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1.
J Nucl Cardiol ; : 101911, 2024 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-39009215

RESUMO

PURPOSE: The heart-to-mediastinum ratio (H/M-Ratio) of 123iodo-metaiodobenzylguanidine (123I-MIBG) represents state-of-the-art assessment for sympathetic dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). This study aims to evaluate quantitative reconstruction of 123I-MIBG uptake and to demonstrate its correlation with echocardiographic parameters. METHODS: Cardiac innervation was assessed in 23 patients diagnosed with definite ARVC or borderline ARVC and 12 patients with other cardiac disease presenting arrhythmia, using quantitative 123I-MIBG Single Photon Emission Computed Tomography / Computed Tomography (SPECT/CT) imaging. Tracer uptake was evaluated in the left (LV) and right ventricle (RV) based on a CT scan after quantitative image reconstruction. The relationship between tracer uptake and echocardiographic parameter data was examined. RESULTS: Absolute quantification of 123I-MIBG uptake in the LV and RV is feasible and correlates accurately with the gold standard H/M-Ratio. When comparing sensitivity and specificity, the area under the curve (AUC) favors standardized uptake value (SUV) of the RV over the right-ventricle-to-mediastinum-ratio (RV/M-Ratio) for diagnosing ARVC. A reduced RV-SUV in patients with definite ARVC is associated with reduced RV function. RV polar maps revealed globally reduced 123I-MIBG uptake without segment-specific reduction in the RV. CONCLUSION: Quantitative 123I-MIBG SPECT in ARCV patients offers robust potential for clinical reporting and demonstrates a significant correlation with RV function. Segmental RV analysis needs to be evaluated in larger samples. In summary, cardiac 123I-MIBG imaging using SUV could facilitate image-guided therapy in patients diagnosed with ARVC.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38980377

RESUMO

INTRODUCTION: Detailed postoperative rehabilitation protocols after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) are still a matter of debate. Adjunctive hip bracing represents a promising tool to improve early patients' mobilization. To present, the effect of hip brace therapy on postoperative functional outcomes and specific patient individual psychologic factors remains controversially discussed. Consequently, we aimed to report postoperative outcomes focusing on hip function, pain and kinesiophobia between braced and unbraced patients. MATERIALS AND METHODS: A prospective, randomized-controlled trial was conducted, including patients undergoing hip arthroscopy for FAIS. After exclusion, a final study cohort of 36 patients in the intervention group (postoperative hip brace) and 36 patients in the control group (no hip brace) were compared for kinesiophobia (Tampa Scale of Kinesiophobia), pain (Visual analog scale) and joint function (International Hip Outcome Tool-12) within the first six postoperative months. RESULTS: Hip arthroscopy significantly improved all patient-reported outcomes in both groups. Intergroup analysis revealed significantly lower levels of kinesiophobia in braced patients at 6-months follow up (30.7 vs. 34.1, p = 0.04) while not negatively affecting pain and joint function. No intra- and postoperative complications occurred within both groups. CONCLUSIONS: This study could demonstrate that bracing after hip arthroscopy can positively influence kinesiophobia, while the brace did not negatively impact postoperative pain and quality of life. Thus, hip bracing could be a viable assistive therapy in the postoperative rehabilitation phase after hip arthroscopy.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38967778

RESUMO

INTRODUCTION: The treatment option for borderline hip dysplasia (BHD) includes hip arthroscopy and periacetabular osteotomy (PAO). To the present day the controversial discussion remains, which intervention to prefer. Literature reports supporting an educated choice are scare, based on small patient cohorts and do not address the variability of acetabular morphology. Consequently, we intended to report PAO outcomes, from patients diagnosed with BHD, dependent on acetabular morphology, in a large patient cohort and aimed to define risk factors for poor clinical results and patient satisfaction. MATERIALS AND METHODS: A prospective monocentre study was conducted. Patients enrolled underwent PAO for symptomatic BHD (LCEA, 18°-25°). A total of 107 hips were included with 94 complete data sets were available for evaluation with a minimum follow-up of 1 year and a mean follow-up of 2.3 years. The mean age was 31 ± 8.2 years, and 81.3% were female. As the primary outcome measure, we utilized the modified Harris hip score (mHHS) with minimal clinically important change (MCID) of eight to define clinical failure. Results were compared after a comprehensive radiographic assessment distinguishing between lateral deficient vs. anterior/posterolateral deficient acetabular and stable vs. unstable hip joints. RESULTS: Overall, clinical success was achieved in 91.5% of patients and the mHHS improved significantly (52 vs. 84.7, p < 0.001). Eight hips failed to achieve the MCID and four had radiographic signs of overcorrection. Comparing variable joint morphologies, the rate of clinical success was higher in patients with an anterior/posterolateral deficient acetabular covarage compared to lateral deficient acetabular (95.2% vs. 90.4%). tThe highest rate of clinical failure was recorded in unstable hip joints (85.7% vs. 92.5% in stable hips). CONCLUSIONS: This study demonstrates that PAO is an effective means to treat symptomatic BHD with variable acetabular morphologies, achieving a clinical success in 91.5% of all patients. To maintain a high level of safety and patient satisfaction technical accuracy appears crucial.

4.
Q J Nucl Med Mol Imaging ; 67(3): 230-237, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34881846

RESUMO

BACKGROUND: Left ventricular mechanical dyssynchrony (LVMD) and left ventricular function are intertwined. Gated myocardial perfusion SPECT (MPS) and gated fluorodeoxyglucose positron emission computed tomography (FDG PET) is an elegant way for repeated assessment of myocardial dyssynchrony and myocardial function. To the knowledge of the authors at the time this manuscript was prepared, there was no comprehensive evaluation of the interplay of LVMD and left ventricular function as measured by gated MPS and gated FDG PET; as well as no evaluation of the agreement between the two methods. METHODS: Patients were assigned to the reference cohort (RC) and the dyssynchrony cohort (DC) based on the phase analysis results of gated MPS datasets. Subsequently left ventricular function was analyzed. RESULTS: We demonstrated that LVMD as detected by gated MPS is associated with a significantly higher end-diastolic volume (EDV) and end-systolic volume (ESV) as well as a significantly reduced left ventricular ejection fraction (LVEF) both in gated MPS and gated FDG PET imaging. In the RC and the DC SPECT and PET showed good agreement and generally high linear correlations with regard to left ventricular volumes and LVEF. In the combined cohort (RC and DC) increasing amounts of LVMD were associated with increasing left ventricular volumes as well as a decreasing LVEF. The association was strongest for the dyssynchrony parameter Entropy. CONCLUSIONS: We demonstrated that gated SPECT and gated PET are useful tools in the evaluation of left ventricular function in patients with LVMD as detected by gated MPS. Increasing amounts of dyssynchrony were associated with an increasingly reduced myocardial function. For repeated measurements or therapy monitoring, the methods should not be used interchangeably.


Assuntos
Imagem de Perfusão do Miocárdio , Disfunção Ventricular Esquerda , Humanos , Fluordesoxiglucose F18 , Função Ventricular Esquerda , Volume Sistólico , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/complicações , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia por Emissão de Pósitrons/métodos , Perfusão , Imagem de Perfusão do Miocárdio/métodos
5.
Eur J Immunol ; 51(1): 250-252, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32761616

RESUMO

In mouse myocardial infarction, we combined lineage tracing of cardiac macrophages, mapping their ontogeny, with an analysis of their phenotype and phagocytic functions. While embryo-derived macrophages were most abundant in homeostasis, bone marrow-derived MHC-IIlo macrophages increased in both numbers and phagocytic capacity to clear necrotic cardiomyocytes early after ischemia/perfusion injury.


Assuntos
Antígenos de Histocompatibilidade Classe II/metabolismo , Macrófagos/imunologia , Infarto do Miocárdio/imunologia , Miocárdio/imunologia , Animais , Receptor 1 de Quimiocina CX3C/metabolismo , Modelos Animais de Doenças , Embrião de Mamíferos/citologia , Embrião de Mamíferos/imunologia , Macrófagos/patologia , Camundongos , Camundongos Transgênicos , Infarto do Miocárdio/patologia , Miocárdio/patologia , Miócitos Cardíacos/imunologia , Miócitos Cardíacos/patologia , Fagocitose/imunologia
6.
J Nucl Cardiol ; 29(5): 2350-2360, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34282536

RESUMO

BACKGROUND: Due to partly conflicting studies, further research is warranted with the QGS software package, with regard to the performance of gated FDG PET phase analysis as compared to gated MPS as well as the establishment of possible cut-off values for FDG PET to define dyssynchrony. METHODS: Gated MPS and gated FDG PET datasets of 93 patients were analyzed with the QGS software. BW, Phase SD, and Entropy were calculated and compared between the methods. The performance of gated PET to identify dyssynchrony was measured against SPECT as reference standard. ROC analysis was performed to identify the best discriminator of dyssynchrony and to define cut-off values. RESULTS: BW and Phase SD differed significantly between the SPECT and PET. There was no significant difference in Entropy with a high linear correlation between methods. There was only moderate agreement between SPECT and PET to identify dyssynchrony. Entropy was the best single PET parameter to predict dyssynchrony with a cut-off point at 62%. CONCLUSION: Gated MPS and gated FDG PET can assess LVMD. The methods cannot be used interchangeably. Establishing reference ranges and cut-off values is difficult due to the lack of an external gold standard. Further prospective research is necessary.


Assuntos
Fluordesoxiglucose F18 , Disfunção Ventricular Esquerda , Humanos , Compostos Organofosforados , Compostos de Organotecnécio , Compostos Radiofarmacêuticos , Reprodutibilidade dos Testes , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Disfunção Ventricular Esquerda/diagnóstico por imagem
7.
J Nucl Cardiol ; 29(5): 2511-2520, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34341952

RESUMO

BACKGROUND: To evaluate quantitative myocardial perfusion SPECT/CT datasets for routine clinical reporting and the assessment of myocardial tracer uptake in patients with severe TVCAD. METHODS: MPS scans were reconstructed as quantitative SPECT datasets using CTs from internal (SPECT/CT, Q_INT) and external (PET/CT, Q_EXT) sources for attenuation correction. TPD was calculated and compared to the TPD from non-quantitative SPECT datasets of the same patients. SUVmax, SUVpeak, and SUVmean were compared between Q_INT and Q_EXT SPECT datasets. Global SUVmax and SUVpeak were compared between patients with and without TVCAD. RESULTS: Quantitative reconstruction was feasible. TPD showed an excellent correlation between quantitative and non-quantitative SPECT datasets. SUVmax, SUVpeak, and SUVmean showed an excellent correlation between Q_INT and Q_EXT SPECT datasets, though mean SUVmean differed significantly between the two groups. Global SUVmax and SUVpeak were significantly reduced in patients with TVCAD. CONCLUSIONS: Absolute quantification of myocardial tracer uptake is feasible. The method seems to be robust and principally suitable for routine clinical reporting. Quantitative SPECT might become a valuable tool for the assessment of severe coronary artery disease in a setting of balanced ischemia, where potentially life-threatening conditions might otherwise go undetected.


Assuntos
Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Doença da Artéria Coronariana/diagnóstico por imagem , Humanos , Imagem de Perfusão do Miocárdio/métodos , Perfusão , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada de Emissão de Fóton Único/métodos
8.
Int J Mol Sci ; 23(4)2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35216160

RESUMO

Cold physical plasma (CPP), a partially ionized gas that simultaneously generates reactive oxygen and nitrogen species, is suggested to provide advantages in regenerative medicine. Intraoperative CPP therapy targeting pathologies related to diminished bone quality could be promising in orthopedic surgery. Assessment of a clinically approved plasma jet regarding cellular effects on primary bone marrow mesenchymal stromal cells (hBM-MSCs) from relevant arthroplasty patient cohorts is needed to establish CPP-based therapeutic approaches for bone regeneration. Thus, the aim of this study was to derive biocompatible doses of CPP and subsequent evaluation of human primary hBM-MSCs' osteogenic and immunomodulatory potential. Metabolic activity and cell proliferation were affected in a treatment-time-dependent manner. Morphometric high content imaging analyses revealed a decline in mitochondria and nuclei content and increased cytoskeletal compactness following CPP exposure. Employing a nontoxic exposure regime, investigation on osteogenic differentiation did not enhance osteogenic capacity of hBM-MSCs. Multiplex analysis of major hBM-MSC cytokines, chemokines and growth factors revealed an anti-inflammatory, promatrix-assembling and osteoclast-regulating secretion profile following CPP treatment and osteogenic stimulus. This study can be noted as the first in vitro study addressing the influence of CPP on hBM-MSCs from individual donors of an arthroplasty clientele.


Assuntos
Diferenciação Celular , Citocinas/metabolismo , Células-Tronco Mesenquimais/citologia , Osteoblastos/citologia , Gases em Plasma/farmacologia , Idoso , Núcleo Celular/metabolismo , Células Cultivadas , Citocinas/genética , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Pessoa de Meia-Idade , Mitocôndrias/metabolismo , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo
9.
RNA Biol ; 17(12): 1721-1726, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32752923

RESUMO

RNA-binding proteins regulate RNA fate and govern post-transcriptional gene regulation. A new family of RNA-binding proteins is represented by regulatory RNases (Regnase, also known as Zc3h12 or MCPIP), which have emerged as important players in immune homoeostasis. Four members, Regnase1-4, have been identified to date. Here we summarize recent findings on the role of Regnase in the regulation of RNA biology and its consequences for cell functions and inflammatory processes.


Assuntos
Imunomodulação , Proteínas de Ligação a RNA/metabolismo , Ribonucleases/metabolismo , Fatores de Transcrição/metabolismo , Imunidade Adaptativa , Animais , Suscetibilidade a Doenças , Homeostase/imunologia , Humanos , Imunidade Inata , Inflamação/etiologia , Inflamação/metabolismo , Família Multigênica , Proteínas de Ligação a RNA/genética , Ribonucleases/genética , Fatores de Transcrição/genética
10.
Unfallchirurg ; 121(10): 810-816, 2018 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-29368180

RESUMO

BACKGROUND: Operative treatment of clavicle fractures by intramedullary nailing with titanium elastic nailing (TEN) has been established as an alternative to plate osteosynthesis for many years. The main complication after TEN osteosynthesis is nail migration. The goal of this study was evaluation of predictors for medial nail migration and comparison with plate osteosynthesis. MATERIAL AND METHODS: A retrospective analysis of electronic patient charts, surgical protocols and radiographs of all operatively treated clavicle shaft fractures between 2010-2014 (n = 141) was performed. When evaluating the patient charts and the surgical protocols special attention was paid to the fracture type, the duration of the operation, the need for an open reduction and the onset of complications as well as the duration until implant removal. Radiographs were analyzed concerning the implant location and an implant migration. RESULTS: Surgery time (39 vs. 83 min) as well as the time to implant removal (226 vs. 495 days) were significantly reduced (p = 0.00), while complication (39% vs. 21.4%) as well as reoperation rates (15% vs. 7.1%; p = 0.033) were increased in TEN compared to plate osteosynthesis. The main complication was medial nail migration. The following predictors regarding medial migration could be identified: open or closed reduction (p = 0.021), multifragmentary fractures (p = 0.049), oblique fractures (p = 0.08) and TEN thickness (33% at 2 mm, 0% at 3 mm). DISCUSSION: Advantages of TEN are a shorter surgery time as well as a shorter duration until implant removal. The TEN osteosynthesis led to a significantly increased complication rate, with nail migration representing the major reason. When predictors for medial TEN migration are considered, type B and C fractures can also be sufficiently treated by a large diameter TEN.


Assuntos
Pinos Ortopédicos/efeitos adversos , Clavícula/lesões , Fixação Intramedular de Fraturas/efeitos adversos , Fraturas Ósseas/cirurgia , Consolidação da Fratura , Humanos , Falha de Prótese/etiologia , Estudos Retrospectivos , Resultado do Tratamento
11.
Nano Lett ; 15(9): 6267-75, 2015 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-26284499

RESUMO

Plasmonic structures can provide deep-subwavelength electromagnetic fields that are useful for enhancing light-matter interactions. However, because these localized modes are also dissipative, structures that offer the best compromise between field confinement and loss have been sought. Metallic wedge waveguides were initially identified as an ideal candidate but have been largely abandoned because to date their experimental performance has been limited. We combine state-of-the-art metallic wedges with integrated reflectors and precisely placed colloidal quantum dots (down to the single-emitter level) and demonstrate quantum-plasmonic waveguides and resonators with performance approaching theoretical limits. By exploiting a nearly 10-fold improvement in wedge-plasmon propagation (19 µm at a vacuum wavelength, λvac, of 630 nm), efficient reflectors (93%), and effective coupling (estimated to be >70%) to highly emissive (~90%) quantum dots, we obtain Ag plasmonic resonators at visible wavelengths with quality factors approaching 200 (3.3 nm line widths). As our structures offer modal volumes down to ~0.004λvac(3) in an exposed single-mode waveguide-resonator geometry, they provide advantages over both traditional photonic microcavities and localized-plasmonic resonators for enhancing light-matter interactions. Our results confirm the promise of wedges for creating plasmonic devices and for studying coherent quantum-plasmonic effects such as long-distance plasmon-mediated entanglement and strong plasmon-matter coupling.

12.
Bone Joint J ; 106-B(5 Supple B): 54-58, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38688499

RESUMO

Aims: The use of a porous metal shell supported by two augments with the 'footing' technique is one solution to manage Paprosky IIIB acetabular defects in revision total hip arthroplasty. The aim of this study was to assess the medium-term implant survival and radiological and clinical outcomes of this technique. Methods: We undertook a retrospective, two-centre series of 39 hips in 39 patients (15 male, 24 female) treated with the 'footing' technique for Paprosky IIIB acetabular defects between 2007 and 2020. The median age at the time of surgery was 64.4 years (interquartile range (IQR) 54.4 to 71.0). The median follow-up was 3.9 years (IQR 3.1 to 7.0). Results: The cumulative medium-term survival of the acetabular construct was 89%. Two hips (5.1%) required further revision due to shell loosening, one hip (2.6%) due to shell dislocation, and one hip (2.6%) due to infection. The median Harris Hip Score improved significantly from 47 points (IQR 41.5 to 54.9) preoperatively to 80 points (IQR 73.5 to 88.6) at the latest follow-up (p < 0.001). Conclusion: The reconstruction of Paprosky IIIB acetabular defects with porous tantalum shells and two augments using the 'footing' technique showed excellent medium-term results. It is a viable option for treating these challenging defects.


Assuntos
Acetábulo , Artroplastia de Quadril , Prótese de Quadril , Desenho de Prótese , Falha de Prótese , Reoperação , Tantálio , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acetábulo/cirurgia , Artroplastia de Quadril/métodos , Artroplastia de Quadril/instrumentação , Porosidade , Estudos Retrospectivos
13.
ChemSusChem ; : e202301900, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38624078

RESUMO

Flotation of the mineral lithium aluminate by application of the natural product punicine from Punica granatum and some derivatives as collectors is examined. Punicines, 1-(2',5'-dihydroxyphenyl)-pyridinium compounds, are switchable molecules whose properties can be changed reversibly. They exist as cations, neutral mesomeric betaines, anions, and dianions depending on the pH. In light, they form radicals. Five punicine derivatives were prepared which possess ß-methyl, ß-chlorine, γ-tert.-butyl, and γ-acetyl groups attached to the pyridinium ring, and a pyrogallol derivative. On the other hand, LiAlO2 reacts with water to give species such as LiAl2(OH)7 on its surface. Flotations were performed applying the punicines in daylight (3000 lux), in darkness (<40 lux) and under UV-irradiation (4500 lux, 390-400 nm). The pH of the suspension, the collector's concentration, the conditioning time as well as the flotation time were varied. The recovery rates strongly depend on these parameters. For example, the recovery rate of lithium aluminate was increased by 116 % on changing the lighting condition from daylight to darkness, when the pyrogallol derivative of punicine was applied. UV, FTIR, TGA and zeta potential measurements as well as DFT calculations were performed in order to gain insight into the chemistry of punicines on the surface of LiAlO2 and LiAl2(OH)7 in water which influence the flotation's results.

14.
Front Surg ; 11: 1363298, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38476757

RESUMO

This case-report focuses on a 23-year-old soldier suffering from a fracture-related hip joint infection (FRI) due to extensively drug-resistant Klebsiella pneumoniae and S. epidermidis. The patient underwent multiple septic revision surgeries including the removal of remaining shrapnel accompanied by last-resort antimicrobial therapy with cefiderocol and colistin. Additionally, the surgeries included repeated tissue sampling for microbiological and histopathological analysis. An antibiotic-loaded cemented filler containing cefiderocol was used to improve local antimicrobial therapy. The biopsies prior to and during hip replacement surgery confirmed successful microbe eradication. Hip arthroplasty restored hip joint function and significantly improved patient's quality of life. The utilization of a trabecular metal shell and a meta-diaphyseally anchored cementless hip stem ensured secure implant fixation and early patient mobilisation. An adjusted biofilm active oral antimicrobial therapy after arthroplasty intervention was continued to prevent early periprosthetic joint infection. This case emphasizes the difficulties of managing FRI and multidrug-resistant pathogens. It contributes valuable insight into navigating complex orthopedic cases while ensuring successful hip arthroplasty outcomes. In conclusion, early interdisciplinary collaboration, appropriate antimicrobial therapy along with tailored surgical interventions are crucial for managing such complex cases successfully.

15.
RSC Adv ; 14(13): 9353-9364, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38510489

RESUMO

Derivatives of the natural product punicine [1-(2',5'-dihydroxyphenyl)pyridinium chloride] were developed as switchable collectors for the flotation of lithium-containing engineered artifical minerals (EnAMs). These EnAMs are e.g. formed by pyrometallurgical processing of end-of-life lithium-ion batteries. Depending on the pH value and the lighting conditions, punicines exist in water as cations, two different electrostatically neutral mesomeric betaines, anionic tripoles, radical cations or radical anions. The radical species form by photochemically induced disproportionation reactions. We prepared punicine derivatives introducing alkyl chains in the pyridinium moiety (4-methyl, 4-ethyl, 4-octyl and 4-undecanyl) to install hydrophobic groups and examined the recovery rates of the flotation of lithium aluminate (LiAlO2). We varied the lighting conditions (darkness, daylight, LED irradiation at λ = 390-400 nm) and the pH value, the collector's and frother's concentration, and the flotation time. With our collectors, recovery rates of lithium aluminate up to 90% were accomplished when the flotation was conducted in Hallimond tubes exposed to daylight at pH 11 in water.

16.
iScience ; 27(2): 109023, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38352223

RESUMO

The preoperative distinction between glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) can be difficult, even for experts, but is highly relevant. We aimed to develop an easy-to-use algorithm, based on a convolutional neural network (CNN) to preoperatively discern PCNSL from GBM and systematically compare its performance to experienced neurosurgeons and radiologists. To this end, a CNN-based on DenseNet169 was trained with the magnetic resonance (MR)-imaging data of 68 PCNSL and 69 GBM patients and its performance compared to six trained experts on an external test set of 10 PCNSL and 10 GBM. Our neural network predicted PCNSL with an accuracy of 80% and a negative predictive value (NPV) of 0.8, exceeding the accuracy achieved by clinicians (73%, NPV 0.77). Combining expert rating with automated diagnosis in those cases where experts dissented yielded an accuracy of 95%. Our approach has the potential to significantly augment the preoperative radiological diagnosis of PCNSL.

17.
Chest ; 166(1): 157-170, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38295950

RESUMO

BACKGROUND: Chest radiographs (CXRs) are still of crucial importance in primary diagnostics, but their interpretation poses difficulties at times. RESEARCH QUESTION: Can a convolutional neural network-based artificial intelligence (AI) system that interprets CXRs add value in an emergency unit setting? STUDY DESIGN AND METHODS: A total of 563 CXRs acquired in the emergency unit of a major university hospital were retrospectively assessed twice by three board-certified radiologists, three radiology residents, and three emergency unit-experienced nonradiology residents (NRRs). They used a two-step reading process: (1) without AI support; and (2) with AI support providing additional images with AI overlays. Suspicion of four suspected pathologies (pleural effusion, pneumothorax, consolidations suspicious for pneumonia, and nodules) was reported on a five-point confidence scale. Confidence scores of the board-certified radiologists were converted into four binary reference standards of different sensitivities. Performance by radiology residents and NRRs without AI support/with AI support were statistically compared by using receiver-operating characteristics (ROCs), Youden statistics, and operating point metrics derived from fitted ROC curves. RESULTS: NRRs could significantly improve performance, sensitivity, and accuracy with AI support in all four pathologies tested. In the most sensitive reference standard (reference standard IV), NRR consensus improved the area under the ROC curve (mean, 95% CI) in the detection of the time-critical pathology pneumothorax from 0.846 (0.785-0.907) without AI support to 0.974 (0.947-1.000) with AI support (P < .001), which represented a gain of 30% in sensitivity and 2% in accuracy (while maintaining an optimized specificity). The most pronounced effect was observed in nodule detection, with NRR with AI support improving sensitivity by 53% and accuracy by 7% (area under the ROC curve without AI support, 0.723 [0.661-0.785]; with AI support, 0.890 [0.848-0.931]; P < .001). Radiology residents had smaller, mostly nonsignificant gains in performance, sensitivity, and accuracy with AI support. INTERPRETATION: We found that in an emergency unit setting without 24/7 radiology coverage, the presented AI solution features an excellent clinical support tool to nonradiologists, similar to a second reader, and allows for a more accurate primary diagnosis and thus earlier therapy initiation.


Assuntos
Inteligência Artificial , Serviço Hospitalar de Emergência , Radiografia Torácica , Humanos , Radiografia Torácica/métodos , Estudos Retrospectivos , Masculino , Feminino , Competência Clínica , Pessoa de Meia-Idade , Curva ROC , Adulto , Idoso
18.
Elife ; 122024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38775664

RESUMO

Cardiac macrophages are heterogenous in phenotype and functions, which has been associated with differences in their ontogeny. Despite extensive research, our understanding of the precise role of different subsets of macrophages in ischemia/reperfusion (I/R) injury remains incomplete. We here investigated macrophage lineages and ablated tissue macrophages in homeostasis and after I/R injury in a CSF1R-dependent manner. Genomic deletion of a fms-intronic regulatory element (FIRE) in the Csf1r locus resulted in specific absence of resident homeostatic and antigen-presenting macrophages, without affecting the recruitment of monocyte-derived macrophages to the infarcted heart. Specific absence of homeostatic, monocyte-independent macrophages altered the immune cell crosstalk in response to injury and induced proinflammatory neutrophil polarization, resulting in impaired cardiac remodeling without influencing infarct size. In contrast, continuous CSF1R inhibition led to depletion of both resident and recruited macrophage populations. This augmented adverse remodeling after I/R and led to an increased infarct size and deterioration of cardiac function. In summary, resident macrophages orchestrate inflammatory responses improving cardiac remodeling, while recruited macrophages determine infarct size after I/R injury. These findings attribute distinct beneficial effects to different macrophage populations in the context of myocardial infarction.


Assuntos
Macrófagos , Receptores de Fator Estimulador das Colônias de Granulócitos e Macrófagos , Animais , Macrófagos/imunologia , Camundongos , Receptores de Fator Estimulador das Colônias de Granulócitos e Macrófagos/metabolismo , Receptores de Fator Estimulador das Colônias de Granulócitos e Macrófagos/genética , Isquemia Miocárdica/imunologia , Infarto do Miocárdio/patologia , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/imunologia , Masculino , Traumatismo por Reperfusão Miocárdica/imunologia , Traumatismo por Reperfusão Miocárdica/patologia , Camundongos Endogâmicos C57BL , Miocárdio/patologia , Miocárdio/imunologia , Modelos Animais de Doenças
19.
Zootaxa ; 3721: 401-54, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-26120685

RESUMO

The Opiinae (Hymenoptera: Braconidae) species recorded from Turkey until the end of 2011 are listed, the present total number being 182. Changes with respect to the previous Turkish fauna are briefly annotated and the distributions for all the species in each of the 68 biogeographical provinces of Turkey are presented. After the publication of our previous fauna, 174 species have been recorded as new to Turkey. Of these, 105 species are distributed only in Asian Turkey and ten species are distributed only in European Turkey, while 73 species occur in both. The presented checklist covers synonyms, zoogeographical region(s), hosts, host plants of the host species and parasitoid data for the species. In total, 182 species belonging to ten genera are reported for Turkey. The number of species of each genus is represented by: Atormus van Achterberg, 1997: one; Biosteres Foerster, 1862: 17; Bitomus Szépligeti, 1910: three; Diachasma Foerster, 1862: one; Diachasmimorpha Viereck, 1913: one; Eurytenes Foerster, 1862: three; Indiopius Fischer, 1966: three; Opius Wesmael, 1835: 151, Psyttalia Walker, 1860: one; Sternaulopius Fischer, 1965: one.


Assuntos
Himenópteros/classificação , Distribuição Animal , Estruturas Animais/anatomia & histologia , Estruturas Animais/crescimento & desenvolvimento , Animais , Tamanho Corporal , Lista de Checagem , Dípteros/parasitologia , Feminino , Hábitos , Interações Hospedeiro-Parasita , Himenópteros/anatomia & histologia , Himenópteros/crescimento & desenvolvimento , Himenópteros/fisiologia , Masculino , Turquia
20.
Sci Data ; 10(1): 763, 2023 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-37923754

RESUMO

The range of applications of digital surface models of the bones in science and industry is wide. Three-dimensional reconstructions of bones are used in biomechanics, biomedical engineering, medical image processing, orthopedics, traumatology, radiology, patient education, anatomy, anthropometry, forensic anthropology, ergonomics, usability and human factors engineering, or accident and injury analysis and prevention. No open access database or repository of skeletal surface models of the full lower extremities exists. Therefore, the objective of this publication was to provide access to consistent complete bone models of the pelvis and lower limbs of multiple subjects, including biometric data. Segmentations and surface models of the bones of the lower extremities of more than twenty subjects were created from open access postmortem whole-body computed tomography scans. The database provides a broad range of applications by giving access to the data of the complete process chain, from the raw medical imaging data through the segmentations to the surface models.


Assuntos
Osso e Ossos , Tomografia Computadorizada por Raios X , Humanos , Osso e Ossos/diagnóstico por imagem , Cadáver , Antropologia Forense , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional , Tomografia Computadorizada por Raios X/métodos
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