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En bloc tissue samples from all the pigs demonstrated complete wound healing of the PG sites. CONCLUSION Percutaneous application of single or double Perclose ProGlide devices is feasible and safe for the PG closure in a swine model. selleck compound LEVEL OF EVIDENCE No level of evidence, Animal study.PURPOSE In patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib, post-progression survival (PPS) is marked by the pattern of progression. Our aim was to assess the influence of the pattern of progression to selective internal radiotherapy (SIRT) in PPS among patients with HCC. METHODS A retrospective analysis of patients treated with SIRT between 2003 and 2015 was conducted, excluding those with a single nodule  less then  5 cm or with metastases. Four patterns of progression to SIRT were defined target tumour growth, non-target tumour growth, new intrahepatic disease, and new extrahepatic disease. PPS was calculated from the time of progression based on RECIST 1.1 criteria. RESULTS Out of the 102 patients who met the selection criteria, 76 progressed after a median follow-up of 15 months. Median PPS was 6.5 months (95% CI 3.8-9.3 months). Patients who progressed at pre-existing lesions had a better PPS (median 12.5 months) than those who progressed with new lesions inside or outside the liver (median 4.2 months) (p = 0.02). In a Cox model adjusted by liver function and systemic inflammation, the pattern of progression had a hazard ratio of 1.64 (95% CI 0.92-2.93; p = 0.093). CONCLUSION In a cohort of HCC patients treated with SIRT, the pattern of progression associated with worst survival was the development of new intrahepatic lesions or extrahepatic metastases.BACKGROUND The combination of finasteride and topical minoxidil has been used for treating patients with androgenetic alopecia (AGA). However, whether combining these two medications results in greater efficacy than monotherapy is a question worth exploring. OBJECTIVE This meta-analysis aims to determine the efficacy and safety of combined treatment of finasteride and topical minoxidil. METHODS A comprehensive search of the Embase, PubMed, and the Cochrane Library databases was performed. Data were extracted and analyzed according to predefined clinical endpoints. RESULTS Five randomized controlled trials (RCTs) were included in our meta-analysis. All studies compared combined therapy with minoxidil, but only 2 RCTs compared combined therapy with finasteride. Compared with minoxidil or finasteride alone, the combined group had a significantly higher global photographic evaluation score (P  less then  0.00001), more patients with marked improvement (P  less then  0.001), and fewer patients with deterioration or no change (P  less then  0.001). There was no significant difference between the combined group and minoxidil- or finasteride-only groups in the number of patients with moderate and mild improvements, hair density change, or adverse events. CONCLUSIONS In patients with AGA, the combination treatment of finasteride and topical minoxidil has better therapeutic efficacy than and similar safety as monotherapy. However, the best concentration of combination treatment requires further studies with sound methodological quality. LEVEL OF EVIDENCE III 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.Ultrasonography is free of ionizing radiation but during the examination it is accompanied by energy deposition in the tissue. Therefore, users should be familiar with the mechanisms of action and possible risks. Thermal and non-thermal (e.g. cavitation) effects are related to the intensity and sound pressure of ultrasound waves and are therefore also dependent on the ultrasound modality used, e.g., B‑mode, color Doppler and/or pulsed wave (pw) Doppler. With B‑mode ultrasound no dangerous thermal effects are to be expected. In embryos and foetuses as well as febrile patients caution should be exercised. The pw Doppler mode can cause temperature spikes and the risks increase with the duration of use. Ultrasound contrast media are pathogenic for cavitation and should be avoided during the 24 h prior to shock wave lithotripsy. In ultrasound modalities with high local energy deposition, the values for the thermal index (TI) and mechanical index (MI) displayed on the screen should be observed and as with ionizing radiation, the ALARA (as low as reasonably achievable) principle should be adhered to.CLINICAL ISSUE The clinical picture of a subarachnoid haemorrhage (SAH) is associated with a high morbidity and mortality, due to the associated complications. Therefore, both unruptured and ruptured aneurysms are to be treated based on an individual and interdisciplinary treatment concept. Several endovascular procedures are already available for the treatment of intracranial aneurysms. A more recent concept is the treatment with vessel-reconstructive stents so-called flow diverters. PRACTICAL RECOMMENDATIONS Due to the continuous development and revision of flow diverters, the initial complication rates have been significantly reduced, which now effectively and efficiently justifies their clinical use. After careful patient selection and risk-benefit assessment, the implantation of a flow diverter can also be considered for the treatment of ruptured aneurysms and is often the only therapy option in such situations.Herein field recordings were utilized to test the effects of a transient period of pentylenetetrazol (PTZ) treatment on theta-burst long-term potentiation (LTP) at the Schaffer collateral-CA1 synapses as well as RT-PCR was used to investigate the effects of the combination of the pharmacological treatment and the theta-burst LTP induction on the expression of NMDA subunit mRNA in hippocampal slices. The slope of field excitatory postsynaptic potential (fEPSP) was unaffected while the population spike amplitude and area were increased by a transient period of PTZ treatment (3 mM, 10 min). After a theta burst, a brief PTZ exposure can lead to an enhancement of LTP as documented by fEPSP recording. The effect can be blocked by a selective NMDA receptor antagonist DL-AP5. An increase in the expression of GluN2B and GluN2A subunit mRNAs was also shown due to the combined treatment. The results indicate that the combined treatment increases the degree of NMDA-dependent LTP and are in accord with literature data on the subunit alterations of the hippocampal NMDA receptors.