Multispectral analysis of magnetic resonance images

Magnetic resonance (MR) imaging systems produce spatial distribution estimates of proton density, relaxation time, and flow, in a two dimensional matrix form that is analogous to that of the image data obtained from multispectral imaging satellites. Advanced NASA satellite image processing offers sophisticated multispectral analysis of MR images. Spin echo and inversion recovery pulse sequence images were entered in a digital format compatible with satellite images and accurately registered pixel by pixel. Signatures of each tissue class were automatically determined using both supervised and unsupervised classification. Overall tissue classification was obtained in the form of a theme map. In MR images of the brain, for example, the classes included CSF, gray matter, white matter, subcutaneous fat, muscle, and bone. These methods provide an efficient means of identifying subtle relationships in a multi-image MR study.     

A chicken model for DGCR6 as a modifier gene in the DiGeorge critical region

DGCR6 is the most centromeric gene in the human DiGeorge critical region and is the only gene in the region with a second functional copy on a repeat localized more distally on chromosome 22. We isolated the chicken ortholog of DGCR6 and showed an embryonic expression pattern that is initially broad but becomes gradually restricted to neural crest cell derivatives of the cardiovasculature. Retrovirus based gene transduction was used to deliver sense and antisense messages to premigrating neural crest cells in vivo. Embryos in which DGCR6 expression was attenuated revealed cardiovascular anomalies reminiscent of those found in DiGeorge syndrome. Moreover, the expression profiles of three other genes from the DiGeorge critical region, TBX-1, UFD1L, and HIRA, were shown to be altered in this model. TBX-1 and UFD1L levels were increased, whereas HIRA was decreased in the hearts and pharyngeal arches of embryos treated with antisense or partial sense constructs, but not with sense constructs for DGCR6. The expression changes were transient and followed the normal DGCR6 expression profile. These data show that neural crest cells might have a role in the distribution of modulator signals to the heart and pharyngeal arches. Moreover, it shows a repressor function for DGCR6 on the expression of TBX-1 and UFD1L. For the first time, DiGeorge syndrome is shown to be a contiguous gene syndrome in which not only several genes from the critical region, but also different cell types within the embryo, interact in the development of the phenotype.     

New insights in the adjuvant treatment of gastric cancer

The current standard treatment of patients with gastric cancer is partial or total stomach resection and dissection of the draining lymph nodes. This approach, however, results in a rather low survival rate, partly because the diagnosis is often established in an advanced stage. Various strategies, including adjuvant radiotherapy, chemotherapy or more extensive surgical procedures, have resulted mainly in increased morbidity without improving survival. In a recent randomised trial, concurrent postoperative radiotherapy and chemotherapy prolonged survival and reduced the chance of a local recurrence at an acceptable toxicity. Although several aspects of combined radiochemotherapy require further study, this new treatment concept appears to be a promising addition to the therapeutic arsenal for gastric cancer.     

Protection of children born to hepatitis-B-infected mothers

The vaccination schedule implemented on 1 March 2003 for the approximately 1000 Dutch children per year born to hepatitis-B-virus-infected mothers is under discussion. The Health Council of The Netherlands and TNO have both published reports which reveal that the current schedule does not fulfil its objectives, as too many children are completely missed and many of the vaccinated children do not receive their scheduled vaccinations on time. Furthermore, doubts have been expressed about the effectiveness of the present vaccination schedule. In line with one of the schedules proposed by the Health Council we suggest the introduction of a 4-dose vaccination, in which the first vaccination is given immediately after the birth of the child. The subsequent vaccinations can then take place after 2, 4 and 11 months. These are the ages at which other children are also vaccinated against hepatitis B in accordance with the Dutch national vaccination programme. Furthermore, we advise an improved surveillance to ensure compliance with the individual vaccination schedules for these children. If data from the hepatitis-B screening of pregnant women, the regional vaccination registers, and the vaccinations actually administered are linked, then it will be possible to take swift action if a child is late for a hepatitis-B vaccination. In our opinion, this can best be achieved if a single national organisation is made responsible for the entire process, starting from the collection of the hepatitis-B data of pregnant women up to concluding the scheme, whether or not the serologic response is checked.     

Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or hip osteoarthritis

Jans MP, Slootweg VC, Boot CR, de Morton NA, van der Sluis G, van Meeteren NL. Reproducibility and validity of the Dutch translation of the de Morton Mobility Index (DEMMI) used by physiotherapists in older patients with knee or hip osteoarthritis.

Objective

To examine the reproducibility, construct validity, and unidimensionality of the Dutch translation of the de Morton Mobility Index (DEMMI), a performance-based measure of mobility for older patients.

Design

Cross-sectional study.

Setting

Rehabilitation center (reproducibility study) and hospital (validity study).

Participants

Patients (N=28; age >65y) after orthopedic surgery (reproducibility study) and patients (N=219; age >65y) waiting for total hip or total knee arthroplasty (validity study).

Intervention

Not applicable.

Main Outcome Measures

Not applicable.

Results

The intraclass correlation coefficient for interrater reliability was high (.85; 95% confidence interval, 71–.93), and minimal detectable change with 90% confidence was 7 on the 100-point DEMMI scale. Rasch analysis identified that the Dutch translation of the DEMMI is a unidimensional measure of mobility in this population. DEMMI scores showed high correlations with scores on other performance-based measures of mobility (Timed Up and Go test, Spearman r=−.73; Chair Rise Time, r=−.69; walking test, r=.74). A lower correlation of .44 was identified with the self-report measure Western Ontario and McMaster Universities Osteoarthritis Index.

Conclusions

The Dutch translation of the DEMMI is a reproducible and valid performance-based measure for assessing mobility in older patients with knee or hip osteoarthritis.     

高三尖杉酯碱酰胺的结构测定

三尖杉树皮粗提取物中的一个新生物碱—高三尖杉酯碱酰胺(homoharringtonamide)的结构,经质谱—质谱分析,初步建议为16。类似的酰胺类生物碱,例如三尖杉碱酰胺(cephalotaxamide,6)、11-羟基三尖杉碱酰胺(11-hydroxycephalotaxamide,9)、三尖杉酯碱酰胺(harfingtonamide,14)或异三尖杉酯碱酰胺(isoharringtonamide,15)也可能存在,后三者(9,14,15)尚未见报道。     

Folic acid and homocysteine affect neural crest and neuroepithelial cell outgrowth and differentiation in vitro.

The beneficial effect of additional folic acid in the periconceptional period to prevent neural tube defects, orofacial clefts, and conotruncal heart defects in the offspring has been shown. Folate shortage results in homocysteine accumulation. Elevated levels of homocysteine have been related to neural tube defects. We studied the behavior of neuroepithelial cells and cranial and cardiac neural crest cells in vitro. Neural tube explants were cultured for 24 and 48 hr in medium after addition of folic acid and/or homocysteine. Folic acid addition increased neuroepithelial cell outgrowth and increased neural crest cell differentiation into nerve and smooth muscle cells. Addition of homocysteine increased neural crest cell outgrowth and migration from the neural tube and inhibited neural crest cell differentiation. Our findings suggest that neural tube defects caused by folate deficiency and hyperhomocysteinemia develop due to increased neuroepithelial to neural crest cell transformation. This increased transformation leads to a shortage of neuroepithelial cells in the neural tube. Defects in orofacial and conotruncal development are explained by abnormal differentiation of neural crest cells in the presence of high homocysteine concentrations. Our findings supports a critical role for folic acid and homocysteine in the development of neural tube defects and neural crest related heart malformations.