MR Thermography-Guided Head and Neck Lesion Laser Ablation.

Interstitial laser ablation has been successfully used as a minimally invasive treatment option for tumors in many parts of the body, including the head and neck. In this article, we describe the use of MR imaging guidance and mapping sequences for accurate localization of the target lesion, percutaneous interstitial laser ablation methods, and the use of MR thermography for temperature monitoring during laser ablation, with a focus on applications in the head and neck region.

Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany.

Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.

Estimation of effective dose and lifetime attributable risk from multiple head CT scans in ventriculoperitoneal shunted children.

PURPOSE: The purpose of this review is to determine the averaged effective dose and lifetime attributable risk factor from multiple head computed tomography (CT) dose data on children with ventriculoperitoneal shunts (VPS). METHOD AND MATERIALS: A total of 422 paediatric head CT exams were found between October 2008 and January 2011 and retrospectively reviewed. The CT dose data was weighted with the latest IRCP 103 conversion factor to obtain the effective dose per study and the averaged effective dose was calculated. Estimates of the lifetime attributable risk were also calculated from the averaged effective dose using a conversion factor from the latest BEIR VII report. RESULTS: Our study found the highest effective doses in neonates and the lowest effective doses were observed in the 10-18 years age group. We estimated a 0.007% potential increase risk in neonates and 0.001% potential increased risk in teenagers over the base risk. CONCLUSION: Multiple head CTs in children equates to a slight potential increase risk in lifetime attributable risk over the baseline risk for cancer, slightly higher in neonates relative to teenagers. The potential risks versus clinical benefit must be assessed.

[Unusual faces of syphilis]. / Die ungewöhnlichen Gesichter der Syphilis.

The challenging "great masquerader" is resurgent! For several years syphilis has shown an increasing incidence across Europe and its variable manifestations necessitate its inclusion amongst many differential diagnoses. Using serological tests, it is possible to accurately diagnose syphilis, initiate stage-appropriate therapy and exclude co-infections. In this article, we feature nine unusual presentations of secondary syphilis. In four cases, serology confirmed HIV co-infection.

Susceptibility distortion correction for echo planar images with non-uniform B-spline grid sampling: a diffusion tensor image study.

In this paper, we propose a novel method for correcting the geometric distortions in diffusion weighted images (DWI) obtained with echo planar imaging (EPI) protocol. Our EPI distortion correction approach employs a deformable registration framework with the B-splines transformation, where the control point distributions are non-uniform and functions of the expected norm of the spatial distortions. In our framework, the amount of distortions are first computed by estimating the B(0) fieldmap from an initial segmentation of a distortion-free structural image and tissue susceptibility models. Fieldmap estimates are propagated to obtain expected spatial distortion maps, which are used in the sampling of active B-spline control points. This transformation is flexible in locations with large distortion expectations, yet with relatively few degrees-of-freedom and does not suffer from local optima convergence and hence does not distort anatomically salient locations. Results indicate that with the proposed correction scheme, tensor derived scalar maps and fiber tracts of the same subject computed from data acquired with different phase encoding directions provide better coherency and consistency compared traditional registration based approaches.

Direct delayed human adenoviral BMP-2 or BMP-6 gene therapy for bone and cartilage regeneration in a pony osteochondral model.

OBJECTIVE: To evaluate healing of surgically created large osteochondral defects in a weight-bearing femoral condyle in response to delayed percutaneous direct injection of adenoviral (Ad) vectors containing coding regions for either human bone morphogenetic proteins 2 (BMP-2) or -6. METHODS: Four 13mm diameter and 7mm depth circular osteochondral defects were drilled, 1/femoral condyle (n=20 defects in five ponies). At 2 weeks, Ad-BMP-2, Ad-BMP-6, Ad-green fluorescent protein (GFP), or saline was percutaneously injected into the central drill hole of the defect. Quantitative magnetic resonance imaging (qMRI) and computed tomography (CT) were serially performed at 12, 24, and 52 weeks. At 12 (one pony) or 52 weeks, histomorphometry and microtomographic analyses were performed to assess subchondral bone and cartilage repair tissue quality. RESULTS: Direct delivery of Ad-BMP-6 demonstrated delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and histologic evidence of greater Glycosaminoglycan (GAG) content in repair tissue at 12 weeks, while Ad-BMP-2 had greater non-mineral cartilage at the surface at 52 weeks (p<0.04). Ad-BMP-2 demonstrated greater CT subchondral bone mineral density (BMD) by 12 weeks and both Ad-BMP-2 and -6 had greater subchondral BMD at 52 weeks (p<0.05). Despite earlier (Ad-BMP-6) and more persistent (Ad-BMP-2) chondral tissue and greater subchondral bone density (Ad-BMP-2 and -6), the tissue within the large weight-bearing defects at 52 weeks was suboptimal in all groups due to poor quality repair cartilage, central fibrocartilage retention, and central bone cavitation. Delivery of either BMP by this method had greater frequency of subchondral bone cystic formation (p<0.05). CONCLUSIONS: Delivery of Ad-BMP-2 or Ad-BMP-6 via direct injection supported cartilage and subchondral bone regeneration but was insufficient to provide long-term quality osteochondral repair.

Unsupervised learning of brain states from fMRI data.

The use of multivariate pattern recognition for the analysis of neural representations encoded in fMRI data has become a significant research topic, with wide applications in neuroscience and psychology. A popular approach is to learn a mapping from the data to the observed behavior. However, identifying the instantaneous cognitive state without reference to external conditions is a relatively unexplored problem and could provide important insights into mental processes. In this paper, we present preliminary but promising results from the application of an unsupervised learning technique to identify distinct brain states. The temporal ordering of the states were seen to be synchronized with the experimental conditions, while the spatial distribution of activity in a state conformed with the expected functional recruitment.

Automatic deformable diffusion tensor registration for fiber population analysis.

In this work, we propose a novel method for deformable tensor-to-tensor registration of Diffusion Tensor Images. Our registration method models the distances in between the tensors with Geode-sic-Loxodromes and employs a version of Multi-Dimensional Scaling (MDS) algorithm to unfold the manifold described with this metric. Defining the same shape properties as tensors, the vector images obtained through MDS are fed into a multi-step vector-image registration scheme and the resulting deformation fields are used to reorient the tensor fields. Results on brain DTI indicate that the proposed method is very suitable for deformable fiber-to-fiber correspondence and DTI-atlas construction.