Serum neurone-specific enolase (NSE) and computerized tomography (CT) stroke volume were compared in patients admitted within 24 h of an acute stroke. Serum samples were obtained on admission and daily for the next 4 days. Of 163 patients, CT scans revealed 25 with intracerebral haemorrhages, one haemorrhagic infarct and 83 measurable acute infarcts. The serum NSE levels of those with infarcts was significantly higher than in those with haemorrhages at 48 (P = 0.0003) and 72 h (P = 0.04). The maximum serum NSE value tended to occur later in those with large infarcts (P = 0.0035). There was a significant correlation between infarct volume and serum NSE at 48 h (r = 0.27, P = 0.015) and 96 h (r = 0.27, P = 0.015) and with the maximum serum NSE over the 4 days (r = 0.36, P = 0.001). There was no significant correlation between haemorrhage volume and NSE. In conclusion, serum NSE may be a useful marker of infarct volume in studies of therapy in acute stroke. Sampling for NSE should continue, at least in those with large infarcts, for longer than 4 days. Serum NSE cannot be used to distinguish between haemorrhage and infarction in patients with an acute stroke.
Breast and pectoral muscle segmentation is an essential pre-processing step for the subsequent processes in computer aided diagnosis (CAD) systems. Estimating the breast and pectoral boundaries is a difficult task especially in mammograms due to artifacts, homogeneity between the pectoral and breast regions, and low contrast along the skin-air boundary. In this paper, a breast boundary and pectoral muscle segmentation method in mammograms is proposed. For breast boundary estimation, we determine the initial breast boundary via thresholding and employ Active Contour Models without edges to search for the actual boundary. A post-processing technique is proposed to correct the overestimated boundary caused by artifacts. The pectoral muscle boundary is estimated using Canny edge detection and a pre-processing technique is proposed to remove noisy edges. Subsequently, we identify five edge features to find the edge that has the highest probability of being the initial pectoral contour and search for the actual boundary via contour growing. The segmentation results for the proposed method are compared with manual segmentations using 322, 208 and 100mammograms from the Mammographic Image Analysis Society (MIAS), INBreast and Breast Cancer Digital Repository (BCDR) databases, respectively. Experimental results show that the breast boundary and pectoral muscle estimation methods achieved dice similarity coefficients of 98.8% and 97.8% (MIAS), 98.9% and 89.6% (INBreast) and 99.2% and 91.9% (BCDR), respectively.
Cetirizine (once daily), a highly selective H1-antagonist, is efficacious for treating seasonal allergic rhinitis (SAR), perennial allergic rhinitis, and chronic idiopathic urticaria. A 4-week, randomized, double-blind, placebo-controlled trial investigated the safety and efficacy of cetirizine syrup (5 or 10 mg daily) in 209 children ages 6 to 11 years with SAR. Parents assisted patients in recording symptom severity (sneezing, nasal discharge, itchy eyes, itchy nose or mouth, conjunctivitis, nasal congestion) daily. A total symptom severity (TSS) score was derived from all symptoms, excluding nasal congestion. At baseline, TSS was comparable for all groups (range 6.8-7.0). Cetirizine 10 mg produced a significantly greater mean TSS reduction (3.2) than placebo (P < 0.05) over the treatment period. Cetirizine 5 mg once daily produced mean reductions in weekly symptom scores of 2.4; this did not differ statistically from placebo. Furthermore, cetirizine 10 mg significantly improved symptoms of itchy eyes, nose, or mouth. The most commonly reported adverse reactions to both cetirizine and placebo were headache, pharyngitis, and abdominal pain, which did not occur with an incidence statistically different from that of placebo. Once-daily cetirizine is safe for treating SAR in children ages 6-11 years. Once-daily cetirizine 10 mg provides effective improvement in symptoms and is well tolerated.
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