Applying artificial intelligence to assess the impact of orthognathic treatment on facial attractiveness and estimated age

This observational study aimed to use artificial intelligence to describe the impact of orthognathic treatment on facial attractiveness and age appearance. Pre- and post-treatment photographs (n=2164) of 146 consecutive orthognathic patients were collected for this longitudinal retrospective single-centre study. Every image was annotated with patient-related data (age; sex; malocclusion; performed surgery). For every image, facial attractiveness (score: 0-100) and apparent age were established with dedicated convolutional neural networks trained on >0.5million images for age estimation and with >17million ratings for attractiveness. Results for pre- and post-treatment photographs were averaged for every patient separately, and apparent age compared to real age (appearance). Changes in appearance and facial attractiveness were statistically examined. Analyses were performed on the entire sample and subgroups (sex; malocclusion; performed surgery). According to the algorithms, most patients' appearance improved with treatment (66.4%), resulting in younger appearance of nearly 1year [mean change: -0.93years (95% confidence interval (CI): -1.50; -0.36); p=0.002), especially after profile-altering surgery. Orthognathic treatment had similarly a beneficial effect on attractiveness in 74.7% [mean difference: 1.22 (95% CI: 0.81; 1.63); p<0.001], especially after lower jaw surgery. This investigation illustrates that artificial intelligence might be considered to score facial attractiveness and apparent age in orthognathic patients.

Production of membrane proteins using cell–free expression systems

Different overexpression systems are widely used in the laboratory to produce proteins in a reasonable amount for functional and structural studies. However, to optimize these systems without modifying the cellular functions of the living organism remains a challenging task. Cell-free expression systems have become a convenient method for the high-throughput expression of recombinant proteins, and great effort has been focused on generating high yields of proteins. Furthermore, these systems represent an attractive alternative for producing difficult-to-express proteins, such as membrane proteins. In this review, we highlight the recent improvements of these cell-free expression systems and their direct applications in the fields of membrane proteins production, protein therapy and modern proteomics.

Characterization of the cell-penetrating properties of the Epstein-Barr virus ZEBRA trans-activator

The Epstein-Barr virus basic leucine zipper transcriptional activator ZEBRA was shown recently to cross the outer membrane of live cells and to accumulate in the nucleus of lymphocytes. We investigated the potential application of the Epstein-Barr virus trans-activator ZEBRA as a transporter protein to facilitate transduction of cargo proteins. Analysis of different truncated forms of ZEBRA revealed that the minimal domain (MD) required for internalization spans residues 170-220. MD efficiently transported reporter proteins such as enhanced green fluorescent protein (EGFP) and beta-galactosidase in several normal and tumor cell lines. Functionality of internalized cargo proteins was confirmed by beta-galactosidase activity in transduced cells, and no MD-associated cell toxicity was detected. Translocation of MD through the cell membrane required binding to cell surface-associated heparan sulfate proteoglycans as shown by strong inhibition of protein uptake in the presence of heparin. We found that internalization was blocked at 4 degrees C, whereas no ATP was required as shown by an only 25% decreased uptake efficiency in energy-depleted cells. Common endocytotic inhibitors such as nystatin, chlorpromazine, and wortmannin had no significant impact on MD-EGFP uptake. Only methyl-beta-cyclodextrin inhibited MD-EGFP uptake by 40%, implicating the lipid raft-mediated endocytotic pathway. These data suggest that MD-reporter protein transduction occurs mostly via direct translocation through the lipid bilayer and not by endocytosis. This mechanism of MD-mediated internalization is suitable for the efficient delivery of biologically active proteins and renders ZEBRA-MD a promising candidate for therapeutic protein delivery applications.

Low‐dose radiotherapy (LD‐RT) and the modulation of iNOS expression in adjuvant‐induced arthritis in rats

PURPOSE

Low-dose radiotherapy (LD-RT) of arthritic joints applied during the peak of the acute inflammatory response improves the clinical and histomorphological development of adjuvant arthritis. The study was undertaken to investigate the cellular composition of the inflammatory infiltrate and the expression of the pro-inflammatory and anti-inflammatory enzymes, inducible nitric oxide synthase (iNOS), cyclo-oxygenase 2 (COX-2) and haem-oxygenase 1 (HO-1), in response to LD-RT.

MATERIALS AND METHODS

Adjuvant arthritis in female Lewis rats was induced by intradermal injection of heat-inactivated mycobacterium tuberculosis on day 0. Both arthritic hind paws were sham irradiated (group 1) or X-irradiated with either 5 x 1.0 Gy (group 2) or 5 x 0.5 Gy (group 3) from days 15 to 19 after induction (15 animals/group). On days 21 (n=12 joints/group) and 30 (n=18 joints/group), cryostat sections were analysed histologically and immunohistologically after specific staining for macrophages, iNOS, COX-2 and HO-1.

RESULTS

A total of 5 x 1.0 Gy or 5 x 0.5 Gy led to a significant reduction of clinical symptoms from days 21 to 29, and a highly significant reduction of cartilage and bone destruction on day 30. Macrophage-positive areas could be detected continuously throughout the periarticular infiltrate, and were slightly reduced after LD-RT on days 21 and 30. This reduction was more pronounced after 5 x 1.0 Gy. Following LD-RT, the iNOS score was reduced by about 45-50% on days 21 (p<0.05) and 30 (p<0.001). In contrast, the HO-1 score was increased by about 50% on days 21 (p=0.08) and 30 (p=0.03).

CONCLUSIONS

The clinically and histologically observed prevention of the progression of adjuvant arthritis after LD-RT given during the peak of the acute inflammatory response and the reduction of cartilage and bone destruction in the chronic phase appears to be related to the modulation of iNOS activity by low X-ray doses.

Expression and purification of ZEBRA fusion proteins and applications for the delivery of macromolecules into mammalian cells

The recent development of peptide carriers for efficient and specific delivery of biologically active molecules into mammalian cells represents a major advance in the study of both normal and uncontrolled cell growth. In the past few years, this technology has been successfully applied to the delivery of therapeutic molecules in animal models, and now some of these carriers are available in the clinic for the treatment of some human diseases. This unit describes the production, in a bacterial expression system, of reporter proteins (EGFP and beta-galactosidase) fused to a transduction domain of the Epstein-Barr virus ZEBRA protein, as well as purification of the fusion proteins. The purified fusion proteins can be added to any of a large spectrum of mammalian cells and the internalization process measured by flow cytometry and fluorescence microscopy on live cells. Fluorescence microscopy on fixed cells is used to study their intracellular distribution.

Liposome-mediated cellular delivery of active gp91(phox)

Background

Gp91^phox is a transmembrane protein and the catalytic core of the NADPH oxidase complex of neutrophils. Lack of this protein causes chronic granulomatous disease (CGD), a rare genetic disorder characterized by severe and recurrent infections due to the incapacity of phagocytes to kill microorganisms.

Methodology

Here we optimize a prokaryotic cell-free expression system to produce integral mammalian membrane proteins.

Conclusions

Using this system, we over-express truncated forms of the gp91^phox protein under soluble form in the presence of detergents or lipids resulting in active proteins with a “native-like” conformation. All the proteins exhibit diaphorase activity in the presence of cytosolic factors (p67^phox, p47^phox, p40^phox and Rac) and arachidonic acid. We also produce proteoliposomes containing gp91^phox protein and demonstrate that these proteins exhibit activities similar to their cellular counterpart. The proteoliposomes induce rapid cellular delivery and relocation of recombinant gp91^phox proteins to the plasma membrane. Our data support the concept of cell-free expression technology for producing recombinant proteoliposomes and their use for functional and structural studies or protein therapy by complementing deficient cells in gp91^phox protein.

Identification of the genes GPD1 and GPD2 of Pichia jadinii

Two genes coding for proteins with a high degree of sequence similarity to glycerol-3-phosphate dehydrogenases have been isolated from the yeast Pichiajadinii. Fragments of the genes were PCR-amplified with degenerated primers from genomic DNA of P. jadinii. Clones containing the full-length genes PjGPDI and PjGPD2 were isolated by screening genomic libraries. DNA sequencing revealed open reading frames (ORFs) of 1182 bp and 1185 bp for PjGpdlp and PjGpd2p, respectively. In a complementation study PjGPD1 rescued the growth defect of a Saccharomyces cerevisiae Agpdl mutant strain under osmotic stress, while complementation by PjGPD2 is temperature sensitive. The sequences of the PjGPD1 and PjGPD2 ORFs have been submitted to the EMBL Nucleotide Sequence Database under Accession No. AJ632339 and AJ632340, the sequences of the corresponding genomic DNA fragments under Accession No. AJ632341 and AJ635370, respectively.

[Bavarian mammography screening program]

In Bavaria since the 1st April 2003 we have been conducting a high quality mammography-screening carried out in individual practises (BMS). We have used the European and the S 3 guidelines. The best diagnosis is an early diagnosis of the breast carcinoma to save human life. Because of this and the high mortality rate due to this disease it is essential to have a mammogram screening program. There is no single one ideal way of constructing a screening program, it is always based on compromise within the particular health care-systems. Arising problems cannot be avoided, it is only possible when all parties work closely together that the BMS works properly.

Surface models for coupled modelling of runoff and sewer flow in urban areas

Traditional methods fail for the purpose of simulating the complete flow process in urban areas as a consequence of heavy rainfall and as required by the European Standard EN-752 since the bi-directional coupling between sewer and surface is not properly handled. The new methodology, developed in the EUREKA-project RisUrSim, solves this problem by carrying out the runoff on the basis of shallow water equations solved on high-resolution surface grids. Exchange nodes between the sewer and the surface, like inlets and manholes, are located in the computational grid and water leaving the sewer in case of surcharge is further distributed on the surface. Dense topographical information is needed to build a model suitable for hydrodynamic runoff calculations; in urban areas, in addition, many line-shaped elements like houses, curbs, etc. guide the runoff of water and require polygonal input. Airborne data collection methods offer a great chance to economically gather densely sampled input data.

Measurement of frequencies of HPRT mutants, chromosomal aberrations, micronuclei, sister-chromatid exchanges and cells with high frequencies of SCEs in styrene/dichloromethane-exposed workers

Frequencies of HPRT mutants (MFs), chromosomal aberrations with or without gaps (CA+; CA-), aberrant cells (AC), micronuclei (MN), sister-chromatid exchanges (SCEs) and cells with high frequencies of SCEs (HFCs) were measured in lymphocytes collected from 46 workers occupationally exposed to styrene and dichloromethane (DCM = methylene chloride). These parameters were also determined in 23 controls. Time-weighted average (TWA) values for styrene and DCM exposure during an 8-h working day were respectively 70 mg/m3 (range: 0-598) and 108 mg/m3 (range: 0-742). These values correspond to TWA values of 17 ppm styrene and 31 ppm DCM. In exposed workers, all cytogenetic parameters were significantly enhanced (P < 0.0001; one-sided), but, due to the lack of appropriate control data, no definite conclusions could be drawn concerning the mutagenicity of styrene/DCM exposure. Duration of exposure was not correlated with genetic effects analyzed. The TWA value for styrene was not correlated with the extent of genetic damage detected, but the TWA value for DCM was positively correlated with the frequencies of chromosome aberrations (with gaps) and aberrant cells. These observations make it difficult to decide whether styrene or DCM, or both chemicals, induced the cytogenetic effects observed in exposed workers. Using the present styrene/DCM data, earlier ethylene oxide data and unpublished epichlorohydrin data, the relative sensitivity of the genetic endpoints to detect genotoxic exposure was: HFC > CA- > CA+ > SCE > MN > HPRT.

Role of the posterior capsule in the aqueous-vitreous barrier in aphakic and pseudophakic eyes

Clinical observations have shown that an intact posterior capsule between aqueous and vitreous may function as a barrier to low and high molecular weight substances, e.g., prostaglandins or the angiogenic factor. To determine if this protective barrier breaks down after posterior capsulotomy, we examined the distribution of fluorescein in human eyes after intracapsular cataract extraction (ICCE), extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation with capsulotomy, and ECCE and IOL implantation without capsulotomy in 12 patients each. After ICCE and after ECCE and IOL implantation with capsulotomy, diffusion of fluorescein into the vitreous showed similar values. These values were significantly higher than those obtained in patients after ECCE or ECCE and IOL implantation without capsulotomy. This leads us to believe that an intact posterior capsule prevents the diffusion of soluble substances.

Isolated and combined effects of prolonged exposures to noise and whole-body vibration on hearing, vision and strain

This study was carried out in order: (1) to examine the effects of isolated and combined prolonged exposures to noise and whole-body vibration on hearing, vision and subjectively experienced strain, and (2) to check the combined effects with repeated exposures. Six male subjects were exposed twice to noise (N) at 92 dBA, whole-body vibration (V) in the Z-axis at 4 Hz and 1.0 ms-2 rms, and noise and vibration (NV) for 90 min with each condition. Temporary threshold shifts of hearing (TTS) and their integrals (ITTS) were measured at 4, 6, 10, and 12 kHz. Visual acuity was examined by means of a very sensitive test. Cross-modality matching (CMM) of the handgrip force was used to judge the subjectively experienced strain. NV induced a clear tendency of higher TTS and ITTS than N, with several significant differences most pronounced at 10 kHz. With repeated exposures, the effect of NV decreased, while the reactions to N and V remained unchanged. The individual reactions to NV differed. The influence of the duration of exposures on vision depended on the condition; N caused time-dependent changes, whereas V did not. CMM-data increased with the duration of the exposure during V and NV. N was generally judged to be more straining than V; NV caused higher strain than V during the first 30 min of exposure only. Correlations between different effects suggest certain links between them. Additionally, less motivation--daily obtained by a questionnaire--often correlated with higher ITTS during N and NV. The results also illustrate the combined effects on the individual susceptibility, repetition of exposure, the kind of response, and, possibly, the actual psychic state.

Evaluation of endothelial cell function with anterior segment fluorophotometry in pseudophakic patients

Determining fluorescein permeability of the endothelial cell layer provides information on the endothelial cell barrier. Following topical application of fluorescein, the time dependent change of its concentration in the corneal stroma and in the aqueous humor yields the transfer coefficient (Kc) of the corneal endothelium. Measurements with a fluorophotometer resulted in a Kc of 0.002 minute to 0.005 minute for normal eyes. Patients with corneal barrier dysfunction (cornea guttata, Fuch's dystrophy) showed an increased Kc of 0.006 minute to 0.013 minute. Up to five years postoperatively, none of the patients investigated after phacoemulsification and posterior chamber lens implantation showed a disturbance in the endothelial cell barrier function.

Experimental studies with a high-density silicone oil for giant retinal tear

Fluorsilicone oil of high density (1.3 g/cm3) injected into the vitreous cavity after vitrectomy filled the rabbit eyeball in an anterior-posterior direction and unfolded a giant retinal tear (produced by peripheral retinotomy). Fluorsilicone oil injected into the anterior chamber causes a localized opacification of the cornea. Histologically, a fibroplastic metaplasia of the deep corneal layers with a newly formed posterior collagenous layer was found. Histologic findings were identical in fellow eyes in which polydimethylsilicone was used as a control substance.

Increased chromium and nickel content in lung tissue

In random autopsies chromium (n = 23) and nickel (n = 16) together with various other metals, were determined in lung tissue by means of flameless atomic absorption spectrometry. With increasing age a significant increase in concentration of both chromium and nickel was found. This is evaluated as an indicator for a corresponding exposure, which is marked by a local (workplace) and regional (environment) share of a clear increase in the total chromium/nickel load and by a life-long duration. The question arises, whether the selective concentration (long half-life) of the inhaled chromium and nickel particles/compounds in the lung are to be regarded as a stochastic lung cancer risk.

Behavioural changes and bioelectric brain maturation of preterm and fullterm newborn infants: a polygraphic study

Fifty-two preterm and fullterm infants requiring assisted ventilation were observed and examined polygraphically. In addition, 24 preterm infants without prenatal or perinatal complications and not needing assisted ventilation were examined polygraphically in order to validate a special method of differentiating sleep states and sleep cycles. State criteria were EEG records, eye movements and gross body movements. Using this evaluation method, all 14 low-risk preterm infants showed stable sleep states and cycles, as did 16 of 23 high-risk preterm and 10 of 15 high-risk fullterm infants. 11 high-risk preterm and fullterm infants were found to have extremely unstable sleep states, or were comatose. The EEG could not be evaluated in only one case. Infants requiring assisted ventilation showed the following changes in comparison with the infants who did not need ventilation: the percentage of quiet sleep increased significantly; the percentage of indeterminate sleep increased as a sign of more unstable behaviour; and the individual measurements of the recorded and observed variables showed wider variability. Bioelectric brain maturation decreased significantly with increasing risk among both preterm and fullterm infants given assisted ventilation.

[The natural course of atrial septal defects]

61 patients at the age of 18 to 70 years with untreated atrial septum defect were examined 7.5 to 21 (on the average 10.5) years after the first recognition. Subjective symptomatology, clinical picture, size of the heart, mean pressure of the pulmonary artery and shunt volume at the beginning and at the end of the period of observation were analysed. The results reveal an above all favourable prognosis of the congenital malformation. In a course without complications an age can be reached adequate to the average life-expectance. After the 40th year of age, however, in 75% of the patients complaints appeared or their number increased. With growing age the size of the heart and the frequency of disturbances of the cardiac rhythm increased. In the small left-to right-shunt (less than 30% of the pulmonary flow) in the majority of the cases (85%) the prognosis proved to be good. Even in shunt volumes of more than 60% in half of the patients no essential deterioration developed in the period of observation. No clear relations were found between the mean pressure of the pulmonary artery and the clinical degree of severity. The indication to the operative correction of the atrial septum defect diagnosed only at the adult age demands a critical individual judgement, in which case apart from the haemodynamic parameters anamnesis and clinical findings within a cardiological observation of the course are of particular importance.

[Comparative examination of endocrine ophthalmopathy by means of ultrasonography, computerized tomography and fish bioassay]

In 35 patients with Graves' ophthalmopathy (GO) thyroid function was tested by T3-RIA, T4-RIA, TBI, TRH-test, thyroid scanning, and determination of thyroid autoantibodies. Additional ultrasonography (A-scan), computed tomography (CT) of the orbit, and the determination of an exophthalmogenic serum activity in fish bioassay was performed. Typical alterations for GO were observed in 26 cases with ultrasonography. CT showed an enlargement of medial and/or lateral rectus muscles in 24 of 33 patients, and in 17 cases a region of high density in the apex of the muscle cone. The density of retrobulbar fat after i.v. injection of contrast medium did not differ significantly from that observed in normal men. Characteristic signs of GO were not detected in only 2 cases using both methods together. Exophthalmogenic serum activity was found in the IgG fraction of serum protein. The incidence rate was high (69%), but for diagnostic purpose the fish bioassay cannot be recommended.

Computerized tomography and nuclear imaging of the liver: a comparative study in 83 cases

This study was performed to comparatively assess the diagnostic accuracy of computerized tomography (CT) and nuclear liver-scanning in detecting and defining circumscript and diffuse liver diseases in 83 patients. Presence or absence of liver diseases was assessed based on the results of invasive diagnostic procedures such as biopsy, laparoscopy, laparotomy, and/or autopsy. The percentage of true negative diagnoses was 94% for CT and 91% for static gamma-imaging (n = 33). With a rate of 94% true positive diagnoses, CT proved to be superior to gamma imaging with radiocolloids (81% true positives) in diagnosing circumscript liver diseases (n = 31). In addition. CT was superior to nuclear imaging regarding discrimination of number and size of space-occupying lesions within the liver. In contrast to nuclear screening, CT scans were pathognomonic to some circumscript liver diseases such as cysts, metastases, and perhaps echinococciasis. This was also true for obstructive jaundice. Nuclear imaging, because it reflects a sort of liver function, was superior with cirrhosis, whereas CT showed only alterations in the size and shape of the liver and spleen.

Diagnostic accuracy of CT in circumscript liver disease

To evaluate the accuracy of CT in diagnosing circumscript liver disease, CT findings in 105 patients were compared to the results of invasive diagnostic procedures (laparoscopy, laparotomy, and autopsy). In all patients at least one of these procedures was performed in addition to CT. CT proved to be a valuable noninvasive method in detecting and differentiating circumscript liver lesions such us metastases, primary liver tumors, solitary cysts and polycystic disease, abscesses, and echinococciasis. The 10% rate of false positive and false negative diagnoses indicates the limitations of the method.

[Special indications for using the whole body scanner (author's transl)]

In addition to the role of the body scanner in the diagnosis of diseases of the body cavity and parenchymal organs, the authors review the scope and indications for using whole body computer tomography in special situations. Examples are given of its use in the diagnosis of tumours in the vicinity of the skull base, in the orbits, the facial skeleton, soft tissue tumours, bone diseases and CT-controlled biopsies.

[Computerised tomography of the trunk-a first report (author's transl)]

One thousand patients have been examined with the body scanner and a preliminary report is presented on the value of this method in the examination of abdomen and the thorax. Unlike other radiological procedures, computerised tomography is often able to demonstrate disease states directly and not only as a result of their effect on neighbouring structures. It provides a non-invasive means for achieving a diagnosis, for therapy planning and for control of treatment of space-occupying lesions within the trunk. Its role can only be defined after a systematic comparision with conventional diagnostic procedures.

[Urethro-cysto-colpo-rectography, a radiological method for the diagnosis of insufficiency of the pelvic floor (author's transl)]

Contrast examination of pelvic organs was carried out in 200 female patients with insufficiency of the pelvic floor. The topography of the organs in the true pelvis and their functional relation was recorded on full-size film and 70 mm. roll film. Radiological examination provides more accurate indications for plastic surgery of the pelvic floor, influences the operative procedures and permits better evaluation of operative results.

[The accuracy of placental scintigraphy (author's transl)]

The results of 150 placental scans are reported, using 99mTc erythrocytes, 113mIn gelatine and 113mIn tranferrin. Accuracy was checked at surgery and compared with ultra sound findings. In 62% of patients, the indications for placental scintigraphy was suspicion of placenta praevia because of bleeding in late pregnancy. In 38% placental localisation was performed for amniocentesis for Rh incompatibility. Localisation of the placenta was accomplished in 98.6% by scanning and in 95% by ultra sound. Accuracy of scanning was 94% and ultra sound 70%. Placental scanning is at present the most accurate method for a placental localisation and should therefore be used when an accurate diagnosis cannot be achieved by other techniques.

[Value of sequential scintrigraphy and clearance determination following normo- and hypothermic renal ischemia]

Using quantitative sequential camera scintigraphy and simultaneous separated clearance determinations with 131-I-Hippuran and 169-Yb-EDTA renal function was measured applying a new surgical method which permits in-situ kidney perfusion and cooling in animals and patients. While mongrel dogs of 15 kg average weight (control group of N = 5) showed after 1 hour of normothermic ischaemia a postoperative delay of intrarenal transport of 131-I-Hippuran with reduction of 131-I-Hippuran and 169Yb-EDTA clearances, renal function returned to normal on the first postoperative day after 1-hour (N = 5) and 2-hour (N = 5) hypothermic ischaemia. In patients (N = 9) with hypothermic in-situ perfusion of between 40 and 92 min duration a transient postoperative delay of intrarenal 131-I-Hippuran transport and a reduction of the 131I-Hippuran clearance was observed which returned to almost normal 1 1/2 to 3 months after surgery. The results and the significance of the method discussed and are compared with clinical findings and with radiological and laboratory renal function studies.