Advances in Therapeutic Development for Radiation Cystitis

Radiation treatment for pelvic malignancies is typically associated with radiation injury to urinary bladder that can ultimately lead to radiation cystitis (RC). The late sequelae of radiation therapy may take many years to develop and include bothersome storage symptoms such as hematuria, which may be life‐threatening in severe cases of hemorrhagic cystitis. Although no definitive treatment is currently available, various interventions are used for radiation and hemorrhagic cystitis including blood transfusion, bladder irrigation, intravesical instillation of substances such as alum, silver nitrate, prostaglandins or formalin, and fulguration of intravesical bleeding sites and surgery options such as supravesical urinary diversions and cystectomy. Effects of non‐surgical treatments for radiation and hemorrhagic cystitis are of modest success and studies are lacking to control the effects caused by RC. When such measures have proven ineffective, use of bladder botulinum toxin injection has been reported. New therapy, such as intravesical immunosuppression with local tacrolimus formulation is being developed for the treatment of radiation hemorrhagic cystitis.     

Coronary Sinus Shocking Lead As Salvage In Patients with Advanced CHF and High Defibrillation Thresholds

Background: We report a series of three patients whose implantable cardioverter‐defibrillators (ICD) implants were unsuccessful due to inability to achieve defibrillation thresholds (DFT) at maximum available energy after failure of standard modification and enhancement procedures. All patients had advanced cardiomyopathy. Methods: Use of the coronary sinus (CS) for left ventricular (LV) shocking electrode placement resulted in acceptable DFTs in each patient. The position of the shocking coil in all three patients was posterior, and in two patients alongside a left ventricular CS pacing lead. The best shocking configuration tested was LV (CS) + CAN (Anode) to RV (cathode) in each patient. The short‐ and long‐term outcomes of these patients is presented and discussed. Conclusion: This approach is suggested as a salvage option for those problematic patients who have unacceptable DFT results at implantation of an endovascular ICD system. (PACE 2010; 967–972)     

Primary leiomyosarcoma of the seminal vesicle

A case of leiomyosarcoma of the seminal vesicle detected as a prerectal mass on routine per-rectal examination is described in a 37-year-old man. Computed tomography scan confirmed it to be arising from the right seminal vesicle. Per-rectal trucut biopsy showed malignant cells. Radical cystoprostatectomy with bilateral pelvic lymphadenectomy with anterior resection of rectum and urinary diversion with ileal conduit was performed. Microscopic examination of the resected specimen showed moderately differentiated leiomyosarcoma from the seminal vesicle. The patient received adjuvant chemotherapy and sandwiched radiotherapy. He is well and free of tumor 20 months after surgery.     

Possible Involvement of Prostaglandins in Increases in Rat Plasma Adrenocorticotropic Hormone and Corticosterone Levels Induced by Radiation and Interleukin-1{alpha} Alone or Combined

Exposing rats to 1–10 Gy of ionizing radiation increasedplasma adrenocorticotropic hormone (ACTH) and corticoste-rone(CORT) levels. In both irradiated and nonirradiated rats, recombinanthuman interleukin-1 (rhIL-1 1 hr before radiation/sham exposure)enhanced plasma ACTH and CORT levels. Indomethacin, a cyclooxygenaseinhibitor, attenuated plasma ACTH and CORT levels induced byradiation. Indomethacin also attenuated ACTH and CORT levelsinduced by radiation and interleukin-1 alone or combined. Theseresults suggest that prostaglandins are involved in the increasein plasma ACTH and CORT levels induced by radiation and rhIL-1alone or combined.     

同步辐射衍射增强应用于慢性肾小球肾炎模型的研究

目的 应用同步辐射(synchrotron radiation, SR)衍射增强(diffraction enhanced imaging, DEI)对兔慢性肾小球肾炎(chronic glomerulonephritis, CGN)模型病变进行模型研究。方法 采用盐酸阿霉素以17mg/kg的2次注射量,2个月后5只新西兰大白兔慢性肾小球肾炎模型形成。抽取血液做肾功能检查,尿液做尿常规检查,切片做病理检查。动物处死后肾组织固定在4%福尔马林溶液里,准备DEI实验。另取5只正常的兔子做对照组。本实验在北京同步辐射装置4W1A X线实验站(射束能量14keV)进行。取摇摆曲线的腰位,做360度旋转平扫,同时取背景图像。最后用衍射成像软件重建图像,用MATLAB分析CGN和对照组病变区间的灰度差异。结果 在没有静脉注射成像对比剂条件下,DEI方法能清楚地显示两组肾脏微结构,包括动静脉系统,集合管,髓袢及肾小球,其空间分辨率达10μm。CGN组(91~112)的平均肾皮质比对照组(121~141)丢失较多、灰度值、T检验P<0.05。相同皮质感兴趣区(数据点450×80)灰度值定量分析,CGN组总灰度值(55~160)小于对照组(75~175)。DEI图像和病理图像有较多相似性,CGN组的病变微结构得以显示,归功于DEI相位成像(phase-contrast imaging, PCI)的原理优势,从而使应用SR DEI对CGN进行诊断的可能得以成为现实。结论 同步辐射衍射成像实验是一种新的影像学方法,结果表明,影像学形态的变化较CT、MRI、超声更细致明确,它使无创伤、无对比剂的慢性肾小球肾炎的动物模型诊断成为可能。未来随着实验设备的提高和图像分析操作的简易化,DEI很可能在临床上成为CGN诊断的一种新方法。