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PURPOSE Previous reports showed that some patients with renal cell carcinoma (RCC) and renal vein tumor thrombus (RVTT) were misdiagnosed pre-operatively. To improve the accuracy of this diagnosis, the clinical characteristics of RCC with missed RVTT diagnosis were analyzed. METHODS We retrospectively reviewed RCC patients with RVTT between January 2000 and December 2015. The survival analysis was estimated using the Kaplan-Meier method. The Cox proportional hazard models were applied to identify risk factors. RESULTS The missed diagnosis rate of RVTT in RCC was 30.5%. In multivariate analysis, maximal tumor diameter, tumor located in the middle part, renal vein contrast agents filling insufficiently and tumor with collateral vessels (odds ratio = 1.22, 1.35, 1.25, 1.22; and p = .034, .003, .015 and .037, respectively) were independent predictors of missed RVTT diagnosis. A missed-diagnosis score was presented as area under curve of 0.852 (p  less then  .001). Moreover, the missed diagnosis group had favorable prognosis, and tumor with collateral vessels was an independent prognostic indicator of poor overall survival time (hazard ratio = 1.15, p = .025). CONCLUSIONS This was the first study exploring clinical features as predictors of missed RVTT diagnosis. The possibility of complicating tumor thrombus should be considered when there is pre-operative presence of tumor with large diameter, renal tumor in the middle part, renal tumor with collateral vessels and renal vein contrast agents filling insufficiently. Patients with three points in missed-diagnosis scoring suggested a high possibility of missed RVTT diagnosis, and tumor with collateral vessels indicated poor prognosis.During the past 20 years, since I started as a postdoc, the world of genetics and genomics has changed dramatically. My main research goal throughout my career has been to understand human disease genetics, and I have developed comparative genomics and comparative genetics to generate resources and tools for understanding human disease. Through comparative genomics I have worked to sequence enough mammals to understand the functional potential of each base in the human genome as well as chosen vertebrates to study the evolutionary changes that have given many species their key traits. Through comparative genetics, I have developed the dog as a model for human disease, characterising the genome itself and determining a list of germ-line loci and somatic mutations causing complex diseases and cancer in the dog. Pulling all these findings and resources together opens new doors for understanding genome evolution, the genetics of complex traits and cancer in man and his best friend.Introduction Antiepileptic drugs (AEDs) are the cornerstone of treatment of patients with epilepsy, and there are presently 27 licensed AEDs making AEDs among the most common medications for which therapeutic drug monitoring (TDM) is performed. The aim of this review is to provide an overview of the current evidence of the use and implementation of AED TDM in patients with epilepsy and other non-epilepsy conditions.Areas covered The pharmacokinetic variability of AEDs is extensive, resulting in pronounced variability in serum concentrations between patients. TDM may thus be useful to individualize the treatment of patients with epilepsy and also in non-epilepsy conditions. Indications for TDM include settings where pharmacokinetic variability is anticipated (e.g. in children, the elderly, during pregnancy, and patients prescribed polytherapy resulting in drug interactions) and drug adherence. TDM contributes to provide a quality assurance of the treatment. Patient management is, therefore, best guided by the determination of individual therapeutic concentrations.Expert opinion Because of pharmacokinetic variability is prevalent among AEDs, TDM allows a bespoke approach to epilepsy care allowing dose adjustments based on measured drug concentrations so as to optimize clinical outcome. Future advances include the use of additional markers of toxicity and genetic variability so as to further aid individualization and optimize AED treatment.Background Various light based technologies like Diode, long pulsed NdYag and Intense Pulsed Light are used commonly for long-term hair reduction. The commonest indication is hirsutism.Aim 1. To evaluate efficacy and safety of 810 nm Diode laser in Fitzpatrick skin types III, IV and V.2. To assess percentage of cases on the basis of indications, average number of sessions, fluence required, the long-term results and complications using diode laser in darker skin types.Methods A prospective observational study of 55 consecutive patients who came for laser hair reduction by 810 nm Light Sheer Diode laser with Chill tip technology was carried out. The sessions were conducted at an interval of 4-6 weeks and the patients were followed up over a period of 2 years. Data was analyzed using software SPSS (Statistical Package for Social Science. Ver.12, Inc. Chicago, USA).Results Fifty-five patients (51 females and 4 males) were studied. 67.3% (n = 37) had skin type IV. The most common area treated was chin (n = 23). The average growth reduction of terminal hair at the end of three sessions was 61.25%. Naphazoline supplier Only 8% (n = 4) had short-term side effects.Conclusion Diode laser is highly effective for long-term hair reduction of terminal hair growth in Fitzpatrick skin type III, IV and V with no permanent side effects.Abbreviations LHR (Laser Hair Reduction).A number of same species of Cerithiidae are morphologically unlike, whereas most of species in the same genus are morphologically similar and just exhibit subtle differences. It is difficult to identify them by morphological methods alone. DNA barcoding is a modern molecular technique that can be used to identify species accurately, and is particularly helpful when distinguishing morphologically similar species. In order to identify species of Cerithiidae using DNA barcoding technology based on mitochondrial cytochrome oxidase subunit I (COI) and 16S ribosomal RNA (16S rRNA) genes, this study calculated intraspecific and interspecific genetic distance and constructed the phylogenetic trees. A total of 80 COI and 16S rRNA barcode sequences were obtained from 10 species and 3 genera. Some unknown specimens were further identified and a cryptic species may exist in Cerithium traillii, showing that DNA barcoding technology has the potential to discover new species and cryptic species. The phylogenetic trees revealed that all of the cerithiids could converge upon a monophyly with high support values and two genera (Cerithium and Clypeomorus) maybe support the reclassification.
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