Purpose
To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies.
Methods
Thirty-three patients (60
±
12 years) referred for CT-guided biopsy of focal ...liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1
=
best, 6
=
worst), and time for processing was registered.
Results
All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts’ proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts’ proposal. 7 % automatic path proposals were rated not feasible, all being second choice (
n
=
1
) or third choice (
n
=
6
). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42
±
9 s.
Conclusion
Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts’ insertion trajectories.
Context. H ii regions play a crucial role in the measurement of the chemical composition of the interstellar medium and provide fundamental data about element abundances that constrain models of ...galactic chemical evolution. Discrepancies that still exist between observed emission line strengths and those predicted by nebular models can be partly attributed to the spectral energy distributions (SEDs) of the sources of ionizing radiation used in the models as well as to simplifying assumptions made in nebular modeling. Aims. One of the main influences on the nebular spectra is the metallicity, both nebular and stellar, which shows large variations even among nearby galaxies. Although nebular modeling often involves testing of different nebular metallicities against their influence on the predicted spectra, adequate grids of stellar atmospheres and realistic SEDs for different metallicities are still lacking. This is unfortunate because the influence of stellar metallicity on nebular line strength ratios, via its effect on the SEDs, is of similar importance as variations in the nebular metallicity. To overcome this deficiency we have computed a grid of model atmosphere SEDs for massive and very massive O-type stars covering a range of metallicities from significantly subsolar (0.1 Z⊙) to supersolar (2 Z⊙). Methods. The SEDs have been computed using a state-of-the-art model atmosphere code that takes into account the attenuation of the ionizing flux by the spectral lines of all important elements and the hydrodynamics of the radiatively driven winds and their influence on the SEDs. For the assessment of the SEDs in nebular simulations we have developed a (heretofore not available) 3D radiative transfer code that includes a time-dependent treatment of the metal ionization. Results. Using the SEDs in both 1D and 3D nebular models we explore the relative influence of stellar metallicity, gas metallicity, and inhomogeneity of the gas on the nebular ionization structure and emission line strengths. We find that stellar and gas metallicity are of similar importance for establishing the line strength ratios commonly used in nebular diagnostics, whereas inhomogeneity of the gas has only a subordinate influence on the global line emission. Conclusions. Nebular diagnostics as a quantitative tool for measuring the abundances in the interstellar gas can be used to its full potential only when the influence of SEDs, metallicity, and geometric structure of the nebula are taken into account. For these purposes, detailed stellar SEDs like those of our grid are an essential ingredient for the photoionization models used to predict nebular emission line spectra.
Chronic myeloid leukemia (CML) is induced by
BCR-ABL1 and can be effectively treated for many years with Imatinib until leukemia cells acquire drug resistance through
BCR-ABL1 mutations and progress ...into fatal B lymphoid blast crisis (LBC). Despite its clinical significance, the mechanism of progression into LBC is unknown. Here, we show that LBC but not CML cells express the B cell-specific mutator enzyme AID. We demonstrate that AID expression in CML cells promotes overall genetic instability by hypermutation of tumor suppressor and DNA repair genes. Importantly, our data uncover a causative role of AID activity in the acquisition of
BCR-ABL1 mutations leading to Imatinib resistance, thus providing a rationale for the rapid development of drug resistance and blast crisis progression.
Characterization of daytime sources of nitrous acid (HONO) is crucial to understand atmospheric oxidation and radical cycling in the planetary boundary layer. HONO and numerous other atmospheric ...trace constituents were measured on the Mediterranean island of Cyprus during the CYPHEX (CYprus PHotochemical EXperiment) campaign in summer 2014. Average volume mixing ratios of HONO were 35 pptv (±25 pptv) with a HONO ∕ NOx ratio of 0.33, which was considerably higher than reported for most other rural and urban regions. Diel profiles of HONO showed peak values in the late morning (60 ± 28 pptv around 09:00 local time) and persistently high mixing ratios during daytime (45 ± 18 pptv), indicating that the photolytic loss of HONO is compensated by a strong daytime source. Budget analyses revealed unidentified sources producing up to 3.4 × 106 molecules cm−3 s−1 of HONO and up to 2.0 × 107 molecules cm−3 s−1 NO. Under humid conditions (relative humidity > 70 %), the source strengths of HONO and NO exhibited a close linear correlation (R2 = 0.72), suggesting a common source that may be attributable to emissions from microbial communities on soil surfaces.
Second solid tumors are well known late complications after bone marrow transplantation. Treatment strategies are ill defined. We retrospectively evaluated treatment and outcome in a single ...institution. From August 1974 to July 1996, six solid tumors were observed in five of 387 patients 2 to 13 years after BMT, corresponding to a probability of developing a second solid tumor of 9% (1-17%, 95 CI) at 15 years: these comprised endometrial carcinoma, carcinoma of the thyroid gland, cervical carcinoma, sarcoma of the small intestine, osteosarcoma of the tibia and ovarian carcinoma. All five patients were treated as intensively as they would be without a history of BMT. At last follow-up four of the five patients were alive and without signs of tumor. We postulate that second solid tumors after BMT should be treated as de novo tumors. Early detection based on consequent clinical follow-up of the transplant patients might explain the relatively good outcome.
Angiosarcoma of the temporal bone is an extremely rare malignant tumor, which originates from vascular endothelium. We describe a case of a 57-year-old woman, initially presenting with progressive ...hearing loss, otorrhea as well as facial palsy diagnosed as a mastoiditis elsewhere. After subtotal mastoidectomy histological examination revealed an angiosarcoma of the mastoid. Since the tumor was not completely removed lateral petrosectomy and postoperative radiotherapy were performed. Afterwards the patient developed local recurrence with intracerebral tumor extension. During palliative polychemotherapy the patient developed a pneumonia and deceased. In this manuscript the morphology, imaging characteristics and current treatment options of angiosarcomas of the lateral skull base are reviewed and discussed.
Strawberry (Fragaria x ananassa) fruit contains several anthocyanins that give the ripe fruits their attractive red color. The enzyme that catalyzes the formation of the first stable intermediate in ...the anthocyanin pathway is anthocyanidin-3-O-glucosyltransferase. A putative glycosyltransferase sequence (FaGT1) was cloned from a strawberry fruit cDNA library and the recombinant FaGT1 transferred UDP-glucose to anthocyanidins and, to a lesser extent, flavonols, generating the respective 3-O-glucosides. Quantitative polymerase chain reaction revealed that transcripts of FaGT1 were almost undetectable in green fruits, but gene expression increased dramatically in both turning and ripe red fruit, corresponding closely to the accumulation of anthocyanins during fruit ripening. The expression of FaGT1 is fruit associated and negatively regulated by auxin. To elucidate the in planta function of FaGT1, Agrobacterium tumefaciens cells harboring an intron-hairpin construct of a partial FaGT1 sequence were injected into midsized ripening fruits. In about one-third of the injected fruits, this led to significant down-regulation of FaGT1 transcript levels that corresponded to reduced concentrations of anthocyanin pigments in ripe strawberry fruits. In contrast, significant levels of epiafzelechin--formed by anthocyanidin reductase (ANR) from pelargonidin--were identified in FaGT1-silenced fruits, indicating competition of FaGT1 and FaANR for the common anthocyanidin substrate. Thus, FaGT1 represents an important branching-point enzyme because it is channeling the flavonoid pathway to anthocyanins. These results demonstrate a method to redirect the anthocyanin biosynthesis into flavan-3-ol production to increase the levels of bioactive natural products or modify pigments in plant tissues.
A noninvasive, cell-autonomous reporter system was developed to monitor the generation and distribution of physiologically active pools of abscisic acid (ABA). ABA response (abi1-1) and biosynthesis ...(aba2-1) mutants of Arabidopsis (Arabidopsis thaliana) were used to validate the system in the presence and absence of water stress. In the absence of water stress, low levels of ABA-dependent reporter activation were observed in the columella cells and quiescent center of the root as well as in the vascular tissues and stomata of cotyledons, suggesting a nonstress-related role for ABA in these cell types. Exposure of seedlings to exogenous ABA resulted in a uniform pattern of reporter expression. In marked contrast, reporter expression in response to drought stress was predominantly confined to the vasculature and stomata. Surprisingly, water stress applied to the root system resulted in the generation of ABA pools in the shoot but not in the root. The analysis of the response dynamics revealed a spread of physiologically active ABA from the vascular tissue into the areoles of the cotyledons. Later, ABA preferentially activated gene expression in guard cells. The primary sites of ABA action identified by in planta imaging corresponded to the sites of ABA biosynthesis, i.e. guard cells and cells associated with vascular veins. Hence, water stress recognized by the root system predominantly results in shoot-localized ABA action that culminates in a focused response in guard cells.
Quality of life is defined as the result of combining personal resources, control of the environment, personal values, and actual living conditions. Balanced nutrition is an important condition for ...quality of life, health and well-being. During the course of life everyone develops his very individual biography of eating. This includes eating habits, food choice, and meal patterns. The process of aging is accompanied by hardly recognizable physiological, emotional, social, and environmental changes. Ignoring these changes can lead to malnutrition and nutrition-related problems and thus reduce health, diminish the quality of life, and overall well-being. Accordingly, it is necessary to synchronize the individual biography of eating, the physiological, emotional, social, and environmental changes to enable the aged to feel self-determined and self-confident. This presentation will describe successful examples from local homes for the aged/nursing homes. Examples will show that possibilities of food choice answer the need of the residents to control their environment, that residents can be integrated in the planning and preparation of food and how this corresponds with their need to show their knowledge and experience, that meals in residential facilities can be re-arranged to let the residents experience joy and pleasure, and that nutritional concepts in nursing homes can be changed so that the residents experience themselves as subjects of nutrition.
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