protocol in the evaluation of the pediatric trauma patient with a potential cervical spine injury. Cervical spine clearance protocols have been shown to decrease the incidence of missed injuries, minimize excessive radiation exposure, decrease the time to collar removal, and lower overall associated costs. It is our opinion that development of a task force or multicenter research protocol that incorporates existing evidence-based literature is the next best step in improving the care of children with cervical spine injuries. Level 4-economic and decision analyses.

Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine.

PubMed

Ferracini, Gabriela N; Florencio, Lidiane L; Dach, Fabíola; Bevilaqua Grossi, Débora; Palacios-Ceña, María; Ordás-Bandera, Carlos; Chaves, Thais C; Speciali, José G; Fernández-de-Las-Peñas, César

2017-06-01

The role of musculoskeletal disorders of the cervical spine in migraine is under debate. To investigate differences in musculoskeletal impairments of the neck including active global and upper cervical spine mobility, the presence of symptomatic upper cervical spine joints, cervicocephalic kinesthesia and head/neck posture between women with episodic migraine, chronic migraine, and controls. A cross-sectional study. Tertiary university-based hospital. Fifty-five women with episodic migraine, 16 with chronic migraine, and 22 matched healthy women. Active cervical range of motion, upper cervical spine mobility (i.e., flexion-rotation test), referred pain from upper cervical joints, cervicocephalic kinesthesia (joint position sense error test, JPSE), and head/neck posture (i.e. the cranio-vertebral and cervical lordosis angles) were assessed by an assessor blinded to the subject's condition. Women with migraine showed reduced cervical rotation than healthy women (P=0.012). No differences between episodic and chronic migraine were found in cervical mobility. Significant differences for flexion-rotation test were also reported, suggesting that upper cervical spine mobility was restricted in both migraine groups (P<0.001). Referred pain elicited on manual examination of the upper cervical spine mimicking pain symptoms was present in 50% of migraineurs. No differences were observed on the frequency of symptomatic upper cervical joints between episodic and chronic migraine. No differences on JPSE or posture were found among groups (P>0.121). Women with migraine exhibit musculoskeletal impairments of the upper cervical spine expressed as restricted cervical rotation, decreased upper cervical rotation, and the presence of symptomatic upper cervical joints. No differences were found between episodic or chronic migraine. Identification treatment of the musculoskeletal impairments of the cervical spine may help to clinician for better management of patients with migraine.

Reliability and validity of CODA motion analysis system for measuring cervical range of motion in patients with cervical spondylosis and anterior cervical fusion.

PubMed

Gao, Zhongyang; Song, Hui; Ren, Fenggang; Li, Yuhuan; Wang, Dong; He, Xijing

2017-12-01

The aim of the present study was to evaluate the reliability of the Cartesian Optoelectronic Dynamic Anthropometer (CODA) motion system in measuring the cervical range of motion (ROM) and verify the construct validity of the CODA motion system. A total of 26 patients with cervical spondylosis and 22 patients with anterior cervical fusion were enrolled and the CODA motion analysis system was used to measure the three-dimensional cervical ROM. Intra- and inter-rater reliability was assessed by interclass correlation coefficients (ICCs), standard error of measurement (SEm), Limits of Agreements (LOA) and minimal detectable change (MDC). Independent samples t-tests were performed to examine the differences of cervical ROM between cervical spondylosis and anterior cervical fusion patients. The results revealed that in the cervical spondylosis group, the reliability was almost perfect (intra-rater reliability: ICC, 0.87-0.95; LOA, -12.86-13.70; SEm, 2.97-4.58; inter-rater reliability: ICC, 0.84-0.95; LOA, -13.09-13.48; SEm, 3.13-4.32). In the anterior cervical fusion group, the reliability was high (intra-rater reliability: ICC, 0.88-0.97; LOA, -10.65-11.08; SEm, 2.10-3.77; inter-rater reliability: ICC, 0.86-0.96; LOA, -10.91-13.66; SEm, 2.20-4.45). The cervical ROM in the cervical spondylosis group was significantly higher than that in the anterior cervical fusion group in all directions except for left rotation. In conclusion, the CODA motion analysis system is highly reliable in measuring cervical ROM and the construct validity was verified, as the system was sufficiently sensitive to distinguish between the cervical spondylosis and anterior cervical fusion groups based on their ROM.

3-D Distribution of Retained Colloids in Unsaturated Porous Media

NASA Astrophysics Data System (ADS)

Morales, V. L.; Perez-Reche, F. J.; Holzner, M.; Kinzelbach, W. K.; Otten, W.

2013-12-01

It is well accepted that colloid transport processes in porous media differ substantially between water saturated and unsaturated conditions. Differences are frequently ascribed to colloid immobilization by association with interfaces with the gas, as well as to restrictions of the liquid medium through which colloids are transported. Such factors depend on interfacial conditions provided by the water saturation of the porous medium. Yet, the current understanding of the importance of colloid retention at gas interfaces is based on observations of single pores or two-dimensional pore network representations, leaving open the question of their statistical significance when all pores in the medium are considered. In order to address this question, column experiments were performed using a model porous medium of glass beads through which colloidal silver particles were transported for conditions of varying water content. X-ray microtomography was subsequently employed as a non-destructive imaging technique to obtain pore-scale information of the entire column regarding: i) the presence and distribution of the four main locations where colloids can become retained (interfaces with the liquid-solid, gas-liquid and gas-solid, and the bulk liquid), ii) deposition profiles of colloids along the column classified by the available retention location, iii) morphological characteristics of the deposited colloidal aggregates, and iv) channel widths of 3-dimensional pore-water network representations. The results presented provide, for the first time, a direct statistical evaluation on the significance of colloid retention by attachment to the liquid-solid, gas-liquid, gas-solid interfaces, and by straining in the bulk liquid. Additionally, an effective-pore structure characteristic is proposed to improve predictions of mass removal by straining under various water saturations. A) Unsaturated conditions. B) Saturated conditions. Left: Tomograph slice illustrating with false coloring Regions Of Interest corresponding to retention locations at the gas-liquid (purple), gas-solid (white) and solid-liquid interface (blue), and the bulk liquid (teal). Right: Deposition profiles of silver colloids (Ag) per retention location (T: total, GLI: gas-liquid interface, GSI: gas-solid interface, SLI: solid-liquid interface, L: bulk liquid) (Top). Depth profiles of the volume occupied by each retention location (Middle). Normalized deposition profiles of silver volume retained by its corresponding retention-location volume (Bottom).

Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey.

PubMed

Chan, Carmen W H; Choi, Kai Chow; Wong, Rosa S; Chow, Ka Ming; So, Winnie K W; Leung, Doris Y P; Lam, Wendy W T; Goggins, William

2016-12-02

Under-screening may increase the risk of cervical cancer in middle-aged women. This study aimed to investigate cervical cancer screening behaviour and its predictors among women aged 50 years or above. A population-based sample of 959 women was recruited by telephone from domestic households in Hong Kong, using random methods, and a structured questionnaire developed to survey participants. Multivariable logistic regressions were performed to examine the factors independently associated with cervical screening behaviour. Nearly half the sample (48%) had never had a cervical smear test. Multivariable analyses showed that age, educational level, marital status, family history of cancer, smoking status, use of complementary therapy, recommendation from health professionals, and believing that regular visits to a doctor or a Chinese herbalist were good for their health were predictors of cervical screening behaviour. Misconceptions concerned with menopause may reduce women's perceived susceptibility to cervical cancer, especially if they are 50 or above, and exert a negative effect on their screening behaviour. Healthcare professionals should actively approach these high-risk groups-older unmarried women, smokers, those less educated and who are generally not much concerned with their health.

Impact of whey protein coating incorporated with Bifidobacterium and Lactobacillus on sliced ham properties.

PubMed

Odila Pereira, Joana; Soares, José; J P Monteiro, Maria; Gomes, Ana; Pintado, Manuela

2018-05-01

Edible coatings/films with functional ingredients may be a solution to consumers' demands for high-quality food products and an extended shelf-life. The aim of this work was to evaluate the antimicrobial efficiency of edible coatings incorporated with probiotics on sliced ham preservation. Coatings was developed based on whey protein isolates with incorporation of Bifidobacterium animalis Bb-12® or Lactobacillus casei-01. The physicochemical analyses showed that coating decreased water and weight loss on the ham. Furthermore, color analysis showed that coated sliced ham, exhibited no color change, comparatively to uncoated slices. The edible coatings incorporating the probiotic strains inhibited detectable growth of Staphylococcus spp., Pseudomonas spp., Enterobacteriaceae and yeasts/molds, at least, for 45days of storage at 4°C. The sensory evaluation demonstrated that there was a preference for the sliced coated ham. Probiotic bacteria viable cell numbers were maintained at ca. 10 8 CFU/g throughout storage time, enabling the slice of ham to act as a suitable carrier for the beneficial bacteria. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Research strategies in standard decoction of medicinal slices].

PubMed

Chen, Shi-Lin; Liu, An; Li, Qi; Toru, Sugita; Zhu, Guang-Wei; Sun, Yi; Dai, Yun-Tao; Zhang, Jun; Zhang, Tie-Jun; Takehisa, Tomoda; Liu, Chang-Xiao

2016-04-01

This paper discusses the research situation of the standard decoction of medicinal slices at home and abroad. Combined with the experimental data, the author proposes that the standard decoction of medicinal slices is made of single herb using standard process which should be guided by the theory of traditional Chinese medicine, based on clinical practice and referred to modern extraction method with a standard process. And the author also proposes the principles of establishing the specification of process parameters and quality standards and established the basis of drug efficacy material and biological reference. As a standard material and standard system, the standard decoction of medicinal slices can provide standards for clinical medication, standardize the use of the new type of medicinal slices especially for dispensing granules, which were widely used in clinical. It can ensure the accuracy of drugs and consistency of dose, and to solve current supervision difficulties. Moreover the study of standard decoction of medicinal slices will provide the research on dispensing granules, traditional Chinese medicine prescription standard decoction and couplet medicines standard decoction a useful reference. Copyright© by the Chinese Pharmaceutical Association.

Cervical Vertigo: Historical Reviews and Advances.

PubMed

Peng, Baogan

2018-01-01

Vertigo is one of the most common presentations in adult patients. Among the various causes of vertigo, so-called cervical vertigo is still a controversial entity. Cervical vertigo was first thought to be due to abnormal input from cervical sympathetic nerves based on the work of Barré and Liéou in 1928. Later studies found that cerebral blood flow is not influenced by sympathetic stimulation. Ryan and Cope in 1955 proposed that abnormal sensory information from the damaged joint receptors of upper cervical regions may be related to pathologies of vertigo of cervical origin. Further studies found that cervical vertigo seems to originate from diseased cervical intervertebral discs. Recent research found that the ingrowth of a large number of Ruffini corpuscles into diseased cervical discs may be related to vertigo of cervical origin. Abnormal neck proprioceptive input integrated from the signals of Ruffini corpuscles in diseased cervical discs and muscle spindles in tense neck muscles secondary to neck pain is transmitted to the central nervous system and leads to a sensory mismatch with vestibular and other sensory information, resulting in a subjective feeling of vertigo and unsteadiness. Further studies are needed to illustrate the complex pathophysiologic mechanisms of cervical vertigo and to better understand and manage this perplexing entity. Copyright © 2017 Elsevier Inc. All rights reserved.

Reduction of irregular breathing artifacts in respiration-correlated CT images using a respiratory motion model.

PubMed

Hertanto, Agung; Zhang, Qinghui; Hu, Yu-Chi; Dzyubak, Oleksandr; Rimner, Andreas; Mageras, Gig S

2012-06-01

Respiration-correlated CT (RCCT) images produced with commonly used phase-based sorting of CT slices often exhibit discontinuity artifacts between CT slices, caused by cycle-to-cycle amplitude variations in respiration. Sorting based on the displacement of the respiratory signal yields slices at more consistent respiratory motion states and hence reduces artifacts, but missing image data (gaps) may occur. The authors report on the application of a respiratory motion model to produce an RCCT image set with reduced artifacts and without missing data. Input data consist of CT slices from a cine CT scan acquired while recording respiration by monitoring abdominal displacement. The model-based generation of RCCT images consists of four processing steps: (1) displacement-based sorting of CT slices to form volume images at 10 motion states over the cycle; (2) selection of a reference image without gaps and deformable registration between the reference image and each of the remaining images; (3) generation of the motion model by applying a principal component analysis to establish a relationship between displacement field and respiration signal at each motion state; (4) application of the motion model to deform the reference image into images at the 9 other motion states. Deformable image registration uses a modified fast free-form algorithm that excludes zero-intensity voxels, caused by missing data, from the image similarity term in the minimization function. In each iteration of the minimization, the displacement field in the gap regions is linearly interpolated from nearest neighbor nonzero intensity slices. Evaluation of the model-based RCCT examines three types of image sets: cine scans of a physical phantom programmed to move according to a patient respiratory signal, NURBS-based cardiac torso (NCAT) software phantom, and patient thoracic scans. Comparison in physical motion phantom shows that object distortion caused by variable motion amplitude in phase-based sorting is visibly reduced with model-based RCCT. Comparison of model-based RCCT to original NCAT images as ground truth shows best agreement at motion states whose displacement-sorted images have no missing slices, with mean and maximum discrepancies in lung of 1 and 3 mm, respectively. Larger discrepancies correlate with motion states having a larger number of missing slices in the displacement-sorted images. Artifacts in patient images at different motion states are also reduced. Comparison with displacement-sorted patient images as a ground truth shows that the model-based images closely reproduce the ground truth geometry at different motion states. Results in phantom and patient images indicate that the proposed method can produce RCCT image sets with reduced artifacts relative to phase-sorted images, without the gaps inherent in displacement-sorted images. The method requires a reference image at one motion state that has no missing data. Highly irregular breathing patterns can affect the method's performance, by introducing artifacts in the reference image (although reduced relative to phase-sorted images), or in decreased accuracy in the image prediction of motion states containing large regions of missing data. © 2012 American Association of Physicists in Medicine.

The impact of a cervical spine diagnosis on the careers of National Football League athletes.

PubMed

Schroeder, Gregory D; Lynch, T Sean; Gibbs, Daniel B; Chow, Ian; LaBelle, Mark W; Patel, Alpesh A; Savage, Jason W; Nuber, Gordon W; Hsu, Wellington K

2014-05-20

Cohort study. To determine the effect of cervical spine pathology on athletes entering the National Football League. The association of symptomatic cervical spine pathology with American football athletes has been described; however, it is unknown how preexisting cervical spine pathology affects career performance of a National Football League player. The medical evaluations and imaging reports of American football athletes from 2003 to 2011 during the combine were evaluated. Athletes with a cervical spine diagnosis were matched to controls and career statistics were compiled. Of a total of 2965 evaluated athletes, 143 players met the inclusion criteria. Athletes who attended the National Football League combine without a cervical spine diagnosis were more likely to be drafted than those with a diagnosis (P = 0.001). Players with a cervical spine diagnosis had a decreased total games played (P = 0.01). There was no difference in the number of games started (P = 0.08) or performance score (P = 0.38). In 10 athletes with a sagittal canal diameter of less than 10 mm, there was no difference in years, games played, games started, or performance score (P > 0.24). No neurological injury occurred during their careers. In 7 players who were drafted with a history of cervical spine surgery (4 anterior cervical discectomy and fusion, 2 foraminotomy, and 1 suboccipital craniectomy with a C1 laminectomy), there was no difference in career longevity or performance when compared with matched controls. This study suggests that athletes with preexisting cervical spine pathology were less likely to be drafted than controls. Players with preexisting cervical spine pathology demonstrated a shorter career than those without; however, statistically based performance and numbers of games started were not different. Players with cervical spinal stenosis and those with a history of previous surgery demonstrated no difference in performance-based outcomes and no reports of neurological injury during their careers.

Understanding the Low Level of Cervical Cancer Screening in Masaka Uganda Using the ASE Model: A Community-Based Survey.

PubMed

Twinomujuni, Cyprian; Nuwaha, Fred; Babirye, Juliet Ndimwibo

2015-01-01

Cervical cancer is one of the leading causes of cancer deaths among women globally and its impact is mostly felt in developing countries like Uganda where its prevalence is higher and utilization of cancer screening services is low. This study aimed to identify factors associated with intention to screen for cervical cancer among women of reproductive age in Masaka Uganda using the attitude, social influence and self efficacy (ASE) model. A descriptive community based survey was conducted among 416 women. A semi-structured interviewer administered questionnaire was used to collect data. Unadjusted and adjusted prevalence ratios (PR) were computed using a generalized linear model with Poisson family and a log link using STATA 12. Only 7% (29/416) of our study respondents had ever screened for cervical cancer although a higher proportion (63%, 262/416) reported intention to screen for cervical cancer. The intention to screen for cervical cancer was higher among those who said they were at risk of developing cervical cancer (Adjusted prevalence ratio [PR] 2.0, 95% CI 1.60-2.58), those who said they would refer other women for screening (Adjusted PR 1.4, 95% CI 1.06-1.88) and higher among those who were unafraid of being diagnosed with cervical cancer (Adjusted PR 1.6, 95% CI 1.36-1.93). Those who reported discussions on cervical cancer with health care providers (Adjusted PR 1.2, 95% CI 1.05-1.44), those living with a sexual partner (Adjusted PR 1.4, 95% CI 1.11-1.68), and those who were formally employed (Adjusted PR 1.2, 95% CI 1.03-1.35) more frequently reported intention to screen for cervical cancer. In conclusion, health education to increase risk perception, improve women's attitudes towards screening for cervical cancer and address the fears held by the women would increase intention to screen for cervical cancer. Interventions should also target increased discussions with health workers.

Accuracy of limited four-slice CT-scan in diagnosis of chronic rhinosinusitis.

PubMed

Zojaji, R; Nekooei, S; Naghibi, S; Mazloum Farsi Baf, M; Jalilian, R; Masoomi, M

2015-12-01

Chronic rhinosinusitis (CRS) is a common chronic health condition worldwide. Standard CT-scan is the method of choice for diagnosis of CRS but its high price and considerable radiation exposure have limited its application. The main goal of this study was to evaluate the accuracy of limited four-slice coronal CT-scan in the diagnosis of CRS. This cross-sectional study was conducted on 46 patients with CRS, for one year, based on American Society of Head and Neck Surgery criteria. All patients received the preoperative standard and four-slice CT-scans, after which endoscopic sinus surgery was performed. Findings of four-slice CT-scans were compared with those of conventional CT-scan and the sensitivity and specificity of four-slice CT-scan and its agreement with conventional CT-scan was calculated. In this study, 46 patients including 32 males (69.6%) and 14 females (30.46%) with a mean age of 33 and standard deviation of 9 years, were evaluated. Sensitivity and specificity of four-slice CT-scan were 97.5% and 100%, respectively. Also, positive predictive value (PPV) and negative predictive value (NPV) of four-slice CT was 100% and 85.71%, respectively. There was a strong agreement between four-slice CT and conventional CT findings. Considering the high sensitivity and specificity of four-slice CT-scan and strong agreement with conventional CT-scan in the diagnosis of CRS and the lower radiation exposure and cost, application of this method is suggested for both diagnosis and treatment follow-up in CRS. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Geometry Processing of Conventionally Produced Mouse Brain Slice Images.

PubMed

Agarwal, Nitin; Xu, Xiangmin; Gopi, M

2018-04-21

Brain mapping research in most neuroanatomical laboratories relies on conventional processing techniques, which often introduce histological artifacts such as tissue tears and tissue loss. In this paper we present techniques and algorithms for automatic registration and 3D reconstruction of conventionally produced mouse brain slices in a standardized atlas space. This is achieved first by constructing a virtual 3D mouse brain model from annotated slices of Allen Reference Atlas (ARA). Virtual re-slicing of the reconstructed model generates ARA-based slice images corresponding to the microscopic images of histological brain sections. These image pairs are aligned using a geometric approach through contour images. Histological artifacts in the microscopic images are detected and removed using Constrained Delaunay Triangulation before performing global alignment. Finally, non-linear registration is performed by solving Laplace's equation with Dirichlet boundary conditions. Our methods provide significant improvements over previously reported registration techniques for the tested slices in 3D space, especially on slices with significant histological artifacts. Further, as one of the application we count the number of neurons in various anatomical regions using a dataset of 51 microscopic slices from a single mouse brain. To the best of our knowledge the presented work is the first that automatically registers both clean as well as highly damaged high-resolutions histological slices of mouse brain to a 3D annotated reference atlas space. This work represents a significant contribution to this subfield of neuroscience as it provides tools to neuroanatomist for analyzing and processing histological data. Copyright © 2018 Elsevier B.V. All rights reserved.

An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening

NASA Astrophysics Data System (ADS)

Wang, Weiya; Jia, Mengyu; Gao, Feng; Yang, Lihong; Qu, Pengpeng; Zou, Changping; Liu, Pengxi; Zhao, Huijuan

2015-02-01

The cervical cancer screening at a pre-cancer stage is beneficial to reduce the mortality of women. An opto-electronic joint detection system based on DSP aiming at early cervical cancer screening is introduced in this paper. In this system, three electrodes alternately discharge to the cervical tissue and three light emitting diodes in different wavelengths alternately irradiate the cervical tissue. Then the relative optical reflectance and electrical voltage attenuation curve are obtained by optical and electrical detection, respectively. The system is based on DSP to attain the portable and cheap instrument. By adopting the relative reflectance and the voltage attenuation constant, the classification algorithm based on Support Vector Machine (SVM) discriminates abnormal cervical tissue from normal. We use particle swarm optimization to optimize the two key parameters of SVM, i.e. nuclear factor and cost factor. The clinical data were collected on 313 patients to build a clinical database of tissue responses under optical and electrical stimulations with the histopathologic examination as the gold standard. The classification result shows that the opto-electronic joint detection has higher total coincidence rate than separate optical detection or separate electrical detection. The sensitivity, specificity, and total coincidence rate increase with the increasing of sample numbers in the training set. The average total coincidence rate of the system can reach 85.1% compared with the histopathologic examination.

Cervical cancer prevention in HIV-infected women using the "see and treat" approach in Botswana.

PubMed

Ramogola-Masire, Doreen; de Klerk, Ronny; Monare, Barati; Ratshaa, Bakgaki; Friedman, Harvey M; Zetola, Nicola M

2012-03-01

Cervical cancer is a major public health problem in resource-limited settings, particularly among HIV-infected women. Given the challenges of cytology-based approaches, the efficiency of new screening programs need to be assessed. Community and hospital-based clinics in Gaborone, Botswana. To determine the feasibility and efficiency of the "see and treat" approach using visual inspection acetic acid (VIA) and enhanced digital imaging (EDI) for cervical cancer prevention in HIV-infected women. A 2-tier community-based cervical cancer prevention program was implemented. HIV-infected women were screened by nurses at the community using the VIA/EDI approach. Low-grade lesions were treated with cryotherapy on the same visit. Women with complex lesions were referred to our second tier specialized clinic for evaluation. Weekly quality control assessments were performed by a specialist in collaboration with the nurses on all pictures taken. From March 2009 through January 2011, 2175 patients were screened for cervical cancer at our community-based clinic. Two hundred fifty-three patients (11.6%) were found to have low-grade lesions and received same-day cryotherapy. One thousand three hundred forty-seven (61.9%) women were considered to have a normal examination, and 575 (27.3%) were referred for further evaluation and treatment. Of the 1347 women initially considered to have normal exams, 267 (19.8%) were recalled based on weekly quality control assessments. Two hundred ten (78.6%) of the 267 recalled women, and 499 (86.8%) of the 575 referred women were seen at the referral clinic. Of these 709 women, 506 (71.4%) required additional treatment. Overall, 264 cervical intraepithelial neoplasia stage 2 or 3 were identified and treated, and 6 microinvasive cancers identified were referred for further management. Our "see and treat" cervical cancer prevention program using the VIA/EDI approach is a feasible, high-output and high-efficiency program, worthy of considering as an additional cervical cancer screening method in Botswana, especially for women with limited access to the current cytology-based screening services.

SU-E-T-208: Comparison of MR Image Quality of Various Brachytherapy Applicators for Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Soliman, A; Elzibak, A; Fatemi, A

2015-06-15

Purpose: To compare the quality of Magnetic Resonance (MR) images of a recently-proposed novel direction-modulated brachytherapy (DMBT) tandem applicator against two conventional clinical applicators, using the current MRI clinical protocol. Methods: Three tandem applicators were compared: (1) tungsten-based DMBT applicator, (2) conventional plastic applicator and (3) conventional stainless steel applicator. Physical dimensions were 5.4, 3.8 and 3.2 for tandems (1), (2) and (3), respectively. Each applicator was placed in the same water-phantom and independently scanned using the same parameters and coil settings on a 1.5 T 450w GE scanner. Images were acquired using T2-weighted turbo-spin-echo (TSE) with 8-channel body coil.more » Acquisition parameters were TR/TE =7000/108 ms; acquisition matrix = 320 x 256; 30 slices with 4 mm thickness and 0.5 gap; pixel bandwidth = 122 Hz and voxel size = 0.5 x 0.625 mm2 and number of excitations (NEX) = 4. Multiple acquisitions were obtained in para-sagittal and para-axial views (with respect to the tandem axis) for each applicator. Diameters of the tandem were measured at multiple angles and multiple locations and compared to the physical dimensions of the corresponding tandems. Results: Minimal susceptibility artifact was observed with the DMBT and the plastic tandems. The stainless steel tandem produced significantly larger artifact than the first two tandems. The average diameter of the DMBT applicator measured 5.94 ± 0.3 mm. The average diameter of the plastic tandem measured 3.9 ± 0.1 mm. The maximum extent of artifact was 1.5 mm and 0.7 mm for DMBT and plastic tandems, respectively. The susceptibility artifact induced by the stainless steel tandem prevented the measurement of its diameter, and the edges of the tandem could not be identified in any acquisition. Conclusion: This work demonstrated that the plastic and the tungsten-based DMBT tandem applicators are both suitable for MRI-guided brachytherapy of cervical cancer.« less

Focal hypermobility observed in cervical arthroplasty with Mobi-C.

PubMed

Kerferd, Jack William; Abi-Hanna, David; Phan, Kevin; Rao, Prashanth; Mobbs, Ralph J

2017-12-01

In recent decades cervical arthroplasty, or cervical disc replacement, has been steadily increasing in popularity as a procedure for the treatment of degenerative pathologies of the cervical spine. This is based on an evolving body of literature that documents superior outcomes in cervical disc replacement over fusion, for both single and double level pathologies, in well selected patients. One of the more recent and popular implants currently on the market is the Mobi-C cervical artificial disc (LDR Medical; Troyes, France). In this paper we report on two cases where focal hypermobility was observed following total disc replacement using the Mobi-C cervical artificial disc. This is followed by a discussion as to potential contributing factors to this hypermobility in relation to both implant design, and operative technique, suggesting potential changes that might prevent this in future patients.

Development of a community cancer education program: the Forsyth County, NC cervical cancer prevention project.

PubMed

Michielutte, R; Dignan, M B; Wells, H B; Young, L D; Jackson, D S; Sharp, P C

1989-01-01

The authors outline the development and implementation of a public health education program for cervical cancer screening among black women in Forsyth County, NC. The educational program includes distributing electronic and printed information media messages, a program of direct education for women, and providing information on current issues in cervical screening to primary-care physicians. Program development was based on social marketing principles, the PRECEDE model, and the communication-behavior change (CBC) model. Since a true experimental design was not feasible, program evaluation is based on several complementary quasi-experimental designs. Analysis of baseline data indicate that the county where the intervention is taking place, and the control county, are similar with respect to both demographic characteristics and the current level of screening activity. Preliminary results indicate that the program has been successful in raising women's level of awareness of cervical cancer and cervical screening.

Higher risk for cervical herniated intervertebral disc in physicians: A retrospective nationwide population-based cohort study with claims analysis.

PubMed

Liu, Cheng; Huang, Chien-Cheng; Hsu, Chien-Chin; Lin, Hung-Jung; Guo, How-Ran; Su, Shih-Bin; Wang, Jhi-Joung; Weng, Shih-Feng

2016-10-01

There is no study about cervical herniated intervertebral disc (cervical HIVD) in physicians in the literature; therefore, we conceived a retrospective nationwide, population-based cohort study to elucidate the topic. We identified 26,038 physicians, 33,057 non-physician healthcare providers (HCPs), and identical numbers of non-HCP references (i.e., general population). All cohorts matched a 1:1 ratio with age and gender, and each were chosen from the Taiwan National Health Insurance Research Database (NHIRD). We compared cervical HIVD risk among physicians, nonphysician HCPs, and non-HCP references and performed a follow-up between 2007 and 2011. We also made comparisons among physician specialists. Both physicians and nonphysician HCPs had higher cervical HIVD risk than non-HCP references (odds ratio [OR]: 1.356; 95% confidence interval (CI): 1.162-1.582; OR: 1.383; 95% CI: 1.191-1.605, respectively). There was no significant difference of cervical HIVD risk between physicians and nonphysician HCPs. In the comparison among physician specialists, orthopedists had a higher cervical HIVD risk than other specialists, but the difference was not statistically significant (adjusted OR: 1.547; 95% CI: 0.782-3.061). Physicians are at higher cervical HIVD risk than the general population. Because unknown confounders could exist, further prospective studies are needed to identify possible causation.

Atypical Findings on Cervicovaginal Smears Correlate with Cervical Involvement by Malignant Mixed Müllerian Tumors of the Uterus.

PubMed

Hanley, Krisztina Z; Oprea-Ilies, Gabriela; Ormenisan, Claudia; Seydafkan, Shabnam; Mosunjac, Marina B

2015-01-01

A malignant mixed müllerian tumor (MMMT) is a high-grade neoplasm commonly arising from the uterus. Patients present with bleeding and a mass protruding from the cervix. This study was designed to correlate Papanicolaou (Pap) smear findings with histological findings in women diagnosed with MMMT. Women diagnosed with MMMT were identified. Preoperative Pap tests were correlated with histological findings. Statistical analysis was performed to assess associations between abnormal Pap tests and histological findings. Forty patients with MMMT were included in the study. Age ranged from 37-85 years and tumor size ranged from 1.2 to 21 cm. In presurgical Pap tests (4 conventional and 36 liquid based), 11 smears (27.5%) were diagnosed as negative, 5 (12.5%) as atypical squamous cells of undetermined significance, 6 (15%) as atypical glandular cells, 16 (40%) as malignant and 2 (5%) as high-grade squamous intraepithelial lesion. Malignant cells detected on Pap smears showed a strong correlation with endocervical involvement by MMMT (p = 0.002). Larger tumors were more likely to involve the cervix (p = 0.0115). The Pap test can predict cervical involvement by MMMT. On Pap smears, MMMT cells showed no correlation with other adverse histological features (lymphovascular invasion, myoinvasion or adnexal involvement). © 2015 S. Karger AG, Basel.

Spontaneous cervical epidural hematomas with acute hemiparesis should be considered a contraindication for intravenous thrombolysis: a case report with a literature review of 50 cases.

PubMed

Ito, Hirotaka; Takai, Keisuke; Taniguchi, Makoto

2014-01-01

We herein report the case of a 63-year-old woman with an acute spontaneous cervical epidural hematoma who presented with acute hemiparesis and was successfully managed with surgery. Based on a literature review of 50 cases of spontaneous cervical epidural hematomas, we concluded that the relatively high frequency of hemiparesis (12 of 50 cases, 24%) is the result of the fact that epidural hematomas are predominantly distributed dorsolaterally in the region of the mid and lower cervical spine, leading to unilateral cervical cord compression. Clinicians should keep in mind that acute hemiparesis can be caused by spontaneous cervical epidural hematomas for which intravenous thrombolysis is contraindicated.

Evaluation of the clinical significance of human papillomavirus (HPV) 53.

PubMed

Padalko, Elizaveta; Ali-Risasi, Catherine; Van Renterghem, Lieve; Bamelis, Mieke; De Mey, Anja; Sturtewagen, Yolande; Vastenavond, Hilde; Vanden Broeck, Davy; Weyers, Steven; Praet, Marleen

2015-08-01

Human papillomaviruses (HPV) are classified according to their potential for the development of cervical neoplasia. However, the carcinogenicity of HPV types forms an evolving continuum based on the newly available data especially regarding the role of probable and possible high-risk HPV types (pHR-HPV). The objective of the present work was to evaluate clinical significance of the pHR-HPV53. An observational cohort study of potential aetiological association between infection with HPV53 and development of high-grade cervical cytology was performed. The study was conducted in two geographically remoted hospitals, in Belgium and Democratic Republic of Congo, as an attempt to collect data from regions with different geographical distribution of HPV genotypes. The samples were taken during routine gynaecological visit in outpatient clinics of both participating hospitals. A total of 2283 liquid-Pap samples were taken from 1465 women at Ghent University Hospital, Belgium, and from 660 women at General Hospital and Ngaliema Hospital of Kinshasa, DRC. "HPV53-only"-pattern as evaluated by full HPV genotyping was found in samples from only 34 (1.6%) samples. The initial cytology represented next to non-dysplastic, undetermined and low-grade lesions also high-grade lesions (12%). For 26 (76.5%) from the 34 women presented with "HPV53-only"-pattern follow-up results were available showing no progression to malignancy. Our findings support very low to lacking carcinogenic potential of HPV53. Recognising extreme rarity in cervical cancer next to high prevalence in general population of HPV53, further studies investigating progression to high-grade lesions are needed to elucidate the oncogenic potential of pHR-HPV53. Copyright © 2015. Published by Elsevier Ireland Ltd.

HPV prevalence and HPV-related dysplasia in elderly women

PubMed Central

Hermansson, Ruth S.; Olovsson, Matts; Hoxell, Emelie

2018-01-01

Introduction In Sweden, where screening ends at the age of 60, about 30% of the cervical cancer cases occur in women older than 60. The aim of the present study was to investigate the prevalence of HPV and cervical dysplasia in women of 60 years and above. Patients and methods From September 2013 until June 2015, 1051 women aged 60–89 years (mean 68 years) were sampled for an HPV test when attending an outpatient gynecology clinic. Women with positive results had a second HPV test and liquid based cytology (LBC), after 3.5 months on average. Those with a positive second HPV test were examined by colposcopy, and biopsy and a sample for LBC was obtained. Results The prevalence of HPV was 4.1%, (95%CI 3.0–5.5, n = 43) at the first test, and at the second test 2.6% remained positive (95%CI 1.7–3.8, n = 27). The majority of women positive in both HPV tests, had dysplasia in histology, 81.5% (22/27) (4 CIN 2–0.4%, 18 CIN 1–1.7%). HPV-related dysplasia was found in 2.1%, (95%CI 1.3–3.2, n = 22) of the 1051 women. Four of the 22 women with positive HPV tests also had abnormal cytology, one ASCUS and three CIN 1. No cancer or glandular dysplasia was detected. Conclusion A significant proportion of elderly women were found to have a persistent cervical HPV infection. Among them there was a high prevalence of CIN diagnosed by histology. The HPV test showed high sensitivity and specificity in detecting CIN in elderly women, while cytology showed extremely low sensitivity. PMID:29320507

Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme.

PubMed

Ngabo, Fidele; Franceschi, Silvia; Baussano, Iacopo; Umulisa, M Chantal; Snijders, Peter J F; Uyterlinde, Anne M; Lazzarato, Fulvio; Tenet, Vanessa; Gatera, Maurice; Binagwaho, Agnes; Clifford, Gary M

2016-05-24

Cervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV). To provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18-69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR. HPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women. This study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.

Prevalence and predictors of squamous intraepithelial lesions of the cervix in HIV-infected women in Lusaka, Zambia

PubMed Central

Parham, Groesbeck P.; Sahasrabuddhe, Vikrant V.; Mwanahamuntu, Mulindi H.; Shepherd, Bryan E.; Hicks, Michael L.; Stringer, Elizabeth M.; Vermund, Sten H.

2009-01-01

Objectives HIV-infected women living in resource-constrained nations like Zambia are now accessing antiretroviral therapy and thus may live long enough for HPV-induced cervical cancer to manifest and progress. We evaluated the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Zambia. Methods We screened 150 consecutive, non-pregnant HIV-infected women accessing HIV/AIDS care services in Lusaka, Zambia. We collected cervical specimens for cytological analysis by liquid-based monolayer cytology (ThinPrep Pap Test®) and HPV typing using the Roche Linear Array® PCR assay. Results The median age of study participants was 36 years (range 23-49 years) and their median CD4+ count was 165/μL (range 7-942). The prevalence of SIL on cytology was 76% (114/150), of which 23.3% (35/150) women had low-grade SIL, 32.6% (49/150) had high-grade SIL, and 20% (30/150) had lesions suspicious for squamous cell carcinoma (SCC). High-risk HPV types were present in 85.3% (128/150) women. On univariate analyses, age of the participant, CD4+ cell count, and presence of any high-risk HPV type were significantly associated with the presence of severely abnormal cytological lesions (i.e., high-grade SIL and lesions suspicious for SCC). Multivariable logistic regression modeling suggested the presence of any high-risk HPV type as an independent predictor of severely abnormal cytology (adjusted OR: 12.4, 95% CI 2.62-58.1, p=0.02). Conclusions The high prevalence of abnormal squamous cytology in our study is one of the highest reported in any population worldwide. Screening of HIV-infected women in resource-constrained settings like Zambia should be implemented to prevent development of HPV-induced SCC. PMID:16875716

Can an inadequate cervical cytology sample in ThinPrep be converted to a satisfactory sample by processing it with a SurePath preparation?

PubMed

Sørbye, Sveinung Wergeland; Pedersen, Mette Kristin; Ekeberg, Bente; Williams, Merete E Johansen; Sauer, Torill; Chen, Ying

2017-01-01

The Norwegian Cervical Cancer Screening Program recommends screening every 3 years for women between 25 and 69 years of age. There is a large difference in the percentage of unsatisfactory samples between laboratories that use different brands of liquid-based cytology. We wished to examine if inadequate ThinPrep samples could be satisfactory by processing them with the SurePath protocol. A total of 187 inadequate ThinPrep specimens from the Department of Clinical Pathology at University Hospital of North Norway were sent to Akershus University Hospital for conversion to SurePath medium. Ninety-one (48.7%) were processed through the automated "gynecologic" application for cervix cytology samples, and 96 (51.3%) were processed with the "nongynecological" automatic program. Out of 187 samples that had been unsatisfactory by ThinPrep, 93 (49.7%) were satisfactory after being converted to SurePath. The rate of satisfactory cytology was 36.6% and 62.5% for samples run through the "gynecology" program and "nongynecology" program, respectively. Of the 93 samples that became satisfactory after conversion from ThinPrep to SurePath, 80 (86.0%) were screened as normal while 13 samples (14.0%) were given an abnormal diagnosis, which included 5 atypical squamous cells of undetermined significance, 5 low-grade squamous intraepithelial lesion, 2 atypical glandular cells not otherwise specified, and 1 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion. A total of 2.1% (4/187) of the women got a diagnosis of cervical intraepithelial neoplasia 2 or higher at a later follow-up. Converting cytology samples from ThinPrep to SurePath processing can reduce the number of unsatisfactory samples. The samples should be run through the "nongynecology" program to ensure an adequate number of cells.

High frequency of genital human papillomavirus infections and related cervical dysplasia in adolescent girls in Belgium.

PubMed

Merckx, Mireille; Benoy, Ina; Meys, Joris; Depuydt, Christophe; Temmerman, Marleen; Weyers, Steven; Vanden Broeck, Davy

2014-07-01

Human papillomavirus (HPV) infections are causally related to cervical cancer and a range of other diseases, both in adults and in minors. Information on the frequency of genital HPV infections in adolescents is sparse. The aim of this study was to gain insight into the genotype-specific distribution of HPV genotypes in patients younger than 18 years of age. This observational retrospective study included 4807 samples of patients presenting for opportunistic screening in Belgium between June 2006 and January 2012. For statistical analysis, only the first visits of patients were withheld, reducing the sample to 4180. Samples were collected in liquid-based cytology medium and analyzed using a series of genotype-specific real-time PCR reactions. Cytology was read with previous knowledge of HPV infection and scored using the Bethesda classification. The mean age was 16.9 years. Most youngsters had no complaints (88.4%), were using hormonal contraception (79.5%), and clinical examination did not show any abnormalities (96.0%). The overall HPV frequency was 15.7%, with the most frequently found types being HPV16 (16.7%), HPV51 (14.6%), HPV66 (10.4%), HPV31 (9.9%), and HPV39 (9.1%). More than one-third (39.0%) of the infected girls harbored an infection with at least two HPV genotypes. Cytological abnormalities were found in 8.2% of samples. L-SIL (4.2%) was most frequently observed, followed by ASC-US (3.6%), HSIL (0.3%), and ASC-H (0.1%). The severity of lesions worsened with increasing age. Our findings indicate that an aberrant HPV genotype profile can be found in adolescent girls; moreover, this group shows a high rate of cervical abnormalities.

Association Between Risky Sexual Behavior and Cervical Cancer Screening Among Women in Kenya: A Population-Based Study.

PubMed

Haile, Zelalem T; Kingori, Caroline; Chavan, Bhakti; Francescon, John; Teweldeberhan, Asli K

2018-04-01

Women residing in Eastern Africa are disproportionately affected by cervical cancer. Previous studies have identified risky sexual behavior as a major risk factor for cervical cancer. However, population-based studies examining the relationship between sexual behavior and cervical cancer screening are currently lacking. This descriptive cross-sectional study utilized nationally representative secondary data from the 2014 Kenya Demographic and Health Survey (n = 6104) to examine the association between risky sexual behavior and cervical cancer screening among sexually active women. Both descriptive and inferential statistical methods were utilized. Overall, 20.2% of the study sample reported having cervical cancer examination. Approximately 13.1% of the participants reported involvement in risky sexual behavior. Significantly lower proportion of women engaged in risky sexual behavior reported having cervical cancer examination (14.5 vs. 21.0%; p = 0.001). In the multivariable model, we found a significant interaction between risky sexual behavior and marital status on cervical cancer examination. Among women who were married/living together, risky sexual behavior was negatively associated with cervical cancer examination after adjusting for potential confounders (Prevalence Ratio, 95% CI) (0.42; 0.24-0.74; p = 0.002). The prevalence of having visual inspection with VIA or VILI were lower among women who were involved in risky sexual behavior (0.39; 0.18-0.87; p = 0.022). However, we were unable to detect any significant association between risky sexual behavior and having Papanicolaou test. With increasing incidence of cervical cancer in resource-limited settings, it is critical to identify populations at increased risk of infection and provide effective screening and follow-up services.

Knowledge, attitude and practices of women in maldives related to the risk factors, prevention and early detection of cervical cancer.

PubMed

Basu, Partha; Hassan, Salma; Fileeshia, Fathmath; Mohamed, Sizna; Nahoodha, Aminath; Shiuna, Aminath; Sulaiman, Asma Ibrahim; Najeeb, Nazeera; Saleem, Fathmath Jeehan

2014-01-01

A population-based cervical cancer screening program using visual inspection with acetic acid was launched in Maldives in 2014. Our study aimed to assess the knowledge, attitude and practices of women in relation to risk factors of cervical cancer, early detection of the disease and its prevention. The questionnaire based survey was conducted among 20 to 50 year old women, systematically sampled to represent three regions of Maldives. Trained investigators interviewed a total of 2,845 women at home. The prevalence of the risk factors of cervical cancer like early age at marriage and childbirth, multiple marriages, multiple marriages of the husbands, and multiple pregnancies was high. More women knew about breast cancer than cervical cancer. Even among the small number of women who knew of cervical cancer, only 34.6% had the knowledge of at least one early symptom. Very few women knew that the cancer could be prevented by any test. Only 6.2% of the women reported having ever undergone a Pap smear. Many women had the misconception that cervical cancer was infectious. In Maldives the younger women have high literacy rate due to the policy of universal free education and those with higher levels of education had improved knowledge of cervical cancer and its risk factors. The prevalence of risk factors also reduced with improved literacy. Awareness about risk factors and prevention of cervical cancer is limited among Maldivian women in spite of having high exposure to some of the risk factors. A universal literacy program in the country has helped to improve the knowledge of cervical cancer prevention and to reduce the exposure to various risk factors in the younger population.

Ataxia Telangiectasia in Siblings: Oral Motor and Swallowing Characterization.

PubMed

Rondon-Melo, Silmara; de Almeida, Isabel Junqueira; Andrade, Claudia Regina Furquim de; Sassi, Fernanda Chiarion; Molini-Avejonas, Daniela Regina

2017-07-12

BACKGROUND The body of literature on oral motor and swallowing disorders in patients with ataxia telangiectasia (AT) is limited. CASE REPORT The purpose of this study was to characterize oral motor and swallowing disorders in two siblings with AT, based on oral motor and swallowing assessments. Specific procedures were applied for oral motor and swallowing assessments and both patients underwent videofluoroscopy (VFS). Case 1 presented vocal instability, change in postural control during feeding; food retention in oral cavity; slower oral transit time; and multiple swallowing (signs for solid and liquid). Case 2 presented parted lips at rest and reduced muscle strength; reduced strength and mobility of the tongue; vocal weakness and instability; reduced speech precision and intelligibility; decreased intonation pattern; food retention in oral cavity during feeding; slower oral transit time; multiple swallowing (signs for solid and liquid); poor bolus ejection; incoordination and difficulty in controlling the sips of water taken from the cup; altered cervical auscultation after swallowing and respiratory distress (liquid and puree). For both patients VFS results revealed laryngeal penetration for liquid. CONCLUSIONS Although the literature describes the occurrence of dysarthria and swallowing disorders in patients with AT, little attention has been given to describing which oral motor deficits are responsible for these disorders. Early identification of swallowing alterations and rehabilitation could decrease the risk of aspiration pneumonia. Future studies are necessary in order to investigate the deterioration process of swallowing in AT and the influence of rehabilitation in maintaining functional health.

DIY Fraction Pack.

ERIC Educational Resources Information Center

Graham, Alan; Graham, Louise

2003-01-01

Describes a very successful attempt to teach fractions to year 5 pupils based on pupils making their own fraction pack. Children decided for themselves how to make the fractional slices used in the activity using colored cardboard sheets and templates of a paper circle consisting of 24 equal slices. (Author/NB)

The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next?

PubMed

Mitra, Anita; MacIntyre, David A; Marchesi, Julian R; Lee, Yun S; Bennett, Phillip R; Kyrgiou, Maria

2016-11-01

The vaginal microbiota plays a significant role in health and disease of the female reproductive tract. Next-generation sequencing techniques based upon the analysis of bacterial 16S rRNA genes permit in-depth study of vaginal microbial community structure to a level of detail not possible with standard culture-based microbiological techniques. The human papillomavirus (HPV) causes both cervical intraepithelial neoplasia (CIN) and cervical cancer. Although the virus is highly prevalent, only a small number of women have a persistent HPV infection and subsequently develop clinically significant disease. There is emerging evidence which leads us to conclude that increased diversity of vaginal microbiota combined with reduced relative abundance of Lactobacillus spp. is involved in HPV acquisition and persistence and the development of cervical precancer and cancer. In this review, we summarise the current literature and discuss potential mechanisms for the involvement of vaginal microbiota in the evolution of CIN and cervical cancer. The concept of manipulation of vaginal bacterial communities using pre- and probiotics is also discussed as an exciting prospect for the field of cervical pathology.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Yuxia; Gao, Ying; Cheng, Hairong

Cervical cancer is one of the most common carcinomas in the female reproductive system. Treatment of cervical cancer involves surgical removal and chemotherapy. Resistance to platinum-based chemotherapy drugs including cisplatin has increasingly become an important problem in the treatment of cervical cancer patients. We found in this study that stanniocalcin 2 (STC2) expression was upregulated in both cervical cancer tissues and cell lines. The levels of STC2 expression in cervical cancer cell lines were positively correlated with the rate of cell proliferation. Furthermore, in cisplatin resistant cervical cancer cells, the levels of STC2 expression were significantly elevated. Modulation of STC2more » expression by siRNA or overexpression in cisplatin resistant cells resulted in altered cell survival, apoptosis, and cisplatin resistance. Finally, we found that there was significant difference in the activity of the MAPK signaling pathway between cisplatin sensitive and resistant cervical cancer cells, and that STC2 could regulate the activity of the MAPK signaling pathway. - Highlights: • STC2 was upregulated in cervical cancer and promoted cervical cancer cell proliferation. • Cisplatin resistant cells had elevated STC2 levels and enhanced proliferation. • STC2 regulated cisplatin chemosensitivity in cervical cancer cells. • STC2 regulated the activity of the MAPK signaling pathway.« less

Longitudinal Analysis of Carcinogenic Human Papillomavirus Infection and Associated Cytologic Abnormalities in the Guanacaste Natural History Study: Looking Ahead to Cotesting

PubMed Central

Rodriguez, Ana C.; Burk, Robert D.; Hildesheim, Allan; Herrero, Rolando; Wacholder, Sholom; Hutchinson, Martha; Schiffman, Mark

2012-01-01

Background. Few studies have addressed the timing of cervical cytologic abnormalities and human papillomavirus (HPV) positivity during the course of an infection. It remains largely unknown how infections detected by HPV and cytology wax and wane relative to each other. The aim of this analysis was to assess the longitudinal relationship of abnormal cytology and HPV positivity in a 7-year prospective study of 2500 women in Guanacaste, Costa Rica. Methods. At each semiannual or annual visit, cervical specimens were screened using liquid-based cytology and tested for >40 HPV types with use of MY09/MY11 L1 degenerate primer polymerase chain reaction–based methods. On the basis of previous work, we separated prevalent and newly detected infections in younger and older women. Results. Among newly detected HPV- and/or cytology-positive events, HPV and cytology appeared together ∼60% of the time; when discordant, HPV tended to appear before cytology in younger and older women. Combining newly and prevalently detected events, HPV and cytology disappeared at the same time >70% of the time. When discordant, HPV tended to disappear after cytology in younger and older women. Conclusions. Detection of HPV DNA and associated cytological abnormalities tend to come and leave together; however, when discordant, detection of HPV DNA tends to precede and/or last longer than associated cytologic abnormalities. PMID:22147792

SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, X; Zhao, Z; Yang, J

Purpose: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. Methods: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification. Our current standard practice allows treating a maximum of three continuous vertebrae. Here we assess the possibility to achieve submore » millimeter setup accuracy for more than three vertebrae by examining the residual error in every slice of CBCT. The CBCT had a range of 17.5 cm, which covered 5 to 9 continuous vertebrae depending on the patient and target location. In the study, CBCT from the 1st fraction treatment was rigidly registered with the planning CT in Pinnacle. The residual setup error of a vertebra was determined by expanding the vertebra contour on the planning CT to be large enough to enclose the corresponding vertebra on CBCT. The margin of the expansion was considered as setup error. Results: Out of the 20 patients analyzed, initial setup accuracy can be achieved within 1 mm for a span of 5 or more vertebrae starting from T2 vertebra to inferior vertebra levels. 2 cervical and 2 upper thoracic patients showed the cervical spine was difficult to achieve sub millimeter accuracy for multi levels without a customized immobilization headrest. Conclusion: If the curvature of spinal columns can be reproduced in customized immobilization device during treatment as simulation, multiple continuous vertebrae can be setup within 1 mm with the use of a 6D couch.« less

Intrinsic fluorescence for cervical precancer detection using polarized light based in-house fabricated portable device

NASA Astrophysics Data System (ADS)

Meena, Bharat Lal; Singh, Pankaj; Sah, Amar Nath; Pandey, Kiran; Agarwal, Asha; Pantola, Chayanika; Pradhan, Asima

2018-01-01

An in-house fabricated portable device has been tested to detect cervical precancer through the intrinsic fluorescence from human cervix of the whole uterus in a clinical setting. A previously validated technique based on simultaneously acquired polarized fluorescence and polarized elastic scattering spectra from a turbid medium is used to extract the intrinsic fluorescence. Using a diode laser at 405 nm, intrinsic fluorescence of flavin adenine dinucleotide, which is the dominant fluorophore and other contributing fluorophores in the epithelium of cervical tissue, has been extracted. Different grades of cervical precancer (cervical intraepithelial neoplasia; CIN) have been discriminated using principal component analysis-based Mahalanobis distance and linear discriminant analysis. Normal, CIN I and CIN II samples have been discriminated from one another with high sensitivity and specificity at 95% confidence level. This ex vivo study with cervix of whole uterus samples immediately after hysterectomy in a clinical environment indicates that the in-house fabricated portable device has the potential to be used as a screening tool for in vivo precancer detection using intrinsic fluorescence.

Gradient-free MCMC methods for dynamic causal modelling

DOE PAGES

Sengupta, Biswa; Friston, Karl J.; Penny, Will D.

2015-03-14

Here, we compare the performance of four gradient-free MCMC samplers (random walk Metropolis sampling, slice-sampling, adaptive MCMC sampling and population-based MCMC sampling with tempering) in terms of the number of independent samples they can produce per unit computational time. For the Bayesian inversion of a single-node neural mass model, both adaptive and population-based samplers are more efficient compared with random walk Metropolis sampler or slice-sampling; yet adaptive MCMC sampling is more promising in terms of compute time. Slice-sampling yields the highest number of independent samples from the target density -- albeit at almost 1000% increase in computational time, in comparisonmore » to the most efficient algorithm (i.e., the adaptive MCMC sampler).« less

Fat quantification and analysis of lung transplant patients on unenhanced chest CT images based on standardized anatomic space

NASA Astrophysics Data System (ADS)

Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Wu, Caiyun; Christie, Jason; Lederer, David J.

2016-03-01

Chest fat estimation is important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification based on a recently formulated concept of standardized anatomic space (SAS) is presented. The goal of this paper is to seek answers to the following questions related to chest fat quantification on single slice versus whole volume CT, which have not been addressed in the literature. What level of correlation exists between total chest fat volume and fat areas measured on single abdominal and thigh slices? What is the anatomic location in the chest where maximal correlation of fat area with fat volume can be expected? Do the components of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) have the same area-to-volume correlative behavior or do they differ? The SAS approach includes two steps: calibration followed by transformation which will map the patient slice locations non-linearly to SAS. The optimal slice locations found for SAT and VAT based on SAS are different and at the mid-level of the T8 vertebral body for SAT and mid-level of the T7 vertebral body for VAT. Fat volume and area on optimal slices for SAT and VAT are correlated with Pearson correlation coefficients of 0.97 and 0.86, respectively. The correlation of chest fat volume with abdominal and thigh fat areas is weak to modest.

Influencing factors on cervical cancer screening from the Kurdish women's perspective: A qualitative study.

PubMed

Rasul, V H; Cheraghi, M A; Behboodi Moqadam, Z

2015-01-01

Aim: This study was aimed to explore and describe the Kurdish women's perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women's perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening.

Influencing factors on cervical cancer screening from the Kurdish women’s perspective: A qualitative study

PubMed Central

Rasul, VH; Cheraghi, MA; Behboodi Moqadam, Z

2015-01-01

Aim:This study was aimed to explore and describe the Kurdish women’s perception of cervical cancer screening. Methods: A qualitative design based on a conventional content analysis approach. Purposive sampling was applied to 19 women chosen, who had a Pap smear or refused to have one. The study was performed in the Kurdistan Region, Iraq. Semi-structure din-depth individual interviews were carried out to collect data. Results: Four main themes including conflict, belief, and awareness about cervical cancer screening and socio-cultural factors emerged during data analysis Conclusions: Cervical cancer has a high mortality rate in the developing countries. However, only a few Kurdish women participated in the cervical cancer screening in the Kurdistan Region, Iraq. Understanding the factors associated with the women’s perception of cervical cancer could guide future educational planning and clinical interventions improve the cervical cancer screening. PMID:28255397

An update of the appraisal of the accuracy and utility of cervical discography in chronic neck pain.

PubMed

Onyewu, Obi; Manchikanti, Laxmaiah; Falco, Frank J E; Singh, Vijay; Geffert, Stephanie; Helm, Standiford; Cohen, Steven P; Hirsch, Joshua A

2012-01-01

Chronic neck pain represents a significant public health problem. Despite high prevalence rates, there is a lack of consensus regarding the causes or treatments for this condition. Based on controlled evaluations, the cervical intervertebral discs, facet joints, and atlantoaxial joints have all been implicated as pain generators. Cervical provocation discography, which includes disc stimulation and morphological evaluation, is occasionally used to distinguish a painful disc from other potential sources of pain. Yet in the absence of validation and controlled outcome studies, the procedure remains mired in controversy. A systematic review of the diagnostic accuracy of cervical discography. To systematically evaluate and update the diagnostic accuracy of cervical discography. The available literature on cervical discography was reviewed. Methodological quality assessment of included studies was performed using Quality Appraisal of Reliability Studies (QAREL). Only diagnostic accuracy studies meeting at least 50% of the designated inclusion criteria were utilized for analysis. However, studies scoring less than 50% are presented descriptively and analyzed critically. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF).Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. A total of 41 manuscripts were considered for accuracy and utility of cervical discography in chronic neck pain. There were 23 studies evaluating accuracy of discography. There were 3 studies meeting inclusion criteria for assessing the accuracy and prevalence of discography, with a prevalence of 16% to 53%. Based on modified Agency for Healthcare Research and Quality (AHRQ) accuracy evaluation and United States Preventive Services Task Force (USPSTF) level of evidence criteria, this systematic review indicates the strength of evidence is limited for the diagnostic accuracy of cervical discography. Limitations include a paucity of literature, poor methodological quality, and very few studies performed utilizing International Association for the Study of Pain (IASP) criteria. There is limited evidence for the diagnostic accuracy of cervical discography. Nevertheless, in the absence of any other means to establish a relationship between pathology and symptoms, cervical provocation discography may be an important evaluation tool in certain contexts to identify a subset of patients with chronic neck pain secondary to intervertebral disc disorders. Based on the current systematic review, cervical provocation discography performed according to the IASP criteria with control disc(s), and a minimum provoked pain intensity of 7 of 10, or at least 70% reproduction of worst pain (i.e. worst spontaneous pain of 7 = 7 x 70% = 5), may be a useful tool for evaluating chronic pain and cervical disc abnormalities in a small proportion of patients.

Effect of pillow height on the biomechanics of the head-neck complex: investigation of the cranio-cervical pressure and cervical spine alignment

PubMed Central

Yang, Hui; Zhou, Yan; Lin, Jin

2016-01-01

Background While appropriate pillow height is crucial to maintaining the quality of sleep and overall health, there are no universal, evidence-based guidelines for pillow design or selection. We aimed to evaluate the effect of pillow height on cranio-cervical pressure and cervical spine alignment. Methods Ten healthy subjects (five males) aged 26 ± 3.6 years were recruited. The average height, weight, and neck length were 167 ± 9.3 cm, 59.6 ± 11.9 kg, and 12.9 ± 1.2 cm respectively. The subjects lay on pillows of four different heights (H0, 110 mm; H1, 130 mm; H2, 150 mm; and H3, 170 mm). The cranio-cervical pressure distribution over the pillow was recorded; the peak and average pressures for each pillow height were compared by one-way ANOVA with repeated measures. Cervical spine alignment was studied using a finite element model constructed based on data from the Visible Human Project. The coordinate of the center of each cervical vertebra were predicted for each pillow height. Three spine alignment parameters (cervical angle, lordosis distance and kyphosis distance) were identified. Results The average cranial pressure at pillow height H3 was approximately 30% higher than that at H0, and significantly different from those at H1 and H2 (p < 0.05). The average cervical pressure at pillow height H0 was 65% lower than that at H3, and significantly different from those at H1 and H2 (p < 0.05). The peak cervical pressures at pillow heights H2 and H3 were significantly different from that at H0 (p < 0.05). With respect to cervical spine alignment, raising pillow height from H0 to H3 caused an increase of 66.4% and 25.1% in cervical angle and lordosis distance, respectively, and a reduction of 43.4% in kyphosis distance. Discussion Pillow height elevation significantly increased the average and peak pressures of the cranial and cervical regions, and increased the extension and lordosis of the cervical spine. The cranio-cervical pressures and cervical spine alignment were height-specific, and they were believed to reflect quality of sleep. Our results provide a quantitative and objective evaluation of the effect of pillow height on the biomechanics of the head-neck complex, and have application in pillow design and selection. PMID:27635354

Get Vaccinated! & Get Tested!: Developing Primary and Secondary Cervical Cancer Prevention Videos for a Haitian Kreyòl-speaking Audience

PubMed Central

Frett, Brigitte; Aquino, Myra; Fatil, Marie; Seay, Julia; Trevil, Dinah; Fièvre, Michèle Jessica; Kobetz, Erin

2016-01-01

Although routine screening reduces cervical cancer rates between 60-90%, thousands of women worldwide are diagnosed with the disease on an annual basis due to inadequate screening. Haitian women in South Florida experience a disproportionate burden of cervical cancer with disease rates four times higher than the average for women in Miami. An ongoing community based-participatory research (CBPR) initiative to assess and reduce this burden reveals that a complex interplay of factors contributes to lack of access to screening in this community including socioeconomics, language barriers, and traditional understandings of health and disease. In an effort to address some of these barriers and encourage uptake of primary and secondary cervical cancer prevention strategies, two videos on cervical cancer prevention were created using a CBPR framework. The video screenplays were created by a Haitian screenwriter using evidence-based medical information provided by academic researchers. The films feature Haitian actors speaking a Haitian Kreyòl dialogue with a storyline portraying friends and family discussing human papillomavirus (HPV) disease and vaccination, Papanicolaou (Pap) testing, and cervical cancer. Focus groups held with Haitian women in South Florida suggest the films are engaging, feature relatable characters, and impact knowledge about HPV, cervical cancer development, and current prevention recommendations. PMID:27050619

Effects of vehicle-ride exposure on cervical pathology: a meta-analysis

PubMed Central

KOLLOCK, Roger; GAMES, Kenneth; WILSON, Alan E.; SEFTON, JoEllen M.

2015-01-01

Research to date on the effect vehicle-ride exposure has on the development of cervical pathologies in mounted Warfighters is conflicting. The purpose of this study was to determine if the literature suggests a definite effect of vehicle-ride exposure on cervical pathology. Databases were searched using multiple combinations of select terms. Twelve studies meeting the inclusion criteria were included in the meta-analysis. The results of the meta-analysis revealed that overall vehicle-ride exposure was likely to increase cervical pathology (p=0.01, odds ratio=1.59, 95% CI=1.16−2.17). Using vehicle type as a moderator it was found that vehicle-ride exposure in ground-based vehicles (p=0.01, odds ratio=2.33, 95% CI=1.41−3.85) and fixed-wing aircraft (p=0.01, odds ratio =1.59, 95% CI=1.13−2.23) were likely to increase cervical pathology. Using operator/other personnel moderator it was found that in the populations tested, fighter pilots or fighter jet weapons systems operators were more likely to develop a cervical pathology (p<0.001, odds ratio=1.78, 95% CI=1.26−2.50). The available studies indicate an increase in cervical pathology for personnel exposed to ground-based vehicles and fixed-wing aircraft. PMID:25739897

[Cervical cancer screening: past--present--future].

PubMed

Breitenecker, G

2009-12-01

Despite the undisputed and impressive success which has been achieved since the 1960s by cervical cytology in the fight against cervical cancer and its precursor stages, during which the mortality rate in industrialized countries over the last 40 years has been reduced by two-thirds to three-quarters, a perfect and error-free screening procedure is still a long way off and will probably never be reached. There are two main reasons for this, the lack of adequate coverage and suboptimal quality and assessment of smears. Two screening procedures are in use Europe, an opportunistic and an organized system. Both systems have many advantages but also disadvantages. In organized programs the coverage is higher (up to 80%), although similar numbers are also achieved by non-organized programs over a 3-year cycle, even if they cannot be so exactly documented. The decision on which system is used depends on the health system of the country, public or non-public, and many other national circumstances. However, in both systems prerequisites for a satisfactory result is a high quality in the sampling technique, the processing and the assessment. Therefore, several guidelines have been introduced by state and medical societies for internal and external quality assurance. New technologies, such as thin-layer cytology or automation for replacement or support of conventional cytology liquid-based cytology proved not to be superior enough to justify the high costs of these systems. The recognition of the strong causal relationship between persistent infection with high-risk human papillomavirus (HPV) types and cervical cancer and its precursors has resulted in the development of comparably simple tests. Primary screening using HPV typing alone is not recommended in opportunistic screening due to the low specificity but high sensitivity because it leads to many clinically irrelevant results which place women under stress. In organized screening HPV testing is always and only possible in combination with cytology. Various models and approaches are in the testing phase and appear promising. HPV testing is on the other hand well accepted and recommended as a triage test to select women with equivocal smear results (Pap group III, ASCUS) if a biopsy is required or can be followed up and also for follow-up of patients after cone biopsy. However, vaccination of young girls against oncogenic HPV types which has now become widespread still leaves many questions open for the future because the observation period is too short. There is justified hope that this will become a valuable tool in cervical cancer control and may lead to a substantial reduction in the burden of cervical cancer in the future. However, as the current vaccines on the market do not cover all oncogenic virus types and the effects of vaccination will only be observed after many years, the necessity of a cytological screening will remain unrestricted. Therefore, cervical cytology will remain as the trusted, simple to use, economic and proven, like no other method for early cancer detection, efficient procedure even in the foreseeable future. If carried out with the highest quality demands it will play a central role in the early detection of cervical cancer.

Research on major antitumor active components in Zi-Cao-Cheng-Qi decoction based on hollow fiber cell fishing with high performance liquid chromatography.

PubMed

Li, Miaomiao; Hu, Shuang; Chen, Xuan; Wang, Runqin; Bai, Xiaohong

2018-02-05

Hollow fiber cell fishing (HFCF) based on hepatoma HepG-2 cells, human renal tubular ACHN cells or human cervical carcinoma HeLa cells, coupled with high-performance liquid chromatography (HPLC), was developed and employed to research the major active components in Zi-Cao-Cheng-Qi decoction both in vitro and in vivo. The research showed that the active components, such as hesperidin, magnolol, honokiol, shikonin, emodin and β,β'-dimethylacrylshikonin were screened out by HFCF based on the cancer cells in vitro, furthermore they can be absorbed into blood and reach in the target organ, and some of the active components can be fished by the cells and maintain effective concentrations. Before application of HFCF with HPLC, cell growth state, cell survival rate, positive effect on screening results binding between active centers on the fiber and target components, repeatability of retention times and relative peak areas of the target analytes were analysed and investigated. In short, HFCF with HPLC is a simple, inexpensive, effective, and reliable method that can be used in researching active components from traditional Chinese medicine (TCM) and its formula both in vitro and in vivo, elucidating preliminarily the TCM characteristics of multiple components and multiple targets, laying a foundation for expounding the antitumor efficacy material basis in TCM. Copyright © 2017 Elsevier B.V. All rights reserved.

Comparative Analysis of Cervical Spine Management in a Subset of Severe Traumatic Brain Injury Cases Using Computer Simulation

PubMed Central

Carter, Kimbroe J.; Dunham, C. Michael; Castro, Frank; Erickson, Barbara

2011-01-01

Background No randomized control trial to date has studied the use of cervical spine management strategies in cases of severe traumatic brain injury (TBI) at risk for cervical spine instability solely due to damaged ligaments. A computer algorithm is used to decide between four cervical spine management strategies. A model assumption is that the emergency room evaluation shows no spinal deficit and a computerized tomogram of the cervical spine excludes the possibility of fracture of cervical vertebrae. The study's goal is to determine cervical spine management strategies that maximize brain injury functional survival while minimizing quadriplegia. Methods/Findings The severity of TBI is categorized as unstable, high risk and stable based on intracranial hypertension, hypoxemia, hypotension, early ventilator associated pneumonia, admission Glasgow Coma Scale (GCS) and age. Complications resulting from cervical spine management are simulated using three decision trees. Each case starts with an amount of primary and secondary brain injury and ends as a functional survivor, severely brain injured, quadriplegic or dead. Cervical spine instability is studied with one-way and two-way sensitivity analyses providing rankings of cervical spine management strategies for probabilities of management complications based on QALYs. Early collar removal received more QALYs than the alternative strategies in most arrangements of these comparisons. A limitation of the model is the absence of testing against an independent data set. Conclusions When clinical logic and components of cervical spine management are systematically altered, changes that improve health outcomes are identified. In the absence of controlled clinical studies, the results of this comparative computer assessment show that early collar removal is preferred over a wide range of realistic inputs for this subset of traumatic brain injury. Future research is needed on identifying factors in projecting awakening from coma and the role of delirium in these cases. PMID:21544239

Lack of Consensus in Physician Recommendations Regarding Return to Driving After Cervical Spine Surgery.

PubMed

Moses, Michael J; Tishelman, Jared C; Hasan, Saqib; Zhou, Peter L; Zevgaras, Ioanna; Smith, Justin S; Buckland, Aaron J; Kim, Yong; Razi, Afshin; Protopsaltis, Themistocles S

2018-03-09

Cross-Sectional Study. The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery. There is no consensus regarding post-operative driving restrictions. This study addresses how surgeons differ in their recommendations concerning cervical immobilization, narcotic analgesia, and suggested timeline of return to driving following cervical spine surgery. Surgeons at the Cervical Spine Research Society annual meeting completed anonymous surveys assessing postoperative patient management following fusion and non-fusion cervical spine surgeries. 70% of surgeons returned completed surveys (n = 71). 80.3% were orthopaedic surgeons and 94.2% completed a spine fellowship. Experienced surgeons (>15y in practice) were more likely to let patients return to driving within 2 weeks than less experienced surgeons (47.1% vs 24.3%, p = .013) for multi-level ACDF and laminectomy with fusion procedures. There were no differences between surgeons practicing inside and outside the USA for prescribing collars or return to driving time. Cervical collars were used more for fusions than non-fusions (57.7% vs 31.0%, p = .001). Surgeons reported 75.3% of patients ask when they may resume driving. For cervical fusions, 31.4% of surgeons allowed their patients to resume driving while restricting them with collars for longer durations. Furthermore, 27.5% of surgeons allowed their patients to resume driving while taking narcotics post-operatively. This survey-based study highlights the lack of consensus regarding patient 'fitness to drive' following cervical spine surgery. The importance of establishing evidence-based guidelines is critical as recommendations for driving in the post-operative period may have significant medical, legal, and financial implications. 5.

Local diffusion and diffusion-T2 distribution measurements in porous media

NASA Astrophysics Data System (ADS)

Vashaee, S.; Newling, B.; MacMillan, B.; Marica, F.; Li, M.; Balcom, B. J.

2017-05-01

Slice-selective pulsed field gradient (PFG) and PFG-T2 measurements are developed to measure spatially-resolved molecular diffusion and diffusion-T2 distributions. A spatially selective adiabatic inversion pulse was employed for slice-selection. The slice-selective pulse is able to select a coarse slice, on the order of 1 cm, at an arbitrary position in the sample. The new method can be employed to characterize oil-water mixtures in porous media. The new technique has an inherent sensitivity advantage over phase encoding imaging based methods due to signal being localized from a thick slice. The method will be advantageous for magnetic resonance of porous media at low field where sensitivity is problematic. Experimental CPMG data, following PFG diffusion measurement, were compromised by a transient ΔB0(t) field offset. The off resonance effects of ΔB0(t) were examined by simulation. The ΔB0 offset artifact in D-T2 distribution measurements may be avoided by employing real data, instead of magnitude data.

Unilateral Outer Bow Expanded Cervical Headgear Force System: 3D Analysis Using Finite Element Method

PubMed Central

Mortezai, Omid; Esmaily, Masomeh; Darvishpour, Hojat

2015-01-01

Objectives: Headgears are among the effective orthodontic appliances to achieve treatment goals. Unilateral molar distal movement is sometimes needed during an orthodontic treatment, which can be achieved by an asymmetric headgear. Different unilateral headgears have been introduced. The main goal of this study was to analyze the force system of unilateral expanded outer bow asymmetric headgears by the finite element method (FEM). Materials and Methods: Six 3D finite element models of a mesiodistal slice of the maxilla containing upper first molars, their periodontal ligaments (PDLs), cancellous bone, cortical bone, and a cervical headgear with expanded outer bow attached to maxillary first molars were designed in SolidWorks 2010 and meshed in ANSYS Workbench ver. 12.1. The models were the same except for the degree of outer bow expansion. The outer bow ends were loaded with 2 N force. The distal driving force and the net moment were evaluated. Results: A decrease in the distalizing force in the normal side molar from 1.69 N to 1.37 N was shown by increasing the degree of unilateral expansion. At the same time, the force increased from 2.19 N to 2.49 N in the expanded side molar. A net moment increasing from 2.26 N.mm to 4.64 N.mm was also shown. Conclusion: Unilateral outer bow expansion can produce different distalizing forces in molars, which increase by increasing the expansion. PMID:26622282

Definition of compartment-based radical surgery in uterine cancer: radical hysterectomy in cervical cancer as 'total mesometrial resection (TMMR)' by M Höckel translated to robotic surgery (rTMMR).

PubMed

Kimmig, Rainer; Wimberger, Pauline; Buderath, Paul; Aktas, Bahriye; Iannaccone, Antonella; Heubner, Martin

2013-08-26

Radical hysterectomy has been developed as a standard treatment in Stage I and II cervical cancers with and without adjuvant therapy. However, there have been several attempts to standardize the technique of radical hysterectomy required for different tumor extension with variable success. Total mesometrial resection as ontogenetic compartment-based oncologic surgery - developed by open surgery - can be standardized identically for all patients with locally defined tumors. It appears to be promising for patients in terms of radicalness as well as complication rates. Robotic surgery may additionally reduce morbidity compared to open surgery. We describe robotically assisted total mesometrial resection (rTMMR) step by step in cervical cancer and present feasibility data from 26 patients. Patients (n = 26) with the diagnosis of cervical cancer were included. Patients were treated by robotic total mesometrial resection (rTMMR) and pelvic or pelvic/periaortic robotic therapeutic lymphadenectomy (rtLNE) for FIGO stage IA-IIB cervical cancer. No transition to open surgery was necessary. No intraoperative complications were noted. The postoperative complication rate was 23%. Within follow-up time (mean: 18 months) we noted one distant but no locoregional recurrence of cervical cancer. There were no deaths from cervical cancer during the observation period. We conclude that rTMMR and rtLNE is a feasible and safe technique for the treatment of compartment-defined cervical cancer.

Thin-slice vision: inference of confidence measure from perceptual video quality

NASA Astrophysics Data System (ADS)

Hameed, Abdul; Balas, Benjamin; Dai, Rui

2016-11-01

There has been considerable research on thin-slice judgments, but no study has demonstrated the predictive validity of confidence measures when assessors watch videos acquired from communication systems, in which the perceptual quality of videos could be degraded by limited bandwidth and unreliable network conditions. This paper studies the relationship between high-level thin-slice judgments of human behavior and factors that contribute to perceptual video quality. Based on a large number of subjective test results, it has been found that the confidence of a single individual present in all the videos, called speaker's confidence (SC), could be predicted by a list of features that contribute to perceptual video quality. Two prediction models, one based on artificial neural network and the other based on a decision tree, were built to predict SC. Experimental results have shown that both prediction models can result in high correlation measures.

Optimized 3D stitching algorithm for whole body SPECT based on transition error minimization (TEM)

NASA Astrophysics Data System (ADS)

Cao, Xinhua; Xu, Xiaoyin; Voss, Stephan

2017-02-01

Standard Single Photon Emission Computed Tomography (SPECT) has a limited field of view (FOV) and cannot provide a 3D image of an entire long whole body SPECT. To produce a 3D whole body SPECT image, two to five overlapped SPECT FOVs from head to foot are acquired and assembled using image stitching. Most commercial software from medical imaging manufacturers applies a direct mid-slice stitching method to avoid blurring or ghosting from 3D image blending. Due to intensity changes across the middle slice of overlapped images, direct mid-slice stitching often produces visible seams in the coronal and sagittal views and maximal intensity projection (MIP). In this study, we proposed an optimized algorithm to reduce the visibility of stitching edges. The new algorithm computed, based on transition error minimization (TEM), a 3D stitching interface between two overlapped 3D SPECT images. To test the suggested algorithm, four studies of 2-FOV whole body SPECT were used and included two different reconstruction methods (filtered back projection (FBP) and ordered subset expectation maximization (OSEM)) as well as two different radiopharmaceuticals (Tc-99m MDP for bone metastases and I-131 MIBG for neuroblastoma tumors). Relative transition errors of stitched whole body SPECT using mid-slice stitching and the TEM-based algorithm were measured for objective evaluation. Preliminary experiments showed that the new algorithm reduced the visibility of the stitching interface in the coronal, sagittal, and MIP views. Average relative transition errors were reduced from 56.7% of mid-slice stitching to 11.7% of TEM-based stitching. The proposed algorithm also avoids blurring artifacts by preserving the noise properties of the original SPECT images.

TH-EF-BRA-08: A Novel Technique for Estimating Volumetric Cine MRI (VC-MRI) From Multi-Slice Sparsely Sampled Cine Images Using Motion Modeling and Free Form Deformation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harris, W; Yin, F; Wang, C

Purpose: To develop a technique to estimate on-board VC-MRI using multi-slice sparsely-sampled cine images, patient prior 4D-MRI, motion-modeling and free-form deformation for real-time 3D target verification of lung radiotherapy. Methods: A previous method has been developed to generate on-board VC-MRI by deforming prior MRI images based on a motion model(MM) extracted from prior 4D-MRI and a single-slice on-board 2D-cine image. In this study, free-form deformation(FD) was introduced to correct for errors in the MM when large anatomical changes exist. Multiple-slice sparsely-sampled on-board 2D-cine images located within the target are used to improve both the estimation accuracy and temporal resolution ofmore » VC-MRI. The on-board 2D-cine MRIs are acquired at 20–30frames/s by sampling only 10% of the k-space on Cartesian grid, with 85% of that taken at the central k-space. The method was evaluated using XCAT(computerized patient model) simulation of lung cancer patients with various anatomical and respirational changes from prior 4D-MRI to onboard volume. The accuracy was evaluated using Volume-Percent-Difference(VPD) and Center-of-Mass-Shift(COMS) of the estimated tumor volume. Effects of region-of-interest(ROI) selection, 2D-cine slice orientation, slice number and slice location on the estimation accuracy were evaluated. Results: VCMRI estimated using 10 sparsely-sampled sagittal 2D-cine MRIs achieved VPD/COMS of 9.07±3.54%/0.45±0.53mm among all scenarios based on estimation with ROI-MM-ROI-FD. The FD optimization improved estimation significantly for scenarios with anatomical changes. Using ROI-FD achieved better estimation than global-FD. Changing the multi-slice orientation to axial, coronal, and axial/sagittal orthogonal reduced the accuracy of VCMRI to VPD/COMS of 19.47±15.74%/1.57±2.54mm, 20.70±9.97%/2.34±0.92mm, and 16.02±13.79%/0.60±0.82mm, respectively. Reducing the number of cines to 8 enhanced temporal resolution of VC-MRI by 25% while maintaining the estimation accuracy. Estimation using slices sampled uniformly through the tumor achieved better accuracy than slices sampled non-uniformly. Conclusions: Preliminary studies showed that it is feasible to generate VC-MRI from multi-slice sparsely-sampled 2D-cine images for real-time 3D-target verification. This work was supported by the National Institutes of Health under Grant No. R01-CA184173 and a research grant from Varian Medical Systems.« less

Holographic photolysis of caged neurotransmitters

PubMed Central

Lutz, Christoph; Otis, Thomas S.; DeSars, Vincent; Charpak, Serge; DiGregorio, David A.; Emiliani, Valentina

2009-01-01

Stimulation of light-sensitive chemical probes has become a powerful tool for the study of dynamic signaling processes in living tissue. Classically, this approach has been constrained by limitations of lens–based and point-scanning illumination systems. Here we describe a novel microscope configuration that incorporates a nematic liquid crystal spatial light modulator (LC-SLM) to generate holographic patterns of illumination. This microscope can produce illumination spots of variable size and number and patterns shaped to precisely match user-defined elements in a specimen. Using holographic illumination to photolyse caged glutamate in brain slices, we demonstrate that shaped excitation on segments of neuronal dendrites and simultaneous, multi-spot excitation of different dendrites enables precise spatial and rapid temporal control of glutamate receptor activation. By allowing the excitation volume shape to be tailored precisely, the holographic microscope provides an extremely flexible method for activation of various photosensitive proteins and small molecules. PMID:19160517

Quantitative Analysis of the Cervical Texture by Ultrasound and Correlation with Gestational Age.

PubMed

Baños, Núria; Perez-Moreno, Alvaro; Migliorelli, Federico; Triginer, Laura; Cobo, Teresa; Bonet-Carne, Elisenda; Gratacos, Eduard; Palacio, Montse

2017-01-01

Quantitative texture analysis has been proposed to extract robust features from the ultrasound image to detect subtle changes in the textures of the images. The aim of this study was to evaluate the feasibility of quantitative cervical texture analysis to assess cervical tissue changes throughout pregnancy. This was a cross-sectional study including singleton pregnancies between 20.0 and 41.6 weeks of gestation from women who delivered at term. Cervical length was measured, and a selected region of interest in the cervix was delineated. A model to predict gestational age based on features extracted from cervical images was developed following three steps: data splitting, feature transformation, and regression model computation. Seven hundred images, 30 per gestational week, were included for analysis. There was a strong correlation between the gestational age at which the images were obtained and the estimated gestational age by quantitative analysis of the cervical texture (R = 0.88). This study provides evidence that quantitative analysis of cervical texture can extract features from cervical ultrasound images which correlate with gestational age. Further research is needed to evaluate its applicability as a biomarker of the risk of spontaneous preterm birth, as well as its role in cervical assessment in other clinical situations in which cervical evaluation might be relevant. © 2016 S. Karger AG, Basel.

[Sorting role of p16(INK4a)/Ki-67 double immunostaining in the cervical cytology specimens of ASCUS and LSIL cases].

PubMed

Yu, J; Zhu, H T; Zhao, J J; Su, J Z; Xia, Y D

2017-05-08

Objective: To investigate the sorting effect of p16(INK4a)/Ki-67 double immunostaining method in patients with atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) cytology results. Methods: Four-hundred and twenty cases collected during April 2014 to February 2015 of cervical cytology of ASCUS ( n =318) and LSIL ( n =102) were selected, and residual liquid-based cytology specimens were used for p16(INK4a)/Ki-67 double immunostaining. The sensitivity and specificity of the detection of cervical precancerous lesions and cervical cancer were calculated, and the results were compared with high risk HPV. Taking histological follow-up as the gold standard, the test was considered positive when at least one cell exhibited p16(INK4a)/Ki-67 co-staining, without requirement of adjunct morphologic interpretation of positive cells. Results: Further screening CIN2+ in cytology ASCUS and LSIL group , the sensitivity of p16(INK4a)/Ki-67 double immunostaining was slightly lower than high risk HPV (84.2% vs . 94.7%), while the specificity was higher (84.0% vs . 53.9%). For ASCUS patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 82.6% and 91.3%, and the specificity was 88.8% and 63.7%, respectively. For LSIL patients, the sensitivity of p16(INK4a)/Ki-67 double immunostaining and high risk HPV was 86.7% and 100.0%, and the specificity was 67.8% and 20.7%, respectively. For patients younger and older than 30 years, specificity of p16(INK4a)/Ki-67 double immunostaining was both higher than that of high risk HPV (80.8% vs . 42.3%; 84.6% vs . 56.9%). Conclusions: p16(INK4a)/Ki-67 double immunostaining can effectively identify the high risk population in ASCUS or LSIL, with higher specificity than high risk HPV test. p16(INK4a)/Ki-67 double immunostaining may benefit patients younger than 30 years of age as a preliminary or potential cytology-combining screening tool.

Do subjects with acute/subacute temporomandibular disorder have associated cervical impairments: A cross-sectional study.

PubMed

von Piekartz, Harry; Pudelko, Ani; Danzeisen, Mira; Hall, Toby; Ballenberger, Nikolaus

2016-12-01

There is preliminary evidence of cervical musculoskeletal impairment in some temporomandibular disorder (TMD) pain states. To determine whether people with TMD, classified as either mild or moderate/severe TMD, have more cervical signs of dysfunction than healthy subjects. Cross-sectional survey. Based on the Conti Amnestic Questionnaire and examination of the temporomandibular joint (Axis I classification of the Research Diagnostic Criteria for TMD), of 144 people examined 59 were classified to a mild TMD group, 40 to a moderate/severe TMD group and 45 to an asymptomatic control group without TMD. Subjects were evaluated for signs of cervical musculoskeletal impairment and disability including the Neck Disability Index, active cervical range of motion, the Flexion-Rotation Test, mechanical pain threshold of the upper trapezius and obliquus capitis inferior muscles, Cranio-Cervical Flexion test and passive accessory movements of the upper 3 cervical vertebrae. According to cervical musculoskeletal dysfunction, the control group without TMD were consistently the least impaired and the group with moderate/severe TMD were the most impaired. These results suggest, that the more dysfunction and pain is identified in the temporomandibular region, the greater levels of dysfunction is observable on a number of cervical musculoskeletal function tests. The pattern of cervical musculoskeletal dysfunction is distinct to other cervical referred pain phenomenon such as cervicogenic headache. These findings provide evidence that TMD in an acute/subacute pain state is strongly related with certain cervical spine musculoskeletal impairments which suggests the cervical spine should be examined in patients with TMD as a potential contributing factor. Copyright © 2016 Elsevier Ltd. All rights reserved.

An auxiliary classification diagnosis software development of cervical cancer medical data based on various artificial neural networks

NASA Astrophysics Data System (ADS)

Qi, Yong; Lei, Kai; Zhang, Lizeqing; Xing, Ximing; Gou, Wenyue

2018-06-01

This paper introduced the development of a self-serving medical data assisted diagnosis software of cervical cancer on the basis of artificial neural network (SVN, FNN, KNN). The system is developed based on the idea of self-service platform, supported by the application and innovation of neural network algorithm in medical data identification. Furthermore, it combined the advanced methods in various fields to effectively solve the complicated and inaccurate problem of cervical canceration data in the traditional manual treatment.

SU-G-206-01: A Fully Automated CT Tool to Facilitate Phantom Image QA for Quantitative Imaging in Clinical Trials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wahi-Anwar, M; Lo, P; Kim, H

Purpose: The use of Quantitative Imaging (QI) methods in Clinical Trials requires both verification of adherence to a specified protocol and an assessment of scanner performance under that protocol, which are currently accomplished manually. This work introduces automated phantom identification and image QA measure extraction towards a fully-automated CT phantom QA system to perform these functions and facilitate the use of Quantitative Imaging methods in clinical trials. Methods: This study used a retrospective cohort of CT phantom scans from existing clinical trial protocols - totaling 84 phantoms, across 3 phantom types using various scanners and protocols. The QA system identifiesmore » the input phantom scan through an ensemble of threshold-based classifiers. Each classifier - corresponding to a phantom type - contains a template slice, which is compared to the input scan on a slice-by-slice basis, resulting in slice-wise similarity metric values for each slice compared. Pre-trained thresholds (established from a training set of phantom images matching the template type) are used to filter the similarity distribution, and the slice with the most optimal local mean similarity, with local neighboring slices meeting the threshold requirement, is chosen as the classifier’s matched slice (if it existed). The classifier with the matched slice possessing the most optimal local mean similarity is then chosen as the ensemble’s best matching slice. If the best matching slice exists, image QA algorithm and ROIs corresponding to the matching classifier extracted the image QA measures. Results: Automated phantom identification performed with 84.5% accuracy and 88.8% sensitivity on 84 phantoms. Automated image quality measurements (following standard protocol) on identified water phantoms (n=35) matched user QA decisions with 100% accuracy. Conclusion: We provide a fullyautomated CT phantom QA system consistent with manual QA performance. Further work will include parallel component to automatically verify image acquisition parameters and automated adherence to specifications. Institutional research agreement, Siemens Healthcare; Past recipient, research grant support, Siemens Healthcare; Consultant, Toshiba America Medical Systems; Consultant, Samsung Electronics; NIH Grant support from: U01 CA181156.« less

Cervical cancer screening through human papillomavirus testing in community health campaigns versus health facilities in rural western Kenya.

PubMed

Huchko, Megan J; Ibrahim, Saduma; Blat, Cinthia; Cohen, Craig R; Smith, Jennifer S; Hiatt, Robert A; Bukusi, Elizabeth

2018-04-01

To determine the effectiveness of community health campaigns (CHCs) as a strategy for human papillomavirus (HPV)-based cervical cancer screening in rural western Kenya. Between January and November 2016, a cluster-randomized trial was carried out in 12 communities in western Kenya to investigate high-risk HPV testing offered via self-collection to women aged 25-65 years in CHCs versus government health facilities. Outcome measures were the total number of women accessing cervical cancer screening and the proportion of HPV-positive women accessing treatment. In total, 4944 women underwent HPV-based cervical cancer screening in CHCs (n=2898) or health facilities (n=2046). Screening uptake as a proportion of total eligible women in the population was greater in communities assigned to CHCs (60.0% vs 37.0%, P<0.001). Rates of treatment acquisition were low in both arms (CHCs 39.2%; health facilities 31.5%; P=0.408). Cervical cancer screening using HPV testing of self-collected samples reached a larger proportion of women when offered through periodic CHCs compared with health facilities. The community-based model is a promising strategy for cervical cancer prevention. Lessons learned from this trial can be used to identify ways of maximizing the impact of such strategies through greater community participation and improved linkage to treatment. ClinicalTrials.gov registration: NCT02124252. © 2017 International Federation of Gynecology and Obstetrics.

Effectiveness Modelling and Economic Evaluation of Primary HPV Screening for Cervical Cancer Prevention in New Zealand

PubMed Central

Lew, Jie-Bin; Simms, Kate; Smith, Megan; Lewis, Hazel; Neal, Harold; Canfell, Karen

2016-01-01

Background New Zealand (NZ) is considering transitioning from 3-yearly cervical cytology screening in women 20–69 years (current practice) to primary HPV screening. We evaluated HPV-based screening in both HPV-unvaccinated women and cohorts offered HPV vaccination in New Zealand (vaccination coverage ~50%). Methods A complex model of HPV transmission, vaccination, cervical screening, and invasive cervical cancer was extensively validated against national population-based datasets. Sixteen potential strategies for HPV screening were considered. Results Most primary HPV strategies were more effective than current practice, for both unvaccinated women and cohorts offered vaccination. The optimal strategy for both groups was 5-yearly HPV screening in women aged 25–69 years with partial genotyping for HPV 16/18 and referral to colposcopy, and cytological triage of other oncogenic types. This is predicted to reduce cervical cancer incidence and mortality by a further 12–16% and to save 4–13% annually in program costs (excluding overheads). The findings are sensitive to assumptions about future adherence to initiating screening at 25 years. Conclusion Primary HPV screening with partial genotyping would be more effective and less costly than the current cytology-based screening program, in both unvaccinated women and cohorts offered vaccination. These findings have been considered in a review of cervical screening in NZ. PMID:27187495

Intrinsic fluorescence based in-vivo detection of cervical precancer with hand held prototype device

NASA Astrophysics Data System (ADS)

Meena, Bharat Lal; Raikwar, Akanksha; Pandey, Kiran; Agarwal, Asha; Pantola, Chayanika; Pradhan, Asima

2018-02-01

A prototype device (hand held probe) designed and fabricated in the lab has been tested for cervical precancer detection using intrinsic fluorescence. The intrinsic fluorescence gets strongly modulated by the interplay of scattering and absorption. This masks valuable biochemical information which is present in the intrinsic fluorescence. These distortion effects can be minimized by normalizing the polarized fluorescence spectra by the polarized elastic scattering spectra. The measurements have been made with a in-house fabricated device using a 405 nm diode laser and white light source respectively. 166 sites of different grades of cervical pre-cancer biopsy samples (CIN I and CIN II) (CIN: cervical intraepithelial neoplastic) have been discriminated from 29 sites of normal biopsy samples using principal component analysis (PCA) based linear discriminant analysis (LDA). The sensitivity and specificity for discrimination of normal samples from CIN I are found to be 99% and 96% respectively. Further the normal samples can be discriminated from CIN II samples with 96% sensitivity and 96% specificity. Based on these promising ex-vivo results an in-vivo study on patients has been initiated in the hospital. The hand held device built in-house shows promise as a useful tool for in vivo cervical precancer detection by polarized fluorescence. Preliminary in-vivo results on 10 patients indicate the efficacy of the hand held device for screening cervical precancers using intrinsic fluorescence.

Maxillofacial trauma - Underestimation of cervical spine injury.

PubMed

Reich, Waldemar; Surov, Alexey; Eckert, Alexander Walter

2016-09-01

Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery. A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed. Additionally a search of relevant international literature was conducted in PubMed by terms "maxillofacial" AND "cervical spine" AND "injury". Of 3956 patients, n = 3732 (94.3%) suffered from craniomaxillofacial injuries only, n = 174 (4.4%) from cervical spine injuries only, and n = 50 (1.3%) from both craniomaxillofacial and cervical spine injuries. In this study cohort the most prevalent craniofacial injuries were: n = 41 (44%) midfacial and n = 21 (22.6%) skull base fractures. Cervical spine injuries primarily affected the upper cervical spine column: n = 39 (58.2%) vs. n = 28 (41.8%). Only in 3 of 50 cases (6%), the cervical spine injury was diagnosed coincidentally, and the cervical spine column was under immobilised. The operative treatment rate for maxillofacial injuries was 36% (n = 18), and for cervical spine injuries 20% (n = 10). The overall mortality rate was 8% (n = 4). The literature search yielded only 12 papers (11 retrospective and monocentric cohort studies) and is discussed before our own results. In cases of apparently isolated maxillofacial trauma, maxillofacial surgeons should be aware of a low but serious risk of underestimating an unstable cervical spine injury. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Drying characteristics and modeling of yam slices under different relative humidity conditions

USDA-ARS?s Scientific Manuscript database

The drying characteristics of yam slices under different 23 constant relative humidity (RH) and step-down RH levels were studied. A mass transfer model was developed based on Bi-Di correlations containing a drying coefficient and a lag factor to describe the drying process. It was validated using ex...

Brain tumor segmentation in MR slices using improved GrowCut algorithm

NASA Astrophysics Data System (ADS)

Ji, Chunhong; Yu, Jinhua; Wang, Yuanyuan; Chen, Liang; Shi, Zhifeng; Mao, Ying

2015-12-01

The detection of brain tumor from MR images is very significant for medical diagnosis and treatment. However, the existing methods are mostly based on manual or semiautomatic segmentation which are awkward when dealing with a large amount of MR slices. In this paper, a new fully automatic method for the segmentation of brain tumors in MR slices is presented. Based on the hypothesis of the symmetric brain structure, the method improves the interactive GrowCut algorithm by further using the bounding box algorithm in the pre-processing step. More importantly, local reflectional symmetry is used to make up the deficiency of the bounding box method. After segmentation, 3D tumor image is reconstructed. We evaluate the accuracy of the proposed method on MR slices with synthetic tumors and actual clinical MR images. Result of the proposed method is compared with the actual position of simulated 3D tumor qualitatively and quantitatively. In addition, our automatic method produces equivalent performance as manual segmentation and the interactive GrowCut with manual interference while providing fully automatic segmentation.

A sandwich-like differential B-dot based on EACVD polycrystalline diamond slice

NASA Astrophysics Data System (ADS)

Xu, P.; Yu, Y.; Xu, L.; Zhou, H. Y.; Qiu, C. J.

2018-06-01

In this article, we present a method of mass production of a standardized high-performance differential B-dot magnetic probe together with the magnetic field measurement in a pulsed current device with the current up to hundreds of kilo-Amperes. A polycrystalline diamond slice produced in an Electron Assisted Chemical Vapor Deposition device is used as the base and insulating material to imprint two symmetric differential loops for the magnetic field measurement. The SP3 carbon bond in the cubic lattice structure of diamond is confirmed by Raman spectra. The thickness of this slice is 20 μm. A gold loop is imprinted onto each surface of the slice by using the photolithography technique. The inner diameter, width, and thickness of each loop are 0.8 mm, 50 μm, and 1 μm, respectively. It provides a way of measuring the pulsed magnetic field with a high spatial and temporal resolution, especially in limited space. This differential magnetic probe has demonstrated a very good common-mode rejection rate through the pulsed magnetic field measurement.

Gradient-free MCMC methods for dynamic causal modelling.

PubMed

Sengupta, Biswa; Friston, Karl J; Penny, Will D

2015-05-15

In this technical note we compare the performance of four gradient-free MCMC samplers (random walk Metropolis sampling, slice-sampling, adaptive MCMC sampling and population-based MCMC sampling with tempering) in terms of the number of independent samples they can produce per unit computational time. For the Bayesian inversion of a single-node neural mass model, both adaptive and population-based samplers are more efficient compared with random walk Metropolis sampler or slice-sampling; yet adaptive MCMC sampling is more promising in terms of compute time. Slice-sampling yields the highest number of independent samples from the target density - albeit at almost 1000% increase in computational time, in comparison to the most efficient algorithm (i.e., the adaptive MCMC sampler). Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Perception and risk factors for cervical cancer among women in northern Ghana.

PubMed

Opoku, Constance A; Browne, Edmund Nii Laryea; Spangenberg, Kathryn; Moyer, Cheryl; Kolbilla, David; Gold, Katherine J

2016-06-01

This study assessed the perception of risk of cervical cancer and existence of risk factors for cervical cancer based on five known risk factors among women attending the Tamale Teaching Hospital in Tamale, Ghana. A consecutive sample of 300 women was interviewed using a semi-structured questionnaire to inquire about risk factors and perception of risk of cervical cancer. Specific risk factors that were explored included early coitarche, multiple sexual partners, polygamous relationships, history of smoking, and having a current partner who had multiple sexual partners. Sixty-one per cent of women reported that they had no personal risk for cervical cancer. 27% of respondents were in polygamous relationships, and of those, more than half didn't think they were at an increased risk of cervical cancer. 2 women had a total of ≥ 5 sexual partners in their lifetime and neither believed they were at any risk for cervical cancer. 23% said their current partner had had at least 2 sexual partners in his lifetime, and of those, (61%) thought they were at no risk for cervical cancer. 46% of respondents reported not having any of the risk factors listed in the study. 23% of respondents reported having one risk factor while 21% had two risk factors and 11% had three or more risk factors. Women's perception of personal risk for cervical cancer is lower than their actual risk based on the five behavioural risk factors assessed and a lack of knowledge of the personal factors for the disease. This project was supported by NIH Research Training Grant #R25 TW009345 funded by the Fogarty International Centre, in partnership with several NIH Institutes (NIMH, NIGMS, NHLBI, OAR and OWH).

Clinical study of quantitative diagnosis of early cervical cancer based on the classification of acetowhitening kinetics

NASA Astrophysics Data System (ADS)

Wu, Tao; Cheung, Tak-Hong; Yim, So-Fan; Qu, Jianan Y.

2010-03-01

A quantitative colposcopic imaging system for the diagnosis of early cervical cancer is evaluated in a clinical study. This imaging technology based on 3-D active stereo vision and motion tracking extracts diagnostic information from the kinetics of acetowhitening process measured from the cervix of human subjects in vivo. Acetowhitening kinetics measured from 137 cervical sites of 57 subjects are analyzed and classified using multivariate statistical algorithms. Cross-validation methods are used to evaluate the performance of the diagnostic algorithms. The results show that an algorithm for screening precancer produced 95% sensitivity (SE) and 96% specificity (SP) for discriminating normal and human papillomavirus (HPV)-infected tissues from cervical intraepithelial neoplasia (CIN) lesions. For a diagnostic algorithm, 91% SE and 90% SP are achieved for discriminating normal tissue, HPV infected tissue, and low-grade CIN lesions from high-grade CIN lesions. The results demonstrate that the quantitative colposcopic imaging system could provide objective screening and diagnostic information for early detection of cervical cancer.

[S3 guidelines on diagnostics and treatment of cervical cancer: Demands on pathology].

PubMed

Horn, L-C; Beckmann, M W; Follmann, M; Koch, M C; Mallmann, P; Marnitz, S; Schmidt, D

2015-11-01

Between 2011 and the end of 2014 the former consensus S2k guidelines for the diagnostics and treatment of cervical cancer were updated and upgraded to S3 level, methodologically based on the regulations of the German Cancer Society (DKG). The present article summarizes the relevant aspects for the sectioning, histopathological workup, diagnostics and reporting for the pathology of invasive cancer of the uterine cervix. The recommendations are based on the most recent World Health Organization (WHO) and TNM classification systems and consider the needs of the clinician for appropriate surgical and radiotherapeutic treatment of patients. Detailed processing rules of colposcopy-guided diagnostic biopsies, conization and trachelectomy as well as for radical hysterectomy specimens and lymph node resection (including sentinel lymph node resection) are given. In the guidelines deep stromal invasion in macroinvasive cervical cancer is defined for the first time as tumor infiltration of > 66% of the cervical stromal wall. Furthermore, morphological prognostic factors for microinvasive and macroinvasive cervical cancer are summarized.

A cervical cancer community-based participatory research project in a Native American community.

PubMed

Christopher, Suzanne; Gidley, Allison L; Letiecq, Bethany; Smith, Adina; McCormick, Alma Knows His Gun

2008-12-01

The Messengers for Health on the Apsáalooke Reservation project uses a community-based participatory research (CBPR) approach and lay health advisors (LHAs) to generate knowledge and awareness about cervical cancer prevention among community members in a culturally competent manner. Northern Plains Native Americans, of whom Apsáalooke women are a part, continue to be disproportionately affected by cervical cancer. This article examines quantitative and qualitative changes that occurred in the community since the inception of the Messengers for Health program. Paired sample t tests are used to evaluate the one-group pretest and posttest interviews of 83 Apsáalooke women in knowledge, comfort, and cancer awareness levels. Results reveal cervical cancer knowledge gains, gains in participants' comfort discussing cancer issues, and gains in awareness of cervical cancer and the Messengers program. Field notes, meeting minutes, and community perceptions are used to qualitatively evaluate the effectiveness of the Messengers program. Practice implications are discussed.

National Athletic Trainers' Association Position Statement: Acute Management of the Cervical Spine–Injured Athlete

PubMed Central

Swartz, Erik E; Boden, Barry P; Courson, Ronald W; Decoster, Laura C; Horodyski, MaryBeth; Norkus, Susan A; Rehberg, Robb S; Waninger, Kevin N

2009-01-01

Objective: To provide certified athletic trainers, team physicians, emergency responders, and other health care professionals with recommendations on how to best manage a catastrophic cervical spine injury in the athlete. Background: The relative incidence of catastrophic cervical spine injury in sports is low compared with other injuries. However, cervical spine injuries necessitate delicate and precise management, often involving the combined efforts of a variety of health care providers. The outcome of a catastrophic cervical spine injury depends on the efficiency of this management process and the timeliness of transfer to a controlled environment for diagnosis and treatment. Recommendations: Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport, such as football, hockey, or lacrosse; and considerations in the emergency department. PMID:19478836

In vivo photoacoustic imaging of uterine cervical lesion and its image processing based on light propagation in biological medium

NASA Astrophysics Data System (ADS)

Okawa, Shinpei; Sei, Kiguna; Hirasawa, Takeshi; Irisawa, Kaku; Hirota, Kazuhiro; Wada, Takatsugu; Kushibiki, Toshihiro; Furuya, Kenichi; Ishihara, Miya

2017-03-01

For diagnosis of cervical cancer, screening by colposcope and successive biopsy are usually carried out. Colposcope, which is a mesoscope, is used to examine surface of the cervix and to find precancerous lesion grossly. However, the accuracy of colposcopy depends on the skills of the examiner and is inconsistent as a result. Additionally, colposcope lacks depth information. It is known that microvessel density and blood flow in cervical lesion increases associated with angiogenesis. Therefore, photoacoustic imaging (PAI) to detect angiogenesis in cervical lesion has been studied. PAI can diagnose cervical lesion sensitively and provide depth information. The authors have been investigating the efficacy of PAI in the diagnoses of the cervical lesion and cancer by use of the PAI and ultrasonography system with transvaginal probe developed by Fujifilm Corporation. For quantitative diagnosis by use of PAI, it is required to take the light propagation in biological medium into account. The image reconstruction of the absorption coefficient from the PA image of cervix by use of the simulation of light propagation based on finite element method has been tried in this study. Numerical simulation, phantom experiment and in vivo imaging were carried out.

Cervical spine joint hypermobility: a possible predisposing factor for new daily persistent headache.

PubMed

Rozen, T D; Roth, J M; Denenberg, N

2006-10-01

The objective of this study was to suggest that joint hypermobility (specifically of the cervical spine) is a predisposing factor for the development of new daily persistent headache (NDPH). Twelve individuals (10 female, 2 male) with primary NDPH were evaluated by one of two physical therapists. Each patient was tested for active cervical range of motion and for the presence of excessive intersegmental vertebral motion in the cervical spine. All patients were screened utilizing the Beighton score, which determines degree of systemic hypermobility. Eleven of the 12 NDPH patients were found to have cervical spine joint hypermobility. Ten of the 12 NDPH patients had evidence of widespread joint hypermobility with the Beighton score. Based on our findings we suggest that joint hypermobility, specifically of the cervical spine, may be a predisposing factor for the development of NDPH.

Body composition estimation from selected slices: equations computed from a new semi-automatic thresholding method developed on whole-body CT scans

PubMed Central

Villa, Chiara; Brůžek, Jaroslav

2017-01-01

Background Estimating volumes and masses of total body components is important for the study and treatment monitoring of nutrition and nutrition-related disorders, cancer, joint replacement, energy-expenditure and exercise physiology. While several equations have been offered for estimating total body components from MRI slices, no reliable and tested method exists for CT scans. For the first time, body composition data was derived from 41 high-resolution whole-body CT scans. From these data, we defined equations for estimating volumes and masses of total body AT and LT from corresponding tissue areas measured in selected CT scan slices. Methods We present a new semi-automatic approach to defining the density cutoff between adipose tissue (AT) and lean tissue (LT) in such material. An intra-class correlation coefficient (ICC) was used to validate the method. The equations for estimating the whole-body composition volume and mass from areas measured in selected slices were modeled with ordinary least squares (OLS) linear regressions and support vector machine regression (SVMR). Results and Discussion The best predictive equation for total body AT volume was based on the AT area of a single slice located between the 4th and 5th lumbar vertebrae (L4-L5) and produced lower prediction errors (|PE| = 1.86 liters, %PE = 8.77) than previous equations also based on CT scans. The LT area of the mid-thigh provided the lowest prediction errors (|PE| = 2.52 liters, %PE = 7.08) for estimating whole-body LT volume. We also present equations to predict total body AT and LT masses from a slice located at L4-L5 that resulted in reduced error compared with the previously published equations based on CT scans. The multislice SVMR predictor gave the theoretical upper limit for prediction precision of volumes and cross-validated the results. PMID:28533960

Body composition estimation from selected slices: equations computed from a new semi-automatic thresholding method developed on whole-body CT scans.

PubMed

Lacoste Jeanson, Alizé; Dupej, Ján; Villa, Chiara; Brůžek, Jaroslav

2017-01-01

Estimating volumes and masses of total body components is important for the study and treatment monitoring of nutrition and nutrition-related disorders, cancer, joint replacement, energy-expenditure and exercise physiology. While several equations have been offered for estimating total body components from MRI slices, no reliable and tested method exists for CT scans. For the first time, body composition data was derived from 41 high-resolution whole-body CT scans. From these data, we defined equations for estimating volumes and masses of total body AT and LT from corresponding tissue areas measured in selected CT scan slices. We present a new semi-automatic approach to defining the density cutoff between adipose tissue (AT) and lean tissue (LT) in such material. An intra-class correlation coefficient (ICC) was used to validate the method. The equations for estimating the whole-body composition volume and mass from areas measured in selected slices were modeled with ordinary least squares (OLS) linear regressions and support vector machine regression (SVMR). The best predictive equation for total body AT volume was based on the AT area of a single slice located between the 4th and 5th lumbar vertebrae (L4-L5) and produced lower prediction errors (|PE| = 1.86 liters, %PE = 8.77) than previous equations also based on CT scans. The LT area of the mid-thigh provided the lowest prediction errors (|PE| = 2.52 liters, %PE = 7.08) for estimating whole-body LT volume. We also present equations to predict total body AT and LT masses from a slice located at L4-L5 that resulted in reduced error compared with the previously published equations based on CT scans. The multislice SVMR predictor gave the theoretical upper limit for prediction precision of volumes and cross-validated the results.

The Forsyth County Cervical Cancer Prevention Project--I. Cervical cancer screening for black women.

PubMed

Dignan, M; Michielutte, R; Wells, H B; Bahnson, J

1994-12-01

The Forsyth County Cervical Cancer Prevention Project was a 5 year National Cancer Institute-funded community-based public health education program implemented to address the problem of excess mortality from cervical cancer among black women in Forsyth County, North Carolina. The intervention was a community-based public health education program that included mass media, direct education workshops, and provision of education on cervical cancer and screening to health care providers. The intervention was implemented from November 1988 to September 1991. Evaluation of the community intervention used a quasi-experimental design, with Forsyth County, North Carolina, receiving the program and Durham County, North Carolina, serving as the control. Comparison of pre- and post-intervention telephone survey data revealed that, overall, awareness of cervical cancer and the Pap smear increased. Knowledge, attitudes and behaviors showed little change, considering those interviewed in aggregate. Among women defined as high-risk (elderly, low socioeconomic status, public health clinic patients and/or those who do not receive regular care), a significant trend toward greater participation in screening was detected for the 6 month period following the intervention. These results suggest that awareness of cervical cancer can be increased by public health education, but that the additional attention coming to patients through the actions of health care providers and health care delivery systems may supply the additional input needed to produce behavior change.

Improving the time efficiency of the Fourier synthesis method for slice selection in magnetic resonance imaging.

PubMed

Tahayori, B; Khaneja, N; Johnston, L A; Farrell, P M; Mareels, I M Y

2016-01-01

The design of slice selective pulses for magnetic resonance imaging can be cast as an optimal control problem. The Fourier synthesis method is an existing approach to solve these optimal control problems. In this method the gradient field as well as the excitation field are switched rapidly and their amplitudes are calculated based on a Fourier series expansion. Here, we provide a novel insight into the Fourier synthesis method via representing the Bloch equation in spherical coordinates. Based on the spherical Bloch equation, we propose an alternative sequence of pulses that can be used for slice selection which is more time efficient compared to the original method. Simulation results demonstrate that while the performance of both methods is approximately the same, the required time for the proposed sequence of pulses is half of the original sequence of pulses. Furthermore, the slice selectivity of both sequences of pulses changes with radio frequency field inhomogeneities in a similar way. We also introduce a measure, referred to as gradient complexity, to compare the performance of both sequences of pulses. This measure indicates that for a desired level of uniformity in the excited slice, the gradient complexity for the proposed sequence of pulses is less than the original sequence. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Determination of spatial dose distribution in UCC treatments with LDR brachytherapy using Monte Carlo methods.

PubMed

Benites-Rengifo, Jorge Luis; Vega-Carrillo, Hector Rene

2018-05-19

Using Monte Carlos methods, with the MCNP5 code, a gynecological phantom and a vaginal cylinder were modeled. The spatial distribution of absorbed dose rates in Uterine Cervical Cancer treatment through low dose rate brachytherapy was determined. A liquid water gynecology computational phantom, including a vaginal cylinder applicator made of Lucite, was designed. The applicator has a linear array of four radioactive sources of Cesium 137. Around the vaginal cylinder, 13 water spherical cells of 0.5 cm-diameter were modeled to calculate absorbed dose emulating the procedure made by the treatment planning system. The gamma-ray fluence distribution was estimated, as well as the absorbed doses resulting approximately symmetrical for cells located at upper and lower of vaginal cylinder. Obtained results allow the use of the radioactive decay law to determine dose rate for Uterine Cervical Cancer using low dose rate brachytherapy. Copyright © 2018 Elsevier Ltd. All rights reserved.

The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain.

PubMed

Falla, Deborah; O'Leary, Shaun; Farina, Dario; Jull, Gwendolen

2012-09-01

Altered activation of the deep cervical flexors (longus colli and longus capitis) has been found in individuals with neck pain disorders but the response to training has been variable. Therefore, this study investigated the relationship between change in deep cervical flexor muscle activity and symptoms in response to specific training. Fourteen women with chronic neck pain undertook a 6-week program of specific training that consisted of a craniocervical flexion exercise performed twice per day (10 to 20 min) for the duration of the trial. The exercise targets the deep flexor muscles of the upper cervical region. At baseline and follow-up, measures were taken of neck pain intensity (visual analogue scale, 0 to 10), perceived disability (Neck Disability Index, 0 to 50) and electromyography (EMG) of the deep cervical flexors (by a nasopharyngeal electrode suctioned over the posterior oropharyngeal wall) during performance of craniocervical flexion. After training, the activation of the deep cervical flexors increased (P<0.0001) with the greatest change occurring in patients with the lowest values of deep cervical flexor EMG amplitude at baseline (R(2)=0.68; P<0.001). There was a significant relationship between initial pain intensity, change in pain level with training, and change in EMG amplitude for the deep cervical flexors during craniocervical flexion (R(2)=0.34; P<0.05). Specific training of the deep cervical flexor muscles in women with chronic neck pain reduces pain and improves the activation of these muscles, especially in those with the least activation of their deep cervical flexors before training. This finding suggests that the selection of exercise based on a precise assessment of the patients' neuromuscular control and targeted exercise interventions based on this assessment are likely to be the most beneficial to patients with neck pain.

Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer.

PubMed

Chen, Hui-Chi; Schiffman, Mark; Lin, Ching-Yu; Pan, Mei-Hung; You, San-Lin; Chuang, Li-Chung; Hsieh, Chang-Yao; Liaw, Kai-Li; Hsing, Ann W; Chen, Chien-Jen

2011-09-21

Human papillomavirus (HPV) persistence is the pivotal event in cervical carcinogenesis. We followed a large-scale community-based cohort for 16 years to investigate the role of genotype-specific HPV persistence in predicting cervical cancer including invasive and in situ carcinoma. At the baseline examination in 1991-1992, 11,923 participants (aged 30-65 years) consented to HPV testing and cytology; 6923 participants were reexamined in 1993-1995. For HPV testing, we used a polymerase chain reaction-based assay that detected 39 HPV types. Women who developed cervical cancer were identified from cancer and death registries. Cumulative risks for developing cervical cancer among infected and persistently infected women were calculated by the Kaplan-Meier method. Of 10,123 women who were initially cytologically normal, 68 developed cervical cancer. The 16-year cumulative risks of subsequent cervical cancer for women with HPV16, HPV58 (without HPV16), or other carcinogenic HPV types (without HPV16 or HPV58) were 13.5%, 10.3%, and 4.0%, respectively, compared with 0.26% for HPV-negative women. Women with type-specific persistence of any carcinogenic HPV had greatly increased risk compared with women who were HPV-negative at both visits (hazard ratio = 75.4, 95% confidence interval = 31.8 to 178.9). The cumulative cervical cancer risks following persistent carcinogenic HPV infections increased with age: The risks were 5.5%, 14.4%, and 18.1% for women aged 30-44 years, 45-54 years, and 55 years and older, respectively. However, newly acquired infections were associated with a low risk of cervical cancer regardless of age. HPV negativity was associated with a very low long-term risk of cervical cancer. Persistent detection of HPV among cytologically normal women greatly increased risk. Thus, it is useful to perform repeated HPV testing following an initial positive test.

The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based magnetic resonance imaging study: the Wakayama Spine Study.

PubMed

Nagata, Keiji; Yoshimura, Noriko; Hashizume, Hiroshi; Muraki, Shigeyuki; Ishimoto, Yuyu; Yamada, Hiroshi; Takiguchi, Noboru; Nakagawa, Yukihiro; Minamide, Akihito; Oka, Hiroyuki; Kawaguchi, Hiroshi; Nakamura, Kozo; Akune, Toru; Yoshida, Munehito

2014-12-01

A narrow cervical spinal canal (CSC) is a well-known risk factor for cervical myelopathy (CM). However, no epidemiologic data of the CSC based on a population-based cohort are available. The purpose of the study was to investigate the age-related differences in CSC diameters on plain radiographs and to examine the associated magnetic resonance imaging (MRI) abnormalities including cervical cord compression and increased signal intensity (ISI) as well as the clinical CM with the narrow CSC. This was a cross-sectional study. Data were obtained from the baseline survey of the Wakayama Spine Study that was performed from 2008 to 2010 in a western part of Japan. Finally, a total of 959 subjects (319 men and 640 women; mean age, 66.4 years) were included. The outcome measures included in the study were the CSC diameter at C5 level on plain radiographs, cervical cord compression and ISI on sagittal T2-weighted MRI, and physical signs related to CM (eg, the Hoffmann reflex, hyperreflexia of the patellar tendon, the Babinski reflex, sensory and motor function, and bowel/bladder symptoms). The age-related differences of CSC diameters in men and women were investigated by descriptive statistics. The prevalence of MRI abnormalities and clinical CM was compared among the groups divided by the CSC diameter (less than 13, 13-15, and 15 mm or more). In addition, a logistic regression analysis was performed to determine the association of the CSC diameter with cervical cord compression/clinical CM after overall adjustment for age, sex, and body mass index. The CSC diameter was narrower with increasing age in both men and women. The prevalence of cervical cord compression, ISI, and the clinical CM was significantly higher in the narrower CSC group. The prevalence of cervical cord compression, ISI, and CM among subjects with CSC diameter less than 13 mm was 38.0%, 5.4%, and 10.1%, respectively. In the logistic model, the CSC diameter was a significant predictive factor for the clinical CM (p<.0001). This study firstly confirmed the age-related differences in CSC diameters and the significant association of the narrow CSC diameter with CM in a population-based cohort. Copyright © 2014 Elsevier Inc. All rights reserved.

Cervical Cancer Prevention in HIV-infected Women Using the “See and Treat” Approach in Botswana

PubMed Central

Ramogola-Masire, Doreen; de Klerk, Ronny; Monare, Barati; Ratshaa, Bakgaki; Friedman, Harvey M.; Zetola, Nicola M.

2013-01-01

Background Cervical cancer is a major public health problem in resource-limited settings, particularly among HIV-infected women. Given the challenges of cytology-based approaches, the efficiency of new screening programs need to be assessed. Setting Community and hospital-based clinics in Gaborone, Botswana. Objective To determine the feasibility, and efficiency of the “See and Treat” approach using Visual Inspection Acetic Acid (VIA) and Enhanced Digital Imaging (EDI) for cervical cancer prevention in HIV-infected women. Methods A two-tier community-based cervical cancer prevention program was implemented. HIV-infected women were screened by nurses at the community using the VIA/EDI approach. Low-grade lesions were treated with cryotherapy on the same visit. Women with complex lesions were referred to our second tier, specialized clinic for evaluation. Weekly quality control assessments were performed by a specialist in collaboration with the nurses on all pictures taken. Results From March 2009 through January 2011, 2,175 patients were screened for cervical cancer at our community-based clinic. 253 (11.6%) were found to have low-grade lesions and received same-day cryotherapy. 1,347 (61.9%) women were considered to have a normal examination and 575 (27.3%) were referred for further evaluation and treatment. Of the 1,347 women initially considered to have normal exams, 267 (19.8%) were recalled based on weekly quality control assessments. 210 (78.6%) of the 267 recalled women and 499 (86.8%) of the 575 referred women were seen at the referral clinic. Of these 709 women, 506 (71.4%) required additional treatment. Overall, 264 CIN stage 2 or 3 were identified and treated, and six micro-invasive cancers identified were referred for further management. Conclusions Our “See and Treat” cervical cancer prevention program using the VIA/EDI approach is a feasible, high-output and high-efficiency program, worthy of considering as an additional cervical cancer screening method in Botswana, especially for women with limited access to the current cytology-based screening services. PMID:22134146

Shelf-life extension of refrigerated sea bass slices wrapped with fish protein isolate/fish skin gelatin-ZnO nanocomposite film incorporated with basil leaf essential oil.

PubMed

Arfat, Yasir Ali; Benjakul, Soottawat; Vongkamjan, Kitiya; Sumpavapol, Punnanee; Yarnpakdee, Suthasinee

2015-10-01

Microbiological, chemical and sensory changes of sea bass slices wrapped with fish protein isolate (FPI)/fish skin gelatin (FSG) films incorporated with 3 % ZnO nanoparticles (ZnONP) (w/w, based on protein content) and 100 % basil leaf essential oil (BEO) (w/w, based on protein content) during storage of 12 days at 4 °C were investigated. Sea bass slices wrapped with FPI/FSG-ZnONP-BEO film had the lowest growth of psychrophilic bacteria, lactic acid bacteria and spoilage microorganisms including Pseudomonas , H2S-producing bacteria and Enterobacteriaceae throughout storage of 12 days in comparison with those wrapped with FPI/FSG-BEO, FPI/FSG-ZnONP, FPI/FSG film, polypropylene film (PP film) and the control (without wrapping), respectively (P < 0.05). Lowered increases in pH, total volatile base, peroxide value and TBARS value were found in FPI/FSG-ZnO-BEO film wrapped samples, compared with others (P < 0.05). Sensory evaluation revealed that shelf-life of sea bass slices was longest for samples wrapped with FPI/FSG-ZnONP-BEO film (12 days), as compared to the control (6 days) (P < 0.05).

Accuracy of lung nodule density on HRCT: analysis by PSF-based image simulation.

PubMed

Ohno, Ken; Ohkubo, Masaki; Marasinghe, Janaka C; Murao, Kohei; Matsumoto, Toru; Wada, Shinichi

2012-11-08

A computed tomography (CT) image simulation technique based on the point spread function (PSF) was applied to analyze the accuracy of CT-based clinical evaluations of lung nodule density. The PSF of the CT system was measured and used to perform the lung nodule image simulation. Then, the simulated image was resampled at intervals equal to the pixel size and the slice interval found in clinical high-resolution CT (HRCT) images. On those images, the nodule density was measured by placing a region of interest (ROI) commonly used for routine clinical practice, and comparing the measured value with the true value (a known density of object function used in the image simulation). It was quantitatively determined that the measured nodule density depended on the nodule diameter and the image reconstruction parameters (kernel and slice thickness). In addition, the measured density fluctuated, depending on the offset between the nodule center and the image voxel center. This fluctuation was reduced by decreasing the slice interval (i.e., with the use of overlapping reconstruction), leading to a stable density evaluation. Our proposed method of PSF-based image simulation accompanied with resampling enables a quantitative analysis of the accuracy of CT-based evaluations of lung nodule density. These results could potentially reveal clinical misreadings in diagnosis, and lead to more accurate and precise density evaluations. They would also be of value for determining the optimum scan and reconstruction parameters, such as image reconstruction kernels and slice thicknesses/intervals.

Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

PubMed Central

Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.

2014-01-01

Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How does one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous. PMID:24877839

Optimization of abdominal fat quantification on CT imaging through use of standardized anatomic space: A novel approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tong, Yubing; Udupa, Jayaram K., E-mail: jay@mail.med.upenn.edu; Torigian, Drew A.

Purpose: The quantification of body fat plays an important role in the study of numerous diseases. It is common current practice to use the fat area at a single abdominal computed tomography (CT) slice as a marker of the body fat content in studying various disease processes. This paper sets out to answer three questions related to this issue which have not been addressed in the literature. At what single anatomic slice location do the areas of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) estimated from the slice correlate maximally with the corresponding fat volume measures? How doesmore » one ensure that the slices used for correlation calculation from different subjects are at the same anatomic location? Are there combinations of multiple slices (not necessarily contiguous) whose area sum correlates better with volume than does single slice area with volume? Methods: The authors propose a novel strategy for mapping slice locations to a standardized anatomic space so that same anatomic slice locations are identified in different subjects. The authors then study the volume-to-area correlations and determine where they become maximal. To address the third issue, the authors carry out similar correlation studies by utilizing two and three slices for calculating area sum. Results: Based on 50 abdominal CT data sets, the proposed mapping achieves significantly improved consistency of anatomic localization compared to current practice. Maximum correlations are achieved at different anatomic locations for SAT and VAT which are both different from the L4-L5 junction commonly utilized currently for single slice area estimation as a marker. Conclusions: The maximum area-to-volume correlation achieved is quite high, suggesting that it may be reasonable to estimate body fat by measuring the area of fat from a single anatomic slice at the site of maximum correlation and use this as a marker. The site of maximum correlation is not at L4-L5 as commonly assumed, but is more superiorly located at T12-L1 for SAT and at L3-L4 for VAT. Furthermore, the optimal anatomic locations for SAT and VAT estimation are not the same, contrary to common assumption. The proposed standardized space mapping achieves high consistency of anatomic localization by accurately managing nonlinearities in the relationships among landmarks. Multiple slices achieve greater improvement in correlation for VAT than for SAT. The optimal locations in the case of multiple slices are not contiguous.« less

Prospective study of swallowing function in patients with cervical dystonia undergoing selective peripheral denervation

PubMed Central

Munchau, A; Good, C; McGowan, S; Quinn, N; Palmer, J; Bhatia, K

2001-01-01

OBJECTIVE—To characterise swallowing function in patients with cervical dystonia with botulinum toxin treatment failure, before and after selective peripheral denervation surgery.
METHODS—Twelve patients with cervical dystonia had a thorough examination including standardised assessment for cervical dystonia, scoring of subjective dysphagia, and videofluoroscopic swallow. Videofluoroscopy was scored by consensus opinion between a speech and language therapist and an independent blinded radiologist using a validated scoring system.
RESULTS—Seven patients with cervical dystonia experienced no subjective dysphagia either before or after surgery, although in all these patients there was objective videofluoroscopic evidence of underlying mild to moderate oropharyngeal dysphagia preoperatively and postoperatively. The most common finding was delayed initiation of swallow. Three other patients, also without subjective dysphagia before surgery, developed postoperative dysphagia. In these patients, videofluoroscopy showed a delayed swallow reflex before surgery, which was worse postoperatively in two. The remaining two patients had mild subjective dysphagia before surgery that improved postoperatively in one and deteriorated in the other. In the first, videofluoroscopy was normal preoperatively and postoperatively, and in the second, oral bolus preparation was moderately abnormal preoperatively and swallow initiation was delayed postoperatively. Mean subjective dysphagia scores did not change significantly. Apart from a significant improvement of tongue base retraction, videofluoroscopic scores were not significantly different after surgery. Postoperatively there was significant improvement of overall cervical dystonia severity and abnormal head rotation in the group as a whole. There was no correlation between age, duration of symptoms of cervical dystonia, preoperative or postoperative cervical dystonia severity, subjective dysphagia scores, or videofluoroscopic scores. However, in the five patients with persisting anterior sagittal head shift as part of the torticollis, tongue base retraction was less likely to improve after surgery compared with those without head shift.
CONCLUSION—Surgical denervation of dystonic neck muscles, leading to improved neck posture, can also improve tongue base retraction, which is a key component of normal bolus propagation. However, delayed swallow initiation, a common feature in patients with cervical dystonia, can be further compromised by surgery, leading to subjective dysphagia. In general, selective peripheral denervation seems to be a safe procedure with no major compromise of swallowing function.

 PMID:11413266

Province, Indonesia

PubMed

Endarti, Dwi; Satibi, Satibi; Kristina, Susi Ari; Farida, Muhaya Almira; Rahmawanti, Yuni; Andriani, Tika

2018-04-27

Objective: To determine knowledge, perception, and acceptance related to cervical cancer, HPV vaccination and screening for cervical cancer among Indonesian women, particularly in Yogyakarta province. Methods: A convenience sample of 392 women consists of 192 young women, 100 mothers of girls aged 12 – 15 years, and 100 adult women in Yogyakarta province, Indonesia was participated in this study. A self-administered paper-based questionnaire was used to determine demographics characteristics of respondents, as well as their knowledge – perception – acceptance related to cervical cancer, HPV vaccination, and screening for cervical cancer. Data collection were conducted during December 2013 to March 2014. Descriptive statistics was used to analyze description of demographics characteristics, knowledge, perception, and acceptance; while crosstab analysis using Chi-Square was used to analyze the relationship between demographics characteristics versus knowledge, perception, and acceptance. Results: This study found that knowledge and perception regarding cervical cancer, HPV vaccination, and screening for cervical cancer among women in Indonesia, particularly in Yogyakarta Province were still insufficient, however the acceptance was good. Among female young women, 64% had good knowledge, 62% had positive perception of cervical cancer and HPV vaccination, and 92% tended to accept HPV vaccination. Among mothers of girls aged 12 – 15 years, 44% had good knowledge, 46% had positive perception of cervical cancer and HPV vaccination, and 91% tended to accept HPV vaccination for their daughters. Among adult women, 68% had good knowledge, 57% had positive perception of cervical cancer and screening for cervical cancer, and 90% tended to accept cervical cancer screening. In general, demographics characteristics of having experience and exposure to information had significant relationship with knowledge, perception, and acceptance of HPV vaccination and screening for cervical cancer. Conclusions: Either knowledge or perception of cervical cancer and strategies toward it among Indonesian women particularly in Yogyakarta province were still unsatisfied. Efforts should be improved for supporting cervical cancer prevention and control in Indonesia through such as education on cervical cancer disease and strategies toward it. Creative Commons Attribution License

Kidney segmentation in CT sequences using graph cuts based active contours model and contextual continuity.

PubMed

Zhang, Pin; Liang, Yanmei; Chang, Shengjiang; Fan, Hailun

2013-08-01

Accurate segmentation of renal tissues in abdominal computed tomography (CT) image sequences is an indispensable step for computer-aided diagnosis and pathology detection in clinical applications. In this study, the goal is to develop a radiology tool to extract renal tissues in CT sequences for the management of renal diagnosis and treatments. In this paper, the authors propose a new graph-cuts-based active contours model with an adaptive width of narrow band for kidney extraction in CT image sequences. Based on graph cuts and contextual continuity, the segmentation is carried out slice-by-slice. In the first stage, the middle two adjacent slices in a CT sequence are segmented interactively based on the graph cuts approach. Subsequently, the deformable contour evolves toward the renal boundaries by the proposed model for the kidney extraction of the remaining slices. In this model, the energy function combining boundary with regional information is optimized in the constructed graph and the adaptive search range is determined by contextual continuity and the object size. In addition, in order to reduce the complexity of the min-cut computation, the nodes in the graph only have n-links for fewer edges. The total 30 CT images sequences with normal and pathological renal tissues are used to evaluate the accuracy and effectiveness of our method. The experimental results reveal that the average dice similarity coefficient of these image sequences is from 92.37% to 95.71% and the corresponding standard deviation for each dataset is from 2.18% to 3.87%. In addition, the average automatic segmentation time for one kidney in each slice is about 0.36 s. Integrating the graph-cuts-based active contours model with contextual continuity, the algorithm takes advantages of energy minimization and the characteristics of image sequences. The proposed method achieves effective results for kidney segmentation in CT sequences.

NTP and PCr responses to hypoxia by hypothermic and normothermic respiring, superfused, neonatal rat cerebrocortical slices: an NMR spectroscopy study at 14.1 Tesla.

PubMed

Litt, L; Hirai, K; Basus, V J; James, T L

2003-01-01

Although mechanisms of hypothermic neuroprotection during oxygen deprivation have long been investigated, further characterizations of various molecular mechanisms are appropriate. Anticipating future studies of hypothermia and hypoxia/ischemia, we investigated the extent to which our ex vivo, NMR-based, superfused brain slice model might be helpful. (Slices are approximately 350 microm thick, with 18 slices per 8 mm NMR tube.) 31P NMR spectroscopic measurements were made of hypothermia-induced changes in high energy phosphates, while simultaneously monitoring and controlling tissue temperature, using 1H NMR, the high spectroscopic resolution available at 14.1 Tesla (600 MHz for protons), and a recently published protocol. NTP and PCr concentrations in healthy, well-oxygenated slices decreased to (55 +/- 15)% and (66 +/- 30)% of their respective values at 28.0 degrees C when warmed to 38.0 degrees C, in approximate agreement with earlier in vivo studies by others. During 30 min hypoxia NTP and PCr decreased to non-observable values, regardless of temperature. After reoxygenation, NTP and PCr recoveries as percentages of respective prehypoxia values were (63% +/- 16%; 70%) +/- 5%) for hypothermic slices (28.0 degrees C), and (46% +/- 13%; 41% +/- hypothermic neuroprotection during oxygen deprivation in this model, which appears suitable for use in further studies.

The influence of secondary reconstruction slice thickness on NewTom 3G cone beam computed tomography-based radiological interpretation of sheep mandibular condyle fractures.

PubMed

Sirin, Yigit; Guven, Koray; Horasan, Sinan; Sencan, Sabri; Bakir, Baris; Barut, Oya; Tanyel, Cem; Aral, Ali; Firat, Deniz

2010-11-01

The objective of this study was to examine the diagnostic accuracy of the different secondary reconstruction slice thicknesses of cone beam computed tomography (CBCT) on artificially created mandibular condyle fractures. A total of 63 sheep heads with or without condylar fractures were scanned with a NewTom 3G CBCT scanner. Multiplanar reformatted (MPR) views in 0.2-mm, 1-mm, 2-mm, and 3-mm secondary reconstruction slice thicknesses were evaluated by 7 observers. Inter- and intraobserver agreements were calculated with weighted kappa statistics. The receiver operating characteristic (ROC) curve analysis was used to statistically compare the area under the curve (AUC) of each slice thickness. The kappa coefficients varied from fair and to excellent. The AUCs of 0.2-mm and 1-mm slice thicknesses were found to be significantly higher than those of 2 mm and 3 mm for some type of fractures. CBCT was found to be accurate in detecting all variants of fractures at 0.2 mm and 1 mm. However, 2-mm and 3-mm slices were not suitable to detect fissure, complete, and comminuted types of mandibular condyle fractures. Copyright © 2010 Mosby, Inc. All rights reserved.

Torsion Induced Traumatic Optic Neuropathy (TITON): Animal Model for Diagnostics, Drugs Delivery, and Therapeutics for Injuries to the Cental Nervous System

DTIC Science & Technology

2016-06-01

neck and the eye coils are actively decoupled. The following parameters will be used: slice thickness = 1 mm, TR = 4 s, TE = 13 ms, label duration... Eyes were removed with 3-5 mm of optic nerve intact taking care not to stretch or otherwise injure the nerve. Eyes were flash frozen in liquid...nitrogen, then stored at -80°C. The eyes were then sectioned through the optic nerve using a cryostat, then transferred to indium titanium oxide-coated

Changing the calculus of pediatric product development: narrowing the too-big gap between need and solution in a small market.

PubMed

Campbell, Sarah

2015-01-01

First, Deliece Hofen drops the pill into hot water to soften the outside coating. Then, she slices through the center of the pill with an X-ACTO knife and squeezes the isotretinoin inside into a syringe. With the drug in liquid form, she can now administer it to her ten-year-old son Brandon. ?The problem is...some of [the isotretinoin] is still left inside of the capsule and I?m not getting an exact dosage,? admits Hofen.

Reconstructing liver shape and position from MR image slices using an active shape model

NASA Astrophysics Data System (ADS)

Fenchel, Matthias; Thesen, Stefan; Schilling, Andreas

2008-03-01

We present an algorithm for fully automatic reconstruction of 3D position, orientation and shape of the human liver from a sparsely covering set of n 2D MR slice images. Reconstructing the shape of an organ from slice images can be used for scan planning, for surgical planning or other purposes where 3D anatomical knowledge has to be inferred from sparse slices. The algorithm is based on adapting an active shape model of the liver surface to a given set of slice images. The active shape model is created from a training set of liver segmentations from a group of volunteers. The training set is set up with semi-manual segmentations of T1-weighted volumetric MR images. Searching for the optimal shape model that best fits to the image data is done by maximizing a similarity measure based on local appearance at the surface. Two different algorithms for the active shape model search are proposed and compared: both algorithms seek to maximize the a-posteriori probability of the grey level appearance around the surface while constraining the surface to the space of valid shapes. The first algorithm works by using grey value profile statistics in normal direction. The second algorithm uses average and variance images to calculate the local surface appearance on the fly. Both algorithms are validated by fitting the active shape model to abdominal 2D slice images and comparing the shapes, which have been reconstructed, to the manual segmentations and to the results of active shape model searches from 3D image data. The results turn out to be promising and competitive to active shape model segmentations from 3D data.

Four-dimensional MRI using an internal respiratory surrogate derived by dimensionality reduction

NASA Astrophysics Data System (ADS)

Uh, Jinsoo; Ayaz Khan, M.; Hua, Chiaho

2016-11-01

This study aimed to develop a practical and accurate 4-dimensional (4D) magnetic resonance imaging (MRI) method using a non-navigator, image-based internal respiratory surrogate derived by dimensionality reduction (DR). The use of DR has been previously suggested but not implemented for reconstructing 4D MRI, despite its practical advantages. We compared multiple image-acquisition schemes and refined a retrospective-sorting process to optimally implement a DR-derived surrogate. The comparison included an unconventional scheme that acquires paired slices alternately to mitigate the internal surrogate’s dependency on a specific slice location. We introduced ‘target-oriented sorting’, as opposed to conventional binning, to quantify the coherence in retrospectively sorted images, thereby determining the minimal scan time needed for sufficient coherence. This study focused on evaluating the proposed method using digital phantoms which provided unequivocal gold standard. The evaluation indicated that the DR-based respiratory surrogate is highly accurate: the error in amplitude percentile of the surrogate signal was less than 5% with the optimal scheme. Acquiring alternating paired slices was superior to the conventional scheme of acquiring individual slices; the advantage of the unconventional scheme was more pronounced when a substantial phase shift occurred across slice locations. The analysis of coherence across sorted images confirmed the advantage of higher sampling efficiencies in non-navigator respiratory surrogates. We determined that a scan time of 20 s per imaging slice was sufficient to achieve a mean coherence error of less than 1% for the tested respiratory patterns. The clinical applicability of the proposed 4D MRI has been demonstrated with volunteers and patients. The diaphragm motion in 4D MRI was consistent with that in dynamic 2D imaging which was regarded as the gold standard (difference within 1.8 mm on average).

Cervical human papilloma virus (HPV) DNA primary screening test: Results of a population-based screening programme in central Italy.

PubMed

Passamonti, Basilio; Gustinucci, Daniela; Giorgi Rossi, Paolo; Cesarini, Elena; Bulletti, Simonetta; Carlani, Angela; Martinelli, Nadia; Broccolini, Massimo; D'Angelo, Valentina; D'Amico, Maria Rosaria; Di Dato, Eugenio; Galeazzi, Paola; Malaspina, Morena; Spita, Nicoletta; Tintori, Beatrice; Giaimo, Maria Donata

2017-09-01

Objective To present the results of the first and second round human papilloma virus (HPV)-based screening programme in the Umbria region after three years. Methods From August 2010 to November 2011, the entire female population aged 35-64 in a local health district was invited for HPV testing (HPV-DNA cobas4800 on a liquid-based cytology sample). HPV-negative women were re-invited after three years. For HPV-positive women, a slide was prepared and interpreted. Positive cytologies were referred to colposcopy; negatives were referred to repeat HPV after one year. If HPV was persistently positive, women were referred to colposcopy; if negative, to normal screening. Indicators of the first and second round are compared with those of cytology screening in the same area in the preceding three years. Results Participation was 56.5%, the same as cytology (56.6%). HPV-positivity was 6.4% (396/6272), cytology triage positivity was 35.6%; 251 cytology negative women were referred to one-year HPV retesting, 84.1% complied, and 55.5% were positive. Total colposcopy referral was 4.1%, and for cytology 1%. The detection rate for cervical intraepithelial neoplasia grade 2 or more severe was 10‰, compared with 3.7‰ using cytology. After three years, HPV-positivity was 3.4% (129/3831), overall colposcopy referral was 2.3% (most at one-year follow-up), and detection rate was 0.5/1000. Conclusions The first round detection rate was more than twice that of cytology screening, while colposcopy referral increased fourfold. At the second round, the detection rate decreased dramatically, showing that longer interval and more conservative protocols are needed.

Finite element analysis of moment-rotation relationships for human cervical spine.

PubMed

Zhang, Qing Hang; Teo, Ee Chon; Ng, Hong Wan; Lee, Vee Sin

2006-01-01

A comprehensive, geometrically accurate, nonlinear C0-C7 FE model of head and cervical spine based on the actual geometry of a human cadaver specimen was developed. The motions of each cervical vertebral level under pure moment loading of 1.0 Nm applied incrementally on the skull to simulate the movements of the head and cervical spine under flexion, tension, axial rotation and lateral bending with the inferior surface of the C7 vertebral body fully constrained were analysed. The predicted range of motion (ROM) for each motion segment were computed and compared with published experimental data. The model predicted the nonlinear moment-rotation relationship of human cervical spine. Under the same loading magnitude, the model predicted the largest rotation in extension, followed by flexion and axial rotation, and least ROM in lateral bending. The upper cervical spines are more flexible than the lower cervical levels. The motions of the two uppermost motion segments account for half (or even higher) of the whole cervical spine motion under rotational loadings. The differences in the ROMs among the lower cervical spines (C3-C7) were relatively small. The FE predicted segmental motions effectively reflect the behavior of human cervical spine and were in agreement with the experimental data. The C0-C7 FE model offers potentials for biomedical and injury studies.

Implementing a Fee-for-Service Cervical Cancer Screening and Treatment Program in Cameroon: Challenges and Opportunities.

PubMed

DeGregorio, Geneva; Manga, Simon; Kiyang, Edith; Manjuh, Florence; Bradford, Leslie; Cholli, Preetam; Wamai, Richard; Ogembo, Rebecca; Sando, Zacharie; Liu, Yuxin; Sheldon, Lisa Kennedy; Nulah, Kathleen; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

2017-07-01

Cervical cancer screening is one of the most effective cancer prevention strategies, but most women in Africa have never been screened. In 2007, the Cameroon Baptist Convention Health Services, a large faith-based health care system in Cameroon, initiated the Women's Health Program (WHP) to address this disparity. The WHP provides fee-for-service cervical cancer screening using visual inspection with acetic acid enhanced by digital cervicography (VIA-DC), prioritizing care for women living with HIV/AIDS. They also provide clinical breast examination, family planning (FP) services, and treatment for reproductive tract infection (RTI). Here, we document the strengths and challenges of the WHP screening program and the unique aspects of the WHP model, including a fee-for-service payment system and the provision of other women's health services. We retrospectively reviewed WHP medical records from women who presented for cervical cancer screening from 2007-2014. In 8 years, WHP nurses screened 44,979 women for cervical cancer. The number of women screened increased nearly every year. The WHP is sustained primarily on fees-for-service, with external funding totaling about $20,000 annually. In 2014, of 12,191 women screened for cervical cancer, 99% received clinical breast exams, 19% received FP services, and 4.7% received treatment for RTIs. We document successes, challenges, solutions implemented, and recommendations for optimizing this screening model. The WHP's experience using a fee-for-service model for cervical cancer screening demonstrates that in Cameroon VIA-DC is acceptable, feasible, and scalable and can be nearly self-sustaining. Integrating other women's health services enabled women to address additional health care needs. The Cameroon Baptist Convention Health Services Women's Health Program successfully implemented a nurse-led, fee-for-service cervical cancer screening program using visual inspection with acetic acid-enhanced by digital cervicography in the setting of a large faith-based health care system in Cameroon. It is potentially replicable in many African countries, where faith-based organizations provide a large portion of health care. The cost-recovery model and concept of offering multiple services in a single clinic rather than stand-alone "silo" cervical cancer screening could provide a model for other low-and-middle-income countries planning to roll out a new, or make an existing, cervical cancer screening services accessible, comprehensive, and sustainable. © AlphaMed Press 2017.

Development of a new technique for pedicle screw and Magerl screw insertion using a 3-dimensional image guide.

PubMed

Kawaguchi, Yoshiharu; Nakano, Masato; Yasuda, Taketoshi; Seki, Shoji; Hori, Takeshi; Kimura, Tomoatsu

2012-11-01

We developed a new technique for cervical pedicle screw and Magerl screw insertion using a 3-dimensional image guide. In posterior cervical spinal fusion surgery, instrumentation with screws is virtually routine. However, malpositioning of screws is not rare. To avoid complications during cervical pedicle screw and Magerl screw insertion, the authors developed a new technique which is a mold shaped to fit the lamina. Cervical pedicle screw fixation and Magerl screw fixation provide good correction of cervical alignment, rigid fixation, and a high fusion rate. However, malpositioning of screws is not a rare occurrence, and thus the insertion of screws has a potential risk of neurovascular injury. It is necessary to determine a safe insertion procedure for these screws. Preoperative computed tomographic (CT) scans of 1-mm slice thickness were obtained of the whole surgical area. The CT data were imported into a computer navigation system. We developed a 3-dimensional full-scale model of the patient's spine using a rapid prototyping technique from the CT data. Molds of the left and right sides at each vertebra were also constructed. One hole (2.0 mm in diameter and 2.0 cm in length) was made in each mold for the insertion of a screw guide. We performed a simulated surgery using the bone model and the mold before operation in all patients. The mold was firmly attached to the surface of the lamina and the guide wire was inserted using the intraoperative image of lateral vertebra. The proper insertion point, direction, and length of the guide were also confirmed both with the model bone and the image intensifier in the operative field. Then, drilling using a cannulated drill and tapping using a cannulated tapping device were carried out. Eleven consecutive patients who underwent posterior spinal fusion surgery using this technique since 2009 are included. The screw positions in the sagittal and axial planes were evaluated by postoperative CT scan to check for malpositioning. The screw insertion was done in the same manner as the simulated surgery. With the aid of this guide the pedicle screws and Magerl screws could be easily inserted even at the level where the pedicle seemed to be very thin and sclerotic on the CT scan. Postoperative CT scan showed that there were no critical breaches of the screws. This method employing the device using a 3-dimensional image guide seems to be easy and safe to use. The technique may improve the safety of pedicle screw and Magerl screw insertion even in difficult cases with narrow sclerotic pedicles.

Dynamical Nuclear Magnetic Resonance Imaging of Micron-scale Liquids

NASA Astrophysics Data System (ADS)

Sixta, Aimee; Choate, Alexandra; Maeker, Jake; Bogat, Sophia; Tennant, Daniel; Mozaffari, Shirin; Markert, John

We report our efforts in the development of Nuclear Magnetic Resonance Force Microscopy (NMRFM) for dynamical imaging of liquid media at the micron scale. Our probe contains microfluidic samples sealed in thin-walled (µm) quartz tubes, with a micro-oscillator sensor nearby in vacuum to maintain its high mechanical resonance quality factor. Using 10 µm spherical permalloy magnets at the oscillator tips, a 3D T1-resolved image of spin density can be obtained by reconstruction from our magnetostatics-modelled resonance slices; as part of this effort, we are exploring single-shot T1 measurements for faster dynamical imaging. We aim to further enhance imaging by using a 2 ω technique to eliminate artifact signals during the cyclic inversion of nuclear spins. The ultimate intent of these efforts is to perform magnetic resonance imaging of individual biological cells.

Mass detection in digital breast tomosynthesis data using convolutional neural networks and multiple instance learning.

PubMed

Yousefi, Mina; Krzyżak, Adam; Suen, Ching Y

2018-05-01

Digital breast tomosynthesis (DBT) was developed in the field of breast cancer screening as a new tomographic technique to minimize the limitations of conventional digital mammography breast screening methods. A computer-aided detection (CAD) framework for mass detection in DBT has been developed and is described in this paper. The proposed framework operates on a set of two-dimensional (2D) slices. With plane-to-plane analysis on corresponding 2D slices from each DBT, it automatically learns complex patterns of 2D slices through a deep convolutional neural network (DCNN). It then applies multiple instance learning (MIL) with a randomized trees approach to classify DBT images based on extracted information from 2D slices. This CAD framework was developed and evaluated using 5040 2D image slices derived from 87 DBT volumes. The empirical results demonstrate that this proposed CAD framework achieves much better performance than CAD systems that use hand-crafted features and deep cardinality-restricted Bolzmann machines to detect masses in DBTs. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mechanical preconditioning enables electrophysiologic coupling of skeletal myoblast cells to myocardium

PubMed Central

Treskes, Philipp; Cowan, Douglas B.; Stamm, Christof; Rubach, Martin; Adelmann, Roland; Wittwer, Thorsten; Wahlers, Thorsten

2015-01-01

Objective The effect of mechanical preconditioning on skeletal myoblasts in engineered tissue constructs was investigated to resolve issues associated with conduction block between skeletal myoblast cells and cardiomyocytes. Methods Murine skeletal myoblasts were used to generate engineered tissue constructs with or without application of mechanical strain. After in vitro myotube formation, engineered tissue constructs were co-cultured for 6 days with viable embryonic heart slices. With the use of sharp electrodes, electrical coupling between engineered tissue constructs and embryonic heart slices was assessed in the presence or absence of pharmacologic agents. Results The isolation and expansion procedure for skeletal myoblasts resulted in high yields of homogeneously desmin-positive (97.1% ± 0.1%) cells. Mechanical strain was exerted on myotubes within engineered tissue constructs during gelation of the matrix, generating preconditioned engineered tissue constructs. Electrical coupling between preconditioned engineered tissue constructs and embryonic heart slices was observed; however, no coupling was apparent when engineered tissue constructs were not subjected to mechanical strain. Coupling of cells from engineered tissue constructs to cells in embryonic heart slices showed slower conduction velocities than myocardial cells with the embryonic heart slices (preconditioned engineered tissue constructs vs embryonic heart slices: 0.04 ± 0.02 ms vs 0.10 ± 0.05 ms, P = .011), lower stimulation frequencies (preconditioned engineered tissue constructs vs maximum embryonic heart slices: 4.82 ± 1.42 Hz vs 10.58 ± 1.56 Hz; P = .0009), and higher sensitivities to the gap junction inhibitor (preconditioned engineered tissue constructs vs embryonic heart slices: 0.22 ± 0.07 mmol/L vs 0.93 ± 0.15 mmol/L; P = .0004). Conclusions We have generated skeletal myoblast–based transplantable grafts that electrically couple to myocardium. PMID:22980065

The significance of G-CSF expression and myeloid-derived suppressor cells in the chemoresistance of uterine cervical cancer.

PubMed

Kawano, Mahiru; Mabuchi, Seiji; Matsumoto, Yuri; Sasano, Tomoyuki; Takahashi, Ryoko; Kuroda, Hiromasa; Kozasa, Katsumi; Hashimoto, Kae; Isobe, Aki; Sawada, Kenjiro; Hamasaki, Toshimitsu; Morii, Eiichi; Kimura, Tadashi

2015-12-15

Granulocyte-colony stimulating factor (G-CSF) producing malignant tumor has been reported to occur in various organs, and has been associated with poor clinical outcome. The aim of this study is to investigate the significance of tumor G-CSF expression in the chemosensitivity of uterine cervical cancer. The clinical data of recurrent or advanced cervical cancer patients who were treated with platinum-based chemotherapy were analyzed. Clinical samples, cervical cancer cell lines, and a mouse model of cervical cancer were employed to examine the mechanisms responsible for the development of chemoresistance in G-CSF-producing cervical cancer, focusing on myeloid-derived suppressor cells (MDSC). As a result, the tumor G-CSF expression was significantly associated with increased MDSC frequencies and compromised survival. In vitro and in vivo experiments demonstrated that the increased MDSC induced by tumor-derived G-CSF is involved in the development of chemoresistance. The depletion of MDSC via splenectomy or the administration of anti-Gr-1 antibody sensitized G-CSF-producing cervical cancer to cisplatin. In conclusion, tumor G-CSF expression is an indicator of an extremely poor prognosis in cervical cancer patients that are treated with chemotherapy. Combining MDSC-targeting treatments with current standard chemotherapies might have therapeutic efficacy as a treatment for G-CSF-producing cervical cancer.

Cervical cancer screening attitudes and beliefs of Malaysian women who have never had a pap smear: a qualitative study.

PubMed

Wong, L P; Wong, Y L; Low, W Y; Khoo, E M; Shuib, R

2008-01-01

Attitudes toward cervical cancer and participation in early detection and screening services are well known to be profoundly affected by cultural beliefs and norms. This study explored the attitudes and sociocultural beliefs on cervical cancer screening among Malaysian women. In this qualitative study, in-depth interviews were conducted with 20 Malaysian women, ages 21 to 56 years, who have never had a Papanicolaou (Pap) smear. Respondents generally showed a lack of knowledge about cervical cancer screening using Pap smear, and the need for early detection for cervical cancer. Many believed the Pap smear was a diagnostic test for cervical cancer, and since they had no symptoms, they did not go for Pap screening. Other main reasons for not doing the screening included lack of awareness of Pap smear indications and benefits, perceived low susceptibility to cervical cancer, and embarrassment. Other reasons for not being screened were related to fear of pain, misconceptions about cervical cancer, fatalistic attitude, and undervaluation of own health needs versus those of the family. Women need to be educated about the benefits of cervical cancer screening. Health education, counseling, outreach programs, and community-based interventions are needed to improve the uptake of Pap smear in Malaysia.

AMIGAS: Building a Cervical Cancer Screening Intervention for Public Health Practice

PubMed Central

Smith, Judith Lee; Wilson, Katherine M.; Orians, Carlyn E.; Byrd, Theresa L.

2015-01-01

Background Many barriers to cervical cancer screening for Hispanic women have been documented, but few effective interventions exist. The Community Preventive Services Task Force recommends increasing cervical cancer screening through various methods. Building on this evidence, the Centers for Disease Control and Prevention funded the research and testing phases for an evidence-based and theoretically grounded intervention designed to increase cervical cancer screening among never and rarely screened Hispanic women of Mexican descent. In this article, we describe the development process of the AMIGAS (Ayudando a las Mujeres con Información, Guía, y Amor para su Salud) intervention, highlight the integration of scientific evidence and community-based participatory research principles, and identify opportunities for dissemination, adaptation, and implementation of this intervention. Methods The AMIGAS team was a collaboration among researchers, promotoras (community health workers), and program administrators. The multiyear, multiphase project was conducted in Houston, Texas; El Paso, Texas; and Yakima, Washington. The team completed several rounds of formative research, designed intervention materials and methodology, conducted a randomized controlled trial, created a guide for program administrators, and developed an intervention dissemination plan. Results Trial results demonstrated that AMIGAS was successful in increasing cervical cancer screening among Hispanic women. Adaptation of AMIGAS showed minimal reduction of outcomes. Dissemination efforts are underway to make AMIGAS available in a downloadable format via the Internet. Conclusions Developing a community-based intervention that is evidence-based and theoretically grounded is challenging, time-intensive, and requires collaboration among multiple disciplines. Inclusion of key stakeholders—in particular program deliverers and administrators—and planning for dissemination and translation to practice are integral components of successful intervention design. By providing explicit directions for adaptation for program deliverers, relevant information for program administrators, and access to the intervention via the Internet, AMIGAS is available to help increase cervical cancer screening among Hispanic women and other women disproportionately affected by cervical cancer. PMID:23930983

Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations.

PubMed

Freeman, Michael D; Eriksson, Anders; Leith, Wendy

2014-01-01

Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck. In the present study, we accessed data regarding head and neck fractures resulting from fatal falls from a Swedish autopsy database for the years 1992-2010, for the purposes of examining the relationships between skull and cervical spine fracture distribution and the circumstances of the fatal fall. Out of 102,310 medico-legal autopsies performed there were 1008 cases of falls associated with skull or cervical spine fractures. The circumstances of the falls were grouped in 3 statistically homogenous categories; falls occurring at ground level, falls from a height of <3 m or down stairs, and falls from ≥3 m. Only head and neck injuries and fractures that were associated with the fatal CNS injuries were included for study, and categorized as skull vault and skull base fractures, upper cervical injuries (C0-C1 dislocation, C1 and C2 fractures), and lower cervical fractures. Logistic regression modeling revealed increased odds of skull base and lower cervical fracture in the middle and upper fall severity groups, relative to ground level falls (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). C0-C1 dislocations were strongly related to fall height, with an OR of 8.3 for ≥3 m falls versus ground level. The findings of increased odds of skull base and lower cervical spine fracture in falls from a height are consistent with prior observations that the risk of such injuries is related to the degree of victim inversion at impact. The finding that C0-C1 dislocations are most common in falls from more than 3 m is unique, an indication that the injuries likely result from high energy shear forces rather than pure tension, as previously thought. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Quantitative determination of engine water ingestion

NASA Technical Reports Server (NTRS)

Parikh, P.; Hernan, M.; Sarohia, V.

1986-01-01

A nonintrusive optical technique is described for determination of liquid mass flux in a droplet laden airstream. The techniques were developed for quantitative determination of engine water ingestion resulting from heavy rain or wheel spray. Independent measurements of the liquid water content (LWC) of the droplet laden airstream and of the droplet velocities were made at the stimulated nacelle inlet plane for the liquid mass flux determination. The LWC was measured by illuminating and photographing the droplets contained within a thin slice of the flow field by means of a sheet of light from a pulsed laser. A fluorescent dye introduced in the water enchanced the droplet image definition. The droplet velocities were determined from double exposed photographs of the moving droplet field. The technique was initially applied to a steady spray generated in a wind tunnel. It was found that although the spray was initially steady, the aerodynamic breakup process was inherently unsteady. This resulted in a wide variation of the instantaneous LWC of the droplet laden airstream. The standard deviation of ten separate LWC measurements was 31% of the average. However, the liquid mass flux calculated from the average LWC and droplet velocities came within 10% of the known water ingestion rate.

An efficient abnormal cervical cell detection system based on multi-instance extreme learning machine

NASA Astrophysics Data System (ADS)

Zhao, Lili; Yin, Jianping; Yuan, Lihuan; Liu, Qiang; Li, Kuan; Qiu, Minghui

2017-07-01

Automatic detection of abnormal cells from cervical smear images is extremely demanded in annual diagnosis of women's cervical cancer. For this medical cell recognition problem, there are three different feature sections, namely cytology morphology, nuclear chromatin pathology and region intensity. The challenges of this problem come from feature combination s and classification accurately and efficiently. Thus, we propose an efficient abnormal cervical cell detection system based on multi-instance extreme learning machine (MI-ELM) to deal with above two questions in one unified framework. MI-ELM is one of the most promising supervised learning classifiers which can deal with several feature sections and realistic classification problems analytically. Experiment results over Herlev dataset demonstrate that the proposed method outperforms three traditional methods for two-class classification in terms of well accuracy and less time.

Internet-Based Cervical Cancer Screening Program

DTIC Science & Technology

2008-05-01

information technology have facilitated the Internet transmission and archival storage of digital images and other clinical information . The combination of...Phase included: 1) development of hardware, software, and interfaces between computerized scanning device and Internet - linked servers and reading...AD_________________ Award Number: W81XWH-04-C-0083 TITLE: Internet -Based Cervical Cancer Screening

A Cervical Cancer Community-Based Participatory Research Project in a Native American Community

ERIC Educational Resources Information Center

Christopher, Suzanne; Gidley, Allison L.; Letiecq, Bethany; Smith, Adina; McCormick, Alma Knows His Gun

2008-01-01

The Messengers for Health on the Apsaalooke Reservation project uses a community-based participatory research (CBPR) approach and lay health advisors (LHAs) to generate knowledge and awareness about cervical cancer prevention among community members in a culturally competent manner. Northern Plains Native Americans, of whom Apsaalooke women are a…

Skull Base and Cervical Spine Involvement in Jansen Syndrome: Case Report.

PubMed

Khan, Rabia; Oakes, Peter; Fisahn, Christian; Burgess, Brittni; Kirkpatrick, Kristina M; Oskouian, Rod J; Tubbs, R Shane; Blount, Jeffrey P

2017-01-01

Metaphyseal chondrodysplasia, Jansen type (JMD), is a rare form of endochondral ossification resulting in short limbs and dwarfism. A child presented with JMD and was found to have involvement of the cervical spine. Conservative treatment was given to the patient who at the long-term follow-up continues to have no neurological findings or cervical spine instability. To our knowledge, this case represents the first report of involvement of the superior cervical spine in a patient with JMD. Clinicians should be aware of this potential albeit rare finding. © 2017 S. Karger AG, Basel.

Controversies in "clearing" trauma to the cervical spine.

PubMed

Tins, Bernhard; Cassar-Pullicino, Victor

2007-04-01

Clearance of the traumatic cervical spine is a subject affecting most healthcare professionals dealing with trauma patients. There is a host of often contradictory literature making it hard for an interested reader to come to their own informed opinion based on the current evidence. This review aims to outline the relevant literature for the clearance of the traumatic cervical spine with the particular aim of highlighting the contradictions, controversies and unanswered questions still besetting this important subject. A brief, subjective opinion for a combined clinical and imaging protocol for clearance of the traumatic cervical spine is given.

Evidence-Based Consensus Recommendations for Colposcopy Practice for Cervical Cancer Prevention in the United States.

PubMed

Wentzensen, Nicolas; Massad, L Stewart; Mayeaux, Edward J; Khan, Michelle J; Waxman, Alan G; Einstein, Mark H; Conageski, Christine; Schiffman, Mark H; Gold, Michael A; Apgar, Barbara S; Chelmow, David; Choma, Kim K; Darragh, Teresa M; Gage, Julia C; Garcia, Francisco A R; Guido, Richard S; Jeronimo, Jose A; Liu, Angela; Mathews, Cara A; Mitchell, Martha M; Moscicki, Anna-Barbara; Novetsky, Akiva P; Papasozomenos, Theognosia; Perkins, Rebecca B; Silver, Michelle I; Smith, Katie M; Stier, Elizabeth A; Tedeschi, Candice A; Werner, Claudia L; Huh, Warner K

2017-10-01

The American Society for Colposcopy and Cervical Pathology (ASCCP) Colposcopy Standards recommendations address the role of colposcopy and directed biopsy for cervical cancer prevention in the United States (US). The recommendations were developed by an expert working group appointed by ASCCP's Board of Directors. An extensive literature review was conducted and supplemented by a systematic review and meta-analysis of unpublished data. In addition, a survey of practicing colposcopists was conducted to assess current colposcopy practice in the US. Recommendations were approved by the working group members, and the final revisions were made based on comments received from the public. The recommendations cover terminology, risk-based colposcopy, colposcopy procedures, and colposcopy adjuncts. The ASCCP Colposcopy Standards recommendations are an important step toward raising the standard of colposcopy services delivered to women in the US. Because cervical cancer screening programs are currently undergoing important changes that may affect colposcopy performance, updates to some of the current recommendations may be necessary in the future.

A qualitative evaluation of a faith-based breast and cervical cancer screening intervention for African American women.

PubMed

Matthews, Alicia K; Berrios, Nerida; Darnell, Julie S; Calhoun, Elizabeth

2006-10-01

This article presents a formative evaluation of a CDC Racial and Ethnic Approaches to Community Health (REACH) 2010 faith-based breast and cervical cancer early detection and prevention intervention for African American women living in urban communities. Focus groups were conducted with a sample of women (N=94) recruited from each church participating in the intervention. One focus group was conducted in each of the nine participating churches following completion of the 6-month REACH 2010 intervention. Transcribed data were coded to identify relevant themes. Key findings included (a) the acceptability of receiving cancer education within the context of a faith community, (b) the importance of pastoral input, (c) the effectiveness of personal testimonies and lay health advocates, (d) the saliency of biblical scripture in reinforcing health messages, (e) the effectiveness of multimodal learning aids, and (f) the relationship between cervical cancer and social stigma. Study findings have implications for enhancing faith-based breast and cervical cancer prevention efforts in African American communities.

MAVARIC - a comparison of automation-assisted and manual cervical screening: a randomised controlled trial.

PubMed

Kitchener, H C; Blanks, R; Cubie, H; Desai, M; Dunn, G; Legood, R; Gray, A; Sadique, Z; Moss, S

2011-01-01

The principal objective was to compare automation-assisted reading of cervical cytology with manual reading using the histological end point of cervical intraepithelial neoplasia grade II (CIN2) or worse (CIN2+). Secondary objectives included (i) an assessment of the slide ranking facility of the Becton Dickinson (BD) FocalPoint™ Slide Profiler (Becton Dickinson, Franklin Lakes, NJ, USA), especially 'No Further Review', (ii) a comparison of the two approved automated systems, the ThinPrep® Imaging System (Hologic, Bedford, MA, USA) and the BD FocalPoint Guided Screener Imaging System, and (iii) automated versus manual in terms of productivity and cost-effectiveness. A 1 : 2 randomised allocation of slides to either manual reading or automation-assisted paired with manual reading. Cytoscreeners were blinded to whether samples would be read only manually or manually paired with automated. Slide reading procedures followed real-life laboratory protocol to produce a final result and, for paired readings, the worse result determined the management. Costs per event were estimated and combined with productivity to produce a cost per slide, per woman and per CIN2+ and cervical intraepithelial neoplasia grade III (CIN3) or worse (CIN3+) lesion detected. Cost-effectiveness was estimated using cost per CIN2+ detected. Lifetime cost-effectiveness in terms of life-years and quality-adjusted life-years was estimated using a mathematical model. Liquid-based cytology samples were obtained in primary care, and a small number of abnormal samples were obtained from local colposcopy clinics, from different women, in order to enrich the proportion of abnormals. All of the samples were read in a single large service laboratory. Liquid residues used for human papillomavirus (HPV) triage were tested (with Hybrid Capture 2, Qiagen, Crawley, UK) in a specialist virology laboratory in Edinburgh, UK. Histopathology was read by a specialist gynaecological pathology team blinded to HPV results and type of reading. Samples were obtained from women aged 25-64 years undergoing primary cervical screening in Greater Manchester, UK, with small proportions from women outside this age range and from women undergoing colposcopy. The principal intervention was automation-assisted reading of cervical cytology slides which was paired with a manual reading of the same slide. Low-grade cytological abnormalities (borderline and mild dyskaryosis) were triaged with HPV testing to direct colposcopy referral. Women with high-grade cytology were referred for colposcopy and those with negative cytology were returned to recall. The principal outcome measure was the sensitivity of automation-assisted reading relative to manual for the detection of CIN2+. A secondary outcome measure was cost-effectiveness of each type of reading to detect CIN2+. The study was powered to detect a relative sensitivity difference equivalent to an absolute difference of 5%. The principal finding was that automated reading was 8% less sensitive relative to manual, 6.3% in absolute terms. 'No further review' was very reliable and, if restricted to routine screening samples, < 1% of CIN2+ would have been missed. Automated and manual were very similar in terms of cost-effectiveness despite a 60%-80% increase in productivity for automation-assisted reading. The significantly reduced sensitivity of automated reading, combined with uncertainty over cost-effectiveness, suggests no justification at present to recommend its introduction. The reliability of 'no further review' warrants further consideration as a means of saving staff time. Current Controlled Trials ISRCTN66377374. This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 15, No. 3. See the HTA programme website for further project information.

Estimation of in vitro activity of tuberoinfundibular dopaminergic neurons by measurement of DOPA synthesis in the median eminence of hypothalamic slices.

PubMed

Arita, J; Kimura, F

1984-12-01

A new method for estimation of in vitro neurosecretory activity of tuberoinfundibular dopaminergic (TIDA) neurons was developed by measuring the rate of synthesis of dihydroxyphenylalanine (DOPA) in the median eminence of hypothalamic slices. Sagittal hypothalamic slices of ovariectomized rats were incubated in a medium containing 3-hydroxybenzylhydrazine (NSD 1015), an inhibitor of DOPA decarboxylase. DOPA accumulated in the median eminence following incubation with NSD 1015 was determined by high-performance liquid chromatography with electro-chemical detection. The amount of DOPA accumulated in vitro in the median eminence was maximal in a medium containing 10 mM NSD 1015 and linear up to 120 min at 37 degrees C. Increasing the concentration of tyrosine in medium stimulated the synthesis of DOPA in the median eminence. The synthesis of DOPA was blocked by 1 mM alpha-methyltyrosine, an inhibitor of tyrosine hydroxylase. The rate of in vitro synthesis of DOPA in the median eminence was 33% of that of in vivo synthesis. Incubation in a medium containing 50 mM K+ to depolarize neurons caused a 2.4-fold increase in DOPA synthesis in the median eminence. The high K+-induced increase in DOPA synthesis was blocked by omission of Ca2+ and addition of 1 mM EGTA into the medium, suggesting Ca2+ dependency of depolarization-activated DOPA synthesis. These results indicate that this in vitro assay is a useful means to study the regulatory mechanisms of TIDA neurons.

Polychromatic wave-optics models for image-plane speckle. 2. Unresolved objects.

PubMed

Van Zandt, Noah R; Spencer, Mark F; Steinbock, Michael J; Anderson, Brian M; Hyde, Milo W; Fiorino, Steven T

2018-05-20

Polychromatic laser light can reduce speckle noise in many wavefront-sensing and imaging applications. To help quantify the achievable reduction in speckle noise, this study investigates the accuracy of three polychromatic wave-optics models under the specific conditions of an unresolved object. Because existing theory assumes a well-resolved object, laboratory experiments are used to evaluate model accuracy. The three models use Monte-Carlo averaging, depth slicing, and spectral slicing, respectively, to simulate the laser-object interaction. The experiments involve spoiling the temporal coherence of laser light via a fiber-based, electro-optic modulator. After the light scatters off of the rough object, speckle statistics are measured. The Monte-Carlo method is found to be highly inaccurate, while depth-slicing error peaks at 7.8% but is generally much lower in comparison. The spectral-slicing method is the most accurate, always producing results within the error bounds of the experiment.

CD73 promotes proliferation and migration of human cervical cancer cells independent of its enzyme activity.

PubMed

Gao, Zhao-Wei; Wang, Hui-Ping; Lin, Fang; Wang, Xi; Long, Min; Zhang, Hui-Zhong; Dong, Ke

2017-02-15

CD73 has both enzymatic and non-enzymatic functions in cells. As a nucleotidase, CD73 plays its enzymatic function by catalyzing the hydrolysis of AMP into adenosine and phosphate. In addition to this, accumulating data have shown that CD73 is a key regulatory molecule involved in cancer growth and metastasis, but this non-enzymatic function of CD73 in cervical cancer cells has not been well studied. CD73 was overexpressed by pcDNA-NT5E expression vector transfection in Hela and SiHa cells. Cell's proliferation and migration were evaluated by MTT and scratch healing assay. The CD73 specific antagonist -APCP was used to inhibit CD73 enzymatic activity. And the effect of APCP on CD73 activity was determined by high performance liquid chromatography (HPLC). Expression level was assessed by qRT-PCR and western blotting. In the present study, we used Hela and SiHa cell lines to evaluate the effects of CD73 on cervical cancer cells proliferation and migration, and further explore the potential regulating mechanisms. Our data showed that CD73 overexpression significantly promoted cervical cancer cells proliferation and migration, and this promotive effect was not reverted by blocking CD73 enzymatic activity, both in Hela and SiHa cells. On the other hand, our data also showed that high concentration of adenosine inhibited Hela and SiHa cells proliferation and migration. These results demonstrated that the promotive effect of CD73 on cervical cancer cells proliferation and migration in vitro was independent from its enzymatic activity (i.e. production of adenosine). Furthermore, the expressions of EGFR, VEGF and Akt were significantly increased in CD73 overexpression Hela and SiHa cells. Our data suggested that CD73 might promote proliferation and migration via potentiating EGFR/Akt and VEGF/Akt pathway, which was independent of CD73 enzyme activity. These data provide a novel insight into the regulating function of CD73 in cancer cells and suggest that CD73 may be promising therapeutic target in cervical cancer.

Dimensional coordinate measurements: application in characterizing cervical spine motion

NASA Astrophysics Data System (ADS)

Zheng, Weilong; Li, Linan; Wang, Shibin; Wang, Zhiyong; Shi, Nianke; Xue, Yuan

2014-06-01

Cervical spine as a complicated part in the human body, the form of its movement is diverse. The movements of the segments of vertebrae are three-dimensional, and it is reflected in the changes of the angle between two joint and the displacement in different directions. Under normal conditions, cervical can flex, extend, lateral flex and rotate. For there is no relative motion between measuring marks fixed on one segment of cervical vertebra, the cervical vertebrae with three marked points can be seen as a body. Body's motion in space can be decomposed into translational movement and rotational movement around a base point .This study concerns the calculation of dimensional coordinate of the marked points pasted to the human body's cervical spine by an optical method. Afterward, these measures will allow the calculation of motion parameters for every spine segment. For this study, we choose a three-dimensional measurement method based on binocular stereo vision. The object with marked points is placed in front of the CCD camera. Through each shot, we will get there two parallax images taken from different cameras. According to the principle of binocular vision we can be realized three-dimensional measurements. Cameras are erected parallelly. This paper describes the layout of experimental system and a mathematical model to get the coordinates.

Costs of cervical cancer treatment: population-based estimates from Ontario

PubMed Central

Pendrith, C.; Thind, A.; Zaric, G.S.; Sarma, S.

2016-01-01

Objectives The objectives of the present study were to estimate the overall and specific medical care costs associated with cervical cancer in the first 5 years after diagnosis in Ontario. Methods Incident cases of invasive cervical cancer during 2007–2010 were identified from the Ontario Cancer Registry and linked to administrative databases held at the Institute for Clinical Evaluative Sciences. Mean costs in 2010 Canadian dollars were estimated using the arithmetic mean and estimators that adjust for censored data. Results Mean age of the patients in the study cohort (779 cases) was 49.3 years. The mean overall medical care cost was $39,187 [standard error (se): $1,327] in the 1st year after diagnosis. Costs in year 1 ranged from $34,648 (se: $1,275) for those who survived at least 1 year to $69,142 (se: $4,818) for those who died from cervical cancer within 1 year. At 5 years after diagnosis, the mean overall unadjusted cost was $63,131 (se: $3,131), and the cost adjusted for censoring was $68,745 (se: $2,963). Inpatient hospitalizations and cancer-related care were the two largest components of cancer treatment costs. Conclusions We found that the estimated mean costs that did not account for censoring were consistently undervalued, highlighting the importance of estimates based on censoring-adjusted costs in cervical cancer. Our results are reliable for estimating the economic burden of cervical cancer and the cost-effectiveness of cervical cancer prevention strategies. PMID:27122978

Purity and passion: risk and morality in Latina immigrants' and physicians' beliefs about cervical cancer.

PubMed

Martinez, R G; Chavez, L R; Hubbell, F A

1997-06-01

This paper examines how physicians' beliefs about risk factors for cervical cancer compare with Mexican and Salvadoran immigrant women's views (hereafter Latina immigrants). Between August 15, 1991 and August 15, 1992, we conducted ethnographic interviews with 39 Mexican immigrant women, 28 Salvadoran immigrant women, and 30 physicians in northern Orange County, California. Physicians and Latina immigrants converge on their beliefs that sexual behavior is a predominant risk factor for cervical cancer. They diverge, however, on their reasons. Latina immigrants' perceptions of health risks are embedded in a larger set of cultural values centering around gender relations, sexuality, and morality. Latina immigrants also emphasized men's behavior as risk factors. Physicians' views, on the other hand, are largely based on the epidemiology of cervical cancer risk factors. They emphasized beginning sexual relations at an early age, multiple sexual partners, and infection with sexually transmitted viruses. Some physicians, however, displayed moral interpretations of the sex-based risk factors for cervical cancer through the use of the culturally-loaded term "promiscuous" in place of "multiple sexual partners," through specific references to morality, and through characterizations of women at risk for cervical cancer. Both the physicians and the Latina immigrants in our study paid considerably less attention to socioeconomic factors. Our results have important implications for physicians who provide health care for Latina immigrants. Physicians should be clear to point out that women need not be "promiscuous" to get cervical cancer.

Development of a theory-based (PEN-3 and Health Belief Model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping.

PubMed

Scarinci, Isabel C; Bandura, Lisa; Hidalgo, Bertha; Cherrington, Andrea

2012-01-01

The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the sociocultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants.

Development of a Theory-Based (PEN-3 and Health Belief Model), Culturally Relevant Intervention on Cervical Cancer Prevention Among Latina Immigrants Using Intervention Mapping

PubMed Central

Scarinci, Isabel C.; Bandura, Lisa; Hidalgo, Bertha; Cherrington, Andrea

2014-01-01

The development of efficacious theory-based, culturally relevant interventions to promote cervical cancer prevention among underserved populations is crucial to the elimination of cancer disparities. The purpose of this article is to describe the development of a theory-based, culturally relevant intervention focusing on primary (sexual risk reduction) and secondary (Pap smear) prevention of cervical cancer among Latina immigrants using intervention mapping (IM). The PEN-3 and Health Belief Model provided theoretical guidance for the intervention development and implementation. IM provides a logical five-step framework in intervention development: delineating proximal program objectives, selecting theory-based intervention methods and strategies, developing a program plan, planning for adoption in implementation, and creating evaluation plans and instruments. We first conducted an extensive literature review and qualitatively examined the socio-cultural factors associated with primary and secondary prevention of cervical cancer. We then proceeded to quantitatively validate the qualitative findings, which led to development matrices linking the theoretical constructs with intervention objectives and strategies as well as evaluation. IM was a helpful tool in the development of a theory-based, culturally relevant intervention addressing primary and secondary prevention among Latina immigrants. PMID:21422254

Development In Drug Targeting And Delivery In Cervical Cancer.

PubMed

Aggarwal, Urvashi; Goyal, Amit Kumar; Rath, Goutam

2017-10-09

Cervical cancer is the second most common cancer in women. Standard treatment options available for cervical cancer including chemotherapy, surgery and radiation therapy associated with their own side effects and toxicities. Tumor-targeted delivery of anticancer drugs is perhaps one of the most appropriate strategies to achieve optimal outcomes from treatment and improve quality of life. Recently nanocarriers based drug delivery systems owing to their unique properties have been extensively investigated for anticancer drug delivery. In addition to that addressing the anatomical significance of cervical cancer, various local drug delivery strategies for the cancer treatment are introduced like: gels, nanoparticles, polymeric films, rods and wafers, lipid based nanocarrier. Localized drug delivery systems allows passive drug targeting results in high drug concentration at the target site. Further they can be tailor made to achieve both sustained and controlled release behavior, substantially improving therapeutic outcomes and minimizing side effects. This review summarizes the meaningful advances in drug delivery strategies to treat cervical cancer. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

NHERF1 Enhances Cisplatin Sensitivity in Human Cervical Cancer Cells.

PubMed

Tao, Tao; Yang, Xiaomei; Qin, Qiong; Shi, Wen; Wang, Qiqi; Yang, Ying; He, Junqi

2017-01-12

Cervical cancer is one of the most common female malignancies, and cisplatin-based chemotherapy is routinely utilized in locally advanced cervical cancer patients. However, resistance has been the major limitation. In this study, we found that Na⁺/H⁺ Exchanger Regulatory Factor 1 (NHERF1) was downregulated in cisplatin-resistant cells. Analysis based on a cervical cancer dataset from The Cancer Genome Atlas (TCGA) showed association of NHERF1 expression with disease-free survival of patients received cisplatin treatment. NHERF1 overexpression inhibited proliferation and enhanced apoptosis in cisplatin-resistant HeLa cells, whereas NHERF1 knockdown had inverse effects. While parental HeLa cells were more resistant to cisplatin after NHERF1 knockdown, NHERF1 overexpression in CaSki cells promoted cisplatin sensitivity. Overexpression and knockdown studies also showed that NHERF1 significantly inhibited AKT and extracellular signal-regulated kinase (ERK) signaling pathways in cisplatin-resistant cells. Taken together, our results provide the first evidence that NHERF1 can sensitize cisplatin-refractory cervical cancer cells. This study may help to increase understanding of the molecular mechanisms underlying cisplatin resistance in tumors.

NHERF1 Enhances Cisplatin Sensitivity in Human Cervical Cancer Cells

PubMed Central

Tao, Tao; Yang, Xiaomei; Qin, Qiong; Shi, Wen; Wang, Qiqi; Yang, Ying; He, Junqi

2017-01-01

Cervical cancer is one of the most common female malignancies, and cisplatin-based chemotherapy is routinely utilized in locally advanced cervical cancer patients. However, resistance has been the major limitation. In this study, we found that Na+/H+ Exchanger Regulatory Factor 1 (NHERF1) was downregulated in cisplatin-resistant cells. Analysis based on a cervical cancer dataset from The Cancer Genome Atlas (TCGA) showed association of NHERF1 expression with disease-free survival of patients received cisplatin treatment. NHERF1 overexpression inhibited proliferation and enhanced apoptosis in cisplatin-resistant HeLa cells, whereas NHERF1 knockdown had inverse effects. While parental HeLa cells were more resistant to cisplatin after NHERF1 knockdown, NHERF1 overexpression in CaSki cells promoted cisplatin sensitivity. Overexpression and knockdown studies also showed that NHERF1 significantly inhibited AKT and extracellular signal–regulated kinase (ERK) signaling pathways in cisplatin-resistant cells. Taken together, our results provide the first evidence that NHERF1 can sensitize cisplatin-refractory cervical cancer cells. This study may help to increase understanding of the molecular mechanisms underlying cisplatin resistance in tumors. PMID:28085111

Quantification of silver nanoparticle uptake and distribution within individual human macrophages by FIB/SEM slice and view.

PubMed

Guehrs, Erik; Schneider, Michael; Günther, Christian M; Hessing, Piet; Heitz, Karen; Wittke, Doreen; López-Serrano Oliver, Ana; Jakubowski, Norbert; Plendl, Johanna; Eisebitt, Stefan; Haase, Andrea

2017-03-21

Quantification of nanoparticle (NP) uptake in cells or tissues is very important for safety assessment. Often, electron microscopy based approaches are used for this purpose, which allow imaging at very high resolution. However, precise quantification of NP numbers in cells and tissues remains challenging. The aim of this study was to present a novel approach, that combines precise quantification of NPs in individual cells together with high resolution imaging of their intracellular distribution based on focused ion beam/ scanning electron microscopy (FIB/SEM) slice and view approaches. We quantified cellular uptake of 75 nm diameter citrate stabilized silver NPs (Ag 75 Cit) into an individual human macrophage derived from monocytic THP-1 cells using a FIB/SEM slice and view approach. Cells were treated with 10 μg/ml for 24 h. We investigated a single cell and found in total 3138 ± 722 silver NPs inside this cell. Most of the silver NPs were located in large agglomerates, only a few were found in clusters of fewer than five NPs. Furthermore, we cross-checked our results by using inductively coupled plasma mass spectrometry and could confirm the FIB/SEM results. Our approach based on FIB/SEM slice and view is currently the only one that allows the quantification of the absolute dose of silver NPs in individual cells and at the same time to assess their intracellular distribution at high resolution. We therefore propose to use FIB/SEM slice and view to systematically analyse the cellular uptake of various NPs as a function of size, concentration and incubation time.

[Simulation and data analysis of stereological modeling based on virtual slices].

PubMed

Wang, Hao; Shen, Hong; Bai, Xiao-yan

2008-05-01

To establish a computer-assisted stereological model for simulating the process of slice section and evaluate the relationship between section surface and estimated three-dimensional structure. The model was designed by mathematic method as a win32 software based on the MFC using Microsoft visual studio as IDE for simulating the infinite process of sections and analysis of the data derived from the model. The linearity of the fitting of the model was evaluated by comparison with the traditional formula. The win32 software based on this algorithm allowed random sectioning of the particles distributed randomly in an ideal virtual cube. The stereological parameters showed very high throughput (>94.5% and 92%) in homogeneity and independence tests. The data of density, shape and size of the section were tested to conform to normal distribution. The output of the model and that from the image analysis system showed statistical correlation and consistency. The algorithm we described can be used for evaluating the stereologic parameters of the structure of tissue slices.

Web-based volume slicer for 3D electron-microscopy data from EMDB

PubMed Central

Salavert-Torres, José; Iudin, Andrii; Lagerstedt, Ingvar; Sanz-García, Eduardo; Kleywegt, Gerard J.; Patwardhan, Ardan

2016-01-01

We describe the functionality and design of the Volume slicer – a web-based slice viewer for EMDB entries. This tool uniquely provides the facility to view slices from 3D EM reconstructions along the three orthogonal axes and to rapidly switch between them and navigate through the volume. We have employed multiple rounds of user-experience testing with members of the EM community to ensure that the interface is easy and intuitive to use and the information provided is relevant. The impetus to develop the Volume slicer has been calls from the EM community to provide web-based interactive visualisation of 2D slice data. This would be useful for quick initial checks of the quality of a reconstruction. Again in response to calls from the community, we plan to further develop the Volume slicer into a fully-fledged Volume browser that provides integrated visualisation of EMDB and PDB entries from the molecular to the cellular scale. PMID:26876163

Impact of 2-, 4- and 9-valent HPV vaccines on morbidity and mortality from cervical cancer

PubMed Central

Luckett, Rebecca; Feldman, Sarah

2016-01-01

ABSTRACT Cervical cancer causes significant morbidity and mortality worldwide. Most cervical cancers are associated with oncogenic human papillomavirus (HPV), and vaccination with any of 3 available HPV vaccines is anticipated to greatly reduce the burden of cervical cancer. This review provides an overview of the burden of HPV, the efficacy and clinical effectiveness of the bivalent (HPV 16, 18), quadrivalent (HPV 6, 11, 16, 18) and 9vHPV (HPV 6, 11, 16, 1831, 33, 45, 52, 58) vaccines in order to assess the anticipated impact on cervical cancer. All three vaccines show high efficacy in prevention of vaccine-specific HPV-type infection and associated high-grade cervical dysplasia in HPV-naïve women. Early clinical effectiveness data for the bivalent and quadrivalent vaccine demonstrate reduced rates of HPV 16 and 18 prevalence in vaccinated cohorts; data evaluating cervical dysplasia and cervical procedures as outcomes will shed further light on the clinical effectiveness of both vaccines. The bivalent vaccine has demonstrated cross-protection to non-vaccine HPV types, including the types in the 9vHPV vaccine. No clinical effectiveness data is yet available for the 9vHPV vaccine.  While HPV vaccination has great promise to reduce cervical cancer morbidity and mortality, estimated benefits are largely theoretical at present. Large population-based clinical effectiveness studies will provide long-term immunogenicity and effectiveness, as well as assessment of cervical cancer as an endpoint, particularly as young vaccinated women enter the appropriate age range to initiate screening for cervical cancer. Strengthening screening and treatment programs will likely have the greatest impact in the short-term on cervical cancer morbidity and mortality PMID:26588179

The Pittsburgh Cervical Cancer Screening Model: a risk assessment tool.

PubMed

Austin, R Marshall; Onisko, Agnieszka; Druzdzel, Marek J

2010-05-01

Evaluation of cervical cancer screening has grown increasingly complex with the introduction of human papillomavirus (HPV) vaccination and newer screening technologies approved by the US Food and Drug Administration. To create a unique Pittsburgh Cervical Cancer Screening Model (PCCSM) that quantifies risk for histopathologic cervical precancer (cervical intraepithelial neoplasia [CIN] 2, CIN3, and adenocarcinoma in situ) and cervical cancer in an environment predominantly using newer screening technologies. The PCCSM is a dynamic Bayesian network consisting of 19 variables available in the laboratory information system, including patient history data (most recent HPV vaccination data), Papanicolaou test results, high-risk HPV results, procedure data, and histopathologic results. The model's graphic structure was based on the published literature. Results from 375 441 patient records from 2005 through 2008 were used to build and train the model. Additional data from 45 930 patients were used to test the model. The PCCSM compares risk quantitatively over time for histopathologically verifiable CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients for each current cytology result category and for each HPV result. For each current cytology result, HPV test results affect risk; however, the degree of cytologic abnormality remains the largest positive predictor of risk. Prior history also alters the CIN2, CIN3, adenocarcinoma in situ, and cervical cancer risk for patients with common current cytology and HPV test results. The PCCSM can also generate negative risk projections, estimating the likelihood of the absence of histopathologic CIN2, CIN3, adenocarcinoma in situ, and cervical cancer in screened patients. The PCCSM is a dynamic Bayesian network that computes quantitative cervical disease risk estimates for patients undergoing cervical screening. Continuously updatable with current system data, the PCCSM provides a new tool to monitor cervical disease risk in the evolving postvaccination era.

Adrenergic nerve fibres and mast cells: correlation in rat thymus.

PubMed

Artico, Marco; Cavallotti, Carlo; Cavallotti, Daniela

2002-10-21

The interactions between adrenergic nerve fibres and mast cells (MCs) were studied in the thymus of adult and old rats by morphological methods and by quantitative analysis of images (QAIs). The whole thymus was drawn in adult (12 months old) rats: normal, sympathectomized or electrostimulated. Thymuses from the above-mentioned animals were weighed, measured and dissected. Thymic slices were stained with eosin orange for detection of microanatomical details and with Bodian's method for identification of the whole nerve fibres. Thymic MCs were stained with Astrablau. Histofluorescence microscopy was used for staining of adrenergic nerve fibres. Finally, all morphological results were submitted to the QAIs and statistical analysis of data. Our results suggest that after surgical sympathectomy, the greater part of adrenergic nerve fibres disappear while related MCs appear to show less evident fluorescence and few granules. On the contrary, electrostimulation of the cervical superior ganglion induced an increase in the fluorescence of adrenergic nerve fibres and of related MCs.

Extended supraclavicular fasciocutaneous island flap based on the transverse cervical artery for head and neck reconstruction after cancer ablation.

PubMed

Chen, Wei-Liang; Zhang, Da-ming; Yang, Zhao-hui; Huang, Zhi-quan; Wang, Jian-guang; Zhang, Bin; Li, Jing-song

2010-10-01

This clinical study assessed a pedicled supraclavicular fasciocutaneous island flap (SFIF) based on the transverse cervical artery that was extended to include shoulder skin for reconstructing the head and neck. Pedicled SFIFs extended to include the shoulder skin based on the cutaneous feeder vessels and perforator vessels in the deep fascia of the transverse cervical artery were designed for 24 patients with defects of the head and neck after cancer ablation. Preoperative 3-dimensional computed tomographic angiography was performed in all patients. The patients consisted of 15 men and 9 women ranging in age from 24 to 73 years. The primary lesions included squamous cell carcinoma of the tongue, buccal mucosa, floor of the mouth, oropharynx, palate, and lower gingiva. Three-dimensional computed tomographic angiography showed that the transverse cervical artery arose from the thyrocervical trunk in 13 cases and from the subclavian artery in 11 cases. The diameter of the artery ranged from 0.15 to 0.24 cm. The size of flaps ranged from 4 × 8 cm to 6 × 12 cm, and the mean length of the vascular pedicle was approximately 18.5 cm. Of the flaps, 23 survived completely, for a success rate of 95.8%. Three patients underwent radiotherapy, and the follow-up period ranged from 3 to 12 months. One patient died of local tumor recurrence, and cervical recurrences developed in 3 patients. An SFIF extended to include the shoulder skin based on the cutaneous feeder vessels and perforator vessels in the deep fascia of the transverse cervical artery is a useful, viable option for defects of the head and neck after cancer ablation. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Study of gas-liquid flow in model porous media for heterogeneous catalysis

NASA Astrophysics Data System (ADS)

Francois, Marie; Bodiguel, Hugues; Guillot, Pierre; Laboratory of the Future Team

2015-11-01

Heterogeneous catalysis of chemical reactions involving a gas and a liquid phase is usually achieved in fixed bed reactors. Four hydrodynamic regimes have been observed. They depend on the total flow rate and the ratio between liquid and gas flow rate. Flow properties in these regimes influence transfer rates. Rather few attempts to access local characterization have been proposed yet, though these seem to be necessary to better describe the physical mechanisms involved. In this work, we propose to mimic slices of reactor by using two-dimensional porous media. We have developed a two-dimensional system that is transparent to allow the direct observation of the flow and the phase distribution. While varying the total flow rate and the gas/liquid flow rate ratio, we observe two hydrodynamic regimes: at low flow rate, the gaseous phase is continuous (trickle flow), while it is discontinuous at higher flow rate (pulsed flow). Thanks to some image analysis techniques, we are able to quantify the local apparent liquid saturation in the system. Its fluctuations in time are characteristic of the transition between the two regimes: at low liquid flow rates, they are negligible since the liquid/gas interface is fixed, whereas at higher flow rates we observe an alternation between liquid and gas. This transition between trickle to pulsed flow is in relative good agreement with the existing state of art. However, we report in the pulsed regime important flow heterogeneities at the scale of a few pores. These heterogeneities are likely to have a strong influence on mass transfers. We acknowledge the support of Solvay.

Evaluation of Multilayer Cloud Detection Using a MODIS CO2-Slicing Algorithm With CALIPSO-CloudSat Measurements

NASA Technical Reports Server (NTRS)

Viudez-Mora, Antonio; Kato, Seiji

2015-01-01

This work evaluates the multilayer cloud (MCF) algorithm based on CO2-slicing techniques against CALISPO-CloudSat (CLCS) measurement. This evaluation showed that the MCF underestimates the presence of multilayered clouds compared with CLCS and are retrained to cloud emissivities below 0.8 and cloud optical septs no larger than 0.3.

Interactive Simulation of Hardwood Log Veneer Slicing Using CT Images

Treesearch

Daniel L Schmoldt; Pei Li; Philip A. Araman

1996-01-01

Veneer producers must make critical processing decisions based solely on external examination of logs. Unlike sawlog breakdown, however, little research has investigated ways in which veneer logs can best be flitched and sliced for increased value. This gap exists largely due to the variety of ways in which veneer is produced and used and the variety of buyers that...

Using the Theory of Planned Behavior to Understand Cervical Cancer Screening Among Latinas.

PubMed

Roncancio, Angelica M; Ward, Kristy K; Sanchez, Ingrid A; Cano, Miguel A; Byrd, Theresa L; Vernon, Sally W; Fernandez-Esquer, Maria Eugenia; Fernandez, Maria E

2015-10-01

To reduce the high incidence of cervical cancer among Latinas in the United States it is important to understand factors that predict screening behavior. The aim of this study was to test the utility of theory of planned behavior in predicting cervical cancer screening among a group of Latinas. A sample of Latinas (N = 614) completed a baseline survey about Pap test attitudes subjective norms, perceived behavioral control, and intention to be screened for cervical cancer. At 6 months postbaseline, cervical cancer screening behavior was assessed. Structural equation modeling was used to test the theory. Model fit statistics indicated good model fit: χ(2)(48) = 54.32, p = .246; comparative fit index = .992; root mean square error of approximation = .015; weighted root mean square residual = .687. Subjective norms (p = .005) and perceived behavioral control (p < .0001) were positively associated with intention to be screened for cervical cancer, and the intention to be screened predicted actual cervical cancer screening (p < .0001). The proportion of variance (R2) in intention accounted for by the predictors was .276 and the R2 in cervical cancer screening accounted for was .130. This study provides support for the use of the theory of planned behavior in predicting cervical cancer screening among Latinas. This knowledge can be used to inform the development of a theory of planned behavior-based intervention to increase cervical cancer screening among Latinas and reduce the high incidence of cervical cancer in this group of women. © 2015 Society for Public Health Education.

Estrogen contributes to the onset, persistence, and malignant progression of cervical cancer in a human papillomavirus-transgenic mouse model

PubMed Central

Brake, Tiffany; Lambert, Paul F.

2005-01-01

Cervical cancer is a leading cause of death by cancer among women worldwide. High-risk human papillomaviruses (HPVs) are the major etiological agents for cervical cancer, but other factors likely contribute to cervical cancer, because these cancers commonly arise decades after initial exposure to HPV. Estrogen is thought to be one such cofactor; however, its temporal requirements in human cervical cancer are not known. Here we evaluate the temporal requirements of estrogen in cervical carcinogenesis in a mouse model for HPV-associated cervical cancer. Tumors arising in HPV16 transgenic mice treated with estrogen for 9 months were greatly increased in their size compared with tumors developing after 6 months of estrogen treatment. HPV16 transgenic mice treated 6 months with estrogen followed by 3 months without exogenous estrogen had significantly fewer tumors and the tumors were smaller and less aggressive than those arising in mice treated the full 9 months. Importantly, cervical cancers that arose in the mice treated the first 6 of 9 months with estrogen must have regressed, based upon the reduced incidence of cancers in these mice compared with those treated for 6 months with estrogen, then immediately analyzed. We conclude that estrogen plays a critical role not only in the genesis of cervical cancer but also in its persistence and continued development in this mouse model. These findings raise the clinically relevant possibility that, if human cervical cancer has a similar dependence on estrogen for continued tumor growth, then antiestrogen therapy may be effective in the treatment of cervical cancer. PMID:15699322

Multiple biomarkers in molecular oncology. I. Molecular diagnostics applications in cervical cancer detection.

PubMed

Malinowski, Douglas P

2007-03-01

The screening for cervical carcinoma and its malignant precursors (cervical neoplasia) currently employs morphology-based detection methods (Papanicolaou [Pap] smear) in addition to the detection of high-risk human papillomavirus. The combination of the Pap smear with human papillomavirus testing has achieved significant improvements in sensitivity for the detection of cervical disease. Diagnosis of cervical neoplasia is dependent upon histology assessment of cervical biopsy specimens. Attempts to improve the specificity of cervical disease screening have focused on the investigation of molecular biomarkers for adjunctive use in combination with the Pap smear. Active research into the genomic and proteomic alterations that occur during human papillomavirus-induced neoplastic transformation have begun to characterize some of the basic mechanisms inherent to the disease process of cervical cancer development. This research continues to demonstrate the complexity of multiple genomic and proteomic alterations that accumulate during the tumorigenesis process. Despite this diversity, basic patterns of uncontrolled signal transduction, cell cycle deregulation, activation of DNA replication and altered extracellular matrix interactions are beginning to emerge as common features inherent to cervical cancer development. Some of these gene or protein expression alterations have been investigated as potential biomarkers for screening and diagnostics applications. The contribution of multiple gene alterations in the development of cervical cancer suggests that the application of multiple biomarker panels has the potential to develop clinically useful molecular diagnostics. In this review, the application of biomarkers for the improvement of sensitivity and specificity of the detection of cervical neoplasia within cytology specimens will be discussed.

SH3BP1-induced Rac-Wave2 pathway activation regulates cervical cancer cell migration, invasion, and chemoresistance to cisplatin.

PubMed

Wang, Jingjing; Feng, Yeqian; Chen, Xishan; Du, Zheng; Jiang, Shaijun; Ma, Shuyun; Zou, Wen

2018-02-01

Cervical cancer still remains the fourth most common cancer, affecting women worldwide with large geographic variations in cervical cancer incidence and mortality rates. SH3-domain binding protein-1 (SH3BP1) specifically inactivating Rac1 and its target Wave2 is required for cell motility, thus regarded as an essential regulator of cancer cell metastasis. However, the exact effects and molecular mechanisms of SH3BP1 in cervical cancer progression are still unknown. The present study is aimed to investigate the mechanism of SH3BP1 in regulation of cervical cancer cell metastasis and chemoresistance. In the present study, we demonstrated a high SH3BP1 expression in cervical cancer tissues; a higher SH3BP1 expression is also correlated with a shorter overall survival of patients with cervical cancer. Further, we revealed that SH3BP1 overexpression promoted the invasion, migration, and chemoresistance of cervical cancer cell through increasing Rac1 activity and Wave2 protein level. The promotive effect of SH3BP1 could be partially reversed by a Rac1 inhibitor, NSC 23766. In cisplatin-resistant cervical cancer tissues, SH3BP1, Rac1, and Wave2 mRNA expression was significantly up-regulated compared to that of the cisplatin-sensitive cervical cancer tissues. Taken together, SH3BP1/Rac1/Wave2 pathway may potentially act as an effective therapeutic target combined with traditional cisplatin-based chemotherapy for cervical cancer. © 2017 Wiley Periodicals, Inc.

Ophthalmologic diagnostic tool using MR images for biomechanically-based muscle volume deformation

NASA Astrophysics Data System (ADS)

Buchberger, Michael; Kaltofen, Thomas

2003-05-01

We would like to give a work-in-progress report on our ophthalmologic diagnostic software system which performs biomechanically-based muscle volume deformations using MR images. For reconstructing a three-dimensional representation of an extraocular eye muscle, a sufficient amount of high resolution MR images is used, each representing a slice of the muscle. In addition, threshold values are given, which restrict the amount of data used from the MR images. The Marching Cube algorithm is applied to the polygons, resulting in a 3D representation of the muscle, which can efficiently be rendered. A transformation to a dynamic, deformable model is applied by calculating the center of gravity of each muscle slice, approximating the muscle path and subsequently adding Hermite splines through the centers of gravity of all slices. Then, a radius function is defined for each slice, completing the transformation of the static 3D polygon model. Finally, this paper describes future extensions to our system. One of these extensions is the support for additional calculations and measurements within the reconstructed 3D muscle representation. Globe translation, localization of muscle pulleys by analyzing the 3D reconstruction in two different gaze positions and other diagnostic measurements will be available.

Bandwidth scalable, coherent transmitter based on the parallel synthesis of multiple spectral slices using optical arbitrary waveform generation.

PubMed

Geisler, David J; Fontaine, Nicolas K; Scott, Ryan P; He, Tingting; Paraschis, Loukas; Gerstel, Ori; Heritage, Jonathan P; Yoo, S J B

2011-04-25

We demonstrate an optical transmitter based on dynamic optical arbitrary waveform generation (OAWG) which is capable of creating high-bandwidth (THz) data waveforms in any modulation format using the parallel synthesis of multiple coherent spectral slices. As an initial demonstration, the transmitter uses only 5.5 GHz of electrical bandwidth and two 10-GHz-wide spectral slices to create 100-ns duration, 20-GHz optical waveforms in various modulation formats including differential phase-shift keying (DPSK), quaternary phase-shift keying (QPSK), and eight phase-shift keying (8PSK) with only changes in software. The experimentally generated waveforms showed clear eye openings and separated constellation points when measured using a real-time digital coherent receiver. Bit-error-rate (BER) performance analysis resulted in a BER < 9.8 × 10(-6) for DPSK and QPSK waveforms. Additionally, we experimentally demonstrate three-slice, 4-ns long waveforms that highlight the bandwidth scalable nature of the optical transmitter. The various generated waveforms show that the key transmitter properties (i.e., packet length, modulation format, data rate, and modulation filter shape) are software definable, and that the optical transmitter is capable of acting as a flexible bandwidth transmitter.

Mechanisms of cervical spine injuries for non-fatal motorcycle road crash.

PubMed

Ooi, S S; Wong, S V; Radin Umar, R S; Azhar, A A; Yeap, J S; Megat Ahmad, M M H

2004-06-01

Cervical spine injuries such as subluxation and fracture dislocation have long been known to result in severe consequences, as well as the trauma management itself. The injury to the region has been identified as one of the major causes of death in Malaysian motorcyclists involved in road crashes, besides head and chest injuries (Pang, 1999). Despite this, cervical spine injury in motorcyclists is not a well-studied injury, unlike the whiplash injury in motorcar accidents. The present study is a retrospective study on the mechanisms of injury in cervical spine sustained by Malaysian motorcyclists, who were involved in road crash using an established mechanistic classification system. This will serve as an initial step to look at the cervical injuries pattern. The information obtained gives engineer ideas to facilitate design and safety features to reduce injuries. All cervical spine injured motorcyclists admitted to Hospital Kuala Lumpur between January 1, 2000 and December 31, 2001 were included in the present study. Based on the medical notes and radiological investigations (X-rays, CT and MRI scans), the mechanisms of injuries were formulated using the injury mechanics classification. The result shows that flexion of the cervical vertebrae is the most common vertebral kinematics in causing injury to motorcyclists. This indicates that the cervical vertebrae sustained a high-energy loading at flexion movement in road crash, and exceeded its tolerance level. The high frequency of injury at the C5 vertebra, C6 vertebra and C5-C6 intervertebral space are recorded. Classification based on the Abbreviated Injury Scale (AIS) is made to give a view on injury severity, 9.1% of the study samples have been classified as AIS code 1, 51.5% with AIS 2 and 21.2% with AIS 3.

Secondary Primary Malignancy Risk in Patients With Cervical Cancer in Taiwan: A Nationwide Population-Based Study.

PubMed

Teng, Chung-Jen; Huon, Leh-Kiong; Hu, Yu-Wen; Yeh, Chiu-Mei; Chao, Yee; Yang, Muh-Hwa; Chen, Tzeng-Ji; Hung, Yi-Ping; Liu, Chia-Jen

2015-10-01

To evaluate the risk of secondary primary malignancy (SPM) in patients with cervical cancer using a nationwide population-based dataset.Patients newly diagnosed with cervical cancer between 1997 and 2011 were identified using Taiwan's National Health Insurance database. Patients with antecedent malignancies were excluded. Standardized incidence ratios (SIRs) for SPM were calculated by comparing with the cancer incidence in the general population. Risk factors for cancer development were analyzed using Cox proportional hazard models.During the 14-year study period (follow-up of 223,062 person-years), 2004 cancers developed in 35,175 patients with cervical cancer. The SIR for all cancers was 1.56 (95% confidence interval, 1.50-1.63, P < 0.001). SIRs for follow-up periods of >10, 5 to 10, 1 to 5, and <1 year were 1.37, 1.51, 1.34, and 2.59, respectively. After the exclusion of SPM occurring within 1 year of cervical cancer diagnosis, SIRs were significantly higher for cancers of the esophagus (2.05), stomach (1.38), colon, rectum, and anus (1.36); lung and mediastinum (2.28), bone and soft tissue (2.23), uterus (3.76), bladder (2.26), and kidneys (1.41). Multivariate analysis showed that age ≥60 was a significant SPM risk factor (hazard ratio [HR] 1.59). Different treatments for cervical cancer, including radiotherapy (HR 1.41) and chemotherapy (HR 1.27), had different impacts on SPM risk. Carboplatin and fluorouracil independently increased SPM risk in cervical cancer patients.Patients with cervical cancer are at increased risk of SPM development. Age ≥60 years, chemotherapy, and radiotherapy are independent risk factors. Carboplatin and fluorouracil also increased SPM risk independently. Close surveillance of patients at high risk should be considered for the early detection of SPMs.

In vivo electric conductivity of cervical cancer patients based on B₁⁺ maps at 3T MRI.

PubMed

Balidemaj, E; de Boer, P; van Lier, A L H M W; Remis, R F; Stalpers, L J A; Westerveld, G H; Nederveen, A J; van den Berg, C A T; Crezee, J

2016-02-21

The in vivo electric conductivity (σ) values of tissue are essential for accurate electromagnetic simulations and specific absorption rate (SAR) assessment for applications such as thermal dose computations in hyperthermia. Currently used σ-values are mostly based on ex vivo measurements. In this study the conductivity of human muscle, bladder content and cervical tumors is acquired non-invasively in vivo using MRI. The conductivity of 20 cervical cancer patients was measured with the MR-based electric properties tomography method on a standard 3T MRI system. The average in vivo σ-value of muscle is 14% higher than currently used in human simulation models. The σ-value of bladder content is an order of magnitude higher than the value for bladder wall tissue that is used for the complete bladder in many models. Our findings are confirmed by various in vivo animal studies from the literature. In cervical tumors, the observed average conductivity was 13% higher than the literature value reported for cervical tissue. Considerable deviations were found for the electrical conductivity observed in this study and the commonly used values for SAR assessment, emphasizing the importance of acquiring in vivo conductivity for more accurate SAR assessment in various applications.

Global strategies for cervical cancer prevention.

PubMed

Pimple, Sharmila; Mishra, Gauravi; Shastri, Surendra

2016-02-01

Cervical cancer still remains the fourth most common cancer, affecting women worldwide with large geographic variations in cervical cancer incidence and mortality rates. There exist vast disparities in cervix cancer control and prevention efforts globally. The present review addresses the current developments in cervical cancer prevention and control across both high-income countries and low-middle income countries and attempts to identify new strategies that might help address the gaps in cervical cancer care disparities globally. Paradigms for cervix cancer screening are changing in high-resource settings from cytology-based screening to adoption of molecular screening and cotesting to achieve program effectiveness. Low-middle income countries with larger burden of cervical cancer continue to face financial and logistic limitations to make both cervix cancer screening and human papillomavirus vaccine available to their populations. Alternative low-cost screening technologies, operationally feasible implementation strategies, reduction of cost of procurement and delivery approaches for human papillomavirus vaccine need assessment to decrease cancer care disparities. Efforts directed toward cervix cancer prevention and early detection for improvements in cervical cancer outcomes of incidence and mortality have to be proportionately matched by access to acceptable standards of cancer care.

Treatment of cervical intraepithelial lesions.

PubMed

Castle, Philip E; Murokora, Dan; Perez, Carlos; Alvarez, Manuel; Quek, Swee Chong; Campbell, Christine

2017-07-01

Precancerous cervical lesions precede the development of invasive cervical cancer by 10-20 years, making cervical cancer preventable if these lesions are detected and effectively treated. Treatment has evolved in the last few decades and now includes ablative options that can be performed in lower-resource settings where surgical excision is not feasible or routinely available. Gas-based cryotherapy, which freezes cervical tissue to induce localized necrosis, is the most commonly used ablative treatment. However, its implementation in low-resource settings is difficult because the refrigerant gas can be difficult to procure and transport, and is expensive. New cryotherapy devices that do not require an external supply of gas appear promising. Thermal coagulation, which burns cervical tissue to induce necrosis, has become more widely available in the last few years owing to its portability and the feasibility of using battery-powered devices. These two ablative treatments successfully eradicate 75%-85% of high-grade cervical lesions and have minor adverse effects. © 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

In vivo and in vitro hyperspectral imaging of cervical neoplasia

NASA Astrophysics Data System (ADS)

Wang, Chaojian; Zheng, Wenli; Bu, Yanggao; Chang, Shufang; Tong, Qingping; Zhang, Shiwu; Xu, Ronald X.

2014-02-01

Cervical cancer is a prevalent disease in many developing countries. Colposcopy is the most common approach for screening cervical intraepithelial neoplasia (CIN). However, its clinical efficacy heavily relies on the examiner's experience. Spectroscopy is a potentially effective method for noninvasive diagnosis of cervical neoplasia. In this paper, we introduce a hyperspectral imaging technique for noninvasive detection and quantitative analysis of cervical neoplasia. A hyperspectral camera is used to collect the reflectance images of the entire cervix under xenon lamp illumination, followed by standard colposcopy examination and cervical tissue biopsy at both normal and abnormal sites in different quadrants. The collected reflectance data are calibrated and the hyperspectral signals are extracted. Further spectral analysis and image processing works are carried out to classify tissue into different types based on the spectral characteristics at different stages of cervical intraepithelial neoplasia. The hyperspectral camera is also coupled with a lab microscope to acquire the hyperspectral transmittance images of the pathological slides. The in vivo and the in vitro imaging results are compared with clinical findings to assess the accuracy and efficacy of the method.

Evaluation of browning ratio in an image analysis of apple slices at different stages of instant controlled pressure drop-assisted hot-air drying (AD-DIC).

PubMed

Gao, Kun; Zhou, Linyan; Bi, Jinfeng; Yi, Jianyong; Wu, Xinye; Zhou, Mo; Wang, Xueyuan; Liu, Xuan

2017-06-01

Computer vision-based image analysis systems are widely used in food processing to evaluate quality changes. They are able to objectively measure the surface colour of various products since, providing some obvious advantages with their objectivity and quantitative capabilities. In this study, a computer vision-based image analysis system was used to investigate the colour changes of apple slices dried by instant controlled pressure drop-assisted hot air drying (AD-DIC). The CIE L* value and polyphenol oxidase activity in apple slices decreased during the entire drying process, whereas other colour indexes, including CIE a*, b*, ΔE and C* values, increased. The browning ratio calculated by image analysis increased during the drying process, and a sharp increment was observed for the DIC process. The change in 5-hydroxymethylfurfural (5-HMF) and fluorescent compounds (FIC) showed the same trend with browning ratio due to Maillard reaction. Moreover, the concentrations of 5-HMF and FIC both had a good quadratic correlation (R 2  > 0.998) with the browning ratio. Browning ratio was a reliable indicator of 5-HMF and FIC changes in apple slices during drying. The image analysis system could be used to monitor colour changes, 5-HMF and FIC in dehydrated apple slices during the AD-DIC process. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Representation of deformable motion for compression of dynamic cardiac image data

NASA Astrophysics Data System (ADS)

Weinlich, Andreas; Amon, Peter; Hutter, Andreas; Kaup, André

2012-02-01

We present a new approach for efficient estimation and storage of tissue deformation in dynamic medical image data like 3-D+t computed tomography reconstructions of human heart acquisitions. Tissue deformation between two points in time can be described by means of a displacement vector field indicating for each voxel of a slice, from which position in the previous slice at a fixed position in the third dimension it has moved to this position. Our deformation model represents the motion in a compact manner using a down-sampled potential function of the displacement vector field. This function is obtained by a Gauss-Newton minimization of the estimation error image, i. e., the difference between the current and the deformed previous slice. For lossless or lossy compression of volume slices, the potential function and the error image can afterwards be coded separately. By assuming deformations instead of translational motion, a subsequent coding algorithm using this method will achieve better compression ratios for medical volume data than with conventional block-based motion compensation known from video coding. Due to the smooth prediction without block artifacts, particularly whole-image transforms like wavelet decomposition as well as intra-slice prediction methods can benefit from this approach. We show that with discrete cosine as well as with Karhunen-Lo`eve transform the method can achieve a better energy compaction of the error image than block-based motion compensation while reaching approximately the same prediction error energy.

Cervical cancer educational pamphlets: Do they miss the mark for Mexican immigrant women's needs?

PubMed

Hunter, Jennifer L

2005-11-01

The rate of invasive cervical cancer in US Hispanic women is nearly doubled that of non-Hispanics. Using in-depth interviews and content/grade level analysis of educational materials, this study explores the relevance of cervical cancer education materials to the needs of Mexican immigrant women. It also addresses health literacy issues that create barriers to learning. Findings show aspects of language, content, reading level, structure, and visual images in 22 cervical cancer pamphlets from 11 health care sites in a Midwest city were not relevant to the learning needs or health literacy levels of local Mexican immigrant women. Further research is recommended to establish an evidence base regarding optimal presentation of key elements of the cervical cancer educational message for Mexican immigrant women.

Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy

PubMed Central

Rossi, Paolo Giorgi; Ricciardi, Alessandro; Cohet, Catherine; Palazzo, Fabio; Furnari, Giacomo; Valle, Sabrina; Largeron, Nathalie; Federici, Antonio

2009-01-01

Background We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities. Methods The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia) was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region. Results An estimated 6.4 million women aged 25–69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively). Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000–17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to €158.5 million for screening and €22.9 million for the management of cervical abnormalities. Conclusion Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately €181.5 million, of which 87% is attributable to screening. PMID:19243586

Robotic and endoscopic transaxillary thyroidectomies may be cost prohibitive when compared to standard cervical thyroidectomy: a cost analysis.

PubMed

Cabot, Jennifer C; Lee, Cho Rok; Brunaud, Laurent; Kleiman, David A; Chung, Woong Youn; Fahey, Thomas J; Zarnegar, Rasa

2012-12-01

This study presents a cost analysis of the standard cervical, gasless transaxillary endoscopic, and gasless transaxillary robotic thyroidectomy approaches based on medical costs in the United States. A retrospective review of 140 patients who underwent standard cervical, transaxillary endoscopic, or transaxillary robotic thyroidectomy at 2 tertiary centers was conducted. The cost model included operating room charges, anesthesia fee, consumables cost, equipment depreciation, and maintenance cost. Sensitivity analyses assessed individual cost variables. The mean operative times for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were 121 ± 18.9, 185 ± 26.0, and 166 ± 29.4 minutes, respectively. The total cost for the standard cervical, transaxillary endoscopic, and transaxillary robotic approaches were $9,028 ± $891, $12,505 ± $1,222, and $13,670 ± $1,384, respectively. Transaxillary approaches were significantly more expensive than the standard cervical technique (standard cervical/transaxillary endoscopic, P < .0001; standard cervical/transaxillary robotic, P < .0001; and transaxillary endoscopic/transaxillary robotic, P = .001). The transaxillary and standard cervical techniques became equivalent in cost when transaxillary endoscopic operative time decreased to 111 minutes and transaxillary robotic operative time decreased to 68 minutes. Increasing the case load did not resolve the cost difference. Transaxillary endoscopic and transaxillary robotic thyroidectomies are significantly more expensive than the standard cervical approach. Decreasing operative times reduces this cost difference. The greater expense may be prohibitive in countries with a flat reimbursement schedule. Copyright © 2012 Mosby, Inc. All rights reserved.

Outcomes following cervical disc arthroplasty: a retrospective review.

PubMed

Cody, John P; Kang, Daniel G; Tracey, Robert W; Wagner, Scott C; Rosner, Michael K; Lehman, Ronald A

2014-11-01

Cervical disc arthroplasty has emerged as a viable technique for the treatment of cervical radiculopathy and myelopathy, with the proposed benefit of maintenance of segmental range of motion. There are relatively few, non-industry sponsored studies examining the outcomes and complications of cervical disc arthroplasty. Therefore, we set out to perform a single center evaluation of the outcomes and complications of cervical disc arthroplasty. We performed a retrospective review of all patients from a single military tertiary medical center undergoing cervical disc arthroplasty from August 2008 to August 2012. The clinical outcomes and complications associated with the procedure were evaluated. A total of 219 consecutive patients were included in the review, with an average follow-up of 11.2 (±11.0)months. Relief of pre-operative symptoms was noted in 88.7% of patients, and 92.2% of patients were able to return to full pre-operative activity. There was a low rate of complications related to the anterior cervical approach (3.2% with recurrent laryngeal nerve injury, 8.9% with dysphagia), with no device/implant related complications. Symptomatic cervical radiculopathy is a common problem in both the civilian and active duty military populations and can cause significant disability leading to loss of work and decreased operational readiness. There exist several surgical treatment options for appropriately indicated patients. Based on our findings, cervical disc arthroplasty is a safe and effective treatment for symptomatic cervical radiculopathy and myelopathy, with a low incidence of complications and high rate of symptom relief. Published by Elsevier Ltd.

Questions About Cervical and Breast Cancer Screening Knowledge, Practice, and Outcomes: A Review of Demographic and Health Surveys.

PubMed

Viens, Laura; Perin, Doug; Senkomago, Virginia; Neri, Antonio; Saraiya, Mona

2017-05-01

United Nation's Sustainable Development Goals and the World Health Organization's Global Monitoring Framework support a strong global commitment to reducing the high burden of cervical and breast cancers among low- and middle-income countries. Strategies include vaccination, screening, and early diagnosis. Population-based surveys, such as those conducted by the Demographic and Health Surveys (DHS) Program, can collect the information needed to guide cancer control efforts in a standardized comparable manner. We identified and evaluated the breadth of breast and cervical cancer screening information that was collected by the DHS from 1984 through 2015. Then, we determined if these surveys currently provide the specific and measurable data about both the quantity and quality of cancer screening needed to guide national efforts to reduce the overall effects of cervical and breast cancers. We searched the DHS website to identify surveys conducted between the start of the DHS Program in 1984 and November 2015 that included questions about breast and cervical cancer screening. The relevant questions were extracted from the questionnaire, translated into English, and grouped by themes. Of the 90 countries where DHS surveys have been implemented, cervical cancer screening questions were included in 22 countries (24.4%) and breast cancer screening questions in 18 countries (20.0%). The common themes identified were disease knowledge, screening knowledge, screening practice, and screening outcomes. Most countries with survey questionnaires available for review addressed at least one aspect of screening practice (88.9% of cervical and 87.5% of breast), although few countries queried knowledge and outcomes. Questions that assess varied aspects of breast and cervical cancer screening have been incorporated into relatively few DHS surveys. The themes identified could guide the design of a standard set of questions for use in future population-based surveys and enable evaluation beyond the existence of screening, which would include assessment of the quality and impact of cervical and breast cancer screening.

Cervical external immobilization devices: evaluation of magnetic resonance imaging issues at 3.0 Tesla.

PubMed

Diaz, Francis L; Tweardy, Lisa; Shellock, Frank G

2010-02-15

Laboratory investigation, ex vivo. Currently, no studies have addressed the magnetic resonance imaging (MRI) issues for cervical external immobilization devices at 3-Tesla. Under certain conditions significant heating may occur, resulting in patient burns. Furthermore, artifacts can be substantial and prevent the diagnostic use of MRI. Therefore, the objective of this investigation was to evaluate MRI issues for 4 different cervical external immobilization devices at 3-Tesla. Excessive heating and substantial artifacts are 2 potential complications associated with performing MRI at 3-Tesla in patients with cervical external immobilization devices. Using ex vivo testing techniques, MRI-related heating and artifacts were evaluated for 4 different cervical devices during MRI at 3-Tesla. Four cervical external immobilization devices (Generation 80, Resolve Ring and Superstructure, Resolve Ring and Jerome Vest/Jerome Superstructure, and the V1 Halo System; Ossur Americas, Aliso Viejo, CA) underwent MRI testing at 3-Tesla. All devices were made from nonmetallic or nonmagnetic materials. Heating was determined using a gelled-saline-filled skull phantom with fluoroptic thermometry probes attached to the skull pins. MRI was performed at 3-Tesla, using a high level of RF energy. Artifacts were assessed at 3-Tesla, using standard cervical imaging techniques. The Generation 80 and V1 Halo devices exhibited substantial temperature rises (11.6 degrees C and 8.5 degrees C, respectively), with "sparking" evident for the Generation 80 during the MRI procedure. Artifacts were problematic for these devices, as well. By comparison, the 2 Resolve Ring-based cervical external immobilization devices showed little or no heating (< or = 0.6 degrees C) and the artifacts were acceptable for diagnostic MRI examinations. The low degree of heating and minor artifacts associated with the Resolve-based cervical external immobilization devices indicated that these products are safe for patients undergoing MRI at 3-Tesla.

Mixing with propylene glycol enhances the bond strength of mineral trioxide aggregate to dentin.

PubMed

Salem Milani, Amin; Froughreyhani, Mohammad; Charchi Aghdam, Saeed; Pournaghiazar, Fatemeh; Asghari Jafarabadi, Mohammad

2013-11-01

Mixing mineral trioxide aggregate (MTA) with different proportions of propylene glycol (PG) improves its handling property. The aim of this study was to evaluate the effect of PG on MTA-dentin push-out bond strength. Seventy-five 2-mm-thick midroot sections were prepared from single-rooted human extracted teeth. The lumen of each slice was enlarged with Gates-Glidden burs. The slices were randomly divided into 3 groups (n = 25). In each group, 0.3 mL of the liquid was mixed with 1 g MTA (Angelus, Londrina, Brazil). The liquid vehicles used in groups 1-3 were 100% distilled water (DW), 20% PG-80% DW, and 100% PG, respectively. After incubation, the push-out strength of the samples was measured using a universal testing machine. The samples were then cut in halves and examined under a stereomicroscope to determine the failure pattern. One-way analysis of variance followed by the Tukey post hoc test was used to compare the push-out strength among groups. There were statistically significant differences between groups (P < .001). The push-out strength in group 1 (DW) was significantly lower than groups 2 and 3 (P < .001 and P = .022, respectively). However, there was no significant difference between groups 2 (DW-PG) and 3 (PG). Mixing MTA with PG increased its push-out bond strength to dentin. In the present study, the most suitable ratio was 80% DW-20% PG. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

CrossFit-related cervical internal carotid artery dissection.

PubMed

Lu, Albert; Shen, Peter; Lee, Paul; Dahlin, Brian; Waldau, Ben; Nidecker, Anna E; Nundkumar, Anoop; Bobinski, Matthew

2015-08-01

CrossFit is a high-intensity strength and conditioning program that has gained popularity over the past decade. Potential injuries associated with CrossFit training have been suggested in past reports. We report three cases of cervical carotid dissection that are associated with CrossFit workouts. Patient 1 suffered a distal cervical internal carotid artery (ICA) dissection near the skull base and a small infarct in Wernicke's area. He was placed on anticoagulation and on follow-up has near complete recovery. Patient 2 suffered a proximal cervical ICA dissection that led to arterial occlusion and recurrent middle cerebral artery territory infarcts and significant neurological sequelae. Patient 3 had a skull base ICA dissection that led to a partial Horner's syndrome but no cerebral infarct. While direct causality cannot be proven, intense CrossFit workouts may have led to the ICA dissections in these patients.

Comparative evaluation of physicians' pulmonary nodule detection with reduced slice thickness at CT screening

NASA Astrophysics Data System (ADS)

Sinsuat, Marodina; Shimamura, Ichiro; Saita, Shinsuke; Kubo, Mitsuru; Kawata, Yoshiki; Niki, Noboru; Ohmatsu, Hironobu; Kakinuma, Ryutaro; Eguchi, Kenji; Kaneko, Masahiro; Tominaga, Keigo; Moriyama, Noriyuki

2008-03-01

With thin and thick section Multi-slice CT images at lung cancer screening, we have statistically and quantitatively shown and evaluated the diagnostic capabilities of these slice thicknesses on physicians' pulmonary nodule diagnosis. To comparatively evaluate the 2 mm and 10 mm slice thicknesses, MSCT images of 360 people were read by six physicians. The reading criteria consisted of nodule for further examination (NFE), nodule for no further examination (NNFE) and no abnormality (NA) case. For reading results evaluation; firstly, cross-tabulation was carried out to roughly analyze the diagnoses based on whole lung field and each lung lobes. Secondly, from semi-automated extraction result of the nodule, detailed quantitative analysis was carried out to determine the diagnostic capabilities of two slice thicknesses. Finally, using the reading results of 2 mm thick image as the gold standard, the diagnostic capabilities were analyzed through the features and locations of pulmonary nodules. The study revealed that both slice thicknesses can depict lung cancer. Thin section may not be effective to diagnose nodules of <=3 mm in size and nodules of <= 5mm in size for thick section. Though thick section is less tiring for reading physicians, it is not good at depicting nodules located at the border of lung upper lobe and which have a pixel size distance of <=5 from the chest wall. The information presented may serve as a useful reference to determine in which particular pulmonary nodule condition the two slice thicknesses can be effectively used for early detection of lung cancer.

Dynamic 2D self-phase-map Nyquist ghost correction for simultaneous multi-slice echo planar imaging.

PubMed

Yarach, Uten; Tung, Yi-Hang; Setsompop, Kawin; In, Myung-Ho; Chatnuntawech, Itthi; Yakupov, Renat; Godenschweger, Frank; Speck, Oliver

2018-02-09

To develop a reconstruction pipeline that intrinsically accounts for both simultaneous multislice echo planar imaging (SMS-EPI) reconstruction and dynamic slice-specific Nyquist ghosting correction in time-series data. After 1D slice-group average phase correction, the separate polarity (i.e., even and odd echoes) SMS-EPI data were unaliased by slice GeneRalized Autocalibrating Partial Parallel Acquisition. Both the slice-unaliased even and odd echoes were jointly reconstructed using a model-based framework, extended for SMS-EPI reconstruction that estimates a 2D self-phase map, corrects dynamic slice-specific phase errors, and combines data from all coils and echoes to obtain the final images. The percentage ghost-to-signal ratios (%GSRs) and its temporal variations for MB3R y 2 with a field of view/4 shift in a human brain obtained by the proposed dynamic 2D and standard 1D phase corrections were 1.37 ± 0.11 and 2.66 ± 0.16, respectively. Even with a large regularization parameter λ applied in the proposed reconstruction, the smoothing effect in fMRI activation maps was comparable to a very small Gaussian kernel size 1 × 1 × 1 mm 3 . The proposed reconstruction pipeline reduced slice-specific phase errors in SMS-EPI, resulting in reduction of GSR. It is applicable for functional MRI studies because the smoothing effect caused by the regularization parameter selection can be minimal in a blood-oxygen-level-dependent activation map. © 2018 International Society for Magnetic Resonance in Medicine.

Quality comparison of continuous steam sterilization segmented-flow aseptic processing versus conventional canning of whole and sliced mushrooms.

PubMed

Anderson, N M; Walker, P N

2011-08-01

This study was carried out to investigate segmented-flow aseptic processing of particle foods. A pilot-scale continuous steam sterilization unit capable of producing shelf stable aseptically processed whole and sliced mushrooms was developed. The system utilized pressurized steam as the heating medium to achieve high temperature-short time processing conditions with high and uniform heat transfer that will enable static temperature penetration studies for process development. Segmented-flow technology produced a narrower residence time distribution than pipe-flow aseptic processing; thus, whole and sliced mushrooms were processed only as long as needed to achieve the target F₀  = 7.0 min and were not overcooked. Continuous steam sterilization segmented-flow aseptic processing produced shelf stable aseptically processed mushrooms of superior quality to conventionally canned mushrooms. When compared to conventionally canned mushrooms, aseptically processed yield (weight basis) increased 6.1% (SD = 2.9%) and 6.6% (SD = 2.2%), whiteness (L) improved 3.1% (SD = 1.9%) and 4.7% (SD = 0.7%), color difference (ΔE) improved 6.0% (SD = 1.3%) and 8.5% (SD = 1.5%), and texture improved 3.9% (SD = 1.7%) and 4.6% (SD = 4.2%), for whole and sliced mushrooms, respectively. Segmented-flow aseptic processing eliminated a separate blanching step, eliminated the unnecessary packaging of water and promoted the use of bag-in-box and other versatile aseptic packaging methods. Segmented-flow aseptic processing is capable of producing shelf stable aseptically processed particle foods of superior quality to a conventionally canned product. This unique continuous steam sterilization process eliminates the need for a separate blanching step, reduces or eliminates the need for a liquid carrier, and promotes the use of bag-in-box and other versatile aseptic packaging methods. © 2011 Institute of Food Technologists®

Cervical cancer screening and updated Pap guidelines.

PubMed

Warren, Johanna B; Gullett, Heidi; King, Valerie J

2009-03-01

Cervical cancer and its dysplasia precursors account for significant morbidity and mortality in women worldwide. Human papillomavirus infection is common, preventable, and now widely accepted as the causative agent with oncogenic potential in the development of cervical cancer. Screening via Papanicolaou testing is critical, and interpretation of test results with knowledge of patient risk factors is imperative. Many evidence-based guidelines for screening, interpretation, and management have been developed and are widely available for use.

Diagnostic accuracy of high-risk HPV genotyping in women with high-grade cervical lesions: evidence for improving the cervical cancer screening strategy in China.

PubMed

Xu, Huihui; Lin, Aifen; Shao, Xiujuan; Shi, Weiwu; Zhang, Yang; Yan, Weihua

2016-12-13

Currently, clinical data for primary HPV screening alone are lacking in China. Here, we evaluate cervical cancer screening with primary HPV genotyping, as well as possible future screening strategy. Overall, high-risk HPV (hrHPV) prevalence was 18.2% among hospital-based population in Taizhou area. For cervical intraepithelial neoplasia 2 or worse (CIN2+), the sensitivity of primary hrHPV genotyping strategy and current cervical cancer screening strategy were 93.5%, and 71.1%, respectively; whereas the specificity was 17.5%, and 62.4%, respectively. Current cervical screening strategy had slightly higher positive predictive values (28.4%) for CIN2+ than hrHPV genotyping strategy (21.9%), whereas primary hrHPV genotyping strategy demonstrated higher negative predictive values (94.7%) than current cervical screening strategy (91.1%). Compared to HPV35/39/45/51/56/59/66/68 genotypes, the odds ratios (OR) for CIN2+ in HPV16/18/31/33/52/58 infection women were 3.2 (95% confidence interval [CI] 2.3-4.1). Primary hrHPV genotyping strategy provides a better predictive value than HPV16/18 genotyping alone in guiding the clinical management of the current cervical cancer screening. HPV testing without adjunctive cytology may be sufficiently sensitive for primary cervical cancer screening.

Comparison between cervical disc arthroplasty and conservative treatment for patients with single level cervical radiculopathy at C5/6.

PubMed

He, Axiang; Xie, Dong; Qu, Bo; Cai, Xiaomin; Kong, Qin; Yang, Lili; Chen, Xiongsheng; Jia, Lianshun

2018-01-31

Cervical radiculopathy is a common disease that affects millions of people. Patients usually are managed by conservative therapy and surgical treatments. To compare the clinical outcomes between cervical disc arthroplasty (CDA) and conservative management for patients with single level cervical radiculopathy at C5/6. Seventy-two patients with cervical radiculopathy that only affect C5/6 joints were included and thirty-two of them received CDA surgery, and forty patients were treated with conservative management. All the patients were followed up around 4 years. Cervical curvature, cervical range of motion (CROM), horizontal displacement of cervical spine, and intervertebral gap were measured by radiological examination. All the patients have comparable disease severity based on pre-surgical radiological assessments. At the 4-year follow-up examination, patients with CDA surgery had less CROM at C5/6 level, while greater CROM at C4/5 level, than control group. Similarly, the horizontal displacement in CDA group decreased at C5/6 vertebrae, and increased at C4/5 level at the 4-year follow-up examination. The intervertebral gaps of patients in CDA group were larger than control group at one-year and last follow-up examination. CDA surgery stabilized C5/6 vertebrae and increased the CROM and horizontal displacement of upper adjacent C4/5 vertebrae. Copyright © 2018. Published by Elsevier Ltd.

Accurate reconstruction of 3D cardiac geometry from coarsely-sliced MRI.

PubMed

Ringenberg, Jordan; Deo, Makarand; Devabhaktuni, Vijay; Berenfeld, Omer; Snyder, Brett; Boyers, Pamela; Gold, Jeffrey

2014-02-01

We present a comprehensive validation analysis to assess the geometric impact of using coarsely-sliced short-axis images to reconstruct patient-specific cardiac geometry. The methods utilize high-resolution diffusion tensor MRI (DTMRI) datasets as reference geometries from which synthesized coarsely-sliced datasets simulating in vivo MRI were produced. 3D models are reconstructed from the coarse data using variational implicit surfaces through a commonly used modeling tool, CardioViz3D. The resulting geometries were then compared to the reference DTMRI models from which they were derived to analyze how well the synthesized geometries approximate the reference anatomy. Averaged over seven hearts, 95% spatial overlap, less than 3% volume variability, and normal-to-surface distance of 0.32 mm was observed between the synthesized myocardial geometries reconstructed from 8 mm sliced images and the reference data. The results provide strong supportive evidence to validate the hypothesis that coarsely-sliced MRI may be used to accurately reconstruct geometric ventricular models. Furthermore, the use of DTMRI for validation of in vivo MRI presents a novel benchmark procedure for studies which aim to substantiate their modeling and simulation methods using coarsely-sliced cardiac data. In addition, the paper outlines a suggested original procedure for deriving image-based ventricular models using the CardioViz3D software. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Training in the prevention of cervical cancer: advantages of e-learning

PubMed Central

Company, Assumpta; Montserrat, Mireia; Bosch, Francesc X; de Sanjosé, Silvia

2015-01-01

Cervical cancer remains the second most common cancer for women worldwide and is the cancer priority in most low- and middle-income countries (LMIC). The development of vaccines against the human papilloma virus (HPV) and the impact of technology both for the detection of HPV and cervical cancer represent milestones and new opportunities in prevention. New internet-based technologies are generating mass access to training programmes. This article presents the methodology for developing an online training programme for the prevention of cervical cancer as well as the results obtained during the four year period wherein the same programme was delivered in Latin America. PMID:26557878

Training in the prevention of cervical cancer: advantages of e-learning.

PubMed

Company, Assumpta; Montserrat, Mireia; Bosch, Francesc X; de Sanjosé, Silvia

2015-01-01

Cervical cancer remains the second most common cancer for women worldwide and is the cancer priority in most low- and middle-income countries (LMIC). The development of vaccines against the human papilloma virus (HPV) and the impact of technology both for the detection of HPV and cervical cancer represent milestones and new opportunities in prevention. New internet-based technologies are generating mass access to training programmes. This article presents the methodology for developing an online training programme for the prevention of cervical cancer as well as the results obtained during the four year period wherein the same programme was delivered in Latin America.

Cervical fluid interleukin 6 and intra-amniotic complications of preterm prelabor rupture of membranes.

PubMed

Musilova, Ivana; Andrys, Ctirad; Drahosova, Marcela; Soucek, Ondrej; Pliskova, Lenka; Jacobsson, Bo; Kacerovsky, Marian

2018-04-01

To determine if cervical fluid interleukin (IL)-6 concentrations in women with preterm prelabor rupture of membranes (PPROM) allows identification of microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI). One hundred forty-four women with singleton pregnancies complicated by PPROM were included in this prospective cohort study. Cervical and amniotic fluids were collected at the time of admission and concentrations of IL-6 were measured using an ELISA and point-of-care test, respectively. Cervical fluid was obtained using a Dacron polyester swab and amniotic fluid was obtained by transabdominal amniocentesis. MIAC was diagnosed based on a positive PCR result for Ureaplasma species, M. hominis, and/or C. trachomatis and/or by positivity for the 16 S rRNA gene. IAI was defined as amniotic fluid point-of-care IL-6 concentrations ≥745 pg/mL. The women were assigned to four subgroups based on the presence of MIAC and/or IAI: microbial-associated IAI (both MIAC and IAI), sterile IAI (IAI alone), MIAC alone, and without either MIAC or IAI. (1) Women with microbial-associated IAI had higher cervical fluid IL-6 concentrations (median 560 pg/mL) than did women with sterile IAI (median 303 pg/mL; p = .001), women with MIAC alone (median 135 pg/mL; p = .0004), and women without MIAC and IAI (median 180 pg/mL; p = .0001). (2) No differences were found in cervical fluid IL-6 concentrations among women with sterile IAI, with MIAC alone, and without MIAC and IAI. (3) A positive correlation was observed between cervical fluid IL-6 concentrations and the amount of Ureaplasma species in amniotic fluid (copies DNA/mL; rho = 0.57, p < .0001). (4) A weak positive correlation was detected between cervical and amniotic fluid IL-6 concentrations (rho = 0.33, p < .0001). The presence of microbial-associated IAI is associated with the highest cervical fluid IL-6 concentrations. Cervical IL-6 can be helpful in the identification of microbial-associated IAI.

Cost-Utility Analysis of Anterior Cervical Discectomy and Fusion With Plating (ACDFP) Versus Posterior Cervical Foraminotomy (PCF) for Patients With Single-level Cervical Radiculopathy at 1-Year Follow-up.

PubMed

Alvin, Matthew D; Lubelski, Daniel; Abdullah, Kalil G; Whitmore, Robert G; Benzel, Edward C; Mroz, Thomas E

2016-03-01

A retrospective 1-year cost-utility analysis. To determine the cost-effectiveness of anterior cervical discectomy and fusion with plating (ACDFP) in comparison with posterior cervical foraminotomy (PCF) for patients with single-level cervical radiculopathy. Cervical radiculopathy due to cervical spondylosis is commonly treated by either PCF or ACDFP for patients who are refractory to nonsurgical treatment. Although some have suggested superior outcomes with ACDFP as compared with PCF, the former is also associated with greater costs. The present study analyzes the cost-effectiveness of ACDFP versus PCF for patients with single-level cervical radiculopathy. Forty-five patients who underwent ACDFP and 25 patients who underwent PCF for single-level cervical radiculopathy were analyzed. One-year postoperative health outcomes were assessed based on Visual Analogue Scale, Pain Disability Questionnaire, Patient Health Questionnaire, and EuroQOL-5 Dimensions questionnaires to analyze the comparative effectiveness of each procedure. Direct medical costs were estimated using Medicare national payment amounts and indirect costs were based on patient missed work days and patient income. Postoperative 1-year cost/utility ratios and the incremental cost-effectiveness ratio (ICER) were calculated to assess for cost-effectiveness using a threshold of $100,000/QALY gained. The 1-year cost-utility ratio for the PCF cohort was significantly lower ($79,856/QALY gained) than that for the ACDFP cohort ($131,951/QALY gained) (P<0.01). In calculating the 1-year ICER, as the ACDFP cohort showed lower QALY gained than the PCF cohort, the ICER was negative and is not reported, meaning that ACDFP was dominated by PCF. Statistically significant and clinically relevant improvements (through minimum clinically important differences) were seen in both cohorts. Although both cohorts showed improved health outcomes, ACDFP was not cost-effective relative to the threshold of $100,000/QALY gained at 1-year postoperatively, whereas PCF was. The durability of these results must be analyzed with long-term cost-utility analysis studies.

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain

PubMed Central

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.

2017-01-01

Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944

Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.

PubMed

Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A

2017-01-01

Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.

Prevalence of ear disease in dogs undergoing multidetector thin-slice computed tomography of the head.

PubMed

Foster, Allison; Morandi, Federica; May, Elizabeth

2015-01-01

Previous reports describing the prevalence of ear diseases in dogs have primarily been based on dogs presenting with clinical signs of disease. The prevalence of subclinical ear disease remains unknown. The purpose of this cross-sectional retrospective study was to describe the prevalence of lesions consistent with middle and external ear disease in dogs presented for multidetector computed tomography (CT) of the head and/or cranial cervical spine at our hospital during the period of July 2011 and August 2013. For each included dog, data recorded were signalment, CT findings, diagnosis, and treatment. A total of 199 dogs met inclusion criteria. Nineteen dogs (9.5%) were referred for evaluation of suspected ear disease and 27 dogs (13.5%) had histories or physical examination findings consistent with otitis externa. A total of 163 dogs (81.9%) had CT lesions consistent with external ear disease (i.e. ear canal mineralization, external canal thickening, and/or narrowing of the external canal). Thirty-nine dogs (19.5%) had CT lesions consistent with middle ear disease (i.e. soft tissue attenuating/fluid material in the tympanic bullae, bulla wall thickening or lysis, and/or periosteal proliferation of the temporal bone). Findings from this study indicated that the prevalence of external and middle ear disease in dogs could be higher than that previously reported. © 2014 American College of Veterinary Radiology.

Posterior cervical fixation for fracture and degenerative disc disease.

PubMed

An, H S; Coppes, M A

1997-02-01

There are numerous newer techniques that have been developed for the internal fixation of the cervical spine in recent years. Wiring techniques are still appropriate for posterior stabilization of the cervical spine. The halo vest is still widely used for the conservative management of cervical fractures and for postoperative external immobilization. The authors stress that the surgical indications for more modern rigid implants should be adhered to strictly. These implants also should be selected by weighing their advantages versus potential risks. In the upper cervical spine, the surgeon may choose traditional wiring methods and newer C1-C2 screw fixation, occipitocervical plate fixation. For the lower cervical spine, triple wiring technique or lateral mass plating may be used. The surgeon must choose an appropriate device based on the mechanism of injury, pathoanatomy of the lesion, and familiarity with the device, keeping in mind that the goals of internal fixation are stabilization, reduction and maintenance of alignment, early rehabilitation and perhaps enhancement of fusion rates, and avoidance of use of an external halo vest.