Outcomes of Gamma Knife Radiosurgery for Drug-Resistant Primary Trigeminal Neuralgia.

Objective: To evaluate the result of gamma knife radiosurgery (GKRS) for drug-resistant primary trigeminal neuralgia (TN). Methods: Patients who were diagnosed with drug-resistant primary TN were treated with GKRS at the Nuclear Medicine and Oncology Center, Bach Mai Hospital from January 2015 to June 2020. Using the pain rating scale of the Barrow Neurological Institute (BNI), follow-ups and evaluations were conducted at 1 month, 3 months, 6 months, and 9 month, and 1, 2 years, 3 years, and 5 years after radiosurgery. Comparisons of pain levels was performed before and after radiosurgery according to the BNI scale. Results: From January 2015 to June 2020, 33 patients were treated with GKS. There were 23 female patients and 10 male patients; the average age was 61.9. The average onset time of disease was 4.42 years. Among all patients, 84.8% of patients were relieved from pain and 78.8% were pain-free without medication. The mean time for pain relief was 3 months and was not related to the dose of GKS (<80 Gy and ≥80 Gy). The efficacy of pain relief is not related to blood vessel contact with the trigeminal nerve, the dose of GKS, and the onset of disease. The rate of recurrence after the first pain relief was low (14.3%). Conclusions: Gamma knife is an effective method for the treatment of primary drug-resistant TN, especially in elderly patients with underlying medical conditions. The analgesic effect does not depend on the presence of nerve-vascular conflict.

Investigation of ecological risk of microplastics in peatland areas: A case study in Vietnam.

This study aims to investigate the distribution and ecological risk assessment of microplastics (MPs) in peatland areas located in Long An province, Vietnam's Mekong Delta. In general, polyvinyl chloride (60.7%), polyethylene (25.8%), and polypropylene (11.9%) were the most abundant polymers determined in the thirty sediment samples. The hazard index (HI) remarked a level of III for MPs contamination in Tan Thanh and Thanh Hoa districts. The pollution load index (PLI) and potential ecological risk index (RI) indicated that the contamination risk of MPs polymer types in the studied sites is relatively high. According to PLI values, MPs levels of peatlands in Tan Thanh and Thanh Hoa are high and moderate, respectively, while the peatland sediments in Duc Hue district are less contaminated. Furthermore, ecological risk indexes in the peatland areas were relatively high, with PLIoverall (level III); HIoverall (level V), and RIoverall (extreme danger). Hence, this study proposed a SWOT framework for challenges of MPs pollution in order to manage peatlands appropriately and minimize ecological risks. As a result, several practical strategies and appropriate approaches have been recommended to reduce microplastics towards a circular economy. These findings provide the initial quantitative assessment insights into hazard levels and ecological impacts of MPs in Vietnam's Mekong Delta peatlands.

Prognostic Significance of PD-L1 Expression and Standardized Uptake Values in the Primary Lesions of Stage IV Adenocarcinoma Lung Cancer.

Background: This study evaluated the prognostic ability of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) in patients with stage IV adenocarcinoma lung cancer to detect protein death-ligand 1 (PD-L1) expression levels. Methods: In total, 86 patients with stage IV adenocarcinoma lung cancer underwent 18F-FDG PET/CT imaging and PD-L1 expression evaluation before treatment from February 2019 to November 2020 at Bach Mai Hospital, Hanoi, Vietnam. The assessed patient characteristics in this study included sex, age, smoking status, epidermal growth factor receptor (EGFR) mutation, PD-L1 expression level, survival status, tumor, node, and metastasis (TNM) stage, and metastasis locations. Results: The average age was 62.23 ± 9.51 years, and men and women represented 67.4% and 32.6% of the population, respectively. The EGFR mutation rate was 36%. PD-L1 expression was negative (detected in <1% of the tumor) in 40.7% of cases and positive in 59.3% of cases (detected in 1-49% of the tumor in 32.6%; detected in ≥50% of the tumor in 26.7%). The mean maximum standardized uptake value (SUVmax) was 11.09 ± 3.94. SUVmax was significantly higher in PD-L1-positive tumors than in PD-L1-negative tumors (12.24 ± 4.01 and 9.43 ± 3.22, respectively; p = 0.001). Receiver operating characteristic curve analysis revealed an area under the curve of SUVmax was 0.681 (95% confidence interval 0.570-0.793, p = 0.004). Compared with PD-L1-negative cases, SUVmax was significantly different in all PD-L1-positive cases (p = 0.001), weakly PD-L1-positive cases (1-49%, p = 0.005), and strongly PD-L1-positive cases (≥50%, p = 0.003). PD-L1 expression levels were significantly associated with SUVmax (p = 0.001), tumor size (p = 0.022), and EGFR mutation status (p = 0.045). Conclusions: SUVmax in the primary lesions was able to predict PD-L1 expression and may play a role in predicting PD-L1 immunotherapy efficacy in patients with stage IV lung adenocarcinoma.