Thrombospondin-1 and VEGF in inflammatory bowel disease

Background and aim: Angiogenesis is an important process in the pathogenesis of chronic inflammation. We aimed to study the angiogeneic balance in inflammatory bowel disease (IBD) by evaluating the expression of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) on colonic epithelial cells, together with the expression of inducible nitric oxide synthase (iNOS). Methods: Twenty-one ulcerative colitis (UC), 14 Crohn’s disease (CD), 11 colorectal cancer patients, and 11 healthy controls colonic biopsy samples were evaluated immunohistochemically. Results: The expressions of TSP-1, VEGF, and iNOS in UC and CD groups were higher than expression in healthy control group, all with statistical significance. However, in colorectal cancer group, VEGF and iNOS expressions were increased importantly, but TSP-1 expression was not statistically different from healthy control group’s expression. Both TSP-1 and VEGF expressions were correlated with iNOS expression distinctly but did not correlate with each other. Conclusions: Both pro-angiogeneic VEGF and antiangiogeneic TSP-1 expressions were found increased in our IBD groups, but in colorectal cancer group, only VEGF expression was increased. TSP-1 increases in IBD patients as a response to inflammatory condition, but this increase was not enough to suppress pathologic angiogenesis and inflammation in IBD.Keywords: inflammatory bowel disease; thrombospondin-1; VEGF; iNOS; colon cance

How does a biopsy of endoscopically normal terminal ileum contribute to the diagnosis? Which patients should undergo biopsy?

Background: Terminal ileum endoscopy and biopsy are the diagnostic tools of diseases attacking the ileum. However, abnormal histological findings can be found in endoscopically normal terminal ileum.Objective: This study was performed to evaluate the histopathological results of biopsies from endoscopically normal terminal ileum in order to determine pre-procedure clinical and laboratory factors predicting abnormal histopathological results, if any.Methods: A total of 297 patients who underwent colonoscopy and terminal ileum biopsy and had normal terminal ileum or a few aphthous ulcers in the terminal ileum together with completely normal colon mucosa were included in the study. The patients were grouped into two arms as normal cases and cases with aphthous ulcers. Histopathological and pre-procedural laboratory results of patients were analyzed according to their indications.Results: The terminal ileum was endoscopically normal in 200 patients, and 97 patients had aphthous ulcers. Chronic ileitis rate was present in 5.5% of those with endoscopically normal terminal ileum and in 39.2% of the patients with aphthous ulcers. In both groups, the highest rate of chronic ileitis was detected in the patients with known inflammatory bowel disease (IBD) (15.4 and 50%, respectively), anemia (9.5 and 43.5%, respectively), and in the patients having chronic diarrhea together with abdominal pain (7.7 and 44.8%, respectively). We found that the sensitivity of mean platelet volume for predicting chronic ileitis was 87% and the specificity was 45% at a cut-off value lower than 9.35 fl.Conclusion: In anemia indication or chronic diarrhea together with abdominal pain, the frequency of aphthous ulcers detected by ileoscopy and the frequency of chronic ileitis detected histopathologically despite a normal-appearing ileum were elevated.Keywords: Terminal ileum; ileoscopy; chronic ileitis; inflammatory bowel diseas

SSI-AWARE: Self-Sovereign Identity Authenticated backup With Auditing by Remote Entities

Part 5: CybersecurityInternational audienceThe self-sovereign identity (SSI) model entails the full responsibility and sovereignty of a user regarding his identity data. This identity data can contain private data which is solely known to the user. The user himself is therefore required to manage the whole lifecycle of his private data, including the backup and restore. We show that prior work on how to backup and restore the user’s identity data does not meet the requirements of the SSI setting, and we present the first solution which does meet the requirements. Authenticated backup with auditing by remote entities (AWARE) combines SSI sustaining aspects and extends them to create a truly self-sovereign backup-and-restore protocol. In AWARE, trusted, physically met humans, called custodians, hold a secure device. Custodians with a secure device offer an offline backup possibility and a secure channel. The backup and restore are audited by commits on a publicly accessible distributed ledger. These commits are answered by auditing services which are required during restore. Only some auditing services hold relevant data for a restore. The self sovereignty of the user lies in the exclusive information which auditing services hold relevant data. AWARE  is the first backup-and-restore mechanism that fully complies with the SSI model. We perform an in-depth security-risk analysis of AWARE, showing a risk rating which is comparable to the best risk rating o related non-SSI-compliant backup-and-restore mechanisms. We instantiate the AWARE protocol with cryptographic primitives providing a high security level of 256-bit. We show its implementation feasibility by providing a simulation of AWARE, and conclude with an estimated performance analysis on a microcontoller architecture based on our simulation and implementation results in the literature

Colo-Colonic Intussusception Caused by a Submucosal Lipoma: Case Report and Review of the Literature

Adult intussusception is a rare clinical presentation and often not considered clinically in the differential diagnosis of adult patients with vague abdominal complaints. A 44-year-old woman visited our emergency department with sudden onset of intermittent abdominal pain. Diagnostic imaging revealed an intussusception caused by a submucosal lipoma of the sigmoid. A laparotomy was performed and the diagnosis was proven by histological examination. Submucosal lipomas are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain and thus mimic a malignancy. Surgical excision is indicated for symptomatic cases

Letter to Editor: First case of T-cell/histiocyte-rich-large B-cell lymphoma presenting with duodenal obstruction

No Abstract

Prothrombotic gene mutations and Crohn's disease; is there any association?

Background/Aims: Patients with inflammatory bowel disease have an increased tendency for thromboembolism. In this study we aimed to determine the frequency of FV gene and Prothrombin G20210A gene mutations in a group of patients with Crohn's Disease (CD) and estimate its correlation with disease activity and clinical subtype