Imaging in percutaneous ablation for atrial fibrillation

Percutaneous ablation for electrical disconnection of the arrhythmogenic foci using various forms of energy has become a well-established technique for treating atrial fibrillation (AF). Success rate in preventing recurrence of AF episodes is high although associated with a significant incidence of pulmonary vein (PV) stenosis and other rare complications. Clinical workup of AF patients includes imaging before and after ablative treatment using different noninvasive and invasive techniques such as conventional angiography, transoesophageal and intracardiac echocardiography, computed tomography (CT) and magnetic resonance imaging (MRI), which offer different information with variable diagnostic accuracy. Evaluation before percutaneous ablation involves assessment of PVs (PV pattern, branching pattern, orientation and ostial size) to facilitate position and size of catheters and reduce procedure time as well as examining the left atrium (presence of thrombi, dimensions and volumes). Imaging after the percutaneous ablation is important for assessment of overall success of the procedure and revealing potential complications. Therefore, imaging methods enable depiction of PVs and the anatomy of surrounding structures essential for preprocedural management and early detection of PV stenosis and other ablation-related procedures, as well as long-term follow-up of these patients

Effect of water stress on yield and evapotranspiration of sunflower

An experiment was conducted at Rimski Šančevi Experiment Field of Institute of Field and Vegetable Crops in Novi Sad during 2000 - 2005. The soil in the experimental plot was calcareous chernozem on loess terrace. Using the yield response factor (ky), the study investigated how sunflower yield and evapotranspiration were affected by deficit of available soil water during the growing season. The experiment consisted of an irrigated treatment (T1), in which irrigation was used when soil moisture levels dropped to 60-65% of FC (field capacity), and a nonirrigated control treatment (T0). The sunflower hybrid used in the study was NS-H-111. On average, no significant differences in yield level were observed between T1 (3.79 t ha-1) and T0 (3.75 t ha-1) treatments. Seasonal evapotranspiration (ETm) obtained in T1 treatment was in the 402-479 mm range. The yield response factor (ky) was obtained as 0.20 for total growing season and 0.27, 0.31 and 0.48 for vegetative, flowering and yield formation period, respectively. Period from flowering to maturity was the most sensitive towards water deficiency

Apparent diffusion coefficient measurement covering complete tumor area better predicts rectal cancer response to neoadjuvant chemoradiotherapy

Aim To determine the impact of two apparent diffusion coefficient (ADC) measurement techniques on diffusionweighted magnetic resonance images (DW MRI) on the assessment of rectal cancer response to neoadjuvant chemoradiotherapy (CRT). Methods ADC values were measured prospectively with two different techniques – the first, which measures ADCs in the most cellular tumor parts, and the second, which measures the entire tumor area, in 58 patients with locally advanced rectal cancer on pre-CRT and post-CRT image sets. Areas under the receiver operating characteristic curves (AUCs) and parameters of diagnostic accuracy were calculated for pre- and post-CRT ADC values and numeric and percent ADC change for each technique to determine their performance in tumor response evaluation using histopathological tumor-regression grade as the reference standard. Results The second technique yielded higher AUCs (0.935 vs 0.704, P < 0.001), percent-change (0.828 vs 0.636, P < 0.001), and numeric-change (0.866 vs 0.653, P < 0.001) than the first technique for post-CRT ADC. Accuracies for post-CRT ADC assessment were 62% for the first and 88% for the second technique (cut-off values: 0.98 and 1.29 × 10−3 mm2/s, respectively) and for ADC change assessment, both numeric and percent, 59% and 74%, respectively (cut-off values: increase of 0.18 and 0.28 × 10−3 mm2/s; increase of 24% and 37%, respectively). Conclusions The type of measurement technique significantly affected ADC results. ADC measurements covering a larger area better predicted tumor response to therapy. Post-CRT ADCs, regardless of the measurement technique, and numeric ADC change measured in the whole tumor volume accurately identified non-complete responders. Post-CRT ADCs measured in the entire tumor area yielded the highest accuracy level in tumor response evaluation

Seasonal forecasting of green water components and crop yield of summer crops in Serbia and Austria

A probabilistic crop forecast based on ensembles of crop model output estimates, presented here, offers an ensemble of possible realizations and probabilistic forecasts of green water components, crop yield and green water footprints (WFs) on seasonal scales for selected summer crops. The present paper presents results of an ongoing study related to the application of ensemble forecasting concepts in crop production. Seasonal forecasting of crop water use indicators (evapotranspiration (ET), water productivity, green WF) and yield of rainfed summer crops (maize, spring barley and sunflower), was performed using the AquaCrop model and ensemble weather forecast, provided by The European Centre for Medium-range Weather Forecast. The ensemble of estimates obtained was tested with observation-based simulations to assess the ability of seasonal weather forecasts to ensure that accuracy of the simulation results was the same as for those obtained using observed weather data. Best results are obtained for ensemble forecast for yield, ET, water productivity and green WF for sunflower in Novi Sad (Serbia) and maize in Gross-Enzersdorf (Austria) - average root mean square error (2006-2014) was lt 10% of observation-based values of selected variables. For variables yielding a probability distribution, capacity to reflect the distribution from which their outcomes will be drawn was tested using an Ignorance score. Average Ignorance score, for all locations, crops and variables varied from 1.49 (spring barley ET in Gross-Enzersdorf) to 3.35 (sunflower water productivity in Gross-Enzersdorf)

Percutaneous Computed Tomography-Guided Oxygen-Ozone (O₂O₃) Injection Therapy in Patients with Lower Back Pain—An Interventional Two-Year Follow-Up Study of 321 Patients

Objectives: To assess the effect of oxygen-ozone therapy guided by percutaneous Computed Tomography (CT) compared to corticosteroids in individuals experiencing lower back pain (LBP) not attributed to underlying bone-related issues. Methods: A total of 321 patients (192 males and 129 females, mean age: 51.5 ± 15.1 years) with LBP were assigned to three treatment groups: group A) oxygen-ozone only, group B) corticosteroids only, group C) oxygen-ozone and corticosteroids. Treatment was administered via CT-guided injections to the intervertebral disc (i.e., intradiscal location). Clinical improvement of pain and functionality was assessed via self-reported pain scales and magnetic resonance (MR) and CT imaging. Results: At all follow-up times, the mean score of the numeric rating scale and the total global pain scale (GPS) of study groups receiving oxygen-ozone (groups A and C) were statistically significantly lower than the study group receiving corticosteroids only (group B), with p &lt; 0.001. There was a statistically significant difference between groups A and C at 30 days for the numeric rating scale. Conclusions: The percutaneous application of oxygen-ozone in patients with LBP due to degeneration of the lumbosacral spine showed long-lasting significant pain reduction of up to two years post-treatment when compared to corticosteroids alone. Combination therapy of oxygen-ozone and corticosteroids can be useful as corticosteroids showed statistically significant improvement in LBP earlier than the oxygen-ozone-only treatment.</p

Indirektno spektrofotometrijsko određivanje koncentracije pirokatehola korišćenjem oscilatorne reakcije

U ovom radu Bray- Liebhafsky reakcija je korišćena kao matrica za kvantitativna odredjivanja pirokatehola indirektnom spektrofotometrijskom metodom

Assessment of the FAO AquaCrop model in the simulation of rainfed and supplementally irrigated maize, sugar beet and sunflower

Farming in Serbia is traditionally rainfed. Analyses show that drought events of varying severity are frequent in this region, although there is no specific pattern. There is a distinct need for an objective assessment of the impact of drought on strategic field crops, to solve the dilemma whether irrigation is required or not. For this reason, and based on available field data, the FAO AquaCrop water driven model was selected to simulate yield and irrigation water use efficiency (IWUE) for three major field crops (maize, sunflower, and sugar beet), under two scenarios: (1) natural water supply and adequate supply of nutrients, and (2) supplementary irrigation and adequate supply of nutrients. The experiments presented here were conducted between 2000 and 2007 in northern Serbia, where chernozem soil is prevalent. Data of 2003 cropping seasons were used for local calibration, whereas the remaining years for validation. Results were such that local calibration resulted in very minor changes of AquaCrop coefficients (e.g.. maize basal crop coefficient, sunflower harvest index, etc.). Simulated maize yield levels exhibited the greatest departure from measured data under irrigation conditions (-3.6 and 3.3% during an extremely dry and an extremely wet year. respectively). Simulated sunflower yield levels varied by less than 10% in 8 out of 10 comparisons. The most extreme variation was noted during the extremely wet year. The difference between simulated and measured values in the case of sugar beet was from -10.2 to 12.2%. Large differences were noted only in two or three cases, under extreme climatic conditions. Statistical indicators - root mean square error (RMSE) and index of agreement (d) - for all three crops suggested that the model can be used to highly reliably assess yield and IWUE. This conclusion was derived based on low values of RMSE and high values of d (in the case of maize and sugar beet 0.999 for both yield and IWUE, and in the case of sunflower 0.999 for yield and 0.884 for IWUE). It is noteworthy that under wet conditions, the model suggested that sunflower and sugar beer do not require irrigation, as confirmed by experimental research. These data are significant because they show that the AquaCrop model can be used in impartial decision-making and in the selection of crops to be given irrigation priority in areas where water resources are limited

Bilateral ovarian metastases of gallbladder carcinoma - a case report

Introduction. Gallbladder carcinoma is a rare malignancy with a poor prognosis because it is diagnosed late. There are only a few cases of ovarian metastasis from gallbladder carcinoma described in the literature. We presented a rare case of ovarian metastasis of gallbladder carcinoma and highlight the importance of differentiation between primary and metastatic ovarian tumors. Case report. A 55-year old women had cholecystectomy for suspected cholecystitis. However, histological findings showed invasive adenocarcinoma of her gallbladder. The patient refused further proposed treatment. Three months later, the same patient presented with abdominal pain and discomfort. Imaging diagnostic methods (magnetic resonance scan) showed no local tumour mass at the site of cholecystectomy, but large, bilateral, multilocular ovarian tumor of mixed consistency. During surgery, ovarian tumours and infiltration of omentum was found. A total abdominal hysterectomy with bilateral salpingo- oophorectomy and omentectomy was performed. Histological findings indicated adenocarcinoma but could not distinguish between a primary ovarian carcinoma and gallbladder metastatic tumor. An immunohistochemical examination clarified that the findings corresponded to metastatic ovarian adenocarcinoma from the gastrointestinal tract, i.e., adenocarcinoma originating from the gallbladder. Unfortunately, the patient did not successfully recover and died three months later. Conclusion. The presence of ovarian masses of unknown origin and a diagnostic dilemma between primary and metastatic tumor require careful clinical, radiological, intraoperative, and histological examination for the purpose of establishing a definitive diagnosis and providing optimal treatment

The influence of the morphometric parameters of the intercondylar notch on rupture of the anterior cruciate ligament

Background/Aim. Morpohometric parameters of the intercondylar notch of femur present one of the substantial risk factors for rupture of the anterior cruciate ligament (ACL). In morphometric studies of the knee the most often referred indexes are notch width index and notch shape index. The aim of this study was to identificate the morphometric parameters of the intercondylar notch as risk factors for ACL rupture. Methods. This study included 99 patients divided into two groups: the study group (n = 57) composed of patients with chronic instability of the knee because of previos rupture of the ACL, and the control group (n = 42) composed of patients with lesion of the knee, but without rupture of the ACL. Measuring the width and height of intercondylar notch and epicondylar width was observed on a horizontal MR section. According to these values notch width and notch shape indexes were calculated. Results. The study group had statistically significantly higher (p &lt; 0.05) intercondylar notch and lesser notch shape index than the control group (p &lt; 0.05). The difference was highly statistically significant (p &lt; 0.01) only in males, but not in females (p &gt; 0.05). Absolute dimensions of the morphometric parameters of the distal part of the femur had highly statatistically significant larger values (p &lt; 0.01) in males than females, exept in case of the intercondilar height in the control group (p &gt; 0.05). Conclusion. Enhanced height of the intercondylar notch as well as lesser value of the notch shape index are associated with rupture of the ACL in males but not in females

Severe short-lasting left ventricular dysfunction associated with a respiratory infection

Introduction. Since clinical and electrocardiographic features of various cardiac disorders may overlap, the differential diagnosis of left ventricular (LV) dysfunction may be difficult even for the most experienced physicians. Recent advances in cardiac imaging may help clinicians to establish an accurate diagnosis and initiate adequate treatment. The aim of this case report is to raise awareness of a very short-lasting LV dysfunction during respiratory infections and to underline the importance of multimodality imaging in this clinical setting. Case outline. A previously healthy 37-year-old male presented with atypical chest pain and ST-segment elevation in the inferolateral leads during severe mental stress and acute respiratory infection. Acute myocardial infarction, myocarditis, coronary vasospasm and stress cardiomyopathy were all considered as a differential diagnosis. A rapid onset of severe LV dysfunction and a complete recovery within 4 days was detected by echocardiography and further evaluated by multimodality imaging, including multislice computed tomography and cardiac magnetic resonance imaging. Conclusion. Severe, but very short-lasting LV dysfunction may be triggered by various causes, including upper respiratory tract infections. Since the symptoms of respiratory infections may obscure those of LV dysfunction, myocardial dysfunction in these patients may go undetected with possible serious consequences