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Einleitung: Die RPF ist eine seltene, chronisch entzündliche Erkrankung, deren häufigste Komplikation die Ureterkompression mit Hydronephrose und Nierenversagen ist. In der medikamentösen Therapie stellt Tamoxifen (TMX) eine wirksame Alternative zu Corticosteroiden dar. Die Umwandlung[zum vollständigen Text gelangen Sie über die oben angegebene URL], 65. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie

Hintergrund: Die Untersuchung der Netzhaut des Auges mit Hilfe der Optischen Kohärenztomographie (OCT) erlaubt die Darstellung von retinalen Schichten. Die retinale Nervenfaserschicht (RNFL) ist bei Patienten mit Multipler Sklerose (MS) im Vergleich zu gesunden erniedrigt. Erste Studien haben zudem einen Zusammenhang zwischen RNFL Dicke und Hirnatrophie bei Patienten mit MS gezeigt. Zurzeit wird OCT als möglicher Verlaufsparameter für Neurodegeneration bei MS Patienten diskutiert. Zielsetzung: Den Zusammenhang zwischen Veränderungen der retinalen Nervenfaserschichtdicke und Hirnatrophie- Markern in einer geplanten Studie zu belegen und weiter zu untersuchen. Methodik: In vier Studien wurden Patienten mit schubförmig-remittierender MS oder klinisch-isoliertem Syndrom mittels OCT, Magnetresonanztomographie und Magnetresonanzspektroskopie untersucht. Ergebnisse: Ein Zusammenhang zwischen RNFL und Hirnparenchymvolumen konnte bestätigt werden. Zudem besteht ein Zusammenhang zu neurochemischen Parametern der Neurodegeneration im visuellen Cortex. Eine Sehnervenentzündung beeinflusst den Zusammenhang zwischen RNFL und Hirnatrophie. Bei Patienten mit sehr geringer Erkrankungsdauer steht ein Zusammenhang zwischen RNFL und weißer Substanz im Vordergrund. Zusammenfassung: OCT ist ein vielversprechender Parameter zur Verlaufsbeobachtung von MS Patienten. Mit Einschränkungen bei Erkrankungsdauer und Sehnervenentzündungen lassen sich potentiell Aussagen zum Krankheitsverlauf stellen., Background: Imaging the eye’s retina with optical coherence tomography (OCT) allows investigating retinal layers. It is now known that the retinal nerve fiber layer (RNFL) is reduced in patients with multiple sclerosis (MS) in comparison to healthy subjects. Furthermore, a correlation between RNFL thickness and brain atrophy assessed by magnetic resonance imaging (MRI) was shown. Currently, OCT is a potential candidate for monitoring disease progression in MS. Objective: To further investigate the association between retinal markers from OCT with brain atrophy markers from MRI. Methods: In four studies, patients with relapsing-remitting MS or clinically isolated syndrome were investigated with OCT, MRI and magnetic resonance spectroscopy. Results: An association between RNFL and brain atrophy was confirmed. Furthermore, RNFL was associated with neurochemical parameters for neurodegeneration in the visual cortex. A previous optic neuritis interferes with the link between brain atrophy and RNFL. Furthermore, in early MS patients a correlation between RNFL and brain atrophy could only be seen for white matter. Summary: OCT is a promising candidate for monitoring disease progression in MS patients. Potential conclusions about general or brain disease progression are limited by disease duration and optic neuritis.

This study introduces a knowledge-based shape model for fully automatic segmentation of structures on radiographs, here vertebrae of the lumbar spine. The goals of this study were to examine whether the method is exact enough to determine medical structures on radiographs and to decide which practical use it may have. Additionally angles, lengths and distances were automatically calculated to examine if the algorithm is able to automatically assess functional measurements. Special focus was set on the different quality of radiographs. Therefore quality standards were created to divide radiographs into three different categories due to their difficulty for an automatic segmentation. To evaluate the accuracy of the method the automatically segmented structures were compared with manually drawn outlines according to different benchmarks. Particularly the organs outlines and outstanding structure points were verified. The automatically segmented corner points were used to calculate the intervertebral angle, the height of every single vertebra, the height of the intervertebral disc and the sagittal displacement. These figures were compared to manually identified references. Finally the algorithm was transferred from lumbar to cervical spine. The study achieved the following basic results: As the method relies on a statistical model a perfect segmentation of an individual structure cannot be achieved. The method is appropriate to distinguish the structures it was trained on. Outlines were recognized with a certain precision to define from neighbouring structures. Significant structure points were identified with minor deviation. The accuracy of the method decreases with declining image quality. Being a fully automatic method results are always reproducible. But this also means that a primary false estimation of the algorithm necessarily leads to false results which cannot be amended automatically. Functional measurements can be estimated automatically by the computer. It is able calculate both angles and distances. Trained for different closed structures the algorithm may be installed for many different tasks. The algorithm disposes of both a topological order and certain shape information which enable it to ignore interferences in the radiographs. This leads to acceptable results even on images with poor quality. On the basis of the results of this study the introduced algorithm may - with certain restrictions – assist in clinical routine.

Alexander Brandt In Fraktur

Digiteeritud Euroopa Regionaalarengu Fondi rahastusel, projekti "Eesti teadus- ja õppekirjandus" (2014-2020.12.03.21-0848) raames., https://www.ester.ee/record=b1880981*est

Digiteeritud Euroopa Regionaalarengu Fondi rahastusel, projekti "Eesti teadus- ja õppekirjandus" (2014-2020.12.03.21-0848) raames., https://www.ester.ee/record=b4134648*est