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Pyrolysis of metal-organic framework (MOF) to generate nanostructured carbon-based materials is a potential approach for creating carbon-based materials. The development of a cobalt-based MOF (Co-MOF-74) and its application to oxygen electrocatalysis are described in this study. In alkaline media, the as-obtained Co-PC-400 catalyst displayed superior catalytic performance with the onset potential (Eo = 0.90 V vs. RHE) and more outstanding durability than a Pt/C (20 wt%). Results show that the catalyst has a lot of promise in fuel cells. The Co-MOF successfully catalyzes due to its more significant onset potential, higher current density, and extended durability.

Congenital ovarian cyst is the most common cause of abdominal mass in a female fetus.[1][1] The ovarian cyst usually presents in a female fetus in the third trimester under the influence of maternal hormones.[2][2] Ovarian cysts of more than 20 mm are considered pathological.[2][2] They can be

The interaction between bovine hemoglobin (BHb) and local anesthetic drug procaine hydrochloride (PCH) was examined by spectroscopic and computational studies. Intrinsic fluorescence analysis explored the ground-state complex formation in the binding of PCH with BHb through static quenching mechanism. The binding constants (

We report a case of renal arteriovenous malformation (AVM) and describe its angioarchitecture and endovascular management. A 28-year-old male patient presented with visible painless haematuria. CT of the abdomen showed a right renal AVM. Digital subtraction angiography of the right renal vessels showed an AVM of middle and lower pole segmental arteries with communication to a large saccular aneurysm, which was arising from the right main renal vein. Complete occlusion of the AVM was done by using glue (a mixture of n-butyl-cyanoacrylate and lipiodol), resulting in nonvisualisation of the aneurysm on angiography. His vital signs were stable during the procedure. Follow-up CT after 12 months showed no residual flow in the aneurysm, normal upper pole renal parenchyma and nonvisualisation of AVM. Early diagnosis of this clinical entity is of paramount importance for proper management as it can cause massive blood loss and rapid clinical deterioration.

There is a paucity of literature regarding a neglected shoulder dislocation, as it is unusual to miss it clinically due to the apparent deformity. Nevertheless, in some cases, particularly those who received the primary treatment from a local bonesetter, present with neglected dislocation. No high-level studies comparing different treatment modalities in such a situation are available. Therefore, most of the treatment recommendations are based on level four studies and the literature for recurrent dislocation of the shoulder. We herewith describe two cases of neglected anterior dislocation of the shoulder, which we have managed by open reduction and Latarjet procedure in one and Bankart surgery in the other patient. Both of our patients after one-year follow-up had a painless joint with improved yet limited range of motion. This case discussion helps in learning the approach towards the treatment of these patients. It also suggests a sub-optimal functional outcome in them.

Pseudo-aneurysm of the brachial artery is relatively rare condition affecting the arterial vessels of the limbs. It can be due to trauma, infections or systemic vasculitis. We report a patient with aplastic anemia who developed pseudoaneurysm of the brachial artery following an episode of bacterial sepsis. Methicillin resistant Staphylococcus aureus (MRSA) was isolated on blood culture. Patient was treated with systemic antibiotics and underwent embolization of the pseudo-aneurysm. He later developed vascular insufficiency of the forearm and a stent had to be placed in the brachial artery at the site of calcified thrombus inside the pseudo-aneurysm to produce the patency of the artery and ensure adequate blood flow to forearm and hand.

Femoral tunnel preparation during the anterior cruciate ligament reconstruction is a technically demanding step. The anteromedial (AM) portal technique necessitates knee hyperflexion during the femoral tunnel reaming. In a hyperflexed knee, the arthroscopic visualization of the laser markings on the femoral tunnel reamer becomes obscured. Thus, the calculation of the depth of the femoral tunnel becomes difficult. Our technique helps in femoral tunneling reliably without the need for arthroscopic visualization using the AM portal as a reference point to calculate the depth while drilling. This technique can be performed without the need for a second assistant to hold the arthroscope. Furthermore, this technique does not require any specific instruments, and there is no obligation for an additional incision.

Ferroptosis is an iron dependent form of regulatory cell death caused by the accumulation of lipid peroxides that can be exploited as a therapeutic for carcinomas and possibly other cancers. However, some populations of carcinoma cells resist ferroptosis, especially those with an epithelial phenotype but the mechanisms that promote resistance are poorly understood. We discovered that ferroptosis resistance in triple-negative breast cancer cells (TNBC) with an epithelial phenotype is dependent on expression of the integrin β4 and its ligand laminin 332 (LM332). LM332 and the integrin β4 maintain an epithelial cell state by downregulation of the EMT factor ZEB1. We further demonstrate that repression of ZEB1 by integrin β4 and LM332 promotes YAP/TAZ-mediated transcription of the C2 subunit of LM332, activating a positive feedback loop. Lastly, we observed that disrupting the β4/LM332 signaling axis sensitizes epithelial TNBC cells to ferroptosis by inducing ZEB1 expression. Our findings reveal a novel role for the extracellular matrix in promoting ferroptosis resistance by sustaining an epithelial phenotype and they suggest potential therapeutic strategies for overcoming this resistance. Citation Format: Emmet R. Karner, Hira Lal Goel, Arthur M. Mercurio. Ferroptosis resistance in epithelial populations of triple negative breast cancer is mediated by laminin 332 and integrin beta4 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 6097.

Introduction: Triple negative breast cancer (TNBC) represents 15% of all breast cancers, and is a notably aggressive subtype that is prone to early recurrence following initial diagnosis with a median survival of only 9 months following recurrence. One of the few treatment options for patients with advanced and metastatic TNBC is platinum-based chemotherapy, however not all tumors respond, and those that do often become refractory during the course of treatment. The cell surface receptor Neuropilin-2 (NRP2), which acts as a co-receptor for vascular endothelial growth factors (VEGFs), has been shown to be both highly expressed and associated with therapeutic resistance in TNBC. NRP2 also serves as a co-receptor for semaphorins, which may play tumor-suppressor functions in breast cancer. We have previously demonstrated that ATYR2810, a highly specific humanized monoclonal antibody which effectively blocks NRP2/VEGF signaling without disrupting NRP2/Semaphorin 3F signaling, down-regulated epithelial-mesenchymal transition (EMT) genes such as ZEB1 and sensitizes TNBC to chemotherapy both in vitro and in vivo. Results: In this study we have further characterized the breast cancer subtypes that are most responsive to ATYR2810 treatment. Using in vitro 3D colony formation assays (CFAs), we have interrogated ~15 breast cancer cell lines covering luminal, HER2+ and various TNBC subtypes, for responsiveness to ATYR2810 treatment in combination with chemotherapy. All responsive cell lines were associated with the more aggressive subtypes of TNBC such as BL2 (basal-like 2), ML (mesenchymal-like) and MSL (mesenchymal-stem like) subtypes. Additionally, we screened five patient derived xenografts (PDXs) and again found that the responsive PDXs were associated with the more aggressive and chemoresistant subtypes of TNBC. To gain insight into the potential mechanism for enhanced chemosensitivity by ATYR2810 treatment, we performed RNAseq on the PDX tumors. Interestingly, the chemokine receptor CXCR4, which is known to promote drug resistance and tumorigenic potential, was found to be significantly downregulated in responder PDX tumors treated with ATYR2810 in combination with cisplatin as compared to those treated with cisplatin alone. Further, gene set enrichment analysis (GSEA) showed that CXCR4 was found in numerous downregulated pathways enriched in the PDX responder tumors treated with ATYR2810/cisplatin, suggesting that CXCR4 may be driving the responder phenotype of the PDXs. Flow cytometry analysis of TNBC cells treated with ATYR2810 monotherapy in vitro resulted in a reduced frequency of cells expressing CXCR4. Furthermore, ATYR2810 monotherapy inhibited spontaneous lung metastasis in experimental models of mesenchymal TNBC. Conclusion: Taken together, our data suggest that ATYR2810 enhances chemosensitivity in highly aggressive TNBC subtypes, and that this response may be mediated through the downregulation of genes known to be associated with aggressive cancer states such as ZEB1 and CXCR4. ATYR2810 may therefore serve as a novel therapeutic agent for the treatment of advanced and metastatic TNBC and potentially other aggressive cancer types. Zhiwen Xu and Alison Barber are co-first authors of this abstract. Citation Format: Zhiwen Xu, Alison Barber, Christoph Burkart, Hira Lal Goel, Justin Rahman, Kristina Hamel, Zachary Fogassy, Lisa Eide, Clara Polizzi, Jasmine Stamps, Sofia Klopp Savino, Luke Burman, Esther Chong, Suzanne Paz, Arthur M. Mercurio, Leslie A. Nangle. ATYR2810, a fully humanized monoclonal antibody targeting the VEGF-NRP2 pathway sensitizes highly aggressive and chemoresistant TNBC subtypes to chemotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr LB085.

Primitive neuroectodermal tumour (PNET) of renal capsule is a rare entity. We report a case of a 17-year-old girl, who presented with symptoms of epigastric and right hypochondrium pain since 1 year. She was afebrile and physical examination revealed a soft, non-tender, firm, bimanually palpable and ballotable mass along right flank. Ultrasound abdomen showed a large heteroechoic mass in right suprarenal region with indistinct planes with upper pole of right kidney. On CT, a large right suprarenal mass was noted with origin likely from right adrenal gland. Surgery was done and intraoperatively, the large mass in right suprarenal region showed involvement of the upper pole of the right kidney. The right adrenal gland was small in size, compressed and displaced by the lesion. Histopathology revealed the mass to be PNET of kidney. We report the relevant imaging findings of the case with review of literature of this entity.

Hydroxychloroquine has been promoted for its use in treatment of COVID-19 patients based on in-vitro evidences. We searched the databases to include randomized and observational studies evaluating the effect of Hydroxychloroquine on mortality in COVID-19 patients. The outcome was summarized as odds ratios (OR) with a 95% confidence interval (CI).We used the inverse-variance method with a random effect model and assessed the heterogeneity using I2 test. We used ROBINS-I tool to assess methodological quality of the included studies. We performed the meta-analysis using ‘Review manager software version 5.3’. We identified 6 observationalstudies satisfying the selection criteria. In all studies, Hydroxychloroquine was given as add on to the standard care and effect was compared with the standard care alone. A pooled analysis observed 251 deaths in 1331 participants of the Hydroxychloroquine arm and 363 deaths in 1577 participants of the control arm. There was no difference in odds of mortality events amongst Hydroxychloroquine and supportive care arm [1.25 (95% CI: 0.65, 2.38); I2 = 80%]. A similar trend was observed with moderate risk of bias studies [0.95 (95% CI: 0.44, 2.06); I2 = 85%]. The odds of mortality were significantly higher in patients treated with Hydroxychloroquine + Azithromycin than supportive care alone [2.34 (95% CI: 1.63, 3.34); I2 = 0%]. A pooled analysis of recently published studies suggests no additional benefit for reducing mortality in COVID-19 patients when Hydroxychloroquine is given as add-on to the standard care. Graphical Abstract Electronic supplementary material The online version of this article (10.1007/s11481-020-09930-x) contains supplementary material, which is available to authorized users.

A 4-year-old girl was noticed to have abdominal distension by her parents. On evaluation with ultrasound, there was a heterogeneous solid cystic lesion with a predominantly cystic component seen in the left suprarenal region. Contrast enhanced CT (CECT) of the abdomen revealed a large 11×11.5×13

Extramedullary haematopoiesis (EMH) is a physiological process of formation of blood cells outside the bone marrow in response to insufficient production or excessive destruction of blood cells. Most common sites of EMH are liver, spleen, lymph nodes, kidney and paraspinal regions. In this report, we have described a rare case of focal EMH which presented as a mass adjacent to the renal allograft. Imaging characteristics favoured a benign aetiology with MRI signals suggesting the presence of blood and fatty components. The final diagnosis of EMH was made by aspiration cytology and an unnecessary surgery was thus avoided.

The aim of this study is to develop a system which can identify and sort peaberries automatically at low cost for coffee producers in developing countries. In this paper, the focus is on the classification of peaberries and normal coffee beans using image processing and machine learning techniques. The peaberry is not bad and not a normal bean. The peaberry is born in an only single seed, relatively round seed from a coffee cherry instead of the usual flatsided pair of beans. It has another value and flavor. To make the taste of the coffee better, it is necessary to separate the peaberry and normal bean before green coffee beans roasting. Otherwise, the taste of total beans will be mixed, and it will be bad. In roaster procedure time, all the beans shape, size, and weight must be unique; otherwise, the larger bean will take more time for roasting inside. The peaberry has a different size and different shape even though they have the same weight as normal beans. The peaberry roasts slower than other normal beans. Therefore, neither technique provides a good option to select the peaberries. Defect beans, e.g., sour, broken, black, and fade bean, are easy to check and pick up manually by hand. On the other hand, the peaberry pick up is very difficult even for trained specialists because the shape and color of the peaberry are similar to normal beans. In this study, we use image processing and machine learning techniques to discriminate the normal and peaberry bean as a part of the sorting system. As the first step, we applied Deep Convolutional Neural Networks (CNN) and Support Vector Machine (SVM) as machine learning techniques to discriminate the peaberry and normal bean. As a result, better performance was obtained with CNN than with SVM for the discrimination of the peaberry. The trained artificial neural network with high performance CPU and GPU in this work will be simply installed into the inexpensive and low in calculation Raspberry Pi system. We assume that this system will be used in under developed countries. The study evaluates and compares the feasibility of the methods in terms of accuracy of classification and processing speed.

In this study, we compared non-contrast MR angiography (NC-MRA) with conventional 3D contrast-enhanced MRA (CE-MRA) in patients suspected to have renal artery stenosis (RAS). From March 2014 to March 2020, patients who were evaluated for RAS and had a glomerular filtration rate > 30 ml/min/1.73 m2 underwent MR imaging on a 3T MR Scanner (Signa Hdxt General Electrics, Milwaukee, USA) using a Torso PA coil. The NC-MRA sequence was performed using a 3D fat-suppressed inflow inversion recovery balanced steady state free precession (SSFP) sequence (Inhance 3D Inflow IR, GE Medical) whereas the CE-MRA sequence was a 3D fast spoiled gradient echo (FSPGR). Overall quality of images was rated 1 to 4. Stenosis was reported as grade 1 (Normal), 2 ( 50% narrowing) and 4 (Total occlusion). Grade 3 and 4 were considered haemodynamically significant. During the study period, 201 patients were enrolled (400 renal arteries). For hemodynamically significant (grade 3/4) stenosis, NC-MRA correctly diagnosed 72 patients (95 arteries) while in 2 patients (2 arteries), NC-MRA underdiagnosed the stenosis as grade 2 (these were found to have grade 3 stenosis on CE-MRA). The kappa value of agreement between NC-MRA and CE-MRA for detection of RAS showing excellent agreement (p

We describe an extremely rare case of idiopathic spontaneous extensive venous thrombosis in a young man involving the inferior vena cava, the iliac veins and both renal veins associated with right haemorrhagic renal infarction with non-functioning right kidney.

A 31-year-old man presented with dull aching on and off right lower abdominal pain of 3 months’ duration. There was no history of any medical comorbidities or surgical interventions. Clinically, he had an 8×8 cm smooth, firm intra-abdominal lump in the right iliac fossa. On genitalia

Background One of the complications of arthroscopic reconstruction of anterior cruciate ligament (ACL) using hamstring autograft is injury to the infrapatellar branch of the saphenous nerve (IPBSN) leading to loss of sensation around the knee. Its incidence varies according to the orientation of incision for hamstring graft harvest, with oblique incision having the lowest chance of this injury. Aim of this study was to assess clinically and electrophysiologically injury to IPBSN after ACL reconstruction using oblique incision for hamstring graft harvest. Methods Fifty patients that were scheduled to undergo arthroscopic ACL reconstruction were included. All the patients were evaluated both clinically and electrophysiologically preoperatively and at three weeks and six months postoperatively to determine injury to IPBSN. Patient satisfaction after surgery was also compared. Results IPBSN injury was found to be present in 12 out of 50 patients (24%). Both clinical and electrophysiological data correlated completely. The difference in the length of the skin incisions between IPBSN injured and IPBSN intact patients was found to be statistically significant (P = .0043). The difference in the satisfaction score between patients with injured and intact IPBSN was also found to be statistically significant (P = .02). Conclusions Oblique incision for hamstring graft harvest results in lower incidence of IPBSN injury and subsequent sensory loss when compared with similar studies with different skin incisions carried out in the past. Patients undergoing ACL reconstruction should be counseled preoperatively regarding this potential complication, and if this complication occurs, improvement can be expected with time.

Objective The aim of this study was to assess the diagnostic yield of robotic-assisted computed tomography (CT)-guided F-FDG PET/CT-directed biopsy for the evaluation of intrathoracic space occupying lesions. Methods Twenty-four patients being evaluated for intrathoracic masses were included in the study. The indications were patients with unknown/likely primary detected from PET-CT, suspicious lesions identified from PET-CT in a known primary disease and fine needle aspiration cytology/CT-guided biopsy negative lesions with a high index of suspicion for malignancy. Biopsies were carried out with the help of automated radiology arm (ROBIO-EX) which is essentially a needle positioning and holding device. A two-day protocol was followed in which PET-CT scan was done on the first day, biopsy procedure was done on the next scheduled day. PET images were refused with the CT images done on the second day in the console by using manual alignment and then a biopsy was carried out with the help of a robotic arm. Primary outcome was histopathological yield from the obtained specimens. Results Tissue yield was 100% (n = 24) and histopathological diagnosis rate was 96% (n = 23). Out of the 24 lesions biopsied 30% (n = 8) were benign and 70% (n = 16) turned out to be malignant. The complication rates were pneumothorax 4% (n = 1) and haemothorax 4% (n = 1). Conclusion Robotic-assisted CT-guided F-FDG PET/CT-directed biopsy is a useful and accurate technique for diagnostic evaluation of intrathoracic neoplasms with minimal complications rates as compared with conventional imaging techniques.

Accurate gene regulatory network inference from time-series data is a challenging problem in computational biology. Recently, various methods have been developed to infer a gene regulatory network from time series data. Most of which are not scalable, because they limited the regulatory genes by 1 to 3. To resolve the problem, we propose an efficient statistical method called chi-square test for inferring gene regulatory network. A significant threshold p-value is considered to test the independence between target gene and regulatory gene in the chi-square test. Moreover, the p-value is corrected by Bonferroni Step-down (Holm) to reduce the false positives rate. A Boolean network is employed to model gene regulatory network because it is simple to implement, and it can capture network dynamics. To evaluate the performance of our method, we conducted an extensive simulation based on artificial datasets and compare the performance of our propose method with Relevance network and Pearson correlation methods, the experimental result shows that the proposed method significantly outperforms them with respect to structural accuracies. We further tested our method in two biological networks: SOS response of E.coli regulatory network and C.elegans cell cycle network. The simulation results demonstrated that our proposed method achieves better structural performance than relevance network and Pearson correlation methods also in the real dataset.

Kuntscher intramedullary nail (K-nail) proximal migration in the femoral medullary canal is a common postoperative complication. But spontaneous distal migration of the K-nail across the knee joint and protrusion over the tibia till the tibial tuberosity is a complication that has very rarely been reported in the literature previously. This is the case report of a 41-year-old man who presented with a pus discharging sinus over the tibial tuberosity for the last one year. K-nail insertion was done six years ago. The underlying cause of the migration of the K-nail is subject to controversy and speculation. Infection and delayed union with shortening are some etiological possibilities. Wrong selection of K-nail size, loosely fitted nail, premature weight-bearing, and disuse osteoporosis may also be contributory factors.

The region of Tehri is vulnerable to heavy rainfall and floods and other natural disasters. There is a need for an efficient flood forecasting system in the state of Uttarakhand so that preventive measures can be taken before the event occurs in any area. Artificial Neural Networks are a great tool to analyse complex systems in terms of simple weights and biases. The ANN once used efficiently to train, validate and test different datasets on a large scale can be an effective tool for flood forecast. In this paper, we have used monthly data of rainfall and discharge from the year 1964 to 2012 to train and test an ANN model with three hidden layers. Later the climate change data is used to estimate the rainfall for the future century and that rainfall is used as an input for the trained model to estimate the flood for the coming century (up to 2099). The results have been proven to be satisfactory in the training stage and more than 10 instances of high floods are forecasted for the future using climate change inputs.

Cancer stem cells (CSCs) contribute to multidrug resistance, tumor recurrence and metastasis, making them prime therapeutic targets. Their ability to differentiate and lose stem cell properties makes them challenging to study. Currently, there is no simple assay that can quickly capture and trace the dynamic phenotypic changes on the CSC surface. Here, we report rapid discrimination of breast CSCs from non-CSCs using a nanoparticle-fluorescent-protein based sensor. This nanosensor was employed to discriminate CSCs from non-CSCs, as well as CSCs that had differentiated in vitro in two breast cancer models. Importantly, the sensor platform could also discriminate CSCs from the bulk population of cells in patient-derived xenografts of human breast cancer. Taken together, the results obtained demonstrate the feasibility of using the nanosensor to phenotype CSCs and monitor their fate. Furthermore, this approach provides a novel area for therapeutic interventions against these challenging targets.

Background Isolated renal mucormycosis (IRM) is a potentially fatal disease affecting immunocompromised hosts. IRM affecting apparently immunocompetent patients is rare, with few previous reports, mostly from India. We describe 10 cases of bilateral IRM with no underlying risk factors. Methods We performed a retrospective analysis of cases of IRM from our hospital information system admitted between 2009 and 2016. We analyzed the data of this cohort of IRM, including epidemiological characteristics, clinical presentation, diagnostic procedures, treatment details and outcome. Results In all, 10 cases of bilateral IRM were identified. All of them were males with a mean age of 24.7 years (range 10–42). Most patients were initially managed as acute bacterial pyelonephritis with acute kidney injury. A total of eight patients were diagnosed antemortem. Diagnostic clues include sepsis not controlled with broad-spectrum antibiotics and enlarged kidneys with or without hypodensities on ultrasound/computed tomography imaging. Three patients also gave a specific history of passing white flakes in their urine. Eight patients received specific antifungal therapy with amphotericin B with or without posaconazole. Three patients in whom the disease was apparently confined to the pelvicalyceal system underwent local irrigation with Amp-B. One patient underwent bilateral nephrectomy. Four patients succumbed to the disease while five patients were successfully treated. One patient was discharged against medical advice. Conclusions IRM is a rare, life-threatening disease associated with high mortality even in immunocompetent individuals. Typical clinical and radiological findings and a high index of suspicion may help in early diagnosis, but definitive diagnosis requires histopathological and/or microbiological confirmation. Early and rapid diagnosis along with aggressive multidisciplinary management including initiation of specific antifungal therapy with or without surgical debridement is vital for a successful outcome.

Posttransplant lymphoproliferative disease (PTLD) is an uncommon complication of immunosuppression after solid organ transplantation. Early PTLD (1 year after transplantation) does not have such a preference. 18-Fluorodeoxyglucose positron emission tomography-computed tomography (18FDG PET-CT) has clinical significance in the evaluation of PTLD. 18FDG PET-CT scan allows precise anatomic localization of FDG-avid lesions, hence helpful in staging of disease and evaluation of response to therapy. It can better characterize persistent lesions and differentiate residual tumor from fibrosis or necrosis. We present a rare case report of a perigraft PTLD developing 12 years after renal transplantation sparing the graft, in an Epstein–Barr virus-negative patient.

Radiocephalic arteriovenous fistula (RCAVF) is the first choice for native arteriovenous fistula (AVF). Preoperative vessel assessment with ultrasonography (USG) has been reported to enhance the outcome of native AVF, but data regarding its predictive value for functional maturation of RCAVF are scanty. We aimed to determine the role of preoperative duplex USG (DUS) for prediction of functional maturity of radiocephalic fistula in the wrist. The data from 173 patients were analyzed prospectively. The estimated duplex variable included size, patency, and continuity of cephalic vein and size, peak systolic velocity, and wall calcifications in radial artery at the wrist. The subjects underwent RCAVF creation and were reviewed 6–8 weeks post procedure for adequacy of maturation. Doppler variables between successful and failed maturation groups were compared. Successful functional fistula maturation was noted in 138 (80.9%) patients. Values of radial artery diameter, cephalic vein diameter, and peak systolic velocity were >2 mm, 2.2 mm, and 32.8 cm/s, respectively, for successful maturation of RCAVF in more than 90% of cases. Vascular calcifications were detected preoperatively in 15 diabetic patients and 9 (60%) of them had fistula failure. Preoperative DUS can provide a good prediction on functional maturation of RCAVF. Vascular calcifications were associated with high risk of maturation failure in diabetics.

Early graft dysfunction after renal transplantation manifests as acute rejection (AR) or acute tubular necrosis (ATN). Blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging is a noninvasive method of assessing tissue oxygenation, which may be useful for predicting acute allograft dysfunction. This was a prospective study involving 40 patients scheduled for renal transplantation from August 2012 to August 2014. In addition, 15 healthy donors were also enrolled in this study. All recipients underwent BOLD MR imaging (MRI) and R2* mapping 10-20 days after transplant, and additionally within 48 h of biopsy if there was any evidence of graft dysfunction. The healthy donors underwent BOLD MRI 1-2 days before surgery. The biopsies were grouped into AR, ATN, and no evidence of AR or ATN. The mean medullary R2*, cortical R2*, corticomedullary gradient, and medullary: cortical R2* ratio were compared between groups using one-way analysis of variance. Spearman's correlation and multinomial linear regression were applied to determine the influence factors of R2* value. Overall, nine patients had graft dysfunction. Six were reported as AR, two as ATN, and one as no evidence of ATN or rejection. The mean medullary and cortical R2* were significantly higher in ATN group compared with AR and normal group, whereas the mean medullary and cortical R2* of AR group were significantly lower than normal group. The corticomedullary gradient of AR group was significantly lower compared with ATN and normal group. Medullary R2*:cortical R2* ratio was significantly lower in AR group compared with normal group. No significant difference was noted between the 15 donors and patients with normal graft function. R2* values on BOLD MRI are significantly decreased in AR allografts and increased in an early stage of ATN allografts, suggesting that BOLD MRI can become a valuable tool for discriminating between AR and ATN.