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Aim The aim of this study is to present the reliability and efficacy of Exoseal vascular closure device (EVCD) for closure of extrafemoral punctures. Materials and methods All patients who were treated with EVCD following arterial endovascular treatment involving an extrafemoral puncture between April 2013 and January 2014 were examined retrospectively. This study included 11 patients (4 women and 7 men between the ages of 48 and 87 years; average age = 65 years). A total of 13 procedures were performed in 11 patients involving the following access routes: brachial artery (n = 5), popliteal artery (n = 4), and polytetrafluoroethylene graft (n = 4). Results Twelve out of 13 EVCD procedures achieved technical success and procedural success. One minor and one major complications occurred. Both complications were revealed to be pseudoaneurysms, both in the brachial artery. Pseudoaneurysm of the minor complication was treated by Fibrin Sealant (Tisseel) injection guided by ultrasonography and the other pseudoaneurysm was treated by covered stent placement. Conclusions The femoral artery is an essential access route of arterial endovascular procedures; however, in some cases, the extrafemoral arterial route is necessary. In this study, EVCD was found to be useful for closing extrafemoral arterial routes. This study had a limited number of cases and more large-scale studies are needed.

SUMMARY OBJECTIVE: The aim of this study is to evaluate the myocardium structure in patients with chest pain who were determined to have moderate and/or high risk for cardiac ischemic heart disease (IHD) but who had normal findings on conventional coronary angiography by using native cardiac magnetic resonance imaging (CMRI) T1 mapping and comparing with healthy volunteers. METHODS: A total of 50 patients and 30 healthy volunteers who underwent CMRI were included in our prospective study. Patients whose clinical findings were compatible with stable angina pectoris, with moderate and/or high risk for IHD, but whose conventional coronary angiography was normal, were our patient group. Native T1 values were measured for 17 myocardial segments (segmented based on American Heart Association recommendations) by two radiologists independently. The data obtained were statistically compared with the sample t-test. RESULTS: Myocardial native T1 values were found to be significantly prolonged in the patient group compared with the control group (p

Objective To evaluate the association of changes in chest computed tomography (CT) lesion densities with clinical improvement in COVID‐19 patients. Methods This was a cross‐sectional analysis of hospitalised COVID‐19 patients who underwent repeated chest CT. Patients who improved clinically but showed radiological progression were included. Demographic data, presentation complaints and laboratory results were retrieved from the electronic database of the hospital. Lesion density that was measured in Hounsfield units was compred between admission and discharge chest CT scans. Results Forty patients (21 males, mean age 47.4 ± 15.1 years) were included in the analysis. The median white blood cell count and C‐reactive protein significantly decreased, whereas the median lymphocyte count significantly increased at discharge compared with the admission values. The mean density significantly reduced from admission to discharge. Conclusion This is the first study in the literature reporting reduction in chest CT lesion densities correlated with clinical and laboratory improvement in COVID‐19 patients.

BackgroundPreclinical testing of new locoregional therapies for pancreatic cancer has been challenging, due to the lack of a suitable large animal model.PurposeTo develop and characterize a porcine model of pancreatic cancer. Unlike small animals, pigs have similar physiology, drug dosing, and immune response to humans. Locoregional therapy in pigs can be performed using the same size catheters and devices as in humans.MethodsThe Oncopig is a transgenic pig with Cre-inducible TP53R167H and KRASG12D mutations. In 12 Oncopigs, CT-guided core biopsy of the pancreas was performed. The core biopsy was incubated with an adenoviral vector carrying the Cre recombinase gene. The transformed core biopsy was injected back into the pancreas (head, tail, or both). The resulting tumors (n = 19) were characterized on multi-phase contrast-enhanced CT, and on pathology, including immunohistochemistry. Angiographic characterization of the tumors was performed in 3 pigs.ResultsPancreatic tumors developed at 19 out of 22 sites (86%) that were inoculated. Average tumor size was 3.0 cm at 1 week (range: 0.5-5.1 cm). H&E and immunohistochemical stains revealed undifferentiated carcinomas, similar to those of the pancreatobiliary system in humans. Neoplastic cells were accompanied by a major inflammatory component. 1 of 12 pigs only had inflammatory nodules without evidence of neoplasia. On multiphase CT, tumors were hypovascular compared to the normal pancreas. There was no pancreatic duct dilation. In 3 pigs, angiography was performed, and in all 3 cases, the artery supplying the pancreatic tumor could be catheterized using a 2.4 F microcatheter. Selective angiography showed the pancreatic tumor, without extra-pancreatic perfusion.ConclusionPancreatic cancer can be induced in a transgenic pig. Intra-arterial procedures using catheters designed for human interventions were technically feasible in this large animal model.

Purpose To develop and characterize a porcine model of liver cancer that could be used to test new locoregional therapies. Materials and Methods Liver tumors were induced in 18 Oncopigs (transgenic pigs with Cre-inducible TP53R167H and KRASG12D mutations) by using an adenoviral vector encoding the Cre-recombinase gene. The resulting 60 tumors were characterized on multiphase contrast-enhanced CT, angiography, perfusion, micro-CT, and necropsy. Transarterial embolization was performed using 40–120 μm (4 pigs) or 100–300 μm (4 pigs) Embosphere microspheres. Response to embolization was evaluated on imaging. Complications were determined based on daily clinical evaluation, laboratory results, imaging, and necropsy. Results Liver tumors developed at 60/70 (86%) inoculated sites. Mean tumor size was 2.1 cm (range, 0.3–4 cm) at 1 week. Microscopically, all animals developed poorly differentiated to undifferentiated carcinomas accompanied by a major inflammatory component, which resembled undifferentiated carcinomas of the human pancreatobiliary tract. Cytokeratin and vimentin expression confirmed epithelioid and mesenchymal differentiation, respectively. Lymph node, lung, and peritoneal metastases were seen in some cases. On multiphase CT, all tumors had a hypovascular center, and 17/60 (28%) had a hypervascular rim. After transarterial embolization, noncontrast CT showed retained contrast medium in the tumors. Follow-up contrast-enhanced scan showed reduced size of tumors after embolization using either 40–120 μm or 100–300 μm Embosphere microspheres, while untreated tumors showed continued growth. Conclusions Liver tumors can be induced in a transgenic pig and can be successfully treated using bland embolization.

Objectives The objective of this study was to evaluate chest CT outcomes during the treatment of 50 coronavirus disease 2019 (COVID-19) patients treated in Turkey who presented with symptoms such as fever, cough, and dyspnea, and to analyze these results in line with the current literature. Methods Patients' demographic data such as age and gender, symptoms on admission, contact history, comorbidities, and PCR and CT outcomes were recorded and analyzed. In CT examinations, laterality, the presence of consolidation and/or ground-glass opacities (GGO), and central and/or peripheral distribution were analyzed. In addition, segmental analysis was performed with CT results. Results In CT scans, involvement was found at the right lung in 10 (20%) patients and left lung in 1 (2%) patient, whereas bilateral involvement was found in 39 (78%) patients. Peripheral distribution was found in 18 (36%) patients and central + peripheral distribution in 28 (56%) patients. Density of the lesions was GGO in 44 (88%), whereas consolidation + GGO was found in 6 (12%) patients. The mean number of involved segments was 6.92 +/- 6.74 (min-max: 1-20). There was a significant correlation between the involvement of the R3 segment and fever (r = 0.288; p = 0.042). Conclusions Typical COVID-19 patterns on chest CT were GGO, bilateral involvement, peripheral, and central + peripheral distribution. Our results indicate that chest CT may be helpful in diagnosing the disease and monitoring its progression. However, since clinical pictures of COVID-19 may differ, CT outcomes should be carefully interpreted. WOS:000535174200007

WOS: 000442202100030, PubMed ID: 30125303, Purpose Previously, fluorodeoxy glucose conjugated magnetite nanoparticles (FDG-mNPs) injected into cancer cells in conjunction with the application of magnetic hyperthermia have shown promise in new FDG-mNPs applications. The aim of this study was to determine potential toxic or unwanted effects involving both tumour cells and normal tissue in other organs when FDG-mNPs are administered intravenously or intratumourally in mice. Materials and methods FDG-mNPs were synthesized. A group of six prostate-tumour bearing mice were injected with 23.42 mg/ml FDG-mNPs (intravenous injection, n = 3; intratumoural injection into the prostate tumour, n = 3). Mice were euthanized and histological sampling of tissue was conducted for the prostate tumour, as well as for lungs, lymph nodes, liver, kidneys, spleen, and brain, at 1 hour (n = 2) and 7 days (n = 4) post-injection. A second group of two normal (non-cancerous) mice received the same injection intravenously into the tail vein and were euthanised at 3 and 6 months post-injection, respectively, to investigate if FDG-mNPs remained in organs at those time points. Results In prostate-tumour bearing mice, FDG-mNPs concentrated in the prostate tumour, while relatively small amounts were found in the organs of other tissues, particularly the spleen and the liver; FDG-mNP concentrations decreased over time in all tissues. In normal mice, no detrimental effects were found in either mouse at 3 or 6 months. Conclusion Intravenous or intratumoural FDG-mNPs can be safely administered for effective cancer cell destruction. Further research on the clinical utility of FDG-mNPs will be conducted by applying hyperthermia in conjunction with FDG-mNPs in mice., Memorial Sloan Kettering Cancer Centre, Department of Radiology; NIH/NCI Cancer Center Support Grant [P30 CA008748]; NIH Small-Animal Imaging Research Program (SAIRP)United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [R24 CA83084]; NIH Prostate SPORE [P50-CA92629]; Ege University, Institute of Nuclear Sciences, Department of Nuclear Applications, Turkey; School of Engineering and Applied Science, Aston University, Birmingham, UK; Division of Vascular & Endovascular Surgery Department of Cardiac, Thoracic & Vascular Surgery National University Heart Centre, Singapore, This research was funded by Memorial Sloan Kettering Cancer Centre, Department of Radiology, and the NIH/NCI Cancer Center Support Grant P30 CA008748, NIH Small-Animal Imaging Research Program (SAIRP), R24 CA83084; NIH Prostate SPORE, P50-CA92629; Ege University, Institute of Nuclear Sciences, Department of Nuclear Applications, 35100 Turkey; School of Engineering and Applied Science, Aston University, Birmingham, UK, B4 7E and Mr Julian Wong FRCS, Division of Vascular & Endovascular Surgery Department of Cardiac, Thoracic & Vascular Surgery National University Heart Centre, Singapore 1E Kent Ridge Road NUHS Tower Block, Level 9, Singapore 119228.; This research was funded by Memorial Sloan Kettering Cancer Centre, Department of Radiology, and the NIH/NCI Cancer Center Support Grant P30 CA008748, NIH Small-Animal Imaging Research Program (SAIRP), R24 CA83084; NIH Prostate SPORE, P50-CA92629; Ege University, Institute of Nuclear Sciences, Department of Nuclear Applications, 35100 Turkey; School of Engineering and Applied Science, Aston University, Birmingham, UK, B4 7E and Mr Julian Wong FRCS, Division of Vascular & Endovascular Surgery Department of Cardiac, Thoracic & Vascular Surgery National University Heart Centre, Singapore 1E Kent Ridge Road NUHS Tower Block, Level 9, Singapore 119228. The authors would like to thank the staff at Aston University's Biomedical research unit for animal provision and maintenance. The authors also would like to acknowledge Charlotte Bland and the Aston Research Centre for Healthy Ageing (ARCHA) imaging facility for their assistance with our tissue analysis studies.

Purpose: Urinary stones are common and can be diagnosed with computed tomography (CT) easily. In this study, we aimed to specify the opacity characteristics of various types of calcified foci that develop through the urinary system by using an image analysis program. With this method, we try to differentiate the calculi from the non-calculous opacities and also we aimed to present how to identify the characteristic features of renal and ureteral calcules. Materials and methods: We obtained the CT studies of the subjects (n = 48, mean age = 41 years) by using a dual source CT imaging system. We grouped the calculi detected in the dual-energy CT sections as renal (n = 40) or ureteric (n = 45) based on their locations. Other radio-opaque structures that were identified outside but within close proximity of the urinary tract were recorded as calculi "mimickers". We used ImageJ program for morphological analysis. All the acquired data were analyzed statistically. Results: According to thorough morphological parameters, there were statistically significant differences in the angle and Feret angle values between calculi and mimickers (p < 0.001). Multivariate logistical regression analysis showed that Minor Axis and Feret angle parameters can be used to distinguish between ureteric (p = 0.003) and kidney (p = 0.001) stones. Conclusions: Computer-based morphologic parameters can be used simply to differentiate between calcular and noncalcular densities on CT and also between renal and ureteric stones. Yıldırım, D., Öztürk, Ö., Tutar, O. (ve diğerleri...) (2014), A New Method For Computer-Assisted Detection, Definition And Differentiation Of The Urinary Calculi, Birleşik Krallık: Taylor & Francis.

Intussusception is the most frequent complication of Peutz–Jeghers Syndrome (PJS), but usually seen in child age. It is a predictable, but infrequent complication in adults with PJS. However, there is no report about intussusception in pregnancy period secondary to Peutz–Jeghers (PJ) polyps in the literature. In this paper, we present a rare intussusception case in a pregnant woman with PJS, which was diagnosed with magnetic resonance imaging, and discuss this condition with a brief literature review.