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EP1.14-06 Clinical Application of an Appropriate Size NGS Panel in Advanced Non-Small Cell Lung Cancer Management: Personal Experience. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Are we there yet? A critical reflection of Asian medical oncologists on NGS-guided precision treatment in Asia 2018. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy441.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique. Tech Coloproctol 2017; 21:737-743. [DOI: 10.1007/s10151-017-1669-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 06/19/2017] [Indexed: 12/22/2022]
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Interventional management of anterior abdominal wall hematomas: single center experience. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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An imaging review of extramedullary myeloma. Cancer Imaging 2015. [PMCID: PMC4601792 DOI: 10.1186/1470-7330-15-s1-p12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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O12.5 Behavioural interventions improve condom use and hiv testing uptake among female sex workers in china: a systematic review and meta-analysis. Br J Vener Dis 2015. [DOI: 10.1136/sextrans-2015-052270.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Effects of Gender Difference and Caffeine Supplementation on Anaerobic Muscle Performance. Int J Sports Med 2015; 36:974-8. [PMID: 26252548 DOI: 10.1055/s-0035-1550048] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The primary purpose of this study was to investigate the effects of gender difference and caffeine supplementation to maximal voluntary isometric contractions (MVIC) and submaximal voluntary isometric contractions (T(lim)). 10 male (age: 20.10 ± 2.18 years, BMI: 22.23±1.96 kg/m(2)) and 10 female (age: 19.90±0.99 years, BMI: 21.76±2.65 kg/m(2)) elite collegiate athletes were recruited. Subjects ingested caffeine (6 mg/kg) or a placebo in a randomized, double-blind, placebo-control, and counter-balanced fashion. MVIC and T(lim) were measured after supplementations. T(lim) result was calculated based on the time to exhaustion of isometric contraction with 50% MVIC. Fatigue index (FI%) referred to the MVIC tested 20 s after the cessation of T(lim) test, and was indexed by the percentage of MVIC decline. No significant interaction effect was found between the gender factor and the supplementation factor for all dependent variables. Compared to the placebo, caffeine supplementation significantly increased MVIC (5.9%) and T(lim) (15.5%) (p<0.05) whereas it had no significant effect on FI%. This study demonstrates that caffeine supplementation at a 6 mg/kg dosage facilitates performances in MVIC and T(lim). The ergogenic effect of caffeine on muscle power and muscle endurance does not show a gender bias.
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CTPA for clinically suspected pulmonary emboli in oncology patients. Cancer Imaging 2014. [PMCID: PMC4242745 DOI: 10.1186/1470-7330-14-s1-p27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Canadian Spine Society abstracts1.1.01 Supraspinal modulation of gait abnormalities associated with noncompressive radiculopathy may be mediated by altered neurotransmitter sensitivity1.1.02 Neuroprotective effects of the sodium-glutamate blocker riluzole in the setting of experimental chronic spondylotic myelopathy1.1.03 The effect of timing to decompression in cauda equina syndrome using a rat model1.2.04 Intraoperative waste in spine surgery: incidence, cost and effectiveness of an educational program1.2.05 Looking beyond the clinical box: the health services impact of surgical adverse events1.2.06 Brace versus no brace for the treatment of thoracolumbar burst fractures without neurologic injury: a multicentre prospective randomized controlled trial1.2.07 Adverse event rates in surgically treated spine injuries without neurologic deficit1.2.08 Functional and quality of life outcomes in geriatric patients with type II odontoid fracture: 1-year results from the AOSpine North America Multi-Center Prospective GOF Study1.3.09 National US practices in pediatric spinal fusion: in-hospital complications, length of stay, mortality, costs and BMP utilization1.3.10 Current trends in the surgical treatment of adolescent idiopathic scoliosis in Canada1.3.11 Sagittal spinopelvic parameters help predict the risk of proximal junctional kyphosis for children treated with posterior distraction-based implants1.4.12 Correlations between changes in surface topography and changes in radiograph measurements from before to 6 months after surgery in adolescents with idiopathic scoliosis1.4.13 High upper instrumented vertebra (UIV) sagittal angle is associated with UIV fracture in adult deformity corrections1.4.14 Correction of adult idiopathic scoliosis using intraoperative skeletal traction1.5.01 Cauda equina: using management protocols to reduce delays in diagnosis1.5.02 Predicting the need for tracheostomy in patients with acute traumatic spinal cord injury1.5.03 A novel animal model of cervical spondylotic myelopathy: an opportunity to identify new therapeutic targets1.5.04 A review of preference-based measures of health-related quality of life in spinal cord injury research1.5.05 Predicting postoperative neuropathic pain following surgery involving nerve root manipulation based on intraoperative electromyographic activity1.5.06 Detecting positional injuries in prone spinal surgery1.5.07 Percutaneous thoracolumbar stabilization for trauma: surgical morbidity, clinical outcomes and revision surgery1.5.08 Systemic inflammatory response syndrome in spinal cord injury patients: Does its presence at admission affect patient outcomes?2.1.15 One hundred years of spine surgery — a review of the evolution of our craft and practice in the spine surgical century [presentation]2.1.16 Prevalence of preoperative MRI findings of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion2.1.17 Adverse event rates of surgically treated cervical spondylopathic myelopathy2.1.18 Morphometricand dynamic changes in the cervical spine following anterior cervical discectomy and fusion and cervical disc arthroplasty2.1.19 Is surgery for cervical spondylotic myelopathy cost-effective? A cost–utility analysis based on data from the AO Spine North American Prospective Multicentre CSM Study2.2.20 Cost–utility of lumbar decompression with or without fusion for patients with symptomatic degenerative lumbar spondylolisthesis (DLS)2.2.21 Minimally invasive surgery lumbar fusion for low-grade isthmic and degenerative spondylolisthesis: 2- to 5-year follow-up2.2.22 Results and complications of posterior-only reduction and fusion for high-grade spondylolisthesis2.3.23 Fusion versus no fusion in patients with central lumbar spinal stenosis and foraminal stenosis undergoing decompression surgery: comparison of outcomes at baseline and follow-up2.3.24 Two-year results of interspinous spacers (DIAM) as an alternative to arthrodesis for lumbar degenerative disorders2.3.25 Treatment of herniated lumbar disc by sequestrectomy or conventional discectomy2.4.26 No sustained benefit of continuous epidural analgesia for minimally invasive lumbar fusion: a randomized double-blinded placebo controlled study2.4.27 Evidence and current practice in the radiologic assessment of lumbar spine fusion2.4.28 Wiltse versus midline approach for decompression and fusion of the lumbar spine2.5.09 The effect of soft tissue restraints following type II odontoid fractures in the elderly — a biomechanical study2.5.10 Development of an international spinal cord injury (SCI) spinal column injury basic data set2.5.11 Evaluation of instrumentation techniques for a unilateral facet perch and fracture using a validated soft tissue injury model2.5.12 Decreasing neurologic consequences in patients with spinal infection: the testing of a novel diagnostic guideline2.5.13 Prospective analysis of adverse events in surgical treatment of degenerative spondylolisthesis2.5.14 Load transfer characteristics between posterior fusion devices and the lumbar spine under anterior shear loading: an in vitro investigation2.5.15 Preoperative predictive clinical and radiographic factors influencing functional outcome after lumbar discectomy2.5.16 A Thoracolumbar Injury Classification and Severity Score (TLICS) of 4: What should we really do?3.1.29 Adverse events in emergent oncologic spine surgery: a prospective analysis3.1.30 En-bloc resection of primary spinal and paraspinal tumours with critical vascular involvement3.1.31 The treatment impact of minocycline on quantitative MRI in acute spinal cord injury3.1.32 Benefit of minocycline in spinal cord injury — results of a double-blind randomized placebo-controlled study3.2.33 Improvement of magnetic resonance imaging correlation with unilateral motor or sensory deficits using diffusion tensor imaging3.2.34 Comparing care delivery for acute traumatic spinal cord injury in 2 Canadian centres: How do the processes of care differ?3.2.35 Improving access to early surgery: a comparison of 2 centres3.3.36 The effects of early surgical decompression on motor recovery after traumatic spinal cord injury: results of a Canadian multicentre study3.3.37 A clinical prediction model for long-term functional outcome after traumatic spinal cord injury based on acute clinical and imaging factors3.3.38 Effect of motor score on adverse events and quality of life in patients with traumatic spinal cord injury3.4.39 The impact of facet dislocation on neurologic recovery after cervical spinal cord injury: an analysis of data on 325 patients from the Surgical Trial in Acute Spinal Cord Injury Study (STASCIS)3.4.40 Toward a more precise understanding of the epidemiology of traumatic spinal cord injury in Canada3.4.41 Access to care (ACT) for traumatic SCI: a survey of acute Canadian spine centres3.4.42 Use of the Spine Adverse Events Severity (SAVES) instrument for traumatic spinal cord injury3.5.17 Does the type of distraction-based growing system for early onset scoliosis affect postoperative sagittal alignment?3.5.18 Comparison of radiation exposure during thoracolumbar fusion using fluoroscopic guidance versus anatomic placement of pedicle screws3.5.19 Skeletal traction for intraoperative reduction in adolescent idiopathic scoliosis3.5.20 Utility of intraoperative cone-beam computed tomography (O-ARM) and stereotactic navigation in acute spinal trauma surgery3.5.21 Use of a central compression rod to reduce thoracic level spinal osteotomies3.5.22 ICD-10 coding accuracy for spinal cord injured patients3.5.23 Feasibility of patient recruitment in acute SCI trials3.5.24 Treatment of adult degenerative scoliosis with DLIF approaches. Can J Surg 2012. [DOI: 10.1503/cjs.012212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Abstract
This case of splenic peliosis, describes a rare condition when it presents in the spleen, and is better understood when it occurs in the liver. However, the ultrasound and CT features have a wide differential diagnosis including more common aetiologies, of either a vascular, infective or neoplastic nature, which should be considered. Peliosis is an important condition to be aware of because rupture of the blood-filled cysts on the spleen surface can lead to haemorrhagic peritonitis and ultimately be fatal.
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Impact of integrated PET/CT in the staging of oesophageal cancer: a UK population-based cohort study. Clin Radiol 2009; 64:699-705. [PMID: 19520214 DOI: 10.1016/j.crad.2009.03.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 03/25/2009] [Accepted: 03/29/2009] [Indexed: 12/11/2022]
Abstract
AIM To document the impact of integrated positron-emission tomography and computed tomography (PET/CT) on the management of a cohort of UK patients undergoing PET/CT as part of their staging investigations for potentially curable oesophageal cancer. MATERIALS AND METHODS A multicentre, prospective study of newly diagnosed patients with oesophageal cancer undergoing PET/CT was set up across five cancer networks covering a total population of 6.6 million. Data were prospectively collected for cases diagnosed between 1 November 2006 and 31 October 2007. RESULTS One hundred and ninety-one patients underwent PET/CT, with 31 (16%) positive for possible metastatic disease. Amongst the 31 positive examinations, 18 (9.4%) were confirmed to have metastatic disease, and 13 (6.5%) patients had no subsequent evidence of metastatic disease, although in three (1.6%) of these a second previously unsuspected pathology was diagnosed. Two patients had false-negative PET/CT and were found to have metastatic disease. The results of the PET/CT examination down-staged 10 (5%) patients thought to have coeliac/M1a node involvement on CT. Fifteen of 110 (13%) patients with stage 3 or 4 disease at CT and endoscopic ultrasound (EUS) had confirmed metastatic disease at PET/CT, compared with none of 18 with stage 2b, three of 52 (6%) with stage 2a, and none of 10 with stage 1 disease. CONCLUSION This study confirms the role of PET/CT in a multicentre UK setting in the management of patients with potentially curable carcinoma of the oesophagus, improving the accuracy of pre-treatment staging compared with CT and EUS alone. Early tumours infrequently show evidence of metastasis on PET/CT, although further data are required to confidently determine the stage of tumours where PET/CT has no additional value.
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The day-3 thymectomy model for induction of multiple organ-specific autoimmune diseases. ACTA ACUST UNITED AC 2008; Chapter 15:Unit 15.16. [PMID: 18432733 DOI: 10.1002/0471142735.im1516s32] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Autoimmune diseases of the ovary and the stomach are major components of the murine autoimmune polyendocrinopathy syndrome that occurs following experimental perturbation of the normal immune system. Several methods of perturbation can lead to autoimmune disease, and the disease occurs in multiple organs in association with autoantibodies to tissue-specific antigen of the respective organs. The autoimmune diseases develop in a variety of laboratory mouse strains that are not prone to spontaneous autoimmune diseases. This unit describes the induction of autoimmune disease of the ovary and the stomach in mice by thymectomy at the age of day 3 (day-3 thymectomy) and methods for evaluating disease histologically and serologically.
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CT appearances of amyloid lymphadenopathy in a patient with non-Hodgkin's lymphoma. Br J Radiol 2007; 80:e250-2. [DOI: 10.1259/bjr/56686654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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P9 Potential pitfalls in PET???CT imaging. Nucl Med Commun 2006. [DOI: 10.1097/00006231-200612000-00060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Routine computerised tomographic scans of the thorax in surveillance of stage I testicular non-seminomatous germ-cell cancer--a necessary risk? Ann Oncol 2002; 13:237-42. [PMID: 11886000 DOI: 10.1093/annonc/mdf032] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The standard management approach to stage I testicular non-seminomatous germ-cell tumours (NSGCT) in the UK is a surveillance programme with adjuvant bleomycin, etoposide, cisplatin (BEP) chemotherapy being offered to individuals with high risk disease. Conventionally, computed tomography (CT) scanning of the thorax has formed part of the surveillance programme. This paper evaluates the contribution of routine thoracic CT imaging in the management of this disease. PATIENTS AND METHODS We retrospectively reviewed the case notes of 168 patients with stage I NSGCT referred to the Wessex Medical Oncology Unit over a period of 13 years (1986-1998). These patients entered onto a surveillance programme that included serial chest X-ray follow up rather than thoracic CT. RESULTS Forty-two out of 168 patients (25%) evaluated suffered relapse during the follow up period. Eight of 42 patients (19%) relapsed with intrathoracic disease. Seven out of eight of these patients (87.5%) had at least one other indicator of disease recurrence (elevated serum marker, abnormal abdominal CT). One of 42 patients (2.4%) relapsed with isolated intrathoracic disease with no other indicator of relapse. All patients with intrathoracic relapse had evidence of disease on chest X-ray. Of the 42 relapsing patients, 93% could be categorised as having good prognosis metastatic disease. Seven per cent relapsed with intermediate or poor prognostic disease; relapse in these patients would not have been detected earlier with the inclusion of routine thoracic CT. Only one patient has died giving a cure rate of 98% for relapsing patients. CONCLUSIONS The elimination of chest CT did not compromise outcome but significantly reduced radiation exposure thereby minimising the risk of radiation-induced secondary malignancy. Continued review of surveillance programmes is essential if we are to optimise management of this disease.
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Abstract
The mechanism of CD4(+) T cell depletion in human immunodeficiency virus (HIV)-1 infection remains controversial. Using deuterated glucose to label the DNA of proliferating cells in vivo, we studied T cell dynamics in four normal subjects and seven HIV-1-infected patients naive to antiretroviral drugs. The results were analyzed using a newly developed mathematical model to determine fractional rates of lymphocyte proliferation and death. In CD4(+) T cells, mean proliferation and death rates were elevated by 6.3- and 2.9-fold, respectively, in infected patients compared with normal controls. In CD8(+) T cells, the mean proliferation rate was 7.7-fold higher in HIV-1 infection, but the mean death rate was not significantly increased. Five of the infected patients underwent subsequent deuterated glucose labeling studies after initiating antiretroviral therapy. The lymphocyte proliferation and death rates in both CD4(+) and CD8(+) cell populations were substantially reduced by 5-11 weeks and nearly normal by one year. Taken together, these new findings strongly indicate that CD4(+) lymphocyte depletion seen in AIDS is primarily a consequence of increased cellular destruction, not decreased cellular production.
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Abstract
A case of renal cell carcinoma is presented with renal vein and inferior vena cava tumour/thrombus extension and vertebral metastases centred on the basivertebral veins at three contiguous levels in the low thoracic spine. MRI demonstrated tumour in the intervertebral veins, suggesting that the vertebral deposits were due to retrograde venous spread. To our knowledge, vertebral metastatic deposits due to retrograde venous spread in renal cell carcinoma have not been previously demonstrated directly on imaging. A review is given of the venous anatomy relevant to this mode of spread.
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Severe pulmonary toxicity in patients treated with a combination of docetaxel and gemcitabine for metastatic transitional cell carcinoma. Ann Oncol 1999; 10:943-7. [PMID: 10509156 DOI: 10.1023/a:1008377819875] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Both gemcitabine and docetaxel have been associated with pulmonary toxicity when used as single agents. We report a study in which three of five cases developed pulmonary toxicity (which proved fatal in one case) when these drugs were used in combination to treat metastatic transitional cell cancer. PATIENTS AND METHODS Three patients developed dyspnoea, in two cases associated with pulmonary infiltrates, whilst receiving the combination of gemcitabine and docetaxel in a phase I trial. The case notes of all five patients entered into this trial were studied. A literature review was undertaken to gain information on reported pulmonary toxicity with the deoxy-cytidine analogues and taxanes given alone or in combination with or without radiotherapy. RESULTS Three patients developed delayed dyspnoea whilst receiving gemcitabine/docetaxel in combination. This settled with cessation of treatment in one patient, however in the remaining two cases significant hypoxia developed, associated radiologically with evidence of progressive pulmonary infiltrates. One of these patients developed respiratory failure after bronchoscopy and biopsy and died. His chest X-ray changes were consistent with adult respiratory distress syndrome. The transbronchial biopsy and post mortem lung histology in this patient showed diffuse alveolar damage. The remaining patient settled with high dose prednisolone but died subsequently of progressive metastatic disease. CONCLUSION The combination of gemcitabine and docetaxel showed promising activity in this small study. The development of pulmonary symptoms in three cases with radiological lung infiltrates in two other cases was cause for concern. Patients receiving this drug combination should be closely monitored for similar problems.
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The management of inferior vena cava obstruction complicating metastatic germ cell tumors. Cancer 1999; 85:912-8. [PMID: 10091770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Inferior vena cava obstruction (IVCO) is a poorly characterized complication of metastatic germ cell tumor (GCT). The authors identified 31 cases to describe the clinical features, radiologic findings, complications, and treatment of this clinical entity. METHODS Patients with GCT and IVCO were identified from case records of a GCT database. The records of 333 male patients with metastatic GCT (27% with seminoma and 73% with nonseminomatous GCTs) were screened for either clinical or computed tomography (CT) scan evidence of inferior vena cava compression or involvement. RESULTS Thirty-one patients were identified (9.3% of patients with metastatic GCT). Common presenting symptoms were leg swelling and dilated abdominal wall veins. Approximately 29% of patients had thromboembolic complications and there was a single case of fatal pulmonary embolism. Nine patients had no clinical features at presentation but either had CT scan evidence of IVCO or developed symptoms during treatment. Right-sided testicular primary tumors were associated more frequently with IVCO compared with left-sided primary tumors (14% vs. 4% of cases of metastatic GCT, respectively). All patients had an abdominal mass measuring > 5 cm in maximum transverse dimension. CONCLUSIONS The authors recommend careful clinical and radiologic evaluation for the presence of IVCO in cases of bulky metastatic GCT. A high index of suspicion must accompany the evaluation of a patient with a right-sided primary testicular tumor and a paracaval abdominal mass measuring > 5 cm in maximum transverse dimension. When IVCO is identified, prophylactic anticoagulation is recommended.
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Abstract
We describe the radiological findings at presentation and follow up in 24 adult patients with Burkitt's and Burkitt-like lymphoma, age range 17-67 years. This is an older age group than previously described in North American series, but the clinical and imaging characteristics appear similar. Disease confined to the abdomen was seen in 12 (50%) at presentation, of whom 11 had bowel or mesenteric tumours. Of those with bowel involvement, five patients had disease that had arisen in the ileocaecal region. Intra-abdominal disease was large volume (greater than 5 cm) in the majority of patients. Four patients (17%) had small isolated masses in the head and neck region, two (8%) had isolated unilateral axillary lymphadenopathy. Six (25%) patients presented with disseminated disease, all with hepatic and/or splenic involvement, intra-abdominal and peripheral lymphadenopathy. Three of these patients with disseminated disease were human immunodeficiency virus (HIV) positive. Neurological symptoms were present in a total of five patients at presentation or relapse but positive imaging findings were present in only two patients who had MRI. Computed tomography (CT) head scans performed in four patients were normal. Disease recurrence most commonly occurred within the abdomen.
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Malfunctioning central venous catheters. Clin Radiol 1998; 53:708-9. [PMID: 9766731 DOI: 10.1016/s0009-9260(98)80305-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Abstract
The imaging and clinical findings of 31 patients with supradiaphragmatic nodal metastases from primary testicular germ cell cancers were reviewed. In 11 patients the primary testicular tumor was a seminoma, and in 20 a non-seminomatous germ cell tumour (NSGCT). The patterns of spread of these tumour types were compared. All patients had chest radiographs (CXR): 27 had chest computed tomography (CT). One patient with seminoma and eight with NSGCT (40%) had lung metastases. Mediastinal lymphadenopathy was seen on CT in seven patients with seminoma (64%) and in nine patients with NSGCT (45%). Neck lymphadenopathy was present in 10 of 11 (91%) patients with seminoma, and 13 of 20 (65%) patients with NSGCT. Neck disease co-existed with mediastinal disease in six of 11 (55%) patients with seminoma, but in only two of 20 (10%) patients with NSGCT (P=0.012). This study gives further supporting evidence for the relative importance of haematogenous spread in teratoma, and lymphatic spread in seminoma. The contiguous nature of disease spread from abdomen to chest and neck in seminoma is confirmed. In NSGCT, supradiaphragmatic spread is more random but tends to occur in the paraoesophageal and subcarinal groups.
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Primary pure teratoma of the testis. J Urol 1996; 155:939-42. [PMID: 8583612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Despite its histologically benign appearance, primary pure teratoma of the testis is believed to have metastatic potential and behave similarly to other nonseminomatous germ cell tumors. We present our experience with the natural history and management of pure teratoma. MATERIALS AND METHODS We reviewed the histological findings and clinical history of 15 patients with primary pure teratoma who were treated during a 15-year period, accounting for 4.2% of all nonseminomatous germ cell tumors treated during the same period. Fourteen patients were available for followup and are included in this report. RESULTS In 8 patients the tumor was composed entirely of mature teratoma and in 6 immature elements were also present, although this finding was not associated with an increased frequency of metastatic disease. Carcinoma in situ was found adjacent to the tumor in 12 cases. Of 10 patients with stage I disease at presentation who were entered on a surveillance program only 2 have had relapse. The remaining 4 patients had metastatic disease at presentation and, thus, metastatic disease occurred in a total of 6 of the 14 patients (43%) with a median followup of 46 months (range 5 to 197). Metastatic disease was confined to the retroperitoneum in all 6 patients and only 2 patients had elevated serum marker levels. Five patients were treated with primary chemotherapy followed by resection of a residual mass and in all cases teratoma was identified in the resected mass. One patient underwent surgical excision of a retroperitoneal mass, which contained teratoma and yolk sac tumor, followed by chemotherapy. All patients are alive without evidence of progressive disease. CONCLUSIONS In patients with primary pure teratoma of the testis metastatic disease may develop and the metastases may contain other subtypes of nonseminomatous germ cell tumors in addition to teratoma. There is probably a reduced frequency of relapse, which should be considered when advising patients with stage I disease, but otherwise management should be the same as for other testicular nonseminomatous germ cell tumors and the prognosis should be excellent.
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Case report: multiple myeloma--a cause of obstructive jaundice. Clin Radiol 1995; 50:874-5. [PMID: 8536404 DOI: 10.1016/s0009-9260(05)83114-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
Combined appropriate anaesthetic and surgical techniques have allowed increasing numbers of patients to be successfully managed in a general surgical recovery ward after cardiac surgery rather than in an intensive care unit. From 1983 to 1989, 933 of 1542 patients undergoing open heart surgery were transferred to the general surgical recovery ward in the immediate postoperative period. Of these, 718 (77%) had undergone coronary artery bypass grafts, sometimes combined with other procedures and 168 (18%) had had cardiac valve replacements with or without other procedures. The remaining 47 (5%) had had miscellaneous cardiac operations. Significant cardiac complications occurred in 29 (3%) patients. The 24 hour chest radiograph was reported as abnormal (mainly atelectasis and effusion) in 63% of patients. Most resolved spontaneously or with physiotherapy. Twenty nine (3%) patients were re-explored to achieve haemostasis. There were no deaths in the general surgical recovery ward. Thirty seven (4%) patients had to be transferred to the intensive care unit for various reasons. The remaining 896 patients were transferred to the general ward after one night (871 patients) or two nights (25 patients) in the general surgical recovery ward. The average duration of stay in hospital for these patients was 9.3 days. Because of the overall success of such management and the low rate of complications over 80% of patients are now managed in the general surgical recovery ward after open heart surgery. The resulting savings in capital expenditure of equipment, medical, nursing, and technical personnel are substantial, and there are major implications for the planning of new cardiothoracic units.
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T lymphocyte expression of complement receptor 2 (CR2/CD21): a role in adhesive cell-cell interactions and dysregulation in a patient with systemic lupus erythematosus (SLE). Clin Exp Immunol 1992; 90:235-44. [PMID: 1424280 PMCID: PMC1554594 DOI: 10.1111/j.1365-2249.1992.tb07935.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Complement receptor 2 (CR2, CD21), the receptor for both the C3d,g portion of human complement component C3 and the Epstein-Barr virus, has been recently described on peripheral T cells. By using dual stain flow cytometric analysis, we have also observed that a peripheral T lymphocyte subpopulation of normal healthy donors bears CR2 in a range varying from 1.1 to 23.2% (mean 12.6%) of total CD3+ cells. T lymphocytes from nine patients with inactive SLE expressed CR2 in a similar range. Three patients with active SLE were also studied. One of them, having neuropathy and glomerulonephritis, displayed an expansion of the CR2 T cell subpopulation which reached as much as 89% of total CD3+ cells. To examine potential functional roles of T cell CR2, cells from a Jurkat-derived CR2 expressing T cell line were found to bind in vitro to human CR2-, complement-coated K562 cell targets in a CR2- and complement-dependent fashion. Based on these studies, we hypothesize that CR2 might act to increase adherence of T cells to nucleated target cells bearing C3d,g, a function which may be relevant to cytotoxicity or other T cell activities requiring cell-cell interaction.
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Abstract
Sixty seven patients with biopsy proven pulmonary sarcoidosis were prospectively studied to determine whether single point bronchoalveolar lavage cell counts were a useful indicator of functional outcome and whether repeated lavage helped in management. The mean follow up period was 25 (range 13-37) months. No patient was having corticosteroid treatment at the time of initial bronchoalveolar lavage. "High intensity alveolitis" (lymphocyte count greater than or equal to 28%) was present at the initial lavage in 42 patients. These patients showed a significant improvement in their pulmonary function and chest radiographs over the follow up period whereas patients with "low intensity alveolitis" did not. Of the 42 patients with high intensity alveolitis, 31 had chronic sarcoidosis (duration over two years, mean 80 months). These patients showed a significant improvement in FVC but not in TLCO. Corticosteroids resulted in greater functional and radiological improvement in the patients with high intensity alveolitis than in those with low intensity alveolitis. Repeat bronchoalveolar lavage in 34 patients, mean 8.4 months after the original lavage, showed a weak inverse relation between a reduced lymphocyte count and change in forced vital capacity and isotope uptake on a gallium scan. These correlations were too weak to make repeated cell counts useful in management. Our results suggest that high intensity alveolitis may be a favourable prognostic factor for lung function in pulmonary sarcoidosis, even in patients with chronic disease, but that repeat lavage adds little to the management of the individual patient.
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A transient rise in agalactosyl IgG correlating with free interleukin 2 receptors, during episodes of erythema nodosum leprosum. Clin Exp Immunol 1989; 76:343-7. [PMID: 2787714 PMCID: PMC1541882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The proportion of oligosaccharide chains on the Fc fragment of IgG which terminate with N-acetylglucosamine and not galactose (%GO) has previously been shown to be raised in rheumatoid arthritis (RA), Crohn's disease (CD) and tuberculosis (Tb), but to be normal in sarcoidosis (SA), and in both lepromatous and tuberculoid leprosy. However we have now studied %GO in sequential serum samples collected from lepromatous leprosy patients undergoing episodes of erythema nodosum leprosum (ENL). During ENL %GO is transiently raised, and this rise parallels an increase in circulating interleukin 2 receptors (IL-2R). These findings confirm that changes in T cell function occur during ENL. Moreover it appears that %GO rises when there is, simultaneously, T-cell-mediated tissue damage and an acute phase response (RA, CD, Tb, ENL), but not when there is an acute phase response without major T cell involvement, or chronic T cell activity alone (SA, and tuberculoid leprosy). We suggest therefore that %GO is an indicator of a type of T cell activity with broad immunopathological implications.
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32
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Sarcoidosis and lymphoma. SARCOIDOSIS 1988; 5:150-2. [PMID: 3227190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Hodgkin's Disease may mimic sarcoidosis, as seen in this case report.
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Renal transplant obstruction by B cell lymphoproliferative disorder: case report and review of the literature. J Urol 1988; 140:593-5. [PMID: 2842516 DOI: 10.1016/s0022-5347(17)41729-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We report a case of renal transplant ureteral obstruction caused by a cyclosporine-associated B cell lymphoproliferative disorder. The interaction of cyclosporine with Epstein-Barr virus infections and the predisposition towards B cell lymphoproliferative disorders are reviewed. The characterization of these tumors by deoxyribonucleic acid hybridization studies and a review of the clinical experience treating these disorders also are presented.
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34
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35
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Immunologic basis of male infertility. J Transl Med 1987; 57:1-4. [PMID: 3599912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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36
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pH and protease control of acrosomal content stasis and release during the guinea pig sperm acrosome reaction. Biol Reprod 1985; 32:451-62. [PMID: 3886029 DOI: 10.1095/biolreprod32.2.451] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The purpose of this study was to examine how trypsin inhibitors affect the guinea pig sperm acrosome reaction in vitro. Using spermatozoa pretreated with lysophosphatidyl choline, we found that both naturally occurring high molecular weight and the smaller synthetic trypsin inhibitor p-aminobenzamidine (PAB) delayed the onset of the acrosome reaction as monitored by light microscopy. Examination with electron microscopy revealed that acrosomal matrix dispersal rather than membrane fusion was affected. Despite the morphologic delay in acrosomal content release, PAB unexpectedly permitted 96% of soluble acrosomal antigen to be released into the supernatant. In addition, total acrosin release in the presence of PAB was 74% of control, with the vast majority as latent rather than active enzyme. A morphologically intact but membrane-free target of acrosomal matrix (AM), which is sensitive to trypsin inhibitor, was partially purified using Triton-x-100 at pH 5.2. AM remained morphologically stable at pH 5.2; however, shift up to pH 7 resulted in rapid dissolution within several minutes as monitored by light and electron microscopy and light scattering. Trypsin inhibitor prevented dispersion of AM at pH 7. The results suggest that, during the acrosome reaction, one distinct region of the acrosomal contents disperses after membrane vesiculation in a pH and trypsin inhibitor-insensitive fashion while a pH sensitive trypsin-like activity (acrosin?) disperses another discrete region of acrosomal matrix.
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37
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Identification by flow cytometry of human monocytes with fucose-binding lectin (FBL) from Lotus tetragonolobus seeds. JOURNAL OF THE RETICULOENDOTHELIAL SOCIETY 1983; 34:113-23. [PMID: 6577187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Fucose binding lectin (FBL) from Lotus tetragonolobus seeds has previously been shown by fluorescence microscopy to bind to human neutrophils. This study shows using highly sensitive flow cytometry that this lectin binds both to human peripheral blood neutrophils and monocytes but not to lymphocytes. This binding is blocked by the presence of free L-fucose and is reversible when neutrophils or monocytes stained with fluorescent FBL are subsequently incubated in 0.05 M L-fucose. Quantitative comparison of neutrophils and monocytes from the same individual show that neutrophils bind approximately 2.6 times more FBL than monocytes and that FBL binding is more efficiently reversed with neutrophils, as compared with monocytes, by L-fucose. Additional double-labeling studies of cells with FBL and the OKM1 monoclonal antibody, which identifies monocytes and granulocytes, show that all cells binding FBL also stain with the OKM1 monoclonal antibody. This study shows that qualitatively, FBL may be utilized as a human myeloid cell marker to differentiate peripheral blood monocytes and neutrophils from lymphocytes.
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