Laser-targeted photosensitizer-induced lung injury: noninvasive rat model of pulmonary infarction.

Pulmonary infarction is a life-threatening lung injury that requires rapid and accurate diagnosis for proper treatment. Targetable and reproducible small-animal models that would allow experimental development and preclinical evaluation of diagnostic methods for detecting pulmonary infarction are critically missing. The authors report here a novel procedure to selectively induce pulmonary infarction by photodestructive laser-light irradiation in a targeted location within a specific lung compartment after administration of a photosensitizer. Histopathological analysis of the illuminated lung tissue revealed massive hemorrhage and vascular occlusion after acute injury localized to the site of irradiation. Collapse of alveolar structure, neutrophil influx, and necrosis were subsequently observed. Computed tomography (CT) scans showed evidence of abnormal density and airspace consolidation in the irradiated area of the lung, but not elsewhere in the lung compartment. Perfusion imaging using 99mTc-labeled macroaggregated albumin by single-photon emission computed tomography revealed diminished scintigraphic signal in the opaque area of infarcted lung tissue. The histological changes, CT findings, and perfusion characteristics of pulmonary infarction are mimicked using laser-irradiated, photosensitizer-mediated photodestruction to selectively induce chronic lung injury in a localized area. This small-animal model can be easily and readily used for targeted induction of pulmonary infarction in a designated area of lung compartment and offers the potential for use in evaluating novel diagnostic and therapeutic methods.

Antipsychotic treatment and the occurrence of venous thromboembolism: a 10-year nationwide registry study.

OBJECTIVE: To examine the association between antipsychotic use and venous thromboembolism (VTE) in a Taiwan population. METHOD: We conducted a nested case-control study using the National Health Insurance Research Database in Taiwan. A total of 2,162 cases with VTE (defined as pulmonary embolism and infarction [ICD-9-CM-code: 415.1] or deep vein thrombosis [ICD-9-CM-codes: 451.1x, 451.81, or 453.8]) and 12,966 matched controls were identified from 2001 to 2010. Antipsychotic exposure status was measured, and potential confounding factors were adjusted for in the analyses. Conditional logistic regressions were applied to determine the effect of antipsychotic use on VTE. RESULTS: Current antipsychotic use was associated with an increased risk for VTE (adjusted odds ratio [AOR] = 1.52; 95% CI, 1.19-1.93). Among current antipsychotic users, new users had a higher risk of VTE (AOR = 3.26; 95% CI, 2.06-5.17), whereas the risk among continuous users was modest but not statistically significant (AOR = 1.18; 95% CI, 0.89-1.56). CONCLUSIONS: The results demonstrated an increased risk of VTE among subjects with current antipsychotic use. Antipsychotic drugs should be prescribed with caution and attention to the increased risk of VTE. The underlying mechanisms related to the effect of antipsychotics on VTE development warrant further investigation.