Management of arteriovenous malformations (AVMs) remains challenging because of their unpredictable behavior and high recurrence rate. A multidisciplinary approach based on a new classification ...scheme and improved diagnostic techniques may improve their management. The purpose of this study was to review our experience with combined embolotherapy, sclerotherapy (embolo/sclerotherapy), and surgical procedures to manage AVMs.
A total of 797 patients with congenital vascular malformations (January 1995 through December 2001) was investigated with noninvasive studies. Once an AVM was diagnosed, all underwent angiographic confirmation as a roadmap for treatment. Embolo/sclerotherapy and surgical procedures were instituted by the multidisciplinary team with periodic follow-up per protocol. Seventy-six patients with AVMs were reviewed retrospectively to assess the diagnosis and management by a multidisciplinary approach.
Seventy-six (9.5% of all CVM) patients had AVMs, mostly infiltrating, extratruncular form (61/76). Embolo/sclerotherapy with various combinations of absolute ethanol,
N-butyl cyanoacrylate (NBCA), contour particles, and coils were used in 48 patients. Sixteen patients with surgically accessible localized lesions completed preoperative embolism and sclerotherapy through 24 sessions, with subsequent surgical excision with minimal morbidity. Interim results were excellent, with no evidence of recurrence in all 16 patients with a mean follow-up of 24 months. Thirty-two patients with surgically inaccessible lesions (infiltrating) were treated with embolism and sclerotherapy alone. There were nine failures in a total of 171 sessions. Interim results with a mean of 19 months' follow-up of embolism and sclerotherapy alone were excellent in the majority (25/32) and good to fair among the rest (7/32). However, 31 complications, mostly minor (27/31), occurred in 30 sessions. Four major complications occurred, including facial nerve palsy, pulmonary embolism, deep vein thrombosis, and massive necrosis of an ear cartilage.
Diagnosis and management of AVMs by a multidisciplinary approach that integrates surgical therapy with embolism and sclerotherapy appears to improve the results and management with limited morbidity and no recurrence during early follow-up.
Clinical features and outcomes of extranodal natural killer/T-cell lymphoma (ENKL) arising from extranasal sites are not fully understood. The purpose of this study was to study the prognosis and ...treatment outcome of skin/soft tissue primary ENKL.
This multicenter retrospective study included 48 patients with skin/soft tissue primary ENKL diagnosed from 1993 to 2010.
Patients with Ann Arbor stage I, T1–2N0M0 by International Society for Cutaneous Lymphomas–European Organization of Research and Treatment of Cancer TNM (tumour–node–metastasis) stage, International prognostic index score of 0–1, and a Korean prognostic index (KPI) score of 0–1 were associated with better survival. Four of five patients with T1–2N0M0 disease achieved complete response with radiation alone. In disseminated disease, only 6 of 13 patients responded to anthracycline-containing chemotherapy, and all the two patients receiving SMILE showed response.
In conclusion, we identified the prognostic value of KPI, and we suggest a treatment recommendation according to the TNM (tumour–node–metastasis) stage. Radiotherapy with/without chemotherapy seemed to be optimal in localized disease. In advanced stages, a more aggressive treatment regimen with newer agents should be sought.
Background
Asians increasingly seek non-surgical facial esthetic treatments, especially at younger ages. Published recommendations and clinical evidence mostly reference Western populations, but ...Asians differ from them in terms of attitudes to beauty, structural facial anatomy, and signs and rates of aging. A thorough knowledge of the key esthetic concerns and requirements for the Asian face is required to strategize appropriate facial esthetic treatments with botulinum toxin and hyaluronic acid (HA) fillers.
Methods
The Asian Facial Aesthetics Expert Consensus Group met to develop consensus statements on concepts of facial beauty, key esthetic concerns, facial anatomy, and aging in Southeastern and Eastern Asians, as a prelude to developing consensus opinions on the cosmetic facial use of botulinum toxin and HA fillers in these populations.
Results
Beautiful and esthetically attractive people of all races share similarities in appearance while retaining distinct ethnic features. Asians between the third and sixth decades age well compared with age-matched Caucasians. Younger Asians’ increasing requests for injectable treatments to improve facial shape and three-dimensionality often reflect a desire to correct underlying facial structural deficiencies or weaknesses that detract from ideals of facial beauty.
Conclusions
Facial esthetic treatments in Asians are not aimed at Westernization, but rather the optimization of intrinsic Asian ethnic features, or correction of specific underlying structural features that are perceived as deficiencies. Thus, overall facial attractiveness is enhanced while retaining esthetic characteristics of Asian ethnicity. Because Asian patients age differently than Western patients, different management and treatment planning strategies are utilized.
Level of Evidence V
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We investigated the feasibility of i.v. BU, CY and etoposide (BUCYE), followed by auto-SCT (ASCT) in patients with newly diagnosed primary central nervous system lymphoma (PCNSL). The planned ...treatment consisted of induction chemotherapy with five cycles of high-dose MTX and two cycles of high-dose cytarabine followed by conditioning with BUCYE (BU 3.2 mg/m², day -7 to day -5; CY 50 mg/kg, day -3 to day -2 and etoposide 200 mg/m², twice a day, days -5 and -4) and then ASCT. Between May 2005 and November 2008, 11 consecutive PCNSL patients were treated. All patients completed the treatment as planned, with no cases of treatment-related death or veno-occlusive disease. After BUCYE and ASCT, 10 patients achieved complete response (CR) or unconfirmed CR (CRu). Two patients, one partial response and one CRu, received further whole-brain radiotherapy, with all achieving CR. At a median follow-up of 25.0 months (8.8-50.7 months), six patients had relapsed, with a median event-free interval of 15.0 months (95% confidence interval, 4.5-25.6 months). Median survival time was not reached yet with a 2-year survival rate of 88.9%. The current treatment was feasible with a favorable tolerance profile. However, further regimen optimization is necessary because of high relapse rate.
A new reconfigurable field-effect transistor (RFET) named as recessed-channel RFET (RC-RFET) is introduced herein to improve scalability, current drivability and subthreshold swing (S). There are two ...distinct features which allow RC-RFET to show enhanced performance than conventional RFET. First, a novel structure based RC and stacked gates increases effective channel length which results in suppressed short-channel-effect without any integration density penalty. Second, the switching mechanism of RC-RFET (thermionic emission) differs from that of conventional RFET (Schottky barrier tunnelling). It enables RC-RFET to overcome the fundamental limit of S degradation as a function of gate voltage and promises higher ON–OFF current ratio (ION/IOFF) and its low-power applications. As a result, the RC-RFET shows ION/IOFF higher than 107, small drain induced barrier lowering about 15 mV/V and ideal S (∼63 mV/decade) for 50 nm gate length.
Heat shock proteins (HSPs) consist of highly preserved stress proteins that are expressed in response to stress. Two studies were carried out to investigate whether HSP genes in hair follicles from ...beef calves can be suggested as indicators of heat stress (HS). In study 1, hair follicles were harvested from three male Hanwoo calves (aged 172.2 ± 7.20 days) on six dates over the period of 10 April to 9 August 2017. These days provided varying temperature-humidity indices (THIs). In study 2, 16 Hanwoo male calves (aged 169.6 ± 4.60 days, with a BW of 136.9 ± 6.23 kg) were maintained (4 calves per experiment) in environmentally controlled chambers. A completely randomized design with a 2 × 4 factorial arrangement involving two periods (thermoneutral: TN; HS) and four THI treatment groups (threshold: THI = 68 to 70; mild: THI = 74 to 76; moderate THI = 81 to 83; severe: THI = 88 to 90). The calves in the different group were subjected to ambient temperature (22°C) for 7 days (TN) and subsequently to the temperature and humidity corresponding to the target THI level for 21 days (HS). Every three days (at 1400 h) during both the TN and HS periods, the heart rate (HR) and rectal temperature (RT) of each individual were measured, and hair follicles were subsequently collected from the tails of each individual. In study 1, the high variation (P < 0.0001) in THI indicated that the external environment influenced the HS to different extents. The expression levels of the HSP70 and HSP90 genes at the high-THI level were higher (P = 0.0120, P = 0.0002) than those at the low-THI level. In study 2, no differences in the THI (P = 0.2638), HR (P = 0.2181) or RT (P = 0.3846) were found among the groups during the TN period, whereas differences in these indices (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) were observed during the HS period. The expression levels of the HSP70 (P = 0.0010, moderate; P = 0.0065, severe) and HSP90 (P = 0.0040, severe) genes were increased after rapid exposure to heat-stress conditions (moderate and severe levels). We conclude that HSP gene expression in hair follicles provides precise and accurate data for evaluating HS and can be considered a novel indicator of HS in Hanwoo calves maintained in both external and climatic chambers.
Treatments for breast cancer often include interventions related to psychosocial issues such as negative body image, loss of femininity, and low self‐esteem. We identified the psychological effects ...of a cosmetics education programme in patients with breast cancer. Cosmetic programme is a specific care designed to help patients handle appearance‐related side effects. Thirty‐one women with breast cancer at a university hospital in South Korea who received a cosmetics education programme were compared with 29 subjects in a control group who received the treatment as usual. Psychological factors including distress, self‐esteem, and sexual functioning were assessed three times (before and after the programme, and at the 1‐month follow‐up). After the programme, patients in the treatment group were significantly less likely than those in the control group to rely on distress (P = 0.038) and avoidance coping (P < 0.001) but not on self‐esteem. The mean scores in the treatment group for sexual functioning were higher than those in the control group after the treatment. Our results suggest the potential usefulness of a brief cosmetics education programme for reducing distress and reliance on negative coping strategies. Implementing a cosmetics programme for patients with breast cancer may encourage patients to control negative psychological factors.
Synthetic MR imaging enables the acquisition of phase-sensitive inversion recovery images. The aim of this study was to compare the image quality of synthetic phase-sensitive inversion recovery with ...that of other sequences in infants.
Brain MR imaging with 3D T1-weighted fast-spoiled gradient recalled, synthetic T1WI, and synthetic phase-sensitive inversion recovery of 91 infants was compared. Contrast between unmyelinated WM and myelinated WM and between unmyelinated WM and cortical GM was calculated. Qualitative evaluation of image quality and myelination degree was performed. In infants with punctate white matter injuries, the number of lesions was compared.
The contrast between unmyelinated WM and myelinated WM was higher in synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled or synthetic T1WI (
< .001). Compared with synthetic T1WI, synthetic phase-sensitive inversion recovery showed higher gray-white matter differentiation (
< .001) and myelination degree in the cerebellar peduncle (
< .001). The number of detected punctate white matter injuries decreased with synthetic phase-sensitive inversion recovery compared with fast-spoiled gradient recalled sequences (1.2 ± 3.2 versus 3.4 ± 3.6,
= .001).
Synthetic phase-sensitive inversion recovery has the potential to improve tissue contrast and image quality in the brain MR imaging of infants. However, we have to be aware that synthetic phase-sensitive inversion recovery has limited value when assessing punctate white matter injuries compared with 3D fast-spoiled gradient recalled imaging.
The Tb3+-doped gadolinium calcium silicoborate (BSGdCaTb) glasses of composition (55-x) B2O3 - 10 SiO2 - 25 Gd2O3 -10 CaO -x Tb2O3, where x = 0.01, 0.05, 0.1, 0.5, 1.0, and 2.0 mol %, have been ...prepared by conventional melt quenching technique and are characterized through thermal, absorption, excitation, emission and decay rate measurements. The optical band gap (Eopt) and Urbach's energies (ΔE) have been evaluated taking into account the ultraviolet (UV) edge of absorption spectra. The Tb3+ -doped BSGdCaTb glasses exhibit strong emission in the green (5D4 → 7FJ, J = 3,4,5 and 6) and very weak emission in the ultraviolet blue (5D3 → 7FJ, J = 3,4,5 and 6) transitions under excitation at 275 nm, respectively. The intensity of the 5D4 → 7F5 (green at 543 nm) and 5D3 → 7F4 (blue at 436 nm) emissions and their integrated intensity ratios (IG/IB) and (IB/IG) under 275 nm excitation have been obtained as a functions of Tb3+ concentration, respectively. The emission intensity of Gd3+ at 312 nm decreases with increasing of Tb2O3 concentration, while emission intensity of Tb3+ increases upto 1.0 mol % concentration of Tb2O3. The Tb3+ ion decay time for 5D4 level has been determined and is found to be slightly decreases with increasing of Tb2O3 concentration. The CIE color coordinates and color purity have been calculated for Tb3+-doped glasses and it have found to be shift towards the bright green region with increasing of Tb3+ ion concentration in BSGdCaTb glasses.
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•Tb3+-doped gadolinium calcium silicoborate glasses were prepared and characterized.•Luminescence and energy transfer from Gd3+ to Tb3+ ions have been studied.•Intensity ratios (IB/IG) and (IG/IB) under 275 nm excitation were studied as a functions of Tb3+ concentration.•BSGdCaTb2.0 glass exhibits a strong green emission at 543 nm with βexp of 60% and color purity of 78%.•BSGdCaTb glasses could be considered as a good candidate for solid state green laser applications.
Insulating magnets can display novel signatures of quantum fluctuations as similar to the case of metallic magnets. However, their weak spin-lattice coupling has made such observations challenging. ...Here we find that antiferromagnetic (AF) quantum fluctuations manifest in the dielectric properties of multiferroic Ba2CoGe2O7, where a ferroelectric polarization develops concomitant to an AF ordering. Upon application of a magnetic field (H), dielectric constant shows a characteristic power-law dependence near absolute zero temperature and close to the critical field Hc=37.1 T due to enhanced AF quantum fluctuations. When H>Hc, the dielectric constant shows the temperature-dependent anomalies that reflect a crossover from a field-tuned quantum critical to a gapped spin-polarized state. We uncover theoretically that a linear relation between AF susceptibility and dielectric constant stems from the generic magnetoelectric coupling and directly explains the experimental findings, opening a new pathway for studying quantum criticality in condensed matter.
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