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Biomedical subjects

K M Curran

Publications and source records attributed to K M Curran.

4 recordsLinked to original sources

FDG-PET as a "metabolic biopsy" tool in non-lung lesions with indeterminate biopsy.

The differentiation of benign versus malignant disease in a lesion identified on conventional imaging is a commonly encountered problem. Attempted biopsy is often unsuccessful or falsely reassuring and may lead to the patient being sent for more invasive and potentially morbid investigations. Having previously identified the value of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in this circumstance in patients with lung lesions, our current aim was to investigate the role of FDG-PET in helping to identify more accurately those patients with malignant lesions outside the lung. FDG-PET scanning was performed in 50 patients; most had undergone unsuccessful biopsy of a lesion outside the lung, while in a smaller number no attempt at biopsy had been made as it had been considered too dangerous. Follow-up was by histology or, if this was unavailable, by clinical progress to death or a minimum of 12 months post scan. Visual and quantitative analysis was performed. On visual analysis, the positive and negative predictive values were 89% and 100%, respectively. On quantitative (SUV>2.5) analysis, positive and negative predictive values were 93% and 86%, respectively. A negative FDG-PET study in these circumstances virtually excludes malignancy and allows the patient to be reassured. A positive scan encourages the clinician to pursue further biopsy to confirm a histological diagnosis. FDG-PET therefore assists in deciding which patients need to undergo further investigation.

Adult↗

FDG-PET as a "metabolic biopsy" tool in thoracic lesions with indeterminate biopsy.

A common problem encountered in clinical medicine is the classification of a lung lesion (nodule/opacity) on conventional imaging. Often attempts at biopsy are unsuccessful or are falsely reassuring, and the decision to send the patient for more invasive and potentially morbid procedures can be difficult. Our aim was to investigate the role of fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) in helping to identify more accurately those patients with malignant lesions. Sixty-three patients underwent FDG-PET scans following unsuccessful biopsy of a lung lesion or, in a lesser number of cases, when an attempt at biopsy was considered too dangerous. Follow-up was by histology or, if this was unavailable, by clinical progress to death or a minimum of 18 months post scan. Visual and quantitative analysis was performed. On visual analysis, positive and negative predictive values were 90% and 100%, respectively. On quantitative (SUV>2.5) analysis, positive and negative predictive values were 90% and 85%, respectively. We interpret these results as showing that the use of FDG-PET scans in patients in this circumstance is non-invasive and highly sensitive in diagnosing malignancy. The high positive predictive value suggests that those with a positive scan must undergo further investigation, while the 100% negative predictive value means those with no FDG uptake can safely be spared further invasive investigations

Adolescent↗

Changes in physical activity patterns in the United States, by sex and cross-sectional age.

PURPOSE: To determine sex-specific, age-related changes in physical activity patterns. METHODS: We examined cross-sectional data from the National Health Interview Survey, using the 1992 Youth Risk Behavior Survey supplement for adolescents and the 1991 Health Promotion/Disease Prevention supplement for adults. Physical activity patterns were modeled after Healthy People 2000 objectives. RESULTS: Among adolescents, physical activity patterns generally eroded most from ages 15 through 18. The "regular, vigorous activity" and strengthening patterns declined consistently from ages 12 through 21. Young adulthood (18-29 yr) often marked continuing erosion of activity patterns, whereas middle adulthood (30-64 yr) often revealed relatively stable patterns. At retirement age (65 yr), there was a stabilizing, or even an improving, tendency in activity patterns, usually followed by further erosion through the final period of life. Strengthening behavior eroded dramatically with advancing age among adults, especially among men. Among adolescents, differences between female and male respondents were large for regular, vigorous activity (11.3 percentage points greater for male respondents). In comparison with female adolescents and adults, male respondents reported much higher rates of regular, sustained activity (5.5 and 5.9 percentage points, respectively), and strengthening (18.2 and 11.3 percentage points, respectively). Among adults, levels of physical inactivity among women were moderately greater (5.5 percentage points) than for men. Absolute rates of change per year were mostly large to very large (3.0-8.0 percentage points x yr(-1)) during ages 15-18 yr, but, for adults, they were small (<0.5 percentage points x yr(-1)) for 33 of 40 sex, age, and pattern groupings. CONCLUSION: These data suggest that early and continued intervention will be necessary to offset these declines in physical activity throughout adolescence and adulthood.

Adolescent↗

A browser based image bank, useful tool or expensive toy?

DIBS, the Digital Image Banking System, is a web browser based environment for depositing and withdrawing generic medical images. These can be annotated or modified on an individual's computer for use in talks and lectures. DIBS is programmed in 'C', to query and update a database as well as producing web pages on the 'fly'. Images are deposited using an interactive form, minimizing data entry and are received in a digital format or are digitized on demand. Three interfaces allow DIBS to be searched; an image map of the human body presents a simple graphical interface, whilst more specific searches can be performed by selecting categories from predefined scrolling menus or using a full text search. When a DIBS search is performed, preview thumbnail images and descriptions are provided, linked to the full size images that can be saved locally along with the text description. DIBS offers fast and convenient access to a wide range of medical images, eliminating the time consuming process of producing one's own slides or borrowing from colleagues. It is proving to be a useful tool within our Medical School but some copyright, ethical and image security issues still need to be resolved.

Computer Graphics↗