Facile design of autogenous stimuli-responsive chitosan/hyaluronic acid nanoparticles for efficient small molecules to protein delivery.

Easily assembled and biocompatible chitosan/hyaluronic acid nanoparticles with multiple stimuli-responsive ability are ideally suited for efficient delivery of therapeutic agents under specific endogenous triggers. We report a simple and versatile strategy to formulate oxidative stress and pH-responsive chitosan/hyaluronic acid nanocarriers with high encapsulation efficiencies of small drug molecules and nerve growth factor protein. This is achieved through invoking the dual role of a thioketal-based weak organic acid to disperse and functionalize low molecular weight chitosan in one-pot. Thioketal embedded chitosan/hyaluronic acid nanostructures respond to oxidative stress and show controlled release of quercetin, curcumin and NGF. Lowering the pH in the buffer solution led to higher quercetin release from NPs than at physiological pH, and mimicked the nanoparticle behavior in the environment of early to late endosomes. Curcumin and quercetin loaded NPs killed glioblastoma cells with high efficiency, and NGF-loaded nanoparticles retained biological activity of the protein and increased peripheral nerve outgrowth in explanted mouse dorsal root ganglia.

PEG-conjugated pyrrole-based polymers: one-pot multicomponent synthesis and self-assembly into soft nanoparticles for drug delivery.

Polyethylene glycol grafted pyrrole-based conjugated polymers are synthesized through a one-pot multicomponent methodology, the self-assemblies of which enable nanoparticle size-selective encapsulation of drug molecules and their sustained release. Efficient loading of curcumin through drug-nanoparticle core interactions is probed using FRET, and the inherently fluorescent nature of polypyrrole could be used to detect these nanocarriers intracellularly.

Initial single center experience: radiofrequency ablation assisted vertebroplasty and osteoplasty using a bipolar device in the palliation of bone metastases.

BACKGROUND: To assess the safety and clinical outcomes of bipolar radiofrequency ablation (RFA) assisted vertebroplasty (VP) and osteoplasty (OP) in pathological and insufficiency fractures. The insufficiency fractures were in patients who sustained demineralization secondary to cancer treatment. METHODS: Patients referred for symptomatic malignant or insufficiency fractures for VP or OP from January 2011 to May 2015 were retrospectively reviewed. Bipolar RFA was performed (Osteocool RF ablation system, Baylis Medical) reaching a constant temperature of 70 ℃ over 7 to 15 minutes followed by cement injection. Clinical outcomes were evaluated by review of the electronic medical record (EMR). Radiological outcomes were assessed with CT. Pre and post procedural pain scores were also documented for the RFA subset, primarily to see if there were any adverse effects when using RFA on pain relief. RESULTS: Twenty-six patients in the study were treated with the RFA assisted technique. These contributed to 4 OPs and 35 VP levels. Of these four VP levels were insufficiency fractures. All were technically successful without morbidity or mortality. Fifty-six patients were treated with a non RFA assisted technique. All these were VPs and 142 levels were treated in total. Two levels in this subset were insufficiency fractures. All were technically successful without morbidity or mortality. There was a significantly reduced rate of posterior and venous cement leaks when RFA was used prior to VP. There was no difference in the rate of leakage into the disc spaces when comparing RFA assisted to the conventional technique. Pain scores in the RFA assisted group decreased significantly post procedure with no unanticipated neuropathic events. CONCLUSIONS: RFA assisted VP and OP using a bipolar device is safe and allows for controlled injection of cement into a preformed thermal cavity with a significant decrease in venous and posterior cement leaks. Rate of cement leakage into the disc spaces was unaffected.

Case 234: Neuropathic Spondyloarthropathy.

History A 70-year-old woman presented to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. The patient also reported acute on chronic onset of thoracolumbar back pain over a period of 24 hours. She denied any history of recent trauma or intravenous drug use. She did not have any long-term indwelling catheters. The patient's medical history was also complicated by stage 4 renal failure from long-standing type II diabetes, hypertension, iron deficiency anemia, aortic stenosis, and prior bariatric surgery. The patient was not undergoing dialysis for her renal dysfunction, nor was she receiving steroids for COPD. On clinical examination, she was afebrile and tachypneic. Although she was not amenable to a full neurologic examination, she reported subjective leg weakness. There were no localizing signs or evidence of myelopathy. Perianal sensation and rectal tone were preserved. Pulmonary examination revealed wheezes and decreased basilar air entry. The patient's white blood cell count was 6.8 × 10(9)/L. Her blood chemistry was normal, aside from an elevated blood creatinine level of 158 mmol/L. Her erythrocyte sedimentation rate was elevated at 56 mm/h, and her C-reactive protein level was normal at 4.4 mg/L (41.9 nmol/L). Chest radiographs showed mild pulmonary edema with a small right pleural effusion. The patient was transferred to our facility for evaluation of findings on thoracic spine radiographs obtained at a peripheral hospital. Unenhanced thoracic spine magnetic resonance (MR) imaging was performed first and was followed by computed tomography (CT) to further delineate the findings. The patient's renal status precluded intravenous contrast material administration.

Overview of Conventional Imaging-based Intervention in Clinical Practice.

This article presents an overview of image-guided interventions using conventionally available imaging modalities. It discusses technical and clinical aspects of the interventions, and also focuses on site-specific biopsies such as liver, spleen, renal, and soft tissue biopsies in the abdomen. It briefly discusses the emerging role of PET imaging and other technologies that will improve the diagnostic yield of image-guided biopsies.

Is quality and completeness of reporting of systematic reviews and meta-analyses published in high impact radiology journals associated with citation rates?

PURPOSE: The purpose of this study is to determine whether study quality and completeness of reporting of systematic reviews (SR) and meta-analyses (MA) published in high impact factor (IF) radiology journals is associated with citation rates. METHODS: All SR and MA published in English between Jan 2007-Dec 2011, in radiology journals with an IF >2.75, were identified on Ovid MEDLINE. The Assessing the Methodologic Quality of Systematic Reviews (AMSTAR) checklist for study quality, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for study completeness, was applied to each SR & MA. Each SR & MA was then searched in Google Scholar to yield a citation rate. Spearman correlation coefficients were used to assess the relationship between AMSTAR and PRISMA results with citation rate. Multivariate analyses were performed to account for the effect of journal IF and journal 5-year IF on correlation with citation rate. Values were reported as medians with interquartile range (IQR) provided. RESULTS: 129 studies from 11 journals were included (50 SR and 79 MA). Median AMSTAR result was 8.0/11 (IQR: 5-9) and median PRISMA result was 23.0/27 (IQR: 21-25). The median citation rate for SR & MA was 0.73 citations/month post-publication (IQR: 0.40-1.17). There was a positive correlation between both AMSTAR and PRISMA results and SR & MA citation rate; ρ=0.323 (P=0.0002) and ρ=0.327 (P=0.0002) respectively. Positive correlation persisted for AMSTAR and PRISMA results after journal IF was partialed out; ρ=0.243 (P=0.006) and ρ=0.256 (P=0.004), and after journal 5-year IF was partialed out; ρ=0.235 (P=0.008) and ρ=0.243 (P=0.006) respectively. CONCLUSION: There is a positive correlation between the quality and the completeness of a reported SR or MA with citation rate which persists when adjusted for journal IF and journal 5-year IF.

Association of study quality with completeness of reporting: have completeness of reporting and quality of systematic reviews and meta-analyses in major radiology journals changed since publication of the PRISMA statement?

PURPOSE: To evaluate whether completeness of reporting of systematic reviews and meta-analyses in major radiology journals has changed since publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement; a secondary objective is to evaluate whether completeness of reporting (ie, PRISMA) is associated with study quality (ie, Assessing the Methodological Quality of Systematic Reviews [AMSTAR]). MATERIALS AND METHODS: Systematic reviews and meta-analyses published in major radiology journals between January 2007 and December 2011 were identified by searching MEDLINE with the modified Montori method. Studies were reviewed independently by two investigators and assessed for adherence to the AMSTAR and PRISMA checklists. The average results were analyzed to assess for change in mean score before and after PRISMA publication and to assess results over time; a Pearson correlation coefficient was calculated to assess for any association between PRISMA and AMSTAR results. RESULTS: Included were 130 studies from 11 journals. Average PRISMA and AMSTAR results were 21.8 of 27 and 7.2 of 11, respectively. The average result was higher after publication of PRISMA, and PRISMA-reported items were 22.6 of 27 after publication of PRISMA versus 20.9 of 27 before publication of PRISMA; AMSTAR results were 7.7 of 11 after publication of PRISMA versus 6.7 of 11 before publication of PRISMA. There was a strong positive correlation (r = 0.86) between the PRISMA and AMSTAR results. There was high variability between journals. Radiology had the highest PRISMA reported items (24.7 of 27), and American Journal of Neuroradiology had the lowest (19.6 of 27). Two major areas for improvement include study protocol registration and assessment of risk of bias across studies (ie, publication bias). CONCLUSION: In major radiology journal studies, there was modest improvement in completeness of reporting of systematic reviews and meta-analyses, assessed by PRISMA, which was strongly associated with higher study quality, assessed by AMSTAR. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13130273/-/DC1.

Progressive neurolymphomatosis with cutaneous disease: response in a patient with mycosis fungoides.

Peripheral neurolymphomatosis is a rare manifestation of advanced lymphoproliferative disorders. It is often associated with B cell lymphomas and rarely with cutaneous T cell lymphomas, such as mycosis fungoides and Sézary syndrome. In this case report, we present a 78-year-old male with a long-standing history of mycosis fungoides. The patient initially presented with chronic peripheral neuropathy in an ulnar nerve distribution. After an unsuccessful ulnar nerve transposition, the ulnar nerve was re-explored and a mass consistent with diffuse lymphomatous infiltration was diagnosed. Magnetic resonance (MR) imaging of the left brachial plexus and later of the sacral plexus demonstrated diffuse thickening and peripheral nodularity in keeping with neurolymphomatosis. The patient's clinical course rapidly deteriorated thereafter and the patient succumbed to his disease. Although uncommon, neurolymphomatosis may be considered in patients with chronic peripheral neuropathy and an underlying history of a lymphoproliferative disorder. US and MR may serve as helpful non-invasive adjuncts in making the diagnosis and identifying sites for biopsy.