Shape Priors in Medical Image Analysis: Extensions of the Level Set Method

The 3D medical image segmentation problem typically involves assigning labels to 3D pixels, called voxels, which comprise a given medical volume. In its simplest form the segmentation problem involves assigning the labels part of the structure of interest or not part of the structure to each voxel using locally measured properties and prior knowledge of human anatomy. Robust segmentation remains an open research problem today due to the significant challenges in the task including: partial volume averaging, overlapping intensity distributions and image noise. In the face of these challenges prior knowledge needs to be added to make the segmentation methods more robust. Active contours were introduced in the late 1980\u27s mainly to address situations in which the object to be segmented had a single closed boundary. To address situations in which the object(s) to be segmented have unknown topology the level set framework was recently introduced to segment medical images. Unlike active contours, the level set method relies on an implicit shape representation rather than an explicit shape representation and hence new methods to impose prior knowledge about expected shape have to be devised for the new framework. This paper explores recent segmentation methods from four research groups which address the task of imposing prior knowledge of shape for object boundary segmentation. Three of the methods impose priors onto the level set technique and one employs a medial axis shape representation and Statistical shape information to guide a model-based segmentation. All of the methods include a notion of a statistical shape distribution. Each method is described, analyzed for its strengths and weaknesses. The paper concludes with a comparison of all four methods and recommendations for their applicability

Comparison of AlphaLISA and RIA assays for measurement of wool cortisol concentrations

Radioimmunoassay (RIA) methods have always represented a technique of choice for the determination of steroids in biological samples. The Amplified Luminescent Proximity Homogenous Assay-Linked Immunosorbent Assay (AlphaLISA) is now emerging as the new-generation immunoassay technology that does not require washing/separation steps. The aim of this study was to adapt the Perkin-Elmer's AlphaLISA kit for wool cortisol and compare it with a RIA wool cortisol assay. Wool from lambs, 35 at birth (A0) and 54 at two months old (A2), was collected and each extract was evaluated for wool cortisol concentrations (HCC) both by RIA and AlphaLISA immunoassay. The two methods showed good precision, sensitivity and specificity for determining HCC. Both methods were able to detect significant differences between the high and the low HCC assessed in lambs at A0 and A2 (P < 0.01). The HCC assessed with RIA were significantly higher than those assessed with AlphaLISA (P < 0.01). Moreover, the correlation between HCC measured using the AlphaLISA and RIA methods was strong (r = 0.878). The regression analyses show a constant and not proportional error. This could be due to the diversity in the dosage steps and to the diversity of the molecules used in the two methods. Results support the validity of using AlphaLISA as an alternative method to RIA for the quantification of cortisol in sheep wool and considering the performances showed it has a great potential to be further applied as an excellent tool to evaluate HCC in samples derived from animal species

Against the flow: unexpected migration movements over the open sea by inexperienced ospreys

As part of a long-term monitoring program, more than 80 Mediterranean ospreys Pandion haliaetus (both adults and juveniles) were tagged with GPS-GSM transmitters and tracked to study their spatiotemporal behaviour. Here we document the peculiar and unexpected migration movements performed by three inexperienced (juvenile/immature) individuals, who crossed the open sea "against the flow", in the opposite direction to that foreseen for the given season. Using a combination of GPS tracking data and weather information, we found that such movements were linked to particular meteorological conditions occurring over the Mediterranean Sea during migration. Mean values of wind gust of approximately 20 km/h and moderate tailwinds seem to have mediated the onset of the movements, facilitating the flight of ospreys over water. Our findings suggest that both weather conditions (sidewinds) and the inexperience of the birds explain these long migration movements performed towards unexpected directions over the open sea. We conclude that migratory capabilities and the ability to cope with external conditions may lead inexperienced birds to perform extensive and tortuous dispersal/explotrative movements during both first autumn and spring migration

Postnatal and postweaning endocrine setting in dairy calves through hair cortisol, dehydroepiandrosterone and dehydroepiandrosterone sulphate

Importance of the work: The care of calves on dairy farms between birth and weaning can improve their long-term development and growth. In fact, a poor newborn health status and a high allostatic load may adversely affect development in dairy cows. To determine cortisol, dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulphate (DHEA-S) individually is useful for an understanding of the individual state, being biomarkers of hypothalamic-pituitary-adrenal (HPA) axis activity. Objectives: As a preliminary study, to investigate the hair concentrations of cortisol, DHEA, DHEA-S and their ratios in dairy calves in two key periods of their growth characterized by considerable environmental changes. Materials & Methods: Hair sampling was conducted on clinically healthy dairy calves during the postnatal period at age 64.8±0.65 d (POP; mean±standard error; n = 73) and during the postweaning period at age 155.3±0.85 d (PWP, n = 62). The hair hormone concentrations were measured using a radioimmunoassay. Results: Hair cortisol concentrations were higher in the POP than in the PWP. Furthermore, the cortisol:DHEA and cortisol:DHEA-S ratios were higher in the first period of evaluation, showing a higher animal allostatic load at birth. Main finding: Identification was achieved non-invasively of calves with a high allostatic load through biomarkers of HPA axis activity. The evaluation of this activity is very important given its influence on many biological processes, such as energy balance, development of the reproductive system and immune response

Semantic Context Forests for Learning-Based Knee Cartilage Segmentation in 3D MR Images

The automatic segmentation of human knee cartilage from 3D MR images is a useful yet challenging task due to the thin sheet structure of the cartilage with diffuse boundaries and inhomogeneous intensities. In this paper, we present an iterative multi-class learning method to segment the femoral, tibial and patellar cartilage simultaneously, which effectively exploits the spatial contextual constraints between bone and cartilage, and also between different cartilages. First, based on the fact that the cartilage grows in only certain area of the corresponding bone surface, we extract the distance features of not only to the surface of the bone, but more informatively, to the densely registered anatomical landmarks on the bone surface. Second, we introduce a set of iterative discriminative classifiers that at each iteration, probability comparison features are constructed from the class confidence maps derived by previously learned classifiers. These features automatically embed the semantic context information between different cartilages of interest. Validated on a total of 176 volumes from the Osteoarthritis Initiative (OAI) dataset, the proposed approach demonstrates high robustness and accuracy of segmentation in comparison with existing state-of-the-art MR cartilage segmentation methods.Comment: MICCAI 2013: Workshop on Medical Computer Visio

Analysis of 19 Minerals and Cortisol in Red Deer Hair in Two Different Areas of the Stelvio National Park: A Preliminary Study

The aim of the study was to perform an investigation on the concentration of 19 minerals and cortisol in red deer (Cervuselaphus) hair, a matrix that is easy to collect with non-invasive and painless sampling, able to represent an integrative values of long-term substance concentrations, and able to give useful information, also when performed on dead animals, given its extreme stability over time. In the study thirty-five animals were included, coming from two different sides of a valley in the Stelvio National Park, where official water analysis had pointed out elevated concentrations of As in one of the two orographic sides. Hair cortisol concentrations were measured using a RIA(Radio Immuno Assay), while minerals were detected using ICP-MS (Inductively Coupled Plasma- Mass Spectrometry). Results showed a negative relationship between cortisol and some mineral concentrations (Li, Co, As, Cd, Cr and Tl) and significant differences in some mineral concentrations between park areas (Al, Co, Cu, Cd and Ni). As, Cr and cortisol differences approached statistical significance. This preliminary study represents a step forward in the study of wildlife allostatic load and a valid method for applications in wildlife management programs, in environmental studies and in public health programs

Diagnosis and treatment of autoimmune hemolytic anemia in adults: Recommendations from the First International Consensus Meeting

Abstract Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells through warm or cold antibodies. There is currently no licensed treatment for AIHA. Due to the paucity of clinical trials, recommendations on diagnosis and therapy have often been based on expert opinions and some national guidelines. Here we report the recommendations of the First International Consensus Group, who met with the aim to review currently available data and to provide standardized diagnostic criteria and therapeutic approaches as well as an overview of novel therapies. Exact diagnostic workup is important because symptoms, course of disease, and therapeutic management relate to the type of antibody involved. Monospecific direct antiglobulin test is considered mandatory in the diagnostic workup, and any causes of secondary AIHA have to be diagnosed. Corticosteroids remain first-line therapy for warm-AIHA, while the addition of rituximab should be considered early in severe cases and if no prompt response to steroids is achieved. Rituximab with or without bendamustine should be used in the first line for patients with cold agglutinin disease requiring therapy. We identified a need to establish an international AIHA network. Future recommendations should be based on prospective clinical trials whenever possible

Mucormycosis in hematologic malignancies: an emerging fungal infection

Background and Objectives, In recent years pulmonary mucormycosis has been reported in patients with leukemia and lymphoma and bone marrow plant recipients. It carries an extremely poor prognosis. We report our experience of clinical findings, diagnostic procedures, treatment and outcome mucormycosis diagnosed in neutropenic patients affected by hematologic neoplasms admitted to our departments. Design and Methods. From November 1987 to July 1999 we observed 13 patients with mucormycosis. Their median age was 61 years (range 20-75), and they were predominantly in the aplastic post-chemotherapy period (12/13), affected by acute myeloid leukemia (11 cases) or non-Hodgkin's lymphoma (2 cases). Six patients tall with leukemia) were receiving induction-consolidation therapy, 7 had progressive hematologic disease. At the onset infection all patients were neutropenic (N < 0.5x10(9)/L). No patients had diabetes mellitus. Two patients had been receiving steroid therapy for 5 and 7 days. Results. The lung was involved in all cases (13/13); disseminated disease was present in 8/13 patients. All cultures (blood, sputum, nasal swabs and bronchoalveolar lavage) were negative. In 3 patients a diagnosis was made in vivo: in 1 patient by percutaneous pulmonary biopsy, in 1 patient by pulmonary lobectomy, and in the last patient by percutaneous pulmonary biopsy confirmed by excision of cerebellar abscess. In the remaining 10 cases diagnosis was made post-mortem. Five patients were :treated, 2 because of poor clinical condition and because fungal infection was not suspected. Amphotericin B (1 mg/kg/day) was given empirically 6 patients and 2 responded to treatment. remaining 2 patients with neurologic symptoms le onset of infection were treated with liposomal amphotericin, Ambisome(R), one with 3 and one with mg/kg/day; of these two patients the first died in 4 days; the second, with both pulmonary and cerebellar localizations, was treated successfully with 5 mg/kg/day for 4 weeks and then with 3 mg/kg/day, and excision of a brain abscess at neutrophil recovery (total dose of Ambisome(R): 12,000 mg). The 3 surviving leukemic patients were able to complete subsequent consolidation therapy using amphotericin B or liposomal amphotericin as secondary prophylaxis during aplasia. Interpretation and Conclusions. Mucormycosis in neutropenic hematologic patients is rarely suspected. In our patients infection was often characterized by disseminated disease and a rapidly fatal course; only early aggressive amphotericin B (or Ambisome(R)) treatment together with neutrophil recovery appeared to improve the outcome. Diagnosis is very important for programming antifungal therapy and secondary prophylaxis with amphotericin B, because Mucor is usually resistant to itraconazole

Gut microbiota-derived propionate reduces cancer cell proliferation in the liver

Peer reviewedPublisher PD

Infections caused by filamentous fungi in patients with hematologic malignancies. A report of 391 cases by GIMEMA Infection Program.

BACKGROUND AND OBJECTIVES: To evaluate the clinical characteristics of patients with hematologic malignancies developing a filamentous fungi infection (FFI) and to define the prognostic factors for their outcome. DESIGN AND METHODS: A retrospective study, conducted on patients admitted to 14 Hematology divisions of tertiary care or university hospitals, participating in the GIMEMA Infection Program, over a ten-year period (1988-1997). The study included patients with hematological malignancies and a histologically and/or microbiologically proven or probable FFI. RESULTS: We included 391 patients (male/female: 262/129, median age 49 years) with hematologic malignancies (225 acute myeloid leukemia, 67 acute lymphocytic leukemia, 30 chronic myeloid leukemia, 22 non-Hodgkin's lymphoma, 12 myelodysplastic syndrome, 10 aplastic anemia, 7 Hodgkin's disease, 8 chronic lymphocytic leukemia, 5 multiple myeloma, and 5 hairy cell leukemia) who developed a proven FFI. Eighty percent of the patients had been neutropenic for an average of 14 days before the infection, and 71% had an absolute neutrophil count lower than 0.5 x 10(9)/L at the time of FFI diagnosis. The primary sites of infection were: lungs (85%), nose and paranasal sinus (10%), and other sites (5%). The diagnosis was made while still alive in 310 patients (79%), and at autopsy in the remaining 81 patients (21%). Chest X-ray was diagnostic in 77% of patients with pulmonary FFI, while computed tomography (CT) scan of the thorax was positive in 95% of cases. A significant diagnostic advantage for CT scan was observed in 145 patients who had both a chest X-ray and CT scan. Aspergillus was identified as the cause of FFI in 296 patients, Mucorales in 45 patients, Fusarium in 6 patients and other filamentous fungi species in 4 patients, while in a further 40 patients no agent was identifiable. The overall mortality rate three months after the diagnosis of FFI was 74%, and fungal infection had been the cause of death in 51% of patients. INTERPRETATION AND CONCLUSIONS: Our retrospective study shows that FFI still remains a life-threatening complication in neutropenic patients. Despite appropriate treatment, half of the patients die due to this complication. The use of glucocorticoids and recovery from neutropenia are the most important prognostic factors. Mucorales infections are associated with a significantly poorer prognosis than those due to Aspergillus spp