Comparison of the effects of erythropoietin and its carbamylated derivative on behaviour and hippocampal neurogenesis in mice

Erythropoietin (EPO), a well known haematopoietic growth factor, possesses neuroprotective and neurotrophic effects which have been recently reported to improve cognition and to modulate emotional processing. We investigated the effects of EPO and of its non-erythropoietic carbamylated derivative (CEPO) on memory- and emotion-related behaviour in the adult mouse. Locomotor activity, memory performances (place and object recognition tasks), anxiety- (light/dark transition test) and despair-like behaviours (tail suspension test) were assessed over 6 weeks of repeated EPO or CEPO administration (40 μg/kg, twice a week). Given the potential involvement of hippocampal neurogenesis in memory, we also assessed the effects of EPO and CEPO on neurogenesis in the dentate gyrus. Both treatments improved spatial and non-spatial recognition memory and increased the number of NeuN/BrdU double-labeled cells in the dentate gyrus. These effects seem to be, at least partly, independent from an haematopoietic action since administration of CEPO leads to the similar results. Moreover, CEPO decreased, albeit modestly, despair-related behaviour and tended to decrease anxiety-like behaviour. These results suggest that CEPO is as an attractive molecule for the treatment of neuropsychiatric diseases associating memory and/or emotional disorders.     

Transcatheter arterial embolization of splenic artery aneurysms and pseudoaneurysms: short- and long-term results

We evaluated outcomes of endovascular treatment of splenic artery aneurysms and pseudoaneurysms. From April 2002 to May 2007, 17 patients (mean age 55.2 years, range 17-82) with splenic artery aneurysms (n = 7) or pseudoaneurysms (n = 10) underwent endovascular treatment. Six patients were asymptomatic, three had symptomatic nonruptured aneurysms, and eight had ruptured aneurysms. Lesions were in the proximal splenic artery (n = 5), intermediate splenic artery (n = 3), splenic hilum (n = 6), or parenchyma (n = 3). Embolization was with microcoils by sac packing (n = 8), sandwich occlusion of the main splenic artery (n = 4), or cyanoacrylate glue into the feeding artery (n = 4). Computed angiotomography was done within the first month and magnetic resonance angiography after 6 and 12 months, then yearly. Mean follow-up was 29 months (range 1-62). Exclusion of the aneurysm was achieved in 16 (94.1%) patients. One patient with an intraparenchymal pseudoaneurysm underwent splenectomy after failed distal catheterization. No major complications occurred. Postembolization syndrome developed in four patients, who had radiographic evidence of splenic microinfarcts. Transcatheter embolization of splenic artery aneurysms/pseudoaneurysms is safe and effective and may induce less morbidity than open surgery, in particular by preserving the spleen. Coil artifacts may make magnetic resonance angiography preferable over computed tomography for follow-up.     

Vascular complication after insertion of a subcutaneous contraceptive implant

Implanon is a reliable method of contraception widely used in France and around the world. Cases of difficulties encountered in inserting or removing the implant have been described. We report the first case of an insertion accident that led to occlusion of the right brachial artery and required exploratory vascular surgery.     

Combined SPIO–gadolinium magnetic resonance imaging in cirrhotic patients: negative predictive value and role in screening for hepatocellular carcinoma

BACKGROUND: The objective of our study was to assess the negative predictive value (NPV) of double-contrast MRI (DC-MRI) with SPIO and gadolinium, and to determine the role of DC-MRI in screening for hepatocellular carcinoma (HCC) in cirrhotic patients. METHODS: We retrospectively included 160 DC-MRI scans done as second-line investigations in 119 patients with cirrhosis over a 25-month period. Two radiologists independently classified the MRI scans as strongly suggesting HCC (HCC Group), showing benign nodules (benign nodules Group), showing no nodules (no-nodules Group) or indeterminate; they assigned a diagnostic confidence score (DCS) using a 0-10 scale. The reference standard was histology or results of follow-up investigations. Mean follow-up was 16.9 months (12-28 months). RESULTS: The radiologists disagreed for two scans (kappa = 0.98). Of 112 scans [benign nodules Group (n = 32) and no-nodules Group (n = 80)], 11 were excluded (3 patients lost to follow-up and 8 who died with no known cancer) while a HCC was detected during follow-up in 8 patients, yielding a NPV of 92% (93/101) (95% confidence interval, 85%-97%). The DCS was in the 4-6 range (indicating uncertainty) for only 6 (3.75%) scans. CONCLUSIONS: DC-MRI is reliable and reproducible. Its high NPV suggests a role as a second-line investigation after ultrasonography, for HCC screening.     

Comparing the Detectability of Hepatocellular Carcinoma by C-Arm Dual-Phase Cone-Beam Computed Tomography During Hepatic Arteriography With Conventional Contrast-Enhanced Magnetic Resonance Imaging

Purpose  

To evaluate the sensitivity of dual-phase cone-beam computed tomography during hepatic arteriography (CBCTHA) for the detection of hepatocellular carcinoma (HCC) by comparing it with the diagnostic imaging “gold standard”: contrast-enhanced magnetic resonance imaging (CE-MRI) of the liver.