Fractal analysis of heart graft acute rejection microscopic images.

BACKGROUND: Endomyocardial biopsy to evaluate rejection in the transplanted heart is accepted at the "gold standard." The complexity of microscopic images suggested using digital methods for precise evaluating of acute rejection episodes with numerical representation. The aim of the present was study to characterize digitally acute rejection of the transplanted heart using complexity/fractal image analysis. MATERIAL AND METHODS: Biopsy samples harvested form 40 adult recipients after orthotropic heart transplantation were collected and rejection grade was evaluated according to the International Society for Heart and Lung Transplantation (0, 1a, 1b, or 3a) at transverse and longitudinal sections. Fifteen representative digital microscope images from each grade were collected and analyzed after Sobel edge detection and binarization. RESULTS: Only mean fractal dimension showed a progressive and significant increase and correlation based on rejection grade using longitudinal sections. Lacunarity and number of foreground pixels showed unequivocal results. CONCLUSION: Mean fractal diameter could serve as auxiliary digital parameter for grading of acute rejection in the transplanted heart.

Crossroads of cytokine signaling--the chase to stop muscle cachexia.

There is no universal approach to stop muscle cachexia in a number of life-threatening diseases. Accordingly, it is uncertain why the body mass is so critical to keep alive patients with cancer, congestive heart failure (CHF), AIDS or sepsis. At present, it is widely believed that excess muscle wasting diminishes lean body mass to the risky level accompanied by anorexia, anemia, lipolysis, acute phase response and insulin resistance. If missed and/or untreated muscle cachexia inevitably leads to death due to cardiac and respiratory failure (almost one-third of all cancer deaths). This complex metabolic disorder is suited by the elevated levels of inflammatory cytokines (TNF-alpha, IFN-gamma, IL-1-beta, IL-6, IL-2) and low levels of anti-inflammatory/ other cytokines (IL-15, leptin). Concurrently, tissue sensitivity to insulin is considerably reduced. Recent findings indicate that entirely few muscle-specific genes (i.e. MyoD and myosin heavy chain, MyHC) and their products must be targeted to initiate muscle wasting. Muscle atrophy occurs at different levels, starting from repressed gene expression and ended with accelerated protein degradation. Muscle growth (myogenesis) is severely compromised and disruption of sarcomere architecture heralds the proteolysis of contractile apparatus. This review aims to synthesize our present knowledge of intracellular mechanisms and molecular regulation of muscle cachexia with respect to cytokine signaling.