Comparing Apparent Diffusion Coefficient and FNCLCC Grading to Improve Pretreatment Grading of Soft Tissue Sarcoma-A Translational Feasibility Study on Fusion Imaging.

Histological subtype and grading are cornerstones of treatment decisions in soft tissue sarcoma (STS). Due to intratumoral heterogeneity, pretreatment grading assessment is frequently unreliable and may be improved through functional imaging. In this pilot study, 12 patients with histologically confirmed STS were included. Preoperative functional magnetic resonance imaging was fused with a computed tomography scan of the resected specimen after collecting core needle biopsies and placing radiopaque markers at distinct tumor sites. The Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading criteria of the biopsies and apparent diffusion coefficients (ADCs) of the biopsy sites were correlated. Concordance in grading between the specimen and at least one biopsy was achieved in 9 of 11 cases (81.8%). In 7 of 12 cases, fusion imaging was feasible without relevant contour deviation. Functional analysis revealed a tendency for high-grade regions (Grade 2/3 (G2/G3)) (median (range) ± standard deviation: 1.13 (0.78-1.70) ± 0.23 × 10-3 mm2/s) to have lower ADC values than low-grade regions (G1; 1.43 (0.64-2.03) ± 0.46 × 10-3 mm2/s). In addition, FNCLCC scoring of multiple tumor biopsies proved intratumoral heterogeneity as expected. The ADC appears to correlate with the FNCLCC grading criteria. Further studies are needed to determine whether functional imaging may supplement histopathological grading.

The Current S2e Guideline for Hallux valgus - Evidence-based Guideline Development Using Meta-analysis. / Die aktuelle S2e-Leitlinie zum Hallux valgus ­ eine evidenzbasierte Leitlinienentwicklung mittels Metaanalyse.

The hallux valgus deformity is untreated usually regarded as progressive deformity that does not necessarily lead to pain and suffering for the patient. Prevention primary: foot conforming footwear to avoid bruising and to avoid a forced progression of pathology. Functional stabilization of the foot by means of gymnastics or physiotherapy instructions. Secondary: orthotic and/or insoles to improve the functional stabilization. Tertiary: consistent adapted postoperative treatment, which is based on the operation procedure. The indication for initiation of a therapeutic measure is based on the suffering of the patient, age and presence of arthritis in the MTP-I-joint. More patient-specific pathologies may affect the initiation of treatment also. In the first stage of outpatient consultation and physiotherapy are at the forefront, additive analgesic or anti-inflammatory medication. Manual therapies, physiotherapy, orthotics or orthopedic measures adopted in view of the existing pathology and suffering pressure. In stage 2 of outpatient or inpatient surgical treatment therapeutic measures are indicated when symptomatic hallux valgus surgical therapy should be oriented on the severity of the pathology and the postoperative mobilization possibilities of the patient and other patient-specific criteria.

Evaluation of STAT5A Gene Expression in Aflatoxin B1 Treated Bovine Mammary Epithelial Cells.

PURPOSE: Aflatoxin B1 (AFB1) is a potent mycotoxin which has been produced by fungi such as Aspergillus flavus and Aspergillus parasiticus as secondary metabolites due to their growth on food stuffs and induces hepatocellular carcinoma in many animal species, including humans. In the present study, the effect of AFB1 on STAT5A gene expression was investigated in bovine mammary epithelial cells using real time RT-PCR. METHODS: Bovine mammary epithelial cells were seeded in a 24-well culture plate for three-dimensional (3D) culture in Matrigel matrix. After 21 days of 3D culture and reaching the required number of cells, cells were treated with AFB1 and incubated for 8 h. For real time PCR reaction, total RNA from the cultured and treated cells was extracted and used for complementary DNA synthesis. RESULTS: The expression of STAT5A gene was significantly down regulated by AFB1 in dose- dependent manner and led to the reduction of proliferation and differentiation of epithelial cells, which has direct effect in milk protein quantity and quality. CONCLUSION: According to the results, it seems that down regulation of STAT5A gene in AFB1-treated cells maybe due to DNA damage induced by AFB1 in bovine mammary epithelial cells.