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Purpose: Hereditary tumor syndrome Von Hippel-Lindau (VHL) disease is characterized by various benign and malignant tumors that are known to express somatostatin receptors (SSTR). We evaluated the role of 68 Ga-DOTANOC PET/CT scan in patients with positive germline mutation of the VHL gene, presented initially or on follow-up, for the detection of recurrent or synchronous/metachronous lesions., Methods: Fourteen patients (8 males; 6 females) with mean age 30 ± 9.86 years were retrospectively analyzed, were tested positive for VHL on gene dosage analysis, and underwent 68  Ga-DOTANOC PET/CT scan for disease evaluation. The number and site of lesions were determined. The tracer uptake was analyzed semi-quantitatively by calculating the maximum standardized uptake values (SUVmax) of lesion., Results: Four of the 14 patients underwent scan for initial diagnosis as baseline, 6 patients for post-therapy disease status, and 4 patients for initial diagnosis as well as follow-up evaluation of the disease. A total of 67 lesions were detected in 14 patients. The sites of lesions were cerebellar/vertebral/spinal (17; mean SUVmax = 7.85); pancreatic neuroendocrine tumor (NET) (11; mean SUVmax = 20.64); retina (3; mean SUVmax = 10.46); pheochromocytoma (10; mean SUVmax = 16.32); paragangliomas (3; mean SUVmax = 10.65); pancreatic cyst (9; mean SUVmax = 2.54); and renal cyst (8; mean SUVmax = 1.56) and miscellaneous lesions constituted 6 lesions., Conclusion: Our results show that 68  Ga-DOTANOC PET/CT may be a useful modality for screening and follow-up of associated tumors in patients with germline gene mutation for VHL. It can be used as a one-stop imaging modality for VHL patients and may substitute for separate radiological investigations, making it more convenient for patients in terms of time and cost., Competing Interests: Conflict of InterestShamim Ahmed Shamim, Geetanjali Arora, Naresh Kumar, Jhangir Hussain, Shreya Datta Gupta, Arun Raj ST, Kritin Shankar, Alpesh Goyal, Rajesh Khadgawat, Sambit Sagar, and Chandrasekhar Bal declare no conflict of interest., (© The Author(s), under exclusive licence to Korean Society of Nuclear Medicine 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

To evaluate the role of 18FDG-WBPET-CT, Examination under anesthesia (EUA), and multiple-site biopsy in detecting the occult site in head & neck carcinoma of unknown primary (HN-CUP). In this prospective study, 22 patients with diagnosed CUP, after a thorough outpatient endoscopic evaluation of upper airway and radiological evaluation (CT/MRI) that ruled out a primary lesion were included. These patients subsequently underwent whole-body PET-CT and EUA. Based on the presence of suspicious findings ( +) or their absence (-) on 18FDG-WBPET-CT (P) and EUA (E), we divided the patients into 5 groups: P-E-, P-E + , P + E-, P + E + , and P + or E + . All these patients underwent bilateral palatine tonsillectomy, bilateral nasopharyngeal biopsy, and ipsilateral lingual tonsillectomy for identification of occult primary. Out of 22 patients, the primary could be detected in 4 patients (18%) after the workup (three in the oropharynx and one in the hypopharynx, all ipsilateral). 18FDG-PET-CT suspected primaries in 7 patients; biopsy was positive for three (sensitivity-75%, specificity-77%, PPV-43%, NPV-93%). Out of 5 patients, who had suspicious findings on EUA, 3 of the biopsies revealed malignancy (sensitivity-75%, specificity-88%, PPV-60%, NPV-94%). Both PET-CT and EUA when combined, yield a NPV of 100% if both are negative and PPV of 100% when both are positive for suspicious findings. No primary was identified in the absence of a suspicion by PET-CT or EUA. Without a suspicion on 18FDG-WBPET-CT and EUA, there is a limited role of multiple-site biopsies in patients of HN-CUP., Competing Interests: Conflicts of interestThe authors declare that they have no financial or non-financial conflicts of interest., (© Association of Otolaryngologists of India 2021.)

Survivin, an inhibitor of apoptosis protein is a biomarker of significance in prognostication of many malignancies. In the current study we investigated the serum survivin levels in patients with oral submucosal fibrosis (OSMF) and squamous cell carcinoma (OSCC). Serum was isolated from, peripheral blood collected of clinically and histopathologically confirmed OSMF and OSCC patients. Circulating level of survivin was measured in patients and control subjects by ELISA and analyzed further using Kruskal-Wallis test and two-sample Wilcoxon rank-sum (Mann-Whitney) test. Serum Survivin levels were significantly reduced in the OSCC group as compared to the control group. No significant correlation was noted between the serum survivin level and various clinicopathological characteristics of OSCC and OSMF patients. Our study suggests that free, wild form of circulating survivin probably has no role in predicting the prognosis of oral cancer or the malignant transformation potential of oral submucosal fibrosis., Competing Interests: Conflict of interestNo potential conflicts of interest were disclosed., (© Association of Otolaryngologists of India 2020.)

Thyroid carcinoma is the most common neoplasm of endocrine malignancies. Differentiated thyroid carcinoma (DTC) constitutes 90% of the thyroid carcinomas, rest being medullary thyroid carcinoma (MTC), and anaplastic thyroid carcinoma (ATC). Distant metastases occur in up to 10% of patients with DTC. Metastases to axillary lymph nodes (ALN) are very rare. As per literature, only 25 cases have been reported. We report an unusual case of 47-year-old male with Hürthle cell carcinoma of the thyroid presenting with a solitary axillary lymph node metastasis 17 years after thyroidectomy, along with review of literature., Competing Interests: The authors Meghana Prabhu, Deepali Jain, Siddhartha Datta Gupta, Chandra Sekhar Bal, Rakesh Kumar declare that they have no conflict of interest.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.This chapter does not contain any studies with animals performed by any of the authors.The institutional review board of our institute approved this retrospective study, and the requirement to obtain informed consent was waived. Informed consent was obtained from the patient for FDG PET/CT in the study.

Low-Density Lipoprotein (LDL) is known to promote the unregulated proliferation of cells that is progression of cancer. We aimed to investigate the effect of mitogens on the expression of cell cycle proteins, nuclear cholesterol and cell proliferation. We observed that insulin and benzo-α-pyrene (BaP) induced the expression of Low-Density Lipoprotein receptor (LDLR) on HepG2 cells, thereby enhancing the uptake of LDL. The internalized LDL increased the concentration of cholesterol in the cytoplasm and nucleus of the cell. At the same time, insulin and BaP also stimulated the expression of cell cycle proteins viz., Cyclin E and Cdk2, and thus induced more incorporation of Bromodeoxyuridine (BrdU) in cultured cells indicating increased DNA synthesis. Increased expression of cell cycle proteins and DNA synthesis are the indications of DNA replication and new cell synthesis. This suggests a link between the enhanced nuclear cholesterol concentration and new cell formation. On the other hand, UV irradiation with selectively given dose of cell death eventually decreases nuclear cholesterol concentration and LDLR expression. Reduced LDLR shows low functional activity. This, again, repeated the plausibility of the same link between intracellular cholesterol concentration and cell population. The biasness of adverse effect observed by UV irradiation has been compromised by inactivating LDLR with anti-LDLR antibody, resulting in similar effects on Cyclin E expression in the cultured cells. Hence, we concluded that in all the conditions, LDLR expression was found to be a translational event of its transcription factor, SREBP-2, by the induction of insulin, BaP and UV irradiation.

Purpose: To evaluate the diagnostic accuracy of shear wave elastography (SWE) and transient elastography (TE) in the evaluation of liver fibrosis in chronic hepatitis B (CHB) and C (CHC) patients taking liver biopsy as gold standard., Methods: Ethics committee approved this prospective cross-sectional study. Between October 2012 and December 2014, consecutive CHB/CHC patients fulfilling the inclusion criteria were included-age more than 18 years, informed written consent, willing and suitable for liver biopsy. SWE, TE, and biopsy were performed the same day. Liver stiffness measurement (LSM) cut-offs for various stages of fibrosis were generated for SWE and TE. AUC, sensitivity, specificity, and positive/negative predictive values were estimated individually or in combination., Results: CH patients (n = 240, CHB 172, CHC 68), 176 males, 64 females, mean age 32.6 ± 11.6 years were enrolled. Mean LSM of patients with no histological fibrosis (F0) was 5.0 ± 0.7 and 5.1+1.4 kPa on SWE and TE, respectively. For differentiating F2 and F3-4 fibrosis on SWE, at 7.0 kPa cut-off, the sensitivity was 81.3% and specificity 77.6%. For TE, at 8.3 kPa cut-off, sensitivity was 81.8% and specificity 83.1%. For F3 vs. F4, SWE sensitivity was 83.3% and specificity 90.7%. At 14.8 kPa cut-off, TE showed similar sensitivity (83.3%) but specificity increased to 96.5%. Significant correlation between SWE and TE was observed (r = 0.33, p < 0.001). On combining SWE and TE, a drop in sensitivity with increased specificity for all stages of liver fibrosis occured., Conclusion: SWE is an accurate technique for evaluating liver fibrosis. SWE compares favorably with TE especially for predicting advanced fibrosis/cirrhosis. Combining SWE and TE further improves specificity.

A 60-day feeding trial was conducted to evaluate the efficacy of distiller's grain soluble (brewery waste) as a prospective ingredient to substitute expensive and high demand feed component, soybean meal for farming Labeo bata in cages installed in tropical reservoir. Two isonitrogenous and isocaloric diets comprising brewery waste (49.2 % CP) as test diet and soybean meal (44.4 % CP) as reference diet were formulated and extruded to obtain 2-mm floating pellets. The efficacy of the diets was tested in terms of survival (%), live weight gain (%), SGR (%/day), FCR, PER and ANPU and recorded 65 ± 0.2, 96 ± 8.1, 1.9 ± 0.1, 2.5 ± 0.02, 1.4 ± 0.1, 20.3 ± 2.0 and 66 ± 0.6, 112 ± 9.8, 2.2 ± 0.1, 2.2 ± 0.2, 1.6 ± 0.1 and 20 ± 2.1, respectively, for soybean and brewer's waste-based formulated feed. The analyses of results revealed that survival, growth parameters and biochemical composition of whole body tissue did not differ significantly (p > 0.05) despite complete replacement of soybean meal by brewery waste. However, the cost estimate of diet revealed marked reduction of feed cost of Rs. 9.2/kg (33.8 %) in the test diet as compared to the reference diet. The study suggests that brewery waste could effectively replace soybean meal without effecting survival and growth of the fish. The finding thus may pave a productive way for reducing environmental pressure of disposal of an agro-industrial waste.

Purpose: To determine concordance of promoter hypermethylation of ERβ (estrogen receptor β) and RARβ2 (retinoic acid receptor β2) in tumor and circulating DNA of Indian breast cancer patients and their association with clinicopathologic parameters and disease prognosis., Methods: ERβ and RARβ2 methylation was analyzed by methylation-specific PCR in the tumors and circulating DNA of 100 patients with invasive ductal breast carcinoma. Promoter hypermethylation was associated with the expression of the encoded protein in tumors by immunohistochemistry, and their prognostic utility was explored in a follow-up study., Results: Significant correlation was observed between promoter hypermethylation of ERβ (r = + 0.77; p ≤ 0.001) and RARβ2 (r = + 0.85; p ≤ 0.001) in tumors and paired sera. No association was found between ERβ and RARβ2 promoter hypermethylation and loss of protein expression. Kaplan-Meier survival curve showed loss of ERβ expression, and RARβ2 promoter hypermethylation was associated with poor overall survival (OS) (p = 0.03, p = 0.001). Breast cancer patients showing concurrent hypermethylation of ERβ and RARβ2 had a significantly shorter median OS (p = 0.02), underscoring that hypermethylation of these two genes may serve as an adverse prognosticator for breast carcinoma., Conclusions: Methylation status of ERβ and RARβ2 in serum could potentially be used to predict invasive ductal breast carcinoma. Furthermore, concurrent ERβ and RARβ2 methylation as well as loss of ERβ expression may serve as a good prognostic marker.

Background: Expression of oncostatin M receptor beta (OSMRβ) has been reported in human cancers, however its role in esophageal squamous cell carcinoma (ESCC) remains unknown. Using differential display, earlier we reported the identification of an alternatively spliced variant of OSMRβ in ESCC. Here in we characterized this novel variant encoding a soluble form of this receptor (sOSMRβ) and determined its clinical significance and correlation with the expression of oncostatin (OSM) and leukemia inhibitory factor receptor beta (LIFR β) in ESCC., Materials and Methods: In silico analysis was carried out to characterize the differentially expressed transcript of OSMRβ and its expression was determined in ESCCs and matched normal esophageal tissues using semiquantitative RT-PCR. The expressions of both truncated and full length OSMRβ proteins were analyzed in ESCC tissues and patients' sera using western blotting and immunoprecipitation. By immunoprecipitation we have also shown direct interaction between sOSMRB and OSM. We also explored the relationship between expression of OSM and its receptors, OSMRβ and LIFRβ, in primary human ESCCs and normal epithelia using immunohistochemistry., Results: Overexpression of alternatively spliced OSMR β transcript was detected by RT-PCR in 9 of 11 ESCCs. Analysis of the soluble receptor revealed absence of sOSMRβ protein in esophageal tissues, however, immunoprecipitation and western blot analysis showed its presence in sera of ESCC patients further confirming expression of the alternatively spliced OSMR β in ESCC patients. Immunohistochemical analysis in tissue microarray (TMA) format showed expression of OSMR β, LIFR and OSM in 11/50 (23%), 47/50 (94%) and 47/50 (94%) ESCCs, respectively. Strong correlation was observed between cytoplasmic expression of LIFRβ and OSM in tumor cells (p = 0.000, O.R = 50, 95%CI = 8-31.9), and nuclear expression of LIFRβ and OSM (p = 0.039 OR = 3.1, 95% CI = 1.1-8.2), suggesting that LIFRβ serves as the major receptor in ESCCs., Conclusion: An alternatively spliced variant of OSMR transcribing a soluble form of this receptor has been characterized in ESCC. We speculate that the truncated OSMR characterized here in may act as a neutralizing receptor for OSM. Our immunohistochemical study showed that OSMRβ and its pathway is not activated in ESCCs.

This study was aimed at evaluating the association between tumor vascularity and other known prognostic factors in different histopathological subtypes of renal cell carcinoma (RCC). In 41 cases of RCC, immunohistochemistry was performed using anti-CD34 antibody and Ki-67 (MIB-1). Microvessel density was estimated in an area of 0.23 mm(2) representative of the highest microvessel density ("hot spot"). The microvessel area (MVA) was expressed as percentage of total tumor area occupied by vessels. Endothelial proliferation index (EPI) was determined from sections stained by Ki-67. The relationship between MVD, MVA, EPI and prognostic parameters of RCC like stage, grade and tumor cells proliferation index (TPI) was evaluated. The tumor MVA increased significantly with the higher stage of the tumor (P < 0.001) and increase in TPI (P < 0.05). The MVD, however, did not show significant correlation with grade and stage of the tumor. Microvessel area appears to be a better prognostic marker for RCC when compared to microvessel density. The increase in MVA, without increase in MVD, with increasing stage may be due to the development of larger diameter vascular channels in higher-stage tumors, and this is thought to facilitate metastasis.

Adenoid hypertrophy is a normal phenomenon seen in young children. Adenoids may however be of large size or may not reduce in size in adulthood. Large adenoids may cause mouth breathing, overcrowding of teeth or otological symptoms. When adenoids are large and producing these effects, adenoidectomy is necessary. Adenoidectomy immensely benefits such patients but they may still continue to be habitual mouth breathers. This can lead to formation of long narrow face, labially protruded maxillary incisors and class 2 malocclusion. Immediate orthodontic treatment of such patients will improve facial profile and lead to class 1 (Angle) occlusion. We present here a study of 20 patients who were given early orthodontic treatment in postadenoidectomy period as compared to those patients who were not treated by orthodontist.

The recent discovery of HIV-1 genome-encoded novel microRNA (miRNA; designated as hiv1-mir-H1) having ability to target selectively and specifically human cellular AATF gene, prompted us to explore the role of this miRNA in the regulation of genes involved in cellular apoptosis, proliferation and nucleic acid-based immune mechanism governed by miRNAs. Such a study revealed that this miRNA-induced knockdown of AATF gene, within normal human blood mononuclear cells, was responsible for the suppression of genes coding for Bcl-2, c-myc, Par-4 and Dicer. Further, hiv1-mir-H1 had the capacity to downregulate expression of cellular miR149 gene recognized to target Vpr gene encoded by HIV-1. Based upon these findings, we propose an "Epigenomic Pathway" through which hiv1-mir-H1 induced AATF gene knockdown within human mononuclear cells initiates their apoptosis.

Inflammatory pseudotumors (IPT) are uncommon, benign, non-epithelial tumors of the urinary bladder. Only less than 30 cases have been reported so far in world's literature. The transititional cell carcinoma constitutes 90% of malignant epithelial tumors of urinary bladder. Large, endoscopically unresectable tumors require radical surgery. IPT resemble such tumors, morphologically, radiologically and clinically. The benign nature of this tumor warrants conservative surgical management, either transurethral resection or partial cystectomy. Awareness of this entity and its inclusion in the differential diagnosis may prevent unnecessary radical surgery. We report an unusual case of inflammatory pseudotumor of urinary bladder because of its diagnostic and management dilemma.