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Background Progesterone is one of the female steroid hormones and plays an important role in the menstrual cycle and during pregnancy. It is especially important in preparing the uterus for the implantation of the blastocyst and maintaining pregnancy. The concentration in human serum is measured to determine the ovarian function retroactively and the cause of abortion in early pregnancy. Methods A quantification assay based on isotope dilution mass spectrometry to determine the concentration of progesterone in human serum is reported. Incorporated with 13C3-progesterone, serum samples were subjected to progesterone extraction and clean-up by C4 solid-phase-extraction columns and hexane-based liquid/liquid extraction, respectively. The cleaned-up serum samples were then subjected to MALDI-TOF mass spectrometry for the quantification of progesterone. Results Progesterone and the internal standard, 13C3-progesterone, were measured in the selected reaction monitoring mode for the transitions m/z 315.4 to 108.9 and m/z 318.4 to 111.9, respectively. We calculated the peak area ratio of progesterone to 13C3-progesterone. The progesterone concentration in human serum was calculated by substituting the peak area ratio into an isotope dilution calibration curve, and then compared with the radioimmunoassay. Conclusions In the study, the concentrations of serum progesterone were measured, and the recovered progesterone concentration determined by the assay showed good robustness and consistency in comparison to the conventional radioimmunologic assay. We concluded that the 13C3-progesterone-based quantification assay is a robust method for the measurement of serum progesterone.

To investigate the prognostic significance of metabolic parameters and texture analysis on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in patients with breast invasive ductal carcinoma (IDC), from August 2005 to May 2015, IDC patients who had undergone pre-treatment FDG PET/CT were enrolled. The metabolic parameters, including maximal standardized uptake value of breast tumor (SUVbt) and ipsilateral axillary lymph node (SUVln), metabolic tumor volume (MTVbt) and total lesion glycolysis (TLGbt) of breast tumor, whole-body MTV (MTVwb) and whole-body TLG (TLGwb) were recorded. Nine textural features of tumor (four co-occurrence matrices and five SUV-based statistics) were measured. The prognostic significance of above parameters and clinical factors was assessed by univariate and multivariate analyses. Thirty-five patients were enrolled. Patients with low and high MTVwb had 5-year progression-free survival (PFS) of 81.0 and 14.3% (p p = 0.0005). Multivariate analyses showed MTVwb was an independent prognostic factor for PFS (HR: 8.29, 95% CI: 2.17–31.64, p = 0.0020). The SUV, TLG and textural features were not independently predictive. Elevated MTVwb was an independent predictor for shorter PFS in patients with breast IDC.

During the coronavirus disease 2019 (COVID-19) pandemic, several case studies demonstrated that many asymptomatic patients with COVID-19 underwent fluorine-18 fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) examination for various indications. However, there is a lack of literature to characterize the pattern of [18F]FDG PET/CT imaging on asymptomatic COVID-19 patients. Therefore, a systematic review to analyze the pulmonary findings of [18F]FDG PET/CT on asymptomatic COVID-19 patients was conducted. This systematic review was performed under the guidelines of PRISMA. PubMed, Medline, and Web of Science were used to search for articles for this review. Articles with the key words: “asymptomatic”, “COVID-19”, “[18F]FDG PET/CT”, and “nuclear medicine” were searched for from 1 January 2020 to 20 May 2021. Thirty asymptomatic patients with COVID-19 were included in the eighteen articles. These patients had a mean age of 62.25 ± 14.85 years (male: 67.71 ± 12.00; female: 56.79 ± 15.81). [18F]FDG-avid lung lesions were found in 93.33% (28/30) of total patients. The major lesion was [18F]FDG-avid multiple ground-glass opacities (GGOs) in the peripheral or subpleural region in bilateral lungs, followed by the consolidation. The intensity of [18F]FDG uptake in multiple GGOs was 5.605 ± 2.914 (range from 2 to 12) for maximal standardized uptake value (SUVmax). [18F]FDG-avid thoracic lymph nodes (LN) were observed in 40% (12/40) of the patients. They mostly appeared in both mediastinal and hilar regions with an SUVmax of 5.8 ± 2.93 (range from 2.5 to 9.6). The [18F]FDG uptake was observed in multiple GGOs, as well as in the mediastinal and hilar LNs. These are common patterns in PET/CT of asymptomatic patients with COVID-19.

// Chin-Chuan Chang 1, 2 , Shih-Feng Cho 3 , Ya-Wen Chuang 1 , Chia-Yang Lin 1 , Shu-Min Chang 1 , Wen-Ling Hsu 1 and Ying-Fong Huang 1, 4 1 Department of Nuclear Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan 2 Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan 3 Division of Hematology & Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan 4 Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan Correspondence to: Ying-Fong Huang, email: huangyfnm@gmail.com Keywords: diffuse large B-cell lymphoma; MTV; TLG; FDG PET/CT; prognosis Received: May 09, 2017 Accepted: July 25, 2017 Published: August 24, 2017 ABSTRACT Purpose The purpose of this study was to determine the prognostic significance of metabolic parameters on pre-treatment 18 F-fluorodeoxyglucose positron emission tomography/ computed tomography (FDG PET/CT), in patients with diffuse large B-cell lymphoma (DLBCL) receiving rituximab-containing therapy. Materials and Methods From September 2009 to December 2014, DLBCL patients who had received FDG PET/CT scans for staging were enrolled. The maximal standardized uptake value of tumor (SUVt) was recorded. The metabolic tumor volume (MTV) was the volume of lesion with an elevated SUV greater than 2.5. The total lesion glycolysis (TLG) was the sum of the products of MTV and mean SUV in all measured lesions. Univariate and multivariate analyses were used to assess the prognostic significance of maximal SUVt, total MTV, TLG and other clinical parameters. Results There were 118 patients enrolled in this study. The median follow-up time was 28.7 months. The 5-year progression-free survival (PFS) for patients with higher and lower total MTV was 32.3% and 66.0% respectively ( p = 0.0001). The 5-year overall survival (OS) for patients with higher and lower total MTV was 34.3% and 69.9% respectively ( p < 0.0001). Multivariate analysis revealed, besides IPI, that total MTV was independently predictive for PFS (HR: 2.31, 95% CI: 1.16 – 4.60, p = 0.0180) and OS (HR: 2.38, 95% CI: 1.12 – 5.04, p = 0.024). TLG and maximal SUV of tumor were not independent prognostic factors. Conclusions An elevated total MTV was a predictor for shorter PFS and OS in patients with DLBCL receiving rituximab-containing therapy, independent of IPI.

A quantification assay based on isotope dilution mass spectrometry to determine the concentration of progesterone in human serum was reported. Incorporated with 13C3-progesterone, serum samples were subjected to progesterone extraction and clean-up by C4 solid-phase-extraction columns and hexane-based liquid/liquid extraction, respectively. The cleaned-up serum samples were then subjected to MALDI-TOF mass spectrometry for the quantification of progesterone. In the study, the recovered progesterone concentration determined by the assay showed good robustness and constancy in comparison to conventional radioimmunologic assay. We concluded that the 13C3-progesterone-based quantification assay is a robust method for the measurement of serum progesterone. Advantages of this technique includes: • This study describes a MALDI-TOF/MS method for the determination of serum progesterone. • The technique is simple and easy to apply on MALDI-TOF/MS for serum progesterone analysis. • The correlation coefficient between MALDI-TOF MS and RIA was 0.981 for serum progesterone., Graphical abstract Image, graphical abstract

Background: Technetium-99m diethylene triaminepentaacetic acid (Tc-99m DTPA) renal scintigraphy using modified Gate’s method is commonly adopted to calculate glomerular filtration rate (GFR). Objectives: The purpose of this study was to find the correlations between GFRs, which are calculated by the in-house and non-in-house workstations from gamma cameras (GC) manufactured by different firms. Patients and Methods: Medical records of patients receiving Tc-99m DTPA renal scan between January and December 2016 were analyzed. Patients were allocated randomly to a GC (1 or 2). The calculated GFRs were conducted by the in-house workstation (group A: workstation 1/ GC 1; group B: workstation2/ GC 2) and the non-in-house workstation from the GC (group C: workstation 2/ GC 1; group D: workstation 1/ GC 2). All patients had their creatinine levels checked to calculate the estimated GRF (eGFR) as the reference data. Comparison of correlation and difference between GFR calculations (group A, B, C and D), eGFRs and clinical parameters was analyzed. Results: Forty patients (24 men, 16 women) were enrolled in this study. The average of eGFRs was 63.0 ± 38.5 mL/min/1.73m2. The GFRs (group A to D) calculated were all significantly correlated with the eGFR. However, there was a significant difference between group C and eGFR (P = 0.0021), and group D and eGFR (P = 0.0262). Eight patients (20%) had changed stage of chronic kidney disease when using non-in-house workstations, compared to in-house workstations from GC. Conclusion: GFRs calculated by the non-in-house workstation were significantly different from eGFR. Use of workstation and GC from the same manufacturer would provide more accurate data in the clinical setting.

Supplemental Digital Content is available in the text, The purpose of this study was to determine the prognostic significance of F-18 fluorodeoxyglucose (FDG) uptake on a dual-phase positron emission tomography/computed tomography (PET/CT), focusing on the increment in maximal standardized uptake value (SUVinc) of tumor and bone marrow (BM) between initial and delayed phase images and retention index (RI) of tumor and BM, in patients with diffuse large B-cell lymphoma (DLBCL). From September 2009 to January 2013, 70 patients (37 males and 33 females, aged 60.6 ± 17.5 years) with DLBCL who had undergone dual-phase FDG PET/CT scans for pretreatment staging were enrolled. The patients subsequently received combination chemotherapy with rituximab. The dual-phase SUV, including SUVinc of tumor (SUVinc-t), RI of tumor (RI-t), SUVinc of BM, and RI of BM were measured. The clinical observation period was from September 2009 to December 2014. Both univariate and multivariate analyses were then used to assess the prognostic significance of SUVinc, RI, international prognostic index (IPI), gender, age, clinical stage, and laboratory tests. The median follow-up time was 35.5 months. The 3-year overall survival (OS) for patients with low/high SUVinc-t (cut-off 2.0) and for patients with low/high RI-t (cut-off 20) were 87.5%/ 62.1% (P = .08) and 83.3%/ 62.7% (P = .14), respectively. The 3-year OS for patients with SUVinc-i

Summary The aim of this study was to detect brain functional deficits in patients with Behcet's disease (BD) and signs or symptoms of central nervous system (CNS) involvement at different times in their clinical history. A total of 24 patients aged 20 to 53 years (median age 39 years; 20 women, four men) with Behcet's syndrome fulfilling the diagnosis as defined by the syndrome classification were enrolled in this study. Single-photon emission computed tomography (SPECT) with 99mTechnetium (Tc)-hexamethylpropyleneamine oxime (HMPAO) as the perfusion tracer was performed to detect brain lesions. The results of 99mTc-HMPAO brain SPECT scans showed impaired perfusion in all cases with neurological complaints (24 out of 24, 100%). Temporal lobes and basal ganglia were the most common areas with such lesions. In contrast, brain MRI and CT images were normal or non-specific in all cases. In conclusion, 99mTc-HMPAO brain SPECT imaging is a powerful and sensitive tool for disclosing brain involvement in numerous clinical situations, even including patients with subtle neurological symptoms/signs such as headaches and dizziness. It is also a useful modality for evaluating the effects of treatment and disease monitoring to prevent CNS damage.

Background The thyroid hormone, thyroxine (T4), is a tyrosine-based hormone produced by the thyroid gland, which is essential in regulating a number of biological processes, including growth, neurodevelopment, carbohydrate metabolism, oxygen consumption and protein synthesis. Data on human thyroid hormone metabolism were gathered since the middle of the 1970s mainly by the use of radioactive iodinated (125I or 131I) hormones. Methods We describe an isotope dilution-matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) method for the simultaneous determination of endogenous thyroid hormone and its 13C6-labeled analogue in serum. The 13C6-thyroxine (13C6-T4) was used as an internal standard; T4 and its isotopically labeled analogue were measured in the selected reaction monitoring mode for the transitions from m/z 777.8 to 732.1 and from m/z 784.2 to 738.1, respectively. Results Serum samples were prepared and concentrated by a solid-phase extraction chromatography method. The recovery rate was measured by 125I-T4 and can be up to 82.8 ± 2.8%. The detection limit and linear range for T4 were 5 ng/ml and 5–400 ng/ml, respectively. The correlation coefficient (R2) between radioimmunoassay (RIA) and isotope dilution-MALDI-TOF MS for detection of serum T4 was 0.982. Conclusion This assay has a good relationship against a commercial RIA and the isotope dilution-mass spectrometry method and may serve as a reference method for quantitative analysis of T4.

Micelles, with the structure of amphiphilic molecules including a hydrophilic head and a hydrophobic tail, are recently developed as nanocarriers for the delivery of drugs with poor solubility. In addition, micelles have shown many advantages, such as enhanced permeation and retention (EPR) effects, prolonged circulation times, and increased endocytosis through surface modification. In this study, we measured the critical micelle concentrations, diameters, stability, and cytotoxicity and the cell uptake of micelles against hepatic cells with two kinds of hydrophilic materials: PEG-PCL and HA-g-PCL. We used 131I as a radioactive tracer to evaluate the stability, drug delivery, and cell uptake activity of the micelles. The results showed that HA-g-PCL micelles exhibited higher drug encapsulation efficiency and stability in aqueous solutions. In addition, the 131I-lipiodol loaded HA-g-PCL micelles had better affinity and higher cytotoxicity compared to HepG2 cells.

Primary spontaneous pneumothorax (PSP) is a common benign problem. However, PSP recurrence is still a troublesome complication for most patients. This study intended to determine the role of matrix metalloproteinase-2 (MMP-2) and MMP-9 in type II pneumocytes of patients with PSP and its relation with recurrence. Ninety-one patients who had undergone needlescopic video-assisted thoracoscopic surgery wedge resection of lung with identifiable blebs for PSP were included in this study. Immunohistochemical (IHC) staining was used to measure the expression of MMP-2 and MMP-9 in lung tissues of PSP patients. The results were further correlated with clinicopathological parameters and recurrence rates using chi-square or Fisher's exact test. The value of MMP-2 and MMP-9 for overall recurrence was analyzed by univariate and multivariable Cox regression model. IHC data revealed that MMP-2 and MMP-9 staining was predominantly observed in type II pneumocytes of patients with PSP. We found that MMP-2 and MMP-9 expression in PSP, especially male PSP patients, was significantly correlated with recurrence. In the univariate and multivariate analyses, MMP-2 and MMP-9 were statistically significant risk factors for overall recurrence in PSP patients. Therefore, high expression levels of MMP-2 and MMP-9 in type II pneumocytes show a positive correlation with PSP recurrence risk. Further studies are needed to validate whether reduction of MMP-2 and MMP-9 expression may be a promising way for decreasing the risk of PSP recurrence in the future.

The β-nitrostyrene family have been implicated for anti-cancer property. However, the pharmacological role of β-nitrostyrene in esophageal cancer remain unclear. Here, a β-nitrostyrene derivative, CYT-Rx20, was synthesized and assessed for its anti-cancer activities and underlying mechanism in esophageal cancer. CYT-Rx20 induced cytotoxicity in esophageal cancer cells by promoting apoptosis through activation of caspase cascade and poly(ADP-ribose) polymerase (PARP) cleavage. Besides, CYT-Rx20 inhibited esophageal cancer cell migration and invasion by regulating the expression of epithelial to mesenchymal transition (EMT) markers. CYT-Rx20 decreased cell viability and migration through suppression of the PI3K/AKT and STAT3 pathways. Of note, the cytotoxicity and anti-migratory effect of CYT-Rx20 were enhanced by co-treatment with SC79 (AKT activator) or colivelin (STAT3 activator), suggesting the dependency of esophageal cancer cells on AKT and STAT3 for survival and migration, an oncogene addiction phenomenon. In xenograft tumor-bearing mice, CYT-Rx20 significantly reduced tumor growth of the implanted esophageal cancer cells accompanied by decreased Ki-67, phospho-AKT, and phospho-STAT3 expression. In orthotopic esophageal cancer mouse model, decreased tumor growth and lung metastasis with reduced Ki-67 and phospho-STAT3 expression were observed in mice treated with CYT-Rx20. Together, our results suggest that CYT-Rx20 is a potential β-nitrostyrene-based anticancer compound against the tumor growth and metastasis of esophageal cancer.

The microenvironment of neuron cells plays a crucial role in regulating neural development and regeneration. Hyaluronic acid (HA) biomaterial has been applied in a wide range of medical and biological fields and plays important roles in neural regeneration. PC12 cells have been reported to be capable of endogenous NGF synthesis and secretion. The purpose of this research was to assess the effect of HA biomaterial combining with PC12 cells conditioned media (PC12 CM) in neural regeneration. Using SH-SY5Y cells as an experimental model, we found that supporting with PC12 CM enhanced HA function in SH-SY5Y cell proliferation and adhesion. Through RP-nano-UPLC-ESI-MS/MS analyses, we identified increased expression of HSP60 and RanBP2 in SH-SY5Y cells grown on HA-modified surface with cotreatment of PC12 CM. Moreover, we also identified factors that were secreted from PC12 cells and may promote SH-SY5Y cell proliferation and adhesion. Here, we proposed a biomaterial surface enriched with neurotrophic factors for nerve regeneration application.

The use of 201Tl scintigraphy as a routine imaging modality in the follow-up of patients with differentiated thyroid carcinoma (DTC) is controversial. The purpose of this retrospective study was to evaluate the diagnostic accuracy and clinical impact of routine 201Tl scintigraphy in the follow-up of patients with DTC.Three hundred and twenty-one patients (261 women, 60 men) with DTC (243 papillary thyroid carcinomas, 78 follicular thyroid carcinomas) were enrolled in this study. Two hundred and seventy-six patients underwent total or near total thyroidectomy (group 1) and 45 patients underwent subtotal thyroidectomy or unilateral lobectomy (group 2). A total of 1523 201Tl scintigraphy examinations were performed between 1987 and 2003. The duration of follow-up ranged from 13 to 204 months. 201Tl scintigraphy was performed 10 and 60 min after intravenous administration of 74 MBq 201Tl chloride.In group 1, 55 recurrent lesions were confirmed in 39 patients. In a patient-based analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of 201Tl scintigraphy for detecting recurrent DTC were 71.8%, 98.3%, 87.5%, 95.5% and 94.6%, respectively. In a lesion-based analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of 201Tl scintigraphy were 63.6%, 99.7%, 89.7%, 98.5% and 98.3%, respectively. Of the 35 thallium-positive recurrent lesions, 21 (60%) were removed by surgery and seven (20%) were treated with external-beam radiation therapy. All the thallium-negative recurrent lesions were treated with 131I therapy. The difference between the management of thallium-positive and thallium-negative recurrences was statistically significant (P0.001). In group 2, 10 recurrent lesions were confirmed in seven patients. In a patient-based analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of 201Tl scintigraphy for detecting recurrent DTC were 85.7%, 94.7%, 75%, 97.3% and 93.3%, respectively. In a lesion-based analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of 201Tl scintigraphy was 80%, 97.5%, 80%, 97.5% and 95.6%, respectively. All of the seven patients were treated with completion of total thyroidectomy and subsequent 131I ablation therapy.201Tl scintigraphy was not a highly sensitive imaging modality in routine follow-up of patients with DTC after total thyroidectomy. However, it had a clinical impact on the choice of optimal therapeutic approaches. In the follow-up of patients who underwent partial thyroidectomy, 201Tl scintigraphy was useful in the detection of recurrent DTC.

Supplemental Digital Content is available in the text, The purpose of this study was to determine the relevance of standardized uptake value (SUV) on [18F]fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT), focusing on tumor and bone marrow, to disease outcomes based on progression-free survival (PFS) and overall survival (OS) in patients with diffuse large B-cell lymphoma (DLBCL) receiving rituximab-containing chemotherapy. We reviewed the records of patients with DLBCL who were diagnosed between September 2009 and January 2013 and underwent pretreatment whole-body FDG PET/CT scans. All patients received rituximab-containing chemotherapy. The maximal SUV of tumor (SUVt) and maximal SUV of sternum (SUVst) were measured. Univariate and multivariate analyses were used to assess the prognostic significance of SUVt, SUVst, gender, age, clinical stage, international prognostic index (IPI), and laboratory tests. There were total 70 patients enrolled in this study. The median follow-up time was 36 months. An SUVt cut-off value of ≥19 had the best discriminative yield for PFS (P = .04). An SUVst cut-off value of ≥1.6 had the best discriminative yield for OS. The 3-year OS rates for patients with maximal SUVst

Helicobacter pylori is the principal cause of chronic gastritis and is strongly associated with peptic ulcer disease and gastric cancer, as well as with gastric lymphoma (mucosa-associated lymphoid tissue [MALT] type). H. pylori could be recovered by many kinds of media, however, it could not be detected efficiently. This study was trying to ameliorate the isolation and detection rate with selective and non-selective media. Methods. First, type strain (ATCC 43504) was cultured with twelve different kinds of sheep blood agar based on brain heart infusion medium for five days. Then five better non-selective media and five selective media were chosen for the biopsy, which were incubated at 37°C in a microaerophilic incubator for five days. Endoscopic biopsies were collected from 623 patients at Kaohsiung Medical University Hospital. Results. It was found that non-selective media, which contain 5% modified chocolate agar (the ratio of fresh and heated sheep blood is 2) with 1% Isovitalex, had the best detection rate (91.1 ± 0.6)%. Furthermore, 5% modified chocolate agar with 1% Isovitalex and 1% antibiotics would increase the detection rate to (97.1 ± 0.3)%. Conclusions. According to Ansorg's method, the best detection rate (98.4 ± 0.7)% could be obtained with two-section petri dishes which had 5% modified chocolate agar with antibiotics and the other without antibiotics.

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells, which cause high mortality rates. The purpose of this study is to characterize the proteins secreted from the HepG2, MCF-7 and HT-29 cells, which may relate to cell differentiation and tumor metastasis. In the proteomic analysis, the secretome proteins were identified by reverse phase nano-high performance liquid chromatography/electrospray ionization tandem mass spectrometry (RP-nano-UPLC-ESI-MS/MS) followed by peptide fragmentation pattern analysis. Moreover, identifications of tumor cell protein expressions by proteomic approaches were indicated that several proteins may activate or enhance the PI3K/AKT/mTOR pathway. The PI3K/AKT/mTOR pathway has been shown to be related to the cancer cell metastasis and proliferation, and the ubiquitin C (UBC) may serve as potential protein diagnostic biomarker to be examined in further investigations.

Chitosan nanoparticle, a biocompatible material, was used as a potential drug delivery system widely. Our current investigation studies were the bioeffects of the chitosan nanoparticle uptake by liver cells. In this experiment, the characterizations of chitosan nanoparticles were measured by transmission electron microscopy and particle size analyzer. The average size of the chitosan nanoparticle was224.6±11.2 nm, and the average zeta potential was+14.08±0.7 mV. Moreover, using proteomic approaches to analyze the differential protein expression patterns resulted from the chitosan nanoparticle uptaken by HepG2 and CCL-13 cells identified several proteins involved in the PI3K/AKT1/mTOR pathway. Our experimental results have demonstrated that the chitosan nanoparticle may involve in the liver cancer cell metastasis and proliferation.

Ninety patients with old myocardial infarction were studied to evaluate the efficacy of intravenous dipyridamole 201 Tl imaging for the detection of myocardial ischaemia in post-infarction patients, and to compare the prevalence of ischaemia in 63 patients with post-infarction angina (group I) and 27 patients without angina (group II). Thirty-four of the patients in group I and 15 of the patients in group II received coronary arteriography (CAG) for comparison; these were labelled groups IA and IIA, respectively. On 201 Tl imaging, the incidence of scar with ischaemia in the infarct zone and scar with ischaemia at a distance were 72% and 42% in all patients, 89% and 52% in group I vs 33% and 19% in group II (P 0.05, respectively). Thus, dipyridamole 201 Tl imaging is a useful modality and post-infarction angina a proper indicator in the detection of myocardial ischaemia in post-infarction patients.

OBJECTIVE The purpose of this study was to compare the inflammatory activity of pulmonary lesions between active tuberculosis and nontuberculous mycobacterial (NTM) infection in acid-fast bacilli smear-positive non-HIV-infected patients using gallium-67 (Ga) scintigraphy. PATIENTS AND METHODS Twenty-four patients with culture-proven active pulmonary tuberculosis (PTB) and an additional 17 patients meeting the criteria of pulmonary NTM infection were enrolled into the retrospective study. The Ga uptake of the pulmonary lesion was assessed by visual scoring of uptake grade and semiquantitative region of interest analysis of the uptake ratio using the thoracic spine as a reference. RESULTS Ga scans were positive in 23 of the 24 patients (95.8%) with PTB and in 12 of the 17 patients (70.6%) with pulmonary NTM infection. Twenty patients with active PTB had moderate or intense visual Ga uptake grade, whereas only three patients with pulmonary NTM infection had moderate visual Ga uptake grade. The semiquantitative pulmonary Ga uptake ratios in patients with active PTB and NTM infection were 1.17 ± 0.28 (range: 0.77-1.86) and 0.79 ± 0.12 (range: 0.60-1.03), respectively. The Ga uptake grade and ratio of active PTB were both significantly higher than NTM infection (both P < 0.001). In the receiver operating characteristic curve analysis for predicting active PTB, the area under the curves of Ga uptake grade and ratio were 0.90 ± 0.05 and 0.93 ± 0.04, respectively (both P < 0.001). CONCLUSION The inflammatory activity of active PTB is significantly higher than that of pulmonary NTM infection in non-HIV-infected patients. Ga uptake grade and ratio could be used to predict active PTB in acid-fast bacilli smear-positive patients.

Self-assembled monolayers (SAMs) on coinage metallic material can provide versatile modeling systems for studies of interfacial electron transfer, biological interactions, molecular recognition and other interfacial phenomena. Recently, a bio-sensing system has been produced by analysis of the attachment of antibody using alkanethiols, to form SAMs on the face of Au-quartz crystal microbalance (QCM) surfaces. In this study, the attachment of anti-α-fetoprotein monoclonal antibody to a SAMs surface of 11-mercaptoundecanoic acid was achieved using water-soluble N-ethyl-N'-(3-dimethylaminopropyl) carbodiimide hydrochloride and N-hydroxysuccinimide as coupling agents. Surface analyses were utilized by X-ray photoelectron spectroscopy and atomic force microscopy. The quantization of immobilized antibody was characterized by the frequency shift of QCM and the radioactivity change of ¹²⁵I labeled antibody. The limit of detection and linear range of the calibration curve of the QCM method were 15 ng/ml and 15-850 ng/ml. The correlation coefficients of α-fetoprotein concentration between QCM and radioimmunoassay were 0.9903 and 0.9750 for the standards and serum samples, respectively. This report illustrates an investigation of SAMs for the preparation of covalently immobilized antibody biosensors.

An efficient one-pot procedure for the preparation of diazadioxime was described. Treatment of ketooximes with alkyldiamine followed by NaBH4 by in dry ethanol afforded the correspponding d, l-diazadioximes in 56-74% yield without isolation of the intermediates.

Infected aortic aneurysm is an uncommon life-threatening disease. A 68-year-old man had a history of type 2 diabetes mellitus and repeated urinary tract infections. He presented with fever, chills, low back pain, leukocytosis, and Salmonella group B bacteremia. For evaluation of suspected lumbar vertebral osteomyelitis, a 3-phase bone scan and a gallium-67 scan were performed. An abdominal aortic aneurysm was noted incidentally on the blood flow and blood pool phase images. Gallium-67 scan demonstrated increased radioactivity within the soft tissues surrounding the aneurysm, which was suggestive of an infected abdominal aortic aneurysm. The previously unsuspected infected abdominal aortic aneurysm was confirmed by computed tomography.

Introduction: With unique geographic features, mountain climbing has been a popular outdoor activity in Taiwan. Related conferences on safety issues were held by Ministry of Education. It is found that mortality and morbidity of high mountain syndrome (HMS) is highly reverse related to timely diagnosis and management. Generally, it is not easy for mountain climbers to manage this condition without an expert on site. Several climbers died from HMS every year. In 2005, wireless internet service was provided in Yushan National Park (YSNP), the highest national parkin Northeast Asia. We therefore began this project - building an emergent HMS consulting system based on this service.

Hepatocellular carcinoma (HCC) is the most common malignant liver tumor. Analysis of human serum from HCC patients using two-dimensional gel electrophoresis (2DE) combined with nano-high-performance liquid chromatography electrospray ionization tandem mass spectrometry (nano-HPLC-ESI-MS/MS) identified fourteen different proteins differentially expressed between HCC patients and the control group. Twelve proteins were up-regulated and two down-regulated. By using nano-HPLC-MS/MS system to analyze proteome in human serum, 317 proteins were identified, twenty-nine of which to high confidence levels (protein matched at last two unique peptide sequences). Of these twenty-nine proteins, six were present only in HCC patients and may serve as biomarkers for HCC.

Ga-67 is a useful agent for imaging infection, especially in the chest, but is not so reliable in the abdomen because of physiological bowel activity. A 64-year-old man with fever of unknown origin received a Ga-67 scan for survey of any occult infection focus. Focal Ga-67 accumulation was noted in the left lower chest region on the 24-hour image, but a different pattern of radioactivity was shown on the 48-hour image after bowel cleansing. On review of the chest radiographs and history, we found bowel activity in the left lower chest secondary to diaphragmatic paralysis masqueraded as pulmonary infection. Diaphragmatic paralysis should be considered as a differential diagnosis of abnormal activity in the chest on Ga-67 scan.

Most metastatic bone disease appears in the axial skeleton. Appendicular bone metastases are usually found in cases of general spread of the disease, and frequent sites are in the femur and humerus. A solitary appendicular bone metastasis is rare. The authors report a case of lung cancer with unusual presentation of a solitary fibular metastasis. The bone scan showed a solitary fusiform hot lesion in the fibular shaft mimicking the typical appearance of a stress fracture. A metastatic fibular lesion from lung cancer was confirmed by excision biopsy.

Tc- d,d - and Tc- l,l -HMPAO were synthesized. The stability of Tc- d,d - and Tc- l,l -HMPAO in vitro is similar to that of d,l-isomers by the spectrophotometric and three strips methods. Cerebral uptake (%D in brain) for the l,l -isomer is higer than the d,d - and d,l-isomer in rats. Delayed studies shows that Tc- l,l -HMPAO reveals less washout and reflects a higher cerebral deposition properties than the d,d - and d,l-isomer.

The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.

An efficient one-pot procedure for the preparation of diazadioxime was described. Treatment of ketooximes with alkyldiamine followed by NaBH4 by in dry ethanol afforded the correspponding d, l-diazadioximes in 56-74% yield without isolation of the intermediates.

A hydrocele is a collection of fluid within the tunica or processus vaginalis. Most pediatric hydroceles are congenital and adult hydroceles are usually secondary. The latter can present acutely from local injury, infection, radiotherapy, or increased intraabdominal pressure. A 53-year-old man with underlying liver cirrhosis was admitted for dyspnea and abdominal distention. Massive ascites with swelling of the right hemiscrotum was noted. A communicating hydrocele was detected by peritoneal scintigraphy. After surgical repair of the communicating shunt by a Bassini procedure, the problem of the right hydrocele was resolved.