Evaluating the Effectiveness of Calcium Silicate in Enhancing Soybean Growth and Yield

The application of silicon (Si) fertilizer positively impacts crop health, yield, and seed quality worldwide. Si is a "quasi-essential" element that is crucial for plant nutrition and stress response but is less associated with growth. This study aimed to investigate the effect of Si on the yield of cultivated soybean (Glycine max L). Two locations, Gyeongsan and Gunwi, in the Republic of Korea were selected, and a land suitability analysis was performed using QGIS version 3.28.1. The experiments at both locations consisted of three treatments: the control, Si fertilizer application at 2.3 kg per plot (9 m × 9 m) (T1), and Si fertilizer application at 4.6 kg per plot (9 m × 9 m) (T2). The agronomic, root, and yield traits, as well as vegetative indices, were analyzed to evaluate the overall impact of Si. The results demonstrated that Si had consistently significant effects on most root and shoot parameters in the two experimental fields, which led to significantly increased crop yield when compared with the control, with T2 (22.8% and 25.6%, representing an output of 2.19 and 2.24 t ha^-1 at Gyeongsan and Gunwi, respectively) showing a higher yield than T1 (11% and 14.2%, representing 1.98 and 2.04 t ha^-1 at Gyeongsan and Gunwi, respectively). These results demonstrate the positive impact of exogenous Si application on the overall growth, morphological and physiological traits, and yield output of soybeans. However, the application of the optimal concentration of Si according to the crop requirement, soil status, and environmental conditions requires further studies.

Evaluation of Soybean Wildfire Prediction via Hyperspectral Imaging

Plant diseases that affect crop production and productivity harm both crop quality and quantity. To minimize loss due to disease, early detection is a prerequisite. Recently, different technologies have been developed for plant disease detection. Hyperspectral imaging (HSI) is a nondestructive method for the early detection of crop disease and is based on the spatial and spectral information of images. Regarding plant disease detection, HSI can predict disease-induced biochemical and physical changes in plants. Bacterial infections, such as Pseudomonas syringae pv. tabaci, are among the most common plant diseases in areas of soybean cultivation, and have been implicated in considerably reducing soybean yield. Thus, in this study, we used a new method based on HSI analysis for the early detection of this disease. We performed the leaf spectral reflectance of soybean with the effect of infected bacterial wildfire during the early growth stage. This study aimed to classify the accuracy of the early detection of bacterial wildfire in soybean leaves. Two varieties of soybean were used for the experiment, Cheongja 3-ho and Daechan, as control (noninoculated) and treatment (bacterial wildfire), respectively. Bacterial inoculation was performed 18 days after planting, and the imagery data were collected 24 h following bacterial inoculation. The leaf reflectance signature revealed a significant difference between the diseased and healthy leaves in the green and near-infrared regions. The two-way analysis of variance analysis results obtained using the Python package algorithm revealed that the disease incidence of the two soybean varieties, Daechan and Cheongja 3-ho, could be classified on the second and third day following inoculation, with accuracy values of 97.19% and 95.69%, respectively, thus proving his to be a useful technique for the early detection of the disease. Therefore, creating a wide range of research platforms for the early detection of various diseases using a nondestructive method such HSI is feasible.

Silicon as a Smart Fertilizer for Sustainability and Crop Improvement

Silicon (Si), despite being abundant in nature, is still not considered a necessary element for plants. Si supplementation in plants has been extensively studied over the last two decades, and the role of Si in alleviating biotic and abiotic stress has been well documented. Owing to the noncorrosive nature and sustainability of elemental Si, Si fertilization in agricultural practices has gained more attention. In this review, we provide an overview of different smart fertilizer types, application of Si fertilizers in agriculture, availability of Si fertilizers, and experiments conducted in greenhouses, growth chambers, and open fields. We also discuss the prospects of promoting Si as a smart fertilizer among farmers and the research community for sustainable agriculture and yield improvement. Literature review and empirical studies have suggested that the application of Si-based fertilizers is expected to increase in the future. With the potential of nanotechnology, new nanoSi (NSi) fertilizer applications may further increase the use and efficiency of Si fertilizers. However, the general awareness and scientific investigation of NSi need to be thoughtfully considered. Thus, we believe this review can provide insight for further research into Si fertilizers as well as promote Si as a smart fertilizer for sustainability and crop improvement.

Utilization of Spectral Indices for High-Throughput Phenotyping

The conventional plant breeding evaluation of large sets of plant phenotypes with precision and speed is very challenging. Thus, consistent, automated, multifaceted, and high-throughput phenotyping (HTP) technologies are becoming increasingly significant as tools to aid conventional breeding programs to develop genetically improved crops. With rapid technological advancement, various vegetation indices (VIs) have been developed. These VI-based imaging approaches, linked with artificial intelligence and a variety of remote sensing applications, provide high-throughput evaluations, particularly in the field of precision agriculture. VIs can be used to analyze and predict different quantitative and qualitative aspects of vegetation. Here, we provide an overview of the various VIs used in agricultural research, focusing on those that are often employed for crop or vegetation evaluation, because that has a linear relationship to crop output, which is frequently utilized in crop chlorophyll, health, moisture, and production predictions. In addition, the following aspects are here described: the importance of VIs in crop research and precision agriculture, their utilization in HTP, recent photogrammetry technology, mapping, and geographic information system software integrated with unmanned aerial vehicles and its key features. Finally, we discuss the challenges and future perspectives of HTP technologies and propose approaches for the development of new tools to assess plants' agronomic traits and data-driven HTP resolutions for precision breeding.

Influence of surface coating on the intracellular behaviour of gold nanoparticles: a fluorescence correlation spectroscopy study

In the biomedical applications of nanoparticles (NPs), the proper choice of surface chemistry is a crucial aspect in their design. The nature of the coating can heavily impact the interaction of NPs with biomolecules, affect the state of aggregation, and ultimately determine their biological fate. As such, protein corona formation and the aggregation behaviour of gold NPs (Au NPs) are studied here. Au NPs are prepared with four distinct surface functionalisations, namely mercaptosuccinic acid (MSA), N-4-thiobutyroil glucosamine, HS-PEG₅₀₀₀ and HS-alkyl-PEG₆₀₀. Corona formation, aggregation, and the intracellular behaviour of the Au NPs are then investigated by means of Fluorescence Correlation Spectroscopy (FCS) in cell culture media and in live cells. To evaluate the state of aggregation and the formation of a protein corona, the Au NPs are incubated in cell media and the diffusion coefficient is determined via FCS. The in vitro behaviour is compared with the level of aggregation of the NPs in cells. Diffusion times of the NPs are estimated at different positions in the cell after a one hour incubation period. It is found that the majority of MSA and glucose-Au NPs are present inside the cell as slowly diffusing species with diffusion times (τ_D) greater than 6000 μs (hydrodynamic diameter >250 nm). PEGylated Au NPs adsorb a small amount of protein and manifest low agglomeration both in media and in living cells. In particular, the HS-alkyl-PEG₆₀₀ coating shows an excellent correlation between lower protein adsorption, 4-fold lower compared to the MSA coated NPs, and limited intracellular aggregation. In the case of single HS-alkyl-PEG₆₀₀ coated NPs, it is found that typical intracellular τ_D values range from 500 to 1500 μs, indicating that these particles display reduced aggregation in the intracellular environment.

Efficacy of antiviral agents in feline herpetic keratitis: Results of anin vitrostudy

PURPOSE

To determine, by a plaque reduction assay, the in vitro efficacy of novel antiviral agents in the treatment of feline herpes virus 1 (FHV-1) keratitis in the domestic cat (Felis felis).

MATERIALS AND METHODS

A standard plaque reduction assay was performed using a laboratory strain of FHV-1 and embryo-derived feline kidney cells to determine the in vitro efficacy of the antiviral drugs penciclovir (PCV), bromovinyldeoxyuridine (BVdU), and (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl) adenine (HPMPA) and to compare these with the drugs acyclovir (ACV) and trifluorothymidine (TFT). Efficacy was assessed by determining the dose of drug at which 50% plaque reduction was noted (ED(50)).

RESULTS

HPMPA was found to have greatest antiviral activity (ED(50) 0.07 microg/ml). ACV was least active (ED(50) 24 microg/ml), while TFT was active with an ED(50) of 5.7 microg/ml. PCV and BVdU had intermediate activity (ED(50) 1.6 and 1.7 microg/ml, respectively).

CONCLUSIONS

This study suggests that the efficacy of HPMPA, BVdU, and penciclovir in cats with herpesviral keratitis should be determined in vivo as their efficacy in vitro was substantially greater than that of acyclovir, already shown to have demonstrable but limited clinical antiviral activity.

Thymidilate synthase (TS), thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD), and dihydrofolate reductase (DHFR) as predictive markers of capecitabine efficacy in breast cancer patients

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Background: The efficacy of 5-FU and the pro-drug capecitabine (C) is mediated through the thymidylate synthase pathway and may be affected by expression of key enzymes in this pathway. The expression and/or gene copy number of TS, TP, DPD and DHFR was assessed and correlated with time-to progression (TTP) and progression-free survival (PFS). Methods: Adult female patients with pathologically confirmed breast cancer and locally advanced or metastatic disease were treated with C 1000 mg/m2 BID days 1–14 of a 21-day cycle. Formalin-fixed, paraffin-embedded (FFPE) specimens from C-treated patients were processed for RNA extraction. Total RNA was isolated from 32 FFPE tissue samples containing at least 70% tumor cells and RNA levels for TS, TP, DPD and DHFR were quantified using real time RT-PCR and Affymetrix GeneChip microarrays. Custom made TS and TP FISH probes (Dako, Glostrup, Denmark) were used to evaluate gene copy number and gene to reference ratios in at least 60 morphologically intact non-overlapping nuclei. Markers were correlated with TTP and PFS using Cox proportional hazard models in 24 patients. Results: Higher TS gene copy number was significantly associated with a decrease in PFS (HR 1.46, 95% CI 1.08 to 1.96, p=0.014) and TTP (HR 1.49, 95% CI 1.05 to 2.13, p=0.028). However, the association between TS RNA levels (expressed as Ct values) and PFS (HR 0.82, 95% CI 0.61 to 1.11, p=0.198) or TTP (HR 0.74, 95% CI 0.49 to 1.14, p=0.172) failed to reach statistical significance. RNA levels, determined by Affymetrix, were significantly correlated with RT-PCR for TS (r= -0.5073, p=0.0004) and DHFR (r=-0.50994, p=0.003). Neither TP gene copy number nor RNA levels were significantly associated with PFS (HR 099, and HR 0.93) or TTP (HR 1.07 and HR 1.029), respectively. The association between RNA levels and PFS or TTP did not reach statistical significance for both DPD (HR 1.17 and HR 1.13) and DHFR (HR 0.68 and HR 0.63), respectively. Conclusions: These data indicate that TS gene copy number, assessed by FISH with proper standardization, might be a useful and easily accessible marker for C sensitivity in human breast cancer and warrants further investigation.

[Table: see text]

Pharmacological analysis of cannabinoid receptor activity in the rat vas deferens

1. The interaction between the cannabinoid agonists, WIN 55,212-2 or CP 55,940 with the CB(1) receptor-selective antagonists, SR141716A or LY320135 was investigated using the rat electrically-stimulated vas deferens bioassay. 2. Tissues were stimulated by single-field pulses (150 V, 0.5 ms) delivered every 30 mins. In the presence of nifedipine (3 microM), agonists elicited a concentration-dependent inhibition of the contractile response, with pEC(50) values of 7.93 and 6.84 for WIN 55,212-2 and CP 55,940, respectively. 3. SR141716A and LY320135 caused parallel dextral displacements of the agonist concentration-response curves. However, the shift of the agonist curves by either antagonist was accompanied by a concentration-dependent enhancement of basal (agonist-independent) tissue contraction. 4. Addition of the amidase inhibitor, phenylmethylsulphonylfluoride (200 microM), resulted in a significant reduction of the basal twitch response, an effect consistent with the presence of tonic receptor activation mediated by the endogenous cannabinoid, anandamide. 5. In light of these findings, we propose a theoretical model of competitive agonist-antagonist interaction in the presence of endogenous agonist tone that was used to derive an optimized analytical approach for the determination of antagonist potency estimates under conditions of tonic receptor activation. 6. This approach yielded pK(B) estimates for SR141716A and LY320135 that were in good agreement with their activity at cannabinoid CB(1) receptors. 7. It is concluded that the rat vas deferens contains prejunctional cannabinoid CB(1) receptors that are under tonic activation from endogenous substances; under these conditions our analytical approach is preferable to the standard methods for the determination of antagonist potency.

Effect of amlodipine on cardiopulmonary performance in volunteers

1. In order to exclude a significant effect of the calcium channel antagonist amlodipine on cardiopulmonary performance in normal subjects, we performed a double-blind cross-over study of amlodipine (10 mg daily for 2 weeks) on oxygen uptake and catecholamine responses during exercise in eight volunteers. 2. Despite a therapeutic plasma concentration of amlodipine (22.8+/-9 ng/mL), there was no change in resting heart rate or blood pressure. Amlodipine did not cause significant change in oxygen uptake at the anaerobic threshold or at maximum exercise and there was also no change in heart rate or catecholamine responses. 3. Although there was an awareness of peripheral vasodilation and reports of lethargy during the active treatment period, the volunteers had no objective evidence of a decrease in cardiopulmonary performance. We suggest that use of amlodipine as a vasodilator in the perioperative period would not add to the myocardial depressant effects of general anaesthesia in patients with normal cardiac function.

Pharmacological characterisation of cannabinoid CB(1) receptors in the rat and mouse

The role of cannabinoid CB(1) receptors in sympathetic neurotransmission was characterised in nerve-mediated responses of isolated right atria, vasa deferentia and small mesenteric resistance arteries using the cannabinoid CB(1) receptor agonists Delta(9)-tetrahydrocannabinol, CP 55,940 and anandamide and the cannabinoid CB(1)-selective antagonist SR 141716A. In the mouse vas deferens, the twitch response was completely inhibited by each of the putative cannabinoid receptor agonists with pIC(50) values of CP 55,940, 9.2+/-0.1; Delta(9)-tetrahydrocannabinol, 8.4+/-0.1; anandamide, 7.1+/-0.1. SR 141716A 10-100 nM was a competitive antagonist of all three agonists with a pK(B) value of 8.4-8.6, consistent with an interaction at the cannabinoid CB(1) receptor. In the rat vas deferens CP 55,940 (0.01-10 microM) inhibited the contractions to a significant extent (88.5+/-0.5% at 10 microM; pIC(50) of 7.1+/-0.1) while Delta(9)-tetrahydrocannabinol and anandamide (both up to 10 microM) were inactive. CP 55,940 exhibited low potency in rat compared with mouse vas deferens and the rat concentration-response curve was not competitively antagonised by SR 141716A (100 nM) or SR 144528 (10 nM-10 microM), suggesting an interaction at a receptor(s) distinct from cannabinoid CB(1) or CB(2). Sympathetic nerve-induced tachycardia in rat and mouse atria, and rat mesenteric artery smooth muscle contractile responses to perivascular nerve stimulation, were not inhibited by Delta(9)-tetrahydrocannabinol, CP 55,940 or anandamide up to 1 microM. These data indicate that cannabinoid CB(1) receptor activation inhibits sympathetic neurotransmission only in the mouse vas deferens and thus point to species and regional differences in cannabinoid CB(1) receptor involvement in pre-synaptic inhibition of sympathetic neurotransmission and CP 55,940 may have inhibitory actions in rat vas deferens unrelated to cannabinoid receptor activity.

Capsular polysaccharide of Streptococcus pneumoniae type 19F: synthesis of the repeating unit

A new and more versatile synthesis of beta-D-ManpNAc-(1-->4)-alpha-D-Glcp-(1-->2)-alpha-L-Rhap, the trisaccharide repeating unit of the Streptococcus pneumoniae type 19F capsular polysaccharide, is described. The present approach allows a simple access to different fragments containing the trisaccharide and the conjugation of the product(s) to a protein through the selective manipulation of the anomeric position at the reducing end and of the HO-4 function at the nonreducing end. The synthetic scheme shows an efficient application of the sulfoxide method for the stereoselective and high yielding formation of the glycosidic linkages.

Synthesis of N-acetylglucosamine containing Lewis A and Lewis X building blocks based on N-tetrachlorophthaloyl protection--synthesis of Lewis X pentasaccharide

Phenyl 6-O-benzyl-2-deoxy-2-tetrachlorophthalimido-1-thio-beta-D- glucopyranoside (5a) and thexyldimethylsilyl 6-O-benzyl-2-deoxy-2-tetrachlorophthalimido-beta-D- glucopyranoside (5b) gave with O-(2,3,4,6-tetra-O-acetyl-alpha-D-galactopyranosyl)trichloroacetimida te (8) in the presence of BF3.Et2O as catalyst exclusively lactosamine derivatives 7a and 7b, respectively, in high yields. Ensuing reaction with O-(3, 4-di-O-acetyl-2-O-benzyl-alpha-L-fucopyranosyl) trichloroacetimidate (9) in the presence of TMSOTf as catalyst afforded Le(x) trisaccharide intermediates 10a,b. With fucosyl donor 9 and 5a,b as acceptors in the presence of TMSOTf as catalyst glycosylation either at the 3-O or the 4-O was observed, thus leading to mixtures of disaccharides 11a/12a and 11b/12b, respectively; their reaction with 8 furnished Le(x) trisaccharide intermediates 10a,b and Le(a) trisaccharide intermediates 14a,b. Transformation of 10b into the corresponding trichloroacetimidate 17 and reaction with lactose acceptor 19 in the presence of Zn(OTf)2 as catalyst gave protected Le(x) pentasaccahride intermediate 21, which on deprotection led to unprotected Le(x) pentasaccharide 1.

A simple access to lactose-derived building blocks required in glycoconjugate synthesis

Lactose was readily transformed into thexyldimethylsilyl (3,4-O-isopropylidene-beta-D-galactopyranosyl)-(1-->4)-beta- D-glucopyranoside (5); this compound served as intermediate for the generation of partially O-protected lactose building blocks required in oligosaccharide and glycoconjugate synthesis. Thus, from 5 via per-O-benzoylation, desilylation, trichloroacetimidate formation, glycosylation of the Lemieux spacer, and acid-catalyzed de-O-isopropylidenation methoxycarbonyloctyl (2,6-di-O-benzoyl-beta-D-galactopyranosyl)- (1-->4)-2,3,6-tri-O-benzoyl-beta-D-glucopyranoside (12) was obtained. Regioselective benzoylation of 5 with benzoyl cyanide under various conditions afforded 3-O- (13), 2,3,2'-O- (14), 3,2'-O- (16), and 2,2'-O-unprotected (17) lactoside, respectively. De-O-isopropylidenation of 16 gave thexyldimethylsilyl (6-O-benzoyl-beta-D-galactopyranosyl)-(1-->4)-2, 6-di-O-benzoyl-beta-D-glucopyranoside (18), an important 2',3',4'-O-unprotected lactose derivative. Fucosylation of 13 and then de-O-isopropylidenation afforded thexyldimethylsilyl 2,6-di-O-benzoyl-beta-D-galactopyranosyl)-(1-->4)-[(3,4-di-O-acetyl-2-O- benzoyl-alpha-L-fucopyranosyl)-(1-->3)]-2,6-di-O-benzoyl-beta-D- glucopyranoside (21), an important fucosyllactose building block.

Synthesis of the disaccharides methyl 4-O-(2'/3'-O-sulfo-beta-D-glucopyranosyluronic acid)-2-amino-2-deoxy-alpha-D-glucopyranoside disodium salts, related to heparin biosynthesis

The synthesis of the disaccharides methyl 4-O-(2'/3'-O-sulfo-beta-D-glucopyranosyluronic acid)-2-amino-2-deoxy-alpha-D-glucopyranoside 3 and 4 as disodium salts is described. Allyl 4,6-O-benzylidene-alpha-D-glucopyranoside 6 was converted to trichloroacetimidate 20. Glycosylation of 20 with 5 promoted by BF3.OEt2 gave disaccharide 21. Deacetylation of 21 followed by monoacetylation of the resultant diol 22 afforded the two monoacetylated disaccharides 23 and 24. Sulfation and deprotection of each disaccharide gave the desired sulfated compounds 3 and 4.

Identification of O-sulphate substituents on D-glucuronic acid units in heparin-related glycosaminoglycans using novel synthetic disaccharide standards

The two disaccharides, methyl 4-O-(2-O-sulpho-beta-D-glucopyranosyl-uronic acid)-2-deoxy-2-amino-alpha-D-glucopyranoside and methyl 4-O-(3-O-sulpho-beta-D-glucopyranosyluronic acid)-2-deoxy-2-amino-alpha-D-glucopyranoside, were prepared by de novo synthesis, and converted to the corresponding 2,5-anhydro-D-[1-3H]mannitol derivatives by deamination with nitrous acid followed by reduction with NaB3H4. The resultant labelled products were used as standards in the identification, by anion-exchange high-performance liquid chromatography (HPLC), of disaccharides generated by HNO2/NaB3H4 treatment of heparan sulphate isolated from human brain. The two standards, containing 2-O- and 3-O-sulphated glucuronic acid, respectively, were clearly separated by the HPLC procedure. Comparison with the deamination products derived from heparan sulphate showed that the mono-O-sulphated disaccharide species containing a sulphated glucuronic acid unit co-eluted with the 2-O-sulphated standard. The corresponding component isolated from other heparan sulphate preparations, or from heparin, also eluted at the same position. No disaccharide derived from heparin or heparan sulphate appeared at the elution position of the 3-O-sulphated standard. It is concluded that D-glucuronic acid units in heparin-related glycosaminoglycans may be sulphated at C2, whereas no evidence has been found for sulphation at C3. By contrast, analysis of mono-O-sulphated disaccharides derived from a chemically sulphated, bacterial capsular polysaccharide (generated by Escherichia coli K5) clearly demonstrated the occurrence of O-sulphate groups at C-3 of D-glucuronic acid units.

Analysis of hypospadias and fistula repair

A total of 83 children underwent hypospadias repair from 1977 to 1991. The method of repair was based on individual patient pathology. Meatal advancement and glanuloplasty repair (MAGPI) was the most common operation performed (n = 37) followed by flip flap (n = 19), free tube graft (n = 11), and vascularized tube graft (n = 16). Fistula formation was the most common complication, with an overall incidence of 16 per cent. Fifty-four per cent of fistulas occurred following free tube graft urethroplasties, and 25 per cent of fistulas were noted following vascularized tube graft procedures. After 1986 the fistula rate decreased to 11 per cent in vascularized tube grafts, indicating a learning curve for this procedure. Seventy per cent of all fistulas required uncomplicated surgical repair, and 30 per cent closed spontaneously. We present our experience involving hypospadias repair, fistula formation, and management with an emphasis on penile hypospadias.

Provocative testing for cubital tunnel syndrome

This prospective study evaluated the clinical usefulness of provocative testing in 32 subjects with electrodiagnostically proven cubital tunnel syndrome and 33 control subjects. Four provocative tests were included: Tinel's sign, elbow flexion, pressure provocation, and combined elbow flexion and pressure provocation. The mean age of the control group was 41 years and 46 years for the group with cubital tunnel syndrome. In the control group, provocative tests were rarely positive. In 44 extremities with cubital tunnel syndrome, 31 had a Tinel's sign, 33 had a positive elbow flexion test, 39 had symptoms with pressure only, and 41 had symptoms with a combination of pressure provocation and elbow flexion testing. The sensitivity of the Tinel sign was 0.70, and at 30 seconds, the sensitivities of the other provocative tests were: elbow flexion (0.32), pressure provocation (0.55), and pressure-flexion test (0.91). The most sensitive provocative test in the diagnosis of cubital tunnel syndrome was elbow flexion when combined with pressure on the ulnar nerve.

Bilateral pyoderma gangrenosum of the hand: treatment with dapsone

The first reported case of bilateral pyoderma gangrenosum of the hands is presented. One lesion was treated with wound care only, with spontaneous healing after two months. The contralateral lesion which occurred one month later was treated with wound care and oral dapsone. Healing occurred between four and six weeks after the start of dapsone. It is suggested that this acts by limiting the necrotizing process, thus allowing earlier epithelialization. Pyoderma gangrenosum is rare, and treatment is non-surgical. It is important that it is recognized to avoid extension of the necrotizing process through ill-advised surgery.

Value of endoscopic retrograde cholangiopancreatography in determining the cause but not course of acute pancreatitis

We have recently shown that ERCP is the most useful technique for detecting a biliary origin of acute pancreatitis and can be done without side effects. We now report on a second series of 50 patients with acute pancreatitis in whom ERCP, computed tomography (CT), ultrasound (US), and clinical and laboratory assessment were performed within the first 24 to 48 hours of hospitalization. A score for ERCP, CT and US was used to assess the severity of the disease. Patients were followed up until discharge or death and their condition classified according to outcome as mild (less than or equal to 1 complication), severe (greater than 1 complication) or fatal. ERCP was superior in detecting choledochal stones (ERCP 100%, US 25%, CT 50%) and dilated intrahepatic ducts (ERCP 75%, US 75%, CT 37%) but not gallbladder stones (ERCP 70%, US 100%, CT 60%). When the ERCP severity score was calculated there was no relevant difference between patients thereafter having a mild course (0.66 +/- 0.91, range 0-3), a severe course (1.3 +/- 0.80, range 0-3), or a fatal outcome (1.0 +/- 1.1, range 0-3). In contrast, the CT score was different in all three groups (mild: 3.0 +/- 1.9; severe: 5.3 +/- 3.2; lethal: 6.3 +/- 3.1) as was the US score (mild: 1.5 +/- 1.3; severe: 3.2 +/- 2.3; lethal: 4.4 +/- 1.4). It is concluded from these results that ERCP is of value in defining the origin of acute pancreatitis. When a biliary origin is detected this can lead to immediate treatment using endoscopic sphincterotomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Granulocyte elastase in assessment of severity of acute pancreatitis. Comparison with acute-phase proteins C-reactive protein, alpha 1-antitrypsin, and protease inhibitor alpha 2-macroglobulin

Complexes of granulocyte elastase and alpha 1-antitrypsin are markers for granulocyte activation. In 75 patients with acute pancreatitis these complexes were immunologically determined daily in plasma during the first week of hospitalization. Patients were classified into three groups: mild pancreatitis (I, less than or equal to 1 complication, N = 34), severe pancreatitis (II, greater than or equal to 2 complications, N = 29), lethal outcome (III, N = 12). Initially, granulocyte elastase (mean +/- SEM) was lower in group I (348 +/- 39 micrograms/liter) as compared to groups II (897 +/- 183 micrograms/l) and III (799 +/- 244 micrograms/liter), P less than 0.001 for I vs II + III. Initial elastase concentrations greater than 400 micrograms/liter were consistent with a severe or fatal course of the disease but did not distinguish between severe and lethal pancreatitis. In patients with mild or severe disease, mean elastase concentrations decreased continuously during the following days (197 +/- 15 micrograms/liter in mild cases, 325 +/- 30 micrograms/liter in severe cases at day 7). In patients with lethal disease, however, mean elastase concentrations even increased at day 2 and remained higher than 700 micrograms/liter during the observation period. At days 1 and 2 the predictive value for severe or lethal disease of raised (greater than 400 micrograms/liter) elastase concentrations [positive predictive value (PPV) 82%, negative predictive value (NPV) 81%] was better than that of elevated (greater than 100 mg/liter) C-reactive protein (PPV 73%, NPV 73%), elevated (greater than 4.0 g/liter) alpha 1-antitrypsin (PPV 59%, NPV 50%), or decreased (less than 1.5 g/liter) alpha 2-macroglobulin (PPV 82%, NPV 67%).(ABSTRACT TRUNCATED AT 250 WORDS)