Higher diagnostic possibilities of Bioplasm

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According to OMERACT there are no difference between cysts and erosions, and destruction degree is measured in points from 1 to 6. In a work of A.U. Vassiliev cysts and erosions are studied separately, but in our study we preferred to use international method of evaluation OMERACT–RAMRIS.

Higher diagnostic possibilities of Bioplasm  in revealing of bone tissue destruction are defined by physical parameters of this method. Differing from roentgenography, where the basis of the method is absorption of x-ray radiation by osseous tissue, application of non-linear scanning method is based on evaluation of background information noise released by destructing biological structure. That is why Bioplasm diagnostic method allows to evaluate the earliest pre-clinical changes in organs and tissues, which is impossible to do using other hardware methods of investigations (x-ray, ultrasound, CT, MRI), that can detect already formed, “perceptible to the eye” pathological process.

Bioplasm nls software ultramicroscanning with spectral entropic analysis

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Specification of pathomorphological changes, typical for RA, was carried out with application of Bioplasm nls software-ultramicroscanning with spectral-entropic analysis (SEA) by comparison of spectral images of pathologically changed tissues with digital etalons of healthy and pathologically changed tissues stored in a PC memory.

Results of SEA correlated with materials of histological and cytological studies of samples taken from nidi of osseous and articular tissue affection in 87.8% of cases.

Simple requirements for installation of Bioplasm 9d nls analyzer system

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Thanks to comparatively affordable price of such equipment and simple requirements for installation of Bioplasm 9d nls analyzer-system, it finds more extensive application in comparison with CT and MRI. Also we should emphasize comparable sensitivity and specificity of researches with these devices.
At the present moment the major part of carried our researches in Russia represents studies with comparatively small amount of patients with application of low-frequency Bioplasm 9d nls analyzer-systems of obsolete models, “adjusted” to carry out researches of hands and large joins mainly. The present article gives qualitative characteristics of hands affection main symptoms, revealed with high-frequency systems “Metatron”-4025 for Bioplasm 9d nls analyzer-diagnostics of patients with an early RA.

Bioplasm 9d nls in early diagnostics of RA

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At the present moment there are no scientific works describing application of Bioplasm 9d nls in early diagnostics of RA. Until now the method is still not verified and consequently should be investigated further. Also high hopes are put on this method, because according to our data basing of results of Bioplasm 9d nls-study it is possible to carry out early and complete diagnostics of RA, stratify patients in accordance with erosive changes development risk rate and choose a proper tactics of patients with an early RA treatment. Thanks to the absence of radiation exposure, Bioplasm 9d nls research can be repeated quite frequently – it will allow to monitor changes in joints and surrounding soft tissues condition and efficiency of applied treatment, including with application of “biological” agents.

Hardware visualization of bones and joints

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All abovementioned showed a need in perfection of existing methods of hardware visualization of bones and joints, especially of hands and feet, because typical affection of peripheral joints is one of diagnostic characters of RA. Traditional method, tested by decades of practical application and numerous clinical trials – roentgenography has sufficient specificity and accuracy – 93.7% and 85.5% correspondingly, but poor sensitivity – 77.2%. However because of physical parameters standard roentgenography cannot reveal affection of soft tissues, and achieved result – two-dimensional image, representing a summatory picture of various areas of a bone, has a certain limit of sensitivity and cannot be repeated frequently, due to dosage of exposure radiation, absorbed by a patient.
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Efficiency of one of the most widely spread rheumatic disease

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Efficiency of one of the most widely spread rheumatic disease – rheumatoid arthritis (RA) treatment has increased greatly in the last decade because of development and introduction into clinical practice of new medications, which can prevent inevitable progressing of joints destruction and joint dysfunction in patients with RA. Studies of RA pathogenesis allowed to make a conclusion about necessity in active early treatment, application of basic anti-inflammatory therapy (BAIT), because it can help to modify clinical course of the disease more efficiently and also it ensures positive prognosis for functional condition of affected joints. Appearance of new group of preparations – biological agents (antycytoktine therapy) and their application in combination with traditional means of BAIT allow to achieve a significant success in treatment of RA patients. At the same time it was found that duration of “therapeutic period” – a period of time since the moment of definite RA diagnosing till the moment when active therapy poorly affects joints destruction – is quite short – a year approximately, and the best results are achieved in the beginning of a therapy, within first three months since the incursion of the disease.

Bioplasm-graphy is more informative method in diagnostics

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1. Bioplasm-graphy is more informative method in diagnostics of invasive pulmonary mycoses in comparison with roentgenography. Its sensitivity is 86%, specificity – 75% and diagnostic accuracy – 80% (67.2-90.3) (p < 0.05).

2. X-ray pattern depends on duration of the process at IPA. In the beginning of the process (1st – 3rd day) the most frequently revealed sign is nidal and interstitial changes of lungs (75%). 4th – 7th days are characterized by prevalence of roundish induration of pulmonary tissue (75%), halo symptom is revealed (40%). After 8th day nidal and interstitial changes are revealed less frequently, air crescent symptom may be registered (9%).

We diagnosed a pneumothorax through by Bioplasm nls software

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The third period of time (8th – 20th day) was marked by even less amount of changes revealed according to both methods.
During the third period of time we registered IPA pathognomonic symptom – air crescent sign, represented by moderately chromogenic cavity with roundish solid content. The content was separated from a wall by thin crescent achromogenic layer of air, resembling crescent moon. The sign was revealed in 9% by Bioplasm nls software
-study and in 3.6% by roentgenography.

In one patients we diagnosed a pneumothorax.

Bioplasm 9d nls analyzer-graphy in 7 patients

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He most frequently registered change of pulmonary parenchyma at IPA were nidi and foci of hyperchromogeneity (5-6 points at Fleindler’s scale) of pulmonary tissue – 75%.
Alveolar infiltration was detected in 1/3 of patients approximately.
One of the most serious complications of IPA is infarction pneumonia-pneumonia; it was registered by Bioplasm 9d nls analyzer-graphy in 7 (13%) patients. At the same time we detected areas of hyperchromogeneity of pulmonary tissue of conical form, adjoining pleura with broad side. With the same frequency hydrothorax development was revealed.

It should be notes that revealed nidi, foci and pulmonary tissue infiltration areas in majority of cases had subpleural location.

IPA was diagnosed with spectral-entropic analysis

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In 98.6% of patients IPA was diagnosed with spectral-entropic analysis. In affection nidi a high spectral similarity to “Aspergillus fumigatus” etalon (D<0.425) was found. At the early stages of IPA development high body temperature, more than 38, refractory to antibiotics, was registered in 54 (98%) cases, couching – in 34 (62%), pneumorrhagia – in 13 (24%). 13 (34%) patients complained about pain in thoracic region. Dissemination of the process, revealed by SEA, was registered in 3 (5%) patients, at the same time in all of them cerebral affection was diagnosed. During the study 14 (26%) patients died. In one case we registered self-recovery of the patient, in which IPA developed against the background of normal immunity.
Bioplasm 9D NLS can test human body health,it is useful for us.

Bioplasm machine-ultramicroscanning of morphological structures

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When pathological changes were found, the research was extended with Bioplasm machine-scanning in 4D Tissue mode with Bioplasm machine-ultramicroscanning of morphological structures in a researched area. Some patients were subjected to repeated Bioplasm machine-studies in order to evaluate dynamics of changes, revealing of complications and monitoring of therapeutic interventions. At assumption of mycotic process dissemination, we carried out Bioplasm machine-ultramicroscanning and SEA of other anatomic regions (abdominal cavity, brain, paranasal sinuses).
Data acquired during the study was processed at a PC IntelPentium 166 MMX using software system Statistica for Windows (version 5.11).

Fumigatus antigen was defined by latex particle agglutination mathod

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To carry out histological research the authors used paraffin and frozen section, colored with haematoxylin and eosin, azure II-eosin, Gram-Weigert method, PAS-response, Grocott-Gomori method.

Precipitating antibodies to Aspergillus spp. antigens were defined applying enzyme multiplied immunoassay (EMI). A part of patients was subjected to precipitation reaction.

Total IgE and specific IgE to A.fumigatus was found using methods of radioimmunosorbent test in a nuclear medicine laboratory and enzyme multiplied immunoassay in a laboratory of allergens and allergy diagnostics. Measuring of total IgE was done in kU/l (thousands of international units in a litre, 1 unit = 2.4 ng).

fumigatus antigen was defined by latex particle agglutination mathod by Pastorex company.

Invasive pulmonary aspergilliosis IPA is the most severe form of the disease

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Invasive pulmonary aspergilliosis (IPA) is the most severe form of the disease, when dissemination of the process into other organs (CNS, parenchymatous organs of abdominal cavity) is possible. Often the first symptom of invasive mycotic infection is a fever, refractory to broad-spectrum antibiotics. Absence of a result at treatment with antibacterial preparations at clinical picture of acute pneumonia in patients with expressed immune suppression must be regarded as a possibility of IPA development. When such clinical manifestations are registered diagnostic maneuvers must be fulfilled. Speed and intensity of IPA manifestations depend on degree of immune suppression. IPA signs reveal themselves distinctly after granulocytopaenia, Sometimes IPA diagnosis may be made basing on results of a biopsy only, but a risk of haemorrhagic complications in patients with hemoblastoses may be one of barriers for biopsy.

Therapists single out invasive and non-invasive aspergillosis

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Results of 8124 autopsies show that incidence of mycotic infections in clinics of Frankfurt on the Main has increased from 2.2% in 1978 to 5.3% in 2004. This increase happened mainly due to aspergillus infection, incidence of which has increased 10 times within this period of time.

A peculiarity of aspergillus infection course is a variety of its clinical manifestations. Therapists single out invasive and non-invasive aspergillosis.

Three-dimensional virtual Bioplasm 9d nls analyzer-diagnostics mode

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Three-dimensional virtual Bioplasm 9d nls analyzer-diagnostics mode offers accurate presentation of a shape, surface and structure of a researched neoplasm. From a clinician’s point of view such combined information is very essential, because it makes possible to evaluate interrelation of organs and pathological changes in them.

Dealing with a problem of bile excretory ducts differential diagnostics by means of SEA with three-dimensional visualization is regarded as quite promising way, permitting to optimize treatment and diagnostic processes, decrease a number of inefficient researches, cut application rate of expensive invasive methods in algorithm of this category of patients investigation.

Informativity of three-dimensional Bioplasm 9d nls-study exceeded informativity of ultrasound research

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Tumors of distal part of a bile duct were accompanied by significant increasing of gall bladder size. Surface area of gall bladder varied from 32 sq.cm. to 57 sq.cm. Dilation of intrahepatic ducts was registered in 57% of patients. Diameter of intrahepatic bile ducts ranged 0.2-0.8 cm, of a common bile duct – 0.7 – 1.7 cm. Concomitant concrements in a gall bladder were revealed in 14.3% of patients. Localization of a tumor in intramural part of a common bile duct caused an obstruction of major pancreatic duct entrance, which was dilated in 71.4% of patients. Diameter of major pancreatic duct varied from 0.1 to 0.8 cm.

Informativity of three-dimensional Bioplasm 9d nls-study exceeded informativity of ultrasound research (see Table 3).

Bioplasm machine-diagnostics allowed to increase sensitivity

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A direct symptom of major duodenal papilla tumor is revealing of a space-occupying process in its projection. At growing of a neoplasm into a lumen of a duodenum (n = 6), we detected dilation and tortuosity of a common bile duct distal part and significant thickening of a papilla’s walls, echogeneity of which was decreased mainly. There was no sign of significant dilation of a common bile duct (diameter 0.65 – 1 cm). Also there was no dilation of intrahepatic bile ducts and a major pancreatic duct. Presence of a tumor was confirmed by fiberoptic gastroduodenoscopy with the following histological research. In 4 patients we revealed a glandular cancer, in 2 – adenocarcinoma.
Application of three-dimensional bioplasm machine-diagnostics allowed to increase sensitivity up to 100%, specificity – up to 97% (in 1 patient- false-positive result) in comparison with a standard ultrasound research (see Table 2). Application of CT at the absence of a significant dilation of bile-excretory ducts had lesser diagnostic value (sensitivity – 66.7%, specificity – 93.5%).

Bioplasm nls results were compared to data of a standard ultrasound research

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We also used DeepVision mode, which can make transparent external walls of gall bladder wall and biliary ducts and thus to help to monitor and evaluate deep structures of cavitary lesions, normally hidden by the external layers.
To carry out more detailed evaluation of revealed changes we used the following functions: rotation of an image, allowing to rotate three-dimensional array in any projection for accurate perception of a shape and a surface of a scanned object; segmentation of an image (Fast Vision), allowing to select area of interest from the main image and remove screening structures. Modes of rotation, segmentation and multiplanar image scanning help to improve significantly evaluation quality of all analyzed signs with their following analysis, as the addition to transparency of multidimensional image on/off mode. Multiplanar image scanning mode with step-by-step visualization and evaluation of all signs in a researched area allows to specify a localization of an object and evaluate in details all analyzed signs with simultaneous scanning in three planes in a selected crosscut. The optimal procedure is a consecutive application of all available three-dimensional image rendering modes for studying of every patient.

Acquired Bioplasm nls  results were compared to data of a standard ultrasound research, CT, fiberoptic gastroduodenoscopy, endoscopic retrograde cholangiopancreatography and surgery findings.

Bioplasm nls software results were compared to data of a standard ultrasound research

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We also used DeepVision mode, which can make transparent external walls of gall bladder wall and biliary ducts and thus to help to monitor and evaluate deep structures of cavitary lesions, normally hidden by the external layers.

To carry out more detailed evaluation of revealed changes we used the following functions: rotation of an image, allowing to rotate three-dimensional array in any projection for accurate perception of a shape and a surface of a scanned object; segmentation of an image (Fast Vision), allowing to select area of interest from the main image and remove screening structures. Modes of rotation, segmentation and multiplanar image scanning help to improve significantly evaluation quality of all analyzed signs with their following analysis, as the addition to transparency of multidimensional image on/off mode. Multiplanar image scanning mode with step-by-step visualization and evaluation of all signs in a researched area allows to specify a localization of an object and evaluate in details all analyzed signs with simultaneous scanning in three planes in a selected crosscut. The optimal procedure is a consecutive application of all available three-dimensional image rendering modes for studying of every patient.

Acquired Bioplasm nls software  results were compared to data of a standard ultrasound research, CT, fiberoptic gastroduodenoscopy, endoscopic retrograde cholangiopancreatography and surgery findings.

Three-dimensional reconstruction was possible

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At the first stage all patients were subjected to routine ultrasound examination of hepatobiliary system organs. Further on, in order to specify a nosological for of a disease, we used method of three-dimensional virtual Bioplasm 9d nls analyzer
-reconstruction of an image and other hardware and laboratory researches (in accordance to medical and financial standards for this nosological type of a disease).
 Three-dimensional reconstruction was possible because of integrated into Metatron system specialized computer and mathematical program for Bioplasm 9d nls analyzer-information processing and virtual rendering of an image in various formats. The acquired data was processed with programs of interactive multidimensional visualization – 4D Tissue. These programs allow to get images with shaded surface and transparent layers.

Bioplasm 9d nls-investigation is absolutely safe and harmless

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Besides, endoscopic retrograde cholangiopancreatography, just like other endoscopic interventions, is not completely safe and related to a broad spectrum of complications. Serious complications, which can develop due to endoscopic retrograde cholangiopancreatography application, are responsive pancreatitis, hemorrhage from areas of major duodenal papilla, gall bladder, bile-excretory and Wirsung ducts, perforation of duodenum and bile ducts, infectious complications (purulent angiocholitis first of all). According to some authors, frequency of responsive pancreatitis development after endoscopic retrograde cholangiopancreatography was 7% – 40%. Differing from ERCPG, Bioplasm 9d nls-investigation is absolutely safe and harmless.

Bioplasm machine have a significant importance in diagnostics

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Fibrogastroduodenoscopy and three-dimensional Bioplasm machine  have a significant importance in diagnostics of major duodenal papilla tumors. Endoscopic picture of the cancer at late stages is quite typical: tuberiferous tumor of red or crimson color, occupying a part or whole major duodenal papilla.
Due to similar density values of major duodenal papilla cancer and surrounding bile, application of computed tomography cannot visualize this lesion, especially when a tumor is small and bile and pancreatic ducts are not dilated. But CT is more precisely, in comparison with standard two-dimensional Bioplasm machine-study, identifies a side and reason of extrahepatic biliary obstruction. At major duodenal papilla cancer CT shows rupture of common bile duct and major pancreatic duct without any signs of these manifestations combination with tumorous affection. When positive contrast is used, a small defect in an area of major duodenal papilla is seen in duodenum lumen.