Quantitative three-dimensional power Doppler angiography: a flow-free phantom experiment to evaluate the relationship between color gain, depth and signal artifact

Objectives To evaluate the presence of false flow three-dimensional (3D) power Doppler signals in `flow-free` models. Methods 3D power Doppler datasets were acquired from three different flow-free phantoms (muscle, air and water) with two different transducers and Virtual Organ Computer-aided AnaLysis was used to generate a sphere that was serially applied through the 3D dataset. The vascularization flow index was used to compare artifactual signals at different depths (from 0 to 6 cm) within the different phantoms and at different gain and pulse repetition frequency (PR F) settings. Results Artifactual Doppler signals were seen in all phantoms despite these being flow-free. The pattern was very similar and the degree of artifact appeared to be dependent on the gain and distance from the transducer. False signals were more evident in the far field and increased as the gain was increased, with false signals first appearing with a gain of 1 dB in the air and muscle phantoms. False signals were seen at a lower gain with the water phantom (-15 dB) and these were associated with vertical lines of Doppler artifact that were related to PRF, and disappeared when reflections were attenuated. Conclusions Artifactual Doppler signals are seen in flow-free phantoms and are related to the gain settings and the distance from the transducer. In the in-vivo situation, the lowest gain settings that allow the detection of blood flow and adequate definition of vessel architecture should be used, which invariably means using a setting near or below the middle of the range available. Additionally, observers should be aware of vertical lines when evaluating cystic or liquid-containing structures. Copyright (C) 2010 ISUOC. Published by John Wiley & Sons, Ltd.

Evaluation of IFA, MAT, ELISAs and immunoblotting for the detection of anti-Toxoplasma gondii antibodies in paired serum and aqueous humour samples from experimentally infected pigs

The study evaluated the efficiency of diagnostic laboratory methods to detect anti-Toxoplasma gondii antibodies in paired serum and aqueous humour samples from experimentally infected pigs. 18-mixed breed pigs were used during the experiment; these were divided into two groups, G I (infected group, n = 10) and G2 (uninfected group, n = 8). Infection was performed with 4 x 10(4) VEG strain oocysts at day 0 by the oral route in G1 animals. All pigs were euthanized at day 60, when retina, aqueous humour, and blood samples were collected. Anti-T gondii antibody levels were assessed in serum (s) and aqueous humour (ah) by indirect immunofluorescence assay (IFA), modified agglutination test (MAT), m-ELISA (using crude membranes from T gondii tachyzoites as antigen) and r-ELISA (using rhoptries from T gondii tachyzoites as antigen). Polymerase chain reactions (PCR) of samples from the retina were performed by using Tox4 and Tox5 primers. Antibody titers of G1 animals ranged from 128 to 1024 and from 16 to 256 in serum and aqueous humour, respectively. There were differences in the correlation coefficients between IFA(s) x IFA (ah) (r = 0.62, P = 0.05), MAT(s) x MAT (ah) (r = 0.97, P < 0.0001); however, there was no significant difference between r-ELISA(s) x r-ELISA (ah) (r = 0. 14, P = 0.7). Antibodies present in serum and aqueous humour recognized similar antigens. Samples of retina were positive by PCR in 30% (3/10) of infected pigs. G2 animals remained without antibody levels and were PCR negative throughout the experiment. These results suggest that the use of a combination of tests and immunoblotting for paired aqueous humour and serum samples could improve the sensitivity and specificity for the diagnosis of ocular toxoplasmosis. (c) 2007 Elsevier Ltd. All rights reserved.

Accumulative copper poisoning in buffaloes

The main objective of this study was to evaluate the clinical and hematological alterations, and the hepatic concentration of Cu in buffaloes with chronic copper poisoning (CCP). Ten buffalo yearling steers were randomly distributed into two groups: one copper supplemented (BUFCu; n = 6) and another control group (BUF; n = 4). The group BUFCu received, by ruminal fistula, 2 mg Cu/kgBW (as CuSO4.5H2O) daily during one week; after which 2 mg Cu/kgBW was added during each additional week, until the end or the experiment (105(th) day). Three liver biopsies were realized during the experiment (day zero, 45(th), and 105(th) day) to determine the degree of copper accumulation. Alterations in body weight, clinical examination, and hematological values were monitored every 15 days. Two buffaloes supplemented with copper demonstrated clinical manifestations consistent with CCP, and died. Two distinct clinical manifestations were observed, one classical (n = 1) and another atypical (n = 1), characterized by remarkable high levels of liver copper, progressive hyporexia followed by anorexia, dehydration, severe apathy, decreased rumen movements, oliguria, and death. Some animals were resistant to CCP although high copper intake. In buffalos with clinical picture similar to the one described as atypical, CCP should be considered as a possible diagnostic even without presence of macroscopic hemoglobinuria.

Canine visceral leishmaniasis: Performance of a rapid diagnostic test (Kalazar Detect (TM)) in dogs with and without signs of the disease

Current visceral leishmaniasis (VL) control programs in Brazil include the infected dog elimination but, despite this strategy, the incidence of human VL is still increasing. One of the reasons is the long delay between sample collection, analysis, control implementation and the low sensitivity of diagnostic tests. Due to the high prevalence of asymptomatic dogs, the diagnosis of these animals is important considering their vector infection capacity. Hence, a rapid and accurate diagnosis of canine visceral leishmaniasis is essential for an efficient surveillance program. In this study we evaluated the performance of rK39 antigen in an immunochromatographic format to detect symptomatic and asymptomatic Leishmania chagasi infection in dogs and compared the results with those using a crude antigen ELISA. The sensitivity of rK39 dipstick and ELISA were 83% vs. 95%, respectively, while the specificity was both 100%. Our results also demonstrated that the dipstick test was able to detect infected dogs presenting different clinical forms. (C) 2008 Elsevier B.V. All rights reserved.

Diagnostic implications of oral intravascular papillary endothelial hyperplasia

This study examined the clinical, histological, and immunohistochemical features as well as the differential diagnoses of oral intravascular papillary endothelial hyperplasia (IPEH) to aid clinicians and pathologists in its diagnosis. Clinical features of five oral IPEH cases were obtained from medical records, and all histopathological diagnoses were reviewed. Immunohistochemical reactions, including anti-CD-34, laminin, vimentin, estrogen receptor alpha, and Ki-67, were assessed. Microscopically, a reactive proliferation of vascular cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus was seen. CD-34, vimentin, and laminin staining were strongly positive, while estrogen receptor alpha was negative in all cases. A low percentage of cells were positive for Ki-67 in four of five lesions, but one case was strongly positive. A diagnosis of angiosarcoma was investigated and rejected. IPEH presents specific microscopic characteristics that along with clinical data lead to an accurate diagnosis. The general dentist, the first to participate in the diagnostic process, must share the responsibility for diagnosis with the pathologist, and they must work together to determine the correct diagnosis and management. Oral lesions of IPEH are uncommon. Their main significance is that they show a microscopic resemblance to angiosarcoma. Thus, clinicians should have more information regarding this benign entity. Finally, we suggest that in recurrent cases exhibiting strong immunolabeling of proliferative markers the possibility of angiosarcoma should be investigated.

Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups

The research diagnostic criteria for temporomandibular disorders (RDC/TMD) are used for the classification of patients with temporomandibular disorders (TMD). Surface electromyography of the right and left masseter and temporalis muscles was performed during Maximum teeth clenching in 103 TMD patients subdivided according to the RDC/TMD into 3 non-overlapping groups: (a) 25 myogenous; (b) 61 arthrogenous; and (c) 17 psycogenous patients. Thirty-two control subjects matched for sex and age were also measured. During clenching, standardized total muscle activities (electromyographic potentials over time) significantly differed: 131.7 mu V/mu V s % in the normal subjects, 117.6 mu V/mu V s % in the myogenous patients, 105.3 mu V/mu V s % in the arthrogenous patients, 88.7 mu V/mu V s % in the psycogenous patients (p < 0.001, analysis of covariance). Symmetry in the temporalis muscles was larger in normal subjects (86.3%) and in myogenous patients (84.9%) than in arthrogenous (82.7%), and psycogenous patients (80.5%) (p=0.041). No differences were found for masseter muscle symmetry and torque coefficient (p>0.05). Surface electromyography of the masticatory muscles allowed an objective discrimination among different RDC/TMD subgroups. This evaluation could assist conventional clinical assessments. (C) 2007 Elsevier Ltd. All rights reserved.

Diagnostic tool to analyse colour-magnitude diagrams of poorly populated stellar concentrations

The dynamical processes that lead to open cluster disruption cause its mass to decrease. To investigate such processes from the observational point of view, it is important to identify open cluster remnants (OCRs), which are intrinsically poorly populated. Due to their nature, distinguishing them from field star fluctuations is still an unresolved issue. In this work, we developed a statistical diagnostic tool to distinguish poorly populated star concentrations from background field fluctuations. We use 2MASS photometry to explore one of the conditions required for a stellar group to be a physical group: to produce distinct sequences in a colour-magnitude diagram (CMD). We use automated tools to (i) derive the limiting radius; (ii) decontaminate the field and assign membership probabilities; (iii) fit isochrones; and (iv) compare object and field CMDs, considering the isochrone solution, in order to verify the similarity. If the object cannot be statistically considered as a field fluctuation, we derive its probable age, distance modulus, reddening and uncertainties in a self-consistent way. As a test, we apply the tool to open clusters and comparison fields. Finally, we study the OCR candidates DoDz 6, NGC 272, ESO 435 SC48 and ESO 325 SC15. The tool is optimized to treat these low-statistic objects and to separate the best OCR candidates for studies on kinematics and chemical composition. The study of the possible OCRs will certainly provide a deep understanding of OCR properties and constraints for theoretical models, including insights into the evolution of open clusters and dissolution rates.

Alternative diagnostic diagrams and the `forgotten` population of weak line galaxies in the SDSS

A numerous population of weak line galaxies (WLGs) is often left out of statistical studies on emission-line galaxies (ELGs) due to the absence of an adequate classification scheme, since classical diagnostic diagrams, such as [O iii]/H beta versus [N ii]/H alpha (the BPT diagram), require the measurement of at least four emission lines. This paper aims to remedy this situation by transposing the usual divisory lines between star-forming (SF) galaxies and active galactic nuclei (AGN) hosts and between Seyferts and LINERs to diagrams that are more economical in terms of line quality requirements. By doing this, we rescue from the classification limbo a substantial number of sources and modify the global census of ELGs. More specifically, (1) we use the Sloan Digital Sky Survey Data Release 7 to constitute a suitable sample of 280 000 ELGs, one-third of which are WLGs. (2) Galaxies with strong emission lines are classified using the widely applied criteria of Kewley et al., Kauffmann et al. and Stasinska et al. to distinguish SF galaxies and AGN hosts and Kewley et al. to distinguish Seyferts from LINERs. (3) We transpose these classification schemes to alternative diagrams keeping [N ii]/H alpha as a horizontal axis, but replacing H beta by a stronger line (H alpha or [O ii]), or substituting the ionization-level sensitive [O iii]/H beta ratio with the equivalent width of H alpha (W(H alpha)). Optimized equations for the transposed divisory lines are provided. (4) We show that nothing significant is lost in the translation, but that the new diagrams allow one to classify up to 50 per cent more ELGs. (5) Introducing WLGs in the census of galaxies in the local Universe increases the proportion of metal-rich SF galaxies and especially LINERs. In the course of this analysis, we were led to make the following points. (i) The Kewley et al. BPT line for galaxy classification is generally ill-used. (ii) Replacing [O iii]/H beta by W(H alpha) in the classification introduces a change in the philosophy of the distinction between LINERs and Seyferts, but not in its results. Because the W(H alpha) versus [N ii]/H alpha diagram can be applied to the largest sample of ELGs without loss of discriminating power between Seyferts and LINERs, we recommend its use in further studies. (iii) The dichotomy between Seyferts and LINERs is washed out by WLGs in the BPT plane, but it subsists in other diagnostic diagrams. This suggests that the right wing in the BPT diagram is indeed populated by at least two classes, tentatively identified with bona fide AGN and `retired` galaxies that have stopped forming stars and are ionized by their old stellar populations.

Consensus Statement: Chromosomal Microarray Is a First-Tier Clinical Diagnostic Test for Individuals with Developmental Disabilities or Congenital Anomalies

Chromosomal microarray (CMA) is increasingly utilized for genetic testing of individuals with unexplained developmental delay/intellectual disability (DD/ID), autism spectrum disorders (ASD), or multiple congenital anomalies (MCA). Performing CMA and G-banded karyotyping on every patient substantially increases the total cost of genetic testing. The International Standard Cytogenomic Array (ISCA) Consortium held two international workshops and conducted a literature review of 33 studies, including 21,698 patients tested by CMA. We provide an evidence-based summary of clinical cytogenetic testing comparing CMA to G-banded karyotyping with respect to technical advantages and limitations, diagnostic yield for various types of chromosomal aberrations, and issues that affect test interpretation. CMA offers a much higher diagnostic yield (15%-20%) for genetic testing of individuals with unexplained DD/ID, ASD, or MCA than a G-banded karyotype (similar to 3%, excluding Down syndrome and other recognizable chromosomal syndromes), primarily because of its higher sensitivity for submicroscopic deletions and duplications. Truly balanced rearrangements and low-level mosaicism are generally not detectable by arrays, but these are relatively infrequent causes of abnormal phenotypes in this population (<1%). Available evidence strongly supports the use of CMA in place of G-banded karyotyping as the first-tier cytogenetic diagnostic test for patients with DD/ID, ASD, or MCA. G-banded karyotype analysis should be reserved for patients with obvious chromosomal syndromes (e.g., Down syndrome), a family history of chromosomal rearrangement, or a history of multiple miscarriages.

Evaluation of Quantitative RT-PCR Using Nonamplified and Amplified RNA

Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) is a standard assay in molecular medicine for gene expression analysis. Samples from incisional/needle biopsies, laser-microdissected tumor cells and other biologic sources, normally available in clinical cancer studies, generate very small amounts of RNA that are restrictive for expression analysis. As a consequence, an RNA amplification procedure is required to assess the gene expression levels of such sample types. The reproducibility and accuracy of relative gene expression data produced by sensitive methodology as qRT-PCR when cDNA converted from amplified (A) RNA is used as template has not yet been properly addressed. In this study, to properly evaluate this issue, we performed 1 round of linear RNA amplification in 2 breast cell lines (C5.2 and HB4a) and assessed the relative expression of 34 genes using cDNA converted from both nonamplified (NA) and A RNA. Relative gene expression was obtained from beta actin or glyceraldehyde 3-phosphate dehydrogenase normalized data using different dilutions of cDNA, wherein the variability and fold-change differences in the expression of the 2 methods were compared. Our data showed that 1 round of linear RNA amplification, even with suboptimal-quality RNA, is appropriate to generate reproducible and high-fidelity qRT-PCR relative expression data that have similar confidence levels as those from NA samples. The use of cDNA that is converted from both A and NA RNA in a single qRT-PCR experiment clearly creates bias in relative gene expression data.

Cathepsin L-like genes of Trypanosoma vivax from Africa and South America - characterization, relationships and diagnostic implications

We characterized sequences from genes encoding cathepsin L-like (CatL-like) cysteine proteases from African and South American isolates of Trypanosoma vivax and T. vivax-like organisms, and evaluated their suitability as genetic markers for population structure analysis and diagnosis. Phylogenetic analysis of sequences corresponding to CatL-like catalytic domains revealed substantial polymorphism, and clades of sequences (TviCatL1-9) were separated by large genetic distances. TviCatL1-4 sequences were from cattle isolates from West Africa (Nigeria and Burkina Faso) and South America (Brazil and Venezuela), which belonged to the same T. vivax genotype. T. vivax-like genotypes from East Africa showed divergent sequences, including TviCatL5-7 for isolates from Mozambique and TviCatL8-9 for an isolate from Kenya. Phylogenetic analysis of CatL-like gene data supported the relationships among trypanosome species reflected in the phylogenies based on the analysis of small subunit (SSU) of ribosomal RNA gene sequence data. The discovery of different CatL-like sequences for each genotype, defined previously by ribosomal DNA data, indicate that these sequences provide useful targets for epidemiological and population genetic studies. Regions in CatL-like sequences shared by all T. vivax genotypes but not by other trypanosomes allowed the establishment of a specific and sensitive diagnostic PCR for epidemiological studies in South America and Africa. (C) 2008 Elsevier Ltd. All rights reserved.

The monoclonal antibody against the major diagnostic antigen of Paracoccidioides brasiliensis mediates immune protection in infected BALB/c mice challenged intratracheally with the fungus

The protective role of specific antibodies against Paracoccidioides brasiliensis is controversial. In the present study, we analyzed the effects of monoclonal antibodies on the major diagnostic antigen (gp43) using in vitro and in vivo P. brasiliensis infection models. The passive administration of some monoclonal antibodies (MAbs) before and after intratracheal or intravenous infections led to a reduced fungal burden and decreased pulmonary inflammation. The protection mediated by MAb 3E, the most efficient MAb in the reduction of fungal burden, was associated with the enhanced phagocytosis of P. brasiliensis yeast cells by J774.16, MH-S, or primary macrophages. The ingestion of opsonized yeast cells led to an increase in NO production by macrophages. Passive immunization with MAb 3E induced enhanced levels of gamma interferon in the lungs of infected mice. The reactivity of MAb 3E against a panel of gp43-derived peptides suggested that the sequence NHVRIPIGWAV contains the binding epitope. The present work shows that some but not all MAbs against gp43 can reduce the fungal burden and identifies a new peptide candidate for vaccine development.

Bayesian Estimation for Performance Measures of Two Diagnostic Tests in the Presence of Verification Bias

Sensitivity and specificity are measures that allow us to evaluate the performance of a diagnostic test. In practice, it is common to have situations where a proportion of selected individuals cannot have the real state of the disease verified, since the verification could be an invasive procedure, as occurs with biopsy. This happens, as a special case, in the diagnosis of prostate cancer, or in any other situation related to risks, that is, not practicable, nor ethical, or in situations with high cost. For this case, it is common to use diagnostic tests based only on the information of verified individuals. This procedure can lead to biased results or workup bias. In this paper, we introduce a Bayesian approach to estimate the sensitivity and the specificity for two diagnostic tests considering verified and unverified individuals, a result that generalizes the usual situation based on only one diagnostic test.

A computational study of some rheological influences on the ""splashing experiment""

In various attempts to relate the behaviour of highly-elastic liquids in complex flows to their rheometrical behaviour, obvious candidates for study have been the variation of shear viscosity with shear rate, the two normal stress differences N(1) and N(2), especially N(1), the extensional viscosity, and the dynamic moduli G` and G ``. In this paper, we shall confine attention to `constant-viscosity` Boger fluids, and, accordingly, we shall limit attention to N(1), eta(E), G` and G ``. We shall concentrate on the ""splashing"" problem (particularly that which arises when a liquid drop falls onto the free surface of the same liquid). Modern numerical techniques are employed to provide the theoretical predictions. We show that high eta(E) can certainly reduce the height of the so-called Worthington jet, thus confirming earlier suggestions, but other rheometrical influences (steady and transient) can also have a role to play and the overall picture may not be as clear as it was once envisaged. We argue that this is due in the main to the fact that splashing is a manifestly unsteady flow. To confirm this proposition, we obtain numerical simulations for the linear Jeffreys model. (C) 2010 Elsevier B.V. All rights reserved.