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BACKGROUND: High-intensity focused ultrasound (HIFU) is a new, noninvasive technique with potential to ablate and inactivate tumors. Treatment of solid tumors with HIFU has been reported. In this study, the safety and effects of HIFU in the clinical therapy of malignant bone tumors were assessed. METHODS: Biochemical markers and magnetic resonance imaging (MRI) or positron emission tomography (PET)-computed tomography (CT) were used to evaluate 25 patients with malignant bone tumors before and after HIFU treatment. RESULTS: HIFU resulted in significant improvement in biochemical markers, and no severe complications were observed. After HIFU treatment, 21 (87.5%) patients were completely relieved of pain, and 24 (100%) experienced significant relief. On the basis of MRI or PET-CT, HIFU was effective: For patients with primary bone tumors, 6 (46.2%) had a complete response, 5 (38.4%) had a partial response, 1 (7.8%) had a moderate response, and 1 suffered progressive disease; the response rate was 84.6%. For patients with metastatic bone tumors, 5 (41.7%) had complete response, 4 (33.3%) had partial response, 1 (8.3%) had a moderate response, 1 (8.3%) had stable disease, and 1 suffered progressive disease; the response rate was 75.0%. The 1-, 2-, 3-, and 5-year survival rates were 100.0%, 84.6%, 69.2%, and 38.5%, respectively, for patients with primary bone tumors and 83.3%, 16.7%, 0%, and 0%, respectively, for patients with metastatic bone tumors. The survival rates for patients with primary bone tumors were significantly better than for those with metastatic tumors. CONCLUSIONS: HIFU safely and noninvasively ablated malignant bone tumors and relieved pain. HIFU ablation should be further investigated, as it appears to be successful in the treatment of primary malignant bone tumors. Cancer 2010. © 2010 American Cancer Society.

To evaluate (125)I seed brachytherapy combined with sorafenib in the treatment of patients with multiple lung metastases after orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).From July 2006 to December 2009, eight patients with multiple lung metastases after OLT for HCC underwent (125)I brachytherapy combined with sorafenib, and laboratory and radiologic examinations were performed before and after the treatment. Changes in symptoms and survival time were noted at follow-up.The follow-up time ranged from 14 to 37 months. The local control rates of multiple lung metastases after OLT for HCC after 4, 6, 12, 18 and 24 months were 92.2, 82.4, 76.2, 73.3 and 72.2%, respectively. Four patients died (survival time 14, 15, 25 and 37 months, respectively), and four patients are alive at the time of this writing (follow-up time 18, 21, 26 and 30 months, respectively). The overall 1-, 2- and 3-year survival rates were 100, 50 and 12.5%, respectively. The median survival time was 21 months. Procedure-related complications were minimal.(125)I brachytherapy combined with sorafenib is safe, feasible and promising approach in the treatment of patients with multiple lung metastases after OLT for HCC, but large-scale randomized clinical trials are necessary for confirmation.

The purpose of this study was to evaluate the effectiveness of ultrasonographically guided high-intensity focused ultrasound (HIFU) ablation for superficial malignant tumors. HIFU ablation was applied to 38 cases. The diameter of tumors ranged from 1.5-18 cm, includingor =3 cm in seven cases,3 toor =5 cm in four cases,5 to10 cm in 15 cases, andor =10 cm in 12 cases. Using imaging techniques, the volume and activity of tumors were observed before and after HIFU ablation, and the effectiveness of HIFU ablation in superficial malignant tumors was evaluated. For tumorsor =5 cm in diameter, HIFU ablation was completely effective in 100% (11/11) of cases; for tumors5 cm in diameter, HIFU ablation was completely effective in 25.9% (7/27) of cases, partially effective in 14.8% (4/27) of cases, moderately effective in 33.3% (9/27) of cases; the disease remained stable in 14.8% (4/27) of cases and progressed in 11.1% (3/27) of cases. No significant difference was observed in the tumor volumes before (202.6 +/- 230.4 cm(3)) and 6-8 w after HIFU ablation (188.1 +/- 215.8 cm(3)). However, the difference in the active volume before (202.6 +/- 230.4 cm(3)) and after (127.6 +/- 189.7 cm(3)) HIFU ablation was statistically significant. Among 38 the cases, 32 reported painful symptoms, with a pain score of 4.39 +/- 2.36, before the ablation; the values dropped to 0.19 +/- 0.54 after HIFU, and the difference was statistically different. Thus, HIFU is a safe, effective and promising approach for the treatment of superficial malignant tumors.

The purpose of this study is to evaluate high-intensity focused ultrasound (HIFU) ablation combined with transcatheter arterial chemoembolisation (TACE) in the treatment of larger hepatocellular carcinoma (HCC). Eighty-nine (89) patients with unrespectable larger HCC were randomised into a TACE group (n=45) and a TACE plus HIFU group (n=44). Therapeutic effects were assessed at follow-up with physical examination, level of serum alpha-fetoprotein and computed tomography or magnetic resonance imaging. All patients were followed up to observe long-term therapeutic effects and evaluated prognostic factors for survival. No severe complication was observed. Follow-up images showed that total effective rate in tumour response accounted for 72.8% in the TACE-HIFU group, which were significantly higher than that of TACE group (44.5%, P

To extract the important physiological factors related to diabetes from an oral glucose tolerance test (OGTT) by mathematical modeling, highly informative but convenient protocols are required. Current models require a large number of samples and extended period of testing, which is not practical for daily use. The purpose of this study is to make model assessments possible even from a reduced number of samples taken over a relatively short period. For this purpose, test values were extrapolated using a support vector machine. A good correlation was found between reference and extrapolated values in evaluated 741 OGTTs. This result indicates that a reduction in the number of clinical test is possible through a computational approach., {"references":["Y. Naito, H. Ohno, A. Sano, H. Nakajima, and M. Tomita, \"Construction\nof a simulation model of diabetes for pathophysiological analysis using\nE-Cell System,\" Genome Informatics, vol. 13, pp. 478-479, Dec. 2002.","K .G. M. M. Alberti and P. Z. Zimmet, \"Definition, diagnosis and\nclassification of diabetes mellitus and its complications. part. 1: diagnosis\nand classification of diabetes mellitus. Provisional report of a WHO\nConsultation,\" Diabet Med, vol. 15, no. 7, pp. 539-553, Jul. 1998.","C. Dalla Man, M. Campioni, K. S. Polonsky, R. Basu, R. A. Rizza, G. Toffolo,\nand C. Cobelli, \"Two-hour seven-sample oral glucose tolerance test\nand meal protocol: minimal model assessment of beta-cell responsivity\nand insulin sensitivity in nondiabetic individuals,\" Diabetes, vol. 54, no.\n11, pp. 3265-3273, Nov. 2005.","C. Dalla Man, A. Caumo, and C. Cobelli, \"The oral glucose minimal\nmodel: estimation of insulin sensitivity from a meal test,\" IEEE Trans\nBiomed Eng, vol. 49, no.5, pp. 419-429, May. 2002.","G. Toffolo, E. Breda, M. K. Cavaghan, D. A. Ehrmann, K. S. Polonsky,\nand C. Cobelli, \"Quantitative indexes of beta-cell function during graded\nup&down glucose infusion from C-peptide minimal models,\" Am J\nPhysiol Endocrinol Metab, vol. 280, no. 1, pp. E2-E10, Jan. 2001.","V. Vapnik, S. Golowich, and A. J. Smola, \"A support vector method\nfor function approximation, regression estimation, and signal processing,\"\nin Advances in Neural Information Processing Systems: Proceedings of\nthe 1996 conference on Neural Information Processing Systems, vol. 9,\nM. C. Mozer, M. I. Jordan, and T. Petsche, Ed. Cambridge: MIT Press,\n1997, pp. 281-287.","ISO15197, \"In vitro diagnostic test systems: Requirements for bloodglucose\nmonitoring systems for self-testing in managing diabetes mellitus,\"\nMay. 2003.","C. Dalla Man, M. Camilleri, and C. Cobelli, \"A system model of oral\nglucose absorption: validation on gold standard data,\" IEEE Trans Biomed\nEng, vol. 53, no. 12 Pt1, pp. 2472-2478, Dec. 2006."]}

To evaluate the safety and short- to mid-term efficacy of CT-guided (125)I brachytherapy on intra-hepatic recurrent tumors and/or extra-hepatic metastases after liver transplantation for hepatocellular carcinoma (HCC).Among the ten patients, one died of liver failure 15 months and one of renal failure 29 months after brachytherapy. All other eight patients survived till the end of the follow-up. Four of them presented good control of local tumor and no systemic recurrence; the other four survived with tumor presence, including three with recurrent tumors undergoing a second (125)I brachytherapy and one switching to a biological target drug treatment. The local control rates after 4, 6, 12 and 24 months are 90.3, 84.0, 75.6 and 72.7% respectively. Procedure-related complications were minimal.From November 2004-May 2008, ten patients with intra-hepatic recurrent tumors and/or extra-hepatic metastases after liver transplantation for HCC underwent (125)I brachytherapy under the guidance of computed tomography. They were followed up for 4-44 months after brachytherapy and the treatment's efficacy was evaluated.CT-guided (125)I brachytherapy is a safe and effective therapy on intra-hepatic recurrent tumors and/or extra-hepatic metastases after liver transplantation for hepatocellular carcinoma. It has the advantages of minimal invasion, significant short- to mid-term local control and minimal complications.

Context: Berberine, a natural plant alkaloid, is usually used as an antibiotic drug. The potential glucose-lowering effect of berberine was noted when it was used for diarrhea in diabetic patients. In vitro and in vivo studies have then showed its effects on hyperglycemia and dyslipidemia. Objective: The objective of the study was to evaluate the efficacy and safety of berberine in the treatment of type 2 diabetic patients with dyslipidemia. Design: One hundred sixteen patients with type 2 diabetes and dyslipidemia were randomly allocated to receive berberine (1.0 g daily) and the placebo for 3 months. The primary outcomes were changes in plasma glucose and serum lipid concentrations. Glucose disposal rate (GDR) was measured using a hyperinsulinemic euglycemic clamp to assess insulin sensitivity. Results: In the berberine group, fasting and postload plasma glucose decreased from 7.0 ± 0.8 to 5.6 ± 0.9 and from 12.0 ± 2.7 to 8.9 ± 2.8 mm/liter, HbA1c from 7.5 ± 1.0% to 6.6 ± 0.7%, triglyceride from 2.51 ± 2.04 to 1.61 ± 1.10 mm/liter, total cholesterol from 5.31 ± 0.98 to 4.35 ± 0.96 mm/liter, and low-density lipoprotein-cholesterol from 3.23 ± 0.81 to 2.55 ± 0.77 mm/liter, with all parameters differing from placebo significantly (P < 0.0001, P < 0.0001, P < 0.0001, P = 0.001, P < 0.0001, and P Conclusions: Berberine is effective and safe in the treatment of type 2 diabetes and dyslipidemia.

6034 Background: Metastatic nasopharyngeal carcinoma (mNPC) varied greatly from potentially curable to incurable. This study set out to identify the target patients with chance of cure through exte...

To compare enhanced spiral computed tomography (SCT), and plain CT with pathological findings in the diagnosis of peritoneal metastasis.Thirty-eight patients with peritoneal metastasis were examined by whole abdominal plain CT and enhanced SCT within one week before operation. The CT findings were compared with the pathological findings of specimens obtained during operation.In the early phase of contrast SCT, various degrees of enhancement were observed in the majority of peritoneal metastases. Primary cancers and the metastatic lesions were enhanced to same degree. For lesions with rich blood supply, a 2 mm metastatic lesion was usually detected by contrast SCT. The sensitivity of plain CT and enhanced SCT for the detection of peritoneal metastasis in all involvements were 46.7% and 76.6% (chi(2) = 29.07, P0.005). For contrast SCT, the detection rates of peritoneal carcinomatosis were higher then 83% in the fallopian tubes, ovary, subphrenic spaces, mesentery of small intestine, transverse colon and omentum.Enhanced spiral CT, being superior to plain CT, is effective in detecting and diagnosing peritoneal metastasis.

To investigate the influence of MRI on the T, N staging system, 5(th) edition, UICC and the 92 staging system, China by comparing CT and MRI of the nasopharyngeal carcinoma (NPC).From 1993 to Dec. 2000, fifty-six NPC patients proved by pathology underwent CT and MRI examination with Philip T5-II ultra-magnetic system (0.5T) and Elscient CT twin flash. Routine axial scans by CT and SE sequence with axial, sagittal and coronal scans by MRI from oral pharynx (lower border of second cervical vertebra) to supracellar cistern were done with enhancement (50/56).The tumor beyond the nasopharyngeal cavity was accurately defined because the pharyngobasilar fascia could be seen by MRI which appeared to be more sensitive than CT in revealing the invaded soft tissues surrounding the nasopharyngeal cavity, such as longus colli (14 by CT and 26 by MRI), tensor veli palatini and levator veli palatini (17 by CT and 42 by MRI), the skull base erosion (15 by CT and 23 by MRI) and enlargement of retropharyngeal lymph nodes (13 by CT and 24 by MRI). As a result, 28.6% (16/56) of NPC staging system, UICC and 33.9% (19/56) of the 92 staging system of China should undergo changes.MRI is able to reveal the invasion extent into the structures around the tumor mass more accurately than CT, with the pharyngobasilar fascia readily seen and the infiltration and/or destruction of the skull base more easily visualized by MRI than by CT. The impact of MRI upon the 92 staging system of China lies in the differentiation of direct infiltration by the tumor from the enlargement of the retropharyngeal lymph node and the early detection of skull base erosion. The Influence of MRI on the staging system of NPC is more pronounced than that of CT.

To compare quantitatively the enhanced thin CT section with pathologic findings in pulmonary carcinoma, pulmonary inflammatory pseudotumor (IPT) and pulmonary tuberculoma so as to demonstrate the relation of degree of enhancement and the vascular structure within the lesion with special emphasis on pulmonary carcinoma.Enhanced thin CT sections were obtained in 35 cases with nodular or patchy lesions in the peripheral lung field which are difficult to differentiate clinically. There were pulmonary carcinoma 21, inflammatory pseudotumor 7 and tuberculoma 7. The number of small vessels (inner diameter 0.02 approximately 0.1 mm), relatively large vessels (inner diameter0.1 mm) and their vascular bed areas were analyzed by computed image analyzing system. The relation between CT average attenuation and the number of vessels or the vascular bed areas were statistically evaluated.1. The differences of average attenuation in carcinoma, inflammatory pseudotumor and tuberculoma were statistically significant (P0.05). 2. The differences in number of small vessels, relatively large vessels and vascular bed areas among these three types of lesion were also significant (P0.05). 3. A positive correlation was found in the average CT affenuation of lung carcinoma and its number of small vessels and relatively large vessels and 4. A positive correlation was found between the average CT attenuation in these three lesions and the relatively large vessels, total vascular amount and vascular bed areas.1. The average degree of attenuation, being divided into four degrees, is of practical value in the differentiation of lung carcinoma, inflammatory pseudotumor and tuberculoma. 2. The average CT attenuation of lung carcinoma, inflammatory pseudotumor and tuberculoma is in direct proportion to the number of vessels and vessel bed areas and 3. The characteristic CT enhancement in lung carcinoma reflexes the condition of vessels and blood supply within the tumor.

Nasopharyngeal carcinoma (NPC) is one of the common cancers in China. According to mass surveys, the incidence of NPC in some areas of Guangdong is 39.84/100 000. Due to its high contrast resolution CT has the ability to show not only superficial abnormality but also deep infiltration of the fasciae and muscles of the parapharyngeal region. Computed tomography scanning was performed on more than 1000 patients with NPC in the Tumour Hospital in the 2 years from 1984 to 1986. The role of CT scanning in NPC can be summarised as: (1) detection of primary lesions not accessible to pharyngoscopy; (2) determination of the extent of disease; (3) clinical staging; (4) radiotherapy planning; (5) follow up evaluation; (6) the differentiation of recurrence and radiation damage to the brain; and (7) the demonstration of distant metastasis. In contrast to the concept of jugular chain metastasis via the postero-lateral pharyngeal lymph nodes, our material has demonstrated that the lesion most probably spreads to the carotid sheath area directly from the pharyngeal lesion. The tendency of submucosal spread of NPC is emphasised.