RESUMO
OBJECTIVE: To investigate the characteristics of fluorine-18-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) maximum standardized uptake value (SUVmax) in primary intestinal lymphoma (PIL) and its correlation with D-dimer and lactate dehydrogenase (LDH). METHODS: Fifty-two patients diagnosed with PIL from June 2016 to December 2019 were analyzed. All patients underwent 18F-FDG PET/CT. The relationships between SUVmax and different pathological subtypes, clinical stages and risk grades were analyzed. The correlations between SUVmax and Ki-67, LDH and D-dimer were determined. Additionally, PET/CT imaging results were collected from 35 patients with primary intestinal cancer (PIC) and compared with the imaging features of PIL. RESULTS: SUVmax was significantly different between PIL and PIC groups and various PIL pathological subgroups. Patients in the high-risk PIL group had markedly higher SUVmax values than the intermediate-risk and low-risk groups. A significant positive correlation was observed between SUVmax and Ki-67 in patients with PIL. SUVmax was significantly different between the elevated and normal D-dimer groups. D-dimer showed a positive correlation with SUVmax. CONCLUSION: 18F-FDG PET/CT SUVmax reflects the aggressiveness of lymphoma to a certain degree, is correlated with Ki-67 and determines the risk grades of PIL. Moreover, it facilitates differential diagnosis, clinical staging and treatment based on D-dimer levels.
Assuntos
Neoplasias Intestinais , Linfoma , Produtos de Degradação da Fibrina e do Fibrinogênio , Radioisótopos de Flúor , Fluordesoxiglucose F18 , Humanos , L-Lactato Desidrogenase , Linfoma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Estudos RetrospectivosRESUMO
BACKGROUND: Neoantigen (NeoAg) peptides displayed at the tumor cell surface by human leukocyte antigen molecules show exquisite tumor specificity and can elicit T cell mediated tumor rejection. However, few NeoAgs are predicted to be shared between patients, and none to date have demonstrated therapeutic value in the context of vaccination. METHODS: We report here a phase I trial of personalized NeoAg peptide vaccination (PPV) of 24 stage III/IV non-small cell lung cancer (NSCLC) patients who had previously progressed following multiple conventional therapies, including surgery, radiation, chemotherapy, and tyrosine kinase inhibitors (TKIs). Primary endpoints of the trial evaluated feasibility, tolerability, and safety of the personalized vaccination approach, and secondary trial endpoints assessed tumor-specific immune reactivity and clinical responses. Of the 16 patients with epidermal growth factor receptor (EGFR) mutations, nine continued TKI therapy concurrent with PPV and seven patients received PPV alone. RESULTS: Out of 29 patients enrolled in the trial, 24 were immunized with personalized NeoAg peptides. Aside from transient rash, fatigue and/or fever observed in three patients, no other treatment-related adverse events were observed. Median progression-free survival and overall survival of the 24 vaccinated patients were 6.0 and 8.9 months, respectively. Within 3-4 months following initiation of PPV, seven RECIST-based objective clinical responses including one complete response were observed. Notably, all seven clinical responders had EGFR-mutated tumors, including four patients that had continued TKI therapy concurrently with PPV. Immune monitoring showed that five of the seven responding patients demonstrated vaccine-induced T cell responses against EGFR NeoAg peptides. Furthermore, two highly shared EGFR mutations (L858R and T790M) were shown to be immunogenic in four of the responding patients, all of whom demonstrated increases in peripheral blood neoantigen-specific CD8+ T cell frequencies during the course of PPV. CONCLUSIONS: These results show that personalized NeoAg vaccination is feasible and safe for advanced-stage NSCLC patients. The clinical and immune responses observed following PPV suggest that EGFR mutations constitute shared, immunogenic neoantigens with promising immunotherapeutic potential for large subsets of NSCLC patients. Furthermore, PPV with concurrent EGFR inhibitor therapy was well tolerated and may have contributed to the induction of PPV-induced T cell responses.
Assuntos
Vacinas Anticâncer/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Vacinas Anticâncer/farmacologia , Carcinoma Pulmonar de Células não Pequenas/patologia , Receptores ErbB/metabolismo , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , MutaçãoRESUMO
Desorption of pyrene from three different soils was studied using a semipermeable membrane device (SPMD)-assisted method to develop a new approach to predict bioavailability of hydrophobic organic compounds (HOCs) in soils. The results showed that pyrene desorption increased with reduction of soil organic matter content and elevation of pyrene concentration in unaged soils, and the 50-d desorption percentage was 52.2 +/- 3.6%, 76.3 +/- 1.5%, and 99.4 +/- 3.3% for soils 1, 2, and 3, respectively, at an initial pyrene concentration of 10 mg/kg and 73.6 +/- 4.9%, 94.1 +/- 4.1%, and 98.3 +/- 4.9%, respectively, at an initial pyrene concentration of 100 mg/kg. Aging led to a reduction in SPMD-assisted desorption because of movement of pyrene molecules from easy-desorbing to difficult-desorbing sites. The pyrene 50-d desorption percentage from 180-d-aged soils reduced to 5.8 +/- 0.6%, 18.8 +/- 0.9%, and 34.2 +/- 3.1% in soils 1, 2, and 3, respectively, at an initial pyrene concentration of 10 mg/kg and 43.9 +/- 2.9%, 54.3 +/- 4.7%, and 86.3 +/- 3.5%, respectively, at an initial pyrene concentration of 100 mg/kg. Dry and wet conditions during aging had different effects on aging-derived reduction of pyrene desorption, which was found, to our knowledge for the first time, to depend on pollutant concentration. The water to soil ratio during desorption had a significant effect on SPMD-assisted desorption dynamics. When this ratio changed from 10:1 to 1:1, desorption dynamics became more linear and slower, because when the ratio was low, the SPMD could not contact with soil particles well and the diffusion of pyrene from pore water into the SPMD might become the limiting step for SPMD accumulation of pyrene from soils. Good correlations were found between SPMD-assisted desorption and the biota-soil accumulation factor for both unaged and aged soils. The SPMD-assisted desorption is considered to be a reliable approach to predict the bioavailability of HOCs in soils.
Assuntos
Membranas Artificiais , Plantas/metabolismo , Pirenos/isolamento & purificação , Poluentes do Solo/isolamento & purificação , Absorção , Difusão , Interações Hidrofóbicas e Hidrofílicas , Modelos Químicos , Compostos Orgânicos , Permeabilidade , Pesquisa , Solo , ÁguaRESUMO
BACKGROUND: Cardiovascular diseases are the most common cause of death worldwide and are characterized by arrhythmia (i.e. irregular rhythm of heartbeat). Arrhythmia occasionally happens under certain conditions, such as stress. Therefore, it is difficult to be diagnosed using electrocardiogram (ECG) devices available in hospitals for just a few minutes. Constant diagnosis and monitoring of heartbeat is required to reduce death caused by cardiovascular diseases. OBJECTIVE: Mobile healthcare system has emerged as a potential solution to assist patients in monitoring their own heart condition, especially those who are isolated from the reference hospital. This paper proposes a self-diagnostic electrocardiogram system for mobile healthcare that has the capability to perform a real-time ECG diagnostic. METHODS: The self-diagnostic capability of a real-time ECG signal is achieved by implementing a detrended fluctuation analysis (DFA) method. The result obtained from DFA is used to display the patient's health condition on a smartphone anytime and anywhere. If the health condition is critical, the system will alert the patient and his medical practitioner for further diagnosis. RESULTS: Experimental results verified the validity of the developed ECG diagnostic application on a smartphone. CONCLUSION: The proposed system can potentially reduce death caused by cardiovascular diseases by alerting the patient possibly undergoing a heart attack.
Assuntos
Eletrocardiografia Ambulatorial/métodos , Processamento de Sinais Assistido por Computador/instrumentação , Smartphone , Telemedicina/métodos , Humanos , Modelos EstatísticosRESUMO
In order to develop a new method to study the desorption and bioavailability of hydrophobic organic chemicals (HOCs) in soils, a method using semi-permeable membrane device (SPMD) to study desorption of HOCs in soils has been set up, and assisted desorption of polycyclic aromatic hydrocarbons (PAHs), phenanthrene(PHE), pyrene(PYE), and benzo[a] pyrene (B[a]PYE) in three different kinds of soils was studied using SPMD. The results show that SPMD is a good measurement to study the desorption and bioavailability of HOCs in soils. SPMD assisted desorption of PAHs is highly dependent on the properties of the soils and the chemicals. PHE and PYE desorption percentages increase with the reduction of the content of soil organic matter (SOM), so that the desorption of the two chemicals increases from 56.45% and 48.28% to almost 100% when SOM content was reduced from 18.68% to 0.3%. However, clay has a significant holding effect on B[a]PYE, and PYE desorption is only 66.97% in Soil 3 with SOM of 0.3% and clay content of 39.05%. There is a great variety in the desorption among the different PAHs. With the reduction of SOM content and the elevation of contamination concentration, the difference between PHE and PYE decreases gradually, while B[a]PYE exhibits a significant difference from them. This could be attributed to the high lipophilicity and large molecular size of B[a]PYE, which make the molecule of B[a]PYE to be more easier to be held in the nanopores of clay and the dense region of SOM.