Boyi Li

Cerebral vascular resistance and left ventricular myocardial performance in fetuses with Ebstein's anomaly.

We sought to determine whether cerebral vascular resistance and left ventricular myocardial performance (LVTei) are abnormal in fetuses with Ebsteins anomaly. The pulsatility index of the middle cerebral artery (MCAPI) and umbilical artery (UAPI), LVTei, left ventricular ejection fraction (LVEF), and fetal cardiovascular profile score in 11 fetuses with Ebsteins anomaly were evaluated by fetal echocardiography. MCAPI/UAPI values were calculated for the Ebsteins anomaly group. The control group included 44 healthy fetuses of uncomplicated pregnancies matched for gestational age (according to 1:4). MCAPI and MCAPI/UAPI were significantly lower in fetuses with Ebsteins anomaly than in controls (all P < 0.001). UAPI and LVTei were higher in fetuses with Ebsteins anomaly than in control fetuses ( P < 0.001, P < 0.05, respectively). No significant between group difference was observed for LVEF ( P > 0.05). The median cardiovascular profile score (CVPS) for the fetuses with Ebsteins anomaly (median, 7.0; interquartile range [IQR], 5.0 to 8.0) was a full point lower than for controls (median, 10.0; IQR 10.0 to 10.0). This difference was statistically significant ( P < 0.001). MCAPI and LVTei were both correlated with fetal CVPS in fetuses with Ebsteins anomaly (correlation coefficient (1) = 0.477, P < 0.05; correlation coefficient (2) = -0.602, P < 0.05). In fetuses with Ebsteins anomaly in utero, cerebral vascular resistance is decreased; global LV performance, as assessed by the Tei index, is abnormal.

Efficacy Assessment of Newly Developed Open-Window Intervention Needles for the Treatment of Cystic Thyroid Nodules That Cannot Be Aspirated

OBJECTIVE The purpose of this study was to develop a novel open-window needle aspiration method and evaluate its efficacy in drainage and sclerotherapy of cystic thyroid nodules that cannot be aspirated with an 18-gauge needle. METHODS Two rectangular windows 5.0 mm in length and 1.0 mm wide were placed at the end of the percutaneous transhepatic cholangiography (PTCA) needle trocar to develop a new open-window intervention needle. The efficiency of the open-window intervention needle was compared either to a porous interventional needle or to an ordinary PTCA needle by assessing the aspiration efficiency. The efficacy of the modified open-window approach was tested by carrying out sclerotherapy and drainage on 21 thyroid cystic nodules that could not be aspirated with an 18-gauge needle and comparing it to aspiration with an 18-gauge PTCA needle of 50 cystic thyroid nodules. RESULTS The efficacy of aspirating coupling agents of various specifications using the new open-window intervention was superior to aspiration using the PTCA trocar needle or a porous needle (p<0.05). Ethanol ablation efficacy in the treatment of 21 cystic thyroid nodules that could not be aspirated with an 18-gauge needle and the aspiration efficacy of 50 cystic thyroid nodules with an 18-gauge PTCA needle were not significantly different (p>0.05). CONCLUSION The new open-window intervention needle approach was highly effective in conducting ethanol ablation of cystic thyroid nodules that could not be aspirated using conventional methodologies.