Deanmunn7207

Treatment with the hybrid PeptiCRAd significantly enhanced anti-tumor efficacy and induced TT-specific, CD40 ligand-expressing CD4+ T helper cells and maturation of antigen presenting cells (APCs). Importantly, this approach could be extended to naturally occurring tumor peptides (both tumor-associated antigens and neoantigens), as well as to other pathogens beyond tetanus, highlighting the usefulness of this technique to take full advantage of CD4+ memory T cell repertoires when designing immunotherapeutic treatment regimens. Finally, the anti-tumor effect was even more prominent when combined with the immune checkpoint inhibitor anti-PD1, strengthening the rationale behind combination therapy with oncolytic viruses. Copyright ©2020, American Association for Cancer Research.BACKGROUND A consensus on an optical coherence tomography definition of lamellar macular hole (LMH) and similar conditions is needed. METHODS The panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and to differentiate LMH from other similar conditions. RESULTS The panel reached a consensus on the definition of three clinical entities LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on three mandatory criteria and three optional anatomical features. The three mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a central foveal bump and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria the presence of ERM and the presence of schisis at the level of Henle's fibre layer. Three optional anatomical features can also be present the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness and the presence of retinal wrinkling. MPH definition is based on three mandatory criteria and two optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness. CONCLUSIONS The use of the proposed definitions may provide uniform language for clinicians and future research. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND/AIMS Quantitative analysis of optical coherence tomography angiography (OCT-A) images requires a reproducible approach that accounts for sectoral loss. The objective of this study was to determine whether an index that accounts for both global (perfusion density, PD) and asymmetric loss of perfusion, rather than PD alone, more reliably measures loss of perfusion in patients with glaucoma. METHODS We analysed macular OCT-A scans of 95 glaucoma patients and 59 control subjects. Two-dimensional projection images corresponding to the superficial vascular plexus were exported and analyses performed to calculate global PD and image asymmetry. An unsigned perfusion asymmetry index (PAI) that included PD and asymmetry (with 11 wt) was calculated. Perfusion density and PAI were compared with 10-2 visual field mean deviation and ganglion cell layer (GCL) thickness. RESULTS Median (IQR) visual field mean deviation was -1.73 (-3.76, 0.30) dB for the glaucoma group and 0.67 (0.16, 1.18) dB for the control group. The strength of the correlation with mean deviation was stronger for PAI (r=0.47), compared with PD (r=0.35), whereas with GCL thickness they were comparable (r=0.45 and 0.43, respectively). Compared with controls, mean PD was 12% lower in patients with glaucoma (0.27 vs 0.30), while PAI was 17% lower (0.40 vs 0.48). However, diagnostic accuracy of either PD or PAI was worse than GCL thickness. CONCLUSIONS While PAI yielded better correlation with mean deviation and GCL thickness, and a slightly improved separation between patients with glaucoma and healthy controls, diagnostic accuracy was inferior compared with GCL thickness. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.PURPOSE To evaluate use of infrared meibography video to visualise meibomian gland probing and correlate probe findings of intraductal space with meibography images. METHODS Videos were reviewed and probe findings recorded of 996 probed gland orifices from 38 lower lids. RESULTS 996/997 (99.9%) of gland orifices were successfully probed with 91.8% revealing probe location. There were no false passages. 14% (140/997) of all gland orifices showed whole gland atrophy (WGA) with 99.3% (139/140) probed to 1 mm. Cumulative probe findings for all WGA (not differ significantly from non-WGA) showed 106 (76%), 21 (15%) and 12 (9%) glands with fixed, non-fixed and no resistance (NR), respectively. Lids without WGA showed increased NR/total glands probed while lids with WGAs (≥5) showed increased NR/WGA compared with lids with only 1-4 WGAs (p=0.011, p=0.005, respectively, Mann-Whitney U test) suggesting bimodal NR profile. Visualisation of microtube placement was successfully obtained for therapeutic injections and retrieval of meibum specimens. CONCLUSION Video confirmed intraductal location and safety of devices. For 73% of non-WGA and 76% of WGAs as well as proximal ducts of glands with proximal atrophy, probing released fixed resistance restoring ductal integrity. A bimodal profile of NR suggests it is found with less diseased gland ducts as well as more advanced atrophic gland disease. Gland and ducts appeared flexible but not distendable while periglandular tissue appeared spongy. Visualisation of devices enables whole or localised gland therapy and meibum specimen retrieval, elegantly raising future research, therapeutic and regenerative opportunities. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND AND AIMS Advance care planning (ACP) is communication about wishes and preferences for end-of-life care. ACP is not routinely used in any Norwegian hospitals. We performed a pilot study (2014-2017) introducing ACP on a thoracic medicine ward in Norway. The aims of this study were to explore which topics patients discussed during ACP conversations and to assess how patients, relatives and clinicians experienced the acceptability and feasibility of performing ACP. METHODS Conversations were led by a study nurse or physician using a semistructured guide, encouraging patients to talk freely. Each conversation was summarised in a report in the patient's medical record. At the end of the pilot period, clinicians discussed their experiences in focus group interviews. Reports and transcribed interviews were analysed using systematic text condensation. RESULTS Fifty-one patients participated in ACP conversations (41-86 years; 9 COPD, 41 lung cancer, 1 lung fibrosis; 11 women); 18 were accompanied by a relat (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.PURPOSE To retrospectively assess immediate and 1-year success rate of type 2 endoleak (T2E) treatment with ethylene-vinyl-alcohol-polymer using three-dimensional (3D) image fusion guidance with cone beam computed tomography via trans-arterial embolization (TAE) or direct percutaneous sac injection (DPSI). MATERIALS AND METHODS A total of 37 patients with T2E who were treated either using TAE (34/37; 92%) or DPSI (9/37; 8%) were included. There were 34 men and 3 women with a mean age of 86±9 (SD) years (range 67-104years). Mean aneurysm diameter was 67±14 (SD) mm (range 42-101mm) at pre-procedure evaluation. Immediate success was complete embolization of the sac and feeding artery. 1-year success was reduction or stability of the aneurysmal sac diameter based on pre-procedure and 12-month follow-up examinations. Safety (treatment-related complications), patient demographics, duration of procedure and contrast volume were reported. RESULTS Immediate and 1-year successful outcomes were reported in 94% (n=32) anined effective for 88%. Longer follow-up is necessary to assess sac stability in the case of persistent endoleak. PURPOSE To establish simple quantitative variables at short-tau inversion recovery (STIR) magnetic resonance imaging (MRI) to identify lipomas with high specificity in patients with indeterminate subfascial lipomatous tumors. MATERIALS AND METHODS The MRI examinations of 26 patients (14 men, 12 women; mean age 63±12.5 [SD] years; range 40-84years) with histopathologically proven subfascial atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLs) and those of 68 patients (32 men, 36 women; mean age, 56±13.5 [SD] years; range 21-83years) with lipomas were retrospectively reviewed. Ratios derived from region of interest based signal intensity (SI) measurements of tumors and adjacent fat on STIR images were calculated and maximum tumor diameters were noted. Diagnostic parameter capabilities were assessed using ROC curve analysis. Interreader agreement was evaluated by calculation of intraclass correlation coefficients (ICC). RESULTS Using a cut-off value of 1.18, STIR-SI ratios allowed discriminating between lipoma and ALT/WDL (AUC=0.88; P less then 0.001) yielding 93% specificity (95% CI 77-99%) and 74% sensitivity (95% CI 61-84%) for the diagnosis of lipoma. Interreader agreement was excellent (ICC=0.93). https://www.selleckchem.com/products/cabotegravir-gsk744-gsk1265744.html A significant difference in maximum tumor diameter was found between ALT/WDLs (mean 18.1±6.0 [SD] cm; range 5.6-33.1cm) and lipomas (mean 9.7±5.0 [SD] cm; range 2.9-29.1cm) (P less then 0.001). Using a cut-off of 11cm, maximum tumor diameter allowed discriminating between lipoma and ALT/WDLs with 92% specificity (95% CI 75-99%) and 69% sensitivity (95% CI 57-80%). The combination of a STIR-SI ratio less then 1.4 and maximum tumor diameter less then 11cm yielded 100% specificity (95% CI 87-100%) and 65% sensitivity (95% CI 54-77%) for the diagnosis of lipoma. CONCLUSION The combination of STIR-SI ratio and maximum diameter allows discriminating between lipoma and ALT/WDL in initially indeterminate lipomatous tumors. PURPOSE The purpose of this study was to analyze the impact of different options for reduced-dose computed tomography (CT) on image noise and visibility of pulmonary structures in order to define the best choice of parameters when performing ultra-low dose acquisitions of the chest in clinical routine. MATERIALS AND METHODS Using an anthropomorphic chest phantom, CT images were acquired at four defined low dose levels (computed tomography dose index [CTDIvol]=0.15, 0.20, 0.30 and 0.40mGy), by changing tube voltage, pitch factor, or rotation time and adapting tube current to reach the predefined CTDIvol-values. Images were reconstructed using two different levels of iteration (adaptive statistical iterative reconstruction [ASIR®]-v70% and ASIR®-v100%). Signal-to-noise ratio (SNR) as well as contrast-to-noise ratio (CNR) was calculated. Visibility of pulmonary structures (bronchi/vessels) were assessed by two readers on a 5-point-Likert scale. RESULTS Best visual image assessments and CNR/SNR were obtained with high tube voltage, while lowest scores were reached with lower pitch factor followed by high tube current.