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Purpose: To evaluate the relationship between prospectively generated ablative margin estimates and local tumor progression (LTP) among patients undergoing microwave ablation (MWA) of small renal masses (SRMs)., Materials and Methods: Between 2017 and 2020, patients who underwent MWA for SRM were retrospectively identified. During each procedure, segmented kidney and tumor shapes were coregistered with intraprocedural helical CT images obtained after microwave antenna placement. Predicted ablation zone shape and size were then overlaid onto the resultant model, and a model-to-model distance algorithm was employed to calculate multiple ablative margin estimates. LTP was modeled as a function of each margin estimate by hazard regression. Models were evaluated using hazard ratios and Akaike information criterion. Receiver operating characteristic curve area under the curve was also estimated using Harrell's and Uno's C indices (HI and UI, respectively)., Results: One hundred and twenty-eight patients were evaluated (median age 72.1 years). Mean tumor diameter was 2.4 ± 0.9 cm. LTP was observed in nine (7%) patients. Analysis showed that decreased estimated margin size as measured by first quartile (Q1; 25th percentile), maximum, and average ablative margin metrics was significantly associated with risk of LTP. For every one millimeter increase in Q1, maximum, and mean ablative margin, the hazard of LTP increased 67% (HR: 1.67; 95% CI = 1.25-2.20, UI = 0.93, HI = 0.77), 32% (HR: 1.32; 95% CI 1.09-1.60; UI = 0.93; HI = 0.76), and 48% (HR: 1.48; 95% CI 1.18-1.85; UI = 0.83; HI = 0.75), respectively., Conclusion: Prospectively generated ablative margin estimates can be used to predict the risk of local tumor progression following microwave ablation of small renal masses. LEVEL OF EVIDENCE 3: Retrospective cohort study., (© 2023. Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).)

This study evaluated the feasibility of measuring patient recovery after locoregional therapies (LRTs) using a wearable activity tracker (WAT). Twenty adult patients with cancer were provided with a WAT device to wear for a minimum of 7 days prior to their procedure (baseline) and for up to 30 days after their procedure (recovery). Daily step counts were continuously recorded. Patient responses to the Short Form 36-Item Health Survey (SF-36) were also collected before and after LRT. Analysis of WAT data demonstrated a mean of 4,850 daily steps taken at baseline, which decreased to 2,000 immediately after LRT and then rapidly increased to approximately 4,300 daily steps over an average of 10 days (P < .001). No significant changes were observed in SF-36 responses between baseline and follow-up assessments (P > .10). These results suggest that WAT devices capture dynamic periprocedural data not reflected in survey-based assessments and may be used to monitor patient recovery after interventional oncologic procedures., (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)

We present this preliminary investigation into the safety and feasibility of endovascular therapy for morbid obesity in a swine model. A flow-limiting, balloon-expandable covered stent was placed in the superior mesenteric artery of three Yorkshire swine after femoral arterial cutdown. The pigs were monitored for between 15 and 51 days after the procedure and then killed, with weights obtained at 2-week increments. In the two pigs in which the stent was flow limiting, a reduced rate of weight gain (0.42 and 0.53 kg/day) was observed relative to the third pig (0.69 kg/day), associated with temporary food aversion and signs of mesenteric ischemia in one pig.

Bilateral pigmented fundus lesions were found in 65 out of 72 patients with familial adenomatous polyposis, an additional five patients having unilateral lesions. With a family history of familial adenomatous polyposis, the occurrence of multiple bilateral fundus lesions indicates the presence of the abnormal gene, as does the occurrence of oval pigmented lesions with surrounding pale haloes. The absence of pigmented fundus lesions does not exclude the abnormal genotype, while the presence of occasional pigmented spots can be found in an appreciable percentage of the population. Ocular examination would, however, appear to be valuable in screening those at risk, with a positive yield in most carriers of the gene for familial adenomatous polyposis.

In fifteen subjects with oculo-cutaneous or ocular albinism pattern-reversal visual evoked potentials (VEP) were recorded to monocular whole-field (16 degrees radius) and right and left vertical half-field (16 degrees radius) stimulation from an array of occipital electrodes. In all 15 subjects the VEP was of low amplitude and the monocular response to whole-field stimulation showed abnormal asymmetry in scalp topography. This asymmetry was similar to that produced by stimulation of the temporal half-field in the same eye. Two distinct types of VEP asymmetry were readily identified in different subjects. In 5 the major positivity of the response (P100) was distributed in the channels ipsilateral to the stimulated eye or temporal half-field, being similar in distribution to the P100 from the temporal hemifield or normal individuals. In 9 other subjects the converse occurred; the P100 was distributed contralaterally. The remaining subject was unique in that the responses from each eye had a distribution that resembled one of the two main groups. The nasal half-field responses also differentiated the two groups. On stimulation of the nasal field in the first group the P100 was usually absent or attenuated and when present it had the same topography as the temporal half-field P100. In contrast the nasal half-field P100 from the second group was always present and, although almost invariably smaller than the temporal half-field P100, it had an identical distribution. There was no correlation between these two patterns of VEP asymmetry and clinical or known genetic features. The findings confirm that in human albinos each hemisphere receives a predominantly monocular input from the contralateral eye; i.e. in addition to the temporal, half-field, approximately 20 degrees of the nasal half-field is projected to the hemisphere contralateral to each eye and not, as in normal subjects, to the ipsilateral hemisphere. Furthermore, the findings of two distinct and in some respects opposite types of VEP topographical asymmetry raises the possibility of two variants of the geniculo-cortical projection patterns existing in human albinos similar to those described in the Siamese cat.

Results are presented which confirm that in human albinos each cerebral hemisphere receives a predominantly monocular input from the contralateral eye, giving rise to an asymmetry of the visual evoked potential (VEP) to whole-field stimulation which is similar to that for stimulation of the temporal half-field in the same individual. The further finding of two distinct, and in some respects opposite, types of topographical asymmetry raises the possibility that there are two anatomically distinct variants in the retinocortical projection in human albinism, as there are in the Siamese cat.

Minor and major deficiencies of enzymes affecting galactose metabolism may be associated with cataracts of early onset. Results are presented for 10 such families with minor enzymatic disorders. Expression of the major disorders probably involves galactitol accumulation and osmotic lens damage but this mechanism is not obviously associated with minor disorders. The observed incidence of minor incomplete enzymatic disorders of galactose metabolism in families with an incidence of cataracts of early onset may be at least partly incidental.

Examination of clinically normal skin from four patients with X-linked ocular albinism of the Nettleship-Falls type by light and electron microscopy revealed the presence of macromelanosomes in some melanocytes and keratinocytes. Measuring up to 5 micron many of the abnormal melanosomes showed a concentrically laminated structure suggestive of a phasic growth pattern. Epidermis from three female carriers contained similar but fewer macromelanosomes. These findings indicate that skin biopsy could be of value not only in confirming the diagnosis of ocular albinism in affected males, but also to establish carrier status in asymptomatic females.

Further linkage data relating X-linked retinitis pigmentosa and DNA probe DXS7 (L1.28) is presented in this paper. The current mean estimate of the recombination fraction (theta) including this and all published data, is 0.09, with confidence limits 0.04 to 0.17 (maximum Lod score of 14.01 at a theta of 0.08). There is no evidence for heterogeneity of recombination fraction between the 13 families for which data are available. However, it is argued that heterogeneity should be assumed to exist for the purposes of risk estimation. Mean estimates and variances of risk are calculated for hypothetical families each with different linkage data. In families in which no recombination has been observed, the mean and variance of risk are sufficiently small for the clinical use of this probe to be acceptable to many.

It is difficult to truly define iatrogenic complications in the postsurgical state in that the surgery is a condition originated by physician intervention and thus any problems that occur may be technically considered as physician created. In this article we attempt to demonstrate problems that occur both due to technical errors and the choice of operative procedure. In addition, unusual postsurgical anatomy is illustrated with the hope of avoiding further iatrogenic problems from lack of recognition.