Revisiting the Marrow Metabolic Changes after Chemotherapy in Lymphoma: A Step towards Personalized Care

Purpose. The aims were to correlate individual marrow metabolic changes after chemotherapy with bone marrow biopsy (BMBx) for its potential value of personalized care in lymphoma. Methods. 26 patients (mean age, 58 ± 15 y; 13 female, 13 male) with follicular lymphoma or diffuse large B-cell lymphoma, referred to FDG-PET/CT imaging, who had BMBx from unilateral or bilateral iliac crest(s) before chemotherapy, were studied retrospectively. The maximal standardized uptake value (SUV) was measured from BMBx site over the same area on both initial staging and first available restaging FDG-PET/CT scan. Results. 35 BMBx sites in 26 patients were evaluated. 12 of 35 sites were BMBx positive with interval decrease in SUV in 11 of 12 sites (92%). The remaining 23 of 35 sites were BMBx negative with interval increase in SUV in 21 of 23 sites (91%). The correlation between SUV change over the BMBx site before and after chemotherapy and BMBx result was significant (P < 0.0001). Conclusions. This preliminary result demonstrates a strong correlation between marrow metabolic changes (as determined by FDG PET) after chemotherapy and bone marrow involvement proven by biopsy. This may provide a retrospective means of personalized management of marrow involvement in deciding whether to deliver more extended therapy or closer followup of lymphoma patients

Mediastinal cryptococcosis masquerading as therapy-refractory lymphoma

published_or_final_versionSpringer Open Choice, 21 Feb 201

Efeitos do tratamento com captopril e losartan em ratos Wistar e ratos espontaneamente hipertensos submetidos a hipertensão arterial pulmonar com monocrotalina

A hipertensão arterial pulmonar (HAP) é uma doença que se inicia com o aumento da resistência das arteríolas pulmonares. Após a sua instalação, sucedem-se várias alterações sobre os sistemas cardiovascular, respiratório e autonômico. Apesar dos trabalhos disponíveis na literatura, o desenvolvimento desta doença em modelos experimentais de hipertensão arterial sistêmica permanece ainda por ser estudado, bem como os efeitos terapêuticos de bloqueadores do sistema renina-angiotensina na reversão desta doença. Os objetivos deste estudo foram avaliar os efeitos cardiovasculares, autonômicos e respiratórios promovidos pela HAP induzida pela monocrotalina (MCT) em ratos Wistar e SHR e os efeitos terapêuticos do tratamento crônico com captopril e losartan na reversão da HAP. Para tanto, foram utilizados ratos Wistar (150-180g) e SHR (150-180g), divididos nos seguintes grupos: Wistar controle tratado com salina ou MCT (WIS-CON-SAL e WIS-CON-MCT, respectivamente), SHR controle tratado com salina ou MCT (SHR-CON-SAL e SHR-CON-MCT, respectivamente), Wistar tratados com Captopril + salina ou MCT (WIS-CPT-SAL e WIS-CPT-MCT, respectivamente), SHR tratados com Captopril + salina ou MCT (SHR-CPT-SAL e SHR-MCT-CPT, respectivamente), Wistar tratados com Losartan + salina ou MCT (WIS-LOS-SAL e WIS-LOS-MCT, respectivamente), SHR tratados com Losartan + salina ou MCT (SHR-LOS-SAL e SHR-LOS-MCT, respectivamente). Os animais tratados com MCT receberam uma única injeção subcutânea (60 mg/Kg SC) e os controles receberam o mesmo volume de salina (~0,8 mL). Ao término da 3ª senama, quando os animais MCTs controle apresentaram HAP, foi feito o tratamento com captopril (100 mg/Kg/mL) ou losartan (30 mg/Kg/mL) na água de beber por 2 semanas no volume diário de 30 mL. Após o tratamento com captopril ou losartan, foram realizados os registros cardiovasculares, respiratórios, gasométricos e a histologia pulmonar. Os resultados mostraram um significativo aumento do Índice Pulmonar nos animais controles tratados com MCT (Wistar e SHR) quando comparados com seus respectivos controles. As pressões ventriculares (PSmáx, PDI e PDF) também foram significativamente aumentadas nos grupos MCTs, bem como os valores de pressão arterial sistólica and diastólica, frequência cardíaca, pressão de pulso e labilidade da pressão arterial média. O tratamento com captopril normalizou todos os parâmetros estudados, no entanto, o losartan se mostrou ineficiente em normalizar os parâmetros hemodinâmicos. As análises morfométricas mostraram um espessamento da camada média dos dos ramos distais da artéria pulmonar e uma diminuição do lúmen nos grupos tratados com MCT. O tratamento com captopril e losartan normalizou estes parâmetros, embora o grupo tratado com losartan tenha sido menos eficaz que o captopril, pois os tratamentos mostraram diferenças significativas entre si. Quanto a avaliação autonômica, os animais MCT mostraram aumento do tônus simpático cardíaco e redução do tônus parassimpático cardíaco. Novamente, o tratamento com captopril normalizou estes parâmetros, enquanto que o losartan foi ineficaz em normalizá-los. Quanto aos parâmetros respiratórios, observamos aumentos no volume corrente, na frequência respiratória, na ventilação minuto e na ventilação alveolar dos animais controles tratados com MCT. Apenas o tratamento com captopril normalizou estes parâmetros. A avaliação gasométrica mostrou que os grupos controles tratados com MCT apresentaram redução da pressão parcial de O2 (hipóxia), aumento da pressão parcial de CO2 (hipercapnia), queda da porcentagem de saturação da hemoglobina (% Hb), aumento do bicarbonato (HCO3-) e acidose. O tratamento com captopril normalizou todos os parâmetros gasométricos, enquanto que o mesmo não foi observado com o losartan para os animais SHR submetidos a HAP. Nossos resultados mostraram que a MCT induziu ao quadro de HAP nos animais Wistar e SHR, bem como importantes alterações cardiovasculares, autonômicas, respiratórias, gasométricas e morfológicas pulmonares. Os tratamentos com captopril e losartan foram capazes de reverter a HAP em animais Wistar e SHR, porém, o captopril se mostrou mais eficiente em normalizar esses parâmetros quando comparados ao losartan. Estes resultados sugerem que o uso de bloqueadores do sistema renina angiotensina pode ser uma opção terapêutica para o tratamento da HAP. Palavras chave: hipertensão arterial pulmonar; monocrotalina; SHR; captopril; losartan

Children with Respiratory Disease Associated with Metapneumovirus in Hong Kong

Human metapneumovirus (HMPV) is a newly discovered pathogen thought to be associated with respiratory disease. We report the results of a study of 587 children hospitalized with respiratory infection over a 13-month period. HMPV was detected in the nasopharyngeal aspirates from 32 (5.5%) children by reverse transcription-polymerase chain reaction. HMPV infection was associated with clinical diagnoses of pneumonia (36%), asthma exacerbation (23%), or acute bronchiolitis (10%). When compared to those with respiratory syncytial virus infection, children with HMPV infection were older, and wheezing was more likely to represent asthma exacerbation rather than acute bronchiolitis. HMPV viral activity peaked during the spring-summer period in Hong Kong. Phylogenetically, all HMPV virus strains from Hong Kong belonged to one of the two genetic lineages previously described. HMPV contributed to 441.6 hospital admissions per 100,000 population <6 years of age

Deleted in Liver Cancer 2 (DLC2) Was Dispensable for Development and Its Deficiency Did Not Aggravate Hepatocarcinogenesis

DLC2 (deleted in liver cancer 2), a Rho GTPase-activating protein, was previously shown to be underexpressed in human hepatocellular carcinoma and has tumor suppressor functions in cell culture models. We generated DLC2-deficient mice to investigate the tumor suppressor role of DLC2 in hepatocarcinogenesis and the function of DLC2 in vivo. In this study, we found that, unlike homologous DLC1, which is essential for embryonic development, DLC2 was dispensable for embryonic development and DLC2-deficient mice could survive to adulthood. We also did not observe a higher incidence of liver tumor formation or diethylnitrosamine (DEN)-induced hepatocarcinogenesis in DLC2-deficient mice. However, we observed that DLC2-deficient mice were smaller and had less adipose tissue than the wild type mice. These phenotypes were not due to reduction of cell size or defect in adipogenesis, as observed in the 190B RhoGAP-deficient mouse model. Together, these results suggest that deficiency in DLC2 alone does not enhance hepatocarcinogenesis

Paediatric Brain Tumours

Case-based learning of common paediatric brain tumours with emphasis on clinical presentation, patient management, in particular the role of various imaging modalities, and treatment outcomes.published_or_final_versionhttp://www.hku.hk/diaradio/Paediatric%20Radio/index.ht

Diffusion tensor MR imaging in the evaluation of treatment-induced white matter injury in childhood cancer survivors

published_or_final_versionabstractMedicineMasterDoctor of Medicin

Frequency, location, and association with dental pathology of mucous retention cysts in the maxillary sinus. A radiographic study using cone beam computed tomography (CBCT)

OBJECTIVES The purpose of the present study was to evaluate the frequency, locations, and dimensions of mucous retention cysts of the maxillary sinus and analyze potential associated dental pathology. MATERIALS AND METHODS A total of 156 cone beam computed tomography (CBCT) scans were included in the analysis, resulting in an evaluation of 310 maxillary sinuses. The presence of mucous retention cysts (MRC) manifesting as dome-shaped radiopacities in the sinus was diagnosed. Their locations were recorded, and dimensions (mm) were measured in coronal and sagittal/axial slices. The patients were grouped into (a) patients/sinuses with MRCs (test), and (b) patients/sinuses with healthy or any other changes (control) for further comparison and evaluation. RESULTS There were 40 sinuses (12.9%) with a presence of a total of 56 MRCs. The mean age of involved patients was 29.0 years. The analysis showed that gender, age, sinus side, status of dentition, endodontic status, and periodontal status did not have a significant influence on the presence of MRCs when compared between test and control groups. Age and endodontic status exhibited a significant association with cyst location. CONCLUSIONS Most of the sinuses analyzed (79.5%) did not present any MRC, and only 28.6% of the cysts diagnosed were found on the floor of the maxillary sinus. The mean dimension of the MRCs measured 6.28 ± 2.93 mm. No influencing factors on the presence or absence of MRCs were found in the present study. CLINICAL RELEVANCE Most MRCs were not located on the floor of maxillary sinus. Future studies should assess their impact on surgical interventions in the sinus