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Σάββατο, 18 Νοεμβρίου 2017

Multi-detector CT: Liver protocol and recent developments

Publication date: December 2017
Source:European Journal of Radiology, Volume 97
Author(s): N. Kartalis, K. Brehmer, L. Loizou
Multi-detector computed tomography is today the workhorse in the evaluation of the vast majority of patients with known or suspected liver disease. Reasons for that include widespread availability, robustness and repeatability of the technique, time-efficient image acquisitions of large body volumes, high temporal and spatial resolution as well as multiple post-processing capabilities. However, as the technique employs ionizing radiation and intravenous iodine-based contrast media, the associated potential risks have to be taken into account.In this review article, liver protocols in clinical practice are discussed with emphasis on optimisation strategies. Furthermore, recent developments such as perfusion CT and dual-energy CT and their applications are presented.



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Diffusion-weighted magnetic resonance imaging in painful bone metastases: Using quantitative apparent diffusion coefficient as an indicator of effectiveness of single fraction versus multiple fraction radiotherapy

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Daniela Musio, Irene De Francesco, Alessandro Galdieri, Claudia Marsecano, Alfonso Piciocchi, Alessandro Napoli, Francesca De Felice, Vincenzo Tombolini
PurposeBone metastases are a common cause of cancer-related pain. The aim of this study is to determine the optimal radiotherapy schedule for the treatment of painful bone metastases and verify if could cause different biological effects on bone. This has been achieved using functional Magnetic Resonance Imaging (MRI) with diffusion-weighted imaging (DWI).Patients and methodsFifteen patients received Multiple Fractions Radiation Therapy (MFRT) with a total dose of 30Gy in 10 daily fractions of 3Gy given over 2 weeks and 15 patients received a Single Fraction Radiation Therapy (SFRT) with a dose of 8Gy. Quantitative Apparent Diffusion Coefficient (ADC) values after SFRT or MFRT were compared with response to treatment (pain relief), assessed by Visual Analogue Scale (VAS) before radiotherapy and at 1 and 3 months after the completion of treatment.ResultsThe two schedules had equal efficacy in terms of pain control, without any difference at 1 and 3 months post radiotherapy. In both treatments, pain reduction was related to an increase in the ADC. However, the median ADC value had an increase of 575 points between the baseline and 3 months (from 1010 to 1585, p=0.02) in the 30Gy group, while it was only 178 points (from 1417 to 1595) in the 8Gy group.ConclusionsThe increase in the ADC values after radiotherapy corresponds to increased cell death. Despite an equal pain control, MFRT treatment seems to be more effective to achieve cancer cells kill. Our preliminary data could also explain the higher retreatment rates in SFRT vs MFRT in long survivors.



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Hepatocellular carcinoma treated with sorafenib: Arterial tumor perfusion in dynamic contrast-enhanced CT as early imaging biomarkers for survival

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Yuko Nakamura, Tomokazu Kawaoka, Toru Higaki, Wataru Fukumoto, Yukiko Honda, Makoto Iida, Chikako Fujioka, Masao Kiguchi, Hiroshi Aikata, Kazuaki Chayama, Kazuo Awai
ObjectivesTo investigate whether hepatic perfusion CT yields early imaging biomarkers predictive of the prognosis of hepatocellular carcinoma (HCC) patients treated with sorafenib.MethodsWe evaluated 36 HCC patients who underwent hepatic perfusion CT before- and one week after sorafenib therapy. We measured arterial and portal perfusion in the hepatic tumor and liver parenchyma [(AP)(PP)tumor], [(AP)(PP)liver]. The perfusion ratio was calculated by dividing the post- by the pre-sorafenib value. The effect of each value on the overall survival rate was analyzed with the Cox proportional hazards model; statistically significant parameters were subjected to receiver operating characteristic analysis based on median survival after sorafenib administration to determine the overall survival rate with the Kaplan-Meier method.ResultsPre-APtumor was significantly associated with the overall survival rate (hazard ratio (HR) and 95% confidence interval (CI), 0.16 and 0.02-0.84, p=0.03). The APtumor ratio tended to be associated with the overall survival rate (HR and 95% CI, 2.94 and 0.94-7.88, p=0.06). The overall survival rate was higher in patients with pre-APtumor>71.7mL/min/100mL, and with APtumor ratio≦1.1 (p<0.01 and 0.03, respectively, in Kaplan-Meier method with log-rank).ConclusionHepatic perfusion CT yields early imaging biomarkers for predicting overall survival in HCC patients treated with sorafenib.



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Real-time two-dimensional Shear-wave elastography for liver stiffness in children: Interobserver variation and effect of breathing technique

Publication date: December 2017
Source:European Journal of Radiology, Volume 97
Author(s): Hee Mang Yoon, Young Ah Cho, Jeong Rye Kim, Seung Soo Lee, Ah Young Jung, Jin Seong Lee, Seak Hee Oh, Kyung Mo Kim
ObjectivesTo evaluate interobserver variation and to assess the effect of the breathing technique on liver stiffness (LS) measurement using real-time two-dimensional shear-wave elastography (2D-SWE) in children.MethodsPatients who underwent real-time 2D-SWE by two operators (group 1) and patients who underwent real-time 2D-SWE by one operator using the free-breathing and breath-holding techniques (group 2) were included. In group 1, interobserver agreement was assessed using the intraclass correlation coefficient (ICC) and the 95% limits-of-agreement was analyzed to evaluate the maximum change in the LS values based on Bland-Altman analysis. In group 2, the Bland-Altman plot and the paired t-test were used to determine the effect of breathing technique on LS measurement.ResultsThe interobserver agreement of the LS measurement in group 1 (n=63) was excellent (ICC, 0.953), and the 95% limits-of-agreement was 31.8% of the mean LS values. In group 2 (n=45), the free-breathing technique revealed systematically lower LS with a mean difference of −11.1% of the mean LS values, compared to the breath-holding technique (P=0.016).ConclusionLS measurement assessed by real-time 2D-SWE in children showed excellent interobserver agreement. Changes in LS values less than 31.8% of the mean LS values may represent the measurement error. The free-breathing technique showed lower LS values, compared to the breath-holding technique.



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Characterization of testicular germ cell tumors: Whole-lesion histogram analysis of the apparent diffusion coefficient at 3T

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Xiangde Min, Zhaoyan Feng, Liang Wang, Jie Cai, Xu Yan, Basen Li, Zan Ke, Peipei Zhang, Huijuan You
PurposeTo assess the values of parameters derived from whole-lesion histograms of the apparent diffusion coefficient (ADC) at 3T for the characterization of testicular germ cell tumors (TGCTs).Materials and methodsA total of 24 men with TGCTs underwent 3T diffusion-weighted imaging. Fourteen tumors were pathologically confirmed as seminomas, and ten tumors were pathologically confirmed as nonseminomas. Whole-lesion histogram analysis of the ADC values was performed. A Mann-Whitney U test was employed to compare the differences in ADC histogram parameters between seminomas and nonseminomas. Receiver operating characteristic analysis was used to identify the cutoff values for each parameter for differentiating seminomas from nonseminomas; furthermore, the area under the curve (AUC) was calculated to evaluate the diagnostic accuracy.ResultsThe median of 10th, 25th, 50th, 75th, and 90th percentiles and mean, minimum and maximum ADC values were all significantly reduced for seminomas compared with nonseminomas (p<0.05 for all). In contrast, the median of kurtosis and skewness of ADC values of seminomas were both significantly increased compared with those of nonseminomas (p=0.003 and 0.001, respectively). For differentiating nonseminomas from seminomas, the 10th percentile ADC yielded the highest AUC with a sensitivity and specificity of 100% and 92.86%, respectively.ConclusionWhole-lesion histogram analysis of ADCs might be used for preoperative characterization of TGCTs.



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MR elastography is effective for the non-invasive evaluation of fibrosis and necroinflammatory activity in patients with nonalcoholic fatty liver disease

Publication date: Available online 11 November 2017
Source:European Journal of Radiology
Author(s): Luciana Costa-Silva, Silvia Marinho Ferolla, Agnaldo Soares Lima, Paula Vieira Teixeira Vidigal, Teresa Cristina de Abreu Ferrari
ObjectivesTo evaluate the performance of magnetic resonance elastography (MRE) in diagnosing and staging hepatic fibrosis in patients with histologically confirmed nonalcoholic fatty liver disease (NAFLD) and in distinguishing simple steatosis from nonalcoholic steatohepatitis (NASH).MethodsNinety subjects (49 NAFLD patients and 41 healthy volunteers) were prospectively enrolled. Liver stiffness measured by MRE was correlated with the grade of fibrosis and/or inflammation determined by liver biopsy. Correlations, ROC (receiver operator characteristic) curves and diagnostic performance were evaluated. The study was approved by the local ethics committee.ResultsThe area under the ROC curve (AUROC) of MRE in discriminating healthy from NAFLD individuals was 0.964 (P<0.0001), and that for distinguishing advanced (F3-F4) from absent/mild fibrosis (F0-F2) was 0.928 (P<0.0001). The use of a threshold >4.39 kPa resulted in a sensitivity of 90.9% and a specificity of 97.3% for diagnosing advanced fibrosis. For discriminating NASH from simple steatosis, the AUROC was 0.783 (P<0.0001), and the threshold, 3.22 kPa.ConclusionsMRE is an effective, non-invasive method for detecting/staging hepatic fibrosis in NAFLD. This method has good performance in discriminating normal from NAFLD subjects and between the extreme grades of fibrosis. NAFLD patients with inflammation and without fibrosis have higher liver stiffness than those with simple steatosis.



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Inter-exam agreement and diagnostic performance of the Korean thyroid imaging reporting and data system for thyroid nodule assessment: Real-time versus static ultrasonography

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Jung Min Bae, Soo Yeon Hahn, Jung Hee Shin, Eun Young Ko
ObjectiveTo investigate the inter-exam agreement for thyroid nodule between real-time ultrasonography (US) assessment and retrospective US interpretation and to compare the diagnostic performance between two methods by using the most recently published guidelines for the US-based management of thyroid nodules, the Korean Thyroid Imaging Reporting and Data System (K-TIRADS).MethodsThe study included 253 nodules in 238 patients for the inter-exam agreement and 201 nodules in 190 patients for the diagnostic performance. Real-time and retrospectively static US images were analyzed according to the US descriptors and final categories of the K-TIRADS. Inter-exam agreements between real-time US assessments and static US image interpretation were analyzed, as was the diagnostic performance of both methods.ResultsOverall inter-exam agreements were almost perfect for orientation (κ=0.868); and substantial for composition, spongiform appearance, echogenicity, shape, margin, calcification, and final K-TIRADS categories (κ=0.754, 0.786, 0.747, 0.670, 0.666, 0.778, and 0.754, respectively). Specifically, moderate agreements were observed for predominantly cystic composition and ill-defined margin. The overall diagnostic performances of both real-time US assessment and retrospective US interpretation using the K-TIRADS were comparable.ConclusionsOverall inter-exam agreements between real-time and retrospective US image interpretation for thyroid nodules using the K-TIRADS were equal or more than a substantial. Therefore, the use of K-TIRADS can provide consistent description and assessment for thyroid US regardless of the timing of interpretation.



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Support Vector Machines (SVM) classification of prostate cancer Gleason score in central gland using multiparametric magnetic resonance images: A cross-validated study

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Jiance Li, Zhiliang Weng, Huazhi Xu, Zhao Zhang, Haiwei Miao, Wei Chen, Zheng Liu, Xiaoqin Zhang, Meihao Wang, Xiao Xu, Qiong Ye
PurposeTo assess the performance of Support Vector Machines (SVM) classification to stratify the Gleason Score (GS) of prostate cancer (PCa) in the central gland (CG) based on image features across multiparametric magnetic resonance imaging (mpMRI).Materials and methodsThis retrospective study was approved by the institutional review board, and informed consent was waived. One hundred fifty-two CG cancerous ROIs were identified through radiological-pathological correlation. Eleven parameters were derived from the mpMRI and histogram analysis, including mean, median, the 10th percentile, skewness and kurtosis, was performed for each parameter. In total, fifty-five variables were calculated and processed in the SVM classification. The classification model was developed with 10-fold cross-validation and was further validated mutually across two separated datasets.ResultsWith six variables selected by a feature-selection and variation test, the prediction model yielded an area under the receiver operating characteristics curve (AUC) of 0.99 (95% CI: 0.98, 1.00) when trained in dataset A2 and 0.91 (95% CI: 0.85, 0.95) for the validation in dataset B2. When the data sets were reversed, an AUC of 0.99 (95% CI: 0.99, 1.00) was obtained when the model was trained in dataset B2 and 0.90 (95% CI: 0.85, 0.95) for the validation in dataset A2.ConclusionThe SVM classification based on mpMRI derived image features obtains consistently accurate classification of the GS of PCa in the CG.



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Differentiating between benign and malignant sinonasal lesions using dynamic contrast-enhanced MRI and intravoxel incoherent motion

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Jingxuan Jiang, Zebin Xiao, Zuohua Tang, Yufeng Zhong, Jinwei Qiang
PurposeTo explore the value of dynamic contrast-enhanced MRI (DCE-MRI) and intravoxel incoherent motion (IVIM) for distinguishing between benign and malignant sinonasal lesions and investigate the correlations between the two methods.Methods and materialsPatients with sinonasal lesions (42 benign and 31 malignant) who underwent DCE-MRI and IVIM before confirmation by histopathology were enrolled in this prospective study. Parameters derived from DCE-MRI and IVIM were measured, the optimal cut-off values for differential diagnosis were determined, and the correlations between the two methods were evaluated. Statistical analyses were performed using the Wilcoxon rank sum test, receiver operating characteristic (ROC) curve analysis, and Spearman's rank correlation.ResultsSignificantly higher Ktrans and Kep values but lower D and f values were found in malignant lesions than in benign lesions (all p<0.001). There were no significant differences in the Ve and D* values between the two groups. The area under the curve (AUC) of Ktrans was significantly higher than those of other parameters. There was no significant difference between the AUCs of DCE-MRI and IVIM with parameters combined (p=0.86). Significant inverse but weak correlations were found between D and Ktrans (r=−0.46, p<0.001), f and Ktrans (r=−0.41, p<0.001), D and Kep (r=−0.37, p=0.008), and f and Kep (r=−0.33, p=0.004).ConclusionsDCE-MRI and IVIM can effectively differentiate between benign and malignant sinonasal lesions. IVIM findings correlate with DCE-MRI results and may represent an alternative to DCE-MRI.



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Improving digital breast tomosynthesis reading time: A pilot multi-reader, multi-case study using concurrent Computer-Aided Detection (CAD)

Publication date: December 2017
Source:European Journal of Radiology, Volume 97
Author(s): Corinne Balleyguier, Julia Arfi-Rouche, Laurent Levy, Patrick R. Toubiana, Franck Cohen-Scali, Alicia Y. Toledano, Bruno Boyer
PurposeEvaluate concurrent Computer-Aided Detection (CAD) with Digital Breast Tomosynthesis (DBT) to determine impact on radiologist performance and reading time.Materials and methodsThe CAD system detects and extracts suspicious masses, architectural distortions and asymmetries from DBT planes that are blended into corresponding synthetic images to form CAD-enhanced synthetic images. Review of CAD-enhanced images and navigation to corresponding planes to confirm or dismiss potential lesions allows radiologists to more quickly review DBT planes. A retrospective, crossover study with and without CAD was conducted with six radiologists who read an enriched sample of 80 DBT cases including 23 malignant lesions in 21 women. Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) compared the readings with and without CAD to determine the effect of CAD on overall interpretation performance. Sensitivity, specificity, recall rate and reading time were also assessed. Multi-reader, multi-case (MRMC) methods accounting for correlation and requiring correct lesion localization were used to analyze all endpoints. AUCs were based on a 0–100% probability of malignancy (POM) score. Sensitivity and specificity were based on BI-RADS scores, where 3 or higher was positive.ResultsAverage AUC across readers without CAD was 0.854 (range: 0.785-0.891, 95% confidence interval (CI): 0.769,0.939) and 0.850 (range: 0.746-0.905, 95% CI: 0.751,0.949) with CAD (95% CI for difference: −0.046,0.039), demonstrating non-inferiority of AUC. Average reduction in reading time with CAD was 23.5% (95% CI: 7.0–37.0% improvement), from an average 48.2 (95% CI: 39.1,59.6) seconds without CAD to 39.1 (95% CI: 26.2,54.5) seconds with CAD. Per-patient sensitivity was the same with and without CAD (0.865; 95% CI for difference: −0.070,0.070), and there was a small 0.022 improvement (95% CI for difference: ‐0.046,0.089) in per-lesion sensitivity from 0.790 without CAD to 0.812 with CAD. A slight reduction in specificity with a −0.014 difference (95% CI for difference: ‐0.079,0.050) and a small 0.025 increase (95% CI for difference: −0.036,0.087) in recall rate in non-cancer cases were observed with CAD.ConclusionsConcurrent CAD resulted in faster reading time with non-inferiority of radiologist interpretation performance. Radiologist sensitivity, specificity and recall rate were similar with and without CAD.



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Comparing sensitivity and specificity of medical imaging tests when verification bias is present: The concept of relative diagnostic accuracy

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Thomas Filleron
Medical imaging plays a key role in all stages of cancer management. In evaluating a new imaging modality, the optimal design involves a comparison with standard test results as well as a gold standard, such as a pathological evaluation to determine disease status. However, when both the standard and experimental test results are negative, a gold standard may not always be performed, especially if it involves an invasive and/or costly procedure. In this situation, true disease status cannot be verified, which creates an estimation problem for sensitivity and specificity. The aim of this article is to present the concept of relative accuracy which permits to remove the bias when only patients with at least one positive test receive the gold standard.



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Radiological visibility of an immediate contrast medium side-effect

Publication date: Available online 14 November 2017
Source:European Journal of Radiology
Author(s): Ingrid Boehm




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Value of a radiographic score for the assessment of healing of nailed femoral and tibial shaft fractures: A retrospective preliminary study

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Vasiliki Perlepe, Andrea Cerato, Dan Putineanu, Celine Bugli, Guy Heynen, Patrick Omoumi, Bruno Vande Berg
ObjectivesTo assess the value of a radiographic score for the detection of delayed union in nailed fractures.MethodsThe modified radiographic union score (mRUS) values were determined by three separate radiologists on 259 radiographic sets of 58 nailed tibial or femoral fractures obtained at different timepoints after fracture (mean of 4.5 radiographic sets per fracture). A surgeon determined fracture outcome (normal or delayed union) at a mean of 192days after injury. Mean radiographic scores obtained at different timepoints after fracture were compared between fractures with normal or abnormal healing at follow-up.ResultsThe mean score values increased significantly over time for fractures with normal healing for all readers (p<0.001). The mean score values determined 11–14 weeks after injury were higher in fractures with normal healing than in fractures with delayed union at follow-up (p<0.05). Scoring of radiographs obtained at about 3 months after injury or later enabled detection of fractures with delayed union with a sensitivity of 0.63–0.77 and a specificity of 1.0 (area under curve: 0.77- 0.88).ConclusionsThe mRUS score can contribute to the detection of delayed union at a delay of about 3 months after injury in nailed shaft fractures.



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Editorial Board

Publication date: November 2017
Source:European Journal of Radiology, Volume 96





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Upper tract urothelial cancer

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Adam Froemming, Theodora Potretzke, Naoki Takahashi, Bohyun Kim
While urothelial carcinoma is a very common tumor, involvement of the upper tract is relatively uncommon. Consequently, there are no consensus imaging recommendations for upper tract disease. CT urography is the dominant imaging modality for the upper tract, but despite its excellent performance characteristics and being widely accepted as standard of care there is great variability in how CTU exams are performed across practices. MR urography has limited current application, but has the potential to become more mainstream in the future with continued technical advances. Upper tract urothelial carcinoma can manifest as a variety of appearances: a papillary lesion, focal wall thickening, focal enhancement, or as an infiltrative lesion. Pelvicalyceal location is about twice as common as in the ureter. Tumors in the pelvicalyceal location often manifest as an irregular enhancing soft tissue attenuation filling defect, and may be sessile or polypoid in morphology. Within the ureter, 73% are located in the distal segment.



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Using diagnostic reference levels to evaluate the improvement of patient dose optimisation and the influence of recent technologies in radiography and computed tomography

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Patrice Roch, David Célier, Cécile Dessaud, Cécile Etard
ObjectivesTwelve years since the implementation of Diagnostic Reference Levels (DRL) process in France, the Nuclear Safety and Radiation Protection French Institute (IRSN) presents its latest analyses performed on the most recent national data.MethodsStatutorily, each year, medical imaging departments must perform patient exposure evaluation from their clinical practice for at least 2 types of radiographic and computed tomography (CT) examinations freely chosen in the regulatory list. The samples of dosimetric data used for the evaluations must be sent to IRSN for national assessment using a dedicated and secured web portal. The analyses of collected data for radiography and CT allow IRSN to estimate the representativeness of current DRLs in terms of target practices and examinations, dosimetric quantities and numerical values. Technical data are transmitted, such as detector type in radiography or commissioning date of CT, and are included in some complementary analyses in order to evaluate their influence on patient exposure.ResultsSince 2004 the involvement of professionals in the DRL process has highly increased in CT (about 80% in 2015) but remains quite weak in radiography (almost 30%). Analyses show some discordance between regulation references and clinical practice leading to clinical doses data which are 40% lower than DRLs in 2015. As a consequence, the list of examinations types and some numerical values should be updated in the regulation.Focused analyses show a significant patient exposure reduction when digital radiography is used and when CT equipment is under five years old.ConclusionsBased on these findings, IRSN recommends to update DRL regulation with current and relevant examination lists, dosimetric quantities and numerical values. In addition, this study shows that technology and generation of equipment, such as detector type in radiography or image reconstruction algorithm in CT, take an important place in the dose optimisation process, enabling significant patient exposure reduction when it is associated with protocols optimisation.



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Diagnostic performance of CT signs for predicting adnexal torsion in women presenting with an adnexal mass and abdominal pain: A case-control study

Publication date: January 2018
Source:European Journal of Radiology, Volume 98
Author(s): Caroline Mandoul, Cécile Verheyden, Fernanda Curros-Doyon, Gauthier Rathat, Patrice Taourel, Ingrid Millet
PurposeTo determine which CT findings or combinations of CT findings could accurately identify adnexal torsion in a cohort of women admitted for abdominal pain and presenting with an adnexal mass.Materials and methodsThe local institutional review board approved this retrospective case-control study involving adults—the informed consent requirement was waived. Enhanced computed tomography (CT) findings of 32 consecutive adnexal torsion and 32 control patients admitted for abdominal pain and presenting with an adnexal mass were independently reviewed by two radiologists, with consensus by a third one, for all CT findings commonly assessed in adnexal torsion. All twisted and untwisted adnexa were confirmed by surgery. Univariate and multivariate analyses were performed for adnexal torsion prediction.ResultsThe median patient age was 41 years (interquartile range, 30.5–62 years). Only benign masses were encountered in the torsion group. Five CT features were significantly associated with adnexal torsion: a large ovary with a threshold at 80mm (p=0.005), median or contralateral displacement of the adnexa (p=0.00014), asymmetric wall thickening of the mass (p<0.0001), inter-utero-ovarian mass (p<0.0001) and whirlpool sign (p=0.0006). In the multivariate analysis, only the inter-utero-ovarian mass was independently associated with adnexal torsion (odds ratio=130 (CI95%: 15-infinite), p<0.0001) with an excellent overall diagnostic performance (AUC=0.89; CI95%: 0.81–0.97). It was a sensitive (Se=97%, CI95%: 84–100) and specific feature (Sp=81%, CI95%: 64–93).ConclusionAn inter-utero-ovarian mass is an accurate and reliable CT finding for diagnosing adnexal torsion in patients with acute abdominal pain and an adnexal mass.



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Editorial Board

Publication date: December 2017
Source:European Journal of Radiology, Volume 97





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Loco-regional staging accuracy in oesophageal cancer—How good are we in the modern era?

Publication date: December 2017
Source:European Journal of Radiology, Volume 97
Author(s): David Bunting, Tim Bracey, Bruce Fox, Richard Berrisford, Tim Wheatley, Grant Sanders
IntroductionAccuracy of locoregional staging in patients with oesophageal cancer is critical in determining operability and the need for neoadjuvant treatment. Imaging technology has advanced significantly in recent years but it is not known whether this translates to improved staging accuracy. This study investigates staging accuracy in relation to CT, EUS, PET-CT and final pre-operative stage. It specifically addresses the accuracy of staging with respect to the threshold for administering neoadjuvant therapies.Materials and methodsPre-operative staging according to CT, EUS, PET-CT and final pre-operative stage were compared to the postoperative histological staging in 133 patients undergoing potentially curative surgery (without neoadjuvant therapy) for oesophageal cancer between January 2010 and January 2015. T and N stage accuracies were reported separately for each imaging modality. Patients were also divided into two groups depending on whether the final pre-operative stage was below (≤T2, N0, early tumours) or above (≥T3 and/or ≥N1, locally advanced tumours) the threshold for offering neoadjuvant therapy. Accuracy of pre-operative staging was then analysed with respect to identification of patients below/above this threshold. The additional benefit offered by EUS for this purpose was investigated.ResultsT stage accuracies were 72.6%, 76.7% and 79.3% for CT, EUS and final pre-operative stage respectively. N stage accuracies were 75.6%, 77.2%, 74.5% and 78.6% for CT, EUS, PET-CT and final pre-operative stage respectively. Staging accuracy with respect to threshold for neoadjuvant treatment showed 62.0% early tumours were correctly staged and 80.5% advanced tumours were correctly staged. Whether or not patients underwent EUS did not affect the staging accuracy with respect to neoadjuvant treatment threshold.ConclusionsStaging accuracy with respect to the threshold for treatment with neoadjuvant therapy is poor, leading to potential over/under treatment. Predicting individual response to neoadjuvant therapy would provide a better way to determine which patients should receive this additional treatment.



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Histopathologic diversity of gastric cancers: Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type

Publication date: December 2017
Source:European Journal of Radiology, Volume 97
Author(s): Daisuke Tsurumaru, Mitsutoshi Miyasaka, Toshio Muraki, Akihiro Nishie, Yoshiki Asayama, Eiji Oki, Yoshinao Oda, Hiroshi Honda
PurposeTo evaluate the diagnostic value of contrast-enhanced computed tomography gastrography (CE-CTG) to predict the histological type of gastric cancer.Materials and methodsWe analyzed 47 consecutive patients with resectable advanced gastric cancer preoperatively evaluated by multiphasic dynamic contrast-enhanced CT. Two radiologists independently reviewed the CT images and they determined the peak enhancement phase, and then measured the CT attenuation value of the gastric lesion for each phase. The histological types of gastric cancers were assigned to three groups as differentiated-type, undifferentiated-type, and mixed-type. We compared the peak enhancement phase of the three types and compared the CT attenuation values in each phase.ResultsThe peak enhancement was significantly different between the three types of gastric cancers for both readers (reader 1, p=0.001; reader 2, p=0.009); most of the undifferentiated types had peak enhancement in the delayed phase. The CT attenuation values of undifferentiated type were significantly higher than those of differentiated or mixed type in the delayed phase according to both readers (reader 1, p=0.002; reader 2, p=0.004).ConclusionCE-CTG could provide helpful information in diagnosing the histological type of gastric cancers preoperatively.



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Cone-beam computed tomography and anatomical observations of normal variants in the mandible: variant dentists should recognize

Abstract

Many types of cone-beam computed tomography (CBCT) have recently been developed and are being used in many dental clinics. CBCT has significantly changed imaging diagnosis in dentistry by showing detailed structures in multiple dimensions with high spatial resolution. This allows dentists to confirm what cannot be recognized with conventional two-dimensional images, such as small neurovascular canals, the buccolingual location of structures/lesions, and the three-dimensional shapes of hard tissue structures. The aim of this study was to review the normal variants of detailed anatomical structures in relation with the mandibular canal by comparing the previous reports and anatomical evaluations. These structures are likely to be observed on CBCT images by dental practitioners prior to dental procedures involving the mandibular teeth and bone. Understanding the relationship of these structures is useful for dental practitioners and oral surgeons to reduce the possibility of causing damage and patient discomfort during dental procedures.



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MRI findings for primary fallopian tube cancer: correlation with pathological findings

Abstract

Purpose

To clarify the MRI findings for primary fallopian tube cancer (PFTC).

Materials and methods

MRI findings for 11 patients who were pathologically diagnosed with PFTC at our institute were retrospectively reviewed. MRI findings (shape, appearance, signal intensity, ADC value, enhancement patterns, and location of the primary tumor, the morphologic appearance of the ipsilateral ovary, and intrauterine fluid collection) were evaluated and compared with pathological findings including histological subtype and PFTC location.

Results

On MRI, PFTCs with a tubal component (n = 8) exhibited a sausage-like shape in five cases and a nodular or irregular shape in three cases. PFTCs located at the fimbria (n = 3) presented a nodular shape. The PFTC was solid in nine cases (82%), and the solid portion showed high intensity on diffusion-weighted images in all cases. The mean ADC value was 0.86 × 10−3 mm2/s. Rim enhancement of the tumor was seen in six of nine cases (67%), all with a tubal component.

Conclusion

PFTCs with a tubal component are sausage-shaped and PFTCs located at the fimbria have a nodular shape. Rim enhancement is frequently seen in PFTCs with a tubal component, which may suggest a tubal origin.



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MicroRNAs as Predictive Biomarkers for Myocardial Injury in Aged Mice Following Myocardial Infarction

Abstract

The occurrence of myocardial infarction (MI) increases appreciably with age. In the Framingham Heart Study, the incidence of MI more than doubles for men and increases more than 5-fold in women (ages 55 to 64 years compared to 85 to 94 years). MicroRNAs (miRNAs) quantitatively regulate their target's expression post-transcriptionally by either silencing action through binding at the 3'UTR domains or degrading the messages at their coding regions. In either case, these regulations affect the cardiac transcriptional output and cardiac function. Among the known cardiac associated miRNA, miRNA-1, miRNA-133a, and miRNA-34a have been shown to induce adverse structural remodeling to impair cardiac contractile function. In the present study, an in vivo model of MI in young (3 month) and old (22 month) mice is used to investigate the possible role whereby these three miRNAs exert negative effects on heart function following MI. Herein we demonstrate that in older mouse heart, all three microRNAs show increased levels of expression, while miRNA-1 shows a further increase in old mouse heart following MI, which corresponds to left ventricular (LV) wall thinning. These structural changes in cardiac tissue may causes downstream LV dilation and subsequent LV dysfunction. Results presented here suggest that significantly elevated levels of miRNA-1 in post-MI old heart could be predictive of cardiac injury in older mice as the high risk biomarker for MI in older individuals. This article is protected by copyright. All rights reserved



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health technology; +142 new citations

142 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

health technology

These pubmed results were generated on 2017/11/18

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.



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Highly immersive virtual reality laparoscopy simulation: development and future aspects

Abstract

Purpose

Virtual reality (VR) applications with head-mounted displays (HMDs) have had an impact on information and multimedia technologies. The current work aimed to describe the process of developing a highly immersive VR simulation for laparoscopic surgery.

Methods

We combined a VR laparoscopy simulator (LapSim) and a VR-HMD to create a user-friendly VR simulation scenario. Continuous clinical feedback was an essential aspect of the development process. We created an artificial VR (AVR) scenario by integrating the simulator video output with VR game components of figures and equipment in an operating room. We also created a highly immersive VR surrounding (IVR) by integrating the simulator video output with a \(360{^{\circ }}\) video of a standard laparoscopy scenario in the department's operating room.

Results

Clinical feedback led to optimization of the visualization, synchronization, and resolution of the virtual operating rooms (in both the IVR and the AVR). Preliminary testing results revealed that individuals experienced a high degree of exhilaration and presence, with rare events of motion sickness. The technical performance showed no significant difference compared to that achieved with the standard LapSim.

Conclusion

Our results provided a proof of concept for the technical feasibility of an custom highly immersive VR-HMD setup. Future technical research is needed to improve the visualization, immersion, and capability of interacting within the virtual scenario.



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The cephalic morphology of free-living and cave-dwelling species of trechine ground beetles from China (Coleoptera, Carabidae)

Abstract

Morphological adaptations of cave-dwelling organisms including different groups of Coleoptera have fascinated researchers since a long time. Nevertheless, very few detailed documentations of the anatomy of cave beetles using modern techniques are available. In this study, we describe and illustrate external and internal cephalic features of free-living and cave-dwelling trechine carabid beetles using digital microscopy, SEM, micro-CT, and computer-based 3D reconstruction. Morphological characteristics found in three selected species with different habitat preferences are compared. The following derived features distinguish a troglobite species (Sinaphaenops wangorum Ueno et Ran 1998) from a species living in the entrance of caves (Trechiotes perroti Jeannel 1954) and from a fully epigean species (Bembidion sp.): (1) the optic lobes are completely missing; (2) the head capsule, mouth parts, and antennae are distinctly elongated; (3) some muscle attachment areas are shifted; and (4) an additional dilator of the pharynx is present. Despite of conspicuous differences likely related with subterranean habits, the link of some cephalic features to this specific habitat preference remains uncertain.



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IJMS, Vol. 18, Pages 2454: Cytotoxicity of Poly(Alkyl Cyanoacrylate) Nanoparticles

IJMS, Vol. 18, Pages 2454: Cytotoxicity of Poly(Alkyl Cyanoacrylate) Nanoparticles

International Journal of Molecular Sciences doi: 10.3390/ijms18112454

Authors: Einar Sulheim Tore-Geir Iversen Vu To Nakstad Geir Klinkenberg Håvard Sletta Ruth Schmid Anne Hatletveit Ane Wågbø Anders Sundan Tore Skotland Kirsten Sandvig Ýrr Mørch

Although nanotoxicology has become a large research field, assessment of cytotoxicity is often reduced to analysis of one cell line only. Cytotoxicity of nanoparticles is complex and should, preferentially, be evaluated in several cell lines with different methods and on multiple nanoparticle batches. Here we report the toxicity of poly(alkyl cyanoacrylate) nanoparticles in 12 different cell lines after synthesizing and analyzing 19 different nanoparticle batches and report that large variations were obtained when using different cell lines or various toxicity assays. Surprisingly, we found that nanoparticles with intermediate degradation rates were less toxic than particles that were degraded faster or more slowly in a cell-free system. The toxicity did not vary significantly with either the three different combinations of polyethylene glycol surfactants or with particle size (range 100–200 nm). No acute pro- or anti-inflammatory activity on cells in whole blood was observed.



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IJMS, Vol. 18, Pages 2453: In-Depth Glyco-Peptidomics Approach Reveals Unexpected Diversity of Glycosylated Peptides and Atypical Post-Translational Modifications in Dendroaspis angusticeps Snake Venom

IJMS, Vol. 18, Pages 2453: In-Depth Glyco-Peptidomics Approach Reveals Unexpected Diversity of Glycosylated Peptides and Atypical Post-Translational Modifications in Dendroaspis angusticeps Snake Venom

International Journal of Molecular Sciences doi: 10.3390/ijms18112453

Authors: Michel Degueldre Julien Echterbille Nicolas Smargiasso Christian Damblon Charlotte Gouin Gilles Mourier Nicolas Gilles Edwin De Pauw Loïc Quinton

Animal venoms represent a valuable source of bioactive peptides that can be derived into useful pharmacological tools, or even innovative drugs. In this way, the venom of Dendroaspis angusticeps (DA), the Eastern Green Mamba, has been intensively studied during recent years. It mainly contains hundreds of large toxins from 6 to 9 kDa, each displaying several disulfide bridges. These toxins are the main target of venom-based studies due to their valuable activities obtained by selectively targeting membrane receptors, such as ion channels or G-protein coupled receptors. This study aims to demonstrate that the knowledge of venom composition is still limited and that animal venoms contain unexpected diversity and surprises. A previous study has shown that Dendroaspis angusticeps venom contains not only a cocktail of classical toxins, but also small glycosylated peptides. Following this work, a deep exploration of DA glycopeptidome by a dual nano liquid chromatography coupled to electrospray ionization mass spectrometry (nanoLC-ESI-MS) and Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) analyses was initiated. This study reveals unsuspected structural diversity of compounds such as 221 glycopeptides, displaying different glycan structures. Sequence alignments underline structural similarities with natriuretic peptides already characterized in Elapidae venoms. Finally, the presence of an S-cysteinylation and hydroxylation of proline on four glycopeptides, never described to date in snake venoms, is also revealed by proteomics and affined by nuclear magnetic resonance (NMR) experiments.



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IJMS, Vol. 18, Pages 2455: Identification of Physiological Substrates and Binding Partners of the Plant Mitochondrial Protease FTSH4 by the Trapping Approach

IJMS, Vol. 18, Pages 2455: Identification of Physiological Substrates and Binding Partners of the Plant Mitochondrial Protease FTSH4 by the Trapping Approach

International Journal of Molecular Sciences doi: 10.3390/ijms18112455

Authors: Magdalena Opalińska Katarzyna Parys Hanna Jańska

Maintenance of functional mitochondria is vital for optimal cell performance and survival. This is accomplished by distinct mechanisms, of which preservation of mitochondrial protein homeostasis fulfills a pivotal role. In plants, inner membrane-embedded i-AAA protease, FTSH4, contributes to the mitochondrial proteome surveillance. Owing to the limited knowledge of FTSH4’s in vivo substrates, very little is known about the pathways and mechanisms directly controlled by this protease. Here, we applied substrate trapping coupled with mass spectrometry-based peptide identification in order to extend the list of FTSH4’s physiological substrates and interaction partners. Our analyses revealed, among several putative targets of FTSH4, novel (mitochondrial pyruvate carrier 4 (MPC4) and Pam18-2) and known (Tim17-2) substrates of this protease. Furthermore, we demonstrate that FTSH4 degrades oxidatively damaged proteins in mitochondria. Our report provides new insights into the function of FTSH4 in the maintenance of plant mitochondrial proteome.



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IJMS, Vol. 18, Pages 2440: Genome-Wide Development of MicroRNA-Based SSR Markers in Medicago truncatula with Their Transferability Analysis and Utilization in Related Legume Species

IJMS, Vol. 18, Pages 2440: Genome-Wide Development of MicroRNA-Based SSR Markers in Medicago truncatula with Their Transferability Analysis and Utilization in Related Legume Species

International Journal of Molecular Sciences doi: 10.3390/ijms18112440

Authors: Xueyang Min Zhengshe Zhang Yisong Liu Xingyi Wei Zhipeng Liu Yanrong Wang Wenxian Liu

Microsatellite (simple sequence repeats, SSRs) marker is one of the most widely used markers in marker-assisted breeding. As one type of functional markers, MicroRNA-based SSR (miRNA-SSR) markers have been exploited mainly in animals, but the development and characterization of miRNA-SSR markers in plants are still limited. In the present study, miRNA-SSR markers for Medicago truncatula (M. truncatula) were developed and their cross-species transferability in six leguminous species was evaluated. A total of 169 primer pairs were successfully designed from 130 M. truncatula miRNA genes, the majority of which were mononucleotide repeats (70.41%), followed by dinucleotide repeats (14.20%), compound repeats (11.24%) and trinucleotide repeats (4.14%). Functional classification of SSR-containing miRNA genes showed that all targets could be grouped into three Gene Ontology (GO) categories: 17 in biological process, 11 in molecular function, and 14 in cellular component. The miRNA-SSR markers showed high transferability in other six leguminous species, ranged from 74.56% to 90.53%. Furthermore, 25 Mt-miRNA-SSR markers were used to evaluate polymorphisms in 20 alfalfa accessions, and the polymorphism information content (PIC) values ranged from 0.39 to 0.89 with an average of 0.71, the allele number per marker varied from 3 to 18 with an average of 7.88, indicating a high level of informativeness. The present study is the first time developed and characterized of M. truncatula miRNA-SSRs and demonstrated their utility in transferability, these novel markers will be valuable for genetic diversity analysis, marker-assisted selection and genotyping in leguminous species.



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Biotransport kinetics and intratumoral biodistribution of malonodiserinolamide-derivatized [60]fullerene in a murine model of breast adenocarcinoma

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Fabrication of large-pore mesoporous Ca-Si-based bioceramics for bone regeneration

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We're catching up on the latest in prostate cancer care at the #EMUC17 meeting in Barcelona this weekend. Videos to… https://t.co/leNaaQABAu

We're catching up on the latest in prostate cancer care at the #EMUC17 meeting in Barcelona this weekend. Videos to… https://t.co/leNaaQABAu

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All change…transcanal endoscopic ear surgery and house dust mite immunotherapy for allergic rhinitis.

All change…transcanal endoscopic ear surgery and house dust mite immunotherapy for allergic rhinitis.

J Laryngol Otol. 2017 Nov;131(11):939

Authors: Fishman J, Youngs R, Fisher E, Hussain M

PMID: 29148358 [PubMed - in process]



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Evaluating the projected surgical impact of reclassifying noninvasive encapsulated follicular variant of papillary thyroid cancer as noninvasive follicular thyroid neoplasm with papillary-like nuclear features.

Evaluating the projected surgical impact of reclassifying noninvasive encapsulated follicular variant of papillary thyroid cancer as noninvasive follicular thyroid neoplasm with papillary-like nuclear features.

Surgery. 2017 Nov 13;:

Authors: Mainthia R, Wachtel H, Chen Y, Mort E, Parangi S, Sadow PM, Lubitz CC

Abstract
BACKGROUND: The reclassification of noninvasive encapsulated follicular variant of papillary thyroid cancer to noninvasive follicular thyroid neoplasm with papillary-like nuclear features will reduce nonefficacious and potentially harmful care. Reclassification is estimated in 18.6% of patients with papillary thyroid carcinoma; we aimed to quantify the implications of this change.
METHODS: Pathology reports from April 2006 to April 2016 were reviewed to isolate cases that would have been designated as neoplasm with papillary-like nuclear features. Of the 1,335 cases of papillary thyroid carcinomas, 194 cases (14.5%) met criteria. Cases in which neoplasm with papillary-like nuclear features was found in combination with other thyroid malignancies (n = 25) and cases of prior thyroid lobectomy (n = 5) were excluded. Demographic, pathologic, treatment, and follow-up data were assessed for the remaining 164 potential neoplasm with papillary-like nuclear features cases. Logistic regression analysis was performed to evaluate association between fine-needle aspiration result and index procedure.
RESULTS: Of the 164 patients with tumors who met neoplasm with papillary-like nuclear features criteria, fine-needle aspiration results were nondiagnostic (2%), benign (18%), atypia/follicular lesion of undetermined significance (26%), follicular neoplasm or suspicious for follicular neoplasm (20%), suspicious for malignancy (19%), malignant (6%), and not obtained (9%). Eighty-five (52%) patients underwent total thyroidectomy. A "suspicious for malignancy" fine-needle aspiration result was associated with undergoing total thyroidectomy versus thyroid lobectomy (P = .006). Thyroid lobectomy was the index procedure for 79 patients (48%); of these patients, 54% (n = 43, 3.2% of all patients with papillary thyroid carcinomas) underwent subsequent total thyroidectomy, and 24% received postoperative radioactive iodine treatment. There were no recurrences among the 125 patients with >3 months of follow-up.
CONCLUSION: The reclassification of noninvasive encapsulated follicular variant of papillary thyroid cancer as neoplasm with papillary-like nuclear features will decrease nonefficacious treatment and reduce costs. However, the impact of this change with regard to extent of surgery was limited to 3.2% of patients with papillary thyroid carcinomas compared with the projected potential impact on 18.6%. (Surgery 2017;160:XXX-XXX.).

PMID: 29146229 [PubMed - as supplied by publisher]



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CONCORDANCE OF PREOPERATIVE CLINICAL STAGE WITH PATHOLOGICAL STAGE IN PATIENTS ≥ 45 YEARS WITH WELL-DIFFERENTIATED THYROID CANCER.

CONCORDANCE OF PREOPERATIVE CLINICAL STAGE WITH PATHOLOGICAL STAGE IN PATIENTS ≥ 45 YEARS WITH WELL-DIFFERENTIATED THYROID CANCER.

Endocr Pract. 2017 Nov 16;:

Authors: Calcatera NA, Lutfi W, Suman P, Suss NR, Wang CH, Prinz RA, Winchester DJ, Moo-Young TA

Abstract
OBJECTIVE: Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown.
METHODS: The National Cancer Data Base (NCDB) was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012.
RESULTS: There were 16,286 (59.3%) cStage I patients; 4,825 (17.6%) cStage II; 4,329 (15.8%) cStage III; and 2,013 (7.3%) cStage IV patients. The upstage rate was 15.1% and the downstage rate was 4.6%. For cStage II there was a 25.5% upstage rate. The change in cStage was a result of inaccurate T-category in 40.8%, N-category in 36.3%, and both in 22.9%. On multivariate analysis the patients more likely to be upstaged had papillary histology, tumors 2.1-4 cm, total thyroidectomy, nodal surgery, positive margins, or multifocal disease. Upstaged patients received radioiodine more frequently (75.3% vs. 48.1%, p<0.001).
CONCLUSION: Approximately 20% of cStage is discordant to pStage. Certain populations are at risk for inaccurate staging including cT2 and cN0 patients. Upstaged patients are more likely to receive radioactive iodine therapy.
ABBREVIATIONS: cStage = clinical stage; pStage = pathologic stage; NCDB = National Cancer Data Base; DTC = differentiated thyroid cancer; ATA = American Thyroid Association; AJCC = American Joint Committee on Cancer; ICD-O-3 = International Classification of Diseases for Oncology, 3rd edition; RAI = radioactive iodine.

PMID: 29144811 [PubMed - as supplied by publisher]



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PANCREAS METASTASES FROM PAPILLARY THYROID CARCINOMA: A REVIEW OF THE LITERATURE.

PANCREAS METASTASES FROM PAPILLARY THYROID CARCINOMA: A REVIEW OF THE LITERATURE.

Endocr Pract. 2017 Nov 16;:

Authors: Davidson M, Olsen RJ, Ewton AA, Robbins RJ

Abstract
OBJECTIVE: Although loco-regional metastases occur in 5-10% of patients with papillary thyroid cancer (PTC), distant metastases are rare, especially to the pancreas. Here we review the literature regarding metastases to the pancreas from PTC and present an illustrative patient.
METHODS: The literature search was performed through www.pubmed.org . The information regarding our illustrative case was obtained from the medical records of our institution.
RESULTS: Since 1991, 11 cases of pancreas metastases of PTC have been reported. The average age at diagnosis was 55.3 years. There were 8 men and 3 women. Three had classic PTC histology; 2 had tall cell variant; and 2 had follicular variant. Four had T4 tumors, and 2 had T3 tumors. Seven had thyroid cancer spread to regional lymph nodes. One had distant metastasis. The pancreas metastasis was diagnosed from 1 month to 13 years after primary PTC was detected; average was 7 years. Our patient was an 84 year old woman diagnosed with PTC with a BRAFV600E mutation following total thyroidectomy. A whole body scan after radioactive iodine (RAI) remnant ablation was negative for metastases. A pancreatic tumor was identified 2 years later, on screening fluoro-deoxyglucose (FDG)-positron emission tomography (PET) scan. A biopsy of the tumor was histologically similar to PTC and positive for thyroglobulin, TTF-1, and the BRAFV600E mutation.
CONCLUSION: The biological reasons why PTCs metastasize to the pancreas have yet to be elucidated. Older patients with non-RAI avid, FDG-PET positive metastases and symptoms of pancreatitis are at increased risk of having this rare entity.

PMID: 29144798 [PubMed - as supplied by publisher]



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RELATIONSHIP BETWEEN THE EFFECTIVENESS OF INORGANIC IODINE AND THE SEVERITY OF GRAVES' THYROTOXICOSIS: A RETROSPECTIVE STUDY.

RELATIONSHIP BETWEEN THE EFFECTIVENESS OF INORGANIC IODINE AND THE SEVERITY OF GRAVES' THYROTOXICOSIS: A RETROSPECTIVE STUDY.

Endocr Pract. 2017 Nov 16;:

Authors: Honda A, Uchida T, Komiya K, Goto H, Takeno K, Sato J, Suzuki R, Himuro M, Watada H

Abstract
OBJECTIVE: Inorganic iodine is often used to treat patients with Graves' thyrotoxicosis who do not tolerate thionamides due to adverse effects. However, predictors of continued inorganic iodine efficacy have not been fully elucidated yet. This study aimed to investigate the factors affecting the continued efficacy of potassium iodide (KI) in patients with Graves' thyrotoxicosis.
METHODS: In this study, among 1197 patients with Graves' disease who were initially treated with thionamides, we retrospectively studied 24 consecutive Japanese patients whose treatment were changed to KI alone due to the adverse effects of thionamides. We divided these patients into two groups: patients who had maintained euthyroid function for at least 180 days (non-recurrence group, n=11), and patients who had not maintained euthyroid function for 180 days (recurrence group, n=13).
RESULTS: Free triiodothyronine (FT3) and free thyroxine (FT4) levels on the day of changing from thionamides to KI were statistically higher in the recurrence group than in the non-recurrence group [FT3, 9.3 (range, 5.2-11.6) vs. 3.7 (3.3-4.8) pg/mL, p = 0.02 and FT4, 3.6 (1.8-4.5) vs. 1.4 (1.2-1.9) ng/dL, p = 0.02]. FT4 levels on the day of drug change were significantly higher in the recurrence group, even after adjusting for thionamide or KI dose. In the recurrence group, the duration of KI effect was inversed correlated with FT3 and FT4 levels on the day of drug change.
CONCLUSIONS: Continued efficacy of KI after thionamides might be inversely correlated with thyrotoxicosis severity on the day of drug change.
ABBREVIATIONS: eTV = estimated thyroid volume; FT3 = free triiodothyronine; FT4 = free thyroxine; IQR = interquartile range; KI = potassium iodide; MMI = thiamazole; PTU = propylthiouracil; RAIT = radioactive iodine therapy; TRAb = thyrotropin receptor antibody; TSH = thyrotropin.

PMID: 29144795 [PubMed - as supplied by publisher]



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Transport Distraction Osteogenesis in Reconstruction of Condyle: Use of a 3D Model for Vector Planning

Abstract

Introduction

The temporomandibular joint (TMJ) is a complex joint, and it allows bilateral synchronous rotatory and translatory movements. TMJ reconstruction has evolved as an important step in the management of conditions affecting the TMJ like ankylosis, traumatic injuries and congenital deformities. Distraction osteogenesis (DO) is a biological process of forming new bone and adjacent soft tissues by gradual and controlled traction applied on osteotomized bone segments.

Case report

Here is a case report of bilateral TMJ ankylosis which was managed effectively by resection of ankylotic mass and reconstruction of TMJ by transport distraction osteogenesis with preoperative vector planning using a 3D printed model.

Conclusion

Distraction osteogenesis can be considered as an effective means of condylar reconstruction for an anatomical and functional TMJ with minimal complications. Use of 3D models can help making such complex TMJ reconstruction procedures simpler.



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Viruses, Vol. 9, Pages 349: New Paradigms for the Study of Ocular Alphaherpesvirus Infections: Insights into the Use of Non-Traditional Host Model Systems

Viruses, Vol. 9, Pages 349: New Paradigms for the Study of Ocular Alphaherpesvirus Infections: Insights into the Use of Non-Traditional Host Model Systems

Viruses doi: 10.3390/v9110349

Authors: Matthew Pennington Eric Ledbetter Gerlinde Van de Walle

Ocular herpesviruses, most notably human alphaherpesvirus 1 (HSV-1), canid alphaherpesvirus 1 (CHV-1) and felid alphaherpesvirus 1 (FHV-1), infect and cause severe disease that may lead to blindness. CHV-1 and FHV-1 have a pathogenesis and induce clinical disease in their hosts that is similar to HSV-1 ocular infections in humans, suggesting that infection of dogs and cats with CHV-1 and FHV-1, respectively, can be used as a comparative natural host model of herpesvirus-induced ocular disease. In this review, we discuss both strengths and limitations of the various available model systems to study ocular herpesvirus infection, with a focus on the use of these non-traditional virus-natural host models. Recent work has demonstrated the robustness and reproducibility of experimental ocular herpesvirus infections in dogs and cats, and, therefore, these non-traditional models can provide additional insights into the pathogenesis of ocular herpesvirus infections.



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Military Neurosurgery Socioeconomic Data: Benefits, Challenges, and Opportunities.

Military Neurosurgery Socioeconomic Data: Benefits, Challenges, and Opportunities.

Neurosurgery. 2017 Nov 15;:

Authors: Menger R, Robbins JW, Bell R

Abstract
Military conflict and neurosurgery date back to antiquity. Neurosurgery's development is intimately linked with Harvey Cushing's military experience. Previous papers highlighted unique opportunities and socioeconomic challenges facing military neurosurgeons. Here, we provide objective data from military neurosurgeons surrounding these issues.Internet survey responses were solicited from current, separated, and retired military neurosurgeons regarding workforce issues and their perception of military neurosurgery.A total of 80.9% (98/121) of respondents enjoyed their military experience, 63.6% (77/121) were very pleased with their service; 97.4% (114/117) enjoyed treating military patients, and 78.2% (93/119) would recommend military service. Positives included feelings of patriotism (87.4%), development of camaraderie (71.4%), and deployment experience (93.8%).However, 76.5% of respondents noted concerns regarding military and civilian pay disparity. 37.5% were overwhelmed with administrative responsibilities, and over 50% desired higher case volume.Multivariate analysis showed those who failed to develop a sense of camaraderie were more likely to be dissatisfied (P = .02). Those still currently serving trended towards dissatisfaction (P = .08), and current military neurosurgeons were only 0.29 times as likely to recommend military service to another neurosurgeon as compared to those who were retired or separated (P < .024).Service as a military neurosurgeon is an overwhelmingly positive experience but opportunities exist for mechanisms to increase operative case load, reduce administrative responsibilities, and reduce military-civilian income disparity. Addressing these issues is important as current military neurosurgeons were more likely to be dissatisfied with their military experience and less likely to recommend military service to another neurosurgeon.

PMID: 29149336 [PubMed - as supplied by publisher]



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IJMS, Vol. 18, Pages 2459: Infectious Agents in Atherosclerotic Cardiovascular Diseases through Oxidative Stress

IJMS, Vol. 18, Pages 2459: Infectious Agents in Atherosclerotic Cardiovascular Diseases through Oxidative Stress

International Journal of Molecular Sciences doi: 10.3390/ijms18112459

Authors: Marisa Di Pietro Simone Filardo Francesca Falasca Ombretta Turriziani Rosa Sessa

Accumulating evidence demonstrates that vascular oxidative stress is a critical feature of atherosclerotic process, potentially triggered by several infectious agents that are considered as risk co-factors for the atherosclerotic cardiovascular diseases (CVDs). C. pneumoniae has been shown to upregulate multiple enzymatic systems capable of producing reactive oxygen species (ROS) such as NADPH oxidase (NOX) and cyclooxygenase in vascular endothelial cells, NOX and cytochrome c oxidase in macrophages as well as nitric oxide synthase and lipoxygenase in platelets contributing to both early and late stages of atherosclerosis. P. gingivalis seems to be markedly involved in the atherosclerotic process as compared to A. actinomycetemcomitans contributing to LDL oxidation and foam cell formation. Particularly interesting is the evidence describing the NLRP3 inflammasome activation as a new molecular mechanism underlying P. gingivalis-induced oxidative stress and inflammation. Amongst viral agents, immunodeficiency virus-1 and hepatitis C virus seem to have a major role in promoting ROS production, contributing, hence, to the early stages of atherosclerosis including endothelial dysfunction and LDL oxidation. In conclusion, oxidative mechanisms activated by several infectious agents during the atherosclerotic process underlying CVDs are very complex and not well-known, remaining, thus, an attractive target for future research.



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MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial.

MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Oct 12;:

Authors: Hegab AF, Youssef AH, Hameed HIAA, Karam KS

Abstract
OBJECTIVE: This prospective study examined a method using magnetic resonance imaging (MRI) to assess the appropriate effective occlusal splint vertical thickness in the management of disk derangement.
STUDY DESIGN: Patients were diagnosed as having internal disk displacement of the temporomandibular joint and were divided into 2 groups. Group I (disk displacement with reduction) was subdivided randomly into 2 subgroups: subgroup IA (control group) comprising patients treated with 3-mm-thick splints; and subgroup IB (study group) comprising patients treated with MRI-based splint thickness. Group II (disk displacement without reduction) was subdivided randomly into 2 subgroups: subgroup IIA (control group) comprising patients treated with 3-mm-thick splints; and subgroup IIB (study group) comprising patients treated with MRI-based splint thickness. The primary outcome variables were maximum voluntary mouth opening and visual analogue scale scores for pain. The secondary outcome variable was joint sound. The final sample was composed of 162 patients (Group I = 90 and Group II = 72).
RESULTS: Statistical analysis showed significant improvement of the clinical outcomes in subgroups IB and IIB compared with that in subgroups IA and IIA.
CONCLUSIONS: On the basis of MRI measurements and clinical outcome, the present study we recommend 4-mm and 6-mm vertical splint thickness for disk displacement with reduction and disk displacement without reduction, respectively, for 1 year.

PMID: 29146196 [PubMed - as supplied by publisher]



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quality of care; +78 new citations

78 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

quality of care

These pubmed results were generated on 2017/11/18

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.



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Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor.

Effects of middle ear quasi-static stiffness on sound transmission quantified by a novel 3-axis optical force sensor.

Hear Res. 2017 Nov 10;357:1-9

Authors: Dobrev I, Sim JH, Aqtashi B, Huber AM, Linder T, Röösli C

Abstract
BACKGROUND: Intra-operative quantification of the ossicle mobility could provide valuable feedback for the current status of the patient's conductive hearing. However, current methods for evaluation of middle ear mobility are mostly limited to the surgeon's subjective impression through manual palpation of the ossicles. This study investigates how middle ear transfer function is affected by stapes quasi-static stiffness of the ossicular chain. The stiffness of the middle ear is induced by a) using a novel fiber-optic 3-axis force sensor to quantify the quasi-static stiffness of the middle ear, and b) by artificial reduction of stapes mobility due to drying of the middle ear.
METHODS: Middle ear transfer function, defined as the ratio of the stapes footplate velocity versus the ear canal sound pressure, was measured with a single point LDV in two conditions. First, a controlled palpation force was applied at the stapes head in two in-plane (superior-inferior or posterior-anterior) directions, and at the incus lenticular process near the incudostapedial joint in the piston (lateral-medial) direction with a novel 3-axis PalpEar force sensor (Sensoptic, Losone, Switzerland), while the corresponding quasi-static displacement of the contact point was measured via a 3-axis micrometer stage. The palpation force was applied sequentially, step-wise in the range of 0.1-20 gF (1-200 mN). Second, measurements were repeated with various stages of stapes fixation, simulated by pre-load on the stapes head or drying of the temporal bone, and with severe ossicle immobilization, simulated by gluing of the stapes footplate.
RESULTS: Simulated stapes fixation (forced drying of 5-15 min) severely decreases (20-30 dB) the low frequency (<1 kHz) response of the middle ear, while increasing (5-10 dB) the high frequency (>4 kHz) response. Stapes immobilization (gluing of the footplate) severely reduces (20-40 dB) the low and mid frequency response (<4 kHz) but has lesser effect (<10 dB) at higher frequencies. Even moderate levels of palpation force (<3gF, <30 mN), regardless of direction, have negative effect (10-20 dB) on the low frequency (<2 kHz) response, but with less significant (5-10 dB) effect at higher frequencies. Force-displacement measurements around the incudostapedial joint showed quasi-static stiffness in the range of 200-500 N/m for normal middle ears, and 1000-2500 N/m (5-8-fold increase) after artificially (through forced drying) reducing the middle ear transfer function with 10-25 dB at 1 kHz.
CONCLUSION: Effects of the palpation force level and direction, as well as stapes fixation and immobilization have been analyzed based on the measurement of the stapes footplate motion, and controlled application of 3D force and displacement.

PMID: 29149722 [PubMed - as supplied by publisher]



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Quercetin attenuates collagen-induced arthritis by restoration of Th17/Treg balance and activation of Heme Oxygenase 1-mediated anti-inflammatory effect.

Quercetin attenuates collagen-induced arthritis by restoration of Th17/Treg balance and activation of Heme Oxygenase 1-mediated anti-inflammatory effect.

Int Immunopharmacol. 2017 Nov 14;54:153-162

Authors: Yang Y, Zhang X, Xu M, Wu X, Zhao F, Zhao C

Abstract
Quercetin (QU) has been shown obvious anti-arthritic property in pre-clinical studies or clinical studies. Howbeit, the underlying mechanism of it is still not revealed distinctly and should be gotten further insight into. QU at a dosage of 150 mg/kg was administered orally in collagen-induced arthritis rats and then the clinical symptoms were monitored. The protein levels of Th17/Treg-related cytokines were determined by ELISA, and the mRNA levels of cytokines and transcription factors associated with the Th17 and Treg phenotypes were evaluated by real-time PCR, the proportions of Th17 and Treg cells were assessed by flow cytometry. The results showed that QU administration yielded an obvious mitigation of arthritic manifestations including high arthritic scores and paw edema, which was accompanied with decrement of Th17-related cytokines (IL-17A and IL-21) and increment of Treg-related cytokines (IL-10 and TGF-β). QU decreased the percentage of Th17 cells, while increased the percentage of Treg cells. In addition, the activation of NLRP3 inflammasome which plays a crucial role in the development of RA was determined and found that the protein expressions of NLRP3, Caspase-1 and IL-1β were diminished by QU significantly. Moreover, the protein levels of inflammatory mediators which were recognized as chief culprits in inflammatory reaction were assayed. The contents of inflammatory mediators inclusive of TNF-α, IL-1β, IL-6, PGE2, COX-2 and iNOS were down-regulated markedly by QU. But the inhibitory effect of QU on inflammatory mediators was nearly abolished by Heme Oxygenase 1 (HO-1) siRNA. Taken together, QU attenuates CIA via modulating the Th17/Treg balance, inhibiting NLRP3 inflammasome activation as well as activating HO-1-mediated anti-inflammatory response.

PMID: 29149703 [PubMed - as supplied by publisher]



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Letter to the Editor regarding "Robotic or non-robotic transoral laryngectomy".

Letter to the Editor regarding "Robotic or non-robotic transoral laryngectomy".

Head Neck. 2017 Nov 17;:

Authors: Granell J, Fernandez-Fernandez M, Gutierrez-Fonseca R

PMID: 29149536 [PubMed - as supplied by publisher]



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Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians.

Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians.

Head Neck. 2017 Nov 17;:

Authors: Lechelt LA, Rieger JM, Cowan K, Debenham BJ, Krewski B, Nayar S, Regunathan A, Seikaly H, Singh AE, Laupacis A, Alberta Head and Neck Cancer Priority Setting Partnership Steering Committee

Abstract
BACKGROUND: The epidemiology, etiology, and management of head and neck cancer are evolving. Understanding the perspectives and priorities of nonresearchers regarding treatment uncertainties is important to inform future research.
METHODS: Using the James Lind Alliance approach, patients, caregivers, and clinicians responded to a survey regarding their unanswered questions about treating and managing head and neck cancer. Distinct uncertainties were extracted from responses and sorted into themes. Uncertainties already answered in the literature were removed. Those remaining were ranked by patients and clinicians to develop a short list of priorities, which were discussed at a workshop and reduced to the top 10.
RESULTS: One hundred sixty-one respondents posed 818 uncertainties, culminating in 77 for interim ranking and 27 for discussion at a workshop. Participants reached consensus on the top 10, which included questions on prevention, screening, treatment, and quality of life.
CONCLUSION: Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer.

PMID: 29149525 [PubMed - as supplied by publisher]



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Predictive factors for osteoradionecrosis of the jaws: A retrospective study.

Predictive factors for osteoradionecrosis of the jaws: A retrospective study.

Head Neck. 2017 Nov 17;:

Authors: Sathasivam HP, Davies GR, Boyd NM

Abstract
BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.
METHODS: A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.
RESULTS: Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.
CONCLUSION: Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

PMID: 29149496 [PubMed - as supplied by publisher]



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Inhibiting MT2-TFE3-dependent autophagy enhances melatonin-induced apoptosis in tongue squamous cell carcinoma.

Inhibiting MT2-TFE3-dependent autophagy enhances melatonin-induced apoptosis in tongue squamous cell carcinoma.

J Pineal Res. 2017 Nov 17;:

Authors: Fan T, Pi H, Li M, Ren Z, He Z, Zhu F, Tian L, Tu M, Xie J, Liu M, Li Y, Tan M, Li G, Qing W, Reiter RJ, Yu Z, Wu H, Zhou Z

Abstract
Autophagy modulation is a potential therapeutic strategy for tongue squamous cell carcinoma (TSCC). Melatonin possesses significant anti-carcinogenic activity. However, whether melatonin induces autophagy and its roles in cell death in TSCC are unclear. Herein, we show that melatonin induced significant apoptosis in the TSCC cell line Cal27. Apart from the induction of apoptosis, we demonstrated that melatonin-induced autophagic flux in Cal27 cells as evidenced by the formation of GFP-LC3 puncta, and the upregulation of LC3-II and downregulation of SQSTM1/P62. Moreover, pharmacological or genetic blockage of autophagy enhanced melatonin-induced apoptosis, indicating a cytoprotective role of autophagy in melatonin-treated Cal27 cells. Mechanistically, melatonin induced TFE3((Ser321)) dephosphorylation, subsequently activated TFE3 nuclear translocation, and increased TFE3 reporter activity, which contributed to the expression of autophagy-related genes and lysosomal biogenesis. Luzindole, a melatonin membrane receptor blocker, or MT2-siRNA partially blocked the ability of melatonin to promote mTORC1/TFE3 signaling. Furthermore, we verified in a xenograft mouse model that melatonin with hydroxychloroquine or TFE3-siRNA exerted a synergistic anti-tumor effect by inhibiting autophagy. Importantly, TFE3 expression positively correlated with TSCC development and poor prognosis in patients. Collectively, we demonstrated that the melatonin-induced increase in TFE3-dependent autophagy is mediated through the melatonin membrane receptor in TSCC. These data also suggest that blocking melatonin membrane receptor-TFE3-dependent autophagy to enhance the activity of melatonin warrants further attention as a treatment strategy for TSCC. This article is protected by copyright. All rights reserved.

PMID: 29149494 [PubMed - as supplied by publisher]



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Impact of chronic hepatitis C virus infection on the survival of patients with oropharyngeal cancer.

Impact of chronic hepatitis C virus infection on the survival of patients with oropharyngeal cancer.

Cancer. 2017 Nov 17;:

Authors: Economides MP, Amit M, Mahale PS, Hosry JJ, Jiang Y, Bharadwaj U, Sturgis EM, Torres HA

Abstract
BACKGROUND: Although an association between hepatitis C virus (HCV) infection and oropharyngeal cancers (OPCs) has been reported, to the authors' knowledge the clinical significance of this epidemiological finding remains unknown. Therefore, the authors analyzed the oncologic outcomes of HCV-infected patients with OPCs.
METHODS: In this retrospective cohort study, all patients with OPCs who were seen at The University of Texas MD Anderson Cancer Center between January 2004 and December 2015 were reviewed. HCV infection was defined as detectable HCV RNA in the serum. Five-year overall survival and progression-free survival rates were compared between patients infected with HCV and those not infected.
RESULTS: A total of 161 patients were examined. The majority of the patients were white (141 patients; 88%) and male (132 patients; 82%) and had TNM stage III or IV disease (147 patients; 91%). The OPC involved the tonsils (83 patients; 52%), base of the tongue (67patients; 42%), or the soft palate (11 patients; 7%). The median follow-up after an OPC diagnosis was 3 years (range, 1-13 years). HCV-infected patients (25 patients) and HCV-uninfected patients (136 patients) were comparable with regard to smoking and alcohol status. In multivariate analysis, HCV was associated with increased cancer-specific mortality (hazard ratio, 2.15; 95% confidence interval, 1.08-6.85 [P = .02]) and risk of OPC progression (hazard ratio, 5.42; 95% confidence interval, 2.64-11.14 [P = .0008]) independent of age and cirrhosis status. Antivirals were administered after the diagnosis of OPC in 8 of the 25 HCV-infected patients (32%). HCV-infected patients who received antivirals were found to have better 5-year overall survival (70% vs 12%; P = .005) and progression-free survival (72% vs 19%; P = .005) compared with patients who did not.
CONCLUSIONS: The early detection of HCV is important in patients with OPC because this infection may affect their oncologic outcomes. Cancer 2017. © 2017 American Cancer Society.

PMID: 29149493 [PubMed - as supplied by publisher]



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Reply to Letter to the Editor regarding "Robotic or non-robotic transoral laryngectomy".

Reply to Letter to the Editor regarding "Robotic or non-robotic transoral laryngectomy".

Head Neck. 2017 Nov 17;:

Authors: Goyal N, Funk E, Goldenberg D

PMID: 29149475 [PubMed - as supplied by publisher]



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Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial.

Efficacy of systemic and intratympanic corticosteroid combination therapy versus intratympanic or systemic therapy in patients with idiopathic sudden sensorineural hearing loss: a randomized controlled trial.

Eur Arch Otorhinolaryngol. 2017 Nov 17;:

Authors: Ashtiani MK, Firouzi F, Bastaninejad S, Dabiri S, Nasirmohtaram S, Saeedi N, Ghazavi H, Sahebi L

Abstract
OBJECTIVE: The present study was conducted to compare the rates of recovery from idiopathic sudden deafness after the treatment with oral and intratympanic corticosteroids in both mono and combination therapies.
STUDY DESIGN: Triple-blind randomized clinical trial.
SETTINGS: Tertiary referral hospital.
SUBJECTS AND METHODS: A total of 112 patients who were admitted to the ENT emergency department randomly divided into three groups: an oral corticosteroid plus intratympanic placebo (systemic corticosteroid monotherapy group); an intratympanic corticosteroid plus oral placebo group (IT monotherapy group); and a combination therapy group (IT plus systemic combination group). All patients were treated additionally with antiviral and proton pomp inhibitor. An audiometry was performed once before beginning the therapies and again at the end of the therapy.
RESULTS: Of the total of 112 patients, 32 received intratympanic (IT) corticosteroids, 45 were receiving systemic corticosteroids, and 35 were receiving a combination of the two. A total of 74 patients (66.1%) responded positively [response to treatment was calculated as gain of at least 10 dB in 10 dB in average threshold or with the minimum improvement of 15% in speech discrimination scores (SDS)] to corticosteroid therapy. No significant differences were observed between the three groups (IT, systemic group, and combination therapy group) in their overall response to treatment (p = 0.5). Patients who suffered from concomitant tinnitus and dizziness responded less positively to the treatment (p < 0.002). Positive family history of SSNHL seems to be negative prognostic factors in the response to treatment (p < 0.001). The response to treatment was not related to the pattern (p = 0.04) and initial severity of hearing loss (p = 0.9).
CONCLUSION: This study did not find any difference in the rate of hearing improvement between systemic, intratympanic, and combined corticosteroid therapy for sudden hearing loss.
LEVEL OF EVIDENCE: 1b.

PMID: 29149379 [PubMed - as supplied by publisher]



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Correction: Evaluation of Acute Toxicity and Early Clinical Outcome in Head and Neck Cancers Treated With Conventional Radiotherapy and Simultaneous Integrated Boost Arc Radiotherapy.

Correction: Evaluation of Acute Toxicity and Early Clinical Outcome in Head and Neck Cancers Treated With Conventional Radiotherapy and Simultaneous Integrated Boost Arc Radiotherapy.

World J Oncol. 2017 Oct;8(5):174

Authors: Bahl A, Oinam AS, Kaur S, Verma R, Elangovan A, Bhandari S, Bakshi J, Panda N, Ghoshal S

Abstract
[This corrects the article DOI: 10.14740/wjon1049w.].

PMID: 29149224 [PubMed - in process]



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Resveratrol Induces Mitochondrial Apoptosis and Inhibits Epithelial-Mesenchymal Transition in Oral Squamous Cell Carcinoma Cells.

Resveratrol Induces Mitochondrial Apoptosis and Inhibits Epithelial-Mesenchymal Transition in Oral Squamous Cell Carcinoma Cells.

Nutr Cancer. 2017 Nov 17;:1-11

Authors: Kim SE, Shin SH, Lee JY, Kim CH, Chung IK, Kang HM, Park HR, Park BS, Kim IR

Abstract
OSCC is the most common malignant cancer of the head and neck. EMT is an essential cellular process critical to the morphogenesis and homeostasis of solid tissues. It is also involved in the initial stage of cancer metastasis and invasion in which cells lose epithelial characteristics. While cancer therapy protocols such as surgery, radiation, and chemotherapy are effective and useful, the drug tolerance and toxicity of OSCC patients remain a problem. Resveratrol is mainly produced in red grape skin and exhibits anti-oxidative, anti-inflammatory, anti-proliferative, and anti-cancer properties. This study was undertaken to investigate the underlying mechanisms giving rise to the induction of apoptosis by resveratrol in the human tongue squamous cell carcinoma cell line. Resveratrol treatment resulted in a time- and dose-dependent decrease in cell viability and increased the apoptotic cell ratio in CAL-27, SCC15, and SCC25 cells. Resveratrol treatment of CAL-27 cells showed that several lines of apoptotic manifestation and decreased cell migration, invasion, and EMT-inducing transcription factor. Taken together, our findings demonstrate the inhibitory effect of resveratrol in human OSCC cells via the mitochondrial pathway and that resveratrol is able to inhibit cell invasion and migration by inhibiting the EMT-inducing transcription factors.

PMID: 29148840 [PubMed - as supplied by publisher]



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Silenced DMBT1 promotes nasal mucosa epithelial cell growth.

Silenced DMBT1 promotes nasal mucosa epithelial cell growth.

Ann Hum Genet. 2017 Nov 17;:

Authors: Lu X, Xu Y, Zhao Y, Tao Q, Wu J

Abstract
OBJECTIVE: The aim of this study was to investigate the role of the deleted in malignant brain tumors 1 (DMBT1) gene in the development of nasal polyps, as well as related mechanisms.
METHODS: A stable human nasal mucosa epithelial cell (HNEpC) line with low expression of DMBT1 was generated. Three groups were established: a control group (HNEpCs without any treatment), a control short interference RNA (shRNA) group (HNEpCs transfected with an empty vector), and a DMBT1 shRNA group (HNEpCs with silenced DMBT1). Cell viability, apoptosis, and cell cycle distribution were measured after incubation. Expression of p53, signal transducer and activator of transcription 3 (STAT3), protein kinase B (AKT) and extracellular signal-regulated kinase1/2 (ERK1/2) was detected by western blotting.
RESULTS: Compared with the control cell line, HNEpCs with silenced DMBT1 had increased viability and decreased apoptosis. Moreover, after DMBT1 silence, cell numbers were decreased significantly in the G1 phase and increased in the G2 and S phases. DMBT1 silence was associated with increased AKT expression and decreased p53 expression, but it did not alter expression of ERK1/2 or STAT3 (P > 0.05). Compared with the control cell line, HNEpCs transfected with an empty vector did not have altered cell viability, apoptosis, cell cycle distribution or expression of AKT, p53, ERK1/2, or STAT3 (P > 0.05).
CONCLUSION: DMBT1 plays an important role in the growth and division of nasal epithelial cells. The possible mechanism might involve DMBT1 regulating the AKT-p53 pathway to promote cell viability and reduce apoptosis of nasal epithelial cells.

PMID: 29148567 [PubMed - as supplied by publisher]



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Cochlear volume as a predictive factor for residual-hearing preservation after conventional cochlear implantation.

Cochlear volume as a predictive factor for residual-hearing preservation after conventional cochlear implantation.

Acta Otolaryngol. 2017 Nov 17;:1-6

Authors: Takahashi M, Arai Y, Sakuma N, Yabuki K, Sano D, Nishimura G, Oridate N, Usami SI

Abstract
OBJECTIVE: The preservation of residual hearing after conventional cochlear implantation (CI) is frequently observed when atraumatic soft surgery is adopted. The purpose of this study was to elucidate the predictive factors for residual hearing preservation after atraumatic CI.
PATIENTS: This study included 46 patients who underwent CI based on an atraumatic technique using a standard-length flexible electrode implant through a round window approach.
MAIN OUTCOME MEASURE: Cochlear volume was measured using magnetic resonance imaging (MRI). Cochlear duct length (CDL) was taken as the length of the scala media measured using computed tomography (CT). The association between residual hearing preservation and cochlear volume/CDL was then examined.
RESULT: Cochlear volume and CDL were significantly larger in patients with complete hearing preservation than in those with hearing loss. Multivariate logistic regression analysis revealed that cochlear volume was a significant predictive factor for residual hearing preservation.
CONCLUSION: Residual hearing preservation after conventional CI was observed in patients with a larger cochlear volume and longer CDL. Cochlear volume could be a predictive factor for residual hearing preservation after conventional CI.

PMID: 29148288 [PubMed - as supplied by publisher]



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Supraclavicular flap repair in the free flap era.

Supraclavicular flap repair in the free flap era.

ANZ J Surg. 2017 Nov 17;:

Authors: Trautman J, Gore S, Potter M, Clark J, Hyam D, Tan NC, Ngo Q, Ashford B

Abstract
BACKGROUND: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature.
METHODS: The authors contributed primary evidence of 30 cases of SCF repair. Our outcomes are compared with those reported in the last 5 years' literature; 33 articles published between January 2012 and January 2017 that present original clinical experience of 528 SCFs.
RESULTS: SCF is suitable for a wide variety of oral cavity, pharyngeal, skull base and cutaneous defects. Consistent with our experience, SCF is highly reliable even in previously irradiated or dissected necks, so long as the supraclavicular artery is intact. Our case series shows minor complications in 3/30 (10%) and flap loss in 1/30 (3.3%) cases. The literature reports a similar rate of complete flap failure of 3.4% and a slightly higher average minor complication rate of 24.6%.
CONCLUSION: We add our experience of 30 cases of SCF repair to the international literature. We experienced a complication rate lower than the reported average, and maintain that the SCF is an excellent reconstructive option in patients with previously irradiated necks or comorbidities that affect microvasculature and anaesthetic resilience.

PMID: 29148237 [PubMed - as supplied by publisher]



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Current perspectives on the role of tonsillectomy.

Current perspectives on the role of tonsillectomy.

J Paediatr Child Health. 2017 Nov;53(11):1065-1070

Authors: Greig SR

Abstract
Tonsillectomy is one of the most common paediatric surgical procedures performed in Australasia. The aim of this paper is to provide an up-to-date review of the indications for the procedure (and the evidence base for each of these indications), as well as describe the surgical technique and perioperative management and risks for a non-surgical audience. The primary indications for tonsillectomy are obstructive sleep apnoea (OSA) (where it is most commonly performed in association with adenoidectomy) and recurrent pharyngotonsillitis. There is now high-quality evidence that tonsillectomy improves objective measures of OSA on sleep studies, as well as quality of life and child behaviour. The impact of surgery on cognitive function is less well delineated. For recurrent pharyngotonsillitis, tonsillectomy has a modest impact on recurrent sore throat symptoms - clinicians should ensure an appropriate pre-operative observation period and adequately discuss the potential benefits with parents prior to surgery. Traditional approaches to tonsillectomy involve surgically dissecting the entire tonsil from the underlying pharyngeal muscle. Subtotal tonsillectomy (intracapsular tonsillectomy or tonsillotomy) is described for OSA and may reduce perioperative morbidity. Children younger than 3 years and those with moderate to severe OSA or significant comorbidities should be admitted for overnight observation. Simple analgesia is adequate for most patients postoperatively. Codeine is contraindicated due to reports of postoperative death due to respiratory suppression. Overall, tonsillectomy is a well-tolerated procedure, with pain and postoperative haemorrhage (2-4%) being the most common complications. Haemorrhage can be life threatening; however, the mortality rate remains very small at approximately 1:30 000.

PMID: 29148201 [PubMed - in process]



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Absence or mislocalization of DNAH5 is a characteristic marker for motile ciliary abnormality in nasal polyps.

Absence or mislocalization of DNAH5 is a characteristic marker for motile ciliary abnormality in nasal polyps.

Laryngoscope. 2017 Nov 17;:

Authors: Qiu Q, Peng Y, Zhu Z, Chen Z, Zhang C, Ong HH, Tan KS, Hong H, Yan Y, Huang H, Liu J, Li X, Nam HN, Dung NTN, Shi L, Yang Q, Bingle CD, Wang DY

Abstract
OBJECTIVE: Motile cilia impairment is a common condition in patients with chronically inflamed airways, such as is seen in nasal polyps (NPs). The mechanism underlying this pathogenic condition is complex and not fully understood.
METHODS: We investigated the presence and localization of dynein axonemal heavy chain 5 (DNAH5) in motile cilia using immunofluorescence staining in paraffin-embedded nasal biopsies from NPs (n = 120) and inferior turbinate mucosa (n = 35) of healthy controls. We also performed single-cell staining on cytospin samples (NP = 5, control = 5). Three patterns of DNAH5 localization are defined, including pattern A (presence throughout the axoneme), pattern B (undetectable in the distal part of the axoneme), and pattern C (completely missing throughout the entire axoneme). We developed a semiquantitative scoring system for which 0 = (pattern A > 70%); 1 = (patterns A + B > 70%); and 2 = (pattern C ≥ 30%) in each high-power field (5 fields per sample).
RESULTS: Based on our DNAH5 scoring system, the median (1st and 3rd quartile) score was 0.3 (0.2 and 0.4) for samples from controls, and 1.1 (0.6 and 1.6) for samples from NPs in paraffin specimens (P < 0.001). The DNAH5 score had a significant positive relationship with the Lund-Mackay computed tomography score (r = 0.329, P = 0.005) and was higher in patients with eosinophilic NPs (P = 0.006). For cytospin samples, the mean percentage of patterns A, B, and C were 74%, 14%, and 12% in controls, and 48%, 20%, and 32% in NPs, respectively.
CONCLUSION: Our results suggest that the absence or mislocalization of DNAH5 from motile cilia is a common and potentially important pathological phenomenon in chronically inflamed airway epithelium.
LEVEL OF EVIDENCE: NA. Laryngoscope, 2017.

PMID: 29148098 [PubMed - as supplied by publisher]



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The prognostic role of tumor infiltrating T-lymphocytes in squamous cell carcinoma of the head and neck: A systematic review and meta-analysis.

The prognostic role of tumor infiltrating T-lymphocytes in squamous cell carcinoma of the head and neck: A systematic review and meta-analysis.

Oncoimmunology. 2017;6(11):e1356148

Authors: de Ruiter EJ, Ooft ML, Devriese LA, Willems SM

Abstract
Background - The presence of tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment is associated with an improved prognosis and a better response to therapy in different types of cancer. In this systematic review and meta-analysis, we investigated the prognostic value of T cells in head and neck squamous cell carcinoma (HNSCC). Methods - In a systematic review, Pubmed and Embase were searched for publications that investigated the prognostic value of T cells in HNSCC. A meta-analysis was performed including all studies assessing the association between CD3+, CD4+, CD8+, and FoxP3+ TILs and overall survival (OS), disease-free survival (DFS), or locoregional control (LRC). Results - A pooled analysis indicated a favorable, prognostic role for CD3+ TILs (HR 0.64 (95%CI 0.47-0.85) for OS, HR 0.63 (95%CI 0.49-0.82) for DFS) and CD8+ TILs (HR 0.67 (95%CI 0.58-0.79) for OS, HR 0.50 (95%CI 0.37-0.68) for DFS, and HR 0.82 (95%CI 0.70-0.96) for LRC) in the clinical outcome of HNSCC. FoxP3+ TILs were also associated with better OS (HR 0.80 (95%CI 0.70-0.92)). Conclusion - This systematic review and meta-analysis confirmed the favorable, prognostic role of CD3+ and CD8+ T cell infiltration in HNSCC patients and found an association between FoxP3+ TILs and improved overall survival. Future studies using homogeneous patient cohorts with regard to tumor subsite, stage and treatment are necessary to provide more insight in the predictive value of TILs in HNSCC.

PMID: 29147608 [PubMed]



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