Clinical and Radiographical Evaluation of Immediate Loading of Narrow Diameter Dental Implants.

The present study aimed to evaluate the peri-implant tissue response and marginal bone levels of immediately loaded narrow diameter dental implants. In this study, 10 patients with single maxillary anterior edentulous space were included. Implants were placed and immediate provisional crown was given without any centric or eccentric contacts. After three months, a definitive restoration was placed. All the clinical and radiographical parameters were evaluated.

A new method to improve RF safety of implantable medical devices using inductive coupling at 3.0 T MRI.

OBJECTIVE: To enhance RF safety when implantable medical devices are located within the body coil but outside the imaging region by using a secondary resonator (SR) to reduce electric fields, the corresponding specific absorption rate (SAR), and temperature change during MRI. MATERIALS AND METHODS: This study was conducted using numerical simulations with an American Society for Testing and Materials (ASTM) phantom and adult human models of Ella and Duke from Virtual Family Models, along with corresponding experimental results of temperature change obtained using the ASTM phantom. The circular SR was designed with an inner diameter of 150 mm and a width of 6 mm. Experimental measurements were carried out using a 3 T Medical Implant Test System (MITS) body coil, electromagnetic (EM) field mapping probes, and an ASTM phantom. RESULTS: The magnitudes of B1+ (|B1+|) and SAR1g were reduced by 15.2% and 5.85% within the volume of interest (VoI) of an ASTM phantom, when a SR that generates opposing electromagnetic fields was utilized. Likewise, the Δ|B1+| and ΔSAR1g were reduced by up to 56.7% and 57.5% within the VoI of an Ella model containing a copper rod when an opposing SR was used. CONCLUSION: A novel method employing the designed SR, which generates opposing magnetic fields to partially shield a sample, has been proposed to mitigate the risk of induced-RF heating at the VoI through numerical simulations and corresponding experiments under various conditions at 3.0 T.

Comparison of SAR distribution of hip and knee implantable devices in 1.5T conventional cylindrical-bore and 1.2T open-bore vertical MRI systems.

PURPOSE: There is increasing use of open-bore vertical MR systems that consist of two planar RF coils. A recent study showed that the RF-induced heating of a neuromodulation device was much lower in the open-bore system at the brain and the chest imaging landmarks. This study focused on the hip and knee implants and compared the specific absorption rate (SAR) distribution in human models in a 1.2T open-bore coil with that of a 1.5T conventional birdcage coil. METHODS: Computational modeling results were compared against the measurement values using a saline phantom. The differences in RF exposure were examined between a 1.2T open-bore coil and a 1.5T conventional birdcage coil using SAR in an anatomical human model. RESULTS: Modeling setups were validated. The body placed closed to the coil elements led to high SAR values in the birdcage system compared with the open-bore system. CONCLUSION: Our computational modeling showed that the 1.2T planar system demonstrated a lower intensity of SAR distribution adjacent to hip and knee implants compared with the 1.5T conventional birdcage system.

Success Story of Ilizarov in Chronic Non-union of Tibia with 18 Years of Morbidity: A Case Report.

INTRODUCTION: When the fracture fails to heal for more than 12 months, it is called chronic non-union. Surgical intervention becomes mandatory to get this type of fracture healed. We are reporting our results in a case of congenital pseudoarthrosis of the tibia (CPT) having chronic non-union of 18 years duration with superadded infection following attempted surgery, using Ilizarov technology. We shall highlight the problems found during the course of treatment and different strategies to tackle them. CASE PRESENTATION: An 18-year-old female, born with CPT of the right tibia with neurofibromatosis, presented as Type 1 infected non-union following three unsuccessful surgeries. She had neurofibromatic nodules all over the body including the face. The leg had multiple active draining sinuses, with evidence of healed sinuses and operating scars, adherent to underlying bone. She had 20 cm of limb shortening. Prolonged morbidity made her socially isolated. Being poor, they could not manage her medical expenses. They started believing that amputation would be a viable option and with that feeling in mind, they approached us. After few sittings of counseling, they somehow agreed to give it a try. After preparing the patient, a radical excision of the infected and dead tissue was done. A 3 ring Ilizarov assembly was mounted as the distal fragment was very small. A corticotomy was done to fill up 10 cm of gap following excision and subsequent limb lengthening. She developed hyporegenerate, pin-tract infections (PTIs) during the course of treatment which were tackled accordingly. She also developed psychological problems due to nature of treatment that was taken care of too. The fracture united and she could start walking unaided. There was no recurrence of infection. The ring was kept in situ for about 700 days. CONCLUSION: Chronic non-union associated with neurofibromatosis and infection is a very challenging situation. Radical debridement is the key to prevent recurrence of both. Ilizarov system plays the most significant role in forming regenerate by distraction. Hyporegenerate and PTIs could be tackled meticulously to prevent complications and attain the desired result. The patient could achieve painless unaided walking after the treatment. Probably instilling self-confidence in the patient was one of the most important aspects to sustain such an arduous journey.

Betaine supplementation to rats alleviates disturbances induced by high-fat diet: pleiotropic effects in model of type 2 diabetes.

Betaine is a biologically active compound exerting beneficial effects in the organism, however, the exact mechanisms underlying its action are not fully elucidated. The present study aimed to explore, whether betaine alleviates disorders induced by feeding rats a high-fat diet (HFD). Rats were divided into 3 groups: control, fed an HFD and fed an HFD and receiving betaine (2% water solution for 8 weeks). Betaine improved glucose tolerance, decreased blood levels of non-esterified fatty acids and prevented lipid accumulation in the skeletal muscle of rats on an HFD. Betaine reduced activities of blood alanine aminotransferase, blood levels of bilirubin and hepatic lipid content. Expression of fatty acid synthase in the liver and the skeletal muscle was decreased in response to feeding an HFD, and this effect was deepened by betaine in the muscle tissue. Hepatic and muscular expression of genes related to insulin signaling were unchanged in HFD-fed rats. Lipolysis stimulated by epinephrine (an adrenergic receptor agonist), forskolin (an activator of adenylate cyclase), dibutyryl-cAMP (an activator of protein kinase A) and DPCPX (an adenosine A1 receptor antagonist) was diminished in the adipocytes of rats fed an HFD, however, this effect was alleviated by betaine. Moreover, blood leptin levels in HFD-fed rats were elevated, whereas leptinemia have normalized by betaine supplementation. Betaine prevented the increase in expression of N-methyl D-aspartate receptors in the hippocampus and in the cerebral cortex. These results indicate that betaine positively affects the insulin-sensitive tissues: liver (hepatoprotective effects), skeletal muscle (reduced lipid accumulation) and adipose tissue (a rise in lipolysis), which is associated with improved insulin sensitivity. Betaine-induced prevention of hyperleptinemia indicates restoration of leptin action, and changes in the brain reveal neuroprotective properties. Our results show that betaine induces positive changes in HFD-fed rats, its action is pleiotropic and involves different tissues.

Acute Shortening and Re-Lengthening (ASRL) in Infected Non-union of Tibia - Advantages Revisited.

INTRODUCTION: A gap non-union in various conditions has been treated successfully by the Ilizarov method. The gap can be filled up either by an acute shortening and re-lengthening (ASRL) procedure or by an internal bone transport (IBT). We compared the functional and clinical outcome of ASRL and IBT in gap non-unions of the infected tibia. MATERIAL AND METHODS: A retrospective study was conducted in our department from the data collected in the period between 1997 and 2010. There were 86 cases of infected non-union of the tibia, in patients of the age group 18 to 65 years, with a minimum two-year follow-up. Group A consisted of cases treated by ASRL (n=46), and Group B, of cases by IBT (n=40). The non-union following both open and closed fractures had been treated by plate osteosynthesis, intra-medullary nails and primary Ilizarov fixators. Radical debridement was done and fragments stabilised with ring fixators. The actual bone gap and limb length discrepancy were measured on the operating table after debridement. In ASRL acute docking was done for defects up to 3cm, and subacute docking for bigger gaps. Corticotomy was done once there was no infection and distraction started after a latency of seven days. Dynamisation was followed by the application of a patellar tendon bearing cast for one month after removal of the ring with the clinico-radiological union. RESULTS: The bone loss was 3 to 8cm (4.77±1.43) in Group A and 3 to 9cm (5.31± 1.28) in Group B after thorough debridement. Bony union, eradication of infection and primary soft- tissue healing was 100%, 85% and 78% in Group A and 95%, 60%, 36% in Group B respectively. Nonunion at docking site, equinus deformity, false aneurysm, interposition of soft-tissue, transient nerve palsies were seen only in cases treated by IBT. CONCLUSION: IBT is an established method to manage gap non-union of the tibia. In our study, complications were significantly higher in cases where IBT was employed. We, therefore, recommend ASRL with an established protocol for better results in terms of significantly less lengthening index, eradication of infection, and primary soft tissue healing. ASRL is a useful method to bridge the bone gap by making soft tissue and bone reconstruction easier, eliminating the disadvantages of IBT.

Sensitivity and uniformity improvement of phased array MR images using inductive coupling and RF detuning circuits.

OBJECTIVE: To improve sensitivity and uniformity of MR images obtained using a phased array RF coil, an inductively coupled secondary resonator with RF detuning circuits at 300 MHz was designed. MATERIALS AND METHODS: A secondary resonator having detuning circuits to turn off the resonator during the transmit mode was constructed. The secondary resonator was located at the opposite side of the four-channel phased array to improve sensitivity and uniformity of the acquired MR images. Numerical simulations along with phantom and in vivo experiments were conducted to evaluate the designed secondary resonator. RESULTS: The numerical simulation results of |B1+| in a transmit mode showed that magnetic field uniformity would be decreased with a secondary resonator having no detuning circuits because of unwanted interferences between the transmit birdcage coil and the secondary resonator. The standard deviation (SD) of |B1+| was decreased 57% with a secondary resonator containing detuning circuits. The sensitivity and uniformity of |B1-| in the receive mode using a four-channel phased array were improved with the secondary resonator. Phantom experiments using a uniform saline phantom had 20% improvement of the mean signal intensity and 50% decrease in the SD with the secondary resonator. Mice with excess adipose tissue were imaged to demonstrate the utility of the secondary resonator. CONCLUSION: The designed secondary resonator having detuning circuits improved sensitivity and uniformity of mouse MR images acquired using the four-channel phased array.

Incidence, characteristics, and mortality of infective endocarditis in France in 2011.

OBJECTIVES: We assessed the determinants of mortality in infective endocarditis (IE), using the national hospital discharge databases (HDD) in 2011. METHODS: IE stays were extracted from the national HDD, with a definition based on IE-related diagnosis codes. This definition has been assessed according to Duke criteria by checking a sample of medical charts of IE giving a predictive positive value of 86.1% (95% confidence interval (CI): 82.7% - 89.5%). The impact of heart valve surgery on survival has been studied if performed during the initial stay, and over the year of follow-up. Risk factors of in-hospital mortality were identified using logistic regression model for the initial stay and Cox Time-dependent model for the 1-year mortality. RESULTS: The analysis included 6,235 patients. The annual incidence of definite IEs was 63 cases/million residents. Staphylococci and Streptococci were the most common bacteria (44% and 45%, respectively). A valvular surgery was performed in 20% of cases, but substantial variations existed between hospitals. The in-hospital mortality was 21% (ranging 12% to 27% according to the region of patients), associated with age>70, chronic liver disease, renal failure, S. aureus, P. aeruginosa or candida infection and strokes whereas valvular surgery, a native valve IE or intraveinous drug use (right heart IE) were significantly protective for an initial death. The same factors were associated with the one-year mortality, except for valvular surgery which was associated with a 1.4-fold higher risk of death during the year post IE. CONCLUSION: We reported a high IE incidence rate. Valvular surgery was considerably less frequent in this study than in the previous published data (near 50%) whereas mortality was similar. Surgery was associated with higher survival if undergone within the initial stay. There were significant regional differences in frequency of surgery but it did not impact mortality.

Improvement of 19F MR image uniformity in a mouse model of cellular therapy using inductive coupling.

OBJECTIVE: Improve 19F magnetic resonance imaging uniformity of perfluorocarbon (PFC)-labeled cells by using a secondary inductive resonator tuned to 287 MHz to enhance the induced radio frequency (RF) magnetic field (B1) at 7.05 T. MATERIALS AND METHODS: Following Faraday's induction law, the sign of induced B1 made by the secondary resonator can be changed depending on the tuning of the resonator. A secondary resonator located on the opposite side of the phantom of the 19F surface coil can be shown to enhance or subtract the induced B1 field, depending upon its tuning. RESULTS: The numerical simulation results of rotating transmit B1 magnitude (|B 1 + |) and corresponding experimental 19F images were compared without and with the secondary resonator. With the secondary resonator tuned to 287 MHz, improvements of |B 1 + | and 19F image uniformity were demonstrated. The use of the secondary resonator improved our ability to visualize transplanted cell location non-invasively over a period of 6 weeks. CONCLUSION: The secondary resonator tuned to enhance the induced B1 results in improved image uniformity in a pre-clinical application, enabling cell tracking of PFC-labeled cells with the secondary resonator.

Hyperpolarized 13C MRI: Path to Clinical Translation in Oncology.

This white paper discusses prospects for advancing hyperpolarization technology to better understand cancer metabolism, identify current obstacles to HP (hyperpolarized) 13C magnetic resonance imaging's (MRI's) widespread clinical use, and provide recommendations for overcoming them. Since the publication of the first NIH white paper on hyperpolarized 13C MRI in 2011, preclinical studies involving [1-13C]pyruvate as well a number of other 13C labeled metabolic substrates have demonstrated this technology's capacity to provide unique metabolic information. A dose-ranging study of HP [1-13C]pyruvate in patients with prostate cancer established safety and feasibility of this technique. Additional studies are ongoing in prostate, brain, breast, liver, cervical, and ovarian cancer. Technology for generating and delivering hyperpolarized agents has evolved, and new MR data acquisition sequences and improved MRI hardware have been developed. It will be important to continue investigation and development of existing and new probes in animal models. Improved polarization technology, efficient radiofrequency coils, and reliable pulse sequences are all important objectives to enable exploration of the technology in healthy control subjects and patient populations. It will be critical to determine how HP 13C MRI might fill existing needs in current clinical research and practice, and complement existing metabolic imaging modalities. Financial sponsorship and integration of academia, industry, and government efforts will be important factors in translating the technology for clinical research in oncology. This white paper is intended to provide recommendations with this goal in mind.

Radio-Frequency Safety Assessment of Stents in Blood Vessels During Magnetic Resonance Imaging.

Purpose: The purpose of this study was to investigate the need for high-resolution detailed anatomical modeling to correctly estimate radio-frequency (RF) safety during magnetic resonance imaging (MRI). RF-induced heating near metallic implanted devices depends on the electric field tangential to the device (Etan ). Etan and specific absorption rate (SAR) were analyzed in blood vessels of an anatomical model to understand if a standard gel phantom accurately represents the potential heating in tissues due to passive vascular implants such as stents. Methods: A numerical model of an RF birdcage body coil and an anatomically realistic virtual patient with a native spatial resolution of 1 mm3 were used to simulate the in vivo electric field at 64 MHz (1.5 T MRI system). Maximum values of SAR inside the blood vessels were calculated and compared with peaks in a numerical model of the ASTM gel phantom to see if the results from the simplified and homogeneous gel phantom were comparable to the results from the anatomical model. Etan values were also calculated in selected stent trajectories inside blood vessels and compared with the ASTM result. Results: Peak SAR values in blood vessels were up to ten times higher than those found in the ASTM standard gel phantom. Peaks were found in clinically significant anatomical locations, where stents are implanted as per intended use. Furthermore, Etan results showed that volume-averaged SAR values might not be sufficient to assess RF safety. Conclusion: Computational modeling with a high-resolution anatomical model indicated higher values of the incident electric field compared to the standard testing approach. Further investigation will help develop a robust safety testing method which reflects clinically realistic conditions.

Global Network for Women's and Children's Health Research: probable causes of stillbirth in low- and middle-income countries using a prospectively defined classification system.

OBJECTIVE: We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm. DESIGN: Prospective, observational study. SETTING: Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya. POPULATION: Pregnant women residing in defined study regions. METHODS: Basic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hierarchal algorithm assigned cause of stillbirth. Causes included birth trauma, congenital anomaly, infection, asphyxia, and preterm birth, based on existing cause of death classifications and included contributing maternal conditions. MAIN OUTCOME MEASURES: Primary cause of stillbirth. RESULTS: Of 109 911 women who were enrolled and delivered (99% of those screened in pregnancy), 2847 had a stillbirth (a rate of 27.2 per 1000 births). Asphyxia was the cause of 46.6% of the stillbirths, followed by infection (20.8%), congenital anomalies (8.4%) and prematurity (6.6%). Among those caused by asphyxia, 38% had prolonged or obstructed labour, 19% antepartum haemorrhage and 18% pre-eclampsia/eclampsia. About two-thirds (67.4%) of the stillbirths did not have signs of maceration. CONCLUSIONS: Our algorithm determined cause of stillbirth from basic data obtained from lay-health providers. The major cause of stillbirth was fetal asphyxia associated with prolonged or obstructed labour, pre-eclampsia and antepartum haemorrhage. In the African sites, infection also was an important contributor to stillbirth. Using this algorithm, we documented cause of stillbirth and its trends to inform public health programs, using consistency, transparency, and comparability across time or regions with minimal burden on the healthcare system. TWEETABLE ABSTRACT: Major causes of stillbirth are asphyxia, pre-eclampsia and haemorrhage. Infections are important in Africa.

Differences in Fundamental Sagittal Pelvic Parameters Based on Age, Sex, and Race.

STUDY DESIGN: This is a retrospective cohort study. OBJECTIVE: To determine whether age, sex, and race have independent effects on sagittal pelvic parameters. SUMMARY OF BACKGROUND DATA: Pelvic parameters and sagittal balance correlate with health-related quality of life and are important for patient assessment and surgical planning. Age, sex, and race are 3 unalterable patient factors that may influence pelvic morphology. METHODS: We conducted a retrospective review of consecutive adult patients who presented to our radiology practice between 2010 and 2015 and had a standing, lateral lumbosacral radiograph. Any patients without both femoral heads and L1-S1 visible on the radiograph, and any patients presenting with traumatic injury, coronal deformity, prior instrumentation, spondylolisthesis, or neoplasm of the spine were excluded. Univariate analysis determined differences in measurements among African American, white, and Hispanic races, as well as between male and female sexes. Correlation analysis between age and different measurements was also conducted. Multivariable regression was then used to determine the independent effect of age, sex, and race on pelvic parameters. RESULTS: We investigated 1801 adults (older than 18 y) and 1246 had a recorded race. There were 1165 women, 636 men, 525 whites, 404 African Americans, and 317 Hispanics. Multivariable regression demonstrated a statistically significant increase in pelvic tilt (PT), pelvic incidence (PI), and pelvic incidence-lumbar lordosis (PI-LL) with aging, and statistically significant decrease in sacral slope (SS) and LL with aging. Women had a statistically greater LL than men. African Americans had a statistically smaller PT and greater SS and PI-LL relative to whites, while Hispanics had a statistically smaller PT and PI-LL, and a statistically greater SS and LL relative to whites. CONCLUSIONS: Pelvic parameters were different between sexes, among races, and changed with age. These findings are important for patient assessment and preoperative planning to obtain optimal sagittal balance. LEVEL OF EVIDENCE: Level 3.

Kidney Disease in Human Immunodeficiency Virus-seropositive Patients: Absence of Human Immunodeficiency Virus-associated Nephropathy was a Characteristic Feature.

Human immunodeficiency virus (HIV) infection can cause a broad spectrum of renal diseases. However, there is paucity of Indian data on the patterns of renal lesions in HIV-seropositive patients. The aim of the present study was to delineate the spectrum of renal lesions in HIV/acquired immunodeficiency syndrome patients. In this prospective study, all HIV-positive patients of both genders aged >18 years were screened for renal disease. Patients with proteinuria of more than 1 g/24 h were subjected to renal biopsy. A total of 293 HIV-positive patients were screened; of these, 136 (46.4%) patients found to have renal involvement. Dipstick-positive proteinuria of 1+ or more was observed in 112 (38.2%) patients, and 16 (14.2%) patients had proteinuria of more than 1 g/24 h. Renal biopsy in 14 cases revealed glomerulonephritis (GN) in 12 (85.7%) (isolated GN in 4 [28.5%] and GN mixed with chronic TIN in 8 [57.1%]) patients. These include mesangioproliferative GN in 5 (35.7%), membranoproliferative GN in 2 (14.2%), focal segmental glomerulosclerosis in 2 (14.2%), diffuse proliferative GN in 2 (14.2%), and diabetic nephropathy in 1 (7.1%) patients. Chronic interstitial nephritis was noted in 10 (71.42%) (superimposed on GN in 8 [57.1%], isolated in 2 [14.2%]) patients. Granulomatous interstitial nephritis was seen in 3 (24.1%) cases. GN and chronic interstitial nephritis were noted in 85.7% and 71.42% of patients, respectively, mostly superimposed on each other. Mesangioproliferative GN was the most common glomerular lesion, but classical HIV-associated nephropathy was not observed.

Improvement of Electromagnetic Field Distributions Using High Dielectric Constant (HDC) Materials for CTL-Spine MRI: Numerical Simulations and Experiments.

This study investigates the use of pads with high dielectric constant (HDC) materials to alter electromagnetic field distributions in patients during magnetic resonance imaging (MRI). The study was performed with numerical simulations and phantom measurements. An initial proof-of-concept and validation was performed using a phantom at 64 MHz, showing increases of up to 10% in electromagnetic field when using distilled water as the high dielectric material. Additionally, numerical simulations with computational models of human anatomy were performed at 128 MHz. Results of these simulations using barium titanate (BaTiO3) beads showed a 61% increase of [Formula: see text] with a quadrature driven RF coil and a 64% increase with a dual-transmit array. The presence of the HDC material also allowed for a decrease of SAR up to twofold (e.g., peak 10 g-averaged SAR from 54 to 22 W/kg with a quadrature driven RF coil and from 27 to 22 W/kg with a dual-transmit array using CaTiO3 powder at 128 MHz). The results of this study show that the use of HDC pads at 128 MHz for MRI spine applications could result in improved magnetic fields within the region of interest, while decreasing SAR outside the region.

RF Safety Evaluation of a Breast Tissue Expander Device for MRI: Numerical Simulation and Experiment.

This study describes the MRI-related radio frequency (RF) safety evaluation of breast tissue expander devices to establish safety criteria. Numerical simulations and experimental measurements were performed at 64 MHz with a gel phantom containing a breast expander. Additionally, computational modeling was performed (64 and 128 MHz) with an adult female model, containing a virtually implanted breast tissue expander device for four imaging landmark positions. The presence of the breast tissue expander device led to significant alterations in specific absorption rate (SAR) and|B1+|distributions. The main source of SAR alterations with the use of the breast expander device was the saline-filled pouch of the expander. Conversely, the variation of RF magnetic field (B1+) was mainly caused by the metallic port. The measured values of electric field magnitude did not increase significantly due to the introduction of the expander device. The maximum 1g- or 10g-averaged SAR values in tissues near the implant were lower than those expected in other regions of the patient body with normalization of both|B1+|equal to 2 µT at the coil isocenter and whole body averaged SAR equal to 4W/kg.

Effects of iron oxide nanoparticles on biological responses and MR imaging properties in human mammary healthy and breast cancer epithelial cells.

Superparamagnetic iron oxide nanoparticles (SPIONs, diameters >50 nm) have received great attention due to their promising use as magnetic resonance imaging (MRI) contrast agents. In this study, we evaluated the cellular uptake and biological responses in vitro of ultrasmall SPIONs (USPIONs, diameters < 50 nm). We compared the cellular responses between breast epithelia isolated from healthy and breast cancer donors after exposure to carboxy-terminated USPIONs (10 and 30 nm PEG-coated, 10 and 30 nm non-PEG-coated). The particles were characterized using transmission electron microscopy (TEM), dynamic light scattering (DLS) and gel electrophoresis. Cellular interactions with USPIONs were assessed by confocal microscopy and TEM. Cellular uptake of USPIONs was quantified using ICP-MS. Cell viability was measured by MTT and neutral red uptake assays. T2* weighted MRI scans were performed using a 7T scanner. Results demonstrated that cell association/internalization of USPIONs was size- and surface coating-dependent (PEG vs. non-PEG), and higher cellular uptake of 10 and 30 nm non-coated particles was observed in both cell types compared with PEG-coated particles. Cell uptake for 10 and 30 nm non-coated particles was higher in cancer cells from two of three tested donors compared to healthy cells from three donors. There was no significant cytotoxicity observed for all tested particles. Significantly enhanced MRI contrast was observed following exposure to 10 and 30 nm non-coated particles compared to PEG-coated particles in both cell types. In comparison, cancer cells showed more enhanced MRI signals when compared to normal cells. The data indicate that cell responses following exposure to USPIONs are dependent on particle properties. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1032-1042, 2016.

A Rotational Cylindrical fMRI Phantom for Image Quality Control.

PURPOSE: A novel phantom for image quality testing for functional magnetic resonance imaging (fMRI) scans is described. METHODS: The cylindrical, rotatable, ~4.5L phantom, with eight wedge-shaped compartments, is used to simulate rest and activated states. The compartments contain NiCl2 doped agar gel with alternating concentrations of agar (1.4%, 1.6%) to produce T1 and T2 values approximating brain grey matter. The Jacard index was used to compare the image distortions for echo planar imaging (EPI) and gradient recalled echo (GRE) scans. Contrast to noise ratio (CNR) was compared across the imaging volume for GRE and EPI. RESULTS: The mean T2 for the two agar concentrations were found to be 106.5±4.8, 94.5±4.7 ms, and T1 of 1500±40 and 1485±30 ms, respectively. The Jacard index for GRE was generally found to be higher than for EPI (0.95 versus 0.8). The CNR varied from 20 to 50 across the slices and echo times used for EPI scans, and from 20 to 40 across the slices for the GRE scans. The phantom provided a reproducible CNR over 25 days. CONCLUSIONS: The phantom provides a quantifiable signal change over a head-size imaging volume with EPI and GRE sequences, which was used for image quality assessment.

Acute kidney injury in patients with human immunodeficiency virus infection.

Acute kidney injury (AKI) is an important cause of hospitalization and morbidity in human immunodeficiency virus (HIV)-positive patients. However, the data on AKI in such patients is limited. The aim of the present study was to analyze the incidence, causes and outcome of AKI in HIV-positive patients from our antiretroviral therapy centre. All HIV-positive patients were evaluated for evidence of clinical AKI. AKI was noted in 138/3540 (3.9%) patients. Of 138 AKI patients, 96 (69.6%) had acquired immuno deficiency syndrome and 42 (30.4%) were HIV seropositive. Majority of AKI patients belonged to AKI network (AKIN) Stage II (42%) or III (48.5%) at presentation. Prerenal, intrinsic and postrenal AKI were noted in 53.6%, 44.2% and 2.2% of cases, respectively. Hypovolemia (44.2%) and sepsis (14.5%) contributed to AKI in vast majority of cases. AKI was multifactorial (volume depletion, sepsis and drugs) in 39% of patients. Acute tubular necrosis (ATN) was the most common intrinsic lesion. Acute interstitial nephritis and diffuse endocapillary proliferative glomerulonephritis were noted in five and two cases, respectively. In-hospital mortality was 24.64%. Lower CD4 count, decreased serum albumin level and Stage 4 WHO disease were associated with higher mortality. At 3 months or more follow-up complete recovery of renal function, chronic kidney disease Stage 3-5 and progression to end stage renal disease were noted in 58.69%, 14.5% and 2.2% of cases, respectively. Thus, prerenal factors and ischemic ATN were the most common cause of AKI in HIV-infected patients. Recovery of renal function was seen in 59% of cases, but AKI had high in-hospital mortality.