Aucubin promotes angiogenesis via estrogen receptor beta in a mouse model of hindlimb ischemia

Publication date: Available online 12 July 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Lu Chen, Yue Yang, Lusha Zhang, Chunxiao Li, Joel Wake Coffie, Xiao Geng, Lizhen Qiu, Xingyu You, Zhirui Fang, Min Song, Xiumei Gao, Hong Wang
Aucubin (AU) is an iridoid glycoside that has been shown to display estrogenic properties and has various pharmacological effects. Herein, we described the angiogenic properties of AU. In the study, hindlimb ischemia was induced by ligation of femoral artery on the right leg of ovariectomized mice. AU treatment significantly accelerated perfusion recovery and reduced tissue injury in mice muscle. Quantification of CD31-positive vessels in hindlimb muscles provided evidences that AU promoted angiogenesis in peripheral ischemia. In addition, results from quantitative PCR and western blot suggested AU induced angiogenesis via vascular endothelial cell growth factor (VEGF)/Akt/endothelial nitric oxide synthase (eNOS) signaling pathway. More interestingly, AU's angiogenic effects could be completely abolished in estrogen receptor beta (ERβ) knockout mice. In conclusion, the underlying mechanisms were elucidated that AU produced pro-angiogenic effects through ERβ-mediated VEGF signaling pathways. These results expand knowledge about the beneficial effects of AU in angiogenesis and blood flow recovery. It might provide insight into the ERβ regulating neovascularisation in hindlimb ischemia and identify AU as a potent new compound used for the treatment of peripheral vascular disease.

Graphical abstract

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Oncogenic Activities of IDH1/2 Mutations: From Epigenetics to Cellular Signaling

Publication date: Available online 12 July 2017
Source:Trends in Cell Biology
Author(s): Laurence M. Gagné, Karine Boulay, Ivan Topisirovic, Marc-Étienne Huot, Frédérick A. Mallette
Gliomas and leukemias remain highly refractory to treatment, thus highlighting the need for new and improved therapeutic strategies. Mutations in genes encoding enzymes involved in the tricarboxylic acid (TCA) cycle, such as the isocitrate dehydrogenases 1 and 2 (IDH1/2), are frequently encountered in astrocytomas and secondary glioblastomas, as well as in acute myeloid leukemias; however, the precise molecular mechanisms by which these mutations promote tumorigenesis remain to be fully characterized. Gain-of-function mutations in IDH1/2 have been shown to stimulate production of the oncogenic metabolite R-2-hydroxyglutarate (R-2HG), which inhibits α-ketoglutarate (αKG)-dependent enzymes. We review recent advances on the elucidation of oncogenic functions of IDH1/2 mutations, and of the associated oncometabolite R-2HG, which link altered metabolism of cancer cells to epigenetics, RNA methylation, cellular signaling, hypoxic response, and DNA repair.



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Adaption of the human population to the environment: Current knowledge, clues from Czech cytogenetic and “omics” biomonitoring studies and possible mechanisms

Publication date: Available online 12 July 2017
Source:Mutation Research/Reviews in Mutation Research
Author(s): Andrea Rossnerova, Michaela Pokorna, Vlasta Svecova, Radim J. Sram, Jan Topinka, Friedo Zölzer, Pavel Rossner
The human population is continually exposed to numerous harmful environmental stressors, causing negative health effects and/or deregulation of biomarker levels. However, studies reporting no or even positive impacts of some stressors on humans are also sometimes published. The main aim of this review is to provide a comprehensive overview of the last decade of Czech biomonitoring research, concerning the effect of various levels of air pollution (benzo[a]pyrene) and radiation (uranium, X-ray examination and natural radon background), on the differently exposed population groups. Because some results obtained from cytogenetic studies were opposite than hypothesized, we have searched for a meaningful interpretation in genomic/epigenetic studies.A detailed analysis of our data supported by the studies of others and current epigenetic knowledge, leads to a hypothesis of the versatile mechanism of adaptation to environmental stressors via DNA methylation settings which may even originate in prenatal development, and help to reduce the resulting DNA damage levels. This hypothesis is fully in agreement with unexpected data from our studies (e.g. lower levels of DNA damage in subjects from highly polluted regions than in controls or in subjects exposed repeatedly to a pollutant than in those without previous exposure), and is also supported by differences in DNA methylation patterns in groups from regions with various levels of pollution.In light of the adaptation hypothesis, the following points may be suggested for future research: (i) the chronic and acute exposure of study subjects should be distinguished; (ii) the exposure history should be mapped including place of residence during the life and prenatal development; (iii) changes of epigenetic markers should be monitored over time.In summary, investigation of human adaptation to the environment, one of the most important processes of survival, is a new challenge for future research in the field of human biomonitoring that may change our view on the results of biomarker analyses and potential negative health impacts of the environment.



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Identification and preliminary characterization of a putative C-type lectin receptor-like protein in the T. cruzi tomato lectin endocytic-enriched proteome

Publication date: Available online 12 July 2017
Source:Microbiological Research
Author(s): Sébastien Brosson, Guy Bottu, Etienne Pays, Sabrina Bousbata, Didier Salmon
Trypanosoma cruzi, the etiological agent of the Chagas' disease in Latin America undergoes a complex life cycle involving two hosts, a mammalian host and a reduviid insect vector (triatomine). In the insect midgut the parasite multiplies as epimastigote forms, which rely on endocytosis for their energy requirement. We recently showed that posttranslational modification of endocytic N-glycoproteins by tomato lectin (TL) binding-N-glycans is crucial for receptor-mediated endocytosis (RME) in epimastigote forms. In an attempt to characterize the endocytic proteome we used a TL affinity chromatography, which significantly enriched glycoproteins of the trypanosomal endocytic pathway. In addition to various lysosomal hydrolases, we found an endosomal C-type lectin-like protein, which displays some structural and topological characteristics of the mammalian lectin receptor superfamily. This lectin encoding a large transmembrane protein of around 375kDa contained three putative extracellular N-terminal C-type lectin domains (CTLD) and located inside the flagellar pocket (FP)/cytostome and endosomal compartments of the insect stage of the parasite and on the surface of the plasma membrane of intracellular amastigote parasites. Noteworthy, this endogenous lectin displayed similar sugar-binding specificity to that of TL and therefore could be important in either the N-glycan mediated endocytosis or parasite adhesion to host cells. We postulated that during the evolution of trypanosomatids, genes encoding lectin harboring 3 CTDLs represent an old acquisition present in free-living, monoxenic and heteroxenic trypanosomatids, which would have been secondarily lost in extracellular parasites from the T. brucei clade.



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Treatment of refractory and severe hypothyroidism with sublingual levothyroxine in liquid formulation

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Risk factors of postcardiotomy ventricular dysfunction in moderate-to-high risk patients undergoing open-heart surgery

Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker

Annals of Cardiac Anaesthesia 2017 20(3):287-296

Introduction: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. Methods: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7. The primary outcome was the occurrence of PCVD as defined by the need for sustained inotropic drug support and by transesophageal echography. The secondary outcomes included in-hospital mortality and the incidence of any major adverse events as well as Intensive Care Unit (ICU) and hospital length of stay. Results: The incidence of PCVD was 28.4%. Patients with PCVD experienced higher in-hospital mortality (12.6% vs. 0.6% in patients without PCVD) with a higher incidence of cardiopulmonary and renal complications as well as a prolonged stay in ICU (median + 2 days). Myocardial infarct occurred more frequently in patients with PCVD than in those without PCVD (19 [30.2%] vs. 12 [7.6%]). By logistic regression analysis, we identified four independent predictors of PCVD: left ventricular ejection fraction <40% (odds ratio [OR] = 6.36; 95% confidence interval [CI], 2.59–15.60), age older than 75 years (OR = 3.35; 95% CI, 1.64–6.81), prolonged aortic clamping time (OR = 3.72; 95% CI, 1.66–8.36), and perioperative bleeding (OR = 2.33; 95% CI, 1.01–5.41). The infusion of glucose-insulin-potassium was associated with lower risk of PCVD (OR = 0.14; 95% CI, 0.06–0.33). Conclusions: This cohort study indicates that age, preoperative ventricular function, myocardial ischemic time, and perioperative bleeding are predictors of PCVD which is associated with poor clinical outcome.

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Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury during off-pump coronary artery bypass grafting

Muralidhar Kanchi, R Manjunath, Jos Massen, Lloyd Vincent, Kumar Belani

Annals of Cardiac Anaesthesia 2017 20(3):297-302

Background: Acute kidney injury (AKI) following cardiac surgery is a major complication resulting in increased morbidity, mortality, and economic burden. In this study, we assessed the usefulness of estimating serum neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker in predicting AKI in patients with stable chronic kidney disease (CKD) and undergoing off-pump coronary artery bypass grafting (OP-CABG). Patients and Methods: We prospectively studied sixty nondialysis-dependent CKD patients with estimated glomerular filtration rate <60 ml/min/1.73 m2 who required elective OP-CABG. Patients were randomized into two groups, Group D received dopamine infusion at 2 μg/kg/min following anesthesia induction till the end of the surgery and Group P did not receive any intervention. Serum creatinine, NGAL, brain natriuretic peptide, and troponin-I were estimated at specified intervals before, during, and after surgery. The results of the study patients were also compared to a simultaneous matched cohort control of thirty patients (Group A) without renal dysfunction who underwent OP-CABG. Results: No patient required renal replacement therapy, and no mortality was observed during perioperative and hospitalization period. Six patients from control group (n = 30), ten patients from placebo group (n = 30), and 12 patients from dopamine group (n = 30) developed stage 1 AKI. However, we did not observe any stage 2 and stage 3 AKI among all the groups. There was a significant increase in serum NGAL levels at the end of surgery and 24 h postoperatively in placebo and dopamine groups as compared to the control. Conclusion: The measurement of NGAL appears to predict the occurrence of AKI after OP-CAB surgery. However, large multicentric studies may be required to confirm the findings of this study.

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Idarucizumab (Praxbind) for reversal of pradaxa prior to emergent repair of contained ruptured transverse arch aneurysm

Erol Vahit Belli, Teng Lee

Annals of Cardiac Anaesthesia 2017 20(3):369-371

Idarucizumab before cardiopulmonary bypass was used for the reversal of dabigatran during an emergent frozen elephant trunk repair of a transverse arch aneurysm. Reversal was successful and minimal not massive transfusion was required with no abnormal sequelae seen with use before cardiopulmonary bypass.

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Coronary artery bypass graft patients' perception about the risk factors of illness: Educational necessities of second prevention

Ali Soroush, Saeid Komasi, Mozhgan Saeidi, Behzad Heydarpour, Danilo Carrozzino, Mario Fulcheri, Paolo Marchettini, Massimo Rabboni, Angelo Compare

Annals of Cardiac Anaesthesia 2017 20(3):303-308

Background: Patients' beliefs about the cause of cardiac disease (perceived risk factors) as part of the global psychological presentation are influenced by patients' health knowledge. Hence, the present study aimed to assess the relationship between actual and perceived risk factors, identification of underestimated risk factors, and indication of underestimation of every risk factor. Materials and Methods: In this cross-sectional study, data of 313 coronary artery bypass graft (CABG) patients admitted to one hospital in the west of Iran were collected through a demographic interview, actual risk factors' checklist, open single item of perceived risk factors, and a life stressful events scale. Data were analyzed by means of Spearman's correlation coefficients and one-sample Z-test for proportions. Results: Although there are significant relations between actual and perceived risk factors related to hypertension, family history, diabetes, smoking, and substance abuse (P < 0.05), there is no relation between the actual and perceived risk factors, and patients underestimate the role of actual risk factors in disease (P < 0.001). The patients underestimated the role of aging (98.8%), substance abuse (95.2%), overweight and obesity (94.9%), hyperlipidemia (93.1%), family history (90.3%), and hypertension (90%) more than diabetes (86.1%), smoking (72.5%), and stress (54.7%). Conclusion: Cardiac patients seem to underestimate the role of aging, substance abuse, obesity and overweight, hyperlipidemia, family history, and hypertension more than other actual risk factors. Therefore, these factors should be highlighted to patients to help them to (i) increase the awareness of actual risk factors and (ii) promote an appropriate lifestyle after CABG surgery.

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Appropriate size of double-lumen tubes in Asians

Chitra Rajeswari Thangaswamy

Annals of Cardiac Anaesthesia 2017 20(3):388-388



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Cardiovascular operation: A significant risk factor of arytenoid cartilage dislocation/subluxation after anesthesia

Seri Tsuru, Mayuko Wakimoto, Takeshi Iritakenishi, Makoto Ogawa, Yukio Hayashi

Annals of Cardiac Anaesthesia 2017 20(3):309-312

Background: Arytenoid cartilage dislocation/subluxation is one of the rare complications following tracheal intubation, and there have been no reports about risk factors leading this complication. From our clinical experience, we have an impression that patients undergoing cardiovascular operations tend to be associated with this complication. Aims: We designed a large retrospective study to reveal the incidence and risk factors predicting the occurrence and to examine whether our impression is true. Settings and Designs: This was a retrospective study. Methods: We retrospectively studied 19,437 adult patients who were intubated by an anesthesiologist in our operation theater from 2002 to 2008. The tracheal intubation was performed by a resident anesthesiologist managing the patients. Only patients whose postoperative voice was disturbed more than 7 days were referred to the Department of Otorhinolaryngology-Head and Neck Surgery and examined using laryngostroboscopy by a laryngologist to diagnose arytenoid cartilage dislocation/subluxation. We evaluated age, sex, weight, height, duration of intubation, difficult intubation, and major cardiovascular operation as risk factors to lead this complication. Statistical Analysis: The data were analyzed by logistic regression analysis to assess factors for arytenoid cartilage dislocation/subluxation after univariate analyses using logistic regression analysis. Results: Our analysis indicated that difficult intubation (odds ratio: 12.1, P = 0.018) and cardiovascular operation (odds ratio: 9.9, P < 0.001) were significant risk factors of arytenoid cartilage dislocation/subluxation. Conclusion: The present study demonstrated that major cardiovascular operation is one of the significant risk factors leading this complication.

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Management of a case of double aortic arch with tracheal compression complicated with postoperative tracheal restenosis

Hemang Gandhi, T Vikram Kumar Naidu, Amit Mishra, Pankaj Garg, Jigar Surti, Visharad Trivedi, Himanshu Acharya

Annals of Cardiac Anaesthesia 2017 20(3):362-364

Tracheal stenosis in association with the double aortic arch (DAA) is uncommon; however, it carries a high risk of morbidity, mortality, and restenosis. Although surgery is the mainstay of managing a case of the DAA with tracheal stenosis, management of tracheal restenosis requires a multidisciplinary approach. In this case report, we present our successful experience in managing a child of DAA with tracheal stenosis who developed tracheal restenosis after sliding tracheoplasty of trachea.

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Propofol versus Ketofol for Sedation of Pediatric Patients Undergoing Transcatheter Pulmonary Valve Implantation: A Double-blind Randomized Study

Rabie Soliman, Mohammed Mofeed, Tarek Momenah

Annals of Cardiac Anaesthesia 2017 20(3):313-317

Objective: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. Design: This was a double-blind randomized study. Setting: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. Patients and Methods: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation. Intervention: The study included sixty patients, classified into two groups (n = 30). Group A: Propofol was administered as a bolus dose (1–2 mg/kg) and then a continuous infusion of 50–100 μg/kg/min titrated as needed. Group B: Ketofol was administered 1–2 mg/kg and then infusion of 20–60 μg/kg/min. The medication was prepared by the nursing staff and given to anesthetist blindly. Measurements: The monitors included heart rate, mean arterial blood pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, fentanyl dose, antiemetic medications, and Aldrete score. Main Results: The comparison of heart rate, mean arterial pressure, respiratory rate, temperature, SPO2and PaCO2, Michigan Sedation Score, and Aldrete score were insignificant (P > 0.05). The total fentanyl increased in Group A more than Group B (P = 0.045). The required antiemetic drugs increased in Group A patients more than Group B (P = 0.020). The durations of full recovery and in the postanesthesia care unit were longer in Group A than Group B (P = 0.013, P < 0.001, respectively). Conclusion: The use of propofol and ketofol is safe and effective for sedation of pediatric patients undergoing pulmonary valve implantation in a catheterization laboratory. However, ketofol has many advantages more than the propofol. Ketofol has a rapid onset of sedation, a rapid recovery time, decreased incidence of nausea and vomiting and leads to rapid discharge of patients from the postanesthesia care unit.

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Sugammadex to reverse neuromuscular blockade in a child with a past history of cardiac transplantation

Karen Miller, Brian Hall, Joseph D Tobias

Annals of Cardiac Anaesthesia 2017 20(3):376-378

Sugammadex is a novel agent for the reversal of neuromuscular blockade. The speed and efficacy of reversal with sugammadex are significantly faster than acetylcholinesterase inhibitors, such as neostigmine. Sugammadex also has a limited adverse profile when compared with acetylcholinesterase inhibitors, specifically in regard to the incidence of bradycardia. This adverse effect may be particularly relevant in the setting of a heart transplant recipient with a denervated heart. The authors present a case of an 8-year-old child, status postcardiac transplantation, who required anesthetic care for laparoscopy and lysis of intra-abdominal adhesions. Sugammadex was used to reverse neuromuscular blockade and avoid the potential adverse effects of neostigmine. The unique mechanism of action of sugammadex is discussed, previous reports of its use in this unique patient population are reviewed, and its potential benefits compared to traditional acetylcholinesterase inhibitors are presented.

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Randomized comparative study of intravenous infusion of three different fixed doses of milrinone in pediatric patients with pulmonary hypertension undergoing open heart surgery

Neeraj Kumar Barnwal, Sanjeeta Rajendra Umbarkar, Manjula Sudeep Sarkar, Raylene J Dias

Annals of Cardiac Anaesthesia 2017 20(3):318-322

Background: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. Methodology: Patients were randomized into three groups. All patients received fixed bolus dose of milrinone 50 μg/kg on pump during rewarming. Following this, patients in low-dose group received infusion of milrinone at the rate of 0.375 μg/kg/min, medium-dose group received 0.5 μg/kg/min, and high-dose group received 0.75 μg/kg/min over 24 h. Heart rate, mean arterial pressure (MAP), mean airway pressure (MaP), oxygenation index (OI), and central venous pressure (CVP) were compared at baseline and 24 h postoperatively. Dose of inotropic requirement, duration of ventilatory support and Intensive Care Unit (ICU) stay were noted. Results: MAP, MaP, OI, and CVP were comparable in all three groups postoperatively. All patients in the low-dose group required low inotropic support while 70% of patients in the high-dose group needed high inotropic support to manage episodes of hypotension (P = 0.000). Duration of ventilatory support and ICU stay in all three groups was comparable (P = 0.412, P = 0.165). Conclusion: Low-dose infusions while having a clinical impact were more beneficial in avoiding adverse events and decreasing inotropic requirement without affecting duration of ventilatory support and duration of ICU stay.

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Asystole following neuromuscular blockade reversal in cardiac transplant patients

Njinkeng J Nkemngu

Annals of Cardiac Anaesthesia 2017 20(3):385-386



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The blalock and taussig shunt revisited

Usha Kiran, Shivani Aggarwal, Arin Choudhary, B Uma, Poonam Malhotra Kapoor

Annals of Cardiac Anaesthesia 2017 20(3):323-330

The systemic to pulmonary artery shunts are done as palliative procedures for cyanotic congenital heart diseases ranging from simple tetralogy of Fallots (TOFs)/pulmonary atresia (PA) to complex univentricular hearts. They allow growth of pulmonary arteries and maintain regulated blood flow to the lungs till a proper age and body weight suitable for definitive corrective repair is reached. We have reviewed the BT shunt with its anaesthtic considerations and management of associated complications.

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View Point

Prabhat Tewari

Annals of Cardiac Anaesthesia 2017 20(3):285-286



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Interesting images: Multiple coronary artery aneurysms

Jonathon M Howard, Omar Viswanath, Alfredo Armas, Orlando Santana, Gerald P Rosen

Annals of Cardiac Anaesthesia 2017 20(3):331-332

We present the case of a 65-year-old male who presented with stable angina and dyspnea on exertion. His initial workup yielded a positive treadmill stress test for reversible apical ischemia, and transthoracic echocardiogram demonstrated impaired systolic function. Cardiac catheterization was then performed, revealing severe atherosclerotic disease including multiple coronary artery aneurysms. As a result, the patient was advised to and subsequently underwent a coronary artery bypass graft. This case highlights the presence of multiple coronary artery aneurysms and the ability to appreciate these pathologic findings on multiple imaging modalities, including coronary angiogram, transesophageal echocardiography, and direct visualization through the surgical field.

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Anesthetic challenges of extrinsic trachea-bronchial compression due to posterior mediastinal mass: Our experience with a large esophageal mucocele

Saipriya Tewari, Puneet Goyal, Amit Rastogi, Aarti Agarwal, PK Singh

Annals of Cardiac Anaesthesia 2017 20(3):359-361

Large posterior mediastinal masses may lead threatening complications such as critical tracheobronchial compression. Airway management in these individuals is a challenge and being a lower airway obstruction; rescue strategies are limited. We encountered one such case of a large esophageal mucocele causing extrinsic tracheobronchial compression. We have described the anesthetic management of this case using awake fiber-optic assessment followed by intubation. Close communication with the surgical team, meticulous planning of airway management, and early drainage of the mucocele are the cornerstones of management in such patients.

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Inadequate venous drainage-transesophageal echocardiography as rescue

Monish S Raut, Arun Maheshwari, Sumir Dubey, Ganesh Shivnani, Sandeep Joshi, Arvind Verma, Swetanka Das

Annals of Cardiac Anaesthesia 2017 20(3):333-334

Malposition of venous cannula can cause inadequate venous drainage during cardiopulmonary bypass. It would be good clinical practice to use TEE to check the position of inferior venous cannula to avoid this problem at the earliest.

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A rare case of acyanotic congenital heart disease, large patent ductus arteriosus with pre-ductal coarctation of descending thoracic aorta with patent ductus arteriosus closure and extra anatomical bypass grafting

Zara Wani, Deepak Tiwari, Rajeev Gehlot, Deepak Kumar, Sushil Chhabra, Meenaxi Sharma

Annals of Cardiac Anaesthesia 2017 20(3):365-368

We report a case of 18-year-old female patient with large patent ductus arteriosus (PDA)-preductal coarctation of descending thoracic aorta. She underwent large PDA closure with a prosthetic graft from ascending aorta to descending thoracic aorta by mid-sternotomy on cardiopulmonary bypass machine under total hypothermic circulatory arrest.

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An antenatal diagnosis: Congenital high airway obstruction

S Miital, A Mittal, R Singal, S Singal, G Sekhon

Annals of Cardiac Anaesthesia 2017 20(3):335-336

Congenital high airway obstruction (CHAOS) is a rare lethal fetal malformation characterised by obstruction to the fetal upper airway, which can be partial or complete. Antenatal diagnosis of CHAOS is important due to recent management options. Diagnosis is made with secondary changes such as hyperechoic enlarged lungs resulting in mediastinal compression, ascites, hydrops, flattened or everted diaphragms and dilated distal airways. We reported a case of CHAOS, antenatally on ultrasonography (USG) at 20 weeks of gestation.

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Common Carotid Artery Flow Measured by 3-D Ultrasonic Vector Flow Imaging and Validated with Magnetic Resonance Imaging

Publication date: Available online 12 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Simon Holbek, Kristoffer Lindskov Hansen, Hamed Bouzari, Caroline Ewertsen, Matthias Bo Stuart, Carsten Thomsen, Michael Bachmann Nielsen, Jørgen Arendt Jensen
Ultrasound (US) examination of the common carotid artery was compared with a through-plane magnetic resonance imaging (MRI) sequence to validate a recently proposed technique for 3-D US vector flow imaging. Data from the first volunteer examined were used as the training set, before volume flow and peak velocities were calculated for the remaining eight volunteers. Peak systolic velocities (PSVs) and volume flow obtained with 3-D US were, on average, 34% higher and 24% lower than those obtained with MRI, respectively. A high correlation was observed for PSV (r = 0.79), whereas a lower correlation was observed for volume flow (r = 0.43). The overall standard deviations were ±5.7% and ±5.7% for volume flow and PSV with 3-D US, compared with ±2.7% and ±3.2% for MRI. Finally, the data were re-processed with a change in the parameter settings for the echo-canceling filter to investigate its influence on overall performance. PSV was less affected by the re-processing, whereas the difference in volume flow between 3-D vector flow imaging and MRI was reduced to −9%, and with an improved overall standard deviation of ±4.7%. The results illustrate the feasibility of using 3-D US for precise and angle-independent volume flow and PSV estimation in vivo.



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Guar and Locust bean gum: Composition, total phenolic content, antioxidant and antinutritional characterisation

Publication date: Available online 12 July 2017
Source:Bioactive Carbohydrates and Dietary Fibre
Author(s): Afshan Mumtaz Hamdani, Idrees Ahmed Wani
Guar and locust bean gum are added to various food products because of their ability to modify the texture and rheology. No sufficient data is available about their bioactive roles except that these are physiologically similar to dietary fibre and may be used as low-energy fat replacers. Present study was undertaken to find out the nutraceutical and antinutritional properties of guar and locust bean gum. Antioxidant activity of gums was determined by ferrous ion chelating ability, reducing power, FRAP (ferric reducing antioxidant power) and ABTS (2, 2-azinobis (3-ethylbenzothiazolin-6-sulfonate) scavenging power. Determination of phytic acid, haemagglutinins, terpenoids, saponins and alkaloids was carried out to evaluate their antinutritional activity. Gums showed low antioxidant potential except ferrous ion chelating ability which was significant in both methanolic (65.08–66.82%) and ethanolic (36.46–55.40%) extracts. Gums also exhibited a high DPPH (1,1-diphenyl-2- picrylhydrazyl) radical scavenging activity (11.67–29.78%). Bile acid binding capacity was high i.e., 49.83% (guar gum) and 54.42% (locust bean gum). Tannin and phytic acid content varied from 1.28–3.72 TAE/g and 0.098–0.165mg/g, respectively. Haemagglutinin activity of gums was low (0.066–0.432 HU/mg protein) while the terpenoids, saponins and alkaloids were completely absent. Thus, gums may play beneficial bioactive roles in consumers in addition to conferring desirable organoleptic properties in different food products.

Graphical abstract

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Treatment of refractory and severe hypothyroidism with sublingual levothyroxine in liquid formulation

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Neoadjuvant Therapy with Weekly Nanoparticle Albumin‐Bound Paclitaxel for Luminal Early Breast Cancer Patients: Results from the NABRAX Study (GEICAM/2011‐02), a Multicenter, Non‐Randomized, Phase II Trial, with a Companion Biomarker Analysis

AbstractBackground.Nanoparticle albumin‐bound paclitaxel (nab‐Paclitaxel) is an alternative to standard taxanes for breast cancer (BC) treatment. We evaluated nab‐Paclitaxel efficacy as neoadjuvant treatment for early estrogen receptor‐positive (ER+), human epidermal growth factor receptor 2‐negative (HER2‐) disease.Materials and Methods.Women with ER+, HER2‐, stage II–III BC were treated preoperatively with four cycles of weekly nab‐Paclitaxel (150 mg/m2), 3 weeks on and 1 week off. We hypothesized that poor pathological response rate (residual cancer burden [RCB] III; Symmans criteria) would be ≤16%.Results.Eighty‐one patients with a median age of 47 years were treated; 64.2% were premenopausal, and 69% of tumors were stage II. Residual cancer burden III rate was 28.4% (95% confidence interval [CI]: 18.6%–38.2%), RCB 0+I (good response) rate was 24.7% (95% CI: 15.3%–34.1%) and RCB 0 (complete response) rate was 7.4% (95% CI: 1.7%–13.1%). Objective response rate by magnetic resonance imaging was 76.5% and rate of conversion to breast conserving surgery was 40.0%. The most frequent grade 3 and 4 toxicity was neutropenia (12.3% and 3.7% of patients, respectively), without any febrile neutropenia. Sensory neuropathy grade 2 and 3 were seen in 25.9% and 2.5% of patients, respectively. Tumor secreted protein, acidic, cysteine‐rich (SPARC) overexpression was significantly associated with RCB 0 (odds ratio: 0.079; 95% CI: 0.009–0.689; p = .0216).Conclusion.Despite failing to confirm an RCB III rate ≤16% in nab‐Paclitaxel‐treated patients, the RCB 0+I rate indicates a significant drug antitumor activity with low rates of grade 3–4 toxicity. Our exploratory biomarker analysis suggests a potential predictive role of complete response for SPARC. Confirmatory analyses are warranted, adapting dose and schedule to decrease peripheral neurotoxicity. (Trial registration: European Clinical Trials Database study number: 2011‐004476‐10; ClinicalTrials.gov: NCT01565499)Implications for Practice.The pathological response rate (residual cancer burden [RCB]; Symmans criteria) of nanoparticle albumin‐bound paclitaxel administered as neoadjuvant treatment for early estrogen receptor‐positive, human epidermal growth factor receptor 2‐negative disease was evaluated. Whereas poor response (RCB III) was 24.7%, similar to that for docetaxel, good response (RCB 0+I) reached 23.0%, far superior to the 13% for docetaxel, while keeping toxicity low. Exploratory biomarker analysis suggests secreted protein, acidic, cysteine‐rich overexpression in tumor cells as a potential predictor of complete response (RCB 0). Findings point to an encouraging single‐agent neoadjuvant treatment with low toxicity, which warrants future research and development.

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Quality Assessment of Reporting Performance for EGFR Molecular Diagnosis in Non‐Small Cell Lung Cancer

AbstractBackground.Reports serve as a bridge between laboratories and clinicians, help synthesize an overwhelming amount of raw data into evidence‐based medicine, and play a significant role in designing clinical treatments. In an effort to guarantee high‐quality epidermal growth factor receptor (EGFR) gene mutation testing and reporting performance, the National Center for Clinical Laboratories launched a proficiency testing (PT) scheme reflecting clinical practices in China since 2014. This study focuses on the quality assessment of gene mutation reports.Materials and Methods.Fifty‐three laboratories that submitted reports in both 2014 and 2016 EGFR gene mutation PT schemes were selected for report analysis and comparison according to predefined evaluation criteria.Results.The average score for reports from 2014 was 14 out of 30 points. The overall scores for reports from 2016 improved substantially, yielding an average score of 20 out of 30 points. Among the evaluation criteria, general items were well documented in the reports. However, items specific to molecular diagnosis were far from satisfactory, and some items were even missing.Conclusion.The quality assessment of clinical written reports from 2014 and 2016 demonstrates that substantial improvements have been made in overall reporting performance. However, not all statements pertaining to important elements met expectations. To continue education, repeated PT schemes need to be executed in a timely fashion to expose and address existing shortcomings in clinical reports. There remains ample room for improvement towards generating concise, comprehensive, and readable reports.Implications for Practice.This article compares the quality of clinical gene mutation reports submitted in 2014 to those submitted in 2016 epidermal growth factor receptor proficiency testing schemes, exposes the existing shortcomings, and discusses ways to communicate results more effectively in the future. The findings demonstrate that notable progress was observed in the overall reporting performance. However, key points specific to molecular diagnosis were far from expectation, and some items were even missing. Standardization needs to be emphasized to improve the report format and content. This article provides a reference that laboratories can use to write concise, comprehensive, and readily accessible clinical reports.

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Distinct Tertiary Lymphoid Structure Associations and Their Prognostic Relevance in HER2 Positive and Negative Breast Cancers

AbstractBackground.The presence of tumor infiltrating lymphocytes (TIL) is associated with favorable prognosis. Recent evidence suggested that not only their density, but also the spatial organization as tertiary lymphoid structures (TLS), play a key role in determining patient survival.Materials and Methods.In a cohort of 248 breast cancers, the clinicopathologic association and prognostic role of TLS was examined.Results.Tertiary lymphoid structures were associated with higher tumor grade, apocrine phenotype, necrosis, extensive in situ component, lymphovascular invasion (LVI), and high TIL. For biomarkers, TLS were associated with hormone receptors negativity, HER2 positivity, and c‐kit expression. Tertiary lymphoid structures were significantly related to better disease‐free survival (DFS) in HER2 positive (HER2+) breast cancers (log‐rank = 4.054), which was not dependent on high TIL status. The combined TLS and TIL status was an independent favorable factor associated with DFS in those cases. Interestingly, tumor cell infiltration into the TLS was found in 41.9% of TLS positive cases. It was associated with LVI in HER2 negative (HER2−) TLS positive (particularly estrogen receptor positive [ER+] HER2−) cases. In the ER+ HER2− cases, tumor cell infiltration into TLS was also associated with increased pathologic nodal stage (pN) stage and nodal involvement.Conclusion.Tertiary lymphoid structures showed a similar relationship with clinicopathologic features and biomarkers as TIL. The presence of TLS, irrespective of TIL level, could be an important favorable prognostic indicator in HER2+ breast cancer patients. Given the significance of TLS in promoting effective antitumor immunity, further understanding of its organization and induction may provide new opportunities to improve the current immunotherapy strategies.Implications for Practice.Despite recent interest on the clinical value of tumor infiltrating lymphocyte (TIL), little was known on the clinical significance on their spatial organization as tertiary lymphoid structures (TLS). Although TLS showed similar relationships with clinicopathologic features and biomarkers as TIL, the prognostic value of TLS, particularly in HER2 positive cancers, was independent of TIL. Moreover, tumor infiltration could be present in TLS which appears to be related to tumor invasion in HER2 negative cancers. Overall, the results demonstrated the additional value for TLS in HER2 cancer subtypes. Further investigations and its standardized evaluation will enhance its use as standard practice.

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Clinical Application of Targeted Deep Sequencing in Solid‐Cancer Patients; Utility of Targeted Deep Sequencing for Biomarker‐Selected Clinical Trial

AbstractMolecular profiling of actionable mutations in refractory cancer patients has the potential to enable "precision medicine," wherein individualized therapies are guided based on genomic profiling. The molecular‐screening program was intended to route participants to different candidate drugs in trials based on clinical‐sequencing reports. In this screening program, we used a custom target‐enrichment panel consisting of cancer‐related genes to interrogate single‐nucleotide variants, insertions and deletions, copy number variants, and a subset of gene fusions. From August 2014 through April 2015, 654 patients consented to participate in the program at Samsung Medical Center. Of these patients, 588 passed the quality control process for the 381‐gene cancer‐panel test, and 418 patients were included in the final analysis as being eligible for any anticancer treatment (127 gastric cancer, 122 colorectal cancer, 62 pancreatic/biliary tract cancer, 67 sarcoma/other cancer, and 40 genitourinary cancer patients). Of the 418 patients, 55 (12%) harbored a biomarker that guided them to a biomarker‐selected clinical trial, and 184 (44%) patients harbored at least one genomic alteration that was potentially targetable. This study demonstrated that the panel‐based sequencing program resulted in an increased rate of trial enrollment of metastatic cancer patients into biomarker‐selected clinical trials. Given the expanding list of biomarker‐selected trials, the guidance percentage to matched trials is anticipated to increase.Implications for Practice.This study demonstrated that the panel‐based sequencing program resulted in an increased rate of trial enrollment of metastatic cancer patients into biomarker‐selected clinical trials. Given the expanding list of biomarker‐selected trials, the guidance percentage to matched trials is anticipated to increase.

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Adipose‐Derived Fatty Acid‐Binding Proteins Plasma Concentrations Are Increased in Breast Cancer Patients

AbstractBackground.Adipose tissue is an endocrine organ that could play a role in tumor progression via its secreted adipokines. The role of adipose‐derived fatty acid‐binding protein (FABP) 4 and FABP5 in breast cancer is presently under study, but their circulating levels in this pathology are poorly known. We analyzed the blood concentrations of FABP4 and FABP5 in breast cancer patients to determine whether there is an association between them and breast cancer.Materials and Methods.We studied 294 women in the oncology department with a family history of breast cancer; 198 of the women had breast cancer, and 96 were healthy controls. The levels of FABP4, FABP5, lipid profile, standard biochemical parameter, and high‐sensitivity C‐reactive protein (hsCRP) were determined. We analyzed the association of FABP4 and FABP5 with breast cancer, while adjusting for demographic, anthropometric, and biochemical parameters.Results.Breast cancer patients had a 24.8% (p < .0001) and 11.4% (p < .05) higher blood concentration of FABP4 and FABP5, respectively. Fatty acid‐binding protein 4 was positively associated with age, body mass index (BMI), FABP5, very‐low‐density lipoprotein cholesterol (VLDLc), non‐high‐density lipoprote in cholesterol (non‐HDLc), Apolipoprotein B 100 (ApoB100), triglycerides, glycerol, glucose, and hsCRP (p < .05), and was negatively associated with HDLc (p < .005) in breast cancer patients. Fatty acid‐binding protein 5 was positively associated with BMI, FABP4, VLDLc, triglycerides, glycerol, and hsCRP (p < .05), and was negatively associated with HDLc and Apolipoprotein AI (ApoAI) (p < .05) in breast cancer patients. Using a logistic regression analysis and adjusting for age, BMI, hsCRP, non‐HDLc, and triglycerides, FABP4 was independently associated with breast cancer (odds ratio [OR]: 1.091 [95% CI: 1.037–1.149]). Moreover, total cholesterol, VLDLc, non‐HDLc, ApoB100, triglycerides, and hsCRP were significantly increased in breast cancer patients (p < .005). In contrast, the non‐esterified fatty acids concentrations were significantly decreased in breast cancer patients (p < .05).Conclusion.Circulating FABP4 and FABP5 levels were increased in breast cancer patients compared with controls. The positive association of FABP4 with breast cancer was maintained after adjusting for important covariates, while the association with FABP5 was lost. Our data reinforce the role of adipose tissue and their adipokines in breast cancer. Despite these data, further studies must be performed to better explain the prognosis or diagnostic value of these blood parameters and their possible role in breast cancer.Implications for Practice.We focus on the effect of adipose tissue on cancer, which is increasingly recognized. The association between adipocyte‐derived adipokines and breast cancer opens new diagnosis and therapy perspectives. In this study, we provide original data concerning FABP4 and FABP5 plasma concentrations in breast cancer patients. Compared to control group, breast cancer patients show higher FABP4 and FABP5 blood levels. Our data suggest that, particularly, circulating FABP4 levels could be considered a new independent breast cancer biomarker. Our work translates basic science data to clinic linking the relationship between adipose tissue and lipid metabolism to breast cancer.

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Feasibility and Efficacy of Microwave Ablation Combined with Iodine‐125 Seed Implantation in Local Control of Recurrent Retroperitoneal Liposarcomas: Initial Clinical Experience

AbstractIntroduction.The objective of the present study was to evaluate the feasibility, safety, and short‐term efficacy of microwave ablation (MWA) combined with iodine‐125 (125I) seed implantation in recurrent retroperitoneal liposarcomas (rRPLs).Materials and Methods.From September 2012 to March 2015, 11 patients were enrolled in this prospective study. Eleven tumors (median, 9 cm; range, 5.5–12.5 cm) were treated with computerized tomography‐guided MWA for 11 sessions and 125I seed implantation for 18 sessions. 125I seed implantation was performed 4 weeks after MWA.Results.There were no procedure‐related deaths. Post‐MWA pain (grade ≥2) was the most common complication (6 of 11 patients, 54.5%), and fever (grade ≥2) was observed in two patients. Reversible nerve injury, defined as transient limb paresthesia or leg weakness, was observed in one patient. There were fewer complications associated with the 125I seed implantation procedure compared with the MWA procedure. All 11 patients who underwent the MWA procedure achieved a partial response (PR), according to the modified Response Evaluation Criteria in Solid Tumors, 1 month post‐ablation; after 125I seed implantation was performed, a complete response was observed in three, five, and six target tumors in 3, 6, and 12 months, respectively.Conclusion.In selected patients with rRPLs, MWA combined with 125I seed implantation is feasible and safe with favorable local control efficacy.Implications for Practice.This study evaluated the feasibility, safety, and short‐term efficacy of microwave ablation (MWA) combined with iodine‐125 (125I) seed implantation in recurrent retroperitoneal liposarcomas (rRPLs). Results suggest that a single session of MWA may be not sufficient in large‐volume rRPLs and that as a supplement treatment, 125I seed implantation is safe and easy accessible. MWA combined with 125I seed has excellent local control effectiveness, and long‐term efficacy and survival benefit still need to be more comprehensively evaluated.

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Negative (18)F-FDG PET and positive CT and MRI findings in multifocal splenic hamartoma.

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Negative (18)F-FDG PET and positive CT and MRI findings in multifocal splenic hamartoma.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Van de Wiele C, Verstraete K, Bourgeois S, Maes A

Abstract
We report our fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)FFDG PET/CT) findings in a 51 years old female presenting with B symptoms, respectively fever, night sweats and malaise, that underwent an (18)F-FDG PET/CT examination to exclude underlying lymphomatous disease. Whereas (18)F-FDG PET scan findings were negative, CT put to evidence the presence of multiple small lesions suggestive for multifocal hamartoma. On a subsequently performed magnetic resonance imaging (MRI) of the spleen, multiple infracentimetric foci were visualized displaying characteristic findings for hamartoma. During a follow-up period of two years no change in size or characteristics of these lesions occurred.
CONCLUSION: The normal :F-FDG PET/CT findings suggested that, at least in this patient, splenic hamartoma may display a similar :F-FDG avidity when compared to normal splenic tissue. Alternatively, due to the infra-centrimeric size of the hamartoma and spill-over from :F-FDG activity from neighbouring normal tissue, the true (18)F-FDG avidity of the hamartomas present might also be overestimated.

PMID: 28697199 [PubMed - as supplied by publisher]

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Unusual diffuse liver (18)F-FDG uptake in melanoma patient treated by ipilimumab.

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Unusual diffuse liver (18)F-FDG uptake in melanoma patient treated by ipilimumab.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Raoul M, Ioannis K, Carlos A, Camilo G, Feoli F, Joseph K, Patrick F

Abstract
We present herein a case of unusual (18)F-FDG PET-CT diffuse hypermetabolic liver uptake in melanoma patient treated by ipilimumab.

PMID: 28697198 [PubMed - as supplied by publisher]

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Increased and normalized uptake of (18)F-FDG in a case of bone periprosthetic infection treated by antibiotics.

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Increased and normalized uptake of (18)F-FDG in a case of bone periprosthetic infection treated by antibiotics.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Lavelli V, Ferrari C, Niccoli Asabella A, Altini C, Saverio Vella F, Rubini G

Abstract
We report the case of a 69 years old man with left hip prosthesis, who presented clinical, biochemical and imaging signs of periprosthetic infection treated with linezolid, an antibacterial agent of the oxazolidinone class. Two weeks after this treatment, a fluorine-18-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) scan showed increased uptake in the skeleton and also increased uptake in several focal areas in the spine and near the prosthesis and the surgical wound on the left gluteus medius. Bone marrow biopsy was negative; meanwhile the antibiotic therapy, after four weeks of treatment was stopped due to red blood cells and platelets toxicity. Six weeks later, the patient developed high fever again and in order to revaluate the periprosthetic inflammation, he was resubmitted to (18)F-FDG PET/CT which showed normal (18)F-FDG uptake in the whole skeleton, including the prosthesis and the subcutaneous wound. Some focal areas of increased uptake in the lumbar spine were still detected. In the next 4 weeks the patient was under a "watch and wait" follow-up in a steady state.
IN CONCLUSION: In the case we report, since we found no otnt focal areas in the lumbar spine where due to age-related bone deformities including some Schmorl's nodes. The inflammation in the bone prosthesis and the subcutaneous wound responded almost totally to the antibiotic treatment we applied.

PMID: 28697197 [PubMed - as supplied by publisher]

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Fluorine-18-fluorodeoxyglucose positron emission tomography/ computed tomography findings in a pediatric mucoepidermoid carcinoma and differential diagnosis.

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Fluorine-18-fluorodeoxyglucose positron emission tomography/ computed tomography findings in a pediatric mucoepidermoid carcinoma and differential diagnosis.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Xie J, Ma C, Tang J

Abstract
An 11 years old boy was referred to our hospital. He complained for the last three months for intermittent cough and shortness of breath after exercise which worsened recently. Airways computed tomography (CT) showed an abnormal endobronchial tumor, obstructing the right main bronchus and also atelectasis in the upper lobe of the right lung. Bronchoscopy showed a wet on its surface mass obstructing the right main bronchus. Biopsy showed a mucoepidermoid carcinoma (MEC). The fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) scan showed in the same area a mass with slightly increased (18)F-FDG uptake (maximum standardized uptake value, SUVmax: 3.8), without mediastinal lymph nodes involvement. The boy had thoracoscopic resection of the right upper lobe, right main bronchus and right inferior lobe bronchial sleeve anastomosis. Histological examination confirmed the diagnosis of a low to intermediate grade malignant MEC without lymph nodes metastases. The patient has been well and free from recurrence for 2 years postoperatively.

PMID: 28697196 [PubMed - as supplied by publisher]

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Fluorine-18-FDG PET/CT in a patient with angiomyolipoma: Response to mammalian target of rapamycin inhibitor therapy.

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Fluorine-18-FDG PET/CT in a patient with angiomyolipoma: Response to mammalian target of rapamycin inhibitor therapy.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Anwar H, Sachpekidis C, Schwarzbach M, Dimitrakopoulou-Strauss A

Abstract
We report on a 27 years old female patient who was referred to our department for whole-body as well as dynamic positron emission tomography/computed tomography (dPET/CT) scan of the upper and middle abdomen with fluorine-18-fluorodeoxy glucose ((18)F-FDG), for further evaluation of a mass in the left adrenal gland region. Positron emission tomography showed a suspicious, enlarged, hypermetabolic mass with an average standardized uptake value (SUV) of 4.5 and a maximum SUV of 5.9. The patient was referred for biopsy, which revealed an angiomyolipoma, a perivascular epithelioid cell tumor (PEComa) of the adrenal gland. Perivascular epithelioid cell tumors are mesenchymal tumors consisting of blood vessels, smooth muscles and fat cells. The patient received anti-proliferative treatment with Afinitor, a mammalian target of rapamycin (mTOR) inhibitor, and was referred again one month after onset of therapy for early response assessment. The follow-up (18)F-FDG PET/CT scan showed a nearly complete resolution of the previously detected adrenal mass, with very low tracer uptake and a decrease in its functional volume. Fluorine- 18-FDG PET/CT can be used for treatment response evaluation of angiomyolipoma treated with mTOR-inhibitors.

PMID: 28697195 [PubMed - as supplied by publisher]

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Enhancing contrast agents and radiotracers performance through hyaluronic acid-coating in neuroradiology and nuclear medicine.

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Enhancing contrast agents and radiotracers performance through hyaluronic acid-coating in neuroradiology and nuclear medicine.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Ganau M, Syrmos NC, D'Arco F, Ganau L, Chibbaro S, Prisco L, Ligarotti GKI, Ambu R, Soddu A

Abstract
The use of hyaluronic acid nanoshells has been proposed to encapsulate prodrugs and exploit the mechanisms of interactions between living cells, like endocytes or cancer cells and hyaluronic acid, which is a natural component of the extracellular matrix. In this review we describe the potential and the limits of this promising research trend and discuss the theoretical advantages of such an engineering approach. Is it a possible scalability to increase the efficacy and biodegradability of molecules like contrast media and radiotracers especially for neuroradiology and nuclear medicine studies.

PMID: 28697194 [PubMed - as supplied by publisher]

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The value of (18)FDG PET/CT parameters, hematological parameters and tumor markers in predicting KRAS oncogene mutation in colorectal cancer.

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The value of (18)FDG PET/CT parameters, hematological parameters and tumor markers in predicting KRAS oncogene mutation in colorectal cancer.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Oner AO, Budak ES, Yıldırım S, Aydın F, Sezer C

Abstract
OBJECTIVE: In this study we investigated the predictive value of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), neutrophils/lymphocytes ratio (NLR), platelets/lymphocytes ratio (PLR), carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) in the prediction of KRAS gene mutation which plays an important role in the choice of treatment in colorectal cancer patients.
SUBJECTS AND METHODS: A total of 55 cases with untreated colorectal cancer who had undergone both PET/CT examinations for initial staging and also mutation analysis of KRAS oncogene were studied. Fluorine-18-FDG PET/CT parameters (SUVmax, MTV, TLG), hematological parameters (NLR, PLR), and tumor markers (CEA, CA 19-9) were recorded and the relationship between these parameters and KRAS oncogene mutation was evaluated using receiver operating characteristics (ROC) analysis and multiple logistic regression analysis.
RESULTS: In 20 cases mutations in the KRAS gene were detected, while in 35 cases mutations were not observed (wild-type). ROC analysis revealed that SUVmax, MTV, TLG, NLR, PLR, and CA 19-9 could not predict mutations in KRAS oncogene (P=0.600, 0.263, 0.214, 0.057, 0.104, 0.189, respectively) although CEA value showed signi..cant difference (P=0.031) but without high value of the area under the curve (0.676). Multivariate logistic regression analysis also did not show significant association between KRAS gene mutations and SUVmax, MTV, TLG, NLR, PLR, CEA, CA 19-9 values.
CONCLUSION: We observed that in patients with colorectal cancers, we cannot predict KRAS gene mutations using PET/CT parameters (SUVmax, MTV, TLG), hematological parameters (NLR, PLR) or tumor marker CA 19-9. We detected a significant but not very strong association only between CEA and KRAS mutations.

PMID: 28697193 [PubMed - as supplied by publisher]

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A prototype PET/SPECT/X-rays scanner dedicated for whole body small animal studies.

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A prototype PET/SPECT/X-rays scanner dedicated for whole body small animal studies.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Rouchota M, Georgiou M, Fysikopoulos E, Fragogeorgi E, Mikropoulos K, Papadimitroulas P, Kagadis G, Loudos G

Abstract
OBJECTIVE: To present a prototype tri-modal imaging system, consisting of a single photon emission computed tomography (SPET), a positron emission tomography (PET), and a computed tomography (CT) subsystem, evaluated in planar mode.
MATERIALS AND METHODS: The subsystems are mounted on a rotating gantry, so as to be able to allow tomographic imaging in the future. The system, designed and constructed by our group, allows whole body mouse imaging of competent performance and is currently, to the best of our knowledge, unequaled in a national and regional level. The SPET camera is based on two Position Sensitive Photomultiplier Tubes (PSPMT), coupled to a pixilated Sodium Iodide activated with Thallium (NaI(Tl)) scintillator, having an active area of 5x10cm(2). The dual head PET camera is also based on two pairs of PSPMT, coupled to pixelated berillium germanium oxide (BGO) scintillators, having an active area of 5x10cm(2). The X-rays system consists of a micro focus X-rays tube and a complementary metal-oxide-semiconductor (CMOS) detector, having an active area of 12x12cm(2).
RESULTS: The scintigraphic mode has a spatial resolution of 1.88mm full width at half maximum (FWHM) and a sensitivity of 107.5cpm/0.037MBq at the collimator surface. The coincidence PET mode has an average spatial resolution of 3.5mm (FWHM) and a peak sensitivity of 29.9cpm/0.037MBq. The X-rays spatial resolution is 3.5lp/mm and the contrast discrimination function value is lower than 2%.
CONCLUSION: A compact tri-modal system was successfully built and evaluated for planar mode operation. The system has an efficient performance, allowing accurate and informative anatomical and functional imaging, as well as semi-quantitative results. Compared to other available systems, it provides a moderate but comparable performance, at a fraction of the cost and complexity. It is fully open, scalable and its main purpose is to support groups on a national and regional level and provide an open technological platform to study different detector components and acquisition strategies.

PMID: 28697192 [PubMed - as supplied by publisher]

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An innovative method for precise lymph node detection before surgical treatment.

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An innovative method for precise lymph node detection before surgical treatment.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Matovic M, Nikolic D, Filipovic N, Chen D, Jeremic M, Jankovic SM, Ninkovic S, Cvetkovic A, Vlajkovic M, Rankovic A

Abstract
OBJECTIVE: To describe a new method of 3D interactive modeling which integrates images obtained by separate SPET and multi slice computed tomography (MSCT) modalities using an original software in order to better localize SNL in BC patients.
SUBJECTS AND METHODS: We used technetium-99m-colloid rhenium sulphate for identifying SNL in seven patients with BC. Markers were made of lead pearls wrapped with cotton wool soaked in (99m)Tc-pertechnetate and placed on the skin of the patients forming of a triangle. Using an original software, two separate 3D models were made after SPET and MSCT imaging and then merged into a hybrid 3D model which enabled precise visualization and localization of the SNL.
RESULTS: In all cases the position of the SNL established by our method was successfully verified using a gamma probe. Duration of SNL identification and extirpation were significantly reduced in less than 10 minutes per patient. The reproducibility of this method was confirmed by precise identification and biopsy of the SNL.
CONCLUSION: We found this integrated SPET/MSCT 3D model to be much faster and easier to use as compared with the "classic" method, which was based on a radioactivity detection probe. In addition, our method was reproducible, accurate and of low cost. In other words, the method described in this paper could be very useful for health facilities with modest budget, because it obviates the need for buying expensive integrated SPET/MSCT hybrid imaging systems while detecting SNLs more accurately and in shorter time.

PMID: 28697191 [PubMed - as supplied by publisher]

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(18)F-FDG PET/CT and histology for diagnosing recurrent/remnant tumors in head and neck cancer patients treated with radiotherapy.

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(18)F-FDG PET/CT and histology for diagnosing recurrent/remnant tumors in head and neck cancer patients treated with radiotherapy.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Han EJ, O JH, Yoo IR, Kim YS, Kim MS, Kang JH, Choi WH

Abstract
OBJECTIVE: The aim of this study was to assess the diagnostic performance of fluorine-18-fluoro-2-deoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) for locoregional recurrent/residual tumor in patients with head and neck cancer (HNC) who underwent previous radiotherapy (RT).
SUBJECTS AND METHODS: (18)F-FDG PET/CT images from patients with HNC who previously underwent RT were retrospectively reviewed. Only cases with histological confirmation within 4 weeks of PET/CT imaging were included. Standardized uptake values were obtained for lesions and PET/CT findings were compared with histological results.
RESULTS: Of 181 cases, 114 (63%) were histologically confirmed as malignant and 67 (37%) as benign. The sensitivity, specificity, and accuracy of PET/CT were 93%, 64%, and 82%, respectively. Inflammation was the most common cause of false positives and small tumor volume and low (18)F-FDG avidity were the causes of false negatives. PET/CT had 100% sensitivity and 56% specificity for detecting recurrent or residual disease within 12 weeks after RT and 93% sensitivity and 64% specificity, more than 12 weeks after RT. The frequency of false positives in PET/CT images within 12 weeks of RT was similar to the results obtained 12 weeks after RT (15% vs. 14%). False positives were more frequent in PET/CT cases after two-dimensional or three-dimensional conformal RT than in those after intensity-modulated RT, although not statistically significant (15% vs. 9%, p>0.05).
CONCLUSION: (18)F-FDG PET/CT might aid the diagnosis of locoregional residual/recurrent tumors in patients with HNC previously treated with RT. Inflammation was the main cause of false positives regardless of the interval between RT and PET/CT, even several years after RT. Therefore, histological verification of positive PET/CT findings should be conducted during follow-up of HNC patients treated with RT.

PMID: 28697190 [PubMed - as supplied by publisher]

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Gallium-68-dotatate PET/CT is better than CT in the management of somatostatin expressing tumors: First experience in Africa.

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Gallium-68-dotatate PET/CT is better than CT in the management of somatostatin expressing tumors: First experience in Africa.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Lawal IO, Ololade KO, Lengana T, Reyneke F, Ankrah AO, Ebenhan T, Vorster M, Sathekge MM

Abstract
OBJECTIVE: In this study we aimed to present our experience on the use of Gallium-68-dotatate with positron emission tomography, computed tomography ((68) Ga-dotatate PET/CT) in the management of neuroendocrine tumors (NET) and other somatostatin expressing tumors.
SUBJECTS AND METHODS: We retrospectively reviewed patients with histologically confirmed or biochemically suspected NET and other somatostatin expressing (SSTR) tumors imaged at our department with (68)Ga-dotatate PET/CT. We determined the performance of this imaging technique as well as its impact on patients management. A total of 203 patients were studied: 103 females, 100 males median age 52years.
RESULTS: The commonest tumor type was gastroenteropancreatic NET (41% of patients) and the commonest sites of distant metastases were lymph nodes and the liver 34.0% and 30.5% respectively. Positron emission tomography detected foci of disease in 19 patients where CT was falsely negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (68) Ga-dotatate PET/CT imaging of NET and other SST expressing tumors were 94.16%, 91.89%, 95.55%, 89.47% and 96.55% respectively.
CONCLUSION: Gallium-68-dotatate PET/CT was better than CT in detecting primary sites of the disease and highly sensitive and specific for diagnosis and treatment of NET and other SSTR expressing tumors.

PMID: 28697189 [PubMed - as supplied by publisher]

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Impact of tall cell variant histology on predicting relapse and changing the management of papillary thyroid carcinoma patients.

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Impact of tall cell variant histology on predicting relapse and changing the management of papillary thyroid carcinoma patients.

Hell J Nucl Med. 2017 Jul 12;:

Authors: Gunalp B, Okuyucu K, Ince S, Ayan A, Alagoz E

Abstract
OBJECTIVE: There has been much discussion recently about the risk category of tall cell variant (TVC) histology and its effects on the management of papillary thyroid carcinoma (PTC). We, therefore, undertook a retrospective study to compare stage-matched risk factors and recurrence rates between classical PTC (cPTC) patients and patients with TCV histology.
SUBJECTS AND METHODS: A total of 3128 well-differentiated thyroid carcinoma patients who were treated and followed-up for more than 5 years in our clinic from 1995 to 2016 were included in this study. There were 2783 PTC (89%) patients, 1113 (40%) of them were cPTC and 56 (2%) of them were TCV patients.
RESULTS: In all stages, the stage-matched incidence of extrathyroidal extension (ETE), lymphovascular invasion and initial lymph node metastases were significantly higher in TCV patients than in cPTC patients (P<0.001). Recurrence was in 10 of 27 patients (37%) with TCV and in 91 of 890 (10%) patients with cPTC diagnosed in stage I (odds ratio (OR)=5.16); in 4 of 6 patients with TCV and 18 of 84 (21%) patients with cPTC in stage II (OR=7.33); in 5 of 6 patients with TCV and 11 of 46 (23%) patients with cPTC in stage III (OR=15.90); and in 13 of 17 patients with TCV and 31 of 93 (33%) patients with cPTC in stage IV (OR=6.50). Stage-matched recurrence rates were found significantly higher in all stages of TCV patients than in cPTC patients (OR=8.49, P<0.001). Recurrence with distant metastases was seen more frequently in TCV patients than in cPTC patients (P<0.001) and treatment of metastatic disease was more difficult in TCV patients.
CONCLUSION: Tall cell variant was an independent poor prognostic factor in papillary thyroid carcinoma patients even if they were diagnosed at early stages of the disease. Patients with tall cell variant histology required more aggressive therapeutic approach and closer follow-up than classical patients.

PMID: 28697188 [PubMed - as supplied by publisher]

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Can semiquantitative measurements of SUVmax and cut-off values differentiate malignant from benign colorectal cancer?

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Can semiquantitative measurements of SUVmax and cut-off values differentiate malignant from benign colorectal cancer?

Hell J Nucl Med. 2017 Jul 12;:

Authors: Nguyen T, Hess S, Petersen H, Alavi A, Høilund-Carlsen PF

Abstract
OBJECTIVE: We investigated maximum standardized uptake value (SUVmax) and cut-off values for differentiation of malignant and benign lesions in colorectal cancer (CC) as multiple studies have questioned their validity. We also investigated more extended indices using common semi-quantification analysis in incidental colorectal findings (ICF).
SUBJECTS AND METHODS: Fluorine-18-fluoro deoxy glucose positron emission tomography/computed tomography in 25 patients with a total of 30 focal ICF was retrospectively analysed using dedicated software. Method variability was tested through application of three common threshold-based lesion delineation techniques as well as a partial-volume correction (PVC). Lesion SUVmax, SUVmean, metabolically active volume (MAV) and mean total lesion glycolysis (TLG) were thereby extracted along with PVC corrected values (cSUVmean, cTLG) and SUVpeak.
RESULTS: In all lesions, SUVmax was >5 and SUVmean≥2.7. Malignant SUVmax values (mean±SD: 16.5±6.2) were overall significantly higher than benign levels (9.8±3.6). There was a substantial overlap with values in polyps/adenomas (14.4±7.7). Both SUVpeak and SUVmean showed similar characteristics. Malignant MAV and TLG showed more distinct levels. Though different segmentation methods introduced variations, largest in MAV (-58.6%-141.5%), and PVC generally increased measures significantly by a factor of 1.2-2.7, neither changed relative levels much. SUVmax values were inadequate for aetiological differentiation of ICF, which also precludes a clinically significant cut-off value. The same applies to SUVpeak and SUVmean while TLG measures may be more indicative.
CONCLUSION: Semi-quantitative measurements of SUVmax and cut-off values proved inadequate for differentiating colorectal malignancies from benign findings. While integrated measures, e.g. cTLG, are potentially better indicators of disease severity and extent, more optimal segmentation and PVC methods are required.

PMID: 28697187 [PubMed - as supplied by publisher]

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Whiplash Syndrome- a disorder of the brain?

Related Articles

Whiplash Syndrome- a disorder of the brain?

Hell J Nucl Med. 2017 Jul 12;:

Authors: Biendara J, Otte A

Abstract
In the past two decades much has been published on whiplash injury, yet both the confusion regarding the condition, and the medicolegal discussion about it have increased. In this paper, functional imaging research results are summarized using MRIcroGL 3D visualization software and assembled in an image comprising regions of cerebral activation and deactivation.

PMID: 28697186 [PubMed - as supplied by publisher]

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Contents of Previous Special Issues in this Series of Perspectives

Publication date: Available online 12 July 2017
Source:DNA Repair





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Zebularine induces replication-dependent double-strand breaks which are preferentially repaired by homologous recombination

Publication date: Available online 12 July 2017
Source:DNA Repair
Author(s): Manuel Luis Orta, Nuria Pastor, Estefanía Burgos-Morón, Inmaculada Domínguez, José Manuel Calderón-Montaño, Carlos Huertas Castaño, Miguel López-Lázaro, Thomas Helleday, Santiago Mateos
Zebularine is a second-generation, highly stable hydrophilic inhibitor of DNA methylation with oral bioavailability that preferentially target cancer cells. It acts primarily as a trap for DNA methyl transferases (DNMTs) protein by forming covalent complexes between DNMT protein and zebularine-substrate DNA. It's well documented that replication-blocking DNA lesions can cause replication fork collapse and thereby to the formation of DNA double-strand breaks (DSB). DSB are dangerous lesions that can lead to potentially oncogenic genomic rearrangements or cell death. The two major pathways for repair of DSB are non-homologous end joining (NHEJ) and homologous recombination (HR). Recently, multiple functions for the HR machinery have been identified at arrested forks. Here we investigate in more detail the importance of the lesions induced by zebularine in terms of DNA damage and cytotoxicity as well as the role of HR in the repair of these lesions. When we examined the contribution of NHEJ and HR in the repair of DSB induced by zebularine we found that these breaks were preferentially repaired by HR. Also we show that the production of DSB is dependent on active replication. To test this, we determined chromosome damage by zebularine while transiently inhibiting DNA synthesis. Here we report that cells deficient in single-strand break (SSB) repair are hypersensitive to zebularine. We have observed more DSB induced by zebularine in XRCC1 deficient cells, likely to be the result of conversion of SSB into toxic DSB when encountered by a replication fork. Furthermore we demonstrate that HR is required for the repair of these breaks. Overall, our data suggest that zebularine induces replication-dependent DSB which are preferentially repaired by HR.



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Experimental investigation of performance and emissions of a VCR diesel engine fuelled with n -butanol diesel blends under varying engine parameters

Abstract

The continuous rise in the cost of fossil fuels as well as in environmental pollution has attracted research in the area of clean alternative fuels for improving the performance and emissions of internal combustion (IC) engines. In the present work, n-butanol is treated as a bio-fuel and investigations have been made to evaluate the feasibility of replacing diesel with a suitable n-butanol-diesel blend. In the current research, an experimental investigation was carried out on a variable compression ratio CI engine with n-butanol-diesel blends (10–25% by volume) to determine the optimum blending ratio and optimum operating parameters of the engine for reduced emissions. The best results of performance and emissions were observed for 20% n-butanol-diesel blend (B20) at a higher compression ratio as compared to diesel while keeping the other parameters unchanged. The observed deterioration in engine performance was within tolerable limits. The reductions in smoke, nitrogen oxides (NO_x ), and carbon monoxide (CO) were observed up to 56.52, 17.19, and 30.43%, respectively, for B20 in comparison to diesel at rated power. However, carbon dioxide (CO₂) and hydrocarbons (HC) were found to be higher by 17.58 and 15.78%, respectively, for B20. It is concluded that n-butanol-diesel blend would be a potential fuel to control emissions from diesel engines.

Graphical abstract

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Intrarater Reliability and Agreement of Linear Encoder Derived Heel-Rise Endurance Test Outcome Measures in Healthy Adults

Publication date: Available online 12 July 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Christopher Byrne, David J. Keene, Sarah E. Lamb, Keith Willett
A linear encoder measuring vertical displacement during the heel-rise endurance test (HRET) enables the assessment of work and maximum height in addition to the traditional repetitions measure. We aimed to compare the test-retest reliability and agreement of these three outcome measures. Thirty-eight healthy participants (20 females, 18 males) performed the HRET on two occasions separated by a minimum of seven days. Reliability was assessed by the intraclass correlation coefficient (ICC) and agreement by a range of measures including the standard error of measurement (SEM), coefficient of variation (CV), and 95% limits of agreement (LoA). Reliability for repetitions (ICC = 0.77 (0.66, 0.85)) was equivalent to work (ICC = 0.84 (95% CI 0.76, 0.89)) and maximum height (ICC = 0.85 (0.77, 0.90)). Agreement for repetitions (SEM = 6.7 (5.8, 7.9); CV = 13.9% (11.9, 16.8%); LoA = -1.9 ± 37.2%) was equivalent to work (SEM = 419 J (361, 499 J); CV = 13.1% (11.2, 15.8%); LoA = 0.1 ± 34.8%) with maximum height superior (SEM = 0.8 cm (0.6, 1.0 cm); CV = 6.6% (5.7, 7.9%); LoA = 1.3 ± 17.1%). Work and maximum height demonstrated acceptable reliability and agreement that was at least equivalent to the traditional repetitions measure.



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Intra-operatively measured spastic semimembranosus forces of children with cerebral palsy

Publication date: Available online 12 July 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Can A. Yucesoy, Yener Temelli, Filiz Ateş
The knee kept forcibly in a flexed position is typical in cerebral palsy. Using a benchmark, we investigate intra-operatively if peak spastic hamstring force is measured in flexed knee positions. This tests the assumed shift of optimal length due to adaptation of spastic muscle and a decreasing force trend towards extension. Previously we measured spastic gracilis (GRA) and semitendinosus (ST) forces. Presently, we studied spastic semimembranosus (SM) and tested the following hypotheses: spastic SM forces are (1) high in flexed and (2) low in extended positions. We compared the data to those of GRA and ST to test (3) if percentages of peak force produced in flexed positions are different. During muscle lengthening surgery of 8 CP patients (9 years, 4 months; GMFCS levels=II-IV; limbs tested=13) isometric SM forces were measured from flexion (120°) to full extension (0°). Spastic SM forces were low in flexed knee positions (only 4.2% (3.4%) and 10.7% (9.7%) of peak force at KA=120° and KA=90° respectively, indicating less force production compared to the GRA or ST) and high in extended knee positions (even 100% of peak force at KA=0°). This indicates absence of strong evidence for shift of optimal muscle length of SM towards flexion.



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Occurrence and risk assessment of antidepressants in Huangpu River of Shanghai, China

Abstract

Antidepressants are gaining public attention because of increasing reports of their occurrence in environment and their potential impact on ecosystems and human health. Continuous input of pharmaceuticals into rivers, through psychiatric hospital or wastewater treatment plant (WWTPs) effluent, may cause adverse effects on the aquatic ecosystems of the receiving water bodies. This work investigates the occurrence and sources of 8 antidepressants in main stream and tributaries of Huangpu River in Shanghai. The detected concentrations of the selected antidepressants ranged from low nanogram per liter to 42.9 ng L⁻¹ (fluoxetine) in main stream and ranged from low nanogram per liter to 33.7 ng L⁻¹ (fluoxetine) in tributaries. To study the effect of hospital or wastewater treatment plants (WWTPs) on environment, the upstream and downstream samples were analyzed. Generally, antidepressants had greater concentrations in downstream than that in upstream of the WWTPs or hospitals. It is suggesting that WWTPs and hospitals may introduce pollution into water environment. A preliminary risk assessment was conducted: none of the eight target compounds yielded risk quotient (RQ) values more than 0.1, thus indicating that no adverse effect is expected in water environment. These results will provide background data for future antidepressants pollution control and management in Shanghai, China.

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Risk assessment of heavy metals in soil of Tongnan District (Southwest China): evidence from multiple indices with high-spatial-resolution sampling

Abstract

Assessment of heavy metal (HM) pollution in soil is critical for human health, ecological remediation, and soil conservation. In this study, statistical analyses and geochemical approaches such as enrichment factor (EF), the index of geoaccumulation (Igeo), and potential ecological risk index (RI) were used for characterization and risk assessment of soil HMs through a high-spatial-resolution 385 samples from Tongnan District, an important agricultural practice area in Chongqing Municipality in Southwest China. Igeo and EF indicated that Hg and Cd could be considered as low and moderate polluted, respectively, and others HMs were not a major concern. Comprehensive ecological risk information further demonstrated that the HMs have caused a moderate risk. Principal component analysis (PCA) extracted two principal components (PCs) with eigenvalue >1 explaining about 66.1% of the total variance in the HM data sets, demonstrating major source of anthropogenic activity, phosphate fertilizers, vehicle, and pesticides. These multi-index methods have the capacity of HM assessment in soil, which are useful for soil conservation and ecological remediation.

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Soy molasses as a fermentation substrate for the production of biosurfactant using Pseudomonas aeruginosa ATCC 10145

Abstract

Soy molasses is a product co-generated during soybean processing that has high production and low commercial value. Its use has great potential in fermentative processes due to the high concentration of carbohydrates, lipids and proteins. This study investigated the use of Pseudomonas aeruginosa to produce biosurfactants in a soy molasses-based fermentation medium. A central composite design (CCD) was prepared with two variables and three replicates at the central point to optimize the production of biosurfactant. The concentration of soy molasses had values between 29.3 and 170.7 g/L and the initial concentration of microorganism varied between 0.2 and 5.8 g/L. All the experiments were performed in duplicate on a shaker table at 30.0 ± 1.0 °C and 120 rpm for 72 h with samples taken every 12 h. Thus, to validate the experiments, the values of 120 g/L for the initial concentration of soy molasses and 4 g/L for the initial concentration of microorganisms were used. In response, the following values were obtained at 48 h of fermentation: surface tension of 31.9 dyne/cm, emulsifying index of 97.4%, biomass concentration of 11.5 g/L, rhamnose concentration of 6.9 g/L and biosurfactant concentration of 11.70 g/L. Further analysis was carried out for critical micelle concentration (CMC) which was obtained at approximately 80 mg/L. The bands found in Fourier transform infrared spectroscopy analysis had characteristic glycolipids as reported in the literature. These values show a great potential for biosurfactant production using soy molasses as a substrate and bacteria of the species P. aeruginosa.

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Assessment of potential health risk of fluoride consumption through rice, pulses, and vegetables in addition to consumption of fluoride-contaminated drinking water of West Bengal, India

Abstract

A study was conducted in fluoride-affected Bankura and Purulia districts of West Bengal to assess the potential health risk from fluoride exposure among children, teenagers, and adults due to consumption of rice, pulses, and vegetables in addition to drinking water and incidental ingestion of soil by children. Higher mean fluoride contents (13–63 mg/kg dry weight) were observed in radish, carrot, onion bulb, brinjal, potato tuber, cauliflower, cabbage, coriander, and pigeon pea. The combined influence of rice, pulses, and vegetables to cumulative estimated daily intake (EDI) of fluoride for the studied population was found to be 9.5–16%. Results also showed that intake of ivy gourd, broad beans, rice, turnip, fenugreek leaves, mustard, spinach, and amaranth grown in the study area is safe at least for time being. The cumulative EDI values of fluoride (0.06–0.19 mg/kg-day) among different age group of people of the study area were evaluated to be ~10⁴ times higher than those living in the control area; the values for children (0.19 and 0.52 mg/kg-day for CTE and RME scenarios, respectively) were also greater than the "Tolerable Upper Intake Level" value of fluoride. The estimated hazard index (HI) for children (3.2 and 8.7 for CTE and RME scenarios, respectively) living in the two affected districts reveals that they are at high risk of developing dental fluorosis due to the consumption of fluoride-contaminated rice, pulses, and vegetables grown in the study area in addition to the consumption of contaminated drinking water.

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The necessity of intrathecal chemotherapy for the treatment of breast cancer patients with leptomeningeal metastasis: A systematic review and pooled analysis

Publication date: Available online 12 July 2017
Source:Current Problems in Cancer
Author(s): Yen-Chien Lee, Chung-Cheng Hsieh, Jen-Pin Chuang, Chung-Yi Li
BackgroundLeptomeningeal carcinomatosis is a devastating disease. Despite its numerous complications, intrathecal (IT) chemotherapy remains a longstanding treatment for leptomeningeal carcinomatosis. Using case studies with internationally reported results, we attempted to determine the necessity of IT chemotherapy in treating leptomeningeal carcinomatosis.MethodsWe conducted a systematic review and pooled analysis to compare hormone therapy, chemotherapy, and IT therapy. We excluded articles on IT trastuzumab therapy. We performed our literature search without language restriction. We retrieved articles that were published by as late as July 19, 2016. The present study was performed in accordance with the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis. The Cox proportional hazard regression model was performed to examine the effects of prognostic variables.ResultsA total of 34 patients from 32 studies were considered eligible. The median age of the patients in the hormone treatment, chemotherapy, and IT therapy groups was 46, 51.5, and 51 years, respectively. The median overall survival (OS) of the patients in the hormone treatment, chemotherapy, and IT therapy groups was 65, 52, and 41 weeks, respectively. One patient who received hormone therapy exhibited the longest survival of approximately 8.5 years. Only magnetic resonance imaging response was associated with overall survival (hazard ratio=0.05, 95% confidence interval 0.00–0.74; p=0.03). Hormone status, HER2 status, age, central nervous system (CNS) radiation therapy, IT therapy, metastasis sites (CNS only vs. others), and cerebrospinal fluid responses were all not associated with overall survival.ConclusionGiven its obvious side effects and lack of evidence of effectiveness from prospective randomized clinical trials, IT chemotherapy should be used with caution in the treatment of LM breast cancer patients.



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An alternative screening model for the estimation of outdoor air concentration at large contaminated sites

Publication date: September 2017
Source:Atmospheric Environment, Volume 165
Author(s): Iason Verginelli, Massimo Nocentini, Renato Baciocchi
Simplified analytical solutions of fate and transport models are often used to carry out risk assessment on contaminated sites, to evaluate the long-term air quality in relation to volatile organic compounds in either soil or groundwater. Among the different assumptions employed to develop these solutions, in this work we focus on those used in the ASTM-RBCA "box model" for the evaluation of contaminant dispersion in the atmosphere. In this simple model, it is assumed that the contaminant volatilized from the subsurface is dispersed in the atmosphere within a mixing height equal to two meters, i.e. the height of the breathing zone. In certain cases, this simplification could lead to an overestimation of the outdoor air concentration at the point of exposure. In this paper we first discuss the maximum source lengths (in the wind direction) for which the application of the "box model" can be considered acceptable. Specifically, by comparing the results of "box model" with the SCREEN3 model of U.S.EPA we found that under very stable atmospheric conditions (class F) the ASTM-RBCA approach provides acceptable results for source lengths up to 200 m while for very unstable atmospheric conditions (class A and B) the overestimation of the concentrations at the point of the exposure can be already observed for source lengths of only 10 m. In the latter case, the overestimation of the "box model" can be of more than one order of magnitude for source lengths above 500 m. To overcome this limitation, in this paper we introduce a simple analytical solution that can be used for the calculation of the concentration at the point of exposure for large contaminated sites. The method consists in the introduction of an equivalent mixing zone height that allows to account for the dispersion of the contaminants along the source length while keeping the simplistic "box model" approach that is implemented in most of risk assessment tools that are based on the ASTM-RBCA standard (e.g. RBCA toolkit). Based on our testing, we found that the developed model replicates very well the results of the more sophisticated dispersion SCREEN3 model with deviations always below 10%. The key advantage of this approach is that it can be very easily incorporated in the current risk assessment screening tools that are based on the ASTM standards while ensuring a more accurate evaluation of the concentration at the point of exposure.



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Aerosol radiative effect in UV, VIS, NIR, and SW spectra under haze and high-humidity urban conditions

Publication date: October 2017
Source:Atmospheric Environment, Volume 166
Author(s): Ming Zhang, Yingying Ma, Wei Gong, Lunche Wang, Xiangao Xia, Huizheng Che, Bo Hu, Boming Liu
Aerosol properties derived from sun-photometric observations at Wuhan during a haze period were analyzed and used as input in a radiative transfer model to calculate the aerosol radiative effect (ARE) in ultraviolet (UV), visible (VIS), near-infrared (NIR), and shortwave (SW) spectra. The results showed that the aerosol optical depth (AOD) at 440 nm increased from 0.32 under clear-air conditions to 0.85 during common haze and 1.39 during severe haze. An unusual inverse relationship was found between the Ångström exponent (AE) and AOD during the haze period at Wuhan. Under high-humidity conditions, the fine-mode median radius of aerosols increased from 0.113 μm to approximately 0.2–0.5 μm as a result of hygroscopic growth, which led to increases in the AOD and decreases in the AE simultaneously. These changes were responsible for the inverse relationship between AE and AOD at Wuhan. The surface ARE in the UV (AREUV), VIS (AREVIS), NIR (ARENIR), and SW (ARESW) spectra changed from −4.46, −25.37, −12.15, and −41.99 W/m² under clear-air conditions to −9.48, −53.96, −29.81, and −93.25 W/m² during common hazy days and −12.89, −80.16, −55.17, and −148.22 W/m² during severe hazy days, respectively, and the percentages of AREUV, AREVIS, and ARENIR in ARESW changed from 11%, 61%, and 28%–9%, 54%, and 37%, respectively. Meanwhile, the ARE efficiencies (REE) in SW varied from −206.5 W/m² under clear-air conditions to −152.94 W/m² during the common haze period and −131.47 W/m² during the severe haze period. The smallest decreasing rate of the REE in NIR was associated with the increase of ARENIR. The weakened REE values were related to the strong forward scattering and weak backward scattering of fine aerosol particles with increasing size resulting from hygroscopic growth, while the variation of the single scattering albedo showed less impact. Source region analysis by back trajectories and the concentration weighted trajectory (CWT) method showed that black carbon came from nearby regions with low trajectories, and the surrounding haze areas were major sources of fine-mode particles in the haze in Wuhan.



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Emissions from prescribed burning of agricultural fields in the Pacific Northwest

Publication date: October 2017
Source:Atmospheric Environment, Volume 166
Author(s): A.L. Holder, B.K. Gullett, S.P. Urbanski, R. Elleman, S. O'Neill, D. Tabor, W. Mitchell, K.R. Baker
Prescribed burns of winter wheat stubble and Kentucky bluegrass fields in northern Idaho and eastern Washington states (U.S.A.) were sampled using ground-, aerostat-, airplane-, and laboratory-based measurement platforms to determine emission factors, compare methods, and provide a current and comprehensive set of emissions data for air quality models, climate models, and emission inventories. Batch measurements of PM2.5, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), and polychlorinated dibenzodioxins/dibenzofurans (PCDDs/PCDFs), and continuous measurements of black carbon (BC), particle mass by size, CO, CO2, CH4, and aerosol characteristics were taken at ground level, on an aerostat-lofted instrument package, and from an airplane. Biomass samples gathered from the field were burned in a laboratory combustion facility for comparison with these ground and aerial field measurements. Emission factors for PM2.5, organic carbon (OC), CH4, and CO measured in the field study platforms were typically higher than those measured in the laboratory combustion facility. Field data for Kentucky bluegrass suggest that biomass residue loading is directly proportional to the PM2.5 emission factor; no such relationship was found with the limited wheat data. CO2 and BC emissions were higher in laboratory burn tests than in the field, reflecting greater carbon oxidation and flaming combustion conditions. These distinctions between field and laboratory results can be explained by measurements of the modified combustion efficiency (MCE). Higher MCEs were recorded in the laboratory burns than from the airplane platform. These MCE/emission factor trends are supported by 1–2 min grab samples from the ground and aerostat platforms. Emission factors measured here are similar to other studies measuring comparable fuels, pollutants, and combustion conditions. The size distribution of refractory BC (rBC) was single modal with a log-normal shape, which was consistent among fuel types when normalized by total rBC mass. The field and laboratory measurements of the Angstrom exponent (α) and single scattering albedo (ω) exhibit a strong decreasing trend with increasing MCEs in the range of 0.9–0.99. Field measurements of α and ω were consistently higher than laboratory burns, which is likely due to less complete combustion. When VOC emissions are compared with MCE, the results are consistent for both fuel types: emission factors increase as MCE decreases.

Graphical abstract

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Bactericidal activity of Cu-, Zn-, and Ag-containing zeolites toward Escherichia coli isolates

Abstract

Two types of zeolites—natural clinoptilolite (NZ) and synthetic zeolite A (A)—were enriched with approx. 0.25 mmol of Cu(II), Zn(II), or Ag(I) ions, and the obtained materials (M-Z) were tested against three different isolates of Escherichia coli. Two isolates were environmental isolates from waters in Serbia whereas the third one was DSM 498. Antibacterial activity was studied in different water media—nutrient-rich media (peptone water), water from Sava Lake, and commercially available spring water. The Ag-containing zeolites showed bactericidal activity in the nutrient-rich peptone water after 1 h of contact. Cu- and Zn-containing zeolites showed bactericidal activity in real water samples. Antibacterial activity of the M-Z decreases in all three examined water media in the following order: Ag-NZ ≈ Ag-A > Cu-NZ ≈ Cu-A > Zn-NZ >>> Zn-A, suggesting that mainly the metal type and not the zeolite type have a role in the antibacterial activity. Leaching experiments showed small amounts of the leached Cu(II) and Zn(II) ions, indicating that the antibacterial activity is not due to the metal ions but should be attributed to the M-Z itself. However, leached amounts of Ag(I) from Ag-NZ and Ag-A in peptone water indicate that the released Ag(I) could be mainly responsible for the bactericidal effect of the Ag(I)-containing zeolites. Since no loss of cellular material was found, the antibacterial activity is not attributed to cytoplasmic membrane damage.

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Time series analysis of ambient air pollution effects on daily mortality

Abstract

Although the growths of ambient pollutants have been attracting public concern, the characteristic of the associations between air pollutants and mortality remains elusive. Time series analysis with a generalized additive model was performed to estimate the associations between ambient air pollutants and mortality outcomes in Shenzhen City for the period of 2012–2014. The results showed that nitrogen dioxide (NO₂)-induced excess risks (ER) of total non-accidental mortality and cardiovascular mortality were significantly increased (6.05% (95% CI 3.38%, 8.78%); 6.88% (95% CI 2.98%, 10.93%), respectively) in interquartile range (IQR) increase analysis. Also, these associations were strengthened after adjusting for other pollutants. Moreover, similar associations were estimated for sulfur dioxide (SO₂), particulate matter with an aerodynamic diameter of <10 μm (PM₁₀), and total non-accidental mortality. There were significant higher ERs of associations between PM₁₀ and mortality for men than women; while there were significant higher ERs of associations between PM₁₀/NO₂ and mortality for elders (65 or elder) than youngers (64 or younger). Season analyses showed that associations between NO₂ and total non-accidental mortality were more pronounced in hot seasons than in warm seasons. Taken together, NO₂ was positively associated with total non-accidental mortality and cardiovascular mortality in Shenzhen even when the concentrations were below the ambient air quality standard. Policy measures should aim at reducing residents' exposure to anthropogenic NO₂ emissions.

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Response to Letter to the Editor: Safety of transcranial direct current stimulation: Evidence based update 2016

Publication date: Available online 12 July 2017
Source:Brain Stimulation
Author(s): Marom Bikson, Pnina Grossman, Adantchede Louis Zannou, Greg Kronberg, Dennis Truong, Paulo Boggio, Andre R. Brunoni, Leigh Charvet, Felipe Fregni, Brita Fritsch, Bernadette Gillick, Roy H. Hamilton, Benjamin M. Hampstead, Adam Kirton, Helena Knotkova, David Liebetanz, Anli Liu, Colleen Loo, Michael A. Nitsche, Janine Reis, Jessica D. Richardson, Alexander Rotenberg, Peter E. Turkeltaub, Adam J. Woods




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Transient anger attacks associated with bifrontal transcranial direct current stimulation

Publication date: Available online 12 July 2017
Source:Brain Stimulation
Author(s): Galen Chin-Lun Hung, Ming-Chyi Huang




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Bacteria Tell Us How to Protect Our Intestine

Publication date: 12 July 2017
Source:Cell Host & Microbe, Volume 22, Issue 1
Author(s): George Birchenough, Gunnar C. Hansson
The inner colon mucus layer capacity to separate bacteria from the epithelium is dependent on bacterial colonizers signaling to the host epithelium. In this issue of Cell Host & Microbe, Wlodarska et al. (2017) demonstrate that the mucin-utilizing Peptostreptococcus russellii protects the host from inflammatory disease via metabolite signals.

Teaser

The inner colon mucus layer capacity to separate bacteria from the epithelium is dependent on bacterial colonizers signaling to the host epithelium. In this issue of Cell Host & Microbe, Wlodarska et al. (2017) demonstrate that the mucin-utilizing Peptostreptococcus russellii protects the host from inflammatory disease via metabolite signals.


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