Comparative Evaluation of Combined Navigated Laser Photocoagulation and Intravitreal Ranibizumab in the Treatment of Diabetic Macular Edema

Objective: To evaluate if a standardized combination therapy regimen, utilizing 3 monthly ranibizumab injections followed by navigated laser photocoagulation, reduces the number of total ranibizumab injections required for treatment of diabetic macular edema (DME). Research Design and Methods: A 12-month, prospective comparison of 66 patients with center-involving DME: 34 patients with combination therapy were compared to 32 patients treated with ranibizumab monotherapy. All patients initially received 3 monthly ranibizumab injections (loading phase) and additional injections pro re nata (PRN). Combination therapy patients additionally received navigated laser photocoagulation after the loading phase. Main outcome measures were mean number of injections after the loading phase and change in BCVA from baseline to month 12. Results: Navigated laser combination therapy and ranibizumab monotherapy similarly improved mean BCVA letter score (+8.41 vs. +6.31 letters, p=0.258). In the combination group significantly less injections were required after the 3 injection loading phase (0.88 +/- 1.23 vs. 3.88 +/- 2.32, p<=0.001). By month 12, 84% of patients in the monotherapy group had required additional ranibizumab injections as compared to 35% in the combination group (p<=0.001). Conclusions: Navigated laser combination therapy demonstrated significant visual gains in most patients. Retreatment rate and number of injections were significantly lower compared to ranibizumab monotherapy and compared to the results of conventional laser combination therapy previously reported in pivotal anti-VEGF studies

Dynamics of myelin content decrease in the rat stroke model

A majority of studies were usually focused on neuronal death after brain ischemia, however, stroke affects all cell types including oligodendrocytes that form myelin sheath in the CNS. Our study is focused on the changes of myelin content in ischemic core and neighbor structures in early terms (1, 3 and 10 days) after stroke. Stroke modeled with middle cerebral artery occlusion (MCAo) in 15 male rats that were divided in three groups by time-points after operation. Brain sections were histologically stained with Luxol Fast Blue (LFB) for myelin quantification. The significant demyelination was found in the ischemic core, corpus callosum, anterior commissure, whereas myelin content was increased in caudoputamen, internal capsule and piriform cortex compared with the contralateral hemisphere. The motor cortex showed a significant increase of myelin content on the 1st day and a significant decrease on the 3rd and 10th days after MCAo. These results suggest stroke influences myelination not only in ischemic core but also in distant structures

Создание опытного образца геохода. Временной фактор изготовления компонентов и их сборки в конечное изделие

Изложен опыт реализации проекта №02.G25.31.0076 в рамках открытого конкурса Министерства образования и науки РФ и Постановления Правительства РФ №218 от 09.04.2010 г. Дано описание временных рамок реализации проекта, в частности, работы над созданием опытного образца щитового проходческого агрегата - геохода, диаметром 3,2 м. В настоящее время проект находится в стадии завершения. Главная идея статьи - поделиться опытом создания новой техники и показать, сколько времени затрачивается на решение тех или иных производственных процессов по созданию опытных образцов горных машин на примере геохода. Данная статья будет полезна организациям, планирующим участие в реализации проектов по созданию высокотехнологичного производства, и может являться ориентиром для составления Плана-графика реализации подобных проектов. Автор статьи лично принимал участие в реализации данного проекта и принимал решения по планированию и организации работ.The experience of the project №02.G25.31.0076 is presented. The project was operated in the framework of the open competition of the Ministry of education and science of the Russian Federation and the RF Government Decree №218 from 09.04.2010. Description of the time frame of the project implementation, particularly the activities of the TBM prototype creation - geokhod, with a diameter of 3.2 m. is presented. Currently, the project is closer to complete. The main idea of the article is to share the experience of creating new technology and show how much time is spent on the decision of production processes to create prototypes of mining machines on the example of a geokhod. This article will be useful for organizations planning to participate in the implementation of projects to create high-tech production, and can be a guide for drawing up a Plan-schedule of such projects. The author of this article personally participated in the implementation of this project and made decisions on planning and organization of activities

Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting

<p>Abstract</p> <p>Background</p> <p>Previous experiences of whole body MR angiography are predominantly available in linear 0.5 M gadolinium-containing contrast agents. The aim of this study was to compare image quality on a four-point scale (range 1–4) and diagnostic accuracy of a 1.0 M macrocyclic contrast agent (gadobutrol, n = 80 patients) with a 0.5 M linear contrast agent (gadopentetate dimeglumine, n = 85 patients) on a 1.5 T whole body MR system. Digital subtraction angiography served as standard of reference.</p> <p>Results</p> <p>All examinations yielded diagnostic image quality. There was no significant difference in image quality (3.76 ± 0.3 versus 3.78 ± 0.3, p = n.s.) and diagnostic accuracy observed. Sensitivity and specificity of the detection of hemodynamically relevant stenoses was 93%/95% in the gadopentetate dimeglumine group and 94%/94% in the gadobutrol group, respectively.</p> <p>Conclusion</p> <p>The high diagnostic accuracy of gadobutrol in the clinical routine setting is of high interest as medical authorities (e.g. the European Agency for the Evaluation of Medicinal Products) recommend macrocyclic contrast agents especially to be used in patients with renal failure or dialysis.</p

Radiobiological restrictions and tolerance doses of repeated single-fraction hdr-irradiation of intersecting small liver volumes for recurrent hepatic metastases

<p>Abstract</p> <p>Background</p> <p>To assess radiobiological restrictions and tolerance doses as well as other toxic effects derived from repeated applications of single-fraction high dose rate irradiation of small liver volumes in clinical practice.</p> <p>Methods</p> <p>Twenty patients with liver metastases were treated repeatedly (2 - 4 times) at identical or intersecting locations by CT-guided interstitial brachytherapy with varying time intervals. Magnetic resonance imaging using the hepatocyte selective contrast media Gd-BOPTA was performed before and after treatment to determine the volume of hepatocyte function loss (called pseudolesion), and the last acquired MRI data set was merged with the dose distributions of all administered brachytherapies. We calculated the BED (biologically equivalent dose for a single dose d = 2 Gy) for different α/β values (2, 3, 10, 20, 100) based on the linear-quadratic model and estimated the tolerance dose for liver parenchyma D₉₀as the BED exposing 90% of the pseudolesion in MRI.</p> <p>Results</p> <p>The tolerance doses D₉₀after repeated brachytherapy sessions were found between 22 - 24 Gy and proved only slightly dependent on α/β in the clinically relevant range of α/β = 2 - 10 Gy. Variance analysis showed a significant dependency of D₉₀with respect to the intervals between the first irradiation and the MRI control (p < 0.05), and to the number of interventions. In addition, we observed a significant inverse correlation (p = 0.037) between D₉₀and the pseudolesion's volume. No symptoms of liver dysfunction or other toxic effects such as abscess formation occurred during the follow-up time, neither acute nor on the long-term.</p> <p>Conclusions</p> <p>Inactivation of liver parenchyma occurs at a BED of approx. 22 - 24 Gy corresponding to a single dose of ~10 Gy (α/β ~ 5 Gy). This tolerance dose is consistent with the large potential to treat oligotopic and/or recurrent liver metastases by CT-guided HDR brachytherapy without radiation-induced liver disease (RILD). Repeated small volume irradiation may be applied safely within the limits of this study.</p

Predictive Policing in Germany

The subject of predictive policing has been very virulent in Germany since 2014. Currently different approaches are running in six federal states. Despite the many approaches, there is still no scientific report that grants a corresponding overview. The reason for the lack of such an overview lies in the fact that less official reports of the different approaches have been published.1 In this article, we introduce the German idea of predictive policing and make a brief reference to the problem of the comparability of different solutions. After that we survey the existing solutions chosen by the federal states and their police authorities.publishe