Aims: To study the clinical significance and prognostic value of monitoring procalcitonin (PCT) and interleukin 6 (IL-6) levels in acute respiratory distress syndrome (ARDS) patients with multiple organ dysfunction (MODS). Methods: We enrolled 24 ARDS ...

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Objective: To determine diagnostic performance of serum PCT-Q (BRAHMS procalcitonin commercial kit) for bacterial lower respiratory tract infection among COPD patient with exacerbation. Material and methods: Prospective study was conducted in 40 hospitalized COPD patients with exacerbation between June 2008 and January 2009. Patient clinical profiles including the presence of infiltrate on chest roentgenogram, leukocytosis, positive sputum culture for bacteria and clinical outcome (mortality, length of stay and mechanical ventilation requirement) were determined. Serum procalcitonin concentration was measured by both PCT-Q commercial kits and standard quantitative assay on the first day of admission. Result: The diagnostic yield of PCT-Q for pneumonic exacerbation (the presence of pulmonary infiltrate) exhibits sensitivity and specificity of 100% and 71.9% whereas the test exhibits 50.0% sensitivity and 73.3% specificity for the presence of leukocytosis. However, positive PCT-Q provides 40.9 % sensitivity and 50.0%specificity for determining bacterial causes of exacerbation (defined by bacterial culture positivity in sputum). There is no significant correlation between positive PCT-Q and the mechanical ventilator requirement (p=0.864) as well as an average length of stay (p=0.139). The correlation between the positive PCT-Q and positive standard serum assay is noted. Conclusion: PCT-Q can be used as biomarker for pneumonic exacerbation in COPD patients whereas the PCT-Q level is poorly correlated with the clinical outcome. In addition, correlation of kits and standard assay is noted. However, the benefit of PCT-Q is shorter turnaround time.

This book brings together scholars from around the world to address the question of how culture and mind are related through symbols: it is through the mediation of symbols that we think, act, imagine, feel, dream and remember. Thus, to understand the structure, function and development of symbols is to understand what it means to be human. Part I of the book constructs a theoretical foundation in semiotics for thinking about symbols, and analyzes their place in speech, images, affect and evolution. Part II explores how our experience is transformed through symbols: why we are moved by a movie or political speech, how bread and wine can taste like Christ’s body and blood, and why our memories are forever changing. Part III focuses on symbols in the human life-course, particularly in connection with play, language and art. And lastly, Part IV explores how identities, such as being a sex-worker or HIV-positive, are constituted in social relationships through society’s symbols. This

BACKGROUND AND PURPOSE: The Patlak model has been applied to first-pass perfusion CT (PCT) data to extract information on blood-brain barrier permeability (BBBP) to predict hemorrhagic transformation in patients with acute stroke. However, the Patlak model was originally described for the delayed steady-state phase of contrast circulation. The goal of this study was to assess whether the first pass or the delayed phase of a contrast bolus injection better respects the assumptions of the Patlak model for the assessment of BBBP in patients with acute stroke by using PCT. MATERIALS AND METHODS: We retrospectively identified 125 consecutive patients (29 with acute hemispheric stroke and 96 without) who underwent a PCT study by using a prolonged acquisition time up to 3 minutes. The Patlak model was applied to calculate BBBP in ischemic and nonischemic brain tissue. Linear regression of the Patlak plot was performed separately for the first pass and for the delayed phase of the contrast bolus injection. Patlak linear regression models for the first pass and the delayed phase were compared in terms of their respective square root mean squared errors (√MSE) and correlation coefficients ( R ) by using generalized estimating equations with robust variance estimation. RESULTS: BBBP values calculated from the first pass were significantly higher than those from the delayed phase, both in nonischemic brain tissue (2.81 mL × 100 g−1 × min−1 for the first pass versus 1.05 mL × 100 g−1 × min−1 for the delayed phase, P < .001) and in ischemic tissue (7.63 mL × 100 g−1 × min−1 for the first pass versus 1.31 mL × 100 g−1 × min−1 for the delayed phase, P < .001). Compared with regression models from the first pass, Patlak regression models obtained from the delayed data were of better quality, showing significantly lower √MSE and higher R . CONCLUSION: Only the delayed phase of PCT acquisition respects the assumptions of linearity of the Patlak model in patients with and without stroke.

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BACKGROUND AND PURPOSE: The Patlak model has been applied to first-pass perfusion CT (PCT) data to extract information on blood-brain barrier permeability (BBBP) to predict hemorrhagic transformation in patients with acute stroke. However, the Patlak model was originally described for the delayed steady-state phase of contrast circulation. The goal of this study was to assess whether the first pass or the delayed phase of a contrast bolus injection better respects the assumptions of the Patlak model for the assessment of BBBP in patients with acute stroke by using PCT. MATERIALS AND METHODS: We retrospectively identified 125 consecutive patients (29 with acute hemispheric stroke and 96 without) who underwent a PCT study by using a prolonged acquisition time up to 3 minutes. The Patlak model was applied to calculate BBBP in ischemic and nonischemic brain tissue. Linear regression of the Patlak plot was performed separately for the first pass and for the delayed phase of the contrast bolus injection. Patlak linear regression models for the first pass and the delayed phase were compared in terms of their respective square root mean squared errors (√MSE) and correlation coefficients ( R ) by using generalized estimating equations with robust variance estimation. RESULTS: BBBP values calculated from the first pass were significantly higher than those from the delayed phase, both in nonischemic brain tissue (2.81 mL × 100 g−1 × min−1 for the first pass versus 1.05 mL × 100 g−1 × min−1 for the delayed phase, P < .001) and in ischemic tissue (7.63 mL × 100 g−1 × min−1 for the first pass versus 1.31 mL × 100 g−1 × min−1 for the delayed phase, P < .001). Compared with regression models from the first pass, Patlak regression models obtained from the delayed data were of better quality, showing significantly lower √MSE and higher R . CONCLUSION: Only the delayed phase of PCT acquisition respects the assumptions of linearity of the Patlak model in patients with and without stroke.

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The Gallery at Penn College is dedicated to promoting art appreciation through exhibitions of contemporary art and accompanying programs.

Where we go one, we go all.

The aging population is a global phenomenon. The skyrocketing costs of healthcare and the shortage of healthcare providers will soon become a crucial issue all over the world. Taiwan's government executed the Taiwan's Telehealth Pilot Project (TTPP) from July 1, 2008 to December 31, 2008, using heal …

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Objectives This study aimed to investigate the performance of computed tomography derived fractional flow reserve based interactive planner (FFRCT planner) to predict the physiological benefits of p...