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BACKGROUND: Incidental hepatocellular carcinomas (iHCCs) are tumors discovered on the explanted liver that were not present on imaging before transplantation. The natural history, histopathologic characteristics, and prognosis are not clearly defined. METHODS: We compared the characteristics of iHCC and previously known hepatocellular carcinoma (pkHCC) in patients who underwent liver transplantation from 1998 to 2012 in a retrospective study. RESULTS: During this period a total of 675 patients were transplanted; 56 patients (9%) had pkHCC and 12 (2%) had iHCC. The sex and age distributions were similar. The median Model for End-Stage Liver Disease score in iHCC patients was 17.0 versus 13.0 in patients with pkHCC (P = .001). Thirty-three percent of iHCC patients had multiple tumors, and 25% had bilobar involvement. The median cumulative tumor size in iHCC was 1.8 cm, and 5.5 cm in pkHCC (P = .005). Incidence of microvascular invasion was not different (16.7% vs 38.9%; P = .191). American Joint Committee on Cancer T1 stage was found in 58.3% of patients with iHCC and in 22.2% of pkHCC patients. Patients with iHCC had 1-, 3-, and 5-year survivals, respectively, of 100%, 83% and 64%, compared with 80%, 66%, and 38% for patients with pkHCC (P = .138). None of the patients with iHCC had recurrence of HCC, whereas incidence of recurrence in pkHCC patients was 12.5%. CONCLUSIONS: iHCC occurred in patients with more advanced liver disease. The cumulative tumor size of iHCC was smaller but one-third were multifocal. Survival was similar to patients with pkHCC, and recurrence was not noted in patients with iHCC.

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The presence of hydrogen in as-grown carbon nanotubes (CNTs) synthesized by microwave plasma (MP) chemical vapour deposition (CVD) technique is demonstrated. Our results showed that the MPCVD, as-grown CNTs were hydrogenated consisting of C-H bonds; whereas, the tubes synthesized by arc discharge consisted of non-hydrogenated multi-walled CNTs. Fourier transform infrared spectroscopy (FTIR) and micro-Raman spectroscopy techniques were used to detect C-H bonding in the as-grown CNTs. The effective functionalization of as-grown hydrogenated CNTs grown using a microwave CVD process is first time demonstrated by laser assisted CVD process. It was found that the laser-assisted CVD process resulted in the termination of hydrogen and the oxidation of as-grown CNT structure leading to the carboxylic group attachment. The FTIR results show the presence of -OH and C=O bonds in the functionalized samples. However, the non-hydrogenated CNTs could not be effectively functionalized by the same process, probably due to the fact that it did not contain active sites pre-requisite for functionalization, as did the CVD grown samples. The functionalization of CVD grown tubes is believed to take place at the 'active' hydrogen-terminated sites on the CNT surfaces.

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The Hot Filament Chemical Vapour Deposition (HFCVD) method was employed to study hydrogen adsorption on multi-walled carbon nanotubes (MWCNTs) modified by nickel doping. Prior to the nickel doping, effective functionalisation of CNTs was achieved by treating them in HNO3/H2O2 medium. Samples were characterized using Scanning Electron Microscopy (SEM), Energy Dispersive X-ray (EDS), and Fourier Transform Infrared (FTIR) and Raman spectroscopy techniques. SEM analyses revealed the morphology of the samples and the presence of nickel was identified by EDS analyses. Raman analysis revealed the enhancement of defects on the CNTs after the nickel modification. The defects created along with the catalytic activity of nickel supplied more hydrogen access to the CNTs. This was inferred from highest intensity ratio of D and G band (ID/IG) for hydrogen treated samples. However, FTIR spectra did not exhibit any C-H related bands. This confirms that the adsorption of hydrogen onto CNTs is primarily by surface adsorption.

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Rehabilitation of overuse injuries requires the health care professional to understand normal and common pathologic mechanics of the patient's sport or physical activity. Evaluation of the total mechanics of the body, not just the local area presenting with discomfort, is important. [figure: see text] The cause of the presenting injury can be a dysfunction at a distant site. Rest and supportive devices are helpful in allowing the athlete to return to a normal activity level. A progressive reconditioning program needs to address strength and flexibility issues and endurance and eccentric exercises.

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A 23-year-old collegiate football player reported to the training room the day after a game, complaining of severe pain in his right shoulder. He recalled no significant injury during the game. Physical examination revealed pain, tenderness, and apprehension with all attempts to palpate or move the joint. There was no obvious effusion, redness, or warmth about the shoulder joint. The neurovascular examination was negative, and x-rays revealed no fracture. The patient's temperature was 102 degrees F. The team orthopedist aspirated 10cc of purulent fluid from the joint. Subsequent analysis revealed a white cell count greater than 50,000 mm(3), but no organisms were seen. The diagnosis of septic arthritis was made on the basis of the elevated cell count of the joint aspirate, in conjunction with fever (102 degrees F) and the clinical findings of an excessively painful joint. The patient was admitted for arthroscopic irrigation and debridement of the joint. Cultures subsequently showed a light growth of a Gram-negative organism. The patient was treated initially with intravenous broad-spectrum antibiotics and was ultimately discharged and put on oral antibiotics at the time of discharge. Rehabilitation followed the usual protocol for diagnostic arthroscopy, and the patient made an excellent recovery. He has had no residual sequelae or recurrence of infection.