Accessory spleen mimicking pancreatic tumour: evaluation by 99mTc-labelled colloid SPECT/CT study. Report of two cases and a review of nuclear medicine methods utility.

The accessory spleen is a common congenital anomaly, typically asymptomatic and harmless to the patient. However, in some clinical cases, this anomaly beco-mes significant as it can be mistaken for a tumour or lymph node and be missed during a therapeutic splenectomy. There are nuclear medicine modalities which can be applied in the identification and localisation of an accessory spleen. They include scintigraphy with radiolabelled colloids or heat damaged red blood cells, which are trapped in the splenic tissue. Modern techniques, including hybrid imaging, enable simultaneous structure and tracer distribution evaluations. Additionally, radiation-guided surgery can be used in cases where the accessory spleen, which is usually small (not exceeding 1 cm) and difficult to find among other tissues, has to be removed. In the study, we would like to present 2 cases of patients in which the malignancy had to be excluded for the reason that the multiple accessory spleens were very closely related to the pancreas. There was a lack of certainty in the multi-phase computed tomography (CT) evaluation; however, this situation was clearly resolved by using the 99mTc-stannous colloid single photon emission computed tomography/ CT study. We would also like to briefly analyse the clinical applications of nuclear medicine in case of an accessory spleen.

Urinary bladder diverticulum as an unusual content of the inguinal canal.

The inguinal urinary bladder hernia is a rare pathology observed mostly in males. A new case of asymptomatic reducible acquired inguinal hernia was revealed in a 54-year-old male during computed tomography (CT) undertaken for oncological follow-up. The right nephrectomy was previously performed due to clear cell carcinoma. The hernia was not visible on the CT 6 months before and on ultrasound performed after voiding. Slight herniation with a wide invagination of transversalis fascia but with empty bladder was seen on CT 4 months after the initial detection of hernia.

Safety and efficacy of neratinib (HKI-272) plus vinorelbine in the treatment of patients with ErbB2-positive metastatic breast cancer pretreated with anti-HER2 therapy.

BACKGROUND: Neratinib (HKI-272) is a potent irreversible pan-ErbB tyrosine kinase inhibitor with clinical activity in patients with ErbB2/HER2-positive breast cancer. PATIENTS AND METHODS: Phase I of this open-label, phase I/II study investigated the maximum tolerated dose (MTD) of oral neratinib (160 or 240 mg/day) plus vinorelbine (25 mg/m2; days 1 and 8 of each 21-day cycle) in patients with solid tumors. Phase II assessed the safety, clinical activity, and pharmacokinetics of the combination in patients with HER2-positive metastatic breast cancer; the primary efficacy end point was objective response (OR). RESULTS: In phase I (n=12), neratinib (240 mg) plus vinorelbine (25 mg/m2) was established as the MTD. In phase II, 79 patients with HER2-positive metastatic breast cancer were treated at the MTD. The most common treatment-related adverse events were diarrhea (96%), neutropenia (54%), and nausea (50%). Three patients discontinued treatment due to diarrhea. No clinically important skin side-effects were observed. The OR rate in assessable phase II patients was 41% (no prior lapatinib) and 8% (prior lapatinib). There was no evidence of pharmacokinetic interaction between neratinib and vinorelbine. CONCLUSION: Neratinib plus vinorelbine showed promising antitumor activity and no unexpected toxic effects in HER2-positive metastatic breast cancer patients. Trial registration ClinicalTrials.gov #NCT00706030.

Anatomical classification of the shape and topography of the operated stomach.

The aim of the study was to present the classification of anatomical variants of the operated stomach, based on radiological and historical data. Different anatomical variants of the operated organ were found in 431 out of 2034 patients examined in the years 2006-2010. Four main groups were established: abnormal position along longitudinal (I) and horizontal axis (II), as well as abnormal shape (III) and stomach connections (IV). An additional group (V) encloses mixed forms that combine features of two or more of the main groups. The first group contains the partial and total translocation of the stomach into the thoracic cavity after the partial or total oesophagectomy. Depending on the applied surgical techniques used during the total oesophagectomy, the stomach could be located anteriorly or posteriorly to the pericardial sac. An elongated and gastrectatic form often with signs of pylorostenosis is visible in patients treated by vagotomy. The consequences of fundoplication included: lack of or narrow cardiac angle, and often a mild form of stomach cascade. The most common abnormal shape of the stomach was secondary to gastrectomy and gastric bending. The final organ shape depends on the type of applied surgical procedure that maintains physiological connection with the duodenum or an un-anatomical one, mostly with the jejunal loop. In banding, the body of the stomach forms an hourglass at the level of the artificial adjustable band, typically applied in surgical treatment of obesity (slim surgery).

Anatomical variances and dimensions of the superior orbital fissure and foramen ovale in adults.

The aim of the study was the retrospective morphological analysis of selected structures of the middle cranial fossa, i.e. foramen ovale and superior orbital fissure, in relation to the external head and cranial diameters in adults from the Lublin region (Poland). The study was performed on data collected during computed tomography examinations of 60 individuals (age 20-30 years), without any cranial or brain abnormalities. Based on the post-processing reconstructions, 3-dimensional views of the skull and head were obtained. The length and width of both structures, as well as thickness of the frontal, temporal, and occipital squamae, were measured. The morphology of the ovale foramina and superior orbital fissures were checked. The length and width of the skull and head were the only parameters that significantly differed between males and females. The thickness of the frontal and temporal squama was insignificantly lower in males than in females. Almond and oval shapes were the most typical for the foramen ovale. The superior orbital fissure was found as a wide form - with or without accessory spine originating from its lower margin or as a laterally narrowed form. The length and width of the foramen ovale were insignificantly higher in males than in females. The same results were found for the area of the right superior orbital fissure. The thickness of the frontal and occipital squamae influenced the thickness of the temporal squama. The analysed individuals had asymmetrical, oval, or almond-shape ovale foramina. Unlike the seldom visible laterally narrowed form of the superior orbital fissure, a wide form with or without accessory spine was the most commonly observed. The diameters of both superior orbital fissures and ovale foramina indicated the asymmetry of the neurocranium.

Circulating anti-p53 antibodies in esophageal cancer patients.

Circulating anti-p53 protein antibodies (p53-Abs) have been detected in some cancer patients. The aim of the study was to determine the presence of circulating anti-p53 protein antibodies and their clinical significance in patients with esophageal carcinoma. Serum specimens from 75 consecutive patients with squamous cell carcinomas and 10 healthy subjects were studied. Enzyme linked immunosorbent assay (ELISA--Pharma Cell) was used to detect p53-Abs. At the time of diagnosis 20 (26.6%) of 75 analyzed patients had positive result in the p53-Abs test, but not any of the healthy subjects. The positive rate was 25% (1/4) cases in stage I, 41% (10/24) cases in stage IIA, 0% (0/8) cases in stage IIB, 28% (8/28) cases in stage III and 9% (1/11) cases in stage IV. In respect of tumour differentiation, cases graded as G1, G2 and G3 were positive in 28.5% (4/14), 25.9% (7/27) and 26.4% (9/34), respectively. There was no correlation between presence of p53-Abs and stage, rumour differentiation, lymph nodes metastases, tumour size, patient age and sex. In conclusion, the results of the present study indicate that serum p53-Abs did not correlate with cliniocopathologic feature of esophageal carcinoma.

Detection of human papillomavirus in papillomas of oral cavity.

The oral cavity is exposed to many harmful factors among others: tobacco, alcohol and viral infection e.g. human papillomaviruses (HPV). HPV belongs to a family of tumorigenic viruses and induces cutaneous and mucosal proliferations of epithelial cells. The aim of our study was to estimate the frequency of HPV occurrence in papillomas of oral cavity in the Podlasie region. The study included 38 papillomas of oral cavity. HPV was found in 14 cases (36.8%). High risk HPV was present in 12 papillomas, while low risk HPV was detected in 2 papillomas.

Heavy metal poisoning in glass worker characterised by severe.

The paper presents the clinical description of the masticatory organ and biochemical assessment of dental tissue in a patient employed in a glassworks for 20 years. During 12 years the patient has suffered baldness ("Alopecia areata") and atypical extensive and non-healing cutaneous lesions. Dental examination revealed changes typical of chronic poisoning by cadmium and bismuth compounds.

Effects of Venoruton on early postradiation damage in the lungs of rats.

The study aimed at testing the effects of Venoruton on the early postradiation damage in the lungs of rats. The chests of the rats were irradiated with Co-60, fractional dose 250 cGy/DD, total dose 2500 cGy/DD. Venoruton was given intraperitoneally, in quantities of 0.1 ml once daily for 90 days. The experiment have proved that Venoruton lowers the intensity of the early postradiation changes, mainly those which depend on the vascular damage.

[Sequelae of prolonged consumption of honey in excessive amounts]. / Nastepstwa kilkuletniego spozywania miodu w duzych ilosciach.

A case of a 46-year patient with honey poisoning is presented. It is worth mentioning that honey eaten for a long time may produce severe pathologies. Honey in the south-eastern Poland, where the patient lives, contains not only water, sugars such as sucrose, glucose and fructose, dextrins, and nitrogen compounds but also low levels of antibiotics and sulphonamides, used as prophylaxis against honey-bee diseases, heavy metals ions, and various bacteria.

Solcoseryl prevents early postradiation changes in the lungs.

The aim of the study was to test the influence of Solcoseryl on early postradiation changes in the lungs of rats. The chests of the rats were irradiated with Co-60, fractional dose 250 cGy/DT, total dose 2500 cGy/DT. Solcoseryl was given intraperitoneally in quantities of 0,1ml daily, during 60 days of the experiment. Morphological examinations of the lungs revealed that Solcoseryl decreased significantly the effects of early postradiation damage of the respiratory organ in rats.