Standard Adult Gastric Emptying Scintigraphy Criteria Is Applicable for Partial Meal Ingestion

BACKGROUND/AIMS

Gastric emptying scintigraphy is commonly performed to assess for dysmotility. A standardized meal with associated threshold criteria was established in 2000 to enable robust interpretation. However, no guidance is available to interpret results when patients do not ingest the entire meal. The purpose of this study is to determine the continued appropriateness of the threshold criteria in contemporary clinical practice and its relevance for partially ingested meals.

METHODS

This retrospective study analyzed patients (n = 1365 total) who underwent solid-phase gastric emptying scintigraphy at an academic medical center. Patients were stratified based on their completion of the standard meal. Patients were further stratified into normal and delayed gastric emptying cohorts based on the current criteria. Percent gastric retention values at 1, 2, 3, and 4 h were compared.

RESULTS

Median (95% upper reference) normal gastric retention values for the complete standard meal were 64% (87%) at 1 h, 25% (60%) at 2 h, 13% (54%) at 3 h and 4% (9%) at 4 h. Consumption of at least 50% of the standard meal yielded similar retention; 53% (86%) at 1 h, 19% (58%) at 2 h, 6% (29%) at 3 h and 3% (10%) at 4 h. There was no significant age- or gender-specific differences using the current criteria, and no differences were observed based on diabetic status. Retention values matched well with the current criteria and validated with data-driven clustering.

CONCLUSION

Adult normative standards for gastric emptying scintigraphy are appropriate for differentiating normal and delayed populations and can be applied to partial meals with at least 50% completion.

[Clinical efficacy and safety of endobronchial one-way valves for the treatment of bronchopleural fistula]

Objective: To investigate the efficacy and safety of interventional endobronchial one-way valves (EBV) for the treatment of peripheral bronchopleural fistula (BPF). Methods: A total of 33 patients with peripheral BPF who underwent EBV implantation in Endoscopy Center of Shanghai Pulmonary Hospital from August 2017 to December 2021 were selected as the research objects. All the patients were diagnosed with peripheral BPF before the implantation surgery. The detailed medical records of the patients were collected, and the etiology, lesion location, treatment method and operation process, treatment efficacy and postoperative complications were analyzed to evaluate the efficacy and safety of EBV implantation. Results: Of the 33 patients in our study, 26 were male and 7 were female. The median age was 54.7 (28-86) years. There were 18 cases of BPF after thoracic surgery (54.5%), 6 cases of chronic obstructive pulmonary disease complicated with spontaneous pneumothorax (18.2%), and 12 cases of pulmonary tuberculosis and non-tuberculous mycobacterial infection with spontaneous pneumothorax (36.4%). A total of 63 valves were inserted in the 33 cases, and a maximum of valves and at least one were inserted in a single case. The lesions were located in the right lower lobe in 16 cases (48.5%) and the left upper lobe in 12 cases (36.4%). Of the 33 patients undergoing EBV placement, 22 (66.7%) were successful, with chest drainage tube indwelling duration of (88.5±36.6) days and (29.6±11.4) days, respectively, before and after EBV treatment. The time from EBV placement to successful withdrawal of EBV was (102.2±31.3) days. During a postoperative follow-up of 6 months after EBV treatment, the main complications were 29 cases with attachment of secretions to the EBV (90.6%) and 13 cases (40.6%) with mild granulation proliferation. In addition, there were five patients with moderate to severe granulation proliferation (15.6%), one with valve displacement or shedding (3.1%), and one with bleeding (3.1%). Conclusions: In this study, the success rate of EBV placement and occlusion was 66.7%. Transbronchoscopic EBV placement in the treatment of peripheral BPF is a effective treatment with relatively minor complications.

SIRT3 Promotes the Development of Esophageal Squamous Cell Carcinoma by Regulating Hexokinase 2 through the AKT Signaling Pathway

In the present study, we explored whether sirtuin-3 (SIRT3) regulates the proliferation and migration of esophageal squamous cell carcinoma (ESCC) and investigated the mechanisms underlying the oncogene role of SIRT3. siRNA was used to transfect Eca109 cells and downregulate SIRT3. The proliferation and migration of Eca109 cells were examined by the CCK-8 assay, colony formation assay, Transwell assay, and scratch test. Quantitative real-time PCR and Western blotting were used to detect SIRT3, hexokinase 2, AKT, and p-AKT in Eca109 cells. Functional assays showed that downregulation of SIRT3 could inhibit the proliferation and migration of ESCC cells. Reduced SIRT3 expression downregulated hexokinase 2 expression and inhibited AKT activation in ESCC. These results indicated that SIRT3 promote ESCC development and progression by regulating hexokinase 2 through the AKT signaling pathway. SIRT3 promote ESCC proliferation and migration by regulating HK-2 through the AKT signaling pathway.

Key Factors to Attract More U.S. Diagnostic Radiology Residents into the Field of Nuclear Medicine and Molecular Imaging: A National Survey

RATIONALE AND OBJECTIVES

To understand the current state of radiology residents' exposure to nuclear medicine and molecular imaging (NM/MI), determine key factors that may attract more trainees into the field, and identify differentiating aspects between those specializing in NM/MI and those who are not.

MATERIALS AND METHODS

An anonymous web-based survey was sent to contacts at all diagnostic radiology residency programs in the United States for dissemination to their residents, collecting information about trainees' NM/MI exposure during residency and factors that may attract them to NM/MI.

RESULTS

A total of 198 trainees responded to the survey, 34 of whom plan on pursuing a career in NM/MI. Most trainees reported early exposure to NM/MI during residency; most (97.4%) reported ample exposure to general NM/MI and oncologic studies. Less than 3% of trainees reported adequate exposure to therapies, neurological applications, molecular imaging/research advances, and physics. Respondents reported a need for better quality education (38.9%) and exposure to mentors (28.8%) as ways to attract trainees to NM/MI. Routinely encountered clinical pathology was the most interesting for those specializing in NM/MI (29.4%), whereas lifestyle was the most attractive aspect of NM/MI for those not pursuing a career in the field (27.4%). NM/MI-associated research was the least attractive for those specializing in NM/MI (35.3%), while job market concerns was the least attractive aspect for those not specializing in NM/MI (37.2%). Trainees planning to specialize in NM/MI reported higher satisfaction with their orientation to NM/MI during their first clinical rotation compared to those who do not plan to specialize in the field (3.03/5.00 and 2.67/5.00, respectively, p = 0.04).

CONCLUSION

This survey highlights several factors that training programs and national societies can target to improve interest in NM/MI among radiology residents. We found that optimized education initiatives, including improved orientation to the field, increased mentoring, and career opportunities are essential levers for recruiting radiology trainees into the NM/MI workforce.

Diffusion MRI biomarkers of white matter microstructure vary nonmonotonically with increasing cerebral amyloid deposition

Beta amyloid (Aβ) accumulation is the earliest pathological marker of Alzheimer's disease (AD), but early AD pathology also affects white matter (WM) integrity. We performed a cross-sectional study including 44 subjects (23 healthy controls and 21 mild cognitive impairment or early AD patients) who underwent simultaneous PET-MR using 18F-Florbetapir, and were categorized into 3 groups based on Aβ burden: Aβ- [mean mSUVr ≤1.00], Aβi [1.00 < mSUVr <1.17], Aβ+ [mSUVr ≥1.17]. Intergroup comparisons of diffusion MRI metrics revealed significant differences across multiple WM tracts. Aβi group displayed more restricted diffusion (higher fractional anisotropy, radial kurtosis, axonal water fraction, and lower radial diffusivity) than both Aβ- and Aβ+ groups. This nonmonotonic trend was confirmed by significant continuous correlations between mSUVr and diffusion metrics going in opposite direction for 2 cohorts: pooled Aβ-/Aβi and pooled Aβi/Aβ+. The transient period of increased diffusion restriction may be due to inflammation that accompanies rising Aβ burden. In the later stages of Aβ accumulation, neurodegeneration is the predominant factor affecting diffusion.

Functional Translocation of Broca's Area in a Low-Grade Left Frontal Glioma: Graph Theory Reveals the Novel, Adaptive Network Connectivity

We describe frontal language reorganization in a 50–60 year-old right-handed patient with a low-grade left frontotemporal insular glioma. Pre-operative fMRI revealed robust activation in the left superior temporal gyrus (Wernicke Area, WA) and in the right inferior frontal gyrus (right anatomical homolog of Broca Area, BA). Intra-operative cortical stimulation of the left inferior frontal gyrus and adjacent cortices elicited no speech deficits, and gross total resection including the expected location of BA resulted in no speech impairment. We employed statistical inference methods to reconstruct the functional brain network and determined how different brain areas connect with one another. We found that the right homolog of the BA in this patient functionally connected to the same areas as the left BA in a typical healthy control. As opposed to the functional connection of the left BA in a healthy brain, the right BA did not connect directly with the left WA, but connected indirectly, mediated by the pre-Supplementary Motor Area and the Middle Frontal Gyrus. This case illustrates that pre-surgical fMRI may be used to identify atypical hemispheric language reorganization in the presence of brain tumor and that network theory opens the possibility for future insight into the neural mechanism underlying the language reorganization.

Accurate self-calibrated fiber transfer delay measurement

An accurate self-calibrated fiber transfer delay measurement method is demonstrated. Using the simplified self-calibration configuration, the measurement uncertainty of fiber transfer delay is improved. To demonstrate the accuracy of the method, the measurement results of two systems are compared. It shows that this method achieves a sub-picosecond accuracy. Besides, the chromatic dispersion of fiber under test is also obtained, which is in agreement with the nominal value.

Accurate and fast fiber transfer delay measurement based on phase discrimination and frequency measurement

An accurate and fast fiber transfer delay measurement method is demonstrated. As a key technique, a simple ambiguity resolving process based on phase discrimination and frequency measurement is used to overcome the contradiction between measurement accuracy and system complexity. The system achieves a high measurement accuracy of 0.2 ps with a 0.1 ps measurement resolution and a large dynamic range up to 50 km as well as no dead zone.

Enhancing local luminescence in a hollow ZnO microcolumn by antiresonant reflecting

Hollow ZnO microcolumns with size induced photoluminescence and cathodoluminescence properties were prepared by a thermal chemical vapor transport and condensation method. It was found that the luminescence emission could be confined in the nano-sized hollow core and the wavelength dependent light intensity could be influenced by the geometric structure of the ZnO microcolumn, which can act as a hollow optical waveguide. Based on the antiresonant reflection in the optical waveguide, we established a theoretical model to address the field enhancement in the hollow ZnO microcolumn, which systematically clarifies the influence of the geometric structure of the microcolumn on the field enhancement. We report for the first time, the enhanced emission of the near ultraviolet light (working wavelength of 385 nm) along the axial direction of the ZnO microcolumn. The corresponding microsized light emitter has also been obtained. Experiments agree well with both theoretical predictions and computer simulations based on the finite-difference time-domain method with perfectly matched layer boundary conditions. These findings provide valuable information for the application of ZnO micro- and nanostructures in optoelectronic devices.

fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca's area

INTRODUCTION

Functional MRI (fMRI) can assess language lateralization in brain tumor patients; however, this can be limited if the primary language area-Broca's area (BA)-is affected by the tumor. We hypothesized that the middle frontal gyrus (MFG) can be used as a clinical indicator of hemispheric dominance for language during presurgical workup.

METHODS

Fifty-two right-handed subjects with solitary left-hemispheric primary brain tumors were retrospectively studied. Subjects performed a verbal fluency task during fMRI. The MFG was compared to BA for fMRI voxel activation, language laterality index (LI), and the effect of tumor grade on the LI.

RESULTS

Language fMRI (verbal fluency) activated more voxels in MFG than in BA (MFG = 315, BA = 216, p < 0.001). Voxel activations in the left-hemispheric MFG and BA were positively correlated (r = 0.69, p < 0.001). Mean LI in the MFG was comparable to that in BA (MFG = 0.48, BA = 0.39, p = 0.06). LIs in MFG and BA were positively correlated (r = 0.62, p < 0.001). Subjects with high-grade tumors demonstrate lower language lateralization than those with low-grade tumors in both BA and MFG (p = 0.02, p = 0.02, respectively).

CONCLUSION

MFG is comparable to BA in its ability to indicate hemispheric dominance for language using a measure of verbal fluency and may be an adjunct measure in the clinical determination of language laterality for presurgical planning.

Highly accurate fiber transfer delay measurement with large dynamic range

A novel and efficient method for fiber transfer delay measurement is demonstrated. Fiber transfer delay measurement in time domain is converted into the frequency measurement of the modulation signal in frequency domain, accompany with a coarse and easy ambiguity resolving process. This method achieves a sub-picosecond resolution, with an accuracy of 1 picosecond, and a large dynamic range up to 50 km as well as no measurement dead zone.

Self-trapped spatiotemporal necklace-ring solitons in the Ginzburg-Landau equation

We consider a class of self-trapped spatiotemporal solitons: spatiotemporal necklace-ring solitons, whose intensities are azimuthally periodically modulated. We reveal numerically that the spatiotemporal necklace-ring solitons carrying zero, integer, and even fractional angular momentum can be self-trapped over a huge propagation distance in the three-dimensional cubic-quintic complex Ginzburg-Landau equation, even in the presence of random perturbations.

Robust absorption broadband in one-dimensional metallic-dielectric quasi-periodic structure

We demonstrated that a broad and robust absorption band for a wide range of incidence angles and for both polarizations can be realized using a one-dimensional metallic-dielectric quasi-periodic structure, when the thickness of the constituent metal is comparable to its skin depth. The absorptance in such peculiar structure can exceed 99% to meet different applications. Furthermore, employing the effective medium approach, a theoretical expression has been deduced to instruct the working frequency of the absorption band. By tuning the permittivity and thickness of the constituent layers, the robust absorption band can cover the wavelength from the visible to the near-infrared.

Tunable sharp angular defect mode with invariant transmitted frequency range in one-dimensional photonic crystals containing negative index materials

We propose a different photonic crystal structure with a novel defect mode. In this defect mode, the transmitted angle is sharp and the pass band is of rectangular shape. Surprisingly, there is a critical refractive index of the defect layer in the crystal. By changing the refractive index in a range higher than this critical value, the sharp transmitted angle can be tuned with transmitted frequency range maintained; when the refractive index is lower than this critical value, only the transmittance of the defect mode is adjusted, with the sharp transmitted angle and transmitted frequency kept unchanged. All these phenomena provide possible mechanisms for angular filtering, optical switching (i.e., an optical switch working in the angular domain) and setting optical limits.

Formation principles of two-dimensional compound photonic lattices by one-step holographic lithography

From the view of crystallography, a systematic theoretical study on one-step formation of two-dimensional compound photonic lattices by four noncoplanar elliptical waves is presented. A general formula for the interference intensity of N elliptically polarized waves, and relevant phase shifts that compensate for the initial phases and control the relative position and size of the motifs, have been deduced. Using appropriate polarization configurations, four kinds of beam geometries can be used to form various compound lattices. This provides an ideal new experimental platform for fabricating large-area compound photonic lattices.

[The dynamic changes of NOSmRNA in endothelial cells of aortae and pulmonary arteries in rats under tail suspension]

Objective. Through the observations of dynamic changes of eNOSmRNA and iNOSmRNA in arterial endothelial cells of systematic circulation and pulmonary circulation under simulated weightlessness, to collect some data for studies of the adaptive mechanisms of local regulation in arterial systems. Method. Wistar rats were -30 degrees tail suspended to simulate the effects of weightlessness. The rats were randomly divided into three groups: control group (CON), 7-day tail suspension group (TS7) and 14-day tail suspension group (TS14). Changes of NOSmRNA expresses in endothelial cells of the thoracic aortae and pulmonary arteries were observed with in situ hybridization technique. Result. The eNOSmRNA and iNOSmRNA of thoracic aortic and pulmonary arterial endothelial cells in TS7 rats increased very significantly. The eNOSmRNA of thoracic aortic endothelial cells from TS14 rats returned to control level, but remained very significantly increased in pulmonary arteries. The iNOSmRNA in pulmonary arterial endothelial cells from TS14 rats decreased very significantly, but that in thoracic aortae returned to the control level. Conclusion. The responses of eNOSmRNA and iNOSmRNA in arterial endothelial cells of systematic circulation to tail suspension were similar, but they were different in pulmonary arterial endothelial cells, which might be due to the difference in the peak course of the shift of fluid from lower body entering the pulmonary or systematic circulation during initial period of simulated weightlessness. It could be a kind of important sign of depressed local regulative function under simulated weightlessness and might contribute to orthostatic intolerance after simulated weightlessness.

[The effect of lycium barbarum polysaccharide on vascular tension in two-kidney, one clip model of hypertension]

In the present study, the effects of lycium barbarum polysaccharide (LBP) on endothelial function in the two-kidney, one clip model of hypertension were observed. The results showed that the increase of blood pressure in hypertension rats (HR) could be prevented significantly by treatment with 10% LBP. In isolated aortic rings of LBP-treated rats, the contraction of phenylephrine (PE) was reduced as compared with HR rats. Removal of the endothelium abolished the difference of PE-induced vasoconstriction among groups. In vitro incubation of aortic rings from LBP-treated rats with methyl blue (MB) or N-nitro-L-arginine methyl ester (L-NAME) increased the magnitude of PE-induced contraction. Meanwhile the response to acetylcholine (ACh) was significantly increased in LBP-treated rats, but the response to nitroprusside had no significant difference among groups. Pretreatment with L-arginine partially restored ACh-induced relaxation in RH rats, but no effect in LBP-treated rats. These results suggested that the role of LBP in decreasing vasoconstriction to PE may be mediated by increase of the effects or/and production of endothelium-derived relaxation factor (EDRF). LBP increased formation of EDRF may be related to increase the substrate of EDRF.

[Protection of superoxide dismutase on hypoxia-reoxygenation injury to endothelial cell]

Short term hypoxia induced endothelial cells (ECs) injury, as manifested in increasing lactate dehydrogenase (LDH) release and malondialdehyde (MDA) content, decreasing nitric oxide (NO) production and antioxidant enzyme glutathione peroxidase (GSH-Px) activity and increased intracellular calcium concentration, which were further exaggerated by reoxygenation. Administration of 200 U/ml superoxide dismutase (SOD) before hypoxia could partially prevent EC from such injuries, suggesting that the presence of oxygen free radicals may be one of the main factors involved in hypoxia-reoxygenation injury. The ameliorative effect of SOD in case is obviously due to elimination of oxygen free radicals.

[Association of air pollution with unscheduled outpatient visits in Beijing Longfu Hospital, 1991]

Outpatient visits to Beijing Longfu Hospital, a community-based hospital, were analyzed to assess the association of air pollution with daily outpatient visits in 1991. Measurements of total suspended particulate (TSP) were available for 224 days (mean was 359 micrograms/m3) and sulfur dioxide (SO2) for 221 days (mean was 124 micrograms/m3). The effects of TSP and SO2 were assessed by linear regressions adjusting for temperature, humidity, seasons and the workdays as covariables with a Markov correction for auto-correlation in time series data. There was a significant exposure-response relationship between TSP level and non-surgery outpatient visits but not for surgery visits. SO2 was only significantly associated with pediatric visits.

[Integrated control of pests injuring Chinese hawthorn Crataegus pinatifida Bge. var. major N.E.Br. by nonpollution techniques]

Field experiments on integrated control of pests injuring Chinese hawthorn by some nonpollution techniques including agricultural biological and physical methods, were carried out in Xinglong County, Hebei Province during 1989-1991. Satisfactory results were obtained. Compared with synthetic pesticides, the new techniques improve the control effect by 30%-60% generally, increase the number of natural enemies by 51.26%-68.51%, and enhance the yield by 47.58%. The test shows that the hawthorns from the field treated by the new techniques are either free of pesticide residual or with a residual 500-1000 times less than the residual standard fixed by FAO/WHO or the state.

[Scavenging effect of EDTA-fluorocarbon microspheres on 210lead]

EDTA-fluorocarbon microspheres (EDTAFM), calcium disodium ethylene diaminetetraacetate (CaNa2EDTA), calcium- or zinc-diethylene triamine pentaacetate (Ca- or Zn-DTPA) were investigated for their ability to treat experimental lead intoxication in mice. The 48 ICR mice were divided into six groups. Group I = no treatment; The other groups were injected with single ip doses of 210Pb (10 mg Pb2+ +555 kBq/kg). After 24 h they were injected in the tail vein with the chelating agents (20 mg/kg) or an equal volume of 10% glucose (10 mg/kg). Each mouse was housed in one metabolic cage, and urine was collected daily for 3 d. After 3 d, the mice were sacrificed for comparison of lead distribution within the liver, kidney, femur and the entire carcass as measured by 0.047 Mev gamma emission from 210Pb. The results reveal that injection of EDTA-FM to lead poisoned mice pretreated with 210Pb was more effective than Zn- or Ca-DTPA and CaNa2EDTA in reducing the lead induced inhibition in the activity of blood ALAD, and that it increased the excretion of 210Pb into the urine. The hepatic, renal and femur 210Pb contents after treatment with EDTAFM were much more decreased than Zn- or Ca-DTPA and CaNa2-EDTA. The order of effectiveness was EDTAFM greater than Zn-DTPA greater than Ca-DTPA greater than CaNa2-EDTA.