Recovery from left ventricular dysfunction was associated with the early introduction of heart failure medical treatment in cancer patients with anthracycline-induced cardiotoxicity.

BACKGROUND: Left ventricular (LV) dysfunction due to anthracycline-induced cardiotoxicity (AIC) has been believed to be irreversible. However, this has not been confirmed and standard medical treatment for heart failure (HF) including renin-angiotensin inhibitors and ß-blockers may lead to its recovery. METHODS AND RESULTS: We thus retrospectively studied 350 cancer patients receiving anthracycline-based chemotherapy from 2001 to 2015 in our institution. Fifty-two patients (14.9%) developed AIC with a decrease in LV ejection fraction (LVEF) of 24.1% at a median time of 6 months [interquartile range (IQR) 4-22 months] after anthracycline therapy. By multivariate analysis, AIC was independently associated with cardiac comorbidities including ischemic heart disease, valvular heart disease, arrhythmia, and cardiomyopathy [odds ratio (OR) 6.00; 95% confidence interval (CI) 2.27-15.84, P = 0.00044), lower baseline LVEF (OR per 1% 1.09; 95% CI 1.04-1.14, P = 0.00034). During the median follow-up of 3.2 years, LV systolic dysfunction recovered among 33 patients (67.3%) with a median time of 4 months (IQR 2-6 months), which was independently associated with the introduction of standard medical treatment for HF (OR 9.39; 95% CI 2.27-52.9, P = 0.0014) by multivariate analysis. CONCLUSION: Early initiation of standard medical treatment for HF may lead to LV functional recovery in AIC.

[Comparison of effects of periocular region dry and wet warming on visual acuity and near reflex].

PURPOSE: To investigate the influence of warming the periocular region for 10 minutes after visual display terminal (VDT) work on the near reflex, and the differences in influence between lid closure, dry and wet warming, and the amounts of water vapor. SUBJECTS AND METHODS: Subjects in the first trial were 10 healthy volunteers (10 eyes). Following VDT, subjects wore either a warming eye steamer (water vapor: 200 mg/10 min) or an eye mask with their eyelids closed for 10 minutes. Subjects in the second trial were 5 healthy volunteers (5 eyes). Following VDT, subjects applied either a dry-warming sheet (water vapor: 0 mg/10 min) or a wet-warming sheet (water vapor: 20, 35, 160 and 200 mg/10 min) to there eyelids and the periocular region for 10 minutes. In both experiments, subjective amplitude of accommodation, pupillary reaction, convergence reaction, near vision, and breakup time were measured before and immediately after VDT work and after 2 experimental settings. RESULTS: The warming eye steamer significantly improved amplitude of accommodation (p<0.05), and near vision (p<0.05). Warming the periocular region with water vapor improved subjective amplitude of accommodation, and near vision, the effect of which depended on the amount of water vapor (p<0.05). CONCLUSIONS: Warming the periocular region with water vapor improved subjective amplitude of accommodation, near vision and the effect depended on the amount of water vapor.

Three-dimensional cholangiography applying C-arm computed tomography in bile duct carcinoma: a new radiological technique.

A C-arm equipped with a flat detector CT (C-arm CT) has been developed, which provides images with high spatial resolution that could facilitate effective 3D information during interventional procedures. The cone beam reconstructive method was applied for reconstruction of images. Time of reconstruction of 3D images was approximately one minute after the scan. The axial thin-slice images, the real-time volume rendering, maximum intensity projection, shaded surface display and multiplanner reconstruction images could be obtained from any direction in a single scan. We experienced 7 cases and present two informative cases with biliary obstruction caused by tumor that underwent C-arm CT. The First case shows gallbladder carcinoma invading the hilum. The C-arm CT provided precise images of the stenotic bile ducts that could be viewed in any direction. Multiple expandable metallic stent could be accurately placed in 3 stenotic bile ducts. The second case shows a hilar bile duct carcinoma. By using various pressure infusion of the contrast medium, severely stenotic hepatic duct was confirmed before surgery. C-arm CT provided useful information regarding the precise 3D status of the bile duct and the extent of tumor invasion.