Bestimmung der Genauigkeit zweier modellbasierter, dreidimensionaler Animationstechniken zur Bewegungsanalyse der Phalangen des Pferdes mittels nichtinvasiver biplanarer Hochfrequenz Fluoreszenzkinematographie

Einleitung: Lahmheiten ausgehend von der distalen Gliedmaße sind die häufigste Ursache für Leistungsminderung und frühes Ausscheiden von Pferden aus ihrer Nutzung. Genaue Kenntnisse über die Orientierung der Phalangen im Raum und innerhalb der verschiedenen Bewegungsphasen sind von entscheidender Bedeutung für Prävention und Therapie orthopädischer Erkrankungen. Eine neue Möglichkeit der dreidimensionalen Bewegungsanalyse von Knochen ist die biplanare Hochfrequenz-Fluoreszenzkinematographie, die die hoch präzise dreidimensionale Rekonstruktion der Knochen und ihrer Positionsveränderungen in Bewegung erlaubt. Es existiert eine invasive Variante dieser Methode, die markerbasierte Rekonstruktionstechnik. Diese Variante ist validiert und gilt als Goldstandard. Alternativ kann die Rekonstruktion ohne vorherige Markerimplantation, also nichtinvasiv, durch ein softwaregestütztes (Autoscoping (AS)) oder manuelles (Scientific Rotoscoping (SR)) Verfahren erfolgen. Die beiden zuletzt genannten Verfahren sind aufgrund der nicht vorhandenen Invasivität vorzuziehen, da sie den physiologischen Bewegungsablauf des Tieres nicht beeinflussen. Es gibt jedoch keine Angaben zu ihrer Genauigkeit für die Anwendung an der distalen Gliedmaße des Pferdes. Ziele der Untersuchungen: Diese Studie widmete sich daher der Untersuchung der Genauigkeit nichtinvasiver Rekonstruktionsverfahren von hochfrequenz-fluoreszenzkinematographischen Aufnahmen der Phalangen des Pferdes im Vergleich zum Goldstandard. Außerdem war von Interesse, ob das Filtern der Bewegungsdaten einen signifikanten Unterschied erbringt. Material und Methoden: Für die Phalanges proximales (PP), mediae (PM) und distales (PD) von fünf isolierten, distalen Gliedmaßen von Schlachtponys wurde biplanare Hochfrequenz Fluoreszenzkinematographie durchgeführt. Die fünf Beine wurden unter Simulation eines Schrittes jeweils manuell im Aufnahmefenster bewegt. Für die so entstandenen drei Animationen je Bein, jeweils basierend auf der markerbasierten und den beiden nichtinvasiven Techniken (AS, SR), wurden von jeder Phalanx die Bewegungen in sechs Freiheitsgraden (drei Translationen und drei Rotationen) bestimmt. Darüber hinaus wurden die so gewonnenen Koordinaten für alle drei Techniken zusätzlich mit einem low pass Butterworth Filter fünfter Ordnung bei 20 Hz gefiltert. Die nachfolgenden Berechnungen erfolgten analog sowohl für ungefilterte als auch für gefilterte Daten in R (Version 3.2.3, R Foundation for Statistical Computing, Wien, Österreich). Um die Genauigkeit von AS und SR im Vergleich zum Goldstandard zu bestimmen, wurden jeweils die Differenzen zwischen AS bzw. SR und markerbasierter Technik berechnet. So ergaben sich für PP 2859 auswertbare Einzelwerte pro räumlicher Kategorie (drei Translationen, drei Rotationen und zwei euklidische Werte), für PM waren es 3341 und für PD 3417. Von diesen Datensätzen wurden jeweils Mittelwert und Standardabweichung, sowie Perzentile berechnet. Die Datensätze wurden mittels Shapiro Wilk Test (p<0,05) auf Normalverteilung geprüft. Anschließend wurde mittels Wilcoxon Rangsummen Test für eine Stichprobe (p<0,05) in jeder räumlichen Kategorie auf statistische Ähnlichkeit zwischen Animationen mit AS bzw. SR und markerbasierten Animationen getestet. Für den Abgleich von AS und SR wurden die Stichproben jeweils mit Mann Whitney U Test (p<0,05) verglichen. Abschließend wurden die korrespondierenden Stichproben aus den ungefilterten und gefilterten Datensätzen mittels Mann Whitney U Test (p<0,05) auf die Signifikanz ihrer Übereinstimmung hin untersucht. Ergebnisse: Der p Wert des Shapiro Wilk Tests aller Datensätze war 0,00, die Daten folgten also keiner Normalverteilung. Animationen aus AS und SR wichen in allen acht räumlichen Kategorien signifikant von der markerbasierten Technik ab. Der Vergleich der Mediane und Mittelwerte zeigte, dass weder AS noch SR in allen räumlichen Kategorien kleinere Abweichungen erreichte, als die jeweils andere Technik. Vielmehr ergab SR für PP und PM häufiger den kleineren Fehler, während AS für PD häufiger den geringeren Fehler erzielte. Der statistische Unterschied zwischen AS und SR war mit wenigen Ausnahmen (Translation: PP in Y ungefiltert; Rotation: PP in Y, PM in Z) signifikant. Der Vergleich gefilterter und ungefilterter Datensätze war mit sechs Ausnahmen (Translation: SR von PP in Y, Z, euklidisch und AS von PD in Y; Rotation: AS von PP und PD in Z) nicht signifikant. Schlussfolgerungen: Die Rekonstruktion der simulierten Fußungsbewegung der Phalangen der distalen Gliedmaße des Pferdes mittels nichtinvasiver biplanarer Hochfrequenz Fluoreszenzkinematographie ist möglich. Beide nichtinvasive Techniken, AS und SR, unterscheiden sich dabei aber signifikant vom Goldstandard. Dennoch sind sie, wo die Anforderungen an die Genauigkeit es zulässt, der markerbasierten, invasiven Technik vorzuziehen. Der Vergleich zwischen SR und AS erbrachte keinen eindeutigen Unterschied in Bezug auf die Genauigkeit für alle drei Phalangen. Wo dies machbar ist, sollte SR für PP und PM und AS für PD verwendet werden. Soll nur eine Technik angewandt werden, ist SR vorzuziehen. Das in der Bewegungsanalyse übliche Filtern der Daten zur Reduktion von Rauschen erbrachte in dieser Studie meist keine signifikante Verbesserung

Binding of galectin-1 to breast cancer cells MCF7 induces apoptosis and inhibition of proliferation in vitro in a 2D-and 3D-cell culture model

Background: Galectin-1 (gal-1) belongs to the family of beta-galactoside-binding proteins which primarily recognizes the Gal beta 1-4GlcNAc sequences of oligosaccharides associated with several cell surface glycoconjugates. The lectin recognizes correspondent glycoepitopes on human breast cancer cells. Galectin-1 is expressed both in normal and malignant tissues. Lymphatic organs naturally possessing high rates of apoptotic cells, express high levels of Galectin-1. Furthermore galectin-1 can initiate T cell apoptosis. Binding of galectin-1 to trophoblast tumor cells presenting the oncofetal Thomsen-Friedenreich (TF) carbohydrate antigen inhibits tumor cell proliferation. In this study we examined the impact galectin-1 has in vitro on cell proliferation, apoptotic potential and metabolic activity of MCF-7 and T-47D breast cancer cells in dependence to their expression of the Thomsen-Friedenreich (TF) tumor antigen. Methods: For proliferation and apoptosis assays cells were grown in presence of 10, 30 and 60 mu g gal-1/mlmedium. Cell proliferation was determined by a BrdU uptake ELISA. Detection of apoptotic cells was done by M30 cyto death staining, in situ nick translation and by a nucleosome ELISA method. Furthermore we studied the impact galectin-1 has on the metabolic activity of MCF-7 and T-47D cells in a homotypic three-dimensional spheroid cell culture model mimicking a micro tumour environment. Results: Gal-1 inhibited proliferation of MCF-7 cells (strong expression of the TF epitope) but did not significantly change proliferation of T-47D cells (weak expression of the TF epitope). The incubation of MCF-7 cells with gal-1 raised number of apoptotic cells significantly. Treating the spheroids with 30 mu g/ml galectin-1 in addition to standard chemotherapeutic regimes (FEC, TAC) resulted in further suppression of the metabolic activity in MCF-7 cells whereas T-47D cells were not affected. Conclusions: Our results demonstrate that galectin-1 can inhibit proliferation und metabolic cell activity and induce apoptosis in breast tumor cell lines with high expression levels of the Thomsen-Friedenreich (TF) antigen in monolayer and spheroid cell culture models

Binding of galectin-1 to breast cancer cells MCF7 induces apoptosis and inhibition of proliferation in vitro in a 2D-and 3D-cell culture model

Background: Galectin-1 (gal-1) belongs to the family of beta-galactoside-binding proteins which primarily recognizes the Gal beta 1-4GlcNAc sequences of oligosaccharides associated with several cell surface glycoconjugates. The lectin recognizes correspondent glycoepitopes on human breast cancer cells. Galectin-1 is expressed both in normal and malignant tissues. Lymphatic organs naturally possessing high rates of apoptotic cells, express high levels of Galectin-1. Furthermore galectin-1 can initiate T cell apoptosis. Binding of galectin-1 to trophoblast tumor cells presenting the oncofetal Thomsen-Friedenreich (TF) carbohydrate antigen inhibits tumor cell proliferation. In this study we examined the impact galectin-1 has in vitro on cell proliferation, apoptotic potential and metabolic activity of MCF-7 and T-47D breast cancer cells in dependence to their expression of the Thomsen-Friedenreich (TF) tumor antigen. Methods: For proliferation and apoptosis assays cells were grown in presence of 10, 30 and 60 mu g gal-1/mlmedium. Cell proliferation was determined by a BrdU uptake ELISA. Detection of apoptotic cells was done by M30 cyto death staining, in situ nick translation and by a nucleosome ELISA method. Furthermore we studied the impact galectin-1 has on the metabolic activity of MCF-7 and T-47D cells in a homotypic three-dimensional spheroid cell culture model mimicking a micro tumour environment. Results: Gal-1 inhibited proliferation of MCF-7 cells (strong expression of the TF epitope) but did not significantly change proliferation of T-47D cells (weak expression of the TF epitope). The incubation of MCF-7 cells with gal-1 raised number of apoptotic cells significantly. Treating the spheroids with 30 mu g/ml galectin-1 in addition to standard chemotherapeutic regimes (FEC, TAC) resulted in further suppression of the metabolic activity in MCF-7 cells whereas T-47D cells were not affected. Conclusions: Our results demonstrate that galectin-1 can inhibit proliferation und metabolic cell activity and induce apoptosis in breast tumor cell lines with high expression levels of the Thomsen-Friedenreich (TF) antigen in monolayer and spheroid cell culture models

Applied Learning Activity for Health and Fitness Students to Advocate for School Playground and Gymnasium Safety

Playground accidents are a leading cause of injury to children at school and home. Health and physical education faculty and students from a university school of education and college of nursing collaborated with wellness team members in a public school system to complete a systematic planning process. The aim was to enhance the school health program and reduce risk of injuries. University faculty mentored health and physical education students as they developed professional competencies related to program planning and advocacy. Students identified safety hazards in 52 school/community playgrounds and 45 gymnasiums, and reported maintenance issues to reduce the risk of injuries. Teachers, parents, students and community residents can learn to assess playground and gymnasium safety, identify hazards, and plan improvements to the school health environment

Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO

USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring). The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points) on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (n = 70). Seventy paired left-sided CO measurements (transaortic access = COUS-A) were obtained. The mean COUS-A were 6.55 l/min (±2.19) versus COPiCCO 6.5 l/min (±2.18). The correlation coefficient was r = 0.89. Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min) leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO). It seems to be appropriate in situations where CO measurements are most pertinent to patient management

Nucleosomes in serum of patients with early cerebral stroke

Background: Nucleosomes are cell death products that are elevated in serum of patients with diseases that are associated with massive cell destruction. We investigated the kinetics of circulating nucleosomes after cerebral stroke and their correlation with the clinical status. Methods: In total, we analyzed nucleosomes by ELISA in sera of 63 patients with early stroke daily during the first week after onset. For correlation with the clinical pathology, patients were grouped into those with medium to slight functional impairment (Barthel Index BI >= 50) and those with severe functional impairment (BI = 50 showed a continuous increase in nucleosomes until day 5 (median: 523 arbitrary units, AU) followed by a slow decline. In contrast, patients with BI = 50 (497 AU; p = 0.031). Concerning the infarction volume, nucleosomes showed significant correlations for the concentrations on day 3 (r = 0.43; p = 0.001) and for the area under the curve (r = 0.34; p = 0.016). Conclusion: Even if nucleosomes are nonspecific cell death markers, their release into serum after cerebral stroke correlates with the gross functional status as well as with the infarction volume and can be considered as biochemical correlative to the severity of stroke. Copyright (c) 2006 S. Karger AG, Basel

Mortality of Patients with Hematological Malignancy after Admission to the Intensive Care Unit

Background: The admission of patients with malignancies to an intensive care unit (ICU) still remains a matter of substantial controversy. The identification of factors that potentially influence the patient outcome can help ICU professionals make appropriate decisions. Patients and Methods: 90 adult patients with hematological malignancy (leukemia 47.8%, high-grade lymphoma 50%) admitted to the ICU were analyzed retrospectively in this single-center study considering numerous variables with regard to their influence on ICU and day-100 mortality. Results: The median simplified acute physiology score (SAPS) II at ICU admission was 55 (ICU survivors 47 vs. 60.5 for non-survivors). The overall ICU mortality rate was 45.6%. With multivariate regression analysis, patients admitted with sepsis and acute respiratory failure had a significantly increased ICU mortality (sepsis odds ratio (OR) 9.12, 95% confidence interval (CI) 1.1-99.7, p = 0.04; respiratory failure OR 13.72, 95% CI 1.39-136.15, p = 0.025). Additional factors associated with an increased mortality were: high doses of catecholamines (ICU: OR 7.37, p = 0.005; day 100: hazard ratio (HR) 2.96, p < 0.0001), renal replacement therapy (day 100: HR 1.93, p = 0.026), and high SAPS II (ICU: HR 1.05, p = 0.038; day 100: HR 1.2, p = 0.027). Conclusion: The decision for or against ICU admission of patients with hematological diseases should become increasingly independent of the underlying malignant disease

Bone Loss after Allogeneic Haematopoietic Stem Cell Transplantation: A Pilot Study on the Use of Zoledronic Acid

Purpose. Bone loss is a common phenomenon following allogeneic haematopoietic stem cell transplantation (allo-HSCT). The study aimed on tolerance and efficacy of zoledronic acid (ZA) in patients after allo-HSCT. Methods. 40 patients' with osteoporosis or osteopenia were recruited on this phase II study. ZA was given at a dose of 4 mg IV every 3 months for 2 years (yrs). BMD was determined by dual-energy X-ray absorptiometry (LS lumbar spine, FH femur hip). Patients were evaluated for deoxypyridinoline (Dpd) and calcium excretion by longitudinal measurements. Results. 36 patients who had received at least 3 doses of ZA were evaluable. 26 patients had at least two BMD measurements since baseline (BMD group). Among these patients, BMD increased from 0.97 ± 0.15 to 1.10 ± 0.18 g/cm² (LS baseline—2 yrs, Δ+11.6 ± 6.0%, P < 0.001) and from 0.82 ± 0.10 to 0.91 ± 0.10 g/cm² (FH baseline—2 yrs, Δ+7.5 ± 7.0%, P < 0.001). Factors associated with an increase in BMD were younger age, female donor sex, and immunosuppression with CSA/MTX. Conclusion. ZA was generally well tolerated; it increases BMD and reduces Dpd excretion significantly in patients with bone loss after allo-HSCT

Biplanar High-Speed Fluoroscopy of Pony Superficial Digital Flexor Tendon (SDFT)-An In Vivo Pilot Study.

The superficial digital flexor tendon (SDFT) is the most frequently injured structure of the musculoskeletal system in sport horses and a common cause for early retirement. This project's aim was to visualize and measure the strain of the sound, injured, and healing SDFTs in a pony during walk and trot. For this purpose, biplanar high-speed fluoroscopic kinematography (FluoKin), as a high precision X-ray movement analysis tool, was used for the first time in vivo with equine tendons. The strain in the metacarpal region of the sound SDFT was 2.86% during walk and 6.78% during trot. When injured, the strain increased to 3.38% during walk and decreased to 5.96% during trot. The baseline strain in the mid-metacarpal region was 3.13% during walk and 6.06% during trot and, when injured, decreased to 2.98% and increased to 7.61%, respectively. Following tendon injury, the mid-metacarpal region contributed less to the overall strain during walk but showed increased contribution during trot. Using this marker-based FluoKin technique, direct, high-precision, and long-term strain measurements in the same individual are possible. We conclude that FluoKin is a powerful tool for gaining deeper insight into equine tendon biomechanics