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Horner syndrome, characterized by the triad of unilateral ptosis, miosis, and anhidrosis, typically arises following a stroke, surgical interventions in the neck and chest, or trauma. Horner syndrome is rare in children. This study presents the case of a 9-year-old girl with End-Stage Renal Disease (ESRD) caused by renal hypodysplasia. After permcath insertion, she developed a severe headache and anisocoria, followed by ptosis and a progressively expanding neck hematoma. Physical examination and MRI of the neck revealed that Horner syndrome, caused by hematoma formation following permcath placement, was the diagnosis. Supportive interventions were implemented, leading to significant improvement in Horner syndrome over a six-month period. Complications from permcath insertion can be a cause of Horner syndrome.
OBJECTIVE: To evaluate the efficacy of drug-eluting beads transarterial chemoembolization (DEB-TACE) in the treatment of hepatocellular carcinoma (HCC) by propensity score matching (PSM) technique. METHODS: The clinical data of HCC patients treated with DEB-TACE in the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2020 as well as their 36-month-follow-up data were retrospectively analyzed. The subjects were matched in pairs based on baseline data and laboratory indicators using the PSM method and divided into a pirarubicin group (n = 34), raltitrexed group (n = 34), and arsenic trioxide group (n = 34). Clinical efficacy was evaluated according to mRECIST criteria. The levels of alpha fetal protein (AFP), carcinoma embryonic antigen (CEA) and carbohydrate antigen-125 (CA125) in serum were detected by enzyme-linked immunosorbent assay (ELISA). The progression-free survival (PFS) and overall survival (OS) were recorded by outpatient, inpatient, and telephone follow-up. Adverse reactions were counted. RESULTS: month post-operation was significantly higher than that of the raltitrexed group (all P<0.05). Before and 1 month after treatment, there were no significant differences in the aspartate aminotransferase (AST), alanine aminotransferase (ALT), or total bilirubin (TBIL) levels between the three groups (all P>0.05). Before treatment, no significant differences were observed in AFP, CEA, or CA125 levels among the three groups (all P>0.05). After treatment, the levels of AFP in the pirarubicin group and arsenic trioxide group were lower than those in the raltitrexed group (both P<0.05), but there were no significant differences in CEA and CA125 levels (all P>0.05). There were no significant differences in PFS and OS among the three groups (all P>0.05), and the incidence of fever, abdominal pain, and myelosuppression showed no significant differences among the three groups (all P>0.05). CONCLUSION: The efficacies of DEB-TACE loaded with pirarubicin, raltitrexed, or arsenic trioxide in treating HCC were generally comparable, and the survival benefit of patients was similar. The short-term efficacy of the pirarubicin group and arsenic trioxide group was slightly better than that of the raltitrexed group.
Accurate needle placement is critical in percutaneous thoracoabdominal interventions. Conventional CT-guided procedures are limited by iterative scans, operator-dependent variability, and two-dimensional visualization. This preclinical study evaluates a novel display-based augmented reality (AR) navigation system integrating virtual-to-real registration via deltille grid position sensing (DGPS) markers for enhanced needle guidance. Experiments were conducted on a CIRS abdominal phantom with three operators: one expert interventional radiologist and two novices. Puncture accuracy, angular deviation, procedure time, and number of verification scans were assessed. AR guidance achieved first-pass distance errors of 1.50 (0.46) mm for the expert and 1.66 (0.50) mm and 1.58 (1.06) mm for novices, with angular deviations of 1.41°, 1.30°, and 1.39°, respectively. No significant operator-related differences were observed. Compared with conventional step-and-shoot CT guidance, AR guidance reduced the first-pass and final-pass targeting error, while conventional CT guidance relies on iterative scan-adjust-advance steps to achieve acceptable final accuracy, with AR reducing intermediate re-scans while retaining a single final verification scan. The findings indicate that AR navigation enhances first-pass precision, reduces procedural variability, and improves workflow efficiency, supporting its potential clinical value for more consistent and efficient minimally invasive interventions.
Background: The pathological diagnosis of mediastinal lesions is crucial for precision oncology. While endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is the preferred minimally invasive method for visceral mediastinal lesions, its diagnostic yield can be limited for high-risk lesions surrounded by great vessels. This case demonstrates that under such complex anatomical constraints, a meticulously planned CT-guided percutaneous biopsy serves as a safe and effective alternative. Case presentation: A middle-aged male patient was highly suspected of having lung cancer with mediastinal metastasis based on clinical and radiological findings. Two successive bronchoscopic biopsies of the pulmonary lesion failed to yield a diagnosis. Although the medical team recommended EBUS-TBNA at a tertiary hospital, the patient opted for a CT-guided biopsy at our institution after considering personal convenience and economic factors. The target was a high-risk mediastinal lymph node located within the vascular "core area" between the aorta and superior vena cava. Intervention and outcome: Preprocedural planning with contrast-enhanced CT simulated three potential trajectories (transcostochondral, transsternal, transpulmonary). The transsternal approach was prioritized to avoid lung parenchyma, thereby eliminating the risk of pneumothorax-a critical consideration given the patient's comorbid emphysema and bullae. The initial transcostochondral approach was abandoned due to pain upon vascular contact and restricted maneuverability. The subsequent transsternal approach was successfully performed using a coaxial biopsy system to navigate the narrow vascular space, followed by tract embolization upon needle withdrawal. The procedure was safe, with only minimal, self-resolving mediastinal emphysema. Adequate tissue cores were obtained, enabling a definitive diagnosis of metastatic lung adenocarcinoma. Conclusion: For complex mediastinal lesions where standard approaches are unsuitable or declined by the patient, a meticulously planned CT-guided percutaneous biopsy based on three-dimensional anatomical assessment is a feasible and valuable diagnostic strategy.
Primary pulmonary adenoid cystic carcinoma (PACC) is an exceedingly rare malignant lung tumor. We report an extremely rare case of a 38-year-old female. In 2013, a computed tomography (CT) scan suggested lung cancer in the left upper lobe, and a percutaneous biopsy confirmed PACC pathologically. She underwent surgical resection followed by postoperative adjuvant chemotherapy in the same year, with no recurrence during the 5-year post-operative follow-up. In December 2019, follow-up CT revealed bilateral renal metastases. Subsequently, in 2021, chest wall metastases developed. After sequential radiotherapy, chemotherapy, and combined immunotherapy, the chest wall mass was significantly reduced. During this period, multiple immune-related adverse events (irAEs) occurred. Upon progression of the renal metastases in 2024, ultrasound-guided ablation was performed. Subsequent re-evaluations showed essentially no viability in the bilateral renal tumors, and the chest wall mass remained stable. This patient was diagnosed with PACC in 2013. As of September 2025, her overall survival (OS) has exceeded 11 years. The successful management of this case is attributed to multimodal therapy. To date, no cases of PACC with concurrent bilateral renal and chest wall metastases have been reported, thus providing a valuable reference for the diagnosis and treatment of PACC.
Most ant species engage in nuptial flight, a mating behavior that involves flight dispersal. In temperate regions in particular, nuptial flights are highly synchronized, typically occurring within a period of less than one month each year. Some ant species engage in intranidal mating, in which males and alate gynes mate within the nest. For these species, the mating season remains unknown in many cases due to the difficulty of directly observing their mating behavior. In the Japan-endemic, arboreal-nesting ant Camponotus yamaokai, intranidal mating is estimated to occur around May. However, because this estimate is based on limited indirect evidence, it remains unclear whether it accurately reflects the actual mating season. Thus, in this study, we clarified the true mating season of C. yamaokai by dissecting field-collected gynes and conducting rearing experiments. Dissections revealed gynes shortly after mating not only in May, the previously estimated mating period, but also in January, March, April, June, September, and December. In addition, rearing experiments showed that some individuals emerging in August and September mated without overwintering. Therefore, our results suggest that mating occurs asynchronously in C. yamaokai, leading to extended mating seasons in spring and autumn. In ants, intranidal mating is characterized by lower predation risk, greater ease of encountering mates, a reduced likelihood of reproductive interference with closely related species, and a diminished need for inbreeding avoidance compared with species that engage in nuptial flight. These characteristics suggest that selective pressures for mating synchrony are relaxed, leading to the evolution of reproductive asynchrony.
Homoeusa prolongata Sawada, 1970 Figs 3 E, 13 A – I, 14 A – D (Japanese name: Hirata-ariyadori) Homoeusa prolongata Sawada, 1970 b: 57, fig. 14 (original description); Schülke and Smetana 2015; 682 (catalogue); Maruyama et al. 2013: 26 (distribution and bionomics mentioned). Type material. Not examined. Additional material examined. Japan: Hokkaido • 2 exs.; Near Hime-numa, Oshidomariwannai (alt. 130 m), Rishiri-chô; 5. VI. 2024; T. Yamauchi leg. (OUAVM) • 1 ex.; “ Horokanai Butokamabetsu Riv ” (alt. 300 m); 3. VIII. 1991; A. Smetana leg. (NMST, ex A. Smetana coll.) • 1 ex.; Kanayama, Makoi, Shari-chô; 24. VI. 2002; Y. Kida leg. (KUM) • 1 ♂, 1 ex.; Teine-yama [43.0836, 141.2024], Sapporo-shi; 23. V. 2020; Y. Tasaku leg. (KUM) • 1 ♂; Ôsawaguchi, Nopporo-shizenkôen, Ebetsu-shi; 16–19. VI. 2001; S. Hori leg. (KUM) • 2 exs.; Kannon-zawa, Sapporo-shi; 19. V. 2021; Y. Tasaku leg. (KUM) • 2 exs.; Hakken-zan, Sapporo-shi; 1. VI. 2002; M. Maruyama leg. (KUM) • 1 ♀; Mt. Kariba, Shiribeshi; 12. VI. 1986; S. Nomura leg. (KUM). Honshu: Aomori-ken • 1 ex.; Iwaki river riverbed, Kawazura (alt. 10 m) [40.694, 140.455], Itayanagi-machi; 28. VI. 2023; TS. Nozaki leg. LNS (KUM). Iwate-ken • 1 ♀, 1 ex.; Kitayama, Morioka-shi; 23. IV – 3. V. 2024; N. Nakaya leg. FIT (IPMM) • 1 ex.; Mt. Takabora, Kamiyonai, Morioka-shi; 21. IV – 3. V. 2024; N. Nakaya leg. FIT (IPMM). Akita-ken • 1 ex.; Kawara-bo, Mt. Hachimine, Hanamaki-shi; 22–24. VI. 1980; S. Naomi leg. (KUM). Fukushima-ken • 1 ex.; Zenjin, Mt. Chokai, Yurihonjo-shi; 19–20. VI. 1980; S. Naomi leg. (KUM) • 1 ex.; Yokomuki, Mt. Adatara, Inawashiro-machi; 10. VII. 1985; S. Nomura leg. (KUM) • 1 ex.; Kozodaira, Hinoemata-mura; 26. VII. 1996; S. Naomi leg. (KUM) • 2 exs.; Nanairi, Hinoemata-mura; 24. VII. 1990; T. Kishimoto leg. (KUM). Tochigi-ken • 1 ex.; Mt. Nasu; 3. VI. 1994; S. Naomi leg. (KUM) • 2 exs.; Chuzenji, Nikko-shi; 28–30. VI. 1982; S. Naomi leg. (KUM) • 1 ex.; same locality; 24. VII. 1985; S. Nomura leg. (KUM) • 1 ex.; “ Nikko N. P. Lake Chuzenjiko ” (alt. 1,280 m); “ 14. VII. 80 ” [1980]; A. & Z. Smetana leg. (NMST, ex A. Smetana coll.) • 1 ex.; “ Nikko N. P. Senjugahara ” (alt. 1400 m); “ 15. VII. 80 ” [1980]; A. & Z. Smetana leg. (KUM, ex A. Smetana coll.) • 1 ex.; Nagaishi Forest Road, Ashikaga-shi; 27. V. 1990; H. Ohkawa leg. (KUM) • 1 ♂; Watarase-yûsuichi, Fujioka-machi; 16. IV. 2000; H. Ôkawa leg. (KUM). Gunma-ken • 1 ex.; Mikuni-tôge, Minakami-machi; 27. VI. 1997; S. Naomi leg. (KUM) • 1 ex.; Hôshi-onsen, Minakami-machi; 26. VI. 1997; S. Naomi leg. (KUM) • 1 ex.; Amemi-rindou, Minakami-machi; 4. V. 1998; Shiho Arai leg. (KUM) • 1 ♂, 1 ex.; Sakurayama, Fujioka-shi; 9. V. 1998; Shiho Arai leg. (KUM) • 1 ex.; same locality; 22. V. 1999; K. Toyoda leg. LNH (KUM) • 1 ♀, 3 exs.; same locality; 22. V. 1999; Shiho Arai leg. LNH (KUM) • 1 ex.; same locality; 27. V. 2000; Shiho Arai leg. LNH (KUM). Saitama-ken • 1 ex.; Mt. Jômine-san, Minano-machi; 29. V. 1999; Shiho Arai leg. LNH (KUM) • 1 ex.; Chichibu-kôgen, Higashichichibu-mura; 5. V. 2000; Shiho Arai leg. (KUM) • 1 ex.; Sugaya, Ranzan-machi; 14. VI. 1994; K. Toyoda leg. LNH (KUM) • 1 ex.; same locality; 16. VI. 1994; K. Toyoda leg. (KUM) • 1 ex.; Iwadono, Higashimatsuyama-shi; 3. V. 2005; K. Toyoda leg. LNJ (KUM) • 1 ex.; Near Tsumasaka-Toge, Hanno-shi; 20. VI. 1998; K. Toyoda leg. (KUM) • 1 ♂; Kawaura-keikoku (alt. 600 m), Chichibu-shi; 20. VI. 1998; Shiho Arai leg. (KUM) • 1 ♀; same locality; 27. VI. 1998; Shiho Arai leg. (KUM) • 1 ex.; Kaminaguri, Hanno-shi; 23. V. 1998; Shiho Arai leg. LNH (KUM) • 1 ex.; Sumiyairi-rindô, Hanno-shi; 3. VI. 2000; Shiho Arai leg. LNH (KUM). Chiba-ken • 2 exs.; Ashida (alt. 10 m), Narita-shi; 17–25. VII. 2014; R Nakamura leg. FIT (KUM) • 11 exs.; Okuno, Ichihara-shi; 12–14. VII. 2000; S. Hatsushiba & T. Shimada leg. (KUM) • 1 ex.; same locality; 16–18. V. 2001; S. Hatsushiba & T. Shimada leg. (KUM) • 1 ex.; same locality; 12–14. V. 2001; S. Hatsushiba & T. Shimada leg. (KUM) • 1 ex.; Mt. Gundari, Ichinomiya-machi; 12. IV. 1997; S. Nomura leg. (KUM) • 1 ex.; Umegase, Daifuku-yama, Ichihara-shi; 6. V. 1998; S. Naomi leg. (KUM) • 1 ex.; Amatsu (alt. 70 m) [35.1406, 140.1512], Kamogawa-shi; 3. V. 2016; S. Sejima leg. Litter (KUM). Tokyo-to • 1 ex.; Ônita, Ome-shi; 20. V. 1991; T. Kishimoto leg. (KUM) • 1 ex.; Oyamada-chô, Machida-shi; 19. V. 1992; T. Kishimoto leg. (KUM) • 1 ex.; Machida-shi; 28. V. 1981; T. Niizato leg. (KUM). Kanagawa-ken • 3 exs.; Nanzawa, Tsukui, Sagamihara-shi; 6. V. 1977; R. Kiryu leg. (SCM) • 1 ex.; Miyagase, Aikô; 19. IV. 1977; R. Kiryu leg. (SCM) • 2 exs.; Kozukue, Yokohama-shi; 21. IV. 1994; H. Sato leg. (KUM) • 1 ♂; Niiharutyô 、 Midori-ku [35.50, 139.51], Yokohama-shi; 25. IV. 2012; O. Saitoh leg. (KPMNH) • 3 exs.; Trap St. 1. Park / “ Y. N. S ”, Yokohama-shi; 8. VI. 1988; Y. Kominami leg. (SPMN) • 1 ex.; Yakunimi-yama [35.35, 139.17], Hadano-shi; 27. VI. 2014; O. Saitoh leg. (KPMNH) • 1 ex.; Kinugasa, Yokosuka-shi; 26–27. IV. 1995; S. Tsuboyama leg. (KUM). Niigata-ken • 1 ♂; Kita-ikari (alt. 760 m) [38.1500, 138.4049], Sado-shi; 18. VI. 2023; TS. Nozaki leg. (KUM) • 3 exs.; Mt. Tadara-mine, Ryotsu (alt. 810 m) [38.13, 138.38]; Sado-shi; 11. VI. 2012; M. Yoshida leg. (KUM) • 2 exs.; Yokoyama, Sado-shi; 24–25. V. 1995; T. Kishimoto leg. (KUM) • 1 ex.; Kaikake-onsen, Yuzawa-machi; 23. VI. 1996; K. Haga leg. Leaf litter in Beech forest (KUM) • 1 ex.; Sasagamine, Myoko-shi; 14–15. VI. 1980; S. Naomi leg. (KUM) • 1 ex.; Suginosawa (alt. 950 m) [36.8519, 138.1399], Myoko-shi; 3. VI. 2018; S. Sejima leg. Litter (KUM). Fukui-ken • 1 ex.; Mt. Houonji-san, Katsuyama-shi; 31. V. 1989; Kouichi Matsumoto leg. (KUM) • 1 ex.; Mt. Gongen, Echizen-shi; 22. V. 1981; H. Sasaji leg. (KUM). Yamanashi-ken • 1 ♀; Daibosatsu-rei [35.73, 138.82], Koshu-shi; 9. VI. 2019; O. Saitoh leg. (KPMNH) • 1 ex.; Ryomata-goya, Noro-gawa riv., Minami-alps-shi; 3. VIII. 1996; K. Haga leg. Fallen branch (KUM) • 5 ♂♂, 1 ♀, 2 exs.; Karumizu-rindo (alt. 1600 m), Narusawa-mura; 22–29. VI. 2011; T. Watanabe leg. FIT (KUM) • 1 ex.; same locality; 29. VI – 6. VII. 2011; T. Watanabe leg. FIT (KUM) • 1 ex.; same locality; 27. VI – 4. VII. 2012; T. Watanabe leg. FIT (KUM) • 1 ex.; same locality; 25. VII – 1. VIII. 2012; T. Watanabe leg. FIT (KUM) • 2 exs.; Subashiri-guchi, Fujisan (alt. 1,400 m), Oyama-chô; 15–20. V. 2011; T. Watanabe leg. FIT (KUM) • 1 ex.; Subashiri, Fujisan 1 - gome (alt. 1,400 m), Oyama-chô; 20–26. V. 2011; T. Watanabe leg. FIT (KUM). Nagano-ken • 2 exs.; Shiga-kôgen (alt. 1,380 m) [36.728, 138.478], Yamanouchi-machi; 9. VII. 2022; TS. Nozaki leg. Litter (KUM) • 1 ex.; same locality; 9. VII. 2022; TS. Nozaki leg. LNH (KUM) • 1 ♂; Mizunashiike, Shiga-kôgen, Yamanouchi-machi; 9. VII. 2022; TS. Nozaki leg. (KUM) • 1 ex.; Satoyamabe, Matsumoto-shi; 4. VI. 2009; T. Komatsu leg. LNJ (KUM) • 1 ♂; Tobira, Matsumoto-shi; 5. VI. 2011; M. Maruyama et al. leg. (KUM) • 1 ♀; Kohigashi, Chino-shi; 19. VI. 2011; M. Maruyama et al. leg. (KUM) • 1 ♂; Kannon-daira, Yatsuga-take; 11. VII. 2000; H. Hoshina leg. Beating (KUM). Shizuoka-ken • 1 ex.; Subashiri-guchi, Fujisan (alt. 1,400 m), Oyama-chô; 15–22. VI. 2011; T. Watanabe leg. FIT (KUM) • 2 exs.; Hiekawa, Izu-shi; 2. VI. 1983; T. Tahira leg. (KUM). Kyoto-fu • 1 ex.; Mt. Yôrô-san, Maizuru-shi; 25–26. V. 2000; K. Mizuno leg. (KUM). Hyogo-ken • 1 ex.; Mt. Hyonosen; 5. VI. 1984; S. Nomura leg. (KUM) • 1 ex.; Mt. Mimuro-yama; 7. VI. 1997; H. Hoshina leg. (KUM). Nara-ken • 1 ex.; Nara; “ 11. VIII. 80 ” [1980]; A. & Z. Smetana leg. (KUM, ex A. Smetana coll.) • 1 ex.; Nishitani, Yoshino-chô; 18–19. V. 1995; Y. Nakahara leg. Bait trap (KUM) • 2 exs.; Mt. Nehan-dake (alt. 1,140 m), Shimokitayama-mura; 27. VI. 1998; T. Kishimoto leg. (KUM). Wakayama-ken • 1 ex.; Hirai, Kozagawa-chô; 15. VIII. 1999; M. Maruyama leg. LNJ (KUM) • 1 ex.; same locality; 16. VII. 1999; M. Maruyama leg. LNN (KUM). Tottori-ken • 1 ex.; Hokidaisen, Daisen-chô; 3. VI. 1980; S. Naomi leg. (KUM) • 3 exs.; Mt. Daisen, Daisen-chô; 3–5. VI. 1980; S. Naomi leg. (KUM) • 2 exs.; Ônarubara-kôgen (alt. 770 m), Kôfu-chô; 18–24. V. 2008; A. Watanabe leg. FIT (KUM) • 3 exs.; same locality; 7–23. VI. 2008; A. Watanabe leg. FIT (KUM) • 1 ex.; same locality; 24. V – 1. VI. 2008; A. Watanabe leg. FIT (KUM). Shimane-ken • 1 ♀; Dangyô-no-taki, Dôgo Is., Okinoshima-chô; 5–16. VI. 2008; T. Shimada leg. (KUM). Okayama-ken • 1 ex.; Kanehira, Bicchu-chô (alt. 300 m), Takahashi-shi; 22. V – 2. VI. 2010; A. Watanabe leg. FIT (KUM) • 1 ex.; same locality, Takahashi-shi; 2–19. VI. 2010; A. Watanabe leg. FIT (KUM). Hiroshima-ken • 1 ♂; Mt. Tate-eboshi (alt. 1,180 m) [35.0527, 133.0696], Shobara-shi; 15. VI. 2024; TS. Nozaki leg. (KUM) • 1 ex.; Kakezu-yama, Higashiyawatahara (alt. 850–1,126 m), Kitahiroshima-chô; 30. IV – 9. V. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM) • 2 exs.; same locality; 9–18. V. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM) • 1 ex.; same locality; 30. V – 13. VI. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM) • 5 exs.; same locality; 13–27. VI. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM) • 1 ex.; same locality; 27. VI – 4. VII. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM) • 1 ♂, 1 ex.; same locality; 4–18. VII. 2009; TA. Nozaki & Y. Nozaki leg. FIT (KUM). Yamaguchi-ken • 1 ex.; Nodani, Tokuji-chô; 21. IV. 2004; Y. Fujitani leg. (KUM). Shikoku: Tokushima-ken • 1 ex.; Meoto-ike, Tsurugi-chô; 30. VI. 2006; H. Fujimoto leg. (KUM). Kagawa-ken • 2 exs.; Nagara-dam, Ayakami-chô; 5. V. 2003; S. Nagashima leg. in litter (KUM) • 2 exs.; Shôzaka, Sogisho-higashi, Ayagawa-chô; 9–12. IV. 2009; H. Fujimoto leg. FIT (KUM) • 1 ex.; same locality; 12–18. IV. 2009; H. Fujimoto leg. FIT (KUM) • 1 ex.; same locality; 22–30. V. 2009; H. Fujimoto leg. FIT (KUM) • 1 ex.; same locality; 25. IV – 2. V. 2010; H. Fujimoto leg. FIT (KUM). Kochi-ken • 1 ex.; Mt. Tsutsujô-zan (alt. 1,600 m), Ino-chô; 30. VI. 2007; TA. (Takasuke) Miyata & TO. (Toshie) Miyata leg. (KUM) • 1 ex.; Ekawa, Nishitosa (alt. 120 m) [33.217, 131.784], Shima
OBJECTIVE: To evaluate the efficacy of nasal high-flow humidified oxygen therapy (HFHO) in improving oxygenation and respiratory function. METHODS: ), respiratory parameters, and Radiological Atelectasis Score (RAS). Secondary outcomes included re-intubation rates, ICU length of stay, and overall hospital stay duration. RESULTS: (90.92% ± 0.93%; P < 0.001) post-treatment. Additionally, HFHO was associated with a lower re-intubation rate (6.54% vs 17.6%; P = 0.011) and shorter ICU (3.88 ± 0.63 days; P = 0.023) and hospital stays (10.57 ± 0.6 days; P = 0.004). The RAS significantly improved in the HFHO group by days 3-5 post-operation (1.17 ± 0.3; P = 0.008). CONCLUSION: HFHO offers superior outcomes in oxygenation and respiratory function compared to conventional oxygen therapy in patients with Stanford Type B aortic dissection and hypoxemia.
Postoperative chylous fistula in abdominal surgery for benign pathologies is an extremely rare complication. This condition usually develops after extensive resections, chest or neck surgery, and is characterized by lymphatic leakage outside the abdominal cavity. In the following report, we describe two cases of patients undergoing non-oncologic abdominal surgery who developed a chylous fistula during the postoperative period and who responded adequately to conservative management.
Background/Objectives: Pleural mesothelioma (PM) frequently recurs despite multimodal therapy. Here, we aimed to retrospectively evaluate the safety and potential clinical benefit of radiofrequency ablation (RFA) for recurrent PM. Methods: Fourteen consecutive patients underwent CT-guided RFA between July 2019 and June 2025. The cohort comprised 13 men and 1 woman, with a median age of 69 (range, 54–77) years. All patients had previously received systemic therapy and 12 had undergone surgery. Seven patients (50%) presented with multiple lesions, and 25 tumors (median diameter 1.8 cm; range, 0.5–7.0 cm) were treated in 23 sessions. Outcomes assessed were local tumor control, complications, and survival. Local progression and overall survival were estimated using Kaplan–Meier analysis. Adverse events were classified according to the Society of Interventional Radiology guidelines. Results: Technical success was achieved in all sessions. Two tumors showed local recurrence, corresponding to 1- and 2-year local progression rates of 10.6%. Seven patients showed distant metastases, most of whom subsequently received systemic therapy. Three patients died, two from disease progression and one from treatment-related gastrointestinal perforation during therapy for an unrelated cancer. The overall survival rates were 100%, 100%, and 60% at 1, 3, and 5 years, respectively. Major and minor complications occurred in one case each (4.3%): a refractory skin ulcer and retroperitoneal hematoma, respectively. Conclusions: RFA was technically feasible and generally well tolerated, and helped achieve encouraging local control and survival in patients with recurrent PM, warranting further evaluation of RFA as a complementary approach in multimodal treatment strategies.
<h2>Abstract:</h2><h3>Objective</h3> There has been a significant shift of vascular care and intervention from the inpatient to outpatient setting. The office-based laboratory (OBL) is an increasingly adopted treatment model following the 2008 payor reimbursement modifications for outpatient vascular intervention by the Centers for Medicare and Medicaid Services (CMS). Reports on this phenomenon largely focus on the financial effects with a paucity of safety and outcomes data associated with this treatment setting. In this study, we examine treatment outcomes of elective mesenteric angiograms performed at an OBL, and factors affecting patient selection for safe outpatient intervention. <h3>Methods</h3> A retrospective study was performed of adult patients treated with diagnostic or interventional mesenteric angiography at a single OBL over 9 years. Patient and treatment variables were abstracted from outpatient and inpatient medical records. Primary outcomes of interest were 30-day adverse events (30D A/E) reported with the Clavien-Dindo (CD) classification system. Technical success was examined as a secondary outcome. <h3>Results</h3> Between September 2015 and February 2024, 80 patients underwent 115 mesenteric angiograms by 7 vascular surgeons. Patients were 73 years old on average (SD=9.3, range 44 to 89), predominantly female (53 of 80 patients), predominantly low risk (97 of 115 angiograms were performed on patients with SVS/AAVS MCS<2), with a mean BMI of 25.9 (range 14.1 to 50.6, SD=6). The overall incidence of 30D A/Es was 6.1% (7 of 115), with a 5.2% 30D rate of morbidity (6 of 115), and 0.9% 30D rate of mortality (1 of 115). 6 of 7 cases with 30D A/Es were CD grade 3 or greater. An univariable comparison of mesenteric angiograms resulting in a 30D A/E to those without demonstrated no significant differences in mean age, race distribution, mean BMI, preoperative SVS/AAVS MCS, smoking history, history of malignancy, use of antithrombotic medications, history of prior mesenteric stents, or whether the procedure was performed for reintervention. On multivariable regression, technical failure was a significant predictor for complications CD 3 or greater (Odds Ratio [OR], 6.36; 95% CI, 1.1-37.4, p=.04) when correcting for inter-operator variability. <h3>Conclusion</h3> Variable complexity mesenteric angiography for primary and repeat intervention is safely performed at an office-based lab on selected low and moderate risk patients. Further study of anatomic and patient selection factors predicting technical failure is required.
Darbo autorius: Urtė Lukoševičiūtė Darbo pavadinimas: Dirbtinis intelektas skeleto traumų diagnostikoje: literatūros apžvalga Tyrimo tikslas. Išanalizuoti literatūroje pateiktus DI diagnostinio tikslumo rodiklius skeleto traumų diagnostikoje ir palyginti juos su specialistų rezultatais. Uždaviniai: 1. Išanalizuoti literatūroje aprašytas DI pritaikymo galimybes medicinoje bei radiologijoje. 2. Išanalizuoti literatūroje aprašytą DI pritaikymą, diagnozuojant skeleto trauminius pakitimus. 3. Surinkti straipsnius su tyrimais, kuriuose vertinamas DI modelio jautrumas, specifiškumas ir tikslumas, diagnozuojant įvairių anatominių sričių skeleto traumas rentgenologiniu tyrimu, o gauti rezultatai yra lyginami su specialistų rezultatais. 4. Išanalizuoti šiuos tyrimus ir pateikti rezultatus. Metodai. Atlikta literatūros apžvalga naudojant Pubmed duomenų bazę 2024.01.01 – 2024.12.31. Remiantis įtraukimo ir atmetimo kriterijais į tyrimą įtraukta 17 straipsnių. Rezultatai. Didžiausias jautrumas, specifiškumas ir tikslumas, lyginant su kitų anatominių sričių tyrimais, buvo nustatytas, diagnozuojant proksimalinio šlaunikaulio lūžius – dubens sritis. Visi 3 rodikliai viršijo 95% ribą. Prasčiausiai DI diagnozavo ,,bet kokios anatominės srities“ lūžius – visi trys rodikliai nesiekia 90%. DI pagal jautrumą, specifiškumą ir tikslumą pralenkė gydytojus radiologus trijuose tyrimuose iš 14, o visi skirtumai buvo statistiškai reikšmingi (p < 0,05). Gydytojai radiologai nei viename tyrime nepralenkė DI visais trimis rodikliais. Visuose tyrimuose specialistai, kurie naudojosi DI pademonstravo bent vieną geresnį rodiklį, lyginant su gydytojais, kurie DI nesinaudojo. 2 iš 7 tyrimų specialistai su DI priemone pagerino visus 3 rodiklius – jautrumą, specifiškumą ir tikslumą. Lyginant DI su specialistai, kurie naudojosi DI, 3 tyrimuose iš 4 DI statistiškai reikšmingai (p < 0,05) pagerino specialistų diagnostinį jautrumą, lyginant su vienu DI. Išvados. 1. DI pritaikymas medicinoje neapsiriboja tik diagnostine radiologija. Siekiama pritaikyti šią priemonę tiek dermatologijoje, tiek oftalmologijoje bei visose įmanomose sveikatos priežiūros įstaigos grandyse. 2. Skeleto traumų diagnostikoje pirmiausia bandoma DI inegruoti, analizuojant rentgenologinio tyrimo vaizdus. 3. Surinka 17 straipsnių, kurie lygina 10 DI modelių gebėjimą diagnozuoti 6 skirtingų anatominių sričių lūžius ir lygina gautus tyrimo jautrumo, specifiškumo ir tikslumo rezultatus su gydytojų 4 specialistų. 4. DI tiksliausiai atpažino stambių kaulų (šlaunikaulio) lūžius. Iš 14 tyrimų tik 3 parodė, kad DI statistiškai reikšmingai pagerino visus diagnostinius rodiklius, todėl kai kurie DI modeliai netinka trauminių lūžių diagnostikai. Tik viename tyrime DI reikšmingai pagerino gydytojų diagnostiką, tad jis gali būti laikomas pagalbine priemone. Trijuose tyrimuose specialistai, naudodamiesi DI, geriau diagnozavo lūžius nei pats DI, todėl kai kurie modeliai nėra pakankamai patikimi savarankiškai diagnostikai.
Interventional oncology provides image-guided therapies, including transarterial tumor embolization and percutaneous tumor ablation, for malignant tumors in a minimally invasive manner. As in other medical fields, the application of artificial intelligence (AI) in interventional oncology has garnered significant attention. This narrative review describes the current state of AI applications in interventional oncology based on recent literature. A literature search revealed a rapid increase in the number of studies relevant to this topic recently. Investigators have attempted to use AI for various tasks, including automatic segmentation of organs, tumors, and treatment areas; treatment simulation; improvement of intraprocedural image quality; prediction of treatment outcomes; and detection of post-treatment recurrence. Among these, the AI-based prediction of treatment outcomes has been the most studied. Various deep and conventional machine learning algorithms have been proposed for these tasks. Radiomics has often been incorporated into prediction and detection models. Current literature suggests that AI is potentially useful in various aspects of interventional oncology, from treatment planning to post-treatment follow-up. However, most AI-based methods discussed in this review are still at the research stage, and few have been implemented in clinical practice. To achieve widespread adoption of AI technologies in interventional oncology procedures, further research on their reliability and clinical utility is necessary. Nevertheless, considering the rapid research progress in this field, various AI technologies will be integrated into interventional oncology practices in the near future.
With the development of comprehensive treatment, locoregional transarterial chemotherapy has become an alternative conversion therapy, palliative therapy, and neoadjuvant therapy for many solid malignant tumors. Locoregional transarterial chemotherapy, which is most frequently used for treating liver cancer, has the characteristics of high regional efficacy and few systemic adverse reactions. In recent years, the number of relevant reports of locoregional chemotherapy for treating initially inoperable colorectal cancer (CRC), including non-metastatic and metastatic CRC, has gradually increased. However, the specific treatment options for such locoregional therapy are not the same, and its indications, medication regimens and combined treatments have not reached any consensus. In this review, the application status of locoregional transarterial chemotherapy in primary and metastatic CRC patients has been reviewed and summarized to provide a reference for future clinical work and scientific research.
BACKGROUND: Hepatocellular carcinoma (HCC) is a prevalent malignancy, and transcatheter arterial embolization (TAE) has emerged as a pivotal therapeutic modality. However, TAE may induce symptom distress and fatigue, adversely affecting the quality of life of patients. AIM: To investigate symptom distress, fatigue, and associated factors in HCC patients undergoing TAE. METHODS: We used a cross-sectional design and purposive sampling to enroll HCC patients who underwent TAE at our institution from January to December 2022. Questionnaires were utilized to collect data on symptom distress and fatigue scores from the first to the third day after TAE. RESULTS: Our study revealed a significant reduction in fatigue and symptom distress among patients after TAE. Pain, fatigue, insomnia, fever and abdominal distension were the most common symptoms troubling patients during the first 3 d post-TAE. Marital status, presence of family support, physical functional status, age, and symptom distress were identified as predictors of fatigue in patients. CONCLUSION: Healthcare professionals should educate HCC patients on symptom distress and fatigue, offering personalized relief strategies to lessen their psychological burden.
The algorithm proposed in this paper is innovative in the selection of mass target point, the integration of constraints based on clinical standards, and the utilization of multi-objective optimization algorithm. Comparison experiments have validated the better performance of the proposed algorithm. From a clinical standpoint, the algorithm proposed in this paper has a higher clinical feasibility of the proposed pathway than related studies, which reduces the dependency of the physician's expertise and clinical experience on pathway planning during the percutaneous puncture lung mass biopsy procedure.
Extravasation, the unintended leakage of intravenously administered substances, poses significant challenges in cancer treatment, particularly during chemotherapy and radiotherapy. This comprehensive review explores the pathophysiology, incidence, risk factors, clinical presentation, diagnosis, prevention strategies, management approaches, complications, and long-term effects of extravasation in cancer patients. It also outlines future directions and research opportunities, including identifying gaps in current knowledge and proposing areas for further investigation in extravasation prevention and management. Emerging technologies and therapies with the potential to improve extravasation prevention and management in both chemotherapy and radiotherapy are highlighted. Such innovations include advanced vein visualization technologies, smart catheters, targeted drug delivery systems, novel topical treatments, and artificial intelligence-based image analysis. By addressing these aspects, this review not only provides healthcare professionals with insights to enhance patient safety and optimize clinical practice but also underscores the importance of ongoing research and innovation in improving outcomes for cancer patients experiencing extravasation events.
The caudate lobe is located between the bilateral hepatic lobes and is divided into three subsegments: the Spiegel lobe, paracaval portion, and caudate process. The caudate artery arises from various sites of the bilateral hepatic arteries as an independent branch, common trunk, or arcade. Extrahepatic arteries can enter the caudate lobe mainly by the right inferior phrenic artery. The caudate artery also supplies the main bile duct and posterior aspect of segment IV. Although catheterization into the caudate artery is occasionally difficult because of its small size and sharp angulation, selective embolization of a tumor feeder is a significant prognostic factor in patients with hepatocellular carcinoma originating there. Therefore, we should recognize the peculiarity of its vascular anatomy and should be familiar with catheterization and embolization techniques.
Sinh thiết phổi xuyên thành ngực dưới hướng dẫn chụp cắt lớp vi tính là một công cụ không thể thiếu trong việc đánh giá các bất thường ở phổi do độ chính xác chẩn đoán cao trong việc phát hiện khối u ác tính. Sinh thiết phổi xuyên thành ngực đóng một vai trò quan trọng trong việc thu được bằng chứng bệnh ác tính, hướng dẫn xác định giai đoạn và lập kế hoạch điều trị. Bài viết nêu lên tổng quan, hiệu quả và biến chứng liên quan của kỹ thuật sinh thiết này.
Soft law, defined as a set of not legally binding rules, can play a potentially important role in protecting minorities, but it remains empirically unknown whether and how such law works. This study examines how the introduction of soft law affects the welfare of sexual minorities in the context of Japan, where an increasing number of municipalities have adopted a non-binding policy that officially recognizes same-sex relationships (“Same-sex partnership policy”). Using a difference-in-differences and an event study analysis that exploits the variations in the timing of adoption, I find that the same-sex partnership policy reduces the suicide rate of the general population by 5%. I then show that the partnership policy promotes a greater awareness of sexual minorities among residents. Google search data reveal that the number of searches for the word “LGBT” increases after the introduction of the partnership policy, while that for discriminatory words for sexual minorities decreases. Furthermore, original survey data shows the level of subjective happiness of sexual minorities became higher after their municipalities introduced the partnership policy. The survey analysis also suggests that cisgender heterosexuals from the municipalities with the partnership policy became more tolerant toward sexual minorities. Finally, all of these effects are more prominent in the more liberal municipalities. These results altogether imply that soft law can improve the welfare of sexual minorities by increasing the social awareness and acceptance of sexual minorities, especially where people are more likely to accept the new norms proposed by laws.