Medicine
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This study aimed to investigate the reliability of pseudo-computed tomography (pseudo-CT) imaging based on ultrasound (US) deformation fields under different binary masks in radiotherapy. We used 3-dimensional (3D) CT and US images, including those acquired during CT simulation positioning, and cone-beam CT (CBCT) and US images acquired 1 week after treating 3 patients with cervical cancer. Image data of 3 different layers were selected from the US images, and 3D CT images of each patient were selected. ⋯ A pair t test of normalized gray mean-squared errors was also performed (P < .05), and the difference was statistically significant. The similarity function means between pseudo-CT, that is, based on ROIO, ROI, wholeO, whole, and no binary mask, and CBCT were 0.9084, 0.8365, 0.7800, 0.6830, and 0.5518, respectively. Pseudo-CT based on ROIO binary mask best matched with CTsim and achieved the highest similarity with CBCT.
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Case Reports
A multiple myeloma that progressed as type I cryoglobulinemia with skin ulcers and foot necrosis: A case report.
Type I cryoglobulinemia is a rare and life-threatening condition. It occurs mainly in B-cell lymphoproliferative disorder. In almost half of the patients, type I cryoglobulinemia is characterized by severe cutaneous involvement. ⋯ Though rare, type I cryoglobulinemia can be associated with plasma cell dyscrasias. Any delay in diagnosis and the start of therapy can cause worsening of organ damage and endanger the patient's life. Therapeutic strategies in these cases should be directed to the underlying diseases.
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Traumatic hemipelvectomy is a rare but life-threatening injury that involves separation of the pelvic ring from pubic symphysis usually results from high energy trauma and associated with other injuries. ⋯ In our case, the multimodal management through ERAS path has helped decrease stress level, decrease complication, decrease morbidity, decrease the length of stay in the hospital, and aid in faster recovery.
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Type A aortic dissection (TAAD) usually requires emergency open repair of the ascending aorta. In cases of diffuse dissection that spreads along the descending and abdominal aorta (type I, DeBakey classification), the risk of aneurysmal degeneration varies between 30% and 50% during 5 years and increases even higher during a longer follow-up. Those patients might require complex intervention to prevent aortic rupture. A combination of hybrid arch debranching and the extended provisional extension to induce complete attachment (e-PETTICOAT) technique might be an available alternative in such cases. This is the first report of the successful use of the e-PETTICOAT technique for treating degenerative, diffuse TAAD. ⋯ Lifelong follow-up in extensive TAAD should be considered. The e-PETTICOAT technique is an available alternative to fenestrated endovascular aortic repair for degenerative TAAD, as it promotes favorable remodeling after successful surgery of the ascending aorta.
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The off-label uses of tigecycline (TGC) to treat ventilator-associated pneumonia (VAP) have aroused worldwide concerns. The efficacy about TGC has been recently reported. However, the adverse events (AEs) remain controversial. ⋯ The risk of side effects was related to the TGC duration, although not increased as the dosage rose. Full course of the HD regimen was associated with better outcomes for the treatment of VAP patients, especially for the MDR gram-negative bacilli infection. Inappropriate antimicrobial treatment might lead to clinical treatment failure.