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Lung arteriovenous malformation together with unexplained cyanosis as the initial display of genetic haemorrhagic telangiectasia, case statement, as well as novels review.
INTRODUCTION This study retrospectively evaluated outcomes and adverse radiation effects (AREs) associated with stereotactic body radiation therapy (SBRT) for canine heart base tumors (HBTs). A secondary aim was to identify any demographic or echocardiographic factors that might determine which dogs would most benefit from SBRT. ANIMALS Twenty-six dogs that received SBRT for an imaging-based diagnosis of a HBT were evaluated. METHODS Twenty-three dogs were treated with three fractions of 10 Gy delivered daily or every other day. The remaining 3 dogs received variable protocols of one to five fractions. Demographic, echocardiographic, and radiographic information, AREs, and treatment responses were collected. Correlations of these data with survival time were evaluated. RESULTS The median overall survival time was 404 days (95% confidence interval 239-554 days). The majority of dogs experienced a partial response (25%) or stable disease (60%) for a median duration of 333 days (95% confidence interval 94-526 days). Three dogs had progressive disease within six months of SBRT. Radiographic pneumonitis was identified in 7 of 23 dogs, and clinical pneumonitis was identified in 4 dogs. No other AREs were noted. The rate of distant metastasis was 13%. On multivariate analysis, it was found that vena caval obstruction, supraventricular and ventricular arrhythmias, clinical signs, and enlarged locoregional lymph nodes at presentation were negatively associated with survival time. CONCLUSIONS Stereotactic body radiation therapy was delivered with a low rate and degree of normal tissue complications. Asymptomatic dogs with confirmed, progressive growth of a HBT may most likely benefit from SBRT. BACKGROUND Hereditary angioedema (HAE) with C1-inhibitor deficiency (C1-INH-HAE) is characterized by recurrent episodes of subcutaneous/submucosal edema, which may be preceded by erythema marginatum (EM) as a prodromal symptom. Our aim was to analyze the changes occurring in the parameters of the coagulation system during the development of EM and HAE attacks. MATERIALS AND METHODS Eight C1-INH-HAE patients (1 male, 7 females, median age 41.7 years) were studied. Blood samples were obtained from all patients (during symptom-free periods, EM, and HAE attacks), as well as from 20 sex- and age-matched healthy controls. Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, D-dimer, Factor V, Factor VII, Factor X, Factor XI, and Factor XII levels were measured. RESULTS D-dimer levels were significantly lower, whereas aPTT was significantly prolonged in healthy controls vs. the values measured during the symptom-free period (p = 0.0497; p = 0.0043), in the presence of EM (p = 0.002; p = 0.0002), or during HAE attacks (p less then 0.0001; p = 0.0002). We observed the following differences between samples taken during HAE attacks vs. in symptom-free periods D-dimer levels were significantly elevated (p = 0.0391), while aPTT was significantly shorter during HAE attacks (p = 0.0159). D-dimer levels were significantly higher during EM than in symptom-free periods (p = 0.0078). Comparing the samples drawn during EM or during HAE attacks, there were no significant differences in the study parameters. CONCLUSIONS D-dimer levels were elevated during EM and this suggests that EM may be part of the HAE attack. Nevertheless, further research into the complement and kinin-kallikrein systems is needed in more patients for a better understanding of the pathomechanism of EM. Small molecule inhibitors have proven useful in the treatment of a variety of tumors, but they are often limited by unsustainable benefits and confer resistance quickly. Immunotherapy can result in durable clinical responses, but activity only occurs in a minority of patients. The unfavorable tumor microenvironment (TME) is an important factor limiting immunotherapy. An appropriate understanding of how small molecule inhibitors modulate the TME may optimize the combination of targeted treatment and immunotherapy in managing tumors. In this study, we found that transient treatment with sunitinib malate inhibited the disorganized extension of tumor vessels, pericytes and collagen IV but increased the relative ratio of pericyte-wrapping blood vessels with alleviated hypoxia in tumors, which resulted from tumor vascular normalization. Sunitinib malate increased infiltration of CD8+ T cells and decreased regulatory T cells (Tregs), accompanied by inhibited expression of TGF-β1 and IL-10 and increased CCL-28, IFN-γ and IL-12, but no significant inhibition of myeloid-derived suppressor cells (MDSCs) was observed. In addition, sunitinib malate increased the levels of PD-1 and PD-L1 in TME, combined with anti-PD-1 therapy showed a significant reduction in tumor burden compared with either monotherapy, suggesting that anti-PD-1 therapy is reasonable after sunitinib malate treatment. Seven flavonoid dimers, biflavocochins A-G, together with six known compounds were isolated from the red resins of Dracaena cochinchinensis (Chinese dragon's blood). Their structures were elucidated based on extensive spectroscopic analysis. The absolute configurations of 1-7 was assigned by experimental and quantum chemical calculated ECD spectra, and that of 4 was further established by X-ray diffraction analysis using Cu Kα radiation. Compounds 1-3 are novel dimers of homoisoflavonoid and dihydrochalcone with a unique dibenzopyran ring. Compounds 2, 6, 7 exhibited moderate PTP1B inhibitory activities in an enzyme assay. Compound 1 showed neuroprotective effect on serum deficiency-induced cellular damage in PC12 cells. In this study, using the Cu(OTf)2 catalyst, 1H-pyrazolo[1,2-b]phthalazine-5,10-dione derivative molecules were carried out in one step and with high yield (86-91%). The previously synthesized 1H-pyrazolo[1,2-b]phthalazine-5,10-dione derivatives, carbonic anhydrase I and II isozymes (hCA I and II), acetylcholinesterase (AChE), butyrylcholinesterase (BChE) and α-glycosidase (α-Gly) enzymes with Ki values in the range of 4.88-15.94 nM for hCA I, 7.04-20.83 nM for hCA II, 68.25-158.27 for AChE, 60.17-91.27 for BChE and 0.36-2.36 nM for α-Gly, respectively. In silico studies were performed on the molecules inhibiting hCA I, hCA II, AChE, BChE and α-Gly receptors. When we evaluated the data obtained in this work, we determined the inhibition type of the 1H-pyrazolo[1,2-b]phthalazine-5,10-dione derivatives at the receptors. Reference inhibitors were used for all enzymes. Various experimental investigation had proved that metal dimers possess excellent oxygen reduction reaction (ORR) activity compared to single metal atom catalysts, due to the synergistic effect exerted by two metal atoms. However, it is still unclear how the electrocatalytic activity is enhanced in a fundamental aspect. In this study, we systematically investigated five 3d transition metals (Fe, Co, Ni, Cu and Zn) by density functional theory (DFT) to explore the ability of metal dimers to catalyze the ORR. It is found that different combinations of different metal atoms have different adsorption strengths to oxygenated intermediates, which helps to screen suitable catalyst materials. The scaling relationship of the free energy of adsorption of oxygen-containing species was calculated for various metal-dimer systems. The classical volcanic diagram is derived, and it is found that the CoZnOH embedded nitrogen-doped graphene (the overpotential is 0.61 V) shows the best catalytic properties, and it is predicted that when the adsorption free energy of OH is equal to 0.95 eV, the optimal overpotential is 0.29 V. Electronic structure calculations show that the pairing of different metal atoms alters the d-band center which in turn change the adsorption properties and hence ORR catalytic performance. HYPOTHESIS It is possible to generate fairly monodisperse liquid foams by a dispersion cell, which was originally designed for the generation of fairly monodisperse emulsions. If this is the case, scaling-up the production of monodisperse liquid and solid foams will be no longer a problem. EXPERIMENTS We used the dispersion cell - a batch process - and examined the influence of stirrer speed, membrane pore diameter and injection rate on the structure of the resulting liquid foams. We used an aqueous surfactant solution as scouting system. Once the experimental conditions were known we generated gelatin-based liquid foams and methacrylate-based foamed emulsions. FINDINGS We found that (a) the bubble size of the generated liquid foams can be adjusted by varying the membrane pore diameter, (b) no stirrer should be used to obtain monodisperse foams, and (c) the bubble size is not influenced by the air injection rate. Since (i) the output for all investigated systems is up to two orders of magnitude larger compared to microfluidics and (ii) the membrane technology can very easily be scaled-up if run in a continuous process, the use of membrane foaming is expected to be heavily used for the generation of monodisperse liquid and solid foams, respectively. HYPOTHESIS Previous works have shown that many-body interactions induced by dispersants with increasing correlation length will generate a diminishing two-phase region [Soft Matter 14, 6921 (2018)]. We conjecture that the attenuation of the depletion attraction due to many-body interactions is a ubiquitous phenomenon in medium-induced interactions. We propose mixtures of colloidal particles and rod-like polymers as a feasible experimental system for verifying these predictions, since the intra-molecular correlations are not screened in a good solvent for rod-like polymers as they are in flexible polymers. click here The length of the rods can grow and become the dominant length scale that determines the range of the depletion interactions for the imbedded non-adsorbing particles. Simulations We study many-body depletion forces induced by polymerizing rod-like polymers on spherical non-adsorbing colloids, using Metropolis Monte Carlo simulations. We also employ a simple mean-field theory to further justify our numerical predictions. FINDINGS We demonstrate that the phase diagram displays the same qualitative features that have previously been predicted by many-body theory, for mixtures containing flexible polymers under theta solvent conditions. The contraction of the particle two-phase region that we observe, as the correlation length increases beyond some specific value, could be a signature of the weakening of the depletion caused by many-body effects. BACKGROUND The availability of new disease-modifying treatments (DMTs) in the last years has changed the therapeutic strategies used in Multiple Sclerosis (MS). We aimed to describe trend in DMTs utilization and persistence to treatment in a large sample of patients attending 10 MS centres from four provinces of Veneto, Italy. METHODS Demographic, clinical and DMTs information of patients regularly followed from January 2011 to August 2018 were recorded and analysed. Persistence at 12, 24 months and at last follow-up was assessed by Kaplan Meier survival analysis. Multivariable Cox- proportional hazard model was used to identify predictors of persistence. RESULTS Of 3025 MS patients 65.7% were in treatment al last follow-up. Dimethylfumarate (DMF) was the most prescribed single drug among first-line and fingolimod among second-line DMTs. In the cohort of 1391 cases starting any DMT since 2011 12.9% stopped within 6 months, 24% within 12 and 40.3% within 24 months. Disease duration > 5 years at therapy start was predictive of greater risk of discontinuation, while age and sex were not.
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