A: Utility of B-type natriuretic peptide (BNP) as a screen for left ventricular dysfunction in patients with diabetes.

Background: Oxidant/antioxidant imbalance has been reported in various respiratory diseases including pneumonia. However, the role of blood antioxidants has not been fully discussed. Objectives: The aim of this exploratory study was to assess serum total antioxidant status (TAS) in patients with community-acquired pneumonia (CAP) and the probable correlation with the severity of the disease. Methods: Thirty patients (22 men, 8 women; mean age of 48 ± 21 years) and 10 healthy nonsmokers (mean age 44 ± 16 years) were studied. Clinical, laboratory and radiological findings were recorded on the day of admission and on the 7th day. A severity score was calculated using the Fine scale. Serum TAS was measured at the same time points using a colorimetric method. Results: On admission, TAS (TAS1) was significantly lower than on the 7th day (TAS2) (0.84 ± 0.13 mmo/l vs. 1.00 ± 0.17 mmo/l; p = 0.0001) and compared with the healthy subjects (0.84 ± 0.13 vs. 1.19 ± 0.09 mmol/l; p < 0.001). TAS change (TAS2 – TAS1) was statistically significantly more marked in smokers (0.17 vs. 0.28, p = 0.001), in patients with factors predisposing to CAP (0.12 vs. 0.37; p = 0.000) and in patients with gram-negative pneumonia (0.16 vs. 0.35; p = 0.000). On the other hand, change in TAS was statistically significantly less marked in patients with lobar pneumonia (0.27 vs. 0.17; p = 0.001). Additionally, TAS change was positively correlated to white blood count on admission (r = 0.39; p = 0.029). Conclusions: It is concluded that serum TAS is decreased in patients with CAP, suggesting the presence of oxidative stress, and that change in TAS seems to be influenced by disease severity. TAS measurement may be useful in estimating the severity of CAP and is a probable indication for the administration of antioxidants in the management of the disease.

I. INTRODUCTIONLTRASOUND (US) is a widely used form of medical imaging, both as a primary modality and as an adjunct to other diagnostic procedures, providing substantial clues in differential diagnosis [1][2]. Its main advantages include non-invasiveness, low-cost and short acquisition times. The interpretation of US images is not a trivial task. A long learning curve is required for radiologists so as to acquire skills in recognizing the image features that comprise risk factors for different diseases, whereas it is difficult to remove the I. Legakis is with the Dept. of Endocrinology, Henry Dunant Hospital, Mesogion 107, 11526 Athens, Greece (e-mail: ilegak@med.uoa.gr).subjective element from the diagnostic process. A challenging task for US diagnostics is the assessment of thyroid nodules. Thyroid nodules are solid or cystic lumps formed in the thyroid gland. They may be caused by a variety of thyroid disorders and carry a considerable risk of malignancy. T he most useful features of the US images, which are usually correlated with the pathology of the thyroid nodules, are echogenicity, texture and shape [3]. For example, recent studies [3][4] indicate that nodules of irregular boundary are associated with a higher malignancy risk. A precise US image delineation method capable of capturing these features or indicating their presence to the experts could contribute to the objectification of medical decisions, and could also be used as an educational tool for trainee radiologists.Medical image segmentation approaches based on active contour models have been applied to images generated by medical imaging modalities as varied as US, magnetic resonance (MR), X -ray, computed tomography (CT) and angiography. Two-dimensional and three-dimensional active contours have been used to segment, visualize, track and quantify a variety of anatomic structures ranging in scale from the macroscopic to the microscopic. These structures include the heart, the cerebrum, a kidney, the lungs, objects such as brain tumors, a fetus, and even cellular structures such as neurons and chromosomes [5]. Cheng et al [6] developed and validated an automatic system using active contours for detecting the intimal and the adventitial layers so as to calculate the intima-media thickness of the common carotid artery. Plissiti et al [7] proposed an active contour model for the delineation of the lumen and media-adventitia border in sequential intravascular US frames. Chang et al [8] utilized a 3-D geodesic active contour to obtain the tumor contour for the pre-and the post-operative malignant breast excision by the vacuum assisted biopsy instrument Mammotome. Jeong et al [9] extended and combined the level set active contour segmentation approach and the agglomerative hierarchical k-means approach for unsupervised clustering. Their approach has been applied for the classification/differentiation of soft tissues in multiband high-resolution ultrasonic transmission tomography images.This wide applicability of active contours can be attributed to th...

Oxidative processes, mediated by oxygen free radicals are recognized to contribute significantly to the inflammatory pathology of bronchial asthma. An imbalance between oxidants and antioxidants has also been proposed in this disease. This study examines the serum total antioxidant status (TAS) in asthmatic patients with severe exacerbation of their disease and the probable correlation with clinical or laboratory findings. The TAS was measured in 20 patients (10 men and 10 women, with a mean age of 41.95 +/- 20.75 years), using a colorimetric method. On the days of admission and discharge, the forced expiratory volume in 1 sec (FEV1), the partial arterial oxygen pressure (PaO2), and severity criteria were recorded and correlated with TAS at the same time. The TAS was also measured in 10 healthy subjects (8 men and 2 women, mean age of 39 +/- 9 years). A statistically significant decrease of TAS was observed on admission day compared to that on discharge day (0.98 +/- 0.08 vs. 1.12 +/- 0.17 mmol/L, p < 0.001, respectively, paired t-test) suggesting the presence of oxidative stress during an asthma attack. The TAS on admission was also statistically significantly decreased compared to that of normal subjects (0.98 +/- 0.08 vs. 1.19 +/- 0.09 mmo/L, p < 0.001, respectively, paired t-test). A statistically significant correlation was observed between FEV1 change and TAS change, from admission to discharge day (r = 0.58, p = 0.007, Pearson correlation). Finally, a statistically significant correlation was found between FEV1 change and TAS on discharge day (r = 0.65, p = 0.002). Decreased TAS was found during an asthma attack, probably as a consequence of increased oxidative stress. The TAS change was correlated with severity criteria, such as FEV1. Therefore, it seems that measurement of TAS could be a simple and useful tool in the evaluation of an asthma attack. The supplementary administration of antioxidants in future needs further clarification.