PET probe-guided surgery: applications and clinical protocol

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A review of current and future food applications of natural hydrocolloids

The main aim of this review paper was to focus on current and potential future sources and food applications of natural hydrocolloids in the food industry. The emerging research trends, problems, new methods and alternative approaches in production, environmental concerns, market trends and newly discovered health benefits have been discussed for natural hydrocolloids of commercial relevance. The rheological and surface active properties, interactions, functional properties, films and coatings, encapsulation applications and nanotechnology uses of natural hydrocolloids have been discussed in the light of recent developments. This review also reflected the most up-to-date concepts of applying natural hydrocolloids to meet consumer's and food sector's sophisticated demands related to food products

Applying virtual reality to teach the software development process to novice software engineers

Software development is a complicated process that requires experienced human resources to produce successful software products. Although this process needs experience from the individuals, it is hard to provide this experience without encountering real incidents during the software development process. To fill this gap, this study proposes a Virtual Reality Based Software Development Framework (VR-SODEF), which provides an interactive virtual reality experience for individuals learning about the tasks of software development starting from requirement analysis through software testing. In the VR-SODEF, the participant takes on the role of a novice software developer being recruited into a virtual software development organisation who should work alongside five virtual characters, played by artificial intelligence. This exclusive viewpoint draws participants from the 2D separation of the classical experience and virtually into the world of the software development itself. Participants experience the intense dramatic elements created for simulation and confront the challenges of virtual software practitioners in a somewhat uncompromising virtual simulation environment. To examine the efficiency of the VR-SODEF, it was tested on 32 computing students, with results indicating that virtual reality can be an effective educational medium, especially for skills that might traditionally be acquired through experience rather than traditional classroom-based teaching

Three-dimensional volumetric analysis of the maxillary sinus: a cone-beam computed tomography study

Background: This study aimed to determine the volumetric size of the maxillary sinus and investigate the effect of gender and age on maxillary sinus volume (MSV) using cone-beam computed tomography (CBCT) images in a Turkish subpopulation. Materials and methods: This retrospective volumetric CBCT study was carried out on 133 individuals (84 females, 49 males) between 8 and 51 years old. MSV was measured using the MIMICS 21.0 software (Materialise HQ Technologielaan, Leuven, Belgium). All statistical analyses were performed using the SPSS 21.0 (SPSS, Chicago, IL, USA) software. Mean and standard deviation of both maxillary sinuses measurements were calculated and compared to gender and age. P values < 0.05 were considered to indicate statistical significance. Results: Mean volume of the right maxillary sinus was 13.173 cm3, while for the left was 13.194 cm3. There was no significant difference between right and left maxillary sinus volumes (p > 0.05). There was no significant correlation between MSV and age (p > 0.05). It was found that MSV did not change according to gender (p > 0.05). Conclusions: Right and left maxillary sinus volumes were not different from each other. Gender and age were not found to be related to maxillary sinus volume

Preoperative Y-90 microsphere selective internal radiation treatment for tumor downsizing and future liver remnant recruitment: a novel approach to improving the safety of major hepatic resections

<p>Abstract</p> <p>Background</p> <p>Extended liver resections are being performed more liberally than ever. The extent of resection of liver metastases, however, is restricted by the volume of the future liver remnant (FLR). An intervention that would both accomplish tumor control and induce compensatory hypertrophy, with good patient tolerability, could improve clinical outcomes.</p> <p>Case presentation</p> <p>A 53-year-old woman with a history of cervical cancer presented with a large liver mass. Subsequent biopsy indicated poorly differentiated carcinoma with necrosis suggestive of squamous cell origin. A decision was made to proceed with pre-operative chemotherapy and Y-90 microsphere SIRT with the intent to obtain systemic control over the disease, downsize the hepatic lesion, and improve the FLR. A surgical exploration was performed six months after the first SIRT (three months after the second). There was no extrahepatic disease. The tumor was found to be significantly decreased in size with central and peripheral scarring. The left lobe was satisfactorily hypertrophied. A formal right hepatic lobectomy was performed with macroscopic negative margins.</p> <p>Conclusion</p> <p>Selective internal radiation treatment (SIRT) with yttrium-90 (Y-90) microspheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. We present this case report to suggest that the portal vein radiation dose can be substantially increased with the intent of inducing portal/periportal fibrosis. Such a therapeutic manipulation in lobar Y-90 microsphere treatment could accomplish the end points of PVE with avoidance of the concern regarding tumor progression.</p

Multimodality approach of perioperative 18F-FDG PET/CT imaging, intraoperative 18F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic activity in a case of occult recurrent metastatic melanoma

<p>Abstract</p> <p>Background</p> <p>The use of diagnostic ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) imaging for the staging, restaging, and treatment monitoring of melanoma patients has become a well-recognized standard of care. It plays a key role in detecting sites of occult disease and is widely utilized in the medical and surgical planning of such patients. In the current report, we describe an innovative multimodality approach of perioperative ¹⁸F-FDG PET/CT imaging, intraoperative ¹⁸F-FDG handheld gamma probe detection, and intraoperative ultrasound for tumor localization and verification of resection of all sites of hypermetabolic tumor foci in a case of occult recurrent metastatic melanoma.</p> <p>Case presentation</p> <p>This report discusses a case of occult recurrent metastatic melanoma, isolated to three separate sites within the subcutaneous tissues of the left thigh region, which was not clinically apparent but was found on diagnostic restaging whole body ¹⁸F-FDG PET/CT scan utilizing an intravenous injection of 14.8 mCi ¹⁸F-FDG. Then, on the day of surgery, the patient received an intravenous injection of 12.8 mCi ¹⁸F-FDG. A multimodality approach of intraoperative handheld gamma probe detection, intraoperative ultrasound tumor localization, specimen PET/CT imaging, and postoperative PET/CT imaging was utilized for accomplishing and verifying the excision of all three sites of occult recurrent metastatic melanoma within the left thigh region.</p> <p>Conclusion</p> <p>This innovative multimodality approach of perioperative ¹⁸F-FDG PET/CT imaging, intraoperative ¹⁸F-FDG handheld gamma probe detection, and intraoperative ultrasound is promising combined technology for aiding in tumor localization and verification of excision and may ultimately impact positively upon long-term outcome of selected patients.</p

A migrated sewing needle to the liver.

A 52-year-old woman was investigated for right upper quadrant abdominal pain. Abdominal X-ray revealed a linear metallic object superposed to the liver (Fig. A, arrow). Patient’s history was irrelevant except for a breast biopsy 20 years previously. She did not report any blunt abdominal trauma. Unenhanced abdominal CT was performed for exact localization of the foreign body. A linear metallic opacity was observed in the medial segment of left liver lobe (Fig. B). At laparotomy, a needle was found in the parenchyma over the hilar plate of the liver. Its location was checked by intraoperative fluoroscopy then it was extracted with a clamp through a small incision in the liver parenchyma. High resolution X-ray graph revealed that the foreign body was a sewing needle (Fig. C). At eight months follow up, she is symptom free without any complication

The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral development – a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals.</p> <p>Methods</p> <p>We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms.</p> <p>Results</p> <p>Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (<it>p </it>= 0.001), but less likely to have used statins (<it>p </it>= 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 ± 5.6 vs. 10.4 ± 6.2% respectively, <it>p </it>= 0.214). Nitroglycerin mediated dilation was also similar (13.4 ± 5.9 vs. 12.8 ± 6.5%, <it>p </it>= 0.521).</p> <p>Conclusion</p> <p>No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.</p

Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer

<p>Abstract</p> <p>Background</p> <p>¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) has become an established method for detecting hypermetabolic sites of known and occult disease and is widely used in oncology surgical planning. Intraoperatively, it is often difficult to localize tumors and verify complete resection of tumors that have been previously detected on diagnostic PET/CT at the time of the original evaluation of the cancer patient. Therefore, we propose an innovative approach for intraoperative tumor localization and verification of complete tumor resection utilizing ¹⁸F-FDG for perioperative PET/CT imaging and intraoperative gamma probe detection.</p> <p>Methods</p> <p>Two breast cancer patients were evaluated. ¹⁸F-FDG was administered and PET/CT was acquired immediately prior to surgery. Intraoperatively, tumors were localized and resected with the assistance of a handheld gamma probe. Resected tumors were scanned with specimen PET/CT prior to pathologic processing. Shortly after the surgical procedure, patients were re-imaged with PET/CT utilizing the same preoperatively administered ¹⁸F-FDG dose.</p> <p>Results</p> <p>One patient had primary carcinoma of breast and a metastatic axillary lymph node. The second patient had a solitary metastatic liver lesion. In both cases, preoperative PET/CT verified these findings and demonstrated no additional suspicious hypermetabolic lesions. Furthermore, intraoperative gamma probe detection, specimen PET/CT, and postoperative PET/CT verified complete resection of the hypermetabolic lesions.</p> <p>Conclusion</p> <p>Immediate preoperative and postoperative PET/CT imaging, utilizing the same ¹⁸F-FDG injection dose, is feasible and image quality is acceptable. Such perioperative PET/CT imaging, along with intraoperative gamma probe detection and specimen PET/CT, can be used to verify complete tumor resection. This innovative approach demonstrates promise for assisting the oncologic surgeon in localizing and verifying resection of ¹⁸F-FDG positive tumors and may ultimately positively impact upon long-term patient outcomes.</p