Zinc-doped BSCF perovskite membranes for oxygen separation

Publication date: 22 December 2017
Source:Separation and Purification Technology, Volume 189
Author(s): Xiaozhen Zhang, Julius Motuzas, Shaomin Liu, João C. Diniz da Costa
This work investigates the partial substitution of Zn in the B-site of perovskite as Ba0.5Sr0.5(Co0.8Fe0.2)1−xZnxO3−δ. The membranes were tested for oxygen separation from air and Zn incorporation into the BSCFZ cubic crystal structure proved to be effective as oxygen fluxes increased as compared with a pure BSCF (x=0, no Zn). This was attribute to the increase in oxygen vacancy concentration as a function of Zn concentration. As a result, oxygen fluxes for the BSCFZ membranes were 200% (700°C) and 32% (900°C) higher than the BSCF analogue membrane. However, the correlation between oxygen vacancy concentration and oxygen flux diverged for Zn concentrations x≥0.08, which was associated with the shift and broadening of the main XRD peak 2θ=31.81° of the BSCFZ cubic structure caused by an additional oxide phase (ZnO). Zn doping also affected the microstructure of the sintered BSCFZ membranes. Grain boundary dimensions reduced as Zn substitution in the B-site increased to x=0.06 up to 800°C, resulting in improved oxygen fluxes. Contrary to this, high Zn concentration x≥0.08 increased grain boundary and reduced oxygen fluxes. Therefore, the Zn solubility into BSCF impact upon the oxygen vacancy and microstructural formation, which in turn affected the transport of oxygen ions through the membrane.

Graphical abstract

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Synthesis, characterization and activity evaluation of Cu-based catalysts derived from layered double hydroxides (LDHs) for DeNOx reaction

Publication date: 15 December 2017
Source:Chemical Engineering Journal, Volume 330
Author(s): Yu-sheng Zhang, Changming Li, Chao Yu, Tuyetsuong Tran, Feng Guo, Yunquan Yang, Jian Yu, Guangwen Xu
Catalytic filter for DeNOx reaction composed of practical ceramic filter and catalytic active component enables simultaneous removal of dusts and NOx and therefore is of great potential for industrial application. To find out catalytically active components for DeNOx reaction and concurrently which can be grown on ceramic filter by an in-situ method, the Cu-based catalysts derived from LDHs precursor with different promoters (Co, Ni, Zn, Mg) were synthesized. The results of catalytic activity evaluation showed Zn is the most suitable promoter. Then, the effect of the Cu/Zn ratio on the catalytic performance was examined. It was found that the (CuxZny)2Al-MMO with an Cu/Zn ratio of 4 exhibited the maximum NOx conversion of 80% at 240°C and a NH3/NO ratio of 0.8. The addition of Zn could weaken the catalytic oxidation of ammonia (NH3-SCO) and then improve turnover frequency (TOF) of NOx reduction per Cu atom. The characterizations of the TEM and H2-N2O titration to catalysts reveal that the addition of Zn helps the dispersity of CuO on the surface of the support. The H2-TPR results further demonstrates that the added Zn species facilitate the reducibility of CuO species at low temperature. At last, in-situ growth of Cu-Zn-Al-LDHs on a practical ceramic filter for DeNOx reaction was first successfully carried out and the resulted catalytic filter showed a reasonably high DeNOx activity and strong bonding strength between catalyst and filter.

Graphical abstract

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Volatilization and leaching behavior of heavy metals in MSW incineration fly ash in a DC arc plasma furnace

Publication date: 15 December 2017
Source:Fuel, Volume 210
Author(s): Wenchao Ma, Yunhao Fang, Dongmei Chen, Guanyi Chen, Yongxiang Xu, Hongzhi Sheng, Zhihua Zhou
Three fly ash samples collected from different waste incinerators were vitrified using a direct current arc plasma furnace at 1250–1400°C. The influence of water-wash extraction and wrapping pretreatment on the volatilization and leaching behavior of heavy metals was investigated. Results showed: After thermal arc plasma treatment, the volume reduction and weight loss of fly ash were in the range of 68.7–82.2% and 23.8–56.7%, respectively. The residual fractions (wt.%) of heavy metals in slag are in the following sequence: Cr<Ni<Cd<Pb<Cu<Zn. Water-washing could reduce the volatilization rate of heavy metals due to some volatile salts removed by washing, while wrapping of fly ash could most effectively resist heavy metals against volatilizing, especially for Zn and Ni. The possible CaO – Al2O3 – SiO2 (CAS) ratio for successful melting of fly ash is suggested to be CaO in range of 20–48%, Al2O3 in range of 10–15%, and SiO2 in range of 40–65%. Moreover, toxicity characteristic leaching procedure results showed that the leaching of heavy metals in slags was much lower than the standard limit of toxicity characteristic leaching procedure (TCLP).



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Electrospun dual-layer mats with covalently bonded ZnO nanoparticles for moisture wicking and antibacterial textiles

Publication date: 15 November 2017
Source:Materials & Design, Volume 134
Author(s): Yuliang Dong, Noreen L. Thomas, Xuehong Lu
The fast growing demand for advanced sportswear suitable for tropical countries has led to research on fabrics with both moisture wicking and anti-bacterial properties. In this work, to improve the water transport behaviour, dual-layer nanofibrous nonwoven mats composed of a hydrophilic polyacrylonitrile (PAN) outer layer and a hydrophobic poly(vinylidene fluoride) (PVDF) inner layer are fabricated by electrospinning. The distinct difference in surface hydrophobicity between the inner and outer layers induces a push-pull effect to transport water from the inner to the outer surface efficiently. To render an antibacterial property, zinc oxide (ZnO) nanoparticles are covalently attached to the PVDF nanofibers. The good anti-wash properties and anti-bacterial function of the ZnO-PDVF/PAN dual layer mats are demonstrated.

Graphical abstract

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Title: A novel stereotaxic system for implanting a curved lead to two intracranial targets with high accuracy

Publication date: Available online 20 August 2017
Source:Journal of Neuroscience Methods
Author(s): Chen-Yu Ding, Liang-Hong Yu, Yuan-Xiang Lin, Fan Chen, Wei-Xiong Wang, Zhang-Ya Lin, De-Zhi Kang
BackgroundThe multi-target deep brain stimulation (DBS) aimed at improving symptoms related to different nuclei is a promising research direction. However, to implant a single lead into multiple targets simultaneously is difficult with the current lead implantation method.New MethodWe proposed a novel stereotaxic system used for implanting a curved lead to any two targets of the brain, and used the theoretical "curved lead method". First, a customized novel stereotaxic system was fabricated, and a solid cranial model with six fixed internal targets was made; second, CT scan was performed to locate the fixed internal targets; third, five curved leads were implanted to five selected pairs of targets, each following the calculated parameters of "curved lead pathway" with the novel stereotaxic system, respectively. Finally, CT scans were performed again to determine the exact locations of the curved leads.ResultsThe five curved leads accurately passed through the five pairs of combined targets, respectively, and the average vector error of curved lead implantation was 0.70±0.24mm.Comparison with Existing Method(s): In most situations, performing a multiple-target DBS procedure with the current stereotaxic systems means increased number of implanted leads, increased incidence of operative complications, and increased medical costs. However, the novel stereotaxic system could guide a single lead to reach two selected targets of the brain with high accuracy.ConclusionsThe novel stereotaxic system enables curved lead implantation with high accuracy, and can be considered as a useful complement to the current stereotaxic system.



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Combined treatment with fractional carbon dioxide laser, autologous platelet-rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: A prospective, randomized comparative trial

Summary

Background

Multiple treatment options are introduced in treatment of vitiligo but the response is unsatisfactory.

Objective

In this prospective, randomized, comparative trial, we studied the effect of combined treatment with fractional carbon dioxide (CO₂) laser, platelet-rich plasma (PRP) injection, and narrowband ultraviolet B (NB-UVB) for stable nonsegmental vitiligo regarding repigmentation grade, patient's satisfaction, and side effects.

Methods

Eighty adult patients with localized nonsegmental vitiligo were enrolled in this study. The patients were randomly categorized to receive 4 lines of treatment; fractional CO₂ laser, PRP, combined fractional CO₂ laser and PRP, and combined fractional CO₂ laser and NB-UVB. The treatment period was 2 months. Patients were clinically evaluated 3 months after the last treatment. Outcome was evaluated by 5-point scale for repigmentation, 10-point visual analog scale for patient's satisfaction, and side effects.

Results

Laser and PRP group achieved the best results regarding repigmentation and patient's satisfaction. Sixty percent of the patients developed repigmentation >50% and 40% of patients developed repigmentation >75%. In laser and NB-UVB group, 5% developed repigmentation >75% and 25% developed repigmentation >50%. Only 10% of patients developed repigmentation >75% in laser group and only 20% of patients developed repigmentation >75% in PRP group.

Conclusions

Combination of fractional CO₂ laser with PRP injection is a promising treatment for vitiligo, followed by combination of fractional CO₂ laser with NB-UVB phototherapy. Both fractional CO₂ laser and PRP injection gave poor results if they received alone.

http://ift.tt/2wvEgE2

Combined treatment with fractional carbon dioxide laser, autologous platelet-rich plasma, and narrow band ultraviolet B for vitiligo in different body sites: A prospective, randomized comparative trial

Summary

Background

Multiple treatment options are introduced in treatment of vitiligo but the response is unsatisfactory.

Objective

In this prospective, randomized, comparative trial, we studied the effect of combined treatment with fractional carbon dioxide (CO₂) laser, platelet-rich plasma (PRP) injection, and narrowband ultraviolet B (NB-UVB) for stable nonsegmental vitiligo regarding repigmentation grade, patient's satisfaction, and side effects.

Methods

Eighty adult patients with localized nonsegmental vitiligo were enrolled in this study. The patients were randomly categorized to receive 4 lines of treatment; fractional CO₂ laser, PRP, combined fractional CO₂ laser and PRP, and combined fractional CO₂ laser and NB-UVB. The treatment period was 2 months. Patients were clinically evaluated 3 months after the last treatment. Outcome was evaluated by 5-point scale for repigmentation, 10-point visual analog scale for patient's satisfaction, and side effects.

Results

Laser and PRP group achieved the best results regarding repigmentation and patient's satisfaction. Sixty percent of the patients developed repigmentation >50% and 40% of patients developed repigmentation >75%. In laser and NB-UVB group, 5% developed repigmentation >75% and 25% developed repigmentation >50%. Only 10% of patients developed repigmentation >75% in laser group and only 20% of patients developed repigmentation >75% in PRP group.

Conclusions

Combination of fractional CO₂ laser with PRP injection is a promising treatment for vitiligo, followed by combination of fractional CO₂ laser with NB-UVB phototherapy. Both fractional CO₂ laser and PRP injection gave poor results if they received alone.

http://ift.tt/2wvEgE2

Gene therapy: Human genome editing in heart disease

http://ift.tt/2v592Ak

Human genetic variation and the gut microbiome in disease

Recent microbiome genome-wide association studies have identified numerous associations between human genetic variants and the gut microbiome. Here, the authors review how genetic variation in the host can alter the composition of the gut microbiome towards a disease state, with a focus on disorders of immunity and metabolism.

http://ift.tt/2wvBEWM

Tubo-ovarian abscess infected by Salmonella typhi

We report a case of a tubo-ovarian abscess infected with Salmonella enterica serotype typhi. A 19-year-old Nepalese woman presented to a hospital in Kathmandu with lower abdominal pain, constipation, fever and a non-healing, suppurative surgical wound from an emergency caesarian section performed 2 months previously at 37 weeks of pregnancy. She also had an exploratory laparotomy for an appendix perforation with peritonitis at 25 weeks of gestation. Her wound infection did not respond to cloxacillin and she had an exploratory laparotomy, and a tubo-ovarian abscess was found from which S. typhi was isolated. She had a bilateral salpingo-oophorectomy and responded to 14 days of chloramphenicol. A tubo-ovarian abscess is a rare complication of enteric fever.

http://ift.tt/2uXFZCJ

Solitary biceps muscle metastasis from breast cancer

Although direct muscle invasion by carcinoma is well recognised, skeletal muscle metastases are rare. Breast cancer very rarely metastasises to skeletal muscles. We present a case of breast cancer that metastasised to the biceps muscle. The woman developed breast cancer in 1990 and then developed axillary subcutaneous metastasis in 2001. In 2015, she presented with pain in the left forearm extending to the hand. Initial imaging showed no abnormalities, but the positron emission tomography-CT scanning revealed a hot spot in the left biceps muscle. Additionally, the nerve conduction study showed feature of carpal tunnel syndrome. The hot spot was deemed inconclusive in the view of normal CT and MRI scans, and the patient was treated with carpal tunnel decompression. A few months later, the patient developed a lump in the left biceps muscle, which appeared to be a metastatic lesion from her primary breast cancer. The patient was treated with radiotherapy and responded satisfactorily.

http://ift.tt/2vg7oec

Topical ayurvedic ointment-induced chemical injury presenting as bilateral acute keratitis

A 40-years-old female patient was referred to the cornea clinic as a probable case of bilateral keratitis. The patient had a history of headache followed by acute onset of redness, pain and discharge from both eyes for 15 days. The patient was diagnosed as bilateral keratitis by the first contact physician and was started on topical antibiotics, cycloplegics and lubricating eye-drops. At presentation, both eyes had visual acuity of perception of light, conjunctival congestion, limbal blanching, diffuse corneal oedema and epithelial defect. A detailed history revealed application of Vicks VapoRub [topical ayurvedic analgesic which contains (per 100 g of product) menthol (2.82 g), camphor (5.25 g) and eucalyptol (1.49 mL) and excipients include thymol (0.1 g), turpentine oil (5.57 mL), nutmeg oil (0.54 mL), cedar wood oil and petrolatum)] on the forehead and eyelids for headache several times over 2–3 days before the onset. The patient further confirmed the accidental application of the ointment in the eyes. A provisional diagnosis of acute chemical injury with Vicks VapoRub was made and treatment with topical antibiotic, cycloplegic, steroid, lubricant and vitamin C was started. On follow-up, both eyes showed gradual resolution of corneal oedema and epithelial defect. Visual acuity improved in the left eye to 6/60 with no change in right eye due to corneal haze.

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Vermiform appendix within incisional hernia

The vermiform appendix (whether inflamed or not) within a hernia is very rare occurrence. We present the unprecedented case of a normal appendix found within a Pfannenstiel incisional hernia. A diagnostic laparoscopy was performed as appendicitis was suspected. However, the tip of a normal appendix was visualised within a previous Pfannenstiel incision. Laparoscopic appendicectomy was carried successfully and the patient was discharged. The patient later returned for a successful elective laparoscopic incisional hernia repair.

http://ift.tt/2vgelfr

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities

Abstract

Objective

To estimate the association between sickle cell anaemia or trait with dental and jaw bone abnormalities.

Subjects And Methods

Subjects (n=369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra-oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α=0.05).

Results

Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura and higher prevalence of changes in mandibular trabecular bone (PR:1.43).

Conclusion

Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects.

This article is protected by copyright. All rights reserved.

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Genetic variants of microRNA processing genes and risk of non-syndromic orofacial clefts

Abstract

Objective

MicroRNAs (miRNAs) processing genes play important roles in the craniofacial development. The aim of the present study was to explore the associations between single nucleotide polymorphisms (SNPs) of miRNA processing genes with the risk of non-syndromic orofacial clefts (NSOC).

Methods

We genotyped 12 potentially functional SNPs from seven miRNA processing genes (GEMIN3, DROSHA, DGCR8, GEMIN4, PIWIL1, XPO5, and DICER) in a case-control study of 602 NSOC cases and 605 controls.

Results

Two SNPs were associated with the susceptibility of CL/P: rs10719 in DROSHA led to an increased risk of cleft lip with or without palate (CL/P) (GA/AA: P=0.024, OR=1.33, 95% CI=[1.04, 1.70]; GG+GA/AA: P=0.037, OR=1.29, 95% CI=[1.02, 1.63]), while rs493760 in DROSHA (CC/TT: P=0.049, OR=0.58, 95% CI=[0.34, 0.99]) could reduce the risk of CL/P. In addition, rs10719 (A)-rs493760 (C) haplotype contributed to a decreased risk of CL/P (OR=0.77, 95% CI=[0.63, 0.94]), whereas the rs10719 (G)-rs493760 (C) haplotype contributed to the increased risk of cleft palate only (CPO) (OR=2.70, 95% CI=[1.15, 6.35]). However, there was no difference observed in these SNPs after the Bonferroni correction.

Conclusion

Taken together, our results provided the potential evidence that rs10719 and rs493760 might contribute to the risk of CL/P, and suggested potential genetic basis and mechanisms of CL/P. The lack of association between these SNPs and CPO might be due to the limited sample size of CPO subgroup.

This article is protected by copyright. All rights reserved.

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Susceptibility of partially-desalivated rats to erosive tooth wear by calcium-supplemented beverages

Abstract

Objectives

To investigate the susceptibility of partially-desalivated rats to erosive tooth wear (ETW); the anti-erosive effect of a calcium-supplemented beverage; and the quantification of ETW by micro-computed tomography (micro-CT).

Methods

The study population consisted of thirty-eight rats, divided into partially-desalivated (n=19) and normal salivary flow (n=19). They were randomly allocated into 3 subgroups (n=6-7): A-diet soda, B-diet soda+calcium, C-water (control). Solutions were provided ad-libitum for 28 days, and the rats were euthanized afterwards. Each left hemi-mandible was scanned using micro-CT for enamel volume (3 molars) calculation. Visual analysis of photographs of the lingual surface of 1^st molars was performed independently by 3 blinded examiners. Data were statistically analysed (α=0.05).

Results

Micro-CT revealed no significant differences between partially-desalivated or normal groups. Rats consuming A had more enamel loss than those consuming B or C, which did not differ from each other. For visual analysis, desalivation did not affect ETW. Rats consuming C showed the lowest ETW, followed by B and then A, for both partially-desalivated and normal rats. Spearman correlation between the two ETW quantification methods was -0.65.

Conclusions

Partial desalivation did not increase ETW. Ca-containing beverage prevented ETW. Micro-CT quantified ETW, although it was not as sensitive as visual analysis.

This article is protected by copyright. All rights reserved.

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Meet Enchant

An overview of the Enchant hearing instrument family from Sonic.

http://ift.tt/2vVF5DJ

Cutaneous lupus erythematosus. Quality of life and related factors in a cohort of 260 patients of A Coruña, Spain

Abstract

Dermatological disease has a significant impact on quality of life (QoL). However, information is scarce for cutaneous lupus erythematosus (CLE) in this regard. Thus, the manifestation of and co-morbidities associated with CLE were assessed in the current study to determine factors predictive of QoL impairment. A descriptive cross-sectional study was performed on predominantly Caucasian patients with CLE, recruited at our institution between April 2013 and August 2016 (α = 0.050; precision ± 6.5%).

This article is protected by copyright. All rights reserved.

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Comparison of pyoderma gangrenosum and hypertensive ischemic leg ulcer Martorell in a Swiss cohort

Abstract

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis presenting with painful and sterile skin ulcerations (1). Its aetiology remains largely unknown although an autoinflammatory background seems possible. Several comorbidities as well as triggering factors such as surgery, trauma or pharmacological therapies have been associated with the development of PG (2). Different topical and systemic treatments are recommended for PG, most commonly topical steroids or calcineurin inhibitors as well as systemic steroids, dapsone, infliximab and others, as well as by our group and others canakinumab and ustekinumab (3, 4).

This article is protected by copyright. All rights reserved.

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Cutaneous lupus erythematosus. Quality of life and related factors in a cohort of 260 patients of A Coruña, Spain

Abstract

Dermatological disease has a significant impact on quality of life (QoL). However, information is scarce for cutaneous lupus erythematosus (CLE) in this regard. Thus, the manifestation of and co-morbidities associated with CLE were assessed in the current study to determine factors predictive of QoL impairment. A descriptive cross-sectional study was performed on predominantly Caucasian patients with CLE, recruited at our institution between April 2013 and August 2016 (α = 0.050; precision ± 6.5%).

This article is protected by copyright. All rights reserved.

http://ift.tt/2ihwB6S

Comparison of pyoderma gangrenosum and hypertensive ischemic leg ulcer Martorell in a Swiss cohort

Abstract

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis presenting with painful and sterile skin ulcerations (1). Its aetiology remains largely unknown although an autoinflammatory background seems possible. Several comorbidities as well as triggering factors such as surgery, trauma or pharmacological therapies have been associated with the development of PG (2). Different topical and systemic treatments are recommended for PG, most commonly topical steroids or calcineurin inhibitors as well as systemic steroids, dapsone, infliximab and others, as well as by our group and others canakinumab and ustekinumab (3, 4).

This article is protected by copyright. All rights reserved.

http://ift.tt/2fXuFzK

The coexistence of psychiatric and gastrointestinal problems in children with restrictive eating in a nationwide Swedish twin study

Abstract

Background

Restrictive eating problems are rare in children but overrepresented in those with neurodevelopmental problems. Comorbidities decrease wellbeing in affected individuals but research in the area is relatively scarce. This study describes phenotypes, regarding psychiatric and gastrointestinal comorbidities, in children with restrictive eating problems.

Methods

A parental telephone interview was conducted in 9- or 12-year old twins (n = 19,130) in the Child and Adolescent Twin Study in Sweden. Cases of restrictive eating problems and comorbid problems were established using the Autism, Tics-AD/HD and other Comorbidities inventory, parental reports of comorbidity as well as data from a national patient register. In restrictive eating problem cases, presence of psychiatric and gastrointestinal comorbidity was mapped individually in probands and their co-twin. Two-tailed Mann–Whitney U tests were used to test differences in the mean number of coexisting disorders between boys and girls. Odds ratios were used to compare prevalence figures between individuals with or without restrictive eating problems, and Fisher exact test was used to establish significance.

Results

Prevalence of restrictive eating problems was 0.6% (concordant in 15% monozygotic and 3% of dizygotic twins). The presence of restrictive eating problems drastically increased odds of all psychiatric problems, especially autism spectrum disorder in both sexes (odds ratio = 11.9 in boys, odds ratio = 10.1 in girls), obsessive-compulsive disorder in boys (odds ratio = 11.6) and oppositional defiant disorder in girls (odds ratio = 9.22). Comorbid gastrointestinal problems, such as lactose intolerance (odds ratio = 4.43) and constipation (odds ratio = 2.91), were the most frequent in girls. Boy co-twins to a proband with restrictive eating problems generally had more psychiatric problems than girl co-twins and more girl co-twins had neither somatic nor any psychiatric problems at all.

Conclusions

In children with restrictive eating problems odds of all coexisting psychiatric problems and gastrointestinal problems are significantly increased. The study shows the importance of considering comorbidities in clinical assessment of children with restrictive eating problems.

http://ift.tt/2uWKKfL

Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public: While it is clear that overt hypothyroidism in the mother during pregnancy can affect the baby's brain development or cause other problems with the pregnancy, it is not clear if subclinical hypothyroidism would have similar adverse effects. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology for the Public – Highlighted Article appeared first on American Thyroid Association.

http://ift.tt/2wuBGyc

Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public: While it is clear that overt hypothyroidism in the mother during pregnancy can affect the baby's brain development or cause other problems with the pregnancy, it is not clear if subclinical hypothyroidism would have similar adverse effects. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology for the Public – Highlighted Article appeared first on American Thyroid Association.

http://ift.tt/2wuBGyc

RGD peptide-modified fluorescent gold nanoclusters as highly efficient tumor-targeted radiotherapy sensitizers

Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Guohai Liang, Xudong Jin, Shuxu Zhang, Da Xing
Radiotherapy is a leading treatment approach of cancer therapy. While it is effective in killing tumor cells, it can also cause serious damage to surrounding normal tissue. Targeted radiotherapy with gold nanoparticle-based radiosensitizers is actively being investigated, and considered as a promising means to enhance the efficacy of radiotherapy against tumors under a relatively low and safe radiation dose. In this work, we report a green and one-step strategy to synthesize fluorescent gold nanoclusters by using a commercialized cyclic arginine-glycine-aspartic acid (c(RGDyC)) peptide as the template. The nanoclusters inherit special properties of both the Au core (red/NIR fluorescence emission and strong radiosensitizing effect) and c(RGDyC) shell (active cancer cell-targeting ability and good biocompatibility), and can be applied as fluorescent probes to stain αvβ3 integrin-positive cancer cells, as well as radiosensitizing agents to boost the killing efficacy of radiotherapy. Our data suggest that the as-designed gold nanoclusters have excellent biocompatibility, bright red/NIR fluorescence, active tumor targeting property, and strong radiosensitizing effect, making them highly promising towards potential clinical translation.



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Overcoming resistance to cisplatin by inhibition of glutathione S-transferases (GSTs) with ethacraplatin micelles in vitro and in vivo

Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Shuyi Li, Chan Li, Shubin Jin, Juan Liu, Xiangdong Xue, Ahmed Shaker Eltahan, Jiadong Sun, Jingjie Tan, Jinchen Dong, Xing-Jie Liang
Platinum-based DNA-adducting agents are used extensively in the clinic for cancer chemotherapy. However, the anti-tumor efficacy of these drugs is severely limited by cisplatin resistance, and this can lead to the failure of chemotherapy. One of cisplatin resistance mechanisms is associated with overexpression of glutathione S-transferases (GSTs), which would accelerate the deactivation of cisplatin and decrease its antitumor efficiency. Nanoscale micelles encapsulating ethacraplatin, a conjugate of cisplatin and ethacrynic acid (an effective GSTs inhibitor), can enhance the accumulation of active cisplatin in cancer cells by inhibiting the activity of GSTs and circumventing deactivation of cisplatin. In vitro and in vivo results provide strong evidence that GSTs inhibitor-modified cisplatin prodrug combined with nanoparticle encapsulation favor high effective platinum accumulation, significantly enhanced antitumor efficacy against cisplatin-resistant cancer and decreased system toxicity. It is believed that these ethacraplatin-loaded micelles have the ability of overcoming resistance of cancers toward cisplatin and will improve the prospects for chemotherapy of cisplatin-resistant cancers in the near future.

Graphical abstract

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Metal–carbenicillin framework-based nanoantibiotics with enhanced penetration and highly efficient inhibition of MRSA

Publication date: November 2017
Source:Biomaterials, Volume 144
Author(s): Fei Duan, Xiaochen Feng, Yan Jin, Dawei Liu, Xinjian Yang, Guoqiang Zhou, Dandan Liu, Zhenhua Li, Xing-Jie Liang, Jinchao Zhang
The development of effective therapies to control methicillin-resistant Staphylococcus aureus (MRSA) infections is challenging because antibiotics can be degraded by the production of certain enzymes, for example, β-lactamases. Additionally, the antibiotics themselves fail to penetrate the full depth of biofilms formed from extracellular polymers. Nanoparticle-based carriers can deliver antibiotics with better biofilm penetration, thus combating bacterial resistance. In this study, we describe a general approach for the construction of β-lactam antibiotics and β-lactamase inhibitors co-delivery of nanoantibiotics based on metal–carbenicillin framework-coated mesoporous silica nanoparticles (MSN) to overcome MRSA. Carbenicillin, a β-lactam antibiotic, was used as an organic ligand that coordinates with Fe³⁺ to form a metal–carbenicillin framework to block the pores of the MSN. Furthermore, these β-lactamase inhibitor-loaded nanoantibiotics were stable under physiological conditions and could synchronously release antibiotic molecules and inhibitors at the bacterial infection site to achieve a better elimination of antibiotic resistant bacterial strains and biofilms. We confirmed that these β-lactamase inhibitor-loaded nanoantibiotics had better penetration depth into biofilms and an obvious effect on the inhibition of MRSA both in vitro and in vivo.



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If Cellular Blue Melanocytic Lesions Do Not Form a Spectrum…

No abstract available

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Inespecific Macules in Legs: Challenge

No abstract available

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Anogenital Mammary-Like Glands: A Study of Their Normal Histology With Emphasis on Glandular Depth, Presence of Columnar Epithelial Cells, and Distribution of Elastic Fibers

Abstract: The normal histology of anogenital mammary-like glands (AGMLG) has been studied previously, but some aspects, including glandular depth, presence of columnar epithelium resembling columnar cell change/hyperplasia as defined in mammary pathology, and distribution of elastic fibers, have not been previously investigated. To address these issues, we studied 148 AGMLG identified in 133 paraffin blocks sampled from 64 vulvar wide excision or vulvectomy specimens (64 patients, various indications for surgery). The depth of AGMLG ranged from 0.64 to 3.9 mm. Epithelial columnar cell change was noted in 33.1% of all AGMLG, whereas columnar cell hyperplasia was detected in 10.1%. Occasionally, combinations of cuboidal epithelium and columnar cell change were seen within 1 histological section. Of 22 specimens stained for elastic fibers, in only 6 (27.3%) cases were elastic fibers found around glands. Periductal elastic fibers were demonstrated around 3 of the only 5 ducts, which were available for analysis in slides stained for elastic fibers. The depth of AGMLG should be taken into account when planning topical and surgical therapies for lesions derived or evolving from AGMLG. Alterations identical to columnar cell change may represent a normal variation of AGMLG.

http://ift.tt/2wf4s6j

Palisaded Neutrophilic and Granulomatous Dermatitis/Interstitial Granulomatous Dermatitis Overlap: A Striking Clinical and Histologic Presentation With “Burning Rope Sign” and Subsequent Mirror-Image Contralateral Recurrence

Abstract: Palisaded neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis are uncommon granulomatous dermatoses that often arise in association with rheumatoid arthritis. These 2 entities have overlapping features and may exist on a spectrum. We report an intriguing case of a 53-year-old man with advanced rheumatoid arthritis who presented with a large indurated painful truncal plaque with a palpable cord in addition to a papulonodular eruption on his dorsal hands. Furthermore, our patient had a recurrence in a near-identical mirror-image pattern on the contralateral trunk. The constellation of clinical and histopathological findings in our patient further suggests that palisaded neutrophilic and granulomatous dermatitis and interstitial granulomatous dermatitis exist as overlapping disease entities on a continuum. In addition, we propose that recurrence of skin findings may be indicative of the severity of the underlying systemic disease process.

http://ift.tt/2wfnj18

Eccrine Duct Dilation as a Marker of Cicatricial Alopecia

Background: Eccrine duct dilation (EDD) and syringoma-like sweat duct proliferation have been described as reactive changes occurring in a variety of skin conditions. However, extensive evaluation of EDD in scalp biopsies performed for alopecia has not been performed. Methods: We retrospectively examined 129 cases of cicatricial alopecia (lichen planopilaris, central centrifugal cicatricial alopecia, and discoid lupus erythematosus) and 130 cases of noncicatricial alopecias (androgenetic alopecia, telogen effluvium, and alopecia areata) for the presence of EDD. Results: Overall, EDD occurred in 4% (5/130) of noncicatricial alopecia (2/43 of androgenetic alopecia, 0/15 of telogen effluvium, 3/72 of alopecia areata) and 35% (45/129) of cicatricial alopecia (10/31 of lichen planopilaris, 17/36 central centrifugal cicatricial alopecia, and 18/62 of discoid lupus erythematosus; P

http://ift.tt/2wfkRaZ

Prognostic Implication of Lymphovascular Invasion Detected by Double Immunostaining for D-40 and MITF1 in Primary Cutaneous Melanoma: Beware of MITF1 Specificity and Sensitivity in Unusual Melanoma Subtypes

No abstract available

http://ift.tt/2vVwlxm

Loss of E-cadherin as Part of a Migratory Phenotype in Melanoma Is Associated With Ulceration

Abstract: It has been suggested that embryogenic properties of migratory cells are reactivated during wound healing and metastasis in adults. This might explain the association between wound-induced inflammation and poor survival in patients with ulcerated melanoma. Linking inflammation with a migratory phenotype, we characterize the infiltration of innate inflammatory cells, loss of cell-to-cell adhesion (E-cadherin), factors associated with extracellular matrix degradation [matrix metalloproteinase-9 (MMP-9), and neutrophil elastase (NE)], and spindle-shaped cell morphology, between ulcerated (n = 179) and nonulcerated (n = 206) melanoma. In addition, the presence of "extravascular migratory metastasis" (angiotropism) and tumor-vessel density were evaluated as important factors for tumor cell dispersal in ulcerated melanoma. We showed a correlation between expression of the granulocyte marker cd66b+ and the expression of NE and MMP-9, reflecting activated neutrophils. Ulcerated melanoma correlated with a low global E-cadherin score (P = 0.041) and weak-spot score (P = 0.0004). Thus, 28% of the nonulcerated, 42% of the minimally/moderately ulcerated melanoma, and 53% of the excessively ulcerated melanoma presented low scores as opposed to a high E-cadherin score. In addition, the presence of ulceration was correlated with angiotropism (P

http://ift.tt/2vV7rOA

Inespecific Macules in Legs: Answer

No abstract available

http://ift.tt/2vVwXTR

Broadening the Anatomic Landscape of Sclerosing Perineurioma: A Series of 5 Cases in Nonacral Sites

Abstract: Sclerosing perineurioma is a rare perineurioma variant thought to occur almost exclusively in digits and palms, predominantly in young adult men. It clinically presents as a solitary slow-growing nodule, sometimes associated with prior trauma. Since 01/01/2000, our institution has received 5 cases in consultation of sclerosing perineurioma presenting in atypical locations. Four of 5 patients were women. The median age at presentation was 45 years (range, 31–62 years). Sites included dorsal tongue, anterior neck, mid upper back, forearm, and proximal anterior thigh. Complete clinical histories were not available, although lesions were reported as subcentimeter nodules with at least 1 suspected to have formed after trauma. Histologically, all lesions were circumscribed to dermal/submucosal tumors. Some extended into subcutaneous fat. The neoplasms were composed of an admixture of bland spindled to epithelioid cells with uniform, wavy, thin-to-oval nuclei forming linear cords to whorled sheets in an extensively hyalinized stroma. Mitotic activity was inconspicuous. All tumors expressed epithelial membrane antigen and were negative for S100 protein. All cases stained for CD34 were positive (3/3). This series highlights a broader clinical presentation of sclerosing perineurioma than previously recognized. Acknowledgment of this anatomic variability should provide confidence to dermatopathologists faced with similar cases.

http://ift.tt/2vVkyzd

Occlusive Nonvasculitic Vasculopathy

Abstract: We review the most characteristic clinical and histopathologic findings of the cutaneous manifestations of the occlusive nonvasculitic vasculopathic disorders. Clinically, most of these conditions are characterized by retiform purpura. Histopathologic findings consist of occlusion of the vessel lumina with no vasculitis. Different disorders may produce nonvasculitic occlusive vasculopathy in cutaneous blood and lymphatic vessels, including embolization due to cholesterol and oxalate emboli, cutaneous intravascular metastasis from visceral malignancies, atrial myxomas, intravascular angiosarcoma, intralymphatic histiocytosis, intravascular lymphomas, endocarditis, crystal globulin vasculopathy, hypereosinophilic syndrome, and foreign material. Other times, the occlusive disorder is due to platelet pugging, including heparin necrosis, thrombocytosis secondary to myeloproliferative disorders, paroxysmal nocturnal hemoglobinuria, and thrombotic thrombocytopenic purpura. Occlusive vasculopathy may also appear in cold-related gelling agglutination, like that occurring in cryofibrinogenemia, cryoglobulinemia, cold agglutinin syndrome, and crystalglobulinemia. Microorganisms may also occlude the vessels lumina and this is especially frequent in ecthyma gangrenosum, opportunistic fungi as aspergillosis or fusariosis, Lucio phenomenon of lepromatous leprosy and disseminated strongyloidiasis. Systemic coagulopathies due to defects of C and S proteins, coumarin/warfarin-induced skin necrosis, disseminated intravascular coagulation, and antiphospholipid antibody/lupus anticoagulant syndrome may also result in occlusive nonvasculitic vasculopathy. Finally, vascular coagulopathies such as Sneddon syndrome, livedoid vasculopathy, and atrophic papulosis may also cause occlusion of the vessels of the dermis and/or subcutis. Histopathologic study of occlusive vasculopathic lesions is the first step to achieve an accurate diagnosis, and they should be correlated with clinical history, physical examination, and laboratory findings to reach a final diagnosis.

http://ift.tt/2vVqSqu

Cutaneous Collagenous Vasculopathy: Report of Two Cases Presenting as Disseminated Telangiectasias and Review of the Literature

Abstract: Cutaneous collagenous vasculopathy is a recently described idiopathic microangiopathy characterized by acquired diffuse cutaneous telangiectasias and specific histological features: dilated capillaries in the superficial dermis, with walls thickened by hyaline material containing collagen IV by immunohistochemistry. The authors describe 2 cases and review all cases reported in the literature to date, 34 cases including our own. Cases were mainly observed in women (sex ratio 0.41), median age 63.5 (16–85). Hypertension and diabetes seem more frequent in these patients than in the general population. Typical clinical presentation is fine hair telangiectasias appearing on the lower limbs and progressing toward the trunk and upper limbs, sparing the face. Facial and neck involvement are however reported. When faced with isolated acquired diffuse cutaneous telangiectasias, clinicians should perform a skin biopsy to rule out cutaneous collagenous vasculopathy.

http://ift.tt/2vVq6Kh

Subungual Pigmented Tumor With Onychodystrophy: Challenge

No abstract available

http://ift.tt/2vVq8ln

Mass Spectrometry Imaging Can Distinguish on a Proteomic Level Between Proliferative Nodules Within a Benign Congenital Nevus and Malignant Melanoma

Abstract: Histopathological interpretation of proliferative nodules occurring in association with congenital melanocytic nevi can be very challenging due to their similarities with congenital malignant melanoma and malignant melanoma arising in association with congenital nevi. We hereby report a diagnostically challenging case of congenital melanocytic nevus with proliferative nodules and ulcerations, which was originally misdiagnosed as congenital malignant melanoma. Subsequent histopathological examination in consultation by one of the authors (R.L.) and mass spectrometry imaging analysis rendered a diagnosis of congenital melanocytic nevus with proliferative nodules. In this case, mass spectrometry imaging, a novel method capable of distinguishing benign from malignant melanocytic lesions on a proteomic level, was instrumental in making the diagnosis of a benign nevus. We emphasize the importance of this method as an ancillary tool in the diagnosis of difficult melanocytic lesions.

http://ift.tt/2vVq84R

Periodic Acid-Schiff Stain in Circumscribed Hypokeratosis

No abstract available

http://ift.tt/2vVIqCW

Cutaneous Indeterminate Cell Histiocytosis of Donor Origin After Allogeneic Hematopoietic Stem-Cell Transplantation

Abstract: Allogeneic hematopoietic stem-cell transplantation and solid-organ transplantation are associated with an increased risk of secondary neoplasms. Indeterminate cell histiocytosis (ICH) is a rare disease composed of so-called indeterminate cells, an alleged cutaneous dendritic cell subset displaying histological and some ultrastructural and immunophenotypic features of Langerhans cells but lacking Birbeck granules. We report a case of cutaneous ICH occurring after allogeneic hematopoietic stem-cell transplantation for a myelodysplastic syndrome in a 56-year-old man. Microsatellite analysis demonstrated that the neoplastic cells were derived from the donor's hematopoietic system. This case broadens the spectrum of complications after stem-cell transplantation and demonstrates that cutaneous ICH in the setting of myelodysplastic syndromes may have a nonrelated origin to dysplastic myeloid cells.

http://ift.tt/2vV4TQI

Extensive Hyperkeratotic, Scaly Papules and Plaques in a 56-Year-Old Female: Answer

No abstract available

http://ift.tt/2wfiWTs

Metastatic Cutaneous Paraganglioma: A Case Report and Review of the Literature

Abstract: Paragangliomas are rare neoplasms that arise from chromaffin cells of the sympathetic and parasympathetic nervous system. These tumors are often cured by surgical resection but the risk for metastatic disease exists, particularly for extra-adrenal paragangliomas. The behavior of these tumors is unpredictable, and clinical and histopathological features associated with malignancy have not been determined. The most common sites of metastases include local and distant lymph nodes, bone, liver, and lung. Cutaneous metastases are exceedingly rare with only 2 reported cases, both of which presented on the scalp. Here we describe a 78-year-old woman with cutaneous metastatic paraganglioma presenting as a forehead nodule, which developed 15 years after her initial diagnosis of paraganglioma.

http://ift.tt/2wfpt0A

A Subungual Pigmented Tumor With Onychodystrophy: Answer

No abstract available

http://ift.tt/2vUNjfv

Extensive Hyperkeratotic Scaly Papules and Plaques in a 56-Year-Old Woman: Challenge

No abstract available

http://ift.tt/2vVkGin

Folliculotropic Metastatic Melanoma: A Case Report and Review of the Literature

Abstract: Folliculotropic metastasis of cutaneous melanoma is rare, with only 5 published case reports in the English language literature since it was first described in 2009. We report a 41-year-old man with a primary cutaneous melanoma of the right upper preauricular region with metastatic spread to the parotid gland and pulmonary lymph nodes. Excision of the primary lesion was performed and immunotherapy was initiated. Sixteen months later, the patient presented with 2 new lesions of the left forehead and left neck. Histopathological examination was consistent with folliculotropic dermal deposits of metastatic melanoma. Deeper sectioning into the blocks revealed only sparse perifollicular pigment deposition and rare dermal melanocytes—a potential diagnostic pitfall had this been seen in the initial sections. This case represents the sixth and youngest patient to date with folliculotropic metastatic melanoma. This entity often presents in patients with advanced disease, including increased Breslow thickness and/or multiple metastases to lymph nodes, internal organs, or both. The folliculotropic metastases tend to be small and are often multiple. The precise relationship between folliculotropic primary melanoma and folliculotropic metastasis is unclear. In one reported case and in our patient, the primary tumor was noted to have a "folliculocentric" pattern. Because of the latter finding, the differential diagnosis includes multiple primary folliculotropic melanomas. Thus, clinical correlation and knowledge concerning the evolution of disease in the patient are critical. This case highlights a rare and unusual pattern of metastatic melanoma and potential problems in differential diagnosis.

http://ift.tt/2vVhJ14

CT and MRI features of pseudoaneurysms of the mitral-aortic intervalvular fibrosa

Publication date: Available online 20 August 2017
Source:Clinical Imaging
Author(s): Low Choon Seng Shoen, Anil Attili, David Bach, Prachi Agarwal
ObjectiveTo describe the CT and MR features of pseudoaneurysms of the mitral-aortic intervalvular fibrosa (PMAIVF).Materials and methodsThis retrospective study included 9 patients with a diagnosis of PMAIVF who had CT or MRI within 3months of echocardiography. Echocardiography images were reviewed by a cardiologist and CT and MRI images were reviewed by two experienced cardiothoracic radiologists.ResultsRecognizable imaging features of PMAIVFs were communication with the Left ventricular outflow tract, location between the anterior leaflet of the mitral valve and the aortic valve, systolic expansion and diastolic collapse.ConclusionCT and MRI show characteristic appearances of PMAIVFs and are complementary to echocardiography.



http://ift.tt/2vfcTtC

Clinical Thyroidology High-Impact Articles

FREE ACCESS through September 1, 2017
Read Now:

Parathyroid Lesions Can Be Distinguished from Thyroid Lesions on FNA but May Require Ancillary Studies and Molecular Analysis
Stephanie A. Fish

Older Age and Advanced Disease Are Risk Factors for Complications after Thyroid Cancer Surgery
Masha J. Livhits, Michael W. Yeh 

The Merits of Ultrasound Screening for Familial Nonmedullary Thyroid Cancer Are Strongly Dependent on the Number of Affected Family Members
Charles H. Emerson 

¹⁸F-FDOPA-PET Is More Sensitive than F-18-FDG-PET in Persistent or Recurrent Medullary Thyroid Cancer
Martin Biermann

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

http://ift.tt/2xgEwnz

Correlación entre medidas de evaluación perceptual GRB y cociente de contacto

Publication date: Available online 19 August 2017
Source:Acta Otorrinolaringológica Española
Author(s): Rodrigo Maximiliano Jerez
ObjetivoEl objetivo del presente trabajo es correlacionar los parámetros perceptuales de grade, roughness y breathiness de la escala GRBAS con el cociente de contacto (CQ) obtenido por medio de electroglotografía.Material y métodoSe analizaron 70 muestras de voces normales y patológicas por medio de análisis auditivo-perceptual y electroglotografía. El análisis perceptual fue llevado a cabo por dos jueces expertos en función de los parámetros grade, roughness y breathiness. Los valores de CQ fueron obtenidos por medio del sistema VoceVista Versión 3.3.7.ResultadosLos resultados demuestran correlación fuerte entre CQ y soplo (r = -0,869), mientras que, entre grado de disfonía y CQ (r = -0,567), y aspereza y CQ (r = 0,643) la correlación es media.ConclusionesEs posible establecer relaciones entre el comportamiento vibratorio de los pliegues vocales y el fenómeno resultante que percibimos auditivamente. El parámetro más relevante al respecto fue breathiness. La correlación entre grade, roughness y CQ fue más débil.ObjectiveThe aim of the present workis to correlate the perceptual parameters grade, roughness and breathiness of the GRB scale with the contact quotient (CQ) obtained by electroglotography.Material and method70 samples of normal and pathological voices were analyzed by means of auditory-perceptual analysis and electroglotography. The perceptual analysis was carried out by two expert judges depending on the parameters grade, roughness and breathiness. The CQ values were obtained through the VoceVista System Version 3.3.7.ResultsThe results show a strong correlation between CQ and breathiness (r = -0.869), whereas between grade of dysphonia and CQ (r = -0.567), and roughness and CQ (r = 0.643) the correlation is average.ConclusionsIt is possible to establish relationships between the vibrational behavior of the vocal folds and the resulting phenomenon that we perceive auditively. The most relevant parameter in this respect was breathiness. The correlation between grade, roughness and CQ was weaker.



http://ift.tt/2vfcebF

Clinical Thyroidology High-Impact Articles

FREE ACCESS through September 1, 2017
Read Now:

Parathyroid Lesions Can Be Distinguished from Thyroid Lesions on FNA but May Require Ancillary Studies and Molecular Analysis
Stephanie A. Fish

Older Age and Advanced Disease Are Risk Factors for Complications after Thyroid Cancer Surgery
Masha J. Livhits, Michael W. Yeh 

The Merits of Ultrasound Screening for Familial Nonmedullary Thyroid Cancer Are Strongly Dependent on the Number of Affected Family Members
Charles H. Emerson 

¹⁸F-FDOPA-PET Is More Sensitive than F-18-FDG-PET in Persistent or Recurrent Medullary Thyroid Cancer
Martin Biermann

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

http://ift.tt/2xgEwnz

Keeping Residents in the Dark: Do Night-Float Rotations Provide a Valuable Educational Experience?

Publication date: Available online 18 August 2017
Source:Journal of Surgical Education
Author(s): Alessandra Landmann, Heidi Mahnken, Mara B. Antonoff, SuAnn White, Arpit Patel, Aaron M. Scifres, Jason S. Lees
ObjectiveTo qualify and characterize resident overnight activity.DesignA prospective 3-phase study was conducted of surgical residents with attention to activities performed on the overnight rotation: needs assessment, direct observation of activities, and feedback.SettingThis study was conducted at the University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma. This is both a tertiary referral center and the only American College of Surgeons (ACS) verified level 1 trauma center in the state.ParticipantsThis study included current surgical residents within the residency program.ResultsDuring the study period, 270 pages were individually recorded, with 60% of these pages defined as time-sensitive activities. In addition, most of the pages involved pressing patient-care issues irrespective of postgraduate year level. Analyses revealed that residents spend most of their time performing educational activities (62%).On feedback, residents reported overall satisfaction with the learning opportunities during night-shift (6.4/7.0) and indicated their perceptions of an adequate balance of service and education on night float (6.6/7.0). This correlates with our annual rotation assessment where residents identify night-float as an overall positive experience which provides educational benefit.ConclusionsWork-hour restrictions induce residency programs to adapt to new training models. Our results report a breakdown of resident activities while on night-float and demonstrate that overnight shifts continue to provide important educational opportunities during training.



http://ift.tt/2fXj2J0

Surgical Practical Skills Learning Curriculum: Implementation and Interns' Confidence Perceptions

Publication date: Available online 19 August 2017
Source:Journal of Surgical Education
Author(s): Danilo Acosta, Manuel Castillo-Angeles, Alejandro Garces-Descovich, Ammara A. Watkins, Alok Gupta, Jonathan F. Critchlow, Tara S. Kent
ObjectiveTo provide an overview of the practical skills learning curriculum and assess its effects over time on the surgical interns' perceptions of their technical skills, patient management, administrative tasks, and knowledge.DesignAn 84-hour practical skills curriculum composed of didactic, simulation, and practical sessions was implemented during the 2015 to 2016 academic year for general surgery interns. Totally, 40% of the sessions were held during orientation, whereas the remainder sessions were held throughout the academic year. Interns' perceptions of their technical skills, administrative tasks, patient management, and knowledge were assessed by the practical skills curriculum residents' perception survey at various time points during their intern year (baseline, midpoint, and final). Interns were also asked to fill out an evaluation survey at the completion of each session to obtain feedback on the curriculum.SettingGeneral Surgery Residency program at a tertiary care academic institution.Participants20 General Surgery categorical and preliminary interns.ResultsSignificant differences were found over time in interns' perceptions on their technical skills, patient management, administrative tasks, and knowledge (p < 0.001 for all). The results were also statistically significant when accounting for a prior boot camp course in medical school, intern status (categorical or preliminary), and gender (p < 0.05 for all). Differences in interns' perceptions occurred both from baseline to midpoint, and from midpoint to final time point evaluations (p < 0.001 for all). Prior surgical boot camp in medical school status, intern status (categorical vs. preliminary), and gender did not differ in the interns' baseline perceptions of their technical skills, patient management, administrative tasks, and knowledge (p > 0.05 for all).ConclusionsImplementation of a Practical Skills Curriculum in surgical internships can improve interns' confidence perception on their technical skills, patient management skills, administrative tasks, and knowledge.



http://ift.tt/2fWYpwB

From Symptom to Diagnosis – the Pre-Diagnostic Symptomatic Interval of Paediatric Central Nervous System Tumours in Austria

Publication date: Available online 18 August 2017
Source:Pediatric Neurology
Author(s): Amedeo A. Azizi, Kirsten Heßler, Ulrike Leiss, Chryssa Grylli, Monika Chocholous, Andreas Peyrl, Johannes Gojo, Irene Slavc
BackgroundChildren with central nervous system (CNS) tumours may present with a multitude of symptoms, ranging from elevated intracranial pressure (ICP) to focal neurologic deficit. In every-day practice, some signs may be misleading, thereby causing prolonged pre-diagnostic symptomatic intervals (PSI). PSI are longer for paediatric brain tumours than for other childhood malignancies. This study evaluated PSI, and parental and diagnostic intervals for paediatric patients with CNS tumours in Austria. It also considered socio-economic factors.ProcedurePatients ≤ 19 years of age treated at the Medical University of Vienna and diagnosed during the years 2008-2013 were included. Patients diagnosed incidentally or by screening were excluded.ResultsTwo hundred and twelve consecutive patients were included in the study. They reflected the expected spectrum of CNS tumours. Patients presented with a median of five symptoms at diagnosis, most frequently with signs of elevated ICP. The median PSI was 60 days (0 days – 7 years), the median parental interval 30 days (0 days – 6.7 years) and the median diagnostic interval 3 days (0 days – 6.5 years).In spinal tumours alone (n=7) median PSI was 70 days (10 days – 7 years), and 3/7 patients had a PSI longer than 320 days.Young age, higher tumour grade and ataxia were associated with shorter PSI. Localisation in the supratentorial midline, histology of craniopharyngioma and endocrine symptoms prolonged PSI. There was a clear trend for longer PSI in non-native speakers.ConclusionsResults are comparable to other industrialised countries. However, long delays in diagnosis of CNS tumours still occur, urging increased awareness.



http://ift.tt/2vUTqR1

Correction: Characterization of choroidal morphological and vascular features in diabetes and diabetic retinopathy

Gupta P, Thakku SG, Sabanayagam C, et al. Characterisation of choroidal morphological and vascular features in diabetes and diabetic retinopathy. Br J Ophthalmol 2017;101:1038–1044.

This paper has been corrected since it first published. Author Rupesh Agrawal has been added. The new author list and affiliations are:

Preeti Gupta,^1,2 Sri Gowtham Thakku,^1,2 Charumathi Sabanayagam,^1,2,3

Gavin Tan,^1,2,3 Rupesh Agrawal,^1,4,5 Chui Ming Gemmy Cheung,^1,2,3 Ecosse L Lamoureux,^1,2,3 Tien-Yin Wong,^1,2,3 Ching-Yu Cheng^1,2,3

¹Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore

²Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore

³Duke-NUS Medical School, Singapore, Singapore

⁴Tan Tock Seng Hospital, Singapore

⁵School of Material Science and Engineering, Nanyang Technological University, Singapore

http://ift.tt/2v43aqT

Regulatory T cell subsets in patients with medulloblastoma at diagnosis and during standard irradiation and chemotherapy (PBTC N-11)

Abstract

Background

We evaluated circulating levels of immunosuppressive regulatory T cells (T_regs) and other lymphocyte subsets in patients with newly diagnosed medulloblastoma (MBL) undergoing surgery compared to a control cohort of patients undergo craniectomy for correction of Chiari malformation (CM) and further determined the impact of standard irradiation and chemotherapy on this cell population.

Methods

Eligibility criteria for this biologic study included age 4–21 years, patients with CM undergoing craniectomy (as non-malignant surgical controls) and receiving dexamethasone for prevention of post-operative nausea, and those with newly diagnosed posterior fossa tumors (PFT) undergoing surgical resection and receiving dexamethasone as an anti-edema measure. Patients with confirmed MBL were also followed for longitudinal blood collection and analysis during radiotherapy and chemotherapy.

Results

A total of 54 subjects were enrolled on the study [22-CM, 18-MBL, and 14-PFT]. Absolute number and percentage T_regs (defined as CD4⁺CD25⁺FoxP3⁺CD127^low/−) at baseline were decreased in MBL and PFT compared to CM [p = 0.0016 and 0.001, respectively). Patients with MBL and PFT had significantly reduced overall CD4⁺ T cell count (p = 0.0014 and 0.0054, respectively) compared to those with CM. Radiation and chemotherapy treatment in patients with MBL reduced overall lymphocyte counts; however, within the CD4⁺ T cell compartment, T_regs increased during treatment but gradually declined post therapy.

Conclusions

Our results demonstrate that patients with MBL and PFT exhibit overall reduced CD4⁺ T cell counts at diagnosis but not an elevated proportion of T_regs. Standard treatment exacerbates lymphopenia in those with MBL while enriching for immunosuppressive T_regs over time.

http://ift.tt/2vPLzFT

Inhibition of EGF-induced migration and invasion by sulfated polysaccharide of Sepiella maindroni ink via the suppression of EGFR/Akt/p38 MAPK/MMP-2 signaling pathway in KB cells

Publication date: November 2017
Source:Biomedicine & Pharmacotherapy, Volume 95
Author(s): Wenjie Jiang, Weilu Tian, Muhammad Ijaz, Fengshan Wang
SIP-SII, the sulfated Sepiella maindroni ink polysaccharide (SIP), has been manifested to possess anti-tumor and anti-metastasis activity in vivo and in vitro. In the present study, we evaluated its inhibitory effect on the epidermal growth factor (EGF)-induced migration and invasion of human epidermoid carcinoma cell (KB cell line) as well as the related signaling pathways. The results of MTT assay indicated that SIP-SII inhibited the proliferation of KB cells in a concentration and time dependent manner. Notably, the attenuation of cell growth by SIP-SII was enlarged in the presence of EGF. The wound healing assay and transwell invasion assay were used to evaluate the effect of SIP-SII on the EGF-induced migration and invasion of KB cells and the results showed that SIP-SII markedly attenuated the EGF-induced migration and invasion. Besides, the EGF-induced matrix metalloproteinase-2 (MMP-2) expression was also suppressed by SIP-SII. However, SIP-SII showed no significant inhibition of the EGF-induced matrix metalloproteinase-9 (MMP-9) expression. Further research revealed that SIP-SII decreased the EGF-induced phosphorylation of epidermal growth factor receptor (EGFR), Akt and p38, but no significant suppression on EGF-induced phosphorylation of extracellular signal-regulated kinase 1 and 2 (Erk1/2) and c-Jun N-terminal kinases (JNK) by SIP-SII treatment was observed. The involvement of EGFR/Akt/p38 pathway was confirmed by evidence that SIP-SII would enlarge the inhibitory effect of the specific signal pathway inhibitors. These results indicate that SIP-SII has the potential to be used as the inhibitor of tumor metastasis especially for cancers characterized by over-activation of EGF/EGFR signaling.



http://ift.tt/2uV7Cfn

Mid-radiotherapy PET/CT for prognostication and detection of early progression in patients with stage III non-small cell lung cancer

Publication date: Available online 19 August 2017
Source:Radiotherapy and Oncology
Author(s): Michael F. Gensheimer, Julian C. Hong, Christine Chang-Halpenny, Hui Zhu, Neville C.W. Eclov, Jacqueline To, James D. Murphy, Heather A. Wakelee, Joel W. Neal, Quynh-Thu Le, Wendy Y. Hara, Andrew Quon, Peter G. Maxim, Edward E. Graves, Michael R. Olson, Maximilian Diehn, Billy W. Loo
Background and purposePre- and mid-radiotherapy FDG-PET metrics have been proposed as biomarkers of recurrence and survival in patients treated for stage III non-small cell lung cancer. We evaluated these metrics in patients treated with definitive radiation therapy (RT). We also evaluated outcomes after progression on mid-radiotherapy PET/CT.Material and methodsSeventy-seven patients treated with RT with or without chemotherapy were included in this retrospective study. Primary tumor and involved nodes were delineated. PET metrics included metabolic tumor volume (MTV), total lesion glycolysis (TLG), and SUVmax. For mid-radiotherapy PET, both absolute value of these metrics and percentage decrease were analyzed. The influence of PET metrics on time to death, local recurrence, and regional/distant recurrence was assessed using Cox regression.Results91% of patients had concurrent chemotherapy. Median follow-up was 14months. None of the PET metrics were associated with overall survival. Several were positively associated with local recurrence: pre-radiotherapy MTV, and mid-radiotherapy MTV and TLG (p=0.03–0.05). Ratio of mid- to pre-treatment SUVmax was associated with regional/distant recurrence (p=0.02). 5/77 mid-radiotherapy scans showed early out-of-field progression. All of these patients died.ConclusionsSeveral PET metrics were associated with risk of recurrence. Progression on mid-radiotherapy PET/CT was a poor prognostic factor.



http://ift.tt/2vdIlbI

Assessment of an air pollution monitoring network to generate urban air pollution maps using Shannon information index, fuzzy overlay, and Dempster-Shafer theory, A case study: Tehran, Iran

Publication date: October 2017
Source:Atmospheric Environment, Volume 167
Author(s): Parham Pahlavani, Hossein Sheikhian, Behnaz Bigdeli
Air pollution assessment is an imperative part of megacities planning and control. Hence, a new comprehensive approach for air pollution monitoring and assessment was introduced in this research. It comprises of three main sections: optimizing the existing air pollutant monitoring network, locating new stations to complete the coverage of the existing network, and finally, generating an air pollution map. In the first section, Shannon information index was used to find less informative stations to be candidate for removal. Then, a methodology was proposed to determine the areas which are not sufficiently covered by the current network. These areas are candidates for establishing new monitoring stations. The current air pollution monitoring network of Tehran was used as a case study, where the air pollution issue has been worsened due to the huge population, considerable commuters' absorption and topographic barriers. In this regard, O3, NO, NO2, NOx, CO, PM10, and PM2.5 were considered as the main pollutants of Tehran. Optimization step concluded that all the 16 active monitoring stations should be preserved. Analysis showed that about 35% of the Tehran's area is not properly covered by monitoring stations and about 30% of the area needs additional stations. The winter period in Tehran always faces the most severe air pollution in the year. Hence, to produce the air pollution map of Tehran, three-month of winter measurements of the mentioned pollutants, repeated for five years in the same period, were selected and extended to the entire area using the kriging method. Experts specified the contribution of each pollutant in overall air pollution. Experts' rankings aggregated by a fuzzy-overlay process. Resulted maps characterized the study area with crucial air pollution situation. According to the maps, more than 45% of the city area faced high pollution in the study period, while only less than 10% of the area showed low pollution. This situation confirms the need for effective plans to mitigate the severity of the problem. In addition, an effort made to investigate the rationality of the acquired air pollution map respect to the urban, cultural, and environmental characteristics of Tehran, which also confirmed the results.



http://ift.tt/2uVqawb

The Mechanisms of T Cell Selection in the Thymus

Publication date: Available online 19 August 2017
Source:Trends in Immunology
Author(s): Hiroyuki Takaba, Hiroshi Takayanagi
T cells undergo positive and negative selection in the thymic cortex and medulla, respectively. A promiscuous expression of a wide array of self-antigens in the thymus is essential for the negative selection of self-reactive T cells and the establishment of central tolerance. Aire was originally thought to be the exclusive factor regulating the expression of tissue-restricted antigens, but Fezf2 recently emerged as a critical transcription factor in this regulatory activity. Fezf2 is selectively expressed in thymic medullary epithelial cells, regulates a large number of tissue-restricted antigens and suppresses the onset of autoimmune responses. Here, we discuss novel findings on the transcriptional mechanisms of tissue restricted-antigen expression in the medullary thymic epithelial cells and its effects on T cell selection.



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cGAS–STING and Cancer: Dichotomous Roles in Tumor Immunity and Development

Publication date: Available online 19 August 2017
Source:Trends in Immunology
Author(s): Kevin W. Ng, Erin A. Marshall, John C. Bell, Wan L. Lam
cGMP–AMP synthase (cGAS)–stimulator of interferon genes (STING) sensing has emerged as a key regulator of innate immune responses to both exogenous and endogenous DNA. Recent studies reveal critical roles for this pathway in natural antitumor immunity across cancer types as well as in immune checkpoint blockade therapy. However, it is also clear that some tumors evade cGAS–STING-mediated immune responses, and immunomodulatory therapeutics are currently being explored to target this pathway. Finally, we also discuss recent observations that cGAS–STING-mediated inflammation may promote tumor initiation, growth, and metastasis in certain malignancies and how this may complicate the utility of this pathway in therapeutic development.



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Conidiobolomycosis: An Unusual Fungal Disease—Our Experience

Abstract

Conidiobolomycosis is a rare mycotic disease caused by Conidiobolus coronatus. Very few cases have been reported in English literature. Often it is clinically misdiagnosed as soft tissue tumour. A prospective case study was done from 2006 to 2015 in a tertiary care hospital of West Bengal, India. The objectives of our study were to describe the epidemiological and clinical features and treatment of Conidiobolomycosis to prevent disfigurement. Patients clinically suspected to be suffering from Conidiobolomycosis were subjected to biopsy followed by histopathological and mycological examinations. Then they were treated with oral saturated solution of potassium iodide along with other drugs. Total six cases were histopathologically proved to be suffering from Conidiobolomycosis. Fungus was isolated and identified in one case. Complete resolution was seen in five patients. Conidiobolomycosis should be brought into mind as differential diagnosis of subcutaneous swelling in the rhinofacial region.

http://ift.tt/2wlhuQ5

Conidiobolomycosis: An Unusual Fungal Disease—Our Experience

Abstract

Conidiobolomycosis is a rare mycotic disease caused by Conidiobolus coronatus. Very few cases have been reported in English literature. Often it is clinically misdiagnosed as soft tissue tumour. A prospective case study was done from 2006 to 2015 in a tertiary care hospital of West Bengal, India. The objectives of our study were to describe the epidemiological and clinical features and treatment of Conidiobolomycosis to prevent disfigurement. Patients clinically suspected to be suffering from Conidiobolomycosis were subjected to biopsy followed by histopathological and mycological examinations. Then they were treated with oral saturated solution of potassium iodide along with other drugs. Total six cases were histopathologically proved to be suffering from Conidiobolomycosis. Fungus was isolated and identified in one case. Complete resolution was seen in five patients. Conidiobolomycosis should be brought into mind as differential diagnosis of subcutaneous swelling in the rhinofacial region.

http://ift.tt/2wlhuQ5

Design, synthesis and biological evaluation of novel hydroxamic acid based histone deacetylase 6 selective inhibitors bearing phenylpyrazol scaffold as surface recognition motif

Publication date: Available online 19 August 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Jinyu Yang, Gaoliang Cheng, Qihao Xu, Shenglin Luan, Shuxiang Wang, Dan Liu, Linxiang Zhao
In recent years, inhibition of HDAC6 became a promising therapeutic strategy for the treatment of cancer and HDAC6 inhibitors were considered to be potent anti-cancer agents. In this work, celecoxib showed moderate degree of HDAC6 inhibition activity and selectivity in preliminary enzyme inhibition activity assay. A series of hydroxamic acid derivatives bearing phenylpyrazol moiety were designed and synthesized as HDAC6 inhibitors. Most compounds showed potent HDAC6 inhibition activity. 11i was the most selective compound against HDAC6 with IC50 values of 0.020 µM and selective factor of 101.1. Structure-activity relationship analysis indicated that locating the linker group at 1' of pyrazol gave the most selectivity. The most compounds 11i (GI50 = 3.63 μM) exhibited 6-fold more potent than vorinostat in HepG2 cells. Considering of the high selectivity against HDAC6 and anti-proliferation activity, such compounds have potential to be developed as anti-cancer agents.

Graphical abstract

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Advances in macrocyclic peptide-based antibiotics

Publication date: Available online 19 August 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Anatol Luther, Christian Bisang, Daniel Obrecht
Macrocyclic peptide-based natural products have provided powerful new antibiotic drugs, drug candidates, and scaffolds for medicinal chemists as a source of inspiration to design novel antibiotics. While most of those natural products are active mainly against Gram-positive pathogens, novel macrocyclic peptide-based compounds have recently been described, which exhibit potent and specific activity against some of the most problematic Gram-negative ESKAPE pathogens. This mini-review gives an up-date on recent developments.

Graphical abstract

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Structural basis of the broad substrate tolerance of the antibody 7B9-catalyzed hydrolysis of p-nitrobenzyl esters

Publication date: Available online 19 August 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Naoki Miyamoto, Miho Yoshimura, Yuji Okubo, Kayo Suzuki-Nagata, Takeshi Tsumuraya, Nobutoshi Ito, Ikuo Fujii
Catalytic antibody 7B9, which was elicited against p-nitrobenzyl phosphonate transition-state analogue (TSA) 1, hydrolyzes a wide range of p-nitrobenzyl monoesters and thus shows broad substrate tolerance. To reveal the molecular basis of this substrate tolerance, the 7B9 Fab fragment complexed with p-nitrobenzyl ethylphosphonate 2 was crystallized and the three-dimensional structure was determined. The crystal structure showed that the strongly antigenic p-nitrobenzyl moiety occupied a relatively shallow antigen-combining site and therefore the alkyl moiety was located outside the pocket. These results support the observed broad substrate tolerance of 7B9 and help rationalize how 7B9 can catalyze various p-nitrobenzyl ester derivatives. The crystal structure also showed that three amino acid residues (Asn^H33, Ser^H95, and Arg^L96) were placed in key positions to form hydrogen bonds with the phosphonate oxygens of the transitions-state analogue. In addition, the role of these amino acid residues was examined by site-directed mutagenesis to alanine: all mutants (Asn^H33Ala, Ser^H95Ala, and Arg^L96Ala) showed no detectable catalytic activity. Coupling the findings from our structural studies with these mutagenesis results clarified the structural basis of the observed broad substrate tolerance of antibody 7B9-catalyzed hydrolyses. Our findings provide new strategies for the generation of catalytic antibodies that accept a broad range of substrates, aiding their practical application in synthetic organic chemistry.

Graphical abstract

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A Successfully Treated Case of Gastrointestinal Stromal Tumor Causing Severe Anemia and Localized Peritonitis Showing Angina Pectoris Resulting in Watershed Cerebral Infarction

Ischemic stroke following acute myocardial infarction is a rare but a serious complication. Because the pathophysiology of stroke is dynamic, it is often hard to identify the cause of stroke. Here, we present the case of a 75-year-old man with ischemic stroke following angina pectoris caused by severe anemia and localized peritonitis due to gastrointestinal stromal tumor of small intestine. On admission, he showed consciousness disturbance, fever, and left hemiplegia. The electrocardiogram on admission showed ST-segment depression in V2 to V6 which was normalized 4 hours later. The ultrasound cardiogram showed the mild hypokinesis in the apical portion of left ventricle which was also normalized later. The magnetic resonance imaging and angiography showed ischemic stroke in watershed area between right anterior and middle cerebral arteries area and stenosis of distal portion of right middle cerebral artery. The computed tomography of abdomen showed a mass of small intestine. We decided to perform curative surgery after transfusion and successfully resected the mass of the small intestine, which was revealed to be a gastrointestinal stromal tumor (GIST). This is a successfully treated case of GIST in which the complicated pathophysiology of watershed cerebral infarction following angina pectoris might be clearly revealed.

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Effects of cavity reconstruction on morbidity and quality of life after canal wall down tympanoplasty

Publication date: Available online 19 August 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Sinan Uluyol, Omer Ugur, Ilker Burak Arslan, Ozlem Yagiz, Murat Gumussoy, Ibrahim Cukurova
IntroductionCanal wall down (CWD) tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma. The advantages of CWD mastoidectomy are excellent exposure for disease eradication and postoperative control of residual disease; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, fungal cavity infections, and the occurrence of dizziness and vertigo by changing temperature or pressure.ObjectiveTo evaluate whether cavity-induced problems can be eliminated and patient comfort can be increased with mastoid cavity reconstruction.MethodsIn total, 11 patients who underwent mastoid cavity reconstruction between March 2013 and June 2013 comprised the study group, and 11 patients who had dry, epithelialized CWD cavities were recruited as the control group. The study examined three parameters: epithelial migration, air caloric testing, and the Glasgow Benefit Inventory (GBI). Epithelial migration, air caloric testing, and the GBI were studied in the study and control groups.ResultsThe epithelial migration rate was significantly faster in study group (1.63±0.5mm/week) than control group (0.94±0.37mm/week) (p=0.003, p<0.05). The mean slow component velocity of nystagmus of the study group (13.33±5.36°/s) was significantly lower when compared to control group (32.11±9.12°/s) (p=0.018). The overall GBI score was −7.21, and the general subscale, physical and social health scores were −9.71, −21.09, and +20.35, respectively in the control group. These were +33.93, +35.59, +33.31, and +29.61, respectively in the study group. All but the social health score improved significantly (0.007, 0.008, 0.018, and 0.181, respectively).ConclusionsCavity reconstruction improves epithelial migration, normalizes caloric responses and increases the quality of life. Thus, cavity rehabilitation eliminates open-cavity-induced problems by restoring the functional anatomy of the ear.



http://ift.tt/2vPmyL9

Conidiobolomycosis: An Unusual Fungal Disease—Our Experience

Abstract

Conidiobolomycosis is a rare mycotic disease caused by Conidiobolus coronatus. Very few cases have been reported in English literature. Often it is clinically misdiagnosed as soft tissue tumour. A prospective case study was done from 2006 to 2015 in a tertiary care hospital of West Bengal, India. The objectives of our study were to describe the epidemiological and clinical features and treatment of Conidiobolomycosis to prevent disfigurement. Patients clinically suspected to be suffering from Conidiobolomycosis were subjected to biopsy followed by histopathological and mycological examinations. Then they were treated with oral saturated solution of potassium iodide along with other drugs. Total six cases were histopathologically proved to be suffering from Conidiobolomycosis. Fungus was isolated and identified in one case. Complete resolution was seen in five patients. Conidiobolomycosis should be brought into mind as differential diagnosis of subcutaneous swelling in the rhinofacial region.

http://ift.tt/2wlhuQ5

Conidiobolomycosis: An Unusual Fungal Disease—Our Experience

Abstract

Conidiobolomycosis is a rare mycotic disease caused by Conidiobolus coronatus. Very few cases have been reported in English literature. Often it is clinically misdiagnosed as soft tissue tumour. A prospective case study was done from 2006 to 2015 in a tertiary care hospital of West Bengal, India. The objectives of our study were to describe the epidemiological and clinical features and treatment of Conidiobolomycosis to prevent disfigurement. Patients clinically suspected to be suffering from Conidiobolomycosis were subjected to biopsy followed by histopathological and mycological examinations. Then they were treated with oral saturated solution of potassium iodide along with other drugs. Total six cases were histopathologically proved to be suffering from Conidiobolomycosis. Fungus was isolated and identified in one case. Complete resolution was seen in five patients. Conidiobolomycosis should be brought into mind as differential diagnosis of subcutaneous swelling in the rhinofacial region.

http://ift.tt/2wlhuQ5

Interlaboratory variability of Ki67 staining in breast cancer

Publication date: October 2017
Source:European Journal of Cancer, Volume 84
Author(s): Cornelia M. Focke, Horst Bürger, Paul J. van Diest, Kai Finsterbusch, Doreen Gläser, Eberhard Korsching, Thomas Decker
BackgroundPostanalytic issues of Ki67 assessment in breast cancers like counting method standardisation and interrater bias have been subject of various studies, but little is known about analytic variability of Ki67 staining between pathology labs. Our aim was to study interlaboratory variability of Ki67 staining in breast cancer using tissue microarrays (TMAs) and central assessment to minimise preanalytic and postanalytic influences.MethodsThirty European pathology labs stained serial slides of a TMA set of breast cancer tissues with Ki67 according to their routine in-house protocol. The Ki67-labelling index (Ki67-LI) of 70 matched samples was centrally assessed by one observer who counted all cancer cells per sample. We then tested for differences between the labs in Ki67-LI medians by analysing variance on ranks and in proportions of tumours classified as luminal A after dichotomising oestrogen receptor–positive cancers into cancers showing low (<14%, luminal A) and high (≥14%, luminal B HER2 negative) Ki67-LI using Cochran's Q.ResultsSubstantial differences between the 30 labs were indicated for median Ki67-LI (0.65%–33.0%, p < 0.0001) and proportion of cancers classified as luminal A (17%–57%, p < 0.0001). The differences remained significant when labs using the same antibody (MIB-1, SP6, or 30-9) were analysed separately or labs without prior participation in external quality assurance programs were excluded (p < 0.0001, respectively).ConclusionSubstantial variability in Ki67 staining of breast cancer tissue was found between 30 routine pathology labs. Clinical use of the Ki67-LI for therapeutic decisions should be considered only fully aware of lab-specific reference values.



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Pro-inflammatory fatty acid profile and colorectal cancer risk: A Mendelian randomisation analysis

Publication date: October 2017
Source:European Journal of Cancer, Volume 84
Author(s): Sebastian May-Wilson, Amit Sud, Philip J. Law, Kimmo Palin, Sari Tuupanen, Alexandra Gylfe, Ulrika A. Hänninen, Tatiana Cajuso, Tomas Tanskanen, Johanna Kondelin, Eevi Kaasinen, Antti-Pekka Sarin, Johan G. Eriksson, Harri Rissanen, Paul Knekt, Eero Pukkala, Pekka Jousilahti, Veikko Salomaa, Samuli Ripatti, Aarno Palotie, Laura Renkonen-Sinisalo, Anna Lepistö, Jan Böhm, Jukka-Pekka Mecklin, Nada A. Al-Tassan, Claire Palles, Susan M. Farrington, Maria N. Timofeeva, Brian F. Meyer, Salma M. Wakil, Harry Campbell, Christopher G. Smith, Shelley Idziaszczyk, Timothy S. Maughan, David Fisher, Rachel Kerr, David Kerr, Michael N. Passarelli, Jane C. Figueiredo, Daniel D. Buchanan, Aung K. Win, John L. Hopper, Mark A. Jenkins, Noralane M. Lindor, Polly A. Newcomb, Steven Gallinger, David Conti, Fred Schumacher, Graham Casey, Lauri A. Aaltonen, Jeremy P. Cheadle, Ian P. Tomlinson, Malcolm G. Dunlop, Richard S. Houlston
BackgroundWhile dietary fat has been established as a risk factor for colorectal cancer (CRC), associations between fatty acids (FAs) and CRC have been inconsistent. Using Mendelian randomisation (MR), we sought to evaluate associations between polyunsaturated (PUFA), monounsaturated (MUFA) and saturated FAs (SFAs) and CRC risk.MethodsWe analysed genotype data on 9254 CRC cases and 18,386 controls of European ancestry. Externally weighted polygenic risk scores were generated and used to evaluate associations with CRC per one standard deviation increase in genetically defined plasma FA levels.ResultsRisk reduction was observed for oleic and palmitoleic MUFAs (OROA = 0.77, 95% CI: 0.65–0.92, P = 3.9 × 10⁻³; ORPOA = 0.36, 95% CI: 0.15–0.84, P = 0.018). PUFAs linoleic and arachidonic acid had negative and positive associations with CRC respectively (ORLA = 0.95, 95% CI: 0.93–0.98, P = 3.7 × 10⁻⁴; ORAA = 1.05, 95% CI: 1.02–1.07, P = 1.7 × 10⁻⁴). The SFA stearic acid was associated with increased CRC risk (ORSA = 1.17, 95% CI: 1.01–1.35, P = 0.041).ConclusionResults from our analysis are broadly consistent with a pro-inflammatory FA profile having a detrimental effect in terms of CRC risk.



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Health-related quality of life results from the PRODIGE 5/ACCORD 17 randomised trial of FOLFOX versus fluorouracil–cisplatin regimen in oesophageal cancer

Publication date: October 2017
Source:European Journal of Cancer, Volume 84
Author(s): C. Bascoul-Mollevi, S. Gourgou, M.-P. Galais, J.-L. Raoul, O. Bouché, J.-Y. Douillard, A. Adenis, P.-L. Etienne, B. Juzyna, L. Bedenne, T. Conroy
BackgroundA recent prospective randomised trial did not reveal significant differences in median progression-free survival between two chemoradiotherapy (CRT) regimens for inoperable non-metastatic oesophageal cancer patients. This secondary analysis aimed to describe the impact of CRT on health-related quality of life (HRQOL), physical functioning, dysphagia, fatigue and pain and to evaluate whether baseline HRQOL domains can predict overall survival.Patients and methodsA total of 267 patients were randomly assigned to receive with 50 Gy of radiotherapy in 25 fractions six cycles of FOLFOX or four cycles of fluorouracil and cisplatin on day 1. HRQOL was prospectively assessed using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire version 3.0 with the oesophageal cancer module (QLQ-OES18).ResultsBoth groups showed high baseline compliance. Subsequently, compliance reduced to 41% at the 6-month follow-up. Baseline HRQOL scores showed no statistical differences between treatment arms. During treatment, both groups exhibited lower physical and social functioning and increased fatigue and dyspnoea, although dysphagia moderately improved in the fluorouracil–cisplatin arm only (p = 0.047).During follow-up, HRQOL scores revealed no significant differences between chemotherapy regimens. Linear mixed model exhibited a treatment-by-time interaction effect for dysphagia (p = 0.017) with a greater decrease in dysphagia in the fluorouracil–cisplatin group. Time until definitive deterioration analysis showed no significant differences in global HRQOL, functional or main symptom domains. However, time until definitive deterioration was significantly longer for the fluorouracil and cisplatin arm compared with FOLFOX for appetite loss (p = 0.002), QLQ-OES-18 pain (p = 0.008), trouble swallowing saliva (p = 0.011) and trouble talking (p = 0.020).ConclusionAnalyses of HRQOL scores revealed no statistically significant differences between patients with inoperable non-metastatic oesophageal cancer treated by FOLFOX versus those treated with a fluorouracil–cisplatin regimen as part of definitive CRT.



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Humanization of JAA-F11, a Highly Specific Anti-Thomsen-Friedenreich Pancarcinoma Antibody and In Vitro Efficacy Analysis

Publication date: September 2017
Source:Neoplasia, Volume 19, Issue 9
Author(s): Swetha Tati, John C. Fisk, Julia Abdullah, Loukia Karacosta, Taylor Chrisikos, Padraic Philbin, Susan Morey, Diala Ghazal, Fatma Zazala, Joseph Jessee, Sally Quataert, Stephen Koury, David Moreno, Jing Ying Eng, Vladislav V. Glinsky, Olga V. Glinskii, Muctarr Sesay, Anthony W. Gebhard, Karamveer Birthare, James R. Olson, Kate Rittenhouse-Olson
JAA-F11 is a highly specific mouse monoclonal to the Thomsen-Friedenreich Antigen (TF-Ag) which is an alpha-O-linked disaccharide antigen on the surface of ~80% of human carcinomas, including breast, lung, colon, bladder, ovarian, and prostate cancers, and is cryptic on normal cells. JAA-F11 has potential, when humanized, for cancer immunotherapy for multiple cancer types. Humanization of JAA-F11, was performed utilizing complementarity determining regions grafting on a homology framework. The objective herein is to test the specificity, affinity and biology efficacy of the humanized JAA-F11 (hJAA-F11). Using a 609 target glycan array, 2 hJAA-F11 constructs were shown to have excellent chemical specificity, binding only to TF-Ag alpha-linked structures and not to TF-Ag beta-linked structures. The relative affinity of these hJAA-F11 constructs for TF-Ag was improved over the mouse antibody, while T20 scoring predicted low clinical immunogenicity. The hJAA-F11 constructs produced antibody-dependent cellular cytotoxicity in breast and lung tumor lines shown to express TF-Ag by flow cytometry. Internalization of hJAA-F11 into cancer cells was also shown using a surface binding ELISA and confirmed by immunofluorescence microscopy. Both the naked hJAA-F11 and a maytansine-conjugated antibody (hJAA-F11-DM1) suppressed in vivo tumor progression in a human breast cancer xenograft model in SCID mice. Together, our results support the conclusion that the humanized antibody to the TF-Ag has potential as an adjunct therapy, either directly or as part of an antibody drug conjugate, to treat breast cancer, including triple negative breast cancer which currently has no targeted therapy, as well as lung cancer.



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Clinical and Genetic Features of 64 Young Male Paediatric Patients with Congenital Hypogonadotropic Hypogonadism (CHH)

Summary

Context

The diagnosis of congenital hypogonadotropic hypogonadism (CHH) in prepuberty has always been challenging. Here, we aimed at studying the clinical and genetic features of paediatric CHH, especially the phenotype of hypospadias and dual defects (patients showing hypothalamic and/or pituitary defects and testicular hypoplasia), so as to have a better understanding of CHH.

Design

The clinical and genetic features of CHH patients were analysed and the relationships between hypospadias, dual defects and genetics investigated.

Patients

Patients who visited Beijing Children's Hospital and were positively diagnosed with CHH.

Measurements

The collected data included sex hormones, MRI of the olfactory bulb, human chorionic gonadotropin (hCG) test and genetic testing. We analysed clinical features and genetic results, especially hypospadias and dual defects, and compared the stimulated testosterone (T) levels in patients with and without cryptorchidism.

Results

Sixty-four patients were positively diagnosed, and forty-seven (73.4%) had Kallmann Syndrome (KS). Four patients (6.3%) had hypospadias, including 2 KS. Micropenis combined with cryptorchidism was the most common phenotype (39%). Approximately 2/3 patients showed a poor response to hCG; 15 cases were diagnosed with dual defects, and there were no significant differences between those with and without cryptorchidism. Twenty-six cases in 51 patients (51%) were identified as having classical HH mutations, affecting 10 different genes, with oligogenic mutations in 5 cases (9.8%). The most common mutations were in PROKR2 (17.6%), FGFR1 (13.7%) and CHD7 (7.8%). The frequency of PROKR2 mutations was higher in dual HH when compared to other HH cases (6/15 vs 3/36, p=0.021).

Conclusions

Micropenis and/or cryptorchidism can serve as important signs for the diagnosis of HH in paediatrics and the coexistence of hypospadias, does not exclude the diagnosis of CHH, including KS or normosmic isolated HH (nIHH). <comment> Au: OK? Author: OK. Thank you!</comment>Testicular function may be impaired earlier than expected, and PROKR2 mutations need to be evaluated to identify presumed dual defects.

This article is protected by copyright. All rights reserved.

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Quartz crystal microbalance: Sensing cell-substrate adhesion and beyond

Publication date: 15 January 2018
Source:Biosensors and Bioelectronics, Volume 99
Author(s): Jennifer Y. Chen, Lynn S. Penn, Jun Xi
Cell adhesion is an essential aspect of cellular behavior. Finding innovative methods to probe the adhesion of cells in their native state can greatly advance the understanding of control and regulation of cellular behavior and their impact on human health. The quartz crystal microbalance (QCM) is a label-free, biosensing system that has, in the past fifty years, evolved from a simple acoustic based mass sensor to a powerful bioanalytical tool. Its unique capability of monitoring the cell-substrate interaction non-invasively in real time has led to the emergence of its applications in areas that are relevant to fundamental cell biology and medical research. This review is intended to provide readers an overview of the use of the QCM for examination of cell-substrate adhesion. It also describes how this innovative approach can be extended to the study of other aspects of cellular behavior, such as cell morphology, cell mechanics, cell motility, cell signaling, all of which can potentially be applied to medical diagnosis and/or pharmaceutical development. In this review a major emphasis is placed on informing readers about some of the most important practical aspects of the QCM-based cell study including data acquisition and analysis, the substrate surface manipulation, and cell manipulation.



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Corrigendum to “The Relationship between Population T4/TSH Set Point Data and T4/TSH Physiology”

http://ift.tt/2we6Slq

Hypermetabolic Thyroid Incidentaloma on Positron Emission Tomography: Review of Laboratory, Radiologic, and Pathologic Characteristics

Introduction. Incidental hypermetabolic thyroid lesions on Positron Emission Tomography have significant clinical value and may harbor malignancy. In this study we evaluated laboratory, radiologic, and pathologic characteristics of incidental hypermetabolic thyroid lesions. Materials and Methods. We evaluated 18 patients prospectively with various malignancies and hypermetabolic thyroid incidentaloma. The thyroid function tests, ultrasound assessment, and guided FNA biopsy were performed on all cases. Results. We included 9 male and 9 female patients with mean age of 51 years. Most common malignancy was colon cancer. Metabolic activity quantification using maximum standard uptake value demonstrated range between 1.4 and 65.4 with mean value of 9.4. We found highest metabolic activity in patients with lung adenocarcinoma, B-cell lymphoma, and colon adenocarcinoma. On ultrasound exam most thyroid lesions were of solid, hypoechoic, noncalcified nature with either normal or peripheral increased vascularity. FNA biopsy report was benign in 15 cases and malignant or highly suggestive for malignancy in 3 other cases. Two of the three malignant cases demonstrated metabolic activity higher than average SUV max. Conclusion. Most thyroid hypermetabolic incidentalomas are benign lesions, while higher values of SUV max are in favor of malignancy. This mandates further evaluation of incidentally found thyroid hypermetabolic lesions on routine PET/CT scans.

http://ift.tt/2vUN9EW