In this report, we describe a reverse-engineering strategy for es

In this report, we describe a reverse-engineering strategy for estimating these microscopic constants. Methods: Our approach involves analyzing

responses measured downstream in the signaling pathway of a G protein-coupled receptor under conditions of allosteric modulation and reduced receptor expression or partial receptor inactivation. The analysis also yields estimates of the isomerization constant of the unoccupied receptor, the sensitivity constant of the signaling pathway, and the more empirical parameters of the receptor population including the observed affinities and efficacies of allosteric and orthosteric ligands – including inverse agonists www.selleckchem.com/products/go-6983.html – and the efficacy of the unoccupied receptor ( i.e., constitutive activity). Results and discussion: We validate our approach with an analytical proof and by analysis of simulated data. We also use our method to analyze

data from the literature. We show that the values of the microscopic constants of orthosteric and allosteric ligands are constant regardless of the allosteric interaction and the nature of the receptor-signaling pathway as long as the same active state mediates the response. Our analysis is useful for quantifying probe-dependent allosteric interactions and the selectivity of agonists for different signaling pathways. Knowing the isomerization constant and sensitivity constant of a signaling pathway in a given cell line or tissue preparation mTOR inhibition enables future investigators to estimate the affinity constants of agonists for receptor states simply through analysis of their concentration-response curves. Our approach also provides a means of validating in silico estimates of ligand affinity for crystal structures of active and inactive https://www.selleckchem.com/products/urmc-099.html states of the receptor. (C) 2014 Elsevier Inc. All rights reserved.”
“Four new lanostane-type

triterpenoids, inonotsuoxodiol B (1), inonotsuoxodiol C (2), epoxyinonotsudiol (3), and methoxyinonotsutriol (4), were isolated from the sclerotia of Inonotus obliquus. Their structures were determined to be 3 beta,22R-dihydroxylanosta-9(11),24-dien-7-one (1), 3 beta, 22R-dihydroxylanosta-7,24-dien-11-one (2), 9 alpha, 11 alpha-epoxy-lanosta-7,24-diene-3 beta,22R-diol (3), and 7 beta-methoxylanosta-8,24-diene-3 beta,11 alpha,22R-triol (4) on the basis of NMR spectroscopy, including 1D and 2D (H-1-H-1-COSY, NOESY, HMQC, HMBC) NMR spectra, and EIMS. (C) 2012 Phytochemical Society of Europe. Published by Elsevier B.V. All rights reserved.”
“The essential oils obtained by simultaneous distillation and extraction (SDE) from the fresh and dried needles and dried berries of Juniperus communis L. of Estonian origin were subjected to GC-FID and GC-MS analyses. The yields of the oils ranged between 0.2% and 0.6% from juniper berries and between 0.5% and 1.0% from needles (dried weight).

Instantaneous current efficiency decreased with increase

Instantaneous current efficiency decreased with increase

in current density.

CONCLUSIONS: The degradation of pollutants occurred mainly at the boundary layer between the electrode and the bulk solution. The indirect oxidation by active chlorine generated from the chlorides was proven to be the primary mechanism of electrochemical oxidation treatment. The removal of COD(Cr) in this study followed a pseudo-first-order kinetic model. (C) 2011 Society of Chemical Industry”
“Microbial biotransformation of acetyl-11-keto-boswellic acid by Cunninghamella elegans AS 3.1207 was carried out, and totally four transformed products were isolated. On the basis of the extensive spectral data, their structures were characterized as 7-hydroxy-11-keto-boswellic acid (1), 7,30-dihydroxy-11-keto-boswellic acid (2), 7,16-dihydroxy-3-acetyl-11-keto-boswellic Z-IETD-FMK datasheet acid (3), and 7,15,21-trihydroxy-3-acetyl-11-keto-boswellic acid (4), respectively. Among them, products 1 and 2 are the new compounds.”
“Case Description-A

4-year-old 29-kg (63.8-Ib) spayed female Husky crossbred was referred for emergency treatment because of catastrophic hemorrhagic shock following Compound C in vivo attempts at cystocentesis for investigation of suspected urinary tract infection.

Clinical Findings-On arrival at the hospital, clinicopathologic assessments revealed rapidly decreasing PCV and worsening hypoproteinemia, compared with findings immediately prior to referral. The dog had severe hyperlactemia. Ultrasonography revealed the presence of free fluid in the abdomen; the fluid appeared to be blood (determined via abdominocentesis).

Treatment and Outcome-Urgent surgical exploration was undertaken. Two small lacerations in the ventral aspect of the abdominal aorta just dorsal to the bladder were identified and repaired. Multiple transfusions of packed RBCs (5 units) and fresh frozen plasma (3 units) were administered, and autotransfusion of blood (1.2 L) from the abdomen was performed. The dog recovered well from surgery and anesthesia, selleck compound but

developed signs of severe pain and swelling of both hind limbs, which were attributed to reperfusion injury following aortic occlusion during surgery. Treatment included administration of S-adenosylmethionine (23 mg/kg [10.5 mg/lb], PO, q 24 h) and analgesia; 5 days after surgery, the hind limb problems had resolved and treatments were discontinued.

Clinical Relevance-In the clog of this report, aortic laceration secondary to cystocentesis was successfully treated with a combination of surgery and massive transfusion; the development of reperfusion injury was an interesting and reversible complication of surgery. The possibility of damage to intra-abdominal structures should be investigated if a dog becomes acutely ill after cystocentesis.

The proband manifested typical neurological symptoms and patholog

The proband manifested typical neurological symptoms and pathological abnormalities. The case had 2 heterozygous missense mutations in GAN gene: 1. c. 224 T>A in exon 2, her mother was a heterozygote of this mutation and had normal phenotype; 2. c. 1634G>A in exon 10, and her father was a heterozygote of this mutation

and had normal phenotype. VX-770 ic50 Both of the mutations caused amino acid changes in the gigaxonin protein. In this family, missense mutation of c.224 T>A and missense mutation of c. 1634G>A in GAN gene caused the phenotype of giant axonal neuropathy in the proband. Her parents are heterozygotes of the disease without symptoms.”
“Background: Rotator cuff tears are a common clinical problem, and few long-term studies concerning the outcomes of rotator cuff repairs have been performed. The purpose of this study was to report the fifteen-year outcomes of arthroscopic subacromial decompression with mini-open rotator cuff repair.

Methods: The study included seventy-nine patients who had undergone arthroscopic subacromial decompression with mini-open rotator cuff repair from 1993 to 1996. Outcomes were reviewed in 1997, 2002, and 2010. At

the final review, forty-nine patients (forty-nine shoulders) were LY2606368 available or were suitable for evaluation. There were eight large tears, forty medium tears, and one small tear. The patients were assessed with the University of California, Los Angeles (UCLA) score at each evaluation. The mean age of the patients at the time of follow-up was 70.1 years, and the mean follow-up period was 15.6 years.

Results: At the time of final follow-up, the outcome was good or www.selleckchem.com/products/AZD7762.html excellent in thirty-four patients (69%), fair in seven, and poor in eight. Three patients required a reoperation. Between the two and fifteen-year evaluations, twenty-nine patients (59%) had maintained

their good or excellent result; the overall raw scores had deteriorated for fifteen patients (31%), and they had improved for twenty-four (49%). Forty-one patients (84%) were satisfied with the final outcome of the shoulder surgery.

Conclusions: This study shows that arthroscopic subacromial decompression with mini-open rotator cuff repair can provide a lasting, durable, and satisfactory outcome for a large proportion of patients fifteen years after surgery. Patient satisfaction at the final evaluation did not necessarily correspond with a good or an excellent UCLA score.”
“Merkel cell carcinoma (MCC) is an uncommon but potentially aggressive neuroendocrine carcinoma of the skin. It typically develops on sun-exposed areas of the head and neck, particularly the eyelid, periorbital region, and extremities. We report a case of unusually located MCC, presenting as a conjunctival mass, which has only been reported once in the English literature. An 83-year-old male presented with a 0.8 x 0.7 cm sized mass protruding from the lower fornix of the right conjunctiva.

A model

was proposed to interpret the distribution of ful

A model

was proposed to interpret the distribution of full width at half maximum, which can help us understand the formation and glide process of the dislocations. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3115450]“
“ObjectiveTo observe the therapeutic effect of peripheral nerve adjustment for the treatment of postherpetic neuralgia (PHN).

MethodsOne hundred and two patients with PHN were randomly assigned to three groups; the control group (A), the experimental group (B), which was subjected to peripheral nerve adjustment, and patients who received a sham peripheral nerve adjustment, thus serving as a positive control group (C). The patients’ Visual Analogue Scale (VAS) and total oral rescue dosage for pain management were recorded at days 1, 3, 7, 14, and 28 following treatment. Quality of life (QOL), 36-Item

PX-478 Short-Form Health Survey (SF-36), and side effects were recorded following treatment.

ResultsWe observed that the average VAS score was significantly lower in the treatment group (B) than in the control groups A and C following treatment (P<0.05). In addition, the QOL and SF-36 scores for group B improved substantially following treatment compared to groups A and C, and GDC-0994 in vivo this effect was maintained up to 180 days after treatment (P<0.05). The average dosage of pain medication was also lower in group B, compared to groups A and C, following treatment

(P<0.05).

ConclusionsWe conclude that peripheral nerve adjustment can relieve PHN pain and improve patients’ quality of life. Selleck Quisinostat The possible mechanisms involved may include the reduction of both peripheral and central sensitization, the modulation of nerve plasticity, and an increase in endogenous analgesic molecules.”
“The microstructure and combination behavior of transitional metal Ni and hydrogen (H) in hydrothermally grown ZnO were investigated by infrared absorption spectroscopy. An infrared absorption peak at 2782.9 cm(-1) was observed in ZnO crystal hydrogenated in H(2) gas at 725 degrees C for 30 min. Isotope substitution experiments and polarized infrared absorption spectra revealed that this peak results from the stretch local vibrational mode of a single interstitial hydrogen bound to oxygen, with OH bond oriented at an angle of 108 to the c axis of ZnO. Different from the mode at 3577.3 cm(-1) induced by the OH-Li complex in the same sample, the mode at 2782.9 cm(-1) is ascribed to the OH-Ni complex related to a bond-centered hydrogen, which is sitting in the basal plane of the hexagonal lattice between the substitutional Ni at a Zn site and O. Moreover, this OH-Ni complex is thermally stable up to 500 degrees C. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.


“Background: The Canadian cervical spine rule (CCS) has be


“Background: The Canadian cervical spine rule (CCS) has been found to be an effective tool to determine the need for radiographic evaluation of the cervical spine (c-spine) incorporating both clinical findings and mechanism. Previously, it has been validated only through clinical follow-up or selective use of X-rays. The purpose of this study was to validate it using computed tomography (CT) as the gold standard HM781-36B chemical structure to identify fractures.

Methods: Prospective evaluation was performed on 3,201 blunt trauma patients who were screened by CCS

and were compared with a complete c-spine CT. CSS positive indicated at least one positive clinical or mechanism

check details finding, whereas CT positive indicated presence of a fracture.

Results: There were 192 patients with c-spine fractures versus 3,009 without fracture on CT. The fracture group was older (42.7 +/- 19.0 years vs. 37.8 +/- 17.5 years, p = 0.0006), had a lower Glasgow Coma Scale score (13.8 +/- 4.2 vs. 14.4 +/- 4.3, p < 0.0001), and lower systolic blood pressure (133.3 +/- 23.8 mm Hg vs. 139.5 +/- 23.1 mm Hg, p = 0.0023). The sensitivity of CCS was 100% (192/192), specificity was 0.60% (18/3009), positive predictive value was 6.03% (192/3183), and negative predictive value was 100% (18/18). Logistic regression identified only 8 of the VS-6063 19 factors included in the CCS to be independent predictors of c-spine fracture.

Conclusions: CCS is very sensitive but not very specific to determine the need for radiographic evaluation

after blunt trauma. Based on this study, the rule should be streamlined to improve specificity while maintaining sensitivity.”
“Anesthesiologists commonly use opioids for pain control in the operating room and postanesthesia care unit, and are constantly vigilant in looking for possible adverse outcomes. Therefore, common complications such as nausea, vomiting, and pruritus are well known. However, neurologic complications after opioid administration are relatively rare except for reduced consciousness, for example drowsiness or sedation. We recently experienced a case in which a 73-year-old woman presented predominantly vertical nystagmus as a neurological complication after epidural administration of fentanyl. A few previous reports on opioids as causative agents for nystagmus have all after use of epidural morphine, and there are yet no publications reporting epidural fentanyl as the cause of nystagmus. Physicians should keep in mind that epidural fentanyl could cause the nystagmus as a neurological complication even though it is used within conventional dosage ranges, although this is very rare.

Sixteen SNPs (rs2114724, rs2228611, rs2228612, rs8101866, and rs1

Sixteen SNPs (rs2114724, rs2228611, rs2228612, rs8101866, and rs16999593 CT99021 chemical structure in DNMT1; rs13420827, rs11887120, rs13428812, rs1550117, rs11695471, and rs6733301 in DNMT3A; rs2424908, rs2424913, and rs6087990 in DNMT3B; rs113593938 in DNMT3L, and rs11254413 in DNMT2) in 408 women with breast cancer and 469 controls were genotyped using a MassARRAY matrix-assisted laser desorption/ionization time-of-flight mass spectrometry platform. Two SNPs, rs16999593 in DNMT1 and rs2424908 in DNMT3B, were significantly associated with breast cancer risk. The heterozygous genotype CT of rs16999593 was associated with increased breast cancer risk [odds ratio (OR) = 1.60; 95% confidence interval (95% CI)

= 1.20-2.14; P = 0.0052], whereas rs2424908 was associated with decreased risk (OR = 0.62; 95% CI = 0.46-0.84; P = 0.0061). Other DNMT polymorphisms showed no significant

associations with breast cancer risk in the study population. Haplotype CGTC of rs2114724, rs2228611, rs8101866, and rs16999593 in DNMT1 differed significantly as a risk factor between the MRT67307 datasheet case and control groups (OR = 1.51; 95% CI = 1.18-1.93; P = 0.0012). The heterozygous genotypes of rs16999593 in DNMT1 and rs2424908 in DNMT3B were strongly associated with breast cancer risk.”
“Flavonols, and specially quercetin, are widely distributed in plants and are present in considerable amounts in fruits and vegetables. In addition to their anti-oxidant effect, flavonols interfere with a large

number of biochemical signaling pathways and, therefore, physiological and pathological processes. There is solid evidence that, in vitro, quercetin and related flavonols exert endothelium-independent vasodilator effects, protective effect on nitric oxide and endothelial function under conditions of oxidative stress, platelet antiaggregant effects, inhibition of LDL oxidation, reduction of adhesion molecules and other inflammatory markers and prevention of neuronal oxidative and inflammatory damage. The metabolites of quercetin show partial protective learn more effects on endothelial function and LDL oxidation. Quercetin produces undisputed antihypertensive and antiatherogenic effects, prevents endothelial dysfunction and protects the myocardium from ischemic damage. It has no clear effects on serum lipid profile and on insulin resistance. Human intervention trials with isolated flavonols demonstrate an antihypertensive effect. The meta-analysis of epidemiological studies show an inverse association between flavonol (together with flavone) intake and coronary heart disease and stroke. Therefore, although there is no solid proof yet, a substantial body of evidence suggests that quercetin may prevent the most common forms of cardiovascular disease contributing to the protective effects afforded by fruits and vegetables. (C) 2010 Elsevier Ltd. All rights reserved.

We investigated the safety of probiotics for subjects with food a

We investigated the safety of probiotics for subjects with food allergy.

Material and methods: Labels of probiotics commercially available in Spain were examined to assess their content of cows milk or hens egg. Skin prick tests with these compounds (20 mg/ml) were performed in five children allergic to cows milk, Trichostatin A five children allergic to hens white egg, and five control subjects non-allergic to food. Three serum pools: I (positive-specific IgE to cows milk and hens egg white proteins), II (positive-specific IgE to cows

milk and negative to hens egg white proteins), and III (negative-specific IgE to cows milk and positive to hens egg white proteins) were used to detect cows milk and hens egg white allergens in probiotics. ImmunoCAP (R) (Phadia), in-house ELISA, SDS-PAGE immunoblotting, and inhibition studies of these assays were performed. Proteins were quantified by enzyme-immunoassay.

Results: Eleven probiotics were studied. No label advertised about egg content, eight labels warned about lactose, lactic acid or cows milk, one label claimed to be milk-free, and two gave no information. Cows milk proteins were detected, by at least one lab technique, in 10/11 probiotics, three over 2.5 mg/kg (21, 52, 112 mg/kg). Hens egg white proteins were detected

in 3/11 probiotics, only one had more than 2.5 mg/kg (47 mg/kg).

Conclusion: Probiotic compounds may contain selleck screening library hidden allergens of food and may not be safe for subjects with allergy to cows milk or hens egg.”
“We report a patient with non-ischemic dilated cardiomyopathy presenting with an electrical storm because of a poorly tolerated monomorphic ventricular tachycardia. Electroanatomical mapping revealed a scar restricted to the epicardium, whereas the endocardial voltage map was completely normal. Epicardial catheter ablation based on substrate mapping and limited pace and entrainment mapping eliminated the tachycardia.”
“P>Varicella zoster virus (VZV) disease is a frequent complication after allogeneic hematopoietic stem cell transplantation (HSCT). We carried out a trial of 1-year low-dose valacyclovir (VCV) prophylaxis against VZV

disease to evaluate its efficacy and safety. Patients received oral acyclovir (ACV) 1000 mg/day until day 35 after HSCT. Oral VCV 500 mg/day, 3 times a week, was started on day 36 and continued until 1 year after Cl-amidine cost HSCT. The development of VZV disease was monitored until 2 years after HSCT. A total of 40 patients with a median age of 43 years were enrolled. VCV was well tolerated in all but 1 patient who discontinued it on day 224 because of thrombocytopenia of unknown cause. Seven patients developed VZV disease at a median of 479 days (range 145-651) after HSCT, with a cumulative incidence of 18.5%. Two patients developed breakthrough disease during VCV prophylaxis. The other 5 patients developed VZV disease after the discontinuation of VCV, and 3 of these had developed extensive chronic graft-versus-host disease.

008), but overall survival did not differ between the groups (HR

008), but overall survival did not differ between the groups (HR 0.968; 95 % CI 0.267-3.507; p = 0.960).

We found that, compared with DES, CABG showed significantly better MACCE-free survival in chronic hemodialysis patients.”
“Cobalt ferrite nanoparticles (size: 26 +/- 4 nm) have been synthesized by coprecipitation route. The coercivity of nanoparticles follows a simple model of thermal activation of particle moments over the anisotropy barrier in the temperature range of 30-300 K in accordance with https://www.selleckchem.com/products/KU-55933.html Kneller’s law; however, at low temperatures (< 30 K), the coercivity shows some deviation from this law. The saturation magnetization follows the modified Bloch’s law in the temperature range

of 10-300 K. Exchange bias (H(ex)) studies of the samples show that H(ex) increases with decreasing temperature of the sample. A strong increase in the H(ex) values is found below 30 K for the low applied field (+/- 20 kOe), while a smaller increase is found for the high applied field (+/- BAY 80-6946 cell line 90 kOe). The slow increase in the exchange

bias at high applied field has been attributed to the high field effects on the surface (shell) spins. These shell spins align along the field direction that weakens the core-shell interface interactions leading to the reduction in the exchange bias at lower temperatures. (C) 2009 American Institute of Physics. [DOI: 10.1063/1.3139293]“
“BACKGROUND Infiltration anesthesia of the skin is an analgesic procedure often practiced before minor surgical interventions or punctures. The addition of hyaluronidase is a possible option to improve the effectiveness of the local anesthetic with respect to expansion of effect. OBJECTIVE To validate the safety of intracutaneous application of hyaluronidase as a lidocaine adjuvant. MATERIALS AND METHODS The influence of adjuvant hyaluronidase on wound healing was investigated using the suction blister method in a prospective, single-center, placebo-controlled, double-blind, intraindividual comparison study with 20 participants. Selleckchem EX 527 The target parameters were defined as the time of normalization of transepidermal water loss, hemovascular perfusion, and complete macroscopic epithelization of the wound. RESULTS No evidence was

found that adjuvant application of hyaluronidase retards wound healing. CONCLUSION The addition of hyaluronidase to lidocaine in intracutaneous infiltration analgesia does not lead to retardation of wound healing, and no additional relevant risks were observed.”
“We examined a total of 1014 patients over 18 years of age; 252 with urethritis and 762 with chronic prostatitis syndrome. The mean age of patients with urethritis was 32.7 and with prostatitis syndrome 37.6 years. Clinical symptoms of urethritis were present from a few days to several months. In patients with chronic prostatitis syndrome, symptoms were present for at least 3 months. Chlamydia trachomatis alone was confirmed in 26 (10%) and in combination with Ureaplasma urealyticum in 6 (2%) patients with urethritis.

New software workflows (i e , the step-by-step progression throug

New software workflows (i.e., the step-by-step progression through various screens in the software program during a computer-guided procedure) specific to individual procedures and implants may hasten adoption of these techniques.”
“Pseudomyogenic hemangioendothelioma is a recently described vascular tumor that occurs predominantly in the distal extremities of young adults. Because of multifocal presentation, epithelioid morphology, and strong NVP-AUY922 cytokeratin expression, the tumor was frequently misdiagnosed as epithelioid sarcoma. However, substantial immunohistochemical studies revealed an endothelial nature. It has been currently considered a tumor

of intermediate malignancy with frequent local recurrence but low risk of distant metastasis. BTSA1 ic50 In this report, we describe a case of pseudomyogenic hemangioendothelioma occurring in a 22-year-old man who

presented with multifocal disease in the lower extremity and developed bilateral pulmonary metastases within a short period.”
“Dynamic progress in the basic sciences such as clinical chemistry exerted a great influence on the development of clinical science in medicine in the 19th century. We should rate Prof. Leon Marchlewski among the group of prominent foreign and Polish scientists working in that period. Marchlewski was born in 1869 in Wloclawek, Poland. He began his chemical studies in Warsaw and then continued at the Zurich Technical University. After having graduated, he began working in the famous Edward Schunk’s laboratory in Kersal near Manchester in England. At that time he achieved recognition for his research on the chemical affinity of dyes of the animal SBC-115076 nmr and plant world. Later he cooperated in this field with another great scholar Marceli Nencki. In 1900 he returned to Poland, and in 1906 he took charge

of the Department of Medical Chemistry at Jagiellonian University. He was nominated for the Nobel Prize twice in 1913 and 1914 for his numerous achievements in the field of clinical chemistry. He took many positions at Jagiellonian University in Krakow, including dean and rector. In 1930-1935 he was a senator of the Republic of Poland. He died in 1946 in Krakow.”
“Measuring knee biomechanics in six degrees of freedom with acceptable accuracy has been proven to be technically challenging. At our bioengineering laboratory, we have employed both an in vitro robotic testing system and an in vivo combined dual fluoroscopic and magnetic resonance imaging technique to analyze the impact of anterior cruciate ligament rupture on the knee joint.

When measuring the tibiofemoral kinematics of nine cadavers with the robotic testing system, we found that anterior cruciate ligament deficiency not only altered anterior translation and axial rotation of the tibia, but it also increased the medial translation of the tibia as well.

This creates opportunities for new trials that incorporate SABR a

This creates opportunities for new trials that incorporate SABR and patient-specific systemic strategies. This selective mini-review focuses on the emerging role of SABR in patients with early-stage and oligometastatic NSCLC.”
“Scale up studies for production of lipoic acid (LA) from Saccharomyces cerevisiae have been reported in this paper for the first time. LA production in batch mode was carried out in a stirred tank bioreactor at varying agitation and aeration with maximum LA production of 512 mg/L obtained at 350 rpm and 25 % dissolved oxygen in batch culture conditions. Thus, LA production increased from 352 mg/L in shake flask to 512 mg/L in batch mode

in a 5 L stirred tank bioreactor. Biomass production under these conditions was mathematically explained using logistic equation and data obtained for LA production and substrate utilization were ML323 cell line successfully fitted using Luedeking-Piret and Mercier’s models. The kinetic studies showed LA production to be growth associated. Further enhancement of LA production was carried out using fed-batch (variable volume) and semi-continuous modes of fermentation. Semi-continuous fermentation with three feeding cycles of

sucrose selleck kinase inhibitor effectively increased the production of LA from 512 to 725 mg/L.”
“Background Surgery is the fundamental curative option for gastric cancer patients. Imaging scans are routinely prescribed in an attempt to stage the disease prior to surgery. Consequently, the correlation between radiology exams and pathology is crucial for appropriate treatment planning.

Methods Systematic searches were conducted Nocodazole supplier using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 1, 2009. We calculated the accuracy, overstaging rate, understaging rate, Kappa statistic, sensitivity, and specificity for abdominal ultrasound (AUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography

(PET) with respect to the gold standard (pathology). We also compared the performance of CT by detector number and image type. A meta-analysis was performed.

Results For pre-operative T staging MRI scans had better performance accuracy than CT and AUS; CT scanners using >= 4 detectors and multi-planar reformatted (MPR) images had higher staging performances than scanners with <4 detectors and axial images only. For pre-operative N staging PET had the lowest sensitivity, but the highest specificity among modalities; CT performance did not significantly differ by detector number or addition of MPR images. For pre-operative M staging performance did not significantly differ by modality, detector number, or MPR images.

Conclusions The agreement between pre-operative TNM staging by imaging scans and post-operative staging by pathology is not perfect and may affect treatment decisions.