Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of th...Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases,porto-sinusoidal vascular disease and portal hypertension.Untreated Mahvash disease can be lethal.The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists’unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy.These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma,diffuse pancreatic lymphoma,and autoimmune pancreatitis.Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis.To prevent missing the diagnosis of this significant disease,I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.展开更多
The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstruct...The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstructured grid and the experimental results of smooth wall tunnel were verified.Numerical simulation studies were conducted on three tunnel enlarged section parameters,the enlarged section distribution along circumferential direction,the enlarged section area and the enlarged section distribution along tunnel length direction.The calculation results show that the influence of the different enlarged section distributions along tunnel circumferential direction on pressure transients in the tunnel is basically consistent.There is an optimal enlarged section area for the minimum value of the pressure variation amplitude and the average pressure variation in the tunnel.The law of the pressure variation amplitude and the average pressure variation of the enlarged section distribution along tunnel length direction are obtained.展开更多
Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patien...Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study.展开更多
BACKGROUND：Continuous hemorrhage or hematoma enlargement often occurs following cerebral hemorrhage attacks. OBJECTIVE： To retrospectively analyze the influential factors for hematoma enlargement in patients with hy...BACKGROUND：Continuous hemorrhage or hematoma enlargement often occurs following cerebral hemorrhage attacks. OBJECTIVE： To retrospectively analyze the influential factors for hematoma enlargement in patients with hypertensive cerebral hemorrhage prior to minimally invasive surgery. DESIGN, TIME AND SETTING： A comparative analysis of 90 patients with cerebral hemorrhage undergoing minimally invasive surgery at the Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between April 2005 and February 2007. PARTICIPANTS： Fifty-eight males and thirty-one females aged （52.7 ± 5.23） years （range, 28-73 years）. METHODS： Cranial CT was performed twice to objectively identify hematoma enlargement. Patients with hematoma enlargement prior to surgery were selected as the observation group （n = 30）, and those with no obvious hematoma changes served as the control group （n = 60）. Following cranial CT localization, the two groups underwent minimally invasive hematoma aspiration and drainage, according to Standardized Treatment Guidelines for Micro-invasive Aspiration and Drainage of Intracranial Hematoma. MAIN OUTCOME MEASURES： Hemorrhage site, coagulation function, diabetes history, and clinical symptoms. RESULTS： There were no significant differences in hemorrhage sites between the two groups （χ2 = 2.262, P 〉 0.05）. The percent of intemperance patients in the observation group was significantly larger than the control group （χ2 = 6.923, P 〈 0.01）. No significant differences in terms of percent of coagulation dysfunction or diabetes were determined between the two groups （χ2 = 0.03, 0.08, P 〉 0.05）. The percent of patients with clinical deterioration was significantly higher in the observation group, compared to the control group （χ2 = 25.57, P 〈 0.01）. CONCLUSION： Intemperance and preoperative clinical deterioration may increase incidence of hematoma enlargement prior to minimally invasive surgery in patients with hypertensive cerebral hemorrhage.展开更多
Objectives:Distal segment aortic enlargement(DSAE)is a common complication that influences the long-term prognosis of type B aortic dissection(TBAD)after thoracic endovascular aortic repair(TEVAR).In this study,a mult...Objectives:Distal segment aortic enlargement(DSAE)is a common complication that influences the long-term prognosis of type B aortic dissection(TBAD)after thoracic endovascular aortic repair(TEVAR).In this study,a multivariate analysis was performed to find potential factors predictive of DSAE.Methods:A single-center retrospective study was performed from 1999 to 2016.Included in the study were complicated TBAD patients who underwent TEVAR with uncovered residual tears.Based on the diameter of the distal segment of the uncovered aorta,we assigned patients to an enlargement group and a non-enlargement group.Data extracted from the medical records included demographic and clinical characteristics and followup computed tomography angiography data.The primary endpoints were the all-cause mortality and the presumably aortic-related events that required reintervention during the follow-up period.Results:For the 333 patients,all-cause mortality was 38(11.41%),and 76(22.82%)patients underwent reintervention.A total of 70(21.02%)patients experienced DSAE,among them were 2 patients who died of aortic rupture and 58 patients who accepted reintervention.Multivariate analysis reviewed independent risk factors of postoperative DSAE,including current smoking,the residual length of the patent false lumen,the postoperative number of dissection tears in the thoracic aorta and type III aortic arch;as well as protective factors,including the application of a restrictive bare stent(RBS),the length of covered stent in the descending thoracic aorta,and the distance from the residual first tear to the left subclavian artery(LSA).Conclusion:DSAE after TEVAR for patients with a complicated TBAD can be influenced by their current smoking habit,the residual length of patent false lumen,the postoperative number of dissection tears in the thoracic aorta and the aortic arch type.Meanwhile,RBS usage,the length of the covered stent in the descending thoracic aorta and the distance from the residual first tear to the LSA could have positive effect on the prognosis.展开更多
Enlarged vestibular aqueduct(EVA), the most frequent identifiable cause of congenital hearing loss, is evaluated with high-definition multidetector CT in the axial plane. Our purpose was to determine which reformatted...Enlarged vestibular aqueduct(EVA), the most frequent identifiable cause of congenital hearing loss, is evaluated with high-definition multidetector CT in the axial plane. Our purpose was to determine which reformatted CT measurements are most reproducible. Seven multiplanar reformatted images were created for each of the 64 temporal bones in patients with EVA. Intraclass correlation coefficients(ICC) were used to assess inter-observer variability, and both linear regression and ROC analyses were used to compare the measurements with severity of hearing loss, as assessed by pure tone audiometry. All seven measurements had excellent inter-observer variability, with average-measure ICC ranging from 0.92 to 0.98. There was no statistically significant correlation between the radiologic degree of aqueduct enlargement and severity of hearing loss using any of the seven measurements; ROC analyses revealed areas under the curves ranging from 0.57 to 0.73. Optimal accuracy was obtained with a threshold of 1.75 mm as measured at the aqueductal aperture in the P€oschl plane, with sensitivity of 0.75 and specificity of0.63. Although the radiologic measurement may not serve as a reliable tool for assessing severity of EVA, P€oschl plane reformatting has proven to be better than conventional axial acquisition plane for identifying patients with clinically significant hearing loss.展开更多
The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of ar...The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of artificial intelligence.Based on the analysis of the major factors affecting the scale of enlarged production,we first interpreted in detail the design principles and structure of the intelligent system.Secondly,we introduced an ANN subsystem.In order to ensure technological and scale efficien- cies of the training samples for ANN,we filtrated the samples with a DEA method.Finally,we trained the intelligent system,which was proved to be very efficient.展开更多
AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induce...AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits.A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits.Then,a solution of SonazoidTM(GE Healthcare,Oslo,Norway)was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS:In the contrast-enhanced ultrasonography of the tumor-induced metastasis model,the sentinel lymph node was imaged.An area of filling defect was observed in that enlarged lymph node.In the histology examination,the area of filling defect corresponded to the metastatic lesion of the tumor.Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement,and that of the acute inflam-mation model performed 3-7 d later,revealed dense staining that was comparatively uniform.The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells.Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining.Inflammation-induced cell infiltration and fiberization,which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION:Sentinel lymph node imaging was made possible by subcutaneous injection of SonazoidTM.Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.展开更多
The inhibition of 5-a reductase type 2(SRD5A2)by finasteride is commonly used for the management of urinary obstruction resulting from benign prostatic enlargement(BPE).Certain BPE patients showing no SRD5A2 protein e...The inhibition of 5-a reductase type 2(SRD5A2)by finasteride is commonly used for the management of urinary obstruction resulting from benign prostatic enlargement(BPE).Certain BPE patients showing no SRD5A2 protein expression are resistant to finasteride therapy.Our previous work showed that methylated cytosine-phosphate-guanine(CpG)islands in the SRD5A2 gene might account for the absence or reduction of SRD5A2 protein expression.Here,we found that the expression of the SRD5A2 protein was variable and that weak expression of the SRD5A2 protein(scored 0-100)occurred in 10.0%(4/40)of benign adult prostates.We showed that the expression of SRD5A2 was negatively correlated with DNA methyltransferase 1(DNMT1)expression.In vitro SRD5A2-negative BPH-1 cells were resistant to finasteride treatment,and SRD5A2 was re-expressed in BPH-1 cells when SRD5A2 was demethylated by 5-Aza-2T-deoxycytidine(5-Aza-CdR)or N-phthalyl-L-tryptophan(RG108).Furthermore,we determined the exact methylation ratios of CpG dinucleotides in a CpG island of SRD5A2 through MassArray quantitative methylation analysis.Ten methylated CpG dinucleotides,including four CpG dinucleotides in the promoter and six CpG dinucleotides in the first exon,were found in a CpG island located from-400 bp to+600 bp in SRD5A2,which might lead to the silencing of SRD5A2 and the absence or reduction of SRD5A2 protein expression.Finasteride cannot exert a therapeutic effect on patients lacking SRD5A2,which may partially account for the resistance to finasteride observed in certain BPE patients.展开更多
In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equi...In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equivalent condition of a point outside the convex set is given and proved rigorously.Then,the ELP condition describing the CPOA constraints equivalently is given without introducing binary variables,and its geometric meaning is explained.Finally,the ELP method is used to transform the CPOA trajectory optimization problem into an optimal control problem without binary variables.The effectiveness and validity of ELP method are demonstrated through simulations with both simple linear dynamic model(unmanned aerial vehicle)and complex nonlinear dynamic model(hypersonic glide vehicle).Comparison indicates the computational time of ELP method is only 1%-20%of that of the traditional Mixed-Integer Programming(MIP)method.展开更多
Let Bt be an Ft Brownian motion and Gt be an enlargement of filtration of Ft from some Gaussian random variables. We obtain equations for ht such that Bt ht is a Gt-Brownian motion.
BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;h...BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion.展开更多
Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open...Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open port when the enlarged cell technique conformal finite-difference time-domain（ECT-CFDTD） method is used to simulate the wave propagation inside a perfect electric conductor（PEC） waveguide.The algorithm has the same numerical stability as the ECT-CFDTD method.For the long-time propagation problems of an evanescent wave in a waveguide,several numerical simulations are performed to analyze the reflection error by sweeping the constitutive parameters of the integral-based conformal CPML.Our numerical results show that the integral-based conformal CPML can be used to efficiently truncate the open port of the waveguide.展开更多
BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with ...BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.展开更多
The procedure for the ring enlargement of N-heterocycles with the net result of CH2 insertion was successfully carried out with certain alkaloids such as tetrahydroberberine and strychnine.
Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and ...Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.展开更多
PRKAG2 cardiac syndrome(PS)is a rare inherited disease due to PRKAG2 gene mutation and characterized by Wolff-Parkinson-White syndrome(WPWs),conduction system lesions and myocardial hypertrophy.It can also lead to ser...PRKAG2 cardiac syndrome(PS)is a rare inherited disease due to PRKAG2 gene mutation and characterized by Wolff-Parkinson-White syndrome(WPWs),conduction system lesions and myocardial hypertrophy.It can also lead to serious consequences,such as sudden death.But the genetic and clinical heterogeneity makes the early diagnosis of PS difficult.Here we studied a family with familial hypertrophic cardiomyopathy and other diverse manifestations.Gene analysis identified a missense mutation(Arg302Gln)in the five affected subjects of the family.The electrocardiograph performance of the five was composed of sinus bradycardia(SB),WPWs,right bundle branch block(RBBB),atrioventricular block(AVB),left bundle branch block(LBBB),supraventricular tachycardia(SVT)and atrial premature beat(APB).Among them,the youngest one began to show paroxysmal palpitation at the age of nine and was confirmed to have WPWs at 17 years old;two members progressed over time to serious conduction damage,and the proband received a pacemaker at the age of 27 due to AVB.Besides,according to cardiac magnetic resonance and echocardiography,the youngest one showed symmetric hypertrophy;three older members showed asymmetric myocardial hypertrophy characterized with a diffuse pattern of middle-anterior-lateral-inferior wall hypertrophy and especially interventricular septal hypertrophy;all five affected patients showed atrial enlargement regardless of myocardial hypertrophy at an earlier stage.In conclusion,the conduction system disorder,familial atrial enlargement and symmetric cardiac hypertrophy may occur in the early stage of PRKAG2 R302Q mutation.展开更多
This paper gives a new algorithm to enlarge images based on local matching. Its main advantage is capable of preserving the edge of the enlarged image and improving both the subjective effect and the objective effect.
A refractive index insensitive temperature sensor based on waist-enlarged few mode fiber(FMF) bitapers is presented. The first section of FMF is spliced between two single-mode fibers. In fusion process,the waist-enla...A refractive index insensitive temperature sensor based on waist-enlarged few mode fiber(FMF) bitapers is presented. The first section of FMF is spliced between two single-mode fibers. In fusion process,the waist-enlarged FMF bitapers can be obtained by large current discharging repeatedly. The refractive index and temperature sensing mechanisms are analyzed. For the sensors with different sizes,the refractive index and temperature experiments have been performed. The results show that in the refractive index ranges of 1.335 0—1.346 6 and 1.348 2—1.419 3,the refractive index insensitivity is verified. In a temperature range of 31.9—90 °C,the sensor sensitivity can be up to 85.57 pm/°C. In addition,it has a compact structure. Therefore,the sensor can avoid the cross sensitivity for measuring the refractive index and temperature simultaneously.展开更多
In this paper, we present a study on activity functions for an MLNN (multi-layered neural network) and propose a suitable activity function for data enlargement processing. We have carefully studied the training perfo...In this paper, we present a study on activity functions for an MLNN (multi-layered neural network) and propose a suitable activity function for data enlargement processing. We have carefully studied the training performance of Sigmoid, ReLu, Leaky-ReLu and L & exp. activity functions for few inputs to multiple output training patterns. Our MLNNs model has L hidden layers with two or three inputs to four or six outputs data variations by BP (backpropagation) NN (neural network) training. We focused on the multi teacher training signals to investigate and evaluate the training performance in MLNNs to select the best and good activity function for data enlargement and hence could be applicable for image and signal processing (synaptic divergence) along with the proposed methods with convolution networks. We specifically used four activity functions from which we found out that L & exp. activity function can suite DENN (data enlargement neural network) training since it could give the highest percentage training abilities compared to the other activity functions of Sigmoid, ReLu and Leaky-ReLu during simulation and training of data in the network. And finally, we recommend L & exp. function to be good for MLNNs and may be applicable for signal processing of data and information enlargement because of its performance training characteristics with multiple teacher training patterns using original generated data and hence can be tried with CNN (convolution neural networks) of image processing.展开更多
文摘Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases,porto-sinusoidal vascular disease and portal hypertension.Untreated Mahvash disease can be lethal.The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists’unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy.These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma,diffuse pancreatic lymphoma,and autoimmune pancreatitis.Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis.To prevent missing the diagnosis of this significant disease,I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.
基金Project (2016YFB1200602-11) supported by National Key R&D Plan of China
文摘The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstructured grid and the experimental results of smooth wall tunnel were verified.Numerical simulation studies were conducted on three tunnel enlarged section parameters,the enlarged section distribution along circumferential direction,the enlarged section area and the enlarged section distribution along tunnel length direction.The calculation results show that the influence of the different enlarged section distributions along tunnel circumferential direction on pressure transients in the tunnel is basically consistent.There is an optimal enlarged section area for the minimum value of the pressure variation amplitude and the average pressure variation in the tunnel.The law of the pressure variation amplitude and the average pressure variation of the enlarged section distribution along tunnel length direction are obtained.
基金supported by grants from the Health & Medical Collaborative Innovation Project of Guangzhou City,China(No.201400000001)the Sun Yat-sen University Clinical Research 5010 Program(No.2012011)+1 种基金the Science and Technology Project of Guangzhou City,China(No.14570006)the Planned Science and Technology Project of Guangdong Province,China(No. 2013B020400004)
文摘Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study.
文摘BACKGROUND：Continuous hemorrhage or hematoma enlargement often occurs following cerebral hemorrhage attacks. OBJECTIVE： To retrospectively analyze the influential factors for hematoma enlargement in patients with hypertensive cerebral hemorrhage prior to minimally invasive surgery. DESIGN, TIME AND SETTING： A comparative analysis of 90 patients with cerebral hemorrhage undergoing minimally invasive surgery at the Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between April 2005 and February 2007. PARTICIPANTS： Fifty-eight males and thirty-one females aged （52.7 ± 5.23） years （range, 28-73 years）. METHODS： Cranial CT was performed twice to objectively identify hematoma enlargement. Patients with hematoma enlargement prior to surgery were selected as the observation group （n = 30）, and those with no obvious hematoma changes served as the control group （n = 60）. Following cranial CT localization, the two groups underwent minimally invasive hematoma aspiration and drainage, according to Standardized Treatment Guidelines for Micro-invasive Aspiration and Drainage of Intracranial Hematoma. MAIN OUTCOME MEASURES： Hemorrhage site, coagulation function, diabetes history, and clinical symptoms. RESULTS： There were no significant differences in hemorrhage sites between the two groups （χ2 = 2.262, P 〉 0.05）. The percent of intemperance patients in the observation group was significantly larger than the control group （χ2 = 6.923, P 〈 0.01）. No significant differences in terms of percent of coagulation dysfunction or diabetes were determined between the two groups （χ2 = 0.03, 0.08, P 〉 0.05）. The percent of patients with clinical deterioration was significantly higher in the observation group, compared to the control group （χ2 = 25.57, P 〈 0.01）. CONCLUSION： Intemperance and preoperative clinical deterioration may increase incidence of hematoma enlargement prior to minimally invasive surgery in patients with hypertensive cerebral hemorrhage.
基金supported by the National Nature Science Foundation of China[grant number 81800403].
文摘Objectives:Distal segment aortic enlargement(DSAE)is a common complication that influences the long-term prognosis of type B aortic dissection(TBAD)after thoracic endovascular aortic repair(TEVAR).In this study,a multivariate analysis was performed to find potential factors predictive of DSAE.Methods:A single-center retrospective study was performed from 1999 to 2016.Included in the study were complicated TBAD patients who underwent TEVAR with uncovered residual tears.Based on the diameter of the distal segment of the uncovered aorta,we assigned patients to an enlargement group and a non-enlargement group.Data extracted from the medical records included demographic and clinical characteristics and followup computed tomography angiography data.The primary endpoints were the all-cause mortality and the presumably aortic-related events that required reintervention during the follow-up period.Results:For the 333 patients,all-cause mortality was 38(11.41%),and 76(22.82%)patients underwent reintervention.A total of 70(21.02%)patients experienced DSAE,among them were 2 patients who died of aortic rupture and 58 patients who accepted reintervention.Multivariate analysis reviewed independent risk factors of postoperative DSAE,including current smoking,the residual length of the patent false lumen,the postoperative number of dissection tears in the thoracic aorta and type III aortic arch;as well as protective factors,including the application of a restrictive bare stent(RBS),the length of covered stent in the descending thoracic aorta,and the distance from the residual first tear to the left subclavian artery(LSA).Conclusion:DSAE after TEVAR for patients with a complicated TBAD can be influenced by their current smoking habit,the residual length of patent false lumen,the postoperative number of dissection tears in the thoracic aorta and the aortic arch type.Meanwhile,RBS usage,the length of the covered stent in the descending thoracic aorta and the distance from the residual first tear to the LSA could have positive effect on the prognosis.
文摘Enlarged vestibular aqueduct(EVA), the most frequent identifiable cause of congenital hearing loss, is evaluated with high-definition multidetector CT in the axial plane. Our purpose was to determine which reformatted CT measurements are most reproducible. Seven multiplanar reformatted images were created for each of the 64 temporal bones in patients with EVA. Intraclass correlation coefficients(ICC) were used to assess inter-observer variability, and both linear regression and ROC analyses were used to compare the measurements with severity of hearing loss, as assessed by pure tone audiometry. All seven measurements had excellent inter-observer variability, with average-measure ICC ranging from 0.92 to 0.98. There was no statistically significant correlation between the radiologic degree of aqueduct enlargement and severity of hearing loss using any of the seven measurements; ROC analyses revealed areas under the curves ranging from 0.57 to 0.73. Optimal accuracy was obtained with a threshold of 1.75 mm as measured at the aqueductal aperture in the P€oschl plane, with sensitivity of 0.75 and specificity of0.63. Although the radiologic measurement may not serve as a reliable tool for assessing severity of EVA, P€oschl plane reformatting has proven to be better than conventional axial acquisition plane for identifying patients with clinically significant hearing loss.
基金Project 50374005 supported by the National Natural Science Foundation of China
文摘The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of artificial intelligence.Based on the analysis of the major factors affecting the scale of enlarged production,we first interpreted in detail the design principles and structure of the intelligent system.Secondly,we introduced an ANN subsystem.In order to ensure technological and scale efficien- cies of the training samples for ANN,we filtrated the samples with a DEA method.Finally,we trained the intelligent system,which was proved to be very efficient.
文摘AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits.A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits.Then,a solution of SonazoidTM(GE Healthcare,Oslo,Norway)was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS:In the contrast-enhanced ultrasonography of the tumor-induced metastasis model,the sentinel lymph node was imaged.An area of filling defect was observed in that enlarged lymph node.In the histology examination,the area of filling defect corresponded to the metastatic lesion of the tumor.Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement,and that of the acute inflam-mation model performed 3-7 d later,revealed dense staining that was comparatively uniform.The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells.Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining.Inflammation-induced cell infiltration and fiberization,which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION:Sentinel lymph node imaging was made possible by subcutaneous injection of SonazoidTM.Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.
基金the National Natural Science Foundation of China(No.81770754)the Beiing Natural Science Foundation(No.7172081)at Beijing Chaoyang Hospital,Capital Medical University,through funding provided to YNN.
文摘The inhibition of 5-a reductase type 2(SRD5A2)by finasteride is commonly used for the management of urinary obstruction resulting from benign prostatic enlargement(BPE).Certain BPE patients showing no SRD5A2 protein expression are resistant to finasteride therapy.Our previous work showed that methylated cytosine-phosphate-guanine(CpG)islands in the SRD5A2 gene might account for the absence or reduction of SRD5A2 protein expression.Here,we found that the expression of the SRD5A2 protein was variable and that weak expression of the SRD5A2 protein(scored 0-100)occurred in 10.0%(4/40)of benign adult prostates.We showed that the expression of SRD5A2 was negatively correlated with DNA methyltransferase 1(DNMT1)expression.In vitro SRD5A2-negative BPH-1 cells were resistant to finasteride treatment,and SRD5A2 was re-expressed in BPH-1 cells when SRD5A2 was demethylated by 5-Aza-2T-deoxycytidine(5-Aza-CdR)or N-phthalyl-L-tryptophan(RG108).Furthermore,we determined the exact methylation ratios of CpG dinucleotides in a CpG island of SRD5A2 through MassArray quantitative methylation analysis.Ten methylated CpG dinucleotides,including four CpG dinucleotides in the promoter and six CpG dinucleotides in the first exon,were found in a CpG island located from-400 bp to+600 bp in SRD5A2,which might lead to the silencing of SRD5A2 and the absence or reduction of SRD5A2 protein expression.Finasteride cannot exert a therapeutic effect on patients lacking SRD5A2,which may partially account for the resistance to finasteride observed in certain BPE patients.
基金supported by the National Natural Science Foundation of China(No.52232014)the National Natural Science Foundation of China Joint Fund(No.U2241215)。
文摘In this article,an Enlarged Polygon/Polyhedron(ELP)method without binary variables is proposed to represent the Convex Polygonal/Polyhedral Obstacle Avoidance(CPOA)constraints in trajectory optimization.First,the equivalent condition of a point outside the convex set is given and proved rigorously.Then,the ELP condition describing the CPOA constraints equivalently is given without introducing binary variables,and its geometric meaning is explained.Finally,the ELP method is used to transform the CPOA trajectory optimization problem into an optimal control problem without binary variables.The effectiveness and validity of ELP method are demonstrated through simulations with both simple linear dynamic model(unmanned aerial vehicle)and complex nonlinear dynamic model(hypersonic glide vehicle).Comparison indicates the computational time of ELP method is only 1%-20%of that of the traditional Mixed-Integer Programming(MIP)method.
文摘Let Bt be an Ft Brownian motion and Gt be an enlargement of filtration of Ft from some Gaussian random variables. We obtain equations for ht such that Bt ht is a Gt-Brownian motion.
文摘BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion.
基金supported by the National Natural Science Foundation of China(Grant No.61231003)
文摘Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open port when the enlarged cell technique conformal finite-difference time-domain（ECT-CFDTD） method is used to simulate the wave propagation inside a perfect electric conductor（PEC） waveguide.The algorithm has the same numerical stability as the ECT-CFDTD method.For the long-time propagation problems of an evanescent wave in a waveguide,several numerical simulations are performed to analyze the reflection error by sweeping the constitutive parameters of the integral-based conformal CPML.Our numerical results show that the integral-based conformal CPML can be used to efficiently truncate the open port of the waveguide.
文摘BACKGROUND High-riding nipple is one of the common complications after mastopexty and breast reconstruction.However,to date,a limited number of techniques have concentrated on how to lower the high-riding nipple with enlarged areola.CASE SUMMARY This is a case report describing a combination of surgical techniques to decrease high-riding nipple.A 26-year-old woman,who previously underwent several breast operations,sought correction for high-riding nipple with enlarged areola.Expanders were used and multi-stage techniques were performed.After one year of follow-up,lowered nipple,reduced areola size,ensured nipple blood supply,and improved breast ptosis were achieved,and the patient was satisfied with the breast contour.CONCLUSION The proposed technique offers a feasible treatment option for postoperative nipple over-elevation combined with areola dilation.
文摘The procedure for the ring enlargement of N-heterocycles with the net result of CH2 insertion was successfully carried out with certain alkaloids such as tetrahydroberberine and strychnine.
文摘Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.
文摘PRKAG2 cardiac syndrome(PS)is a rare inherited disease due to PRKAG2 gene mutation and characterized by Wolff-Parkinson-White syndrome(WPWs),conduction system lesions and myocardial hypertrophy.It can also lead to serious consequences,such as sudden death.But the genetic and clinical heterogeneity makes the early diagnosis of PS difficult.Here we studied a family with familial hypertrophic cardiomyopathy and other diverse manifestations.Gene analysis identified a missense mutation(Arg302Gln)in the five affected subjects of the family.The electrocardiograph performance of the five was composed of sinus bradycardia(SB),WPWs,right bundle branch block(RBBB),atrioventricular block(AVB),left bundle branch block(LBBB),supraventricular tachycardia(SVT)and atrial premature beat(APB).Among them,the youngest one began to show paroxysmal palpitation at the age of nine and was confirmed to have WPWs at 17 years old;two members progressed over time to serious conduction damage,and the proband received a pacemaker at the age of 27 due to AVB.Besides,according to cardiac magnetic resonance and echocardiography,the youngest one showed symmetric hypertrophy;three older members showed asymmetric myocardial hypertrophy characterized with a diffuse pattern of middle-anterior-lateral-inferior wall hypertrophy and especially interventricular septal hypertrophy;all five affected patients showed atrial enlargement regardless of myocardial hypertrophy at an earlier stage.In conclusion,the conduction system disorder,familial atrial enlargement and symmetric cardiac hypertrophy may occur in the early stage of PRKAG2 R302Q mutation.
文摘This paper gives a new algorithm to enlarge images based on local matching. Its main advantage is capable of preserving the edge of the enlarged image and improving both the subjective effect and the objective effect.
基金supported by the National Natural Science Foundation of China(Nos.61475133 and 61575170)the Key Basic Research Program of Hebei Province(Nos.16961701D and QN2016078)+1 种基金the Natural Science Foundation of Hebei Province(Nos.F2015203270 and F2016203392)the“Xin Rui Gong Cheng”Talent Project of Yanshan University
文摘A refractive index insensitive temperature sensor based on waist-enlarged few mode fiber(FMF) bitapers is presented. The first section of FMF is spliced between two single-mode fibers. In fusion process,the waist-enlarged FMF bitapers can be obtained by large current discharging repeatedly. The refractive index and temperature sensing mechanisms are analyzed. For the sensors with different sizes,the refractive index and temperature experiments have been performed. The results show that in the refractive index ranges of 1.335 0—1.346 6 and 1.348 2—1.419 3,the refractive index insensitivity is verified. In a temperature range of 31.9—90 °C,the sensor sensitivity can be up to 85.57 pm/°C. In addition,it has a compact structure. Therefore,the sensor can avoid the cross sensitivity for measuring the refractive index and temperature simultaneously.
文摘In this paper, we present a study on activity functions for an MLNN (multi-layered neural network) and propose a suitable activity function for data enlargement processing. We have carefully studied the training performance of Sigmoid, ReLu, Leaky-ReLu and L & exp. activity functions for few inputs to multiple output training patterns. Our MLNNs model has L hidden layers with two or three inputs to four or six outputs data variations by BP (backpropagation) NN (neural network) training. We focused on the multi teacher training signals to investigate and evaluate the training performance in MLNNs to select the best and good activity function for data enlargement and hence could be applicable for image and signal processing (synaptic divergence) along with the proposed methods with convolution networks. We specifically used four activity functions from which we found out that L & exp. activity function can suite DENN (data enlargement neural network) training since it could give the highest percentage training abilities compared to the other activity functions of Sigmoid, ReLu and Leaky-ReLu during simulation and training of data in the network. And finally, we recommend L & exp. function to be good for MLNNs and may be applicable for signal processing of data and information enlargement because of its performance training characteristics with multiple teacher training patterns using original generated data and hence can be tried with CNN (convolution neural networks) of image processing.
