Relative search popularity of five advanced prostate cancer medications using Google Trends.

BACKGROUND: There are many FDA-approved drugs for advanced prostate cancer (PC), yet public interest in these drugs is not well understood. We compared public interest and state-level predictors of interest in five common oral adjunctive hormonal therapies. METHODS: Google Trends™ was queried for: "Enzalutamide", "Abiraterone Acetate", "Bicalutamide", "Apalutamide", and "Darolutamide" in the United States from January 2004 to November 2022. Data are presented as relative search index (RSI) by month. RSI ranges from 0 to 100 with 100 being peak popularity, 50 being half of the peak popularity, and 0 representing insufficient data to be determined. RESULTS: Several drugs abruptly increased in popularity following FDA approval including abiraterone, enzalutamide, and apalutamide. All drugs decreased in popularity from January 2020 to July 2020, corresponding with the COVID-19 pandemic. In the most recent 5 years, enzalutamide and abiraterone were the most common searched drugs, with bicalutamide a close 3rd place. States that did not expand Medicaid were significantly more likely to have bicalutamide as the top search drug vs. states that expanded Medicaid (p = 0.012). Across all states with data (n = 39), higher bicalutamide RSIs were significantly associated with lower household income (r = 0.385, p = 0.02) and greater percent of uninsured adults (r = 0.426, p = 0.007). This is the first study using Google Trends to compare advanced PC drugs by search popularity. CONCLUSIONS: Despite the emergence of more effective medications, bicalutamide remains relatively popular, particularly in states with lower household income, more uninsured adults, or those that did not expand Medicaid, possibly due to its lower cost.

Evaluación de la posición condilar mediante tomografía computarizada de haz cónico en pacientes Clase III sometidos a cirugía ortognática / Evaluation of the condylar position by conical beam computed tomography in Class III patients undergoing orthognathic surgery

Objetivo . El propósito de este estudio fue comparar los cambios mediante tomografía computarizada de haz cónico en el posicionamiento condilar de pacientes Clase III antes y después de una osteotomía sagital bilateral de rama mandibular indicada para la retro- posición mandibular. Métodos . Se analizaron 30 pacientes, 16 mujeres y 14 hombres con rango de edad de 15 a 40 años y deformidad dentofacial Clase III no tratada que asistieron a consulta de diagnóstico en el periodo del año 2013 al 2016 en el Hospital Regional "General Ignacio Zaragoza" (CDMX, México), realizándoseles mediciones de la posición condilar en tres tiempos: prequirúrgico, intermedio (4 días posquirúrgico) y final (9 meses posquirúrgico), en dos planos: corte sagital y corte coronal. Resultados . No se observó diferencia significativa en los espacios anterior, central y posterior antes (2,56 ± 0,55 mm; 1,78 ± 0,48 mm; 1,92 ± 0,36 mm) y después (2,68 ± 0,51 mm; 1,87 ± 0,43 mm; 2,01 ± 0,37 mm), diferencia de medias -0,120; -0,085; -0,090 p =0,921; 0,948 y 0,778, respectivamente. Del mismo modo, en el corte coronal no se observan cambios significativos en los ángulos condilares derecho antes (68,25 ± 1,56°) y después (68,77 ± 1,63°) p =0,217; e izquierdo antes (68,92 ± 1,63°) y después (69,30 ± 2°) p =0,215. Conclusiones . La osteotomía sagital bilateral de rama mandibular en pacientes Clase III es una técnica quirúrgica que ofrece mínimas alteraciones condilares, pues mantiene una estabilidad condilar en el posoperatorio a 9 meses.

Objective. The purpose of this study was to compare the changes by conical beam com- puted tomography in the condylar positioning of Class III patients before and after a sagittal osteotomy of the bilateral mandibular ramus in Class III indicated for mandibu- lar retroposition. Methods. Thirty patients were analyzed, 16 women and 14 men with an age range of 15 to 40 years and untreated Class III dentofacial deformity who were attended by diagnostic consultation during the period from 2013 to 2016 at the "Gen eral Ignacio Zaragoza" Regional Hospital (CDMX, Mexico), performing measurements of the condylar position in three stages: presurgical, intermediate (4 days after surgery) and final (9 months after surgery), in two planes: sagittal section and coronal section. Re - sults. No significant difference was observed in the anterior, central and posterior spaces before (2.56 ± 0.55 mm; 1.78 ± 0.48 mm; 1.92 ± 0.36 mm) and after (2.68 ± 0.51 mm; 1.87 ± 0.43 mm; 2.01 ± 0.37 mm), mean difference -0.120; -0,085; -0.090 p =0.921; 0.948 and 0.778, respectively. Similarly, in the coronal section there are no significant changes in the right condylar angles before (68.25 ± 1.56 °) and after (68.77 ± 1.63°) p =0.217; and left before (68.92 ± 1.63°) and then (69.30 ± 2°) p =0.215. Conclusions. Sagittal osteotomy of the bilateral mandibular ramus in Class III patients is a surgical technique that offers minimal condylar alterations, since it maintains a condylar stability in the postoperative period at 9 months.

First molecular and serological detection of Epizootic Hemorrhagic Disease virus in white tailed deer ( Odocoileus virginianus ) from Tamaulipas, Mexico / Primeira detecção molecular e sorológica do vírus Doença Hemorrágica Epizoótica em veados de cauda branca (Odocoileus virginianus) de Tamaulipas, Mexico

Epizootic hemorrhagic disease viruses (EHDV) are dsRNA arboviruses transmitted by biting midges of the genus Culicoides that cause disease in domestic and wild ruminants. Epizootic hemorrhagic disease (EHD) is considered the most important infectious disease of white tailed deer (WTD) in North America, some studies in Northeast Mexico reported EHDV-seropositive WTD and EHDV-infected Culicoides vectors. The increasing population of WTD that share habitat with livestock in Northeast México highlights the importance of EHD for the livestock industry in the transboundary region with the U.S. One hundred and twenty two samples from WTD in Tamaulipas state, Mexico were tested by ELISA and RT-PCR for EHDV antibodies and nucleic acid, respectively. Twelve animals were seropositive to ELISA and eleven animals were positive by RT-PCR. This is the first report of EHDV nucleic acid detection in WTD from Mexico. It is hypothesized that applying the transboundary disease approach to interdisciplinary research will help fill knowledge gaps, which could help develop countermeasures to mitigate the threat of EHDV infection in wildlife and livestock along the U.S.-Mexico border.(AU)

Virus da doença hemorrágica epizoótica (EHDV) são arbovírus dsRNA transmitidos por mordidas do genus Culicoides que causam doenças em ruminantes domésticos e selvagens. Doença hemorrágica epizoótica (EHD) é considerada uma das doenças infecciosas mais importantes dos veados de cauda branca (WTD) na América do Norte. Alguns estudos no Nordeste do México relatam soropositividade para EHDV em WTD e vetores Culicoides infectados com EHDV. A crescente população de WTD que compartilham hábitats com pecuária no Nordeste do México realçam a importância de EHD para a indústria pecuária na região de fronteira com os Estados Unidos. Cento e vinte duas amostras de WTD no estado de Tamaulipas, Mexico, foram testados por ELISA e RT-PCR para anticorpos e ácido nucleico de EHDV, respectivamente. Esse é o primeiro relato de detecção de ácido nucleico de EHDV em WTD do México. A hipótese é de que a aplicação de uma resposta transfronteira e pesquisa interdisciplinar ajudará a preencher lacunas de conhecimento levando a medidas reativas para mitigar a ameaça de infecção por EHDV na pecuária e animais selvagens na fronteira entre os Estados Unidos e o Mexico.(AU)

Effects of Obesity on the Regulation of Macrophage Population in the Prostate Tumor Microenvironment.

Obesity is associated with a greater risk of prostate cancer mortality. However, the mechanisms connecting obesity to the progression of prostate cancer remain unknown. This study determined the impact of obesity on macrophage recruitment and tumor-associated macrophage (TAM) polarization in the prostate tumor microenvironment, since a high concentration of TAMs in tumors has been linked to progression in prostate cancer. We utilized an in vitro model in which pre-adipocytes, prostate cancer cells, and macrophages were exposed to sera from obese or nonobese men, or conditioned media generated under obese or nonobese conditions. Matrigel invasion chambers were used to assess macrophage recruitment in vitro, and immunohistochemical analysis evaluated recruitment in a PTEN knockout mouse model. qPCR was used to measure mRNA levels of CCL2, COX-2, IL-10, TGF-beta, VEGF-A, arginase-1, and MMP-9. PGE2 production was measured by ELISA. Obesity increased macrophage and TAM recruitment, and increased mRNA levels of TAM markers in macrophages. Similarly, obese conditions increased CCL2 and COX-2 expression, as well as PGE2 levels in prostate cancer cells. COX-2 inhibition resulted in lower expression of obesity-induced TAM markers. Our data suggest that obesity promotes macrophage infiltration into the prostate tumor microenvironment, and induces TAM polarization through the COX-2/PGE2 pathway.

Leucoplasia verrucosa proliferativa: Caso idiopático y revisión de la literatura / Proliferative verrucous leukoplakia: Idiopathic case and review of the literature

La leucoplasia verrucosa proliferativa (LVP) es de etiología multifactorial, en la actualidad aún no se encuentra un agente etiológico direccional, la alta tasa de transformación maligna a un carcinoma verrucoso es la principal preocupación en estos pacientes, con la presencia de una placa blanca irregular de características verrucoides, que se encuentra en diferentes sitios de la economía de la cavidad bucal. Hasta el momento, no se cuenta con un protocolo estandarizado de tratamiento; los retinoides y fármacos tópicos así como la criocirugía, la terapia láser y la cirugía convencional, han fracasado en la mayoría de los casos con una persistencia de la lesión o recurrencia. Presentamos una revisión de la literatura y el caso específico de una paciente femenina, de 70 años de edad, con una LVP en región de maxilar superior izquierdo y de aparición incipiente en maxilar derecho.

Proliferative verrucous leukoplakia (PVL) is of multifactorial etiology; at present there is still no directional etiologic agent; the high rate of malignant transformation to verrucous carcinoma is the main concern in these patients with the presence of a white plaque irregular verrucoid characteristics found in different sites of the economy of the oral cavity, so far no standardized treatment protocol is available for retinoids and topical drugs as well as cryosurgery, laser therapy and conventional surgery have failed. In most cases with a persistent lesion or recurrence, we present a review of the literature and the specific case of a 70-year-old female patient with a PVL in the region of the upper left jaw and incipient right jaw.

Bupropion reduces the inflammatory response and intestinal injury due to ischemia-reperfusion.

Intestinal ischemia-reperfusion (I/R) causes severe organ failure and intense inflammatory responses, which are mediated in part by the cytokine tumor necrosis factor-alpha (TNF-alpha). Bupropion is an antidepressant known to inhibit TNF-alpha production. We sought to examine the protective effects of bupropion on intestinal I/R injury in 15 male Sprague-Dawley rats that were randomized to sham surgery, 45 minutes of intestinal ischemia followed by 180 minutes reperfusion, or bupropion (100 mg/kg) before the intestinal I/R injury. To evaluate the systemic inflammatory response induced by intestinal I/R, we measured serum levels of TNF-alpha, interleukins-1 and -6, lipid peroxidation, and transaminases. Histologic analysis evaluated intestinal injury using the Chiu muscosal injury score. After I/R, Chiu score in control animals was 3.6 ± 1.2 vs 2.6 ± 0.53 in animals that received bupropion (P < .05). Bupropion pretreatment reduced intestinal. I/R injury and blunted serum elevations of TNF-alpha (0.96 ± 1.1 ng/mL vs 0.09 ± 0.06 ng/mL, P < .05) and interleukin-1 (0.53 ± 0.24 ng/mL vs 0.2 ± 0.11 ng/mL, P < .05). Bupropion in reduced intestinal I/R injury through immunomodulatory machanisms that involve inflammatory cytokines such as TNF-alpha.

Effects of thalidomide and pentoxyphylline over local and remote organ injury after intestinal ischemia/reperfusion.

OBJECTIVE: We investigated the effects of thalidomide alone or in combination with pentoxyphylline upon intestinal ischemia/reperfusion (I/R) injury in the rat. MATERIALS AND METHODS: Twenty male Wistar rats were randomized into 5 groups: sham-operated (SHAM), control (CTL), thalidomide (400 mg/kg) treatment (THAL), pentoxyphylline (50 mg/kg) treatment and a combination group (THAL + POX). I/R was induced by clamping the superior mesenteric artery for 45 minutes, followed by 120 minutes of reperfusion. We measured serum concentrations of aspartate-aminotransferase (AST), lactate dehydrogenase (LDH), tumor necrosis factor (TNF)-alpha as well as lipid peroxidation and antioxidant status. Intestinal samples were morphologically analyzed, and dry to wet (W/D) ratios calculated in intestinal, lung and liver samples, as a measurement of tissue edema. RESULTS: Serum concentrations of AST, LDH, and TNF-alpha were increased after I/R in the CTL compared with the SHAM group (P < .05). Lipid peroxidation was also increased, and antioxidant capacity in serum, decreased (P < .05). The W/D ratio was elevated in all tissue samples as well (P < .05). Both thalidomide and pentoxyphylline effectively reduced AST, LDH, TNF-alpha, and lipid peroxidation levels, as well as attenuated tissue edema and intestinal injury induced by I/R (P < .05). Combination treatment showed only modest additive effects on lung W/D ratio and TNF-alpha levels. CONCLUSION: Both drugs protected the intestine, lungs, and liver against intestinal I/R injury, probably by inhibition of TNF-alpha and lipid peroxidation. However, combination treatment showed small, additive effects.

Variables asociadas a la calidad de la dieta en preescolares de Hidalgo, México / Associated factors with diet quality in preschool children from Hidalgo, Mexico

Nutrition and health are both associated with the nutritional status of individuals. In this paper we evaluate the quality of the diet and its association with relevant socioeconomic aspects in preschool children from Hidalgo, México. We obtained data for children 24-59 months of age on weight, height, food intake using 24-hr recall and socioeconomic data. The data was processed in PLANUT 3.0, ANTHRO 2005 and STATA 9.0. The median value of calorie intake was 1090 and 933 Kcall day for boys and girls respectively; higher intakes were observed in urban areas. The group presented deficiencies in calorie intake, retinol, calcium, iron and zinc. Variables that showed significant association with percent adequacy were motherís use of indigenous language, beneficiaries of food programs and weekly food expenditure. The most relevant problems were chronic under nutrition in rural communities (23.9%) and obesity in urban areas (10.6%). Differences in the quality of the diet and nutritional status between rural and urban areas in Hidalgo, México reflect the socioeconomic inequalities in social groups and smaller regions.

La alimentación es el principal factor que determina el estado de nutrición y salud. En este trabajo se pretende evaluar la calidad de la dieta y su asociación con factores socioeconómicos relevantes en preescolares del Estado de Hidalgo, México. Se obtuvieron datos de peso y talla, dieta por recordatorio de 24 horas y datos socioeconómicos de niño(a)s de 24 a 59 meses. Los datos se procesaron en PLANUT 3.0, ANTHRO 2005 y STATA 9.0. La mediana de consumo fue de 1090 para niños y 933 Kcal en niñas, siendo mayor el consumo de energía en localidades urbanas. El grupo estudiado presentó importantes deficiencias en el consumo de energía, retinol, calcio, hierro y zinc. Las variables que mostraron significativa asociación con porcentaje de adecuación fueron uso de lengua indígena en la madre, beneficiarios de programas alimentarios y gasto semanal en alimentos. Los problemas más relevantes fueron la desnutrición crónica en localidades rurales (23,9%) y la obesidad en urbanas (10,6%). Los contrastes de la calidad de la dieta y estado de nutrición entre localidades rurales y urbanas del estado de Hidalgo, México, reflejan la desigualdad socioeconómica entre grupos sociales y micro regiones.

Malignant glioma as a secondary malignant neoplasm after radiation therapy for craniopharyngioma: report of a case and review of reported cases.

BACKGROUND: The development of a secondary neoplasm in childhood cancer survivors attains growing importance due to the reported excellent survival and therefore the long exposure to potentially carcinogenic effects of treatment. CASE REPORT: We report a 14-year-old girl in whom a large craniopharyngioma (CP) was diagnosed. After surgery, radiation therapy (RT) was given for residual tumour. Discrete progression necessitated further surgery, resulting in permanent tumour control. Soon after the second surgery hypothalamic-pituitary dysfunction developed together with obesity. Supportive hormone therapy was initiated. Growth hormone (GH) therapy was also given for 15 months. Four years after the diagnosis, a cerebropontine anaplastic astrocytoma WHO grade III was detected, with the main lesion being at the dorsal edge of the irradiated area. The girl died 1 month later from this secondary presumably radiation-induced tumour. Only recently a second child with RT for a CP was diagnosed with malignant glioma in our hospital. CASE REPORTS IN THE LITERATURE: 12 other cases of malignant glioma have been reported after RT for CP. Including our present cases, the mean latency period was 10.7 years (median 9.6 years). However, the shortest latency periods were found in patients who had received GH therapy. In numerous cases, the secondary tumour was seen at the edge of the irradiated volume, and not in the region with the highest absorbed dose. CONCLUSIONS: Therapy-induced secondary gliomas after treatment of CP or other intracranial tumours are rare but dramatic late events with a very poor prognosis. Including our own 2 patients, we reviewed 14 cases of CP with occurrence of a secondary, probably radiation-induced malignant glioma. The short latency periods for patients treated with GH is remarkable. We therefore suspect that GH therapy may accelerate the development of a secondary brain tumour. We are reluctant to recommend GH therapy in conventionally irradiated CP patients. In order to seriously answer the questions about therapy-induced secondary neoplasms, a life-long follow-up is mandatory for all patients who are survivors of childhood cancer.

Reproducibility of lymphoscintigraphy in cutaneous melanoma: can we accurately detect the sentinel lymph node by expanding the tracer injection distance from the tumor site?

UNLABELLED: The aim of the study was to determine whether the sentinel lymph node (SLN) can be accurately detected in cutaneous melanoma patients when the injection distance from the tumor site is expanded. METHODS: In 100 patients with cutaneous melanoma, lymphoscintigraphy was performed twice. First, we injected 37 MBq (99m)Tc nanocolloid intracutaneously at a 2- to 5-mm distance from either the melanoma or the biopsy scar. The injection was followed by dynamic imaging, which continued until the SLN became visible. On another day, we repeated the investigation, injecting the radiopharmaceutical intracutaneously exactly 10 mm from the previous injection site. The detected SLNs of both investigations were compared to determine the number and location of SLNs for each patient. RESULTS: The SLN identification rate was 94% with close injection and 100% with 10-mm-distant injection. All SLNs detected with close injection were visible with distant injection. In 84 of 100 patients, the images of both investigations showed the same number and location of SLNs. In the remaining 16 patients, an additional SLN was detected with the distant injection. CONCLUSION: The reproducibility of lymphoscintigraphy using different injection distances was 84%. The discordance in the remaining 16% was caused by detection of a lymph node in addition to the original SLN with distant injection. Diagnostic excision of the primary tumor before lymphoscintigraphy was possible without preventing detection of the original SLN. However, in 16% of our patients, excision of an additional lymph node had to be considered when lymphoscintigraphy was performed after diagnostic excision.

Lymphoscintigraphy in breast cancer patients--comparison of peritumoural and intradermal injection.

UNLABELLED: AIM of this study was to determine whether the sentinel lymph nodes (SLNs) can be accurately identified in breast cancer patients with intradermal injection of the radiotracer above the primary tumour in comparison to peritumoural injection. METHODS: In 45 women with breast cancer we performed lymphoscintigraphy on two separate days. We injected Tc-99m nanocolloid on the first day peritumourally, and on a separate day intradermally. The results of both investigations using different injection sites were compared in order to determine the number and location of SLNs. RESULTS: The SLN identification rate using peritumoural injection was 71% (32 of 45 patients) and 96% (43 out of 45 patients) using intradermal injection. In 62% (28 of 45 patients) the number and location of the SLNs were identical. In 97% (31 of 32 patients) in whom a SLN was detected using peritumoural injection, the same SLNs reappeared with intradermal injection. There were no false negative findings with the peritumoural administration of tracer whereas the intradermal administration approach resulted in a false negative rate of 13%. CONCLUSION: In women with breast cancer the reproducibility of lymphoscintigraphy using peritumoural and intradermal injection sites was 62%. The intradermal injection modality enables the detection of a SLN in patients where the peritumoural injection failed but it has the disadvantage of a higher false negative rate in comparison to the peritumoural injection technique.

[Risk factors for preeclampsia. Multivariate analysis]. / Factores de riesgo para preeclampsia. Análisis multivariado.

OBJECTIVE: To determine in multivariate analysis the clinical, social, and demographic factors for preeclampsia. STUDY DESIGN: A case-control study was designed. Three hundred patients were included, divided in two groups. 150 cases with criteria diagnosis for preeclampsia. 150 patients with normal pregnancy and deliveries. The main variables analyzed were age, schooling, marital status, employment, socioeconomic status, smoking and alcohol consumption, body mass index, familiar history of preeclampsia, history of preeclampsia in previous pregnancy, parity and type of pregnancy (single or multiple). STATISTICAL ANALYSIS: For comparison of cases and controls on categorical variables, odds ratios and 95% confidence intervals were calculated, and multiple logistic regression analyses. RESULTS: Multiple logistic regression analysis showed that history of preeclampsia in previous pregnancy has OR 23.7, 95% p < 0.001, familiar history of preeclampsia OR 1.62, p < 0.08, high body mass has OR 1.60. CONCLUSIONS: The knowledge of the most important risk factors in our population could be useful for the clinical to pre-detect the patient who will develop preeclampsia.

Detecting the sentinel lymph node in patients with differentiated thyroid carcinoma.

The aim of this study was to evaluate sentinel lymph node mapping in patients with differentiated thyroid carcinoma. Nine patients with suspected thyroid carcinoma who were scheduled to undergo thyroidectomy underwent scintigraphic localization of sentinel lymph nodes (SLNs). On the day of surgery we injected 37 MBq technetium-99m nanocolloid intratumourally. Dynamic data up to 10 min followed by planar anterior and lateral oblique images up to 1 h after tracer administration were recorded. At surgery the primary tumour was excised first, then the SLNs were removed using a gamma probe. Four patients had papillary carcinoma, two follicular carcinoma, one an oncocytic tumour and two benign tumours. An SLN was identified in all four patients with papillary carcinoma. In the two patients with follicular carcinoma, SLN detection failed. Five patients had one radioactive node, one had three and one had four. In one patient, no SLN was visible with scintigraphic imaging but at surgery three SLNs could be clearly identified using the gamma probe after removal of the primary tumour. There were no false-negative findings. This initial study indicates that in patients with papillary thyroid carcinoma detection of the SLN is possible, whereas the technique failed in two patients with follicular carcinoma. A study on a larger patient sample is now warranted.

[Detection of melanoma metastases with Tc-99m-tetrofosmin]. / Nachweis von Melanommetastasen mit Tc-99m-Tetrofosmin.

AIM: The aim of this study was to evaluate Tc-99m-tetrofosmin whole-body imaging in the detection of metastases in patients with malignant melanoma. METHODS: In 30 patients with suspected melanoma metastases we performed whole body imaging. After administration of about 600 MBq Tc-99m-tetrofosmin dynamic images up to 10 min were performed in 7 patients (1 image per 10 sec) to evaluate the optimal tracer uptake in the metastases. In all patients whole-body images were performed 5-10 min p.i. using an acquisition time of 5 min per image. The final diagnosis was confirmed by surgical histology in 30 lesions, by computertomography and clinical course in the remaining lesions. RESULTS: Out of 64 melanoma metastases 49 were detected using Tc-99m-tetrofosmin scintigraphy (49 rp., 15 fn.). The overall sensitivity for the detection of malignant lesions was 77%. Referring only to the lymph node metastases, the sensitivity was 87% (26 rp.; 4 fn.). The maximal tracer uptake was reached 1 min after injection, with a slow decrease in the following 10 minutes. The size of the lesions ranged between 0.5 and 7.0 cm and the T/B ratios between 1.3 and 3.0 (mean 1.88). CONCLUSIONS: Tc-99m-tetrofosmin whole body imaging is a simple and side-effectless method for the detection of melanoma metastases especially of lymph node metastases. The results are comparable to Tc-99m-sestamibi and Tl-201 scintigraphy.

Whole-body scintigraphy in melanoma patients: comparison of 99Tcm-tetrofosmin and 201Tl.

The aim of this study was to determine the diagnostic value of 99Tcm-tetrofosmin whole-body imaging in comparison to 201Tl scintigraphy in patients with metastatic melanoma. In 27 patients with known or suspected melanoma metastases we performed 201Tl scintigraphy and 99Tcm-tetrofosmin scintigraphy using a 1-day protocol. In five patients with known locoregional metastasis the in vivo uptake kinetics of both radiotracers were compared. The final diagnosis was confirmed by surgical histology in 39 lesions (group I) and computed tomography (CT) and clinical course in 14 lesions (group II). In group I, containing mainly locoregional metastases, 201Tl scintigraphy correctly identified 36 of 39 metastases and 99Tcm-tetrofosmin 35 of 39 resulting in a sensitivity of 92% and 90% respectively. The T/B ratios of 201Tl (1.4-4.0, mean 2.15) were statistically significantly higher in comparison to tetrofosmin (1.3-3.0, mean 1.88). However, both radiotracers showed similar uptake and washout kinetics with a maximum of tracer uptake between 1 and 5 min p.i. In group II, containing mainly cerebral and pulmonary metastases, both methods correctly identified six of 14 metastases resulting in a sensitivity of only 43%. We conclude that the uptake of 99Tcm-tetrofosmin and 201Tl in melanoma metastases is very similar. The T/B ratios with 99Tcm-tetrofosmin are significantly lower than with 201Tl. In locoregional melanoma metastases the sensitivity of tetrofosmin scintigraphy is identical with 201Tl imaging and amounts to 90%. In cerebral and lung metastases the sensitivity of both methods is limited when using whole-body scintigraphy.

Detection of melanoma metastases with thallium-201 scintigraphy.

UNLABELLED: Thallium-201 accumulates well in various malignant tumors. The aim of this study was to evaluate the potential of 201Tl imaging in patients with metastatic melanoma. METHODS: Fifty patients with suspected melanoma metastases were studied after intravenous injection of a mean tracer activity of 100 MBq 201Tl-chloride. We took sequence images up to 5 min (15 sec/image) and immediate whole-body images with a double-headed camera and a high-resolution collimator. RESULTS: Of 36 patients with metastatic melanoma confirmed by histopathology, metastases were detected in 28 patients using 201Tl imaging. The tumor-to-background ratio ranged from 2.0 to 4.5 (mean 3.2). There were 8 patients with false-negative findings (sensitivity = 78%). Five false-negative findings were lymph nodes greater than 1.5 cm with tumor-to-background ratios lower than 1.5. Only a few cutaneous metastases smaller than 1 cm could be detected. There was one false-positive finding of an inflamed lymph node. The optimum time for imaging was 2-5 min postinjection. CONCLUSION: These data suggest that 201Tl imaging is an accurate method for the detection of melanoma metastases. The short waiting period after injection, the lack of side effects and the sensitivity of about 80% may qualify this method as a routine investigation in patients with high-risk melanoma.

Luteinizing hormone-releasing hormone antagonist Cetrorelix (SB-75) and bombesin antagonist RC-3940-II inhibit the growth of androgen-independent PC-3 prostate cancer in nude mice.

BACKGROUND: Hormones like bombesin (BN)/gastrin-releasing peptide (GRP) and luteinizing hormone-releasing hormone (LH-RH) and growth factors such as epidermal growth factor (EGF) might be involved in the relapse of prostate cancer under androgen ablation therapy. Interference with receptors for BN/GRP, LH-RH, or EGF might provide a therapeutic approach to inhibit tumor growth of androgen-independent prostate cancer. METHODS: LH-RH antagonist Cetrorelix (SB-75) and the BN/GRP antagonist RC-3940-II were tested for their effects on the growth of the androgen-independent PC-3 human prostate cancer cell line xenografted into nude mice. Tumor growth, serum hormone levels, and receptor concentrations for BN/GRP and EGF were measured. RESULTS: When the treatment was started, tumor volume in all groups was 70-80 mm3. After 4 weeks, tumor volume in the control animals injected with saline was 871 +/- 233 mm3 and that of animals treated with Cetrorelix only 197 +/- 61 mm3. The BN/GRP antagonist RC-3940-II also significantly reduced PC-3 tumor volume in nude mice to 122 +/- 20 mm3. The combination of Cetrorelix and RC-3940-II produced no additional inhibition. High-affinity receptors for EGF were detected in the tumor membranes and their number was significantly decreased after administration of Cetrorelix or RC-3940-II. CONCLUSIONS: These findings demonstrate that LH-RH antagonists and BN/GRP antagonists inhibit the growth of the androgen-independent prostate cancer cell line PC-3 in vivo. Both analogs may exert a direct inhibitory effect on tumor growth through a down-regulation of EGF receptors.