Notes

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The use of the ethiodized oil- Lipiodol in conventional trans-arterial chemoembolization (cTACE) ensures radiopacity to visualize drug delivery in the process of providing selective drug targeting to hepatic cancers and arterial embolization. Lipiodol functions as a carrier of chemo drugs for targeted therapy, as an embolic agent, augmenting the drug effect by efflux into the portal veins as well as a predictor for the tumor response and survival.

To prospectively evaluate the role of 3D quantitative assessment of intra-procedural Lipiodol deposition in liver tumors on CBCT immediately after cTACE as a predictive biomarker for the outcome of cTACE.

This was a post-hoc analysis of data from an IRB-approved prospective clinical trial. Thirty-two patients with hepatocellular carcinoma or liver metastases underwent contrast enhanced CBCT obtained immediately after cTACE, unenhanced MDCT at 24h after cTACE, and follow-up imaging 30-, 90- and 180-days post-procedure. Lipiodol deposition was quantified on CBCTas an intra-procedural surrogate for tumor response, with potential implications for the prediction of survival.
3D quantification of Lipiodol deposition on intra-procedural CBCT is a predictive biomarker of outcome in patients with primary or metastatic liver cancer undergoing cTACE. There are spatial and volumetric agreements between 3D quantification of Lipiodol deposition on intra-procedural CBCT and 24 h post-cTACE MDCT. The spatial and volumetric agreement between Lipiodol deposition on intra-procedural CBCT and 24 h post-cTACE MDCT could suggest that acquiring MDCT 24 h after cTACE is redundant. Importantly, the demonstrated relationship between levels of tumor coverage with Lipiodol and degree and timeline of tumor response after cTACE underline the role of Lipiodol as an intra-procedural surrogate for tumor response, with potential implications for the prediction of survival.
Markup of generalized interictal epileptiform discharges (IEDs) on EEG is an important step in the diagnosis and characterization of epilepsy. However, manual EEG markup is a time-consuming, subjective, and the specialized task where the human reviewer needs to visually inspect a large amount of data to facilitate accurate clinical decisions. In this study, we aimed to develop a framework for automated detection of generalized paroxysmal fast activity (GPFA), a generalized IED seen in scalp EEG recordings of patients with the severe epilepsy of Lennox-Gastaut syndrome (LGS).

We studied 13 children with LGS who had GPFA events in their interictal EEG recordings. Time-frequency information derived from manually marked IEDs across multiple EEG channels was used to automatically detect similar events in each patient's interictal EEG. selleck We validated true positives and false positives of the proposed spike detection approach using both standalone scalp EEG and simultaneous EEG-functional MRI (EEG-fMRI) recordingsepilepsy syndromes in which monitoring the burden of epileptic activity can aid clinical decision-making and faster assessment of treatment response and estimation of future seizure risk.
This study provides a novel methodology that enables a fast, automated, and objective inspection of generalized IEDs in LGS. The proposed framework may be extendable to a wider range of epilepsy syndromes in which monitoring the burden of epileptic activity can aid clinical decision-making and faster assessment of treatment response and estimation of future seizure risk.Extended-spectrum cephalosporin (ESC)-resistant Escherichia coli were isolated from fecal samples enriched in ESC-containing broth over two years from broiler chickens raised with and without therapeutic antimicrobials. Pooled samples were obtained from 13 different farms in Canada over two rearing cycles each. Resistant isolates were screened for blaCMY, blaCTX-M, and blaSHV by PCR, and several isolates were sequenced and assembled using Oxford Nanopore MinION technology. Flocks raised with or without antimicrobials contained similar ESC-resistant E. coli. Some plasmids were found in isolates from both farm types and many shared replicon types (IncI1, F, C, and B/O/K/Z) and resistance determinants. Although the use of cephalosporins has stopped in poultry production in Canada, the prevalence of ESC-resistant E. coli found in this study remained high; therefore, further studies are required to determine routes of transmission and persistence.
Schwannomas are a benign tumor of peripheral nerve sheath origin. Although most commonly arising in the extremities, head, and neck there have been rare cases of schwannomas presenting within or adjacent to the pancreas reported in the literature.

We present an asymptomatic and otherwise healthy 57-year-old male with an incidental peripancreatic mass measuring 3.5×3.7cm found on abdominal computed tomography (CT). The patient underwent complete enucleation of the mass at our hospital. Pathological analysis of the excised specimen showed spindle shaped cells. Immunohistochemical staining was positive for S100 protein expression, confirming the definitive diagnosis of peripancreatic schwannoma. The patient's postoperative course was uneventful.

Schwannoma is a commonly benign, encapsulated, and slowly growing tumor arising from myelin producing cells of peripheral nerves. A schwannoma presenting within or adjacent to solid abdominal viscera, such as the pancreas, may be challenging to diagnose preoperatively as it may mimic other lesions. Radiological appearance of schwannoma may be nonspecific and definitive diagnosis is reliant upon pathological analysis. The use of endoscopic ultrasound (EUS) with fine needle aspiration (FNA) may assist the clinician in preoperative diagnosis, however these interventions are not widely available. Accurate preoperative diagnosis of a peripancreatic schwannoma is of high importance as it may preclude unnecessary pancreatectomy or radical resection.

Although rare, schwannoma should be part of the differential diagnosis of a cystic or solid appearing mass within or surrounding the pancreas. Total resection carries an excellent prognosis with little to no documented recurrence.
Although rare, schwannoma should be part of the differential diagnosis of a cystic or solid appearing mass within or surrounding the pancreas. Total resection carries an excellent prognosis with little to no documented recurrence.
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