Uncovering hidden treasures: Mapping morphological changes in the differentiation of human mesenchymal stem cells to osteoblasts using deep learning

Deep Learning (DL) is becoming an increasingly popular technology being employed in life sciences research due to its ability to perform complex and time-consuming tasks with significantly greater speed, accuracy, and reproducibility than human researchers - allowing them to dedicate their time to more complex tasks. One potential application of DL is to analyze cell images taken by microscopes. Quantitative analysis of cell microscopy images remain a challenge - with manual cell characterization requiring excessive amounts of time and effort. DL can address these issues, by quickly extracting such data and enabling rigorous, empirical analysis of images. Here, DL is used to quantitively analyze images of Mesenchymal Stem Cells (MSCs) differentiating into Osteoblasts (OBs), tracking morphological changes throughout this transition. The changes in morphology throughout the differentiation protocol provide evidence for a distinct path of morphological transformations that the cells undergo in their transition, with changes in perimeter being observable before changes in eceentricity. Subsequent differentiation experiments can be quantitatively compared with our dataset to concretely evaluate how different conditions affect differentiation and this paper can also be used as a guide for researchers on how to utilize DL workflows in their own labs.

Progress in cardiovascular bioprinting

Cardiovascular disease has been the leading cause of death globally for the past 15 years. Following a major cardiac disease episode, the ideal treatment would be the replacement of the damaged tissue, due to the limited regenerative capacity of cardiac tissues. However, we suffer from a chronic organ donor shortage which causes approximately 20 people to die each day waiting to receive an organ. Bioprinting of tissues and organs can potentially alleviate this burden by fabricating low cost tissue and organ replacements for cardiac patients. Clinical adoption of bioprinting in cardiovascular medicine is currently limited by the lack of systematic demonstration of its effectiveness, high costs, and the complexity of the workflow. Here, we give a concise review of progress in cardiovascular bioprinting and its components. We further discuss the challenges and future prospects of cardiovascular bioprinting in clinical applications.

Profound approach to check legitimacy of an old technique used to gauge palatal rugae

Aims

The present study aimed at assessing two fixed points of reference from where the mesial and distal point of all rugae can be measured so that the exact movement of particular rugae in any direction can be evaluated and assessing the changes in the palatal rugae after orthodontic treatment.

Methods

A longitudinal study conducted among a sample of 20 (8 male and 12 female) adult patients. Pre- and post-orthodontic treatment casts of patients were obtained from the Department of Orthodontics College of Dentistry Jazan University. Antero-posterior linear distances (Technique I) between medial and lateral points of primary, secondary and tertiary rugae were measured. Also, the transverse linear distance (Technique II) between medial and lateral points of right and left rugae were measured. Technique III involved marking two fixed points and using these two points a third point is located on the medial or lateral end of rugae of right and left side in pre and post-treatment orthodontic casts. The independent sample t-test was employed to compare gender. Difference between the pre- and post-treatment mean values were checked by the paired t-test.

Results

Technique III successfully showed the statistically significant difference (P ≤ 0.05, 95% CI) in the overall pre and post-treatment values on the patients' cast (N = 20) which was not observed with a technique I and technique II.

Conclusion

The triangle created by the three reference points in the technique III was able to identify the changes in the palatine rugae more precisely than the technique I and Technique II.

Exercise tolerance in obstructive sleep apnea-hypopnea (OSAH), before and after CPAP treatment: Effects of autonomic dysfunction improvement

BACKGROUND

Obstructive sleep apnea hypopnea (OSAH) is associated with decreased exercise tolerance and autonomic abnormalities and represents a risk for cardiovascular diseases. The aim of the study was to evaluate the effects of CPAP on cardiovascular autonomic abnormalities and exercise performance in patients with OSAH without changes in lifestyle and body weight during treatment.

METHODS

Twelve overweight subjects with OSAH underwent anthropometric measures, autonomic cardiovascular and incremental symptom-limited cardio-respiratory exercise tests before and after two months of treatment with CPAP.

RESULTS

Lower frequency component of power spectrum of heart rate variability (59.5±24.2 msec² vs 43.2±25.9 msec²; p<0.05) and improvements of maximal workload (99.3±13.5 vs 108.3±16.8%pred.; p<0.05) and peak oxygen consumption (95.3±7.6 vs 105.5±7.9%pred.; p<0.05) were observed in these patients after CPAP, being their BMI unchanged.

CONCLUSIONS

CPAP-induced decrease of sympathetic hyperactivity is associated with better tolerance to the effort in OSAH patients that did not change their BMI and lifestyle, suggesting that OSAH limits per se the exercise capacity.

Diagnosis and management of chronic obstructive pulmonary disease: the Swiss guidelines. Official guidelines of the Swiss Respiratory Society

The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements are based on the available literature, on other national guidelines and, in particular, on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report. Our aim is to advise pulmonary physicians, general practitioners and other health care workers on the early detection and diagnosis, prevention, best symptomatic control, and avoidance of COPD as well as its complications and deterioration.

Familial adenomatous polyposis. Surgical treatment: when and how

Familial adenomatous polyposis is an autosomal dominated inherited disease, caused by the mutation of the tumour suppressor gene adenomatous polyposis coli on chromosome 5. Despite being a rare disorder, accounting for some 1% of colorectal cancers, it represents an interesting model of hereditary disease, because of its intrinsic characteristics, conventionally defined by the presence of more than 100 colorectal polyps, as well as extra-colon manifestations, the attenuated form of the disease, genetic aspects, the inevitable progression to colorectal cancer and hence the correct therapy to treat or prevent the fatal evolution of the disease. Surgical treatment is based above all on two techniques: ileorectal anastomosis, which requires careful surveillance of rectal remnant, and ileal pouch-anal anastomosis, which totally eradicates the disease. The suitability of using these two techniques is discussed in view of new genetic and clinical findings, acquired from personal experience and from the literature.

[The minimal bowel resection in Crohn's disease: analysis of prognostic factors on the surgical recurrence]

OBJECTIVE

To assess the effect of disease pattern and involvement of the margins on early and late results of enteric resections with hand-sewn anastomosis for Crohns disease.

BACKGROUND

Bowel sparing is one of the aims of the surgery for CD. When strictureplasties are not possible, "minimal surgery" (the resection just of the grossly involved tract of bowel) is the current choice.

METHODS

One hundred and forty-six cases of resections in 128 patients were performed in the years 1991-2001. We investigated if there is a relationship between disease pattern (perforating and non-perforating) or hystologic involvement of the margins and recurrence (reoperation for recurrent preanastomotic disease). Hand-sewn anastomosis were performed almost in all the cases; we compared the results with the main series of stapled and hand-sewn sutures.

RESULTS

Nine surgical complications occurred (7%), requiring six relaparotomies and three conservative treatments. Overall rate of recurrence (median follow-up 44 months) is 17%: 9% in patients with non perforating disease and 19% in patients with perforating disease. The rate of recurrence is 6% in the group of patients with involved margins and 23% in the group with non involved margins.

CONCLUSIONS

Limited surgery for CD doesn't increase rate of recurrence; the involvement of margins is not a risk factor for early reoperation. Hand-sewn anastomosis seem to be as safe as stapled ones.

[Intestinal carcinoma in Crohn's disease. Report of four cases and review of the literature]

BACKGROUND

Increasing numbers of intestinal carcinomas in patients affected by Crohn's disease have been reported by several authors, even if the strength of this associations (age, longstanding of the disease, its characteristics and distribution) still has to be elucidated.

METHODS

From January 1992 to July 2000, 130 patients with Crohn's disease were submitted to surgery.

RESULTS

Four patients showed an associated intestinal carcinoma at operation, in 3 cases located in the ileum, and in 1 case in the colon. Patients' mean age was 54 years. Mean duration time of the Crohn's disease was 7 years. One patient died 3 months after surgery for disseminated peritoneal carcinomatosis, whereas 3 patients are still alive with malignancy free at 5, 8, and 11 years after the tumor resection.

CONCLUSIONS

These results suggest the difficulty in recognizing patients with Crohn's disease who are at risk for intestinal carcinoma. Longstanding disease, previous intestinal exclusion surgery, enterocutaneous or other types of fistulas should be considered for the development of cancer. Therefore, the prognosis may be good if early diagnosis and treatment are made.

Conservative management of a broncho-oesophageal fistula in a patient with non-Hodgkin's lymphoma

We describe the case of a 56-year-old male patient with a 2-year history of productive cough and weight loss. The diagnosis of a broncho-oesophageal fistula due to a low-grade Non-Hodgkin's lymphoma was made. The patient was referred for surgical closure of the fistula and resection of the left lower lobe because of intractable severe pneumonia. As an alternative treatment option, oesophageal or bronchial stent placement was considered. Because of the relatively favourable prognosis of this type of lymphoma, treatment with chemotherapy alone and a feeding gastrostomy were started. After eight cycles of cyclophosphamide and prednisone, the fistula healed spontaneously. Two years later, the patient continues to do well and is in remission. In patients with Non-Hodgkin's lymphoma and an oesophagorespiratory fistula, treatment should first be conservative; surgery or stent placement should be postponed.

Insufficient control of asthma: increase the dose of inhaled steroids or add long-acting beta 2-agonists?

Internationally accepted treatment guidelines for bronchial asthma have established the early introduction of inhaled corticosteroids as a disease-modifying treatment, in addition to bronchodilator treatment as needed. In a small group of patients this approach does not lead to sufficient control of asthma. It is a matter of debate whether in this situation the dose of inhaled steroids should be increased or the bronchodilator treatment intensified by the introduction of long-acting beta 2-agonists. Advantages and limitations of both treatment strategies are discussed in the light of recent data. Guidelines for the use of long-acting beta 2-agonists are proposed.

[Poisoning with cholinesterase inhibitors]

A 32-year-old woman who had ingested 300 ml of a potent cholinesterase inhibitor insecticide (Fonofos) with suicidal intent became progressively comatose and finally suffered respiratory arrest. Tracheal intubation, mechanical ventilation, vigorous gastric lavage and intravenous administration of atropine and obidoxime brought about complete clinical recovery within 24 hours of ingestion of this potentially fatal dose of Fonofos.

[Severe acute pneumopathy following low-dose methotrexate therapy in chronic polyarthritis]

A 70-year-old patient with a history of rheumatoid arthritis was hospitalized for severe acute pneumonitis after 36 weeks of treatment with low-dose methotrexate (7.5 mg/week). High dose corticotherapy and assisted ventilation were necessary to obtain a clinical response. Medical history, clinical signs, laboratory findings. X-ray films of the chest and special investigations suggest the diagnosis of acute low-dose methotrexate pneumonitis.

[Plasmapheresis therapy in Guillain-Barré polyneuroradiculitis]

The outcome of Guillain-Barré polyneuritis is not always benign. Since no therapy of proven effectiveness is available and an immunologic etiology is presumed, plasma exchange treatment has been repeatedly used. We report on three patients with severe polyneuritis who were unable to walk. Two were also in acute respiratory failure. All the cases exhibited surprisingly good improvement correlating in time with plasma exchange. A review of the literature suggests that plasma exchange can at least be recommended in severe cases of Guillain-Barré acute polyneuritis with inability to walk. Treatment should be started within 1-2 weeks of onset of the disease.

[Somatic symptoms in opiate abuse]

Medical complications of heroin overdose and the diseases of addicts play an increasingly important role in the daily routine of hospital medical departments. The percentage of drug-related admissions to the Medical Clinic of the University Hospital, Zürich, increased from 0.18% to 4.45% between 1972 and 1983. During this 12-year period, 492 patients were admitted 569 times because of heroin overdose or intoxications combined with other drugs, and 191 drug addicts were hospitalized 226 times for a variety of medical problems. Certain complications, such as heroin pulmonary edema and talc granulomas of the lung, occur only in parenteral drug addiction. Other diseases such as right heart endocarditis, Candida-endophthalmitis, septic arthritis and osteomyelitis are almost exclusively observed in intravenous drug abusers. Sexually transmitted infections and hepatitis B are frequently diagnosed in addicts.