Symptomatic Remote Cyst after BCNU Wafer Implantation for Malignant Glioma
|
|
- Camron Hawkins
- 5 years ago
- Views:
Transcription
1 Cse Report doi: /nmc.cr Neurol Med Chir (Tokyo) 58, , 2018 Symptomtic Remote Cyst fter BCNU Wfer Implnttion for Mlignnt Gliom Online My 21, 2018 Hideki MATSUMURA, 1 Eiichi ISHIKAWA, 1 Mshide MATSUDA, 1 Noriki SAKAMOTO, 1 Hiroyoshi AKUTSU, 1 Shingo TAKANO, 1 nd Akir MATSUMURA 1 1 Deprtment of Neurosurgery, University of Tsuku, Tsuku, Irki, Jpn Astrct A 43-yer-old mn ws operted on for right frontl oligostrocytom. 14 yers fter the surgery, mgnetic resonnce imging nd positron emission tomogrphy reveled new lesion ner the surgicl cvity. He underwent gross totl resection of the lesion nd implnttion of is-chloroethylnitrosoure (BCNU) wfers fter intropertive pthologicl dignosis of recurrent high-grde gliom. A few dys fter the opertion, the level of consciousness grdully worsened nd left hemipresis developed. A computed tomogrphy scn reveled cyst remote to the surgicl cvity which did not exist 3 dys prior. We performed nterior cyst wll fenestrtion nd removed ll wfers. The chrcteristic pthologicl finding t the wfer implnttion site ws severe inflmmtion within nd round smll vessels. This inflmmtory rection ws not seen on the surfce of the rin prenchym. After surgery nd rehilittion, the ptient s Krnofsky Performnce Sttus stilized to pre-incident score of 90 nd he returned to work. The exct pthophysiologicl mechnism of the cyst ws not cler, ut check-vlve nd/or osmotic grdient mechnisms relted to BCNU wfer implnttion could hve contriuted to this phenomenon. As remote cyst development hppened week fter surgery, surgeons should e wre of such rre condition when implnting wfers s consciousness impirment nd hemipresis my occur. Close rdiologicl follow-up is therefore necessry. Key words: BCNU wfers, crmustine wfers, cyst formtion, symptomtic remote cyst, mlignnt gliom Introduction is-chloroethylnitrosoure (BCNU, crmustine) wfer implnttion is common djuvnt therpy for mlignnt gliom. 1,2) After tumor removl, the wfers re plced on the wlls of the resection cvity nd BCNU is slowly relesed over period of 2 weeks. A phse III, rndomized, controlled tril demonstrted significnt improvement in the medin overll survivl time of 120 ptients y months. 1) Some complictions of BCNU wfer implnttion, such s edem formtion, hydrocephlus, nd wound site complictions, re known nd the formtion of tumor ed cysts is lso considered s compliction. 3) This is ecuse BCNU wfers sometimes form spce-occupying cyst in nd/or round the resection cvity which forms so-clled tumor ed cyst nd severl previous reports descrie this phenomenon. 4,5) However, remote cyst formtion Received Novemer 12, 2017; Accepted April 5, 2018 Copyright 2018 y The Jpn Neurosurgicl Society This work is licensed under Cretive Commons Attriution- NonCommercil-NoDerivtives Interntionl License. fter BCNU implnttion on the cvity wlls hs not een descried previously. Herein, we report first cse of remote cyst formtion cusing hemipresis nd consciousness impirment fter BCNU wfer implnttion. We lso discuss pthologicl findings of the rin prenchym round wfers nd the cyst wll. Cse Report A 43-yer-old Jpnese mn ws dignosed with right frontl rin tumor nd underwent gross totl resection. After pthologicl dignosis of oligostrocytom y the 2007 World Helth Orgniztion (WHO) Clssifiction of Tumors of the Centrl Nervous System (CNS) criteri, he susequently underwent rdition therpy (60.4 Gy) with two rounds of vincristine (2 mg) nd nimustine (140 mg). After completing the chemordiotherpy, the ptient ws dischrged nd visited regionl hospitl regulrly for follow-ups. He did not develop ny neurologicl sequele other thn occsionl episodes of epilepsy [Krnofsky Performnce Sttus (KPS) ws 90]. 270
2 Symptomtic Remote Cyst fter BCNU Wfer Implnttion yers fter the first opertion, in spite of eing symptomtic, T 2 -weighted mgnetic resonnce imging (MRI) reveled new high-intensity re round the surgicl cvity (Fig. 1) nd positron emission tomogrphy using 11 C-methionine showed high integrtion degree in tht re (Fig. 1). The lesion ws dignosed s tumor recurrence nd tumorectomy/bncu wfer implnttion on the surgicl cvity wll fter intropertive pthologicl dignosis of recurrent high-grde gliom (HGG) ws performed uneventfully s follows: The previous opertion (14 yers prior) hd fused the dur mter to the cererl surfce nd shrp dissection ws needed to detch it. The lterl ventricle ws opened during tumor resection nd we reconstructed the ventricle wll with hemosttic geltin sponge nd firin glue efore implnting 6 wfers on the resected cvity (Figs. 2 nd 2). MRI reveled no residul tumor nd no dverse events, except for smll cererl infrction (Fig. 1f, white rrow), occurred the dy fter surgery (Figs. 1c 1f). There were no new neurologicl symptoms soon fter surgery, however, the level of consciousness grdully worsened nd left hemipresis developed grdully over 4 dys fter surgery. Although no new lesions ppered on computed tomogrphy (CT) scns 4 dys post-surgery (Fig. 3), on the 7th post-surgicl dy CT scns reveled cyst with mximl dimeter of 37 mm, locted wy from the surgicl cvity, nd compressing the right primry motor re (Fig. 3). The intensity of the fluid in the cyst ws lmost the sme s the cererospinl fluid (CSF) (Figs. 3c 3f), however, fluid-ttenuted inversion recovery (FLAIR) imges showed the different intensities etween surgicl cvity nd the cyst. Though the signl intensity ws reltive vlue, the men of tumor resected cvity, contrlterl lterl ventricle, nd cyst were 194, 153, nd 497 respectively under the sme imging prmeters (Figs. 4 4c). The surgicl removl of the wfers nd fenestrtion of the nterior wll of the cyst ws then performed s follows: The exposed cyst Fig. 1 Periopertive neuroimging. A T 2 -weighted mgnetic resonnce imging (MRI) () nd 11 C-methionine positron emission tomogrphy () indicting the recurrence of the tumor next to the previous surgicl cvity in the right frontl loe. T 2 -weighted MRI on the dy fter surgery showing the postopertive cvity fter recurrent tumor resection with open nterior horn of the right lterl ventricle (c). BCNU wfers plced on the surfce of the cvity fter closing the lterl ventricle with n sorle compressed geltin sponge (d nd e). The diffusion-weighted MRI shows smll high intensity spot-like re in the right frontl loe (f, white rrow hed), the smll cererl ischemi re locted prt from the surgicl cvity.
3 272 H. Mtsumur et l. Fig. 2 Opertive findings of the tumor resection. Opertive findings showing the tumor resected cvity efore () nd fter () occlusion of the ventricle nd implnttion of 6 wfers. The upper right side indictes the frontl crnil se nd the upper left indictes the medil side. The sterisk showing the lterl ventricle reconstructed y the geltin sponge. c d e f Fig. 3 Consecutive postopertive neuroimging. Computed tomogrphy (CT) scn on 4 th dy fter the surgery shows no cyst formtion (). CT nd MRI on the 7th dy fter the surgery revels remote cyst formtion ( f). The cyst is prt from the resection cvity on sgittl T 2 -weighted MRI (d). No scess evidence on diffusionweighted imges (e). Signl intensity of liquid content of the cyst is lmost the sme s the cererospinl fluid (CSF) on T 2 -weighted MRI (f). ws visile on the rin surfce immeditely fter reopening the sutured dur mter (Figs. 5 nd 5) nd ws locted wy from the initil surgicl cvity with distnce of one to two gyri etween them. We punctured the cvity with the dissector nd trnsprent fluid resemling CSF effused with moderte pressure (Figs. 5 nd 5d). We removed the nterior wll of the cyst nd connected the cyst directly to the tumor-resected cvity. We lso removed the BCNU wfers nd opened the lterl ventricle previously occluded y the hemosttic geltin sponge (Fig. 5e). After fenestrtion, consciousness level nd left hemipresis grdully improved while susequent CT reveled decrese in cystic portion (Figs. 5c nd 5f). Pthologicl nlysis of the cyst wll reveled no inflmmtory or tumor cells (Figs. 6 nd 6) ut there ws n inflmmtory rection t the ttchment site of the BCNU wfers (Fig. 7). These inflmmtory cell infiltrtions were predominnt within nd round smll vessels which were short distnce from the BCNU wfers (Figs. 7 nd 7). After 3 months of rehilittion, the ptient returned to work with KPS of 90 s efore the opertion. The finl pthologicl dignosis ws recurrent HGG comptile with nplstic oligodendrogliom (NOS in the 2016 WHO clssifiction of CNS tumors)
4 Symptomtic Remote Cyst fter BCNU Wfer Implnttion c d e f 273 Fig. 4 Intensity difference of tumor resected cvity, lterl ventricle, nd cyst on fluid-ttenuted inversion recovery (FLAIR) imges. FLAIR imges tken under the sme imging prmeters show the different intensities in the tumor resected cvity (), contrlterl lterl ventricle s control vlue of CSF (), nd the cyst (c). Ech column ( c) shows sme coronl FLAIR imge (upper, originl imges; lower, mgnified imges with intensity vlues of rndomly selected three points). c d e f Fig. 5 Opertive findings of the cyst fenestrtion. Opertive findings showing the cyst efore opening ( nd ) nd fter opening (d). The cyst ws esily punctured ( nd d). The posterior wll of the tumor resected cvity nd the nterior wll of the cyst re prtilly removed, nd the cyst nd the tumor resected cvity re connected to ech other (e). The left side of the imges corresponds to the frontl crnil se, nd the lower side of the imges corresponds to the medil side of the hed. CT scns the dy fter cyst fenestrtion show the disppernce of the cyst (c nd f).
5 274 H. Mtsumur et l. Fig. 6 Pthologicl exmintion of the cyst wll. No inflmmtory cell infiltrtion or tumor cells on the nterior wll of the cyst ( nd ). nd the ptient received djuvnt temozolomide. There is no evidence of recurrence t over 26 months fter the first opertion for recurrent HGG. Discussion In the present cse, the symptomtic remote cyst formtion occurred fter BCNU wfer implnttion. BCNU wfers hve een widely used for gliom djuvnt therpy fter eing pproved y the United Sttes Food nd Drug Administrtion in ) Although considered efficcious s n ntineoplstic, BCNU dverse events such s wound complictions, CSF lekge, locl edem, seizures, nd hydrocephlus hve een reported.3,7 9) Tumor ed cysts hve lso een reported previously s spce-occupying cyst in the resection cvity.4,5,10) However, to the est of our knowledge, this is the first cse of symptomtic remote cyst ssocited with BCNU wfers. Fig. 7 Pthologicl exmintion of the resected cvity wll ttched to BCNU wfers. Inflmmtory cell infiltrtion in smll vessels prt from the ttchment surfce. The inflmmtory rection is weker on the surfce thn in the distnt vessels (). Enlrged imge shows inflmmtory cells in smll vessel (). Although it ws not ovious on CT scns up to 4 dys post-surgery, we eventully detected the remote cyst on the 7th dy. Judging from such rdiologicl findings, the formtion of the cyst seems to hve occurred fter the 4th dy. Bsed on the cystic fluid exmintion nd pthologicl findings of the cyst wll, scess or hemorrhge were not oserved nd could not e relted to or cuse cyst formtion. Similrly, the tumor recurrence could not e directly relted to cyst formtion s the cyst ws chrcterized y cute formtion nd no tumor cells in the cyst wll. Therefore, the detiled pthophysiology of this remote cystic formtion remins oscure. In our cse, the lterl ventricle ws opened nd reconstructed with hemosttic geltin sponge. A previous report out tumor ed cyst identified sttisticlly negtive correltion etween tumor ed cyst enlrgement nd ventriculr opening, since the rective fluid drining into the CSF limits the enlrgement of the tumor ed cyst in cse of
6 Symptomtic Remote Cyst fter BCNU Wfer Implnttion 275 ventriculr opening. 4) This ide ws reinforced y nother report where fluid concentrtions were clculted from the Ommy reservoir inserted into the resected tumor cvity. The verge drug concentrtion in ventriculr opening cses ws 2.05 μmol/l versus 4.49 μmol/l in non-opened cses. 11) From this previous dt, we speculte tht the check-vlve phenomenon nd/or osmotic grdient effect could e the pthophysiologicl mechnism leding to cyst formtion. Retrospective nlysis of MRI on the 1st dy fter surgery reveled smll cererl ischemic re ner the resected cvity (Fig. 1f, white rrow). As the remote cyst ws formed t the sme loction (the ischemic re), we cn hypothesize tht the smll ischemic lesion ws lso ssocited with the lrge remote cyst. As BCNU wfers cuse some inflmmtory chnge in ttched tissues nd the rchnoid memrne dmge occurred during opening the dherent dur mtter, there ws possiility of generting check-vlve mechnism through the heling process within few dys fter surgery. The ischemic, necrotic lesion could then ecome semi-isolted re due to the check-vlve mechnism of the dmged rchnoid cyst. The BCNU concentrtion oth in the resected cvity nd lesion ws elevted just fter the surgery. As the resected cvity hd connection with the lterl ventricle nd the ischemic lesion ecme semiisolted, the drug concentrtion in the ischemic lesion could ecome reltively higher thn in the resected cvity. Thus, the osmotic grdient effect ws generted, nd the ischemic lesion could pull CSF nd crete cvity which ws further enlrged from this hydrosttic pressure. The intensity difference etween the tumor resected cvity nd the cyst on FLAIR imging would support our hypothesis. We re not wre of previous reports on such cystic formtion relted to ischemic lesions. However, cogultive necrosis occurs from 3 to 37 dys s nturl course of cererl infrction 12) nd such cogultive necrosis cn e seen histopthologiclly nd mcroscopiclly t utopsy. Thus, this necrotic process could hve dmged the lood-rin rrier nd loclly compromised fluid regultion, leding to the formtion of cyst. As BCNU wfers re very unique type of locl chemotherpy nd we hve never seen formtion of sucute cysts fter neurosurgery without them, this points to n ssocition etween BCNU wfers nd remote cyst formtion. Although further reports re needed to determine the incidence of such remote cysts, their formtion fter BCNU wfer implnttion should e kept in mind, especilly if imging shows ny ischemic res ner the resection cvity. In conclusion, we experienced symptomtic remote cyst formtion fter BCNU wfer implnttion for recurrent HGG. The cyst ws formed within severl dys in the postopertive period. We hypothesized tht check-vlve or osmotic grdient effect relted to different BCNU concentrtions ws one of the mechnisms of the cyst formtion. This indictes tht ny imging nomlies, especilly those indictive of ischemi, should e monitored fter wfer implnts, even up to week fter n uneventful surgery. Acknowledgments We thnk Dr. Alexnder Zoronok of the University of Tsuku Fculty of Medicine, Deprtment of Neurosurgery, for professionl revision nd Dr. Bryn J. Mthis of the University of Tsuku Medicl English Communiction Center for ntive English revision. Conflicts of Interest Disclosure The uthors declre tht they hve no finncil or other conflicts of interest in reltion to this reserch nd its puliction. References 1) Westphl M, Hilt DC, Bortey E, et l.: A phse 3 tril of locl chemotherpy with iodegrdle crmustine (BCNU) wfers (Glidel wfers) in ptients with primry mlignnt gliom. Neuro-oncology 5: 79 88, ) Brem H, Pintdosi S, Burger PC, et l.: Plceocontrolled tril of sfety nd efficcy of intropertive controlled delivery y iodegrdle polymers of chemotherpy for recurrent glioms. The polymerrin tumor tretment group. Lncet 345: , ) Aoki T, Nishikw R, Sugiym K, et l.: A multicenter phse I/II study of the BCNU implnt (Glidel ( ) Wfer) for Jpnese ptients with mlignnt glioms. Neurol Med Chir (Tokyo) 54: , ) Hsegw Y, Iuchi T, Skid T, Yokoi S, Kwski K: The influence of crmustine wfer implnttion on tumor ed cysts nd peritumorl rin edem. J Clin Neurosci 31: 67 71, ) Dörner L, Ulmer S, Rohr A, Mehdorn HM, Nvi A: Spce-occupying cyst development in the resection cvity of mlignnt glioms following Glidel implnttion incidence, therpeutic strtegies, nd outcome. J Clin Neurosci 18: , ) Smpth P, Brem H: Implntle slow-relese chemotherpeutic polymers for the tretment of mlignnt rin tumors. Cncer Control 5: , 1998
7 276 H. Mtsumur et l. 7) Ishikw E, Ymmoto T: [Intropertive BCNU wfer implnttion for high-grde gliom questionnire trgeting Jpnese neurosurgeons]. Gn To Kgku Ryoho 43: , 2016 (Jpnese) 8) Ishikw E, Ymmoto T, Stomi K, et l.: Intropertive pthologicl dignosis in 205 gliom ptients in the pre-bcnu wfer er: retrospective nlysis with intropertive implnttion of BCNU wfers in mind. Brin Tumor Pthol 31: , ) Msud Y, Ishikw E, Ymmoto T, et l.: Erly postopertive expnsion of prenchyml highintensity res on T 2 -weighted imging predicts delyed cererl edem cused y crmustine wfer implnttion in ptients with high-grde gliom. Mgn Reson Med Sci 15: , ) Ohue S, Kohno S, Inoue A, et l.: Evlution of seril chnges on computed tomogrphy nd mgnetic resonnce imging fter implnttion of crmustine wfers in ptients with mlignnt glioms for differentil dignosis of tumor recurrence. J Neurooncol 126: , ) Ohue S: [Using BCNU Wfers in the tretment of Mlignnt Glioms]. Jpn J Neurosurg (Tokyo) 25: , 2016 (Jpnese) 12) Men H, Cdvid D, Rushing EJ: Humn cererl infrct: proposed histopthologic clssifiction sed on 137 cses. Act Neuropthol 108: , 2004 Address reprint requests to: Eiichi Ishikw, Deprtment of Neurosurgery, University of Tsuku, Tennodi, Tsuku, Irki , Jpn. e-mil: e-ishikw@md.tsuku.c.jp
Efficacy of Pembrolizumab in Patients With Advanced Melanoma With Stable Brain Metastases at Baseline: A Pooled Retrospective Analysis
Efficcy of Pembrolizumb in Ptients With Advnced Melnom With Stble Brin Metstses t Bseline: A Pooled Retrospective Anlysis Abstrct 1248PD Hmid O, Ribs A, Dud A, Butler MO, Crlino MS, Hwu WJ, Long GV, Ancell
More informationPNEUMOVAX 23 is recommended by the CDC for all your appropriate adult patients at increased risk for pneumococcal disease 1,2 :
PNEUMOVAX 23 is recommended y the CDC for ll your pproprite dult ptients t incresed risk for pneumococcl disese 1,2 : Adults ged
More informationGeneral Microscopic Changes
Generl Microscopic Chnges 2 This chpter covers collection of microscopic chnges tht lck dignostic specificity ut occur in different specific diseses, s will ecome pprent in susequent chpters. Almost ll
More informationThe Dynamics of Varicella-Zoster Virus Epithelial Keratitis in Herpes Zoster Ophthalmicus
Chpter 2 The Dynmics of Vricell-Zoster Virus Epithelil Kertitis in Herpes Zoster Ophthlmicus The morphology of n individul VZV lesion reflects sequence of events triggered y the virus impct on cornel epithelil
More informationEffects of physical exercise on working memory and prefrontal cortex function in post-stroke patients
Effects of physicl exercise on working memory nd prefrontl cortex function in post-stroke ptients M Moriy, C Aoki, K Sktni Grdute School of Helth Sciences Reserch, Mjor of Physicl Therpy, TeikyoHeisei
More informationProsthetic Valve Dysfunction 35 Years after Mitral Valve Replacement with a Starr-Edwards Caged-disc Valve
CASE REPORT Prosthetic Vlve Dysfunction 35 Yers fter Mitrl Vlve Replcement with Strr-Edwrds Cged-disc Vlve Tetsuro Yokokw 1, Tkhiro Ohr 1, Seiji Tkshio 1, Mri Skmoto 1,YukoWd 1, Kenji Nkmur 1, Hiroyuki
More informationSYNOPSIS Final Abbreviated Clinical Study Report for Study CA ABBREVIATED REPORT
Finl Arevited Clinicl Study Report Nme of Sponsor/Compny: Bristol-Myers Squi Ipilimum Individul Study Tle Referring to the Dossier (For Ntionl Authority Use Only) Nme of Finished Product: Yervoy Nme of
More informationBENIGN ulceration along the greater curvature of the pars media of the
BENIGN ULCERS OF THE GREATER CURVATURE OF THE STOMACH Report of Two Cses CHARLES H. BROWN, M.D. Deprtment of Gstroenterology nd ANTHONY D. INTRIERE, M.D.* BENIGN ulcertion long the greter curvture of the
More informationCheckMate 153: Randomized Results of Continuous vs 1-Year Fixed-Duration Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer
CheckMte 53: Rndomized Results of Continuous vs -Yer Fixed-Durtion Nivolumb in Ptients With Advnced Non-Smll Cell Lung Cncer Abstrct 297O Spigel DR, McCleod M, Hussein MA, Wterhouse DM, Einhorn L, Horn
More informationChordoid Glioma Originating in the Intrasellar and Suprasellar Regions: Case Report
pissn 2384-1095 eissn 2384-1109 imri 2015;19:117-121 http://dx.doi.org/10.13104/imri.2015.19.2.117 Chordoid Gliom Originting in the Intrsellr nd Suprsellr Regions: Cse Report Jisun Hwng 1, Aleum Lee 1,
More informationUniversity of Cape Town
.. I i I II I I The copyright of this thesis vests in the uthor. No quottion from it or informtion derived from it is to be published without full cknowledgement of the source. The thesis is to be used
More informationCase Report Surgical Resection of a Leiomyosarcoma of the Inferior Vena Cava Mimicking Hepatic Tumor
Cse Reports in Medicine Volume 2013, Article ID 235698, 5 pges http://dx.doi.org/10.1155/2013/235698 Cse Report Surgicl Resection of Leiomyosrcom of the Inferior Ven Cv Mimicking Heptic Tumor Junji Ued,
More informationA Rare Manifestation of Solitary Primary Bone Lymphoma of the Finger: a Case Report
pissn 2384-1095 eissn 2384-1109 imri 2018;22:240-244 A Rre Mnifesttion of Solitry Primry Bone Lymphom of the Finger: Cse Report Jeong A Yeom 2, You Seon Song 1 *, In Sook Lee 1, Kyung Un Choi 3, Jeung
More informationMeat and Food Safety. B.A. Crow, M.E. Dikeman, L.C. Hollis, R.A. Phebus, A.N. Ray, T.A. Houser, and J.P. Grobbel
Met nd Food Sfety Needle-Free Injection Enhncement of Beef Strip Loins with Phosphte nd Slt Hs Potentil to Improve Yield, Tenderness, nd Juiciness ut Hrm Texture nd Flvor B.A. Crow, M.E. Dikemn, L.C. Hollis,
More informationThe potential future of targeted radionuclide therapy: implications for occupational exposure? P. Covens
The potentil future of trgeted rdionuclide therpy: implictions for occuptionl exposure? Introduction: Trgeted Rdionuclide Therpy (TRT) Systemic tretment Molecule lbelled with rdionuclide delivers toxic
More informationStudy of Stress Distribution in the Tibia During Stance Phase Running Using the Finite Element Method
Ksetsrt J. (Nt. Sci.) 48 : 729-739 (2014) Study of Stress Distriution in the Tii During Stnce Phse Running Using the Finite Element Method Thepwchr Ruchirh 1, Tumrong Puttpitukporn 1, * nd Siriporn Ssimontonkul
More informationThallium-201 chloride scintigraphy in soft tissue tumors
136 ORIGINAL Thllium-201 chloride scintigrphy in soft tissue tumors Hideki Otsuk, Kori Terzw, Nomi Morit, Yoichi Otomi, Shoichiro Tko, Seiji Iwmoto, Kyosuke Oski, Msfumi Hrd, nd Hiromu Nishitni Deprtment
More informationThe effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel
Gut, 1971, 12, 11-15 The effects of diversion of intestinl contents on the progress of Crohn's disese of the lrge owel J. H. BURMAN, H. THOMPSON, W. T. COOKE, AND J. ALEXANDER WILLIAMS From the Nutritionl
More informationAnus,Rectum and Colon
JOURNAL OF THE Anus,Rectum nd Colon http://journl-rc.jp CASE REPORT Anl Cnl Dupliction Associted with Prescrl Cyst in n Adult Tkyuki Toyong 1), Hiromitsu Mtsud 1), Ryuichi Miu 1), Yohei Toming 1), Keiji
More informationBright Futures Medical Screening Reference Table 2 to 5 Day (First Week) Visit
Bright Futures Medicl Reference Tle 2 to 5 Dy (First Week) Visit Universl Action Metolic nd Verify documenttion of neworn metolic screening results, pproprite rescreening, nd needed follow-up. Document
More informationEfficacy of Sonidegib in Patients With Metastatic BCC (mbcc)
AAD 216 eposter 3368 Efficcy of Sonidegib in Ptients With Metsttic BCC (mbcc) Colin Morton, 1 Michel Migden, 2 Tingting Yi, 3 Mnish Mone, 3 Dlil Sellmi, 3 Reinhrd Dummer 4 1 Stirling Community Hospitl,
More informationCase Report Acute Zonal Occult Outer Retinopathy with Atypical Findings
Cse Reports in Medicine Volume 24, Article ID 29696, 7 pges http://dx.doi.org/.55/24/29696 Cse Report Acute Zonl Occult Outer Retinopthy with Atypicl Findings Dimitrios Krginnis, Georgios A. Kontdkis,
More informationUsing Paclobutrazol to Suppress Inflorescence Height of Potted Phalaenopsis Orchids
Using Pcloutrzol to Suppress Inflorescence Height of Potted Phlenopsis Orchids A REPORT SUBMITTED TO FINE AMERICAS Linsey Newton nd Erik Runkle Deprtment of Horticulture Spring 28 Using Pcloutrzol to Suppress
More informationInput from external experts and manufacturer on the 2 nd draft project plan Stool DNA testing for early detection of colorectal cancer
Input externl experts nd mnufcturer on the 2 nd drft project pln Stool DNA testing for erly detection of colorectl cncer (Project ID:OTJA10) All s nd uthor s replies on the 2nd drft project pln Stool DNA
More informationSevere Gummy Smile with Class II Malocclusion Treated with LeFort I Osteotomy Combined with Horseshoe Osteotomy and Intraoral Vertical Ramus
2013 67 1 5560 Severe Gummy Smile with Clss II Mlocclusion Treted with LeFort I Osteotomy Comined with Horseshoe Osteotomy nd Introrl Verticl Rmus Osteotomy * 56 Shimo et l. Act Med. Okym Vol. 67, No.
More informationFindings Regarding an Intracranial Hemorrhage on the Phase Image of a Susceptibility-Weighted Image (SWI), According to the Stage, Location, and Size
pissn 2384-1095 eissn 2384-1109 imri 2015;19:107-113 http://dx.doi.org/10.13104/imri.2015.19.2.107 Findings Regrding n Intrcrnil Hemorrhge on the Phse Imge of Susceptiility-Weighted Imge (SWI), According
More informationProphylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications
Gstric Cncer (2018) 21:703 709 https://doi.org/10.1007/s10120-017-0781-y ORIGINAL ARTICLE Prophylctic effect of neodjuvnt chemotherpy in gstric cncer ptients with postopertive complictions Kojiro Eto 1
More informationGiant insulinoma: report of a case and review of published reports
Ued et l. Surgicl Cse Reports (2016) 2:136 DOI 10.1186/s40792-016-0265-z CASE REPORT Gint insulinom: report of cse nd review of pulished reports Open Access Kzumitsu Ued *, Tetsuro Tir, Hiroyuki Hkod,
More informationA case of pulmonary adenocarcinoma showing rapid progression of peritoneal dissemination after immune checkpoint inhibitor therapy
Shinozki et l. BMC Cncer (2018) 18:620 https://doi.org/10.1186/s12885-018-4549-5 CASE REPORT A cse of pulmonry denocrcinom showing rpid progression of peritonel dissemintion fter immune checkpoint inhiitor
More informationSurgical Neurology International
Surgicl Neurology Interntionl SNI: Unique Cse Oservtions, supplement to Surgicl Neurology Interntionl OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com Editor: Jmes I. Ausmn,
More informationAortoesophageal Fistula after Thoracic Endovascular Aortic Repair Diagnosed and Followed with Endoscopy
CASE REPORT Aortoesophgel Fistul fter Thorcic Endovsculr Aortic Repir Dignosed nd Followed with Endoscopy Disuke Chi 1,2, Norihiro Hnt 1, Ysumitsu Arki 1, Mnu Swy 1, Tetsuro Yoshimur 1, Mshiko Aoki 3,
More informationArthroscopic Anatomy of Shoulder
Arthroscopic Antomy of Shoulder Murt Bozkurt, Mehmet Emin Simsek, nd Hlil İrhim Açr 2 2.1 Introduction In the lst 30 yers, shoulder rthroscopy hs ecome of greter importnce in the dignosis nd tretment of
More informationClinical Study Report Synopsis Drug Substance Naloxegol Study Code D3820C00018 Edition Number 1 Date 01 February 2013 EudraCT Number
EudrCT Number 2012-001531-31 A Phse I, Rndomised, Open-lbel, 3-wy Cross-over Study in Helthy Volunteers to Demonstrte the Bioequivlence of the Nloxegol 25 mg Commercil nd Phse III Formultions nd to Assess
More informationA review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital
MEDICAL ONCOLOGY A review of the ptterns of docetxel use for hormone-resistnt prostte cncer t the Princess Mrgret Hospitl S.N. Chin MD,* L. Wng MSc, M. Moore MD,* nd S.S. Sridhr MD MSc* ABSTRACT Bckground
More informationEFFECTS OF AN ACUTE ENTERIC DISEASE CHALLENGE ON IGF-1 AND IGFBP-3 GENE EXPRESSION IN PORCINE SKELETAL MUSCLE
Swine Dy 22 Contents EFFECTS OF AN ACUTE ENTERIC DISEASE CHALLENGE ON IGF-1 AND IGFBP-3 GENE EXPRESSION IN PORCINE SKELETAL MUSCLE B. J. Johnson, J. P. Kyser, J. D. Dunn, A. T. Wyln, S. S. Dritz 1, J.
More informationSurgical Neurology International
Surgicl Neurology Interntionl SNI: Peditric Neurosurgery, supplement to Surgicl Neurology Interntionl OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com How I Do It: Mngement
More informationInfluence of lateral cephalometric radiography in orthodontic diagnosis and treatment planning
Originl Article Influence of lterl cephlometric rdiogrphy in orthodontic dignosis nd tretment plnning An Reis Durão ; Ali Alqerbn b ; Afonso Pinhão Ferreir c ; Reinhilde Jcobs d ABSTRACT Objective: To
More informationCase Report INTRODUCTION CASE REPORT. pissn eissn X
pissn 2287-2728 eissn 2287-285X Cse Report Clinicl nd Moleculr Heptology 2018;24:424-429 Complete cure of dvnced heptocellulr crcinom with right drenl glnd metstsis nd portl vein thrombosis by multiple
More informationAgilent G6825AA MassHunter Pathways to PCDL Software Quick Start Guide
Agilent G6825AA MssHunter Pthwys to PCDL Softwre Quick Strt Guide Wht is Agilent Pthwys to PCDL? Fetures of Pthwys to PCDL Agilent MssHunter Pthwys to PCDL converter is stnd-lone softwre designed to fcilitte
More informationSeeding Metastasis of Chromophobe Renal Cell Carcinoma after Robot-Assisted Laparoscopic Partial Nephrectomy
pissn 2384-1095 eissn 2384-1109 imri 2017;21:119-124 https://doi.org/10.13104/imri.2017.21.2.119 Seeding Metstsis of Chromophoe Renl Cell Crcinom fter Root-Assisted Lproscopic Prtil Nephrectomy Knghun
More informationCheck your understanding 3
1 Wht is the difference etween pssive trnsport nd ctive trnsport? Pssive trnsport is the movement of prticles not requiring energy. Movement of prticles in ctive trnsport uses energy. 2 A gs tp in the
More informationA Case of Intraductal Papillary Mucinous Carcinoma in the Head of the Pancreas Associated With Absence of the Duct of Wirsung
CASE REPORT A Cse of Intrductl Ppillry Mucinous Crcinom in the Hed of the Pncres Associted With Asence of the Duct of Wirsung Ismu Mkino, Tkhis Ymguchi, Mitsuyoshi Okzki, Tomohru Miyshit, Hidehiro Tjim,
More informationHIROATSU NAKASHIMA, MASAHIRO YOSHIDA & KENTARO MIYAMOTO. Department of Orthopedic Surgery, Aichi Hospital, Aichi Cancer Center, Okazaki, Japan
Upsl Journl of Medicl Sciences. 2012; 117: 460 464 CASE REPORT Antomicl reconstruction of the ptellr tendon using the fsci lt ttched to the ilic one following resection for soft tissue srcom: A cse report
More informationFundamentals of Spine MRI and Essential Protocols
Fundmentls of Spine MRI nd Essentil Protocols A. C. Dougls-Akinwnde, MD Octoer 13, 2009 Fundmentls of Spine MRI Lerning Ojectives: 1. List the essentil sequences for Spine MRI exmintion 2. Discuss the
More informationMagnetic Resonance Imaging (MRI) in Syringomyelia
Act Neurochir (Wien)(1995) 134:93-99 :Act. _ N urochlrurgc 9 Springer-Verlg t995 Printed in Austri Mgnetic Resonnce Imging (MRI) in Syringomyeli H. L. J. Tnghe Deprtment of Rdiodignostics, University Hospitl
More informationComputed Tomography for Localization of Intra- Abdominally Dislocated Intrauterine Devices
Act Rdiologic ISSN: 0284-1851 (Print) 1600-0455 (Online) Journl homepge: https://www.tndfonline.com/loi/ird20 Computed Tomogrphy for Locliztion of Intr- Adominlly Dislocted Intruterine Devices Esjörn Hederström,
More informationTHE EVALUATION OF DEHULLED CANOLA MEAL IN THE DIETS OF GROWING AND FINISHING PIGS
THE EVALUATION OF DEHULLED CANOLA MEAL IN THE DIETS OF GROWING AND FINISHING PIGS THE EVALUATION OF DEHULLED CANOLA MEAL IN THE DIETS OF GROWING AND FINISHING PIGS John F. Ptience nd Doug Gillis SUMMARY
More informationC reactive protein: an aid to assessment and
C rective protein: n id to ssessment nd monitoring of cute pncretitis J Clin Pthol 1984;37:27-211 AD MAYR,* MJ McMAHON,* MARGART BOWN,t H COOPRt From the *University Deprtment ofsurgery, Generl Infrmry,
More informationIntroduction. These patients benefit less from conventional chemotherapy than patients identified as MMR proficient or microsatellite stable 3-5
Nivolumb + Ipilimumb Combintion in Ptients With DNA Mismtch Repir-Deficient/Microstellite Instbility-High Metsttic Colorectl Cncer: First Report of the Full Cohort From CheckMte-142 Abstrct 553 André T,
More informationRare case of a rapidly enlarging symptomatic arachnoid cyst of the posterior fossa in an infant: A case report and review of the literature
SNI: Peditric Neurosurgery OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com Editor: Sndi Lm, MD University of Chicgo Medicl Center, Chicgo, IL, USA Cse Report Rre cse of
More informationGd-based Contrast Enhancement of the Perivascular Spaces in the Basal Ganglia
Mgn Reson Med Sci 2017; 16; 61 65 doi:10.2463/mrms.mp.2016-0039 Pulished Online: July 12, 2016 MAJOR PAPER Gd-sed Contrst Enhncement of the Perivsculr Spces in the Bsl Gngli Shinji Ngnw *, Toshiki Nkne,
More informationThe Selective Arterial Calcium Injection Test is a Valid Diagnostic Method for Invisible Gastrinoma with Duodenal Ulcer Stenosis: A Case Report
Hiroshim J. Med. Sci. Vol. 65, No. 1, 13~17, Mrch, 2016 HIJM 65 3 13 The Selective Arteril Clcium Injection Test is Vlid Dignostic Method for Invisile Gstrinom with Duodenl Ulcer Stenosis: A Cse Report
More informationEmerging Options for Thromboprophylaxis After Orthopedic Surgery: A Review of Clinical Data
Emerging Options for Thromboprophylxis After Orthopedic Surgery: A Review of Clinicl Dt Bob L. Lobo, Phrm.D. In four rndomized, controlled studies of ptients undergoing orthopedic surgery, the ntithrombotic
More informationEsophageal carcinoma is the eighth most common cancer
ORIGINAL ARTICLE Tumor-Strom Rtio Is n Independent Predictor for Survivl in Esophgel Squmous Cell Crcinom Ki Wng, MD,* Wei M, MD,* Jinbo Wng, MD,* Ling Yu, MD, Xiomei Zhng, MD, Zhenbo Wng, MD, Bingxu Tn,
More informationWSU Tree Fruit Research and Extension Center, Wenatchee (509) ext. 265;
FINAL REPORT WTFRC Project # AH-1-5 WSU Project # 13C-355-3 Project title: PI: Orgniztion: Coopertors: of Sunburn in Apples with RAYNOX Lrry Schrder, Horticulturist WSU Tree Fruit Reserch nd Extension
More informationDr. Javier Polo Vice President Research & Development
Efecto de l suplementción con concentrdo de inmunoglobulins prtir del suero bovino en l Microbiot y su contribución l slud intestinl y l sistem nervioso centrl Dr. Jvier Polo Vice President Reserch & Development
More informationMOLECULAR AND CLINICAL ONCOLOGY 7: , 2017
336 Effect of intrtumorl bscess/necrosis on the outcome for hed nd neck cncer ptients treted by hypofrctionted stereotctic re irrdition using CyberKnife HIDEYA YAMAZAKI 1,2, MIKIO OGITA 3, KENGO HIMEI
More informationET 100 EXTERIOR FRONT DOOR BLACK OUT TAPE INSTALLATION
100 EXTERIOR FRONT DOOR BLCK OUT TPE INSTLLTION The procedure descried elow is for the LH side. Use the sme procedure for oth the RH nd LH sides, unless otherwise specified. 1. INSTLL NO. 2 BLCK OUT TPE
More informationEVALUATION OF DIFFERENT COPPER SOURCES AS A GROWTH PROMOTER IN SWINE FINISHING DIETS 1
Swine Dy 2001 Contents EVALUATION OF DIFFERENT COPPER SOURCES AS A GROWTH PROMOTER IN SWINE FINISHING DIETS 1 C. W. Hstd, S. S. Dritz 2, J. L. Nelssen, M. D. Tokch, nd R. D. Goodbnd Summry Two trils were
More informationDural Repair DURAL REPAIR. Solutions
Durl Repir DURAL REPAIR Solutions Science Technology Innotion Proen Performnce Six Pltform Technologies At Collgen Mtrix we re pssionte bout dncing the science of tissue repir nd We he deeloped six proprietry
More informationReview article. Key words non specific low back pain, exercise therapy, stretching, motor control. Grade D
Spinl Surgery 31 2 140 144 2017 総説 Review rticle Astrct Exercise therpy is useful for low ck pin. Exercise therpy ims to improve posturl lignment, muscle strength, nd endurnce, nd lso contriutes to pin
More informationSupplementary Online Content
Supplementry Online Content Zulmn DM, Pl Chee C, Ezeji-Okoye SC, et l. Effect of n intensive outptient progrm to ugment primry cre for high-need Veterns Affirs ptients: rndomized clinicl tril. JAMA Intern
More informationIMpower133: Primary PFS, OS, and safety in a Ph1/3 study of 1L atezolizumab + carboplatin + etoposide in extensive-stage SCLC
IMpower133: Primry PFS, OS, nd sfety in Ph1/3 study of 1L tezolizumb + crbopltin + etoposide in extensive-stge SCLC S. V. Liu, 1 A. S. Mnsfield, 2 A. Szczesn, 3 L. Hvel, 4 M. Krzkowski, 5 M. J. Hochmir,
More informationPROVEN ANTICOCCIDIAL IN NEW FORMULATION
PROVEN ANTICOCCIDIAL IN NEW FORMULATION Coxidin 100 microgrnulte A coccidiosttic dditive for roilers, chickens rered for lying nd turkeys Contins 100 g of monensin sodium per kg Aville s homogenous grnules
More informationPatient Survival After Surgical Treatment of Rectal Cancer
Originl Article Ptient Survivl After Surgicl Tretment of Rectl Cncer Impct of Surgeon nd Hospitl Chrcteristics Dvid A. Etzioni, MD, MSHS 1,2 ; Toni M. Young-Fdok, MD, MS 1 ; Robert R. Cim, MD, MA 2,3 ;
More informationXII. HIV/AIDS. Knowledge about HIV Transmission and Misconceptions about HIV
XII. HIV/AIDS Knowledge bout HIV Trnsmission nd Misconceptions bout HIV One of the most importnt prerequisites for reducing the rte of HIV infection is ccurte knowledge of how HIV is trnsmitted nd strtegies
More informationSurgical Neurology International
Surgicl Neurology Interntionl OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com Editor: Jmes I. Ausmn, MD, PhD University of Cliforni, Los Angeles, CA, USA Originl Article
More informationInvasive Pneumococcal Disease Quarterly Report July September 2018
Invsive Pneumococcl Disese Qurterly Report July Septemer Introduction Since 17 Octoer 2008, invsive pneumococcl disese (IPD) hs een notifile to the locl Medicl Officer of Helth under the Helth Act 1956.
More informationLocalized IgG4-related Cholecystitis Mimicking Gallbladder Cancer
CASE REPORT Loclized IgG4-relted Cholecystitis Mimicking Gllldder Cncer Tdhis Inoue 1, Fumihiro Okumur 1, Tkshi Mizushim 1, Hirotd Nishie 1, Hiroysu Iwski 1, Kiki Ane 1, Tknori Ozeki 1, Kent Kchi 1, Shigeki
More informationJuvenile spondylodiscitis : the value of magnetic resonance imaging A report of two cases
Act Orthop. Belg., 2004, 70, 627-631 CASE REPORT Juvenile spondylodiscitis : the vlue of mgnetic resonnce imging A report of two cses Herbert PLASSCHAERT, Kristof DE GEETER, Guy FABRY From the Deprtment
More informationOriginal Article. Breast Care 2016;11: DOI: /
Originl Article Brest Cre 2016;11:323 327 DOI: 10.1159/000452079 Published online: October 24, 2016 Neodjuvnt Chemotherpy with Docetxel, Crbopltin nd Weekly Trstuzumb Is Active in HER2-Positive Erly Brest
More informationImpact of Positive Nodal Metastases in Patients with Thymic Carcinoma and Thymic Neuroendocrine Tumors
Originl Article Impct of Positive Nodl Metstses in Ptients with Thymic Crcinom nd Thymic Neuroendocrine Tumors Benny Weksler, MD, Anthony Holden, MD, nd Jennifer L. Sullivn, MD Introduction: Thymic crcinoms
More informationSEIZURES AND EPILEPSY
SEIZURES AND EPILEPSY CONTENT CREATED BY Lern more t www.helth.hrvrd.edu TALK WITH YOUR DOCTOR Tble of Contents WHAT IS A SEIZURE? 4 WHAT IS EPILEPSY? 6 TESTING 7 TREATMENT OPTIONS 9 ANTI-SEIZURE MEDICATION
More informationInvasive Pneumococcal Disease Quarterly Report. July September 2017
Invsive Pneumococcl Disese Qurterly Report July September 2017 Prepred s prt of Ministry of Helth contrct for scientific services by Rebekh Roos Helen Heffernn October 2017 Acknowledgements This report
More informationBreast carcinomas: why are they missed?
O r i g i n l A r t i c l e Singpore Med J 2006; 47(10) : 851 Brest crcinoms: why re they missed? Muttrk M, Pojchmrnwiputh S, Chiwun B ABSTRACT Introduction: Mmmogrphy hs proven to e n effective modlity
More informationResults of the Tokyo Consensus Meeting Tokyo Guidelines
J Heptobiliry Pncret Surg (2007) 14:114 121 DOI 10.1007/s00534-006-1163-8 Results of the Tokyo Consensus Meeting Tokyo Guidelines Toshihiko Myumi 1, Tdhiro Tkd 2, Yoshifumi Kwrd 3, Yuji Nimur 4, Mshiro
More information8/1/2017. Correlating Radiomics Information with Clinical Outcomes for Lung SBRT. Disclosure. Acknowledgements
Correlting Rdiomics Informtion with Clinicl Outcomes for Lung SBRT Fng-Fng Yin, PhD Duke University Medicl Center AAPM 2017 Denver CO Disclosure This reserch is prtilly funded by reserch grnt from Vrin
More informationYoshihiro Otani, Kazuhiko Kurozumi, Joji Ishida, Masafumi Hiramatsu, Masahiro Kameda, Tomotsugu Ichikawa, Isao Date
SNI: Generl Neurosurgery OPEN ACCESS For entire Editoril Bord visit : http://www.surgiclneurologyint.com Editor: Eric Nussum, M.D. Ntionl Brin Aneurysm nd Tumor Center, Twin Cities, MN, USA Technicl Note
More informationReconstruction with ipsilateral fibula transfer with pasteurized bone after excision of bone sarcoma of the tibia
Srcom, June/Septemer 2004, VOL. 8, NO. 2/3, 97 102 TECHNICAL NOTE Reconstruction with ipsilterl fiul trnsfer with psteurized one fter excision of one srcom of the tii TOSHIFUMI OZAKI 1, KAZUO FUJIWARA
More informationLATE RESULTS OF TRANSFER OF THE TIBIAL TUBERCLE FOR RECURRENT DISLOCATION OF THE PATELLA1
LATE RESULTS OF TRANSFER OF THE TIBIAL TUBERCLE FOR RECURRENT DISLOCATION OF THE PATELLA1 W. G. J. HAMPSON nd P. HILL, BRISTOL, ENGLAND The uthors wished to determine the lte results of the Huser opertion,
More informationLung cancer is the leading cause of cancer death worldwide, EGFR Mutation and Brain Metastasis in Pulmonary Adenocarcinomas
Originl Article EGFR Muttion nd Brin Metstsis in Pulmonry Adenocrcinoms Dong-Yeop Shin, MD,* Im Il N, MD,* Cheol Hyeon Kim, MD, PhD, Sunhoo Prk, MD, PhD, HeeJong Bek, MD, PhD, nd Sung Hyun Yng, MD, PhD*
More informationAdenosine A1 receptor antagonist improves intradialytic hypotension
http://www.kidney-interntionl.org & 26 Interntionl Society of Nephrology originl rticle see commentry on pge 789 Adenosine A1 receptor ntgonist improves intrdilytic hypotension E Imi 1, M Fujii 2, Y Kohno
More informationPulmonary langerhans cell histiocytosis: Two cases with varied radiologic findings
CASE REPORT Est J Med 21(1): 45-49, 2016 Pulmonry lngerhns cell histiocytosis: Two cses with vried rdiologic findings Huly Guntr 1,*, Alpsln Yvuz 2, Bunymin Sertogullrindn 1, Selmi Ekin 1, Selvi Asker
More informationImproved prognosis of postoperative hepatocellular carcinoma patients when treated with functional foods: a prospective cohort study
Journl of Heptology 37 (2002) 78 86 www.elsevier.com/locte/jhep Improved prognosis of postopertive heptocellulr crcinom ptients when treted with functionl foods: prospective cohort study Yoichi Mtsui*,
More informationComputed Tomography after Modified Whipple Procedure with Pancreatic Duct Occlusion
Act Rdiologic ISSN: 0284-1851 (Print) 1600-0455 (Online) Journl homepge: https://www.tndfonline.com/loi/ird20 Computed Tomogrphy fter Modified Whipple Procedure with Pncretic Duct Occlusion A. Aildgrd,
More informationNon-invasive Diagnosis of Liver Clinical Condition by Real-time Tissue Elastography and Shear Wave Measurement : Get More Accessible by One Probe
XXXXXXXXXX Non-invsive Dignosis of Liver Clinicl Condition y Rel-time Tissue Elstogrphy nd Sher Wve Mesurement : Get More Accessile y One Proe Norihis Yd Mstoshi Kudo Deprtment of Gstroenterology nd Heptology,
More information27 June Bmnly L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION
27 June 1964 Bmnly MEDICAL JOURNAL L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION x 1,638.) FIG. 2.-Foci of sme tumour s in Fig. 1 contining vible tumour cells with scnty cytoplsm, reltively
More informationImpact of Pharmacist Intervention on Diabetes Patients in an Ambulatory Setting
Impct of Phrmcist Intervention on Dibetes Ptients in n Ambultory Setting Julie Stding, PhrmD, CDE, Jmie Herrmnn, PhrmD, Ryn Wlters, MS, Chris Destche, PhrmD, nd Aln Chock, PhrmD Dibetes is the seventh-leding
More informationSignificance of Expression of TGF- in Pulmonary Metastasis in Non-small Cell Lung Cancer Tissues
Originl Article Significnce of Expression of in Pulmonry Metstsis in Non-smll Cell Lung Cncer Tissues Hisshi Sji, Hruhiko Nkmur, Idiris Awut, Norihito Kwski, Msru Hgiwr, Akihiko Ogt, Mkoto Hosk, Tkmoto
More informationCopy Number ID2 MYCN ID2 MYCN. Copy Number MYCN DDX1 ID2 KIDINS220 MBOAT2 ID2
Copy Numer Copy Numer Copy Numer Copy Numer DIPG38 DIPG49 ID2 MYCN ID2 MYCN c DIPG01 d DIPG29 ID2 MYCN ID2 MYCN e STNG2 f MYCN DIPG01 Chr. 2 DIPG29 Chr. 1 MYCN DDX1 Chr. 2 ID2 KIDINS220 MBOAT2 ID2 Supplementry
More informationSUPPLEMENTARY INFORMATION
TM TM tip link horizontl top connectors 1 leucine-rich (21 %) otoncorin-like 1809 ntigenic peptides B D signl peptide hydrophoic segment proline/threonine-rich (79 %) Supplementry Figure 1. () The outer
More informationSkull fracture vs. accessory sutures: how can we tell the difference?
Emerg Rdiol (2010) 17:413 418 DOI 10.1007/s10140-010-0877-8 PICTORIAL ESSAY Skull frcture vs. ccessory sutures: how cn we tell the difference? Thoms Snchez & Deorh Stewrt & Mtthew Wlvick & Leonrd Swischuk
More informationPostinfective physeal bars MRI features and choice of management
Postinfective physel rs MRI fetures nd choice of mngement Murry Hyes, MB ChB Svvs Andronikou, MB BCh, FC Rd, FRCR, PhD Crey Mckenzie, MB ChB, FCRd Jco du Plessis, MB ChB Reen George, MB BS, MMed Rd Slomine
More informationA Vital Role of Magnetic Resonance Imaging in Pregnancy-Related Neurological Complications
Originl Article Print ISSN: 2321-6379 Online ISSN: 2321-595X DOI: 10.17354/ijss/2017/125 A Vitl Role of Mgnetic Resonnce Imging in Pregnncy-Relted Neurologicl Complictions Prveen Kumr Mgudeeswrn 1, Aucker
More informationThe RUTHERFORD-2 trial in heterozygous FH: Results and implications
The RUTHERFORD-2 tril in heterozygous FH: Results nd implictions Slide deck kindly supplied s n eductionl resource by Professor Derick Rl MD PhD Crbohydrte & Lipid Metbolism Reserch Unit University of
More informationCase report. Primary squamous cell carcinoma of the stomach
136 Gstric Cncer (1999) 2: 136 141 S. Mrushi et l.: Primry squmous cell crcinom of the stomch 1999 y Interntionl nd Jpnese Gstric Cncer Associtions Cse report Primry squmous cell crcinom of the stomch
More informationAge related differences in prognosis and prognostic factors among patients with epithelial ovarian cancer
MOLECULAR AND CLINICAL ONCOLOGY 9: 329-334, 2018 Age relted differences in prognosis nd prognostic fctors mong ptients with epithelil ovrin cncer KENJI YOSHIKAWA, TAKESHI FUKUDA, RYO UEMURA, HIROAKI MATSUBARA,
More informationUSE OF SORGHUM-BASED DISTILLERS GRAINS IN DIETS FOR NURSERY AND FINISHING PIGS
Swine Dy 1996 USE OF SORGHUM-BASED DISTILLERS GRAINS IN DIETS FOR NURSERY AND FINISHING PIGS B. W. Senne, J. D. Hncock, I. Mvromichlis, S. L. Johnston, P. S. Sorrell, I. H. Kim, nd R. H. Hines Summry Two
More informationFetal craniofacial structure and intracranial morphology in a case of Apert syndrome
Ultrsound Ostet Gynecol 1999;13:274 280 Fetl crniofcil structure nd intrcrnil morphology in cse of Apert syndrome R. K. Pooh, Y. Nkgw, K. H. Pooh*, Y. Nkgw* nd N. Ngmchi Deprtment of Ostetrics nd Gynecology
More informationShinhaeng Cho, Youngmoon Goh, Chankyu Kim, Haksoo Kim, Jong Hwi Jeong, Young Kyung Lim, Se Byeong Lee, Dongho Shin
Originl Article PMP Progress in Medicl Physics 28(4), Decemer 217 https://doi.org/1.14316/pmp.217.28.4.144 pissn 28-444, eissn 28-443 Dosimetric Impct of Ti Mesh on Proton Bem Therpy Shinheng Cho, Youngmoon
More information