Case report: Poorly differentiated breast carcinoma presenting as a breast abscess.

We report a case of 31-year-old female with no past medical history who presented with sudden onset discharging skin ulcer in left inframammary fold with erythema and swelling immediately after she came back from holiday for which she presented to the breast one stop clinic and underwent ultrasound-guided aspiration of the detected cystic lesion in the left breast with impression of breast abscess. Afterwards, as the result of cytology reporting as C5, ultrasound-guided Core-Needle Biopsy was performed, which confirmed poorly differentiated carcinoma of breast. Furthermore, similar necrotizing masses were found in axillary lymph nodes and Liver. The final diagnosis was concluded as poorly differentiated breast carcinoma with metastasis to axillary lymph nodes and the liver. This case reports a very uncommon presentation of breast carcinoma in a young patient with no past medical history, presenting with cystic necrotizing mass which is extremely rare in breast cancer. At the time of presentation, carcinoma had spread to the liver and axillary nodes.

Triptorelin Peptide Conjugated Alginate Coated Gold Nanoparticles as A New Contrast Media for Targeted Computed Tomography Imaging of Cancer Cells.

OBJECTIVE: Increasing research has been focused on the development of various nanocomplexes as targeted contrast media in diagnostic modalities, mainly in computed tomography (CT) scan imaging. Herein, we report a new method that uses Triptorelin [a luteinizing hormone-releasing hormone (LHRH) agonist]-targeted gold nanoparticles (AuNPs) via alginate for early detection of cancer by molecular CT imaging. MATERIALS AND METHODS: In the experimental study, the formed multifunctional AuNPs coated with alginate conjugated with Triptorelin peptide (Triptorelin-Alginate-AuNPs) were synthesized and characterized via different techniques, including transmission electron microscopy (TEM), dynamic light scattering (DLS), and fourier transform infrared (FTIR) spectroscopy. The MTT assay was applied to calculate the toxicity of the NPs. RESULTS: The results indicated that the formed Triptorelin-Alginate-AuNPs with an Au core size of ~18 nm are noncytotoxic at 127-, 254-, 381- and 508-mM concentrations and revealed significant improvement in the attenuation of X-rays intensity and contrast to noise ratio (CNR), compared with non-targeted cells at the highest energies (90, 120, 140 kVp). At 90 kVp, compared to non-targeted cells, targeted cells (Triptorelin-Alginate-AuNPs) enable 1.58, 1.69, 3.7 and 3.43 times greater contrast at a concentration of 127 mM, 254 mM, 381 mM, and 508 mM, respectively. CONCLUSION: These results suggest that the developed Triptorelin-Alginate-AuNPs may be considered an effective contrast agent for molecular CT imaging of gonadotropin-releasing hormone (GnRH) receptor-expressing cancer cells.

A review of the neurological complications of breast cancer.

Conducting broad assessments of the main burden of breast cancer is the core factor for improving overdiagnosis and overtreatment of breast cancer patients as well as their survival rates. Breast cancer patients may experience neurological complications that cause devastating effects on them. Chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain are two of the most reported complications. Objective: This study aims to review the neurological complications of breast cancer and the ways to control and treat them. Comprehensive searches were carried out about the keywords of Breast Cancer, Neurological Complications, and Breast Cancer Consequences. These keywords were searched through the most well-known databases of MEDLINE, PUBMED, Cochrane Library, Best Evidence, CancerLit, HealthSTAR, and LegalTrac. In this regard, 83 articles were chosen to be included in this study from 2010 to 2021. The identification and treatment process of neurologic syndromes are not easy. The main neurologic syndromes which the breast cancer patients face are opsoclonus myoclonus syndrome (OMS), encephalitis, sensorimotor neuropathy, retinopathy, cerebellar degeneration, and stiff-person's syndrome. CIPN and neuropathic pain are among the most prevalent side effects which are categorized as neurological complications and mainly seen 1 year after the management of breast cancer. Aiming to minimize the burden following the treatment of breast cancer, these complications should be diagnosed and treated accurately.

Modified Bismuth Nanoparticles: A New Targeted Nanoprobe for Computed Tomography Imaging of Cancer.

OBJECTIVE: Recently, development of multifunctional contrast agent for effective targeted molecular computed tomography (CT) imaging of cancer cells stays a major problem. In this study, we explain the ability of Triptorelin peptide-targeted multifunctional bismuth nanoparticles (Bi2S3@ BSA-Triptorelin NPs) for molecular CT imaging. MATERIALS AND METHODS: In this experimental study, the formed nanocomplex of Bi2S3@ BSA-Triptorelin NPs was characterized using different methods. The MTT cytotoxicity test was performed to determine the appropriate concentration of nanoparticles in the MCF-7 cells. The X-ray attenuation intensity and Contrast to Noise Ratio (CNR) of targeted and non-targeted nanoparticles were measured at the concentrations of 25, 50, and 75 µg/ml and X-ray tube voltages of 90, 120 and 140 kVp. RESULTS: We showed that the formed Bi2S3@ BSA-Triptorelin NPs with a Bi core size of approximately ~8.6 nm are nontoxic in a given concentration (0-200 µg/ml). At 90, 120, and 140 tube potentials (kVp), the X-ray attenuation of targeted cells were 1.35, 1.36, and 1.33-times, respectively, more than non-targeted MCF-7cells at the concentration of 75 µg/ml. The CNR values at 90, 120, and 140 kVp tube potentials were 171.5, 153.8 and 146.3 c/Ï­, respectively. CONCLUSION: These findings propose that the diagnostic nanocomplex of Bi2S3@ BSA-Triptorelin NPs can be applied as a good contrast medium for molecular CT techniques.

DNA double-strand break repair and adaptive responses of low-dose radiation in normal and tumor lung cell lines.

The adaptive response (AR), which can be induced by low-dose ionizing radiation (LD), may influence the therapeutic ratio of cancer treatment. We investigated the AR and the DNA double-strand break (DSB) repair pathway in human lung tumor cells and normal cells. We measured viability and proliferation of normal lung cells (MRC-5) and lung cancer cells (QU-DB) using the MTT and colony formation assays. Flow cytometric analysis of γ-H2AX was used to measure DNA-DSBs induction, repair, and residual damages. AR was seen in the normal cells but not in the cancer cells. Our findings suggest that LD stimulates DSB repair and that this may contribute to distinctive AR in normal vs. cancer cells.

A review of the revisions and complications management procedure in sinus surgery.

One of the most standard and least invasive surgical procedures that could be applied mostly for the treatment of inflammation of the paranasal sinuses is endonasal endoscopic sinus surgery. The main objective of this study is to assess the available strategies for avoiding, diagnosis and also dealing with various kinds of potential complications of sinus disorders as well as the symptoms which specify the need for revision endoscopic sinus surgery mainly for the treatment of chronic rhinosinusitis. Based on the objectives of this study, the studies were categorized within four main groups; sinus disorders, diagnosis, management, and treatment. In this regard, wide research has been done in various scientific databases of PubMed, EMBASE, Europe PMC, HubMed, MEDLINE, Scientific Information Database (SID) and Google Scholar. From a total of 315 founded records, the final number of 91 records were reviewed. The rate of complication associated with endoscopic sinus surgery is not much and the improvement of surgical technology and experience could decrease its side effects. Performing immediate extensive surgery among patients who have inflammatory sinonasal disease could modify long-term consequences. Applying endoscopic sinus surgery could yield the most appropriate positive outcomes. For achieving the most suitable surgical consequences, the surgeon should be adequately qualified in diagnosis and facing with any possible complications during the operation in addition to cases with complex and revision problems.

Observation of targeted gold nanoparticles in nasopharyngeal tumour nude mice model through dual-energy computed tomography.

This study was performed to specify the efficiency of imaging nanoparticle concentration as contrast media in dual-energy computed tomography (DECT). Gold nanoparticles (AuNPs) and gold nanoparticles-conjugated folic acid through cysteamine (FA-Cya-AuNPs) were both considered as contrast agents. Characterization of NPs was performed using Dynamic Light Scattering (DLS) and zeta potential. The hemocompatibility of NPs was confirmed by different blood parameters such as white blood cell, red cell distribution width, hemoglobin, lymphocytes counts and haemolysis assay. DECT algorithm was confirmed using calibration phantom at different concentrations of NPs and tube potentials (80 and 140 kVp). Then, DECT was used to quantify the concentration of both AuNPs and FA-Cys-AuNPs in human nasopharyngeal cancer cells. Mice were injected with non-targeted AuNPs and targeted AuNps at a concentration of 3 × 103 µg/ml. Then, they were scanned with different tube potentials. The concentration of nanoparticles in the various organs of nude mice was measured through DECT imaging and inductively coupled plasma mass spectrometry (ICP-MS) analysis. The results of DECT images were compared with ICP-MS analysis and indicated that they were approximately similar. In sum, FA-Cys-AuNPs can be a proper candidate for targeted contrast media in DECT molecular scanning of human nasopharyngeal tumours.

In vivo study of interferon-γ, transforming growth factor-ß, and interleukin-4 gene expression induced by radioadaptive response.

INTRODUCTION: In the present study, the radioadaptive role of the immune system induced by low dose (LD) was investigated for its in vivo protective activity. MATERIALS AND METHODS: Quantitative analysis of cytokine gene expression was assessed for their in vivo activity in BALB/c mice. To evaluate the adaptive response induced by LD on the mice spleen lymphocyte, the cytokine interleukin (IL)-4, interferon (IFN)-γ, and transforming growth factor (TGF)-ß expression was measured by a real-time quantitative polymerase chain reaction. To verify the radioadaptive effect of LD, animals were preirradiated at 10 cGy from a 60 Co source and then challenge dose at 200 cGy was delivered. Independent sample student's t-test was employed to compare cytokine gene expression in radioadaptive (10 + 200 cGy), LD (10 cGy), high-dose (HD, 200 cGy), and control groups of animals. RESULTS: Following the HD, the cytokine gene expression of IFN-γ, IL-4, and TGF-ß was significantly decreased compared to the control group (P = 0.0001). However, TGF-ß expression was also decreased significantly in the LD and adaptive groups compared to the control group (P = 0.0001). IFN-γ/IL-4 ratio in the adaptive group was significantly decreased compared to the HD group (P = 0.0001). CONCLUSION: These results indicate that the immune system plays an important role for radioadaptive response induction by LD radiation to adjust the harmful effects of HD irradiation.

Regulation of XPA could play a role in inhibition of radiation-induced bystander effects in QU-DB cells at high doses.

INTRODUCTION: Radiation-induced bystander effects (RIBE) is the radiobiological effects detected in nonirradiated cells that have received signals from neighboring irradiated cells. In some studies, there are observations that RIBE unexpectedly reduces at high doses. In this study, the expression of two selected apoptotic and repair genes and their possible role in the formation of this unexpected reduction is examined. MATERIALS AND METHODS: The QU-DB cells were irradiated with gamma rays of a60 Co teletherapy unit at doses of 2, 4, 6, and 8 Gy. One hour following irradiation, their culture media were transferred to bystander cells to induced RIBE. After 24 h incubation, the RNA of cells was isolated and cDNA synthesized. Expression levels of BAX, XPA, and XPA/BAX ratio were examined by relative quantitative reverse transcription-polymerase chain reaction. RESULTS: In target cells, up-regulation of both genes was observed at all doses. In bystander cells, at the low dose (2 Gy), the expression of BAX was more than XPA; at 4 Gy, the ratio was balanced. A significant correlation was found between the XPA/BAX ratio and the dose, at high doses pattern of gene expression dominated by DNA repair gene. CONCLUSION: Gene expression profile was distinctive in bystander cells compared to target cells. The observed linear increasing of the ratio of XPA/BAX could support the hypothesis that the DNA repair system is stimulated and causes a reduction in RIBE at high doses.

Dual-energy CT imaging of nasopharyngeal cancer cells using multifunctional gold nanoparticles.

The purpose of this study is to measure the concentration of gold nanoparticles (AuNPs) attached to folic acid through cysteamin as the linker (FA-Cys-AuNPs) and AuNPs in KB human nasopharyngeal cancer cells using dual-energy CT (DECT). In this study, nanoparticles with a size of ∼15 nm were synthesized and characterised using UV-Vis, TEM, FTIR and ICP-OES analyses. The non-toxicity of nanoparticles was confirmed by MTT assay under various concentrations (40-100 µg/ml) and incubation times (6, 12 and 24 h). To develop an algorithm for revealing different concentrations of AuNPs in cells, a corresponding physical phantom filled with 0.5 ml vials containing FA-Cys-AuNPs was used. The CT scan was performed at two energy levels (80 and 140 kVp). One feature of DECT is material decomposition, which allows separation and identification of different elements. The values obtained from the DECT algorithm were compared with values quantitatively measured by ICP-OES. Cells were also incubated with AuNPs and FA-Cys-AuNPs at different concentrations and incubation times. Subsequently, by increasing the incubation time in the presence of FA-Cys-AuNPs, in comparison with AuNPs, DECT pixels were increased. Thus, FA-Cys-AuNPs could be a suitable candidate for targeted contrast agent in DECT molecular imaging of nasopharyngeal cancer cells.

Targeted gold nanoparticles enable molecular CT imaging of head and neck cancer: An in vivo study.

The development of various cost-effective multifunctional contrast agent for specific targeting molecular imaging of tumors presents a great challenge. We report here the in vivo targeting imaging of folic acid (FA) gold nanoparticles (AuNPs) through cysteamine (Cys) linking for targeted of human nasopharyngeal head and neck cancer by computed tomography (CT). The toxicity of nanoparticles in kidney, heart, spleen, brain and liver was evaluated by H&E (hematoxylin and eosin) assay. We showed that the formed FA-Cys-AuNPs with an Au core size of ˜13 nm are non-cytotoxic in the particle concentration of 3 × 103 µg/ ml. The nude mice were scanned using a 64-slice CT scan with parameters (80 kVp, slice thickness: 0.625 mm, mAs: 200, pitch: 1). CT scan was performed before and after (Three and six hours) I.V (Intra Venous) injection of AuNPs and FA-Cys-AuNPs. The distribution of nanoparticles in the nude mice was evaluated by imaging and coupled plasma optical emission spectrometry (ICP-OES) analysis. The findings clearly illustrated that a small tumor, which is undetectable via computed tomography, is enhanced by X-ray attenuation and becomes visible (4.30-times) by the molecularly targeted AuNPs. It was further demonstrated that active tumor cells targeting (FA-Cys-AuNPs) is more specific and efficient (2.03-times) than passive targeting AuNPs. According to the results, FA-Cys-AuNPs can be employed as a promising contrast agent in CT scan imaging and maybe in radiotherapy that require enhanced radiation dose.

Folic acid-cysteamine modified gold nanoparticle as a nanoprobe for targeted computed tomography imaging of cancer cells.

Development of various cost-effective multifunctional nanoprobes for efficient targeted molecular imaging of tumors remains a great challenge in medicine. Herein, we report a simple method of forming folic acid-targeted multifunctional gold nanoparticles via cost-effective cysteamine as a template for tumor molecular computed tomography (CT) imaging technique. The formed multifunctional cysteamine-folic acid conjugated gold nanoparticles (FA-Cys-AuNPs) were characterized via different techniques. Colony assay, hematoxylin and eosin (H&E), MTT, and flow cytometry analysis were used to evaluate the cytocompatibility of the particles. We showed that the formed FA-Cys-AuNPs with an Au core size of ~15 nm are non-cytotoxic in a given concentration range and revealed greater X-ray attenuation intensity than iodine-based contrast agent under the same concentration of the active element. At 80 kVp, FA-Cys-AuNPs enable 1.77-times greater contrast per unit mass compared with iodine at a concentration of 2000 µg/ml, and importantly, the developed FA-Cys-AuNPs can be used as a contrast media for targeted CT imaging of folic acid receptor-expressing cancer cells in vitro. CT values of the targeted cells were 2-times higher than that of non-targeted cells at 80 kVp. These findings propose that the designed FA-Cys-AuNPs can be used as a promising contrast agent for molecular CT imaging. This data can be also considered for the application of gold nanostructures in radiation dose enhancement where nanoparticles with high X-ray attenuation are applied.

Assessment of The Dose-Response Relationship of Radiation-Induced Bystander Effect in Two Cell Lines Exposed to High Doses of Ionizing Radiation (6 and 8 Gy).

OBJECTIVES: The dose-response relationship of radiation-induced bystander effect (RIBE) is controversial at high dose levels. The aim of the present study is to assess RIBE at high dose levels by examination of different endpoints. MATERIALS AND METHODS: This experimental study used the medium transfer technique to induce RIBE. The cells were divided into two main groups: QU-DB cells which received medium from autologous irradiated cells and MRC5 cells which received medium from irradiated QU-DB cells. Colony, MTT, and micronucleus assays were performed to quantify bystander responses. The medium was diluted and transferred to bystander cells to investigate whether medium dilution could revive the RIBE response that disappeared at a high dose. RESULTS: The RIBE level in QU-DB bystander cells increased in the dose range of 0.5 to 4 Gy, but decreased at 6 and 8 Gy. The Micronucleated cells per 1000 binucleated cells (MNBN) frequency of QU-DB bystander cells which received the most diluted medium from 6 and 8 Gy QU-DB irradiated cells reached the maximum level compared to the MNBN frequency of the cells that received complete medium (P<0.0001). MNBN frequency of MRC5 cells which received the most diluted medium from 4 Gy QU-DB irradiated cells reached the maximum level compared to MNBN frequency of cells that received complete medium (P<0.0001). CONCLUSIONS: Our results showed that RIBE levels decreased at doses above 4 Gy; however, RIBE increased when diluted conditioned medium was transferred to bystander cells. This finding confirmed that a negative feedback mechanism was responsible for the decrease in RIBE response at high doses. Decrease of RIBE at high doses might be used to predict that in radiosurgery, brachytherapy and grid therapy, in which high dose per fraction is applied, normal tissue damage owing to RIBE may decrease.

A Nanotechnology-based Strategy to Increase the Efficiency of Cancer Diagnosis and Therapy: Folate-conjugated Gold Nanoparticles.

BACKGROUND: Gold nanoparticles (AuNPs), owing to their elegant physicochemical properties, have recently been introduced as promising theranostic nanoparticles. Folic acid is a necessary vitamin for cell proliferation. Accordingly, the surface functionalization of AuNP with folic acid may offer a great potential for the development of a strategy to increase the efficiency of cancer diagnosis and therapy based on the new nanotechnology. In this study, we have reviewed the recent progress made in the design and the biomedical application of various folate-conjugated gold nanoparticles (FAuNPs). METHODS: We performed a structured search in bibliographic databases and made a comprehensive list of relevant papers. The main subjects considered in this review included (1) methods for the preparation of F-AuNPs, (2) applications of F-AuNPs in computed tomography (CT), and (3) the use of F-AuNPs in targeted cancer therapy. RESULTS: As many as 96 papers were selected for the review. Accordingly, we explained the noncovalent and the covalent methods of fabricating the various types of F-AuNPs. Particular applications of F-AuNP in cancer diagnosis using the CT scan modality were described. In addition, the applications of F-AuNPs in targeted radiation therapy, chemotherapy, and hyperthermia were elucidated in depth. In the hyperthermia section, we presented certain extra explanations on F-AuNP-based laser, radiofrequency, and ultrasoundbased hyperthermia methods. CONCLUSION: This review identifies the important roles of F-AuNPs in current cancer studies that are being undertaken worldwide. The findings of this review confirm that F-AuNP is a new theranostic agent, which has a great potential for simultaneous cancer therapy and diagnosis.

Comparison of the hypothetical (57)Co brachytherapy source with the (192)Ir source.

AIM OF THE STUDY: The (57)Co radioisotope has recently been proposed as a hypothetical brachytherapy source due to its high specific activity, appropriate half-life (272 days) and medium energy photons (114.17 keV on average). In this study, Task Group No. 43 dosimetric parameters were calculated and reported for a hypothetical (57)Co source. MATERIAL AND METHODS: A hypothetical (57)Co source was simulated in MCNPX, consisting of an active cylinder with 3.5 mm length and 0.6 mm radius encapsulated in a stainless steel capsule. Three photon energies were utilized (136 keV [10.68%], 122 keV [85.60%], 14 keV [9.16%]) for the (57)Co source. Air kerma strength, dose rate constant, radial dose function, anisotropy function, and isodose curves for the source were calculated and compared to the corresponding data for a (192)Ir source. RESULTS: The results are presented as tables and figures. Air kerma strength per 1 mCi activity for the (57)Co source was 0.46 cGyh(-1) cm 2 mCi(-1). The dose rate constant for the (57)Co source was determined to be 1.215 cGyh(-1)U(-1). The radial dose function for the (57)Co source has an increasing trend due to multiple scattering of low energy photons. The anisotropy function for the (57)Co source at various distances from the source is more isotropic than the (192)Ir source. CONCLUSIONS: The (57)Co source has advantages over (192)Ir due to its lower energy photons, longer half-life, higher dose rate constant and more isotropic anisotropic function. However, the (192)Ir source has a higher initial air kerma strength and more uniform radial dose function. These properties make (57)Co a suitable source for use in brachytherapy applications.

Frequency and etiology of solitary hot spots in the pelvis at whole-body positron emission tomography/computed tomography imaging.

PURPOSE: To determine the frequency and etiology of a single hypermetabolic focus within the pelvis with no other areas of increased 18-fluorodeoxyglucose (FDG) uptake in the reminder of the whole body in an oncological population. METHOD AND MATERIALS: We retrospectively examined the first 700 whole-body PET/CT scans performed at our institution for baseline staging or follow-up of cancer and identified all patients with a solitary focus of increased FDG uptake in the pelvis. All available medical records and imaging findings in these patients were reviewed in order to determine the etiology of increased FDG uptake. RESULTS: Eight (1.1%) of the 700 patients had a solitary hot spot in the pelvis at positron emission tomography (PET)/computed tomography (CT) imaging, consisting of seven of 380 women and one of 320 men. In the seven women, increased FDG uptake was due to physiological endometrial uptake (n=2), leiomyoma (n=1), corpus luteum cyst (n=1), physiological ovarian uptake (n=1), urinary leak (n=1), and nonspecific colitis (n=1). In the man, uptake was due to recurrent rectosigmoid adenocarcinoma. None of the 700 patients was found to have metastatic disease in the pelvis. CONCLUSION: Isolated pelvic hot spots at PET/CT imaging in an oncological population are not common and usually benign; physiological endometrial or ovarian uptake is the single commonest cause.