Deep Brain Stimulation of the Anterior Limb of the Internal Capsule May Be Efficacious for Explosive Aggressive Behaviour

Background: Intermittent explosive disease (IED) is a psychiatric disorder characterized by intermittent attacks of rage and violence frequently resistant to pharmacological therapy. Deep brain stimulation (DBS) of the posteromedial hypothalamus has been applied with fair results and clinical improvement with some surgical morbidity due to neurovegetative side effects. The anterior limb of the internal capsule/ventral capsule/ventral striatum (VC/VS) has never been used alone as a target for this disease. Objectives: The aim of this study is to evaluate the efficacy of bilateral DBS of the VC/VS for the treatment of IED. Methods: We performed bilateral DBS of the VC/VS in a 21-year-old patient with IED. This young man had a traumatic birth complicated by hypoxia, and he showed a mild mental impairment. Different pharmacological treatments were carried out with no results before DBS was proposed to the patient's relatives after multidisciplinary approval. Results: After 22 months of high-frequency monopolar bilateral DBS of the VC/VS, the patient showed a significant improvement. Postoperative ¹⁸F-FDG PET-CT studies ruled out a reduction of the hypermetabolic areas located in the limbic system previously detected in pre-operative investigations. Conclusions: Bilateral DBS of the VC/VS may be considered for the treatment of IED without the risk of neurovegetative side effects.
Stereotact Funct Neurosurg 2016;94:371-378

http://ift.tt/2eUc4Qf

Geometric morphometrics of different malocclusions in lateral skull radiographs

Abstract

Background

To evaluate the role of craniofacial shape in malocclusion by application of geometric morphometrics to a set of two-dimensional landmarks and semilandmarks obtained from lateral skull radiographs.

Methods

Cephalometric radiograph tracings of 88 untreated Caucasians (age range 7–39 years) were assigned to four groups according to their occlusion: neutrocclusion, distocclusion, mesiocclusion, and anterior open bite. The geometric morphometric shape analysis incorporated 66 landmarks and semilandmarks, which underwent generalized Procrustes analysis, between-groups principal component analysis, thin-plate spline deformation grid visualization, permutation tests, and receiver operating characteristic curves.

Results

The position and shape of the mandible contributed to differences between the distocclusion and mesiocclusion groups, whereas the maxillary shape showed less variation. The growth-related shape alteration during adolescence was most pronounced in the mesiocclusion group and least pronounced in the neutrocclusion group. The open bite group was associated with an altered orientation of the mandibular body and the maxilla,  showed the most hyperdivergent maxillomandibular pattern but was not an own skeletal entity. Despite clear differences in mean shape across the four groups, the individual distribution of craniofacial shape overlapped between the groups without discrete clusters.

Conclusions

Craniofacial shape was clearly associated with dental malocclusion and showed considerable variation. Geometric morphometrics was a powerful research tool but for diagnosing individual malocclusion standard cephalometric measurements including overjet and overbite were equally or more efficient than geometric morphometric descriptors.

http://ift.tt/2f0YnSn

Stage-specific Embryonic Antigen-4 (SSEA-4) as a novel marker of ductal cells of human eccrine sweat glands

Summary

Background

Different populations of unipotent or multipotent stem cells were identified in human epidermis and its appendages. It is well documented that these cells maintain tissue homeostasis and actively participate in epidermal regeneration after injury. However, there is no evidence of the presence of pluripotent stem cells in human epidermis.

Objective

In this study, we investigated whether cells positive for embryonic stem cell marker SSEA-4 are present in adult human epidermis and if so, whether they are pluripotent and may correspond to the population of primitive stem cells.

Methods

The expression of SSEA-4 antigen and pluripotency transcription factors were analysed using flow cytometry. By means of immunohistochemical staining, we studied the exact localization of these cells in human skin sections.

Results

We show that a population of SSEA-4⁺ cells is present in human epidermis. In contrast to a commonly accepted belief, the expression of SSEA-4 antigen is not connected with the pluripotent character of the isolated cells. We found that these SSEA-4⁺ cells are localized in the ducts of eccrine sweat glands.

Conclusion

Our results indicate that the SSEA-4 antigen is a novel marker identifying the ductal cells of human sweat glands. The surface character of the antigen provides for simple method of isolation of this cell population and suggests the application of SSEA-4 for future cell therapy research.

This article is protected by copyright. All rights reserved.

http://ift.tt/2f0Zxx6

DOMINO, doxycycline 40mg vs minocycline 100mg in the treatment of rosacea: a randomised, single blinded, non-inferiority trial, comparing efficacy and safety

Summary

Background

There is lack of evidence for minocycline in the treatment of rosacea.

Objectives

To compare the efficacy and safety of doxycycline 40mg versus minocycline 100mg in papulopustular rosacea.

Methods

In this randomised single centre, 1:1 allocation, assessor blinded, non-inferiority trial, patients with a mild to severe papulopustular rosacea, were randomly allocated to either oral doxycycline 40mg or minocycline 100mg for a 16-week period with 12 weeks of follow up.

Our primary outcomes were the change in lesion count and change in patient's Health Related Quality of Life (HRQoL): RosaQoL scores.

Our secondary outcomes were: Patient's Global Assessment (PaGA) success ("excellent" or "good" improvement), Investigator Global Assessment (IGA) success ("clear" or "near clear"), Clinicians Erythema Assessment (CEA) success (at least one point decrease), the relapse rate at follow up and safety profile of the treatment drugs.

Intention to treat (ITT) and per protocol analyses (PPA) were performed.

Results

Of the 80 patients randomised, (40 for minocycline and 40 for doxycycline) 71 patients were treated for 16 weeks. 68 patients completed the study.

At week 16, the median change in lesion count was comparable in both groups: doxycycline versus minocycline respectively 13 versus 14 lesions less. (Non-inferiority difference 3, 90% Confidence interval (CI) -2 to 8). The RosaQoL scores were decreased for both doxycycline and minocycline, respectively 0.62 and 0.86. (Non-inferiority difference 0.15, 90% CI -0.09 to 0.42).

Secondary outcomes were comparable except for IGA success, which was assessed significantly more often in the minocycline group than in the doxycycline group (respectively 60% and 17.5%; p<0.001).

At week 28, outcomes were comparable, except for RosaQoL scores and PaGA, which were significantly different in favour of minocycline (P=0.005 and P=0.043 respectively), and less relapses were recorded in the minocycline group than in the doxycycline group (respectively 6.7% and 48%; p<0.001). In this study no serious adverse reactions (SAEs) were reported.

Conclusions

Minocycline 100mg is non-inferior to doxycycline 40mg in efficacy over a 16- week treatment period. Furthermore, at follow up, RosaQoL scores and PaGA were statistically significantly more improved in the minocycline group than in the doxycycline group, and minocycline 100mg gives longer remission than doxycycline 40mg. In this study there was no significant difference in safety between these treatments, however, based on previous literature minocycline has a lower risk/benefit ratio than doxycycline. Minocycline 100mg may be a good alternative treatment for those patients who, for any reason, are unable or unwilling to take doxycycline 40mg.

This article is protected by copyright. All rights reserved.

http://ift.tt/2eU3SPQ

The expression of serine protease inhibitors in epidermal keratinocytes is increased by calcium, but not 1,25(OH)2 vitamin D3 or retinoic acid

Summary

Background

In the human skin, the serine proteases kallikrein-related peptidases (KLK) 5 and KLK7 degrade corneodesmosome proteins, which leads to desquamation. The serine protease activity of the skin is tightly regulated by the interplay between such proteases and serine protease inhibitors, which include lympho-epithelial Kazal-type related inhibitor (LEKTI) encoded by SPINK5, secretory leukocyte peptidase inhibitor (SLPI), and elafin. The expression of KLK5 and KLK7 is controlled and up-regulated by stimulants such as calcium, 1,25(OH)₂ vitamin D₃ (1,25(OH)₂VD₃), and retinoic acid (RA).

Objectives

To understand the effect of calcium, 1,25(OH)₂VD₃, and RA on the expression of serine protease inhibitors in epidermal keratinocytes.

Methods

We stimulated normal human epidermal keratinocytes (NHEKs) with high calcium, 1,25(OH)₂VD₃, or RA and then analysed the expression of serine protease inhibitors using quantitative real-time-PCR, ELISA, and immunocytofluorescence. We also analysed trypsin- and chymotrypsin-like serine protease activities in stimulated NHEKs.

Results

High calcium, but not 1,25(OH)₂VD₃ or RA, significantly induced the expression of LEKTI, SLPI, and elafin at both transcript and protein levels in NHEKs. These inductions were time- and dose-dependent. The activities of trypsin- and chymotrypsin-like serine proteases were significantly up- and down-regulated by high calcium, respectively, in NHEKs.

Conclusions

High calcium, but not 1,25(OH)₂VD₃ or RA, increases the expression of serine protease inhibitors in epidermal keratinocytes. Our findings contribute to the understanding of the mechanisms by which serine protease activities are regulated by serine proteases and related inhibitors in epidermal keratinocytes.

This article is protected by copyright. All rights reserved.

http://ift.tt/2f0YPA4

Stage-specific Embryonic Antigen-4 (SSEA-4) as a novel marker of ductal cells of human eccrine sweat glands

Summary

Background

Different populations of unipotent or multipotent stem cells were identified in human epidermis and its appendages. It is well documented that these cells maintain tissue homeostasis and actively participate in epidermal regeneration after injury. However, there is no evidence of the presence of pluripotent stem cells in human epidermis.

Objective

In this study, we investigated whether cells positive for embryonic stem cell marker SSEA-4 are present in adult human epidermis and if so, whether they are pluripotent and may correspond to the population of primitive stem cells.

Methods

The expression of SSEA-4 antigen and pluripotency transcription factors were analysed using flow cytometry. By means of immunohistochemical staining, we studied the exact localization of these cells in human skin sections.

Results

We show that a population of SSEA-4⁺ cells is present in human epidermis. In contrast to a commonly accepted belief, the expression of SSEA-4 antigen is not connected with the pluripotent character of the isolated cells. We found that these SSEA-4⁺ cells are localized in the ducts of eccrine sweat glands.

Conclusion

Our results indicate that the SSEA-4 antigen is a novel marker identifying the ductal cells of human sweat glands. The surface character of the antigen provides for simple method of isolation of this cell population and suggests the application of SSEA-4 for future cell therapy research.

This article is protected by copyright. All rights reserved.

http://ift.tt/2f0Zxx6

DOMINO, doxycycline 40mg vs minocycline 100mg in the treatment of rosacea: a randomised, single blinded, non-inferiority trial, comparing efficacy and safety

Summary

Background

There is lack of evidence for minocycline in the treatment of rosacea.

Objectives

To compare the efficacy and safety of doxycycline 40mg versus minocycline 100mg in papulopustular rosacea.

Methods

In this randomised single centre, 1:1 allocation, assessor blinded, non-inferiority trial, patients with a mild to severe papulopustular rosacea, were randomly allocated to either oral doxycycline 40mg or minocycline 100mg for a 16-week period with 12 weeks of follow up.

Our primary outcomes were the change in lesion count and change in patient's Health Related Quality of Life (HRQoL): RosaQoL scores.

Our secondary outcomes were: Patient's Global Assessment (PaGA) success ("excellent" or "good" improvement), Investigator Global Assessment (IGA) success ("clear" or "near clear"), Clinicians Erythema Assessment (CEA) success (at least one point decrease), the relapse rate at follow up and safety profile of the treatment drugs.

Intention to treat (ITT) and per protocol analyses (PPA) were performed.

Results

Of the 80 patients randomised, (40 for minocycline and 40 for doxycycline) 71 patients were treated for 16 weeks. 68 patients completed the study.

At week 16, the median change in lesion count was comparable in both groups: doxycycline versus minocycline respectively 13 versus 14 lesions less. (Non-inferiority difference 3, 90% Confidence interval (CI) -2 to 8). The RosaQoL scores were decreased for both doxycycline and minocycline, respectively 0.62 and 0.86. (Non-inferiority difference 0.15, 90% CI -0.09 to 0.42).

Secondary outcomes were comparable except for IGA success, which was assessed significantly more often in the minocycline group than in the doxycycline group (respectively 60% and 17.5%; p<0.001).

At week 28, outcomes were comparable, except for RosaQoL scores and PaGA, which were significantly different in favour of minocycline (P=0.005 and P=0.043 respectively), and less relapses were recorded in the minocycline group than in the doxycycline group (respectively 6.7% and 48%; p<0.001). In this study no serious adverse reactions (SAEs) were reported.

Conclusions

Minocycline 100mg is non-inferior to doxycycline 40mg in efficacy over a 16- week treatment period. Furthermore, at follow up, RosaQoL scores and PaGA were statistically significantly more improved in the minocycline group than in the doxycycline group, and minocycline 100mg gives longer remission than doxycycline 40mg. In this study there was no significant difference in safety between these treatments, however, based on previous literature minocycline has a lower risk/benefit ratio than doxycycline. Minocycline 100mg may be a good alternative treatment for those patients who, for any reason, are unable or unwilling to take doxycycline 40mg.

This article is protected by copyright. All rights reserved.

http://ift.tt/2eU3SPQ

The expression of serine protease inhibitors in epidermal keratinocytes is increased by calcium, but not 1,25(OH)2 vitamin D3 or retinoic acid

Summary

Background

In the human skin, the serine proteases kallikrein-related peptidases (KLK) 5 and KLK7 degrade corneodesmosome proteins, which leads to desquamation. The serine protease activity of the skin is tightly regulated by the interplay between such proteases and serine protease inhibitors, which include lympho-epithelial Kazal-type related inhibitor (LEKTI) encoded by SPINK5, secretory leukocyte peptidase inhibitor (SLPI), and elafin. The expression of KLK5 and KLK7 is controlled and up-regulated by stimulants such as calcium, 1,25(OH)₂ vitamin D₃ (1,25(OH)₂VD₃), and retinoic acid (RA).

Objectives

To understand the effect of calcium, 1,25(OH)₂VD₃, and RA on the expression of serine protease inhibitors in epidermal keratinocytes.

Methods

We stimulated normal human epidermal keratinocytes (NHEKs) with high calcium, 1,25(OH)₂VD₃, or RA and then analysed the expression of serine protease inhibitors using quantitative real-time-PCR, ELISA, and immunocytofluorescence. We also analysed trypsin- and chymotrypsin-like serine protease activities in stimulated NHEKs.

Results

High calcium, but not 1,25(OH)₂VD₃ or RA, significantly induced the expression of LEKTI, SLPI, and elafin at both transcript and protein levels in NHEKs. These inductions were time- and dose-dependent. The activities of trypsin- and chymotrypsin-like serine proteases were significantly up- and down-regulated by high calcium, respectively, in NHEKs.

Conclusions

High calcium, but not 1,25(OH)₂VD₃ or RA, increases the expression of serine protease inhibitors in epidermal keratinocytes. Our findings contribute to the understanding of the mechanisms by which serine protease activities are regulated by serine proteases and related inhibitors in epidermal keratinocytes.

This article is protected by copyright. All rights reserved.

http://ift.tt/2f0YPA4

Re: The effects of Air Pollution on asthma Hospital admissions in Adelaide, South Australia, 2003-2013: time series and case-crossover analysis

Abstract

We read with great interest the recent study by Chen K and colleagues [1] which showed an increase risk of asthma hospital admissions in all age groups with total pollen. However, there are numerous issues that have been overlooked in the analysis of the pollen variable. If these issues were considered, the authors may have observed stronger species-specific effects thereby contributing to the evidence base on which pollen species is the major trigger of asthma exacerbations requiring hospitalization.

This article is protected by copyright. All rights reserved.

http://ift.tt/2eU2EUu

Re: The effects of Air Pollution on asthma Hospital admissions in Adelaide, South Australia, 2003-2013: time series and case-crossover analysis

Abstract

We read with great interest the recent study by Chen K and colleagues [1] which showed an increase risk of asthma hospital admissions in all age groups with total pollen. However, there are numerous issues that have been overlooked in the analysis of the pollen variable. If these issues were considered, the authors may have observed stronger species-specific effects thereby contributing to the evidence base on which pollen species is the major trigger of asthma exacerbations requiring hospitalization.

This article is protected by copyright. All rights reserved.

http://ift.tt/2eU2EUu

Can routine office-based audiometry predict cochlear implant evaluation results?

Objectives/Hypothesis

Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates.

Study Design

Retrospective, observational, diagnostic study.

Methods

The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test).

Results

The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation.

Conclusions

Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation.

Level of Evidence

4 Laryngoscope, 2016

http://ift.tt/2f0OLXS

Can routine office-based audiometry predict cochlear implant evaluation results?

Objectives/Hypothesis

Determining cochlear implant candidacy requires a specific sentence-level testing paradigm in best-aided conditions. Our objective was to determine if findings on routine audiometry could predict the results of a formal cochlear implant candidacy evaluation. We hypothesize that findings on routine audiometry will accurately predict cochlear implant evaluation results in the majority of candidates.

Study Design

Retrospective, observational, diagnostic study.

Methods

The charts of all adult patients who were evaluated for implant candidacy at a tertiary care center from June 2008 through June 2013 were included. Routine, unaided audiologic measures (pure-tone hearing thresholds and recorded monosyllabic word recognition testing) were then correlated with best-aided sentence-level discrimination testing (using either the Hearing in Noise Test or AzBio sentences test).

Results

The degree of hearing loss at 250 to 4,000 Hz and monosyllabic word recognition scores significantly correlated with sentence-level word discrimination test results. Extrapolating from this association, we found that 86% of patients with monosyllabic word recognition scores at or below 32% (or 44% for patients with private insurance) would meet candidacy requirements for cochlear implantation.

Conclusions

Routine audiometric findings can be used to identify patients who are likely to meet cochlear implant candidacy upon formal testing. For example, patients with pure-tone thresholds (250, 500, 1,000 Hz) of ≥75 dB and/or a monosyllabic word recognition test score of ≤40% have a high likelihood of meeting candidacy criteria. Utilization of these predictive patterns during routine audiometric evaluation may assist hearing health professionals in deciding when to refer patients for a formal cochlear implant evaluation.

Level of Evidence

4 Laryngoscope, 2016

http://ift.tt/2f0OLXS

Multimodality Cardiac Imaging in a Patient with Kawasaki Disease and Giant Aneurysms

Kawasaki disease is a well-known cause of acquired cardiac disease in the pediatric and adult population, most prevalent in Japan but also seen commonly in the United States. In the era of intravenous immunoglobulin (IVIG) treatment, the morbidity associated with this disease has decreased, but it remains a serious illness. Here we present the case of an adolescent, initially diagnosed with Kawasaki disease as an infant, that progressed to giant aneurysm formation and calcification of the coronary arteries. We review his case and the literature, focusing on the integral role of multimodality imaging in managing Kawasaki disease.

http://ift.tt/2eTLOW9

Mercury Vapour Long-Lasting Exposure: Lymphocyte Muscarinic Receptors as Neurochemical Markers of Accidental Intoxication

Introduction. Chronic poisoning may result in home setting after mercury (Hg) vapours inhalation from damaged devices. We report a chronic, nonoccupational Hg poisoning due to 10-year indoor exposure to mercury spillage. Case Report. A 72-year-old man with polyneuropathy of suspected toxic origin. At hospitalization, toxicological clinical evaluations confirmed the altered neurological picture documented across the last decade. Periodic blood and urine Hg levels (BHg, UHg) monitoring were performed from admission (), until 1 year later (), paralleled by blood neurochemical markers assessment, that is, lymphocytes muscarinic receptors (l-MRs). At : BHg and UHg were 27 and 1.4 microg/L, respectively (normal values: BHg 1–4.5; UHg 0.1–4.5), associated with l-MRs increase, 185.82 femtomoL/million lymphocytes (normal range: 8.0–16.0). At (two days after DMSA-mobilization test), BHg weak reduction, paralleled by UHg 3.7-fold increase, was measured together with further l-MRs enhancement (205.43 femtomoL/million lymphocytes). At (eight months after two cycles of DMSA chelating therapy ending), gradual improving of clinical manifestations was accompanied by progressive decrease of BHg and UHg (4.0 and 2.8 microg/L, resp.) and peripheral l-MRs neurochemical marker (24.89 femtomoL/million lymphocytes). Conclusion. l-MRs modulatory effect supports their use as peripheral neurochemical marker in Hg poisoning diagnosis and chelation therapy monitoring.

http://ift.tt/2f0Iqvo

Phase I/II Study OF Metformin in Combination With Cisplatin and Radiation in Head and Neck Squamous Cell Carcinoma

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:   Drug: Metformin
Sponsor:   Baylor College of Medicine
Not yet recruiting - verified October 2016

http://ift.tt/2f5caoE

A Study of Laparoscopic Right Hemicolectomy Using the Caudal-to-cranial Approach

Conditions:   Ascending Colon Cancer;   Ileocaecal Valve Carcinoma;   Cancer Flexure Hepatic;   Adenocarcinoma of Hepatic Flexure (Diagnosis)
Interventions:   Procedure: the caudal-to-cranial approach;   Procedure: the medial-to-lateral approach
Sponsor:   Guangdong Provincial Hospital of Traditional Chinese Medicine
Recruiting - verified October 2016

http://ift.tt/2f0PnwD

The Efficacy of Vocal Function Exercises for Laryngeal Cancers

Condition:   Vocal Folds
Interventions:   Procedure: Vocal Function Exercises;   Procedure: Vocal Hygiene
Sponsor:   Vrushali Angadi
Recruiting - verified October 2016

http://ift.tt/2eTSdjV

Phase I/II Study OF Metformin in Combination With Cisplatin and Radiation in Head and Neck Squamous Cell Carcinoma

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:   Drug: Metformin
Sponsor:   Baylor College of Medicine
Not yet recruiting - verified October 2016

http://ift.tt/2f5caoE

A Study of Laparoscopic Right Hemicolectomy Using the Caudal-to-cranial Approach

Conditions:   Ascending Colon Cancer;   Ileocaecal Valve Carcinoma;   Cancer Flexure Hepatic;   Adenocarcinoma of Hepatic Flexure (Diagnosis)
Interventions:   Procedure: the caudal-to-cranial approach;   Procedure: the medial-to-lateral approach
Sponsor:   Guangdong Provincial Hospital of Traditional Chinese Medicine
Recruiting - verified October 2016

http://ift.tt/2f0PnwD

The Efficacy of Vocal Function Exercises for Laryngeal Cancers

Condition:   Vocal Folds
Interventions:   Procedure: Vocal Function Exercises;   Procedure: Vocal Hygiene
Sponsor:   Vrushali Angadi
Recruiting - verified October 2016

http://ift.tt/2eTSdjV

Test

Test thyroid system post

The post Test appeared first on American Thyroid Association.

http://ift.tt/1PAQjVG

Test

Test thyroid system post

The post Test appeared first on American Thyroid Association.

http://ift.tt/1PAQjVG

New insights into Mesolithic human diet in the Mediterranean from stable isotope analysis: The sites of Campu Stefanu and Torre d'Aquila, Corsica

Abstract

Mesolithic human remains are rare in the archaeological record of the French Mediterranean. Only the island of Corsica has so far produced relatively well preserved burials, and recent archaeological excavations have brought to light new Mesolithic human remains. The site of Campu Stefanu, located in Sollacaro in the southeast of the island, contained a collective burial of 7-8 individuals in a previously unobserved funerary context. A re-evaluation of collections in regional museums yielded the remains from another Mesolithic individual from the site of Torre d'Aquila, excavated at Pietracorbara, in the northern part of the island, at the beginning of the 1990s. These two discoveries presented the rare opportunity to obtain new radiocarbon dates and paleodietary insights from this crucial time period using stable isotope analysis (δ¹³C, δ¹⁵N) on collagen. From Campu Stefanu one individual had sufficient collagen preserved for radiocarbon dating, revealing that it is the oldest Mesolithic human known on the island, dated to 10216-9920 cal. BP. At Torre d'Aquila, radiocarbon dates indicate that the individual belonged to a younger Mesolithic phase than Campu Stefanu, dated to 9903-9596 cal. BP. δ¹³C and δ¹⁵N isotope ratios are similar between the Campu Stefanu and Torre d'Aquila individuals and indicate a diet dominated by the consumption of terrestrial animal protein, and a lack of marine resources. These findings are in contrast with the previous results from two other Mesolithic individuals from Corsica from the sites of Araguina Sennola and Monte Leone, for which about 25-30% of the consumed proteins came from a marine diet. The dietary variability recorded in Corsica is consistent with results obtained from Mesolithic human remains of Sicily and the Iberian Peninsula. We can hypothesize, that despite the nomadic lifestyle, the distance to the sea played a major role in Mesolithic food choices in Corsica. This article is protected by copyright. All rights reserved.

http://ift.tt/2dUJ4KY

Morphometry of a Pre-Hispanic Dog From Northwestern Argentina (Ad 800-1200)

Abstract

A detailed morphometric description of a dog skull from the pre- Hispanic archaeological site La Isla de Tilcara (northwestern Argentina, ca. AD 800-1200) is presented. The resulting data were compared with those of dog skulls from other South American archaeological sites to establish dog morphotype. The examined skull belonged to a small, long-snouted dog, similar to the smallest morphotypes from the Central Andes.

http://ift.tt/2eqH7T0

BRAF V600D mutation in a paediatric high-grade glioma

The authors report a case of high-grade glioma with unusual pathology that has not previously been reported in glioma pathology. The 5-year-old patient presented to the emergency department with a 1-day history of a right temporal swelling on a background history of increasing nausea and vomiting for the preceding 5 months. A computed tomography brain was performed, which showed a large right-sided temporoparietal lesion. The patient underwent surgery to remove the mass and pathology confirmed anaplastic astrocytoma (WHO Grade 3). This report focuses on prognostic factors in high-grade glioma, particularly on pathological indicators, namely epidermal growth factor receptor, O6-methylguanine-DNA-methyltransferase expression and BRAF V600D mutation.

http://ift.tt/2ee67yY

Spontaneous resolution of symptomatic lumbar synovial cyst

Lumbar synovial cyst arises from the facet joint and can lead to back pain, radiculopathy, neurogenic claudication or even cauda equina syndrome. Although most surgeons would consider surgery to be the treatment of choice, the natural history of the disease process remains unknown and uncertainty still exists regarding optimal management of this controversial entity. We illustrate a case of large L5/S1 synovial cyst for which surgery was initially planned. However, it resolved spontaneously without any treatment. We also provide a brief literature review regarding conservative, surgical and minimally invasive management of symptomatic lumbar synovial cyst with special reference to patient outcome.

http://ift.tt/2eebaj3

Extensive upper extremity deep venous thrombosis following brief application of an operative arm tourniquet

Extensive upper extremity deep venous thrombosis and compartment syndrome secondary to operative tourniquet application are rare outcomes of established practice. We present the case of a 54-year-old female who underwent elective removal of a right olecranon plate under general anaesthetic with brief application of a tourniquet. In recovery, she developed a swollen and erythematous forearm, without significant pain and paraesthesia. An urgent dual-phase computed tomography angiogram identified no venous outflow proximal to the axillary vein. Concern for early compartment syndrome necessitated emergency fasciotomies of the right forearm and hand, precluding thrombolysis. Thrombosis was found in the superficial and deep veins throughout the forearm, but the muscles were healthy. The patient commenced anticoagulation therapy early and made good recovery. Further haematology review concluded that she had a 'provoked thrombosis' and no need for long-term anticoagulation.

http://ift.tt/2f8QKFB

The presence of respiratory disorders in individuals with low back pain: A systematic review.

Related Articles

The presence of respiratory disorders in individuals with low back pain: A systematic review.

Man Ther. 2016 Dec;26:77-86

Authors: Beeckmans N, Vermeersch A, Lysens R, Van Wambeke P, Goossens N, Thys T, Brumagne S, Janssens L

Abstract
BACKGROUND: Inspiratory muscles, such as the diaphragm, play a key role in both respiration and spinal control. Therefore, diaphragm dysfunctions are often related to low back pain (LBP). However, few is known on the association between the presence of LBP and the presence of respiratory disorders (RD).
OBJECTIVES: To perform a systematic review on the relation between RD and LBP.
STUDY DESIGN: Systematic review.
METHODS: Two reviewers searched on PubMed/MEDLINE for studies concerning LBP and RD, from 1950 up to January 2016. The search string consisted of the following key words: low back pain, dyspnea, respiratory problems, lung diseases, comorbidity, pulmonary disease, chronic obstructive, smoking, asthma, allergy, sinusitis, respiratory tract infection and hyperventilation. The aim was to evaluate a potential correlation, co-occurrence or causality between RD and LBP.
RESULTS: A total of 16 articles were included. A significant correlation between the presence of LBP and the presence of RD such as dyspnea, asthma, different forms of allergy, and respiratory infections was found. No correlation was found between Chronic Obstructive Pulmonary Disease (COPD) and LBP, and no articles were found on the correlation between hyperventilation and LBP.
CONCLUSIONS: This is the first study providing an overview of the literature on the relation between LBP and RD. Immunological, biomechanical, psychosocial and socio-economic factors might explain this correlation. Smoking is likely to contribute. Future studies must reveal the causative relationship.
LEVEL OF EVIDENCE: Therapy, level 2a.

PMID: 27501326 [PubMed - in process]

http://ift.tt/2f03Toj

Comparing TiO 2 photocatalysis and UV-C radiation for inactivation and mutant formation of Salmonella typhimurium TA102

Abstract

Salmonellosis is one of the most common causes of foodborne bacterial human disease worldwide, and the emergence of multidrug-resistant (MDR) strains of Salmonella enterica serovar Typhimurium (S. typhimurium) was associated to the incidence of invasive salmonellosis. The objective of the present work was to investigate the effects of the TiO₂ photocatalysis process in terms of both bacteria inactivation and the emergence of mutants, on S. typhimurium TA102 water suspensions. The TiO₂ photocatalysis was compared with a conventional disinfection process such as UV-C radiation. In spite of the faster bacterial inactivation obtained in UV-C disinfection experiments (45, 15, and 10 min for total inactivation for initial cell density 10⁹, 10⁸, and 10⁷ CFU mL⁻¹, respectively), photocatalytic disinfection (60, 30, and 15 min) was more energy efficient because of a lower energy requirement (2–20 mWs cm⁻²) compared to the UV-C disinfection process (5–30 mWs cm⁻²). During the photocatalytic experiments, the mutation frequency increased up to 1648-fold compared to background level for a 10⁸ CFU mL⁻¹ initial bacterial density, and mutants were inactivated after 1–10-min treatment, depending on initial bacterial cell density. In UV-C disinfection experiments, the mutation frequency increased up to 2181-fold for a 10⁸ CFU mL⁻¹ initial bacterial cell density, and UV-C doses in the range of 0.5–4.8 mWs cm⁻² were necessary to decrease mutation frequency. In conclusion, both disinfection processes were effective in the inactivation of S. typhimurium cells, and mutants released into the environment can be avoided if cells are effectively inactivated.

http://ift.tt/2eToesi

Release of anthracene from estuarine sediments by crab bioturbation effects

Abstract

To investigate bioturbation effects on anthracene (Ant) release from sediments to the overlying water, indoor microcosms were developed. Naturally contaminated estuarine sediments were exposed to the crab Helice tiensinensis over 70 days and compared with sediments with no crab. Bioturbation by crab could significantly increase the release of both particulate and dissolved Ant. The releases of particulate Ant with bioturbation treatments were 2.3–11.7 times higher than in the control treatments. However, the releases of dissolved Ant with bioturbation treatments were 1.7–3.7 times higher than in the control treatments. The ratio of particulate Ant/total Ant varied from 89 % to 98 % in the bioturbation treatments, which was significantly higher than in the control treatments. These results indicate that crab bioturbation significantly enhanced both particulate and dissolved Ant release from sediment, but the particulate Ant is the predominant process.

http://ift.tt/2eZYUUu

Liver metabolic disruption induced after a single exposure to PCB126 in rats

Abstract

Polychlorinated biphenyls (PCBs) have been recognized as metabolic disruptors. The liver plays a pivotal role in detoxification of an organism. Fatty liver results from altered intra-, and extra-hepatic mediators and is associated with increased glucose-related protein 78 (GRP78), commonly used as a marker for endoplasmic reticulum (ER) stress signaling. This pilot study aimed to study the effects of a single exposure on fatty liver metabolic parameters. The objective of the study is to characterize the effects of 3,3′,4,4′,5-pentachlorobiphenyl (PCB126) on ER stress protein chaperon GRP78 and CCAAT-enhancer-binding protein homologous protein (CHOP) and intra-hepatic mediators such as microsomal triglyceride transfer protein (MTP), sterol regulatory element-binding protein 1c (SREBP1c), and peroxisome proliferator-activated receptor alpha (PPARα), as well as extra-hepatic factors such as non-esterified fatty acid (NEFA) and tumor necrosis factor alpha (TNFα). Hepatic GRP78 mRNA and protein levels, indicating the presence of ER stress, were significantly increased following a single PCB126 exposure in rats. Intra-hepatic mechanisms such as lipoprotein secretion pathway (i.e., MTP), lipogenesis de novo (i.e., SREBP1c), and oxidation (i.e., PPARα) were altered in PCB126-treated rats. In addition, a state of inflammation measured by higher TNFα plasma levels was present in contaminated rats. These data indicate that a single injection of PCB126-modulated expression of GRP78 associated with hepatic ER stress and systemic inflammation in rats.

http://ift.tt/2eTo4kW

Sodium chlorate, a herbicide and major water disinfectant byproduct, generates reactive oxygen species and induces oxidative damage in human erythrocytes

Abstract

Sodium chlorate (NaClO₃) is a widely used non-selective herbicide. It is also generated as a byproduct during disinfection of drinking water by chlorine dioxide. In the present work, the effects of NaClO₃ on human erythrocytes were studied under in vitro conditions. Incubation of erythrocytes with different concentrations of NaClO₃ at 37 °C for 90 min resulted in significant hemolysis. Cell lysates were prepared from NaClO₃-treated and untreated (control) erythrocytes and assayed for various biochemical parameters. Methemoglobin levels were significantly increased and methemoglobin reductase activity was reduced upon NaClO₃ treatment. There was a significant increase in protein oxidation and lipid peroxidation with a decrease in reduced glutathione and total sulfhydryl content. This suggests the induction of oxidative stress in erythrocytes upon exposure to NaClO₃. The occurrence of oxidative stress was confirmed by significantly increased generation of reactive oxygen species and lowered antioxidant response of the cells. NaClO₃ treatment also increased nitric oxide levels showing induction of nitrosative stress. The activities of major antioxidant and membrane-bound and metabolic enzymes were significantly altered upon incubation of erythrocytes with NaClO₃. The erythrocytes became more osmotically fragile while electron microscopic images showed gross morphological alterations in NaClO₃-treated cells. These results show that NaClO₃ induces oxidative stress in human erythrocytes, which results in extensive membrane damage and lowers the antioxidant response.

http://ift.tt/2f00ohq

Using solid 13 C NMR coupled with solution 31 P NMR spectroscopy to investigate molecular species and lability of organic carbon and phosphorus from aquatic plants in Tai Lake, China

Abstract

Forms and labilities of plant-derived organic matters (OMs) including carbon (C) and phosphorus (P) were fundamental for understanding their release, degradation and environmental behaviour in lake ecosystems. Thus, solid ¹³C and solution ³¹P nuclear magnetic resonance (NMR) spectroscopy were used to characterize biomass of six aquatic plants in Tai Lake, China. The results showed that carbohydrates (61.2% of the total C) were predominant C functional group in the solid ¹³C NMR spectra of plant biomass, which may indicate high lability and bioavailability of aquatic plants-derived organic matter in lakes. There was 72.6–103.7% of the total P in aquatic plant biomass extracted by NaOH–EDTA extracts. Solution ³¹P NMR analysis of these NaOH–EDTA extracts further identified several molecular species of P including orthophosphate (50.1%), orthophosphate monoesters (46.8%), DNA (1.6%) and pyrophosphate (1.4%). Orthophosphate monoesters included β-glycerophosphate (17.7%), hydrolysis products of RNA (11.7%), α-glycerophosphate (9.2%) and other unknown monoesters (2.1%). Additionally, phytate, the major form of organic P in many lake sediments, was detected in floating plant water poppy. These inorganic P (e.g. orthophosphate and pyrophosphate) and organic P (e.g. diester and its degradation products) identified in plant biomass were all labile and bioavailable P, which would play an important role in recycling of P in lakes. These results increased knowledge of chemical composition and bioavailability of OMs derived from aquatic plants in lakes.

http://ift.tt/2eToc3F

Serum adipocyte-fatty acid binding protein (FABP4) levels in women from Mexico exposed to polycyclic aromatic hydrocarbons (PAHs)

Abstract

Recent studies indicate that exposure to polycyclic aromatic hydrocarbons (PAHs) is a very important risk factor for the development of cardiovascular diseases (CVDs). Correspondingly, adipocyte-fatty acid binding protein (FABP4, also known as aP2 and AFABP) has been proposed as a new, meaningful and useful biomarker to predict metabolic and cardiovascular diseases. Therefore, the aim of this study was to evaluate serum FABP4 levels in Mexican women exposed to PAHs. Urinary 1-hydroxypyrene ((1-OHP), exposure biomarker for PAHs) levels were quantified using a high-performance liquid chromatography (HPLC) technique, and serum FABP4 concentrations were analyzed using a commercially available ELISA kit. The mean urinary 1-OHP level found in women participating in this study was 1.30 ± 1.10 μmol/mol creatinine (2.45 ± 2.10 μg/g creatinine). Regarding serum FABP4 concentrations, the levels ranged from 3.80 to 62.5 ng/mL in the assessed population. Moreover, a significant association (p < 0.001) was found between urinary 1-OHP levels and serum FABP4 concentrations in women after adjusting for potential confounding variables. The presented data in this study can be considered only as a starting point for further studies. Then, in order to elucidate whether FABP4 represents a risk factor for CVD disease in humans exposed to air contaminants (such as PAHs), large epidemiological studies are necessary.

http://ift.tt/2eZZcKV

Sequential two-column electro-Fenton-photolytic reactor for the treatment of winery wastewater

Abstract

The high amount of winery wastewaters produced each year makes their treatment a priority issue due to their problematic characteristics such as acid pH, high concentration of organic load and colourful compounds. Furthermore, some of these effluents can have dissolved pesticides, due to the previous grape treatments, which are recalcitrant to conventional treatments. Recently, photo-electro-Fenton process has been reported as an effective procedure to mineralize different organic contaminants and a promising technology for the treatment of these complex matrixes. However, the reactors available for applying this process are scarce and they show several limitations. In this study, a sequential two-column reactor for the photo-electro-Fenton treatment was designed and evaluated for the treatment of different pesticides, pirimicarb and pyrimethanil, used in wine production. Both studied pesticides were efficiently removed, and the transformation products were determined. Finally, the treatment of a complex aqueous matrix composed by winery wastewater and the previously studied pesticides was carried out in the designed sequential reactor. The high removals of TOC and COD reached and the low energy consumption demonstrated the efficiency of this new configuration.

http://ift.tt/2eTo5p0

Prolonged operative time in laparoscopic appendectomy: predictive factors and outcomes.

Prolonged operative time in laparoscopic appendectomy: predictive factors and outcomes.

Int J Surg. 2016 Oct 26;:

Authors: Jeon BG, Kim HJ, Jung KH, Kim SW, Park JS, Kim KH, Kim ID, Lee SJ

Abstract
INTRODUCTION: To our knowledge, this study is the first to identify the predictive factors and outcomes of prolonged operative time associated with laparoscopic appendectomy. We aimed to identify preoperative factors that influence operation time and to determine how operative time affects laparoscopic appendectomy outcomes.
METHODS: The medical records of 3,049 patients who had undergone laparoscopic appendectomy between January 2008 and December 2014 were retrospectively reviewed. Prolonged operative time was defined in the top 10% according to distribution (>90 min). A multivariate regression model was generated to assess potential predictive factors and outcomes of prolonged operative time.
RESULTS: In laparoscopic appendectomy for non-perforated appendicitis, independent factors that predict a prolonged operative time as identified through multivariate analysis were elevated C-reactive protein levels, symptom duration of more than 3 days, and computed tomography findings indicating an appendiceal diameter of more than 10 mm. In laparoscopic appendectomy for perforated appendicitis, overweight, elevated C-reactive protein, symptom duration of more than 3 days, and computed tomography findings of abscess were independent predictive factors for prolonged operative time. Prolonged surgery increases the risk of complications, prolonged hospital stay, and readmission.
CONCLUSIONS: Overweight, elevated C-reactive protein, symptom duration of more than 3 days, appendiceal diameter of more than 10 mm, and abscess were independent predictive factors of prolonged operative time. Furthermore, prolonged operative time was associated with adverse postoperative outcomes after laparoscopic appendectomy.

PMID: 27794471 [PubMed - as supplied by publisher]

http://ift.tt/2f026iU

Rosai-Dorfman Disease Involving Multiple Organs: An Unusual Case with Poor Prognosis

Rosai-Dorfman disease is a rare, benign histiocytic proliferative disorder that usually affects the lymph nodes. Although extranodal involvement has been reported in diverse sites, manifestation in the cardiovascular system is extremely rare. Specifically, cardiac involvement in Rosai-Dorfman disease is an extraordinarily infrequent event. We describe a case of a 36-year-old female who presented Rosai-Dorfman disease of multiple organs including the heart, with poor prognosis.

http://ift.tt/2dUxAY6

Rapid Recovery from Paraplegia in a Patient with Foix-Alajounine Syndrome.

Rapid Recovery from Paraplegia in a Patient with Foix-Alajounine Syndrome.

World Neurosurg. 2016 Oct 26;:

Authors: Joswig H, Haji FA, Martinez-Perez R, Steven DA, Boulton MR

Abstract
BACKGROUND: Foix-Alajounine syndrome describes the acute neurological deterioration in the setting of a spinal dural arteriovenous fistula.
CASE DESCRIPTION: The following case report on a young patient with an unusual clinical onset of Foix-Alajounine Syndrome coincidentally occurring after his Outpatient Clinic appointment, illustrates how prompt surgical treatment can result in rapid recovery of neurological function despite preoperative paraplegia.
CONCLUSIONS: Venous hypertension with subsequent rapid resolution after surgical treatment is the pathophysiological mechanism underlying a dural arteriovenous fistula, in contrast to historical views suggesting these lesions result from irreversible venous thrombosis resulting in necrotic myelopathy.

PMID: 27794514 [PubMed - as supplied by publisher]

http://ift.tt/2fmndx8

Long-term Survival Primary Intracranial Plasmablastic Lymphoma: Case Report and Review of the Literature.

Long-term Survival Primary Intracranial Plasmablastic Lymphoma: Case Report and Review of the Literature.

World Neurosurg. 2016 Oct 26;:

Authors: Hu ZC, Ma H, Wei MH, Qin HM

PMID: 27794513 [PubMed - as supplied by publisher]

http://ift.tt/2eqpRgu

Differences in type composition of symptom clusters as predictors of quality of life between patients with meningioma and glioma.

Differences in type composition of symptom clusters as predictors of quality of life between patients with meningioma and glioma.

World Neurosurg. 2016 Oct 26;:

Authors: Kim SR, Shin YS, Kim JH, Choi M, Yoo SH

Abstract
OBJECTIVE: The purposes of this study were to identify and compare symptom clusters in patients with meningioma and glioma, and to assess and compare predictors of quality of life (QoL) in both patient groups.
METHODS: Data were collected using the MD Anderson Symptom Inventory Brain Tumour Module, the Functional Assessment of Cancer Therapy-General, and the Karnofsky Performance Scale (KPS). Of the 158 participating patients, 77 had meningioma and 81 had glioma.
RESULTS: Four symptom clusters were identified with 55.4% total variance in patients with meningioma. These clusters were 1) physical, 2) cognitive, 3) elimination-appearance, and 4) motor-sensory symptoms. In patients with glioma, four clusters with a total variance of 67.3% were identified: 1) treatment-related, 2) cognitive, 3) appearance-elimination, and 4) gastrointestinal symptoms. Predictors of QoL were KPS score (β = 0.41, p < .001), cognitive symptom cluster (β = -0.36, p < .001), and physical symptom cluster (β = -0.32, p = .001) in patients with meningioma whereas treatment-related symptom cluster (β = -0.55, p < .001) was identified as the predictor of QoL in patients with glioma.
CONCLUSIONS: This study demonstrates that the type and composition of symptom clusters differed between patients with meningioma and glioma. In addition, our data provide evidence that even when the participants reported mild symptoms, these clusters could be used to predict QoL in patients with meningioma and glioma.

PMID: 27794512 [PubMed - as supplied by publisher]

http://ift.tt/2f8I2aJ

Multisensory interplay within human auditory cortex: new evidence from intraoperative optical imaging of intrinsic signal.

Multisensory interplay within human auditory cortex: new evidence from intraoperative optical imaging of intrinsic signal.

World Neurosurg. 2016 Oct 26;:

Authors: Zhou Q, Wang Y, Yi L, Tan Z, Jiang Y

Abstract
BACKGROUND: The primary auditory cortex that was ever considered to be unisensory specific has been recently challenged to be multisensory. However, the temporal details of processing non-auditory stimuli in the human auditory cortex still remain unclear, due to the low temporal and spatial resolution of the adopted imaging techniques.
METHODS: In the present study, using intraoperative optical imaging of intrinsic signals (iOIS) recording techniques, detailed cortical activations within the auditory cortex in response to auditory and somatosensory stimulation were recorded from three intraoperative anesthetized patients with brain tumor located at superior temporal gyrus.
RESULT: At both green-light (545±13 nm) and red-light (610±10 nm) illumination, the primary and secondary auditory cortices showed to be respond significantly to the somatosensory stimulation. As induced by the somatosensory stimulus, the average overlapping rate of the activated region was 74.51% ± 0.15%, and the peak responding time occurred at post-stimulus 7-8 seconds. In addition, there was no significant difference of the peak responding time between auditory and somatosensory stimuli (P<0.01, paired t-test).
CONCLUSION: These findings provide novel evidence for multisensory interplay within human auditory cortex at early stage of cortical processing, which extends the understandings of multisensory mechanism of human brain functions.

PMID: 27794511 [PubMed - as supplied by publisher]

http://ift.tt/2f4xXN8

En bloc resections in the spine - the experience of 220 cases over 25 years.

En bloc resections in the spine - the experience of 220 cases over 25 years.

World Neurosurg. 2016 Oct 26;:

Authors: Boriani S, Gasbarrini A, Bandiera S, Ghermandi R, Lador R

Abstract
BACKGROUND AND OBJECTIVES: En bloc resections aim at surgically removing a tumor in a single, intact piece. Approach must be planned for the complete removal of the tumor without violation of its margins. The shared knowledge of the morbidity, mortality, risk assessment for local disease recurrence, complications and death, related to spine tumors excised en bloc could improve the treating physician's apprehension of the diseases and decision making process before, during and after surgical treatment. The purpose of this study was to review and report the experience gained in one of the worlds biggest spine oncological centers of over 25 years.
METHODS: A retrospective study of prospective collected data of 1,681 patients affected by spine tumors, of whom 220 enbloc resections was performed.
RESULTS: Most tumors were primary - 165 cases (43 benign and 122 malignant), metastases occurred in 55 cases. 61 patients died from the disease. 153 complications were observed in 100 patients. 33 local recurrences were recorded. A total of 61 patients died from the disease. A total of 153 complications were observed in 100 out of 216 patients (46.2%). 64 of these patients (30%) suffered one complication, while the rest had 2 or more. All complications were categorized according to temporal distribution and severity. These were further divided into 7 groups according to the type of complication. There were 105 major and 48 minor complications. seven patients (4.6%) died as a result of complications. 33 local recurrences (15.28%) were recorded, Contaminated cases, surgical margins of the resected tumor - intralesional, marginal, and malignant tumors, were statistically significant independent risk factors for local recurrence of the tumor. Contamination, local recurrence, neo-adjuvant RT, the number of level resected, and metastatic tumors compared to primary malignant tumor, were shown to be independent risk factors for patient's death.
CONCLUSION: Treatment of spinal aggressive benign and malignant bone tumors through en bloc resections is beneficial, in terms of better local control and prognosis, although it is a highly demanding and risky procedure. Margins are the key point of this procedure, thus, a careful preoperative oncological and surgical staging is necessary to define the optimal surgical approach. The adverse event profile of these surgeries is high; therefore, it should be performed by experienced and multidisciplinary teams in specialized high volume centers.

PMID: 27794510 [PubMed - as supplied by publisher]

http://ift.tt/2f40gf1

The β2-Adrenoceptor Agonist Terbutaline Stimulates Angiogenesis via Akt and ERK Signaling.

Related Articles

The β2-Adrenoceptor Agonist Terbutaline Stimulates Angiogenesis via Akt and ERK Signaling.

J Cell Physiol. 2017 Feb;232(2):298-308

Authors: Lemmens S, Kusters L, Bronckaers A, Geurts N, Hendrix S

Abstract
Angiogenesis is associated with changes in endothelial cell (EC) proliferation and tube formation, controlled by extracellular receptor-activated kinase (ERK)/mitogen activated protein kinase (MAPK) and Akt signaling. Important regulators of these systems include hormones acting on G-protein-coupled receptors, such as beta 2-adrenoceptors (β2-ARs). In central nervous system (CNS) trauma, the importance of β2-AR modulation has been highlighted, although the effects on revascularization remain unclear. Vascular protection and revascularization are, however, key to support regeneration. We have investigated the angiogenic capacity of the specific β2-AR agonist terbutaline on ECs derived from the CNS, namely bEnd.3-cells. As angiogenesis is a multistep process involving increased proliferation and tube formation of ECs, we investigated the effects of terbutaline on these processes. We show that terbutaline significantly induced bEnd.3 tube formation in a matrigel in vitro assay. Moreover, administration of specific inhibitors of ERK and Akt signaling both inhibited terbutaline-induced tube formation. The proliferation rate of the ECs was not affected. In order to investigate the general effects of terbutaline in an organotypic system, we have used the chick chorioallantoic membrane (CAM)-assay. Most importantly, terbutaline increased the number of blood vessels in this in ovo setting. Although we observed a positive trend, the systemic administration of terbutaline did not significantly improve the functional outcome, nor did it affect revascularization in our spinal cord injury model. In conclusion, these data indicate that terbutaline is promising to stimulate blood vessel formation, underscoring the importance of further research into the angiotherapeutic relevance of terbutaline and β2-AR signaling after CNS-trauma. J. Cell. Physiol. 232: 298-308, 2017. © 2016 Wiley Periodicals, Inc.

PMID: 27403604 [PubMed - in process]

http://ift.tt/2eLG5Ef

Anti-Diabetic Agent Sodium Tungstate Induces the Secretion of Pro- and Anti-Inflammatory Cytokines by Human Kidney Cells.

Related Articles

Anti-Diabetic Agent Sodium Tungstate Induces the Secretion of Pro- and Anti-Inflammatory Cytokines by Human Kidney Cells.

J Cell Physiol. 2017 Feb;232(2):355-362

Authors: Bertinat R, Westermeier F, Silva P, Shi J, Nualart F, Li X, Yáñez AJ

Abstract
Diabetic kidney disease (DKD) is the major cause of end stage renal disease. Sodium tungstate (NaW) exerts anti-diabetic and immunomodulatory activities in diabetic animal models. Here, we used primary cultures of renal proximal tubule epithelial cells derived from type-2-diabetic (D-RPTEC) and non-diabetic (N-RPTEC) subjects as in vitro models to study the effects of NaW on cytokine secretion, as these factors participate in intercellular regulation of inflammation, cell growth and death, differentiation, angiogenesis, development, and repair, all processes that are dysregulated during DKD. In basal conditions, D-RPTEC cells secreted higher levels of prototypical pro-inflammatory IL-6, IL-8, and MCP-1 than N-RPTEC cells, in agreement with their diabetic phenotype. Unexpectedly, NaW further induced IL-6, IL-8, and MCP-1 secretion in both N- and D-RPTEC, together with lower levels of IL-1 RA, IL-4, IL-10, and GM-CSF, suggesting that it may contribute to the extent of renal damage/repair during DKD. Besides, NaW induced the accumulation of IκBα, the main inhibitor protein of one major pathway involved in cytokine production, suggesting further anti-inflammatory effect in the long-term. A better understanding of the mechanisms involved in the interplay between the anti-diabetic and immunomodulatory properties of NaW will facilitate future studies about its clinical relevance. J. Cell. Physiol. 232: 355-362, 2017. © 2016 Wiley Periodicals, Inc.

PMID: 27186953 [PubMed - in process]

http://ift.tt/2f3Wjag

Letter to the Editor, Re: van der Heijden AG, Mengual L, Lozano JJ, Ingelmo-Torres M, Ribal MJ, Fernández PL, Oosterwijk E, Schalken JA, Alcaraz A, Witjes JA. A five-gene expression signature to predict progression in T1G3 bladder cancer. Eur J Cancer. 2016; 64:127–136

Publication date: Available online 30 October 2016
Source:European Journal of Cancer
Author(s): Anna Orsola, Stephanie A. Mullane, Joaquim Bellmunt




http://ift.tt/2edZBs8

Reply to letter commenting on: A five-gene expression signature to predict progression in T1G3 bladder cancer

Publication date: Available online 30 October 2016
Source:European Journal of Cancer
Author(s): Antoine G. van der Heijden, Lourdes Mengual




http://ift.tt/2f8MQwF

Synthetic multi-line kymographic analysis: A spatiotemporal data reduction technique for high-speed videoendoscopy.

Synthetic multi-line kymographic analysis: A spatiotemporal data reduction technique for high-speed videoendoscopy.

J Acoust Soc Am. 2016 Oct;140(4):2703

Authors: Ikuma T, Kunduk M, Fink D, McWhorter AJ

Abstract
High-speed videoendoscopy (HSV) enables observation of the true vibratory behavior of the vocal folds. To quantify the vocal fold vibration captured by the HSV, lateral movement features (e.g., glottal width and vocal fold edge displacements) have been extracted as functions of time. The most common analysis method is to extract the features on a lateral strip used to form digital kymogram. The weakness of this method is that it can only capture the vibrational behavior local to the strip location. While the multi-line kymographic approach has been utilized to capture the spatial diversity, the observation points are either fixed or manually positioned. Behaviors of pathological vocal folds, especially those with lesions, are expected to be spatially diverse and also diverse among speakers, making fixed observation points ineffective. This paper proposes a technique to synthesize kymographic waveforms from full spatiotemporal HSV feature data to extract distinctive behaviors automatically. Each synthesized waveform represents a non-overlapping section of the glottis, where vocal folds are locally behaving homogeneously. The efficacy of the algorithm is demonstrated with four HSV recordings (three pathological) and discussed, including mitigation of the known drawbacks.

PMID: 27794340 [PubMed - in process]

http://ift.tt/2f3QKII

Mechanics of human voice production and control.

Mechanics of human voice production and control.

J Acoust Soc Am. 2016 Oct;140(4):2614

Authors: Zhang Z

Abstract
As the primary means of communication, voice plays an important role in daily life. Voice also conveys personal information such as social status, personal traits, and the emotional state of the speaker. Mechanically, voice production involves complex fluid-structure interaction within the glottis and its control by laryngeal muscle activation. An important goal of voice research is to establish a causal theory linking voice physiology and biomechanics to how speakers use and control voice to communicate meaning and personal information. Establishing such a causal theory has important implications for clinical voice management, voice training, and many speech technology applications. This paper provides a review of voice physiology and biomechanics, the physics of vocal fold vibration and sound production, and laryngeal muscular control of the fundamental frequency of voice, vocal intensity, and voice quality. Current efforts to develop mechanical and computational models of voice production are also critically reviewed. Finally, issues and future challenges in developing a causal theory of voice production and perception are discussed.

PMID: 27794319 [PubMed - in process]

http://ift.tt/2eLAPjW

Effects of age and hearing loss on overshoot.

Effects of age and hearing loss on overshoot.

J Acoust Soc Am. 2016 Oct;140(4):2481

Authors: Jennings SG, Ahlstrom JB, Dubno JR

Abstract
The detection of a brief, sinusoidal probe in a long broadband, simultaneous masker improves as the probe is delayed from the masker's onset. This improvement ("overshoot") may be mediated by a reduction in cochlear amplifier gain over the timecourse of the masker via the medial olivocochlear (MOC) reflex. Overshoot was measured in younger adults with normal hearing and in older adults with normal and impaired hearing to test the hypothesis that aging and cochlear hearing loss result in abnormal overshoot, consistent with changes in certain structures along the MOC pathway. Overshoot decreased with increasing quiet probe thresholds and was only minimally influenced by increasing age. Marked individual differences in overshoot were observed due to differences in masking thresholds for probes presented near the masker's onset. Model simulations support the interpretation that reduced overshoot in hearing-impaired listeners is due to limited cochlear amplifier gain and therefore less gain to adjust over the timecourse of the masker. Similar overshoot among younger and older adults with normal hearing suggests that age-related changes to mechanisms underlying overshoot do not result in significant differences in overshoot among younger and older adults with normal hearing.

PMID: 27794300 [PubMed - in process]

http://ift.tt/2f3QysV

MORC2 mutation causes severe spinal muscular atrophy-phenotype, cerebellar atrophy, and diaphragmatic paralysis.

MORC2 mutation causes severe spinal muscular atrophy-phenotype, cerebellar atrophy, and diaphragmatic paralysis.

Brain. 2016 Oct 29;:

Authors: Schottmann G, Wagner C, Seifert F, Stenzel W, Schuelke M

PMID: 27794525 [PubMed - as supplied by publisher]

http://ift.tt/2edVQmw

Head impacts in a junior rugby league team measured with a wireless head impact sensor: an exploratory analysis.

Related Articles

Head impacts in a junior rugby league team measured with a wireless head impact sensor: an exploratory analysis.

J Neurosurg Pediatr. 2016 Oct 28;:1-11

Authors: King D, Hume P, Gissane C, Clark T

Abstract
OBJECTIVE The aim of this study was to investigate the frequency, magnitude, and distribution of head impacts sustained by players in a junior rugby league over a season of matches. METHODS The authors performed a prospective cohort analysis of impact magnitude, frequency, and distribution on data collected with instrumented XPatches worn behind the ear of players in an "under-11" junior rugby league team (players under 11 years old). RESULTS A total of 1977 impacts were recorded. Over the course of the study, players sustained an average of 116 impacts (average of 13 impacts per player per match). The measured linear acceleration ranged from 10g to 123g (mean 22g, median 16g, and 95th percentile 57g). The rotational acceleration ranged from 89 rad/sec(2) to 22,928 rad/sec(2) (mean 4041 rad/sec(2), median 2773 rad/sec(2), and 95th percentile 11,384 rad/sec(2)). CONCLUSIONS The level of impact severity based on the magnitude of impacts for linear and rotational accelerations recorded was similar to the impacts reported in studies of American junior and high school football, collegiate football, and youth ice hockey players, but the players in the rugby league cohort were younger, had less body mass, and played at a slower speed than the American players. Junior rugby league players are required to tackle the player to the ground and use a different tackle technique than that used in American football, likely increasing the rotational accelerations recorded at the head.

PMID: 27791705 [PubMed - as supplied by publisher]

http://ift.tt/2enHptI

Impact of intraoperative 3-T MRI with diffusion tensor imaging on hemispherectomy.

Related Articles

Impact of intraoperative 3-T MRI with diffusion tensor imaging on hemispherectomy.

J Neurosurg Pediatr. 2016 Oct 28;:1-7

Authors: Kim GH, Seo JH, Schroff S, Chen PC, Lee KH, Baumgartner J

Abstract
OBJECTIVE Hemispherectomy can produce remarkable seizure control of medically intractable hemispheric epilepsy in children, but some patients continue to have seizures after surgery. A frequent cause of treatment failure is incomplete surgical disconnection of the abnormal hemisphere. This study explores whether intraoperative 3-T MRI with diffusion tensor imaging (DTI) during hemispherectomy can identify areas of incomplete disconnection and allow complete disconnection during a single surgery. METHODS The charts of 32 patients with epilepsy who underwent hemispherectomy between January 2012 and July 2014 at the Florida Hospital for Children were reviewed. Patients were grouped as having had curative or palliative hemispherectomy. To assess the completeness of disconnection when the surgeon considered the operation completed, intraoperative 3-T MRI-DTI was performed. If incomplete disconnection was identified, additional surgery was performed until MRI-DTI sequences confirmed satisfactory disconnection. Seizure outcome data were collected via medical records at last follow-up. RESULTS Of 32 patients who underwent hemispherectomy, 23 had curative hemispherectomy and 9 had palliative hemispherectomy. In 11 of 32 surgeries, the first intraoperative MRI-DTI sequences suggested incomplete disconnection and additional surgery followed by repeat MRI-DTI was performed. Complete disconnection was accomplished in 30 of 32 patients (93.8%). Two of 32 disconnections (6.3%) were incomplete on postoperative imaging. Cross-sectional results showed that 21 of 23 patients (91.3%) who had curative hemispherectomy remained free of seizures (International League Against Epilepsy Class 1) at a median follow-up of 1.7 years (range 0.4-2.9 years). The longitudinal seizure freedom after curative hemispherectomy was 95.2% (SE 0.05) at 6 months, 90.5% (SE 0.06) at 1 year, and 90.5% (SE 0.05) at 2 years. CONCLUSIONS Intraoperative 3-T MRI-DTI sequences can identify incomplete disconnection during hemispherectomy and allow higher rates of complete disconnection in a single surgery. Higher rates of complete disconnection seem to achieve better seizure-free outcome following modified functional hemispherectomy.

PMID: 27791704 [PubMed - as supplied by publisher]

http://ift.tt/2enC0D7

Reconstruction of a large calvarial traumatic defect using a custom-made porous hydroxyapatite implant covered by a free latissimus dorsi muscle flap in an 11-year-old patient.

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Reconstruction of a large calvarial traumatic defect using a custom-made porous hydroxyapatite implant covered by a free latissimus dorsi muscle flap in an 11-year-old patient.

J Neurosurg Pediatr. 2016 Oct 28;:1-5

Authors: Morice A, Kolb F, Picard A, Kadlub N, Puget S

Abstract
Reconstruction of complex skull defects requires collaboration between neurosurgeons and plastic surgeons to choose the most appropriate procedure, especially in growing children. The authors describe herein the reconstruction of an extensive traumatic bone and soft tissue defect of the cranial vault in an 11-year-old boy. The size of the defect, quality of the tissues, and patient's initial condition required a 2-stage approach. Ten months after an initial emergency procedure in which lacerated bone and soft tissue were excised, reconstruction was performed. The bone defect, situated on the left frontoparietal region, was 85 cm(2) and was filled by a custom-made porous hydroxyapatite implant. The quality of the overlying soft tissue did not allow the use of classic local and locoregional coverage techniques. A free latissimus dorsi muscle flap branched on the contralateral superficial temporal pedicle was used and left for secondary healing to take advantage of scar retraction and to minimize alopecia. Stable well-vascularized implant coverage as well as an esthetically pleasing skull shape was achieved. Results in this case suggest that concomitant reconstruction of large calvarial defects by cranioplasty with a custom-made hydroxyapatite implant covered by a free latissimus dorsi muscle flap is a safe and efficient procedure in children, provided that there is no underlying infection of the operative site.

PMID: 27791703 [PubMed - as supplied by publisher]

http://ift.tt/2enCKIs

Hemispherotomy in children with electrical status epilepticus of sleep.

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Hemispherotomy in children with electrical status epilepticus of sleep.

J Neurosurg Pediatr. 2016 Oct 28;:1-7

Authors: Jeong A, Strahle J, Vellimana AK, Limbrick DD, Smyth MD, Bertrand M

Abstract
OBJECTIVE Electrical status epilepticus of sleep (ESES) is a rare electrographic pattern associated with global regression, which is often poorly responsive to traditional epilepsy treatments and can have a devastating and permanent neurocognitive outcome. The authors analyzed clinical, electroencephalographic, and neuropsychological outcomes in 9 patients with refractory ESES treated with functional hemispherotomy to illustrate the wide clinical spectrum associated with the disease and explore the role of hemispherotomy in its treatment. METHODS During the period between 2003 and 2015, 80 patients underwent hemispherotomy at the authors' institution. Video electroencephalography (EEG) reports were reviewed for ESES or continuous spikes and waves during sleep (CSWS). Patients with preoperative ESES (> 85% slow-wave sleep occupied by spike waves), a unilateral structural lesion amenable to surgery, and more than 6 months of follow-up data were included in the analysis. Clinical data, EEG recordings, neuropsychological testing, and parental and clinician reports were retrospectively reviewed. RESULTS Nine patients were eligible for study inclusion. Age at seizure onset ranged from birth to 4.2 years (mean 1.9 years), age at ESES diagnosis ranged from 3.5 to 8.8 years (mean 6.0 years), and age at hemispherotomy ranged from 3.7 to 11.5 years (mean 6.8 years). All patients had drug-resistant epilepsy. The duration of epilepsy prior to hemispherotomy ranged from 2.7 to 8.9 years (mean ± SD, 5.0 ± 2.2 years). Engel Class I seizure outcome was observed in all 9 children, with a mean follow-up of 3.0 years (range 0.5-6.1 years). Hemispherotomy terminated ESES in 6 of 6 patients with available postoperative sleep EEG. All children had preoperative neuropsychological impairments. Developmental regression was halted postoperatively, but none of the children returned to their original pre-ESES baseline. Four children demonstrated academic gains, 2 of whom transitioned to mainstream classes. CONCLUSIONS Children with drug-resistant ESES and a unilateral structural lesion should be evaluated for hemispherotomy as they may experience the cessation of seizures, termination of ESES, and improvement in neuropsychological status.

PMID: 27791702 [PubMed - as supplied by publisher]

http://ift.tt/2enHdux

Football fatalities: the first-impact syndrome.

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Football fatalities: the first-impact syndrome.

J Neurosurg Pediatr. 2016 Oct 28;:1-6

Authors: Bailes JE, Patel V, Farhat H, Sindelar B, Stone J

PMID: 27791701 [PubMed - as supplied by publisher]

http://ift.tt/2enD5uA

Does Shear Wave Elastography Provide Additional Value in the Evaluation of Thyroid Nodules That Are Suspicious for Malignancy?

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Does Shear Wave Elastography Provide Additional Value in the Evaluation of Thyroid Nodules That Are Suspicious for Malignancy?

J Ultrasound Med. 2016 Nov;35(11):2397-2404

Authors: Wang F, Chang C, Gao Y, Chen YL, Chen M, Feng LQ

Abstract
OBJECTIVES: We aimed to determine whether the integration of shear wave elastography (SWE) with conventional ultrasonography (US) improves diagnostic performance for suspicious thyroid lesions.
METHODS: For 215 thyroid lesions in 185 patients classified as Thyroid Imaging Reporting and Data System category 4 or 5 according to the findings of conventional US, SWE elasticity indices were automatically calculated. A receiver operating characteristic curve analysis was used to determine the threshold. Thyroid Imaging Reporting and Data System categories were upgraded for high-stiffness nodules and unchanged for low- and normal-stiffness nodules. The diagnostic performances were assessed and compared with histologic findings. Intraobserver and interobserver variability of SWE was assessed.
RESULTS: Elasticity indices were significantly higher in malignant versus benign nodules (P≤ .001). The minimum elasticity index (cutoff, 40.7 kPa) of the stiffest part combined with conventional US showed the highest area under the curve (0.774; 95% confidence interval, 0.682-0.866) but was not superior to conventional US (0.791; 95% confidence interval, 0.706-0.876; P = .48). Combined with the standard deviation of the elasticity index for the whole lesion (cutoff, 6.8 kPa), US yielded the highest sensitivity (95.5%; P < .001) and lowest specificity (42.1%; P < .001). Sensitivity increased and specificity decreased by adding any other SWE elasticity index. The intraobserver and interobserver reliability of SWE was fair to excellent according to the interclass correlation coefficients, with correlation coefficients of 0.765 to 0.846 (all P < .001).
CONCLUSIONS: The SWE elasticity indices of malignant thyroid nodules were significantly high. Adding SWE to conventional US did not improve diagnostic performance.

PMID: 27794130 [PubMed - in process]

http://ift.tt/2dSpIpX

Phase I Study of the Pan-PI3K Inhibitor Buparlisib in Adult Chinese Patients with Advanced Solid Tumors.

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Phase I Study of the Pan-PI3K Inhibitor Buparlisib in Adult Chinese Patients with Advanced Solid Tumors.

Anticancer Res. 2016 Nov;36(11):6185-6194

Authors: Wu YL, Zhang LI, Trandafir L, Dong T, Duval V, Hazell K, Xu B

Abstract
BACKGROUND/AIM: The phosphatidylinositol-3-kinase (PI3K) signaling pathway is frequently activated in cancer. Buparlisib (BKM120), an oral pan-PI3K inhibitor, inhibits proliferation of human cancer in preclinical models. Studies of buparlisib in Western and Japanese adults with advanced solid tumors established a recommended dose of 100 mg/day and showed an acceptable safety profile and evidence of efficacy. This phase I dose-escalation/expansion study aimed to establish the maximum tolerated dose (MTD) of single-agent, once daily oral buparlisib in Chinese patients with advanced solid tumors.
MATERIALS AND METHODS: Patients (n=32; primary tumor site: lung (n=15), breast (n=10) or head and neck (n=7); ≥2 prior lines of antineoplastic therapy (n=26)) received 80 mg (n=15) or 100 mg (n=17) daily buparlisib.
RESULTS: Five patients experienced dose-limiting toxicities: grade (G)3 depression (n=1), G2 hyperglycemia (n=3) and G3 hyperglycemia (n=1). Most frequent buparlisib-related adverse events were hyperglycemia (n=18; 56%), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase (n=9; 28%), as well as anxiety (n=6; 19%); most common buparlisib-related G3/4 adverse events: hyperglycemia (n=3; 9%), ALT and AST increase (n=2; 6%), as well as gamma-glutamyltransferase increase (n=2; 6%). Best response was stable disease (SD) in 10 patients (31%).
CONCLUSION: The MTD of buparlisib was declared as 100 mg/day. Safety, efficacy and pharmacokinetic data from this study were similar to those previously reported in Western and Japanese populations.

PMID: 27793950 [PubMed - in process]

http://ift.tt/2enFxRQ

The Behavior and Role of Lipolysis-stimulated Lipoprotein Receptor, a Component of Tricellular Tight Junctions, in Head and Neck Squamous Cell Carcinomas.

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The Behavior and Role of Lipolysis-stimulated Lipoprotein Receptor, a Component of Tricellular Tight Junctions, in Head and Neck Squamous Cell Carcinomas.

Anticancer Res. 2016 Nov;36(11):5895-5904

Authors: Takano K, Kakuki T, Obata K, Nomura K, Miyata R, Kondo A, Kurose M, Kakiuchi A, Kaneko Y, Kohno T, Himi T, Kojima T

Abstract
BACKGROUND/AIM: Lipolysis-stimulated lipoprotein receptor (LSR) knockdown has also been reported to increase the motility and invasiveness of certain cancer cells. Here, we describe, for the first time, the behavior and role of LSR in head and neck squamous cell carcinoma (HNSCC) in vivo and in vitro.
MATERIALS AND METHODS: Samples of HNSCC, normal palatine tonsils, the pharynx carcinoma cell line Detroit562 and primary cultured HNSCC were characterized by immunostaining, western blot, real-time polymerase chain reaction (PCR), Matrigel invasion and proliferation assays.
RESULTS: Protein and mRNA of LSR were strongly expressed, as well as claudin-1 in HNSCC tissues than in normal tissues, especially in invasive tissues. Knock-down of LSR and claudin-1 (CLDN-1), but not tricellulin (TRIC) by siRNAs, markedly induced invasiveness of Detroit562 cells and primary cultured HNSCC. LSR inhibited the development and progression of HNSCC.
CONCLUSION: LSR is a potential target for new forms of head and neck cancer therapy.

PMID: 27793914 [PubMed - in process]

http://ift.tt/2f1V6zu

Central odontogenic fibromyxoma of mandible: an aggressive odontogenic pathology.

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Central odontogenic fibromyxoma of mandible: an aggressive odontogenic pathology.

BMJ Case Rep. 2016 Oct 28;2016:

Authors: Bahl S, Raju GS, Shah G, Chandarana P

Abstract
Myxoma of the jaws which was first described by Thoma and Goldman in 1947 is a rare neoplasm and its rate of prevalence and incidence is not available. Myxoma term, according to 1992 WHO classification, is used along with odontogenic myxoma (OM) and myxofibroma. There are two forms of myxomas or fibromyxomas that are recognised in head and neck region: one is derived from the facial skeleton and the other is derived from the soft tissue. Most of the OM are located intraosseously, but peripheral ones are also recognised. OM behaves differently from myxomatous tumours of long bones, which recur more often and may transform into malignancy. A majority of these lesions occur between 2nd and 4th decade. In the pathogenesis of OM, dental papilla, dental follicle and periodontal ligament tissues have been implicated as possible 'germ centres'. This case describes an uncommon finding of central odontogenic fibromyxoma, throwing light on its epidemiology, clinical, histopathology, molecular and treatment aspects.

PMID: 27793851 [PubMed - in process]

http://ift.tt/2enFqpk

Ameloblastoma of the jaws: Management and recurrence rate.

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Ameloblastoma of the jaws: Management and recurrence rate.

Eur Ann Otorhinolaryngol Head Neck Dis. 2016 Oct 25;:

Authors: Laborde A, Nicot R, Wojcik T, Ferri J, Raoul G

Abstract
INTRODUCTION: Ameloblastoma is a rare, benign odontogenic tumour associated with a high recurrence rate. It accounts for 1% of all tumours of the jaws. The purpose of this study was to compare the ameloblastoma recurrence rate according to the type of treatment: radical or conservative.
PATIENTS AND METHODS: All patients with a diagnosis of ameloblastoma between 1991 and 2013 were retrospectively identified in order to extract topographic, radiological, and histological data and the type of treatment: conservative (marsupialization, enucleation, curettage) or radical (segmental resection) and to compare the recurrence rate according to the type of treatment.
RESULTS: Twenty-seven patients were included, managed by conservative treatment (CT) in 22 cases and radical treatment (RT) in 14 cases. The recurrence rate was 90.9% in the CT group and 9.1% in the RT group (P=0.025) with a mean follow-up of 56.2 months.
DISCUSSION: The recurrence rate after conservative treatment was higher than that after radical treatment. These results are similar to those reported in the literature. The choice of treatment must be adapted to the macroscopic and histological characteristics of each tumour and to the patient.

PMID: 27793625 [PubMed - as supplied by publisher]

http://ift.tt/2enEOA8

A panel of four genes accurately differentiates benign from malignant thyroid nodules.

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A panel of four genes accurately differentiates benign from malignant thyroid nodules.

J Exp Clin Cancer Res. 2016 Oct 28;35(1):169

Authors: Wang QX, Chen ED, Cai YF, Li Q, Jin YX, Jin WX, Wang YH, Zheng ZC, Xue L, Wang OC, Zhang XH

Abstract
BACKGROUND: Clinicians are confronted with an increasing number of patients with thyroid nodules. Reliable preoperative diagnosis of thyroid nodules remains a challenge because of inconclusive cytological examination of fine-needle aspiration biopsies. Although molecular analysis of thyroid tissue has shown promise as a diagnostic tool in recent years, it has not been successfully applied in routine clinical use, particularly in Chinese patients.
METHODS: Whole-transcriptome sequencing of 19 primary papillary thyroid cancer (PTC) samples and matched adjacent normal thyroid tissue (NT) samples were performed. Bioinformatics analysis was carried out to identify candidate diagnostic genes. Then, RT-qPCR was performed to evaluate these candidate genes, and four genes were finally selected. Based on these four genes, diagnostic algorithm was developed (training set: 100 thyroid cancer (TC) and 65 benign thyroid lesions (BTL)) and validated (independent set: 123 TC and 81 BTL) using the support vector machine (SVM) approach.
RESULTS: We discovered four genes, namely fibronectin 1 (FN1), gamma-aminobutyric acid type A receptor beta 2 subunit (GABRB2), neuronal guanine nucleotide exchange factor (NGEF) and high-mobility group AT-hook 2 (HMGA2). A SVM model with these four genes performed with 97.0 % sensitivity, 93.8 % specificity, 96.0 % positive predictive value (PPV), and 95.3 % negative predictive value (NPV) in training set. For additional independent validation, it also showed good performance (92.7 % sensitivity, 90.1 % specificity, 93.4 % PPV, and 89.0 % NPV).
CONCLUSIONS: Our diagnostic panel can accurately distinguish benign from malignant thyroid nodules using a simple and affordable method, which may have daily clinical application in the near future.

PMID: 27793213 [PubMed - in process]

http://ift.tt/2dSqALn

Subcellular localisation of pMEK has a different prognosis in locally advanced head and neck cancer treated with concomitant radiochemotherapy.

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Subcellular localisation of pMEK has a different prognosis in locally advanced head and neck cancer treated with concomitant radiochemotherapy.

BMC Cancer. 2016 Oct 28;16(1):829

Authors: Gomez-Millan J, Pajares B, Perez-Villa L, Carnero A, Alvarez M, De Luque V, Rivas F, Trigo JM, Toledo MD, Alba E, Medina JA

Abstract
BACKGROUND: MEK1 (MAP2K1) and MEK2 (MAP2K2) are closely related dual-specificity protein kinases which function by phosphorylating both serine/threonine and tyrosine residues of their substrates ERK1 and ERK2, controlling fundamental cellular processes that include cell growth and proliferation. To investigate the prognostic significance of pMEK expression in the nucleus and cytoplasm among patients with locally advanced head and neck cancer treated with concurrent radiochemotherapy.
METHODS: Immunohistochemistry was performed on the retrieved archival tissue of 96 patients to detect pMEK, p53 and Ki-67.
RESULTS: Sixty-six percent of patients were positive for pMEK expression in the nucleus and 41 % in cytoplasm. On univariate analysis, high nuclear pMEK was predictive of worse 5y-DFS and 5y-OS, with a trend to significance (26 % vs. 41 %, p = 0.09; 36 % vs. 47 %, p = 0.07). High cytoplasmic pMEK was predictive of better 5-y OS and 5-y DFS outcomes (61 % vs. 27 %, p = 0.01; 46 % vs. 22 %, p = 0.02). On multivariate analysis, low cytoplasmic pMEK and high nuclear pMEK predicted worse DFS and OS (p = 0.01; p = 0.04 and p = 0.02; p = 0.02 respectively).
CONCLUSIONS: Subcellular localisation of pMEK has different prognosis in locally advanced head and neck cancer treated with radiochemotherapy.

PMID: 27793200 [PubMed - in process]

http://ift.tt/2enFTaR

Detailed vascular anatomy of the medial femoral condyle and the significance of its use as a free flap.

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Detailed vascular anatomy of the medial femoral condyle and the significance of its use as a free flap.

J Plast Reconstr Aesthet Surg. 2016 Oct 5;:

Authors: Weitgasser L, Cotofana S, Winkler M, Buerger H, Jamnig D, Anderhuber F, Gaggl A

Abstract
OBJECTIVE: The aim of this study is to provide detailed information on the arterial variations of the descending geniculate artery (DGA) for the harvest of a cortico-periostal flap from the medial femoral condyle and a fascio-cutaneous perforator flap with its respective pedicles.
MATERIAL AND METHODS: A total of 50 lower limbs from embalmed cadavers were dissected. The distribution pattern, length, and diameter of the DGA, saphenous artery (SA), muscular, periostal, and articular branches, and their concomitant veins were measured and evaluated.
RESULTS: The DGA was present in 98% of the cases. In 80%, a Y-shaped distribution was identified where the SA branched from the DGA. Here, the mean lengths of DGA, SA, and the articular branch of the DGA were 3.2 ± 1.1, 7.18 ± 3.2, and 6.72 ± 2.07 cm, respectively. In 18%, an H-shaped distribution was noted, where the SA emerged directly from the femoral artery with a length of 10.2 ± 1.9 cm, whereas the length of the DGA (and its terminal articular branch) was 7.5 ± 1.5 cm. The mean length of the arterial pedicle for a cortico-periostal flap from the medial condyle was 9.92 cm, whereas for the fascio-cutaneous perforator flap, it was 9.46 cm in Y-shaped distribution and 10.2 cm for the H-shaped distribution.
CONCLUSION: Different arterial distribution patterns increase the need for routine preoperative vascular imaging when planning to harvest a cortico-periostal flap and a fascio-cutaneous perforator flap from the medial femoral condyle, especially when a double-chimeric flap is targeted.
LEVEL OF EVIDENCE: Level 4, case series.

PMID: 27793561 [PubMed - as supplied by publisher]

http://ift.tt/2f0ASXl

A pilot study demonstrating the feasibility of supermicrosurgical end-to-side anastomosis onto large recipient vessels in head and neck reconstruction.

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A pilot study demonstrating the feasibility of supermicrosurgical end-to-side anastomosis onto large recipient vessels in head and neck reconstruction.

J Plast Reconstr Aesthet Surg. 2016 Sep 28;:

Authors: Iida T, Yoshimatsu H, Yamamoto T, Koshima I

Abstract
In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent. We have introduced supermicrosurgical end-to-side anastomosis to such arteries in 12 cases of head and neck reconstruction. Double-needle, short-thread microsutures were used to facilitate this procedure, and indocyanine green intraoperative angiography was used to confirm patency. All patients, except one with partial necrosis, survived. We believe that our method is a safe and reliable option for cases in which there is a discrepancy between the flap pedicle and recipient arteries.

PMID: 27789210 [PubMed - as supplied by publisher]

http://ift.tt/2f0zPXG

Three-dimensional printing for restoration of the donor face: A new digital technique tested and used in the first facial allotransplantation patient in Finland.

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Three-dimensional printing for restoration of the donor face: A new digital technique tested and used in the first facial allotransplantation patient in Finland.

J Plast Reconstr Aesthet Surg. 2016 Oct 5;:

Authors: Mäkitie AA, Salmi M, Lindford A, Tuomi J, Lassus P

Abstract
BACKGROUND AND AIMS: Prosthetic mask restoration of the donor face is essential in current facial transplant protocols. The aim was to develop a new three-dimensional (3D) printing (additive manufacturing; AM) process for the production of a donor face mask that fulfilled the requirements for facial restoration after facial harvest.
MATERIALS AND METHODS: A digital image of a single test person's face was obtained in a standardized setting and subjected to three different image processing techniques. These data were used for the 3D modeling and printing of a donor face mask. The process was also tested in a cadaver setting and ultimately used clinically in a donor patient after facial allograft harvest.
RESULTS: and Conclusions: All the three developed and tested techniques enabled the 3D printing of a custom-made face mask in a timely manner that is almost an exact replica of the donor patient's face. This technique was successfully used in a facial allotransplantation donor patient.

PMID: 27789209 [PubMed - as supplied by publisher]

http://ift.tt/2f0Aus7

Belinostat and Vincristine demonstrate mutually synergistic cytotoxicity associated with mitotic arrest and inhibition of polyploidy in a preclinical model of aggressive diffuse large B cell lymphoma.

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Belinostat and Vincristine demonstrate mutually synergistic cytotoxicity associated with mitotic arrest and inhibition of polyploidy in a preclinical model of aggressive diffuse large B cell lymphoma.

Cancer Biol Ther. 2016 Oct 28;:0

Authors: Havas AP, Rodrigues KB, Bhakta A, Demirjian JA, Hahn S, Tran J, Scavello M, Tula-Sanchez AA, Zeng Y, Schmelz M, Smith CL

Abstract
Diffuse Large B-cell lymphoma (DLBCL) is an aggressive malignancy that has a 60 percent five-year survival rate, highlighting a need for new therapeutic approaches. Histone deacetylase inhibitors (HDACi) are novel therapeutics being clinically-evaluated in combination with a variety of other drugs. However, rational selection of companion therapeutics for HDACi is difficult due to their poorly-understood, cell-type specific mechanisms of action. To address this, we developed a pre-clinical model system of sensitivity and resistance to the HDACi belinostat using DLBCL cell lines. In the current study, we demonstrate that cell lines sensitive to the cytotoxic effects of HDACi undergo early mitotic arrest prior to apoptosis. In contrast, HDACi-resistant cell lines complete mitosis after a short delay and arrest in G1. To force mitotic arrest in HDACi-resistant cell lines, we used low dose vincristine or paclitaxel in combination with belinostat and observed synergistic cytotoxicity. Belinostat curtails vincristine-induced mitotic arrest and triggers a strong apoptotic response associated with downregulated MCL-1 expression and upregulated BIM expression. Resistance to microtubule targeting agents (MTAs) has been associated with their propensity to induce polyploidy and thereby increase the probability of genomic instability that enables cancer progression. Co-treatment with belinostat effectively eliminated a vincristine-induced, actively cycling polyploid cell population. Our study demonstrates that vincristine sensitizes DLBCL cells to the cytotoxic effects of belinostat and that belinostat prevents polyploidy that could cause vincristine resistance. Our findings provide a rationale for using low dose MTAs in conjunction with HDACi as a potential therapeutic strategy for treatment of aggressive DLBCL.

PMID: 27791595 [PubMed - as supplied by publisher]

http://ift.tt/2f0uW0z

Blocking NOTCH Pathway can Enhance the Effect of EGFR Inhibitor through Targeting CD133+ Endometrial Cancer Cells.

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Blocking NOTCH Pathway can Enhance the Effect of EGFR Inhibitor through Targeting CD133+ Endometrial Cancer Cells.

Cancer Biol Ther. 2016 Oct 28;:0

Authors: Shang C, Lang B, Meng LR

Abstract
ABSTACT Although the molecular therapeutics targeting key biomarkers such as epithelial growth factor receptor (EGFR), PI3K/AKT/mTOR, and vascular endothelial growth factor (VEGF) shows some success in clinical trials, some internally existing challenges in endothelial cancer biology hinder the drug effects. One of the major challenges stems from cancer stem cell-derived drug resistance. CD133 positive cells are well believed as cancer stem cells (CSC) in endometrial cancers and NOTCH pathway plays a critical role in retaining CD133+ cells by promoting CSC self-renewal and chemoresistance. Here, we initiated a therapeutic strategy to improve effects of EGFR inhibition by targeting NOTCH pathway of CD133+ cells in endometrial cancers. We first detected and purified the CD133+ cell fraction in endometrial cancer cell line Ishikawa (IK), and validated activation of NOTCH pathway in the CD133+ cells that have higher proliferation rate and lower apoptosis rate, comparing to CD133- cells. Results of nude mouse xenograft experiments further demonstrated CD133+ cells retain higher tumorigenesis capacity than CD133- cells, indicating their tumor-initiating property. Last, we applied both NOTCH inhibitor DAPT and EGFR inhibitor AG1478 treatment on endometrial cancer lines IK and HEC-1A and the results suggested improvement effects of the combination therapy compared to the treatments of DAPT or AG1478 alone. These findings indicated targeting NOTCH pathway in CD133+ cells, combining with EGFR inhibition, which provides a novel therapeutic strategy for endometrial cancer diseases.

PMID: 27791463 [PubMed - as supplied by publisher]

http://ift.tt/2eICoPF