Superselective Transcatheter Arterial Embolization for Large Unruptured Renal Angiomyolipoma in Lymphangioleiomyomatosis.

PURPOSE: To retrospectively evaluate therapeutic performance and complications of superselective transcatheter arterial embolization (TAE) for unruptured renal angiomyolipoma (AML) in patients with lymphangioleiomyomatosis (LAM) and to investigate the correlation between percentage reduction in tumor volume and intratumoral fat content. MATERIALS AND METHODS: Superselective TAE was performed in 14 consecutive patients with 15 large unruptured renal AMLs associated with LAM (mean age, 38 y; range, 21-57 y). Patients had renal AML with aneurysms ≥ 5 mm in diameter, tumor-related abdominal symptoms, or both. In all cases, embolization of 1 tumor was achieved in a single session by using multiporous gelatin sponge particles (GSPs) with additional metallic coils in all but 1 case. Tumor volume and fat content percentage were measured on CT or MR imaging before and after superselective TAE (median, 11 months; range, 6-14 months). RESULTS: Residual tumor staining declined by > 90% after all TAE sessions except 2, with embolization of all treated aneurysms. No nontarget embolization or severe complications were encountered. Mean percentage reduction in tumor volume after superselective TAE was 69% (range, 21%-95%). Percentage tumor volume reduction was negatively correlated with fat content before embolization (P < .01). CONCLUSIONS: Superselective TAE with multiporous GSPs and metallic coils for large unruptured renal AML in patients with LAM is useful for reducing tumor volume and treating intratumoral aneurysms without major pulmonary or renal complications. Extent of tumor reduction may be influenced by fat content before embolization.

Development of a Dual Plasma Desorption/Ionization System for the Noncontact and Highly Sensitive Analysis of Surface Adhesive Compounds.

We developed a dual plasma desorption/ionization system using two plasmas for the semi-invasive analysis of compounds on heat-sensitive substrates such as skin. The first plasma was used for the desorption of the surface compounds, whereas the second was used for the ionization of the desorbed compounds. Using the two plasmas, each process can be optimized individually. A successful analysis of phenyl salicylate and 2-isopropylpyridine was achieved using the developed system. Furthermore, we showed that it was possible to detect the mass signals derived from a sample even at a distance 50 times greater than the distance from the position at which the samples were detached. In addition, to increase the intensity of the mass signal, 0%-0.02% (v/v) of hydrogen gas was added to the base gas generated in the ionizing plasma. We found that by optimizing the gas flow rate through the addition of a small amount of hydrogen gas, it was possible to obtain the intensity of the mass signal that was 45-824 times greater than that obtained without the addition of hydrogen gas.

Development of a High-Density Microplasma Emission Source for a Micro Total Analysis System.

To achieve a highly sensitive and onsite analysis of a small amount samples, a microplasma-based micro total analysis systems (µ-TAS) device was developed. A dielectric barrier discharge (DBD) that can generate a stable plasma at atmospheric pressure was generated in a microchip and used as the plasma source. The use of DBD suppresses the temperature rise of the electrodes and enables operation for long times because of a reduction of the electrode damage due to suppression of the current via dielectric interposing between the electrodes. It is expected that the analytical system can be miniaturized because helium plasma is generated in the microchannel contained in the microchip. Emissions from gaseous Cl, Br, and I were analyzed using the plasma source, and it was found that the detection limits for these analytes were 0.22, 0.18, and 0.14 ppm, respectively. The calibration curves for gaseous Cl, Br, and I were also plotted obtaining correlation coefficients of 0.975, 0.955 and 0.986, respectively, and showing good linearity for the developed plasma source.

Development of Desolvation System for Single-cell Analysis Using Droplet Injection Inductively Coupled Plasma Atomic Emission Spectroscopy.

With a view to enhance the sensitivity of analytical instruments used in the measurement of trace elements contained in a single cell, we have now equipped the previously reported micro-droplet injection system (M-DIS) with a desolvation system. This modified M-DIS was coupled to inductively coupled plasma atomic emission spectroscopy (ICP-AES) and evaluated for its ability to measure trace elements. A flow rate of 100 mL/min for the additional gas and a measurement point -7.5 mm above the load coil (ALC) have been determined to be the optimal parameters for recording the emission intensity of the Ca(II) spectral lines. To evaluate the influence of the desolvation system, we recorded the emission intensities of the Ca(I), Ca(II), and H-ß spectral lines with and without inclusion of the desolvation system. The emission intensity of the H-ß spectral line reduces and the magnitude of the Ca(II)/Ca(I) emission intensity ratio increases four-fold with inclusion of the desolvation system. Finally, the elements Ca, Mg, and Fe present in a single cell of Pseudococcomyxa simplex are simultaneously determined by coupling the M-DIS equipped with the desolvation system to ICP-AES.

Development of a gas-cylinder-free plasma desorption/ionization system for on-site detection of chemical warfare agents.

A gas-cylinder-free plasma desorption/ionization system was developed to realize a mobile on-site analytical device for detection of chemical warfare agents (CWAs). In this system, the plasma source was directly connected to the inlet of a mass spectrometer. The plasma can be generated with ambient air, which is drawn into the discharge region by negative pressure in the mass spectrometer. High-power density pulsed plasma of 100 kW could be generated by using a microhollow cathode and a laboratory-built high-intensity pulsed power supply (pulse width: 10-20 µs; repetition frequency: 50 Hz). CWAs were desorbed and protonated in the enclosed space adjacent to the plasma source. Protonated sample molecules were introduced to the mass spectrometer by airflow through the discharge region. To evaluate the analytical performance of this device, helium and air plasma were directly irradiated to CWAs in the gas-cylinder-free plasma desorption/ionization system and the protonated molecules were analyzed by using an ion-trap mass spectrometer. A blister agent (nitrogen mustard 3) and nerve gases [cyclohexylsarin (GF), tabun (GA), and O-ethyl S-2-N,N-diisopropylaminoethyl methylphosphonothiolate (VX)] in solution in n-hexane were applied to the Teflon rod and used as test samples, after solvent evaporation. As a result, protonated molecules of CWAs were successfully observed as the characteristic ion peaks at m/z 204, 181, 163, and 268, respectively. In air plasma, the limits of detection were estimated to be 22, 20, 4.8, and 1.0 pmol, respectively, which were lower than those obtained with helium plasma. To achieve quantitative analysis, calibration curves were made by using CWA stimulant dipinacolyl methylphosphonate as an internal standard; straight correlation lines (R(2) = 0.9998) of the peak intensity ratios (target per internal standard) were obtained. Remarkably, GA and GF gave protonated dimer ions, and the ratios of the protonated dimer ions to the protonated monomers increased with the amount of GA and GF applied.

A retrospective statistical analysis of the late complications associated with central venous port placements.

PURPOSE: Central venous (CV) ports are being used increasingly in both hospital and home care settings. Here, we investigated the rates and causes of CV port complications. MATERIALS AND METHODS: We retrospectively analyzed the placement of 264 consecutive CV ports in 239 consecutive patients admitted to our hospital between September 2009 and February 2012. All CV ports were inserted under fluoroscopy and ultrasound visualization by interventional radiologists using maximum barrier precautions. CV port complications were checked in detail and analyzed statistically. RESULTS: Total indwelling time for all CV ports was 51,033 catheter days. Of the 264 CV ports assessed, 50 were removed during the study period because of any complication and 147 remained at the end of the study period. In 33 cases, the patient died before the end of the study. Of the 50 patients who underwent CV port removal, 13 were diagnosed as having catheter-related bloodstream infection (CRBSI). The total rate of CV port removal because of any complication was 0.98 cases per 1,000 catheter days, that of catheter troubles was 0.22 cases per 1,000 catheter days and that of CRBSI was 0.25 cases per 1,000 catheter days. Steroid administration and total parenteral nutrition (TPN) were associated with increased rates of infection. It seems that chemotherapy and indwelling time were also considered important factors. CONCLUSION: Steroid administration and TPN were associated with increased rates of infection. In addition, patients receiving chemotherapy or whose CV ports are left in place for a long time should be carefully observed to decrease these complications.