Multiparametric MRI in rectal cancer

MRI has a pivotal role in both pretreatment staging and posttreatment evaluation of rectal cancer. The accuracy of MRI in pretreatment staging is higher compared with posttreatment evaluation. This occurs due to similar signal intensities of tumoral and posttreatment fibrotic, necrotic, and inflamed tissue. This limitation occurs with conventional MRI of the rectum with morphologic sequences. There is a need towards increasing the accuracy of MRI, especially for posttreatment evaluation. The term multiparametric MRI implies addition of functional sequences, namely, diffusion and perfusion to the routine protocol. This review summarizes the technique, potential implications and previously published studies about multiparametric MRI of rectal cancer

Growth and reproduction studies on gilthead seabream (Sparus aurata) in Beymelek Lagoon, Turkey

In the present study, age, growth, length-weight relationship and reproduction were investigated in gilthead seabream (Sparus aurata L., 1758) collected from Beymelek Lagoon (Antalya, Turkey) between February 2006 and July 2007. The age, total length and weight of samples ranged from 0+ to 4 years, 10.6 to 35.5cm, and 18 to 928g, respectively. Growth was described by the standard form of the von Bertalanffy growth equation and the estimated parameters were L∞ = 44.6cm, k = 0.394yr^-1 and t0 = -1.331yr. Length-weight relationship was determined as W=0.0174TL^2.9769 (R^2=0.965), and weight increased with size isometrically (b = 2.9769) for all fish. Sex inversion occurred mainly at 26 cm in total length and females reached sexual maturity at 28.5 cm. The spawning period was from December to February, while the gamete emission peaked in December

Multiparametric MRI of rectal cancer—repeatability of quantitative data: a feasibility study

PURPOSEIn this study, we aimed to analyze the repeatability of quantitative multiparametric rectal magnetic resonance imaging (MRI) parameters with different measurement techniques.METHODSAll examinations were performed with 3 T MRI system. In addition to routine sequences for rectal cancer imaging protocol, small field-of-view diffusion-weighted imaging and perfusion sequences were acquired in each patient. Apparent diffusion coefficient (ADC) was used for diffusion analysis and ktrans was used for perfusion analysis. Three different methods were used in measurement of these parameters; measurements were performed twice by one radiologist for intraobserver and separately by three radiologists for interobserver variability analysis. ADC was measured by the lowest value, the value at maximum wall thickness, and freehand techniques. Ktrans was measured at the slice with maximum wall thickness, by freehand drawn region of interest (ROI), and at the dark red spot with maximum value.RESULTSA total of 30 patients with biopsy-proven rectal adenocarcinoma were included in the study. The mean values of the parameters measured by the first radiologist on the first and second measurements were as follows: mean lowest ADC, 721.31±147.18 mm2/s and 718.96±135.71 mm2/s; mean ADC value on the slice with maximum wall thickness, 829.90±144.24 mm2/s and 829.48±149.23 mm2/s; mean ADC value measured by freehand ROI on the slice with maximum wall thickness, 846.56±136.31 mm2/s and 848.23±144.15 mm2/s; mean ktrans value on the slice with maximum wall thickness, 0.219±0.080 and 0.214±0.074; mean ktrans by freehand ROI technique (including as much tumoral tissue as possible), 0.208±0.074 and 0.207±0.069; mean ktrans measured from the dark red foci, 0.308±0.109 and 0.311±0.105. Intraobserver agreement was very good among diffusion and perfusion parameters obtained with all three measurement techniques. Interobserver agreement was very good, except for one of the measurement techniques. As far as interobserver variability is considered, only ADC value measured on the slice with maximum wall thickness differed significantly.ConclusionMultiparametric MRI of rectum, using ADC as the diffusion and ktrans as the perfusion parameter is a repeatable technique. This technique may potentially be used in prediction and evaluation of neoadjuvant treatment response. New studies with larger patient groups are needed to validate the role of multiparametric MRI

Serum uric acid as a surrogate marker of favorable response to bevacizumab treatment in patients with metastatic colon cancer

WOS: 000385182500005PubMed ID: 26781472Bevacizumab is a monoclonal antibody which is a vascular endothelial growth factor inhibitor. It obscures vascularization of tumor tissue and damages intratumoral microcirculation. The damaged intratumoral microcirculation leads to tissue hypoxia and results in increase of uric acid level. The main aim of our study was to investigate the relationship between uric acid change and response to bevacizumab therapy. This study included a total of 158 patients with metastatic colorectal cancer who had received bevacizumab therapy. The number of male patients was 100 (63.3 %) while female patients number was 58 (37.7 %). The median age was 61 (29-83). There was relationship between increase of uric acid level of third month uric acid level and stable disease (p < 0.001). There was a significant overall survival increased in the group with increased uric acid level (p < 0.001). The decline of CEA level was related to uric acid level (p < 0.022). In conclusion, this study is the first showing significant increases of serum uric acid in patients with metastatic colorectal cancer who favorably responded to chemotherapy with bevacizumab. But further studies are justified to test whether monitoring uric acid levels might predict clinical outcomes of patients with metastatic colorectal cancer

Postoperatif paralitik ileus tedavisinde parasempatomimetik sakız kullanımı etkindir

GİRİŞ-AMAÇ: Postoperatif paralitik ileus hastanede yatış süresini uzatır, enteral beslenmeyi geciktirir ve hastane maliyetlerini arttırır. Pratikte pek çok yalancı beslenme yöntemi tedavide kullanılmaktadır. Nikotin güçlü bir parasempatomimetik olup, paralitik ileus tedavisinde denenmemiştir. Çalışmamızın amacı nikotin sakızı da dahil olmak üzere değişik yalancı beslenme metodlarının rektum kanseri cerrahisi sonrası gelişen paralitik ileusa etkilerini ortaya koymaktı. GEREÇ-YÖNTEM: Etik kurul onamını takiben aşağı anterior rezeksiyon ve saptırıcı ileostomi ameliyatı planlanan 68 rektum kanseri hastası çalışmaya dahil edildi. Hastalar 4 gruba randomize edildi; kontrol (n:16), dondurma (n:18), sakız (n:17) ve nikotin sakızı (n:17). Kontrol grubu hastalarına ileostomi deşarjı olana kadar sadece intravenöz tedavi verilirken, dondurma grubunda hastalara ameliyat sonrası 6. saatten itibaren her 8 saatte bir 100 ml sade dondurma (Atatürk Orman Çiftliği, Sade Dondurma, 100ml, Ankara, Türkiye) verildi. Sakız grubu hastalarının yine ameliyat sonrası 6. saatte başlanarak her 8 saatte bir 30 dakika süreyle şekersiz sakız (Falım Sakız, Falım Sakız Sanayi ve Ticaret, İstanbul, Türkiye) çiğnemelerine izin verilirken, nikotin sakız grubunda aynı süre ve aralıkta, hastalara 2 mg nikotin içeren sakız (Nicotinell Sakız, 2 mg; Novartis Consumer Health S.A. Nyon, İsviçre) çiğnettirildi. Hastaların demografik özellikleri, sigara içme alışkanlıkları, kabızlık skorları (Wexner Konstipasyon Skoru), peroperatif kanama ve sıvı infüzyon miktarları, dren kullanımı, hissedilen ilk bağırsak hareket zamanı, ileostomi çalışma zamanı ve acıkma hissi zamanları kaydedildi ve karşılaştırıldı. İstatistiki analizde NCSS (Number Cruncher Statistical System) 2007&amp;PASS (Power Analysis and Sample Size) 2008 Statistical Software (Utah, USA) programı kullanıldı. BULGULAR: Hastaların demografik özellikleri, konstipasyon skorları, neoadjuvan tedavi dağılımları, geçirilmiş batın cerrahisi durumları, cerrahi tipleri, ameliyat süreleri, peroperatif kanama ve verilen intavenöz sıvı miktarları, dren kullanım durumları benzerdi (p&gt;0,05). En yüksek konstipasyon skoru nikotin grubunda hesaplandı (p=0,069). İlk bağırsak hareketi hissi nikotin grubunda kontrol ve sakız grubuna göre kısaydı (p=0,004 ve p=0,046). İleostomi çalışma ve açlık hissi zamanı en kısa nikotin grubunda bulundu. İkili karşılaştırmalarda ileostomi çalışma zamanı nikotin grubunda kontrol grubuna göre anlamlı kısaydı (p=0,011). Sakız grubuyla kıyaslandığında yine nikotin grubunda açlık hissi zamanı daha kısa bulundu (p=0,036). SONUÇ: Rektum kanser cerrahisi sonrası postoperatif ileus tedavisinde nikotinli sakız çiğneme etkili bir yöntemdir

Beymelek Lagünü’ndeki (Antalya, Türkiye) mırmır ( Lithognathus mormyrus L., 1758) (Sparidae) balıklarında yaş, büyüme, boy-ağırlık ilişkisi ve üreme

Age, growth, length-weight relationship and reproduction were investigated for striped seabream ( Lithognathus mormyrus L., 1758) collected from Beymelek Lagoon (Antalya, Turkey) between February 2006 and January 2007. The ages of striped seabream ranged from 0 to 3 years for males and from 0 to 4 years for females. Their total lengths and weights ranged between 14.4 and 26.4 cm and 42 and 297 g for males and 14.3 and 27.4 cm and 40 and 329 g for females, respectively. The growth parameters of the von Bertalanffy equation were: L ∞ = 28.3 cm, K = 0.456 year -1 and t 0 = -1.859 year for males, L ∞ = 28.1 cm, K = 0.466 year -1 , and t 0 = -1.982 year for females and L ∞ = 31.5 cm, K = 0.319 year -1 and t 0 = -2.201 year for all individuals (male, female, and immature). The fitted length-weight relationships of males and females were W = 0.0089×L 3.1599 (r 2 = 0.9591) and W = 0.0076×L 3.2187 (r 2 = 0.8982), respectively. Weight increased positive allometrically with the total length for males, while isometri cally for females. First sexual maturity length was determined as 17.8 cm for male and 18.5 cm for female striped seabream in Beymelek Lagoon. According to trends of GSI values, it was assumed that the spawning was in April and May.Şubat 2006 - Ocak 2007 tarihleri arasında Beymelek Lagünü’nden yakalanan mırmır balıklarının ( Lithognathus mormyrus L., 1758) yaş, büyüme, boy-ağırlık ilişkisi ve üremesi incelenmiştir. Mır mır balıklarının yaşları erkekler için 0 ile 3, dişiler için 0 ile 4 arasında değişmiştir. Total boy ve ağırlıkların da erkekler için 14,4-26,4 cm ve 42-297 g, dişiler için 14,3-27,4 cm and 40-329 g arasında değiştiği saptanmıştır. Von Bertalanffy büyüme denkleminin parametreleri erkekler için L ∞ = 28,3 cm, K = 0,456 yıl -1 ve t 0 = -1,859 yıl, dişiler için L ∞ = 28,1 cm, K = 0,466 yıl -1 ve t 0 = -1,982 yıl ve tüm bireyler (erkek, dişi ve eşeysel olgunluğa erişmemiş) için L ∞ = 31,5 cm, K = 0,319 year -1 and t 0 = -2,201 şeklinde bulunmuştur. Boy-ağırlık ilişkisi ise erkek ve dişi bireyler için sırasıyla W = 0,0089×L 3,1599 (r 2 =0,9591) ve W = 0,0076×L 3,2187 (r 2 =0,8982) olarak belirlenmiştir. Ağırlığın boy ile erkek bireylerde positive allometrik, dişi bireylerde ise isometric olarak arttığı saptanmıştır. İlk eşeysel olgunluk boyu erkek lerde 17,8 cm, dişilerde 18,5 cm olarak bulunmuştur. Üremenin ise, GSI değerlerinin seyrine göre Nisan ve Mayıs ayında gerçekleştiği tahmin edilmiştir