Efficacy and Safety of MRI and CT Guided VX2 Hepatic Para-vascular Tumor Model in Rabbits.

OBJECTIVE: To compare the efficacy and safety of 1.5 T MRI and CT-guided VX2 hepatic para-vascular tumor model in rabbits. MATERIALS AND METHODS: Sixty New Zealand white rabbits were randomly and equally divided into MRI-guided group (n=30) and CT-guided group (n=30). Rabbit VX2 tumor fragments were implanted beside the rabbit hepatic great vessels under MRI and CT guidance in the MRI and CT group to evaluate the success rate of tumor model establishment, puncture needle display and tip peripheral vascular situation, operation time and safety. RESULTS: In the MRI-guided group, 29 rabbits (29/30, 96.7%) had a successful establishment of liver tumor model, and 1 rabbit had needle metastasis. In the CT-guided group, 24 rabbits (24/30, 80%) had a successful establishment of liver tumor model, while 2 rabbits had needle metastasis, 3 rabbits had metastases in other parts of the liver, and 1 had an unknown cause of death. The differences in tumor model establishment success rate between the two groups were statistically significant (χ2 = 4.043, P < 0.05). The fold number of artifacts at T1WI was 7.26±0.38 for the 20 G coaxial puncture needle in the MRI-guided group and 2.51±0.57 for the 20 G coaxial puncture needle in the CT-guided group, and the difference was statistically significant (t=36.76, P < 0.001), but star-shaped hypodense artifacts would appear around the needle tip. The operation time was longer in the MRI-guided group than in the CT-guided group (13.32±2.45 minutes in the MRI-guided group vs. 8.42±1.46 minutes in the CTguided group; t=9.252, P < 0.001). A small number of ascites occurred in 2 patients (2/30, 6.67%) in the CT-guided group; no serious complications such as liver abscess, jaundice or diaphragmatic perforation were observed in both groups. CONCLUSION: Compared with CT, MRI-guided hepatic para-vascular tumor implantation in rabbits might be a more effective modeling method. Although the needle tip pseudopacity of the puncture needle is large and the operation time is long, the incidence of complications is low.

Magnetic resonance neurography in the management of trigeminal neuralgia: a cohort study of 55 patients.

OBJECTIVE: To explore the usefulness of magnetic resonance neurography (MRN) in the diagnosis and management of trigeminal neuralgia (TN). STUDY DESIGN: In total, 55 patients clinically diagnosed with TN were imaged with 3.0-T magnetic resonance imaging. Images were reconstructed to show the full course of the trigeminal nerve. Clinical findings included mean duration of symptoms (41.99 months) and mean visual analog scale pain intensity (5.98). Final diagnoses were microvascular compression (19), inflammation (21), microvascular compression with inflammation (5), normal (5), tumor (1), peripheral nerve injury (2), and multiple sclerosis (2). RESULTS: MRN had substantial impact on diagnosis and treatment in 56.4% of cases. A total of 33 patients underwent intervention for pain. MRN had substantial impact on 54.5% of the treated patients. The correlation between MRN results and intervention response was excellent in 19 patients (57.6%) and moderate in 14 (42.4%). Pain was reduced after surgery or interventional procedure in most cases (75.8%). CONCLUSIONS: MRN is suitable for the diagnosis of clinical TN with beneficial impact on diagnosis and clinical management and moderate-to-excellent correlation with intervention response. Diagnosis of TN should focus not only on microvascular compression but also on the conditions of the peripheral branches of the trigeminal nerve.

Novel insights into the role of Clostridium novyi-NT related combination bacteriolytic therapy in solid tumors.

Several solid tumors (for example leiomyosarcoma, melanoma and hepatocellular carcinoma) possess areas of hypoxia, which underlies one of the primary reasons of failure of conventional anticancer therapies. The areas of poor vascularization are insensitive to radiotherapy and chemotherapeutic drugs. Conversely, the hypoxic regions of tumors provide an ideal environment for anaerobic bacteria. The attenuated anaerobic bacterium, Clostridium novyi-NT (C. novyi-NT), is highly sensitive to oxygen and can target the destruction of hypoxic and necrotic areas of tumors, inducing oncolysis and characteristics indicative of an immune response. Theoretically, chemotherapy, radiotherapy and immunotherapy combined with bacterial therapy can be used as a novel means of treating solid tumors, promoting tumor regression and inhibiting metastasis formation with a notable beneficial effect. The present review discusses the molecular mechanisms of combined bacteriolytic therapy, predominantly focusing on C. novyi-NT, and summarizes the findings of previous studies on experimental animal models, including its efficacy and safety via different drug delivery routes. This strategy has great potential to overcome the limitations of conventional cancer therapy, resulting in improved treatments, and thus potentially improved outcomes for patients.

Structural and Functional Brain Abnormalities in Trigeminal Neuralgia: A Systematic Review.

AIMS: To evaluate the available literature on structural and functional brain abnormalities in trigeminal neuralgia (TN) using several brain magnetic resonance imaging (MRI) techniques to further understand the central mechanisms of TN. METHODS: PubMed and Web of Science databases and the reference lists of identified studies were searched to identify potentially eligible studies through January 2019. Eligible articles were assessed for risk of bias and reviewed by two independent researchers. RESULTS: A total of 17 articles meeting the inclusion criteria were included in this study. The methodologic quality of the included studies was moderate. A total of 10 studies evaluated structural gray matter (GM) changes, and there was reasonable evidence that the GM of some specific brain regions changed in TN patients. In addition, there was a significant change in the root entry zone of the trigeminal nerve and in several regions of white matter. Functional changes in resting state were assessed in 9 studies. TN patients showed increased activation of resting state, and this activation was reduced in specific brain regions. There were several studies that focused on the correlation between functional parameters or strength of functional connectivity and clinical features (eg, visual analog score and pain duration), but each study focused on different brain areas or different functional connectivities within the brain. CONCLUSION: There is moderate evidence that TN patients show structural brain differences in specific cortical and subcortical regions. In addition, TN patients show changes in pain-related functional connections in the resting state. Future research should focus on longitudinal designs and integration of different brain-imaging techniques.

Vitamin D Ameliorates Impaired Wound Healing in Streptozotocin-Induced Diabetic Mice by Suppressing Endoplasmic Reticulum Stress.

BACKGROUND: This study is designed to investigate whether vitamin D promotes diabetic wound healing and explore the potential mechanism which may be involved in the healing process. MATERIAL AND METHODS: Human umbilical vein endothelial cells (HUVECs) were treated with 200 µg/ml of advanced glycation end product-modified human serum albumin (AGE-HSA) and 250 mg/dl of glucose with vitamin D. Cell viability was analyzed using the CCK-8 assay, and the apoptosis rate was measured using flow cytometry. Endogenous markers of ER stress were quantified using Western blot and a real-time polymerase chain reaction. Diabetic mice were treated with vitamin D (100 ng/kg per day) for 14 days. The ulcer area and ulcerative histology were detected dynamically. RESULTS: Vitamin D administration not only decreased the apoptosis rate but also increased cell viability. Furthermore, the expression of endogenous markers of ER stress was downregulated as a result of vitamin D treatment. Vitamin D supplementation significantly accelerated wound healing of diabetic mice and improved the healing quality. Further studies showed that reduced ER stress was associated with the positive outcome. CONCLUSION: These results suggest that vitamin D may ameliorate impaired wound healing in diabetic mice by suppressing ER stress.

Vitamin D ameliorates impaired wound healing in streptozotocin-induced diabetic mice by suppressing NF-κB-mediated inflammatory genes.

Diabetic wounds are characterized by delayed wound healing due to persistent inflammation and excessive production of reactive oxygen species. Vitamin D, which is well acknowledged to enhance intestinal calcium absorption and increase in plasma calcium level, has recently been shown to display beneficial effects in various vascular diseases by promoting angiogenesis and inhibiting inflammatory responses. However, the role of Vitamin D in diabetic wound healing is still unclear. In the present study, we investigated the role of Vitamin D in cutaneous wound healing in streptozotocin (STZ)-induced diabetic mice. Four weeks after injection of STZ, a full thickness excisional wound was created with a 6-mm diameter sterile biopsy punch on the dorsum of the mice. Vitamin D was given consecutively for 14 days by intraperitoneal injection. Vitamin D supplementation significantly accelerated wound healing in diabetic mice and improved the healing quality as assessed by measuring the wound closure rate and histomorphometric analyses. By monitoring the level of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin (IL) 6 (IL-6), IL-1ß) in the wounds, reduced inflammatory response was found in VD treatment group. Furthermore, nuclear factor κB (NF-κB) pathway was found to be involved in the process of diabetic wound healing by assessing the relative proteins in diabetic wounds. Vitamin D supplementation obviously suppressed NF-κB pathway activation. These results demonstrated that Vitamin D improves impaired wound healing in STZ-induced diabetic mice through suppressing NF-κB-mediated inflammatory gene expression.

Application of magnetic resonance imaging in cervical spondylotic myelopathy.

Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction and is caused by static or dynamic repeated compression of the spinal cord resulting from degenerative arthritis of the cervical spine and some biological injuries to the cervical spine. The T2 signal change on conventional magnetic resonance imaging (MRI) is most commonly associated with neurological deficits. Diffusion tensor imaging and MR spectroscopy show altered microstructure and biochemistry that reflect patient-specific pathogenesis and can be used to predict neurological outcome and response to intervention. Functional MRI can help to assess the neurological functional recovery after decompression surgery for CSM.

Magnetic resonance imaging correlates of bee sting induced multiple organ dysfunction syndrome: A case report.

Occasionally systemic complications with high risk of death, such as multiple organ dysfunction syndrome (MODS), can occur following multiple bee stings. This case study reports a patient who presented with MODS, i.e., acute kidney injury, hepatic and cardiac dysfunction, after multiple bee stings. The standard clinical findings were then correlated with magnetic resonance imaging (MRI) findings, which demonstrates that MRI may be utilized as a simpler tool to use than other multiple diagnostics.

Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and meta-analysis.

BACKGROUND: The objective of this study was to perform a systematic review and a meta-analysis in order to estimate the diagnostic accuracy of diffusion weighted imaging (DWI) in the preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma. METHODS: Studies evaluating DWI for the detection of deep myometrial invasion in patients with endometrial carcinoma were systematically searched for in the MEDLINE, EMBASE, and Cochrane Library from January 1995 to January 2014. Methodologic quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies tool. Bivariate random-effects meta-analytic methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and receiver operating characteristic (ROC) curves. The study also evaluated the clinical utility of DWI in preoperative assessment of deep myometrial invasion. RESULTS: Seven studies enrolling a total of 320 individuals met the study inclusion criteria. The summary area under the ROC curve was 0.91. There was no evidence of publication bias (P = 0.90, bias coefficient analysis). Sensitivity and specificity of DWI for detection of deep myometrial invasion across all studies were 0.90 and 0.89, respectively. Positive and negative likelihood ratios with DWI were 8 and 0.11 respectively. In patients with high pre-test probabilities, DWI enabled confirmation of deep myometrial invasion; in patients with low pre-test probabilities, DWI enabled exclusion of deep myometrial invasion. The worst case scenario (pre-test probability, 50%) post-test probabilities were 89% and 10% for positive and negative DWI results, respectively. CONCLUSION: DWI has high sensitivity and specificity for detecting deep myometrial invasion and more importantly can reliably rule out deep myometrial invasion. Therefore, it would be worthwhile to add a DWI sequence to the standard MRI protocols in preoperative evaluation of endometrial cancer in order to detect deep myometrial invasion, which along with other poor prognostic factors like age, tumor grade, and LVSI would be useful in stratifying high risk groups thereby helping in the tailoring of surgical approach in patient with low risk of endometrial carcinoma.