Internal Wireless Electrical Stimulation from Piezoelectric Barium Titanate Nanoparticles as a New Strategy for the Treatment of Triple-Negative Breast Cancer.

Triple-negative breast cancer (TNBC) is an aggressive BC subtype with a higher metastatic rate and a worse 5-year survival ratio than the other BC. It is an urgent need to develop a noninvasive treatment with high efficiency to resist TNBC cell proliferation and invasion. Internal wireless electric stimulation (ES) based on piezoelectric materials is an emerging noninvasive strategy, with adjustable ES intensity and excellent biosafety. In this study, three different barium titanate nanoparticles (BTNPs) with different crystal phases and piezoelectric properties were studied. Varying intensities of internal ES were generated from the three BTNPs (i.e., BTO, U-BTO, P-BTO). In vitro tests revealed that the internal ES from BTNPs was efficient at reducing the proliferative potential of cancer cells, particularly BC cells. In vitro experiments on MDA-MB-231, a typical TNBC cell line, further revealed that the internal wireless ES from BTNPs significantly inhibited cell growth and migration up to about 82% and 60%, respectively. In vivo evaluation of MDA-MB-231 tumor-bearing mice indicated that internal ES not only resisted almost 70% tumor growth but also significantly inhibited lung metastasis. More importantly, in vitro and in vivo studies demonstrated a favorable correlation between the anticancer impact and the intensities of ES. The underlying mechanism of MDA-MB-231 cell proliferation and metastasis inhibition caused by internal ES was also investigated. In summary, our results revealed the effect and mechanism of internal ES from piezoelectric nanoparticles on TNBC cell proliferation and migration regulation and proposed a promising noninvasive therapeutic strategy for TNBC with minimal side effects while exhibiting good therapeutic efficiency.

Value of routine timed barium esophagram follow-up in achalasia after myotomy.

OBJECTIVES: The value of routine timed barium esophagram (TBE) in longitudinal follow-up of achalasia after Heller myotomy is unknown. We prospectively prescribed a yearly follow-up TBE. Purposes were to characterize esophageal emptying over time after myotomy, identify preoperative TBE measures associated with follow-up TBE, and characterize follow-up TBE over time in relationship to reintervention. METHODS: From March 1995 to April 2013, 635 patients underwent Heller myotomy for achalasia; 559 had at least 1 follow-up TBE. Temporal trends of 1335 follow-up TBEs in all nonreintervention and reintervention patients were assessed. Multivariable longitudinal analysis identified preoperative TBE measures associated with follow-up TBE. RESULTS: On average, TBE height and width at 1 and 5 minutes decreased approximately 50% and 60%, respectively, at first postoperative follow-up, and remained stable or slightly decreased for up to 5 years. Wider TBE width at 5 minutes was associated with greater follow-up TBE height and width at 1 minute. Of 118 patients undergoing reintervention, 64 (57%) had only 1 reintervention, with follow-up TBE returning to that of nonreintervention patients. Patients whose follow-up TBE remained abnormal underwent a further reintervention, some normalizing on subsequent TBE, and some not. CONCLUSIONS: Follow-up TBE is valuable postmyotomy, particularly if there is substantial esophageal dilatation preoperatively. Follow-up TBE reassures patients with stable or decreasing TBE measures, permitting decreased follow-up intensity. Reintervention should not be considered a myotomy failure, because a successful, single, nonsurgical reintervention often results in long-term successful palliation. More than 1 reintervention requires intensification of TBE follow-up, facilitating treatment planning.

Hypocobalaminaemia as a cause of bone marrow failure and pancytopenia in a cat.

CASE REPORT: A male Domestic Short-hair cat was presented for chronic weight loss, lethargy and hyporexia. Complete haematological examination revealed non-regenerative anaemia, neutropenia and thrombocytopenia, as well as Howell-Jolly bodies, anisocytosis, polychromasia and macrocytosis on blood smear evaluation. Histopathological evaluation of bone marrow biopsy disclosed hypocellularity consistent with bone marrow failure. Concurrent hypocobalaminaemia was identified and treated with parenteral cyanocobalamin supplementation. Other differential diagnoses for pancytopenia, including infectious, toxic, immune-mediated and neoplastic causes, were ruled out. CONCLUSION: The cat's erythrocyte, leucocyte and platelet counts normalised after 2 months of cyanocobalamin supplementation, suggesting that pancytopenia may be a rare manifestation of feline cobalamin deficiency.

The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study.

OBJECTIVE: The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk. METHODS: From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups. RESULTS: The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3). CONCLUSIONS: BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.

Diagnostic investigation rates and use of prescription and non-prescription medications amongst dyspeptics: a population-based study of 2300 Australians.

BACKGROUND: : There is limited knowledge of the diagnostic investigation rates and use of prescription and non-prescription drugs amongst dyspeptics. AIM: : To assess the investigation rates and use of prescription and non-prescription anti-ulcer medications amongst dyspeptics in the population. METHODS: : A cross-sectional survey was performed of 2300 Australians. RESULTS: : Of 748 dyspeptics, 422 (56%) had consulted a doctor regarding dyspepsia at some time in their life. Of the consulters, 64% had undergone investigations at some time: 37% an endoscopy, 54% a barium meal and 27% both. A diagnosis of peptic ulcer was reported by 31% of those investigated. The symptom profile of gastroscopy patients differed significantly from that of uninvestigated dyspeptics. Of the consulters, 36% had taken anti-ulcer prescription drugs in the last 3 months: Histamine-2 receptor antagonists (73% of prescriptions), proton pump inhibitors (17%), cytoprotectants (5%) and prokinetic drugs (5%). Antacids were taken by 30% of non-consulting dyspeptics, 44% of consulters not on prescription drugs and 58% of dyspeptics taking prescription drugs. Advancing age, but not gender, was associated with diagnostic investigation and prescription and non-prescription drug usage. CONCLUSIONS: : There are high rates of diagnostic investigation amongst dyspeptics who consult doctors. Many individuals with dyspepsia decide to self-medicate with antacids regardless of consulting or prescriptions, suggesting that current management is suboptimal.

Intravertebral clefts opacified during vertebroplasty: pathogenesis, technical implications, and prognostic significance.

BACKGROUND AND PURPOSE: Intravertebral clefts have long been considered as pathognomonic for avascular necrosis and as a rare cause of compression fracture. We have observed unsuspected clefts opacifying frequently during vertebroplasty. Our purpose in this study was to determine the incidence of these clefts in symptomatic osteoporotic compression fractures, assess the sensitivity of MR imaging and conventional radiography in the detection of these clefts, and determine whether there is any prognostic significance of these clefts in patients treated with vertebroplasty. METHODS: Retrospective chart reviews were conducted of 135 vertebroplasty procedures performed during a 2-year period. MR images and conventional radiographs were reviewed for the presence of clefts defined as fluid-filled cavities on MR images or gas-filled cavities on conventional radiographs. Digital radiographs obtained at the time of the procedure were inspected for the presence of opacified clefts. Imaging findings were correlated with subjective pain scores documented before the procedure and at 1 week, 1 month, 6 months, and 12 months after vertebroplasty. RESULTS: Two hundred thirty-six osteoporotic compression fractures were treated with polymethylmethacrylate in 125 patients. Thirty-one and eight-tenths percent of the fractures were noted to contain clefts at the time of vertebroplasty. Fluid-filled clefts were detected on preoperative MR images in only 52.8% of the fractures with opacified clefts at vertebroplasty. Gas-filled clefts were evident on preoperative conventional radiographs in only 11.4% of the fractures with opacified clefts at vertebroplasty. No significant difference was noted in numerical pain scores between the two populations at baseline or 1 week or 1 month after the procedure. Pain scores at 6 and 12 months after vertebroplasty showed a trend toward greater pain relief in patients with clefts, although the difference was not statistically significant. A sustained, statistically significant decrease in pain scores after treatment (P <.01) was noted in both groups. CONCLUSION: Intravertebral clefts are much more common than previously described and probably represent fracture nonunions. Imaging is not sensitive in detecting these clefts before vertebroplasty. We advocate complete filling of the cleft with cement during vertebroplasty to maximize stabilization of the fracture fragments. There is a trend toward greater pain relief being achieved 6 and 12 months after the procedure in patients with clefts that are opacified at the time of vertebroplasty.

Percutaneous pediculoplasty: polymethylmethacrylate injection into lytic vertebral pedicle lesions.

Two patients with painful lytic lesions of the vertebral pedicle were treated with percutaneous pediculoplasty. This technique, similar to vertebroplasty but with increased procedural risks because of the immediate vicinity of neural structures, was performed under high-quality biplane fluoroscopic guidance. For lesions involving both the pedicle and the vertebral body, a double-needle unipedicular technique is advocated.

[Intussusception: barium vs. pneumatic reduction]. / Invaginación intestinal: Neumoenema versus enema de bario.

At the Hospital Niño Jesús air pressure enema has recently replaced the use of barium as treatment of choice in the reduction of intussusception. The purpose of this study was to review the air enema reductions done from June 1992 to February 1994 in 137 patients (group II) and to compare them with a previous series of 153 patients that underwent barium reduction treatment (group I). The groups were similar with regard to sex, age and presentins symptoms as well as clinical signs. Successful reduction was achieved in 131 patients (85.6%) out of 146 attempts treated with barium enema and in 124 patients (90.5%) out of 134 attempts treated with air enema. Among the unsuccessful reduction cases, operation was performed in 22 cases in group I and in 13 cases of group II. In the group I there were two perforations during the reduction attempt, while in group II we did not have any with the air enema. There were two recurrent intussusceptions following barium enema reduction and nine following air enema reduction in the first 48 hours. Patients treated with air enema stayed less days at hospital (1,6 days) than those treated with barium (3 days). We believe that the air enema treatment is easy to perform, is lower in cost and presents less morbility, and that it should be considered as the treatment of choice in the initial management of intussusception.

Barium decreases defibrillation energy requirements.

Certain antiarrhythmic drugs that inhibit myocardial repolarizing currents decrease defibrillation energy, but the effect of blocking particular currents on defibrillation is not well understood. We therefore investigated the effect of barium, a relatively selective blocker of inwardly rectifying potassium current (Ik1) on voltage and energy requirements for defibrillation in an open-chest dog model. Defibrillation energy and voltage requirements were assessed by delivering monophasic shocks through epicardial electrode patches at varying voltages to construct a dose-dependent curve of energy and voltage versus success in defibrillation. The energy and voltage for 50% success in defibrillation (E50 and V50, respectively) were determined by logistic regression. Monophasic action potential duration at 90% repolarization (MAPD90) was measured with a contact electrode, and ventricular refractory period (VERP) was measured. After baseline measurements were obtained of E50, V50, MAPD90, and VERP, saline (control) (n = 6) or barium (1.1 mg/kg/min for 5 min followed by 0.25 mg/kg/min) (n = 11) was administered. Defibrillation voltage and energy requirements and electrophysiologic measures were repeated after 30 and 120 min of barium or saline infusion. In control animals, there was no significant change with time in V50 (2.0 +/- 12.4 and -0.2 +/- 16.0% at 30 and 120 min, respectively), VERP (+3 +/- 5 and -2 +/- 3% at 30 and 120 min, respectively) or MAPD90 (+1 +/- 4 and -2 +/- 6, at 30 and 120 min, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Tiempo de depuración esofágica de bario (TIDEB) una nueva técnica para valorar disfunción esofágica en esclerodermia / Esophageal depuration time of barium: a new technique to asess esophageal disfunction in sclerodermia

En 52 pacientes con Esclerodermia el tiempo de depuración esofágica de bario hiperviscoso (TIDEB) promedio fue de 25 min, mientras que en 40 controles sanos el promedio fue de 3 min (p<0.001). Esta técnica que mide la disfunción motora esofágica (DME), es más sensible que la radiografía baritada convencional y capaz de detectar DME aún en pacientes asintomáticos. Esta técnica inédita en la literatura mundial es simple y de bajo costo, su especifidad es de 97% y su sensibilidad similar al de la manometría

Intussusception: hydrostatic pressure equivalents for barium and meglumine sodium diatrizoate.

The pressures generated by a barium suspension and various solutions of meglumine sodium diatrizoate in water were measured with a manometer. A pressure of 120 mm Hg was produced by a 3.5-foot (105-cm) column of 60% wt/vol barium and a 5-foot (150-cm) column of either a 1:3 or 1:4 solution of meglumine sodium diatrizoate and water. This is the pressure used to reduce an intussusception with air.

Inhibitory effect of barium on caries formation in rats.

The aim of this investigation was to study the effect of barium and fluoride in drinking water on caries formation in rats. Sprague-Dawley rats were fed a cariogenic diet (MIT-200) 17 times daily in a König-Hofer programmed feeding machine for 37 days. Drinking water containing barium (0, 50 or 100 ppm) and fluoride (0 or 10 ppm) was available ad libitum. Rats to whose water was added 50 ppm barium had significant reductions in the mean severity of both buccolingual lesions and sulcal lesions compared with those rats whose water contained no barium. As expected, F at 10 ppm in the drinking water significantly reduced caries severity but this F effect was independent of the barium effect. This suggests that the inhibitory effects of barium and fluoride at these levels are additive and operate by separate mechanisms.

Trials with a long acting parenteral selenium preparation in ruminants: sheep.

Barium selenate was developed as a long-acting subcutaneous injection for selenium treatment. The results from trials using this product show that it is a safe preparation for treating and preventing selenium deficiency in sheep. It produces a satisfactory selenium status which will be maintained for at least six months and, when injected into pregnant ewes, results in the transfer of selenium from the ewe to its progeny.