Deformities of the feet in children can influence not only optimal foot development but also the development of other body segments. The aim of the study was to compare the hip and pelvis kinematics in groups of children with and without valgus deformity of the hindfoot. Three groups of children participated in the study: bilateral hindfoot valgosity (11 children, age 5.4 ± 1.4 years), unilateral hindfoot valgosity (14 children, age 5.6 ± 1.6 years) and the control group (8 children, 4.8 ± 1.2). Hindfoot valgus angle was measured clinically during standing. Hindfoot valgosity was considered in the range of 6 to 20 degrees. Kinematic data from five trials for each child was obtained using the Vicon MX system (six infrared cameras, frequency 200 Hz, Vicon Motion Systems, Oxford, UK). The results of our study showed significantly higher pelvic anteversion during the whole gait cycle for both unilateral and bilateral hindfoot valgosity children and significantly higher hip external rotation during the first half of the stance phase in bilateral deformity. The differences in the hip and pelvis kinematics, when compared to the control group, are higher for the group with bilateral deformity than in the group with unilateral deformity.

• MeSH
• Gait * MeSH
• Walking MeSH
• Coxa Valga diagnosis   etiology   physiopathology   MeSH
• Child MeSH
• Ankle Joint physiopathology   MeSH
• Hip Joint physiopathology   MeSH
• Humans MeSH
• Flatfoot complications   diagnosis   physiopathology   MeSH
• Child, Preschool MeSH
• Reproducibility of Results MeSH
• Range of Motion, Articular MeSH
• Sensitivity and Specificity MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Adenoma MeSH
• Optic Chiasm MeSH
• Glioma MeSH
• Craniopharyngioma MeSH
• Humans MeSH
• Meningioma MeSH
• Visual Field Tests methods   MeSH
• Visual Fields pathology   MeSH
• Check Tag
• Humans MeSH

PURPOSE: This study assesses a large multi-institutional database to present the outcomes of World Health Organization grade 2 meningiomas treated with stereotactic radiosurgery (SRS). We also compare the 3-year progression-free survival (PFS) to that reported in the Radiation Therapy Oncology Group 0539 phase 2 cooperative group meningioma trial. METHODS AND MATERIALS: From an international, multicenter group, data were collected for grade 2 meningioma patients treated with SRS for demonstrable tumor from 1994 to 2019. Statistical methods used included the Kaplan-Meier method, Cox proportional hazards analysis, and recursive partitioning analysis. RESULTS: Two hundred thirty-three patients treated at 12 institutions were included. Patients presented at a median age of 60 years (range, 13-90), and many had at least 2 prior resections (30%) or radiation therapy (22%). Forty-eight percent of patients had prior gross total resection. At SRS, the median treatment volume was 6.1 cm3 (0.1-97.6). A median 15 Gy (10-30) was delivered to a median percent isodose of 50 (30-80), most commonly in 1 fraction (95%). A model was developed using recursive partitioning analysis, with one point attributed to age >50 years, treatment volume >11.5 cm3, and prior radiation therapy or multiple surgeries. The good-prognostic group (score, 0-1) had improved PFS (P < .005) and time to local failure (P < .005) relative to the poor-prognostic group (score, 2-3). Age >50 years (hazard ratio = 1.85 [95% confidence interval, 1.09-3.14]) and multiple prior surgeries (hazard ratio = 1.80 [1.09-2.99]) also portended reduced PFS in patients without prior radiation therapy. Two hundred eighteen of 233 patients in this study qualified for the high-risk group of Radiation Therapy Oncology Group 0539, and they demonstrated similar outcomes (3-year PFS: 53.9% vs 58.8%). The good-prognostic group of SRS patients demonstrated slightly improved outcomes (3-year PFS: 63.1% vs 58.8%). CONCLUSIONS: SRS should be considered in carefully selected patients with atypical meningiomas. We suggest the use of our good-prognostic group to optimize patient selection, and we strongly encourage the initiation of a clinical trial to prospectively validate these outcomes.

• MeSH
• Progression-Free Survival MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Meningeal Neoplasms pathology   radiotherapy   MeSH
• Meningioma pathology   radiotherapy   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Radiosurgery * MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Neoplasm Grading MeSH
• World Health Organization * MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE: The Tofts and the extended Tofts models are the pharmacokinetic models commonly used in dynamic contrast-enhanced MRI (DCE-MRI) perfusion analysis, although they do not provide two important biological markers, namely, the plasma flow and the permeability-surface area product. Estimates of such markers are possible using advanced pharmacokinetic models describing the vascular distribution phase, such as the tissue homogeneity model. However, the disadvantage of the advanced models lies in biased and uncertain estimates, especially when the estimates are computed voxelwise. The goal of this work is to improve the reliability of the estimates by including information from neighboring voxels. THEORY AND METHODS: Information from the neighboring voxels is incorporated in the estimation process through spatial regularization in the form of total variation. The spatial regularization is applied on five maps of perfusion parameters estimated using the tissue homogeneity model. Since the total variation is not differentiable, two proximal techniques of convex optimization are used to solve the problem numerically. RESULTS: The proposed algorithm helps to reduce noise in the estimated perfusion-parameter maps together with improving accuracy of the estimates. These conclusions are proved using a numerical phantom. In addition, experiments on real data show improved spatial consistency and readability of perfusion maps without considerable lowering of the quality of fit. CONCLUSION: The reliability of the DCE-MRI perfusion analysis using the tissue homogeneity model can be improved by employing spatial regularization. The proposed utilization of modern optimization techniques implies only slightly higher computational costs compared to the standard approach without spatial regularization.

• MeSH
• Algorithms MeSH
• Phantoms, Imaging MeSH
• Glioblastoma diagnostic imaging   MeSH
• Contrast Media pharmacology   MeSH
• Rats MeSH
• Magnetic Resonance Imaging * MeSH
• Brain diagnostic imaging   MeSH
• Brain Neoplasms diagnostic imaging   MeSH
• Perfusion MeSH
• Permeability MeSH
• Computer Simulation MeSH
• Image Processing, Computer-Assisted MeSH
• Signal-To-Noise Ratio MeSH
• Reproducibility of Results MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Na souboru 22 nemocných s meningeomem báze přední lebeční jámy autoři dokazují, že operační mortalita a morbidita klesá pod vlivem mikroskopického způsobu operování a optimalizace přístupové cesty k nádoru. Nebezpečná úskalí operace lze navíc obejít radiochirurgickým zákrokem. Rozhodujícím faktorem však zůstává včasná diagnóza, která se poměrně snadno dosáhne CT vyšetřením při sebemenším podezření na poruchu zraku, čichu anebo na poruchu mentálních schopností postiženého.

In a group of 22 patients with merungiomas of the base of the anterior cranial fossa the authors provide evidence that the mortality and morbidity after siu-gery declines due to the microscopic method of surgery and optimization of tihe approach to the tumour. Dangerous pitfalls of surgery can be moreover overcome by radiosurgery. The decisive factor remains, however, early diagnosis which is achieved relatively easily by CT exanunation in case of the slightest suspicion of disorders of eyesight or smell or disorders of mental capacities of the affected subject.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Meningioma diagnosis   etiology   surgery   MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH

BACKGROUND: The Heartmate 3 (HM3) is a Conformiteé Européenne mark-approved left ventricular (LV) assist device (LVAD) with fully magnetically levitated rotor and features consisting of a wide range operational speeds, wide flow paths, and artificial pulse. We performed a hemodynamic-echocardiographic speed optimization evaluation in HM3-implanted patients to achieve optimal LV- and right ventricular (RV) shape. METHODS AND RESULTS: Sixteen HM3 patients underwent pump speed ramp tests with right heart catheterization. Three-dimensional echocardiographic (3DE) LV and RV datasets (Philips) were acquired, and volumetric (Tomtec) and shape (custom software) analyses were performed (LV: sphericity, conicity; RV: septal and free-wall curvatures). Data were recorded at up to 13 speed settings. Speed changes were in 100-rpm steps, starting at 4600 rpm and ramping up to 6200 rpm. 3DE was feasible in 50% of the patients. Mean original speed was 5306 ± 148 rpm. LV end-diastolic (ED) diameter (-0.15 ± 0.09 cm/100 rpm) and volumes (ED: 269 ± 109 mL to 175 ± 90 mL; end-systolic [ES]: 234 ± 111 mL to 146 ± 81 mL) progressively decreased as the shape became less spherical and more conical; RV volumes initially remained stable, but at higher speeds increased (ED: from 148 ± 64 mL to 181 ± 92 mL; ES: 113 ± 63 mL to 130 ± 69 mL). On average, the RV septum became less convex (bulging toward the LV) at the highest speeds. CONCLUSIONS: LV and RV shape changes were noted in HM3-supported patients. Although a LV volumetric decrease and shape improvement was consistently noted, RV volumes grew in response to increase in speed above a certain point. A next concern would be whether understanding of morphologic and function changes in LV and RV during LVAD speed change assessed with the use of 3DE helps to optimize LVAD speed settings and improve clinical outcomes.

• MeSH
• Echocardiography, Three-Dimensional trends   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Field Therapy methods   trends   MeSH
• Heart-Assist Devices trends   MeSH
• Prospective Studies MeSH
• Aged MeSH
• Cardiac Catheterization methods   trends   MeSH
• Heart Ventricles diagnostic imaging   surgery   MeSH
• Heart Failure diagnostic imaging   therapy   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH

Úvod: Incidence meningeomů po 65. roku života exponenciálně roste. Tento věk je ovšem typický vyšším výskytem komorbidit a benefit operace nemusí být vždy vyšší než její riziko. Optimalizace léčby by proto měla být objektivně posouzena i s využitím skórovacích systémů. Materiál a metodika: Retrospektivní analýzou byla zhodnocena skupina pacientů léčených ve FN Brno v období 2010–2018 (n = 108). Pacienti byli starší 65 let. V léčbě byly uplatňovány tři postupy: strategie „watch and wait“, operace a stereotaktická radiochirurgie. Skupiny pacientů byla vyhodnocena z pohledu výskytu komorbidit a celkového stavu pacienta s ohledem na výběr terapeutické modality. V indikaci k jednotlivým typům léčby se uplatňovaly skórovací systémy. Dále byly v jednotlivých skupinách vyhodnoceny krátkodobá i dlouhodobá morbidita a mortalita. Výsledky: Pozorovali jsme významnou závislost při analýze roční mortality u systému SKALE. Mezi mortalitou a pohlavím, kolaterálním edémem a lokalizací nádoru nebyla nalezena statisticky významná závislost. Naopak věk, velikost nádoru a skóre Karnofsky před zahájením léčby byly významnými prediktory prognózy. Závěr: Individualizovaná analýza pacientů a zkušenosti neurochirurga nadále zůstávají významnými faktory ve výběru léčby u starších pacientů s diagnózou meningeomu. Nicméně skórovací systémy uplatňované u výběru léčebné modality u pacientů vyššího věku umožňují významně optimalizovat léčebný postup a v konečném důsledku prognózu onemocnění.

Introduction: The incidence of meningiomas increases exponentially after the age of 65. However, this age is characterized by a higher incidence of comorbidities and the benefit of the surgery may not always exceed its risk. Treatment optimization should therefore be objectively assessed using scoring systems as well. Materials and methods: A retrospective analysis evaluated the group of patients treated at the Brno University Hospital between 2013–2018 (N = 108). Patients were older than 65 years of age. Three procedures were considered in the treatment: watch and wait strategy, surgery and stereotactic radiosurgery. The groups of patients were evaluated in terms of the incidence of comorbidities and the outcome of the patients with regard to the choice of treatment modality. Scoring systems were used in the indication for individual types of treatment. Furthermore, short-term and long-term morbidity and mortality were evaluated in individual groups. Results: Significant dependence in the analysis of annual mortality in the SKALE system has been proved. No statistically significant relationship was found between mortality and sex, collateral oedema, and tumour location. In contrast, age, tumour size, and Karnofsky score before treatment were significant predictors of prognosis. Conclusion: Individualized patient analysis and neurosurgeon experience continue to be important factors in treatment selection in elderly patients with a diagnosis of meningioma. However, the scoring systems used to select a treatment modality in elderly patients make it possible to significantly optimize the treatment process and, ultimately, the prognosis of the disease.

• Keywords
• skórovací systémy,
• MeSH
• Comorbidity MeSH
• Humans MeSH
• Meningioma * surgery   MeSH
• Postoperative Complications MeSH
• Retrospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

Introduction: Scoliosis influences the optimal posture of the human body. The effect on the gait cycle of this entity is of major interesting. Purpose: Young adults with moderate idiopathic scoliosis (MIS) present kinematic modifications regarding the convex or concave side of the body compared to healthy people. Aim was to identify these variations. Methods: A cohort of twenty young adults (group A) having MIS and a control group (B) of fifteen healthy individuals were submitted in 3-D gait analysis with direct linear transformation method. The parameters examined were concerning the displacement of the knee and the ankle joints on x, y and z axes. The gait cycle and the knee range of motion were examined. Results: Gait cycle in scoliosis patients showed increased duration compared to healthy people, p<0,05. Regarding side to side comparison of the lower extremities in scoliosis patients the following outcomes were identified: Knee and ankle joint displacement in the ipsilateral (convex) side was increased regarding sagittal axis (x), p<0,05. When compared both groups the following differences found, p<0,05: The knee joint in the ipsilateral side (group A) had increased mean (z) frontal displacement. In the controlateral side (concave) of group A had decreased mean sagittal displacement and increased mean frontal and mean vertical (y) displacement. The ankle joint in the ipsilateral side had increased mean sagittal and frontal displacement. In the controlateral side had increased mean frontal displacement. The knee range of motion during the phases of gait cycle in scoliosis patients was seriously reduced compared to control group, p<0,05. Discussion: Asymmetries observed amongst the lower extremities during the gait cycle of scoliosis patients. Also asymmetries observed in comparison to healthy people. Some of these asymmetries agree to other studies. A compensatory walking close to normal walking existed. These observations might prove to be helpful in treating the gait cycle of young adults with MIS.

• Keywords
• kolenní a hlezenní kloub,
• MeSH
• Video Recording MeSH
• Biomechanical Phenomena MeSH
• Gait physiology   MeSH
• Walking * physiology   statistics & numerical data   MeSH
• Adult MeSH
• Adaptation, Physiological MeSH
• Ankle Joint physiology   physiopathology   MeSH
• Knee Joint * physiology   physiopathology   MeSH
• Humans MeSH
• Young Adult MeSH
• Image Processing, Computer-Assisted MeSH
• Range of Motion, Articular MeSH
• Scoliosis * complications   physiopathology   MeSH
• Statistics as Topic MeSH
• Case-Control Studies MeSH
• Weight-Bearing MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH

BACKGROUND: Manual segmentations of intracranial hemorrhage on non-contrast CT images are the gold-standard in measuring hematoma growth but are prone to rater variability. AIMS: We demonstrate that a convex optimization-based interactive segmentation approach can accurately and reliably measure intracranial hemorrhage growth. METHODS: Baseline and 16-h follow-up head non-contrast CT images of 46 subjects presenting with intracranial hemorrhage were selected randomly from the ANNEXA-4 trial imaging database. Three users semi-automatically segmented intracranial hemorrhage to measure hematoma volume for each timepoint using our proposed method. Segmentation accuracy was quantitatively evaluated compared to manual segmentations by using Dice similarity coefficient, Pearson correlation, and Bland-Altman analysis. Intra- and inter-rater reliability of the Dice similarity coefficient and intracranial hemorrhage volumes and volume change were assessed by the intraclass correlation coefficient and minimum detectable change. RESULTS: Among the three users, the mean Dice similarity coefficient, Pearson correlation, and mean difference ranged from 76.79% to 79.76%, 0.970 to 0.980 (p < 0.001), and -1.5 to -0.4 ml, respectively, for all intracranial hemorrhage segmentations. Inter-rater intraclass correlation coefficients between the three users for Dice similarity coefficient and intracranial hemorrhage volume were 0.846 and 0.962, respectively, and the corresponding minimum detectable change was 2.51 ml. Inter-rater intraclass correlation coefficient for intracranial hemorrhage volume change ranged from 0.915 to 0.958 for each user compared to manual measurements, resulting in an minimum detectable change range of 2.14 to 4.26 ml. CONCLUSIONS: We spatially and volumetrically validate a novel interactive segmentation method for delineating intracranial hemorrhage on head non-contrast CT images. Good spatial overlap, excellent volume correlation, and good repeatability suggest its usefulness for measuring intracranial hemorrhage volume and volume change on non-contrast CT images.

• MeSH
• Stroke * diagnostic imaging   MeSH
• Head MeSH
• Intracranial Hemorrhages diagnostic imaging   MeSH
• Humans MeSH
• Tomography, X-Ray Computed MeSH
• Reproducibility of Results MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

BACKGROUND: The optimal management of clinoidal meningiomas (CMs) continues to be debated. METHODS: We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of these tumors. The data from the literature along with contemporary practice patterns were discussed within the task force to generate consensual recommendations. RESULTS AND CONCLUSION: This article represents the consensus opinion of the task force regarding pre-operative evaluations, patient's counselling, surgical classification, and optimal surgical strategy. Although this analysis yielded only Class B evidence and expert opinions, it should guide practitioners in the management of patients with clinoidal meningiomas and might form the basis for future clinical trials.

• MeSH
• Skull Base MeSH
• Consensus MeSH
• Humans MeSH
• Meningeal Neoplasms * surgery   MeSH
• Meningioma * surgery   MeSH
• Neurosurgical Procedures MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH