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Circulation Research Feb 2016The remarkable plasticity and plethora of biological functions performed by macrophages have enticed scientists to study these cells in relation to atherosclerosis for... (Review)
Review
The remarkable plasticity and plethora of biological functions performed by macrophages have enticed scientists to study these cells in relation to atherosclerosis for >50 years, and major discoveries continue to be made today. It is now understood that macrophages play important roles in all stages of atherosclerosis, from initiation of lesions and lesion expansion, to necrosis leading to rupture and the clinical manifestations of atherosclerosis, to resolution and regression of atherosclerotic lesions. Lesional macrophages are derived primarily from blood monocytes, although recent research has shown that lesional macrophage-like cells can also be derived from smooth muscle cells. Lesional macrophages take on different phenotypes depending on their environment and which intracellular signaling pathways are activated. Rather than a few distinct populations of macrophages, the phenotype of the lesional macrophage is more complex and likely changes during the different phases of atherosclerosis and with the extent of lipid and cholesterol loading, activation by a plethora of receptors, and metabolic state of the cells. These different phenotypes allow the macrophage to engulf lipids, dead cells, and other substances perceived as danger signals; efflux cholesterol to high-density lipoprotein; proliferate and migrate; undergo apoptosis and death; and secrete a large number of inflammatory and proresolving molecules. This review article, part of the Compendium on Atherosclerosis, discusses recent advances in our understanding of lesional macrophage phenotype and function in different stages of atherosclerosis. With the increasing understanding of the roles of lesional macrophages, new research areas and treatment strategies are beginning to emerge.
Topics: Animals; Arteries; Atherosclerosis; Cell Differentiation; Cellular Microenvironment; Cholesterol; Foam Cells; Humans; Inflammation Mediators; Macrophages; Phenotype; Plaque, Atherosclerotic; Signal Transduction
PubMed: 26892964
DOI: 10.1161/CIRCRESAHA.115.306256 -
Journal of Nuclear Medicine : Official... Jan 2022We sought to evaluate the performance of Ga-DOTA-FAPI-04 ( Ga-FAPI) PET/MR for the diagnosis of primary tumor and metastatic lesions in patients with gastric carcinomas...
We sought to evaluate the performance of Ga-DOTA-FAPI-04 ( Ga-FAPI) PET/MR for the diagnosis of primary tumor and metastatic lesions in patients with gastric carcinomas and to compare the results with those of F-FDG PET/CT. Twenty patients with histologically proven gastric carcinomas were recruited, and each patient underwent both F-FDG PET/CT and Ga-FAPI PET/MR. A visual scoring system was established to compare the detectability of primary tumors and metastases in different organs or regions (the peritoneum, abdominal lymph nodes, supradiaphragmatic lymph nodes, liver, ovary, bone, and other tissues). The original SUV and normalized SUV (calculated by dividing a lesion's original SUV with the SUV of the descending aorta) of selected lesions on both F-FDG PET/CT and Ga-FAPI PET/MR were measured. Original/normalized SUV and SUV were compared for patient-based (including a single lesion with the highest activity uptake in each organ/region) and lesion-based (including all lesions [≤5] or the 5 lesions with highest activity [>5]) analyses, respectively. The 20 recruited patients (median age: 56.0 y; range: 29-70 y) included 9 men and 11 women, 14 patients for initial staging and 6 for recurrence detection. Ga-FAPI PET was superior to F-FDG PET for primary tumor detection (100.00% [14/14] vs. 71.43% [10/14]; = 0.034), and the former had higher tracer uptake levels ( < 0.05). Ga-FAPI PET was superior to F-FDG PET in both patient-based and lesion-based evaluation except for the metastatic lesions in supradiaphragmatic lymph nodes and ovaries. Additionally, multiple sequences of MR images were beneficial for the interpretation of hepatic metastases in 3 patients, uterine and rectal metastases in 1 patient, ovarian lesions in 7 patients, and osseous metastases in 2 patients. Ga-FAPI PET/MR outperformed F-FDG PET/CT in visualizing the primary and most metastatic lesions of gastric cancer and might be a promising method, with the potential of replacing F-FDG PET/CT.
Topics: Positron Emission Tomography Computed Tomography
PubMed: 33863819
DOI: 10.2967/jnumed.120.258467 -
Indian Journal of Otolaryngology and... Dec 2022To present a case of malignant melanoma. A 55-year old female presented with swelling over left upper gingiva which bled on brushing. She was diagnosed with left oral...
UNLABELLED
To present a case of malignant melanoma. A 55-year old female presented with swelling over left upper gingiva which bled on brushing. She was diagnosed with left oral malignant melanoma on histopathology of punch biopsy specimen, which was then followed by C.T. P.N.S and Neck to know the lesion's extent and Ultrasonography of Abdomen and Pelvis to rule out any metastatic deposits. Patient was managed by left lower partial maxillectomy with left radical neck dissection. No intra-operative or post-operative complications seen. Patient was then sent for chemoradiotherapy. No any complications seen at fifteen months follow-up. Oral malignant melanoma is amenable to surgery and chemoradiotherapy with excellent results if detected at an early stage.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1007/s12070-021-02735-1.
PubMed: 36742579
DOI: 10.1007/s12070-021-02735-1 -
Journal of Neurological Surgery. Part... Feb 2021A host of different types of direct and indirect, primary and secondary injuries can affect different portions of the optic nerve(s). Thus, in the setting of penetrating...
A host of different types of direct and indirect, primary and secondary injuries can affect different portions of the optic nerve(s). Thus, in the setting of penetrating as well as nonpenetrating head or facial trauma, a high index of suspicion should be maintained for the possibility of the presence of traumatic optic neuropathy (TON). TON is a clinical diagnosis, with imaging frequently adding clarification to the full nature/extent of the lesion(s) in question. Each pattern of injury carries its own unique prognosis and theoretical best treatment; however, the optimum management of patients with TON remains unclear. Indeed, further research is desperately needed to better understand TON. Observation, steroids, surgical measures, or a combination of these are current cornerstones of management, but statistically significant evidence supporting any particular approach for TON is absent in the literature. Nevertheless, it is likely that novel management strategies will emerge as more is understood about the converging pathways of various secondary and tertiary mechanisms of cell injury and death at play in TON. In the meantime, given our current deficiencies in knowledge regarding how to best manage TON, "primum non nocere" (first do no harm) is of utmost importance.
PubMed: 33777624
DOI: 10.1055/s-0040-1722632 -
Neurology Aug 2022We sought to characterize the natural history and standard-of-care practices between the radiologic appearance of brain lesions, the appearance of lesional enhancement,...
BACKGROUND AND OBJECTIVES
We sought to characterize the natural history and standard-of-care practices between the radiologic appearance of brain lesions, the appearance of lesional enhancement, and treatment with hematopoietic stem-cell transplant or gene therapy among boys diagnosed with presymptomatic childhood-onset cerebral adrenoleukodystrophy (CCALD).
METHODS
We analyzed a multicenter, mixed retrospective/prospective cohort of patients diagnosed with presymptomatic CCALD (Neurologic Function Score = 0, Loes Score [LS] = 0.5-9.0, and age <13 years). Two time-to-event survival analyses were conducted: (1) time from CCALD lesion onset-to-lesional enhancement and (2) time from enhancement-to-treatment. The analysis was repeated in the subset of patients with (1) the earliest evidence of CCALD, defined as an MRI LS ≤ 1, and (2) patients diagnosed between 2016 and 2021.
RESULTS
Seventy-one boys were diagnosed with presymptomatic cerebral lesions at a median age of 6.4 years [2.4-12.1] with a LS of 1.5 [0.5-9.0]. Fifty percent of patients had lesional enhancement at diagnosis. In the remaining 50%, the median Kaplan-Meier (KM)-estimate of time from diagnosis-to-lesional enhancement was 6.0 months (95% CI 3.6-17.8). The median KM-estimate of time from enhancement-to-treatment is 3.8 months (95% CI 2.8-5.9); 2 patients (4.2%) developed symptoms before treatment. Patients with a diagnostic LS ≤ 1 were younger (5.8 years [2.4-11.5]), had a time-to-enhancement of 4.7 months (95% CI 2.7-9.30), and were treated in 3.8 months (95% CI 3.1-7.1); no patients developed symptoms before treatment. Time from CCALD diagnosis-to-treatment decreased over the course of the study (ρ = -0.401, = 0.003).
DISCUSSION
Our findings offer a more refined understanding of the timing of lesion formation, enhancement, and treatment among boys with presymptomatic CCALD. These data offer benchmarks for standardizing clinical care and designing future clinical trials.
Topics: Male; Humans; Child; Adolescent; Adrenoleukodystrophy; Retrospective Studies; Prospective Studies; Hematopoietic Stem Cell Transplantation; Magnetic Resonance Imaging
PubMed: 35609989
DOI: 10.1212/WNL.0000000000200571 -
Canadian Urological Association Journal... Jun 2020Most cohort studies are limited by sampling and accrual bias. The capability to detect specific lesions identified in radiological text reports could eliminate these...
INTRODUCTION
Most cohort studies are limited by sampling and accrual bias. The capability to detect specific lesions identified in radiological text reports could eliminate these biases and benefit patient care, clinical research, and trial recruitment. This study derived and internally validated text search algorithms to identify four common urological lesions (solid renal masses, complex renal cysts, adrenal masses, and simple renal cysts) using radiology text reports.
METHODS
A simple random sample of 10 000 abdominal ultrasound (US) and computed tomography (CT) reports was drawn from our hospital's data warehouse. Reports were manually reviewed to determine the true status of the four lesions. Using commonly available software, we created logistic regression models having as predictors the status of a priori selected text terms in the report. We used bootstrap sampling with 95 percentile thresholds to select variables for the final models, which were modified into point systems. A second independent, random sample of 2855 reports, stratified by the number of points for each abnormality, was reviewed in a blinded fashion to measure the accuracy of each lesion's point system.
RESULTS
The prevalence of solid renal mass, complex renal cyst, adrenal mass, and simple renal cyst, was 2.0%, 1.7%, 3.2%, and 20.0%, respectively. Each model contained between one and five text terms with c-statistics ranging between 0.66 and 0.90. In the independent validation, the scoring systems accurately predicted the probability that a text report cited the four lesions.
CONCLUSIONS
Textual radiology reports can be analyzed using common statistical software to accurately determine the probability that important abnormalities of the kidneys or adrenal glands exist. These methods can be used for case identification or epidemiological studies.
PubMed: 31977309
DOI: 10.5489/cuaj.6105 -
Journal of Thoracic Disease Apr 2021Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current... (Review)
Review
Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM.
PubMed: 34012607
DOI: 10.21037/jtd-19-3791 -
Imaging Science in Dentistry Jun 2022The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone. (Review)
Review
PURPOSE
The aim of this study was to characterize the cone-beam computed tomographic (CBCT) imaging features of central giant cell granuloma (CGCG) of the jawbone.
MATERIALS AND METHODS
This study retrospectively reviewed 26 CBCT studies of histologically proven cases of CGCG during a period of 20 years, from 1999 to 2019. Patients' demographic data were recorded, and radiographic features were assessed (location, border, cortication, appearance of the internal structure, locularity, septation, expansion, cortical perforation, effects on surrounding tissue, whether the lesion crossed the midline, and lesion volume).
RESULTS
In this study, CGCGs were seen almost twice as often in the mandible than in the maxilla, and 64.7% of mandibular lesions involved the anterior region. Only 26.9% of lesions crossed the midline, a feature that was considered characteristic of CGCG. Furthermore, 65.4% of lesions were unilocular and 34.6% were multilocular. The correlation between a lesion's size and its locularity was statistically significant, and larger lesions showed a multilocular appearance. The mean volume of multilocular lesions was greater than that of unilocular lesions.
CONCLUSION
CGCGs showed variable radiographic features on CBCT, and this imaging modality is highly effective at demonstrating the radiographic spectrum and lesional extent of CGCGs in the jawbone.
PubMed: 35799967
DOI: 10.5624/isd.20220130 -
Proceedings of SPIE--the International... Feb 2020Kidney biopsies are currently performed using preoperative imaging to identify the lesion of interest and intraoperative imaging used to guide the biopsy needle to the...
Kidney biopsies are currently performed using preoperative imaging to identify the lesion of interest and intraoperative imaging used to guide the biopsy needle to the tissue of interest. Often, these are not the same modalities forcing the physician to perform a mental cross-modality fusion of the preoperative and intraoperative scans. This limits the accuracy and reproducibility of the biopsy procedure. In this study, we developed an augmented reality system to display holographic representations of lesions superimposed on a phantom. This system allows the integration of preoperative CT scans with intraoperative ultrasound scans to better determine the lesion's real-time location. An automated deformable registration algorithm was used to increase the accuracy of the holographic lesion locations, and a magnetic tracking system was developed to provide guidance for the biopsy procedure. Our method achieved a targeting accuracy of 2.9 ± 1.5 mm in a renal phantom study.
PubMed: 32476704
DOI: 10.1117/12.2550593