Image Processing for the Evaluation of Gastric Ulcer Scars Using a Personal Computer

Abstract: Image processing of gastric ulcer scars was conducted using a computer-equipped electronic endoscope in order to quantitatively classify the quality of gastric ulcer scars. Frontal images of 66 gastric ulcer scars (red scar stage), in 60 patients, obtained by electronic endoscopy were fed into a desktop computer system. Ulcer scars were classified according to the standard deviation of green signal intensity and unevenness of the scar surface, following repeated application of smoothing, into three groups. Group I: ulcer scars with a standard deviation of green signal intensity less than or equal to 15 and a flat surface after smoothing had been carried out 10 times. Group II: ulcers other than Group I or III. Group III: ulcers with a standard deviation greater than or equal to 25 and markedly uneven features after smoothing had been carried out 20 times. Follow-up gastroscopy examinations were performed at 2-week intervals and the cumulative recurrence rate, as well as the transition from red scar stage to white scar phase, were determined 7 months after initial healing. There were 15 Group I, 28 Group II and 23 Group III ulcer scars. The proportion of ulcer relapse was 6.7% in Group I, 35.7% in Group II and 47.5% in Group III. Regarding the relationship between the transition rate from red scar to white scar and the scar classification, 66.7% of Group I, 28.6% of Group II and 17.4% of Group III ulcer scars progressed to the white scar stage. This classification of gastric ulcer scars provides a representative index of the quality of ulcer healing, which is potentially useful for planning maintenance treatment.     

Predictors of Positive Head-Up Tilt Test in Patients with Suspected Neurocardiogenic Syncope or Presyncope

OH, J.H., et al .: Predictors of Positive Head-Up Tilt Test in Patients with Suspected Neurocardiogenic Syncope or Presyncope. Neurocardiogenic syncope is the most common cause of syncope in patients who present in outpatient clinics. Head-up tilt test (HUT) has been widely used to diagnose neurocardiogenic syncope. However, the HUT does not always produce a positive response in patients with suspected neurocardiogenic syncope. The aim of the present study was to assess the clinical history and characteristics of patients with suspected neurocardiogenic syncope or presyncope who undertook HUT, and to identify prognostic factors of a positive HUT response. During the first phase of HUT, patients were tilted to a 70-degree angle for 30 minutes. If the first phase produced a negative response, the second phase was subsequently performed involving intravenous isoproterenol administration. Of 711 patients, 423 (59.5%) patients showed a positive HUT response. In contrast to previous studies, this study showed that the vasodepressive type (76.6%) was the most common pattern of positive response, and that the rate of positive response during the first phase was low (7.1%). By multivariate analysis, the occurrence of junctional rhythm was found to be a predictor of an impending positive response in HUT   (P < 0.001)   . The shorter time interval between the last episode and HUT was also a predictor of positive response   (P = 0.0015)   . Younger age   (P = 0.0003)   and a history of physical injury during a syncopal episode   (P = 0.019)   were found to be associated with a positive response in the first phase of HUT. (PACE 2003; 26[Pt. I]:593–598)     

Distribution of mesalazine enemas in active and quiescent ulcerative colitis.

BACKGROUND: The efficacy of mesalazine enemas depends on intraluminal concentration of the drug and is therefore limited by the enema distribution in the colon. Active ulcerative colitis changes colon motility and this leads to uncertainty about enema spread. AIM: To assess the influence of disease activity on enema distribution, we conducted a physician-blinded, longitudinal study of the retrograde spread of three mesalazine enemas. METHODS: Thirty-one patients with mild to moderate ulcerative colitis were subdivided into three groups, and treated with 2 g mesalazine in 30 mL (group I, n = 10), 4 g mesalazine in 60 mL (group II, n = 12) or 1 g mesalazine in 100 mL (group III, n = 9). All patients received oral mesalazine 500 mg t.d.s. Enemas were labelled by adding 10 MBq (99mTc)technetium-sulphur colloid. Anterior scintigraphic images were taken at the start of the study and after 12 weeks of therapy; retrograde spread was assessed by calculating the percentage of the enema in each colonic segment. RESULTS: The activity score of ulcerative colitis diminished significantly after 12 weeks of treatment, but five patients dropped out of the study. At the start of treatment enema activity in group I was mainly concentrated in the sigmoid (99%); in group II activity was found in the rectum (9%), the sigmoid (61%) and the descending colon (15%); in group III activity was distributed between the sigmoid (66%) and descending colon (25%). The colonic distribution of mesalazine enemas was not influenced by disease activity. CONCLUSION: Volume, but not disease activity, is the important determinant of retrograde colonic spread of mesalazine enemas in ulcerative colitis.     

Fetal hydrocephalus: sonographic detection and clinical significance of associated anomalies

Sixty-one cases of fetal hydrocephalus were reviewed to determine the accuracy and clinical significance of prenatal ultrasound (US) for detecting concurrent anomalies. Of 61 fetuses studied, 51 (84%) had one or more major central nervous system (CNS) malformations (38 fetuses with 39 anomalies) and/or extra-CNS anomalies (34 fetuses). Only ten (16%) fetuses had no concurrent anomaly. Anomalies of the CNS were correctly identified with US in 35 of 39 (90%) cases. Of 34 fetuses (56%) with extra-CNS anomalies, 27 had multiple anomalies. One or more extra-CNS abnormality was identified with US in 22 of the 27 (81%) fetuses with multiple anomalies but no anomalies were identified with US in the seven patients with an isolated anomaly. Fetal mortality was directly related to the presence of extra-CNS anomalies (P less than .01). Many important anomalies coexisting with fetal hydrocephalus can be identified with US. Furthermore, sonographic detection of extra-CNS malformations carries a poor prognosis and was associated with a uniformly fatal outcome in this series.     

Recurrent stent thrombosis associated with lupus anticoagulant due to renal cell carcinoma

A case is presented of recurrent stent thrombosis unexplained by angiographic appearance, which subsequently revealed a diagnosis of antiphospholipid syndrome secondary to renal cell carcinoma.     

Modulatory effect of pineapple peel extract on lipid peroxidation,catalase activity and hepatic biomarker levels in blood plasma of alcohol-induced oxidative stressed rats

Objective

To investigate the ability of the methanolic extract of pineapple peel to modulate alcohol-induced lipid peroxidation, changes in catalase activities and hepatic biochemical marker levels in blood plasma.

Methods

Oxidative stress was induced by oral administration of ethanol (20% w/v) at a dosage of 5 mL/kg bw in rats. After 28 days of treatment, the rats were fasted overnight and sacrificed by cervical dislocation. Blood was collected with a 2 mL syringe by cardiac puncture and was centrifuged at 3 000 rpm for 10 min. The plasma was analyzed to evaluate malondialdehyde (MDA), catalase activity, aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) concentrations.

Results

Administration of alcohol caused a drastic increase (87.74%) in MDA level compared with the control. Pineapple peel extract significantly reduced the MDA level by 60.16% at 2.5 mL/kg bw. Rats fed alcohol only had the highest catalase activity, treatment with pineapple peel extract at 2.5 mL/kg bw however, reduced the activity. Increased AST, ALP and ALT activities were observed in rats fed alcohol only respectively, treatment with pineapple peel extract drastically reduced their activities.

Conclusions

The positive modulation of lipid peroxidation, catalase activities as well as hepatic biomarker levels of blood plasma by the methanolic extract of pineapple peels under alcohol-induced oxidative stress is an indication of its protective ability in the management of alcohol-induced toxicity.