Objectives
To investigate the performance of real-time 2D shear wave elastography (RT 2D-SWE) for non-invasive staging of liver disease in patients with chronic viral hepatitis (CVH).
Materials and ...methods
Naive CVH patients underwent liver (LS) and spleen stiffness (SS) measurements by an intercostal approach. Patients with ALT >3× upper limit of normal, cholestasis as revealed by dilated intrahepatic biliary tree, and liver congestion were excluded. Results were expressed in kPa and compared to histological stage (Ishak) of liver fibrosis (LF). Patients with decompensated liver cirrhosis (LC) were diagnosed using standard clinical, ultrasound, and endoscopic criteria.
Results
Of 123 patients, LS was successfully measured in 79.7 % and SS in 53.7 %. LS accurately differentiated between liver disease stages, with cut-off values of 8.1 (AUC 0.991) for F ≥ 3, 10.8 kPa (AUC 0.954) for F ≥ 5, and 27 kPa (AUC 0.961) for decompensated LC. SS was significantly different between non-cirrhotic stages (F0–4) and LC (cut-off 24 kPa; AUC 0.821). While both LS and SS increased with liver disease progression, the difference between them decreased, as reflected by the stiffness ratio index.
Conclusions
RT 2D-SWE can accurately differentiate between the stages of LF, and can distinguish LF from LC and compensated from decompensated LC.
Key Points
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RT 2D
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SWE is an accurate method for assessment of liver fibrosis
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RT 2D
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SWE is applicable in 80
%
of patients with chronic viral hepatitis
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RT 2D
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SWE accurately differentiates compensated from decompensated liver cirrhosis
.
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Both liver and spleen stiffness increase with progression of liver fibrosis
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In cirrhosis
,
the difference between liver and spleen stiffness decreases
.
Primary: to evaluate predictivity of liver stiffness (LS), spleen stiffness (SS), and their ratio assessed by real-time 2D shear wave elastography (RT-2D-SWE) for adverse outcomes (hepatic ...decompensation, hepatocellular carcinoma or death; "event") in compensated liver cirrhosis (LC) patients. Secondary: to evaluate ability of these measures to discriminate between cirrhotic patients with/without esophageal varices (EV).
Predictivity of LS, SS, and LS/SS was assessed in a retrospectively analyzed cohort of compensated LC patients (follow-up cohort) and through comparison with incident patients with decompensated cirrhosis (DC) (cross-sectional cohort). Both cohorts were used to evaluate diagnostic properties regarding EV.
In the follow-up cohort (n=44) 18 patients (40.9%) experienced an "event" over a median period of 28 months. LS≥21.5 kPa at baseline was independently associated with 3.4-fold (95% confidence interval CI 1.16-10.4, P=0.026) higher risk of event. Association between SS and outcomes was weaker (P=0.056), while there was no association between LS/SS ratio and outcomes. Patients with DC (n=43) had higher LS (35.3 vs 18.3 kPa, adjusted difference 65%, 95% CI 43%-90%; P<0.001) than compensated patients at baseline. Adjusted odds of EV increased by 13% (95% CI 7.0%-20.0%; Plt;0.001) with 1 kPa increase in LS. At cut-offs of 19.7 and 30.3 kPa, LS and SS had 90% and 86.6% negative predictive value, respectively, to exclude EV in compensated patients.
This is the first evaluation of RT-2D-SWE as a prognostic tool in LC. Although preliminary and gathered in a limited sample, our data emphasize the potential of LS to be a reliable predictor of clinical outcomes and the presence of EV in LC patients.
Background The aim of this study was to investigate the effect of the macrolide antibiotic azithromycin on mucosal changes and colonic bacterial load in a murine model of colitis. Methods Colitis was ...induced in CD1 mice using enema of 0.2% solution of dinitrofluorobenzene, combined with skin sensitization. Four experimental groups of animals (N = 10 per group) were treated with 50 mg/kg/day azithromycin (AZ) or metronidazole (MN) perorally, starting 24 h before (AZ−1, MN−1) or 6 h after (AZ+1, MN+1) induction of colitis and for consecutive 5 days. Additional experimental mice group was treated with 10 mg/kg/day methylprednisolone intraperitoneally after induction of experimental colitis in the same manner (MP). Two control groups consisted of healthy animals (C) that received the challenge enema with phosphate-buffered saline (PBS) and animals with experimental colitis (chall) treated with equivolume of PBS perorally. Clinical score (0-5) and histopathologic score (0-30) were used to assess inflammatory changes, and colon washings were used to determine changes in bacterial load. Results The anti-inflammatory effect of azithromycin did not differ from the effect of methylprednisolone, when compared with control group with experimental colitis. Metronidazole did not show a significant anti-inflammatory effect. Number of colonic bacteria did not differ significantly between control and experimental groups of animals. Conclusions We documented the anti-inflammatory effect of azithromycin in a murine model of acute colitis, suggesting that effects were targeted to oxidative burst and on mucosal/bacterial interface, independent of luminal bacterial load. Further studies should be focused on effect of azithromycin on the role of bacterial biofilm in perpetuation of chronic intestinal inflammation.
We report a case of a 71-year-old male with multiple primary malignancies involving kidney and urinary bladder, combined with synchronous lymphoma. The patient was admitted to the hospital because of ...painless gross hematuria. Examination revealed tumor of the right kidney and papillary tumor in the urinary bladder and enlarged lymph nodes along aorta and inferior vena cava. Transurethral resection of bladder tumor (TUR), radical nephrectomy of the right kidney and retroperitoneal lymphadenectomy were performed. Pathohistologic evaluation, together with immunohistochemistry, gave the patient the final diagnosis of renal cell carcinoma (RCC), urothelial carcinoma of the urinary bladder and B- small cell Non-Hodgkin lymphoma (B-CLL).
We report a case of a 71-year-old male with multiple primary malignancies involving kidney and urinary bladder, combined with synchronous lymphoma. The patient was admitted to the hospital because of ...painless gross hematuria. Examination revealed tumor of the right kidney and papillary tumor in the urinary bladder and enlarged lymph nodes along aorta and inferior vena cava. Transurethral resection of bladder tumor (TUR), radical nephrectomy of the right kidney and retroperitoneal lymphadenectomy were performed. Pathohistologic evaluation, together with immunohistochemistry, gave the patient the final diagnosis of renal cell carcinoma (RCC), urothelial carcinoma of the urinary bladder and B- small cell Non-Hodgkin lymphoma (B-CLL).
Materials science has a significant impact on society and its quality of life, e.g., through the development of safer, more durable, more economical, environmentally friendly, and sustainable ...materials. Visual computing in materials science integrates computer science disciplines from image processing, visualization, computer graphics, pattern recognition, computer vision, virtual and augmented reality, machine learning, to human-computer interaction, to support the acquisition, analysis, and synthesis of (visual) materials science data with computer resources. Therefore, visual computing may provide fundamentally new insights into materials science problems by facilitating the understanding, discovery, design, and usage of complex material systems. This seminar is considered as a follow-up of the Dagstuhl Seminar 19151 Visual Computing in Materials Sciences, held in April 2019. Since then, the field has kept evolving and many novel challenges have emerged, with regard to more traditional topics in visual computing, such as topology analysis or image processing and analysis, to recently emerging topics, such as uncertainty and ensemble analysis, and to the integration of new research disciplines and exploratory technologies, such machine learning and immersive analytics. With the current seminar, we target to strengthen and extend the collaboration between the domains of visual computing and materials science (and across visual computing disciplines), by foreseeing challenges and identifying novel directions of interdisciplinary work. We brought visual computing and visualization experts from academia, research centers, and industry together with domain experts, to uncover the overlaps of visual computing and materials science and to discover yet-unsolved challenges, on which we can collaborate to achieve a higher societal impact.
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