Interpretation of peripheral circulation in ill neonates is crucial but difficult. The aim was to analyse parameters potentially influencing peripheral oxygenation and circulation. In a prospective ...observational cohort study in 116 cardio-circulatory stable neonates, peripheral muscle near-infrared spectroscopy (NIRS) with venous occlusion was performed. Tissue oxygenation index (TOI), mixed venous oxygenation (SvO(2)), fractional oxygen extraction (FOE), fractional tissue oxygen extraction (FTOE), haemoglobin flow (Hbflow), oxygen delivery (DO(2)), oxygen consumption (VO(2)), and vascular resistance (VR) were assessed. Correlation coefficients between NIRS parameters and demographic parameters (gestational age, birth weight, age, actual weight, diameter of calf, subcutaneous adipose tissue), monitoring parameters (heart rate, arterial oxygen saturation (SaO(2)), mean blood pressure (MAP), core/peripheral temperature, central/peripheral capillary refill time) and laboratory parameters (haemoglobin concentration (Hb-blood), pCO(2)) were calculated. All demographic parameters except for Hbflow and DO(2) correlated with NIRS parameters. Heart rate correlated with TOI, SvO(2), VO(2) and VR. SaO(2) correlated with FOE/FTOE. MAP correlated with Hbflow, DO(2), VO(2) and VR. Core temperature correlated with FTOE. Peripheral temperature correlated with all NIRS parameters except VO(2). Hb-blood correlated with FOE and VR. pCO(2) levels correlated with TOI and SvO(2). The presence of multiple interdependent factors associated with peripheral oxygenation and circulation highlights the difficulty in interpreting NIRS data. Nevertheless, these findings have to be taken into account when analysing peripheral oxygenation and circulation data.
Abstract Objective To compare image quality, the lesion detection, and the diagnostic efficacy of full-field digital mammography (FFDM) and computed radiography-based mammography using digital ...storage phosphor plates (DSPM) in the evaluation of breast lesions. Materials and methods In this prospective study, 150 patients with suspicious breast lesions underwent FFDM and DSPM. Nine aspects of image quality (brightness, contrast, sharpness, noise, artifacts, and the detection of anatomic structures, i.e., skin, retromamillary space, glandular tissue, and calcifications) were evaluated by five radiologists. In addition, the detection of breast lesions and the diagnostic efficacy, based on the BI-RADS classification, were evaluated with histologic and follow-up correlation. Results For contrast, sharpness, and the detection of all anatomic structures, FFDM was rated significantly better ( p < 0.05). Mass lesions were equally detected, whereas FFDM detected more lesions consisting of calcifications (85 versus 75). DSPM yielded two false-negative results. Both lesions were rated BI-RADS 4 with FFDM, but BI-RADS 2 with DSPM. Both were invasive carcinoma at histology. The sensitivity, specificity, PPV, NPV, and accuracy of FFDM were 1.0, 0.397, 0.636, 1.0, and 0.707, compared to 0.974, 0.397, 0.630, 0.935, and 0.693 of DSPM. Conclusion Based on image quality parameters, FFDM is, in part, significantly better than DSPM. Furthermore, the detection of breast lesions with calcifications is favorable with FFDM. However, the diagnostic efficacy of FFDM and DSPM was equal. The interpretation of the false-negative results suggests that the perception and characterization of breast lesions is not defined solely by the digital mammography system but is strongly influenced by the radiologist, who is one of the determinants in the interpretation of breast imaging.
Purpose
Standard therapy for lupus nephritis is based on non-specific immunosuppression. We aimed to identify specific alterations in T cell and cytokine homeostasis and possible associations with ...disease activity in children with lupus nephritis (LN).
Methods
The phenotype of circulating T cells from children with LN and healthy controls (HC) was analyzed by flow cytometry. Intracellular expression of IL-17 and INF-γ was assessed after stimulation with anti-CD3 and anti-CD28. Serum concentrations of IP10, CCL2, TGF-β, IL-17, and IL-23 were measured by ELISA. Disease activity was determined using the Systemic Lupus Erythematosus Disease Activity Index 2000 update (SLEDAI-2K).
Results
Children with active LN displayed increased frequencies of effector memory CD4
+
CD45RO
+
CCR7
−
and terminal differentiated CD4
+
CD45RA
+
CCR7
−
T cells and reduced naive CD4
+
CD45RA
+
CCR7
+
T cells compared to those with inactive LN or HC. Circulating CD4
+
CXCR3
+
and CD4
+
CCR2
+
T cells correlated inversely with the renal SLEDAI-2K, whereas IP10 and CCL2 showed a positive correlation. Reduced CD4
+
Foxp3
+
T cells and serum TFG-β levels in active LN were associated with high serum IL-17 and IL-23 levels and correlated inversely with the renal SLEDAI-2K (
r
= −0.5855,
p
= 0.0013 and
r
= −0.6246,
p
= 0.0005, respectively), whereas IL-17 and IL-23 correlated positively (
r
= 0.5516,
p
= 0.0029 and
r
= 0.6116,
p
= 0.0007, respectively). Expansion of Th17 and Th1/Th17 cells in children with LN was significantly greater than in HC (
p
= 0.0304 and
p
= 0.0067, respectively).
Conclusion
Children with active LN display high levels of pro-inflammatory cytokines associated with an increase in effector T cells and reduction of regulatory T cells. Therapeutic regulation of the aberrant cytokine profile might specifically interrupt pathogenic mechanisms.
Introduction
The behavioral variant of frontotemporal dementia (bvFTD) is a rare neurodegenerative disease. Reliable predictors of disease progression have not been sufficiently identified. We ...investigated multivariate magnetic resonance imaging (MRI) biomarker profiles for their predictive value of individual decline.
Methods
One hundred five bvFTD patients were recruited from the German frontotemporal lobar degeneration (FTLD) consortium study. After defining two groups (“fast progressors” vs. “slow progressors”), we investigated the predictive value of MR brain volumes for disease progression rates performing exhaustive screenings with multivariate classification models.
Results
We identified areas that predict disease progression rate within 1 year. Prediction measures revealed an overall accuracy of 80% across our 50 top classification models. Especially the pallidum, middle temporal gyrus, inferior frontal gyrus, cingulate gyrus, middle orbitofrontal gyrus, and insula occurred in these models.
Discussion
Based on the revealed marker combinations an individual prognosis seems to be feasible. This might be used in clinical studies on an individualized progression model.
Background
Endothelial cell injury plays a key role in the pathogenesis of lupus nephritis (LN) and atherosclerosis. The aim of this study was to identify factors involved in the process of ...endothelial damage in children and adolescents with LN.
Methods
We evaluated the relationship between plasma vascular endothelial growth factor (VEGF), its soluble receptors sVEGFR-1 and sVEGFR-2 and markers of endothelial inflammation and injury (angiopoietin-2 and thrombomodulin, respectively) in 23 children and adolescents with LN (active LN,
n
= 14; inactive LN,
n
= 9; mean age 15 years) and 20 healthy controls (HC; mean age 12 years).
Results
VEGF, sVEGFR-1, angiopoietin-2 and thrombomodulin levels were significantly higher in children and adolescents with active LN than in patients in remission or HC. In active LN, however, VEGF was inversely related to sVEGFR-1 (
r
= −0.802,
p
< 0.001), angiopoietin-2 (
r
= −0.684,
p
= 0.007) and thrombomodulin (
r
= −0.697,
p
= 0.006). There was a significant positive correlation between sVEGFR-1 and thrombomodulin (
r
= 0.814,
p
< 0.0001), but sVEGFR-2 did not significantly differ between the patient groups and did not correlate with thrombomodulin (
r
= 0.046,
p
= 0.833).
Conclusions
sVEGFR-1 may play an important role in promoting endothelial damage in children and adolescents with active LN and could possibly be used to monitor disease severity.
Background Endothelial cell injury plays a key role in the pathogenesis of lupus nephritis (LN) and atherosclerosis. The aim of this study was to identify factors involved in the process of ...endothelial damage in children and adolescents with LN. Methods We evaluated the relationship between plasma vascular endothelial growth factor (VEGF), its soluble receptors sVEGFR-1 and sVEGFR-2 and markers of endothelial inflammation and injury (angiopoietin-2 and thrombomodulin, respectively) in 23 children and adolescents with LN (active LN, n=14; inactive LN, n =9; mean age 15 years) and 20 healthy controls (HC; mean age 12 years). Results VEGF, sVEGFR-1, angiopoietin-2 and thrombomodulin levels were significantly higher in children and adolescents with active LN thaninpatientsinremission or HC. In active LN, however, VEGF was inversely relatedtosVEGFR-1 (r=-0.802,p<0.001), angiopoietin2(r=-0.684, p=0.007) and thrombomodulin (r = -0.697, p=0.006). There was a significant positive correlation between sVEGFR-1 and thrombomodulin (r=0.814, p< 0.0001), but sVEGFR-2 did not significantly differ between the patient groups and did not correlate with thrombomodulin (r=0.046, p =0.833). Conclusions sVEGFR-1 may play an important role in promoting endothelial damage in children and adolescents with active LN and could possibly be used to monitor disease severity. Keywords Endothelial injury * Lupus nephritis * SLEDAI-2 K * Soluble VEGF receptors * Vascular endothelial growth factor
Background: Pharmacologic studies in atopic eczema (AE) are difficult to standardize. Patients with AE differ in the stage of their skin disease (acute, subacute, chronic). Objective: This study was ...designed to assess macroscopic and microscopic effects of pretreatment with topical glucocortico-steroids (GCSs) and tar on the atopy patch test (APT) reaction in patients with atopic eczema. Methods: Nonlesional skin of the back of patients with AE (n = 6) was treated for 3 weeks at 3 different sites with triamcin-olonacetonide 0.1% in cetamacrogol ointment (GCSs), pix liquida 10% in cetamacrogol ointment (tar), and cetamacrogol ointment (vehicle), respectively. APTs were performed, and biopsy specimens were taken from all these sites (time = 0 and 24 hours) for immunohistochemical analysis. Results: Treatment with both GCSs and tar was able to reduce the macroscopic outcome of the APT reaction. Furthermore, both treatment modalities had an almost equally inhibiting effect on the influx of T cells, eosinophils, and CD1+, RFD1+, IFN-γ+, and IL-4+ cells, as well as on the percentage of vessels expressing the adhesion molecules vascular cell adhesion molecule 1 and E-selectin in response to epicutaneous aeroallergen challenge. Conclusion: Although both treatments significantly reduced the various cellular constituents of allergic inflammation, all cell types remained present. In addition, this study shows that the APT can be used to evaluate the effect of topical anti-inflammatory treatments on allergic inflammation in patients with AE. (J Allergy Clin Immunol 2000;106:737-43.)
Zusammenfassung:
"Das Papier präsentiert ein Konzept für die Modellierung von Organisationen als System von kommunizierenden Agenten, eine Referenzarchitektur für agentenbasierte Modellierung von ...betrieblichen Anwendungen und ein ganzheitliches Konzept für die gemeinsame Entwicklung von Organisationen und Kommunikationskanälen."
Zusammenfassung:
'Das Papier präsentiert ein Konzept für die Modellierung von Organisationen als System von kommunizierenden Agenten, eine Referenzarchitektur für agentenbasierte Modellierung von ...betrieblichen Anwendungen und ein ganzheitliches Konzept für die gemeinsame Entwicklung von Organisationen und Kommunikationskanälen.
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