Evidence-based practice has become a buzz word these days, particularly in the healthcare system. One of the questions I would like to draw attention to is about evidence-based practice (EBP). It often compels me to ...
Publication date: 15 April 2017
Source:Materials & Design, Volume 120
Author(s): Enrico Sassoni, Gabriela Graziani, Giovanni Ridolfi, Maria Chiara Bignozzi, Elisa Franzoni
The response to thermal variations is the primary cause of marble deterioration in ancient and modern buildings. In this study, the thermal behavior of Carrara marble after consolidation by an innovative hydroxyapatite-based treatment was investigated in comparison with ammonium oxalate and ethyl silicate. Samples were subjected to heating-cooling cycles up to 80°C. All the consolidating treatments were found to be fairly compatible, as in no case the residual strain after the thermal cycles was found to increase compared to the unweathered untreated marble. Anyway, the hydroxyapatite-treatment has the advantage of causing the highest increase in marble cohesion and the lowest residual strain, besides being more chromatically compatible and durable than the alternative commercial consolidants.
<span class="paragraphSection"><div class="boxTitle">Abstract</div>Prehension movements typically include a reaching phase, guiding the hand toward the object, and a grip phase, shaping the hand around it. The dominant view posits that these components rely upon largely independent parieto-frontal circuits: a dorso-medial circuit involved in reaching and a dorso-lateral circuit involved in grasping. However, mounting evidence suggests a more complex arrangement, with dorso-medial areas contributing to both reaching and grasping. To investigate the role of the dorso-medial reaching circuit in grasping, we trained monkeys to reach-and-grasp different objects in the dark and determined if hand configurations could be decoded from functional magnetic resonance imaging (MRI) responses obtained from the reaching and grasping circuits. Indicative of their established role in grasping, object-specific grasp decoding was found in anterior intraparietal (AIP) area, inferior parietal lobule area PFG and ventral premotor region F5 of the lateral grasping circuit, and primary motor cortex. Importantly, the medial reaching circuit also conveyed robust grasp-specific information, as evidenced by significant decoding in parietal reach regions (particular V6A) and dorsal premotor region F2. These data support the proposed role of dorso-medial "reach" regions in controlling aspects of grasping and demonstrate the value of complementing univariate with more sensitive multivariate analyses of functional MRI (fMRI) data in uncovering information coding in the brain.</span>
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<span class="paragraphSection"><div class="boxTitle">Abstract</div>Neuroimaging studies in autism spectrum disorders (ASDs) have provided inconsistent evidence of cortical abnormality. This is probably due to the small sample sizes used in most studies, and important differences in sample characteristics, particularly age, as well as to the heterogeneity of the disorder. To address these issues, we assessed abnormalities in ASD within the Autism Brain Imaging Data Exchange data set, which comprises data from approximately 1100 individuals (~6–55 years). A subset of these data that met stringent quality control and inclusion criteria (560 male subjects; 266 ASD; age = 6–35 years) were used to compute age-specific differences in cortical thickness in ASD and the relationship of any such differences to symptom severity of ASD. Our results show widespread increased cortical thickness in ASD, primarily left lateralized, from 6 years onwards, with differences diminishing during adulthood. The severity of symptoms related to social affect and communication correlated with these cortical abnormalities. These results are consistent with the conjecture that developmental patterns of cortical thickness abnormalities reflect delayed cortical maturation and highlight the dynamic nature of morphological abnormalities in ASD.</span>
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<span class="paragraphSection"><div class="boxTitle">Abstract</div>Polymicrogyria is a malformation of cortical folding and layering underlying different cognitive and neurological manifestations. The polymicrogyric cortex has heterogeneous morphofunctional patterns, qualitatively described at magnetic resonance imaging (MRI) by variable severity gradients and functional activations. We investigated the link between abnormal cortical folding and cortical function in order to improve surgical planning for patients with polymicrogyria and intractable epilepsy. We performed structural and functional MRI on 14 patients with perisylvian polymicrogyria and adopted surface-based methods to detect alterations of cortical thickness (CT) and local gyrification index (LGI) compared with normal cortex (30 age-matched subjects). We quantitatively assessed the grade of anatomic disruption of the polymicrogyric cortex and defined its relationship with decreased cortical function. We observed a good matching between visual analysis and morphometric measurements. CT maps revealed sparse clusters of thickening, while LGI maps disclosed circumscribed regions of maximal alteration with a uniformly decreasing centrifugal gradient. In polymicrogyric areas in which gyral and sulcal patterns were preserved, functional activation maintained the expected location, but was reduced in extent. Morphofunctional correlations, evaluated along cortico-cortical paths between maximum morphologic alterations and significant activations, identified an interindividual threshold for LGI (<span style="font-style:italic;">z-</span>value = −1.09) beyond which functional activations were no longer identifiable.</span>
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Allergien nehmen in der westlichen Welt stetig an Bedeutung zu. Seit über 100 Jahren stellt die Immuntherapie die einzig kausale Therapie dar. Die spezifische Immuntherapie (SIT) zielt auf Heilung oder zumindest eine Symptomfreiheit der Allergien. Hierbei stellt die Adhärenz ein komplexes Problem dar. Beide üblicherweise in Deutschland eingesetzten Therapieapplikationen, sublinguale und subkutane Immuntherapien, verzeichnen eine schlechte Persistenz der Patienten. In den meisten Fällen wird die SIT nicht bis zum Ende der empfohlenen Dauer durchgeführt, sondern frühzeitig beendet. Hierbei reichen die Zahlen in der Literatur zu 3‑jährigen Studien von 41–93 % nicht beendeter SLIT und 40–77 % nicht beendeter SCIT. Die Adhärenz der Patienten unterliegt Einflussfaktoren unterschiedlicher Dimensionen, die in komplexen Beziehungen voneinander abhängen. Das Arzt-Patienten-Verhältnis stellt für den Therapieerfolg einen ebenso entscheidenden Faktor dar wie das Verständnis des Patienten von Allergie, Therapie und Bedeutung seiner Adhärenz.
Das Spektrum zu erwartender psychischer Störungen der Kopfhaut zeigt aufgrund der Sichtbarkeit, einer möglichen Stigmatisierung sowie der Behaarung einige Besonderheiten auf. Von praktischer Relevanz ist die Trichotillomanie, die neu zu den Zwangsstörungen gezählt wird. Eine weitere psychodermatologische Herausforderung stellen Patienten mit Fokussierung eines normwertigen physiologischen Haarausfalls dar. Die Behandlung von psychotrichologischen Erkrankungen erfolgt mit psychosomatischer Grundversorgung, Verhaltenstherapie oder Psychopharmaka.
This systematic review aims to answer the question: "Is there an association between any specific signs and symptoms of bruxism and the presence of tori?"
Observational studies, which evaluated the association between signs and symptoms of bruxism and tori, were selected. Signs and symptoms of bruxism (such as teeth grinding, jaw clenching, abnormal tooth wear, facial muscle hypertrophy, pain, or fatigue) had to be determined by questionnaire or anamnesis and tori within clinical assessment. Search-strategies were developed for five databases, in addition to three gray literature's databases. The risk of bias was evaluated using the "Meta-Analysis of Statistics Assessment and Review Instrument". A summary of overall strength of evidence was estimated using GRADE's Summary of findings table.
Among 575 studies, five were included. Two studies were categorized as moderate risk of bias and three as high risk of bias. Self-report of teeth grinding and/or clenching presented contradictory results. Presence of abnormal tooth wear increased the odds of having tori, mainly for torus mandibularis. The overall quality of evidence ranged from low to very low.
Based on available evidence, the presence of abnormal tooth wear might be associated with tori, mainly torus mandibularis. There is no sufficient evidence to credit or discredit the association of tori and other signs and/or symptoms of bruxism.
Bruxism diagnosis is a challenge. The association between signs and symptoms of bruxism and tori could help clinicians on the recognition of patients susceptible to bruxism. This knowledge might also aid to the understanding of tori's development and stimulate new relevant research.
The aim of this study was to compare the interproximal bone level at root canal-filled teeth and non-root canal-filled teeth.
The records of patients from the department were consecutively screened from January 2009 to October 2011. The distance between the coronal reference point to the alveolar bone crest (AC) was assessed at the mesial and distal aspects of root canal-filled teeth (RCF+) and their contralateral non-root canal-filled teeth (RCF−) on periapical radiographs. Generalised linear mixed-effects models were applied.
The sample consisted of 128 pairs of teeth comprising data from 72 patients. The results for AC revealed a median distance of 3.2 mm for RCF+ and 3.4 mm for RCF− (p = 0.61). Using the maximal distance on either the distal or the mesial tooth surface, a median distance of 3.6 mm was detected for RCF+ and 3.8 mm for RCF−, respectively (p = 0.42). Even after taking several tooth- and subject-specific variables into account, the differences between AC on RCF+ and RCF− were statistically not significant (p > 0.05).
The interproximal bone loss did not differ statistically significant between root canal-filled teeth and non-root canal-filled teeth.
Existence of appropriately done root canal fillings in periodontitis patients has no effect on the prognosis of periodontal disease.
Rheumatoid arthritis (RA) is a chronic inflammatory disease leading to joint destruction. Cytokines play a key role in its pathogenesis. They contribute to the induction and maintenance of inflammation and thus provide therapeutic targets. Many cytokines are involved in RA, and this review focuses on a few critical ones: tumor necrosis factor (TNF), interleukin (IL)-6, IL-1, IL-17, and GM-CSF. TNF and IL-6 are both well-established targets in RA treatment, and new biologic agents are reaching the market. IL-1 represents a more complex cytokine as results in humans do not reach those in animal models. IL-17 and GM-CSF are cytokines representing new targets either as early treatment or in non-responders to other biologics. The interaction between cytokines and their signaling pathways are the basis for the development of new strategies with small molecules or bispecific antibodies. Clearly, the targeting of cytokines has been a major progress in RA treatment, but many issues remain open. Although remission can be better achieved, reactivation of the disease too often occurs upon treatment discontinuation. Better understanding and targeting of chronicity remains a goal to achieve in the future.
Degradation of the hybrid layer created in dentin by dentin adhesives is caused by enzyme activities present within the dentin matrix that destroy unprotected collagen fibrils. The aim of the present study was to evaluate the effect of a one-step self-etch adhesive system on dentinal matrix metalloproteinases 2 and 4 (MMP-2 and MMP-9, respectively) using in situ zymography and an enzymatic activity assay. The null hypothesis tested was that there are no differences in the activities of dentinal MMPs before and after treatment with a one-step adhesive system. The MMP-2 and MMP-9 activities in dentin treated with the one-step adhesive, Adper Easy Bond, were quantified using an enzymatic activity assay system. The MMP activities within the hybrid layer created by the one-step adhesive tested were also evaluated using in situ zymography. The enzymatic assay revealed an increase in MMP-2 and MMP-9 activities after treatment with adhesive. In situ zymography indicated that gelatinolytic activity is present within the hybrid layer created with the one-step self-etch adhesive. The host-derived gelatinases were localized within the hybrid layer and remained active after the bonding procedure. It is concluded that the one-step self-etch adhesive investigated activates endogenous MMP-2 and MMP-9 with the dentin matrix, which may cause collagen degradation over time.
Publication date: Available online 17 February 2017
Source:Practical Radiation Oncology
Author(s): Lukasz M. Mazur, Prithima R. Mosaly, Gregg Tracton, Marjorie P. Stiegler, Robert Adams, Bhishamjit Chera, Lawrence B. Marks
PurposeTo help with ongoing safety challenges in radiation therapy (RT) the objective of this research was to develop and assess the impact of simulation-based training intervention on radiation oncology providers' workload and performance during treatment planning and quality assurance (QA) tasks.Methods and materials18 radiation oncology professionals completed routine treatment planning and QA tasks on two clinical scenarios in a simulation laboratory, as part of a prospective IRB-approved study. Workload was measured at the end of each assessment/scenario using the NASA Task-Load Index (NASA-TLX). Performance was quantified based on procedural compliance (adherence to pre-set/standard QA tasks), time-to-scenario completion, and clinically relevant performance. Participants were then randomized to receive (vs. not receive) simulation-based training intervention (e.g., standardized feedback on workload and performance) and underwent repeat measurements of workload and performance. Pre- and post-intervention changes in workload and performance from participants who received (vs. did not receive) were compared using two-way analysis of variance (ANOVA).ResultsSimulation-based training was associated with significant improvements in procedural compliance (p=0.01) and increases in time-to-scenario completion (p=0.01), but had no significant impact on subjective workload or clinically relevant performance.ConclusionSimulation-based training may be a tool to improve procedural compliance of RT professionals and to acquire new skills and knowledge to proactively maintain RT professionals' preoccupation with patient safety.
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Violence and Gender , Vol. 0, No. 0.
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| Related Articles |
Efficacy and safety of ClairYg(®), a ready-to-use intravenous immunoglobulin, in adult patients with primary immune thrombocytopenia.
Am J Blood Res. 2017;7(1):1-9
Authors: Slama B, Fain O, Maisonneuve H, Jourdan E, Viallard JF, Ouaja R, Alfa-Cissé O, Godeau B, Study Investigators
Abstract
PURPOSE: The present study was designed to assess the efficacy and safety of IGNG that is a new liquid, saccharose and maltose-free highly purified ready-to-use 5% intravenous immunoglobulin (IVIg), in primary immune thrombocytopenic patients with severe thrombocytopenia.
METHODS: Nineteen adults with a platelet count ≤ 25 × 10(9)/L received a single dose of IGNG (1 g/kg) on Day 1, with a second identical dose on Day 3 if needed. Patients were followed for 30 days. Primary endpoint was the response rate, defined as the proportion of patients with a platelet count ≥ 50 × 10(9)/L within 96 hours after the first IGNG dose.
RESULTS: All but one of the 17 evaluable patients for efficacy responded with an overall response rate of 94.1% (95% CI 71.3%-99.9%). Response was observed after only one infusion (1 g/kg boby weight) in 11 patients (59%) and the others required a second dose. Mean time to response was 2.2 days. Maximum platelet count was reached within 1 week after the first dose and lasted for approximately 2 weeks. Patients requiring a second dose had lower platelet counts at baseline than patients requiring a single dose. In the 19 evaluable patients for safety, IGNG demonstrated good safety, good hepatic and renal tolerance, and did not induce hemolysis. This trial was registered at the French Medical Agency (AFSSAPS) as #DI n°060735.
PMID: 28203488 [PubMed]
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OnabotulinumtoxinA (OnabotA) is considered effective in in patients with chronic migraine (CM) who failed on traditional therapies. This study was designed to evaluate the effect of OnabotA injection series on...
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Fluorouracil and folinic acid with irinotecan (FOLFIRI) plus bevacizumab (BV) is widely used as second-line chemotherapy for patients with metastatic colorectal cancer (mCRC) previously treated with fluoropyrimidines, oxaliplatin, and BV. FOLFIRI requires a CV catheter and an infusion pump, which are inconvenient for patients. Sufficient data are not available for characterizing the effectiveness of fluoropyrimidines beyond first disease progression. In this study, we evaluated the efficacy and safety of irinotecan (CPT-11) plus BV as second-line therapy.
Patients with mCRC previously treated with at least four courses of a fluoropyrimidine, oxaliplatin, and BV were designated to receive 150 mg/m2 of CPT-11 and 10 mg/kg of BV every 2 weeks as second-line therapy. The primary endpoint was progression-free survival (PFS), and secondary endpoints included response rate (RR), overall survival (OS), and adverse events.
Thirty patients from six institutes were enrolled from March 2011 to January 2014. The median PFS was 5.7 months (95% CI 4.2–7.3 months), and the RR was 6.7% (range 0.8–22.1%). Grades 3–4 adverse events included leucopenia (36.7%), neutropenia (50%), thrombocytopenia (26.7%), anemia (30%), diarrhea (3.3%), anorexia (6.7%), and hypertension (3.3%). Relative dose intensities were 94.5 and 96.3% for CPT-11 and BV, respectively. The median OS was 11.8 months (6.3 months—not reached).
Administration of CPT-11 plus BV to patients with mCRC achieved comparable efficacies with relatively lower toxicities compared with the results of previous studies using FOLFIRI plus BV as second-line therapy. The dose intensity of CPT-11 was judged as satisfactory.
UMIN000005228
Publication date: Available online 17 February 2017
Source:Free Radical Biology and Medicine
Author(s): Suhrid Banskota, Sushil Chandra Regmi, Jaya Gautam, Pallavi Gurung, Yu-Jeong Lee, Sae Kwang Ku, Jin-Hyung Lee, Jintae Lee, Hyeun Wook Chang, Sang Joon Park, Jung-Ae Kim
Adherent-invasive E. coli colonization and Toll-like receptor (TLR) expression are increased in the gut of inflammatory bowel disease (IBD) patients. However, the underlying mechanism of such changes has not been determined. In the current study, it was examined whether gut serotonin (5-hydroxytryptamine, 5-HT) can induce adherent-invasive E. coli colonization and increase TLR expression. In a co-culture system, commensal E. coli strain (BW25113, BW) adhered minimally to colon epithelial cells, but this was significantly enhanced by 5-HT to the level of a pathogenic strain (EDL933). Without inducing bacterial virulence, such as, biofilm formation, 5-HT enhanced BW-induced signaling in colon epithelial cells, that is, NADPH oxidase (NOX)-dependent superoxide production, the up-regulations of IL-8, TLR2, TLR4, and ICAM-1, and the down-regulations of E-cadherin and claudin-2. In a manner commensurate with these gene modulations, BW induced an increase in NF-κB and a decrease in GATA reporter signals in colon epithelial cells. However, 5-HT-enhanced BW adhesion and colon epithelial responses were blocked by knock-down of NOX2, TLR2, or TLR4. In normal mice, 5-HT induced the invasion of BW into gut submucosa, and the observed molecular changes were similar to those observed in vitro, except for significant increases in TNFα and IL-1β, and resulted in death. In dextran sulfate sodium-induced colitis mice (an IBD disease model), in which colonic 5-HT levels were markedly elevated, BW administration induced death in along with large amount of BW invasion into colon submucosa, and time to death was negatively related to the amount of BW injected. Taken together, our results demonstrate that 5-HT induces the invasion of commensal E. coli into gut submucosa by amplifying commensal bacteria-induced epithelial signaling (superoxide production and the inductions of NOX2 and TLR2/TLR4). The authors suggest that these changes may constitute the molecular basis for the pathogenesis of IBD.
Capsule summary: New T-cell subsets have not been considered in the context of drug hypersensitivity. Herein, we show that antigen-specific circulating and skin resident CD4+ and CD8+ T-cells secrete IL-22 and cytolytic molecules following drug treatment.
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Embryos extend their anterior-posterior (AP) axis in the conserved process of axis elongation. Drosophila axis elongation occurs in an epithelial monolayer, the germband, and is driven by cell intercalation, cell shape changes, and oriented cell divisions at the posterior germband. Anterior germband cells also divide during axis elongation. We developed image analysis and pattern recognition methods to track dividing cells from confocal microscopy movies in a generally-applicable approach. Mesectoderm cells, forming the ventral midline, divided parallel to the AP axis, while lateral cells displayed a uniform distribution of division orientations. Mesectoderm cells did not intercalate and sustained increased AP strain before cell division. After division, mesectoderm cell density increased along the AP axis, thus relieving strain. We used laser ablation to isolate mesectoderm cells from other tissues. Uncoupling the mesectoderm from intercalating cells did not affect cell division orientation. Conversely, separating the mesectoderm from the anterior and posterior poles of the embryo resulted in uniformly-oriented divisions. Our data suggest that mesectoderm cells align their division angle to reduce strain caused by mechanical forces along the AP axis of the embryo.
Substance P (SP) is linked to itch and inflammation through activation of receptors on mast cells and sensory neurons. There is increasing evidence that SP functions through Mas-related G protein–coupled receptors (Mrgprs) in addition to its conventional receptor, neurokinin-1.
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Toll-like receptors (TLRs) and substance P (SP) have both been shown to contribute to airway disease, particularly during viral infection. The present paper demonstrates a novel role for SP in kick-starting the TLR-driven immune response.
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Publication date: 15 June 2017
Source:Biosensors and Bioelectronics, Volume 92
Author(s): Ece Eksin, Erhan Zor, Arzum Erdem, Haluk Bingol
Recently, the low-cost effective biosensing systems based on advanced nanomaterials have received a key attention for development of novel assays for rapid and sequence-specific nucleic acid detection. The electrochemical biosensor based on reduced graphene oxide (rGO) modified disposable pencil graphite electrodes (PGEs) were developed herein for electrochemical monitoring of DNA, and also for monitoring of biointeraction occurred between anticancer drug, Daunorubicin (DNR), and DNA. First, rGO was synthesized chemically and characterized by using UV–Vis, TGA, FT-IR, Raman Spectroscopy and SEM techniques. Then, the quantity of rGO assembling onto the surface of PGE by passive adsorption was optimized. The electrochemical behavior of rGO–PGEs was examined by cyclic voltammetry (CV). rGO-PGEs were then utilized for electrochemical monitoring of surface-confined interaction between DNR and DNA using differential pulse voltammetry (DPV) technique. Additionally, voltammetric results were complemented with electrochemical impedance spectroscopy (EIS) technique. Electrochemical monitoring of DNR and DNA was resulted with satisfying detection limits 0.55µM and 2.71µg/mL, respectively.
The forkhead box O family consists of FoxO1, FoxO3, FoxO4 and FoxO6 proteins in mammals. Expressed ubiquitously in the body, the four FoxO isoforms share in common the amino DNA binding domain, known as "forkhead box" domain. They mediate the inhibitory action of insulin or insulin-like growth factor on key functions involved in cell metabolism, growth, differentiation, oxidative stress, senescence, autophagy and aging. Genetic mutations in FoxO genes or abnormal expression of FoxO proteins are associated with metabolic disease, cancer or altered lifespan in humans and animals. Of the FoxO family, FoxO6 is the least characterized member and is shown to play pivotal roles in the liver, skeletal muscle and brain. Altered FoxO6 expression is associated with the pathogenesis of insulin resistance, dietary obesity and type 2 diabetes, and risk of neurodegeneration disease. FoxO6 is evolutionally divergent from other FoxO isoforms. FoxO6 mediates insulin action on target genes in a mechanism that is fundamentally different from other FoxO members. Here we focus our review on the role of FoxO6, in contrast with other FoxO isoforms, in health and disease. We review the distinctive mechanism by which FoxO6 integrates insulin signaling to hepatic glucose and lipid metabolism. We highlight the importance of FoxO6 dysregulation in the dual pathogenesis of fasting hyperglycemia and hyperlipidemia in diabetes. We review the role of FoxO6 in memory consolidation and its contribution to neurodegeneration disease and aging. We discuss the potential therapeutic option of pharmacological FoxO6 inhibition for improving glucose and lipid metabolism in diabetes.
As placental morphology as well as trophoblast characteristics exhibit wide diversity across mammalian species, underling molecules were also thought to vary greatly. In the majority of cases, however, regardless of the mode of implantation, physiological and biochemical processes in conceptus implantation to the maternal endometrium including the kinds of gene expression and their products are now considered to share many similarities. In fact, recent progress has identified that in addition to the hormones, cytokines, proteases and cell adhesion molecules classically characterized, molecules related to lymphocyte homing and epithelial-mesenchymal transition (EMT) are all required for the progression of conceptus implantation to placentation. In this review, therefore, the newest findings are all incorporated into the molecular and cellular events related to conceptus implantation to the maternal endometrium; primarily from noninvasive bovine placentation, but also from invasive human implantation.
Liposuction and subsequent autologous fat grafting have become essential techniques for fat augmentation in plastic surgery. However, standard harvesting techniques that ensure survival of adipocytes and stromal vascular fraction (SVF) cells and thus preserve the transplanted fat volume are lacking. In particular, the effect of different parameters of the tumescent solution has not been studied in this context. We hypothesized that the osmolality of the tumescent solution could have a significant effect on the survival of adipocytes and SVF cells.
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This study aims to determine whether a bar-like implant made of poly lactic-co-glycolic acid (PLGA) could be used for cartilage suspension, and whether the implant would be suitable for rhinoplasty.
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Patients with involutional blepharoptosis sometimes require reoperation because of functional or aesthetic reasons after the primary operation. Few studies have analyzed risk factors for reoperation in such cases.
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While abdominally based flaps remain the first choice for autologous breast reconstruction, alternative donor sites are necessary when the abdomen is unavailable. Abdominal donor site suitability is determined, at times, based on DIEP-protocol computed tomographic angiography (CTA) results. CTA also provides information about the pelvis/upper thigh that can be used to evaluate suitability of other donor sites. The purpose of this study was to examine the utility of DIEP-protocol CTA in the assessment of a lateral thigh perforator flap (LTP).
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The trend towards optimizing stabilization of the craniomaxillofacial skeleton (CMFS) with the minimum amount of fixation required to achieve union, and away from maximizing rigidity, requires a quantitative understanding of craniomaxillofacial biomechanics. This study uses computational modeling to quantify the structural biomechanics of the CMFS under maximal physiologic masticatory loading.
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Pediatric congenital heart disease patients are at risk for vascular injuries during surgical procedures or when the arterial system is accessed for monitoring or diagnostic studies. Our treatment of emergent situations in this patient population using microvascular techniques shows the feasibility of such techniques.
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Using IndoCyanine Green (ICG) near-infrared fluorescence as a dye to assess tissue vascularisation is now well standardized. The aim of this literature review was to review and resume the most recent recommendations for ICG use in its plastic surgery applications.
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To describe a novel technique for involutional entropion (IE) correction and to present a retrospective case study.
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We report long-term outcomes analysis of twelve patients undergoing two-stage abdominal wall reconstruction using combined submuscular tissue expansion (TE) and anterior components separation (CS) technique.
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Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach.
A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots). Management of the injured upper roots was done by neurotization. Recovery was assessed as per our motor grading system.
After a minimum follow-up of 4 years, hand functional recovery was considered good in 7 patients and excellent in the remaining 7 patients.
We highlight the scarring of lower roots with evidence of partial avulsion-in situ in obstetric palsy. We also document that neurolysis is an acceptable approach to such lesions.
Level of Evidence: Level IV, therapeutic study.
Aging brings a number of health conditions that can compromise the healing process in elderly individuals, significantly when it comes to bone tissue. The aim of the present study was to analyze the effects of zoledronic acid (ZL) therapy on socket healing of aged male rats.
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Nowadays, in orbital wall reconstruction, maxillofacial surgeons have the possibility to treat patients in modern ways such as with individual implants. Nevertheless, conventional treatment including standard titanium mesh shaped during the surgical procedure is also widely used. The aim of this study was to compare the above methods of orbital wall reconstructions.
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TGF-β1 signaling modulates epithelial mesenchymal transitions (EMT) of head and neck squamous cell carcinoma (HNSCC). Bone marrow mesenchymal stromal cells (BMSC) are able to exert a regulating influence on the expression of markers of EMT in HNSCC cells. It was thus the aim of this study to test the hypothesis that TGF-β1 modulates the interactions of tumor transition between BMSCs and HNSCC, affecting the expression of E-cadherin, Vimentin, Snail, Twist, MMP14 and beta-catenin. Furthermore, we analyzed alterations in the AKT-signaling of tumor and stroma cells.
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Modifications of the temporomandibular joint position after mandible osteotomy are reluctantly accepted in orthognathic surgery. To tackle this problem, we developed a new navigation system using miniaturized electromagnetic sensors. Our imageless navigation approach is therefore optimized to avoid complications of previously proposed optical approaches such as the interference with established surgical procedures and the line of sight problem.
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Pharmaceutical wastewater treatment plants (PWWTPs) receive industrial effluents from the plant that contain extremely high levels of antibiotics and are regarded as one of the major sources of antibiotics in the environment. Two PWWTPs have been selected in Zhejiang Province, China, to assess the removal mechanisms of fluoroquinolone antibiotics (FQs). PWWTP A uses activated sludge with biocarriers in a moving bed biofilm reactor in anoxic and aerobic units, and PWWTP B uses biological units under anaerobic, aerobic, and anoxic conditions. The wastewater samples and solid samples (sludge and suspended solid matter) were analyzed using solid-phase extraction and ultra-performance liquid chromatography-mass spectrometry. Ofloxacin (OFX) was detected in each stage of PWWTP A, and enrofloxacin and ciprofloxacin were detected in PWWTP B. The concentrations of FQs ranged from 0.32 μg/L to 5.7 mg/L. Although the FQs were largely removed in the biological units (94.5 to 99.9%), large amounts were still discharged in the final effluent (up to 88.0 ± 7.0 μg/L) and dewatered sludge (up to 0.85 ± 0.24 mg/kg). Mass balance analyses of samples from PWWTP A indicated that biodegradation (93.8%) was the major mechanism responsible for the removal of OFX, whereas the contribution of sorption by sludge (0.79%) was less significant, deviating from the findings of most similar studies. Using linear analysis and correlation analysis, we found that the log10 values of the FQ concentration in the sludge were positively related with the log10 values of the equilibrium concentration in water (C w ). These relationships can be described by a Freundlich-like equation. However, these relationships were negative when the C w values were high. Our preliminary explanation is that the equilibrium C w plays an important role in controlling the sorption behavior of FQs in activated sludge.
The state of Assam in north-east India gained popularity in Asia because of discovery of oil. Pollution due to petroleum and gas exploration is a serious problem in Assam. Oil and gas exploration by various agencies in Assam resulted in soil pollution due to hydrocarbons (HCs) and heavy metals (HMs). Bioremediation gained considerable significance in addressing petroleum hydrocarbon polluted sites in various parts of the world. In this investigation, we have observed 15 species of plants belonging to grass growing on the contaminated soils. Among 15 species of grasses, 10 species with high important value index (IVI) were found to be better adapted. The highest IVI is exhibited by Axonopus compressus (21.41), and this grass can be identified as key ecological tool in the rehabilitation of the degraded site. But no definite correlation between the IVI and the biomass of the various grass existed in the study sites. Chemical study of rhizosphere (RS) and non-rhizosphere (NRS) soil of these grasses revealed both aromatic and aliphatic compounds (M.W. 178–456). Four-ring pyrene was detected in NRS soil but not in RS soil. Microbiological study of RS and NRS soil showed high colony-forming unit (CFU) of HC-degrading microbes in RS compared to NRS. The increased microbial catabolism in RS soil established the fact that pyrene is transformed to aliphatic compounds. Metals in RS soil ranged from (in mg kg−1) 222.6 to 267.3 (Cr), 854 to 956 (Pb) and 180 to 247 (Ni), but despite the very high total metal concentration in RS and NRS soil, the CaCl2-extracted metals were relatively low in RS soil (1.04 for Cr, 0.56 for Pb, 0.35 for Ni). Plants with the highest uptake of metals were Leersia hexandra (36.43 mg Cr kg−1) and Kyllinga brevifolia (67.73 mg Pb kg−1 and 40.24 mg Ni kg−1). These plant species could be potentially exploited for biomonitoring and bioremediation. Out of 15 plant species, 8 of them have high percentages of cellulose, crude fibres, lignin and holocellulose (14–16%). The explored species thus qualify as energy crops since they have high bioproductivity and are more resilient and adaptable in HM/HC-contaminated sites.
Hydropower offers a reliable source of electricity in several countries, and Brazil supplies its energy needs almost entirely through hydropower plants. Nevertheless, hydropower plants comprise large buildings and water reservoirs and dams, resulting in huge ecological disruptions. Here, we analyzed the impact of four hydropower reservoirs construction in metals and pesticides incidence and the cytotoxic and genotoxic potential of sediment elutriate of rivers from southern Brazil. Our analyses have evidenced the elevated incidence of different metals (lead, iron, cadmium, and chrome) and pesticides (methyl parathion, atrazine, and 2,4-dichlorophenoxyacetic acid). We showed that Allium cepa exposed to sediment elutriates did not change the seed germination rate and mitotic index. However, roots from Allium cepa exposed to reservoirs sediment elutriates showed increased occurrence of chromosomal aberrations and nuclear abnormalities. Therefore, the results obtained in our study indicate that sediment from reservoirs present elevated concentration of metals and pesticides and a significant genotoxic potential. Taken together, our data support that hydropower reservoirs represent an environmental scenario that could impact surrounding wildlife and population.
Changes in land-uses and fertilization are important factors regulating methane (CH4) emissions from paddy soils. However, the responses of soil CH4 emissions to these factors and the underlying mechanisms remain unclear. The objective of this study was to explore the effects of land-use conversion from paddies to orchards and fertilization on soil CH4 fluxes, and the abundance and community compositions of methanogens and methanotrophs. Soil CH4 fluxes were quantified by static chamber and gas chromatography technology. Abundance and community structures of methanogens and methanotrophs (based on mcrA and pmoA genes, respectively) were determined by quantitative real-time PCR (qPCR), and terminal restriction fragment length polymorphism (TRFLP), cloning and sequence analysis, respectively. Results showed that land-use conversion from paddies to orchards dramatically decreased soil CH4 fluxes, whereas fertilization did not distinctly affect soil CH4 fluxes. Furthermore, abundance of methanogens and methanotrophs were decreased after converting paddies to orchards. Fertilization decreased the abundance of these microorganisms, but the values were not statistically significant. Moreover, land-use conversion had fatal effects on some members of the methanogenic archaea (Methanoregula and Methanosaeta), increased type II methanotrophs (Methylocystis and Methylosinus), and decreased type I methanotrophs (Methylobacter and Methylococcus). However, fertilization could only significantly affect type I methanotrophs in the orchard plots. In addition, CH4 fluxes from paddy soils were positively correlated with soil dissolved organic carbon contents and methanogens abundance, whereas CH4 fluxes in orchard plots were negatively related to methanotroph abundance. Therefore, our results suggested that land-use conversion from paddies to orchards could change the abundance and community compositions of methanogens and methanotrophs, and ultimately alter the soil CH4 fluxes. Overall, our study shed insight on the underlying mechanisms of how land-use conversion from paddies to orchards decreased CH4 emissions.
Publication date: Available online 17 February 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Filippo Alongi, Stefano Arcangeli, Berardino De Bari, Niccolò Giaj-Levra, Alba Fiorentino, Rosario Mazzola, Marco Trovò
Small cell lung cancer (SCLC) is relative rare histology in lung cancer patients. The standard treatment, in patients with an intra-thoracic disease, is represented by the use of concurrent chemo-radiotherapy; while patients with early SCLC stage, surgical resection could be recommended. Stereotactic body radiotherapy (SBRT) is a recently introduced technique allowing the delivery of very high radiation doses to limited target volumes and it is considered the standard approach in the treatment of not operable stage I Non Small-Cell Lung Cancer (NSCLC). The successful role option of SBRT in early NSCLC in terms of local control and toxicity profile opened the issue in the use of this approach in early stage small cell lung cancer (SCLC). Aim of this review is to discuss the current literature in the safety and efficacy of SBRT in the treatment of patients with stage I SCLC.
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Transseptal access with crossing multiple incisions for improved pedicle control and septum preservation: "How I do it.
Am J Rhinol Allergy. 2017 Feb 15;:
Authors: Omura K, Asaka D, Nayak J, Tanaka Y
Abstract
INTRODUCTION: Recently, the surgical management of nasal tumors has been greatly influenced by advanced endoscopic techniques. To achieve complete endoscopic resection of large obstructing nasal tumors, a sufficient corridor for adequate exposure is also required. In the Japanese language, TACMI means "master expert," and herein we describe an endoscopic technique with novel elements that we term transseptal access with crossing multiple incisions (TACMI). This approach enables a direct transseptal approach to the pedicle through tumor transposition while allowing complete septal reconstruction and stability.
METHODS: We prospectively collected data from eight patients who underwent the TACMI approach for sinonasal tumors.
RESULTS: When using TACMI, complete en bloc neoplasm resection was achieved in all but one patient, who underwent piecemeal tumor removal. The follow-up duration ranged from 10 to 28 months (mean, 19 months). None of the patients experienced septal perforation, nasal valve incompetence, or tumor recurrence.
CONCLUSION: We presented evidence that TACMI was a simple, efficient, and effective technique for tumor transposition, and for pedicle visualization and access of challenging unilateral sinonasal lesions. These advantages contributed to limited blood loss, improved pedicle control, and complete nasal valve andseptum preservation without functional deficits.
PMID: 28205501 [PubMed - as supplied by publisher]
Publication date: January–February 2017
Source:Acta Otorrinolaringologica (English Edition), Volume 68, Issue 1
Author(s): Maria Dablanca, Ana Maeso, Desiree del C. Méndez, Primitivo Ortega
Autoimmune origin ranks fifth in the etiologic classification of laryngotracheal stenosis. Wegener's disease is the autoimmune illness most associated with stenosis; however, there are other autoimmune diseases that may also be associated with it.A descriptive, retrospective study of 9 cases of laryngotracheal stenosis associated with autoimmune disease was carried out. There were 9 patients (8 females and 1 male) with an average age of 27.9 years. Four of the patients suffered from Wegener's disease, 1 from ulcerative colitis, and 1 from purple vasculitis. The other 3 patients only had positive c-ANA. Endoscopic treatment was performed in 3 cases. The other 6 patients required open surgery. Respiratory results were acceptable. Based on our study, we feel that the immunological profiles should be studied in all patients with stenosis, given that not only Wegener's disease is linked to stenosis.
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Publication date: 5 June 2017
Source:Journal of Molecular Structure, Volume 1137
Author(s): Khalid Al-Adilee, Hussein A.K. Kyhoiesh
The preparation and spectral identification of metal complexes for Cr(III), Mn(II), Fe(III), Co(II), Ni(II), Cu(II), Zn(II), Cd(II) and Hg(II) ions with new heterocyclic azo dye as ligand 2-[2−- (1- Hydroxy - 4- Chloro phenyl) azo ]- imidazole (HClPAI) were prepared by reacting adizonium chloride salt solution of 2-amino -4- chloro phenol with imidazole in alkaline ethanolic solution. Azo dye ligand and their metal complexes have been characterized by analytical data, 1H NMR, Mass spectrum, Infrared, Electronic spectral data, XRD, SEM, thermal analysis (TG-DSC-DTG), magnetic susceptibility and molar conductance. The elemental analysis of the metal complexes confirm the stoichiometry of the type [M(L)2] Cl where M = Cr(III), Fe(III), Co(II) and [M(L)2] where M = Mn(II), Ni(II), Cu(II), Zn(II), Cd(II), Hg(II) and L = azo dye ligand. Molar conductance measurements for prepared metal complexes showed 1:1 electrolyte for Cr(III), Fe(III) and Co(III) ions and non-electrolyte the rest metal complexes. The data show that the azo dye ligand behaves a tridentate and coordinates to the metal ion via nitrogen atom of azo group which is the farthest of imidazole molecule, nitrogen atom of azomethine group of heterocyclic imidazole ring and phenolic oxygen. Octahedral environment is suggested for all metal complexes.
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Publication date: 1 June 2017
Source:Geoderma, Volume 295
Author(s): M. Izquierdo, A.M. Tye, S.R. Chenery
Flooded soils are systems with complex chemistry and understanding the mechanisms that control the mobility and bioavailability of metals in these soils is important for their management. This work uses stable metal multi-element isotopic dilution combined with sequential extraction assays to help understand the changes in solid and solution speciation of Cd, Fe, Pb and Zn in a contaminated soil following submergence. However, it is necessary to ensure that the isotopic dilution principles, originally developed for aerobic soils, are not compromised; in particular due to the presence of non-labile colloids in the solution phase. In particular, no studies examining the validity of these assays in systems where rapid pH and Eh changes are occurring due to fermentation reactions have been published. Thus sucrose (0.42% and 1.26% added C) was used as a carbon source to stimulate bacterial mediated fermentation reactions allowing changes in Cd, Zn, Fe and Pb isotopic exchangeability, speciation and solution chemistry to be examined after 10, 20 and 42days of submergence. Without the addition of added C, submergence for 42days only produced minor changes in the speciation of the metals in solid or solution phases. However, the presence of easily labile carbon produced significant responses depending on the quantity of C added. Assessments of whether fermentation products caused over-estimation of the isotopically exchangeable pool of metals (E-values) were made by measuring concentrations with and without a resin purification step. Results showed generally good agreement over a pH range of 4–7 for Pb, Cd, Zn and Fe and demonstrate that fermentation by-products do not induce the formation of non-exchangeable metal colloids. E-value concentrations were compared with fractions extracted using a modified Tessier sequential extraction. With no carbonate phases present in the soils, the E-values for Cd, Zn, Fe and Pb compared favourably with the concentrations of metal present in the combined solution, exchangeable and specifically adsorbed fractions. This provided additional evidence that the conditions for the isotopic dilution assays were not violated as these fractions should be isotopically exchangeable. Combining results from the different treatments and stages of the reduction process, strong pH dependence was found for the isotopically exchangeable and the solution pools of Cd, Zn and Pb.
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Reconstruction of the craniofacial complex is challenging because of the unique anatomy, the presence of vital structures, and the diversity of defects. In craniofacial reconstruction, restoration of appearance and function is the primary goal. Autografts are the gold standard treatment,1 but they have several disadvantages, which has led to research into alloplastic materials. The development of CADCAM systems allows for precise preoperative planning and design of patient-specific implants.2,3 The workflow of custom-made implants is shown in Fig.
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