Fig. 1. Immune cell infiltration of lung carcinoma-in-situ lesions. (a-b) Immunohistochemistry images of (a) progressive CIS lesion and (b) regressive CIS lesion with CD4+ cells stained in brown, CD8+ cells in red and FOXP3+ in blue. Immune cells are separately quantified within the CIS lesion and in the surrounding stroma. c) Combined quantitative immunohistochemistry data of CD4, CD8 and FOXP3 staining (n=44; 28 progressive, 16 regressive) with total lymphocyte quantification from H&E images (n=116; 69 progressive, 47 regressive) shown. We observe increased lymphocytes (p=0.023) and CD8+ cells (p=0.037) per unit area of epithelium within regressive CIS lesions compared to progressive. Stromal regions adjacent to CIS lesions showed no significant differences in immune cells between progressive and regressive lesions. p-values are calculated using linear mixed effects models to account for samples from the same patient; *p<0.05. 2 | bioRχiv Pennycuick et al. | Immune surveillance in clinical regression of pre-invasive squamous cell lung cancer .
Background: Ill-defined areas of water-like signal on bone magnetic resonance imaging (MRI), characterized as bone marrow edema or edema-equivalent signal-changes (EESC), is a hallmark of active-stage pedal neuro-osteoarthropathy (Charcot foot) in painless diabetic neuropathy, and is accompanied by local soft-tissue edema and hyperthermia. The longitudinal effects on EESC of treating the foot in a walking cast were elucidated by reviewing consecutive cases of a diabetic foot clinic.
Study design: Retrospective observational study, chart review
Material and methods: Cases with active-stage Charcot foot were considered, in whom written reports on baseline and follow-up MRI studies were available for assessment. Only cases without concomitant infection or skin ulcer were chosen, in whom both was documented, onset of symptomatic foot swelling and patient compliance with cast treatment.
Results: From 1994 to 2017, 45 consecutive cases in 37 patients were retrieved, with 95 MRI follow-up studies (1–6 per case, average interval between studies 13 weeks). Decreasing EESC was documented in 66/95 (69%) follow-up studies. However, 29/95 (31%) studies revealed temporarily increasing, migrating or stagnating EESC.
Conclusion: EESC on MRI disappear in response to prolonged offloading and immobilizing treatment; however, physiologic as well as pathologic fluctuations of posttraumatic EESC have to be considered when interpreting the MR images. Conventional MRI is useful for surveillance of active-stage Charcot foot recovery.
Lung cancer remains the most common cause of cancer related death in both the UK and USA. Development of diagnostic approaches that have the ability to detect lung cancer early are a research priority with potential to improve survival. Analysis of exhaled breath metabolites, or volatile organic compounds (VOCs) is an area of considerable interest as it could fulfil such requirements. Numerous studies have shown that VOC profiles are different in the breath of patients with lung cancer compared to healthy individuals or those with non-malignant lung diseases. This review provides a scientific and clinical assessment of the potential value of a breath test in lung cancer. It discusses the current understanding of metabolic pathways that contribute to exhaled VOC production in lung cancer and reviews the research conducted to date. Finally, we highlight important areas for future research and discuss how a breath test could be incorporated into various clinical pathways.
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