Modified Surgical Drain–Guided Percutaneous Catheter Drainage of Postoperative Fluid Collection in Inaccessible Locations

PurposeTo investigate the feasibility and safety of a modified surgical drain–guided percutaneous catheter drainage technique for postoperative fluid collection in inaccessible locations.Materials and MethodsThe modified technique was used in 24 patients (age, 58.6 years ± 11.3; men, 58.3%) from September 2015 to March 2021. All fluid collections had no safe access route on preprocedural computed tomography (CT) images. Every patient had a long (>20 cm) and tortuous surgical drain, which prevented the use of conventional surgical drain exchange. A favorable midpoint of the surgical drain tract was punctured under either ultrasound or fluoroscopic guidance, and a guide wire was advanced into the fluid collection. Technical success was defined as the successful placement of a drainage catheter, and clinical success was defined as the complete evacuation of fluid collection without recurrence. Follow-up was performed using CT images and a chart review. Adverse events within 30 days of the procedure were evaluated.ResultsTarget fluid collections in the pelvic cavity (n = 9); subphrenic (n = 7), peripancreatic (n = 4), and subhepatic spaces (n = 3); and abdominal cavity (n = 1) were drained using catheters measuring 7–10.2 F in diameter and 25–30 cm in length. The technical success rate was 91.7% (22/24), and the clinical success rate was 90.9% (20/22). No procedure-related or catheter-related adverse events were observed. The median follow-up period was 8.2 months (range, 10–1,721 days).ConclusionsThe modified surgical drain–guided percutaneous catheter drainage technique is a useful alternative when conventional exchange techniques cannot be used because of long and tortuous surgical drain paths.     

Geometrical Measurement of Central Tumor Location in cT1N0M0 NSCLC Predicts N1 but Not N2 Upstaging

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Molecular imaging in oncology: Current impact and future directions

The authors define molecular imaging, according to the Society of Nuclear Medicine and Molecular Imaging, as the visualization, characterization, and measurement of biological processes at the molecular and cellular levels in humans and other living systems. Although practiced for many years clinically in nuclear medicine, expansion to other imaging modalities began roughly 25 years ago and has accelerated since. That acceleration derives from the continual appearance of new and highly relevant animal models of human disease, increasingly sensitive imaging devices, high-throughput methods to discover and optimize affinity agents to key cellular targets, new ways to manipulate genetic material, and expanded use of cloud computing. Greater interest by scientists in allied fields, such as chemistry, biomedical engineering, and immunology, as well as increased attention by the pharmaceutical industry, have likewise contributed to the boom in activity in recent years. Whereas researchers and clinicians have applied molecular imaging to a variety of physiologic processes and disease states, here, the authors focus on oncology, arguably where it has made its greatest impact. The main purpose of imaging in oncology is early detection to enable interception if not prevention of full-blown disease, such as the appearance of metastases. Because biochemical changes occur before changes in anatomy, molecular imaging—particularly when combined with liquid biopsy for screening purposes—promises especially early localization of disease for optimum management. Here, the authors introduce the ways and indications in which molecular imaging can be undertaken, the tools used and under development, and near-term challenges and opportunities in oncology.     

不同性别骨性Ⅱ类无鼾青少年患者的上气道、舌骨及牙颌软硬组织差异性研究

目的:比较不同性别12～16岁青少年上气道、舌骨及牙颌软硬组织差异及其相关性，为临床制定具有性别差异的诊疗参考。方法:选择70例骨性Ⅱ类青少年患者，男女比例为1∶1，年龄、垂直骨面型严格匹配。用Invivo 5进行三维重建并测上气道、舌骨及牙颌软硬组织指标，进行独立样本 t检验及Pearson相关性分析。 结果:男、女性患者舌咽体积分别为[(6.68±2.71) cm 3、(5.36±1.73) cm 3， P＝0.019]，男、女性患者舌骨垂直距离分别为[(101.56±16.72) mm、(92.44±19.11) mm, P＝0.037]，具有统计学意义。男、女性Y轴角、NP-FH、RH、PFH、AFH、FHR、OP-SN、IOB、U1-E、Sn-G均有统计学意义。男性上气道与颌骨有显著相关性，女性上气道与牙齿角度及软组织有显著相关性。 结论:男性舌咽体积更大，牙颌软硬组织趋向于 平面平整且上唇及颏部靠前的水平生长型。临床上制定不同性别的诊疗方案时，男性趋向于着重考虑颌骨指标对上气道及舌骨的影响，女性着重考虑牙性指标对上气道及舌骨的影响，旨在逐步建立反映不同性别患者特征的颌骨及牙性指标，为预判不同性别患者治疗后上气道形态及舌骨位置的改变提供一定参考依据。