Prevention of contrast‐induced acute kidney injury in patients with stable chronic renal disease undergoing elective percutaneous coronary and peripheral interventions: Randomized comparison of two preventive strategies

Objective : We compared use of intravenous (IV) normal saline (NS) to sodium bicarbonate (NaHCO₃) with or without oral N‐acetylcysteine (NAC) for prevention of contrast‐induced acute kidney injury (CI‐AKI). Background : CI‐AKI is associated with significant adverse clinical events. Use of NAC has produced variable results. Recently, intravenous hydration with NaHCO₃ for CI‐AKI prophylaxis has been adopted as standard treatment for patients with stable chronic renal disease undergoing catheterization procedures. Methods : We prospectively enrolled 320 patients with baseline renal insufficiency scheduled to undergo catheterization. Patients were randomly assigned to receive either IV NS ± NAC (n = 161) or IV dextrose 5% in water containing 154 mEq/l of NaHCO₃ ± NAC (n = 159). IV NS was administered at 1 ml/kg body weight for 12 hr preprocedure and 12 more hr postprocedure. IV NaHCO₃ was administered at 3 ml/kg body weight for 1 hr preprocedure followed by 1 ml/kg body weight postprocedure. A 1,200 mg oral dose of NAC was given 2–12 hr preprocedure and 6–12 hr postprocedure in 50% of patients in each study arm. CI‐AKI was defined as an increase of >0.5 mg/dl or >25% above baseline creatinine. Results : Overall incidence of CI‐AKI was 10.3%. There was no significant difference in incidence among the two groups (NS ± NAC 11.8% vs. NaHCO₃ ± NAC 8.8%, p = ns). Incidence of CI‐AKI increased with increasing age (p = 0.001), contrast agent use >3 ml/kg body weight (p = 0.038) and diuretic use (p = 0.005). Conclusion : Incidence of CI‐AKI was no different in the NaHCO₃ group compared to NS group, and NAC did not reduce CI‐AKI in the two study arms. © 2011 Wiley Periodicals, Inc.     

Synthesis and Evaluation of [67Ga]-AMD3100: A Novel Imaging Agent for Targeting the Chemokine Receptor CXCR4

In order to develop a possible C-X-C chemokine receptor type 4 (CXCR4) imaging agent for oncological scintigraphy, [⁶⁷Ga]-labeled 1,1′-[1,4-Phenylene-bis(methylene)]bis(1,4,8,11-tetraazacyclotetradecane) ([⁶⁷Ga]-AMD3100) was prepared by using [⁶⁷Ga]GaCl₃ and AMD-3100 for 2 h at 50 °C (radiochemical purity: >95% ITLC, >99% HPLC, specific activity: 1800–2000 TBq/mmol) in acetate buffer. The stability of the complex was checked in the presence of human serum (37 °C) and in the final formulation for four days. The biodistribution of the labeled compound in the vital organs of wild type Sprague-Dawley rats was determined and compared with that of the free Ga³⁺ cation up to 48 h. Considering the spleen as the target organ, the best target:non target ratios were obtained 48 h post-injection (spleen:blood ratio; 14.5 and spleen:muscle ratio; 88.4). Initial SPECT images and biodistribution results in the wild type rats matched each other and demonstrated rapid washout of the tracer from the urinary tract. SPECT images in human breast carcinoma-bearing mice demonstrated a detectable tumor uptake in 48 h post-injection.     

The Effect of Tropical Environment on Fatigue Failure in Royal Malaysian Airforce (RMAF) Aircraft Structure and Operational Readiness

The environmental condition in which the Royal Malaysian Airforce is currently operating its aircraft is prone to corrosion. This is due to the high relative humidity and temperature. With most of its aircraft being in the legacy aircraft era, the aircraft’s main construction consists of the aluminium 2024 material. However, this material is prone to corrosion, thus reducing fatigue life and leading to fatigue failure. Using the concept of either Safe Life or Damage Tolerance as its fatigue design philosophy, the RMAF adopts the Aircraft Structure Integrity Program (ASIP) to monitor its structural integrity. With the current problem of not having the structural limitation on corrosion-damaged structure, the RMAF has embarked on its fatigue testing method. Finite Element (FE) studies and flight tests were conducted, and the outcome is summarized. The conclusion is that the longeron tested on the aircraft can withstand the operational load, and its yield strength is below the ultimate yield strength of the material. These research outcomes will also enhance the ASIP for other aircraft platforms in the RMAF fleet for its structure life assessment or service life extension program.     

Transseptal use of high-density grid catheter for VT mapping and retrograde hemodynamic support with Impella pump in presence of Mitraclips

Journal of Interventional Cardiac Electrophysiology - We sought to establish the technical feasibility of VT-mapping with high-density catheters in patients with Mitraclips, requiring a hemodynamic...