DW-MRI of liver lesions: can a single ADC-value represent the entire lesion?

AIM: To evaluate whether focal liver lesions (FLLs) exhibit a homogeneous appearance on apparent diffusion coefficient (ADC) maps and whether there is inter-section variation in the calculated ADC values of FLLs (inter-section range). MATERIALS AND METHODS: Eighty-eight patients with 128 FLLs (70 benign, 58 malignant) who underwent abdominal magnetic resonance imaging (MRI) including diffusion-weighted (DW)-MRI were included. Two observers evaluated variation of signal intensity of each FLL within each ADC map image (intra-section) and among different ADC map images through the lesion (inter-section). ADC values of each FLL and neighbouring liver parenchyma were measured on all sections. The inter-section range of FLLs was compared with the neighbouring liver parenchyma. RESULTS: Intra-section inhomogeneity was noted in 39.8% (97/244 sections) and 38.9% (95/244) of benign lesions, and 61% (114/187 sections) and 61.5% (115/187) of malignant lesions, by observer 1 and observer 2, respectively. Inter-section inhomogeneity was noted in 25.7% (18/70) and 27.1% (19/70) of benign lesions, and 51.7% (30/58) and 50% (29/58) of malignant lesions, by observer 1 and observer 2, respectively. The inter-section range for both benign (0.28 × 10(-3) mm(2)/s) and malignant (0.25 × 10(-3) mm(2)/s) FLLs were significantly greater than that of liver parenchyma surrounding benign (0.16 × 10(-3) mm(2)/s, p < 0.001) and malignant (0.14 × 10(-3) mm(2)/s, p = 0.01) FLLs. CONCLUSION: Due to intra-/inter-section variations in ADC values of benign and malignant FLLs, a single ADC value may not reliably represent the entire lesion.

Novel NHLRC1 mutations and genotype-phenotype correlations in patients with Lafora's progressive myoclonic epilepsy.

BACKGROUND: Lafora's progressive myoclonic epilepsy (Lafora's disease) is an autosomal recessive neurodegenerative disorder characterised by the presence of polyglucosan intracellular inclusions called Lafora bodies. Mutations in two genes, EPM2A and NHLRC1, have been shown to cause the disease. A previous study showed mutations in the EPM2A gene in 14 Lafora's disease families and excluded the involvement of this gene in five other families who were biopsy proven to have the disease. OBJECTIVE: To relate the genetic findings to the clinical course of the disease. METHODS: As part of an ongoing mutational study of the Lafora's disease genes, five new families with the disease were recruited and the genetic analysis was extended to screen the entire coding region of the NHLRC1 gene. Genotype-phenotype correlations were carried out. RESULTS: Seven NHLRC1 mutations were identified, including five novel mutations (E91K, D195N, P218S, F216_D233del, and V359fs32), in eight families with Lafora's disease. On relating the genetic findings to the clinical course of the disease it was shown that patients with NHLRC1 mutations had a slower rate of disease progression (p<0.0001) and thus appeared to live longer than those with EPM2A mutations. A simple DNA based test is described to detect the missense mutation C26S (c.76T-->A) in the NHLRC1 gene, which is prevalent among French Canadians. CONCLUSIONS: Patients with NHLRC1 mutations have a slower rate of disease progression than those with EPM2A mutations.

Finding trajectories of feature points in a monocular image sequence.

Identifying the same physical point in more than one image, the correspondence problem, is vital in motion analysis. Most research for establishing correspondence uses only two frames of a sequence to solve this problem. By using a sequence of frames, it is possible to exploit the fact that due to inertia the motion of an object cannot change instantaneously. By using smoothness of motion, it is possible to solve the correspondence problem for arbitrary motion of several nonrigid objects in a scene. We formulate the correspondence problem as an optimization problem and propose an iterative algorithm to find trajectories of points in a monocular image sequence. A modified form of this algorithm is useful in case of occlusion also. We demonstrate the efficacy of this approach considering synthetic, laboratory, and real scenes.

Hierarchical classifier design using mutual information.

A nonparametric algorithm is presented for the hierarchical partitioning of the feature space. The algorithm is based on the concept of average mutual information, and is suitable for multifeature multicategory pattern recognition problems. The algorithm generates an efficient partitioning tree for specified probability of error by maximizing the amount of average mutual information gain at each partitioning step. A confidence bound expression is presented for the resulting classifier. Three examples, including one of handprinted numeral recognition, are presented to demonstrate the effectiveness of the algorithm.

Renal function status in leprosy.

75 leprosy patients comprising of 47 males and 28 females ranging in age from 10 years to 75 years (mean 33.76 years) were studied. Duration of disease ranged from one month to 12 years. Thirty (40%) cases were in reaction. Renal involvement occurred in 53.66% of cases. 80% of type 2 reaction leprosy patients showed renal involvement as compared to 53% of type 1 reaction. 80% of leprosy cases with more than 3 years duration of disease showed renal involvement as compared to 46.6% of cases with less than 3 years duration of disease. 9% of cases showed reduction in one or both kidney size with loss of corticomedullary differentiation on USG.

Growth responses of race 222 of Puccinia graminis tritici in defined media.

Aseptically produced uredospores of race 222 of Puccinia graminis tritici were seeded on defined liquid media containing Czapek's minerals, sucrose or glucose, and various combinations and concentrations of 19 amino acids and a tripeptide, glutathione. The cultures were incubated in the dark at 16--17 degrees C. A medium containing a high concentration of aspartic acid (5988 ppm), cysteine (557 ppm), and glutathione (1014 ppm) supported a profuse growth of the fungus in the form of floating white, fluffy, and vegetative colonies. A sulphur-containing amino acid appears to be essential for the axenic culture of the fungus.

Agnihotra in the treatment of alcoholism.

Agnihotra is a Vedic ritual of litting fire in a copper pyramid pot with use of Mantras at sunrise and sunset time. It is found to have neurophysiological effect on human body and brain. Clinically it produces mental tranquility and reported to have useful adjunct effect on deaddiction. In our present study effect of Agnihotra was studied on 18 cases of alcoholism. It is found that it leads to total abstinence without other restrain after 2 weeks of continuous Agnihotra practice. An obsessive compliance to perform Agnihotra develops. After discontinuing, its effect last for another few weeks. Though relapse may develop on discontinuing Agnihotra, a sizeable number of cases i.e. 55%, continued to remain abstinent for more than 8 weeks. Agnihotra is not a total cure for alcoholism, but it may serve as an useful adjunct.

Agnihotra - a useful adjunct in recovery of a resistant demotivated smack addict.

AGNIHOTRA is a simple vedic ritual of lightening a pyramid of fire in a small copper pot and giving offering of Ghee & Rice on this fire at the time of sunset and sunrise with enchanting of two mantras. It is reported to enhance the state of tranquility of mind and is reported to be of benefit to those addicted to various types of intoxicants. We used Agnihotra in a young smack addict who was poorly motivated and resisted all efforts to help him even when he got over the physical withdrawal features. The results were encouraging. Over a period of 4 weeks, we found him to be a totally changed man who could go back to his work without any drugs. Follow up for more than a year, revealed no recurrence and positive achievements in his work performance. The paper presents practice of Agnihotra, also known as homa therapy, and discusses its role in drug addiction.

Ketamine abreaction : a new approach to narcoanalysis.

Ketamine is a parenterally administered non barbiturate anaesthetic agent, in use for more than a decade. It is a safer than Na Pentothal. Administered intramuscularly, in dose of 6 to 15 mgm/Kg body wt. it produces dissociative anaesthesia. But, in smaller sub anaesthetic doses it may act as an abreactant. We report in this study the abreaction effect of Ketamine in dose of .5 to 1.5 mgm/kg body wt. given intramuscularly in 30 selected psychiatric cases requiring narcoanalysis for diagnostic or therapeutic purpose. The results are compared with another ten cases subjected to pentothal interview and five cases subjected to narcoanalysis with intravenous Na Amytal and methidrine. Our findings suggest that Ketamine has property of an efficacious abreactant in doses of 1 to 1.5 mgm/kg body wt. administered intramuscularly and can successfully be used for narcoanalysis in properly selected cases as a good substitute for intravenous pentothal or sodium amytal with methidrine. The relative cardio respiratory safety and ease of administration are its two added advantages.