Multiparametric approach with diffusion-weighted imaging and dynamic contrast-enhanced MRI: a comparison study for differentiating between benign and malignant bone lesions in adults.

AIM: To evaluate and compare the diagnostic performance of quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant bone tumours. MATERIALS AND METHODS: Fifty-five patients (age range, 21-82 years; mean age, 55 years) underwent pretreatment MRI. Apparent diffusion coefficient (ADC) values were calculated by DWI. The DCE-MRI data were analysed for the volume transfer constant (Ktrans), extravascular extracellular volume fraction (Ve), and volume rate constant (Kep), and Ktrans/ADC ratio. Each parameter's performance was evaluated using the area under the receiver operating characteristic (ROC) curv (AUC), and their AUCs were compared. ROC curves were analysed and each parameter's optimal cut-off value was determined, from which each parameter was evaluated for sensitivity, specificity, accuracy, and positive and negative predictive values. The odds ratio (OR) with 95% confidence interval for detecting malignant bone lesions after adjusting the age factor of each parameter was estimated. RESULTS: All parameter values (except Ve) were significantly different between benign and malignant bone tumours (p<0.05). The Ktrans had a significantly greater AUC than Ve (p=0.03). The Ktrans/ADC and Kep had the best sensitivity (0.917) and specificity (0.632), respectively. The Kep and Ktrans/ADC had the best positive (0.811) and negative (0.769) predictive values, respectively. The OR was highest for Ktrans/ADC (17.38; p=0.0013). CONCLUSION: The Ktrans, Kep, ADC, and Ktrans/ADC could help to detect malignant lesions from bone tumours and Ktrans/ADC appears to be the superior variable among them.

Diagnostic performance of conventional MRI parameters and apparent diffusion coefficient values in differentiating between benign and malignant soft-tissue tumours.

AIM: To compare the abilities of conventional magnetic resonance imaging (MRI) and apparent diffusion coefficient (ADC) in differentiating between benign and malignant soft-tissue tumours (STT). MATERIAL AND METHODS: A total of 123 patients with STT who underwent 3 T MRI, including diffusion-weighted imaging (DWI), were retrospectively analysed using variate conventional MRI parameters, ADCmean and ADCmin. RESULTS: For the all-STT group, the correlation between the malignant STT conventional MRI parameters, except deep compartment involvement, compared to those of benign STT were statistically significant with univariate analysis. Maximum diameter of the tumour (p=0.001; odds ratio [OR], 8.97) and ADCmean (p=0.020; OR, 4.30) were independent factors with multivariate analysis. For the non-myxoid non-haemosiderin STT group, signal heterogeneity on axial T1-weighted imaging (T1WI; p=0.017), ADCmean, and ADCmin (p=0.001, p=0.001), showed significant differences with univariate analysis between malignancy and benignity. Signal heterogeneity in axial T1WI (p=0.025; OR, 12.64) and ADCmean (p=0.004; OR, 33.15) were independent factors with multivariate analysis. CONCLUSION: ADC values as well as conventional MRI parameters were useful in differentiating between benign and malignant STT. The ADCmean was the most powerful diagnostic parameter in non-myxoid non-haemosiderin STT.

Clinical relevance of the apparent diffusion coefficient value of metastatic bone tumours on diffusion-weighted MRI images: differences according to the types of primary tumour, the affected bones, and clinical factors.

AIM: To evaluate whether the apparent diffusion coefficient (ADC) of metastatic bone tumours on diffusion-weighted magnetic resonance imaging (MRI) images differs according to the type of primary cancer, the affected bone, and clinical factors. MATERIALS AND METHODS: For this retrospective study, two radiologists reviewed MRI images, including ADC maps, of 67 patients (M:F=38:29; median age, 48 years) who were diagnosed with bone metastasis by means of histological or clinical confirmation. The primary tumours included 29 lung adenocarcinomas, 15 invasive ductal adenocarcinomas of the breast, 13 hepatocellular carcinomas, six prostatic carcinomas, and four renal cell carcinomas. ADC values of the metastatic tumour were compared according to the type of primary malignancy, the affected bone, and the age and sex of the patient using Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction. In addition, pre-contrast CT images were available in 38 of 67 patients; a subanalysis of the CT radiodensity and ADC values were performed with Spearman correlation. RESULTS: The mean, standard deviation, and minimum and maximum values of the ADC of metastatic bone tumours did not differ significantly according to type of primary malignancy, the affected bone, or clinical variables (p>0.1). The ADC value was not significantly correlated with CT radiodensity (p=0.24). Intra- and interobserver agreements for the mean ADC values were excellent (intra-observer: p=0.98; interobserver: p=0.98). CONCLUSIONS: Assessment of the ADC value of metastatic bone tumours is not reliable for differentiation of the type of primary cancer.

T2 mapping of the articular cartilage in the ankle: correlation to the status of anterior talofibular ligament.

AIM: To evaluate differences in T2 relaxation time of ankle cartilage using magnetic resonance imaging (MRI) according to the status of the anterior talofibular ligament (ATFL). MATERIALS AND METHODS: The talar trochlear cartilage (TTC) was evaluated in 52 patients with ankle pain that were categorized according to the status of ATFL; normal (NL; n = 23, mean age 40 years); partial tear (PT; n = 21, mean age 39 years); or complete tear (CT; n = 8, mean age 33 years). The TTC was divided into six compartments (medial anterior, medial centre, medial posterior, lateral anterior, lateral centre, and lateral posterior). The mean T2 value of each compartment was obtained using the multi-echo sequence. Data were analysed with parametric and non-parametric statistical tests. RESULTS: The mean T2 values of the TTC showed significant differences between the three groups; NL, PT, and CT (p < 0.001). The T2 value between the three ligamentous groups were significantly different in the medial anterior, lateral anterior, and lateral centre compartments (p = 0.003, 0.002, 0.002, respectively). T2 values of the PT and CT groups were significantly higher than those of the NL group in the medial anterior compartment (p = 0.015, 0.002) and lateral anterior compartment (p = 0.026, <0.001). The T2 value of the CT group was significantly higher than that of NL and PT groups in the lateral centre compartment (p < 0.001, 0.031). CONCLUSION: The T2 value of the TTC in patients with ATFL injury increased at the medial anterior, lateral anterior, and lateral centre compartments.

TLR9 gene polymorphism (rs187084, rs352140): association with acute rejection and estimated glomerular filtration rate in renal transplant recipients.

The Toll-like receptors (TLRs) are related to innate immunity. TLR9, a member of TLRs, is expressed in immune cell-rich tissues and mediates cellular response. We investigated the association between TLR9 polymorphisms and kidney allograft outcomes. To investigate whether TLR9 polymorphisms are associated with acute rejection after renal transplantation, two single nucleotide polymorphisms (SNPs) of TLR9 gene (rs187084 -1486; rs352140, G2848A) were selected and genotyped by direct sequencing in 342 renal transplant recipients. SNPStats, SNPAnalyzer, Helixtree and Haploview version 4.2 were used to analyse genetic data. Multiple logistic regression models (codominant, dominant, recessive and log-additive) were used to evaluate odds ratios (ORs), 95% confidence intervals (CIs) and P values. Both SNPs, TLR9 rs187084 -1486 and rs352140 G2848A, of recipients were associated with the risk of acute rejection in renal transplantation. C allele of rs187084 -1486 and A allele of rs352140 G2848A were protective genotype for acute rejection (OR 0.6, 95% CI 0.40-0.92; P = 0.018, OR 0.64, 95% CI 0.42-0.98; P = 0.04, respectively). rs187084 -1486 CT and rs352140 G2848A GA genotype were associated with a lower eGFR after a year of renal transplantation. TLR9 polymorphisms, rs187084 and rs352140, of recipients were associated with the risk of acute rejection in renal transplantation. The patients with rs187084 -1486 CT and rs352140 G2848A GA genotype showed a lower eGFR after a year of renal transplantation.

Three-dimensional isotropic T2-weighted cervical MRI at 3T: comparison with two-dimensional T2-weighted sequences.

AIM: To compare three-dimensional (3D) isotropic T2-weighted magnetic resonance imaging (MRI) sequences and reformation with two-dimensional (2D) T2-weighted sequences regarding image quality of the cervical spine at 3T. MATERIALS AND METHODS: A phantom study was performed using a water-filled cylinder. The signal-to-noise and image homogeneity were evaluated. Fourteen (n=14) volunteers were examined at 3T using 3D isotropic T2-weighted sagittal and conventional 2D T2-weighted sagittal, axial, and oblique sagittal MRI. Multiplanar reformation (MPR) of the 3D T2-weighted sagittal dataset was performed simultaneously with image evaluation. In addition to artefact assessment, the visibility of anatomical structures in the 3D and 2D sequences was qualitatively assessed by two radiologists independently. Cohen's kappa and Wilcoxon signed rank test were used for the statistical analysis. RESULT: The 3D isotropic T2-weighted sequence resulted in the highest signal-to-noise ratio (SNR) and lowest non-uniformity (NU) among the sequences in the phantom study. Quantitative evaluation revealed lower NU values of the cerebrospinal fluid (CSF) and muscles in 2D T2-weighted sagittal sequences compared to the 3D volume isotropic turbo spin-echo acquisition (VISTA) sequence. The other NU values revealed no statistically significant difference between the 2D turbo spin-echo (TSE) and 3D VISTA sequences (0.059

Which oblique plane is more helpful in diagnosing an anterior cruciate ligament tear?

AIM: To evaluate the diagnostic role of additional oblique coronal and oblique sagittal magnetic resonance imaging (MRI) for an anterior cruciate ligament (ACL) tear. MATERIALS AND METHODS: A total of 101 patients who had undergone preoperative knee MRI examinations with orthogonal and two sets of oblique images were enrolled in the study. Two radiologists evaluated the MRI images by the use of four methods: orthogonal images only (method A); orthogonal and additional oblique coronal images (method B); orthogonal and oblique sagittal images (method C); and orthogonal images with oblique coronal and sagittal images (method D). The status of the ACL (normal or tear) was determined by consensus. The sensitivity, specificity, and accuracy for an ACL tear with the use of each method were calculated in comparison with arthroscopy as the reference standard, and values were statistically analysed using the McNemar test. The diagnostic accuracies were compared using receiver operating characteristic (ROC) analysis. RESULTS: Arthroscopy identified 10 partial ACL tears and 30 complete ACL tears. The specificities and accuracies for methods B, C, and D were significantly higher than the specificities and accuracies for method A (p<0.05). There was no significant difference in the sensitivity, specificity, and accuracy for methods B, C, and D. Diagnostic ability was not significantly different for each method, as determined by ROC analysis (p>0.05). CONCLUSIONS: Additional oblique imaging for an ACL tear improved the specificity. Either of the oblique imaging methods is sufficient, and no further improvement in the diagnostic efficacy was achieved by simultaneous use.

A case of disseminated Nocardia farcinica diagnosed through DNA sequencing in a kidney transplantation patient.

Nocardia is a rare gram-positive bacteria causing opportunistic infection, and belongs to the aerobic Actinomycetes group. As the mortality in the immunocompromised patients with nocardiosis is high, early diagnosis and treatment is very important. However, clinical manifestations of infection caused by Nocardia are very variable and early diagnosis is limited by the difficulty in obtaining specimens and its isolation. Rapid diagnosis of Nocardia infection may allow for earlier effective therapy, thus improving patient outcome. We report a case of Nocardia farcinica diagnosed by DNA sequencing through blood culture in a renal transplant recipient with severe pneumonia and multiple brain abscesses.

Association of MCP-1 and CCR2 polymorphisms with the risk of late acute rejection after renal transplantation in Korean patients.

Among the factors modulating transplant rejection, chemokines and their respective receptors deserve special attention. Increased expression of monocyte chemoattractant protein-1 (MCP-1) and its corresponding receptor (chemokine receptor-2, CCR2) has been implicated in renal transplant rejection. To determine the impact of the MCP-1-2518G and CCR2-64I genotypes on renal allograft function, 167 Korean patients who underwent transplantation over a 25-year period were evaluated. Genomic DNA was genotyped using polymerase chain reaction followed by restriction fragment length polymorphism analysis. Fifty-five (32.9%) patients were homozygous for the MCP-1-2518G polymorphism. Nine (5.4%) patients were homozygous for the CCR2-64I polymorphism. None of the investigated polymorphism showed a significant shift in long-term allograft survival. However, a significant increase was noted for the risk of late acute rejection in recipients who were homozygous for the MCP-1-2518G polymorphism (OR, 2.600; 95% CI, 1.125-6.012; P = 0.022). There was also an association between the MCP-1-2518G/G genotype and the number of late acute rejection episodes (P = 0.024). Although there was no difference in the incidence of rejection among recipients stratified by the CCR2-V64I genotype, recipients with the CCR2-V64I GG genotype in combination with the MCP-1-2518G/G genotype had a significantly higher risk of acute or late acute rejection among the receptor-ligand combinations (P = 0.006, P = 0.008, respectively). The MCP-1 variant may be a marker for risk of late acute rejection in Korean patients.

Diagnostic efficacy in knee MRI comparing conventional technique and multiplanar reconstruction with one-millimeter FSE PDW images.

BACKGROUND: Magnetic resonance (MR) imaging has proved to be an excellent tool in diagnosing injuries of the cruciate ligaments and menisci. However, multiple planes and sometimes optimal oblique or double-oblique scan planes are needed due to the variability in the positioning of important structures, which means there is a lower throughput and longer scanning time. PURPOSE: To compare the performance of a 1-mm-thickness fast spin-echo (FSE) proton-density-weighted (PDW) MR imaging technique with multiplanar reconstruction (MPR) in diagnosing tears of the menisci and cruciate ligaments with that of conventional MR imaging. MATERIAL AND METHODS: Twenty-five consecutive patients underwent preoperative conventional and 1-mm-thickness FSE PDW MR imaging with subsequent knee arthroscopic surgery. Two musculoskeletal radiologists evaluated the status of the cruciate ligaments and menisci using two sets of MR images (method A: conventional images including seven sequences, taking 26 min; method B: 1-mm-thickness FSE PDW images with MPR, taking 7 min 20 s). The diagnostic efficacies of both methods for tears of the cruciate ligament and menisci were calculated and compared. RESULTS: Arthroscopic surgery revealed 10 anterior cruciate ligament (ACL) tears, one posterior cruciate ligament (PCL) tear, and 26 meniscal tears. The diagnostic values of both methods were 100% for a cruciate ligament tear. The diagnostic values (sensitivity, specificity, accuracy, positive predictive value, and negative predictive value) for meniscal tears were 90%, 100%, 96%, 100%, and 94% for method A, and 95%, 100%, 98%, 100%, and 97% for method B, respectively. There were no significant differences in the diagnostic values between methods A and B. CONCLUSION: 1-mm-slice-thickness FSE PDW imaging with MPR showed comparable performance in diagnosing tears of the cruciate ligaments and menisci to conventional sequences but the scan time was much shorter. Therefore, this technique (method B) might improve the throughput of a 3T MR imaging system.

Preexisting Cerebral Aspergillosis Successfully Treated After Liver Transplantation: A Case Report.

BACKGROUND: Invasive aspergillosis (IA) is a rare condition that generally affects immunosuppressed patients. The mortality of IA is known to be >90% in liver transplantation (LT) recipients; the lung is the most commonly affected organ, followed by the brain. There have been reports in the literature of cerebral aspergillosis (CA) in LT recipients. In all previous reports, CA developed after LT. We present the first case (to the best of our knowledge) of preexisting CA diagnosed and successfully treated after LT. CASE REPORT: A 59-year-old male patient underwent emergency deceased-donor LT for alcoholic liver cirrhosis. Preoperative imaging showed multiple lesions in both cerebral hemispheres, indicative of brain abscess or metastases. Before definitive diagnosis of the brain lesion, the deceased-donor LT was performed. On postoperative day 15, the patient developed a fever of 38.0°C and drowsy mental status. Magnetic resonance imaging showed increased number and size of brain abscesses. Stereotactic brain abscess aspiration was performed, and pathologic findings revealed aspergillosis. Voriconazole was started immediately. The patient improved steadily and was discharged 1 month after initiation of voriconazole treatment. CONCLUSIONS: This case is the first report of preexisting CA treated successfully after LT. Voriconazole is a potent therapeutic agent of CA. When LT is performed with an undiagnosed brain lesion, aggressive diagnostic measures are necessary postoperatively. If CA is diagnosed, successful treatment may be possible with voriconazole.

Matrix Metalloproteinase Gene Polymorphisms and New-Onset Diabetes After Kidney Transplantation in Korean Renal Transplant Subjects.

BACKGROUND: New-onset diabetes after transplantation (NODAT) is a serious metabolic complication that may follow renal transplantation. Matrix metalloproteinases (MMPs) contribute to insulin insufficiency and beta-cell dysfunction in a rat model. The MMP-2 concentrations were lower in patients with type 2 diabetes mellitus, and the plasma MMPs levels were related to diabetes. Similar to the pathogenesis of type 2 diabetes mellitus, insulin resistance and insulin secretion dysfunction occur in patients with the development of NODAT. Therefore, we examined the association between NODAT and 11 single-nucleotide polymorphisms (SNPs) located within the 3 genes of MMPs that might be related to NODAT. METHODS: A total of 309 renal transplant recipients without a history of diabetes were included in this study. DNA was extracted from the blood samples of recipients, and we analyzed the association between the development of NODAT and a panel of 11 SNPs within 3 MMP genes (MMP-1, MMP-2, and MMP-3). RESULTS: In terms of allele frequencies, rs243849*C (MMP-2) was significantly higher in patients with NODAT. Two of the 11 (18.1%) SNPs were significantly associated with NODAT development after adjusting for age, sex, and tacrolimus usage: MMP-2 (rs1132896) and MMP-2 (rs243849). In the multiple logistic regression analysis, these 2 SNPs were significantly associated with the development of NODAT in the codominant and recessive or codominant and dominant models. CONCLUSIONS: MMP-2 gene rs1132896 and rs243849 polymorphisms may serve as genetic markers for the development of NODAT. The exact molecular mechanisms still must be clarified.

Performing a Right Hemihepatectomy Sequentially After Deceased Donor Liver Transplantation--The Solution for a Large-for-size Graft: A Case Report.

BACKGROUND: Large-for-size (LFS) is a serious problem that can develop during liver transplantation (LT) and is related to morbidities such as insufficient blood supply causing graft dysfunction or impractical closure of the abdominal wall leading to graft compression. LFS is usually discussed in pediatric LT and is often managed by reducing the size of the graft before implantation. In contrast, only a few cases about managing unexpected LFS during adult LT have been reported, and no case after the vascular anastomosis has been completed has been reported. CASE REPORT: A 36-year-old, 43-kg woman underwent an emergency LT using a deceased donor, although the estimated graft/recipient weight ratio was 3.98%. After completing the vascular anastomosis, a severe hepatic venous outflow obstruction from the graft developed due to compression of the inferior vena cava from the hypertrophied right posterior lobe of the graft. We performed a right hemihepatectomy sequentially after LT, and hepatic blood flow recovered sufficiently based on a Doppler sonogram. The postoperative clinical course was uneventful without vascular or ductal complications, and the primary abdominal wall closure was successfully achieved without wound complications. CONCLUSIONS: Performing a right hemihepatectomy sequentially after completing the vascular anastomosis during LT could be a very simple and effective solution for unexpected LFS during LT.

Reuse of a previously transplanted kidney from a deceased donor using Luminex virtual crossmatching: a case report.

Kidney transplantation is the most desired modality of renal replacement therapy for patients with end-stage renal disease (ESRD). We have attempted to expand the organ donor pool through several methods, including the use of expanded donor criteria. Although previously transplanted kidneys are rarely reused, they can be suitable for transplantation into patients in need. We report a case of successful reuse of a previously transplanted kidney from a deceased donor by means of Luminex virtual crossmatching with the first donor and actual crossmatching with the second donor.

Reducing metallic artefacts in post-operative spinal imaging: slice encoding for metal artefact correction with dual-source parallel radiofrequency excitation MRI at 3.0 T.

OBJECTIVE: To compare the effects of metal artefacts and acquisition time among slice encoding for metal artefact correction (SEMAC), SEMAC with dual-source parallel radiofrequency (SEMAC-DSPRF) transmission and fast spin echo (FSE) images using 3.0-T MRI. METHODS: The signal-to-noise ratio (SNR) was calculated in a phantom study using a pedicle screw. A total of 16 patients who underwent spinal surgery using pedicle screws were included in the clinical study. T1 weighted FSE, SEMAC and SEMAC-DSPRF images were obtained. Four imaging findings (visibility of the dural sac, neural foramens, bone-implant interface and overall artefacts) were evaluated by using five-point scales independently by two observers. The mean scan time was recorded. RESULTS: The mean SNR was 71.2, 25.7 and 28.4 for FSE, SEMAC and SEMAC-DSPRF images, respectively. FSE images were ranked lower than SEMAC and SEMAC-DSPRF images, and ranking of SEMAC and SEMAC-DSPRF images did not differ statistically for all four imaging findings. The mean scan time was 9 min 51 s and 6 min 31 s for SEMAC and SEMAC-DSPRF images, respectively. CONCLUSION: SEMAC can reduce metallic artefacts and improve the visualisation of anatomical structures around metal implants. An additional DSPRF technique can reduce the acquisition time of SEMAC images without the loss of SNR and image quality. ADVANCES IN KNOWLEDGE: This study demonstrates that the use of the DSPRF transmission technique can reduce the acquisition time of SEMAC images without loss of image quality in patients with metal implants.

The biomechanical performance of locking plate fixation with intramedullary fibular strut graft augmentation in the treatment of unstable fractures of the proximal humerus.

We evaluated the biomechanical properties of two different methods of fixation for unstable fractures of the proximal humerus. Biomechanical testing of the two groups, locking plate alone (LP), and locking plate with a fibular strut graft (LPSG), was performed using seven pairs of human cadaveric humeri. Cyclical loads between 10 N and 80 N at 5 Hz were applied for 1,000,000 cycles. Immediately after cycling, an increasing axial load was applied at a rate of displacement of 5 mm/min. The displacement of the construct, maximum failure load, stiffness and mode of failure were compared. The displacement was significantly less in the LPSG group than in the LP group (p = 0.031). All maximum failure loads and measures of stiffness in the LPSG group were significantly higher than those in the LP group (p = 0.024 and p = 0.035, respectively). In the LP group, varus collapse and plate bending were seen. In the LPSG group, the humeral head cut out and the fibular strut grafts fractured. No broken plates or screws were seen in either group. We conclude that strut graft augmentation significantly increases both the maximum failure load and the initial stiffness of this construct compared with a locking plate alone.

Impact of IL2 and IL2RB genetic polymorphisms in kidney transplantation.

Patient genetic make-up may contribute to a higher risk for acute rejection episodes (AREs). Because interleukin-2 (IL2) and IL2 receptor ß (IL2RB) play key roles in immune modulation, we investigated the effect of single-nucleotide polymorphisms (SNPs) in the IL2 gene (rs2069762; T>G, promoter; and rs2069763; G>T, exon 1, Leu38Leu) and IL2RB gene (rs228942: C>A, exon 1, Asp391Glu; and rs228953: C>T, exon 8, Gly250Gly) on renal ARE risk in 61 ARE patients and 276 control renal allograft recipients in Korea. The genotype frequencies of the IL2 and IL2RB SNPs showed Hardy-Weinberg equilibrium in both ARE and control groups. No significant difference in the genotype frequencies of the 2 IL2 SNPs was detected between non-ARE and ARE subjects (P > .05). The occurrence of AREs was significantly associated with genetic variants of the IL2RB gene (rs228942: odds ratio [OR] 2.11, 95% confidence interval [CI] 1.19-3.74; P = .0096, dominant model; rs228953: OR 1.58, 95% CI 1.04-2.38; P = .029, codominant model). In the haplotype-based analysis, the AC haplotype of IL2RB (χ(2) = 4.738; P = .0295) showed associations with ARE. Our results demonstrate that genetic variants of IL2RB may be associated with the development of AREs and may help predict ARE risk in kidney transplantation patients.

Blind oral endotracheal intubation of rats using a ventilator to verify correct placement.

Endotracheal intubation in rats is challenging due to difficulties visualizing the epiglottis and vocal cords. No visualization of these structures results in repeated intubation attempts which can cause trauma to the oral cavity and/or oesophagus, and death of the animal due to respiratory failure. Here, we describe a simple blind oral tracheal intubation technique in the rat that decreases the frequency of repeated intubations using an intubation device that comprises a 16 G intravenous catheter and a modified 18 G epidural needle, and a rodent ventilator. The epidural needle is bent in such a way that it curves in conformity with the rat's oral airway in order to direct the catheter into the larynx, and the rodent ventilator is used to verify its correct placement. The first attempt success rate of endotracheal intubation using the blind oral tracheal intubation technique with a rodent ventilator was greater than the first attempt success rate using the blind oral tracheal intubation technique without using a rodent ventilator. Although this method is a simple modification of a previously described method of blind oral endotracheal intubation, our method is easy to learn, inexpensive and does not require specialized equipment.

Effect of iron and ascorbate on cyclosporine-induced oxidative damage of kidney mitochondria and microsomes.

The stimulatory effect of iron and ascorbate on the damaging action of cyclosporine in kidney mitochondria, microsomes and epithelial cells was examined. Cyclosporine induced malondialdehyde formation and hydrogen peroxide production in mitochondria and attenuated the activity of MnSOD and glutathione peroxidase. The damaging effect of cyclosporine (50 microM) plus Fe2+(20 microM) on mitochondrial and microsomal lipids and proteins as well as mitochondrial thiols was greater than the summation of the oxidizing action of cyclosporine alone and Fe2+ alone. As for tissue components, iron enhanced cyclosporine-induced viability loss in kidney epithelial cells. Fe2+, EDTA and H2O2- induced 2-alpha deoxyribose degradation was attenuated by 10 mM DMSO and 200 microM DTPA but not affected by 200 microM cyclosporine. The addition of Fe2+ caused a change in the absorbance spectrum of cyclosporine in the wavelength range 230-350 nm. The simultaneous addition of cyclosporine (50 microM) and ascorbate (100 microM) showed the enhanced peroxidative effect on mitochondrial and microsomal lipids, which was inhibited by DTPA and EDTA (1 mM). Similar to iron, ascorbate enhanced cyclosporine-induced cell viability loss. The results show that iron and ascorbate promote the damaging action of cyclosporine in kidney cortex mitochondria and microsomes and in kidney epithelial cells, which may contribute to the enhancement of cyclosporine-induced nephrotoxicity.

Microscopic origin of surface-plasmon radiation in plasmonic band-gap nanostructures.

We report spatial domain measurements of the damping of surface-plasmon excitations in metal films with periodic nanohole arrays. The measurements reveal a short coherent propagation length of a few microm inside nanohole arrays, consistent with delays of about 10 fs in ultrafast transmission experiments. This implies that the transmission spectra of the entire plasmonic band-gap structure are homogeneously broadened by radiative damping of surface-plasmon excitations. We show that a Rayleigh-like scattering of surface plasmons by the periodic hole array is the microscopic origin of this damping, allowing the reradiation rate to be controlled.