Isolated Right Ventricular Metastasis of Hepatocellular Carcinoma: Clinical Findings and Histopathology of an Atypical Presentation.

Cardiac metastases are a rare site for metastatic hepatocellular carcinoma (HCC). We describe an atypical presentation of an isolated right ventricular metastasis of HCC following successful treatment with no evidence of primary disease recurrence. The case presented as gradually worsening hypertension and erythrocytosis in the setting of normal surveillance scans and alpha-fetoprotein levels.

Radiological Sublingual Space Invasion in Tongue Squamous Cell Carcinoma: Clinicopathological Associations and Impact on Survival.

Objectives: We investigate if sublingual space invasion (SLI) determined on magnetic resonance imaging confers differences in clinicopathological manifestations and treatment outcomes of oral tongue squamous cell carcinoma (OTSCC).

Study Design: Retrospective cohort study.

Setting: Tertiary Academic Medical Center.

Otitic hydrocephalus and papilloedema-re-evaluating a treatment paradigm.

Background: Otitic hydrocephalus is increased intracranial pressure without ventricular dilation secondary to mastoiditis and cerebral venous sinus thrombosis (CVST). It is associated with significant visual morbidity, though more detailed data on visual outcomes is lacking. We sought to better characterize the management of increased intracranial pressure and visual outcomes in this population.

Collaboration between clinicians and vision-language models in radiology report generation.

Automated radiology report generation has the potential to improve patient care and reduce the workload of radiologists. However, the path toward real-world adoption has been stymied by the challenge of evaluating the clinical quality of artificial intelligence (AI)-generated reports. We build a state-of-the-art report generation system for chest radiographs, called Flamingo-CXR, and perform an expert evaluation of AI-generated reports by engaging a panel of board-certified radiologists.

Upfront Surgery Versus Upfront Concurrent Chemoradiotherapy as Primary Modality in Hypopharyngeal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

Importance: The management of hypopharyngeal squamous cell carcinoma (HPSCC) continues to be one of the most formidable challenges in the realm of head and neck oncology.

Objectives: The aim of this meta-analysis was to evaluate the disparity in survival outcomes between upfront surgery and upfront concurrent chemoradiotherapy as the primary treatment modality in patients with HPSCC.

Design: Systemic review with meta-analysis.

Scalable watermarking for identifying large language model outputs.

Large language models (LLMs) have enabled the generation of high-quality synthetic text, often indistinguishable from human-written content, at a scale that can markedly affect the nature of the information ecosystem. Watermarking can help identify synthetic text and limit accidental or deliberate misuse, but has not been adopted in production systems owing to stringent quality, detectability and computational efficiency requirements. Here we describe SynthID-Text, a production-ready text watermarking scheme that preserves text quality and enables high detection accuracy, with minimal latency overhead.

Symptoms Do Not Predict White Matter Injury in the Watershed Regions in Children with Moyamoya.

Objective: To assess whether white matter injuries differ in symptomatic vs asymptomatic moyamoya-affected hemispheres using diffusion magnetic resonance imaging since there is controversy regarding when or if to revascularize children with asymptomatic moyamoya.

Study Design: We conducted a cross-sectional study of children with moyamoya who underwent diffusion magnetic resonance imaging before revascularization surgery as well as controls without moyamoya. We measured the fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity of white matter tracts in the watershed regions.

Characterizing Revascularization After Encephalo-Duro-Arterio-Synangiosis (EDAS) in Adult Patients With Moyamoya Disease Using the Orbital Grading System.

Background: The Matsushima grade has traditionally been used to evaluate vessel ingrowth from the superficial temporal artery after encephalo-duro-arterio-synangiosis (EDAS) for Moyamoya disease (MMD) patients. However, this grading is subjective and prone to measurement variability. Herein, we propose the orbital grading system quantifying leptomeningeal and burr hole-related vessel-ingrowth from the superficial temporal artery and/or middle meningeal artery to the middle and anterior cerebral arteries post EDAS in MMD patients.

Pyroglutamic acidosis in the setting of bacteremia treated with flucloxacillin-An uncommon cause of high anion gap metabolic acidosis.

Pyroglutamic acidosis (PGA) or 5-Oxoprolinuria is an uncommon and often overlooked cause of high anion gap metabolic acidosis (HAGMA). This case highlights the importance of systematically approaching HAGMA, and to consider PGA as a differential diagnosis when medications that disrupt the γ-glutamyl cycle such as flucloxacillin and paracetamol are present.

The evolution and future directions of bypass surgery.

Cerebral bypass surgery is one of the most complex and elegant procedures in neurosurgery. It involves several meticulous steps that test the skills of even the most prepared neurosurgeons. This surgery has transcended its traditional role in arterial stenosis and atherosclerosis, expanding its applications to include flow preservation techniques for complex conditions such as aneurysms, tumors, and vascular malformations.

The Association of Obstructive Sleep Apnea with Urological Cancer Incidence and Mortality-A Systematic Review and Meta-analysis.

Background And Objective: While obstructive sleep apnea (OSA) and urological cancer are both strongly associated with hypoxia, controversy exists regarding their association with each other. This study aims to summarize and synthesize evidence to clarify the association between OSA and urological cancer incidence and mortality.

Methods: According to a prespecified protocol, PubMed, Embase, Cochrane Library, and Scopus were searched from inception to November 16, 2023, for observational and randomized studies reporting the association of OSA with urological cancer incidence or mortality.

A phase Ib study to assess the safety of the human papillomavirus DNA vaccine (AMV002) in combination with durvalumab for HPV-associated oropharyngeal squamous cell carcinoma.

Background: Programmed cell death ligand 1 (PD-L1) inhibitors have limited efficacy as monotherapy in patients with recurrent/metastatic (R/M) Human Papilloma Virus (HPV) oropharyngeal squamous cell carcinoma (OPSCC). A phase I study of the therapeutic HPV-16 DNA vaccine AMV002 in curatively treated patients with OPSCC demonstrated a measurable immune response against HPV while being associated with high safety and tolerability. This prospective phase Ib single centre pilot study aims to test the safety and tolerability of combined PD-L1 inhibitor, Durvalumab, with AMV002 in 12 patients with recurrent OPSCC.

Five-year outcomes of fractionated stereotactic body radiotherapy for oligometastatic prostate cancer from the TRANSFORM phase II trial.

Metastasis-directed therapy (MDT) for oligometastatic prostate cancer (PCa), including stereotactic body radiotherapy (SBRT), has shown promise but is still considered investigational. This is the 5-year analysis of the TRANSFORM trial, the largest prospective cohort of men with oligometastatic PCa treated with SBRT-based MDT. The primary endpoint was 5-year treatment escalation-free survival (TE-FS), defined as freedom from any new cancer therapy other than further SBRT.

Prevalence and Association of Sarcopenia with Mortality in Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis.

Background: The objective of this meta-analysis was to assess the association of sarcopenia defined on computed tomography (CT) head and neck with survival in head and neck cancer patients.

Methods: Following a PROSPERO-registered protocol, two blinded reviewers extracted data and evaluated the quality of the included studies using the Quality In Prognostic Studies (QUIPS) tool, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework.

Optic Nerve Edema in Pediatric Middle Cranial Fossa Arachnoid Cysts: Report of 51 Patients From a Single Institution.

Background: Middle fossa arachnoid cysts (MFACs) are rare, congenital lesions that may rupture and cause symptoms of elevated intracranial pressure. We sought to describe the presence of and factors associated with optic nerve edema in MFACs, focusing on the utility of ophthalmologic evaluations for guiding cyst management.

Methods: We reviewed clinical and radiographic information for all patients with MFACs with ophthalmologic evaluations at our institution.

Postoperative radiotherapy versus surgery alone in pN1 oral cavity cancer patients: A meta-analysis.

Objectives: The aim of this meta-analysis is to evaluate the potential benefits of postoperative radiotherapy (PORT) in patients with pN1 oral cavity squamous cell carcinoma.

Methods: A literature search through major databases was conducted until January 2023. The adjusted hazard ratio (aHR) or risk ratio (RR) with 95% confidence intervals (CIs) of different survival outcomes were extracted and pooled.

A Review of the Current State and Future Directions for Management of Scalp and Facial Vascular Malformations.

Vascular malformations are structural abnormalities that are thought to result from errors in vasculogenesis and angiogenesis during embryogenesis. Vascular malformations of the scalp present unique management challenges due to aesthetic and functional implications. This review examines the pathophysiology, clinical presentation, and management techniques for six common types of vascular malformations of the face and scalp : infantile hemangioma, capillary malformations, venous malformations, lymphatic malformations, arteriovenous malformations, and arteriovenous fistulas.

Low-profile mechanical thrombectomy devices for large vessel occlusion in pediatric ischemic stroke.

Background: Mechanical thrombectomy (MT) is a well-established treatment modality for large vessel occlusion (LVO) in adults, but there are limited data in the pediatric population. The rarity of the condition makes prospective trial design difficult, and therefore evaluation of MT devices and outcomes is sparse. In pediatric LVO cases, some newer devices may be appropriate for use in revascularization procedures.

Endovascular Applications for the Management of High-Grade Gliomas in the Modern Era.

High-grade gliomas (HGGs) have a poor prognosis and are difficult to treat. This review examines the evolving landscape of endovascular therapies for HGGs. Recent advances in endovascular catheter technology and delivery methods allow for super-selective intra-arterial cerebral infusion (SSIACI) with increasing precision.