Expiratory flow rate, breath hold and anatomic dead space influence electronic nose ability to detect lung cancer

BACKGROUND: Electronic noses are composites of nanosensor arrays. Numerous studies showed their potential to detect lung cancer from breath samples by analysing exhaled volatile compound pattern ("breathprint"). Expiratory flow rate, breath hold and inclusion of anatomic dead space may influence the exhaled levels of some volatile compounds; however it has not been fully addressed how these factors affect electronic nose data. Therefore, the aim of the study was to investigate these effects. METHODS: 37 healthy subjects (44 +/- 14 years) and 27 patients with lung cancer (60 +/- 10 years) participated in the study. After deep inhalation through a volatile organic compound filter, subjects exhaled at two different flow rates (50 ml/sec and 75 ml/sec) into Teflon-coated bags. The effect of breath hold was analysed after 10 seconds of deep inhalation. We also studied the effect of anatomic dead space by excluding this fraction and comparing alveolar air to mixed (alveolar + anatomic dead space) air samples. Exhaled air samples were processed with Cyranose 320 electronic nose. RESULTS: Expiratory flow rate, breath hold and the inclusion of anatomic dead space significantly altered "breathprints" in healthy individuals (p 0.05). These factors also influenced the discrimination ability of the electronic nose to detect lung cancer significantly. CONCLUSIONS: We have shown that expiratory flow, breath hold and dead space influence exhaled volatile compound pattern assessed with electronic nose. These findings suggest critical methodological recommendations to standardise sample collections for electronic nose measurements

Endoscopic sphincterotomy for delaying choLecystectomy in mild acute biliarY pancreatitis (EMILY study): Protocol of a multicentre randomised clinical trial

Introduction: According to the literature, early cholecystectomy is necessary to avoid complications related to gallstones after an initial episode of acute biliary pancreatitis (ABP). A randomised, controlled multicentre trial (the PONCHO trial) revealed that in the case of gallstone-induced pancreatitis, early cholecystectomy was safe in patients with mild gallstone pancreatitis and reduced the risk of recurrent gallstone-related complications, as compared with interval cholecystectomy. We hypothesise that carrying out a sphincterotomy (ES) allows us to delay cholecystectomy, thus making it logistically easier to perform and potentially increasing the efficacy and safety of the procedure. Methods/Design: EMILY is a prospective, randomised, controlled multicentre trial. All patients with mild ABP, who underwent ES during the index admission or in the medical history will be informed to take part in EMILY study. The patients will be randomised into two groups: (1) early cholecystectomy (within 6 days after discharge) and (2) patients with delayed (interval) cholecystectomy (between 45 and 60 days after discharge). During a 12-month period, 93 patients will be enrolled from participating clinics. The primary endpoint is a composite endpoint of mortality and recurrent acute biliary events (that is, recurrent ABP, acute cholecystitis, uncomplicated biliary colic and cholangitis). The secondary endpoints are organ failure, biliary leakage, technical difficulty of the cholecystectomy, surgical and other complications

Current Updates in Bleomycin-Based Electrochemotherapy for Deep-Seated Soft-Tissue Tumors

Electrochemotherapy (ECT) has evolved significantly during the last decade, expanding treatment indications from superficial skin lesions to advanced-stage, deep-seated tumors in hard-to-reach areas. Electrodes have also shown steady technological improvement throughout the years. Besides standard and VEG (variable geometry electrode) electrodes, the introduction of laparoscopic electrodes has brought on a new era in ECT treatment, making the minimally invasive approach a reality. The exact role of ECT in the oncological dashboard is yet to be determined; however, increased tumor response, pain relief, and a low number of adverse events may yield the way for more widespread application of the technique with possible further inclusion of ECT in international oncological guidelines. The aim of this review is to give an overview on the current status of ECT in deep-seated tumor treatment and shed light on its emerging role in local anticancer therapy

Nanodisperse gold catalysts in oxidation of benzyl alcohol: comparison of various supports under different conditions

Monodisperse gold particles (ca. 2 nm) were prepared and deposited on various supports (SiO2, Al2O3, HAP, MgAl2O4 and MgO). The acid/base properties of supports were characterized by NH3 and CO2 sorption. The size of the gold nanoparticles spans in the 1.7-6.5 nm mean diameter range after calcination as determined from TEM measurements. The amounts of accessible surface sites were estimated by binary concentration pulse chromatography of CO with Kr adsorption. The data are in agreement with the results of CO adsorption obtained by DRIFT spectroscopy. The activities of the catalysts were compared in the oxidation of benzyl alcohol in stirred batch reactors under two different conditions: in xylene solvent with atmospheric oxygen at 60 degrees C (in presence and in absence of K2CO3), and in a solvent-free mixture at elevated pressure and temperature (5 bar O-2, 150 degrees C, 5 h). The activities of catalysts in benzyl alcohol conversion are described in two variants, namely related to (i) active catalytic sites (ASNA), and (ii) number of Au atoms on the geometric surface of particles (GSNA). The activities of catalysts in xylene solvent at 60 degrees C were excellent, with 0.28-1.11 s(-1) characteristic GSNA(ini) values (initial reaction rates related to surface Au atoms, Au-surf) in presence of K2CO3. The observed order of activities under these conditions is Au/SiO2 < Au/Al2O3 < Au/HAP < Au/MgAl2O4 < Au/MgO. In the experiments performed at 150 degrees C under solvent-free conditions, the reaction partners are depleted in greater extents (with the exception of Au/Al2O3), thus the obtained average GSNA(ave) (average reaction rate during 5 h reaction related to Au-surf) values are less reliable, however selectivity data provide useful information as well. These estimated average GSNA(ave) values (0.14-0.83 s(-1)) attest still good activities. For the interpretation of the obtained data, the roles of active sites on gold nanoparticles of various dispersion and the accessibility of their surfaces as well as the acid-base properties and surface hydroxyl concentration of supports, water ad- and desorption phenomena are considered simultaneously

Evening and morning exhaled volatile compound patterns are different in obstructive sleep apnoea assessed with electronic nose

PURPOSE: Electronic noses represent a technique for the measurement of exhaled breath volatile compound pattern which can discriminate patients with obstructive sleep apnoea (OSA) from control subjects. Although overnight changes in circulating biomarkers were reported, this effect on the exhaled volatile compound pattern has not been studied before. We aimed to compare breath patterns in the evening and in the morning in patients with OSA and to study the ability of the electronic nose to distinguish patients from controls based on these exhaled volatile patterns. METHODS: Exhaled breath volatile compound pattern was measured before and after night in 26 patients with suspected sleep-disordered breathing (53 +/- 15 years) who underwent polysomnography and in ten control subjects (37 +/- 15 years), by whom sleep-disordered breathing was excluded with a home apnoea screening device. Breath measurements were also performed in the morning in 26 healthy, non-smoking age-matched controls (48 +/- 10 years) with no complaints about disturbed sleep. Exhaled volatile compound pattern was processed with a Cyranose 320 electronic nose, and principal component analysis was used for statistical analysis. RESULTS: Exhaled volatile compound patterns recorded in the evening and in the morning were different in patients with OSA (p = 0.01) but not in non-OSA habitual snorers (p = 0.49) or in control subjects (p = 0.23). The electronic nose distinguished patients with OSA from control subjects based on the breath samples collected in the morning (p 0.05). CONCLUSIONS: Evening and morning exhaled volatile compound patterns are different in OSA. This might affect the ability of electronic noses to identify this disorder. Overnight alterations in volatile substances need to be taken into account during exhaled breath measurements in OSA

Release of TGFβig-h3 by gastric myofibroblasts slows tumor growth and is decreased with cancer progression

Tumor progression has been linked to changes in the stromal environment. Myofibroblasts are stromal cells that are often increased in tumors but their contribution to cancer progression is not well understood. Here, we show that the secretomes of myofibroblasts derived from gastric cancers [cancer-associated myofibroblasts (CAMs)] differ in a functionally significant manner from those derived from adjacent tissue [adjacent tissue myofibroblasts (ATMs)]. CAMs showed increased rates of migration and proliferation compared with ATMs or normal tissue myofibroblasts (NTMs). Moreover, conditioned medium (CM) from CAMs significantly stimulated migration, invasion and proliferation of gastric cancer cells compared with CM from ATMs or NTMs. Proteomic analysis of myofibroblast secretomes revealed decreased abundance of the extracellular matrix (ECM) adaptor protein like transforming growth factor-β-induced gene-h3 (TGFβig-h3) in CAMs, which was correlated with lymph node involvement and shorter survival. TGFβig-h3 inhibited IGF-II-stimulated migration and proliferation of both cancer cells and myofibroblasts, and suppressed IGF-II activation of p42/44 MAPkinase; TGFβig-h3 knockdown increased IGF-II- and CM-stimulated migration. Furthermore, administration of TGFβig-h3 inhibited myofibroblast-stimulated growth of gastric cancer xenografts. We conclude that stromal cells exert inhibitory as well as stimulatory effects on tumor cells; TGFβig-h3 is a stromal inhibitory factor that is decreased with progression of gastric cancers

Exhaled Breath Condensate pH in Lung Cancer, the Impact of Clinical Factors

PURPOSE: Lung cancer may be associated with airway acidification due to enhanced airway inflammation and oxidative stress. Exhaled breath condensate (EBC) pH is a non-invasive indicator of airway acidity; however, it is still unclear how EBC pH changes in lung cancer. The aim of the study was to investigate EBC pH in lung cancer together with clinical variables. METHODS: Thirty-five patients with lung cancer and 37 control subjects (21 patients with stable COPD and 16 non-COPD smokers) were enrolled. EBC was collected for pH, which was determined with the argon-purging method, compared among the groups and correlated with clinical variables of patients with lung cancer. RESULTS: No difference was found in EBC pH between patients with lung cancer and control subjects. However, endobronchial tumour localisation, squamous-cell carcinoma subtype and gastro-oesophageal reflux were associated with low EBC pH values. No relationship was observed between EBC pH and the presence of COPD, lung function variables or smoking history. CONCLUSIONS: Although, EBC pH is unchanged in lung cancer, lower EBC pH values are associated with distinct phenotypes. Our findings could facilitate further research on airway acidity in lung cancer