Adverse health and environmental outcomes of sewage treatment plant on surrounding groundwater with emphasis on some mitigation recommendations.

Water quality deterioration hinders economic and social development in developing countries that are facing freshwater security and shortages. Based on the collection of 29 water samples, this study focused on the relationship between sewage treatment plant and groundwater system surrounding it using multidisciplinary approach that combines the characterization of groundwater system and its connection with surrounding canal and drains, using chemical and isotopic characterization revealing that there is a direct relation between the surface water system and surrounding groundwater system. About 58% of the groundwater samples and all surface water samples in the investigated area are threatened by high concentrations of trace elements. The multivariate statistical analysis elucidates that anthropogenic effect and fertilizers sewage contamination are the main causes of groundwater pollution. Nearly, 31% and 11.5% of groundwater samples were posing oral chronic non-carcinogenic health risk and dermal chronic risk for adult, respectively, while all surface water samples were posing oral chronic non-carcinogenic health risk, with no dermal hazard. The uncharged species of Fe and Al are expected to be more mobile in groundwater because they would not be attracted to the surface charge of minerals. Inorganic ligands (HCO3-, SO42-, Cl-, and NO3-) act as nucleation centers that were linked with those trace elements creating new species with higher solubility degree in water that are transported away randomly for long distances in the water path.

Afatinib versus methotrexate as second-line treatment in Asian patients with recurrent or metastatic squamous cell carcinoma of the head and neck progressing on or after platinum-based therapy (LUX-Head & Neck 3): an open-label, randomised phase III trial.

BACKGROUND: Treatment options are limited for patients with recurrent or metastatic squamous cell carcinoma of the head and neck (HNSCC) following progression after first-line platinum-based therapy, particularly in Asian countries. PATIENTS AND METHODS: In this randomised, open-label, phase III trial, we enrolled Asian patients aged ≥18 years, with histologically or cytologically confirmed recurrent/metastatic HNSCC following first-line platinum-based therapy who were not amenable for salvage surgery or radiotherapy, and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0/1. Patients were randomised (2 : 1) to receive oral afatinib (40 mg/day) or intravenous methotrexate (40 mg/m2/week), stratified by ECOG performance status and prior EGFR-targeted antibody therapy. The primary end point was progression-free survival (PFS) assessed by an independent central review committee blinded to treatment allocation. RESULTS: A total of 340 patients were randomised (228 afatinib; 112 methotrexate). After a median follow-up of 6.4 months, afatinib significantly decreased the risk of progression/death by 37% versus methotrexate (hazard ratio 0.63; 95% confidence interval 0.48-0.82; P = 0.0005; median 2.9 versus 2.6 months; landmark analysis at 12 and 24 weeks, 58% versus 41%, 21% versus 9%). Improved PFS was complemented by quality of life benefits. Objective response rate was 28% with afatinib and 13% with methotrexate. There was no significant difference in overall survival. The most common grade ≥3 drug-related adverse events were rash/acne (4% with afatinib versus 0% with methotrexate), diarrhoea (4% versus 0%), fatigue (1% versus 5%), anaemia (<1% versus 5%) and leukopenia (0% versus 5%). CONCLUSIONS: Consistent with the phase III LUX-Head & Neck 1 trial, afatinib significantly improved PFS versus methotrexate, with a manageable safety profile. These results demonstrate the efficacy and feasibility of afatinib as a second-line treatment option for certain patients with recurrent or metastatic HNSCC. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01856478.

A comprehensive study for the potential removal of 152+154Eu radionuclides using a promising modified strontium-based MOF.

A facile modification of a strontium-based MOF using oxalic acid was carried out to prepare MTSr-OX MOF, which was used as a potential substance for eliminating 152+154Eu radioisotopes. Various analytical techniques were used to characterize MTSr-OX-MOF. The prepared MOF had a rod-like structure with a BET surface area of 101.55 m2 g-1. Batch sorption experiments were used to investigate the sorption performance of MTSr-OX-MOF towards 152+154Eu radionuclides where different parameters like pH, contact time, initial 152+154Eu concentration, ionic strength, and temperature were scrutinized to determine the optimum conditions for 152+154Eu removal. MTSr-OX-MOF showed superior effectiveness in the elimination of 152+154Eu with a maximum sorption capacity of 234.72 mg g-1 at pH 3.5. Kinetics fitted with the pseudo-second-order model and the Langmuir model correctly described the sorption mechanism. The thermodynamic variables were carefully examined, demonstrating that the 152+154Eu sorption was endothermic as well as spontaneous. The MTSr-OX-MOF has been found to be a significantly more effective sorbent towards 152+154Eu than that of many other adsorbents. When applied to real active waste, MTSr-OX-MOF demonstrated excellent removal performance for a wide range of radionuclides. As a result, the MTSr-OX-MOF can be recognized as an attractive solution for the 152+154Eu purification from active waste.

Recent progress in high-performance environmental impacts of the removal of radionuclides from wastewater based on metal-organic frameworks: a review.

The nuclear industry is rapidly developing and the effective management of nuclear waste and monitoring the nuclear fuel cycle are crucial. The presence of various radionuclides such as uranium (U), europium (Eu), technetium (Tc), iodine (I), thorium (Th), cesium (Cs), and strontium (Sr) in the environment is a major concern, and the development of materials with high adsorption capacity and selectivity is essential for their effective removal. Metal-organic frameworks (MOFs) have recently emerged as promising materials for removing radioactive elements from water resources due to their unique properties such as tunable pore size, high surface area, and chemical structure. This review provides an extensive analysis of the potential of MOFs as adsorbents for purifying various radionuclides rather than using different techniques such as precipitation, filtration, ion exchange, electrolysis, solvent extraction, and flotation. This review discusses various MOF fabrication methods, focusing on minimizing environmental impacts when using organic solvents and solvent-free methods, and covers the mechanism of MOF adsorption towards radionuclides, including macroscopic and microscopic views. It also examines the effectiveness of MOFs in removing radionuclides from wastewater, their behavior on exposure to high radiation, and their renewability and reusability. We conclude by emphasizing the need for further research to optimize the performance of MOFs and expand their use in real-world applications. Overall, this review provides valuable insights into the potential of MOFs as efficient and durable materials for removing radioactive elements from water resources, addressing a critical issue in the nuclear industry.

Neoadjuvant endocrine therapy with or without palbociclib in low-risk patients: a phase III randomized double-blind SAFIA trial.

BACKGROUND: The most prevalent subtype of breast cancer (BC) is luminal hormonal-positive breast cancer. The neoadjuvant chemotherapy regimens have side effects, emphasizing the need to identify new startegies. OBJECTIVE: Analyze the complete pathologic response (pCR) rate and overall response in a low-risk hormone-positive subset of patients receiving neoadjuvant hormone treatment (NAHT) with or without Palbociclib (a CDK4/CDK6 inhibitor) to boost NAHT effectiveness. MATERIALS AND METHODS: Based on the upfront 21-gene Oncotype DX or low-risk Breast Recurrence Score assay (RS™), the SAFIA trial is designed as a prospective multicenter international, double-blind neoadjuvant phase-III trial that selects operable with luminal BC patients that are HER2-negative for the induction hormonal therapy with Fulvestrant 500 mg ± Goserelin (F/G) followed by randomization of responding patients to palbociclib versus placebo. The pCR rate served as the study's main outcome, while the secondary endpoint was a clinical benefit. RESULTS: Of the 354 patients enrolled, 253 initially responded and were randomized to either F/G fulvestrant with palbociclib or placebo. Two hundred twenty-nine were eligible for the evaluation of the pathologic response. No statistically significant changes were observed in the pCR rates for the patients treated with the F/G therapy with placebo or palbociclib (7% versus 2%, respectively) per the Chevallier classification (Class1 + Class2) (p = 0.1464) and 3% versus 10% assessed per Sataloff Classification (TA, NA/NB) (p = 0.3108). Palbociclib did not increase the rate of complete pathological response. CONCLUSION: Neoadjuvant hormonal therapy is feasible in a selected population with a low RS score of < 31 CLINICAL TRIAL: NCT03447132.

Rutin and Hesperidin Revoke the Hepatotoxicity Induced by Paclitaxel in Male Wistar Rats via Their Antioxidant, Anti-Inflammatory, and Antiapoptotic Activities.

Paclitaxel, one of the most effective chemotherapeutic drugs, is used to treat various cancers but it is exceedingly toxic when used long-term and can harm the liver. This study aimed to see if rutin, hesperidin, and their combination could protect male Wistar rats against paclitaxel (Taxol)-induced hepatotoxicity. Adult male Wistar rats were subdivided into 5 groups (each of six rats). The normal group was orally given the equivalent volume of vehicles for 6 weeks. The paclitaxel-administered control group received intraperitoneal injection of paclitaxel at a dose of 2 mg/Kg body weight twice a week for 6 weeks. Treated paclitaxel-administered groups were given paclitaxel similar to the paclitaxel-administered control group together with oral supplementation of rutin, hesperidin, and their combination at a dose of 10 mg/Kg body weight every other day for 6 weeks. The treatment of paclitaxel-administered rats with rutin and hesperidin significantly reduced paclitaxel-induced increases in serum alanine transaminase, aspartate transaminase, lactate dehydrogenase, alkaline phosphatase, and gamma-glutamyl transferase activities as well as total bilirubin level and liver lipid peroxidation. However, the levels of serum albumin, liver glutathione content, and the activities of liver superoxide dismutase and glutathione peroxidase increased. Furthermore, paclitaxel-induced harmful hepatic histological changes (central vein and portal area blood vessel congestion, fatty changes, and moderate necrotic changes with focal nuclear pyknosis, focal mononuclear infiltration, and Kupffer cell proliferation) were remarkably enhanced by rutin and hesperidin treatments. Moreover, the elevated hepatic proapoptotic mediator (caspase-3) and pro-inflammatory cytokine (tumor necrosis factor-α) expressions were decreased by the three treatments in paclitaxel-administered rats. The cotreatment with rutin and hesperidin was the most effective in restoring the majority of liver function and histological integrity. Therefore, rutin, hesperidin, and their combination may exert hepatic protective effects in paclitaxel-administered rats by improving antioxidant defenses and inhibiting inflammation and apoptosis.

Effect of olive, flaxseed, and grape seed nano-emulsion essential oils on semen buffalo freezability.

The existing treatise targeted to compare the effects of adding different nano-emulsions essential oils (olive, flaxseed, and grapeseed oils) in freezing extender on semen quality and freezability in buffalo. Nano-emulsions were prepared from olive, flaxseed, and grapeseed oils and characterized for their sizes and shapes. Semen extended in four tubes were supplemented with 0 (control) and 3.5% nanoemulsion oils, including olive (NEO), flaxseed (NEFO) and grape seed oils (NEGSO) respectively. NEGSO resulted in the highest (p < 0.05) membrane integrity, vitality, progressive motility (P-motility) of sperm compared to the other groups in post-thawed buffalo bull semen (at 37 °C for 30 s). The addition of NEGSO had the best results for membrane integrity, progressive motility, and vitality of sperm after incubation (at 37 °C and 5% CO2 for 2 h). A superior (p < 0.05) value of total antioxidant capacity in frozen-thawed spermatozoa was monitored in all supplemented groups as relative to the control. The values of malondialdehyde (MDA) and nitric oxide (NO) were lower (p < 0.05) in NEGSO group compared with other groups. Both NEO and NEFO exhibited the same results for MDA, and NO levels (p > 0.05). All supplemented groups exhibited lower hydrogen peroxide levels (p < 0.05) as relative to the un-treated group. The lowest (p < 0.05) caspase 3 levels were verified in NEGSO treatment, followed by NEFO and NEO treatments. Post-thawed sperm showed ultrastructural damages in the control group, and theses damages were attenuated or resorted by the NEGSO, NEFO and NEO supplemented to freezing extender. In consequences with in vitro results regarding the sperm attribute, a greater pregnancy rate (92%) was observed in NEGSO group as compared with NEFO (88%), NEO (76%) and CON (68%) groups. Our findings demonstrate that NEGSO (3.5%) could be used as a new strategy in enhancing sperm functionality, potential fertility and reducing the oxidative damage and apoptosis markers. This could be significantly applicable for sperm physiology cryopreservation in the milieu of assisted reproduction systems.

Effects of pre-treatment with inulin on the kidney in lipopolysaccharide-induced endotoxemia in rats.

This study was aimed to evaluate the effects of inulin used as prebiotic on the kidney in lipopolysaccharide (LPS)-induced endotoxemia model. Wistar Albino rats were divided into four groups: Control group, LPS (endotoxemia) group, Inulin + LPS group in which LPS (1.5 mg/kg, E. coli, Serotype 0111: B4) was treated after inulin (500 mg/kg) given by gavage for 21 days and Inulin group. The animals were sacrificed 24 h after the last LPS injection. Kidney samples were taken for biochemical and immunohistochemical analyses. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), malondialdehyde (MDA) and myeloperoxidase (MPO) values were determined. In addition, kidney sections were stained for inducible nitric oxide synthase (iNOS), tumor necrosis factor (TNF)-α and interleukine-6 (IL-6) expression, and leukocyte infiltration. LPS caused oxidative stress and inflammation. Inulin administration could prevent oxidative stress and lipid peroxidation. Moreover, inulin decreased iNOS, TNF-α and IL-6 expression. However, it did not change the distribution of leukocytes in kidney tissues. These results suggest to promising benefits of inulin as prebiotic in reducing the effects of endotoxemia. Further studies should be conducted to evaluate the capacity of prebiotics in endotoxemia.

A novel strontium-based MOF: synthesis, characterization, and promising application in removal of 152+154Eu from active waste.

Removal of hazardous radioactive materials such as 152+154Eu from active waste using the batch approach has attracted attention nowadays. In this work, a novel melamine-terephthalic strontium metal-organic framework (MTSr-MOF) was prepared via a hydrothermal method. The MTSr-MOF was characterized by various analytical techniques such as FT-IR, 1H/13C-NMR, mass spectroscopy, XPS, XRD, TGA, BET, FE-SEM/EDX, TEM, and UV. The obtained data revealed that MTSr-MOF exhibited brick-like building blocks that were bridged together by the linkers, and each block had a thickness of ∼120 nm. The BET surface area was 74.04 m2 g-1. MTSr-MOF was used for the removal of 152+154Eu radionuclides from active waste. Further functionalization using various modifiers, including oxalic acid, EDTA, sulfuric acid, and sodium hydroxide was carried out to improve the sorption efficiency of MTSr-MOF towards 152+154Eu radionuclides. Among them, MTSr-MOF modified with oxalic acid (MTSr-OX-MOF) demonstrated a superior removal efficiency toward 152+154Eu radionuclides when compared to MTSr-MOF or other published reports, with a removal efficiency of more than 96%. The higher sorption efficiency of the MTSr-OX-MOF indicates that it could be a promising candidate for the removal of 152+154Eu radionuclides from radioactive waste.

Predicted structural similarities of the DNA binding domains of c-Myc and endonuclease Eco RI.

The c-Myc oncoprotein belongs to a family of proteins whose DNA binding domains contain a basic region-helix-loop-helix (bHLH) motif. Systematic mutagenesis of c-Myc revealed that dimerized bHLH motifs formed a parallel four-helix bundle with the amino termini of helices 1 and 2 directed toward the inner and outer nucleotides of the DNA binding site, respectively. Both the basic region and the carboxyl-terminal end of the loop contributed to DNA binding specificity. The DNA binding domain of c-Myc may therefore be structurally similar to that of restriction endonuclease Eco RI.

Electrochemical hydroxyapatite-cobalt ferrite nanocomposite coatings as well hyperthermia treatment of cancer.

The fabrication of hydroxyapatite-Co-ferrite nanocomposite coatings was performed on stainless steel by chronoamperometry technique. HA-CoFe2O4 nanocomposite films were characterized using X-ray diffraction, scanning electron microscopy, and vibrating sample magnetometer (VSM). The results reveal that CoFe2O4 nanoparticles dispersed within the HA matrix have flake and strip shapes. The magnetic property of the nanocomposite was increased by increasing the concentration of CoFe2O4 and a good saturation magnetization value was found to be 20.6emu/g with 50% CoFe2O4. By comparing with pure CoFe2O4, the composite still retain moderate magnetization as well as its biocompatible characters. The specific absorption rate (SAR) values were altered according to the change in CoFe2O4 concentration and the maximum SAR value was 125W/g. The incorporation of CoFe2O4 nanoparticles with HA coating was increased the corrosion resistance of HA in simulated body fluid (SBF). The results indicated that HA-CoFe2O4 nanocomposite coating could be a promising surface treatment technique for stainless steel medical implants as well hyperthermia treatment of cancer.

The teratogenic effects of imatinib mesylate on rat fetuses.

Imatinib mesylate, a selective tyrosine kinase inhibitor, is the first line treatment against chronic myelogenous leukemia and gastrointestinal stromal tumors. The aim of the present study is to investigate the effects of imatinib mesylate on the pregnant rats and their fetuses. Pregnant rats were divided into three groups; the first group served as a control group. The second and third groups were orally administered imatinib at doses of 36 mg/kg body weight or 54 mg/kg b.wt. on gestation days (SDs) 6 through 13 or SDs 13 through 19, respectively. All animals were sacrificed on the 20th day of gestation. Treatment with imatinib caused a reduction of maternal body weight gain, uterine and placental weights, increased rate of abortion and fetal resorptions. High dose of imatinib caused fetal congenital deformities represented in harelip, contraction of the fore limbs, and paralysis of the hind limbs, exencephaly, encephalocoele and distended abdominal wall, besides occurrence of wavy ribs and absence of other ribs in addition to skeletal growth retardation and lack of ossification of the most skeletal elements. The present work concluded that imatinib is teratogenic when given orally to pregnant rats at 54 mg/kg b.wt. and causes direct maternal or developmental toxicity.

Once weekly irradiation for carcinoma of the bladder.

PURPOSE: A dose-searching study was carried out treating selected elderly patients or patients with poor performance with bladder cancer with once weekly fractionation to determine an effective dose per fraction, and to evaluate acute and late effects resulting from this schedule. METHODS AND MATERIALS: Seventy patients with invasive transitional cell carcinoma of the bladder were entered in the study. The dose used was 36-39 Gy in six fractions over 35 days in 27 patients (Group 1). The remaining 43 patients were treated with 34.5 Gy in six fractions over 39 days (Group 2). RESULTS: Six patients developed Grade 1-2 European Organization for Research on Treatment of Cancer (EORTC) bowel reaction. Three patients in Group 1 developed Grade 3 late bowel reaction and a fourth patient developed Grade 4 reaction requiring colostomy. However, only one patient in Group 2 developed Grade 3 reaction. The difference between the two groups was statistically significant (chi 2 = 3.794, p = 0.05). CONCLUSIONS: The acute and late reaction as well as the 5-year free survival for patients in Group 2 compare favorably with daily treatment. We conclude that 34.5 Gy given over 39 days is a safe and effective treatment for selected patients with bladder cancer.

Treatment results for 149 medulloblastoma patients from one institution.

PURPOSE: Retrospective analysis of patients with medulloblastoma to determine the effectiveness of previous treatments for medulloblastoma and plan for future management strategies. METHODS AND MATERIALS: During the period March 1976 to December 1991, 172 patients with cerebellar medulloblastoma were referred to King Faisal Specialist Hospital and Research Center. One hundred and forty-nine patients were treated with curative intent. There were six postoperative deaths, and 10 patients planned for radiotherapy treatment failed to complete the prescribed course. One hundred and thirty-three patients completed a course of radiotherapy after surgery. Adjuvant chemotherapy was not used routinely (six patients only). Tumors were staged retrospectively according to the Chang staging system. There were no T1 patients, 32 patients had T2 tumors, 76 had T3 tumors, and 29 had T4 tumors. The T stage could not be allocated in 12 patients. Ninety-nine patients required a shunting procedure either pre- or postoperatively. Forty-six patients had complete resection of tumor, 91 had incomplete resection, and 6 patients had biopsy only. The extent of resection could not he determined in six patients. The median radiation dose for the whole brain was 34 Gy, spine 32.5 Gy, and posterior fossa 52.8 Gy. Fraction sizes ranged from 1.7-1.8 Gy for craniospinal fields and 2 Gy for the posterior fossa boost. Seventy percent completed the prescribed course within 7 weeks. RESULTS: Actuarial survival for the whole group of 149 patients was 53% at 5 years and 38% at 10 years. On univariate analysis, patients with T2 tumors did significantly better as compared to patients with T3 and T4 tumors. Survival of patients who had clinical and radiological complete resection of tumor at surgery was significantly better than patients with incomplete tumor removal. The presence of a ventriculoperitoneal (VP) shunt had a significant negative impact on survival. Treatment failure by site was analyzed with respect to the radiation dose. Doses greater than 50 Gy for the posterior fossa, and greater than 30 Gy for craniospinal axis, resulted in significantly better survival. On multivariate analysis, the only significant prognostic factor was the presence of a VP shunt in patients with T2 tumors. CONCLUSION: T stage, VP shunt, radiation doses and extent of surgery were important prognostic factors. In this study, radiation doses of more than 50 Gy to the posterior fossa and 30 Gy to the craniospinal axis resulted in improved survival.

Radiation therapy for retinoblastoma: a retrospective review of 120 patients.

PURPOSE: To characterize the patient population and treatment outcomes in patients with Retinoblastoma (RB) referred for External Beam Orbital Radiotherapy (EBORT) to King Faisal Specialist Hospital & Research Centre (KFSH&RC), Riyadh, Saudi Arabia from 1976 to 1993. METHODS AND MATERIALS: A retrospective study of 120 patients with RB affecting a total of 192 eyes. Patients were divided into three groups. Group A are 60 patients (64 eyes) treated with EBORT to the intact eye to preserve vision. Reese-Ellsworth (RE) Staging was: 1: 12%; 2: 10%; 3: 12%; 4: 23%; and 5: 43%. Twenty-eight patients (47%) also received Vincristine, Adriamycin, and Cyclophosphamide chemotherapy (C/T). Mean follow-up, per patient, was 48.5 months. Standard treatment until 1992 was 45 Gy in 12 fractions of 3.75 Gy, three times weekly over 18 days. Assuming the alpha/beta ratio for early effects and tumor control at 10, Tk = 21 days, Tpot = 5 days, then the Biological Equivalent Dose (BED) was 62 Gy10 for early effects, and 101 Gy3 for late effects. Group B are 28 patients (28 eyes) treated for curative intent with EBORT to the orbit for locally advanced disease, usually after enucleation (24 eyes). Nineteen patients (83%) also had C/T. Mean follow-up was 22.6 months. Group C are 37 patients with advanced disease treated with radiotherapy for palliation. Seventeen (46%) also received C/T. Mean follow-up was 11.7 months. RESULTS: Group A-following EBORT useful vision was retained in RE Stage 1 to 5: 7 of 7, 6 of 6, 4 of 8, 10 of 15, and 7 of 28 eyes, respectively. There was no significant difference between patients who received adjuvant chemotherapy and those who did not. Complications included cataract (27%), retinopathy (25%), vitreous hemorrhage (19%), and orbital deformities (11%). In Group B the local control rate was 71%. In Group C, 10 (27%) of the 37 patients were alive at last contact, and 27 (73%) were either terminal or dead of disease. None of Group A or B patients had positive CSF cytology, bone scan, or bone marrow examination. In Group C 19% had positive CSF cytology, and bone marrow, and 14% had a positive bone scan. CONCLUSIONS: 1) EBORT preserved useful vision in a significant proportion of patients even in eyes with advanced RE Stage RB, but longer follow-up is likely to reveal an even higher complication rate with this regime. 2) High dose per fraction probably contributed to the increased complications. 3) Chemotherapy did not demonstrate any effect on retaining vision in this study. 4) For disease that is confined to within the eye clinically and radiologically, invasive procedures for CSF cytology, bone marrow examination, and bone scan do not seem warranted. 5) The optimum technique, fractionation, and dosage for RB is still not well defined.

Experimental hepatic tumor necrosis. Comparison of spin-echo and pulsed magnetization transfer contrast magnetic resonance imaging.

RATIONALE AND OBJECTIVES: We compared the effectiveness of pulsed magnetization transfer contrast (MTC) magnetic resonance imaging (MRI) and spin-echo MRI in detecting tumor necrosis. METHODS: Adenocarcinoma cells were transplanted in the livers of 12 syngenic BDIX rats. To induce various degrees of tumor necrosis, the rats were randomly assigned to the following groups: 1) control; 2) localized hyperthermia; 3) intralesional cisplatin; and 4) hyperthermia plus intralesional cisplatin. At day 7 after treatment, the rats were imaged using a 1.5-T imager with 1) multiplanar gradient-recalled echo sequence (MPGR) 500/8/20 degrees with and without magnetization transfer contrast (MTC); 2) spin-echo 2500/20,80, and 3) spin-echo 300/20 pulse sequences. The rats were then sacrificed and pathologic specimens were prepared using MR images as guidance. T2 and ratios of signal intensity after saturation to signal intensity before saturation (Ms/Mo ratios) of the necrotic and granulation tissues and viable tumors were determined in 10 rats. RESULTS: Compared with standard MPGR images, MPGR images with MTC provided better contrast between the pathologic tissues and normal liver. However, T2 values were more useful than Ms/Mo ratios in distinguishing necrotic areas from viable tumor. The T2 values of coagulative necrosis and granulation tissue were significantly different from that of viable tumor. No significant difference between the Ms/Mo ratios of the different pathologic tissues and normal liver was found. CONCLUSION: Pulsed magnetization transfer contrast MRI was inferior to spin-echo MRI in distinguishing necrotic from viable tumors in rat livers using the pulse sequences described, and none of the sequences studied was thought to be reliable enough for this purpose.

A longitudinal study of Bancroftian filariasis in the Nile Delta of Egypt: baseline data and one-year follow-up.

We initiated a longitudinal study of Bancroftian filariasis to improve understanding of dynamics and risk factors for infection in villages near Cairo, Egypt. Baseline prevalence rates for microfilaremia and filarial antigenemia for 1,853 subjects more than 9 years of age were 7.7% and 11.2%, respectively. Microfilaria counts, antigen levels, and microfilaremia incidence over a 1-year period were all significantly lower in older people. These findings suggest that humans develop partial immunity to Wuchereria bancrofti over time. One-year incidence rates for microfilaremia and antigenemia were 1.8% and 3.1%, respectively. Filarial antigenemia, IgG4 antibody to recombinant antigen BmM14, and household infection were all significant risk factors for microfilaremia incidence. Microfilaria counts and parasite antigen levels were significantly reduced by diethylcarbamazine therapy, but many infected subjects refused treatment, and most treated people were still infected one year later. Incident infections approximately balanced infections lost to produce an apparent state of dynamic equilibrium.

Primary thyroid lymphoma: a retrospective analysis of prognostic factors and treatment outcome for localized intermediate and high grade lymphoma.

Non-Hodgkin's lymphoma presenting in the thyroid gland is uncommon. A review of the King Faisal Specialist Hospital and Research Centre (KFSH & RC) experience was performed to assess treatment outcome and prognostic factors in this rare extranodal presentation of localized lymphoma. Sixty patients treated at KFSH & RC between 1975 and 1995 were identified, and their records were reviewed retrospectively. Eight patients who had stage III or IV disease, low grade, or did not complete their prescribed treatment were excluded from the study. There were 38 female and 14 male patients with a median age of 59.5 years at the time of diagnosis (range: 10-87 years). Thirty-five of the 52 patients underwent diagnostic partial or total thyroidectomy at other institutions based on a preoperative assumption of thyroid carcinoma. All 52 patients had non-Hodgkin's lymphoma of intermediate (94%) or high (6%) grade. Detailed staging was carried out in all patients; 16 patients (31%) had disease confined to the thyroid gland (stage IE), whereas 36 (69%) had associated disease in cervical lymph nodes and/or the mediastinum (stage IIE) disease. All patients were treated with curative intent. A total of 18 patients (35%) were treated with a single-modality treatment--radiotherapy alone in 2, chemotherapy alone in 13, and surgery alone in the remaining 3 patients. The majority of patients (34/52; 65%) were treated with a combined-modality approach. The overall relapse-free survival (RFS) and overall survival (OS) at 5 years were 72% and 88%, respectively. There were no significant differences in outcome between those treated with single-modality and those with combined-modality therapy. A univariate analysis showed that the presence of mediastinal lymph node involvement was the most important prognostic factor affecting both RFS and OS. Patients with Hashimoto thyroiditis and without "B" symptoms were found to have a significantly higher RFS without influence on the OS. However, patients who had a good performance status (PS) of 0, 1, and 2 were found to have a significantly higher overall survival in comparison to those with poor performance status. Age, sex, stage, histology, lactic acid dehydrogenase level, tumor bulk, and the treatment modality were not found to correlate with RFS or OS. Mediastinal involvement and PS were found to be the most important independent prognostic factors influencing RFS and OS.

Positron emission tomography in breast cancer: a clinicopathological correlation of results.

We conducted a retrospective study to evaluate the sensitivity, specificity and accuracy of positron emission tomography (PET) scans in 109 patients with primary recurrent or metastatic breast cancer. All patients had a PET scan, X-ray or CT scan of the chest, an ultrasound or CT scan of the liver and a bone scan. Mammography was available for 86 patients. Correlation between the PET scan result and histological findings were made. The sensitivity, specificity and accuracy of the PET scan were calculated for both the primary tumour (T) and lymph nodes (N). In patients with metastasis (M) the accuracy of the PET scan was compared with other imaging modalities. Histological results of the site in question were available in only 105 patients. Information for the primary tumour was available for 93 patients and for nodes in 74. The PET scan was accurate in 89.2% for (T), with 3.2% false positive and 7.6% false negative. For (N) the PET scan was accurate in 90.5% with 9.5% false negative. In the 86 patients who underwent both mammography and PET scanning, the PET scan was more accurate in 89.5% versus 72% (p = 0.0003). In the 19 patients with metastasis, the PET scan was in agreement with other imaging modalities in 100% of cases. PET scanning is the only non-invasive imaging procedure that will detect tumours in the breast, lymph nodes, lung, liver, bone and bone marrow with high sensitivity, specificity and accuracy. It is a valuable tool in the management of patients in all stages of breast cancer for diagnosis, staging and following treatment response.

Successful control of extensive thoracic lymphangiomatosis by irradiation.

Lymphangiomas are very rare benign tumours, believed to arise from congenital malformations of the lymphatic system. They grow very slowly, but are capable of massive expansion and infiltration of the surrounding tissues. If left untreated they can cause serious and sometimes fatal complications. The thorax is commonly affected, with involvement of the ribs, pleura, pericardium, lung parenchyma, mediastinum and vertebrae. Treatment depends on the extent of the disease. While local excision is the treatment of choice for localized lesions, radiotherapy is used for more extensive disease. In this report we describe three patients with extensive thoracic lymphangiomatosis who were treated successfully with irradiation alone. The value of early diagnosis and treatment is emphasized.