Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A new pitfall on abdominal PET/CT: a retained surgical sponge

Positron emission tomography (PET)/computed tomography (CT) and multidetector CT findings of an abdominal retained surgical sponge (RSS) are presented. A PET/CT study performed for evaluation of a suspected abdominal tumor demonstrated the inconclusive finding of a hypometabolic area surrounded by increased 2-[fluorine-18] fluoro-2-deoxy-D-glucose uptake. Follow-up contrast-enhanced multidetector CT suggested the correct diagnosis of an RSS. This is the first known report of the PET/CT appearance of an RSS

CT Imaging Findings after Stereotactic Radiotherapy for Liver Tumors

Purpose. To study radiological response to stereotactic radiotherapy for focal liver tumors. Materials and Methods. In this IRB-approved, HIPAA-compliant study CTs of 68 consecutive patients who underwent stereotactic radiotherapy for liver tumors between 01/2006 and 01/2010 were retrospectively reviewed. Two independent reviewers evaluated lesion volume and enhancement pattern of the lesion and of juxtaposed liver parenchyma. Results. 36 subjects with hepatocellular carcinoma (HCC), 25 with liver metastases, and seven with cholangiocarcinoma (CCC) were included in study. Mean follow-up time was 5.6 ± 7.1 months for HCC, 6.4 ± 5.1 months for metastases, and 10.1 ± 4.8 months for the CCC. Complete response was seen in 4/36 (11.1%) HCCs and 1/25 (4%) metastases. Partial response (>30% decrease in long diameter) was seen in 25/36 (69%) HCCs, 14/25 (58%) metastases, and 7/7 (100%) of CCCs. Partial response followed by local recurrence (>20% increase in long diameter from nadir) occurred in 2/36 (6%) HCCs and 4/25 (17%) metastases. Liver parenchyma adjacent to the lesion demonstrated a prominent halo of delayed enhancement in 27/36 (78%) of HCCs, 19/21 (91%) of metastases, and 7/7 (100%) of CCCs. Conclusion. Sustainable radiological partial response to stereotactic radiotherapy is most frequent outcome seen in liver lesions. Prominent halo of delayed enhancement of the adjacent liver is frequent finding

Antegrade MDCT pyelography for the evaluation of patients with obstructed urinary tract

The purpose of this study was to design an alternative imaging technique to CT urography in patients with high-grade urinary tract obstruction, with or without impaired renal function, that uses the superior resolution of MDCT and avoids IV contrast material administration. Antegrade MDCT pyelography is an alternative imaging technique to CT urography in patients with high-grade urinary tract obstruction with or without impaired renal function. It enables accurate diagnosis of the level of obstruction, as well as its etiology, including nephroureterolithiasis, urothelial tumors, primary congenital megaureter, uretero-pelvic junction stenosis, ureteral edema, ureteral stricture, retroperitoneal fibrosis, and pelvic lymphadenopathy

The Relevance of Readmissions after Common IR Procedures: Readmission Rates and Association with Early Mortality

PURPOSE: To determine all-cause readmission rates for 12 IR procedures and association of time to readmission with risk-adjusted 90-day mortality. MATERIALS AND METHODS: Patients discharged after 12 inpatient IR procedures at a tertiary-care hospital between June 2008 and May 2013 (N = 4,163) were categorized as no readmission (n = 1,479; 40.5%) or readmission between 0 and 7 (n = 379; 10.4%), 8 and 30 (n = 650; 17.8%), 31 and 60 (n = 378; 10.3%), 61 and 90 (n = 169; 4.6%), or 91 and 180 days (n = 280; 7.7%). Readmission rate \u3e/= 15% was considered high based on published national readmission rates for procedures. Risk-adjusted 90-day mortality for each interval was calculated for transjugular intrahepatic portosystemic shunt (TIPS), transjugular and percutaneous liver biopsy (TJLB, PLB), ports, inferior vena cava (IVC) filter, lower extremity angioplasty (LEA), arteriovenous fistulagrams, vascular embolization (VE), percutaneous cholecystostomy (PC), percutaneous transhepatic biliary drainage (PTBD), primary urinary drainage, and feeding tube placement. Covariates included age, sex, race, insurance status, and Charlson Comorbidity Index. RESULTS: All procedures had high 30-day readmission rates (15%-50.5%). Readmissions were highest for ports (50.5%), TJLB (43.4%), PTBD (38.5%), PC (31.9%), and TIPS (31.3%). Readmissions occurred most frequently 8-30 days after discharge for all procedures except VE (31-60 d; 10.6%), PC (31-60 d; 23.4%), and LEA (91-180 d; 15.1%). On multivariate analysis, 30-day readmissions for LEA (AOR 3.19; 95% CI, 1.2-8.2; P = .02), VE (AOR 10.01; 95% CI, 3.1-32.9; P \u3c .001), IVC filter (AOR 2.98; 95% CI, 1.3-6.9; P = .01), PLB (AOR 2.86; 95% CI, 1.71-4.79; P \u3c .001), and PCN (AOR 3.09; 95% CI, 1.29-7.37; P = .01) were associated with 90-day mortality. CONCLUSIONS: Inpatient IR procedures have high 30-day all-cause readmission rates, which can be associated with increased 90-day mortality. Further evaluation to determine preventable causes for readmission may impact 90-day mortality