RESUMEN

Our objective is to evaluate the accuracy of three algorithms in differentiating the origins of outflow tract ventricular arrhythmias (OTVAs). This study involved 110 consecutive patients with OTVAs for whom a standard 12-lead surface electrocardiogram (ECG) showed typical left bundle branch block morphology with an inferior axis. All the ECG tracings were retrospectively analyzed using the following three recently published ECG algorithms: 1) the transitional zone (TZ) index, 2) the V2 transition ratio, and 3) V2 R wave duration and R/S wave amplitude indices. Considering all patients, the V2 transition ratio had the highest sensitivity (92.3%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (93.9%). The latter finding had a maximal area under the ROC curve of 0.925. In patients with left ventricular (LV) rotation, the V2 transition ratio had the highest sensitivity (94.1%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (87.5%). The former finding had a maximal area under the ROC curve of 0.892. All three published ECG algorithms are effective in differentiating the origin of OTVAs, while the V2 transition ratio, and the V2 R wave duration and R/S wave amplitude indices are the most sensitive and specific algorithms, respectively. Amongst all of the patients, the V2 R wave duration and R/S wave amplitude algorithm had the maximal area under the ROC curve, but in patients with LV rotation the V2 transition ratio algorithm had the maximum area under the ROC curve.

Asunto(s)

RESUMEN

Our objective is to evaluate the accuracy of three algorithms in differentiating the origins of outflow tract ventricular arrhythmias (OTVAs). This study involved 110 consecutive patients with OTVAs for whom a standard 12-lead surface electrocardiogram (ECG) showed typical left bundle branch block morphology with an inferior axis. All the ECG tracings were retrospectively analyzed using the following three recently published ECG algorithms: 1) the transitional zone (TZ) index, 2) the V2 transition ratio, and 3) V2 R wave duration and R/S wave amplitude indices. Considering all patients, the V2 transition ratio had the highest sensitivity (92.3%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (93.9%). The latter finding had a maximal area under the ROC curve of 0.925. In patients with left ventricular (LV) rotation, the V2 transition ratio had the highest sensitivity (94.1%), while the R wave duration and R/S wave amplitude indices in V2 had the highest specificity (87.5%). The former finding had a maximal area under the ROC curve of 0.892. All three published ECG algorithms are effective in differentiating the origin of OTVAs, while the V2 transition ratio, and the V2 R wave duration and R/S wave amplitude indices are the most sensitive and specific algorithms, respectively. Amongst all of the patients, the V2 R wave duration and R/S wave amplitude algorithm had the maximal area under the ROC curve, but in patients with LV rotation the V2 transition ratio algorithm had the maximum area under the ROC curve.

Asunto(s)

RESUMEN

One novel gene product, hMAP126, was demonstrated to interact with p29 in the yeast two-hybrid assay. The full-length cDNA of hMAP126 has been obtained and encodes a protein of 1120 amino acids. Multiple tissue Northern blot analysis showed that hMAP126 was abundantly expressed in the testis. Polyclonal antiserum against hMAP126 was raised and affinity-purification of anti-hMAP126 antibodies was performed. The subcellular distribution of hMAP126 was localized to the mitotic spindle. Furthermore, hMAP126 was identified to be post-translationally modified and phosphorylated by p34(cdc2) kinase in vitro. Taken together, we have isolated a novel protein, hMAP126, which may be involved in the functional and dynamic regulation of mitotic spindles.

Asunto(s)

RESUMEN

OBJECTIVE: To assess the validity of four models for the role of quantitative ultrasound (QUS) in the management of osteoporosis. DESIGN: Cross-sectional survey and review of literature. SETTINGS: Nuclear medicine departments of three teaching hospitals in Sydney. SUBJECTS: 1000 women aged 22 to 88 years (mean, 59 years) referred for assessment of osteoporotic fracture risk. MAIN OUTCOME MEASURES: BMD categories as defined by dual-energy x-ray absorptiometry (DEXA) of the lumbar spine and proximal femur, and QUS category as defined by calcaneal ultrasound stiffness; prevalence of DEXA-defined osteoporosis in the different QUS categories. RESULTS: In women with QUS Achilles stiffness < or = 70 the prevalence of axial osteoporosis was 51%, whereas in the group with stiffness > 70 the prevalence of axial osteoporosis was 8%. In women 65 years and over the corresponding values were 59% and 17%. CONCLUSIONS: Of the four possible models for QUS, the use of QUS for the estimation of BMD, or in a "standalone" model, can not be recommended at the current time. The model of QUS as a "prescreening" modality may be acceptable assuming adequate education of clinicians and patients of its limitations, particularly the risk of false negatives. The model of QUS as one factor in a composite risk factor assessment of patients is promising but more data are required.

Asunto(s)

RESUMEN

Change in renal cortex echogenicity relative to the adjacent liver, from neonates to adults, was determined by using ultrasonography in ninety-nine cases. The kidney/liver echogenicity ratio in neonates was 0.96 +/- 0.10, decreasing with maturation to an approximate adult level (0.66 +/- 0.05) by two years of age. The kidney/liver echogenicity ratio (Y) was constructed by regression analysis on the equation Y = 0.9309-0.1201X (X = age in years) for age less than two years.

Asunto(s)

RESUMEN

The aim of this study was to compare the accuracy of intra-operative ultrasound (IOUS) with other imaging modalities and with surgical palpation in detecting liver metastases from colorectal cancer (CRC). Intra-operative ultrasound was performed in 100 patients undergoing surgery for CRC. All patients had pre-operative liver function tests, transcutaneous ultrasound and computerized tomography (CT) scan of the liver. The liver was palpated intra-operatively by a surgeon who was unaware of the pre-operative findings. The liver was then assessed by IOUS. Intra-operative ultrasound detected more patients with metastases than either CT scan, transcutaneous ultrasound or surgical palpation. It also detected a greater number of smaller metastases in these patients and allowed better anatomical definition compared with pre-operative investigations.

Asunto(s)

RESUMEN

Thirty cases of early-onset congenital diaphragmatic hernia were admitted to National Taiwan University Hospital from 1976 to 1990. The mortality rate has increased in recent years, with an overall mortality rate of 26.7%. Low PH value of initial blood gas, early onset of symptoms at birth and total absence of hemidiaphragm were the three most poor prognostic factors (P less than 0.01). Preoperative stabilization of those patients with an initial PH value less than 7.2 may be helpful (P less than 0.04).

Asunto(s)

RESUMEN

Ataxia-telangiectasia (A-T) is an autosomal recessive, multisystem disease characterized clinically by the onset of progressive cerebellar ataxia at about one year of age, followed by the development of fan-shaped telangiectasia of bulbar conjunctiva, usually at four- to six-years of age; and frequent sinopulmonary infections. The outstanding pathological findings in the central nervous system in A-T are loss of Purkinje cells and, to a lesser degree, basket and granular cells of the cerebellum. Although choreoathetosis and myoclonic jerks had been described in patients with A-T, torticollis has never been reported in the literature. A 7-year-old girl with A-T and torticollis is therefore presented in this paper.

Asunto(s)

RESUMEN

Ultrasound guided fine needle biopsies were performed in 69 patients with space occupying lesions in the liver. Fifty five of these patients had material obtained for both cytology and histology with a 22 gauge modified Menghini needle, while the other 14 were biopsied with a conventional Chiba needle. Results of cytology, histology of Menghini cores, and histology of cell blocks, were reviewed and correlated with the final diagnoses obtained by clinical review and follow-up. Cytology detected 95% of malignant cases, and Menghini core histology detected 89%. A number of factors should determine the choice of fine needle biopsy for cytology or histology or both.

Asunto(s)

RESUMEN

From June 1988 to May 1989, 444 throat swab specimens were tested with an enzyme immunoassay kit for rapid diagnosis of group A streptococcal pharyngitis. The results were compared with those of throat culture method. The rapid test was positive in 37 of 42 culture-positive specimens and negative in 379 of 402 culture-negative specimens, thus yielding a total agreement of 93.7%, sensitivity 88.1%, specificity 94.7%, positive predictive value 61.7%, negative predictive value 98.7%. According to this practical application, we suggest that enzyme immunoassay test can be applied in outpatient clinics by busy pediatricians for rapid diagnosis of group A streptococcal pharyngitis.

Asunto(s)

RESUMEN

Arrhythmogenic right ventricular dysplasia is a rare disease that sometimes leads to sudden death in young people. In this report, we describe our experience with diagnosis and treatment of a case of arrhythmogenic right ventricular dysplasia.

Asunto(s)

RESUMEN

Our experience with ultrasound-guided fine needle aspiration biopsy in 65 patients suspected of having malignancy of the liver is reviewed. The results of cytology smears were correlated with cell block sections, histology of the liver and/or other relevant sites, and clinical course. Aspiration cytology was positive in 52 of 57 patients (91%) who had a final diagnosis of malignancy, and there were no false positive results. The cell type reported by cytology correlated completely in 23 of 27 cases with histological confirmation, whilst cytology showed better differentiating features in the remaining 4 cases. The microscopic appearances have been described. There was only one significant complication of the procedure.

Asunto(s)

Asunto(s)

RESUMEN

Grey-scale ultrasound tomography was used to examine the liver and biliary tree of 100 consecutive unselected jaundiced patients in a prospective study. It was successful in differentiating between hepato-cellular and obstructive jaundice in 94%. It precisely localised the site of obstruction in 75% of those patients with enlargement of the head of the pancreas from either carcinoma or gall-stones impacted in the Ampulla of Vater. This figure was reduced to 60% when all cases of obstruction were considered. Cirrhosis and chronic active hepatitis were found to be associated with an abnormal pattern of echoes within the liver. These echoes were stronger and more numerous than normal. This association was not apparent with drug-induced cholestasis or acute viral hepatitis. Grey-scale ultrasound tomography is quick, safe and completely non-invasive. It should be the initial investigation of choice in the differential diagnosis of jaundice. When precise localisation of an obstruction is not possible after a repeat attempt, then percutaneous transhepatic cholangiography should be considered.

Asunto(s)

RESUMEN

Gas in the biliary tree has a striking but not unique ultrasonic appearance consisting of acoustic shadows trailing behind well-defined discrete high amplitude echoes deep within the liver parenchyma, and may be mimicked by intrahepatic gall stones and calcified tumours and granulomas. It interferes with assessment of liver structure, and renders ultrasound B-scan unreliable for the detection of liver metastases. Computed tomography remains unaffected by biliary gas.

Asunto(s)

Asunto(s)