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BackgroundABO-incompatible kidney transplantation (ABOiKT) has been accepted as a viable and cost-effective modality with outcomes comparable to ABO-compatible transplants, but there is a concern regarding higher infectious complications in ABOiKT because of the heightened immunosuppression.The desensitization protocol normally includes antibody removal, B cell depletion by rituximab (RTX), and immunomodulation with intravenous immunoglobulin. Efforts have been made over the years to decrease the dose of RTX in an effort to decrease the infective complications. There is limited literature about the minimum effective dose of RTX, which can cause an effective B cell depletion. This prospective study was designed to correlate the RTX dose with peripheral absolute B cell count, graft function, graft and patient survival, and infective complications.MethodsThis study included 52 adult ABOiKT recipients with anti-A/B antibody titer up to a maximum of 1:512. The participants were divided into 2 groups of 26 each according to the RTX dosage used: Group A received 100 mg/patient, and Group B received 200 mg/patient. RTX was given 14 days prior to transplant after B cell measurement by flow cytometry. The outcomes were compared after 1 year of follow-up.ResultsBoth the dosages effectively depleted the absolute B cell count. Although patient survivals, graft survival, graft function, acute rejection episodes, and post-transplant hospital stay were similar in both groups, infective complications were significantly higher in group B.ConclusionA low dose (100 mg/patient) of RTX produces effective depletion of B cells while lowering the infective complications in ABOiKT.  相似文献   
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Purpose:

The purpose was to examine the existence of divine proportions among the Indian faces in Moradabad population.

Materials and Methods:

Totally, 100 patients (50 males; 50 females) aged 25-45 years were selected for the study. All facial photographs were analyzed based on the method of Ricketts assessing the divine proportions in vertical and transverse facial planes. Six horizontal and seven vertical ratios were determined, which were then compared with the phi ratio.

Results:

The horizontal ratio results showed that three male and female ratios were not significantly different from each other (P > 0.05), and interchilion/nose width ratio was highly significant (P < 0.001). The horizontal mean ratios for females as well as males were highly significant from the phi ratio (P < 0.001) except for interchilion/interdacryon ratio, which was significant (P < 0.05) for females and not significant (P > 0.05) for males. The vertical ratio results showed that there was a highly significant difference (P < 0.001) for forehead height/stomion-soft menton ratio and no significant difference for two ratios between the mean ratios of males and females. All the vertical mean ratios for both the groups were highly significant (P < 0.001), except for the intereye-soft menton/intereye-stomion ratio, which was significant (P < 0.05) for female group and not significant (P > 0.05) for the male group.

Conclusion:

Although, the golden proportion is a prominent and recurring theme in esthetics, it should not be embraced as the only method by which human beauty is measured to the exclusion of others factors.  相似文献   
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Background

The pancreas and peripancreatic region may be a site of metastasis from distant sites. Recent data suggest that pancreatic metastasectomy may achieve long-term survival. We seek to examine our experience with this metastasectomy by reporting the perioperative and survival outcomes.

Methods

Patients undergoing resection of isolated pancreatic metastasis were identified from a prospective pancreatic surgical database at the Department of Gastrointestinal Surgery, North Shore campus of the University of Sydney between January 2004 and June 2015 and selected for retrospective review. Data on operative morbidity and mortality were reported. Survival analysis was performed using the Kaplan–Meier method.

Results

Fifteen patients underwent pancreatic metastasectomy after a median disease-free interval of 63 months (range 0 to 199). Pancreatoduodenectomy was performed in six patients (40 %), distal pancreatectomy with or without splenectomy in three patients (20 %), and pancreatectomy with other visceral organ resection in six patients (40 %). Major complications occurred in six patients (40 %) without mortality. The median survival was 40 months (95 % CI 24.3 to 53.7), and 1-, 3-, and 5-year survival were 76, 48, and 31 % respectively. Cox proportional hazard model identified margin negative resection (hazard ratio (HR) 10.5; P?=?0.044) as a predictor of improved survival.

Conclusion

Long-term survival may be achieved in selected patients with pancreatic metastasis through pancreatic metastasectomy with acceptable morbidity. Selection of patients should be individualized and based on their primary disease origin, biological behavior of the tumor, resectability of the tumor, and the relative effectiveness of systemic or targeted therapies.
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