Chengbriggs9740
Nasal endoscopy from the ostium revealed a granulomatous lesion with hemorrhage at the base of the maxillary sinus. After pathological examination by endoscopic sinus surgery, the patient was diagnosed with CG.Sweet disease is a multisystem inflammatory disorder characterized by fever, cutaneous erythematous plaques, and aseptic neutrophilic infiltration of various organs. Neuro-Sweet disease is a known rare central nervous system complication of Sweet disease. A 67-year-old Japanese woman who was diagnosed with neuro-Sweet disease underwent C-methionine (C-MET) PET. C-MET PET revealed increased accumulation in the affected brain tissues. After steroid therapy, she became asymptomatic, and a follow-up C-MET PET scan showed disappearance of the abnormal uptake of C-MET.A 24-year-old man presented with decreased appetite, fatigue, abdominal pain, and acute renal insufficiency. Ultrasound showed bilateral hydronephrosis. CT of the abdomen revealed enlarged seminal vesicles causing bilateral hydronephrosis, mesenteric and peritoneal metastases, liver lesions, and enlarged lymph nodes in the retroperitoneum. A biopsy from a peritoneal lesion demonstrated metastasis of a neuroendocrine tumor grade 2. A Ga-DOTATOC PET/CT scan was performed, which showed enhanced uptake in all lesions including the enlarged seminal vesicles. This case illustrates the very rare presentation of involved seminal vesicles in neuroendocrine tumors.A 68-year-old man with hereditary hypercoagulability was referred to nuclear medicine for elevated aminotransferases after a recent living-donor liver transplant. A hepatic infarction was suspected. A Tc-mebrofenin SPECT/CT was performed and showed decreased radiotracer uptake in a wedge-shaped distribution in the anterior liver suggestive of a hepatic infarction. Subsequently, an enhanced MRI corroborated the diagnosis. Oral anticoagulation therapy was then initiated, and aminotransferases soon normalized.
We evaluated F-FDOPA PET and MRI characteristics in association with the molecular status and overall survival (OS) in a large number of low-grade gliomas (LGGs).
Eighty-six patients who underwent F-FDOPA PET and MRI and were diagnosed with new or recurrent LGGs were retrospectively evaluated with respect to their isocitrate dehydrogenase (IDH) and 1p19q status (10 IDH wild type, 57 mutant, 19 unknown; 1p19q status in IDH mutant 20 noncodeleted, 37 codeleted). After segmentation of the hyperintense area on fluid-attenuated inversion recovery image (FLAIRROI), the following were calculated normalized SUVmax (nSUVmax) of F-FDOPA relative to the striatum, F-FDOPA hypermetabolic volume (tumor-to-striatum ratios >1), FLAIRROI volume, relative cerebral blood volume, and apparent diffusion coefficient within FLAIRROI. Receiver operating characteristic curve and Cox regression analyses were performed.
PET and MRI metrics combined with age predicted the IDH mutation and 1p19q codeletion statuses with sensitivities of 73% and 76% and specificities of 100% and 94%, respectively. Significant correlations were found between OS and the IDH mutation status (hazard ratio [HR] = 4.939), nSUVmax (HR = 2.827), F-FDOPA hypermetabolic volume (HR = 1.048), and FLAIRROI volume (HR = 1.006). The nSUVmax (HR = 151.6) for newly diagnosed LGGs and the F-FDOPA hypermetabolic volume (HR = 1.038) for recurrent LGGs demonstrated significant association with OS.
Combining F-FDOPA PET and MRI with age proved useful for predicting the molecular status in patients with LGGs, whereas the nSUVmax and F-FDOPA hypermetabolic volume may be useful for prognostication.
Combining F-FDOPA PET and MRI with age proved useful for predicting the molecular status in patients with LGGs, whereas the nSUVmax and F-FDOPA hypermetabolic volume may be useful for prognostication.
We present the case of a 75-year-old man with osteosarcoma of the sternum in whom 68Ga-prostate-specific membrane antigen (PSMA) PET/CT showed high radiotracer activity in the primary tumor and metastatic lesions than 18F-FDG PET/CT. The present case shows that 68Ga-PSMA PET/CT is very useful for staging of osteosarcoma due to in vivo expression of PSMA. 68Ga-PSMA PET/CT can have potential effects on prognosis and in response assessment following treatment in osteosarcoma. The use of PSMA-targeted radioligand treatments may be beneficial especially in metastatic chemorefractory osteosarcoma.
We present the case of a 75-year-old man with osteosarcoma of the sternum in whom 68Ga-prostate-specific membrane antigen (PSMA) PET/CT showed high radiotracer activity in the primary tumor and metastatic lesions than 18F-FDG PET/CT. The present case shows that 68Ga-PSMA PET/CT is very useful for staging of osteosarcoma due to in vivo expression of PSMA. 68Ga-PSMA PET/CT can have potential effects on prognosis and in response assessment following treatment in osteosarcoma. The use of PSMA-targeted radioligand treatments may be beneficial especially in metastatic chemorefractory osteosarcoma.The National Database for Nursing Quality Indicators is an important source of information used to benchmark nursing by unit category in multiple areas related to not only structure and process but also outcome. It also provides some information regarding best practices and the cost to achieve certain results. The Practice Environment Scale of the Nursing Work Index is a frequently used way to measure the professional practice environment of nurses and the relationship of the latter to quality, safety, and other outcomes.
Brain death (BD) affects the viability of lungs for transplantation. A correlation exists between high-lung inflammation after BD and the decrease in female sex hormones, especially estradiol. Therefore, we investigated the effects of 17β-estradiol (E2) treatment on the lungs of female brain dead rats.
Female Wistar rats were divided into 4 groups BD (submitted to BD for 6 h), sham (false operated), E2-T0 (treated with E2 immediately after BD; 50 μg/mL, 2 mL/h), and E2-T3 (treated with E2 after 3 h of BD; 50 μg/mL, 2 mL/h). Lung edema, hemorrhage, and leukocyte infiltration were analyzed. Adhesion molecules were evaluated, and analysis of NO synthase gene and protein expression was performed using real-time PCR and immunohistochemistry, respectively. Release of chemokines and matrix degradation in the lungs was analyzed.
BD increased leukocyte infiltration, as shown by intravital microscopy (P = 0.017), bronchoalveolar lavage cell count (P = 0.016), the release of inflammatory mediators (P = 0.02), and expression of adhesion molecules. BD also increased microvascular permeability and the expression and activity of matrix metalloproteinase-9 in the lungs. E2 treatment reduced leukocyte infiltration, especially in the E2-T3 group, release of inflammatory mediators, adhesion molecules, and matrix metalloproteinase activity in the lungs.
E2 treatment was successful in controlling the lung inflammatory response in females submitted to BD. Our results suggest that E2 directly decreases the release of chemokines, restraining cell traffic into the lungs. Thus, E2 has a therapeutic potential, and its role in improving donor lung quality should be explored further.
E2 treatment was successful in controlling the lung inflammatory response in females submitted to BD. Our results suggest that E2 directly decreases the release of chemokines, restraining cell traffic into the lungs. Thus, E2 has a therapeutic potential, and its role in improving donor lung quality should be explored further.
Several studies reported favorable outcomes of small-for-size (SFS) grafts with graft-to-recipient weight ratio (GRWR) <0.8% in living-donor liver transplantation (LDLT). However, their indications should be carefully determined because they must have been indicated for lower-risk cases over larger grafts with 0.8%≤ GRWR. Furthermore, evidence for minimum requirements of GRWR remains inconclusive. We investigated the safety of SFS grafts against larger grafts by adjusting for confounding risk factors, and minimum requirement of graft volume in adult LDLT.
We enrolled 417 cases of primary adult-to-adult LDLT in our center between 2006 and 2019. The outcomes of small grafts (0.6%≤ GRWR <0.8%, n =113) and large grafts (0.8%≤ GRWR, n =289) were mainly compared using a multivariate analysis and Kaplan-Meier estimates.
The multivariate analysis showed that small grafts were not a significant risk factor for overall graft survival (GS). In the Kaplan-Meier analysis, small grafts did not significantly affect overall GS regardless of lobe selection (vs large grafts). find more However, GRWR <0.6% was associated with poor overall GS. Although there were no significant differences between the two groups, unadjusted Kaplan-Meier curves of small grafts were inferior to those of large grafts in sub-cohorts with ABO incompatibility, and donor age ≥50 years.
Similar outcomes were observed for small and large graft use regardless of lobe selection. 0.6% in GRWR was reasonable as the minimum requirement of graft volume in LDLT. However, small grafts should be indicated carefully for high-risk cases.
Similar outcomes were observed for small and large graft use regardless of lobe selection. 0.6% in GRWR was reasonable as the minimum requirement of graft volume in LDLT. However, small grafts should be indicated carefully for high-risk cases.
Experience with sequential hematopoietic stem cell transplant (HSCT) and kidney transplant (KT) is limited.
We conducted a retrospective observational study of adult patients who underwent both HSCT and KT at our center, with a median follow-up of 11 years.
In our 54 patients cohort (94% autologous HSCT), 36 (67%) patients received HSCT first followed by KT, while 18 (33%) received KT prior to HSCT. In both groups, AL amyloidosis represented 50% of hematologic diagnosis. Only 4 patients expired due to hematologic disease relapse (2 patients in each group) and only 3 allografts were lost due to hematologic disease recurrence (HSCT first n=1 and KT first n=2). Overall 1-year, 5 years and 10 years death-censored graft survival rates were 94%, 94%, and 94%, respectively for HSCT first group and 89%, 89%, and 75%, respectively for KT first group. Overall 1-year, 5 years and 10 years patients survival rates were 100%, 97% and 90%, respectively for HSCT first group and 100%, 76% and 63%, respectively for KT first group.
Our study supports safety of sequential KT and HSCT, with improved overall patient survival compared to recipients of HSCT remaining on dialysis and good long-term kidney allograft outcome.
Our study supports safety of sequential KT and HSCT, with improved overall patient survival compared to recipients of HSCT remaining on dialysis and good long-term kidney allograft outcome.
A wearable artificial lung could improve lung transplantation outcomes by easing implementation of physical rehabilitation during long-term pretransplant respiratory support. The Modular Extracorporeal Lung Assist System (ModELAS) is a compact pumping artificial lung currently under development. This study evaluated the long-term in vivo performance of the ModELAS during venovenous support in awake sheep. Feedback from early trials and computational fluid dynamic (CFD) analysis guided device design optimization along the way.
The ModELAS was connected to healthy sheep via a dual-lumen cannula in the jugular vein. Sheep were housed in a fixed-tether pen while wearing the device in a holster during support. Targeted blood flow rate and support duration were 2-2.5 L/min and 28-30 days, respectively. Anticoagulation was maintained via systemic heparin. Device pumping and gas exchange performance and hematologic indicators of sheep physiology were measured throughout support.
CFD-guided design modifications successfully decreased pump thrombogenicity from initial designs.