Plasma bile acids in association with Crohn's disease.

BACKGROUND: In addition to facilitating lipid digestions, bile acids (BA) are signalling molecules acting on receptors on immune cells and along the gastrointestinal (GI) tract. The aim of this study was to assess if altered bile acid profiles in plasma are associated with Crohn's disease (CD). METHOD: This cross-sectional study included individuals (aged ≥18 years) referred for colonoscopy at a tertiary centre in Stockholm between 2016 and 2019. All participants received bowel preparation, completed a lifestyle questionnaire and provided blood samples for analysis. During colonoscopy, severity of disease was graded, and biopsies were taken from colonic mucosa. In the current substudy, 88 individuals with CD and 88 age-matched controls were selected for analysis of BA in plasma with ultra performance liquid chromatography (UPLC). Linear regression models were then used to compare mean bile acid concentrations and concentration ratios between CD and controls. RESULTS: Individuals with CD had lower plasma concentrations of the majority of secondary BA compared to controls, in total CD/CC ratio 0.60 (SE 0.12), p = 0.001. The most prominent observations were lower levels of deoxycolic acid derivates and lithocolic acid derivates among participants with CD. Moreover, plasma concentration for secondary BA among participants with active CD was significantly lower compared to those with CD in remission, CD active/CD remission ratio 0.65 (SE 0.11), p < 0.002. CONCLUSION: Crohn's disease may be associated with altered plasma bile acid composition. The significance of colonic bacterial diversity in this context needs to be investigated in further studies.

It is known that Crohn's disease is associated with dysbiosis in the gut microbiota and that primary bile acids are transformed to secondary bile acids by bacterial enzymes in the gut before reabsorbed and transported back to the liver.In this cross-sectional study, Crohn's disease was associated with lower concentrations of secondary bile acids in blood plasmaThe findings should encourage further studies the role of the gut microbiome and bile acid metabolism in development of Crohn's disease and bile acid profile as a biomarker for bowel inflammation.

Evaluation of plasma Short chain fatty acid levels as markers for Inflammatory bowel disease.

BACKGROUND: Specific variations of short chain fatty acids in fecal samples have been shown for patients with inflammatory bowel disease. The aim of this study was to assess if Crohn's disease and ulcerative colitis are associated with altered concentrations of short chain fatty acids also in blood plasma. METHOD: Between 2016-2019, Swedish adults referred to a tertiary center for colonoscopy were asked to participate in a cross-sectional study. Individuals with Crohn's disease or ulcerative colitis as well as individuals with no findings on the colonoscopy (defined as clean colon) were included in the study. Data on colonoscopy findings, blood samples (including haemoglobin, C-reactive protein and short chain fatty acid analysis) as well as a validated lifestyle questionnaire including 277 questions were collected from all participants. Linear regression was used to compare mean concentrations of short chain fatty acids between Crohn's disease, ulcerative colitis and clean colon. RESULTS: The cohort consisted of 132 individuals with Crohn's disease, 119 with ulcerative colitis and 205 with clean colon. In the crude model, succinic acid was significantly lower (p < 0.05) among patients with Crohn's disease (mean 3.00 µM SE 0.10) and ulcerative colitis (mean 3.13 µM SE 0.10) in comparison to clean colon (mean 3.41 µM SE 0.08), however when adjusting for sex, age and diet the results did not remain statistically significant. No differences in plasma concentration of the other measured short chain fatty acids were detected. CONCLUSION: Crohn's disease and ulcerative colitis are not associated with altered short chain fatty acid concentrations in plasma. Further research is needed to confirm or refute our findings.

In this cross-sectional study including individuals with inflammatory bowel disease and healthy subjects we found no association between Crohn's disease and ulcerative colitis and short chain fatty acid concentrations in plasma.

Childhood appendicitis and future risk of inflammatory bowel disease - A nationwide cohort study in Sweden 1973-2017.

AIM: The aim of this study was to investigate the association between juvenile appendicitis, treated conservatively or with appendectomy, and adult risk of inflammatory bowel disease (IBD), either ulcerative colitis (UC) or Crohn's disease (CD). We used nationwide population data from more than 100,000 individuals followed for over four decades. METHOD: All Swedish patients discharged with a diagnosis of appendicitis before the age of 16 years between 1973 to 1996 were identified. Everyone diagnosed with appendicitis was matched to an individual in the general population without a history of juvenile appendicitis (unexposed) of similar age, sex and region of residence. The study population was retrospectively followed until 2017 for any development of UC or CD. Cox proportional-hazards models compared disease-free survival time between exposed and unexposed individuals, also analysing the impact of treatment (conservative treatment versus appendectomy). RESULTS: The final cohort consisted of 52,391 individuals exposed to appendicitis (1,674,629 person years) and 51,415 unexposed individuals (1,638,888 person years). Childhood appendicitis with appendectomy was associated with a significantly lower risk of adult IBD [adjusted hazard ratio (aHR) 0.48 (0.42-0.55)], UC [aHR 0.30 (0.25-0.36)] and CD [aHR 0.82 (0.68-0.97)]. Those treated conservatively had a lower risk of adult UC [aHR 0.29 (0.12-0.69)] but not CD [aHR 1.12 (0.61-2.06)] compared with unexposed individuals. CONCLUSION: Juvenile appendicitis treated with appendectomy was associated with a decreased risk of adult IBD, both UC and CD. Those treated conservatively instead of with surgery had a lower risk of UC only. Our findings warrant more research on the role of the appendix and gut microbiota in the pathogenesis of IBD.

Dendritic Fibrous Colloidal Silica Internally Cross-linked by Bivalent Organic Cations: An Efficient Support for Dye Removal and the Reduction of Nitrobenzene Derivatives.

We designed a new unique amphoteric monodisperse colloid with a large complex internal structure, in which silica surfaces are bridged with an organic cross-linker. The rationale was that such colloids would be excellent adsorbents for cationic and anionic dyes and, when doped with noble metal nanoparticles, would be an excellent catalyst for the reduction of a variety of organic compounds. In the first step, the organo-silica bridging agent (bivalent organic cross-linkers) DABCO-S (silanated DABCO) was prepared through a simple nucleophilic substitution reaction between (3-chloropropyl)triethoxysilane and bivalent 1,4-diazabicyclo[2.2.2]octane (DABCO) (a strong base). In the second step, a DABCO-S bridge was introduced into dendritic fibrous nanostructured colloidal silica (DFNS) under open-vessel reflux conditions. We refer to the product obtained by incorporating DABCO-S in DFNS as DDS. The unique characteristics of DFNS are completely preserved in this new type of periodic mesoporous organo-silica-DFNS. The produced nanocomposite has a high surface area of about 807 m2 g-1, a large pore volume of 1.9 cm3 g-1, and a bimodal pore size distribution, with small 2.5 nm pores and large 30 nm pores. As such, DDS is an efficient adsorbent for dye removal from wastewater. The results show that DDS can adsorb positive and negative dyes such as methylene blue, orange II sodium salt (OR), and procion red mx-58 (PR) with a capacity of 678, 3192, and 3190 mg dye/g adsorbent. Introducing silver nanoparticles in situ into DDS leads to a composite with excellent accessibility of reactants to the Ag surface, resulting in an efficient catalytic reduction of nitro aromatic compounds (NACs) in aqueous media.

Hybrid Aerogel Nanocomposite of Dendritic Colloidal Silica and Hairy Nanocellulose: an Effective Dye Adsorbent.

In this study, a new type of silica-cellulose hybrid aerogel was synthesized through a green and facile chemical cross-linking process. In a first step, dendritic fibrous nanostructured (colloidal) silica particles (DFNS) were prepared by a simple hydrothermal technique. Then, the surface of DFNS particles was functionalized with amine groups using 3-aminopropyltriethoxysilane to produce DFNS-NH2. In a second step, bifunctional hairy nanocellulose (BHNC) particles were functionalized with both aldehyde and carboxylic groups. The aldehyde groups of BHNC and the amine groups of DFNS-NH2 chemically reacted through a Schiff base reaction to form a hybrid hydrogel nanocomposite. Therefore, no external cross-linker is required in the synthesis. This hybrid aerogel is very lightweight and highly porous with a density of 0.107 g mL-1 and a porosity of 93.0 ± 0.4%. It has a large surface area of 350 m2 g-1, a large pore volume of 0.23 cm3 g-1, and a small pore size of 3.9 nm. The developed aerogel contains both positively and negatively charged functional groups and is a highly efficient substrate for dye adsorption from water, for both cationic and anionic organic dyes. These aerogels were found to have an outstanding adsorption capacity toward methylene blue (MB) as a cationic dye and methyl orange (MO) as an anionic dye. The results show that the aerogels can adsorb MB and MO with a capacity of 270 and 300 mg dye/g adsorbent, respectively.

A green, catalyst-free synthesis of pyrazolopyranopyrimidines in polyethylene glycol as a biodegradable medium at ambient temperature.

A facile, efficient and environmentally safe strategy for the synthesis of pyrazolopyranopyrimidines via one-pot, four-component reaction of hydrazine hydrate, barbituric acid, ethyl acetoacetate, and aromatic aldehydes in polyethylene glycol (PEG) as a safe solvent in the absence of catalyst at ambient temperature has been described. The advantages of the present protocol, such as simplicity, mild conditions, high yields of products, straightforward workup procedure, a green and biodegradable reaction medium, make this new process an attractive to current methodologies.

Synergistic chemo-photothermal therapy using gold nanorods supported on thiol-functionalized mesoporous silica for lung cancer treatment.

Cancer therapy necessitates the development of novel and effective treatment modalities to combat the complexity of this disease. In this project, we propose a synergistic approach by combining chemo-photothermal treatment using gold nanorods (AuNRs) supported on thiol-functionalized mesoporous silica, offering a promising solution for enhanced lung cancer therapy. To begin, mesoporous MCM-41 was synthesized using a surfactant-templated sol-gel method, chosen for its desirable porous structure, excellent biocompatibility, and non-toxic properties. Further, thiol-functionalized MCM-41 was achieved through a simple grafting process, enabling the subsequent synthesis of AuNRs supported on thiol-functionalized MCM-41 (AuNR@S-MCM-41) via a gold-thiol interaction. The nanocomposite was then loaded with the anticancer drug doxorubicin (DOX), resulting in AuNR@S-MCM-41-DOX. Remarkably, the nanocomposite exhibited pH/NIR dual-responsive drug release behaviors, facilitating targeted drug delivery. In addition, it demonstrated exceptional biocompatibility and efficient internalization into A549 lung cancer cells. Notably, the combined photothermal-chemo therapy by AuNR@S-MCM-41-DOX exhibited superior efficacy in killing cancer cells compared to single chemo- or photothermal therapies. This study showcases the potential of the AuNR@S-MCM-41-DOX nanocomposite as a promising candidate for combined chemo-photothermal therapy in lung cancer treatment. The innovative integration of gold nanorods, thiol-functionalized mesoporous silica, and pH/NIR dual-responsive drug release provides a comprehensive and effective therapeutic approach for improved outcomes in lung cancer therapy. Future advancements based on this strategy hold promise for addressing the challenges posed by cancer and transforming patient care.

A Population-Based Study of Unfavorable Prognostic Factors Associated With Pyogenic Liver Abscess.

Background: Pyogenic liver abscess (PLA) is a rare entity that is associated with substantial mortality and morbidity. Our objective was to investigate variables associated with mortality and subsequent PLA in patients diagnosed with PLA in southern Sweden. Methods: We conducted a population-based observational study comprising all episodes of PLA that occurred between 2011 and 2020 in the county of Skåne, southern Sweden. The primary outcome was defined as all-cause 90-day mortality and the secondary outcome was defined as the occurrence of a subsequent PLA. Results: A total of 452 episodes of PLA occurred in 360 patients during the study period. The 90-day mortality rate was 16% (n = 58) and the subsequent PLA rate was 20% (n = 92). In a multivariable logistic regression model, female sex (odds ratio [OR], 2.0 [95% confidence interval {CI}, 1.1-3.9]), malignancy (OR, 3.7 [95% CI, 1.9-7.1]), liver failure (OR, 6.3 [95% CI, 2.7-14.5]), and polymicrobial findings (OR, 3.8 [95% CI, 2.2-6.9]) were associated with death within 90 days (P < .05). Male sex (OR, 2.1 [95% CI, 1.2-3.6]), malignancy (OR, 2.1 [95% CI, 1.3-3.6]), age (64-74 years: OR, 2.5 [95% CI, 1.3-4.8]), and chronic liver disease (OR, 3.0 [95% CI, 1.4-6.5]) were associated with the risk of subsequent PLA (P ≤ .01). Conclusions: Identifying different clinical variables associated with an unfavorable outcome may improve the management and treatment of patients with PLA and thus prevent the risk of death and subsequent PLA.

Increasing incidence of pyogenic liver abscess in Southern Sweden: a population-based study from 2011 to 2020.

BACKGROUND: Pyogenic liver abscess (PLA) is a rare but potentially life-threatening disease, and estimates suggest a gradual increase in the incidence during the last decades. The primary aim of this study was to report the incidence, trend and aetiology of PLA during a decade in Southern Sweden. METHODS: This was a population-based observational cohort study between 2011 and 2020 in Skåne, Southern Sweden. Data were retrieved from the Swedish National Board of Health and Welfare for all individuals diagnosed with liver abscess (K750) according to ICD-10 (International Statistical Classification of Diseases, 10th revision). RESULTS: A total of 456 episodes of PLA occurred in 364 patients during the study period. The median age of the first PLA episode was 71 years (range 3-97) and 57% (n = 206) were men. The mean incidence of all patients was 3.4/100,000 person-years (range 1.8-5.2). The incidence increased almost three times, from 1.8/100,000 person-years in 2011 to 5.2/100,000 person-years in 2020. Streptococcus species, Escherichia coli and Klebsiella species accounted for the vast majority of both mono- and polymicrobial findings in both blood and local abscess cultures. 16s rDNA added information about aetiology in 37% of episodes. CONCLUSION: The incidence of PLA increased during the study period, and Streptococcus spp., Klebsiella spp. and E. coli dominated both blood and local cultures. Despite antimicrobial therapy, pathogens could be found in local abscess cultures several weeks into treatment. Increased use of 16s rDNA in the management of PLA could be beneficial.

Internally bridged nanosilica for loadings and release of sparsely soluble compounds.

The engineering of a new monodisperse colloid with a sea urchin-like structure with a large complex internal structure is reported, in which silica surfaces are bridged by an aromatic organic cross-linker to serve as a nanocarrier host for drugs such as doxorubicin (DOX) against breast cancer cells. While dendritic fibrous nanosilica (DFNS) was employed and we do not observe a dendritic structure, these particles are referred to as sea urchin-like nanostructured silica (SNS). Since the structure of SNS consists of many silica fibrils protruding from the core, similar to the hairs of a sea urchin. For the aromatic structured cross-linker, bis(propyliminomethyl)benzene (b(PIM)B-S or silanated terephtaldehyde) were employed, which are prepared with terephtaldehyde and 3-aminopropyltriethoxy-silane (APTES) through a simple Schiff base reaction. b(PIM)B-S bridges were introduced into SNS under open vessel reflux conditions. SPS refers to the product obtained by incorporating the cross-linker b(PIM)B-S in ultra-small colloidal SNS particles. In-situ incorporation of DOX molecules resulted in SPS-DOX. The pH-responsive SPS nanocomposites were tested as biocompatible nanocarriers for controllable doxorubicin (DOX) delivery. We conclude that SPS is a unique colloid which has promising potential for technological applications such as advanced drug delivery systems, wastewater remediation and as a catalyst for green organic reactions in water.

RSM process optimization of biodiesel production from rapeseed oil and waste corn oil in the presence of green and novel catalyst.

In the scenario of global warming and pollution, the green synthesis and use of biodiesel has acquired utmost priority. Due to several limitations of homogeneous catalysis, organobase immobilized heterogeneous catalyzed production of biodiesel has come out as a favored route. The present report demonstrates the design and synthesis of Peganum harmala spice seed extract modified GO-CuFe2O4 (SSE@GO-CuFe2O4) nanocomposite as an organobase functionalized high surface area magnetic nanocatalyst. Pistachio leaves were used in the green reduction of precursor salts to synthesize CuFe2O4 NPs. The as-synthesized nanomaterial was characterized physicochemically by Fourier-transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), energy dispersive X-Ray analysis (EDX), elemental mapping, transmission electron microscopy (TEM), X-Ray diffraction (XRD), thermogravimetric analysis (TGA) and vibrating sample magnetometer techniques (VSM). Subsequently, the catalyst was explored in the efficient synthesis of biodiesels by trans-esterification of two substrates, the rapeseed oil and waste corn oil. The optimum conditions for biodiesel production were determined through response surface methodology based on Box-Behnken design including the study of calibration curves and 3D contour plots. Easy separation and workup, use of green medium, excellent reused for several times and short reaction time are outstanding benefits of this study.

The risk of inflammatory bowel disease after bariatric surgery.

BACKGROUND: The association between bariatric surgery and new onset of inflammatory bowel disease has so far only been sparsely studied and with conflicting results. OBJECTIVES: To investigate the association between bariatric surgery and inflammatory bowel disease in a large population-based cohort. SETTING: Nationwide in Sweden. METHODS: This population-based retrospective cohort study included Swedish individuals registered in the Scandinavian Obesity Surgery Registry who underwent primary Roux-en-Y gastric bypass or sleeve gastrectomy during 2007-2018. Ten control individuals from the general population were matched according to age, sex, and region of residence at time of exposure. The study population was followed until 2019 with regard to the development of inflammatory bowel disease. Cox proportional hazards models were used to compare disease-free survival time between subgroups and control individuals for each outcome. RESULTS: The final cohort consisted of 64,188 exposed individuals with a total follow-up of 346,860 person-years and 634,530 controls with total follow-up of 3,444,186 person-years. Individuals who underwent Roux-en-Y-gastric bypass had an increased risk of later development of Crohn's disease (hazard ratio [HR] 1.8, 95% CI 1.5-2.2) and unclassified inflammatory bowel disease (HR 2.7, 95% CI 2.0-3.7) but not ulcerative colitis (HR .9, 95% CI .8-1.1) compared with control individuals, whereas individuals who underwent sleeve gastrectomy had an increased risk of ulcerative colitis (HR 1.8, 95% CI 1.1-3.1) but not Crohn's disease (HR .8, 95% CI .3-2.1) and unclassified inflammatory bowel disease (HR 2.5, 95% CI .8-7.8). CONCLUSIONS: Roux-en-Y gastric bypass was associated with increased risk of Crohn's disease and unclassified inflammatory bowel disease, whereas sleeve gastrectomy was associated with increased risk of ulcerative colitis only.

Biotemplated Hollow Mesoporous Silica Particles as Efficient Carriers for Drug Delivery.

We designed three types of hollow-shaped porous silica materials via a three-step biotemplate-directed method: porous hollow silica nanorods, hollow dendritic fibrous nanostructured silica (DFNS), and ultraporous sponge-like DFNS. The first step was making a biotemplate, for which we used cellulose nanocrystals (CNCs), consisting of rod-shaped nanoparticles synthesized by conventional acid hydrolysis of cellulose fibers. In a second step, core-shell samples were prepared using CNC particles as hard template by two procedures. In the first one, core-shell CNC-silica nanoparticles were synthesized by a polycondensation reaction, which exclusively took place at the surface of the CNCs. In the second procedure, a typical synthesis of DFNS was conducted in a bicontinuous microemulsion with the assistance of additives. DFNS was assembled on the surface of the CNCs, giving rise to core-shell CNC-DFNS structures. Finally, all of the silica-coated CNC composites were calcined, during which the CNC was removed from the core and hollow structures were formed. These materials are very lightweight and highly porous. All three structures were tested as nanocarriers for drug delivery and absorbents for dye removal applications. Dye removal results showed that they can adsorb methylene blue efficiently, with ultraporous sponge-like DFNS showing the highest adsorption capacity, followed by hollow DFNS and hollow silica nanorods. Furthermore, breast cancer cells show a lower cell viability when exposed to doxorubicin-loaded hollow silica nanorods compared with control or doxorubicin cultures, suggesting that the loaded nanorod has a greater anticancer effect than free doxorubicin.

A simple and rapid protocol for the synthesis of phenacyl derivatives using macroporous polymer-supported reagents.

This article describes the use of Amberlite IRA-910 with different counter ions as excellent polymer-supported reagents in nucleophilic substitution reactions. The versatility of this protocol allowed the synthesis of a diversified library of phenacyl derivatives with high yields. The polymeric reagents can be reloaded several times with no loss of their efficiency.

Evaluation of the tibial cortical thickness accuracy in osteoporosis diagnosis in comparison with dual energy X-ray absorptiometry.

BACKGROUND: Unlike public awareness around the world, osteoporosis is still underdiagnosed in most cases till bone fractures. Currently, the dual-energy X-ray absorptiometry (DEXA) is the gold standard diagnostic method of osteoporosis, but unfortunately this method is not available in all diagnostic centers, especially in developing countries. AIMS: To evaluate the accuracy of tibial cortical thickness in the diagnosis of osteoporosis compared with DEXA. MATERIALS AND METHODS: In this descriptive--analytic study, patients suspicious of osteoporosis who referred to Imam Khomeini Hospital, Ahvaz from 2016 --2017 were recruited. Data was collected for each patient including age, sex, radiography, and DEXA. The total thickness of the tibia cortex (sum of the two sides) was measured using knee anteroposterior radiography at 10 cm from the proximal tibial joint. The bone mineral density (BMD) was measured by DEXA method and reported as T-score. RESULTS: In this study, 62 patients (90% female) were evaluated. The mean age of the patients was 57 years (range 45--80 years). T-score had a direct significant correlation with TCT level (r = 0.51, P < 0.0001). Also, T-score had a reverse and significant correlation with age of patients (r = -0.280, P = 0.028). The area under the curve (AUC) was 77%. Also, the sensitivity and specificity for the TCT level less than 4.37 mm (as cutoff point) was 100% and 39.1%, respectively. CONCLUSION: The findings of this study indicate that TCT has a direct significant correlation with the T-score obtained by the DEXA method. It has also been shown that TCT can be a relatively accurate diagnostic tool for predicting osteoporosis.

Poly(ethylene glycol) grafted onto Dowex resin: an efficient, recyclable, and mild polymer-supported phase transfer catalyst for the regioselective azidolysis of epoxides in water.

In this study, an efficient method was designed to graft poly(ethylene glycol) effectively onto commercial Dowex resin. The catalytic efficiency of the copolymer obtained as a new solid-liquid phase transfer catalyst was studied. It was proved that this organocatalyst is an efficient heterogeneous catalyst for regioselective azidolysis of epoxide in water and gave azidohydrin in excellent yield under mild reaction conditions. The polymeric catalyst was easily recovered by simple filtration and showed no appreciable loss of activity when recycled several times.

ß-Cyclodextrin engineered γ-Fe2O3@ hydroxyapatite nanocomposite as a novel scaffold for the synthesis of phenacyl derivatives.

Magnetic hydroxyapatite (HAp) is being widely investigated for various applications in medical engineering and nanocomposite for transformation reaction. The present work describes an efficient procedure for the synthesis of phenacyl derivatives employing a novel, green and magnetically retrievable nanocomposite via the grafting of ß-cyclodextrin moieties on the magnetic hydroxyapatite surface, γ-Fe2O3@HAp-CD. The structure and composition of the nanocomposite was performed by different methods and analyzed by Infrared Spectroscopy (FT-IR), Field Emission Scanning Electron Microscopy (FE-SEM), transmission electron microscopy (TEM), Thermo-Gravimetric Analysis (TGA), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDS) and Brunauer Emmett Teller (BET) and vibrating sample magnetometry (VSM). Our results indicate that conjugation with ß-CD improves the catalytic activity in the reaction.

Clinical application of ultrasound for preparation of (99m)Tc-sestamibi complex.

OBJECTIVE: The main aim of this investigation is the clinical application of ultrasound irradiation technique as an alternative method to reconstitute sestamibi kits in comparison of water boiling bath method. METHODS: The 740-3700 MBq (20-100 mCi) (99m)Tc-MIBI (sestamibi) complex samples were prepared due to ultrasound irradiation technique or boiled water bath method as a standard method. Twenty patients (8 men and 12 women; age range 30-72, median 52.45 years) have been referred to Golestan hospital for myocardial perfusion imaging (MPI). The subjects have been divided randomly into group A (3 men, 7 women, age range 36-67, median 51.7 years) and group B (5 men, 5 women, age range 30-72, median 50.3 years), respectively. The (99m)Tc-MIBI radiopharmaceuticals have been prepared by Ultrasound irradiation technique administrated to group A and (99m)Tc-MIBI complex samples due to the boiled water bath technique administrated to the other group. For all patients, the 2-day stress/rest MPI protocol was performed. RESULTS: The radio-HPLC and TLC studies have indicated that the (99m)Tc-MIBI complex samples with good yields could be prepared successfully due to new developed technique. The scintigraphy imaging studies have demonstrated that the (99m)Tc-sestamibi prepared due to the above-mentioned modalities shows very identical biodistribution in the heart, thyroid, lung, liver, gallbladder, kidneys, stomach, large intestine and bladder of the subjects. Any unexpected accumulation of radiotracer samples have not been observed in our approach. CONCLUSIONS: The ultrasound irradiation technique is convenient and sufficient method to prepare (99m)Tc-sestamibi. It can be recommended as an alternative method to reconstitute sestamibi kits particularly in emergency situations to reduce potentially medical risk by avoiding any delay in acute therapy for myocardial infarction.

99 mTc-MIBI washout as a complementary factor in the evaluation of idiopathic dilated cardiomyopathy (IDCM) using myocardial perfusion imaging.

Rapid technetium-99 m methoxyisobutylisonitrile (99 mTc-MIBI) washout has been shown to occur in impaired myocardia. This study is based on the hypothesis that scintigraphy can be applied to calculate the myocardial 99 mTc-MIBI washout rate (WR) to diagnose and evaluate heart failure severity and other left ventricular functional parameters specifically in idiopathic dilated cardiomyopathy (IDCM) patients. Patients with IDCMP (n = 17; 52.65 ± 11.47 years) and normal subjects (n = 6; 49.67 ± 10.15 years) were intravenously administered 99 mTc-hexakis-2-methoxyisobutylisonitrile (99 mTc-MIBI). Next, early and delayed planar data were acquired (at 3.5-h intervals), and electrocardiogram (ECG)-gated myocardial perfusion single photon emission computed tomography (SPECT) was performed. The 99 mTc-MIBI WR was calculated using early and delayed planar images. Left ventricular functional parameters were also analyzed using quantitative gated SPECT (QGS) data. In target group, myocardial WRs (29.13 ± 6.68%) were significantly higher than those of control subjects (14.17 ± 3.31%; P < 0.001). The 99 mTc-MIBI WR increased with the increasing severity of the NYHA functional class (23.16 ± 1.72% for class I, 30.25 ± 0.95% for class II, 32.60 ± 6.73% for class III, and 37.50 ± 7.77% for class IV; P = 0.02). The WR was positively correlated with the end-diastolic volume (EDV) index (r (2) = 0.216; ß = 0.464; P = 0.02 [ml/m(2)], the end-systolic volume (ESV) index (r (2) = 0.234; ß = 0.484; P = 0.01 [ml/m(2)]), the summed motion score (SMS) (r (2) = 0.544; ß = 0.738; P = 0.00), and the summed thickening score (STS) (r (2) = 0.656; ß = 0.810; P = 0.00); it was negatively correlated with the left ventricular ejection fraction (LVEF) (r (2) = 0.679; ß = -0.824; P = 0.00). It can be concluded that 99 mTc-MIBI scintigraphy might be a valuable molecular imaging tool for the diagnosis and evaluation of myocardial damage or dysfunction severity.