Laser-irradiating infrared attenuated total reflection spectroscopy of articular cartilage: Potential and challenges for diagnosing osteoarthritis.

Objective: A prototype infrared attenuated total reflection (IR-ATR) laser spectroscopic system designed for in vivo classification of human cartilage tissue according to its histological health status during arthroscopic surgery is presented. Prior to real-world in vivo applications, this so-called osteoarthritis (OA) scanner has been tested at in vitro conditions revealing the challenges associated with complex sample matrices and the accordingly obtained sparse spectral datasets. Methods: In vitro studies on human knee cartilage samples at different contact pressures (i.e., 0.2-0.5 â€‹MPa) allowed recording cartilage degeneration characteristic IR signatures comparable to in vivo conditions with high temporal resolution. Afterwards, the cartilage samples were assessed based on the clinically acknowledged osteoarthritis cartilage histopathology assessment (OARSI) system and correlated with the obtained sparse IR data. Results: Amide and carbohydrate signal behavior was observed to be almost identical between the obtained sparse IR data and previously measured FTIR data used for sparse partial least squares discriminant analysis (SPLSDA) to identify the spectral regions relevant to cartilage condition. Contact pressures between 0.3 and 0.4 â€‹MPa seem to provide the best sparse IR spectra for cylindrical (d â€‹= â€‹3 â€‹mm) probe tips. Conclusion: Laser-irradiating IR-ATR spectroscopy is a promising analytical technique for future arthroscopic applications to differentiate healthy and osteoarthritic cartilage tissue. However, this study also revealed that the flexible connection between the laser-based analyzer and the arthroscopic ATR-probe via IR-transparent fiberoptic cables may affect the robustness of the obtained IR data and requires further improvements.

Mortality of people with intellectual disabilities during the 2017/2018 influenza epidemic in the Netherlands: potential implications for the COVID-19 pandemic.

BACKGROUND: Data on the development of Covid-19 among people with intellectual disabilities (IDs) are scarce and it is uncertain to what extent general population data applies to people with ID. To give an indication of possible implications, this study investigated excess mortality patterns during a previous influenza epidemic. METHODS: Using Dutch population and mortality registers, a historical cohort study was designed to compare mortality during the 2017-2018 influenza epidemic with mortality in the same period in the three previous years. People with ID were identified by entitlements to residential ID-care services as retrieved from a national database. RESULTS: Data covered the entire adult Dutch population (12.6 million; GenPop), of which 91 064 individuals were identified with an ID. During the influenza epidemic, mortality among people with ID increased almost three times as much than in the GenPop (15.2% vs. 5.4%), and more among male individuals with ID (+19.5%) than among female individuals with ID (+10.6%), as compared with baseline. In both cohorts, comparable increases in mortality within older age groups and due to respiratory causes were seen. Particularly in the ID-cohort, excess deaths also occurred in younger age groups, due to endocrine diseases and ID-specific causes. CONCLUSIONS: During the 2017-2018 influenza epidemic, excess mortality among people with ID was three times higher than in the general Dutch population, appeared more often at young age and with a broader range of underlying causes. These findings suggest that a pandemic may disproportionally affect people with ID while population data may not immediately raise warnings. Early detection of diverging patterns and faster implementation of tailored strategies therefore require collection of good quality data.

[Disseminated tuberculosis during induction chemotherapy in acute myeloid leukemia]. / Disseminierte Tuberkulose unter Induktionschemotherapie bei akuter myeloischer Leukämie.

A patient with acute myeloid leukemia developed disseminated tuberculosis with cerebral involvement in the early phase of induction chemotherapy before allogenic stem cell transplantation. He presented with persisting fever of unknown origin, and initially misinterpreted organ lesions in CT scans.

Photoacoustic spectroscopy with quantum cascade distributed-feedback lasers.

We present photoacoustic (PA) spectroscopy measurements of carbon dioxide, methanol, and ammonia. The light source for the excitation was a single-mode quantum cascade distributed-feedback laser, which was operated in pulsed mode at moderate duty cycle and slightly below room temperature. Temperature tuning resulted in a typical wavelength range of 3cm(-1)at a linewidth of 0.2cm(-1). The setup was based on a Herriott multipass arrangement around the PA cell; the cell was equipped with a radial 16-microphone array to increase sensitivity. Despite the relatively small average laser power, the ammonia detection limit was 300 parts in 10(9)by volume.

General description of the simultaneous response of potentiometric ionophore-based sensors to ions of different charge.

The response of ion-selective membrane electrodes is usually still described with the semiempirical Nicolskii-Eisenman equation although it cannot correctly reproduce experimental data if ions of different charges are involved. The recently published self-consistent model that was derived for two ions of any charges is now extended to any number of ions of any charge. One single explicit equation is here given for the first time for any number of monovalent, divalent, and trivalent ions. Deviations relative to the Nicolskii-Eisenman equation are shown to be especially high at low interferences and bias calibrations if done in a mixed solution of a target sample as well as multivariate calibrations with sensor arrays.

Changes of sonographic, magnetic resonance tomographic, electromyographic, and histopathologic findings within a 2-month period of examinations after experimental muscle denervation.

This study compares sonographical, histopathological, magnetic resonance imaging (MRI), and electromyographical (EMG) findings following acute muscle denervation. We performed an experimental denervation of the supraspinatus and infraspinatus muscles on 35 New Zealand white rabbits by segment resection of the suprascapular nerve. The sonographical appearance of the supraspinatus muscle was followed and documented at short time intervals within a 2-month follow-up period. The sonographical, histopathological, and MRI changes due to denervation suggest a regular pattern. Apart from the reduction of the muscle diameter, there were considerable sonographical signs of denervation with an increase of echointensity and inhomogenicity of echotexture that appeared on day 14 after injury, and progressed continuously with time. MRI revealed a remarkable increase in signal intensity 3 weeks after denervation and reproducible T2 times. Pathological spontaneous activity on EMG could also be detected from day 14 after injury. Conventional histopathological staining methods (H&E, NADH, ATPase, basic and acid phosphatase) confirmed denervation and absence of reinnervation. The first nonspecific histopathological changes were seen 11 days after denervation in the form of moderately atrophic fibers. Typical histopathological signs of denervation appeared 3 weeks after nerve dissection. In summary, EMG, ultrasound, MRI, and histopathology each showed first abnormalities after about 2 weeks. In addition to EMG, sonography and MRI can document the course of muscle atrophy and mesenchymal abnormalities in neurogenic muscle lesions.

Influence of lipophilic inert electrolytes on the selectivity of polymer membrane electrodes.

Lipophilic inert electrolytes, i.e., salts without ion-exchange properties, may influence the selectivity of ionophore-based liquid membrane electrodes by affecting the activity coefficients in the organic phase. It is expected by a theoretical model that the addition of a lipophilic salt renders the ion-selective electrode more selective for divalent over monovalent ions. These predictions are confirmed with Ca(2+)-responsive membranes containing the ionophores ETH 2120, ETH 1001, and ETH 129. The effect is especially pronounced with nonpolar membrane phases containing a low concentration of charged species, where up to 2 orders of magnitude selectivity improvement is observed.

Omasal and abomasal impaction in beef suckler cows.

A group of late gestation suckler cows were housed in straw yards and had been fed solely on pea haulm for the previous three weeks. Four cows became ill, with a variety of clinical signs, two died, one was euthanased and one recovered spontaneously. Postmortem examination revealed severe omasal and abomasal impaction. No further cases occurred after changes were made to the diet of the cows.

Sonography and MRI of experimental muscle injuries.

After sonographical examination with a 7.5-MHz linear array scanner, we created an experimental muscle injury of known site and location on 28 New Zealand white rabbits by stabbing them with a scalpel in the supraspinatus muscle. The changes in the healing process were followed and documented by sonography and magnetic resonance imaging (MRI) before and 2, 5, 11, 14, 36 and 64 days after injury. The changes in sonography and MRI followed a regular course. Ultrasound revealed an echo-poor area after injury with ever increasing echogenicity from the 14th day. Strong reflexes were found after 2 months. MRI showed few changes, only a slight increase of signal intensity, but a characteristic curve of calculated T2-times (a program of the MRI software). The interpretation of the sonographical picture in histopathological terms remained limited. The development of a hematoma and of fibrous scars can be followed up by sonography, but it is not possible to determine the point of time after injury very accurately. Nevertheless, sonography is a method of great value in the diagnosis of muscle injuries and, given certain limits, in the follow-up of the healing process, too. The significance of MRI can be increased by calculations with the implemented software, as in our study calculated T2-times produced a characteristic curve reflecting the shift of fluids after muscle injury.

[Magnetic resonance tomography and histopathologic findings after muscle denervation. A comparative animal experiment study during a two month follow-up]. / Kernspintomographische und histopathologische Befunde nach Muskeldenervierungen. Eine vergleichende tierexperimentelle Studie während einer zweimonatigen Verlaufsuntersuchung.

Recently, MRI was described as a method in the diagnosis of changes of muscle after acute neurogenic muscle atrophy. This study was performed to compare MRI results with myopathological findings, to document the appearance of the MRI changes and to check the sensitivity of this method. We performed a segment resection of the suprascapular nerve resulting in a denervation of the supraspinatus and infraspinatus muscles on 18 Newzeeland white rabbits. MRI changes were followed and documented for two months in short periods of time. The results were compared with histological findings. In myopathology and MRI we found systematical changes: Apart from the reduction of the muscle diameter visual assessment revealed increased signal intensities on the 21st and 35th examination day after denervation. On the 2nd, 5th, 11th and 64th examination day signal intensities were normal. The changes were represented by calculated T2 times, too.

[DIL vena cava filter. Initial experiences in 15 patients]. / DIL Vena-Cava-Filter. Erste Erfahrungen bei 15 Patienten.

DIL filters were permanently inserted through the cubital vein, using a 7-F catheter, in 15 patients and were followed up for six months in 12 patients. One filter could not be opened and 4 others were only partly open. Clinically there were no recurrences of pulmonary emboli. There were no complications from the correctly placed filters. Amongst the 4 incompletely expanded filters, two caused perforation of the cava, in one the cava thrombosed and in another the filter migrated to the bifurcation of the pulmonary artery. It follows that unexpanded filters should not be placed in the cava. Measurements in 10 patients showed the cava reduced to less than 10 mm lumen. In two cases the reduction of lumen was only slight, measuring more than 15 mm. The effect of the reduction in the lumen remains to be compared with that achieved by other filters.

[The nitinol stent as a palliative measure in inoperable carcinoma of the esophagus and cardia. Possibilities and limitations of the procedure]. / Der Nitinolstent als Palliativmassnahme bei inoperablem Osophagus- und Kardiakarzinom. Möglichkeiten und Grenzen des Verfahrens.

Nitinol stents were used in ten patients as palliative treatment for carcinoma of the esophagus and the cardia. Following insertion of the stent the severity of dysphagia decreased on average from 3.2 to 1.5 (on a scale from 0-4). Difficulties with stent opening and passage through the gut were found particularly in the region of metal sutures at esophago-jejunal anastomoses. One stent, which had been obstructed by mucosal folds, had to be removed and replaced. One stent which had been incorrectly placed was extended by introducing a second stent by a coaxial technique. During the period of observation, six patients died after an average of 4.6 months. The palliative effect of the stent lasted on average for eleven weeks. In two patients the tumour grew beyond the stent and in three there was tumour growth into the stent.

Magnetic resonance imaging of skeletal muscles in idiopathic inflammatory myopathies of adults.

The purpose of the study was to describe typical MRI findings in various types of idiopathic inflammatory myopathies in adulthood and to correlate the MRI with histopathological and electromyographic findings, and the serum creatine kinase (CK) activity. A third goal was to assess the diagnostic value of the use of gadolinium-DTPA (Gd-DTPA). Fifty-eight patients (35 women, 23 men), aged 21-83 years (median age 59 years), suffering from idiopathic myositides (13 with acute and 45 chronic diseases; 25 with polymyositis, 14 with dermatomyositis, 8 with granulomatous and 11 with inclusion body myositides) were examined with MRI. Seventeen of them received an intravenous infusion of Gd-DTPA. Histopathological and MRI findings of 21 muscles of 18 patients were compared. MRI of skeletal muscles showed abnormal signal intensities in 56 (96.6%) of the 58 patients. MRI abnormalities were found more often than elevated CK activity (P < 0.001). The hyperintensity of T2-weighted images was more conspicuous than on T1-weighted images in 26 (44.8%) patients, indicating oedema-like abnormalities. MRI of 50 (86.2%) patients showed fat replacement. In acute myositides, oedema-like abnormalities were more often visible and in muscle lipomatosis less often visible than in chronic diseases (P < 0.05 each). In dermatomyositis oedema-like abnormalities were more and lipomatosis less frequent than in the other types of myositis (P < 0.005) and correlated with the acuteness of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hemophiliac arthropathy of the knee joint. Gd-DTPA-enhanced MRI; clinical and roentgenological correlation]. / Hämophile Arthropathie des Kniegelenkes. Gd-DTPA-verstärkte MRT; klinische und röntgenologische Korrelation.

17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0.1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) on FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39.6%/min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process.

[Rheumatoid arthritis of the wrist. Dynamic Gd-DTPA enhanced MRT]. / Rheumatoide Arthritis des Handgelenkes. Dynamische Gd-DTPA-verstärkte MRT.

21 patients with rheumatoid arthritis of the wrist diagnosed according to the criteria of the American Rheumatism Association were examined by dynamic MRT before and after the i.v. injection of Gd-DTPA (0.1 mmol/kg). The results were correlated with the clinical and radiological findings. The increased signal intensity of the pannus was 1.17 +/- 0.45%/sec and this differed significantly (p < 0.001) from bone marrow (0.16 +/- 0.11%/sec) and from muscle (0.25 +/- 0.16%/sec). Blood sedimentation rate correlated with the gradient of synovial proliferation (p < 0.05). There were no further statistically significant correlations between the clinical, radiological and MRT findings and the change in signal intensity from synovial proliferation as shown by dynamic MRT.

Imaging techniques in myotonic dystrophy. A comparative study of ultrasound, computed tomography and magnetic resonance imaging of skeletal muscles.

Limb and trunk muscles of 57 patients with the juvenile or adult form of myotonic dystrophy were studied by imaging techniques (ultrasound, computed tomography, magnetic resonance imaging). Typical findings were atrophy of the tibialis anterior and triceps brachii muscles and fatty degeneration of the vastus intermedius, sartorius, tibialis anterior and soleus muscles as well as of medial head of the gastrocnemius muscle. Magnetic resonance imaging was the most sensitive technique in depicting mesenchymal muscle alterations, followed by computed tomography and ultrasound. The data support that imaging is more sensitive in detecting the myopathy than measurement of the creatine kinase activity.

["Metastasizing" Echinococcus alveolar of the liver]. / "Metastasierender" Echinococcus alveolaris der Leber.

We report a case of metastatic alveolar echinococcosis of the liver. There were calcifications of the liver parenchyma, and a large tumour adjacent to the porta hepatis infiltrated neighbouring structures. In addition, haematogenous metastases to the spine and foot were found. This extensive haematogenous "metastasis" is rare and may complicate diagnosis, but the typical findings in the liver should permit the correct conclusion.