Software-based Detection of Acute Rejection Changes in Face Transplant

2021 ◽  
Author(s):  
Miguel I. Dorante ◽  
Branislav Kollar ◽  
Marian Bittner ◽  
Alice Wang ◽  
Yannick Diehm ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Mixed Models ◽  
Allograft Rejection ◽  
Healthy Controls ◽  
Non Invasive ◽  
Face Transplant ◽  
Marginal Means ◽  
Invasive Method ◽  
The Mean ◽  
R Value

Abstract Background An objective, non-invasive method for redness detection during acute allograft rejection in face transplantation (FT) is lacking. Methods A retrospective cohort study was performed with 688 images of 7 patients with face transplant (range, 1 to 108 months post-transplant). Healthy controls were matched to donor age, sex, and had no prior facial procedures. Rejection state was confirmed via tissue biopsy. An image-analysis software developed alongside VicarVision (Amsterdam, Netherlands) was used to produce R, a measure of differences between detectable color and absolute red. R is inversely proportional to redness, where lower R values correspond to increased redness. Linear mixed models were used to study fixed effect of rejection state on R values. Estimated marginal means of fitted models were calculated for pairwise comparisons. Results Of 688 images, 175, 170, 202, and 141 images were attributable to Banff Grade 0,1,2, and 3, respectively. Estimated change in R value of facial allografts decreased with increasing Banff Grade (p = 0.0001). The mean R value of clinical rejection (Banff Grade ⅔) (16.67, 95% Confidence Interval [CI] 14.79–18.58) was lower (p = 0.005) than non-rejection (Banff Grade 0/1) (19.38, 95%CI 17.43–21.33). Both clinical and non-rejection mean R values were lower (p = 0.0001) than healthy controls (24.12, 95%CI 20.96–27.28). Conclusion This proof-of-concept study demonstrates that software-based analysis can detect and monitor acute rejection changes in FT. Future studies should expand on this tool's potential application in telehealth and as a screening tool for allograft rejection.

scholarly journals CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

2021 ◽  
Author(s):  
Patrick Veit-Haibach ◽  
Martin W. Huellner ◽  
Martin Banyai ◽  
Sebastian Mafeld ◽  
Johannes Heverhagen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Ct Perfusion ◽  
Arterial Disease ◽  
Lower Leg ◽  
Therapy Control ◽  
Non Invasive ◽  
Before And After ◽  
Invasive Method ◽  
The Mean ◽  
Peripheral Arterial

Abstract Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

scholarly journals Mid-stream clean catch urine collection in newborns: a non-invasive and safe technique

2019 ◽  
Vol 6 (2) ◽  
pp. 349 ◽  
Author(s):  
Rajendra Kumar ◽  
Nithin . ◽  
Sudha Rudrappa
Keyword(s):  
Success Rate ◽  
Urine Sample ◽  
Invasive Technique ◽  
Urine Collection ◽  
Non Invasive ◽  
Invasive Method ◽  
Safe Technique ◽  
The Mean ◽  
Invasive Techniques ◽  
Mean Time

Background: The aim of this study is to determine the success rate and safety of a non-invasive technique to obtain clean-catch midstream urine samples in newborns.Methods: Prospective bedside clinical study. After obtaining written informed consent,120 consecutive newborns admitted in NICU with no dehydration, poor feeding, need for immediate urine sample by invasive method  for whom urine collection was advised for various reasons who met the inclusion criteria were included in the study with consent being taken from the parents. After adequate milk intake supra pubic and lumbar para vertebral areas were stimulated in repeated cycles of 30 s until micturition began.Results: Success rate in obtaining a midstream urine sample within 5 min. The success rate was 90%. The mean time taken to collect urine was 64.24s, for males it was 62.55s and for females 65.93s.Conclusions: The technique has been demonstrated to be safe, quick and effective. The discomfort and time consumption usually associated with bag collection methods as well as invasive techniques can be avoided.

Testicular responsiveness to hCG during infancy measured by salivary testosterone

1990 ◽  
Vol 123 (6) ◽  
pp. 633-636 ◽  
Author(s):  
Leo Dunkel ◽  
Ilpo Huhtaniemi
Keyword(s):  
Serum Testosterone ◽  
Maximal Level ◽  
Salivary Testosterone ◽  
Non Invasive ◽  
Basal Serum ◽  
Age Related ◽  
Invasive Method ◽  
Prepubertal Boys ◽  
The Mean

Abstract. To investigate the role of gonadotropins in postnatal testicular activation, testosterone responsiveness to human chorionic gonadotropin was studied in 11 male infants (aged 5-180 days). The boys were given a single im injection of 5000 IU/1.7m2 hCG, and serum and salivary testosterone responses were then measured for 7 days. The results were compared with the serum testosterone responses of 8 older prepubertal boys (aged 1.7-10.4 years) studied with the same protocol. The mean (±sem) basal serum testosterone levels were 2.67±1.27 nmol/l in the infants and 0.09±0.02 nmol/l in the prepubertal boys (p<0.05). Both groups gave a significant response to hCG stimulation (p<0.001, ANOVA, one-way). The stimulated concentrations of serum testosterone were higher in the infants than in the prepubertal boys (p<0.001). The mean basal level of salivary testosterone was 30.5 ±7.0 and the mean maximal level was 97± 10.3 pmol/l in the infants (p<0.001). No age-related changes were observed in either basal or hCG-stimulated levels. In infants the mean (±sem) maximal hCG-stimulated increase was 25 ± 10-fold in serum and 8±4-fold in saliva (p=0.13). A clear stimulatory effect of hCG on testicular testosterone production was found, suggesting that the postnatal increase in serum testosterone concentration in male infants is gonadotropin-mediated. Salivary testosterone concentrations can be increased by hCG, indicating that measurements of salivary testosterone may provide an optional, non-invasive method for assessing gonadal function in children.

Values of T/QRS ratio in pregnancies complicated by intrauterine growth restriction

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Tomasz Fuchs
Keyword(s):  
Intrauterine Growth Restriction ◽  
Well Being ◽  
Study Groups ◽  
Growth Restriction ◽  
Healthy Controls ◽  
Value Differences ◽  
Intrauterine Growth ◽  
Non Invasive ◽  
Invasive Method ◽  
Ratio Variables

AbstractAims:To evaluate values of T/QRS ratio in normal pregnancies and those complicated by intrauterine growth restriction (IUGR) using non-invasive method with transabdominal electrodes. Assessment of fetal well-being in IUGR pregnancies.Methods:Fetal electrocardiograms were recorded and analyzed by KOMPOREL software from ITAM (Zabrze, Poland) and T/QRS ratios were automatically calculated. Doppler velocimetry of the middle cerebral artery and umbilical artery was carried out. The study group consisted of IUGR pregnancies with normal cerebroplacental ratios (CPRs) (n=110), IUGR pregnancies with decreased CPRs (n=29), and healthy controls (n=549). Analyses were performed between the study groups and by gestational age. T/QRS ratio variables and CPRs were calculated. Analysis of variance and linear regression were performed.Results:Maximum values, maximum minimal value differences, and standard deviations of T/QRS ratio were significantly different between the IUGR group with reduced CPRs and normal CPRs (P=0.0009, P=0.0000, P=0.0034, respectively) as well as between the IUGR group with reduced CPRs and healthy controls (P=0.0000, P=0.0001, P=0.0009, respectively). Mean maximum values in the IUGR group with reduced CPRs exceeded normal values.Conclusions:T/QRS ratio may be useful in assessing fetal well-being in IUGR pregnancies; however, future studies are needed to determine typical ranges of T/QRS ratio in pregnancies complicated by IUGR.

Acetabular component migration in total HIP arthroplasty using CT and a semiautomated program for volume merging

2002 ◽  
Vol 43 (5) ◽  
pp. 517-527 ◽  
Author(s):  
L. Olivecrona ◽  
J. Crafoord ◽  
H. Olivecrona ◽  
M. E. Noz ◽  
G. Q. Maguire ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Plain Radiography ◽  
Acetabular Cup ◽  
Visual Evaluation ◽  
Total Hip ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean ◽  
Component Migration

Purpose: To develop a non-invasive method for detection of acetabular cup migration after total hip arthroplasty (THA) with a higher degree of accuracy than routine plain radiography. Material and Methods: Two CT examinations, 10 min apart, were obtained from each of 10 patients that had undergone THA. Using an in-house developed semiautomated program for volume merging, the pelves in the two examinations were fused and the acetabular cup was visually and numerically evaluated to test the method's accuracy in detecting migration. Results: In the visual evaluation of the best match a 1-mm translation of the cup was detectable. The numerical evaluation, comparing landmarks placed in the images of the acetabular cup and the head of the femur component in the two examinations, showed the mean difference in orientation of acetabular axes to be 2.5°, the mean distance between centre of cup face to be 2.5 mm and the mean distance between centre of the head of the prosthetic femoral component to be 1 mm. Conclusion: This method has a significantly higher accuracy than routine plain radiography in detecting acetabular cup migration and could be used in clinical practice. It gives both a visual and a numerical correlate to migration.

scholarly journals Treatment of Moderate-sized Kidney Stone with Third-generation Electromagnetic Shock Wave Lithotripter

2020 ◽  
Vol 8 (B) ◽  
pp. 851-857
Author(s):  
Ivica Stojanoski ◽  
Toni Krstev ◽  
Lazar Iievski ◽  
Nerhim Tufekgioski ◽  
Sotir Stavridis
Keyword(s):  
Shock Wave ◽  
Kidney Stones ◽  
Kidney Stone ◽  
Renal Stones ◽  
Third Generation ◽  
Treatment Rate ◽  
Moderate Size ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean

BACKGROUND: The extracorporeal shock wave lithotripsy (ESWL) is a non-invasive method in the treatment of urinary tract stones and its discovery has led to a complete change in the therapeutic strategy for urolithiasis. Due to the low morbidity and excellent fragmentation of the stones, ESWL has proven to be an effective and non-invasive method in the treatment of renal stones. AIM: The aim of this retrospective study is to evaluate the efficacy and safety of the ESWL as a monotherapy in the treatment of moderate size kidney stones with stone area (SA) of 100–300 mm². MATERIALS AND METHODS: We made a retrospective study of 98 patients with moderate size kidney stones with SA of 100–300 mm², divided into two subgroups, into a group with a SA of 100–200 mm² and with 200–300 mm², treated with ESWL in the period of November 2018–December 2019. The patients were treated with a third-generation electromagnetic lithotripter (Lithoskop®, Siemens Medical Systems, Erlangen, Germany), with a source of electromagnetic shocks (Pulso™) and dual ultrasonographic/fluoroscopic system for detection of the stones. The stone location, size, maximum energy used, localization technique, number of shock waves, sessions, re-treatment rate, and additional procedures were reviewed. All the patients before the intervention had a complete laboratory and radiological examinations. Postoperatively, patients were monitored on the 1st, 30th, and 90th post-operative days. RESULTS: Ninety-eight patients with solitary kidney stone with a SA of 100–300 mm² were treated with ESWL. The study included 58 men (59.18%) and 44 women (40.81%). The average length and width of the stone were 15.47 ± 2.68 mm and 12.99 ± 2.83 mm, respectively. The average surface area of the stones in our series was 203.78 ± 72.85 mm². The mean number of treatments for the entire series of patients was 1.82 ± 0.91. The mean number of shock waves for the total series of patients was 3899.11 ± 40. The mean energy used for the overall patient series was 110106.17 ± 21489.61 mJ. The total re-treatment rate was 47.95%. The entire rate of additional procedures was 19.38%. The overall success rate (SR) in our study was 77.55%. The efficiency quotient for the upper-middle and lower calyx was 55.57, 57.15, and 30.81, respectively. CONCLUSION: ESWL is a safe and effective method in the treatment of renal stones, and we recommend as the first method in the treatment of moderate size kidney stone with a surface area of 100–300 mm². The treatment of each patient should be individualized and take into account all favored and non-favored factors that influence the decision to choose extracorporeal lithotripsy as a method of treatment of medium-sized stones.

scholarly journals Assessment the Adherence of Radiologists to the Thyroid Imaging Reporting and Data System (TIRADS)

2021 ◽  
Author(s):  
Fariba Zarei ◽  
Mohammad Reza Sasani ◽  
Banafsheh Zeinali Rafsanjani ◽  
Mahdi Saeedi Moghadam
Keyword(s):  
Thyroid Nodules ◽  
Fine Needle Aspiration Biopsy ◽  
Needle Aspiration ◽  
Data System ◽  
Fars Province ◽  
Non Invasive ◽  
Thyroid Imaging ◽  
Invasive Method ◽  
The Mean ◽  
Echogenic Foci

Introduction: Thyroid nodules are the most common findings among adults. Usually, Fine Needle Aspiration Biopsy (FNAB) can be used to distinguish the malignant and benign lesions. Application of a non-invasive method for determining the chance of malignancy in a nodule is desirable. Thyroid Imaging Reporting and Data System (TIRADS) was introduced to decrease the unnecessary FNABs and to optimize the management of these patients. The objective of this study was to assess the adherence of radiologist’s reports to TIRADS, after 10 years from the introduction of this system to radiologists in Fars Province. Methods: In this retrospective study, sonography report of the patients, who were referred to hospital for FNAB was assessed. If the patients did not have the previous sonography reports or the report was unreadable, they would be excluded from the study. Composition, echogenicity, shape, size, and margin were assessed and scored in this study. As the reports noted to each of the above-mentioned issues, score 1 was assigned to them. SPSS version 15 was used to analyze the data and calculated the standard deviation. Results: Sonography reports of 111 out of 250 patients was evaluated. The mean score of sonography reports from 5 was 2.63±0.86. The percentage of adherence of sonography reports to the expression of the first five categories was 52.61±17.25 %. Echogenic foci were also evaluated in the patients that it existed. The radiologists were reported them in almost 81% of cases. Conclusion: Overall adherence of sonographic report to TIRADS was 57.34%. The adherence can be definitely improved by training the radiologists.

Increased circulating concentrations of interleukin 2 receptor during rejection episodes in heart- or kidney-transplant recipients

1990 ◽  
Vol 36 (12) ◽  
pp. 2106-2109 ◽  
Author(s):  
G C Zucchelli ◽  
A Clerico ◽  
R De Maria ◽  
M Carmellini ◽  
R Di Stefano ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Allograft Rejection ◽  
Interleukin 2 ◽  
Clinical Markers ◽  
Kidney Transplant Recipients ◽  
Interleukin 2 Receptor ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
The Mean

Abstract Concentrations of interleukin 2 receptor (sIL-2R) have been suggested as a marker of rejection episodes after organ transplantation. To evaluate the analytical performance of a "sandwich-type" enzyme immunoassay method for sIL-2R and to verify whether increased concentrations of sIL-2R might be a useful marker of allograft rejection, we quantified sIL-2R in serum samples from heart- or kidney-transplant patients. The mean (+/- SD) pre-transplant value of sIL-2R (592 +/- 209 kilo-units/L) in heart-transplant patients was significantly higher (P less than 0.01) than that observed in controls (350 +/- 101 kilo-units/L). After heart transplantation, the concentrations of sIL-2R slowly decreased to baseline in successfully treated patients but increased significantly (1129 +/- 215 kilo-units/L; P less than 0.01) during acute rejection crisis. However, severe infections were also associated with a significant increase of sIL-2R, so the sIL-2R test is not specific for allograft rejection. The mean pre-transplant concentration of sIL-2R was also increased (1943 +/- 878 kilo-units/L) in 26 renal-transplant patients; after transplantation, this value returned to normal, as did that for creatinine, but persisted steadily high in five patients who experienced acute tubular necrosis. In this group of patients, the sIL-2R concentration increased by 1.5- to fourfold, both during acute rejection episodes and in clinically evident infection; thus measurement of creatinine and sIL-2R concentrations can help to distinguish between rejection, infection, and cyclosporine toxicity. In two episodes of mild cyclosporine-induced nephrotoxicity, we observed slight increases in serum creatinine (which returned to baseline when the cyclosporine dose was decreased) not associated with an increase in sIL-2R. We conclude that systematic monitoring of sIL-2R together with other biochemical and clinical markers may be useful in the management of kidney-transplant patients.

scholarly journals Failure of noninvasive prediction of pulmonary hypertension in patients with idiopathic pulmonary fibrosis

2015 ◽  
Vol 75 (3) ◽  
Author(s):  
F. Salajka ◽  
V. Bartoš ◽  
J. Novosad ◽  
J. Št'ásek ◽  
J. Bis ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Ultrasound Examination ◽  
Published Data ◽  
Noninvasive Method ◽  
Non Invasive ◽  
Invasive Method ◽  
The Mean ◽  
Made In

Background. Pulmonary hypertension (PH) in patients with advanced idiopathic pulmonary fibrosis (IPF) is a complication connected with unfavorable prognosis. Great efforts have been made in attempting to establish a reliable non-invasive method which would enable detection of this complication. In this context a formula using pulmonary function parameters was published with outstanding results. Methods. We tested the formula in 27 IPF patients who underwent a lung function examination, cardiac ultrasonography and catheterisation on the same day. Results. Pulmonary hypertension was detected by catheterisation in 17 patients (63%). In our group, contrary to the published data, the aforementioned formula was neither useful for detecting patients with a high probability of PH nor as a means of calculating the mean pulmonary artery pressure in individual patients (p=0.502 and p=0.833, respectively). Ultrasound examination reached borderline correlation with the values measured by catheterisation when we compare patients with relevant results (r=0.531, p=0.051). However, the examination gave no usable results in 13 patients (48%). Conclusion. Our data suggests that no reliable, noninvasive method is currently available for detecting and confirming PH in IPF patients. We did not confirm the usefulness of the published formula. Further carefully organised studies will be necessary to verify or refute it.

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