| Transforming Screening Uptake in Low-resource and Underinformed Populations: A Preliminary Study of Factors Influencing Women's Decisions to Uptake Screening Publication date: Available online 23 March 2019 Source: Journal of Medical Imaging and Radiation Sciences Author(s): Judith D. Akwo, Akwa E. Erim, Valentine C. Ikamaise, Bassey Archibong, Ernest U. Ekpo AbstractObjectivesThe objective of this study was to assess the factors influencing women's decision to uptake screening mammography in an underinformed population. Study DesignThe study is a cross-sectional survey of factors influencing screening uptake. MethodsA modified breast cancer awareness measure was used to assess women's knowledge of breast cancer, mammography, and factors that influence screening uptake. A second questionnaire investigated health professionals' (HPs') attitude to screening and the criteria for screening recommendation. Descriptive statistics were used to assess women's breast cancer awareness, factors that influence screening uptake, and HPs' attitude to breast cancer education and mammography recommendation. We ranked HPs' responses pertaining to criteria for screening recommendation using a Kendall's W test. ResultsSixty-nine percent (n = 180) of women were aware of breast cancer, and half of them had performed breast self-examination (n = 131). About 53% (n = 138) of women were not aware of mammography, and only 15.4% (n = 40) of them have had a screening mammogram. Women's awareness of breast cancer risk factors and symptoms was poor. Many women would consider having a screening mammogram if instructed to do so by their husbands (87.7%; n = 228), HPs (96.2%; n = 250), and if government-funded screening programmes are available (90%; n = 234). Less than 40% (n = 21) of HPs had referred at least one woman for screening mammography within the last 6 months. Family history, age, and reproductive factors ranked as the highest criteria for screening recommendation. ConclusionsSpouses and HPs may be crucial to changing the current status quo around screening utilisation and government-funded screening programmes may increase screening uptake. RésuméObjectifÉvaluer les facteurs ayant une incidence sur la décision des femmes de se prêter à la mammographie de dépistage dans une population sous-informée. Conception de l'étudecette étude est un sondage transversal sur les facteurs ayant une incidence sur la participation au dépistage. MéthodologieUne mesure de sensibilisation au cancer du sein modifiée a été utilisée pour évaluer le degré de connaissance du cancer du sein, de la mammographie et des facteurs qui influencent le dépistage chez les femmes. Un deuxième questionnaire examinait l'attitude des professionnels de la santé (PS) envers le dépistage et les critères utilisés pour recommander le dépistage. La statistique descriptive a été utilisée pour évaluer la sensibilisation des femmes face au cancer du sein, les facteurs qui influencent la participation au dépistage, et l'attitude des PS face à l'éducation au cancer du sein et aux recommandations de mammographie. Nous avons classé les réponses des PS sur les critères de recommandation de dépistage selon le coefficient de concordance de Kendall. RésultatsSoixante-neuf pour cent (n=180) des femmes connaissaient le cancer du sein, et la moitié d'entre elles avaient fait un autoexamen des seins (n=131). Environ 53% (n=138) des femmes ne connaissaient pas la mammographie, et seulement 15,4% (n=40) d'entre elles avaient eu une mammographie de dépistage. La sensibilisation des femmes face aux facteurs de risques et aux symptômes du cancer du sein était faible. Plusieurs femmes envisageraient d'avoir une mammographie de dépistage si leur mari (87,7%; n=228), ou leur PS (96,2%; n=250) le leur conseillait, ou si des programmes de dépistages financés par le gouvernement étaient offerts (90%; n=234). Moins de 40% (n=21) des PS avaient prescrit une mammographie de dépistage à au moins une femme au cours des six mois précédents. Les antécédents familiaux, l'âge et les facteurs liés à la reproduction sont les critères classés les plus élevés pour une recommandation de dépistage. ConclusionsLes conjoints et les PS pourraient avoir un rôle crucial à jouer pour modifier le statu quo sur le recours au dépistage et des programmes de dépistage financés par le gouvernement pourraient augmenter la participation au dépistage. |
| The Effect of Lumpectomy Cavity Changes on Planning Dose in Breast Radiotherapy Boost Publication date: Available online 23 March 2019 Source: Journal of Medical Imaging and Radiation Sciences Author(s): Grace Lee, Henna Parmar, Winnie Li, Andrea Shessel AbstractIntroductionThe addition of a postoperative tumour bed (cavity) boost after whole-breast radiotherapy (RT) is known to decrease the risk of local in-breast recurrence. The purpose of this retrospective study is to assess breast excision cavity changes and planned doses at the time of initial boost RT treatments after the completion of whole-breast RT. MethodsOver a 4-month period, women with highly visible cavity on computed tomography (CT) and treated with whole-breast RT followed by a conformal photon boost to the tumour bed were identified. The patient's day 1 boost online cone beam CT (CBCT) and corresponding setup corrections were overlaid with the planning CT image. The cavity and dose evaluation volumes (DEVs = 1 cm expansion of the cavity, excluding 5 mm of lung and skin) were assessed. Dosimetric evaluations were performed for maximum and minimum cavity doses, cavity volume receiving 90% (V90) and 95% (V95) of prescription dose, and DEV receiving 85% (V85), 95%, and 105% (V105) of the prescription dose. The two-tailed student t-test and Pearson's correlation test were performed for statistical analysis. ResultsEighteen patients were included in the analysis. The CT cavity (CAVCT) volume (mean: 28.8 cc, SD 27.9) was larger than the CBCT cavity (CAVCBCT) volume (mean: 21.1 cc, SD: 22.4) (P value= .003). The CT DEV similarly decreased at the time of boost; DEVCT (mean: 113.9 cc, SD: 63.2) versus DEVCBCT (mean: 92.3 cc, SD: 50.8), (P = .002). A strong correlation was observed between the initial CT cavity volume and cavity shrinkage observed at time of boost (day 1 CBCT) (Pearson's r = 0.697; r2= 0.486, P = .001). Both time periods from surgery to CT (median: 92 days, range: 31–227) and from surgery to day 1 CBCT (median: 141 days, range: 56–265) were not associated with cavity volume change. However, an inverse correlation was observed between time from initial CT to day 1 boost CBCT (median: 33 days, range: 24–54) and % cavity volume change (Pearson's r = −0.642; r2= 0.4121, P = .004). Dosimetric evaluations of the cavity and DEV showed no significant differences in maximum, minimum, and target dose coverage between the CT and boost volumes. ConclusionIn patients with breast cancer treated with a tumour bed boost after whole-breast RT, the postoperative cavity can shrink between the time of CT and day 1 boost. The extent of cavity reduction was greatest in patients with large postoperative cavities on initial CT. Despite the cavity size change, conformal boost fields provide adequate dose coverage to the cavity. RĂ©sumĂ©IntroductionOn sait dĂ©jĂ que l'ajout d'un lit tumoral post-opĂ©ratoire après la radiothĂ©rapie du sein entier permet de diminuer le risque de rĂ©currence locale du cancer. Le but de cette Ă©tude rĂ©trospective est d'Ă©valuer les changements dans la cavitĂ© d'excision mammaire et les doses planifiĂ©es au moment des traitement adjuvants de radiothĂ©rapie après l'achèvement de la radiothĂ©rapie du sein entier. MĂ©thodologieSur une pĂ©riode de quatre mois, des femmes prĂ©sentant une cavitĂ© très visible Ă la TDM et traitĂ©es par radiothĂ©rapie du sein entier suivie d'un traitement adjuvant conformationnel au lit tumoral ont Ă©tĂ© recensĂ©es. Le traitement adjuvant de tomodensitomĂ©trie Ă faisceau conique (TDMFC) au Jour 1 et les corrections de positionnement correspondantes ont Ă©tĂ© superposĂ©s sur l'image de planification TDM. Le volume de la cavitĂ© et le volume de la dose d'Ă©valuation (VDE = expansion de la cavitĂ© de 1 cm, excluant 5 mm pour le poumon et de peau) ont Ă©tĂ© Ă©valuĂ©s. Des Ă©valuations dosimĂ©triques ont Ă©tĂ© faites pour une dose minimum et maximum Ă la cavitĂ©, le volume de la cavitĂ© recevant 90% (V90) et 95% (V95) de la dose prescrite, et le VDE recevant 85% (V85), 95% et 105% (V105) de la dose prescrite. Le test t bilatĂ©ral de Student et le test de corrĂ©lation de Pearson ont Ă©tĂ© utilisĂ©s pour l'analyse statistique. RĂ©sultatsL'analyse a portĂ© sur 18 patientes. Le volume de la cavitĂ© TDM (CAVTDM) (moyenne: 28,8 cc, ÉT 27,9) Ă©tait plus grand que le volume de la cavitĂ© TDMFC (CAVTDMFC) (moyenne: 21,1 cc, ÉT: 22,4) (P = .003). De la mĂŞme façon, le VDE a diminuĂ© au moment du traitement adjuvant; VDETDM (moyenne: 113,9 cc, ÉT: 63,2) c. VDETDMFC (moyenne: 92,3 cc, ÉT: 50,8), (P = .002). Une forte corrĂ©lation a Ă©tĂ© observĂ©e entre le volume initial de la cavitĂ© TDM et la diminution de la cavitĂ© observĂ©e au moment du traitement adjuvant (TDMFC Jour 1) (r de Pearson = 0,697; r2 = 0,486, P = .001). Ni le dĂ©lai entre la chirurgie et la TDM (mĂ©diane: 92 jours, plage: 31–227) ni entre la chirurgie et la TDMFC Jour 1 (mĂ©diane: 141 jours, plage: 56–265) ne sont associĂ©es Ă un changement dans le volume de la cavitĂ©. Cependant, une corrĂ©lation inverse a Ă©tĂ© observĂ©e entre le dĂ©lai entre la TDM initiale et la TDMFC adjuvante Jour 1 (mĂ©diane: 33 jours, plage: 24–54) et le pourcentage de changement du volume de la cavitĂ© (r de Pearson = −0,642; r2 = 0,4121, P = .004). L'Ă©valuation dosimĂ©trique de la cavitĂ© et du VDE ne montre aucune diffĂ©rence significative dans la couverture de dose maximum, minimum et cible entre le volume de TDM et le volume du traitement adjuvant. ConclusionChez les patientes atteintes d'un cancer du sein ayant reçu un traitement adjuvant du lit tumoral après la radiothĂ©rapie du sein entier, la taille de la cavitĂ© post-opĂ©ratoire peut diminuer entre le moment de la TDM et le traitement adjuvant Jour 1. L'ampleur de la rĂ©duction de taille de la cavitĂ© Ă©tait plus importante chez les patientes qui prĂ©sentaient la plus importante cavitĂ© post-opĂ©ratoire Ă la TDM initiale. MalgrĂ© le changement dans la taille de la cavitĂ©, les champs adjuvants conformationnels assurent une couverture de dose adĂ©quate Ă la cavitĂ©. |
| Impact of Immobilization on Interfractional Errors for Upper Extremity Soft Tissue Sarcoma Radiation Therapy Publication date: Available online 7 March 2019 Source: Journal of Medical Imaging and Radiation Sciences Author(s): Aran Kim, Valerie Kelly, Colleen Dickie, Charles Catton, Winnie Li AbstractIntroduction/BackgroundOwing to the rare nature and presentation of upper extremity soft tissue sarcomas (STSs) and the high mobility of associated anatomy, various patient positioning strategies are used for radiation therapy. The purpose of this study is to measure the interfractional setup errors associated with upper extremity sarcomas using different immobilization methods through cone-beam computed tomography (CBCT) images. MethodsAll patients treated with daily CBCT guidance for upper extremity STSs during 2014–2015 were identified and triaged based on type of immobilization. After defining an optimal region of interest for image registration, daily CBCT images were automatically registered to reference CT images to quantify positional discrepancies. Means and standard deviations were calculated, and one-way analysis of variance was calculated to determine significance of data. ResultsSeventeen patients with upper extremity sarcoma met inclusion criteria: 13 were treated to the shoulder/axilla/upper arm and 4 to the arm/elbow/forearm. Three main types of immobilization were identified: vacuum cradle with custom thermoplastic shell, vacuum cradle alone, and no immobilization accessory used. Patient repositioning occurred if translational and rotational displacements were larger than 1 mm and 5°, respectively, as per institutional guidelines. Patient repositioning rates were 18% for vacuum cradle with thermoplastic shells, 15% for vacuum cradles only, and 6% for no immobilization accessories. Mean translational displacements in right/left (R/L), superior/inferior (S/I), and anterior/posterior (A/P) directions were −0.04 ± 0.33 cm, 0.32 ± 0.33 cm, and 0.12 ± 0.25 cm for vacuum cradle with thermoplastic shell; 0.25 ± 0.10 cm, −0.07 ± 0.22 cm, and 0.00 ± 0.17 cm for vacuum cradle alone; and 0.14 ± 0.15 cm, 0.08 ± 0.45 cm, and −0.01 ± 0.24 cm for no immobilization. For all patients, rotational displacements in the pitch, roll, and yaw were 0.15 ± 1.99°, 0.31 ± 2.11°, and −0.21 ± 1.76°, respectively. There were significant (P < .05) differences in systematic error values for all translational and rotational axes between immobilization methods. ConclusionLarge interfractional errors, especially in the rotational axes, were observed, regardless of immobilization strategy. Small study population and unequal representation of different parts of the upper extremity are identified limitations. The need for better immobilization techniques for upper extremity STS treatments is clearly demonstrated. RĂ©sumĂ©Introduction/contexteEn raison de la raretĂ© et de la prĂ©sentation des sarcomes des tissus mous des membres supĂ©rieurs et de la mobilitĂ© Ă©levĂ©e de l'anatomie connexe, diffĂ©rentes stratĂ©gies de positionnement du patient sont utilisĂ©es pour la radiothĂ©rapie. Le but de cette Ă©tude est de mesurer les erreurs de positionnement interfractionnel associĂ©es aux sarcomes des membres supĂ©rieurs en utilisant diffĂ©rentes mĂ©thodes d'immobilisation en utilisant des images de tomodensitomĂ©trie Ă faisceau conique (CBCT). MĂ©thodologieTous les patients traitĂ©s avec guidage CBCT quotidien pour un sarcome des tissus mous des membres supĂ©rieurs en 2014–2015 ont Ă©tĂ© recensĂ©s et triĂ©s selon le type d'immobilisation. Après avoir dĂ©fini une rĂ©gion d'intĂ©rĂŞt optimale pour la registration d'image, les images CBCT quotidiennes ont Ă©tĂ© automatiquement liĂ©es aux images de tomodensitomĂ©trie de rĂ©fĂ©rence afin de quantifier les divergences positionnelles. Les moyennes et les Ă©cart-types ont Ă©tĂ© calculĂ©es et une analyse de variance unidirectionnelle a Ă©tĂ© faite pour dĂ©terminer l'importance statistique des donnĂ©es. RĂ©sultatsDix-sept patients prĂ©sentant un sarcome des membres supĂ©rieurs rĂ©pondaient aux critères d'inclusion; de ce nombre, 13 avaient reçus des traitements Ă l'Ă©paule, l'aisselle ou au bras, et quatre au coude ou Ă l'avant-bras. Trois types d'immobilisation principaux ont Ă©tĂ© recensĂ©s : système VAC-Cradle avec coquille thermoplastique personnalisĂ©e, VAC-Cradle seulement, et aucun accessoire d'immobilisation. Les patients Ă©taient repositionnĂ©s si le dĂ©placement translationnel ou rotationnel Ă©tait respectivement supĂ©rieur Ă 1 mm ou 5°, conformĂ©ment aux lignes directrices de l'institution. Le taux de repositionnement des patients Ă©tait de 18 % pour le VAC-Cradle avec coquille thermoplastique personnalisĂ©e, 15 % pour le VAC-Cradle utilisĂ© seul et 6 % lorsqu'aucun accessoire d'immobilisation n'Ă©tait utilisĂ©. Le dĂ©placement translationnel moyen en direction gauche/droite, supĂ©rieure/infĂ©rieure et antĂ©rieure/postĂ©rieure Ă©taient respectivement de −0,04±0,33 cm, 0,32±0,33 cm et 0,12±0,25 cm pour le VAC-Cradle avec coquille thermoplastique; 0,25±0,10 cm, −0,07±0,22 cm et 0,00±0,17 cm pour le VAC-Cradle utilisĂ© seul; et 0,14±0,15 cm, 0,08±0,45 cm et −0,01±0,24 cm lorsqu'aucun accessoire d'immobilisation n'Ă©tait utilisĂ©. Pour tous les patients, le dĂ©placement rotationnel en tangage, en roulis et en lacet Ă©tait respectivement de 0,15±1,99°, 0,31±2,11° et −0,21±1,76°. On a notĂ© des diffĂ©rences significatives (p<0,05) dans les valeurs d'erreur systĂ©matique entre les mĂ©thodes d'immobilisation pour tous les axes de translation et de rotation. ConclusionD'importantes erreurs interfractionnelles ont Ă©tĂ© observĂ©es, principalement dans les axes de rotation, sans Ă©gard Ă la stratĂ©gie d'immobilisation. La petite taille de l'Ă©chantillon et la reprĂ©sentation inĂ©gale des diffĂ©rentes parties des membres supĂ©rieurs sont des limitations reconnues. La nĂ©cessitĂ© de meilleures techniques d'immobilisation pour le traitement des sarcomes des tissus mous des membres supĂ©rieurs est clairement dĂ©montrĂ©e. |
| Development and Validation of Methods for Quantitative In Vivo SPECT of Pb-212 Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1, Supplement Author(s): Bin He, Eric Frey, George Sgouros, Michael Ghaly, Izabela Tworowska, Ebrahim Delpassand |
| Density-dependent Energy Loss of Protons in Pb and Be Targets and Percent Mass-Stopping Power from Bethe-Bloch Formula and Bichsel-Sternheimer Data Within 1–12 MeV Energy Range: A Comparative Study Based on Bland-Altman Analysis Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Azmat Iqbal, Nasir Ullah, Amin Ur Rahman AbstractBackgroundThis comparative study calculated Bethe-Bloch results with Bichsel-Sternheimer values, employing the Bland-Altman analysis within 95% limit of agreement for the first time. The Bethe-Bloch formula was employed for the physical realization of the density-dependent energy loss of protons in lead (208Pb) and beryllium (9Be) targets in the energy range 1–12 MeV. MethodsThe mass-stopping power of protons for the given elements was calculated and the corresponding normalized difference and standard deviation was also calculated. The obtained theoretical results were compared with the Bichsel-Sternheimer values for the same targets within the same energy range of the projectile protons in terms of stopping-power percent difference. ResultsAs a general trend, as the energy of proton increases the percent normalized difference decreases. For elements having a high atomic number like lead, the percent difference is large. This may mean that calculated values of percent difference for heavy elements like lead are not in agreement with experimental results. ConclusionThe calculated mass-stopping power in view of the normalized percent difference is consistent with the Bichsel-Sternheimer results for the same projectile of higher energy in Pb and Be targets. However, results deviate from the Bichsel-Sternheimer results for high atomic number materials for the same projectile of lower energy. The difference may be attributed to the adjusted parameters in the Bethe-Bloch formula. RĂ©sumĂ©ContexteDans le cadre de cette Ă©tude comparative, nous avons calculĂ© les rĂ©sultats Ă l'aide de la formule de Bethe-Bloch et des valeurs de Bichsel et de Sternheimer, en ayant recours Ă l'analyse de Bland et d'Altman et en Ă©tablissant les limites de l'intervalle de confiance Ă 95% pour la première fois. Nous avons eu recours Ă la formule de Bethe-Bloch pour la rĂ©alisation physique de la perte d'Ă©nergie en fonction de la densitĂ© des protons dans des cibles de plomb (208 Pb) et de bĂ©ryllium (9 Be) pour des gammes d'Ă©nergies de 1 Ă 12 MeV. MĂ©thodologieNous avons calculĂ© le pouvoir d'arrĂŞt de masse des protons des Ă©lĂ©ments donnĂ©s, de mĂŞme que la diffĂ©rence normalisĂ©e et l'Ă©cart-type correspondants. Nous avons ensuite comparĂ© les rĂ©sultats thĂ©oriques obtenus aux valeurs de Bichsel et Sternheimer pour ces mĂŞmes cibles et pour les mĂŞmes gammes d'Ă©nergie des protons projectiles en ce qui concerne la diffĂ©rence de pouvoir d'arrĂŞt en pourcentage. RĂ©sultatsDe façon gĂ©nĂ©rale, Ă mesure que l'Ă©nergie du proton augmente, la diffĂ©rence normalisĂ©e en pourcentage diminue. Dans le cas des Ă©lĂ©ments qui ont un numĂ©ro atomique Ă©levĂ©, comme le plomb, la diffĂ©rence en pourcentage est grande. Il se peut que les valeurs obtenues pour la diffĂ©rence en pourcentage des Ă©lĂ©ments lourds comme le plomb ne concordent pas avec les rĂ©sultats empiriques. ConclusionLe pouvoir d'arrĂŞt de masse calculĂ© du point de vue la diffĂ©rence normalisĂ©e en pourcentage concorde avec les rĂ©sultats de Bichsel et Sternheimer pour le mĂŞme projectile caractĂ©risĂ© par une Ă©nergie supĂ©rieure pour les cibles de Pb et de Be. Toutefois, les rĂ©sultats s'Ă©cartent de ceux de Bichsel et de Sternheimer pour les matĂ©riaux qui ont un numĂ©ro atomique Ă©levĂ© pour le mĂŞme projectile caractĂ©risĂ© par une Ă©nergie infĂ©rieure. La diffĂ©rence peut ĂŞtre attribuĂ©e aux paramètres ajustĂ©s de la formule de Bethe-Bloch. |
| Optimized Production and Biological Evaluation of 68Ga-PDTMP as a New Agent for PET Bone Scanning Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Neda Tadayon, Hassan Yousefnia, Ali Ramazani, Samaneh Zolghadri, Behrooz Alirezapour, Amir Reza Jalilian, Hossein Afarideh, Mahdokht Vaez-Tehrani AbstractIntroductionIn this study, 68Ga-PDTMP was introduced as a novel agent for PET bone scanning. Methods68Ga-PDTMP was prepared with radiochemical purity of higher than 98% at the optimized conditions. ResultsStability tests showed no decrease in radiochemical purity, even after 120 min. The capacity binding of 76.3% ± 0.7% after 10 min incubation for 68Ga-PDTMP was observed. ConclusionBiological studies in normal mice demonstrated that most of the remained activity is transmitted from blood into bones. The results show that 68Ga-PDTMP can be considered as a potential radiolabelled complex for PET bone scanning. RĂ©sumĂ©IntroductionDans le cadre de cette Ă©tude, le 68Ga-PDTMP est prĂ©sentĂ© comme un nouvel agent pour les tomographies par Ă©mission de positons (TEP) des os. MĂ©thodologieLe 68Ga-PDTMP a Ă©tĂ© prĂ©parĂ© de manière Ă ce que sa puretĂ© radiochimique soit supĂ©rieure Ă 98% dans des conditions optimales. RĂ©sultatsLes essais de stabilitĂ© montrent que la puretĂ© radiochimique n'a pas diminuĂ©, mĂŞme au bout de 120 min. Nous avons observĂ© une capacitĂ© de liaison pour l'agent 68Ga-PDTMP de l'ordre de 76, 3% (±0, 7%) Ă la suite d'une pĂ©riode d'incubation de 10 min. ConclusionDes Ă©tudes biologiques de souris normales ont dĂ©montrĂ© qu'il y avait eu une transformation de la majoritĂ© de l'activitĂ©, du sang aux os. D'après les rĂ©sultats, le 68Ga-PDTMP a le potentiel d'ĂŞtre un complexe identifiĂ© Ă l'aide de marqueur radioactif pour les TEP des os. |
| Impact of Mobile Phone Interference on Gamma Camera Performance Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Melissa Dowling, Samantha O'Loughlin, Geoffrey M. Currie AbstractIntroductionElectromagnetic interference (EMI) due to a mobile phone device has been reported to produce a detrimental effect on the function of a gamma camera system. This effect provides evidentiary support of potential bans or restrictions regarding mobile phone use within a nuclear medicine department. MethodologyA 3G Apple iPhone 6 was tested against a thyroid phantom in four operating modes, in three positions. Testing was carried out on a Siemens E-Cam gamma camera and a GE Discovery 670 SPECT/CT gamma camera. The protocols were standardized for operation on both systems with static images obtained for assessment. The static images were arithmetically assessed by means of subtraction from a baseline image, for results of potential EMI to be determined following comparison to the baseline image. ResultsInitial assessment of static images acquired provided no abnormality between modes and positions. Following the application of arithmetic processes, the inferior right lobe presented with an increased ring of activity on activation of mobile signals regardless of position when tested on the Siemens E-Cam gamma camera. When compared to the GE Discovery 670 SPECT/CT gamma camera, these results did not appear to be present. This was confirmed numerically as a statistical significant difference was noted in count differences between the Siemens E-Cam and GE Discovery (P = 0.0004). ConclusionThe function of a gamma camera has the potential to be influenced by EMI produced by mobile phone devices. Further investigation is warranted employing SPECT acquisition to assess the potential for amplification of errors. RésuméIntroductionIl a été indiqué que l'interférence électromagnétique (EMI) causée par un téléphone mobile pouvait produire un effet nuisible au fonctionnement d'un système de caméra gamma. Cet effet vient appuyer par des données probantes l'interdiction potentielle ou les restrictions à l'utilisation des téléphones mobiles dans un service de médecine nucléaire. MéthodologieUn appareil Apple iPhone 6 3G a été testé avec un fantôme de thyroïde dans quatre modes de fonctionnement, en trois positions. Les essais ont été menés sur une caméra gamma Siemens E-Cam et une caméra gamma de TEM/TDM GE Discovery 670. Les protocoles ont été normalisés pour le fonctionnement sur les deux systèmes et des images statiques ont été obtenues pour évaluation. Les images statiques ont été évaluées arithmétiquement par soustraction à partir d'une image de référence, afin de déterminer l'EMI potentielle après comparaison avec l'image de référence. RésultatsL'évaluation initiale des images statiques acquises n'a montré aucune anomalie entre les modes et les positions. Après application des traitements arithmétiques, le lobe inférieur droit présentait une ceinture d'activité accrue au moment de l'activation du signal mobile sans égard à la position lors des tests sur la caméra gamma Siemens E-Cam. En comparaison, ces résultats ne semblent pas apparaître avec la caméra gamma TEM/TDM GE Discovery 670, ce qui a été confirmé numériquement, une différence statistiquement significative ayant été notée dans les écarts de compte entre les appareils Siemens E-Cam et GE Discovery (P=0,0004). ConclusionLe fonctionnement des caméras gamma peut potentiellement être influencé par l'EMI produite par les téléphones mobiles. Des recherches plus poussées sont justifiées, en utilisant l'acquisition d'image par TEM pour évaluer le potentiel d'amplification des erreurs. |
| The Educational Utility of Blogging for MRI Technologists Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Holly C.P. Chun, Siew-Mei Skinner, Tara Rosewall AbstractIntroductionThe value of a blog as an educational tool is thought to be underestimated by health care professionals. This research aimed to explore the MRI educational utility of blogs, and to determine who was participating in writing those blogs. It was hoped that this research would increase awareness of alternative education formats that would be useful for MRI technologists. MethodsBetween March and April of 2017, an online blog search was performed using MRI-related keywords. Strict exclusion criteria were then applied. Two coders independently used lean coding to analyse selected blog posts and organized the codes into themes. Data were tested for intercoder reliability. ResultsResearchers analysed 39 posts from 9 blogs and identified the following themes: focus on MRI techniques and technologies, knowledge dissemination, sharing of experience, collaborative learning, authorship, and informal writing. Bloggers, self-identified as practitioners or scholars, communicated about research projects and used an informal writing style. Evidence of intentional teaching of MRI-specific content and sharing of professional and personal experiences was found. Communication between authors and readers from most of the MRI professions was observed, with the exception of MRI technologists. ConclusionsThis research found that MRI-related blogs provide a credible and accessible forum for the sharing and discussion of knowledge, experiences, and ideas. Although many MRI professionals author blogs, MRI technologists do not seem to participate in this form of communication. As social media gains in popularity within the medical radiation technologist profession, it is hoped that more MRI technologists will make use of blogging to facilitate learning, collaboration, and communication. RésuméIntroductionOn pense que les professionnels de la santé sous-estiment la valeur d'un blogue comme outil d'éducation. Cette recherche vise à explorer l'utilité des blogues pour l'éducation en IRM et déterminer qui participe à leur rédaction. Les auteurs espéraient que cette recherche permettrait d'augmenter le degré de sensibilisation envers les formats d'éducation alternatifs qui pourraient être utiles pour les technologues en IRM. MéthodologieEntre mars et avril 2017, une recherche en ligne a été effectuée sur les blogues, en utilisant des mots-clés reliés à l'IRM. Des critères d'exclusion stricts ont ensuite été appliqués. Deux codeurs indépendants ont utilisé le codage efficace pour analyser des entrées de blogues et faire des regroupements par thèmes. Les données ont ensuite été testées pour évaluer la fiabilité entre les codeurs. RésultatsLes chercheurs ont analysé 39 entrées de neuf blogues et recensé les thèmes suivants: accent sur les techniques et les technologies en IRM, diffusion des connaissances, partage des expériences, apprentissage collaboratif, statut d'auteur et rédaction informelle. Les blogueurs s'identifient comme praticiens ou universitaires, parlent de projets de recherche et utilisent un style d'écriture informel. Des preuves d'intention d'enseigner du contenu spécifique à l'IRM et de partage d'expériences professionnelles et personnelles ont été trouvées. Une communication entre les auteurs et les lecteurs de la plupart des professions liées à l'IRM a été constatée, à l'exception des technologues en IRM. ConclusionsLes auteurs ont constaté que les blogues sur l'IRM constituaient un forum crédible et accessible pour le partage et les discussions sur les connaissances, les expériences et les idées. Bien que plusieurs professionnels de l'IRM tiennent des blogues, les technologues en IRM ne semblent pas participer à cette forme de communication. À mesure que les médias sociaux gagnent en popularité au sein de la population des technologues en radiation médicale, il est à espérer que davantage de technologues en IRM utiliseront les blogues pour faciliter l'apprentissage, la collaboration et la communication. |
| The Feasibility of Integrating Resting-State fMRI Networks into Radiotherapy Treatment Planning Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Chandler Sours Rhodes, Hao Zhang, Kruti Patel, Nilesh Mistry, Young Kwok, Warren D. D'Souza, William F. Regine, Rao P. Gullapalli AbstractBackgroundFunctional magnetic resonance imaging (fMRI) presents the ability to selectively protect functionally significant regions of the brain when primary brain tumors are treated with radiation therapy. Previous research has focused on task-based fMRI of language and sensory networks; however, there has been limited investigation on the inclusion of resting-state fMRI into the design of radiation treatment plans. Methods and materialsIn this pilot study of 9 patients with primary brain tumors, functional data from the default mode network (DMN), a network supporting cognitive functioning, was obtained from resting-state fMRI and retrospectively incorporated into the design of radiation treatment plans. We compared the dosimetry of these fMRI DMN avoidance treatment plans with standard of care treatment plans to demonstrate feasibility. In addition, we used normal tissue complication probability models to estimate the relative benefit of fMRI DMN avoidance treatment plans over standard of care treatment plans in potentially reducing memory loss, a surrogate for cognitive function. ResultsOn average, we achieved 20% (P = 0.002) and 12% (P = 0.002) reductions in the mean and maximum doses, respectively, to the DMN without compromising the dose coverage to the planning tumor volume or the dose-volume constraints to organs at risk. Normal tissue complication probability models revealed that when the fMRI DMN was considered during radiation treatment planning, the probability of developing memory loss was lowered by more than 20%. ConclusionIn this pilot study, we demonstrated the feasibility of including rs-MRI data into the design of radiation treatment plans to spare cognitively relevant brain regions during radiation therapy. These results lay the groundwork for future clinical trials that incorporate such treatment planning methods to investigate the long-term behavioral impact of this reduction in dose to the cognitive areas and their neural networks that support cognitive performance. RésuméContexteL'imagerie par résonance magnétique fonctionnelle (IRMf) permet de protéger de manière sélective des régions fonctionnellement importantes du cerveau lorsque des tumeurs cérébrales primaires sont traitées par radiothérapie. Des recherches antérieures ont mis l'accent sur l'IRMf basée sur les tâches des réseaux langagiers et sensoriels; il y a cependant eu peu d'études sur l'inclusion de l'IRMf au repos (IRMf-rs) dans la conception des plans de traitement en radiothérapie. Méthodologie et matérielDans cette étude pilote mené auprès de neuf patients atteints de tumeurs cérébrales primaires, les données fonctionnelles du réseau du mode par défaut (MPD), un réseau qui soutient les fonctions cognitives, ont été obtenues par IRMf-rs et incorporées de manière rétrospective dans les plans de traitement. Nous avons comparé la dosimétrie de ces plans de traitement d'IRMf évitant le MPD avec les plans de traitement de la norme de soins afin d'en démontrer la faisabilité. De plus, nous avons utilisé des modèles de probabilité de complication des tissus sains (NTCP) pour estimer les avantages relatifs des plans de traitement sur les plans de traitement de la norme de soins dans la réduction potentielle de la perte de mémoire, un indicateur de la fonction cognitive. RésultatsEn moyenne, nous avons obtenu des réductions de 20% (P = 0,002) et de 12% (P = 0,002) de la dose moyenne et maximale, en regard du MDN, sans compromettre la couverture de dose du volume tumoral de planification ou les contraintes de dose-volume pour les organes à risque. Les modèles de NTCP montrent que lorsque l'IRMf évitant le MPD était envisagée durant la planification du traitement de radiothérapie, la probabilité de perte de mémoire était réduite de plus de 20%. ConclusionDans cette étude pilote, nous avons démontré la faisabilité d'inclure les données d'IRMf dans la conception des plans de traitement en radiothérapie afin d'épargner les régions cognitivement pertinente du cerveau durant la radiothérapie. Ces résultats établissent les bases pour des essais cliniques futurs incorporant de telles méthodes de planification de traitement afin d'étudier les effets à long terme sur le comportement de cette réduction de dose sur les aires cognitives et les réseaux neuronaux qui appuient le rendement cognitif. |
| Self-Reported Competence and Impact of Research Training among Medical Radiography Graduates from a Developing Country Publication date: March 2019 Source: Journal of Medical Imaging and Radiation Sciences, Volume 50, Issue 1 Author(s): Aloysius Gonzaga Mubuuke, Francis Businge AbstractIntroductionResearch output from radiographers in developing countries is generally low. This could be attributable to a lack of basic research skills. One way of improving this is research training for undergraduate radiography students. The objective of this study was to assess the self-reported competence of graduate radiographers regarding the research skills obtained during their undergraduate training, as well as the impact of this research training to their work. MethodsA cross-sectional descriptive survey was sent to 70 radiography graduates who had received research training. Data from the radiography graduates were collected electronically using self-administered questionnaires. The questionnaire responses were tallied, counted, and analysis was carried out using MS Excel. ResultsThe response rate of the radiographers was 71.4%. 70% of the radiographers were males, and 30% were females. 70% of the radiographers reported being competent in identifying a research problem, and 80% rated themselves as competent in formulating a research question. 44% reported being competent in appraising relevant literature, and 64% were able to formulate appropriate conclusions and recommendations from their research work. 76% of the radiographers were involved in some research activities in their places of work, and 50% of them expressed willingness to continue engaging in research activities. ConclusionsMost of the graduate radiographers who participated in this study reported being competent in research skills attained, with over 50% willing to continue engaging in research activities. RésuméIntroductionLes résultats de recherches par les radiographes dans les pays en développement sont généralement rares, en raison d'un manque de compétences de base en recherche. Une façon d'améliorer cette situation est d'offrir une formation en recherche aux étudiants en radiographie. L'objectif de cette étude était d'évaluer les compétences en recherche que les radiographes diplômés disent avoir acquises pendant leur formation ainsi que l'incidence de cette formation en recherche sur leur travail. MéthodologieIl s'agit d'un sondage descriptif intersectionnel des diplômés en radiographie ayant reçu une formation en recherche. Les données ont été recueillies auprès des diplômés au moyen d'un questionnaire électronique autoadministré. Soixante-dix radiographes ont été contactés pour cette étude. Les réponses ont été compilées, comptabilisées et analysées dans un fichier MS Excel. RésultatsLe taux de réponse des radiographes a été de 71,4%. Parmi les répondants, 70% étaient des hommes et 30% des femmes. Parmi les répondants, 70% se sont dits en mesure d'identifier un problème de recherche alors que 80% disent avoir la compétence nécessaire pour formuler une question de recherche. 44% des répondants disent avoir la compétence d'évaluer la documentation scientifique pertinente tandis que 64% étaient en mesure de formuler des conclusions et des recommandations appropriées à partir de leurs travaux de recherche. 76% des radiographes étaient toujours engagés dans certains travaux de recherche dans leur milieu de travail tandis que 50% d'entre eux se disent disposés à continuer de s'engager dans des activités de recherche. ConclusionsLa majorité des radiographes diplômés qui ont participé à cette étude disent posséder des compétences de recherche et plus de 50% d'entre eux sont disposés à continuer de s'engager dans des activités de recherche. |
ENT-MD Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174,00302841026182,alsfakia@gmail.com
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Monday, April 1, 2019
Medical Imaging and Radiation Sciences
Oral Surgery, Oral Medicine, Oral Pathology ,Oral Radiology
| Multiple calcifying epithelial odontogenic tumor: case report and review of the literature Publication date: Available online 1 April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology Author(s): Ana Carolina Hanaoka Ibituruna, AnaĂra Ribeiro Guedes Fonseca Costa, Luiz Fernando Barbosa de Paulo, Paulo RogĂ©rio de Faria, SĂ©rgio Vitorino Cardoso, Adriano Mota Loyola AbstractCalcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasm, and few cases of multiple lesions have been published. This article reports the case of a 26-year-old male patient with bilateral gingival lesions near the maxillary canines and a hard tumor on the left side of the mandible. All lesions presented mixed radiographic appearance (radiolucent and radiopaque). Incisional biopsies revealed typical histopathological findings of CEOT. The gingival lesions were removed by curettage, and the mandibular tumor was surgically resected. No recurrence was detected after six years of treatment. Five well-documented cases of multiple CEOT were retrieved from the PubMed database. These patients were slightly older than those with solitary tumors, and none of them presented syndromic features. Three cases had only multiple central tumors while the other two had multiple peripheral lesions, so the present patient is the first to manifest both central and peripheral tumors. |
| Evaluation of different soft tissue–simulating materials in pixel intensity values in cone beam computed tomography Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Gustavo Machado Santaella, Maria Augusta Portella Guedes Visconti, Karina Lopes Devito, Francisco Carlos Groppo, Francisco Haiter-Neto, Luciana Asprino ObjectiveThis study aimed to evaluate different materials as soft tissue simulators and the influence of soft tissues in cone beam computed tomography. Study DesignImages of 5 piglet heads were acquired with intact soft tissues, with the tissues stripped, and with the use of different soft tissue simulators, following the same acquisition protocol. Four different materials were tested, individually or in combination: acrylic, water, utility wax, and expanded polystyrene (EPS). Pixel intensity values of 8 quadrangular regions, that is, upper and lower teeth and alveolar bone, were obtained. The mean values were used for comparison by analysis of variance (ANOVA; α = 5%). ResultsNo differences were observed for the "No Material," "EPS," "Acrylic," and "EPS and Wax" groups for the lower anterior and posterior teeth, the upper posterior tooth, and the anterior and posterior bone, and for the "No Material," "EPS," and "EPS and Wax," groups for the lower posterior bone. All groups showed statistical differences for the lower anterior bone and the upper anterior tooth. ConclusionsExpanded 2-cm thick polystyrene, with or without 1-cm thick utility wax, was effective for most regions, followed by acrylic 0.5 cm. Soft tissues were not of great influence in most regions. Water was not an effective material for any of the regions. |
| Postprocessing of all-zirconia restorations in digital dental radiographs: a quality assurance predicament Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Allison Buchanan, Amelia Orta, Sajitha Kalathingal ObjectivesThe aim of this study was to describe a quality assurance issue, that is, the production of nondiagnostic high-contrast radiographs when imaging teeth restored with all-zirconia crowns on bitewing radiographs. Study DesignAll-zirconia crowns were imaged with DIGORA Optime photostimulable phosphor (PSP) plates (Soredex/Orion Corp., Helsinki, Finland). To assess the differences in software processing, the PSP plates were scanned into third-party software as well as directly into the twain and native software provided by the manufacturer. Gamma correction, histogram stretch, and scanner resolution settings were adjusted. Vertical bitewings were acquired to increase anatomic coverage. ResultsScanning into third-party software or directly into the twain and native software did not improve contrast. Shifting the lower limit of the histogram stretch to 3 with a gamma correction of 2 resolved the problem. Neither scanner resolution setting nor vertical bitewings improved contrast. ConclusionsThe nondiagnostic high-contrast radiographs result from imaging software not effectively displaying the available gray scale. The software processing error appears to be initiated by the high-attenuation characteristics of zirconia. Consequently, radiographs with a high ratio of zirconia crown to normal anatomy are particularly susceptible. |
| Multiple superficial mucoceles concomitant with oral lichen planus: a case series Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Kejia Lv, Jianhua Liu, Weijia Ye, Guohua Wang, Hua Yao Superficial mucoceles are a relatively rare variant of common mucoceles and have an unclear etiology. Clinically, they are small, translucent, subepithelial vesicles affecting the oral mucosa in the retromolar region, the lower labial and buccal regions, and the bilateral soft palate. Superficial mucocele is easily misdiagnosed as pemphigoid, bullous lichen planus, herpes lesion, or venous lake when it is concomitant with oral lichen planus (OLP) or lichenoid disorders on the basis of the initial impression. An inflammatory mechanism related to OLP has been hypothesized to induce the development of superficial mucoceles. It is essential to be familiar with this entity. This report presents 9 cases of multiple superficial mucoceles that occurred sequentially concomitant with OLP and with consistent clinical and histopathologic features. Relevant studies reported in the literature are also reviewed to provide additional clarification of the etiology, clinicopathologic characteristics, and differential diagnosis. |
| Twist and E-cadherin deregulation might predict poor prognosis in lower lip squamous cell carcinoma Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Everton Freitas de Morais, Hellen Bandeira de Pontes Santos, Israel Leal Cavalcante, Silvia Helena Barem Rabenhorst, Jean Nunes dos Santos, Hébel Cavalcanti Galvão, Roseana de Almeida Freitas ObjectiveThe aim of this study was to evaluate the expression of Twist and E-cadherin in lower lip squamous cell carcinoma (LLSCC) and their association with clinicopathologic parameters. Study DesignFifty-nine cases of LLSCC were analyzed by applying immunohistochemistry techniques in a semiquantitative manner. The systems proposed by Bryne etal., Brandwein-Gensler etal., and Almangush etal. were applied for analysis of the histopathologic malignancy grading system. ResultsHigher E-cadherin expression (general and membrane) was observed in cases presenting with disease-free survival after 5years of follow-up (P < .05). Higher Twist expression was observed in lesions classified as being in advanced stages, displaying recurrence, and having a high degree of malignancy. A significant negative correlation was detected between cytoplasmic Twist expression and membrane E-cadherin expression (P = .028). A statistically significant relationship was detected between high total Twist expression in tumors classified as high risk by Brandwein-Gensler etal., and no significant difference was observed among total, membrane, and cytoplasmic E-cadherin expressions in LLSCC cases and the 3 applied grading systems (P > .05). ConclusionsThe results of the present study suggest the potential involvement of Twist and E-cadherin in the modulation of events related to worse prognoses in LLSCC cases. |
| Comparison of fatty acid synthase and cyclooxygenase-2 immunoexpression in embryonal, benign, and malignant odontogenic tissues Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Celeste Sánchez-Romero, Adalberto Mosqueda-Taylor, Wilson Delgado-Azañero, Oslei Paes de Almedia, Ronell Bologna-Molina ObjectivesThe aim of this study was to analyze the immunohistochemical expression of fatty acid synthase (FASN) and cyclooxygenase-2 (COX-2) in tooth germ (TG), ameloblastoma (AM), ameloblastic carcinoma (AC), ameloblastic fibroma (AF), and ameloblastic fibrosarcoma (AFS). Study DesignImmunohistochemistry for FASN and COX-2 was performed in 10 TG, 44 AM, 10 AC, 9 AF, and 5 AFS specimens. The results were analyzed by using the immunoreactive score (IRS) and Kruskal-Wallis test followed by Dunn's post-test. ResultsMost TG specimens were strongly positive for FASN, whereas COX-2 was weak or negative. All AM and AC specimens expressed both proteins. In AF specimens, FASN and COX-2 were variably expressed in the epithelium and negative in the mesenchyme. In AFS specimens, FASN was strongly positive in the malignant mesenchyme and variable in the epithelium; COX-2 was focal or weak in both components. FASN expression showed significant differences in the following comparisons: TG vs AC, AM vs AC, and AF vs AFS. Differences in COX-2 were significant when comparing TG specimens with AM, AC, and AF specimens. ConclusionsThe results suggest that FASN and COX-2 overexpression may have a role in the pathogenesis of AM and AC, whereas in AFS, FASN seems to be mainly involved. Further studies are necessary to clarify these mechanisms and their clinical implications. |
| Efficacy of curcumin for management of oral submucous fibrosis: a systematic review of randomized clinical trials Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Sadeq Ali Al-Maweri ObjectivesOral submucous fibrosis (OSF) is a chronic debilitating disease that has a high risk of malignant transformation. Management of OSF is quite challenging, with no definitive cure being available. This systematic review assessed the available evidence for using curcumin for pain alleviation and clinical improvement in patients with OSF. Study DesignA comprehensive search of PubMed/Medline, Scopus, and ISI Web of Science databases was conducted to identify all relevant clinical trials comparing patients receiving curcumin treatment to active and/or nonactive controls for the treatment of OSF. ResultsSix clinical trials comprising 298 patients were included. All studies found curcumin to be effective in the management of OSF. Three studies found significantly higher improvement in burning sensation in the curcumin group compared with controls, whereas 3 other studies found comparable results. With regard to clinical signs, 2 studies showed better improvement in mouth opening in the curcumin group; 3 studies reported no differences in effectiveness; and only 1 study found curcumin to be inferior to conventional therapy. ConclusionsThe available evidence remains inconclusive but suggests that curcumin is a promising effective treatment option for the management of patients with OSF. Further well-designed clinical trials with large sample sizes and adequate follow-up periods are warranted. |
| Medication-related osteonecrosis of the jaw unrelated to bisphosphonates and denosumab—a review Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Rebecca King, Nikki Tanna, Vinod Patel The link between medication-related osteonecrosis of the jaw (MRONJ) and bone modulating drugs, such as bisphosphonates and denosumab, is well established, and the number of reported cases is increasing. The development of novel medications used in the treatment of cancer, as well as autoimmune and bone conditions, has led to more cases of MRONJ being reported. However, in addition to this group of medications, increasing numbers of new agents in cancer therapy, such as antiangiogenic agents, have also been implicated in the development of MRONJ. As these newer agents with similar mechanisms are routinely used, the numbers of reported cases will likely rise further. This article aims to identify and summarize the drugs implicated in MRONJ, besides bisphosphonates and denosumab. A wide range of medications classified as tyrosine kinase inhibitors, monoclonal antibodies, mammalian target of rapamycin inhibitors, radiopharmaceuticals, selective estrogen receptor modulators, and immunosuppressants have been implicated in MRONJ. It remains crucial that oral health care providers are aware of these new medications and their associated risks to manage their patients appropriately. |
| How well do we manage the odontogenic keratocyst? A multicenter study Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Brian Kinard, Gentry Hansen, Marshall Newman, Peter Dennis, Tyler Haeffs, Sebastian Perez, Aya Hamao-Sakamoto, Martin Steed, Pamela Hughes, Meredith August, Shelly Abramowicz ObjectiveThe aim of this study was to answer the following clinical questions: Among patients treated for odontogenic keratocysts (OKCs), what is the overall 5-year disease-free rate, and what factors are associated with disease recurrence? Study DesignWe implemented a multicenter retrospective cohort study composed of patients presenting for the evaluation and management of previously untreated OKCs. The predictor variables were grouped into demographic, medical, radiographic, and operative categories. The primary outcome variable was time to lesion recurrence. Data analyses were performed by using bivariate analysis and univariate or multivariate Cox proportional hazards models. ResultsThe study sample was composed of 231 OKCs. Of these, 57 (24.7%) were treated with decompression with residual cystectomy, 86 (37.2%) with enucleation without adjuvant therapy, and 78 (33.8%) with enucleation with peripheral ostectomy. There were 44 recurrences (19%), with a median time to recurrence of 26.7 months (range 15.8–49.8). ConclusionsThis multicenter study is the largest study analyzing disease recurrence after treatment of OKCs by using appropriate statistical analysis for a time-to-event outcome (disease recurrence). The 5-year disease-free estimate was 29%. Mandibular lesions, multilocular lesions, and lesions treated with decompression and residual cystectomy were associated with recurrence. |
| Dental and craniofacial alterations in long-term survivors of childhood head and neck rhabdomyosarcoma Publication date: April 2019 Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 4 Author(s): Valkiria D'Aiuto de Mattos, Sima Ferman, Denise Maria AraĂşjo MagalhĂŁes, HĂ©liton SpĂndola Antunes, Simone Queiroz Chaves Lourenço ObjectiveRhabdomyosarcoma (RMS) represents the most common soft tissue sarcoma that affects children. Treatment involves chemoradiotherapy. This study aimed at evaluating the long-term alterations to teeth and cranial bones in children, teenagers, and young adults after oncologic treatment. Study DesignWe conducted a cross-sectional study of patients undergoing treatment for head and neck RMS between 1988 and 2011. We evaluated demographic, clinical, and treatment data and performed panoramic radiography, cephalometry, and photography. ResultsWe evaluated 27 long-term survivors, most of whom had been treated between ages 0 to 5 years (51.9%). The total radiation dose applied was 50.4 Gy, and the chemotherapy combination included vincristine, actinomycin D, and cyclophosphamide in 51.9% of the cases. We observed 603 dental alterations, among which 377 (62.7%) occurred in patients ages 0 to 5 years, and root shortening was the most frequent alteration observed (24.2%). With regard to facial bones, 74% of the patients had some level of facial asymmetry, 70.4% had reduced facial depth, 48.4% had mandibles of short size, and 77.8% had reduced facial height. ConclusionsChildren submitted to RMS treatment involving chemotherapy and radiotherapy displayed significant dental and craniofacial alterations, especially when treatment occurred between ages 0 and 5 years. |
Atmospheric Environment
| Impact of aerosols of sea salt origin in a coastal basin: Sydney, Australia Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Jagoda Crawford, David D. Cohen, Scott D. Chambers, Alastair G. Williams, Armand Atanacio AbstractSea salt is one of the major aerosols in the atmosphere in both the fine and coarse size ranges. Newly formed sea salt particles have a similar composition to seawater; including elements such as Na, Cl, Mg, S, Ca, Br and K. However, once in the atmosphere sea salt particles can undergo chemical reactions with other airborne pollutants, resulting in a loss of chlorine (whereas Na is conservative). The modified aerosol is commonly referred to as aged sea spray or aged sea salt. Fine aerosols from two sites in the Sydney Basin were analysed for source fingerprints with components that may have originated from the ocean (i.e. fresh and aged sea spray). At Lucas Heights, 18.4 km from the nearest coast, the average source fingerprint concentrations of fresh and aged sea spray were 0.47 ± 0.02 and 1.08 ± 0.03 ÎĽg/m3, respectively. At Richmond, 58 km from the coast, the average fingerprint concentrations of fresh and aged sea spray were 0.26 ± 0.01 and 0.87 ± 0.02 ÎĽg/m3, respectively. At Lucas heights, fresh and aged sea spray contributed to 11% and 21% of PM2.5, respectively. At Richmond fresh and aged sea spray contributed to 4.8 ± 0.35 and 16 ± 0.5% of the PM2.5, respectively. The Cl/Na ratios of aged sea spray at Lucas Heights and Richmond were 0.72 and 0.87, respectively, in comparison to 1.54 for fresh sea salt. At Richmond the corresponding Ca/Na and K/Na ratios were both 0.037 (close to that of seawater), and at Lucas Heights, the corresponding ratios were 0.038 and 0.026, respectively. Back trajectory and Radon-222 analysis demonstrated that the largest concentrations of aged sea spray occur when the air masses had travelled over regions of anthropogenic sources. This confirms an interaction between anthropogenic precursors and sea spray that liberates chlorine enabling it to contribute to other chemical reactions in the atmosphere, e.g. resulting in an increase in the formation of ozone. |
| Quantifying the emission potentials of fugitive dust sources in Nanjing, East China Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Mengchun Cui, Huayu Lu, Vic Etyemezian, Quanlong Su AbstractMost cities in China have suffered severe atmospheric particulate matter (PM) pollution, with reduced visibility and worsened air quality. Fugitive dust that primarily originates from soils through the action of wind and anthropogenic activities is recognized to be a major source of urban PM. However, it remains challenging to quantify and parameterize fugitive dust emission from various sources due to a lack of observation data. In this study, a portable wind erosion system, PI-SWERL, was applied to characterize the dynamics and magnitude of PM10 and PM2.5 (particles smaller than 10 ÎĽm and 2.5 ÎĽm respectively) emissions from several possible sources in Nanjing, a typical large city in the Yangtze River Delta economic regions, East China. Results indicate that aerodynamic suspension and abrasion were two major physical mechanisms responsible for fugitive dust emissions, with varying characteristics by location. Changes of emission characteristics and quantities were primarily associated with differences in the supply of fine particles available for wind erosion, controlled by source-specific surface characteristics and anthropogenic disturbances. Construction sites and unpaved roads were identified as two significant sources, with total emission rates of 95.85 (56.97) and 57.22 (32.62) kg s−1respectively for PM10 (PM2.5) at a friction velocity of 0.82 m s−1. These values were up to five times the amounts of PM emitted from arable lands and woodlands, and 1–2 orders of magnitude greater than those from paved roads, grasslands and bare lands. These data demonstrate the importance of construction sites and unpaved roads as local PM sources which might be significant in policy making for air quality management strategies and prioritization of emission control targets in an urban area. |
| An assessment of important SPECIATE profiles in the EPA emissions modeling platform and current data gaps Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Casey D. Bray, Madeleine Strum, Heather Simon, Lee Riddick, Mike Kosusko, Marc Menetrez, Michael D. Hays, Venkatesh Rao AbstractThe United States (US) Environmental Protection Agency (EPA)'s SPECIATE database contains speciated particulate matter (PM) and volatile organic compound (VOC) emissions profiles. Emissions profiles from anthropogenic combustion, industry, wildfires, and agricultural sources among others are key inputs for creating chemically-resolved emissions inventories for air quality modeling. While the database and its use for air quality modeling are routinely updated and evaluated, this work sets out to systematically prioritize future improvements and communicate speciation data needs to the research community. We first identify the most prominent profiles (PM and VOC) used in the EPA's 2014 emissions modeling platform based on PM mass and VOC mass and reactivity. It is important to note that the on-road profiles were excluded from this analysis since speciation for these profiles is computed internally in the MOVES model. We then investigate these profiles further for quality and to determine whether they were being appropriately matched to source types while also considering regional variability of speciated pollutants. We then applied a quantitative needs assessment ranking system which rates the profile based on age, appropriateness (i.e. is the profile being used appropriately), prevalence in the EPA modeling platform and the quality of the reference. Our analysis shows that the highest ranked profiles (e.g. profile assignments with the highest priority for updates) include PM2.5profiles for fires (prescribed, agricultural and wild) and VOC profiles for crude oil storage tanks and residential wood combustion of pine wood. Top ranked profiles may indicate either that there are problems with the currently available source testing or that current mappings of profiles to source categories within EPA's modeling platform need improvement. Through this process, we have identified 29 emissions source categories that would benefit from updated mapping. Many of these mapping mismatches are due to lack of emissions testing for appropriate source categories. In addition, we conclude that new source emissions testing would be especially beneficial for residential wood combustion, nonroad gasoline exhaust and nonroad diesel equipment. |
| Can a single water molecule catalyze the OH+CH2CH2 and OH+CH2O reactions? Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Mohamad Akbar Ali, Balaganesh M, Soonmin Jang AbstractThe reaction of OH radicals with ethylene (CH2CH2) and formaldehyde (CH2O) molecules with and without water have been investigated using ab initio/DFT potential energy surfaces (PESs) at CCSD(T)/aug-cc-pVTZ//BHandHLYP//aug-cc-pVTZ levels of theory. The rate coefficients for the bimolecular reaction pathways OH + CH2X···H2O (X = CH2, O) and CH2X + H2O⋯HO were calculated using canonical variational transition state theory (CVT) with small curvature tunneling (SCT) correction. The kinetic results show that OH radical adds to C=C bond in CH2CH2, and abstract the hydrogen atoms from CH2O, similar to its isoelectronic analogous OH + CH2NH (+H2O) reaction. The catalytic effect of a single water molecule on OH + CH2X (X = CH2, O) reaction system shows that the initial water complexation step is essential in the rate coefficients calculation. The calculated rate coefficient for the OH + CH2CH2(+H2O) reaction at 300K is 6 × 10−16 cm3 molecule−1 s−1 and for OH + CH2O(+H2O) reaction at 300K is 8.1 × 10−14 cm3 molecule−1 s−1. The rate coefficient for OH + CH2CH2(+H2O) reaction is at least two orders of magnitude smaller than OH + CH2NH(+H2O) reaction (at 300K is 5.1 × 10−14 cm3 molecule−1 s−1) and rate coefficient for OH + CH2O reaction is in good agreement with OH + CH2NH reaction. In general, the rate coefficients for OH + CH2X (X = CH2, O)⋯H2O and for CH2X + H2O⋯HO reactions are ∼3–4 orders of magnitude smaller than reaction without water molecule. Our results predict that catalytic effect of single water molecule on OH + CH2CH2 and OH + CH2O reactions can make a negligible contribution to the gas phase removal of CH2CH2 and CH2O by OH radicals because the dominated water-assisted process depends parametrically on water concentration. As a result, the overall reaction rate coefficients are smaller. The present results provide a better understanding of gas phase catalytic effect of a water molecule on the most important atmospheric and combustion reaction prototypes. Graphical abstract![]() |
| Kinetics and mechanisms of the gas-phase reactions of OH radicals with three C15 alkanes Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Bo Shi, Weigang Wang, Li Zhou, Junling Li, Jing Wang, Yan Chen, Wenyu Zhang, Maofa Ge AbstractThe reaction constants and products for the reactions of OH radicals with different C15 alkanes, were determined by using Proton-Transfer-Reaction Mass Spectrum (PTR-MS) in the smog chamber. Rate coefficients (in units of 10−11 cm3 molecule−1 s−1) k1(pentadecane) = 1.72 ± 0.18,k2(2,6,10-trimethyldodecane) = 1.90 ± 0.20, k3(nonylcyclohexane) = 2.09 ± 0.22 were first obtained by the relative rate method using toluene and m-xylene as reference compounds at (298 ± 1)K and atmospheric pressure. In addition, the products of these reactions were measured by PTR-MS simultaneously. The results show that the major gas phase products observed in the OH radicals reactions were aldehydes and ketones for C15 alkanes. The possible reaction mechanisms were speculated and the atmospheric implications were also discussed. |
| High resolution, extreme isotopic variability of precipitation nitrate Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Lucy A. Rose, Zhongjie Yu, Daniel J. Bain, Emily M. Elliott AbstractDeposition of atmospheric nitrate (NO3−) in precipitation can be an important source of reactive nitrogen (N) to ecosystems, particularly in regions with high nitrogen oxide (NOx = nitric oxide (NO)+nitrogen dioxide (NO2)) emissions. However, high resolution deposition data are lacking for most systems. We conducted hourly precipitation sampling across six growing season storms in a forested area historically subjected to some of the highest levels of chronic N deposition in the United States. To characterize the influence of electricity generating unit (EGU), vehicle, and biogenic NOx emissions on NO3− deposition, we calculated the total NOx emitted from these sources within a 100 km radius of air mass back trajectories determined for Fernow Experimental Forest (West Virginia, USA). We combined these emissions estimates with established 15N isotope values for NOx sources in a three end-member mixing model to predict source-based δ15N values of deposition reaching the study site on an hourly basis. To evaluate the effect of NOx oxidation pathways on measured δ15N-NO3-values, we compared observed hourly isotope values to a coupled δ15N and Δ17O array representing N isotope exchange between atmospheric oxidized N molecules. Within individual events, δ15N, δ18O, and Δ17O values ranged by as much as 19.5‰, 28.9‰, and 13.8‰, respectively. This extreme short-term isotopic variability suggests a dynamic mix of NOx sources, oxidation pathways, and fractionation processes contributing to HNO3formation. During every storm, precipitation δ15N-NO3- values were lower than those expected to result from predominant HNO3 formation pathways or oxidation of estimated NOx emissions along back trajectories, suggesting a systematic underestimation of NOx contributions to atmospheric HNO3 formation from isotopically depleted soil emissions. Together, these analyses represent the most comprehensive assessment to date relating high temporal resolution δ15N-NO3- observations to NOx emission sources, oxidation chemistry, and isotopic fractionation effects. We present the first observations of extreme intra-storm δ15N, δ18O, and Δ17O variability, emphasizing the need for improved constraints on soil NOx emissions, forest canopy effects, and their role in atmospheric NO3− deposition and isotope dynamics in forests. |
| Spatio-temporal assessment of nocturnal surface ozone in Malaysia Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Mohd Famey Yusoff, Mohd Talib Latif, Liew Juneng, Md Firoz Khan, Fatimah Ahamad, Jing Xiang Chung, Anis Asma Ahmad Mohtar AbstractThis study aims to determine the level and potential sources of nocturnal surface ozone (NSO) in different regions in Malaysia. Eleven-year (2005–2015) ozone data from 37 continuous air quality monitoring stations throughout Malaysia have been analysed to determine spatio-temporal variations in NSO concentrations. NSO daily maximum concentrations from different regions in Malaysia were used for seasonal variation analysis while linear regression and the Mann-Kendall trend test were used for the annual variation analysis. Average ratios of mean NSO to daytime surface ozone (DSO) for the whole country were found to be 60% of DSO (0.58–0.61). The east coast of the Malaysian Peninsula recorded the highest ratio (70% of DSO) while the central region recorded the lowest concentration (50% of DSO). Titration processes, particularly by NO in the urban areas of the central region, and long transboundary movement of ozone to the east coast are expected to influence the concentration of ozone in these two regions, respectively. On certain occasions, the NSO concentrations (with a maximum value of 137 ppb) exceeded the limit of 100 ppb, the value suggested by Malaysian Air Quality Standard for ambient ozone concentration. The monthly diurnal variation analysis revealed the occurrence of secondary/nocturnal peaks at more than 50% of the stations occurring around 0300–0500 h. The NSO was found to be influenced by the monsoonal season with higher concentrations mainly observed during the boreal winter season. The long-term trend analysis presented the country's overall NSO as having an increasing trend at 27% of the stations. |
| Potential impacts of electric vehicles on air quality and health endpoints in the Greater Houston Area in 2040 Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Shuai Pan, Anirban Roy, Yunsoo Choi, Ebrahim Eslami, Stephanie Thomas, Xiangyu Jiang, H. Oliver Gao AbstractSignificant emissions from transportation contribute to the formation of O3 and fine particulate matter (PM2.5), causing poor air quality and health. In this study, four scenarios were developed to understand how future fleet electrification and turnover of both gasoline and diesel vehicles affect air quality and health in the Houston Metropolitan area. These scenarios considered increased vehicle activity and various configurations of emissions controls. Comparing to a base year of 2013, model predictions for 2040 indicated a ∼50% emissions increase in the Business As Usual (BAU) case, and ∼50%, ∼75%, and ∼95% reductions in the three distinct emissions control cases, the Moderate Electrification (ME), Aggressive Electrification (AE), and Complete Turnover (CT) cases, respectively. Each modeling scenario was conducted using a high-resolution (1 km) WRF-SMOKE-CMAQ-BenMAP air quality and health modeling framework, which helped capture urban features in higher detail. The emissions control cases resulted in 1–4 ppb maximum 8 h O3 increase along highways and reductions both in the regions enclosed by the highways and those downwind. Simulated PM2.5 concentrations decreased between 0.5 and 2 ÎĽg m−3. Health impact results suggest that increased O3 and PM2.5 concentrations from the BAU case will lead to 122 additional premature deaths with respect to 2013. However, reduced emissions for the control cases (ME, AE, CT) will prevent 114–246 premature deaths. Additionally, about 7,500 asthma exacerbation and 5,500 school loss days will be prevented in the ME case, benefiting younger individuals. The economic benefits generally followed the same trends as health impacts. The analysis framework developed in this study can be applied to other metropolitan areas. The effects of motor vehicle electrification on power plant emissions were estimated using the Argonne National Laboratory's Autonomie data, and indicated the electrification load to be negligible as opposed to projected electricity generation. |
| Secondary organic aerosol formation from the OH-initiated oxidation of guaiacol under different experimental conditions Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Changgeng Liu, Jun Liu, Yongchun Liu, Tianzeng Chen, Hong He AbstractGuaiacol (2-methoxyphenol) has a high emission rate from wood burning and mainly exists in the gas phase, but the formation potential of secondary organic aerosol (SOA) from the atmospheric oxidation of guaiacol has not been well determined yet. In this work, SOA formation from the gas-phase reaction of guaiacol with OH radicals was investigated using an oxidation flow reactor (OFR) under different experimental conditions. The results showed that SOA yield was dependent on guaiacol concentration, OH exposure, and the presence of SO2 and NO2. SOA yield firstly increased and then decreased as a function of OH exposure. The maximum SOA yield (0.28–0.54) obtained at different guaiacol concentrations could be well-expressed by a one-product model. The SOA oxidation degree was represented by the carbon oxidation state (OSC) and f44/f43 (the ratio of organic mass fractions of m/z 44 to m/z 43), which both increased linearly and significantly with the increase of OH exposure. In addition, SO2 and NO2 promoted SOA formation, for which the maximum yield enhancements were 13.38% and 10.69%, respectively. The N/C ratio (0.034–0.045) indicated that NO2 participated in the OH-initiated reaction of guaiacol, consequently resulting in the formation of organic nitrates. The experimental results would be helpful to further the understanding of SOA formation from the atmospheric oxidation of guaiacol and its subsequent impacts on air quality and climate. Graphical abstract![]() |
| Sensitivity of simulating a dust storm over Central Asia to different dust schemes using the WRF-Chem model Publication date: 15 June 2019 Source: Atmospheric Environment, Volume 207 Author(s): Tiangang Yuan, Siyu Chen, Jianping Huang, Xiaorui Zhang, Yuan Luo, Xiaojun Ma, Guolong Zhang AbstractFrequent dust storms have harm to human health and agricultural activities in Central Asia. However, there has been a great deal of uncertainty in prediction of dust storms in Central Asia. One of the important reasons is that the adaptability of different dust emission schemes has not been evaluated. Here, the Goddard Chemistry Aerosol Radiation and Transport (GOCART), Air Force Weather Agency (AFWA) and Shao2004 (Shao04) dust schemes coupled to the WRF-Chem model were used to simulate the severe dust storm occurred in Central Asia on 12–15 July 2016. Generally, this dust storm was initialed by a vortex at 500 hPa and surface cold front, and then swept across Turkmenistan, Uzbekistan and Tajikistan. The Shao04 case could represent the spatial-temporal evolution of the dust storm well, especially at the northern Iran and Turkmenistan, due to its better description of the physical process of dust emission. But it overestimated the aerosol optical depth (AOD) to the southeast of the Aral Sea, which might be associated with the uncertainties of the soil particle distribution dataset. The AFWA case simulated AOD as better as Shao04 case with improved soil moisture correction factors, saltation algorithms and particle size distributions although it had smaller particle size, indicating that smaller particles are assignable. The GOCART case showed the largest dust emission areas due to the low threshold velocity. Yet both the AFWA and GOCART scheme underestimated the high AOD over northern Iran owe to its low erodibility factors. The total dust emission of the four-day period in the Shao04 scheme was 11.9 Tg, which was 2–3 times larger than those obtained in the AFWA and GOCART schemes. The significant differences of dust emission between three dust schemes may essentially depend on the sensitivities of threshold friction velocity on surface property. |
Natural Medicines
| Quantification of Panax notoginseng saponins metabolites in rat plasma with in vivo gut microbiota-mediated biotransformation by HPLC-MS/MS Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Yin-Ping GUO, Man-Yun CHEN, Li SHAO, Wei ZHANG, Tai RAO, Hong-Hao ZHOU, Wei-Hua HUANG AbstractPanax notoginseng saponins (PNS) are the major components of Panax notoginseng, with multiple pharmacological activities but poor oral bioavailability. PNS could be metabolized by gut microbiota in vitro, while the exact role of gut microbiota of PNS metabolism in vivo remains poorly understood. In this study, pseudo germ-free rat models were constructed by using broad-spectrum antibiotics to validate the gut microbiota-mediated transformation of PNS in vivo. Moreover, a high performance liquid chromatography-electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was developed for quantitative analysis of four metabolites of PNS, including ginsenoside F1 (GF1), ginsenoside Rh2 (GRh2), ginsenoside compound K (GCK) and protopanaxatriol (PPT). The results showed that the four metabolites could be detected in the control rat plasma, while they could not be determined in pseudo germ-free rat plasma. The results implied that PNS could not be biotransformed effectively when gut microbiota was disrupted. In conclusion, gut microbiota plays an important role in biotransformation of PNS into metabolites in vivo. |
| Two new nimbolinin- and trichilin-class limonoids isolated from the fruits of Melia azedarach Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Lu QIU, Li HENG, Rong XU, Jun LUO, Yi LI AbstractTwo new furan fragment isomerized limonoids, meliazedalides A and B (compounds 1 and 2), were isolated from the fruits of Melia azedarach Linn.. Their chemical structures were elucidated on the basis of HR-ESI-MS and 1D and 2D NMR data, which belonged to nimbolinin- and trichilin-class, respectively. Compound 2 exhibited weak inhibitory effect on NO production in lipopolysaccharide (LPS)-activated RAW 264.7 macrophages with IC50 being 37.41 ÎĽmol·L−1. |
| Lower clearance of sodium tanshinone IIA sulfonate in coronary heart disease patients and the effect of total bilirubin: a population pharmacokinetics analysis Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Wei-Wei QIN, Li WANG, Zheng JIAO, Bin WANG, Cheng-Yu WANG, Li-Xuan QIAN, Wei-Lin QI, Ming-Kang ZHONG AbstractThis study developed a population pharmacokinetic model for sodium tanshinone IIA sulfonate (STS) in healthy volunteers and coronary heart disease (CHD) patients in order to identify significant covariates for the pharmacokinetics of STS. Blood samples were obtained by intense sampling approach from 10 healthy volunteers and sparse sampling from 25 CHD patients, and a population pharmacokinetic analysis was performed by nonlinear mixed-effect modeling. The final model was evaluated by bootstrap and visual predictive check. A total of 230 plasma concentrations were included, 137 from healthy volunteers and 93 from CHD patients. It was a two-compartment model with first-order elimination. The typical value of the apparent clearance (CL) of STS in CHD patients with total bilirubin (TBIL) level of 10 ÎĽmol(L−1 was 48.7 L(h−1 with inter individual variability of 27.4%, whereas that in healthy volunteers with the same TBIL level was 63.1 L(h−1. Residual variability was described by a proportional error model and estimated at 5.2%. The CL of STS in CHD patients was lower than that in healthy volunteers and decreased when TBIL levels increased. The bootstrap and visual predictive check confirmed the stability and validity of the final model. These results suggested that STS dosage adjustment might be considered based on TBIL levels in CHD patients. |
| Two natural molecules preferentially inhibit azole-resistant Candida albicans with MDR1 hyperactivation Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Hong-Zhuo SHI, Wen-Qiang CHANG, Ming ZHANG, Hong-Xiang LOU AbstractAntifungal drug resistance is a significant clinical problem, and antifungal agents that can evade resistance are urgently needed. In infective niches, resistant organisms often co-existed with sensitive ones, or a subpopulation of antibiotic-susceptible organisms may evolve into resistant ones during antibiotic treatment and eventually dominate the whole population. In this study, we established a co-culture assay in which an azole-resistant Candida albicans strain was mixed with a susceptible strain labeled with green fluorescent protein to mimic in vivo conditions and screen for antifungal drugs. Fluconazole was used as a positive control to verify the validity of this co-culture assay. Five natural molecules exhibited antifungal activity against both susceptible and resistant C. albicans. Two of these compounds, retigeric acid B (RAB) and riccardin D (RD), preferentially inhibited C. albicans strains in which the efflux pump MDR1 was activated. This selectivity was attributed to greater intracellular accumulation of the drugs in the resistant strains. Changes in sterol and lipid compositions were observed in the resistant strains compared to the susceptible strain, and might increase cell permeability to RAB and RD. In addition, RAB and RD interfered with the sterol pathway, further aggregating the decrease in ergosterol in the sterol synthesis pathway in the MDR1-activated strains. Our findings here provide an alternative for combating resistant pathogenic fungi. |
| The Zuo Jin Wan Formula increases chemosensitivity of human primary gastric cancer cells by AKT mediated mitochondrial translocation of cofilin-1 Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Meng-Yao SUN, Dan-Dan WANG, Jian SUN, Xiao-Hua ZHAO, Si CAI, Qiu-Xue WU, Tao JIE, Zhen-Hua NI, Jian-Yue SUN, Qing-Feng TANG AbstractResistance to cisplatin (DDP)-based chemotherapy is a major cause of treatment failure in human gastric cancer (GC). It is necessary to identify the drugs to re-sensitize GC cells to DDP. In our previous research, Zuo Jin Wan Formula (ZJW) has been proved could increase the mitochondrial apoptosis via cofilin-1 in a immortalized cell line, SGC-7901/DDP. Due to the immortalized cells may still difficult highly recapitulate the important molecular events in vivo, primary GC cells model derived from clinical patient was constructed in the present study to further evaluate the effect of ZJW and the underlying molecular mechanism. Immunofluorescent staining was used to indentify primary cultured human GC cells. Western blotting was carried out to detect the protein expression. Cell Counting Kit-8 (CCK-8) was used to evaluate cell proliferation. Flow cytometry analysis was performed to assess cell apoptosis. ZJW inhibited proliferation and induced apoptosis in primary DDP-resistant GC cells. Notably, the apoptosis in GC cells was mediated by inducing cofilin-1 mitochondrial translocation, down-regulating Bcl-2 and up-regulating Bax expression. Surprisingly, the level of p-AKT protein was higher in DDP-resistant GC cells than that of the DDP-sensitive GC cells, and the activation of AKT could attenuate ZJW-induced sensitivity to DDP. These data revealed that ZJW can increase the chemosensitivity in DDP-resistant primary GC cells by inducing mitochondrial apoptosis and AKT inactivation. The combining chemotherapy with ZJW may be an effective therapeutic strategy for GC chemoresistance patients. |
| Houttuynia cordata polysaccharide alleviated intestinal injury and modulated intestinal microbiota in H1N1 virus infected mice Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Mei-Yu CHEN, Hong LI, Xiao-Xiao LU, Li-Jun LING, Hong-Bo WENG, Wei SUN, Dao-Feng CHEN, Yun-Yi ZHANG AbstractHouttuynia cordata polysaccharide (HCP) is extracted from Houttuynia cordata, a key traditional Chinese medicine. The study was to investigate the effects of HCP on intestinal barrier and microbiota in H1N1 virus infected mice. Mice were infected with H1N1 virus and orally administrated HCP at a dosage of 40 mg(kg−1(d−1. H1N1 infection caused pulmonary and intestinal injury and gut microbiota imbalance. HCP significantly suppressed the expression of hypoxia inducible factor-1α and decreased mucosubstances in goblet cells, but restored the level of zonula occludens-1 in intestine. HCP also reversed the composition change of intestinal microbiota caused by H1N1 infection, with significantly reduced relative abundances of Vibrio and Bacillus, the pathogenic bacterial genera. Furthermore, HCP rebalanced the gut microbiota and restored the intestinal homeostasis to some degree. The inhibition of inflammation was associated with the reduced level of Toll-like receptors and interleukin-1β in intestine, as well as the increased production of interleukin-10. Oral administration of HCP alleviated lung injury and intestinal dysfunction caused by H1N1 infection. HCP may gain systemic treatment by local acting on intestine and microbiota. This study proved the high-value application of HCP. |
| Non-volatile constituents and pharmacology of Chimonanthus: A review Publication date: March 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 3 Author(s): Ren-Geng SHU, Yi-Li WAN, Xiao-Min WANG AbstractChimonanthus plants widely distributed in southern area of China, which have a long history of edibles and medicine. Phytochemical investigations have shown that Chimonanthus produced 143 non-volatile constituents, including alkaloids, flavonoids, terpenoids, coumarins and others, which exhibit significant anti-oxidant, anti-bacterial, anti-cancer, anti-inflammatory, antihyperglycemic, antihyperlipidemic and other biological activities. On the basis of systematic reviewing of literatures, this article overviews the non-volatile constituents and pharmacology of Chimonanthus from domestic and foreign over the last 30 years (until June 2018), and may provide a useful reference for the further development of Chimonanthus. |
| Romipeptides A and B, two new romidepsin derivatives isolated from Chromobacterium violaceum No.968 and their antitumor activities in vitro Publication date: February 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 2 Author(s): Lei XIONG, Chang-Fa CHEN, Tao-Ling MIN, Hai-Feng HU AbstractRomipeptides A and B (1 and 2), two new romidepsin derivatives, and three known compounds, chromopeptide A (3), romidepsin (4) and valine-leucine dipeptide (5) were isolated from the fermentation broth of Chromobacterium violaceum No. 968. Their structures were elucidated by interpretation of their UV, HR-ESI-MS and NMR spectra. The absolute configuration of compound 1 and 2 were established by single crystal X-ray diffraction analysis. Compounds 1–5 were evaluated for their anti-proliferative activities against three human cancer cell lines, SW620, HL60, and A549. The results showed most of these compounds exhibited antitumor activities in vitro, in which compound 2 displayed potent cytotoxicity to SW620, HL60 and A549 cell lines, with IC50 of 12.5, 6.7 and 5.7 nmol·L−1, respectively. |
| Peptides and polyketides isolated from the marine sponge-derived fungus Aspergillus terreus SCSIO 41008 Publication date: February 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 2 Author(s): Xiao-Wei LUO, Yun LIN, Yong-Jun LU, Xue-Feng ZHOU, Yong-Hong LIU AbstractTwo new isomeric modified tripeptides, aspergillamides C and D (compounds 1 and 2), together with fifteen known compounds (compounds 3–17), were obtained from the marine sponge-derived fungus Aspergillus terreusSCSIO 41008. The structures of the new compounds, including absolute configurations, were determined by extensive analyses of spectroscopic data (NMR, MS, UV, and IR) and comparisons between the calculated and experimental electronic circular dichroism (ECD) spectra. Butyrolactone I (compound 11) exhibited strong inhibitory effects against Mycobacterium tuberculosis protein tyrosine phosphatase B (MptpB) with the IC50 being 5.11 ± 0.53 ÎĽmol·L−1, and acted as a noncompetitive inhibitor based on kinetic analysis. |
| Two symmetrical unsaturated acids isolated from Viscum album Publication date: February 2019 Source: Chinese Journal of Natural Medicines, Volume 17, Issue 2 Author(s): Duo CAO, Li-Qing WANG, Xiao-Min HAN, Hui-Rui GUAN, Meng LEI, Ya-Hui WEI, Liang CHENG, Pei-Ming YANG, Zheng-Liang SUN, Wen GAO, Jia-Kun DAI AbstractIn the present study, two new acetylene conjugate compounds, dibutyl (2Z, 6Z)-octa-2, 6-dien-4-yne dioate (1), and dibutyl (2E, 6E)- octa-2, 6-dien-4-yne dioate (2), were isolated from the dry stem leaves of Viscum album, along with nine known compounds (3 – 11). Their structures were confirmed on the basis of spectroscopic data. Compounds 1 and 8 showed antioxidant activity against xanthine oxidase (XOD) and 1,1-diphenyl-2-picrylhydrazyl radical 2,2-diphenyl-1-(2,4,6-trinitrophenyl) hydroxyl (DPPH), with the IC50 of 1.22 and 1.33 ÎĽmol·L−1, and the SC50 of 4.34 and 8.22 ÎĽmol·L−1, respectively. |
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