Head and Neck Diseases by Alexandros G.Sfakianakis: 01/08/16

Παρασκευή 8 Ιανουαρίου 2016

Molecular aging of the mammalian vestibular system.

Molecular aging of the mammalian vestibular system.

Ageing Res Rev. 2015 Dec 28;

Authors: Brosel S, Laub C, Averdam A, Bender A, Elstner M

Abstract
Dizziness and imbalance frequently affect the elderly and contribute to falls and frailty. In many geriatric patients, clinical testing uncovers a dysfunction of the vestibular system, but no specific etiology can be identified. Neuropathological studies have demonstrated age-related degeneration of peripheral and central vestibular neurons, but the molecular mechanisms are poorly understood. In contrast, recent studies into age-related hearing loss strongly implicate mitochondrial dysfunction, oxidative stress and apoptotic cell death of cochlear hair cells. While some data suggest that analogous biological pathomechanisms may underlie vestibular dysfunction, actual proof is missing. In this review, we summarize the available data on the molecular causes of vestibular dysfunction.

PMID: 26739358 [PubMed - as supplied by publisher]

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Molecular aging of the mammalian vestibular system.

Molecular aging of the mammalian vestibular system.

Ageing Res Rev. 2015 Dec 28;

Authors: Brosel S, Laub C, Averdam A, Bender A, Elstner M

PMID: 26739358 [PubMed - as supplied by publisher]

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A marker placement laser device for improving repeatability in 3D-foot motion analysis

Publication date: February 2016
Source:Gait & Posture, Volume 44
Author(s): Eva Kalkum, Stefan van Drongelen, Johannes Mussler, Sebastian I. Wolf, Benita Kuni
BackgroundIn 3D gait analysis, the repeated positioning of markers is associated with a high error rate, particularly when using a complex foot model with many markers. Therefore, a marker placement laser device was developed that ensures a reliable repositioning of markers. We report the development and reliability of this device for the foot at different tape conditions.MethodsIn 38 subjects, markers were placed at the foot according to the Heidelberg foot measurement method. Subjects were tested barefoot and barefoot with three different tape conditions. For all conditions, a static standing trial was captured. We analyzed differences in distances between markers and the intra-class correlation coefficients (ICC).ResultsSmall differences between the conditions (0.03–3.28mm) and excellent ICCs (0.91–0.97mm) were found for all parameters.ConclusionThe laser marker placement device appeared to be a reliable method to place markers on a tape at previously palpated positions and ensures an exact position. The device could find a wide application in different clinical research fields.

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A marker placement laser device for improving repeatability in 3D-foot motion analysis

Publication date: February 2016
Source:Gait & Posture, Volume 44
Author(s): Eva Kalkum, Stefan van Drongelen, Johannes Mussler, Sebastian I. Wolf, Benita Kuni
BackgroundIn 3D gait analysis, the repeated positioning of markers is associated with a high error rate, particularly when using a complex foot model with many markers. Therefore, a marker placement laser device was developed that ensures a reliable repositioning of markers. We report the development and reliability of this device for the foot at different tape conditions.MethodsIn 38 subjects, markers were placed at the foot according to the Heidelberg foot measurement method. Subjects were tested barefoot and barefoot with three different tape conditions. For all conditions, a static standing trial was captured. We analyzed differences in distances between markers and the intra-class correlation coefficients (ICC).ResultsSmall differences between the conditions (0.03–3.28mm) and excellent ICCs (0.91–0.97mm) were found for all parameters.ConclusionThe laser marker placement device appeared to be a reliable method to place markers on a tape at previously palpated positions and ensures an exact position. The device could find a wide application in different clinical research fields.

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A marker placement laser device for improving repeatability in 3D-foot motion analysis

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POGZ truncating alleles cause syndromic intellectual disability.

POGZ truncating alleles cause syndromic intellectual disability.

Genome Med. 2016;8(1):3

Authors: White J, Beck CR, Harel T, Posey JE, Jhangiani SN, Tang S, Farwell KD, Powis Z, Mendelsohn NJ, Baker JA, Pollack L, Mason KJ, Wierenga KJ, Arrington DK, Hall M, Psychogios A, Fairbrother L, Walkiewicz M, Person RE, Niu Z, Zhang J, Rosenfeld JA, Muzny DM, Eng C, Beaudet AL, Lupski JR, Boerwinkle E, Gibbs RA, Yang Y, Xia F, Sutton VR

Abstract
BACKGROUND: Large-scale cohort-based whole exome sequencing of individuals with neurodevelopmental disorders (NDDs) has identified numerous novel candidate disease genes; however, detailed phenotypic information is often lacking in such studies. De novo mutations in pogo transposable element with zinc finger domain (POGZ) have been identified in six independent and diverse cohorts of individuals with NDDs ranging from autism spectrum disorder to developmental delay.
METHODS: Whole exome sequencing was performed on five unrelated individuals. Sanger sequencing was used to validate variants and segregate mutations with the phenotype in available family members.
RESULTS: We identified heterozygous truncating mutations in POGZ in five unrelated individuals, which were confirmed to be de novo or not present in available parental samples. Careful review of the phenotypes revealed shared features that included developmental delay, intellectual disability, hypotonia, behavioral abnormalities, and similar facial characteristics. Variable features included short stature, microcephaly, strabismus and hearing loss.
CONCLUSIONS: While POGZ has been associated with neurodevelopmental disorders in large cohort studies, our data suggest that loss of function variants in POGZ lead to an identifiable syndrome of NDD with specific phenotypic traits. This study exemplifies the era of human reverse clinical genomics ushered in by large disease-directed cohort studies; first defining a new syndrome molecularly and, only subsequently, phenotypically.

PMID: 26739615 [PubMed - in process]

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Virologists, start your poliovirus destruction!

I have worked on poliovirus for over thirty-six years, first as a posdoctoral fellow with David Baltimore in 1979, and then in my laboratory at Columbia University. The end of that research commences this year with the destruction of my stocks of polioviruses.

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Extensive Metoidioplasty as a Technique Capable of Creating a Compatible Analogue to a Natural Penis in Female Transsexuals

Abstract

Objective

To introduce the operative technique of "extensive metoidioplasty" (EM) in female transsexual surgery, for achieving an effective reconstruction of a male-appearing, normally functioning, fully sensate and erectile external genitalia.

Patients and Methods

Ten female transsexuals (46 xx karyotype) between the ages of 20 and 40 years underwent EM as their sex reassignment surgical procedure with the mean operative time of 171 min (45–211, SD 19.55 min) between 2007 and 2014 in a general hospital in Tehran, Iran. Subjects were closely followed for the mean time of 68.4 months. All participants were thoroughly rehearsed about the nature of their surgical procedure and an informed written consent was obtained before surgery. We extensively detached the native clitoris to the point of a nearly complete detachment from its attachments to the pubic arch and approximated the originally divergent corporal bodies to each other. We were also able to increase the penile size by the application of PEP, a procedure which is in practice at our clinic.

Results

Postoperatively all ten patients achieved a mean penile length of 8.7 (6–12) cm and 7/10 (70 %) were capable of obtaining erection, rigid enough for intromission. We did not observe any significant postoperative complications.

Conclusion

EM in association with the application of PEP could result in a natural-looking, erotically fully sensate and functional penis in majority of female transsexuals undergoing this procedure. This operative technique should be given serious considerations in well-informed female transsexual. Larger studies may be needed to validate this technique further.

Level of Evidence V

This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://ift.tt/18t7xNj.

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Molecular aging of the mammalian vestibular system.

Molecular aging of the mammalian vestibular system.

Ageing Res Rev. 2015 Dec 28;

Authors: Brosel S, Laub C, Averdam A, Bender A, Elstner M

PMID: 26739358 [PubMed - as supplied by publisher]

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Molecular aging of the mammalian vestibular system.

Molecular aging of the mammalian vestibular system.

Ageing Res Rev. 2015 Dec 28;

Authors: Brosel S, Laub C, Averdam A, Bender A, Elstner M

PMID: 26739358 [PubMed - as supplied by publisher]

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A marker placement laser device for improving repeatability in 3D-foot motion analysis

Publication date: February 2016
Source:Gait & Posture, Volume 44
Author(s): Eva Kalkum, Stefan van Drongelen, Johannes Mussler, Sebastian I. Wolf, Benita Kuni
BackgroundIn 3D gait analysis, the repeated positioning of markers is associated with a high error rate, particularly when using a complex foot model with many markers. Therefore, a marker placement laser device was developed that ensures a reliable repositioning of markers. We report the development and reliability of this device for the foot at different tape conditions.MethodsIn 38 subjects, markers were placed at the foot according to the Heidelberg foot measurement method. Subjects were tested barefoot and barefoot with three different tape conditions. For all conditions, a static standing trial was captured. We analyzed differences in distances between markers and the intra-class correlation coefficients (ICC).ResultsSmall differences between the conditions (0.03–3.28mm) and excellent ICCs (0.91–0.97mm) were found for all parameters.ConclusionThe laser marker placement device appeared to be a reliable method to place markers on a tape at previously palpated positions and ensures an exact position. The device could find a wide application in different clinical research fields.

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A marker placement laser device for improving repeatability in 3D-foot motion analysis

POGZ truncating alleles cause syndromic intellectual disability.

POGZ truncating alleles cause syndromic intellectual disability.

Genome Med. 2016;8(1):3

PMID: 26739615 [PubMed - in process]

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Odds are good that risky gambling choices are influenced by a single brain connection

One person's risky bet is another's exciting opportunity.The difference between those outlooks comes down to more than just disposition: It turns out that people with a stronger connection…

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Virologists, start your poliovirus destruction!

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Extensive Metoidioplasty as a Technique Capable of Creating a Compatible Analogue to a Natural Penis in Female Transsexuals

Abstract

Objective

Patients and Methods

Results

Conclusion

Level of Evidence V

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Evaluation of individually body weight adapted contrast media injection in coronary CT-angiography

Publication date: Available online 7 January 2016
Source:European Journal of Radiology
Author(s): Casper Mihl, Madeleine Kok, Sibel Altintas, Bas L.J.H. Kietselaer, Jakub Turek, Joachim E. Wildberger, Marco Das
ObjectivesContrast media (CM) injection protocols should be customized to the individual patient. Aim of this study was to determine if software tailored CM injections result in diagnostic enhancement of the coronary arteries in computed tomography angiography (CTA) and if attenuation values were comparable between different weight categories.Materials and Methods265 consecutive patients referred for routine coronary CTA were scanned on a 2nd generation dual-source CT. Group 1 (n=141) received an individual CM bolus based on weight categories (39–59kg; 60–74kg; 75–94kg; 95–109kg) and scan duration ('high-pitch: 1s; "dual-step prospective triggering": 7s), as determined by contrast injection software (Certegra™ P3T, Bayer, Berlin, Germany). Group 2 (n=124) received a standard fixed CM bolus; Iopromide 300mgI/ml; volume: 75ml; flow rate: 7.2ml/s. Contrast enhancement was measured in all proximal and distal coronary segments. Subjective and objective image quality was evaluated. Statistical analysis was performed using SPSS (IBM, version 20.0).ResultsFor group 1, mean attenuation values of all segments were diagnostic (>325HU) without statistical significant differences between different weight categories (p>0.17), proximal vs. distal: 449±65–373±58HU (39–59kg); 443±69–367±81HU (60–74kg); 427±59–370±61HU (75–94kg); 427±73–347±61HU (95–109kg). Mean CM volumes were: 55±6ml (39–59kg); 61±7ml (60–74kg); 71±8ml (75–94kg); 84±9ml (95–109kg). For group 2, mean attenuation values were not all diagnostic with differences between weight categories (p<0.01), proximal vs. distal: 611±142–408±69HU (39–59kg); 562±135–389±98HU (60–74kg); 481±83–329±81HU (75–94kg); 420±73–305±35HU (95–109kg). Comparable image noise and image quality were found between groups (p≥0.330).ConclusionsIndividually tailored CM injection protocols yield diagnostic attenuation and a more homogeneous enhancement pattern between different weight groups. CM volumes could be reduced for the majority of patients utilizing individualized CM bolus application.

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Activity-dependent regulation of calcium and ribosomes in the chick cochlear nucleus

Publication date: 1 March 2016
Source:Neuroscience, Volume 316
Author(s): C.L. Call, R.L. Hyson
Cochlea removal results in the death of 20–30% of neurons in the chick cochlear nucleus, nucleus magnocellularis (NM). Two potentially cytotoxic events, a dramatic rise in intracellular calcium concentration ([Ca²⁺]i) and a decline in the integrity of ribosomes are observed within 1h of deafferentation. Glutamatergic input from the auditory nerve has been shown to preserve NM neuron health by activating metabotropic glutamate receptors (mGluRs), maintaining both normal [Ca²⁺]i and ribosomal integrity. One interpretation of these results is that a common mGluR-activated signaling cascade is required for the maintenance of both [Ca²⁺]i and ribosomal integrity. This could happen if both responses are influenced directly by a common messenger, or if the loss of mGluR activation causes changes in one component that secondarily causes changes in the other. The present studies tested this common-mediator hypothesis in slice preparations by examining activity-dependent regulation of [Ca²⁺]i and ribosomes in the same tissue after selectively blocking group I mGluRs (1-Aminoindan-1,5-dicarboxylic acid (AIDA)) or group II mGluRs (LY 341495) during unilateral auditory nerve stimulation. Changes in [Ca²⁺]i of NM neurons were measured using fura-2 ratiometric calcium imaging and the tissue was subsequently processed for Y10B immunoreactivity (Y10B-ir), an antibody that recognizes a ribosomal epitope. The group I mGluR antagonist blocked the activity-dependent regulation of both [Ca²⁺]i and Y10B-ir, but the group II antagonist blocked only the activity-dependent regulation of Y10B-ir. That is, even when group II receptors were blocked, stimulation continued to maintain low [Ca²⁺]i, but it did not maintain Y10B-ir. These results suggest a dissociation in how calcium and ribosomes are regulated in NM neurons and that ribosomes can be regulated through a mechanism that is independent of calcium regulation.

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Clinical outcomes of melanoma brain metastases treated with stereotactic radiation and anti-PD-1 therapy

Anti-PD-1 therapy has demonstrated significant activity in metastatic melanoma. We report good local control and minimal neurotoxicity with the combination of nivolumab and stereotactic radiation in the management of melanoma brain metastases. Overall survival and distant brain metastases control appear improved.

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Quantification of diabetes consultations by the main primary health care nurse groups in Auckland, New Zealand

Brief Report
Barbara Daly, Bruce Arroll, Nicolette Sheridan, Timothy Kenealy, Robert Scragg
Primary Health Care Research Development, FirstView Article(s), 6 pages

Abstract

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Synthetic Bax-Anti Bcl 2 combination module actuated by super artificial hTERT promoter selectively inhibits malignant phenotypes of bladder cancer

Abstract

Background

The synthetic biology technology which enhances the specificity and efficacy of treatment is a novel try in biomedical therapy during recent years. A high frequency of somatic mutations was shown in the human telomerase reverse transcriptase (hTERT) promoter in bladder cancer, indicating that a mutational hTERT promoter might be a tumor-specific element for bladder cancer therapy. In our study, we aimed to construct a synthetic combination module driven by a super artificial hTERT promoter and to investigate its influence on the malignant phenotypes of bladder cancer.

Methods

The dual luciferase assay system was used to verify the driven efficiency and tumor-specificity of the artificial hTERT promoter and to confirm the relationship between ETS-1 and the driven efficiency of the artificial hTERT promoter. CCK-8 assay and MTT assay were used to test the effects of the Bax-Anti Bcl2 combination module driven by the artificial hTERT promoter on cell proliferation. Simultaneously, the cell apoptosis was detected by the caspase 3ELISA assay and the flow cytometry analysis after transfection. The results of CCK-8 assay and MTT assay were analyzed by ANOVA. The independent samples t-test was used to analyze other data.

Results

We demonstrated that the artificial hTERT promoter had a higher driven efficiency which might be regulated by transcription factor ETS-1 in bladder cancer cells, compared with wild-type hTERT promoter. Meanwhile, the artificial hTERT promoter showed a strong tumor-specific effect. The cell proliferation inhibition and apoptosis induction were observed in artificial hTERT promoter- Bax-Anti Bcl2 combination module -transfected bladder cancer 5637 and T24 cells, but not in the module -transfected normal human fibroblasts.

Conclusion

This module offers us a useful synthetic biology platform to inhibit the malignant phenotypes of bladder cancer in a more specific and effective way.

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Changes in Tumor Expression of HER2 and Hormone Receptors Status after Neoadjuvant Chemotherapy in 21,755 Patients from the Japanese Breast Cancer Registry

We confirmed that loss of HER2-positive status can occur after neoadjuvant treatment in patients with primary HER2-positive breast cancer. Our data strongly support the need for retest ER, PgR, HER2 of surgical sample after neoadjuvant therapy in order to accurately determine appropriate use of targeted therapy.

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Impact of Robotic Platforms on Surgical Approach and Costs in the Management of Morbidly Obese Patients with Newly Diagnosed Uterine Cancer

Abstract

Background

Minimally invasive surgery (MIS) is associated with decreased complication rates, length of hospital stay, and cost compared with laparotomy. Robotic-assisted surgery—a method of laparoscopy—addresses many of the limitations of standard laparoscopic instrumentation, thus leading to increased rates of MIS. We sought to assess the impact of robotics on the rates and costs of surgical approaches in morbidly obese patients with uterine cancer.

Methods

Patients who underwent primary surgery at our institution for uterine cancer from 1993 to 2012 with a BMI ≥40 mg/m2 were identified. Surgical approaches were categorized as laparotomy (planned or converted), laparoscopic, robotic, or vaginal. We identified two time periods based on the evolving use of MIS at our institution: laparoscopic (1993–2007) and robotic (2008–2012). Direct costs were analyzed for cases performed from 2009 to 2012.

Results

We identified 426 eligible cases; 299 performed via laparotomy, 125 via MIS, and 2 via a vaginal approach. The rates of MIS for the laparoscopic and robotic time periods were 6 % and 57 %, respectively. The rate of MIS was 78 % in this morbidly obese cohort in 2012; 69 % were completed robotically. The median length of hospital stay was 5 days (range 2–37) for laparotomy cases and 1 day (range 0–7) for MIS cases (P < 0.001). The complication rate was 36 and 15 %, respectively (P < 0.001). The rate of wound-related complications was 27 and 6 %, respectively (P < 0.001). Laparotomy was associated with the highest cost.

Conclusions

The robotic platform provides significant health and cost benefits by increasing MIS rates in this patient population.

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Imaging of tarsal navicular stress injury with a focus on MRI: A pictorial essay

Summary

Predominantly diagnosed in athletes, stress fracture of the tarsal navicular is becoming increasingly recognised by clinicians as a cause of midfoot pain. Delayed diagnosis can increase the significant morbidity associated with this condition. Consequently the role of MRI is increasing, given the potential to identify a stress reaction in the navicular prior to the development of a discrete stress fracture. It is necessary for radiologists to be familiar with the typical and atypical appearances of this important condition.

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Screen-detected breast carcinoma with macroscopic dystrophic calcification: A pictorial essay with radiolological pathological correlation

Summary

Breast calcifications are among the most common abnormal radiographic findings detected at screening mammography. This essay illustrates the clinico-pathological features of nine screen-detected breast carcinomas, which had benign-appearing macrocalcifications, as a radiographically dominant presenting feature. We aimed to demonstrate that benign-appearing calcifications within a breast lesion are not diagnostic of a benign process if the other imaging characteristics of the lesion are suspicious of malignancy.

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Melanoma Patient-Reported Quality of Life Outcomes Following Sentinel Lymph Node Biopsy, Completion Lymphadenectomy, and Adjuvant Interferon: Results from the Sunbelt Melanoma Trial

Abstract

Background

Quality of life (QOL) and physical condition (PC) outcomes after sentinel lymph node biopsy (SLNB), completion lymph node dissection (CLND), and adjuvant therapy with interferon alfa-2b (IFN) were evaluated in this study.

Methods

Self-reported QOL and PC scores were evaluated in patients enrolled in a prospective, multicenter, randomized, clinical trial evaluating adjuvant IFN. After SLN biopsy, patients with a positive SLN underwent CLND then were randomized to adjuvant IFN or observation. QOL and PC scores were compared between patients who underwent SLNB alone, CLND without IFN, and CLND with IFN. Time to return to baseline QOL and PC scores reported at the time of SLNB was recorded and compared.

Results

There were statistically significant differences in time to return to baseline QOL (p = 0.0018) and PC (p = 0.0018) scores across the three treatment groups. The time to return to baseline QOL and PC scores was similar for SLND and CLND alone. Differences in time to return to baseline QOL and PC were sustained when stratified by recurrence status but did not differ significantly for different lymph node regions. There was a delay in return to baseline QOL and PC condition scores that was sustained beyond the cessation of IFN therapy.

Conclusions

CLND is well-tolerated with a similar effect on self-reported QOL outcomes in both the short- and long-term compared with SLNB alone. IFN therapy is associated with worse QOL outcomes compared with SLNB and CLND, an effect that may be sustained following cessation of adjuvant IFN.

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Data supporting the structural and functional characterization of Thrombin-Activatable Fibrinolysis Inhibitor in breast cancer.

Data supporting the structural and functional characterization of Thrombin-Activatable Fibrinolysis Inhibitor in breast cancer.

Data Brief. 2015 Dec;5:981-9

Authors: Fawzy MS, Toraih EA

Abstract
The data in this paper is related to the research article entitled "Thrombin-activatable fibrinolysis inhibitor Thr325Ile polymorphism and plasma level in breast cancer: A pilot study" (Fawzy et al., 2015) [1]. Many emerging studies have begun to unravel the pathophysiologic role of the fibrinolytic system in breast cancer (BC) progression (Zorio et al., 2008) [2]. Activation of the fibrinolytic plasminogen/plasmin system results in degradation of protein barriers, thereby mediating cell migration essential for tumor growth, angiogenesis, and dissemination (Castellino and Ploplis, 2005) [3]. In the current study, in silico data analysis of Thrombin-Activatable Fibrinolysis Inhibitor (TAFI) gene and protein has been done. Data have been retrieved from several databases mentioned in details in the text. Determination and analysis of the structural and functional impact of TAFI and its expression could help elucidate the contribution of the TAFI pathway to acquired hemostatic dysfunction and will form the basis of potential therapeutic strategies to manipulate this pathway. An inhibition of TAFI (e.g. by FXI inhibitors) will offer the therapeutic possibilities to improve the decreased fibrinolysis and increase the efficiency of fibrinolytic therapy in thrombotic disorders including cancer.

PMID: 26740968 [PubMed]

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Author reply.

http:--linkinghub.elsevier.com-ihub-imag

Author reply.

Can J Ophthalmol. 2015 Oct;50(5):396

Authors: Iordanous Y, Sheidow TG

PMID: 26455980 [PubMed - indexed for MEDLINE]

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Intravitreal ranibizumab for treatment of fibrovascular pigment epithelial detachment in age-related macular degeneration.

Intravitreal ranibizumab for treatment of fibrovascular pigment epithelial detachment in age-related macular degeneration.

Can J Ophthalmol. 2015 Oct;50(5):395

Authors: Yolcu U, Tas A, Altun S

PMID: 26455979 [PubMed - indexed for MEDLINE]

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Final overall survival and safety analysis of OCEANS, a phase 3 trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent ovarian cancer.

Final overall survival and safety analysis of OCEANS, a phase 3 trial of chemotherapy with or without bevacizumab in patients with platinum-sensitive recurrent ovarian cancer.

Gynecol Oncol. 2015 Oct;139(1):10-6

Authors: Aghajanian C, Goff B, Nycum LR, Wang YV, Husain A, Blank SV

Abstract
OBJECTIVE: OCEANS is a randomized, placebo (PL)-controlled, phase 3 trial evaluating the efficacy and safety of bevacizumab combined with gemcitabine+carboplatin (GC) for patients with platinum-sensitive recurrent ovarian cancer (ROC). The study met its primary endpoint, demonstrating improved progression-free survival with GC+bevacizumab compared with GC+PL. Herein, we describe results of final overall survival (OS) and updated safety.
METHODS: Patients with recurrent platinum-sensitive ROC (recurring ≥6months after first-line platinum-based therapy) and measurable disease at baseline were randomized to receive GC+bevacizumab or GC+PL for 6-10cycles; PL or bevacizumab was then continued until disease progression. In this updated analysis, a Cox proportional hazards model was used to compare OS between the 2 treatment arms.
RESULTS: At the data cutoff date (July 19, 2013), 353 patients (72.9%) had died. Median follow-up for OS was 58.2months in the experimental arm and 56.4months in the control arm. Consistent with interim analyses, median OS was comparable between arms (GC+bevacizumab: 33.6months; GC+PL: 32.9months; hazard ratio=0.95; log-rank p=0.65), and was consistent across all examined patient subgroups. The frequency and severity of adverse events were consistent with previous analyses; no new safety concerns were identified.
CONCLUSIONS: Results from final OS analysis of the phase 3 OCEANS study showed no significant difference in OS for patients treated with GC+bevacizumab compared with GC+PL.

PMID: 26271155 [PubMed - indexed for MEDLINE]

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Ascites predicts treatment benefit of bevacizumab in front-line therapy of advanced epithelial ovarian, fallopian tube and peritoneal cancers: an NRG Oncology/GOG study.

Ascites predicts treatment benefit of bevacizumab in front-line therapy of advanced epithelial ovarian, fallopian tube and peritoneal cancers: an NRG Oncology/GOG study.

Gynecol Oncol. 2015 Oct;139(1):17-22

Authors: Ferriss JS, Java JJ, Bookman MA, Fleming GF, Monk BJ, Walker JL, Homesley HD, Fowler J, Greer BE, Boente MP, Burger RA

Abstract
OBJECTIVES: Predictive factors for efficacy of bevacizumab in advanced ovarian cancer have remained elusive. We investigated ascites both as a prognostic factor and as a predictor of efficacy for bevacizumab.
METHODS: Using data from GOG 0218, patients receiving cytotoxic therapy plus concurrent and maintenance bevacizumab were compared to those receiving cytotoxic therapy plus placebo. The presence of ascites was determined prospectively. Chi-square and Wilcoxon-Mann-Whitney tests compared baseline variables between subgroups. Survival was estimated by Kaplan-Meier method, and Cox proportional hazard models were used to evaluate independent prognostic factors and estimate their covariate-adjusted effects on survival.
RESULTS: Treatment arms were balanced with respect to ascites and other prognostic factors. Overall, 886 (80%) women had ascites, 221 (20%) did not. Those with ascites were more likely to have: poorer performance status (p<0.001); serous histology (p=0.012); higher baseline CA125 (p<0.001); and suboptimal cytoreduction (p=0.004). In multivariate survival analysis, ascites was prognostic of poor OS (Adjusted HR 1.22, 95% CI 1.00-1.48, p=0.045), but not PFS. In predictive analysis, patients without ascites treated with bevacizumab had no significant improvement in either PFS (AHR 0.81, 95% CI 0.59-1.10, p=0.18) or OS (AHR 0.94, 95% CI 0.65-1.36, p=0.76). Patients with ascites treated with bevacizumab had significantly improved PFS (AHR 0.71, 95% CI 0.62-0.81, p<0.001) and OS (AHR 0.82, 95% CI 0.70-0.96, p=0.014).
CONCLUSIONS: Ascites in women with advanced ovarian cancer is prognostic of poor overall survival. Ascites may predict the population of women more likely to derive long-term benefit from bevacizumab.

PMID: 26216729 [PubMed - indexed for MEDLINE]

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Fine-Needle Diathermy Guided by Angiography.

http:--pt.wkhealth.com-pt-pt-core-templa

Fine-Needle Diathermy Guided by Angiography.

Cornea. 2015 Sep;34(9):e29-30

Authors: Romano V, Steger B, Kaye SB

PMID: 26203758 [PubMed - indexed for MEDLINE]

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Comparing the effectiveness and costs of Bevacizumab to Ranibizumab in patients with Diabetic Macular Edema: a randomized clinical trial (the BRDME study).

Comparing the effectiveness and costs of Bevacizumab to Ranibizumab in patients with Diabetic Macular Edema: a randomized clinical trial (the BRDME study).

BMC Ophthalmol. 2015;15:71

Authors: Schauwvlieghe AM, Dijkman G, Hooymans JM, Verbraak FD, Hoyng CB, Dijkgraaf MG, Van Leeuwen R, Vingerling JR, Moll AC, Schlingemann RO

Abstract
BACKGROUND: The effectiveness of ranibizumab in the treatment of diabetic macular edema has been proven with large clinical trials. For bevacizumab only two clinical trials have been published and a head-to-head comparison is lacking to date. However, if proved non-inferior to ranibizumab, use of the off-label bevacizumab could reduce costs enormously without a loss in visual acuity. A cost-effectiveness study has been designed to substantiate this hypothesis.
AIM: To compare the effectiveness and costs of 1.25 mg of bevacizumab to 0.5 mg ranibizumab given as monthly intravitreal injections during 6 months in patients with diabetic macular edema. It is hypothesized that bevacizumab is non-inferior to ranibizumab regarding its effectiveness.
DESIGN: This is a randomized, controlled, double masked, clinical trial in 246 patients in seven academic trial centres in The Netherlands.
OUTCOMES: The primary outcome measure is the change in best-corrected visual acuity (BCVA) in the study eye from baseline to month 6. Secondary outcomes are the proportions of patients with a gain or loss of 15 letters or more or a BCVA of 20/40 or more at 6 months, the change in leakage on fluorescein angiography and the change in foveal thickness by optical coherence tomography at 6 months, the number of adverse events in 6 months, and the costs per quality adjusted life-year of the two treatments.

PMID: 26149170 [PubMed - indexed for MEDLINE]

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1-year results of combined half-dose photodynamic therapy and ranibizumab for polypoidal choroidal vasculopathy.

1-year results of combined half-dose photodynamic therapy and ranibizumab for polypoidal choroidal vasculopathy.

BMC Ophthalmol. 2015;15:66

Authors: Wong IY, Shi X, Gangwani R, Zhao P, Iu LP, Li Q, Ng A, Li X

Abstract
BACKGROUND: To evaluate the efficacy and safety of half-dose photodynamic therapy (PDT combined with ranibizumab for polypoidal choroidal vasculopathy (PCV). PCV is commonly treated with a combination of anti-vascular endothelial growth factor and standard-dose photodynamic therapy (PDT). Choroidal ischemia and visual loss can be resulted from the standard-dose PDT. Half-dose PDT has proved to produce similar results and safety profile in treating central serous chorioretinopathy. Half-dose PDT may offer an alternative for PCV cases where the damage to choroidal vasculature maybe less. Here, we report the efficacy of treating PCV cases with combination of ranibizumab and half-dose PDT.
METHODS: In this prospective, non-comparative, interventional case series, 19 treatment-naive eyes were treated with combined half-dose PDT and ranibizumab. All subjects were followed up for 12 months with measurement of best-corrected visual acuity (BCVA), central foveal thickness (CFT) by optical coherence tomography. Indocyanine green angiogram (ICG) was performed every 3-monthly, and subjects assessed in terms of polyp regression rates, changes in vision and central foveal thickness, need to repeat half-dose PDT. Subgroup analysis was performed based on ICG features.
RESULTS: The mean logMAR BCVA improved from 0.64 at baseline to 0.41 at 12 months. The mean CFT improved from 459.6 mum at baseline to 384.2 mum at 12 months. The difference between baseline BCVA and CFT and that at 12 months were statistically significant (both P = 0.03). Polyp regression rate after one half-dose PDT was 42.1 %. This was 61.5 % in the polyp-only group, while that in the branching-vascular-network (BVN) group was 0 % (P = < 0.01).
CONCLUSION: Half-dose PDT combined with intravitreal ranibizumab was able to induce high polyp regression rate in PCV cases that had one single polyp.

PMID: 26122636 [PubMed - indexed for MEDLINE]

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Pharmacologic evaluation of ammonium tetrathiomolybdate after intravenous and oral administration to healthy dogs.

Pharmacologic evaluation of ammonium tetrathiomolybdate after intravenous and oral administration to healthy dogs.

Am J Vet Res. 2015 May;76(5):445-53

Authors: Chan CM, Langlois DK, Buchweitz JP, Lehner AF, Olivier NB, Herdt TH, Bailie MB, Schall WD

Abstract
OBJECTIVE: To evaluate pharmacokinetics of ammonium tetrathiomolybdate (TTM) after IV and oral administration to dogs and effects of TTM administration on trace mineral concentrations.
ANIMALS: 8 adult Beagles and Beagle crossbreds (4 sexually intact males and 4 sexually intact females).
PROCEDURES: Dogs received TTM (1 mg/kg) IV and orally in a randomized crossover study. Serum molybdenum and copper concentrations were measured via inductively coupled plasma mass spectrometry in samples obtained 0 to 72 hours after administration. Pharmacokinetics was determined via noncompartmental analysis.
RESULTS: For IV administration, mean ± SD terminal elimination rate constant, maximum concentration, area under the curve, and half-life were 0.03 ± 0.01 hours(-1), 4.9 ± 0.6 μg/mL, 30.7 ± 5.4 μg/mL•h, and 27.7 ± 6.8 hours, respectively. For oral administration, mean ± SD terminal elimination rate constant, time to maximum concentration, maximum concentration, area under the curve, and half-life were 0.03 ± 0.01 hours(-1), 3.0 ± 3.5 hours, 0.2 ± 0.4 μg/mL, 6.5 ± 8.0 μg/mL•h, and 26.8 ± 8.0 hours, respectively. Oral bioavailability was 21 ± 22%. Serum copper concentrations increased significantly after IV and oral administration. Emesis occurred after IV (2 dogs) and oral administration (3 dogs).
CONCLUSIONS AND CLINICAL RELEVANCE: Pharmacokinetics for TTM after a single IV and oral administration was determined for clinically normal dogs. Absorption of TTM after oral administration was variable. Increased serum copper concentrations suggested that TTM mobilized tissue copper. Further studies will be needed to evaluate the potential therapeutic use of TTM in copper-associated chronic hepatitis of dogs.

PMID: 25909377 [PubMed - indexed for MEDLINE]

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Actinometric and Φ-order photodegradation properties of anti-cancer Sunitinib.

Actinometric and Φ-order photodegradation properties of anti-cancer Sunitinib.

J Pharm Biomed Anal. 2015 Jun 10;110:34-41

Authors: Maafi M, Lee LY

Abstract
The photodegradation reaction of Sunitinib (SUT), occurring via Z-E photoisomerisation, has been evaluated in this study using the recently developed Φ-order kinetics. In ethanol, the forward (Z → E) photoreaction of SUT was invariant with irradiation (its quantum yield, Φ(E-->Z)(λ)(irr) ≈ 0.019) in contrast to the E → Z isomerisation whose Φ(E-->Z)(λ)(irr) undergoes a 30-fold, sigmoid-shaped, increase with increasing irradiation wavelength. This situation limited usefully the extent of Z-SUT photodegradation at the photostationary state to a maximum of c.a. 30% of the initial concentration. Nevertheless, these results support a strong recommendation for a complete protection of SUT from light at all stages. Furthermore, a SUT-actinometer was developed and was proven to be useful for the 320-480 nm spectral range. The latter wavelength interval defined as well SUT photodegradation causative range. The formalism of Φ-order kinetics proves to be a useful investigative tool for drugs' photodegradation studies.

PMID: 25796061 [PubMed - indexed for MEDLINE]

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Kidney cancer in 2014: Key advances promise progress for kidney cancer patients.

Kidney cancer in 2014: Key advances promise progress for kidney cancer patients.

Nat Rev Urol. 2015 Feb;12(2):69-70

Authors: Ito T, Kutikov A

PMID: 25600094 [PubMed - indexed for MEDLINE]

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Utility of 18F-FDG PET/CT in the assessment of lymphoepithelioma-like carcinoma.

Utility of 18F-FDG PET/CT in the assessment of lymphoepithelioma-like carcinoma.

Nucl Med Commun. 2016 Jan 6;

Authors: Chan HY, Tsoi A, Wong MP, Ho JC, Lee EY

Abstract
Lymphoepithelioma-like carcinoma (LELC) is a rare Epstein-Barr virus (EBV)-related disease, which commonly originates from the lung and is associated with more favourable treatment outcomes compared with other non-LELC thoracic carcinomas. Radiological assessment utilizing fluorine-18 fluorodeoxyglucose PET combined with computed tomography (F-FDG PET/CT) is important for initial disease staging to tailor the treatment strategy, evaluation of treatment response and detection of disease recurrence. The aim of this article was to highlight the utility of F-FDG PET/CT in different stages of disease evaluation of LELC. We reviewed seven patients with histologically proven LELC who underwent F-FDG PET/CT for disease evaluation. We described the F-FDG-avidity of LELC (ranged from maximum standardized uptake value 7.6 to maximum standardized uptake value 14.5 in our series) and highlighted the clinical values of F-FDG PET/CT in different stages of disease evaluation. F-FDG PET/CT enables accurate evaluation of the primary tumour, its relationship with the surrounding structures and accurate staging. It is also useful in treatment response assessment to monitor the efficacy of the treatment and to decide upon treatment strategy. Given the F-FDG-avidity of LELC, F-FDG PET/CT is advantageous in detecting tumour recurrence of LELC. LELC is a rare disease entity associated with EBV and is more prevalent in Asia, where EBV is endemic. LELC is an F-FDG-avid tumour. Although the features on F-FDG PET/CT are not specific, F-FDG PET/CT provides valuable information for disease management of LELC.

PMID: 26741291 [PubMed - as supplied by publisher]

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The role of fluorine-18 fluorodeoxyglucose PET in prognosis evaluation for stem cell transplantation of lymphoma: a systematic review and meta-analysis.

The role of fluorine-18 fluorodeoxyglucose PET in prognosis evaluation for stem cell transplantation of lymphoma: a systematic review and meta-analysis.

Nucl Med Commun. 2016 Jan 6;

Authors: Wang C, Li P, Wu S, Lu J, Liu Q, Luo H, Song S

Abstract
The role of fluorine-18 fluorodeoxyglucose PET (F-FDG PET) in prognostic evaluation of pre-stem cell transplantation (SCT) and post-SCT is still uncertain. A systematic review and meta-analysis were carried out to detect the prognostic power of F-FDG PET. 'PubMed', EMBASE, and Springer were searched for relevant articles. Subgroup analysis was carried out to evaluate the F-FDG PET in predicting the prognosis between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma. Finally, 17 studies that included 1192 patients were eligible, 16 studies for progression-free survival (PFS) and 12 studies for overall survival (OS). For the pre-SCT PET or PET/computed tomography scan, the combined hazard ratios (HRs) of PET for PFS and OS were 2.32 and 2.64, respectively. Subgroup analysis showed that the HRs of PFS for HL and non-Hodgkin lymphoma were 3.28 and 2.00, respectively. For the post-SCT PET scan, the combined HR for PFS was 4.61. The sensitivity analysis showed that exlcusion of any single study had no significant effect on HR. We found that F-FDG PET was especially effective in predicting pre-STC and post-STC prognosis. The patients with a negative PET scan had a better prognosis compared with those with a positive scan in PFS and OS. In the subgroup analysis, F-FDG PET had a higher value in predicting prognosis before SCT for HL patients.

PMID: 26741290 [PubMed - as supplied by publisher]

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Occurrence of typical perfusion defects attributed to jailed or occluded side branch after ramus descendens anterior stenting in a patient cohort referred for 13NH3 myocardial PET/CT.

Occurrence of typical perfusion defects attributed to jailed or occluded side branch after ramus descendens anterior stenting in a patient cohort referred for 13NH3 myocardial PET/CT.

Nucl Med Commun. 2016 Jan 6;

Authors: Kan H, Knol RJ, Lazarenko SV, Wondergem M, Van der Zant FM

Abstract
AIM: Coronary stenting is frequently accompanied by occlusion or jailing of side branches. This can cause small reversible or persistent perfusion defects on myocardial perfusion single photon emission computed tomography studies, but data from NH3 myocardial perfusion PET/computed tomography (CT) are lacking. This study aimed to describe the occurrence of perfusion defects in patients with ramus descendes anterior (RDA) stents on myocardial perfusion imaging as measured by NH3 PET/CT.
METHODS: From 10 September 2013 till 29 August 2014, 53 consecutive RDA-stented patients, who were referred for NH3 PET/CT, were entered into a database. All scans were evaluated for the occurrence of reversible or persisting perfusion defects within the RDA flow territory, which was categorized as normal, infarction, ischemia, or as a small persisting defect after stent placement or small area of ischemia after stent placement, attributable to side-branch occlusion (SBO).
RESULTS: Of the 53 patients [65±10 years, male : female 33 (62%) : 20 (38%)] with an RDA stent, 29 had received a stent in the proximal RDA, 18 in the mid-RDA, and six in both the proximal and the mid-RDA.NH3-measured myocardial perfusion was scored as normal in 26 (49%), as infarction in 5 (9%), and as ischemia in 2 patients (4%). Six patients (11%) showed a small persisting defect within the RDA flow territory, whereas 14 patients (26%) showed a small area of ischemia in the RDA territory.
CONCLUSION: myocardial perfusion abnormalities attributed to SBO are frequently observed on NH3 PET/CTs of patients with RDA stents. In the present cohort, 38% of patients showed such small defects in the RDA territory, which proved to be reversible in 70% of the cases. Recognizing and reporting SBO-related perfusion abnormalities will help clinicians to interpret NH3 myocardial PET/CT properly.

PMID: 26741289 [PubMed - as supplied by publisher]

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Profiling the Behavior of Distinct Populations of Head and Neck Cancer Stem Cells.

Profiling the Behavior of Distinct Populations of Head and Neck Cancer Stem Cells.

Cancers (Basel). 2016;8(1)

Authors: Almeida LO, Guimarães DM, Squarize CH, Castilho RM

Abstract
Cancer stem cells (CSCs) are a subpopulation of tumor cells endowed with self-renewal properties and the capacity to dynamically adapt to physiological changes that occur in the tumor microenvironment. CSCs play a central role in resistance to therapy and long-term disease recurrence. Better characterization and understanding of the available in vitro tools to study the biology of CSCs will improve our knowledge of the processes underlying tumor response to therapy, and will help in the screening and development of novel strategies targeting CSCs. We investigated the behavior of different populations of head and neck CSCs grown under ultra-low adhesion conditions. We found that invasion and adhesion differ among tumorsphere subtypes (holospheres, merospheres and paraspheres), and their tumor cell progeny also harbor distinct self-renewal and clonogenic potentials. Furthermore, holospheres contained higher numbers of head and neck CSCs, as detected by the CD44 cancer stem cell marker and aldehyde dehydrogenase (ALDH) enzymatic activity. In addition, holospheres showed reduced proliferation (Ki67), hypoacetylation of histones, and increased expression of the BMI-1 epithelial stem cell marker, suggesting activation of stem cell programs. Collectively, our results suggest that holospheres enrich a specific population of CSCs with enhanced "stemness" and invasive potential.

PMID: 26742076 [PubMed - as supplied by publisher]

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Commentary on "The View from Outside".

Commentary on "The View from Outside".

South Med J. 2016 Jan;109(1):23

Authors: Holt GR

PMID: 26741868 [PubMed - as supplied by publisher]

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Isolation and Localization of Mesenchymal Stem Cells in Human Palatine Tonsil by W5C5 (SUSD2).

Isolation and Localization of Mesenchymal Stem Cells in Human Palatine Tonsil by W5C5 (SUSD2).

Cell Physiol Biochem. 2016 Jan 8;38(1):83-93

Authors: Lee BJ, Kang DW, Park HY, Song JS, Kim JM, Jang JY, Lee JC, Wang SG, Jung JS, Shin SC

Abstract
BACKGROUND/AIMS: Although tonsil-mesenchymal stem cells (T-MSCs) have been studied as a new autologous or homologous source of MSCs, research on specific markers of MSCs and localization for purified T-MSC isolation has not yet been reported. This study investigates the expression of W5C5 (SUSD2) in tonsil stromal cells and the colony-forming ability and differentiation potential of W5C5+ cells to determine the usefulness of W5C5+ MSCs as a marker that can be used for the purification of T-MSCs. In addition, the location of W5C5+ cells expressed in the tonsil tissues is examined.
METHODS: T-MSCs were isolated from the tonsillar tissues of 12 patients undergoing tonsillectomy. The colony-forming ability, surface markers, proliferation potential, and differentiation capacities of purified W5C5+ MSCs, W5C5- MSCs, and unselected T-MSCs were evaluated. The location of the W5C5+ cells in the tonsillar tissues was also investigated by immunohistochemistry.
RESULTS: W5C5 was expressed in 2.5±0.4% of fresh human tonsil stromal cells. W5C5+ cells formed many colonies, but W5C5- cells did not form any colonies. The colony-forming number of W5C5+ cells (74.4 ± 9.8) was significantly higher than that of unselected tonsil stromal cells (23.6 ± 3.7). However, the differences in proliferation potential, surface marker expression, and differentiation potential between W5C5+ T-MSCs and unselected T-MSCs were not significant. W5C5+ cells were identified in the perivascular area around the blood vessels.
CONCLUSION: W5C5+ T-MSCs possessed typical MSC properties with high colony-forming efficiency, and niches of W5C5+ T-MSCs were located in the perivascular area of tonsil tissues. These findings suggest that W5C5 is a useful single marker for the isolation of purified T-MSCs.

PMID: 26741828 [PubMed - as supplied by publisher]

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Association Between HbA1c Level and Hearing Impairment in a Nondiabetic Adult Population.

Association Between HbA1c Level and Hearing Impairment in a Nondiabetic Adult Population.

Metab Syndr Relat Disord. 2016 Jan 7;

Authors: Kang SH, Jung DJ, Cho KH, Park JW, Lee KY, Do JY

Abstract
BACKGROUND: The aim of this study was to investigate whether glycosylated hemoglobin (HbA1c) level in nondiabetic patients is associated with hearing impairment in the general Korean population.
PATIENTS AND METHODS: Data from the Korean National Health and Nutrition Examination Survey 2011-2013 were used in the analyses. Participants were excluded from this study for the following reasons: they could not provide data regarding pure tone audiometry, they had ear disease, they had brain disorders, asymmetric sensory neural hearing loss (HL), or they were younger than 40 years or had diabetes mellitus. Finally, 7449 participants were included in this study.
RESULTS: The mean HbA1c levels in the low, middle, and high tertiles were 5.3% ± 0.2%, 5.7% ± 0.1%, and 6.1% ± 0.2%, respectively. The numbers of participants in the low, middle, and high tertiles were 2808, 2509, and 2132, respectively. The low-frequency, mid-frequency, high-frequency, and average hearing thresholds were significantly increased with increasing HbA1c tertile. Linear regression analyses showed that HbA1c level in the nondiabetic participants was associated with components of metabolic syndrome. The mean numbers of metabolic syndrome components in the low, middle, and high HbA1c tertiles were 1.22, 1.53, and 2.02, respectively. The participants in the middle and high HbA1c tertiles had a 1.239- and 1.253-fold increased risk of HL, respectively, compared with those in the low HbA1c tertile.
CONCLUSION: HbA1c level was associated with hearing impairment in the nondiabetic participants of this study. Therefore, the participants with high HbA1c levels should be closely monitored for hearing impairment.

PMID: 26741701 [PubMed - as supplied by publisher]

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The Influence of Nebulized Drugs on Nasal Ciliary Activity.

The Influence of Nebulized Drugs on Nasal Ciliary Activity.

J Aerosol Med Pulm Drug Deliv. 2016 Jan 7;

Authors: Boon M, Jorissen M, Jaspers M, Augustijns P, Vermeulen FL, Proesmans M, De Boeck K

Abstract
INTRODUCTION: Nebulized drugs are used in the treatment of cystic fibrosis (CF) lung disease, asthma, and COPD, and increasingly also in other chronic lung diseases. Their use in CF is reasonably evidence based, but this is not so for use in other orphan diseases. Potential side effects often have not been studied. Therefore, we evaluated the influence of nebulized drugs on ciliary activity in an in vitro model.
METHODS: We constructed an in vitro nebulization model to examine the effect of drugs on ciliary activity. The model was validated by testing solutions with known neutral, positive, or negative effect on ciliary beat frequency (CBF). Next, the influence on CBF of other inhaled drugs was tested.
RESULTS: Nebulization of NaCl 0.9% had no influence on CBF, and was used as paired neutral control in further experiments. Salbutamol (Ventolin(®)) had a ciliostimulatory effect (CBF +18%, CBF at t0-t10-t60 7.1-8.5-8.6 Hz, p = 0.002), while hypertonic saline (CBF - 11%, CBF at t0-t10-t60 6.5-5.1-5.9 Hz, p = 0.018) and dry air (CBF -10%, CBF at t0-t10-t60 6.8-5.8-6.1 Hz, p = 0.008) had a cilioinhibitory effect. Nebulization of tobramycin inhaled solution (TOBI(®)) (p = 0.662), colistimethate (Colistineb(®)) (p = 0.369), rhDNAse (Pulmozyme(®)) (p = 0.069), ceftazidim (Glazidim(®)) (p = 0.875), and aztreonam (Cayston(®)) (p = 0.435) did not affect CBF. Obracin(®), a tobramycin containing solution manufactured for intravenous use, had a negative effect on CBF (CBF - 21%, CBF at t0-t10-t60 6.9-5.2-4.5 Hz, p = 0.004).
CONCLUSION: Inhaled drugs that are used off-label might have an influence on ciliary activity. This must be taken into account when prescribing these drugs for non-CF indications.

PMID: 26741301 [PubMed - as supplied by publisher]

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An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma.

An extremely rare case of thyroid malignancy from the non-Alpine region: Angiosarcoma.

Int J Surg Case Rep. 2015 Dec 23;19:92-96

Authors: Bayır Ö, Yılmazer D, Ersoy R, Akca Y, Saylam G, Han Ü, Özdek A, Çakır B, Korkmaz MH

Abstract
INTRODUCTION: Thyroid angiosarcoma is a rather rare malignancy featuring a poor prognosis, and which may interfere with other aggressive thyroid tumors; it is usually seen in the Alpine region.
CASE PRESENTATION: A 74-year-old male was referred to our center with complaints of progressive neck swelling and dyspnea. He had multiple nodules featuring cystic degeneration and calcifications in the thyroid gland, together with multiple lymphadenopathies of the neck region. Fine-needle aspiration cytology (FNAC) confirmed the presence of anaplastic carcinoma. A total thyroidectomy was performed. During the postoperative period, multiple drainage were performed for recurrent hematomas, but hematoma development could not be prevented. On postoperative day 7, the patient died due to multiple-system failure. Histopathological investigation of the thyroidectomy specimen indicated that the lesion was an angiosarcoma.
DISCUSSION: The cytological diagnosis of thyroid angiosarcoma is quite difficult. Extracapsular invasion and distant organ metastasis during surgery are known as strong and negative prognostic factors for thyroid angiosarcoma. Treatment is quite difficult, since this tumor is locally aggressive, destructive, and features a high recurrence rate. In this case, since extracapsular invasion, as well as lymph node and lung metastasis were present at the time of surgery; the expected survival time was quite short.
CONCLUSION: This case shows that during differential diagnosis, patients initially diagnosed with anaplastic carcinoma via FNAC may actually present with angiosarcoma. It may be helpful to review the treatment modalities for this cancer type, which has a rather poor prognosis and features severe bleeding, as well as local and distant metastasis.

PMID: 26741273 [PubMed - as supplied by publisher]

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Παρασκευή 8 Ιανουαρίου 2016

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Level of Evidence V

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Objective

Patients and Methods

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Level of Evidence V

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Background

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Summary

Abstract

Background

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