The Value of Somatostatin Receptor Scintigraphy (SRS) in Patients with NETG1/G2 Pancreatic Neuroendocrine Neoplasms (p-NENs).

Background: Neuroendocrine neoplasms of the pancreas (p-NEN) are common gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs). The aim of this retrospective study was to review the of value of Somatostatin Receptor Scintigraphy (SRS) in initial detection of p-NEN, evaluation of tumour extent and as imaging follow-up after radical surgery in patients with confirmed well (NETG1) or moderate (NETG2) differentiated p-NEN based on pathological WHO 2017 classification. Material and methods: Overall 281 patients with confirmed p-NEN were enrolled. The SRS was performed to evaluation of primary p-NEN, also to assess clinical stage of disease, based on current World Health Organization (WHO) classification and during clinical follow-up. A total of 829 examinations were performed over time in these 281 patients using 99mTc HYNICTOC. Images were acquired between 1 – 3 h after i.v. injection of radiotracer. Initially whole body WB-SPECT and then WB-SPECT/CT, with standard iterative reconstruction were used. Results: There were 159 patients with NETG1 (57%) and 122 subjects with NETG2 (43%). The female to male ratio was 1.1:1. In 68 patients (22%) with NETG1/G2 eight-seven SRS (10%) were performed to confirm initial diagnosis. SRS results were as follow: true positive (TP) = 84 (97%), false negative (FN) = 3 (3%), no true negative (TN) or false positive (FP) results of SRS examination (sensitivity of SRS per patient was 96%). In 198 subjects (66%) SRS was used in evaluation and re-evaluation of the clinical stage, A total of 661 (80%) examinations were carried out in these patients. There were TP=514 (77%), TN=136 (21%), FN=7 (1%) and FP=4 (1%) results. The sensitivity and specificity per patient were: 96% and 95%. The sensitivity and specificity per study: 98% and 97%. In 35 patients (12%) SRS was used as imaging follow-up after radical surgery, there were overall 81 examination (10%) which were performed. There were 76 (91%) TN results of examinations of SRS and in 4 patients we identified recurrence (TP). In total, which consists of initial diagnosis/staging and follow-up patients, the sensitivity of SRS was 96% and specificity 97% per patient and per study sensitivity and specificity was 98%. Conclusions: SRS using 99mTc HYNICTOC acquired in WB-SPECT or WB-SPECT/CT techniques is an excellent imaging modality in detection of primary NETG1/G2 p-NEN. Our study confirms that SRS has high sensitivity and specificity, as a result has tremendous value as an examination method to assess clinical stage of disease and as an imaging follow-up after radical treatment

Anti-tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: The CLARINET open-label extension study

In the CLARINET study, lanreotide Autogel (depot in USA) significantly prolonged progression-free survival (PFS) in patients with metastatic pancreatic/intestinal neuroendocrine tumours (NETs). We report long-term safety and additional efficacy data from the open-label extension (OLE). Patients with metastatic grade 1/2 (Ki-67 %) nonfunctioning NET and documented baseline tumour-progression status received lanreotide Autogel 120 mg (n=101) or placebo (n=103) for 96 weeks or until death/progressive disease (PD) in CLARINET study. Patients with stable disease (SD) at core study end (lanreotide/placebo) or PD (placebo only) continued or switched to lanreotide in the OLE. In total, 88 patients (previously: lanreotide, n=41; placebo, n=47) participated: 38% had pancreatic, 39% midgut and 23% other/unknown primary tumours. Patients continuing lanreotide reported fewer adverse events (AEs) (all and treatment-related) during OLE than core study. Placebo-to-lanreotide switch patients reported similar AE rates in OLE and core studies, except more diarrhoea was considered treatment-related in OLE (overall diarrhoea unchanged). Median lanreotide PFS (core study randomisation to PD in core/OLE; n=101) was 32.8 months (95% CI: 30.9, 68.0). A sensitivity analysis, addressing potential selection

Targeted Inactivation of p12Cdk2ap1, CDK2 Associating Protein 1, Leads to Early Embryonic Lethality

Targeted disruption of murine Cdk2ap1, an inhibitor of CDK2 function and hence G1/S transition, results in the embryonic lethality with a high penetration rate. Detailed timed pregnancy analysis of embryos showed that the lethality occurred between embryonic day 3.5 pc and 5.5 pc, a period of implantation and early development of implanted embryos. Two homozygous knockout mice that survived to term showed identical craniofacial defect, including a short snout and a round forehead. Examination of craniofacial morphology by measuring Snout Length (SL) vs. Face Width (FW) showed that the Cdk2ap1+/− mice were born with a reduced SL/FW ratio compared to the Cdk2ap1+/+ and the reduction was more pronounced in Cdk2ap1−/− mice. A transgenic rescue of the lethality was attempted by crossing Cdk2ap1+/− animals with K14-Cdk2ap1 transgenic mice. Resulting Cdk2ap1+/−:K14-Cdk2ap1 transgenic mice showed an improved incidence of full term animals (16.7% from 0.5%) on a Cdk2ap1−/− background. Transgenic expression of Cdk2ap1 in Cdk2ap1−/−:K14-Cdk2ap1 animals restored SL/FW ratio to the level of Cdk2ap1+/−:K14-Cdk2ap1 mice, but not to that of the Cdk2ap1+/+:K14-Cdk2ap1 mice. Teratoma formation analysis using mESCs showed an abrogated in vivo pluripotency of Cdk2ap1−/− mESCs towards a restricted mesoderm lineage specification. This study demonstrates that Cdk2ap1 plays an essential role in the early stage of embryogenesis and has a potential role during craniofacial morphogenesis

Imaging in situ breast carcinoma (with or without an invasive component) with technetium-99m pentavalent dimercaptosuccinic acid and technetium-99m 2-methoxy isobutyl isonitrile scintimammography

INTRODUCTION: The aim of the study was to retrospectively define specific features of the technetium-99m pentavalent dimercaptosuccinic acid ((99m)Tc-(V)DMSA) and technetium-99m 2-methoxy isobutyl isonitrile ((99m)Tc-Sestamibi [(99m)Tc-MIBI]) distribution in ductal breast carcinoma in situ and lobular breast carcinoma in situ (DCIS/LCIS), in relation to mammographic, histological and immunohistochemical parameters. MATERIALS AND METHODS: One hundred and two patients with suspicious palpation or mammographic findings were submitted preoperatively to scintimammography (a total of 72 patients with (99m)Tc-(V)DMSA and a total of 75 patients with (99m)Tc-Sestamibi, 45 patients receiving both radiotracers). Images were acquired at 10 min and 60 min, and were evaluated for a pattern of diffuse radiotracer accumulation. The tumor-to-background ratios were correlated (T-pair test) with mammographic, histological and immunohistochemical characteristics. RESULTS: Histology confirmed malignancy in 46/102 patients: 20/46 patients had DCIS/LCIS, with or without coexistent invasive lesions, and 26/46 patients had isolated invasive carcinomas. Diffuse (99m)Tc-(V)DMSA accumulation was noticed in 18/19 cases and (99m)Tc-Sestamibi in 6/13 DCIS/LCIS cases. Epithelial hyperplasia demonstrated a similar accumulation pattern. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for each tracer were calculated. Solely for (99m)Tc-(V)DMSA, the tumor-to-background ratio was significantly higher at 60 min than at 10 min and the diffuse uptake was significantly associated with suspicious microcalcifications, with the cell proliferation index ≥ 40% and with c-erbB-2 ≥ 10%. CONCLUSION: (99m)Tc-(V)DMSA showed high sensitivity and (99m)Tc-Sestamibi showed high specificity in detecting in situ breast carcinoma ((99m)Tc-(V)DMSA especially in cases with increased cell proliferation), and these radiotracers could provide clinicians with preoperative information not always obtainable by mammography

Intralesional collagenase in the management of Peyronie’s disease: current best practice

The use of Clostridium histolyticum collagenase (CCH) has become increasingly widespread for the treatment of Peyronie’s disease (PD) in recent years. Numerous trials have confirmed both its safety and efficacy in appropriately selected patients with this condition. The purpose of this review is to examine pivotal trials demonstrating the efficacy of CCH, revisit viable candidates for treatment with intralesional injection therapy, and provide a summary of injection technique and appropriate management of patients receiving this treatment at the time of therapy and in follow up

Analiza skladu i stopnia zadymienia spalin na podstawie zuzycia aparatury wtryskowej silnika ciagnika rolniczego

W pracy przedstawiono wyniki badań składu spalin, szczególnie pod kątem emisji toksycznych ich związków, w oparciu o stan techniczny wybranych elementów aparatury wtryskowej silnika ciągnikowego S4002. Analizę spalin wykonano przy użyciu spektrometru masowego.This paper presents the results of studies on the concentration of components in combustion gases and the degree of fumes smokiness at different wearing of precise pairs of injection apparatus of tractor's engine. The studies were carried out in engine test house. Technical state of precise pairs was determined with the hydraulic method, the degree of fumes smokiness with filtration method, and analysis of combustion gases with spectrometric method. The results were presented on graphs as relationships of Co, NOx, CH, CO₂, O₂ , H₂O and the degree of fumes smokiness (Zs) in function of effective engine power (Ne)

Grazing of Merino-Lincoln and Tsigeian-Kentish sheep on an intensively fertilized pasture at different density of animals

В 1979 г. был проведен опыт по использованию пастбища в Лэнжицах около г. Душники расположенного на высоте около 600 м н.у.м., удобряемого 180 кг N, 90 кг Р₂O₅ и 120 кг К₂O на гектар. На этом пастбище стравливали загонной системой мерино линкольские и цигайкентские овцы при средней плотности животных 3,1, 2,3 и 1,6 голов на гектар. Продуктивность пастбища была хорошей, составляя 36-51 т зеленой массы с гектара. Овцы поедали в среднем 8,8-12,7 кг зеленого корма на голову в сутки. Продукция шерсти и привесы тела с единицы и лощади пастбища показывают, что при соответствующем уровне удобрения Судетских пастбищ возможен выпас овец с плотностью 3 головы на гектар в сутки.An experiment on utilization of a pasture at Łężyce near Duszniki at the altitude of about 600 m a.s.l., fertilized with 180 kg N, 90 kg Р₂O₅ and 120 kg K₂O per hectare was carried out in 1979. Merino-Lincoln and Tsigeian-Kentish sheep were grazed rotationally on the pasture at an average density of 3.1, 2.3 and 1.6 animals per hectare a day. A good productivity of the pasture amounting to 36-51 t of green fodder from 1 hectare was obtained.The sheep consumed, on the average, 8.8-12.7 kg of green fodder per head a day. The wool production and the body weight gains from the area unit of the pasture prove that at an appropriate fertilization of the Sudety pastures it would be possible to graze sheep at the density of 3 heads per hectare a day

Data from: Health IT, hacking, and cybersecurity: national trends in data breaches of protected health information

OBJECTIVE: The rapid adoption of health IT coupled with growing reports of ransomware and hacking has made cybersecurity a priority in healthcare. This study leverages federal data in order to better understand current cybersecurity threats in the context of health IT. MATERIALS AND METHODS: Retrospective observational study of all available reported data breaches in the United States from 2013-2017, downloaded from a publicly available federal regulatory database. RESULTS: There were 1512 data breaches affecting 154,415,257 patient records from a heterogeneous distribution of covered entities (p<0.001). There were 128 EMR-related breaches of 4,867,920 patient records, while 363 hacking incidents affected 130,702,378 records. DISCUSSION AND CONCLUSION: Despite making up less than 25% of all breaches, hacking was responsible for nearly 85% of all affected patient records. As medicine becomes increasingly interconnected and informatics-driven, significant improvements to cybersecurity must be made so our health IT infrastructure is simultaneously effective, safe, and secure