AggreProt: a web server for predicting and engineering aggregation prone regions in proteins.

Recombinant proteins play pivotal roles in numerous applications including industrial biocatalysts or therapeutics. Despite the recent progress in computational protein structure prediction, protein solubility and reduced aggregation propensity remain challenging attributes to design. Identification of aggregation-prone regions is essential for understanding misfolding diseases or designing efficient protein-based technologies, and as such has a great socio-economic impact. Here, we introduce AggreProt, a user-friendly webserver that automatically exploits an ensemble of deep neural networks to predict aggregation-prone regions (APRs) in protein sequences. Trained on experimentally evaluated hexapeptides, AggreProt compares to or outperforms state-of-the-art algorithms on two independent benchmark datasets. The server provides per-residue aggregation profiles along with information on solvent accessibility and transmembrane propensity within an intuitive interface with interactive sequence and structure viewers for comprehensive analysis. We demonstrate AggreProt efficacy in predicting differential aggregation behaviours in proteins on several use cases, which emphasize its potential for guiding protein engineering strategies towards decreased aggregation propensity and improved solubility. The webserver is freely available and accessible at https://loschmidt.chemi.muni.cz/aggreprot/.

Spinal Involvement in Patients with Chronic Non-Bacterial Osteomyelitis (CNO): An Analysis of Distinctive Imaging Features.

Spinal involvement by chronic non-bacterial osteomyelitis (CNO) has been increasingly reported in recent years, often being presented as a diagnostic dilemma requiring differential diagnosis with bacterial spondylodiscitis and/or neoplasia. This study was aimed at identifying the imaging features of CNO facilitating its differentiation from other spinal diseases. Two radiologists assessed the imaging studies of 45 patients (16 male and 29 female, aged from 6 to 75 years, 15 children) with CNO collected from 5 referential centers. Spinal lesions were found in 17 patients (2 children and 15 adults), most often in the thoracic spine. In children, the lesions involved short segments with a destruction of vertebral bodies. In adults, the main findings were prominent bone marrow edema and osteosclerosis, endplate irregularities, and ankylosing lesions extending over long segments; paraspinal inflammation was mild and abscesses were not observed. In both children and adults, the involvement of posterior elements (costovertebral and facet joints) emerged as an important discriminator between CNO and neoplasia/other inflammatory conditions. In conclusion, a careful inspection of imaging studies may help to reduce the number of biopsies performed in the diagnostic process of CNO.

How to increase the accuracy of the diagnosis of the accessory bone of the foot?

PURPOSE: The study was conducted to search for confident radiological signs in symptomatic cases of accessory bones. A normal accessory bone appearance on X-ray does not exclude that the accessory bone is the source of the discomfort; because of this, MRI examination can later be applied as part of the diagnosis. METHODS: We retrospectively analysed cases of 64 patients with recognized 70 symptomatic accessory bones of the foot. The average age was 29.2 (range 8-42) years. We included only patients with X-ray and MRI examinations. We investigated the following radiological features of the bone (structural and signal) in relation to soft tissue. RESULTS: The most constant symptoms identified in our study were bone marrow oedema (93%) and soft tissue oedema (77%). Changes in structures in which accessory bones were located or in adjacent structures to accessory bone were identified: tendon changes 51%, fluid adjacent to bone 51% and tenosynovitis 46%. MRI revealed changes in bone structure that are not seen on X-ray, including changes in contour (28%), sclerosis (3%) or osteonecrosis (3%). CONCLUSIONS: MRI plays an important role in determining whether accessory bones cause symptoms because it shows specific and accurate changes in accessory bone and/or in adjacent soft tissue.

Ischiofemoral Impingement Syndrome: A Case Report and a Review of Literature.

BACKGROUND: Ischiofemoral impingement syndrome is characterized by a hip pain associated with abnormalities in quadriceps femoris muscle and ipsilaterally reduced distance between the lesser trochanter and the ischium. Thus far, the congenital variant of this entity has been reported exclusively in women. CASE REPORT: We report a case of a 22-year old male with painful hips in whom on the basis of the imaging studies the constitutional variant of ischiofemoral impingement was diagnosed. CONCLUSIONS: Ischiofemoral conflict should be taken into consideration in the differential diagnosis of hip pain, particularly among women, but also in patients with valgus hip deformity and other abnormalities leading to reduction of the space between femoral and ischial bones independent of gender.

Cortical fibrous defects and non-ossifying fibromas in children and young adults: The analysis of radiological features in 28 cases and a review of literature.

BACKGROUND: To assess and describe the variability of radiological presentations of fibrous cortical defects and non-ossifying fibromas in children and young adults. MATERIAL/METHODS: Medical records of 28 patients (15 males, 13 females, mean age of 17 years) with a radiological diagnosis of cortical fibrous defect or non-ossifying fibroma were reviewed retrospectively. The presentation of the lesion, its location and morphology according to Ritschl's classification, as well as the number and types of imaging studies performed in the study group were assessed. RESULTS: Almost all lesions constituted an incidental finding discovered on plain films performed due to trauma. One lesion presented with a pathological fracture. There were 4 patients (mean age of 11 years) with stage A lesion, 9 patients (mean age of 16 years) with stage B lesion, 10 patients (mean age of 18 years) with stage C lesion, and 5 patients (mean age of 23 years) with stage D lesion. The lesions were located mostly in bones around the knee joint. In more than a half of the patients, further imaging was performed apart from plain films. Four lesions were biopsied (1 of stage B and 3 of stage C). CONCLUSIONS: A considerable morphological variability of cortical fibrous defects and non-ossifying fibromas, especially of stage C, seems to be the main cause of unnecessary additional imaging and invasive diagnostic procedures in patients with this benign pathology. The knowledge of their age-related evolution and typical skeletal distribution should help in making a correct diagnosis.

Intraosseous lipomas: A report of six cases and a review of literature.

BACKGROUND: Intraosseous lipoma is a very rare lesion, which constitutes not more than 0.1% of bone tumors. The introduction of cross-sectional imaging, especially MRI, seems to have increased the detection rate of these lesions. CASE REPORT: The authors presented 6 cases of intraosseous lipomas in bones of the lower extremities. All lesions were detected incidentally and presented radiographically as radiolucent lesions with sclerotic borders and internal trabeculations. One lesion caused bone expansion. CT and MRI identified fatty tissue in all lesions. Cystic degeneration was present in one lesion and dystrophic calcifications in two. DISCUSSION: The radiographic appearance of intraosseous lipomas is not characteristic and requires differential diagnostics conducted for a long time. However, CT and MRI allow for a tissue-specific diagnosis. The detection of a predominant fatty component in a lesion confirms its benign character and no further diagnostic work-up is required.

[Evaluation of attitude towards euthanasia expressed by first year medical students from Szczecin, Greifswald and Lund medical faculties]. / Ocena podejscia do eutanazji studentów pierwszego roku medycyny w Szczecinie, Greifswaldzie i Lund.

INTRODUCTION: Medical students' attitude towards euthanasia is a very important ethical problem because they may grapple with this question as future doctors. The aim of the study was to compare the attitude to euthanasia in the group of first year medical students from Pomeranian Medical University in Szczecin, Ernst-Moritz-Arndt University Greifswald (Germany) and Lund University (Sweden). MATERIAL AND METHODS: The study is based on anonymous filling out of the questionnaire about euthanasia by first year medical students. 233 students (61%) answered the questionnaire. There were 65 Polish students, 71 German and 97 Swedish ones. In the group of respondents there were 129 (55%) women and 104 (45%) men. The average age was 22.3 years. RESULTS: 82% of questioned German students declared the acceptance of euthanasia and it was a significantly higher percentage than in comparison to 61% of Swedish students (p < 0.007) and 48% Polish ones (p < 0.0001). Poles were more often against euthanasia (29%) in comparison to 12% of Swedes (p < 0.02) and 3% of Germans (p < 0.001). Unnatural support of patient's life was the most often accepted by students clinical situation to use euthanasia. Significantly more Germans than Poles (79% vs 48%; p < 0.005) and Swedes (79% vs 50%; p < 0.02) accepted euthanasia in the group of questioned students declaring themselves as believers. CONCLUSIONS: German students in the highest percentage declared the acceptance of euthanasia and Polish ones--the highest objection. It may be connected with religious beliefs as the element of cultural differences among above three countries. It seems very proper to continue the study among older medical students.

Tumours of the metatarsus.

BACKGROUND: Tumours of the metatarsus are rare and more frequently affect males. Relevant literature to date has mostly been confined to case reports. Single cases of the following tumours have been discussed: giant cell tumour, metastases (lung, prostate gland), chondroblastoma, aneurysmal bone cyst, Ewing's sarcoma, clear cell carcinoma, osteosarcoma, intraosseous ganglion, chondromyxoid fibroma and granuloma. We present our own clinical experience with metatarsal tumours during the period of the last 20 years. The aim of the present study was to carry out a systematic examination of metatarsal tumours with regard to methods of diagnosis (location) and morphology. MATERIAL AND METHODS: Fifteen patients with metatarsal tumours were diagnosed in the Department of Orthopaedics in Warsaw. Biplane radiographs were obtained as the initial examination in all cases. Subsequent work-up included angiography in three patients, ultrasonography in six and MRI in five patients. The results were histopathologically verified. RESULTS: Most of the metatarsal tumours were benign. Malignancies were found in four patients. CONCLUSIONS: 1. Bone tumours are rarely located in the metatarsus. 2. The presenting clinical and radiological signs of metatarsal tumours are usually not characteristic and may be difficult to detect. 3. The biplane X-ray should always be the first diagnostic test. Further diagnostic work-up (ultrasonography, CT, MRI) depends on the initial radiological findings. 4. The frequently unequivocal presentation of metatarsal tumours requires a multidisciplinary diagnosis involving a clinician, a radiologist and a histopathologist.

Diagnostic imaging of the locomotor system- historical reviev.

This work discusses the stages in the development of techniques used for imaging the locomotor apparatus. Attention is also drawn to the fact that from the very beginning of the "Roentgen era" Polish scientists were among its leading advocates and promoters.

The diabetic foot - diagnostic difficulties.

Foot disease is the most common complication of diabetes leading to hospitalization.
Pathologic processes that develop in the diabetic foot depends on:
- vascular problems - septic diabetic foot
- neurologic problems - aseptic diabetic foot
- both vascular and neurologic problems - mixed diabetic foot.
Diagnostic imaging has a great importance in establishing the diagnose, staging of foot changes and plan the treatment. The first choice in the study is still conventional plain x-ray, as a second procedures the US, CT, MRI and scintigraphy should be used.
Authors presents diagnostic difficulties in assessment of diabetic foot lesions.

Diagnostic problems in long bones bending assessment.

Some metabolic disorders and local affection processes taking place in long bones may generate their deflection. It can appear when bones grow irregularly or comes to deformations in consequence of partial or general diminishing of their resistance. Differentiation ot those two cases among other things is the problem of imaging. In our study we have chosen cases of the changed long bones axis making analysis of the reasons based on dihedral pictures.

Difficulties in the interpretation of radiological images of the locomotor system.

Normal tissue structures of the locomotor system revealed in imaging can be mistaken by inexperienced radiologists for lesions resulting from trauma or disease. The author discusses the images that most often cause diagnostic difficulties.

The radiological image of Paget's didease.

Background. Paget's disease is a metabolic bone disease characterized by excessive bone resorption and activated osteoclasts. The aim of the present study was to examine the localization and extent of lesions, radiological traits, and complications.
Material and methods. During the period 1981-2001. 24 patients (14 women, 10 men) with Paget's disease were examined, using x-rays of the skull, spine, pelvis, and the long bones of the limbs, and computer tomography (1 patient) of the skull and pelvis.
Results. In 15 patients (62,5%), the disease was monoostotic, while in 9 cases (37,5%) it was polyostic. The most common places for changes were in the vault of the skull (9 cases), the tibia (7 cases), the pelvis (5 cases), the femur (3 cases), and the lumbar spine (3 cases). Osteosclerotic changes dominates in the radiological picture. Three of the patients were in the osteolitic phase of Paget's disease.
Conclusions. The radiological picture of fully developed Paget's disease is very characteristic. It is possible to make a diagnosis on the basis of conventional radiography.

Radiological diagnosis of Brodie's abscess.

Background. Brodie's abscess is a kind of rare subacute or chronic osteitis. It is probably caused by mistreated or non-treated osteitis, or by bacteria of low virulence.
Material and methods. In the Orthopedic and Traumatology Clinic of our medical school 5 patients were diagnosed with Brodie's obsecess between 1999 and 2002. all the patients had conventional x-rays, while one also had CT and MRI.
Results and conclusions. The typical x-ray image shows an osteolytic lesion with sclerotic margin in the diametophysis. Each of the 5 patients had surgery. In 4 cases the histopatological results confirmed the radiological diagnosis. In one case fibrous dysplasia was found.

Clinical sequelae of difficulties in the interpretation of radiological images of the locomotor apparatus.

Working on his own obserwations, the author draws attention to numerous mistakes made in the evaluation of x-rays. The decision to operate is sometimes made on the basis of misdiagnosis resulting from erroneous descriptions. The operation is unsuccessful, the symptoms do not resolve, and in some cases, though fortunately rare, there are complications.

Osteomyelitis: always a timely topic.

The present atudy analyzed the usefulness of particular imaging methods in the of non-specific inflammatory lesions in bone tissue. Examples are given osteomyelitic changes in unusual locations and unique courses of illness in patients referred to the Orthopedics Department for diagnosis or treatment.

Diagnostic imaging in the planning and monitoring of limb lengthening by the Ilizarov method.

Limb lengthening is a long and complicated process, and therefore requires monitoring by use of imaging methods. In planning the application of the Ilizarov method, it is essential to consider the pathology as a whole, and not merely the individual symptoms. This is particularly important in generalized defect on bone formation. The baseline clinical and radiological evaluation should elucidate the etiology of deformations and the extent of changes. Routine X ray examinations during limb lengthening (apart from baseline and immediate post-surgery) should be performed after two and four weeks of distraction, and then every month until the Ilizarov apparatus is removed. Bone cross-sections obtained in CT scans enable the evaluation of the rate of bone regeneration and the reconstruction of tubular bone shape. In doubtful situations CT scans of the regenerated bone three months after removal of the apparatus are also recommended.