The role of PET/CT with fluorine-18-deoxyglucose in the detection of relapsed serous ovarian cancer in patients with normal serum CA125 levels

Objectives: To assess the role of the positron emission tomography with fluorine-18-deoxyglucose (PET/CT) in the detection of recurrent serous ovarian cancer in patients with normal serum CA125 level. Material and methods: Thirty-one patients with suspected recurrent serous ovarian cancer with normal (< 35 IU/mL) serum CA125 level and no prior recurrence underwent PET/CT imaging. The results of the PET/CT were analyzed considering clinical data of the patients, histological diagnosis and 6 months follow-up. Results: The patients were referred to the PET/CT due to suspected relapse in imaging tests (CT — 11 cases, US — 3 cases, MRI — 2 cases; n = 16; 51.6%), clinical examination (n = 4; 12.9%) and clinical symptoms (n = 11; 35.5%). The recurrent serous ovarian cancer was present in 16 patients (51.6%). In 9 these cases (56.3%) the recurrences were diagnosed in patients aged 51–70 years. In 15 cases (93.8%) the recurrences were diagnosed within 24 months after treatment. There were 15 true positive (48.4%), 12 true negative (38.7%), 3 false positive (9.7%) and 1 false negative (3.2%) PET/CT results. Sensitivity, specificity, positive and negative predictive value of the PET/CT were calculated as 93.8% (95% CI, 86.1–97.4%), 80.0% (95% CI, 69.7–88.9%), 83.3% (95% CI, 74.3–90.4%) and 92.3% (95% CI, 84.2–98.3%), respectively. Conclusions: In patients with a diagnosis of complete remission after treatment for serous ovarian cancer, even a multifocal recurrence may occur during follow up despite normal serum CA125 levels. Our results showed a usefulness of the PET/CT in detecting and differentiating malignant from benign lesions in patients with normal serum CA125 levels but inconclusive results in other imaging tests. We observed false results of the PET/CT for lesions in parotid gland, mesorectal adipose tissue and mediastinal lymph nodes

The value of [18F]FDG PET/CT examination in the detection and differentiation of recurrent ovarian cancer

Background: The exact role of positron emission tomography with fluorine-18-deoxyglucose ([18F]FDG PET/CT) in an early diagnosis of relapsed ovarian cancer is not clearly defined. The aim of the study was to assess the value of [18F]FDG PET/CT in the detection and differentiation of recurrent ovarian cancer. Material and methods: Eighty-four patients with suspected recurrent ovarian cancer underwent [18F]FDG PET/CT examination. Results of PET/CT were analyzed taking into account clinical data of the patients, histological diagnosis, and 6-month follow-up. Results: The [18F]FDG PET/CT examinations showed abnormal findings in 67 patients (79.76%). There were 63 true positive results (75.00%), 14 true negative (16.67%), 4 false positive (4.76%), and 3 false negative (3.57%) results. Sensitivity, specificity, positive and negative predictive values of [18F]FDG PET/CT were 95%, 78%, 94%, and 82%, respectively. In patients with elevated serum Ca 125 concentration (n = 43), sensitivity and specificity of [18F]FDG PET/CT was 95.00% and 66.67%, respectively. Recurrence was confirmed in 22 (88.00%) of 25 patients referred for [18F]FDG PET/CT due to suspected relapse in imaging tests. Conclusions: A high frequency of recurrent ovarian cancer detected in the [18F]FDG PET/CT examinations due to increased Ca 125 concentration in patients without clinical symptoms and without changes in other imaging tests confirmed the usefulness of [18F]FDG PET/CT in such cases. In patients with suspected recurrent ovarian cancer implied in radiological findings, [18F]FDG PET/CT results in most cases differed from the original results of imaging examination. Our results showed high accuracy of [18F]FDG PET/CT in the evaluation of recurrent ovarian cancer and presented this diagnostic method as a useful tool in detecting and differentiating suspected lesions in this group of patients

PSD-95 in CA1 area regulates spatial choice depending on age

Cognitive processes that require spatial information rely on synaptic plasticity in the dorsal CA1 area (dCA1) of the hippocampus. Since the function of the hippocampus is impaired in aged individuals, it remains unknown how aged animals make spatial choices. Here, we used IntelliCage to study behavioural processes that support spatial choices of aged female mice living in a group. As a proxy of training-induced synaptic plasticity, we analysed the morphology of dendritic spines and expression of a synaptic scaffold protein, PSD-95. We observed that spatial choice training in young adult mice induced correlated shrinkage of dendritic spines and downregulation of PSD-95 in dCA1. Moreover, long-term depletion of PSD-95 by shRNA in dCA1 limited correct choices to a reward corner, while reward preference was intact. In contrast, old mice used behavioural strategies characterised by an increased tendency for perseverative visits and social interactions. This strategy resulted in a robust preference for the reward corner during the spatial choice task. Moreover, training decreased the correlation between PSD-95 expression and the size of dendritic spines. Furthermore, PSD-95 depletion did not impair place choice or reward preference in old mice. Thus, our data indicate that while young mice require PSD-95-dependent synaptic plasticity in dCA1 to make correct spatial choices, old animals observe cage-mates and stick to a preferred corner to seek the reward. This strategy is resistant to the depletion of PSD-95 in the CA1 area. Overall, our study demonstrates that aged mice combine alternative behavioral and molecular strategies to approach and consume rewards in a complex environment

Estrogen receptor β Potential functional significance of a variety of mRNA isoforms

AbstractRecent cloning of estrogen receptor β (ERβ) was followed by the discovery of a variety of its isoforms. This review describes the complexity of ERβ mRNAs in various species for which most data have been gathered so far. The most surprising finding is the great variation in isoform structure among various mammalian species. This may reflect either the fact that only a very limited number of isoforms have been described so far or between-species specificity, especially as common elements in closely related species could still be noted. Isoform variations, as detected mainly at the mRNA sequence level, should result in profound functional differences at the level of proteins as already shown in selected cases. Thus, it is proposed that the diversity of ERβ isoforms implies a functional role of this phenomenon in cellular physiology and pathology of estrogen response

Food, Mechanic and Septic Complications in Patients Enterally Nutritioned in Home Conditions

Home enteral nutrition (HEN for short) allows practically normal living for patients who cannot be fed orally but at the same time do not have to stay in hospitals, which is often found to decrease their mental condition, increase of probability of complications and costs of medical treatment. The aim of the study was to analyze the frequency of nutritional, mechanical and septic complications in patients fed enterally in home conditions. Material and methods. The study performed using retrospective analysis of study results and reports from control visits for patients in the period between 2012-2013. 147 patients fed enterally using HEN method participated in the study, including 70 men and 77 women aged 19 to 99 years (average 65 years). The following type of gastrointestinal tract access was used for patients: PEG in 113 (76.5%), feeding jejunostomy - 21 (1.4%), PEG-PEJ - 5 (3.5%), in case of the remaining 8 patients the nasogastric gavage (5.5%) was used. Results. The most common complication were infections (of gastric tract, skin soft tissue in the region of nutritional fistula entry, in three cases the aspiration pneumonia was diagnosed) found in 55 (49.1%) of cases. Mechanical complications were found out in 29 (25.9% of all complications), nutritional complications were present 28 times, which constituted 25% of all complications. Conclusions. In the studied group of patients with an implemented HEN procedure, septic complications were the most common problem. The longest average nutrition time with PEG-PEJ probably results from the effective protection of the patient against aspiration pneumonia