Optimization of SPIO injection for sentinel lymph node dissection in a rat model

The magnetic technique, consisting of a magnetic tracer and a handheld magnetometer, is a promising alternative technique for sentinel lymph node dissection (SLND) and was shown to be non-inferior to the standard technique in terms of identification rates. In this study, injection characteristics (iron dose, dilution, time course and massaging) were evaluated to optimize magnetic tracer uptake in the sentinel lymph nodes (SLN) in a rat hindleg model. 202 successful SLNDs were performed. Iron uptake in the SLN is proportional (10% utilization rate) to the injection dose between 20 and 200 μg, showing a plateau uptake of 80 μg in the SLN around 1,000 μg injection. Linear regression showed that time had a higher impact than dilution, on the SLN iron uptake. Massaging showed no significant change in iron uptake. The amount of residual iron at the injection site was also proportional to the injection dose without any plateau. Time was a significant factor for wash-out of residual iron. From these results, preoperative injection may be advantageous for SLN detection as well as reduction in residual iron at the injection site by potential decrease in required injection dose

Economic Value of Dengue Vaccine in Thailand

With several candidate dengue vaccines under development, this is an important time to help stakeholders (e.g., policy makers, scientists, clinicians, and manufacturers) better understand the potential economic value (cost-effectiveness) of a dengue vaccine, especially while vaccine characteristics and strategies might be readily altered. We developed a decision analytic Markov simulation model to evaluate the potential health and economic value of administering a dengue vaccine to an individual (≤ 1 year of age) in Thailand from the societal perspective. Sensitivity analyses evaluated the effects of ranging various vaccine (e.g., cost, efficacy, side effect), epidemiological (dengue risk), and disease (treatment-seeking behavior) characteristics. A ≥ 50% efficacious vaccine was highly cost-effective [< 1× per capita gross domestic product (GDP) ($4,289)] up to a total vaccination cost of$60 and cost-effective [< 3× per capita GDP ($12,868)] up to a total vaccination cost of$200. When the total vaccine series was $1.50, many scenarios were cost saving

Development of device for quantifying magnetic nanoparticle tracers accumulating in sentinel lymph nodes

The developed device with electromagnetic coils and small permanent magnets quantifies the iron contents of superparamagnetic iron oxide nanoparticles for sentinel lymph node (SLN) biopsy. To remove diamagnetic and paramagnetic components and detect only superparamagnetic components, a 2nd harmonics signal is detected by a gradiometer under a moderate AC magnetic field (1–2 mT) with the fundamental frequency (2.944 kHz) of the coils and DC magnetic field (1–2 mT) of the magnets. The detection limit with a signal-to-noise ratio of 5 is approximately 0.28 μg of iron, and the device has a wide dynamic range of 104, 0.28 μg–2.8 mg. Additional coils and permanent magnets play an important role producing the optimum distribution of AC/DC magnetic fields for an iron distribution-independent and SLN size-independent quantification. We demonstrated the quantification of the iron in phantoms, which have a size of 3–20 mm with varied iron distributions and contain magnetic nanoparticles numerically. These results indicate that the developed device is useful for quantifying the magnetic nanoparticles accumulating in SLNs