ImageMiner: a software system for comparative analysis of tissue microarrays using content-based image retrieval,high-performance computing,and grid technology

Objective and design

The design and implementation of ImageMiner, a software platform for performing comparative analysis of expression patterns in imaged microscopy specimens such as tissue microarrays (TMAs), is described. ImageMiner is a federated system of services that provides a reliable set of analytical and data management capabilities for investigative research applications in pathology. It provides a library of image processing methods, including automated registration, segmentation, feature extraction, and classification, all of which have been tailored, in these studies, to support TMA analysis. The system is designed to leverage high-performance computing machines so that investigators can rapidly analyze large ensembles of imaged TMA specimens. To support deployment in collaborative, multi-institutional projects, ImageMiner features grid-enabled, service-based components so that multiple instances of ImageMiner can be accessed remotely and federated.

Results

The experimental evaluation shows that: (1) ImageMiner is able to support reliable detection and feature extraction of tumor regions within imaged tissues; (2) images and analysis results managed in ImageMiner can be searched for and retrieved on the basis of image-based features, classification information, and any correlated clinical data, including any metadata that have been generated to describe the specified tissue and TMA; and (3) the system is able to reduce computation time of analyses by exploiting computing clusters, which facilitates analysis of larger sets of tissue samples.     

Treatment of 'en coup de sabre' deformity with porous polyethylene implant

Linear scleroderma "en coup de saber" (LSCS) deformity is a subgroup of scleroderma characterized by unilateral atrophy and depression above the level of the eyebrow. In rare cases where it involves the whole unilateral face it can be mistaken with Parry-Romberg syndrome. Involvement of the trunk and extremities together with facial lesions has been extremely rare in the literature. We report an unusual case of linear scleroderma "en coup de sabre" where there is concomitant involvement of the ipsilateral side of the trunk and lower extremity. The patient's facial deformity is reconstructed with a polyethylene implant.     

Erythema multiforme‐like eruption localized to a sun‐exposed area

We report on a 35‐year‐old woman with cutaneous lesions characterized by an erythema multiforme‐like appearance localized in the photo‐distributed pattern. She had no history of systemic drug ingestion, herpes simplex virus or any other infection, possible causes of erythema multiforme, before the sun exposure. She had normal tolerance to a phototest, but photoprovocation tests could not be performed because she did not agree to them. This case was diagnosed to be an erythema multiforme‐like variant of a polymorphous light eruption; the differential diagnosis of target‐like lesions in a photo‐distributed pattern is discussed.     

How much Reliable Is Alvarado Scoring System in Reducing Negative Appendectomy?

There is still an ongoing debate, especially regarding early diagnosis of acute appendicitis. Early surgery leads to inadequate evaluation of acute abdominal pain and negative appendectomy, whereas delayed surgery leads to appendicitis perforation complications. The diagnosis of this condition is considerably difficult, especially due to subtle early symptoms and clinical condition. The aim of the present study was to identify whether the Alvarado scoring system could reduce the incidence of negative appendectomy in patients who will undergo surgery for acute appendicitis. Patients who underwent surgery with acute appendicitis prediagnosis were retrospectively classified as negative appendectomies (group A) and positive appendectomies (group B) according to histological diagnosis. All groups were evaluated for age, gender, Alvarado scores, and parameters. Two hundred eighty-one patients were included in the study. Group A contained 71 (25.3 %) patients, and group B contained 210 (74.7 %) patients. There was a significant difference in WBC, left shift, rebound, and change of pain localization between the groups (p?=?0.002, p?<?0.001, p?<?0.001, and p?=?0.023, respectively). Alvarado scores were significantly different between the groups (p?<?0.001). In logistic model examination, the major factor was the Alvarado score (7 or above) and the minor factor was spreading pain. The Alvarado scoring system can be used to reduce negative appendectomy in patients who will undergo surgery with acute appendicitis.     

Pregnancy under treatment of imatinib and successful labor in a patient with chronic myelogenous leukemia (CML). Outcome of discontinuation of imatinib therapy after achieving a molecular remission

Because of the teratogenicity data in rats, it is recommended that women treated with imatinib should be aware of the potential teratogenicity of imatinib and effective contraception should be used during imatinib therapy to prevent pregnancy. We describe successful pregnancy and delivery, without any congenital anomaly, in a patient with CML under treatment of imatinib. The fetus had been exposed to imatinib for 8 weeks. The patient remained off treatment during gestation and cytogenetic relapse of CML (5 months after discontinuation of imatinib therapy) developed at seventh month of gestation.     

Multiple pilomatricoma with perforation

A 22‐year‐old woman presented to our clinic with a complaint of masses on various parts of her body. A mass on her right forearm had appeared 5 years ago and had enlarged during the past 6 months. Two lesions on the back of her neck had a 3‐year history, one lesion on her eyebrow had a 2‐year history, and one lesion on her left forearm had a 1‐year history. The lesion on her left forearm was discharging purulent material. Dermatologic examination revealed a 15 × 16 mm tumor on the right forearm, 11 × 6 mm and 10 × 5 mm tumors on the back of the neck, and a 20 × 20 mm tumor on the eyebrow; they were flesh‐colored, well‐defined, firm tumors. On her left forearm, there was a 12 × 10 mm, well‐defined, firm, blue–red tumor discharging chalky white granules; purulent material was detected ( Fig. 1 ).

Figure 1 Open in figure viewer PowerPoint Firm, blue–red tumor discharging chalky white granules     

Diagnostic performance of conventional diffusion weighted imaging and diffusion tensor imaging for the liver fibrosis and inflammation

Objective

To evaluate the diagnostic accuracy of liver apparent diffusion coefficient (ADC) measured with conventional diffusion-weighted imaging (CDI) and diffusion tensor imaging (DTI) for the diagnosis of liver fibrosis and inflammation.

Materials and methods

Thirty-seven patients with histologic diagnosis of chronic viral hepatitis and 34 healthy volunteers were included in this prospective study. All patients and healthy volunteers were examined by 3 T MRI. CDI and DTI were performed using a breath-hold single-shot echo-planar spin echo sequence with b factors of 0 and 1000 s/mm². ADCs were obtained with CDI and DTI. Histopathologically, fibrosis of the liver parenchyma was classified with the use of a 5-point scale (0–4) and inflammation was classified with use of a 4-point scale (0–3) in accordance with the METAVIR score. Quantitatively, signal intensity and the ADCs of the liver parenchyma were compared between patients stratified by fibrosis stage and inflammation grade.

Results

With a b factor of 1000 s/mm², the signal intensity of the cirrhotic livers was significantly higher than those of the normal volunteers. In addition, ADCs reconstructed from CDI and DTI of the patients were significantly lower than those of the normal volunteers. Liver ADC values inversely correlated with fibrosis and inflammation but there was only statistically significant for inflammatory grading. CDI performed better than DTI for the diagnosis of fibrosis and inflammation.

Conclusion

ADC values measured with CDI and DTI may help in the detection of liver fibrosis. They may also give contributory to the inflammatory grading, particularly in distinguishing high from low grade.