1H MR Spectroscopy in Gliomatosis: Is there a Sensitivity Issue?

Objective. 1H MR spectroscopy (MRS) is widely performed for assessment of brain tumours and is considered a highly sensitive technique capable of differentiating benign from malignant conditions and tumour grading. Method. We present a case of a 69 year old woman who was suspected to have gliomatosis on MRI. Results. MRS performed using single voxel and chemical shift/multivoxel techniques was within normal limits. A repeat scan 6 months later showed progressive disease, and biopsy was performed that proved the diagnosis of glioblastoma. Conclusion. Normal MRS in a patient with suspicion of gliomatosis on MRI should not reassure clinicians into assuming a benign aetiology or a good prognosis in short term

Класифікація ЕКГ сигналів методами машинного навчання

The importance of electrocardiogram (ECG) analysis is difficult to overestimate. Rhythm of life, stress and other factors affect the frequency of diseases and their early appearance. At the same time, the technologization (digitalization) of life and hardware-software complexes, such as mobile electronic cardiographs and wearable devices in general, which are rapidly developing, open new opportunities for rapid analysis of human state by certain indicators, as well as allow to diagnose on the new higher level in almost real time. There are many methods for analyzing cardiograms. In this paper, the authors propose a new approach based on an ensemble of individual classifiers, which effectively solves the problem of ECG analysis. The study is based on the PhysioNet Computing in Cardiology Challenge 2017 and the MIT-BIH Arrhythmia Database. The algorithm consists of the following stages: data filtering using moving average and Butterworth filters, R-peak localization via threshold and grouping method, ECG resampling for the better comparability, “Noisy” vs “NotNoisy” classification as the most hard-to-identify class, final classification as “Normal”, “Atrial Fibrillation”, “Other” using an ensemble of 1D CNN classifiers and a final classifier of selection using logistic regression, random forest or support vector machine (SVM). The proposed method shows high accuracy by the metric F1, so it gives the background for further research, optimization and implementation. This way this algorithm could help to save human’s life by in-time detection of problems with cardiovascular system (CVS) at early stage. Pages of the article in the issue: 70 - 77 Language of the article: UkrainianВажливість аналізу електрокардіограм (ЕКГ) важко переоцінити. Ритм життя, стреси та інші фактори впливають на частоту захворювань та їх ранні прояви. Разом з тим, технологізація (цифровізація) життя та апаратно-програмних комплекси, такі як мобільні електронні кардіографи та носимі пристрої загалом, що бурхливо розвиваються останнім часом, відкривають нові можливості для швидкого аналізу стану людини за певними показниками, а також дозволяють проводити діагностику на новому рівні практично у реальному часі. Існує багато методів для аналізу кардіограм. В даній роботі авторами запропоновано новий підхід, що ефективно розв’язує задачу аналізу ЕКГ. Дослідження базується на наборі даних PhysioNetComputing in Cardiology Challenge 2017 та MIT-BIH Arrhythmia Database. Алгоритм складається зтаких етапів: фільтрація даних, локалізація R піків, передискретизація ЕКГ, визначення класу ЕКГ задопомогою ансамблю з 1D CNN та підсумкового класифікатора. Запропонований метод показує високу точність за метрикою F1, тому являє собою цінність дляподальших досліджень, оптимізації та впровадження

Predictors of growth kinetics and outcomes in small renal masses (SRM ≤4 cm in size):Tayside Active Surveillance Cohort (TASC) Study

Objective: To determine outcomes of small renal masses (≤4 cm) on active surveillance and explore factors which can influence their growth.Patients and Methods: Two hundred twenty six patients between January 2007 and December 2014 were analysed using cross-linked methodology of healthcare data and independent review. Cancer specific and non-specific survival were the primary outcomes. Growth kinetics, factors influencing growth and need for interventions were secondary outcomes.Results: 101 (64.4%) solid and 4 (5.9%) cystic SRMs showed growth. 43 (19.02%) of SRMs required treatment interventions. Seven patients (7/158; 4.4%) died due to renal cancer at a median follow-up of 21.7 (SD 10.6, min 6-42) months, all in solid category. Independent review of serial radiological imaging of these seven cases showed two patients had subtle metastatic disease at the initial presentation, and 5 of the 7 did not adhere to recommended imaging regime. 33 (33/158; 20.8%) died due to other causes including non-renal cancers (14/158; 8.8%). Multivariate analyses showed that lower eGFR at baseline, co-morbidities and tumour location were independently associated with growth in size.Conclusions: A higher cancer-specific mortality was seen in the present study compared to the reported literature. Independent critical review of imaging of cases with poor outcome underscored the importance of adherence to a robust protocol including follow up. Comorbid conditions had a significant impact on growth and overall survival of patients with SRMs.</p

Surgical Management of Neurogenic Sphincter Incompetence in Children

We report on the results of a literature review regarding the indications and results of operations to increase bladder outlet resistance to achieve dryness in children with neurogenic sphincter incompetence (NSBD). The relative advantages and disadvantages of injection of bulking agents, periurethral slings, bladder neck reconfiguration, artificial sphincters, and bladder neck closure based on a literature review and our combined clinical experience are discussed. Based on this review and our experience, we propose that periurethral injection of bulking agents is not justified as a primary treatment. Likewise, operations that reconfigure the bladder neck are not very useful since most patients also require bladder augmentation and an abdominal catheterizable channel. Bladder neck slings with autologous tissues are effective, mostly in females bur in the majority of patients a bladder augmentation is necessary. There is a role also for implantation of artificial urinary sphincters but when done as an isolated procedure, close monitoring to detect possible detrusor changes is needed. Bladder neck closure is an effective measure when other methods have failed

Ribs of Pinna nobilis shell induce unexpected microstructural changes that provide unique mechanical properties

The reinforcement function of shell ribs depends not only on their vaulted morphology but also on their microstructure. They are part of the outer layer which, in the case of the Pinna nobilis bivalve, is built from almost monocrystalline calcitic prisms, always oriented perpendicular to the growth surfaces. Originally, prisms and their c-axes follow the radii of rib curvature, becoming oblique to the shell thickness direction. Later, prisms bend to reach the nacre layer perpendicularly, but their c-axes retain the initial orientation. Calcite grains form nonrandom boundaries. Most often, three twin disorientations arise, with two of them observed for the first time. Nano-indentation and impact tests demonstrate that the oblique orientation of c-axes significantly improves the hardness and fracture toughness of prisms. Moreover, compression tests reveal that the rib area achieves a unique strength of 700 MPa. The detection of the specific microstructure formed to toughen the shell is novel.The work was supported by the Polish National Agency for Academic Exchange (grant PPI/APM/2018/1/00049/U/001) and the National Science Center (grant UMO-2018/29/B/ST8/02200). MS was supported by the European Union from the resources of the European Social Fund (Project No.WNDPOWR. 03.02.00-00-I043/16). AGC was funded by project CGL2017-85118-P of the Spanish Ministerio de Ciencia e Innovación