A computational method for semi-automatic measurement of pressure ulcers.

Pressure ulcers are skin lesions caused by the excessive compression of soft tissues between bones and hard surfaces that may increase treatment risks and costs. Manual techniques to evaluate the area of the affected region include the use of adhesive labels and rulers in direct contact with the ulcer. In this article, a semi-automatic method is proposed to estimate the lesion area through computerized techniques in different color spaces using filters and morphological operators. Experiments with a set of 110 images of pressure ulcers resulted in a statistically significant increase in effectiveness, when compared with other published results, reaching 90.8% of precision, 81.6% of sensitivity, and 81.3% of accuracy.

Neuropsychiatric and sleep study in autosomal dominant dopa-responsive dystonia.

Introduction: Although the diurnal fluctuation of motor dysfunction, reversible with small doses of dopamine, is a cornerstone for the phenotype of the autosomal dominant Segawa syndrome, the non-motor symptoms of this neurotransmitter deficiency have still received limited attention. Objective: This study aims to evaluate non-motor symptoms of this dopa-responsive dystonia through an intrafamilial comparative cross-sectional study. Methods: Seventeen individuals with a c.IVS5 + 3insT (c.626 + 3insT) variation in the GTP cyclohydrolase-1 gene (GCH1, HGNC: 4193) and 34 intrafamilial controls were studied using the Beck Depression Inventory-II, the Wiener Matrizen Test 2, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, the MINI/MINI PLUS Questionnaires, the World Health Organization Quality of Life - BREF Instrument and a drug use assessment questionnaire. Results: No significant difference was found between the groups in the prevalence of sleep disorders and in cognitive function. Nevertheless, generalized anxiety disorder (p = 0.050) and attention-deficit/hyperactivity disorder in childhood (p = 0.011) were observed only in individuals without the molecular variation. The group with the GCH1 variation presented a worse perception about how safe they feel in their daily lives (p = 0.034), less satisfaction with themselves (p = 0.049) and with their relationships (p = 0.029), and a higher prevalence of past major depressive episodes before use of L-Dopa (p = 0.046). Conclusion: Low dopamine could have been protective against generalized anxiety disorder and attention-deficit/hyperactivity disorder in childhood in Segawa group individuals. The prevalence of depression was higher in individuals with the molecular variant prior to the L-Dopa treatment. Considering it, the penetrance estimates for the variant carriers increased from 58.8% to up to 88% in this large studied family. Additionally, neuropsychiatric tests of all individuals with a molecular diagnosis in an affected family are a valuable instrument for its clinical management.

Raman spectroscopy with a 1064-nm wavelength laser as a potential molecular tool for prostate cancer diagnosis: a pilot study.

Raman spectroscopy is widely used to investigate the structure and property of the molecules from their vibrational transitions and may allow for the diagnosis of cancer in a fast, objective, and nondestructive manner. This experimental study aims to propose the use of the 1064-nm wavelength laser in a Raman spectroscopy and to evaluate its discrimination capability in prostate cancer diagnosis. Seventy-four spectra from patients who underwent radical prostatectomy were evaluated. The acquired signals were filtered, normalized, and corrected for possible oscillations in the laser intensity and fluorescence effects. Wilcoxon tests revealed significant differences between the benign and malign samples associated with the deformation vibration characteristic of nucleic acids, proteins, and lipids. A classifier based on support vector machines was able to predict the Gleason scores of the samples with 95% of accuracy, opening a perspective for the use of the 1064-nm excitatory wavelength in prostatic cancer diagnosis.

Corpus callosum morphology and ventricular size in chromosome 22q11.2 deletion syndrome.

In this paper, novel methods were used to map the corpus callosum morphology of children with chromosome 22q11.2 deletion syndrome in order to further investigate changes to that structure and to examine their possible effects on cognitive function. The callosal profiles were extracted from the centermost MRI midsagittal slice by supervised thresholding and the structure's boundary and midline were computed automatically. Difference analysis was based on non-rigid registration, in which a template image is warped to conform to the shape of each corpus callosum in the sample. Boundaries and midlines were registered to a template and the results used to determine the average callosal shapes for children with the deletion and for controls. Pointwise registration also enabled the detailed evaluation of callosal curvature, width, area and length. Significant differences between the two groups were found in shape, size and bending angle. Results showed group differences that were concentrated in the anterior part of the structure, more specifically in the rostrum, which was larger and longer in the group with the syndrome. Correlation analyses showed that ventricular enlargement does not fully account for callosal morphology differences in children with the deletion. However, areal measurements did reveal important relationships between changes in callosal morphology and cognitive function. These novel findings reveal intricate relationships between genetic and disease-specific factors in the callosal anatomy and the potential impact of those changes on cognitive functions.

Effects on 18F-FDG PET/CT Brain Glucose Metabolism in Rectal Cancer Patients Undergoing Neoadjuvant Chemotherapy.

PURPOSE: Retrospective study of the effects of anticancer treatment on the brain metabolism of patients diagnosed with rectal cancer based on a large and homogeneous sample of 40 paired F-FDG PET/CT volumes taken from 20 patients. The results are compared to the ones presented by related works to help elucidating the mechanisms of neurotoxicity associated to a decrease in memory, learning and motor skills. PATIENTS AND METHODS: Twenty patients with rectal adenocarcinoma were scanned before and after neoadjuvant chemoradiation based exclusively on 5-fluorouracil and leucovorin. The sample was non-rigidly registered to a common template to allow for the comparison of regional metabolism. Statistical analysis was based on adjusted paired t-tests. RESULTS: The analysis primarily revealed a statistically significant decrease in the metabolism after neoadjuvant chemotherapy at the hypothalamus, putamen, head of the caudate, globus pallidus, red nucleus, substantia nigra, amygdala, cerebellum and the parahippocampal gyrus. The analysis also revealed smaller regions of increased metabolic activity at the middle temporal gyrus, precuneus of the parietal lobe and cuneus of the occipital lobe. CONCLUSIONS: The regions of decreased metabolism detected in the study are related to memory, learning and voluntary movement which is consistent with previous findings based on clinical studies and neuropsychological tests that report impairments on neurocognitive and motor skills associated to these therapies.

Structural shape characterization via exploratory factor analysis.

UNLABELLED: This article presents an exploratory factor analytic approach to morphometry in which a high-dimensional set of shape-related variables is examined with the purpose of finding clusters with strong correlation. This clustering can potentially identify regions that have anatomic significance and thus lend insight to knowledge discovery and morphometric investigations. METHODS: The information about regional shape is extracted by registering a reference image to a set of test images. Based on the displacement fields obtained form image registration, the amount of pointwise volume enlargement or reduction is computed and statistically analyzed with the purpose of extracting a reduced set of common factors. EXPERIMENTS: The effectiveness and robustness of the method is demonstrated in a study of gender-related differences of the human corpus callosum anatomy, based on a sample of 84 right-handed normal controls. RESULTS: The method is able to automatically partition the structure into regions of interest, in which the most relevant shape differences can be observed. The confidence of results is evaluated by analyzing the statistical fit of the model and compared to previous experimental works.

MammoSys: A content-based image retrieval system using breast density patterns.

In this paper, we present a content-based image retrieval system designed to retrieve mammographies from large medical image database. The system is developed based on breast density, according to the four categories defined by the American College of Radiology, and is integrated to the database of the Image Retrieval in Medical Applications (IRMA) project, that provides images with classification ground truth. Two-dimensional principal component analysis is used in breast density texture characterization, in order to effectively represent texture and allow for dimensionality reduction. A support vector machine is used to perform the retrieval process. Average precision rates are in the range from 83% to 97% considering a data set of 5024 images. The results indicate the potential of the system as the first stage of a computer-aided diagnosis framework.