Pre-targeting of polymeric nanomaterials to balance tumour accumulation and clearance.

Pre-targeting of bispecific antibodies is probed to enhance tumour retention while limiting clearance of administered multifunctional branched PEGylated nanomedicines. The temporal influence of pre-targeting on polymer interaction with tumour cells and tissue is explored using in vitro assays through to preclinical validation.

Antenatal diagnosis of fetal splenic cyst. A case report.

Antenatal ultrasonography detected a fetal splenic cyst at 35 weeks' gestation. Serial ultrasonography and follow-up neonatal ultrasonography confirmed the presence of a solitary splenic cyst. The finding of asymptomatic but potentially serious fetal lesions allows optimum management of the newborn infant and adds to the benefits of antenatal sonography.

The transjugular route as an alternative to direct percutaneous needle biopsy of the liver.

Transjugular liver biopsy was attempted in 32 cases of hepatocellular dysfunction with hemocoagulation disorders, ascites or marked obesity. A catheter was inserted in the right internal jugular vein and advanced into a hepatic vein under fluoroscopic control. A long needle was passed through the catheter and into the liver parenchyma for the biopsy. Diagnostic specimens were obtained in 28 instances (88%). The procedure was always well tolerated and no complications occurred. The transjugular approach offers a safe, practical alternative for liver biopsy in cases where direct percutaneous puncture is contraindicated.

Transjugular liver biopsy in high-risk patients with hepatic disease.

Records were reviewed of 160 patients who underwent transjugular liver biopsy (TJLB) during a five-year period. Percutaneous transperitoneal needle biopsy was contraindicated in 95% of these patients because of coagulation abnormalities or massive ascites. Moderate complications occurred in two patients. Diagnostic biopsy material was obtained in 129 (81%). TJLB provided useful information in 44 of 58 patients without documented alcohol abuse (clinical Groups III and IV). TJLB disclosed additional diagnoses aside from Laennec cirrhosis in 15 of 48 alcoholic patients with sudden clinical deterioration (Group II), including 11 cases with other stages of alcholic liver disease and four cases of primary or metastatic neoplasm. TJLB revealed diagnoses other than Laennec cirrhosis, including three neoplasms, in six of 54 clinically stable alcoholics (Group I). TJLB frequently yielded important data relative to clinical management or prognosis in Group II, III, and IV patients; it was less useful in Group I patients.

Stage II (N1) lung cancer.

As therapies evolve and mature, the authors predict that the next 20 years will see significant advances in the understanding of non-small-cell lung cancer (NSCLC), in molecular stratification of NSCLC, and significant improvement in survival and cure rates. This survival will be achieved through early detection and combined treatments using effective surgical interventions, improved radiotherapeutics, and especially significantly enhanced, rationally designed systemic therapies.