Evaluation of automated measurement of left ventricular volume by novel real-time 3-dimensional echocardiographic system: Validation with cardiac magnetic resonance imaging and 2-dimensional echocardiography

AbstractBackgroundTraditional 3-dimensional echocardiography (3DE) with volumetric scanning technique requires several heart cycles for full-volume acquisition and complicated manual contouring of left ventricular (LV) endocardium. The new real-time 3DE (RT3DE) system allows acquisition of an instantaneous full-volume dataset in a single heart cycle and automated measurement of LV volume by the algorithm software. However, it has not been evaluated adequately whether automated measurement by RT3DE has better agreement with cardiac magnetic resonance imaging (CMR) than 2-dimensional echocardiography (2DE) with CMR.PurposeThis study aimed to evaluate the accuracy of automated measurement of LV volume using RT3DE compared with 2DE and CMR.Methods and resultsForty-four consecutive patients who underwent RT3DE, 2DE, and CMR were evaluated in this study. The feasibility of automated measurement by RT3DE was 93.2% and the mean operation time was 6min. LV volume and ejection fraction (EF) from semi-automated measurement [end-diastolic volume: r=0.96, limits of agreement (LOA) −30.5 to 39.3ml; end-systolic volume: r=0.97, LOA −22.6 to 32.7ml; EF: r=0.90, LOA −16.1 to 14.2%, respectively] had better agreement with CMR than those from 2DE (r=0.87, LOA −50.5 to 72.2ml; r=0.93, LOA −34.1 to 65.2ml; r=0.89, LOA −20.9 to 10.0%, respectively).ConclusionSemi-automated measurement by RT3DE has better agreement with CMR than 2DE in LV volume and EF. In addition, it is simple to operate and acceptable in feasibility for the clinical setting although there may be room for further learning required to incorporate small hypertrophic LV into the automated algorithm software

EVALUATION OF MITRAL VALVE AREA AFTER MITRACLIP PROCEDURE: A REAL-TIME 3D TRANSESOPHAGEAL ECHOCARDIOGRAPHIC STUDY

Podeu consultar la versió en català a: http://hdl.handle.net/11703/87414Podeu consultar la versió en anglès a: http://hdl.handle.net/11703/8741

Unexpected Complication of R-CHOP Chemotherapy: Rapidly Progressive Bronchiolitis Obliterans Syndrome

Background: Bronchiolitis obliterans syndrome (BOS) is the term used for the progressive obliteration of small airways before the patient has had a confirmatory lung biopsy. It is also recognized as a transplant-related complication. There have been no reports of BOS during initial standard chemotherapy. Case presentation: A 50-year-old woman with newly diagnosed follicular lymphoma grade 2, stage 3A, presented with hypoxia and progressive dyspnoea after the fifth cycle of R-CHOP. High-resolution computed tomography showed air trapping enhanced at the end-expiratory phase. Pulmonary function testing revealed severe obstructive and restrictive failure without bronchodilator response. We diagnosed BOS based on current criteria and treated the patient with glucocorticoids and cyclosporin. She was discharged home on oxygen therapy. However, soon after discharge, her respiratory symptoms deteriorated and she was hospitalized in a palliative care unit. She died of respiratory failure within a year of symptom onset. Conclusions: This is the first case report to describe rapidly progressive BOS in a patient undergoing R-CHOP treatment, which strongly suggests the condition was caused by the chemotherapy. Although a pathological diagnosis was not obtained, the clinical diagnosis of BOS was important so that the patient could receive appropriate treatment and palliative care based on the prognosis of this incurable condition

Monocyte or white blood cell counts and β₂ microglobulin predict the durable efficacy of daratumumab with lenalidomide

BACKGROUND: Daratumumab is one of the most widely used treatments for relapsed/refractory multiple myeloma (MM) patients. However, not all patients achieve a lasting therapeutic response with daratumumab. OBJECTIVES: We hypothesized that a durable response to daratumumab could be predicted by the balance between the MM tumor burden and host immune status. DESIGN: We conducted a retrospective study using the real-world data in the Kansai Myeloma Forum (KMF) database. METHODS: We retrospectively analyzed 324 relapsed/refractory MM patients who were treated with daratumumab in the KMF database. RESULTS: In this study, 196 patients were treated with daratumumab, lenalidomide, and dexamethasone (DLd) regimen and 128 patients were treated with daratumumab, bortezomib, and dexamethasone (DBd) regimen. The median age at treatment, number of prior treatment regimens and time-to-next-treatment (TTNT) were 68, 4 and 8.02 months, respectively. A multivariate analysis showed that the TTNT under the DLd regimen was longer with either higher monocyte counts (analysis 1), higher white blood cell (WBC) counts (analysis 2), lower β2 microglobulin (B2MG < 5.5 mg/L) or fewer prior regimens (<4). No parameters were correlated with TTNT under the DBd regimen. CONCLUSION: We propose a simple scoring model to predict a durable effect of the DLd regimen by classifying patients into three categories based on either monocyte counts (0 points for ⩾200/μl; 1 point for <200/μl) or WBC counts (0 points for ⩾3500/μl; 1 point for <3500/μl) plus B2MG (0 points for <5.5 mg/L; 1 point for ⩾5.5 mg/L). Patients with a score of 0 showed significantly longer TTNT and significantly better survival compared to those with a score of 1 or 2 (both p < 0.001). To confirm this concept, our results will need to be validated in other cohorts

Preparation and characterization of water-soluble jingle-bell-shaped silica-coated cadmium sulfide nanoparticles

Treatment of surface silanol groups with hydrophilic compounds enabled silica-coated cadmium sulfide (SiO2/CdS) nanoparticles of core−shell morphologies to be dissolved in a water/methanol mixture. Size-selective photoetching of the particles was performed by irradiation with monochromatic light at 458 nm, resulting in a blue shift of its absorption onset because of the decreasing size of the CdS. TEM analyses revealed that the SiO2 shell structure was not shrunken by photoetching and that a void space (ca. 2.3 nm) was formed between the CdS core and the SiO2 shell to give a jingle-bell structure. The emission spectra of photoetched particles showed the development of band-gap emission when cadmium ion (Cd2+) was added and the pH was adjusted to 10, whereas the same treatment of original particles gave no peaks assigned to band-gap emission, indicating that the SiO2 shell was sufficiently porous for small ionic species such as Cd2+ to penetrate through the shell and that the photoetched CdS core incorporated in the SiO2 shell had a bare surface to be covered with a cadmium hydroxide layer. With increasing shell thickness, the rate of CdS photoetching was reduced as a result of decrease in the rate of scavenging of the photogenerated electrons in CdS by electron acceptors such as O2 and methyl viologen (MV2+) in solution. The structure of the SiO2 layer was varied by surface modification of the CdS with both 3-mercaptopropionic acid (MPA) and 3-mercaptopropyltrimethoxysilane (MPTS) followed by hydrolysis of its trimethoxysilyl group. FT-IR spectra showed that MPA molecules, but not MPTS molecules, attached to the CdS core surface were eliminated by photoetching of the particles, resulting in the formation of windows in the SiO2 shell. The behavior of CdS emission quenching suggested that MV2+ is transported through the windows to the void space inside the SiO2 shell to reach the CdS core