The effect of radiofrequency ablation on pain score and non-steroidal painkiller use in osteoid osteoma patients.

AIM: CT-guided radiofrequency ablation (RFA) is among the thermal ablative procedures and provides great benefits with a minimally invasive procedure. In this prospective study, we aimed to reveal the significance of a multidisciplinary method in reducing the recurrence and complications in osteoid osteoma patients with CT-guided RFA performed by a team of experts in the field. MATERIALS AND METHODS: A total of consecutive 40 patients with osteoid osteoma were prospectively evaluated and treated with CT-guided RFA. Before and the post ablation the visual analog scale (VAS) and use of nonsteroidal anti-inflammatory drugs (NSAIDS) were compared. RESULTS: Post-ablation VAS of the patients at the 1st week and 3rd month after the procedure decreased significantly (p < 0.01) compared to the pre-ablation. The frequency of NSAID use after the ablation decreased significantly (p < 0.01) compared to the pre-ablation time. The pre-procedure NSAID use of our patients included in the study was average 6.93 per week, the NSAID use in the 3rd month post-procedure controls was average 0.53 per week. Recurrence was detected in 4 of our patients, 36 patients had complete recovery. CONCLUSION: Radiofrequency ablation is an effective treatment method in the management of osteoid osteomas. Radiofrequency ablation has low recurrence rates and provides rapid regression in patients' pain after treatment.

A surgical method to be reminded for the treatment of symptomatic ipsilateral central venous occlusions in patients with hemodialysis access: Axillo-axillary venous bypass case report and review of the literature.

BACKGROUND: In this case report, we present two chronic hemodialysis patients with upper extremity swelling due to central venous occlusions together with their clinical presentation, surgical management and brief review of the literature. METHODS: The first patient who was a 63-year-old female patient with a history of multiple bilateral arteriovenous fistulas (AVFs) was referred to our clinic. Physical examination demonstrated a functioning right brachio-cephalic AVF, with severe edema of the right arm, dilated venous collaterals, facial edema, and unilateral breast enlargement. In her history, multiple ipsilateral subclavian venous catheterizations were present for sustaining temporary hemodialysis access. The second patient was a 47-year-old male with a history of failed renal transplant, CABG surgery, multiple AV fistula procedures from both extremities, leg amputation caused by peripheral arterial disease, and decreased myocardial functions. He was receiving 3/7 hemodialysis and admitted to our clinic with right arm edema, accompanied by pain, stiffness, and skin hyperpigmentation symptoms ipsilateral to a functioning brachio-basilic AVF. He was not able to flex his arms, elbow, or wrist due to severe edema. RESULTS: Venography revealed right subclavian vein stenosis with patent contralateral central veins in the first patient. She underwent percutaneous transluminal angioplasty (PTA) twice with subsequent re-occlusions. After failed attempts of PTA, the patient was scheduled for axillo-axillary venous bypass in order to preserve the AV access function. In second patient, venography revealed right subclavian vein occlusion caused secondary to the subclavian venous catheters. Previous attempts for percutaneously crossing the chronic subclavian lesion failed multiple times by different centers. Hence, the patient was scheduled for axillo-axillary venous bypass surgery. CONCLUSION: In case of chronic venous occlusions, endovascular procedures may be ineffective. Since preserving the vascular access function is crucial in this particular patient population, venous bypass procedures should be kept in mind as an alternative for central venous reconstruction, before deciding on ligation and relocation of the AVF.

Metabolites of lactic acid bacteria present in fermented foods are highly potent agonists of human hydroxycarboxylic acid receptor 3.

The interplay of microbiota and the human host is physiologically crucial in health and diseases. The beneficial effects of lactic acid bacteria (LAB), permanently colonizing the human intestine or transiently obtained from food, have been extensively reported. However, the molecular understanding of how LAB modulate human physiology is still limited. G protein-coupled receptors for hydroxycarboxylic acids (HCAR) are regulators of immune functions and energy homeostasis under changing metabolic and dietary conditions. Most mammals have two HCAR (HCA1, HCA2) but humans and other hominids contain a third member (HCA3) in their genomes. A plausible hypothesis why HCA3 function was advantageous in hominid evolution was lacking. Here, we used a combination of evolutionary, analytical and functional methods to unravel the role of HCA3 in vitro and in vivo. The functional studies included different pharmacological assays, analyses of human monocytes and pharmacokinetic measurements in human. We report the discovery of the interaction of D-phenyllactic acid (D-PLA) and the human host through highly potent activation of HCA3. D-PLA is an anti-bacterial metabolite found in high concentrations in LAB-fermented food such as Sauerkraut. We demonstrate that D-PLA from such alimentary sources is well absorbed from the human gut leading to high plasma and urine levels and triggers pertussis toxin-sensitive migration of primary human monocytes in an HCA3-dependent manner. We provide evolutionary, analytical and functional evidence supporting the hypothesis that HCA3 was consolidated in hominids as a new signaling system for LAB-derived metabolites.

Correction: Metabolites of lactic acid bacteria present in fermented foods are highly potent agonists of human hydroxycarboxylic acid receptor 3.

[This corrects the article DOI: 10.1371/journal.pgen.1008145.].

The impact of IV contrast enhanced 18F-FDG PET/CT on the staging of bladder cancer.

OBJECTIVE: The aim of this retrospective study was to compare the diagnostic accuracies of conventional radiological imaging (CI) methods magnetic resonance imaging or computed tomography (MRI or CT) and intra venous (IV) contrast enhanced (CE) fluorine-18-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) for the staging of bladder cancer (BC). MATERIALS AND METHODS: The 18F-FDG CE-PET/CT results of 35 consecutive patients with BC were analyzed. Diagnostic value of CE-PET/CT and CI are compared for their accuracy in revealing primary tumors, nodal-distant metastasis, and the final tumor staging. The imaging results were compared with the gold standard, including of histopathology and clinical follow-up. We also investigated the effect of maximum standardize uptake value (SUVmax) and lymph node metastasis on survival. RESULTS: The CE-PET/CT had a diagnostic accuracy of 89% (31/35), compared to 57% (19/35) for CI. The results of CE-PET/CT imaging lead to upstaging in 37% (13/35) patients compared to CI staging. For primary tumor detection, the sensitivity of CE-PET/CT was 97% (34/35). Contrast enhanced-PET/CT detected nodal metastases in 19 (54%) patients, whereas CI detected in 9 (26%) patients. Contrast enhanced-PET/CT detected distant metastases in 14 (40%) patients, while conventional methods showed distant metastases in 9 (26%) patients. Maximum SUV of primary tumor does not have a significant effect on survival, whereas the median survival time of patients without lymph node metastasis is longer than patients who have lymph node metastasis (P=0.038). CONCLUSION: These data suggest that 18F-FDG CE-PET/CT had good diagnostic performance compared to conventional imaging for detecting primary tumor, nodal and distant metastasis in BC. Upstaging by CE-PET/CT changed the management of patients.

The repertoire of Adhesion G protein-coupled receptors in adipocytes and their functional relevance.

BACKGROUND: G protein-coupled receptors (GPCR) are well-characterized regulators of a plethora of physiological functions among them the modulation of adipogenesis and adipocyte function. The class of Adhesion GPCR (aGPCR) and their role in adipose tissue, however, is poorly studied. With respect to the demand for novel targets in obesity treatment, we present a comprehensive study on the expression and function of this enigmatic GPCR class during adipogenesis and in mature adipocytes. METHODS: The expression of all aGPCR representatives was determined by reanalyzing RNA-Seq data and by performing qPCR in different mouse and human adipose tissues under low- and high-fat conditions. The impact of aGPCR expression on adipocyte differentiation and lipid accumulation was studied by siRNA-mediated knockdown of all expressed members of this receptor class. The biological characteristics and function of mature adipocytes lacking selected aGPCR were analyzed by mass spectrometry and biochemical methods (lipolysis, glucose uptake, adiponectin secretion). RESULTS: More than ten aGPCR are significantly expressed in visceral and subcutaneous adipose tissues and several aGPCR are differentially regulated under high-caloric conditions in human and mouse. Receptor knockdown of six receptors resulted in an impaired adipogenesis indicating their expression is essential for proper adipogenesis. The altered lipid composition was studied in more detail for two representatives, ADGRG2/GPR64 and ADGRG6/GPR126. While GPR126 is mainly involved in adipocyte differentiation, GPR64 has an additional role in mature adipocytes by regulating metabolic processes. CONCLUSIONS: Adhesion GPCR are significantly involved in qualitative and quantitative adipocyte lipid accumulation and can control lipolysis. Factors driving adipocyte formation and function are governed by signaling pathways induced by aGPCR yielding these receptors potential targets for treating obesity.

Comparison of direct laryngoscope and McGrath videolaryngoscope in terms of glottic view and hemodynamics in bariatric surgery

Background/aim: In the recent years, videolaryngoscopes (VL) have emerged as alternative devices to direct laryngoscopes (DL) in difficult intubation situations. Therefore, we aimed to compare the Macintosh DL and McGrath VL in terms of the glottic image quality, intubation success, intubation time, hemodynamic response after intubation, and complications in bariatric surgery patients. Material and methods: After obtaining approval by the ethics committee and receiving informed consent, we recorded the demographic and physical data of patients undergoing bariatric surgery. Patients were divided into 2 groups: Group M was intubated with the Macintosh DL, and Group V was intubated with the McGrath VL. After intubation, we noted the Cormack­Lehane score, the duration of intubation, the number of intubation interventions, and the hemodynamic data of patients. Results: A total of 62 patients (ASA II, body mass index of >35 kg/m2) were included in the study. All patients except 1 patient were intubated on the first attempt. Although there was a decrease in heart rate and blood pressure with induction, similar hemodynamic data were obtained between groups during the operation. In group V, we obtained a better glottic image (P = 0.011), but intubation success was similar between the study groups. We also measured the intubation time in group M as 45.9 ± 19.1 s and group V as 57.1 ± 15.8 s (P = 0.015). Discussion: Although we measured longer intubation times with the McGrath VL compared with the Macintosh DL, we obtained a better glottic image without causing hemodynamic changes. However, these findings did not make any difference in terms of intubation success.

Cerebral Protection with a Temporary Ascending Aorta-External Carotid Artery Bypass during Common Carotid Artery Revascularization.

Atherosclerosis is a systemic disease, and multiarterial involvement is common. Involvement of all the supra-aortic arteries may occur in the same patient making cerebral revascularization challenging. In this report, we present complete supra-aortic revascularization, that is, revascularization of the bilateral common carotid and subclavian arteries in a 51-year-old male patient with occluded brachiocephalic trunk, left subclavian artery, and proximally stenotic left common carotid artery. A temporary ascending aorta to left external carotid artery bypass provided meticulous cerebral protection with pulsatile cerebral flow in the presence of a proximal arterial clamp; hence, a neurologically uneventful procedure during bilateral common carotid artery revascularization.

Incidentally Detected ALK-Positive Histiocytosis with EML4::ALK Fusion in a Solitary Pulmonary Nodule Following COVID-19 Infection: A Rare Case Report.

We hereby report a patient with ALK-positive histiocytosis with localized lung involvement. A 47-year-old woman presented with a solitary pulmonary nodule in the left upper lobe, 7 months after COVID infection. A well-defined 15 mm yellow mass was found in trisegmentectomy specimen. Histopathological examination revealed that the mass was composed of epithelioid and spindle cells with foamy cytoplasms. No necrosis, pleomorphism, or nuclear atypia was detected. The cells were positive for CD68, CD163, PU.1, ALK and negative for KRT, smooth muscle actin (SMA), S100, Melan-A, CD34, STAT6, and BRAF VE1. Flourescence in situ hybridization demonstrated ALK gene rearrangement, and next generation sequencing confirmed EML4::ALK fusion. Lung involvement in ALK-positive histiocytosis is characterized by the presence of pulmonary nodules, which can be seen in all forms of the disease. However, lung involvement is rarely seen in single-system ALK-positive histiocytosis. Our report represents the fourth documented instance of localized lung involvement in ALK-positive histiocytosis, an exceedingly rare occurrence, and it is the third instance with available molecular data.

Intraoperative lateral wall breach simulation in the cadaveric spine and the impact of thread designs of screws on pullout strength in the osteoporotic thoracic vertebrae: A biomechanical study in human cadavers.

OBJECTIVE: This study aimed (1) to simulate pedicle screw pullout after intraoperative external wall perforation and (2) to assess restoration strength with different thread designs in the pedicle screw instrumentation for osteoporotic thoracic vertebrae. METHODS: Twenty fresh-frozen human cadaveric thoracic vertebra bodies were prepared and divided into 4 groups: group 1, 5.5 mm × 45 mm polyaxial single thread pedicle screws (PASTS); group 2, after wall injury 5.5 mm × 45 mm PASTS; group 3, 6.5 mm × 45 mm PASTS after wall injury; and group 4: 6.5 mm × 45 mm polyaxial mixed-threaded screws after wall injury. While group 1 was the control group, groups 2, 3, and 4 were used as study groups after the lateral wall breach. All prepared screw units were placed on a universal pullout measurement testing device. RESULTS: The mean bone mineral density for 20 thoracic vertebrae was 0.57 ± 0.12 g/cm2 (range 0.53-0.6 g/cm2 ). The mean pullout strength was 474.90 Newtons (N) for group 1, 412.85 N for group 2, 475.4 N for group 3, and 630.74N for group 4. The lateral wall breach caused a 14.1 % decrease in average pullout strength compared with the initial screw pullout. Mixed (double)-threaded screws increased pullout strength compared to 6.5 mm screws (P=.036) Conclusion: Using a 1 mm thicker polyaxial pedicle screw or mixed (double)-threaded pedicle screw seems to increase pullout strength; however, this was statistically significant only for group 4. In the thoracic spine, the redirection possibility of the pedicle screw is limited, and augmentation with cement will not be appropriate due to the risk of wall injury-related leakage. Therefore, care should be taken to avoid violating the lateral cortex by using appropriate pedicle entry points and trajectories.

Endovascular and surgical management of splenic artery aneurysms.

BACKGROUND: Although true splenic artery aneurysms (SAA) are rare, due to advancements in imaging techniques, they are seen more frequently. The aim of this study is to present our strategy of managing patients with SAA. METHODS: Retrospectively, 13 patients who were treated in a tertiary university care center between 2012 and 2020 were included. Their demographic, clinical information, and post-operative complications were analyzed. RESULTS: Seven male and six female patients were evaluated between the ages of 27 and 73. The mean age was 49.8±13.2. The diameter of the aneurysm was between 17 and 80 mm with a mean range of 31.5±16 mm. Seven patients were treated with endovascular interventions (EV). Two patients were referred to surgery with failed attempt of EV, but patients refused surgery and were followed up consequently. Patients who had larger aneurysms with an increased risk of rupture underwent aneurysmectomy and splenectomy. Conservative management was decided on two patients initially: A patient who was previously operated on for a sigmoid colon tumor, and had an aneurysm size of 15 mm and another patient with a surgical history of thoracic aortic dissection with an aneurysm size of 18 mm. One patient who underwent surgery had post-operative pancreatic fistula and was treated with percutaneous drainage. The treatment of the remaining 12 patients was completed without any further complications. CONCLUSION: Splenic artery aneurysm treatment should be individualized. Endovascular treatment can be considered for patients with stable aneurysms larger than 2 cm in the elective setting. Open surgical treatment should be considered in patients with ruptured SAA or hemodynamically unstable, complicated patients.

Evaluation of Dynamic Foraminal Stenosis with Positional MRI in Patients with C6 Radiculopathy-Mimicking Pain: A Prospective Radiologic Cohort Study.

Objective: Patients with a C6 radiculopathy-mimicking complaint are always in the gray zone if the diagnosis is not clear. The aim of the study is to make the diagnosis clear if the neck and shoulder pain is caused by a dynamic stenosis of the neural foramen at the C5-C6 level. Methods: Patients with a C6 radiculopathy-mimicking complaint were included in the study. Patients had a cervical spine magnetic resonance imaging (MRI) at the normal limits, or a minimal protrusion at the C5-C6 level underwent a dynamic MRI procedure. We measured the foraminal area and spinal cord diameter (SCD) at the C5-C6 level by using the PACS system ROI irregular are determination integral embedded to PACS. Inter- and intraobserver reliability of measurements was evaluated. Results were analyzed statistically, and a p value< 0.05 was accepted as statistically meaningful. Results: A total of 23 patients between January 2019 and June 2019 were included in the study. There were 10 men and 13 women, and the mean age was 41.3 (range 33-53). Foraminal area decrease at C5-C6 in extension and increase in flexion when compared with the neutral position was statistically significant (p < 0.001). Foraminal area changes between the complaint side and the opposite side was not statistically different (p > 0.05). Interobserver and intraobserver reliability of measurements were classified as in almost perfect agreement. Conclusions: Our present work presented dynamic and positional foraminal changes in MRI with radiculopathy-mimicking patients. Soever, we did not find a difference between the clinical complaint side and the opposite side in radiculopathy-mimicking patients. Cervical radiculopathy pain should not be attributed only to foraminal sizes. PACS embedded irregular area measurement integral allows the easy measure of a big number of patients without additional set-up and digital work requirements.

The Comparison of Ottawa Ankle Rules and Shetty test performances in foot-ankle trauma patients visited to the emergency department.

BACKGROUND: The Ottawa Ankle Rules (OARs) and Shetty test (ST), are assessment guidelines intended to minimize radiographs in patients with ankle trauma. The aim of this study is to determine and compare the effectiveness of OARs and ST in patients admitted to the emergency department (ED) with foot and ankle trauma. METHODS: This prospective cohort study was carried out in the ED of a tertiary care teaching hospital. OARs and ST were practiced by different doctors to patients, who were admitted with foot and ankle trauma. X-ray images were analyzed by a radiologist. Accuracy measures were covered such as sensitivity, specificity, positive predictive value, negative predictive value. RESULTS: The study was completed a total of 207 patients, after achieving the inclusion and exclusion criteria. The mean age of the patients was 33.1±16.3, and 96 (46.4%) were female. For OARs, it was determined that as sensitivity 97.22%, specificity 48.89%, positive predictive value 50.36%, negative predictive value 97.06%, positive likelihood ratio 1.9 and negative likelihood ratio 0.06. If the OARs had been used, there would have been a 32.8% reduction in the ankle X-ray system. For the ST, it was determined that as sensitivity 51.39%, specificity 85.93%, positive predictive value 66.07%, negative predictive value 76.82%, positive likelihood ratio 3.65 and negative likelihood ratio 0.57. DISCUSSION: The OARs can be used as a screening tool, due to causing the high sensitivity in foot and ankle traumas. The ST was found to be inefficient in this study. In addition, the significant reduction in the number of X-rays with the use of OARs is another major result of the study.

Expression level of a gibberellin 20-oxidase gene is associated with multiple agronomic and quality traits in barley.

The use of dwarfing genes has resulted in the most significant improvements in yield and adaptation in cereal crops. The allelic dwarfing gene sdw1/denso has been used throughout the world to develop commercial barley varieties. The sdw1 gene has never been used successfully for malting barley, but only for a large number of feed varieties. One of the gibberellin 20-oxidase genes (Hv20ox2) was identified as the candidate gene for sdw1/denso. Semi-quantitative real-time RT-PCR revealed that Hv20ox2 was expressed at different levels in various organs of barley. Transcriptional levels were reduced in leaf blade, sheath, stem and rachis tissue in the barley variety Baudin with the denso gene. Subsequently, the relative expression levels of Hv20ox2 were determined by quantitative real-time RT-PCR in a doubled haploid population and mapped as a quantitative trait. A single expression quantitative trait locus (eQTL) was identified and mapped to its structural gene region on chromosome 3H. The eQTL was co-located with QTLs for yield, height, development score, hectolitre weight and grain plumpness. The expression level of Hv20ox2 was reduced fourfold in the denso mutant, but around 60-fold in the sdw1 mutant, compared to the control variety. The reduced expression level of Hv20ox2 enhanced grain yield by increasing the number of effective tillers, but had negative effects on grain and malting quality. The sdw1 gene can be used only in feed barley due to its severe reduction of Hv20ox2 expression. The gene expression marker for Hv20ox2 can be used to distinguish different alleles of sdw1/denso.

Idiopathic and secondary epiretinal membranes: do they differ in terms of morphology? An optical coherence tomography-based study.

PURPOSE: The purpose of this study was to define the morphologic differences in idiopathic and secondary epiretinal membranes (ERMs) using a time domain optical coherence tomography. METHODS: The medical records and optical coherence tomography images of 293 eyes of 236 consecutive patients diagnosed to have ERM were evaluated retrospectively. Demographic features, best-corrected visual acuities, central macular thickness, membrane attachment patterns, macular changes, and the presence of posterior retinal detachment at the time of diagnosis were compared between the groups (idiopathic group, n = 125 eyes; secondary group, n = 168 eyes). RESULTS: The mean age was higher among idiopathic ERMs (67 ± 9 vs. 62 ± 10 years, P = 0.001). In the secondary group, best-corrected visual acuity was estimated to be worse (P < 0.001) and central macular thickness higher (P = 0.02) than the idiopathic group. In both groups, ERMs were mostly diagnosed at Grade 1 level. Diffuse attachment was more common in both of the groups. Among macular changes, only cystoid macular degeneration differed significantly between the groups (P = 0.0001). CONCLUSION: Idiopathic and secondary ERMs were estimated to differ significantly at the time of diagnosis in terms of age, visual acuities, macular thickness, presence of cystoid macular degeneration, and posterior vitreous detachment. These parameters may assist the retinal surgeon in the treatment process of ERM.

Outcomes of 23-Gauge Transconjunctival Sutureless Vitrectomy in Patients with Diabetic Retinopathy.

OBJECTIVES: This study evaluated the anatomical and functional results of 23-G transconjunctival sutureless vitrectomy (TSV) in diabetic retinopathy (DR) patients with a variety of vitreoretinal diseases. METHODS: Consecutive patients who underwent 23-G TSV for complications of DR were evaluated retrospectively. The primary outcome measures were best-corrected visual acuity (BCVA), intraocular pressure (IOP), and intraoperative and postoperative complications. RESULTS: A total of 42 eyes of 41 patients were included and followed up for a mean of 15.64±10.0 months. The mean patient age was 59.33±7.4 years. Indications for surgery were nonclearing vitreous hemorrhage (VH) (n=10), tractional retinal detachment (TRD) (n=8), TRD+VH (n=12), epiretinal membrane (n=5), diabetic macular edema (n=3), submacular hemorrhage (n=2), macular hole (n=1), or vitreomacular traction (n=1). There was a significant improvement in the BCVA at the postoperative first and third months, and at the last visit compared with the preoperative value (p<0.001). There was no significant change in the mean IOP measured on the postoperative first day, first week, first month, third month, or the last visit (p>0.05). In the postoperative period, the VH resolved spontaneously in 9 eyes. Repeat 23-G vitrectomy was performed in 6 eyes: 4 with recurrent retinal detachment and 2 with VH. CONCLUSION: The results indicate that 23-G TSV is an effective technique for vitreoretinal disease in patients with DR.

Analysis of intra-observer and inter-observer variability of pathologists for non-benign thyroid fine needle aspiration cytology according to Bethesda system categories.

AIM: To examine the intra- and inter-observer variability for non-benign thyroid cytological subcategories according to the Bethesda classification system after the second review. METHODS: Between November 2018 and May 2019, thyroid fine needle aspiration biopsies of 381 nodules were retrospectively evaluated. Among them, 74 non-benign (category III-VI) thyroid biopsies, analyzed according to the Bethesda system (pathologist 1:40 vs pathologist 2:34) by two independent pathologists, were reassessed by the same pathologists and by a cytopathologist. In this observer-blinded study, weighted Cohen's kappa was used to assess the intra-observer agreement, and Krippendorff's alpha was used to assess the inter-observer agreement. RESULTS: At the first and second evaluations of pathologists 1 and 2, the percentage agreement was 62.5% for pathologist 1 and 58.8% for pathologist 2. The intra-observer agreement was substantial (κ = 0.705) for pathologist 1, and moderate (κ = 0.447) for pathologist 2. In the second evaluation of pathologist 1 and 2, which was compared with the cytopathologist, the agreement percentage of pathologist 1 with the cytopathologist was 50.0%, and that of pathologist 2 was 56.8%. The inter-observer agreement was below the lowest acceptable limit for an overall agreement (α = 0.634) among the three raters. The inter-observer agreement was only acceptable between the cytopathologist and the second pathologist, while it was low between the other raters. In the evaluation of the non-benign nodules, the mean category score of the cytopathologist was 3.22 and lower than both pathologists (3.73 and 3.58, respectively). CONCLUSIONS: The intra-observer agreement of pathologists was moderate-to-substantial in the evaluation of non-benign thyroid biopsies according to the Bethesda reporting system. However, the inter-observer agreement was below the lowest acceptable limit when the cytopathologist was taken as a reference.

68Ga-PSMA PET/CT Versus 18F-FDG PET/CT for Imaging of Hepatocellular Carcinoma

Objectives: This study aimed to compare the metabolic parameters obtained from 18fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) and gallium-68 (68Ga)-prostate-specific membrane antigen (PSMA) PET/CT and investigate the relationship between serum alpha-fetoprotein and PET scan parameters in patients with hepatocellular carcinoma. Methods: Fourteen patients were recruited after dynamic magnetic resonance imaging (MRI) of the upper abdomen, and 18F-FDG and 68Ga-PSMA PET/CT imaging studies were conducted. Regions of interest (ROIs) were drawn from lesion-free liver tissue, abdominal aorta (A), and right medial gluteal muscle (G) for the background activity. Maximum standard uptake value (SUVmax) of these regions were compared with the SUVmax of primary tumor (T). Results: On visual assessment, five patients (36%) experienced low 18F-FDG uptake in the primary lesion, three patients (21%) experienced moderate uptake, and six patients (43%) experienced high uptake. However, only one patient (7%) showed low 68Ga-PSMA uptake, two patients (14%) showed moderate uptake, and 11 patients (79%) showed high uptake. Four patients with a low 18F-FDG uptake showed high 68Ga-PSMA uptake, while one patient exhibited low uptake with both 18F-FDG and 68Ga-PSMA. The number of lesions on 68Ga-PSMA PET/CT and MRI was significantly higher than 18F-FDG PET/CT (p=0.042 and 0.026, respectively). T/A and T/G values were significantly higher in 68Ga-PSMA than 18F-FDG (p=0.002 and 0.002, respectively). Conclusion: 68Ga-PSMA PET/CT is superior to 18F-FDG PET/CT in the staging of hepatocellular carcinoma. High 68Ga-PSMA uptake could be promising for PSMA-targeted radionuclide treatments.

Insertion site-based polymorphism markers open new perspectives for genome saturation and marker-assisted selection in wheat.

In wheat, the deployment of marker-assisted selection has long been hampered by the lack of markers compatible with high-throughput cost-effective genotyping techniques. Recently, insertion site-based polymorphism (ISBP) markers have appeared as very powerful new tools for genomics and genetic studies in hexaploid wheat. To demonstrate their possible use in wheat breeding programmes, we assessed their potential to meet the five main requirements for utilization in MAS: flexible and high-throughput detection methods, low quantity and quality of DNA required, low cost per assay, tight link to target loci and high level of polymorphism in breeding material. Toward this aim, we developed a programme, IsbpFinder, for the automated design of ISBP markers and adapted three detection methods (melting curve analysis, SNaPshot Multiplex System and Illumina BeadArray technology) for high throughput and flexible detection of ISBP or ISBP-derived SNP markers. We demonstrate that the high level of polymorphism of the ISBPs combined with cost-effective genotyping methods can be used to efficiently saturate genetic maps, discriminate between elite cultivars, and design tightly linked diagnostic markers for virtually all target loci in the wheat genome. All together, our results suggest that ISBP markers have the potential to lead to a breakthrough in wheat marker-assisted selection.

Pneumatic displacement of acute submacular hemorrhage with and without the use of tissue plasminogen activator.

PURPOSE: To evaluate the efficacy of C(3)F(8) gas-assisted pneumatic displacement in the treatment of massive submacular hemorrhage, with and without the use of tissue plasminogen activator (tPA). METHODS: Twenty-one eyes of 21 patients with recently developed (up to 10 days) dense submacular hemorrhage underwent intravitreal injection of pure C(3)F(8) gas (0.4-0.5 mL) followed by face-down positioning for pneumatic displacement. Seven of them received additional intravitreal injection of 25-50 microg tPA. The primary etiology of submacular hemorrhage was age-related macular degeneration (n=16), myopic choroidal neovascularization (n=2), retinal arterial macroaneurysm (n=2), and trauma (n=1). Visual acuity and displacement of hemorrhage were the main outcome measures. RESULTS: Follow-up period was 6-12 months. Effective displacement of hemorrhage was obtained in 20 of 21 patients within 7 days. Final median Snellen visual acuity (0.18) was found significantly improved compared to baseline (0.03) (p<0.001). Visual acuity improvement was similar in both groups (p=0.72). CONCLUSIONS: Intravitreal injection of C(3)F(8) effectively displaced thick submacular hemorrhage and improved visual acuity independently from primary cause. Additional tPA use in this study had no impact on the final outcomes.