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Multiple diagnostic modalities may be needed to establish the source of excessive androgen production in women. The role of selective venous catheterization in this process has not been established fully.
A study of hyperandrogenemic subjects and literature review.
Four hyperandrogenemic women and an additional 132 previously reported cases with available testing data and a pathologic diagnosis were evaluated.
Serum androgens, diagnostic imaging, and ovarian venous effluent sampling. Criteria to distinguish ovarian tumours from other ovarian conditions and to localize the lesion(s) were evaluated.
Basal peripheral testosterone levels ≥4.51 nmol/L (≥130 ng/dL) discriminated ovarian tumours from benign causes of hyperandrogenism (sensitivity: 93.8%, 95%CI: 85.0-98.2%; specificity: 77.8%, 95%CI: 66.4-86.7%). Single lesions produced higher ipsilateral testosterone concentrations (612.6±162.0 nmol/L; 17,653±4,670 ng/dL) compared to contralateral values (testosterone: 26.4±5.2 nmol/L; 761±150 ng/dL). In women with peripheral testosterone ≥4.51 nmol/L, a right-to-left (R:L) ovarian testosterone ratio ≥1.44 correctly identified all 18 women with right-sided tumours and misclassified 2 with bilateral lesions; 12 of 14 women with left-sided or bilateral lesions had a lower R:L value. When this criterion was combined with a left-to- right (L:R) ovarian testosterone effluent ratio of > 15 to identify left sided tumours, overall 66% of women were correctly categorized.
Peripheral testosterone concentrations identified ovarian androgen-producing tumours, and venous sampling could correctly localize 66% of these, suggesting a role for sampling when imaging studies are not revealing.
selective venous sampling, effluent sampling, hyperandrogenism, ovarian tumours, hirsutism
Selective venous sampling for androgen producing ovarian pathology
Eric D. Levens,* Brian W. Whitcomb,† John M. Csokmay,* and Lynnette K. Nieman*
2010 Apr 1.
Background and purpose
An earlier Nordic Arthroplasty Register Association (NARA) report on 280,201 total hip replacements (THRs) based on data from 1995-2006, from Sweden, Norway, and Denmark, was published in 2009. The present study assessed THR survival according to country, based on the NARA database with the Finnish data included.
Material and methods
438,733 THRs performed during the period 1995-2011 in Sweden, Denmark, Norway, and Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities with 95% confidence interval (CI). Cox multiple regression, with adjustment for age, sex, and diagnosis, was used to analyze implant survival with revision for any reason as endpoint.
The 15-year survival, with any revision as an endpoint, for all THRs was 86% (CI: 85.7-86.9) in Denmark, 88% (CI: 87.6-88.3) in Sweden, 87% (CI: 86.4-87.4) in Norway, and 84% (CI: 82.9-84.1) in Finland. Revision risk for all THRs was less in Sweden than in the 3 other countries during the first 5 years. However, revision risk for uncemented THR was less in Denmark than in Sweden during the sixth (HR = 0.53, CI: 0.34-0.82), seventh (HR = 0.60, CI: 0.37-0.97), and ninth (HR = 0.59, CI: 0.36-0.98) year of follow-up.
The differences in THR survival rates were considerable, with inferior results in Finland. Brand-level comparison of THRs in Nordic countries will be required.
Countrywise results of total hip replacement An analysis of 438,733 hips based on the Nordic Arthroplasty Register Association database
Keijo T Makela,corresponding author 1 Markus Matilainen, 2 Pekka Pulkkinen, 3 Anne M Fenstad, 4 Leif I Havelin, 4 , 5 Lars Engesaeter, 4 , 5 Ove Furnes, 4 , 5 Søren Overgaard, 6 , 8 Alma B Pedersen, 6 , 7 Johan Karrholm, 9 Henrik Malchau, 9 Goran Garellick, 9 Jonas Ranstam, 10 and Antti Eskelinen 11
Date palm (Phoenix dactylifera L.), a member of Arecaceae family, is one of the three major economically important woody palms—the two other palms being oil palm and coconut tree—and its fruit is a staple food among Middle East and North African nations, as well as many other tropical and subtropical regions. Here we report a complete sequence of the data palm chloroplast (cp) genome based on pyrosequencing.
After extracting 369,022 cp sequencing reads from our whole-genome-shotgun data, we put together an assembly and validated it with intensive PCR-based verification, coupled with PCR product sequencing. The date palm cp genome is 158,462 bp in length and has a typical quadripartite structure of the large (LSC, 86,198 bp) and small single-copy (SSC, 17,712 bp) regions separated by a pair of inverted repeats (IRs, 27,276 bp). Similar to what has been found among most angiosperms, the date palm cp genome harbors 112 unique genes and 19 duplicated fragments in the IR regions. The junctions between LSC/IRs and SSC/IRs show different features of sequence expansion in evolution. We identified 78 SNPs as major intravarietal polymorphisms within the population of a specific cp genome, most of which were located in genes with vital functions. Based on RNA-sequencing data, we also found 18 polycistronic transcription units and three highly expression-biased genes—atpF, trnA-UGC, and rrn23.
Unlike most monocots, date palm has a typical cp genome similar to that of tobacco—with little rearrangement and gene loss or gain. High-throughput sequencing technology facilitates the identification of intravarietal variations in cp genomes among different cultivars. Moreover, transcriptomic analysis of cp genes provides clues for uncovering regulatory mechanisms of transcription and translation in chloroplasts.
The Complete Chloroplast Genome Sequence of Date Palm (Phoenix dactylifera L.)
Meng Yang, 1 , 2 Xiaowei Zhang, 1 , 2 Guiming Liu, 1 , 2 Yuxin Yin, 1 , 2 Kaifu Chen, 1 , 2 Quanzheng Yun, 1 , 2 Duojun Zhao, 1 , 2 Ibrahim S. Al-Mssallem, 1 , 3 , * and Jun Yu 1 , 2 , *