Diagnostic accuracy of (18)F-FDG-PET/CT in early and late stages of high-risk cutaneous malignant melanoma.

BACKGROUND: The precise role of total body (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) in the clinical management of patients with cutaneous malignant melanoma (CMM) is not well established. OBJECTIVE: The purpose of this study was to investigate the diagnostic accuracy of PET/CT in early- and late-stage patients with high-risk CMM. METHODS: We retrospectively analysed various imaging, histopathological and clinical data from 97 patients also examined by PET/CT during a 5-year period (2007-2011). Three groups were assessed: stage I/II, resected stage III and unresectable stage III/stage IV. RESULTS: The median follow-up time of living patients was 43.48 ± 19.67 (15-142) months. We observed a high diagnostic accuracy in all stages (91.3%, 92.5% and 96.2% respectively). PET/CT appeared to be reliable diagnostic tool even for the detection of small lymph node metastases. PET/CT was informative in 14 of 19 cases wherein another imaging examination provided inconclusive results regarding lesion dignity. However, PET/CT was less suitable for properly evaluating the dignity of a lung lesion. A true positive scan was twice as likely in clinically negative patients with resected stage III disease than in patients with stage I/II disease (35.9% and 14.5%, P = 0.007). CONCLUSIONS: These results confirm that PET/CT is an important diagnostic tool in the management of patients with high-risk CMM, but it cannot replace the standard of care examinations. More accurate clinicopathological and timing criteria must be defined to best utilize the advantages of this imaging method.

Treatment of partial thickness burns with Zn-hyaluronan: lessons of a clinical pilot study.

A clinical investigation to determine the effectiveness of Zn-hyaluronan gel for the treatment of partial thickness burns was carried out. 60 patients were enrolled in the study with an average of 3% TBSA burn. Exudation lasted 3 days, no infectious complications were observed. By day 14 the wounds of 52 patients have healed, average complete healing time was 10,5 days. An overall 93,3% healing rate was achieved within the planned observation period. Reduction of spontaneous and movementrelated pain was reduced to less than half of the initial values by day 5,5 and 6,3 respectively. Development of a thin, elastic, well tolerable and protective membrane-like layer was noted. This kept the wounds moist while clean during wound-healing, and was spontaneously shed as epithelisation proceeded. Zn-hyaluronan gel is a novel topical wound care product that has proven to be suitable for the treatment of partial thickness burns.

Long-term followup of dermal substitution with acellular dermal implant in burns and postburn scar corrections.

Full-thickness burn and other types of deep skin loss will result in scar formation. For at least partial replacement of the lost dermal layer, there are several options to use biotechnologically derived extracellular matrix components or tissue scaffolds of cadaver skin origin. In a survey, we have collected data on 18 pts who have previously received acellular dermal implant Alloderm. The age of these patients at the injury varied between 16 months and 84 years. The average area of the implants was 185 cm(2). Among those, 15 implant sites of 14 patients were assessed at an average of 50 months after surgery. The scar function was assessed by using the modified Vancouver Scar Scale. We have found that the overall scar quality and function was significantly better over the implanted areas than over the surrounding skin. Also these areas received a better score for scar height and pliability. Our findings suggest that acellular dermal implants are especially useful tools in the treatment of full-thickness burns as well as postburn scar contractures.

Evaluation of mortality following severe burns injury in Hungary: external validation of a prediction model developed on Belgian burn data.

PURPOSE: To evaluate mortality in a group of Hungarian burn patients and, as such, to perform an external validation of a prediction model developed on Belgian burn data by which the mortality appraisal was executed. BASIC PROCEDURES: In a historical cohort we analysed all burn patients admitted between 1998 and 2006 to the Debrecen University Hospital (n=2326). The prediction model, based on three criteria (age, burned surface area (BSA) and inhalation injury) was also used to evaluate several subpopulations based on gender and age. MAIN FINDINGS: Mean age was 35.3 years, mean BSA was 10.7%, 54% of the population was male, inhalation injury was rare (n=7; 0.3%) and overall mortality was 1.4% (1.6% male, 1.1% female). The men were younger and more severely burned, which was significant in every age group above 2 years. The model gave an accurate prediction of mortality, with a small overestimation in the lower risk categories. The receiver operating characteristic analysis demonstrated an area under the curve of 0.94 (95% confidence interval: 0.89-0.98). CONCLUSION: Overall burn mortality in Hungary was low. The mortality prediction model demonstrated a high discriminative value. As such, this model is a helpful tool for outcome prediction and risk stratification for research purposes in burn patients.

Simultaneous occurrence of Graves' disease with endocrine ophthalmopathy. Thyroiditis and thyroid carcinoma.

The simultaneous occurrence of Graves' disease with ophthalmopathy lymphocytic and subacute de Quervains' thyroiditis has been observed in two male patients suffering from follicular-type thyroid carcinoma. In one of them Sjögren syndrome and a mild form of diabetes were also diagnosed. It is assumed, on the basis of indirect evidence, that the humoral and cellular lesions determined by genetic factors and influenced by prolonged thyrostatic and steroid treatment are jointly responsible for tumour genesis.

Rapid clonal multiplication of Digitalis lanata in tissue culture.

Shoot cultures of Digitalis lanata have been established by inoculating the shoot tip of seedlings germinated in aseptic culture, or of field-grown plants, onto Linsmaier and Skoog's RM medium supplemented with 1 mg 6-benzylaminopurine and 0.1 mg indolacetic acid 1(-1). On this medium formation of up to 30 new axillary shoots could be induced. Shoots could be grown into functional plants after root induction on a medium containing reduced amounts (one-fifth of normal) of nitrogen and indolebutyric acid (0.5 mg 1(-1)).

Leukocyte migration test for the study of immune reactivity in cases of Graves disease associated with infiltrative ophthalmopathy.

The leukocyte migration test was carried out in 26 untreated cases of Graves disease, using crude thyroid extract, human eye muscle antigen and actomyosin as antigens. A significant reduction in the spontaneous (antigen-free) migration values was demonstrable in the cases of Graves disease, compared with the controls. The migration inhibition test gave positive results with the thyroid antigen in the hyperthyroid cases, in opposition to euthyroid ophthalmopathy, where it was found negative. The results were positive with retrobulbar muscle antigen in hyperthyroid and euthyroid infiltrative ophthalmopathy. In advanced cases of infiltrative ophthalmopathy, the results were positive with actomyosin as well.

Leukocyte migration inhibition in vitro in untreated and methimazole-treated patients with Graves disease.

The leukocyte migration tests has been applied to investigate immune-reactivity of 43 untreated and methimazole-treated patients against thyroid crude antigen. A significant migration inhibition was observed in 21 untreated patients, while in 22 methimazole-treated patients the migration test was negative independently of T3 suppressibility. Migration inhibition against thyroid antigen and purified protein derivative (PPD) was reduced or abolished after preincubation with methimazole of leukocytes of untreated patients. It seems that methimazole-treatment influences not only thyroid iodine metabolism, but by means of a direct effect on lymphocytes it also decreases the pathological stimulation.