High Positive Ratio Research Articles

Prevalence of hypothyroidism in Japanese chronic kidney disease patients

Background Major symptoms of progressive chronic kidney disease (CKD) are similar to those of hypothyroidism. Hidden symptoms of hypothyroidism underlying CKD are often observed in clinical practice. This study aimed to ascertain the frequency of hypothyroidism complicated by CKD, and to analyze factors impacting thyroid function. Methods During the period from April 2012 through October 2016, 510 CKD patients at our outpatient clinic were measured thyroid and kidney function for diagnosing hypothyroidism (overt hypothyroidism, OH; subclinical hypothyroidism, SH; non-thyroidal illness, NTI) and evaluating the stage of CKD. All patients were over 15 years of age. Results There were significant differences in age, estimated glomerular filtration rate (eGFR), urinary protein (UP), and serum albumin (Alb) among patients with OH, SH, and NTI compared to the normal group in univariate and multivariate analyses. UP showed the highest odds ratio of OH, SH, and NTI but no differences were recognized in gender in each group. Frequency distribution showed that the prevalence of thyroid dysfunction was greater among more severe stage of CKD with higher amount of UP. OH and SH did not show high positive ratio of anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb). NTI and normal subjects showed higher positive ratio as 50.0% and 42.9% of TgAb and TPOAb than OH and SH. Conclusions Hypothyroidism complicated by CKD exhibited a high prevalence. Age, eGFR, UP, and serum Alb were related to the prevalence of hypothyroidism, whereas gender was not and this was contradicted to the prevalence of hypothyroidism in general population. The prevalence of OH and SH was higher among patients with higher stage of CKD with increased UP. Hypothyroidism complicated by CKD may involve different onset mechanisms unrelated to antithyroid antibodies (ATAb). In CKD patients, assessments of OH and SH, as well as NTI, are needed for proper diagnosis.

Color image zero-watermarking based on fast quaternion generic polar complex exponential transform

As one promising solution, zero-watermarking techniques have been proposed to enhance the image visual quality and applied to protect the intellectual property rights of the medical images, remote sensing images and military images. Owing to their favorable image description capability and geometric invariance, moments and moment invariants have become a popular tool for the zero-watermarking. However, two issues of the moments-based zero-watermarking methods should be addressed: First, most of them ignore the analysis and experiment on discriminability, resulting in a high false positive ratio; Second, direct computation of the moments from their definition is inefficient, numerically unstable and inaccurate, which severely affects the performances of these moments-based methods. To overcome the two challenges, in this paper, we present a Fast Quaternion Generic Polar Complex Exponential Transform (FQGPCET) based color image zero-watermarking algorithm. We first propose a novel computation strategy, i.e. FGPCET, to solve the moments computing problems. We then show that it is possible to generate a robust and discriminative image feature, by mixing the low-order QGPCET moments/coefficients. And finally, we develop a new color image zero-watermarking approach using FQGPCET and asymmetric tent map. Theoretical analysis and experimental results show that the proposed zero-watermarking algorithm achieves a good trade-off between robustness and discriminability, and has certain superiority in terms of security, capacity and time complexity.

Impact of Affect on Lung Transplant Candidate Outcomes.

We examined the association of adult lung transplant candidates' self-reported affect with transplant-related outcomes, evaluating whether a positive (vs negative) frame of mind might be protective. Consenting waitlisted candidates from 6 centers completed the questionnaires including the Positive and Negative Affect Schedule annually and posttransplant. Univariate logistic regression analysis was performed to determine the association of baseline affect with outcomes of death or delisting. Models were subsequently adjusted for age, marital status, and education. Questionnaires were completed by 169 candidates (77.9% participation). Mean positive affect, negative affect, and positive-to-negative affect ratio (positivity ratio) were similar to expected norms. The scores of the questionnaire did not change significantly over time. Fifteen (8.9%) waitlisted participants died. Candidates who died while waiting had lower positivity ratios compared to those who survived (1.82 vs 2.45; P = .02). A more negative affect was associated with increased death on the waiting list (adjusted odds ratio [OR] 1.10; P = .021). Conversely, a higher positivity ratio was associated with decreased death while waiting (adjusted OR: 0.45; P = .027). Negative affect may represent a novel risk factor for death on the waitlist. Enhancing positive affect may represent a useful target for psychological optimization in lung transplant candidates.

Machine Learning Readmission Risk Modeling: A Pediatric Case Study.

Background Hospital readmission prediction in pediatric hospitals has received little attention. Studies have focused on the readmission frequency analysis stratified by disease and demographic/geographic characteristics but there are no predictive modeling approaches, which may be useful to identify preventable readmissions that constitute a major portion of the cost attributed to readmissions. Objective To assess the all-cause readmission predictive performance achieved by machine learning techniques in the emergency department of a pediatric hospital in Santiago, Chile. Materials An all-cause admissions dataset has been collected along six consecutive years in a pediatric hospital in Santiago, Chile. The variables collected are the same used for the determination of the child's treatment administrative cost. Methods Retrospective predictive analysis of 30-day readmission was formulated as a binary classification problem. We report classification results achieved with various model building approaches after data curation and preprocessing for correction of class imbalance. We compute repeated cross-validation (RCV) with decreasing number of folders to assess performance and sensitivity to effect of imbalance in the test set and training set size. Results Increase in recall due to SMOTE class imbalance correction is large and statistically significant. The Naive Bayes (NB) approach achieves the best AUC (0.65); however the shallow multilayer perceptron has the best PPV and f-score (5.6 and 10.2, resp.). The NB and support vector machines (SVM) give comparable results if we consider AUC, PPV, and f-score ranking for all RCV experiments. High recall of deep multilayer perceptron is due to high false positive ratio. There is no detectable effect of the number of folds in the RCV on the predictive performance of the algorithms. Conclusions We recommend the use of Naive Bayes (NB) with Gaussian distribution model as the most robust modeling approach for pediatric readmission prediction, achieving the best results across all training dataset sizes. The results show that the approach could be applied to detect preventable readmissions.

TGF-β induces corneal endothelial senescence via increase of mitochondrial reactive oxygen species in chronic corneal allograft failure.

The corneal endothelium (CE) dysfunction impairs optical transparency and leads to corneal allograft failure. Morphologically, CE cells are characterized by premature senescence at the late stage of corneal graft. However, the detailed molecular mechanisms are largely unknown. Here we found that transforming growth factor-β (TGF-β) is elevated in the CE of late graft failure. In addition, senescence-associated gene p21 and p16 are increased as well, which is consistent with their elevation upon TGF-β treatment in human corneal endothelial cell B4G12. Furthermore, TGF-β treatment leads to high positive ratio of SA-β-gal, indicating B4G12 cells undergo cellular senescence. Mechanistically, we demonstrated that TGF-β could induce mitochondrial ROS (mtROS) production and mtROS scavenger could rescue CE cell senescence upon TGF-β treatment. Our study provides new evidence that elevated TGF-β plays a crucial role in the CE cell senescence and loss in chronic corneal graft failure, which could be potential targets for clinical treatment.

Functional variable selection via Gram–Schmidt orthogonalization for multiple functional linear regression

ABSTRACTFunctional linear model is of great practical importance, as exemplified by applications in high-throughput studies such as meteorological and biomedical research. In this paper, we propose a new functional variable selection procedure, called functional variable selection via Gram–Schmidt (FGS) orthogonalization, for a functional linear model with a scalar response and multiple functional predictors. Instead of the regularization methods, FGS takes into account the similarity between the functional predictors in a data-driven way and utilizes the technique of Gram–Schmidt orthogonalization to remove the irrelevant predictors. FGS can successfully discriminate between the relevant and the irrelevant functional predictors to achieve a high true positive ratio without including many irrelevant predictors, and yield explainable models, which offers a new perspective for the variable selection method in the functional linear model. Simulation studies are carried out to evaluate the finite sample performance of the proposed method, and also a weather data set is analysed.

Effects of trastuzumab on locoregional recurrence in human epidermal growth factor receptor 2-overexpressing breast cancer patients treated with chemotherapy and radiotherapy.

In the present study, the ability of adjuvant trastuzumab to reduce locoregional recurrence in patients with human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer receiving adjuvant chemotherapy and radiotherapy (RT) was investigated. We retrospectively included 520 patients with HER2-overexpressing breast cancer who received surgery followed by adjuvant RT and cytotoxic chemotherapy from 2003 to 2011. Adjuvant trastuzumab was administered to 286 patients. Propensity score matching was conducted to compare trastuzumab-treated and non-treated cohorts. Median follow-up duration was 7.1years (range 1.1-14.1years). Propensity score matching yielded 171 matched pairs of patients with no significantly different clinical factors. An improved 7-year locoregional control (LRC) rate was observed in the trastuzumab-treated cohort compared with the non-treated cohort (95.6% vs. 89.9%, p = 0.014). Based on multivariate analysis, hormone receptor negativity (hazard ratio [HR] = 5.348, p = 0.007), positive lymph node ratio > 0.25 (HR = 2.549, p = 0.040), and lack of adjuvant trastuzumab (HR = 3.401, p = 0.017) were identified as significant risk factors for poor LRC. Adjuvant trastuzumab significantly reduced the locoregional recurrence rate in patients with one or two risk factors (7-year LRC = 95.0% vs. 84.2%, p = 0.007); however, the benefit of adjuvant trastuzumab was non-significant in patients with no risk factors (7-year LRC = 95.8% vs. 97.9%, p = 0.75). Adjuvant trastuzumab improved LRC in patients with HER2-overexpressing breast cancer receiving adjuvant RT and cytotoxic chemotherapy, especially in hormone receptor-negative, HER2-enriched subtype, and high positive lymph node ratio breast cancer.

CK19, CK20, EGFR and HER2 status of circulating tumor cells in patients with breast cancer.

The major cause of death in breast cancer patients is metastasis. Various biomarkers have been used for the early detection of circulating tumor cells in the peripheral blood of breast cancer patients. The aims of the current study were to analyze circulating tumor cells in the blood of breast cancer patients by investigating EGFR, CK19, CK20 and HER2 expression profiles and to evaluate their prognostic importance. CK19, CK20 and EGFR gene expression profiles were evaluated in the blood samples of 84 female patients with primary invasive ductal breast cancer and 20 healthy female volunteers using SYBR green-based real-time qPCR assays. HER2 expression analyses were conducted in 46 patients who had an HER2-positive primary tumor and in 30 healthy women to determine the cutoff level of positivity. The positive rates of CK20, EGFR, CK19 and HER2 mRNA expression in the peripheral blood were 28.57% (24/84), 20.23% (17/84), 5.95% (5/84) and 2.17% (1/46), respectively. The high positive ratio of CK20 mRNA expression in the peripheral blood of breast cancer was identified for the first time in the current study. Significant differences were identified in CK20 expression status and several clinical parameters related with aggressiveness of tumors using a binary logistic regression analysis. Higher CK20-positive levels were observed in patients who had lymph node metastasis and advanced-grade primary tumors, which were estrogen receptor-negative. We have demonstrated that CK20 may be a novel biomarker that is useful to identify circulating tumor cells and predict breast cancer progression. The results suggest that the investigation of CK20 mRNA with other biomarkers in the peripheral blood of breast cancer patients may be useful to monitor the presence of disseminated tumor cells in the blood circulation and to predict the prognosis of breast cancer.

Risk and Survival of Patients with Head and Neck Cutaneous Melanoma: National Perspective

Objective: Head and neck cutaneous melanoma represents a distinct entity of skin cancer. We aim to examine management and survival of patients with head and neck cutaneous melanoma. Methods: A retrospective cohort study utilizing the National Cancer Database, 2004-2012. Results: A total of 20,322 (21.2%) head and neck melanomas and 75,547 (78.8%) melanomas of other sites were included. The median follow-up time of head and neck melanoma was 41.6 months (interquartile range: 22.9-68.2 months). Patients with melanoma of the head and neck were more likely to be ≥65 years old, male, and/or white (p < 0.001 each). Positive surgical margin was more prevalent in head and neck melanoma [OR: 2.19, 95% CI: (2.03, 2.37)], and was associated with a lower survival [HR: 1.41, 95% CI: (1.28, 1.57)]. High positive lymph node ratio was associated with a lower survival [HR: 2.00, 95% CI: (1.13, 3.57)]. Adjuvant immunotherapy was associated with an improved survival [HR: 0.67, 95% CI: (0.57, 0.80)]. Conclusion: Head and neck cutaneous melanoma is associated with certain demographics. Surgical margin status, lymph node ratio, and immunotherapy are independently associated with overall survival.

Relationship between Self-Reported Vaccination History and Measles and Rubella Antibody Titers in Medical and Nursing Students

In hospitals, infection control for measles and rubella is important. Medical and nursing students as well as healthcare workers must have immunity against these diseases. Many countries have adopted requirements for healthcare workers’ documented vaccination history or laboratory tests as evidence of their immunity. Evaluating a written vaccination history is difficult in many cases. Therefore, we compared measles and rubella antibody titers with self-reported vaccination history and we evaluated the association between the history and measles and rubella antibody titers, using the medical and nursing students’ data. We analyzed 564 data for measles and 558 data for rubella. Vaccination history was requested to be completed as accurately as possible. Students with one or more measles or rubella vaccinations had high positive ratios of titer, and the ratio was significantly higher than that of the students without vaccinations. The positive ratio between the two-dose and one-dose vaccination groups was not significantly different for measles or rubella (measles: p = 0.534, rubella: p = 0.452). Although it should be requested that the history is complete by using other resources, such as referring to maternity passbooks or proof of vaccination, self-reported history may be useful to confirm immunity, even if there is a possibility that the history is not accurate.

Selective Weakly Supervised Human Detection under Arbitrary Poses

In this paper we study the problem of weakly supervised human detection under arbitrary poses within the framework of multi-instance learning (MIL). Our contributions are threefold: (1) we first show that in the context of weakly supervised learning, some commonly used bagging tools in MIL such as the Noisy-OR model or the ISR model tend to suffer from the problem of gradient magnitude reduction when the initial instance-level detector is weak and/or when there exist large number of negative proposals, resulting in extremely inefficient use of training examples. We hence advocate the use of more robust and simple max-pooling rule or average rule under such circumstances; (2) we propose a new Selective Weakly Supervised Detection (SWSD) algorithm, which is shown to outperform several previous state-of-the-art weakly supervised methods; (3) finally, we identify several crucial factors that may significantly influence the performance, such as the usefulness of a small amount of supervision information, the need of relatively higher RoP (Ratio of Positive Instances), and so on – these factors are shown to benefit the MIL-based weakly supervised detector but are less studied in the previous literature. We also annotate a new large-scale data set called LSP/MPII-MPHB (Multiple Poses Human Body), in which and another popular benchmark dataset we demonstrate the superiority of the proposed method compared to several previous state-of-the-art methods.

Detection of Syphilis Infection among Voluntary Blood Donors from 2010 to 2014 in Chinese Nanjing Area

To understand the epidemiological characteristics of syphilis infection in blood donors of Chinese Nanjing area, to strengthen control of blood quality and to provide the scientific evidence for working out the strategy of prevention and treatment of syphilis infection. Firstly the double antigen sandwich ELISA was carried out according to its instructions, test results showing positive will be examed by double orifice second-round. A total of 362425 blood samples were collected from 2010 to 2014, among them 1277 positive samples were detected. The average rate of syphilis infection was 0.35％. The positive rates of different old years were statistically different（X(2)=265.679,P<0.001）, and the change trend of 5 years was statistically different(X(2)trend=237.928,P<0.001）. Among all age groups in the detection of treponema pallidema(TP), the most amount of positive samples and the lowest positive ratio 0.23% were found in the group 18 to 29 years old. The highest positive ratio was shown in age 50 years old and above. There was statistical different in all age groups(X(2)=361.620,P<0.001）. The positive ratio of the detection of TP was 0.32% in male donors which was lower than that in female donors(0.42%). There was statistical different in all sex groups(X(2)=24.659,P<0.001）. Peasant group had the highest positive ratio(1.07%) in the detection of TP and the student group had the lowest positive ratio(0.19%). There was statistical different in all occupation groups(X(2)=300.198,P<0.001）. Junior and under group had the highest positive ratio(0.59%) in the detection of TP and the undergraduates group has the lowest positive ratio(0.19%). There was statistical different in all education groups(X(2)=241.734,P<0.001）. Through chi-square test and trend test analysis showed that there was statistical different in sex, age, educational level and occupation differences. The tendency of the groups' statistics in 5 years is equally important. It is necessary to publicize blood donation information consultation scientifically before blood donation, especially for high-risk population. To ensure blood supply safety, it is important to recruit low-risk blood donors and develop permanent voluntary blood donors for reducing blood waste.

Cost-effectiveness of Campylobacter interventions on broiler farms in six European countries

Broilers are an important reservoir for human Campylobacter infections, one of the leading causes of acute diarrheal disease in humans worldwide. Therefore, it is relevant to control Campylobacter on broiler farms. This study estimated the cost-effectiveness ratios of eight Campylobacter interventions on broiler farms in six European countries: Denmark, the Netherlands, Norway, Poland, Spain, and United Kingdom. The cost-effectiveness ratio of an intervention was the estimated costs of the intervention divided by the estimated public health benefits due to the intervention, and was expressed in euro per avoided disability-adjusted life year (DALY). Interventions were selected on the basis of a European risk factor study and other risk factor research. A deterministic simulation model was developed to estimate the cost-effectiveness ratio of each intervention, if it would be implemented on all broiler farms in a country where it isn't implemented yet and implementation is possible. The model considered differences between countries in number and size of broiler farms and established practices, in import, export and transit of live broilers, broiler meat and meat products, in effect of interventions on Campylobacter prevalence in broilers, in disease burden of Campylobacter related human illness, in national economic factors, such as interest rate and general cost levels, and in technical and economic farm performance. Across interventions, cost-effectiveness ratios were the lowest for Poland and Spain, and highest for Norway and Denmark. Across countries, applying designated tools for each farm house and building an anteroom with hygiene barrier in each farm house had the lowest cost-effectiveness ratios, whereas a ban on thinning (partial depopulation), slaughter at 35 days, replacing old houses by new houses, and applying drink nipples without cup had the highest. Applying fly screens in Denmark had an intermediate cost-effectiveness ratio. A maximum downtime between flocks of ten days had a negative cost-effectiveness ratio (i.e. revenue) in Poland, a low positive cost-effectiveness ratio in Spain and high positive cost-effectiveness ratios in Denmark, the Netherlands and United Kingdom. Estimated cost-effectiveness ratios of Campylobacter interventions on broiler farms differed substantially between the six countries, but the order of interventions in increasing cost-effectiveness ratio was generally similar across the countries.

Attitudes Toward Dreaming Predict Subjective Well-Being Outcomes Mediated Through Emotional Positivity Bias

The current study examined how attitudes toward dreams, as well as an appraisal of typical emotions experienced in dreams, predicted greater subjective well-being. Participants completed a measure of attitude and beliefs about dreams, and appraised their positive and negative dream affect in an average dream. Additionally, participants completed measures of typical daily affect (positive and negative) along with life satisfaction, as measures of subjective well-being. Results showed that having a positive attitude toward dreams was associated with life satisfaction and positive waking affect, and that these associations were fully mediated by a high ratio of positive to negative emotional appraisal for dreams. This emotional positivity bias in dream recall was the link between positive attitudes toward dreams and psychological health. Results remained significant while controlling for other variables related to the experience of dreaming (emotional intensity and recall/frequency). Implications for subjective well-being are discussed.

Accessing spoilage features of osmotolerant yeasts identified from kiwifruit plantation and processing environment in Shaanxi, China

Osmotolerant yeasts originating from kiwifruit industrial chain can result in spoilage incidences, while little information is available about their species and spoilage features. This work identified possible spoilage osmotolerant yeasts from orchards and a manufacturer (quick-freeze kiwifruit manufacturer) in main producing areas in Shaanxi, China and further characterized their spoilage features. A total of 86 osmotolerant isolates dispersing over 29 species were identified through 26S rDNA sequencing at the D1/D2 domain, among which Hanseniaspora uvarum occurred most frequently and have intimate relationships with kiwifruit. RAPD analysis indicated a high variability of this species from sampling regions. The correlation of genotypes with origins was established except for isolates from Zhouzhi orchards, and the mobility of H. uvarum from orchard to the manufacturer can be speculated and contributed to spoilage sourcing. The manufacturing environment favored the inhabitance of osmotolerant yeasts more than the orchard by giving high positive sample ratio or osmotolerant yeast ratio. The growth curves under various glucose levels were fitted by Grofit R package and the obtained growth parameters indicated phenotypic diversity in the H. uvarum and the rest species. Wickerhamomyces anomalus (OM14) and Candida glabrata (OZ17) were the most glucose tolerant species and availability of high glucose would assist them to produce more gas. The test osmotolerant species were odor altering in kiwifruit concentrate juice. 3-Methyl-1-butanol, phenylethyl alcohol, phenylethyl acetate, 5-hydroxymethylfurfural (5-HMF) and ethyl acetate were the most altered compound identified by GC/MS in the juice. Particularly, W. anomalus produced 4-vinylguaiacol and M. guilliermondii produced 4-ethylguaiacol that would imperil product acceptance. The study determines the target spoilers as well as offering a detailed spoilage features, which will be instructive in implementing preventative measures to increase production safety of kiwifruit.

How Suitable Are Registry Data for Recurrence Risk Calculations? Validation of Diagnoses on 1,593 Families With Congenital Heart Disease.

Congenital heart disease (CHD) occurs in approximately 1% of all live births, and 3% to 8% of these have until now been considered familial cases, defined as the occurrence of two or more affected individuals in a family. The validity of CHD diagnoses in Danish administrative registry data has only been studied previously in highly selected patient populations. These studies identified high positive predictive values (PPVs) and recurrence risk ratios (RRRs-ratio between probabilities of CHD given family history of CHD and no family history). However, the RRR can be distorted if registry data are used indiscriminately. Here, we investigated the consequences of misclassifications for the RRR using validated diagnoses on Danish patients with familial CHD. Danish citizens are assigned a civil registration number (CPR number) at birth or immigration, which acts as a unique identifier in the Danish registries, thus enabling connection of information from several registries. Utilizing the CPR number, we identified Danish patients with familial CHD and reviewed each patient's file. We compared diagnoses from the registries with those manually assigned, which enabled calculation of the PPVs of diagnoses in the Danish registries, and from this, we deduced the false discovery rate (FDR). To measure the consequences on the RRR, the FDR was applied to a simulated data set with true RRR values of 2 and 10. We validated diagnoses of 2,442 patients from 1,593 families. Of these, 874 patients were misclassified corresponding to an FDR of 36%. Applying this FDR on the simulated data sets, we found that the RRR decreased from 2 and 10 to 1.4 and 5.1, respectively. Lastly, we estimated that 11% of all cases with CHD were familial. We found that approximately one of nine of all cases with CHD are familial, and we also found that 36% of individuals with CHD in administrative medical registries are misclassified, which distort the RRR in simulated scenarios.

Distribution and characteristics of slow-cycling cells in rat vocal folds.

Stem cells are known to proliferate at a slow rate in adult organs, and thus slow-cycling cells exhibiting pluripotency are considered tissue-specific stem cells in some organs. Slow-cycling cells in the vocal fold (VF) have not been well documented. Here we sought to clarify the distributions and characteristics of slow-cycling cells in rat VFs. We applied double-labeling technique to detect the distribution of slow-cycling cells. We injected the exogenous proliferation marker 5-bromo-2'-deoxyuridine (BrdU) into Sprague-Dawley rats. After a chasing period, VFs were immunostained with antibodies to BrdU and the second endogenous proliferation marker, Ki-67. BrdU (+) Ki-67(+) cells were regarded as slow-cycling cells and counted by VF regions. To reveal slow-cycling cells' characteristic, their immunophenotypes were histologically investigated and their kinetics in injured VFs were evaluated. Most slow-cycling cells were detected in the basal layer of the epithelium. Slow-cycling cells in the epithelium displayed a low positive ratio of E-cadherin and CK5 and a high positive ratio of vimentin and CD31 as compared with the other epithelial cells. The expression of S100A4 was low in slow-cycling cells of the lamina propria and the macula flava. FGFR1, HAS1, HAS2, and HAS3 were not detected in the slow-cycling cells. A time-dependent reduction of slow-cycling cells was observed in injured VFs. Most slow-cycling cells resided in the epithelium, exhibiting various phenotypes in a relatively undifferentiated condition, and they are suspected to contribute to the tissue repair of the injured VFs. N/A.

Natural history of renal cell carcinoma: An immunohistochemical analysis of growth rate in patients with delayed treatment.

To investigate the natural history of renal cell carcinoma (RCC) with delayed treatment and to immunohistochemically analyze the correlation between some biomarkers and the growth rate of RCC. We reviewed our institutional databases to identify renal tumors which were confirmed to be RCC by delayed surgical treatment after at least 12 months of active surveillance (AS). Growth rate was defined as the average growth rate of the maximal diameter on computed tomography or magnetic resonance imaging. The clinicopathological characteristics and immunohistochemical biomarkers (Ki-67, p53, bcl-2, and vascular endothelial growth factor) were analyzed the correlation with the growth rate of RCC. We identified 45 RCCs from 45 patients. The mean patient age was 54 years (range, 26-78 years). The mean tumor size increased from 2.39cm (range, 0.10-6.70cm) at presentation to 4.54cm (range, 1.40-11.80cm) after a mean time of 45.4 months (range, 12-155 months) of AS. The mean growth rate was 0.79cm/y (range, 0.10-4.74cm), and 36 (80.0%) tumors presented a growth rate≤1.00cm/y. Clear cell RCC had a trend of growing faster than other histological subtypes. Pathological grade was significantly correlated with the growth rate of RCC (p=0.043). High positive ratio of Ki-67 (r=0.351, p=0.018) and being p53 positive (p=0.019) were significantly correlated to the fast growth rate of RCC. In general, RCCs under AS are slow growing with a wide variation of growth rate, with a portion of RCCs presenting rapid growth kinetics. RCC with rapid growth during AS is characterized by a high histological grade, high positive ratio of Ki-67, and being p53 positive.

V10-01 INTRAURETERAL INDOCYANINE GREEN TO FACILITATE ROBOTIC URETEROLYSIS IN PATIENTS WITH URETERAL OBSTRUCTION DUE TO RETROPERITONEAL FIBROSIS

PPV 88.8%; NPV 89.5%; and accuracy 94.5% in detecting regional LN spread. In patients who had neo-adjuvant chemotherapy, PET/CT accurately predicted downstaging of cancer with 80% sensitivity and 80% specificity. All lesions that were suspicious for metastasis on PET/CT were found to be positive on biopsy. Recommendations of urologists changed in 17% of cases when information from PET scans were provided. 8 studies were eligible for inclusion in the meta-analysis. Pooled sensitivity and specificity for detecting local lymph node metastasis were 53% and 96% respectively. Positive likelihood ratio was 11.53. CONCLUSIONS: PET/CT has high sensitivity and specificity in detecting locoregional LN. These results indicate that PET CT has better performance characteristics than CT alone. A positive LN on PET/CT is very likely to be metastatic on pathology as based on high positive LH ratio. PET CT performed with forced diuresis can predict response to neo-adjuvant chemotherapy with relatively high accuracy.

Electric field tuning characteristic of multiple optical parametric oscillator based on MgO:QPLN

The quasi-phase matching optical parametric oscillator tuning methods, i.e. grating period tuning, temperature tuning, pumping wavelength tuning, and angle tuning are more simple and convenient than the traditional mechanical tuning which requires inserting the frequency selective element into the cavity. However, itneed to be improved for wavelength tuning in quick response and high-accuracy control. In this paper, the tunability of multiple optical parametric oscillator (MOPO) based on MgO:QPLN has been studied under an applied electric field. Based on the linear electro-optic effect of LiNbO3, we theoretically analyze the feasibility of achieving parametric light wavelengths tuning by applying electric field of particular direction on the z-direction of LiNbO3. We study the relationships between the ability of electric field tuning and the polarization structure parameters, and analyze the feasibility of MgO:QPLN with high positive and negative superlattice domain ratio for electric field tuning. The relationship of output wavelength and loading voltage is achieved by simulation. Simulation results show that the tuning rates of 1.57 μm signal light and 3.84 μm idler light are about 0.27 and 0.93 nm/kV, respectively. By reasonably controlling the temperature of MgO:QPLN crystal, tuning sections of the parametric light electric field could be linked orderly, and the output wavelength of parametric lights could be turned continuously in a wide range, which greatly expands the spectral bandwidth of the electric field tuning. In the experiment, a high-repetition-rate acousto-optic Q-switched Nd:YVO4 laser at 1064 nm is applied as the pumping source. The laser works at 200 kHz with a pulse width of 9.756 ns and its maximumouput power is 22.8 W on average. When the temperature of MgO:QPLN is stable at 20℃, the average output power of 1.57 μm signal light and 3.84 μm idler light are 1.7 and 0.72 W, respectively, and the corresponding pulse width of the two parametric lights is 9.132 and 8.463 ns. By loading proper electric field on MgO:QPLN (on-load voltage：-3000 V-+3000 V), we achieve the electric tuning of the parametric light at 3.84 μm range, and the bandwidth of spectral tuning is about 6 nm with the tuning rate approaching 1 nm/kV. Combining the temperature tuning with the electric field tuning, we further achieved high-precision continuous tuning of the parametric light in a wide spectrum range. All the final experimental results agree basically with the theoretical analysis one. In addition, results show that the electric field tuning performs better than the temperature tuning in accuracy control and quick response. For MgO:QPLN-MOPO, its irregular domain configuration could work adequately by introducing the electric tuning.