Notes

Time within? A novel way of anastomotic biliary strictures.
It is well known that stochastically modeled reaction networks that are complex balanced admit a stationary distribution that is a product of Poisson distributions. In this paper, we consider the following related question supposing that the initial distribution of a stochastically modeled reaction network is a product of Poissons, under what conditions will the distribution remain a product of Poissons for all time? By drawing inspiration from Crispin Gardiner's "Poisson representation" for the solution to the chemical master equation, we provide a necessary and sufficient condition for such a product-form distribution to hold for all time. Interestingly, the condition is a dynamical "complex-balancing" for only those complexes that have multiplicity greater than or equal to two (i.e. the higher order complexes that yield non-linear terms to the dynamics). We term this new condition the "dynamical and restricted complex balance" condition (DR for short).OBJECTIVE To report the technique of hydrodissection of the sub-diaphragmatic bare area of the liver, in order to protect the diaphragm/heart during percutaneous thermal ablation (PTA) of sub-cardiac hepatic tumours. MATERIALS AND METHODS Between January 2016 and December 2018, five patients (four female, one male; mean age 56.2 years) with five sub-cardiac liver tumours (two hepatocellular carcinoma, three metastases; mean size 39 mm) abutting the bare area (segments II/IVA) with expected ablation zones ≤ 5 mm from the myocardium were treated with PTA and adjunctive hydrodissection. Time to perform hydrodissection, distance between superior hepatic and diaphragmatic/pericardial surfaces before and after hydrodissection, ablation efficacy, complications, and local tumour progression (LTP) at last imaging follow-up were recorded. RESULTS Technical feasibility was 100%, with mean hydrodissection-volume of 126 ml (range 80-200 ml) and median hydrodissection-time of 9 min (range 8-45 min). Liver-diaphragmatic and liver-pericardial distance increased, respectively, from 2.4 mm (range 0-8 mm) to 10.8 mm (range 6-19 mm) and from 4 mm (range 1-10 mm) to 12.6 mm (range 8-20 mm) post-hydrodissection. All procedures were performed at full-power with complete tumour ablation and without complications (including peri-procedural haemodynamic/electrocardiographic disturbances, pericardial effusion and diaphragmatic hernia) or evidence of LTP at mean 12.2-month (range 1-26 month) follow-up. CONCLUSION Hydrodissection of the sub-diaphragmatic bare area of the liver is technically feasible and may potentially optimize safety PTA of sub-cardiac hepatic tumours.AIM To investigate the effects of cleansing Fleet's™ enema (FE) on rectal distention and image quality of diffusion-weighted imaging (DWI) in prostate magnetic resonance imaging (MRI). METHODS This study included 117 prospectively accrued active surveillance patients who underwent prostate MRI both without (prep-) and with bowel preparation consisting of FE (prep+) obtained within 12 months of each other. The anterior-posterior (AP) diameter of the rectum, degree of perceived distention in the rectum and image quality scores were assessed by two independent readers for both (prep- and prep+) scans. DWI distortion was assessed quantitatively using the degree of anatomic mismatches between images obtained at different b values and the T2-weighted MRI. DWI artifact was qualitatively scored based on the presence of blurring, poor signal-to-noise, and artifact lines. The difference in rectal AP diameters between the two methods was tested by the paired Wilcoxon rank test. Stuart Maxell test was used in comparing rvalue of bowel prep is not conclusively validated in this study.PURPOSE Pelvic organ prolapse (POP) is assessed differently by gynecologists and radiologists. It is clinically staged by physical examination using the POP-Q (Pelvic Organ Prolapse Quantification) system and radiologically staged by modalities such as by Magnetic Resonance Defecography (MRD). The purpose of this study was to correlate the two methods of staging pelvic organ prolapse for each pelvic compartment by comparing correlative anatomic points and differences in technique. This understanding will help synthesize information from two different perspectives and bridge the gap between multiple specialists who participate in the care of patients with complex pelvic floor disorders. METHODS A retrospective single institution study comparison of patients who underwent both dynamic magnetic resonance pelvic floor imaging and pelvic organ prolapse quantification (POP-Q) at our medical center was done. Two urogynecologists performed the POP-Q and one fellowship-trained radiologist interpreted the MRD and both and imaging criteria account for this. MRD, however, still provides anatomic details on static images, real time simultaneous overview of multi-compartmental prolapse, characterizes contents of cul-de-sac hernias and rectal evacuation on dynamic imaging. Corroborative information derived from both methods of staging organ will result in optimum patient care.Artificial intelligence is a technique that holds promise for helping radiologists improve the care of our patients. At the same time, implementation decisions we make now can have a long-lasting effect on patient outcomes. In the following article, we discuss four areas with unique considerations for implementation of AI bias, trust, risk, and design. In each section, we highlight applications of AI to abdominal imaging and prostate cancer specifically.OBJECTIVE The aim of this study was to investigate the psychological and personality characteristics of the applicants for facial cosmetic surgery. METHODS This descriptive-analytical study was conducted on 385 facial cosmetic surgery applicants who referred to medical centers in Ahvaz (south Iran). The data collection tool included three questionnaires (1) demographic questions, (2) the General Health Questionnaire (GHQ), and (3) the NEO Five-Factor Inventory (NEO-FFI). RESULTS The results showed that 45.2% of the participants had abnormal health status. The mean score of the participants on the openness subscale was insignificantly lower than that of the general population (p > 0.05). On the other hand, the mean scores of the participants on the conscientiousness and agreeableness subscales were significantly lower (p  less then  0.001). Finally, the mean score of the samples on the extroversion subscale was significantly higher than that of the general population (p  less then  0.001). CONCLUSION Given the results of the study, it is strongly recommended to address the personality and psychological characteristics of the applicants for cosmetic surgery before operating on them. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.Increasing evidence shows that endophytic bacteria living inside plant tissue may possess similar biological activity and produce similar metabolites to their hosts. This study aimed to determine the diversity of endophytic bacteria associated with Vernonia anthelmintica and to evaluate their biological activity. The bacteria were isolated from the plant tissue using culture-dependent techniques. Comparison of the 16S rRNA gene sequences of endophytic bacteria isolated from V. anthelmintica showed that isolates belong to the species Micrococcus endophyticus VERA1, Bacillus megaterium VERA2, Pseudomonas chlororaphis VERA3, P. kilonensis VERA4, Stenotrophomonas pavanii VERA5, B. learn more endophyticus VERA6, S. maltophilia VERA7, Pantoea ananatis VERA8, B. atrophaeus VERA9 and M. flavus VERA10. Activity studies showed that the endophytic bacteria share several similar biological properties with their host plant including antimicrobial, anti-vitiligo and antidiabetic activities. These findings indicate that plant phytochemical compounds and activity play an important role in the physiological properties of their endophytes.PURPOSE This analysis compares salvage lymph node dissection (SLND) to salvage lymph node radiotherapy (SLNRT) of 68Ga-PSMA PET-positive nodal recurrences after radical prostatectomy (RPE). METHODS A total of 67 SLNRT and 33 SLND consecutive patients with pelvic and/or para-aortic nodal recurrences after RPE were retrospectively analyzed. Biochemical recurrence-free survival rates (bRFS; PSA less then 0.2 ng/mL) were calculated according to Kaplan-Meier and survival curves were compared using the log rank test. For multivariable analysis, binary logistic regression analysis was performed (p  less then  0.05). RESULTS Median follow-up was 17 months (range, 6-53 months) in SLND patients and 31 months (range, 3-56 months) in SLNRT patients (p = 0.027). SLNRT patients had significantly more tumours of pT3 and pT4 category (82% vs. 67%; p = 0.006), pathologically involved lymph nodes (45% vs. 27%; p = 0.001) and positive surgical margins (54% vs. 12%; p = 0.001) at time of RPE than SLND patients. PSA persistence after RPE was significantly more frequently observed in the SLNRT cohort (73% vs. 27%; p = 0.001). There was no significant difference in the distribution of PET-positive lymph nodes. Median PSA before SLND was higher than before SLNRT (3.07 ng/ml vs. 1.3 ng/ml; p = 0.393). The 2‑year bRFS was significantly higher in the SLNRT vs. the SLND cohort (92% vs. 30%; p = 0.001) with lower rates of distant metastases (21% vs. 52%; p = 0.002) and secondary treatments (5% vs. 39%; p = 0.011) irrespective of ongoing androgen deprivation therapy at last contact. In multivariable analysis, SLNRT was significantly associated with prolonged bRFS (regression coefficient 1.436, hazard ratio 4.204, 95% CI 1.789-9.878; p = 0.001). CONCLUSION Based on this retrospective study SLNRT might be the preferred treatment option for patients with nodal recurrence after previous RPE.PURPOSE The relation between functional imaging and intrapatient genetic heterogeneity remains poorly understood. The aim of our study was to investigate spatial sampling and functional imaging by FDG-PET/MRI to describe intrapatient tumour heterogeneity. METHODS Six patients with oropharyngeal cancer were included in this pilot study. Two tumour samples per patient were taken and sequenced by next-generation sequencing covering 327 genes relevant in head and neck cancer. Corresponding regions were delineated on pretherapeutic FDG-PET/MRI images to extract apparent diffusion coefficients and standardized uptake values. RESULTS Samples were collected within the primary tumour (n = 3), within the primary tumour and the involved lymph node (n = 2) as well as within two independent primary tumours (n = 1). Genetic heterogeneity of the primary tumours was limited and most driver gene mutations were found ubiquitously. Slightly increasing heterogeneity was found between primary tumours and lymph node metastases. One private predicted driver mutation within a primary tumour and one in a lymph node were found. However, the two independent primary tumours did not show any shared mutations in spite of a clinically suspected field cancerosis. No conclusive correlation between genetic heterogeneity and heterogeneity of PET/MRI-derived parameters was observed. CONCLUSION Our limited data suggest that single sampling might be sufficient in some patients with oropharyngeal cancer. However, few driver mutations might be missed and, if feasible, spatial sampling should be considered. In two independent primary tumours, both lesions should be sequenced. Our data with a limited number of patients do not support the concept that multiparametric PET/MRI features are useful to guide biopsies for genetic tumour characterization.
Read More: https://www.selleckchem.com/products/msab.html