Acquisition and Automated Segmentation of Inertia Sensor Data for Mobile Camptocormia Assessment.

The camptocormia angle has been established as a strong indicator for evaluating the progress of Parkinson's disease and the efficacy of therapeutical approaches. A wearable setup is proposed to measure the camptocormia angle with the perpendicular method using five inertial sensors. This study identifies suitable inertial measurement unit sensors for mobile long-term measurement. Moreover, a machine-learning approach is presented for segmenting the recorded data into periods with different dominant activities. An artificial neural network was the better classifier compared to a support vector machine to recognize certain common activities in patients with camptocormia. The artificial neural network's accuracy, sensitivity, and F1-score were 92.4 %, 82.9 %, and 82.1 %, respectively. Clinical Relevance- The presented approach is expected to lead to a wearable system for long-term monitoring of the progress of camptocormia, yielding improved parameters compared to the conventional static photo method.

Computed tomography and magnetic resonance diagnosis of variations in the anatomical location of the major salivary glands in 1680 dogs and 187 cats.

During assessment of routine clinical magnetic resonance imaging (MRI) of the heads of dogs, variations in the location of mandibular and zygomatic salivary glands (SGs) were observed incidentally. The aims of this retrospective study were to describe anatomical variations of the major SGs found on MRI and computed tomography (CT) studies of the head in dogs and cats and to investigate possible clinical relevancy. No anatomical variation of the SGs was seen in cats, but in dogs, although variation of the parotid SG was not identified, that of the mandibular SG was found in 33/1680 animals (2%), either unilaterally (6/33 right-sided, 13/33 left-sided) or bilaterally (14/33). The Border terrier breed (19/33, 58%) was over-represented. Each atypically located mandibular SG was positioned medial to the digastric muscle and rostral to the retropharyngeal lymph node. The sublingual glands were difficult to delineate from the mandibular glands. Anatomical variation of one zygomatic gland (3/4 left-sided) was identified in four small-breed dogs (0.2%). Each atypically located zygomatic gland was tilted at the ventrorostral aspect of the masseter muscle underneath the skin surface. MRI and CT characteristics were not different between typically and atypically located SGs. None of the dogs had clinical signs related with SG disease. It was concluded that, with suspected breed predispositions, incidental unilateral or bilateral anatomical variations of mandibular and zygomatic SGs can be encountered in dogs and an awareness of these possible variations may be important in pre-surgical planning.

Evaluation of the ventro 20° rostral-dorsocaudal oblique radiographic projection for the investigation of canine nasal disease.

OBJECTIVE: To assess the ventro 20° rostral-dorsocaudal oblique projection for canine nasal disease as an alternative to the dorsoventral intra-oral view. MATERIALS AND METHODS: Thirty-one dogs with nasal disease underwent radiography and computed tomography with a final diagnosis of underlying cause achieved through rhinoscopy, biopsy or cytology. Three independent observers, blinded to diagnosis, reviewed the nasal radiographs on two separate occasions. Intra- and inter-observer agreement and level of confidence on radiographic diagnosis were evaluated and radiographic diagnosis was compared with computed tomography and definitive diagnosis. RESULTS: The ventro 20° rostral-dorsocaudal oblique projection of canine nasal cavities was feasible in anaesthetised dogs and gave diagnostic quality images in most dogs. Assessment of this view showed moderate to substantial agreement with computed tomography diagnosis but gave lower confidence in diagnosis. Interpretation of this radiographic projection had substantial to almost perfect repeatability but moderate reproducibility. CLINICAL SIGNIFICANCE: The ventro 20° rostral-dorsocaudal oblique projection may be used as a valuable initial screening tool for canine nasal pathology in practices without access to advanced imaging, although computed tomography is still likely to provide greater diagnostic information.

Diagnostic Exercise: Circling and Behavioral Changes in a Cat.

A 4-year old spayed male domestic shorthair cat was presented with a history of circling and behavioral changes. Neurologic examination showed mild proprioceptive deficits. The lesion was localized in the forebrain, and magnetic resonance imaging revealed the presence of a large midline intracranial mass extending from the frontal lobe to the tentorial region of the brain. Euthanasia was elected due to poor prognosis. Histopathologic evaluation confirmed the presence of a mass composed by sheets and aggregates of large round/polygonal cells and multinucleate cells associated with deposits of cholesterol clefts, scattered hemorrhages and hemosiderin-laden macrophages. Immunohistochemistry showed that the round/polygonal cells and multinucleate cells were strongly positive for major histocompatibility complex class II antigen, variably positive for CD18, and occasionally positive for S100. Subsets of spindle cells showing variable expression of vimentin, S100, and neuron-specific enolase were also present. The final diagnosis was cholesterol granuloma. Differential diagnosis with meningioma is discussed.

Simulation of nasal flow by lattice Boltzmann methods.

The lattice Boltzmann method is used to calculate the incompressible, viscous flow of air through a model of a nasal cavity, used in experiments. Computations are performed for steady flows at the inspiration and expiration phase of nose breathing. Computed pressure distributions and friction coefficients compare well with Navier-Stokes solutions from a finite-volume method on structured, curvilinear grids. The comparison with conventional Navier-Stokes solvers shows several advantages of the lattice Boltzmann method in particular for bio-medical flow problems. These are the fast grid generation, the simple, granular algorithm, suited for efficient parallelization and the high flexibility for implementing complex boundary conditions and additional transport equations. Lattice Boltzmann methods are therefore efficient candidates for fast flow predictions in the frame of computer-aided rhino-surgery.

[Development of a walking stage test (PWT) for the elderly]. / Entwicklung eines Power-Walking-Stufen-Tests (PWT) für ältere Menschen.

The aim of the project promoted by the federal state of North-Rhine/Westphalia was the development of a field stage test focusing on endurance exercises of elderly people which withstand test-theoretical quality criteria, in particular that of economy. The main objectives were therefore the measurement of individual potential by measuring the heart rate, with simultaneous minimization of health risks and a close link to normal, everyday exercises. The test procedure was supposed to estimate the aerobic endurance of elderly people in order to enable us to give individual training recommendations on walking. In a three-phase procedure (laboratory and field ergometry, test development, and evaluation) with a total of 90 test persons, the individual heart rates and lactate levels were measured in 269 single tests. The findings show that an evaluation of the individual performance capability on the basis of heart rate is possible using a three-stage power walking test (PWT), without requiring maximum strain of the subjects. The PWT can therefore be seen as a diagnostic instrument available for the age group of the 60-80 year-olds, supplying a default for an individual strain dosage for walking. The test is accomplished independently of the respective age of the subjects and the result is an individual training plan for walking on the basis of an estimate of personal endurance. Developed as a staged test, the three levels requiring a 400 m walk on each level at different speeds, all the test requires is the measurement of the heart rate at the end of each level. The validity of the common guides for the planning of training by heart rate for systematic endurance training (walking) is thereby improved enabling a more individual training recommendation.

[Preliminary results in standardization of flow cytometry protocols for monocytic HLA-DR measurement and their application in the follow up of septic shock]. / Standardisation de la mesure de l'antigène HLA-DR monocytaire par cytométrie en flux: résultats préliminaires et application dans le suivi des chocs septiques.

In septic shock, the diminished HLA-DR expression on monocytes has been proposed as a marker of immunoparalysis that correlates with an increased risk for fatal outcome. The present study was designed to determine whether some differences in protocol procedures could lead to discrepant results in HLA-DR measurement. After establishing a reliable protocol, the second objective was to illustrate the immunoparalysis in patients with septic shock. HLA-DR measurement on monocytes was determined by means of flow cytometry in 54 healthy donors and 16 patients with septic shock. We demonstrated that storage temperature, storage duration before staining and red cells lysis constitute crucial steps in HLA-DR measurement. The precision results with coefficients of variation below 5%, were quite convincing for a manual immunoassay. At 48 hours after diagnosis of septic shock, we found severely decreased percentages of monocytes expressing HLA-DR in septic patients (24 +/- 4%, mean +/- SEM) in comparison with healthy donors (90 +/- 1%), p < 0.001). Furthermore, the persistence of a low level of monocytic HLA-DR (less than 50 %) at day 9 after admittance was associated with patients who died. This study illustrates the state of immunoparalysis in patients with septic shock and supports the potential interest in measuring HLA-DR expression on monocytes. However, multicenter studies are now needed to validate this parameter. Based on our analytical results, we conclude that a critical issue in such studies will be the capacity in each center to perform standardized measurement of HLA-DR. It should be remembered that this determination requires the definition of a common analytical procedure between laboratories participating in the trial.

A small protein (Ags1p) and the Pho80p-Pho85p kinase complex contribute to aminoglycoside antibiotic resistance of the yeast Saccharomyces cerevisiae.

We identified the AGS1 and AGS3 genes by their ability to partially complement an ags mutant (RC1707) which is supersensitive to various aminoglycoside antibiotics (J. F. Ernst and R. K. Chan, J. Bacteriol. 163:8-14, 1985). AGS1 is located in proximity to the centromere of chromosome III and encodes a small protein of 88 amino acids. The size of the AGS1 transcript, which in wild-type cells is 1 kb, is reduced to 0.75 kb in mutant RC1707. Disruption of AGS1 rendered strains supersensitive to hygromycin B and increased their resistance to vanadate. In addition, ags1delta strains underglycosylated invertase but had normal carboxypeptidase Y glycosylation, suggesting that Ags1p is required for the elaboration of outer N-glycosyl chains. AGS3 was found to be identical to PHO80 (TUP7), which encodes a cyclin activating the Pho85p protein kinase. Deletion of either PHO80 or PHO85 led to aminoglycoside supersensitivity; pho80delta ags1delta strains showed an enhanced-sensitivity phenotype compared to single mutants. pho80 and pho85 mutants were rendered resistant by deletion of PHO4, indicating that activation of the Pho4p transcription factor is required for increased aminoglycoside sensitivity. Thus, both the Pho80p-Pho85p kinase complex (by Pho4p phosphorylation) and a novel component of the N glycosylation pathway contribute to basal levels of aminoglycoside resistance in Saccharomyces cerevisiae.

Defective threonine-linked glycosylation of human insulin-like growth factor in mutants of the yeast Saccharomyces cerevisiae.

Mutants of the yeast Saccharomyces cerevisiae were identified, in which O-glycosylation at threonine 29 of a heterologous protein, human insulin-like growth factor (hIGF-1), is defective. In mutant M195, O-glycosylation of hIGF-1, but not of yeast proteins chitinase and a-agglutinin, was reduced; in mutant M577 yeast proteins were affected besides hIGF-1. The mutations of M195 and M577 did not affect viability and could not be complemented by the PMT1 or PMT2 genes. The mutant phenotype of strain M195 was reconstituted in an in vitro system, in which a hIGF-1-derived peptide encompassing residues 24-34 was not used as acceptor for mannosylation, while unrelated peptides were glycosylated at wild-type levels. hIGF-1 glycosylation was drastically reduced in pmt1 disruptants and to a lesser extent in pmt2 disruptants, suggesting interaction between the PMT gene products and components mutated in M195 and M577 cells. The results suggest that mutations may only affect O-glycosylation of a specific subset of secreted proteins in yeast.

Practice of autologous preoperative plasmapheresis in Germany in 1993.

Autologous preoperative plasmapheresis which is being performed at the University Hospital of Tübingen since 1984 in advance of surgical, orthopaedic or gynecologic operations, constitutes, in combination with intraoperative autotransfusion (IAT), an optimal method to compensate high losses of intravascular volume. Unlike all other procedures which also substitute lost volume (such as infusion of electrolytic solutions or plasma expanders, haemodilution, retransfusion of preoperatively donated autologous blood, transfusion of homologous plasma or foreign blood) this method grants optimal clotting as well as intravascular retention of volume and in addition to this excludes every risk of infection. Although the therapeutic advantages of autologous preoperative plasmapheresis are well known and confirmed by our statistics (about 75% of the patients do not need any foreign blood), the method is rarely practiced in Germany and mainly performed in specialized hospitals (e.g. in the orthopaedic departments of Tübingen, Ulm, Hamburg, Hannover or Essen). This unfortunate situation is obviously due to some of the following, primarily logistic problems. First of all the procedure of autologous preoperative plasmapheresis needs relatively long planning in advance of the operation (between 2 and 4 weeks) and a number of surgeons renounces the method--even if the patient's medical condition is appropriate and no higher costs are to be expected. The above mentioned alternatives of compensating blood losses are preferred, even if they are in no way comparable in their efficiency. Secondly, in Germany autologous preoperative plasmapheresis is mostly performed by an anaesthetist, who is, however, under our laws obliged to reinfuse the plasma himself, which he has taken from a patient.(ABSTRACT TRUNCATED AT 250 WORDS)

[High resolution autoradiographic detection of beta-gamma emitters in biological tissues: case of Indium 111]. / Détection autoradiographique à haute résolution d'émetteurs beta-gamma dans les tissus biologiques: cas de l'Indium 111.

The present paper proposes an efficient autoradiographic procedure for the microscopic localisation in biological tissues of both low energy electrons and electrons released at relatively high energy. These are emitted by radioactive tracers, decaying by electron capture and/or internal conversion, that are increasingly used in biology and medicine. A detailed inventory of the corpuscular and electromagnetic radiations has been established in the specific case of Indium-111, with emphasis placed on those presenting an autoradiographic interest. As far as the electromagnetic component is concerned, the probability for producing secondary electrons as a function of distance from the source has been calculated. The range of the electrons in the emulsion and in a tissue-like medium has also been taken into account. The comparison with experiments using isolated lymphocytes labelled with 111In-oxine confirms the feasibility to localize and quantify with a high resolution beta-gamma emitters within biological systems by autoradiographic imaging.

[Avoidance of homologous blood transfusions in gynecology and obstetrics]. / Zur Vermeidung von Fremdbluttransfusionen in der Gynäkologie und Geburtshilfe.

Public concern about the safety of transfusion was aroused by the discovery that the acquired immuno deficiency syndrome (AIDS) can be transmitted by blood transfusion. Patients who require transfusion are now apprehensive to the point of seeking alternatives or even refusing to receive blood. "Autologous transfusion" of the patients own blood can completely eliminate the risk of disease of transmission. Autologous transfusion can be accomplished in different ways: through intraoperative salvage and retransfusion of the patient's blood during surgery, and through donation by the patient of the required amount of blood before surgery. Intraoperative salvage is, to some degree at least, an alternative to transfusion of homologous blood for many surgical patients. Predepositing of blood is an alternative for patients whose elective surgery is scheduled far enough in advance (about 3 weeks) to permit deposit of the required amount of blood. Greater use of predonation would reduce the risk of hepatitis and other transfusion-associated illnesses. It should be noted that any transfusion in obstetrics and gynecology - autologous or homologous - may need a severe indication.

Human anti-endoplasmic reticulum autoantibodies appearing in a drug-induced hepatitis are directed against a human liver cytochrome P-450 that hydroxylates the drug.

"Anti-liver/kidney microsome" (anti-LKM) autoantibodies have been found in the serum of patients with cryptogenic chronic hepatitis and with immunoallergic drug-induced hepatitis, such as those induced by halothane or by tienilic acid (called anti-LKM2 in this case). So far the nature of the human microsomal macromolecules recognized by these antibodies has not been determined. Here we show, by using immunoblot techniques, that among the macromolecules present in human adult liver microsomes, one protein called cytochrome P-450-8 is specifically recognized by most sera of patients containing anti-LKM2 antibodies but not by control serum. Human fetal liver microsomes that do not contain cytochrome P-450-8 are not recognized by the anti-LKM2 antibodies. It is also shown that anti-cytochrome P-450-8 antibodies as well as human serum containing anti-LKM2 antibodies specifically inhibit the hydroxylation of tienilic acid by human liver microsomes. These results indicate that anti-LKM2 antibodies appearing in patients with hepatitis and concomitant administration of tienilic acid are directed against a cytochrome P-450 isoenzyme that catalyzes the metabolic oxidation of this drug. This suggests a possible mechanism for the appearance of anti-organelle antibodies in a drug-induced hepatitis.

[The quality of washed autotransfused erythrocytes. The elimination of plasma hemoglobin, osmotic fragility and survival rate of retransfused erythrocytes]. / Die Qualität gewaschener autotransfundierter Erythrozyten. Untersuchungen zur Elimination von Plasmahämoglobin, osmotischen Resistenz und Uberlebensrate retransfundierter Erythrozyten.

Intraoperative transfusion has until recently been understood to mean full retransfusion of the blood removed by a suction pump without significant changes due to external influences, which considerably limited its utilization. Intraoperative transfusion can only be performed without decisive disadvantages when the blood can be suctionally removed in large amounts and immediately retransfused. In recent years, the Cell Saver has provided a system which can also prepare soiled blood for retransfusion. Extensive orthopedic surgery entails large blood losses due to oozing from expanded wound areas; only rarely does acute bleeding occur. Because of intensive tissue contact, the suctioned blood has been soiled with activated clotting factors, lytic enzymes, free haemoglobin from damaged red cells, cleaning solutions, and other undesired elements. With the Cell Saver system, it is possible to remove the plasma and recover 70-80% of the intact red cells sufficiently freed from stroma and free haemoglobin. The osmotic fragility of these cells served as a measure of integrity and membrane stability. They were compared to red cells withdrawn preoperatively and showed an identical osmotic relationship. Determining the survival rate of the retransfused cells in vivo shows that they provide a high-quality and in most cases, a sufficient replacement of blood loss. Even after 6 days, over 70% were found in the circulating blood. Premature, disproportionate elimination, which could be dangerous for the patient, does not occur.

[Autotransfusion and plasmapheresis in preparation for surgery. Behavior of coagulation]. / Autotransfusion und operationsvorbereitende Plasmapherese.

With the current day implementation of methods of autotransfusion one retransfuses if possible only washed red cell concentrates and eliminates the plasma. In the case of operations where patients undergo large blood loss, one must effect a substitution for the lost plasma volume and the lost clotting factors. In addition to electrolyte and colloidal solutions one can use a substitution of homologous and also autologous fresh frozen plasma (FFP). The effects of different substitutes on the clotting reaction has been investigated in 47 patients on whom extensive orthopaedic and also traumatologic surgical operations have been performed. By the combination of homologous blood and homologous FFP as also with autologous red cells and homologous FFP the clotting reactions remain the same. This determines the advantages of autotransfusion as compared with conventional techniques but, in addition, there is a saving in the usage of homologous blood. Where an operation can be planned in advance, the necessary FFP can be obtained from the patient. By utilisation of autologous FFP the operative and post- operative blood losses are reduced. As a result it is possible e.g. in total hip prosthesis, in approximately 90% of all cases, to operate without using homologous blood or plasma. The determined stability of AT III in autologous plasma--without AT III prophylaxis of thrombosis by Heparin is ineffective--and all other clotting factors leads to an expectancy of a not activated clotting mechanism and at the same time to low thrombosis risks.(ABSTRACT TRUNCATED AT 250 WORDS)

[Horner's syndrome in obstetrics. A rare complication of peridural regional anesthetic procedures]. / Das Hornersyndrom in der Geburtshilfe. Eine seltene Komplikation rückenmarksnaher Regionalanaesthesieverfahren.

A case of Horner's syndrome (HS) following lumbar epidural block during labor is described. 10 min after injection of the local anaesthetic the symptoms and signs of HS were recognized. They spontaneously disappeared 60 min later. It is concluded, that HS seems to be a benign complication of epidural anaesthesia which may, however, present the first sign or symptom of an extensive block of serious consequence. Pregnant women in labor receiving epidural block, seem to be predisposed to HS.

Hepatic uptake and disposition of human polymeric IgA1 in perfused rat liver: evidence for incomplete biliary excretion and intrahepatic degradation.

The hepatic uptake of polymeric immunoglobulin A (IgA) is mediated by secretory component; the resulting secretory IgA is excreted intact into bile. To define the hepatic metabolism of polymeric IgA, we quantitated the uptake and transport of human polymeric IgA1 after a single pass through the perfused rat liver. Uptake of polymeric IgA1 was compared with that of asialoorosomucoid, a glycoprotein whose uptake is mediated by the asialoglycoprotein receptor. Single-pass hepatic uptake of 125I-polymeric IgA1 and of 125I-asialoorosomucoid averaged 18.0 +/- 3.1% (SE) and 71.8 +/- 2.8%, respectively. The uptake of 125I-polymeric IgA1 was inhibited by excess unlabeled polymeric IgA1 but not by asialoorosomucoid. Only 13.0 +/- 1.6% of the 125I-polymeric IgA1 extracted by the liver was excreted into bile, whereas three-fourths was released into the hepatic venous effluent in degraded form. Thus, both the uptake and biliary excretion of polymeric IgA1 by the rat liver are inefficient processes. Polymeric IgA1 follows two distinct pathways after uptake by the liver: a small proportion is excreted intact into bile, while the majority is degraded and released back into the circulation.

Experience with Dimer-X 1-ventriculography.

Positive contrast ventriculography was carried out in 72 cases, using the water-soluble contrast medium Dimer-X. The examinations were performed 1--3 days after ventricular drainage had been carried out to relieve raised intracranila pressure. After injection of 2--7.5 ml. of the medium into the non-anaesthetised patients -- including 37 children and juveniles -- the ventriculographs were taken under visual control using Mimer III. This method is simple and can be rapidly carried out. Radiographs taken in two planes, supplement by tomography if required, are sufficient for an accurate diagnosis. During the examination only two children suffered from vomiting, while another patient sustained a generalised convulsion because the contrast agent came into contact with the surface of the brain.