Comparison of elastography methods in patients with pancreatic masses.

INTRODUCTION: Endoscopic ultrasonography (EUS) quantitative elastography methods are developed for non-invasive differentiation of pancreatic masses. AIMS: First: To evaluate the diagnostic value of strain ratio (SR) and hue histogram (HH) in patients with pancreatic masses and to determine the cut-off value between pancreatic cancer and focal pancreatitis using a pancreatic tissue close to the mass as a reference area. Second: To calculate new variable HH ratio (HHR) in an attempt to improve sensitivity, specificity and accuracy of the method. METHODS: In a prospective single center study, 149 patients were examined: 105 with the pancreatic masses and 44 controls using Pentax EUS linear probes in combination with Hitachi platforms. SR and HH were automatically calculated by machine software. Finally, two groups were formed: Pancreatic cancer group (58 patients) and focal pancreatitis group (47 patients). All statistical analysis has been made in SPSS 14.0 (SPSS Inc., Chicago, USA). CONCLUSION: Statistical analysis in our study showed that SR with a cut-off value of 7.59 reaches 100% sensitivity and 95% specificity with overall accuracy of 97% (confidence intervals [CI]: 92-97%) in detection of pancreatic cancer. Statistical analysis also showed that HH with a cut-off value of ≥86 reaches 100% sensitivity and just 45% specificity with overall accuracy of 66% (CI: 61-66%) in detection of pancreatic cancer. New variable HHR with cut-off ≥1.153 was slightly better with 98% sensitivity and 50% specificity, with overall accuracy of 69% (CI: 63-70%). SR showed significantly higher specificity compared with HH and HHR. More HH studies on Hitachi platforms are needed.

The prevalence of Shiga toxin-producing Escherichia coli in domestic animals and food in Serbia.

Faecal samples of 2660 domestic animals from 116 farms and 956 samples of food were examined for the presence of Shiga toxin-producing Escherichia coli (STEC). STEC was recovered from 126 (15.3%) cattle, 135 (11.3%) pigs, 135 (66.8%) sheep, 31 (73.8%) goats, 4 (1%) chicken, and 15 (1.6%) food samples. Of all STEC isolates, 21.5, 25.8 and 15% produced enterohaemolysin, alpha-haemolysin, and aerobactin respectively, 1.6% displayed localized adherence (LA) to HEp-2 cells, 27.6% were sorbitol negative, and 30% were resistant to antibiotics. Only 14 (3.1%) of the STEC isolates belonged to human infection-associated serogroups (O26, O55, O111, O128 and 0157), designated as enterohaemorrhagic E. coil (EHEC). This study revealed that STEC are prevalent in domestic animals, and to a lesser extent in food of animal origin in Serbia, but the absence of a EHEC phenotypic profile (characteristic serogroup, LA, enterohaemolysin production) in most animal STEC strains may explain the low incidence of human STEC infection in this part of the world.

Interstitial hypertension in superficial metastatic melanomas in humans.

Since 1950, several investigators have demonstrated that interstitial hypertension is a pathophysiological characteristic of experimental solid tumors. To date, interstitial fluid pressure (IFP) has not been measured in human tumors in situ. In this study we measured with the wick-in-needle technique the interstitial fluid pressure in superficial melanoma metastases (n = 12) in patients (n = 10) before and during systemic therapy. In the majority of tumors the pressure was found to be almost uniform, while in others it varied severalfold. The large variations in IFP in some tumors may be due to technical or biological factors. With the data obtained before and during therapy grouped, the mean IFP in melanoma lesions varied between 2 and 41 mm Hg with an overall mean of 14.3 +/- 12.5 (SD). IFP was found to be significantly higher (P less than 0.01) in large (22.8 +/- 13 mm Hg; n = 6) than in small (5.8 +/- 2mm Hg; n = 6) lesions. This study demonstrates that IFP can be measured in human tumors using the wick-in-needle technique and that the pressure in some of the large melanomas exceeds the values measured to date in rodent tumors or human tumor xenografts. The latter result suggests that caution must be exercised in extrapolating values of pathophysiological parameters from transplanted tumors to human tumors.