Pilot Programs in Medical Research

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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.

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.

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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SUMMARY: Perfusion imaging of brain tumors has been performed by using various tracer and nontracer modalities and can provide additional physiologic and hemodynamic information, which is not available with routine morphologic imaging. Tumor vascular perfusion parameters obtained by using CT or MR perfusion have been used for tumor grading, prognosis, and treatment response in addition to differentiating treatment/radiation effects and non-neoplastic lesions from neoplasms. This article is an overview of the utility of PCT for assessment of brain tumors and describes the technique, its advantages, and limitations. BBB : blood-brain barrier CBF : cerebral blood flow CBV : cerebral blood volume DSC : dynamic susceptibility contrast FDG-PET : fluorodeoxyglucose–positron-emission tomography K trans : volume transfer coefficient MRI : MR imaging MTT : mean transit time MVCP : microvascular cellular proliferation MVD : microvascular density PCT : perfusion CT PS : permeability surface-area product rCBV : regional cerebral blood flow ROI : region of interest rPSR : relative percentage signal recovery SDF-1 : stromal derived factor-1 TDL : tumefactive demyelinating lesion TVA : total vascular area VEGF : vascular endothelial growth factor WHO : World Health Organization

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The healing of an extraction socket involved a series of events including the formation of a coagulum that was replaced by (i) a provisional connective tissue matrix, (ii) woven bone, and (iii) lamellar bone and BM. During the healing process a hard tissue bridge--cortical bone--formed, which "close …

Sepsis is one of the leading causes of mortality and morbidity, even with the current availability of extended spectrum antibiotics and advanced medical care. Biomarkers offer a tool in facilitating early diagnosis, in identifying patient populations ...

Tumoural angioneogenesis and its quantification are important in predicting the tumour grade and in the management with respect to the treatment available and to assess the response to treatment and the prognosis. It also plays major role in the growth ...

Values of low density lipoprotein (LDL) and procalcitonin (PCT) levels in evaluating the condition and prognosis of patients with acute cerebral infarction (ACI) were investigated. According to the volume of cerebral infarction, 150 patients with ACI (observation group) were divided into the mild infarction group (n=50), moderate infarction group (n=50), and severe infarction group (n=50). Besides, another 50 healthy subjects were enrolled during the same period as the control group. The levels of serum LDL and PCT on admission and at the 1st, 3rd, 7th and 10th day after treatment were detected, which were compared with those in the control group. Ten days after treatment, patients were divided into two groups, the effective group and non-effective group, based on the clinical efficacy. The differences in LDL and PCT levels were compared between the two groups. After 1 month, the clinical efficacy was evaluated again, and the correlations of LDL and PCT levels with prognosis were analyzed. The levels of serum LDL and PCT in the observation group 1 day after admission were higher than those in the control group (P

The identification significance of C-reactive protein (CRP) and procalcitonin (PCT) levels in the intensive care unit patients with combined infection and their prognostic effects of patients with sepsis was investigated. A total of 203 patients were divided into the sepsis (n=60) and the non-sepsis group (n=143). The predictive effects of CRP and PCT levels in patients in the intensive care unit on sepsis and their effects on the prognosis of patients with sepsis were analyzed. The results showed that CRP and PCT levels in patients in the sepsis were higher than those in the non-sepsis group (p0.05); CRP and PCT levels in patients surviving sepsis at 1 week after admission were significantly decreased compared with those at admission (p

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BACKGROUND AND PURPOSE: A previous study demonstrated the need to use delayed acquisition rather than first-pass data for accurate blood-brain barrier permeability surface product (BBBP) calculation from perfusion CT (PCT) according to the Patlak model, but the optimal duration of the delayed acquisition has not been established. Our goal was to determine the optimal duration of the delayed PCT acquisition to obtain accurate BBBP measurements while minimizing potential motion artifacts and radiation dose. MATERIALS AND METHODS: We retrospectively identified 23 consecutive patients with acute ischemic anterior circulation stroke who underwent a PCT study with delayed acquisition. The Patlak model was applied for the full delayed acquisition (90–240 seconds) and also for truncated analysis windows (90–210, 90–180, 90–150, 90–120 seconds). Linear regression of Patlak plots was performed separately for the full and truncated analysis windows, and the slope of these regression lines was used to indicate BBBP. The full and truncated analysis windows were compared in terms of the resulting BBBP values and the quality of the Patlak fitting. RESULTS: BBBP values in the infarct and penumbra were similar for the full 90- to 240-second acquisition (95% confidence intervals for the infarct and penumbra: 1.62–2.47 and 1.75–2.41 mL ×100 g−1 × min−1, respectively) and the 90- to 210-second analysis window (1.82–2.76 and 2.01–2.74 mL × 100 g−1 × min−1, respectively). BBBP values increased significantly with shorter acquisitions. The quality of the Patlak fit was excellent for the full 90- to 240-second and 90- to 210-second acquisitions, but it degraded with shorter acquisitions. CONCLUSIONS: The duration for the delayed PCT acquisition should be at least 210 seconds, because acquisitions shorter than 210 seconds lead to significantly overestimated BBBP values.

Only by tuning the steric configuration of CHDM, other than the introduction of third co-monomers, the modified PCT demonstrating satisfied T g, T m, crystallizability, and thermal stability was obta...

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Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Imaging is important for establishing a diagnosis of HCC. Several imaging modalities including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron ...

Sepsis-associated severe interleukin-6 storm in critical coronavirus disease...

The aim of the study was to analyze the dynamic changes and diagnostic and prognostic significance of serum procalcitonin (PCT), high-sensitivity C-reactive protein (hs-CRP) and s-100 protein in central nervous system infection. A total of 110 patients diagnosed with central nervous system infection in Department of Neurology in the People's Hospital of Rizhao from January 2014 to January 2016 were selected and retrospectively analyzed; they were divided into the bacterium (n=70) and virus (n=40

Acute-phase reactants such as erythrocyte sedimentation rate and C-reactive protein have traditionally been used as markers for inflammation and as a measure of “sickness index” in infectious and noninfectious conditions. In the last decade, ...

Traditional biomarkers, including C-reactive protein, leukocytes, erythrocyte sedimentation rate, and clinical signs and symptoms, are not sufficiently sensitive or specific enough to guide treatment decisions in infectious febrile diseases. Procalcitonin ...

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