Purpose: Pseudoprogression (PsP) is characterized by therapyassociated but not tumor growth-associated increases of contrastenhancing glioblastoma lesions on MRI. Although typically occurring during the first 3 months after radiochemotherapy, PsP may occur later in the course of the disease and may then be particularly difficult to distinguish from true tumor progression. We explored PET using O-(2-Experimental Design: Twenty-six patients with glioblastoma that presented with increasing contrast-enhancing lesions later than 3 months after completion of radiochemotherapy underwent 18 F-FET-PET. Maximum and mean tumor/brain ratios (TBR max and TBR mean ) of 18 F-FET uptake as well as time-to-peak (TTP) and patterns of the time-activity curves were determined. The final diagnosis of true progression versus late PsP was based on follow-up MRI using RANO criteria.Results: Late PsP occurred in 7 patients with a median time from radiochemotherapy completion of 24 weeks while the remaining patients showed true tumor progression. TBR max and TBR mean were significantly higher in patients with true progression than in patients with late PsP (TBR max 2.4 AE 0.1 vs. 1.5 AE 0.2, P ¼ 0.003; TBR mean 2.1 AE 0.1 vs. 1.5 AE 0.2, P ¼ 0.012) whereas TTP was significantly shorter (mean TTP 25 AE 2 vs. 40 AE 2 min, P < 0.001). ROC analysis yielded an optimal cutoff value of 1.9 for TBR max to differentiate between true progression and late PsP (sensitivity 84%, specificity 86%, accuracy 85%, P ¼ 0.015).Conclusions: O-(2-[ 18 F]fluoroethyl)-L-tyrosine PET provides valuable information in assessing the elusive phenomenon of late PsP. Clin Cancer Res; 22(9); 2190-6. Ó2015 AACR.
Background-Revascularization is an adaptive repair mechanism that restores blood flow to undersupplied ischemic tissue. Nitric oxide plays an important role in this process. Whether dietary nitrate, serially reduced to nitrite by commensal bacteria in the oral cavity and subsequently to nitric oxide and other nitrogen oxides, enhances ischemia-induced remodeling of the vascular network is not known. Methods and Results-Mice were treated with either nitrate (1 g/L sodium nitrate in drinking water) or sodium chloride (control) for 14 days. At day 7, unilateral hind-limb surgery with excision of the left femoral artery was conducted. Blood flow was determined by laser Doppler. Capillary density, myoblast apoptosis, mobilization of CD34
During a 3-month period 259 pediatric surgical procedures in 236 patients were followed for the development of surgical site infections (SSI): 17 sites became infected, an overall infection rate of 6.6%. The incidence in our study was therefore higher than expected. As expected, the infection rate increased according to wound contamination: dirty sites had a SSI rate of 30%. Emergency procedures, operation duration over 1 h, and inpatients showed a statistically significant higher risk of developing SSI. Although there were differences between males and females, individual surgeons, and the use of antibiotic prophylaxis, these differences were not statistically significant.
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