Assessing genetic and environmental influences on epicardial and abdominal adipose tissue quantities: a classical twin study.

BACKGROUND/OBJECTIVES: Various adipose tissue compartments play an important role in the development of cardiometabolic diseases. The quantity of different fat compartments is influenced by genetic and environmental factors. The aim of our study was to evaluate the magnitude of genetic and environmental effects on epicardial, subcutaneous and visceral adipose tissue (EAT, SAT and VAT) quantities in a cohort of adult twin pairs. SUBJECTS/METHODS: In this cross-sectional study we investigated adult twins (57 monozygotic (MZ) and 33 dizygotic (DZ) same-gender twin pairs; 180 twin subjects). We measured EAT volume using electrocardiogram-gated native computed tomography (CT) scan of the heart, and abdominal SAT and VAT areas were quantified between the third and fourth lumbar vertebra on native CT images. We calculated genetic and environmental impact on the size of various adipose tissue compartments by analyzing co-twin correlations in MZ and DZ pairs separately, and furthermore by using genetic structural equation models. RESULTS: In co-twin analysis, MZ twins had stronger correlations than DZ twins for EAT (rMZ=0.81, rDZ=0.32), similar to SAT and VAT quantities (rMZ=0.80, rDZ=0.68 and rMZ=0.79, rDZ=0.48, respectively). In multi-trait model fitting analysis, the overall contribution of genetic factors to EAT, SAT and VAT volumes were 80%, 78% and 70%, whereas environmental factors were 20%, 22% and 30%, respectively. Common pathway model analyses indicated that none of the EAT, SAT and VAT phenotypes was independent of the other two. CONCLUSIONS: Genetic factors have substantial influence, while environmental factors have only a modest impact on EAT volume, abdominal SAT and VAT quantities. There is a considerable amount of common genetic background influencing the quantities of all three adipose tissue compartments.

Qualitative and quantitative assessment of cartilage degeneration using full-field optical coherence tomography ex vivo.

OBJECTIVE: The purpose of this study was to investigate the ability of full-field optical coherence tomography (FFOCT) to qualitatively and quantitatively evaluate cartilage degeneration using the qualitative evaluation of histology sections as the reference. DESIGN: Thirty-three human knee cartilage samples of variable degeneration were included in the study. A closely matching histology and FFOCT image was acquired for each sample. The cartilage degeneration was qualitatively evaluated by assigning a grade to each histology and FFOCT image. The relevance of the performed grading was assessed by calculating the intra- and inter-observer reproducibility and calculating the concordance between the histology and FFOCT grades. A near-automatic algorithm was developed to quantitatively characterize the cartilage surface in each image. The correlation between the quantitative results and the reference qualitative histology was calculated. RESULTS: An almost perfect agreement was achieved for both the intra- and inter-reproducibility of the histology and FFOCT qualitative grading (κ ≥ 0.91). A high and statistically significant level of agreement was measured between the histology and FFOCT grades (W = 0.95, P < 0.05). Strong and statistically significant correlations were measured between the quantitative results and the reference qualitative histology grades (ρ ≥ 0.75, P < 0.05). CONCLUSIONS: We have demonstrated that FFOCT is an alternative approach to conventional optical coherence tomography (OCT) that is as well adapted for the qualitative and quantitative assessment of human cartilage as the reference gold standard - histology. This study constitutes the first promising results towards developing a new diagnostic tool in the field of osteoarthritis.

[Rigid cystoscopy versus retrovision for adjustable peri-urethral balloons guidance: Comparison of precision thanks to a surgical navigation system]. / Cystoscopie rigide versus rétro-vision pour le guidage des ballonnets péri-urétraux : comparaison de la précision grâce à un système de navigation chirurgicale.

OBJECTIVES: The main goal of our phantom study was to compare the precision of adjustable periurethral balloons positioning depending whether the guidance was obtained by retrovision or rigid cystoscopy. MATERIAL AND METHODS: A navigation guidance system was used to localize the introduction mandrel which was equipped with tracking targets. Two ideal sites of implantation were predefined and recorded into the navigation system. The two points were placed symmetrically to the phantom reproducing the urethra. Four different users were asked to position the tip of the introduction mandrel as close as possible to the ideal site of implantation with the help of each method of guidance. For each attempt, the distance (mm) between the tip of the introduction mandrel and the ideal position was recorded by the navigation system. RESULTS: For each method of guidance, a total of 20 attempts on each side were made by direct puncture on one side and a symmetrical contralateral puncture. For direct puncture, the median distances were 5.20 (±3.96) and 4.38 (±1.55) mm with rigid cystoscopy and retrovision respectively (P=0.29). For symmetrical contralateral puncture, the median distance were 7,19 (±3,78) and 6,86 (±2,76) mm with rigid cystoscopy and retrovision respectively (P=0,32) CONCLUSION: This study could not demonstrate any significant difference between the two guidance systems. Nevertheless, it showed that navigation guidance system could be used to compare the precision of surgical interventions. LEVEL OF EVIDENCE: 4.

Unintended Consequences of Sensor, Signal, and Imaging Informatics: New Problems and New Solutions.

OBJECTIVES: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2016 of excellent research in the broad field of Sensor, Signal and Imaging Informatics published in the year 2015, with a focus on Unintended consequences: new problems and new solutions. METHODS: We performed a systematic initial selection and a double blind peer review process to find the best papers in this domain published in 2015, from the PubMed and Web of Science databases. The set of MesH keywords used was provided by experts. RESULTS: The constant advances in medical technology allow ever more relevant diagnostic and therapeutic approaches to be designed. Nevertheless, there is a need to acquire expert knowledge of these innovations in order to identify precociously new associated problems for which new solutions need to be designed and developed.

How Sensor, Signal, and Imaging Informatics May Impact Patient Centered Care and Care Coordination.

OBJECTIVE: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2015 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2014, with a focus on patient centered care coordination. METHODS: The two section editors performed a systematic initial selection and a double blind peer review process to select a list of candidate best papers in the domain published in 2014, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. This selection was peer-reviewed by external reviewers. RESULTS: The review process highlighted articles illustrating two current trends related to care coordination and patient centered care: the enhanced capacity to predict the evolution of a disease based on patient-specific information can impact care coordination; similarly, better perception of the patient and his treatment could lead to enhanced personalized care with a potential impact on care coordination. CONCLUSIONS: This review shows the multiplicity of angles from which the question of patient-centered care can be addressed, with consequences on care coordination that will need to be confirmed and demonstrated in the future.

Transesophageal echocardiography in patients with ischemic stroke accurately detects significant coronary artery stenosis and often changes management.

OBJECTIVES: TEE is performed in many patients with ischemic stroke, and it is possible to examine the proximal coronaries by TEE in these patients. Our purpose was to (1) determine the accuracy of transesophageal echocardiography (TEE) in the diagnosis of proximal coronary stenosis in patients with ischemic stroke and (2) show that TEE detection of proximal coronary stenosis changed management in a substantial number of patients. METHODS: Thirty-two patients with ischemic stroke undergoing TEE, in whom the proximal coronaries were examined and who had angiographic results available, were studied. RESULTS: Proximal coronaries were visualized as follows: left main (LM) in 31 (97%), left anterior descending (LAD) in 32 (100%), left circumflex (LCx) in 30 (94%) and right coronary artery (RCA) in 21 (66%). The sensitivity and specificity of TEE in diagnosing significant coronary stenosis in visualized vessels were as follows: LM 100% and 100%, LAD 100% and 95%, LCx 100% and 96%, and RCA 100% and 100%, respectively. When visualized and nonvisualized segments were considered, TEE detected significant stenosis as follows: 4 of 5 in the LM (80%), 13 of 13 in the LAD (100%), 2 of 3 in the LCx (66%), and 2 of 8 in the RCA (25%). Of the 32 patients, TEE results changed management in 17 patients (53%). Angiographic findings resulted in 10 of the 17 patients (59%) undergoing revascularization. CONCLUSIONS: TEE was very accurate in diagnosing significant coexisting coronary artery disease in patients with ischemic stroke. TEE diagnosis of these lesions prompted coronary angiography and subsequent revascularization in a substantial number of patients.

Discovery of new morganocin types of Morganella morganii in strains of diverse serotype and the apparent independence of bacteriocin type from serotype of strains.

A collection of 45 serologically distinct strains of Morganella morganii from several European countries was typed by morganocin production (p) and sensitivity (s). This permitted their differentiation into 33 morganocin p/s types; 15 new types of morganocin and one new morganocin sensitivity type were found and are defined. Morganocin production and sensitivity characteristics appeared to be unrelated to the O and H antigens of the strain. The finest strain recognition in M. morganii might be achieved by a combination of bacteriocin and serotyping methods.

Protein profile typing--a new method of typing Morganella morganii strains.

A new, simple and stable method for typing Morganella morganii strains is described. The 150 strains examined, principally from faeces, contained haemolytic and non-haemolytic representatives of diverse O serogroup, bacteriocin type and biotype. Among the biotypes were some trehalose-fermenting, tetracycline-resistant strains and some non-motile, tetracycline-sensitive, glycerol fermenters. After analysis of cell lysates by sodium dodecyl sulphate-discontinuous polyacrylamide gel electrophoresis, strains could be differentiated into 21 types on the basis of outer membrane proteins (OMP) of 35-40 Kda. The OMP profile was not altered by culture on various common media and was unrelated to either O antigen or morganocin p-type. The finest strain recognition in M. morganii can be achieved by application of all three distinct typing methods.

[Effect of homogenized human pathogenic Helicobacter pylori on the viability of isolated rat gastric mucosal cells]. / A humán patogén Helicobacter pylori homogenizátum hatása patkány izolált gyomornyálkahártya sejtjeinek életképességére.

Aim of this study was to detect the possible direct cellular effect of Helicobacter pylori (Hp) (obtained by biopsy from patients with gastric and duodenal ulcer) on freshly isolated rat gastric mucosal cells. Urease test positive Hp cultured from human biopsy sample was sonicated and incubated with freshly isolated rat gastric mucosal cells. The direct cellular damaging effect of Hp was evaluated alone and in combination with ethanol and indomethacin. The cellular damaging effect was tested morphologically (Trypan blue exclusion) and biochemically (measurements of lactate dehydrogenase, succinic dehydrogenase and ethidium bromide DNA fluorescence). Hp alone, or in combination with ethanol and indomethacin had no direct cellular toxicity on freshly isolated rat gastric mucosal cells. The isolated and cultured Hp collected from human beings did not produce any cellular damage on freshly isolated rat gastric mucosal cells.

[Management of maxillofacial injuries under extraordinary conditions]. / A maxillo-facialis sérültek ellátása rendkívüli körülmények között.

The authors analyze the most important conditions of the management of patients with maxillofacial injuries in disaster circumstances. Under extraordinary conditions the injuries are frequently complex therefore the establishment of a precise diagnosis is difficult, and one must reckon with the lack of time caused by the occasionally large number of patients to be managed. Under extraordinary conditions the management of maxillofacial injured can only be solved with compromises.

[Management of patients with maxillofacial injuries at the Oral Surgery Department of the Hungarian Central Military Hospital (analysis of a 10-year patient material)]. / A Magyar Honvédség Központi Honvédkórház Szájsebészeti Osztálya arc- és állcsontsérült betegeinek ellátása (10 év beteganyagának elemzése).

The authors have worked up the most important data of as many as 500 patients with malar and mandibular bone injuries. It is established that these injuries mostly derive from aggressive actions and traffic accidents. During this decade the ratio of injuries regarding the mandible and centre of the face has changed from 2.5:1 to 1:1. Since January 1, 1994 the number of managed injured patients has significantly increased, as a consequence of the maxillofacial service connected into the duty management in Budapest.

[The importance of professional cooperation in the management of orbital injuries]. / Társszakmák együttmüködésének jelentösége az orbitasérültek ellátásában.

The injuries of the maxilla and the mandible are usually composite, often requiring the close cooperation of professionals of various specialties. In the Central Military Hospital the authors have set up a team for the complex diagnostic and therapeutic management of patients with orbit injuries. The organizational aspects and basic principles of the team work are dealt with.

Sensor, signal, and imaging informatics: big data and smart health technologies.

OBJECTIVES: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2014 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2013, with a focus on Big Data and Smart Health Technologies Methods: We performed a systematic initial selection and a double blind peer review process to find the best papers in this domain published in 2013, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. RESULTS: Big Data are collections of large and complex datasets which have the potential to capture the whole variability of a study population. More and more innovative sensors are emerging, allowing to enrich these big databases. However they become more and more challenging to process (i.e. capture, store, search, share, transfer, exploit) because traditional tools are not adapted anymore. CONCLUSIONS: This review shows that it is necessary not only to develop new tools specifically designed for Big Data, but also to evaluate their performance on such large datasets.

Sensor, signal, and imaging informatics: evidence-based health informatics.

OBJECTIVES: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2013 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2012. METHODS: We performed a systematic initial selection and a double blind peer review process to find the best papers in this domain published in 2012, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. RESULTS: Current research in the field of sensor signal and imaging informatics is based on innovative sensors from which relevant information (signal and imaging) can be acquired and integrated into workflow based or patient based models. This rich environment can help the medical staff in carrying out more optimal care. The demonstration of the added value of such innovations is more and more performed through evidence-based evaluations. CONCLUSIONS: The best paper selection of articles on sensors, signal, and imaging informatics illustrates the wide spectrum covered by this field in 2012, and the attention paid to evaluations.

New O antigens of Morganella morganii and the relationships between haemolysin production. O antigens and morganocin types of strains.

A collection of 142 strains of Morganella morganii, principally from unrelated patients' faeces was examined to determine the relationship, if any, between haemolysin production, O antigen and morganocin production/sensitivity type. Only 55 (38.7%) were agglutinable with the existing 44 O antisera. However, when O antisera were raised to some of the non-typable strains 11 new O antigens were found and 126 (88.7%) of the strains were typable. The number of O antigenic groups in M. morganii is now 55. It was confirmed that the O antigenic characteristics of strains were independent from morganocin producer types. An epidemiological retrospective survey showed that finer strain recognition in M. morganii can be achieved by using both methods than either method alone. Approximately 30% of strains were haemolytic. The ability to produce haemolysin was more common in strains of certain O serogroups and morganocin producer types than in others.