Recurrent prostate cancer detection with <Emphasis Type="Italic">anti</Emphasis>-3-[<Superscript>18</Superscript>F]FACBC PET/CT: comparison with CT

Purpose

To compare the diagnostic performance of the synthetic amino acid analogue PET radiotracer anti-3-[¹⁸F]FACBC (fluciclovine) with that of CT in the detection of recurrent prostate carcinoma.

Methods

This was a retrospective analysis of 53 bone scan-negative patients with suspected recurrent prostate carcinoma who underwent fluciclovine PET/CT and routine clinical CT within 90 days of each other. The correlation between imaging findings and histology and clinical follow-up was evaluated. Positivity rates and diagnostic performance were calculated for fluciclovine PET/CT and CT.

Results

Of 53 fluciclovine PET/CT and 53 CT examinations, 41 (77.4 %) and 10 (18.9 %), respectively, had positive findings for recurrent disease. Positivity rates were higher with fluciclovine PET/CT than with CT at all prostate-specific antigen (PSA) levels, PSA doubling times and original Gleason scores. In the prostate/bed, fluciclovine PET/CT was true-positive in 31 and CT was true-positive in 4 of 51 patients who met the reference standard. In extraprostatic regions, fluciclovine PET/CT was true-positive in 12 and CT was true-positive in 3 of 41 patients who met the reference standard. Of the 43 index lesions used to prove positivity, 42 (97.7 %) had histological proof. In 51 patients with sufficient follow-up to calculate diagnostic performance in the prostate/bed, fluciclovine PET/CT demonstrated a sensitivity of 88.6 %, a specificity of 56.3 %, an accuracy of 78.4 %, a positive predictive value (PPV) of 81.6 %, and a negative predictive value (NPV) of 69.2 %; the respective values for CT were 11.4 %, 87.5 %, 35.3 %, 66.7 % and 31.1 %. In 41 patients with sufficient follow-up to calculate diagnostic performance in extraprostatic regions, fluciclovine PET/CT demonstrated a sensitivity of 46.2 %, a specificity of 100 %, an accuracy of 65.9 %, a PPV of 100 %, and an NPV of 51.7 %; the respective values for CT were 11.5 %, 100 %, 43.9 %, 100 % and 39.5 %.

Conclusion

The diagnostic performance of fluciclovine PET/CT in recurrent prostate cancer is superior to that of CT and fluciclovine PET/CT provides better delineation of prostatic from extraprostatic recurrence.

     

Effect of progesterone on gonococci-induced apoptosis and respiratory burst of human polymorphonuclear leukocytes in vitro

Background  Progesterone may have clinical relevance in females with asymptomatic gonococcal infections.
Aim  To investigate the regulatory effect of progesterone on apoptosis and oxidative burst activity of polymorphonuclear leukocytes (PMNs) challenged by Neisseria gonorrhoeae in vitro .
Methods  Isolated PMNs were incubated with progesterone or staurosporine. Staurosporine was used as a positive control for our in vitro model. Expression levels of inhibitory apoptosis proteins (IAPs), cellular IAP2 (cIAP2), and X-linked IAP (XIAP) were determined by real-time polymerase chain reaction (PCR). In addition, PMN apoptosis at various time points (3, 8, 12, and 24 h) was assayed by flow cytometry. Luminol amplified chemiluminescence methods were used to quantify the oxidative burst function of PMNs challenged with N. gonorrhoeae ST2951.
Results  cIAP2 was upregulated significantly in PMNs with progesterone treatment in 3 h, and XIAP was upregulated slightly compared with the medium + ST2951 group, whereas cIAP2 was downregulated in staurosporine-challenged PMNs. In addition, we found that progesterone delayed the onset of apoptosis activity in N. gonorrhoeae ST2951-challenged PMNs, notably at 12 h. No statistically significant changes in PMN oxidative burst activity were observed at 10 ng/mL of progesterone. Staurosporine enhanced the production of superoxide anion (respiratory burst) of human PMNs stimulated by N. gonorrhoeae .
Conclusion  Progesterone plays an important regulatory role in the interaction of PMNs and N. gonorrhoeae . Delayed PMN apoptosis induced by progesterone presumably acts as a mechanism for N. gonorrhoeae to avoid the innate immune response and establish long-term, low-level infection in the female reproductive tract.     

浅论我国古代档案工作的几个特点

探讨我国古代档案工作的特点.笔者就有限的历史记载,对我国古代档案工作在特定的发展时期所呈现出的不同 特点进行了研究.总结出我国古代档案工作的历史悠久、范围广泛、一专多能等几个特点.     

The Community Medical Alliance: an integrated system of care in Greater Boston for people with severe disability and AIDS

The Community Medical Alliance in Boston has adapted principles of prepaid managed care to redesign service delivery for people with severe physical disability and with late-stage AIDS. Experience to date suggests that the flexibility of capitation can be used to substantially shift care from its usual hospital focus to clinicians in home and community settings, especially nurse practitioners, with a high degree of patient satisfaction and without apparent compromise in quality. Instead of limiting access, managed care can use prepayment to support early interventions, coordination, and the development of services specifically designed to meet the needs of the target population.     

Superficial acupuncture in the relief of chronic low back pain

A single-blind, randomised, placebo-controlled trial of superficial acupuncture in the treatment of low back pain was carried out by comparing 8 patients treated by acupuncture with 9 patients treated by placebo. In all five measures of efficacy chosen for study the acupuncture group achieved better responses than the placebo group; four of the five inter-group differences were statistically significant. In addition, an overall mean for all five measures combined showed significant superiority of acupuncture over placebo.