Laryngology litigation in the United States: Thirty years in review

Objectives/Hypothesis

Malpractice claims pertaining to laryngology procedures are a potentially important source of information that could be used to minimize the risk of future litigation and improve patient care.

Study Design

A retrospective review of two publicly available databases containing jury verdicts and settlements.

Methods

The LexisNexis Jury Verdicts and Settlements and WestlawNext legal databases were reviewed for all lawsuits and out-of-court adjudications related to the practice of laryngology. Data including patient demographics, type of surgery performed, plaintiff allegation, nature of injury, outcomes, and indemnities were collected and analyzed.

Results

Of 87 cases meeting inclusion criteria, 56 were decided by a jury and 31 were adjudicated out of court. Vocal cord surgery was the most commonly litigated surgery. The two most commonly cited legal allegations were physical injury and negligence. No statistical difference for legal outcome was found when death or vocal cord injuries occurred. Complications in procedures that utilized a laser predicted an unfavorable outcome (P = 0.013). A payout was made in over one-half of cases, but defendants were favored in over two-thirds of cases decided by a jury. The average indemnities were significant for both jury verdicts ($4.6 million) and out-of-court settlements ($0.9 million).

Conclusion

An awareness of laryngology malpractice litigation has the potential to provide better patient care and help laryngologists avoid potential risks for litigation. The factors determining legal responsibility in laryngology cases underscore the importance of close communication with anesthesiologists and careful evaluation of hoarseness in all patients regardless of risk factors.

Level of Evidence

N/A. Laryngoscope, 2015

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Mammakarzinom früh diagnostizieren

Tumornachweis über den Urin?
Um Brustkrebs anhand von Urinproben nachzuweisen, setzen Freiburger Senologen auf Mikro-RNA.

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Nuclear rumours delay India’s bid for neutrino glory

Rumours frustrate physicists in a global competition to understand elusive particles.

Nature 529 140 doi: 10.1038/529140a

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Cancer blood test venture faces technical hurdles

A major player's entry into DNA-based detection of emerging tumours will test the technology's potential.

Nature News doi: 10.1038/nature.2016.19152

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Two-stage optical system for colorectal polyp assessments

Abstract

Background and aims

Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.

Methods

The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.

Results

Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09 %, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79 %, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12 %, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100 %.

Conclusions

Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.

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Relation between soft tissue and skeletal changes after mandibular setback surgery: A systematic review and meta-analysis

Publication date: Available online 12 January 2016
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Eleftherios G. Kaklamanos, Olga-Elpis Kolokitha
Accurate prediction of hard and soft tissue changes is essential in orthognathic surgery. The aim of the present study was to systematically investigate the relation between soft and hard tissue relocation after mandibular setback surgery. A systematic search was performed, correlation coefficients and ratios were retrieved from the eligible studies, and the risk of bias was assessed. The random effects method was used to combine data. The five eligible studies showed that sagittal changes in pogonion, point B, and incision inferius incisalis are highly correlated with respective soft tissue movements and exhibit ratios ranging from 0.915 to 1.051. Only two studies were classified as having a moderate risk of bias. Although the characteristics of the included data limit the formation of definite conclusions, the soft to hard tissue movement ratios produced constitute initial clinically relevant guidance. Further long-term standardized and well-conducted trials are needed.

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Astragalar and calcaneal morphology of the middle Eocene primate Anchomomys frontanyensis (Anchomomyini): Implications for early primate evolution

Publication date: February 2016
Source:Journal of Human Evolution, Volume 91
Author(s): Judit Marigó, Imma Roig, Erik R. Seiffert, Salvador Moyà-Solà, Doug M. Boyer
Astragali and calcanei of Anchomomys frontanyensis, a small adapiform from the middle Eocene of Sant Jaume de Frontanyà (Southern Pyrenean basins, northeastern Spain) are described in detail. Though these bones have been known for some time, they have never been carefully analyzed in a context that is comprehensively comparative, quantitative, considers sample variation (astragalus n = 4; calcaneus n = 16), and assesses the phylogenetic significance of the material in an explicit cladistic context, as we do here. Though these bones are isolated, regression analyses provide the first formal statistical support for attribution to A. frontanyensis. The astragalus presents features similar to those of the small stem strepsirrhine Djebelemur from the middle Eocene of Tunisia, while the calcaneus more closely resembles those of the basal omomyiform Teilhardina. The new phylogenetic analyses that include Anchomomys' postcranial and dental data recover anchomomyins outside of the adapiform clade, and closer to djebelemurids, azibiids, and crown strepsirrhines. The small size of A. frontanyensis allows comparison of similarly small adapiforms and omomyiforms (haplorhines) such that observed variation has more straightforward implications for function. Previous studies have demonstrated that distal calcaneal elongation is reflective of leaping proclivity when effects of body mass are appropriately accounted for; in this context, A. frontanyensis has calcaneal elongation suggesting a higher degree of leaping specialization than other adapiforms and even some early omomyiforms. Moreover, comparison to a similarly-sized early adapiform from India, Marcgodinotius (which shows no calcaneal elongation) confirms that high distal calcaneal elongation in A. frontanyensis cannot be simply explained by allometric effects of small size compared to larger adapiform taxa. This pattern is consistent with the idea that significant distal calcaneal elongation evolved at least twice in early euprimates, and that early primate niche space frequently included demands for increased leaping specialization.

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Mechanisms of MicroRNA Deregulation and MicroRNA Targets in Gastric Cancer

Oncol Res Treat

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Synthetic cannabinoids: In silico prediction of the cannabinoid receptor 1 affinity by a quantitative structure-activity relationship model

Publication date: Available online 12 January 2016
Source:Toxicology Letters
Author(s): Alexander Paulke, Ewgenij Proschak, Kai Sommer, Janosch Achenbach, Cora Wunder, Stefan W. Toennes
The number of new synthetic psychoactive compounds increase steadily. Among the group of these psychoactive compounds, the synthetic cannabinoids (SCBs) are most popular and serve as a substitute of herbal cannabis. More than 600 of these substances already exist. For some SCBs the in vitro cannabinoid receptor 1 (CB1) affinity is known, but for the majority it is unknown.A quantitative structure-activity relationship (QSAR) model was developed, which allows the determination of the SCBs affinity to CB1 (expressed as binding constant (Ki)) without reference substances. The chemically advance template search descriptor was used for vector representation of the compound structures. The similarity between two molecules was calculated using the Feature-Pair Distribution Similarity. The Ki values were calculated using the Inverse Distance Weighting method. The prediction model was validated using a cross validation procedure.The predicted Ki values of some new SCBs were in a range between 20 (considerably higher affinity to CB1 than THC) to 468 (considerably lower affinity to CB1 than THC).The present QSAR model can serve as a simple, fast and cheap tool to get a first hint of the biological activity of new synthetic cannabinoids or of other new psychoactive compounds.

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Hexabromocyclododecane (HBCD) induced changes in the liver proteome of eu- and hypothyroid female rats

Publication date: Available online 12 January 2016
Source:Toxicology Letters
Author(s): I. Miller, T. Serchi, S. Cambier, C. Diepenbroek, J. Renaut, J.H.J. Van der Berg, C. Kwadijk, A.C. Gutleb, E. Rijntjes, A.J. Murk
Hexabromocyclododecane (HBCD) is a brominated flame retardant known for its low acute toxicity as observed in animal experiments. However, HBCD exposure can affect liver functioning and thyroid hormone (TH) status. As exact mechanisms are unknown and only limited toxicological data exists, a gel-based proteomic approach was undertaken. In a eu- and hypothyroid female rat model, rats were exposed to 3 and 30mg/kg bw/day HBCD for 7 days via their diet, and exposure was related to a range of canonical endpoints (hormone status, body weight) available for these animals. Alterations in the liver proteome under HBCD exposure were determined in comparison with patterns of control animals, for both thyroid states. This revealed significantly changed abundance of proteins involved in metabolic processes (gluconeogenesis/glycolysis, amino acid metabolism, lipid metabolism), but also in oxidative stress responses, in both euthyroid and hypothyroid rats. The results provide a more detailed picture on the mechanisms involved in these alterations, e.g. at the protein level changes of the proposed influence of HBCD on the lipid metabolism. Present results show that proteomic approaches can provide further mechanistic insights in toxicological studies.

Graphical abstract

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Initial experience of laparoscopic pelvic exenteration and comparison with conventional open surgery

Abstract

Background

Generalization of laparoscopic pelvic surgery has brought about profound knowledge of the pelvic anatomy and has encouraged expansion of indications for laparoscopic surgery to extended pelvic surgery. Pelvic exenteration (PE) is still a demanding surgical procedure and remains an essential technique for pelvic surgery although minimally invasive and function-preserving surgery is in the mainstream of surgical treatment. However, the techniques of laparoscopic PE (LPE) have been rarely explained nor has its feasibility been fully evaluated. The aim of this study was to describe important technical points and to assess the feasibility of LPE for pelvic malignancies.

Methods

Data on 67 patients with pelvic malignancies, who underwent PE between June 2006 and August 2014, were analyzed retrospectively. LPE has been indicated since 2013. Patients were divided into the LPE group (n = 9) and the conventional open PE (OPE) group (n = 58).

Results

Operative time in the LPE and OPE groups was similar (935 vs. 883 min, p = 0.398). Intraoperative blood loss in the LPE group was significantly less than that in the OPE group (830 vs. 2769 ml, p = 0.003). Pathological R0 resection rate was similar in both groups (77.8 vs. 75.9 %). Overall incidence of any complication and major complications were much lower in the LPE group (66.7 and 0 %) compared to the OPE group (89.7 and 32.8 %), although not statistically significant (p = 0.094 and 0.053, respectively). Postoperative hospital stay was significantly shorter in the LPE group than in the OPE group (27 vs. 43 days, p = 0.003).

Conclusions

We confirmed that LPE for pelvic malignancies resulted in less blood loss, a lower complication rate, and shorter postoperative hospital stay compared to OPE. LPE performed by an experienced pelvic surgeon was safe and efficient, and might be a promising option for carefully selected patients.

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Two-stage optical system for colorectal polyp assessments

Abstract

Background and aims

Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.

Methods

The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.

Results

Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09 %, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79 %, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12 %, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100 %.

Conclusions

Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.

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Pinning down the ticking of the neural clock

Our innate ability to track time is important for our everyday lives. We would not be able to speak, or even walk properly if we were not able to get the timing of each action just right.

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Administration of Ethanolic Extract of Ocimum Basilicum Leaves Attenuates Depression like Behavior in the Rats Sensitized by Ovalbumin

A relationship between inflammation and depression has been suggested. Ocimum basilicum, has been reported to have preventive effects of inflammatory responses. The aim of this study was to evaluate the effects of hydro-ethanolic extract of Ocimum basilicum leaves on depressive behaviors in rats sensitized by ovalbumin. The animals were grouped into: (1) Control: saline was injected, (2) Sensitized: sensitization was carried out by ovalbumin, (3-5) three groups including Sent-Ocim 50, Sent- Ocim 100 and Sent- Ocim 200 : sensitization was carried and also 50, 100 or 200 mg/kg, of Ocimum basilicum leave extract was injected. In open- field (O-F) test, the number of crossing in the central zone of the sensitized group was lower while, the number of crossing in the peripheral zone was higher…

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Perrigo Initiates Voluntary Product Recall in the U.S. Of Children’s Guaifenesin Grape Liquid and Guaifenesin DM Cherry Liquid Due to a Potential Defect with the Dosage Cup

Perrigo Company plc (NYSE: PRGO; TASE)of Dublin, Ireland, announced today that, following the recent recall of certain dosing cups by its supplier, it has initiated a voluntary product recall in the US to the retail level of 2 batches of its children's guaifenesin grape liquid (100mg/5 mL) and 3 batches of its children's guaifenesin DM cherry liquid (100mg guaifenesin and 5mg dextromethorphan HBr/ 5 ml) sold in 4 oz. bottles with dosage cup in a box under the store brand products listed below. This recall is being initiated because some packages contain an oral dosing cup with incorrect dose markings. (Source: Food and Drug Administration)

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Fatty Acid (FA) Compositions and Trans Content of Frequently Consumed Edible Oils and Fats from Iran’ Market

In this study, trans FA (TFA) contents and also intakes of TFAs of frequently consumed edible oils and fats marketed in Iran were estimated. 6 brands in 4 groups of edible oils and fats (partially vegetable hydrogenated oils, non-hydrogenated vegetable oils, frying oils and margarines) were considered. The highest amount of TFA was found in partially vegetable hydrogenated oils (7.38%) and margarines (11.63%). Moreover, Ministry of Health and Medical Education of Iran has drastically decreased the TFA intake from 12.3 g/day in 2007 to 1.42 g/day in 2013 by planning. (Source: Current Nutrition and Food Science)

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Zeaxanthin: Review of Toxicological Data and Acceptable Daily Intake

Zeaxanthin is a nutritional carotenoid with a considerable amount of safety data based on regulatory studies, which form the basis of its safety evaluation. Subchronic OECD guideline studies with mice and rats receiving beadlet formulations of high purity synthetic zeaxanthin in the diet at dosages up to 1000 mg/kg body weight (bw)/day, and in dogs at over 400 mg/kg bw/day, produced no adverse effects or histopathological changes. In developmental toxicity studies, there was no evidence of fetal toxicity or teratogenicity in rats or rabbits at dosages up to 1000 or 400 mg/kg bw/day, respectively. Formulated zeaxanthin was not mutagenic or clastogenic in a series of in vitro and in vivo tests for genotoxicity. A 52-week chronic oral study in Cynomolgus monkeys at doses of 0.2 and 20 mg/kg bw/day, mainly designed to assess accumulation and effects in primate eyes, showed no adverse effects. In a rat two-generation study, the NOAEL was 150 mg/kg bw/day. In 2012, this dosage was used by EFSA (NDA Panel), in association with a 200-fold safety factor, to propose an Acceptable Daily Intake equivalent to 53 mg/day for a 70 kg adult. The requested use level of 2 mg/day was ratified by the EU Commission.

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Molecular diagnosis and phylogenetic analysis of human papillomavirus type-16 from suspected patients in Pakistan

Abstract

Background

Human Papillomavirus (HPV) is well known pathogen that can cause benign and malignant tumors in humans, yet there is very little information regarding HPV types prevalent in Pakistan.

Methods

A total of 92 cervical secretions were collected from suspected married female patients and used for DNA isolation using a novel isolation method. The samples were tested through Polymerase Chain Reaction (PCR) using already reported primers MY09/MY11, GP5/GP6, GP5+/GP6+, CP65/CP70, CP66/CP69 and SPF1/SPF2 and with those developed in this study including HRT1 and HRT2 primer sets for typing HPV types and HACTB primer set for human beta actin gene as internal positive control. Sequencing and phylogenetic analyses were performed for two isolates to determine circulating HPV types.

Results

PCR with HRT1 and HRT2 indicated 2 (2.17 %) patients were positive for HPV type- 16 while 1 (1.08 %) with HPV type 18. Sequencing and phylogenetic analysis of isolates confirmed HPV type-16 in genus alpha 9 which have 99 % homology with already reported HPV from Japan and Costa Rica.

Conclusion

This is the first report of HPV type-16 genus alpha 9 in Pakistan and the reported assay and sequence data will serve as valuable tools in further epidemiological studies for HPV surveillance to improve public health, especially of females in Pakistan.

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Resilience at the End of Life as a Predictor for Postloss Growth in Bereaved Caregivers of Cancer Patients: A Prospective Pilot Study

The loss of a close family member is one of the most stressful experiences that people encounter and requires intense readjustment. Adjustment after loss is highly individual, and numerous studies have identified the factors associated with poor psychological adjustment to bereavement.1 Most research in this area has focused on negative experiences, but the bereaved also can find benefit in loss. Loss of a loved one is often an opportunity to review life and make changes to life interests and attitudes. (Source: Journal of Pain and Symptom Management)

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Molecular diagnosis and phylogenetic analysis of human papillomavirus type-16 from suspected patients in Pakistan

Abstract

Background

Human Papillomavirus (HPV) is well known pathogen that can cause benign and malignant tumors in humans, yet there is very little information regarding HPV types prevalent in Pakistan.

Methods

A total of 92 cervical secretions were collected from suspected married female patients and used for DNA isolation using a novel isolation method. The samples were tested through Polymerase Chain Reaction (PCR) using already reported primers MY09/MY11, GP5/GP6, GP5+/GP6+, CP65/CP70, CP66/CP69 and SPF1/SPF2 and with those developed in this study including HRT1 and HRT2 primer sets for typing HPV types and HACTB primer set for human beta actin gene as internal positive control. Sequencing and phylogenetic analyses were performed for two isolates to determine circulating HPV types.

Results

PCR with HRT1 and HRT2 indicated 2 (2.17 %) patients were positive for HPV type- 16 while 1 (1.08 %) with HPV type 18. Sequencing and phylogenetic analysis of isolates confirmed HPV type-16 in genus alpha 9 which have 99 % homology with already reported HPV from Japan and Costa Rica.

Conclusion

This is the first report of HPV type-16 genus alpha 9 in Pakistan and the reported assay and sequence data will serve as valuable tools in further epidemiological studies for HPV surveillance to improve public health, especially of females in Pakistan.

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Mechanisms of MicroRNA Deregulation and MicroRNA Targets in Gastric Cancer

Oncol Res Treat

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Pharmaceuticals, Vol. 9, Pages 2: 3,1-Benzothiazines, 1,4-Benzodioxines and 1,4-Benzoxazines as Inhibitors of Matriptase-2: Outcome of a Focused Screening Approach

The liver enzyme matriptase-2 is a multi-domain, transmembrane serine protease with an extracellular, C-terminal catalytic domain. Synthetic low-molecular weight inhibitors of matriptase-2 have potential as therapeutics to treat iron overload syndromes, in particular in patients with β-thalassemia. A sub-library of 64 compounds was screened for matriptase-2 inhibition and several active compounds were identified. (S)-Ethyl 2-(benzyl(3-((4-carbamidoylphenoxy)methyl)-2,3-dihydrobenzo[b][1,4]dioxin-6-yl)amino)-2-oxoacetate ((S)-12) showed an IC50 value of less than 10 µM. Structure-activity relationships were discussed and proposals to design new matriptase-2 inhibitors were made.

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First Pediatric Case of Tularemia after a Coyote Bite

Bite-transmitted tularemia is a rare event in humans and most of the cases have been associated with cat bites. We report the first pediatric case of tularemia caused by a coyote (Canis latrans) bite. Coyotes can be healthy carriers of Francisella tularensis and transmit this infectious agent through a bite. Pediatricians should be aware of this risk after a carnivore bite and implement appropriate antibiotic therapy, as amoxicillin/clavulanate potassium (Augmentin) may have prolonged the typical two to three days' incubation period commonly observed for tularemia after an animal bite and was not effective in preventing clinical signs in this child. Finally, it emphasizes again the importance of early and late serum samples for appropriate serodiagnostic.

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Laryngology litigation in the United States: Thirty years in review

Objectives/Hypothesis

Malpractice claims pertaining to laryngology procedures are a potentially important source of information that could be used to minimize the risk of future litigation and improve patient care.

Study Design

A retrospective review of two publicly available databases containing jury verdicts and settlements.

Methods

The LexisNexis Jury Verdicts and Settlements and WestlawNext legal databases were reviewed for all lawsuits and out-of-court adjudications related to the practice of laryngology. Data including patient demographics, type of surgery performed, plaintiff allegation, nature of injury, outcomes, and indemnities were collected and analyzed.

Results

Of 87 cases meeting inclusion criteria, 56 were decided by a jury and 31 were adjudicated out of court. Vocal cord surgery was the most commonly litigated surgery. The two most commonly cited legal allegations were physical injury and negligence. No statistical difference for legal outcome was found when death or vocal cord injuries occurred. Complications in procedures that utilized a laser predicted an unfavorable outcome (P = 0.013). A payout was made in over one-half of cases, but defendants were favored in over two-thirds of cases decided by a jury. The average indemnities were significant for both jury verdicts ($4.6 million) and out-of-court settlements ($0.9 million).

Conclusion

An awareness of laryngology malpractice litigation has the potential to provide better patient care and help laryngologists avoid potential risks for litigation. The factors determining legal responsibility in laryngology cases underscore the importance of close communication with anesthesiologists and careful evaluation of hoarseness in all patients regardless of risk factors.

Level of Evidence

N/A. Laryngoscope, 2015

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Pharmaceuticals, Vol. 9, Pages 2: 3,1-Benzothiazines, 1,4-Benzodioxines and 1,4-Benzoxazines as Inhibitors of Matriptase-2: Outcome of a Focused Screening Approach

The liver enzyme matriptase-2 is a multi-domain, transmembrane serine protease with an extracellular, C-terminal catalytic domain. Synthetic low-molecular weight inhibitors of matriptase-2 have potential as therapeutics to treat iron overload syndromes, in particular in patients with β-thalassemia. A sub-library of 64 compounds was screened for matriptase-2 inhibition and several active compounds were identified. (S)-Ethyl 2-(benzyl(3-((4-carbamidoylphenoxy)methyl)-2,3-dihydrobenzo[b][1,4]dioxin-6-yl)amino)-2-oxoacetate ((S)-12) showed an IC50 value of less than 10 µM. Structure-activity relationships were discussed and proposals to design new matriptase-2 inhibitors were made.

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Two-stage optical system for colorectal polyp assessments

Abstract

Background and aims

Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.

Methods

The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.

Results

Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09 %, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79 %, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12 %, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100 %.

Conclusions

Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.

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Astragalar and calcaneal morphology of the middle Eocene primate Anchomomys frontanyensis (Anchomomyini): Implications for early primate evolution

Publication date: February 2016
Source:Journal of Human Evolution, Volume 91
Author(s): Judit Marigó, Imma Roig, Erik R. Seiffert, Salvador Moyà-Solà, Doug M. Boyer
Astragali and calcanei of Anchomomys frontanyensis, a small adapiform from the middle Eocene of Sant Jaume de Frontanyà (Southern Pyrenean basins, northeastern Spain) are described in detail. Though these bones have been known for some time, they have never been carefully analyzed in a context that is comprehensively comparative, quantitative, considers sample variation (astragalus n = 4; calcaneus n = 16), and assesses the phylogenetic significance of the material in an explicit cladistic context, as we do here. Though these bones are isolated, regression analyses provide the first formal statistical support for attribution to A. frontanyensis. The astragalus presents features similar to those of the small stem strepsirrhine Djebelemur from the middle Eocene of Tunisia, while the calcaneus more closely resembles those of the basal omomyiform Teilhardina. The new phylogenetic analyses that include Anchomomys' postcranial and dental data recover anchomomyins outside of the adapiform clade, and closer to djebelemurids, azibiids, and crown strepsirrhines. The small size of A. frontanyensis allows comparison of similarly small adapiforms and omomyiforms (haplorhines) such that observed variation has more straightforward implications for function. Previous studies have demonstrated that distal calcaneal elongation is reflective of leaping proclivity when effects of body mass are appropriately accounted for; in this context, A. frontanyensis has calcaneal elongation suggesting a higher degree of leaping specialization than other adapiforms and even some early omomyiforms. Moreover, comparison to a similarly-sized early adapiform from India, Marcgodinotius (which shows no calcaneal elongation) confirms that high distal calcaneal elongation in A. frontanyensis cannot be simply explained by allometric effects of small size compared to larger adapiform taxa. This pattern is consistent with the idea that significant distal calcaneal elongation evolved at least twice in early euprimates, and that early primate niche space frequently included demands for increased leaping specialization.

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Valbro : un nouveau site à vertébrés de l’Oligocène inférieur (MP 22) de France (Quercy). IV – Marsupialia, Insectivora

Publication date: Available online 12 January 2016
Source:Annales de Paléontologie
Author(s): Jean-Yves Crochet
La faune de vertébrés de la phosphatière de Valbro est exceptionnelle pour le MP 22. Les marsupiaux sont apparus en Europe occidentale au cours de l'Eocène inférieur et sont peu diversifiés à Valbro par rapport à d'autres sites d'âge comparable. Deux espèces seulement y sont identifiées : Amphiperatherium minutum et Peratherium elegans. L'insectivore nyctithériidé Darbonetus aubrelongensis, originellement décrit du MP 21, n'est représenté à Valbro que par trois spécimens.The vertebrate fauna of the Valbro phosphate chamber is unique for the mammalian standard level MP 22. Marsupials appeared in the early Eocene of Western Europe; they remain poorly diversified in Valbro compared to other contemporaneous sites. Two species were recognized: Amphiperatherium minutum and Peratherium elegans. The insectivorous nyctitheriid Darbonetus aubrelongensis, which first appears in MP 21, is only represented by three specimens in Valbro.

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Valbro : un nouveau site à vertébrés de l’Oligocène inférieur (MP 22) de France (Quercy). IV – Marsupialia, Insectivora

Publication date: Available online 12 January 2016
Source:Annales de Paléontologie
Author(s): Jean-Yves Crochet
La faune de vertébrés de la phosphatière de Valbro est exceptionnelle pour le MP 22. Les marsupiaux sont apparus en Europe occidentale au cours de l'Eocène inférieur et sont peu diversifiés à Valbro par rapport à d'autres sites d'âge comparable. Deux espèces seulement y sont identifiées : Amphiperatherium minutum et Peratherium elegans. L'insectivore nyctithériidé Darbonetus aubrelongensis, originellement décrit du MP 21, n'est représenté à Valbro que par trois spécimens.The vertebrate fauna of the Valbro phosphate chamber is unique for the mammalian standard level MP 22. Marsupials appeared in the early Eocene of Western Europe; they remain poorly diversified in Valbro compared to other contemporaneous sites. Two species were recognized: Amphiperatherium minutum and Peratherium elegans. The insectivorous nyctitheriid Darbonetus aubrelongensis, which first appears in MP 21, is only represented by three specimens in Valbro.

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Nuclear rumours delay India’s bid for neutrino glory

Rumours frustrate physicists in a global competition to understand elusive particles.

Nature 529 140 doi: 10.1038/529140a

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Cu(2+)-attached pumice particles embedded composite cryogels for protein purification.

Cu(2+)-attached pumice particles embedded composite cryogels for protein purification.

Artif Cells Nanomed Biotechnol. 2016 Jan 11;:1-8

Authors: Alkan H, Cömert ŞC, Gürbüz F, Doğru M, Odabaşı M

Abstract
In this study, chromatographic performance of Cu(2+)-attached pumice particles embedded to monolithic cryogels (Cu(2+)-APPsEMC) for human serum albumin (HSA) was investigated. Monolithic composite cryogels were prepared by means of polymerization of gel-forming precursors at sub-zero temperatures. The chemical composition of pumice and surface of composite cryogels were determined by X-ray fluorescence spectrometer and scanning electron microscopy, respectively. The highest adsorption capacity (549.5 mg/g pumice) of cryogels was achieved at phosphate buffer of pH 8.0 with initial HSA solution of 3 mg/ml. SDS-PAGE analysis was performed for the samples studied on human serum to determine HSA adsorption/desorption performance of cryogel qualitatively.

PMID: 26755205 [PubMed - as supplied by publisher]

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Synthesis, self-assembly, and in vitro toxicity of fatty acids-modified Bletilla striata polysaccharide.

Synthesis, self-assembly, and in vitro toxicity of fatty acids-modified Bletilla striata polysaccharide.

Artif Cells Nanomed Biotechnol. 2016 Jan 11;:1-7

Authors: Wang W, He S, Hong T, Zhang Y, Sui H, Zhang X, Ma Y

Abstract
Hydrophobic modification of Bletilla striata polysaccharide (BSP) was performed by grafting fatty acids to BSP backbone and then characterized on their physicochemical properties. All neutral derivatives were able to self-assemble into spherical particles within the size range of 250-400 nm, their size and critical micelle concentration decreased with increasing hydrophobicity and substitution degree of the fatty acids. Also, the BSP-stearic acid conjugates showed a preferable performance on hemolysis test and cytotoxicity analysis on HepG2 cells, which suggested their potential application as a drug delivery vector.

PMID: 26754958 [PubMed - as supplied by publisher]

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Enhancing activity of artesunate against breast cancer cells via induced-apoptosis pathway by loading into lipid carriers.

Enhancing activity of artesunate against breast cancer cells via induced-apoptosis pathway by loading into lipid carriers.

Artif Cells Nanomed Biotechnol. 2016 Jan 11;:1-9

Authors: Tran TH, Nguyen AN, Kim JO, Yong CS, Nguyen CN

Abstract
Artesunate-loaded nanostructured lipid carriers (ART-NLCs) were prepared by hot homogenization followed by ultrasonication technique. The optimized ART-NLC demonstrated a particle size of 117.5 ± 6.1 nm, with good stability regarding zeta-potential of  -19.47 ± 0.9 mV and drug entrapment efficiency of 92.93 ± 1.47%. ART-NLC showed good cellular uptake in breast cancer cells, which was confirmed by confocal laser scanning microscopy (CLSM) and flow cytometry analysis. The significantly higher in vitro cytotoxicity of ART-NLCs against human breast cancer MCF-7, MDA-MB-231 cells as compared with the free ART was recorded.  Hoechst 33342 staining indicated that ART-NLC induced higher apoptosis rates in MCF-7 as well as MDA-MB-231cells than free ART.

PMID: 26754823 [PubMed - as supplied by publisher]

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Mammakarzinom früh diagnostizieren

Tumornachweis über den Urin?
Um Brustkrebs anhand von Urinproben nachzuweisen, setzen Freiburger Senologen auf Mikro-RNA.

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Intracorporeal ileocolic anastomosis in patients with laparoscopic right hemicolectomy

Abstract

Background

Since the introduction of laparoscopic colorectal surgery, there has been a controversy between creating an intracorporeal or extracorporeal ileocolic anastomosis in right hemicolectomy. The purpose is to report our experience in intracorporeal anastomosis following right hemicolectomy in both malignant and benign pathologies.

Study design

A retrospective review of a prospectively collected database was conducted at Virgen de la Arrixaca Clinical University Hospital (Murcia) between January 2000 and April 2014. The study includes all surgery patients who received a laparoscopic right hemicolectomy with an intracorporeal ileocolic anastomosis. The criteria for exclusion were conversion to open surgery during the procedure due to technical difficulties during dissect. Tumours considered T4 were not excluded, nor were stage IV patients or those with a history of previous abdominal surgery.

Results

There were 173 patients (63 females) aged 67 (range 14–91) years, with body mass index of 27 (17–52) kg/m2 and ASA 1:2:3:4 of 12:78:68:15; 41 % had previous abdominal surgery and 70 % had a pre-existing comorbidity. Operating time was 142 (60–270) min. Specimen extraction site incision length was 8.1 (6–11.1) cm. Conversion rate was 9.2 %, and there were 39 complications (22.54 %) and 9 reoperations (5.2 %). Readmission rate was 5.2 %. Length of stay was 5.7 (1–35) days.

Conclusion

The intracorporeal procedure is a safe and feasible alternative for creating an ileocolic anastomosis. It involves a similar rate of complications and may prevent some of the drawbacks presented by extracorporeal anastomosis.

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Zeaxanthin: Review of Toxicological Data and Acceptable Daily Intake

Zeaxanthin is a nutritional carotenoid with a considerable amount of safety data based on regulatory studies, which form the basis of its safety evaluation. Subchronic OECD guideline studies with mice and rats receiving beadlet formulations of high purity synthetic zeaxanthin in the diet at dosages up to 1000 mg/kg body weight (bw)/day, and in dogs at over 400 mg/kg bw/day, produced no adverse effects or histopathological changes. In developmental toxicity studies, there was no evidence of fetal toxicity or teratogenicity in rats or rabbits at dosages up to 1000 or 400 mg/kg bw/day, respectively. Formulated zeaxanthin was not mutagenic or clastogenic in a series of in vitro and in vivo tests for genotoxicity. A 52-week chronic oral study in Cynomolgus monkeys at doses of 0.2 and 20 mg/kg bw/day, mainly designed to assess accumulation and effects in primate eyes, showed no adverse effects. In a rat two-generation study, the NOAEL was 150 mg/kg bw/day. In 2012, this dosage was used by EFSA (NDA Panel), in association with a 200-fold safety factor, to propose an Acceptable Daily Intake equivalent to 53 mg/day for a 70 kg adult. The requested use level of 2 mg/day was ratified by the EU Commission.

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Molecular diagnosis and phylogenetic analysis of human papillomavirus type-16 from suspected patients in Pakistan

Abstract

Background

Human Papillomavirus (HPV) is well known pathogen that can cause benign and malignant tumors in humans, yet there is very little information regarding HPV types prevalent in Pakistan.

Methods

A total of 92 cervical secretions were collected from suspected married female patients and used for DNA isolation using a novel isolation method. The samples were tested through Polymerase Chain Reaction (PCR) using already reported primers MY09/MY11, GP5/GP6, GP5+/GP6+, CP65/CP70, CP66/CP69 and SPF1/SPF2 and with those developed in this study including HRT1 and HRT2 primer sets for typing HPV types and HACTB primer set for human beta actin gene as internal positive control. Sequencing and phylogenetic analyses were performed for two isolates to determine circulating HPV types.

Results

PCR with HRT1 and HRT2 indicated 2 (2.17 %) patients were positive for HPV type- 16 while 1 (1.08 %) with HPV type 18. Sequencing and phylogenetic analysis of isolates confirmed HPV type-16 in genus alpha 9 which have 99 % homology with already reported HPV from Japan and Costa Rica.

Conclusion

This is the first report of HPV type-16 genus alpha 9 in Pakistan and the reported assay and sequence data will serve as valuable tools in further epidemiological studies for HPV surveillance to improve public health, especially of females in Pakistan.

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Resilience at the End of Life as a Predictor for Postloss Growth in Bereaved Caregivers of Cancer Patients: A Prospective Pilot Study

The loss of a close family member is one of the most stressful experiences that people encounter and requires intense readjustment. Adjustment after loss is highly individual, and numerous studies have identified the factors associated with poor psychological adjustment to bereavement.1 Most research in this area has focused on negative experiences, but the bereaved also can find benefit in loss. Loss of a loved one is often an opportunity to review life and make changes to life interests and attitudes. (Source: Journal of Pain and Symptom Management)

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Molecular diagnosis and phylogenetic analysis of human papillomavirus type-16 from suspected patients in Pakistan

Abstract

Background

Human Papillomavirus (HPV) is well known pathogen that can cause benign and malignant tumors in humans, yet there is very little information regarding HPV types prevalent in Pakistan.

Methods

A total of 92 cervical secretions were collected from suspected married female patients and used for DNA isolation using a novel isolation method. The samples were tested through Polymerase Chain Reaction (PCR) using already reported primers MY09/MY11, GP5/GP6, GP5+/GP6+, CP65/CP70, CP66/CP69 and SPF1/SPF2 and with those developed in this study including HRT1 and HRT2 primer sets for typing HPV types and HACTB primer set for human beta actin gene as internal positive control. Sequencing and phylogenetic analyses were performed for two isolates to determine circulating HPV types.

Results

PCR with HRT1 and HRT2 indicated 2 (2.17 %) patients were positive for HPV type- 16 while 1 (1.08 %) with HPV type 18. Sequencing and phylogenetic analysis of isolates confirmed HPV type-16 in genus alpha 9 which have 99 % homology with already reported HPV from Japan and Costa Rica.

Conclusion

This is the first report of HPV type-16 genus alpha 9 in Pakistan and the reported assay and sequence data will serve as valuable tools in further epidemiological studies for HPV surveillance to improve public health, especially of females in Pakistan.

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Mechanisms of MicroRNA Deregulation and MicroRNA Targets in Gastric Cancer

Oncol Res Treat

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Pharmaceuticals, Vol. 9, Pages 2: 3,1-Benzothiazines, 1,4-Benzodioxines and 1,4-Benzoxazines as Inhibitors of Matriptase-2: Outcome of a Focused Screening Approach

The liver enzyme matriptase-2 is a multi-domain, transmembrane serine protease with an extracellular, C-terminal catalytic domain. Synthetic low-molecular weight inhibitors of matriptase-2 have potential as therapeutics to treat iron overload syndromes, in particular in patients with β-thalassemia. A sub-library of 64 compounds was screened for matriptase-2 inhibition and several active compounds were identified. (S)-Ethyl 2-(benzyl(3-((4-carbamidoylphenoxy)methyl)-2,3-dihydrobenzo[b][1,4]dioxin-6-yl)amino)-2-oxoacetate ((S)-12) showed an IC50 value of less than 10 µM. Structure-activity relationships were discussed and proposals to design new matriptase-2 inhibitors were made.

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First Pediatric Case of Tularemia after a Coyote Bite

Bite-transmitted tularemia is a rare event in humans and most of the cases have been associated with cat bites. We report the first pediatric case of tularemia caused by a coyote (Canis latrans) bite. Coyotes can be healthy carriers of Francisella tularensis and transmit this infectious agent through a bite. Pediatricians should be aware of this risk after a carnivore bite and implement appropriate antibiotic therapy, as amoxicillin/clavulanate potassium (Augmentin) may have prolonged the typical two to three days' incubation period commonly observed for tularemia after an animal bite and was not effective in preventing clinical signs in this child. Finally, it emphasizes again the importance of early and late serum samples for appropriate serodiagnostic.

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Laryngology litigation in the United States: Thirty years in review

Objectives/Hypothesis

Malpractice claims pertaining to laryngology procedures are a potentially important source of information that could be used to minimize the risk of future litigation and improve patient care.

Study Design

A retrospective review of two publicly available databases containing jury verdicts and settlements.

Methods

The LexisNexis Jury Verdicts and Settlements and WestlawNext legal databases were reviewed for all lawsuits and out-of-court adjudications related to the practice of laryngology. Data including patient demographics, type of surgery performed, plaintiff allegation, nature of injury, outcomes, and indemnities were collected and analyzed.

Results

Of 87 cases meeting inclusion criteria, 56 were decided by a jury and 31 were adjudicated out of court. Vocal cord surgery was the most commonly litigated surgery. The two most commonly cited legal allegations were physical injury and negligence. No statistical difference for legal outcome was found when death or vocal cord injuries occurred. Complications in procedures that utilized a laser predicted an unfavorable outcome (P = 0.013). A payout was made in over one-half of cases, but defendants were favored in over two-thirds of cases decided by a jury. The average indemnities were significant for both jury verdicts ($4.6 million) and out-of-court settlements ($0.9 million).

Conclusion

An awareness of laryngology malpractice litigation has the potential to provide better patient care and help laryngologists avoid potential risks for litigation. The factors determining legal responsibility in laryngology cases underscore the importance of close communication with anesthesiologists and careful evaluation of hoarseness in all patients regardless of risk factors.

Level of Evidence

N/A. Laryngoscope, 2015

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Pharmaceuticals, Vol. 9, Pages 2: 3,1-Benzothiazines, 1,4-Benzodioxines and 1,4-Benzoxazines as Inhibitors of Matriptase-2: Outcome of a Focused Screening Approach

The liver enzyme matriptase-2 is a multi-domain, transmembrane serine protease with an extracellular, C-terminal catalytic domain. Synthetic low-molecular weight inhibitors of matriptase-2 have potential as therapeutics to treat iron overload syndromes, in particular in patients with β-thalassemia. A sub-library of 64 compounds was screened for matriptase-2 inhibition and several active compounds were identified. (S)-Ethyl 2-(benzyl(3-((4-carbamidoylphenoxy)methyl)-2,3-dihydrobenzo[b][1,4]dioxin-6-yl)amino)-2-oxoacetate ((S)-12) showed an IC50 value of less than 10 µM. Structure-activity relationships were discussed and proposals to design new matriptase-2 inhibitors were made.

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Two-stage optical system for colorectal polyp assessments

Abstract

Background and aims

Macroscopic real-time evaluations of the histopathology and degree of invasion of colorectal polyps help to select the most suitable endoscopic treatment method. Dual-focus (DF) narrow-band imaging (NBI) is a new imaging enhancement system that uses digital and optical methods to enhance the view of blood vessels on mucosal surfaces. However, the superiority of this technique over standard imaging techniques has not been previously reported. The aim of this study was to determine whether the two-stage optical systems in a new generation of endoscopes will increase the diagnostic accuracy of colorectal polyp recognition.

Methods

The study included 270 patients, and 386 colorectal polyps were diagnosed and removed. The polyps were assessed with white light and NBI using one- and two-stage optical systems, respectively. After being classified according to the Kudo pit pattern schemes, the polyps were removed and histopathologically verified.

Results

Regarding non-neoplastic lesions (Kudo I and II), no difference was observed in the recognition of polyps when using the NBI-DF function. We observed improved accuracy in the preliminary diagnoses of Kudo IIIL lesions (from 87.16 to 90.09 %, p < 0.05) and Kudo IIIS lesions (from 87.29 to 92.79 %, p < 0.01). NBI-DF also increased the accuracy of preliminary diagnoses of Kudo IV lesions (from 88.24 to 94.12 %, p < 0.01). The Kudo V pit patterns were also more distinct with NBI-DF imaging, increasing the diagnostic accuracy from 91.67 to 100 %.

Conclusions

Using a two-stage optical system with electronic colorization of the mucosa increased diagnostic accuracy for differentiating colorectal polyps with neoplastic potential.

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Astragalar and calcaneal morphology of the middle Eocene primate Anchomomys frontanyensis (Anchomomyini): Implications for early primate evolution

Publication date: February 2016
Source:Journal of Human Evolution, Volume 91
Author(s): Judit Marigó, Imma Roig, Erik R. Seiffert, Salvador Moyà-Solà, Doug M. Boyer
Astragali and calcanei of Anchomomys frontanyensis, a small adapiform from the middle Eocene of Sant Jaume de Frontanyà (Southern Pyrenean basins, northeastern Spain) are described in detail. Though these bones have been known for some time, they have never been carefully analyzed in a context that is comprehensively comparative, quantitative, considers sample variation (astragalus n = 4; calcaneus n = 16), and assesses the phylogenetic significance of the material in an explicit cladistic context, as we do here. Though these bones are isolated, regression analyses provide the first formal statistical support for attribution to A. frontanyensis. The astragalus presents features similar to those of the small stem strepsirrhine Djebelemur from the middle Eocene of Tunisia, while the calcaneus more closely resembles those of the basal omomyiform Teilhardina. The new phylogenetic analyses that include Anchomomys' postcranial and dental data recover anchomomyins outside of the adapiform clade, and closer to djebelemurids, azibiids, and crown strepsirrhines. The small size of A. frontanyensis allows comparison of similarly small adapiforms and omomyiforms (haplorhines) such that observed variation has more straightforward implications for function. Previous studies have demonstrated that distal calcaneal elongation is reflective of leaping proclivity when effects of body mass are appropriately accounted for; in this context, A. frontanyensis has calcaneal elongation suggesting a higher degree of leaping specialization than other adapiforms and even some early omomyiforms. Moreover, comparison to a similarly-sized early adapiform from India, Marcgodinotius (which shows no calcaneal elongation) confirms that high distal calcaneal elongation in A. frontanyensis cannot be simply explained by allometric effects of small size compared to larger adapiform taxa. This pattern is consistent with the idea that significant distal calcaneal elongation evolved at least twice in early euprimates, and that early primate niche space frequently included demands for increased leaping specialization.

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Valbro : un nouveau site à vertébrés de l’Oligocène inférieur (MP 22) de France (Quercy). IV – Marsupialia, Insectivora

Publication date: Available online 12 January 2016
Source:Annales de Paléontologie
Author(s): Jean-Yves Crochet
La faune de vertébrés de la phosphatière de Valbro est exceptionnelle pour le MP 22. Les marsupiaux sont apparus en Europe occidentale au cours de l'Eocène inférieur et sont peu diversifiés à Valbro par rapport à d'autres sites d'âge comparable. Deux espèces seulement y sont identifiées : Amphiperatherium minutum et Peratherium elegans. L'insectivore nyctithériidé Darbonetus aubrelongensis, originellement décrit du MP 21, n'est représenté à Valbro que par trois spécimens.The vertebrate fauna of the Valbro phosphate chamber is unique for the mammalian standard level MP 22. Marsupials appeared in the early Eocene of Western Europe; they remain poorly diversified in Valbro compared to other contemporaneous sites. Two species were recognized: Amphiperatherium minutum and Peratherium elegans. The insectivorous nyctitheriid Darbonetus aubrelongensis, which first appears in MP 21, is only represented by three specimens in Valbro.

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Valbro : un nouveau site à vertébrés de l’Oligocène inférieur (MP 22) de France (Quercy). IV – Marsupialia, Insectivora

Publication date: Available online 12 January 2016
Source:Annales de Paléontologie
Author(s): Jean-Yves Crochet
La faune de vertébrés de la phosphatière de Valbro est exceptionnelle pour le MP 22. Les marsupiaux sont apparus en Europe occidentale au cours de l'Eocène inférieur et sont peu diversifiés à Valbro par rapport à d'autres sites d'âge comparable. Deux espèces seulement y sont identifiées : Amphiperatherium minutum et Peratherium elegans. L'insectivore nyctithériidé Darbonetus aubrelongensis, originellement décrit du MP 21, n'est représenté à Valbro que par trois spécimens.The vertebrate fauna of the Valbro phosphate chamber is unique for the mammalian standard level MP 22. Marsupials appeared in the early Eocene of Western Europe; they remain poorly diversified in Valbro compared to other contemporaneous sites. Two species were recognized: Amphiperatherium minutum and Peratherium elegans. The insectivorous nyctitheriid Darbonetus aubrelongensis, which first appears in MP 21, is only represented by three specimens in Valbro.

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Nuclear rumours delay India’s bid for neutrino glory

Rumours frustrate physicists in a global competition to understand elusive particles.

Nature 529 140 doi: 10.1038/529140a

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Characterization of Enhancing MS Lesions by Dynamic Texture Parameter Analysis of Dynamic Susceptibility Perfusion Imaging

Purpose. The purpose of this study was to investigate statistical differences with MR perfusion imaging features that reflect the dynamics of Gadolinium-uptake in MS lesions using dynamic texture parameter analysis (DTPA). Methods. We investigated 51 MS lesions (25 enhancing, 26 nonenhancing lesions) of 12 patients. Enhancing lesions () were prestratified into enhancing lesions with increased permeability (EL+; ) and enhancing lesions with subtle permeability (EL−; ). Histogram-based feature maps were computed from the raw DSC-image time series and the corresponding texture parameters were analyzed during the inflow, outflow, and reperfusion time intervals. Results. Significant differences () were found between EL+ and EL− and between EL+ and nonenhancing inactive lesions (NEL). Main effects between EL+ versus EL− and EL+ versus NEL were observed during reperfusion (mainly in mean and standard deviation (SD): EL+ versus EL− and EL+ versus NEL), while EL− and NEL differed only in their SD during outflow. Conclusion. DTPA allows grading enhancing MS lesions according to their perfusion characteristics. Texture parameters of EL− were similar to NEL, while EL+ differed significantly from EL− and NEL. Dynamic texture analysis may thus be further investigated as noninvasive endogenous marker of lesion formation and restoration.

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