IL-23/IL-17 Axis in Chronic Hepatitis C and Non-Alcoholic Steatohepatitis-New Insight into Immunohepatotoxicity of Different Chronic Liver Diseases.

Considering the relevance of the research of pathogenesis of different liver diseases, we investigated the possible activity of the IL-23/IL-17 axis on the immunohepatotoxicity of two etiologically different chronic liver diseases. A total of 36 chronic hepatitis C (CHC) patients, 16 with (CHC-SF) and 20 without significant fibrosis (CHC-NSF), 19 patients with non-alcoholic steatohepatitis (NASH), and 20 healthy controls (CG) were recruited. Anthropometric, biochemical, and immunological cytokines (IL-6, IL-10, IL-17 and IL-23) tests were performed in accordance with standard procedure. Our analysis revealed that a higher concentration of plasma IL-23 was associated with NASH (p = 0.005), and a higher concentration of plasma IL-17A but a lower concentration of plasma IL-10 was associated with CHC in comparison with CG. A lower concentration of plasma IL-10 was specific for CHC-NSF, while a higher concentration of plasma IL-17A was specific for CHC-SF in comparison with CG. CHC-NSF and CHC-SF groups were distinguished from NASH according to a lower concentration of plasma IL-17A. Liver tissue levels of IL-17A and IL-23 in CHC-NSF were significantly lower in comparison with NASH, regardless of the same stage of the liver fibrosis, whereas only IL-17A tissue levels showed a difference between the CHC-NSF and CHC-SF groups, namely, a lower concentration in CHC-NSF in comparison with CHC-SF. In CHC-SF and NASH liver tissue, IL17-A and IL-23 were significantly higher in comparison with plasma. Diagnostic accuracy analysis showed significance only in the concentration of plasma cytokines. Plasma IL-6, IL-17A and IL-23 could be possible markers that could differentiate CHC patients from controls. Plasma IL-23 could be considered a possible biomarker of CHC-NSF patients in comparison with controls, while plasma IL-6 and IL-17-A could be biomarkers of CHC-SF patients in comparison with controls. The most sophisticated difference was between the CHC-SF and CHC-NSF groups in the plasma levels of IL-10, which could make this cytokine a useful biomarker of liver fibrosis.

Evaluation of the Limb Symmetry Index: The Side Hop Test.

The main objective of present study was to evaluate inter-rater reliability and concurrent validity of Side Hop Test stopwatch vs. force plates timing, and to determine the number of sessions and trials required to minimize the effects of learning on Side Hop Test total time and limb symmetry index. Fifteen healthy male physical education students (mean ± SD: age, 23 ± 3 years; height, 181 ± 9 cm; and weight 72 ± 6 kg) participated. Side Hop Test total time (stopwatch and force plates) of left and right leg, and limb symmetry index (force plates) were obtained over seven sessions conducted 5-7 days apart. Time recordings of two raters were similar (t = -0.56, p > 0.05) with high reliability (all ICC >0.99 and CV% <0.1) and no systematic bias when compared to force plate data (p > 0.05; for rater 1 and 2, respectively). Total time improved across the Sessions (F = 25.87, p < 0.01, ω 2 = 0.18) and Trials (F = 68.15, p < 0.01, ω 2 = 0.10), with no significant interaction between factors. No between-leg differences were detected (F = 0.52, p > 0.05, ω 2 = 0.001). Limb symmetry index ranged from 0.999 to 1.055 across all sessions and trials (all p > 0.05 and ω 2 < 0.00). Due to low coefficient of correlation, high interclass correlation coefficient, and the lack in heteroscedasticity, stopwatch measurements are valid to measure total time in the Side Hop Test. Moreover, stopwatch measurements could be reliably used to measure total time in the Side Hop Test, while the test could be administrated with only one experienced rater. Unlike total times, findings on limb symmetry index suggest it could be reliably assessed after seven familiarization sessions.

Endometrioid adenocarcinoma of the ovary: MRI findings with emphasis on diffusion-weighted imaging for the differentiation of ovarian tumors.

BACKGROUND: Preoperative differentiation of ovarian malignant tumors still remains a challenge. Diffusion-weighted imaging (DWI) provides information about cellularity of the lesion and might facilitate discrimination between different malignant ovarian lesions. PURPOSE: To evaluate magnetic resonance imaging (MRI) findings of endometrioid adenocarcinoma of the ovary and to determine the value of DWI in the differential diagnosis of malignant and benign adnexal tumors. MATERIAL AND METHODS: The following MRI findings were reviewed in 162 patients (21 endometrioid adenocarcinoma, 103 other malignant tumors, 38 benign tumors): lesion size, morphological appearance, T2-weighted (T2W) signal intensity, T1-weighted (T1W) signal intensity, contrast-enhancement pattern, DWI signals with apparent diffusion coefficient (ADC) calculated for b = 800 s/mm(2) in solid tumor components. RESULTS: The most common morphological appearance was predominantly cystic lesion, found in 90.3% of patients with endometriod adenocarcinoma. The solid parts were slightly hyperintense on T2W images in 19 patients with marked enhancement after contrast administration. No significant difference (P = 0.13) in conventional MRI features was found between endometrioid adenocarcinoma and other malignant ovarian tumors. Hyperintensity on DWI was more frequently observed in malignant tumors than in benign lesions (P < 0.001). ADC values were significantly lower in endometrioid adenocarcinoma than other malignant tumors (0.79 ± 0.21 vs. 0.90 ± 0.19; P = 0.04) and in all malignant lesions compared with benign tumors (0.88 ± 0.31 vs. 1.33 ± 0.17; P < 0.001). CONCLUSION: DWI with ADC measurement could indicate the presence of endometrioid adenocarcinomas due to a slightly but significantly lower ADC values compared to other malignant ovarian lesions. Thus, DWI is beneficial and should be part of a standard protocol for the evaluation of indeterminate adnexal lesions.

Evaluating the role of content in subjective video quality assessment.

Video quality as perceived by human observers is the ground truth when Video Quality Assessment (VQA) is in question. It is dependent on many variables, one of them being the content of the video that is being evaluated. Despite the evidence that content has an impact on the quality score the sequence receives from human evaluators, currently available VQA databases mostly comprise of sequences which fail to take this into account. In this paper, we aim to identify and analyze differences between human cognitive, affective, and conative responses to a set of videos commonly used for VQA and a set of videos specifically chosen to include video content which might affect the judgment of evaluators when perceived video quality is in question. Our findings indicate that considerable differences exist between the two sets on selected factors, which leads us to conclude that videos starring a different type of content than the currently employed ones might be more appropriate for VQA.

MR image based approach for metal artifact reduction in X-ray CT.

For decades, computed tomography (CT) images have been widely used to discover valuable anatomical information. Metallic implants such as dental fillings cause severe streaking artifacts which significantly degrade the quality of CT images. In this paper, we propose a new method for metal-artifact reduction using complementary magnetic resonance (MR) images. The method exploits the possibilities which arise from the use of emergent trimodality systems. The proposed algorithm corrects reconstructed CT images. The projected data which is affected by dental fillings is detected and the missing projections are replaced with data obtained from a corresponding MR image. A simulation study was conducted in order to compare the reconstructed images with images reconstructed through linear interpolation, which is a common metal-artifact reduction technique. The results show that the proposed method is successful in reducing severe metal artifacts without introducing significant amount of secondary artifacts.

Salient motion features for video quality assessment.

Design of algorithms that are able to estimate video quality as perceived by human observers is of interest for a number of applications. Depending on the video content, the artifacts introduced by the coding process can be more or less pronounced and diversely affect the quality of videos, as estimated by humans. While it is well understood that motion affects both human attention and coding quality, this relationship has only recently started gaining attention among the research community, when video quality assessment (VQA) is concerned. In this paper, the effect of calculating several objective measure features, related to video coding artifacts, separately for salient motion and other regions of the frames of the sequence is examined. In addition, we propose a new scheme for quality assessment of coded video streams, which takes into account salient motion. Standardized procedure has been used to calculate the Mean Opinion Score (MOS), based on experiments conducted with a group of non-expert observers viewing standard definition (SD) sequences. MOS measurements were taken for nine different SD sequences, coded using MPEG-2 at five different bit-rates. Eighteen different published approaches related to measuring the amount of coding artifacts objectively on a single-frame basis were implemented. Additional features describing the intensity of salient motion in the frames, as well as the intensity of coding artifacts in the salient motion regions were proposed. Automatic feature selection was performed to determine the subset of features most correlated to video quality. The results show that salient-motion-related features enhance prediction and indicate that the presence of blocking effect artifacts and blurring in the salient regions and variance and intensity of temporal changes in non-salient regions influence the perceived video quality.

Position of intragastric balloons in global initiative for obesity treatment.

Obesity is chronic disease with multiple health consequences and among the most severe health problems worldwide. According to public health records around 65% of population in Croatia are overweight and 20% obese. National physicians chamber with support of Health and Social Welfare Ministry gave recommendations on diagnosing and treating of obesity in form of national consensus. Treatment of obesity is complex and enrolls multiple clinical specialties. Change of life style, strenuous physical activity and pharmacotherapy are part of conservative treatments. Patients are treated more efficiently by minimally invasive endoscopic procedures or bariatric surgery depending on starting body mass index score. Implantation of intragastric balloons is conceptually simple method of obesity treatment. Modern devices as Bio-Enterics intragastric balloons (BIB), (Inamed Health, USA) are gaining wide popularity among both patients and physicians. BIB intragastric offers the best gains with individuals ranging BMI from 35 to 40. Efficiency has relative timeline dependance from 85% at 6 months to 24% at 36 months. BIB offers substantial ameliorative influence on obesity comorbidities, particularly cardiovascular risk. Treatment with BIB is also efficient but transient treatment modality in morbidly and superobese individuals to reduce preoperative risks of general and bariatric surgery. Obesity treatment with BIB is well tolerated and safe, offering better quality of life. Nevertheless, due to relative poor results of conservative obesity treatments on long-term follow up further investigations defining new clinical parameters for solving treatment resistance. In order to provide resourcefully individualized approach modern perspectives are focused on endocrine constitutes of obesity. Hormonal effects of BIB treatment in compare to bariatric surgery are potentially interesting for the prospect studies.

[Reconstruction of the esophagus with a jejunal segment--case report]. / Rekonstrukcija jednjaka jejunalnim reznjem--prikaz slucaja.

INTRODUCTION: Portions of gastrointestinal tract may be used as microvascular transfers for reconstruction of hypopharynx and esophagus. Colon, jejunum and portions of stomach have also been successfully used. Intestinal transfer by revascularization was reported by Seidenberg in 1959, long before the development of other free tissue transfers. MATERIAL AND METHODS: When an appropriate piece of jejunum is being selected for transfer, the important considerations are its shape and its vascular supply. Because of multiple curves of jejunum, it is difficult to obtain straight lengths longer than 12-15 cm without separating it from its mesentery at both ends. DISCUSSION: Mucous production is very important in the first postoperative days. When edema decreases and patients can swallow fluids well, oral intake can gradually be increased to full fluids and eventual regular diet. It is important to monitor jejunum following its transfer. Anastomosis thrombosis and unrecognized gangrene of jejunum may cause serious neck infections. CONCLUSION: Portions of gastrointestinal tract may be used as microvascular transfers for reconstruction of hypopharynx and esophagus. Intestinal transfer by revascularization was reported by Seidenberg in 1959. It is important to monitor jejunum following its transfer.

[Hormonal and hyperglycemic response in laparoscopic and open cholecystectomy]. / A szervezet hormonális és hiperglikémiás válaszának összehasonlítása a laparoszkópos és hagyományos epehólyag mútétek esetében.

The aim of the study is to evaluate the intensity of the operative trauma during laparoscopic and open cholecystectomy measured by hormonal (cortisol level) and metabolic (blood sugar level) response. Prospective randomized study was conducted in seventy patients with cholelithiasis. They were divided in two groups: thirty five underwent laparoscopic cholecystectomy and thirty five underwent open cholecystectomy (control group). Mean cortisol concentration and glucose concentration were measured preoperatively and postoperatively after 2, 4, 8, 12, 24 and 48 hours. The examined groups were comparable in age and sex. Preoperative plasma cortisol concentration was within normal range in both groups. Postoperatively plasma cortisol level increased in the laparoscopically operated group, and peak level occurred eight hours after surgery (692.6 +/- 27.2 nmol/L). Peak plasma cortisol level in control group developed 8 hours postoperatively (841.1 +/- 33.2 nmol/L). The mean cortisol concentration was significantly higher (p < 0.05) following open procedure between fourth and 48th postoperative hour. Mean plasma glucose concentrations after laparoscopic and open cholecystectomy were significantly higher (p < 0.05) than preoperative values. The mean glucose concentration during the initial 24 hours was significantly higher (p < 0.05) following open cholecystectomy.

[Gastrointestinal stromal tumor: case report]. / Gastrointestinalni stromalni tumor: prikaz slucaja.

INTRODUCTION: Gastrointestinal stromal tumors represent extremely rare tumors of the gastrointestinal system, especially when localized on the small intestine. CASE REPORT: We report a case of a female patient, with recurrent gastrointestinal bleeding and severe anemia, caused by gastrointestinal stromal tumor of the small intestine. After negative endoscopic findings, she underwent radiological examination of the small intestine. Primary diagnostic radiological evaluation included: small intestine passage enteroclysis, computed tomography of the abdominal cavity and selective angiographic study of the three major aortic branches that supply the gastrointestinal tract in the abdomen (celiac axis, superior mesenteric artery and inferior mesenteric artery). Secondly, ultrasound of abdominal cavity was performed. Findings of small intestine passage and enteroclysis were negative. The tumor was visualized by computed tomography and ultrasound, but without distinctive anatomical localization in the abdominal cavity. DISCUSSION: The diagnostic dilemma has been resolved by using selective angiographic examination of celiac axis and superior mesenteric artery and thus a tumor formation was visualized in the mesenterium of the small intestine. Radiological findings were confirmed by surgery. Histopathological findings were positive for gastrointestinal stromal tumor. CONCLUSION: Gastrointestinal stromal tumors of the small intestine rarely cause recurrent bleeding, but they should be included in differential diagnosis.