The purpose of this investigation was to study the lymph drainage of the neoplastic mammary glands in the bitch using indirect lymphography. The main conclusions drawn from the study of 41 natural cases were as follows: the first or cranial thoracic and second or caudal thoracic neoplastic mammary glands usually drain into the ipsilateral axillary lymph nodes and rarely into the ipsilateral axillary and sternal lymph nodes, simultaneously. The third or cranial abdominal neoplastic mammary gland usually drains into the ipsilateral axillary and superficial inguinal lymph nodes simultaneously, but sometimes only cranially into the ipsilateral axillary lymph nodes. Rarely, it drains only caudally into the ipsilateral superficial inguinal and medial iliac lymph nodes, simultaneously. The fourth or caudal abdominal neoplastic mammary gland usually drains only caudally into the ipsilateral superficial inguinal lymph nodes. Rarely, it drains into the ipsilateral axillary and superficial inguinal lymph nodes simultaneously. The fifth or inguinal neoplastic mammary gland usually drains into the ipsilateral superficial inguinal lymph nodes but rarely, does it also drain into the ipsilateral popliteal lymph node and into a lymphatic plexus at the medial aspect of the ipsilateral thigh. Lymphatic connections between the neoplastic and adjacent normal mammary glands were demonstrated in only one case. The lymph drainage pattern of the neoplastic mammary glands is slightly different to that described in normal glands using the same radiographic method.
Computed tomographic angiography (CTA) and magnetic resonance angiography (MSA) have been used recently for evaluation of intracranial aneurysms. If they are to replace conventional digital subtraction angiography (DSA), their sensitivity and specificity should be equal to the latter. In order to determine whether computed tomographic angiography and magnetic resonance angiography can provide the necessary information for presurgical evaluation we compared blindly the results of helical CT angiography and MR angiography with the results of digital subtraction angiography and the intraoperative findings. We evaluated 35 patients with the possible clinical diagnosis of intracranial aneurysm. Our data suggest that both CTA and MRA can provide valuable preoperative information concerning the location, the characteristics and the relationships of most intracranial aneurysms. Both original and reconstructed images should be evaluated together for higher accuracy. In addition helical CT, being a fast, inexpensive and noninvasive method, can be used as a reliable alternative to DSA in emergency situations demanding immediate operation.
Next-generation genetic sequencing (NGS) technologies facilitate the screening of multiple genes linked to neurodegenerative dementia, but there is little guidance available about their use in clinical practice. Guidelines on which patients would most profit from testing, and information on the likelihood of discovery of a causal variant in a clinical syndrome, are conspicuously absent from the literature, mostly for a lack of large-scale studies. We applied a validated NGS dementia panel to 3241 patients with dementia and healthy aged controls; 13,152 variants were classified by likelihood of pathogenicity. We identified 354 deleterious variants (DV, 12.6% of patients); 39 were novel DVs. Age at clinical onset, clinical syndrome and family history each strongly predict the likelihood of finding a DV, but healthcare setting and gender did not. DVs were frequently found in genes not usually associated with the clinical syndrome. Patients recruited from primary referral centres were compared to those seen at higher-level research centres and a national clinical neurogenetic laboratory; rates of discovery were comparable, making selection bias unlikely and the results generalizable to clinical practice. We estimated penetrance of DVs using large-scale online genomic population databases and found 71 with evidence of reduced penetrance. Two DVs in the same patient were found more frequently than expected. These publicly-available data should provide a basis for informed counselling and clinical decision making.
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