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Einleitung: Die konventionelle Galaktografie stellte jahrzehntelang das einzige bildgebende Verfahren zur Darstellung von Milchgängen in der Brust dar. Heute verfügen wir in der Diagnostik über ein multimodales Konzept aus hochauflösendem Ultraschall, der Magnetresonanz-(MR-)Mammografie und der Duktoskopie/Galaktoskopie mit Sensitivitäten und Spezifitäten bis zu 95%. Ziel unserer Untersuchung war es, erstmalig die Tomosynthesetechnik in der Galaktografie einzusetzen und die daraus generierten synthetischen digitalen 2-D-Vollfeld-Mammografien mit der etablierten Methode der duktusorientierten Sonografie zu vergleichen. Es sollen mit beiden Methoden invasive Mammakarzinome und deren Vorstufen wie duktale Carcinoma in situ (DCIS) sowie benigne Befunde erkannt werden. Material und Methoden: Wir führten bei 5 Patientinnen mit pathologischer Mamillensekretion sowohl eine duktusorientierte Sonografie, eine kontrastmittelunterstützte Galaktografie mithilfe der Tomosynthese in 3-D sowie auch den daraus generierten synthetischen digitalen 2-D-Vollfeld-Mammografien durch. Die Auswertung der unterschiedlichen Untersuchungsmodalitäten erfolgte durch 3 in der komplementären Mammadiagnostik erfahrene Untersucher (1, 5 und 15 Jahre) und wurde mit der endgültigen Histologie korreliert. Ergebnisse: Alle 3 Untersucher beurteilten unabhängig voneinander die Bilder des duktusorientierten Ultraschalls und der kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik in 3-D und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien. Die Ergebnisse wurden mit den histopathologischen Befunden der Operationspräparate korreliert, wobei sich bei den 5 Patientinnen 1 invasives Mammakarzinom, 2-mal ein duktales Carcinoma in situ (DCIS) und 2 benigne Befunde ergaben. Alle drei Untersucher lagen bei der Verdachtsdiagnose in der Standardbildgebung der duktusorientierten Sonografie seltener richtig als bei der erstmalig durchgeführten, kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien. Schlussfolgerung: Erstmalig wurde die Brusttomosynthese in der Galaktografie (Galaktomosynthese) eingesetzt und ermöglichte eine digitale, 3-dimensionale Darstellung von suspekten Befunden. Zusammen mit den daraus synthetisierten, digitalen 2-D-Vollfeld-Mammografien könnte dies in Zukunft eine sinnvolle Ergänzung der komplementären Mammadiagnostik sein – und eine Renaissance dieser Methode. Im Vergleich mit dem duktusorientierten Ultraschall in Hochauflösung erzielten die Untersucher mit der kontrastmittelunterstützten Galaktografie in Tomosynthesetechnik und den daraus generierten, synthetischen digitalen 2-D-Vollfeld-Mammografien bessere Ergebnisse in Korrelation mit den histopathologischen Befunden.
Introduction: For decades, conventional galactography was the only imaging technique capable of showing the mammary ducts. Today, diagnosis is based on a multimodal concept which combines high-resolution ultrasound with magnetic resonance (MR) mammography and ductoscopy/galactoscopy and has a sensitivity and specificity of up to 95%. This study used tomosynthesis in galactography for the first time and compared the synthetic digital 2D full-field mammograms generated with this technique with the images created using the established method of ductal sonography. Both methods should be able to detect invasive breast cancers and their precursors such as ductal carcinoma in situ (DCIS) as well as being able to identify benign findings.
Material and Methods: Five patients with pathological nipple discharge were examined using ductal sonography, contrast-enhanced 3D galactography with tomosynthesis and the synthetic digital 2D full-field mammograms generated with the latter method. Evaluation of the images created with the different imaging modalities was done by three investigators with varying levels of experience with complementary breast diagnostics (1, 5 and 15 years), and their evaluations were compared with the histological findings.
Results: All 3 investigators independently evaluated the images created with ductal sonography, contrast-enhanced 3D galactography with tomosynthesis, and generated synthetic digital 2D full-field mammograms. Their evaluations were compared with the histopathological assessment of the surgical specimens resected from the 5 patients. There was 1 case of invasive breast cancer, 2 cases with ductal carcinoma in situ and 2 cases with benign findings. All 3 investigators made more mistakes when they used the standard imaging technique of ductal sonography to diagnose suspicious lesions than when they used contrast-enhanced galactography with tomosynthesis and the generated synthetic digital 2D full-field mammograms.
Conclusion: This is the first time breast tomosynthesis was used in galactography (galactomosynthesis) to create digital 3-dimensional images of suspicious findings. When used together with the generated synthetic digital 2D full-field mammograms, it could be a useful complementary procedure for the diagnosis of breast anomalies and could herald a renaissance of this method. Compared with high-resolution ductal ultrasound, the investigators achieved better results with contrast-enhanced galactography using tomosynthesis and the generated synthetic digital 2D full-field mammograms, as confirmed by histopathological findings.
Electron transfer in respiratory chains generates the electrochemical potential that serves as energy source for the cell. Prokaryotes can use a wide range of electron donors and acceptors and may have alternative complexes performing the same catalytic reactions as the mitochondrial complexes. This is the case for the alternative complex III (ACIII), a quinol:cytochrome c/HiPIP oxidoreductase. In order to understand the catalytic mechanism of this respiratory enzyme, we determined the structure of ACIII from Rhodothermus marinus at 3.9 Å resolution by single-particle cryo-electron microscopy. ACIII presents a so-far unique structure, for which we establish the arrangement of the cofactors (four iron–sulfur clusters and six c-type hemes) and propose the location of the quinol-binding site and the presence of two putative proton pathways in the membrane. Altogether, this structure provides insights into a mechanism for energy transduction and introduces ACIII as a redox-driven proton pump.
Background: Definite diagnosis and therapeutic management of cholangiocarcinoma (CCA) remains a challenge. The aim of the current study was to investigate feasibility and potential impact on clinical management of targeted sequencing of intraductal biopsies.
Methods: Intraductal biopsies with suspicious findings from 16 patients with CCA in later clinical course were analyzed with targeted sequencing including tumor and control benign tissue (n = 55 samples). A CCA-specific sequencing panel containing 41 genes was designed and a dual strand targeted enrichment was applied.
Results: Sequencing was successfully performed for all samples. In total, 79 mutations were identified and a mean of 1.7 mutations per tumor sample (range 0–4) as well as 2.3 per biopsy (0–6) were detected and potentially therapeutically relevant genes were identified in 6/16 cases. In 14/18 (78%) biopsies with dysplasia or inconclusive findings at least one mutation was detected. The majority of mutations were found in both surgical specimen and biopsy (68%), while 28% were only present in biopsies in contrast to 4% being only present in the surgical tumor specimen.
Conclusion: Targeted sequencing from intraductal biopsies is feasible and potentially improves the diagnostic yield. A profound genetic heterogeneity in biliary dysplasia needs to be considered in clinical management and warrants further investigation.
Translational impact: The current study is the first to demonstrate the feasibility of sequencing of intraductal biopsies which holds the potential to impact diagnostic and therapeutical management of patients with biliary dysplasia and neoplasia.
Acute myeloid leukemia (AML) is characterized by uncontrolled proliferation and accumulation of immature myeloblasts, which impair normal hematopoiesis. While this definition categorizes the disease into a distinctive group, the large number of different genetic and epigenetic alterations actually suggests that AML is not a single disease, but a plethora of malignancies. Still, most AML patients are not treated with targeted medication but rather by uniform approaches such as chemotherapy. The identification of novel treatment options likely requires the identification of cancer cell vulnerabilities that take into account the different genetic and epigenetic make-up of the individual tumors. Here we show that STK3 depletion by knock-down, knock-out or chemical inhibition results in apoptotic cells death in some but not all AML cell lines and primary cells tested. This effect is mediated by a premature activation of cyclin dependent kinase 1 (CDK1) in presence of elevated cyclin B1 levels. The anti-leukemic effects seen in both bulk and progenitor AML cells suggests that STK3 might be a promising target in a subset of AML patients.
Powerful environment perception systems are a fundamental prerequisite for the successful deployment of intelligent vehicles, from advanced driver assistance systems to self-driving cars. Arguably the most essential task of such systems is the reliable detection and localization of obstacles in order to avoid collisions. Two particularly challenging scenarios in this context are represented by small, unexpected obstacles on the road ahead, and by potentially dynamic objects observed from a large distance. Both scenarios become exceedingly critical when the ego-vehicle is traveling at high speed. As a consequence, two major requirements placed on environment perception systems are the capability of (a) high-sensitivity generic object detection and (b) high-accuracy obstacle distance estimation. The present thesis addresses both requirements by proposing novel approaches based on stereo vision for spatial perception.
First, this work presents a novel method for the detection of small, generic obstacles and objects at long range directly from stereo imagery. The detection is based on sound statistical tests using local geometric criteria which are applicable to both static and moving objects. The approach is not limited to predefined sets of semantic object classes and does not rely on restrictive assumptions on the environment, such as oversimplified global ground surface models. Free-space and obstacle hypotheses are evaluated based on a statistical model of the input image data in order to avoid a loss of sensitivity through intermediate processing steps. In addition to the detection result, the algorithm simultaneously yields refined estimates of object distances, originating from an implicit optimization of the geometric obstacle hypothesis models. The proposed detection system provides multiple flexible output representations, ranging from 3D obstacle point clouds to compact mid-level obstacle segments to bounding box representations of object instances suitable for model-based tracking. The core algorithm concept lends itself to massive parallelization and can be implemented efficiently on dedicated hardware. Real-time execution is demonstrated on a test vehicle in real-world traffic. For a thorough quantitative evaluation of the detection performance, two dedicated datasets are employed, covering small and hard-to-detect obstacles in urban environments as well as distant dynamic objects in highway driving scenarios. The proposed system is shown to significantly outperform current general purpose obstacle detection approaches in both setups, providing a considerable increase in detection range while reducing the false positive rate at the same time.
Second, this work considers the high-accuracy estimation of object distances from stereo vision, particularly at long range. Several new methods for optimizing the stereo-based distance estimates of detected objects are proposed and compared to state-of-the-art concepts. A comprehensive statistical evaluation is performed on an extensive dedicated dataset, establishing reference values for the accuracy limits actually achievable in practice. Notably, the refined distance estimates implicitly provided by the proposed obstacle detection system are shown to yield highly accurate results, on par with the top-performing dedicated stereo matching algorithms considered in the analysis.
Ich hatte im Wintersemester 1968 in Frankfurt mit dem Pharmaziestudium angefangen. Das pharmazeutische Institut lag ja damals in der Georg-Voigt-Straße, also nicht weit entfernt vom Zentrum der Studentenunruhen, dem Uni-Hauptgebäude mit der Aula. Daher haben wir einiges von den Protesten mitbekommen. ...
Über die Bedeutung des geistigen Erbes von 68 wird 50 Jahre später trefflich gestritten. Mögen die politischen Ideen des Aufbruchs und das daran anknüpfende Handeln heute für Kontroversen sorgen, so erfreut sich hingegen der Sound der Revolution, der damals zum Ärger orthodoxer Kommunisten ganz klar von der Rockmusik dominiert wurde, einer nahezu ungebrochenen Begeisterung: Das "»Weiße Album" der Beatles, "Electric Ladyland" von Jimi Hendrix oder "Beggars Banquet" von den Rolling Stones, alle 68 erschienen, werden heute mehr denn je bewundert. Im Zeichen einer grassierenden "Retromania" (Simon Reynolds) gewinnt der mit Mythen und Heldengeschichten aufgeladene Sound der Vergangenheit mit zunehmendem zeitlichen Abstand sogar noch an Bedeutung. In ihrer Frühphase ist die Popmusik noch ein Wettstreit verschiedener Stile, Techniken und auch Bands. Ihre steigende gesellschaftliche Akzeptanz lässt aber spätestens in den 70er Jahren Zweifel laut werden an ihrer weiterhin behaupteten und auch inszenierten Widerständigkeit.