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Superparamagnetic iron oxide nanoparticles (SPIONs) coated with glucose (Glc-SPIONs) were prepared by a new approach called Metal Vapor Synthesis (MVS) and their morphological/structural features were investigated by transmission electron microscopy (TEM) and dynamic light scattering. TEM analysis revealed the presence of small roundish crystalline iron oxide nanoparticles in the organic amorphous phase of glucose, The particles were distributed in a narrow range (1.5 nm-3.5 nm) with a mean diameter of 2.7 nm. The hydrodynamic mean diameter of the Glc-SPIONs, was 15.5 nm. From 4 mg/mL onwards, there was a constant level of positive contrast in a T1-weighted sequence. In vitro experiments were performed in three cell lines: pancreatic cancer (PSN-1), human thyroid cancer (BCPAP), and human embryonic kidney non-tumor cells. We evaluated GLUT1 expression in each cell line and demonstrated that the exposure time and concentration of the Glc-SPIONs we used did not affect cell viability. PSN-1 cells were the most effective at internalizing Glc-SPIONs. Although significantly higher than the control cells, a lower Fe content was detected BCPAP cells treated with Glc-SPIONs. To confirm the involvement of GLUT1 in Glc-SPIONs internalization, cellular uptake experiments were also conducted by pre-treating cancer cells with specific GLUT1 inhibitors, All the inhibitors reduced the cancer cell uptake of Glc-SPIONs In vivo tests were performed on mice inoculated with Lewis lung carcinoma. Mice were treated with a single i.v. injection of Glc-SPION and our results showed a great bioavailability to the malignant tissue by the i.v. administration of Glc-SPIONs. Glc-SPIONs were efficiently eliminated by the kidney. To the best of our knowledge, our study demonstrates for the first time that Glc-SPIONs prepared with MVS can be electively internalized by tumor cells both in vitro and in vivo by exploiting one of the most universal metabolic anomalies of cancer., Competing Interests: The authors have declared that no competing interests exists.

Objectives: To assess the usefulness of MRI in the evaluation of the relationships between the mandibular canal and impacted mandibular third molars., Methods: 29 young patients from our hospital dental service, all with a unilateral impacted mandibular third molar, were investigated with MR and the anatomical details were evaluated in three dimensions by two MR-experienced radiologists from our radiology division. MR images were obtained by using a 1.0 T Siemens Magnetom Expert unit with a radiofrequency (RF) head coil. T(1) weighted axial oblique images and proton density-weighted sagittal/coronal oblique images were acquired in order to evaluate the anatomical details in the three dimensions., Results: In all of the cases it was possible to evaluate the depth of the third molar in the alveolar bone, its inclination towards the occlusal plane and the relationships with the mandibular canal, but in 2 of 29 cases it was not possible to distinguish the mandibular canal from the third molar because of magnetic susceptibility artefacts., Conclusions: Owing to the possibility of inferior alveolar nerve injury during oral surgery, where dental panoramic radiography is not sufficient to demonstrate the relationships between mandibular third molar teeth and the mandibular canal, a dental CT scan is often needed; however, in young patients, to avoid high levels of radiation dose, MRI of the jaw may be useful.

Purpose: In patients with advanced-stage non-small-cell lung cancer (NSCLC) pretreated with chemotherapy, docetaxel 75 mg/m2 every 3 weeks prolongs survival compared with best supportive care alone or chemotherapy with ifosfamide or vinorelbine. Neutropenia is the dose-limiting toxicity of this schedule, and thus limits its use in elderly patients. Therefore, we studied a modified schedule of docetaxel in order to reduce the toxicity of this regimen and to improve the compliance to treatment in an elderly population, while maintaining the same dose intensity of the original regimen., Patients and Methods: Thirty-three elderly patients (aged > or = 70 years) with advanced-stage NSCLC, Eastern Cooperative Oncology Group performance status 0-2, and a median age of 74 years (range, 70-83 years) who had progressed after 1 line of chemotherapy were treated with docetaxel 37.5 mg/m2 on days 1 and 8 every 3 weeks for a maximum of 6 courses., Results: Seven of 33 patients (21.2%; 95% confidence interval, 8.98%-38.91%) exhibited a partial response (according to the intent-to-treat analysis), 12 patients (36.3%) exhibited stable disease, and 14 patients (42.4%) exhibited progression. Grade 3 (National Cancer Institute Common Toxicity Criteria) neutropenia and anemia were observed in 9% and 3% of patients, respectively. The main nonhematologic toxicity consisted of grade 3 nausea/vomiting, diarrhea, and asthenia in 6% of patients each, and grade 3 nail toxicity in 3% of patients., Conclusion: Our modified schedule of docetaxel is an active and well-tolerated second-line treatment in elderly patients with advanced-stage NSCLC and has a favorable toxicity profile.

Renal involvement during lymphoma can be extrinsic, i.e., renal compression or displacement due to lymph node masses, or intrinsic, i.e., parenchymal involvement secondary to blood or lymphatic spread, or primary, as initial neoplastic site. Primary renal lymphoma is very rare (3% of all renal lymphomas) for the absence of lymphatic tissue in the kidney. The disease might be due to parapyelic lymph nodes or to blood spreading from an unknown site. In our study we reviewed the CT findings of five cases of primary non-Hodgkin's renal lymphoma with surgical or histologic confirmation. Renal alterations due to lymphomatous involvement were classified according to macroscopic pathologic findings: type I (single nodular disease, 2 patients), type II (multinodular disease, 1 patient), and type III (infiltrating disease with retroperitoneal involvement, 2 patients). In the two patients with single nodular involvement (type I), CT showed a solid, hypodense and clear-cut nodule. In the only patient with multinodular disease (type II), renal tissue was replaced by multiple hypodense nodular masses, which were partially confluent. In the two infiltrating forms with retroperitoneal involvement (type III), renal structure was diffusely disorganized, with thickening of soft tissues and perirenal fasciae, peripyelic infiltration and, in one case, urinary tract obstruction. To conclude, CT always allowed the accurate assessment of the presence, site and size of renal lesions and of perirenal and urinary involvement. However, CT findings were completely aspecific, not allowing an unquestionable differential diagnosis with other conditions, e.g., hypernephroma, transitional cell carcinoma, metastatic lesions or chronic inflammations. Therefore, a biopsy specimen is necessary to make an unquestionable diagnosis.

The authors describe a case of lymphoblastic lymphoma of the renal lodge complicated by hemorrhagic pericarditis, cardiac tamponade and quickly evolved in an unfavourable way. Lymphoblastic lymphoma is classified into lymphocytic lymphomas (or non-Hodgkin) with a higher grade of malignancy. These lymphomas have, in 40% of cases, an initially extra-lymph node localization: among these, the renal or perirenal localization is not very frequent. The concomitant presence of a pericarditis of hemorrhagic type is also less frequent. Unlike Hodgkin's lymphomas, lymphocytic lymphomas are frequently in an advanced stage at the moment of diagnosis, and their evolution is of acute-subacute, often fatal type. The case report is about a 70 year old male, who arrived at the clinical investigation for the subjective presence of asthenia, dyspnea, tachycardia and the objective evidence of jugular turgor, hepatomegaly and distal edemas, hypophonesis of right lung basis, according to a clinical picture of systemic venous congestion which instrumental examinations confirm to be of pericardial origin. The abdominal echographic examination showed an occupation of the perirenal space, so the CAT characterized as a 25 cm long formation (from the renal cavity to pelvis), with a dislocation of close structures. Unfortunately, the clinical picture had a quick evolution towards the exitus for cardiac tamponade, only permitting us a bioptic examination for the diagnosis of the case.

Computerized tomography has been introduced in studies concerning neoplastic pathology of the pelvis. In this study, we have attempted to define a series of radiological signs, resulting from CT tests of pelvis or abdomen in patients with gynaecological tumors, each of which corresponds to a particular anatomopathologic situation. For each gynaecologic tumor, there is a set of more frequently found signs, the presence of which, in the single case, depends on the stage of evolution of the disease. In the staging of cervical or endometrial carcinoma, the evaluation of the relation to the bladder and rectum is very important, just like vaginal, parametrial and ureteral infiltration. In the presurgical staging of ovarian carcinoma the CT can reveal the size and shape of mono- or bilateral ovarian tumour masses and the relation that they have established with the pelvic organs and with the intestine. In spite of inevitable limitations the CT plays an essential role in gynaecologic oncologic diagnostics.

Urinary stress incontinence has been examined in 42 women with a standard radiographic technique, such as CCURG (colpocystourethrorectography) and echotomography. With these techniques 6 parameters have been established and measured both at rest and under Valsalva's maneuver. Stress incontinence has been diagnosed through variation of the normal values above physiological limits during the passage from rest to stress. In particular, reliability of echotomography in measuring the six parameters has been established and advantages and disadvantages have been evaluated in comparison with CCURG.

Echotomographic examinations were performed in 64 patients suffering from thoracic wall, pleural, pulmonary and mediastinal diseases, after preliminary examinations using standard radiographic techniques. The value of echography in the detection and evaluation of the location and extent of the lesion is assessed. Particular stress is placed on the physical difficulties involved in the detection and correct evaluation of the relationship with the adjacent organs. The importance of echography in detecting the type of the lesion is under-lined and the semeiological criteria for its correct location are given.

Computerized Tomography (CT) has largely contributed to the diagnosis of the pathology of the female pelvis. After setting up a technique to outline the different viscera the authors have employed this method in the staging of neoplastic pathology of the cervix and ovary. They describe the successes obtained and the main cause of error in the interpretation of the images of CT.

Fourteen patients affected by primitive retroperitoneal tumors were examined by means of sonography in order to assess the value of this technique in this type of pathology. Ten patients underwent fine needle biopsy, 5 barium meal examination, 2 intravenous pyelography. In 8 patients CT was also performed. Surgical removal or explorative laparotomy followed by histological examination was performed in all patients. Sonography proved reliable in identifying and in assessing the type of the lesion (if associated with fine needle biopsy which was performed in 10 out of 14 patients). Sonography proved little less satisfactory in determining the site and the local extension of the lesion since the huge dimensions of the tumor did not always allow to use those semeiologic signs described in the literature. All tumors examined presented, in fact, as large masses, this fact indicating the scanty progress sonography has taken in the field of the early diagnosis. Since the huge dimensions of these tumors do not always allow a complete surgical removal, and because of their proven tendency of relapsing, the prognosis of these tumors seems to persist unfavourable notwithstanding the widespread use of sonography.