El papel pronóstico de la PET/TC en el cáncer pulmonar de células pequeñas / The prognostic role of PET/CT in small-cell lung cancer

OBJETIVO: El propósito del presente estudio es determinar el valor pronóstico de los parámetros metabólicos relacionados con los tumores primarios detectados en los exámenes por tomografía por emisión de positrones/tomografía computarizada (PET/TC) del pretratamiento flúor-18 2-fluoro-2-desoxi-D-glucosa (18F FDG) de pacientes a los que se les ha diagnosticado cáncer pulmonar de células pequeñas (SCLC, por sus siglas en inglés). MATERIALES Y MÉTODOS: En este estudio retrospectivo se inscribieron 63 pacientes con un diagnóstico histopatológicamente confirmado de SCLC a los que se les aplicó un escáner PET/TC con 18F FDG en la línea basal. Se registraron la etapa de la enfermedad, la edad en su diagnóstico, el sexo, el nivel de albúmina y el valor máximo de captación estándar (SUVmax), SUVmean, el volumen de tumor metabólico (MTV) y los valores de glucólisis total de la lesión) relacionados con el tumor primario en el escáner PET de línea basal y se evaluó la relación de estos factores con la supervivencia libre de progresión (PFS) y la supervivencia global (OS). RESULTADOS: El estudio incluyó un total de 63 pacientes (10 mujeres, 53 hombres, con una edad media de 64,8 y un rango de edad de 43-82 años), 22 de los cuales tenía enfermedad limitada (LD) y 41 tenía enfermedad extendida (ED). Los OS y PFS fueron significativamente mayores en pacientes con LD que en pacientes con ED (15+/-2,9 ante 10+/-0,9 meses, p = 0,002 para OS; 10+/- 0,7 ante 6+/-0,6 meses, p = 0,014 para PFS). Sin embargo, no se identificó una relación estadísticamente significativa entre el sexo, el nivel de albúmina, la edad y los niveles SUVmax, SUVmean, MTV y TLG relacionados con el tumor primario y PFS u OS. CONCLUSIÓN: El presente estudio descubrió que los parámetros PET del pretratamiento no tenían valor predictivo para el PFS y OS en pacientes con SCLC

OBJECTIVE: The aim in the present study is to determine the prognostic value of metabolic parameters related to the primary tumors detected in pretreatment Fluorine-18 2-fluoro-2-Deoxy-D-glucose (18F FDG) positron emission tomography/computerized tomography (PET/CT) scans of patients diagnosed with small-cell lung cancer (SCLC). MATERIAL AND METHODS: Enrolled in this retrospective study were 63 patients with a histopathologically confirmed diagnosis of SCLC who underwent an 18F FDG PET/CT scan at baseline. Disease stage, age at diagnosis, gender, albumin level and maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values related to the primary tumor at the baseline PET scan were recorded, and the relationship of these factors with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The study included a total of 63 patients (10 female, 53 male, mean age of 64.8 and age range of 43-82 years), 22 of which had limited disease (LD) and 41 had extensive disease (ED). The OS and PFS were significantly higher in patients with LD than in patients with ED (15+/-2.9 vs. 10+/-0.9 months, p = 0.002 for OS; 10+/- 0.7 vs 6+/-0.6 months, p = 0.014 for PFS). However, no statistically significant relationship was identified between gender, albumin level, age and SUVmax, SUVmean, MTV, TLG values related to the primary tumor and PFS or OS. CONCLUSION: The present study found that pretreatment PET parameters were of not predictive value for PFS and OS in patients with SCLC

The prognostic role of PET/CT in small-cell lung cancer. / El papel pronóstico de la PET/TC en el cáncer pulmonar de células pequeñas.

OBJECTIVE: The aim in the present study is to determine the prognostic value of metabolic parameters related to the primary tumors detected in pretreatment Fluorine-18 2-fluoro-2-Deoxy-D-glucose (18F FDG) positron emission tomography/computerized tomography (PET/CT) scans of patients diagnosed with small-cell lung cancer (SCLC). MATERIAL AND METHODS: Enrolled in this retrospective study were 63 patients with a histopathologically confirmed diagnosis of SCLC who underwent an 18F FDG PET/CT scan at baseline. Disease stage, age at diagnosis, gender, albumin level and maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) values related to the primary tumor at the baseline PET scan were recorded, and the relationship of these factors with progression-free survival (PFS) and overall survival (OS) was evaluated. RESULTS: The study included a total of 63 patients (10 female, 53 male, mean age of 64.8 and age range of 43-82 years), 22 of which had limited disease (LD) and 41 had extensive disease (ED). The OS and PFS were significantly higher in patients with LD than in patients with ED (15±2.9 vs. 10±0.9 months, p = 0.002 for OS; 10± 0.7 vs 6±0.6 months, p = 0.014 for PFS). However, no statistically significant relationship was identified between gender, albumin level, age and SUVmax, SUVmean, MTV, TLG values related to the primary tumor and PFS or OS. CONCLUSION: The present study found that pretreatment PET parameters were of not predictive value for PFS and OS in patients with SCLC.

Insulin Resistance in Nonobese Renal Allograft Recipients on Maintenance Doses of Cyclosporine or Tacrolimus.

PURPOSE: In comparison to cyclosporine (CsA), tacrolimus (Tac) seems to be more diabetogenic in renal transplant recipients, and post-transplant diabetes mellitus is more common in patients using Tac, especially during the first year after transplantation. However, at maintenance doses, there are no comparative data of insulin resistance (IR) in patients using Tac or CsA. The purpose of this study was to investigate the IR indexes in patients on maintenance doses of CsA or Tac. METHODS: Forty-five nondiabetic and nonobese renal transplant recipients participated in the study (M:F, 30:15; age, 36 ± 9 years); 27 patients were on CsA, and 18 were on Tac. All had stable graft function, were transplanted at least 6 months previously, and were receiving maintenance doses of steroids (5.0 mg/d), azathioprine or mycophenolate mofetil, and calcineurin inhibitors (CsA [2.14 ± 0.46 mg/kg/d] or Tac [0.06 ± 0.03 mg/kg/d]). IR was evaluated by the homeostasis model assessment (HOMA) index and composite body insulin sensitivity index. RESULTS: We did not determine any significant difference in the HOMA and composite body insulin sensitivity index levels among patients using CsA or Tac (1.5 ± 1.3 vs 1.5 ± 1.1, P > .05, and 9.9 ± 5.8 vs 14.6 ± 11.7, P > .05, respectively). There was a significant correlation between creatinine and HOMA values. CONCLUSION: There was no difference in IR indexes in renal transplant recipients receiving maintenance doses of either CsA or Tac.

Risk factors for progression of renal disease in patient with diabetic nephropathy.

AIM: The aim of this study was to investigate the annual rate of glomerular filtration rate (GFR) decline and associated risk factors with this decline in diabetic nephropathy patients. PATIENTS AND METHODS: A total of 122 type 2 diabetes mellitus (DM) patients (66F, mean follow up time 39 +/- 19 months, mean age 56 +/- 10 years, mean duration of diabetes diagnosis 12.1 +/- 9.5 years) between 2003 and 2010 were evaluated retrospectively. Socio-demographic characteristics and blood pressure data, laboratory parameters, HbAlc, daily urine protein excretion both of the first and last visits of all patients were recorded. Patients were separated into three groups according to rate of GFR decline. Group 1 (n:35), group 2 (n:42) and group 3 (n:45) consisted of patients < 1 ml/dk/1.73 m2, 1-5 ml/dk/1.73 m2 and > 5 ml/dk/1.73 m2 annual rate of GFR decline respectively. Demographics, laboratory data and their treatments were compared in all three groups and were investigated factors that may influence the rate of GFR decline. RESULTS: The annual rate of GFR decline was 1.4 +/- 2.3 ml/sec, -2.9 +/- 1.0 ml/sec and -11.9 +/- 9.1 ml/sec in group 1, 2 and 3 respectively. Daily urine protein excretion was 0.9 +/- 1.3, 1.2 +/- 1.5 and 5.2 +/- 5.5 g in groups respectively, was found significantly higher in group 3 (p < 0.001). Serum albumin level was significantly lower in group 3 (p < 0.001). We found positive correlation between annual rate of GFR decline and last visit systolic blood pressure (SBP), daily proteinuria and parathormone levels (r: 0.339, 0.447 and 0.289 p < 0.001, < 0.001 and 0.02 respectively) and negative correlation between GFR decline and deltaSBP (delta systolic blood pressure), pretreatment albumin, calcium and hemoglobin levels (r: -0.409, -0.526, -0.233 and -0.467, p < 0.001, < 0.001, < 0.001 and 0.016 respectively). CONCLUSIONS: Proteinuria, hypoalbuminemia, anemia, and a change in SBP were found most effective in annual rate of GFR decline in patients with diabetic nephropathy. The early detection of these factors may slow the progression of nephropathy.

Effect of whey pH at drainage on physicochemical, biochemical, microbiological, and sensory properties of Mozzarella cheese made from buffalo milk during refrigerated storage.

The objective of this research was to determine the effect of drainage pH on physicochemical, biochemical, microbiological and sensory properties of Mozzarella cheese made from buffalo milk during refrigerated storage. Four vats of cheese were made at 4 different whey drainage pH (6.2, 5.9, 5.6, and 5.2). Lower drainage pH caused higher pH 4.4-soluble N and pH 4.4-soluble N:total N. Interaction of drainage pH at d 1 and 30 of storage on all soluble nitrogen fractions was significant. Degradation of caseins in samples made at a drainage pH of 6.2 was lower than that of other cheese samples. The decreasing whey drainage pH significantly increased counts of thermophilic and mesophilic lactobacilli of the samples during refrigerated storage. No coliforms or Escherichia coli were detected in the cheeses. The average sensory property scores of all cheese samples were very close, and, as expected, storage time had a negative effect on all sensory scores.

Early effects of fibrin sealant on colonic anastomosis in rats: an experimental and case-control study.

BACKGROUND: Leakage from colonic anastomoses leads to mortality and morbidity. Fibrin adhesives can be used to increase the strength of the anastomosis. In this study, we evaluated the early effects of fibrin sealant and hyaluronic acid-carboxymethylcellulose on colonic anastomosis in rats. METHODS: Anastomoses were made in the descending colon of 38 female Wistar-Albino rats, in three groups: control group (n = 12), group 1 treated with hyaluronic acid-carboxymethylcellulose (n = 16), and group 2 treated with fibrin sealant (n = 10). After 72 hours, adhesion scores, bursting pressure, rupture strength and histopathologic healing scores were evaluated. RESULTS: Due to postoperative mortality, we evaluated 10, 10 and 9 rats in the control group and in groups 1 and 2, respectively. Of these, we excluded 4, 5 and 4 rats that had macroperforations at autopsy. In the remaining rats, bursting pressure (123.2 +/- 14.8 mmHg) and rupture strength (400 +/- 16 mg) in the fibrin sealant group were significantly greater than in the two other groups ( CONTROL: 68.0 +/- 10.6 p = 0.006 and 325 +/- 52 p = 0.009; Group 1: 74.0 +/- 9.8 p = 0.03, 330 +/- 27 p = 0.016). However, we did not observe any significant difference between adhesion scores (2.5 +/- 0.6, 2.0 +/- 0.7, 2.0 +/- 0.7, p = 0.343). CONCLUSIONS: In this experimental study, fibrin sealant increased bursting pressure and rupture strength of colonic anastomoses while hyaluronic acid-carboxymethylcellulose had no effects in rats, but both of them showed no effect on adhesion scores. In order to use fibrin sealant to decrease the rate of early leakages from colonic anastomoses, further studies have to be performed.

Effects of vesicular-arbuscular mycorrhizal (VAM) fungi on the seedling growth of three Pistacia species.

The experiment was undertaken to test the efficiency of inoculation of vesicular-arbuscular mycorrhizal (VAM) fungi on the seedling growth of three Pistacia species used as rootstocks. The stratified Pistacia seeds were inoculated with VAM fungi. The highest rate of inoculated roots was 96.7% in P. khinjuck seedlings with G. clarum and G. etunicatum, 83.3% in P. vera seedlings with G. caledonium and 73.3% in P. terebinthus seedlings with G. caledonium. Mycorrhizal inoculations improved seedling height only in P. terebinthus. Certain mycorrhizal inoculations increased the leaf N, but not P and K contents. Seedlings inoculated with G. caledonium had higher reducing sugar contents. It was concluded that pre-inoculated Pistacia seedlings could have a better growth in the harsh field conditions.

Efficacy of an adenosine A1 receptor agonist compared with atropine and pralidoxime in a rat model of organophosphate poisoning.

The objective of this study was to evaluate the effects of an adenosine A1 agonist, phenylisopropyl adenosine (PIA), on metamidophos poisoning compared to specific antidotes. Rats were poisoned with metamidophos (30 mg/kg, oral) and observed for 24 hours. One group received sodium chloride (1 mL/kg) and four experimental groups received atropine (5 mg/kg), pralidoxime (PAM, 20 mg/kg), atropine/PAM (5/20 mg/kg) or PIA (1 mg/kg) intraperitoneally. Atropine reduced salivation and prevented respiratory distress when compared to sodium chloride-treated rats. Treatment with PAM did not cause any suppression of cholinergic signs. Atropine and PAM combination prevented salivation, convulsion and respiratory distress. PIA delayed initial time of the salivation, convulsion and time to death. However, PIA was found ineffective against the metamidophos-induced cholinergic symptoms and mortality. All treatments, except PIA, lead to survival of these animals. Acetylcholinesterase (AChE) activity was not normalized by PIA or PAM. PIA prevented metamidophos-induced diaphragmatic muscle necrosis as much as PAM. In conclusion, a single dose of PIA was unable to protect the rats from metamidophos toxicity. Further studies are needed involving a combination of PAM and/or atropine with repeated doses of PIA to clarify the efficacy of adenosine agonists in OP poisoning.

Comparison of the effects of acarbose and metformin use on ovulation rates in clomiphene citrate-resistant polycystic ovary syndrome.

BACKGROUND: The aim of this study was to evaluate the effects of metformin and acarbose on insulin resistance, hormone profiles and ovulation rates in patients with clomiphene citrate-resistant polycystic ovary syndrome (PCOS). METHODS: Thirty clomiphene citrate-resistant patients were selected randomly and divided into two groups. Group I was treated with 100 mg/day clomiphene citrate and 300 mg/day acarbose 100 mg/day orally, for 3 months. Group II was treated with clomiphene citrate 100 mg/day and metformin 1700 mg/day orally, for 3 months. Serum fasting insulin and glucose, FSH, LH, estradiol, progesterone, prolactin and total testosterone levels plus body mass index (BMI) were measured before and after treatment. Follicle growth was followed by transvaginal ultrasonography. RESULTS: LH:FSH ratio and total testosterone concentrations decreased (P<0.05) and ovulation rates increased in both groups. Reduction in weight and BMI was only significant in the acarbose group. CONCLUSIONS: Both treatment modalities were effective in the treatment of insulin resistance and improving ovulation rates. Increase in the number of eumenorrhoeic and normoinsulinaemic cases and decrease in the number of insulin-resistant cases were significant in both groups (P<0.05). Ovulation rate was greater in the metformin group in the second month of therapy (P<0.05). Acarbose was found to be a safe and effective agent that could be used in cases with clomiphene-resistant PCOS.

Radioprotective effects of exogenous glutathione against whole-body gamma-ray irradiation: age- and gender-related changes in malondialdehyde levels, superoxide dismutase and catalase activities in rat liver.

Age- and gender-related changes in malondialdehyde (MDA) levels, superoxide dismutase (SOD) and catalase (CAT) activities in rat livers exposed to different doses of whole-body gamma-ray radiation were determined. In addition, the effects of exogenous glutathione (GSH) against radiation injury in rat livers were investigated. We found that MDA levels have an age-associated increment and an increasing radiation dose-related elevation, although they decrease slightly in the 4 Gy group. The MDA levels in old rats were lower in males than in females, while those of young rats did not change. There were no observed age-related changes in SOD activities, although male rats had higher SOD activity than females. Female rats had the highest CAT activities in the 4 Gy group, while male rats had the highest CAT activities in the 6 Gy group. CAT activities in the 8 Gy group were lower than those of the 2 Gy group for each gender and age. While MDA levels were decreased and CAT activities increased by GSH, SOD activities remained unchanged. The results indicate that gamma-ray radiation affects gender- and age-dependent MDA levels, SOD and CAT activities. Administration of GSH appears to be a useful approach to reduce radiation injury by reducing MDA levels and increasing CAT activities.

Diagnosis of hepatitis B infections and monitoring of treatment.

Worldside viral hepatitis is still recognized as a major problem particularly in developing countries. During the past two decades there has been important progress in the field of viral hepatitis; the adaptation of molecular biology techniques to viral hepatitis has proven to be of great utility in the diagnosis of 'classical' hepatitis viruses, in monitoring during treatment, and also in learning more about the 'new' viruses. Here, the progress and pitfalls of serologic and molecular diagnosis techniques for viral hepatitis, unusual profiles and benefits of quantitative DNA/RNA tests will be discussed.

A comparison between short synacthen test and depot synacthen test in the evaluation of cortisol reserve of adrenal gland in normal subjects.

Synacthen test has been widely used as a screening test for evaluation of adrenal cortisol reserve. We investigated whether depot Synacthen test can be used in place of short Synacthen test in the evaluation of cortisol reserve of the adrenal gland. The study included 20 healthy volunteers of both sexes. We examined plasma cortisol response 30, 60, 90, and 120 min after administration of plain Synacthen, 250 micrograms, iv (Group 1), and depot Synacthen, 1000 micrograms, im (Group 2). Peak cortisol values were statistically similar between the groups. The increment in cortisol levels following Synacthen was also similar between the groups. A plasma cortisol value above 550 or 600 nmol/L was achieved in both groups during the test of 90 or 120 minutes duration, respectively. We think that depot Synacthen test, im 1000 micrograms, may be used in place of plain Synacthen, iv 250 micrograms, for evaluation of adrenal cortisol reserve.

Estimation of increased hospital stay due to nosocomial infections in surgical patients: comparison of matched groups.

An investigation, using a prospective cohort study, was performed to estimate the prolongation of hospital stay caused by nosocomial infections in surgical patients. An evaluation of the one-to-one matching method, as a model for similar studies was also undertaken. Between 1992 and 1994, 225 of 1482 surgical patients (15%) developed infection. Of these, 223 evaluable patients were compared with 1256 uninfected cases, in an unmatched analysis. In a further analysis, 151 infected cases were matched one-to-one with uninfected controls, and other factors such as age, length of preoperative stay, presence of malignancy or diabetes and presence of foley catheters or drains, were evaluated. Patients with infection were hospitalized for 10.6 days longer than the matched controls. In the unmatched analysis, infected patients appear to remain in hospital for a further 17 days. The difference in the prolongation of stay between matched and unmatched groups indicates the importance of matching as an essential model for such studies. In cases where matching cannot be performed, the median can be a good alternative measure to the arithmetic mean.

Inverse relationship between the size of pattern reversal visual evoked potentials from the left brain and the degree of left-hand preference in left-handed normal subjects: importance of the left brain.

The relation of the degree of left-hand preference to pattern reversal visual evoked potentials (VEPs) from right and left brain was studied in male left-handers. The degree of the left-hand preference was assessed by the Waterloo Handedness Questionnaire. Visual stimuli consisted of black and white checkerboard patterns generated on a TV screen. VEPs were simultaneously recorded from occipital leads of the right and left hemispheres. The degree of left-hand preference was found to be inversely and significantly related to size of VEPs only from left brain, not from right brain. That is, the conduction time, amplitude, duration, and area of N1-P1 waves linearly decreased as the degree of left-hand preference increased. These results were in accord with the testosterone hypothesis of cerebral lateralization, but not compatible with the right shift theory of handedness. It was concluded that visuomotor control by the left brain would be the main biological correlate of left-hand preference with regard to sensorimotor and cognitive functions.

Relationships among nonverbal intelligence, hand speed, and serum testosterone level in left-handed male subjects.

The relationships among nonverbal intelligence, hand speed, and serum testosterone level were studied in male left-handers ranging in age from 17 to 19 years. Hand speed was measured by a peg moving task. To assess the differences between nonverbal IQs. Cattell's Culture Fair Intelligence Test was used. There was a direct correlation between IQ and testosterone. IQ increased linearly with right-hand speed, which was directly related to testosterone. There was no significant correlation between IQ and left-hand speed, which was not significantly correlated with testosterone. IQ decreased with left- minus right-hand speed, which also decreased with testosterone. It was suggested that nonverbal spatial reasoning ability may be directly associated with the efficiency of left brain, which is favored by testosterone in male left-handers. It was also concluded that the left to right asymmetry in hand speed may depend on efficiency of the right brain in left-handed males.

Inverse relationship between nonverbal intelligence and the parameters of pattern reversal visual evoked potentials in left-handed male subjects: importance of right brain and testosterone.

The relationships between latencies of visual evoked potentials (VEPs) and nonverbal intelligence test scores (IQs from Cattell's Culture Fair Intelligence Test) and correlations between serum testosterone level and VEP latencies were studied to examine the neural speed hypothesis of intelligence and its hormonal mechanisms in left-handed male subjects (Geschwind Scores). In accordance with the speed theory of intelligence, N1 and P1 latencies (and amplitudes) were found to be inversely related to IQ. However, this was true only for the right brain; the left brain did not contribute to this relationship. There was an inverse relationship between serum testosterone level and P1 latency; left minus right N1 latency, depending on N1 latency from right brain, linearly increased with testosterone. It was concluded that nonverbal intelligence largely depends on speed of information processing only by the right brain, not by the left brain in left-handed male subjects. This may have been created by testosterone in these subjects. Inconsistencies in the IQ literature concerning the speed hypothesis of intelligence may be explained by differences in cerebral lateralization.

Contributions of the right and left brains to manual asymmetry in hand skill in right-handed normal subjects.

The relation of intermanual difference in hand skill to cerebral lateralization was studied in right-handed male and female subjects. Hand preference was assessed by the Edinburgh Handedness Inventory. Hand skill was measured by the peg moving task. In subjects with familial sinistrality (FS+), the mean right hand peg moving times (PMTs) were found to be significantly and negatively linearly correlated with the mean left minus right (L - R) hand PMTs in females (no correlation in males). Contrarily, there was a direct relationship between the mean L - R hand PMTs and the mean left hand PMTs in FS+ males (no correlation in FS+ females). Similar results were obtained with the FS- subjects. The correlations were modified by eye and foot preferences. The overall results suggested that generally the right brain in males and the left brain in females are of importance in determining the intermanual difference in hand skill; an insufficient right brain (a slower left hand) in males and a sufficient left brain (a faster right hand) in females would create a more asymmetrical organization in skill between hands.

There is a direct relationship between nonverbal intelligence and serum testosterone level in young men.

It was confirmed that there is a direct relationship between serum testosterone level and nonverbal intelligence (Cattel's Culture Fair Intelligence Test) only in right-handed male subjects without familial sinistrality (FS-), with right eye preference. There was no significant correlation between these variables in young women and young men with mixed eye preference. It was concluded that testosterone would be an important factor which affects cognitive development in men.

MR imaging using a rampable system.

A series of cranial images obtained at three magnetic field strengths in a volunteer on a fast ramp magnetic resonance system is presented. This study was undertaken in the space of 5 h.