•ALS patients show muscle signal changes on T2 imaging and DWI at early disease stages.•Whole-body muscle MRI allows for an exhaustive mapping of muscle involvement in ALS patients.•The adjunction of ...DWI to T2-weighted imaging improves the sensitivity for the detection of acute denervation in early ALS.
To evaluate muscle signal abnormalities on whole-body muscle MRI with T2 and diffusion-weighted imaging in early ALS stages.
101 muscles were analyzed in newly diagnosed ALS patients and healthy controls on a whole-body MRI protocol including four-point T2-Dixon imaging and diffusion-weighted imaging (b0 and b800). Sensitivity and inter-observer agreement were assessed.
15 patients (mean age, 64 +/− 12 SD, 9 men) who met the Awaji-Shima criteria for definite, probable or possible ALS and 9 healthy controls were assessed (mean age, 53 +/− 13 SD, 2 men). 61 % of the muscles assessed in ALS patients (62/101) showed signal hyperintensities on T2-weighted imaging, mainly in the upper and lower extremities (legs, hands and feet). ALS patients had a significantly higher number of involved muscles compared to healthy controls (p = 0,006). Diffusion-weighted imaging allowed for the detection of additional involvement in 22 muscles, thus improving the sensitivity of whole-body MRI from 60 % (using T2-weighted imaging only) up to 80 % (with the combination of T2-weighted and diffusion-weighted imaging).
ALS patients exhibited significant muscle signal abnormalities on T2-weighted and diffusion-weighted imaging in early disease stages. Whole-body MRI could be used for pre-EMG mapping of muscle involvement in order to choose suitable targets, thus improving early diagnosis.
•A deep learning tool was developed to differentiate facioscapulohumeral muscular dystrophy from myositis using muscle MRI.•This deep learning tool does not require segmentation or manual grading of ...signal changes in each muscle.•The diagnostic performance of the deep learning tool is equivalent to that of two radiologists.
The purpose of this study was to assess the capabilities of a deep learning (DL) tool to discriminate between type 1 facioscapulo-humeral dystrophy (FSHD1) and myositis using whole-body muscle magnetic resonance imaging (MRI) examination without the need for visual grading of muscle signal changes.
A total of 40 patients who underwent whole-body MRI examination that included T1-weighted and STIR sequences were included. There were 19 patients with proven FSHD1 (9 men, 10 women; mean age, 47.7 ± 18.0 SD years; age range: 20–72 years) and 21 patients with myositis fulfilling European Neuromuscular Centre criteria and European League Against Rheumatism and American College of Rheumatology criteria (11 men, 10 women; mean age, 59.3 ± 17.0 SD; age range: 19–78 years). Based on thigh, calf, and shoulder sections a supervised training of a neural network was performed and its diagnostic performance was studied using a 5-fold cross validation method and compared to the results obtained by two radiologists specialized in musculoskeletal imaging.
The DL tool was able to differentiate FSHD1 from myositis with a correct classification percentage respectively of 69 % (95% CI: 39–99), 75% (95% CI: 48–100) and 77% (95% CI: 60–94) when thigh only, thigh and calf or the thigh, calf, and shoulder MR images were analyzed. The percentages of correct classification of the two radiologists for these later MR images were 38/40 (95%) and 35/40 (87.5%), respectively; with no differences with DL tool correct classification (P = 0.41 and P > 0.99, respectively). Among the seven patients who were misclassified by the radiologists, the DL tool correctly classified six of them.
A DL tool was developed to discriminate between FSHD1 and myositis using whole-body MRI with performances equivalent to those achieved by two radiologists. This study provides a proof of concept of the effectiveness of a DL approach to distinguish between two myopathies using MRI with a small amount of data, and no prior muscle signal changes grading.
Background and objectives
Small batch‐pooled (mini‐pool) whole blood (WB)‐derived plasma could be an alternative cost‐effective source of therapeutic plasma (TP), but carries an increased risk of ...transfusion‐transmitted infection due to exposure of the recipient to several donors. This risk can be mitigated by inactivation of pathogens susceptible to the amotosalen‐UVA (AUVA)‐treatment. We evaluated the conservation of coagulation factors in AUVA‐plasma prepared from WB stored overnight under routine operating conditions, to determine its therapeutic efficacy. Thrombin generation (TG) by the AUVA‐plasma was used to provide an integrated measure of the hemostatic capacity.
Materials and methods
WB‐donations (~450 ml) stored overnight were processed to prepare five leucocyte‐depleted plasma mini‐pools (1300 ml), which were divided into two parts and treated with AUVA. Each mini‐pool yielded six AUVA‐plasma units (200 ml) which were frozen (−25°C) within 19 h of WB‐collection. Their hemostatic quality was evaluated before and after treatment for up to 12 months of storage.
Results
Immediately after AUVA‐treatment, the regulatory criteria for FVIII activity and fibrinogen content were met. As compared to untreated plasma there was a reduction in fibrinogen (14%), FV (9%), FVII (25%) and FVIII (32%). However, TG was similar in treated and untreated plasma at all‐time‐points.
Conclusions
Frozen WB‐derived AUVA‐plasma prepared from mini‐pools within 19 h of WB‐collection met the quality standards required for TP and retained hemostatic capacity for up to 12 months. This product could provide a cost‐effective convenient substitute for apheresis plasma.
Pourquoi et comment les médecins recourent-ils aux plantes pour dire et comprendre le corps humain ? De la plante au cosmos en passant par le corps de l’homme, médecins et philosophes conçoivent de ...façon analogique les semences, la génération, la nutrition, la circulation, la croissance et rassemblent ainsi des choses et des êtres qui peuvent aujourd’hui paraître davantage étrangers les uns aux autres. L’enquête menée à travers des textes médicaux, botaniques, agricoles ou philosophiques européens de l’Antiquité, du Moyen-Âge et de la première Modernité repère les usages des analogies végétales pour dire, penser, voir et soigner le corps humain. Le prisme végétal rend ainsi visible l’intuition d’une communauté des processus élémentaires entre différents types de vivants.
Identification of chromosomal abnormalities is mandatory for classification of acute myeloid leukemia (AML), and the abnormalities have to be determined quickly, to allow patient enrollment in ...multicenter protocols and/or for selecting therapeutic strategies. Rapid AML molecular diagnosis is often difficult to achieve, however, because it is based on numerous different RT-PCR protocols. We developed a new RT-PCR method, one that does not require a nested step, to simultaneously detect all AML fusion transcripts from six major recurrent translocations found in adults: t(15;17)(q22;q12), inv(16)(p13.1q22) t(16;16)(p13.1;q22), t(8;21)(q22;q22), t(6;9)(p23;q34), t(9;22)(q34;q11), and t(10;11)(p13;q14). Specific primers for RT-PCR detection of the 24 fusion transcripts, along with two transcripts for controls, were designed for this 26-plex RT-PCR. Each PCR product had a different size and was separated by capillary electrophoresis. We also designed a multiplex positive control with 24 chimeric RNAs, corresponding to all chimeric RNAs tested. Compared with classical molecular biology protocols and cytogenetic analyses used as reference standards, results of the 26-plex RT-PCR method were concordant in all 204 (100%) cases of adult AML tested. Results were obtained in less than 24 hours. Because of the multiplex positive control, interpretation of the peaks was very easy, without any ambiguity. The tumor cell detection threshold was 1.5%.
...systematic cardiac examinations are required. The detection of systolic dysfunction is known as a crucial issue for the prognostic evaluation of patients with cardiomyopathy associated with ...muscular diseases. 5 Since intense exercise may exacerbate myocardial damage via increases in LV pressure and volume overload, our patients were recommended to abstain from engaging in strenuous physical activities. ...the early use of afterload reducing drugs (ACE inhibitors) may provide effective prevention and warrants study.
Sand cores are used to produce internal cavities of metallic cast parts with complex shapes like automotive cylinder heads. Foundry cores are granular materials made of sand grains aggregated with ...binder bridges. In the cold box coring process, the binder is a polyurethane resin. It is noteworthy that during the casting of the liquid metal, the polymer binder is seriously damaged. This kind of materials has been poorly investigated so far. This study aims for a better understanding of the mechanical behaviour and fracture of cores subjected to various loads and thermal ageing. Particularly, the focus is on the decoring step, which consists in removing the sand by hammering and vibration of the metallic part after casting. This major project, generated from the collaboration of the aluminum casting company Montupet, and two laboratories Centre des Matériaux (CdM) and MATEIS, includes both experimental and numerical activities in order to model the decoring step of cylinder heads based on empiric data. Here, the experimental part of the work is presented.
Introduction. Hypothyroidism has been associated with mood disorders but some cases of acute psychosis have also been reported. However, less attention has been paid to suicidal behavior in these ...patients. Case Report. We report a case of suicide attempt by self-stabbing in a 43-year-old woman without past psychiatric history, four months after radioiodine therapy for Graves’ disease. On clinical examination remarkable signs of myxedema were found and blood investigations showed hypothyroidism with an extremely high thyroid stimulating hormone (TSH) level (152 mUI/L; reference range 0.20-5.10). The patient presented delirium symptoms at the time of self-stabbing, which was associated with persecutory delusions and auditory harm command hallucinations. A rapid physical and psychiatric improvement was observed after the initiation of an oral thyroid replacement therapy without relapse after early discontinuation of the antipsychotic treatment. Discussion. The most distinctive feature of our case is that the violent suicide attempt could be attributed to the myxedema psychosis. Suicide may result from several factors, including psychosocial stressors, psychiatric symptoms, and hormonal disturbance. This unique presentation should remind clinicians to systematically consider ordering additional tests in patients with atypical psychiatric presentation, even when serious behavioral disorders (such as violent suicide attempts) are present and may result in premature transfer to psychiatric units.
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