Changes in volume, surface estimate, three-dimensional shape and total number of neurons of the human primary visual cortex from midgestation until old age.

Macroscopic features such as volume, surface estimate, thickness and caudorostral length of the human primary visual cortex (Brodman's area 17) of 46 human brains between midgestation and 93 years were studied by means of camera lucida drawings from serial frontal sections. Individual values were best fitted by a logistic function from midgestation to adulthood and by a regression line between adulthood and old age. Allometric functions were calculated to study developmental relationships between all the features. The three-dimensional shape of area 17 was also reconstructed from the serial sections in 15 cases and correlated with the sequence of morphological events. The sulcal pattern of area 17 begins to develop around 21 weeks of gestation but remains rather simple until birth, while it becomes more convoluted, particularly in the caudal part, during the postnatal period. Until birth, a large increase in cortical thickness (about 83% of its mean adult value) and caudorostral length (69%) produces a moderate increase in cortical volume (31%) and surface estimate (40%) of area 17. After birth, the cortical volume and surface undergo their maximum growth rate, in spite of a rather small increase in cortical thickness and caudorostral length. This is due to the development of the pattern of gyrification within and around the calcarine fissure. All macroscopic features have reached the mean adult value by the end of the first postnatal year. With aging, the only features to undergo significant regression are the cortical surface estimate and the caudorostral length. The total number of neurons in area 17 shows great interindividual variability at all ages. No decrease in the postnatal period or in aging could be demonstrated.

Total and segmental liver volume variations: implications for liver surgery.

BACKGROUND: Liver remnant volumes after major hepatic resection and graft volumes for liver transplantation correlate with surgical outcome. The relative contributions of the hepatic segments to total liver volume (TLV) are not well established. METHODS: TLV and hepatic segment volumes were measured with computed tomography (CT) in 102 patients without liver disease who underwent CT for conditions unrelated to the liver or biliary tree. RESULTS: TLV ranged from 911 to 2729 cm(3). On average, the right liver (segments V, VI, VII, and VIII) contributed approximately two thirds of TLV (997+/-279 cm(3)), and the left liver (segments II, III and IV) contributed approximately one third of TLV (493+/-127 cm(3)). Bisegment II+III (left lateral section) contributed about half the volume of the left liver (242+/-79 cm(3)), or 16% of TLV. Liver volumes varied significantly between patients--the right liver varied from 49% to 82% of TLV, the left liver, 17% to 49% of TLV, and bisegment II+III (left lateral section) 5% to 27% of TLV. Bisegment II+III contributed less than 20% of TLV in more than 75% of patients and the left liver contributed 25% or less of TLV in more than 10% of patients. DISCUSSION: There is clinically significant interpatient variation in hepatic volumes. Therefore, in the absence of appreciable hypertrophy, we recommend routine measurement of the future liver remnant before extended right hepatectomy (right trisectionectomy) and in selected patients before right hepatectomy if a small left liver is anticipated.

Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL).

BACKGROUND: Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed. PATIENTS AND METHODS: The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors. RESULTS: With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS. CONCLUSION: TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.

Three-Dimensional Ultrasonographic Assessment of Fetal Total Lung Volume as a Prognostic Factor in Primary Pleural Effusion

Objectives-The purpose of this study was to predict perinatal outcomes using fetal total lung volumes assessed by 3-dimensional ultrasonography (3DUS) in primary pleural effusion.Methods-Between July 2005 and July 2010, total lung volumes were prospectively estimated in fetuses with primary pleural effusion by 3DUS using virtual organ computer-aided analysis software. The first and last US examinations were considered in the analysis. The observed/expected total lung volumes were calculated. Main outcomes were perinatal death (up to 28 days of life) and respiratory morbidity (orotracheal intubation with mechanical respiratory support >48 hours).Results-Twelve of 19 fetuses (63.2%) survived. Among the survivors, 7 (58.3%) had severe respiratory morbidity. The observed/expected total lung volume at the last US examination before birth was significantly associated with perinatal death (P < .01) and respiratory morbidity (P < .01) as well as fetal hydrops (P < .01) and bilateral effusion (P = .01).Conclusions-Fetal total lung volumes may be useful for the prediction of perinatal outcomes in primary pleural effusion.

Maximal strength, number of repetitions , and total volume are differently affected by static-ballistic, and proprioceptive neuromuscular facilitation stretching

Barroso, R, Tricoli, V, dos Santos Gil, S, Ugrinowitsch, C, and Roschel, H. Maximal strength, number of repetitions, and total volume are differently affected by static-, ballistic-, and proprioceptive neuromuscular facilitation stretching. J Strength Cond Res 26(9): 2432-2437, 2012-Stretching exercises have been traditionally incorporated into warm-up routines before training sessions and sport events. However, the effects of stretching on maximal strength and strength endurance performance seem to depend on the type of stretching employed. The objective of this study was to compare the effects of static stretching (SS), ballistic stretching (BS), and proprioceptive neuromuscular facilitation (PNF) stretching on maximal strength, number of repetitions at a submaximal load, and total volume (i.e., number of repetitions 3 external load) in a multiple-set resistance training bout. Twelve strength-trained men (20.4 +/- 4.5 years, 67.9 +/- 6.3 kg, 173.3 +/- 8.5 cm) volunteered to participate in this study. All of the subjects completed 8 experimental sessions. Four experimental sessions were designed to test maximal strength in the leg press (i.e., 1 repetition maximum [1RM]) after each stretching condition (SS, BS, PNF, or no-stretching [NS]). During the other 4 sessions, the number of repetitions performed at 80% 1RM was assessed after each stretching condition. All of the stretching protocols significantly improved the range of motion in the sit-and-reach test when compared with NS. Further, PNF induced greater changes in the sit-and-reach test than BS did (4.7 +/- 1.6, 2.9 +/- 1.5, and 1.9 +/- 1.4 cm for PNF, SS, and BS, respectively). Leg press 1RM values were decreased only after the PNF condition (5.5%, p < 0.001). All the stretching protocols significantly reduced the number of repetitions (SS: 20.8%, p < 0.001; BS: 17.8%, p = 0.01; PNF: 22.7%, p < 0.001) and total volume (SS: 20.4%, p < 0.001; BS: 17.9%, p = 0.01; PNF: 22.4%, p < 0.001) when compared with NS. The results from this study suggest that, to avoid a decrease in both the number of repetitions and total volume, stretching exercises should not be performed before a resistance training session. Additionally, strength-trained individuals may experience reduced maximal dynamic strength after PNF stretching.

Is there a relationship between the total volume of load lifted in bench press exercise and the rating of perceived exertion?

Aim. The purpose of the study was to investigate the relationship between the total volume of load lifted (TVLL) and the rating of perceived exertion (RPE) measures during different resistance training (RT) schemes using the bench press exercise. Methods. The present study was divided into two experiments. In the first experiment, 18 healthy men performed three different RT schemes: a strength oriented scheme (SS), a muscular endurance oriented scheme (ES) and a hypertrophy oriented scheme (HS). TVLL was calculated for each scheme. Mean-RPE and session-RPE were assessed. In the second experiment, 23 men performed two resistance exercise bouts at different intensities (50 %-1RM and 75%-1RM) with matched TVLL. Mean-RPE and session-RPE were also assessed. Results. SS and HS showed higher TVLL and greater RPE scores as compared to ES (P<0.05). No significant difference was observed between SS and HS. It was verified significant positive correlations between TVLL and session-RPE (SS r=0.63, HS r=0.64, ES r=0.56; P<0.05), and between mean-RPE and TVLL (SS r=0.55, HS r=0.52, ES r=0.47; P<0.05) for all schemes. No differences were observed for mean-RPE, session-RPE and TVLL between the 50%-1RM and 75%1RM. Significant positive relationships between TVLL and session-RPE (50 %-1RM r=0.61, 75 %-1RM r=0.66; p<0.05) and between TVLL and mean-RPE (50 %-1RM r=0.51, 75%1RM r=0.49; P<0.05) were observed. Conclusion. The results of this study have shown that the TVLL in RT influences RPE measures. These findings corroborates the existence of a relationship between total work performed (external training load) and perception of effort (internal training load).

Three-Dimensional Ultrasonographic Assessment of Fetal Total Lung Volume as a Prognostic Factor in Primary Pleural Effusion

Objectives-The purpose of this study was to predict perinatal outcomes using fetal total lung volumes assessed by 3-dimensional ultrasonography (3DUS) in primary pleural effusion. Methods-Between July 2005 and July 2010, total lung volumes were prospectively estimated in fetuses with primary pleural effusion by 3DUS using virtual organ computer-aided analysis software. The first and last US examinations were considered in the analysis. The observed/expected total lung volumes were calculated. Main outcomes were perinatal death (up to 28 days of life) and respiratory morbidity (orotracheal intubation with mechanical respiratory support >48 hours). Results-Twelve of 19 fetuses (63.2%) survived. Among the survivors, 7 (58.3%) had severe respiratory morbidity. The observed/expected total lung volume at the last US examination before birth was significantly associated with perinatal death (P < .01) and respiratory morbidity (P < .01) as well as fetal hydrops (P < .01) and bilateral effusion (P = .01). Conclusions-Fetal total lung volumes may be useful for the prediction of perinatal outcomes in primary pleural effusion.

Total Tumor Volume and Alpha Fetoprotein for selection of transplant candidates with hepatocellular carcinoma: A prospective validation.

The selection of liver transplant candidates with hepatocellular carcinoma (HCC) is currently validated based on Milan criteria. The use of extended criteria has remained a matter of debate, mainly because of the absence of prospective validation. The present prospective study recruited patients according to the previously proposed Total Tumor Volume (TTV ≤115 cm(3) )/alpha fetoprotein (AFP ≤400 ng/ml) score. Patients with AFP >400 ng/ml were excluded, and as such the Milan group was modified to include only patients with AFP <400 ng/ml; these patients were compared to patients beyond Milan, but within TTV/AFP. From January 2007 to March 2013, 233 patients with HCC were listed for liver transplantation. Of them, 195 patients were within Milan, and 38 beyond Milan but within TTV/AFP. The average follow-up from listing was 33,9 ±24,9 months. The risk of drop-out was higher for patients beyond Milan but within TTV/AFP (16/38, 42,1%), than for patients within Milan (49/195, 25,1%, p=0,033). In parallel, intent-to-treat survival from listing was lower in the patients beyond Milan (53,8% vs. 71,6% at four years, p<0,001). After a median waiting time of 8 months, 166 patients were transplanted, 134 patients within Milan criteria, and 32 beyond Milan but within TTV/AFP. They demonstrated acceptable and similar recurrence rates (4,5% vs. 9,4%, p=0,138) and post-transplant survivals (78,7% vs. 74,6% at four years, p=0,932). CONCLUSION Based on the present prospective study, HCC liver transplant candidate selection could be expanded to the TTV (≤115 cm(3) )/AFP (≤400 ng/ml) criteria in centers with at least 8-month waiting time. An increased risk of drop-out on the waiting list can be expected but with equivalent and satisfactory post-transplant survival. This article is protected by copyright. All rights reserved.

Relationship of hospital volume to patient mortality, length of stay and total costs in patients receiving brain surgery for cancer: A nationwide analysis

Better morbidity and mortality outcomes associated with increased hospital procedural volume have been demonstrated across a number of different medical procedures. Existence of such a volume-outcome relationship is posited to lead to increased specialization of care, such that patients requiring specific procedures are funneled to physicians and hospitals that achieve a minimum volume of such procedures each year. In this study, the 2009 Nationwide Inpatient Sample is used to examine the relationship between hospital volume and patient outcome among patients undergoing procedures related to malignant brain cancer. Multiple regression models were used to examine the impact of hospital volume on length of inpatient stay and cost of inpatient stay; logistic regression was used to examine the impact of hospital volume on morbidity. Hospital volume was found to be a significant predictor of both length of stay and cost of stay. Hospital volume was associated with a lower length of stay, but was also associated with increased costs. Hospital volume was not found to be a statistically significant predictor of morbidity, though less than three percent of this sample died while in the hospital. Volume is indeed a significant predictor of outcome for procedures related to brain malignancies, though further research regarding the cost of such procedures is recommended.^

Estimate of the total ice volume of Svalbard glaciers and their potential contribution to sea-level rise = Estimación del volumen de hielo de Svalbard y su contribución potencial a la subida del nivel del mar

El objetivo final de las investigaciones recogidas en esta tesis doctoral es la estimación del volumen de hielo total de los ms de 1600 glaciares de Svalbard, en el Ártico, y, con ello, su contribución potencial a la subida del nivel medio del mar en un escenario de calentamiento global. Los cálculos más exactos del volumen de un glaciar se efectúan a partir de medidas del espesor de hielo obtenidas con georradar. Sin embargo, estas medidas no son viables para conjuntos grandes de glaciares, debido al coste, dificultades logísticas y tiempo requerido por ellas, especialmente en las regiones polares o de montaña. Frente a ello, la determinación de áreas de glaciares a partir de imágenes de satélite sí es viable a escalas global y regional, por lo que las relaciones de escala volumen-área constituyen el mecanismo más adecuado para las estimaciones de volúmenes globales y regionales, como las realizadas para Svalbard en esta tesis. Como parte del trabajo de tesis, hemos elaborado un inventario de los glaciares de Svalbard en los que se han efectuado radioecosondeos, y hemos realizado los cálculos del volumen de hielo de más de 80 cuencas glaciares de Svalbard a partir de datos de georradar. Estos volúmenes han sido utilizados para calibrar las relaciones volumen-área desarrolladas en la tesis. Los datos de georradar han sido obtenidos en diversas campañas llevadas a cabo por grupos de investigación internacionales, gran parte de ellas lideradas por el Grupo de Simulación Numérica en Ciencias e Ingeniería de la Universidad Politécnica de Madrid, del que forman parte la doctoranda y los directores de tesis. Además, se ha desarrollado una metodología para la estimación del error en el cálculo de volumen, que aporta una novedosa técnica de cálculo del error de interpolación para conjuntos de datos del tipo de los obtenidos con perfiles de georradar, que presentan distribuciones espaciales con unos patrones muy característicos pero con una densidad de datos muy irregular. Hemos obtenido en este trabajo de tesis relaciones de escala específicas para los glaciares de Svalbard, explorando la sensibilidad de los parámetros a diferentes morfologías glaciares, e incorporando nuevas variables. En particular, hemos efectuado experimentos orientados a verificar si las relaciones de escala obtenidas caracterizando los glaciares individuales por su tamaño, pendiente o forma implican diferencias significativas en el volumen total estimado para los glaciares de Svalbard, y si esta partición implica algún patrón significativo en los parámetros de las relaciones de escala. Nuestros resultados indican que, para un valor constante del factor multiplicativo de la relacin de escala, el exponente que afecta al área en la relación volumen-área decrece según aumentan la pendiente y el factor de forma, mientras que las clasificaciones basadas en tamaño no muestran un patrón significativo. Esto significa que los glaciares con mayores pendientes y de tipo circo son menos sensibles a los cambios de área. Además, los volúmenes de la población total de los glaciares de Svalbard calculados con fraccionamiento en grupos por tamaño y pendiente son un 1-4% menores que los obtenidas usando la totalidad de glaciares sin fraccionamiento en grupos, mientras que los volúmenes calculados fraccionando por forma son un 3-5% mayores. También realizamos experimentos multivariable para obtener estimaciones óptimas del volumen total mediante una combinación de distintos predictores. Nuestros resultados muestran que un modelo potencial simple volumen-área explica el 98.6% de la varianza. Sólo el predictor longitud del glaciar proporciona significación estadística cuando se usa además del área del glaciar, aunque el coeficiente de determinación disminuye en comparación con el modelo más simple V-A. El predictor intervalo de altitud no proporciona información adicional cuando se usa además del área del glaciar. Nuestras estimaciones del volumen de la totalidad de glaciares de Svalbard usando las diferentes relaciones de escala obtenidas en esta tesis oscilan entre 6890 y 8106 km3, con errores relativos del orden de 6.6-8.1%. El valor medio de nuestras estimaciones, que puede ser considerado como nuestra mejor estimación del volumen, es de 7.504 km3. En términos de equivalente en nivel del mar (SLE), nuestras estimaciones corresponden a una subida potencial del nivel del mar de 17-20 mm SLE, promediando 19_2 mm SLE, donde el error corresponde al error en volumen antes indicado. En comparación, las estimaciones usando las relaciones V-A de otros autores son de 13-26 mm SLE, promediando 20 _ 2 mm SLE, donde el error representa la desviación estándar de las distintas estimaciones. ABSTRACT The final aim of the research involved in this doctoral thesis is the estimation of the total ice volume of the more than 1600 glaciers of Svalbard, in the Arctic region, and thus their potential contribution to sea-level rise under a global warming scenario. The most accurate calculations of glacier volumes are those based on ice-thicknesses measured by groundpenetrating radar (GPR). However, such measurements are not viable for very large sets of glaciers, due to their cost, logistic difficulties and time requirements, especially in polar or mountain regions. On the contrary, the calculation of glacier areas from satellite images is perfectly viable at global and regional scales, so the volume-area scaling relationships are the most useful tool to determine glacier volumes at global and regional scales, as done for Svalbard in this PhD thesis. As part of the PhD work, we have compiled an inventory of the radio-echo sounded glaciers in Svalbard, and we have performed the volume calculations for more than 80 glacier basins in Svalbard from GPR data. These volumes have been used to calibrate the volume-area relationships derived in this dissertation. Such GPR data have been obtained during fieldwork campaigns carried out by international teams, often lead by the Group of Numerical Simulation in Science and Engineering of the Technical University of Madrid, to which the PhD candidate and her supervisors belong. Furthermore, we have developed a methodology to estimate the error in the volume calculation, which includes a novel technique to calculate the interpolation error for data sets of the type produced by GPR profiling, which show very characteristic data distribution patterns but with very irregular data density. We have derived in this dissertation scaling relationships specific for Svalbard glaciers, exploring the sensitivity of the scaling parameters to different glacier morphologies and adding new variables. In particular, we did experiments aimed to verify whether scaling relationships obtained through characterization of individual glacier shape, slope and size imply significant differences in the estimated volume of the total population of Svalbard glaciers, and whether this partitioning implies any noticeable pattern in the scaling relationship parameters. Our results indicate that, for a fixed value of the factor in the scaling relationship, the exponent of the area in the volume-area relationship decreases as slope and shape increase, whereas size-based classifications do not reveal any clear trend. This means that steep slopes and cirque-type glaciers are less sensitive to changes in glacier area. Moreover, the volumes of the total population of Svalbard glaciers calculated according to partitioning in subgroups by size and slope are smaller (by 1-4%) than that obtained considering all glaciers without partitioning into subgroups, whereas the volumes calculated according to partitioning in subgroups by shape are 3-5% larger. We also did multivariate experiments attempting to optimally predict the volume of Svalbard glaciers from a combination of different predictors. Our results show that a simple power-type V-A model explains 98.6% of the variance. Only the predictor glacier length provides statistical significance when used in addition to the predictor glacier area, though the coefficient of determination decreases as compared with the simpler V-A model. The predictor elevation range did not provide any additional information when used in addition to glacier area. Our estimates of the volume of the entire population of Svalbard glaciers using the different scaling relationships that we have derived along this thesis range within 6890-8106 km3, with estimated relative errors in total volume of the order of 6.6-8.1% The average value of all of our estimates, which could be used as a best estimate for the volume, is 7,504 km3. In terms of sea-level equivalent (SLE), our volume estimates correspond to a potential contribution to sea-level rise within 17-20 mm SLE, averaging 19 _ 2 mm SLE, where the quoted error corresponds to our estimated relative error in volume. For comparison, the estimates using the V-A scaling relations found in the literature range within 13-26 mm SLE, averaging 20 _ 2 mm SLE, where the quoted error represents the standard deviation of the different estimates.