ABSTRACT
BACKGROUND: Accurate measurement of the extent skin has aged is crucial for skin aging research. Image analysis offers a quick and consistent approach for quantifying skin aging features from photographs, but is prone to technical bias and requires proper validation. METHODS: Facial photographs of 75 male and 75 female North-European participants, randomly selected from the Rotterdam Study, were graded by two physicians using photonumeric scales for wrinkles (full face, forehead, crow's feet, nasolabial fold and upper lip), pigmented spots and telangiectasia. Image analysis measurements of the same features were optimized using photonumeric grades from 50 participants, then compared to photonumeric grading in the 100 remaining participants stratified by sex. RESULTS: The inter-rater reliability of the photonumeric grades was good to excellent (intraclass correlation coefficients 0.65-0.93). Correlations between the digital measures and the photonumeric grading were moderate to excellent for all the wrinkle comparisons (Spearman's rho ρ = 0.52-0.89) bar the upper lip wrinkles in the men (fair, ρ = 0.30). Correlations were moderate to good for pigmented spots and telangiectasia (ρ = 0.60-0.75). CONCLUSION: These comparisons demonstrate that all the image analysis measures, bar the upper lip measure in the men, are suitable for use in skin aging research and highlight areas of improvement for future refinements of the techniques.
Subject(s)
Face/anatomy & histology , Image Interpretation, Computer-Assisted/methods , Pattern Recognition, Automated/methods , Photography/methods , Skin Aging/pathology , Female , Humans , Image Enhancement/methods , Male , Middle Aged , Observer Variation , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
BACKGROUND: Pulmonary arteriovenous malformations (PAVM) can be found in approximately 20 % to 35 % of patients with hereditary hemorrhagic telangiectasia (HHT). PAVM should be treated since they are a source of paradoxical embolization, potentially resulting in severe neurologic complications. The treatment of choice is the endovascular embolization with coils. PATIENTS AND METHODS: Seven patients with HHT underwent superselective embolization of PAVM detected during screening for PAVM. Four patients had a single PAVM and one patient 3, 4 and 5 PAVMs, respectively. Electrolytically detachable coils were used for embolization. In addition, coils with synthetic fibers were used during 6 embolizations for completion of embolization. RESULTS: Embolization was technically successful in all patients. Complete primary occlusion was achieved in all PAVM. No coil migration or occlusion of unaffected pulmonary arteries was observed. After embolization, one patient developed a small pleural effusion, which was treated symptomatically. CONCLUSION: As a minimally invasive procedure, superselective embolization is the treatment of choice in treating PAVM in patients with HHT. With the use of electrolytically detachable coils, the ideal coil size can be chosen and exact placement achieved without the risk of coil migration or occlusion of unaffected pulmonary arteries.
Subject(s)
Arteriovenous Malformations/therapy , Embolization, Therapeutic/instrumentation , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Telangiectasia, Hereditary Hemorrhagic/therapy , Adolescent , Adult , Aged , Angiography , Arteriovenous Malformations/diagnosis , Arteriovenous Malformations/diagnostic imaging , Embolization, Therapeutic/methods , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Tomography, Spiral Computed , Tomography, X-Ray ComputedABSTRACT
UNLABELLED: We have developed an integrated laboratory information system that allows the flexible handling of pedigree, phenotype and genotype information. Specifically, it includes client applications for an integrated data import from TaqMan typing files, Mendel checking, data export, handling of pedigree and phenotype information and analysis features. AVAILABILITY: The SQL source code, sources and binaries of the client applications (NT and Windows95/98 platforms) and additional documentation are available at http://www.mucosa.de/.
