Adaptable image cuts for motility inspection using WCE

The Wireless Capsule Endoscopy (WCE) technology allows the visualization of the whole small intestine tract. Since the capsule is freely moving, mainly by the means of peristalsis, the data acquired during the study gives a lot of information about the intestinal motility. However, due to: (1) huge amount of frames, (2) complex intestinal scene appearance and (3) intestinal dynamics that make difficult the visualization of the small intestine physiological phenomena, the analysis of the WCE data requires computer-aided systems to speed up the analysis. In this paper, we propose an efficient algorithm for building a novel representation of the WCE video data, optimal for motility analysis and inspection. The algorithm transforms the 3D video data into 2D longitudinal view by choosing the most informative, from the intestinal motility point of view, part of each frame. This step maximizes the lumen visibility in its longitudinal extension. The task of finding “the best longitudinal view” has been defined as a cost function optimization problem which global minimum is obtained by using Dynamic Programming. Validation on both synthetic data and WCE data shows that the adaptive longitudinal view is a good alternative to the traditional motility analysis done by video analysis. The proposed novel data representation a new, holistic insight into the small intestine motility, allowing to easily define and analyze motility events that are difficult to spot by analyzing WCE video. Moreover, the visual inspection of small intestine motility is 4 times faster then by means of video skimming of the WCE.     

Heterogeneity of mutations in Bulgarian phenylketonuria haplotype 1 and 4 alleles

A study of Bulgarian patients with classical PKU demonstrated that haplotypes 1 and 4 carry a significant number of rare molecular defects resulting from independent mutational events. Differences in mutations associated with these common haplotypes exist even between populations which share a common major PKU mutation. Some amino acid substitutions, previously reported to lead to mild phenylalanine hydroxylase deficiency, were detected in the present study in compound heterozygotes with severe PKU. These findings preclude carrier testing and hyperphenylalaninemia typing by genomic analysis at least in the heterogeneous Bulgarian population.     

National estimates of the use of hematopoietic stem-cell transplantation in children with cancer in the United States

National utilization data for hematopoietic stem-cell transplantation (HSCT) for childhood cancers in the United States have not been reported. We identified cancer encounters for children aged 18 years and younger from 1997 to 2001 in US nonfederal, acute care hospitals. We compared patient, hospital, and resource use characteristics and in-patient mortality associated with HSCT and non-HSCT encounters, estimated the number of HSCT encounters by stem-cell source and cancer type, and examined resource use and mortality in each category. We identified 461,175 cancer encounters, of which 6380 (1.4%) were HSCT encounters. There was wide variation in resource use and mortality by stem-cell source and cancer type. Of note, 17% of HSCT encounters were for patients with acute lymphoblastic leukemia without remission or sarcoma, conditions for which there is little evidence of benefit from HSCT in children. These encounters were associated with high in-patient mortality and long lengths of stay. Also, we observed an increasing use of cord blood over the study period. Future research should examine potentially important sociodemographic differences in patients undergoing HSCT compared to those who do not. Additional analyses incorporating disease stage and severity are needed.     

Congenital cataracts facial dysmorphism neuropathy syndrome, a novel complex genetic disease in Balkan Gypsies: clinical and electrophysiological observations.

During a study of hereditary motor and sensory neuropathy-Lom in Bulgaria, a previously unrecognized neurological disorder was encountered, mainly in Wallachian Gypsies, who represent a relatively recent genetic isolate. The disorder has been termed the congenital cataracts facial dysmorphism neuropathy (CCFDN) syndrome to emphasize its salient features. Fifty individuals from 19 extended pedigrees were identified and examined clinically and electrophysiologically. At least 1 patient from each family was admitted to the hospital in Sofia for full investigation. Pedigree analysis indicates autosomal recessive inheritance. The disorder is recognized in infancy by the presence of congenital cataracts and microcorneas. A predominantly motor neuropathy beginning in the lower limbs and later affecting the upper limbs develops during childhood and leads to severe disability by the third decade. Associated neurological features are a moderate nonprogressive cognitive deficit in most affected individuals together with pyramidal signs and mild chorea in some. Accompanying nonneurological features include short stature, characteristic facial dysmorphism, and hypogonadotrophic hypogonadism. Nerve conduction studies suggest a hypomyelinating/demyelinating neuropathy, confirmed by nerve biopsy. The CCFDN syndrome is thus a pleomorphic autosomal recessive disorder displaying a combination of neurological and nonneurological features.     

High Archaea diversity in Varvara hot spring, Bulgaria

The phylogeny of the latest recognized domain, Archaea, is still complicated and it is largely based on environmental sequences. A culture independent molecular phylogenetic analysis revealed high Archaea diversity in a terrestrial hot spring, village Varvara, Bulgaria. A total of 35 archaeal operational taxonomic units (OTUs) belonging to three of the classified five Archaea phyla were identified. Most of the sequences were affiliated with the phylum Crenarchaeota (23), grouped in four branches. The rest of the sequences showed highest similarity to the unidentified archaeal clones (9), Euryarchaeota (2), and "Korarchaeota " (1). Eight (23%) of the sequenced 16S rDNAs didn't have known close relatives and represented new and diverse OTUs, four of them forming a new archaeal subgroup without close described sequences or culturable relatives. A sequence affiliated with "Korarchaeota " showed low similarity (90%) to the closest neighbor and both sequences formed unique branch in this phylum. Consequently, the constructed archaeal libraries are characterized by (1) high proportion of OTUs representing uncultivated archaeal phylogroups, (2) the abundance of novel phylotype sequences, (3) the presence of high proportions of Crenarchaeota phylotypes unrelated to cultivated organisms and (4) the presence of a sequence only distantly related to "Korarchaeota " phylum.     

In vitro Study of Apically Extruded Debris and Irrigant Following the Use of Conventional and Rotary Instrumentation Techniques

The complete preparation of the root canal space is one of the most important stages in endodontic treatment. While the root canal space is being prepared, debris, irrigant, necrotic tissue or bacteria may be extruded into the periapical region, leading to periapical inflammation and postoperative flare-ups. The aim of this study is to compare in vitro the amount of debris and irrigant extruded apically after a root canal preparation, using two instrumentation techniques--the conventional hand ＂step back＂ technique with SS K-files and the engine-driven ＂crown down＂ technique with Ni-Ti K3 files. Two groups of 20 extracted teeth with single canals were used. In group 1 （10 teeth）, the root canals were instrumented using a ＂step back＂ technique and stainless steel K-files. In group 2 （10 teeth）, the root canals were instrumented using a ＂crown-down＂ technique and nickel-titanium K3 rotary instruments. Debris and irrigant extruded from the apical foramen during instrumentation were collected into vials and the amounts were measured. The debris extruded through the apical foramen in group 1 （K-files） was 0.400 mg and in group 2 （K3 files）--0.225 mg. The volume of the extruded irrigant was 0.443 mL in group 1 and 0.247 mL in group 2. The time taken for instrumentation was 13 min for the step back technique and 8.7 min for the crown-down technique. There is a significant difference in the amount of debris and irrigant produced between the two groups. During biomechanical preparation of the root canal space, debris and irrigant were extruded through the apical foramen by both instrumentation techniques.     

Evaluation of dipyridamole efficacy as an agent for preventing acute respiratory viral diseases

The epidemiological effectiveness of a low molecular interferon inducer, dipyridamole, as a means of prevention of influenza and ARD was studied in a double-blind epidemiological trial in a period of seasonal rise of ARD (Dec., 26, 1984-March 13, 1985). A statistically significant decrease of ARD incidence (1.91-fold) in the experimental group was confirmed by the results of serological studies and titrations of serum interferon in paired sera collected before the prevention and 10 days after its termination in selected subgroups from the experimental and control groups. The results indicate that the use of dipyridamole may be effective for mass prevention of influenza and ARD.     

Intestinal inflammation induces adaptation of P-glycoprotein expression and activity

Recent studies suggest that P-glycoprotein (Pgp) encoded by MDR1 gene, may be an important factor in the pathogenesis of inflammatory bowel disease (IBD). In this study, we investigated intestinal Pgp expression and activity: (1) in IL10 deficient (IL10(-/-)) mice which spontaneously develop intestinal inflammation affecting the small and large intestine and (2) in DSS (dextran sodium sulfate)-induced rat colitis. In IL10(-/-) enterocolitis mice, rhodamine 123 efflux was reduced by two to three-fold along the small and large intestine. This decrease was associated with a reduction in membrane's Pgp protein levels. A similar three-fold decrease in Pgps activity and expression was observed in the proximal colon in DSS-induced colitis in rats. However, in the non-inflamed ileum in DSS-induced rat colitis, epithelial cell's Pgp activity and protein levels were unexpectedly increased. This effect was specific to local inflammation since LPS induced systemic inflammation did affect neither the intestinal rho 123 efflux transport nor the abundance of the Pgp protein. These data demonstrate for the first time, an impaired function of epithelial Pgp in IL10 deficient enterocolitis mice. They also show an increase in Pgps activity in the non-inflamed ileum in the DSS-induced rat colitis, which may represent an adaptive mechanism to compensate the impaired activity of Pgp in the colon.     

Use of aspirin associates with longer primary patency of hemodialysis grafts

Extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts, but the individual contributions of each component are unknown. Here, we analyzed whether use of aspirin at baseline associated with primary unassisted graft patency among participants in a randomized trial that compared ERDP/ASA and placebo in newly created grafts. We used Cox proportional hazards regression, adjusting for prespecified baseline comorbidities and covariates. Of all participants, 43% reported use of aspirin at baseline; of these, 82% remained on nonstudy aspirin (i.e., excluding ERDP/ASA) at 1 year. After 1 year of follow-up, the incidence of primary unassisted patency among participants using aspirin at baseline was 30% (95% CI: 24 to 35%) and among those not using aspirin was 23% (95% CI: 18 to 27%). Use of aspirin at baseline associated with a dose-dependent prolongation of primary unassisted graft patency that approached statistical significance (adjusted HR, 0.83; 95% CI: 0.68 to 1.01; P=0.06). Use of aspirin at baseline did not associate with prolongation of cumulative graft patency or participant survival. In conclusion, use of aspirin associates with a trend toward longer primary unassisted patency of newly placed hemodialysis grafts similar to that observed for ERDP/ASA.     

Clinical trials treating focal segmental glomerulosclerosis should measure patient quality of life

Optimal therapy of patients with steroid-resistant primary focal segmental glomerulosclerosis (FSGS) remains controversial. This report describes the initial study design, baseline characteristics, and quality of life of patients enrolled in the FSGS Clinical Trial, a large multicenter randomized study of this glomerulopathy comparing a 12-month regimen of cyclosporine to the combination of mycophenolate mofetil and oral dexamethasone. Patients with age ranging 2-40 years, with an estimated glomerular filtration rate > 40 ml/min per 1.73 m2, a first morning urine protein-to-creatinine ratio over one, and resistant to corticosteroids were eligible. The primary outcome was complete or partial remission of proteinuria over 52 weeks after randomization. In all, 192 patients were screened, of whom 138 were randomized for treatment. Ethnic distributions were 53 black, 78 white, and 7 other. By self- or parent-proxy reporting, 26 of the 138 patients were identified as Hispanic. The baseline glomerular filtration rate was 112.4 (76.5, 180.0) ml/min per 1.73 m2, and urine protein was 4.0 (2.1, 5.3) g/g. Overall, the quality of life of the patients with FSGS was lower than healthy controls and similar to that of patients with end-stage renal disease. Thus, the impact of FSGS on quality of life is significant and this measurement should be included in all trials.