Reproducibility of perfusion CT derived CBV and rCBV measurements with different slice thickness in patients with brain neoplasms

Objective:To assess inter-and intraobserver reproducibility for measuring perfusion CT derived cerebral blood volume (CBV) and relative cerebral blood volume (rCBV) with different slice thickness in patients with brain neoplasms. Meth- ods: Three independent observers who were blinded to the histopathologic diagnosis performed perfusion derived CBV and rCBV measurements with 5 mm and 10 mm slice thickness in 52 patients with various cerebral neoplasms. The results of the measurements with different slice thickness were compared. Calculation of coefficient of variation (CV), and relative paired difference of the measurements were used to determine the levels of inter- and intraobserver reproducibility. Results: The differences of CBV and rCBV measurements between different slice thickness groups were statistically significant (P < 0.05) respectively in observer 2, and were not significant in the other two observers (P > 0.05). For the same slice thickness, both the difference of CBV and rCBV measurements among the three observers were not statistically significant. Interobserver CV and relative paired difference of the measurements with 10 mm slice thickness group were slightly lower than those of 5 mm slice thickness group. Interobserver CV and relative paired difference of CBV group were slightly lower than those of rCBV group. The intraobserver differences of CBV and rCBV in 10 mm slice thickness group were statistically significant for observer 2 respectively. No other intraobserver differences of measurements were statistically significant. CV and relative paired difference of intraobserver CBV and rCBV measurements for observer 2 were significantly higher than for the other two observers. Conclusion: High reproducibility of CBV and rCBV measurements was acquired with the two different slice thickness. Suitable training may be helpful to maintain a high level of consistency for measurements.

Serum positive cagA in patients with non-ulcer dyspepsia and peptic ulcer disease from two centers in different regions of Turkey

AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One hundred and eighty Helicobacter pyloripositive patients with peptic ulcer disease or non-ulcer dyspepsia were included in the study. One hundred and fourteen patients had non-ulcer dyspepsia and 66 had peptic ulcer disease (32 with gastric ulcers and/or erosions and 34with duodenal ulcers). Each patient was tested for serum antibody to H. pylori cagA protein by enzyme immunoassay.RESULTS: The total frequency of serum positive cagA in the study group was 97.2 %. The rates in the patients with peptic ulcers and in those with non-ulcer dyspepsia were 100% and 95.6%, respectively. These results were similar to those reported in Asian studies, but higher than those that have been noted in other studies from Turkey and Western countries.CONCLUSION: The high rates of serum positive cagA in these patients with peptic ulcer disease and non-ulcer dyspepsia were similar to results reported in Asia. The fact that there was high seroum prevalence regardless of ulcer status suggests that factors other than cagA might be responsible for ulceration or other types of severe pathology in H. pylori-positive individuals.

Measuring episodic abdominal pain and disability in suspected sphincter of Oddi dysfunction

AIM:To evaluate the reliability of an instrument that measures disability arising from episodic abdominal pain in patients with suspected sphincter of Oddi dysfunction(SOD).METHODS:Although several treatments have been utilized to reduce pain and associated disability,measurement tools have not been developed to reliably track outcomes.Two pilot studies were conducted to assess test-retest reliability of a newly developed instrument,the recurrent abdominal pain intensity and disability(RAPID) instrument.The RAPID score is a 90-d summation of days where productivity for various daily activities is reduced as a result of abdominal pain episodes,and is modeled after the migraine disability assessment instrument used to measure headache-related disability.RAPID was administered by telephone on 2 consecutive occasions in 2 consenting populations with suspected SOD:a pre-sphincterotomy population(Pilot Ⅰ,n = 55) and a post-sphincterotomy population(Pilot Ⅱ,n = 70).RESULTS:The average RAPID scores for Pilots Ⅰ and Ⅱ were:82 d(median:81.5 d,SD:64 d) and 48 d(median:0 d,SD:91 d),respectively.The concordance between the 2 assessments for both populations was very good:0.81 for the pre-sphincterotomy population and 0.95 for the post-sphincterotomy population.CONCLUSION:The described pilot studies suggest that RAPID is a reliable instrument for measuring disability resulting from abdominal pain in suspected SOD patients.

Influencing factors of rat small intestinal epithelial cell cultivation and effects of radiation on cell proliferation

INTRODUCTIONCrypt epithelial cells in normal small intestineproliferate at a high speed. But they are verydifficult to culture in vitro and passage stably. A lotof studies have been done[1-16]. Some domestic labsisolated and cultured crypt cells from embryonalintestines and aseptic animal intestine, but failed.We introduced normal rat epithelial cell line-IEC-6from the USA and its living condition for stablepassage was successfully established after trials. Thecell line was testified to be the small intestinalepithelial cell by electron microscopy,immunihistochemistry and enzymatic histoch-emistry. It has been applied to some relatedresearch work[17-21]. It was found that manyfactors were involved in the culture system. Ourpresent study focuses on the culture method and theinfluencing factors on IEC-6.

Is laparoscopy an advantage in the diagnosis of cirrhosis in chronic hepatitis C virus infection?

AIM:To evaluate the potential of laparoscopy in the diagnosis of cirrhosis and outcome of interferon treatment in HCV-infected patients. METHODS:In this retrospective study,diagnostic laparoscopy with laparoscopic liver biopsy was performed in 72 consecutive patients with chronic HCV infection.The presence or absence of drrhosis was analyzed macroscopically by laparoscopy and microscopically by liver biopsy specimens.Clinical and laboratory data and outcome of interferon-alfa treatment were compared between cirrhotic and noncirrhotic patients. RESULTS:Laparoscopically,cirrhosis was seen in 29.2 % (21/72)and non-cirrhosis in 70.8 %(51/72)of patients. Cirrhotic patients were significantly older with a significant longer duration of HCV infection than noncirrhotic patients. Laboratory parameters(AST,y-GT,y-globulin fraction)were measured significantly higher as well as significantly lower (prothrombin index,platelet count)in cirrhotic patients than in non-cirrhotic patients.Histologically,cirrhosis was confirmed in 11.1%(8/72)and non cirrhosis in 88.9 %(64/72).Patients with macroscopically confirmed cirrhosis(n=21)showed histologically cirrhosis in 38.2 %(8/21)and histologically non- cirrhosis in 61.9 %(13/21).In contrast,patients with macroscopically non-cirrhosis(n=51)showed histologically non cirrhosis in all cases(51/51).Thirty-nine of 72 patients were treated with interferon-alfa,resulting in 35.9 %(14/39) patients with sustained response and 64.1%(25/39)with non response.Non-responders showed significantly more macroscopically cirrhosis than sustained responders.In contrast,there were no significant histological differences between non-responders and sustained responders. CONCLUSION:Diagnostic laparoscopy is more accurate than liver biopsy in recognizing cirrhosis in patients with chronic HCV infection.Liver biopsy is the best way to assess inflammatory grade and fibrotic stage.The invasive marker for staging,prognosis and management,and treatment outcome of chronic HCV-infected patients need further research and dinical thals.Laparoscopy should be performed for recognition of drrhosis if this parameter is found to be of prognostic and therapeutic relevance in patients with chronic HCV infection.

A 3D-printable device allowing fast and reproducible longitudinal preparation of mouse intestines

Accurate and reproducible analysis of murine small and large intestinal tissue is key for preclinical models involving intestinal pathology.Currently,there is no easily ac-cessible,standardized method that allows researchers of different skill levels to con-sistently dissect intestines in a time-efficient manner.Here,we describe the design and use of the 3D-printed“Mouse Intestinal Slicing Tool”(MIST),which can be used to longitudinally dissect murine intestines for further analysis.We benchmarked the MIST against a commonly used procedure involving scissors to make a longitudinal cut along the intestines.Use of the MIST halved the time per mouse to prepare the intestines and outperformed alternative methods in smoothness of the cutting edge and overall reproducibility.By sharing the plans for printing the MIST,we hope to contribute a uniformly applicable method for saving time and increasing consistency in studies of the mouse gastrointestinal tract.

Chronic liver disease questionnaire:Translation and validation in Thais

AIM:Quality of life (QOL) is a concept that incorporates many aspects of life beyond“health”.The chronic liver disease questionnaire (CLDQ) was developed to evaluate the impact of chronic liver diseases (CLD) on QOL.The objectives of this study were to translate and validate a liver specific questionnaire,the CLDQ. METHODS:The CLDQ was formally translated from the original version to Thai language with permission.The translation process included forward translation,back translation,cross-cultural adaptation and a pretest.Reliability and validity of the translated version was examined in CLD patients.Enrolled subjects included CLD and normal subjects with age- and sex-matched.Collected data were demography, physical findings and biochemical tests.All subjects were asked to complete the translated versions of CLDQ and SF- 36,which was previously validated.Cronbach's alpha and test-retest were performed for reliability analysis.One-way Anova or non-parametric method was used to determine discriminant validity.Speerman's rank correlation was used to assess convergent validity.P-value<0.05 was considered statistically significant. RESULTS:A total of 200 subjects were recruited into the study,with 150 CLD and 50 normal subjects.Mean ages (SD) were 47.3(11.7) and 49.1(8.5) years,respectively.The number of chronic hepatitis:cirrhosis was 76:74,and the ratio of cirrhotic patients classified as Child A:B:C was 37 (50%):26(35%):11(15%).Cronbach's alpha of the overall CLDQ scores was 0.96 and of all domains were higher than 0.93.Item-total correlation was>0.45.Test-retest reliability done at 1 to 4 wk apart was 0.88 for the average CLDQ score and from 0.68 to 0.90 for domain scores.The CLDQ was found to have discriminant validity.The highest scores of CLDQ domains were in the normal group,scores were lower in the compensated group and lowest in the decompensated group.The significant correlation between domains of the CLDQ and SF-36 was found.The average CLDQ score was strongly correlated with the general health domain of SF-36.(P=0.69:P=0.01). CONCLUSION:The translated CLDQ is valid and applicable in Thais with CLD.CLDQ reveals that QOL in these patients is lower than that in normal population.QOL is more impaired in advanced stage of CLD.

Acrylic Customized X-Ray Positioning Stent for Prospective Bone Level Analysis in Long-Term Clinical Implant Studies

Objectives: This paper describes a technique to produce individualized X-ray positioning devices for intraoral digital imaging of dental implants with long-term stability. Materials and Methods: An X-ray positioning device was built for Gendex? Visualix? eHD sensor, using the Dentsply rinn XCP-DS? system individualized by the incorporation of the bite piece within an acrylic stent to perform successive standardized radiographs to 16 patients. X-ray tube stabilization was achieved with polivinylsiloxane. Series of 3 radiographs were taken to each patient in different moments. Specific linear measurements as the implant diameter (mesio-distal width) and the height between consecutive threads (thread pitch) were made to all radiographs to determine the reproducibility and accuracy of the procedure. Results: The intraclass correlation coefficient for the mesio-distal width was 0.964 [(0.920 - 0.986) 95% CI] (p 0.00156 mm for the test value of 3.3 (p = 0.9), -0.00026 mm for 0.8 (p = 0.96) and 0.0124 for 4.125 (p = 0.72), respectively, after the application of a magnification correction factor. Conclusion: The device produced reproducible images in different moments and was suitable for comparative clinical examinations of marginal bone as it was convenient to perform reliable linear measurements.

Evaluation of the reliability and validity of the modified Morisky scale for patient's compliance with moxibustion

Objective： A questionnaire for the compliance with moxibustion was designed based on the 4-item Morisky scale, and the reliability and validity of the questionnaire was investigated. Methods： A modified Morisky scale was designed based on the 4-item Morisky scale for the compliance with moxibustion, and 146 patients having received moxibustion for over 2 weeks were investigated using this scale to evaluate their compliance with moxibustion; the internal equity and the construct validity of the scale were statistically analyzed. Results： The analysis of reliability showed that in item of internal consistency, the Cronbach＇s α was 0.72 and the split-half coefficient was 0.71, the correlation coefficients between the 4 component scores and the total score ranged 0.67-0.80, and the between-component correlation coefficients ranged 0.24-0.56; the exploratory factor analysis（EFA） totally extracted 1 common factor, and the explicable variation was 55.02%, and the loads of the 4 items were respectively 0.82, 0.81, 0.74 and 0.58. Conclusion： The reliability and validity of the modified Morisky scale for the compliance with moxibustion are acceptable, while several items need further modification and improvement in the expression and content.

Development and evaluation of short form of constitution in Chinese medicine questionnaire:a national epidemiological survey data of 21948 cases

OBJECTIVE:To develop the best short form of constitution in Chinese medicine questionnaire(CCMQ)and evaluate its psychometric properties in Chinese population.METHODS:A total of 21948 subjects were used to refine the short form.Correlation coefficient,exploratory factor analysis(EFA)and Cronbach's alpha coefficient were used to analyze and select items to form the short form.Separate sample of 205 subjects were collected to further evaluate the short from.EFA,confirmatory factor analysis(CFA),item-scale correlation,discriminant validity,internal consistency reliability and split-half reliability were carried out to evaluate the short form.RESULTS:The short form CCMQ included 26 items.Seven common factors of characteristic root>1 were extracted to explain 58.488%of the total variation.Result of CFA was consistent with the 9-factors structure.The mean differences of Blood-stasis body constitution and Qi-stagnation body constitution had statistical significance in body mass index differentiation.Cronbach's alpha coefficient of short form CCMQ was 0.863.The split-half reliability of total scale was 0.813,and each scale was 0.568-0.770.The item-scale correlations ranged from 0.620-0.849.CONCLUSION:The short form CCMQ consisted of 26 items with good psychometric properties.The short form should be recommended for the measurement of health of Chinese population in any clinical trial.

Reliability of a patient survey assessing ＂Short Form Injury Questionnaire 7＂ in Iran

Objective： Injury is a major cause of morbidity and mortality in the world. The assessment of patterns and severity of injury in high-risk groups is crucial for planning and service development. On a large scale na- tional household survey, we estimated the annual incidence and the patterns of injury, the demographics of the injured people, as well as the service use for all injuries in Iran. The current study aims at assessing the reliability of the ques- tionnaire before carrying out a national survey. Methods： In a pilot study using cluster random sam- pling approach, 73 people were interviewed. The interview- ers asked the participants to report all injuries occurred in them and the care provided during the previous 12 months, based on ＂Short Form Injury Questionnaire 7＂. About two weeks later, the interview was repeated by another interviewer. Results： In our test-retest reliability, Kappa score was good for three and moderate for four questions. The ques- tion on the injured organ had the highest test-retest reliabil- ity with a Kappa score of 0.84. Conclusions： The reliability of the questionnaire and the procedure of questioning are confirmed. The ques- tionnire is proper for utilization in large national surveies.

Determination of symptoms associated with hiesho among young females using hie rating surveys

Objective： Hie （cold sensation） is one of the most well-known health complaints in Japan and elsewhere in East Asia. Those who suffer from severe hie are considered to have hiesho （cold disorder）. This study was conducted to determine symptoms associated with hie in young females using a survey consisting of the hie scale and hie diary. Methods： Two hundred and seventy-one participants were included for the analysis. Survey forms were distributed to the participants. Diagnosis of hiesho was determined by using the hie scale. A discriminant score of over -0.38 was considered hiesho. The Short Form-8 Health Survey Standard Version （SF-8） was used to measure health-related quality of life （QOL）. The participants were also asked to respond to the questionnaire evaluating 14 physical and emotional symptoms, utilizing a six-level Likert scale item. Results： The 1st factor （hie factor） was correlated with hie （r= 0.546）, dry mouth （r= 0.332）, lower- extremity edema （r = 0.450）, headrushes （r=0.470）, shoulder stiffness （r = 0.311 ）, headrushes with chills （r = 0.726）, and fatigue （r= 0.359）. Cronbach＇s α of the 1st factor was 0.748, which indicated reliability between the items. When hie factor was the dependent variable, standardized partial regression coefficient was β=-0.387 for physical component score （P 〈 0.001） and β=-0.243 for mental component score （P 〈 0.001 ）. Conclusion： This study indicated that hiesho symptoms among young female adults were associated with bodily pain and general health perceptions of the SF-8 QOL survey.