Non-invasive evaluation of meibomian gland morphology and tear film and anterior segment parameters in women with polycystic ovarian syndrome

PurposeTo compare the meibomian glands (MG), non-invasive tear film break-up time (NITBUT), and corneal and anterior segment measurements in patients with polycystic ovary syndrome and healthy women.MethodsThe study included 66 polycystic ovarian syndrome (PCOS) patients and 42 healthy volunteers aged 18–35 years. The first and average NITBUT, MG loss, mean keratometry (Km), central (CCT) and thinnest (TCT) corneal thicknesses, anterior chamber depth (ACD), anterior chamber volume (ACV), irido-corneal angle (ICA), corneal volume (CV) and Ocular Surface Disease Index (OSDI) results were analyzed.ResultsThe mean MG loss values were 29.9 ± 11.9 and 20.8 ± 11.0 in the PCOS and control groups, respectively (p < 0.001). MG loss (meiboscale ≥ 1) was determined in 64 (96.9%) eyes in the PCOS group and in 36 (85.7%) eyes in the control group. There was no significant difference between the groups in respect of NITBUT, OSDI, Km, CCT, TCT, ACD, ACV, ICA and CV values (p > 0.05, for all).ConclusionMG loss is a physiological process which is distinct in PCOS patients, but does not cause tear film alterations. Further studies are needed to show the contributing factors of MGD in PCOS patients.     

Myocardial substrate and route of administration determine acute cardiac retention and lung bio-distribution of cardiosphere-derived cells

Background

Quantification of acute myocardial retention and lung bio-distribution of cardiosphere-derived cells (CDCs) following transplantation is important to improve engraftment.

Methods and results

We studied acute(1 hour) cardiac/lung retention in 4 groups (n = 25) of rats (normal—NL, acute ischemia-reperfusion—AI-RM, acute permanent ligation—PL, and chronic infarct by ischemia-reperfusion—CI-R) using intra-myocardial delivery, 1 group using intracoronary delivery (acute ischemia-reperfusion, AI-RC, n = 5) and 1 group using intravenous delivery (acute ischemia-reperfusion, AI-RV, n = 5) of CDCs by PET. Cardiac retention was similar in the NL, AI-RM, CI-R, and A-IRC groups (13.6% ± 2.3% vs 12.0% ± 3.9% vs 9.9 ± 2.8 vs 15.4% ± 5.5%; P = NS), but higher in PL animals (22.9% ± 5.2%; P < .05). Low cardiac retention was associated with significantly higher lung activity in NL and AI-RM groups (43.3% ± 5.6% and 39.9% ± 9.3%), compared to PL (28.5% ± 5.9%), CI-R (20.2% ± 9.3%), and A-IRC (19.9% ± 5.6%) animals (P < .05 vs AI-RM and NL). Lung activity was highest following intravenous CDC delivery (55.1% ± 9.3%, P < .001) and was associated with very low cardiac retention (0.8% ± 1.06%). Two-photon microscopy indicated that CDCs escaped to the lungs via the coronary veins following intra-myocardial injection.

Conclusions

Acute cardiac retention and lung bio-distribution vary with the myocardial substrate and injection route. Intra-myocardially injected CDCs escape into the lungs via coronary veins, an effect that is more pronounced in perfused myocardium.     

Comparison of corneal,endothelial, and anterior segment parameters in eyes with and without pigment dispersion

BackgroundTo evaluate the differences of central corneal thickness (CCT), corneal endothelial cell morphology, and biometric parameters of the anterior chamber and iridocorneal angle in pigment dispersion syndrome (PDS), pigmentary glaucoma (PG), primary open-angle glaucoma (POAG), and healthy group.MethodsTwenty- three eyes in the PDS group, 39 eyes in the PG group, 33 eyes in the POAG group, and 45 eyes in the healthy control group were included in this cross-sectional retrospective study. Corneal endothelial cell density, the coefficient of variation in the cell area, hexagonality, and central corneal thickness (CCT) were obtained by specular microscopy (CEM 530, NIDEK, Japan). Anterior chamber depth (ACD), iridocorneal angle parameters and CCT were measured by anterior segment optical coherence tomography (AS-OCT) (Visante OCT, Carl Zeiss AG, Germany).ResultsThe mean CCT via specular microscopy (SM-CCT) was measured at the thinnest value in the PG group (531.20 ± 34.91 µm) and the thickest in the control group (569.13 ± 37.52 µm). CV value was higher in PG (34.65 ± 6.84) and POAG group (34.27 ± 9.93) and lower in control group (28.82 ± 5.18) (p = 0,005). The mean AS-OCT-CCT was the thinnest in the PG group (513.61 ± 39.94 µm), and the thickest in the control group (547.04 ± 36.72 µm) (p = 0.001). All parameters of the iridocorneal angle were larger in the PDS and PG groups (p < 0.001). In the correlation analysis of the glaucomatous eyes, a negative correlation between the C/D ratio and SM-CCT and AS-OCT-CCT (p = 0.037, p = 0.017, respectively) and a positive correlation between the pRNFL thickness and AS-OCT- CCT (p = 0.002).ConclusionCCT values obtained with both SM and AS-OCT were found to be significantly thinner in PG cases. CV, which is the measure of polymegatism, was found to be significantly higher in PG cases.     

32P-磷酸铬-聚-L-乳酸粒子植入治疗裸鼠荷人胰腺癌移植瘤的研究

目的 探讨32p-磷酸铬-聚-L-乳酸(32P-CP-PLLA)粒子瘤体间质给药治疗BALB/c裸鼠荷人胰腺癌( BxPc-3)移植瘤的药效学及全身不良反应.方法 24只荷瘤裸鼠,随机分为4组:空白对照组、37.0、18.5、9.3 MBq组.经瘤体分别给予剂量为0、9.3、18.5和37.0 MBq 32p-CP-P...     

Influence of photodynamic therapy and different lasers Er,Cr:YSGG and Er,YAG on dentin conditioning bonded to conventional and bioactive cement

AimThe aim of the present study was to evaluate the bond integrity of bioactive cement (BA_c) in contrast to conventional cement Calibra (C) after dentin treated with different surface conditioners (PDT, EYL, ECL)Materials and MethodsSixty non-carious permanent mandibular molars were disinfected and embedded in acrylic resin till cement-o-enamel junction. For homogeneity the buccal surface were grounded and polished. Samples were categorized into three main groups based on conditioning technique. Samples in group 1 and 2 dentin conditioned with Er,Cr:YSGG (ECL), group 3 and 4 surface treated with Er:YAG (EYL) and group 5 and 6 treated with photodynamic therapy (PDT).On conditioned surface bonding agent was applied and light cured. Samples from group 1,3,5 were bonded to Calibra (C). Whereas, specimens in group 2,4,6 were conditioned with bioactive cement (BA_c) and subjected to ageing followed by shear bond strength testing (SBS) in universal testing machine. To detect significance difference between means of different groups analysis of variance (ANOVA) was performed followed by Tukey’s post-hoc tests.ResultsThe maximum SBS was displayed in group 1, dentin conditioned with ECL and bonded to C (20.23 ± 0.47 MPa). Whereas, group 6, PDT of dentin to BA_c demonstrated lowest bond integrity among experimental groups (12.97 ± 0.25 MPa). Bond strength of group 1, ECL-C (21.55 ± 3.08 MPa) and group 3 EYL-C (19.11 ± 0.65 MPa) were comparable (p > 0.05). Group 5 samples treated with PDT, MB-C (13.41±0.32 MPa) and group 6, MB-BA_c (12.97 ± 0.25 MPa) were also comparable (p > 0.05)ConclusionBAc bonded to dentin after surface conditioning with ECL, EYL and PDT presented lower SBS in comparison to conventional cement C. Further studies are required to extrapolate the current findings.     

The effect of bone marrow mononuclear stem cell therapy on left ventricular function and myocardial perfusion

Background

Bone morrow stem cell (BMC) transfer is an emerging therapy with potential to salvage cardiomyocytes during acute myocardial infarction and promote regeneration and endogenous repair of damaged myocardium in patients with left ventricular (LV) dysfunction. We performed a meta-analysis to examine the association between administration of BMC and LV functional recovery as assessed by imaging.

Methods and Results

Our meta-analysis included data from 32 trials comprising information on 1,300 patients in the treatment arm and 1,006 patients in the control arm. Overall, BMC therapy was associated with a significant increase in LV ejection fraction by 4.6% ± 0.7% (P < .001) (control-adjusted increase of 2.8% ± 0.9%, P = .001), and a significant decrease in perfusion defect size by 9.5% ± 1.4% (P < .001) (control-adjusted decrease of 3.8% ± 1.2%, P = .002). The effect of BMC therapy was similar whether the cells were administered via intra-coronary or intra-myocardial routes and was not influenced by baseline ejection fraction or perfusion defect size.

Conclusions

BMC transfer appears to have a positive impact on LV recovery in patients with acute coronary syndrome and those with stable coronary disease with or without heart failure. Most studies were small and a minority used a core laboratory for image analysis.     

Preoperative Arterial Embolization for Heterotopic Ossification of the Hip

PurposeTo investigate the efficacy and safety of preoperative arterial embolization for neurogenic heterotopic ossification (NHO) of the hip.Materials and MethodsThis single-center retrospective study reviewed outcomes in 16 consecutive patients who had surgical resection of NHO of the hip: 8 of whom underwent preoperative arterial embolization and 8 of whom did not. Both patient cohorts had similar baseline characteristics. A mean of 2.62 ± 1.9 arteries per patient, including the gluteal, lateral circumflex femoral, and deep circumflex iliac branches, were embolized using an n-butyl cyanoacrylate (NBCA)–ethiodized oil mixture. Data from both cohorts regarding intraoperative blood loss, volume of blood transfused, complications, and duration of hospitalization were compared.ResultsA mean of 2.6 ± 1.9 arteries were embolized with NBCA–ethiodized oil, mainly the gluteal arteries, lateral circumflex femoral artery, and deep circumflex iliac artery. In the embolization group, mean intraoperative blood loss was 875 mL ± 320, mean number of units of blood used was 0.5 ± 0.7, and mean number of days of hospitalization was 6.4 days ± 1.6. In the control group, mean intraoperative blood loss was 1,350 mL ± 120, mean number of units of blood used was 2 ± 1.1, and average number of days of hospitalization was 11.5 days ± 1.4. The embolization group had a mean reduction in blood loss of 40.7% (P = 0.035), reduction in units of blood administered of 75% (P = 0.021), and reduction in days of hospitalization of 44.7% (P = 0.014). No procedural complications were recorded.ConclusionsPreoperative arterial embolization is effective and safe in reducing intraoperative blood loss, number of hospitalization days, and need for blood transfusions in surgical resection of NHO of the hip.     

蛋白酶体抑制剂MG132联合X射线对人肺腺癌细胞生长迁移和周期的影响及作用机制

目的 研究蛋白酶体抑制剂MG132联合X射线对人肺腺癌A549细胞生长、迁移、侵袭、细胞周期分布的影响及机制。方法 MTT法检测不同MG132浓度处理后不同时间肺腺癌A549细胞的增殖;克隆形成实验检测A549细胞的存活能力;划痕实验测定A549细胞的迁移能力;Transwell小室测定其侵袭能力;流式细胞术测定细胞周期分布的改变;Western blot法测定蛋白表达水平。结果 MG132明显抑制人肺腺癌A549细胞的生长,并呈现剂量-效应和时间-效应关系。MG132联合X射线对A549细胞克隆存活能力有显著抑制作用（F=554.78、954.64,P<0.01）,且加MG132组克隆存活率均低于照射组（t=4.44、12.41、3.52、6.72,P<0.05）。MG132在无毒性剂量下联合X射线可显著抑制A549细胞的迁移及侵袭能力（t=12.79,P<0.01）,并明显增加G₁期细胞阻滞（t=4.29,P<0.05）;MG132联合X射线明显降低A549细胞中基质金属蛋白酶-2,-9和G₁期相关蛋白Cyclin D1的表达水平,同时增加细胞中P53的表达。结论 MG132可以显著抑制人肺腺癌A549细胞的生长,且在无毒性剂量下联合X射线可以明显降低其转移和侵袭能力,显著增加肿瘤细胞的G₁期阻滞。     

Improved accuracy of myocardial perfusion SPECT for detection of coronary artery disease by machine learning in a large population

Objective

We aimed to improve the diagnostic accuracy of myocardial perfusion SPECT (MPS) by integrating clinical data and quantitative image features with machine learning (ML) algorithms.

Methods

1,181 rest ²⁰¹Tl/stress ^99mTc-sestamibi dual-isotope MPS studies [713 consecutive cases with correlating invasive coronary angiography (ICA) and suspected coronary artery disease (CAD) and 468 with low likelihood (LLk) of CAD <5%] were considered. Cases with stenosis <70% by ICA and LLk of CAD were considered normal. Total stress perfusion deficit (TPD) for supine/prone data, stress/rest perfusion change, and transient ischemic dilatation were derived by automated perfusion quantification software and were combined with age, sex, and post-electrocardiogram CAD probability by a boosted ensemble ML algorithm (LogitBoost). The diagnostic accuracy of the model for prediction of obstructive CAD ≥70% was compared to standard prone/supine quantification and to visual analysis by two experienced readers utilizing all imaging, quantitative, and clinical data. Tenfold stratified cross-validation was performed.

Results

The diagnostic accuracy of ML (87.3% ± 2.1%) was similar to Expert 1 (86.0% ± 2.1%), but superior to combined supine/prone TPD (82.8% ± 2.2%) and Expert 2 (82.1% ± 2.2%) (P < .01). The receiver operator characteristic areas under curve for ML algorithm (0.94 ± 0.01) were higher than those for TPD and both visual readers (P < .001). The sensitivity of ML algorithm (78.9% ± 4.2%) was similar to TPD (75.6% ± 4.4%) and Expert 1 (76.3% ± 4.3%), but higher than that of Expert 2 (71.1% ± 4.6%), (P < .01). The specificity of ML algorithm (92.1% ± 2.2%) was similar to Expert 1 (91.4% ± 2.2%) and Expert 2 (88.3% ± 2.5%), but higher than TPD (86.8% ± 2.6%), (P < .01).

Conclusion

ML significantly improves diagnostic performance of MPS by computational integration of quantitative perfusion and clinical data to the level rivaling expert analysis.     

Effet de l'intensité de l'entraînement sur les réponses en catécholamines à l'exercice supramaximal chez des endurants de sexe masculin

Introduction – In this study we compared catecholamine responses to the Wingate-test in 2 male endurance trained groups: 6 middle distance runners (DFC) (800m and 1500m) and 6 long distance runners (DFL) (5000 m and 10,000 m).Results – As expected DFL exibited higher maximal oxygen consumption (72 ± 2,5 vs 79 ± 4,5 ml min^–1kg ^–1 fat free mass respectively for DFC and DFL) and DFC exibited higher performances during the Wingate-test (15,8 ± 0,3 vs 14,7 ± 0,4 W kg^–1 fat free mass respectively for DFC and DFL). In opposite differences between maximal catecholamine responses (Adrénaline: 3,8 ± 0,7 vs 3,5 ± 0,3 nmol l^–1. Noradrénaline: 20,4 ± 1,5 vs 16 ± 2,1 nmol l^–1 respectively for DFC and DFL) and maximal plasma lactate were not significant.Conclusion – This results suggests that endurance specificity may not induce different catecholamines responses to sprint exercise.     

Validation of the mIBG skeletal SIOPEN scoring method in two independent high-risk neuroblastoma populations: the SIOPEN/HR-NBL1 and COG-A3973 trials

Background

Validation of the prognostic value of the SIOPEN mIBG skeletal scoring system in two independent stage 4, mIBG avid, high-risk neuroblastoma populations.

Results

The semi-quantitative SIOPEN score evaluates skeletal meta-iodobenzylguanidine (mIBG) uptake on a 0–6 scale in 12 anatomical regions. Evaluable mIBG scans from 216 COG-A3973 and 341 SIOPEN/HR-NBL1 trial patients were reviewed pre- and post-induction chemotherapy. The prognostic value of skeletal scores for 5-year event free survival (5 yr.-EFS) was tested in the source and validation cohorts. At diagnosis, both cohorts showed a gradual non-linear increase in risk with cumulative scores. Several approaches were explored to test the relationship between score and EFS. Ultimately, a cutoff score of ≤3 was the most useful predictor across trials. A SIOPEN score ≤ 3 pre-induction was found in 15% SIOPEN patients and in 22% of COG patients and increased post-induction to 60% in SIOPEN patients and to 73% in COG patients. Baseline 5 yr.-EFS rates in the SIOPEN/HR-NBL1 cohort for scores ≤3 were 47% ± 7% versus 26% ± 3% for higher scores at diagnosis (p < 0.007) and 36% ± 4% versus 14% ± 4% (p < 0.001) for scores obtained post-induction. The COG-A3973 showed 5 yr.-EFS rates for scores ≤3 of 51% ± 7% versus 34% ± 4% for higher scores (p < 0.001) at diagnosis and 43% ± 5% versus 16% ± 6% (p = 0.004) for post-induction scores. Hazard ratios (HR) significantly favoured patients with scores ≤3 after adjustment for age and MYCN-amplification. Optimal outcomes were recorded in patients who achieved complete skeletal response.

Conclusions

Validation in two independent cohorts confirms the prognostic value of the SIOPEN skeletal score. In particular, patients with an absolute SIOPEN score > 3 after induction have very poor outcomes and should be considered for alternative therapeutic strategies.

     

Changes caused by fluorescein in tear film by hybrid break-up time test- part one; on quantitative values

PurposeTo examine the effect of fluorescein on the tear film by measuring tear break-up time (BUT).MethodsIn this prospective study, after determining the natural BUT value of the tear with the non-invasive break-up time (NI-BUT) method, we re-evaluated the changes in the tear film stained with fluorescein using the topographical method. The topographic evaluation of tears stained with fluorescein was called as Hybrid-BUT (H-BUT) test. The first BUT (BUT₁), the second BUT (BUT₂), the third BUT (BUT₃), the fourth BUT (BUT₄), and the fifth BUT (BUT₅) values of each participant's NI-BUT and H-BUT tests were compared.ResultsThe present study was conducted with 82 participants. Although the mean BUT₁ value was 4.1 ± 2.7 s in the NI-BUT test, it was 5.1 ± 3.2 s in the H-BUT test (p = 0.029). The mean BUT₂ value was 5.0 ± 3.0 s in the NI-BUT test, and 6.2 ± 3.3 s in the H-BUT test (p = 0.029). The mean BUT₃ value in the NI-BUT test was 5.8 ± 3.4 s, and 7.2 ± 3.7 s in the H-BUT test (p = 0.021). The mean BUT₄ value in the NI-BUT test was 6.2 ± 3.4 s and 7.9 ± 3.9 s in the H-BUT test (p = 0.009).ConclusionsFluorescein causes changes in the break-up time test, and depending on this, in the tear film pattern. These changes can be compared and detected quantitatively and objectively of the fluorescein-stained tear film with the NI-BUT test and the topographic devices by using the H-BUT test.     

Hydratation dans les sports de glace. Étude du jeune hockeyeur

Objectives – To study the water balance of the young ice hockey players (12 to 13 years old) during their training sessions and one match.Methods – Twenty one players of an ice hockey club  are weighed before and after two training sessions and one match in order to evaluate their water balance in these different conditions. The exact amount of water ingested by each subject during the tests is measured.Results – Water intakes vary from 0.25 ± 0.51 to 0.84 ± 0.42 l h^–1 (mean ± standard deviation) in relation to the type of effort. The percentage of players who do not drink water falls from 65% at the first training session to 0% at the second one and the match. The highest loss is observed during the match. The average heart rate varies between 145 ± 11 and 163 ± 12 beats per minute during training and 171 ± 8 beats per minute during the match. From 0 to 60% of the total time of the players is above the anaerobic threshold, which indicates a very high variability of energy expenditure.Conclusion – The water loss at the end of these tests is close to that  observed by some authors for children during physical exercise. The tests show an increase in spontaneous drinking, as, after the second trial, a full rehydration of the players is observed.     

Stress radionuclide studies after acute myocardial infarction: Changes with revascularization

Background

Successful revascularization of ischemic asynergic myocardium should be followed by improvement in contractile function. However, a clear improvement is not always observed. Assessment of contractile reserve may allow a better evaluation of procedural results.

Methods and Results

To assess the changes in global and regional left ventricular ejection fraction (EF), as well as the contractile reserve after revascularization, equilibrium radionuclide angiography was performed in 16 patients with acute myocardial infarction who had periinfarct redistribution (observed in stress-rest-reinjection thallium single-photon emission computed tomography). Regional EF was defined in the asynergic region at rest, which corresponded to the infarct plus periinfarct areas. Both thallium single-photon emission computed tomography and equilibrium radionuclide angiography were performed at rest and during stress with dobutamine, up to a maximal dose of 40 μg/kg/min. The same studies were repeated 8±6 months after successful revascularization (nine coronary angioplasties and seven bypass procedures). After intervention, the thallium defect score decreased significantly at rest and during stress. Global EF changed from 45%±10% to 47%±11% (difference not significant) at rest and from 49%±12% to 63%±13% (p=0.0001) at peak stress. Regional EF changed from 27%±8% to 35%±18% (p=0.03) at rest and from 29%±10% to 56%±21% (p=0.0001) at peak stress.

Conclusions

In patients with asynergy caused by periinfarct ischemia, there can be an increase in regional but not global EF at rest after revascularization. However, both parameters improve at peak dobutamine dose. This indicates an improvement in contractile reserve.     

Noninvasive determination of myocardial blood flow, oxygen consumption and efficiency in normal humans by carbon-11 acetate positron emission tomography imaging

The aims of this study were: (1) to measure noninvasively and near simultaneously myocardial blood flow, oxygen consumption, and contractile function and (2) to analyze myocardial energy expenditure and efficiency at rest and during dobutamine stress in normal humans. Dynamic and gated carbon-11 acetate positron emission tomography (PET) imaging was performed in 11 normal subjects. The initial uptake of ¹¹C-acetate was measured to estimate myocardial blood flow. Oxygen consumption was derived from the monoexponential slope of the ¹¹C-clearance curve recorded during myocardial washout. ECG-gated systolic and diastolic images were acquired during the peak myocardial ¹¹C activity to measure left ventricular radius, myocardial wall thickness, and long axis length. Myocardial oxygen consumption and parameters of cardiac geometry were used to determine myocardial energetics and cardiac efficiency by tension-area area analysis. Myocardial blood flow averaged 0.8±0.06 ml min^–1 g^–1 at rest and 1.48±0.15 ml min^–1 g^–1 during dobutamine stress. Oxygen delivery and consumption were 151±13 and 88±15 μl O₂ min^–1 g^–1 at rest and increased to 291±31 and 216±31 μl O₂ min^–1 g^–1, respectively, during pharmacological stress (P<0.001). Oxygen extraction increased from 59%±8% at rest to 76%±9% during stress (P<0.001). Mechanical efficiency was 29%±6% at rest and 32%±6% during dobutamine stress (P=NS) while external work efficiency was 16%±6% at rest and increased to 21%±4% (P<0.01) during dobutamine stress. Stepwise linear regression analysis identified rate-pressure product and external cardiac work as major correlates of oxygen consumption. In summary, rapid dynamic and gated PET ¹¹C acetate imaging provides the unique capability to study noninvasively determinants of myocardial energy delivery, expenditure, and efficiency. Received: 15 March and in revised form 28 May 1999     

Anatomical and functional impact of verteporfin shortage in patients with chronic central serous chorioretinopathy

BackgroundTo describe the functional and anatomical impact that the worldwide shortage of verteporfin has had on patients diagnosed with chronic central serous chorioretinopathy (cCSCR) whose treatment with photodynamic therapy (PDT) had to be delayed.MethodsProspective observational study. Patients were divided into two groups based on the time interval since PDT had been indicated: groups 1 and 2, with waiting times of less and more than 9 months respectively. Best corrected visual acuity (BCVA), the maximum height of the subretinal fluid (MSRF) and subfoveal choroidal thickness (SFCT) at the baseline visit and the last visit were compared.Results49 eyes of 48 patients with cCSCR were included. The mean waiting time for PDT was 9.0 ±3.8 months. The mean BCVA was 69.0 ±17.1 letters and 68.9 ±16.4 letters for the baseline and last visit respectively, showing no difference (p= 0.958). Although there was no difference in the mean global BCVA, 15 eyes (30.5%) showed a deterioration of ≥5 letters, including 7 eyes (14%) with a decrease of ≥10 letters. Mean MSRF height was 151.4 ±97.2 μm and 98.2 ±83.1 μm for the baseline and last visit respectively (p= 0.005), persisting in 74.5% of the eyes.ConclusionNo significant impact was observed in the BCVA in cCSCR due to the shortage of verteporfin. However, one-third of patients had BCVA loss. There was a significant spontaneous decrease in MSRF, but it persisted in the majority of the patients, still susceptible to PDT.     

Single-Center Retrospective Study of Preoperative Prostatic Artery Embolization with the Use of Gelatin Sponge: Initial Experience and Influence for Blood Loss in Prostate Surgery

PurposeTo investigate the safety and effectiveness of preoperative prostatic artery embolization (PAE) in relation to decrease in hemoglobin level, requirement for blood transfusion, length of hospitalization, and procedure-related complications.Materials and MethodsTen consecutive patients who underwent surgery after preoperative PAE were identified from May 2017 to October 2018 (embolization group: holmium-laser enucleation of the prostate [HoLEP] in 6 patients and robotic simple prostatectomy in 4 patients, mean age 72.9 ± 8.7 years, mean prostatic volume 106.5 ± 22.0 mL). For comparison, consecutive patients with a large prostatic volume (≥70 mL) who underwent surgery without preoperative PAE during the same period were enrolled (nonembolization group: HoLEP in 9 patients and robotic simple prostatectomy in 1 patients, mean age 71.2 ± 5.7 years, mean prostatic volume 87.8 ± 26.7 mL).ResultsPAE was technically successful in 90% of patients (9/10). The median interval between PAE and surgery was 2 days. The mean hemoglobin reduction was lower (1.40 ± 0.92 g/dL vs 3.07 ± 1.50 g/dL; P = .008) and the median length of hospitalization was shorter (8.5 days vs 11 days; P = .039) in the embolization group than the nonembolization group. The operating time (mean for HoLEP 146 ± 38 min vs 179 ± 59 min [P = .248], mean for robotic simple prostatectomy 223 ± 32 min vs 354 min) and number of blood transfusion (1 patient vs 2 patients; P = .392) were not significantly different between the 2 groups. None of the patients developed any complications except bleeding requiring transfusion.ConclusionsPreoperative PAE is safe and may reduce blood loss during prostate surgery.     

Transarterial Chemoembolization with Drug-eluting Beads in Hepatocellular Carcinoma: Usefulness of Contrast Saturation Features on Cone-Beam Computed Tomography Imaging for Predicting Short-term Tumor Response

PurposeTo evaluate the predictability of the short-term tumor response and the clinical usefulness of cone-beam computed tomography (CT) performed immediately after drug-eluting bead (DEB) transarterial chemoembolization in patients with unresectable hepatocellular carcinoma (HCC).Materials and MethodsThis retrospective study comprised 90 patients (male-to-female ratio = 66:24; mean age, 60.4 y) with 119 tumors (mean size, 3.2 cm). All patients underwent DEB transarterial chemoembolization and received cone-beam CT after embolization. The marginal contrast saturation was defined as a contrast stasis that was observed along the margin of the tumor on the cone-beam CT images. The degree of marginal contrast saturation was calculated as a percentage and was classified into five grades in 25% increments. The degree of marginal contrast saturation and the tumor response were correlated based on follow-up imaging.ResultsThere was a complete response in 63.8% (n = 76) of all tumors. Partial response, stable disease, and progressive disease were identified in 21.8% (n = 26), 13.4% (n = 16), and 0.8% (n = 1) of tumors. Marginal contrast saturation by cone-beam CT was 86%±16.3, 73.2%±28.8, 16.9%±27.2, and 0% for complete response, partial response, stable disease, and progressive disease, which indicated a significant correlation of a higher contrast saturation with a better response (P<.001) by follow-up imaging criteria. The positive predictive value of the G5 group showing a complete response was 98.1%.ConclusionsMarginal contrast saturation showed a high positive predictive value for short-term tumor response. This technique may improve the success rates of DEB transarterial chemoembolization procedures and may reduce technical difficulties and shorten procedural time.     

Synthesis and application of 188Re-MN-16ET/Lipiodol in a hepatocellular carcinoma animal model

IntroductionHepatocellular carcinoma is the most common form of primary hepatic carcinoma. A new N₂S₂ tetradentate ligand, N-[2-(triphenylmethyl)thioethyl]-3-aza-19-ethyloxycarbonyl-3-[2-(triphenylmethyl)thioethyl]octadecanoate (H₃MN-16ET), was introduced and labeled with ¹⁸⁸Re to create ¹⁸⁸Re-MN-16ET in the Lipiodol phase. The potential of ¹⁸⁸Re-MN-16ET/Lipiodol for hepatoma therapy was evaluated in a hepatocellular carcinoma animal model of Sprague–Dawley rats implanted with the N1S1 cell line.MethodsSynthesis of H₃MN-16ET was described, and characterization was identified by infrared, nuclear magnetic resonance and mass spectra. We compared the effects of transchelating agents (glucoheptonate or tartaric acid) and a reducing agent (stannous chloride) on the complexing of ¹⁸⁸Re-perrhenate and H₃MN-16ET. Twenty-four rats implanted with hepatoma were injected with 3.7 MBq/0.1 ml of ¹⁸⁸Re-MN-16ET/Lipiodol or ¹⁸⁸Re-MN-16ET via transcatheter arterial embolization. Biodistribution experiments and single-photon emission computed tomography imaging were performed to investigate tumor accumulation.ResultsH₃MN-16ET was proved to easily conjugate with the Re isotope and showed good solubility in Lipiodol. The radiochemical purity of ¹⁸⁸Re-MN-16ET/Lipiodol with 10 mg tartaric acid and stannous chloride was shown to be more than 90%. The major distribution sites of ¹⁸⁸Re-MN-16ET in Sprague–Dawley rats were hepatoma and the liver. However, the radioactivity at the tumor site postadministered with ¹⁸⁸Re-MN-16ET was quickly decreased from 9.15±0.23 (at 1 h) to 2.71%±0.18% of injected dose/g (at 48 h). The biodistribution and micro-single-photon emission computed tomography/computed tomography image data showed that ¹⁸⁸Re-MN-16ET/Lipiodol was selectively retained at the tumor site, with 11.55±1.44, 13.16±1.46 and 10.67%±0.95% of injected dose/g at 1, 24 and 48 h postinjection, respectively. The radioactivity in normal liver tissue was high but significantly lower than that of the tumors.ConclusionH₃MN-16ET is a suitable tetradentate ligand for ¹⁸⁸Re labeling. From the animal data, we suggest that ¹⁸⁸Re-MN-16ET/Lipiodol has the potential to be a therapeutic radiopharmaceutical for hepatoma treatment.     

Automated attenuation-based selection of tube voltage and tube current for coronary CT angiography: Reduction of radiation exposure versus a BMI-based strategy with an expert investigator

BackgroundRecently developed automated algorithms use the topogram and the corresponding attenuation information before coronary CT angiography (CTA) to allow for an individualized anatomic-based selection of tube current (mAs) and voltage (kV).ObjectivesThe value of these algorithms in reducing the associated radiation exposure was evaluated.MethodsOne hundred patients underwent coronary CTA with dual-source CT with prospectively electrocardiogram-triggered axial data acquisition. In all patients, tube parameters (current and voltage) were suggested by both an experienced investigator according to the patient's body mass index (BMI; calculated as weight divided by height squared; kg/m²) and by an automated software according to attenuation values of the initial topogram. The first 50 consecutive patients (group 1) underwent coronary CTA with dual-source CT with tube parameters suggested by the experienced investigator (BMI-based tube parameters), whereas in another 50 consecutive patients (group 2) CT data acquisition was performed with tube settings of the automated software. Subsequently, subjective image quality (4-point rating score from 0 = nondiagnostic to 3 = excellent image quality), image noise (SD of CT number within the aortic root), as well as signal- and contrast-to-noise ratios and mean effective radiation doses, were compared between both groups.ResultsBoth groups showed comparable image quality parameters (group 1 vs 2: noise, 28.1 ± 6.0 HU vs 29.9 ± 5.4 HU, P = .12; signal-to-noise ratio, 16.4 ± 3.9 vs 16.8 ± 4.1, P = .54; contrast-to-noise ratio, 18.6 ± 4.1 vs 19.2 ± 4.3, P = .49; 4-point rating score, 2.8 ± 0.3 vs 2.9 ± 0.3, P = .81). Tube voltage, current, and mean effective radiation dose for groups 1 and 2 were 111 ± 12 kV and 108 ± 12 kV (P = .18), 361 ± 32 mAs and 320 ± 48 mAs (P < .001), and 2.3 mSv (25th; 75th percentile, 1.5; 2.8 mSv) and 1.4 mSv (25th; 75th percentile, 1.1; 1.9 mSv) (P < .001), respectively.ConclusionsAutomated attenuation-based selections of individualized tube parameters are superior to BMI-based selections with expert oversight and show a potential for reduction of radiation exposure in coronary CTA, and image quality is maintained.