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Luo H, Liu S, Huang W, Lei Y, Xing Y, Wesemann L, Luo B, Li W, Hu J, Tian Y. A comparison of the postoperative outcomes between intraoperative leak testing and no intraoperative leak testing for gastric cancer surgery: a systematic review and meta-analysis. Surg Endosc 2024; 38:1709-1722. [PMID: 38413470 DOI: 10.1007/s00464-024-10715-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Postoperative anastomotic leakage (PAL) is a serious complication of gastric cancer surgery. Although perioperative management has made considerable progress, anastomotic leakage (AL) cannot always be avoided. The purpose of this study is to evaluate whether intraoperative leak testing (IOLT) can reduce the incidence of PAL and other postoperative outcomes in gastric cancer surgery. MATERIALS AND METHODS In this meta-analysis, we searched the PubMed, Embase, and Cochrane Library databases for clinical trials to assess the application of IOLT in gastric cancer surgery. All patients underwent laparoscopic radical gastrectomy for gastric cancer surgery. Studies comparing the postoperative outcomes of IOLT and no intraoperative leak testing (NIOLT) were included. Quality assessment, heterogeneity, risk of bias, and the level of evidence of the included studies were evaluated. PAL, anastomotic-related complications, 30-day mortality, and reoperation rates were compared between the IOLT and NIOLT group. RESULTS Our literature search returned 721 results, from which six trials (a total of 1,666 patients) were included in our meta-analysis. Statistical heterogeneity was low. The primary outcome was PAL. IOLT reduced the incidence of PAL [2.09% vs 6.68%; (RR = 0.31, 95% Cl 0.19-0.53, P < 0.0001]. Anastomotic-related complications, which included bleeding, leakage, and stricture, were significantly higher in the NIOLT group than in the IOLT group [3.24% VS 10.85%; RR = 0.30, 95% Cl 0.18-0.53, P < 0.0001]. Moreover, IOLT was associated with lower reoperation rates [0.94% vs 6.83%; RR = 0.18, 95% CI 0.07-0.43, P = 0.0002]. CONCLUSION Considering the observed lower incidence of postoperative anastomotic leakage (PAL), anastomotic-related complications, and reoperation rates, IOLT appears to be a promising option for gastric cancer surgery. It warrants further study before potential inclusion in future clinical guidelines.
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Affiliation(s)
- Heng Luo
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
| | - Shunying Liu
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
- Department of Dermatology, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Wentao Huang
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
- Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Yu Lei
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
| | - Yan Xing
- Department of Science &Technology with Teaching, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, China
| | - Luke Wesemann
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Binyu Luo
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
| | - Wenjing Li
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Yunhong Tian
- Department of General Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University), Nanchong, 637000, Sichuan, China.
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Shi RY, Wu R, Ran J, Tang LL, Wesemann L, Hu J, Du L, Zhang WJ, Xu JR, Zhou Y, Zhao L, Pu J, Wu LM. Fractal analysis of left ventricular trabeculae in post-STEMI: from acute to chronic phase. Insights Imaging 2024; 15:75. [PMID: 38499900 PMCID: PMC10948656 DOI: 10.1186/s13244-024-01641-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/09/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE The temporal evolution of ventricular trabecular complexity and its correlation with major adverse cardiovascular events (MACE) remain indeterminate in patients presenting with acute ST elevation myocardial infarction (STEMI). METHODS This retrospective analysis enrolled patients undergoing primary percutaneous coronary intervention (pPCI) for acute STEMI, possessing cardiac magnetic resonance (CMR) data in the acute (within 7 days), subacute (1 month after pPCI), and chronic phases (6 months after pPCI) from January 2015 to January 2020 at the three participating sites. Fractal dimensions (FD) were measured for the global, infarct, and remote regions of left ventricular trabeculae during each phase. The potential association of FD with MACE was analyzed using multivariate Cox regression. RESULTS Among the 200 analyzed patients (182 men; median age, 61 years; age range, 50-66 years), 37 (18.5%) encountered MACE during a median follow-up of 31.2 months. FD exhibited a gradual decrement (global FD at acute, subacute, and chronic phases: 1.253 ± 0.049, 1.239 ± 0.046, 1.230 ± 0.045, p < 0.0001), with a more pronounced decrease observed in patients subsequently experiencing MACE (p < 0.001). The global FD at the subacute phase correlated with MACE (hazard ratio 0.89 (0.82, 0.97), p = 0.01), and a global FD value below 1.26 was associated with a heightened risk. CONCLUSION In patients post-STEMI, the global FD, serving as an indicator of left ventricular trabeculae complexity, independently demonstrated an association with subsequent major adverse cardiovascular events, beyond factors encompassing left ventricular ejection fraction, indexed left ventricular end-diastolic volume, infarct size, heart rate, NYHA class, and post-pPCI TIMI flow. CRITICAL RELEVANCE STATEMENT In patients who have had an ST-segment elevation myocardial infarction, global fractal dimension, as a measure of left ventricular trabeculae complexity, provided independent association with subsequent major adverse cardiovascular event. KEY POINTS • Global and regional FD decreased after STEMI, and more so in patients with subsequent MACE. • Lower global FD at the subacute phase and Δglobal FD from acute to subacute phase were associated with subsequent MACE besides clinical and CMR factors. • Global FD at the subacute phase independently correlated with MACE and global FD value below 1.26 was associated with higher risk.
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Affiliation(s)
- Ruo-Yang Shi
- Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China
- Jiading Branch, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Wu
- Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China
| | - Jinjun Ran
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lang-Lang Tang
- Department of Radiology, Longyan First Hospital of Fujian Medical University, Long Yan, Fu Jian, China
| | - Luke Wesemann
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Liang Du
- Shanghai Robotics Institute, Shanghai University, Shanghai, China
| | - Wei-Jun Zhang
- School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-Rong Xu
- Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China
| | - Yan Zhou
- Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China
| | - Lei Zhao
- Department of Radiology, An Zhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China.
| | - Jun Pu
- Department of Cardiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China.
| | - Lian-Ming Wu
- Department of Radiology, School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai, 200127, China.
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Jiang WY, Chen BH, Zhang C, Shi RY, Wu R, An DA, Ma XH, Wesemann L, Hu J, Zhou Y, Xu JR, Zhao L, Wu LM. Fractal analysis in cardiovascular magnetic resonance: prognostic value of biventricular trabecular complexity in hypertrophic cardiomyopathy. Cardiovasc Diagn Ther 2023; 13:1030-1042. [PMID: 38162100 PMCID: PMC10753232 DOI: 10.21037/cdt-23-162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/02/2023] [Indexed: 01/03/2024]
Abstract
Background Trabecular complexity can be quantified by fractal analysis based on cine images of cardiovascular magnetic resonance (CMR), yielding fractal dimension (FD) index. We aimed to investigate the prognostic value of biventricular FD in patients with hypertrophic cardiomyopathy (HCM). Methods This retrospective study included 284 (192 men, median age 53 years) patients with HCM who underwent CMR, with median follow-up of 24 months. Biventricular trabeculae complexity was quantified as FD using short-axis cine images. The primary end point included sudden cardiac death (SCD) events. The secondary end point included both SCD events and rehospitalization due to heart failure. Cox regressions were performed. Prediction models were established by adding ventricular FDs to ESC predictors and late gadolinium enhancement (LGE) percentage and the C indices were calculated. Results Cox regressions revealed that left ventricular (LV) maximal apical FD (HR range 1.114-1.133; all P<0.05) and right ventricular (RV) global FD (HR range 1.135-1.150; all P<0.05) were significant prognostic factors of both end points after adjustment for the European Society of Cardiology (ESC) predictors (age, maximum LV wall thickness, LV atrial size, peak left ventricular outflow tract (LVOT) gradient, family history of SCD, unexplained syncope, non-sustained ventricular tachycardia), and LGE percentage. The prediction model with the addition of biventricular FDs (C-index: 0.864-0.877) had the best performance. Conclusions LV maximal apical FD and RV global FD were independent predictors of SCD events and rehospitalization due to heart failure in patients with HCM. The addition of biventricular FDs to the conventional prediction model contributed incremental prognosis value in HCM.
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Affiliation(s)
- Wen-Yi Jiang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bing-Hua Chen
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chen Zhang
- Department of Interventional Diagnosis and Therapy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Ruo-Yang Shi
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Rui Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dong-Aolei An
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiao-Hai Ma
- Department of Interventional Diagnosis and Therapy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Luke Wesemann
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Yan Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jian-Rong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Zhao
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Lian-Ming Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Chen BH, Wu CW, An DA, Zhang JL, Zhang YH, Yu LZ, Watson K, Wesemann L, Hu J, Chen WB, Xu JR, Zhao L, Feng C, Jiang M, Pu J, Wu LM. A deep learning method for the automated assessment of paradoxical pulsation after myocardial infarction using multicenter cardiac MRI data. Eur Radiol 2023; 33:8477-8487. [PMID: 37389610 DOI: 10.1007/s00330-023-09807-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/12/2023] [Accepted: 03/26/2023] [Indexed: 07/01/2023]
Abstract
OBJECTIVE The current study aimed to explore a deep convolutional neural network (DCNN) model that integrates multidimensional CMR data to accurately identify LV paradoxical pulsation after reperfusion by primary percutaneous coronary intervention with isolated anterior infarction. METHODS A total of 401 participants (311 patients and 90 age-matched volunteers) were recruited for this prospective study. The two-dimensional UNet segmentation model of the LV and classification model for identifying paradoxical pulsation were established using the DCNN model. Features of 2- and 3-chamber images were extracted with 2-dimensional (2D) and 3D ResNets with masks generated by a segmentation model. Next, the accuracy of the segmentation model was evaluated using the Dice score and classification model by receiver operating characteristic (ROC) curve and confusion matrix. The areas under the ROC curve (AUCs) of the physicians in training and DCNN models were compared using the DeLong method. RESULTS The DCNN model showed that the AUCs for the detection of paradoxical pulsation were 0.97, 0.91, and 0.83 in the training, internal, and external testing cohorts, respectively (p < 0.001). The 2.5-dimensional model established using the end-systolic and end-diastolic images combined with 2-chamber and 3-chamber images was more efficient than the 3D model. The discrimination performance of the DCNN model was better than that of physicians in training (p < 0.05). CONCLUSIONS Compared to the model trained by 2-chamber or 3-chamber images alone or 3D multiview, our 2.5D multiview model can combine the information of 2-chamber and 3-chamber more efficiently and obtain the highest diagnostic sensitivity. CLINICAL RELEVANCE STATEMENT A deep convolutional neural network model that integrates 2-chamber and 3-chamber CMR images can identify LV paradoxical pulsation which correlates with LV thrombosis, heart failure, ventricular tachycardia after reperfusion by primary percutaneous coronary intervention with isolated anterior infarction. KEY POINTS • The epicardial segmentation model was established using the 2D UNet based on end-diastole 2- and 3-chamber cine images. • The DCNN model proposed in this study had better performance for discriminating LV paradoxical pulsation accurately and objectively using CMR cine images after anterior AMI compared to the diagnosis of physicians in training. • The 2.5-dimensional multiview model combined the information of 2- and 3-chamber efficiently and obtained the highest diagnostic sensitivity.
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Affiliation(s)
- Bing-Hua Chen
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China
| | - Chong-Wen Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China
| | - Dong-Aolei An
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China
| | | | | | - Ling-Zhan Yu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China
| | - Kennedy Watson
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Luke Wesemann
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, 48201, USA
| | | | - Jian-Rong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China
| | - Lei Zhao
- Department of Radiololgy, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China
| | - ChaoLu Feng
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, No.195, Chuangxin Road, Hunnan District, Shenyang, 110819, Liaoning, China.
| | - Meng Jiang
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China.
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China.
| | - Lian-Ming Wu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No.160 PuJian Road, Shanghai, 200127, China.
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Klag EA, Lizzio VA, Charters MA, Ayoola AS, Wesemann L, Banka TR, North WT. Increased Accuracy in Templating for Total Knee Arthroplasty Using 3D Models Generated from Radiographs. J Knee Surg 2022. [PMID: 35240715 DOI: 10.1055/s-0042-1743496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Templating prior to total hip arthroplasty is a widely adopted practice that aims to improve operative efficiency and reduce clinical outliers. Predicting implant size before total knee arthroplasty (TKA), although less common, could increase operating room efficiency by reducing necessary equipment needed for the procedure. This study compared templating accuracy in TKA using two-dimensional (2D) digital radiographs to a novel imaging technology that generates a three-dimensional (3D) model from these 2D radiographs. Two hundred and two robotic-assisted primary TKA surgical cases using Persona Knee System (Zimmer Biomet, Warsaw, IN) were retrospectively analyzed. For all cases, 3D templating was completed preoperatively using a novel radiographic image acquisition protocol. Using the same radiographs, the knee was templated using a 2D digital templating program. All surgeons were blinded to the final implant sizes, and all templating was done independently. The accuracy of predictions within ± 1 from the final implant size was determined for the femoral and tibial components. The accuracy (within 1 size) of tibial size predictions was comparable between attending surgeons and residents (87 vs. 82%, p = 0.08), but attending surgeons more accurately predicted the femoral size (77 vs. 60%, p < 0.05). The 2D to 3D imaging technology more accurately predicted both tibial and femoral sizes compared with the attending surgeons (99.5 vs. 87%, p < 0.05; 84% vs. 77%, p < 0.05). However, the imaging technology, attending surgeons, and residents were all more likely to overestimate femur size (p < 0.05). Moreover, the 3D imaging technology predicted the exact tibial component size in 93.1% of cases, which was significantly greater compared with residents (40%, p < 0.01) and attending surgeons (53%, p < 0.01). The 2D to 3D imaging technology more accurately predicted tibial and femoral component sizes compared with 2D digital templating done by surgeons. All templating predictions were more accurate for the tibial implant size than for the femoral size. The increased accuracy of implant size predictions from this 3D templating technology has the potential to improve intraoperative efficiency and minimize costs and surgical time.
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Affiliation(s)
- Elizabeth A Klag
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
| | - Vincent A Lizzio
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
| | - Michael A Charters
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
| | | | - Luke Wesemann
- Wayne State University School of Medicine, Detroit, Michigan
| | - Trevor R Banka
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
| | - W Trevor North
- Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
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Zhou H, Wei Y, An DA, Ni Z, Xu J, Fang W, Lu R, Ying L, Chen B, Jin H, Huang J, Yao Q, Wesemann L, Wu LM, Mou S. Myocardial Iron Deficiency Quantification and Effective Cardiac Iron Management Strategy Exploration evaluated by Cardiac T2* Mapping in End-Stage Renal Disease Patients. Acad Radiol 2021; 28:e101-e109. [PMID: 32402784 DOI: 10.1016/j.acra.2020.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore myocardial iron content using Cardiac T2* Mapping in dialysis patients undergoing oral iron therapy or intravenous iron supplements compared to healthy controls. METHODS Fifty-nine dialysis patients, including 30 peritoneal dialysis (PD) patients who underwent oral iron therapy, 29 hemodialysis (HD) dialysis patients who underwent intravenous iron supplements, and 30 healthy controls were included in the study. Cardiac MRI, including cine, T2 stir, and T2* mapping, was conducted at 3.0T. Quantitive T2* mapping, Cine imaging analysis was performed by two radiologists using cvi42. RESULTS The global cardiac T2* value was higher in dialysis patients than in healthy controls (27.1 ± 6.29 ms versus 24.6 ± 3.60 ms, p< 0.05). The global cardiac T2* value of PD patients was higher than that of HD patients (28.5 ± 4.30 ms versus 25.x7 ± 3.54 ms, p< 0.05). The anteroseptal cardiac T2* value was higher in PD patients than in healthy controls (32.0 ± 4.49 ms versus 27.8 ± 4.02 ms, p< 0.05). The global T2* value negatively correlated with left ventricular ejection fraction (LVEF), peak radial strain, circumferential strain, and longitudinal strain. CONCLUSION Our study confirmed that PD patients have myocardial iron deficiency despite undergoing oral iron therapy compared to HD patients who received intravenous iron treatments. And the Cardiac T2* value was found to be an independent risk factor and predictor of LVEF and left ventricular altered mechanics. Intravenous iron supplements may be an effective cardiac iron management strategy in patients with HD-dependent end-stage renal disease.
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Zhou H, An DA, Ni Z, Xu J, Fang W, Lu R, Ying L, Huang J, Yao Q, Li D, Chen B, Shen J, Jin H, Wei Y, Hu J, Fahmy LM, Wesemann L, Qi S, Wu LM, Mou S. Texture Analysis of Native T1 Images as a Novel Method for Noninvasive Assessment of Uremic Cardiomyopathy. J Magn Reson Imaging 2021; 54:290-300. [PMID: 33604934 DOI: 10.1002/jmri.27529] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Noncontrast cardiac T1 times are increased in dialysis patients which might indicate fibrotic alterations in uremic cardiomyopathy. PURPOSE To explore the application of the texture analysis (TA) of T1 images in the assessment of myocardial alterations in dialysis patients. STUDY TYPE Case-control study. POPULATION A total of 117 subjects, including 22 on hemodialysis, 44 on peritoneal dialysis, and 51 healthy controls. FIELD STRENGTH A 3 T, steady-state free precession (SSFP) sequence, modified Look-Locker imaging (MOLLI). ASSESSMENT Two independent, blinded researchers manually delineated endocardial and epicardial borders of the left ventricle (LV) on midventricular T1 maps for TA. STATISTICAL TESTS Texture feature selection was performed, incorporating reproducibility verification, machine learning, and collinearity analysis. Multivariate linear regressions were performed to examine the independent associations between the selected texture features and left ventricular function in dialysis patients. Texture features' performance in discrimination was evaluated by sensitivity and specificity. Reproducibility was estimated by the intraclass correlation coefficient (ICC). RESULTS Dialysis patients had greater T1 values than normal (P < 0.05). Five texture features were filtered out through feature selection, and four showed a statistically significant difference between dialysis patients and healthy controls. Among the four features, vertical run-length nonuniformity (VRLN) had the most remarkable difference among the control and dialysis groups (144 ± 40 vs. 257 ± 74, P < 0.05), which overlap was much smaller than Global T1 times (1268 ± 38 vs. 1308 ± 46 msec, P < 0.05). The VRLN values were notably elevated (cutoff = 170) in dialysis patients, with a specificity of 97% and a sensitivity of 88%, compared with T1 times (specificity = 76%, sensitivity = 60%). In dialysis patients, VRLN was significantly and independently associated with left ventricular ejection fraction (P < 0.05), global longitudinal strain (P < 0.05), radial strain (P < 0.05), and circumferential strain (P < 0.05); however, T1 was not. DATA CONCLUSION The texture features obtained by TA of T1 images and VRLN may be a better parameter for assessing myocardial alterations than T1 times. LEVEL OF EVIDENCE 4 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Hang Zhou
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dong-Aolei An
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaohui Ni
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianrong Xu
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Fang
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Renhua Lu
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liang Ying
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaying Huang
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiuying Yao
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dawei Li
- Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Binghua Chen
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianxiao Shen
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haijiao Jin
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuehan Wei
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, Michigan, USA
| | - Lara M Fahmy
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Luke Wesemann
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Shouliang Qi
- Sino-Dutch Biomedical and Information Engineering School of Northeastern University, Shenyang, Liaoning, China
| | - Lian-Ming Wu
- Department of Radiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Krebs KM, Freitag S, Maudrich JJ, Schubert H, Sirsch P, Wesemann L. Coordination chemistry of stannylene-based Lewis pairs – insertion into M–Cl and M–C bonds. From base stabilized stannylenes to bidentate ligands. Dalton Trans 2018; 47:83-95. [DOI: 10.1039/c7dt04044j] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The coordination chemistry of intramolecular stannylene phosphorus Lewis pairs incorporated into four or three membered ring molecules is presented.
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Affiliation(s)
- K. M. Krebs
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
| | - S. Freitag
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
| | - J.-J. Maudrich
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
| | - H. Schubert
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
| | - P. Sirsch
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
| | - L. Wesemann
- Institut für Anorganische Chemie
- Universität Tübingen
- 72076 Tübingen
- Germany
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9
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Sabatos-Peyton CA, Nevin J, Brock A, Venable JD, Tan DJ, Kassam N, Xu F, Taraszka J, Wesemann L, Pertel T, Acharya N, Klapholz M, Etminan Y, Jiang X, Huang YH, Blumberg RS, Kuchroo VK, Anderson AC. Blockade of Tim-3 binding to phosphatidylserine and CEACAM1 is a shared feature of anti-Tim-3 antibodies that have functional efficacy. Oncoimmunology 2017; 7:e1385690. [PMID: 29308307 DOI: 10.1080/2162402x.2017.1385690] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/21/2017] [Accepted: 09/24/2017] [Indexed: 01/07/2023] Open
Abstract
Both in vivo data in preclinical cancer models and in vitro data with T cells from patients with advanced cancer support a role for Tim-3 blockade in promoting effective anti-tumor immunity. Consequently, there is considerable interest in the clinical development of antibody-based therapeutics that target Tim-3 for cancer immunotherapy. A challenge to this clinical development is the fact that several ligands for Tim-3 have been identified: galectin-9, phosphatidylserine, HMGB1, and most recently, CEACAM1. These observations raise the important question of which of these multiple receptor:ligand relationships must be blocked by an anti-Tim-3 antibody in order to achieve therapeutic efficacy. Here, we have examined the properties of anti-murine and anti-human Tim-3 antibodies that have shown functional efficacy and find that all antibodies bind to Tim-3 in a manner that interferes with Tim-3 binding to both phosphatidylserine and CEACAM1. Our data have implications for the understanding of Tim-3 biology and for the screening of anti-Tim-3 antibody candidates that will have functional properties in vivo.
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Affiliation(s)
- Catherine A Sabatos-Peyton
- Exploratory Immuno-oncology, Novartis Institutes for BioMedical Research, 250 Massachusetts Avenue, Cambridge, MA, USA
| | - James Nevin
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Ansgar Brock
- Department of Biotherapeutics and Biotechnology, Genomics Institute of the Novartis Research Foundation, 10675 John Jay Hopkins Dr., San Diego, CA, USA
| | - John D Venable
- Department of Biotherapeutics and Biotechnology, Genomics Institute of the Novartis Research Foundation, 10675 John Jay Hopkins Dr., San Diego, CA, USA
| | - Dewar J Tan
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Nasim Kassam
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Fangmin Xu
- Analytical Sciences, Novartis Institutes for BioMedical Research, 250 Massachusetts Avenue, Cambridge, MA
| | - John Taraszka
- Analytical Sciences, Novartis Institutes for BioMedical Research, 250 Massachusetts Avenue, Cambridge, MA
| | - Luke Wesemann
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Thomas Pertel
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Nandini Acharya
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Max Klapholz
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Yassaman Etminan
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Xiaomo Jiang
- Exploratory Immuno-oncology, Novartis Institutes for BioMedical Research, 250 Massachusetts Avenue, Cambridge, MA, USA
| | - Yu-Hwa Huang
- Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Richard S Blumberg
- Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Vijay K Kuchroo
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Ana C Anderson
- Evergrande Center for Immunologic Diseases and Ann Romney Center for Neurologic Diseases, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
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10
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Krebs KM, Maudrich JJ, Wesemann L. Reaction of stannylene phosphorus Lewis pairs with dichlorides of germanium, tin and lead - the formation of base stabilized stannyl stannylenes/germylenes and redox reaction with PbCl2. Dalton Trans 2017; 45:8081-8. [PMID: 27077483 DOI: 10.1039/c6dt00916f] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The reaction of intramolecular stannylene phosphorus Lewis pairs with heavier dichlorides of group 14 (GeCl2, SnCl2, PbCl2) is reported. Phosphine base stabilized stannyl germylenes/stannylenes were formed by the oxidative addition of an E-Cl bond to the stannylene tin atom (E = Ge, Sn). In solution, a dynamic equilibrium between two diastereomeric configurations was observed. With PbCl2 a redox reaction towards elemental lead and the dichlorinated tin(iv) compound was found. All compounds were characterized by X-ray diffraction, NMR spectroscopy and elemental analysis.
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Affiliation(s)
- K M Krebs
- Institut für Anorganische Chemie, Universität Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany.
| | - J-J Maudrich
- Institut für Anorganische Chemie, Universität Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany.
| | - L Wesemann
- Institut für Anorganische Chemie, Universität Tübingen, Auf der Morgenstelle 18, 72076 Tübingen, Germany.
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11
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Abstract
The reaction of a terphenyl tin(ii) compound bearing an η3 coordinating allyl ligand with adamantyl phosphaalkyne is reported.
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Affiliation(s)
- K. M. Krebs
- Institut für Anorganische Chemie
- 72076 Tübingen
- Germany
| | - J. Jamin
- Institut für Anorganische Chemie
- 72076 Tübingen
- Germany
| | - L. Wesemann
- Institut für Anorganische Chemie
- 72076 Tübingen
- Germany
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12
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Abstract
A bidentate diphenylphosphino substituted diazaborole ligand was obtained and coordinated at platinum and iridium.
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Affiliation(s)
- H. Schubert
- Institute of Inorganic Chemistry
- University of Tübingen
- 72076 Tübingen, Germany
| | - W. Leis
- Institute of Inorganic Chemistry
- University of Tübingen
- 72076 Tübingen, Germany
| | - H. A. Mayer
- Institute of Inorganic Chemistry
- University of Tübingen
- 72076 Tübingen, Germany
| | - L. Wesemann
- Institute of Inorganic Chemistry
- University of Tübingen
- 72076 Tübingen, Germany
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13
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Marx T, Wesemann L, Dehnen S, Pantenburg I. Stannaborate transition metal chemistry: ligand properties, reactivity, and density functional theory calculations of platinum and palladium complexes. Chemistry 2001; 7:3025-32. [PMID: 11495429 DOI: 10.1002/1521-3765(20010716)7:14<3025::aid-chem3025>3.0.co;2-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Three stannaborate complexes of platinum(II) and a novel stannoborate palladium(II) derivative have been prepared in excellent yield. The tin transition metal bond is formed through nucleophilic substitution and the resulting complexes [Bu3MeN] [trans-[(Et3P)2Pt(SnB11H11)H]] (6), [trans-[(Et3P)2Pt(SnB11H11)(CNtBu)]] (7), [Bu3MeN]2[trans-[(Et3P)2Pt(SnB11H11)2-(CNtBu)]] (8), and [Bu3MeN][(dppe)-Pd(SnB11H11)Me] (12) (dppe = 1,2-bis-(diphenylphosphanyl)ethane) were characterized by NMR spectroscopy and elemental analysis. In the cases of the zwitterion 7, the pentacoordinated complex 9, the palladium salt 12 and [(triphos)Pt(SnB11H11)] (10) (triphos = 1,1,1-tris(diphenylphosphanylmethyl)ethane), their solid-state structures are determined by X-ray crystal structure analyses. The trans influence of the [SnB11H11] ligand is evaluated from the results of the IR spectroscopy and X-ray crystallographic structures of complexes 6, 7, and 12. The dipole moment of the zwitterion 7 is calculated by density functional theory (DFT) methods. The alignment of the dipole moments of the polar molecules 7 and 12 in the solid state is discussed.
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Affiliation(s)
- T Marx
- Institut für Anorganische Chemie Universität zu Köln, Germany
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14
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Wesemann L, Ramjoie Y, Wagner T. A new silyl substituted arachno-tetraborane(8) derivative. INORG CHEM COMMUN 1998. [DOI: 10.1016/s1387-7003(98)00118-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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15
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