Large histological serial sections for computational tissue volume reconstruction.

OBJECTIVES: A proof of principle study was conducted for microscopic tissue volume reconstructions using a new image processing chain operating on alternately stained large histological serial sections. METHODS: Digital histological images were obtained from conventional brightfield transmitted light microscopy. A powerful nonparametric nonlinear optical flow-based registration approach was used. In order to apply a simple but computationally feasible sum-of-squared-differences similarity measure even in case of differing histological stainings, a new consistent tissue segmentation procedure was placed upstream. RESULTS: Two reconstructions from uterine cervix carcinoma specimen were accomplished, one alternately stained with p16(INK4a) (surrogate tumor marker) and H&E (routine reference), and another with three different alternate stainings, H&E, p16(INK4a), and CD3 (a T-lymphocyte marker). For both cases, due to our segmentation-based reference-free nonlinear registration procedure, resulting tissue reconstructions exhibit utmost smooth image-to-image transitions without impairing warpings. CONCLUSIONS: Our combination of modern nonparametric nonlinear registration and consistent tissue segmentation has turned out to provide a superior tissue reconstruction quality.

[Topographical anatomy of the female pelvis in ultrasound]. / Die sonomorphologische Topographie des weiblichen Beckens.

AIM: Achieving a high quality gynaecological ultrasound examination requires thorough knowledge of topographic anatomy. To date, there are no guidelines for a standardised course of the examination. The goal of the study was to define exact planes by means of cross-sectional anatomy and then to standardise the gynaecological ultrasound examination with the transabdominal, introital and transvaginal technique. METHOD: We developed a software tool based on IDL (Interactive Data Language) for the female data set of the Visible Human Project which generates free determinable planes in the volume. The organs of the female pelvis were divided into landmark- and target structures according to the ultrasonic visibility and the variability of the position, shape and structure. From this, a course for the gynaecological ultrasound examination was created and verified on 65 patients each with an inconspicuous ultrasound finding. In addition, the average duration of the examination was determined. RESULTS: The landmark structures could be demonstrated in all patients. Five planes were defined for each technique, and the course of the whole examination with 15 exact planes was described. The average duration of the examination was 4.5 minutes. CONCLUSION: As of now, the digitally reconstructed anatomical illustrations have achieved the best image resolution and quality regardless of the position of the plane in the examination volume. The standardised course of the gynaecological ultrasound examination can serve as a basis for the improvement of training quality and the evaluation of a general gynaecological ultrasound screening.

[Nephrologic analysis of 94 women with diagnosed "primary" gestosis]. / Oddalna ocena nefrologiczna 94 kobiet z rozpznana gestoza "pierwotna".

Among 94 women with diagnosed "primary" gestosis during pregnancy, 67 patients demonstrated (3-6 months after delivery) chronic glomerulonephritis (25 women) or chronic pyelonephritis (28 women) or hypertension caused by others than nephrologic reasons. "Primary" gestosis was diagnosed correctly only in 29% cases. The most often reason of "secondary" gestosis was undiagnosed chronic nephropathy before and during pregnancy. Obtained results confirm other data informing that "primary" gestosis is a rare phenomenon.

[Vestibular function in calcium and phosphate metabolism disorders in chronic renal failure]. / Funkcja ukladu równowagi w zaburzeniach gospodarki wapniowo-fosforanowej w przewleklej niewydolnosci nerek.

45 patients with chronic renal failure (25 dialysed and 20 undialysed) were examined for function of vestibular organ and 35 patients with chronic renal failure treated by diet and drugs were examined for hearing acuity by pure tone audiometry and above-threshold audiometry. All patients serum sample's were examined for calcium, inorganic phosphates and uric acid. The examination revealed the damage of vestibular organ in 84.4 per cent of patients and statistically significant increase of parathormone serum concentration in patients with central type of damage. The hearing loss was found in 51 per cent of patients. The hearing loss in most number of cases was symmetrical and it was mainly the extracochlear auditory damage. The role of disturbances in calcium and phosphates metabolism in the pathogenesis of hearing loss seems to be unsure.

[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. I. Hypercalciuria]. / Wystepowanie hiperkalciurii i pierwotnej nadczynnosci przytarczyc u chorych na kamice nerkowa. Czesc I. Hiperkalciuria.

In 1819 patients with active or non active respectively nephrolithiasis the following parameters were assessed: plasma level of calcium, phosphate, and uric acid and urinary excretion of calcium, phosphate, oxalate, uric acid and creatinine. These parameters were estimated after 5 days of diet containing 400 mg of calcium, 800 mg of phosphate, 100 mg of purines and 40 g of proteins. In 3/4 of all examined patients at least one lithogenic factor was present. More than 40% of patients showed presence of hypercalciuria. Among these patients in 68% renal in 17% absorptive and in 15% undefined hypercalciuria was diagnosed. Patients with active nephrolithiasis showed a similar frequency of hypercalciuria but more profound abnormalities of Ca P metabolism than patients with non active renal stone disease.

[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. II. Primary hyperparathyroidism]. / Wystepowanie hiperkalciurii i pierwotnej nadczynnosci przytarczyc u chorych na kamice nerkowa. Czesc II. Pierwotna nadczynnosc przytarczyc (P.N.P.)

Among 1819 patients with renal stone disease 44 cases with primary hyperparathyroidism (p.h.p.) were diagnosed. In all cases the diagnosis of php was confirmed by histomorphological examination. In 34 patients with php solitary adenoma was found, in 5 patients an adenoma with concomitant hyperplasia of the parathyroid glands, in 2 patients hyperplasia and in 3 patients carcinoma of the parathyroid glands. Hypercalcemia was found in 86% of patients, while elevated plasma levels of PTH in 90% of patients with php. Not in all patients PTH secretion was entirely autonomous. No significant correlation was found between plasma levels of PTH and kind of pathology of the parathyroid glands as well as clinical feature of php respectively.

Pharmacokinetics of ritanserin in patients undergoing hemodialysis.

The pharmacokinetics of ritanserin were studied in five patients with chronic renal insufficiency and who were undergoing periodic hemodialysis. Immediately after breakfast, a single 10-mg ritanserin tablet was administered to each patient on a day that they did not undergo dialysis. Plasma ritanserin levels were measured by a specific high-performance liquid chromatographic assay sensitive to 2 ng/mL plasma. After the oral 10-mg dose, the average time to reach the peak plasma concentration, Tmax, was 4.4 +/- 2.2 hours in these uremic patients, with a range of 2 to 8 hours. The average peak plasma concentration was 73.6 +/- 26.9 ng/mL (range: 54.6-120.0 ng/mL). Compared with a previous study in healthy volunteers, the uremic patients had a slower absorption profile, with a 39% reduction in peak plasma concentration and mean delay of 2.5 hours in Tmax. The mean area under the plasma concentration-time curve for ritanserin (2031 +/- 636 ng.hr/mL) was 47% lower compared with that in healthy volunteers (3867 +/- 1413 ng.hr/mL). The observed delayed and lower ritanserin absorption in these uremic patients may be caused by the chronic use of antacids such as aluminum hydroxide and calcium carbonate in all patients and/or by concurrent pathologic changes in the gastrointestinal mucosa of these patients. The regular hemodialysis sessions every 2-3 days did not affect the elimination rate of ritanserin, as the terminal half-life in these patients (39 +/- 23 hr) is similar to that in healthy volunteers (41 +/- 14 hr).

Cimetidine pharmacokinetics after oral administration of cimetidine retard in normal and impaired renal function.

Cimetidine pharmacokinetics was investigated in four groups: Group I with three normals (serum creatinine less than 1.5 mg/dl), Group II with three kidney patients, renal function slightly impaired (serum creatinine greater than 1.8-4.3 mg/dl), Group III with three patients suffering from severe impairment (serum creatinine greater than 4.3 mg/dl) and Group IV with three patients on chronic hemodialysis. All four groups were given cimetidine retard (350 mg tablets Neutronorm retard, Ebewe Arzneimittel GmbH, A-4866 Unterach a.A., Austria). Groups I and II (normals and slightly impaired renal function) received the tablets twice a day with an interval of 12 h (7:00 a.m. and 7:00 p.m.). Groups III and IV (severely impaired renal function and hemodialysis patient were only given one dose a day (7:00 a.m.). The group of normals (I) and the group with slightly impaired renal function (II) had the highest serum cimetidine concentrations one to two h after the morning dose, followed by an exponential decrease. After the evening dose in Group I, the highest concentrations were found after 4 h. Group II had the highest concentrations four to eight h after administration. Compared to the morning dose, the exponential decrease of the serum cimetidine concentration was delayed in onset and slower in phasing out. Furthermore, concentration was higher during the night than during the day.(ABSTRACT TRUNCATED AT 250 WORDS)

[Serum levels of calcitonin, parathyroid hormone and 25-hydroxycholecalciferol in patients with diabetes mellitus]. / Poziomy kalcytoniny, parathormonu I 25-hydroksycholekalcyferolu w surowicy krwi chorych na cukrzyce.

Blood serum levels of calcitonin, parathyroid hormone, calcium, magnesium and inorganic phosphate have been measured in basal condition and following intravenous administration of calcium in 31 patients with diabetes of type I, in 31 patients with diabetes of type II and in 29 healthy subjects. The level of 25-hydroxy cholecalciferol was measured in all these patients in basal condition only. It was found that the basal calcitonin level was significantly higher in patients with both types of diabetes than in healthy subjects. The administration of calcium caused a significantly higher increase in the blood calcitonin level in patients with type I diabetes than in those with type II diabetes. It was found in addition that in women with type II diabetes blood serum level of parathyroid hormone was significantly higher than that in men suffering from diabetes of the same type, suggesting the participation of some sex-related factor in the pathogenesis of the abnormal parathyroid level in these patients.

[Selected indicators of calcium-phosphate metabolism in patients with diabetes mellitus]. / Wybrane wskazniki gospodarki wapniowo-fosforanowej u chorych na cukrzyce.

The changes in blood serum concentrations of calcium, magnesium, inorganic phosphate, total activity of alkaline phosphatase and the activity of its bone fraction, as well as urinary excretion of calcium, phosphate, hydroxyproline and oxalate have been measured in 31 patients with insulin-dependent (type I) diabetes, in 31 patients with non-insulin-dependent (type II) diabetes and in 29 healthy subjects in the condition of low-calcium diet. The elevated urinary excretion of calcium, phosphate, hydroxyproline and oxalate, lowered blood serum level of magnesium, and increased total and bone fraction activities of alkaline phosphatase were found in diabetic patients. The urinary excretion of calcium and hydroxyproline, and the activity of bone fraction alkaline phosphatase were significantly higher in patients with type II diabetes than in those with type I diabetes. It was concluded that there is a significant relation between the state of metabolic normalization of diabetes and the degree of biochemical aberrations concerning calcium-phosphate metabolism.

[Diagnostic value of the captopril test in patients with arterial hypertension]. / Wartosc diagnostyczna testu kaptoprylowego u chorych z nadcisnieniem tetniczym.

In 30 patients with renovascular hypertension, 50 with hypertension in a course of arteries, 71 hypertensive subjects with coexisting parenchymal nephropathy and in 63 with primary hypertension the captopril test was performed after 8 hours night rest and within high sodium diet. Positive test result was stated in 76.67% of patients with renovascular hypertension, in 70.59% of patients with arteritis, in 53.52% of patients with hypertension and coexisting parenchymal nephropathy and in 63.49% of patients with primary hypertension. Significant correlation between increase of plasma renin activity and blood pressure decrease after captopril administration was only stated in patients with renovascular hypertension and in those with arteritis. Results of performed studies impaired the captopril test value in diagnostics of renin-dependent hypertension.

[Are glomerular hyperfiltration and hyperperfusion involved in the development and progression of nephropathies?]. / Sind glomeruläre Hyperfiltration und Hyperperfusion an der Entstehung und Progression von Nephropathien beteiligt?

In the present paper the significance of non-immunological factors in the development and progression of nephropathies according to the hypothesis of Brenner et al. especially hemodynamic changes in the glomerula with glomerular hyperperfusion and/or hyperfiltration is discussed and therapeutic conclusions are made. The normalized glomerular pressure conditions (converting-enzyme inhibitors), a normalization of hyperglycemia in diabetics, a retention in the use of protein-rich diet and platelet-aggregation inhibitors, respectively, play a special part in the treatment of chronic nephropathies.