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Background@#Pharmacological and non-pharmacological therapies have been used to treat patients with chemotherapy-induced peripheral neuropathy (CIPN). However, the effect of therapies in cancer patients has yet to be investigated comprehensively. We hypothesized that cyclic thermal therapy would improve blood flow and microcirculation and improve the symptoms driven by CIPN. @*Methods@#The criteria of assessment were blood volume in region of interest (ROI) in the images, and European Organization for Research and Treatment of Cancer–Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy 20 questionnaire scores. The blood volume was quantified by using red blood cell (RBC) scintigraphy. All patients were treated 10 times during 10 days. The thermal stimulations, between 15° and 41°, were repeatedly delivered to the patient’s hands. @*Results@#The total score of the questionnaires, the score of questions related to the upper limbs, the score of questions closely related to the upper limbs, and the score excluding the upper limbs questions was decreased. The blood volume was decreased, and the variance of blood volume was decreased. During cooling stimulation, the blood volume was decreased, and its variance was decreased. During warming stimulation, the blood volume was decreased, and its variance was decreased. @*Conclusions@#We suggest that cyclic thermal therapy is useful to alleviate CIPN symptoms by blood circulation improvement. RBC scintigraphy can provide the quantitative information on blood volume under certain conditions such as stress, as well as rest, in peripheral tissue.
RESUMEN
Background@#Pharmacological and non-pharmacological therapies have been used to treat patients with chemotherapy-induced peripheral neuropathy (CIPN). However, the effect of therapies in cancer patients has yet to be investigated comprehensively. We hypothesized that cyclic thermal therapy would improve blood flow and microcirculation and improve the symptoms driven by CIPN. @*Methods@#The criteria of assessment were blood volume in region of interest (ROI) in the images, and European Organization for Research and Treatment of Cancer–Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy 20 questionnaire scores. The blood volume was quantified by using red blood cell (RBC) scintigraphy. All patients were treated 10 times during 10 days. The thermal stimulations, between 15° and 41°, were repeatedly delivered to the patient’s hands. @*Results@#The total score of the questionnaires, the score of questions related to the upper limbs, the score of questions closely related to the upper limbs, and the score excluding the upper limbs questions was decreased. The blood volume was decreased, and the variance of blood volume was decreased. During cooling stimulation, the blood volume was decreased, and its variance was decreased. During warming stimulation, the blood volume was decreased, and its variance was decreased. @*Conclusions@#We suggest that cyclic thermal therapy is useful to alleviate CIPN symptoms by blood circulation improvement. RBC scintigraphy can provide the quantitative information on blood volume under certain conditions such as stress, as well as rest, in peripheral tissue.
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Purpose@#2-Deoxy-2-[18F] fluoro-d-glucose positron emission tomography (18F-FDG-PET) is a less-invasive and widely useddiagnostic tool for detection of malignant tumors. However, prolonged retention of 18F-FDG in the body increases radiationexposure. This study evaluated the effect of oral administration of milk and ursodeoxycholic acid (UDCA) in terms of reducingradiation exposure by 18F-FDG. @*Methods@#18F-FDG radioactivity was measured using a digital γ counter in the whole body and in various organs of rats after oraladministration of milk andmilk plusUDCA (milk + UDCA).Western blotting was performed to measure the expression levels ofG6Pase, HK 2, CREB, FoxO1, and PGC-1α in the brain, liver, small intestine, and large intestine to assess the mechanismunderlying the reduction in radiation exposure from 18F-FDG by oral administration of milk and UDCA. @*Results@#We found a significant reduction in 18F-FDG radioactivity in the whole body and in the brain, liver, and small and largeintestines. Expression of G6Pase was significantly increased in the above-mentioned organs in the milk and milk + UDCAgroups. Expression of HK 2 was significantly decreased in the brain and small intestine in the milk and milk + UDCA groups.CREB, FoxO1, and PGC-1α expression levels in the brain, liver, and small intestine were increased in the milk and milk +UDCA groups. However, expression of PGC-1α in the large intestine in the milk and milk + UDCA groups was significantlydecreased compared with that in the control group. @*Conclusion@#The present study demonstrated that administration of milk and UDCA increased G6Pase expression levels and 18FFDGrelease from the tissue. These results suggest milk and UDCA could be used to reduce radiation exposure from 18F-FDGafter image acquisition. The mechanisms underpinning this phenomenon should be explored in a human study.
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Hyperinsulinemic hypoglycemia in the absence of exogenous insulin use is caused by disorders such as insulinoma, diffuse beta-cell hyperplasia/nesidioblastosis, and autoimmune hypoglycemia. Nesidioblastosis is a rare cause of hypoglycemia in adults, accounting for 0.5~7.0% of organic hyperinsulinemia cases. Although pancreatic resection is considered the best treatment modality for curing nesidioblastosis, there is no consensus regarding the indications for and extent of the surgery due to its high risk and complication rate. A 75-year-old woman presented with an altered mental state, a mass suspected of being an insulinoma, and insulin receptor antibodies. The patient underwent surgery because of recurrent life-threatening hypoglycemia. Postoperative pathology of her pancreas revealed nesidioblastosis.