Metastasis to the Heart: A Radiologic Approach to Diagnosis With Pathologic Correlation.

OBJECTIVE: Evaluating metastatic disease to the heart and pericardium, from detection to diagnosis, often requires a multimodality imaging approach. A radiologist's ability to evaluate cardiac metastases hinges on an understanding of the epidemiology, anatomy, and imaging features of this disease process. CONCLUSION: On surveillance imaging of patients with cancer or when metastatic disease is suspected, detection of metastatic disease may be greatly enhanced by an understanding of which primary tumors metastasize to the heart and the most common routes of spread.

Electrokinetically-enhanced emplacement of lactate in a chlorinated solvent contaminated clay site to promote bioremediation.

Bioremediation through the injection of electron donors and bacterial cultures is effective at treating chlorinated solvent contamination. However, it has had limited application in low permeability zones where amendments cannot be delivered successfully. This field-scale study investigated the application of electrokinetics to enhance the delivery of lactate at a clay site contaminated with chlorinated solvents. Groundwater and soil samples were collected before, during and for 1 year after the 71-day field test and analyzed for a wide suite of chemical and biological parameters. Lactate was successfully delivered to all monitoring locations. Lactate emplacement resulted in the stimulation of bacterial populations, specifically within the phylum Firmicutes, which contains fermenters and strict anaerobes. This likely led to biodegradation, as the field trial resulted in significant decreases in both soil and aqueous phase chlorinated solvent concentrations. Contaminant decreases were also partially attributable to dilution, given evidence of some advective lactate flux. This research provides evidence that electrokinetically-enhanced bioremediation has potential as a treatment strategy for contaminated low permeability strata.

Reduced Axial Scan Length Coronary Calcium Scoring Reduces Radiation Dose and Provides Adequate Clinical Decision-Making Before Coronary CT Angiography.

Extensive coronary artery calcium (CAC) diminishes the accuracy of coronary computed tomography angiography (CCTA). Many imagers adjust CCTA acquisition parameters depending on a preCCTA Agatston CAC score to optimize diagnostic accuracy. Typical preCCTA CAC imaging adds considerably to radiation exposure, partially attributable to imaging beyond the area known for highest CAC, the proximal coronary arteries. We aimed to determine whether a z-axis reduced scan length (RSL) would identify the majority of CAC and provide adequate information to computed tomography angiography providers relative to a standard full-scan length (FSL) preCCTA noncontrast CT. We retrospectively examined 200 subjects. The mean CAC scores detected in RSL and FSL were 77.4 (95% CI 50.6 to 104.3) and 93.9 (95% CI 57.3 to 130.5), respectively. RSL detected 81% of the FSL CAC. Among false negatives, with no CAC detected in RSL, FSL CAC severity was minimal (mean score 2.8). There was high concordance, averaging 88%, between CCTA imaging parameter adjustment decisions made by 2 experienced imagers based on either RSL or FSL. CAC detected and decision concordance decreased with increasing CAC burden. CAC detected was lower, and false negatives were more common in the right coronary artery owing to its anatomic course, placing larger segments outside RSL. Axial scan length and effective dose decreased 59% from FSL (∼14.5 cm/∼1.1 mSv) to RSL (∼5.9 cm/∼0.45 mSv). This retrospective study suggests that RSL identifies most CAC, results in similar CCTA acquisition parameter modifications, and reduces radiation exposure. Our colleagues corroborated these results in a recently published prospective study.

Exposure to the Florida red tide dinoflagellate, Karenia brevis, and its associated brevetoxins induces ecophysiological and proteomic alterations in Porites astreoides.

As reef-building corals are increasingly being exposed to persistent threats that operate on both regional and global scales, there is a pressing need to better understand the complex processes that diminish coral populations. This study investigated the impacts of the Florida red tide dinoflagellate Karenia brevis and associated brevetoxins on selected facets of coral biology using Porites astreoides as a model system. When provided with choice assays, P. astreoides larvae were shown to actively avoid seawater containing red tide (5×105 cells L-1-7.6×106 cells L-1) or purified brevetoxins (0.018 µg mL-1 brevetoxin-2 and 0.0018 µg mL-1 brevetoxin-3). However, forced exposure to similar treatments induced time-dependent physiological and behavioral changes that were captured by PAM fluorometry and settlement and survival assays, respectively. Adult fragments of P. astreoides exposed to red tide or associated brevetoxins displayed signs of proteomic alterations that were characterized by the use of an iTRAQ-based quantitative proteomic analysis. The novel use of this technique with P. astreoides demonstrated that protein regulation was highly contingent upon biological versus chemical treatment (i.e. live K. brevis vs. solely brevetoxin exposure) and that several broad pathways associated with cell stress were affected including redox homeostasis, protein folding, energy metabolism and reactive oxygen species production. The results herein provide new insight into the ecology, behavior and sublethal stress of reef-building corals in response to K. brevis exposure and underscore the importance of recognizing the potential of red tide to act as a regional stressor to these important foundation species.

Field test of electrokinetically-delivered thermally activated persulfate for remediation of chlorinated solvents in clay.

In situ chemical oxidation (ISCO) has demonstrated success in remediating soil and groundwater contaminated with chlorinated volatile organic compounds (CVOCs). However, its performance is often hindered in low-permeability or heterogeneous media due to an inability to effectively deliver the oxidants. This field-scale study investigated the novel approach of applying electrokinetics (EK) to enhance the delivery of persulfate in a low-permeability media and the ability of electrical resistance heating (ERH) to thermally activate the delivered persulfate. Results showed that 40% of the mass of total sulfur delivered was due to EK mechanisms, demonstrating that EK has the potential to enhance oxidant delivery. ERH may have activated some of the persulfate, but catalytic reactions with reduced forms of iron likely resulted in appreciable persulfate decomposition prior to ERH. Significant decreases (>80%) in the aqueous concentration of CVOCs was observed before and after ERH initiation, attributed to in situ transformation and physical processes (e.g., dilution). In situ transformation of CVOCs was assessed by compound-specific isotope analysis (CSIA) of 1,2-dichloroethane (1,2-DCA) samples collected after ERH application. Enrichment of 13C was only measured in the well with appreciable persulfate breakthrough, confirming dechlorination of 1,2-DCA. Results from this field study demonstrate that EK and ERH can be used for persulfate delivery and activation for remediation of CVOCs in low-permeability media.

Concentration rebound following in situ chemical oxidation in fractured clay.

A two-dimensional, transient-flow, and transport numerical model was developed to simulate in situ chemical oxidation (ISCO) of trichloroethylene and tetrachloroethylene by potassium permanganate in fractured clay. This computer model incorporates dense, nonaqueous phase liquid dissolution, reactive aquifer material, multispecies matrix diffusion, and kinetic formulations for the oxidation reactions. A sensitivity analysis for two types of parameters, hydrogeological and engineering, including matrix porosity, matrix organic carbon, fracture aperture, potassium permanganate dosage, and hydraulic gradient, was conducted. Remediation metrics investigated were the relative rebound concentrations arising from back diffusion and percent mass destroyed. No well-defined correlation was found between the magnitude of rebound concentrations during postremedy monitoring and the amount of contaminant mass destroyed during the application. Results indicate that all investigated parameters affect ISCO remediation in some form. Results indicate that when advective transport through the fracture is dominant relative to diffusive transport into the clay matrix (large System Peclet Number), permanganate is more likely to be flushed out of the system and treatment is not optimal. If the System Peclet Number is too small, indicating that diffusion into the matrix is dominant relative to advection through the fracture, permanganate does not traverse the entire fracture, leading to postremediation concentration rebound. Optimal application of ISCO requires balancing advective transport through the fracture with diffusive transport into the clay matrix.

Multiphase flow and transport through fractured heterogeneous porous media.

The migration of Dense, Non-Aqueous Phase Liquid (DNAPL) and dissolved phase contamination through a fractured heterogeneous porous medium has been investigated through the use of a multiphase compositional model. The sensitivity of the timescales of migration and the distribution of contaminant in the subsurface to the mean permeability, the variance of the permeability, and the degree of fracturing of the domain were examined. It was found that increasing the mean permeability of the domain allowed the DNAPL to penetrate deeper into the subsurface, while decreasing the mean permeability caused the DNAPL to pool at shallower depths. The presence of fractures within the system was found to control the infiltration only in the most fractured domain. Moment analysis of the nonwetting phase showed that large-scale movement had ceased after approximately 9 years (maximum duration of the source-on condition was approximately 4.5 years). This tended to be due to a redistribution of the DNAPL towards a residual configuration, as was evidenced by the gradual trending of average nonwetting phase saturations within the domain to a static value. The dissolved phase plume was found to migrate at essentially the same rate as the nonwetting phase, due to the reduced relative permeability of lenses containing DNAPL, and due to diffusive losses of mass to the matrix of fractured clay and silty-clay lenses. Some exceptions to this were found when the DNAPL could not overcome the displacement pressure of a lens, and could not by-pass the lens due to the lack of available driving force after the source had been shut off.

Electrokinetic in situ oxidation remediation: assessment of parameter sensitivities and the influence of aquifer heterogeneity on remediation efficiency.

A newly developed groundwater and electrokinetic (EK) flow and reactive transport numerical model was applied to simulate electrokinetic in situ chemical oxidation (EK-ISCO) remediation. Scenario simulations that considered the oxidation of a typical organic contaminant (tetrachloroethene) by permanganate were used to gain a better understanding of the key processes and parameters that control remediation efficiency. In a first step a sensitivity analysis was carried out to investigate a range of EK, hydraulic and engineering parameters on the performance of EK-ISCO. While all investigated parameters affected the remediation process to some extent, the duration and energy required for remediation were shown to be most dependent upon the applied voltage gradient, the natural oxidant demand and the concentration of the injected oxidant. Secondly, the efficacy of EK-induced oxidant transport was further examined for a heterogeneous aquifer system with random permeability fields. Oxidant migration under EK was slower in low-permeability media due to the increased oxidant consumption of competing reductants. Instead of injecting oxidant only at the cathode, locating injection wells between the electrodes greatly increased the contaminant degradation by decreasing the distance the amendment had to migrate before reaching the contaminant.

Use of electrophoresis for transporting nano-iron in porous media.

Research has been conducted to evaluate if electrophoresis could transport surface stabilized nanoscale zero-valent iron (nZVI) through fine grained sand with the intent of remediating a contaminant in situ. The experimental procedure involved determining the transport rates of polymer modified nZVI and hematite in fine grained sands under an applied electrical gradient under different physical and chemical conditions. Results indicated transport of polymer modified nZVI and hematite can be accomplished by electrophoresis, with rates found to be much higher than diffusion alone and comparable to those predicted by electrokinetic theory. This study indicates there is potential for this method to deliver polymer modified nZVI into contaminated zones within fine grained sands for the purpose of remediation.

Discretizing the fracture-matrix interface to simulate solute transport.

This article examines the required spatial discretization perpendicular to the fracture-matrix interface (FMI) for numerical simulation of solute transport in discretely fractured porous media. The discrete-fracture, finite-element model HydroGeoSphere (Therrien et al. 2005) and a discrete-fracture implementation of MT3DMS (Zheng 1990) were used to model solute transport in a single fracture, and the results were compared to the analytical solution of Tang et al. (1981). To match analytical results on the relatively short timescales simulated in this study, very fine grid spacing perpendicular to the FMI of the scale of the fracture aperture is necessary if advection and/or dispersion in the fracture is high compared to diffusion in the matrix. The requirement of such extremely fine spatial discretization has not been previously reported in the literature. In cases of high matrix diffusion, matching the analytical results is achieved with larger grid spacing at the FMI. Cases where matrix diffusion is lower can employ a larger grid multiplier moving away from the FMI. The very fine spatial discretization identified in this study for cases of low matrix diffusion may limit the applicability of numerical discrete-fracture models in such cases.

Electrokinetic migration of permanganate through low-permeability media.

This research was conducted to evaluate the combination of electromigration and potassium permanganate as a potential remediation method for low-permeability media (e.g., soil and sediment) contaminated with dissolved and sorbed organic contaminants. The experimental procedure was composed of two stages: determination of migration rates of permanganate through homogeneous cores and a primarily qualitative analysis of migration in more heterogeneous, two-dimensional scenarios. Results indicated that transport of permanganate through fine-grained porous media and clays can be undertaken using electromigration, and electromigration rates were found to be at least 400% faster than diffusion alone. In addition, the use of an applied electric field in a flushing scenario was shown to result in almost 100% sweep efficiency of a domain consisting of clay blocks interspersed in a glass bead medium. The results of the study show that there is potential for this method to be able to deliver permanganate and other potential remedial agents to treat contaminated zones within heterogeneous and low-permeability porous media through in situ chemical oxidation or other processes.