Salivary gland cancer in Southern Brazil: a prognostic study of 107 cases.

BACKGROUND: Salivary gland cancers (SGC) represent an uncommon group of heterogeneous tumors. We performed a retrospective survey of SGC diagnosed in a reference center for treatment of malignant tumors from the south of Brazil aiming to determine the prognostic value of demographic, clinic and pathologic features. MATERIAL AND METHODS: Cases diagnosed as SGC between 2006 and 2016 were retrospectively collected. Medical records were examined to extract demographic, clinic, pathologic and follow-up information. RESULTS: One-hundred and seven cases of SGC were identified. The most common SGC were mucoepidermoid carcinoma (MEC) (n = 39) followed by adenoid cystic carcinoma (AdCC) (n = 29). Among AdCCs, 55.2% of cases were classified as cribriform, 27.6% as tubular and 17.2% as solid. The tubular subtype had the highest percentage of cases with perineural invasion (p=0.01). Among MEC, 61.5% of cases were classified as low grade, 15.4% as intermediate grade and 19.9% as high grade. Low grade MEC had the lowest percentage of cases with perineural invasion (p=0.04). The 5-year survival for loco-regional control, disease-free survival (DFS) and disease-specific survival were 75%, 70% and 84%, respectively. The following features were associated with poor DFS: advanced age (p=0.03), rural residency (p=0.01), being a smoker or former smoker (p=0.01), pain (p=0.03), nodal metastasis (p<0.001), need for chemotherapy (p=0.02), neck dissection (p=0.04), perineural invasion (p=0.01), and being diagnosed with AdCC compared to MEC (p=0.02). CONCLUSIONS: The clinco-demographic and pathologic features identified as prognostic factors reveal the profile of patients at increased risk of recurrence and who would benefit from closer follow-up.

Investigation of the prevalence and severity of foot pad dermatitis at the slaughterhouse in fattening turkeys reared in organic production systems in Germany.

The present study shows the prevalence and severity of foot pad dermatitis (FPD) in turkeys reared in organic production systems assessed at slaughterhouses in Germany. The investigations of altogether 1,860 turkeys of the strains Kelly Broad Breasted Bronze (Kelly BBB; 540 toms, 540 hens) and British United Turkeys (B.U.T.) 6 and the Test Product 7 (TP 7; 780 hens) showed that 97.7% of the examined turkeys were diagnosed with different degrees of FPD. Only 4.6% of the toms and 1.3% of the hens had feet without lesions. Most frequent were necrotic lesions measuring up to 2 cm in diameter (64.3% of all turkeys). Extensive necrotic lesions of the foot pads (toms: 29.8%; hens: 12.4%) and necrosis of superficial scales (toms: 11.3%; hens: 7.6%) were less frequent. Plantar abscesses were rare findings (1.9%). In general, the feet of the Kelly BBB hens were more affected by foot pad lesions than those of the Kelly BBB toms. There were significant differences between the investigated flocks concerning the occurrence of foot pad lesions. The aim in rearing turkeys must be the reduction of FPD.

Dual-energy CT pulmonary angiography in patients with suspected pulmonary embolism: value for the detection and quantification of pulmonary venous congestion.

OBJECTIVE: To evaluate if vascular and pulmonary parenchymal enhancement values in dual-energy (DE) CT pulmonary angiography (CTPA) can suggest the diagnosis of pulmonary congestion. METHODS: DE-CTPA images of 90 out of 1321 patients negative for pulmonary embolism showed signs of congestive heart failure. We measured DE-derived pulmonary parenchymal [perfused blood volume (PBV)], pulmonary artery (PA) and left atrium (LA) enhancement values in these patients and in 142 control patients. Enhancement values were compared between the populations and correlated with serum values of B-type natriuretic peptide (BNP) and proBNP, where available. RESULTS: No significant difference of PBV but significant differences of mean PA and LA enhancement and individual enhancement differences (PA - LA) were found between the populations. PA - LA was higher in patients with elevated BNP and proBNP and was positively correlated with these values. Receiver operating characteristic analysis revealed a moderate discriminatory power of the PA - LA difference for the presence of cardiac biomarker elevations. CONCLUSION: PBV in DE-CTPA is not altered in patients with signs of congestive heart failure. However, differences in enhancement values in the pre- and post-pulmonary vessels were found in comparison with the control population. ADVANCES IN KNOWLEDGE: Altered pulmonary vascular haemodynamics in pulmonary venous congestion are not reflected in dual-energy-derived PBV maps. In the diagnosis of left heart failure in patients with chest pain and dyspnoea, density measurements in the pulmonary artery and in the left atrium in CTPA images may be a helpful diagnostic tool.

Onsite wastewater system nitrogen contributions to groundwater in coastal North Carolina.

The objective of the study described in this article was to evaluate the nitrogen contributions from two onsite wastewater systems (sites 1 and 2) to groundwater and adjacent surface waters in coastal Beaufort County, North Carolina. Groundwater levels and water quality parameters including total nitrogen, nitrogen species, temperature, and pH were monitored from October 2009 to May 2010. Nitrogen was also tested in groundwater from deeper irrigation or drinking water wells from the two sites and six additional neighboring residences. Mean total nitrogen concentrations in groundwater beneath onsite wastewater systems 1 and 2 were 34.3 +/- 16.7 mg/L and 12.2 +/- 2.9 mg/L, respectively, and significantly higher than background groundwater concentrations (< 1 mg/L). Groundwater in the deeper wells appeared not to be influenced by the onsite systems. Groundwater nitrogen concentrations typically decreased with distance down-gradient from the systems, but were still elevated relative to background conditions more than 15 m from the systems and near the estuary. This was a pioneering effort to better understand the link of onsite systems, the fate of nitrogen in the environment, and public health.

Multimodality imaging using ultrasound image fusion in renal lesions.

OBJECTIVES: To assess the benefit of ultrasound (US) image fusion in the identifiability and assessment of the dignity of renal lesions. MATERIALS AND METHODS: 25 patients with 29 renal lesions were investigated using standard US and CEUS (contrast enhanced US) with image fusion (CT or MRI). Identifiability and assessment of dignity was evaluated using cross-sectional images and US separately as well as using both US-techniques with additional image fusion. The respective modality was rated by two experienced radiologists (10 and 5 years of experience) using a (subjective) 5 point rank scale (1 = best). RESULTS: Using CEUS, image fusion resulted in improved identifiability (score: 1.1 ± 0.4) and improved assessment of dignity (score 1.0 ± 0) of renal lesions than using cross sectional images (score 1.8 ± 1.2 and 3.8 ± 1.2 respectively) separately. CONCLUSION: Image fusion improved the identifiability and the assessment of the dignity of renal lesions compared to using the respective modalities separately.

Module-assisted preparation of 64Cu with high specific activity.

In this work the production of (64)Cu via the (64)Ni(p,n)(64)Cu reaction with optimized conditions for low current irradiation is presented. Different target setups and cleaning steps for lowering metal contaminations in the product were applied. (64)Cu with high specific activities up to 1685 GBq/µmol was produced despite low overall activity (≈ 4.2 GBq per run). The module processing leads to a highly reproducible, reliable product quality (<1 µg Cu and <7 µg Ni). Besides its diagnostic value (64)Cu may be of interest even for therapeutic purposes due to its decay characteristics.

Erythropoietin-induced progenitor cell mobilisation in patients with acute ST-segment-elevation myocardial infarction and restenosis.

Erythropoietin improves myocardial function and enhances re-endothelialisation. Aim of this study was to analyse progenitor cell mobilisation and restenosis in patients from the Regeneration of Vital Myocardium in ST-Segment Elevation Myocardial Infarction by Erythropoietin (REVIVAL-3) study. Patients with STEMI undergoing percutaneous coronary intervention (PCI) were randomly assigned to Epoetin beta (EPO) (n=68) or placebo (n=70). Drug-eluting stents (DES) were utilised in 93% of patients receiving EPO and in 95% of patients receiving placebo (p=0.83). Serial venous blood samples were drawn; CD133+ progenitor cells were quantified by four-colour flow cytometry and cytokines interleukin (IL)-1ß, IL-6, IL-8, IL-10, IL-12 and tumour necrosis factor (TNF) alpha were analysed by cytometric bead array. Forty-eight hours after PCI a significant increase in CD133+ progenitor cells was observed in the EPO group. Yet, no differences in plasma cytokines were found. Quantitative coronary angiography after six months revealed an increase in segment diameter stenosis in the EPO group (32 ± 19% vs. 26 ± 14%, p=0.046). However, this increase in neointima generation was not associated with progenitor cell mobilisation. EPO in patients with STEMI treated with PCI is associated with an increase in diameter stenosis that is not associated with circulating progenitor cells.

Dual Energy CT lung perfusion imaging--correlation with SPECT/CT.

OBJECTIVE: Aims were (1) to determine the diagnostic accuracy of Dual Energy CT (DECT) in the detection of perfusion defects and (2) to evaluate the potential of DECT to improve the sensitivity for PE. METHODS: 15 patients underwent Dual Energy pulmonary CT angiography (DE CTPA) and a combination of lung perfusion SPECT/CT and ventilation scintigraphy. CTPA and DE iodine distribution maps as well as perfusion SPECT/CT and inhalation scintigrams were reviewed for pulmonary embolism (PE) diagnosis. DECT and SPECT perfusion images were assessed regarding localization and extent of perfusion defects. Diagnostic accuracy of DE iodine (perfusion) maps was determined with reference to SPECT/CT. Diagnostic accuracies for PE detection of DECT and of SPECT/CT with ventilation scintigraphy were calculated with reference to the consensus reading of all modalities. RESULTS: DE CTPA had a sensitivity/specificity of 100%/100% for acute PE, while the combination of SPECT/CT and ventilation scintigraphy had a sensitivity/specificity of 85.7%/87.5%. For perfusion defects, DECT iodine maps had a sensitivity/specificity of 76.7% and 98.2%. CONCLUSION: DECT is able to identify pulmonary perfusion defects with good accuracy. This technique may potentially enhance the diagnostic accuracy in the assessment of PE.

Oxygen-enhanced MRI of the lungs: intraindividual comparison between 1.5 and 3 tesla.

PURPOSE: To assess the feasibility of oxygen-enhanced MRI of the lung at 3 Tesla and to compare signal characteristics with 1.5 Tesla. MATERIALS AND METHODS: 13 volunteers underwent oxygen-enhanced lung MRI at 1.5 and 3 T with a T 1-weighted single-slice non-selective inversion-recovery single-shot half-Fourier fast-spin-echo sequence with simultaneous respiratory and cardiac triggering in coronal orientation. 40 measurements were acquired during room air breathing and subsequently during oxygen breathing (15 L/min, close-fitting face-mask). The signal-to-noise ratio (SNR) of the lung tissue was determined with a difference image method. The image quality of all acquisitions was visually assessed. The mean values of the oxygen-induced relative signal enhancement and its regional coefficient of variation were calculated and the signal enhancement was displayed as color-coded parameter maps. Oxygen-enhancement maps were visually assessed with respect to the distribution and heterogeneity of the oxygen-related signal enhancement at both field strengths. RESULTS: The mean relative signal enhancement due to oxygen breathing was 13 % (± 5.6 %) at 1.5 T and of 9.0 % (± 8.0 %) at 3 T. The regional coefficient of variation was significantly higher at 3 T. Visual and quantitative assessment of the enhancement maps showed considerably less homogeneous distribution of the signal enhancement at 3 T. The SNR was not significantly different but showed a trend to slightly higher values (increase of about 10 %) at 3 T. CONCLUSION: Oxygen-enhanced pulmonary MRI is feasible at 3 Tesla. However, signal enhancement is currently more heterogeneous and slightly lower at 3 T.

Improved visualization of renal lesions using three-dimensional ultrasound--a feasibility study.

PURPOSE: To evaluate the potential benefit of three-dimensional ultrasound in the assessment of renal lesions. MATERIALS AND METHODS: 21 patients with unclear renal findings were prospectively included in the study. Every patient was examined using two-dimensional (2D) ultrasound (US), X-plane technique (simultaneous display of main image and second image at a plane at right angles to the first), and real time three-dimensional (3D) US. The imaging model used were standard gray scale-, duplex- and contrast-enhanced ultrasound (CEUS). All acquisitions were compared to each other with regard to image quality and identifiability of renal lesions. Additionally, when using the X-plane technique the quality of the first and the second image were analysed separately. The assessment was done using a subjective 6 point scale (1 = best). RESULTS: All acquisitions were successfully performed and no patient had to be excluded. Image quality of real time 3D-US (score: 2.4 ± 0.73) was slightly inferior to 2D-US and X-plane technique (main image) with a score of 2.2 ± 0.43 and 2.2 ± 0.5, respectively. The image quality of second image in the X-plane mode -due to a lower spatial resolution- was lower with a score of 3.2 ± 0.5. Real time 3D-US and X-plane technique allowed for better identifiability (score: 1.4 ± 0.59 and 1.9 ± 0.53) of renal lesions compared to 2D-US (score: 2.5 ± 0.6). The most marked difference was observed between the simultaneous use of real time 3D-US and X-plane technique versus 2D-US in case of renal cell carcinoma, especially with regard to extra-capsular tumor extension (score: 1.6 ± 0.52, 1.8 ± 0.71, and 3.0 ± 0.52, respectively). CONCLUSION: Assessment of renal lesions using real time 3D-US is feasible and improves the identifiability of renal lesions.

Crosstalk of osteoblast and osteoclast precursors on mineralized collagen--towards an in vitro model for bone remodeling.

Bone remodeling and, therefore, integration of implant materials require the coordinated regulation of osteoblast and osteoclast activity. This is why the in vitro evaluation of biomaterials for bone regeneration should involve not only the analysis of osteoblast differentiation but also the formation and differentiation of osteoclasts. In the present study, we applied a material made of mineralized collagen I that mimics extracellular bone matrix to establish a culture system, which allows the cocultivation of human monocytes and human mesenchymal stem cells (hMSCs), which were differentiated into osteoclast-like cells and osteoblasts, respectively. Both cell types were cultivated on membrane-like structures from mineralized collagen. Transwell inserts were used to spatially separate the cell types but allowed exchange of soluble factors. The osteoclastogenesis and osteogenic differentiation were evaluated by analysis of gene expression, determination of alkaline phosphatase (ALP), and tartrate-resistant acidic phosphatase (TRAP) activity. Furthermore, cell morphology was studied using scanning electron and transmission electron microscopy. Osteogenically induced hMSC showed an increased specific ALP activity as well as increased gene expression of gene coding for alkaline phosphatase (ALPL), when cocultivated with differentiating osteoclasts. Adipogenic differentiation of hMSCs was suppressed by the presence of osteoclasts as indicated by a major decrease in adipocyte cell number and a decrease in gene expression of adipogenic markers. The formation of multinucleated osteoclasts seems to be decreased in the presence of osteogenically induced hMSC as indicated by electron microscopic evaluation and determination of TRAP activity. However, gene expression of osteoclast markers was not decreased in coculture with osteogenically induced hMSC.

[MRI of pulmonary embolism]. / MRT der akuten Lungenembolie.

Recent technical developments have substantially improved the potential of MRI for the diagnosis of pulmonary embolism. On the MR scanner side this includes the development of short magnets and dedicated whole-body MRI systems, which allow a comprehensive evaluation of pulmonary embolism and deep venous thrombosis in a single exam. The introduction of parallel imaging has substantially improved the spatial and temporal resolution of pulmonary MR angiography. By combining time-resolved pulmonary perfusion MRI with high-resolution pulmonary MRA a sensitivity and specificity of over 90% is achievable, which is comparable to the accuracy of CTA. Thus, for certain patient groups, such as patients with contraindications to iodinated contrast media and young women with a low clinical probability for pulmonary embolism, MRI can be considered as a first-line imaging tool for the assessment of pulmonary embolism.

Female infertility--effect of perinatal xenoestrogen exposure on reproductive functions in animals and humans.

Environmental chemicals with inherent estrogenic activity are supposed to be responsible for the decrease of quantity and quality of human sperms during the past 40 years. The current hypothesis is that estrogenic agents acting during fetal life may lead to impaired development of the testes and of the male reproductive tract in the human as well as in several wildlife species. However, from clinical and experimental data it is known, that estrogens may also lead to impairment of female reproductive functions. Perinatal application of DDT, octylphenol and benzylbutylphthalate resulted in persistent estrus in rats, in- and subfertility, respectively, and impaired sexual behaviour. Epidemiological and experimental data speak in favour of environmental estrogens to be one cause for the development of polycystic ovaries, being the most important reason for female infertility in the human.

[Classification, regionalization, and an information theoretical approach to the analysis and diagnosis of regional population processes]. / Typisierung, Regionierung und ein informations theoretischer Ansatz zur Analyse und Diagnose regionaler Bevolkerungsprozesse.

PIP: Various methods are used to analyze regional population trends in the East German county of Potsdam. Data are for the period 1968-1980 and concern 754 villages. Areas with similar population trends are identified. Special attention is given to areas of low or high migration. (SUMMARY IN ENG AND RUS)^ieng