Computer aided processing of cervical spine radiographs

Quite a number of medical specialties require distance and angle measurements on x-ray images. Drafting and measurement on traditional x-ray films can be done with marker pens, rulers and protractor, but this method is time consuming and often inaccurate. Authors present a computer aided drafting and measurement method for both digitized and digital x-rays.Evaluation of cervical spine x-rays is especially important for patients suffering from rheumatoid arthritis. Our computer program helps users to mark necessary points and draw lines on x-rays interactively on the computer screen, then the program calculates relevant angles and distances based on literature data.Manual drafting on traditional x-ray films is time consuming, and it is usually impossible or at least difficult to repeat. When one wants to try drafting more than once, previous lines have to be erased from the film, or a separate transparent film can be used. Reading distance and angle values requires a ruler and a protractor. The tip size of the marker pen and the precision of ruler, protractor positioning can result in measurement errors of multiple millimeters and degrees.Contrarily, computer based drafting allows arbitrary number of users arbitrary number of attempts to define necessary points on x-rays, and then predefined algorithms calculate the results.Computer aided drafting can be performed by many persons, a number of times. Accuracy can be improved by using image processing capabilities such as zooming, contrast correction, etc. Results can be superimposed on x-ray images, making follow-up easier.Compared to „traditional” drafting, the computer-aided method’s repeatability and reliability is a great advantage. It is easier to learn computer-based drafting, especially when a large number of points have to be marked and complicated measurements are involved. With an appropriate drafting and evaluation protocol, processing of x-rays provides added diagnostic value, e.g. further examinations can be ordered based on the results, scheduling of follow-ups can be optimized. DOI: 10.17489/biohun/2013/1/1

A harmadik szinapszis. Molekuláris kölcsönhatások az elhaló sejtek és az azokat eltávolító makrofágok, dendritikus sejtek között. = The third synapsis. Molecular interactions between dying cells and macrophages or dendritic cells.

A tudományos iskola keretében új interdiszciplináris kutatási terület megteremtésére került sor az apoptótikus sejtek és az azokat eltávolító sejtek közötti harmadi szinapszis tanulmányozására. Megállapítottuk, hogy a transzglutamináz 2 (TG2) enzim szerepet játszik az apoptotikus sejtek eltávolításában, az enzim hiányában autoimmun kórkép alakúl ki. A TG2 bejuthat a sejmagba, sejtbiokémiai hatása összefügg génkifejeződés befolyásolásával. Alzheimer kórban a TG2 résztvesz kovalensen összekötött fehérje aggregátumok létrehozásában. A TG2 védőhatást fejt ki a sejtelhalással szemben májsejtekben és szívizomsejtekben G fehérje, ill. protein diszulfid izomeráz aktivitásával. A PPAR? szerepet játszik az apoptótikus sejteket eltávolító fagocitáló képesség kialakításában fokozva fagocitózis gének kifejeződését. A PPAR?, a retinoid receptor és az LXR receptor szignál utak összekapcsolódnak a makrofágok koleszterol szintjének szabályozásában. A PPAR? aktiváció hatására a dendritikus sejekből fokozott fagocitózisra, hatékony lipid prezentációra és iNKT aktivitásra képes alpopuláció alakul. Apopto-fagocita Taqman Low Density Array-t fejleszttünkl 94 gén mennyiségi kifejeződése vizsgálatára. Az autofágiával elhaló sejtek eltávolítása szintén fagocitózissal történik, specifikus gének indukálódnak. A dendritikus sejtek kölcsönhatása apoptótikus vagy nekrotikus sejtekkel alkalmas az immunválasz finom szabályozására. | In the supported Research School a new interdisciplinary research area has been developed to study the third synapse formed between apoptotic cells and those which engolfe them. It has been established that the transglutaminase 2 (TG2) enzyme plays an important role in the clearance of apoptotic cells, the lack of this enzyme leads to autoimmune disease. TG2 can enter the nucleus and its cell biochemical effects are related to modulation of gene expression and modification of the cytoskeleton. In Alzheimer's disease TG2 participates in the formation of covalently cross-linked protein aggregates. TG2 can protect hepatocytes and cardiomyocytes against apoptosis through its G protein and protein disulphide isomerase activities. PPARγ contributes to the development of phagocytic capacity of macrophages by inducing specific phagocytic genes. The PPARγ, rretinoid and LXR receptor signal pathways are interlinked in regulating cholesterol content of cells. Activation of PPARγ in dendritic cells leads to the development of a subpopulation with increased phagocytic capacity, effective lipid presentation and iNKT activity. An apopto-phagocytic Taqman Low Density array has been developed for quantitative measuring of 94 genes in parallel. Cells dying by autophagy are removed by the same mechanism as apoptotic cells while specific phagocytic genes are induced. Dendritic cells interacting with apoptotic cells can fine tune the immune system

RGB-02 (biosimilar pegfilgrastim) in the treatment of chemotherapy-induced neutropenia

Pegfilgrastim is widely used for the prevention of chemotherapy-induced neutropenia. The development and use of biosimilar agents help to rationalize healthcare expenditure and improve access to modern therapies to all who need them. This review focuses on pegfilgrastims with important role in oncology supportive care. RGB-02 (Gedeon Richter) is a proposed biosimilar to pegylated granulocyte-colony stimulating factor (Neulasta((R)), Amgen) with sustained release properties. The clinical analyses in three randomized clinical studies provided comparative data between RGB-02 and Neulasta, in a Phase III study patients receiving docetaxel-doxorubicin chemotherapy treatment equivalence was found. No difference was detected in any safety measure including immunogenicity; treatment switch, from the reference product to RGB-02 proved safe. Long-acting pegylated filgrastim RGB-02 has successfully accomplished various steps of biosimilar development

Synthesis and functional evaluation of a peptide derivative of 1-beta-D-arabinofuranosylcytosine

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Wernicke-encephalopathia kialakulása fogyasztótabletta használata és kiegyensúlyozatlan diéta következtében [Wernicke's encephalopathy induced by the use of diet pills and unbalanced diet].

A Wernicke-encephalopathia akutan kialakuló, életet veszélyeztető neurológiai kórkép, amely a tiaminhiány következtében alakul ki. A betegséget nagyon gyakran nem diagnosztizálják időben, így megfelelő terápia hiányában a krónikus forma, a Korsakoff-szindróma kialakulásához vagy egyes esetekben halálhoz is vezethet. A tiaminhiány fejlett országokban leggyakrabban krónikus alkoholfogyasztás következtében alakul ki, de az utóbbi időben az alkoholfogyasztással nem összefüggő esetek száma is gyarapodott. A szerzők egy 23 éves nőbeteg esetét mutatják be, akinél drasztikus diéta és fogyasztótabletta használata következtében alakult ki szemmozgászavar, zavartság és ataxia, amelyek hátterében Wernicke-encephalopathia igazolódott. A diagnózist támogatta, hogy a tünetek parenteralis tiaminpótlás hatására napokon belül megszűntek. A szerzők az esetet etiológiai ritkasága és diagnosztikai nehézsége miatt közlik, illetve rámutatnak a legfrissebb ajánlásokra a kórkép diagnosztikáját és terápiáját illetően. Orv. Hetil., 2014, 155(12), 469–474. | Wernicke’s encephalopathy is an acute, potentially life-threatening, neurological syndrome resulting from thiamine deficiency. The disorder is still greatly underdiagnosed and, without prompt treatment, the condition can lead to the chronic form of the disease, Korsakoff’s syndrome or even death. In developed countries Wernicke’s encephalopathy has been associated with alcoholism, but in recent years there has been an increasing number of non-alcoholic cases. Authors report the case of a 23-year-old woman who developed oculomotor dysfunction, encephalopathy and ataxia as a result of an extreme diet and use of diet pills. The diagnosis of Wernicke’s encephalopathy was supported by the resolution of neurological signs after parenteral thiamine replacement. This case is presented because of the rare etiology and diagnostic difficulty, and the latest diagnostic and therapic guidelines are also highlighted. Orv. Hetil., 2014, 155(12), 469–474

Efficacy and safety of RGB-02, a pegfilgrastim biosimilar to prevent chemotherapy-induced neutropenia: results of a randomized, double-blind phase III clinical study vs. reference pegfilgrastim in patients with breast cancer receiving chemotherapy

Abstract Background Treatment with recombinant human granulocyte-colony stimulating factor (G-CSF) is accepted standard for prevention of chemotherapy-induced neutropenia. RGB-02 (Gedeon Richter) is a proposed biosimilar to pegylated G-CSF (Neulasta®, Amgen) with sustained release properties. This is a randomized, comparative, double-blind, multicenter study to evaluate efficacy and safety of RGB-02 in breast cancer patients receiving cytotoxic regimen. Methods Two hundred thirty-nine women presenting with breast cancer were randomized to RGB-02 (n = 121) and the reference product (n = 118). All patients received up to 6 cycles of docetaxel/doxorubicin chemotherapy combination and a once-per-cycle injection of a fixed 6 mg dose of pegfilgrastim. Primary endpoint was the duration of severe neutropenia (ANC < 0.5 × 109/L) in Cycle 1 (2-sided CI 95%). Secondary endpoints included incidence and duration of severe neutropenia (in cycles 2–4), incidence of febrile neutropenia, time to ANC recovery, depth of ANC nadir, and safety outcomes. Results The mean duration of severe neutropenia in Cycle 1 was 1.7 (RGB-02) and 1.6 days (reference), with a difference (LS Mean) of 0.1 days (95% CI -0.2, 0.4). Equivalence could be established as the CI for the difference in LS Mean lay entirely within the pre-defined range of ±1 day. This positive result was supported by the analysis of secondary endpoints, which also revealed no clinical meaningful differences. Safety profiles were comparable between groups. No neutralizing antibodies against pegfilgrastim were identified. Conclusions Treatment equivalence in reducing the duration of chemotherapy induced neutropenia between RGB-02 and Neulasta® could be demonstrated. Similar efficacy and safety profiles of the once-per-cycle administration of RGB-02 and the pegfilgrastim reference were demonstrated. Trial registration The trial was registered prospectively, prior to study initiation. EudraCT number (2013–003166-14). The date of registration was 12 July, 2013

Central Nervous System Involvement in Primary Sj&ouml;gren&rsquo;s Syndrome: Narrative Review of MRI Findings

Central nervous system (CNS) involvement is one of the numerous extraglandular manifestations of primary Sj&ouml;gren&rsquo;s syndrome (pSS). Moreover, neurological complaints precede the sicca symptoms in 25&ndash;60% of the cases. We review the magnetic resonance imaging (MRI) lesions typical for pSS, involving the conventional examination, volumetric and morphometric studies, diffusion tensor imaging (DTI) and resting-state fMRI. The most common radiological lesions in pSS are white matter hyperintensities (WMH), scattered alterations hyperlucent on T2 and FLAIR sequences, typically located periventricularly and subcortically. Cortical atrophy and ventricular dilatation can also occur in pSS. Whilst these conditions are thought to be more common in pSS than healthy controls, DTI and resting-state fMRI alterations demonstrate evident microstructural changes in pSS. As pSS is often accompanied by cognitive symptoms, these MRI alterations are expectedly related to them. This relationship is not clearly delineated in conventional MRI studies, but DTI and resting-state fMRI examinations show more convincing correlations. In conclusion, the CNS manifestations of pSS do not follow a certain pattern. As the link between the MRI lesions and clinical manifestations is not well established, more studies involving larger populations should be performed to elucidate the correlations

Central Nervous System Involvement in Primary Sjögren’s Syndrome: Narrative Review of MRI Findings

Central nervous system (CNS) involvement is one of the numerous extraglandular manifestations of primary Sjögren’s syndrome (pSS). Moreover, neurological complaints precede the sicca symptoms in 25–60% of the cases. We review the magnetic resonance imaging (MRI) lesions typical for pSS, involving the conventional examination, volumetric and morphometric studies, diffusion tensor imaging (DTI) and resting-state fMRI. The most common radiological lesions in pSS are white matter hyperintensities (WMH), scattered alterations hyperlucent on T2 and FLAIR sequences, typically located periventricularly and subcortically. Cortical atrophy and ventricular dilatation can also occur in pSS. Whilst these conditions are thought to be more common in pSS than healthy controls, DTI and resting-state fMRI alterations demonstrate evident microstructural changes in pSS. As pSS is often accompanied by cognitive symptoms, these MRI alterations are expectedly related to them. This relationship is not clearly delineated in conventional MRI studies, but DTI and resting-state fMRI examinations show more convincing correlations. In conclusion, the CNS manifestations of pSS do not follow a certain pattern. As the link between the MRI lesions and clinical manifestations is not well established, more studies involving larger populations should be performed to elucidate the correlations