Duodenal tumors on cross-sectional imaging with emphasis on multidetector computed tomography: a pictorial review

Duodenal tumours are uncommon, but they can cause significant morbidity and mortality. As stomach and colon are a more common site of gastrointestinal malignancies, radiologists sometimes neglect the duodenum. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) can accurately locate and characterize mass-forming duodenal lesions, making them invaluable for the differential diagnosis and determining management strategies such as biopsy or surgery. Although conventional endoscopy continues to play an important role in the diagnosis of duodenal tumors, MDCT and MRI are very useful for evaluating the duodenal wall, extraduodenal space, and surrounding viscera, as well as the intraluminal content seen on endoscopy. This pictorial review aims to illustrate the most common benign and malignant mass-forming duodenal lesions and to focus on the imaging features that are most helpful in reaching the correct diagnosis

Sentinel lymph node biopsy in prostate cancer patients: results from an injection technique targeting the index lesion in the prostate gland

Objectives: to determine the accuracy of nodal staging in patients with prostate cancer (PCa) when 99 m Tc-nanocolloid radiotracer is injected into an index lesion (IL). Methods: this prospective study was conducted at our institution between June 2016 and October 2020. It included 64 patients with localized PCa with at least a 5% possibility for lymph node involvement in the Memorial Sloan Kettering Cancer Center nomogram, suitable for surgical treatment. All patients underwent magnetic resonance imaging (MRI) with IL and were pathologically confirmed. The day before surgery, transrectal ultrasound-guided injection (TRUS) of 99 m Tc-nanocolloid into the IL was performed. Surgical procedures included radical prostatectomy (RP), sentinel lymph node biopsy (SLNB), and extended pelvic lymphadenectomy (ePLND). Analysis was performed, including histopathological findings of RP, ePLND, and SLNB. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), false negative (FN), false positive (FP), diagnostic yield, and non-diagnostic rate were calculated. Results: a total of 1,316 lymph nodes were excised, including 1,102 from the ePLND (83.7%) and 214 (16.3%) sentinel lymph nodes (SLN). 26 SLN were dissected outside the ePLND template. The final pathology demonstrated 46 (3.5%) lymph node metastasis, 31 (67.4%) in the SLNB and 15 (32.6%) in the non-SLN ePLND. At the patient level, 18 (28.1%) patients had pN1. With a mean follow-up of 33.1 months, 4/19 (21.1%) pN1 patients had undetectable PSA, and 3/19 (15.8%) had a PSA < 0.1 ng/mL. Lymph node dissection included 20.6 lymph nodes per patient (IQR 15-24.2), with 3.3 SLNB nodes per patient (IQR 2-4.2). PPV and NPV were 100 and 97.8%, respectively. Sensitivity and specificity were 94.4 and 100%, respectively. FN was 5.5% and FP was 4.3%. Diagnostic yields were 95.3% and the non-diagnostic rate was 4.7%. Conclusion: radiotracer injection into the prostate IL offers promising results for staging purposes in cases in which ePLND is considered. Negative SLNB is a predictor of negative ePLND. Patients with a limited burden of nodal metastasis have a significant chance of remaining free of biochemical recurrence at mid-term follow-up

A 12-gene expression signature is associated with aggressive histological in prostate cancer: SEC14L1 and TCEB1 genes are potential markers of progression. American journal of pathology

The main challenge for clinical management of prostate cancer is to distinguish tumors that will progress faster and will show a higher tendency to recur from the more indolent ones. We have compared expression profiles of 18 prostate cancer samples (seven with a Gleason score of 6, eight with a Gleason score of 7, and three with a Gleason score of ≥8) and five nonneoplastic prostate samples, using the Affymetrix Human Array GeneChip Exon 1.0 ST. Microarray analysis revealed 99 genes showing statistically significant differences among tumors with Gleason scores of 6, 7, and ≥8. In addition, mRNA expression of 29 selected genes was analyzed by real-time quantitative RT-PCR with microfluidic cards in an extended series of 30 prostate tumors. Of the 29 genes, 18 (62%) were independently confirmed in the extended series by quantitative RT-PCR: 14 were up-regulated and 4 were down-regulated in tumors with a higher Gleason score. Twelve of these genes were differentially expressed in tumors with a Gleason score of 6 to 7 versus ≥8. Finally, IHC validation of the protein levels of two genes from the 12-gene signature (SEC14L1 and TCEB1) showed strong protein expression levels of both genes, which were statistically associated with a high combined Gleason score, advanced stage, and prostate-specific antigen progression. This set of genes may contribute to a better understanding of the molecular basis of prostate cancer. TCEB1 and SELC14L1 are good candidate markers for predicting prognosis and progression of prostate cancer

Effect of Insulin on ACE2 Activity and Kidney Function in the Non-Obese Diabetic Mouse - Figure 2

<p><b>A. Representative micrographs of periodic acid–Schiff (PAS)-stained kidney sections.</b> Upper panel: Diabetic, Diabetic-INS early stage of diabetes and Control mice. B: Lower panel: Diabetic, Diabetic-INS late stage of diabetes and Control mice. <b>B. Podocyte number in Diabetic, Diabetic-INS, and Control mice.</b> Representative photomicrograph depicting glomerular WT-1 staining in glomeruli from Diabetic, Diabetic-INS mice at late stage of diabetes and Control mice. Original magnification X400. <b>C. Ultrastructural studies in non-treated non-obese diabetic mice, Diabetic-insulin treated mice and Controls.</b> Upper panel: Diabetic, Diabetic-INS early stage of diabetes and Control mice. Lower panel: Diabetic, Diabetic-INS late stage of diabetes and Control mice. Glomeruli from late stage NOD Diabetic mice (lower middle panel) showed increased mesangial expansion due to increased mesangial matrix increase (see asterisks) as compared with Control mice. Insulin administration prevented mesangial expansion in NOD Diabetic mice. Original magnification, X4600.</p

Blood pressure and kidney function parameters in non-treated non-obese diabetic mice (Diabetic), NOD-insulin treated mice (Diabetic+INS) and non-obese resistant non-diabetic mice (Control).

<p>A: At the end of the early stage study, systolic and diastolic blood pressure measured by tail-cuff method in Diabetic, Diabetic+INS and Control mice. B: Urinary albumin/creatinine ratio of Diabetic, Diabetic+INS and Control mice at both study stages. C: Glomerular filtration rate measured by inulin in Diabetic, Diabetic+INS and Control mice studied at early stage of diabetes. *<i>P≤0.05.</i></p