MR引导下高强度聚焦超声消融子宫肌瘤温度曲线参数与治疗效果的关系

目的观察MR引导下高强度聚焦超声(HIFU)消融子宫肌瘤温度曲线参数与治疗效果的关系。方法对31例子宫肌瘤患者行MR引导下高强度聚焦超声消融子宫肌瘤,通过HIFU消融子宫肌瘤过程中的热量分布情况获得温度曲线,然后利用Matlab语言编程计算以下温度曲线参数:温度上升斜率、温度下降斜率、曲线下面积、加热时间、最高平均温度和温度达峰时间。应用Spearman秩相关性检验分析HIFU治疗前与治疗后6个月子宫肌瘤体积变化与治疗过程中温度曲线参数的关系。结果治疗后6个月,子宫肌瘤体积平均缩小率为(39.43±27.01)%;子宫肌瘤HIFU消融过程中,温度曲线示温度上升斜率为(0.97±0.84)℃/s,温度下降斜率为(-0.56±0.39)℃/s,曲线下面积为(2 240.03±455.93)℃·s,加热时间为(28.34±12.88)s,最高平均温度为(47.01±4.63)℃,温度达峰时间为(22.79±9.47)s。温度下降斜率与子宫肌瘤体积缩小率呈正相关(r_s=0.473,P=0.007)。结论 MR引导下HIFU消融后子宫肌瘤温度下降越慢,治疗效果越好。     

Heart Rate and Energy Expenditure During Aqua Dynamics

In brief: The heart rate, oxygen uptake, and energy expenditure of three young women were measured during 20-minute low-gear, 30-minute middle-gear, and 60-minute high-gear aqua dynamics workouts. All three workouts were moderate in intensity, eliciting average heart rates of 132 to 143 beats min^?1 (70% to 77% HR max), average oxygen uptakes of 1.2 to 1.3 liters min^?1 (51% to 57% VO₂ max), and average energy expenditures of 5.9 to 6.5 kcals min^?1 The findings indicate that aqua dynamics could be a beneficial conditioning program for people who have relatively low physical work capacity and enjoy swimming but cannot conveniently engage in lap swimming.     

In vivo feasibility of image-guided transvaginal focused ultrasound therapy for the treatment of intracavitary fibroids

OBJECTIVE: To determine the feasibility of uterine tissue ablation in vivo using a transvaginal focused ultrasound applicator guided by ultrasound imaging. DESIGN: Randomized in vivo animal study. SETTING: Academic research environment. ANIMAL(S): Healthy anesthetized sheep. INTERVENTION(S): Uterine treatment location was determined using a computerized targeting system. Five sonications 10 seconds in duration and averaging 2,000 W/cm(2) of focal ultrasound intensity were applied in each animal's uterus. Animals were euthanized either immediately or 2, 7, or 30 days post-treatment. MAIN OUTCOME MEASURE(S): Gross and microscopic analysis of the dissected uterus was used to quantitatively and qualitatively determine the ablated region and treatment side effects. RESULT(S): Treatments resulted in coagulative necrosis. Histopathological analysis showed that over 7 days, inflammatory cells appeared and smooth muscle bundles regenerated. By day 30, treated tissues healed and scar tissue formed. None of the animals showed abnormal behavior or medical problems. Complications in three animals were damage to the vaginal wall and colon, possibly due to inadequate applicator cooling and an empty bladder during treatment. CONCLUSION(S): Transvaginal image-guided high-intensity focused ultrasound has potential for treating uterine fibroids. Further safety testing of this treatment will prepare it for human use.     

3.0 TMRI对子宫肌瘤高强度聚焦超声治疗后的早期效果评价

目的 采用3.0 TMRI平扫及增强扫描对子宫肌瘤高聚焦超声(HIFU)早期疗效评价.方法 33例子宫肌瘤患者,其中单发肌瘤20例,多发肌瘤13例,共59个,患者平均年龄(34.3±8.7)岁,所有患者均于HIFU术前及术后1 d行MRI平扫、增强扫描检查,观察并定量测定肌瘤、肌壁HIFU术前、后T2压脂、T2WI、T1WI平扫及增强扫描信号值,并计算肌瘤最大消融区面积,对其疗效进行评估.结果 59个肌瘤于HIFU术后在T1WI增强扫描序列均出现无强化的消融区,平均消融率达70.9%.MRI增强扫描消融区T1信号值与术前比较明显减低(P<0.01).术后消融区在T1平扫像上呈不同程度高信号,T2像上消融区范围显示不明确,但T2信号值较术前明显升高(P<0.01).MRI平扫所见术后T1信号增高区1.0 cm)肌壁T2压脂信号各组间均无统计学差别.结论 3.0 TMRI增强扫描可以直观、准确的显示肌瘤消融区,T1术后高信号区可以显示肌瘤HIUF术后坏死区,可以评价消融范围.     

The possible combinatory effects of acute consumption of caffeine,creatine, and amino acids on the improvement of anaerobic running performance in humans

Preexercise nutritional investigations have recently become a popular avenue of examining the interaction of multiple ingredients on exercise and training methods. The critical velocity (CV) test is used to quantify the relationship between total running distance and time to exhaustion (TTE), yielding aerobic (CV) and anaerobic parameters (anaerobic running capacity [ARC]). The purpose of this study was to examine the hypothesis that a preexercise supplement containing caffeine, creatine, and amino acids (Game Time; Corr-Jen Laboratories Inc, Aurora, CO) would positively impact CV and ARC in college-aged men and women. In a single-blind crossover design, 10 participants consumed the preexercise supplement (ACT) or placebo (PL) before each testing session. Each participant completed runs to exhaustion on a treadmill at 110%, 90% (day 1), and 105% and 100% (day 2) of the peak velocity (PV) determined from a graded exercise test. The ACT elicited a 10.8% higher ARC (P = .02) compared with the PL, whereas no difference was found in CV (0.6%, P = .38). The TTE was greater for the ACT than the PL at 110% (ACT = 125.7 ± 9.6 seconds, PL = 117.3 ± 12.6 seconds), 105% (ACT = 156.9 ± 11.0 seconds, PL = 143.8 ± 12.9 seconds), and 100% PV (ACT = 185.7 ± 10.7 seconds, PL = 169.7 ± 12.8 seconds) (P = .01-.04); but there was no difference for the TTE at 90% PV (ACT = 353.5 ± 52.7 seconds, PL = 332.7 ± 54.0 seconds) (P = .08). These findings suggest that the acute ingestion of this preexercise supplement may be an effective strategy for improving anaerobic performance, but appears to have no effect on aerobic power.     

Probiotic Supplementation and High-Intensity Interval Training Modify Anxiety-Like Behaviors and Corticosterone in High-Fat Diet-Induced Obesity Mice

Evidence supports the role of exercise training and probiotics on reducing obesity. Considering the relationship between obesity and high-fat diet with anxiety indices, the aim of this study was to assess the effect of probiotic supplementation and high-intensity interval training (HIIT) on anxiety-like behaviors, corticosterone and obesity indices in high-fat diet (HFD)-induced obesity mice. Thirty male adult C57BL/6 mice were randomly divided into five groups: (1) Control with normal diet (CON), (2) High-fat diet (HFD), (3) HFD + exercise training (HT), (4) HFD + probiotics supplement (HP) and (5) HFD + exercise training +probiotics (HTP). Exercise training consisted of 8 weeks of high-intensity interval training (HIIT) programs. Probiotics supplement included 0.2 mL Lactobacillus rhamnosus GG. Anxiety-like behaviors were measured by open field (OF) and Elevated plus maze (EPM). OF and EPM tests, visceral fat mass (VFM) measurement, and blood sampling for corticosterone were performed after the intervention. Bodyweight was measured at different stages during the intervention. HFD regime in C57BL/6 mice increased bodyweight, VFM, and serum corticosterone levels and anxiety-like behaviors (p < 0.05). HIIT, probiotic and their combination, decreased bodyweight, VFM, and serum corticosterone levels and improved anxiety-like behavior in the HFD mice (p < 0.05). The effect of a combination of HIIT and probiotic on most of the anxiety indices was more than each one separately (p < 0.5). HIIT and probiotic supplements separately or above all in combination, may have beneficial effects in reducing obesity and anxiety indices.     

Intoxication and binge and high-intensity drinking among US young adults in their mid-20s

ABSTRACT

Background: Alcohol use is a key risk factor for young adult mortality and disease, but limited research has focused on high-risk alcohol use among individuals moving from early young adulthood into building and maintaining an initial structure of adult life. This study estimated the prevalence of a range of alcohol use behaviors among US young adults aged 25/26, examined evidence for historical change in prevalence rates, and estimated associations between alcohol use and key demographic, substance use, and adult social role characteristics. Methods: Data were obtained from 3542 individuals selected for follow-up from the nationally representative 12th-grade student Monitoring the Future study. Respondents self-reported alcohol use behaviors at age 25/26 during calendar years 2005–2014. Results: Two fifths (39.9%) of young adults aged 25/26 reported being intoxicated at least once in the past 30 days; 25.6% reported usually experiencing a sustained high of 3 or more hours when drinking alcohol. Past-2-week binge drinking (5+ drinks in a row) was reported by 36.3% of respondents. Past-2-week high-intensity drinking (10+ drinks in a row) was reported by 12.4%. These age 25/26 alcohol use prevalence rates remained stable over the 10 years of data examined, in contrast to significant declines over historical time in alcohol prevalence rates among these same individuals at age 18. High-risk drinking was particularly associated with being male, white, unmarried, employed, a nonparent, and an alcohol user before finishing high school. Conclusions: Among US young adults in their mid-20s, alcohol use was highly normative and frequently included participation in high-risk drinking behaviors. High-risk alcohol use prevention approaches developed specifically to reach young adults in their mid-20s are needed, as well as efforts to increase proactive clinician screening to identify young adults participating in high-risk alcohol use.     

Establishment of a scoring system for predicting the difficulty level of high-intensity focussed ultrasound ablation of uterine fibroids

Purpose: To establish a scoring system that predicts the difficulty level of high-intensity focussed ultrasound (HIFU) ablation of uterine fibroids.

Materials and methods: Four hundred and twenty-two patients with fibroids were enrolled. The energy efficiency factor (EEF) and sonication time were set as dependent variables, with factors possibly affecting EEF and sonication time including age, body mass index (BMI), the volume of fibroids, the location of the uterus, the type of fibroids, the signal intensity on the T2-weighted imaging (T2WI), the enhancement type, the thickness of the rectus abdominis and the subcutaneous fat layer, the distance from the anterior/posterior surface of the fibroid to the skin, and the abdominal wall scars were set as predictors for building optimal scaling regression models.

Results: The volume of the fibroids, the location of the uterus, the signal intensity on T2WI, enhancement type, rectus abdominis thickness, subcutaneous fat thickness, and distance from the anterior surface of fibroid to the skin were related to EEF. Signal intensity on T2WI, the volume of fibroids, distance from the posterior surface of fibroid to the skin, and enhancement type were related to sonication time. Models that can predict the difficulty level of HIFU for fibroids have been established: for EEF, y?′?=?0.338X?′₁???0.231X?′₂+0.156X?′₃+0.167X?′₄?; for sonication time, y?=?0.227X₁+0.321X₂+0.157X₃+0.194X₄.

Conclusions: A scoring system for predicting the difficulty level of HIFU treatment for uterine fibroids has been established and it can be used to help select patients and to predict the sonication time for a given fibroid.     

Thermal diffusivity and perfusion constants from in vivo MR-guided focussed ultrasound treatments: a feasibility study

Purpose: This study investigates the feasibility of non-invasively determining thermal diffusivity (α) and the Pennes perfusion parameter (w) from pre-clinical and clinical magnetic resonance-guided focussed ultrasound (MRgFUS) temperature data.

Materials and methods: Pre-clinical MRgFUS experiments were performed in rabbit muscle (N?=?3, 28 sonications) using three-dimensional MR thermometry. Eight sonications were made in a clinical QA phantom with two-dimensional thermometry. Retrospective property determination was performed on clinical uterine fibroid (N?=?8, 9 sonications) and desmoid tumour (N?=?4, 7 sonications) data. The property determination method fits an analytical solution to MRgFUS temperatures in the coronal MR plane, including all temperatures acquired during heating and one cooling image. When possible, additional cooling data were acquired for property determination.

Results: Rabbit α and w from Heating Data (α?=?0.164?mm²s^?1, w?=?7.9 kg?m^?3?s^?1) and Heating and Cooling Data (α?=?0.146?mm²s^?1, w?=?3.3 kg?m^?3?s^?1) were within the range of gold-standard invasive measurements, with >50% reduction in variability by including cooling data. QA phantom property determination with cooling data yielded properties within 3% of expected values (α?=?0.144?mm²s^?1, w?=?0.0 kg?m^?3?s^?1), a difference that was not statistically significant (p?=?0.053). Uterine fibroid (Heating Data: α?=?0.212?mm²s^?1, w?=?11.0 kg?m^?3?s^?1) and desmoid tumour (Heating &; Cooling Data: α?=?0.245?mm²s^?1, w?=?4.7 kg?m^?3?s^?1) properties are feasible but lack independent verification.

Conclusions: Thermal diffusivity and the Pennes perfusion parameter can be obtained from in vivo data and with clinical MRgFUS protocols. Property values are consistently improved by including cooling data. The utility of this property determination method will increase as clinical protocols implement improved temperature imaging.