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Jin L, Zhang X, Li Z, Ni S, Yan D, Liu S, An C. 1749P A multivariate logistic regression model to predict lateral lymph node metastases of medullary thyroid cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Huang C, Sun Q, Jiang D, Zhang X, Chen C, Yan D, Liu X, Zhou Y, Ding C, Lan L, Wu J, Li L, Li A, Liu X, Yang S. Characteristics of facial skin problems and microbiome variation during wearing masks for fighting against COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e853-e855. [PMID: 34363249 PMCID: PMC8446999 DOI: 10.1111/jdv.17580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/29/2021] [Indexed: 01/22/2023]
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Ding X, Liu G, Zhao L, Yan D, Deraniyagala R, Stevens C, Li X. PD-0907 Modeling the first proton arc delivery sequence and investigating its efficiency improvement. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07186-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ding X, Liu G, Zhao L, Yan D, Li X. OC-0304 A novel direct machine-specific parameter Spot-scanning proton arc (SPArc) optimization algorithm. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06851-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Hong X, Zhao J, Zhu X, Dai Q, Zhang H, Xuan Y, Yin J, Zhang Y, Yang X, Fang S, Wang Q, Shen H, Zhang Y, Yan D, Wang Y, Peng Z, Zhang Y, Wang B, Ma X. The association between the vaginal microenvironment and fecundability: a register-based cohort study among Chinese women. BJOG 2021; 129:43-51. [PMID: 34258836 DOI: 10.1111/1471-0528.16843] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To evaluate the association between the vaginal microenvironment and fecundability among women. DESIGN Register-based nationwide cohort study. SETTING Chinese National Free Pre-conception Check-up Project from 2015 to 2018. POPULATION Our study included a total of 3 388 554 eligible women who were attempting to become pregnant. METHOD We assessed the vaginal microenvironment at baseline by considering four indices: vaginal pH, clue cell examination, whiff test and vaginal cleanliness grading. If any of these indicators was abnormal, the vaginal microenvironment was defined as poor. Propensity score matching was used to control for potential confounders and reduce bias. Logistic models were used to estimate the fecundability odds ratios (FORs) after adjustment for covariates. MAIN OUTCOME MEASURES Achievement of a pregnancy within 1 year. RESULTS Of the total study population, 379 718 women (11.2%) had a poor vaginal microenvironment and their pregnancy rate after 1 year was significantly lower than the group with a normal microenvironment (71.8% versus 76.1%, P < 0.001). After adjusting for potential confounders, the women with a poor vaginal microenvironment were associated with a 9% reduction in fecundability compared with the normal microenvironment group (FOR 0.91, 95% CI 0.90-0.92). The adverse effects of a poor vaginal microenvironment were stronger among multipara (FOR 0.89, 95% CI 0.87-0.90) or women with irregular menstruation (FOR 0.86, 95% CI 0.84-0.89). CONCLUSION There was a negative association between a poor vaginal microenvironment and the fecundability of women. These findings highlight the significance of assessing the vaginal microenvironment during pre-pregnancy health examinations. TWEETABLE ABSTRACT Women with a poor vaginal microenvironment were associated with a reduction in fecundability.
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Browne F, Chen S, Doornenbal P, Obertelli A, Ogata K, Utsuno Y, Yoshida K, Achouri NL, Baba H, Calvet D, Château F, Chiga N, Corsi A, Cortés ML, Delbart A, Gheller JM, Giganon A, Gillibert A, Hilaire C, Isobe T, Kobayashi T, Kubota Y, Lapoux V, Liu HN, Motobayashi T, Murray I, Otsu H, Panin V, Paul N, Rodriguez W, Sakurai H, Sasano M, Steppenbeck D, Stuhl L, Sun YL, Togano Y, Uesaka T, Wimmer K, Yoneda K, Aktas O, Aumann T, Boretzky K, Caesar C, Chung LX, Flavigny F, Franchoo S, Gasparic I, Gerst RB, Gibelin J, Hahn KI, Holl M, Kahlbow J, Kim D, Körper D, Koiwai T, Kondo Y, Koseoglou P, Lee J, Lehr C, Linh BD, Lokotko T, MacCormick M, Miki K, Moschner K, Nakamura T, Park SY, Rossi D, Sahin E, Schindler F, Simon H, Söderström PA, Sohler D, Takeuchi S, Törnqvist H, Tscheuschner J, Vaquero V, Wagner V, Wang S, Werner V, Xu X, Yamada H, Yan D, Yang Z, Yasuda M, Zanetti L. Pairing Forces Govern Population of Doubly Magic ^{54}Ca from Direct Reactions. PHYSICAL REVIEW LETTERS 2021; 126:252501. [PMID: 34241497 DOI: 10.1103/physrevlett.126.252501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/03/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
Direct proton-knockout reactions of ^{55}Sc at ∼220 MeV/nucleon were studied at the RIKEN Radioactive Isotope Beam Factory. Populated states of ^{54}Ca were investigated through γ-ray and invariant-mass spectroscopy. Level energies were calculated from the nuclear shell model employing a phenomenological internucleon interaction. Theoretical cross sections to states were calculated from distorted-wave impulse approximation estimates multiplied by the shell model spectroscopic factors, which describe the wave function overlap of the ^{55}Sc ground state with states in ^{54}Ca. Despite the calculations showing a significant amplitude of excited neutron configurations in the ground-state of ^{55}Sc, valence proton removals populated predominantly the ground state of ^{54}Ca. This counterintuitive result is attributed to pairing effects leading to a dominance of the ground-state spectroscopic factor. Owing to the ubiquity of the pairing interaction, this argument should be generally applicable to direct knockout reactions from odd-even to even-even nuclei.
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Patel J, Vazquez T, Yan D, Keyes E, Diaz D, Li Y, Grinnell M, Feng R, Werth V. 024 Immune microenvironment deep profiling of cutaneous lupus erythematosus skin stratified by patient response to antimalarials. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vazquez T, Patel J, Keyes E, Yan D, Diaz D, Bashir M, Feng R, Grinnell M, Werth V. 021 Multidimensional in situ immune profiling of discoid and subacute cutaneous lupus erythematosus. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ravishankar A, Bax C, Grinnell M, Yan D, Feng R, Okawa J, Werth V. 429 Spirulina use and its temporal association with dermatomyositis exacerbation. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu G, Li X, Chinnaiyan P, Zhao L, Yan D, Stevens C, Kabolizadeh P, Ding X. PO-1468: Redefine the role of proton pencil beam scanning technique in the brain stereotactic radiosurgery. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Qin A, Chen S, Liu G, Li X, Zheng W, Deraniyagala R, Kabolizadeh P, Stevens C, Yan D, Ding X. The Feasibility and Accuracy of Utilizing CBCT and Generative-Adversarial-Network (GAN) to Perform Proton Treatment Dose Evaluation for Lung and Head and Neck Patients. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Li X, Ding X, Zheng W, Liu G, Janssens G, Souris K, Barragán Montero A, Yan D, Stevens C, Kabolizadeh P. A Novel Linear Energy Transfer Integrated Spot-Scanning Proton Arc Therapy Algorithm: Feasibility Study and Clinical Potential. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu G, Qin A, Zhou J, Yan D, Zhao L, Stevens C, Grills I, Kabolizadeh P, Li X, Ding X. PO-1759: A dose validation tool prior to proton and photon treatment in spine SRS. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01777-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Han Y, Cao G, Sun B, Wang J, Yan D, Xu H, Shi Q, Liu Z, Xu L, Liu B, Zou Y. 179P Regorafenib combined with transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma (HCC) with previous systematic treatment: A preliminary investigation of safety and efficacy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bax CE, Ravishankar A, Yan D, Concha J, Kushner CJ, Zamalin D, Feng R, Payne AS, Werth VP. Identifying the required degree of disease clearance to improve quality of life in pemphigus vulgaris. Br J Dermatol 2020; 184:573-575. [PMID: 33090460 DOI: 10.1111/bjd.19625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 11/29/2022]
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He XY, Pan XM, Jin MM, Yang YL, Yang ZQ, Yan D, Ma JX. Long non-coding RNA AK027294 promotes tumor growth by upregulating PCNA in gastric cancer. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:5762-5769. [PMID: 31298327 DOI: 10.26355/eurrev_201907_18314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Recent researches have proved that long non-coding RNAs (lncRNAs) has an important role in many diseases. In this research, lncRNA AK027294 was explored to identify how it functions in the development of gastric cancer (GC). PATIENTS AND METHODS Real Time-quantitative-Polymerase Chain Reaction (RT-qPCR) was utilized to detect AK027294 expression in GC patients. Then, MTT assay, colony formation assay, and EdU incorporation assay were performed to identify its function in GC cells. Furthermore, the potential mechanism was also explored using mechanism assays. RESULTS AK027294 expression level was significantly higher in GC tissue samples and cell lines. Results of MTT assay, colony formation assay, and EdU incorporation assay showed that cell proliferation was inhibited through the silence of AK027294 in GC cells, while cell proliferation was promoted through overexpression of AK027294 in GC cells. Furthermore, the expression of PCNA was downregulated via silence of AK027294 in GC cells, while the expression of PCNA was upregulated via overexpression of AK027294 in GC cells. The correlation analysis showed that PCNA expression was positively correlated with AK027294 expression in GC tissues. CONCLUSIONS Our results suggest that AK027294 could enhance cell proliferation of GC cells by upregulating PCNA and might be applied as a novel target for therapy of GC.
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Wang X, Xiao C, Ji C, Liu Z, Song X, Liu Y, Li C, Yan D, Li H, Qin Y, Liu X. Isolation and characterization of endophytic bacteria for controlling root rot disease of Chinese jujube. J Appl Microbiol 2020; 130:926-936. [PMID: 32777121 DOI: 10.1111/jam.14818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 11/29/2022]
Abstract
AIM Fusarium oxysporum is the primary pathogen causing root rot disease that severely affects cultivation of jujube fruit in the Xinjiang province of China. The aim of this study was to identify endophytic bacteria in healthy jujube organs that could effectively suppress F. oxysporum growth. METHODS AND RESULTS Different plant organs (leaves, twigs and roots) were collected from healthy Chinese jujube cultivated in southern Xinjiang province of China. The endophytic bacterium Brevibacterium halotolerans JZ7 was selected for its strong antagonistic activity and growth-promoting characteristics. Gas-chromatography mass-spectrometry analysis showed that acetoin, 2,3-butanediol and fenretinide were the three dominant volatile organic compounds produced by strain JZ7. Fenretinide strongly suppressed spore germination of F. oxysporum in vitro. Pot experiments showed that strain JZ7 colonized both the roots and rhizosphere soil of Chinese jujube and significantly reduced F. oxysporum level in jujube rhizosphere soil. CONCLUSION We demonstrated that B. halotolerans JZ7 can be developed into a biological control agent to combat root rot disease of Chinese jujube in the Xinjiang province of China. SIGNIFICANCE AND IMPACT OF THE STUDY The suggested strategy for biological control of jujube root rot disease is fully in accordance with the current principles of sustainability.
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Pan XM, He XY, Yang YL, Jia WJ, Yang ZQ, Yan D, Ma JX. MiR-630 inhibits papillary thyroid carcinoma cell growth, metastasis, and epithelial-mesenchymal transition by suppressing JAK2/STAT3 signaling pathway. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2020; 23:2453-2460. [PMID: 30964171 DOI: 10.26355/eurrev_201903_17392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Evidence has demonstrated that miR-630 is involved in multiple processes in cancer development and progression. However, the exact functions of miR-630 in papillary thyroid carcinoma (PTC) and the underlying mechanisms remain undefined. Therefore, the aims of the present study were to investigate the role and potential mechanism of miR-630 in tumorigenicity of PTC. PATIENTS AND METHODS Microarrays were used to analyze the differentially expressed miRNAs in PTC tissues. Expression of miR-630 in PTC tissues and cell lines were determined by a qRT-PCR assay. CCK-8 assays, clonogenic survival assays, cell apoptosis analysis, wound healing assays and transwell invasion assays were used to examine the tumorigenesis function of miR-630 in vitro. Protein expression of signaling pathways was determined by using Western blot. RESULTS We found that miR-630 was significantly downregulated in PTC tissues and cell lines. Overexpression of miR-630 inhibited PTC cell proliferation and induced cell apoptosis via suppressing the expression of caspase-3 and caspase-6. In addition, up-regulation of miR-630 suppressed the migration and invasion in PTC cells by suppressing EMT progress. Mechanistic investigations showed forced miR-660 expression decreased proteins expression of phosphorylation levels in JAK2/STAT3 signaling. CONCLUSIONS We firstly provided the evidence that miR-630 displayed a tumor-promotive role in PTC progression through modulating JAK2/STAT3 pathway, and that a potential therapeutic strategy through enhancing miR-630 expression might benefit PTC patients.
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Yan D, Wang S, Temkin‐Greener H, Cai S. Hcbs Service Intensity and Nursing Home Placement for Patients with Alzheimer's Disease and Related Dementias: Does Race Matter? Health Serv Res 2020. [DOI: 10.1111/1475-6773.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Wang S, Yan D, Temkin‐Greener H, Cai S. Does Medicaid Hcbs Generosity Influence Nursing Home Placement for Dually Eligible Adrd Patients? Health Serv Res 2020. [DOI: 10.1111/1475-6773.13356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ravishankar A, Yan D, Bax C, Concha J, Shields B, Pappas-Taffer L, Feng R, Okawa J, Werth V. 505 Immunostimulatory herbal supplements in patients with autoimmune skin diseases. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Concha J, Yan D, Ravishankar A, Bax C, Borucki R, Werth V. 424 Quality of life in patients with facial cutaneous lupus erythematosus. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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You JQ, Yan D, He Y, Zhou JG, Ge YL, Song GW. Polyethyleneimine-Protected Ag2S Quantum Dots for Near-Infrared Fluorescence-Enhanced Detection of Trace-Level Hg2+ in Water. J WATER CHEM TECHNO+ 2020. [DOI: 10.3103/s1063455x20010105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Liu Y, Wang L, Su Y, Brown K, Yang R, Zhang Y, Duanmu Y, Guo Z, Zhang W, Yan C, Yan D, Cheng X. CTXA hip: the effect of partial volume correction on volumetric bone mineral density data for cortical and trabecular bone. Arch Osteoporos 2020; 15:50. [PMID: 32193671 DOI: 10.1007/s11657-020-00721-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 02/25/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study compares the results of computed tomography X-ray absorptiometry (CTXA) hip volumetric BMD (vBMD) analyses of cortical and trabecular bone with and without partial volume correction. For cortical bone in some circumstances, corrected cortical volumes were negative and corrected vBMD was very high. For trabecular bone, the correction effects are smaller. CTXA volumetric data should be interpreted with caution. PURPOSE Previous studies have reported concerns about the reliability of CTXA hip cortical vBMD measurements generated using partial volume (PV) correction (the "default" analysis, with cortical PV correction). To date, no studies have examined the results of the alternative ("new") analysis (with trabecular PV correction). This study presents in vivo and phantom data comparing the corrected and uncorrected data for cortical and trabecular bone respectively. METHODS We used the commercial QCTPro CTXA software to analyze CT scans of 129 elderly Chinese men and women and an anthropomorphic European Proximal Femur phantom (EPFP) and accessed data for two alternative scan analyses using the database dump utility. The CTXA software gives the user two methods of performing the PV correction: (1) a default analysis in which only cortical bone results are corrected; (2) a new analysis in which only trabecular bone results are corrected. Both methods are based on a numerical recalculation of vBMD values without any change in volume of interest (VOI) placement. RESULT In vivo, the results of the two analyses for integral bone were the same while cortical and trabecular results were different. PV correction of cortical bone led to a decrease of cortical volume for all four VOIs: total hip (TH), femoral neck (FN), trochanter (TR), and intertrochanter (IT) volumes were reduced on average by 7.8 cm3, 0.9 cm3, 2.5 cm3, and 4.3 cm3 respectively. For TR, where cortex was thinnest, average corrected cortical volume was negative (- 0.4± 1.3 cm3). Corrected cortical vBMD values were much larger than uncorrected ones for TH, FN, and IT. Scatter plots of corrected cortical vBMD against cortical bone thickness showed that elevated results correlated with thinner cortices. When trabecular bone was corrected for the PV effect, trabecular volumes of TH, FN, TR, and IT were reduced on average by 7.9 cm3, 0.8 cm3, 2.6 cm3, and 4.4 cm3 respectively, while vBMD measurements were increased correspondingly. The trabecular volume and vBMD measurements of the two datasets both had highly positive correlations. For the EPFP, the PV-corrected FN data deviated from the nominal phantom value, but was closer for the TR and IT VOIs. Both corrected and uncorrected data overestimated trabecular vBMD, with the corrected results showing greater deviation from nominal values. CONCLUSION The default and new CTXA analyses for volumetric data generate different results, both for cortical and trabecular bone. For cortical bone, the uncorrected results are subject to partial volume effects but the correction method of the default analysis overcorrects the effect leading to in part unreasonable results for cortical bone volume and BMD. For trabecular bone, the correction effects are smaller. CTXA volumetric data should be interpreted with caution.
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Zuo QY, Cao X, Liu BY, Yan D, Xin Z, Niu XH, Li C, Deng W, Dong ZY, Yang JK. Clinical and genetic analysis of idiopathic normophosphatemic tumoral calcinosis in 19 patients. J Endocrinol Invest 2020; 43:173-183. [PMID: 31535357 DOI: 10.1007/s40618-019-01097-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/02/2019] [Indexed: 01/27/2023]
Abstract
PURPOSE Tumoral calcinosis is a rare clinicopathological entity characterized by ectopic soft-tissue calcification, typically periarticular. Normophosphatemic tumoral calcinosis is seldom reported in East Asian populations, and the preoperative diagnosis is often elusive. This study was performed to characterize the clinical profile of normophosphatemic tumoral calcinosis and investigate the presence of the SAMD9 gene mutation. METHODS The clinical features, pathological examination findings, and outcomes of 19 subjects were retrospectively reviewed. All patients were analyzed for SAMD9 gene mutation using paraffin-embedded tumoral calcinosis specimens. RESULTS Nineteen subjects were analyzed (7 males, 12 females). Their mean age at surgery, mean age at symptom onset, and median disease duration was 51.9 ± 17.3 (range 7-75) years, 49.1 ± 17.2 (range 7-74) years, and 1.3 (interquartile range 0.5-3.0) years, respectively. Lesions were located in the hand in 8 (42.1%) subjects; wrist in 5 (26.3%); shoulder in 2 (10.5%); and hip, knee, buttock, and scrotum in 1 (5.3%) subject each. The lesions in 17 (89.5%) subjects were located around the joints [small joints (hand and wrist) in 13 (68.4%) and large joints (shoulder, hip, and knee) in 4 (21.1%)]. Lesions occurred in the upper limbs in 15 (78.9%) subjects and in the lower limbs in 2 (10.5%). Multiple-lesion involvement (distal right index finger and middle finger) occurred in one (5.3%) subject. Symptoms included pain in 15 (78.9%) subjects, impaired mobility in 5 (26.3%), swelling in 5 (26.3%), numbness in 2 (10.5%), and an asymptomatic mass in 2 (10.5%). The serum inorganic phosphorus concentration was normal in all 19 subjects (mean 1.17 ± 0.15 mmol/L). The serum calcium concentration was normal in 18 subjects and low in 1. The serum alkaline phosphatase concentration was normal in all 19 subjects. Pathological examination indicated multiple nodules of calcified materials that manifested an amorphous or granular blue-purple crystal and were surrounded by proliferation of mononuclear or multinuclear macrophages, osteoclastic-like giant cells, fibroblasts, and chronic inflammatory cells. Notably, different phases of pathological manifestations were observed in the same microscopic field. During follow-up (0.5-65.0 months), no recurrence of tumoral calcinosis was observed in 18 (94.7%) subjects, but 1 subject developed in situ recurrence of an asymptomatic subcutaneous mass after 6 months postoperatively. Genetic analysis in all 19 subjects revealed no SAMD9 gene mutations. CONCLUSIONS Most subjects were females and developed calcinosis in adulthood. Small joints (hand and wrist) and the upper limbs were frequently involved. The presence of different phases of pathological features in the same subject suggests that about half of the study participants had been misdiagnosed with another condition (such as gout, osteoarthritis, etc.). Complete surgical excision led to cure without recurrence during follow-up in majority of the study participants.
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