Percutaneous embolization of contained iatrogenic vesicourethral fistula using Amplatzer vascular plug and N-butyl-2-cyanoacrylate : a case report

Purpose: Reports on percutaneous embolization of vesicourethral anastomotic fistula are limited. Case presentation: A 59-year-old male presented with persistent contained vesicourethral fistula following low anterior resection and radical retropubic prostectomy for rectal cancer. A contained fistula with urinary leakage of 350 ml/day through a Jackson-Pratt (JP) tube was found at the posterior aspect of the vesicourethral anastomotic site on cystography. After 1 month of failed conventional urinary drainage manoeuvre, percutaneous embolization of the contained fistula was successfully performed through the JP tube. An Amplatzer vascular plug (AVP) was used to block the fistula and N-butyl-2-cyanoacrylate (NBCA) was used to obliterate the urinoma cavity. Computed tomography scans at 1-month and 1-year follow-ups showed stable AVP position and complete obliteration of the cavity by NBCA. Conclusions: The contained vesicourethral anastomotic fistula was successfully managed with AVP and NBCA via a JP drainage tube. It is expected that AVP will block the fistula and NBCA will obliterate the urinoma cavity effectively

Lymphangiography to treat postoperative lymphatic leakage: a technical review.

In addition to imaging the lymphatics and detecting various types of lymphatic leakage, lymphangiography is a therapeutic option for patients with chylothorax, chylous ascites, and lymphatic fistula. Percutaneous thoracic duct embolization, transabdominal catheterization of the cisterna chyli or thoracic duct, and subsequent embolization of the thoracic duct is an alternative to surgical ligation of the thoracic duct. In this pictorial review, we present the detailed technique, clinical applications, and complications of lymphangiography and thoracic duct embolization

Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application

Radiofrequency (RF) ablation has been gaining popularity as a minimally invasive treatment for benign thyroid nodules regardless of the extent of the solid component. RF ablation of benign nodules demonstrated volume reductions of 33–58% after one month and 51–85% after six months, while solving nodule-related clinical problems. RF ablation has recently shown positive short-term results for locoregional control as well as symptom improvement in patients with recurrent thyroid cancers. This paper reviews the basic physics, indications, patient preparation, devices, procedures, clinical results, and complications of RF ablation

Reinforcing effects of methamphetamine in an animal model of Attention-Deficit/Hyperactivity Disorder-the Spontaneously Hypertensive Rat

Substrains of the Spontaneously Hypertensive rat (SHR), a putative animal model of Attention-Deficit/Hyperactivity Disorder (ADHD), have demonstrated increased sensitivity to many drugs of abuse, including psychostimulants. Therefore, it was suggested that studies in SHR may help elucidate ADHD and comorbidity with substance use disorder (SUD). However, the drug intake profile of the SHR in the most relevant animal model of drug addiction, the self-administration (SA) test, and its response on the conditioned place preference (CPP) paradigm are not yet determined. In the present study, we employed SA and CPP tests to investigate the reinforcing effects of the psychostimulant methamphetamine in an SHR substrain obtained from Charles River, Japan (SHR/NCrlCrlj). Concurrent tests were also performed in Wistar rats, the strain representing "normal" heterogeneous population. To address if the presence of ADHD behaviors further increases sensitivity to the rewarding effect of methamphetamine during adolescence, a critical period for the onset of drug abuse, CPP tests were especially conducted in adolescent Wistar and SHR/NCrlCrlj. We found that the SHR/NCrlCrlj also acquired methamphetamine SA and CPP, indicating reinforcing effects of methamphetamine in this ADHD animal model. However, we did not observe increased responsiveness of the SHR/NCrlCrlj to methamphetamine in both SA and CPP assays. This indicates that the reinforcing effects of methamphetamine may be similar in strains and that the SHR/NCrlCrlj may not adequately model ADHD and increased sensitivity to methamphetamine

Differential Genomic Imprinting and Expression of Imprinted microRNAs in Testes-Derived Male Germ-Line Stem Cells in Mouse

BACKGROUND: Testis-derived male germ-line stem (GS) cells, the in vitro counterpart of spermatogonial stem cells (SSC), can acquire multipotency under appropriate culture conditions to become multipotent adult germ-line stem (maGS) cells, which upon testicular transplantation, produce teratoma instead of initiating spermatogenesis. Consequently, a molecular marker that can distinguish GS cells from maGS cells would be of potential value in both clinical and experimental research settings. METHODS AND FINDINGS: Using mouse as a model system, here we show that, similar to sperm, expression of imprinted and paternally expressed miRNAs (miR-296-3p, miR-296-5p, miR-483) were consistently higher (P<0.001), while those of imprinted and maternally expressed miRNA (miR-127, miR-127-5p) were consistently lower (P<0.001) in GS cells than in control embryonic stem (ES) cells. DNA methylation analyses of imprinting control regions (ICR), that control the expression of all imprinted miRNAs in respective gene clusters (Gnas-Nespas DMR, Igf2-H19 ICR and Dlk1-Dio3 IG-DMR), confirmed that imprinted miRNAs were androgenetic in GS cells. On the other hand, DNA methylation of imprinted miRNA genes in maGS cells resembled those of ES cells but the expression pattern of the imprinted miRNAs was intermediate between those of GS and ES cells. The expression of imprinted miRNAs in GS and maGS cells were also altered during their in vitro differentiation and varied both with the differentiation stage and the miRNA. CONCLUSIONS: Our data suggest that GS cells have androgenetic DNA methylation and expression of imprinted miRNAs which changes to ES cell-like pattern upon their conversion to maGS cells. Differential genomic imprinting of imprinted miRNAs may thus, serve as epigenetic miRNA signature or molecular marker to distinguish GS cells from maGS cells

Neurologic Recovery According to Early Magnetic Resonance Imaging Findings in Traumatic Cervical Spinal Cord Injuries

The aim of this study was to determine the usefulness of early magnetic resonance imaging findings in predicting neurologic recovery at or below the injured level in traumatic cervical spinal cord injuries. Thirty patients with traumatic cervical spinal cord injuries were included. All of the patients received a magnetic resonance imaging and a neurologic examination in the emergency room, within 7 days of injury and at 6 months following the injury. To quantify neurologic recovery below the injured level, we modified clinical scales, particularly the motor ratio and the sensory ratio. We used the neurologic level to quantify recovery around the injured level. We assessed neurologic recovery according to MRI patterns and lesion extents. The pure hemorrhagic MRI pattern was not observed. In edematous and mixed types, the improvement of neurologic levels was not significantly different. The motor ratio and sensory ratio improved significantly more in edematous type patients than in mixed type patients. Based on MRI lesion extent, the improvement of neurologic levels was not significantly different, and motor ratio and sensory ratio improved significantly more in those with one or two segments involved than in those with more than two segments involved. In conclusion, early MRI pattern and lesion extent after traumatic cervical spinal cord injury may provide important information to help predict neurologic recovery, especially below the injured level

Development of Micro-Heaters with Optimized Temperature Compensation Design for Gas Sensors

One of the key components of a chemical gas sensor is a MEMS micro-heater. Micro-heaters are used in both semiconductor gas sensors and NDIR gas sensors; however they each require different heat dissipation characteristics. For the semiconductor gas sensors, a uniform temperature is required over a wide area of the heater. On the other hand, for the NDIR gas sensor, the micro-heater needs high levels of infrared radiation in order to increase sensitivity. In this study, a novel design of a poly-Si micro-heater is proposed to improve the uniformity of heat dissipation on the heating plate. Temperature uniformity of the micro-heater is achieved by compensating for the variation in power consumption around the perimeter of the heater. With the power compensated design, the uniform heating area is increased by 2.5 times and the average temperature goes up by 40 °C. Therefore, this power compensated micro-heater design is suitable for a semiconductor gas sensor. Meanwhile, the poly-Si micro-heater without compensation shows a higher level of infrared radiation under equal power consumption conditions. This indicates that the micro-heater without compensation is more suitable for a NDIR gas sensor. Furthermore, the micro-heater shows a short response time of less than 20ms, indicating a very high efficiency of pulse driving

Evaluation of Direct Immunofluorescence Test with PCR for Detection of Novel Influenza A (H1N1) Virus during 2009 Pandemic

During the 2009 novel influenza (H1N1) pandemic, the sensitivity of direct immunofluorescence assay (DFA) for H1N1 infection was 62% (266/429) of that of the polymerase chain reaction (PCR) test. The sensitivity of the DFA differed significantly with the age of patients: the sensitivity was the highest (71.8%) for patients aged <10 years and the lowest for patients aged ≥30 years. The sensitivity of DFA in patients aged ≥30 years was 40.7%. Furthermore, the sensitivity (67.3%, 171/254) of DFA was higher for patients who had a high temperature at admission. An increase in the incidence of H1N1 infection did not influence the sensitivity of DFA (62.1% vs. 62%; p=0.984) test, but resulted in a decrease in the negative predictive value, from 92.4% (700/757) to 69.6% (247/355). PCR may be useful as the initial test for diagnosing H1N1 infection in patients aged ≥30 years with a normal temperature at presentation