Development of an efficient, effective, and economical technology for proteome analysis.

We present an efficient, effective, and economical approach, named E3technology, for proteomics sample preparation. By immobilizing silica microparticles into the polytetrafluoroethylene matrix, we develop a robust membrane medium, which could serve as a reliable platform to generate proteomics-friendly samples in a rapid and low-cost fashion. We benchmark its performance using different formats and demonstrate them with a variety of sample types of varied complexity, quantity, and volume. Our data suggest that E3technology provides proteome-wide identification and quantitation performance equivalent or superior to many existing methods. We further propose an enhanced single-vessel approach, named E4technology, which performs on-filter in-cell digestion with minimal sample loss and high sensitivity, enabling low-input and low-cell proteomics. Lastly, we utilized the above technologies to investigate RNA-binding proteins and profile the intact bacterial cell proteome.

Prospective Study of Polytetrafluoroethylene-Covered Microplugs and Detachable Coils for Embolization of Pulmonary Arteriovenous Malformations: Technical Results, Procedure Times, and Costs.

PURPOSE: To determine time to occlusion and procedure costs of embolization of pulmonary arteriovenous malformations (PAVMs) using a polytetrafluoroethylene-covered microplug compared with embolization using detachable coils. MATERIALS AND METHODS: In this prospective study, 37 patients (mean age, 39.1 years [SD ± 17.6]) with 82 PAVMs underwent embolization with microplug or detachable coils between April 2019 and January 2023. Technical success, procedure time intervals, and costs were analyzed. RESULTS: In 37 patients, 82 PAVMs and 101 feeding arteries were successfully treated (microplug, 64; microplug + another device, 5; detachable coils alone, 32). Time from embolic device inserted into the catheter to device deployed and time to occlusion differed significantly between microplug and detachable coil cohorts (P < .0001 for both). Embolization with ≥1 microplug had a significantly shorter occlusion time than embolization with detachable coils (median, 10.0 minutes saved per feeding artery) (P < .0001). Compared with detachable coil embolization, microplug embolization saved a median of 9.0 minutes per feeding artery (P < .0001) and reduced room cost by a median of $429 per feeding artery (P < .0001). Device costs per feeding artery did not differ significantly between microplug ($2,790) and detachable coil embolization ($3,147) (P = .87). CONCLUSIONS: Compared with coils, microplugs had an equally high technical success rate but significant time to occlusion and room costs savings per feeding artery. Total room cost and device cost together did not differ significantly between microplugs and coils. Microplugs may be considered technically effective and at least cost-neutral for PAVM embolization where clinically appropriate.

Predictive metabolomic signatures for safety assessment of three plastic nanoparticles using intestinal organoids.

Nanoplastic particles are pervasive environmental contaminants with potential health risks, while mouse intestinal organoids provide accurate in vitro models for studying these interactions. Metabolomics, especially through LC-MS, enables detailed cellular response studies, and there's a novel interest in comparing metabolic changes across nanoparticle species using gut organoids. This study used a mouse intestinal organoid combined with cell model to explore the differences in metabolites and toxicity mechanisms induced by exposure to three nanoplastics (PS, PTFE, and PMMA). The results showed that PS, PTFE, and PMMA exposure reduced mitochondrial membrane potential, intracellular ROS accumulation and oxidative stress, and inhibited the AKT/mTOR signaling pathway. Non-targeted metabolomics results confirmed that three types of nanoplastic particles regulate cellular status by regulating fatty acid metabolism, nucleotide metabolism, necroptosis and autophagy pathways. More importantly, these representative metabolites were further validated in model groups after mouse intestinal organoids and HCT116 cells were exposed to the respective NPs, indicating that organoid metabolomics results can be used to effectively predict toxicity. Untargeted metabolomics is sensitive enough to detect subtle metabolomic changes when functional cellular analysis shows no significant differences. Overall, our study reveals the underlying metabolic mechanism of NPs-induced intestinal organoid toxicity and provides new insights into the possible adverse consequences of NPs.

Safety Assessment of Polyfluorinated Polymers as Used in Cosmetics.

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 12 polyfluorinated polymers in cosmetic products; most of these ingredients have the reported function of film former in common. However, PTFE, the only ingredient that is reported as currently used in cosmetics, functions as a bulking agent and slip modifier, but not as a film former. The Panel reviewed data relevant to the safety of these ingredients under the intended conditions of use in cosmetic formulations, and concluded that PTFE and Hexafluoropropylene/Tetrafluoroethylene Copolymer are safe in cosmetics in the present practices of use and concentration described in the safety assessment; the data are insufficient to determine the safety of the 4 fluorinated-side-chain polymers and 6 fluorinated polyethers.

Assessment of the effect of spacer material on gap and void formation in an endodontic temporary restoration using micro-computed tomography.

This study aimed to evaluate the effect of two spacer materials (cotton pellet and polytetrafluoroethylene [PTFE]) on gap and void formation in the Cavit restoration used for endodontic temporization. Thirty-four extracted human single-rooted premolars were matched and allocated into two groups (n = 17/group) according to the access cavity spacer (cotton pellet or PTFE). Standardized endodontic access cavities were prepared in all the teeth. Subsequently, the teeth were scanned by micro-computed tomography (micro-CT) to determine the volume of the access cavities. The teeth were then temporized by placing either cotton pellet or PTFE as spacer materials on the canal orifices, followed by the Cavit restoration. Following the temporization procedure, the teeth were subjected to a second micro-CT scan to determine the percentage volume of gaps and voids along the margins and within the Cavit restoration, respectively. Statistical analysis was performed using the Shapiro-Wilk and Wilcoxon signed-rank tests with a 5% significance level. The PTFE spacer was associated with significantly less gap formation between the Cavit restoration and the access cavity walls (P < 0.05) compared with the cotton pellet. No difference existed in void formation between the groups (P > 0.05). These findings indicate that the spacer material placed under the Cavit restoration can influence the quality of overlying restoration. PTFE was associated with less gap formation and, therefore, performed better than the cotton pellet as a spacer material beneath the Cavit restoration during endodontic treatment.

GORE-TEX SCLERAL-SUTURED ENVISTA INTRAOCULAR LENS DISLOCATION: THREE CASES AND AN ASSESSMENT OF EYELET TENSILE STRENGTH, FRACTURE CHARACTERISTICS, AND RISK FACTORS.

PURPOSE: Three cases of dislocation of a Gore-Tex scleral-sutured EnVista intraocular lens are reported. The tensile strength of the lens eyelets under two suturing methods is assessed. Pursuant surgical considerations are discussed. METHODS: A chart review was performed to identify cases of scleral-sutured EnVista lens dislocations. In addition, six EnVista lenses were suspended in a balanced salt solution tank, tied either with suture over haptic or simple pass technique. Eyelet tensile strength was calculated by gradual addition of weights. Eyelet fracture position and width were measured. The tensile strength of one additional EnVista lens was assessed in open air. PATIENTS: In a retrospective, consecutive case series, three dislocated lenses were identified out of 17 surgeries from one institution. Two dislocations occurred postoperatively, and one occurred intraoperatively. RESULTS: The EnVista eyelet demonstrated greater tensile strength tied with the simple pass method (0.27 ± 0.017 N, n = 3) than with the suture over haptic method (0.15 ± 0.016 N, n = 3; P = 0.0015). Eyelet fracture location corresponded to tensile strength. The lens in air withstood greater tensile stress. CONCLUSION: Stress is placed on different regions of the eyelet with each suturing method. Simple pass may withstand greater tension and decrease risk for lens fracture, but the operating surgeon must consider multiple factors when forming an operative plan.

Prevalence and risk assessment of microplastics in the Nile Delta estuaries: "The Plastic Nile" revisited.

Recent research is directed toward studying plastic pollution in rivers, and estuaries due to the importance of freshwater bodies in all aspects of life. The river deltas and estuaries are interesting for studying the flux of plastics into the oceans. The Nile River has been identified as a hot spot of plastic litter flux in the eastern Mediterranean basin. In addition, it was nicknamed "Plastic Nile", yet this major river is largely unexplored with a lack of field measurements and adequate surveys. The current study was based on bridging this scientific gap. Three trips were conducted, covering 30 km in the Rosetta branch and 23 km in the Damietta branch, during the high water level in summer 2021, and 10 km off the inlet of Lake Burullus, in spring 2021. Microplastics in surface water ranged from 761 ± 319 to 1718 ± 1008 MPs/m3, and from 167 ± 137 to 1630 ± 1303 MPs/kg of dry sediments. Land use/ land cover mapping using Sentinel-2 images showed several sources of pollution that contribute to plastic contamination in the study area. Thermal analysis indicated seven plastic polymers; including, PE, PP, PET, PEVA, and PTFE, using discarded plastic products as reference materials. Microplastics were composed of colored and glossy fragments of sizes <500 µm, originating from land-based sources. Pollution load, polymer risk assessment, and ecological risk indices were calculated. Based on field observations macro-plastics were retained within the extensive network of infrastructure and dam systems. 80-106 billion MPs/year were estimated to flux from the Nile estuaries into the Mediterranean Sea. The current situation urges the development of binding plans to reduce plastic waste in the Nile Delta, as well as setting environmental monitoring points along the Deltaic coast.

Assessment of the migration of perfluorinated compounds and primary aromatic amines from PTFE-coated non-stick cookware marketed in Turkey.

Two perfluorinated compounds (PFCs) and 17 different primary aromatic amines (PAAs) were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in migrants from 35 cookware samples marketed in Turkey. Among PFCs, only PFOA was identified in 6 samples. Only two components among PAAs, namely aniline (ANL) and 4,4'-methylenedianiline (4,4'-MDA), were detected in analyzed samples. Although aniline was detected in all samples, 4,4'-MDA was detected in only 4 samples. The effects of simulant volume, temperature, and repeated use on the release of these migrants from non-stick cookware were investigated. Three simulant volumes (200, 500, and 1000 mL) were used in migration tests. PFCs and PAAs were identified in simulants at 200 and 500 mL. The increase in the amount of simulant caused a decrease in the concentration of these migrants. The lowest migration values were observed in the samples at consecutive usage cycles. PFCs and PAAs exhibited the highest migration ability with increasing temperature.

Investigation of the effects of biomaterials on proton Bragg peak and secondary neutron production by the Monte Carlo method in the slab head phantom.

Interest in proton therapy has increased in the last decade, as protons are effective to treat deeply located tumors, cause less damage to healthy tissue and allow controlling the energy to be transferred in a target-oriented manner (or energy transfer within target limits). It is known that secondary particles such as neutrons are produced by a result of nuclear interactions of protons with the target. Secondary neutrons can cause an uncontrolled dose increase in healthy tissue near the target site, and because they have a high radiobiological effectiveness, they raise the risk of secondary cancer. There are not enough studies examining the effect of biomaterials on secondary neutron production (SNP) in proton therapy. This study aims to investigate the effect of biomaterials used as implants instead of cranium in the skull on proton depth dose distribution and SNP with Monte Carlo-based PHITS code. Therefore, Bragg peaks and SNPs for 40-140 MeV energy protons were calculated and compared with the literature in a slab head phantom containing stainless steel, CoCrMo (CCM) alloy, alumina, polytetrafluoroethylene, Ti alloy, and NiTi alloy biomaterials used in cranioplasty. It was observed that the most compatible biomaterial compared to cranium for all energies is polytetrafluoroethylene. When polytetrafluoroethylene biomaterial was placed instead of the cranium in the skull, the Bragg peak position of the 100 MeV protons was decreased by 5.04% compared to that in the cranium. In this case, the energy absorbed in the polytetrafluoroethylene biomaterial increased by approximately 28% compared to the cranium, while it decreased by approx. 4% in the brain tissue. It was also observed that while SNP was 0.0501 in the cranium, it increased by almost 18% in PTFE.

A quantitative assessment of silicone and PTFE-based stamp techniques for restoring occlusal anatomy using resin-based composites.

OBJECTIVES: Publications on stamp techniques for placing resin-based composite (RBC) restorations consist mainly of case studies. Furthermore, comparative studies are rare and no longer relevant to the materials tested today. Thus, two general techniques were investigated in this study. MATERIALS AND METHODS: Standardized occlusion class I cavities were prepared in twenty-eight extracted caries-free wisdom teeth with unimpaired occlusal surfaces and restored with the RBC material Grandio®. Light curing of the final layer was performed either after removal of the stamp isolated with PTFE tape or by leaving a stamp made of transparent polysiloxane in place. CEREC scans of the RBC restorations placed (follow-up) were superimposed on scans of the unimpaired occlusal surface (baseline) and quantitatively analyzed with the software OraCheck with regard to volume change and gain or loss of layer thickness in six sectional planes. RESULTS: Assessing the excess material, there was no difference (p = 0.31) between the silicone technique (0.26 mm ± 0.02) and the PTFE technique (0.22 mm ± 0.02 mm). Nevertheless, the loss of tooth substance was significantly greater (p < 0.001) with the silicone technique (-0.29 mm ± 0.02 mm) than with the PTFE technique (-0.15 mm ± 0.02 mm). CONCLUSIONS: With the PTFE stamp technique, less healthy tooth structure was removed during the finishing procedure and the stamp was more dimensionally stable. CLINICAL RELEVANCE: The study shows the advantages and disadvantages of the investigated stamp techniques and helps the practitioner to choose an appropriate technique.

Continuous Segmented-Flow Synthesis of Ag and Au Nanoparticles Using a Low Cost Microfluidic PTFE Tubing Reactor.

We present in here a simple and low cost continuous segmented-flow process for the synthesis of Ag and Au spherical-shaped nanoparticles. Different residence times (RT) were used to perform the nanoparticle synthesis, observing that at low RT, the Ag nanoparticles production, which uses a fast reduction reaction with NaBH4, is improved due to an enhancement in the mixing of the reactants. However, the flow conditions have an opposite effect in the case of Au nanoparticles synthesis. Indeed, since the chemical reduction process (Turkevich method) exhibit a much slower kinetics, high RT (low flowrates) improve the synthesis yield and the quality of the nanoparticles. The Ag and Au nanoparticles were characterized by UV-Vis spectrophotometry (UV-Vis) and Transmission Electron Microscopy (TEM). The Ag spherical-shaped nanoparticles presented a LSPR at 400 nm (size ≈ 4 nm), while the synthesized Au nanoparticles exhibit LSPR and sizes in the range 520 - 550 nm and 14 - 17 nm, respectively.

Microbiological and FE-SEM Assessment of d-PTFE Membrane Exposed to Oral Environment after Alveolar Socket Preservation Managed with Granular nc-HA.

AIM: The aim of this study was to analyze, by the aid of microbiological analysis and the field emission scanning electron microscopical (FE-SEM) analysis, the role of high-density polytetrafluoroethylene (d-PTFE) membranes in avoiding the microbial colonization of a nanocrystalline hydroxyapatite (nc-HA) bone graft and the involvement of this colonization in the healing process. MATERIALS AND METHODS: Six patients underwent extraction of unrecoverable teeth, and a socket preservation technique was carried out with nc-HA synthetic bone graft and then covered with a d-PTFE membrane. After 28 days from surgery, FE-SEM analysis and BioTimer assay technique to assess the microbiological count of streptococci species were carried out. Data were collected and analyzed by the Student's t test (confidence interval: 95%). RESULTS: The mean amount of bacteria measured on the upper side of the membrane was 6.52 ± 0.50 CFU, while on the lower side, it was 6.59 ± 0.40 CFU. Significant differences were not found between the two sides of the membrane or between the different sectors (p > 0.05). The FE-SEM analysis revealed structured biofilms on both sides of the membrane: species of cocci, bacilli, and fusobacteria were recognizable in occasional settled vegetations. CONCLUSION: Since the amount of bacteria found was low, the improved impermeability of the d-PTFE membrane permitted the healing process to proceed uneventful and without signs of infection or inflammation. CLINICAL RELEVANCE: The infection of the graft site could lead to a failure of the socket preservation technique which could delay or compromise the rehabilitation following procedures. The use of d-PTFE can improve the bone regeneration thanks to its antimicrobial properties.

Reliable identification of cardiac liability in drug discovery using automated patch clamp: Benchmarking best practices and calibration standards for improved proarrhythmic assessment.

INTRODUCTION: Screening compounds for activity on the hERG channel using patch clamp is a crucial part of safety testing. Automated patch clamp (APC) is becoming widely accepted as an alternative to manual patch clamp in order to increase throughput whilst maintaining data quality. In order to standardize APC experiments, we have investigated the effects on IC50 values under different conditions using several devices across multiple sites. METHODS: APC instruments SyncroPatch 384i, SyncroPatch 384PE and Patchliner, were used to record hERG expressed in HEK or CHO cells. Up to 27 CiPA compounds were used to investigate effects of voltage protocol, incubation time, labware and time between compound preparation and experiment on IC50 values. RESULTS: All IC50 values of 21 compounds recorded on the SyncroPatch 384PE correlated well with IC50 values from the literature (Kramer et al., 2013) regardless of voltage protocol or labware, when compounds were used immediately after preparation, but potency of astemizole decreased if prepared in Teflon or polypropylene (PP) compound plates 2-3 h prior to experiments. Slow acting compounds such as dofetilide, astemizole, and terfenadine required extended incubation times of at least 6 min to reach steady state and therefore, stable IC50 values. DISCUSSION: Assessing the influence of different experimental conditions on hERG assay reliability, we conclude that either the step-ramp protocol recommended by CiPA or a standard 2-s step-pulse protocol can be used to record hERG; a minimum incubation time of 5 min should be used and although glass, Teflon, PP or polystyrene (PS) compound plates can be used for experiments, caution should be taken if using Teflon, PS or PP vessels as some adsorption can occur if experiments are not performed immediately after preparation. Our recommendations are not limited to the APC devices described in this report, but could also be extended to other APC devices.

Comparing the performance of some dedicated radioprotection disks in breast intraoperative electron radiotherapy: a Monte Carlo study.

Radiation-shielding of healthy tissue is mandatory in breast intraoperative electron radiotherapy (IOERT). In this regard, dedicated radioprotection disks have been introduced. The aim of this study was to evaluate and compare the performance of three radioprotection disks widely used for breast IOERT. A Monte Carlo simulation approach was used for this purpose. The considered disks included Al + Pb, PMMA + Copper, and PTFE + Steel. They were stimulated by means of the MCNPX Monte Carlo code at depths around R100 and R90 of different electron energies in a water phantom, and their impact on the dosimetric properties of the therapeutic beam was evaluated in both correct and upside down disk placements. The electron energy spectrum immediately above and below each disk was calculated and analyzed. Furthermore, performance characteristics of the studied disks such as backscatter factors (BSFs) and transmission factors (TFs) at different electron energies were determined and compared. The results show that the Al + Pb disk most effectively attenuates the beam, while at the same time exhibits maximum BSF values. Employing the PMMA + Copper disk can minimize the BSF value but at the expense of an increased TF. The Al + Pb disk showed the best performance from the radiation protection viewpoint, while its highest BSF values could lead to perturbation of dose homogeneity within the target volume. PTFE + Steel disk showed an intermediate performance regarding the electron backscattering and transmission among the studied disks. The reverse placement of each disk can substantially increase the BSF value as compared to the correct situation but had less impact on the TF value.

Fast and Low-Cost Purification Strategy for Oligosaccharide Synthesis Based on a Hop-On/Off Carrier.

A feasible and convenient strategy for oligosaccharide synthesis, which realizes reaction in solution while product purification occurs only by solid-liquid filtration, has been developed. By using a hop-on/off carrier (polytetrafluoroethylene particle), rapid synthesis of tumor-associated antigen Globo-H hexasaccharide has been successfully achieved within 5 steps in 48% overall yield without any intermediate purification by column chromatography. Also, global deprotection, including the cleavage of the tag, proceeded simultaneously only by one-step hydrogenolysis.

Experimental assessment of histological and biological properties of the induced membrane and the membrane formed around the d-PTFE membrane: A pilot study.

BACKGROUND: The aim of this prospective pilot study is to find answers to the following question: In the treatment protocol of open membrane technique defined by Funakoshi, do the histological and biological properties of the tissue that has already covered the graft surface following the removal of the d-PTFE membrane resemble those properties of induced membrane? MATERIAL AND METHODS: 4 male, white Vienna rabbits were used for experiments. Bicortical and 10mm in diameter four bone defects were created on each calvarial bone. 2 rabbits (8 defects) were accepted as group I and other 2 rabbits (8 defects) were accepted as group II. Bone cement was placed into the all-defect in group I. 8 defects were filled with Bi-Oss graft material and covered with d-PTFE membranes in group II. After 8 weeks, sacrifice of the rabbits was performed. In group I, without damaging the formed membrane around it, the bone cement was removed from the defects and the achieved membrane was sent to the pathology department. In group II, the thin film layer that formed under the d-PTFE membrane was sent for histological evaluations. Inflammation, edema, foreign body reaction, synovial-like epithelium existence, thickness, vascularisation (CD31, VEGF), fibrosis were assessed. RESULTS: Inflammation, fibrosis and thickness measurements are significantly different between the groups (P<0,05) and for these parameters, the mean of d-PTFE group (Group II) is significantly higher than the mean of the induced-membrane group (Group I). There isn't any significant difference for other parameters. CONCLUSION: The morphological characteristics of membranes of the two groups were similar. There was a cell-rich, vascularised tissue with fibrous structures; fibroblasts, myofibroblast, and collagen, orientated parallel to the cement.

Use of Nasal Implants and Dorsal Modification When Treating the East Asian Nose.

Dorsal augmentation and tip surgery are essential procedures for East Asians seeking rhinoplasty, because they generally have thicker skin and poorly developed nasal dorsum and tip. For dorsal augmentation, many Asian surgeons prefer using alloplastic material, like silicone, Gore-Tex, and filler injection, for cost-effectiveness, easy handling, and short operation times. Compared with autologous implant materials, the use of synthetic implant is suggested to be associated with many complications, such as infection, extrusion, and deviation. However, even with the use of the autologous material, problems such as reabsorption after grafting, donor site complications can take place.

Comprehensive assessment of mechanical behavior of an extremely long stent graft to control hemorrhage in torso.

Traumatic vascular injuries, resulting from either civilian accidents or wounded soldiers, require new endovascular devices (i.e., stent graft) to rapidly control the excessive internal hemorrhage in torso region. Current stent designs are limited by their permanent nature, which is note well suited for emergent placement. A retrievable stent graft could regulate the internal bleeding temporarily, as fast as possible with the most feasible performance, until the patients arrive the hospital to receive the proper treatment. The novel endovascular device of this study is designed according to the anatomy of a porcine model with plans to transition to a human model in the future. The stent graft is manufactured using a substantially long nitinol backbone and covered selectively based on anatomic measurements, with highly stretchable expanded-polytetrafluoroethylene (ePTFE). In this study, our group comprehensively explored designing and manufacturing methods, and their impact on the stent graft performance. Geometric parameters and heat treatment conditions were investigated to show their effect on the radial force of the metallic backbone. As a retrievable device, the resistance force for retrieval as well as deployment were measured, and analyzed to be manipulated through ePTFE covering configurations. In vitro measurements for bleeding were measured using swine aorta to show the functionality of the stent graft under the simulated pulsatile flow circulation. Finally, the stent graft showed substantial effectiveness for hemorrhage control in vivo, using swine model. The new design and fabrication methods enable rapid hemorrhage control that can be removed at the time of a dedicated surgical repair.

Assessment of Pull-out Forces in TEVAR and ANACONDA FEVAR Combination and Early Clinical Results: Creation of a Proximal Landing Zone for FEVAR in Patients with Extent I and Extent IV TAAAs.

BACKGROUND: Although recent data on the treatment of thoracoabdominal aortic aneurysms (TAAAs) are promising, in some cases, the paravisceral segment of the aorta may not be suitable for a branched endograft due to space restrictions. A combination of a fenestrated aneurysm repair (FEVAR) with a thoracic aneurysm repair (TEVAR) may represent a feasible treatment option. The current investigation was performed to assess the stability of a fenestrated Anaconda device implanted into a set of thoracic endografts from different manufacturers. We then assessed our clinical results with the FEVAR/TEVAR combination. METHODS: Pull-out forces were measured in vitro after docking a fenestrated Anaconda graft within the distal end of different TEVAR devices. Anaconda devices were implanted in 28- or 30-mm thoracic tube grafts (oversizing of at least 2 mm: 13.3-21.4; minimum overlap of 15 mm). Continuously increasing longitudinal pull forces of up to 100 N were applied on an Instron Tensile Tester. Initial break point and damage to the endografts were documented. Clinical results of patients treated with such an FEVAR/TEVAR combination at our institution are presented as a second part of this study. RESULTS: Median pull-out forces ranged from 2.38 N to 55.0 N. The highest stability was achieved with 34-mm Anaconda devices in 28-mm thoracic tube grafts. Grafts with either thinner Dacron material or those featuring a polytetrafluorethylene membrane seemed especially vulnerable to punctures and tears caused by the downward-looking hooks of the Anaconda device. Between April 1, 2013 and December 31, 2018, in 28 of 172 patients treated with a fenestrated Anaconda device, prior implantation of a thoracic tube graft was necessary to create a sufficient proximal landing zone. In 25 cases (89.3%), the aneurysm was successfully treated. Although the 30-day reintervention rate in this subgroup was relatively high at 28.6%, none of these was due to a failure of the FEVAR/TEVAR combination. Upon an average follow-up of 15 months, no failure of the graft connection and no type III endoleak due to membrane damage were observed. CONCLUSIONS: The combination of a thoracic tube graft and a fenestrated Anaconda device is a viable option for the treatment of patients with Extent I or IV TAAAs with no adequate landing zone above the celiac trunk. Although pull-out testing has shown good stability with most assessed grafts, the thoracic devices with thicker Dacron membranes seemed to be especially suitable.

On the conversion from dose-to-medium to dose-to-water in heterogeneous phantoms with Acuros XB and Monte Carlo calculations.

The method implemented in Monte Carlo (MC) algorithm to convert dose-to-medium (D m) to dose-to-water (D w) is usually based on the Bragg-Gray cavity theory. Acuros XB (AXB) reports also D m and D w but the method to calculate D w is based on the energy deposition cross sections for water in place of those for the local media. For both algorithms, the calculation of D w in non-water media is similar to the dose received in a small volume of water, small enough not to disturb the fluence of charged particles. Recently, two new methods revised the Bragg-Gray cavity theory, one proposed by Andreo and the other by Reynaert et al. In this context, comparisons between AXB and MC were carried out in terms of dose-to-medium ([Formula: see text]) and dose-to-water ([Formula: see text]), respectively. Multilayer slab heterogeneous phantoms made of lung, bone and polytetrafluoroethylene (PTFE) were investigated and measurements were carried out using radiochromic films. These latter were then compared to [Formula: see text] and to D w which would be obtained according to the conversion methods proposed by Andreo and Reynaert et al [Formula: see text] agreed with [Formula: see text] for all cases (±1%). In lung, all D w calculations and film measurements were in agreement. By contrast, [Formula: see text] and [Formula: see text] differed notably in bone (4.5%) and PTFE (3.5%), and both algorithms overestimated film measurements. These findings demonstrate that the conversion method is different between AXB and MC. Furthermore, films were not able to give dose in a small volume of water according to the definition of [Formula: see text] and [Formula: see text]. Applying either the fluence correction factor suggested by Andreo or the mass energy absorption ratios proposed by Reynaert et al, resulted in a good agreement (<1%) with film measurements. According to the method used for the conversion, different D w could be obtained which might lead to several issues in clinical context.