Breast cancer: Monitoring response to neoadjuvant chemotherapy using Tc-99m sestamibi scintimammography

Background: Aim of the study was to assess the value of scintimammography using Tc-99m sestamibi in the evaluation of tumor response to neoadjuvant chemotherapy. Material and Methods: Results were calculated for 9 patients undergoing neoadjuvant chemotherapy. Scintimammography using 740 MBq Tc-99m sestamibi was performed before, during and after chemotherapy, and sestamibi uptake was scored visually and semiquantitatively to evaluate tumor response. Results: In the case of complete response (n = 3) sestamibi uptake decreased 8 days after beginning neoadjuvant chemotherapy and normalized in the following course. Focal uptake decreased more slowly in patients with partial response (n = 3), who showed clear, persisting tracer accumulation after therapy. The patients without response (n = 3) showed a persisting high tumor activity even after chemotherapy was completed. Conclusions: The preliminary data suggest that in contrast to other imaging modalities scintimammography appears to yield early information regarding tumor response to neoadjuvant chemotherapy

Assessment of a 3-Dimensional Computerised PASI Tool for calculating and documenting psoriasis area and severity index scores

Psoriasis Area and Severity Index(PASI) scoring was initially developed by Fredriksson and Pettersson in 1978[1], as a method to clinically evaluate and quantitate the amount and severity of psoriasis, and therefore the responses to a new treatment. Despite its advantages, there are numerous limitations such as high intra- and inter-observer variability and reproducibility in assessment of each of the PASI parameters[2], with scores varying two or three fold between scorers[2-5]. This article is protected by copyright. All rights reserved

Preoperative Imaging of Charcot Neuroarthropathy in Diabetic Patients: Comparison of Ring PET, Hybrid PET, and Magnetic Resonance Imaging

Introduction: The treatment of Charcot neuroarthropathy in the feet of diabetic patients has undergone fundamental changes in the last few years. Formerly, treatment was almost exclusively limited to nonoperative measures; since the late 1990s, however, current practice has shifted to early, stage-appropriate surgical therapy. The objective of this prospective study was to investigate the value of two types of positron emission tomography (PET) in the preoperative evaluation of diabetic patients with Charcot foot deformities. Materials and Methods: Ring 18FFDG (2-fluoro-2-deoxy-glucose) and hybrid PET were compared to magnetic resonance imaging (MRI). MRI, ring PET, and hybrid PET imaging were used as part of the preoperative evaluation of 16 patients with type II diabetes mellitus. The diagnosis of Charcot neuropathy of the foot requiring operative treatment had been made on the basis of clinical and radiographic criteria. Results: Of 39 Charcot lesions confirmed at surgery, 37 were detected by ring PET, 30 by hybrid PET, and 31 by MRI. Conclusions: PET (ring or hybrid) can be used in the evaluation of patients with metal implants that would compromise the accuracy of MRI. Another advantage of PET is its ability to distinguish between inflammatory and infectious soft-tissue lesions, and between osteomyelitis and Charcot neuroarthropathy. The differentiation between Charcot neuroarthropathy and florid osteomyelitis provides the surgeon with important additional information that often is unavailable from MRI. Because it provides important additional data, ring PET may be preferable to radiography and MRI in the preoperative evaluation of patients with Charcot neuroarthropathy of the foot. Hybrid PET, because of its poorer resolution compared to ring PET, appears less suitable for routine clinical application

Functional Implications of LH/hCG Receptors in Pregnancy-Induced Cushing Syndrome

Context: Elevated human choriogonadotropin (hCG) may stimulate aberrantly expressed luteinizing hormone (LH)/hCG receptor (LHCGR) in adrenal glands, resulting in pregnancy-induced bilateral macronodular adrenal hyperplasia and transient Cushing syndrome (CS). Objective: To determine the role of LHCGR in transient, pregnancy-induced CS. Design, Setting, Patient, and Intervention: We investigated the functional implications of LHCGRs in a patient presenting, at a tertiary referral center, with repeated pregnancy-induced CS with bilateral adrenal hyperplasia, resolving after parturition. Main Outcome Measures and Results: Acute testing for aberrant hormone receptors was negative except for arginine vasopressin (AVP)–increased cortisol secretion. Long-term hCG stimulation induced hypercortisolism, which was unsuppressed by dexamethasone. Postadrenalectomy histopathology demonstrated steroidogenically active adrenocortical hyperplasia and ectopic cortical cell clusters in the medulla. Quantitative polymerase chain reaction showed upregulated expression of LHCGR, transcription factors GATA4, ZFPM2, and proopiomelanocortin (POMC), AVP receptors (AVPRs) AVPR1A and AVPR2, and downregulated melanocortin 2 receptor (MC2R) vs control adrenals. LHCGR was localized in subcapsular, zona glomerulosa, and hyperplastic cells. Single adrenocorticotropic hormone–positive medullary cells were demonstrated in the zona reticularis. The role of adrenal adrenocorticotropic hormone was considered negligible due to downregulated MC2R. Coexpression of CYP11B1/CYP11B2 and AVPR1A/AVPR2 was observed in ectopic cortical cells in the medulla. hCG stimulation of the patient’s adrenal cell cultures significantly increased cyclic adenosine monophosphate, corticosterone, 11-deoxycortisol, cortisol, and androstenedione production. CTNNB1, PRKAR1A, ARMC5, and PRKACA gene mutational analyses were negative. Conclusion: Nongenetic, transient, somatic mutation-independent, pregnancy-induced CS was due to hCG-stimulated transformation of LHCGR- positive undifferentiated subcapsular cells (presumably adrenocortical progenitors) into LHCGR-positive hyperplastic cortical cells. These cells respond to hCG stimulation with cortisol secretion. Without the ligand, they persist with aberrant LHCGR expression and the ability to respond to the same stimulus

Chemotherapy-Response Monitoring of Breast Cancer Patients Using Quantitative Ultrasound-Based Intra-Tumour Heterogeneities

© 2017 The Author(s). Anti-cancer therapies including chemotherapy aim to induce tumour cell death. Cell death introduces alterations in cell morphology and tissue micro-structures that cause measurable changes in tissue echogenicity. This study investigated the effectiveness of quantitative ultrasound (QUS) parametric imaging to characterize intra-tumour heterogeneity and monitor the pathological response of breast cancer to chemotherapy in a large cohort of patients (n = 100). Results demonstrated that QUS imaging can non-invasively monitor pathological response and outcome of breast cancer patients to chemotherapy early following treatment initiation. Specifically, QUS biomarkers quantifying spatial heterogeneities in size, concentration and spacing of acoustic scatterers could predict treatment responses of patients with cross-validated accuracies of 82 ± 0.7%, 86 ± 0.7% and 85 ± 0.9% and areas under the receiver operating characteristic (ROC) curve of 0.75 ± 0.1, 0.80 ± 0.1 and 0.89 ± 0.1 at 1, 4 and 8 weeks after the start of treatment, respectively. The patients classified as responders and non-responders using QUS biomarkers demonstrated significantly different survivals, in good agreement with clinical and pathological endpoints. The results form a basis for using early predictive information on survival-linked patient response to facilitate adapting standard anti-cancer treatments on an individual patient basis

Das Leben und Leiden der Deutschen im Russischen Reiche, besonders in den Ostseeprovinzen, verfasst und vorgetragen am 8. Febr. 1906 im Auftrage des Hilfsausschusses und am 13. Febr. 1906 im Konservativen Vereine in Cassel

http://www.ester.ee/record=b4011407*es

Anwendungen des Sozialkonstruktivismus. Kritikpotential und psychologische Praxis

Der vorliegenden Arbeit geht es um die Beziehung zwischen Theorie und Praxis des Sozialkonstruktivismus (�Social Constructionism�, vgl. Burr, 2003). Zunächst versuche ich zu zeigen, daß dessen psychologische Erklärungsmöglichkeiten bislang nicht ausgeschöpft worden sind. Wie anhand der Begriffe Handlung, Subjektivität und Identität beispielhaft erläutert wird, leidet er an einer Überbetonung sprachlicher Aspekte menschlichen Handelns zulasten kultureller und sozialer. Ich schlage deshalb eine alternative sozialkonstruktivistische Konzeption vor, die sich erstens, kulturpsychologischen Ansätzen ähnlich, einer inhaltlich-kontextuellen Sichtweise menschlichen Handelns verschreibt, und zweitens im Begriff der Anerkennung ein schlüssiges sozialkonstruktivistisches Motivationskonzept gefunden zu haben meint, welches auch eine gesellschaftstheoretische Anbindung zur Verfügung stellt. Diese Anbindung wiederum ermöglicht es meinem Ansatz, psychologie- und gesellschaftskritische Anliegen besser artikulieren zu können als herkömmliche, etwa postmoderne Herangehensweisen. Ich schlage daher eine Variante �kritischer� Psychologie vor, die über den Anerkennungsbegriff Verbindungen zwischen Individuum und Gesellschaft sichtbar zu machen versucht. Dies ermöglicht gleichzeitig eine alternative Form psychologischer Praxis, die nämlich weder, wie bei der Mainstream-Psychologie zu beobachten, psychosoziale Probleme einseitig in den einzelnen hineinverlegt, noch den Betroffenen unnötigerweise das postmoderne Menschenbild aufzwingt, wie dies die sozialkonstruktivistische Praxis gewöhnlich vornimmt. Diese Zusammenhänge werden vor allem am Beispiel der Psychotherapie verdeutlicht

Was ist Religion? : eine Predigt / in höchster Gegenwart Ihro Hochfürstl. Durchlaucht der Herzoginn Dorothea in der Mitauischen Reformirten Kirche den 22sten April 1787 gehalten und auf Befehl in Druk gegeben von J. N. Tiling

http://tartu.ester.ee/record=b1310912~S1*es

Ankündigung seiner Vorlesungen im Akademischen Gymnasium in Mitau

TÜR-i eksemplari R Est.A-4675(III) (konvoluut) 23. alligaathttp://tartu.ester.ee/record=b1373048~S1*es

Die Kirche zu Bickern bei Riga

http://www.ester.ee/record=b4011354*es