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- Benton, S., et al.
(författare)
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Impact of Next-generation Sequencing on Interobserver Agreement and Diagnosis of Spitzoid Neoplasms
- 2021
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Ingår i: American Journal of Surgical Pathology. - : Ovid Technologies (Wolters Kluwer Health). - 0147-5185 .- 1532-0979. ; 45:12, s. 1597-1605
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Tidskriftsartikel (refereegranskat)abstract
- Atypical Spitzoid melanocytic tumors are diagnostically challenging. Many studies have suggested various genomic markers to improve classification and prognostication. We aimed to assess whether next-generation sequencing studies using the Tempus xO assay assessing mutations in 1711 cancer-related genes and performing whole transcriptome mRNA sequencing for structural alterations could improve diagnostic agreement and accuracy in assessing neoplasms with Spitzoid histologic features. Twenty expert pathologists were asked to review 70 consultation level cases with Spitzoid features, once with limited clinical information and again with additional genomic information. There was an improvement in overall agreement with additional genomic information. Most significantly, there was increase in agreement of the diagnosis of conventional melanoma from moderate (kappa=0.470, SE=0.0105) to substantial (kappa=0.645, SE=0.0143) as measured by an average Cohen kappa. Clinical follow-up was available in all 70 cases which substantiated that the improved agreement was clinically significant. Among 3 patients with distant metastatic disease, there was a highly significant increase in diagnostic recognition of the cases as conventional melanoma with genomics (P<0.005). In one case, none of 20 pathologists recognized a tumor with BRAF and TERT promoter mutations associated with fatal outcome as a conventional melanoma when only limited clinical information was provided, whereas 60% of pathologists correctly diagnosed this case when genomic information was also available. There was also a significant improvement in agreement of which lesions should be classified in the Spitz category/WHO Pathway from an average Cohen kappa of 0.360 (SE=0.00921) to 0.607 (SE=0.0232) with genomics.
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- Cung, T. -T., et al.
(författare)
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Cyclosporine before PCI in Patients with Acute Myocardial Infarction
- 2015
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Ingår i: New England Journal of Medicine. - 0028-4793. ; 373:11, s. 1021-1031
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND Experimental and clinical evidence suggests that cyclosporine may attenuate reperfusion injury and reduce myocardial infarct size. We aimed to test whether cyclosporine would improve clinical outcomes and prevent adverse left ventricular remodeling. METHODS In a multicenter, double-blind, randomized trial, we assigned 970 patients with an acute anterior ST-segment elevation myocardial infarction (STEMI) who were undergoing percutaneous coronary intervention (PCI) within 12 hours after symptom onset and who had complete occlusion of the culprit coronary artery to receive a bolus injection of cyclosporine (administered intravenously at a dose of 2.5 mg per kilogram of body weight) or matching placebo before coronary recanalization. The primary outcome was a composite of death from any cause, worsening of heart failure during the initial hospitalization, rehospitalization for heart failure, or adverse left ventricular remodeling at 1 year. Adverse left ventricular remodeling was defined as an increase of 15% or more in the left ventricular end-diastolic volume. RESULTS A total of 395 patients in the cyclosporine group and 396 in the placebo group received the assigned study drug and had data that could be evaluated for the primary outcome at 1 year. The rate of the primary outcome was 59.0% in the cyclosporine group and 58.1% in the control group (odds ratio, 1.04; 95% confidence interval, 0.78 to 1.39; P = 0.77). Cyclosporine did not reduce the incidence of the separate clinical components of the primary outcome or other events, including recurrent infarction, unstable angina, and stroke. No significant difference in the safety profile was observed between the two treatment groups. CONCLUSIONS In patients with anterior STEMI who had been referred for primary PCI, intravenous cyclosporine did not result in better clinical outcomes than those with placebo and did not prevent adverse left ventricular remodeling at 1 year. (Funded by the French Ministry of Health and NeuroVive Pharmaceutical; CIRCUS ClinicalTrials.gov number, NCT01502774; EudraCT number, 2009-013713-99.)
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- Emri, M., et al.
(författare)
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Software development framework supporting multimodal tomographic imaging
- 2007
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Ingår i: 2006 IEEE Nuclear Science Symposium Conference Record. - : IEEE. - 1424405610 - 9781424405619 ; , s. 1857-1859
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Konferensbidrag (refereegranskat)abstract
- Engineers specialized in multimodal tomography regularly face a wide scale of programming tasks requiring an integrated software system to ensure cost efficiency. Accordingly, a software development framework has been worked out comprising libraries for cluster-based data acquisition, image reconstruction, management of data files and complex multimodal volumetric visualization. This framework enabled us to develop complex software for our miniPET project [1]. This software contains a graphical application integrating data acquisition, cluster monitoring, event sorting, image reconstruction, interactive image processing tools for advanced multimodal visualization. It also contains utilities to solve these tasks without graphical user interface. The components of our acquisition program can run on embedded Linux systems making new ways to develop any other types of data acquisition software that uses embedded Linux systems. A versatile development framework is developed containing specific libraries and special file formats that support multimodal tomography. This framework was successfully used to elaborate our complex miniPET software.
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- Hegyesi, G., et al.
(författare)
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Development of an FPGA-based data acquisition module for small animal PET
- 2004
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Ingår i: 2004 IEEE Nuclear Science Symposium Conference Record. - 0780387007 ; , s. 2957-2961
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Konferensbidrag (refereegranskat)abstract
- We report on the design of a DAQ module for a small animal PET camera developed at our institutes. During the design an important guideline was to develop a system which is built up from strictly identical DAQ modules, and which has no built-in hardware limitation on the maximum number of modules. The developed DAQ module comprises of an LSO scintillator crystal block, a position sensitive PMT, analog signal conditioning circuits, a digitizer, an FPGA for digital signal processing and a communication module through which the collected data is sent to a cluster of computers for post processing and storage. Instead of implementing hardware coincidence detection between the modules we attach a precise time-stamp to each event in our design, and the coincidence is determined by the data collecting computers during the post processing. The digital CFD algorithm implemented in the FPGA gives a time resolution of 2 to 3 ns FWHM for real detector signals.
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