RESUMO
PURPOSE: To evaluate retrospectively the long-term survival of patients with early-stage non-small cell lung cancer (NSCLC) treated with cryoablation. MATERIALS AND METHODS: Cryoablation was performed on 47 T1N0M0 NSCLCs in 45 consecutive patients between 2006 and January 2011. All ablative procedures were performed with 16-gauge or 13-gauge cryoprobes. The number of probes used was determined by the size and geometry of the tumor. Local and regional recurrence rates were monitored. Complications were assessed by the Society of Interventional Radiology (SIR) classification system. RESULTS: The 5-year survival rate was 67.8% ± 15.3, the cancer-specific survival rate at 5 years was 56.6% ± 16.5, and the 5-year progression-free survival rate was 87.9% ± 9. The probe per unit tumor diameter was 1.4 probes/cm. In eight patients, 16-gauge cryoprobes were used. Two cases were performed with a single needle. The remaining cases were performed with 13-gauge cryoprobes except for one case in which both probe sizes were used. The combined local and regional recurrence rate was 36.2%. Major complications occurred in 6.4% of patients, including two cases of hemoptysis and a prolonged placement of a chest tube requiring mechanical sclerosis in one patient. There were no deaths in the first 30 days after treatment. CONCLUSIONS: Cryoablation is associated with a good overall long-term survival with minimally significant complications. Cryoablation is a potentially curative, viable therapeutic option for patients with stage I NSCLC who are deemed medically inoperable.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Criocirurgia/mortalidade , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Recidiva Local de Neoplasia/mortalidade , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/patologia , Estudos de Coortes , Criocirurgia/estatística & dados numéricos , Intervalo Livre de Doença , Feminino , Humanos , Incidência , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , New York/epidemiologia , Pneumonectomia/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
The overexpression of certain membrane-bound receptors is a hallmark of cancer progression and it has been suggested to affect the organization, activation, recycling and down-regulation of receptor-ligand complexes in human cancer cells. Thus, comparing receptor trafficking pathways in normal vs. cancer cells requires the ability to image cells expressing dramatically different receptor expression levels. Here, we have presented a significant technical advance to the analysis and processing of images collected using intensity based Förster resonance energy transfer (FRET) confocal microscopy. An automated Image J macro was developed to select region of interests (ROI) based on intensity and statistical-based thresholds within cellular images with reduced FRET signal. Furthermore, SSMD (strictly standardized mean differences), a statistical signal-to-noise ratio (SNR) evaluation parameter, was used to validate the quality of FRET analysis, in particular of ROI database selection. The Image J ROI selection macro together with SSMD as an evaluation parameter of SNR levels, were used to investigate the endocytic recycling of Tfn-TFR complexes at nanometer range resolution in human normal vs. breast cancer cells expressing significantly different levels of endogenous TFR. Here, the FRET-based assay demonstrates that Tfn-TFR complexes in normal epithelial vs. breast cancer cells show a significantly different E% behavior during their endocytic recycling pathway. Since E% is a relative measure of distance, we propose that these changes in E% levels represent conformational changes in Tfn-TFR complexes during endocytic pathway. Thus, our results indicate that Tfn-TFR complexes undergo different conformational changes in normal vs. cancer cells, indicating that the organization of Tfn-TFR complexes at the nanometer range is significantly altered during the endocytic recycling pathway in cancer cells. In summary, improvements in the automated selection of FRET ROI datasets allowed us to detect significant changes in E% with potential biological significance in human normal vs. cancer cells.
Assuntos
Endocitose , Processamento de Imagem Assistida por Computador , Transferrinas/metabolismo , Animais , Linhagem Celular Tumoral , Cães , Transferência Ressonante de Energia de Fluorescência , Corantes Fluorescentes/química , Humanos , Células Madin Darby de Rim Canino , Microscopia de Fluorescência , Transporte Proteico , SoftwareRESUMO
Increased public and regulatory scrutiny of imaging-related radiation exposure requires familiarity with current dose-monitoring techniques and best practices. CT-related ionizing radiation exposure has been cited as the largest and fastest growing source of population-wide iatrogenic ionizing radiation exposure. Upcoming federal regulations require imaging centers to familiarize themselves with available dose-monitoring techniques and implement comprehensive strategies to track patient dose, with particular emphasis on CT. Because of institution-specific and vendor-specific technologies, there are significant barriers to adoption and implementation. In this article, the authors outline the core components of a universal dose-monitoring strategy and detail a few of the many available commercial platforms. In addition, the authors introduce a cloud-based hybrid model dose-tracking system with the goal of rapid implementation, multicenter scalability, real-time dose feedback for technologists, cumulative dose monitoring, and optional dose communication to patients and into the record; doing so results in improved patient loyalty, referring physician satisfaction, and opportunity for repeat business.
Assuntos
Exposição Ocupacional/análise , Segurança do Paciente , Lesões por Radiação/prevenção & controle , Monitoramento de Radiação/métodos , Proteção Radiológica/métodos , Tomografia Computadorizada por Raios X/métodos , Contagem Corporal Total/métodos , Carga Corporal (Radioterapia) , Humanos , Doses de Radiação , Estados UnidosRESUMO
BACKGROUND: Percutaneous irreversible electroporation (IRE) of lung tumors is a new minimally invasive technique which has recently been used in the treatment of soft tissue tumors. CASE REPORTS: The case histories are presented of two patients with unresectable malignancies in the lung, who underwent irreversible electroporation as a treatment attempt. The procedure was performed under CT guidance and was uneventful. CONCLUSIONS: At follow up 6 months later, the tumors both appeared to have recurred. To our knowledge, no similar cases have previously been reported in the literature.
Assuntos
Eletroporação/métodos , Neoplasias Pulmonares/terapia , Adulto , Idoso , Biópsia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Masculino , Sarcoma/patologia , Tomografia Computadorizada por Raios XRESUMO
DNA replication in Escherichia coli is initiated by DnaA binding to oriC, the replication origin. During the process of assembly of the replication factory, the DnaA is released back into the cytoplasm, where it is competent to reinitiate replication. Premature reinitiation is prevented by binding SeqA to newly formed GATC sites near the replication origin. Resolution of the resulting SeqA cluster is one aspect of timing for reinitiation. A Markov model accounting for the competition between SeqA binding and methylation for one or several GATC sites relates the timing to reaction rates, and consequently to the concentrations of SeqA and methylase. A model is proposed for segregation, the motion of the two daughter DNAs into opposite poles of the cell before septation. This model assumes that the binding of SeqA and its subsequent clustering results in loops from both daughter nucleoids attached to the SeqA cluster at the GATC sites. As desequestration occurs, the cluster is divided in two, one associated with each daughter. As the loops of DNA uncoil, the two subclusters migrate apart due to the Brownian ratchet effect of the DNA loop.
Assuntos
Proteínas da Membrana Bacteriana Externa/fisiologia , Replicação do DNA/fisiologia , Proteínas de Ligação a DNA/fisiologia , Proteínas de Escherichia coli/fisiologia , Escherichia coli/fisiologia , Modelos Biológicos , Origem de Replicação/fisiologia , Divisão Celular/fisiologia , Escherichia coli/citologia , Cadeias de Markov , Processos EstocásticosRESUMO
Escherichia coli is a rod-shaped bacterium that divides at its midplane, partitioning its cellular material into two roughly equal parts. At the appropriate time, a septum forms, creating the two daughter cells. Septum formation starts with the appearance of a ring of FtsZ proteins on the cell membrane at midplane. This Z-ring causes an invagination in the membrane, which is followed by growth of two new endcaps for the daughter cells. Invagination occurs against a cell overpressure of several atmospheres. A model is presented for the shape of the cell as determined by the tension in the Z-ring. This model allows the calculation of the force required for invagination. Then three possible models to generate the force necessary to achieve invagination are presented and analyzed. These models are based on converting GTP-bound FtsZ polymeric structures to GDP-bound FtsZ structures, which then leave the polymer. Each model is able to generate the force by relating the hydrolyzation to an irreversible molecular binding event, resulting in a net motion of putative anchors for the structures. All three models show that cross-linking the FtsZ protofilaments into a polymer structure allows the removal of GDP-FtsZ without interrupting the structure during force generation, as would happen for a simple polymeric chain.