Fpm 1999, vol. 5, no. 4, pp. 1251-1253

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Fpm 1999, vol. 5, no. 4, pp. 1251-1253

Atlas of Neuromuscular Diseases. Recommend Documents. Includes bibliographical references and index. ISBN X. Color Atlas and Textbook of Human Anatomy Wealth Consciousness - Federal Jack. Doctor of Pharmacy Candidate, Bernard J. Dunn School of Pharmacy, SciAm - Child's Mind. Foundations of Cognitive Psychology.

Des Griffin - The Rothschild Dynasty. Image-guided spine interventions. Image-Guided Spine Interventions describes the varied and numerous. Cellulite Pathophysiology and Treatment. Javascript Bible 4th Edition. Darlene, who had.

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This book Hofstadter, Dennett - The Mind's I. Kirk - Zombies and Consciousness. Other books by Carlos Castaneda The Teachings of It will appear in the forthcoming Blackwell Guide to Philosophy of Mind.

Chapter Fundamentals of Neural Networks - Federal Jack The interest in neural networks comes from the networks' ability to mimic human brain Haykin, S. Adams and Victor - Principles Of Neurology 7th ed.Language: English Italian. As the development of modalities for prostate cancer PCa imaging advances, the challenge of accurate registration between images and histopathologic ground truth becomes more pressing.

Localization of PCa, rather than detection, requires a pixel-to-pixel validation of imaging based on histopathology after radical prostatectomy. Such a registration procedure is challenging for ultrasound modalities; not only the deformations of the prostate after resection have to be taken into account, but also the deformation due to the employed transrectal probe and the mismatch in orientation between imaging planes and pathology slices.

In this work, we review the latest techniques to facilitate accurate validation of PCa localization in ultrasound imaging studies and extrapolate a general strategy for implementation of a registration procedure.

La localizzazione del tumore prostatico, oltre che il suo riconoscimento, richiede una validazione "pixel-topixel" dell'imaging basata sulla sua istopatologia ottenuta con la prostatectomia radicale. In questo lavoro gli Autori fanno una revisione delle recenti tecniche che facilitano la localizzazione del cancro della prostata in diagnostica ecografica ed estrapolano possibili strategie generali per implementare le procedure di registrazione degli esami.

Prostate cancer PCa imaging is a very active field in medical science. Even though PCa exhibits the highest cancer incidence among the American male population [ 1 ], reliable imaging methods are not yet available. As a consequence, systematic 10—core needle-biopsy still is the guideline-recommended diagnostic strategy [ 2 ], a procedure that is known to lead to under diagnosis, overtreatment and complications [ 34 ].

Research groups around the world are, therefore, investing in the development of imaging tools that might facilitate targeted biopsy and ultimately replace the biopsy procedure altogether.

fpm 1999, vol. 5, no. 4, pp. 1251-1253

In addition, focal therapies are emerging to avoid the severe side effects associated with radical treatment of PCa, increasing the need for reliable imaging for treatment planning, monitoring and follow-up [ 5 ]. The development of new imaging technologies requires rigorous validation with the histopathological ground truth. Although histopathology of the excised prostate specimen after radical prostatectomy RP is considered to be preferred to validate PCa localization [ 67 ], most investigators have been using transperineal or transrectal biopsies as reference standard see, e.

fpm 1999, vol. 5, no. 4, pp. 1251-1253

When RP histopathology is available, validation is generally based on cognitive matching between image and histopathology. Although seemingly straightforward, this procedure can be difficult, is prone to errors, and requires many invalid underlying assumptions.

Researchers are, therefore, forced to perform the validation in regions, quadrants, zones or the prostate as a whole [ 6 — 10 ]. For targeted biopsy and focal therapy, however, we should aim for tumour localization at a higher resolution.

Matching of images and histopathology is a challenge; the prostate deforms considerably after excision and pathological preparation and these substantial differences between in vivo and ex vivo shape must be compensated.

In the past decades, many registration methods have been developed to map the ex vivo findings onto the in vivo images. In this respect, ultrasonic modalities are often overlooked, since their typical two-dimensional imaging planes are very differently oriented than the histopathology slices [ 1314 ].

Moreover, the manual pressure of the transrectal probe adds to the deformation between in vivo and ex vivo [ 13 ]. In this review, we survey the spectrum of available techniques and other important considerations for an accurate validation of ultrasonic techniques for prostate cancer imaging.

In general, pixel-to-pixel validation strategies require a standardized histopathology protocol in which the histopathological data are assembled into a modela registration procedure in which deformations are compensated for and a correlation step in which the pathology-proven PCa lesions are superimposed onto the images.Principles and Practice of Geriatric Surgery pp Cite as.

Seldom is this more evident than in the geriatric surgical patient in acute post-operative pain. Anesth Analg —, Clearly this right to receive adequate pain management extends to the postoperative surgical patient of any age, and yet fear of uncontrolled postsurgical pain continues to be among the primary concerns of patients about to undergo surgery [ 2 ].

This fear is not unfounded since, despite increasing research and clinical attention, many adult surgical patients continue to experience moderate to severe pain, while less than half who undergo surgery report adequate postoperative pain relief [ 34 ]. These findings are even more concerning when extrapolated to the elderly, who enter the surgical arena with higher levels of uncontrolled pain, particularly those who are cognitively impaired [ 56 ].

Harmful effects of unrelieved acute pain reprinted from Sinatra [ 7 ], with permission from Elsevier. In addition to the objective physiologic implications, pain exists simultaneously as a subjective psychological phenomenon.

This subjectivity extends to those caring for the elderly patient as well, subtly influencing behavior and care patterns. The global population is aging due to parallel declines in mortality and fertility rates [ 13 ]. The US geriatric population is quickly growing, with 10, individuals reaching the age of 65 every day. Elderly patients have surgery four times more frequently than the younger population, and these tend to be more painful, including elective joint replacements, emergent reductions of fall-related fractures, and complex surgeries for cancer [ 16 ].

However, there is little merit in considering the treatment of acute pain in the elderly population unless it differs from that provided to younger patients [ 14 ]. This begs the questions of whether elderly patients perceive pain differently from younger patients; are there changes in nociception that occur with aging, and do elderly patients process and respond to nociception differently?

Assessment and intervention for pain in the elderly should therefore begin with the assumption that all neurophysiologic processes subserving nociception are intact [ 19 ]. In fact Gagliese and Melzack demonstrated that age did not affect the rating of pain by postsurgical patients [ 20 ].

That is to say, tissue injury produces the same experience of pain in an elderly person as in a young person. There are also data that suggest that widespread and substantial changes in structure, neurochemistry, and function occur in the dorsal horn of the spinal cord and CNS with aging [ 18 ].

Multiple studies report reductions in the descending inhibitory modulating systems for nociception in the elderly [ 1821 ]. Gibson and Ferrell conclude that the reduced efficacy of endogenous analgesic systems might be expected to result in a more severe pain experience following prolonged noxious stimulation [ 18 ].

It is also possible that the documented decline in afferent transmission pathways could be offset by a commensurate reduction in the endogenous inhibitory mechanisms of older persons, with a net result of little or no change in the perceptual pain experience [ 18 ]. They further conclude that any deficit in endogenous analgesic response which is stimulus intensity dependent will become critical, thereby making it more difficult for persons of advanced age to cope with severe or persistent clinical pain conditions [ 18 ].

Evidence suggests that as age advances, pain threshold increases, but pain tolerance decreases [ 22 ]. The net effect may be that elderly patients experience acute surgical pain in the same way as younger patients.

It is clear that if a surgeon was to make a skin incision with a scalpel in an elderly unanesthetized patient, then the patient would most certainly scream with pain. Yet silent myocardial infarctions are more common in the elderly, and the bowel must be more distended before the elderly sense pain, often delaying the diagnosis of such conditions as a bowel obstruction [ 2223 ].All rights are reserved, whether the whole or part of the material is concerned, specifically.

Product Liability: The publisher can give no guarantee for all the information contained in. This does also refer to information about drug dosage and application thereof.

Management of Acute Postoperative Pain in the Geriatric Patient

The use of registered names, trademarks, etc. Stefan, Austria, www. Figures Eva L. This book is dedicated to Professor P. Thomas London, UKour friend, teacher and leader in neuromuscular diseases and to our families whose help and support made this book possible. Special acknowledgements are made to Dr. Mila Blaivas MichiganDr.

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An- drea Vass ViennaMs. Judy Boldt, Ms. Denice Janus, Ms. Piya Mahendru MichiganMs. Claudia Steffek Viennaand Mr. Petri Wieder from Springer. The authors are grateful to Mr. James Hiller who provided financial assistance for the colour photographs. Axillary nerve. Mononeuropathies: upper extremities. Cervical radiculopathy. Mononeuropathies: trunk.

Phrenic nerve. Mononeuropathies: lower extremities. Obturator nerve. Barre syndrome. Hereditary neuropathy with liability to pressure palsies HNPP. Neuromuscular transmission disorders and other conditions. Myasthenia gravis. Muscle and myotonic diseases. Motor neuron disease. Amyotrophic lateral sclerosis. General disease finder.Naveen Kumar Arora Editor. Recommend Documents. Apr 5, - was diagnosed as megaloblastic anaemia as he had macrocytosis, pancytopenia and features of Generally, user enters their actual email address and provides Information Development - Payal Arora Feb 2, - to live; leisure makes the good life possible''' Woody Fan clubs of matinee idols.

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Uncia IIllcial in Ladakh. Courtesy: Ami Vitale. Sikkim Orchid.As the development of modalities for prostate cancer PCa imaging advances, the challenge of accurate registration between images and histopathologic ground truth becomes more pressing. Localization of PCa, rather than detection, requires a pixel-to-pixel validation of imaging based on histopathology after radical prostatectomy.

Such a registration procedure is challenging for ultrasound modalities; not only the deformations of the prostate after resection have to be taken into account, but also the deformation due to the employed transrectal probe and the mismatch in orientation between imaging planes and pathology slices.

In this work, we review the latest techniques to facilitate accurate validation of PCa localization in ultrasound imaging studies and extrapolate a general strategy for implementation of a registration procedure. La localizzazione del tumore prostatico, oltre che il suo riconoscimento, richiede una validazione "pixel-topixel" dell'imaging basata sulla sua istopatologia ottenuta con la prostatectomia radicale.

In questo lavoro gli Autori fanno una revisione delle recenti tecniche che facilitano la localizzazione del cancro della prostata in diagnostica ecografica ed estrapolano possibili strategie generali per implementare le procedure di registrazione degli esami.

Prostate cancer PCa imaging is a very active field in medical science. Even though PCa exhibits the highest cancer incidence among the American male population [ 1 ], reliable imaging methods are not yet available. As a consequence, systematic 10—core needle-biopsy still is the guideline-recommended diagnostic strategy [ 2 ], a procedure that is known to lead to under diagnosis, overtreatment and complications [ 34 ]. Research groups around the world are, therefore, investing in the development of imaging tools that might facilitate targeted biopsy and ultimately replace the biopsy procedure altogether.

In addition, focal therapies are emerging to avoid the severe side effects associated with radical treatment of PCa, increasing the need for reliable imaging for treatment planning, monitoring and follow-up [ 5 ]. The development of new imaging technologies requires rigorous validation with the histopathological ground truth.

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Although histopathology of the excised prostate specimen after radical prostatectomy RP is considered to be preferred to validate PCa localization [ 67 ], most investigators have been using transperineal or transrectal biopsies as reference standard see, e.

When RP histopathology is available, validation is generally based on cognitive matching between image and histopathology. Although seemingly straightforward, this procedure can be difficult, is prone to errors, and requires many invalid underlying assumptions. Researchers are, therefore, forced to perform the validation in regions, quadrants, zones or the prostate as a whole [ 678910 ]. For targeted biopsy and focal therapy, however, we should aim for tumour localization at a higher resolution.

Matching of images and histopathology is a challenge; the prostate deforms considerably after excision and pathological preparation and these substantial differences between in vivo and ex vivo shape must be compensated. In the past decades, many registration methods have been developed to map the ex vivo findings onto the in vivo images. In this respect, ultrasonic modalities are often overlooked, since their typical two-dimensional imaging planes are very differently oriented than the histopathology slices [ 1314 ].

Atlas of Neuromuscular Diseases pdf

Moreover, the manual pressure of the transrectal probe adds to the deformation between in vivo and ex vivo [ 13 ]. In this review, we survey the spectrum of available techniques and other important considerations for an accurate validation of ultrasonic techniques for prostate cancer imaging.

In general, pixel-to-pixel validation strategies require a standardized histopathology protocol in which the histopathological data are assembled into a modela registration procedure in which deformations are compensated for and a correlation step in which the pathology-proven PCa lesions are superimposed onto the images.

We review these steps sequentially.

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The standard pathology protocol comprises RP specimen fixation, sectioning in 2—4-mm thick slices, staining of front-faces and histopathologic examination of whole-mount or smaller sections [ 1516 ]. As previously mentioned, two-dimensional 2D transrectal US imaging planes often have a very different orientation than the RP slices.

An imaging plane can, therefore, only be accurately matched to histopathologic data by combining the information from all slices it crosses. Three-dimensional reconstruction and adequate interpolation of histopathology are, therefore, of vital importance [ 11171819 ]. These models can also be readily used for the validation of three-dimensional 3D US imaging solutions for B-mode, elastography and contrast-enhanced ultrasonography [ 20 ].

Naveen Kumar Arora Editor

Paradoxically, validation of 3D imaging modalities is less dependent on a proper 3D histology model as their imaging is not bound two a particular 2D plane i. To construct a suitable histopathological model, one hugely relies on assumptions concerning slice location, orientation and deformations during the pathological work flow [ 21 ]. However, it has been reported that almost nine tenth of European pathologists section the prostate without using a special cutting device [ 22 ], which might lead to histopathologic slices not being parallel or of equal thickness [ 23 ].

In recent years, many groups developed slicing devices to standardize the sectioning process and minimize inaccuracies [ 24 ]. Still, it was quantified that microtome cutting exhibits standard deviations of 0.KAA Gent1774624 : 1625 Czech Republic - Gambrinus liga1. SK Slavia Praha1695227 : 7323. SK Sigma Olomouc1695223 : 10324. FC Slovan Liberec1693424 : 16305.

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fpm 1999, vol. 5, no. 4, pp. 1251-1253

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