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Now showing items 1 - 16 of 87291

  • Is diffusion-weighted MRI sufficient for follow-up of neuroendocrine tumour liver metastases?

    Lavelle, L. P.   O'Neill, A. C.   McMahon, C. J.   Cantwell, C. P.   Heffernan, E. J.   Malone, D. E.   Daly, L.   Skehan, S. J.  

    AIM: To assess if diffusion-weighted imaging (DWI) alone could be used for follow-up of neuroendocrine hepatic metastases. MATERIAL AND METHODS: This was a retrospective study, approved by the institutional review board. Twenty-two patients with neuroendocrine liver metastases who had undergone more than one liver magnetic resonance imaging (MRI) examination, (including DWI and using hepatocyte-specific contrast medium) were evaluated. Up to five metastases were measured at baseline and at each subsequent examination. The reference standard measurement was performed on the hepatocyte phase by one reader. Three independent readers separately measured the same lesions on DWI sequences alone, blinded to other sequences, and recorded the presence of any new lesions. RESULTS: The longest diameters of 317 liver metastases (91 on 22 baseline examinations and a further 226 measurements on follow-up) were measured on the reference standard by one reader and on three b-values by three other readers. The mean difference between DWI measurements and the reference standard measurement was between 0.01-0.08 cm over the nine reader/b-value combinations. Based on the width of the Bland and Altman interval containing approximately 95% of the differences between the reader observation and the mean of reference standard and DWI measurement, the narrowest interval over the nine reader/b-value combinations was -0.6 to +0.7 cm and the widest was -0.9 to 1 cm. In the evaluation of overall response using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, the weighted kappa statistic was between 0.49 and 0.86, indicating moderate-to-good agreement between the reference standard and DWI. CONCLUSION: The visualisation and measurement of hepatic metastases using DWI alone are within acceptable limits for clinical use, allowing the use of this rapid technique to restage hepatic disease in patients with neuroendocrine metastases. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
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  • . Plucker, J. A., & Peters, S. J. (2016)

    Zahide Alaca  

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  • Hupp, S., & Jewell, J. (2015).

    Howard A. Paul  

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  • S by J. J. Abrams, Doug Dorst

    Regier Willis G.  

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  • S by J. J. Abrams, Doug Dorst

    Regier, Willis G.  

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  • Ralph S. J. Koijen

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  • J?RG WIDMANN\"S JAGDQUARTETT

    Armstrong   Asher Ian  

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  • Whatever by S. J. Goslee

    Coats, Karen  

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  • A J Cronin\"s Citadel

    Richardson   Ruth  

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  • J. B. S. Haldane and (Lysenkovschina)

    Dejong-Lambert, William  

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  • Cartoon of J. B. S. Haldane

    Crow, James F.  

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  • Cartoon of J. B. S. Haldane

    Crow   James F.  

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  • S. J. (Jim) Morrison, 1917-2016

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  • S. J. (Jim) Morrison, 1917-2016

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  • J. B. S.: The Life and Work of J. B. S. Haldane

    Ronald Clark  

    THE lives of academics, considered as Lives, almost always make dull reading. The undergraduate career, full of promise later to be fulfilled; fellowships and chairs and perhaps a manly grappling with administration; honorary degrees, an Order maybe, and grateful letters from high places—these are splendid distinctions, but not of a kind to enthral the reading public. This is understandable enough and there is no reason to lament it. Academics cannot lead lives that are spacious or exciting in a worldly sense. They need laboratories or libraries and the company of other academics. Their work is in no way deepened or made more cogent by privation, distress or worldly buffering. Close enquiry might show their private lives to be unhappy, strangely mixed up or comic, but not in ways that give one any special insight into the nature or direction of their work. Yet J. B. S. Haldane's life, as Mr. Ronald Clark recounts it, is fascinating from end to end. Unless one is in the know already, there is no foretelling at one moment what comes next. He could have made a success of any one of half a dozen careers—as mathe- matician, classical scholar, philosopher, scientist, journalist or imaginative writer. To unequal degrees he was in fact all of these things. On his life's showing he could not have been a politician, administrator (heavens, no!), jurist or, I think, a critic of any kind. In the outcome he became one of the three or four most influential biologists of his generation. In some respects—-quickness of grasp, and the power to connect things in his mind in completely unexpected ways—-he was the cleverest man I ever knew. He had something new and theoretically illuminating to say on every scientific subject he chose to give his mind to—-on the kinetics of enzyme action, on disease as a factor in evolution, on the relationship between antigens and genes, and on the impairment of judgement by prolonged exposure to high concentrations of carbon dioxide. Haldane was the first to describe the genetic phenomenon of linkage in animals generally, and the first to estimate mutation rate in man. His greatest work began in the 1920s, when independently of R. A. Fisher and Sewall Wright he undertook to refound Darwinism upon the concepts of Mendelian genetics. It should have caused a great awakening of Darwinian Theory, and in due course it did so, though at the time it did no more than make Darwinism stir uneasily in its sleep. This is "classical work" assimilated into all the standard texts. If he had done nothing else, he would still be classified as a Grand Master of modern evolution theory. Yet Haldane was not a profoundly original thinker. His genius was to enrich the soil, not to bring new land into cultivation. He was not the author of any great biological conception, nor did his ideas arouse the misgivings and resentment so often stirred up by what is revolutionary or entirely new. On the contrary, everything he said was at once recognized as fruitful and illuminating, something to be taken very seriously, something one would have been proud and delighted to have thought of oneself, even if later research should prove it to be mistaken. What are we to make of Haldane as a human being? The first thing to be said in answer to such a question is that we are under no obligation to make any thing of him at all. It makes no difference now. It might have made a difference if Haldane in his lifetime had come to realise the degree to which his work was obstructed by his own perversity. He was so very ignorant he held them. When he burst into terrible anger over real or imagined grievances it was over the heads of minor functionaries and clerks. A page describes a scene which those who knew him came to regard as typical. On behalf of one of his students Haldane applied for one of the Agricultural Research Council's postgraduate awards. These awards are made provisionally, and are confirmed if the candidate gets an adequate degree- To speed things up, one of the Council's junior officers rang Haldane's secretary up to find out what class of degree the candidate had in fact been given. As it happened, the class lists had not been published, so the reasonable answer would have been "I'm sorry, we can't tell you yet because the results aren't out." Instead Haldane accused the Council of blackmail and an attempt to violate the secrecy of exams: "I refuse to give you the information, and withdraw my request for a grant. I shall pay for her out of my own pocket." If indeed he did so, he inflicted an appropriate punishment on himself. Yet more than once he scored an important victory; over the Sex Viri, for example, a sort of buffo male voice sextet that tried to deprive him of his Cambridge Readership on the ground of immorality. Indeed, the scenes accompanying the divorce that freed Haldane to marry Charlotte read like the libretto of a comic opera—including adultery, chaste in spite of appearances to the contrary. We must not take all Haldane's outbursts at their face value. His declaration that he left England to live in India because of the disgrace of Suez was a remarkably effective way of expressing his contempt for the Suez adventure; but it simply wasn't true. I remember Haldane's once going back on a firm promise to chair a public lecture given by a distinguished American scientist on the grounds that it would be too embarrassing for the lecturer: he had once been the victim of a sexual assault by the lecturer's wife. The accusation was utterly ridiculous, and Haldane did not in the least resent my saying so. He simply didn't want to be bothered by the chairmanship, and felt too ashamed to say so in the usual way. But the trouble was that his extravagances became self-defeating. He became a "character", and people began laughing in anticipation of what he would say or be up to next. It is sort of Anglo-Saxon form of liquidation. In the Russia of Haldane's day, as Mr. Clark makes clear, he would have been much more offensive and with very much better reasons, but he would not have lasted long. Physical bravery, but sometimes moral cowardice; intelligence and folly, reasonableness and obstinacy, vanity and humility, kindness and aggressiveness, generosity and pettiness—-it is like a formulary for all mankind. Haldane was with knobs on variant of us all. People who are tired of reading of how lofty thoughts can go with silly opinions, or of how a man may fight for freedom yet sometimes condone the work of its enemies, have a simple remedy: they need read no further. But they will miss a great deal if they don't.
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  • J. B. S. Haldane: an isolated souvenir

    Divakaran, P. P.  

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