A new detector concept based on the prompt gamma radiation analysis for In vivo boron monitoring in BNCT

The problem of boron concentration monitoring during the boron neutron capture therapy (BNCT) therapy is one of the main challenges of this type of radiotherapy and is directly related to the nature of the interaction of neutrons with mater. Among the available in vivo methods of boron monitoring positron emission tomography seems to be very promising but it requires a new boron carrier with a β+ emitter, which is not yet clinically available. An alternative solution may be the prompt gamma radiation analysis (PGRA) based on the secondary radiation emitted in the interaction of neutrons with the patient’s tissues. This method requires, however, compact gamma radiation detection systems sustaining high counting rates and characterized by very good energy resolution. In this contribution, we present state-of-the-art solutions for monitoring in BNCT based on PGRA. Moreover, we describe a new concept of such a system based on position-sensitive scintillator detectors equipped with an anti-Compton shield and data analysis supported with modern artificial intelligence algorithms

Terapia wewnątrzmaciczna w nieimmunologicznym obrzęku płodu (NIHF) – analiza 38 przypadków

Objective: The aim of the study was to perform an audit the results of fetal therapy in cases of nonimmune hydrops fetalis (NIHF), isolated hydrothorax and isolated ascites. Methods: A total of 38 fetuses (17-35 weeks of pregnancy) were included in the study, whereas 6 patients were excluded due to abnormal karyotype. NIHF was diagnosed in 24 cases, hydrothorax in 4 cases, and ascites in 4 cases. Shunts were implanted in 26 (81%) cases and 7 (19%) participants underwent therapeutic cordocentesis. Results: After therapy anterior-posterior diameter of the right and the left lung increased to 9.6 mm (27%) and 12.4 mm (35%), respectively. Early complications were observed in 5 (16%) cases: PROM 2 (40%), fetal death 1 (20%), infection 1 (20%), and preterm delivery 1 (20%). Out of the 27 patients, 65% had a caesarian section without early complications and 35% had a vaginal delivery, with 58% at term and 42% pre-term. Conclusions: Preceding results show that intrauterine therapy significantly improves prognisis of fetuses with NIHF.Cel pracy: Analiza wyników terapii płodów z nieimmunologicznym obrzękiem, izolowanym hydrothorax oraz izolowanym wodobrzuszem. Materiał i metody: Analizę przeprowadzono na 38 przypadkach ciąż ( od 17 do 35 hbd). U 6 pacjentek z cechami NIHF u płodów nie podjęto terapii wewnątrzmacicznej ze względu na nieprawidłowy kariotyp płodu. NIHF zdiagnozowano w 24 przypadkach, hydrothorax w 4 przypadkach oraz wodobrzusze w 4 przypadkach podjętych obserwacji ciąż. W 26 przypadkach (81%) przeprowadzono implantację shuntu. W 7 przypadkach (19%) przeprowadzono terapeutyczną kordocentezę. Wyniki: Po terapii wymiar podstawno-szczytowy płuca prawego zwiększył się średnio o 9,6 mm (27%), płuca lewego o 12,4 mm (35%). Powikłania wczesne wystąpiły w 5 przypadkach (16%): w 2 przypadkach PROM, w 1 przypadku - wewnątrzmaciczna śmierć płodu, 1- infekcja,1- poród przedwczesny. 65% z 27 pacjentek bez wczesnych powikłań urodziło drogą cięcia cesarskiego, 35% siłami natury. 58% pacjentek urodziło o czasie, 42% przed terminem porodu. Wnioski: Terapia wewnątrzmaciczna znacznie zwiększa szansę przeżycia płodów ze zdiagnozowanym wewnątrzmacicznie NIHF, izolowanym hydrothoraxem bądź izolowanym wodobrzuszem

Treatment of twin to twin transfusion syndrome – comparison of two therapeutic methods – amnioreduction and lasertherapy

Background: Twin to twin transfusion syndrome occurs in 15% of monochorionic twin pregnancies. Untreated, TTTS has been reported to have a mortality of nearly 100%. Two main therapies include serial amnioreduction and fetoscopic laser coagulation for the vascular anastomoses. Objectives: The aim of the project was to investigate the optimal diagnostic and therapeutic procedure in pregnancies complicated by TTTS. Additionally, the study was supposed to compare non – invasive and invasive methods of treatment and to show antenatal and postnatal follow – up to 4 months of age. Methods: 42 pregnant women with twin-to-twin transfusion syndrome were assigned to laser therapy using diode laser and 33 pregnant women underwent only several amnioreductions. Selected parameters characterizing the pregnancy were compared in both groups. Results: In the amnioreduction group, the perinatal survival rate seven days after the delivery was 31.8%. The survival rate of at least one twin was 39.4%. As compared to the amnioreduction group, in the laser group the survival rate of at least one twin was observed in 31 cases (31/42) and it was equal to 74%. Neurological complications in the amninoreduction group were obsereved in 19% (4/21) of cases, in the laser group and in 5% (2/40) of neonates at 4 months of age. Conclusions: Currently, the preferred and only method that addresses the cause of the disease is the endoscopic laser coagulation of anastomoses. Comparison of the two treatments shows better outcomes with higher survival rates and minor neurological defects in cases treated with laser coagulation

Association of low ficolin-2 concentration in cord serum with respiratory distress syndrome in preterm newborns

IntroductionFicolin-2 is a serum pattern recognition molecule, involved in complement activation via the lectin pathway. This study aimed to investigate the association of ficolin-2 concentration in cord blood serum with complications related to premature birth.Methods546 premature neonates were included. The concentration of ficolin-2 in cord blood serum was determined by a sandwich TRIFMA method. FCN2 genetic variants were analysed with RFLP-PCR, allele-specific PCR, Sanger sequencing or allelic discrimination using TaqMan probes method.FindingsCord blood serum ficolin-2 concentration correlated positively with Apgar score and inversely with the length of hospitalisation and stay at Neonatal Intensive Care Unit (NICU). Multivariate logistic regression analysis indicated that low ficolin-2 increased the possibility of respiratory distress syndrome (RDS) diagnosis [OR=2.05, 95% CI (1.24-3.37), p=0.005]. Median ficolin-2 concentration was significantly lower in neonates with RDS than in premature babies without this complication, irrespective of FCN2 gene polymorphisms localised to promoter and 3’untranslated regions: for patients born <33 GA: 1471 ng/ml vs. 2115 ng/ml (p=0.0003), and for patients born ≥33 GA 1610 ng/ml vs. 2081 ng/ml (p=0.012). Ficolin-2 level was also significantly lower in neonates requiring intubation in the delivery room (1461 ng/ml vs. 1938 ng/ml, p=0.023) and inversely correlated weakly with the duration of respiratory support (R=-0.154, p<0.001). Interestingly, in the neonates born at GA <33, ficolin-2 concentration permitted differentiation of those with/without RDS [AUC=0.712, 95% CI (0.612-0.817), p<0.001] and effective separation of babies with mild RDS from those with moderate/severe form of the disease [AUC=0.807, 95% CI (0.644-0.97), p=0.0002].ConclusionLow cord serum ficolin-2 concentration (especially in neonates born at GA <33 weeks) is associated with a higher risk of developing moderate/severe RDS, requiring respiratory support and intensive care

Zalecenia Polskiej Grupy Mięsakowej w odniesieniu do postępowania diagnostyczno-terapeutycznego oraz kontroli u chorych na neurofibromatozę typu 1 (NF1) oraz związanego z nią złośliwego nowotworu osłonek nerwów obwodowych

Type 1 neurofibromatosis (NF1 syndrome in von Recklinghausen’s disease) is inherited as an autosomal dominant disease, caused by mutations in the NF1 gene encoding the neurofibromin protein. NF1 patients are at an increased risk of the develop­ment of a malignant neoplasm and their life span is shorter by 20 years than that of the general population. National Institute of Health (NIH) criteria make a diagnosis possible from about 4 years of age. Examination of children and adults should encom­pass a physical and a subjective component, but also next-generation sequencing (NGS) genetic analysis, histopathological examination of skin lesions, neurological, ophthalmological and radiological examination. If a malignant peripheral nerve sheath tumor (MNPST) is diagnosed in a patient with NF1, the therapeutic procedure should not differ from the general principles of treating soft tissue sarcomas. Patients from the high risk group should be monitored at least once a year, the remaining patients once every 2–3 years by a specialized medical team, and every year by their primary physicians, internal medicine specialists and dermatologists. Patients should have access to genetic counselling.Neurofibromatoza typu 1 (zespół NF1 w chorobie Recklinghausena, nerwiakowłókniakowatość typu 1), jest dziedziczona au­tosomalnie dominująco, a odpowiadają za nią mutacje genu NF1 kodującego białko neurofibrominy. Pacjenci z NF1 są naraże­ni na zwiększone ryzyko rozwoju nowotworu złośliwego i żyją około 20 lat krócej niż populacja ogólna. Kryteria National Insti­tute of Health (NIH) umożliwiają postawienie diagnozy już około 4 roku życia. Badanie dzieci i dorosłych powinno objąć bada­nie przedmiotowe i podmiotowe, ale też badanie genetyczne techniką sekwencjonowania nowej generacji (NGS), badanie histopatologiczne zmian skóry, badanie neurologiczne, okulistyczne i radiologiczne. W przypadku postawienia roz­poznania złośliwego nowotworu osłonek nerwów obwodowych (malignant peripheral nerve sheath tumor – MPNST) u chorego na NF1 postępowanie terapeutyczne nie powinno odbiegać od ogólnych zasad leczenia mięsaków tkanek miękkich. Pacjenci z grupy wysokiego ryzyka powinni być monitorowani przynajmniej raz w roku, pozostali – raz na 2–3 lata – przez zespół lekarzy specjalistów, a co roku przez lekarzy podstawowej opieki zdrowotnej (POZ), chorób wewnętrznych i dermatologów. Pacjentom należy zapewnić poradnictwo genetyczne

DNA damage and repair in endometrial cancer in correlation with the hOGG1 and RAD51 genes polymorphism

The cellular reaction to the DNA-damaging agents may modulate individual’s cancer susceptibility. This reaction is mainly determined by the efficacy of DNA repair, which in turn, may be influenced by the variability of DNA repair genes, expressed by their polymorphism. The hOGG1 gene encodes a glycosylase of base excision repair and RAD51 specifies a key protein in homologues recombination repair. Both proteins can be involved in the repair of DNA lesions, which are known to contribute to endometrial cancer. In the present work we determined the extent of basal DNA damage and the efficacy of removal of DNA damage induced by hydrogen peroxide and N-methyl-N′-nitro N-nitrosoguanidyne (MNNG) in peripheral blood lymphocytes of 30 endometrial cancer patients and 30 individuals without cancer. The results from DNA damage and repair study were correlated with the genotypes of two common polymorphisms of the hOGG1 and RAD51 genes: a G>C transversion at 1245 position of the hOGG1 gene producing a Ser → Cys substitution at the codon 326 (the Ser326Cys polymorphism) and a G>C substitution at 135 position of the RAD51 gene (the 135G>C polymorphism). DNA damage and repair were evaluated by alkaline single cell gel electrophoresis and genotypes were determined by restriction fragment length polymorphism PCR. We observed a strong association between endometrial cancer and the C/C genotype of the 135G>C polymorphism of the RAD51 gene. Moreover, there was a strong correlation between that genotype and endometrial cancer occurrence in subjects with a high level of basal DNA damage. We did not observe any correlation between the Ser326Cys polymorphism of the hOGG1 gene and endometrial cancer. Our result suggest that the 135G>C polymorphism of the RAD51 gene may be linked to endometrial cancer and can be considered as an additional marker of this disease

New classification system of endometrial hyperplasia WHO 2014 and its clinical implications

Endometrial hyperplasia (EH) is a pathological condition characterised by hyperplastic changes in endometrial glandular and stromal structures lining the uterine cavity. Endometrial hyperplasia, particularly with atypia, is a significant clinical concern because it can be a precursor of endometrial cancer. Accurate diagnosis of precancerous lesions of the endometrium and exclusion of coexisting endometrial carcinomas are absolutely required for the optimal management of patients. The classification of endometrial hyperplasia has had numerous terminology. According to the classification of WHO94, based on glandular complexity and nuclear atypia, EH is divided into four groups: non-atypical endometrial hyperplasia (simple, complex) and atypical endometrial hyperplasia (simple, complex). Estimated risk of progression of atypical hyperplasia to endometrial cancer is 8-29%. The American College of Obstetricians and Gynaecologists and the Society of Gynaecological Oncology states that endometrial intraepithelial neoplasia (EIN) classification is superior to the World Health Organisation (WHO 94) classification for histology of endometrial hyperplasia. However, the WHO classification system remains the most commonly used and reported in existing literature. The new classification, WHO 2014, accepted by the International Society of Gynaecological Pathologists, divided hyperplasia into two groups: benign hyperplasia and atypical hyperplasia/endometrial intraepithelial neoplasia (EIN). The WHO 2014 schema is more likely to successfully identify precancerous lesions than the WHO94 classification

Nowe aspekty leczenia osteoporozy pomenopauzalnej

Menopauza i zmniejszenie stężenia estrogenów są najczęstszymi przyczynami osteoporozy u kobiet. Skutkiemtych zmian jest szybkie zmniejszanie się gęstości mineralnej kości (bone mineral density – BMD) i wzrostryzyka złamań. W leczeniu osteoporozy pomenopauzalnej wykorzystywane są leki o działaniu antyresorpcyjnym,takie jak estrogeny, bisfosfoniany, selektywne modulatory receptora estrogenowego (selective estrogen receptormodulators – SERM), kalcytonina. U starszych kobiet korzystnie jest zastosowanie leków pobudzającychkościotworzenie: sole strontu i parathormon (PTH). W artykule omówiono nowe strategie leczenie osteoporozyoparte na badaniach genetycznych i biologii molekularnej. Przedstawiono korzyści, jakie można osiągnąć, stosującwyżej wymienione leki. Omówiono też dostępne w Polsce leki i wskazania do ich stosowania na różnychetapach rozwoju osteoporozy

Application of Gas Sensor Arrays in Assessment of Wastewater Purification Effects

A gas sensor array consisting of eight metal oxide semiconductor (MOS) type gas sensors was evaluated for its ability for assessment of the selected wastewater parameters. Municipal wastewater was collected in a wastewater treatment plant (WWTP) in a primary sedimentation tank and was treated in a laboratory-scale sequential batch reactor (SBR). A comparison of the gas sensor array (electronic nose) response to the standard physical-chemical parameters of treated wastewater was performed. To analyze the measurement results, artificial neural networks were used. E-nose—gas sensors array and artificial neural networks proved to be a suitable method for the monitoring of treated wastewater quality. Neural networks used for data validation showed high correlation between the electronic nose readouts and: (I) chemical oxygen demand (COD) (r = 0.988); (II) total suspended solids (TSS) (r = 0.938); (III) turbidity (r = 0.940); (IV) pH (r = 0.554); (V) nitrogen compounds: N-NO3 (r = 0.958), N-NO2 (r = 0.869) and N-NH3 (r = 0.978); (VI) and volatile organic compounds (VOC) (r = 0.987). Good correlation of the abovementioned parameters are observed under stable treatment conditions in a laboratory batch reactor