Proceedings of the 2014 6th International Advanced Research Workshop on In Silico Oncology and Cancer Investigation - The CHIC Project Workshop (IARWISOCI), 2014
In order to find out whether sialic acid (SA) is suitable as a tumor marker this compound was det... more In order to find out whether sialic acid (SA) is suitable as a tumor marker this compound was determined in the sera of 48 healthy and of 168 sick children. In healthy children under six months of age lower concentrations of SA were found (x = 41 +/- 5 mg/dl) than in subjects aged six months to 18 years (x = 68 +/- 8 mg/dl). Inflammatory diseases of various etiologies lead to a significant increase in both age groups (x = 93 +/- 28 mg/dl), the same could be observed in subjects up to 14 days after surgery. In children with malignant disorders the concentration of SA was significantly higher (x = 83 +/- 27 mg/dl) than in the healthy subjects, but not higher than in patients with inflammatory diseases. We conclude that SA might play a role in the follow up protocol of patients with malignant tumors.
The European project p-medicine creates an information technology infrastructure that facilitates... more The European project p-medicine creates an information technology infrastructure that facilitates the development from current medical practice to personalised medicine. The main access point to this infrastructure is the p-medicine portal that provides clinicians, patients, and researchers a platform to collaborate, share data and expertise, and use tools and services to improve personalised treatments of patients. In this document, we describe the community-based structure of the p-medicine portal and provide information about the p-medicine security framework implemented in the portal. Finally, we show the user interface and describe the p-medicine tools and services integrated in the portal.
Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the... more Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the calculation according to state-of-the-art research is crucial for curing the child. Computer-assistance can be of great value. The objective of our research was to work out a meta-model of chemotherapy planning based on the Unified Modeling Language (UML). The meta-model is used for the development of an application system which serves as a knowledge-acquisition tool for chemotherapy protocols in pediatric oncology as well as for providing protocol-based care. We applied evolutionary prototyping, software reengineering techniques and grounded theory, a qualitative method in social research. We repeated the following steps several times over the years: Based on a requirements analysis (i) a meta-model was developed or adapted, respectively (ii). The meta-model served as a basis for implementing evolutionary prototypes (iii). Further requirements were identified (i) from clinical use of t...
Snakes or active contours are energy minimizing deformable curves that are used for locating obje... more Snakes or active contours are energy minimizing deformable curves that are used for locating object boundaries. Although they give accurate results in homogeneous regions, they might fail to provide an accurate segmentation result in cases where both rigid and very elastic behavior is needed at the same time. In this paper, we propose a new technique, based on spatially adaptable parameters, which allows the curve to bend locally, according to underlying gradient and corner image characteristics. This way, strong, smooth edges are robustly defined without falling into local minima while the curve adapts to high curvature, local inhomogeneities in the boundary, also including (or excluding) important anatomical features near the outline of interest that, depending on the application, could be important for the segmentation result. To demonstrate the efficiency of the presented method results on both synthetic and real medical images with clinical annotation, are presented.
Studies in health technology and informatics, 2011
The challenges regarding seamless integration of distributed, heterogeneous and multilevel data a... more The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obt...
Bei der Untersuchung sahen wir einen 113 cm großen und 26 kg schweren Jungen, der von seinem Vate... more Bei der Untersuchung sahen wir einen 113 cm großen und 26 kg schweren Jungen, der von seinem Vater wegen Knochenschmerzen getragen wurde. Er war geistig und motorisch retardiert und hatte einen iatrogenen cushingoiden Habitus. Als pathologische Befunde waren eine ausgeprägte Stomatitis, ein kariös zerstörtes Gebiß sowie eine chronische Otitis media mit perforierten Trommelfellen beidseits zu erheben. Der übrige Untersuchungsbefund war unauffällig.
Times Cited: 0 Meeting Abstract English Cited References Count: 0 532DS 1900 M STREET. NW SUITE 2... more Times Cited: 0 Meeting Abstract English Cited References Count: 0 532DS 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA WASHINGTON
The option of nephron sparing surgery for unilateral Wilms tumor has been debated in the recent l... more The option of nephron sparing surgery for unilateral Wilms tumor has been debated in the recent literature. This procedure is being used increasingly to preserve kidney tissue and function. However, nephron sparing surgery is feasible only for selected cases, and a higher local relapse rate has been observed. Moreover, a significant reduction of nephrons is associated with development of renal hypertension and progressive renal failure. We analyzed outcomes after bilateral partial nephrectomy and unilateral partial plus contralateral total nephrectomy in patients with bilateral Wilms tumor. We analyzed data from the Society of Pediatric Oncology and Hematology database on 22 patients with bilateral Wilms tumor. Kidney size was measured using volumetric analysis of magnetic resonance imaging. Patients were matched with children who had undergone magnetic resonance imaging of the abdomen for other malignancies. Mean kidney volumes after unilateral partial plus total contralateral nephrectomy (66.9 cm(3)) were significantly greater than the reference kidneys (p = 0.028), whereas controls were equal to the bilateral partial nephrectomy group (49.7 cm(3), p = 0.959). Total kidney volume was significantly larger after bilateral partial nephrectomy (102.1 cm(3)) vs unilateral partial plus total contralateral nephrectomy (66.9 cm(3), p = 0.0338). Eight patients (66.7%) had renal hypertension after unilateral partial plus total contralateral nephrectomy but only 2 (20%) after bilateral partial nephrectomy (p = 0.043). Overall survival and relapse rates were equal between the groups and did not correlate with unfavorable histology. Our findings suggest that patients with bilateral Wilms tumor benefit from bilateral nephron sparing surgery. Hypertension is less common after bilateral partial nephrectomy, and rates of local relapse or disease associated death are distributed equally between the groups.
Proceedings of the 2014 6th International Advanced Research Workshop on In Silico Oncology and Cancer Investigation - The CHIC Project Workshop (IARWISOCI), 2014
In order to find out whether sialic acid (SA) is suitable as a tumor marker this compound was det... more In order to find out whether sialic acid (SA) is suitable as a tumor marker this compound was determined in the sera of 48 healthy and of 168 sick children. In healthy children under six months of age lower concentrations of SA were found (x = 41 +/- 5 mg/dl) than in subjects aged six months to 18 years (x = 68 +/- 8 mg/dl). Inflammatory diseases of various etiologies lead to a significant increase in both age groups (x = 93 +/- 28 mg/dl), the same could be observed in subjects up to 14 days after surgery. In children with malignant disorders the concentration of SA was significantly higher (x = 83 +/- 27 mg/dl) than in the healthy subjects, but not higher than in patients with inflammatory diseases. We conclude that SA might play a role in the follow up protocol of patients with malignant tumors.
The European project p-medicine creates an information technology infrastructure that facilitates... more The European project p-medicine creates an information technology infrastructure that facilitates the development from current medical practice to personalised medicine. The main access point to this infrastructure is the p-medicine portal that provides clinicians, patients, and researchers a platform to collaborate, share data and expertise, and use tools and services to improve personalised treatments of patients. In this document, we describe the community-based structure of the p-medicine portal and provide information about the p-medicine security framework implemented in the portal. Finally, we show the user interface and describe the p-medicine tools and services integrated in the portal.
Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the... more Chemotherapy planning in pediatric oncology is complex and time-consuming. The correctness of the calculation according to state-of-the-art research is crucial for curing the child. Computer-assistance can be of great value. The objective of our research was to work out a meta-model of chemotherapy planning based on the Unified Modeling Language (UML). The meta-model is used for the development of an application system which serves as a knowledge-acquisition tool for chemotherapy protocols in pediatric oncology as well as for providing protocol-based care. We applied evolutionary prototyping, software reengineering techniques and grounded theory, a qualitative method in social research. We repeated the following steps several times over the years: Based on a requirements analysis (i) a meta-model was developed or adapted, respectively (ii). The meta-model served as a basis for implementing evolutionary prototypes (iii). Further requirements were identified (i) from clinical use of t...
Snakes or active contours are energy minimizing deformable curves that are used for locating obje... more Snakes or active contours are energy minimizing deformable curves that are used for locating object boundaries. Although they give accurate results in homogeneous regions, they might fail to provide an accurate segmentation result in cases where both rigid and very elastic behavior is needed at the same time. In this paper, we propose a new technique, based on spatially adaptable parameters, which allows the curve to bend locally, according to underlying gradient and corner image characteristics. This way, strong, smooth edges are robustly defined without falling into local minima while the curve adapts to high curvature, local inhomogeneities in the boundary, also including (or excluding) important anatomical features near the outline of interest that, depending on the application, could be important for the segmentation result. To demonstrate the efficiency of the presented method results on both synthetic and real medical images with clinical annotation, are presented.
Studies in health technology and informatics, 2011
The challenges regarding seamless integration of distributed, heterogeneous and multilevel data a... more The challenges regarding seamless integration of distributed, heterogeneous and multilevel data arising in the context of contemporary, post-genomic clinical trials cannot be effectively addressed with current methodologies. An urgent need exists to access data in a uniform manner, to share information among different clinical and research centers, and to store data in secure repositories assuring the privacy of patients. Advancing Clinico-Genomic Trials (ACGT) was a European Commission funded Integrated Project that aimed at providing tools and methods to enhance the efficiency of clinical trials in the -omics era. The project, now completed after four years of work, involved the development of both a set of methodological approaches as well as tools and services and its testing in the context of real-world clinico-genomic scenarios. This paper describes the main experiences using the ACGT platform and its tools within one such scenario and highlights the very promising results obt...
Bei der Untersuchung sahen wir einen 113 cm großen und 26 kg schweren Jungen, der von seinem Vate... more Bei der Untersuchung sahen wir einen 113 cm großen und 26 kg schweren Jungen, der von seinem Vater wegen Knochenschmerzen getragen wurde. Er war geistig und motorisch retardiert und hatte einen iatrogenen cushingoiden Habitus. Als pathologische Befunde waren eine ausgeprägte Stomatitis, ein kariös zerstörtes Gebiß sowie eine chronische Otitis media mit perforierten Trommelfellen beidseits zu erheben. Der übrige Untersuchungsbefund war unauffällig.
Times Cited: 0 Meeting Abstract English Cited References Count: 0 532DS 1900 M STREET. NW SUITE 2... more Times Cited: 0 Meeting Abstract English Cited References Count: 0 532DS 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA WASHINGTON
The option of nephron sparing surgery for unilateral Wilms tumor has been debated in the recent l... more The option of nephron sparing surgery for unilateral Wilms tumor has been debated in the recent literature. This procedure is being used increasingly to preserve kidney tissue and function. However, nephron sparing surgery is feasible only for selected cases, and a higher local relapse rate has been observed. Moreover, a significant reduction of nephrons is associated with development of renal hypertension and progressive renal failure. We analyzed outcomes after bilateral partial nephrectomy and unilateral partial plus contralateral total nephrectomy in patients with bilateral Wilms tumor. We analyzed data from the Society of Pediatric Oncology and Hematology database on 22 patients with bilateral Wilms tumor. Kidney size was measured using volumetric analysis of magnetic resonance imaging. Patients were matched with children who had undergone magnetic resonance imaging of the abdomen for other malignancies. Mean kidney volumes after unilateral partial plus total contralateral nephrectomy (66.9 cm(3)) were significantly greater than the reference kidneys (p = 0.028), whereas controls were equal to the bilateral partial nephrectomy group (49.7 cm(3), p = 0.959). Total kidney volume was significantly larger after bilateral partial nephrectomy (102.1 cm(3)) vs unilateral partial plus total contralateral nephrectomy (66.9 cm(3), p = 0.0338). Eight patients (66.7%) had renal hypertension after unilateral partial plus total contralateral nephrectomy but only 2 (20%) after bilateral partial nephrectomy (p = 0.043). Overall survival and relapse rates were equal between the groups and did not correlate with unfavorable histology. Our findings suggest that patients with bilateral Wilms tumor benefit from bilateral nephron sparing surgery. Hypertension is less common after bilateral partial nephrectomy, and rates of local relapse or disease associated death are distributed equally between the groups.
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