Peculiar radiopaque foreign body in the upper aerodigestive tract in a newborn corpse from the Indian Ocean

Publication date: Available online 14 December 2017
Source:Journal of Forensic Radiology and Imaging
Author(s): Stéphane Chapenoire, Saverio Braccini, Karl Krämer, Laurent Hauret, Fabienne Jordana, Charles Agostini, Yves Schuliar
The authors present a single case report illustrating on the body of a newborn found on the seashore of the island of Mayotte in the Indian Ocean, the diagnostic difficulties inherent in the detection during the post-mortem scan of a voluminous highly radiopaque foreign body in the upper aerodigestive tract. The internal examination has highlighted black sand in abundance in the upper aerodigestive tract. The CT scanning of a sand sample from the lagoon shore confirmed its high-density radiopaque nature. In a specialized laboratory, the magnetic part of this sample was investigated by means of energy dispersive X-ray spectroscopy (EDS), powder X-ray diffraction (XRD), and Mössbauer spectroscopy. The mineral composition is dominantly magnetite (Fe3O4) but contrary to pure magnetite, a relevant fraction of titanium was detected.This case demonstrates how post-mortem CT may lead to inappropriate diagnosis and highlights the interest of the physicochemical study in the forensic context.



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Beware of Multiphase CTA Interpretation [LETTERS]

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Reply: [LETTERS]

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Optimal Fat Suppression in Head and Neck MRI: Comparison of Multipoint Dixon with 2 Different Fat-Suppression Techniques, Spectral Presaturation and Inversion Recovery, and STIR [HEAD & NECK]

BACKGROUND AND PURPOSE:

Uniform complete fat suppression is essential for identification and characterization of most head and pathology. Our aim was to compare the multipoint Dixon turbo spin-echo fat-suppression technique with 2 different fat-suppression techniques, including a hybrid spectral presaturation with inversion recovery technique and an inversion recovery STIR technique, in head and neck fat-suppression MR imaging.

MATERIALS AND METHODS:

Head and neck MR imaging datasets of 72 consecutive patients were retrospectively reviewed. All patients were divided into 2 groups based on the type of fat-suppression techniques used (group A: STIR and spectral presaturation with inversion recovery gadolinium-T1WI; group B: multipoint Dixon T2 TSE and multipoint Dixon gadolinium-T1WI TSE). Objective and subjective image quality and scan acquisition times were assessed and compared between multipoint Dixon T2 TSE versus STIR and multipoint Dixon gadolinium-T1WI TSE versus spectral presaturation with inversion recovery gadolinium-T1WI using the Mann-Whitney U test.

RESULTS:

A total of 64 patients were enrolled in the study (group A, n = 33 and group B, n = 31). Signal intensity ratios were significantly higher for multipoint Dixon T2 and gadolinium-T1WI techniques compared with STIR (P < .001) and spectral presaturation with inversion recovery gadolinium-T1WI (P < .001), respectively. Two independent blinded readers revealed that multipoint Dixon T2 and gadolinium-T1WI techniques had significantly higher overall image quality (P = .022 and P < .001) and fat-suppression grades (P < .013 and P < .001 across 3 different regions) than STIR and spectral presaturation with inversion recovery gadolinium-T1WI, respectively. The scan acquisition time was relatively short for the multipoint Dixon technique (2 minutes versus 4 minutes 56 seconds for the T2-weighted sequence and 2 minutes versus 3 minutes for the gadolinium-T1WI sequence).

CONCLUSIONS:

The multipoint Dixon technique offers better image quality and uniform fat suppression at a shorter scan time compared with STIR and spectral presaturation with inversion recovery gadolinium-T1WI techniques.

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Feasibility of Permanent Stenting with Solitaire FR as a Rescue Treatment for the Reperfusion of Acute Intracranial Artery Occlusion [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The Solitaire FR can be used not only as a tool for mechanical thrombectomy but also as a detachable permanent stent. Our aim was to assess the feasibility and safety of permanent stent placement with the Solitaire FR compared with other self-expanding stents for intracranial artery recanalization for acute ischemic stroke.

MATERIALS AND METHODS:

From January 2011 through January 2016, we retrospectively selected 2979 patients with acute ischemic stroke. Among them, 27 patients who underwent permanent stent placement (13 patients with the Solitaire FR [Solitaire group] and 14 patients with other self-expanding stents [other stent group]) were enrolled. The postprocedural modified TICI grade and angiographic and clinical outcomes were assessed. The safety and efficacy of permanent stent placement of the Solitaire FR for acute large-artery occlusion were evaluated.

RESULTS:

Stent placement was successful in all cases. Modified TICI 2b–3 reperfusion was noted in 84.6% of the Solitaire group and in 78.6% of the other stent group. Procedural time was significantly shorter in the Solitaire group than in the other stent group (P = .022). Shorter procedural time was correlated with favorable outcome ( = 0.46, P = .035). No significant differences were found in the modified TICI grade, NIHSS score, mRS, and hemorrhagic transformation rate between the 2 groups. The acute in-stent thrombosis rate at discharge was significantly lower when a glycoprotein IIb/IIIa inhibitor was injected during the procedure (P = .013).

CONCLUSIONS:

Permanent stent placement with the Solitaire FR compared with other self-expanding stents appears to be feasible and safe as a rescue tool for refractory intra-arterial therapy.

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Improved Precision of Automatic Brain Volume Measurements in Patients with Clinically Isolated Syndrome and Multiple Sclerosis Using Edema Correction [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The presence of edema will result in increased brain volume, which may obscure progressing brain atrophy. Similarly, treatment-induced edema reduction may appear as accelerated brain tissue loss (pseudoatrophy). The purpose of this study was to correlate brain tissue properties to brain volume, to investigate the possibilities for edema correction and the resulting improvement of the precision of automated brain volume measurements.

MATERIALS AND METHODS:

A group of 38 patients with clinically isolated syndrome or newly diagnosed MS were imaged at inclusion and after 1, 2, and 4 years using an MR quantification sequence. Brain volume, relaxation rates (R₁ and R₂), and proton density were measured by automated software.

RESULTS:

The reduction of normalized brain volume with time after inclusion was 0.273%/year. The mean SDs were 0.508%, 0.526%, 0.454%, and 0.687% at baseline and 1, 2, and 4 years. Linear regression of the relative change of normalized brain volume and the relative change of R₁, R₂, and proton density showed slopes of –0.198 (P < .001), 0.156 (P = .04), and 0.488 (P < .001), respectively. After we applied the measured proton density as a correction factor, the mean SDs decreased to 24.2%, 4.8%, 33.3%, and 17.4%, respectively. The observed atrophy rate reduced from 0.273%/year to 0.238%/year.

CONCLUSIONS:

Correlations between volume and R₁, R₂, and proton density were observed in the brain, suggesting that a change of brain tissue properties can affect brain volume. Correction using these parameters decreased the variation of brain volume measurements and may have reduced the effect of pseudoatrophy.

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Diagnostic Accuracy of Amino Acid and FDG-PET in Differentiating Brain Metastasis Recurrence from Radionecrosis after Radiotherapy: A Systematic Review and Meta-Analysis [ADULT BRAIN]

BACKGROUND:

Current studies that analyze the usefulness of amino acid and FDG-PET in distinguishing brain metastasis recurrence and radionecrosis after radiation therapy are limited by small cohort size.

PURPOSE:

Our aim was to assess the diagnostic accuracy of amino acid and FDG-PET in differentiating brain metastasis recurrence from radionecrosis after radiation therapy.

DATA SOURCES:

Studies were retrieved from PubMed, Embase, and the Cochrane Library.

STUDY SELECTION:

Fifteen studies were included from the literature. Each study used PET to differentiate radiation necrosis from tumor recurrence in contrast-enhancing lesions on follow-up brain MR imaging after treating brain metastasis with radiation therapy.

DATA ANALYSIS:

Data were analyzed with a bivariate random-effects model. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were pooled, and a summary receiver operating characteristic curve was fit to the data.

DATA SYNTHESIS:

The overall pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of PET were 0.85, 0.88, 7.0, 0.17, and 40, respectively. The area under the receiver operating characteristic curve was 0.93. On subgroup analysis of different tracers, amino acid and FDG-PET had similar diagnostic accuracy. Meta-regression analysis demonstrated that the method of quantification based on patient, lesion, or PET scan (based on lesion versus not, P = .07) contributed to the heterogeneity.

LIMITATIONS:

Our study was limited by small sample size, and 60% of the included studies were of retrospective design.

CONCLUSIONS:

Amino acid and FDG-PET had good diagnostic accuracy in differentiating brain metastasis recurrence from radionecrosis after radiation therapy.

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Imaging of Anaplastic Thyroid Carcinoma [HEAD & NECK]

SUMMARY:

Anaplastic thyroid carcinoma is fatal if unresectable. However, improved survival has been reported after gross total resection and multimodality therapy. In this report, we describe the contrast-enhanced high-resolution CT characteristics of anaplastic thyroid carcinoma in 57 patients. Anaplastic thyroid carcinoma presented as a large neck mass with necrosis in 82% of cases. The tumors demonstrated common extrathyroidal extension (91%). Sixty-two percent of tumors demonstrated calcification. Visceral space invasion involved the esophagus (62%), trachea (57%), and larynx (29%). Carotid artery encasement was present in 42%, and 43% involved the internal jugular vein. Sixty-three percent had lateral compartment lymphadenopathy; 58% of these nodes were necrotic, and 11% were cystic. No metastatic nodes had calcification. Central compartment lymphadenopathy was seen in 56% of cases, and lateral retropharyngeal lymphadenopathy was detected in 12%. Knowledge of these imaging features aids in guiding the approach to the initial tissue diagnosis with either fine-needle aspiration or core biopsy, assessing the feasibility of surgical resection, and determining prognosis.

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Measuring Cerebral and Cerebellar Glutathione in Children Using 1H MEGA-PRESS MRS [PEDIATRICS]

BACKGROUND AND PURPOSE:

Glutathione is an important antioxidant in the human brain and therefore of interest in neurodegenerative disorders. The purpose of this study was to investigate the feasibility of measuring glutathione in healthy nonsedated children by using the ¹H Mescher-Garwood point-resolved spectroscopy (MEGA-PRESS) sequence at 3T and to compare glutathione levels between the medial parietal gray matter and the cerebellum.

MATERIALS AND METHODS:

Glutathione was measured using MEGA-PRESS MRS (TR = 1.8 seconds, TE = 131 ms) in the parietal gray matter (35 x 25 x 20 mm³) of 6 healthy children (10.0 ± 2.4 years of age; range, 7–14 years; 3 males) and in the cerebellum of 11 healthy children (12.0 ± 2.7 years of age; range, 7–16 years; 6 males). A postprocessing pipeline was developed to account for frequency and phase variations in the edited ON and nonedited OFF spectra. Metabolites were quantified with LCModel and reported both as ratios and water-scaled values. Glutathione was quantified in the ON-OFF spectra, whereas total NAA, total Cho, total Cr, mIns, Glx, and taurine were quantified in the OFF spectra.

RESULTS:

We found significantly higher glutathione, total Cho, total Cr, mIns, and taurine in the cerebellum (P < .01). Glx and total NAA were significantly higher in the parietal gray matter (P < .01). There was no significant difference in glutathione/total Cr (P = .93) between parietal gray matter and cerebellum.

CONCLUSIONS:

We demonstrated that glutathione measurement in nonsedated children is feasible. We found significantly higher glutathione in the cerebellum compared with the parietal gray matter. Metabolite differences between the parietal gray matter and cerebellum agree with published MRS data in adults.

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Combining Quantitative Susceptibility Mapping with Automatic Zero Reference (QSM0) and Myelin Water Fraction Imaging to Quantify Iron-Related Myelin Damage in Chronic Active MS Lesions [ADULT BRAIN]

BACKGROUND AND PURPOSE:

A hyperintense rim on susceptibility in chronic MS lesions is consistent with iron deposition, and the purpose of this study was to quantify iron-related myelin damage within these lesions as compared with those without rim.

MATERIALS AND METHODS:

Forty-six patients had 2 longitudinal quantitative susceptibility mapping with automatic zero reference scans with a mean interval of 28.9 ± 11.4 months. Myelin water fraction mapping by using fast acquisition with spiral trajectory and T2 prep was obtained at the second time point to measure myelin damage. Mixed-effects models were used to assess lesion quantitative susceptibility mapping and myelin water fraction values.

RESULTS:

Quantitative susceptibility mapping scans were on average 6.8 parts per billion higher in 116 rim-positive lesions compared with 441 rim-negative lesions (P < .001). All rim-positive lesions retained a hyperintense rim over time, with increasing quantitative susceptibility mapping values of both the rim and core regions (P < .001). Quantitative susceptibility mapping scans and myelin water fraction in rim-positive lesions decreased from rim to core, which is consistent with rim iron deposition. Whole lesion myelin water fractions for rim-positive and rim-negative lesions were 0.055 ± 0.07 and 0.066 ± 0.04, respectively. In the mixed-effects model, rim-positive lesions had on average 0.01 lower myelin water fraction compared with rim-negative lesions (P < .001). The volume of the rim at the initial quantitative susceptibility mapping scan was negatively associated with follow-up myelin water fraction (P < .01).

CONCLUSIONS:

Quantitative susceptibility mapping rim-positive lesions maintained a hyperintense rim, increased in susceptibility, and had more myelin damage compared with rim-negative lesions. Our results are consistent with the identification of chronic active MS lesions and may provide a target for therapeutic interventions to reduce myelin damage.

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Peripheral zone lesions of intermediary risk in multiparametric prostate MRI: frequency and validation of the PI-RADSv2 risk stratification algorithm based on focal contrast enhancement

Publication date: Available online 14 December 2017
Source:European Journal of Radiology
Author(s): Matthias Benndorf, Lorenz Waibel, Malte Krönig, Cordula Annette Jilg, Mathias Langer, Tobias Krauss
PurposeTo validate the risk stratification algorithm of the Prostate Imaging Reporting and Data System (PI-RADSv2) for intermediary risk lesions (PI-RADSv2 category 3) in the peripheral zone based on focal contrast enhancement and to compare cancer rates in category 3, upgraded category 4 and category 4 based on markedly low ADC value.Materials and methodsWe retrospectively analyze 172 consecutive patients undergoing prostate MRI with 315 histopathologically verified lesions. We select all lesions either assigned category 3 or category 4 in the peripheral zone for further analysis. We compare cancer rates with the two-sided chi-squared test. To determine inter-observer agreement about contrast enhancement two blinded radiologists evaluate the subset of category 3 lesions based on the diffusion weighted sequence.ResultsThe frequency of peripheral PI-RADS 3, upgraded PI-RADS 4 and PI-RADS 4 lesions based on markedly low ADC value is 10.8%, 10.8% and 20.3%, respectively. Cancer rates (significant cancer only) in these subgroups are 8.8% (3/34), 23.5% (8/34) and 40.6% (26/64), P<0.01. Inter-observer agreement is moderate for evaluation of contrast enhancement with kappa values between 0.46 and 0.5.ConclusionWe demonstrate a trend of increasing cancer rate from PI-RADSv2 category 3 to upgraded category 4 to category 4 based on markedly low ADC value. Peripheral lesions of intermediary risk in the diffusion weighted sequence account for 21.6% of all prostate lesions encountered. Since it is likely that patient management recommendations will be linked to assessment categories in future versions of PI-RADS, cancer rates in upgraded category 4 and category 4 based on markedly low ADC values should be in a similar range. We conclude that in future studies of PI-RADSv2 upgraded category 4 and category 4 based on markedly low ADC value should be reported separately to generate a database for meta-analysis of cancer rates.



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PTA Stent of Dural Sinuses in Brain DAVF

Abstract

Background and Purpose

Type I and IIa dural arteriovenous fistulas (DAVFs) have a low hemorrhagic risk, but are often the cause of debilitating tinnitus that requires treatment. While Onyx® and PHIL™ (Precipitating hydrophobic injectable liquid) transarterial embolization represent the first endovascular option, there are occasional cases where performing angioplasty and stenting of the affected sinus may lead to satisfactory results.

Material and Methods

We retrospectively analyzed four consecutive cases of patients with DAVF-induced pulsatile tinnitus secondary to type I and II DAVFs who were treated with angioplasty and stenting of the sinus only. All the patients had clinical and radiological long-term follow-up.

Results

We noticed a significant radiological and clinical improvement in all the cases. Of the patients two were completely cured at follow-up with eradication of the neurological symptoms as well as the fistula, one was retreated with Onyx® for a very small residual shunt despite having no more tinnitus, and one showed improvement in venous drainage (from type IIa+b to type I fistula) without resolution of the fistula.

Conclusion

In cases of type I and II DAVFs associated with sinus stenosis, angioplasty and stenting alone seem to be safe and effective. This treatment probably compresses the venules within the sinus walls, promoting thrombosis of the shunts thus solving the underlying cause of the fistula.

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Borderline- und maligne mesenchymale Tumoren des Abdomens

Zusammenfassung

Hintergrund

Zu den häufigsten malignen mesenchymalen Tumoren im Abdomen zählen v. a. die Sarkome, deren bildgebende Charakterisierung durch ihre teilweise unspezifische Morphologie erschwert sein kann.

Ziel der Arbeit

Diese Übersichtsarbeit soll eine Auswahl der häufigsten mesenchymalen Tumoren im Abdomen und ihre bildgebenden Charakteristika sowie die zugehörigen Differenzialdiagnosen vorstellen. Die Kenntnis der grundlegenden pathologisch-anatomischen und radiologischen Merkmale, wie die Klassifikation dieser Neoplasien, sollen dem Radiologen eine möglichst exakte Differenzialdiagnose erlauben und den Patienten zeitnah in eine der komplexen, multimodalen Therapien führen.

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Abdominelle lymphatische Malformationen

Zusammenfassung

Hintergrund

Abdominelle lymphatische Malformationen (LM) stellen relativ seltene Befunde in der Differenzialdiagnose fokaler abdomineller Läsionen dar. Dennoch sind sie gerade bei Patienten in einer jungen Altersgruppe diagnostisch eine Herausforderung. Das Ziel dieses Übersichtsartikels ist es, aktuellste Informationen über die unterschiedlichen Arten der Manifestation von LM zu geben. Darüber hinaus werden die in diesem Zusammenhang auftretenden Syndrome sowie typischen Merkmale der Bildgebung behandelt.

Resultate

Klinisch treten abdominelle LM meist asymptomatisch auf. In der Bildgebung werden häufig Zufallsbefunde von dünnwandig begrenzten zystischen Raumforderungen im gesamten Abdomen auffällig. Die Flüssigkeit in den zystischen Raumforderungen kann proteinreich sein, Blut enthalten oder Zeichen der Infektion aufweisen. Die radiologische Präsentation überschneidet sich dabei häufig mit anderen zystischen Erkrankungen. Das typische Zeichen der LM ist das Fehlen von soliden Anteilen und die ausschließliche Kontrastmittelaufnahme der zystischen Wände und Septen.

Schlussfolgerung

Differenzialdiagnostisch müssen Radiologen bei zystischen abdominellen Raumforderungen v. a. bei Kindern und jungen Erwachsenen eine LM in Betracht ziehen. Die kürzlich neu definierten Entitäten dieses Krankheitsspektrums sind die sog. „central conducting lymphatic anomaly" (CCLA) und die generalisierte lymphatische Anomalie (GLA).

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Ein hämatologischer Sonderfall

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Characteristic miRNA expression signature and random forest survival analysis identify potential cancer-driving miRNAs in a broad range of head and neck squamous cell carcinoma subtypes

Publication date: January–February 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 1
Author(s): Yury O. Nunez Lopez, Berta Victoria, Pawel Golusinski, Wojciech Golusinski, Michal M. Masternak
AimTo characterize the miRNA expression profile in head and neck squamous cell carcinoma (HNSSC) accounting for a broad range of cancer subtypes and consequently identify an optimal miRNA signature with prognostic value.BackgroundHNSCC is consistently among the most common cancers worldwide. Its mortality rate is about 50% because of the characteristic aggressive behavior of these cancers and the prevalent late diagnosis. The heterogeneity of the disease has hampered the development of robust prognostic tools with broad clinical utility.Materials and methodsThe Cancer Genome Atlas HNSC dataset was used to analyze level 3 miRNA-Seq data from 497 HNSCC patients. Differential expression (DE) analysis was implemented using the limma package and multivariate linear model that adjusted for the confounding effects of age at diagnosis, gender, race, alcohol history, anatomic neoplasm subdivision, pathologic stage, T and N stages, and vital status. Random forest (RF) for survival analysis was implemented using the randomForestSRC package.ResultsA characteristic DE miRNA signature of HNSCC, comprised of 11 upregulated (i.e., miR-196b-5p, miR-1269a, miR-196a-5p, miR-4652-3p, miR-210-3p, miR-1293, miR-615-3p, miR-503-5p, miR-455-3p, miR-205-5p, and miR-21-5p) and 9 downregulated (miR-376c-3p, miR-378c, miR-29c-3p, miR-101-3p, miR-195-5p, miR-299-5p, miR-139-5p, miR-6510-3p, miR-375) miRNAs was identified. An optimal RF survival model was built from seven variables including age at diagnosis, miR-378c, miR-6510-3p, stage N, pathologic stage, gender, and race (listed in order of variable importance).ConclusionsThe joint differential miRNA expression and survival analysis controlling for multiple confounding covariates implemented in this study allowed for the identification of a previously undetected prognostic miRNA signature characteristic of a broad range of HNSCC.



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Morbidity dynamics in proton–photon or photon radiation therapy for locally advanced prostate cancer

Publication date: January–February 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 1
Author(s): Evgeny V. Khmelevsky, Irina N. Kancheli, Vladimir S. Khoroshkov, Andrey D. Kaprin
AimThis study evaluated the frequency and long-term dynamics of early and late post irradiation damage after proton–photon or photon therapy for locally advanced prostate cancer.BackgroundThe results of a randomized study of proton–photon or photon therapy using several fractionation regimes were analyzed in 272 patients with high and intermediate risk of progression.Materials and methodsThree variants of proton boost fractionation were studied sequentially: 3.0 (8 daily fractions), 4.0 (5 fractions, 3 or 5 fractions/week), and 5.5 (3 fractions, 3 fractions/week) Gy(RBE).ResultsA significant decrease in the severity of both acute and late gastrointestinal injuries is achievable with a proton beam. The dynamics of late gastrointestinal and genitourinary toxicity over a 10-year period were generally characterized by a decrease in severity of morbidity by 30% and 15%, respectively.ConclusionsLocal irradiation with a fractional dose of 3.0–5.5Gy(RBE) and a cumulative dose of 28.0–28.8Gy(RBE) for protons significantly reduces the early and late rectitis severity, but does not reduce the risk of lower urinary tract injuries. Fractionation regimens do not significantly differ in toxicity levels.



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Treatment outcomes and late toxicities of intensity-modulated radiation therapy for 1091 Japanese patients with localized prostate cancer

Publication date: January–February 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 1
Author(s): Hidekazu Tanaka, Takahiro Yamaguchi, Kae Hachiya, Shingo Kamei, Satoshi Ishihara, Masahide Hayashi, Shinichi Ogawa, Hironori Nishibori, Satoshi Goshima, Masayuki Matsuo
AimThis study aimed to evaluate the treatment result of intensity-modulated radiation therapy (IMRT) in a large number of Japanese patients with prostate cancer.BackgroundA total of 1091 patients with localized prostate cancer were recruited between March 2006 and July 2014. The patients were stratified into low- (n=205 [18.8%]), intermediate- (n=450 [41.2%]), high- (n=345 [31.6%]), and very high-risk (n=91 [8.3%]) groups according to the National Comprehensive Cancer Network classification. All patients were irradiated via IMRT at a dose of 74–78Gy with or without androgen-deprivation therapy. The mean follow-up period was 50 months (range, 2–120 months).ResultsThe biochemical failure-free rate (BFFR), the clinical failure-free rate, and the overall survival rate at the 5-year follow-up for all patients was 91.3%, 96.2%, and 99.1%, respectively. In univariate analysis, the prostate-specific antigen (PSA) levels (≤20 vs. >20ng/ml) were significantly correlated with BFFR. A trend toward higher BFFR was noted in patients with a Gleason score (GS) of ≤7 than in patients with GS ≥8. In multivariate analysis, only PSA (≤20 vs. >20ng/ml) was significantly correlated with BFFR. The cumulative incidence rate of gastrointestinal and genitourinary toxicity (≥grade 2) at the 5-year follow-up was 11.4% and 4.3%, respectively.ConclusionsThe findings of this study indicate that IMRT is well tolerated and is associated with both good long-term tumor control and excellent outcomes in patients with localized prostate cancer.



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Absorption ratio of treatment couch and effect on surface and build-up region doses

Publication date: January–February 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 1
Author(s): Taylan Tuğrul
AimIn this study, at different fields, energies and gantry angles, treatment couch and rails dose absorption ratio and treatment couch effect on surface and build-up region doses were examined.BackgroundIt is assumed that radiation attenuation is minimal because the carbon fiber couches have low density and it is not generally accounted for during treatment planning. Consequently, it leads to a major dosimetric mistake.Materials and methodsSolid water phantom was used for relative dose measurement. The measurements were done using a Farmer ion chamber with 0.6cc volume and a parallel plane ion chamber starting from surface with 1mm depth intervals at 10×10cm² field, SSD 100cm. Measurements were taken for situations where the beams intersect the couch and couch rails.ResultsDose absorption ratio of carbon fiber couch obtained at gantry angle of 180° was 1.52%, 0.69%, 0.33% and 0.25% at different field sizes for 6MV. For 15MV, this ratio was 0.95%, 0.27%, 0.20% and 0.05%. The absorption ratio is between 3.4% and 1.22% when the beams intersect with couch rails. The couch effect increased surface dose from 14% to 70% for 6MV and from 11.34% to 53.03% for 15MV.ConclusionsThe results showed that the carbon fiber couch increased surface dose during posterior irradiation. Therefore, the skin-sparing effect of the high energy beams was decreased. If the effect of couch is not considered, it may cause significant differences at dose which reaches the patient and may cause tissue problems such as erythema.



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Relationships between temporomandibular joint disk displacements and condylar volume.

Related Articles

Relationships between temporomandibular joint disk displacements and condylar volume.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Nov 14;:

Authors: Ahn SJ, Chang MS, Choi JH, Yang IH, An JS, Heo MS

Abstract
OBJECTIVES: The aim of this study was to assess the relationship between mandibular condylar volume and disk displacement status in adult males and females.
STUDY DESIGN: We evaluated 122 temporomandibular joints in 61 patients using magnetic resonance imaging (MRI) and computed tomography (CT). MRI data were used to assign disk status as normal disk position (NR), disk displacement with reduction (DDR), or disk displacement without reduction (DDNR). CT data were used to calculate total condylar volume and its components, cortical volume, and trabecular volume. The relationships among condylar volume, disk status, and gender were tested with 2-way analysis of variance.
RESULTS: Condylar volumes significantly correlated with disk displacement, tending to decrease as displacement increased. There were significant differences in both total condylar volume and trabecular volume among the DD status (NR > DDR > DDNR), whereas cortical volume was significantly different only between NR/DDR and DDNR (NR/DDR > DDNR). The volume decreases associated with temporomandibular joint DD were found in both males and females, with greater decreases in men than in women as DD progressed.
CONCLUSIONS: Condylar volumes are significantly associated with disk displacement status. Joints with nonreducing disks showed the smallest condylar volumes in both males and females.

PMID: 29233525 [PubMed - as supplied by publisher]

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Downward migration of radiocesium in an abandoned paddy soil after the Fukushima Dai-ichi Nuclear Power Plant accident

Publication date: February 2018
Source:Journal of Environmental Radioactivity, Volume 182
Author(s): Junko Takahashi, Shokichi Wakabayashi, Kenji Tamura, Yuichi Onda
After the Fukushima Dai-ichi Nuclear Power Plant accident on March 2011, continuous monitoring of the detailed vertical distribution of radiocesium in soil is required to evaluate the fate of radiocesium and establish strategies for remediation and management of the contaminated land. It is especially important to investigate paddy soil because little knowledge has been accumulated for paddy soil and wetland rice is a major staple in Japan. Therefore, we monitored the vertical distribution of ¹³⁷Cs in abandoned paddy soil in a planned evacuation zone from June 2011 to March 2016. The decontamination works (i.e., 5 cm of surface soil removal and re-covering with uncontaminated soil) were conducted by the government in 2015. As a result of monitoring, the ¹³⁷Cs gradually migrated downward with time and the ¹³⁷Cs concentration in the 0–10 cm soil was almost homogenous in October 2014, although it was non-cultivated. The liner relationship was obtained between the median depth, which is the thickness of a soil layer containing half of the total ¹³⁷Cs inventory, and the time after the accident, indicating the migration rate was constant (1.3 cm y⁻¹) before the decontamination works. After the decontamination works, the ¹³⁷Cs concentration in the uppermost surface layer was reduced by 90%, however the total ¹³⁷Cs inventory was reduced by only 50–70%. It was shown that the efficiency of ¹³⁷Cs removal by the decontamination works decrease linearly over time in fields like the studied paddy, in which the homogenization of ¹³⁷Cs concentration occurred. Conversely, the downward migration of ¹³⁷Cs to subsurface layers deeper than 10 cm (i.e., plowpan layer) with low permeability rarely occurred. It is expected that these unique trends in distribution and migration of ¹³⁷Cs would be found in abandoned paddy soils with properties similar to the studied soil, sandy loam but poorly drained because of the low permeable plowpan layer, although further validation is necessary.

Graphical abstract

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Observed Deposition of Gadolinium in Bone Using a New Noninvasive in Vivo Biomedical Device: Results of a Small Pilot Feasibility Study.

Observed Deposition of Gadolinium in Bone Using a New Noninvasive in Vivo Biomedical Device: Results of a Small Pilot Feasibility Study.

Radiology. 2017 Dec 13;:171161

Authors: Lord ML, Chettle DR, Gräfe JL, Noseworthy MD, McNeill FE

Abstract
Purpose To perform a preliminary evaluation of a noninvasive measurement system to assess gadolinium deposition in bone and to investigate the relationship between the administration of gadolinium-based contrast agents (GBCAs) and gadolinium retention in bone. Materials and Methods In vivo measurement of gadolinium retention in tibia bones was performed in 11 exposed subjects who previously received GBCAs (six exposed subjects were from a study performed 5 years previously involving injection of GBCAs in healthy volunteers; five exposed subjects had self-reported GBCA exposure), and 11 sex- and age-matched control subjects without a history of GBCA exposure. Each subject underwent one measurement of gadolinium retention in the tibia with x-ray fluorescence in a laboratory at McMaster University. A one-tailed t test was performed to compare gadolinium concentration in the exposed group with that in the control group. The relationship between the dose of GBCA administered and the gadolinium concentration measured in bone was analyzed with linear regression. Results Gadolinium concentration in bone was significantly higher in exposed subjects (mean, 1.19 μg Gd/g bone mineral ± 0.73 [standard deviation]) than in control subjects (mean, -1.06 μg Gd/g bone mineral ± 0.71) (P = .01). There was also a positive correlation between the dose of GBCA administered and the gadolinium concentration measured in bone (R2 = 0.41); gadolinium concentration in bone increased by 0.39 μg Gd/g bone mineral ± 0.14 per 1 mL of GBCA administered. Gadolinium was detected in bone up to 5 years after one GBCA administration. Conclusion This x-ray fluorescence system is capable of measuring gadolinium deposition in bone noninvasively in vivo. Gadolinium can be retained in bone after one dose of GBCA in healthy subjects. © RSNA, 2017 Online supplemental material is available for this article.

PMID: 29237148 [PubMed - as supplied by publisher]

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Treatment of Early-stage Extracranial Arteriovenous Malformations with Intralesional Interstitial Bleomycin Injection: A Pilot Study.

Treatment of Early-stage Extracranial Arteriovenous Malformations with Intralesional Interstitial Bleomycin Injection: A Pilot Study.

Radiology. 2017 Dec 13;:162076

Authors: Jin Y, Zou Y, Hua C, Chen H, Yang X, Ma G, Chang L, Qiu Y, Lyu D, Wang T, Chang SJ, Qiao C, Luo C, Tremp M, Lin X

Abstract
Purpose To assess the efficacy and safety of intralesional interstitial bleomycin injection in the treatment of early-stage (Schobinger stage I or II) extracranial arteriovenous malformations (AVMs). Materials and Methods This prospective study involved 34 patients with early-stage AVMs, as defined by the Schobinger staging system. The patients received intralesional interstitial bleomycin injected at a maximum dose of 15 000 IU or 1000 IU per kilogram of body weight for children who weighed less than 15 kg per procedure for a total of 6 months (once every month). Therapeutic outcome was evaluated by the degree of devascularization at angiography and the clinical outcome 3 months after the last treatment. Further follow-up was evaluated based on further clinical outcome. Adverse events were recorded according to the Society of Interventional Radiology classification. Results Of the 34 patients with early-stage AVM, 32 (mean age, 20.5 years; 24 female [75%]) completed the study. The results showed that 27 (84.4%, 95% confidence interval [CI]: 71.1, 97.7) patients were responsive to bleomycin injection, including nine (28.1%) with a complete response. Four (12.5%) patients showed no response, and one (3.1%) patient experienced worsening 3 months after the last treatment. During further follow-up (mean follow-up time, 20.7 months; range, 5-28 months), the outcome remained stable in 31 (96.9%) of the 32 patients. A major complication, anaphylactic shock, was observed in one (3.1%, 95% CI: 0, 9.5) patient. Common minor complications included hyperpigmentation, nausea, pruritus, and bullae. Conclusion Intralesional interstitial bleomycin injection is a feasible approach for early-stage AVMs and yields safe and effective outcomes. © RSNA, 2017.

PMID: 29237147 [PubMed - as supplied by publisher]

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Digital Breast Tomosynthesis with Synthesized Two-Dimensional Images versus Full-Field Digital Mammography for Population Screening: Outcomes from the Verona Screening Program.

Digital Breast Tomosynthesis with Synthesized Two-Dimensional Images versus Full-Field Digital Mammography for Population Screening: Outcomes from the Verona Screening Program.

Radiology. 2017 Dec 13;:170745

Authors: Caumo F, Zorzi M, Brunelli S, Romanucci G, Rella R, Cugola L, Bricolo P, Fedato C, Montemezzi S, Houssami N

Abstract
Purpose To examine the outcomes of a breast cancer screening program based on digital breast tomosynthesis (DBT) plus synthesized two-dimensional (2D) mammography compared with those after full-field digital mammography (FFDM). Materials and Methods This prospective study included 16 666 asymptomatic women aged 50-69 years who were recruited in April 2015 through March 2016 for DBT plus synthetic 2D screening in the Verona screening program. A comparison cohort of women screened with FFDM (n = 14 423) in the previous year was included. Screening detection measures for the two groups were compared by calculating the proportions associated with each outcome, and the relative rates (RRs) were estimated with multivariate logistic regression. Results Cancer detection rate (CDR) for DBT plus synthetic 2D imaging was 9.30 per 1000 screening examinations versus 5.41 per 1000 screening examinations with FFDM (RR, 1.72; 95% confidence interval [CI]: 1.30, 2.29). CDR was significantly higher in patients screened with DBT plus synthetic 2D imaging than in those screened with FFDM among women classified as having low breast density (RR, 1.53; 95% CI: 1.13, 2.10) or high breast density (RR, 2.86; 95% CI: 1.42, 6.25). The positive predictive value (PPV) for recall was almost doubled with DBT plus synthetic 2D imaging: 23.3% versus 12.9% of recalled patients who were screened with FFDM (RR, 1.81; 95% CI: 1.34, 2.47). The recall rate was similar between groups (RR, 0.95; 95% CI: 0.84, 1.06), whereas the recall rate with invasive assessment was higher for DBT plus synthetic 2D imaging than for FFDM (RR, 1.93; 95% CI: 1.31, 2.03). The mean number of screening studies interpreted per hour was significantly lower for screening examinations performed with DBT plus synthetic 2D imaging (38.5 screens per hour) than with FFDM (60 screens per hour) (P < .001). Conclusion DBT plus synthetic 2D imaging increases CDRs with recall rates comparable to those of FFDM. DBT plus synthetic 2D imaging increased image reading time and the time needed for invasive assessments. © RSNA, 2017.

PMID: 29237146 [PubMed - as supplied by publisher]

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Evaluation of bone metastatic burden by bone SPECT/CT in metastatic prostate cancer patients: defining threshold value for total bone uptake and assessment in radium-223 treated patients

Abstract

Objectives

To establish a new three-dimensional quantitative evaluation method for bone metastasis, we applied bone single photon emission tomography with computed tomography (SPECT/CT). The total bone uptake (TBU), which measures active bone metastatic burden, was calculated as the sum of [mean uptake obtained as standardized uptake value (SUV) above a cut-off level] × (the volume of the lesion) in the trunk using bone SPECT/CT. We studied the threshold value and utility of TBU in prostate cancer patients treated with radium-223 (Ra-223) therapy.

Methods

To establish the threshold value of TBU, we compared bone metastatic and non-metastatic regions in 61 prostate cancer patients with bone metastasis and 69 without. Five fixed sites in each patient were selected as evaluation points and divided into bone metastatic and non-metastatic sites. Sensitivity and specificity analysis was applied to establish the threshold level. Using the obtained threshold value, we then calculated the TBU in nine prostate cancer patients who received Ra-223 therapy, and compared the results with the bone scan index (BSI) by BONENAVI^® and visual evaluation of bone scintigraphy.

Results

Uptake was significantly lower in non-metastatic sites in patients with bone metastasis than in patients without metastasis. Sensitivity and specificity analysis revealed SUV = 7.0 as the threshold level. There was a discrepancy between TBU and BSI change in two of the nine patients, in whom TBU change correlated with visual judgement, but BSI change did not. In two patients, BSI was nearly 0 throughout the course, but the TBU was positive and changed, although the change was not large. These results suggest that TBU may be more accurate and sensitive than BSI for quantitative evaluation of active bone metastatic burden.

Conclusion

We established a threshold value (SUV > 7.0) for three-dimensional TBU for evaluating active bone metastatic burden in prostate cancer patients using bone SPECT/CT. Despite the small number of patients, we expect the change in TBU could be more accurate and sensitive than the change in BSI among patients who received Ra-223.

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Sickle Cell Beta-Plus Thalassemia with Subcapsular Hematoma of the Spleen

While splenic complications like hypersplenism, sequestration crisis, and infarction are commonly reported in sickle cell variants like sickle cell beta-plus thalassemia, splenic rupture with hematoma is rare. We present a case of a 32-year-old young male who presented with dull left upper quadrant pain who was found to have multiple subcapsular splenic lacerations and hematoma on abdominal imaging. Hemoglobin electrophoresis confirmed sickle cell beta-plus thalassemia in the patient. There was no history of trauma, and rest of the workup for possible cause of spontaneous rupture of spleen was negative. With the patient refusing splenectomy, he was managed conservatively. Clinicians need to be aware of this rare complication of sickle cell variants.

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The Relation between the Quasi-Localized Energy-Momentum Complexes and the Thermodynamic Potential for the Schwarzschild-de Sitter Black Hole

The Schwarzschild-de Sitter black hole solution, which has two event horizons, is considered to examine the relation between the energy component of quasi-localized energy-momentum complexes on and the heat flows passing through its boundary . Here is the patch between cosmological event horizon and black hole event horizon of the SdS black hole solution. Conclusively, the relation, like the Legendre transformation, between the energy component of quasi-localized Einstein and Møller energy-momentum complex and the heat flows passing through the boundary is obeyed, and these two energy components of quasi-localized energy-momentum complexes could be corresponding to thermodynamic potentials.

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Effects of UV-C Light Exposure and Refrigeration on Phenolic and Antioxidant Profiles of Subtropical Fruits (Litchi, Longan, and Rambutan) in Different Fruit Forms

The objectives of this study were to investigate how UV-C irradiation and refrigeration affect shelf-life and antioxidant level of litchi, longan, and rambutan. Three forms (whole, dehulled, and destoned) of fresh fruits were treated by refrigeration and UV-C irradiations. After processing, deterioration rate, phenolics compounds, and antioxidant capacity were quantified. The deterioration rate was recorded as decay index. The results showed that both refrigeration and UV-C exposure extended the shelf-life of the fruits. The refrigeration enriched antioxidant levels of litchi but caused nutritional degradation in longan and rambutan; UV-C radiation enriched litchi antioxidant contents but was related to reduction of antioxidant capacity in longan and rambutan. Removing hulls and stones was associated with the decrease of antioxidants in litchi. The effects on antioxidant levels varied from fruit to fruit, resulting from hormesis phenomenon. The change of phytochemical levels was hypothesized as an accumulative process. The effects of fruit forms were not consistent in different fruits, which could be multifactorially influenced.

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Co(II) Coordination in Prokaryotic Zinc Finger Domains as Revealed by UV-Vis Spectroscopy

Co(II) electronic configuration allows its use as a spectroscopic probe in UV-Vis experiments to characterize the metal coordination sphere that is an essential component of the functional structure of zinc-binding proteins and to evaluate the metal ion affinities of these proteins. Here, exploiting the capability of the prokaryotic zinc finger to use different combinations of residues to properly coordinate the structural metal ion, we provide the UV-Vis characterization of Co(II) addition to Ros87 and its mutant Ros87_C27D which bears an unusual CysAspHis2 coordination sphere. Zinc finger sites containing only one cysteine have been infrequently characterized. We show for the CysAspHis2 coordination an intense d-d transition band, blue-shifted with respect to the Cys2His2 sphere. These data complemented by NMR and CD data demonstrate that the tetrahedral geometry of the metal site is retained also in the case of a single-cysteine coordination sphere.

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Almost Automorphic Functions on the Quantum Time Scale and Applications

We first propose two types of concepts of almost automorphic functions on the quantum time scale. Secondly, we study some basic properties of almost automorphic functions on the quantum time scale. Then, we introduce a transformation between functions defined on the quantum time scale and functions defined on the set of generalized integer numbers; by using this transformation we give equivalent definitions of almost automorphic functions on the quantum time scale; following the idea of the transformation, we also give a concept of almost automorphic functions on more general time scales that can unify the concepts of almost automorphic functions on almost periodic time scales and on the quantum time scale. Finally, as an application of our results, we establish the existence of almost automorphic solutions of linear and semilinear dynamic equations on the quantum time scale.

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Study of Nitrogen Removal Performance When Treating Low Carbon Sewage Using External Solid Carbon Sources in SBBR Systems

Based on low carbon wastewater as the research object and using corncob as an external solid carbon source, the performance of corncob organic matter was assessed for its release potential, quantity of release, and safety of use. The effects of varying quantities of the solid carbon source on simultaneous nitrification and denitrification were investigated in a sequencing biofilm batch reactor (SBBR). Results show that the regularity of corncob as solid carbon source material was linear, with released concentrations of heavy metals being below the Chinese national standard limit values for heavy metals according to the surface water environment quality standards (I and II) (GB3838-2002). When temperatures were within 28~31°C, the dissolved oxygen level was  mg/L and the pH conditions were within 7.5~8.0. The optimal quantity for corncob dosing was 5 g per 1.5 L of low carbon wastewater. Following treatment, the average effluent concentrations of -N and TN were 2.85 mg/L and 4.51 mg/L, respectively. The effluent concentration of -N, TN had reached the A level national standard of sewage treatment plant pollutant discharge standard (GB18918-2002).

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Emergency Evacuation of Hazardous Chemical Accidents Based on Diffusion Simulation

The recent rapid development of information technology, such as sensing technology, communications technology, and database, allows us to use simulation experiments for analyzing serious accidents caused by hazardous chemicals. Due to the toxicity and diffusion of hazardous chemicals, these accidents often lead to not only severe consequences and economic losses, but also traffic jams at the same time. Emergency evacuation after hazardous chemical accidents is an effective means to reduce the loss of life and property and to smoothly resume the transport network as soon as possible. This paper considers the dynamic changes of the hazardous chemicals’ concentration after their leakage and simulates the diffusion process. Based on the characteristics of emergency evacuation of hazardous chemical accidents, we build a mixed-integer programming model and design a heuristic algorithm using network optimization and diffusion simulation (hereafter NODS). We then verify the validity and feasibility of the algorithm using Jinan, China, as a computational example. In the end, we compare the results from different scenarios to explore the key factors affecting the effectiveness of the evacuation process.

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A Novel Mutation in ACTG2 Gene in Mother with Chronic Intestinal Pseudoobstruction and Fetus with Megacystis Microcolon Intestinal Hypoperistalsis Syndrome

Background. A novel mutation in the ACTG2 gene is described in a pregnant patient followed up for chronic intestinal pseudoobstruction (CIPO) during pregnancy and her fetus with megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS). Case. 24-year-old gravida 1 para 1 with CIPO and persistent nausea and vomiting in pregnancy, admitted at 28 weeks of gestation. Ultrasound revealed a fetus measuring greater than the 95th percentile, polyhydramnios, and megacystis. At delivery, the newborn was noted to have an enlarged bladder, microcolon, and intolerance of oral intake. Genetic testing of mother and child revealed a novel mutation in the ACTG2 gene (C632F>A, p.R211Q). Conclusion. This is the first case in the literature describing a novel mutation in ACTG2 associated with visceral myopathy affecting both mother and fetus/neonate. Visceral myopathy should be included in the differential diagnosis of megacystis diagnosed by ultrasound, and suspicion should increase with family history of CIPO or MMIHS.

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Development of Practical Finite Element Models for Collapse of Reinforced Concrete Structures and Experimental Validation

This paper describes two practical methodologies for modeling the collapse of reinforced concrete structures. They are validated with a real scale test of a two-floor structure which loses a bearing column. The objective is to achieve accurate simulations of collapse phenomena with moderate computational cost. Explicit finite element models are used with Lagrangian meshes, modeling concrete, and steel in a segregated manner. The first model uses 3D continuum finite elements for concrete and beams for steel bars, connected for displacement compatibility using a penalty method. The second model uses structural finite elements, shells for concrete, and beams for steel, connected in common nodes with an eccentricity formulation. Both are capable of simulating correctly the global behavior of the structural collapse. The continuum finite element model is more accurate for interpreting local failure but has an excessive computational cost for a complete building. The structural finite element model proposed has a moderate computational cost, yields sufficiently accurate results, and as a result is the recommended methodology.

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Preparation and Anticorrosion of Octadecyl Trichlorosilane SAMs for Copper Surface

The self-assembled monolayer (SAM) was prepared using octadecyl trichlorosilane (OTS) in distilled solution on the copper surface. The effect of inhibitor concentration on the rate of inhibition efficiency and corrosion rate in corrosion medium on copper by using polarization curves, electrochemical impedance spectroscopy (EIS), scanning electron microscope (SEM) was studied. The results showed that OTS SAMs exhibit the better corrosion resistance; the corrosion potential of copper OTS SAMs protection increased by about 1.02 V, while the corrosion current density decreased to 0.59 A/cm2. The corrosion rate is minimized and flattened and can reach 9.2% while the inhibition efficiency reached 95.4%, when the corrosion inhibitor has concentration of 40 ppm.

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Rare Case of Cocaine-Induced Aortic Aneurysm: A Near Dissection Event

Cocaine use has been associated with cardiovascular complications such as coronary atherosclerosis, coronary artery spasm, cardiac arrhythmias, acute myocardial infarction, myocarditis, and dilated cardiomyopathies. Aortic dissection is a rare but life-threatening complication of cocaine use. Cocaine and stimulant use can cause aortic aneurysm by increasing the aortic wall stress, and the most feared complications are dissection, rupture, and death. There are no clear guidelines about screening cocaine abusers with CT scan of the chest. We do not know if the number of years of cocaine use or the amount of cocaine use can be associated with higher incidence of aortic aneurysm or dissection. Cocaine-induced aortic aneurysm does not have any specific clinical feature. Common presentation is chest discomfort or chest pain. This common presentation is bewildering enough for clinicians to think of more common causes of chest pain like myocardial infarction and myocarditis. The sudden onset of severe, sharp, stabbing chest or back pain is suggestive of aortic dissection. Here, we present a young otherwise healthy patient with chronic cocaine use presenting with chest pain and found to have significant size aortic aneurysm.

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The Diagnostic Utility and Clinical Impact of After-Hours CT Scans of the Abdomen and Pelvis Investigating Abdominal Pain

Introduction. The aim of this study was to evaluate the diagnostic utility and impact on clinical management of after-hours CT scans investigating abdominal pain in surgical patients. Methods. After-hours CT A/P reports investigating the acute surgical abdomen were compared with clinical outcomes and histopathological findings to assess sensitivity and specificity of CT reporting. Comparisons between CT reports and clinical notes were made. CT scans were categorised as having direct effects on clinical management, ruling out a serious pathology, ruling out a nonserious pathology, or having no effect. Discrepancies between information in case-notes and information provided to radiologists were also analysed. Results. 79 clinical notes were located. After-hours CT demonstrated 91% sensitivity and 82% reporting specificity using clinical outcomes as the standard. In the 26 patients with histopathological findings, CT reports demonstrated 91% sensitivity. In 79.7% of cases, CT scanning had an impact on management. In 35.4% of cases, an indication for scanning was not documented with variation in clinical information in 8.9% of cases. Discussion. This study demonstrates after-hours CT A/P reports result in significant impacts on clinical management of surgical patients with acute abdominal pain. Improvements in providing information when requesting scans are however needed to facilitate accurate reporting.

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Molecular characterization of the spike gene of the porcine epidemic diarrhea virus in Mexico, 2013–2016

Abstract

In Mexico, the first outbreaks suggestive of the circulation of the porcine epidemic diarrhea virus (PEDV) were identified at the beginning of July 2013. To identify the molecular characteristics of the PEDV Spike (S) gene in Mexico, 116 samples of the intestine and diarrhea of piglets with clinical signs of porcine epidemic diarrhea (PED) were obtained. Samples were collected from 14 farms located in six states of Mexico (Jalisco, Puebla, Sonora, Veracruz, Guanajuato, and Michoacán) from 2013 to 2016. To identify PEDV, we used real-time RT-PCR to discriminate between non-INDEL and INDEL strains. We chose samples according to state and year to characterize the S gene. After amplification of the S gene, the obtained products were sequenced and assembled. The complete amino acid sequences of the spike protein were used to perform an epitope analysis, which was used to determine null mutations in regions SS2, SS6, and 2C10 compared to the sequences of G2. A phylogenetic analysis determined the circulation of G2b and INDEL strains in Mexico. However, several mutations were recorded in the collagenase equivalent (COE) region that were related to the change in polarity and charge of the amino acid residues. The PEDV strain circulating in Jalisco in 2016 has an insertion of three amino acids (²³²LGL²³⁴) and one change in the antigenic site of the COE region, and strains from the years 2015 and 2016 changed the index of the surface probability, which could be related to the re-emergence of disease outbreaks.

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Interferon lambda4 polymorphism is not associated with human papillomavirus infection outcome

Abstract

Interferon (IFN) lambdas are important specific components of the mucosal innate immune response. The IFN lambda 4 (IFNL4) dinucleotide polymorphism (ΔG/TT) determines the IFN lambdas and related Interferon-stimulated genes activation, in HCV and other chronic infections. Our group first reported that IFN Lambda response was impaired in high-risk Human Papillomavirus (HPV) cervical infections and in precancerous lesions. Accordingly, we sought to evaluate the possible role of the IFNL4 polymorphism in determining HPV infection outcome. The ΔG/TT alleles were not differently distributed in 221 women with high- or low-risk HPV infection, with HPV infection clearance or persistence, and with abnormal cytology.

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Transcriptome analysis of Δ mig1 Δ mig2 mutant reveals their roles in methanol catabolism, peroxisome biogenesis and autophagy in methylotrophic yeast Pichia pastoris

Abstract

Two catabolite repressor genes (MIG1 and MIG2) were previously identified in Pichia pastoris, and the derepression of alcohol oxidase (AOX) expression was realized in Δmig1 or Δmig1Δmig2 mutants grown in glycerol, but not in glucose. In this study, genome-wide RNA-seq analysis of Δmig1Δmig2 and the wild-type strain grown in glycerol revealed that the expression of numerous genes was greatly altered. Nearly 7% (357 genes) of approximately 5276 genes annotated in P. pastoris were significantly upregulated, with at least a two-fold differential expression in Δmig1Δmig2; the genes were mainly related to cell metabolism. Approximately 23% (1197 genes) were significantly downregulated; these were mainly correlated with the physiological characteristics of the cell. The methanol catabolism and peroxisome biogenesis pathways were remarkably enhanced, and the genes AOX1 and AOX2 were upregulated higher than 30-fold, which was consistent with the experimental results of AOX expression. The Mig proteins had a slight effect on autophagy when cells were grown in glycerol. The expression analysis of transcription factors showed that deletion of MIG1 and MIG2 significantly upregulated the binding of an essential transcription activator, Mit1p, with the AOX1 promoter, which suggested that Mig proteins might regulate the AOX1 promoter through the regulation of Mit1p. This work provides a reference for the further exploration of the methanol induction and catabolite repression mechanisms of AOX expression in methylotrophic yeasts.

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Selected microRNA-192 mutant indicates association with several function genes in bovine cells

Abstract

MicroRNAs are implicated in many cellular processes such as cell differentiation and development, tumorigenesis, and immune regulation. In this study, miR192 was detected using quantitative real-time polymerase chain reaction (qRT-PCR) when MDBK cells were exposed to Escherichia coli. Cells with malfunction of bta-miR-192 were established using transcription activator-like effector nuclease (TALEN) technology. Finally, bta-miR-192 mutant cells were screened for differentially expressed genes using RNA-sequencing (RNA-seq). The results showed that miR192 significantly decreased in cells exposed to E. coli F18ac and E. coli K88ac. The RNA-seq results showed that 1673 differentially expressed transcripts were identified; 890 genes were upregulated and 775 genes were downregulated. With the gene ontology enrichment analysis, 431 differentially expressed genes (DEGs) were classified into 937 gene ontology terms. The pathway enrichment analysis showed that 535 genes were involved in 254 pathway terms. Interestingly, most of these DEGs were associated with the pathways in cancers or infectious diseases. When the selected DEGs (n = 162) in these pathways were intersected with 120 differential transcripts, 11 DEGs were identified. Subsequently, several genes associated with regulation, cancers, or viral infections, such as LEF1, AXIN2, MX1, and FCGR2B, were identified among the DEGs using functional analysis. Furthermore, associations between bta-miR-192 and DEGs were detected by intersecting the bta-miR-192’s target genes with the DEGs, indicating that three genes including CBL, DICER1 and TRERF1 were involved in this relationship. These findings provided useful guidance for investigating the role played by bta-miR-192 in cellular functionality in bovine cells.

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Orbital Subperiosteal Abscess Associated with Mandibular Wisdom Tooth Infection: A Case Report

Abstract

Background

Orbital infection related to mandibular third molar infection is extremely rare. Most of cases reported in literature are related to maxillary molar teeth. Odontogenic infections are not common causes of orbital abscess but it should always be put in consideration when dealing with orbital cellulitis and abscess.

Case presentation

This is a case of orbital abscess involving the left eye as consequence of lower left third molar infection in otherwise healthy 35-year-old black male patient. CT scan confirmed the unusual pathway of this space infection from the lower third molar and excluded any intracranial involvement. The abscess was drained immediately by intraoral incisions and the tooth was extracted. There was a dramatic improvement in a very short time with normal eye movement.

Conclusion

This case demonstrates one of the serious consequences of odontogenic infection which may lead to cavernous sinus thrombosis and blindness if not treated promptly.

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The Privileged and Useful Migrant: An Evaluation of Changing Policy and Scholarly Approaches Towards High-skilled Migration

The purpose of this paper has been to examine the position of high-skilled migration within the contemporary migration debate in relation to the wider issue of who and what constitutes skilled migration. The paper reviews policy and scholarly approaches towards high-skilled migration within three main strands of research literature: immigration policy analysis, research on migrationdevelopment nexus and studies on integration/incorporation in receiving countries. Drawing on the interpretation of trends in these three research strands, this paper presents high-skilled migration as a necessary part of economic competitiveness, as self-help development from below and as a prototype of social mobility. In this sense, highly skilled migrants are portrayed as those who: a) are economically useful and contribute to economic competitiveness; b) benefit development outcomes in their countries of origin; and c) are easily integrated in labor markets and societies at large. As autonomous and economically independent, skilled migrants have privileged treatment and are counted on to boost economies of host societies and of their countries of origin, without posing any issues with their presence. This paper shows how policy and scholarly approaches towards highly skilled migrants determine who will be included in this privileged position. It exposes the not-soclear-cut distinction between low- and high-skilled migration and furthers our understanding of the extent to which changing government priorities and ideologies impact international mobility by providing opportunities to move and stay for some, while erecting barriers for others.

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Lucid Dreams - Alluring Cities: Imaginaries of the Urban in West Africa

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Antitumor effect of Quercetin on Y79 retinoblastoma cells via activation of JNK and p38 MAPK pathways

Quercetin (QCT) is a flavonol present in many vegetables, it is proved to show chemo preventive effect against lung, cervical, prostate, breast and colon cancer due to its anti-inflammatory, anti-tumor and ant...

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Effects of sesamin on primary human synovial fibroblasts and SW982 cell line induced by tumor necrosis factor-alpha as a synovitis-like model

Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic synovitis, cartilage degradation and bone deformities. Synovitis is the term for inflammation of the synovial membrane, an early stage of ...

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Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer

Despite improvement of tumour response rates in patients with progressive and metastatic cancer, immune checkpoint inhibitors (ICM) induce toxicities in cancer patients. Viscum album L. (VA, mistletoe) extracts a...

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Adding Chinese herbal medicine to conventional therapy brings cognitive benefits to patients with Alzheimer’s disease: a retrospective analysis

Conventional therapy (CT) such as donepezil and memantine are well-known short-term treatments for the symptoms of Alzheimer’s disease (AD). The efficacy of them, however, drops below baseline level after 9 mo...

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Extraction of amplifiable DNA from embalmed human cadaver tissue

The expansion of molecular techniques in medical diagnosis, forensics, and education requires the development of improved techniques of DNA extraction from fixed tissues. Cadaver tissues are not commonly used ...

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Making healthy homes? A pilot study of the return on investment from an external wall insulation intervention

External Wall Insulation (EWI) insulates and protect homes against damp. The Energy Company Obligation (ECO) scheme incentivised large energy providers in the UK delivering energy efficiency measures such as E...

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Local recurrences after curative IMRT for HNSCC: Effect of different GTV to high-dose CTV margins

Publication date: Available online 13 December 2017
Source:Radiotherapy and Oncology
Author(s): Ruta Zukauskaite, Christian R. Hansen, Cai Grau, Eva Samsøe, Jørgen Johansen, Jørgen B.B. Petersen, Elo Andersen, Carsten Brink, Jens Overgaard, Jesper G. Eriksen
IntroductionThe aim was to analyze position of CT-verified local recurrences (LR) and local control (LC) among three centers that used different GTV to CTV1 margins.Materials and methodsIn total, 1576 patients completing radical primary IMRT for larynx, pharynx, oral cavity HNSCC in three centers in Denmark between 2006 and 2012 were included. CT-verified LRs were analyzed as possible points of recurrence origin and compared between groups of small (0–2.5 mm), larger (>2.5 mm), and anatomical GTV-CTV1 margins. The recurrence point's position relative to the GTV and 95% prescription dose was evaluated. Overall local control rate was evaluated using Cox uni- and multi-variate analysis.ResultsAfter a median follow-up of 41 months, 272 patients had local failure. Median GTV-CTV1 margin in Center1, 2 and 3 was 0.0, 3.7 and 9.7 mm, respectively. 51% of local recurrences were inside the GTV. No difference in distribution of LRs in relation to GTV surface (p = 0.4) or the dose to LRs (p = 0.2) was detected between the groups. A difference in LC was found univariate between the centers (p = 0.03), but not in multivariate analysis (p = 0.4).ConclusionsNo relation was found between the recurrences' distributions as function of the margins used at three centers. In multivariate analysis, local control was not influenced by the centers.



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Severe lymphopenia during neoadjuvant chemoradiation for esophageal cancer: A propensity matched analysis of the relative risk of proton versus photon-based radiation therapy

Publication date: Available online 14 December 2017
Source:Radiotherapy and Oncology
Author(s): Yutaka Shiraishi, Penny Fang, Cai Xu, Juhee Song, Sunil Krishnan, Eugene J. Koay, Reza J. Mehran, Wayne L. Hofstetter, Mariela Blum-Murphy, Jaffer A. Ajani, Ritsuko Komaki, Bruce Minsky, Radhe Mohan, Charles C. Hsu, Brian P. Hobbs, Steven H. Lin
Background and purposeCirculating lymphocytes are exquisitely sensitive to radiation exposure, even to low scattered doses which can vary drastically between radiation modalities. We compared the relative risk of radiation-induced lymphopenia between intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT) in esophageal cancer (EC) patients undergoing neoadjuvant chemoradiation therapy (nCRT).Material and methodsEC patients treated with IMRT and PBT were propensity matched based on key clinical variables. Treatment-associated lymphopenia was graded using CTCAE v.4.0. Using matched cohorts, univariate and multivariable multiple logistic regression was used to identify factors associated with increased risk of grade 4 lymphopenia as well as characterize their relative contributions.ResultsAmong the 480 patients treated with nCRT, 136 IMRT patients were propensity score matched with 136 PBT patients. In the matched groups, a greater proportion of the IMRT patients (55/136, 40.4%) developed grade 4 lymphopenia during nCRT compared with the PBT patients (24/136, 17.6%, P < 0.0001). On multivariable analysis, PBT was significantly associated with a reduction in grade 4 lymphopenia risk (odds ratio, 0.29; 95% confidence interval, 0.16–0.52; P < 0.0001).ConclusionPBT is associated with significant risk reduction in grade 4 lymphopenia during nCRT in esophageal cancer.



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Validated Alzheimer’s Disease Risk Index (ANU-ADRI) is associated with smaller volumes in the default mode network in the early 60s

Abstract

Strong evidence is available suggesting that effective reduction of exposure to demonstrated modifiable risk factors in mid-life or before could significantly decrease the incidence of Alzheimer’s disease (AD) and delay its onset. A key ingredient to achieving this goal is the reliable identification of individuals at risk well before they develop clinical symptoms. The aim of this study was to provide further neuroimaging evidence of the effectiveness of a validated tool, the ANU Alzheimer’s Disease Risk Index, for the assessment of future risk of cognitive decline. Participants were 461 (60–64 years, 48% female) community-living individuals free of dementia at baseline. Associations between risk estimates obtained with the ANU-ADRI, total and regional brain volumes including in the default mode network (DMN) measured at the same assessment and diagnosis of MCI/dementia over a 12-year follow-up were tested in a large sample of community-living individuals free of dementia at baseline. Higher risk estimates on the ANU-ADRI were associated with lower cortical gray matter and particularly in the DMN. Importantly, difference in participants with high and low risk scores explained 7–9% of the observed difference in gray matter volume. In this sample, every one additional risk point on the ANU-ADRI was associated with an 8% increased risk of developing MCI/dementia over a 12-year follow-up and this association was partly mediated by a sub-region of the DMN. Risk of cognitive decline assessed with a validated instrument is associated with gray matter volume, particularly in the DMN, a region known to be implicated in the pathological process of the disease.

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Action, observation or imitation of virtual hand movement affect differently regions of the mirror neuron system and the default mode network

Abstract

Virtual reality (VR)-based paradigms use visual stimuli that can modulate visuo-motor networks leading to the stimulation of brain circuits. The aims of this study were to compare the changes in blood-oxygenation level dependent (BOLD) signal when watching and imitating moving real (RH) and virtual hands (VH) in 11 healthy participants (HP). No differences were found between the observation of RH or VH making this VR-based experiment a promising tool for rehabilitation protocols. VH-imitation involved more the ventral premotor cortex (vPMC) as part of the mirror neuron system (MNS) compared to execution and VH-observation conditions. The dorsal-anterior Precuneus (da-Pcu) as part of the Precuneus/posterior Cingulate Cortex (Pcu/pCC) complex, a key node of the Default Mode Network (DMN), was also less deactivated and therefore more involved. These results may reflect the dual visuo-motor roles for the vPMC and the implication of the da-Pcu in the reallocation of attentional and neural resources for bimodal task management. The ventral Pcu/pCC was deactivated regardless of the condition confirming its role in self-reference processes. Imitation of VH stimuli can then modulate the activation of specific areas including those belonging to the MNS and the DMN.

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Aberrant baseline brain activity in psychogenic erectile dysfunction patients: a resting state fMRI study

Abstract

Recent neuroimaging studies have elucidated many interesting and promising findings on sexuality regarding the neural underpinnings of both normal and abnormal sexual processes. Psychogenic erectile dysfunction (pED) consists of a major part of male sexual dysfunction in China, but the understanding of the central mechanism of pED is still in its infancy. It is commonly appreciated that pED is a functional disorder, which can be attributed predominantly or exclusively to psychological factors, such as anxiety, depression, loss of self-esteem, and psychosocial stresses. Most previous studies probed the central response in the brain of pED patients using sexual-related stimuli. However, little concern has been given to a more fundamental issue whether the baseline brain activity is altered in pED or not. With rs-fMRI data, the current study aimed to explain the central mechanism behind pED by investigating the alterations in baseline brain activity in patients with pED, as indexed by the amplitude of low-frequency (0.01–0.08 Hz) fluctuation (ALFF). After the psychological screening and urological examination procedure, 26 pED patients and 26 healthy matched controls were enrolled. Our results explicated significantly lower baseline brain activity in the right anterior insula and right orbitofrontal cortex for pED patients (multiple comparison corrected). Additionally, the voxel-wise correlation analysis showed that ALFF of the right anterior insula was correlated with the outcomes of erectile function (multiple comparison corrected). Our results implied there was impaired cognitive and motivational processing of sexual stimuli in pED patients. Our current findings may shed light on the neural pathology underlying pED. We hope that our study has provided a new angle looking into pED research by investigating resting state brain activity. Furthermore, we suggest that the current study may put forward a more subtle conception of insular influence on pED, which may help foster new specific, mechanistic insights.

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Neural processing of food and monetary rewards is modulated by metabolic state

Abstract

In humans, food is considered a powerful primary reinforcer, whereas money is a secondary reinforcer, as it gains a value through learning experience. Here, we aimed to identify the neural regions supporting the processing of food-related reinforcers, relate it to the neural underpinnings of monetary reinforcers, and explore their modulation by metabolic state (hunger vs satiety). Twenty healthy male participants were tested in two experimental sessions, once hungry and once satiated, using functional magnetic resonance imaging. Participants performed an associative learning task, receiving food or monetary rewards (in the form of images) on separate blocks. Irrespective of incentive type, both food and monetary rewards engaged ventral striatum, medial orbitofrontal cortex and amygdala, regions that have been previously associated with reward processing. Food incentives additionally engaged the opercular part of the inferior frontal gyrus and the insula, collectively known as a primary gustatory cortex. Moreover, in response to negative feedback (here, reward omission), robust activation was observed in anterior insula, supplementary motor area and lateral parts of the prefrontal cortex, including middle and inferior frontal gyrus. Furthermore, the interaction between metabolic state and incentive type resulted in supramarginal gyrus (SMG) activity, among other motor and sensory-related regions. Finally, functional connectivity analysis showed correlation in the hungry state between the SMG and mesolimbic regions, including the hippocampus, midbrain and cingulate areas. Also, the interaction between metabolic state and incentive type revealed coupling between SMG and ventral striatum. Whereas general purpose reward-related regions process incentives of different kinds, the current results suggest that the SMG might play a key role in integrating the information related to current metabolic state and available incentive type.

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Reply: The iron-deficient rat as a model of restless legs syndrome: Was anything lost in translation?

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Successful treatment of task-specific lower extremity dystonia by ventro-oral thalamotomy

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Failed Attempt With Paired Associative Stimulation to Separate Functional and Organic Dystonia

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Objects

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Hermann Burgers selbstmörderische Poetologie. Zur Performanz testamentarischer Sprechakte

Der Selbstmord des Schweizer Schriftstellers Hermann Burger, so zeigt der Artikel, ist ein literarisch vielfach grundierter. Doch nicht so sehr die motivische Todesnähe von Burgers Werk interessieren Aeberhard, als vielmehr die schriftmedialen Techniken der Selbstverdoppelung, durch welche sich der Selbstmörder mithilfe letztwilliger Formulierungen kalkuliert deren Performanz sichert. Im Tractatus logico-suicidalis widmet Burger, ein knappes Jahr vor seinem eigenen Selbstmord, 36 Paragraphen Heinrich von Kleist und den Umständen von dessen Selbsttötung. Burger setzt Kleist ganz oben auf die »Todesbestenliste aller Selbstmörder«, rekapituliert die Ereignisse vom 21. November 1811, zitiert aus den Briefen an Marie und Ulrike von Kleist sowie aus den gerichtsmedizinischen Akten. Die deutliche Bewunderung Burgers gilt dem Schriftstellerkollegen, der – sich selbst verabgründend – »mit frostnächtlichem Kalkül« ein Denkmal aus Wörtern setzt: »Kleists Tod war sein erster durchschlagender Erfolg.« Die letzten Briefe Kleists kennen ein Äußerungssubjekt, welches das Zeitliche bereits transzendiert haben wird, wenn die von ihm gezeichneten Buchstaben entziffert werden. Das Gelingen der testamentarischen Schreibakte und die entsprechend überstarke und durch das Datum des Todes identifizierend gesicherte Autorschaftsfunktion ist nur um den Preis des eigenen Lebens zu erreichen. Burgers eigene Texte, so zeigt Aeberhard, imitieren diese selbstimplizierende Logik und argumentieren dabei implizit den Selbstmord als eine theatrale Geste der Selbstauthentifikation.

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Acknowledgement to the Reviewers

Oncology 2017;93:407-409

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Contents Vol. 93, 2017

Oncology 2017;93:I-V

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Erratum

Oncology 2017;93:406

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First-decade patient with colorectal cancer carrying both germline and somatic mutations in APC gene

Colorectal carcinoma (CRC) is one of the most common causes of cancer-related deaths. The mean age of patients with CRC ranges from 49 to 60 years. Pediatric CRC is unusual, which often escapes early diagnosis...

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Pulmonary embolus as cause of death in an adolescent: demonstration on postmortem CT

Abstract

Computed tomography (CT) is widely accepted in adult forensic death investigations (determination of cause and manner of death) but is only beginning to play a larger role in the cause of death determination in infants and children. We present a case of an adolescent with nephrotic syndrome who sustained cardiac arrest and died in the emergency department. A postmortem CT was requested by the state Office of the Medical Examiner as part of the medicolegal death investigation. Postmortem CT showed a saddle pulmonary embolus that was confirmed on conventional autopsy, demonstrating a natural manner of death.

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Time-Varying Noise Statistic Estimator Based Adaptive Simplex Cubature Kalman Filter

To address the problem that filtering accuracy is reduced with the inaccurate time-varying noise statistic in conventional cubature Kalman filter, a noise statistic estimator based adaptive simplex cubature Kalman filter is put forward in this paper. First, the simplex cubature rule is adopted to approximate the intractable nonlinear Gaussian weighted integral in the filter. Secondly, a suboptimal unbiased constant noise statistic estimator is derived based on the maximum a posteriori estimation criterion. For the time-varying noise, the above estimator is modified using an exponential weighted attenuation method to realize the oblivion of stale data which results in a fading memory estimator, which has the ability to estimate the time-varying noise statistic to revise the filter online. The simulation results indicate that the proposed filter can achieve higher accuracy than conventional filters with inaccurate noise statistic.

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VCH-ECCR: A Centralized Routing Protocol for Wireless Sensor Networks

A wireless sensor network (WSN) is a collection of hundreds to thousands of compact, battery-operated sensors. It is deployed to accumulate useful information from the nearby environment. Depending upon the type of application, the sensors have to work for months to years with a finite energy source. In some extreme environments, the replacement of energy source is challenging and sometimes not feasible. Therefore, it is vital for sensors to perform their duties in an energy efficient way to improve the longevity of the network. This paper proposes an energy-efficient centralized cluster-based routing protocol called Vice-Cluster-Head-Enabled Centralized Cluster-based Routing protocol (VCH-ECCR). The VCH-ECCR uses a two-level hierarchy of vice cluster heads to use the energy of sensors efficiently and to cut back the frequency of the clustering. The performance of VCH-ECCR is compared with low-energy adaptive clustering hierarchy (LEACH), LEACH-Centralized (LEACH-C), and base station controlled dynamic clustering protocol (BCDCP). The experimental results show that the VCH-ECCR outperforms over its comparative in terms of network lifetime, overall energy consumption, and throughput.

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Natural Immunomodulators

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Bilevel Optimal Control, Equilibrium, and Combinatorial Problems with Applications to Engineering

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Characteristics of Winter Clouds and Precipitation over the Mountains of Northern Beijing

There are few studies which reported the characteristics of winter clouds and precipitation in the Haituo Mountains of Northern Beijing where the 2022 Winter Olympic Games will be held. This paper outlines comprehensive datasets, including the surface measurements, remote sensing and aircraft measurements, to study cloud and precipitation characteristics over the mountainous terrain. The analysis results show (1) high-level trough and vortex were the main weather system in all 12 cases. (2) 58% of precipitation occurred only at night, and only 8% of snowfall occurred only at daytime, but under the surface inverse trough snowfall (in 4 of the 12 cases) persisted from night to day peaking at 20 hours; Snowfall persisted at least 3 hours in 83% of the snowfall, 5–10 hours in 50% of cases, and more than 10 hours in 33% of the storms. In 67% of cases, the maximum snowfall occurred within the initial 1-2 hours. (3) In 12 cases, 83% of orographic clouds reached Yan Jiaping, after increased southwesterly winds, resulting in visibility below 100 m. (4) during snowfall, The dominant wind direction is southwest. The start of the snowfall corresponded with an increase in southwesterly wind. The snowfall is maintained according to with the strengthening of southwesterly wind and dissipated accordingly with the receding of southwesterly wind. Whenever the snowfall stopped, the northwest wind was strong at all heights. (5) The first peak value of integral liquid water appeared in the early stage of snow, and we also observed integral liquid water increases with orographic cloud uplift, presenting potentially favorable seeding opportunities in 10 cases. (6) The primary crystal habits collected at Yan Jiaping during steady snowfall were rimed and aggregated planar dendrites.

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A Pore Scale Flow Simulation of Reconstructed Model Based on the Micro Seepage Experiment

Researches on microscopic seepage mechanism and fine description of reservoir pore structure play an important role in effective development of low and ultralow permeability reservoir. The typical micro pore structure model was established by two ways of the conventional model reconstruction method and the built-in graphics function method of Comsol® in this paper. A pore scale flow simulation was conducted on the reconstructed model established by two different ways using creeping flow interface and Brinkman equation interface, respectively. The results showed that the simulation of the two models agreed well in the distribution of velocity, pressure, Reynolds number, and so on. And it verified the feasibility of the direct reconstruction method from graphic file to geometric model, which provided a new way for diversifying the numerical study of micro seepage mechanism.

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Accelerated Tooth Movement with Orthodontic Mini-Screws

This case report outlines the possibility of accelerated tooth movement with the combination of microosteoperforation and mini-screws. A 14-year-old male patient presented Class II malocclusion with maxillary incisor protrusion. Upper first premolars were extracted, and after leveling, accelerated canine distalization started. For pre- and postdistalization times, amount of distalization, periodontal health, and root resorption were assessed. Within the limitations of this case report, micro-osteoperforations with mini-screw have a potential for shortening the treatment time.

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Issue 10 for volume 23 is out

Read more...

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Demethylzeylasteral (ZST93) Inhibits Cell Growth and Enhances Cell Chemosensitivity to Gemcitabine in Human Pancreatic Cancer Cells via Apoptotic and Autophagic Pathways

Abstract

The overall 5-year survival rate of patients with human pancreatic cancer remains less than 8% because of its aggressive growth, early metastasis, and resistance to conventional chemoradiotherapy. It is essential to develop innovative and effective therapeutic agents to improve its prognosis. Demethylzeylasteral (ZST93) is a novel triterpenoid monomer extracted from the xylem of Tripterygium roots. This study aimed to assess the effects of ZST93 on cell proliferation and its role in the chemosensitivity to gemcitabine in human pancreatic cancer cells. The effects of ZST93 on cancer cell proliferation, cell cycle distribution, apoptosis and autophagy were evaluated in various human pancreatic cancer cell lines, and the anti-tumor effects of ZST93 alone and in combination with gemcitabine were identified in a xenograft mouse model. The results showed that ZST93 could inhibit the proliferation of pancreatic cancer cells and arrest cell cycle at G0/G1 phase by regulating the expression of Cyclin D1 and Cyclin A2. Moreover, ZST93 killed pancreatic cancer cells through two different mechanisms: inducing autophagic cell death at low concentrations and apoptotic cell death at high concentrations. Furthermore, ZST93 could enhance the chemosensitivity of pancreatic cancer cells to gemcitabine both in vitro and in vivo through modulation of the cross-talk between autophagy and apoptosis. ZST93 is a potential therapeutic agent for developing novel therapeutic strategies in human pancreatic cancer. This article is protected by copyright. All rights reserved.

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Impaired functional vitamin B6 status is associated with increased risk of lung cancer

Abstract

Circulating vitamin B6 levels have been found to be inversely associated with lung cancer. Most studies have focused on the B6 form pyridoxal 5'-phosphate (PLP), a direct biomarker influenced by inflammation and other factors. Using a functional B6 marker allows further investigation of the potential role of vitamin B6 status in the pathogenesis of lung cancer. We prospectively evaluated the association of the functional marker of vitamin B6 status, the 3-hydroxykynurenine:xanthurenic acid ratio (HK:XA), with risk of lung cancer in a nested case-control study consisting of 5,364 matched case control pairs from the Lung Cancer Cohort Consortium (LC3). We used conditional logistic regression to evaluate the association between HK:XA and lung cancer, and random effect models to combine results from different cohorts and regions. High levels of HK:XA, indicating impaired functional B6 status, were associated with an increased risk of lung cancer, the odds ratio comparing the fourth and the first quartiles (OR _4th vs _1st) was 1.25 [95% confidence interval, 1.10-1.41]. Stratified analyses indicated that this association was primarily driven by cases diagnosed with squamous cell carcinoma. Notably, the risk associated with HK:XA was approximately 50% higher in groups with a high relative frequency of squamous cell carcinoma, i.e. men, former and current smokers. This risk of squamous cell carcinoma was present in both men and women regardless of smoking status. This article is protected by copyright. All rights reserved.

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A Randomized Phase III Trial of Neoadjuvant Recombinant Human Endostatin, Docetaxel and Epirubicin as First-Line Therapy for Patients with Breast Cancer (CBCRT01)

Abstract

To further assess the efficacy and safety of recombinant human endostatin (rh-endostatin), a phase III, multicenter, prospective, randomized, controlled clinical trial was conducted. Patients to be treated with neoadjuvant docetaxel and epirubicin (DE) or DE plus rh-endostatin (DEE) were eligible for this trial. The primary endpoint was clinical/pathological response. Secondary endpoints included adverse events and quality of life (QOL). Finally, 803 patients were enrolled and randomly assigned to receive DE (n = 402) or DEE (n = 401) regimen. After 3 cycles of neoadjuvant therapy, CR achieved in 14.2% of patients in DEE group vs 6.7% in DE group, PR achieved in 76.8% vs 71.1%, while SD in 6.0% vs 18.9%, PD in 3.0% vs 3.2% of patients. The rate of objective response in DEE and DE group was 91.0% and 77.9%, respectively (P < 0.001). In spite of a relatively higher pCR achieved following the combination therapy, no significant difference was found between two arms. Adverse events were mostly of grade 1-2. No significant difference in adverse event and QOL was found between the two arms. In conclusion, the combination of chemotherapy and rh-endostatin achieved better outcomes than chemotherapy alone, and thus can be considered as a promising therapeutic strategy for breast cancer. This article is protected by copyright. All rights reserved.

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Seasonal variations in size distribution, water-soluble ions, and carbon content of size-segregated aerosols over New Delhi

Abstract

Size distribution, water-soluble inorganic ions (WSII), and organic carbon (OC) and elemental carbon (EC) in size-segregated aerosols were investigated during a year-long sampling in 2010 over New Delhi. Among different size fractions of PM₁₀, PM_0.95 was the dominant fraction (45%) followed by PM_3–7.2 (20%), PM_7.2–10 (15%), PM_0.95–1.5 (10%), and PM_1.5–3 (10%). All size fractions exceeded the ambient air quality standards of India for PM_2.5. Annual average mass size distributions of ions were specific to size and ion(s); Ca²⁺, Mg²⁺, K⁺, NO₃⁻, and Cl⁻ followed bimodal distribution while SO₄²⁻ and NH₄⁺ ions showed one mode in PM_0.95. The concentrations of secondary WSII (NO₃⁻, SO₄²⁻, and NH₄⁺) increased in winters due to closed and moist atmosphere whereas open atmospheric conditions in summers lead to dispersal of pollutants. NH₄⁺and Ca²⁺were dominant neutralization ions but in different size fractions. The summer-time dust transport from upwind region by S SW winds resulted in significantly high concentrations of PM_0.95 and PM_3–7.2 and PM_7.2–10. This indicted influence of dust generation in Thar Desert and its transport is size selective in nature in downwind direction. The mixing of different sources (geogenic, coal combustions, biomass burning, plastic burning, incinerators, and vehicular emissions sources) for soluble ions in different size fractions was noticed in principle component analysis. Total carbon (TC = EC + OC) constituted 8–31% of the total PM_0.95 mass, and OC dominated over EC. Among EC, char (EC1) dominated over soot (EC2 + EC3). High SOC contribution (82%) to OC and OC/EC ratio of 2.7 suggested possible role of mineral dust and high photochemical activity in SOC production. Mass concentrations of aerosols and WSII and their contributions to each size fraction of PM₁₀ are governed by nature of sources, emission strength of source(s), and seasonality in meteorological parameters.

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Acknowledgement to Referees

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Current management of lipoblastoma

Abstract

Lipoblastoma is a rare and benign tumor arising from embryonal fat cells. It is generally diagnosed in children younger than 3 years of age and can occur in the extremities or on the trunk. We present our series of 10 children with lipoblastoma treated at Schneider Children’s Medical Center of Israel between 2011 and 2016. Six boys and four girls underwent tumor resection at a median age of 2 years and 3 months (range 5 months to 5.6 years). Locations were trunk (6), groin (2), perineum (1), and omentum (1). Follow up ranges from 1 to 5 years. Two patients had a local recurrence and required a second resection 2 years (perineal) and 6 years (trunk) after the first surgery without further recurrence at 1.9 and 2.9 years, respectively.

Conclusion: Higher awareness of lipoblastoma enables optimal imaging strategies and resection. Long follow up is required due to local recurrences. The treatment of choice consists of complete, but non mutilating surgical resection.

What is Known: • Lipoblastoma is a rare benign tumor of fatty tissue affecting children • Treatment consists of surgical resection

What is New: • MRI is the modality of choice for follow up • Ten-year long-term follow up is required due to late recurrence

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