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The selective radical/radical cross-coupling of two different organic radicals is a great challenge due to the inherent activity of radicals. In this paper, a copper-catalyzed radical/radical C(sp 3)-H/P-H cross-coupling has been developed. It provides a radical/radical cross-coupling in a selective manner. This work offers a simple way toward ß-ketophosphonates by oxidative coupling of aryl ketone o-acetyloximes with phosphine oxides using CuCl as catalyst and PCy3 as ligand in dioxane under N2 atmosphere at 130 °C for 5â h, and yields ranging from 47% to 86%. The preliminary mechanistic studies by electron paramagnetic resonance (EPR) showed that, 1)â the reduction of ketone o-acetyloximes generates iminium radicals, which could isomerize to α-sp(3) -carbon radical species; 2)â phosphorus radicals were generated from the oxidation of phosphine oxides. Various aryl ketone o-acetyloximes and phosphine oxides were suitable for this transformation.
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PURPOSE: To evaluate combined radiofrequency (RF) ablation and percutaneous osteoplasty (POP) in patients with painful extraspinal bone metastases. MATERIALS AND METHODS: In a retrospective study, 38 patients with 54 extraspinal bone metastases (ilium, n = 24; acetabulum, n = 21; femur, n = 7; ischium, n = 1; tibia, n = 1) were treated with RF ablation and POP. All patients had pain refractory to analgesic medication with intensity > 3 on a visual analog scale (VAS). Changes in quality of life were evaluated based on pain relief (VAS score), function on a Karnofsky performance scale, and analgesic dose before and immediately after the procedure and during follow-up. VAS score was the primary outcome, and the others were secondary outcomes. RESULTS: Technical success was achieved in 37 patients (97.4%). Mean VAS score declined significantly from 7.1 ± 1.5 before treatment to 2.2 ± 2.0 at 24 hours after treatment (P < .05), 1.6 ± 1.8 at 3 months after treatment (P < .05), and 1.3 ± 1.8 at 6 months after treatment (P < .05). Pain relief immediately after the procedure was reported by 35 patients (92.1%); pain regressed completely in 7 (18.4%) patients. After 6 months, narcotic analgesia had been suspended in 32 of 33 patients (97.0%). Pain was controlled by nonsteroidal antiinflammatory drugs in 8 patients (24.2%), and no analgesia was necessary in 24 patients (72.7%). Mean Karnofsky performance scale score after treatment was higher than before treatment (P < .05). The major complication rate was 2.6% (1 of 38 patients), with one case of vasovagal shock. The minor complication rate was 23.7% (9 of 38 patients). CONCLUSIONS: RF ablation with POP is effective for pain relief and functional recovery in patients with painful extraspinal bone metastases and can significantly improve quality of life.
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Neoplasias Ósseas/secundário , Neoplasias Ósseas/terapia , Ablação por Cateter , Cementoplastia , Manejo da Dor/métodos , Dor/prevenção & controle , Cuidados Paliativos , Adulto , Idoso , Analgésicos/uso terapêutico , Neoplasias Ósseas/complicações , Ablação por Cateter/efeitos adversos , Cementoplastia/efeitos adversos , China , Terapia Combinada , Feminino , Humanos , Avaliação de Estado de Karnofsky , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Dor/diagnóstico , Dor/etiologia , Manejo da Dor/efeitos adversos , Medição da Dor , Qualidade de Vida , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
High-intensity focused ultrasound (HIFU) is a non-invasive interventional radiology technology, which has been generally accepted in clinical practice for the treatment of benign and malignant tumors. HIFU can cause targeted tissue coagulative necrosis and protein denaturation by thermal or non-thermal effects, guided by diagnostic ultrasound or magnetic resonance imaging, without destruction of the normal adjacent tissue, under sedation or general anesthesia. HIFU has become an important alternative to standard treatments of solid tumors, including surgery, radiation, and medications. The aim of this review is to describe the development, principle, devices, and clinical applications of HIFU.
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The combination of Traditional Chinese Medicine and Interventional Radiology has an excellent clinical effect. This paper reviews the principles and methods of the combined application of Traditional Chinese Medicine and Interventional Radiology, aiming to promote the complementary and coordinated development of Traditional Chinese Medicine and Interventional Radiology.
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The recent interest in precision medicine among interventionists has led to the establishment of the concept of precision interventional radiology (PIR). This concept focuses not only on the accuracy of interventional operations using traditional image-guided techniques, but also on the comprehensive evaluation of diseases. The invisible features extracted from CT, MRI, or US improve the accuracy and specificity of diagnosis. The integration of multi-omics and molecule imaging provides more information for interventional operations. The development and application of drugs, embolic materials, and devices broaden the concept of PIR. Integrating medicine and engineering brings new image-guided techniques that increase the efficacy of interventional operations while reducing the complications of interventional treatment. In all, PIR, an important part of precision medicine, emphasizing the whole disease management process, including precision diagnosis, comprehensive evaluation, and interventional therapy, maximizes the benefits of patients with limited damage.
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OBJECTIVE: Our study aimed to analyze morphological features of spinal epidural metastases using magnetic resonance imaging (MRI) and investigate the formation mechanism and clinical significance of the "toxic twin-leaf" sign in spinal epidural metastasis. MATERIALS AND METHODS: We retrospectively studied 108 patients with spinal epidural metastases who underwent MRI. Patients were divided into "toxic twin-leaf" sign group (group A) and irregular group (group B). Chi-square test was used to analyze data on sex, vertebra location, presence of fracture in the corresponding vertebral body, involvement of the corresponding pedicle, and the primary tumor. Further, group data were analyzed using the rank sum test; p â< â0.05 was considered significant. RESULTS: The "twin-leaf" sign was noted in 88 cases with 136 epidural masses and 20 cases of irregular shape in 108 patients; the "toxic twin-leaf" sign accounted for 87.18% of spinal epidural metastases. A difference between groups in the vertebra location (p â< â0.01) was observed, but no differences were found in sex, presence of fractures in the corresponding vertebral body, involvement of the corresponding pedicle, and primary tumor (p â> â0.05). Intergroup differences in the rate of spinal stenosis on axial and sagittal images were significant. CONCLUSIONS: MRI axial sequences clearly revealed the morphology of spinal epidural metastases. Detection of the "toxic twin-leaf" sign in spinal epidural metastases was of great clinical significance. Furthermore, determining the degree of spinal stenosis in the axial sequence provided a more accurate evaluation of patients' condition compared to the sagittal sequence.
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[This corrects the article DOI: 10.1016/j.jimed.2020.01.001.].
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Intervention nursing emerged in China in the 1980s. It has been developing rapidly since then, along with interventional radiology, and has become an indispensable professional discipline in clinical nursing. In this paper, the author focuses on the initiation and development of intervention wards in a Chinese context and how the development of the topic in scientific research, periodical publications, and academic exchanges shows that intervention nursing in China is moving toward specialization, standardization, and scientificalization, and is gradually getting known in the international intervention nursing community via these international conferences which provide a platform for the exchange of innovative ideas.
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As an extension of percutaneous vertebroplasty (PVP), percutaneous osteoplasty (POP) refers broadly to percutaneous bone cement injected into various parts of the body and narrowly to cement injected into extraspinal bone lesions. POP mainly includes such surgeries as percutaneous sacroplasty, percutaneous acetabuloplasty, percutaneous femoral osteoplasty, and percutaneous iliac osteoplasty (Figure 1). Currently, POP is a positive and an effective treatment for extraspinal bone lesions in that it can rapidly relieve pain, effectively prevent pathological fractures, and partially inactivate tumors, with few complications. The aim of this review is to detail the POP techniques and report their safety and efficacy in the treatment of extraspinal metastases.
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Cistos Ósseos/terapia , Cementoplastia , Tálus , Adulto , Artralgia/etiologia , Artralgia/prevenção & controle , Cistos Ósseos/complicações , Cistos Ósseos/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Tálus/diagnóstico por imagem , Tálus/patologia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
OBJECT: The authors conducted a study to evaluate the advantages of a 3D volume-rendering technique (VRT) in follow-up digital subtraction (DS) angiography of coil-embolized intracranial aneurysms. METHODS: One hundred nine patients with 121 intracranial aneurysms underwent endovascular coil embolization and at least 1 follow-up DS angiography session at the authors' institution. Two neuroradiologists independently evaluated the conventional 2D DS angiograms, rotational angiograms, and 3D VRT images obtained at the interventional procedures and DS angiography follow-up. If multiple follow-up sessions were performed, the final follow-up was mainly considered. The authors compared the 3 techniques for their ability to detect aneurysm remnants (including aneurysm neck and sac remnants) and parent artery stenosis based on the angiographic follow-up. The Kruskal-Wallis test was used for group comparisons, and the kappa test was used to measure interobserver agreement. Statistical analyses were performed using commercially available software. RESULTS: There was a high statistical significance among 2D DS angiography, rotational angiography, and 3D VRT results (X(2) = 9.9613, p = 0.0069) when detecting an aneurysm remnant. Further comparisons disclosed a statistical significance between 3D VRT and rotational angiography (X(2) = 4.9754, p = 0.0257); a high statistical significance between 3D VRT and 2D DS angiography (X(2) = 8.9169, p = 0.0028); and no significant difference between rotational angiography and 2D DS angiography (X(2) = 0.5648, p = 0.4523). There was no statistical significance among the 3 techniques when detecting parent artery stenosis (X(2) = 2.5164, p = 0.2842). One case, in which parent artery stenosis was diagnosed by 2D DS angiography and rotational angiography, was excluded by 3D VRT following observations of multiple views. The kappa test showed good agreement between the 2 observers. CONCLUSIONS: The 3D VRT is more sensitive in detecting aneurysm remnants than 2D DS angiography and rotational angiography and is helpful for identifying parent artery stenosis. The authors recommend this technique for the angiographic follow-up of patients with coil-embolized aneurysms.
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Angiografia Cerebral/métodos , Embolização Terapêutica/métodos , Imageamento Tridimensional/métodos , Aneurisma Intracraniano/diagnóstico , Aneurisma Intracraniano/terapia , Angiografia Digital/métodos , Encéfalo/patologia , Constrição Patológica/patologia , Embolização Terapêutica/instrumentação , Feminino , Seguimentos , Humanos , Aneurisma Intracraniano/patologia , Masculino , Pessoa de Meia-Idade , Rotação , Sensibilidade e EspecificidadeRESUMO
Percutaneous osteoplasty (POP) as a technical extension of percutaneous vertebroplasty has been used as a treatment for osteolytic lesions in weight-bearing bones besides the vertebrae, and has demonstrated beneficial outcomes in terms of pain relief and functional improvement. However, its efficacy in non-weight-bearing bones is not well known. Herein, we present the case of a patient with an osteolytic lesion from multiple myeloma in the sternum, a non-weight-bearing bone, who obtained sustained pain relief and improvement of life quality after POP. These data suggest that POP may be an alternative treatment for osteolytic lesions in non-weight-bearing bones.