instruction:
In this task, you are given a passage which has a question and the context. You have to generate an answer to the question based on the information present in the context.
question:
Context: Dynamic pelvic magnetic resonance imaging (DP-MRI) offers a comprehensive evaluation of pelvic organ structure in addition to functional information regarding evacuation. Opportunity to apply this technology can be limited due to regional lack of availability. Ideally, clues from standard anorectal testing could predict abnormalities on DP-MRI, leading to its efficient use. The aim of this study is to determine whether high-resolution anorectal manometry (HR-ARM) correlates with findings on DP-MRI.', "This is a retrospective study of HR-ARM performed on patients with constipation who also underwent DP-MRI. Studies were reviewed for significant findings including posterior pelvic organ prolapse, rectocele\u2009>\u20093\u2009cm, rectal intussusception, and anorectal angle. Statistical analysis was performed using Pearson's correlation coefficient, Student's t-test, and Fisher's exact test.", 'Twenty-three patients undergoing HR-ARM (age range 25-78) also underwent DP-MRI. All were female; 76% were Caucasian. Twenty had significant structural findings: small pelvic prolapse (n\u2009=\u20092), moderate pelvic prolapse (n\u2009=\u200910), large pelvic prolapse (n\u2009=\u20099), rectocele (n\u2009=\u20098), or rectal intussusception (n\u2009=\u20093). Only intrarectal pressure on HR-ARM weakly correlated with size of rectocele (r\u2009=\u20090.46; P\u2009=\u20090.03) and degree of pelvic organ prolapse (r\u2009=\u20090.48; P\u2009=\u20090.02). The remainder of the HR-ARM parameters did not significantly correlate with DP-MRI findings. Patients with dyssynergy were not more likely to have rectoceles\u2009>\u20093\u2009cm (44.4% versus 35.7%; P\u2009=\u20090.5) or large prolapses (44.4% versus 50%, P\u2009=\u20091.0), compared with those without dyssynergy, on HR-ARM.\Question: Are high-resolution anorectal manometry and dynamic pelvic magnetic resonance imaging complementary technologies?
answer:
We were unable to find a correlation between HR-ARM findings and structural pelvic defects on DP-MRI. Therefore, these two technologies provide complementary information in the evaluation of defecatory dysfunction.


question:
Context: To determine the effect of introducing a rapid enzyme-linked immunosorbent assay (ELISA) D-dimer on the percentage of emergency department (ED) patients evaluated for pulmonary embolism (PE), the use of associated laboratory testing, pulmonary vascular imaging, and the diagnoses of PE.', 'Patients evaluated for PE during three 120-day periods were enrolled: immediately before (period 1), immediately after (period 2), and one year after the introduction of a rapid ELISA D-dimer in the hospital. The frequency of ED patients evaluated for PE with any test, with D-dimer testing, and with pulmonary vascular imaging and the frequency of PE diagnosis during each time period were determined.', 'The percentage of patients evaluated for PE nearly doubled; from 1.36% (328/24,101) in period 1 to 2.58% (654/25,318) in period 2 and 2.42% (583/24,093) in period 3. The percentage of patients who underwent D-dimer testing increased more than fourfold; from 0.39% (93/24,101) in period 1 to 1.83% (464/25,318) in period 2 and 1.77% (427/24,093) in period 3. The percentage of patients who underwent pulmonary vascular imaging increased from 1.02% (247/24,101) in period 1 to 1.36% (344/25,318) in period 2 and to 1.39% (334/24,093) in period 3. There was no difference in the percentage of patients diagnosed as having PE in period 1 (0.20% [47/24,101]), period 2 (0.27% [69/25,318]), and period 3 (0.24% [58/24,093]).\Question: Does a highly sensitive ELISA D-dimer increase testing but not diagnosis of pulmonary embolism?
answer:
In the study's academic ED, introduction of ELISA D-dimer testing was accompanied by an increase in PE evaluations, D-dimer testing, and pulmonary vascular imaging; there was no observed change in the rate of PE diagnosis.


question:
Context: To compare prognosis of clival chordomas with different dural penetration, and establish the relationship between dural penetration and platelet-derived growth factor receptor (PDGFR)-β signaling pathway.', 'Tumors in Type I (33 cases) showed limited dural penetration, while those in Type II (34 cases) had more serious dural penetration. Cox multivariate regression analysis was used to analyze risk factors affecting survival. Kaplan-Meier analysis measured overall survival (OS) and progression-free survival (PFS). To determine relationship between dural penetration and PDGFR-β signaling, expression of PDGFR-β, Akt, mammalian target of rapamycin (mTOR), and phosphatase and tensin homolog (PTEN) expression was compared using immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and western blotting.', 'Total resection was achieved in nine cases in Type I and eleven in Type II. There were significant correlations between OS and dural penetration (P=0.032) and age (P=0.034). PFS correlated significantly with dural penetration (P=0.022), gender (P=0.001), and degree of resection (P=0.001). Mean OS in Type I was significantly longer than in Type II (P=0.046). Patients aged <55 years had longer OS than those aged ≥55 years (P=0.004). Total resection was correlated with longer PFS (P=0.011). Among patients with tumor totally resected, mean PFS in Type I was significantly longer than in Type II (P=0.007). Expression of PDGFR-β in Type II was higher than in Type I.\Question: Are differences in dural penetration of clival chordomas associated with different prognosis and expression of platelet-derived growth factor receptor-β?
answer:

Clival chordomas have different degrees of dural penetration. Patients with chordomas with serious dural penetration have poorer prognosis. Higher expression of PDGFR-β is related to more serious dural penetration of clival chordomas.