Citations

Abstract Minimal residual disease (MRD) is an important predictor of relapse in acute lymphoblastic leukemia (ALL), but its relationship to other prognostic variables has not been fully assessed. The Children's Oncology Group studied the prognostic impact of MRD measured by flow cytometry in the peripheral blood at day 8, and in end-induction (day 29) and end-consolidation marrows in 2143 children with precursor B-cell ALL (B-ALL). The presence of MRD in day-8 blood and day-29 marrow MRD was associated with shorter event-free survival (EFS) in all risk groups; even patients with 0.01% to 0.1% day-29 MRD had poor outcome compared with patients negative for MRD patients (59% ± 5% vs 88% ± 1% 5-year EFS). Presence of good prognostic markers TEL-AML1 or trisomies of chromosomes 4 and 10 still provided additional prognostic information, but not in National Cancer Insitute high-risk (NCI HR) patients who were MRD+. The few patients with detectable MRD at end of consolidation fared especially poorly, with only a 43% plus or minus 7% 5-year EFS. Day-29 marrow MRD was the most important prognostic variable in multi-variate analysis. The 12% of patients with all favorable risk factors, including NCI risk group, genetics, and absence of days 8 and 29 MRD, had a 97% plus or minus 1% 5-year EFS with nonintensive therapy. These studies are registered at www.clinicaltrials.gov as NCT00005585, NCT00005596, and NCT00005603.

Abstract Rationale The 2002 American Thoracic Society/European Respiratory Society classification of idiopathic interstitial pneumonias identified nonspecific interstitial pneumonia (NSIP) as a provisional diagnosis. Concern was expressed that NSIP was a “wastebasket” category, difficult to distinguish from other idiopathic interstitial pneumonias. Objectives The following questions were addressed: (1) Is idiopathic NSIP a distinct entity? 2) If so, what are its clinical, radiologic and pathologic characteristics? (3) What is the role of radiology and pathology in establishing the diagnosis? (4) To make a diagnosis of idiopathic NSIP, what other disorders need to be excluded and how should this be done? Methods Investigators who had previously reported cases of idiopathic NSIP were invited to submit cases for review (n = 305). After initial review, cases with complete clinical, radiologic, and pathologic information (n = 193) were reviewed in a series of workshops. Measurements and Main Results Sixty-seven cases were identified as NSIP. Mean age was 52 years, 67% were women, 69% were never-smokers, and 46% were from Asian countries. The most common symptoms were dyspnea (96%) and cough (87%); 69% had restriction. By high-resolution computed tomography, the lower lung zones were predominantly involved in 92% of cases; 46% had a peripheral distribution; 47% were diffuse. Most showed a reticular pattern (87%) with traction bronchiectasis (82%) and volume loss (77%). Lung biopsies showed uniform thickening of alveolar walls with a spectrum of cellular to fibrosing patterns. Five-year survival was 82.3%. Conclusions Idiopathic NSIP is a distinct clinical entity that occurs mostly in middle-aged women who are never-smokers. The prognosis of NSIP is very good.

Despite percutaneous intervention after an acute coronary syndrome, patients remain at high risk for recurrent events in the first year. Prior studies have shown that a plaque rupture can occur not only at a single culprit lesion site but also in other atherosclerotic plaques throughout the coronary vasculature in patients with stable angina, silent myocardial ischemia, and during acute coronary syndromes. A 71-year-old man who presented with exertional angina and who had a successful stent in a culprit right coronary artery is described in this article. After 4 weeks, he represented with accelerated angina. A prior lesion in the obtuse marginal artery, remote from the site of the index lesion, had progressed from a 30% to 90% stenosis. This case report demonstrates the systemic nature of acute coronary syndromes, highlights the inherent instability of coronary artery disease, and supports the notion of aggressive secondary prevention in these patients.

Ultrasound vibro-acoustography is a novel medical imaging modality that combines the high resolution of high-frequency ultrasound with the speckle-free images obtained using low-frequency methods. This imaging modality relies on the non-linear interaction of two high frequency beams at slightly different frequencies. We describe the physics of ultrasound vibro-acoustography and outline a strategy for its modeling, simulation, and optimal design.

Arterial wall stiffness can be associated with various diseases. The stiffness of an artery can be assessed by measurement of the pulse wave velocity (PWV). Usually, PWV is estimated using the foot-to-foot method. However, the foot of the pressure wave is not very clear due to reflected waves. Also, the blood pressure wave generated by the heart is normally a low frequency wave, hence the time resolution is low. PWV is an average indicator of artery stiffness between two measuring locations, therefore, it is not easy to identify local stiffness. In this paper a short external pulse is generated in an artery by the radiation force of ultrasound. The propagation velocity of the pulse wave is measured along the artery. The temporal resolution of this method, which is in the range of microseconds, is much higher than the conventional pressure PWV method, and therefore allows the wave velocity to be measured accurately over a few millimeters.

MRI guided focused ultrasound (FUS) has been shown to create thermal lesions where tissue stiffness changes significantly. To assess the correlation between tissue stiffness change and tissue ablation, a pilot animal based study was conducted to treat LNCaP tumors in vivo and Hep3B tumors immediately post mortem. MR elastography was used to analyze tissue stiffness before and after ablation. Treated tissue was excised immediately after each experiment and processed by routine histological analysis. Four prostate cancer tumors and four liver cancer tumors showed, on average, a threefold increase in stiffness due to FUS thermal treatment. Histology showed complete (100%) coagulation necrosis in these cases. These data suggest that MRE may be an effective means to assess tissue ablation.

In paper, we report our recent results of using the air force ultrasound transducer to study the resonance of rubber tubes. Experiments were carried out on a rubber latex tube. Seven resonant frequencies were measured between 50 Hz and 200 Hz. Theoretical calculation of the resonant frequency on the tube was done with the wave propagation approach. The relative differences of the seven resonant frequencies between the experiment and the theory are less than 6 %. This research shows that the air force ultrasound transducer can be used for tube resonance measurement.

A custom computer-controlled rapid prototyping system was designed and developed in this research. This system for bio-manufacturing of polymer scaffolds included 3D motion control components, a nozzle, a pressure controller, and a temperature-controlled reservoir containing a biomaterial. Heating elements built into the reservoir melted the biomaterial. The pressure line attached to the reservoir provided a controllable force that extruded the polymer biomaterial through the nozzle and deposited the polymer biomaterial onto a platform to fabricate scaffolds. A low pressure (830 KPa) system was designed and fabricated to accommodate different temperatures, motion speeds, and viscosities of polymer biomaterials. The reservoir with the nozzle was mounted to servo motor-controlled linear x-y motion devices along with a third servo motor-controlled device that controlled the z-position of the platform. Poly(ε-caprolactone) [PCL] was used to fabricate scaffolds with designed structure that were used in cell and tissue regeneration studies. 3D computer-aided design (CAD) with Pro-Engineer and computational finite element analysis (FEA) programs with MSC_Patran and MSC_Marc were used to model scaffold designs with appropriate architecture and material selection. The CAD models were used in FEA to develop new methods for determining mechanical properties of tissue scaffolds of desired structure and geometry. FEA models were validated by mechanical testing and other published results. Technology developed in this research has potential for the advancement of bio-manufacturing, and design optimization of scaffolds for tissue engineering.

This article discusses the possibility of using microbubble contrast agents in the Vibro-Acoustography (VA) technique. An existing mathematical model is used to determine the interaction of encapsulated microbubbles with VA ultrasound fields. Such models may lead to a better understanding of the underlying mechanics and interactions in clinical settings.