Computed tomography of the abdomen and pelvis is a useful imaging modality for identifying origin and extent of ovarian cancer before primary debulking surgery. However, the International Federation of Gynecology and Obstetrics staging for ovarian cancer is determined based on surgico-pathological findings. The purpose of this study is to determine whether computed tomography staging can be the surrogate for surgico-pathological International Federation of Gynecology and Obstetrics staging in advanced ovarian cancer undergoing neoadjuvant chemotherapy. Computed tomography staging was compared with surgico-pathological International Federation of Gynecology and Obstetrics staging in primary debulking surgery arm patients in a randomized controlled trial comparing primary debulking surgery and neoadjuvant chemotherapy (JCOG0602). The cancer of primary debulking surgery arm was identically diagnosed regarding the origin and extent with the cancer of neoadjuvant chemotherapy arm before accrual, using imaging isease of ovarian cancer patients undergoing neoadjuvant chemotherapy without diagnostic surgery, but reliability of diagnosis of stage IIIB disease is inadequate.Clinical trial registration UMIN000000523(UMIN-CTR). Preoperative computed tomography staging in each institution can be the surrogate for surgico-pathological diagnosis in stage III disease of ovarian cancer patients undergoing neoadjuvant chemotherapy without diagnostic surgery, but reliability of diagnosis of stage IIIB disease is inadequate.Clinical trial registration UMIN000000523(UMIN-CTR). More effective therapies are needed to treat progressive desmoid tumors when active surveillance and systemic therapy fail. To assess the efficacy and safety of sandwich isolation surgery on the local control of progressive desmoid tumors involving neurovascular bundles. A total of 27 patients with progressive desmoid tumors at extremities involving neurovascular bundles who received surgery at our hospital between August 2014 and August 2018 were identified. A total of 13 patients received sandwich isolation surgery, in which R2 resection was performed in neurovasculature-involving regions, and a biomaterial patch was used to envelop involved neurovascular structures and isolate residual tumors. In non-neurovasculature-involving regions, wide resection was performed without isolation. A total of 14 patients received traditional surgery, which included tumor resection without isolation procedure. In sandwich isolation group, tumor progressions and local recurrences occurred in 3 patients outside the isolated neurovasculature-involving regions. However, no progressions or recurrences occurred in any patients in the isolated neurovasculature-involving regions where R2 resection was performed. Sandwich isolation surgery group and traditional surgery group shared similar baseline clinical characteristics. https://www.selleckchem.com/products/gambogic-acid.html The estimated 3-yr event-free survival rate was 76.9% after sandwich isolation surgery, and 32.7% after traditional surgery (P=.025). Patients who received sandwich isolation surgery were less likely to have local recurrence (hazard ratio 0.257, P=.040). No complications were noted except intermittent mild pain in operative regions (2 cases). Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles. Sandwich isolation surgery is effective and safe for local control of desmoid tumors involving neurovascular bundles. Herbaria were recently advertised as reliable sources of information regarding historical changes in plant traits and biotic interactions. To justify the use of herbaria in global change research, we asked whether the characteristics of herbarium specimens have changed during the past centuries and whether these changes were due to shifts in plant collection practices. We measured nine characteristics from 515 herbarium specimens of common European trees and large shrubs collected from 1558‒2016. We asked botanists to rank these specimens by their scientific quality, and asked artists to rank these specimens by their beauty. Eight of eleven assessed characteristics of herbarium specimens changed significantly during the study period. The average number of leaves in plant specimens increased threefold, whereas the quality of specimen preparation decreased. Leaf size negatively correlated with leaf number in specimen in both among-species and within-species analyses. The proportion of herbarium sheets cons. Our findings strongly support the hypothesis that many characteristics of herbarium specimens have changed systematically and substantially from the 16 th to 21 st centuries due to changes in plant collection and preservation practices. These changes may both create patterns which could be erroneously attributed to environmental changes and obscure historical trends in plant traits. The utmost care ought to be taken to guard against the possibility of misinterpretation of data obtained from herbarium specimens. We recommend that directional changes in characters of herbarium specimens which occurred during the past 150‒200 years, primarily in specimen's size and in the presence of reproductive structures, are accounted for when searching for the effects of past environmental changes on plant traits.Approximately 35% of patients with Type 1 von Willebrand Disease (VWD) do not have a known pathogenic variant in the VWF gene. We aimed to understand the impact of coding variants in VWF on VWD risk and VWF antigen (VWFAg) levels. 527 Low VWF and VWD patients and 210 healthy controls were studied. VWF sequencing was performed and VWFAg levels assayed. CADD (Combined Annotation Dependent Depletion) score >20 was used as a measure of predicted pathogenicity. The number of rare nonsynonymous VWF variants significantly predicted VWFAg levels (p=1.62x10-21). There was an association between average number of rare nonsynonymous VWF variants with VWD Type 1 (p=2.4x10-13) and Low VWF (p=1.6x10-27) compared to normal subjects, with Type 1 subjects possessing on average >2 times as many rare variants as those with Low VWF and eight times as many as normal subjects. The number of rare nonsynonymous variants significantly predicts VWFAg levels even after controlling for presence of a variant with CADD score > 20 or a known pathogenic variant in VWF (p=2.