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The images focus on a very rare atrial septal anatomy known as "double atrial septum with persistent interatrial space.” Only scarce reports of this anomaly are found in literature. Due to increasing use of catheter-based interventions requiring a transseptal puncture, the recognition of this anomaly is essential for performing safe and effective procedures. 相似文献
134.
Robert Mlynski Thi Dao Nguyen Stefan K. Plontke Sabrina Kösling 《European archives of oto-rhino-laryngology》2014,271(4):665-672
Various titanium coupling elements, Vibroplasty Couplers, maintaining the attachment of the Floating Mass Transducer (FMT) of the active middle ear implant Vibrant Soundbridge (VSB) to the round window, the stapes suprastructure or the stapes footplate are in use to optimally transfer energy from the FMT to the inner ear fluids. In certain cases it is of interest to radiologically verify the correct position of the FMT coupler assembly. The imaging appearance of FMT connected to these couplers, however, is not well known. The aim of this study was to present the radiological appearance of correctly positioned Vibroplasty Couplers together with the FMT using two different imaging techniques. Vibroplasty Couplers were attached to the FMT of a Vibrant Soundbridge and implanted in formalin fixed human temporal bones. Five FMT coupler assemblies were implanted in different positions: conventionally to the incus, a Bell-Coupler, a CliP-Coupler, a Round Window-Coupler and an Oval Window-Coupler. High spatial resolution imaging with Multi-Detector CT (MDCT) and Cone Beam CT (CBCT) was performed in each specimen. Images were blind evaluated by two radiologists on a visual basis. Middle ear details, identification of FMT and coupler, position of FMT coupler assembly and artefacts were assessed. CBCT showed a better spatial resolution and a higher visual image quality than MDCT, but there was no significant advantage over MDCT in delineating the structures or the temporal bone of the FMT Coupler assemblies. The FMT with its coupler element could be clearly identified in the two imaging techniques. The correct positioning of the FMT and all types of couplers could be demonstrated. Both methods, MDCT and CBCT, are appropriate methods for postoperative localization of FMT in combination with Vibroplasty Couplers and for verifying their correct position. If CBCT is available, this method is recommended due to the better spatial resolution and less metal artifacts. 相似文献
135.
Thi Tuan Linh Pham Ching‐I Teng Daniel Friesner Kai Li Wan‐Er Wu Yen‐Ni Liao Yin‐Tzu Chang Tsung‐Lan Chu 《Journal of clinical nursing》2019,28(13-14):2669-2680
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Vincent K. Lam Hai T. Tran Kimberly C. Banks Richard B. Lanman Waree Rinsurongkawong Nir Peled Jeff Lewis J. Jack Lee Jack Roth Emily B. Roarty Stephen Swisher AmirAli Talasaz P. Andrew Futreal Vassiliki Papadimitrakopoulou John V. Heymach Jianjun Zhang 《Clinical lung cancer》2019,20(1):30-36.e3
Background
Major guidelines do not recommend routine molecular profiling of lung squamous-cell carcinoma (LUSC) because the prevalence of actionable alterations is thought to be low. Increased utilization of next-generation sequencing (NGS), particularly with cell-free circulating tumor DNA, facilitates reevaluation of this premise.Patients and Methods
We retrospectively evaluated the prevalence of actionable alterations in 2 distinct LUSC cohorts totaling 492 patients. A total of 410 consecutive patients with stage 3B or 4 LUSC were tested with a targeted cell-free circulating DNA NGS assay, and 82 patients with LUSC of any stage were tested with a tissue NGS cancer panel.Results
In the overall cohort, 467 patients (94.9%) had a diagnosis of LUSC, and 25 patients (5.1%) had mixed histology with a squamous component. A total of 10.5% of the LUSC subgroup had somatic alterations with therapeutic relevance, including in EGFR (2.8%), ALK/ROS1 (1.3%), BRAF (1.5%), and MET amplification or exon 14 skipping (5.1%). Sixteen percent of patients with mixed histology had an actionable alteration. In the LUSC subgroup, 3 evaluable patients were treated with targeted therapy for an actionable alteration; all of them experienced partial response.Conclusion
In this large, real-world LUSC cohort, we observed a clinically significant prevalence of actionable alterations. Accurate local histopathologic assessment in advanced-stage LUSC can be challenging. Further evaluation of the genomic landscape in this setting is warranted to potentially identify underappreciated treatment options. 相似文献138.
139.
Khoi Tran Derrick Wang Jackson Scharf SriniVas Sadda David Sarraf 《Eye (London, England)》2020,34(11):1958
There has been a sharp rise of reported handheld laser-induced maculopathy (HLIM) cases over the past decade, a concerning trend that may continue due to unregulated online access to high power lasers. Though HLIM has distinct clinical features, not uncommonly it may masquerade as other retinal disorders. It is critical therefore to recognise the clinical and multimodal imaging characteristics of this important and potentially devastating condition. As HLIM patients are typically young, unique issues need to be considered, such as delayed presentation, difficult history, poor compliance and behavioural or psychiatric comorbidity. This article will review the clinical and diagnostic features of laser injury, with a special emphasis on the multimodal retinal findings. In addition, we present a unique case of HLIM, resembling the presentation of a placoid disease variant and illustrating choroidal ischaemia using advanced retinal imaging, that offers further insight into the mechanisms of laser injury and its complications. The issues addressed in this review aim to increase recognition of an increasingly important and trending condition with potentially profound visual complications.Subject terms: Retinal diseases, Paediatrics, Trauma 相似文献
140.
Improvements in childhood cancer survival have allowed boys and their families to increasingly focus on quality of life after therapy, particularly their future ability to father children. Treatments should maintain comprehensive cancer care goals and consider the long-term quality of life of these children. While semen cryopreservation is a well-established method of fertility preservation for post-pubertal children, the use of cryopreserved pre-treatment testicular tissue represents a promising, yet experimental method of fertility preservation for prepubertal males facing sterilizing therapy. Healthcare providers should counsel families about the fertility risks of therapy, discuss or refer patients for standard fertility preservation options, and consider experimental approaches to fertility preservation while being mindful of the ethical questions these treatments raise. 相似文献