Initial screening of gastric cancer using oral contrast-enhanced trans-abdominal ultrasonography in rural asymptomatic individuals

Background & aimsInitial screening for high-risk population of gastric cancer (GC) is needed in rural areas of large-population countries. This study aims to explore the feasibility of applying noninvasive ultrasonography as an initial screening strategy to improve the early diagnosis and prevention of GC.MethodsOral contrast-enhanced trans-abdominal ultrasonography (OCTU) was initially applied to screen around 15,000 residents from 24 different rural villages of Changxing Island in Shanghai, China, facilitating the identification of high-risk population for further endoscopy examination.Results176 subjects (1.18 %) were initially identified with gastric diseases using OCTU while 14,787 ones (98.93 %) were normal with negative results. 145 out of 176 individuals (82.39 %) took further endoscopy examination, and 16 were diagnosed with GC with biopsy examination, with 9 of them at the early stage. We followed up with the Center for Disease Control and Prevention, and identified another 6 GC cases occurred within one year among OCTU-negative population, serving as an adjustment factor for sensitivity analysis. As a result, with a total of 22 GC cases included in this cohort, the positive predictive rate, the negative predictive value, sensitivity, and specificity were 9.09％, 99.96 %, 75.5 %, and 98.93 %, respectively.ConclusionsOCTU is feasible, non-invasive, low-cost, and widely acceptable in rural area, thus we proposed that OCTU is practicable to serve as a supplementary screening method to improve the early detection of GC in rural area of China and other developing countries with large population.     

Demonstration of extended field-of-view ultrasound’s potential to increase the pool of muscles for which in vivo fascicle length is measurable

Static, B-mode ultrasound is the most common method of measuring fascicle length in vivo. However, most forearm muscles have fascicles that are longer than the field-of-view of traditional ultrasound (T-US). As such, little work has been done to quantify in vivo forearm muscle architecture. The extended field-of-view ultrasound (EFOV-US) method, which fits together a sequence of B-mode images taken from a continuous ultrasound scan, facilitates direct measurements of longer, curved fascicles. Here, we test the validity and reliability of the EFOV-US method for obtaining fascicle lengths in the extensor carpi ulnaris (ECU). Fascicle lengths from images of the ECU captured in vivo with EFOV-US were compared to lengths from a well-established method, T-US. Images were collected in a joint posture that shortens the ECU such that entire fascicle lengths were captured within a single T-US image. Resulting measurements were not significantly different (p = 0.18); a Bland-Altman test demonstrated their agreement. A novice sonographer implemented EFOV-US in a phantom and in vivo on the ECU. The novice sonographer’s measurements from the ultrasound phantom indicate that the combined imaging and analysis method is valid (average error = 2.2 ± 1.3 mm) and the in vivo fascicle length measurements demonstrate excellent reliability (ICC = 0.97). To our knowledge, this is the first study to quantify in vivo fascicle lengths of the ECU using any method. The ability to define a muscle’s architecture in vivo using EFOV-US could lead to improvements in diagnosis, model development, surgery guidance, and rehabilitation techniques.     

Influence of l-arginine supplementation on reproductive blood flow and embryo recovery rates in mares

Supplementation with l-arginine can increase uterine arterial blood flow and vascular perfusion of the preovulatory follicle in mares. Increased vascular perfusion of the preovulatory follicle has been correlated with successful pregnancy in mares. The objective of this study was to determine if supplemental l-arginine would increase ovarian arterial blood flow, vascular perfusion of the preovulatory follicle, and embryo recovery rates in mares. Mares were blocked by age and breed and assigned at random within block to l-arginine supplementation or control groups. Mares were fed l-arginine beginning 17 days before and through the duration of the study. Transrectal Doppler ultrasonography was used to measure ovarian arterial blood flow and vascular perfusion of the preovulatory follicle daily when it reached 35 mm and subsequent CL on Days 2, 4, and 6. Mares, on achieving a follicle of 35 mm or more were bred via artificial insemination and an embryo collection was attempted 7 days after ovulation. Treatment did not affect interovulatory interval (arginine-treated, 18.1 ± 2.6 days; control, 20.7 ± 2.3 days) or embryo recovery rate (arginine-treated, 54%; control, 48%). Mares treated with l-arginine had a larger follicle for the 10 days preceding ovulation than control mares (30.4 ± 1.2 and 26.3 ± 1.3 mm, respectively; P < 0.05) and vascular perfusion of the dominant follicle tended (P = 0.10) to be greater for the 4 days before ovulation. No differences were observed between groups in diameter or vascular perfusion of the CL. Resistance indices, normalized to ovulation, were not significantly different between groups during the follicular or luteal phase. Oral l-arginine supplementation increased the size and tended to increase perfusion of the follicle 1, but had no effect on luteal perfusion or embryo recovery rates in mares.     

B-Mode ultrasonographic evaluation of the testis in relation to serum testosterone concentration in male Yangtze finless porpoise (Neophocaena phocaenoides asiaeorientalis) during the breeding season

The use of ultrasonography as a noninvasive tool for assessing the reproductive status of the male Yangtze finless porpoise (YFP; Neophocaena phocaenoides asiaeorientalis) was validated by correlating ultrasonographically determined testicular volume (TV) and testicular parenchyma pixel intensity (PI) with serum testosterone (T) concentration. The testes of 13 free-ranging male YFPs from the Tian-e-Zhou Reserve and three captive animals from the Baiji Dolphinarium (Wuhan, China) were examined ultrasonographically during April 2008. Testis volume was determined using Lambert's formula for an ellipsoid. Testicular parenchyma PI was evaluated by analyzing testicular ultrasonograms using pixel analysis software (Image J). Serum T concentrations were determined using a single-antibody radioimmunoassay. The TV, PI, and serum T concentration were low and similar in animals with body length <133 cm, highest in those with body length ≥142 cm, and highly variable in those with body length from 133 to 141 cm. Both TV and PI were closely correlated with serum T concentration (r = 0.91 and r = 0.85, respectively; P < 0.01), indicating a consistent association between structural and functional development of the testis. In conclusion, we inferred that puberty onset in male YFPs occurred when TV was >150 cm³ and PI was >60 during the breeding season and that testicular ultrasonography and pixel analysis was an efficient, noninvasive, real-time tool to evaluate testicular function of live male YFPs.     

肝肿瘤实时超声造影45 例分析

目的：探讨宴时超声造影在肝肿瘤诊断中的应用价值。方法：经静脉注射造影剂Sono Vue后,对45（男24、女21）例肝肿瘤患者（共63个病灶）,在低机械指数状态下进行实时超声造影检查,并对录像资料进行回放、分析诊断,与基础超声诊断结果进行比较,通过病理证实。结果：基础超声、实时超声造影对肝肿瘤病灶的检出率分别为87．3％和96．8％,最大径小于1．0cm的肿瘤,基础超声、实时超声造影对肝肿瘤病灶的检出率分别是41.7％和83．3％。基础超声有52．4％（33／63）的肿瘤边界显示不清晰,实时超声造影有6．3％（4／63）的肿瘤边界显示不清。对肝恶性肿瘤的诊断,基础超声诊断的敏感性、特异性、住确性分别是51．4％、66．7％和56．4％;实时超声造影诊断的敏感性、特异性、准确性分别为95.3％,94．4％和95．1％,两者之间差异具有统计学意义（P〈0．05）。结论：实时超声造影在发现肿瘤数目、大小、边界较基础超声提供的信息多,实时超声造影对肝肿瘤性质鉴别优于基础超声。     

Superovulation and embryo transfer in wood bison (Bison bison athabascae)

Two experiments were done to develop an effective superovulatory treatment protocol in wood bison for the purpose of embryo collection and transfer. In experiment 1, donor bison were assigned randomly to four treatment groups (N = 5 per group) to examine the effects of method of synchronization (follicular ablation vs. estradiol-progesterone treatment) and ovarian follicular superstimulation (single slow-release vs. split dose of FSH). Recipient bison were synchronized with donor bison by either follicular ablation (N = 8) or estradiol-progesterone treatment (N = 9). In experiment 2, bison were assigned randomly to four treatment groups (N = 5 per group) to examine the ovarian response to two versus four doses of FSH, and the effect of progesterone (ovarian superstimulation with or without an intravaginal progesterone-releasing device). Donor bison were inseminated with fresh chilled wood bison semen 12 and 24 hours after treatment with GnRH (experiment 1) or LH (experiment 2). The ovarian response was assessed using ultrasonography. In experiment 1, the number of large follicles (≥7 mm) increased in response to both FSH treatments, but the diameter of the largest follicle detected 4 and 5 days after the start of ovarian superstimulation was greater in bison treated with a single dose of FSH than in those treated with two doses (P < 0.05). A total of 10 ova and/or embryos were collected. One blastocyst was transferred to each of five recipient bison resulting in the birth of two live wood bison calves. In experiment 2, two doses of FSH resulted in a greater number of large follicles (≥9 mm) on Days 4, 5, and 6 (P < 0.05) after beginning of superstimulation (Day 0), and more ovulations than four doses of FSH (11.2 ± 2.4 vs. 6.4 ± 0.8; P < 0.05). Embryo collection was performed on only five donors, and a total of 19 ova and/or embryos were recovered. In summary, fewer FSH treatments were as good or better than multiple treatments, consistent with the notion that minimizing handling stress improves the superovulatory response in bison. Follicular ablation and estradiol plus progesterone treatment were effective for inducing ovarian synchronization in embryo donor and recipient bison, and an intravaginal progesterone-releasing device during superstimulatory treatment did not influence the superovulatory response or embryo collection. Delaying ovulation-inducing treatment (GnRH or LH) to 5 days after superstimulatory treatment resulted in a greater number of ovulations and improved embryo collection efficiency (experiment 2). Embryo collection and transfer resulted in live offspring from wild wood bison.     

Re-use of intravaginal progesterone devices associated with the Short-term Protocol for timed artificial insemination in goats

Because intravaginal devices impregnated with 0.3 g of progesterone (i.e., CIDR-G) contain remaining hormone after their use in a Short-term Protocol (5 to 7 d of treatment), the reuse of these devices is proposed in goats. Two experiments were designed to study the effects of the reutilization of CIDR-G, establishing serum progesterone concentrations, follicular development, ovulatory response, and fertility. Experiment 1: Thirty dairy goats received a Short-term Protocol for 5 d using CIDR-G of first use (new devices, n = 10), second use (previously used for 5 d, n = 10), or third use (previously used twice for 5 d each time, n = 10). Goats were given (im) prostaglandin F_2α (10 mg dinoprost) and eCG (300 IU) at device insertion and withdrawal, respectively. Serum progesterone concentrations induced by CIDR-G of first use were higher than CIDR-G of second or third use (P < 0.05); concentrations were consistently > 1 ng/mL in all females treated with reused devices. Estrus and ovulation were synchronized in 100% of goats (no differences among treatments). All females treated with new devices, but only 80% of females treated with re-used devices ovulated a new follicle that emerged after CIDR-G insertion (P = NS). Ovulation occurred between 60 and 70 h after device removal (no differences among groups). Experiment 2: In goats subjected to a Short-term Protocol followed by AI at 54 h after CIDR-G, pregnancy rates with CIDR-G of first, second, and third use were 75.3% (64/85), 67.4% (60/89), and 62.1% (54/87), respectively (devices of first versus third use, P < 0.05). In summary, intravaginal devices originally containing 0.3 g of progesterone appeared effective to synchronize estrus and ovulation after first, second and third use in the Short-term Protocol. Although the pregnancy rate with reused devices was acceptable (i.e., > 60%), it was significantly lower than that achieved with new devices and further studies to ensure adequate follicular turnover are required.     

Effect of intraovarian proximity between dominant follicle and corpus luteum on dimensions and blood flow of each structure in heifers

An intraovarian positive physiologic coupling between the extant CL and the ipsilateral preovulatory follicle (PF) or the future or established postovulatory dominant follicle (DF) was studied in 26 heifers. Ovaries were scanned by ultrasonic imaging from Day 16 (Day 0 = ovulation) of the preovulatory period until Day 6 of the postovulatory period. Hemodynamics of the follicles and CL were assessed by color-Doppler ultrasonography. When the PF and CL were ipsilateral compared with contralateral, blood-flow resistance in wall of the PF was lower (P < 0.04) on Days –2 and –1, and percentage blood-flow signals in the CL approached being greater (P < 0.08) on Days –4 to –1. During the postovulatory period, percentage of DF wall with blood-flow signals (44.1 ± 1.2% vs. 31.4 ± 2.8%) and percentage of CL with blood-flow signals (51.8 ± 1.2% vs. 42.5 ± 3.1%) were each greater (P < 0.05) when the two ipsilateral structures were adjacent (distance between antrum and CL wall, ≤ 3 mm) than when separated. On Day 0, the distance between follicle and ipsilateral CL was less (P < 0.02) for the future DF than for the future largest subordinate. Growth rate between Days 0 and 2 averaged over all growing follicles was greater (P < 0.01) when the follicles were ≤3 mm from the CL (1.1 ± 0.1 mm/day) than when farther from the CL (0.9 ± 0.1 mm/day). Results supported the hypotheses that (1) a positive intraovarian coupling occurs between the PF or postovulatory DF and the extant CL and (2) the coupling is enhanced when the ipsilateral DF and CL are in close proximity.     

Early vs. late rate of torque development: Relation with maximal strength and influencing factors

We re-examined the relationship between rate of torque development (RTD) and maximal voluntary contractions (MVC) torque, and investigated some possible neuromuscular determinants of early (≤100 ms) and late (≥200 ms) RTD. Seventeen healthy men performed maximal explosive isometric knee extensions at five joint angles, from which MVC torque, RTD at different time intervals (50–250 ms), and early quadriceps EMG activity (EMG₅₀) were evaluated. Quadriceps muscle thickness (MT) was quantified by longitudinal ultrasonography. The relationship between MVC torque, EMG₅₀ and MT against RTD was assessed with Pearson’s and repeated measures correlation coefficients. Moderate-to-strong correlation coefficients were observed between MVC torque and RTD (r = 0.50–0.88, p < 0.001), with stronger relationships for late RTD than for early RTD. Weak-to-strong correlation coefficients were observed amongst RTD and EMG₅₀ (r = 0.37–0.83, p < 0.001), with stronger relationships for early RTD than for late RTD. Only late RTD was significantly correlated with MT, though only moderately (r = 0.50–0.52, p < 0.05). These findings suggest that early and late knee extension RTD are potentially governed by different neuromuscular factors. Neuromuscular activation seems to have a greater influence on early RTD than on late RTD, and vice versa for muscle mass.     

卷尾猴的卵泡生长发育及排卵的超声监测

目的建立卷尾猴正常月经周期卵泡生长发育变化规律及排卵的超声监测(ultrasound examination,US)技术。方法采用阴道细胞涂片及超声监测技术,对5只卷尾猴连续3个周期检查阴道细胞变化,对卵泡生长发育进行超声监测。结果阴道脱落细胞在生殖周期内呈周期性变化,月经周期为(21.13±2)d。阴道细胞学涂片显示卷尾猴的月经周期分为以下各期:月经期(menstrual phase,M)、滤泡期(follicular phase,F)、排卵前期(pre-ovulationphase,Po),黄体期(luteal phase,L)。US技术在滤泡期及排卵前期可观测到直径约3~9 mm的优势卵泡(dominantfollicle,DF)的生长过程。当DF较前一天至少小10%,轮廓不规则,回声较以前强,阴道细胞涂片显示淋巴细胞出现,提示排卵已发生,黄体开始形成。结论B型超声技术能实时监测卷尾猴的卵泡生长发育过程,预知优势卵泡排卵时间。