Commercial α1-antitrypsin preparations markedly differ in their potential to inhibit the ATP-induced release of monocytic interleukin-1β

The acute phase protein α1-antitrypsin (AAT) inhibits numerous proteases, specifically neutrophil elastase. Patients with an AAT deficiency due to mutations frequently develop early onset emphysema. The commercial preparations of human plasma AAT are clinically used as biopharmaceuticals to protect the lung tissue of AAT-deficient patients from damage caused by neutrophil elastase. Accordingly, preparations of AAT are validated for their anti-elastase activity. However, several anti-inflammatory effects of AAT were described, some of them being independent from its anti-protease function. We recently demonstrated that AAT isolated from the blood of healthy persons efficiently inhibits the ATP-induced release of interleukin-1β by human monocytes. This finding is of therapeutic relevance, because IL-1β plays an important role in numerous debilitating and life-threatening inflammatory diseases. As anti-inflammatory functions of AAT are of increasing clinical interest, we compared the potential of two widely used AAT preparations, Prolastin® and Respreeza®, to inhibit the ATP-induced release of IL-1β using human monocytic U937 cells. We detected marked functional differences between both medicaments. The AAT preparation Respreeza® is less active compared to Prolastin® regarding the inhibition of the ATP-induced release of monocytic IL-1β. Chemical oxidation of Respreeza® restored this anti-inflammatory activity, while destroying its anti-protease function. Our data suggest that the anti-inflammatory potential and the anti-protease function of AAT can be fully uncoupled. In the light of the increasing clinical interest in anti-inflammatory functions of AAT, commercial AAT preparations should be carefully reinvestigated and optimized to preserve the dual anti-protease and anti-inflammatory activity of native AAT.

A deep learning approach to generate contrast-enhanced computerised tomography angiograms without the use of intravenous contrast agents

Introduction

Contrast-enhanced computerised tomographic (CT) angiograms are widely used in cardiovascular imaging to obtain a non-invasive view of arterial structures. In aortic aneurysmal disease (AAA), CT angiograms are required prior to surgical intervention to differentiate between blood and the intra-luminal thrombus, which is present in 95% of cases. However, contrast agents are associated with complications at the injection site as well as renal toxicity leading to contrast-induced nephropathy (CIN) and renal failure.

Purpose

We hypothesised that the raw data acquired from a non-contrast CT contains sufficient information to differentiate blood and other soft tissue components. Therefore, we utilised deep learning methods to define the subtleties between the various components of soft tissue in order to simulate contrast enhanced CT images without the need of contrast agents.

Methods

Twenty-six AAA patients with paired non-contrast and contrast-enhanced CT images were randomly selected from an ethically approved ongoing study (Ethics Ref 13/SC/0250) and used for model training and evaluation (13/13). Non-contrast axial slices within the aneurysmal region from 10 patients (n=100) were sampled for the underlying Hounsfield unit (HU) distribution at the lumen, intra-luminal thrombus and interface locations, identified from their paired contrast axial slices. Subsequently, paired axial slices within the training cohort were augmented in a ratio of 10:1 to produce a total of 23,551 2-D images. We trained a 2-D Cycle Generative Adversarial Network (cycleGAN) for this non-contrast to contrast transformation task. Model output was assessed by comparison to the contrast image, which serves as a gold standard, using image similarity metrics (ex. SSIM Index).

Results

Sampling HUs within the non-contrast CT scan across multiple axial slices (Figure 1A) revealed significant differences between the blood flow lumen (yellow), blood/thrombus interface (red), and thrombus (blue) regions (p<0.001 for all comparisons). This highlighted the intrinsic differences between the regions and established the foundation for subsequent deep learning methods. The Non-Contrast-to-Contrast (NC2C)-cycleGAN was trained with a learning rate of 0.0002 for 200 epochs on 256 x 256 images centred around the aorta. Figure 1B depicts “contrast-enhanced” images generated from non-contrast CT images across the aortic length from the testing cohort. This preliminary model is able to differentiate between the lumen and intra-luminal thrombus of aneurysmal sections with reasonable resemblance to the ground truth.

Conclusion

This study describes, for the first time, the ability to differentiate between visually incoherent soft tissue regions in non-contrast CT images using deep learning methods. Ultimately, refinement of this methodology may negate the use of intravenous contrast and prevent related complications.

CTA Generation from Non-Contrast CTs

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Clarendon

Sensitivity analysis of a strongly-coupled human-based electromechanical cardiac model: Effect of mechanical parameters on physiologically relevant biomarkers

The human heart beats as a result of multiscale nonlinear dynamics coupling subcellular to whole organ processes, achieving electrophysiologically-driven mechanical contraction. Computational cardiac modelling and simulation have achieved a great degree of maturity, both in terms of mathematical models of underlying biophysical processes and the development of simulation software. In this study, we present the detailed description of a human-based physiologically-based, and fully-coupled ventricular electromechanical modelling and simulation framework, and a sensitivity analysis focused on its mechanical properties. The biophysical detail of the model, from ionic to whole-organ, is crucial to enable future simulations of disease and drug action. Key novelties include the coupling of state-of-the-art human-based electrophysiology membrane kinetics, excitation-contraction and active contraction models, and the incorporation of a pre-stress model to allow for pre-stressing and pre-loading the ventricles in a dynamical regime. Through high performance computing simulations, we demonstrate that 50% to 200% - 1000% variations in key parameters result in changes in clinically-relevant mechanical biomarkers ranging from diseased to healthy values in clinical studies. Furthermore mechanical biomarkers are primarily affected by only one or two parameters. Specifically, ejection fraction is dominated by the scaling parameter of the active tension model and its scaling parameter in the normal direction ( k ort 2 ); the end systolic pressure is dominated by the pressure at which the ejection phase is triggered ( P ej ) and the compliance of the Windkessel fluid model ( C ); and the longitudinal fractional shortening is dominated by the fibre angle ( ϕ ) and k ort 2 . The wall thickening does not seem to be clearly dominated by any of the considered input parameters. In summary, this study presents in detail the description and implementation of a human-based coupled electromechanical modelling and simulation framework, and a high performance computing study on the sensitivity of mechanical biomarkers to key model parameters. The tools and knowledge generated enable future investigations into disease and drug action on human ventricles.

Does heart surgery change the capacity of α1-antitrypsin to inhibit the ATP-induced release of monocytic interleukin-1β? A preliminary study

Heart surgery involving cardiopulmonary bypass induces systemic inflammation that is, at least in part, caused by extracellular ATP originating from damaged cells and by proteases secreted by activated neutrophils. The anti-protease α1-antitrypsin (AAT) forms complexes with several proteases including neutrophil elastase, resulting in a mutual loss of activity. We demonstrated recently that AAT inhibits the ATP-induced release of the pro-inflammatory cytokine interleukin-1β by human monocytes by a mechanism involving activation of metabotropic functions at nicotinic acetylcholine receptors. Interleukin-1β importantly contributes to the pathogenesis of sterile inflammatory response syndrome. Thus, AAT might function as an endogenous safeguard against life-threatening systemic inflammation. In this preliminary study, we test the hypothesis that during cardiopulmonary bypass, AAT is inactivated as an anti- protease and as an inhibitor of ATP-induced interleukin-1β release. AAT was affinity-purified from the blood plasma of patients before, during and after surgery. Lipopolysaccharide-primed human monocytic U937 cells were stimulated with ATP in the presence or absence of patient AAT to test for its inhibitory effect on interleukin-1β release. Anti-protease activity was investigated via complex formation with neutrophil elastase. The capacity of patient AAT to inhibit the ATP-induced release of interleukin-1β might be slightly reduced in response to heart surgery and complex formation of patient AAT with neutrophil elastase was unimpaired. We conclude that surgery involving cardiopulmonary bypass does not markedly reduce the anti-inflammatory and the anti-protease activity of AAT. The question if AAT augmentation therapy during heart surgery is suited to attenuate postoperative inflammation warrants further studies in vivo.

Phosphocholine - an agonist of metabotropic but not of ionotropic functions of α9-containing nicotinic acetylcholine receptors

We demonstrated previously that phosphocholine and phosphocholine-modified macromolecules efficiently inhibit ATP-dependent release of interleukin-1β from human and murine monocytes by a mechanism involving nicotinic acetylcholine receptors (nAChR). Interleukin-1β is a potent pro-inflammatory cytokine of innate immunity that plays pivotal roles in host defence. Control of interleukin-1β release is vital as excessively high systemic levels cause life threatening inflammatory diseases. In spite of its structural similarity to acetylcholine, there are no other reports on interactions of phosphocholine with nAChR. In this study, we demonstrate that phosphocholine inhibits ion-channel function of ATP receptor P2X7 in monocytic cells via nAChR containing α9 and α10 subunits. In stark contrast to choline, phosphocholine does not evoke ion current responses in Xenopus laevis oocytes, which heterologously express functional homomeric nAChR composed of α9 subunits or heteromeric receptors containing α9 and α10 subunits. Preincubation of these oocytes with phosphocholine, however, attenuated choline-induced ion current changes, suggesting that phosphocholine may act as a silent agonist. We conclude that phophocholine activates immuno-modulatory nAChR expressed by monocytes but does not stimulate canonical ionotropic receptor functions.

Intravenous immunoglobulin in necrotizing fasciitis - A case report and review of recent literature

Introduction

Necrotizing fasciitis (NF) is an inflammatory disease of the soft tissue, which causes local tissue destruction and can lead to lethal septic shock. The therapy consists of early surgical treatment of the septic focus and an accompanying broad spectrum antibiotic therapy. Recent literature considers the additional use of immunoglobulin therapy in severe soft skin and tissue infections.

Presentation of case

In this report, we describe the case of a 33-year-old male patient treated at a university hospital intensive care unit because of an NF of his left leg. The patient rapidly developed a complicated septic disease after a minor superficial trauma. Despite intense microbiological diagnosis, no causative pathogens were identified. After non-responding to established broad anti-infective treatment, the patient received intravenous immunoglobulin, that rapidly improved his clinical condition.

Discussion

NF represents a disease processes, which is characterized by fulminant, widespread necrosis of soft tissue, systemic toxicity, and high mortality (>30%). Beside the surgical debridement and broad spectrum antibiotic therapy IVIg therapy might be an additional option in the treatment of NF. But the current literature supporting the use of IVIG in NF is largely based on retrospective or case-controlled studies, and only small randomized trials.

Conclusion

The demonstrated case suggests that IVIg treatment of patients with NF can be considered in case of hemodynamic unstable, critically ill patients. Although randomized controlled trials are missing, some patients might benefit from diminishing hyperinflammation by immunoglobins.

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Necrotizing fasciitis (NF) is an inflammatory disease, which causes local tissue destruction up to lethal septic shock.

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We describe the case of a 33-year-old male patient representing an NF of his left leg.

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After non-responding to established broad anti-infective treatment, the patient received immunoglobulin (IVIg).

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The presented case suggests that IVIg treatment of patients with NF might be considered in case of critically ill patients.

Proliferation of CD8-positive T cells in blood vessels of rat renal allografts

It is still disputed in which anatomical compartments of allograft recipients T-cells proliferate. After experimental renal transplantation, host monocytes and lymphocytes accumulate in the lumina of graft blood vessels. In this study, we test the hypothesis that T lymphocytes proliferate in the vascular bed of the graft. Kidneys were transplanted in the Dark Agouti to Lewis rat strain combination, an established experimental model for acute rejection. Isogeneic transplantation was performed as a control. Cells in the S-phase of mitosis were detected in situ three days posttransplantation by pulse-labeling with BrdU and by immunohistochemical detection of the proliferating cell nuclear antigen (PCNA). More than 20% of all T-cells in the lumina of allograft blood vessels incorporated BrdU and approximately 30% of them expressed PCNA. In the blood vessels of isografts as well as in other organs of allograft recipients, only few BrdU(+) cells were detected. A majority of the BrdU(+) cells in graft blood vessels expressed CD8. In conclusion, we demonstrate that CD8(+) T lymphocytes proliferate in the lumina of the blood vessels of renal allografts during the onset of acute rejection.

Integrated approach for the study of anatomical variability in the cardiac Purkinje system: from high resolution MRI to electrophysiology simulation

The ordered electrical stimulation of the ventricles is achieved by a specialized network of fibres known as the Purkinje system. The gross anatomy and basic functional role of the Purkinje system is well understood. However, very little is known about the detailed anatomy of the Purkinje system, its inter-individual variability and the implications of the variability in ventricular function, in part due to limitations in experimental techniques. In this study, we aim to provide new insight into the inter-individual variability of the free running Purkinje system anatomy and its impact on ventricular electrophysiological function. As a first step towards achieving this aim, high resolution magnetic resonance imaging (MRI) datasets of rat and the rabbit ventricles are obtained and analysed using a novel semi-automatic image processing algorithm for segmentation of the free-running Purkinje system. Segmented geometry from the MRI datasets is used to construct a computational model of the Purkinje system, which is incorporated in to an anatomically-based ventricular geometry to simulate ventricular electrophysiological activity.

Extratumoral spiral fixed wire marking of small pulmonary nodules for thoracoscopic resection

BACKGROUND

Video-assisted thoracoscopic surgery (VATS) for pulmonary nodules close to the visceral pleura is an established procedure. Different methods have been developed to mark these nodules when resecting small nodules distant to the pleural surface. The possibility of tumor cell spread due to nodule penetration is a major drawback. Furthermore, guide wire-based marking systems have revealed the problem of accidental wire dislocation prior to resection.

METHODS

In this study, a new marker system for computed tomography-guided extranodular spiral fixed wire marking (ESFWM) was evaluated in an attempt to maintain tumor integrity while reducing the risk of wire dislocation.

RESULTS

Our study included 42 patients with 44 marked nodules. 40 nodules were resected by VATS in 38 of these patients. The remaining 4 patients required conversion to thoracotomy due to adhesions and a non-deflated lung. Wire dislocation and nodule penetration occurred only once.

CONCLUSION

The new lung marker system revealed a very low risk of wire dislocation. Peritumoral marking allows the safe resection of subpleural nodules without a risk of tumor cell spread.

Keratinocyte growth factor prevents intra-alveolar oedema in experimental lung isografts

Primary graft dysfunction, characterised by intra-alveolar oedema, is a major obstacle in pulmonary transplantation. The present study evaluates the potential of keratinocyte growth factor (palmiferin; DeltaN23-KGF) for the prevention of oedema in lung transplants. Intratracheal instillation of 5 mg x kg(-1) DeltaN23-KGF was performed in Lewis rats on days 3 and 2 before explantation. Control animals obtained an equivalent volume of vehicle. Left lungs were isogeneically transplanted and the graft recipients were sacrificed 1 day later for stereological analysis of intra-alveolar oedema and bronchoalveolar lavage. The total protein and phospholipid content, as well as surfactant proteins, were measured. Surfactant activity was analysed with a pulsating bubble surfactometer. In grafts from control treated donors, the fraction of intra-alveolar oedema amounted to 3.4+/-1.1% of the total parenchymal volume. Treatment of donor lungs with DeltaN23-KGF reduced oedema to a fraction of 1.6+/-0.8%. In the lavage fluid of pulmonary grafts from DeltaN23-KGF-treated donors, the total protein content was decreased compared with vehicle-treated lung transplants, whereas phospholipids did not differ. The protein fraction contained increased amounts of surfactant protein-C after DeltaN23-KGF treatment and surfactant function was improved. Treatment of donor lungs with palifermin protects against intra-alveolar oedema formation upon transplantation. This effect appears to be mediated by an improved surfactant homeostasis.

Lung Transplantation in the Fischer 344→Wistar Kyoto Rat Strain Combination is Not Suitable to Study Bronchiolitis Obliterans

BACKGROUND

To elucidate the pathogenesis of bronchiolitis obliterans (BO) a reliable animal model is needed. According to the literature, lung transplantation from Fischer 344 (F344) to Wistar Kyoto (WKY) rats is the only model that reliably results in BO without a further stimulus.

METHODS

We performed orthotopic left lung transplantation in F344 to WKY rats and in both isogeneic rat strain combinations. Suture and cuff techniques for anastomosis were compared. The time course of rejection and the morphology of the bronchial anastomoses were documented by repeated flat-panel volumetric computed tomography (fpVCT) in the living animal. Graft histopathology was analyzed 3 months post-transplant.

RESULTS

According to the graft outcome, as revealed by fpVCT, grafts were sub-divided into two groups: In Group 1, infiltrates due to acute rejection occurred early after transplantation and resolved thereafter. Graft histopathology showed minor changes but no BO. In Group 2, acute rejection caused total atelectasis that never resolved. After 3 months, grafts were shrunken and exhibited tissue remodeling with some similarities to BO. No correlation between graft outcome and anastomotic technique was apparent.

CONCLUSIONS

Modeling lung transplantation using the F344-to-WKY combination is without clinical relevance because BO does not develop in grafts with life-sustaining function. Consecutive fpVCT is useful to monitor pathologic changes in rat pulmonary grafts.

Improved watershed transform for medical image segmentation using prior information

The watershed transform has interesting properties that make it useful for many different image segmentation applications: it is simple and intuitive, can be parallelized, and always produces a complete division of the image. However, when applied to medical image analysis, it has important drawbacks (oversegmentation, sensitivity to noise, poor detection of thin or low signal to noise ratio structures). We present an improvement to the watershed transform that enables the introduction of prior information in its calculation. We propose to introduce this information via the use of a previous probability calculation. Furthermore, we introduce a method to combine the watershed transform and atlas registration, through the use of markers. We have applied our new algorithm to two challenging applications: knee cartilage and gray matter/white matter segmentation in MR images. Numerical validation of the results is provided, demonstrating the strength of the algorithm for medical image segmentation.

Effective mass of two-dimensional 3He

We use structural information from diffusion Monte Carlo calculations for two-dimensional 3He to calculate the effective mass. Static effective interactions are constructed from the density and spin-structure functions using sum rules. We find that both spin and density fluctuations contribute about equally to the effective mass. Our results show, in agreement with recent experiments, a flattening of the single-particle self-energy with increasing density, which eventually leads to a divergent effective mass.

GeRTiSS: Generic Real Time Surgery Simulation

Minimally invasive surgery is a technique that permits interventions through very small incisions. This minimises the patients' trauma and permits a faster recovery in comparison with classical surgery. The disadvantage of this surgery technique, though, is its complexity, requiring a high training effort of the surgeon. In this paper, we present a general surgery simulator for training surgeons in minimally invasive surgery. The application allows to create environments and interaction modes very similar to those encountered in real surgical interventions. The virtual environments are optionally composed of an actual patient's organs the intervention on which one desires to practice in a beforehand manner, or of synthetically generated organs with arbitrary pathologies. The intervention is carried out by means of haptic interfaces with force feedback, providing the surgeon with a sense of touch, a fundamental element of all types of surgery.

Zero-temperature equation of state of two-dimensional 3He

The equation of state of two-dimensional 3He at zero temperature has been calculated using the diffusion Monte Carlo method. By means of a combination of the fixed-node and released-node techniques, it is shown that backflow correlations provide a very accurate equation of state. The results prove unambiguously the non-self-bound character of two-dimensional 3He due to its Fermi statistics. We present solid evidence that the gas phase, predicted for the two-dimensional system, can be extrapolated to the case of 3He adsorbed on a strong substrate such as graphite.

Monocytes in the rat: phenotype and function during acute allograft rejection

Cells of the monocyte/macrophage system originate from the bone marrow, reach the organs via the blood, immigrate through postcapillary venules and further differentiate into organ-specific tissue macrophages. In rats and other species, activated monocytes/macrophages aggravate autoimmune reactions, rejection of non-vascularized allografts and chronic allograft rejection. It is very likely that they also contribute to acute allograft destruction. So far it has been impossible to distinguish the function of monocytes from that of macrophages, because cell phenotypes and their alterations upon activation are ill-defined. We have thus begun to characterize the ex vivo phenotype and function of rat monocytes in the normal state and during renal allograft rejection. Monocytes are recovered from both the central and the marginal blood pool by perfusing either the recipient's circulation or the allograft vasculature. Rat monocytes have a unique surface phenotype. During allograft rejection or after infusion of interferon-gamma they up-regulate class II MHC molecules, CD161 (NKR-P1A), CD62L and CD8, while CD4 and CD43 are down-modulated. Activated perfusate monocytes exert increased in vitro cytotoxicity against tumour targets, which differs from that of NK cells. We speculate that activated monocytes contribute to kidney allograft destruction by directly damaging endothelial cells or by promoting intravascular coagulation.

Automatic localization of cephalometric Landmarks

A system for automatic detection of cephalometric landmarks is presented. Landmark detection is carried out in two steps: a line detection module searches for significant, well-contrasted lines of the image, such as the jaw line or the nasal spine. The landmark detection module uses the lines located in the first module to determine the search areas and then applies a pattern detection algorithm, based on mathematical morphology techniques. Relations between landmarks and lines are determined by means of a training process. The system has been tested for the detection of 17 landmarks on 20 images: more than 90% of the landmarks are accurately identified.

Accumulating monocytes in the vasculature of rat renal allografts: phenotype, cytokine, inducible no synthase, and tissue factor mRNA expression

BACKGROUND

Necrotic patches and hemorrhagic lesions develop in the renal tissue between day 4 and day 5 after transplantation of fully allogeneic DA rat kidneys to LEW recipients. These lesions are at least in part due to destruction and obstruction of blood vessels. Damage of graft endothelial cells and blood coagulation are likely to be mediated by intravascular graft leukocytes. However, this cell population has not been thoroughly characterized before.

METHODS

We perfused untreated control kidneys, renal isografts, and allografts on day 4 after transplantation with phosphate-buffered saline/ethylenediaminetetraacetic acid to harvest leukocytes from both the blood stream as well as from the marginal intravascular pool. The mRNA expression of typical products of activated monocytes was analyzed in reverse-transcriptase polymerase chain reaction experiments. Graft monocytes were purified and their immunophenotype was investigated by flow cytometry.

RESULTS

Allograft rejection led to a 10-fold increase in the number of intravascular graft leukocytes compared to isografts. A mean number of about 100x10(6) leukocytes was harvested from a single allogeneic kidney, about 73% of these cells were monocytes and most of them displayed an activated phenotype. Compared to isografts, intravascular allograft leukocytes displayed an increased expression of tumor necrosis factor-alpha, inducible NO synthase and tissue factor.

CONCLUSIONS

Our study shows that large numbers of activated monocytes accumulate inside allograft vessels. As they express genes the products of which might damage the allograft by inducing cell death or thrombosis, we speculate that they directly participate in allograft destruction.

Interactive image-guided surgery system with high-performance computing capabilities on low-cost workstations: a prototype

We present a new frameless stereotatic system prototype that has been initially validated in functional neurosurgery operations and that makes use of an optical position tracker for image-guided neurosurgery. Several devices for tracking different surgical instruments have been designed and manufactured. These devices include an array of infrared light-emitting diodes that are tracked by three charge-coupled device cameras. The system presents several new approaches for surgery planning. For high-quality 3D images of the patient's anatomy, we have developed a parallel version of a volume-rendering algorithm, thus enabling real-time 3D anatomy manipulation on low-cost PC workstations. In order to test the accuracy of the system, the localization of the target by means of a stereotatic frame has been compared with frameless techniques, obtaining a difference of about 1 +/- 1 mm.

Monocytes in the rat

We review our methods for definition and phenotypical characterisation of normal and activated rat monocytes. To obtain a comprehensive sample of all blood monocytes including cells from the marginal pool of the blood stream, we extensively perfuse the extrapulmonary circulation with cold PBS/EDTA. Normal rat monocytes are isolated from untreated specified pathogen-free male LEW rats. In vivo activated monocytes are investigated after three days of infusion of recombinant IFN-gamma or during acute renal allograft rejection. Rat monocytes are defined by reactivity with mAbs ED1 and ED9, detecting a lysosomal membrane antigen and a member of the signal-regulatory protein family, respectively, as well as by expression of CD11b. Concomitantly rat monocytes are characterized by the absence of CD5, the absence of the B cell form of CD45R, and the absence of reactivity with mAb RP-1. The majority of the monocytes from untreated LEW rats are CD4+, CD11a(high), CD18high, CD43high, CD62-L-, CD161-, and MHC class II-. Upon stimulation of the immune system in vivo, a second monocyte population increases in number. These cells have a larger diameter and an increased granularity. They are CD4-, CD11a(int), CD18int, CD43low, CD62-L+, CD161int, and MHC class II+. Although some reagents are not yet available (e.g. antibodies against rat CD14 and CD16), rat monocytes can be defined and their state of activation can be characterized. The functionally important population of monocytes, which have already marginated, is accessible by perfusion and relatively high monocyte numbers are isolated per rat. As specified pathogen-free rats are available and numerous experimental systems involving acute or chronic inflammation have been established in rats, differentially activated monocytes may be investigated. The rat is thus a suitable experimental animal for basic research on monocytes.

Chemokine expression during acute rejection of rat kidneys

During acute rejection of fully allogeneic rat renal allografts, few neutrophil granulocytes are detected, whereas an abundant infiltrate of macrophages and T lymphocytes becomes apparent. The mechanisms leading to this specific pattern of infiltration are not understood. We performed a sequential daily Northern blot analysis of the mRNA expression of the CC-chemokines MCP-1, MIP-1alpha and RANTES and of the CXC-chemokines GRO/KC and MIP-2 in rat renal isografts (LEW --> LEW, n = 1 per day) and allografts during acute rejection (DA --> LEW, n = 3 per day). MCP-1 gene expression strongly increased on days 3-4 after allotransplantation and returned to control levels on day 6. The expression of MIP-1alpha and RANTES continuously rose until day 3-4 and remained stable thereafter. Isografts displayed minor changes in CC-chemokine expression. In contrast to CC-chemokines, GRO/KC was expressed in low amounts during rejection and MIP-2 mRNA remained undetectable. In conclusion, the expression of the CC-chemokines MCP-1, MIP-1 and RANTES was clearly upregulated during rejection, whereas the mRNA of the CXC-chemokines MIP-2 and GRO/KC was not detected at all or remained at low levels. This pattern of chemokine gene expression is in good accordance with the predominant mononuclear leukocyte infiltrate in allografts.

Multiresolution segmentation of three-dimensional medical images using mathematical morphology techniques

A semi-automatic method for three-dimensional segmentation of medical images is proposed. A multiresolution representation is achieved through the application of morphological filters, which assures causality for image extrema. This allows for a compact scale space representation, in which each extremum is assigned a scale value. Interactive selection of the interesting extrema of the image is carried out, aided by this scale information and other relevant features. Extrema selected are then used as markers in three-dimensional watersheds calculation. The system has been developed and tested under low cost platforms, and can be the base for totally automatic, knowledge based segmentation systems.

A new efficient method for 3D registration using human brain atlases

In this article a new efficient method in deformable brain atlases is proposed. To achieve this goal we use the composition of two applications, an affine transformation and other one. In this second application we have used three different approaches. One approach that has been used and two new approaches. We use a set of points to be identified both in brain atlas and in patient's brain for registration. The three approach present an advantage: the mathematical solution obtained makes it to be very fast, almost immediate. Several results have been obtained and they have been classified as very satisfactory by the neurosurgeons that have tested our system.

A system for the simulation and planning of orthodontic treatment using a low cost 3D laser scanner for dental anatomy capturing

The detection and correction of malocclusions and other dental abnormalities is a significant area of work in orthodontic diagnosis. To assess the quality of occlusion between the teeth the orthodontist has to estimate distances between specific points located on the teeth of both arches. Distance measuring is based on the observation, by the orthodontist, of a plaster model of the mouth. Gathering of information required to make the diagnosis is a time consuming and costly operation. On the other hand, obtaining and manipulation of plaster casts constitute a huge problem in clinics, due to both the large space needed and high costs associated with plaster casts manufacturing. For this problem we present a new system for three-dimensional orthodontic treatment planning and movement of teeth. We describe a computer vision technique for the acquisition and processing of three-dimensional images of the profile of hydrocolloids dental imprints taken by mean of a own developed 3D laser scanner. Profile measurement is based on the triangulation method which detects deformation of the projection of a laser line on the dental imprints. The system is computer-controlled and designed to achieve depth and lateral resolutions of 0.1 mm and 0.2 mm, respectively, within a depth range of 40 mm. The developed diagnosis software system (named MAGALLANES) and the 3D laser scanner (named 3DENT) are both commercially available and have been designed to replace manual measurement methods, which use costly plaster models, with computer measurements methods and teeth movement simulation using cheap hydrocolloid dental wafers. This procedure will reduce the cost and acquisition time of orthodontic data and facilitate the conduct of epidemiological studies.

Computer-aided periodontal disease diagnosis using computer vision

Periodontal diseases are the major cause of tooth loss. The study of the evolution of these diseases is crucial to achieve adequate planning and treatment. Depth probing is essential to know the periodontal disease stage. In this paper we present a new system for Computer-Aided Periodontal Disease Diagnosis using computer vision. The system automates the depth probing and incorporates a colour camera fitted together with a plastic probe that automatically and exactly obtains the depth probing measure. The system has been tested by several periodontists and with 125 teeth of different patients. The differences between the values taken by the system and two periodontists have not been significant.

De novo expression of MHC class II molecules by microglial cells during acute rat renal allograft rejection

The expression of MHC class I and class II molecules in the cerebral cortex of rats was investigated at daily intervals from day 3 to day 6 after fully allogeneic (DA-->LEW) and isogeneic (LEW-->LEW) kidney transplantation. MHC class II molecules were temporarily induced on the previously negative microglial cells and on the endothelia of arterioles and venules during acute rejection. On the endothelia of all brain vessels MHC class I expression was enhanced. MHC class I+ cells with microglial cell morphology were discernible within the diffusely MHC class I+ brain parenchyma. In contrast, the brain parenchyma of isograft recipients and untreated control animals did not express detectable levels of MHC molecules. In conclusion, we demonstrate that a strong immune reaction in the periphery is able to activate microglial cells in the central nervous system.