Referring hospitals were categorized into two groups according to their referral grades; tertiary hospitals (general hospitals with tertiary [highest] referral grade, n = 42) and non-tertiary hospitals (others, n = 79).

Results: : Patients referred from tertiary hospitals had significantly larger number of high-grade tumors (p = 0.019) but lower chance of finding a residual tumor at re-excision (p = 0.020) than non-tertiary hospitals. For oncological outcomes, referral from tertiary hospital was an independent factor for better local control (hazard ratio, 0.211; 95% confidence interval, DNA Damage inhibitor 0.061-0.730). However, there was no difference in disease-specific death

(p = 0.729) or metastasis (p = 0.978) between the two groups.

Conclusions: : Despite having worse clinicopathologic characteristics, patients referred from tertiary Selleck Quisinostat hospitals had fewer local recurrences than patients from non-tertiary hospitals. The impact of the referring hospital on patient outcome and disease characteristics needs to be considered in unplanned excision of STS. (C) 2013 Elsevier Ltd. All rights reserved.”
“Vacuum-assisted deliveries are fairly commonly used in obstetrical

practice. Most newborns who have a vacuum-assisted delivery undergo extracranial birth traumas that have no residual consequences. Vacuum-assisted deliveries that complicate intracranial https://www.sellecn.cn/products/BEZ235.html vascular infarction are rarely reported. We present 2 cases of intracranial vessel infarction after vacuum-assisted deliveries. One newborn, with scalp erosion, showed an unusual left middle cerebral artery infarct, and the other, with a severe subgaleal hematoma, had a venous

thrombosis. Before the diagnosis, made using brain ultrasonography, neither had specific observable neurological symptoms. In conclusion, vacuum-assisted deliveries should be given special attention, especially when they are combined with a severe extracranial birth trauma.”
“Cerebral edema is very common in patients with acute liver failure and encephalopathy. In severe cases, it produces brain tissue shift and potentially fatal herniation. Brain swelling in acute liver failure is produced by a combination of cytotoxic (cellular) and vasogenic edema. Accumulation of ammonia and glutamine leads to disturbances in the regulation of cerebral osmolytes, increased free radical production and calcium-mediated mitochondrial injury, and alterations in glucose metabolism (inducing high levels of brain lactate), resulting in astrocyte swelling. Activation of inflammatory cytokines can cause increased blood-brain barrier permeability leading to vasogenic edema, although the relative contribution of vasogenic edema is probably minor compared with cellular swelling.