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In metastatic melanoma, with a dismal survival rate and propensity for treatment resistance and recurrence, it is critical to establish biomarkers that better predict treatment response and disease severity. The melanoma glycome, composed of complex carbohydrates termed glycans, is an under-investigated area of research, although it is gaining momentum in the cancer biomarker and therapeutics field. Novel findings suggest that glycans play a major role in influencing melanoma progression and could be exploited for prognosticating metastatic activity and/or as therapeutic targets. In this review, we discuss the role of aberrant glycosylation, particularly the specialized function of ß1,6 N-acetylglucosaminyltransferase 2 (GCNT2), in melanoma pathogenesis and summarize mechanisms of GCNT2 regulation to illuminate its potential as a predictive marker and therapeutic target.

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Transesophageal echocardiography (TEE) has improved the detection of thoracic aortic pathology and further elucidated its role as a source of peripheral arterial emboli. Since 1993 we have used TEE to evaluate the thoracic aorta in patients with peripheral emboli without identifiable cardiac sources. Five patients suffered a total of eight embolic events originating from thoracic aortic mural thrombus (TAMT). The four females and one male ranged in age from 56 to 82 years. Emboli occurred to the upper extremities in four instances, lower extremities in three instances, and the visceral vessels in a single instance. Thromboembolectomy was performed in each case except for a patient who initially underwent aortobifemoral bypass. He was discovered to have TAMT after a subsequent embolic event. All patients were anticoagulated after TAMT was identified but in one case anticoagulants were discontinued after an intraabdominal hemorrhage. All patients are alive without limb loss while one patient has experienced recurrent embolization despite anticoagulation. TEE is a sensitive and useful diagnostic modality in patients with "cryptogenic" arterial embolization. Whether surgical management or anticoagulation for the primary lesion is optimal therapy remains a question. However, anticoagulation appears effective in this small experience.

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This study was performed to determine the cost effectiveness of radiologic imaging studies in diagnosing Pseudomonas aeruginosa infections after puncture wounds and the respective comparison of imaging and scintigraphy. Using retrospective medical record review, we studied 12 patients with culture-proven Pseudomonas infections of bone, cartilage or joint, or soft tissues. Attention was paid to radiographic presentation, scintigraphic studies, and magnetic resonance imaging results. All available imaging studies were reviewed. A survey of the costs of each imaging study was conducted. All patients underwent surgery. Three patients had magnetic resonance imaging studies that provided definitive diagnosis of osteomyelitis and precise localization of involved bones, soft tissue edema, and periosteal abscess. Eight patients had bone scans, one of which was consistent with cellulitis; seven, with osteomyelitis; and two with no abnormalities. All patients had radiographs of the involved foot. Case 4 had three series of radiographs. Nine of the twelve patients (75%) had normal findings on radiographs, with only soft tissue swelling or osteoporosis. Five patients had evidence of osteomyelitis. Magnetic resonance imaging is a cost-effective method in diagnosing Pseudomonas osteomyelitis. Early use of magnetic resonance imaging can provide definitive diagnosis and more precise anatomic localization necessary for surgical intervention.

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Lumbar facet joint (LFJ) pain is a common cause of low back pain. Thirty-four consecutive patients with a clinical diagnosis of LFJ pain received injections of a local anaesthetic agent and a long-acting corticosteroid agent under radiological control. Nineteen patients experienced immediate lessening of their pain after the injection of local anaesthetic agent, their response supporting the clinical diagnosis. Twelve of these 19 patients experienced clinically significant relief of pain for more than six months. LFJ injection offers improved diagnosis and treatment of LFJ pain.

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Two patients were scanned 2-5 weeks following onset of subarachnoid haemorrhage. A similar CT appearance was seen in each case. A ring enhancing mass lesion was present within the corpus callosum, suggesting an underlying tumour. However subsequent angiography showed that each case was in fact due to rupture of a pericallosal artery aneurysm. The enhancing membrane of the haematoma gave the false impression of a corpus callosum tumour.

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Low back pain is a very common clinical problem, the cause of which is frequently poorly understood. Improvements in equipment design and scanning techniques have resulted in a better anatomical display of the lumbar spine by computed tomographic (CT) scanning. Advances in this area have provided a considerable insight into the causes of the lumbago-sciatica syndrome.

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The computed tomographic (CT) findings in six cases of subdural hemorrhage in the peritentorial region are listed and discussed. The CT appearance of peritentorial subdural hemorrhage sometimes mimicks that of intra-axial lesions, but coronal scanning or reconstruction can be used to resolve this problem. Awareness of this unusual location for subdural hemorrhage is helpful in providing an accurate preoperative diagnosis.

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The stability of certain human enteroviruses in the Hawaiian ocean environment was examined. The present data indicated that the time for 90% reduction of poliovirus type 1 at 24 +/- 1 degree C in seawater samples obtained from different sites in Hawaii ranged from 24 to 48 h, and complete inactivation occurred within 72 to 96 h. The accumulated evidence also strongly indicated that a virus-inactivating agent(s) of a microbiological nature was present in both clean and sewage-polluted seawaters, but not in fresh, mountain stream waters. The antiviral activity was lost when the seawater samples were subjected to boiling, autoclaving, or filtration through a 0.22- or 0.45-micrometer, but not a 1.0-micrometer, membrane filter. That the antiviral activity of the seawater was related to the growth activities of microorganisms was corroborated by the observed effects of added nutrients, a lower temperature of incubation, and the presence of certain antibiotics. Other enteric viruses, such as coxsackie virus B-4 and echo virus-7, were also shown to be similarly inactivated in seawater.

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