Recent progress in development and applications of second near-infrared (NIR-II) nanoprobes.

Optical probes for near-infrared (NIR) light have clear advantages over UV/VIS-based optical probes, such as their low levels of interfering auto-fluorescence and high tissue penetration. The second NIR (NIR-II) window (1000-1350 nm) offers better light penetration, lower background signal, higher safety limit, and higher maximum permitted exposure than the first NIR (NIR-I) window (650-950 nm). Therefore, NIR-II laser-based photoacoustic (PA) and fluorescence (FL) imaging can offer higher sensitivity and penetration depth than was previously available, and deeper lesions can be treated in vivo by photothermal therapy (PTT) and photodynamic therapy (PDT) with an NIR-II laser than with an NIR-I laser. Advances in creation of novel nanomaterials have increased options for improving light-induced bioimaging and treatment. Nanotechnology can provide advantages such as good disease targeting ability and relatively long circulation times to supplement the advantages of optical technologies. In this review, we present recent progress in development and applications of NIR-II light-based nanoplatforms for FL, PA, image-guided surgery, PDT, and PTT. We also discuss recent advances in smart NIR-II nanoprobes that can respond to stimuli in the tumor microenvironment and inflamed sites. Finally, we consider the challenges involved in using NIR-II nanomedicine for effective diagnosis and treatment.

Dosing Recommendations for Quetiapine When Coadministered With HIV Protease Inhibitors.

Although current quetiapine labeling recommends that its dosage should be lowered 6-fold when coadministered with strong cytochrome P450 (CYP)3A inhibitors, a reported case of coma in a patient receiving quetiapine with lopinavir and ritonavir prompted the reevaluation of labeling recommendations for the dosing of quetiapine when coadministered with human immunodeficiency virus (HIV) protease inhibitors. Literature and database (FDA Adverse Event Reporting System and United States Symphony Health Solutions' Integrated Dataverse Database) searches allowed us to identify cases of coma and related adverse events involving the coadministration of quetiapine and HIV protease inhibitors and to estimate the frequency of concomitant use. Literature review and physiologically based pharmacokinetic modeling allowed us to estimate the potential for CYP3A inhibition to contribute to adverse events related to HIV protease inhibitor-quetiapine coadministration. We identified excess sedation following coadministration of quetiapine and an HIV protease inhibitor in 3 reports without obvious confounders. In prescription claims data, 0.4% of quetiapine patients were dispensed a concurrent ritonavir prescription. The quetiapine dose was not reduced on ritonavir initiation in 90% of therapy episodes. Available data indicate to us that all HIV protease inhibitors combined with ritonavir are likely to be strong CYP3A inhibitors. We predicted that ritonavir would increase quetiapine exposure comparable to the strong CYP3A inhibitor ketoconazole. The current dosing recommendations for use of quetiapine with strong CYP3A inhibitors (ie, 6-fold lower quetiapine dose) are appropriate and should be followed when quetiapine is coadministered with HIV protease inhibitors.

Hypermetabolism of Compensatory Laryngeal Muscles in Unilateral Vocal Cord Palsy: Comparison Study between Speech and Silence with Normal Subjects by Co-registered PET-CT Fusion Images / 핵의학분자영상

PURPOSE: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. METHODS: Eleven patients with unilateral vocal cord palsy (thyroidectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. RESULTS: In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group (SUV=5.88+/-2.65) than with non-phonation group (SUV=2.30+/-0.39). Normal control subjects showed hypermetabolism (3.68+/-0.96) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. CONCLUSION: FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation during FDG-PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.

Evaluation of Internal Laryngeal Muscles Related to Phonation and the Compensatory Mechanism in Patients with Unilateral Vocal Cord Paralysis Using (18)F-Fluorodeoxyglucose-Positron Emission Tomography / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES : Several studies have reported that (18)F-fluorodeoxyglucose (FDG) uptake in positron emission tomography (PET) imaging is physiologically increased at the intact vocal cord in patients with unilateral vocal cord paralysis, which is explained by a compensatory mechanism of the intact vocal cord. We aimed to evaluate internal laryngeal muscles related to phonation and the compensatory mechanism in patients with unilateral vocal cord paralysis. SUBJECTS AND METHOD : We performed (18)FDG-PET imaging and neck computed tomography (CT) scan in the normal control group composed of 13 subjects and the paralyzed group composed of 11 patients with unilateral vocal cord paralysis. The two groups were divided into two groups, phonating and silent, before performing (18)FDG-PET. (18)FDG-PET and neck CT images by Syntegra. A specialist in nuclear medicine performed all the test measurements, the standardized uptake value (SUV) in the interarytenoid muscle (IA), both thyroarytenoid muscles (TA), and both lateral cricoarytenoid muscles (LCA). The mean SUVs were statistically analyzed. RESULTS : In the Normal-Phonating group, the mean SUV of IA was the highest, with 3.68+/-0.96 (Mean+/-SD), followed by that of LCA, with 2.34+/-0.67. However, when compared with the same muscles in the Phonating-Silent group, only the SUV of IA was significantly increased by phonation. In the Paralyzed-Silent group, the SUV of TA in the intact side was the highest, with 2.30+/-0.39. In the Paralyzed-Phonating group, the SUV of TA in the intact side, IA, and LCA in the intact side were 5.88+/-2.65, 3.92+/-1.65, and 3.87+/-1.37, respectively. When compared with the same muscles in the Phonating-Silent group, the SUVs of TA and IA were significantly increased. CONCLUSION : The muscle related to the compensatory mechanism in patients with unilateral vocal cord paralysis is thyroarytenoid muscle in the intact side. The interarytenoid muscle plays a major role in the mechanism of phonation in humans.

Analysis of Chromosomal Aberrations in Thyroid Papillary Carcinomas Using Comparative Genomic Hybridization (CGH) / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Cancer of the thyroid is the sixth common cancer in Korea, and fourth common among the Korean women, in particular. Aming the prevalent carcinomas of thyroid, the papillary thyroid carcinoma is the most frequent type. Genomic instability is the characteristic of nearly all tumors as well as thyroid cancers. However, despite the high frequency of papillary thyroid carcinomas, their chromosomal alterations are poorly characterized in Korea. Comparative genomic hybridization (CGH) is a new fluorescence in situ hybridization (FISH) technique to identify genomic imbalances in cancers. In this study, CGH was carried out with the aim of analyzing non-random chromosomal aberrations involved in papillary thyroid carcinomas. MATERIALS AND METHOD: CGH was carried out. Biotin-labeled tumor DNA and digoxigenin-labeled normal DNA were co-hybridized to normal metaphase cells. Then, the ratio of fluorescence was analyzed by an image analyzer. In array-CGH, Cy3 labeled tumor DNA and Cy5 labeled normal DNA were hybridized to microarray template, and then image analysis was performed by microarray image analyzer. RESULTS: Gains of 22q13, 6p24, 7p13, 7q21, 7q31, 8q24, 17q24 and 19p13.3 were found frequently. CONCLUSION: Non-random aberrations which were disclosed in this study might be candidate regions for the abnormal genes involved in papillary thyroid cancer.

A Case of AIDS Related Non-Hodgkin's Lymphoma / 대한이비인후과학회지

In an HIV-infected patient, cervical lymphadenopathy such as tubercuolosis, lymphoma, metastatic carcinoma must be differentiated from persistent generalized lymphadenopathy (PGL). Lymphoma is known as a late manifestation of HIV infection, generally occurring in patients with CD4+ T cell counts less than 200/microl. AIDS-related lymphomas were explained as variably associated with EBV infection, dysfunction of T cells, and HIV itself. The decision to perform a diagnostic open biopsy should be driven by a suspicion of malignancy or infection in the setting of a negative or inconclusive of FNA. Healthcare workers, especially those who deal with large numbers of HIV-infected patients, have a small but definite risk of becoming infected with HIV as a result of invasive procedures. Healthcare workers can minimize their risk of occupational HIV infection by following the guidelines discussed in this study.