The objective of this retrospective study was to determine the complications of the first 30 tibial tuberosity advancement rapid (TTA-rapid) and 30 modified circular tibial tuberosity advancement (mcTTA) procedures performed by our team, and to compare the results with the findings reported in the literature. Our research was based on 30 procedures in each group. All dogs were client-owned. Data were collected only for the study of cases that had a minimum follow-up period of 3 months. Intraoperative (IO) and postoperative (PO) complications were assessed, with the latter divided into two subgroups: major and minor. Results obtained for the TTA-rapid group: IO complications 23.3% (7/30), major PO complications 13.3% (4/30), minor PO complications 16.7% (5/30). Results of the mcTTA group: IO complications 0% (0/30), major PO complications 3.3% (1/30), minor PO complications 20% (6/30). Comparing the complication rates, we found that there was a significant difference between the two groups in the occurrence of IO complications (P = 0.01054); however, there was no significant difference in the incidence of major (P = 0.3533) and minor (P > 0.9999) PO complications between groups. Our results are consistent with the findings reported in the literature and suggest that both techniques are efficient and carry a relatively low complication rate.
The objective of the present pilot study was to determine the force required to break (a) intact canine tibiae, (b) tibiae following the osteotomy of the tibial tuberosity and (c) tibiae following Tibial Tuberosity Advancement- (TTA-) rapid surgery. Six pairs of tibiae of dogs between 15 and 35 kg body weight were used in a cadaver study. Three groups were created with four tibiae in each group; intact (Group 1), osteotomy of the tibial tuberosity and tibial crest (Group 2) and TTA-rapid (Group 3). The tibiae were put under static axial compressive load, applied until failure. The force required to break the tibiae was termed maximal force (F max). The mean of F max was 8193.25 ± 2082.84 N in Group 1, 6868.58 ± 1950.44 N in Group 2 and 7169.71 ± 4450.39 N in Group 3. The sample size was small for a statistical analysis but as a preliminary result, we have determined the force (F max) required to break canine tibiae. Furthermore, we hypothesise that osteotomies result in weakening of the tibial structure.
Improved methods for malaria diagnosis are urgently needed. Here, we evaluate a novel method named rotating-crystal magneto-optical detection (RMOD) in 956 suspected malaria patients in Papua New Guinea. RMOD tests can be conducted within minutes and at low cost. We systematically evaluate the capability of RMOD to detect infections by directly comparing it with expert light microscopy, rapid diagnostic tests and polymerase chain reaction on capillary blood samples. We show that compared to light microscopy, RMOD exhibits 82% sensitivity and 84% specificity to detect any malaria infection and 87% sensitivity and 88% specificity to detect Plasmodium vivax. This indicates that RMOD could be useful in P. vivax dominated elimination settings. Parasite density correlates well with the quantitative magneto-optical signal. Importantly, residual hemozoin present in malaria-negative patients is also detectable by RMOD, indicating its ability to detect previous infections. This could be exploited to reveal transmission hotspots in low-transmission settings.
Positron emission tomography (PET) is a medical imaging method belonging to the realm of nuclear medicine. It has been a clinical research tool since the sixties but during the late nineties it became widely utilized in clinical practice too. PET technique requires special radioactive isotopes, which may be generated only in particle accelerators (cyclotrons) and their transport is limited owing to the short physical half-life. PET/CT was born from the combination of PET and CT (computer tomography). The first combined PET/CT scanner began to operate in 1998 and the method has been used in clinical practice since 2001. It is a hybrid (multi-modality) medical imaging equipment which can provide anatomical, morphologic (CT) and functional, metabolic information (PET) simultaneously. PET/CT imaging has gained clinical acceptance mainly in oncology - owing to the attributes of the most frequently used PET tracer, fluoro-deoxy glucose (FDG) - and in a lesser extent in neuropsychiatry and cardiology. The authors in this paper review the basics and key indications of the method, the wider used radiofarmacons, including potential neurological and psychiatric applications, and the possible causes of false positivity and false negativity.
The search for the biological foundations of human culture inevitably leads to nonverbal communication. Superficial intuition suggests that nonverbal communication is a "sine qua non" for the evolution of sociality. Without it, the diversity and sophistication of today's social systems would be unimaginable. However, there is the opposite hypothesis that the evolution of nonverbal communication may in part be the result of our being thoroughly social entities: Our sociality itself may have amplified the evolution of a capacity we share with other primates but have developed to a degree unequaled by any other species. Advances in the evolution of nonverbal communication as presented in this volume will certainly contribute to further insights into the intricacies of the biological and the social worlds. This volume grew out of a conference at the Center for Interdisciplinary Research in Bielefeld, Germany. The conference was organized by a research group working on the overarching theme of "Biological Foundations of Human Culture," so that scholars in such wide-ranging areas as biology, psychology, sociology, anthropology, economics, primatology, history, and philosophy of science could present and discuss recent approaches toward a biologically and sociologically founded understanding of human culture. This pluralistic perspective made it possible to bring the diverse disciplinary approaches into fruitful dialogue.
We present a study of the structure of hadronic events recorded by the L3 detector at LEP at the center of mass energies of 161 and 172 GeV. The data sample corresponds to an integrated luminosity of 21.25 pb“ 1 collected during the high energy runs of 1996. The distributions of event shape variables and the energy dependence of their mean values are well reproduced by QCD models. From a comparison of the data with resummed QCD calculations, we determine the strong coupling constant at the two energies. Combining this with our earlier measurements we find that the strong coupling constant decreases with increasing energy as expected in QCD. © 1997 Published by Elsevier Science B.V. ..... ......................................................................................................................................................................................................................................................................................................................... .................. ................................................................................................................................ ...................—
ABSTRACT Purpose To use T1-, T2-weighted and diffusion tensor MR images to portray glioma grade by employing a voxel-wise supervised machine learning approach, and to assess the feasibility of this tool in preoperative tumor characterization. Materials and Methods Conventional MRI, DTI datasets and histopathological evaluations of 40 patients with WHO grade II-IV gliomas were retrospectively analyzed. Databases were construed incorporating preoperative images, tumor delineation and grades. This data was used to train a multilayer perceptron based artificial neural network that performed voxel-by-voxel correlation of tumor grade and the feature vector. Results were mapped to grayscale images, whereas grade map was defined as a composite image that depicts grade assignments for intra-tumoral regions. The voxel-wise probability for high grade tumor classification was calculated for the entire tumor volumes, defined as the grade index. Results The color hue on glioma grade maps allowed the discrimination of low and high grade cases. This method revealed connection between the heterogeneous appearance of tumors and the histopathological findings. Classification by the grade index had 92.31% specificity, 85.71% sensitivity. Conclusion Glioma grade maps are advantageous in the visualization of the heterogeneous nature of intra-tumoral diffusion and relaxivity and can further enhance the characterization of tumors by providing a preoperative modality that expands information available for clinicians. ABBREVIATIONS ADC apparent diffusion coefficient; ANN artificial neural networks; DWI diffusion weighted imaging; DTI diffusion tensor imaging; FA fractional anisotropy; HGPM high grade probability map; LGPM low grade probability map; TPM tumor probability map; WHO World Health Organization
The second part of the study presents a detailed description of the surgical technique and early results with circular Tibial Tuberosity Advancement (cTTA), a novel method for the treatment of canine cranial cruciate ligament rupture. For preoperative planning, see part one of the present article. The technique is based on Tibial Tuberosity Advancement (TTA), sharing the same principle of biomechanical stabilization. To the authors knowledge, there are only two studies available on cTTA to date. The study involved 16 patients, followed up to two weeks after implant removal. omplications occurred in seven patients (43.75%), one of which had two different complications at two different periods of time. Though the rate of complications might seem high, all were classified as minor, and none required reoperation. After the removal of the implants, all patients performed well.
We describe a patient who within 2 months of undergoing radio-chemotherapy for glioblastoma developed an Epstein-Barr virus-positive primary diffuse large B-cell CNS lymphoma. To our knowledge, this is the first such case reported in the literature showing that new tumefactions following aggressive treatment for glioblastomata might represent secondary malignancies.
Attempts to explicate the neural abnormalities behind autism spectrum disorders frequently revealed impaired brain connectivity, yet our knowledge is limited about the alterations linked with autistic traits in the non-clinical population. In our study, we aimed at exploring the neural correlates of dimensional autistic traits using a dual approach of diffusion tensor imaging (DTI) and graph theoretical analysis of resting state functional MRI data. Subjects were sampled from a public neuroimaging dataset of healthy volunteers. Inclusion criteria were adult age (age: 18-65), availability of DTI and resting state functional acquisitions and psychological evaluation including the Social Responsiveness Scale (SRS) and Autistic Spectrum Screening Questionnaire (ASSQ). The final subject cohort consisted of 127 neurotypicals. Global brain network structure was described by graph theoretical parameters: global and average local efficiency. Regional topology was characterized by degree and efficiency. We provided measurements for diffusion anisotropy. The association between autistic traits and the neuroimaging findings was studied using a general linear model analysis, controlling for the effects of age, gender and IQ profile. Significant negative correlation was found between the degree and efficiency of the right posterior cingulate cortex and autistic traits, measured by the combination of ASSQ and SRS scores. Autistic phenotype was associated with the decrease of whole-brain local efficiency. Reduction of diffusion anisotropy was found bilaterally in the temporal fusiform and parahippocampal gyri. Numerous models describe the autistic brain connectome to be dominated by reduced long-range connections and excessive short-range fibers. Our finding of decreased efficiency supports this hypothesis although the only prominent effect was seen in the posterior limbic lobe, which is known to act as a connector hub. The neural correlates of the autistic trait in neurotypicals showed only limited similarities to the reported findings in clinical populations with low functioning autism.
The aim of this work was to use probabilistic diffusion tractography to examine the organization of the human insular cortex based on the similarities of its remote projections. Forty right-handed healthy subjects (33.8 ± 12.7 years old) with no history of neurological injury were included in the study. After the spatial standardization of diffusion tensor images, insular cortical masks were delineated based on the Harvard–Oxford Cortical Atlas and were used to initiate fibertracking. Cluster analysis by the k-means algorithm was employed to partition the insular voxels into two groups that featured the most distinct distribution of connections. In order to perform volumetric comparisons, the assigned label maps were transformed back to space of the subjects’ native anatomical MR images. The outlines of the change in connectivity profile did not respect the known cytoarchitectural subdivisions and were shown to be independent from the gyral anatomy. Interhemispheric asymmetry in the volumes of connectivity-based subdivisions was observed putatively marking a leftward functional dominance of the anterior insula and its reciprocally interconnected targets which influences the size of insular area where similar connections are represented. The fractional anisotropy values were not significantly different between the hemipsheres or connectivity-based clusters; however, the mean diffusivity was higher in the anterior insula in both hemispheres.
Summary We present four cases of confirmed anti-NMDA receptor encephalitis; three presented initially with serious psychiatric symptoms and the other developed significant psychiatric symptoms during the initial phase of illness. Brain biopsy findings of one patient are also described. Psychiatrists should consider anti-NMDA receptor encephalitis in patients presenting with psychosis and additional features of dyskinesias, seizures and catatonia, particularly where there is no previous history of psychiatric disorder.
Emotions are parts of organizational reality to an ever increasing extent. Importantly, they are not just tools in the hand of healthcare workers to achieve better physician / healthcare professional-to-patient interactions but intrinsic processes and characteristics with psychic, cognitive and somatic actions. For a thorough investigation of the issue, a PANAS-X questionnaire was used to examine the emotions of 187 physicians and other healthcare professionals, all engaged in oncology, in 2009. The research succeeded in exploring the overall emotional state oncology professionals had assumed in relation with their job as well as enabled the authors of this study to draw the respondents' emotional map and assess their fundamental emotional attitudes. Furthermore, the authors managed to identify groups of respondents that had felt more intense positive, and/or less intense negative emotions that are socially accepted than others. They included those of senior experienced oncologists, males, individuals with families, childless individuals, ward workers, and skilled professionals. According to the findings, the range of emotions an oncologist experiences / feels intently during his everyday work is dependent upon a great number of factors.
Introduction Current endeavors in neuro-oncology include morphological validation of imaging methods by histology, including molecular and immunohistochemical techniques. Diffusion tensor imaging (DTI) is an up-to-date methodology of intracranial diagnostics that has gained importance in studies of neoplasia. Our aim was to assess the feasibility of discriminant analysis applied to histograms of preoperative diffusion tensor imaging-derived images for the prediction of glioma grade validated by histomorphology. Methods Tumors of 40 consecutive patients included 13 grade II astrocytomas, seven oligoastrocytomas, six grade II oligodendrogliomas, three grade III oligoastrocytomas, and 11 glioblastoma multiformes. Preoperative DTI data comprised: unweighted ( B 0 ) images, fractional anisotropy, longitudinal and radial diffusivity maps, directionally averaged diffusion-weighted imaging, and trace images. Sampling consisted of generating histograms for gross tumor volumes; 25 histogram bins per scalar map were calculated. The histogram bins that allowed the most precise determination of low-grade (LG) or high-grade (HG) classification were selected by multivariate discriminant analysis. Accuracy of the model was defined by the success rate of the leave-one-out cross-validation. Results Statistical descriptors of voxel value distribution did not differ between LG and HG tumors and did not allow classification. The histogram model had 88.5% specificity and 85.7% sensitivity in the separation of LG and HG gliomas; specificity was improved when cases with oligodendroglial components were omitted. Conclusion Constructing histograms of preoperative radiological images over the tumor volume allows representation of the grade and enables discrimination of LG and HG gliomas which has been confirmed by histopathology.
The guiding principle of this chapter is the importance of combining traditional morphological data with the recently acquired knowledge on the genetic and epigenetic signalling pathways which drive the evolution of CNS tumors. The official World Health Organization terminology (WHO, 2007) will be used since it is the source of information for neurooncology, neuroradiology, neurosurgery, etc. It is of outmost importance that new entities have emerged since 2007 and it seems inevitable to see a new classification in the near future. It is beyond the scope if this chapter to dwell on the pitfalls in diagnostic surgical neuropathology, suffice is to say that the classic, traditional case descriptions which are usually presented in textbooks comprise only a fraction of diagnostic dilemmas so often hunting practicing neuro-oncopathologists. The main focus will be placed on intracranial lesions but it needs to be emphasized that the diagnostic entities which come the way of a surgical neuropathologist broadly overlap with an extensive range of entities which basically belong to hematopathology, soft tissue and bone/chondroid tumors. In all textbooks on neuropathology the usual way to start is to point out that knowledge of brain and spinal cord anatomy as well as familiarity with the broad range of cellular reactions in diseased CNS are essential for success in understanding pathology reports. There is no way to cover all these details, hence a list of reference books is provided. This chapter is born out of the need to outline unambiguous and consistent terminology of brain tumors. This together with a strong urge to define the use of a universally accepted grading system (be that weak as it is despite of century-old efforts) could help not only all specialists who are involved in treating brain tumor patients but also and of outmost importance the patients themselves.
The mental and emotional state of the individuals have a strong effect on the course of their illnesses as well as the speed of recovery. Adequate quantity and quality of information and social support are a prerequisite for mental, and often for physical well-being. In our investigation at the DE OEC, we gathered data on the psychological and physical states of 100 breast cancer patients in order to reveal the role of a helping atmosphere in the recovery phase of their illness. The results suggested that patients attending the HIVAS support group could cope with their disease and its side effects better, and experienced a higher level of well-being.