Τρίτη, 27 Φεβρουαρίου 2018

Review of reduction factors by buildings for gamma radiation from radiocaesium deposited on the ground due to fallout

Publication date: July 2018
Source:Journal of Environmental Radioactivity, Volume 187
Author(s): Hiroko Yoshida-Ohuchi, Norihiro Matsuda, Kimiaki Saito
In order to estimate residents' external dose due to radionuclide exposure resulting from fallout deposit on the ground, the shielding and dose reduction effects provided by structures such as houses and workplaces are taken into account as most individuals spend a large portion of their time indoors. Many works on both calculation and measurement for European and American settlements have been reported and factors such as, shielding factors, protection factors, reduction factors, and location factors have been determined. However, measurement data for Japanese settlements are lacking. Thus, the Japanese government used reduction factors given in the International Atomic Energy Agency documents from American and European settlements when Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident occurred. The United Nations Scientific Committee on the Effects of Atomic Radiation used location factors from European settlements for the same reason. Soon after the FDNPP accident, several measurements and calculations were performed to obtain specific reduction factors for Japanese settlements due to this lack of data. This research reviews previous studies that determined factors such as, shielding factors, protection factors, reduction factors, and location factors and summarizes specific results for Japan. We discuss the issues in determining these factors and in applying them to estimate indoor dose. The contribution of surface contamination to the indoor ambient dose equivalent rate is also discussed.



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7Be concentration in the near-surface layer of the air in Bialystok (north-eastern Poland) in the years 1992–2010

Publication date: July 2018
Source:Journal of Environmental Radioactivity, Volume 187
Author(s): Jacek Kapała, Maria Karpińska, Stanisław Mnich, Anna Gromotowicz-Popławska, Grzegorz Kulesza
Weekly measurements of air 7Be concentrations (n = 769) were performed in the years 1992–2010 in Bialystok (north-eastern Poland) using gamma spectrometry. The arithmetic mean (AM) concentration of 7Be was 2.51 mBq m−3, and the median (M) was 2.24 mBq m−3 (range 0.47–7.81 mBq m−3). The observed 7Be concentrations were within the range of levels recorded in Europe. Typical seasonal variability was observed. Concentrations of 7Be in the warm season (May, June, July) were almost twice as high as those in the cold season (November, December, January).A correlation was found between weekly 7Be concentrations and mean weekly values of relative humidity, temperature, and wind speed throughout the observation period. Pearson's correlation coefficients were −0.63, p < 0.001; 0.477, p < 0.001; −0.288, p < 0.001, respectively.The correlation coefficient between sunspot number and mean annual 7Be concentrations in the air in the years 1992–2010 was −0.609.



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Imaging biomarkers of outcome after radiotherapy for pediatric ependymoma

Ependymoma is the third most common brain tumor in children. Radiation therapy (RT) is systematically administered after maximum surgical resection, utilizing recent advances in radiation delivery. Imaging can make a significant contribution to improving treatment outcome. This prompted us to look for significant preoperative and postoperative imaging markers for survival.

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Cystic Lung Disease from Protein Deposition: Pathogenesis and Associated Conditions

Abstract

Purpose of Review

We explicate the development of cystic lung disease from the deposition of protein in the lung. The protein may be in the form of amyloid or non-amyloid (typically immunoglobulin-associated light chains) and is usually seen in the context of three entities: idiopathic light-chain deposition disease, Sjogren's syndrome, and clonal lymphoplasmacytic proliferative disorders. A commonly observed and distinctive feature of the circumscribed cystic spaces is the presence of internal tissue septations.

Recent Findings

The traditional causal association of lung cysts and the pathologic entity of lymphocytic interstitial pneumonitis is untenable. Instead, the development of cysts as a consequence of the degradation of lung extracellular matrix by metalloproteinases, the process initiated with the accumulation of macrophages around deposited protein, is a compelling alternative explanation.

Summary

Lung cysts may be a consequence of parenchymal protein deposition. When internal septations are present, this particular pathogenesis should explicitly be considered, and the presence of associated clinical disorders further pursued.



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Thoracic Infections in Immunocompromised Patients

Abstract

Purpose of Review

The purpose of this review is to summarize the imaging findings of thoracic infections occurring in immunocompromised patients. Lung infection remains one of the most common complications in immunocompromised patients and is one of the major contributors to morbidity and mortality. Imaging examinations are frequently performed in immunocompromised patients suspected of having chest infection. This review primarily illustrates the CT findings of lung infection. Early detection is important because these patients can rapidly develop fulminant disease.

Recent Findings

The imaging findings of a variety of pulmonary infections have been described, and it is well recognized that there is significant overlap of imaging findings across a variety of infections. However, the presence or absence of certain findings can favor one type of infection over another, especially when clinical factors are taken into consideration.

Summary

Radiologists play a central role in identifying chest infections in immunocompromised patients. Knowledge of the association between specific infections and specific types of immunodeficiency can aid the radiologist in providing a focused differential diagnosis. Furthermore, knowledge of noninfectious complications such as drug reaction or neoplasm can help guide patient management.



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IJMS, Vol. 19, Pages 663: Detection of Aggregation-Competent Tau in Neuron-Derived Extracellular Vesicles

IJMS, Vol. 19, Pages 663: Detection of Aggregation-Competent Tau in Neuron-Derived Extracellular Vesicles

International Journal of Molecular Sciences doi: 10.3390/ijms19030663

Authors: Francesc Guix Grant Corbett Diana Cha Maja Mustapic Wen Liu David Mengel Zhicheng Chen Elena Aikawa Tracy Young-Pearse Dimitrios Kapogiannis Dennis Selkoe Dominic Walsh

Progressive cerebral accumulation of tau aggregates is a defining feature of Alzheimer’s disease (AD). A popular theory that seeks to explain the apparent spread of neurofibrillary tangle pathology proposes that aggregated tau is passed from neuron to neuron. Such a templated seeding process requires that the transferred tau contains the microtubule binding repeat domains that are necessary for aggregation. While it is not clear how a protein such as tau can move from cell to cell, previous reports have suggested that this may involve extracellular vesicles (EVs). Thus, measurement of tau in EVs may both provide insights on the molecular pathology of AD and facilitate biomarker development. Here, we report the use of sensitive immunoassays specific for full-length (FL) tau and mid-region tau, which we applied to analyze EVs from human induced pluripotent stem cell (iPSC)-derived neuron (iN) conditioned media, cerebrospinal fluid (CSF), and plasma. In each case, most tau was free-floating with a small component inside EVs. The majority of free-floating tau detected by the mid-region assay was not detected by our FL assays, indicating that most free-floating tau is truncated. Inside EVs, the mid-region assay also detected more tau than the FL assay, but the ratio of FL-positive to mid-region-positive tau was higher inside exosomes than in free solution. These studies demonstrate the presence of minute amounts of free-floating and exosome-contained FL tau in human biofluids. Given the potential for FL tau to aggregate, we conclude that further investigation of these pools of extracellular tau and how they change during disease is merited.



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Evaluation of eczema, asthma, allergic rhinitis and allergies among the Grade-1 children of Iqaluit

Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas.

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Retraction



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Retraction



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RT @FionaRawlinson1 : HINDI version of the 20 FREE e-learning modules for palliative care in India and the case based discussions now laun…

RT @FionaRawlinson1 : HINDI version of the 20 FREE e-learning modules for palliative care in India and the case based discussions now laun…

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Watch Prof Gordon McVie, founding editor of ecancer, discuss the highlights from https://t.co/Y8RR24m04D for the mo… https://t.co/QY6zfh7Cw3

Watch Prof Gordon McVie, founding editor of ecancer, discuss the highlights from https://t.co/Y8RR24m04D for the mo… https://t.co/QY6zfh7Cw3

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“The Notion of Neutrality in Clinical Ethics Consultation”

Clinical ethics consultation (CEC), as an activity that may be provided by clinical ethics committees and consultants, is nowadays a well-established practice in North America. Although it has been increasingl...

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David Oliver: What might Health Education England’s workforce strategy mean for doctors?

It may seem extraordinary but, in the NHS’s entire history, we’ve never seen anything resembling a comprehensive, medium term workforce strategy. The NHS has tended to rely rather complacently on...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=b-6ICdgM2ts:eIsnEQawz1I:V_sGLiP recent?d=qj6IDK7rITs recent?i=b-6ICdgM2ts:eIsnEQawz1I:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=b-6ICdgM2ts:eIsnEQawz1I:F7zBnMy recent?i=b-6ICdgM2ts:eIsnEQawz1I:-BTjWOF


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BMA responds to articles on assisted dying

The BMA recognises that a range of views on physician assisted dying exist, both from the public and within the profession.In response to your series of articles on the subject in February’s...
recent?d=yIl2AUoC8zA recent?d=dnMXMwOfBR0 recent?i=M5RVVajSw68:1XdLr8mhzjg:V_sGLiP recent?d=qj6IDK7rITs recent?i=M5RVVajSw68:1XdLr8mhzjg:gIN9vFw recent?d=l6gmwiTKsz0 recent?d=7Q72WNTAKBA recent?i=M5RVVajSw68:1XdLr8mhzjg:F7zBnMy recent?i=M5RVVajSw68:1XdLr8mhzjg:-BTjWOF


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New study shows repurposing leukaemia drugs may prevent melanoma metastasis

Data from a new study led by University of Kentucky Markey Cancer Center researchers shows that repurposing drugs used to treat leukaemia has promise for preventing melanoma metastasis. Published in Science Signalling, the study showed new evidence...

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Anatomy of the right colic vein and pancreaticoduodenal branches: a surgical landmark for laparoscopic complete mesocolic excision of the right colon.

Anatomy of the right colic vein and pancreaticoduodenal branches: a surgical landmark for laparoscopic complete mesocolic excision of the right colon.

Surg Radiol Anat. 2018 Feb 26;:

Authors: Osawa T, Komatsu S, Ishiguro S, Sano T

Abstract
PURPOSE: Knowledge of mesenteric venous anatomy is important to safely perform laparoscopic complete mesocolic excision (CME) of the right colon. Despite their previously reported diversity, consistent features of the right colonic and pancreatic veins can be discerned. The objective of this study was to evaluate anatomical consistency of the right colic vein (RCV) and the pancreaticoduodenal vein associated with the colic vein (PDV-C).
METHODS: This study included 125 consecutive patients undergoing contrast-enhanced multidetector-row CT of the abdomen. Images of 100 of these cases were retrospectively reviewed for the positioning of the colonic, gastric and pancreatic veins associated with the superior mesenteric vein (SMV). RCV were classified as three types: Type-I, running on the ventral aspect of the pancreatic head and draining into the right lateral wall of the SMV; Type-II, running apart from the pancreatic head and directly draining into the SMV; and Type-III, draining into the tributaries of the SMV.
RESULTS: The RCV was identified in 88% of cases, in which the frequencies of Type-I, -II and -III anatomies were 84.1, 9.1, and 6.8%, respectively. All of the Type-I RCVs formed a common trunk with other veins, including the gastroepiploic vein (93.2%) and the superior RCV (59.5%). The PDV-C joined the RCV in 63.5% of the Type-I cases.
CONCLUSIONS: Anatomical consistency of the RCV together with the PDV-C is present in the majority of cases. Our findings support the view that the appearance of the veins is a useful landmark for laparoscopic CME of the right colon.

PMID: 29480372 [PubMed - as supplied by publisher]



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health technology; +328 new citations

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

health technology

These pubmed results were generated on 2018/02/27

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



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Radioactive iodine: An unappreciated threat to salivary gland function.

Radioactive iodine: An unappreciated threat to salivary gland function.

Oral Dis. 2018 Mar;24(1-2):198-201

Authors: Sunavala-Dossabhoy G

Abstract
Thyroid cancer is an endocrine malignancy whose prevalence is increasing in the United States. Nearly 57,000 new cases of thyroid cancer are estimated to be diagnosed in 2017. The standard of care for differentiated thyroid cancer is thyroidectomy followed by ablation of thyroid remnants with high-dose radioactive iodine (131 I). Apart from thyroid glands, 131 I accumulates in cells of salivary glands and compromises its function. Xerostomia is, therefore, a frequent and often persistent complaint of patients. Despite adoption of standard preventive measures, parenchymal damage and chronic salivary dysfunction are observed in a substantial number of patients. Saliva is important for oral homeostasis, and its reduction increases the risk of oral morbidity. As differentiated thyroid cancer patients have an excellent survival rate, preservation of salivary gland function carries added significance. A focus on treatments that preserve or restore long-term salivary flow can significantly improve the quality of life of thyroid cancer survivors.

PMID: 29480611 [PubMed - in process]



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Multicomponent Aqueous Synthesis of Iodo-1,2,3-triazoles: Single-Step Models for Dual Modification of Free Peptide and Radioactive Iodo Labeling.

Related Articles

Multicomponent Aqueous Synthesis of Iodo-1,2,3-triazoles: Single-Step Models for Dual Modification of Free Peptide and Radioactive Iodo Labeling.

Chemistry. 2017 Jan 23;23(5):1166-1172

Authors: Li L, Ding S, Yang Y, Zhu A, Fan X, Cui M, Chen C, Zhang G

Abstract
Iodo-1,2,3-triazoles are of considerable interest for chemical and biomedical applications. However, current synthetic methods for preparing iodo-1,2,3-triazoles cannot easily be applied to the direct modification of bioactive molecules in water. Through the combination of water-compatible oxidative iodination and the copper-catalyzed alkyne-azide cycloaddition reaction, a novel copper-catalyzed aqueous multicomponent synthetic method for the preparation of 5-iodo-1,2,3-triazoles has been developed. The method is highly effective and selective for substrates including biologically relevant compounds with nucleoside, sugar, and amino acid moieties. Based on this aqueous tandem reaction, a direct single-step multicomponent dual modification of peptide is developed from readily available starting materials. Furthermore, the method could also be applied to concise and fast multicomponent radioactive 125 I labeling from an aqueous solution of commercially available sodium 125 iodide as a starting material.

PMID: 27862485 [PubMed - indexed for MEDLINE]



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These strange lines of cloud are seeded by pollution from ships

Much as an aeroplane leaves contrails, streaks of white cloud condense onto the tiny particles thrown into the air by the exhausts of travelling ships

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IJERPH, Vol. 15, Pages 406: Regional Assessment of Temperature-Related Mortality in Finland

IJERPH, Vol. 15, Pages 406: Regional Assessment of Temperature-Related Mortality in Finland

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph15030406

Authors: Reija Ruuhela Otto Hyvärinen Kirsti Jylhä

The aim of this study was to assess regional differences in temperature–mortality relationships across 21 hospital districts in Finland. The temperature dependence of the daily number of all-cause, all-aged deaths during 2000–2014 was studied in each hospital district by using daily mean temperatures, spatially averaged across each hospital district, to describe exposure to heat stress and cold stress. The relationships were modelled using distributed lag non-linear models (DLNM). In a simple model version, no delayed impacts of heat and cold on mortality were taken into account, whereas a more complex version included delayed impacts up to 25 days. A meta-analysis with selected climatic and sociodemographic covariates was conducted to study differences in the relationships between hospital districts. A pooled mortality-temperature relationship was produced to describe the average relationship in Finland. The simple DLNM model version without lag gave U-shaped dependencies of mortality on temperature almost without exception. The outputs of the model version with a 25-day lag were also U-shaped in most hospital districts. According to the meta-analysis, the differences in the temperature-mortality relationships between hospital districts were not statistically significant on the absolute temperature scale, meaning that the pooled mortality–temperature relationship can be applied to the whole country. However, on a relative temperature scale, heterogeneity was found, and the meta-regression suggested that morbidity index and population in the hospital districts might explain some of this heterogeneity. The pooled estimate for the relative risk (RR) of mortality at a daily mean temperature of 24 °C was 1.16 (95% CI 1.12–1.20) with reference at 14 °C, which is the minimum mortality temperature (MMT) of the pooled relationship. On the cold side, the RR at a daily mean temperature of −20 °C was 1.14 (95% CI 1.12–1.16). On a relative scale of daily mean temperature, the MMT was found at the 79th percentile.



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Indeterminate Adnexal Cysts at US: Prevalence and Characteristics of Ovarian Cancer.

Indeterminate Adnexal Cysts at US: Prevalence and Characteristics of Ovarian Cancer.

Radiology. 2018 Feb 26;:172271

Authors: Sadowski EA, Paroder V, Patel-Lippmann K, Robbins JB, Barroilhet L, Maddox E, McMahon T, Sampene E, Wasnik AP, Blaty AD, Maturen KE

Abstract
Purpose To assess the prevalence of indeterminate adnexal cysts in women presenting to academic medical centers for pelvic ultrasonography (US), determine the incidence of malignancy, and identify cyst and patient characteristics that are predictive of malignancy. Materials and Methods A multicenter study of US-detected adnexal cysts with appropriate follow-up (surgical pathologic examination, imaging and/or clinical examination) was conducted from January 2008 to June 2012. Indeterminate cysts were classified as category 1 (typical benign appearing cysts >5 cm) or category 2 (cysts with avascular solid components) on the basis of a combination of definitions in the existing literature. The incidence of neoplasms and malignant tumors was calculated. Patient and cyst characteristics associated with neoplasm and malignant tumors were evaluated with the χ2 test or Fisher exact test for categorical variables and the t test for continuous variables. A backward stepwise logistic regression model was performed for two outcomes: (a) the presence of any neoplasm (benign or malignant) and (b) the presence of a malignant tumor. Results There were 1637 women with an adnexal cyst at US; 391 (mean age = 41.8 years ± 13.5.1; range = 17-91 years) had an indeterminate adnexal cyst at US. The prevalence of indeterminate adnexal cysts was 23.9% (391 of 1637; 95% confidence interval [CI]: 0.22, 0.26). Three hundred three indeterminate cysts in 280 women (mean age = 42.9 years ± 14.1; range = 17-88 years) had adequate follow-up. The incidence of ovarian neoplasms (benign and malignant) was 24.8% (75 of 303 cysts; 95% CI: 0.20, 0.30), and the incidence of malignant tumors was 3.6% (11 of 303 cysts; 95% CI: 0.02, 0.06). The proportion of ovarian neoplasms differed between category 1 and category 2 cysts (17.5% [25 of 143 cysts; 95% CI: 0.12, 0.25] vs 31.3% [50 of 160 cysts; 95% CI: 0.24, 0.39], respectively; P = .001). The proportion of malignant tumors differed between categories 1 and 2 cysts (0% [0 of 143 cysts] vs 6.9% [11 of 160 cysts; 95% CI: 0.03, 0.12]; P < .001). The presence of an avascular nodular component was a significant predictor of malignancy at stepwise logistic regression analysis (odds ratio = 2.83; P ≤ .0001; 95% CI: 1.69, 4.70). Conclusion The presence of an avascular nodular component was the most significant predictor of the presence of malignancy in indeterminate adnexal cysts. The risk of malignancy is higher with category 2 cysts than with category 1 cysts. © RSNA, 2018.

PMID: 29480762 [PubMed - as supplied by publisher]



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Sports Injuries at the Rio de Janeiro 2016 Summer Olympics: Use of Diagnostic Imaging Services.

Sports Injuries at the Rio de Janeiro 2016 Summer Olympics: Use of Diagnostic Imaging Services.

Radiology. 2018 Feb 26;:171510

Authors: Guermazi A, Hayashi D, Jarraya M, Crema MD, Bahr R, Roemer FW, Grangeiro J, Budgett RG, Soligard T, Domingues R, Skaf A, Engebretsen L

Abstract
Purpose To describe the occurrence of imaging-depicted sports-related stress injuries, fractures, and muscle and tendon disorders during the 2016 Summer Olympic Games in Rio de Janeiro, Brazil. Materials and Methods Data on radiologic examinations were collected and retrospectively analyzed centrally by two board-certified musculoskeletal radiologists (with a third musculoskeletal radiologist acting as an adjudicator in case of discrepancies). Descriptive data on all imaging examinations by using radiography, ultrasonography (US), and magnetic resonance (MR) imaging were collected and analyzed according to imaging modality, country of origin of the athletes, type of sport, and type and location of injury. Results There were 1101 injuries that occurred in 11 274 (9.8%) athletes. A total of 1015 radiologic examinations were performed, including 304 (30.0%) radiographic, 104 (10.2%) US, and 607 (59.8%) MR examinations. Excluding 10 athletes categorized as refugees, athletes from Africa had the highest utilization rate (14.8%, 148 of 1001). Athletes from Europe underwent the most examinations with 103 radiographic, 39 US, and 254 MR examinations. Gymnastics (artistic) had the highest percentage of athletes who underwent imaging (15.5%, 30 of 194). Athletics (track and field) had the most examinations (293, including 53 radiographic, 50 US, and 190 MR examinations). Conclusion The overall occurrence of imaging used to help diagnose sports-related injuries at the Rio de Janeiro 2016 Summer Olympics was 6.4% of athletes. In these cases, MR imaging comprised 60% of imaging utilization. © RSNA, 2018 Online supplemental material is available for this article.

PMID: 29480758 [PubMed - as supplied by publisher]



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Abnormal functional connectivity density in sleep-deprived subjects

Abstract

Sleep deprivation (SD) can alter the intrinsic brain functional organization. However, its effects on intrinsic low-frequency connectivity in the whole brain have not been well characterized. In this study, we used voxel-based functional connectivity density (FCD) analysis to investigate the effects of SD on the spontaneous functional organization of the brain. Thirty-seven healthy participants underwent this within-subject crossover functional magnetic resonance imaging (fMRI) study during rested wakefulness (RW) and after 36 h of total sleep deprivation (TSD). Decreased long-/short-range FCDs were observed in the posterior cingulate cortex, precuneus, inferior parietal lobule, dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and ventromedial prefrontal cortex. Increased long-/short-range FCDs were found in the sensory integration and arousal regulating areas, including the postcentral gyrus, thalamus, superior temporal gyrus, and occipital-temporal cortex. Moreover, a significant negative correlation was found between the short-range FCD of the PCC and the reaction time of Psychomotor Vigilance Task. In the present study, spontaneous functional organization with significant group-wise differences between RW and TSD sessions was identified. Our findings extend our understanding of the neural mechanism of how brain activity is altered in sleep-deprived individuals.



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Table of Contents, Editor's Choice, Highlights



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Cover Image, Volume 233, Number 6, June 2018

Thumbnail image of graphical abstract

Cover: The cover image, by Ji Hu et al., is based on the Mini - Review Progress and prospects of circular RNAs in Hepatocellular carcinoma: Novel insights into their function DOI: 10.1002/jcp.26154.



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Microenvironment dependent gene expression signatures in reprogrammed human colon normal and cancer cell lines

Since the first evidence suggesting existence of stem-like cancer cells, the process of cells reprogramming to the stem cell state remains as an attractive tool for cancer stemness research. Current knowledge ...

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High-level cytoplasmic claudin 3 expression is an independent predictor of poor survival in triple-negative breast cancer

The subtype of claudin-low breast cancer can be reliably determined only by gene-expression profiling. Attempts have been made to develop immunohistochemical surrogates, which nearly always focus on membranous...

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Gap junctions contribute to anchorage-independent clustering of breast cancer cells

Cancer cell aggregation is a key process involved in the formation of clusters of circulating tumor cells. We previously reported that cell-cell adhesion proteins, such as E-cadherin, and desmosomal proteins a...

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Principles of ultrasound elastography

Abstract

Tissue stiffness has long been known to be a biomarker of tissue pathology. Ultrasound elastography measures tissue mechanical properties by monitoring the response of tissue to acoustic energy. Different elastographic techniques have been applied to many different tissues and diseases. Depending on the pathology, patient-based factors, and ultrasound operator-based factors, these techniques vary in accuracy and reliability. In this review, we discuss the physical principles of ultrasound elastography, discuss differences between different ultrasound elastographic techniques, and review the advantages and disadvantages of these techniques in clinical practice.



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Risk Stratification of Oral Potentially Malignant Disorders in Fanconi Anemia Patients Using Autofluorescence Imaging and Cytology-On-A Chip Assay.

Risk Stratification of Oral Potentially Malignant Disorders in Fanconi Anemia Patients Using Autofluorescence Imaging and Cytology-On-A Chip Assay.

Transl Oncol. 2018 Feb 23;11(2):477-486

Authors: Abram TJ, Pickering CR, Lang AK, Bass NE, Raja R, Meena C, Alousi AM, Myers JN, McDevitt JT, Gillenwater AM, Vigneswaran N

Abstract
Fanconi anemia (FA) is a hereditary genomic instability disorder with a predisposition to leukemia and oral squamous cell carcinomas (OSCCs). Hematopoietic stem cell transplantation (HSCT) facilitates cure of bone marrow failure and leukemia and thus extends life expectancy in FA patients; however, survival of hematologic malignancies increases the risk of OSCC in these patients. We developed a "cytology-on-a-chip" (COC)-based brush biopsy assay for monitoring patients with oral potentially malignant disorders (OPMDs). Using this COC assay, we measured and correlated the cellular morphometry and Minichromosome Maintenance Complex Component 2 (MCM2) expression levels in brush biopsy samples of FA patients' OPMD with clinical risk indicators such as loss of autofluorescence (LOF), HSCT status, and mutational profiles identified by next-generation sequencing. Statistically significant differences were found in several cytology measurements based on high-risk indicators such as LOF-positive and HSCT-positive status, including greater variation in cell area and chromatin distribution, higher MCM2 expression levels, and greater numbers of white blood cells and cells with enlarged nuclei. Higher OPMD risk scores were associated with differences in the frequency of nuclear aberrations and differed based on LOF and HSCT statuses. We identified mutation of FAT1 gene in five and NOTCH-2 and TP53 genes in two cases of FA patients' OPMD. The high-risk OPMD of a non-FA patient harbored FAT1, CASP8, and TP63 mutations. Use of COC assay in combination with visualization of LOF holds promise for the early diagnosis of high-risk OPMD. These minimally invasive diagnostic tools are valuable for long-term surveillance of OSCC in FA patients and avoidance of unwarranted scalpel biopsies.

PMID: 29481998 [PubMed - as supplied by publisher]



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A novel dual-luciferase assay for anti-HIV drug screening based on the CCR5/CXCR4 promoters.

A novel dual-luciferase assay for anti-HIV drug screening based on the CCR5/CXCR4 promoters.

J Virol Methods. 2018 Feb 23;:

Authors: Feng L, Lu W, Ma Y, Guo W, Wang Y, Sun Q, Wu J, Zhao G, Zhang X

Abstract
Acquired immunodeficiency syndrome (AIDS) is a serious worldwide disease caused by infection with the human immunodeficiency virus (HIV). C-C chemokine receptor 5 (CCR5) and C-X-C chemokine receptor 4 (CXCR4) are important coreceptors mediating HIV-1 cell entry. Many new anti-HIV drugs are currently in preclinical and clinical trials; however, drug development has proceeded slowly partly because of the lack of a high-throughput system to screen these drugs. Here, we describe the development of a novel dual-luciferase assay using a CCR5/CXCR4 promoter-driven firefly and Renilla luciferase vector (pGL4.10-RLUC-CCR5 /CXCR4). Drugs were screened for the ability to regulate CCR5 and CXCR4 promoter activities. The CCR5 and CXCR4 promoters were inserted separately into the recombinant vector and transfected into the acute T lymphocyte leukemia cell line H9. Treatment of stable transfected cells with four traditional Chinese medicine compounds resulted in the dose-dependent inhibition of the CXCR4 and CCR5 promoter activities. The dual-luciferase reporter assay provides a rapid and direct method to screen anti-AIDS/HIV drugs.

PMID: 29481882 [PubMed - as supplied by publisher]



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The impact of adjuvant chemoradiotherapy timing on survival of head and neck cancers.

The impact of adjuvant chemoradiotherapy timing on survival of head and neck cancers.

Laryngoscope. 2018 Feb 26;:

Authors: Tam M, Wu SP, Gerber NK, Lee A, Schreiber D, Givi B, Hu K

Abstract
BACKGROUND: Delays in postoperative head and neck (HN) radiotherapy have been associated with decreased overall survival; however, the impact of delays in postoperative HN chemoradiotherapy remains undefined.
METHODS: All patients with nonmetastatic HN cancer (oral cavity, oropharynx, larynx, hypopharynx) who underwent curative intent surgery and received adjuvant chemoradiotherapy were identified from the National Cancer Database (2005-2012). Overall treatment time (OTT) was defined as the time from surgery to the end of radiation therapy. Statistical methods included Cox proportional hazards modeling, which adjusted for clinicopathologic, demographic, and socioeconomic factors. Recursive partitioning analysis (RPA) identified the optimal threshold of OTT via conditional inference trees to estimate the greatest differences in overall survival (OS) on the basis of randomly selected training and validation sets.
RESULTS: A total of 16,733 patients were included, with a median follow-up of 37 months. Median OS for OTT in a predefined threshold of ≤ 13 weeks was 10.1 years (95% confidence interval [CI], 9.8 years; not reached) compared with 8.7 years (95% CI, 8.2-9.2 years) in > 13 weeks. On multivariate analysis, OTT of > 13 weeks versus ≤ 13 weeks independently increased mortality risk (hazard ratio, 1.10; 95% CI, 1.04-1.17; P = < 0.001). RPA identified an optimal OTT threshold of 97 days (interquartile range: 96-98 days). The OTT threshold of 97 days was confirmed in a full Cox regression model estimating the risk of death according to overall treatment time as a continuous variable.
CONCLUSION: In this large hospital-based national data, an OTT of greater than approximately 14 weeks most consistently increased the risk of death.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2018.

PMID: 29481712 [PubMed - as supplied by publisher]



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Unilateral radiotherapy treatment for p16/human papillomavirus-positive squamous cell carcinoma of unknown primary in the head and neck.

Unilateral radiotherapy treatment for p16/human papillomavirus-positive squamous cell carcinoma of unknown primary in the head and neck.

Laryngoscope. 2018 Feb 26;:

Authors: Tiong A, Rischin D, Young RJ, Herschtal A, Solomon B, D'Costa I, Fua T, Liu C, Coleman A, Kleid S, Dixon BJ, Corry J

Abstract
OBJECTIVES/HYPOTHESIS: The outcomes of unilateral radiotherapy treatment for patients with p16/HPV-positive squamous cell carcinomas of unknown primary (SCCUP) affecting cervical lymph nodes are under-reported. Compared to radiating large volumes of the pharyngeal axis (the more common approach), this is potentially a much less toxic treatment for a good prognosis group.
STUDY DESIGN: Retrospective cohort study.
METHODS: We identified patients with SCCUP who were treated radically at our center and did not have parotid or isolated level IV or V nodal involvement. Failure-free and overall survivals were calculated using Kaplan-Meier methods.
RESULTS: From 2004 to 2012, there were 49 radically treated patients with SCCUP. Fourteen patients had bilateral neck treatment (they had bilateral nodal disease or suspected lesions in the base of tongue, though not proven with biopsy), two had surgery alone, whereas 33 had unilateral radiotherapy (after neck dissection, excisional biopsy, or definitively with concurrent chemotherapy). Of the 33 patients, 21 tested positive to p16/HPV and had median follow-up of 57 months. In this group, no isolated contralateral neck failures or putative primaries emerged. There was 1/21 (4.3%) ipsilateral neck failure, 1/21 (4.3%) concurrent contralateral neck and distant failure, and 1/21 (4.3%) patient with distant failure. The 5-year freedom from failure was 78% (95% confidence interval [CI]: 56%-100%) and overall survival was 90% (95% CI: 79%-100%).
CONCLUSIONS: With no emergence of putative primaries and no isolated contralateral neck failures, this single-institution experience in p16/HPV-positive SCCUP patients suggests that unilateral radiotherapy may be an underutilized management strategy.
LEVELS OF EVIDENCE: 4 Laryngoscope, 2018.

PMID: 29481710 [PubMed - as supplied by publisher]



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Utility of the bow and lean test in predicting subtype of benign paroxysmal positional vertigo.

Utility of the bow and lean test in predicting subtype of benign paroxysmal positional vertigo.

Laryngoscope. 2018 Feb 26;:

Authors: Choi S, Choi HR, Nahm H, Han K, Shin JE, Kim CH

Abstract
OBJECTIVES/HYPOTHESIS: To investigate the role of the bow and lean test (BLT) in the diagnosis of benign paroxysmal positional vertigo (BPPV).
STUDY DESIGN: Retrospective case-control study.
METHODS: Between March 2015 and June 2017, we enrolled 113 patients with posterior semicircular canal (PSCC) BPPV, 74 patients with lateral semicircular canal (LSCC) canalolithiasis, 53 patients with LSCC cupulolithiasis, and 32 patients with light cupula. We retrospectively assessed bowing nystagmus (BN) and leaning nystagmus (LN).
RESULTS: In PSCC BPPV, 75% of the patients showed at least one of BN and LN, and direction of nystagmus provoked by a Dix-Hallpike test on the affected side was consistent with that of LN and opposite to that of BN. In LSCC canalolithiasis, 65% (48 of 74) of the patients showed both BN and LN, which were in the same direction in 38 patients (of 48) and in the opposite direction in 10 patients (of 48). The affected side can be determined according to the results of THE BLT in 74% (55 of 74) of LSCC canalolithiasis patients, and among them, the side determined according to the results of head-roll test was discordant with that according to the BLT in 20 of 55 patients (36%). In LSCC cupulopathy (n = 85), both BN and LN were persistent and observed in all cases, but we could not distinguish LSCC cupulolithiasis from light cupula according to nystagmus direction in the BLT.
CONCLUSIONS: Although a BLT yields better lateralization in LSCC canalolithiasis, it may be more useful in predicting the diagnosis and lateralization of PSCC BPPV than LSCC canalolithiasis.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2018.

PMID: 29481705 [PubMed - as supplied by publisher]



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Patterns of concurrent cigarette, alcohol, and e-cigarette use: Off-setting or additive behaviors?

Patterns of concurrent cigarette, alcohol, and e-cigarette use: Off-setting or additive behaviors?

Laryngoscope. 2018 Feb 26;:

Authors: Parikh AS, Bhattacharyya N

Abstract
OBJECTIVES: To understand nationwide concurrent use of e-cigarettes (Ecig) with alcohol and conventional cigarettes (Ccig), the major risk factors for head and neck cancer.
STUDY DESIGN: Cross-sectional analysis of nationally representative survey.
METHODS: The National Health Interview Surveys for 2014 and 2015 were analyzed for adult responses to specific questions regarding the daily frequency of alcohol, Ccig, and Ecig use. Statistical relationships between these social habits were determined.
RESULTS: A total of 241.1 million adults (raw N = 162,048) were surveyed (mean age 47.1 years, 51.8% female). Of those, 12.1% (29.2 million) and 3.8% (9.08 million) reported being every day Ccig users and some days Ccig users, respectively. A total of 2.3% (5.63 million) and 1.1% (2.76 million) reported being every day Ecig users and some days Ecig users, respectively. In addition, 58.4% of everyday Ecig users reported also being everyday Ccig users (P < 0.001). Furthermore, 25.6% (61.3 million) and 8.3% (20.0 million) of adults reported light drinking (1-3 drinks/week) and moderate/heavy drinking (4-7 drinks/week), respectively. Of the moderate/heavy drinkers, 17.7% were everyday Ccig users, whereas 12.2% of everyday Ccig users were moderate/heavy drinkers (P < 0.001). Among everyday Ecig users, 34.6% and 11.2% were light drinkers and moderate/heavy drinkers, respectively (P < 0.001). Among non-Ccig users, everyday Ecig users were likely to consume higher levels of alcohol given that 36.5% and 8.9% were light drinkers and moderate/heavy drinkers, respectively (P < 0.01).
CONCLUSION: We demonstrate a substantial level of Ccig use among moderate/heavy drinkers and Ecig users, as well as a novel independent association between Ecig and moderate/heavy alcohol use. These patterns of concurrent risk factor exposure should be considered when counseling patients who report Ecig use.
LEVEL OF EVIDENCE: 2b. Laryngoscope, 2018.

PMID: 29481701 [PubMed - as supplied by publisher]



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In response to Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes.

In response to Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes.

Laryngoscope. 2018 Feb 26;:

Authors: Iwata AJ, Williams AM, Chang SS, Taylor AR

PMID: 29481699 [PubMed - as supplied by publisher]



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Osseointegrated implants for auricular prostheses: An alternative to autologous repair.

Osseointegrated implants for auricular prostheses: An alternative to autologous repair.

Laryngoscope. 2018 Feb 26;:

Authors: Ryan MA, Khoury T, Kaylie DM, Crowson MG, Brown CS, McClennen J, Raynor EM

Abstract
OBJECTIVES/HYPOTHESIS: This study compares the hospital cost of osseointegrated implants for retention of an auricular prosthesis to autologous ear reconstruction.
STUDY DESIGN: Retrospective review.
METHODS: This study includes patients who underwent reconstruction for either congenital or acquired ear defects at Duke University Medical Center during 2009 to 2015.
RESULTS: A total of nine patients had autologous repair representing nine operative ears, and 16 patients had an osseointegrated implant representing 18 operative ears (two bilateral). The average age for the autologous repair was 11.6 years with 56% male versus 40.7 years with 56% male for the osseointegrated implant patients. For autologous patients, indications for surgery were anotia/microtia in 8/9 (89%) and trauma in 1/9 (11%) versus 6/16 (387.5%) anotia/microtia, 8/16 (50%) cancer, and 2/16 (132.5%) trauma in the osseointegrated implant group. The mean number of surgeries was 3.1 for autologous repairs and 1.0 for osseointegrated repairs (mean difference confidence interval [CI]: -2.4 to -1.8, P < .001). The average cost to the hospital for an osseointegrated repair was $6,491.39 versus $10,047.93 for autologous repairs (CI: $6,496.38 to $-616.68, P = .02) CONCLUSIONS: Osseointegrated implants for retaining an auricular prosthesis has a similar cost to autologous repair of ear defects, but patients underwent an average of two more surgeries with autologous repair. Patients should be able to choose the reconstruction option that best suits their condition and preferences.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2018.

PMID: 29481697 [PubMed - as supplied by publisher]



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Factors associated with benefit of active middle ear implants compared to conventional hearing aids.

Factors associated with benefit of active middle ear implants compared to conventional hearing aids.

Laryngoscope. 2018 Feb 26;:

Authors: McRackan TR, Clinkscales WB, Ahlstrom JB, Nguyen SA, Dubno JR

Abstract
OBJECTIVE: Identify factors associated with benefit of middle ear implants (MEIs) as compared to conventional hearing aids (HAs).
STUDY DESIGN: Independent review of audiological data from a multicenter prospective U.S. Food and Drug Administration (FDA) clinical trial. Preoperative and postoperative earphone, unaided/aided/implanted pure-tone thresholds, and word recognition scores were evaluated.
RESULTS: Ninety-one subjects were included in this study. Mean word recognition was better with MEIs than with HAs (81.8% ± 12.0% vs. 77.6% ± 14.6%, P = 0.035). Word recognition with MEIs showed a low positive correlation with word recognition measured with earphones (r = 0.25, P = 0.016) and a moderate positive correlation with aided word recognition (r = 0.42, P < 0.001). Earphone word recognition alone was not predictive of MEI benefit over HA benefit (r = 0.09, P = 0.41), unlike differences between scores with earphone and HAs (earphone-aided differences [EAD]) (r = 0.62, P < 0.011). As compared to those with -EADs, subjects with +EADs showed greater improvement in word recognition from unaided to implanted and from HAs to implanted (P < 0.0001). Using the 95% CI for word recognition scores, 16 subjects showed significantly higher scores with the MEI than with HAs. Of those, 14 had +EAD.
CONCLUSION: Word recognition benefit derived from conventional HAs and MEIs from this large, multi-center FDA trial provides further evidence of the importance of aided word recognition in clinical decision making, such as determining candidacy for and success with MEIs.
LEVEL OF EVIDENCE: 2b. Laryngoscope, 2018.

PMID: 29481695 [PubMed - as supplied by publisher]



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Decreasing Revision Surgery in FAMM Flap Reconstruction of the Oral Cavity: Traditional Versus Modified Harvesting Technique.

Decreasing Revision Surgery in FAMM Flap Reconstruction of the Oral Cavity: Traditional Versus Modified Harvesting Technique.

Laryngoscope. 2018 Feb 26;:

Authors: Ibrahim B, Rahal A, Bissada E, Christopoulos A, Moubayed SP, Guertin L, Tabet JC, Olivier MJ, Ayad T

Abstract
OBJECTIVE: To compare the surgical and functional outcomes between two harvesting techniques for the inferiorly based facial artery musculomucosal (FAMM) flap for oral cavity and oropharynx reconstructions.
METHODS: Multicenter retrospective chart review.
RESULTS: We reviewed 55 cases of FAMM flap, including 29 traditional cases and 26 performed using the modified harvesting method. The overall rate of surgical re-intervention in the traditional group was 31% (n = 9 of 29) and 15% (n = 4 of 26) in the modified group (P = 0.196). The specific re-intervention rate for pedicle sectioning was 27% (n = 8 of 29) in the traditional group versus 0% (n = 0 of 26) in the modified group. The overall rate of complications was 21%. Nine out of 10 dentate patients in the traditional group and four out of five in the modified group needed tooth extraction. There was no difference between the two groups in terms of tracheostomy duration (P = 0.338) and time to first oral intake (P = 0.629). Speech and feeding outcomes were similar among groups (P = 0.922; P = 0.700, respectively). Dental rehabilitation was achieved in 67% and 78% of patients in the traditional and modified groups, respectively.
CONCLUSION: The FAMM flap offers a low morbidity approach to reconstruct the oral cavity. The modified approach to harvesting the flap is a safe and effective technique, with similar functional results and equally low morbidity profile as the traditional technique. It has the added advantage of lower rates of secondary surgical interventions.
LEVEL OF EVIDENCE: 4. Laryngoscope, 00:000-000, 2018.

PMID: 29481692 [PubMed - as supplied by publisher]



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Esthesioneuroblastoma: A Patterns-of-Care and Outcomes Analysis of the National Cancer Database.

Esthesioneuroblastoma: A Patterns-of-Care and Outcomes Analysis of the National Cancer Database.

Neurosurgery. 2018 Feb 22;:

Authors: Orton A, Boothe D, Evans D, Lloyd S, Monroe MM, Jensen R, Shrieve DC, Hitchcock YJ

Abstract
BACKGROUND: The available literature to guide treatment decision making in esthesioneuroblastoma (ENB) is limited.
OBJECTIVE: To define treatment patterns and outcomes in ENB according to treatment modality using a large national cancer registry.
METHODS: This study is a retrospective cohort analysis of 931 patients with a diagnosis of ENB who were treated with surgery, radiation therapy, and/or chemotherapy in the United States between the years of 2004 and 2012. Log-rank statistics were used to compare overall survival by primary treatment modality. Logistic regression modeling was used to identify predictors of receipt of postoperative radiotherapy (PORT). Cox proportional hazards modeling was used to determine the survival benefit of PORT. Subgroup analyses identified subgroups that derived the greatest benefit of PORT.
RESULTS: Primary surgery was the most common treatment modality (90%) and resulted in superior survival compared to radiation (P < .01) or chemotherapy (P < .01). On multivariate analysis, PORT was associated with decreased risk of death (hazard ratio [HR] 0.53, P < .01). PORT showed a survival benefit in Kadish stage C (HR 0.42, P < .01) and D (HR 0.09, P = .01), but not Kadish A (HR 1.17, P = .74) and B (HR 1.37, P = .80). Patients who received chemotherapy derived greater benefit from PORT (HR 0.22, P < .01) compared with those who did not (HR 0.68, P = .13). Predictors of PORT included stage, grade, extent of resection, and chemotherapy use.
CONCLUSION: Best outcomes were obtained in patients undergoing primary surgery. The benefit of PORT was driven by patients with stages C and D disease, and by those also receiving chemotherapy.

PMID: 29481629 [PubMed - as supplied by publisher]



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Surgical Treatment Outcomes of Vocal Process Granuloma After Endotracheal Intubation.

Surgical Treatment Outcomes of Vocal Process Granuloma After Endotracheal Intubation.

J Craniofac Surg. 2018 Feb 23;:

Authors: Lee DH, Yoon TM, Lee JK, Lim SC

Abstract
INTRODUCTION: The objective of this study was to review the clinical characteristics and surgical treatment outcomes of the vocal process granuloma after the endotracheal intubation.
METHODS: A retrospective chart review was performed at Chonnam National University Hwasun Hospital from January 2008 to December 2015.
RESULTS: Twenty-one vocal process granulomas after endotracheal intubation were diagnosed in 13 patients. The most common symptom was hoarseness. Among 13 patients, bilateral vocal process granulomas were in 8 patients. For the remaining 5 patients, their unilateral vocal process granulomas were all left-sided. All the cases of vocal process granulomas after the endotracheal intubation were treated by laryngoscope microsurgery under general anesthesia. Recurrence of vocal process granulomas was identified in 1 lesion.
CONCLUSION: This study suggests that surgery for vocal process granuloma after endotracheal intubation is a good treatment option for a rapid resolution of lesions and the associated symptoms, along with having low recurrence rates.

PMID: 29481512 [PubMed - as supplied by publisher]



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Removal of the Residual Roots Displaced Into the Maxillary Sinus via Endoscopy.

Removal of the Residual Roots Displaced Into the Maxillary Sinus via Endoscopy.

J Craniofac Surg. 2018 Feb 23;:

Authors: Wang X, Li S, Huang Z, Cai Q, Huang Z, Chen W

Abstract
Minimally invasive endoscopic surgery has been developed for various indications in the craniomaxillofacial area. The case report presented in this article is focused on the possibility of removing the residual roots displaced into the maxillary sinus by means of an endoscopic technique. When planning endoscopic surgery to access the residual roots displaced in the maxillary sinus, we performed 2 different approaches into the maxillary sinus, a transnasal approach through the middle or inferior turbinate and transoral approach via the anterior maxillary sinus wall. The endoscopic surgical approach described is reliable and minimally invasive for removing the residual roots displaced into the maxillary sinus. Therefore, we concluded that the application of this clinical procedure is worth promoting.

PMID: 29481510 [PubMed - as supplied by publisher]



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Reliability of Color Doppler Ultrasound Imaging for the Assessment of Anterolateral Thigh Flap Perforators: A Prospective Study of 30 Perforators.

Reliability of Color Doppler Ultrasound Imaging for the Assessment of Anterolateral Thigh Flap Perforators: A Prospective Study of 30 Perforators.

Plast Reconstr Surg. 2018 Mar;141(3):762-766

Authors: Debelmas A, Camuzard O, Aguilar P, Qassemyar Q

Abstract
Despite numerous advantages, the anterolateral thigh perforator flap suffers from the variable position and nature of its perforators. The aim of the authors' study was to assess the reliability of preoperative color Doppler ultrasound imaging for the exploration of perforator location and course of anterolateral thigh perforator flaps. A prospective cohort study involving patients for whom head and neck reconstruction was planned with thin anterolateral thigh perforator flaps was conducted. Each patient underwent a color Doppler ultrasound exploration of the thighs, in the operating room, immediately before surgery. The sonographer was the surgeon who raised the flaps. Perforators were sought according to surgical needs, and the same location protocol was followed for all of the cases, using an orthonormal coordinate system to report the passages of the perforators through the vastus lateralis aponeurosis. Between January of 2016 and January of 2017, 22 thin anterolateral thigh perforator flaps were successfully harvested. Thirty perforators were located and used. The median distance between the preoperative color Doppler ultrasound planning and the final location of the perforators was 5 mm, statistically smaller than a 10-mm threshold (p = 0.002). Color Doppler ultrasound effectively predicted the nature of the perforators in 90 percent of the cases. The median duration for perforator color Doppler ultrasound location was 3 minutes, statistically shorter than 10 minutes (p = 0.0001). Preoperative color Doppler ultrasound seems to be reliable, accurate, and compatible with a quick routine assessment during patient setup for the elevation of thin anterolateral thigh perforator flaps.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, II.

PMID: 29481406 [PubMed - in process]



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Transpalpebral approach for frontal sinus diseases: a camouflaged technique.

Transpalpebral approach for frontal sinus diseases: a camouflaged technique.

Clin Otolaryngol. 2018 Feb 26;:

Authors: Michel J, Radulesco T, Graziani J, Penicaud M, Dessi P

Abstract
Endoscopic or transfacial external frontal sinus approaches do not provide good monitoring of the frontal sinus lateral extent. Moreover, endoscopic or transfacial external approaches remain associated with numerous complications or therapeutic failure, e.g. frontal sinus drainage pathway synechia, healing problems or residual hypoesthesia. We propose a rapid, easy-to-perform, 5-step procedure called the transpalpebral approach which is indicated in case of sequestered disease within the lateral extent of the frontal sinus. We use this technique in the following indications (osteomas, mucoceles, inverted papillomas, fungus balls, foreign bodies). Our transpalpebral approach avoids leaving a visible scar and entails no danger to the skull base, the frontal sinus drainage pathway or the supratrochlear and supraorbital pedicles. It provides wide access to the lateral extent of the frontal sinus and also reduces the number of transfacial external approaches required. This article is protected by copyright. All rights reserved.

PMID: 29480961 [PubMed - as supplied by publisher]



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Interleaved 3D-CNNs for Joint Segmentation of Small-Volume Structures in Head and Neck CT Images.

Interleaved 3D-CNNs for Joint Segmentation of Small-Volume Structures in Head and Neck CT Images.

Med Phys. 2018 Feb 26;:

Authors: Ren X, Xiang L, Nie D, Shao Y, Zhang H, Shen D, Wang Q

Abstract
PURPOSE: Accurate 3D image segmentation is a crucial step in radiation therapy planning of head and neck tumors. These segmentation results are currently obtained by manual outlining of tissues, which is a tedious and time-consuming procedure. Automatic segmentation provides an alternative solution, which, however, is often difficult for small tissues (i.e., chiasm and optic nerves in head and neck CT images) because of their small volumes and highly diverse appearance/shape information. In this work, we propose to interleave multiple 3D Convolutional Neural Networks (3D-CNNs) to attain automatic segmentation of small tissues in head and neck CT images.
METHOD: A 3D-CNN was designed to segment each structure of interest. To make full use of the image appearance information, multi-scale patches are extracted to describe the center voxel under consideration and then input to the CNN architecture. Next, as neighboring tissues are often highly related in the physiological and anatomical perspectives, we interleave the CNNs designated for the individual tissues. In this way, the tentative segmentation result of a specific tissue can contribute to refine the segmentations of other neighboring tissues. Finally, as more CNNs are interleaved and cascaded, a complex network of CNNs can be derived, such that all tissues can be jointly segmented and iteratively refined.
RESULT: Our method was validated on a set of 48 CT images, obtained from the Medical Image Computing and Computer Assisted Intervention (MICCAI) Challenge 2015. The Dice coefficient (DC) and the 95% Hausdorff Distance (95HD) are computed to measure the accuracy of the segmentation results. The proposed method achieves higher segmentation accuracy (with the average DC: 0.58±0.17 for optic chiasm, and 0.71±0.08 for optic nerve; 95HD: 2.81±1.56 mm for optic chiasm, and 2.23±0.90 mm for optic nerve) than the MICCAI challenge winner (with the average DC: 0.38 for optic chiasm, and 0.68 for optic nerve; 95HD: 3.48 for optic chiasm, and 2.48 for optic nerve).
CONCLUSION: An accurate and automatic segmentation method has been proposed for small tissues in head and neck CT images, which is important for the planning of radiotherapy. This article is protected by copyright. All rights reserved.

PMID: 29480928 [PubMed - as supplied by publisher]



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Cancer Patients Dying in the Intensive Care Units and Access to Palliative Care.

Cancer Patients Dying in the Intensive Care Units and Access to Palliative Care.

J Palliat Med. 2018 Feb 26;:

Authors: Ledoux M, Tricou C, Roux M, Dreano-Hartz S, Ruer M, Filbet M

Abstract
BACKGROUND: In France, cancer has become the leading cause of death. Intensive care units (ICU) focus on survival, which may not be an appropriate setting to provide palliative care (PC) as needed by cancer patients and families.
OBJECTIVE: To describe the cancer patients who died in the ICU in 2010 in a French academic medical center.
DESIGN: Retrospective study Measurements: We reviewed medical records of all cancer patients who died in the ICU in 2010. The information collected from electronic medical records included patient sociodemographics and clinical characteristics, PC service referral, and the date of first contact with PC.
RESULTS: Among the 536 cancer patients who died in 2010, 42 (8%) died in the ICU. The cancers were hematological (21%), gastrointestinal (21%) and head and neck (21%). One patient had a PC referral versus 45% in the total population (p < 0.001) and the referral was the same day as the death. Eight (19%) patients had chemotherapy during their last month of life and 2 during the ICU hospitalization. Seventy-four per cent of patient admissions to the ICU related directly to malignancy. The mean time between diagnosis of cancer and death was 2.3 years (standard deviation, 4.4).
CONCLUSIONS: Our work highlights the need for early PC in the illness trajectory of cancer patients to prevent the transfer of dying patients to the ICU. More studies are needed to understand the decision making leading to such transfers.

PMID: 29480751 [PubMed - as supplied by publisher]



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Human papillomavirus load in benign HPV-associated oral lesions from HIV/AIDS individuals.

Human papillomavirus load in benign HPV-associated oral lesions from HIV/AIDS individuals.

Oral Dis. 2018 Mar;24(1-2):210-214

Authors: Camacho-Aguilar S, Ramírez-Amador V, Rosendo-Chalma P, Guido-Jiménez M, García-Carrancá A, Anaya-Saavedra G

Abstract
BACKGROUND: Although HPV emerged as a crucial carcinogenic and prognostic biomarker in head and neck cancer, and considering the increase in HPV-associated oral lesions (HPV-OLs) in HIV individuals, molecular information about HPV-OLs is scarce; thus, our aim was to determine viral loads in HPV-OLs from HIV/AIDS individuals.
METHODS: HIV/AIDS subjects with HPV-OL were included in this cross-sectional study. Following informed consent, biopsies were obtained. HPV detection and typing were carried out by PCR and sequencing (MY09/11, GP5+/6+). HPV-13 and HPV-32 loads were determined by a high-resolution melting assay. For statistical analysis, X2 , Fisher's exact, and Mann-Whitney U tests were applied, using SPSS software (v.23).
RESULTS: Twenty-nine HIV subjects (median age 38 years, 93% males) were included. Most were AIDS individuals (72.4%) under HAART (89.7%). Twenty-two (75.9%) participants had more than one HPV-OL (four with florid presentations), mostly multifocal epithelial hyperplasia (62%), being HPV-13 (26%) and HPV-32 (31%) the most frequent types. HPV load was higher in individuals with multiple HPV-OLs than in solitary lesions (4.9 vs. 3.2 Log10 copies/ml, p = .090) and in HPV-32+ than in HPV-13+ (8.3 vs. 6.4 Log10 copies/ml, p = .014).
CONCLUSIONS: Multiple HPV-OLs showed high HPV loads, possibly indicating transcriptional activity of the virus; however, in the HIV setting, the individual and local immunological response could be the key process.

PMID: 29480634 [PubMed - in process]



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The medically compromised patient: Are dental implants a feasible option?

The medically compromised patient: Are dental implants a feasible option?

Oral Dis. 2018 Mar;24(1-2):253-260

Authors: Vissink A, Spijkervet F, Raghoebar GM

Abstract
In healthy subjects, dental implants have evolved to be a common therapy to solve problems related to stability and retention of dentures as well as to replace failing teeth. Although dental implants are applied in medically compromised patients, it is often not well known whether this therapy is also feasible in these patients, whether the risk of implant failure and developing peri-implantitis is increased, and what specific preventive measures, if any, have to be taken when applying dental implants in these patients. Generally speaking, as was the conclusion by the leading review of Diz, Scully, and Sanz on placement of dental implants in medically compromised patients (J Dent, 41, 2013, 195), in a few disorders implant survival may be lower, and the risk of a compromised peri-implant health and its related complications be greater, but the degree of systemic disease control outweighs the nature of the disorder rather than the risk accompanying dental implant treatment. So, as dental implant treatment is accompanied by significant functional benefits and improved oral health-related quality of life, dental implant therapy is a feasible treatment in almost any medically compromised patient when the required preventive measures are taken and follow-up care is at a high level.

PMID: 29480621 [PubMed - in process]



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Lyophilized bone marrow cell extract functionally restores irradiation-injured salivary glands.

Lyophilized bone marrow cell extract functionally restores irradiation-injured salivary glands.

Oral Dis. 2018 Mar;24(1-2):202-206

Authors: Su X, Fang D, Liu Y, Ruan G, Seuntjens J, Kinsella JM, Tran SD

Abstract
OBJECTIVE: Bone marrow cell extract (BMCE) was previously reported to restore salivary gland hypofunction caused by irradiation injury. Proteins were shown to be the main active factors in BMCE. However, BMCE therapy requires multiple injections and protein denaturation is a concern during BMCE storage. This study aimed to preserve, by lyophilization (freeze-drying), the bioactive factors in BMCE.
METHODS: We developed a method to freeze-dry BMCE and then to analyze its ingredients and functions in vivo. Freeze-dried (FD) BMCE, freshly prepared BMCE (positive control), or saline (vehicle control) was injected into the tail vein of mice that had received irradiation to damage their salivary glands.
RESULTS: Results demonstrated that the presence of angiogenesis-related factors and cytokines in FD-BMCE remained comparable to those found in fresh BMCE. Both fresh and FD-BMCE restored comparably saliva secretion, increased cell proliferation, upregulated regenerative/repair genes, protected salivary acinar cells, parasympathetic nerves, and blood vessels from irradiation-damaged salivary glands.
CONCLUSION: Lyophilization of BMCE maintained its bioactivity and therapeutic effect on irradiation-injured salivary glands. The advantages of freeze-drying BMCE are its storage and transport at ambient temperature.

PMID: 29480601 [PubMed - in process]



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Daffodils to fight against cancer

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