Selective intraarterial radionuclide therapy with Yttrium-90 (Y-90) microspheres for unresectable primary and metastatic liver tumors

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to evaluate the success of selective intraarterial radionuclide therapy (SIRT) with Yttrium-90 (Y-90) microspheres in liver metastases of different tumors. We also interpreted the contribution of SIRT to survival times according to responder- non responder and hepatic- extra hepatic disease.</p> <p>Methods</p> <p>The clinical and follow-up data of 124 patients who were referred to our department for SIRT between June 2006 and October 2010 were evaluated retrospectively. SIRT has been applied to 78 patients who were suitable for treatment. All the patients had primary liver tumor or unresectable liver metastasis of different malignancies. The treatment was repeated at least one more time in 5 patients to the same or other lobes. Metabolic treatment response evaluated by fluorine-18 fluorodeoxyglucose (F18-FDG) positron emission tomography/computed tomography (PET/CT) in the 6^thweek after treatment. F18-FDG PET/CT was repeated in per six weeks periods. The response criterion had been described as at least 20% decrease of SUV value. Also in patients with neuroendocrine tumor serial Gallium-68 (Ga-68) PET/CT was used for evaluation of response. Patients were divided into 2 groups according to their treatment response.</p> <p>Results</p> <p>68 patients received treatment for the right lobe, seven patients received treatment for the left lobe and 3 patients for both lobes. The mean treatment dose was estimated at 1.62 GBq. In the evaluation of treatment response; 43(55%) patients were responder (R) and 35 (45%) patients were non-responder (NR) in the sixth week F18-FDG PET/CT. Mean pretreatment SUVmax value of R group was 11.6 and NR group was 10.7. While only 11 (31%) out of 35 NR patients had H disease, 30 (69%) out of 43 R patients had H disease (p < 0.05). The mean overall survival time of R group was calculated as 25.63 ± 1.52 months and NR group's 20.45 ± 2.11 (p = 0.04). The mean overall survival time of H group was computed as 25.66 ± 1.52 months and EH group's 20.76 ± 1.97 (p = 0.09).</p> <p>Conclusions</p> <p>SIRT is a useful treatment method which can contribute to the lengthening of survival times in patients with primary or metastatic unresectable liver malignancies. Also F18-FDG PET/CT is seen to be a successful imaging method in evaluating treatment response for predicting survival times in this patient group.</p

Ga-68 DOTATATE Accumulation in Sarcoidosis

We aimed in this case series to show Ga-68 DOTATATE uptake in relation with disease activity in sarcoidosis cases. 8 patients with previous diagnosis of sarcoidosis were included to the study. Ga-68 DOTATATE PET/CT was performed to evaluate of disease activity. Disease activity was described clinically by chest disease specialist by evaluation of lung function tests, serum ACE measurements and thorax CT. Correlation between Ga-68 DOTATATE uptake and disease activity was analyzed. Ga-68 DOTATATE PET/CT as a combination of SSR scintigraphy and anatomical imaging might be beneficial in the evaluation of active sarcoidosis

Impact of 18F-FDG PET/CT for Detecting Primary Tumor Focus in Patients with Histopathologically Proven Metastasis

Purpose: To describe the impact of fluorine (18F) - fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in detecting primary tumor focus in our patient population who had histopathologically proven metastasis.Methods: 37 patients who underwent 18F-FDG PET/CT to detect primary tumor focus in our department were included in the study. The results of PET/CT and clinical follow-up data were reviewed retrospectively. PET/CT results were compared with histological analysis and/or clinical follow-up data.Results: Primary site of malignancy was correctly identified by PET/CT in 16 patients (16/37, 43%). Lung was the most common detected site (7/16). The mean SUV of metastatic tumor was higher than that of primary tumor. False positive and false negative results were obtained in 2 patients, respectively. In the remaining patients (17/37; 46%) the primary tumor was not localized by PET/CT. According to these results, the sensitivity and specificity of PET/CT were calculated as 89% and 90%, respectively. However, PET/CT scan determined additional metastatic focus and therapy management was changed (9/37, 24%). The primary focus was established in 4 of 8 (50%) patients with metastatic cervical adenopathy and in 12 of 29 (41%) patients with extra cervical metastases.Conclusions: 18F-FDG PET/CT can detect the primary tumor focus in about half of all patients with histopathologically proven metastases. In the remaining patients, it may contribute to therapy management by identifying additional foci

Silver Nanoparticle-Coated Polyhydroxyalkanoate Based Electrospun Fibers for Wound Dressing Applications

Wound dressings are high performance and high value products which can improve the regeneration of damaged skin. In these products, bioresorption and biocompatibility play a key role. The aim of this study is to provide progress in this area via nanofabrication and antimicrobial natural materials. Polyhydroxyalkanoates (PHAs) are a bio-based family of polymers that possess high biocompatibility and skin regenerative properties. In this study, a blend of poly(3-hydroxybutyrate) (P(3HB)) and poly(3-hydroxyoctanoate-co-3-hydroxy decanoate) (P(3HO-co-3HD)) was electrospun into P(3HB))/P(3HO-co-3HD) nanofibers to obtain materials with a high surface area and good handling performance. The nanofibers were then modified with silver nanoparticles (AgNPs) via the dip-coating method. The silver-containing nanofiber meshes showed good cytocompatibility and interesting immunomodulatory properties in vitro, together with the capability of stimulating the human beta defensin 2 and cytokeratin expression in human keratinocytes (HaCaT cells), which makes them promising materials for wound dressing applications

Beyond the heterodimer model for mineralocorticoid and glucocorticoid receptor interactions in nuclei and at DNA.

Glucocorticoid (GR) and mineralocorticoid receptors (MR) are believed to classically bind DNA as homodimers or MR-GR heterodimers to influence gene regulation in response to pulsatile basal or stress-evoked glucocorticoid secretion. Pulsed corticosterone presentation reveals MR and GR co-occupy DNA only at the peaks of glucocorticoid oscillations, allowing interaction. GR DNA occupancy was pulsatile, while MR DNA occupancy was prolonged through the inter-pulse interval. In mouse mammary 3617 cells MR-GR interacted in the nucleus and at a chromatin-associated DNA binding site. Interactions occurred irrespective of ligand type and receptors formed complexes of higher order than heterodimers. We also detected MR-GR interactions ex-vivo in rat hippocampus. An expanded range of MR-GR interactions predicts structural allostery allowing a variety of transcriptional outcomes and is applicable to the multiple tissue types that co-express both receptors in the same cells whether activated by the same or different hormones

Composite structural motifs of binding sites for delineating biological functions of proteins

Most biological processes are described as a series of interactions between proteins and other molecules, and interactions are in turn described in terms of atomic structures. To annotate protein functions as sets of interaction states at atomic resolution, and thereby to better understand the relation between protein interactions and biological functions, we conducted exhaustive all-against-all atomic structure comparisons of all known binding sites for ligands including small molecules, proteins and nucleic acids, and identified recurring elementary motifs. By integrating the elementary motifs associated with each subunit, we defined composite motifs which represent context-dependent combinations of elementary motifs. It is demonstrated that function similarity can be better inferred from composite motif similarity compared to the similarity of protein sequences or of individual binding sites. By integrating the composite motifs associated with each protein function, we define meta-composite motifs each of which is regarded as a time-independent diagrammatic representation of a biological process. It is shown that meta-composite motifs provide richer annotations of biological processes than sequence clusters. The present results serve as a basis for bridging atomic structures to higher-order biological phenomena by classification and integration of binding site structures.Comment: 34 pages, 7 figure

Carbamazepine overdose after exposure to simethicone: a case report

<p>Abstract</p> <p>Introduction</p> <p>Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine.</p> <p>Case presentation</p> <p>We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.</p> <p>Conclusion</p> <p>Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.</p

Fatal encephalitis associated with novel influenza A (H1N1) virus infection in a child

A 4-year-old girl presented with fever, coughing, and vomiting; followed by unconsciousness. Magnetic resonance imaging showed hyperintense changes in the thalami bilaterally, brain stem, cerebellum, and subcortical cortex. Novel influenza A (H1N1) virus was identified by polymerase chain reaction in patient’s nasopharyngeal swab specimen. We reported a rare case of clinically severe, novel influenza A-associated encephalitis. Novel influenza A should be considered in the differential diagnosis in patients with seizures and mental status changes, especially during an influenza outbreak

The Role of 18F-Flourodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in Pelvic and Paraaortic Lymph Node Staging of Uterine Cervical Cancer

 Abstract: Aim: We aimed to evaluate the sensitivity of 18F-Flourodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pelvic and paraaortic lymph node metastases of uterine cervical cancer.Material and Method: 32 female patients (mean age: 56.1±12.6) who underwent 18F-FDG PET/CT for preoperative staging of uterine cervical cancer between April 2009 and October 2013 were included to the study. Ethical committee approval was taken from Ankara University Medical Faculty Ethics Committee. All the patients had been performed trans-vaginal examination and diagnosed as uterine cervical cancer before 18F-FDG PET/CT. 18F-FDG PET/CT findings were compared with histopathological examination results. Sensitivity, specificity and accuracy of pelvic MRI and 18F-FDG PET/CT were calculated in the detection of pelvic and paraaortic lymph node metastases.Results: 18F-FDG uptake was seen in primary cervical lesions of all the patients. Mean SUV max of primary cervical lesions was calculated as 13.6±6.6 (range: 6.7-25). In 16 (50%) patients, 18F-FDG uptake was not seen in pelvic and paraaortic lymph nodes. In the remaining patients, 18F-FDG uptake was detected in pelvic nodes in all the patients (50%) and in paraaortic nodes in 6 (18%) patients. Mean SUV max of pelvic lymph nodes were calculated as 8.4±5.2 and of paraaortic lymph nodes 12.45±6.41. 18F-FDG uptake was detected in a total of 47 lymph node stations in 16 patients. Mean SUVmax of all lymph nodes were calculated as 8.9±5.83 (range: 2.6-21.9). According to 18F-FDG PET/CT findings, disease was upstaged from I to IV in 1 (3%) patient, II to III in 2 (6%) patients, III to IV in 1 (3%) patients and I to III in 2 (6%) patients, and down staged from III to I in 1 (3%) patient, respectively. In the patient-based analysis, 18F-FDG PET/CT was TP, TN, FP and FN in 14 (%44), 14 (44%), 2 (6%) and 2 (6%) patients, respectively. Patients based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 87%, 87% and 87%, respectively. In the lesion-based analysis, 18F-FDG PET/CT was TP, FP, TN and FN in 30, 7, 37 and 5 lymph node stations, respectively. Lesion based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 85%, 84% and 84%, respectively.Conclusion: 18F-FDG PET/CT is a reliable imaging tool with its high sensitivity and specificity in the pelvic and paraaortic lymph node staging of uterine cervical cancer. When performed in the preoperative staging it changes disease stage about in ¼ of patients. In combination of pelvic MRI, primary staging of primary cervical lesions and also pelvic/paraaortic lymph nodes can be done successfully

The Role of 18F-Flourodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in Pelvic and Paraaortic Lymph Node Staging of Uterine Cervical Cancer

Aim: We aimed to evaluate the sensitivity of 18F-Flourodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the detection of pelvic and paraaortic lymph node metastases of uterine cervical cancer.  Material and Method: 32 female patients (mean age: 56.1±12.6) who underwent 18F-FDG PET/CT for preoperative staging of uterine cervical cancer between April 2009 and October 2013 were included to the study. Ethical committee approval was taken from Ankara University Medical Faculty Ethics Committee. All the patients had been performed trans-vaginal examination and diagnosed as uterine cervical cancer before 18F-FDG PET/CT. 18F-FDG PET/CT findings were compared with histopathological examination results. Sensitivity, specificity and accuracy of pelvic MRI and 18F-FDG PET/CT were calculated in the detection of pelvic and paraaortic lymph node metastases.  Results: 18F-FDG uptake was seen in primary cervical lesions of all the patients. Mean SUV max of primary cervical lesions was calculated as 13.6±6.6 (range: 6.7-25). In 16 (50%) patients, 18F-FDG uptake was not seen in pelvic and paraaortic lymph nodes. In the remaining patients, 18F-FDG uptake was detected in pelvic nodes in all the patients (50%) and in paraaortic nodes in 6 (18%) patients. Mean SUV max of pelvic lymph nodes were calculated as 8.4±5.2 and of paraaortic lymph nodes 12.45±6.41. 18F-FDG uptake was detected in a total of 47 lymph node stations in 16 patients. Mean SUVmax of all lymph nodes were calculated as 8.9±5.83 (range: 2.6-21.9). According to 18F-FDG PET/CT findings, disease was upstaged from I to IV in 1 (3%) patient, II to III in 2 (6%) patients, III to IV in 1 (3%) patients and I to III in 2 (6%) patients, and down staged from III to I in 1 (3%) patient, respectively. In the patient-based analysis, 18F-FDG PET/CT was TP, TN, FP and FN in 14 (%44), 14 (44%), 2 (6%) and 2 (6%) patients, respectively. Patients based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 87%, 87% and 87%, respectively. In the lesion-based analysis, 18F-FDG PET/CT was TP, FP, TN and FN in 30, 7, 37 and 5 lymph node stations, respectively. Lesion based sensitivity; specificity and accuracy of 18F-FDG PET/CT were calculated as 85%, 84% and 84%, respectively.  Conclusion: 18F-FDG PET/CT is a reliable imaging tool with its high sensitivity and specificity in the pelvic and paraaortic lymph node staging of uterine cervical cancer. When performed in the preoperative staging it changes disease stage about in ¼ of patients. In combination of pelvic MRI, primary staging of primary cervical lesions and also pelvic/paraaortic lymph nodes can be done successfully