Recent Developments for Introducing a Hexafluoroisopropanol Unit into the Vitamin D Side Chain

Publication date: Available online 14 July 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Fumihiro Kawagoe, Toru Sugiyama, Motonari Uesugi, Atsushi Kittaka
Among numerous studies on synthetic approaches to and the biological activities of vitamin D analogues, we herein focused on falecalcitriol, an analogue of calcitriol (1α,25-dihydroxyvitamin D3), in which a 26,26,26,27,27,27-hexafluoroisopropanol unit has been introduced into the side chain. Falecalcitriol was designed to escape from the metabolism of CYP24A1 and has been used as a drug to treat secondary hypoparathyroidism since 2001. Its metabolite, the 23-hydroxy form, retains biological activity and resistants to further metabolism. Recent developments in synthetic methodologies for introducing the hexafluoroisopropanol unit into the vitamin D CD-ring side chain were described herein.

Graphical abstract

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Properties of Purified CYP2R1 in a Reconstituted Membrane Environment and its 25-Hydroxylation of 20-Hydroxyvitamin D3

Publication date: Available online 14 July 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Chloe Y.S. Cheng, Tae-Kang Kim, Saowanee Jeayeng, Andrzej T. Slominski, Robert C. Tuckey
Recent studies indicate that CYP2R1 is the major 25-hydroxylase catalyzing the first step in vitamin D activation. Since the catalytic properties of CYP2R1 have been poorly studied to date and it is a membrane protein, we examined the purified enzyme in a membrane environment. CYP2R1 was expressed in E. coli and purified by nickel affinity- and hydrophobic interaction-chromatography and assayed in a reconstituted membrane system comprising phospholipid vesicles plus purified human NADPH-P450 oxidoreductase. CYP2R1 converted vitamin D3 in the vesicle membrane to 25-hydroxyvitamin D3 [25(OH)D3] with good adherence to Michaelis-Menten kinetics. The kinetic parameters for 25-hydroxylation of vitamin D3 by the two major vitamin D 25-hydroxylases, CYP2R1 and CYP27A1, were examined in vesicles under identical conditions. CYP2R1 displayed a slightly lower kcat than CYP27A1 but a much lower Km for vitamin D3, and thus an overall 17-fold higher catalytic efficiency (kcat/Km), consistent with CYP2R1 being the major vitamin D 25-hydroxylase. 20-Hydroxyvitamin D3 [20(OH)D3], the main product of vitamin D3 activation by an alternative pathway catalyzed by CYP11A1, was metabolized by CYP2R1 to 20,25-dihydroxyvitamin D3 [20,25(OH)2D3], with catalytic efficiency similar to that for the 25-hydroxylation of vitamin D3. 20,25(OH)2D3 retained full, or somewhat enhanced activity compared to the parent 20(OH)D3 for the inhibition of the proliferation of melanocytes and dermal fibroblasts, with a potency comparable to 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. The 20,25(OH)2D3 was also able to act as an inverse agonist on retinoic acid-related orphan receptor α, like its parent 20(OH)D3. Thus, the major findings of this study are that CYP2R1 can metabolize substrates in a membrane environment, the enzyme displays higher catalytic efficiency than CYP27A1 for the 25-hydroxylation of vitamin D, it efficiently hydroxylates 20(OH)D3 at C25 and this product retains the biological activity of the parent compound.



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Vitamin D levels in childhood and adolescence and cardiovascular risk factors in a cohort of healthy Australian children

Publication date: Available online 15 July 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Larry Ke, Rebecca S. Mason, Louise A. Baur, Chris T. Cowell, Xiaoying Liu, Sarah P. Garnett, Kaye E. Brock
As the prevalence of obesity appears to be increasing in Australia's youth the overall objective of this study was to examine serum 25-hydroxyvitamin D (25OHD) concentrations in a cohort of 8-year-olds (n=249) followed up at age 15 (n=162) and explore associations between 25OHD with cardiovascular disease (CVD) risk factors in these populations. This was done in two stages: the first, two cross-sectional analyses (at ages 8 and 15); and the second, a prospective analysis from age 8 to 15. At both ages data on 25OHD, blood lipids, and anthropometry were measured. Date of blood draw was used as a surrogate of sunlight exposure. Results were then analysed by multivariate linear analyses taking into account interaction and confounding. Mean 25OHD concentrations decreased from 94±25nmol/L to 63±16nmol/L between age 8 and 15 years (p<0.001). On cross-sectional analysis of 8year olds, no CVD risk factor was found to be significantly associated with 25OHD concentrations. On cross-sectional analysis of 15year olds lower 25OHD levels were significantly associated with higher body fat (adjusted β=−0.24, p=0.003). Prospectively, lower 25OHD levels in 8-year-old boys, but not girls, were significantly associated with higher blood total cholesterol (adjusted β=−0.28, p=0.040) and triglyceride levels (adjusted β=−0.33, p=0.030) at age 15. The limitation of these data is the relatively small sample sizes, however these results suggest that low 25OHD in childhood needs to be further investigated in larger cohort studies as there may be later cardiovascular consequences in adolescence.



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Butyrate-inserted Ni–Ti layered double hydroxide film for H2O2-mediated tumor and bacteria killing

Publication date: Available online 13 July 2017
Source:Materials Today
Author(s): Donghui Wang, Feng Peng, Jinhua Li, Yuqin Qiao, Qianwen Li, Xuanyong Liu
The selective tumor- and bacteria-killing property is promising for biomedical implants in directly contact with tumor tissue but still presents a considerable challenge. In this study, a butyrate-inserted Ni–Ti layered double hydroxide film (LDH/Butyrate) is prepared on the surface of nitinol alloy via a simple hydrothermal treatment. The prepared film can selectively inhibit tumor growth and metastasis and bacterial infection by taking advantage of the overproduced H2O2 in tumor and infection microenvironments: the pro-tumor and pro-infection molecule H2O2 can be consumed by LDH/Butyrate, and cytotoxic butyrate inserted in LDH/Butyrate is subsequently exchanged out. Such a novel endogenous stimuli-responsive platform is expected to prevent tumor overgrowth, metastasis and bacterial infection and will find a promising application in the design of localized drug-eluting systems.

Graphical abstract

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Ex vivo and in vivo evaluation of microemulsion based transdermal delivery of E. coli specific T4 bacteriophage: A rationale approach to treat bacterial infection

Publication date: 30 September 2017
Source:European Journal of Pharmaceutical Sciences, Volume 107
Author(s): Vaibhav Rastogi, Pragya Yadav, Anurag Verma, Jayanta K. Pandit
This study is focused on the development and evaluation of transdermal delivery of E. coli-specific T4 bacteriophages both ex-vivo and in-vivo using microemulsion as delivery carrier in eradicating the infection caused by E. coli. Microemulsions were prepared by mixing selected oil, surfactants and aqueous phase containing bacteriophages. The formulations were subjected to physicochemical characterization, ex-vivo and in-vivo permeation, stability studies, histological and immunofluorescence examination. The colloidal system exhibits a uniform size distribution, of finite size (150–320nm). Transmission electron microscopy revealed the encapsulation of bacteriophage in the aqueous globule. Ex-vivo permeation across skin was successfully achieved as 6×10⁶PFU/mL and 6.7×10⁶PFU/mL of T4 permeated from ME 6% and 10%, respectively. ME 6% was found to be thermodynamically stable and in-vivo permeation resulted in 5.49×10⁵PFU/mL of bacteriophages in the blood of the E. coli challenged rats, while 2.48×10⁵PFU/mL was detected in germ free rats, at the end of the study. Infected rats that were treated with bacteriophage were survived while significant mortality was observed in others. Histological and IL-6 immunofluorescence examination of the tissues revealed the efficacy/safety of the therapy. The microemulsion-based transdermal delivery of bacteriophage could be a promising approach to treat the infections caused by antibiotic-resistant bacteria.

Graphical abstract

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Impact of pneumococcal conjugate vaccine (PCV7 and PCV13) on pneumococcal invasive diseases in Italian children and insight into evolution of pneumococcal population structure

Publication date: Available online 14 July 2017
Source:Vaccine
Author(s): Romina Camilli, Fabio D'Ambrosio, Maria Del Grosso, Fernanda Pimentel de Araujo, Maria Grazia Caporali, Martina Del Manso, Giovanni Gherardi, Fortunato D'Ancona, Annalisa Pantosti
BackgroundThe use of PCV7 for children immunization was gradually implemented in the Italian regions starting from 2006 and was replaced by PCV13 in 2010–2011. In this study we aimed to assess the PCV impact on invasive pneumococcal diseases (IPD) incidence, serotype distribution and antibiotic resistance in Italian children under 5years old.MethodsAll IPD cases in children from 5 Italian regions (Emilia-Romagna, Lombardia, A. P. Bolzano, A. P. Trento, and Piemonte) reported through the nationwide surveillance system during 2008–2014 were included in this study. Pneumococcal isolates were subjected to serotyping, antibiotic susceptibility testing, and clonal analysis according to standard methods.ResultsDuring the study period overall IPD incidence decreased from 7.8 cases/100,000 inhabitants in 2008 to 3.0 cases/100,000 in 2014 (61% decrease, P<0.001). In particular, from 2008 to 2014, PCV7-type IPD decreased from 2.92 to 0.13 cases/100,000 inhabitants (95% decrease, P<0.001) while PCV13-non-PCV7 type IPD decreased from 3.2 to 0.89 cases/100,000 inhabitants (72% decrease, P=0.008).Conversely, non-vaccine serotype (NVS) IPD increased overtime, becoming more common than PCV13 serotype IPD in 2013–2014. Emergent NVS 24F and 12F were the most prevalent in 2014. Antibiotic resistance testing revealed an overall increasing trend in penicillin resistance, from 14% in 2008 to 23% in 2014. Erythromycin resistance showed a downward trend, from 38% in 2008 to 27% in 2014. While in 2008 PCV13 serotypes were the major responsible for antibiotic resistance, during the following years antimicrobial resistance due to NVS increased, mainly as a result of expansion of pre-existing clones.ConclusionsBoth PCVs led to a substantial decrease in vaccine-related IPD incidence in the children population. However NVS-related IPD increased, becoming the most prevalent in the last two-years period. Continuous surveillance is an essential tool to monitor evolution of pneumococcal population causing IPD in children.



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Calcium phosphate nanoparticle (CaPNP) for dose-sparing of inactivated whole virus pandemic influenza A (H1N1) 2009 vaccine in mice

Publication date: Available online 14 July 2017
Source:Vaccine
Author(s): Tülin Morçӧl, Brett L. Hurst, E. Bart Tarbet
The emergence of pandemic influenza strains, particularly the reemergence of the swine-derived influenza A (H1N1) in 2009, is reaffirmation that influenza viruses are very adaptable and influenza remains as a significant global public health treat. As recommended by the World Health Organization (WHO), the use of adjuvants is an attractive approach to improve vaccine efficacy and allow dose-sparing during an influenza emergency. In this study, we utilized CaPtivate Pharmaceutical's proprietary calcium phosphate nanoparticles (CaPNP) vaccine adjuvant and delivery platform to formulate an inactivated whole virus influenza A/CA/04/2009 (H1N1pdm) vaccine as a potential dose-sparing strategy. We evaluated the relative immunogenicity and the efficacy of the formulation in BALB/c mice following single intramuscularly administration of three different doses (0.3, 1, or 3µg based on HA content) of the vaccine in comparison to non-adjuvanted or alum-adjuvant vaccines. We showed that, addition of CaPNP in vaccine elicited significantly higher hemagglutination inhibition (HAI), virus neutralization (VN), and IgG antibody titers, at all dose levels, relative to the non-adjuvanted vaccine. In addition, the vaccine containing CaPNP provided equal protection with 1/3rd of the antigen dose as compared to the non-adjuvanted or alum-adjuvanted vaccines. Our data provided support to earlier studies indicating that CaPNP is an attractive vaccine adjuvant and delivery system and should play an important role in the development of safe and efficacious dose-sparing vaccines. Our findings also warrant further investigation to validate CaPNP's capacity as an alternative adjuvant to the ones currently licensed for influenza/pandemic influenza vaccination.



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Erratum to: Dye removal of AR27 with enhanced degradation and power generation in a microbial fuel cell using bioanode of treated clinoptilolite-modified graphite felt

http://ift.tt/2tVr2gu

Cone beam computed tomography evaluation of midpalatal suture maturation in adults

The aim of this study was to evaluate midpalatal suture maturation in adults, as observed in cone beam computed tomography (CBCT) images. CBCT scans from 78 subjects (64 female and 14 male, age range from 18 to 66 years) were evaluated. Midpalatal suture maturation was verified on the central cross-sectional axial slice in the superior–inferior dimension of the palate, using methods validated previously. Intra-examiner agreement was analyzed by weighted kappa test. Multinomial logistic regression was used to test whether sex and chronological age (adults <30 years or ≥30 years) could be used as a predictor for the maturational stages of the midpalatal suture.

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Characteristics of mandibular injuries caused by bullets and improvised explosive devices: a comparative study

The purpose of this study was to investigate the difference in mandibular trauma caused by two mechanisms for the delivery of missile injuries: firearms and improvised explosive devices (IEDs). The data investigated included sex, age, mechanism of injury, and other clinical and radiographic manifestations. Seventy consecutive patients, predominantly male, with a mean age of 28.6±14 years (range 2–60 years) were enrolled: 38 patients (54.3%) sustained mandibular fractures caused by bullet injuries and 32 patients (45.7%) had mandibular fractures caused by IED explosion injuries.

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The bone lid technique in oral surgery: a case series study

The aim of this case series study was to illustrate the bone lid technique implemented using piezoelectric surgery to access mandibular alveolar bone diseases and to assess the clinical and radiographic outcomes. The technique was used to treat 21 consecutive patients with various conditions: cysts in six cases, impacted teeth with associated cysts in nine, keratocystic odontogenic tumours in three, impacted teeth in two, and an endodontic lesion in one. The bone lid was fashioned using piezoelectric surgery and a thin osteotomy insert.

http://ift.tt/2ujQwa2

Clinical significance of preoperative serum C-reactive protein in oral squamous cell carcinoma

C-reactive protein (CRP) is an index of systemic inflammation. However, CRP is not usually assessed preoperatively. Hence the study intended to evaluate the preoperative serum CRP levels in oral squamous cell carcinoma (OSCC) patients and to analyse its relationship with the clinicopathologic characteristics. CRP values for 60 OSCCs and 30 healthy controls were evaluated using a CRP assessment kit and spectrophotometer. The Mann–Whitney U test, χ2 test, receiver operating characteristic (ROC) curve analysis, and logistic regression were applied.

http://ift.tt/2t0Pr39

Shaping and Reshaping Transcriptome Plasticity during Evolution

Publication date: Available online 14 July 2017
Source:Trends in Biochemical Sciences
Author(s): Shobbir Hussain
Transcriptome plasticity, usually associated with alternative isoform generation, is recognised as a key mechanism driving proteomic diversity and biological complexity. Recent findings of Liscovitch-Brauer et al. and Ma et al. suggest that RNA base modifications are an additional central mode of transcriptome malleability that have the potential to determine evolutionary outcomes.



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Cell Polarity Regulates Biased Myosin Activity and Dynamics during Asymmetric Cell Division via Drosophila Rho Kinase and Protein Kinase N

Publication date: Available online 14 July 2017
Source:Developmental Cell
Author(s): Anna Tsankova, Tri Thanh Pham, David Salvador Garcia, Fabian Otte, Clemens Cabernard
Cell and tissue morphogenesis depends on the correct regulation of non-muscle Myosin II, but how this motor protein is spatiotemporally controlled is incompletely understood. Here, we show that in asymmetrically dividing Drosophila neural stem cells, cell intrinsic polarity cues provide spatial and temporal information to regulate biased Myosin activity. Using live cell imaging and a genetically encoded Myosin activity sensor, we found that Drosophila Rho kinase (Rok) enriches for activated Myosin on the neuroblast cortex prior to nuclear envelope breakdown (NEB). After NEB, the conserved polarity protein Partner of Inscuteable (Pins) sequentially enriches Rok and Protein Kinase N (Pkn) on the apical neuroblast cortex. Our data suggest that apical Rok first increases phospho-Myosin, followed by Pkn-mediated Myosin downregulation, possibly through Rok inhibition. We propose that polarity-induced spatiotemporal control of Rok and Pkn is important for unequal cortical expansion, ensuring correct cleavage furrow positioning and the establishment of physical asymmetry.

Graphical abstract

Teaser

Most cells divide symmetrically, but several cell types are known to generate unequal-sized siblings with different functions. Tsankova et al. report that the conserved polarity protein Pins controls the activity of the motor protein Myosin through two protein kinases, to ensure that Drosophila neural stem cells divide asymmetrically.


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Electronic, magnetic properties of transition metal doped Tl2S: First-principles study

Publication date: 15 December 2017
Source:Applied Surface Science, Volume 425
Author(s): Nahong Song, Yusheng Wang, Weiyang Yu, Liying Zhang, Yuye Yang, Yu Jia
In this paper, the structural, electric and magnetic properties of transition metal (TM) doped monolayer Tl2S are investigated by means of first-principles methods The results show that all the considered TM atoms are strongly bonded to the Tl vacancy site. The magnetic moment, the dilute magnetic semiconductor and metal characteristics are varied depending on the specific TM atoms. The TM doped Tl2S (TM-Tl2S) (from Sc to Ni) systems have fractional magnetic moments changing from 0.539μB to 4.479μB. However, Cu- and Zn-Tl2S systems exit the nonmagnetic ground states. The spin polarized metallic states are achieved by Sc, Ti, V, Mn and Fe doping, while spin polarized semiconducting states are realized by Cr, Co and Ni doping. The charge transfer, the total magnetic moment and the band gap obtained with PBE method are less than the values obtained by PBE+U, which suggests that the Hubbard U plays an important role in TM-Tl2S systems. In the case of two same types of TM atoms doped Tl2S systems, there exist AFM in Sc-, V-, Mn-Tl2S systems and FM only in Ti-Tl2S system. Interestingly, the Cr-, Fe-, Co-, Ni-Tl2S systems manifest paramagnetic. These findings may provide a new route for exploring two-dimensional diluted magnetic semiconductors experimentally and theoretically.



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A common password improves validation rates for elogbook

A validated log of operations is an essential component of a surgical trainee's portfolio. For all specialties in the UK, the eLogbook1 is the official electronic version.

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Fertility And Pregnancy Issues In Brca-Mutated Breast Cancer Patients

Publication date: Available online 14 July 2017
Source:Cancer Treatment Reviews
Author(s): Matteo Lambertini, Oranite Goldrat, Angela Toss, Hatem A. Azim, Fedro A. Peccatori, Michail Ignatiadis, Lucia Del Mastro, Isabelle Demeestere
Fertility and pregnancy-related issues represent one of the main areas of concerns for young women with breast cancer. Carrying a germline deleterious BRCA mutation adds additional burden on this regard due to the specific issues that should be considered during the oncofertility counseling of this special patient group. Despite the availability of a growing amount of data in the general breast cancer population on the feasibility and safety of fertility preservation and pregnancy after diagnosis, numerous challenges remain for BRCA-mutated breast cancer patients in whom very limited studies have been performed so far. Therefore, studies aiming to address the specific issues of these patients, including the impact of the mutation on their fertility potential, the safety and efficacy of the different strategies for fertility preservation, and the feasibility of having a pregnancy after diagnosis, should be considered a research priority.The aim of the present manuscript is to perform an in depth overview on the role of BRCA mutations in breast cancer with a specific focus on their impact on reproductive potential, and to discuss the fertility and pregnancy issues faced by BRCA-mutated breast cancer patients. The final goal of this manuscript is to highlight current and upcoming knowledge in this field for trying to help physicians dealing with these patients during oncofertility counseling.



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Freehand 3-D Ultrasound Imaging: A Systematic Review

Publication date: Available online 14 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Mohammad Hamed Mozaffari, Won-Sook Lee
Two-dimensional ultrasound (US) imaging has been successfully used in clinical applications as a low-cost, portable and non-invasive image modality for more than three decades. Recent advances in computer science and technology illustrate the promise of the 3-D US modality as a medical imaging technique that is comparable to other prevalent modalities and that overcomes certain drawbacks of 2-D US. This systematic review covers freehand 3-D US imaging between 1970 and 2017, highlighting the current trends in research fields, the research methods, the main limitations, the leading researchers, standard assessment criteria and clinical applications. Freehand 3-D US systems are more prevalent in the academic environment, whereas in clinical applications and industrial research, most studies have focused on 3-D US transducers and improvement of hardware performance. This topic is still an interesting active area for researchers, and there remain many unsolved problems to be addressed.



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Training Midwives to Perform Basic Obstetric Point-of-Care Ultrasound in Rural Areas Using a Tablet Platform and Mobile Phone Transmission Technology—A WFUMB COE Project

Publication date: Available online 14 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Sudhir Vinayak, Joyce Sande, Harvey Nisenbaum, Christian Pállson Nolsøe
Point-of-care ultrasound (POCUS) has become a topical subject and can be applied in a variety of ways with differing outcomes. The cost of all diagnostic procedures including obstetric ultrasound examinations is a major factor in the developing world and POCUS is only useful if it can be equated to good outcomes at a lower cost than a routine obstetric examination. The aim of this study was to assess a number of processes including accuracy of images and reports generated by midwives, performance of a tablet-sized ultrasound scanner, training of midwives to complete ultrasounds, teleradiology solution transmissions of images via internet, review of images by a radiologist, communication between midwife and radiologist, use of this technique to identify high-risk patients and improvement of the education and teleradiology model components. The midwives had no previous experience in ultrasound. They were stationed in rural locations where POCUS was available for the first time. After scanning the patients, an interim report was generated by the midwives and sent electronically together with all images to the main hospital for validation. Unique software was used to send lossless images by mobile phone using a modem. Transmission times were short and quality of images transmitted was excellent. All reports were validated by two experienced radiologists in our department and returned to the centers using the same transmission software. The transmission times, quality of scans, quality of reports and other parameters were recorded and monitored. Analysis showed excellent correlation between provisional and validated reports. Reporting accuracy of scans performed by the midwives was 99.63%. Overall flow turnaround time (from patient presentation to validated report) was initially 35 min but reduced to 25 min. The unique mobile phone transmission was faultless and there was no degradation of image quality. We found excellent correlation between final outcomes of the pregnancies and diagnoses on the basis of reports generated by the midwives. Only 1 discrepancy was found in the midwives' reports. Scan results versus actual outcomes revealed 2 discrepancies in the 20 patients identified as high risk. In conclusion, we found that it is valuable to train midwives in POCUS to use an ultrasound tablet device and transmit images and reports via the internet to radiologists for review of accuracy. This focus on the identification of high-risk patients can be valuable in a remote healthcare facility.



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Unmyelinated Peripheral Nerves Can Be Stimulated in Vitro Using Pulsed Ultrasound

Publication date: Available online 14 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Christopher J. Wright, Seyyed R. Haqshenas, John Rothwell, Nader Saffari
Appreciation for the medical and research potential of ultrasound neuromodulation is growing rapidly, with potential applications in non-invasive treatment of neurodegenerative disease and functional brain mapping spurring recent progress. However, little progress has been made in our understanding of the ultrasound–tissue interaction. The current study tackles this issue by measuring compound action potentials (CAPs) from an ex vivo crab walking leg nerve bundle and analysing the acoustic nature of successful stimuli using a passive cavitation detector (PCD). An unimpeded ultrasound path, new acoustic analysis techniques and simple biological targets are used to detect different modes of cavitation and narrow down the candidate biological effectors with high sensitivity. In the present case, the constituents of unmyelinated axonal tissue alone are found to be sufficient to generate de novo action potentials under ultrasound, the stimulation of which is significantly correlated to the presence of inertial cavitation and is never observed in its absence.



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Non-invasive Evaluation of Right Ventricular Function with Real-Time 3-D Echocardiography

Publication date: Available online 14 July 2017
Source:Ultrasound in Medicine & Biology
Author(s): Ran Chen, Meihua Zhu, Kacie Amacher, Xia Wu, David J. Sahn, Muhammad Ashraf
The aim of this study was to evaluate the accuracy and feasibility of real-time 3-D echocardiography (3-DE) in assessing right ventricular (RV) systolic function. A latex balloon was inserted into the right ventricle of 20 freshly harvested pig hearts which were then passively driven by a pulsatile pump apparatus. The RV global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS) and RV ejection fraction (RVEF), derived from 3-DE, as well as the RVEF obtained from 2-D echocardiography (2-DE) were quantified at different stroke volumes (30–70 mL) and compared with sonomicrometry data. In all comparisons, 3-D GLS, GCS, GAS, 2-D RVEF and 3-D RVEF exhibited strong correlations with sonomicrometry data (r = 0.89, 0.79, 0.74, 0.80, and 0.93, respectively; all p values < 0.001). Bland–Altman analyses revealed slight overestimations of echo-derived GLS, GCS, 2-DE RVEF and 3-DE RVEF compared with sonomicrometry values (bias = 1.55, 2.72, 3.59 and 2.21, respectively). Furthermore, there is better agreement among GLS, 3-D RVEF and the sonomicrometry values than between GCS and 2-D RVEF. Real-time 3-DE is more feasible and accurate for assessing RV function than 2-DE. GLS is a potential alternative parameter for quantifying RV systolic function.



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Congenital undifferentiated sarcoma associated to BCOR-CCNB3 gene fusion

Publication date: Available online 14 July 2017
Source:Pathology - Research and Practice
Author(s): Clara Alfaro-Cervello, Verónica Andrade-Gamarra, Gema Nieto, Lara Navarro, Susana Martín-Vañó, Juan Pablo García de la Torre, Maria Bengoa Caamaño, Mª Luisa García Mauriño, Rosa Noguera, Samuel Navarro
Small round cell sarcomas are aggressive bone and soft tissue tumors that predominantly affect children and young adults. A new group of sarcomas with a recurrent BCOR-CCNB3 gene fusion has been recently identified in previously unclassifiable small round cell sarcomas. BCOR-CCNB3 sarcomas share clinical and pathologic similarities with Ewing sarcoma, but show a stronger male predilection and less aggressiveness, as well as distinct gene expression profiling and pangenomic SNP array analyses.We report the unusual case of a congenital BCOR-CCNB3 retroperitoneal sarcoma in a female born at 34th gestational week, which was diagnosed in necropsy after 21h of life. Immunohistochemical analysis showed diffuse expression of CD99 and CCNB3. SNPa showed two focal segmentary deletions at 5q34 and 22q11.23, the latter harboring among others the SMARCB1/INI1 tumor suppressor gene. Immunohistochemistry confirmed loss of INI1 in tumor cells, which has not been previously reported in this type of undifferentiated sarcomas.



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PKC-δ attenuates the cancer stem cell among squamous cell carcinoma cells through down-regulating p63

Publication date: Available online 14 July 2017
Source:Pathology - Research and Practice
Author(s): Dongmei Zhang, Mingjing Fu, Lingyan Li, Huan Ye, Zhiqi Song, Yongjun Piao
Protein kinase C delta (PKC-δ) has been identified as a tumor suppressor. However, the effects of PKC-δ on the cancer stem cells in squamous cell carcinomas (SCC) have not been clarified. The purpose of this study was to detect the regulation of PKC-δ on cancer stem cell among SSC cells and the role of p63 during the regulation.Immunohistochemistry of human cutaneous SCC tissues was performed to detect the expression of PKC-δ. After the human SCC13 cells infected by recombinant adenoviruses, the cell proliferation were determined. The correlation of PKC-δ and p63 was detected by western blot. The colony forming activity and the number of cancer stem cells (CSCs) in SCC identified by double-staining with anti-integrin α6 and anti-CD71 antibodies were detected.The expression of PKC-δ was obviously decreased in SCC tissues compared with that in normal skin tissues. The higher protein level of p63 in SCC was attenuated by the transfection of PKC-δ. The higher proliferation capacity of SCC13 cells, the higher activity and expression of CSCs in SCC13 cells induced by p63 were significantly suppressed by the transfection of PKC-δ.In conclusion, PKC-δ played as a protective role in SCC partly by down-regulating p63, leading to the suppression of SCC cell proliferation, attenuation of the activity and expression of CSCs in SCC cells.



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Surgical treatment associated with improved survival in patients with cutaneous angiosarcoma

Abstract

Cutaneous angiosarcoma is a rare aggressive vasoformative neoplasm of the skin with a poor prognosis.¹ The neoplasm preferentially involves areas of head and neck and usually diagnosed in advanced stage.^{1, 2} The neoplasm accounts for only 2% of soft-tissue sarcomas in the U.S. and most often affects elderly white males, patients treated with radiation, and individuals with certain chronic lymphatic disorders.³ Surgery with or without adjuvant or neoadjuvant radiation therapy (RT) is considered the mainstay of therapy.^{1, 3} Due to low incidence rates, the clinical outcomes data has been limited to case reports and single institution studies, with a lack of direct comparison between various treatment modalities: surgery, RT, and chemotherapy (CT).^{4, 5} In this study, we aimed to investigate the impact of undergoing different therapeutic approaches on long-term overall survival (OS) using cross-institutional data.

This article is protected by copyright. All rights reserved.

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Severe sequelae of erythema multiforme: three cases

Abstract

Erythema multiforme (EM) is a skin condition for which main causes are infectious factors (Herpes simplex virus, Mycoplasma pneumoniae). Anti-plakin auto-antibodies are found in some patients ¹. EM must be distinguished from Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are drug-induced in most cases ^2-5.

This article is protected by copyright. All rights reserved.

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Is toll-like receptor-2 really inhibiting FoxP3+ TLR2+ cells and enhancing the anti-tumour response in oral squamous cell carcinoma?

Publication date: Available online 14 July 2017
Source:Acta Histochemica
Author(s): Xi Zeng, Mao Li, Guang-dong Liao, Ming-Rong Xi




http://ift.tt/2uoMo8w

Structural, rheological, antioxidant, and functional properties of β–glucan extracted from edible mushrooms Agaricus bisporus, Pleurotus ostreatus and Coprinus attrimentarius

Publication date: Available online 14 July 2017
Source:Bioactive Carbohydrates and Dietary Fibre
Author(s): Asma Ashraf Khan, Adil Gani, F.A. Masoodi, Umar Mushtaq, Azza Silotry Naik
β-glucan was extracted from three edible mushroom varieties namely Agaricus bisporus, Pleurotus ostreatus and Coprinus attrimentarius using hot water extraction method. The extracted β-glucan was studied to investigate its structural, rheological, antioxidant and functional properties. The ATR-FTIR was used to elicit the structural conformations of the three β-glucan and SEM was used to study the surface topography. The rheological properties showed that with the increase in the concentration of β-glucan, the elastic behavior increased. The antioxidant activities were determined using different assays like DPPH (2, 2-diphenyl-1-picryl-hydrazyl), reducing power, metal chelating ability and ABTS (2,2-Azino-bis, 3-ethylbenzothiazoline-6- sulfonic acid) and all these activities varied significantly (p≤0.05) among all the β-glucan, however the β-glucan from Coprinus attrimentarius showed the highest values for all antioxidant activities. As far as the functional properties were concerned, Coprinus β-glucan also showed the highest swelling power, fat binding, emulsifying properties, bile acid binding capacity and viscosity, however foaming properties were the highest in Pleurotus β-glucan.

Graphical abstract

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Extract critical factors affecting the length of hospital stay of pneumonia patient by data mining (case study: an Iranian hospital)

Publication date: Available online 13 July 2017
Source:Artificial Intelligence in Medicine
Author(s): Naghmeh Khajehali, Somayeh Alizadeh
MotivationPneumonia is a prevalent infection of lower respiratory tract caused by infected lungs. Length of stay (LOS) in hospital is one of the simplest and most important indicators in hospital activity that is used for different purposes. The aim of this study is to explore the important factors affecting the LOS of patients with pneumonia in hospitals.MethodsThe clinical data set for the study were collected from 387 patients in a specialized hospital in Iran between 2009 and 2015. Patients discharge summary includes their demographic details, reasons for admission, prescribed medications for the patient, the result of laboratory tests, and length of treatment.Results and conclusionsThe proposed model in the study demonstrates the way various scenarios of data processing impact on the scale efficiency model, which points to the significance of the pre-processing in data mining. In this article, some methods were utilized; it is noteworthy that Bayesian boosting method led to better results in identifying the factors affecting LOS (accuracy 95.17%). In addition, it was found that 58% of patients younger than 15 years old and 74% of the elderly within the age range of 74–88 were more vulnerable to pneumonia disease. Also, it was found that the Meropenem is a relatively more effective medicine compared to other antibiotics which are used to treat pneumonia in the majority of age groups. Regardless of the impact of various laboratory findings (including CRP, ESR, WBC, NA, K), the patients LOS decreased as a result of Meropenem.



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Second Primary Cancer in Patients with Differentiated Thyroid Cancer: Does Radioiodine Play a Role?

Thyroid , Vol. 0, No. 0.


http://ift.tt/2ujATPL

Resveratrol inhibits IgE binding and down-regulates intracellular phosphorylation of Syk following IgE aggregation on human basophils

Publication date: Available online 14 July 2017
Source:Allergology International
Author(s): Sayaka Arakawa, Maho Suzukawa, Sayaka Igarashi, Hirotoshi Matsui, Masao Yamaguchi, Takahide Nagase, Ken Ohta




http://ift.tt/2utsUjU

Sleep and cognitive performance: Cross-sectional associations from the UK Biobank

The relationship between insomnia symptoms and cognitive performance is unclear, particularly at the population level. We conducted the largest examination of this association to date through analysis of the UK Biobank, a large population-based sample of adults aged 40-69 yrs. We also sought to determine associations between cognitive performance and self-reported chronotype, sleep medication use, and sleep duration.

http://ift.tt/2t0xeCU

Adherence to Continuous Positive Airway Pressure Improves Attention/Psychomotor Function and Sleepiness: A Bias-Reduction Method with Further Assessment of APPLES

Variable adherence to prescribed therapies for sleep disorders is commonplace. This study was designed to integrate three available statistical technologies (instrumental variables, residual inclusion, and shrinkage) to allow sleep investigators to employ data on variable adherence in the estimation of the causal effect of treatment as received on clinical outcomes.

http://ift.tt/2utqaDa

Second Primary Cancer in Patients with Differentiated Thyroid Cancer: Does Radioiodine Play a Role?

Thyroid , Vol. 0, No. 0.


http://ift.tt/2ujATPL

Detection principles of biological and chemical FET sensors

Publication date: 15 December 2017
Source:Biosensors and Bioelectronics, Volume 98
Author(s): Matti Kaisti
The seminal importance of detecting ions and molecules for point-of-care tests has driven the search for more sensitive, specific, and robust sensors. Electronic detection holds promise for future miniaturized in-situ applications and can be integrated into existing electronic manufacturing processes and technology. The resulting small devices will be inherently well suited for multiplexed and parallel detection. In this review, different field-effect transistor (FET) structures and detection principles are discussed, including label-free and indirect detection mechanisms. The fundamental detection principle governing every potentiometric sensor is introduced, and different state-of-the-art FET sensor structures are reviewed. This is followed by an analysis of electrolyte interfaces and their influence on sensor operation. Finally, the fundamentals of different detection mechanisms are reviewed and some detection schemes are discussed. In the conclusion, current commercial efforts are briefly considered.



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Effect of limb dominance and sex on neuromuscular activation patterns in athletes under 12 performing unanticipated side-cuts

Publication date: Available online 14 July 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Michael Del Bel, Alana Fairfax, Michelle Jones, Kendal Steele, Scott Landry
Non-contact ACL injuries are one of the most common injuries to the knee joint among adolescent/collegiate athletes, with sex and limb dominance being identified as risk factors. In children under 12 years of age (U12), these injuries occur less often and there is no sex-bias present. This study set out to explore if sex and/or limb dominance differences exist in neuromuscular activations in U12 athletes. Thirty-four U12 males and females had six bilateral muscles analyzed during unanticipated side-cuts. Principal component analysis was performed, capturing differences in overall magnitudes and timing of peak magnitudes. Two-way mixed-model ANOVAs determined significant limb effects with both sexes displaying i) greater magnitudes in the lateral gastrocnemius and both hamstrings in the dominant limb and ii) earlier timing of peak magnitudes in both gastrocnemii, both hamstrings and vastus medialis in the non-dominant limb, while no sex differences were identified. This study demonstrated that limb dominance, not sex, affects neuromuscular activation strategies in U12 athletes during unanticipated side-cuts. When developing injury prevention programs for younger athletes, an increased focus on balancing neuromuscular activations in both limbs could be beneficial in reducing the likelihood of ACL injuries in these athletes as they mature through puberty.



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Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls

Publication date: Available online 14 July 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Katrine Tholstrup Bech, Camilla Marie Larsen, Gisela Sjøgaard, Andreas Holtermann, Janet L. Taylor, Karen Søgaard
Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique.Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100 mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction.Presented as mean±SD for cases and controls, respectively: VAS; 16.0±14.4mm and 2.1±4.1mm (P=0.004), MVC; 545±161N and 664±195N (P=0.016), upper trapezius muscle thickness; 10.9±1.9mm and 10.4±1.5mm (P=0.20), VA; 93.6±14.2% and 96.3±6.0% (P=0.29).In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality.



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Post-tonsillectomy hemorrhagic outcomes in children with bleeding disorders at a single institution

To report on the post-tonsillectomy bleeding outcomes and factors associated with hemorrhage among children with pre- or post-operatively diagnosed bleeding disorders treated with an institutional protocol.

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Amyloid precursor protein in pancreatic islets

The amyloid precursor protein (APP) has been extensively investigated for its role in the production of amyloid beta (Aβ), a plaque forming peptide in Alzheimer's disease (AD). Epidemiological evidence suggests type 2 diabetes is a risk factor for AD. The pancreas is an essential regulator of blood glucose levels through the secretion of the hormones insulin and glucagon. Pancreatic dysfunction is a well characterized consequence of type 1 and type 2 diabetes. In this study we have examined the expression and processing of pancreatic APP to test the hypothesis that APP may play a role in pancreatic function and the pathophysiology of diabetes. Our data demonstrates the presence of APP within the pancreas, including pancreatic islets in both mouse and human samples. Additionally, we report that the APP/PS1 mouse model of AD overexpresses APP within pancreatic islets, although this did not result in detectable levels of Aβ. We compared whole pancreas and islet culture lysates by western blot from C57BL/6 (WT), APP-/-, and APP/PS1 mice and observed APP-dependent differences in the total protein levels of GLUT4, IDE and BACE2. Immunohistochemistry for BACE2 detected high levels in pancreatic α cells. Additionally, both mouse and human islets processed APP to release sAPP into cell culture media. Moreover, sAPP stimulated insulin but not glucagon secretion from islet cultures. We conclude that APP and its metabolites are capable of influencing the basic physiology of the pancreas, possibly through the release of sAPP acting in an autocrine or paracrine manner.

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MicroRNA-9 regulates fetal alcohol induced changes in D2 receptor to promote prolactin production

Fetal alcohol exposure (FAE) is known to increase prolactin (PRL) secretion from the pituitary lactotropes. In this study we determined whether microRNAs (miRs) are involved in FAE induced alteration in PRL release. We employed a rat animal model of FAE involving feeding pregnant Fisher 344 rats with a liquid diet containing 6.7% alcohol between gestational day 7 to 21 (AF). Both cyclic and estradiol implanted FAE females showed increased levels of plasma PRL and pituitary PRL mRNA but reduced levels of pituitary dopamine D2 receptor (D2R) and its short spliced form (D2S). FAE increased the expression levels of miR-9 and miR-326 and did not produce any significant changes in miR-153 or miR-200a levels in the pituitary. FAE effects on miR-9 and miR-326 were associated with reduced levels of D2R and D2S, increased levels of PRL in the pituitary, and in plasma. These effects of FAE on D2R, D2S and PRL were enhanced following estradiol treatment. In PRL producing MMQ cells, ethanol increased miR-9 but not miR-326, reduced levels of D2R and D2S and increased levels of PRL. Treatment of MMQ cells with an anti-miR-9 oligo reduced ethanol effects on miR-9, D2R, D2S and PRL. MiR-9 mimic oligos reduced the luciferase activity of reporter vector containing D2R 3'UTR, but failed to reduce the mutant luciferase activity. These data suggest that FAE programs the pituitary to produce increased amounts of miR-9 expression that represses the D2R gene and its spliced variant D2S by targeting its 3' UTR leading to an increase in PRL production and secretion.

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Serotonin depletion increases seizure susceptibility and worsens neuropathological outcomes in kainate model of epilepsy

Publication date: Available online 14 July 2017
Source:Brain Research Bulletin
Author(s): Gisela H. Maia, Cátia S. Brazete, Joana I. Soares, Liliana L. Luz, Nikolai V. Lukoyanov
Serotonin is implicated in the regulation of seizures, but whether or not it can potentiate the effects of epileptogenic factors is not fully established. Using the kainic acid model of epilepsy in rats, we tested the effects of serotonin depletion on (1) susceptibility to acute seizures, (2) development of spontaneous recurrent seizures and (3) behavioral and neuroanatomical sequelae of kainic acid treatment. Serotonin was depleted by pretreating rats with p-chlorophenylalanine. In different groups, kainic acid was injected at 3 different doses: 6.5mg/kg, 9.0mg/kg or 12.5mg/kg. A single dose of 6.5mg/kg of kainic acid reliably induced status epilepticus in p-chlorophenylalanine-pretreated rats, but not in saline-pretreated rats. The neuroexcitatory effects of kainic acid in the p-chlorophenylalanine-pretreated rats, but not in saline-pretreated rats, were associated with the presence of tonic-clonic convulsions and high lethality. Compared to controls, a greater portion of serotonin-depleted rats showed spontaneous recurrent seizures after kainic acid injections. Loss of hippocampal neurons and spatial memory deficits associated with kainic acid treatment were exacerbated by prior depletion of serotonin. The present findings are of particular importance because they suggest that low serotonin activity may represent one of the major risk factors for epilepsy and, thus, offer potentially relevant targets for prevention of epileptogenesis.



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Prelimbic α1-adrenoceptors are involved in the regulation of depressive-like behaviors in the hemiparkinsonian rats

Publication date: Available online 14 July 2017
Source:Brain Research Bulletin
Author(s): Zhong Heng Wu, Qiao Jun Zhang, Cheng Xue Du, Yue Xi, Wen Juan Li, Fang Yuan Guo, Shu Qi Yu, Ya Xin Yang, Jian Liu
At present, it is not clear whether α1-adrenoceptors in the prelimbic cortex (PrL) are involved in Parkinson's disease-related depression. Here we examined effects of PrL α1-adrenoceptors on depressive-like behaviors in rats with unilateral 6-hydroxydopamine lesions of the medial forebrain bundle. The lesion induced depressive-like responses as measured by the sucrose preference and forced swim tests compared to sham-operated rats. Intra-PrL injection of α1-adrenoceptor agonist phenylephrine induced or increased the expression of depressive-like behaviors in sham-operated and the lesioned rats. Further, intra-PrL injection of α1-adrenoceptor antagonist benoxathian produced antidepressant effects in two groups of rats. Intra-PrL injection of phenylephrine increased the mean firing rate of PrL pyramidal neurons in both sham-operated and the lesioned rats, while benoxathian decreased the mean firing rate of the neurons. Compared to sham-operated rats, the duration of phenylephrine and benoxathian action on the firing rate of the pyramidal neurons was shortened in the lesioned rats. Neurochemical results showed that intra-PrL injection of phenylephrine or benoxathian increased or decreased dopamine and noradrenaline and serotonin levels in the medial prefrontal cortex, ventral hippocampus and habenula in sham-operated and the lesioned rats, respectively. Altogether, these results suggest that activation and blockade of α1-adrenoceptors in the PrL change the firing activity of the pyramidal neurons, and then increase or decrease levels of three monoamines in the limbic and limbic-related brain regions, which are involved in the regulation of depressive-like behaviors. Additionally, the results also suggest that the dopaminergic lesion leads to hypofunctionality of α1-adrenoceptors on pyramidal neurons of the PrL.



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Vincristine, Ifosfamide, and Doxorubicin for Initial Treatment of Ewing Sarcoma in Adults

AbstractBackground.There are no clinical trials specifically addressing chemotherapy for adults with Ewing sarcoma (ES). Five‐year event‐free survival (EFS) of adults on pediatric studies of ES (44%–47%) is worse than that of children treated with the same therapy (69%). The object of this study was to review the results of therapy with vincristine, ifosfamide, and doxorubicin (VID) in the multidisciplinary treatment of adults with ES at our institution.Materials and Methods.Charts for adults treated for ES from 1995 to 2011 were retrospectively reviewed. Clinician‐reported radiographic tumor response, type of local therapy, pathologic response, and survival data were collected.Results.Seventy‐one patients were identified who received VID as initial therapy. The median age was 25 (range: 16–64). Forty‐two patients (59%) presented with a localized disease and 29 patients (41%) presented with a distant metastasis. Of all patients treated with VID, 83.6% showed a radiological response. Patients who presented with a localized disease had a 5‐year overall survival (OS) of 68% (median not reached), compared with 10.3% (median: 1.9 years) in those who presented with distant metastases. Five‐year EFS was 67%. The nine patients with a pelvic primary tumor had inferior 5‐year OS (42%) to the 33 with primary tumors at other sites (75%). The 5‐year OS of those who had greater than or equal to 95% necrosis after neoadjuvant VID (n = 20; 5‐year OS: 84%) was superior to those who had less than 95% necrosis (n = 13; 5‐year OS: 53%).Conclusion.In adults with primary ES, VID combined with an adjuvant strategy based on post‐treatment percent necrosis has favorable outcomes compared with historical adult controls.Implications for Practice.Ewing sarcoma (ES) is a rare tumor in adults, and there are no dedicated clinical trials in the adult population. Most therapy is modeled after the published pediatric studies, although the small numbers of adult patients included on those studies did significantly worse than the children. We modeled our treatment on other adult sarcomas and reviewed the charts of 71 adult patients with ES treated with vincristine, ifosfamide, and doxorubicin (VID). In adults with primary ES, VID combined with an adjuvant strategy based on post‐treatment percent necrosis has favorable outcomes compared with historical adult controls.

http://ift.tt/2tpvxy3

Robert L. Comis: In Memoriam

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Geochemical characteristics of dissolved rare earth elements in acid mine drainage from abandoned high-As coal mining area, southwestern China

Abstract

Acid mine drainage (AMD) represents a major source of water pollution in the small watershed of Xingren coalfield in southwestern Guizhou Province. A detailed geochemical study was performed to investigate the origin, distribution, and migration of REEs by determining the concentrations of REEs and major solutes in AMD samples, concentrations of REEs in coal, bedrocks, and sediment samples, and modeling REEs aqueous species. The results highlighted that all water samples collected in the mining area are identified as low pH, high concentrations of Fe, Al, SO₄²⁻ and distinctive As and REEs. The spatial distributions of REEs showed a peak in where it is nearby the location of discharging of AMD, and then decrease significantly with distance away from the mining areas. Lots of labile REEs have an origin of coal and bedrocks, whereas the acid produced by the oxidation of pyrite is a prerequisite to cause the dissolution of coal and bedrocks, and then promoting REEs release in AMD. The North American Shale Composite (NASC)-normalized REE patterns of coal and bedrocks are enriched in light REEs (LREEs) and middle REEs (MREEs) relative to heavy REEs (HREEs). Contrary to these solid samples, AMD samples showed slightly enrichment of MREEs compared with LREEs and HREEs. This behavior implied that REEs probably fractionate during acid leaching, dissolution of bedrocks, and subsequent transport, so that the MREEs is primarily enriched in AMD samples. Calculation of REEs inorganic species for AMD demonstrated that sulfate complexes (Ln(SO₄)⁺and Ln(SO₄)₂⁻) predominate in these species, accounting for most of proportions for the total REEs species. The high concentrations of dissolved SO₄²⁻ and low pH play a decisive role in controlling the presence of REEs in AMD, as these conditions are necessary for formation of stable REEs-sulfate complexes in current study. The migration and transportation of REEs in AMD are more likely constrained by adsorption and co-precipitation of Fe-Al hydroxides/hydroxysulfate. In addition, the MREEs is preferentially captured by poorly crystalline Fe-Al hydroxides/hydroxysulfate, which favors that sediments also preserve NASC-normalized patterns with MREEs enrichment in the stream.

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Multi-class determination of pharmaceuticals in wastewaters by solid-phase extraction and liquid chromatography tandem mass spectrometry with matrix effect study

Abstract

In this work, a multi-class analytical method for determination of 22 frequently used pharmaceuticals was developed and validated. Analytes were from different classes for example macrolides, fluoroquinolones, tetracyclines, sulfonamides, anthelmintics, anesthetics, and others. Method was intended for analysis of aqueous samples so the sample preparation was done using solid-phase extraction (SPE). Different sorbents (C8, C18, polymeric, and ion exchange sorbents) combining different eluents (methanol, ethanol, acetonitrile, acetone, ethyl acetate) were investigated during development of sample preparation step. Samples were analyzed using HPLC-MS/MS, and therefore, chromatographic and mass spectrometer conditions were investigated. Optimal extraction efficiencies for most of the investigated analytes were obtained with Oasis HLB polymeric sorbents with acetonitrile as eluent. A study of matrix effect was carried out for wastewater treatment plant (WWTP) influent and effluent. The method was validated for linearity, detection limits and quantification limits, repeatability, and reproducibility. Method detection limits were in the range of 2.0–204.0 ng L⁻¹ for WWTP influent except for sulfaguanidine and dexamethasone. Also, method detection limits for WWTP effluent were from 1.0 to 115.4 ng L⁻¹. Method was successfully applied for analysis of real wastewater samples from municipal wastewater treatment plant. In the influent, pharmaceuticals from all investigated groups were present and the concentrations were from 50.0 to 4914.3 ng L⁻¹ for influent and 26.9 to 1699.2 ng L⁻¹ for effluent. It was also reported that some pharmaceuticals showed higher concentrations in the wastewater effluent than in the influent.

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Quality of Life, Anxiety Prevalence, Depression Symptomatology and Suicidal Ideation among Acne Patients in Lithuania

Abstract

Background/Objective

We aimed to determine the prevalence of anxiety, depression symptomatology and suicidal ideation among patients with acne and the impact of this skin condition on the quality of life in Lithuania.

Methods

The mental health of patients with acne was assessed using an adapted Hospital Anxiety and Depression Scale, the Dermatology Quality of Life Index, questions about characteristics of acne. The study was authorized by the Regional Biomedical Research Ethics Committee.

Results

A total of 255 responders out of 324 patients with acne included (84.4%) were assessed. 56.1% of the responders had comorbid anxiety, depression symptomatology or suicidal ideation related to acne; Among them 38.4% had anxiety symptoms, 23.1% had depression symptoms and 12.9% had suicidal thoughts due to acne. 96.5% of the responders had a reduced quality of life due to acne.

Conclusion

More than a half of the patients with acne who participated at the study had comorbid emotional disorders. Anxiety was the most prevalent sign, 1.7-fold more prevalent than depression and 3-fold more prevalent than suicidal ideation. Depression was prevalent in more than every fourth responder and suicidal ideation afflicted every eighth acne patient. More than 90% of the patients had impaired life quality.

This article is protected by copyright. All rights reserved.

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Long term fine aerosols at the Cape Grim global baseline station: 1998 to 2016

Publication date: October 2017
Source:Atmospheric Environment, Volume 166
Author(s): Jagoda Crawford, David D. Cohen, Eduard Stelcer, Armand J. Atanacio
Fine aerosol measurements have been undertaken at the Cape Grim global baseline station since 1992. Ion beam analysis techniques were then used to determine the elemental composition of the samples from which source fingerprints can be determined. In this study six source fingerprints were identified to contribute to the measurements of PM2.5 at Cape Grim (from 1998 to 2016); fresh sea salt (57%), secondary sulfate and nitrates (14%), smoke (13%), aged sea salt (the product of NaCl reactions with SO2; 12%), soil dust (2.4%) and industrial metals (1.5%). Back trajectory analysis showed that local Tasmanian sources of soil dust contributed to the high soil dust measurements. High measurements of secondary aerosols were recorded when air masses were arriving from the Australian mainland, in the direction of the Victorian power stations.When air masses were arriving from the baseline sector, the maximum concentration of aged sea salt was 1.3 μg/m³, compared to overall maximum of 4.9 μg/m³. For secondary sulfates and nitrates the maximum concentrations were 2.5 and 7.5 μg/m³ from the baseline sector and overall, respectively. While measurements at Cape Grim can be affected from long range transport from mainland Australia and some local Tasmanian sources, the average concentrations of anthropogenic sources are still considerably lower than those measured at more populated areas. For example, at Lucas Heights (located south-west of the Sydney central business district, with little local sources) the average concentrations of secondary sulfates/nitrates and aged sea air were 1.4 and 1.0 μg/m³, respectively; compared to average concentrations of 0.8 and 0.6 μg/m³, at Cape Grim. The average concentrations of smoke were compatible at the two sites. The impact of primary aerosols from vehicle exhaust at Cape Grim was limited and no corresponding fingerprint was resolved.



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Modeling dry deposition of reactive nitrogen in China with RAMS-CMAQ

Publication date: October 2017
Source:Atmospheric Environment, Volume 166
Author(s): Xiao Han, Meigen Zhang, Andrei Skorokhod, Xingxia Kou
China has the world highest production of reactive nitrogen (Nr), and the Nr consumption increased sharply during the last decade. However, the potential environmental influence of dry nitrogen (N) deposition in China remains uncertain due to that the long-term measurement or remote sensing of various N species are difficult. This requires a better understanding of dry N deposition over China in its various forms and including magnitude and distribution features. Thus, the air quality modeling system RAMS-CMAQ was applied to simulate dry deposition of Nr over China from 2010 to 2014. The model results were then analyzed to investigate the long-term spatial and temporal distributions of major inorganic nitrogen (N) components (10 species) and selected organic N components (5 species). Comparisons between modeled and observed deposition rates and surface mass concentrations showed generally good agreement. Model results indicated a total dry N deposition budget of 9.31 Tg N yr⁻¹ in China, including 4.29 Tg N yr⁻¹ as NOy and 4.43 Tg N yr⁻¹ as NH3. NOy was the main component of dry N deposition in the Beijing-Tianjin-Hebei area (0.31  Tg N yr⁻¹), the Yangtze River Delta (0.29  Tg N yr⁻¹), and the Pearl River Delta (0.09  Tg N yr⁻¹), where the major megacity clusters of China are located. NH3 was the main component of dry N deposition in Shandong province (0.24  Tg N yr⁻¹), Northeast China (0.46  Tg N yr⁻¹), the Sichuan Basin (0.48  Tg N yr⁻¹), and central China (0.95  Tg N yr⁻¹), where the major agricultural regions are located. The highest values of the deposition flux for NH3 occurred in Shandong province (19.40  kg N ha⁻¹ yr⁻¹) and Beijing-Tianjin-Hebei (17.20  kg N ha⁻¹ yr⁻¹). The seasonal variation of total dry N deposition was obvious in the east part of China, and was higher in July and lower in January. The spatio-temporal variations and major sources of dry N deposition were strongly heterogeneous, implying that the comprehensive pollution control strategies should be implemented to reduce the risk associated with N deposition.



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Quantifying primary and secondary source contributions to ultrafine particles in the UK urban background

Publication date: October 2017
Source:Atmospheric Environment, Volume 166
Author(s): S.M.L. Hama, R.L. Cordell, P.S. Monks
Total particle number (TNC, ≥7 nm diameter), particulate matter (PM2.5), equivalent black carbon (eBC) and gaseous pollutants (NO, NO2, NOx, O3, CO) have been measured at an urban background site in Leicester over two years (2014 and 2015). A derived chemical climatology for the pollutants showed maximum concentrations for all pollutants during the cold period except O3 which peaked during spring. Quantification of primary and secondary sources of ultrafine particles (UFPs) was undertaken using eBC as a tracer for the primary particle number concentration in the Leicester urban area. At the urban background site, which is influenced by fresh vehicle exhaust emissions, TNC was segregated into two components, TNC = N1 + N2. The component N1 represents components directly emitted as particles and compounds which nucleate immediately after emission. The component N2 represents the particles formed during the dilution and cooling of vehicle exhaust emissions and by in situ new particle formation (NPF). The values of highest N1 (49%) were recorded during the morning rush hours (07:00–09:00 h), correlating with NOx, while the maximum contribution of N2 to TNC was found at midday (11:00–14:00 h), at around 62%, correlated with O3. Generally, the percentage of N2 (57%) was greater than the percentage of N1 (43%) for all days at the AURN site over the period of the study. For the first time the impact of wind speed and direction on N1 and N2 was explored. The overall data analysis shows that there are two major sources contributing to TNC in Leicester: primary sources (traffic emissions) and secondary sources, with the majority of particles being of secondary origin.

Graphical abstract

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Economic growth and environmental pollution in Myanmar: an analysis of environmental Kuznets curve

Abstract

This empirical study examines the short- and long-run relationship between GDP as an economic growth indicator and CO₂ emissions as an environmental pollution indicator in Myanmar by using annual time series data over the period of 1970–2014. It also carefully considered other proxies, such as trade openness, financial openness and urbanization, and structural breaks in the country. The fundamental objective of this study is to test the validity of environmental Kuznets curve (EKC) in the context of Myanmar. The dynamic estimates of the long- and short-term relationship among greenhouse gases (CO₂, CH₄, N₂O), GDP, trade intensity, financial openness, and urbanization growth are built through an autoregressive distributed lag (ARDL) model. The empirical findings indicate that there is positive short- and long-run relationship between CO₂ and GDP and thus, no evidence of EKC hypothesis is found for CO₂ in Myanmar. Nevertheless, the existence of the EKC is observed for CH₄ and N₂O. On the other hand, trade and financial openness have inverse relationship with CO₂ emissions. These results demonstrate that trade liberalization and financial openness will improve the environment quality in Myanmar in the long run.

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Patulous Eustachian Tube and Otitis Media With Effusion as Complications After Trigeminal Nerve Injury.

Objectives: To describe three patients of patulous Eustachian tube (pET) after trigeminal nerve injury and to demonstrate for the first time their magnetic resonance imaging (MRI) findings to hypothesize the mechanism of the pET after trigeminal nerve injury. Patients: Three patients presented with autophony after trigeminal nerve injury caused by the removal of intracranial tumors. Main Outcome Measures: Clinical patient records, audiological data, and MRI. Results: Each patient initially developed transient otitis media with effusion (OME) within a few months after surgery and subsequently developed pET. The MRI of the three patients when they developed pET demonstrated atrophy and fat infiltration of the muscles innervated by the mandibular branch of the trigeminal nerve. Conclusion: All three patients transiently manifested OME before pET was diagnosed. Based on the MRI findings and anatomical considerations, this chronological transition from OME to pET was speculated as an initial motor paralysis of the tensor veli palatini muscle, followed by volume decrease of the muscles in the vicinity of the ET due to denervation atrophy and fat infiltration, which resulted in ET closing failure. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

http://ift.tt/2ujwnkv

Proposal of a Video-recording System for the Assessment of Bell's Palsy: Methodology and Preliminary Results.

Hypothesis: To propose a new objective video-recording procedure to assess and monitor over time the severity of facial nerve palsy. Background: No objective methods for facial palsy (FP) assessment are universally accepted. Methods: The face of subjects presenting with different degrees of facial nerve deficit, as measured by the House-Brackmann (HB) grading system, was videotaped after positioning, at specific points, 10 gray circular markers made of a retroreflective material. Video-recording included the resting position and six ordered facial movements. Editing and data elaboration was performed using a software instructed to assess marker distances. From the differences of the marker distances between the two sides was then extracted a score. Results: The higher the FP degree, the higher the score registered during each movement. The statistical significance differed during the various movements between the different FP degrees, being uniform when closing the eyes gently; whereas when wrinkling the nose, there was no difference between the HB grade III and IV groups and, when smiling, no difference was evidenced between the HB grade IV and V groups. The global range index, which represents the overall degree of FP, was between 6.2 and 7.9 in the normal subjects (HB grade I); between 10.6 and 18.91 in HB grade II; between 22.19 and 33.06 in HB grade III; between 38.61 and 49.75 in HB grade IV; and between 50.97 and 66.88 in HB grade V. Conclusion: The proposed objective methodology could provide numerical data that correspond to the different degrees of FP, as assessed by the subjective HB grading system. These data can in addition be used singularly to score selected areas of the paralyzed face when recovery occurs with a different timing in the different face regions. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Significance of Endolymphatic Hydrops in Ears With Unilateral Sensorineural Hearing Loss.

Objective: The purpose of this study was to investigate the existence of endolymphatic hydrops (EH) in affected and unaffected ears in patients with unilateral sensorineural hearing loss (SNHL) using contrast-enhanced magnetic resonance imaging (MRI), and to evaluate the significance of EH in various otological diseases. Study Design: Retrospective study. Setting: University hospital. Methods: One hundred eighty-two ears from 91 patients with unilateral SNHL were studied. The endolymphatic space was evaluated using 3-Tesla MRI with gadodiamide hydrate. Imaging data about the degree of EH in the cochlea and vestibule were analyzed and compared between ears with various otological diseases. Results: All affected ears with delayed endolymphatic hydrops had EH. In affected ears with definite Meniere's disease, cochlear EH was observed in all ears and vestibular EH in 93% of ears, and these rates were significantly higher in the affected than in the unaffected ears. EH was also observed in the cochlea and vestibule in 66% and 41%, respectively, of the affected ears with idiopathic sudden SNHL; however, these percentages did not differ significantly from those in the unaffected ears (52% and 38%, respectively). Conclusion: MRI showed that a high percentage of ears affected by Meniere's disease or delayed endolymphatic hydrops had EH. Further studies should evaluate the implications of EH in ears, especially in those with sudden SNHL, in terms of secondary or pre-existing EH. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Can Preoperative CT Scans Be Used to Predict Facial Nerve Stimulation Following CI?.

Objectives: 1) To determine the ability of preoperative computed tomography (CT) to predict facial nerve stimulation (FNS) after cochlear implantation (CI). 2) To recognize the limitations of CT in predicting FNS. Study Design: Patient control study. Setting: Tertiary care academic medical center. Subjects: Adult patients with CI from 2003 to 2015. Methods: Patients with severe FNS (n = 4) were compared with randomly selected CI patients (n = 28). Three blinded reviewers evaluated preoperative temporal bone CT scans to measure the distance from the labyrinthine segment of the facial nerve to the basal turn of the cochlea and attempted to predict whether or not the subject had FNS after CI. Results: In total, 32 CT scans were evaluated representing 49 ears that underwent CI. The distances (mm) measured from the labyrinthine segment of the facial nerve to the basal turn of the cochlea in both the axial (0.3 +/- 0.3 versus 0.6 +/- 0.3) and coronal (0.4 +/- 0.2 versus 0.6 +/- 0.2) orientation were significantly different between the two groups (p = 0.0001 and p = 0.0034) respectively. The intraclass correlation coefficient demonstrated good (K > 0.7) reviewer correlation in both the reviewers' measurements and predictions. The sensitivity, specificity, positive predictive value, and negative predictive value for preoperative CT scans to predict FNS were 38.5, 85.1, 19.2, and 93.8% respectively. The reviewers were 23% accurate in predicting FNS. Conclusion: Based on a blinded retrospective patient-control study, CT scan measurements show a significantly reduced distance between the labyrinthine facial nerve and the basal turn of the cochlea in patients with FNS. However, it is difficult to predict who will have FNS based on these measurements. Copyright (C) 2017 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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Role of Multislice CT Imaging in Predicting the Visibility of the Round Window in Pediatric Cochlear Implantation.

Background: High-resolution computed tomography (HRCT) magnifies the role of preoperative imaging for detailed inner and middle ear anatomical information and enhances more efforts for better dependent correlation and measurements of round window (RW). Objective: To find an applicable way by HRCT imaging for the prediction of the visibility of the RW during cochlear implantation (CI) surgery. Methods: Five radiologic measurements were performed on the axial HRCT and these measurements were correlated with the degree of RW visibility after performing posterior tympanotomy during CI surgery. Results: Sixty ears of 60 children were included in the current study. A significant correlation was found between the degree of RW visibility and the following: 1) the angle between RW, facial nerve (FN), and the coronal axis (p

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The Traditional Audiogram—Can We Do Better?

http://ift.tt/2tcxZfZ

Aural Rehabilitation for Older Adults with Hearing Loss: Impacts on Quality of Life—A Systematic Review of Randomized Controlled Trials

http://ift.tt/2tVwLmz

Verification of a Proposed Clinical Electroacoustic Test Protocol for Personal Digital Modulation Receivers Coupled to Cochlear Implant Sound Processors

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Perspectives on the Pure-Tone Audiogram

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JAAA CEU Program

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Chordoid Glioma: A Neoplasm Found in the Anterior Part of the Third Ventricle.

Chordoid glioma is a rare low-grade tumor that originates almost exclusively in the anterior part of the third ventricle. The diagnosis and treatment of the tumor remain controversial. In this article, the authors present a novel case of chordoid glioma of the third ventricle. The patient was treated with less invasive microsurgery followed by low-dose gamma knife radiosurgery. Magnetic resonance imaging revealed a decrease in tumor size and necrosis in the central region of the tumor, without significant complications at follow-up 14 months later. Based on these findings, the authors suggest that less invasive microsurgical resection followed by low-dose gamma knife radiosurgery is safe and effective for the treatment of chordoid glioma of the third ventricle. (C) 2017 by Mutaz B. Habal, MD.

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Rare Complication in Third Maxillary Molar Extraction: Dislocation in Infratemporal Fossa.

Aim: Removal of impacted third maxillary molar is frequently carried out without difficulties and low rate of intraoperative complications. The rare and particularly challenger to manage it is the third molar dislocation into the infratemporal fossa (IF). In this clinical report, the authors present their solution to manage and resolve this particular complication. Methods: A 28-year-old woman was referred to the emergency rescue unit of the authors' hospital by her dentistry, after the attempt to extract the left impacted maxillary third molar. During the procedure the tooth accidentally dislodged and was lost sight of it. The patient had significant mouth-opening limitation, omolateral mid face swelling and pain. Computer tomography was immediately performed to determine the exact position of the tooth, showing the dental element dislocated into the IF. Results: Considering all of possible complications the best surgical option must guarantee a direct approach and a constant eye contact of the tooth, even in case of further displacement during the procedure, and allow early surgery. The authors used an endoscopic transoral approach through the preexisted access and solved all the issues reducing morbidity. Conclusion: Removing tooth from the IF could be burdened by serious risk of bleeding and/or nerve injury. The endoscopic approach provides direct view of the IF reducing morbidity. (C) 2017 by Mutaz B. Habal, MD.

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Comparison of the Effects of Local and Systemic Zoledronic Acid Application on Mandibular Distraction Osteogenesis.

Bisphosphonates are antibone resorptive drugs that are used to prevent bone tissue resorption in several skeletal diseases. The aim of this study was to examine the effects of systemic and local applications of zoledronic acid (ZA) on newly regenerated bone in a model of experimental distraction osteogenesis (DO). To do this mandibular DO was applied to 30 adult female Sprague Dawley rats, which were randomly divided into 3 groups: control, DO only, systemic zoledronic acid (SZA), and local zoledronic acid (LZA). In the LZA group, the gap between the bone fragments was filled with a gelatin sponge soaked in 2 mg of ZA and 0.1 mL of sterile saline. In the SZA group, a single dose of 0.1 mg/kg ZA was administered systemically. After the surgery, there was a 5-day latent waiting period and 10-day distraction phase. Following a 28-day consolidation period, the rats were euthanized and their mandibles were collected. The distracted bone area was seen to be filled with newly regenerated bone tissue in all 3 groups, both histologically and histomorphometrically. In addition, amounts of new bone formation, osteoblast cella, osteoclast (OC) cells, osteopontin, and vascular endothelial growth factor in the SZA and LZA groups were found to be higher when compared with the controls. Furthermore, in the SZA group, new bone formation, osteoblast, OC, osteopontin, and vascular endothelial growth factor were detected in significant amounts compared with the LZA group. Osteoclast numbers did not differ in a statistically significant manner in the SZA group with respect to the LZA group. Based on the results of this study, systemic and local applications of ZA could increase the formation of new bone in patients of DO, and systemic application is a more effective method compared with local application. (C) 2017 by Mutaz B. Habal, MD.

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A Digital Assessment of the Maxillary Deformity Correction in Infants With Bilateral Cleft Lip and Palate Using Computer-Aided Nasoalveolar Molding.

Objectives: To evaluate the maxillary alveolar repositioning of the infants with bilateral cleft lip and palate (BCLP) undergoing computer-aided nasoalveolar molding (CAD-NAM). Methods: A total of 19 BCLP infants undergoing CAD-NAM were recruited as the treatment group, and 21 nonpresurgically treated BCLP patients served as controls. The upper alveolar morphology was measured and evaluated. Changes in all variables between pre- and post-CAD-NAM were compared. Results: By the end of CAD-NAM, significant difference was found in the P-A, P'-A', and L-ideal midline (P

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Modified Technique of Cultured Epithelial Cells Transplantation on Facial Segmental Vitiligo.

Background: Cultured epithelial cells transplantation is a known surgical technique for vitiligo. Objective: To evaluate the factors influencing efficacy and safety of cultured epithelial cells transplantation in 9-month follow-up. Methods: Demographic, clinical, and repigmentation outcomes were reviewed for patients with facial segmental vitiligo who had undergone cultured epithelial cells transplantation from November 2013 to July 2015 at the clinic of the Department of Dermatology, Huashan Hospital, China. Results: Twenty-eight patients who had undergone cultured epithelial cells transplantation were included. A satisfactory result (>50% repigmentation) was achieved in 79% patients with facial segmental vitiligo in 9 months. The treatment effect was significantly different in 6th month (P = 0.032), 9th month (P = 0.006) compared with 3rd month. Disease stability did significantly affect repigmentation outcome in 9th month (Z = 2.113, P = 0.035). No significant difference was observed between single segmental type versus mixed type (Z = 1.081, P = 0.280). Adverse effects were nearly absent. Conclusion: Cultured epithelial cells transplantation is a relatively safe and effective therapy for facial segmental stable vitiligo patients. (C) 2017 by Mutaz B. Habal, MD.

http://ift.tt/2usUPAf

Oral Localization of Kaposi Sarcoma: Clinical Presentation and Conservative Management.

Kaposi sarcoma (KS) caused by human herpes virus type-8 is the most frequent immunosuppression-associated malignancy worldwide and its treatment is still controversial. We report on the clinical management of a patient who developed oral KS after liver transplantation. The disease appeared 1 month after the transplant and recurred after 4 months. The patient represents, to our knowledge, a rare case that was treated successfully only by shifting a conventional immunosuppressive therapy to everolimus alone. (C) 2017 by Mutaz B. Habal, MD.

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Global Craniofacial Care.

No abstract available

http://ift.tt/2toZ37c

Analysis of Stress Trajectories in Human Adult Cleft Skull.

The craniofacial skeleton is designed to withstand the functional forces during mastication. Distribution of these forces is along the stress trajectories that can vary in a cleft skull compared with a normal skull. In this study, the authors constructed finite element models of cleft and normal skull and subjected them for occlusal loading in the posterior teeth. The results showed variation in the trajectories between the models and between the cleft and noncleft sides within the cleft model. (C) 2017 by Mutaz B. Habal, MD.

http://ift.tt/2tT2ruF

Locking Plate System Versus Standard Plate Fixation in the Management of Mandibular Fractures: Meta-Analysis of Randomized Controlled Trials.

Purpose: The aim of this meta-analysis was to evaluate the efficacy of the 2.0-mm locking miniplate system in comparison with the standard miniplate system in treatment of mandible fractures. Methods: A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and PubMed databases, eligible studies were restricted to comparative controlled trials. Inclusion criteria were based on humans randomized controlled trials, controlled clinical trials, with the aim of comparing 2 fixation techniques, namely locking miniplate and standard miniplate (nonlocking miniplate) techniques. In addition, the incidence of complications was evaluated. Results: Nine studies with 380 patients and 551 fracture sites were enrolled into the analysis. The results showed that there were no significant differences in overall complications (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.34-1.22; P = 0.2), postoperative infection (OR, 0.53; 95% CI, 0.23-1.23, P = 0.15), and occlusion discrepancy (P > 0.05) when comparing 2.0-mm locking miniplates with 2.0-mm nonlocking miniplates in treating mandible fractures. However, the use of 2.0-mm locking miniplates had a lower postoperative maxillomandibular fixation rate than the use of 2.0-mm nonlocking miniplates (OR, 0.43; 95% CI, 0.22-0.83; P

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Clinical Application of Multimodal Neuronavigation System in Neuroendoscope-Assisted Skull Base Chordoma Resection.

Skull base chordoma is a rare tumor arising from embryonic remnants of the notochord with invasive potential. Due to the destruction of osseous landmarks and invasion of surrounding structures, surgical resection is challenging. The authors explored the clinical value of a multimodal neuronavigation system in skull base chordoma resection using a neuroendoscope. Between January 2012 and January 2016, the authors utilized neuroendoscopy to excise skull base chordoma in 93 patients. The authors performed 45 operations assisted by multimodal neuronavigation (neuronavigation group) and 48 without intraoperative imaging guidance (control group). In the control group, 35 patients (73%) underwent gross total resection. In the neuronavigation group, all patients underwent gross total resection without radiographically identified bleeding. Only 1 patient (2%) in the neuronavigation group showed a temporary reduction in vision, which improved after symptomatic treatment. In contrast, there were 4 patients (8%) with postoperative complication, including 2 patients with intracranial hematoma and 2 with neurological deficits. Complication rates were higher than the neuronavigation group. In the follow-up period, 2 patients in the control group with subtotal resection had recurrence within 24 months, but without extracranial metastases. The multimodal neuronavigation system could contribute intraoperative real-time guidance for spatial relationships between lesions and adjacent neurovascular structures, as well as eroded and distorted anatomical landmarks through multiple image fusion and 3-dimensional reconstruction. It significantly improves surgical outcome and provides a new insight into the management of skull base chordomas. (C) 2017 by Mutaz B. Habal, MD.

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The Current Challenge for Plastic and Reconstructive Surgery in China, the Biggest Developing Country.

No abstract available

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The Status of Affected Infraorbital Nerve and Inferior Alveolar Nerve in Patients With Jaw Fibrous Dysplasia: A Clinical and Radiographic Evaluation.

The affected infraorbital nerve (IFBN) and inferior alveolar nerve (IFAN) status in patients with jaw fibrous dysplasia has not been definitely depicted. In this study, the authors try to explore the status of affected IFBN and IFAN in patients with jaw fibrous dysplasia. Ten patients with jaw fibrous dysplasia were included in this study. The complaints of numbness in the IFBA and IFAN innervated area were asked and recorded, and careful clinical examination was performed to evaluate the touch sense, pain sense, pressure sense, and temperature sense in the IFBA and IFAN innervated areas. Computed tomography scans also were performed to evaluate the imaging characteristics of affected IFBA and IFAN. The results showed that 1 patient with maxillary lesion showed complaints of slight numbness, and clinical examination showed that the patient exhibited slight insensitive in pain sense. In addition, 1 patient with mandibular lesion showed relative obvious complaints of numbness, and clinical examination showed that the patient exhibited slight insensitive in pain sense and temperature sense, but not serious. All other patients exhibited no numbness in the IFBA and IFAN innervated area. Although the position and morphology changed in some patients, all neural canal of affected IFBA or IFAN existed and showed no invasion of lesion. Taking these findings together, it further confirmed that evaluation of the function of IFBAN and IFAN is necessary for patients with jaw fibrous dysplasia, and the affected IFBAN and IFAN may should be reserved in most patients with jaw fibrous dysplasia when resecting or recontouring the lesion. (C) 2017 by Mutaz B. Habal, MD.

http://ift.tt/2tTaDee

Utility of Brainstem Trigeminal Evoked Potentials in Patients With Primary Trigeminal Neuralgia Treated by Microvascular Decompression.

Objective: To investigate the characteristics of brainstem trigeminal evoked potentials (BTEP) waveform in patients with and without trigeminal neuralgia (TN), and to discuss the utility of BTEP in patients with primary TN treated by microvascular decompression (MVD). Methods: A retrospective review of 43 patients who underwent BTEP between January 2016 and June 2016, including 33 patients with TN who underwent MVD and 10 patients without TN. Brainstem trigeminal evoked potentials characteristics of TN and non-TN were summarized, in particular to compare the BTEP changes between pre- and post-MVD, and to discover the relationship between BTEP changes and surgical outcome. Results: Brainstem trigeminal evoked potentials can be recorded in patients without trigeminal neuralgia. Abnormal BTEP could be recorded when different branches were stimulated. After decompression, the original W2, W3 disappeared and then replaced by a large wave in most patients, or original wave poorly differentiated improved in some patients, showed as shorter latency and (or) amplitude increased. Brainstem trigeminal evoked potentials waveform of healthy side in patients with trigeminal neuralgia was similar to the waveform of patients without TN. In 3 patients, after decompression the W2, W3 peaks increased, and the latency, duration, IPLD did not change significantly. Until discharge, 87.9% (29/33) of the patients presented complete absence of pain without medication (BNI I) and 93.9% (31/33) had good pain control without medication (BNI I-II). Conclusion: Brainstem trigeminal evoked potentials can reflect the conduction function of the trigeminal nerve to evaluate the functional level of the trigeminal nerve conduction pathway. The improvement and restoration of BTEP waveforms are closely related to the postoperative curative effect. (C) 2017 by Mutaz B. Habal, MD.

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Reconstruction of Facial-Cervical Scars With Pedicled Expanded Deltopectoral Flap.

The facial-cervical scars bring the suffering to the patients both physically and mentally. Choosing a proper donor soft tissue is always one of the critical issues, especially to Asian patients. Among the common used donor sites, the deltopectoral site was conceived as the most suitable donor tissue for the reconstruction in face and neck for its adjacent site and match in color and texture. There were 220 patients with facial-cervical scars reconstructed by the pedicled expanded deltopectoral flap between 2007 through 2015 in the authors' hospital. There are 4 stages, including tissue expansion, flap pedicled transfer, pedicle delaying, and pedicle division, for the reconstruction of the facial-cervical scars using the pedicled expanded deltopectoral flap. Good skin compliance, normal contours, and emotional expression were noted in all the patients after the reconstruction. However, there were complications including expander exposure, stretch marks, flap tip necrosis, and mild postoperative hypertrophic scars. The unpleasant skin wound or color caused by the complications was repaired by further treatments such as skin grafting and laser. In conclusion, the pedicled expanded deltopectoral flap is a reliable and excellent option for the reconstruction of the facial-cervical scars. (C) 2017 by Mutaz B. Habal, MD.

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Erratum to: Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients

J reconstr Microsurg
DOI: 10.1055/s-0037-1604271

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Full text

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Imaging Modalities for Correct Positioning of Percutaneous Right Ventricular Assist Device After Left Ventricular Assist Device Implantation.

No abstract available

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In Response.

No abstract available

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Esmolol Administration to Control Tachycardia in an Ovine Model of Peritonitis.

BACKGROUND: Excessive adrenergic signaling may be harmful in sepsis. Using [beta]-blockers to reduce sympathetic overactivity may modulate sepsis-induced cardiovascular, metabolic, immunologic, and coagulation alterations. Using a randomized ovine fecal peritonitis model, we investigated whether administration of a short-acting [beta]-blocker, esmolol, could control tachycardia without deleterious effects on hemodynamics, renal perfusion, cerebral perfusion, cerebral metabolism, or outcome. METHODS: After induction of fecal peritonitis, 14 anesthetized, mechanically ventilated, and hemodynamically monitored adult female sheep were randomly assigned to receive a continuous intravenous infusion of esmolol to control heart rate between 80 and 100 bpm (n = 7) or a saline infusion (control group, n = 7). Esmolol was discontinued when the mean arterial pressure decreased below 60 mm Hg. Fluid resuscitation was titrated to maintain pulmonary artery occlusion pressure at baseline values. Left renal blood flow and cerebral cortex perfusion and metabolism were monitored in addition to standard hemodynamic variables. RESULTS: Esmolol was infused for 11 (9-14) hours; the target heart rate (80-100 bpm) was achieved between 3 and 8 hours after feces injection. In the first 5 hours after the start of the infusion, the decrease in heart rate was compensated by an increase in stroke volume index; later, stroke volume index was not statistically significantly different in the 2 groups, so that the cardiac work index was lower in the esmolol than in the control group. Hypotension (mean arterial pressure

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Hyperbaric Versus Isobaric Bupivacaine for Spinal Anesthesia: Systematic Review and Meta-analysis for Adult Patients Undergoing Noncesarean Delivery Surgery.

BACKGROUND: It is widely believed that the choice between isobaric bupivacaine and hyperbaric bupivacaine formulations alters the block characteristics for the conduct of surgery under spinal anesthesia. The aim of this study was to systematically review the comparative evidence regarding the effectiveness and safety of the 2 formulations when used for spinal anesthesia for adult noncesarean delivery surgery. METHODS: Key electronic databases were searched for randomized controlled trials, excluding cesarean delivery surgeries under spinal anesthesia, without any language or date restrictions. The primary outcome measure for this review was the failure of spinal anesthesia. Two independent reviewers selected the studies and extracted the data. Results were expressed as relative risk (RR) or mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: Seven hundred fifty-one studies were identified between 1946 and 2016. After screening, there were 16 randomized controlled clinical trials, including 724 participants, that provided data for the meta-analysis. The methodological reporting of most studies was poor, and appropriate judgment of their individual risk of bias elements was not possible. There was no difference between the 2 drugs regarding the need for conversion to general anesthesia (RR, 0.60; 95% CI, 0.08-4.41; P = .62; I2 = 0%), incidence of hypotension (RR, 1.15; 95% CI, 0.69-1.92; P = .58; I2 = 0%), nausea/vomiting (RR, 0.29; 95% CI, 0.06-1.32; P = .11; I2 = 7%), or onset of sensory block (MD = 1.7 minutes; 95% CI, -3.5 to 0.1; P = .07; I2 = 0%). The onset of motor block (MD = 4.6 minutes; 95% CI, 7.5-1.7; P = .002; I2 = 78%) was significantly faster with hyperbaric bupivacaine. Conversely, the duration of motor (MD = 45.2 minutes; 95% CI, 66.3-24.2; P

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Socioeconomic Deprivation and Utilization of Anesthetic Care During Pregnancy and Delivery: A French Retrospective, Multicenter, Cohort Study.

BACKGROUND: Socioeconomic deprivation is associated with reduced use of antenatal resources and poor maternal outcomes with pregnancy. Research examining the association between socioeconomic deprivation and use of obstetric anesthesia care in a country providing universal health coverage is scarce. We hypothesized that in a country providing universal health coverage, France, socioeconomic deprivation is not associated with reduced use of anesthetic care during pregnancy and delivery. This study aimed to examine the association between socioeconomic deprivation and (1) completion of a mandatory preanesthetic evaluation during pregnancy and (2) use of neuraxial analgesia during labor. METHODS: Data were from a cohort of 10,419 women who delivered between 2010 and 2011 in 4 public teaching hospitals in Paris. We used a deprivation index that included 4 criteria: social isolation, poor housing condition, no work-related household income, and state-funded health care insurance. Socioeconomic deprivation was defined as a deprivation index greater than 1. Preanesthetic evaluation was considered completed if performed more than 48 hours before delivery. The association between socioeconomic deprivation and completion of the preanesthetic evaluation and use of neuraxial labor analgesia was assessed by multivariable logistic regression adjusting for education level, country of birth, and maternal and pregnancy characteristics. RESULTS: Preanesthetic evaluation was completed for 8142 of the 8624 women (94.4%) analyzed and neuraxial labor analgesia was used by 6258 of the 6834 women analyzed (91.6%). After adjustment, socioeconomic deprivation was associated with reduced probability of completed preanesthetic evaluation (adjusted odds ratio 0.88 [95% confidence interval, 0.79-0.98]; P = .027) but not use of neuraxial labor analgesia (adjusted odds ratio 0.97 [95% confidence interval, 0.87-1.07]; P = .540). CONCLUSIONS: In a country providing universal health care coverage, women who were socioeconomically deprived showed reduced completion of preanesthetic evaluation during pregnancy but not reduced use of neuraxial labor analgesia. Interventions should be targeted to socioeconomically deprived women to increase the completion of the preanesthetic evaluation. (C) 2017 International Anesthesia Research Society

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Replication of Data Makes Statistical Analysis Difficult.

No abstract available

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Improving the Success Rate of Chest Compression-Only CPR by Untrained Bystanders in Adult Out-of-Hospital Cardiac Arrest: Maintaining Airway Patency May Be the Way Forward.

No abstract available

http://ift.tt/2v1L88U

Fixing Medical Prices.

No abstract available

http://ift.tt/2usHiZB

The effects of uvulopalatal flap operation on speech nasalance and the acoustic parameters of the final nasal consonants

Publication date: Available online 13 July 2017
Source:Auris Nasus Larynx
Author(s): Soo Kyoung Park, Yong Soo Lee, Young Ae Kang, Jun Xu, Ki Sang Rha, Yong Min Kim
ObjectiveThe acoustic characteristics of voice are determined by the source of the sound and shape of the vocal tract. Various anatomical changes after uvulopalatal flap (UPF) operation can change nasalance and/or other voice characteristics. Our aim was to explore the possible effects of UPF creation on speech nasalance and the resonatory features of the final nasal consonants, and thus voice characteristics.MethodsA total of 30 patients (26 males, 4 females) with obstructive sleep apnea who underwent UPF operation were recruited. A Nasometer II 3.4 instrument was used to assess nasalance pre- and post-operatively; the patients read standard Korean passages and the readings were recorded in Computer Speech Laboratory for later spectral analysis. Praat software was used to identify frequency bands affecting perioperative nasalance scores. Minima, maxima, and slopes were analyzed.ResultsWe found no significant correlation between nasalance scores (any passage) and the respiratory distress index or body mass index. No significant perioperative change in any nasalance score. The moment variations in the final consonants /m/ and /n/ did not change significantly postoperatively. However, the postoperative moment variation of the final consonant /ng/ differed significantly in the third formant (F3) and second bandwidth (BW2).ConclusionFew significant changes in nasal resonance speech quality were apparent after UPF operation. However, a postoperative acoustic change in the final sound /ng/ may be sustained. Patients may be preoperatively advised that the risk of voice change is very low, but not absent.



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Effects of salinity, C/S ratio, S/N ratio on the BESI process, and treatment of nanofiltration concentrate

Abstract

A laboratory-scale biodegradation and electron transfer based on the sulfur metabolism in the integrated (BESI^®) process was used to treat a saline petrochemical nanofiltration concentrate (NFC). The integrated process consisted of activated sludge sulfate reduction (SR), and sulfide oxidation (SO) reactors, and a biofilm nitrification reactor. During the process, the total removal efficiencies of chemical oxygen demand (COD), ammonia nitrogen, and total nitrogen (TN) were 76.2, 83.8, and 73.1%, respectively. In the SR reactor, most of the organic degradation occurred and approximately 70% COD were removed by the sulfate-reducing bacteria (SRB). In the SO reactor, both the autotrophic and heterotrophic denitrifications were observed to take place. In parallel, batch experiments were conducted to detect the effects of different C/S and S/N ratios on COD removal and denitrification efficiency. The batch experiments were also conducted to detect the effects of salinity on COD and sulfate reduction. The composition of pollutants in the wastewater was complex, and some existing organics were not degraded by the SRB. The non-SRB groups also played important roles in the reactor. Under salinity-induced stress, the metabolisms of the SRBs and non-SRB groups were both inhibited. However, 6 g/L NaCl did not have much effect on the final COD removal efficiency. In the batch experiments, the added sulfide served as the electron donor for autotrophic denitrification. The added organics provided substance for heterotrophic denitrification.

http://ift.tt/2tp83JD