Improving CT-guided transthoracic biopsy of mediastinal lesions by diffusion-weighted magnetic resonance imaging

OBJECTIVES: To evaluate the preliminary results obtained using diffusion-weighted magnetic resonance imaging and the apparent diffusion coefficient for planning computed tomography-guided biopsies of selected mediastinal lesions. METHODS: Eight patients with mediastinal lesions suspicious for malignancy were referred for computed tomography-guided biopsy. Diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient measurement were performed to assist in biopsy planning with diffusion/computed tomography fused images. We selected mediastinal lesions that could provide discordant diagnoses depending on the biopsy site, including large heterogeneous masses, lesions associated with lung atelectasis or consolidation, lesions involving large mediastinal vessels and lesions for which the results of biopsy using other methods and histopathological examination were divergent from the clinical and radiological suspicion. RESULTS: In all cases, the biopsy needle was successfully directed to areas of higher signal intensity on diffusion-weighted sequences and the lowest apparent diffusion coefficient within the lesion (mean, 0.8 [range, 0.6-1.1]×10-3 mm2/s), suggesting high cellularity. All biopsies provided adequate material for specific histopathological diagnoses of four lymphomas, two sarcomas and two thymomas. CONCLUSION: Functional imaging tools, such as diffusion-weighted imaging and the apparent diffusion coefficient, are promising for implementation in noninvasive and imaging-guided procedures. However, additional studies are needed to confirm that mediastinal biopsy can be improved with these techniques

Blood pressure variability and cognitive dysfunction: A systematic review and meta‐analysis of longitudinal cohort studies

Abstract The variability of blood pressure (BPV) has been suggested as a clinical indicator for cognitive dysfunction, yet the results from clinical studies are variable. This study investigated the relationship between BPV and the risk of cognitive decline or dementia. Bibliographic databases, including PubMed, Scopus, and Embase, were searched systematically for longitudinal cohort studies with BPV measurements and neuropsychological examinations or dementia diagnosis. A traditional meta‐analysis with subgroup analysis, and a further dose‐response meta‐analysis were conducted. Twenty cohort studies with 7 924 168 persons were included in this review. The results showed that a higher systolic BPV (SBPV), when measured with the coefficient of variation (SBP‐CV) or standard deviation (SBP‐SD), was associated with a higher risk of all‐cause dementia diagnosis but not incidence of cognitive decline on neuropsychological examinations. In subgroup analysis, the effect was more prominent when using BPV of shorter timeframes, during shorter follow‐ups, or among the elderly aged more than 65 years. No dose‐response relationship could be found. Our study suggested possible positive associations between SBPV and the risk of dementia. Further studies are required to validate these findings

Additional file 1: Figure A. of Improving immunological tumor microenvironment using electro-hyperthermia followed by dendritic cell immunotherapy

(a) Representative flow cytometric analysis on immature and mature DCs. The purple histograms represent the isotype-matched control, and the red line histograms represent staining with specific antibodies. *MFI represents the mean fluorescence intensity, which are expressed on the right upper corner of each histogram. Error bars represent standard errors. (b) Histogram plot of MFI. (*) P < 0.05, (**) P < 0.01 (t-test) compared with the immature DC. Figure B. Endocytotic activity was measured by flow cytometry in DCs generated from bone marrow cultured for 9 d with 20 ng/ml of GM-CSF; mDCs obtained from iDCs were incubated with 10 g/mL of AH1 and 50 g/mL of Hsp70 for 24 h and reacted with 100 mg/mL of FITC-Dextran at 4°C (purple) or 37 °C (green line) for 2 h before analysis. This result was represented from one of three independent experiments. (DOCX 608 kb