AFP is a glycoprotein of an oncofoetal origin. Its level is increased in patients with cirrhosis complicated by HCC. Primarily, it is a foetal-specific antigen produced in the liver of the foetus. After birth, its serum concentration falls rapidly and decreases through adult life. Elevation of serum AFP occurs normally during pregnancy, and an abnormal rise has been reported with gonadal tumours (both germ cell and non-germ cell)[85] and in a different variety of other malignancies, especially cancer stomach[86]. Several studies reported a rise of serum AFP in patients with chronic hepatic disease without HCC, and in patients with acute or chronic viral hepatitis[87,88]. In addition, patients with HCV-related cirrhosis may have a slightly higher concentration level of AFP. In one series, patients who had been treated with a combination of pegylated interferon plus ribavirin for HCV-related cirrhosis demonstrated significant decrease in AFP level after treatment[89]. Additionally, in small HCCs the serum concentrations of AFP are normal in up to 40%, as not all tumours secrete AFP[90].
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The overall culture positivity rate was 7.5%. Of 83 cultured organisms, 38(46%) were Gram-negative, 43(52%) Gram-positive and 2(2%) Candida species. Among the 38 Gram-negative isolates, 16 (42%) were E. coli, 15 (39%) K. pneumoniae and 4 (11%) P. aeruginosa. Resistance against commonly used antibiotics for Gram-negative bacteria at the study site was: piperacillin/tazobactam 48%(13), ampicillin/sulbactam 93%(25), cefotaxime 89%(24), ceftazidime 74%(20), cefipime74%(20), and amikacin 4%(1). Of 27 Gram-negative bacteria available for resistance-gene detection, blaNDM-1 was detected in one K. pneumoniae isolate and blaNDM-1 plus blaOXA-51 in A. baumannii. 81% (22/27) of the Gram-negative rods were confirmed to contain ESBL-genes as follows: TEM 17 (77%), CTX-M-1-group 15(68%), and SHV-6(27%).
after a year-plus of searching, we were fortunate to find a dream team of IT experts who agreed to restore the FACT tool we lost to the Remove-Flash-from-Browsers campaign and make the Classic tool Mac-User-friendly. Here is an exerpts from the agreement signed today.
Spinal intradural arachnoid cysts are rare causes of radiculopathy or myelopathy. Treatment options include resection, fenestration, or cyst drainage. To classify intradural spinal arachnoid cysts and present results of their treatment. Among 1519 patients with spinal space occupying lesions, 130 patients demonstrated intradural arachnoid cysts. Neuroradiological and surgical features were reviewed and clinical data analyzed. Twenty-one patients presented arachnoid cysts as a result of an inflammatory leptomeningeal reaction related to meningitis, subarachnoid hemorrhage, intrathecal injections, intradural surgery, or trauma, ie, secondary cysts. For the remaining 109 patients, no such history could be elucidated, ie, primary cysts. Forty-six percent of primary and 86% of secondary cysts were associated with syringomyelia. Patients presented after an average history of 53 88 months. There were 122 thoracic and 7 lumbar cysts plus 1 cervical cyst. Fifty-nine patients with primary and 15 patients with secondary cysts underwent laminotomies with complete or partial cyst resection and duraplasty. Mean follow-up was 57 52 months. In the first postoperative year, profound improvements for primary cysts were noted, in contrast to marginal changes for secondary cysts. Progression-free survival for 10 years following surgery was determined as 83% for primary compared to 15% for secondary cysts. Despite differences in clinical presentation, progression-free survival was almost identical for patients with or without syringomyelia. Complete or partial resection leads to favorable short- and long-term results for primary arachnoid cysts. For secondary cysts, surgery can only provide clinical stabilization for a limited time due to the often extensive arachnoiditis. Copyright 2017 by the Congress of Neurological Surgeons
The authors present the case of a 64-year-old woman who was referred for severe sacral pain. She reported that her pain had been longstanding, and had greatly increased after percutaneous fibrin glue placement therapy for a sacral meningeal cyst 2 months earlier at a different hospital. An MRI scan obtained immediately after fibrin glue placement at that hospital suggested that fibrin glue had migrated superiorly into the subarachnoid space from the sacral cyst to the level of L-4. On admission to the authors' institution, physical examination demonstrated no abnormal findings except for perianal hypesthesia. An MRI study obtained at admission demonstrated a cystic lesion in the peridural space from the level of S-2 to S-4. Inhomogeneous intensity was identified in this region on T2-weighted images. Because the cauda equina and nerve roots appeared to be compressed by the lesion, total cyst excision was performed. The cyst cavity was filled with fluid that resembled CSF, plus gelatinous material. Histopathological examination revealed that the cyst wall was composed of hyaline connective tissue with some calcification. No nervous tissue or ganglion cells were found in the tissue. The gelatinous material was acellular, and appeared to be degenerated fibrin glue. Sacral pain persisted to some extent after surgery. The authors presumed that migrated fibrin glue caused the development of adhesive arachnoiditis. The risk of adhesive arachnoiditis should be considered when this therapy is planned. Communication between a cyst and the subarachnoid space should be confirmed to be sufficiently narrow to prevent the migration of injected fibrin glue.
One hundred and seventy-eight cases of unicameral bone cysts (UBC) treated with curettage and bone grafting were compared to 141 cases treated with cortisone injections. The end results were comparable in the two groups. Local recurrence risk factors in the surgical group were active cyst and previous operations. In the other group they were multilocation of the cyst, active cyst, and size of cyst. A new radiographic classification of aneurysmal bone cyst (ABC) is proposed in a report of 198 cases of ABC. The treatment of choice in ABC is surgical and the type (curettage, curettage plus phenole or cryosurgery, resection or hemiresection) is selected on the basis of the radiographic aspect and the rate of growth of the cyst. Radiotherapy is only indicated in inoperable ABC cases.
Estarellas, Marta P., D'Amico, Irene orcid.org/0000-0002-4794-1348 and Spiller, Timothy P. orcid.org/0000-0003-1083-2604 (2017)Robust quantum entanglement generation and generation-plus-storage protocols with spin chains. Physical Review A. 042335. ISSN 1094-1622 2ff7e9595c