Clinical Role of Upfront F-18 FDG PET/CT in Determining Biopsy Sites for Lung Cancer Diagnosis.

PURPOSE: This study aimed to investigate the impact of FDG PET/CT timing for biopsy site selection in patients with stage IV lung cancer regarding complications and diagnostic yield. METHODS: This retrospective analysis was performed on 1297 patients (924 men and 373 women with a mean age of 71.4 ± 10.2 years) who underwent percutaneous needle biopsy (PNB) for stage IV lung cancer diagnosis in two hospitals. Data collected included the patient's characteristics, order date of the biopsy and PET/CT exams, biopsy target site (lung or non-lung), guidance modality, complications, sample adequacy, and diagnostic success. Based on the order date of the PNB and PET/CT exams, patients were categorized into upfront and delayed PET/CT groups. RESULTS: PNB for non-lung targets resulted in significantly lower rates of minor (8.1% vs. 16.2%), major (0.2% vs. 3.4%), and overall complications (8.3% vs. 19.6%) compared to PNB for lung targets (p < 0.001 for all types of complications). Compared to the delayed PET/CT group, the upfront PET/CT group exhibited a lower probability of lung target selection of PNB (53.9% vs. 67.1%, p < 0.001), including a reduced incidence of major complications (1.0% vs. 2.9%, p = 0.031). Moreover, there was no significant difference in the occurrence of minor and total complications between the two groups. Upfront PET/CT and delayed PET/CT groups showed no significant difference regarding sample adequacy and diagnostic success. CONCLUSIONS: Upfront PET/CT may have an impact on the selection of the biopsy site for patients with advanced lung cancer, which could result in a lower rate of major complications with no change in the diagnostic yield. Upfront PET/CT demonstrates potential clinical implications for enhancing the safety of lung cancer diagnosis in clinical practice.

Synthesis of Isolated DNA Aptamer and Its Application of AC-Electrothermal Flow-Based Rapid Biosensor for the Detection of Dengue Virus in a Spiked Sample.

Dengue fever is an infectious disease caused by the dengue virus (DENV) and is transmitted by mosquitoes in tropical and subtropical regions. The early detection method at a low cost is essential. To address this, we synthesized the isolated DENV aptamer for fabricating a rapid electrochemical biosensor on a Au interdigitated microgap electrode (AuIMGE). The DENV aptamers were generated using the SELEX (systemic evolution of ligands by exponential enrichment) method for binding to DENV surface envelope proteins. To reduce the manufacturing cost, unnecessary nucleotide sequences were excluded from the isolation process of the DENV aptamer. To reduce the detection time, the alternating current electrothermal flow (ACEF) technique was applied to the fabricated biosensor, which can shorten the detection time to 10 min. The performance of the biosensor was evaluated using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). In the diluted DENV protein solution, the linear range of the concentrations was from 1 pM to 1 µM and the LOD was 76.7 fM. Moreover, the proposed biosensor detected DENV in a diluted spiked sample at a linear range of 10-6 to 106 TCID50/mL, while the detection performance was proven with an LOD of 1.74 × 10-7 TCID50/mL along with high selectivity.

Three consecutive cytosolic glycolysis enzymes modulate autophagic flux.

Autophagy serves as an important recycling route for the growth and survival of eukaryotic organisms in nutrient-deficient conditions. Since starvation induces massive changes in the metabolic flux that are coordinated by key metabolic enzymes, specific processing steps of autophagy may be linked with metabolic flux-monitoring enzymes. We attempted to identify carbon metabolic genes that modulate autophagy using VIGS screening of 45 glycolysis- and Calvin-Benson cycle-related genes in Arabidopsis (Arabidopsis thaliana). Here, we report that three consecutive triose-phosphate-processing enzymes involved in cytosolic glycolysis, triose-phosphate-isomerase (TPI), glyceraldehyde-3-phosphate dehydrogenase (GAPC), and phosphoglycerate kinase (PGK), designated TGP, negatively regulate autophagy. Depletion of TGP enzymes causes spontaneous autophagy induction and increases AUTOPHAGY-RELATED 1 (ATG1) kinase activity. TGP enzymes interact with ATG101, a regulatory component of the ATG1 kinase complex. Spontaneous autophagy induction and abnormal growth under insufficient sugar in TGP mutants are suppressed by crossing with the atg101 mutant. Considering that triose-phosphates are photosynthates transported to the cytosol from active chloroplasts, the TGP enzymes would be strategically positioned to monitor the flow of photosynthetic sugars and modulate autophagy accordingly. Collectively, these results suggest that TGP enzymes negatively control autophagy acting upstream of the ATG1 complex, which is critical for seedling development.

Construction of a rapid electrochemical biosensor consisting of a nanozyme/aptamer conjugate for waterborne microcystin detection.

Microcystin-LR (MC-LR) is a hepatotoxin generated by the excessive proliferation of cyanobacteria, which is a threat to humans and wildlife. Therefore, rapid detection of MC-LR is an important challenge. This study describes a rapid electrochemical biosensor comprising nanozymes and aptamers. Alternating current electrothermal flow (ACEF) significantly reduced the MC-LR detection period to 10 min. We also used MnO2/MC-LR aptamer conjugates to improve the sensitivity to MC-LR detection. Here, MnO2 amplified the electrochemical signal and the aptamer showed high selectivity for MC-LR. Under the optimal conditions, the limit of detection (LOD) and selectivity in freshwater were detected using cyclic voltammetry and differential pulse voltammetry. As a result, an LOD of 3.36 pg mL-1 was observed in the linear concentration range of 10 pg mL-1 to 1 µg mL-1. This study quickly and sensitively detected MC-LR in a situation where it causes serious damage worldwide. In addition, the ACEF technology introduction is the first example of MC-LR detection, suggesting a wide range of possibilities for MC-LR biosensors.

Correction: Optical humidity sensors based on lead-free Cu-based perovskite nanomaterials.

[This corrects the article DOI: 10.1039/D2NA00168C.].

Optical humidity sensors based on lead-free Cu-based perovskite nanomaterials.

Organometallic halide perovskite materials possess unique and tunable optical properties with a wide range of optoelectronic applications. However, these materials suffer from humidity-driven degradation in ambient atmospheres. In this paper we investigate stable copper-based perovskite nanocrystals for potential use in humidity sensors, specifically examining their unique humidity-dependent optical properties and reversibility. We controlled stoichiometric ratios of Cu-based perovskites and demonstrated that (methylammonium)2CuBr4 nanocrystals showed excellent reversible physisorption of water molecules. These perovskite nanocrystals exhibited reversible hydro-optical properties, including transparency changes in response to variations in relative humidity under ambient conditions. The perovskite nanomaterial humidity sensor was highly reliable and stable, with a linear correlation in a relative humidity range of 7% to 98%. Accordingly, the lead-free Cu-based perovskite materials developed herein have the potential to be employed as real-time, self-consistent humidity sensors.

Silencing of the Target of Rapamycin Complex Genes Stimulates Tomato Fruit Ripening.

The target of rapamycin complex (TORC) plays a key role in plant cell growth and survival by regulating the gene expression and metabolism according to environmental information. TORC activates transcription, mRNA translation, and anabolic processes under favorable conditions, thereby promoting plant growth and development. Tomato fruit ripening is a complex developmental process promoted by ethylene and specific transcription factors. TORC is known to modulate leaf senescence in tomato. In this study, we investigated the function of TORC in tomato fruit ripening using virus-induced gene silencing (VIGS) of the TORC genes, TOR, lethal with SEC13 protein 8 (LST8), and regulatory-associated protein of TOR (RAPTOR). Quantitative reverse transcription-polymerase chain reaction showed that the expression levels of tomato TORC genes were the highest in the orange stage during fruit development in Micro-Tom tomato. VIGS of these TORC genes using stage 2 tomato accelerated fruit ripening with premature orange/red coloring and decreased fruit growth, when control tobacco rattle virus 2 (TRV2)-myc fruits reached the mature green stage. TORC-deficient fruits showed early accumulation of carotenoid lycopene and reduced cellulose deposition in pericarp cell walls. The early ripening fruits had higher levels of transcripts related to fruit ripening transcription factors, ethylene biosynthesis, carotenoid synthesis, and cell wall modification. Finally, the early ripening phenotype in Micro-Tom tomato was reproduced in the commercial cultivar Moneymaker tomato by VIGS of the TORC genes. Collectively, these results demonstrate that TORC plays an important role in tomato fruit ripening by modulating the transcription of various ripening-related genes.

Rapid electrochemical dual-target biosensor composed of an Aptamer/MXene hybrid on Au microgap electrodes for cytokines detection.

Rapid detection methods for cytokine storm markers, such as tumor necrosis factor α (TNF-α) and interferon gamma (IFN-γ), are required. Herein, we describe the fabrication of a rapid electrochemical dual-target biosensor composed of aptamer/MXene (Ti3C2) nanosheet on an Au microgap electrode. Alternating current electrothermal flow (ACEF) significantly reduced the detection time (<10 min) to achieve the rapid biosensor construction. Additionally, MXene nanosheet was synthesized to improve the detection sensitivity. A dual-type Au microgap electrode was designed to measure TNF-α and IFN-γ levels using a single biosensor. Moreover, it performs 12 measurements using a small sample volume. To reduce detection time with stable aptamer-target complex formation, various ACEF conditions were evaluated and optimized to 10 min. Using the optimal conditions, the limit of detection (LOD) and selectivity were determined by electrochemical impedance spectroscopy (EIS). A linear region was observed in the concentration range of 1 pg/mL to 10 ng/mL of TNF-α and IFN-γ. The LOD of TNF-α and IFN-γ were 0.15 pg/mL and 0.12 pg/mL within 10 min, respectively. Furthermore, the proposed biosensor detected TNF-α and IFN-γ diluted in 10% human serum in the concentration range of 1 pg/mL to 10 ng/mL with LODs of 0.25 pg/mL and 0.26 pg/mL, respectively.

RGI-GOLVEN signaling promotes cell surface immune receptor abundance to regulate plant immunity.

Plant immune responses must be tightly controlled for proper allocation of resources for growth and development. In plants, endogenous signaling peptides regulate developmental and growth-related processes. Recent research indicates that some of these peptides also have regulatory functions in the control of plant immune responses. This classifies these peptides as phytocytokines as they show analogies with metazoan cytokines. However, the mechanistic basis for phytocytokine-mediated regulation of plant immunity remains largely elusive. Here, we identify GOLVEN2 (GLV2) peptides as phytocytokines in Arabidopsis thaliana. GLV2 signaling enhances sensitivity of plants to elicitation with immunogenic bacterial elicitors and contributes to resistance against virulent bacterial pathogens. GLV2 is perceived by ROOT MERISTEM GROWTH FACTOR 1 INSENSITIVE (RGI) receptors. RGI mutants show reduced elicitor sensitivity and enhanced susceptibility to bacterial infection. RGI3 forms ligand-induced complexes with the pattern recognition receptor (PRR) FLAGELLIN SENSITIVE 2 (FLS2), suggesting that RGIs are part of PRR signaling platforms. GLV2-RGI signaling promotes PRR abundance independent of transcriptional regulation and controls plant immunity via a previously undescribed mechanism of phytocytokine activity.

Oral administration of East Asian herbal medicine for peripheral neuropathy: A protocol for systematic review and meta-analysis with using association rule analysis to identify core herb pattern.

BACKGROUND: Peripheral neuropathy (PN) is one of the most common medical problems encountered. Since the pathophysiology and symptom manifestation characteristics of PN are very diverse, it is difficult to provide an appropriate treatment. East Asian herbal medicine (EAHM) has long contributed to the treatment of neurological and pain disorders. The goal of this systematic review is to measure the efficacy and safety of EAHM for PN and to identify core herb patterns. In order to derive a more conservative result, a random effect model will be applied regardless of the significance of heterogeneity. METHODS: We will search 10 databases to identify suitable studies. There will be no restrictions regarding language or publication date. Primary outcomes will be nerve conduction velocity and response rate. Secondary outcomes will be any objective tool that can measure the efficacy of EAHM, and adverse events will be included. We will perform a meta-analysis of trials with the same intervention and outcome with comparator in a similar population. Meanwhile, in order to explore significant potential correlation in herb preparation, association rule analysis based on the Apriori algorithm will be performed on the collected composition data of herbal medicines. RESULTS: This study will provide scientific evidence for the treatment of EAHM for PN. CONCLUSIONS: Based on the results of this review, it is expected that the efficacy and safety of EAHM for PN can be confirmed. In addition, through additional analysis using data mining techniques, it will be possible to present a core herb pattern related to this research topic.

Chaperone-like protein DAY plays critical roles in photomorphogenesis.

Photomorphogenesis, light-mediated development, is an essential feature of all terrestrial plants. While chloroplast development and brassinosteroid (BR) signaling are known players in photomorphogenesis, proteins that regulate both pathways have yet to be identified. Here we report that DE-ETIOLATION IN THE DARK AND YELLOWING IN THE LIGHT (DAY), a membrane protein containing DnaJ-like domain, plays a dual-role in photomorphogenesis by stabilizing the BR receptor, BRI1, as well as a key enzyme in chlorophyll biosynthesis, POR. DAY localizes to both the endomembrane and chloroplasts via its first transmembrane domain and chloroplast transit peptide, respectively, and interacts with BRI1 and POR in their respective subcellular compartments. Using genetic analysis, we show that DAY acts independently on BR signaling and chlorophyll biogenesis. Collectively, this work uncovers DAY as a factor that simultaneously regulates BR signaling and chloroplast development, revealing a key regulator of photomorphogenesis that acts across cell compartments.

Coding of plant immune signals by surface receptors.

The detection of molecular signals derived from other organisms is central to the evolutionary success of plants in the colonization of Earth. The sensory coding of these signals is critical for marshaling local and systemic immune responses that keep most invading organisms at bay. Plants detect immune signals inside and outside their cells using receptors. Here, we focus on receptors that function at the cell surface. We present recent work that expands our understanding of the repertoire of immune signals sensed by this family of receptors.

Signatures of antagonistic pleiotropy in a bacterial flagellin epitope.

Immune systems respond to "non-self" molecules termed microbe-associated molecular patterns (MAMPs). Microbial genes encoding MAMPs have adaptive functions and are thus evolutionarily conserved. In the presence of a host, these genes are maladaptive and drive antagonistic pleiotropy (AP) because they promote microbe elimination by activating immune responses. The role AP plays in balancing the functionality of MAMP-coding genes against their immunogenicity is unknown. To address this, we focused on an epitope of flagellin that triggers antibacterial immunity in plants. Flagellin is conserved because it enables motility. Here, we decode the immunogenic and motility profiles of this flagellin epitope and determine the spectrum of amino acid mutations that drives AP. We discover two synthetic mutational tracks that undermine the detection activities of a plant flagellin receptor. These tracks generate epitopes with either antagonist or weaker agonist activities. Finally, we find signatures of these tracks layered atop each other in natural Pseudomonads.

A complex immune response to flagellin epitope variation in commensal communities.

Immune systems restrict microbial pathogens by identifying "non-self" molecules called microbe-associated molecular patterns (MAMPs). It is unclear how immune responses are tuned to or by MAMP diversity present in commensal microbiota. We systematically studied the variability of commensal peptide derivatives of flagellin (flg22), a MAMP detected by plants. We define substantial functional diversity. Most flg22 peptides evade recognition, while others contribute to evasion by manipulating immunity through antagonism and signal modulation. We establish a paradigm of signal integration, wherein the sequential signaling outputs of the flagellin receptor are separable and allow for reprogramming by commensal-derived flg22 epitope variants. Plant-associated communities are enriched for immune evading flg22 epitopes, but upon physiological stress that represses the immune system, immune-activating flg22 epitopes become enriched. The existence of immune-manipulating epitopes suggests that they evolved to either communicate or utilize the immune system for host colonization and thus can influence commensal microbiota community composition.

Effects of tympanic membrane perforation, middle ear cavity volume, and mastoid aeration on hearing impairment.

AIMS: To investigate the effects of the location and size of tympanic membrane (TM) perforation and middle ear cavity volume on conductive hearing loss in patients with TM perforation. METHODS: Data were collected via a retrospective medical chart review. RESULTS: We enrolled 128 patients with a mean age of 45.6 ± 10.1 years. The mean perforation size was 21.2 ± 8.6% of the TM area, and the mean air-bone gap (ABG) was 20.2 ± 8.6 dB HL on pure tone audiometry. Patients were divided into two groups based on mean ABG. Patients with a large ABG had a significantly larger TM perforation area and smaller mastoid volume. The TM perforation was most commonly located in the central section. However, regression analyses showed that the proportion of the perforated TM area was the only independent predictor of a large ABG (odds ratio, 1.053; 95% confidence interval, 1.022-1.085; p = 0.001). When we analyzed the frequencies in which hearing loss occurred due to TM perforation, we confirmed that hearing loss occurred mainly in the low-frequency range. CONCLUSION: In patients with TM perforation, conductive hearing loss occurs mainly at low frequencies and in proportion to the size of the TM perforation.

Sentinel lymph node biopsy in acral melanoma: A Korean single-center experience with 107 patients (2006-2018).

BACKGROUND: Sentinel lymph node biopsy (SLNB) of primary cutaneous melanoma as an important staging method has not been popularly undertaken in Korea and only a few studies with small patient numbers have been published. AIM: We examined the clinical feasibility and overall outcomes of SLNB in acral melanoma (AM) of Korean in Kyungpook National University Hospital (KNUH) over the past 13 years. METHODS: SLNB in AM patients during 2006-2018 were analyzed retrospectively for sentinel lymph node (SLN) harvesting rate, positivity rate, positivity-relevant overall survival (OS) and disease-free survival (DFS), and its side effects. RESULTS: A total of 109 AM patients who underwent SLNB were enrolled. Harvested nodes were identified from 107 patients and SLN harvesting rate was 98.2%. The mean Breslow thickness (±standard deviation) was 3.38 ± 3.03 mm, and the proportion of ulcerated melanomas was 64%. Twenty-two (20.6%) had a tumor-positive SLN and, among them, 82% (18/22) underwent immediate complete lymph node dissection (CLND). The metastasis-positive nodal basin after CLND was detected in 16.7% of cases (3/18). Tumor-negative SLN cohorts showed significantly better OS and DFS than tumor-positive ones (P = 0.006 and P < 0.001 for each). Two side effects, one seroma and one lymphocele, were observed without major sequelae. CONCLUSION: SLNB, crucial management of melanoma, proved its efficacy to predict patients' prognosis and could be performed successfully and safely in Korean AM patients by interdisciplinary cooperation between dermatology and other surgical departments. SLN(-) showed significantly better OS and DFS than SLN(+). Significant risk factors for DFS were Breslow thickness, the presence of ulceration and the presence of SLN metastasis. SLNB should be encouraged in order to stage melanoma accurately and direct the proper management in Korean AM.

Dangguijagyag-san for primary dysmenorrhea: A PRISMA-compliant systematic review and meta-analysis of randomized-controlled trials.

BACKGROUND: This systematic review and meta-analysis aim to assess the effectiveness of Dangguijagyag-san (DJS) for primary dysmenorrhea (PD) and to update the previous reviews. METHODS: We searched for randomized controlled trials (RCTs) of DJS for PD from inception to April 2019. The search databases were the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Oriental Medicine Advanced Searching Integrated System, Korean Traditional Knowledge Portal, Korean Medical Database, National Digital Science Library, and the China National Knowledge Infrastructure. The selection of studies, the extraction of data, and the quality assessment with risk of bias tool were performed by 2 authors independently. To analyze the data, the meta-analysis was conducted and qualitative analysis was also performed. RESULTS: Total 2766 studies were identified, and 14 RCTs were enrolled in this review. According to the type of interventions, the analysis was performed in 4 groups. In comparison to western medication, DJS showed a higher total effective rate (TER) (RR 1.16, 95% CI 1.08-1.24) and a higher effect in reducing the pain (MD = -0.86, 95% CI -1.56--0.16). Compared with placebo, DJS was superior to placebo in reducing pain (MD = -1.1, 95% CI -2.04 --0.16) and also in reducing the consumption of the rescue medication during menstrual period (MD = -2.3, 95% CI -3.58--1.02). Compared with other herbal medicines, the subgroup analysis showed that DJS applied with PD of differentiated patterns had a higher total effective rate (TER) (RR 1.21, 95% CI 1.03-1.43, P=.02). DJS with moxibustion as an adjuvant therapy was also more effective than western medication (RR 1.47, 95% CI 1.23-1.76). CONCLUSION: DJS may be effective for the treatment of PD. However, the quality of the evidence is relatively low, so larger-scale and well-designed RCTs are needed to confirm the effects of DJS. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number is CRD42019130768.

Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation.

Simple posterolateral elbow dislocations (SPLED) may be treated nonoperatively using closed reduction, followed by controlled mobilization. However, the extent of soft tissue injuries might affect the choice of treatment, rehabilitation approach, and prognosis. The purpose of this study is to compare the characteristics of soft tissue injuries between patients with unstable and stable SPLED using MRI findings. Thirty MRIs of elbows with SPLED (unstable group (n = 15); stable group (n = 15)) were randomly reviewed by two experienced musculoskeletal radiologists. Soft tissue injuries were characterized as an intact, partial tear or complete tear for the: medial collateral ligament (MCL) complex, common flexor complex, lateral collateral ligament (LCL) complex, common extensor complex, anterior capsule, and posterior capsule. Moderate to substantial interobserver reliability and substantial to perfect intraobserver reliability were observed for medial and lateral complexes in SPLED. The proportion of soft-tissue injuries of the common extensor complex were significantly different between the unstable (four partial tears and 11 complete tears) and stable groups (11 partial tears and four complete tears). In conclusion, based on MRI findings, the degree of common extensor complex injuries may be a predictor of stability and help inform treatment decisions for SPLED.

Effect of neoadjuvant chemotherapy on breast tissue composition: a longitudinal mammographic study with automated volumetric measurement.

OBJECTIVES: To investigate the effect of neoadjuvant chemotherapy (NAC) on breast tissue composition with mammographic automated volumetric measurement. METHODS: This retrospective study included 168 breast cancer patients who were treated with NAC and underwent serial mammography (pre-treatment, mid-treatment, and post-treatment) between January 2015 and October 2018. Automated volumetric measurements of the contralateral breast volume (BV), fibroglandular volume (FGV), and breast density (BD) were performed using Volpara software. BD grades were divided into 4 groups by Volpara density grade (VDG). The longitudinal changes in BV, FGV, BD, and their associated factors were evaluated. RESULTS: Repeated-measures analysis of variance demonstrated a significant reduction in BV, FGV, and BD over time (p < 0.001, p < 0.001, and p = 0.002, respectively). BV showed a greater reduction in the second half than in the first half (- 28.6 cm3 vs. - 15.2 cm3), BD showed a greater reduction in the first half than in the second half (- 0.8% vs. - 0.1%), and FGV steadily decreased (- 4.6 cm3 and - 3.9 cm3 in the first and second halves). On multivariable linear regression analysis, chemotherapy regimen was associated with BV change between pre- and post-treatment (p = 0.002); age (p = 0.024) and VDG (p = 0.027) were associated with FGV change; age (p = 0.037), VDG (p = 0.002), and chemotherapy regimen (p = 0.003) were associated with BD change. CONCLUSIONS: NAC affects breast tissue composition, reflected as reductions in BV, FGV, and BD. Mammography with automated volumetric measurement can capture quantitative changes in these breast tissue parameters during NAC. KEY POINTS: • Neoadjuvant chemotherapy (NAC) affects breast tissue composition with different patterns of reduction in breast volume, fibroglandular volume, and breast density. • Age, Volpara density grades, and NAC regimen were independent factors associated with breast density change between pre-treatment and post-treatment. • Mammography with automated volumetric measurement enables identification of longitudinal changes in breast tissue composition.

Over-the-wire deployment techniques of option elite inferior vena cava filter: 3D printing vena cava phantom study.

PURPOSE: To compare filter tilt and filter jumping during Option inferior vena cava (IVC) filter deployment with 3 different wires techniques using a 3-dimensional (3D) printing vena cava phantom. MATERIALS AND METHODS: An IVC 3D printed vena cava phantom was made from a healthy young male's computed tomographic data. Option IVC filters were deployed with 3 different wires: i) original push wire, ii) hydrophilic stiff wire, and iii) bent stiff wire. Right internal jugular and right femoral access were used 5 times with each wire. Filter tilt angle, tilt ratio, jumping, and tip abutment to the IVC wall were analyzed. RESULTS: The transfemoral approach with original push wire had significantly higher tilt angle than did the transjugular approach (6.1˚ ± 1.9 vs. 3.5˚ ± 1.3, p = 0.04). Mean tilt ratio was significantly lower with the bent wire with transfemoral access (0.49 ± 0.13 vs. 0.78 ± 0.18 [original push-wire] and 0.67 ± 0.08 [stiff wire], p = 0.019). The ratio was lower also with original push wire with transjugular access (0.34 ± 0.19 vs. 0.57 ±0.11 [stiff wire] and 0.58 ±0.17 [bent wire], p = 0.045). Filter jumping occurred more often with the transjugular approach with original push wire than with stiff or bent-wire delivery. Filter tip abutment to the IVC wall occurred only with the transfemoral approach. CONCLUSIONS: Bent wire with transfemoral access and original push wire with transjugular access had lower filter tilt ratio at Option IVC filter deployment. However, filter jumping was common using the original push wire with transjugular access.