ABSTRACT
BACKGROUND: The declining mortality rate of patients with colorectal cancer (CRC) can be explained, at least partially, with early diagnosis. Simple diagnostic methods are needed to achieve a maximal patient participation rate in screening. MATERIALS AND METHODS: Liquid chromatography electrospray tandem mass spectrometry (LC-MS/MS) was used to determine urinary polyamine (PA) profiles. In a prospective setting, 116 patients were included in the study: 57 with CRC, 13 with inflammatory bowel disease (IBD), 12 with adenoma, and 34 controls. RESULTS: N1,N12-diacetylspermine (DiAcSPM) level was significantly higher in patients with CRC than controls (sensitivity=78.0%, specificity=70.6%; p=0.00049). The level of diacetylated cadaverine (p=0.0068) was lower and that of diacetylated putrescine (p=0.0078) was higher in patients with CRC than in those with IBD. Cadaverine (p=0.00010) and spermine (p=0.042) levels were lower and that of DiAcSPM (p=0.018) higher in patients with CRC than in those with adenoma. CONCLUSION: The simultaneous determination of urinary PAs by means of LC-MS/MS can be used to discriminate CRC from controls and patients with benign colorectal diseases.
Subject(s)
Biomarkers, Tumor/urine , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/urine , Polyamines/urine , Adult , Aged , Chromatography, Liquid/methods , Early Diagnosis , Female , Humans , Male , Middle Aged , Prospective Studies , Sensitivity and Specificity , Spermine/analogs & derivatives , Spermine/urine , Tandem Mass Spectrometry/methodsABSTRACT
PURPOSE: To compare cardiac MRI and radionuclide ventriculography (RVG) in cardiac monitoring during anthracycline (doxorubicin)-based chemotherapy. MATERIALS AND METHODS: We studied 10 previously untreated adult non-Hodgkin lymphoma patients. Left ventricular ejection fraction (LVEF) was assessed by MRI and RVG simultaneously. In addition, left ventricular (LV) and left atrial size were determined by MRI. Both MRI and RVG measurements were determined at baseline and then repeated after eight cycles of CHOP chemotherapy (cumulative doxorubicin dose of 400 mg/m²). Power calculations were made on the basis of reproducibility measurements. RESULTS: Clinical heart failure was not observed in any patient during the study. MRI detected a statistically significant increase in LV end-diastolic volume (128 ± 39 vs. 151 ± 46 ml, P<0.05) and LV mass (119 ± 32 vs. 146 ± 49 g, P<0.05) after doxorubicin therapy but no change in LVEF (46 ± 8 vs. 47 ± 11%, P=NS) or left atrial area. A significant LVEF reduction compared with baseline was observed by RVG (61 ± 10 vs. 50 ± 6%, P<0.01). On average, MRI resulted in 7 ± 10% lower LVEF values compared with RVG. CONCLUSION: RVG seems to be a valuable and repeatable tool in detecting early, subclinical deterioration in cardiac function and is the method of choice in the follow-up of LV function during anthracycline-based chemotherapy. Whether LV volumetric and mass changes found in MRI could predict later significant permanent cardiac damage should be evaluated in larger studies with long-term follow-up.
Subject(s)
Antibiotics, Antineoplastic/therapeutic use , Doxorubicin/therapeutic use , Heart Diseases/diagnostic imaging , Lymphoma, Non-Hodgkin/drug therapy , Stroke Volume/physiology , Ventricular Function, Left/physiology , Adult , Aged , Antibiotics, Antineoplastic/adverse effects , Doxorubicin/adverse effects , Female , Follow-Up Studies , Heart Diseases/chemically induced , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Prospective Studies , Radionuclide Ventriculography , Reproducibility of Results , Stroke Volume/drug effects , Treatment Outcome , Ventricular Function, Left/drug effectsABSTRACT
Ascites is an accumulation of fluid into the peritoneal cavity. Most often it is an end-complication of chronic liver disease. Other reasons for ascites should be considered sometimes in clinical practice. We present a patient who had primary (AL) amyloidosis as the reason for remarkable amount of ascites. The prognosis of amyloidosis is poor especially if the diagnosis is delayed.
