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Studier-Fischer A, Schwab FM, Rees M, Seidlitz S, Sellner J, Özdemir B, Ayala L, Odenthal J, Knoedler S, Kowalewski KF, Haney CM, Dietrich M, Salg GA, Kenngott HG, Müller-Stich BP, Maier-Hein L, Nickel F. ICG-augmented hyperspectral imaging for visualization of intestinal perfusion compared to conventional ICG fluorescence imaging: an experimental study. Int J Surg 2023; 109:3883-3895. [PMID: 38258996 PMCID: PMC10720797 DOI: 10.1097/js9.0000000000000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/13/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Small bowel malperfusion (SBM) can cause high morbidity and severe surgical consequences. However, there is no standardized objective measuring tool for the quantification of SBM. Indocyanine green (ICG) imaging can be used for visualization, but lacks standardization and objectivity. Hyperspectral imaging (HSI) as a newly emerging technology in medicine might present advantages over conventional ICG fluorescence or in combination with it. METHODS HSI baseline data from physiological small bowel, avascular small bowel and small bowel after intravenous application of ICG was recorded in a total number of 54 in-vivo pig models. Visualizations of avascular small bowel after mesotomy were compared between HSI only (1), ICG-augmented HSI (IA-HSI) (2), clinical evaluation through the eyes of the surgeon (3) and conventional ICG imaging (4). The primary research focus was the localization of resection borders as suggested by each of the four methods. Distances between these borders were measured and histological samples were obtained from the regions in between in order to quantify necrotic changes 6 h after mesotomy for every region. RESULTS StO2 images (1) were capable of visualizing areas of physiological perfusion and areas of clearly impaired perfusion. However, exact borders where physiological perfusion started to decrease could not be clearly identified. Instead, IA-HSI (2) suggested a sharp-resection line where StO2 values started to decrease. Clinical evaluation (3) suggested a resection line 23 mm (±7 mm) and conventional ICG imaging (4) even suggested a resection line 53 mm (±13 mm) closer towards the malperfused region. Histopathological evaluation of the region that was sufficiently perfused only according to conventional ICG (R3) already revealed a significant increase in pre-necrotic changes in 27% (±9%) of surface area. Therefore, conventional ICG seems less sensitive than IA-HSI with regards to detection of insufficient tissue perfusion. CONCLUSIONS In this experimental animal study, IA-HSI (2) was superior for the visualization of segmental SBM compared to conventional HSI imaging (1), clinical evaluation (3) or conventional ICG imaging (4) regarding histopathological safety. ICG application caused visual artifacts in the StO2 values of the HSI camera as values significantly increase. This is caused by optical properties of systemic ICG and does not resemble a true increase in oxygenation levels. However, this empirical finding can be used to visualize segmental SBM utilizing ICG as contrast agent in an approach for IA-HSI. Clinical applicability and relevance will have to be explored in clinical trials. LEVEL OF EVIDENCE Not applicable. Translational animal science. Original article.
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Affiliation(s)
| | | | - Maike Rees
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ)
- Faculty of Mathematics and Computer Science
| | - Silvia Seidlitz
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ)
- Faculty of Mathematics and Computer Science
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg
| | - Jan Sellner
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ)
- Faculty of Mathematics and Computer Science
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe
| | - Berkin Özdemir
- Departments ofGeneral, Visceral, and Transplantation Surgery
| | - Leonardo Ayala
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ)
- Medical Faculty, Heidelberg University
| | - Jan Odenthal
- Departments ofGeneral, Visceral, and Transplantation Surgery
| | - Samuel Knoedler
- Departments ofGeneral, Visceral, and Transplantation Surgery
- Division of Plastic Surgery, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | | | | | | | | | | | - Lena Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ)
- Faculty of Mathematics and Computer Science
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg
| | - Felix Nickel
- Departments ofGeneral, Visceral, and Transplantation Surgery
- HIDSS4Health—Helmholtz Information and Data Science School for Health, Karlsruhe
- Department of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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2
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Studier-Fischer A, Seidlitz S, Sellner J, Bressan M, Özdemir B, Ayala L, Odenthal J, Knoedler S, Kowalewski KF, Haney CM, Salg G, Dietrich M, Kenngott H, Gockel I, Hackert T, Müller-Stich BP, Maier-Hein L, Nickel F. HeiPorSPECTRAL - the Heidelberg Porcine HyperSPECTRAL Imaging Dataset of 20 Physiological Organs. Sci Data 2023; 10:414. [PMID: 37355750 PMCID: PMC10290660 DOI: 10.1038/s41597-023-02315-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023] Open
Abstract
Hyperspectral Imaging (HSI) is a relatively new medical imaging modality that exploits an area of diagnostic potential formerly untouched. Although exploratory translational and clinical studies exist, no surgical HSI datasets are openly accessible to the general scientific community. To address this bottleneck, this publication releases HeiPorSPECTRAL ( https://www.heiporspectral.org ; https://doi.org/10.5281/zenodo.7737674 ), the first annotated high-quality standardized surgical HSI dataset. It comprises 5,758 spectral images acquired with the TIVITA® Tissue and annotated with 20 physiological porcine organs from 8 pigs per organ distributed over a total number of 11 pigs. Each HSI image features a resolution of 480 × 640 pixels acquired over the 500-1000 nm wavelength range. The acquisition protocol has been designed such that the variability of organ spectra as a function of several parameters including the camera angle and the individual can be assessed. A comprehensive technical validation confirmed both the quality of the raw data and the annotations. We envision potential reuse within this dataset, but also its reuse as baseline data for future research questions outside this dataset. Measurement(s) Spectral Reflectance Technology Type(s) Hyperspectral Imaging Sample Characteristic - Organism Sus scrofa.
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Affiliation(s)
- Alexander Studier-Fischer
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Silvia Seidlitz
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Karlsruhe, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany
| | - Jan Sellner
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Karlsruhe, Heidelberg, Germany
| | - Marc Bressan
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Berkin Özdemir
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Leonardo Ayala
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Jan Odenthal
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Samuel Knoedler
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Karl-Friedrich Kowalewski
- Department of Urology, Medical Faculty of Mannheim at the University of Heidelberg, Mannheim, Germany
| | - Caelan Max Haney
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Gabriel Salg
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Maximilian Dietrich
- Department of Anesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Hannes Kenngott
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, Leipzig University Hospital, Leipzig, Germany
| | - Thilo Hackert
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
- Department of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Beat Peter Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Lena Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Karlsruhe, Heidelberg, Germany
- National Center for Tumor Diseases (NCT) Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany.
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Karlsruhe, Heidelberg, Germany.
- Department of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
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3
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Nickel F, Studier-Fischer A, Özdemir B, Odenthal J, Müller LR, Knoedler S, Kowalewski KF, Camplisson I, Allers MM, Dietrich M, Schmidt K, Salg GA, Kenngott HG, Billeter AT, Gockel I, Sagiv C, Hadar OE, Gildenblat J, Ayala L, Seidlitz S, Maier-Hein L, Müller-Stich BP. Optimization of anastomotic technique and gastric conduit perfusion with hyperspectral imaging and machine learning in an experimental model for minimally invasive esophagectomy. Eur J Surg Oncol 2023:S0748-7983(23)00444-4. [PMID: 37105869 DOI: 10.1016/j.ejso.2023.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/26/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Esophagectomy is the mainstay of esophageal cancer treatment, but anastomotic insufficiency related morbidity and mortality remain challenging for patient outcome. Therefore, the objective of this work was to optimize anastomotic technique and gastric conduit perfusion with hyperspectral imaging (HSI) for total minimally invasive esophagectomy (MIE) with linear stapled anastomosis. MATERIAL AND METHODS A live porcine model (n = 58) for MIE was used with gastric conduit formation and simulation of linear stapled side-to-side esophagogastrostomy. Four main experimental groups differed in stapling length (3 vs. 6 cm) and simulation of anastomotic position on the conduit (cranial vs. caudal). Tissue oxygenation around the anastomotic simulation site was evaluated using HSI and was validated with histopathology. RESULTS The tissue oxygenation (ΔStO2) after the anastomotic simulation remained constant only for the short stapler in caudal position (-0.4 ± 4.4%, n.s.) while it was impaired markedly in the other groups (short-cranial: -15.6 ± 11.5%, p = 0.0002; long-cranial: -20.4 ± 7.6%, p = 0.0126; long-caudal: -16.1 ± 9.4%, p < 0.0001). Tissue samples from avascular stomach as measured by HSI showed correspondent eosinophilic pre-necrotic changes in 35.7 ± 9.7% of the surface area. CONCLUSION Tissue oxygenation at the site of anastomotic simulation of the gastric conduit during MIE is influenced by stapling technique. Optimal oxygenation was achieved with a short stapler (3 cm) and sufficient distance of the simulated anastomosis to the cranial end of the gastric conduit. HSI tissue deoxygenation corresponded to histopathologic necrotic tissue changes. The experimental model with HSI and ML allow for systematic optimization of gastric conduit perfusion and anastomotic technique while clinical translation will have to be proven.
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Affiliation(s)
- F Nickel
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany; HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany
| | - A Studier-Fischer
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany; School of Medicine, Heidelberg University, Heidelberg, Germany
| | - B Özdemir
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - J Odenthal
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - L R Müller
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany; Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
| | - S Knoedler
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - K F Kowalewski
- Department of Urology, Medical Faculty of Mannheim at the University of Heidelberg, Mannheim, Germany
| | - I Camplisson
- Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, USA
| | - M M Allers
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - M Dietrich
- Department of Anaesthesiology, Heidelberg University Hospital, Heidelberg, Germany
| | - K Schmidt
- Department of Anaesthesiology and Intensive Care Medicine, Essen University Hospital, Essen, Germany
| | - G A Salg
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - H G Kenngott
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - A T Billeter
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - I Gockel
- Department of Visceral, Transplantation, Thoracic and Vascular Surgery, Leipzig University Hospital, Leipzig, Germany
| | - C Sagiv
- DeePathology Ltd., Ra'anana, Israel
| | | | | | - L Ayala
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany; Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - S Seidlitz
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany; Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Maier-Hein
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany; Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany; Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - B P Müller-Stich
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany; HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg and Karlsruhe, Germany.
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4
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Ayala L, Adler TJ, Seidlitz S, Wirkert S, Engels C, Seitel A, Sellner J, Aksenov A, Bodenbach M, Bader P, Baron S, Vemuri A, Wiesenfarth M, Schreck N, Mindroc D, Tizabi M, Pirmann S, Everitt B, Kopp-Schneider A, Teber D, Maier-Hein L. Spectral imaging enables contrast agent-free real-time ischemia monitoring in laparoscopic surgery. Sci Adv 2023; 9:eadd6778. [PMID: 36897951 PMCID: PMC10005169 DOI: 10.1126/sciadv.add6778] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Laparoscopic surgery has evolved as a key technique for cancer diagnosis and therapy. While characterization of the tissue perfusion is crucial in various procedures, such as partial nephrectomy, doing so by means of visual inspection remains highly challenging. We developed a laparoscopic real-time multispectral imaging system featuring a compact and lightweight multispectral camera and the possibility to complement the conventional surgical view of the patient with functional information at a video rate of 25 Hz. To enable contrast agent-free ischemia monitoring during laparoscopic partial nephrectomy, we phrase the problem of ischemia detection as an out-of-distribution detection problem that does not rely on data from any other patient and uses an ensemble of invertible neural networks at its core. An in-human trial demonstrates the feasibility of our approach and highlights the potential of spectral imaging combined with advanced deep learning-based analysis tools for fast, efficient, reliable, and safe functional laparoscopic imaging.
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Affiliation(s)
- Leonardo Ayala
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Tim J. Adler
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
| | - Silvia Seidlitz
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
| | - Sebastian Wirkert
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Alexander Seitel
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jan Sellner
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
| | | | | | - Pia Bader
- Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | | | - Anant Vemuri
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manuel Wiesenfarth
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicholas Schreck
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Diana Mindroc
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Minu Tizabi
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Pirmann
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Brittaney Everitt
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Dogu Teber
- Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Lena Maier-Hein
- Division of Intelligent Medical Systems, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
- Helmholtz Information and Data Science School for Health, Karlsruhe/Heidelberg, Germany
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5
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Kausch L, Thomas S, Kunze H, Norajitra T, Klein A, Ayala L, El Barbari J, Mandelka E, Privalov M, Vetter S, Mahnken A, Maier-Hein L, Maier-Hein K. C-arm positioning for standard projections during spinal implant placement. Med Image Anal 2022; 81:102557. [DOI: 10.1016/j.media.2022.102557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/09/2022] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
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6
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Seidlitz S, Sellner J, Odenthal J, Özdemir B, Studier-Fischer A, Knödler S, Ayala L, Adler TJ, Kenngott HG, Tizabi M, Wagner M, Nickel F, Müller-Stich BP, Maier-Hein L. Robust deep learning-based semantic organ segmentation in hyperspectral images. Med Image Anal 2022; 80:102488. [DOI: 10.1016/j.media.2022.102488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/28/2022] [Accepted: 05/20/2022] [Indexed: 12/15/2022]
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7
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Gröhl J, Dreher KK, Schellenberg M, Rix T, Holzwarth N, Vieten P, Ayala L, Bohndiek SE, Seitel A, Maier-Hein L. SIMPA: an open-source toolkit for simulation and image processing for photonics and acoustics. J Biomed Opt 2022; 27:JBO-210395SSR. [PMID: 35380031 PMCID: PMC8978263 DOI: 10.1117/1.jbo.27.8.083010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/28/2022] [Indexed: 05/09/2023]
Abstract
SIGNIFICANCE Optical and acoustic imaging techniques enable noninvasive visualisation of structural and functional properties of tissue. The quantification of measurements, however, remains challenging due to the inverse problems that must be solved. Emerging data-driven approaches are promising, but they rely heavily on the presence of high-quality simulations across a range of wavelengths due to the lack of ground truth knowledge of tissue acoustical and optical properties in realistic settings. AIM To facilitate this process, we present the open-source simulation and image processing for photonics and acoustics (SIMPA) Python toolkit. SIMPA is being developed according to modern software design standards. APPROACH SIMPA enables the use of computational forward models, data processing algorithms, and digital device twins to simulate realistic images within a single pipeline. SIMPA's module implementations can be seamlessly exchanged as SIMPA abstracts from the concrete implementation of each forward model and builds the simulation pipeline in a modular fashion. Furthermore, SIMPA provides comprehensive libraries of biological structures, such as vessels, as well as optical and acoustic properties and other functionalities for the generation of realistic tissue models. RESULTS To showcase the capabilities of SIMPA, we show examples in the context of photoacoustic imaging: the diversity of creatable tissue models, the customisability of a simulation pipeline, and the degree of realism of the simulations. CONCLUSIONS SIMPA is an open-source toolkit that can be used to simulate optical and acoustic imaging modalities. The code is available at: https://github.com/IMSY-DKFZ/simpa, and all of the examples and experiments in this paper can be reproduced using the code available at: https://github.com/IMSY-DKFZ/simpa_paper_experiments.
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Affiliation(s)
- Janek Gröhl
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
| | - Kris K. Dreher
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Faculty of Physics and Astronomy, Heidelberg, Germany
| | - Melanie Schellenberg
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Faculty of Mathematics and Computer Science, Heidelberg, Germany
- HIDSS4Health - Helmholtz Information and Data Science School for Health, Heidelberg, Germany
| | - Tom Rix
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Faculty of Mathematics and Computer Science, Heidelberg, Germany
| | - Niklas Holzwarth
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
| | - Patricia Vieten
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Faculty of Physics and Astronomy, Heidelberg, Germany
| | - Leonardo Ayala
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Medical Faculty, Heidelberg, Germany
| | - Sarah E. Bohndiek
- University of Cambridge, Cancer Research UK Cambridge Institute, Robinson Way, Cambridge, United Kingdom
- University of Cambridge, Department of Physics, Cambridge, United Kingdom
| | - Alexander Seitel
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
| | - Lena Maier-Hein
- German Cancer Research Center (DKFZ), Division of Intelligent Medical Systems, Heidelberg, Germany
- Heidelberg University, Faculty of Mathematics and Computer Science, Heidelberg, Germany
- Heidelberg University, Medical Faculty, Heidelberg, Germany
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8
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Ayala L, Isensee F, Wirkert SJ, Vemuri AS, Maier-Hein KH, Fei B, Maier-Hein L. Band selection for oxygenation estimation with multispectral/hyperspectral imaging. Biomed Opt Express 2022; 13:1224-1242. [PMID: 35414995 PMCID: PMC8973188 DOI: 10.1364/boe.441214] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 05/24/2023]
Abstract
Multispectral imaging provides valuable information on tissue composition such as hemoglobin oxygen saturation. However, the real-time application of this technique in interventional medicine can be challenging due to the long acquisition times needed for large amounts of hyperspectral data with hundreds of bands. While this challenge can partially be addressed by choosing a discriminative subset of bands, the band selection methods proposed to date are mainly restricted by the availability of often hard to obtain reference measurements. We address this bottleneck with a new approach to band selection that leverages highly accurate Monte Carlo (MC) simulations. We hypothesize that a so chosen small subset of bands can reproduce or even improve upon the results of a quasi continuous spectral measurement. We further investigate whether novel domain adaptation techniques can address the inevitable domain shift stemming from the use of simulations. Initial results based on in silico and in vivo experiments suggest that 10-20 bands are sufficient to closely reproduce results from spectral measurements with 101 bands in the 500-700 nm range. The investigated domain adaptation technique, which only requires unlabeled in vivo measurements, yielded better results than the pure in silico band selection method. Overall, our method could guide development of fast multispectral imaging systems suited for interventional use without relying on complex hardware setups or manually labeled data.
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Affiliation(s)
- Leonardo Ayala
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Authors contributed equally
| | - Fabian Isensee
- Division of Medical Image Computing (MIC), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Applied Computer Vision Lab, Helmholtz Imaging, Dallas, Texas 75001, USA
- Authors contributed equally
| | - Sebastian J Wirkert
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anant S Vemuri
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Klaus H Maier-Hein
- Division of Medical Image Computing (MIC), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
| | - Baowei Fei
- Department of Bioengineering, The University of Texas at Dallas, Richardson, Texas 75080-4551, USA
- Advanced Imaging Research Center, The University of Texas Southwestern Medical Center, Dallas, Texas 75001, USA
- Department of Radiology, The University of Texas Southwestern Medical Center, Dallas, Texas 75001, USA
| | - Lena Maier-Hein
- Division of Computer Assisted Medical Interventions (CAMI), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
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9
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Abstract
The increasing networking of data systems in medicine is not only leading to modern interdisciplinarity in the sense of cooperation between different medical departments, but also poses new challenges regarding the building and room infrastructure. The surgical operating room of the future expands or augments its reality, away from the pure building characteristics, towards an intelligent and communicative space platform. The building infrastructure (operating theatre) serves as sensor and actuator. Thus, it is possible to inform about missing diagnostics as well as to register them directly in the contextualization of the planned surgical intervention or to integrate them into the processes. Integrated operating theatres represent a comprehensive computer platform based on a corresponding system architecture with software-based protocols. An underlying modular system consisting of various modules for image acquisition and analysis, interaction and visualization supports the integration and merging of heterogeneous data that are generated in a hospital operation. Integral building data (e.g., air conditioning, lighting control, device registration) are merged with patient-related data (age, type of illness, concomitant diseases, existing diagnostic CT and MRI images). New systems coming onto the market, as well as already existing systems will have to be measured by the extent to which they will be able to guarantee this integration of information-similar to the development from mobile phone to smartphone. Cost reduction should not be the only legitimizing argument for the market launch, but the vision of a new quality of surgical perception and action.
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Affiliation(s)
- D Teber
- Urologische Klinik, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
| | - C Engels
- Urologische Klinik, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland
| | - L Maier-Hein
- Abteilung Computer-assistierte Medizinische Interventionen (CAMI), Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - L Ayala
- Abteilung Computer-assistierte Medizinische Interventionen (CAMI), Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - S Onogur
- Abteilung Computer-assistierte Medizinische Interventionen (CAMI), Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - A Seitel
- Abteilung Computer-assistierte Medizinische Interventionen (CAMI), Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
| | - K März
- Abteilung Computer-assistierte Medizinische Interventionen (CAMI), Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
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Ayala L, Seidlitz S, Vemuri A, Wirkert SJ, Kirchner T, Adler TJ, Engels C, Teber D, Maier-Hein L. Light source calibration for multispectral imaging in surgery. Int J Comput Assist Radiol Surg 2020; 15:1117-1125. [PMID: 32535848 PMCID: PMC7316688 DOI: 10.1007/s11548-020-02195-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/29/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE Live intra-operative functional imaging has multiple potential clinical applications, such as localization of ischemia, assessment of organ transplantation success and perfusion monitoring. Recent research has shown that live monitoring of functional tissue properties, such as tissue oxygenation and blood volume fraction, is possible using multispectral imaging in laparoscopic surgery. While the illuminant spectrum is typically kept constant in laparoscopic surgery and can thus be estimated from preoperative calibration images, a key challenge in open surgery originates from the dynamic changes of lighting conditions. METHODS The present paper addresses this challenge with a novel approach to light source calibration based on specular highlight analysis. It involves the acquisition of low-exposure time images serving as a basis for recovering the illuminant spectrum from pixels that contain a dominant specular reflectance component. RESULTS Comprehensive in silico and in vivo experiments with a range of different light sources demonstrate that our approach enables an accurate and robust recovery of the illuminant spectrum in the field of view of the camera, which results in reduced errors with respect to the estimation of functional tissue properties. Our approach further outperforms state-of-the-art methods proposed in the field of computer vision. CONCLUSION Our results suggest that low-exposure multispectral images are well suited for light source calibration via specular highlight analysis. This work thus provides an important first step toward live functional imaging in open surgery.
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Affiliation(s)
- Leonardo Ayala
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Silvia Seidlitz
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
- HIDSS4Health – Helmholtz Information and Data Science School for Health, Karlsruhe, Heidelberg, Germany
| | - Anant Vemuri
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian J. Wirkert
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Kirchner
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tim J. Adler
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany
| | - Christina Engels
- Urologische Klinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Dogu Teber
- Urologische Klinik, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Lena Maier-Hein
- Division of Computer Assisted Medical Interventions, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty, Heidelberg University, Heidelberg, Germany
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Adler TJ, Ardizzone L, Vemuri A, Ayala L, Gröhl J, Kirchner T, Wirkert S, Kruse J, Rother C, Köthe U, Maier-Hein L. Uncertainty-aware performance assessment of optical imaging modalities with invertible neural networks. Int J Comput Assist Radiol Surg 2019; 14:997-1007. [PMID: 30903566 DOI: 10.1007/s11548-019-01939-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Optical imaging is evolving as a key technique for advanced sensing in the operating room. Recent research has shown that machine learning algorithms can be used to address the inverse problem of converting pixel-wise multispectral reflectance measurements to underlying tissue parameters, such as oxygenation. Assessment of the specific hardware used in conjunction with such algorithms, however, has not properly addressed the possibility that the problem may be ill-posed. METHODS We present a novel approach to the assessment of optical imaging modalities, which is sensitive to the different types of uncertainties that may occur when inferring tissue parameters. Based on the concept of invertible neural networks, our framework goes beyond point estimates and maps each multispectral measurement to a full posterior probability distribution which is capable of representing ambiguity in the solution via multiple modes. Performance metrics for a hardware setup can then be computed from the characteristics of the posteriors. RESULTS Application of the assessment framework to the specific use case of camera selection for physiological parameter estimation yields the following insights: (1) estimation of tissue oxygenation from multispectral images is a well-posed problem, while (2) blood volume fraction may not be recovered without ambiguity. (3) In general, ambiguity may be reduced by increasing the number of spectral bands in the camera. CONCLUSION Our method could help to optimize optical camera design in an application-specific manner.
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Affiliation(s)
- Tim J Adler
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany. .,Faculty of Mathematics and Computer Science, Heidelberg University, Heidelberg, Germany.
| | | | - Anant Vemuri
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Leonardo Ayala
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Janek Gröhl
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany.,Medical Faculty, Heidelberg University, Heidelberg, Germany
| | - Thomas Kirchner
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany.,Faculty of Physics and Astronomy, Heidelberg University, Heidelberg, Germany
| | - Sebastian Wirkert
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
| | - Jakob Kruse
- Visual Learning Lab, Heidelberg University, Heidelberg, Germany
| | - Carsten Rother
- Visual Learning Lab, Heidelberg University, Heidelberg, Germany
| | - Ullrich Köthe
- Visual Learning Lab, Heidelberg University, Heidelberg, Germany
| | - Lena Maier-Hein
- Computer Assisted Medical Interventions, Deutsches Krebsforschungszentrum, Im Neuenheimer Feld 223, 69120, Heidelberg, Germany
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Alvarado JM, Tenemaza MA, Merchán SL, Argudo DE, Méndez MS, Soria ME, Galarza LR, Ayala L, Hernández HJ, Perea FP. 66 Bovine corpus luteum affects embryo developmental competence and production. Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This study was conducted with the aim to determine the effect of the bovine corpus luteum on in vitro embryo production. Immature cumulus-oocyte complexes (COC) were aspirated from abattoir ovaries from cows (mainly Holstein and dairy crossbred cows and heifers) with (ipsilateral; CL+) and without (contralateral; CL−) corpus luteum (CL), and from cows without CL in any of the ovaries. The average weight of the ovaries from each group was 10.4±0.25, 5.7±0.25, and 6.1±0.25g for CL+, CL−, and C, respectively. The experiment was completed within 12 replicates (100 ovaries per group). The COC were cultured in maturation medium (TCM-199 supplemented with 10% fetal bovine serum, 100µg mL−1 sodium pyruvate, 0.75mg mL−1 of L-glutamine, 4µg mL−1 of FSH-p, 100 µM cysteamine, and 250µg mL−1 of gentamicin) followed by IVF (synthetic oviducal fluid medium supplemented with 10µg mL−1 heparin) and in vitro culture (citrate synthetic oviducal fluid medium). On Day 7 after IVF, the embryos were evaluated and classified into morulae (M), early blastocysts (EB), regular blastocysts (RB), expanded blastocysts (ExB), and hatched blastocysts (HB), and the embryos with quality 1 (according to IETS criteria) were recorded. Data were analysed by logistic regression and general linear model of SAS (SAS Institute Inc., Cary, NC, USA), and means were compared by the least squares means method. Results of cleavage, embryo rate at Day 7, and rates of M+EB, RB, ExB, and HB are shown in Table 1. The number of embryos per ovary was greater (P<0.01) in CL+ (1.16±0.11) than in CL− (0.45±0.15) and C (0.55±0.15). Also, the number of embryos per cultured oocyte was significantly greater in CL+ than in CL− and C (0.27±0.02v. 0.14±0.03 and 0.15±0.03, respectively; P<0.01). The results of this study reveal that the presence of the corpus luteum in the ovary at the time of the oocyte recovery affects the developmental capacity of the bovine embryos, and such influence probably occur through intraovarian interactions.
Table 1.Effect of bovine corpus luteum on embryo production
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Martínez Y, Ayala L, Hurtado C, Más D, Rodríguez R. Effects of Dietary Supplementation with Red Algae Powder (Chondrus crispus) on Growth Performance, Carcass Traits, Lymphoid Organ Weights and Intestinal pH in Broilers. Braz J Poult Sci 2019. [DOI: 10.1590/1806-9061-2019-1015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - L Ayala
- Instituto de Ciencia Animal, Cuba
| | | | - D Más
- Universidad Autónoma de Querétaro, Mexico
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Ayala L, Ortiz M, Gelcich S. Exploring the role of fishers knowledge in assessing marine megafauna bycatch: insights from the Peruvian longline artisanal fishery. Anim Conserv 2018. [DOI: 10.1111/acv.12460] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- L. Ayala
- Programa de Doctorado en Ciencias Aplicadas Mención Sistemas Marinos Costeros Facultad de Recursos del Mar Universidad de Antofagasta Antofagasta Chile
- Asociación Peruana para la Conservación de la Naturaleza‐APECO Lima Perú
| | - M. Ortiz
- Instituto Antofagasta Instituto de Investigaciones Oceanológicas Facultad de Recursos del Mar Universidad de Antofagasta Antofagasta Chile
| | - S. Gelcich
- Center of Applied Ecology and Sustainability (CAPES) & Center for the Study of Multiple‐Drivers on Marine Socio‐Ecological Systems (MUSELS) Departamento de Ecologia Facultad de Ciencias Biológicas Pontificia Universidad Católica de Chile Santiago Chile
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Arteaga M, Ayala L, Nicolau J, Lladó B, Sanchis P, Blanco J, Romerosa J, Masmiquel L. Nutritional status and screening of depressive disorder among patients waiting for knee or hip arthroplasty. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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16
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Nicolau J, Simó R, Sanchís P, Ayala L, Fortuny R, Rivera R, Masmiquel L. Prevalence and Clinical Correlators of Undiagnosed Significant Depressive Symptoms Among Individuals with Type 2 Diabetes In A Mediterranean Population. Exp Clin Endocrinol Diabetes 2016; 124:630-636. [DOI: 10.1055/s-0042-109606] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- J. Nicolau
- Endocrinology and Nutrition Department, Hospital Son LLàtzer (Palma, Spain), University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa)
| | - R. Simó
- Diabetes Research Unit, Endocrinology Division, Hospital Universitari Vall d’Hebron, Universistat Autònoma de Barcelona (Barcelona, Spain)
| | - P. Sanchís
- Endocrinology and Nutrition Department, Hospital Son LLàtzer (Palma, Spain), University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa)
| | - L. Ayala
- Endocrinology and Nutrition Department, Hospital Son LLàtzer (Palma, Spain), University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa)
| | - R. Fortuny
- Hormonal Laboratory Department, Hospital Son Llàtzer (Palma, Spain)
| | - R. Rivera
- Endocrinology and Nutrition Department, Hospital Son LLàtzer (Palma, Spain), University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa)
| | - L. Masmiquel
- Endocrinology and Nutrition Department, Hospital Son LLàtzer (Palma, Spain), University Institute of Health Sciences Research (IUNICS) and Health Research Institute of Palma (IdISPa)
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Palanco S, Marino S, Gabás M, Ayala L, Ramos-Barrado JR. Tailored synthesis of nanostructures by laser irradiation of a precursor microdroplet stream in open-air. Nanoscale 2015; 7:492-499. [PMID: 25407984 DOI: 10.1039/c4nr04768k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A method to synthesize multicomponent nanostructures in open-air is presented. A microdroplet precursor target is irradiated with a nanosecond laser pulse to induce plasma. At low droplet dispensing rates, the precursor and solvent are fully atomized without debris to produce nanoparticles and nanofilaments during plasma cooling. More complex structures like nanolayers or nanofoams can be synthetised at kilohertz droplet dispensing rates as additional droplets in the vicinity of the target droplet are subjected to the laser-induced plasma and its associated shockwave. Examples of both low- and fast-rate mechanisms are presented for Mn-Fe bi-metal oxide nanoparticles and zinc oxide nanoparticles, nanofilaments and nanofoams. Real-time diagnostics were carried out with time-resolved imaging, atomic emission spectroscopy, light scattering and shadowgraphy. In addition to overcoming some of the difficulties associated with pulsed-laser deposition (PLD), the use of a liquid precursor whose composition can be tailored on a droplet-to-droplet basis opens a number of possibilities.
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Affiliation(s)
- S Palanco
- Universidad de Málaga, Andalucía Tech, Departamento de Física Aplicada I, The Nanotech Unit, Campus de Teatinos, s/n, 29071 Málaga, Spain.
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Poiré X, Black S, Ayala L, McBride P, McCall P, Steinhauer C, Garcia I, Kline J, Artz A, Odenike O, Larson R, Stock W, van Besien K. Can We Do Better In Management Of Neutropenic Fever In Hematological Patients? Biol Blood Marrow Transplant 2010. [DOI: 10.1016/j.bbmt.2009.12.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dickson-Gonzalez S, de Uribe ML, Ayala L, Zucker E, Rodriguez-Morales A. P260 Necrotizing hepatitis and acute cholecystitis associated to histoplasmosis. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70479-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Sarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. Sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. Spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia and bowel dysfunction. Magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed.
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Affiliation(s)
- L Ayala
- Department of Rehabilitation Medicine, University of Texas Health Science Center, San Antonio 78284-7798, USA
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Ayala L, van Ginkel M, Khairallah M, Keller B, Henry M. Expression of Thinopyrum intermedium-Derived Barley yellow dwarf virus Resistance in Elite Bread Wheat Backgrounds. Phytopathology 2001; 91:55-62. [PMID: 18944278 DOI: 10.1094/phyto.2001.91.1.55] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
ABSTRACT Resistance to Barley yellow dwarf virus (BYDV) is not found in wheat but is available in a Thinopyrum intermedium translocation (Ti) carried on chromosome 7DL of bread wheat recombinant lines. We used one of those lines (TC14/2*Spear) to introgress the Ti into bread wheat cultivars and to determine the influence of wheat backgrounds, with and without known tolerance to BYDV, on the expression of resistance. Two single and three backcross populations, segregating for the presence of the alien fragment, were tested under field conditions and artificial inoculation with BYDV isolates MAV-Mex and PAV-Mex. Lines containing the fragment were identified using the microsatellite marker gwm37. Tillering, biomass, grain yield, thousand-kernel weight, and seed quality were evaluated in inoculated and noninoculated plots. Resistance was assessed by enzyme-linked immunosorbent assay. In early generations, the alien fragment followed expected Mendelian segregation, whereas in the advanced ones a slight bias against its transmission was observed. No positive nor negative effects of Ti on agronomic performance and quality were found. A significant optical density reduction in individuals carrying the fragment was observed after PAV infection in crosses with lines Anza and Baviacora but not with Milan. In addition, the fragment was associated with a lower frequency of infected plants for both PAV and MAV isolates. The reduced yield loss associated with the presence of the translocation was due largely to the lower infection rate.
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Mohr R, Martinowitz U, Golan M, Ayala L, Goor DA, Ramot B. Platelet size and mass as an indicator for platelet transfusion after cardiopulmonary bypass. Circulation 1986; 74:III153-8. [PMID: 3769188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Platelet count, mean platelet volume (MPV), and plateletcrit (PCT) were studied in 51 patients after cardiopulmonary bypass (CPB). MPV was significantly lower in 10 patients who developed postoperative bleeding (bleeders) compared to 41 with no significant bleeding (nonbleeders) (7.7 +/- 0.86 vs 8.5 +/- 1.2 fl, p less than .05). Postoperative platelet count was significantly lower in the group of bleeders (93.3 +/- 22.4 vs 127.5 +/- 43 X 10(9)/liters, p less than .02). A cutoff point of MPV or platelet count that would include bleeders and exclude nonbleeders could not be found due to the large overlap between the two groups. However, such a cutoff point does exist for PCT (PCT = total platelet mass). PCT was significantly lower among the bleeders (0.072 +/- 0.02% vs 0.108 +/- 0.036%, p less than .05) and a cutoff point of PCT less than 0.1% included all the bleeders and excluded 65% of nonbleeders. The low PCT and bleeding tendency can be corrected by platelets transfusion. In 15 patients (eight bleeders and seven nonbleeders) with low postoperative PCT (0.078 +/- 0.014), transfusion of 10 platelet units increased platelet count from 101 +/- 32 to 169 +/- 22 X 10(9)/liter, increased PCT to 0.128 +/- 0.2%, and stopped bleeding in all bleeders. A finding of PCT less than 0.1% after CPB is a clear indication for platelet transfusion in patients who develop post-CPB bleeding. This supports the observation that large platelets are more active than smaller ones, and that PCT, rather than PLT counts, predicts the risk of bleeding in patients with thrombocytopenia.
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Celestino A, Castillo T, Ayala L. Colonoscopy in colon diseases. Am J Proctol Gastroenterol Colon Rectal Surg 1982; 33:18-22, 24. [PMID: 7114208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Fernández JA, Rosales TC, Naupari MO, Ayala L, Caller A, Del Aguila RP. [South American blastomycosis. Diagnosis by colonoscopy]. Arq Gastroenterol 1979; 16:24-9. [PMID: 475611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Two cases of South American Blastomycosis are presented; the disease is not frequent in our country; the cases are a segmentary and difuse type primitive localized in the colon. In both of them the colonoscopy was a very important aid in the diagnosis.
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Foradori A, Lira P, Ayala L, Garayar B, Grebe G. [An experimental model of nutritional iron deficiency anemia (author's transl)]. Rev Med Chil 1978; 106:339-42. [PMID: 684301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Espejo H, Ayala L, Osorio M. [Duodenitis]. G E N 1976; 30:265-72. [PMID: 829868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Castillo TS, Ayala L. [Gastroesophageal reflux. Study with Helderberg's telemetric capsule]. G E N 1975; 30:31-6. [PMID: 829077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Thirty patients in which there was a clinical suspicion of esophagitis reflux were studied. After radiological and endoscopic study, the gastroesophageal reflux was determined by means the Heidelberg telemetric capsule, for this purpose HCl 0.1N was used and changes in the gastroesophageal pH were registered in the Trendelenburg position. The results were correlated with the radiological and endoscopic findings.
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García-Tamayo F, Ayala L, Kumate J. [The nitroblue tetrazolium test in liver amebiasis in children]. Bol Med Hosp Infant Mex 1974; 31:683-90. [PMID: 4138935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Ayala L, Carleo C. [Trials of an association of corticoids in dermatology]. G Ital Dermatol Minerva Dermatol 1971; 46:220-3. [PMID: 5109149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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31
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Ayala L. [Rifampicin in dermatology and venereology]. G Ital Dermatol Minerva Dermatol 1969; 44:665-72. [PMID: 5395529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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32
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Ayala L, Chaud A. [Intraluminal pressure in achalasia]. Rev Esp Enferm Apar Dig 1969; 28:637-46. [PMID: 5344669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Ayala L. [On an unusual parasitic dermatosis due to Sclerodermus brevicornis]. Minerva Dermatol 1967; 42:593-7. [PMID: 5622833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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