Roy Santosham

Nanomedicine: towards development of patient-friendly drug-delivery systems for oncological applications.

The focus on nanotechnology in cancer treatment and diagnosis has intensified due to the serious side effects caused by anticancer agents as a result of their cytotoxic actions on normal cells. This nonspecific action of chemotherapy has awakened a need for formulations capable of definitive targeting with enhanced tumor-killing. Nanooncology, the application of nanobiotechnology to the management of cancer, is currently the most important area of nanomedicine. Currently several nanomaterial-based drug-delivery systems are in vogue and several others are in various stages of development. Tumor-targeted drug-delivery systems are envisioned as magic bullets for cancer therapy and several groups are working globally for development of robust systems.

A rare case of primary malignant pericardial mesothelioma.

Primary malignant pericardial mesothelioma (PMPM) is a rare tumor of the pericardium. The cause of this tumor is unknown and it has a very poor prognosis. Exposure to asbestos is correlated with the onset of pleural and peritoneal mesothelioma; however, the role of asbestos in pericardial mesothelioma is unclear. Here we highlight the radiological features of this rare tumor and its correlative pathological confirmation with the help of new immunohistochemical (IHC) markers.

Automated texture-based characterization of fibrosis and carcinoma using low-dose lung CT images

Lung cancer is the most common cause of cancer deaths worldwide and account for 1.38 million deaths per year. Patients with lung cancer are often misdiagnosed as pulmonary tuberculosis (TB) leading to delay in the correct diagnosis as well as exposure to inappropriate medication. The diagnosis of TB and lung cancer can be difficult as symptoms of both diseases are similar in computed tomography (CT) images. However, treating TB leads to inflammatory fibrosis in some of the patients. There comes the need of an efficient computer aided diagnosis (CAD) of the fibrosis and carcinoma diseases. To design a fully automated CAD for characterizing fibrous and carcinoma tissues without human intervention using lung CT images. The 18 subjects in this study include seven healthy, two fibrosis and eight carcinoma, and one necrosis cases. The dataset is built by CT cuts representing healthy is 113, fibrosis is 103, necrosis is 39, and carcinoma is 185 totalling 440 images. The gray‐level spatial dependence matrix and gray level run length matrix approach are used for extracting texture‐based features. These features are given to neural network classifier and statistical classifier. These classifier performances are evaluated using receiver‐operating characteristics (ROC). The proposed method characterizes these tissues without human intervention. Sensitivity, specificity, precision, and accuracy followed by ROC curves were obtained and also studied. Thus, the proposed automated image‐based classifier could act as a precursor to histopathological analysis, thereby creating a way to class specific treatment procedures.

Role of dynamic MR imaging in obstructive sleep apnoea

The purpose of this study is to assess the role of dynamic MR imaging in the evaluation of obstructive sleep apnea. In this prospective study, MRI was performed in 22 patients (eighteen male and four female, ranging in age from 26 to 70 years) suspected of having obstructive sleep aponea (OSA). 18 of them had a polysomnography study prior to MRI evaluation, which confirmed the presence of OSA. Positive cases were classified according to anatomic location and cause of narrowing. Patients with isolated retropalatal narrowing on MRI were advised uvulopalatopharyngoplasty (UPPP). Two patients had normal findings on MRI, 8 patients had retropalatal narrowing, five had retroglossal narrowing and seven had narrowing at multiple levels. All twenty-patients had collapse of lateral pharyngeal wall. Four patient with isolated retropalatal narrowing, who underwent UPPP after MRI evaluation were found to be cured on 6 month postoperative follow up.Dynamic MR imaging can accurately diagnose the cause and level of upper airway narrowing in patients with OSA. It can characterize and anatomically classify the level of narrowing for planning reparative surgery.

CNS toxoplasmosis in an immunocompetent individual.

Toxoplasmosis is a serious and life-threatening disease in humans with a high prevalence in immunocompromised persons. The disease has a wide spectrum, depending on the immune status of the person. A CNS manifestation of toxoplasmosis in an immunocompetent person is very rare and often undetected. Our case of CNS toxoplasmosis in an immunocompetent person emphasizes the radiological diagnosis, which was further confirmed by advanced microbiology technique.

Efficacy of Dipeptide-Coated Magnetic Nanoparticles in Lung Cancer Models Under Pulsed Electromagnetic Field

ABSTRACT Lung cancer is the leading cause of cancer deaths and the overall 5-year survival rate is less than 17%. Hyperthermia is an alternative approach for the treatment of lung cancer and is associated with fewer side effects. We employed ironoxide nanoparticles in inducing localized hyperthermia in lung cancer cells using a pulsed electromagnetic field (PEMF). We synthesized, characterized and determined the uptake of dipeptide-coated iron oxide nanoparticles. Further, their ability in inducing localized hyperthermia in PEMF on lung cancer cells was assessed. Results showed nanoparticles are non-cytotoxic and showed enhanced cellular uptake in lung cancer cells. In vivo studies in nude mice lung tumor xenografts confirmed the presence in the tumors. Lung cancer cells pretreated with dipeptide-coated magnetic nanoparticles upon PEMF exposure induced cell death.

Atypical Presentation of Gastrointestinal Stromal Tumours—A Case Report

Gastrointestinal stromal tumors (GISTs) are benign mesenchymal tumors of the gastrointestinal tract (GIT). Their clinical presentations are variable. We report a case of a 31-year-old man who presented with pain in the abdomen and vomiting. CT abdomen revealed a large exophytic mass in the epigastrium with enhancement pattern similar to hemangioma. No relationship of the mass could be made out with the adjacent structures on CT, histopathology proved it to be a GIST.

How I do it: Radiofrequency ablation

Over the past decade, image-guided tumor ablation using thermal energy has emerged as a promising technique for treating focal, primary or secondary, nonoperable tumors. Radiofrequency ablation (RFA) is minimally invasive and requires less resources, time, and recovery period and is, moreover, relatively inexpensive. RFA has been used to treat tumors located in the liver, lung, bone, kidneys, brain, thyroid, breast, and pancreas. This article will describe how to choose an appropriate case; precisely place the needle into the tumor; the precautions to be taken before, during, and after the procedure; probable complications; and the follow-up of patients undergoing ablation.