Variations in radioiodine ablation: decision-making after total thyroidectomy.

BACKGROUND: The role of radioiodine treatment following total thyroidectomy for differentiated thyroid cancer is changing. The last major revision of the American Thyroid Association (ATA) Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer in 2015 changed treatment recommendations dramatically in comparison with the European Association of Nuclear Medicine (EANM) 2008 guidelines. We hypothesised that there is marked variability between the different treatment regimens used today. METHODS: We analysed decision-making in all Swiss hospitals offering radioiodine treatment to map current practice within the community and identify consensus and discrepancies. RESULTS AND CONCLUSION: We demonstrated that for low-risk DTC patients after thyroidectomy, some institutions offered only follow-up, while RIT with significant activities is recommended in others. For intermediate- and high-risk patients, radioiodine treatment is generally recommended. Dosing and treatment preparation (recombinant human thyroid stimulation hormone (rhTSH) vs. thyroid hormone withdrawal (THW)) vary significantly among centres.

Association between cartilage degeneration and subchondral bone remodeling in patients with knee osteoarthritis comparing MRI and (99m)Tc-DPD-SPECT/CT.

OBJECTIVE: The purpose of this retrospective cross-sectional study was to investigate the association between cartilage lesions assessed with 3T-MRI and remodeling of the subchondral bone detected by (99m)Tc-DPD-SPECT/CT. DESIGN: (99m)Tc-DPD-SPECT/CT and MRI of 27 knees of 25 patients with chronic knee pain and risk factors for osteoarthritis (OA) were evaluated by one nuclear physician and one radiologist. Six regions of the knee (in total 162 regions in 27 knees) were assessed according to structural joint lesions graded with a modified Whole Organ MR imaging score (WORMS) and according to subchondral (99m)Tc-DPD-SPECT uptake. Relationships between regional WORMS scores and uptake were quantified using general estimating equations. In a secondary analysis the uptake sum with the WORMS sum per joint was compared using Spearman correlations. RESULTS: Elevated subchondral uptake was significantly associated with the grade of cartilage lesions (P < 0.0001). Mean uptake was significantly higher subjacent to full thickness cartilage lesions compared to partial thickness lesions (P < 0.0001). A similar association was observed between bone marrow edema pattern (BMEP) and cartilage lesions. The sum of uptakes per joint was positively correlated to the WORMS sum (rs = 0.42) and to the sum of cartilage lesions per joint (rs = 0.50). CONCLUSION: Both functional and structural changes of the subchondral bone in terms of scintigraphic osseous activity and the presence and degree of BMEP were significantly associated with cartilage lesions in patients with OA of the knee. This association was pronounced with full thickness lesions, indicating a possible protective effect of the cartilage layer for the subjacent bone.

Vardenafil protects isolated rat hearts at reperfusion dependent on GC and PKG.

BACKGROUND AND PURPOSE: The type-5 PDE inhibitor vardenafil reduces myocardial infarct size in situ, following ischemia/reperfusion, when applied at reperfusion in animal models. Little is known about the underlying protective signaling. Here, we test whether vardenafil is protective in rat isolated hearts and in a cell model of calcium stress. EXPERIMENTAL APPROACH: Infarct size in rat isolated hearts was measured after a 30 min regional ischemia and 120 min reperfusion. Vardenafil (1 nM-1 microM) was infused during reperfusion. HL-1 cardiomyocytes were loaded with tetramethylrhodamine ethyl ester (TMRE), a fluorescent marker of mitochondrial membrane potential (psi m). KEY RESULTS: Vardenafil at reperfusion reduced infarct size as percentage of the ischemic zone from 45.8+/-2.0% in control hearts to 26.2+/-2.7% (P<0.001) only at 10 nM, whereas higher or lower dosages failed to protect. This protective effect was blocked by co-administration of either the GC inhibitor, 1H-(1,2,4)oxadiazolo(4,3-a)quinoxalin-1-one (ODQ), or the PKG inhibitor, KT-5823. HL-1 cardiomyocytes, loaded with TMRE, were treated for 80 min with the calcium ionophore, calcimycin, to induce calcium stress. This reduced the mean cell fluorescence to 63.3 +/- 3.8% of baseline values and vardenafil protected against this fall (78.6 +/- 3.6%, P<0.01). The vardenafil-induced protection of HL-1 cells was blocked by ODQ, KT-5823 or the PKG-inhibiting peptides DT-2 and DT-3, confirming a role for GC and PKG. CONCLUSIONS AND IMPLICATIONS: These results further support the hypothesis that PDE-5 inhibitors are protective in ischemic hearts, in addition to their known clinical effects in the treatment of erectile dysfunction in men.

Template synthesis of a tetraazamacrocyclic ligand with two pendant pyridinyl groups: properties of the isomers of the metal-free ligand and of their first-row transition metal compounds.

The one-step reaction of [Cu(en)(2)](2+) (en = 1,2-diaminoethane) with formaldehyde, ethyl 2-pyridyl acetate, and base produces a mixture of [Cu(s-pypymac)](2+) and [Cu(a-pypymac)](2+) (s-pypymac = syn-6,13-bis(2-pyridinyl)-1,4,8,11-tetraazacyclotetradecane, a-pypymac = anti-6,13-bis(2-pyridinyl)-1,4,8,11-tetraazacyclotetradecane; syn-to-anti ratio approximately 1:9) in low yield (6%). Ion exchange chromatography is used for isomer separation, and the two isomers of the metal-free ligand are obtained by reduction of the copper(II) complexes and subsequent ion exchange chromatography. Crystal structure analyses of the metal-free a-pypymac ligand, of two isomeric copper(II) compounds of a-pypymac and one of s-pypymac, and of the cobalt(III) complexes of a- and s-pypymac and nickel(II), as well as zinc(II) complexes of a-pypymac, are reported and discussed on the basis of the expectations from force field calculations and from published experimental data of the transition metal compounds of the bis-pendant amine derivative diammac.

Two-dimensional optical architectures for the receive mode of phased-array antennas.

We propose and experimentally demonstrate two optical architectures that process the receive mode of a p x p element phased-array antenna. The architectures are based on free-space propagation and switching of the channelized optical carriers of microwave signals. With the first architecture a direct transposition of the received signals in the optical domain is assumed. The second architecture is based on the optical generation and distribution of a microwave local oscillator matched in frequency and direction. Preliminary experimental results at microwave frequencies of approximately 3 GHz are presented.