Liver Segmentation and its Application to Hepatic Interventions

The thesis addresses the development of an intuitive and accurate liver segmentation approach, its integration into software prototypes for the planning of liver interventions, and research on liver regeneration. The developed liver segmentation approach is based on a combination of the live wire paradigm and shape-based interpolation. Extended with two correction modes and integrated into a user-friendly workflow, the method has been applied to more than 5000 data sets. The combination of the liver segmentation with image analysis of hepatic vessels and tumors allows for the computation of anatomical and functional remnant liver volumes. In several projects with clinical partners world-wide, the benefit of the computer-assisted planning was shown. New insights about the postoperative liver function and regeneration could be gained, and most recent investigations into the analysis of MRI data provide the option to further improve hepatic intervention planning

Bundespräsidentschaftswahlkampf 2010 von Dr. Heinz Fischer

Die Diplomarbeit beschäftigt sich mit dem Bundespräsidentschaftswahlkampf 2010 von Heinz Fischer und hat ihren Fokus auf die Zielgruppenarbeit und den Umgang mit Social Media in der Kampagne gelegt. Ausgehend von der Tatsache, dass Heinz Fischer am 25. April 2010 mit 79,3% der WählerInnenstimmen zum Bundespräsidenten wieder gewählt wurde, kamen die Frage nach der Besonderheit seines Wahlkampfes und der Unterschied zum vorhergehenden Wahlkampf auf. Mit Hilfe von qualitativen Interviews mit fünf ehemaligen WahlkampfmitarbeiterInnen konnte festgestellt werden, dass sich sein Wahlkampf in einigen Punkten von dem des Jahres 2004 unterschied, da die Wahlkampagne im Jahr 2010 sehr modern und innovativ war und sich besonders durch die groß angelegte Internetkampagne und die Social Media Aktivitäten, die es in dieser Form in Österreich noch nicht gab, auszeichnete. Der Wahlkampf war ohne Zweifel nach amerikanischem Vorbild gestaltet, auch wenn weder das politische System, noch die politische Kultur und oder die Größe der Länder vergleichbar sind. Mit dem Einsatz von ExpertInnen auf den Gebieten PR, Marketing, Social Media und Web, der gezielten Zielgruppenarbeit und der Fokussierung auf das Internet entsprach der Wahlkampf von Heinz Fischer einem neuen, professionalisierten Wahlkampf. Neben Heinz Fischers Bekanntheit und Beliebtheit und der innovativen Kampagne spielten seine von den Medien zu Beginn an als chancenlos bezeichneten GegenkandidatInnen Barbara Rosenkranz und Rudolf Gehring eine beträchtliche Rolle in der Umsetzung der Kampagne.This work is based on the hypothesis that there were two key elements which made Heinz Fischer's campaign successful. On the one hand, the circumstances of the election itself contributed to the final outcome. For example, the fact that Heinz Fischer was the acting president at the time of election contributed to his victory, because he could rely on familiarity and recognition that were not shared by his opponents, especially considering that none of them actually had a strong political profile at the federal level. On the other hand, the innovative use of social media as part of the electoral campaign, as well as Heinz Fischer's strong orientation towards particular target groups, was also essential to the success of his candidature. In order to confirm the validity of those assumptions I use the two following methods. Firstly, extensive review of existing scientific research is used to determine typical elements of presidential elections and how they relate to the likely outcome of a campaign. This helps to conceptualize which elements of Heinz Fischer's candidature should be regarded as typical and which strategies deserve special attention within the analysis. In addition, qualitative interviews were conducted with five key contributors to the campaign. This serves a double purpose: As participants in the campaign, they are able to reveal facts of the election background which have not yet been worked on Moreover, as professional experts, they are also competent to give an assessment with regard to the certainty of strategic elements influencing the election outcom

Selective late steroid withdrawal after renal transplantation

Steroid withdrawal (SW) after paediatric renal transplantation (RTPL) is controversial. Selective late SW has been performed in our unit since 1995. The safety and effects of SW were analysed retrospectively in 47 patients undergoing RTPL between 1995 and 2004. Initial immunosuppression consisted of cyclosporine A, azathioprine or mycophenolate mofetil and steroids. Criteria for SW were: (1) stable renal function, (2) time interval after RTPL ≥ 1year, (3) no rejection or time interval after last rejection ≥ 1year and (4) good compliance. SW was performed in 30 patients at an age of 13.5years (range 4.5-18.5) and 2.2years (range 1-6.6) after RTPL. After SW, one patient experienced a steroid-sensitive rejection. Follow-up after SW (1.3year; range 0.25-7.5) showed maintained renal function: glomerular filtration rate at SW and currently was 82 (65-128) and 82 (42-115) ml/min per 1.73m2, respectively. The number of patients on antihypertensive treatment did not significantly change (at SW: n = 15; currently: n = 11). Height and body mass index (BMI) remained stable: Median standard deviation score (SDS) for height/BMI at SW and currently was −1.1/0.2 and −0.8/0.1, respectively. Selective late SW was safe regarding renal function and had no significant effect on blood pressure and growt

Successful long-term outcome after renal transplantation in a patient with atypical haemolytic uremic syndrome with combined membrane cofactor protein CD46 and complement factor I mutations

Background: Atypical haemolytic uremic syndrome (aHUS) is often associated with a high risk of disease recurrence and subsequent graft loss after isolated renal transplantation. Evidence-based recommendations for a mutation-based management after renal transplantation in aHUS caused by a combined mutation with complement factor I (CFI) and membrane cofactor protein CD46 (MCP) are limited. Case-diagnosis/Treatment: We describe a 9-year-old boy with a first manifestation of aHUS at the age of 9months carrying combined heterozygous mutations in the CFI and MCP genes. At the age of 5years, he underwent isolated cadaveric renal transplantation. Fresh frozen plasma was administered during and after transplantation, tapered and finally stopped after 3years. Conclusions: During the 5-year follow-up after transplantation there have been no signs of aHUS recurrence and graft function has remained good. The combination of heterozygous MCP and CFI mutations with aHUS might have a positive impact on the post-transplant course, possibly predicting a lower risk of aHUS recurrence after an isolated cadaveric renal transplantatio

Mental health conditions in older multimorbid patients presenting to the emergency department for acute cardiac symptoms: Cross‐sectional findings from the EMASPOT study

Background: This study aimed to (1) examine the proportion of patients presenting to an emergency department (ED) for acute cardiac symptoms with comorbid mental health conditions (MHCs) comprising current depression, generalized anxiety disorder, and panic disorder; (2) compare cardiac patients with and without MHCs regarding sociodemographic, medical, and psychological characteristics; and (3) examine recognition and treatment rates of MHCs. Methods: Multimorbid patients, aged ≥50 years, presenting to an inner-city ED with acute cardiac symptoms including chest pain, dyspnea, and palpitations, completed validated self-report instruments assessing MHCs and a questionnaire collecting psychosocial and medical information. In addition, routine medical data were extracted from the electronic health record. Results: A total of 641 patients were included in the study. Mean (±SD) age was 68.8 (±10.8) years and 41.7% were female. Based on screening instruments, 28.4% of patients were affected with comorbid MHCs. Patients reported clinically significant symptoms of depression (23.3% PHQ-9 ≥10), generalized anxiety disorder (12.2% GAD-7 ≥10), and panic disorder (4.7% PHQ-PD). Patients with MHCs were more likely to be younger, female, lower educated, and unemployed. The presence of MHCs was associated with higher cardiac symptom burden and subjective treatment urgency as well as more psychosocial distress (PHQ-stress) and impaired quality of life (SF-12v2). Of all patients, 15.6% were identified with new or unrecognized MHCs. Conclusions: MHCs are prevalent in nearly one-third of patients presenting with cardinal cardiac symptoms. Thus, the ED visit offers an opportunity to identify and refer patients with MHCs to appropriate and timely care after exclusion of life-threatening conditions