Distribution on MR images was compared with
the results of pathologic analysis. Forty additional in vivo monopolar RFAs were performed in paraspinal muscles of seven minipigs after animal care committee approval (10 standard control ablations, 30 were preceded Fludarabine in vitro by direct injection of saturated NaCl at various volumes [3-9 mL] and rates [1 or 6mL/min]). Postablation low-field-strength (n = 20) and high-field-strength (n = 20) MR examinations consisted of T2-weighted imaging, short inversion time inversion-recovery (STIR) imaging, and contrast material-enhanced T1-weighted imaging. Ablation shape, conspicuity, volume, and signal intensity were compared between the two groups and with the results of pathologic analysis. The difference in volumes with and PLX4032 without NaCl injection was evaluated by using two-way analysis of variance.
Results: Mean CNR was highest on fast spin-echo T2-weighted images and was significantly higher for PSIF than for FISP (P < .0001) or true FISP (P = .003). NaCl distribution on MR images corresponded with the results of pathologic analysis in ex vivo livers. Interactive in vivo monitoring of NaCl injection and electrode placement was feasible. NaCl-enhanced ablations had irregular shapes, a higher CNR, and significantly larger volumes (F = 22.0; df = 1, 90; P < .00001). All ablations had intermediate
or low signal intensity with high-signal-intensity rims on all images. Fluid signals overlaid NaCl-enhanced ablations on fast spin-echo T2-weighted and STIR images, particularly on high-field-strength MR images.
Conclusion: MR imaging can be used to reliably monitor the distribution of injected NaCl solution in tissues. Interventional MR imaging techniques can be used to guide and monitor RFAs within NaCl pretreated tissues, with good correlation
with pathologic results.”
“Dietary therapies are established as beneficial for ERK signaling pathway inhibitor symptomatic generalized epilepsies such as Lennox-Gastaut syndrome; however, the outcome for idiopathic generalized epilepsy has never been specifically reported. The efficacy of the ketogenic and modified Atkins diet for childhood and juvenile absence epilepsy was evaluated from both historical literature review and patients treated at Johns Hopkins Hospital. Upon review of 17 published studies in which absence epilepsy was included as a patient subpopulation, approximately 69% of 133 with clear outcomes patients who received the ketogenic diet had a > 50% seizure reduction, and 34% of these patients became seizure free. At Johns Hopkins Hospital, the ketogenic diet (n = 8) and modified Atkins diet (n = 13) led to similar outcomes, with 18 (82%) having a > 50% seizure reduction, of which 10 (48%) had a > 90% seizure reduction and 4 (19%) were seizure free.