Intrarectal Foley catheter-assisted high-intensity focused ultrasound ablation for benign uterine diseases beyond the treatment region.

OBJECTIVE: To evaluate the feasibility of using an intrarectal Foley catheter during ultrasound-guided high-intensity focused ultrasound (US-HIFU) in patients with benign uterine diseases of the posterior wall beyond the HIFU therapeutic range. METHODS: Patients were treated with US-HIFU and lesion changes were monitored using contrast-enhanced MRI from June 2020 to September 2021. A Foley catheter was inserted into the rectum to facilitate a successful US-HIFU ablation. Complications and lesion responses were recorded during the treatment and follow-up. RESULTS: Thirteen patients with 14 lesions beyond the device's treatable area were enrolled. The average placement time and insertion depth of the intrarectal Foley catheter was 7.6 ± 2.7 min and 23.2 ± 7.6 cm, respectively. A median of 50 mL degassed water was injected into the Foley catheter balloon. All 14 lesions were successfully pushed into a treatable area and subjected to HIFU. The average treatment time, irradiation time, and total therapeutic energy of HIFU were 44.2 ± 17.3 min, 394.4 ± 295.7 s, and 73.3 ± 46.6 kJ, respectively. The mean non-perfusion volume (NPV) in all treated lesions was 23.2 ± 19.2 cm3, and the mean NPV ratio was 57.8 ± 16.9%. Major complications were not observed. CONCLUSION: Intrarectal Foley catheter-assisted US-HIFU is effective and safe. Its clinical application could benefit patients with benign uterine diseases outside the HIFU therapeutic range.

Synthesis of N-Methyl-o-phenylenediamine-Bridged Bis(phenolato) Lanthanide Alkoxides and Their Catalytic Performance for the (Co)Polymerization of rac-Butyrolactone and l-Lactide.

A series of lanthanide alkoxo complexes supported by ONNO salalen ligands were synthesized and characterized. A one-pot reaction of LH2 (L = (2-O-C6H2-tBu2-3,5)CH═N-C6H4-N(CH3)CH2(2-O-C6H2-tBu2-3,5)) with LnCp3(THF) in a 1:1 molar ratio followed by the addition of 1 equiv of ROH (R = Bn, iPr, and CF3CH2), afforded the dimeric lanthanide alkoxo complexes [LLn(µ-OCH2Ph)]2 [Ln = Lu (1), Yb (2), Sm (3), Nd (4)], [L2Yb(µ-OiPr)]2 (5), and [L2Yb(µ-OCH2CF3)]2 (6) in good isolated yields. All these lanthanide complexes were characterized by elemental analysis and FT-IR spectroscopy. In addition, complex 1 has been characterized by NMR spectroscopy. Single-crystal X-ray diffraction analysis of complexes 1, 2, 5, and 6 showed that these lanthanide alkoxo complexes are dimeric in the solid state. Complexes 1-6 showed good activity toward the homopolymerization of rac-butyrolactone (rac-BBL) to give atactic PHB, and ionic radii of central metals have profound influence on the polymerization. The polymerization behavior of l-lactide (l-LA) initiated by complex 2 was also explored. The kinetic study revealed that the polymerizations of rac-BBL and l-LA initiated by salalen lanthanide akoxide are first order for both the monomer and the initiator concentrations. Furthermore, it was found that complexes 1 and 2 showed good activity in the copolymerization of l-LA and rac-BBL, affording gradient copolymers.