scholarly journals Optical Imaging Technology: A Useful Tool to Identify Remission in Cushing Disease After Surgery

2019 ◽  
Vol 51 (02) ◽  
pp. 120-126 ◽  
Author(s):  
Ali Afshari ◽  
Margaret Keil ◽  
Charalampos Lyssikatos ◽  
Elena Belyavskaya ◽  
Nuria Valdés ◽  
...  
Keyword(s):  
Optical Imaging ◽  
Water Content ◽  
Blood Volume ◽  
Volume Fraction ◽  
Cushing Syndrome ◽  
Specific Area ◽  
Treatment Modalities ◽  
Cushing Disease ◽  
Imaging Technology ◽  
Before And After

AbstractWe recently reported the use of optical imaging technology to quantify facial plethora in endogenous Cushing syndrome (CS). In the present study, we studied a larger cohort of patients with Cushing disease (CD) and examined water content fraction as well as blood volume fraction as bio-optic markers for determining the efficacy of this methodology as a predictor of lasting remission after surgery for CS. We imaged 49 patients before and after transsphenoidal surgery (TSS) for Cushing disease (CD); 22 patients were also seen at 3–6 months, and 13 patients 12 months post-operatively. On all patients, we used multi-spectral imaging (MSI) to evaluate hemodynamic distributions as well as water content at a specific area of the face. We found a decrease in blood volume fraction after vs. before surgical treatment in the tested facial area in 37 of the 40 patients, as determined with biochemical markers (p<0.001). All patients that were followed up for up to 12 months showed the same decrease from preoperative values and they remained in remission from CD. We conclude that MSI can be used for the evaluation of remission from CD, at least in the immediate post-operative period and up to one year after surgery. The use of this technology can supplement biochemical and other testing for the evaluation of the various treatment modalities available for patients with CD.

scholarly journals Correction: Optical Imaging Technology: A Useful Tool to Identify Remission in Cushing Disease After Surgery

2019 ◽  
Vol 51 (02) ◽  
pp. e1-e1
Author(s):  
Ali Afshari ◽  
Margaret Keil ◽  
Charalampos Lyssikatos ◽  
Elena Belyavskaya ◽  
Nuria Valdés ◽  
...  
Keyword(s):  
Optical Imaging ◽  
Cushing Disease ◽  
Imaging Technology

scholarly journals The use of microbubbles as contrast agents in the optical imaging of tissue

2021 ◽  
Author(s):  
Homa Assadi
Keyword(s):  
Optical Properties ◽  
Contrast Agents ◽  
Optical Imaging ◽  
Contrast Enhancement ◽  
Blood Volume ◽  
Volume Fraction ◽  
Repeated Administration ◽  
Skin Tissue ◽  
Surrounding Water ◽  
Tissue Phantom

In this study, micrometer-sized (< 5μm) microbubbles (MBs) were investigated as optical contrast agents. Exogenous contrast agents in optical imaging can enhance the detection of cancerous tissue, however they are limited by their potential side effects such as organ accumulation and toxicity with repeated administration. In ultrasound imaging, microbubbles are FDA approved and used clinically as contrast agents. Microbubbles can also produce a refractive index mismatch between the gas-filled core and surrounding water media, potentially modifying optical properties of tissue when injected intravenously into tissue. Cancer detection can potentially be achieved by imaging microvasculature functionality through the blood volume fraction measurements with diffuse optical imaging (DOI). In order to study the potential application of using MBs for DOI, the effect of MBs on the bulk optical properties of a skin tissue phantom solution at various volume fraction of human blood was assessed at various injection doses of Definity® microbubble. The absorption and reduced scattering coefficients were computed and compared in the absence and presence of microbubbles. The presence of microbubbles in the blood caused a statistically significant enhancement in the reduced scattering contrast (~1.3 times) at 660 nm wavelength which increases with the dose of Definity® MBs (166 μL/kg) at 6% blood volume fraction. However, the absorption contrast enhancement remained relatively constant as microbubble dose increased. The scattering contrast enhancement confirmed the feasibility of using MBs as DOI contrast agents to improve the detection of tissue with high blood concentration conditions. Microbubbles were also investigated as optical coherence tomography (OCT) contrast agents. OCT structural and speckle variance (sv) images, as well as the speckle decorrelation times, were evaluated under no-flow and flow conditions from a skin tissue phantom with two embedded microtubes. Faster decorrelation times and greater structural and svOCT image contrasts were detected with the presence of MBs. The effects of the presence of MBs on the image contrast were maximal (2 times) at no flow in the svOCT imaging mode and reduced with blood average flow velocity from zero to 12 mm/s. This result confirmed the feasibility of using MBs to enhance svOCT visualization of microvasculature morphology.

scholarly journals The use of microbubbles as contrast agents in the optical imaging of tissue

2021 ◽  
Author(s):  
Homa Assadi
Keyword(s):  
Optical Properties ◽  
Contrast Agents ◽  
Optical Imaging ◽  
Contrast Enhancement ◽  
Blood Volume ◽  
Volume Fraction ◽  
Repeated Administration ◽  
Skin Tissue ◽  
Surrounding Water ◽  
Tissue Phantom

In this study, micrometer-sized (< 5μm) microbubbles (MBs) were investigated as optical contrast agents. Exogenous contrast agents in optical imaging can enhance the detection of cancerous tissue, however they are limited by their potential side effects such as organ accumulation and toxicity with repeated administration. In ultrasound imaging, microbubbles are FDA approved and used clinically as contrast agents. Microbubbles can also produce a refractive index mismatch between the gas-filled core and surrounding water media, potentially modifying optical properties of tissue when injected intravenously into tissue. Cancer detection can potentially be achieved by imaging microvasculature functionality through the blood volume fraction measurements with diffuse optical imaging (DOI). In order to study the potential application of using MBs for DOI, the effect of MBs on the bulk optical properties of a skin tissue phantom solution at various volume fraction of human blood was assessed at various injection doses of Definity® microbubble. The absorption and reduced scattering coefficients were computed and compared in the absence and presence of microbubbles. The presence of microbubbles in the blood caused a statistically significant enhancement in the reduced scattering contrast (~1.3 times) at 660 nm wavelength which increases with the dose of Definity® MBs (166 μL/kg) at 6% blood volume fraction. However, the absorption contrast enhancement remained relatively constant as microbubble dose increased. The scattering contrast enhancement confirmed the feasibility of using MBs as DOI contrast agents to improve the detection of tissue with high blood concentration conditions. Microbubbles were also investigated as optical coherence tomography (OCT) contrast agents. OCT structural and speckle variance (sv) images, as well as the speckle decorrelation times, were evaluated under no-flow and flow conditions from a skin tissue phantom with two embedded microtubes. Faster decorrelation times and greater structural and svOCT image contrasts were detected with the presence of MBs. The effects of the presence of MBs on the image contrast were maximal (2 times) at no flow in the svOCT imaging mode and reduced with blood average flow velocity from zero to 12 mm/s. This result confirmed the feasibility of using MBs to enhance svOCT visualization of microvasculature morphology.

An Empirical Study on the Operative Treatment of Symptomatic Urolithiasis in Germany

2021 ◽  
pp. 1-7
Author(s):  
Alina Reicherz ◽  
Rüveyde Sahin ◽  
Lorine Häuser ◽  
Joachim Noldus ◽  
Peter Bach
Keyword(s):  
Response Rate ◽  
Intraoperative Complications ◽  
Nationwide Survey ◽  
Treatment Modalities ◽  
European Guidelines ◽  
Operative Care ◽  
Double J Stent ◽  
Before And After ◽  
Related Group ◽  
Ureteral Stenting

<b><i>Purpose:</i></b> The guidelines of the German, European, and American Urological Associations on urolithiasis advise against general ureteral stenting before and after an uncomplicated ureterorenoscopy (URS). However, German and European guidelines state that stenting prior to URS facilitates stone extraction and reduces intraoperative complications. According to the published literature, German practice seems to deviate from recommendations. This nationwide survey aimed to evaluate the treatment modalities of urolithiasis. <b><i>Methods:</i></b> In November 2018 and March 2019, a total of 199 urological hospital departments in Germany were anonymously surveyed about operative care of symptomatic urolithiasis. The response rate was 72.9%. The survey consisted of 25 questions about diagnostics, surgical technique, and aftercare of the URS. This questionnaire is available in the appendix. <b><i>Results:</i></b> A primary URS is performed in ≤10% in 49.6% of the hospitals. In every second urological department (49.7%), the German Diagnosis Related Group (G-DRG) system influences the period of pre-stenting before a secondary URS. After a secondary URS, which is performed in 53.8% of the departments in over 80% of the patients, 14% of the departments omit stenting. The standard for stenting seems to be a 28-cm-long 7 Charrière double-J stent in Germany. <b><i>Conclusion:</i></b> In Germany, the percentage of primary URS is low, and a ureter stenting is performed in most of the urological departments after URS. Delaying therapy due to economic aspects is the standard in almost half of all urological departments.

scholarly journals How Stereological Analysis of Vascular Morphology Can Quantify the Blood Volume Fraction as a Marker for Tumor Vasculature: Comparison with Magnetic Resonance Imaging

2011 ◽  
Vol 32 (3) ◽  
pp. 489-501 ◽  
Author(s):  
Adriana T Perles-Barbacaru ◽  
Boudewijn PJ van der Sanden ◽  
Regine Farion ◽  
Hana Lahrech
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rat Brain ◽  
Blood Volume ◽  
Volume Fraction ◽  
Three Dimensional ◽  
Simulated Data ◽  
Tumor Model ◽  
Tumor Vasculature ◽  
Resonance Imaging

To assess angiogenesis noninvasively in a C6 rat brain tumor model, the rapid-steady-state- T1 (RSST1) magnetic resonance imaging (MRI) method was used for microvascular blood volume fraction (BVf) quantification with a novel contrast agent gadolinium per (3,6 anhydro) α-cyclodextrin (Gd-ACX). In brain tissue contralateral to the tumor, equal BVfs were obtained with Gd-ACX and the clinically approved gadoterate meglumine (Gd-DOTA). Contrary to Gd-DOTA, which leaks out of the tumor vasculature, Gd-ACX was shown to remain vascular in the tumor tissue allowing quantification of the tumor BVf. We sought to confirm the obtained tumor BVf using an independent method: instead of using a ‘standard’ two-dimensional histologic method, we study here how vascular morphometry combined with a stereological technique can be used for three-dimensional assessment of the vascular volume fraction ( VV). The VV is calculated from the vascular diameter and length density. First, the technique is evaluated on simulated data and the healthy rat brain vasculature and is then applied to the same C6 tumor vasculature previously quantified by RSST1-MRI with Gd-ACX. The mean perfused VV and the BVf obtained by MRI in tumor regions are practically equal and the technique confirms the spatial heterogeneity revealed by MRI.

Soil water dynamics after fire in a Portuguese shrubland

2006 ◽  
Vol 15 (1) ◽  
pp. 99 ◽  
Author(s):  
Joaquim S. Silva ◽  
Francisco C. Rego ◽  
Stefano Mazzoleni
Keyword(s):  
Water Content ◽  
Soil Water ◽  
Plant Community ◽  
Root Distribution ◽  
Control Plot ◽  
The Other ◽  
Water Dynamics ◽  
Soil Water Dynamics ◽  
Surface Layers ◽  
Before And After

This paper presents a study where soil water content (SW) was measured before and after an experimental fire in a shrubland dominated by Erica scoparia L. in Portugal. Two plots were established: one was kept as a control plot and the other was burned by an experimental fire in June 2001. Measurements were taken before fire (2000), and after fire (2001, 2002, and 2003) at six depths down to 170 cm, from June to December. Measurements before fire allowed comparison of the two plots in terms of the SW differential, using 2000 as a reference. Results for 2001 showed that SW decreased less during the drying season (June–September) and increased more during the wetting season (October–December) in the burned plot than in the control plot. The magnitude of these effects decreased consistently in 2002 and 2003, especially at surface layers. The maximum gain of SW for the total profile in the burned plot was estimated as 105.5 mm in 2001, 70.2 mm in 2002, and 35.6 mm in 2003. The present paper discusses the mechanisms responsible for the increase in SW taking into account the characteristics of the plant community, including the root distribution, and the results of other studies.

Increase of dermal blood volume fraction reduces the threshold for laser-induced purpura: Implications for port wine stain laser treatment

2004 ◽  
Vol 34 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Lars O. Svaasand ◽  
Guillermo Aguilar ◽  
John A. Viator ◽  
Lise L. Randeberg ◽  
Sol Kimel ◽  
...  
Keyword(s):  
Laser Treatment ◽  
Blood Volume ◽  
Volume Fraction ◽  
Port Wine Stain ◽  
Port Wine

scholarly journals Mifepristone as Bridge or Adjunct Therapy in the Management of Challenging Cushing Disease Cases

2021 ◽  
Vol 14 ◽  
pp. 117955142199410
Author(s):  
Alice Y Chang ◽  
Sasan Mirfakhraee ◽  
Elizabeth E King ◽  
Jennifer U Mercado ◽  
Diane M Donegan ◽  
...  
Keyword(s):  
Cushing Syndrome ◽  
Severe Disease ◽  
Disease Recurrence ◽  
Adjunctive Treatment ◽  
Therapeutic Trial ◽  
Cushing Disease ◽  
The Us ◽  
Clinical Benefits ◽  
Effects Of Radiation ◽  
Bridge Therapy

Establishing a definitive diagnosis of Cushing disease (CD), given its clinical and biochemical heterogeneity, initiating effective treatment to control the effects of hypercortisolism, and managing recurrence are challenging disease aspects to address. Mifepristone is a competitive glucocorticoid receptor antagonist that is approved in the US by the Food and Drug Administration to control hyperglycemia secondary to endogenous hypercortisolism (Cushing syndrome) in patients who have glucose intolerance or type 2 diabetes mellitus and have failed surgery or are not candidates for surgery. Herein, we describe 6 patients with CD who received mifepristone as adjunct/bridge therapy in the following clinical settings: to assess clinical benefits of treatment for suspected recurrent disease, to control hypercortisolism preoperatively for severe disease, to control hypercortisolism during the COVID-19 pandemic, and to provide adjunctive treatment to radiation therapy. The patients were treated at multiple medical practice settings. Mifepristone treatment in each of the described cases was associated with clinical improvements, including improvements in overall glycemia, hypertension, and weight loss. In addition, in one case where biochemical and radiological evidence of disease recurrence was uncertain, clinical improvement with mifepristone pointed toward likely disease recurrence. Adverse events associated with mifepristone reported in the 6 cases were consistent with those previously reported in the pivotal trial and included cortisol withdrawal symptoms, antiprogesterone effects (vaginal bleeding), hypothyroidism (treated with levothyroxine), and hypokalemia (treated with spironolactone). These cases show how mifepristone can potentially be utilized as a therapeutic trial in equivocal cases of CD recurrence; as a presurgical treatment strategy, particularly during the COVID-19 pandemic; and as bridge therapy, while awaiting the effects of radiation.

Adrenal Hypertension

2017 ◽  
Author(s):  
Naomi D.L. Fisher ◽  
Gail K Adler
Keyword(s):  
Myocardial Infarction ◽  
Adrenal Glands ◽  
Cushing Syndrome ◽  
Rare Tumor ◽  
Cushing Disease ◽  
Increased Risk ◽  
Aldosterone Production ◽  
Artery Disease ◽  
Secondary Causes ◽  
Adrenal Hypertension

The secondary causes of hypertension are associated with the excess of the principal hormones produced by the adrenal glands: cortisol, epinephrine, and aldosterone. Excess aldosterone production is recognized as primary hyperaldosteronism, or primary aldosteronism (PA). Individuals with PA are at increased risk for a variety of disorders, including atrial fibrillation, coronary artery disease, myocardial infarction, and stroke. Pheochromocytoma is a very rare tumor (accounting for fewer than one in 10,000 hypertension cases) and is marked by high secretions of catecholamines, mostly epinephrine as well as norepinephrine. Cushing disease and Cushing syndrome are addressed in a separate review. This review contains 5 highly rendered figures, 4 tables, and 39 references.

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