Submillisievert coronary CT angiography with adaptive prospective ECG-triggered sequence acquisition and iterative reconstruction in patients with high heart rate on the dual-source CT.

PURPOSE: To assess the application value of submillisievert coronary CT angiography (CCTA) in patients with a high heart rate (HR) acquired with adaptive prospective ECG-triggered sequence acquisition and iterative reconstruction on the secondary generation dual-source CT. MATERIALS AND METHODS: A total of 120 consecutive high-HR patients suspected with coronary artery disease underwent CCTA and invasive coronary angiography (ICA) within two weeks. Patients were randomly assigned into three groups: group A (n = 40), where the patients underwent retrospectively ECG-triggered acquisition CCTA at 100 kVp; group B (n = 40), where the patients received adaptive prospective ECG-triggered sequence acquisition at 100 kVp; and group C (n = 40), where the patients performed adaptive prospective ECG-triggered sequence acquisition at 80 kVp with iterative reconstruction. The mean CT values, signal noise ratios (SNR) and contrast noise ratios (CNR) in the ascending aorta and coronary arteries of the three groups were measured and compared. The image quality and radiation dose among the three groups were compared. The consistency of displaying the coronary stenosis of each group was assessed compared with the results of ICA as the gold standard. RESULTS: There was no significant difference in gender, age and body mass index (BMI) (all P > 0.05). The mean attenuations, SNRs and CNRs in the ascending aorta and coronary artery were not significantly different between group A and group B (P > 0.05). The mean attenuations of group C were significantly higher than group A and group B (P < 0.01), but the image noise and CNR were significantly lower in group C (P < 0.01). The number of appreciable segments among the three groups was not significantly different on a per-segment and per-vessel basis (P > 0.05). The subjective image quality among the three groups was not significantly different (P > 0.05). With the ICA result as a reference standard, there was good consistency in the evaluation of the coronary stenosis degree between CCTA and ICA (r > 0.75), as well as in the assessment of the coronary stenosis rate using the Bland- Altman analysis. The mean radiation dose in group B was half of that in group A. Moreover, the mean radiation dose in group C was less than one sixth of that in group A and less than 1 mSv (0.7±0.2 mSv). CONCLUSIONS: For patients with high HR, adaptive prospective ECG-triggered sequence acquisition on the FLASH dual-source CT results in equal image quality and half of the radiation dose reduction compared with retrospectively ECG-triggered spiral acquisition at the same tube voltage (100 kVp) and same R-R interval of exposure. In addition, adaptive prospective ECG-triggered sequence acquisition combined with low tube voltage and iterative reconstruction can further reduce the radiation dose to the submillisievert level without compromising image quality and the accuracy of assessing the coronary stenosis degree, and can be popularized as a routine technique.

Promotional effect of platelet-rich plasma on hair follicle reconstitution in vivo.

BACKGROUND: Platelet-rich plasma (PRP) containing various growth factors has attracted attention in various medical fields. PRP has recently been used during hair transplantation to increase hair density. OBJECTIVE: To investigate the effects of PRP on hair follicle (HF) reconstitution. METHODS AND MATERIALS: Freshly isolated epidermal cells and cultured dermal papilla cells (DPCs) were mixed with various concentrations of activated PRP and transferred to a grafting chamber that was implanted onto the dorsal skin of nude mice. The chambers were removed 1 week after grafting, and HF formation was monitored for 4 weeks. RESULTS: We observed a significant difference (p < .05) in the number of newly formed follicles in the area of reconstituted skin (344 ± 27 with 10% PRP vs 288 ± 35 without PRP). PRP also shortened the time of hair formation significantly; the first hairs were observed in 18 ± 1 days using 10% PRP, versus 20 ± 1 days without PRP. CONCLUSION: A considerable effect of PRP on the time of hair formation and the yield of HF reconstitution was observed in this study. Considering the limited evidence available to judge its efficacy, further studies are required to investigate the mechanism of action of PRP.

A novel stent coated with antibodies to endoglin inhibits neointimal formation of porcine coronary arteries.

Endoglin/CD105 is an accessory protein of the transforming growth factor-ß receptor system that plays a critical role in proliferation of endothelial cells and neovasculature. Here, we aimed to assess the effect of novel stents coated with antibodies to endoglin (ENDs) on coronary neointima formation. Thirty ENDs, thirty sirolimus-eluting stents (SESs), and thirty bare metal stents (BMSs) were randomly assigned and placed in the coronary arteries in 30 juvenile pigs. Histomorphometric analysis and scanning electron microscopy were performed after stent implantation. Our results showed that after 7 days, there was no difference in the neointimal area and percent area stenosis in ENDs compared with SMSs or BMSs. After 14 days, the neointima area and percent area stenosis in ENDs were markedly decreased than those in BMSs or SESs (P < 0.05). Moreover, the percentage of reendothelialization was significantly higher in ENDs than that in SESs or BMSs (P < 0.01) at 7 and 14 days. The artery injury and the inflammation scores were similar in all groups at 7 and 14 days. In conclusion, our results demonstrated for the first time to our knowledge that endoglin antibody-coated stents can markedly reduce restenosis by enhancing reendothelialization in the porcine model and potentially offer a new approach to prevent restenosis.

[Preparation of polyclonal antibody against sAPRIL and analysis of function in suppressing sAPRIL-mediated lymphocyte proliferation].

This study was aimed to prepare the polyclonal antibody against the soluble proliferation-inducing ligand (sAPRIL) antigen and to investigate its effects in suppressing sAPRIL mediated lymphocyte proliferation. Mutated recombinant sAPRIL protein, which lacks biological activity but maintains immunogenicity, was used as antigen to immunize humanized SCID mice. Sera were obtained at 6 weeks after immunization. Indirect ELISA and Western blot were used to detect the antibody titer and specificity. The inhibition of polyclonal antibodies on Raji and Jurkat cell proliferation stimulated by sAPRIL was assessed by the MTT assay. The results showed that the mutant of sAPRIL could induce the production of polyclonal antibodies against human sAPRIL. Western blot and indirect ELISA analyses indicated that the anti-serum had higher specificity with a titer of 1:640. Functional analysis revealed that these polyclonal antibodies significantly inhibited the proliferation of Raji and Jurkat cell stimulated by sAPRIL (p < 0.05). It is concluded the polyclonal antibody against human sAPRIL is successfully prepared, which can inhibit the proliferation of Raji and Jurkat cells stimulated by sAPRIL in vitro.

[Effect of intense pulsed light on transforming growth factor-beta1 mRNA expression in rat skin].

OBJECTIVE: To observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation. METHODS: Fifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization. RESULTS: In the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA. CONCLUSION: IPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.

[Genioplasty with morselized autologous bone graft].

OBJECTIVE: To investigate a new method of genioplasty for treatment of a prominent mandibular angle with mandibular malformation. METHODS: According to the different types of the mandible, the prominent mandibular angle was grinded with the masseter muscle kept intact. Autologous micromorselized bone of the grinded mandibular angle was collected and implanted into the chin for augmentation mentoplasty, and the chin was fixed with gypsum after operation. RESULTS: Fifteen patients receiving the surgery were followed up for 6 -12 months, and satisfactory effects were achieved in 12 patients. One patient requested modification of the shape of the chin 10 days after the operation, and another two sustained chin distortion due to external forces and underwent subsequent shape adjustment of the chin. CONCLUSION: The procedure described avoids graft rejection and causes less complications for genioplasty with easy moulding and satisfactory outcome.