This paper presents a novel concept for resource management in cluster-based image retrieval systems. First, the paper describes image retrieval using static and dynamic feature extraction. The complexity of dynamic feature extraction requires the utilization of powerful parallel architectures and in order to provide the user with reasonable response times. Most existing methods for resource management in parallel image retrieval systems are based on sinlge query execution and do not take quality of service (QoS) aspects into account. This appears not to be practical in large-scale and commercial applications of image databases having a large number of users at any time. In order to allow an efficient utilization of the parallel system and to meet user-defined QoS demands associated with queries, we need to develop a new concept and a novel resource management architecture. Interesting aspects of the model include utility theory, flexible computations, QoS levels, and a hierarchical resource management architecture. Finally, an approach for algorithmic solution is described.

Objective: Mesenteric blood flow measurement has been found to predict relapse after steroid-induced remission in patients with Crohn's disease (CD) and ulcerative colitis (UC). Therefore, we assessed prospectively the possible relationship between changes in mesenteric blood flow and prognosis in chronically active patients with need of immunosuppressive therapy with azathioprine (AZA) or 6-mercaptopurine (6-MP).Methods: Doppler ultrasound (DUS) measurements of the pulsatility index (PI) of the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA) were pet-formed in 52 patients with chronically active inflammatory bowel disease (CD 31 patients; UC 21 patients) before beginning therapy with A.ZA/6-MP (US1) and during clinical remission (CD activitv index <150, Truelove index score 1) (US2). Patients were weaned from concomitant therapy with corticosteroids as soon as possible and were followed up for 12 months.Results: After 1 year, 16 patients with CD (51.6%) and 13 patients with UC (61.9%) were in remission, whereas 23 patients had recurrent disease or had undergone surgery. A decreased SMA PI at US2 predicted clinical relapse in all patients with CD [100%; P < 0.001, mean (+/-SD,) 77 +/- 67 d after US1], but only 4 of 8 patients (50%; difference not significant, mean 84 +/- 75 d after US1) with UC. Conversely, an increase of SMA PI was associated with sustained remission in the majority of CD patients (12/16 patients; 75%; P < 0.002), but in only 7 of 13 patients (54%) with UC. Flow measurements in the IMA and postprandial values for both arteries were less reliable.Conclusion: Repeated DUS measurements of the SMA PI predict response to AZA,,6-MP in patients with chronic active CD.

Summary form only given. We propose architecture and a general optimization framework for dynamic, distributed real-time systems. Interesting features of this model include the consideration of adaptive applications and utility functions. We extend by formalizing the corresponding multicriterial optimization problem. As the most difficult part of this problem, we identified the evaluation and comparison of the quality of single allocations and sets of allocations, respectively. To this end, we propose and examine metrics for measuring the goodness of solutions within our general resource management framework. These metrics lay the basis for further work on developing both online and offline algorithms to tackle the general optimization problem and provide an efficient adaptive resource manager for dynamic, distributed real-time systems.

The main research in the area of image databases addresses the improvement of retrieval quality and the speedup of the query processing. A number of image retrieval systems reached meanwhile a level, where these are used in real-world applications and thus create new demands. In particular dealing with a large, simultaneous number of users and queries requires concepts for resource management, which strongly consider the underlying architecture and the various approaches for image retrieval. This paper is our first step in this direction, as it provides a formal problem specification and a proof that this problem is NP-hard.

Objective: The diagnostic significance of increased splanchnic blood flow in Crohn's disease is unclear. This prospective study was therefore undertaken to define the role of Doppler sonography in the assessment of disease activity and in the prediction of early relapse. Methods: Splanchnic flowmetry was performed in 59 patients with Crohn's disease and 20 healthy volunteers during fasting and 30 min after ingestion of a standardized meal. Twenty-one patients measured during the active state and in clinical remission were followed-up for 6 months. Hemodynamic parameters of the superior and inferior mesenteric arteries and the portal vein were related to clinical (Crohn's disease activity index [CDAI]), laboratory (C-reactive protein), and endoscopic (Crohn's Disease Endoscopic Index of Severity) parameters of disease activity. Results: The postprandial mean velocity of the superior mesenteric artery correlated closest with clinical activity (CDAI, p < 0.005) and C-reactive protein (p < 0.01), but was unrelated to endoscopic activity. All patients in remission after 6 months (9/9) showed an increase in postprandial pulsatility index of the superior mesenteric artery, compared with an initial measurement during active disease (+28%). In contrast, the majority of patients with later relapse or surgery (11/12) had decreased pulsatility index during initial remission (−20%). The positive predictive value of this index for maintenance of remission was 0.82. Conclusion: Postprandial flow measurements in the superior mesenteric artery are closely related to clinical but not endoscopic disease activity in patients with Crohn's disease. The repeated measurement of the postprandial pulsatility index allows estimation of the risk of recurrence.

BACKGROUND:Octreotide is a potent splanchnic hypotensive somatostatin analogue effective in the treatment of acute variceal bleeding.AIM:To study the effects of octreotide on basal and postprandial splanchnic and systemic haemodynamics, and hormonal changes in humans.METHODS:Twenty-four healthy volunteers were randomized to receive a liquid meal and either octreotide (OCT, 100 microg bolus) or placebo repeatedly every 4 h for 48 h. Splanchnic (Doppler ultrasound) and systemic haemodynamics (non-invasive cardiac monitoring) were assessed for 2 h on four consecutive days: one control day and after doses 1 (0 h), 7 (24 h) and 13 (48 h).RESULTS:The maximum postprandial increases in mean blood velocity of the superior mesenteric artery (SMA-Vmean +72%), portal (PBF +52%) and total hepatic blood flow (HBF +50%) observed in the placebo group, were abolished after the first dose of octreotide (SMA-Vmean -23%, P<0.01; PBF -22%, P<0.01; HBF -21%, P<0.01). Postprandial hyperemia was restored at the end of the 48-h study period, but baseline SMA-Vmean (placebo 40+/-12, OCT 29+/-11 cm/s, P<0.05) and PBF (placebo 1200+/-971, OCT 743+/-449 mL/min, P<0.05) remained significantly lower in the octreotide group. The postprandial decrease of systemic vascular resistance and increase of cardiac index were prevented by octreotide for 48 h.CONCLUSIONS:Repeated 4-hourly bolus injections of octreotide reduce splanchnic blood flow for at least 48 h, but the prevention of food-induced splanchnic hyperemia is short-lasting.

BACKGROUND/AIMS:Diminished postprandial portal hyperemia has been demonstrated by echo-Doppler flowmetry in patients with liver cirrhosis, but its diagnostic role is unclear. This prospective study was therefore undertaken in patients with varying severity of portal hypertension and degree of liver cirrhosis.METHODS:Portal flowmetry was performed in 66 patients with cirrhosis and 20 healthy volunteers during fasting and 30 min after ingestion of a standardized meal. Hemodynamic parameters were related to the degree of esophageal varices, variceal bleeding, portal hypertensive gastropathy and Child-Pugh score.RESULTS:The postprandial portal blood velocity increment was low in patients with esophageal varices of any degree (22-24%), compared to patients without varices (49%, p<0.01) and healthy controls (65%, p<0.001), but was not different in patients with or without variceal bleeding (22% vs. 20%). In contrast, the congestion index (CI; ratio of portal vein cross-sectional area and portal blood velocity) pre-/postprandial decreased in the bleeding group only (CI pre/ CI post 1.30+/-0.23 (no bleeding) vs. 0.86+/-0.29 (bleeding); p<0.01). Portal hypertensive gastropathy was not related to any of the portal flow parameters. The portal blood velocity increment was comparable in controls (65%) and patients with Child-Pugh class A cirrhosis (56%), but lower in patients with class B (32%) and class C cirrhosis (15%, p<0.05 vs. class A). Also, there was no postprandial decrease in congestion index in patients with the most severe cirrhosis (p<0.01 class C vs. class A and B).CONCLUSIONS:The postprandial rise in portal flow is inversely related to the severity of portal hypertension and liver cirrhosis, and may be a valuable parameter with respect to the risk of variceal bleeding.

In summary, the seroprevalence of HGV in anti-HIV positive patient is higher when compared to healthy blood donors (p < .0001).Sexual or parenteral routes present the same risk in acquiring HGV infection.Most anti-HIV positive patients displayed an efficient humoral immune response able to clear HGV-RNA.

The following article contains a short review on gastrointestinal problems of the elderly. The diseases of the esophagus occurring in the elderly are not much different from those in younger patients. Clinically relevant in the stomach are above all bleeding ulcerations and the gastric carcinoma occurring more frequently in advanced age. The pyogenic liver abscess is diagnosed primarily in the elderly and is at a rule the consequence of an infection of the gall bladder and other abdominal sites. The hepatocellular carcinoma does not grow rapidly in the elderly, but its accompanying unfavourable survival rate at five years is also approximately 5 per cent. In the case of symptomatic cholelithiasis, older high risk patients do especially profit from minimally invasive laparoscopic surgical procedures. Today, bile duct calculi are preferably treated by endoscopic papillotomy and following extraction of the calculi. The pancreas is subjected to atrophy lipomatosis and fibrosis at the advanced age. However, these changes are rarely of clinical relevance. A frequent problem in clinical practice is that of constipation, from which 35% of patients suffer above the age of 65 years. Another typical symptom of the elderly is the incontinence, the different causes are being discussed. In advanced age, gastrointestinal hemorrhages are mostly occurring above the Treitz's ligament. Hemorrhages of the lower gastrointestinal tract occur mostly in the form of diverticle bleedings and those of angiodysplasias in the elderly. The diverticulosis is also a disease observed in over 50 per cent of patients above 70 years, but it is symptomatic in only part of the patients. When suspecting an inflammatory bowel disease in the elderly, the possibility of a mesenterial ischemia must always be considered as differential diagnosis. The classical chronic inflammatory bowel diseases can, however, also occur at advanced age. The colon carcinoma is one of the most frequent lethal causes in the Western countries. 90 per cent of the cases of colon carcinoma are found in patients older than 50 years of age. Intensive attention is therefore required in this age group.

The following article contains a short review on gastrointestinal problems of the elderly. The diseases of the esophagus occurring in the elderly are not much different from those in younger patients. Clinically relevant in the stomach are above all bleeding ulcerations and the gastric carcinoma occurring more frequently in advanced age. The pyogenic liver abscess is diagnosed primarily in the elderly and is at a rule the consequence of an infection of the gall bladder and other abdominal sites. The hepatocellular carcinoma does not grow rapidly in the elderly, but its accompanying unfavourable survival rate at five years is also approximately 5 per cent. In the case of symptomatic cholelithiasis, older high risk patients do especially profit from minimally invasive laparoscopic surgical procedures. Today, bile duct calculi are preferably treated by endoscopic papillotomy and following extraction of the calculi. The pancreas is subjected to atrophy, lipomatosis and fibrosis at the advanced age. However, these changes are rarely of clinical relevance. A frequent problem in clinical practice is that of constipation, from which 35% of patients suffer above the age of 65 years. Another typical symptom of the elderly is the incontinence, the different causes are being discussed. In advanced age, gastrointestinal hemorrhages are mostly occurring above the Treitz's ligament. Hemorrhages of the lower gastrointestinal tract occur mostly in the form of diverticle bleedings and those of angiodysplasias in the elderly. The diverticulosis is also a disease observed in over 50 per cent of patients above 70 years, but it is symptomatic in only part of the patients. When suspecting an inflammatory bowel disease in the elderly, the possibility of a mesenterial ischemia must always be considered as differential diagnosis. The classical chronic inflammatory bowel diseases can, however, also occur at advanced age. The colon carcinoma is one of the most frequent lethal causes in the Western countries 90 per cent of the cases of colon carcinoma are found in patients older than 50 years of age. Intensive attention is therefore required in this age group.