Treatment of a mixed acinar-endocrine carcinoma with uptake on 68Gallium-DOTATOC positron emission tomography-computed tomography : a case report

The case of a 35-year old female patient with a diagnosis of metastatic mixed acinar-endocrine carcinoma (MAEC) is investigated in the present study. The patient was believed to have a well-differentiated neuroendocrine tumor (NET) with a high Ki-67 index and uptake on (68)Gallium-DOTATOC positron emission tomography-computed tomography for 9 years, and was treated accordingly. The patient had long lasting disease control by treatment with sunitinib, and a response was observed in numerous lesions with peptide receptor radionuclide therapy (PRRT). Following treatment for metastatic disease for >4 years, liver transplantation was performed, as an exception to normal recommendations, at the time of progression of a centrally located liver lesion inducing obstructive jaundice. Following transplantation, the diagnosis of a Grade 3 NET, as defined by the WHO 2010 classification, was challenged and changed to MAEC. MAEC is a rare type of tumor of the pancreas, exhibiting endocrine and acinar differentiation. It is difficult to diagnose, often being misidentified as acinar cell carcinoma or predominantly as neuroendocrine neoplasms. Immunohistochemical labelling provides the only evidence for the dual differentiation of neuroendocrine (synaptophysin and chromogranin) and acinar (lipase, trypsin and chymotrypsin) cell markers. Studies investigating MAECs with a clear histopathological diagnosis are scarce, in addition to evidence of disease behaviour and treatment options. It is generally agreed that surgery is the primary treatment in patients with resectable tumors. The responses to sunitinib and PRRT suggested that treatments considered or developed for NETs may be beneficial in MAEC cases

Size effect on strength and fracture energy for numerical concrete with realistic aggregate shapes

Fracture of concrete at the scale of the aggregate structure (or smaller) is a complicated process. Simple simulation models may be of help in understanding fracture in more detail, provided that the material structure is incorporated in as much detail as possible. A combined approach using computed tomography and image processing allows us to model concrete close to reality. The shape of the aggregates is included in a 3D beam lattice model for fracture. Fracture of concrete beams is simulated under 3-point bending with different sizes, aggregate densities and aggregates shapes, focusing on the size effect on structural strength and fracture energ

Atomistic modeling of zeolitic materials

A review with 166 refs. on modeling the structure and properties of the bare zeolitic framework. The topics include modeling methods and interat. potential developmen

A genuine four-partite entangled state

In a recent paper, a genuine four-partite entangled state is proposed [Y. Yeo and W. K. Chua, Phys. Rev. Lett. 96, 060502 (2006)], which has been found to have many interesting entanglement properties. We show this state is locally equivalent to some graph states.Comment: submitte

Rectilinear Link Diameter and Radius in a Rectilinear Polygonal Domain

We study the computation of the diameter and radius under the rectilinear link distance within a rectilinear polygonal domain of $n$ vertices and $h$ holes. We introduce a \emph{graph of oriented distances} to encode the distance between pairs of points of the domain. This helps us transform the problem so that we can search through the candidates more efficiently. Our algorithm computes both the diameter and the radius in $\min \{\,O(n^\omega), O(n^2 + nh \log h + \chi^2)\,\}$ time, where $\omega<2.373$ denotes the matrix multiplication exponent and $\chi\in \Omega(n)\cap O(n^2)$ is the number of edges of the graph of oriented distances. We also provide a faster algorithm for computing the diameter that runs in $O(n^2 \log n)$ time

Automated radiosynthesis of Al[18F]PSMA-11 for large scale routine use.

Objectives: We report a reproducible automated radiosynthesis for large scale batch production of clinical grade Al[F-18]PSMA-11. Methods: A SynthraFCHOL module was optimized to synthesize Al[F-18]PSMA-11 by Al[F-18]-chelation. Results Al[F-18]PSMA-11 was synthesized within 35 min in a yield of 21 +/- 3% (24.0 +/- 6.0 GBq) and a radiochemical purity > 95%. Batches were stable for 4 h and conform the European Pharmacopeia guidelines. Conclusions: The automated synthesis of Al[F-18]PSMA-11 allows for large scale production and distribution of Al [F-18]PSMA-11