Computed tomography evaluation of early post-operative complications of the Whipple procedure

Purpose: Pancreaticoduodenectomy (the Whipple procedure) is the only potential curative treatment for periampullary tumours. Although mortality due to the procedure is gradually decreasing, the morbidity rates remain high. This study aimed to evaluate early computed tomography (CT) findings in patients suspected of complications following the Whipple procedure. Material and methods: The CT images of patients who underwent the conventional Whipple procedure between January 2015 and January 2019 and underwent CT examination for the detection of early postoperative complications were retrospectively evaluated by two radiologists. Results: The Whipple operation was performed to 65 patients, and the CT scans of 45 patients (30 males, 15 females) were included in the study. There were no complications in 21 patients. Complications were present in 24 patients (53.33%), of whom 13 had more than one complication. Eight patients had fluid collection in the operation site, two had haematoma, 10 had an abscess, and five had a pancreatic fistula. In addition, a hepatic abscess was detected in one patient, delayed gastric emptying in six patients, anastomotic leakage from the gastrojejunostomy line in two patients, superior mesenteric vein (SMV) thrombosis in two patients, and intraluminal haemorrhage and active extravasation in one patient. Mortality due to complications occurred in one patient in the early postoperative period. Other complications were treated by spontaneous, surgical or percutaneous interventional procedures. Conclusions: Despite the decreasing mortality rates in recent years, the Whipple procedure is risky and has high morbidity even when performed in experienced centres. CT is the adequate imaging modality for the evaluation of this anatomically altered region and detection of complications

Galectin-3 and plasma cytokines in patients with acute myocardial infarction

WOS: 000343954700009PubMed ID: 25316666Objective: To investigate the concentrations of plasma cytokines and Galectin-3 (Gal-3) as inflammatory markers in patients with acute myocardial infarction (AMI). Methods: The study population consisted of 29 patients with AMI and 29 healthy control subjects. We measured Gal-3, tumor necrosis factor alpha (TNF-alpha), and interleukin-6 (IL-6) levels in plasma using enzyme-linked immunosorbent assays (ELISAs). We measured levels of C-reactive protein (CRP) via the nephelometric method. Results: Patients with AMI showed significantly higher plasma Gal-3, TNF-alpha, and IL-6 levels compared with controls. Gal-3 levels were positively and significantly correlated with plasma IL-6, TNF-alpha, and CRP levels in the control and patient groups. Conclusion: Our findings suggest that Gal-3 can be a new circulating biomarker of inflammation associated with AMI

RIBFIND: a web server for identifying rigid bodies in protein structures and to aid flexible fitting into cryo EM maps

Motivation: To better analyze low-resolution cryo electron microscopy maps of macromolecular assemblies, component atomic structures frequently have to be flexibly fitted into them. Reaching an optimal fit and preventing the fitting process from getting trapped in local minima can be significantly improved by identifying appropriate rigid bodies in the fitted component. Results: Here we present the RIBFIND server, a tool for identifying rigid bodies in protein structures. The server identifies rigid bodies in proteins by calculating spatial proximity between their secondary structural elements. Availability: The RIBFIND web server and its standalone program are available at http://ribfind.ismb.lon.ac.uk

Structural analysis and functional characteristics of greenhouses in the Mediterranean region of Turkey

This study was carried out to determine the structural analysis and functional characteristics of the greenhouses in the Mediterranean region where 87% of the greenhouse production area in Turkey is concentrated. Information about types, material and construction properties, placement and arrangement of greenhouses in the research area was gathered by questionnaires; then greenhouses in enterprises were divided into three groups based on the covering material, load bearing materials anddirectional placement. Five greenhouse types with the most economic cross-section were selected and loads acting on structural members of these were calculated. The stretch ratios, resulting from loads acting on beams of each greenhouse, were analyzed by SAP2000 program. Also, the stretch ratios as per whether greenhouse types and covering materials have a statistically significant effect were examined. According to the obtained data, it was found that all of the selected greenhouses could notcarry the dead and/or dynamic loads safely. It was also obtained that covering material has a significant effect on dead loads but not on dynamic loads at 0.05 probability levels whereas dead and dynamicloads were significantly affected by structural materials of the  greenhouses

Downregulation of Yap1 during limb regeneration results in defective bone formation in axolotl

The Hippo pathway plays an imperative role in cellular processes such as differentiation, regeneration, cell migration, organ growth, apoptosis, and cell cycle. Transcription coregulator component of Hippo pathway, YAP1, promotes transcription of genes involved in cell proliferation, migration, differentiation, and suppressing apoptosis. However, its role in epimorphic regeneration has not been fully explored. The axolotl is a well-established model organism for developmental biology and regeneration studies. By exploiting its remarkable regenerative capacity, we investigated the role of Yap1 in the early blastema stage of limb regeneration. Depleting Yap1 using gene-specific morpholinos attenuated the competence of axolotl limb regeneration evident in bone formation defects. To explore the affected downstream pathways from Yap1 down-regulation, the gene expression profile was examined by employing LC-MS/MS technology. Based on the generated data, we provided a new layer of evidence on the putative roles of increased protease inhibition and immune system activities and altered ECM composition in diminished bone formation capacity during axolotl limb regeneration upon Yap1 deficiency. We believe that new insights into the roles of the Hippo pathway in complex structure regeneration were granted in this study.Science Academ

Evaluation of prostate volume in mpMRI: comparison of the recommendations of PI-RADS v2 and PI-RADS v2.1

PURPOSEWe aimed to evaluate the prostate volumes calculated as recommended in the PI-RADS v2 and PI-RADS v2.1 guidelines, intraobserver and interobserver variability, and the agreement between the two measurement methods.METHODSProstate mpMRI examinations of 114 patients were evaluated retrospectively. T2-weighted sequences in the axial and sagittal planes were used for the measurement of the prostate volume. The measurements were performed by two independent observers as recommended in the PI-RADS v2 and PI-RADS v2.1 guidelines. Both observers conducted the measurements twice and the average values were obtained. In order to prevent bias, the observers carried out measurements at one-week intervals. In order to assess intraobserver variability, observers repeated the measurements again at one-week intervals. The prostate volume was calculated using the ellipsoid formula (W×H×L×0.52).RESULTSIntraclass correlation coefficient (ICC) revealed almost perfect agreement between the first and second observers for the measurements according to both PI-RADS v2 (0.93) and PI-RADS v2.1 (0.96) guidelines. The measurements were repeated by both observers. According to the ICC values, there was excellent agreement between the first and second measurements with respect to both PI-RADS v2 and PI-RADS v2.1 for first (0.94 and 0.96, respectively) and second observer (0.94 and 0.97, respectively). For both observers, the differences had a random, homogeneous distribution, and there was no clear relationship between the differences and mean values.CONCLUSIONThe ellipsoid formula is a reliable method for rapid assessment of prostate volume, with excellent intra- and interobserver agreement and no need for expert training. For the height measurement, the recommendations of the PIRADS v2.1 guideline seem to provide more consistently reproducible results

Evaluatıon of some parameters affectıng embroıdery qualıty

Vezenje je ukrašavanje tekstila koji može biti raznih oblika uzoraka (organskih, anorganskih ili geometrijskih motiva) i različitih tekstura. U području tekstila i odjeće vezenje je značajna radna faza jer direktno utječe na izgled i troškove, kako vizualno tako i s obzirom na dizajn i proces izrade. U radu je prikazano općenito vezenje, te parametri koji utječu na kvalitetu veza i vezenja tekstila i odjeće. Određeni parametri su vrednovani u odnosu na standardne tipove vezenja. Za kvalitetu veza razmatrane su i podloge za vez. Podloge od netkanog tekstila, taljive podloge veza koje se termički otklanjaju, odnosno tale ili vodotopive podloge mogu biti prikladne za vezenje velikih površina za koje nije poželjno da budu debele i teške. Podloge, koje se ne mogu potpuno ukloniti s vezene površine, mogu se upotrebljavati za male površine vezenja kao kod vezenja logotipova.Embroidery is an important work step in Textile and Apparel sector, because it affects directly the appearance and the costs of both visually and the design and application process. This study offers generally information on embroidery first. Factors influencing the quality of embroidery applied to textiles and garments have been identified and these factors have been evaluated practically with a standard embroidery type. As a result, heat and water-soluble interlinings may be suitable for embroidery with large areas that are undesirable to be thick and heavy. Interlinings that cannot be completely removed from the embroidered area can be used for small embroidered areas such as the brand logo

Large-scale proteomic analysis of patients with type 2 diabetes mellitus and atherosclerosis using a label-free LC-MS/MS approach

Objective: Type 2 diabetes mellitus (T2D) is a metabolic disease whose molecular events have not yet been fully clarified. However, next-generation powerful molecular approaches such as mass spectrometry (MS)-based proteomics holds promise. In this study, we aimed to reveal the protein profile of serum samples obtained from patients with T2D and atherosclerotic cardiovascular disease using the high-resolution liquid chromatography (LC)-MS/MS system. Materials and Methods: Immune depletion was performed for the top 12 abundant proteins in 10 μl serum samples taken from individuals. Then, tryptic peptides were obtained from total proteins by applying a digestion protocol. Accordingly, reduction, alkylation, and digestion with trypsin enzyme were carried out, respectively. Tryptic peptides were analyzed in an ultra-high-pressure LC-MS/MS system with a label-free proteomic approach. The raw data were processed using the software program. Results: LC-MS/MS analyses revealed 120 proteins with significant expression changes. Some of these proteins were associated with inflammation, lipid transport, and oxidative stress, which are known to play an important role in T2D and its complications. Conclusion: As a result, LC-MS/MS analyses highlighted the proteins that will provide predictions in the treatment and course of T2D. We believe that validation of these proteins with targeted proteomic approaches in a larger sample in further studies will contribute to the development of clinically usable panels

Tissue factor and vascular endothelial growth factor in detecting thromboembolic complications in diabetic atherosclerotic patients

BackgroundAtherosclerosis, which is one of the leading causes of death all over the world, can create major or minor thromboembolic complications with the exponentially increasing diabetic status. Despite all the studies, the mechanism by which endothelial damage in atherosclerosis is triggered in diabetic setting is still not fully understood. MethodsIn this study, tissue factor (TF), which is thought to act together in the formation of vasular endothelial growth factor (VEGF-A) and coagulopathy in diabetic atherosclerotic patients, may be an important indicator in this regard, a total of 100 cases who were undergone off-pump coronary artery bypass (OPCAB) which were at same risk group examined by dividing into diabetic status. Early postoperative process and biochemical parameters analyzed in terms of TF and VEGF-A levels measured before and after the operation. ResultsTF and VEGF-A expression of the T1DM group were statistically high compared to non-diabetics. Significantly longer hospital stays with changes in TF and VEGF-A were found in patients in the diabetic group compared to pre- and postoperatively, respectively; TF (95% CI: 0.879-0.992; p = 0.025), VEGF-A (95% CI: 0.964-0.991; p = 0.001) and hospital stay (95% CI: 1.96-7.49; p = 0.0001). Preoperatively measured carotid intima-media thickness (CT) was higher in diabetics and was significantly associated with atrial fibrillation (AF), (r = 0.873). Surgical team and protocols were same and OPCAB procedures were routinely applied to all patients in our clinic. No minor or major events were observed in any of the cases. ConclusionTF and VEGF-A values in patients with diabetic atherosclerosis may be important in the early detection of thromboembolic complications

Are the washout values currently accepted for lesion characterization in dedicated adrenal CT adequate for diagnosis?

PURPOSEWe aimed to investigate the accuracy of density characteristics and washout values of lesions detected on computed tomography (CT) at the cutoff values obtained from the literature by taking the pathological results of adrenalectomy specimens as reference and to determine the cutoff values of parameters evaluated on CT for the differentiation of adenoma and nonadenoma lesions in the study group.METHODSHospital records and standard CT imaging data (noncontrast early phase [65 s] and late phase [15 min] ) of 84 patients with 87 lesions who underwent adrenalectomy between January 2012 and December 2018 were retrospectively reevaluated by two radiologists in consensus. The patients were categorized as having adenoma and nonadenoma lesions according to the pathology results. The sensitivity, specificity and diagnostic accuracy of CT parameters (density values and washout percentages) were evaluated. Differences in the CT parameters (size, noncontrast and early-late enhancement density and absolute and relative washout values) were investigated. The optimal cutoff values of CT parameters were determined by ROC analysis.RESULTSNoncontrast CT had a specificity of 87.75% and 95.9%, sensitivity of 60% and 48.6%, diagnostic accuracy of 77.7% and 89.47% for adenomas, at the cutoff values of ≤10 HU and ≤0 HU, respectively. For absolute washout value ≥ 60%, the sensitivity, specificity and accuracy were 64.7%, 52.38% and 56.75%, respectively; while these rates were 76.47%, 56.52% and 62.16%, respectively, for relative washout value ≥40%. Adenomas and nonadenomas showed significant difference in terms of size (p < 0.0001), unenhanced attenuation (p < 0.0001), relative washout (p = 0.020) and delay enhancement (p < 0.001). But there were no differences in terms of absolute washout (p = 0.230) and early enhancement (p = 0.264). The cutoff values for the differentiation of adenomas and nonadenomas were as follows: size ≤44 mm, noncontrast density <20 HU, early-phase density ≥45 HU, delayed-phase density ≤44 HU, absolute washout 74.83% and relative washout 57.76%.CONCLUSIONThe current washout criteria used in the differentiation of adenoma and nonadenoma lesions in dynamic CT imaging can give false negative and positive results. According to the existing criteria, the most reliable parameter in adenoma–nonadenoma differentiation is ≤ 0 HU noncontrast CT density value