Calcium scoring in low-dose ungated chest CT scans using convolutional long-short term memory networks.

We aimed to develop a novel deep-learning based method for automatic coronary artery calcium (CAC) quantification in low-dose ungated computed tomography attenuation correction maps (CTAC). In this study, we used convolutional long-short -term memory deep neural network (conv-LSTM) to automatically derive coronary artery calcium score (CAC) from both standard CAC scans and low-dose ungated scans (CT-attenuation correction maps). We trained convLSTM to segment CAC using 9543 scans. A U-Net model was trained as a reference method. Both models were validated in the OrCaCs dataset (n=32) and in the held-out cohort (n=507) without prior coronary interventions who had CTAC standard CAC scan acquired contemporarily. Cohen's kappa coefficients and concordance matrices were used to assess agreement in four CAC score categories (very low: <10, low:10-100; moderate:101-400 and high >400). The median time to derive results on a central processing unit (CPU) was significantly shorter for the conv-LSTM model- 6.18s (inter quartile range [IQR]: 5.99, 6.3) than for UNet (10.1s, IQR: 9.82, 15.9s, p<0.0001). The memory consumption during training was much lower for our model (13.11Gb) in comparison with UNet (22.31 Gb). Conv-LSTM performed comparably to UNet in terms of agreement with expert annotations, but with significantly shorter inference times and lower memory consumption.

Effects of gastric acidity on peristomal infection after percutaneous endoscopic gastrostomy placement.

Peristomal infection is a common complication following percutaneous endoscopic gastrostomy (PEG) placement. This study investigated the effect of gastric acidity on peristomal infection, including type of bacteria and the relationship between bacteria cultured from the oropharynx and PEG tube site. Sixty-seven patients with dysphagia underwent PEG placement at Otaki Hospital between 1998 and 2001. Gastric acidity was evaluated by 24h pH monitoring. Patients were observed for peristomal infection for two weeks after PEG placement, with specimens collected from the oropharynx and PEG tube site. Twenty-one (31.3%) of the patients who had undergone PEG insertion developed peristomal infections. Of 52 patients who were not colonised with meticillin-resistant Staphylococcus aureus (MRSA) in the oropharynx, 11 cases (21.2%) developed peristomal infection. The median gastric pH of infected patients (11 cases) was 5.05+/-2.55 (mean+/-SD) and in patients without infection (41 cases) it was 3.06+/-1.83 (P=0.019). Peristomal infection developed in 66.7% (10/15) of patients carrying MRSA compared with only 21.2% (11/52) of patients who were not colonised by MRSA (P<0.001). The incidence of peristomal infection was affected by gastric acidity and the presence of MRSA in the oropharynx.

Development of an enzyme-linked immunosorbent assay using recombinant chicken anemia virus proteins expressed in a baculovirus vector system.

Recombinant baculoviruses were constructed to express the putative proteins VP1, VP2 or VP3 of the chicken anemia virus (CAV). The recombinant VP1, VP2 or VP3 were detected by SDS-PAGE, and their molecular weights were 50, 30/27 and 16 kDa, respectively. The VP2 and VP3 reacted with sera from CAV-infected chickens in Western blot analysis and when used as an enzyme-linked immunosorbent assay (ELISA) antigen, but VP1 did not. Antibodies to CAV were detected, by ELISA using crude insect cell lysates containing VP2 or VP3, from 2 to 20 weeks or 2 to 7 weeks after CAV infection, respectively. These findings indicate that recombinant VP2 and VP3 expressed in the baculovirus vector system can be used as antigens to detect anti-CAV antibodies in ELISA.

Rupture of a dissecting aneurysm into the superior vena cava in Marfan's syndrome.

Aneurysmal dilatation of the aorta with subsequent dissection or rupture occurs frequently in patients with Marfan's syndrome. These complications are among the major causes of death. We report the case of a 51-year-old man with annulo-aortic ectasia in Marfan's syndrome. Acute aortic dissection and rupture into the superior vena cava occurred 8 years after aortic valve replacement. The preoperative diagnosis was made by right heart catheterization and computed tomography. A markedly increased left-to-right shunt occurred with rapid enlargement of the fistula due to the fragility of the aortic wall characteristic of Marfan's syndrome. Postmortem examination demonstrated severe medial necrosis with rupture of the aortic wall into the superior vena cava which was adherent to the suture line of the aortotomy from the previous surgery. Type A aortic dissection with severe congestive heart failure strongly suggested rupture into the pulmonary circulation.

Gene organization of chicken anemia virus.

The genomic DNA of chicken anemia virus (CAV) was cloned and sequenced from a Japanese isolate CAA82-2. The nucleotide sequence of CAA82-2 isolate was 98% identical with that of the European Cuxhaven-1 strain (Noteborn et al., J. Virol. 65, 3131-3139, 1991). Nine open reading frames (ORFs) consisting of more than 100 nucleotides were found, i.e., four ORFs (CA1-CA4) on the plus strand and five ORFs (CA1R-CA5R) on the minus strand. These ORFs with the exception of CA4 are conserved between the two CAV isolates. All of these ORFs were expressed in Escherichia coli as fusion proteins with beta-galactosidase. By Western blot analysis, the CA2 and CA3 fusion proteins were found to react with CAV-infected chicken sera. Rabbit hyperimmune sera against the CA1, CA2, and CA3 fusion proteins were produced and tested their reactivity to CAV-infected cells. Two viral proteins with the apparent size of 54 and 16 kDa reacted with the antibodies against CA1 and CA3 fusion proteins, respectively. The 16-kDa protein, CA3, was suggested to be a major immunogen on CAV infection.

Occurrence of autoimmune antibodies to liver microsomal proteins associated with lethal hepatitis in LEC rats: effects of TJN-101 ((+)-(6S,7S,R-biar)- 5,6,7,8-tetrahydro-1,2,3,12-tetramethoxy-6,7-dimethyl-10,11- methylenedioxy-6-dibenzo[a,c]cyclooctenol) on the development of hepatitis and the autoantibodies.

Long Evans Cinnamon (LEC) rats, that spontaneously develop hepatitis, were found to possess autoantibodies to liver microsomal proteins (anti-LM) before the development of hepatitis. Anti-LM antibody was assumed to appear in association with the lethal hepatitis in the LEC rats. Thus, the purpose of this study was to investigate the effects of an anti-hepatitis drug on the development of hepatitis and the occurrence of the antibody in LEC rats. Mortality, blood biochemical parameters and the titer of serum anti-LM antibody were measured. In control LEC rats, 4 of 8 rats died before 20 weeks of age. In rats treated with TJN-101 ((+)-(6S,7S,R-biar)-5,6,7,8-tetrahydro-1,2,3,12-tetramethoxy -6,7-dimethyl-10,11 - methylenedioxy-6-dibenzo[a,c]cyclooctenol), 4 of 7 rats died of hepatitis, but the time of death was delayed by 7-10 weeks compared to the control rats. The titer of the anti-LM antibody increased 3-7 weeks before death in the non-survivors in control and TJN-101-treated rats, supporting the idea that anti-LM antibody occurs in association with acute lethal hepatitis.

Pathogenesis of highly virulent infectious bursal disease virus infection in intact and bursectomized chickens.

The pathogenesis of highly virulent infectious bursal disease (IBD) virus (IBDV) infection was studied using 6-week-old intact and 5-week-old bursectomized chickens inoculated with highly virulent strain 90-11 or reference strain I. Chickens inoculated with 10(0.7) EID50 of strain 90-11 showed neither clinical signs nor lesions during the 4-day observation period. In contrast, birds inoculated with 10(2.7) or 10(4.7) EID50 developed severe clinical IBD, as well as gross and histologic lesions, typical of IBD, and produced IBDV antigen demonstrable by immunostaining in the bursa of Fabricius (BF), thymus, spleen and bone marrow from day 2 post-inoculation (PI) onwards. The antigen was also detected by the agar-gel precipitation and latex microsphere agglutination tests in a bursal suspension of these birds from day 2 or day 3 PI on. Birds inoculated with 10(6.1) EID50 of strain I developed only slight clinical signs at day 4 PI. Their lesion- and antigen-scores in the BF were almost the same as those in virulent strain-infected chickens, but lesion- and antigen-scores in the other organs were negligible. Bursectomized chickens inoculated with strain 90-11 did not develop clinical IBD despite the presence of infection that was evidenced by histologic lesions in the thymus and spleen as well as IBDV antigen demonstrable by immunostaining in these organs.

Direct correlation between the titer of infectious bursal disease virus VP2-specific antibody and protection.

The titer of antibody specific to infectious bursal disease virus (IBDV) was measured by a new method and correlated with protection. Challenge was carried out in chickens with various antibody titers, which were measured using a latex agglutination-inhibition (LI) test, a rapid and easy technique for measuring IBDV VP2-specific antibody. When actively immunized chickens had LI titers of 1:2 or more, almost all were protected from subsequent challenge with highly virulent IBDV. In contrast, even when chickens passively immunized with maternally derived antibody had LI titers of 1:4, half were susceptible to the same challenge.

Rapid and quantitative assay system for measuring anti-infectious bursal disease virus antibody using monoclonal antibody bound to polystyrene latex microspheres.

A monoclonal antibody (MAb) to infectious bursal disease virus (IBDV) that has virus-neutralizing activity was bound to polystyrene latex microspheres The microspheres agglutinated with extracts of bursae from chickens infected with IBDV. Agglutination was inhibited in a competitive manner by adding serum obtained from IBDV-infected chickens. The level of agglutination-inhibition depended on the serum antibody titer against IBDV. The reaction was visually accomplished within 5 minutes. The titer of this rapid assay showed a close relationship with that of the virus-neutralization test.

A rapid quantitative method for detecting infectious bursal disease virus using polystyrene latex microspheres.

A monoclonal antibody (mAb) to infectious bursal disease virus (IBDV) was bound to polystyrene latex microspheres. The microspheres agglutinated with extracts of bursae and sera from chickens infected with all strains or isolates of IBDV tested. Agglutination appeared within a 10-min reaction time. The assay could detect a 10(3.7) to 10(4.5) mean embryo infective dose (EID50) of the virus in 0.01 ml and the titer of the assay was 10- to 40-times higher than that of the agar gel precipitin test.

Sequence comparisons of a highly virulent infectious bursal disease virus prevalent in Japan.

Variable cDNA regions in the VP2 gene of five highly virulent infectious bursal disease viruses (IBDVs) isolated in Japan were amplified by polymerase chain reaction (PCR) and sequenced. The nucleotide sequences of five highly virulent IBDVs were identical. Comparisons of the nucleotide and the deduced amino acid sequences with those of other strains of IBDV indicated that Japanese highly virulent IBDV is different from all other strains of IBDV that were compared. The number of amino acids that differed between strains (substitution score) showed that highly virulent IBDV is more closely related to European virulent strain 52/70 than to Japanese conventional strains. These results strongly suggest that a single strain of highly virulent IBDV that might have originated from a European strain is prevalent in Japan.

Immunosuppressive effect of a highly virulent infectious bursal disease virus isolated in Japan.

The immunosuppressive effect of infectious bursal disease virus (IBDV) on vaccination against Newcastle disease (ND) was compared among 2-, 3-, and 4-week-old chickens inoculated with the highly virulent IBDV field isolate 90-11 and the reference serotype 1 strain GBF-1. In all age groups, isolate 90-11 severely suppressed antibody response to ND vaccination and protective vaccinal immunity against ND. In contrast, chickens inoculated with strain GBF-1 and vaccinated with ND vaccine were well protected from the ND virus challenge. The mitogenic response to phytohemagglutinin of splenic lymphocytes from chickens inoculated with isolate 90-11 or strain GBF-1 was significantly lower than that of uninoculated controls. There was no difference between the two inoculated groups in responsiveness, although lymphocyte depletion in the thymus was more severe in chickens inoculated with isolate 90-11 than in chickens inoculated with strain GBF-1.

Occurrence of acute infectious bursal disease with high mortality in Japan and pathogenicity of field isolates in specific-pathogen-free chickens.

Highly virulent infectious bursal disease virus (IBDV) was isolated from field cases, and the pathogenicity of the isolates was examined in specific-pathogen-free chickens. Chickens inoculated with the isolates developed severe clinical disease with a high mortality rate. Histopathologically, infectious bursal disease was characterized by bursal and thymic necrosis, aplastic anemia, acute hepatitis with fatty change, and systemic inflammatory response. In addition to functional abnormalities in the liver, a hypoxic state was induced by aplastic anemia and severe inflammation in the pulmonary air capillary walls. These pathological changes appeared to be closely related to the cause of death.

Persistence of maternal antibody to chicken anaemia agent and its effect on the susceptibility of young chickens.

Based on the incidence of anaemia, chicks derived from immune dams were shown to resist the parenteral challenge with chicken anaemia agent (CAA) until 14 days of age. Judging from thymic atrophy induced by the CAA-challenge, maternally-derived immunity of chicks against CAA infection persisted up to at least day 21. A very low level of maternal anti-CAA antibody seemed to be efficacious to the CAA-challenge. These results are discussed in relation to the significance of CAA anaemia under field conditions.

Carcinogenicity study of gamma-oryzanol in B6C3F1 mice.

The carcinogenic potential of gamma-oryzanol, a drug mainly used for the treatment of hyperlipidaemia, was studied in B6C3F1 mice. Groups of 50 males and 50 females were fed a diet containing 0 (control), 200, 600 or 2000 mg gamma-oryzanol/kg body weight/day for 78 wk. No treatment-related changes were observed in general condition, body weight, food consumption, mortality, organ weight or haematology. Histopathological examinations showed various tumours in all groups, including the control group. In the control and 2000-mg/kg groups, relatively high tumour incidences were observed in the liver of males and in the haematopoietic organs of females. However, there was no statistically significant difference in the incidence of any tumours between the control and the 2000-mg/kg groups. The findings indicate that under the experimental conditions described gamma-oryzanol was not carcinogenic in B6C3F1 mice.

Detection of antibody to chicken anaemia agent: a comparison of three serological tests.

A comparison was made between sensitivities of the virus neutralisation (VN) test, indirect fluorescent-antibody (IFA) test and enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies to chicken anaemia agent (CAA). Sera from chickens inoculated with CAA at 11 weeks of age and from specific pathogen-free (SPF) and field breeder chicken flocks were tested. Seroconversion was detected by the three tests in all the inoculated birds at 2 to 3 weeks post-inoculation (pi). Neutralising antibody to CAA was still detectable in all the inoculated birds 37 weeks after infection, the end of the observation period. One of the seven inoculated birds tested by the ELISA gave positive results for the same period whereas the IFA test detected anti-CAA antibody only for 9 weeks. In field sera, the VN test detected many more positive sera than did the ELISA and IFA test. No antibodies to CAA were detected in sera of SPF chickens by the three tests. The IFA test frequently gave false positive results when VN antibody-negative sera were tested at dilutions of