Lykkesteen8807

There was a statistically significant association observed between the dilated duct diameter (p = 0.049) and presence of intraductal vascularity (p = 0.0005) with presence of malignancy. CONCLUSION Rate of malignancy is low in solitary dilated ducts, especially among asymptomatic patients. Patient's presenting with clinical symptoms, larger dilated duct diameters, and/or intraductal vascularity may require additional evaluation including biopsy to exclude malignancy. ADVANCES IN KNOWLEDGE Clinical and imaging factors can assist in better identifying patients with solitary dilated ducts who should undergo biopsy.OBJECTIVE For real-time markerless tumour tracking in stereotactic lung radiotherapy, we propose a different approach which uses patient-specific deep learning (DL) using a personalised data generation strategy, avoiding the need for collection of a large patient data set. We validated our strategy with digital phantom simulation and epoxy phantom studies. METHODS We developed lung tumour tracking for radiotherapy using a convolutional neural network trained for each phantom's lesion by using multiple digitally reconstructed radiographs (DRRs) generated from each phantom's treatment planning four-dimensional CT. We trained tumour-bone differentiation using large numbers of training DRRs generated with various projection geometries to simulate tumour motion. We solved the problem of using DRRs for training and X-ray images for tracking using the training DRRs with random contrast transformation and random noise addition. RESULTS We defined adequate tracking accuracy as the percentage frames satisfying less then 1 mm tracking error of the isocentre. In the simulation study, we achieved 100% tracking accuracy in 3 cm spherical and 1.5×2.25×3 cm ovoid masses. In the phantom study, we achieved 100 and 94.7% tracking accuracy in 3 cm and 2 cm spherical masses, respectively. This required 32.5 ms/frame (30.8 fps) real-time processing. CONCLUSIONS We proved the potential feasibility of a real-time markerless tumour tracking framework for stereotactic lung radiotherapy based on patient-specific DL with personalised data generation with digital phantom and epoxy phantom studies. ADVANCES IN KNOWLEDGE Using DL with personalised data generation is an efficient strategy for real-time lung tumour tracking.To test whether high insulin influence the transport of β-alanine into skeletal muscle at either saturating or sub-saturating β-alanine concentrations, we conducted two studies whereby β-alanine and insulin concentrations were controlled. 1) 12 men received supraphysiological amounts of β-alanine intravenously (0.11g·kg·min-1 for 150min) along with insulin infusion or without insulin infusion. β-alanine and carnosine were measured with mass spectrometry in muscle before and 30 min after infusion. Blood samples were taken throughout the infusion protocol for plasma insulin and β-alanine analyses. β-alanine content in 24-h urine was assessed. 2) 6 men ingested typical doses of β-alanine (10mg·kg-1) before insulin infusion or no infusion. β-alanine was assessed in muscle before and after 120 min following the ingestion. In the experiment 1, no differences between conditions were shown for plasma β-alanine, muscle β-alanine, muscle carnosine and urinary β-alanine concentrations (all p>0.05). In the experiment 2, no differences between conditions were shown for plasma β-alanine or muscle β-alanine concentrations (all p>0.05). Hyperinsulinemia did not increase β-alanine uptake by skeletal muscle cells, neither when substrate concentrations exceed the Vmax of β-alanine transporter TauT, nor when it was below saturation. This refutes the notion that β-alanine supplementation alongside meals is necessary to maximise its transport into muscle.OBJECTIVE To evaluate phantomless assessment of volumetric bone mineral density (vBMD) based on virtual non-contrast images of arterial (VNCa) and venous phase (VNCv) derived from spectral detector CT in comparison to true non-contrast (TNC) images and adjusted venous phase conventional images (CIV(adjusted)). METHODS 104 consecutive patients who underwent triphasic spectral detector CT between January 2018 and April 2019 were retrospectively included. TNC, VNCa, VNCv and venous phase images (CIV) were reconstructed. vBMD was obtained by two radiologists using an FDA/CE-cleared software. Average vBMD of the first three lumbar vertebrae was determined in each reconstruction; vBMD of CIV was adjusted for contrast enhancement as suggested earlier. RESULTS vBMD values obtained from CIV(adjusted) are comparable to vBMD values derived from TNC images (91.79 ± 36.52 vs 90.16 ± 41.71 mg/cm3, p = 1.00); however, vBMD values derived from VNCa and VNCv (42.20 ± 22.50 and 41.98 ± 23.3 mg/cm3 respectively) were significantly lower as compared to vBMD values from TNC and CIV(adjusted) (all p ≤ 0.01). Selleckchem SB-297006 CONCLUSION Spectral detector CT-derived virtual non-contrast images systematically underestimate vBMD and therefore should not be used without appropriate adjustments. Adjusted venous phase images provide reliable results and may be utilized for an opportunistic BMD screening in CT examinations. ADVANCES IN KNOWLEDGE Adjustments of venous phase images facilitate opportunistic assessment of vBMD, while spectral detector CT-derived VNC images systematically underestimate vBMD.CONTEXT.— The percentage of pregnant women with advanced maternal age (AMA) has increased during the past several decades due to various socioeconomic factors and advances in assisted reproduction. These pregnancies are associated with adverse maternal and fetal outcomes. However, the underlying placental pathology has not been well described. OBJECTIVE.— To investigate the placental histopathology associated with AMA pregnancies. DESIGN.— Placental pathology from 168 AMA women 35 years or older at delivery was reviewed. The cases were subdivided into two age subgroups, ages 35 to 39 and 40 or older, as well as a "pure AMA" subgroup where the only indication for placental examination was AMA. A group of 60 consecutive non-AMA placentas was also identified and used as comparison. The spectrum of histologic features in each case was catalogued. RESULTS.— Of the overall AMA cases, meconium deposition was seen in 55% (93 of 168), chorangiosis in 40% (68 of 168), and acute chorioamnionitis in 36% (60 of 168). Fetal vascular malperfusion was also seen with high frequency (30%; 50 of 168).