HLA-G 5'URR regulatory polymorphisms are associated with the risk of developing gliomas

BACKGROUND

Human leukocyte antigen G (HLA-G) belongs to non-classical MHC class I molecules that is involved in the suppression of immune response. As HLA-G plays important role in the maintenance of fetal tolerance, its overexpression has been associated with tumor progression. For the regulation of HLA-G levels, genetic variants within the 5' upstream regulatory region (5'URR) are of crucial importance. Our study aimed to analyze the association between 16 HLA-G 5'URR variants, sHLA-G level and clinical variables in glioma patients.

METHODS

We investigated 59 patients with gliomas (mean age 54.70 ± 15.10 years) and 131 healthy controls (mean age 41.45 ± 9.75 years). Patient's blood was obtained on the day of surgical treatment. The HLA-G 5'URR polymorphisms were typed by direct sequencing and the plasma level of sHLA-G assessed by ELISA.

RESULTS

Haploblock within HLA-G 5'URR consisting of -762T, -716G, -689G, -666T, -633A, followed by -486C and -201A alleles were significantly more frequent in patients with gliomas than in the controls (p < 0.05). No correlation of HLA-G 5'URR variants with sHLA-G plasma level was found. Analysis of HLA-G 5'URR variants with main clinical variables in patients with grade IV gliomas revealed that haploblock carriers of -762CT, -716TG, -689AG, -666GT, -633GA, -486AC, -477GC, -201GA followed by -369AC carriers tend to have lower age at onset as compared to other genotype carriers (p = 0.04).

CONCLUSION

Our results suggest genetic association of HLA-G 5'URR variants with risk of developing gliomas and possible contribution of HLA-G to disease pathology.

BDNF, sHLA-G, and sTREM-1 are useful blood biomarkers for identifying grade IV glioma patients

Inflammation and immunity belong to the main factors influencing tumor growth. In this study, we attempted to identify a profile of biomarkers associated with gliomas. We found decreased serum levels of sTREM-1 (soluble triggering receptor expressed on myelocytes) and increased levels of IL-10 in all grades of glioma patients in comparison with healthy controls (sTREM-1: grade II: p=0.0051, grade III: p=0.02, grade IV: p=0.01; IL-10: grade II: p=0.0017, grade III: p=0.03, grade IV: p=0.007). However, we did not find any combination of tested markers with good sensitivity and specificity in grades II and III of glioma patients to discriminate them from healthy controls. In grade IV glioma patients, two sets of markers showed promising results in distinguishing patients from healthy people. For the first set consisting of four selected markers, sTREM-1, sHLA-G, BDNF, and IL-13, the ROC curves indicate a good discriminatory capability for glioblastoma patients (AUC=0.9510). The best discriminatory capability for glioblastoma patients (AUC=0.9534) was found for the second set consisting of three selected markers sTREM-1, sHLA-G, and BDNF with 79.2% sensitivity and 94.1% specificity.

Processing Real-Life Recordings of Facial Expressions of Polish Sign Language Using Action Units

Automatic translation between the national language and sign language is a complex process similar to translation between two different foreign languages. A very important aspect is the precision of not only manual gestures but also facial expressions, which are extremely important in the overall context of a sentence. In this article, we present the problem of including facial expressions in the automation of Polish-to-Polish Sign Language (PJM) translation-this is part of an ongoing project related to a comprehensive solution allowing for the animation of manual gestures, body movements and facial expressions. Our approach explores the possibility of using action unit (AU) recognition in the automatic annotation of recordings, which in the subsequent steps will be used to train machine learning models. This paper aims to evaluate entropy in real-life translation recordings and analyze the data associated with the detected action units. Our approach has been subjected to evaluation by experts related to Polish Sign Language, and the results obtained allow for the development of further work related to automatic translation into Polish Sign Language.

HLA-G 14bp Ins/Del Polymorphism, Plasma Level of Soluble HLA-G, and Association with IL-6/IL-10 Ratio and Survival of Glioma Patients

HLA-G is an immune checkpoint molecule with immunosuppressive and anti-inflammatory activities, and its expression and level of its soluble form (sHLA-G) may play an important role in tumor prognosis. The HLA-G 14bp ins/del polymorphism and the plasma level of soluble HLA-G (sHLA-G) were investigated by a polymerase chain reaction and ELISA, respectively, in 59 glioma patients. A significantly higher proportion of glioma patients had the 14 nt insert in both homozygous and heterozygous states compared to the control group. Glioma patients also had higher plasma levels of sHLA-G. Patients with methylated MGMT promoters had lower levels of sHLA-G than those with unmethylated MGMT promoters. The level of sHLA-G negatively correlated with the overall survival of patients. Glioblastoma patients who survived more than one year after diagnosis had lower levels of sHLA-G than those surviving less than one year. Patients with sHLA-G levels below the cut-off value of 40 U/mL survived significantly longer than patients with sHLA-G levels above 40 U/mL. The levels of sHLA-G were also negatively correlated with the level of IL-6 (p = 0.0004) and positively with IL-10/IL-6 (p = 0.046). Conclusion: The presence of the 14 nt insert in both homozygous and heterozygous states of the HLA-G 14bp ins/del polymorphism is more frequent in glioma patients and the elevated plasma levels of sHLA-G are negatively associated with their survival.

Preference-Driven Classification Measure

Classification is one of the main problems of machine learning, and assessing the quality of classification is one of the most topical tasks, all the more difficult as it depends on many factors. Many different measures have been proposed to assess the quality of the classification, often depending on the application of a specific classifier. However, in most cases, these measures are focused on binary classification, and for the problem of many decision classes, they are significantly simplified. Due to the increasing scope of classification applications, there is a growing need to select a classifier appropriate to the situation, including more complex data sets with multiple decision classes. This paper aims to propose a new measure of classifier quality assessment (called the preference-driven measure, abbreviated p-d), regardless of the number of classes, with the possibility of establishing the relative importance of each class. Furthermore, we propose a solution in which the classifier’s assessment can be adapted to the analyzed problem using a vector of preferences. To visualize the operation of the proposed measure, we present it first on an example involving two decision classes and then test its operation on real, multi-class data sets. Additionally, in this case, we demonstrate how to adjust the assessment to the user’s preferences. The results obtained allow us to confirm that the use of a preference-driven measure indicates that other classifiers are better to use according to preferences, particularly as opposed to the classical measures of classification quality assessment.

Minimum Query Set for Decision Tree Construction

A new two-stage method for the construction of a decision tree is developed. The first stage is based on the definition of a minimum query set, which is the smallest set of attribute-value pairs for which any two objects can be distinguished. To obtain this set, an appropriate linear programming model is proposed. The queries from this set are building blocks of the second stage in which we try to find an optimal decision tree using a genetic algorithm. In a series of experiments, we show that for some databases, our approach should be considered as an alternative method to classical ones (CART, C4.5) and other heuristic approaches in terms of classification quality.

Real-World Data Difficulty Estimation with the Use of Entropy

In the era of the Internet of Things and big data, we are faced with the management of a flood of information. The complexity and amount of data presented to the decision-maker are enormous, and existing methods often fail to derive nonredundant information quickly. Thus, the selection of the most satisfactory set of solutions is often a struggle. This article investigates the possibilities of using the entropy measure as an indicator of data difficulty. To do so, we focus on real-world data covering various fields related to markets (the real estate market and financial markets), sports data, fake news data, and more. The problem is twofold: First, since we deal with unprocessed, inconsistent data, it is necessary to perform additional preprocessing. Therefore, the second step of our research is using the entropy-based measure to capture the nonredundant, noncorrelated core information from the data. Research is conducted using well-known algorithms from the classification domain to investigate the quality of solutions derived based on initial preprocessing and the information indicated by the entropy measure. Eventually, the best 25% (in the sense of entropy measure) attributes are selected to perform the whole classification procedure once again, and the results are compared.

Muscle Tissue as a Surrogate for In Vitro Drug Release Testing of Parenteral Depot Microspheres

Despite the importance of drug release testing of parenteral depot formulations, the current in vitro methods still require ameliorations in biorelevance. We have investigated here the use of muscle tissue components to better mimic the intramuscular administration. For convenient handling, muscle tissue was used in form of a freeze-dried powder, and a reproducible process of incorporation of tested microspheres to an assembly of muscle tissue of standardized dimensions was successfully developed. Microspheres were prepared from various grades of poly(lactic-co-glycolic acid) (PLGA) or ethyl cellulose, entrapping flurbiprofen, lidocaine, or risperidone. The deposition of microspheres in the muscle tissue or addition of only isolated lipids into the medium accelerated the release rate of all model drugs from microspheres prepared from ester-terminated PLGA grades and ethyl cellulose, however, not from the acid-terminated PLGA grades. The addition of lipids into the release medium increased the solubility of all model drugs; nonetheless, also interactions of the lipids with the polymer matrix (ad- and absorption) might be responsible for the faster drug release. As the in vivo drug release from implants is also often faster than in simple buffers in vitro, these findings suggest that interactions with the tissue lipids may play an important role in these still unexplained observations.

Low serum vitamin D levels are associated with a low percentage of TREM-2+ monocytes in low-grade gliomas and poorer overall survival in patients with high-grade gliomas

INTRODUCTION

Anti-inflammatory effect of vitamin D (VD) could be beneficial in improving the survival of glioma patients. The aim of our study was to analyse the serum levels of vitamin D in glioma patients and to find an association with the prognosis of glioma patients and other investigated parameters.

MATERIAL AND METHODS

The study included 63 patients with gliomas. Percentage of CD14+ monocytes, TREM-1+ and TREM-2+ monocytes were determined by flow cytometry, serum levels of 25(OH)D were evaluated by electrochemiluminescent binding test.

RESULTS

Six patients out of 63 had normal levels of VD. A significant difference in the overall survival (OS) in the patients with severe VD deficiency, VD deficiency and insufficiency in grade IV was found. In grade II and III, the levels of vitamin D positively correlated with the percentage of TREM-2+ monocytes, and in grade II also a negative correlation of VD with TREM-1/TREM-2 ratio was observed.

CONCLUSION

Levels of VD could influence the prognosis of patients with high-grade gliomas. Serum level of 25(OH)D in low-grade gliomas positively correlated with the percentage of anti-inflammatory acting TREM-2+ monocytes and negatively with TREM-1/TREM-2 ratio. This could be protective against the progression to high-grade glioma, because TREM-2 is associated with protective functions such as: tissue repair, control of local inflammation, or phagocytosis (Tab. 4, Fig. 4, Ref. 79).

Geocoding of worldwide patent data

The dataset provides geographic coordinates for inventor and applicant locations in 18.8 million patent documents spanning over more than 30 years. The geocoded data are further allocated to the corresponding countries, regions and cities. When the address information was missing in the original patent document, we imputed it by using information from subsequent filings in the patent family. The resulting database can be used to study patenting activity at a fine-grained geographic level without creating bias towards the traditional, established patent offices.

Silk Fibroin as a Novel Alcohol-Resistant Excipient for Sustained-Release Tablet Formulation

Concomitant intake of alcoholic beverages with sustained-release oral formulations may potentially lead to dose dumping. Alcohol-resistance testing is currently a requirement for the manufacturers by regulatory authorities. Silk fibroin produced by silkworm Bombyx mori is suggested in this work as a potential alternative to a narrow spectrum of alcohol-resistant excipients. Oxycodone HCl, tramadol HCl, and flurbiprofen were selected as model drugs and formulated with regenerated silk fibroin either in the form of an amorphous solid dispersion or as a physical mixture and compressed into tablets. Preliminary compactability and tampering-resistance studies were performed. The ethanol-resistance was tested in media containing 5%, 10%, 20%, or 40% (v/v) ethanol concentration. Drug release profiles were compared using f₂ similarity factor. Good mechanical tampering-resistance (tensile strength of 14.6 MPa at 400 MPa compression pressure) was obtained for tablets compressed from physical mixture. Tablets compressed from amorphous solid dispersion had lower tensile strength (2.2 MPa) but showed chemical tampering-resistance to extraction by pure ethanol (7.1% of oxycodone HCl after 24 h). Drug release is controlled predominantly by swelling and diffusion. With an increasing ethanol concentration in release medium, the tablets swelled less, resulting in a slower release. This trend was similar for all tested drugs and for both physical states formulations. No dose dumping occurred in the presence of ethanol; therefore, silk fibroin could be considered as an alternative alcohol-resistant excipient for sustained release application.

Novel approach to two-component speciation analysis. Spectrophotometric flow-based determinations of Fe(II)/Fe(III) and Cr(III)/Cr(VI)

The proposed approach to two-component speciation analysis relies on simultaneous application of two calibration methods to determination of two different forms of an analyte. One form is determined in extrapolative way, whereas the second form is determined in interpolative way, with the use of the same calibration graph, after appropriate chemical treatment, e.g. oxidation or reduction. The applicability of the approach has been verified on the examples of spectrophotometric determinations of Fe(II)/Fe(III) and Cr(VI)/Cr(III) using 1,10-phenanthroline and 1,5-diphenylcarbazide methods, respectively. In the above methods, ascorbic acid and Ce(IV) have been used to reduce Fe(III) to Fe(II) and to oxidize Cr(III) to Cr(VI), respectively. Lab-In-Syringe and SIA systems (for determination of iron and chromium species, respectively) have been applied to make the implementation of the proposed approach more convenient. The approach was verified on the example of determination of the analytes in synthetic and certified reference materials of ground and waste water samples. Using the developed methods, Fe(II)/Fe(III) and Cr(VI)/Cr(III) were determined within the concentration ranges of 0.06-4.0/0.06-3.0 and 0.03-0.5/0.05-7.0mgL^-1, with precision (RSD, %) less than 3.8/2.0 and 2.2/6.0, and accuracy (RE, %) better than 2.9/4.3 and 6.8/5.2, respectively. The detection limits (mgL^-1) are 0.02/0.02 and 0.01/0.02 for determination of both forms of iron and chromium, respectively. The applicability of the approach has been checked by analysis of artesian water (Fe(II)/Fe(III)) and post-production waste samples (Cr(III)/Cr(VI)).

MAPPING SECONDARY FOREST SUCCESSION ON ABANDONED AGRICULTURAL LAND IN THE POLISH CARPATHIANS

Land abandonment and secondary forest succession have played a significant role in land cover changes and forest cover increase in mountain areas in Europe over the past several decades. Land abandonment can be easily observed in the field over small areas, but it is difficult to map over the large areas, e.g., with remote sensing, due to its subtle and spatially dispersed character. Our previous paper presented how the LiDAR (Light Detection and Ranging) and topographic data were used to detect secondary forest succession on abandoned land in one commune located in the Polish Carpathians by means of object-based image analysis (OBIA) and GIS (Kolecka et al., 2015). This paper proposes how the method can be applied to efficiently map secondary forest succession over the entire Polish Carpathians, incorporating spatial sampling strategy supported by various ancillary data. Here we discuss the methods of spatial sampling, its limitations and results in the context of future secondary forest succession modelling.

Tyrosinase-based biosensor for determination of bisphenol A in a flow-batch system

A tyrosinase-based amperometric biosensor is proposed for determination of bisphenol A (BPA) in a flow-batch monosegmented sequential injection system. The enzyme was entrapped in a sol-gel TiO2 matrix modified with multi-walled carbon nanotubes (MWCNTs), polycationic polymer poly(diallyldimethylammonium chloride), (PDDA) and Nafion. Morphology of TYR/TiO2/MWCNTs/PDDA/Nafion matrix composite was studied via scanning electron microscopy (SEM). Electrochemical behavior of the developed biosensor towards bisphenol A was examined and analytical characteristics were assessed with respect to linear range, biosensor sensitivity, limit of detection, long term stability, repeatability and reproducibility. Linear range of biosensor response was found between 0.28 and 45.05 µM with high sensitivity of 3263 µA mM(-1) cm(-2) and detection limit 0.066 µM. The approach was successfully employed for determination of BPA in natural samples.

Dobutamine stress echocardiography in the diagnosis of asymptomatic ischemic heart disease in patients with chronic kidney disease--review of literature and single-center experience

BACKGROUND

Coronary artery disease (CAD) may be present in kidney transplant (KT) candidates without the presence of CAD clinical symptoms. This study joins an ongoing discussion about appropriate noninvasive diagnostic approaches for ischemic heart disease (IHD) assessment and patient selection for revascularization procedures. The aim of this study was to evaluate the role of dobutamine stress echocardiography (DSE) in IHD diagnosis in initially asymptomatic maintenance hemodialysis (HD) patients.

METHODS

Forty HD patients aged 52.4 ± 2.0 years, were studied for 2.5 years. At inclusion, they were free of both symptoms and history of IHD. Standard electrocardiography (ECG), chest X-ray, standard echocardiography, DSE, 24-hour Holter ECG, and Doppler ultrasonography (carotids and lower extremities) were performed. Results were analyzed according to a predefined diagnostic algorithm.

RESULTS

DSE yielded negative results in all patients. Left ventricular (LV) ejection fraction ≤ 60%, LV hypertrophy, and Holter ECG silent ischemia features were noticed in 15%, 70%, and 10% of patients, respectively. Atherosclerotic lesions in lower extremities and carotid arteries were present in 50% and 37.5% of patients, respectively. During the follow-up, 9/40 patients died, including 6 cardiovascular (CV) deaths: 2 with intermediate and 4 with high CV risk according to the proposed algorithm.

CONCLUSIONS

In asymptomatic KT candidates, not only DSE, but also other noninvasive tests (eg, echocardiography and Doppler ultrasonography of the carotid and peripheral arteries) along with a detailed profile of the remaining CV risk factors should be performed and analyzed. Defined composition of risk factors and particular changes in noninvasive tests may be an indication for coronary angiography.

Error analysis for determination of accuracy of an ultrasound navigation system for head and neck surgery

OBJECTIVE

The use of conventional CT- or MRI-based navigation systems for head and neck surgery is unsatisfactory due to tissue shift. Moreover, changes occurring during surgical procedures cannot be visualized. To overcome these drawbacks, we developed a novel ultrasound-guided navigation system for head and neck surgery. A comprehensive error analysis was undertaken to determine the accuracy of this new system.

MATERIALS AND METHODS

The evaluation of the system accuracy was essentially based on the method of error definition for well-established fiducial marker registration methods (point-pair matching) as used in, for example, CT- or MRI-based navigation. This method was modified in accordance with the specific requirements of ultrasound-guided navigation. The Fiducial Localization Error (FLE), Fiducial Registration Error (FRE) and Target Registration Error (TRE) were determined.

RESULTS

In our navigation system, the real error (the TRE actually measured) did not exceed a volume of 1.58 mm(3) with a probability of 0.9. A mean value of 0.8 mm (standard deviation: 0.25 mm) was found for the FRE. The quality of the coordinate tracking system (Polaris localizer) could be defined with an FLE of 0.4 +/- 0.11 mm (mean +/- standard deviation). The quality of the coordinates of the crosshairs of the phantom was determined with a deviation of 0.5 mm (standard deviation: 0.07 mm).

CONCLUSION

The results demonstrate that our newly developed ultrasound-guided navigation system shows only very small system deviations and therefore provides very accurate data for practical applications.

Navigation-supported and sonographically-controlled fine-needle puncture in soft tissues of the neck

In surgery, sonography has been a well-accepted means of orientation for years. The immediate vicinity of many vital structures in the head and neck region calls for a very exact visualization of the surgical instrument in the 2-D ultrasonic picture. We report on the development of a new method for navigation-supported and sonographically-controlled fine-needle puncture in soft tissues of the neck. Our system comprises a navigated ultrasound probe, a navigated fine-puncture needle and a coordinate sensor. A personal computer with specially-developed software assists calibration and surgical application. The applicability test for the system is described. In vitro, a model lymph node of 9 mm in diameter had been hit. It is shown that the target structure can be aimed at very precisely by the navigated puncture needle. An accuracy of 97% and a specificity of 99% could be demonstrated. The development of a very precise and easy-to-handle method for navigation-supported fine-needle puncture in the neck region is presented. The outstanding advantage of this method is that no rigid reference gadget fixed to the patient's body is necessary. That makes this method very suitable for surgery in the neck region. Contrary to other sonographically-supported navigation methods in the head and neck region, preoperative imaging (CT or MRT) is dispensable.

[Navigation-assisted sonography for soft tissues in the head and neck region]

BACKGROUND

In soft tissue surgery of the head and neck region tissue shifts limit the usefulness of conventional CT/MRI-based navigation procedures. Furthermore, changes caused by invasive measures cannot be visualized.

METHODS

A novel navigation device for sonography of soft tissues was developed. This consists of a navigated ultrasound scanner, a navigated surgical instrument, and a personal computer with custom-made software. Its use makes an additional visualization by means of CT or MRI dispensable.

RESULTS

The system deviation (three-dimensional error) of this newly developed prototype was less than 1 mm. The practical application in a model setup showed good handling properties of the system. Orientation and approach of the surgical instrument to the sonographically visualized target structure were rapid and accurate.

CONCLUSION

This new navigation system does not require additional CT or MRI images. The navigated ultrasound probe shows tissue changes in real time. This navigation system is especially suitable for invasive procedures in soft tissues.

Immunohistochemical evaluation of P21ras and P53 proteins expression in human non-small-cell lung cancers

Human non-small-cell lung cancers (NSCLCs) of 48 patients were analyzed immunohistochemically to detect P21 ras and P53 proteins expression. The relationship between P21 ras and P53 proteins expression and clinicopathologic findings was also assessed. DAKO EnVision TM detection system was employed in the study. The P21 ras and P53 proteins expression was shown in 75% (36/48) and 33.3% (16/48) studied NSCLCs, respectively. In both cases the difference was significant when compared with adequate negative control. Simultaneous expression of both studied proteins was observed in all cases in which P53 expression was noticed. No significant association of P21 ras and P53 expression was found with age, histologic type, histologic grade, tumor size or lymph node metastasis of the studied NSCLCs. Therefore, our study suggests that P21 ras and P53 protein play a role in the pathogenesis of NSCLCs but they have no value as a prognostic markers in the case of lung cancers.

Semiautomated registration using new markers for assessing the accuracy of a navigation system

OBJECTIVES

New markers are described that can be used for an improved registration procedure and for the exact comparison of navigation systems. The advantages of the markers are demonstrated, together with an automated segmentation algorithm for locating the centroid of the markers in image space. Compared to manual registration, this method shows an improved registration accuracy.

MATERIALS AND METHODS

The new markers are detected completely automatically within all scan images. This allows a semiautomatic registration, as a preregistration is performed via the algorithm. Furthermore, the exact coordinates within one scan slice are now determined with the calculation procedure. The calculated data from the preregistration were matched up with a manual preregistration and some reference data, so as to confirm the quality of this new algorithm. The accuracies of several manual and semiautomatic registrations were also compared.

RESULTS

The average deviation between the coordinates of the algorithm and the reference data (coordinate measuring machine) was 0.3 mm. The standard deviation amounted to 0.131 mm. Comparing several manual registrations with the reference data showed that the middle fiducial registration error (FRE) was between 0.7 and 2 mm. In comparison, the FRE remained constant at around 0.7 mm for the semiautomatic registration procedure.

CONCLUSIONS

The measured results show a significant improvement in the preregistration data using the new markers together with the algorithm. This improvement leads to a reproducible and more accurate registration. The combination of the new marker type with the automated segmentation algorithm minimizes the human error factor, and provides the opportunity to directly compare image-guided and robotic systems.

Effects of screening errors and differential mortality on the estimation of the incidence of dementia in the Canadian Study of Health and Aging

The Canadian Study of Health and Aging produced an estimate of the incidence of dementia among elderly Canadians by following up, after 5 years, the undemented found in an initial prevalence survey. Initial and follow-up estimates could be biased by false-negative error in the screening tool used for subjects living in the community, and by erroneous classification of subjects who died in the interim. Here, we use a deterministic model to quantify those possible biases. We conclude that, using the estimates of the errors from control samples, the incidence among community subjects would be overestimated by 15%, and the incidence among the institutional subjects would be underestimated by 37%. The overall incidence would be underestimated by 14%. Most of the bias can be attributed to inaccuracies in the classification of deaths.

[Cerebral arteriovenous malformation complicated by pulmonary embolism]

Endovascular treatment of cerebral arteriovenous malformation (AVM) lies in selective catheterisation through feeder and AVM nidus. Sticking mixture is applied after proper verification of microcatheter location. Malformation embolisation is normal when the vessel net is of small diameter. In the presented case embolisation material penetrated cerebral vein system and then lungs, where numerous emboli developed. X-ray where confirmed pulmonary embolism resulted in severe respiratory insufficiency. Treatment of this rare complication as well as the cause of its occurrence have been presented. Prevention of such complications has been considered.

[Thyroglossal duct cyst imitating mediastinal tumor]

A rare case of thyroglossal duct cyst mimicking the mediastinal tumour is described. Due to localisation, simple cystectomy was performed. The early and two year postoperative results are good, any recurrence of the cyst has not been observed.

[A large pancreatic pseudocyst penetrating into mediastinum causing progressive airways occlusion and death: a case report]

Pancreatic pseudocysts arise mostly as a complication of acute or chronic pancreatitis. In this paper we present a case of 44-years-old female suffering from large pancreatic pseudocyst leading to death, as a result of airways suppression.

[A case of traumatic rupture of the median bronchus]

The case of rupture of median bronchus after road accident was described. Early diagnose and treatment let us to obtain complete reconstruction of bronchial tree and preserve two lung lobes.

A simple method for estimating incidence from prevalence

A two-state deterministic model is used to estimate the incidence of an irreversible disease from prevalence and mortality data. The method is simpler than those described previously. Diabetes and dementia are used as examples.

Likelihood and clinical trials

The history of the application of statistical theory to the analysis of clinical trials is reviewed. The current orthodoxy is a somewhat illogical hybrid of the original theory of significance tests of Edgeworth, Karl Pearson, and Fisher, and the subsequent decision theory approach of Neyman, Egon Pearson, and Wald. This hegemony is under threat from Bayesian statisticians. A third approach is that of likelihood, stemming from the work of Fisher and Barnard. This approach is illustrated using hypothetical data from the Lancet articles by Bradford Hill, which introduced clinicians to statistical theory.

Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming

Normative data stratified by three levels of age (16-59, 60-79, and 80-95 years) and three levels of education (0-8, 9-12, and 13-21 years) are presented for phonemic verbal fluency (FAS) and categorical verbal fluency (Animal Naming). The normative sample, aged 16 to 95 years, consisted of 1,300 cognitively intact individuals who resided in the community. Years of education ranged from 0 to 21. The total number of words in 1 minute for each of the letters F, A, and S was correlated r =.52 with the number of animal names generated in 1 minute. Regression analyses showed that FAS was more sensitive to the effects of education (18.6% of the variance) than age (11.0% of the variance). The opposite relationship occurred for Animal Naming, where age accounted for 23.4% of the variance and education accounted only for 13.6%. Gender accounted for less than 1% of variance for FAS and Animal Naming. The clinical utility of these norms is discussed.

[Endometriosis of the lung diagnosed with videothoracoscopy]

A case of non symptomatic pulmonary endometriosis appearing as multiple nodules on chest X ray and chest CT scan is reported. 43 year old woman was admitted to surgical department because of suspicion of neoplastic dissemination of unknown origin. Non invasive diagnostic procedures were not effective. Diagnosis of pulmonary endometriosis was established with thoracoscopy with lung sampling, confirmed with histopathologic evidence.