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Inflammation plays an important role in acute and chronic cerebral ischemia. read more Recent reports indicate that the inflammatory response triggered by tissue damage is mediated by a multiple-protein complex called the inflammasome. The NOD-like receptor family, pyrin domain containing 3 (NLRP3) and absent in melanoma 2 (AIM2) inflammasome complex triggers caspase 1-mediated maturation of interleukin (IL)-1β and IL-18. This study tested the hypothesis that chronic cerebral hypoperfusion activates inflammasomes in the white matter of the brain. To induce cerebral hypoperfusion, C57BL/6J mice were subjected to a sham or bilateral common carotid artery stenosis (BCAS) operation using microcoils with an internal diameter of 0.18 mm. At 2 and 4 weeks after BCAS, the mice were sacrificed (n = 5 in each group). Coronal sections were stained with anti-NLRP3 and anti-AIM2 antibodies. Activation of the inflammasome and cytokines was assessed using immunohistochemistry and cell counting. IL-18 and IL-1β levels were determined by ELISA. Cell counting revealed an increase in NLRP3 and AIM2 inflammasomes at 2 and 4 weeks after BCAS. Immunoreactivity was observed in glial cells in the white matter and corpus callosum. IL-18 and IL-1β concentrations were significantly increased compared with those in the sham operation group. Expression of NLRP3 and AIM2 was upregulated in glial cells in the autopsied brains of patients with cerebral infarction in the chronic phase. These results suggest that chronic cerebral hypoperfusion induces upregulation of NLRP3 and AIM2 inflammasomes; therefore, inflammasomes may play an important role in the sterile inflammatory response in astrocytes and microglia during chronic cerebral hypoperfusion. BACKGROUND Whether the quality and clinical performance of mammograms obtained in vehicles and those obtained in fixed facilities are equal remains unknown. We compared the characteristics of examinees screened in hospital and vehicle settings. PATIENTS AND METHODS Data from women who had undergone mammography at Shuang Ho Hospital from January 1, 2013, to December 31, 2016, were obtained from the Women's Breast Screening Database and used for analysis. The records revealed that 43,807 and 11,955 women had undergone mammography in vehicle and hospital settings, respectively. The performance benchmarks, including recall rate, cancer detection rate, and positive predictive value, in the 2 settings were compared. In addition, the image quality was compared by reviewing 110 records from each setting. RESULTS The hospital mammograms had greater subtotal mean scores (189.2 ± 5.9) compared with the vehicle mammograms (185.5 ± 7.7; P  less then .0001) in the mediolateral oblique view. Mobile mammography contributed to a lower odds ratio of classification in the Breast Imaging Reporting and Data System categories of 0, 4, and 5. In general, all performance benchmarks, including the cancer detection rate and positive predictive value of mobile and hospital mammography, were satisfactory. However, the recall rate with the hospital mammography service was slightly greater than the acceptable benchmark. link2 CONCLUSION Mobile mammography services should be continued with improvements in image quality. The reduction in the number of patients with a category of 0 in the classification system in both mammography service settings and the enhancement of data linking to previous mammograms warrants additional attention. BACKGROUND B3 breast lesions are a heterogeneous group with uncertain malignant potential and, as such, provide a source of diagnostic difficulty. We calculated the prevalence of B3 lesions at our center along with the upgrade rates (positive predictive value) to in situ or invasive malignancy. MATERIALS AND METHODS We searched our pathology database over a 3-year period to include all B3 biopsies. The subsequent excision for each biopsy was reviewed, and the rate of upgrade was calculated by subtype. These results were compared against data published in large United Kingdom studies. link3 RESULTS A total of 9206 breast biopsies were identified, of which 614 (6.7%) were classified as B3. Lesions displaying epithelial atypia were the most common subtype of lesion, with a prevalence of 39.6%. Lesions displaying epithelial atypia were upgraded to malignancy in 35.7% of cases. Among non-atypical cases, papillary lesions were the most common diagnosis (32.1%) with an upgrade rate of 2%. In situ lobular neoplasia (10.4%) was the third most frequently encountered diagnosis, and was upgraded to malignancy in 10.9% of cases. The upgrade rate in the remaining non-atypical lesions was invariably low (0%-2.6%). CONCLUSIONS Herein, we have shown an overall B3 rate in keeping with published data, whereas lesions displaying epithelial atypia showed upgrade rates to malignancy comparable with that of large United Kingdom studies. In our study, lesions without epithelial atypia showed very low rates of upgrade. A wide range of upgrade rates is seen in cases of lobular neoplasia, which highlights the need for uniformity of nomenclature and reporting within this subtype to accurately ascertain the true risk of upgrade associated with these lesions. The surgical guidelines for male breast cancer (MBC) have been largely guided by female-predominant clinical trials. Because no clinical trial has been conducted to examine the surgical treatment of MBC, we performed a systematic review comparing the survival of patients with MBC who had undergone breast conserving surgery (BCS) and those who had undergone mastectomy and evaluated the patients' radiotherapy compliance after BCS. We performed a systematic search of electronic databases to find MBC cohort studies that had reported ≥ 1 survival outcome (disease-free survival [DFS], disease-specific survival [DSS], or overall survival [OS]) stratified by surgical treatment (BCS and/or mastectomy) and/or radiotherapy compliance with BCS. A total of 1 prospective and 9 retrospective cohort studies were included, with the number of patients ranging from 7 to 6039. Of the BCS patients, compliance with postoperative radiotherapy was low (range, 27%-46%), with the exception of 1 single-institution prospective study that reported 86% compliance (6 of 7 patients). The pooled estimate for all patients with MBC was 83% (95% confidence interval [CI], 78%-88%) for 5-year DSS and 66% (95% CI, 63%-70%) for 5-year OS. Most studies reported no differences in DFS, DSS, or OS for BCS and mastectomy. BCS is a reasonable treatment approach for MBC because it was associated with oncologic outcomes similar to those with mastectomy. However, the low rates of radiotherapy compliance among male patients who underwent BCS is concerning and highlights the importance of shared decision-making with patients with MBC when selecting a surgical treatment strategy. Endobronchial volatile sulfur compounds in patients with lung abscess or lung cancer were measured using the Oral Chroma™ gas chromatograph. High levels of hydrogen sulfide and methyl mercaptan were observed in some patients with lung abscess but not in patients with lung cancer. Measuring endobronchial volatile sulfur compounds could be useful for the rapid diagnosis of lung abscess caused by obligate anaerobes. Dr. Christopher Moriates is the Assistant Dean for Healthcare Value at Dell Medical School, at the University of Texas at Austin. He is also Executive Director for Costs of Care, an international nonprofit focused on clinical insights that improve care at a lower cost. He is also the creator of the Choosing Wisely STARS program in the United States, a national education program teaching medical students about healthcare value. Dr. Moriates is the author of "Understanding Value-Based Healthcare," a guidebook for current and future clinicians. Although the initial clinical trials of cardiac cell therapy have failed to demonstrate unequivocal clinical benefits, the accumulation of preclinical data gathered in parallel can now help us to understand the main causes of failures, while providing mechanistic insights that may be leveraged to improve the outcomes of subsequent clinical studies using cells or their secreted products. This review briefly describes the current status of clinical trials, discusses the potential mechanisms of action of the grafted cells, and the impact of this knowledge on the design of future studies, and finally draws some perspectives. OBJECTIVE To present our initial experience with single-port percutaneous transvesical simple prostatectomy using the novel SP ® robotic surgical system. METHODS Ten patients underwent single-port transvesical simple prostatectomy between February and November 2019. Percutaneous access to the bladder dome was made and all SP ® instruments were inserted through the SP ® multichannel cannula directly into the bladder. Prostate adenoma enucleation, hemostasis and trigonization were done according to the principles of open simple prostatectomy technique. Demographics and perioperative outcomes were prospectively collected and analyzed. RESULTS All procedures were performed successfully without the need for conversion to open surgery. Median pre-operative estimated prostate size was 159 (IQR 108-223) grams. No intraoperative complications occurred. Median operative time and estimated blood loss were 190 (IQR 146-203) minutes and 100 (IQR 68-175) ml, respectively. Mean postoperative specimen weight was 84.3 ± 34 grams. Median length of hospital stay was 19 (IQR 17 - 28) hours. All patients were satisfied with their urinary flow after catheter removal without any episode of acute urinary retention 1 - 6 months, postoperatively. CONCLUSION Single-port transvesical simple prostatectomy can be offered as an alternative treatment option for surgical management of lower urinary tract symptoms associated with large prostate adenoma. Sparing the peritoneal cavity, minimum dissection of the bladder, excellent visualization of the prostate fossa can be some of the potential advantages of this minimally invasive approach. Comparative studies with standard techniques are advisable to evaluate the surgical outcome and postoperative morbidity of each treatment modality. A 74-year-old woman presented to the urology clinic with a protruding mass in her urinary bladder detected by ultrasonography. She had no symptoms. Cystoscopy revealed a 1-cm lesion with a lock of 1-cm-long white hair-like structures on the right side of the bladder. White plaques were also noted covering some areas of the bladder. Transurethral resection of the lesion and biopsy of the white plaques were performed. Pathological examination confirmed a diagnosis of keratinizing squamous metaplasia of the bladder with no evidence of malignancy. Metanephric adenoma (MA) describes a rare renal tumor and is generally considered a benign lesion. However, there are cases with regional lymphogenic and distant metastases. Non-invasive diagnosis of MA using conventional imaging remains challenging. Here, we describe a case of histologically verified MA with additional advanced molecular imaging consisting of 18F-PSMA-1007 PET/CT, 99mTc-Sestamibi SPECT and contrast-enhanced ultrasound. INTRODUCTION Everolimus and bendamustine both have single-agent activity against lymphoid hematologic malignancies. We examined this combination in a group of heavily pretreated patients with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), and multiple myeloma (MM). PATIENTS AND METHODS In this phase I trial, 18 patients (8 with NHL, 6 with MM, and 4 with HL) were treated with bendamustine 90 mg/m2 on days 1 and 2 and everolimus from 5 to 10 mg daily on a 28-day cycle, for up to 4 cycles. RESULTS Adverse events were generally mild and mostly hematologic in nature. The most frequent grade 3/4 adverse events were lymphopenia (61%), thrombocytopenia (22%), leukopenia (22%), neutropenia (17%), and fatigue (17%). Overall response rate varied by malignancy diffuse large B-cell lymphoma, 20% (1 of 5 patients); HL (2 of 4 patients), 50%; MM, 80% (4 of 5 patients); and indolent lymphomas, 100% (3 of 3 patients). The maximum tolerated dose of everolimus was determined to be 7.5 mg daily. CONCLUSION The combination of everolimus and bendamustine appeared to be well-tolerated and relatively efficacious.