Pain and itch in Wallenberg's syndrome: anatomical-functional correlations.
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Electrophysiology↗
Biomedical subjects
Hubertus Axer
Publications and source records attributed to Hubertus Axer.
Anisotropy of human linea alba: a biomechanical study.
BACKGROUND: Recently, a new model of fiber architecture of the linea alba has been described consisting of an oblique fiber layer of intermingling oblique fibers, a transverse fiber layer containing mainly transverse fibril bundles, and a variable, small irregular fiber layer. In this study the morphological model was proven using direction-specific biomechanical measurements of the linea alba. MATERIAL AND METHODS: Thirty-one human abdominal walls were analyzed (16 male and 15 female). Six strips of collagen tissue with a width of 1 cm were exsected from each linea alba transversely, obliquely, and longitudinally according to the main fiber directions. An increasing force from 2 to 24 N was applied to these strips, and the corresponding strain represented by the relative elongation was measured, which allows the calculation of a direction-specific compliance of the tissue. RESULTS: The compliance is highest in longitudinal and smallest in transverse direction. In the infraumbilical part of the female linea alba the compliance was significantly smaller in the transverse direction than in the oblique direction. Moreover, the compliance in the transverse direction was significantly smaller in women than in men. CONCLUSIONS: A distinct anisotropy of morphological and biomechanical properties was demonstrated as well as sex-dependent differences. The compliance correlates with the distribution of fiber orientation in the linea alba. These biomechanical results constitute the functional correlation with the fiber morphology of the linea alba and correspond well to our earlier proposed model of fiber architecture.
Abdominal Muscles↗
Organic bipolar disorder occurring together with spontaneous intracranial hypotension.
Spontaneous intracranial hypotension (SIH) is known to cause postural headache, often combined with auditory, and vestibular symptoms, nausea, vomiting, and diplopia. We report a 63-year-old male patient who for the first time developed a depressive episode followed by acute manic symptoms during the course of SIH, both relieved after treatment of the underlying organic disturbance.
Bipolar Disorder↗
Evolving rule-based systems in two medical domains using genetic programming.
OBJECTIVE: To demonstrate and compare the application of different genetic programming (GP) based intelligent methodologies for the construction of rule-based systems in two medical domains: the diagnosis of aphasia's subtypes and the classification of pap-smear examinations. MATERIAL: Past data representing (a) successful diagnosis of aphasia's subtypes from collaborating medical experts through a free interview per patient, and (b) correctly classified smears (images of cells) by cyto-technologists, previously stained using the Papanicolaou method. METHODS: Initially a hybrid approach is proposed, which combines standard genetic programming and heuristic hierarchical crisp rule-base construction. Then, genetic programming for the production of crisp rule based systems is attempted. Finally, another hybrid intelligent model is composed by a grammar driven genetic programming system for the generation of fuzzy rule-based systems. RESULTS: Results denote the effectiveness of the proposed systems, while they are also compared for their efficiency, accuracy and comprehensibility, to those of an inductive machine learning approach as well as to those of a standard genetic programming symbolic expression approach. CONCLUSION: The proposed GP-based intelligent methodologies are able to produce accurate and comprehensible results for medical experts performing competitive to other intelligent approaches. The aim of the authors was the production of accurate but also sensible decision rules that could potentially help medical doctors to extract conclusions, even at the expense of a higher classification score achievement.
Aphasia↗
Intraoperative three-dimensional visualization of the pyramidal tract in a neuronavigation system (PTV) reliably predicts true position of principal motor pathways.
BACKGROUND: This prospective study employs anisotropic diffusion-weighted (ADW) magnetic resonance imaging for the integration of individual spatial information concerning the principal motor pathways into the operating room during microneurosurgery in the central region. We hypothesize that the three-dimensional (3-D) visualization of the pyramidal tract position (PTV) in a neuronavigation system based on ADW provides valid information concerning the position and extension of the principal motor pathways. METHODS: A total of 13 consecutive patients with lesions adjacent to the pyramidal tracts and the central region underwent microneurosurgery with the help of pyramidal tract visualization (PTV). An ADW sequence obtained preoperatively was fused to an anatomic navigation sequence. The 3-D reconstructions of the precentral gyrus (PG), the pyramidal tract, and the tumor were available in a customized neuronavigation system during surgery. Intraoperatively the PG was identified on the basis of the aforementioned data. Electric motorcortex stimulation (CS) was used to directly verify the PG location and indirectly the fiber tract position. RESULTS: In 11 cases (92%) the prediction of the principal motor pathways' position was correct. In one case of a meningioma, according to PTV, the tumor was falsely localized postcentrally. In the case of a precentral cavernoma, no motor response could be elicited by cortical stimulation. CONCLUSION: Intraoperative PTV on the basis of ADW provides the neurosurgeon with reliable information concerning the position of the principal motor pathways during intracranial procedures as proved with intraoperative electrophysiological testing. The technique has the potential to reduce operative morbidity. PTV is straightforward and can be adapted to other customized neuronavigation devices.
Adult↗
The application of fuzzy-based methods to central nerve fiber imaging.
This paper discusses the potential of fuzzy logic methods within medical imaging. Technical advances have produced imaging techniques that can visualize structures and their functions in the living human body. The interpretation of these images plays a prominent role in diagnostic and therapeutic decisions, so physicians must deal with a variety of image processing methods and their applications. This paper describes three different sources of medical imagery that allow the visualization of nerve fibers in the human brain: (1) an algorithm for automatic segmentation of some parts of the thalamus in magnetic resonance images based on the differences in myelin content in various thalamic subnuclei; (2) polarized light for classifying the 3D orientation of the nerve fibers at each point; and (3) confocal laser scanning microscopy (CLSM) for calculating semiquantitative variables for myelin content. Fuzzy logic methods were applied to analyze these pictures from low- to high-level image processing. The solutions presented here are motivated by problems of routine neuroanatomic research demonstrating fuzzy-based methods to be valuable tools in medical image processing.
Algorithms↗
Three-dimensional reconstruction of a rhesus monkey brain from the Friedrich Sanides collection.
For this study, serial sections of a rhesus monkey brain prepared by Friedrich Sanides (1914-1984) were used to examine the architectonic parcellation of the cerebral cortex. The sections through the anterior part of a rhesus monkey brain (250 sections stained for myeloarchitecture and 250 sections stained for cytoarchitecture) were digitally photographed, three-dimensionally aligned to each other, and three-dimensionally reconstructed. For three-dimensional registration of the sections rigid transformations were applied with the Euclidian distance as fit criterion. Afterwards, the derived volume was used for manual segmentation of several central structures of the monkey brain (caudate nucleus, putamen, pallidum, thalamus, ventricles, cortex, hippocampus, amygdala, etc.). Thus, a three-dimensional model of the rhesus monkey brain was developed, which can be used as a three-dimensional framework for mapping morphological structures as basis for a digital atlas.
Anatomy↗
Microwave dielectric measurements and tissue characteristics of the human brain: potential in localizing intracranial tissues.
This study describes the measurements of dielectric properties in the microwave range to differentiate various human central nervous structures. Using a vector network analyser transmission and reflection coefficients were measured from 500 MHz to 18 GHz in four human formalin fixed human brains. The positions of the electrodes were marked, and the tissue was histologically stained to visualize the myelo- and the cytoarchitecture as well as the nerve fibre orientation at the electrodes. The profiles of the transmission coefficients showed a characteristic minimum peak. In order to describe this peak, a mathematical function was fitted. Parameters derived from digital image processing were used to characterize the myelo- and cytoarchitecure of the tissue at the electrodes. A multiple regression model, with the frequency at the transmission peak minimum as a dependent variable and two tissue characteristics at the two electrodes as independent variables, showed a multiple regression coefficient of 0.765. A neural network model was able to estimate the frequency at the transmission peak minimum from the tissue characteristics at the electrode. The measurements of dielectric properties are well suited to differentiate distinct intracerebral structures. The method could be used for online monitoring of the needle's position during a stereotactic intervention in neurosurgery.
Biophysical Phenomena↗
The glucose transport facilitator GLUT8 is predominantly associated with the acrosomal region of mature spermatozoa.
The glucose transporter 8 (GLUT8) is a recently identified member of the family of sugar transport facilitators. In human tissues GLUT8 is predominantly expressed in testis in a gonadotropin-dependent manner. It is shown here that the onset of mRNA synthesis of GLUT8 during the maturation of mouse testis coincides with the appearance of mature spermatozoa. Furthermore, immunohistochemistry with antiserum against the C-terminus of GLUT8 indicated that the protein was associated with spermatozoa within the seminiferous and the epididymal tubules. The GLUT8 immunoreactivity was detected within the head of mouse and human spermatozoa in the acrosomal region, and appeared to be located at the plasma membrane as well as within the cells. This specific expression and localization of GLUT8 suggests that the transport facilitator plays a major role in the fuel supply of mature spermatozoa, and that it is a potential target for inhibition of sperm cell function.
Acrosome↗
Anatomy of the SMAS revisited.
Despite the relevance of the superficial musculoaponeurotic system (SMAS) in facial rejuvenation a clear anatomic definition of the SMAS is still lacking. Therefore, the morphology of the SMAS in 18 cadavers was investigated using different macroscopic and microscopic techniques. The region-specific anatomy of the SMAS is described in the forehead, parotid, zygomatic, and infraorbital regions, the nasolabial fold, and the lower lip. The SMAS is one continuous, organized fibrous network connecting the facial muscles with the dermis. It consists of a three-dimensional scaffold of collagen fibers, elastic fibers, and fat cells. Two different types of SMAS morphology were demonstrated: type 1 SMAS architecture is located lateral to the nasolabial fold with relatively small fibrous septa enclosing lobules of fat cells, whereas type 2 architecture is located medial to the nasolabial fold, where the SMAS consists of a dense collagen-muscle fiber meshwork. Overall, it was demonstrated that different facial regions show specific morphological characteristics, and thus region-specific surgical interventions may be necessary in facial rejuvenation.
Adipose Tissue↗
A 3D fiber model of the human brainstem.
A new neuroanatomic approach to evaluate the fiber orientation in gross histological sections of the human brain was developed. Serial sections of a human brainstem were used to derive fiber orientation maps by analysis of polarized light sequences of these sections. Fiber inclination maps visualize angles of inclination, and fiber direction maps show angles of direction. These angles define vectors which can be visualized as RGB-colors. The serial sections were aligned to each other using the minimized Euclidian distance as fit criterion. In the 3D data set of the human brainstem the major fiber tracts were segmented, and three-dimensional models of these fiber tracts were generated. The presented results demonstrate that two kinds of fiber atlases are feasible: a fiber orientation atlas representing a vector in each voxel, which shows the nerve fiber orientation, and a volume-based atlas representing the major fiber tracts. These models can be used for the evaluation of diffusion tensor data as well as for neurosurgical planning.
Aged↗