BackgroundIn recent years, magnetic resonance imaging (MRI) has become important in brain tumor diagnosis. Using this modality, physicians can locate specific pathologies by analyzing differences in tissue character presented in different types of MR images.This paper uses an algorithm integrating fuzzy-c-mean (FCM) and region growing techniques for automated tumor image segmentation from patients with menigioma. Only non-contrasted T1 and T2 -weighted MR images are included in the analysis. The study's aims are to correctly locate tumors in the images, and to detect those situated in the midline position of the brain.MethodsThe study used non-contrasted T1- and T2-weighted MR images from 29 patients with menigioma. After FCM clustering, 32 groups of images from each patient group were put through the region-growing procedure for pixels aggregation. Later, using knowledge-based information, the system selected tumor-containing images from these groups and merged them into one tumor image. An alternative semi-supervised method was added at this stage for comparison with the automatic method. Finally, the tumor image was optimized by a morphology operator. Results from automatic segmentation were compared to the "ground truth" (GT) on a pixel level. Overall data were then evaluated using a quantified system.ResultsThe quantified parameters, including the "percent match" (PM) and "correlation ratio" (CR), suggested a high match between GT and the present study's system, as well as a fair level of correspondence. The results were compatible with those from other related studies. The system successfully detected all of the tumors situated at the midline of brain.Six cases failed in the automatic group. One also failed in the semi-supervised alternative. The remaining five cases presented noticeable edema inside the brain. In the 23 successful cases, the PM and CR values in the two groups were highly related.ConclusionsResults indicated that, even when using only two sets of non-contrasted MR images, the system is a reliable and efficient method of brain-tumor detection. With further development the system demonstrates high potential for practical clinical use.

Age, gender, and BC should be taken into considerations at interpretation of PVR tests in children. Repeating PVR test is recommended when a single PVR is higher than the 95th percentile of age- and gender-specific PVR. Neurourol. Urodynam. 32: 1014-1018, 2013. © 2013 Wiley Periodicals, Inc.

BackgroundUreteral obstruction caused by extrinsic compression is often associated with intra-abdominal cancers. Internal drainage with ureteral stents is typically the first-line therapy to relieve such obstructions. Novel designs of ureteral stents made of different materials have been invented to achieve better drainage. In this study, we described the functional outcomes of a Resonance metallic ureteral stent (Cook Medical, Bloomington, Indiana, USA) in patients with malignant ureteral obstruction and compare the functional duration of Resonance stents with regular polymeric stents in the same cohort.MethodsCancer patients who received polymeric stents and subsequent Resonance stents for ureteral obstruction between July 2009 and November 2012 were included in a chart review. Stent failure was detected by clinical symptoms, imaging studies, and renal function tests. The functional durations of each stent were calculated, and possible factors affecting stent patency were investigated.ResultsA total of 50 stents were successfully inserted into 50 ureteral units in 42 patients with malignant ureteral obstruction. There were 7 antegrade stents and 43 retrograde stents. There were no major complications. Stent-related symptoms were similar in both kinds of stents. After polymeric stents were replaced with Resonance metallic stents, hydronephrosis subsided or remained stable in 90% (45/50) of the ureteral units. Serum creatinine decreased or remained stable in 90% (38/42) of these patients. The Resonance stent exhibited a mean increase in functional duration of 4 months compared with the polymeric stents (p<0.0001), and 50% (25/50) of the Resonance stents exhibited a significant increase in functional duration (more than 3 months). Pre-operative serum creatinine < 2 was associated with a substantial increase in stent duration.ConclusionsResonance stents are effective and safe in relieving malignant ureteral obstructions after polymeric stents failure. Resonance stents can provide a longer functional duration than polymeric stents and should be offered as an option for internal drainage.

TRUS guided prostate needle biopsy is a safe diagnostic tool in most elderly males with or without systemic underlying disease.

Objectives:To prospectively evaluate the effectiveness of tamsulosin in treating women with voiding difficulty. Methods: Female patients presenting chronic, bothersome voiding symptoms, combined with subnormal uroflow were treated with 0.2 mg tamsulosin daily for six weeks. Outcome analyses included the International Prostate Symptom Score and uroflowmetry with post-void residual urine. Patients achieving a 50% or greater reduction in their voiding symptom score, combined with a 30% or greater increment in their maximal flow rate were regarded as having a good therapeutic response. Subgroup analysis was performed in patients classified as having bladder outlet obstruction, or detrusor underactivity based on pressure-flow study, excluding those with indwelling catheterization or intermittent selfcatheterization as well as those with anatomic obstruction. Results: Ninety-seven patients met the study inclusion criteria and were enrolled. Significant improvements in voiding symptom score, storage symptom score, maximal flow rate, post-void residual urine and voiding efficiency were observed in all patients while on tamsulosin. A good therapeutic response was observed in 35.1% of patients. Of these, 33 were classified as having bladder outlet obstruction and 52 had detrusor underactivity. Although both groups experienced significant reduction in their voiding symptom scores, patients with bladder outlet obstruction were more likely to achieve a reduction of their voiding symptom score. The magnitude of improvement in uroflow parameters as well as the proportion of patients achieving a good therapeutic response (39.4% for bladder outlet obstruction vs 32.7% for detrusor underactivity, P = 0.69) were similar between the two groups. Adverse events were mild and tolerable. Conclusions: Tamsulosin has beneficial effects in a significant proportion of women with voiding difficulty.

Efficient identification of patient, intervention, comparison, and outcome (PICO) components in medical articles is helpful in evidence-based medicine. The purpose of this study is to clarify whether first sentences of these components are good enough to train naive Bayes classifiers for sentence-level PICO element detection. We extracted 19,854 structured abstracts of randomized controlled trials with any P/I/O label from PubMed for naive Bayes classifiers training. Performances of classifiers trained by first sentences of each section (CF) and those trained by all sentences (CA) were compared using all sentences by ten-fold cross-validation. The results measured by recall, precision, and F-measures show that there are no significant differences in performance between CF and CA for detection of O-element (F-measure=0.731±0.009 vs. 0.738±0.010, p=0.123). However, CA perform better for I-elements, in terms of recall (0.752±0.012 vs. 0.620±0.007, p<0.001) and F-measures (0.728±0.006 vs. 0.662±0.007, p<0.001). For P-elements, CF have higher precision (0.714±0.009 vs. 0.665±0.010, p<0.001), but lower recall (0.766±0.013 vs. 0.811±0.012, p<0.001). CF are not always better than CA in sentence-level PICO element detection. Their performance varies in detecting different elements.

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Obese community children were at a higher risk of having OAB while not for MNE.