2011-01-01·Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology1区 · 医学

Improving the preoperative classification of adnexal masses as benign or malignant by second‐stage tests

1区 · 医学

Article

作者: Van Holsbeke, C. ; Fruscio, R. ; Ombelet, W. ; Bourne, T. ; Czekierdowski, A. ; Guerriero, S. ; Rossi, A. ; Melis, G. B. ; Timmerman, D. ; Valentin, L. ; Vergote, I. ; De Moor, B. ; Daemen, A. ; Jurkovic, D.

Abstract:

Objective:

The aim of this study was to establish when a second‐stage diagnostic test may be of value in cases where a primary diagnostic test has given an uncertain diagnosis of the benign or malignant nature of an adnexal mass.

Methods:

The diagnostic performance with regard to discrimination between benign and malignant adnexal masses for mathematical models including ultrasound variables and for subjective evaluation of ultrasound findings by an experienced ultrasound examiner was expressed as area under the receiver–operating characteristics curve (AUC), sensitivity and specificity. These were calculated for the total study population of 1938 patients with an adnexal mass as well as for subpopulations defined by the certainty with which the diagnosis of benignity or malignancy was made. The effect of applying a second‐stage test to the tumors where risk estimation was uncertain was determined.

Results:

The best mathematical model (LR1) had an AUC of 0.95, sensitivity of 92% and specificity of 84% when applied to all tumors. When model LR1 was applied to the 10% of tumors in which the calculated risk fell closest to the risk cut‐off of the model, the AUC was 0.59, sensitivity 90% and specificity 21%. A strategy where subjective evaluation was used to classify these 10% of tumors for which LR1 performed poorly and where LR1 was used in the other 90% of tumors resulted in a sensitivity of 91% and specificity of 90%. Applying subjective evaluation to all tumors yielded an AUC of 0.95, sensitivity of 90% and specificity of 93%. Sensitivity was 81% and specificity 47% for those patients where the ultrasound examiner was uncertain about the diagnosis (n = 115; 5.9%). No mathematical model performed better than did subjective evaluation among the 115 tumors where the ultrasound examiner was uncertain.

Conclusion:

When model LR1 is used as a primary test for discriminating between benign and malignant adnexal masses, the use of subjective evaluation of ultrasound findings by an experienced examiner as a second‐stage test in the 10% of cases for which the model yields a risk of malignancy closest to its risk cut‐off will improve specificity without substantially decreasing sensitivity. However, none of the models tested proved suitable as a second‐stage test in tumors where subjective evaluation yielded an uncertain result. Copyright © 2010 ISUOG. Published by John Wiley & Sons, Ltd.

2006-01-01·Swedish dental journal

Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri.

Article

作者: Paulsson, Annette ; Sinkiewicz, Gabriela ; Carlsson, Birgitta ; Krasse, Per ; Nilsson, Asa ; Dahl, Carina

The primary aim of this study was to assess if the probiotic Lactobacillus reuteri could be effective in the treatment of gingivitis and further to evaluate the influence of the probiotic on plaque and the lactobacilli population in the saliva. A randomised, placebo-controlled, double blind study was performed over 2 weeks. Fifty-nine patients with moderate to severe gingivitis were included and given one of two different Lactobacillus reuteri formulations (LR-1 or LR-2) at a dose of 2 x 10(8) CFU per day, or a corresponding placebo. At baseline (day 0) gingival index and plaque index were measured on two surfaces and saliva for lactobacilli determination was collected. The patients were instructed how to brush and floss efficiently and study treatment was started.The patients returned on day 14 for final assessment of gingivitis and plaque and saliva was collected. 20 patients were randomised to LR-1, 21 to LR-2 and 18 to placebo. Gingival index fell significantly in all 3 groups (p < 0.0001). LR-1, but not LR-2 improved more than placebo (p < 0.0001). Plaque index fell significantly in LR-1 (p < 0.05) and in LR-2 (p < 0.01) between day o and day 14 but there was no significant change in the placebo group. At day 14, 65% of the patients in LR-1 were colonised with Lactobacillus reuteri and 95% in the LR-2 group. Lactobacillus reuteri was efficacious in reducing both gingivitis and plaque in patients with moderate to severe gingivitis.

2004-07-01·The Journal of heredity

Genetics of Resistance to Two Strains of Soybean Mosaic Virus in Differential Soybean Genotypes

Article

作者: Tolin, S. A. ; Ma, G. ; Chen, P. ; Buss, G. R.

There are seven pathotypes of soybean mosaic virus (SMV) representing seven strain groups (G1-G7) in the United States. Soybean genotypes [Glycine max (L.) Merr.] may exhibit resistant (R), susceptible (S), or necrotic (N) reactions upon interacting with different SMV strains. This research was conducted to investigate whether reactions to two SMV strains are controlled by the same gene or by separate genes. Two SMV-resistant soybean lines, LR1 and LR2, were crossed with the susceptible cultivar Lee 68. LR1 contains a resistance gene Rsv1-s and is resistant to strains G1-G4 and G7. LR2 contains the Rsv4 gene and is resistant to strains G1-G7. Two hundred F(2:3) lines from LR1 x Lee 68 and 262 F(2:3) lines from LR2 x Lee 68 were screened for SMV reaction. Seeds from each F2 plant were randomly divided into two subsamples. A minimum of 20 seeds from each subsample were planted in the greenhouse and plants were inoculated with either G1 or G7. G1 is the least virulent, whereas G7 is the most virulent strain of SMV. The results showed that all the F(2:3) lines from both crosses exhibited the same reaction to G1 and G7. No recombinants were found in all the progenies for reactions to G1 and G7 in either cross. The results indicate that reactions to both G1 and G7 are controlled by either the same gene or very closely linked genes. This research finding is valuable for studying the resistance mechanism and interactions of soybean genotypes and SMV strains and for breeding SMV resistance to multiple strains.

100 项与 LR1 相关的药物交易

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