In Vitro and In Vivo Behaviour of Four Different 99(m)Tc-HEDP Complexes

According to absorption spectra, at least four different 99Tc-HEDP complexes [complex I (colorless), complex II (yellow), complex III (pink-red) and complex IV (brown)] were observed under various labeling conditions. Both pH and Sn (II)-HEDP concentration greatly influenced the formation of these complexes. In acidic or neutral media, complex II was the main product while in alkaline media complex III and complex IV were formed below concentration levels of 1 x 10–3M of Sn (II) and of 3x 10–3M of HEDP. At high Sn (II)-HEDP concentrations complexes I and II were formed, while complexes III and IV were found at lower Sn (II)-HEDP concentrations in weak alkaline media. All four 99(m)Tc-HEDP complexes were stable against air oxidation until at least 6 hrs after preparation. Complexes I and II were stable against dilution by distilled water, while complexes III and IV were unstable and readily dissociated. In organ distribution studies high soft-tissue uptakes were observed with complexes III and IV, while complexes I and II had high bone-seeking properties.

Robotic-assisted multivisceral resection for rectal cancer: short-term outcomes at a single center

BACKGROUND

The safety and feasibility of robotic-assisted multivisceral resection for locally advanced rectal cancer remain unclear. The aim of this study was to assess the short-term outcomes of this procedure at our institution.

METHODS

From December 2011 to December 2016, patients who underwent robotic-assisted multivisceral resection for rectal cancer were investigated. Patient demographics, treatment characteristics, perioperative outcomes, and pathological results were evaluated retrospectively.

RESULTS

There were 31 patients; 17 men (54.8%) and 14 women (45.2%), with a median age of 65 years (range 40-82 years). Twenty-one patients (67.7%) had a cT4 tumor, 9 patients (29.0%) had a pT4b tumor, and all patients except one (96.8%) underwent complete resection of the primary tumor with negative resection margins. Eleven patients (35.5%) received neoadjuvant chemoradiation. The most commonly resected organ was the vaginal wall (n = 12, 38.7%), followed by the prostate (n = 10, 32.3%). Lateral lymph node dissection was performed in 20 patients (64.5%). The median operative time was 394 min (range 189-549 min), and the median blood loss was 41 mL (range 0-502 mL). None of the patients received intraoperative blood transfusions or required conversion to open. Overall, postoperative complications occurred in 11 patients (35.5%). The most frequent complication was urinary retention (n = 5, 16.1%), and none of the patients developed serious complications classified as Clavien-Dindo grades III-V.

CONCLUSIONS

Robotic-assisted multivisceral resection for rectal cancer is safe and technically feasible.

Monitoring of hemostatic abnormalities in major orthopedic surgery patients treated with edoxaban by APTT waveform

INTRODUCTION

An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out.

METHODS

The APTT waveform was analyzed in the above patients to monitor edoxaban administration.

RESULTS

Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications. The peak times of acceleration, velocity, and 1/2 fibrin formation were significantly prolonged after the administration of edoxaban, especially in patients with massive bleeding, and were moderately correlated with the anti-Xa activity. While the heights of velocity and acceleration peak 2 were lower in patients receiving warfarin treatment than in those receiving edoxaban, the widths of these parameters were significantly longer. The height of 1/2 fibrin formation and the width of acceleration peaks 1 and 2 and the velocity were significantly increased after the administration of edoxaban.

CONCLUSION

The peak time of the APTT waveform was significantly prolonged after the administration of edoxaban. The analysis of the APTT waveform may therefore be useful for the prediction of the risk of massive bleeding.