Diagnostic evaluation of separately acquired PET and CT images by nuclear medicine physicians and radiologists in cancer patients.

The aim of our study was to analyze how many oncology patients might benefit from a) integrated positron emission tomography - multidetector computed tomography (PET/MDCT) and additionally b) clinically relevant information provided by either the CT scan or PET scan. A total of 285 consecutive patients 164 male and 121 female, age range 17-84 years, 153 lung cancer, 112 lymphoma, 20 miscellaneous, referred for PET and separate CT scan, were included. The CT scan was performed after the intravenous injection of a soluble contrast media. Patients were retrospectively classified into six Groups: Group I: No pathological uptake on the PET scan, Group II: Suspected lesions were correctly identified by the PET scan alone, Group III: Side-by-side evaluation of PET and CT appeared sufficient to assess the localization of lesions, Group IV: Side-by-side reading was not sufficient and integrated PET/CT was considered beneficial. Additionally all patients with a CT scan with additional clinical relevant information (not visualized by the PET scan) were classified in Group V. Group VI was set for lesions detected by PET alone (not visualized by the CT scan). The CT scan was used as the gold standard to confirm or disprove PET lesion localization. Our results showed: A number of 77 patients, (Group I: 77/285, 27%) had no pathologic fluorine-18-fluorodeoxyglucose (18F-FDG)-uptake. Lesions were correctly localized by either conventional PET alone (Group II: 76/285, 27%) or side-by-side evaluation of PET and CT scans (Group III: 44/285, 15%). Integrated PET/CT or software fusion, was considered beneficial in 31% (88/285) of the patients with pathological 18F-FDG-uptake (Group IV). Additionally to the above, in 15% of all patients clinically relevant information, referring to disseminated small pulmonary lesions, abdominal aortic aneurysms >5 cm, thrombi or pulmonary emboli, was also provided by the CT scan (Group V). Also, in 7% of all patients, unsuspected pathological lesions, mainly bone metastases, were correctly detected by PET alone (Group VI). In conclusion, in 54% of all oncologic patients, PET alone was diagnostic. In 46% of all patients side-by-side reading (15%) or integrated PET/CT images (31%) were considered beneficial for more accurate anatomical localization of the lesions. Additionally, the CT scan added clinically relevant information in 15% of all patients and the PET scan showed unsuspected metastases in 7% of all studied patients. Therefore, integrated reading of PET and MDCT images by nuclear physicians and radiologists may gain quality in the staging of oncology patients.

Infant mortality, ethnicity, and genetically determined disorders in The Netherlands.

BACKGROUND: Infant mortality of ethnic minorities in The Netherlands (10% of the population) is twice as high as in the indigenous Dutch population. Causes of death are different for the diverse migrant groups. METHODS: Hospital records of nearly 600 infants who died in the four major cities between 1995 and 1998 were analysed according to the cause of death, ethnicity, and possible heredity. RESULTS: There was a four to five times higher proportion of hereditary causes of death in the Moroccan and Turkish population, compared with the Surinamese/Antillians and indigenous Dutch. CONCLUSIONS: This might be explained by a high inbreeding coefficient as three-quarters of the marriage partners are recruited from the home villages and between a quarter and a third of these marriages are between first cousins. Health promotion activities in The Netherlands have not been successful so far. Preconception genetic counselling might help in reducing these differences.

Mechanisms underlying the aluminum-induced potentiation of the pro-oxidant properties of transition metals.

Aluminum is known to enhance the ability of iron to promote the generation of reactive oxygen species (ROS) but the mechanism subserving this is unknown. In an attempt to understand the means by which this potentiation occurs, several types of experiment have been conducted. It was found that iron must be in the ferrous form for aluminum-based stimulation of ROS to take place in a cerebral cortical synaptosomal-mitochondrial fraction. The ability of other transition metals of varying valences, copper and chromium, to catalyze formation of ROS was also increased in the presence of aluminum. Catalase but not superoxide dismutase blocked such stimulation suggesting hydrogen peroxide as an intermediate. The formation of aluminosilicates in the presence of brain tissue did not enhance iron-stimulated ROS formation. Furthermore, configurational changes of proteins which have been proposed to account for this phenomenon, do not appear to be a key element since iron-aluminum potentiation could be observed using protein-free liposomal micelles bearing an external negative charge.