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  1. Article ; Online: Unsupervised domain adaptation for the detection of cardiomegaly in cross-domain chest X-ray images

    Patrick Thiam / Ludwig Lausser / Christopher Kloth / Daniel Blaich / Andreas Liebold / Meinrad Beer / Hans A. Kestler

    Frontiers in Artificial Intelligence, Vol

    2023  Volume 6

    Abstract: In recent years, several deep learning approaches have been successfully applied in the field of medical image analysis. More specifically, different deep neural network architectures have been proposed and assessed for the detection of various ... ...

    Abstract In recent years, several deep learning approaches have been successfully applied in the field of medical image analysis. More specifically, different deep neural network architectures have been proposed and assessed for the detection of various pathologies based on chest X-ray images. While the performed assessments have shown very promising results, most of them consist in training and evaluating the performance of the proposed approaches on a single data set. However, the generalization of such models is quite limited in a cross-domain setting, since a significant performance degradation can be observed when these models are evaluated on data sets stemming from different medical centers or recorded under different protocols. The performance degradation is mostly caused by the domain shift between the training set and the evaluation set. To alleviate this problem, different unsupervised domain adaptation approaches are proposed and evaluated in the current work, for the detection of cardiomegaly based on chest X-ray images, in a cross-domain setting. The proposed approaches generate domain invariant feature representations by adapting the parameters of a model optimized on a large set of labeled samples, to a set of unlabeled images stemming from a different data set. The performed evaluation points to the effectiveness of the proposed approaches, since the adapted models outperform optimized models which are directly applied to the evaluation sets without any form of domain adaptation.
    Keywords chest X-ray ; cardiomegaly ; deep learning ; transfer learning ; unsupervised domain adaptation ; Electronic computers. Computer science ; QA75.5-76.95
    Subject code 006
    Language English
    Publishing date 2023-02-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Non-invasive determination of pressure recovery by cardiac MRI and echocardiography in patients with severe aortic stenosis

    Florian Sagmeister / Sebastian Herrmann / Tobias Gassenmaier / Peter Bernhardt / Volker Rasche / Andreas Liebold / Frank Weidemann / Horst Brunner / Meinrad Beer

    Journal of International Medical Research, Vol

    short and long-term outcome prediction

    2020  Volume 48

    Abstract: Objective To assess the influence of pressure recovery (PR)-corrected haemodynamic parameters on outcome in patients with aortic stenosis. Methods Aortic stenosis severity parameters were corrected for PR (increase in static pressure due to decreasing ... ...

    Abstract Objective To assess the influence of pressure recovery (PR)-corrected haemodynamic parameters on outcome in patients with aortic stenosis. Methods Aortic stenosis severity parameters were corrected for PR (increase in static pressure due to decreasing dynamic pressure), assessed using transthoracic echocardiography (TTE) or cardiac magnetic resonance imaging (CMR), in patients with aortic stenosis. PR, indexed PR (iPR) and energy loss index (ELI) were determined. Factors that predicted all-cause mortality, and 9-month or 10-year New York Heart Association classification ≥2 were assessed using Cox proportional hazards regression. Results A total of 25 patients, aged 68 ± 10 years, were included. PR was 17 ± 6 mmHg using CMR, and CMR correlated with TTE measurements. PR correction using CMR data reduced the AS-severity classification in 12–20% of patients, and correction using TTE data reduced the AS-severity classification in 16% of patients. Age (Wald 4.774) was a statistically significant predictor of all-cause mortality; effective orifice area (Wald 3.753) and ELI (Wald 3.772) almost reached significance. Conclusions PR determination may result in significant reclassification of aortic stenosis severity and may hold value in predicting all-cause mortality.
    Keywords Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Cytokine Reduction in the Setting of an ARDS-Associated Inflammatory Response with Multiple Organ Failure

    Karl Träger / Christian Schütz / Günther Fischer / Janpeter Schröder / Christian Skrabal / Andreas Liebold / Helmut Reinelt

    Case Reports in Critical Care, Vol

    2016  Volume 2016

    Abstract: A 45-year-old male was admitted to our hospital with a small bowel obstruction due to torsion and was immediately scheduled for surgical intervention. At anesthesia induction, the patient aspirated and subsequently developed a severe SIRS with ARDS and ... ...

    Abstract A 45-year-old male was admitted to our hospital with a small bowel obstruction due to torsion and was immediately scheduled for surgical intervention. At anesthesia induction, the patient aspirated and subsequently developed a severe SIRS with ARDS and multiple organ failure requiring the use of ECMO, CRRT, antibiotics, and low dose steroids. Due to a rapid deterioration in clinical status and a concurrent surge in inflammatory biomarkers, an extracorporeal cytokine adsorber (CytoSorb) was added to the CRRT blood circuit. The combined treatment resulted in a rapid and significant reduction in the levels of circulating inflammatory mediators. This decrease was paralleled by marked clinical stabilization of the patient including a significant improvement in hemodynamic stability and a reduced need for norepinephrine and improved respiratory function as measured by PaO2/FIO2, ventilator parameters, lung mechanics, and indirect measures of capillary leak syndrome. The patient could be discharged to a respiratory weaning unit where successful respiratory weaning could be achieved later on. We attribute the clinical improvement to the rapid control of the hyperinflammatory response and the reduction of inflammatory mediators using a combination of CytoSorb and these other therapies. CytoSorb treatment was safe and well tolerated, with no device-related adverse effects observed.
    Keywords Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher Hindawi Publishing Corporation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Safety of Intramyocardial Stem Cell Therapy for the Ischemic Myocardium

    Can Yerebakan / Alexander Kaminski / Andreas Liebold / Gustav Steinhoff

    Cell Transplantation, Vol

    Results of the Rostock Trial after 5-Year Follow-Up

    2007  Volume 16

    Abstract: Stem cell treatment for acute or chronic ischemic myocardium has gained major attention in the last decade. Experimental and clinical studies have shown evidence for functional improvement after cell-based treatments in acute or chronically ischemic ... ...

    Abstract Stem cell treatment for acute or chronic ischemic myocardium has gained major attention in the last decade. Experimental and clinical studies have shown evidence for functional improvement after cell-based treatments in acute or chronically ischemic jeopardized myocardium. Since 2001 we have performed bone marrow-derived CD133+ stem cell transplantations with concomitant coronary artery bypass surgery. Although our focus is mainly on the functional results of the stem cell treatment, possible long-term side effects of the new therapeutic strategy should also be addressed. Here we present for the first time the long-term follow-up safety results of the Rostock trial after direct intramyocardial stem cell treatment in 32 patients.
    Keywords Medicine ; R
    Language English
    Publishing date 2007-10-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Stem Cell Therapy for Ischemic Heart Disease

    Christof Stamm DR / Andreas Liebold / Gustav Steinhoff / Dirk Strunk

    Cell Transplantation, Vol

    Beginning or End of the Road?

    2006  Volume 15

    Abstract: Despite improvements in emergency treatment, myocardial infarction is often the beginning of a downward spiral leading to congestive heart failure. Other than heart transplantation, current therapeutic means aim at enabling the organism to survive with a ...

    Abstract Despite improvements in emergency treatment, myocardial infarction is often the beginning of a downward spiral leading to congestive heart failure. Other than heart transplantation, current therapeutic means aim at enabling the organism to survive with a heart that is working at a fraction of its original capacity. It is therefore no surprise that cardiac stem cell therapy has raised many hopes. However, neither the ideal source and type of stem cell nor the critical cell number and mode of application have been defined so far. Early reports on myocardial repair by adult bone marrow stem cells from rodent models promoted an unparalleled boost of clinical and experimental cell therapy studies. The phenomenon of stem/progenitor cell-induced angiogenesis in ischemic myocardium has ever since been reproduced by numerous groups in a variety of small and large animal models. Myogenesis, however, is an altogether different matter. Many of the initial clinical studies were fueled by the suggestion that early hematopoietic stem cells have a plasticity high enough to enable cross-lineage differentiation into cells of cardiomyocyte phenotype, but the initial enthusiasm has largely faded. The myogenic potential of stroma cell-derived mesenchymal stem cells is much better documented in animal models, but transfer to the clinical setting faces a variety of obstacles. In clinical pilot trials, we and others have demonstrated the feasibility and safety of administering progenitor cells derived from autologous bone marrow to the myocardium of patients with ischemic heart disease. Clinical efficacy data are still rare, but the few controlled trials that have been completed uniformly show a tendency towards better heart function in cell-treated patients. This review is an attempt to describe the scientific basis for cardiac cell therapy from the point of view of the clinician, focusing on problems that arise with beginning translation into the clinical setting.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2006-01-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Autologous stem cell therapy with surgical myocardial revascularization - The Rostock University experience

    Gustav Steinhoff / Andreas Liebold / Bernd Westphal / Alexander Kaminski / Can Yerebakan / Murat Uğurlucan

    Anadolu Kardiyoloji Dergisi, Vol 09, Iss 07, Pp 457-

    2009  Volume 464

    Abstract: Ob­jec­ti­ve: Stem cell therapy has gained great attraction in the treatment of acute and chronic myocardial diseases in recent years. The aim was to evaluate our experience in light of the middle term results of intramyocardial stem cell treatment with ... ...

    Abstract Ob­jec­ti­ve: Stem cell therapy has gained great attraction in the treatment of acute and chronic myocardial diseases in recent years. The aim was to evaluate our experience in light of the middle term results of intramyocardial stem cell treatment with concomitant coronary artery bypass surgery (CABG) since 2001.Methods: After encouraging initial results of the Phase I (safety) trial with the first 15 patients, a prospective, controlled Phase II (efficacy) study was begun with 40 patients aiming to determine functional benefit of stem cell treatment using bone marrow derived CD 133+ stem cell therapy with concomitant CABG in comparison to CABG only since 2003. Medium-term results of intervention were evaluated using patient’s clinical findings, Holter monitoring, echocardiography, magnetic resonance imaging, computed tomography and myocardial scintigraphy. Statistical analyses were performed using unpaired t, Mann-Whitney U, ANOVA for repeated measurements and Chi-square tests. Results: Left ventricular ejection fraction (LVEF) has increased significantly at 6th and 18th months follow-up in the first 15 patients who received therapy since 2001 (preoperative: 39.0±8.7%; 6th month: 50.2±8.5% and 18th month: 47.9±6.0%; p=0.012). In the late group of patients, LVEF increased from 37.4±8.4% to 47.1±8.3% (p<0.001) whilst although an increase in LVEF has been observed in the CABG alone group (from 37.9±10.3% to 41.3±9.1%) the increase has not been statistically significant. Mortality occurred in 2 patients [1 patient from the early and 1 patient from the medium term follow-up] due to non-cardiac reasons. Myocardial calcification, lethal ventricular arrhythmia, and tumor formation have not been observed in any of the patients in the long-term follow up.Conclusion: Direct injection of bone marrow derived CD 133+ stem cells into the myocardium with concomitant CABG is safe. However, this treatment modality may only be applied as standard treatment after completion of the long term detailed results of prospective, randomized multicenter trials.
    Keywords Stem cell ; myocardial ischemia ; heart failure ; cardiac surgery ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Cardiovascular ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 610
    Language Turkish
    Publishing date 2009-12-01T00:00:00Z
    Publisher Aves Yayincilik
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Autologous Umbilical Cord Blood Mononuclear Cell Transplantation Preserves Right Ventricular Function in a Novel Model of Chronic Right Ventricular Volume Overload

    Can Yerebakan M.D. / Eugen Sandica / Stephanie Prietz / Christian Klopsch / Murat Ugurlucan / Alexander Kaminski / Sefer Abdija / Björn Lorenzen / Johannes Boltze / Björn Nitzsche / Dietmar Egger / Malte Barten / Dario Furlani / Nan Ma / Brigitte Vollmar / Andreas Liebold / Gustav Steinhoff

    Cell Transplantation, Vol

    2009  Volume 18

    Abstract: We aimed to evaluate the feasibility and efficacy of autologous umbilical cord blood mononuclear cell (UCMNC) transplantation on right ventricular (RV) function in a novel model of chronic RV volume overload. Four-month-old sheep ( n = 20) were ... ...

    Abstract We aimed to evaluate the feasibility and efficacy of autologous umbilical cord blood mononuclear cell (UCMNC) transplantation on right ventricular (RV) function in a novel model of chronic RV volume overload. Four-month-old sheep ( n = 20) were randomized into cell ( n = 10) and control groups ( n = 10). After assessment of baseline RV function by the conductance catheter method, a transannular patch (TAP) was sutured to the right ventricular outflow tract (RVOT). Following infundibulotomy the ring of the pulmonary valve was transected without cardiopulmonary bypass. UCMNC implantation (8.22 ± 6.28 × 10 7 ) in the cell group and medium injection in the control group were performed into the RV myocardium around the TAP. UCMNCs were cultured for 2 weeks after fluorescence-activated cell sorting (FACS) analysis for CD34 antigen. Transthoracic echocardiography (TTE) and computed tomography were performed after 6 weeks and 3 months, respectively. RV function was assessed 3 months postoperatively before the hearts were excised for immunohistological examinations. FACS analysis revealed 1.2 ± 0.22% CD34 + cells within the isolated UCMNCs from which AcLDL + endothelial cells were cultured in vitro. All animals survived surgery. TTE revealed grade II–III pulmonary regurgitation in both groups. Pressure-volume loops under dobutamine stress showed significantly improved RV diastolic function in the cell group (dP/dt min : p = 0.043; E ed : p = 0.009). CD31 staining indicated a significantly enhanced number of microvessels in the region of UCMNC implantation in the cell group ( p < 0.001). No adverse tissue changes were observed. TAP augmentation and pulmonary annulus distortion without cardiopulmonary bypass constitutes a valid large animal model mimicking the surgical repair of tetralogy of Fallot. Our results indicate that the chronically volume-overloaded RV profits from autologous UCMNC implantation by enhanced diastolic properties with a probable underlying mechanism of increased angiogenesis.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2009-08-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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