No description available.

Bakgrund: Venduplex har på senare år vuxit fram som den mest använda metoden vid diagnostik av venös insufficiens eftersom det är en ofarlig, kostnadseffektiv, non-invasiv metod med hög sensitivitet och specificitet där både den anatomiska placeringen av insufficiensen samt den funktionella förändringen av venen kan påvisas direkt vid undersökningen. Olika manövrar kan genomföras för att påfresta venklaffarna och därmed framkalla en eventuell reflux, men det är oklart om de olika manövrerna kan påverka den reflux som provoceras fram och därmed också påverkar bedömningen av insufficiensgraden. Syfte: Syftet med studien var att undersöka om det förelåg skillnad i graderingen av insufficiensen samt om den maximala refluxhastigheten påverkades beroende på vilken manöver som användes för att framkalla en reflux. Metod: 20 v. saphena magna mitt på låret med påvisad reflux deltog i studien. Två upprepade mätningar genomfördes där venklaffarna provocerades med hjälp av en blodtrycksmanschett över vaden, med en manuell kompression över låret samt med en manuell kompression över vaden. Resultat: Den maximala refluxhastigheten blev 0,33±0,20m/s när en blodtrycksmanschett över vaden användes, 0,31±0,22m/s när en manuell handkompression över vaden användes samt 0,17±0,16m/s när en manuell lårkompression genomfördes. Slutsats: Ingen signifikant skillnad på maximal refluxhastighet kunde konstateras när en automatisk uppblåsbar blodtrycksmanschett över vaden jämfördes med en manuell handkompression över vaden. En signifikant högre maximal refluxhastighet konstaterades när en manuell vadkompression jämfördes med en manuell lårkompression.

The plant leaf is one of the most challenging natural objects to be realistically depicted by computer graphics due to its complex morphological and optical characteristics. Although many studies have been done on plant modeling, previous research on leaf modeling required for close-up realistic plant images is very rare. In this thesis, a novel method for modeling of the leaf shape based on the leaf venation is presented. As the first step of the method, the leaf domain is defined by the enclosure of the leaf boundary. Second, the leaf venation is interactively modeled as a hierarchical skeleton based on the actual leaf image. Third, the leaf domain is triangulated with the skeleton as constraints. The skeleton is articulated with nodes on the skeleton. Fourth, the skeleton is interactively transformed to a specific shape. A user can manipulate the skeleton using two methods which are complementary to each other: one controls individual joints on the skeleton while the other controls the skeleton through an intermediate spline curve. Finally, the leaf blade shape is deformed to conform to the skeleton by interpolation. An interactive modeler was developed to help a user to model a leaf shape interactively and several leaves were modeled by the interactive modeler. The ray-traced rendering images demonstrate that the proposed method is effective in the leaf shape modeling.

It has been proposed that the various 14-3-3 isotypes and isoforms present in all eukaryotes are largely functionally equivalent. However, this is not consistent with the conservation of multiple isoforms and isotypes, especially in vertebrates with seven 14-3-3 encoding genes and nine isotypes. The hypothesis tested in this thesis is that both isoform-specific and overlapping functions are likely mediated through tissue specific expression, colocalization and dimerization of 14-3-3 proteins occur in vivo. Drosophila melanogaster was selected because it offers a simple, but representative system to study these proteins functionally. This thesis focuses primarily on D14-3-3?, although the expression pattern and phenotypes associated with all three Drosophila 14-3-3s were determined. I first determined the expression pattern of the three different 14-3-3 isotypes (leoI, leoII and D14-3-3?) and described developmental phenotypes associated with mutations in 14-3-3 isotypes in Drosophila. I found that there is partial redundancy with respect to lethality. Both LEO and D14-3-3? appear required for normal germ-line and somatic gonadal development. However, they do not appear to be functionally equivalent with respect to this phenotype since LEO is unable to compensate for the loss of D14-3-3?. I also determined that D14-3-3? mutants have unique phenotypes including deficits in adult cross-vein formation and rapid habituation to olfactory and footshock stimuli. To further understand the unique role that D14-3-3? plays in the adult CNS, I mapped the areas in the brain involved in olfactory and footshock habituation. I found that although the mushroom bodies (MBs) are necessary to inhibit premature habituation such as that exhibited by D14-3-3? mutants, D14-3-3? expression specifically in the MBs is not sufficient to rescue premature habituation. Although the loss of either LEO or D14-3-3? appears to cause a deficit in olfactory associative learning, premature habituation is the cause of the deficit seen in D14-3-3? mutants. As leo mutants do not exhibit a premature habituation phenotype, it appears that within the MBs LEO and D14-3-3? are not functionally equivalent. Therefore, the data supports the hypothesis that 14-3-3s have functional specificity and redundancy likely to represent use of homo and heterodimers in different processes within the tissues of an organism.

No description available.

A system for vessel characterization aimed at detecting deep vein thrombosis (DVT) in the lower limbs has been developed and evaluated using ultrasound image processing, location and force sensors measurements, blood flow information and a protocol based on the current clinical standard, compression ultrasound. The goal is to provide an objective and repeatable system to measure DVT in a rapid and standardized manner, as this has been suggested in the literature as an approach to improve overall detection of the disease. The system uses a spatial Kalman filter-based algorithm with an elliptical model in the measurement equation to detect vessel contours in transverse ultrasound images and estimate ellipse parameters, and temporal constant velocity Kalman filters for tracking vessel location in real-time. The vessel characterization also comprises building a 3-D vessel model and performing compression and blood flow assessments to calculate measures that indicate the possibility of DVT in a vessel. A user interface designed for assessing a vessel for DVT was also developed. The system and components were implemented and tested in simulations, laboratory settings, and clinical settings. Contour detection results are good, with mean and rms errors ranging from 1.47-3.64 and 3.69-9.67 pixels, respectively, in simulated and patient images, and parameter estimation errors of 5%. Experiments showed errors of 3-5 pixels for the tracking approaches. The measures for DVT were evaluated, independently and integrated in the system. The complete system was evaluated, with sensitivity of 67-100% and specificity of 50-89.5%. System learnability and memorability were evaluated in a separate user study, with good results. Contributions include a segmentation approach using a full parameter ellipse model in an extended Kalman filter, incorporating multiple measurements, an alternate sampling method for faster parameter convergence and application-specific initialization, and a tracking approach that includes a sub-sampled sum of absolutes similarity calculation and a method to detect vessel bifurcations using flow data. Further contributions include an integrated system for DVT detection that can combine ultrasound B-mode, colour flow and elastography images for vessel characterization, a system interface design focusing on usability that was evaluated with medical professionals, and system evaluations through multiple patient studies.

No description available.

Vorhofflimmern ist die häufigste Herzrhythmusstörung bei Erwachsenen und kann zu schwerwiegenden kardiovaskulären Komplikationen bei den betroffenen Patienten führen. Neben einer Einschränkung der Lebensqualität durch symptomatische Episoden u.a. mit Palpitationen, Schwindel, Dyspnoe und Synkopen kommt es zu einer deutlichen Steigerung des Schlaganfallrisikos. Oftmals liegen zusätzlich strukturelle Herzerkrankungen wie Klappenvitien, eine koronare Herzerkrankung oder eine linksventrikuläre Hypertrophie vor, die das Krankheitsbild weiter verschlechtern. Therapeutisch bieten sich neben der pharmakologischen antiarrhythmischen Behandlung auch invasive Methoden wie die Pulmonalvenenablation an. In dieser Arbeit wurden die Erfolge der unterschiedlichen Therapieoptionen bei Patienten mit Vorhofflimmern und der Indikation zur Pulmonalvenenablation anhand von zwei Patientengruppen verglichen. Während die erste Gruppe mit fünf von den ESC-Leitlinien für die Behandlung von Vorhofflimmern zugelassenen Medikamenten rein konservativ behandelt wurde, erhielten die Patienten in der zweiten Gruppe eine kombinierte Therapie aus Medikamenten und Pulmonalvenenablation. Die untersuchten Medikamente waren Betablocker, Klasse IC-Antiarrythmika, Sotalol, Amiodaron und Dronedaron.Insgesamt konnte ein hochsignifikanter Vorteil der kombinierten Therapie gegenüber der rein pharmakologischen Therapie festgestellt werden. Die besten Langzeitergebnisse zeigten sich bei Patienten, die im Falle eines Rezidivs weitere Ablationen erhielten. Beim Vergleich der Wirkung der unterschiedlichen Medikamente miteinander blieb die Überlegenheit eines der Medikamente über einen langfristigen Therapiezeitraum von zwölf Monaten im überwiegenden Teil der Untersuchungen aus. Signifikante Effektivitätsunterschiede konnten lediglich in der Untergruppe „vor Ablation“ festgestellt werden. Dabei war die Amiodarontherapie effektiver als Betablocker, Klasse IC-Antiarrhythmika und Dronedaron. Sotalol war zudem erfolgreicher als Dronedaron.Trotz des teils zufriedenstellenden Ansprechens der Patienten auf die pharmakologische Therapie ist diese durch das Auftreten von Nebenwirkungen beschränkt. Besonders Amiodaron und Dronedaron sind mit einer nicht zu vernachlässigenden Rate an Nebenwirkungen assoziiert. Mit der Pulmonalvenenablation steht eine effektive alternative Therapieoption zur Verfügung, die insbesondere im Rahmen eines kombinierten Therapieansatzes aus Medikamenten und invasiver Therapie inklusive Reablationen einen hochsignifikanten Vorteil gegenüber der rein konservativen Rhythmuskontrolle bietet.

I assessed the accuracy of two clinical prediction rules, the d-dimer blood test and point of care ultrasound for diagnosing lower limb deep vein thrombosis. Emergency physicians were trained in ultrasound and prospectively scanned emergency department patients with suspected deep vein thrombosis. Accuracy of the Wells and AMUSE rules and the ultrasound result was compared to radiology-performed ultrasound and a 90-day clinical outcome. Univariate and multivariate analyses were performed assessing which factors were associated with the outcome. The sensitivity and specificity of the Wells score for the clinical outcome was 85.7% and 68.5%; the AMUSE score 85.7% and 54.4%. Ultrasound had a sensitivity of 91.7% and specificity of 91.7% for radiology-diagnosed thrombus and 78.6% and 95.0% for clinical outcome. The odds ratio of a positive outcome with a positive ultrasound was 65.1. After receiving the ultrasound training program, emergency physicians were unable to demonstrate sufficient accuracy to replace current diagnostic strategies.

The Great Bear magmatic zone, Northwest Territories, hosts numerous giant quartz veins and stockwork zones. These zones can be up to 100m wide and up to 10km long, with two or more generations of quartz. A few of the giant quartz vein zones host base-metal uranium mineralization, and some are proximal to mineralization, although most are barren. Cathodoluminescence imaging shows the quartz veins have complex growth zones and a trace element study suggests that these zones are the result of Al and Li substitution in the quartz lattice. Oxygen isotope (18Oqtz) values of quartz generally fall between +8 to +14.6 (VSMOW). Fluid inclusion homogenization temperatures range from 100 to 375C, and the fluids have variable salinities. The fluids that created the giant quartz veins are epithermal in nature with a meteoric water brine signature, and formed as a result of multiple fluid pulses and re-fracturing events.