Parathyroid hormone (PTH) stimulates aldosterone secretion in human adrenocortex and is regulated by the renin-angiotensin-aldosterone system. We speculated that measurement of PTH may be a valuable aid in the diagnosis of aldosterone-producing adenoma (APA).To test this hypothesis, we recruited 142 patients with adrenal adenoma, of whom 84 had an APA and 58 had a nonfunctioning adrenal adenoma (NFA). Plasma levels of intact PTH, serum potassium, sodium, calcium, phosphate, 25(OH) vitamin D, plasma aldosterone concentration (PAC), plasma renin activity (PRA), and aldosterone to renin ratio (ARR) were measured in every patient. Computed tomography (CT) scanning of the adrenal gland and adrenal hormone levels was used to evaluate the function of the adrenal adenoma. We also evaluated the impact of renin-angiotensin-aldosterone system (RAAS) components on PTH from the recumbent-upright test in 15 patients with APA and 30 patients with NFA.Compared with NFA, PTH levels were significantly increased in patients with APA, and serum calcium and phosphate were significantly decreased. When position was changed from supine to upright, the variation in PTH levels was significantly higher in APA patients compared with NFA patients. Receiver operator characteristic (ROC) curves identified the Youden index, which corresponded to the best tradeoff of combined marker (ARR and PTH) with a sensitivity and specificity of 89.3% and 93.1%, respectively.The baseline and positional variation of serum PTH levels were significant in APA, thus PTH may be a promising auxiliary index for the clinical diagnosis of APA.
Many sensor applications are being developed that require the location of wireless devices, and localization schemes have been developed to meet this need. However, as location-based services become more prevalent, the localization infrastructure will become the target of malicious attacks. These attacks will not be conventional security threats, but rather threats that adversely affect the ability of localization schemes to provide trustworthy location information. This paper identifies a list of attacks that are unique to localization algorithms. Since these attacks are diverse in nature, and there may be many unforeseen attacks that can bypass traditional security countermeasures, it is desirable to alter the underlying localization algorithms to be robust to intentionally corrupted measurements. In this paper, we develop robust statistical methods to make localization attack-tolerant. We examine two broad classes of localization: triangulation and RF-based fingerprinting methods. For triangulation-based localization, we propose an adaptive least squares and least median squares position estimator that has the computational advantages of least squares in the absence of attacks and is capable of switching to a robust mode when being attacked. We introduce robustness to fingerprinting localization through the use of a median-based distance metric. Finally, we evaluate our robust localization schemes under different threat conditions.
Abstract Objectives This study sought to provide contemporary data from a multi‐institution with respect to DNA‐repair genes (DRGs) status and its impact on effects of platinum‐based chemotherapy in treatment‐emergent neuroendocrine prostate cancer (t‐NEPC), for which little data exist. Patients and Methods All patients were retrospectively collected with eligible biopsied tissues for targeted next generation sequencing (NGS). The main outcomes were radiologic progression‐free survival and overall survival according to Response Evaluation Criteria in Solid Tumors, version 1.1. Results Among the 43 NEPC patients, 13/43 (30%) harbored homozygous deletions, deleterious mutations, or both in DRGs. Eleven patients (11/13, 85%) with DRGs aberrations had effective response, including 7 patients with BRCA1/2 defects and 2 with mismatch repair‐deficient caused by MSH2 alterations. While significantly fewer responders (30%) were detected in patients without DRGs aberrations (odds ratio = 12.83, p = 0.003). Compared with patients without genomic DRGs aberrations, the hazard ratio (HR) for radiologic progression in those with DRGs defects was 0.42 (95% confidence interval [CI]: 0.19–0.93), and the HR for death was 0.65 (95% CI: 0.24–1.72). The most common adverse event of Grade 3 or 4 was anemia, as noted in 7 patients (16%). Conclusion The DRGs status is therapeutically meaningful in t‐NEPC. Given the potential responses to platinum‐based chemotherapy, our findings support the clinical use of NGS in t‐NEPC patients to identify DRGs aberrations.
Objective
To investigate the trends in the clinicopathological characteristics of thyroid cancer patients undergoing surgery from 1994 to 2013.
Methods
A retrospective analysis was conducted on the clinical data of inpatients with thyroid nodular diasease undergoing thyroidectomy with pathology results from January 1994 to December 2013. The trends in the pathogenic constituent of thyroid nodule and the clinicopathological characteristics of 3 399 patients with thyroid cancer were analyzed.
Results
(1)Over the past 20 years, the proportion of patients diagnosed as thyroid cancer was gradually increased, especially those with papillary thyroid cancer(PTC). Whereas the proportions of benign nodule and other rare thyroid cancer were gradually decreased(P<0.01). (2)The average age of patients with thyroid cancer was(44.30±11.72)years, with the peak incidence at 30~59 years. The incidence of thyroid cancer was increasing in both males and females, especially more evident in the absolute increase in women(P<0.05). (3)Among 3 399 patients with thyroid cancer, 56.20%(1 910/3 399)underwent subtotal lobectomy. 20.74%(705/3 399)underwent total/near total thyroidectomy, showing an increase trend(P<0.01). Ultrasound-guided aspiration biopsy for thyroid nodule were performed in 48.87%(1 661/3 399)patients before operation. The proportion of aspiration biopsy was gradually increased since 2004.(4)An increase in thyroid cancer of tumor sizes less than 2.0 cm was observed, especially those size≤1.0 cm(P<0.01). 83.96%(2 854/3 399)patients revealed TNM Ⅰ~Ⅱstage, and the proportion of patients with TNM Ⅲ~Ⅳ stage was gradually decreased since 2006(P<0.01).
Conclusion
Over the past 20 years, the proportion of thyroid cancer, especially papillary thyroid microcarcinoma reveals an ascending tendency. The percentages of patients undertaking total/near total thyroidectomy and ultrasound-guided aspiration biopsy before operation are on the rising. (Chin J Endocrinol Metab, 2017, 33: 291-295)
Key words:
Thyroid cancer; Clinical characteristics; Pathology; Tendency
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