Journal of Radiology Case Reports最新文献

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Persistent craniopharyngeal canal with an associated sphenoid sinus fistula. 伴有蝶窦瘘的顽固性颅咽管。

IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-31 eCollection Date: 2023-10-01 DOI: 10.3941/jrcr.v17i8.4707

Chase C Dougherty, Barton F Branstetter

Persistent craniopharyngeal canal (PCC) is a rare congenital anomaly that appears as a linear well-corticated canal running from the sella through the clivus and into the nasopharynx. Case reports of this anomaly have shown it is associated with a range of craniofacial defects, pituitary abnormalities, and meningoencephaloceles. It predisposes patients to bacterial meningitis. In this case a 46-year-old gentleman presenting for preoperative planning for surgical drainage of Potts Puffy tumor was found to have a PCC on CT and MRI. Imaging also demonstrated the presence of chronic inflammation and a fistula extending from the tract into the sphenoid sinus. This unusual presentation of a PCC with a sphenoid sinus fistula broadens the potential clinical presentations of PCC and further emphasizes the ability of this anomaly to serve as a conduit for CNS infection.

持续性颅咽管（PCC）是一种罕见的先天性畸形，表现为从蝶鞍穿过蝶窦进入鼻咽部的线状皮质管。有关这种异常的病例报告显示，它与一系列颅面缺陷、垂体异常和脑膜脑瘤有关。这种畸形易导致患者患细菌性脑膜炎。在本病例中，一名 46 岁的男性患者在进行 Potts Puffy 肿瘤手术引流术前规划时，CT 和 MRI 检查发现他患有 PCC。影像学检查还显示存在慢性炎症，瘘管从瘘道延伸到蝶窦。这种PCC伴有蝶窦瘘管的不寻常表现拓宽了PCC的潜在临床表现，并进一步强调了这种畸形作为中枢神经系统感染管道的能力。

引用次数: 0

Imaging in hepatopulmonary syndrome-case report. A multicenter approach during the coronavirus pandemic. 肝肺综合征的成像--病例报告。冠状病毒大流行期间的多中心方法。

IF 0.6 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-31 eCollection Date: 2023-10-01 DOI: 10.3941/jrcr.v17i8.4411

Afsara Anisa Ahmmed, Randeep Kulshrestha

A 60-year-old lady with alcoholic liver disease developed central cyanosis and orthodeoxia. A technetium-99m macro-aggregated albumin lung perfusion scan and contrast echocardiogram were performed. A 13% right to left shunt was calculated from the macro-aggregated albumin scan. There were more bubbles in the left heart than the right at the end of the contrast echocardiogram. Hepatopulmonary syndrome was therefore diagnosed. The patient had a liver transplant five days after these investigations. Further discussion about hepatopulmonary syndrome will be provided. Normally, macro-aggregated albumin scans are performed in few centers, however as this was at the height of the coronavirus pandemic, the scan needed to be performed locally to reduce the chance of the patient getting coronavirus. Local radiographers were remotely instructed on conducting the macro-aggregated albumin scan by a larger center to provide a timely and important investigation in a logistically difficult scenario.

一位患有酒精性肝病的 60 岁女士出现了中心性紫绀和正位缺氧。医生为其进行了锝-99m 巨聚白蛋白肺灌注扫描和对比超声心动图检查。根据宏观白蛋白聚集扫描结果计算出，右向左分流率为 13%。造影剂超声心动图检查结束时，左心的气泡多于右心。因此诊断为肝肺综合征。在进行这些检查五天后，患者接受了肝脏移植手术。下面将进一步讨论肝肺综合征。通常，大样本白蛋白聚集扫描在少数中心进行，但由于当时正值冠状病毒大流行，扫描需要在当地进行，以减少患者感染冠状病毒的机会。当地的放射技师在一个较大的中心远程指导下进行宏观白蛋白聚集扫描，以便在后勤困难的情况下及时进行重要的检查。

引用次数: 0

Breast cancer in a Hispanic patient with Werner syndrome. 一名患有维尔纳综合征的西班牙裔患者的乳腺癌。

IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-31 eCollection Date: 2023-10-01 DOI: 10.3941/jrcr.v17i8.5168

Manuel Menendez Santos, Carlos Gonzalez Baerga, Sanjay Lamsal, Corey Engel, Savas Ozdemir

Werner Syndrome is a rare autosomal recessive condition characterized by premature aging and increased risk of malignancies due to gene mutations associated with DNA stability. We present the first case report of a 29-year-old Hispanic female with WS diagnosed with breast cancer. Diagnostic mammography and ultrasound, breast MRI and PET examinations revealed two lesions biopsy proven as invasive ductal carcinoma. The patient underwent neoadjuvant chemotherapy and radical mastectomy. Recurrence occurred 10 months postoperatively with molecular analysis demonstrating TP53 mutations. The multifactorial assessment of breast cancer in this case study is crucial towards optimizing screening, diagnosis and management of this disease in patients with WS.

维尔纳综合征（Werner Syndrome）是一种罕见的常染色体隐性遗传病，由于与 DNA 稳定性相关的基因突变而导致早衰和恶性肿瘤风险增加。我们首次报告了一名患有 WS 的 29 岁西班牙裔女性乳腺癌患者的病例。诊断性乳房 X 线照相术和超声波检查、乳腺 MRI 和 PET 检查发现两个病灶，活检证实为浸润性导管癌。患者接受了新辅助化疗和根治性乳房切除术。术后10个月复发，分子分析显示为TP53突变。本病例研究中对乳腺癌的多因素评估对于优化 WS 患者的筛查、诊断和管理至关重要。

引用次数: 0

Preoperative Transcatheter Arterial Embolization for Spontaneous Rupture of Huge Amebic Liver Abscess with Massive Intraperitoneal Hemorrhage 经导管动脉栓塞治疗阿米巴肝脓肿自发性破裂伴大量腹腔内出血

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-11 DOI: 10.3941/jrcr.v17i8.4837

None Koesbandono, Raditya Utomo, Benyamin Lukito, Jusef Treser, Nyoman Aditya Sindunata

An 18-year-old male developed a huge liver abscess with severe anemia over the course of 2 weeks. Abdominal contrast enhanced computed tomography showed ruptured huge liver abscess in the right liver lobe with signs of active hemorrhage (contrast extravasation). Serology examination confirmed amoeba as the suspected pathogen of cause. Angiography was performed followed by transcatheter arterial embolization to localize and control the hemorrhage. Embolization using a combination of polyvinyl alcohol and gelfoam successfully controlled the active hemorrhage. Exploratory laparotomy was performed to evacuate and debride the huge abscess. Metronidazole was given and showed good results. Huge liver abscess size is a predictor of conservative management failure and requires a gradual step-up intervention. The purpose of this paper is to explain the importance of imaging in detecting liver abscess and active hemorrhage along with the role of interventional radiology in this case.

一名18岁男性在2周内出现巨大的肝脓肿并伴有严重贫血。腹部增强计算机断层扫描显示右肝叶破裂的巨大肝脓肿伴活动性出血征象(造影剂外渗)。血清学检查证实阿米巴原虫为疑似致病菌。血管造影后经导管动脉栓塞以定位和控制出血。聚乙烯醇和明胶泡沫联合栓塞成功地控制了活动性出血。剖腹探查术对巨大脓肿进行引流和清创。给予甲硝唑治疗，效果良好。巨大的肝脓肿大小是保守治疗失败的预测因素，需要逐步加强干预。本文的目的是解释影像学在发现肝脓肿和活动性出血中的重要性，以及介入放射学在这种情况下的作用。

引用次数: 0

Flood Syndrome: Endovascular management of spontaneous rupture of an umbilical hernia due to long-standing ascites – A case report 洪水综合征:血管内处理因长期腹水引起的脐疝自发性破裂-一例报告

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-11 DOI: 10.3941/jrcr.v17i8.4884

Pablo Peñalver Calero, Marco Leyva Vásquez-Caicedo, Claudia Jimena González-Nieto, Javier Eduardo Armijo Astrain, José Vicente Méndez Montero

Umbilical hernias are common in patients with cirrhosis of the liver and ascites; however, spontaneous rupture of the hernia is a rare complication. Flood Syndrome occurs very rarely in cirrhotic patients with massive ascites and refers to the spontaneous rupture of an umbilical hernia followed by leakage of ascites fluid. A literature search shows that patients have been managed both operatively and nonoperatively for this condition. We report a case of a 56-year-old man with a history of alcohol-related liver cirrhosis and massive ascites refractory to medical therapy with sudden and spontaneous perforation of his hernia leading to drainage of ascitic fluid from the abdomen. We performed a transjugular intrahepatic portosystematic shunt to relieve portal pressure and subsequent intraabdominal pressure. The patient had resolution of symptoms and the ascitic fluid outflow was resolved.

脐疝常见于肝硬化和腹水患者;然而，自发性疝破裂是一种罕见的并发症。洪水综合征很少发生在肝硬化大量腹水患者中，是指脐疝自发破裂，随后出现腹水漏出。文献检索显示，对于这种情况，患者已接受手术和非手术治疗。我们报告一个56岁的男性，有酒精相关性肝硬化和大量腹水难治性药物治疗的病史，他的疝气突然和自发穿孔导致腹水从腹部排出。我们进行了经颈静脉肝内门静脉系统分流术，以减轻门静脉压力和随后的腹内压力。患者症状缓解，腹水流出得到解决。

引用次数: 0

Descending necrotizing mediastinitis secondary to retropharyngeal abscess 降性坏死性纵隔炎继发于咽后脓肿

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-11 DOI: 10.3941/jrcr.v17i8.5095

Sarah M Nwia, Christian D Huebner, Jeremy B. Nguyen

We report a case of descending necrotizing mediastinitis (DNM) in a 68-year-old male who presented in acute respiratory distress accompanied with anterior cervical neck swelling and pain with swallowing. Contrast enhanced computed tomography (CECT) of the neck demonstrated a large, peripherally enhancing retropharyngeal fluid and air collection that appeared to communicate with a fluid and air collection within the mediastinum. CECT of the chest demonstrated punctate foci of air and fat stranding along the anterior and superior mediastinum. Radiological evidence and the presence of necrosis on surgical debridement of the retropharyngeal abscess established the diagnosis of DNM. This case emphasizes the role of computed tomography (CT) in the diagnosis of DNM and demonstrates the utility of chest imaging in a high-risk patient who presents with a retropharyngeal abscess.

我们报告一例下行坏死性纵隔炎(DNM)在一个68岁的男性谁提出了急性呼吸窘迫，并伴有颈前颈部肿胀和疼痛与吞咽。颈部对比增强计算机断层扫描(CECT)显示大量外周增强的咽后液体和空气收集，似乎与纵隔内的液体和空气收集相通。胸部CECT显示空气和脂肪的点状病灶沿前纵隔和上纵隔排列。放射学证据和手术清除咽后脓肿时出现的坏死确定了DNM的诊断。本病例强调了计算机断层扫描(CT)在DNM诊断中的作用，并证明了胸部成像在出现咽后脓肿的高危患者中的应用。

引用次数: 0

Trigeminal Lipomatosis: A Rare Cause of Intractable Neuralgia 三叉神经脂肪瘤病:难治性神经痛的罕见病因

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-11 DOI: 10.3941/jrcr.v17i8.4709

Apoorva Sehgal, Jyoti Kumar, Ishwar Singh, Ashish Gopal

Lipomatosis of nerve, earlier known as fibrolipomatous hamartoma is a rare condition which predominantly affects peripheral nerves, cranial nerve involvement being extremely uncommon. Preoperative consideration of this entity is of paramount importance as its inadvertent complete surgical resection may inevitably result in significant neurological deficit. We report a case of trigeminal lipomatosis in a young patient with trigeminal neuralgia.

神经脂肪瘤病，早期称为纤维脂肪瘤错构瘤，是一种罕见的疾病，主要影响周围神经，累及脑神经极为罕见。术前考虑这个实体是至关重要的，因为它的不慎完全手术切除可能不可避免地导致严重的神经功能障碍。我们报告一个三叉神经痛的年轻三叉神经痛患者的三叉神经痛脂肪瘤病例。

引用次数: 0

Zinner’s Syndrome: Case report of a Developmental Anomaly of the Mesonephric Duct 津纳综合征:中肾管发育异常1例报告

Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-10-10 DOI: 10.3941/jrcr.v17i8.5055

Mirco Cleva, Luca Montaldo, Giovanna Graziani, Ennio Bruschi, Massimo Valentino

Zinner’s syndrome is a rare congenital malformation characterized by the association of unilateral renal agenesis with ipsilateral seminal vesicle cyst and ejaculatory duct obstruction. Most patients are asymptomatic until the third or fourth decade of life when the syndrome is associated with dysuria, perineal pain, infertility, and painful ejaculation. In this report, we present the common imaging findings of this rare developmental anomaly involving the mesonephric duct in a 48-year-old male patient experiencing pelvic pain, recurrent dysuria, and pollakiuria.

津纳氏综合征是一种罕见的先天性畸形，以单侧肾脏发育不全、同侧精囊囊肿和射精管梗阻为特征。大多数患者在30岁或40岁时才出现症状，此时伴有排尿困难、会阴疼痛、不孕症和射精痛。在这篇报告中，我们报告了一名48岁男性患者的常见影像学表现，该患者表现为盆腔疼痛、复发性排尿困难和尿失禁。

引用次数: 0

Rosai-Dorfman Disease in a Pediatric Patient: Imaging Findings and Pathology with a brief review of the Literature. 一名儿科患者的罗赛-多夫曼病：影像学检查结果和病理学，以及文献简评。

IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-09-01 DOI: 10.3941/jrcr.v17i9.4873

Thomas Hartmann, Nadia Solomon, Gabriel Lerner, Lauren Ehrlich

Rosai-Dorfman Disease, otherwise known as sinus histiocytosis with massive lymphadenopathy, is a rare form of non-Langerhans cell histiocytosis with an estimated incidence of 100 cases per year in the United States. Due to its variable presentation and nonspecific clinical findings, it is particularly difficult to diagnose in pediatric patients. We report a case of an 11-month-old male who presented with a 4-day history of a right groin mass. Ultrasound of the groin and pelvis demonstrated, and MRI of the abdomen and pelvis confirmed an inguinal mass with surrounding lymphadenopathy. Pathology confirmed Rosai-Dorfman Disease and the patient improved after starting oral steroid therapy. To the best of our knowledge, this is the first case of Rosai-Dorfman Disease involving the inguinal region in an infant under 1 year of age reported in the literature. In this case report, we discuss the imaging and histology findings as well as provide a brief literature review for this diagnosis.

罗赛-多夫曼病（Rosai-Dorfman Disease）又称窦性组织细胞增生症伴大量淋巴结病，是一种罕见的非郎格罕氏细胞组织细胞增生症，在美国的发病率估计为每年 100 例。由于其表现多变且临床表现无特异性，因此对儿童患者的诊断尤为困难。我们报告了一例 11 个月大的男性病例，他因右侧腹股沟肿块就诊 4 天。腹股沟和骨盆超声波显示，腹部和骨盆核磁共振成像证实其为腹股沟肿块，周围伴有淋巴结病。病理证实为罗赛-多夫曼病，患者在开始口服类固醇治疗后病情有所好转。据我们所知，这是文献中报道的首例罗赛-多夫曼病累及一岁以下婴儿腹股沟区的病例。在本病例报告中，我们讨论了影像学和组织学检查结果，并对这一诊断进行了简要的文献综述。

引用次数: 0

Nasal obstruction in a 14 year old girl caused by a huge middle turbinate mucocele appearing radiologically as an inverted papilloma. 一名 14 岁女孩因巨大的中鼻甲粘液瘤引起鼻塞，放射学表现为倒置乳头状瘤。

IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiology Case Reports

Pub Date : 2023-09-01 DOI: 10.3941/jrcr.v17i9.4774

W. Wakeford, Dimitrios Ioannidis

Introduction We present a case of a fourteen year old girl who presented with a large intra-nasal mass to the ENT team at a district general hospital in the UK. Presentation of case The girl presented predominantly with nasal obstruction and some symptoms of allergic rhinitis. Imaging revealed a large lesion abutting the skull base and causing bony remodelling with marked septal deviation. Based both on CT and MRI imaging, the reporting (non-head and neck) radiologist suggested inverted papilloma as a differential diagnosis. Intra-operative exploration in fact revealed a very large left middle turbinate mucocele extending to the left frontal sinus. The mass was excised endoscopically without complications. Discussion Although concha bullosa of the middle turbinate of the nose are common, development of a mucocele within them is far less common and for such a mucocele to develop to this size in a child is extremely rare. The egg shell lining of the lesion can be a tell-tale sign of their aetiology when taken alongside other radiological factors. This case highlights challenges in radiological diagnosis of intra-nasal masses in children, which can lead to delays and increased anxiety. Conclusion When assessing nasal masses in children it is important to keep a wide differential due to the challenges of diagnosis. A close conversation should be had with local head and neck radiologists and, of course, where there is a unilateral nasal mass tissue sampling is essential and may be taken as part of a full excision where clinically indicated.

导言：我们介绍一例 14 岁女孩的病例，她因鼻腔内巨大肿块向英国一家地区综合医院的耳鼻喉科团队求诊。病例介绍该女孩主要表现为鼻塞和一些过敏性鼻炎症状。影像学检查发现，她的鼻腔内有一个巨大的病变，与颅底相邻，导致骨质重塑，鼻中隔明显偏曲。根据 CT 和核磁共振成像，报告的放射科医生（非头颈部）建议将倒置乳头状瘤作为鉴别诊断。术中探查实际上发现了一个非常大的左侧中鼻甲粘液瘤，一直延伸到左侧额窦。该肿块经内窥镜切除，无并发症。讨论虽然鼻中鼻甲圆锥囊肿很常见，但在其中形成粘液瘤的情况却少见得多，而且在儿童中形成如此大的粘液瘤也极为罕见。病变的蛋壳状内膜与其他放射学因素结合在一起，可以成为病因的提示性标志。本病例凸显了儿童鼻内肿块放射学诊断的挑战，这可能导致延误和焦虑增加。结论在评估儿童鼻腔肿块时，由于诊断的挑战性，保持广泛的鉴别是非常重要的。当然，如果是单侧鼻腔肿块，则必须进行组织取样，并在有临床指征的情况下作为全切的一部分。

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引用次数: 0

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