Use of oral gadobenate dimeglumine to visualise the oesophagus during magnetic resonance angiography in patients with atrial fibrillation prior to catheter ablation.

BACKGROUND: Atrio-oesophageal fistula was first reported as a fatal complication of surgical endocardial and percutaneous endocardial radiofrequency ablation for atrial fibrillation, with an incidence after catheter ablation between 0.03% and 0.5%. Magnetic resonance angiography (MRA) was usually performed to obtain pre-procedural 3D images, used to merging into an electro-anatomical map, guiding step-by-step ablation strategy of AF. Our aim was to find an easy, safe and cost-effective way to enhance the oesophagus during MRA. METHODS: In 105 consecutive patients, a right-left phase encoding, free breathing, 3D T1 MRA sequence was performed in the axial plane, >24 hours before catheter ablation, using an intravenous injection of gadobenate dimeglumine contrast medium. The oesophagus was enhanced using an oral gel solution of 0.7 mL gadobenate dimeglumine contrast medium mixed with approximately 40 mg thickened water gel, which was swallowed by the patients on the scanning table, immediately before the MRA sequence acquisition. RESULTS: The visualisation of the oesophagus was obtained in 104/105 patients and images were successfully merged, as left atrium and pulmonary veins, into an electro-anatomical map, during percutaneous endocardial radiofrequency ablation. All patients tolerated the study protocol and no immediate or late complication was observed with the oral contrast agent administration. The free-breathing MRA sequence used in our protocol took 7 seconds longer than MRA breath-hold conventional sequence. CONCLUSION: Oesophagus visualization with oral gadobenate dimeglumine is feasible for integration of oesophagus anatomy images into the electro-anatomical map during AF ablation, without undesirable side effects and without significantly increasing cost or examination time

Studio della fluidita dl leghe a base rame

Le leghe di rame sono spesso utilizzate nella produzione di getti o semilavorati con svariate composizioni per la versatilit\ue0 del processo di colata, che permette di utilizzare diverse tecniche e svariati materiali al fine di ottenere le caratteristiche desiderate. Tuttavia, nonostante questa tecnologia di produzione sia largamente utilizzata, non esiste ad oggi un test normato atto a determinarne i parametri ottimali e a prevenire eventuali difetti. Questo lavoro nasce dall'esigenza di mettere a punto un sistema di misura affidabile, che possa ambire a diventare uno standard di uso comune per la valutazione di un parametro fondamentale, come la col abilit\ue0, e che contribuisca allo studio dell\u2019influenza sia di fattori produttivi che di fattori chimici, come la presenza di elementi in lega in concentrazioni macro o micro (< 1%). La ricerca si focalizza sulla standardizzazione di un test di fluidit\ue0 che risponda alle esigenze scientifiche di precisione, sensibilit\ue0 e riproducibilit\ue0, mantenendo l\u2019aspetto pratico di semplicit\ue0 di realizzazione poich\ue9 possa essere di interesse per prove di fonderia

Control of Salivary Secretion by Nitric Oxide and Its Role in Neuroimmunomodulation

Abstract: In many in vivo systems exposure to endotoxins (LPS) leads to the co‐induction of inducible nitric oxide synthase (iNOS) and cyclooxygenase‐2 (COX‐2), which is important to the regulation of the function of different systems during infection. In submandibular glands (SMG) neural (n)NOS is localized in neural terminals and in striated, granular convoluted and excretory ducts, endothelial (e) NOS in vascular endothelium and ducts, and iNOS in macrophages and in tubules and ducts. In normal adult male rats, injection of an inhibitor of NOS decreased the stimulated salivary secretion and a donor of NO potentiated it, indicating that NO exerts a stimulatory role. A single high dose of LPS (5 mg/kg, i.p.) induced an increase in NOS activity measured by the 14C‐citrulline method, increased PGE content almost 100% as measured by RIA, and blocked stimulated salivary secretion. The administration of a specific iNOS inhibitor, aminoguanidine (AG), with LPS not only decreased NOS activity but significantly decreased PGE content, indicating that NO triggered the activation of COX‐2. LPS increased conversion of labeled arachidonate to prostaglandins (PGs) showing that COX was induced. Since a PGE1 analogue blocked stimulated salivation, the LPS‐induced inhibition of salivation is probably due to release of PGs. Therefore, the use of inhibitors of iNOS and COX‐2 could be very useful to increase salivation during infection since saliva has antimicrobial actions.Fil: Besuhli, Valeria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Lomniczi, A.. Universidad de Buenos Aires. Facultad de Odontología; ArgentinaFil: Elverdín, Juan Carlos. Universidad de Buenos Aires. Facultad de Odontología; ArgentinaFil: Suburo, Angela Maria. Universidad Austral; ArgentinaFil: Faletti, Alicia Graciela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: Franchi, Ana Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Centro de Estudios Farmacológicos y Botánicos. Universidad de Buenos Aires. Facultad de Medicina. Centro de Estudios Farmacológicos y Botánicos; ArgentinaFil: McCann, Samuel M.. State University of Louisiana; Estados Unido

Quantitative assessment of HCC wash-out on CT is a predictor of early complete response to TACE

OBJECTIVES: To investigate the predictive value of four-phase contrast-enhanced CT (CECT) for early complete response (CR) to drug-eluting-bead transarterial chemoembolization (DEB-TACE), with a particular focus on the quantitatively assessed wash-in and wash-out. METHODS: A retrospective analysis of preprocedural CECTs was performed for 129 HCC nodules consecutively subjected to DEB-TACE as first-line therapy. Lesion size, location, and margins were recorded. For the quantitative analysis, the following parameters were computed: contrast enhancement ratio (CER) and lesion-to-liver contrast ratio (LLC) as estimates of wash-in; absolute and relative wash-out (WO(abs) and WO(rel)) and delayed percentage attenuation ratio (DPAR) as estimates of wash-out. The early radiological response of each lesion was assessed by the mRECIST criteria and dichotomized in CR versus others (partial response, stable disease, and progressive disease). RESULTS: All quantitatively assessed wash-out variables had significantly higher rates for CR lesions (WO(abs) p = 0.01, WO(rel) p = 0.01, and DPAR p = 0.00002). However, only DPAR demonstrated an acceptable discriminating ability, quantified by AUC = 0.80 (95% CI0.73–0.88). In particular, nodules with DPAR ≥ 120 showed an odds ratio of 3.3(1.5–7.2) for CR (p = 0.0026). When accompanied by smooth lesion margins, DPAR ≥ 120 lesions showed a 78% CR rate at first follow-up imaging. No significative association with CR was found for quantitative wash-in estimates (CER and LLC). CONCLUSIONS: Based on preprocedural CECT, the quantitative assessment of HCC wash-out is useful in predicting early CR after DEB-TACE. Among the different formulas for wash-out quantification, DPAR has the best discriminating ability. When associated, DPAR ≥ 120 and smooth lesion margins are related to relatively high CR rates. KEY POINTS: • A high wash-out rate, quantitatively assessed during preprocedural four-phase contrast-enhanced CT (CECT), is a favorable predictor for early radiological complete response of HCC to drug-eluting-bead chemoembolization (DEB-TACE). • The arterial phase of CECT shows great dispersion of attenuation values among different lesions, even when a standardized protocol is used, limiting its usefulness for quantitative analyses. • Among the different formulas used to quantify the wash-out rate (absolute wash-out, relative wash-out, and delayed percentage attenuation ratio), the latter (DPAR), based only on the delayed phase, is the most predictive (AUC = 0.80), showing a significant association with complete response for values above 120