187 research outputs found

    Assessment of hepatic steatosis based on needle biopsy images from deceased donor livers

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    Background: Assessment of hepatic steatosis (HS) before transplantation requires the pathologist to read a graft biopsy. A simple method based on the evaluation of images from tissue samples with a smartphone could expedite and facilitate the liver selection. This study aims to assess the degree of HS by analysing photographic images from liver needle biopsy samples. Methods: Thirty-three biopsy-images were acquired with a smartphone. Image processing was carried out using ImageJ: background subtraction, conversion to HSB colour space, segmentation of the biopsy area, and evaluation of statistical features of Hue, Saturation, Brightness, Red, Green, and Blue channels on the biopsy area. After feature extraction, correlations were made with gold standard HS percentage assessed at two levels (frozen-section vs glass-slide). Sensitivity, specificity, and accuracy were calculated for each feature. Results: Correlations were found for H, S, R. The sensitivity, specificity, and accuracy of the final classifier based on the K* algorithm were 94%, 92%, 94%. Limitations: Accuracy assessment was performed considering macrovesicular steatosis on specimens with mostly < 30% HS. Conclusions: The steatosis assessment based on needle biopsy images, proved to be an effective and promising method. Deep learning approaches could also be experimented with a larger set of images

    Locally advanced breast implant-associated anaplastic large-cell lymphoma: A combined medical-surgical approach

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    Objective: Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin's T-cell lymphoma that develops around breast implants. Case Presentation: This report illustrates the case of a patient affected by a locally advanced BIA-ALCL which infiltrated the thoracic wall (stage T4N0M0) following implant-based reconstruction after left mastectomy. Given the initial inoperability due to the patient's poor general condition, the treatment plan provided for a primary cycle of systemic neoadjuvant immunotherapy/chemotherapy, surgical removal of the mass, and subsequent systemic chemotherapy/immunotherapy. This resulted in complete remission - the patient remained disease-free even over a year later - without the need for adjuvant radiotherapy. Conclusions: Our real-life case shows how the existing guidelines can be successfully adapted as part of an individualized approach to advanced and/or difficult cases

    Association between indocyanine green clearance test and ischemic type biliary lesions within one year after orthotopic liver transplantation

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    Background: Ischemic type biliary lesions (ITBLs), a particular subset of non-anastomotic biliary strictures (NAS), are characterized by intra and extrahepatic strictures that occur in the absence of either hepatic artery thrombosis or stenosis. When they occur within the first year after liver transplantation their development is mostly related to ischemia\u2013reperfusion injury (IRI). The indocyanine green plasma disappearance rate (ICG-PDR) might be able to predict the probability of IRI-induced graft damage after liver transplantation. Objective: Our aim was to evaluate the association between ICG-PDR and the occurrence of ITBLs. Secondly, we searched for evidence of IRI in patients presenting ITBLs. Methods: This retrospective single-center observational study assessed a cohort of 60 liver transplant patients. Each patient underwent ICG-PDR on the 1st postoperative day. ITBLs were identified by means of either cholangiography or magnetic resonance imaging evidence of a deformity and narrowing of the biliary tree in the absence of hepatic artery thrombosis/stenosis. Results: ITBLs were discovered in 10 patients out of 60 liver recipients (16.67%) within one year after transplantation. A low ICG-PDR value was found to be a significant predictive factor for ITBL development, with an OR of 0.87 and a 95% CI of 0.77\u20130.97. Liver biopsies were performed in 56 patients presenting unexplained abnormal liver function test results. A statistically significant association was found between the development of ITBLs and anatomopathological evidence of IRI. Limitations: Retrospective, single-center study. Conclusions: The findings from this study show a relationship between low ICG-PDR values on first post-operative-day and the occurrence of ITBLs within 1 year after transplantation

    Effects of Delayed Hypothermic Machine Perfusion on Kidney Grafts with a Preliminary Period of Static Cold Storage and a Total Cold Ischemia Time of Over 24 Hours

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    BACKGROUND Hypothermic machine perfusion (HMP) appears to exert a reconditioning effect on the ischemic damage of kidney grafts. However, some concerns still remain about its real effectiveness when it is delayed after a preliminary period of static cold storage (SCS) or with prolonged overall cold ischemia time (CIT). MATERIAL AND METHODS The effect of HMP on hemodynamic, metabolic, histological and ultrastructural features of grafts was investigated in 21 single-kidney grafts treated with a delayed HMP after SCS and with a total CIT of over 24 h. RESULTS The mean CIT, SCS, and HMP times were 29 h, 12 h, and 18 h, respectively. Longer SCS was associated with higher vascular resistance and lower arterial flow. In the pre- vs. post-HMP comparison, a significant decrease in arterial resistances and increase of flow were recorded. The hemodynamic improvement was independent of HMP duration. The perfused grafts retained some metabolic activity, with a statistically significant decrease of pH, pO2, and glucose levels, and increase of lactates in the perfusion liquid, by the end of HMP. Longer SCS was associated with higher pH and greater pO2 decrease during HMP. Light microscopy and transmission electronic microscopy revealed no significant variations in nuclear, cytoplasmic, or ultrastructural damage. SCS, HMP, and CIT were not identified as risk factor for delayed graft function or rejection. CONCLUSIONS A delayed and extended HMP can recover the graft hemodynamic function, maintain some metabolic activity, and stabilize the accumulated ischemic damage due to a preliminary SCS

    Resolutions of co-letterplace ideals and generalizations of Bier spheres

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    We give the resolutions of co-letterplace ideals of posets in a completely explicit, very simple form. This generalizes and simplifies a number of linear resolutions in the literature, among them the Eliahou-Kervaire resolutions of strongly stable ideals generated in a single degree. Our method is based on a general result of K. Yanagawa using the canonical module of a Cohen-Macaulay Stanley-Reisner ring. We discuss in detail how the canonical module may effectively be computed and from this derive directly the resolutions. A surprising consequence is that we obtain a large class of simplicial spheres comprehensively generalizing Bier spheres

    Physics results with the ARGO-YBJ experiment

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    ARGO-YBJ is a multipurpose experiment consisting in a dense sampling air shower array with 93% sensitive area located at very high altitude. The apparatus is in stable data taking since November 2007 at the YangBaJing Cosmic Ray Laboratory (Tibet, PR China, 4300 m a.s.l., 606 g/cm2). In this paper we report the main results in Gamma-Ray Astronomy and Cosmic Ray Physics after about 3 years of operation

    Calibration of the RPC charge readout in the ARGO-YBJ experiment

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    ""The charge readout of Resistive Plate Chambers (RPCs) is implemented in the ARGO-YBJ experiment to measure the charged particle density of the shower front up to 10^4\\\/m^2, enabling the study of the primary cosmic rays with energies in the ''knee'' region. As the first time for RPCs being used this way, a telescope with RPCs and scintillation detectors is setup to calibrate the number of charged particles hitting a RPC versus its charge readout. Air shower particles are taken as the calibration beam. The telescope was tested at sea level and then moved to the ARGO-YBJ site for coincident operation with the ARGO-YBJ experiment. The charge readout shows good linearity with the particle density in the dynamic range (up to 200\\\/m^2)."

    Highlights from the ARGO-YBJ Experiment

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    ""In this work we will report on some of the main results of the ARGO-YBJ. experiment including the observation of galactic and extragalactic gamma ray sources and the. measurements on the charged cosmic ray flux in the 1012. − 1015 eV energy range."

    Cosmic rays in the TeV region with the ARGO-YBJ detector

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    ""\\"Very High Energy (VHE) γ-astronomy and cosmic ray physics are. the main goals of the ARGO-YBJ experiment. The detector is located in Tibet. (People’s Republic of China) and is a full-coverage Extensive Air Shower array consisting. of a carpet of Resistive Plate Chambers (RPCs). Altitude and full coverage. ensure an unprecedented reconstruction of showers close to their maximum size.. The performances of the detector and the present results concerning TeV cosmic. ray physics will be presented.\\""
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