Intrapancreatic accessory spleen false positive to 68Ga-Dotatoc: case report and literature review

Background: Intrapancreatic accessory spleen (IPAS) is an uncommon finding of pancreatic mass. Differential diagnosis with pancreatic tumor, especially with non-functional neuroendocrine tumor (NF-NET), may be very hard and sometimes it entails unnecessary surgery. A combination of CT scan, MRI, and nuclear medicine can confirm the diagnosis of IPAS. 68-Ga-Dotatoc PET/CT is the gold standard in NET diagnosis and it can allow to distinguish between IPAS and NET. Case presentation: A 69-year-old man was admitted to our hospital for an incidental nodule in the tail of the pancreas with focal uptake of 68-Ga-dotatate at PET/CT. NET was suspected and open distal splenopancreatectomy was performed. Pathologic examination revealed an IPAS. Conclusion: This is the second IPAS case in which a positive 68Ga-Dotatoc uptake led to a false diagnosis of pancreatic NET. Here is a proposal of a literature review

Use of lead isotopic ratios as geographical tracer for Lambrusco PDO wines

In this study, the lead isotope signature was tested with the aim to verify its potential as geographic tracer for wine production and particularly for the Lambrusco PDO wines of the province of Modena (Italy). A solid phase extraction procedure, for separating lead from the investigated matrices, soil and wine, was optimized. Furthermore, different mathematical models, based on an exponential law and internal or external correction approach, were evaluated for the correction of instrumental mass dependent fractionation. The optimized analytical procedure yielded isotopic ratio data relative to the lead NIST 981 standard, 208Pb/206Pb = 2.16664 and 207Pb/206Pb = 0.914645, in good agreement both with the tabulated values and with the most recent literature data. Measured isotope ratio data highlight the contribute of multiple lead sources in bottled wine but different from the one present in soils

Chemical Characterization Of Commercial Balsamic Vinegar Glaze

The present study reports the chemical characterization of commercial balsamic vinegar glaze (BVG), a side product of the world-famous Aceto Balsamico di Modena (ABM). BVG, originally a homemade sweet and sour sauce, is now produced on an industrial scale and is gaining a growing success. The determination of total titratable acidity, dry matter, ash, metals, sugars, phenolic acids and furfurals is reported for BVG samples of different batches and years of production. Principal component analysis (PCA) and ANOVA test were applied to evaluate the experimental data. The results showed that the chemical characteristics of the product are almost unchanged in the investigated years and well reflect the characteristics of the ABM. Moreover, it was found that potentially harmful species, namely furfural compounds and heavy metals, were at a lower concentration than that of homologous products. In particular, the concentration of heavy metals, such as Cu, Zn and Pb, suggests that a preventive demetallization of the BVG starting raw materials occurs

Fibrinogen-elongated Chain Inhibits Thrombin-induced Platelet Response, Hindering the Interaction with Different Receptors

The expression of the elongated fibrinogen γ chain, termed γ′, derives from alternative splicing of mRNA and causes an insertion sequence of 20 amino acids. This insertion domain interacts with the anion-binding exosite (ABE)-II of thrombin. This study investigated whether and how γ′ chain binding to ABE-II affects thrombin interaction with its platelet receptors, i.e. glycoprotein Ibα (GpIbα), protease-activated receptor (PAR) 1, and PAR4. Both synthetic γ′ peptide and fibrinogen fragment D*, containing the elongated γ′ chain, inhibited thrombin-induced platelet aggregation up to 70%, with IC50 values of 42 ± 3.5 and 0.47 ± 0.03 μm, respectively. Solid-phase binding and spectrofluorimetric assays showed that both fragment D* and the synthetic γ′ peptide specifically bind to thrombin ABE-II and competitively inhibit the thrombin binding to GpIbα with a mean Ki ≈ 0.5 and ≈35 μm, respectively. Both these γ′ chain-containing ligands allosterically inhibited thrombin cleavage of a synthetic PAR1 peptide, of native PAR1 molecules on intact platelets, and of the synthetic chromogenic peptide d-Phe-pipecolyl-Arg-p-nitroanilide. PAR4 cleavage was unaffected. In summary, fibrinogen γ′ chain binds with high affinity to thrombin and inhibits with combined mechanisms the platelet response to thrombin. Thus, its variations in vivo may affect the hemostatic balance in arterial circulation

Irreversible Electroporation for Liver Metastases from Colorectal Cancer: A Systematic Review

Background: Irreversible electroporation (IRE) is a non-thermal form of ablation based on the delivery of pulsed electrical fields. It has been used to treat liver lesions, particularly those in proximity to major hepatic vasculature. The role of this technique in the portfolio of treatments for colorectal hepatic metastases has not been clearly defined. This study undertakes a systematic review of IRE for treatment of colorectal hepatic metastases.Methods: The study protocol was registered with the PROSPERO register of systematic reviews (CRD42022332866) and reports in compliance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The Ovid MEDLINE\uae, EMBASE, Web of Science and Cochrane databases were queried in April 2022. The search terms \u27irreversible electroporation\u27, \u27colon cancer\u27, \u27rectum cancer\u27 and \u27liver metastases\u27 were used in combinations. Studies were included if they provided information on the use of IRE for patients with colorectal hepatic metastases and reported procedure and disease-specific outcomes. The searches returned 647 unique articles and the exclusions left a total of eight articles. These were assessed for bias using the methodological index for nonrandomized studies (MINORS criteria) and reported using the synthesis without meta-analysis guideline (SWiM).Results: One hundred eighty patients underwent treatment for liver metastases from colorectal cancer. The median transverse diameter of tumours treated by IRE was <3 cm. Ninety-four (52%) tumours were adjacent to major hepatic inflow/outflow structures or the vena cava. IRE was undertaken under general anaesthesia with cardiac cycle synchronisation and with the use of either CT or ultrasound for lesion localisation. Probe spacing was less than 3.2 cm for all ablations. There were two (1.1%) procedure-related deaths in 180 patients. There was one (0.5%) post-operative haemorrhage requiring laparotomy, one (0.5%) bile leak, five (2.8%) post-procedure biliary strictures and a zero incidence of post-IRE liver failure.Conclusions: This systematic review shows that IRE for colorectal liver metastases can be accomplished with low procedure-related morbidity and mortality. Further prospective study is required to assess the role of IRE in the portfolio of treatments for patients with liver metastases from colorectal cancer

Phase transition in the collisionless regime for wave-particle interaction

Gibbs statistical mechanics is derived for the Hamiltonian system coupling self-consistently a wave to N particles. This identifies Landau damping with a regime where a second order phase transition occurs. For nonequilibrium initial data with warm particles, a critical initial wave intensity is found: above it, thermodynamics predicts a finite wave amplitude in the limit of infinite N; below it, the equilibrium amplitude vanishes. Simulations support these predictions providing new insight on the long-time nonlinear fate of the wave due to Landau damping in plasmas.Comment: 12 pages (RevTeX), 2 figures (PostScript

Therapeutic decision-making for patients with fluctuating mitral regurgitation

Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in MR and systolic pulmonary artery pressure during exercise. Identifying patients who have dynamic MR, and understanding the mechanisms underlying the condition, can potentially influence revascularization strategies (such as the surgical restoration of coronary blood flow) and interventional treatment (including cardiac resynchronization therapy and new approaches targeted to the mitral valve)

Impact of contractile reserve on acute response to cardiac resynchronization therapy

Background: Cardiac resynchronization therapy (CRT) provides benefit for congestive heart failure, but still 30% of patients failed to respond to such therapy. This lack of response may be due to the presence of significant amount of scar or fibrotic tissue at myocardial level. This study sought to investigate the potential impact of myocardial contractile reserve as assessed during exercise echocardiography on acute response following CRT implantation. Methods: Fifty-one consecutive patients with heart failure (LV ejection fraction 27% ± 5%, 67% ischemic cardiomyopathy) underwent exercise Doppler echocardiography before CRT implantation to assess global contractile reserve (improvement in LV ejection fraction) and local contractile reserve in the region of the LV pacing lead (assessed by radial strain using speckle tracking analysis). Responders were defined by an increase in stroke volume ≥15% after CRT. Results: Compared with nonresponders, responders (25 patients) showed a greater exercise-induced increase in LV ejection fraction, a higher degree of mitral regurgitation and a significant extent of LV dyssynchrony. The presence of contractile reserve was directly related to the acute increase in stroke volume (r = 0.48, p<0.001). Baseline myocardial deformation as well as contractile reserve in the LV pacing lead region was greater in responders during exercise than in nonresponders (p<0.0001). Conclusions: Heart failure patients referred to CRT have less chance of improving under therapy if they have no significant mitral regurgitation, no LV dyssynchrony and no contractile myocardial recruitment at exercise