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Abstract: In order to plan treatment or follow-up of pancreatic cystic lesions, is crucial to distinguish benign from malignant cystic tumors with reliable, non-invasive methods. Despite evaluation with several preoperative investigations, a correct pathologic diagnosis rate does not exceed 68%. 2–[18F]–fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET-CT) has been found to be a highly sensitive and specific non-invasive procedure to detect malignancy in cystic tumors of the pancreas (CTP). The introduction of hybrid PET/CT scans allowed a more accurate localization of the foci of hypermetabolism. We reviewed 14 series (645 patients) with a CTP who underwent 18F-FDG PET-CT from 2001; four of these studies came from our group of investigators (226 patients). In the last studies, sensitivity in detecting malignancy ranged from 83 to 100% and specificity from 78 to 100%. 18F-FDG PET-CT for a long time was used only when conventional imaging was insufficient to rule out a cancer. In our experience, 18F-FDG PET-CT was found to be reliable to detect “cancer in situ” when no other investigations could detect it, so we stress the use of 18F-FDG PET-CT in the first assessment, as alternative to EUS with FNA, to exclude malignancy. We are lacking data about the use of 18F-FDG PET-CT and timing in the follow-up of patients (un)-operated. We suggest a regular use in the follow up of patients with intraductal papillary mucinous neoplasms (IPMN), due to their multifocality and to the high rate of extra-pancreatic cancers. Keywords: 18F-FDG PET/CT, standardized uptake value (SUV), pancreas, pancreatic cystic neoplasm, intraductal papillary mucinous neoplasm (IPMN). Download Full Article |
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Abstract: Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma. Now, it remains a diagnostic challenge, because of non-specific findings on clinical, laboratory, and imaging studies. Here we present a case of an IVLBCL patient, who presented with fever of unknown origin and had skin involvement, that 18F-FDG PET/CT showed increased metabolism on systemic subcutaneous fat layer with a SUVmax of 1.29. After five courses of R-CHOP, 18F-FDG PET/CT showed disappearance of the diffuse FDG accumulation on systemic subcutaneous fat layer with a SUVmax of 0.55. These features make this case unique. Keywords: Lymphoma, Fever, 18F-FDG, PET/CT. Download Full Article |
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Abstract: The surgery treatment of parotid metastasis of nasopharyngeal carcinoma(NPC) after parotid-gland-sparing IMRT is rare report. We present such a case of NPC patient cT2N2M0 with parotid lymph node metastasis after parotid-gland-sparing IMRT patient who accepted the second operation after the first failure parotid section. This case reminded us that neck dissection added the whole parotid glandresection may be an appropriate method to treat this type of patients. Keywords: Nasopharyngeal carcinoma, Parotid lymph node metastasis, Prognosis, Intensity-modulated radiotherapy, Surgery. Download Full Article |
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Abstract: Current chemotherapeutic drugs act for the most part by killing cancer cells directly. Treatment with these drugs often can be harmful to normal cells and may cause incomplete elimination of the target cells, resulting in the recurrence of the disease. To coop with current treatments the path of biomodulation rather than cytotoxicity, has been seen in the role of cAMP in normal versus malignant cells. It has been found that an increase of cAMP levels in normal cells stimulates proliferation, and that in the same time cancerous cells are inhibited to proliferate. This inverted reaction has given the momentum for synthesis of various cAMP analogues and investigation of there antitumor activity. A number of analogues, such as 8-PIP-cAMP, 8-Br-CAMP or 8-HA–cAMP showed efficacy only in millimolar concentrations. Only one of them, 8-Cl-cAMP as specific analogue has achieved inhibition of proliferation and stimulation of apoptosis of malignant cells in low or micromole concentrations. Still, 25 years later the mechanism of action of 8-clcAMP has not been fully elucidated or defined. This review is to challenge these mechanisms of action and to set a view of the nature of 8-Cl-cAMP action. Keywords: 8-Cl-cAMP, PKA cAMP-dependent protein kinase, biomodulation. Download Full Article |
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Abstract: The investigation updates information on enzymes and proteins related to their classification, functions, properties, and role in human pathology. Enzymes are any of a group of complex or conjugated proteins that are produced by living cells and act as catalysts in specific biochemical reactions. The three types of enzymes, metabolic, digestive and food-based, play key roles in the treatment of all the major sources of morbidity and mortality including cancer, dementia, diabetes, cardiac disease, and obesity. The ability to accurately target metabolic pathways and pathologic pathways allow adaptations by changing the expression of specific enzymes implicated in the pathogenesis or prevention of diseases. This overview provides a summary to guide the development of enzyme-based therapeutics. The changes of expression and activity of lipid metabolising enzymes are directly regulated by oncogenic signals. Hyper activation of the Poly (ADP-ribose) polymerase [PARP] pathway may be exploited to selectively kill cancer cells. Amyloid beta (Aβ) peptides play a major role in the pathogenesis of Alzheimer's disease (AD). Sphingolipid metabolites play important roles in the regulation of glucose metabolism. In diabetes and insulin resistance, sphingosine kinase 1 (SPK1) is the key enzyme in the sphingolipid metabolic pathway. SPK1 gene therapy may represent a novel approach to wound healing related to diabetes. Several P450s enzymes modulate important steps in the pathogenesis of ischemic heart disease (IHD). The homologous sirtuin (Sirt) family of proteins have beneficial effects in metabolism and aging-related diseases in mammalian systems. These proteins play an important role in maintaining neuronal health during aging. Keywords: Mitochondria, metastasis, obesity, caloric restriction, cardiovascular disease. Download Full Article |