Kesslerlutz5266

The aim of this retrospective study was to analyse a consecutive series of patients with oral and oropharyngeal carcinoma who had had sentinel lymph node biopsy (SLNB) at our hospital during 2008-2017. A total of 70 patients with clinically and radiologically confirmed primary oral (n=67) or oropharyngeal (n=3) carcinoma, with no signs of metastatic lymph nodes preoperatively (clinically N0) were included. Patients' clinical and personal data, characteristics of the tumours, sentinel lymph node (SLN) status and outcomes were recorded. Eight patients had invaded SLN. Two patients with clear sentinel lymph node biopsies had recurrences in the cervical lymph nodes with no new primary tumour as origin. The negative predictive value (NPV) and sensitivity for SLNB were 97% and 80%, respectively. The depth of invasion was an individual predictor for cervical lymph node metastasis (p=0.043). Single photo emission computed tomography (SPECT) detected fewer SLN in patients with invaded lymph nodes than in patients with clear lymph nodes (p=0.018). Our data support the use of SLNB as a minimally invasive method for staging the cervical lymph nodes among patients with cN0 oral and oropharyngeal carcinoma. Our results further confirm that greater depth of invasion is associated with cervical lymph node metastases.This paper aims to provide a paediatric cardiac computed tomography angiography expert panel consensus based on the opinions of experts from the Société française d'imagerie cardiaque et vasculaire diagnostique et interventionnelle (SFICV) and the Filiale de cardiologie pédiatrique congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, computed tomography angiography radiation dose reduction techniques and postprocessing techniques. We think that to realize its full potential and to avoid pitfalls, cardiac computed tomography angiography in children with congenital heart disease requires training and experience. Moreover, paediatric cardiac computed tomography angiography protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible, to prevent unnecessary radiation exposure. We also provide a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.Background and aims Disturbances in matrix metalloproteinases (MMPs) and corresponding tissue inhibitors (TIMPs) contribute to hepatitis C virus (HCV)-induced fibrosis. This study aimed to determine MMP-9/TIMP-1 levels in addition to MMP-2 and -9 activities; correlating with the improvement of liver fibrosis in patients under direct-acting antiviral (DAA) therapy. Methods Clinical and laboratory follow-up were performed before treatment and after 12 weeks post-treatment, referred as sustained viral response (SVR). We evaluated liver function including non-invasive fibrosis measurements; MMP activity by zymography; and MMP-9/TIMP-1 complex, inflammatory and pro-fibrogenic mediators by immunoenzymatic assays. Results Cohort included 33 patients (59.5 ± 9.3 years, 60.6% females) whose reached SVR and 11 control-paired subjects (42.5 ± 15 years, 54.5% females). Before treatment, HCV patients presented higher MMP-9/TIMP-1 levels (P less then 0.05) when compared to controls, and the highest values were observed in patients with fibrosis (P less then 0.05). In addition, MMP-9/TIMP-1 levels were significantly reduced after DAA therapy (P less then 0.0001) and were associated with profibrogenic biomarkers. No differences were observed for MMP-2 and -9 activities; however, these biomarkers were significantly associated with inflammatory mediators. Conclusion Our data suggest that MMP-9/TIMP-1 complex can be a promising biomarker of active fibrogenesis, being able to identify the interruption of fibrosis progression after HCV eradication.Applying dual, or mixed photon energies during radiation therapy is a common practice in 3-dimensional conformal radiation therapy (3D-CRT). Mixed photon energies are used to provide uniform dose coverage to a planning target volume (PTV) that ranges in depth from the skin surface. Though the application of mixed photon energies in 3D-CRT was once the convention for treating anal cancers with lymph node involvement (AC-LNI), the advantages offered by volumetric modulated arc therapy (VMAT) prove to be the optimal form of therapy for AC-LNI. Recently, multiple researchers have uncovered benefits in employing multiple photon energies in VMAT planning for prostate cancer. A retrospective study was completed to assess the impact of implementing mixed energy VMAT planning in comparison to conventional single energy VMAT planning for AC-LNI. Data from 20 patients with AC-LNI was collected to analyze the dosimetric effects of mixed energy VMAT treatments in terms of PTV conformity index, PTV homogeneity index, monitor unit usage, and organs at risk sparing. For each patient 3 treatment plans were created a single energy 6 MV plan, a single energy 10 MV plan, and a mixed 6 MV and 10 MV energy plan. Z-VAD-FMK Analysis of the resulting dosimetric outcomes showed statistical significance. The current study concluded that mixed energy VMAT plans have some effect on treating AC-LNI when compared to single energy VMAT plans.Introduction The epidural disease progression is the most common pattern of failure after spine stereotactic body radiotherapy. The aim of this study was to clarify the effect of the dose calculation grid size (CGS) during volumetric modulated arc therapy planning on the dose to the epidural space target. Materials and methods In the planning, the volume obtained by subtracting the planning organ at risk volume (PRV) of the spinal cord and/or cauda equina from the planning target volume (PTV) was defined as the PTVeval. First, we compared the epidural space dose that overlapped with the PTVeval at dose CGSs of 1 mm and 2 mm. Next, we compared the dose that can be given, according to the isotropic distance from the PRV of the spinal cord and/ or cauda equina at dose CGSs of 1 mm and 2 mm. Results The dose to the epidural space overlapping with the PTVeval was significantly larger at the dose CGS of 1 mm (60 to 80 cGy, 3% of the prescription dose) than at the dose CGS of 2 mm (p less then 0.01). In addition, compared with the dose CGS of 2 mm, the dose CGS of 1 mm provided a larger dose to 95% of the volume in the regions where the PTVeval overlapped at isotropic distances of 0 to less then 1, 1 to 2, 2 to 3, 3 to 4, and 4 to 5 mm from the PRV of the spinal cord and/or cauda equina.