Value of 11C-methionine PET in imaging brain tumours and metastases

¹¹C-methionine (MET) is the most popular amino acid tracer used in PET imaging of brain tumours. Because of its characteristics, MET PET provides a high detection rate of brain tumours and good lesion delineation. This review focuses on the role of MET PET in imaging cerebral gliomas. The Introduction provides a clinical overview of what is important in primary brain tumours, recurrent brain tumours and brain metastases. The indications for radiotherapy and the results and problems arising after chemoradiotherapy in relation to imaging (pseudoprogression or radionecrosis) are discussed. The working mechanism, scan interpretation and quantification possibilities of MET PET are then explained. A literature overview is given of the role of MET PET in primary gliomas (diagnostic accuracy, grading, prognosis, assessment of tumour extent, biopsy and radiotherapy planning), in brain metastases, and in the differentiation between tumour recurrence and radiation necrosis. Finally, MET PET is compared to other nuclear imaging possibilities in brain tumour imaging.     

Validation of the urine column measurement as an estimation of the intra-abdominal pressure

Objective  To evaluate the efficacy of the urine column (UC) measurement compared to the intra-vesicular pressure (IVP) measurement as an estimation of intra-abdominal pressure (IAP) in patients with IAP up to 30 mmHg. Methods  Fifteen patients undergoing a laparoscopic cholecystectomy were studied. All patients were catheterized. IVP measurements were performed using a pressure transducer connected to the culture aspiration port. UC measurements were done by holding up the tubing against a measuring rod. The symphysis pubis was used as the zero-reference. IAP was raised from 0 to 30 mmHg using increments of 5 mmHg, during which first the IVP and then UC measurement series were recorded end-expiratory. Fifty and 100 ml of saline were used as a priming volume. Results  The IVP and UC measurements showed a significant correlation with IAP. Comparing IVP and UC showed a correlation of 0.91 (p < 0.001) for 50 ml and 0.87 (p < 0.001) for 100 ml of saline as a priming volume. Using 50 ml of saline, UC was 0.68 mmHg higher than IVP (95% CI −7.21 to +5.85 mmHg). For 100 ml of saline, UC was 1.23 mmHg lower than IVP (95% CI −7.41 to +9.87 mmHg). Conclusion  UC measurement shows significant correlation to IVP measurement as an estimation of the IAP. Further study needs to be done to conclude whether UC measurement is a reliable clinical alternative to IVP measurement.     

EDHF: bringing the concepts together

Endothelial cells synthesize and release vasoactive mediators in response to various neurohumoural substances (e.g. bradykinin or acetylcholine) and physical stimuli (e.g. cyclic stretch or fluid shear stress). The best-characterized endothelium-derived relaxing factors are nitric oxide and prostacyclin. However, an additional relaxant pathway associated with smooth muscle hyperpolarization also exists. This hyperpolarization was originally attributed to the release of an endothelium-derived hyperpolarizing factor (EDHF) that diffuses to and activates smooth muscle K(+) channels. More recent evidence suggests that endothelial cell receptor activation by these neurohumoural substances opens endothelial cell K(+) channels. Several mechanisms have been proposed to link this pivotal step to the subsequent smooth muscle hyperpolarization. The main concepts are considered in detail in this review.     

Effect of smoking and sun on the aging skin

Smoking and ultraviolet radiation are known to have a detrimental effect on human skin. Important characteristics of the aging skin are elastosis and telangiectasia. The purpose of the study was to assess the relative importance of age per se, and the detrimental effects caused by sun exposure and smoking on the development of cutaneous elastosis and telangiectasia in a well-defined group of individuals. We made use of 966 individuals who participated in a case-control study to investigate environmental and genetic risk factors for skin cancer. Exposure measurements for sunlight and smoking were collected and the amount of elastosis and telangiectasia in the face and neck was recorded according to a four-graded score varying from none to severe. Relative risks were estimated using exposure odds ratios from cross-tabulation and logistic regression. Multivariate logistic regression was used to adjust for potential confounders. Among both sexes a strong association was observed between increasing age, sun exposure, and amount of elastosis. The association between increasing age, sun exposure, and amount of telangiectasia was strong among men, but less apparent among women. Smoking was also associated with elastosis among both sexes, and with telangiectasia predominantly among men. Intrinsic differences between men and women (e.g., hormones) or behavior differences (e.g., more frequent use of creams and cosmetics among women) could account for this apparent difference in the occurrence of telangiectasia. In contrast to elastosis, telangiectasia may not be a good marker of the aging skin, specifically not in women.     

HIV prevention and adolescents: a sample survey on Italian high school students

This article resulted from a survey carried out by some researchers of the Telefono Verde AIDS (TVA-National AIDS Help-Line) of the Istituto Superiore di Sanità, with the collaboration of some colleagues of the Segreteria per le Attività Culturali. It is also a summary of strategies of intervention against HIV/AIDS for young people implemented by the Italian Ministry of Health. The study was developed within the context of the workshops on HIV/AIDS education carried out since 1995 by some researchers of TVA. These workshops fall within some other initiatives arranged by the Segreteria per le Attività Culturali for the diffusion of scientific and technological information. Our study aimed at assessing the level of knowledge on HIV/AIDS among some different high-school students. Data processing points out a widespread and quite good level of knowledge on HIV/AIDS in general and particularly on ways of transmission and prevention measures. Results obtained could not be generalized because the sample involved in the survey represented a privileged target, already sensitive to the issues concerning HIV infection and AIDS dealt with in the context of specific teaching programmes.     

Musculoskeletal symptom survey among mason tenders

BACKGROUND: Low back pain (LBP) constitutes a major problem in construction. The magnitude and musculoskeletal injury characteristics in certain construction trades have been studied extensively. Musculoskeletal research targeting mason tenders is limited. High physical demands of the job primarily contribute to an increased risk of LBP experienced by these laborers. METHODS: A symptom survey was conducted to determine the magnitude and musculoskeletal injury characteristics among the mason tenders, and to identify work-related activities perceived by them as contributing to their disorders. RESULTS: The findings revealed that 82% of the mason tenders experienced at least one musculoskeletal symptom in the last year. LBP was the most frequently reported symptom (65%). Due to LBP, 12% of the laborers missed work and 18% of them visited a physician. Bending or twisting the back, working in the same position or in pain, and heavy lifting they perceived as the most problematic work-related activities. The vast majority of the laborers requested job-safety training. CONCLUSIONS: The mason tenders experienced high prevalence of LBP. To address the problem a model for primary prevention of LBP was developed and implemented in the trade. The model incorporated ergonomic principles, hazard recognition, and problem solving in the training curriculum for the union instructors teaching apprentices the trade-specific skills.     

Treatment of advanced gastric cancer with etoposide,folinic acid,and fluorouracil in the clinical setting: efficacy of therapy and value of serum tumor markers

The combination of etoposide, folinic acid, and 5-fluorouracil (5-FU) (ELF regimen) has been proved to be an active chemotherapy in patients with advanced gastric cancer. The aim of this study was to confirm the efficacy in the clinical setting and to correlate response with different parameters like serum tumor markers. We treated 60 patients with advanced gastric cancer with 120 mg/m² etoposide, 300 mg/m² folinic acid, and 500 mg/m² 5-FU, on d 1–3. The cycle was repeated on d 21. Objective response was obtained in 23% of all patients with measurable disease. Stable disease was obtained in 37%. The tumor-growth-control rate in patients with proximal carcinoma was significantly higher than in those with distal carcinoma (85% vs 48%, p=0.04). Median survival for all patients was 8.0 mo (95% confidence interval [CI] 7.0–8.5). In responsive patients, survival was more than two-fold longer than in patients with progressive disease. The administration of ELF could be performed safely on an outpatient basis. Toxicity was rather mild. The most frequently elevated serum tumor marker was CA 72-4 (55% of the patients). An elevated level of carcinoembryonic antigen before treatment was significantly correlated with progressive disease. A more than two-fold elevation of at least one marker under treatment was significantly correlated to progressive disease (p<0.002). A reduction of at least one marker under treatment was significantly correlated to tumor growth control (p<0.00015). The results of the present trial confirm the efficacy and low toxicity of the ELF regimen in advanced gastric carcinoma. Serum tumor markers proved suitable parameters for assessing response to treatment.