[show abstract][hide abstract] ABSTRACT: Although heart failure is a diagnosis made on clinical grounds, cardiac imaging remains essential for quantifying ventricular remodeling and function, and for identifying potentially reversible causes of heart failure. Various nongeometric methods for the assessment of ventricular function have been developed, and 3-dimensional imaging is also gaining ground in its clinical applications. This review focuses on the application of noninvasive imaging strategies in the assessment of heart failure in congenital heart disease, specifically echocardiography, cardiac magnetic resonance imaging, and computed tomography. Both traditional and emerging techniques are discussed, and their potential applications and limitations explored.
[show abstract][hide abstract] ABSTRACT: The process of hematopoietic stem cell transplantation (HSCT) is well defined, yet debate remains surrounding the role and timing of HSCT in patients with multiple myeloma (MM). Since the 1980s, survival advances have been made with the use of newer agents by recognizing the role of transplantation, identifying the anticipated side effects at each phase, and improving supportive care strategies. Data support transplantation as part of the treatment strategy, but the optimal induction regimen and timing of transplantation have yet to be defined. The general consensus is that eligible patients should undergo autologous HSCT at some point in the treatment spectrum, preferably earlier rather than later in the disease. Allogeneic transplantation is only recommended in the context of a clinical trial and in patients with high-risk disease. The transplantation process can be overwhelming for patients and caregivers. Nurses play a key role in improving outcomes by caring for patients and families throughout the transplantation experience and, therefore, need to be knowledgeable about the process. This article is intended to expand discussion on the role of nurses in assisting patients and families undergoing transplantation to include an overview of the acute care phase of the transplantation process.
Clinical Journal of Oncology Nursing 12/2013; 17:33-41.
[show abstract][hide abstract] ABSTRACT: Vascularized lymph node transfer is of high interest for the treatment of lymphedema. Currently, there are few experimental small animal models of vascularized lymph node transplantation. In this article, our aim was to describe a new vascularized cervical lymph node transplantation model in rats.
Ten male Sprague-Dawley rats weighing 200 to 250 g were used in this study. The anatomic features of the neck lymph nodes in rats were explored. Anatomic neck dissections were performed, and lymph node flaps were harvested. The common carotid artery and the jugular vein were used as the vascular pedicles of the lymph node flap. Methylene blue dye was injected into the arterial pedicle. Lymph nodes were identified, and their structure was confirmed by histological evaluation. Laser-assisted indocyanine green angiography was used to confirm perfusion of the lymph node flap.
An adequate perfusion was observed in the lymph node flap. The dye disseminated evenly within the lymph nodes, indicating that the flap had a well-established vascular network and an adequate blood supply. Macroscopically, perfusion of 5 to 6 lymph nodes was observed. Histological examination of tissue samples confirmed well-defined lymph nodes. After indocyanine green administration, fluorescence was observed throughout the lymph node flap and within the venous pedicle of the flap.
To the best of our knowledge, this is the first report describing vascularized lymph node flap in the head and neck region of a rat. Our lymph node flap preparation technique confirmed the presence of 5 to 6 lymph nodes within the flap. The presented vascularized lymph node flap can be applied to transplantation studies, lymphedema studies, and to studies on immunological mechanism of tolerance and rejection.
Annals of plastic surgery 12/2013; 71(6):671-674.
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