GRAPE: a graphical pipeline environment for image analysis in adaptive magnetic resonance imaging

Purpose

We present a platform, GRAphical Pipeline Environment (GRAPE), to facilitate the development of patient-adaptive magnetic resonance imaging (MRI) protocols.

Methods

GRAPE is an open-source project implemented in the Qt C++ framework to enable graphical creation, execution, and debugging of real-time image analysis algorithms integrated with the MRI scanner. The platform provides the tools and infrastructure to design new algorithms, and build and execute an array of image analysis routines, and provides a mechanism to include existing analysis libraries, all within a graphical environment. The application of GRAPE is demonstrated in multiple MRI applications, and the software is described in detail for both the user and the developer.

Results

GRAPE was successfully used to implement and execute three applications in MRI of the brain, performed on a 3.0-T MRI scanner: (i) a multi-parametric pipeline for segmenting the brain tissue and detecting lesions in multiple sclerosis (MS), (ii) patient-specific optimization of the 3D fluid-attenuated inversion recovery MRI scan parameters to enhance the contrast of brain lesions in MS, and (iii) an algebraic image method for combining two MR images for improved lesion contrast.

Conclusions

GRAPE allows graphical development and execution of image analysis algorithms for inline, real-time, and adaptive MRI applications.

     

Tuberculosis defaulters from the "dots" regimen in Jimma zone, southwest Ethiopia

A cross-sectional study was conducted among patients with tuberculosis on the DOTS regimen in the four teaching health centers of Jimma zone to determine rate of defaulting and factors associated with it. All tuberculosis patients registered and treated using DOTS regimen in the 4 teaching health centers (THC's) from the second half of 1999 to December 30, 2000 were included in the study. A sub-sample of one hundred and fourteen 114 (56.2%) defaulters were traced at their homes and interviewed to elicit their reasons for defaulting. The study showed that overall rate of defaulting was 6.7%. The default rate from the DOTS regimen was found to be quite low when compared to the rate of defaulting from the standard regimen in Jimma zone. Socio-economic factors including distance of patients' residence from the health institution, lack of money for paying transportation and poor awareness about the disease were the major reasons contributing to poor compliance and defaulting. Designing community based strategies for DOTS regimen in order to make the drug available within the vicinity of the grass root community and strong information education and communication activities need to be employed in order to reduce the defaulter rate and improve the quality of treatment of tuberculosis cases by the DOTS regimen.     

Predictors of adherence to antiretroviral therapy among people living with HIV/AIDS in resource-limited setting of southwest ethiopia

Background  

Good adherence to antiretroviral therapy is necessary to achieve the best virological response, lower the risk that drug resistance will develop, and reduce morbidity and mortality. Little is known about the rate and predictors of adherence in Ethiopia. Therefore this study determines the magnitude and predictors of adherence to antiretroviral therapy among people living with HIV/AIDS in Southwest Ethiopia.     

Clamp and sew techniques in thoracoabdominal aortic surgery using naloxone and CSF drainage

Surgical repair of thoracoabdominal (TAA) and thoracic aneurysm is challenging, with the potentials for high morbidity and mortality. There is no standardized operative approach. Operative management of TAA consists of simple clamp-and-sew techniques with adjuncts, cerebrospinal fluid (CSF) drainage, naloxone administration, and intraoperative hypothermia, to protect the spinal cord. The use of CSF drainage and naloxone administration has reduced paraplegia to 3.4%, compared with 21% when none of these adjunctive spinal cord measures were used. The authors discuss their operative strategy, surgical technique, and results at the University of Wisconsin Hospital and Clinics.     

The effect of diazepam on human gastric secretion

Human basal gastric secretion is markedly reduced after oral administration of 10 mg diazepam. This effect lasts for five hours.

Gastric nocturnal secretion, collected five hours after the last meal, reveals a decline towards the morning hours with an average of 25% in placebo-treated patients. A comparison between placebo and diazepam reveals a significantly greater decrease of 47% in volume after giving parenterally 10 mg diazepam without noticeable side effects.

     

Risk factors for anemia among pregnant women attending antenatal clinic at Jimma University Hospital, southwest Ethiopia

OBJECTIVE: to determine anemia and its risk factors among pregnant women METHODS: A cross-sectional analytic study was carried out among pregnant women who came for antenatal care follow up for the first time to Jimma University hospital, Jimma town, southwestern Ethiopia from May-June 2005. RESULTS: A total of 168 pregnant women who came for their first antenatal care visit to Jimma University hospital were enrolled in the study. A structured and interviewer administered questionnaire was used to collect data on the socio-demographic variables, dietary habit and other gynecologic and obstetric history. Dietary data were collected using food frequency questionnaire prepared for assessing nutritional factors for anemia. Sahli hemoglobinometer and a microscope were used for assessing hemoglobin level and stool for hookworm infection, respectively. Data were cleaned, edited and entered in to a computer and analyzed using SPSS for windows, version 11.0. Statistical tests were performed at the level of significance of 5%. The prevalence of anemia was 64/168 (38.2%) and the mean hemoglobin level was 11.3 mg/dl. Anemic cases were 4 times likely to have history of excess menstrual bleeding prior to the index pregnancy 2 times likely to have hook worm infection and 3 times likely not to have shoe wearing habit, 3 times likely to have birth intervals less than 24 moths between the previous pregnancy and index pregnancy (p < 0.05). CONCLUSION: This finding suggests the need for strengthening of interventions related to child spacing and raising awareness about family planning methods. All ANC attendants should be screened for anemia and hookworm infection at first visit and those anemic mothers and infected with hookworm should be treated appropriately. Health education should be given to pregnant mothers on family planning, and the need to gynecologic evaluation before pregnancy and the importance of wearing shoes to decrease hook worm infection and subsequent anemia.     

Vertebral artery embolic protection via ipsilateral brachial approach during left subclavian artery angioplasty and stenting--a case report

The purpose of this report is to explore angioplasty and stenting with cerebral embolic protection as a salvage procedure for a compromised carotid-subclavian bypass in the presence of antegrade vertebral artery flow. A 76-year-old woman with a carotid-subclavian bypass presented with graft infection. Failure of medical therapy to treat the infection prompted surgical removal of the graft. The native subclavian artery was still patent, but a severe complex proximal stenosis was present with antegrade flow into the left vertebral artery. Angioplasty and stenting of the subclavian artery was performed with cerebral protection achieved by positioning a FilterWire EX in the left vertebral artery via the left brachial artery approach. Deployment of a filter device in the vertebral artery via the brachial or radial approach can provide embolic protection without interfering with the subclavian artery stenting. The successful treatment of the subclavian artery enabled the complete removal of the infected graft without need for major vascular reconstruction.     

Post-natal effect of overexpressed DKK1 on mandibular molar formation

Dickkopf-related protein 1 (DKK1) is a potent inhibitor of Wnt/β-catenin signaling. Dkk1-null mutant embryos display severe defects in head induction. Conversely, targeted expression of Dkk1 in dental epithelial cells leads to the formation of dysfunctional enamel knots and subsequent tooth defects during embryonic development. However, its role in post-natal dentinogenesis is largely unknown. To address this issue, we studied the role of DKK1 in post-natal dentin development using 2.3-kb Col1a1-Dkk1 transgenic mice, with the following key findings: (1) The Dkk1 transgene was highly expressed in pulp and odontoblast cells during post-natal developmental stages; (2) the 1(st) molar displayed short roots, an enlarged pulp/root canal region, and a decrease in the dentin formation rate; (3) a small malformed second molar and an absent third molar; (4) an increase of immature odontoblasts, few mature odontoblasts, and sharply reduced dentinal tubules; and (5) a dramatic change in Osx and nestin expression. We propose that DKK1 controls post-natal mandibular molar dentin formation either directly or indirectly via the inhibition of Wnt signaling at the following aspects: (i) post-natal dentin formation, (ii) formation and/or maintenance of the dentin tubular system, (iii) mineralization of the dentin, and (iv) regulation of molecules such as Osx and nestin.