Effectiveness of capsaicin nanoparticle gel of Capsicum frutescens L. on oral squamous cell carcinoma in Rattus norvegicus

Background: Oral squamous cell carcinoma (OSCC) is an oral cancer with a low life expectancy, less than five years after diagnosis. The drug therapy often used for OSCC patients is cisplatin, but it is considered to cause tumour persistence, drug resistance, and high toxicity. Therefore, it is important to test the development of alternative drugs from natural ingredients. One potential ingredient is green chilli pepper (Capsicum frutescens L.). It contains capsaicin that functions as an anticancer agent by suppressing BCa tumorigenesis so that proliferation is inhibited, as well as increasing and preventing p53 antibody mutations that play a role in cancer cell apoptosis. Purpose: This study aimed to compare effectiveness using capsaicin nanoparticle gel from green chilli pepper extract levels of 1% and 3.3% to reduce OSCC nodules. Methods: This study used 20 Rattus norvegicus that were randomly divided into five groups; C- (rat without treatment), C+ (rat induced to 7,12-Dimethylbenz(a)anthracene (DMBA)), E1 (DMBA exposed and given cisplatin, E2 (rat induced to DMBA and capsaicin extract nanoparticle gel with a concentration of 1%), and E3 (rat induced to DMBA and capsaicin extract nanoparticle gel with a concentration of 3.3%). The data were analysed statistically with the one-way ANOVA and least significance difference (LSD) test. Results: The comparison of mean nodule volume between C+ (5.834 ± 2.77 mm3) with E1 (1.75 ± 0.37 mm3), E2 (1.747 ± 0.36 mm3), and E3 (1.812 ± 0.11 mm3) had a significant difference (p = 0.00, p ≤ 0.05). Conclusion: Capsaicin nanoparticle gel with green chilli pepper extract at levels of 1% (E2) reduces OSCC nodules by more than gel with green chilli pepper extract at 3.3% (E3) concentration.

Deep-learning reconstruction for ultra-low-dose lung CT: Volumetric measurement accuracy and reproducibility of artificial ground-glass nodules in a phantom study

Objectives The lung nodule volume determined by CT is used for nodule diagnoses and monitoring tumor responses to therapy. Increased image noise on low-dose CT degrades the measurement accuracy of the lung nodule volume. We compared the volumetric accuracy among deep-learning reconstruction (DLR), model-based iterative reconstruction (MBIR), and hybrid iterative reconstruction (HIR) at an ultra-low-dose setting. Methods Artificial ground-glass nodules (6 mm and 10 mm diameters, −660 HU) placed at the lung-apex and the middle-lung field in chest phantom were scanned by 320-row CT with the ultra-low-dose setting of 6.3 mAs. Each scan data set was reconstructed by DLR, MBIR, and HIR. The volumes of nodules were measured semi-automatically, and the absolute percent volumetric error (APEvol) was calculated. The APEvol provided by each reconstruction were compared by the Tukey-Kramer method. Inter- and intraobserver variabilities were evaluated by a Bland-Altman analysis with limits of agreements. Results DLR provided a lower APEvol compared to MBIR and HIR. The APEvol of DLR (1.36%) was significantly lower than those of the HIR (8.01%, p = 0.0022) and MBIR (7.30%, p = 0.0053) on a 10-mm-diameter middle-lung nodule. DLR showed narrower limits of agreement compared to MBIR and HIR in the inter- and intraobserver agreement of the volumetric measurement. Conclusions DLR showed higher accuracy compared to MBIR and HIR for the volumetric measurement of artificial ground-glass nodules by ultra-low-dose CT. Advances in knowledge DLR with ultra-low-dose setting allows a reduction of dose exposure, maintaining accuracy for the volumetry of lung nodule, especially in patients which deserve a long-term follow-up.

Reduction in Tumor Lesions and Exacerbation of Psoriatic Rash after Septic Shock in a Patient with Extramammary Paget’s Disease

We present a case of extramammary Paget’s disease with bilateral inguinal lymph node metastasis treated by monthly docetaxel chemotherapy. He has also well-controlled psoriasis vulgaris for 20 years. One day after completing monthly chemotherapy, cellulitis by Group G <i>Streptococcus</i> occurred on both legs, resulting in septic shock and disseminated intravascular coagulation. During the infection, the tumor nodule volume and the exudate from the tumor decreased, and tumor markers carcinoembryonic antigen and cancer antigen 19-9 showed low values. Simultaneously, the psoriatic eruption reoccurred. We proposed that cytokine storm including tumor necrosis factor-alpha (TNF-α) during sepsis might have suppressed tumor lesions, and also TNF-α-dependent psoriatic rash appeared temporarily on his body.

Defining growth in small pulmonary nodules using volumetry: results from a “coffee-break” CT study and implications for current nodule management guidelines

Objectives An increase in lung nodule volume on serial CT may represent true growth or measurement variation. In nodule guidelines, a 25% increase in nodule volume is frequently used to determine that growth has occurred; this is based on previous same-day, test–retest (coffee-break) studies examining metastatic nodules. Whether results from prior studies apply to small non-metastatic nodules is unknown. This study aimed to establish the interscan variability in the volumetric measurements of small-sized non-metastatic nodules. Methods Institutional review board approval was obtained for this study. Between March 2019 and January 2021, 45 adults (25 males; mean age 65 years, range 37–84 years) with previously identified pulmonary nodules (30–150 mm3) requiring surveillance, without a known primary tumour, underwent two same-day CT scans. Non-calcified solid nodules were measured using commercial volumetry software, and interscan variability of volume measurements was assessed using a Bland–Altman method and limits of agreement. Results One hundred nodules (range 28–170 mm3; mean 81.1 mm3) were analysed. The lower and upper limits of agreement for the absolute volume difference between the two scans were − 14.2 mm3 and 12.0 mm3 respectively (mean difference 1.09 mm3, range − 33–12 mm3). The lower and upper limits of agreement for relative volume difference were − 16.4% and 14.6% respectively (mean difference 0.90%, range − 24.1–32.8%). Conclusions The interscan volume variability in this cohort of small non-metastatic nodules was smaller than that in previous studies involving lung metastases of varying sizes. An increase of 15% in nodule volume on sequential CT may represent true growth, and closer surveillance of these nodules may be warranted. Key Points • In current pulmonary nodule management guidelines, a threshold of 25% increase in volume is required to determine that true growth of a pulmonary nodule has occurred. • This test–retest (coffee break) study has demonstrated that a smaller threshold of 15% increase in volume may represent true growth in small non-metastatic nodules. • Closer surveillance of some small nodules growing 15–25% over a short interval may be appropriate.

Matrix 3D ultrasound-assisted thyroid nodule volume estimation and radiofrequency ablation: a phantom study

Background Two-dimensional (2D) ultrasound is well established for thyroid nodule assessment and treatment guidance. However, it is hampered by a limited field of view and observer variability that may lead to inaccurate nodule classification and treatment. To cope with these limitations, we investigated the use of real-time three-dimensional (3D) ultrasound to improve the accuracy of volume estimation and needle placement during radiofrequency ablation. We assess a new 3D matrix transducer for nodule volume estimation and image-guided radiofrequency ablation. Methods Thirty thyroid nodule phantoms with thermochromic dye underwent volume estimation and ablation guided by a 2D linear and 3D mechanically-swept array and a 3D matrix transducer. Results The 3D matrix nodule volume estimations had a lower median difference with the ground truth (0.4 mL) compared to the standard 2D approach (2.2 mL, p < 0.001) and mechanically swept 3D transducer (2.0 mL, p = 0.016). The 3D matrix-guided ablation resulted in a similar nodule ablation coverage when compared to 2D-guidance (76.7% versus 80.8%, p = 0.542). The 3D mechanically swept transducer performed worse (60.1%, p = 0.015). However, 3D matrix and 2D guidance ablations lead to a larger ablated volume outside the nodule than 3D mechanically swept (5.1 mL, 4.2 mL (p = 0.274), 0.5 mL (p < 0.001), respectively). The 3D matrix and mechanically swept approaches were faster with 80 and 72.5 s/mL ablated than 2D with 105.5 s/mL ablated. Conclusions The 3D matrix transducer estimates volumes more accurately and can facilitate accurate needle placement while reducing procedure time.

Percutaneous, Ultrasound-guided Laser Ablation of Benign Thyroid Nodules: Results of 10-year Follow-up in 171 Patients

Background Percutaneous, ultrasound-guided laser ablation is effective in nodular thyroid disease. The aim of this study was to evaluate the long-term (10-year) efficacy and safety of laser ablation in the treatment of benign thyroid nodules. Methods Between 2009 and 2010, 171 patients received a single session of laser ablation. Evaluation of nodule volume was performed before treatment, at 6 months, and every year. Results Technique efficacy was achieved in 92% of patients at 1 year. Median nodule volume significantly decreased from 16.7 mL (range: 11.0−97.0 mL) at baseline to 5.0 mL (range: 4.1−32.0 mL) at 1 year, a volume reduction ratio (VRR) of 68%. The benefit of the treatment was durable (p &lt; 0.001 vs baseline at all timepoints), with a VRR of 59% after 10 years. No cases of nodule regrowth &gt;50% were observed at 1 year, although such cases did occur after 4 years (n = 3; 1.7% of the overall cohort) and 7 years (n = 8; 4.7%). There were no further cases of regrowth beyond 7 years. When patients were stratified according to baseline nodule volume (&lt;15 mL, 15−25 mL, or &gt;25 mL), durable results were observed across all 3 categories, with the largest, most prolonged effect observed in patients with nodules &lt;15 mL. Treatment was well tolerated, with only minor, transient complications of fever and local pain, and 98% of patients willing to recommend the treatment. Conclusions Percutaneous, ultrasound-guided laser ablation of benign thyroid nodules provides long-term benefits and the treatment is well tolerated.

Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study)

Context Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign nonfunctioning thyroid nodules (BNTNs) Objective To compare the efficacy and safety of both treatments at 12-month follow-up in patients with solid or predominantly solid BNTN. Methods This was a single-center, 12-month, randomized, superiority, open-label, parallel-group trial conducted in an outpatient clinic. Sixty patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems were randomly assigned (1:1 ratio) to receive either a single session of RFA or LA. Twenty-9 patients per group completed the study. The main outcome measures were VRR and proportion of nodules with more than 50% reduction (technical success rate). Results At 12 months, VRR was 70.9 ± 16.9% and 60.0 ± 19.0% in the RFA and LA groups, respectively (P = .024). This effect was confirmed in the linear regression model that was adjusted for age, sex, nodule baseline volume, and proportion of cellular components (RFA treatment: β = .390; P = .009). No significant between-group difference was observed in the technical success rate at 12 months after treatment. A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3 ± 0.8, P &lt; .001; and LA: 4.6 ± 2.1 and 1.6 ± 0.8, respectively, P &lt; .001) and cosmetic (RFA: 3.4 ± 0.6 and 1.3 ± 0.5, P &lt; .001; and LA: 3.4 ± 0.5 and 1.4 ± 0.6, P &lt; .001) scores although the between-group differences were not significant. Conclusion RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.

Long-term follow-up of cystic thyroid nodules treated with percutaneous ethanol injection (PEI) using two different approaches

Background and aim: Cystic thyroid nodules (CNs), although generally benign, can cause compressive or aesthetic problems. Percutaneous ethanol injection (PEI) can represent an alternative to surgery. The present retrospective study evaluates: (i) the long-term outcome of CNs after PEI; (ii) the differences between two different PEI protocols; (iii) the CNs response according to the liquid component. Materials and methods: The study comprises 358 nodules post-PEI followed for at least 2 years. PEI was performed according to two different treatment protocols with a single (Foggia) or double (Turin) alcohol injection. CNs were divided according to their composition: cystic (CYS) >90%, mainly cystic (M-CYS) 75–90%, mixed (MIX) 50–75%, solid-mixed (S-MIX) 35-50%. The volume reduction rate (VRR) was defined as nodule volume (mL) after PEI/nodule volume (mL) before PEI x 100. Results: The 1-year VRR was significantly higher than that at 6 months (89.5% vs 72.9%, P = 0.0005), no differences were observed after 1 year. A significant difference between Turin and Foggia was observed only in VRR at early visit (79% vs 86%, respectively, P = 0.002) and recurrence rate (14% vs 24%, respectively, P = 0.001). Minor side-effects were infrequent. In 192 nodules with a 10-year follow-up CYS showed higher VRR than MIX and S-MIX nodules (P < 0.001). Conclusion: Our study reported that the long-term outcome of CNs treated with PEI is excellent regardless of the PEI technique utilized; the larger the cystic amount, the higher the VRR. Based on present results, PEI can be considered as the first-line choice for treating thyroid CNs.

Response of Chickpea (Cicer aritienum L.) to Sulphur and Zinc Nutrients Application and Rhizobium Inoculation in North Western Ethiopia

In sub-Saharan Africa, multiple plant nutrients deficiency besides nitrogen (N) and phosphorus (P) is a major growth-limiting factor for crop production. As a result, some soils become non-responsive for Rhizobium inoculation besides P application. Based on the soil test result, the soil of Experimental sites had low organic matter (OM), nitrogen (N), phosphorus (P), sulphur (S) and zinc (Zn)[xy1]. Hence, an experiment was carried out on-farm at Gondar Zuria woreda in Tsion and Denzaz Kebeles to evaluate the effect of Rhizobium inoculation, S and Zn application on yield, nodulation, N and P uptake of chickpea. The experiment included twelve treatments developed via factorial combination of two level of inoculation (Rhizobium inoculated, un-inoculated), three level of S (0, 15, 30 kg Sulphur ha-1) and two levels of Zn (0, 1.5 kg Zinc ha-1). The treatment was laid out in randomized complete block design with three replications. Results showed that the highest mean nodule number (15.3) and nodule volume (1.3 ml plant-1) over locations were obtained with Rhizobium inoculation integrated with 15 kg S and 1.5 kg Zn ha-1 which resulted in 37.8% and 116.7% increment over the control check, respectively. It was also observed that combined application of Rhizobium and 30 kg S ha-1 caused the highest (6.7) mean nodulation rating and seed yield (1775.5 kg ha-1) over locations which resulted in 86.1% and 28 % increase over the control check, respectively. Moreover, this treatment improved P use efficiency of chickpea. On the bases of observed result, it can be concluded that the response of chickpea to Rhizobium and P application can be improved by S application and Rhizobium inoculation with application of 30 kg S ha-1 with recommended rate of P and starter N is recommended for chickpea production at the experimental locations in Gonder Zuria Woreda.