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BACKGROUND TruGraf is a blood-based biomarker test that measures differential expression of a collection of genes that have been shown to correlate with surveillance biopsy results. However, in the majority of U.S. transplant centers, surveillance biopsies are not performed. The objectives of this study were to evaluate the clinical validity of TruGraf in stable kidney transplant recipients and to demonstrate the potential clinical utility of serial TruGraf testing in a center not utilizing surveillance biopsies. MATERIAL AND METHODS Serum creatinine levels, TruGraf testing at multiple time points, and subsequent clinical follow-up were obtained for 28 patients. RESULTS Overall concordance of TruGraf results, when compared with independent clinical assessment of testing, was 77% (54/70) for all tests; 79% (22/28) for test 1, 75% (21/28) for test 2, and 79% (11/14) for test 3. The negative predictive value (NPV) was 98.0%. Analysis of clinical utility indicated that 77% of TruGraf results would have been useful in patient management. CONCLUSIONS Our results indicate the value of serial TruGraf testing in those transplant centers that do not perform surveillance biopsies as part of their standard of care. The high negative predictive value indicates the ability of TruGraf to confirm immune quiescence with a high degree of probability in patients with a Transplant eXcellence (TX) result, without the need to perform a surveillance biopsy.BACKGROUND Thyroid cancer, which is the most common endocrine cancer, has shown a drastic increase in incidence globally over the past decade. The present study investigated the thyroid cancer-inhibitory potential of jatrorrhizine-platinum(II) complex (JR-P(II) in vitro and in vivo. MATERIAL AND METHODS The JR-P(II)-mediated cytotoxicity in thyroid carcinoma cells was determined by using MTT assay. Assessment of acetylated histones, tubulin, and DNA repair proteins was made by Western blot assays. Flow cytometry was used for apoptosis and ROS accumulation measurement. RESULTS The JR-P(II) suppressed proliferative capacity of SW1736, BHP7-13, and 8305C cells. JR-P(II) treatment markedly promoted expression of acetylated histone H3, H4, and tubulin in a dose-dependent manner. Treatment with JR-P(II) significantly elevated the proportion of cells in sub-G1 and promoted cleaved caspase-3 and -9. In JR-P(II)-treated cells, DCFH-DA fluorescence was much higher relative to control cells. The JR-P(II) treatment consistently suppressed expression of pS6, p-ERK1/2, p-4E-BP1, and p-AKT, and increased p-H2AX expression and suppressed KU70 and KU80 protein levels. The level of RAD51 was repressed in JR-P(II)-treated cells. JR-P(II) administration in mice caused no significant change in body weight, and it inhibited SW1736 tumor growth in mice. [https://www.selleckchem.com/products/azd6738.html selleck kinase inhibitor] CONCLUSIONS The JR-P(II) induced cytotoxicity in thyroid cancer cells by inhibiting the mechanism responsible for repair of double-stranded DNA. The in vivo data also revealed that JR-P(II) effectively inhibits thyroid tumor growth by inducing DNA damage. Thus, our results suggest that further evaluation of JR-P(II) as a therapeutic candidate for thyroid cancer is warranted.BACKGROUND Brain arteriovenous malformations (AVMs) are benign intracranial vascular anomalies that, under certain circumstances, may become life-threatening. Diffuse calcifications found in the vessel walls, interposing tissue or adjacent cerebral parenchyma are not uncommon, however, intense calcifications of AVMs that render them into veritable "brain stones" are scarcely reported in the literature and a genuine neurosurgical nightmare. CASE REPORT A 55 years-old male patient lacking any personal history of serious morbidities or surgical interventions was referred to our department for several epileptic seizures and severe chronic headache in the parieto-occipital region. Upon clinical examination, the patient was aware, right-handed, and had no motor or sensory deficits. Computed tomography angiography scan showed a large densely calcified frontal AVM. The patient was subjected to neurosurgical removal of the lesion and was discharged a week later with a minor motor deficit of the left arm. CONCLUSIONS Intracranial AVMs are a rare pathology, but a genuine microsurgical trial. The difficulty level soars when the malformed vessels become atherosclerotic and calcified, rendering bipolar ligation or permanent clipping unfeasible. An incomplete resection in the case of a highly calcified lesion can only result in an uncontrollable hemorrhage.STUDY DESIGN This was a single-center, retrospective study. OBJECTIVE The objective of this study was to assess the risk factors for deformity progression after scoliosis correction surgery in spinal muscular atrophy (SMA) patients. SUMMARY OF BACKGROUND DATA Moderate residual postoperative scoliosis curve is common in SMA populations; however, the acceptable postoperative scoliosis curve for preventing deformity progression remains uncertain. MATERIALS AND METHODS Twenty-nine SMA patients undergoing scoliosis correction surgery were included. Scoliosis progression was defined as an increase of 10 degrees in the major curve of Cobb angle (MCCA); pelvic obliquity (PO) or concave-side hip progression was arbitrarily defined as an increase of ≥1 grade after surgery. Risk factors for deformity progression were examined using Cox proportional hazard models. The cumulative incidence rate of deformity progression was performed by the Kaplan-Meier survival analysis RESULTS The mean age at surgery was 13.3 years (rangery earlier had less postoperative MCCA at initial follow-up but with no increase in the risk of postoperative scoliosis progression.STUDY DESIGN Level III-retrospective review. OBJECTIVE To evaluate the impact of hypothyroidism in patients undergoing 1- to 2-level lumbar fusion (1-2LF). SUMMARY OF BACKGROUND DATA Hypothyroidism is a common cause of morbidity and mortality following surgery. Studies have demonstrated the effects of hypothyroidism following orthopedic surgery, but not 1-2LF. MATERIALS AND METHODS Patients undergoing 1-2LF with hypothyroidism were identified within the Medicare population, and served as the study group. Study group patients were randomly matched to controls in a 15 ratio by age, sex, and medical comorbidities. Primary outcomes analyzed included in-hospital lengths of stay (LOS), 90-day readmission rates, 90-day medical complications, and costs of care. Pearson χ tests were used to compare patient demographics. Logistic regression analyses were used to calculate odds ratios (OR) for medical complications and readmissions. Welch t test was used to test for significance in cost between the cohorts. An α value less then 0.