18F-FDG uptake on PET correlates with biological potential in early oral squamous cell carcinoma

Conclusion: The maximum standardized uptake value (SUVmax) of early oral squamous cell carcinoma (OSCC) may have a role as an imaging biomarker for assessment of malignant potential, including cell metabolism and angiogenesis. Objective: The usefulness of ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) has been proven in various cancers, including OSCC. Moreover, in several carcinomas, the SUVmax of the tumor has been shown to correlate with the histological type, tumor stage, differentiation, and prognosis. Here, we investigated whether the SUVmax of early OSCC was associated with the biological features. Methods: Twenty-seven patients with newly diagnosed early OSCC who underwent preoperative FDG-PET and curative surgical resection were included in this study. Tumor sections were stained by immunohistochemistry for glucose transporter 1 (GLUT1), L-type amino acid transporter 1 (LAT1), CD98, microvessels (CD34), cell proliferation marker (Ki-67), and cell cycle regulator (p53). The correlation between SUVmax and clinicopathological findings or the expression level of these molecules was analyzed. Results: SUVmax of primary OSCC was significantly higher in patients with T2 stage. Moreover, patients whose tumors showed vascular invasion had a tendency to show higher SUVmax. A significant correlation was observed between SUVmax and the expression of LAT1 or microvessel density.     

Vulnerable atherosclerotic plaque features: findings from coronary imaging

Pathological studies have suggested that features of vulnerable atherosclerotic plaques likely to progress and lead to acute cardiovascular events have specific characteristics. Given the progress of intravascular coronary imaging technology, some large prospective studies have detected features of vulnerable atherosclerotic plaques using these imaging modalities. However, the rate of cardiovascular events, such as acute coronary syndrome, has been found to be considerably reduced in the limited follow-up period available in the statin era. Additionally, not all disrupted plaques lead to thrombus formation with clinical presentation. If sub-occlusive or occlusive thrombus formation does not occur, a thrombus on a disrupted plaque will organize without any symptoms, forming a “healed plaque”. Although vulnerable plaque detection using intracoronary imaging is focused on “thin-cap fibroatheroma” leading to plaque rupture, superficial plaque erosion is increasingly recognized; however, the underlying mechanism of thrombus formation on eroded plaques is not well understood. One of intravascular imaging, optical coherence tomography (OCT) has the highest image resolution and has enabled detailed characterization of the plaque in vivo. Here, we reviewed the status and limitations of intravascular imaging in terms of detecting vulnerable plaque through mainly OCT studies. We suggested that vulnerable plaque should be reconsidered in terms of eroded plaque and healed plaque and that both plaque and circulating blood should be assessed in greater detail accordingly.

Acute coronary syndrome (ACS) remains a major cause of morbidity and mortality worldwide. For decades, pathological and fundamental studies have primarily focused on “vulnerable plaque” resulting in ACS. The term “vulnerable plaque”, introduced in the late 1980s, refers to a coronary plaque that is most likely to result in plaque rupture.^[1] Although plaque rupture is the most frequent autopsy finding in patients with sudden cardiac death,^[2–4] plaque erosion or calcified nodules are reported to be other underlying mechanisms contributing to ACS.^[2] In the clinical setting, optical coherence tomography (OCT), a high resolution intracoronary imaging modality, has enabled characterization of the culprit plaque that are more in line with the aforementioned diagnosis of the three pathologies in the autopsy studies.^[5] Moreover, studies using OCT have demonstrated plaque erosion to be more common than previously considered.^[6] The representative three types of culprit plaque on OCT images are shown in Figure 1. Naghavi, et al.^[7] recommended that vulnerable plaque be defined in terms of morphological features to include all dangerous plaques that involve a risk of thrombosis and/or rapid progression. In addition, they suggested that not only plaque but also circulating blood plays an important role in the development of ACS.^[7] However, most intracoronary imaging studies concerning vulnerable plaque as a predisposition to ACS have focused on plaque rupture, which is frequently referred to as thin-cap fibroatheroma (TCFA). Figure 2 shows a typical OCT image of TCFA. Additionally, although ACS predominantly arises from occlusive or sub-occlusive coronary thrombosis due to disrupted plaques, non-flow-limiting thrombus may heal without clinical manifestations^[8] and it has been proposed that the healing process of disrupted plaques contributes to the episodic progression of coronary artery stenosis.^[9–12] Herein, we review the present status and the limitations of current intracoronary imaging modalities based on ACS pathogenesis, and we reevaluate the nature of vulnerable plaque through mainly OCT studies. Open in a separate windowFigure 1Representative OCT images of three types of ACS pathologies.(A): Plaque rupture was defined as the presence of fibrous cap discontinuity with a communication between the lumen and the inner core of plaque or with a cavity formation within the plaque; (B): plaque erosion was identified as the presence of an attached thrombus overlying an intact and visualized plaque, luminal surface irregularity at the culprit lesion in the absence of a thrombus, or attenuation of the underlying plaque by a thrombus without superficial lipid or calcification immediately proximal or distal to the site of the thrombus; and (C): calcified plaque was defined as the presence of superficial substantive calcium at the culprit site without evidence of a ruptured lipid plaque. ACS: acute coronary syndrome; OCT: optical coherence tomography.Open in a separate windowFigure 2Representative OCT image of TCFA.(A): Lipid plaque, defined as a signal poor region with a poorly defined or diffuse border, is shown in the whole circumference (white asterisks); and (B): the minimum fibrous thickness was measured as < 65 μm (enlarged view). OCT: optical coherence tomography; TCFA: thin cap fibroatheroma.     

A study of arteriosclerosis in healthy subjects with HBV and HCV infection

Background It is unclear whether infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) affects arteriosclerosis. We performed a cross-sectional study to clarify the effect of HBV and HCV infection on arteriosclerosis. Methods The study subjects were 1806 healthy individuals who visited Shimane Environment and Health Public Corporation for routine medical check-ups. Serum levels of total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, and blood glucose were investigated in all subjects. The degree of arteriosclerosis was assessed using systolic blood pressure, the bilateral ankle brachial index (ABI), the heart-carotid pulse wave velocity (HCPWV), and the heart-ankle PWV (HAPWV). These cardiovascular parameters were compared between control subjects and subjects with HBV and HCV infection, using analysis of covariance to adjust for confounding factors (sex, age, body mass index, and smoking and drinking). Results Of the 1806 subjects, 39 and 31 were diagnosed as positive for HBV and HCV infection, respectively. The remaining 1736 were considered to be the controls. Adjusted serum lipid levels in the subjects with HBV and those with HCV infection tended to be lower than those in the control subjects. Adjusted arteriosclerotic parameters in the subjects with HBV and HCV infection were similar to those in the control subjects, even after adjusting for serum lipid levels. Conclusions Infection with HBV or HCV does not influence the severity of arteriosclerosis in healthy subjects.     

Maximizing the Impact of Voluntary Medical Male Circumcision for HIV Prevention in Zambia by Targeting High-Risk Men: A Pre/Post Program Evaluation

AIDS and Behavior - A well-documented barrier to voluntary medical male circumcision (VMMC) is financial loss due to the missed opportunity to work while undergoing and recovering from VMMC. We...