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Usefulness
Kinds of Usefulness Selected AbstractsCLINICAL USEFULNESS OF COLONOSCOPIC INSERTION OF A DECOMPRESSION TUBE FOR OBSTRUCTIVE COLORECTAL CANCERDIGESTIVE ENDOSCOPY, Issue 2004Kiyonori Kobayashi ABSTRACT We evaluated the clinical usefulness of colonoscopic insertion of a decompression tube (decompression method) for the treatment of ileus associated with left-sided colorectal cancer. Decompression method was done in 48 patients with colorectal cancer (38 primary cancer, 10 metastatic cancer). A decompression tube was successfully inserted in all but 10 patients who had primary cancer with severe strictures. The overall insertion rate was 79%. Decompression method improved obstructive symptoms and decreased intestinal gas as evaluated on plain X-ray films of the abdomen. Emergency operation was unnecessary in 96% of the patients with primary cancers, in whom the decompression tube was successfully inserted. We conclude that decompression method can improve abdominal symptoms caused by obstructive colorectal cancer and reduce the need for emergency operation. [source] EARLY GASTRIC CANCER: USEFULNESS OF INDEX OF HEMOGLOBIN ENHANCED IMAGING FOR THE DIAGNOSIS OF POORLY DIFFERENTIATED ADENOCARCINOMADIGESTIVE ENDOSCOPY, Issue 2002Junko Fujisaki No abstract is available for this article. [source] MIND YOUR ACCRUALS: PERCEIVED USEFULNESS OF FINANCIAL INFORMATION IN THE AUSTRALIAN PUBLIC SECTOR UNDER DIFFERENT ACCOUNTING SYSTEMSFINANCIAL ACCOUNTABILITY & MANAGEMENT, Issue 3 2010Ralph Kober This study examines the usefulness of three accounting systems (cash, Generally Accepted Accounting Principles (GAAP) accrual, and Government Finance Statistics (GFS) accrual) for public sector decision-making. From a survey of internal users, external users, and preparers in Australia, we find that GAAP accrual information is perceived to be relatively more useful and understandable than the other two systems for most decisions examined. The relatively higher ratings for GAAP accrual information differ from earlier studies and may reflect an experience or familiarity effect whereby perceptions of usefulness are enhanced because respondents have become more used to the system. This effect might also explain the lower ratings for GFS accrual. [source] Usefulness of Serial Assessment of Natriuretic Peptides in the Emergency Department for Patients With Acute Decompensated Heart FailureCONGESTIVE HEART FAILURE, Issue 4 2008Salvatore DiSomma MD The value of natriuretic peptides, both B-type natriuretic peptide (BNP) and N-terminal prohormone brain natriuretic peptide (NTproBNP), for determining diagnosis, severity, and prognosis of emergency department (ED) patients with acute decompensated heart failure (ADHF) has been well documented. Emerging data support the hypothesis that repeated natriuretic peptide determinations in the acute phase of ADHF may assist in confirming the diagnosis, monitoring drug therapy, and evaluating the adequacy of patient stabilization. Data from the authors' group demonstrate that in patients admitted to the ED for acute dyspnea, serial NTproBNP measurement at admission and 4, 12, and 24 hours later was useful in confirming the diagnosis of ADHF compared with patients with chronic obstructive pulmonary disease. Moreover, in the same patients receiving intensive intravenous diuretic therapy, there was a progressive reduction of NTproBNP blood levels from hospitalization to discharge (P<.001), accompanied by clinical improvement and stabilization of heart failure. More recently, the authors also demonstrated that in ADHF patients improving with diuretics, a progressive reduction in BNP levels was observed, starting 24 hours after ED admission and continuing until discharge. Comparing BNP and NTproBNP, there was a significant correlation between NTproBNP and BNP levels but not between NTproBNP's and BNP's percent variation compared with baseline. In ADHF, serial ED measurements of BNP are useful for monitoring the effects of treatment. A reduction in BNP from admission to discharge is indicative of clinical improvement. [source] Usefulness of B-Type Natriuretic Peptide as a Predictor of Treatment Outcome in Pulmonary Arterial HypertensionCONGESTIVE HEART FAILURE, Issue 5 2004Myung H. Park MD We examined the utility of early modulation B-type natriuretic peptide (BNP) levels in 20 pulmonary arterial hypertension patients as a marker of response to epoprostenol therapy. The baseline BNP level was 828±217 pg/mL. A total of 19 hospitalizations and one death occurred in nine patients during 11.0±1.8 months. At baseline, a trend toward higher BNP level was observed among the event-free (Group A) as compared with clinical event patients (Group B) (1090±372 vs. 510±235 pg/mL, respectively; p=0.08). After 3 months on epoprostenol, a significant reduction among Group A occurred while Group B demonstrated an increase (288±92 vs. 610±121 pg/mL, p=0.04). A comparison of percent reduction in BNP level demonstrated a ,70±7% change among Group A and an 11±19% increase in Group B (p=0.005). A decrease in BNP level of ,50% during the first 3 months on epoprostenol was strongly predictive of event-free survival (p=0.003). This investigation establishes the utility of BNP for predicting response to epoprostenol therapy in pulmonary arterial hypertension. [source] Usefulness of skin testing in cutaneous drug eruptions in routine practiceCONTACT DERMATITIS, Issue 3 2009Tatiana Tchen Background: Cutaneous drug eruptions are common side-effects. The imputation score combining intrinsic (chronology, clinical and paraclinical signs) and extrinsic criteria used in Pharmacovigilance Centres is insufficient alone to identify with certainty a responsible drug. Objective: To evaluate the imputation score before and after performing skin testing in patients with cutaneous drug eruptions. Patients/Methods: A single-centre retrospective study was performed on 339 patients tested between 2001,2006. Imputation scores were calculated before and after skin tests for each cutaneous drug eruption according to the clinical type of skin eruption and the type of drug. Results: Among 121 patients meeting inclusion criteria, 46% showed an increase of the imputation score as shown by 25/41 cases of maculo-papular exanthema, 4/11 cases of acute generalized exanthematous pustulosis and 17/41 cases of urticaria/anaphylaxis. The imputation score increased in 25/70 cases of the tested antibiotic drugs, in 14/56 cases of cardiovascular drugs, and it increased in 19 patients (34%) with I1 or I2 imputation scores before skin testing and in 29 (52%) with an I3 imputation score before skin testing. Conclusions: Drug skin testing appeared useful in investigating cutaneous drug eruptions in routine practice, including not only drugs with a high imputation score (I3) but also those with a lower score (I1, I2). Drug skin testing should lead to oral rechallenge of drugs with negative tests in order to determine which drugs may be used safely. [source] Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder diseaseDIAGNOSTIC CYTOPATHOLOGY, Issue 6 2009Ph.D., Yoshiki Naito M.D. Abstract Many studies have reported methods of cell collection involving percutaneous transhepatic cholangiodrainage (PTCD) and fine-needle aspiration cytology for the diagnosis of gallbladder disease. However, few studies have described the use of a transpapillary approach, i.e., endoscopic transpapillary catheterization into the gallbladder (ETCG). In this study, we analyzed cells collected by ETCG to evaluate its usefulness in the cytological diagnosis of gallbladder disease. The subjects were 19 patients who had undergone ETCG for the diagnosis of gallbladder disease. Of these patients, 11 and 8 had gallbladder cancer and benign gallbladder disease, respectively. We also evaluated the diagnostic accuracy of PTCD cytology performed in 15 patients with gallbladder cancer. Specimens were cytologically diagnosed as normal or benign, indeterminate, suspected malignancy, malignant, and inadequate in 47% (9/19), 11% (2/19), 0% (0/19), 37% (7/19), and 5% (1/19) of patients, respectively. Specimens were diagnosed as malignant, indeterminate, normal or benign, and inadequate in 7, 2, 1, and 1, respectively, of the 11 patients diagnosed with gallbladder cancer. The sensitivity and specificity of ETCG cytology were 78 and 100%, respectively, whereas the diagnostic accuracy of PTCD cytology was 20% (3/15). None of the patients developed complications of ETCG. Despite its technical difficulty, ETCG for bile cytology allows the collection of adequate cell numbers from patients with benign disease or gallbladder cancer and facilitates a cytological diagnosis, making it a useful method for collecting cells. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] ENDOSCOPIC TRANSPAPILLARY CATHETERIZATION INTO THE GALLBLADDER FOR DIAGNOSIS OF GALLBLADDER CARCINOMADIGESTIVE ENDOSCOPY, Issue 2 2006Naohito Uchida It is often difficult to determine the precise nature of lesions in the gallbladder by radiographic, endoscopic and ultrasonographic methods. The approach to the gallbladder by a percutaneous transhepatic route has been reported. However, there is a possibility of seeding tumor cells into the peritoneal cavity and liver in a percutaneous procedure. On the contrary, transpapillary route can be performed without a possibility of seeding. The double-contrast cholecystography, intragallbladder sonography, direct biopsy of gallbladder lesions and cytology using gallbladder bile have been performed by the procedure of the transpapillary catheterization into the gallbladder. Confirming malignancy by histopathological diagnosis is desirous for determining therapeutic strategy in gallbladder carcinoma. Gathering gallbladder bile is comparatively easier than biopsy of the lesion using the transpapillary catheterization into the gallbladder. Examination of telomerase-related molecules is useful for diagnosis of pancreatic carcinoma. Usefulness of combination assay of human telomerase reverse transcriptase mRNA (hTERT mRNA) and cytology using gallbladder bile obtained by transpapillary catheterization is reported here. However, it would appear that hTERT mRNA is less important in the diagnosis of gallbladder carcinoma than in that of pancreatic carcinoma. When the molecular biological substances with higher sensitivity are found, the reliance of the combination assay of the molecular biological substances and cytology will be established. [source] Usefulness and Limitation of Dobutamine Stress Echocardiography to Predict Acute Response to Cardiac Resynchronization TherapyECHOCARDIOGRAPHY, Issue 1 2010F.R.C.P.C., Mario Sénéchal M.D. Background: It has been hypothesized that a long-term response to cardiac resynchronization therapy (CRT) could correlate with myocardial viability in patients with left ventricular (LV) dysfunction. Contractile reserve and viability in the region of the pacing lead have not been investigated in regard to acute response after CRT. Methods: Fifty-one consecutive patients with advanced heart failure, LV ejection fraction , 35%, QRS duration > 120 ms, and intraventricular asynchronism , 50 ms were prospectively included. The week before CRT implantation, the presence of viability was evaluated using dobutamine stress echocardiography. Acute responders were defined as a ,15% increase in LV stroke volume. Results: The average of viable segments was 5.8 ± 1.9 in responders and 3.9 ± 3 in nonresponders (P = 0.03). Viability in the region of the pacing lead had an excellent sensitivity (96%), but a low specificity (56%) to predict acute response to CRT. Mitral regurgitation (MR) was reduced in 21 patients (84%) with acute response. The presence of MR was a poor predictor of response (sensibility 93% and specificity 17%). However, combining the presence of MR and viability in the region of the pacing lead yields a sensibility (89%) and a specificity (70%) to predict acute response to CRT. Conclusion: Myocardial viability is an important factor influencing acute hemodynamic response to CRT. In acute responders, significant MR reduction is frequent. The combined presence of MR and viability in the region of the pacing lead predicts acute response to CRT with the best accuracy. (Echocardiography 2010;27:50-57) [source] Usefulness of Live/Real Time Three-Dimensional Transthoracic Echocardiography in Evaluation of Prosthetic Valve FunctionECHOCARDIOGRAPHY, Issue 10 2009Preeti Singh M.D. We studied 31 patients with prosthetic valves (PVs) using two-dimensional and three-dimensional transthorathic echocardiography (2DTTE and 3DTTE, respectively) in order to determine whether 3DTTE provides an incremental value on top of 2DTTE in the evaluation of these patients. With 3DTTE both leaflets of the St. Jude mechanical PV can be visualized simultaneously, thereby increasing the diagnostic confidence in excluding valvular abnormalities and overcoming the well-known limitations of 2DTTE in the examination of PVs, which heavily relies on Doppler. Three-dimensional transthorathic echocardiography provides a more comprehensive evaluation of PV regurgitation than 2DTTE with its ability to more precisely quantify PV regurgitation, in determining the mechanism causing regurgitation, and in localizing the regurgitant defect. Furthermore, 3DTTE is superior in identifying, quantifying, and localizing PV thrombi and vegetations, in addition to the unique feature of providing a look inside mass lesions by serial sectioning. These preliminary results suggest the superiority of 3DTTE over 2DTTE in the evaluation of PVs and that it provides incremental knowledge to the echocardiographer. [source] Embolization of Atrial Septal Occluder Device into the Pulmonary Artery: A Rare Complication and Usefulness of Live/Real Time Three-Dimensional Transthoracic EchocardiographyECHOCARDIOGRAPHY, Issue 6 2009Harvinder S. Dod M.D. Percutaneous closure of atrial septal defects (ASD) in adults has emerged as an alternative to surgery. We report a rare complication of an atrial septal occluder device embolization into the pulmonary artery which was detected by fluoroscopy and echocardiography. The potential usefulness of live/real time three-dimensional transthoracic echocardiography in the management of patients undergoing percutaneous ASD occlusion is described. (ECHOCARDIOGRAPHY, Volume 26, July 2009) [source] Knowledge Bases, Talents, and Contexts: On the Usefulness of the Creative Class Approach in SwedenECONOMIC GEOGRAPHY, Issue 4 2009Bjørn Asheim abstract The geography of the creative class and its impact on regional development has been debated for some years. While the ideas of Richard Florida have permeated local and regional planning strategies in most parts of the Western world, critiques have been numerous. Florida's 3T's (technology, talent, and tolerance) have been adopted without considering whether the theory fits into the settings of a specific urban and regional context. This article aims to contextualize and unpack the creative class approach by applying the knowledge-base approach and break down the rigid assumption that all people in the creative class share common locational preferences. We argue that the creative class draws on three different knowledge bases: synthetic, analytical, and symbolic, which have different implications for people's residential locational preferences with respect to a people climate and a business climate. Furthermore, the dominating knowledge base in a region has an influence on the importance of a people climate and a business climate for attracting and retaining talent. In this article, we present an empirical analysis in support of these arguments using original Swedish data. [source] Usefulness of the Head-Upright Tilt Test for Distinguishing Syncope and Epilepsy in ChildrenEPILEPSIA, Issue 6 2001J. Eirís-Puñal Summary: ,Purpose: Episodic loss of consciousness in children, whether or not associated with hypertonia or short-duration clonic movements, presents a diagnostic challenge to the pediatrician and child neurologist. We provide some evidence of the usefulness of the head-upright tilt test for investigating the causes of transient loss of consciousness in children, and for distinguishing between syncope, convulsive syncope, and epilepsy. Methods: We studied nine children previously diagnosed as epileptic on the basis of compatible clinical events and epileptiform findings in routine EEGs who were treated over the long term with antiepileptic drugs, but whose clinical records suggested syncope or convulsive syncope rather than epilepsy on reevaluation. All subjects underwent head-upright tilt testing. Results: The tilt-test result was positive in all nine cases, with the patients reporting the same symptoms as in the previously considered epileptic attacks. Conclusions: Inadequate histories and misuse/overinterpretation of EEG results often lead to misdiagnosis of epilepsy in children. The head-upright tilt test is a useful and reliable diagnostic technique, allowing syncopal events to be induced and evaluated under controlled conditions. In a subset of patients, it may help to distinguish epilepsy from simple or convulsive syncope. [source] Usefulness of CD9 detection in the diagnosis of acute megakaryoblastic leukemiaEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2004Yutaka Yatomi No abstract is available for this article. [source] Usefulness of R72H PCR assay for differentiation between Vibrio parahaemolyticus and Vibrio alginolyticus species: validation by DNA,DNA hybridizationFEMS MICROBIOLOGY LETTERS, Issue 1 2002Annick Robert-Pillot Abstract We compared the efficiencies of biochemical methods and polymerase chain reaction (PCR) for the identification of Vibrio parahaemolyticus strains. The 122 isolates studied, identified by biochemical tests as V. parahaemolyticus or Vibrio alginolyticus, were tested by R72H PCR assay. The results obtained with the two methods were consistent for 90% of the strains studied. PCR amplification of the R72H fragment generated two unique amplicons, 387 bp and 320 bp in length. For 11% of the strains from seawater, the results of biochemical identification did not correlate with PCR results. DNA,DNA hybridization experiments provided evidence that some strains identified as V. alginolyticus in biochemical tests should be considered members of the V. parahaemolyticus species. We therefore suggest that biochemical tests are not accurate enough for the identification of V. parahaemolyticus isolates and we demonstrate that amplification of the R72H fragment, whether the amplicon is 320 bp or 387 bp long, is a powerful tool for the reliable identification of V. parahaemolyticus. [source] Exploring the Uses and Usefulness of ACTFL Oral Proficiency Ratings and Standards in College Foreign Language DepartmentsFOREIGN LANGUAGE ANNALS, Issue 4 2003John M. Norris PhD In particular, college foreign language departments have increasingly adopted oral proficiency ratings as a way of establishing standards for language or graduation requirements. In the study reported here, the authors explored the intended uses of proficiency-based standards in foreign language departments and reviewed the research on which specific ACTFL-level standards are based. They then examined the results of more than 100 SOPIs administered across all levels of instruction within one German foreign language department. The findings suggest that recommended proficiency standards may underestimate the potential and actual achievements of German language learners and miss other valued learning outcomes. The implications of these findings for the valid use of oral proficiency ratings in collegiate settings are discussed. [source] Usefulness of measuring serum markers in addition to comprehensive geriatric assessment for cognitive impairment and depressive mood in the elderlyGERIATRICS & GERONTOLOGY INTERNATIONAL, Issue 1 2006Hidenori Arai Background: To determine the utility of various serum markers for assessment of cognitive and mental functions in the elderly, we performed a Comprehensive Geriatric Assessment (CGA) in the out-patient clinic in Kyoto University Hospital. Methods: We measured serum levels of dehydroepiandrosterone (DHEA), DHEA-S, malondialdehyde low-density lipoproteins (MDA-LDL), and high-sensitivity C-reactive protein (hs-CRP) in 145 patients to find the association of these markers with activities of daily living (ADL), cognitive impairment and depressive symptoms. Results: We found that the levels of hs-CRP were significantly higher in patients with lower scores in Mini-Mental State Examination (MMSE) and Kohs block design test, and higher scores in the button test, indicating that hs-CRP may be associated with the cognitive function in elderly patients. We also found that the levels of DHEA-S were lower in patients with higher scores (9 or over) on the Geriatric Depression Scale-15 (GDS), indicating that DHEA-S may be associated with depressive mode in elderly patients. Total cholesterol, high-density cholesterol (HDL-C), or albumin were not statistically different in each group studied. Conclusions: Thus, our data indicate that measuring hs-CRP and DHEA-S would be helpful to assess the cognitive function and depressive symptoms in elderly patients. [source] Modeling the Usefulness of Spatial Correlation Analysis on Karst SystemsGROUND WATER, Issue 3 2009Trevor J. Budge Cross-correlation analyses on field data collected in karst aquifer systems can be used to develop a conceptual understanding of the aquifer. This includes the use of many data sets from the same aquifer to develop an understanding of how properties vary spatially. We focus on a method for characterizing the distribution of recharge, which is becoming increasingly important in regions where urban development encroaches on these important sources of water. Spatially varying precipitation data and cross-correlation analysis provide a means of spatially characterizing recharge locations on a karst aquifer. Our work expands on the numerical experiments conducted by Padilla and Pulido-Bosch (1995) using the numerical ground water model MODFLOW to introduce spatially varying parameters. The numerical experiments include conduit-controlled, matrix-controlled, and mixed karst systems with more than one precipitation time series input. The results show that spatially varying parameters can be inferred based on the cross-correlation of precipitation data and spring discharge. Simulations were completed using aquifer parameters derived from studies of the Barton Springs segment of the Edwards Aquifer. The simulations indicate that spatial variability within an aquifer can be inferred using cross-correlation analysis. A field study using these methods is summarized for Barton Springs near Austin, Texas. [source] Usefulness of the combination of ultrasonography and 99mTc-sestamibi scintigraphy in the preoperative evaluation of uremic secondary hyperparathyroidismHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2010Carlo Vulpio MD Abstract Background. The usefulness of the combination of technetium-99m-methoxyisobutylisonitrile (99mTc-MIBI) parathyroid scintigraphy and ultrasonography to detect parathyroid glands (PTGs) in secondary hyperparathyroidism (SHPT) is still controversial. Methods. In all, 21 patients with SHPT underwent parathyroidectomy. The sensitivity and specificity of ultrasonography and scintigraphy related to site, size, hyperplasia type of PTG, concomitant thyroid disease, and the frequency of intraoperative frozen sections were determined. Results. The sensitivities of scintigraphy and ultrasonography were 62% and 55%, and the specificity was 95% for both procedures. The sensitivity of combined techniques was 73%. The scintigraphy detected 7/9 (78%) ectopic PTGs, whereas ultrasonography was always negative. A PTG maximum longitudinal diameter <8 mm, the presence of diffuse hyperplasia, the upper localization of glands, and the presence of concomitant thyroid disease reduced the sensitivity and specificity of imaging techniques. In cases of positive imaging, the rate of intraoperative frozen sections was significantly lower. Conclusions. The ultrasonography and sestamibi scintigraphy, which showed a higher sensitivity than that of either ultrasonography or scintigraphy alone, led to a reduction of intraoperative frozen sections and to preoperative diagnosis of ectopic (29%) or supernumerary PTGs (10%) and concomitant nodular thyroid disease (24%). © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source] Usefulness of 201TL SPECT/CT relative to 18F-FDG PET/CT in detecting recurrent skull base nasopharyngeal carcinomaHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2009Ruoh-Fang Yen MD Abstract Background This study was designed to compare 201Tl single photon emission computed tomography (SPECT)/CT with 18-fluoro-2-deoxyglucose (18F-FDG) PET/CT in diagnosing recurrent skull base nasopharyngeal carcinoma (NPC). Methods Twenty-seven patients were recruited. Both 201Tl SPECT/CT and 18F-FDG PET/CT for each patient were performed at least 4 months later after initial therapy. Results The sensitivity and specificity for 201Tl SPECT/CT were 66.7% and 100%, and those for 18F-FDG PET/CT were 86.7% and 75.0%. Lesion/background ratios were obtained for the 10 lesions that were both SPECT and PET true positive. For the 8 patients with recurrences in nasopharyngeal regions, PET lesion/background ratios were all higher than SPECT lesion/background ratios. For the 2 patients with intracranial metastases, SPECT lesion/background ratios were higher than PET lesion/background ratios. Conclusion 201Tl SPECT/CT is as effective as 18F-FDG PET/CT in detecting recurrent NPC. For intracranial recurrence, 201Tl SPECT, because of its high intracranial lesion/background ratio, is probably better than 18F-FDG PET. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Usefulness of MRI volumetric evaluation in patients with squamous cell cancer of the head and neck treated with neoadjuvant chemotherapyHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2007Mehran Baghi MD Abstract Background. The purpose was to evaluate the efficacy of tumor volumetry on MRI as predictive of response to treatment with induction chemotherapy, comparing the results with endoscopy. Methods: Fifty patients with advanced squamous cell carcinoma of the head and neck (SSCHN) who underwent MRI volumetry before and after neoadjuvant chemotherapy consisting of docetaxel, cisplatin, and 5-fluorouracil (TPF) were included in this study. The tumor volume was calculated by a slice-by-slice evaluation. With the standard software of a workstation, the area of the tumor was measured slice by slice using manual segmentation. To evaluate the efficacy of MRI volumetry, pretreatment volume was compared with pretreatment remission status as evaluated with endoscopy. Results. Forty-five (90%) patients demonstrated a tumor downstaging after chemotherapy. Fourteen (28%) patients showed a complete histologic remission (CR), 31 (62%) patients showed a partial remission (PR). Pretreatment tumor volume was significantly different between patients whose tumor completely responded (CR) and those whose tumor did not completely respond or whose disease was stable or was progressive (p = .00023). We defined a threshold for the pretreatment tumor volume in patients with CR, which was equal to 29.71 cc. Conclusion. We propose that MRI tumor volume analyses can be a useful parameter to predict the response to neoadjuvant chemotherapy in SCCHN. © 2006 Wiley Periodicals, Inc. Head Neck, 2007 [source] Usefulness of fluorine-18 fluorodeoxyglucose positron emission tomography in patients with a residual structural abnormality after definitive treatment for squamous cell carcinoma of the head and neckHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 12 2004Robert E. Ware MB Abstract Background. Residual structural abnormalities after definitive treatment of head and neck squamous cell carcinoma (HNSCC) are common and pose difficult management problems. The usefulness of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG PET) to supplement conventional evaluation with clinical and standard radiologic examination (CE) in such patients was assessed. Methods. Fifty-three eligible patients were identified with residual structural abnormalities on CE. True disease extent could be validated in 46 patients. Patients had a median potential follow-up of 55 months (range, 41,75 months) from the date of PET scan to the analysis closeout date. Results. PET had better diagnostic accuracy than CE (p = .0002) and induced management change in 21 patients (40%; 95% confidence interval [CI], 26%,54%), including avoidance of unnecessary planned surgery in 14 patients with negative PET. Appropriate management change was confirmed in 19 (95%) of 20 evaluable cases. Disease presence and extent assessment by PET were significant predictors of survival (p < .0001), whereas the extent of disease determined by CE was not. Conclusion. PET added significantly to the value of CE in restaging disease in patients with structural abnormalities after definitive treatment of HNSCC. Management decisions based on PET were appropriate in most patients. © 2004 Wiley Periodicals, Inc. Head Neck26: 1008,1017, 2004 [source] Comparison of a Stool Antigen Test and Serology for the Diagnosis of Helicobacter pylori Infection in Mass SurveyHELICOBACTER, Issue 2 2009Tadashi Shimoyama Abstract Background: Serum antibody to Helicobacter pylori is tested in mass screening for gastric cancer along with the level of serum pepsinogens (PG) I and II. Recently, stool antigen tests have been developed as a new non-invasive test. We examined H. pylori infection by both serology and stool antigen test in a mass survey and compared the results to estimate applicability of stool antigen test for mass survey. Methods: A total of 994 healthy adults who received mass survey in April 2005 were tested. There were 379 men and 615 women, and the mean age was 57.7 years old. Stool samples were used to measure a H. pylori- specific antigen by enzyme immunoassay. Serum samples were tested for the prevalence of IgG antibody to H. pylori, and the level of PGs I and II was also measured to determine the presence of atrophic gastritis. Results: Infection of H. pylori was defined as positive 61.4% and 56.4% by serology and stool antigen test, respectively. The concordance of both tests was not affected by gender and age of the subjects but difference was seen in subjects with atrophic gastritis. In particular, positivity of stool antigen test (81.8%) was significantly lower than that of serology (88.7%, p < .05) in 303 subjects with severe atrophic gastritis. Conclusions: Stool antigen test, which detects present but not previous infection of H. pylori, would be applicable to diagnose H. pylori infection in mass survey. Usefulness of stool antigen tests for the screening of gastric cancer should be examined. [source] Usefulness of Non-invasive Tests for Diagnosing Helicobacter pylori Infection in Patients Undergoing Dialysis for Chronic Renal FailureHELICOBACTER, Issue 6 2004Thaïs López ABSTRACT Background.,Helicobacter pylori infection in chronic renal failure patients has been linked to peptic ulcer and gastric neoplasia after kidney transplantation. It may also contribute to the accelerated arteriosclerosis that is usual in this population. Few data are available on the usefulness of noninvasive diagnostic tests for H. pylori infection in dialyzed patients, especially regarding the new fecal antigen detection tests. The objective of this study was to determine the efficacy of a noninvasive test for H. pylori infection in patients with chronic renal failure. Methods., Eighty-six patients were included in a cross-sectional study. Urea breath test, serology and three fecal tests , FemtoLab H. pylori (Connex, Germany), Premier Platinum HpSA (Meridian, USA) and Simple H. pylori (Operon SA, Spain) were performed. Helicobacter pylori status was determined by concordance of the tests. Sensitivity, specificity and positive and negative predictive values were calculated for each test. Results., Sensitivity, specificity, positive and negative predictive values were 94%, 96%, 94% and 96% for the urea breath test; 97%, 64%, 66% and 97% for serology; 86%, 100%, 100% and 91%, for FemtoLab H. pylori; 58%, 96%, 91% and 76% for Premier Platinum HpSA and 61%, 78%, 74% and 67% for Simple H. pylori. Conclusions., The urea breath test seems to be the most reliable diagnostic method for H. pylori infection in patients with chronic renal failure. Serology has a low specificity, and the results of the fecal tests vary widely. [source] Usefulness of transient elastography for assessment of liver fibrosis in chronic hepatitis B: Regression of liver stiffness during entecavir therapyHEPATOLOGY RESEARCH, Issue 9 2010Masaru Enomoto Aim:, The usefulness of transient elastography remains to be validated in chronic hepatitis B, particularly as a tool for monitoring the degree of liver fibrosis during treatment. Methods:, The subjects were 50 patients with chronic hepatitis B virus infection. Liver biopsy was performed in 38 patients, and in 12 patients with platelet counts of 50 × 109/L or less, cirrhosis was clinically diagnosed on the basis of specific signs of portal hypertension. Liver stiffness was measured by transient elastography at baseline and after 12 months of treatment in 20 nucleos(t)ide-naïve patients who started entecavir within 3 months after study entry. Results:, Twenty (40%) patients were classified as F1, 10 (20%) as F2, 5 (10%) as F3, and 15 (30%) as F4 (cirrhosis). Median liver stiffness (interquartile range) was 7.0 kPa (5.6,9.4), 9.8 kPa (5.6,14.7), 9.8 kPa (7.6,12.9), and 17.3 kPa (8.2,27.6) in fibrosis stages F1 to F4, respectively. Liver stiffness significantly correlated with fibrosis stage (r = 0.46; P = 0.0014). Of the patients who started entecavir, median liver stiffness significantly decreased from 11.2 kPa (7.0,15.2) to 7.8 kPa (5.1,11.9; P = 0.0090) during 12 months of treatment. Median levels of amino-terminal peptide of type III procollagen and type IV collagen 7S domain in serum significantly decreased from 0.9 (0.6,1.3) to 0.6 (0.5,0.7) U/mL (P = 0.0010) and from 5.0 (4.4,6.7) to 3.9 (3.2,4.4) ng/mL (P = 0.015), respectively. Conclusion:, Liver stiffness measurement can be useful for monitoring regression of liver fibrosis during entecavir treatment in patients with chronic hepatitis B virus infection. [source] Usefulness of follow-up after pancreatoduodenectomy for carcinoma of the ampulla of VaterHPB, Issue 2 2007LAURENCE CHICHE Abstract Background: The prognosis for carcinoma of the ampulla of Vater (CAV) is better than for pancreatic cancer. The 5-year survival median rate after resection of CAV is 45%, but late recurrences remain possible. Several survival factors have been identified (lymph nodes, perineural invasion), but few data are available on the type of recurrences, their impact and their management. Patients and methods: A total of 41 patients treated by pancreatoduodenectomy (PD) for CAV from 1980 to 2003 were studied retrospectively. Patient selection, long-term survival recurrence rate and recurrence treatment were reviewed. Univariate and multivariate proportional hazards analysis were conducted on this series. Results: The mean follow-up was 48 months. Five-year survival was 62.8%. Eleven patients had recurrences (6,67 months). Recurrence was associated with time to all-causes death (hazard ratio [HR] 4.3, p=0.003). Factors predictive of recurrence were perineural invasion (HR 5.3, p=0.02), lymph node invasion (HR 5.3, p=0.02) and differentiation (HR 0.2, p=0.05). Three patients underwent surgical R0 treatment of their recurrences. Two who presented with solitary liver metastasis are alive and disease-free. Conclusions: Recurrence represents a serious threat in the prognosis of CAV after surgery. Some of these recurrences, in particular liver metastases, are accessible for a curative treatment. This finding supports the usefulness of a close and long-term follow-up after surgery to improve survival of patients with CAV, especially in the group of patients with a good prognosis. [source] Auditor,client Interaction and Client Usefulness , A Swedish Case StudyINTERNATIONAL JOURNAL OF AUDITING, Issue 2 2006Niclas Hellman This paper investigates the usefulness of the external audit to a listed client company. The research questions focus on what the auditors discovered, the subsequent auditor,client interaction, and the ways in which this was useful to the client company. The study proceeds from the management letters produced by the auditors in the period 1999,2001. On the basis of these reports, interviews were conducted with financial managers at different organisational levels. The data collection and analysis of the data follows a grounded theory approach. The results suggest that the usefulness of the audit to the client company was primarily linked to the way the management letters, and the auditor,client interaction related to the management letters, supported the client's management control system. Improved management control was achieved as a result of co-operation between the audit firm and the client company's central accounting and finance department, that put pressure on the subordinate units. The reported benefits for the client company must be weighed against potential threats to auditor independence, and the paper also includes empirical results that indicate risks of auditor dependency on the client's accounting and finance department. [source] Usefulness of EGFR mutation screening in pleural fluid to predict the clinical outcome of gefitinib treated patients with lung cancerINTERNATIONAL JOURNAL OF CANCER, Issue 10 2006Junichi Soh Abstract The importance of epidermal growth factor receptor (EGFR) gene mutation has been recognized in nonsmall cell lung cancer (NSCLC), requiring the standardization of mutation screening system including the kind of samples. Here, we examined the EGFR mutation status in 61 pleural fluid samples from NSCLC cases using direct sequencing, nonenriched PCR, mutant-enriched PCR and peptide nucleic acid-locked nucleic acid (PNA-LNA) PCR clamp assay. The mutant-enriched PCR assay detected 16 mutant cases. Among them, the nonenriched PCR assay failed to detect 3 mutant cases. Regarding the discrepancy between mutant-enriched PCR and PNA-LNA PCR clamp assays, 3 cases of exon19-deletions were detected only by mutant-enriched PCR assay and no difference at the L858R mutation. There was no difference in results between direct sequencing and nonenriched PCR assay. We also correlated the EGFR mutation with clinical outcome of gefitinib-treated 29 cases. EGFR mutations were present in 10 cases, revealing 7 partial response and 3 no change (NC). In EGFR wild-type cases, 10 revealed NC and 9 progressive disease. The responders were significantly more frequent among the EGFR mutant cases than among the wild-type (p < 0.0001). Overall survival (p = 0.0092) and progression-free survival (p = 0.018) were significantly longer among the EGFR mutant cases than among the wild-type. In summary, we evaluated the utility of EGFR mutation screening in pleural fluid using 4 assays that showed some discrepancies arising from the designs of the assays. As clinical importance, the EGFR mutation status in pleural fluid can be a biomarker for the favorable outcome of gefitinib-treated NSCLC cases. © 2006 Wiley-Liss, Inc. [source] Sensitivity, Specificity, and Usefulness of the Dutch Fatigue ScaleINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2001Lucas J. Tiesinga PhD Purpose. To test the sensitivity, specificity, and usefulness of the Dutch Fatigue Scale (DUFS), which is based on NANDAs defining characteristics of fatigue. Methods. A cross-sectional design was used among domiciliary patients (N = 213) with chronic heart failure (n = 138) and with breastfeeding postpartum women (n = 75). Findings. Calculations of the sensitivity and specificity of the DUFS, comparisons of the average DUFS sumscores between both nonfatigued and fatigued subjects, as well as between patients with chronic heart failure and postpartum women, and correlation coefficients performed with sociodemographic factors (age, gender, education) demonstrate acceptable psychometric properties. Conclusions. The DUFS is a reliable and valid measurement tool for the assessment of fatigue. Practice Implications. Accurate recognition of the existence and extent of fatigue must precede interventions. Easy to use, reliable tools for the bedside nurse are invaluable assets to practice. Search Terms: Fatigue, measurement of fatigue, psychometric testing [source] Usefulness of a malleable penile prosthesis in patients with a spinal cord injuryINTERNATIONAL JOURNAL OF UROLOGY, Issue 10 2008Young Dong Kim Objectives: The usefulness of a malleable penile prosthesis was evaluated in patients with spinal cord injury (SCI) by investigating the complications and the patients' satisfaction. Methods: A total of 48 patients with a SCI, who underwent malleable penile prosthesis (AMS 600) insertion from 1990 to 2004 were evaluated by reviewing the patients' medical records and interviewing them via questionnaires. The mean patients age was 58.9 years, and the mean follow-up period was 11.7 years. In 23 patients, penile prosthesis implantation was carried out to improve urinary management and to treat erectile dysfunction (ED). Results: Complications occurred in eight patients (16.7%). Wound infections in four (8.3%). Two patients were treated with conservative management, and two were managed through prostheses removal. Other complications were erosion in two patients (4.2%), uncontrolled penile pain owing to excessive prosthesis length in one patient (2.1%), and supersonic transporter (SST) deformity in one patient (2.1%). The overall patient satisfaction rate was 79.2%. The dissatisfaction was mainly due to the complications that resulted in the removal of the prosthesis, or partner's unnatural sensation. All of the prostheses that were implanted in the patients for the improvement of their urinary management gave them the benefit of convenient urinary management, except for two patients, whose prostheses were removed. Conclusions: The insertion of malleable penile prostheses in patients with SCI is associated with low complication rates and good patient satisfaction. It is therefore still an attractive option. [source] | |||||||||||||||||||||||||||||||||||||