Background 18F-FDG uptake in positron emission mammography (PEM): Correlation with mammographic density and background parenchymal enhancement in breast MRI

AbstractWe aimed to determine whether background 18F-FDG uptake in positron emission mammography (PEM) was related to mammographic density or background parenchymal enhancement in breast MRI.MethodsWe studied a total of 52 patients (mean age, 50.9 years, 26 premenopausal, 26 postmenopausal) with newly diagnosed breast cancer who underwent 18F-FDG PEM (positron emission mammography), conventional mammography and breast MRI. The background mean 18F-FDG uptake value on PEM was obtained by drawing a user-defined region of interest (ROI) in a normal area of the contralateral breast. We reviewed the mammography retrospectively for overall breast density of contralateral breast according to the four-point scale (grade 1–4) of the Breast Imaging Reporting and Data System (BI-RADS) classification. The background parenchymal enhancement of breast MRI was classified as minimal, mild, moderate, or marked. All imaging findings were interpreted by two readers in consensus without knowledge of image findings of other modalities.ResultsMultiple linear regression analysis revealed a significant correlation between background 18F-FDG uptake on PEM and mammographic density after adjustment for age and menopausal status (P<0.01), but not between background 18F-FDG uptake on PEM and background parenchymal enhancement on MRI.ConclusionBackground 18F-FDG uptake on PEM significantly increases as mammographic density increases. Background parenchymal enhancement in breast MRI was not an independent predictor of the background 18F-FDG uptake on PEM unlike mammographic density

Status and trends in epidemiologic characteristics of diabetic end-stage renal disease: an analysis of the 2021 Korean Renal Data System

This article provides an update of the trends and characteristics of diabetic kidney disease stage 5D (CKD 5D) patients according to the Korean Renal Data System (KORDS), a nationwide registry database operated by the Korean Society of Nephrology. The KORDS Committee analyzed epidemiologic characteristics of diabetic CKD 5D patients using data from 2001 to 2021 in KORDS. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than non-diabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than non-diabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than non-diabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of non-diabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients

An HR-MAS MR Metabolomics Study on Breast Tissues Obtained with Core Needle Biopsy

BACKGROUND: Much research has been devoted to the development of new breast cancer diagnostic measures, including those involving high-resolution magic angle spinning (HR-MAS) magnetic resonance (MR) spectroscopic techniques. Previous HR-MAS MR results have been obtained from post-surgery samples, which limits their direct clinical applicability. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, we performed HR-MAS MR spectroscopic studies on 31 breast tissue samples (13 cancer and 18 non-cancer) obtained by percutaneous core needle biopsy. We showed that cancer and non-cancer samples can be discriminated very well with Orthogonal Projections to Latent Structure-Discriminant Analysis (OPLS-DA) multivariate model on the MR spectra. A subsequent blind test showed 69% sensitivity and 94% specificity in the prediction of the cancer status. A spectral analysis showed that in cancer cells, taurine- and choline-containing compounds are elevated. Our approach, additionally, could predict the progesterone receptor statuses of the cancer patients. CONCLUSIONS/SIGNIFICANCE: HR-MAS MR metabolomics on intact breast tissues obtained by core needle biopsy may have a potential to be used as a complement to the current diagnostic and prognostic measures for breast cancers

Surgical Outcomes and Efficacy of Isthmusectomy in Single Isthmic Papillary Thyroid Carcinoma: A Preliminary Retrospective Study

Background and Objectives The optimal extent of surgery needed for isthmic papillary thyroid carcinoma (PTC) is not well-defined, although total thyroidectomy is usually recommended. This study aimed to evaluate the efficacy of isthmusectomy in the surgical treatment of isthmic PTC. Materials and Methods: We retrospectively studied 121 patients who underwent thyroidectomy with or without central neck dissection (CND) for single isthmic PTC from January 2003 to June 2019. We excluded patients who were clinically suspected to have clinically positive cervical lymph node metastasis and gross extrathyroidal extension or to have cancers at sites other than the thyroid isthmus. Patients were divided into three groups according to the extent of thyroidectomy—total thyroidectomy, lobectomy with isthmusectomy (the lobectomy group), and isthmusectomy. Clinical and pathologic characteristics, surgical outcomes, recurrence rate, and survival were analyzed. Results: Of 121 isthmic PTC patients, 28 were men and 93 were women. Total thyroidectomy, lobectomy with isthmusectomy, and isthmusectomy were performed in 70 (57.8%), 40 (33.1%), and 11 (9.1%) patients, respectively. Prophylactic CND was performed in 104 (86%) patients. In a subgroup analysis, patients who underwent total thyroidectomy showed higher postoperative hypoparathyroidism (p < 0.001) than those who underwent lobectomy and isthmusectomy. However, there were no differences in the recurrence rate or survival between the three groups. Conclusion: Thyroid isthmusectomy may be effective in the surgical treatment of small single isthmic PTC. Further studies are necessary to verify this result

Screening of Phosphodiesterase-5 Inhibitors and Their Analogs in Dietary Supplements by Liquid Chromatography–Hybrid Ion Trap–Time of Flight Mass Spectrometry

An accurate and reliable method based on ion trap&ndash;time of flight mass spectrometry (IT&ndash;TOF MS) was developed for screening phosphodiesterase-5 inhibitors, including sildenafil, vardenafil, and tadalafil, and their analogs in dietary supplements. Various parameters affecting liquid chromatographic separation and IT&ndash;TOF detection were investigated, and the optimal conditions were determined. The separation was achieved on a reversed-phase column under gradient elution using acetonitrile and water containing 0.2% acetic acid at a flow rate of 0.2 mL/min. The chromatographic eluents were directly ionized in the IT&ndash;TOF system equipped with an electrospray ion source operating in the positive ion mode. The proposed screening method was validated by assessing its linearity, precision, and accuracy. Sequential tandem MS was conducted to obtain structural information of the references, and the fragmentation mechanism of each reference was proposed for providing spectral insight for newly synthesized analogs. Structural information, including accurate masses of both parent and fragment ions, was incorporated into the MSn spectral library. The developed method was successfully applied for screening adulterated dietary supplement samples

Discrimination based on prognostic markers: PR and lymph node metastases.

<p>OPLS-DA score plots based on the statuses of progesterone receptor (A) and lymph node metastasis (B). All of the models were obtained using one predictive and two orthogonal components. Two samples were excluded based on the PCA analysis for (B). Filled box: positive samples, Open circle: negative samples.</p