Ιατρικά Άρθρα Αλέξανδρος Γ. Σφακιανάκης: 02/26/17

Κυριακή 26 Φεβρουαρίου 2017

Epidemiology of Organophosphate Poisoning in the Tshwane District of South Africa

Background: Organophosphate poisoning is a major public health problem in South Africa. Individuals get exposed to organophosphate in both the domestic and industrial spheres. Method: A cross-sectional study was conducted using retrospective, secondary data of organophosphate poisoning cases over a 3-year period, reported at the Tshwane District surveillance office. Data were analysed using Microsoft Excel, and Epi Info version 7 was used for descriptive statistics. Results: A total of 207 cases were reported with ages ranging from 10 months to 59 years. Most of the cases were men (58.9%). Intentional poisoning accounted for 51% of cases. Unintentional poisoning accounted for 21.7% of cases, and 26.5% of cases had unknown circumstances of poisoning. A significant number (50.2%) of intentional poisonings were suicide related. Nonsuicidal cases accounted for 47.4% of cases, and deliberate unlawful poisoning accounted for 2.4% of cases. The mortality rate for the whole group was 3.4%. Conclusions: Improvement in data collection on organophosphate poisoning is essential to properly measure the burden of the problem. More effective regulatory controls for pesticide use are needed in South Africa.

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Ankylosing spondylitis

Ankylosing spondylitis: A form of chronic inflammation of the spine and the sacroiliac joints. Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process called ankylosis. Ankylosing spondylitis can sometimes be seen in patients with psoriasis and inflammatory bowel disease (ulcerative and Crohn's colitis).

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Screening for Tuberculosis in Health Care Workers: Experience in an Italian Teaching Hospital

Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Therefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it suffers of low specificity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specificity and sensitivity but are more expensive. The present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as first- and second-level screening tests, respectively. Out of 2290 HCW enrolled, 141 (6.1%) had a positive TST; among them, 99 (70.2%) underwent the IGRA and 16 tested positive (16.1%). The frequency of HCW tested positive for TB seems not far from other experiences in low incidence countries. Our results confirm the higher specificity of IGRA, but, due to its higher cost, TST can be considered a good first level screening test, whose positive results should be further confirmed by IGRA before the patients undergo X-ray diagnosis and/or chemotherapy.

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Combination of Anti-VEGF and Laser Photocoagulation for Diabetic Macular Edema: A Review

Diabetic macular edema (DME) is the most common cause of vision loss in diabetic patients. Thirty years ago, the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated that focal/grid laser photocoagulation reduces moderate vision loss from DME by 50% or more; thus, macular photocoagulation became the gold standard treatment for DME. However, with the development of anti-VEGF drugs (bevacizumab, ranibizumab, and aflibercept), better outcomes were obtained in terms of visual acuity gain and decrease in macular thickness in some studies when antiangiogenic drugs were administered in monotherapy. Macular laser therapy may still play an important role as an adjuvant treatment because it is able to improve macular thickness outcomes and reduce the number of injections needed. Here, we review some of the clinical trials that have assessed the efficacy of macular laser treatment, either as part of the treatment protocol or as rescue therapy.

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An Identity in Commutative Rings with Unity with Applications to Various Sums of Powers

Let be a commutative ring of characteristic ( may be equal to ) with unity and zero 0. Given a positive integer and the so-called -symmetric set such that for each , define the th power sum as , for We prove that for each positive integer there holds As an application, we obtain two new Pascal-like identities for the sums of powers of the first positive integers.

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Successful Treatment of Clostridium difficile Bacteremia with Aortic Mycotic Aneurysm in a Patient with Prior Endovascular Aortic Aneurysm Repair

The clinical spectrum of Clostridium difficile infection can range from benign gastrointestinal colonization to mild diarrhea and life threatening conditions such as pseudomembranous colitis and toxic megacolon. Extraintestinal manifestations of C. difficile are rare. Here, we report a patient with a history of an endovascular aortic aneurysm repair (EVAR) presenting with an endovascular leak complicated by C. difficile bacteremia and a mycotic aneurysm. He was successfully treated with an explant of the EVAR, an aorto-left renal bypass, and aorto-bi-iliac bypass graft placement along with a six-week duration of intravenous vancomycin and oral metronidazole.

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Use DCE-MRI, pharmacokinetics, for brain metastases

2017_02_24_17_32_04_975_2017_02_27_MRI_i Dynamic contrast-enhanced (DCE) MRI plus measuring changes in the pharmacokinetic...

Temporal trends in peripheral arterial interventions: Observations from the blue cross blue shield of michigan cardiovascular consortium (BMC2 PVI)

Objectives

The aim is to examine trends in procedural indication, arterial beds treated, and device usage in peripheral arterial interventions (PVIs).

Background

There is little data on indication, vascular beds treated and devices utilized for peripheral arterial interventions.

Methods

We used data from 43 hospitals participating in the BMC2 VIC registry. PVIs were separated by year and divided by arterial segment. Lower extremity PVIs were subclassified as having been performed for claudication or critical limb ischemia (CLI). Yearly device usage was also included. A repeated measure ANOVA was used to determine trends.

Results

44,650 PVIs were performed from 2006 to 2013. Renal interventions decreased from 18% of interventions in 2006 to 5.6% in 2013 (P < 0.001) and femoral-popliteal increased from 54.9% in 2006 to 64.5% in 2013 (P < 0.001). No significant trend was seen for aorta-iliac or below-the-knee interventions. 58.6% of PVIs were performed for claudication in 2006 and this decreased to 44.6% in 2013 (P = 0.025). Indications for CLI were 24.1% in 2006 and 47.5% in 2013 (P < 0.001). There were significant increases in the use of balloon angioplasty (P = 0.029) and cutting/scoring balloons (P < 0.001) while cryoballoon usage decreased (P < 0.001). No significant changes were found with stenting, atherectomy, and laser.

Conclusions

There is a significant increase in patients presenting with CLI. Renal artery intervention rates are decreasing while femoral-popliteal interventions are increasing. Additionally, balloon angioplasty and cutting/scoring balloon usage is increasing. © 2017 Wiley Periodicals, Inc.

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Dosimetric impact of contouring and image registration variability on dynamic 125I prostate brachytherapy

Publication date: Available online 24 February 2017
Source:Brachytherapy
Author(s): Hendrik Westendorp, Kathrin Surmann, Sandrine M.G. van de Pol, Carel J. Hoekstra, Robert A.J. Kattevilder, Tonnis T. Nuver, Marinus A. Moerland, Cornelis H. Slump, André W. Minken
PurposeThe quality of permanent prostate brachytherapy can be increased by addition of imaging modalities in the intraoperative procedure. This addition involves image registration, which inherently has inter- and intraobserver variabilities. We sought to quantify the inter- and intraobserver variabilities in geometry and dosimetry for contouring and image registration and analyze the results for our dynamic ¹²⁵I brachytherapy procedure.Methods and MaterialsFive observers contoured 11 transrectal ultrasound (TRUS) data sets three times and 11 CT data sets one time. The observers registered 11 TRUS and MRI data sets to cone beam CT (CBCT) using fiducial gold markers. Geometrical and dosimetrical inter- and intraobserver variabilities were assessed. For the contouring study, structures were subdivided into three parts along the craniocaudal axis.ResultsWe analyzed 165 observations. Interobserver geometrical variability for prostate was 1.1 mm, resulting in a dosimetric variability of 1.6% for V100 and 9.3% for D90. The geometric intraobserver variability was 0.6 mm with a V100 of 0.7% and D90 of 1.1%. TRUS–CBCT registration showed an interobserver variability in V100 of 2.0% and D90 of 3.1%. Intraobserver variabilities were 0.9% and 1.6%, respectively. For MRI–CBCT registration, V100 and D90 were 1.3% and 2.1%. Intraobserver variabilities were 0.7% and 1.1% for the same.ConclusionsProstate dosimetry is affected by interobserver contouring and registration variability. The observed variability is smaller than underdosages that are adapted during our dynamic brachytherapy procedure.

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Suppression of Spindly Delays Mitotic Exit and Exacerbates Cell Death Response of Cancer Cells Treated with Low Doses of Paclitaxel

Microtubule-targeting agents (MTAs) are used extensively for the treatment of diverse types of cancer. They block cancer cells in mitosis through the activation of the spindle assembly checkpoint (SAC), the surveillance mechanism that ensures accurate chromosome segregation at the onset of anaphase. However, the cytotoxic activity of MTAs is limited by premature mitotic exit (mitotic slippage) due to SAC silencing. Here we have explored the dual role of the protein Spindly in chromosome attachments and SAC silencing to analyze the consequences of its depletion on the viability of tumor cells treated with clinically relevant doses of paclitaxel.

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Design and Experimental Evaluation of a Quantified Depth Shave Biopsy Device—Proof of Concept

More diagnoses of skin cancer occur than all other cancers combined. The most common method to biopsy a skin lesion is the shave biopsy (SB), because of efficiency afforded to the provider and patient. However, it produces biopsy specimens with unknown and variable thickness. The present study examines an innovative SB prototype that quantifies the depth of specimen harvest at the time of tissue acquisition. Our objective was to design a quantified >1.1 mm depth of skin tissue harvest SB device that was easy to operate.

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Percutaneous needle fasciotomy for Dupuytren’s disease: minimizing morbidity

We read with interest the letter by Nikkhah and Kang in the January issue of the journal (1), describing anecdotal observations derived from a series of 150 patients treated with percutaneous needle fasciotomy (PNF). Nikkhah and Kang perform PNF along the lines described by Foucher et al. (2). Our own PNF practice differs in several significant respects. In particular, we question the requirement for wrist block, and we highlight differences in the positioning of the PNF sites, the gauge of needle and the post-operative splinting regime.

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Patient Experience of Sentinel Lymph Node Biopsy for Melanoma

Sentinel lymph node biopsy (SLNB) has become an established investigation for assessing microscopic nodal metastasis in melanoma. In a 10-year review of SLNB for melanoma at a single institution, our unit reported a complication rate of 6%1. Despite the widespread use of SLNB for melanoma there are no studies that evaluate patient experience. A method of identifying this information is the study of patient reported outcome measures (PROMs), defined by the Food and Drug Administration as a “measurement of any aspect of a patient's health status that comes directly from the patient”.

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Is it time for a change in the approach to chemical burns? The role of Diphoterine® in the management of cutaneous and ocular chemical injuries

A multitude of household and occupational compounds have the potential to induce chemical burns to the eye and skin. Without prompt intervention, irreversible visual loss and disfigurement may prevail. Diphoterine® and Hexafluorine® are amphoteric, hypertonic, chelating solutions used in the management of general chemical and hydrofluoric acid burns respectively. They rapidly neutralise both acid and alkali agents without heat release and limit diffusion, making them superior to water irrigation alone.

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Story Retelling Skills in Persian Speaking Hearing-impaired Children

In recent years, there has been an increasing interest in seeking ways to evaluate children’s language in a natural context. In Iran the study of language development skills in hearing impaired children is mainly focused on the development of early language skills and story retelling creates a valid way for assessing the effects of cochlear implant on complex linguistic usesuch as pragmatics. Pragmatic abilities, which refer to the actual use of language, are an important area in language. A number of researchers have reported that story retelling creates a valid way for assessing pragmatic and complex structures (1).

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Endoscopic middle ear exploration in pediatric patients with conductive hearing loss

To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions.

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Lack of interaction between between NEMO and SHARPIN impairs linear ubiquitination and NF-κB activation, and leads to incontinentia pigmenti

We identified for the first time in human the NEMO domain involved in SHARPIN interaction which is dispensable for NF-κB signaling. Beside, HOIL-1, HOIP, and OTULIN deficiency we confirmed that defect of linear ubiquitination is responsible for human diseases.

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Efficiency of Polymeric Membrane Graphene Oxide-TiO2 for Removal of Azo Dye

Achieving the desired standard of drinking water quality has been one of the concerns across water treatment plants in the developing countries. Processes such as grid chamber, coagulation, sedimentation, clarification, filtration, and disinfection are typically used in water purification plants. Among these methods, unit filtration which employs polymers is one of the new technologies. There have been many studies about the use of semiconductive TiO2 with graphene oxide (GO) on the base of different polymeric membranes for the removal of azo dyes, especially methylene blue (MB). Polymeric GO-TiO2 membranes have high photocatalytic, antifouling property and permeate the flux removal of organic pollutants. The aim of this study was to investigate the characteristics of different polymeric membranes such as anionic perfluorinated polymer (Nafion), cellulose acetate, polycarbonate (PC), polysulfone fluoride (PSF), and polyvinylidene fluoride (PVDF). The result of this study showed that the GO-TiO2 membrane can be used in the field of water treatment and will be used for the removal of polycyclic aromatic hydrocarbons (PAHs) from wastewater.

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On the Design of Conical Antennas for Broadband Impedance Matching Performance

In the scope of broadband radiators, the biconical antenna, or its monopole conical counterpart, is long known to be a proper choice. One common form of such radiator, the spherically capped conical antenna (SCCA), has closed-form solution to its input impedance, from which the broadband performance potential is easily verified. Nonetheless, from the design perspective, apart from a few clues inferred from existing solutions, little is found to accurately guide the choice of the main geometrical parameters of the antenna that will enable it to comply with a set of imposed bandwidth requirements. This paper proposes a simple 10-step sequence to derive conical or biconical antenna design charts. These charts provide straightforward information on the geometrical limits within which the required antenna impedance matching broadband performance is achieved. The method is assessed for the SCCA and the open conical antenna (OCA) using theoretical and simulated estimates of the input impedance. A discussion on the impact of the cap and the feed gap is included.

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Neural Differentiation in HDAC1-Depleted Cells Is Accompanied by Coilin Downregulation and the Accumulation of Cajal Bodies in Nucleoli

Cajal bodies (CBs) are important compartments containing accumulated proteins that preferentially regulate RNA-related nuclear events, including splicing. Here, we studied the nuclear distribution pattern of CBs in neurogenesis. In adult brains, coilin was present at a high density, but CB formation was absent in the nuclei of the choroid plexus of the lateral ventricles. Cells of the adult hippocampus were characterized by a crescent-like morphology of coilin protein. We additionally observed a 70 kDa splice variant of coilin in adult mouse brains, which was different to embryonic brains and mouse pluripotent embryonic stem cells (mESCs), characterized by the 80 kDa standard variant of coilin. Here, we also showed that depletion of coilin is induced during neural differentiation and HDAC1 deficiency in mESCs caused coilin accumulation inside the fibrillarin-positive region of the nucleoli. A similar distribution pattern was observed in adult brain hippocampi, characterized by lower levels of both coilin and HDAC1. In summary, we observed that neural differentiation and HDAC1 deficiency lead to coilin depletion and coilin accumulation in body-like structures inside the nucleoli.

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On Inverse Problems for Characteristic Sources in Helmholtz Equations

We consider the inverse problem that consists in the determination of characteristic sources, in the modified and classical Helmholtz equations, based on external boundary measurements. We identify the location of the barycenter establishing a simple formula for symmetric shapes, which also holds for the determination of a single source point. We use this for the reconstruction of the characteristic source, based on the Method of Fundamental Solutions (MFS). The MFS is also applied as a solver for the direct problem, using an equivalent formulation as a jump or transmission problem. As a solver for the inverse problem, we may apply minimization using an equivalent reciprocity functional formulation. Numerical experiments with the barycenter and the boundary reconstructions are presented.

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Epidemiology and Outcomes in Critically Ill Patients with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy

Purpose. The impact of critical illness on survival of HIV-infected patients in the era of antiretroviral therapy remains uncertain. We describe the epidemiology of critical illness in this population and identify predictors of mortality. Materials and Methods. Retrospective cohort of HIV-infected patients was admitted to intensive care from 2002 to 2014. Patient sociodemographics, comorbidities, case-mix, illness severity, and 30-day mortality were captured. Multivariable Cox regression analyses were performed to identify predictors of mortality. Results. Of 282 patients, mean age was 44 years (SD 10) and 169 (59%) were male. Median (IQR) CD4 count and plasma viral load (PVL) were 125 cells/mm3 (30–300) and 28,000 copies/mL (110–270,000). Fifty-five (20%) patients died within 30 days. Factors independently associated with mortality included APACHE II score (adjusted hazard ratio [aHR] 1.12; 95% CI 1.08–1.16; ), cirrhosis (aHR 2.30; 95% CI 1.12–4.73; ), coronary artery disease (aHR 6.98; 95% CI 2.20–22.13; ), and duration of HIV infection (aHR 1.07 per year; 95% CI 1.02–1.13; ). CD4 count and PVL were not associated with mortality. Conclusions. Mortality from an episode of critical illness in HIV-infected patients remains high but appears to be driven by acute illness severity and HIV-unrelated comorbid disease rather than degree of immune suppression.

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Semigroup Solution of Path-Dependent Second-Order Parabolic Partial Differential Equations

We apply a new series representation of martingales, developed by Malliavin calculus, to characterize the solution of the second-order path-dependent partial differential equations (PDEs) of parabolic type. For instance, we show that the generator of the semigroup characterizing the solution of the path-dependent heat equation is equal to one-half times the second-order Malliavin derivative evaluated along the frozen path.

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DEPTOR-mTOR Signaling Is Critical for Lipid Metabolism and Inflammation Homeostasis of Lymphocytes in Human PBMC Culture

Abnormal immune response of the body against substances and tissues causes autoimmune diseases, such as polymyositis, dermatomyositis, and rheumatoid arthritis. Irregular lipid metabolism and inflammation may be a significant cause of autoimmune diseases. Although much progress has been made, mechanisms of initiation and proceeding of metabolic and inflammatory regulation in autoimmune disease have not been well-defined. And novel markers for the detection and therapy of autoimmune disease are urgent. mTOR signaling is a central regulator of extracellular metabolic and inflammatory processes, while DEP domain-containing mTOR-interacting protein (DEPTOR) is a natural inhibitor of mTOR. Here, we report that overexpression of DEPTOR reduces mTORC1 activity in lymphocytes of human peripheral blood mononuclear cells (PBMCs). Combination of DEPTOR overexpression and mTORC2/AKT inhibitors effectively inhibits lipogenesis and inflammation in lymphocytes of PBMC culture. Moreover, DEPTOR knockdown activates mTORC1 and increases lipogenesis and inflammations. Our findings provide a deep insight into the relationship between lipid metabolism and inflammations via DEPTOR-mTOR pathway and imply that DEPTOR-mTOR in lymphocytes of PBMC culture has the potential to be as biomarkers for the detection and therapies of autoimmune diseases.

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An Investigation into the Relation between the Technique of Movement and Overload in Step Aerobics

The aim of this research was to determine the features of a step workout technique which may be related to motor system overloading in step aerobics. Subjects participating in the research were instructors () and students () without any prior experience in step aerobics. Kinematic and kinetic data was collected with the use of the BTS SMART system comprised of 6 calibrated video cameras and two Kistler force plates. The subjects’ task was to perform basic steps. The following variables were analyzed: vertical, anteroposterior, and mediolateral ground reaction forces; foot flexion and abduction and adduction angles; knee joint flexion angle; and trunk flexion angle in the sagittal plane. The angle of a foot adduction recorded for the instructors was significantly smaller than that of the students. The knee joint angle while stepping up was significantly higher for the instructors compared to that for the students. Our research confirmed that foot dorsal flexion and adduction performed while stepping up increased load on the ankle joint. Both small and large angles of knee flexion while stepping up and down resulted in knee joint injuries. A small trunk flexion angle in the entire cycle of step workout shut down dorsal muscles, which stopped suppressing the load put on the spine.

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TFCP2 Genetic Polymorphism Is Associated with Predisposition to and Transplant Prognosis of Hepatocellular Carcinoma

TFCP2 is an oncogene and plays crucial roles in the incidence and progression of hepatocellular carcinoma (HCC). However, no reports are available on the impact of TFCP2 genetic polymorphism on the susceptibility to and the transplant prognosis of HCC. Here, we genotyped 7 SNPs of TFCP2 in a case-control study of 119 patients with HCC and 200 patients with chronic liver disease. Of the 7 SNPs in TFCP2, rs7959378 distributed differentially between patients with versus patients without HCC. The patients with the CA (OR = 0.58, 95% CI = 0.35–0.96), the CC (OR = 0.39, 95% CI = 0.20–0.76), and the CA/CC (OR = 0.52, 95% CI = 0.32–0.83) genotypes had significantly decreased risk for HCC compared with those carrying the rs7959378 AA genotype. After adjusting for confounding factors, rs7959378 still conferred significant risk for HCC. Furthermore, the patients who carried rs7959378 AC/CC had a higher overall survival and lower relapse-free survival than those with the rs7959378 AA genotype. Similar results were found in the multivariate analysis adjusted by AFP, tumor size and tumor number, and differentiation. These findings indicate that rs7959378 is associated with the risk of HCC in patient with chronic liver disease and prognosis of HCC patients after liver transplantation.

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Critical Oscillation Constant for Euler Type Half-Linear Differential Equation Having Multi-Different Periodic Coefficients

We compute explicitly the oscillation constant for Euler type half-linear second-order differential equation having multi-different periodic coefficients.

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Potential Protective Effects of Bioactive Constituents from Chinese Propolis against Acute Oxidative Stress Induced by Hydrogen Peroxide in Cardiac H9c2 Cells

Chinese propolis (CP) is known as a health food but its beneficial effects in protecting cardiomyocytes remain elusive. Here, we investigated the effects of CP and its active compounds on hydrogen peroxide (H2O2) induced rats cardiomyocytes (H9c2) oxidative injury. Cell viability decreases induced by H2O2 were mitigated by different CP extracts using various solvents. From these active fractions, six active compounds were separated and identified. Among tested isolated compound, the cytoprotective activities of three caffeates, caffeic acid phenethyl ester (CAPE), benzyl caffeate (BZC), and cinnamyl caffeate (CNC), exerted stronger effects than chrysin, pinobanksin, and 3,4-dimethoxycinnamic acid (DMCA). These three caffeates also increased H9c2 cellular antioxidant potential, decreased intracellular calcium ion () level, and prevented cell apoptosis. Overall, the cardiovascular protective effects of the CP might be attributed to its caffeates constituents (CAPE, BZC, and CNC) and provide evidence for its usage in complementary and alternative medicine.

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Antibacterial and anti-biofilm effects of sodium hypochlorite against Staphylococcus aureus isolates derived from patients with atopic dermatitis

Abstract

Introduction

Atopic dermatitis (AD) is characterised by an increased susceptibility for skin infections. Staphylococcus aureus is reported to dominate in AD lesions and reports have revealed the presence of staphylococcal biofilms. These infections contribute to aggravating the eczema. Sodium hypochlorite is known to reduce bacterial load of skin lesions as well as disease severity in AD patients but the effect on biofilms is unknown.

Objectives

The aim of this study was to investigate the antimicrobial and anti-biofilm effects of sodium hypochlorite against S. aureus isolates derived from patients with AD.

Materials and Methods

Skin biopsy derived from infected AD patient was examined by scanning electron microscopy (SEM). Using radial diffusion assays, biofilm assays and confocal laser scanning microscopy, we assessed the effect of sodium hypochlorite on S. aureus isolates derived from lesional skin of AD patients.

Results

SEM revealed clusters of coccoid bacteria embedded in fibrin and extracellular substances at the skin of a patient with infected AD. At concentrations of 0.01-0.08%, sodium hypochlorite showed antibacterial effects against planktonic cells. Eradication of S. aureus biofilms in vitro was observed in concentrations ranging from 0.01% to 0.16%. Confocal laser scanning microscopy confirmed these results. Finally, when human AD skin was subjected to sodium hypochlorite in an ex vivo model, a dose of 0.04% reduced the bacteria derived from AD skin.

Conclusions

Sodium hypochlorite has antimicrobial and anti-biofilm effects against clinical S. aureus isolates. Our findings suggest usage of a higher concentration than currently used in bleach baths of skin-infected AD patients.

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Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report

Tuberculosis is an infection that requires at least 6 months of chemotherapy in order to clear the bacteria from the patient’s lungs. Usually, therapeutic monitoring is dependent on smear microscopy where a de...

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Correlation of pretreatment 18 F-FDG PET tumor textural features with gene expression in pharyngeal cancer and implications for radiotherapy-based treatment outcomes

Abstract

Purpose

This study investigated the correlation of the matrix heterogeneity of tumors on ¹⁸F-fluorodeoxyglucose positron emission tomography–computed tomography (PET–CT) with gene-expression profiling in patients with pharyngeal cancer and determined the prognostic factors for radiotherapy-based treatment outcomes.

Methods

We retrospectively reviewed the records of 57 patients with stage III–IV oropharyngeal or hypopharyngeal cancer who had completed definitive therapy. Four groups of the textural features as well as 31 indices were studied in addition to maximum standard uptake value, metastatic tumor volume, and total lesion glycolysis. Immunohistochemical data from pretreatment biopsy specimens (Glut1, CAIX, VEGF, HIF-1α, EGFR, Ki-67, Bcl-2, CLAUDIN-4, YAP-1, c-Met, and p16) were analyzed. The relationships between the indices and genomic expression were studied, and the robustness of various textural features relative to cause-specific survival and primary relapse-free survival was analyzed.

Results

The overexpression of VEGF was positively associated with the increased values of the matrix heterogeneity obtained using gray-level nonuniformity for zone (GLNUz) and run-length nonuniformity (RLNU). Advanced T stage (p = 0.01, hazard ratio [HR] = 3.38), a VEGF immunoreactive score of >2 (p = 0.03, HR = 2.79), and a higher GLNUz value (p = 0.04, HR = 2.51) were prognostic factors for low cause-specific survival, whereas advanced T stage, a HIF-1α staining percentage of ≥80%, and a higher GLNUz value were prognostic factors for low primary-relapse free survival.

Conclusions

The overexpression of VEGF was associated with the increased matrix index of GLNUz and RLNU. For patients with pharyngeal cancer requiring radiotherapy, the treatment outcome can be stratified according to the textural features, T stage, and biomarkers.

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Prophylactic use of fibrin sealant (ARTISS(™) ) for facilitating safe transition to drain-free thyroid surgery: a single-centre case series review of 109 procedures.

Prophylactic use of fibrin sealant (ARTISS(™) ) for facilitating safe transition to drain-free thyroid surgery: a single-centre case series review of 109 procedures.

Clin Otolaryngol. 2017 Feb 24;:

Authors: Heyes R, Ramdoo K, Manjaly JG, Charn TC, Tatla T

Abstract
Despite a lack of evidence to support drain insertion in thyroid surgery, drain placement, to prevent rapidly expanding haematoma which occurs in around 1% of cases, remains common (1,2,3) . Throughout surgery there has been a drive towards reducing postoperative length of hospital admission. For day-case thyroidectomy to become a widely adopted clinical reality, the use of drains requires abandonment, but beyond this, the cause for surgeons' reticence to practise drain-free surgery, namely haematoma risk, needs to be addressed. This paper describes a study conducted to examine the efficacy of ARTISS(™) , a commercially available thrombin-dilute fibrin sealant, in thyroid surgery to permit safe transition to drain-free surgery. This article is protected by copyright. All rights reserved.

PMID: 28235239 [PubMed - as supplied by publisher]

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Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma.

Evaluation of the Relationship between Age and Outcome after Microvascular Reconstruction among Patients with Recurrent Head and Neck Squamous Cell Carcinoma.

J Reconstr Microsurg. 2017 Feb 24;:

Authors: Patel VM, Stern C, Miglani A, Weichman KE, Lin J, Ow TJ, Garfein ES

Abstract
Background In patients with head and neck squamous cell carcinoma (HNSCC), disease recurrence remains a significant obstacle to long-term survival. If possible, surgical salvage with reconstruction remains the best treatment option for patients with recurrence. Currently, there is no literature discussing whether age should preclude microvascular reconstruction in these patients. We hypothesize that older age alone does not affect outcomes. Methods A retrospective chart review of patients with HNSCC at our institution between 2008 and 2015 was performed. Patients were included if they underwent simultaneous resection and flap reconstruction for recurrent HNSCC. Data collected included age, sex, primary site, type of reconstruction, previous treatments, postoperative complications (systemic and reconstructive), and overall survival. Results A total of 65 patients met inclusion criteria for the review: 42 (64.6%) patients ≤70 years and 23 (35.4%) patients > 70 years. Overall survival was not significantly different between the younger and older groups (p = 0.199). Five-year survival was 60.1% in the younger group and 46.8% in the older group. No significant difference was found in reconstructive complication rates (p = 0.179) or systemic complication rates (p = 0.241) between the two groups. Multivariate logistic regression analysis further showed no significant association between patients' age (≤70 years or > 70 years) and reconstructive complications (p = 0.396) or systemic complications (p = 0.119). Conclusion Age is not significantly associated with complications among patients undergoing resection and reconstruction for recurrent HNSCC. Microvascular reconstruction remains a feasible option in older patients with recurrent HNSCC. Advanced age alone should not preclude the surgical management of recurrent HNSCC.

PMID: 28235217 [PubMed - as supplied by publisher]

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Inflammation Following Invasive Procedures for Warthin's Tumour: A Retrospective Case Series.

Inflammation Following Invasive Procedures for Warthin's Tumour: A Retrospective Case Series.

Clin Otolaryngol. 2017 Feb 24;:

Authors: Alkan U, Shkedy Y, Mizrachi A, Shpitzer T, Popovtzer A, Bachar G

Abstract
OBJECTIVE: To determine the risk of inflammation associated with fine-needle aspiration during evaluation of Warthin's tumour.
DESIGN: Retrospective case series.
SETTING: Tertiary medical center.
PARTICIPANTS: All patients who underwent fine-needle aspiration followed by parotidectomy between1992-2009 for the diagnosis/evaluation of a parotid gland tumour.
MAIN OUTCOME MEASURE: Rate of fine-needle-aspiration-related parotitis in patients with Warthin's tumour or other parotid pathologies.
RESULTS: A total of 593 parotidectomies were performed in 553 patients during the study period, 96 (16.2%) for Warthin's tumour (study group) and 497 for other parotid-related pathologies (control group). Parotid gland inflammation following fine-needle aspiration was observed in 16 cases in the study group (16.7%) and 8 (1.6%) in the control group (P <0.001). On multivariate regression analysis, parotitis following fine-needle aspiration was more common in patients with Warthin's tumor than other parotid-related pathologies even after adjustment for possible confounders (P<0.007). Signs of inflammation were noted during surgery in 6 cases in the study group (6.3%) and none in the control group (P <0.001); respective rates of postoperative inflammation (wound infection) were 1.04% and 3.3% (P=NS). Management of parotitis consisted of hospitalization and systemic antibiotic therapy.
CONCLUSIONS: Warthin's tumour is associated with a tenfold higher risk of inflammation compared to other parotid tumours following invasive procedures. Clinicians should be alert to this complication in order to initiate proper treatment and patients must be properly counseled. This article is protected by copyright. All rights reserved.

PMID: 28235157 [PubMed - as supplied by publisher]

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Interleukin-10 reorganizes the cytoskeleton of mature dendritic cells leading to their impaired biophysical properties and motilities.

Interleukin-10 reorganizes the cytoskeleton of mature dendritic cells leading to their impaired biophysical properties and motilities.

PLoS One. 2017;12(2):e0172523

Authors: Xu X, Liu X, Long J, Hu Z, Zheng Q, Zhang C, Li L, Wang Y, Jia Y, Qiu W, Zhou J, Yao W, Zeng Z

Abstract
Interlukin-10 (IL-10) is an immunomodulatory cytokine which predominantly induces immune-tolerance. It has been also identified as a major cytokine in the tumor microenvironment that markedly mediates tumor immune escape. Previous studies on the roles of IL-10 in tumor immunosuppression mainly focus on its biochemical effects. But the effects of IL-10 on the biophysical characteristics of immune cells are ill-defined. Dendritic cells (DCs) are the most potent antigen-presenting cells and play a key role in the anti-tumor immune response. IL-10 can affect the immune regulatory functions of DCs in various ways. In this study, we aim to explore the effects of IL-10 on the biophysical functions of mature DCs (mDCs). mDCs were treated with different concentrations of IL-10 and their biophysical characteristics were identified. The results showed that the biophysical properties of mDCs, including electrophoresis mobility, osmotic fragility and deformability, as well as their motilities, were impaired by IL-10. Meanwhile, the cytoskeleton (F-actin) of mDCs was reorganized by IL-10. IL-10 caused the alternations in the expressions of fasin1 and profilin1 as well as the phosphorylation of cofilin1 in a concentration-dependent fashion. Moreover, Fourier transformed infrared resonance data showed that IL-10 made the status of gene transcription and metabolic turnover of mDCs more active. These results demonstrate a new aspect of IL-10's actions on the immune system and represent one of the mechanisms for immune escape of tumors. It may provide a valuable clue to optimize and improve the efficiency of DC-based immunotherapy against cancer.

PMID: 28234961 [PubMed - in process]

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Reply: Suprafascial Anterolateral Thigh Flap Harvest: A Better Way to Minimize Donor-Site Morbidity in Head and Neck Reconstruction.

Reply: Suprafascial Anterolateral Thigh Flap Harvest: A Better Way to Minimize Donor-Site Morbidity in Head and Neck Reconstruction.

Plast Reconstr Surg. 2017 Mar;139(3):810e-811e

Authors: Chen YC

PMID: 28234883 [PubMed - in process]

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Can I Make Robotic Surgery Make Sense in My Practice?

Can I Make Robotic Surgery Make Sense in My Practice?

Plast Reconstr Surg. 2017 Mar;139(3):781e-792e

Authors: Selber JC

Abstract
Over the past 10 years, robotic technology has had a significant impact on minimally invasive surgery. Because plastic surgery is rooted in "open" techniques, robotic applications in the specialty have been slow to emerge. That said, robotic technology possesses superhuman precision and high-definition, three-dimensional optics that are promising attributes in the hands of the plastic surgeon. In this article, the author explores three applications in robotic plastic surgery: (1) transoral robotic reconstructive surgery for head and neck reconstruction, permitting complex oropharyngeal reconstruction without dividing the lip or mandible; (2) robotic muscle harvest, permitting minimally invasive harvest of the latissimus dorsi and rectus abdominis muscle; and (3) robotic microanastomoses, extending the capabilities of the human hand in microvascular and microlymphatic surgery. An overview of the concepts, surgical techniques, and indications is provided. Although progress has been made, many barriers remain to adopting this technology in its current state, and these are also discussed. Robotic surgery is just beginning to have an impact on the field of plastic surgery. As this technology continues to advance in and out of the operating room, it will play an increasingly prominent role in our specialty and in our lives.

PMID: 28234863 [PubMed - in process]

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Transverse Cervical Artery: Consistent Anatomical Landmarks and Clinical Experience with Its Use as a Recipient Artery in Complex Head and Neck Reconstruction.

Transverse Cervical Artery: Consistent Anatomical Landmarks and Clinical Experience with Its Use as a Recipient Artery in Complex Head and Neck Reconstruction.

Plast Reconstr Surg. 2017 Mar;139(3):745e-751e

Authors: Tessler O, Gilardino MS, Bartow MJ, St Hilaire H, Womac D, Dionisopoulos T, Lessard L

Abstract
BACKGROUND: Many head and neck reconstructions occur in patients with extensive history of surgery or radiation treatment. This leads to complicated free flap reconstructions, especially in choosing recipient vessels in a "frozen neck." The transverse cervical artery is an optimal second-line recipient artery in head and neck reconstruction.
METHODS: Seventy-two neck sides in 36 cadavers were dissected, looking for the transverse cervical artery and transverse cervical vein. Anatomical location of these vessels, their diameter, and length were documented. A retrospective analysis on 19 patients who had head and neck reconstruction using the transverse cervical artery as a recipient artery was undertaken as well with regard to outcome of procedures, reason for surgery, previous operations, and use of vein grafts during surgery.
RESULTS: The transverse cervical artery was present in 72 of 72 of cadaveric specimens, and was infraclavicular in two of 72 specimens. Transverse cervical artery length ranged from 4.0 to 7.0 cm, and the mean diameter was 2.65 mm. The transverse cervical vein was present in 61 of 72 cadaveric specimens, the length ranged from 4.0 to 7.0 cm, and the mean diameter was 2.90 mm. The transverse cervical artery averaged 33 mm from midline, and branched off the thyrocervical trunk at an average 17 mm superior to the clavicle. Transverse cervical artery stenosis was markedly less in comparison with external carotid artery stenosis. In a 20-year clinical follow-up study, the transverse cervical artery was the recipient artery in 19 patients. A vein graft was used in one patient, and no flap loss occurred in any of the 19 patients.
CONCLUSION: The transverse cervical artery is a reliable and robust option as a recipient artery in free flap head and neck reconstruction.

PMID: 28234854 [PubMed - in process]

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Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Otol Neurotol. 2017 Feb 23;:

Authors: Roche JP, Goates AJ, Hasan DM, Howard MA, Menezes AH, Hansen MR, Gantz BJ

Abstract
OBJECTIVE: Define the indications and outcomes for subjects undergoing treatment utilizing the extended middle cranial fossa approach (EMCF).
STUDY DESIGN: Retrospective records review.
SETTING: University-based tertiary referral center.
PATIENTS: Subjects undergoing treatment of posterior cranial fossa (PCF) lesions.
INTERVENTION(S): EMCF exposure and treatment of the indicating PCF lesion.
MAIN OUTCOME MEASURE(S): Demographic, audiometric, and cranial nerve functioning variables were assessed.
RESULTS: Thirty-five subjects who underwent an EMCF exposure were identified over a 12-year period. The most common indication was meningioma (18; 51%) followed by schwannomas (six, 17%), and vascular lesions (five, 14%). Preoperative cranial nerve complaints were common (32, 94%) as were objective cranial nerve abnormalities on physical examination (21; 60%). Preoperative audiometric data from subjects with hearing demonstrated good functioning including pure-tone average (PTA) (21.7 ± 15.6 dB HL) and word understanding scores (95.1 ± 7.4%). Most (34, 97%) subjects had intact facial nerve function. The average length of stay was 11.6 days (median = 9). Cranial neuropathies were common postoperatively with 27 (79%) subjects demonstrating some objective cranial nerve dysfunction, the most common of which was trigeminal nerve hypesthesia (21, 61.7%). Subjects with identifiable pre- and postoperative audiometric data and preoperative hearing demonstrated small declines in the four-tone average (16.2 dB) and word recognition scores (22.4%). Two subjects (6%) had new profound hearing loss postoperatively.
CONCLUSIONS: The EMCF approach can provide safe and effective exposure of the anterior PCF.

PMID: 28234787 [PubMed - as supplied by publisher]

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Assessing asthma in the otolaryngologist's office.

Assessing asthma in the otolaryngologist's office.

Curr Opin Otolaryngol Head Neck Surg. 2017 Feb 23;:

Authors: Luk LJ, Rotella MR, Stillman LJ, Wise SK

Abstract
PURPOSE OF REVIEW: To familiarize otolaryngologists and other practitioners with basic diagnosis and treatment of asthma in adults and children based on current literature.
RECENT FINDINGS: Increased fractional excretion of nitrous oxide and sputum eosinophils have been identified in asthmatic patients being evaluated for chronic cough and appear to be more sensitive in diagnosis than traditional spirometry. Both sublingual and subcutaneous immunotherapy modalities are effective in decreasing symptoms and medication use in patients with allergic rhinitis and allergic asthma.
SUMMARY: Undiagnosed comorbid asthma is prevalent among patients with chronic rhinosinusitis and allergic rhinitis and control of all diseases processes greatly improves quality of life. Office spirometry is a helpful tool in the evaluation and management of asthma. Otolaryngologists should be able to recognize undiagnosed or poorly controlled asthma, initiate and improve medical therapy, and treat rhinosinusitis to improve asthma control.

PMID: 28234779 [PubMed - as supplied by publisher]

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Scalp melanoma is associated with high mitotic rate and is a poor prognostic factor for recurrence and outcome.

Scalp melanoma is associated with high mitotic rate and is a poor prognostic factor for recurrence and outcome.

Melanoma Res. 2017 Feb 23;:

Authors: Tas F, Erturk K

Abstract
A small subset of head and neck melanoma, scalp melanoma comprises 3-5% of all cutaneous melanomas. So far, small numbers of researches on scalp melanoma have yielded controversial results. In this trial, we aimed to define the histopathological and clinical features specific to scalp melanoma and to compare them with melanomas that occurred on other sites by using a large group of patients from a single institution. The data of 93 patients with scalp melanoma and 1076 patients with melanomas on other sites were analyzed retrospectively. The median age of the patients was 53 (range 18-83) years. The scalp melanomas were found more frequently in male patients (79.6 vs. 52.0%, P=0.001) and they tended to have nodular histology (41.1 vs. 29.2%, P=0.01), with a higher mitotic rate (>3/mm) (56.9 vs. 40.9%, P=0.01). However, the scalp melanoma was not significantly associated with other histopathological parameters, for example, age, Clark invasion level, Breslow thickness, ulceration, regression, lymphovascular invasion, neurotropism, tumor-infiltrating lymphocyte, and BRAF mutation analysis. Besides, no correlation was found between scalp localization and either nodal involvement or metastasis (P>0.05). The scalp patients had poorer survivals compared with those with other sites. The median survival time and 5-year recurrence-free survival rates for scalp and other sites in patients were 15.6 months and 45.1% versus 23.5 months and 63.6%, respectively (P=0.001). Similarly, the median overall survival times and 5-year overall survival rates in scalp and other sites in patients were 25.6 months and 44.1% versus 28.7 months and 62.9%, respectively (P=0.0001). In conclusion, scalp melanoma patients correlate with a high mitotic rate and are associated with poorer survival than patients with melanomas on other sites.

PMID: 28234768 [PubMed - as supplied by publisher]

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Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

Effects of Hearing Impairment and Hearing Aid Amplification on Listening Effort: A Systematic Review.

Ear Hear. 2017 Feb 23;:

Authors: Ohlenforst B, Zekveld AA, Jansma EP, Wang Y, Naylor G, Lorens A, Lunner T, Kramer SE

Abstract
OBJECTIVES: To undertake a systematic review of available evidence on the effect of hearing impairment and hearing aid amplification on listening effort. Two research questions were addressed: Q1) does hearing impairment affect listening effort? and Q2) can hearing aid amplification affect listening effort during speech comprehension?
DESIGN: English language articles were identified through systematic searches in PubMed, EMBASE, Cinahl, the Cochrane Library, and PsycINFO from inception to August 2014. References of eligible studies were checked. The Population, Intervention, Control, Outcomes, and Study design strategy was used to create inclusion criteria for relevance. It was not feasible to apply a meta-analysis of the results from comparable studies. For the articles identified as relevant, a quality rating, based on the 2011 Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines, was carried out to judge the reliability and confidence of the estimated effects.
RESULTS: The primary search produced 7017 unique hits using the keywords: hearing aids OR hearing impairment AND listening effort OR perceptual effort OR ease of listening. Of these, 41 articles fulfilled the Population, Intervention, Control, Outcomes, and Study design selection criteria of: experimental work on hearing impairment OR hearing aid technologies AND listening effort OR fatigue during speech perception. The methods applied in those articles were categorized into subjective, behavioral, and physiological assessment of listening effort. For each study, the statistical analysis addressing research question Q1 and/or Q2 was extracted. In seven articles more than one measure of listening effort was provided. Evidence relating to Q1 was provided by 21 articles that reported 41 relevant findings. Evidence relating to Q2 was provided by 27 articles that reported 56 relevant findings. The quality of evidence on both research questions (Q1 and Q2) was very low, according to the Grading of Recommendations Assessment, Development, and Evaluation Working Group guidelines. We tested the statistical evidence across studies with nonparametric tests. The testing revealed only one consistent effect across studies, namely that listening effort was higher for hearing-impaired listeners compared with normal-hearing listeners (Q1) as measured by electroencephalographic measures. For all other studies, the evidence across studies failed to reveal consistent effects on listening effort.
CONCLUSION: In summary, we could only identify scientific evidence from physiological measurement methods, suggesting that hearing impairment increases listening effort during speech perception (Q1). There was no scientific, finding across studies indicating that hearing aid amplification decreases listening effort (Q2). In general, there were large differences in the study population, the control groups and conditions, and the outcome measures applied between the studies included in this review. The results of this review indicate that published listening effort studies lack consistency, lack standardization across studies, and have insufficient statistical power. The findings underline the need for a common conceptual framework for listening effort to address the current shortcomings.

PMID: 28234670 [PubMed - as supplied by publisher]

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Involvement of the maxillary sinus in bisphosphonate-related osteonecrosis of the jaw: Radiologic aspects.

Involvement of the maxillary sinus in bisphosphonate-related osteonecrosis of the jaw: Radiologic aspects.

Am J Rhinol Allergy. 2017 Jan 01;31(1):36-39

Authors: Wasserzug O, Kaffe I, Lazarovici TS, Weissman T, Yahalom R, Fliss DM, Yarom N

Abstract
BACKGROUND: The use of bisphosphonates is very common among patients with osteoporosis and multiple myeloma as well as those with bone metastases from various malignancies. The benefits of bisphosphonates are well recognized, but it became evident during the past decade that these medications portend the major adverse effect of osteonecrosis of the jaw, known as bisphosphonate-related osteonecrosis of the jaw.
OBJECTIVE: Our aim was to evaluate the specific manifestations of bisphosphonate use on the maxillary sinus in patients with documented bisphosphonate-related osteonecrosis of the jaw.
METHODS: A retrospective review of all the patients diagnosed between October 2003 to August 2014 as having bisphosphonate-related osteonecrosis of the jaw in a large university-affiliated tertiary care medical center. The records of 173 patients diagnosed as having bisphosphonate-related osteonecrosis of the jaw during the study period were retrieved. The available head and neck computed tomographic images were analyzed for cases of involvement of the maxilla.
MAIN OUTCOME MEASURES: Manifestations of bisphosphonate-related osteonecrosis of the jaw as observed on physical examination and on imaging studies.
RESULTS: Seventy-one patients (41%) had involvement of the maxilla, 86 patients (49%) had involvement of the mandible, and 16 patients (9%) had involvement of both the maxilla and the mandible. Computerized tomography studies were available for 50 patients with involvement of the maxilla: 36 (72%) had evidence of maxillary sinus opacification (in comparison, the incidence of maxillary sinus opacification as an incidental finding in the general population is reported to be 19%, p < 0.0001). Sixteen patients (32%) had evidence of oroantral fistula, and five patients (10%) had oronasal fistula.
CONCLUSION: In addition to its well-established effects on the mandible and maxilla, bisphosphonate-related osteonecrosis of the jaw significantly affected the maxillary sinus. Its radiologic manifestations should be recognized by clinicians and especially by otolaryngologists.

PMID: 28234151 [PubMed - in process]

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Removable sinus stent for endoscopic sinus surgery: An animal trial.

Removable sinus stent for endoscopic sinus surgery: An animal trial.

Am J Rhinol Allergy. 2017 Jan 01;31(1):29-32

Authors: Yaniv D, Shlosberg L, Flomenblit J, Frenklach G, Rath-Wolfson L, Yaniv E

Abstract
BACKGROUND: The goal of endoscopic sinus surgery in chronic sinusitis is to create good drainage of the paranasal sinuses. Metal stents used to prevent lateralization of the middle concha are associated with adverse effects.
OBJECTIVE: The aim of this experimental study was to evaluate the feasibility and safety of a newly developed composite removable stent.
METHODS: The composite removable stent was implanted in nine sheep (18 stents) in the ethmoid cavity after performing an ethmoidectomy and was examined for stability, ease of removal, and adverse effects. Histologic findings were compared between implantation and nonimplantation sites at several time points after stent deployment and removal.
RESULTS: None of the stents migrated or fell out of the nose. After 4 weeks, there was no infection in the nose or around the stents, and there was no damage to the mucosa. An histologic study showed only mild-to-moderate inflammatory cell infiltration relative to control sites, with no damage to the mucosal epithelium and no necrosis at distant sites. At 2 weeks after stent removal, slight-to-moderate fibroplasia was noted in the deep nasal tissue, with slight-to-moderate osteocartilaginous metaplasia and bone remodeling but no necrotic or inflammatory changes in surrounding tissues. At 4 weeks after stent removal, the middle meatus remained open.
CONCLUSION: The promising results of the composite removable stent in a sheep model justify further studies in patients undergoing endoscopic sinus surgery for chromic sinusitis.

PMID: 28234150 [PubMed - in process]

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Oral corticosteroid prescribing habits for rhinosinusitis: The American Rhinologic Society membership.

Oral corticosteroid prescribing habits for rhinosinusitis: The American Rhinologic Society membership.

Am J Rhinol Allergy. 2017 Jan 01;31(1):22-26

Authors: Scott JR, Ernst HM, Rotenberg BW, Rudmik L, Sowerby LJ

Abstract
BACKGROUND: In the field of otolaryngology, oral corticosteroids (OCS) are widely prescribed for rhinosinusitis. Although there is evidence in the literature regarding specific OCS dosing protocols, it is not known to what extent these recommendations are being followed.
OBJECTIVE: To examine the current state of OCS prescribing habits for rhinosinusitis by American Rhinologic Society members.
METHODS: An anonymous online survey was sent to all American Rhinologic Society members. Dosing, frequency, tapering, and overall prescribing habits for OCS were assessed in chronic rhinosinusitis with polyposis (CRSwP) and in chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis. The CRSwP group was subdivided into aspirin-exacerbated respiratory disease, allergic fungal sinusitis, and not otherwise specified. Results were compared with current guidelines. Descriptive statistics were used to analyze data.
RESULTS: Ninety-three surveys were completed (response rate, 12.9%). Prednisone was the most common OCS prescribed. In the CRSwP-aspirin-exacerbated respiratory disease group (n = 86), the median starting dose was 60 mg (range, 4-80 mg) and the average duration was 8 days (range, 2-28 days). In the CRSwP-allergic fungal sinusitis group (n = 81), the median starting dose was 50 mg (range, 20-60 mg), and the average duration was 6 days (range, 2-35 days). In the CRSwP-not otherwise specified group (n = 84), the median starting dose was 50 mg (range, 20-80 mg) and the average duration was 5 days (range, 1-21 days). OCS were prescribed for chronic rhinosinusitis without polyposis and acute bacterial rhinosinusitis by 66.0 and 62.4% of respondents, respectively.
CONCLUSION: Significant heterogeneity existed in OCS prescribing habits for rhinosinusitis. Discrepancies were observed between survey results and evidence-based recommendations. Developing standardized OCS treatment protocols for rhinosinusitis may improve the quality of care by optimizing clinical outcomes and reducing the risk of complications.

PMID: 28234148 [PubMed - in process]

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Sinonasal imaging findings in granulomatosis with polyangiitis (Wegener granulomatosis): A systematic review.

Sinonasal imaging findings in granulomatosis with polyangiitis (Wegener granulomatosis): A systematic review.

Am J Rhinol Allergy. 2017 Jan 01;31(1):16-21

Authors: D'Anza B, Langford CA, Sindwani R

Abstract
BACKGROUND: Granulomatosis with polyangiitis (GPA) (Wegener granulomatosis) frequently presents in the head and neck, and the sinonasal cavity is among the most common areas affected. Although the clinical findings, histologic appearance, and laboratory workup have been described, characteristic findings and the distribution of disease on sinonasal imaging are not well established. The appropriate imaging modality to evaluate for sinonasal involvement is also unclear.
OBJECTIVE: To describe the imaging characteristics, distribution, and location of sinonasal pathology in patients with GPA as noted on computed tomography and magnetic resonance imaging modalities.
METHODS: A systematic review was conducted of English language articles, by using appropriate search terms, which reported the computed tomography and magnetic resonance imaging findings specific to sinonasal disease in adult subjects with GPA. Studies were included only when they focused primarily on specific imaging results in patients with GPA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.
RESULTS: A total of 50 articles were identified on an initial search of medical literature data bases. There were seven articles that comprised 224 patients who met inclusion criteria. All the articles were retrospective case series and descriptive in nature. A high incidence of patients with GPA who were imaged showed evidence of pathologic findings. The prevalence of key radiographic findings in patients with GPA were the following: mucosal thickening (87.7% of patients), bony destruction (59.9%), and septal erosion (59.4%). There were no randomized or prospective studies that compared imaging findings between patients with GPA and the controls, and no studies that correlated imaging findings with prognosis.
CONCLUSION: Sinus imaging in GPA revealed a spectrum of nonspecific findings. The constellation of septal erosion, mucosal thickening, and bony changes should raise suspicion for GPA. The current literature was insufficient to make any comments on the time course of sinonasal disease and imaging manifestations. Further comparative studies are needed to determine a role for sinonasal imaging in the diagnosis and prognosis of GPA.

PMID: 28234146 [PubMed - in process]

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The association of allergic sensitization with radiographic sinus opacification.

The association of allergic sensitization with radiographic sinus opacification.

Am J Rhinol Allergy. 2017 Jan 01;31(1):12-15

Authors: Brook CD, Kuperstock JE, Rubin SJ, Ryan MW, Platt MP

Abstract
BACKGROUND: The relationship between allergic sensitization and radiographic sinus inflammation remains unclear.
OBJECTIVES: To determine whether specific allergen sensitization is correlated with sinonasal radiographic opacification.
METHODS: Patients with chronic sinonasal symptoms were selected and included if they had allergy testing and a computed tomography (CT) of the paranasal sinuses. Data regarding demographic characteristics, in vitro allergy test results, and comorbidities were collected. CTs were reviewed, and an overall Lund-Mackay score (LMS) was calculated for each patient. A two-sample t-test was used to compare mean LMS between patients who were sensitized and patients who were not sensitized. A multiple linear regression model was used to determine whether a relationship existed among LMS and allergy results, asthma, nasal polyps, immunoglobulin E (IgE) level, medication usage, in-season versus out-of-season CTs, age, and sex. Significance was determined at an alpha level of 0.05.
RESULTS: There were 437 patients included, of whom, 251 had positive specific allergen test results and 186 had negative test results. A total of 282 patients had allergic rhinitis symptoms without a documented diagnosis of sinusitis, and 155 carried a diagnosis of chronic rhinosinusitis. The mean LMS did not differ between patients who were sensitized and patients who were not sensitized (5.56 versus 5.28; p = 0.61). Linear regression demonstrated an increase in LMS in patients with asthma (p = 0.02), male sex (p < 0.01), elevated IgE (p < 0.01), a history of anaphylaxis (p = 0.03), and nasal polyps (p < 0.01). There was a statistically significant decrease in LMS in patients with an in-season CT (p = 0.02).
CONCLUSIONS: Patients with a positive specific in vitro allergen test result did not have higher overall rates of radiographic sinus inflammation. Asthma, male sex, polyps, elevated IgE, and a history of anaphylaxis were associated with higher LMS.

PMID: 28234144 [PubMed - in process]

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Peripheral blood T-helper cells and eosinophil populations in patients with atopic and nonatopic chronic rhinosinusitis.

Peripheral blood T-helper cells and eosinophil populations in patients with atopic and nonatopic chronic rhinosinusitis.

Am J Rhinol Allergy. 2017 Jan 01;31(1):8-12

Authors: Huang Z, Nayak JV, Sun Y, Huang Q, Zhou B

Abstract
BACKGROUND: Analysis of recent research indicated that T-helper cells may play an important role in the pathogenesis of chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP).
OBJECTIVE: The purpose of this study was to investigate the peripheral blood Th1 and Th2 cells and eosinophil population in patients with CRS.
METHODS: Peripheral blood samples were obtained from nine nonatopic controls, 37 patients with CRSsNP, and 66 patients with CRSwNP. The samples were then analyzed by flow cytometry analysis (Th1 cell [CD4+, interleukin 4-, interferon γ+]; and Th2 cell [CD4+, interleukin 4+, interferon γ-]). The patients were stratified into four groups based on their allergic status by using skin-prick test results and immunoglobulin E level measurements as the following: (1) nonatopic CRSsNP, (2) nonatopic CRSwNP, (3) atopic CRSsNP, and (4) atopic CRSwNP. Eosinophil counts were also compared. The severity of nasal diseases in these patients was assessed via the Lund-Mackay score.
RESULTS: No significant differences in peripheral blood Th1 and Th2 cells were found among all the atopic, nonatopic CRS groups, and the nonatopic control groups. Peripheral blood eosinophil levels in atopic CRSwNP were significantly elevated compared with the nonatopic controls (p < 0.05), but no significant difference was found among all atopic and nonatopic CRS groups.
CONCLUSION: Analysis of our data demonstrated that a proportion of systemic Th1- and Th2-skewed lymphocytes in all CRS groups were similar to that in healthy subjects, irrespective of atopic status. The patients with CRSwNP and with atopy but not the patients with CRSsNP and with atopy demonstrated systemic eosinophilic inflammation. Further studies are needed to investigate underlying pathophysiologic mechanism or endotypes.

PMID: 28234143 [PubMed - in process]

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Cytological findings of langerhans cell sarcoma in a case of quintuple cancer.

Cytological findings of langerhans cell sarcoma in a case of quintuple cancer.

Diagn Cytopathol. 2017 Feb 24;:

Authors: Tabata S, Murata M, Takasawa A, Fukuda A, Ogasawara J, Koseki T, Nakano K, Segawa K, Morita R, Hasegawa T, Sawada N

Abstract
Langerhans cell sarcoma (LCS) and quintuple cancers are extremely rare. In this report, a case of quintuple cancers including LCS was described. An 80-year-old man had squamous cell carcinoma of the nasal skin, colon and rectum adenocarcinomas, and T-cell/histiocyte-rich large B-cell lymphoma. As swelling of multiple submental lymph nodes was observed, fine-needle aspiration was carried out. Many large cells with high-grade nuclear atypia and abundant cytoplasm were observed. Lymphocytes and eosinophils were observed in the background. Although a malignant tumor was suspected, a definite diagnosis could not be made. In a biopsy sample, the tumor cells were positive for vimentin, CD68, S-100, CD1a, and CD163 and negative for epithelial, lymphocyte, and melanoma markers in immunohistochemistry. A diagnosis of LCS was made from the immunohistochemical findings and high mitotic rate with atypical forms. The patient died about 2 months after the first medical examination. Metastasis of LCS was confirmed in many organs by autopsy. LCS has a poor prognosis. In cases with the above-described cytological findings, LCS should be added to the list of differential diagnosis. The cytological findings presented here may be useful for determining appropriate clinical management such as staging of the disease and follow-up of the neoplasm. Diagn. Cytopathol. 2017. © 2017 Wiley Periodicals, Inc.

PMID: 28233936 [PubMed - as supplied by publisher]

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Endoscope-assisted silicone plug insertion for patulous Eustachian tube patients.

Endoscope-assisted silicone plug insertion for patulous Eustachian tube patients.

Laryngoscope. 2017 Feb 24;:

Authors: Ikeda R, Kikuchi T, Kobayashi T

PMID: 28233914 [PubMed - as supplied by publisher]

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Evaluation of a revised indication for determining adult cochlear implant candidacy.

Evaluation of a revised indication for determining adult cochlear implant candidacy.

Laryngoscope. 2017 Feb 24;:

Authors: Sladen DP, Gifford RH, Haynes D, Kelsall D, Benson A, Lewis K, Zwolan T, Fu QJ, Gantz B, Gilden J, Westerberg B, Gustin C, O'Neil L, Driscoll CL

Abstract
OBJECTIVE: To evaluate the use of monosyllabic word recognition versus sentence recognition to determine candidacy and long-term benefit for cochlear implantation.
STUDY DESIGN: Prospective multi-center single-subject design.
METHODS: A total of 21 adults aged 18 years and older with bilateral moderate to profound sensorineural hearing loss and low monosyllabic word scores received unilateral cochlear implantation. The consonant-nucleus-consonant (CNC) word test was the central measure of pre- and postoperative performance. Additional speech understanding tests included the Hearing in Noise Test sentences in quiet and AzBio sentences in +5 dB signal-to-noise ratio (SNR). Quality of life (QoL) was measured using the Abbreviated Profile of Hearing Aid Benefit and Health Utilities Index.
RESULTS: Performance on sentence recognition reached the ceiling of the test after only 3 months of implant use. In contrast, none of the participants in this study reached a score of 80% on CNC word recognition, even at the 12-month postoperative test interval. Measures of QoL related to hearing were also significantly improved following implantation.
CONCLUSION: Results of this study demonstrate that monosyllabic words are appropriate for determining preoperative candidate and measuring long-term postoperative speech recognition performance.
LEVEL OF EVIDENCE: 2c. Laryngoscope, 2017.

PMID: 28233910 [PubMed - as supplied by publisher]

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Kinome Profiling Identifies Druggable Targets For Novel HCMV Antivirals [Research]

Human cytomegalovirus (HCMV) is a significant cause of disease in immunecompromised adults and immune naive newborns. No vaccine exists to prevent HCMV infection, and current antiviral therapies have toxic side effects that limit the duration and intensity of their use. There is thus an urgent need for new strategies to treat HCMV infection. Repurposing existing drugs as antivirals is an attractive approach to limit the time and cost of new antiviral drug development. Virus-induced changes in infected cells are often driven by changes in cellular kinase activity, which led us to hypothesize that defining the complement of kinases (the kinome), whose abundance or expression is altered during infection would identify existing kinase inhibitors that could be repurposed as new antivirals. To this end, we applied a kinase capture technique, MIB-MS kinome profiling, to quantitatively measure perturbations in >240 cellular kinases simultaneously in cells infected with a laboratory-adapted (AD169) or clinical (TB40E) HCMV strain. MIB-MS profiling identified time-dependent increases and decreases in MIB binding of multiple kinases including cell cycle kinases, receptor tyrosine kinases and mitotic kinases. Based on the kinome data, we tested the antiviral effects of kinase inhibitors and other compounds, several of which are in clinical use or development. Using a novel flow cytometry-based assay and a fluorescent reporter virus we identified three compounds that inhibited HCMV replication with IC50 values of <1μM, and at doses that were not toxic to uninfected cells. The most potent inhibitor of HCMV replication was OTSSP167 (IC50 <1.2 nM), a MELK inhibitor, blocked HCMV early gene expression and viral DNA accumulation, resulting in a >3 log decrease in virus replication. These results show the utility of MIB-MS kinome profiling for identifying existing kinase inhibitors that can potentially be repurposed as novel antiviral drugs.

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Proteome and secretome analysis reveals differential post-transcriptional regulation of Toll-like receptor responses [Research]

The innate immune system is the organism's first line of defense against pathogens. Pattern recognition receptors (PRRs) are responsible for sensing the presence of pathogen-associated molecules. The prototypic PRRs, the membrane-bound receptors of the Toll-like receptor (TLR) family, recognize pathogen-associated molecular patterns (PAMPs) and initiate an innate immune response through signaling pathways that depend on the adaptor molecules MyD88 and TRIF. Deciphering the differences in the complex signaling events that lead to pathogen recognition and initiation of the correct response remains challenging. Here we report the discovery of temporal changes in the protein signaling components involved in innate immunity. Using an integrated strategy combining unbiased proteomics, transcriptomics and macrophage stimulations with three different PAMPs, we identified differences in signaling between individual TLRs and revealed specifics of pathway regulation at the protein level.

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Development of a multiplexed LC-MRM/MS method for evaluation of salivary proteins as oral cancer biomarkers [Research]

Multiple (selected) reaction monitoring (MRM/SRM) of peptides is a growing technology for target protein quantification because it is more robust, precise, accurate, high-throughput, and multiplex-capable than antibody-based techniques. The technique has been applied clinically to the large-scale quantification of multiple target proteins in different types of fluids. However, previous MRM-based studies have placed less focus on sample-preparation workflow and analytical performance in the precise quantification of proteins in saliva, a non-invasively sampled body fluid. In this study, we evaluated the analytical performance of a simple and robust MRM-based targeted proteomics approach incorporating liquid chromatography with mass spectrometry detection (LC-MRM/MS). This platform was used to quantitatively assess the biomarker potential of a group of 56 salivary proteins that have previously been associated with human cancers. To further enhance the development of this technology for assay of salivary samples, we optimized the workflow for salivary protein digestion and evaluated quantification performance, robustness and technical limitations in analyzing clinical samples. Using a clinically well-characterized cohort of two independent clinical sample sets (total n = 119), we quantitatively characterized these protein biomarker candidates in saliva specimens from controls and oral squamous cell carcinoma (OSCC) patients. The results clearly showed a significant elevation of most targeted proteins in saliva samples from OSCC patients compared with controls. Overall, this platform was capable of assaying the most highly multiplexed panel of salivary protein biomarkers, highlighting the clinical utility of MRM in oral cancer biomarker research.

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Tiny, Tiny TRAPPIST-1

The 7-planet system of TRAPPIST-1 is remarkable in many ways, including its size

-- Read more on ScientificAmerican.com

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.3 No.2

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The new issue is now available.Journal of Japanese Society for Parenteral and Enteral Nutrition

Vol.32 No.supplement

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The new issue is now available.Japanese Journal of Social Psychology

Vol.29 No.2

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The new issue is now available.JOURNAL OF THE BREWING SOCIETY OF JAPAN

Vol.106 No.9

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The new issue is now available.Nippon Daicho Komonbyo Gakkai Zasshi

Vol.70 No.3

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The new issue is now available.Shikaigaku

Vol.55 No.6

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The new issue is now available.Shikaigaku

Vol.55 No.5

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The new issue is now available.Shikaigaku

Vol.55 No.4

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The new issue is now available.Shikaigaku

Vol.55 No.3

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The new issue is now available.Shikaigaku

Vol.55 No.2

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The new issue is now available.Journal of Japan Association for Earthquake Engineering

Vol.17 No.1

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.5 No.2

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.5 No.1

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.4 No.2

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.4 No.1

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.3 No.1

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newly available online.Total Rehabilitation Research

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The new issue is now available.Total Rehabilitation Research

Vol.3

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The new issue is now available.Journal of the Japan Society for Technology of Plasticity

Vol.58 No.673

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The new issue is now available.The journal of Japanese Language Education Methods

Vol.2 No.2

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The Significant Surface-Water Connectivity of “Geographically Isolated Wetlands”

Abstract

We evaluated the current literature, coupled with our collective research expertise, on surface-water connectivity of wetlands considered to be “geographically isolated” (sensu Tiner Wetlands 23:494–516, 2003a) to critically assess the scientific foundation of grouping wetlands based on the singular condition of being surrounded by uplands. The most recent research on wetlands considered to be “geographically isolated” shows the difficulties in grouping an ecological resource that does not reliably indicate lack of surface water connectivity in order to meet legal, regulatory, or scientific needs. Additionally, the practice of identifying “geographically isolated wetlands” based on distance from a stream can result in gross overestimates of the number of wetlands lacking ecologically important surface-water connections. Our findings do not support use of the overly simplistic label of “geographically isolated wetlands”. Wetlands surrounded by uplands vary in function and surface-water connections based on wetland landscape setting, context, climate, and geographic region and should be evaluated as such. We found that the “geographically isolated” grouping does not reflect our understanding of the hydrologic variability of these wetlands and hence does not benefit conservation of the Nation’s diverse wetland resources. Therefore, we strongly discourage use of categorizations that provide overly simplistic views of surface-water connectivity of wetlands fully embedded in upland landscapes.

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The Lamina Dura

The lamina dura is the bony lining of the socket (alveolus) of a tooth. The periodontal ligaments extend from the lamina dura to the cementum of the tooth, an keep the tooth in place. The lamina dura is cribriform plate produced by the periodontal ligament and fibers of the periodontal ligament are embedded within it.

While loss of the lamina dura (arrow in image above) is sometimes said to be pathognomonic for hyperparathyroidism, it can be seen in a wide range of conditions:

Hyperparathyroidism: The case above is from a patient with primary hyperparathyroidism.
Osteomalacia
Osteoporosis
Paget disease
Leukemia
Myelomatosis
Cushing disease

The lamina dura can be thickened in bisphosphonate-related osteonecrosis of jaw (BRONJ)

References

Arce K, Assael LA, Weissman JL, Markiewicz MR. Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg. 2009 May;67(5 Suppl):75-84.
Berry HM Jr. The lore and the lure o' the lamina dura. Radiology. 1973 Dec;109(3):525-8.

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Congestion Detection and Alleviation in Multihop Wireless Sensor Networks

Multiple traffic flows in a dense environment of a mono-sink wireless sensor network (WSN) experience congestion that leads to excessive energy consumption and severe packet loss. To address this problem, a Congestion Detection and Alleviation (CDA) mechanism has been proposed. CDA exploits the features and the characteristics of the sensor nodes and the wireless links between them to detect and alleviate node- and link-level congestion. Node-level congestion is detected by examining the buffer utilisation and the interval between the consecutive data packets. However, link-level congestion is detected through a novel procedure by determining link utilisation using back-off stage of Carrier Sense Multiple Access with Collision Avoidance (CSMA/CA). CDA alleviates congestion reactively by either rerouting the data traffic to a new less congested, more energy-efficient route or bypassing the affected node/link through ripple-based search. The simulation analysis performed in ns-2.35 evaluates CDA with Congestion Avoidance through Fairness (CAF) and with No Congestion Control (NOCC) protocols. The analysis shows that CDA improves packet delivery ratio by 33% as compared to CAF and 54% as compared to NOCC. CDA also shows an improvement in throughput by 16% as compared to CAF and 36% as compared to NOCC. Additionally, it reduces End-To-End delay by 17% as compared to CAF and 38% as compared to NOCC.

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Ring-Shaped Potential and a Class of Relevant Integrals Involved Universal Associated Legendre Polynomials with Complicated Arguments

We find that the solution of the polar angular differential equation can be written as the universal associated Legendre polynomials. Its generating function is applied to obtain an analytical result for a class of interesting integrals involving complicated argument, that is, , where . The present method can in principle be generalizable to the integrals involving other special functions. As an illustration we also study a typical Bessel integral with a complicated argument .

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Cancer Stem Cells and Their Microenvironment: Biology and Therapeutic Implications

Tumor consists of heterogeneous cancer cells including cancer stem cells (CSCs) that can terminally differentiate into tumor bulk. Normal stem cells in normal organs regulate self-renewal within a stem cell niche. Likewise, accumulating evidence has also suggested that CSCs are maintained extrinsically within the tumor microenvironment, which includes both cellular and physical factors. Here, we review the significance of stromal cells, immune cells, extracellular matrix, tumor stiffness, and hypoxia in regulation of CSC plasticity and therapeutic resistance. With a better understanding of how CSC interacts with its niche, we are able to identify potential therapeutic targets for the development of more effective treatments against cancer.

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A New Processing Method Combined with BP Neural Network for Francis Turbine Synthetic Characteristic Curve Research

A BP (backpropagation) neural network method is employed to solve the problems existing in the synthetic characteristic curve processing of hydroturbine at present that most studies are only concerned with data in the high efficiency and large guide vane opening area, which can hardly meet the research requirements of transition process especially in large fluctuation situation. The principle of the proposed method is to convert the nonlinear characteristics of turbine to torque and flow characteristics, which can be used for real-time simulation directly based on neural network. Results show that obtained sample data can be extended successfully to cover working areas wider under different operation conditions. Another major contribution of this paper is the resampling technique proposed in the paper to overcome the limitation to sample period simulation. In addition, a detailed analysis for improvements of iteration convergence of the pressure loop is proposed, leading to a better iterative convergence during the head pressure calculation. Actual applications verify that methods proposed in this paper have better simulation results which are closer to the field and provide a new perspective for hydroturbine synthetic characteristic curve fitting and modeling.

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A Novel CD48-Based Analysis of Sepsis-Induced Mouse Myeloid-Derived Suppressor Cell Compartments

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous subset of cells that expands dramatically in many disease states and can suppress T-cell responses. MDSCs mainly include monocytic and granulocytic subpopulations that can be distinguished in mice by the expression of Ly6G and Ly6C cell surface markers. This identification system has been validated in experimental tumor models, but not in models of inflammation-associated conditions such as sepsis. We challenged growth factor independent 1 transcription repressor green fluorescent protein (Gfi1:GFP) knock-in reporter mice with cecal ligation and puncture surgery and found that CD11b+ MDSCs in this sepsis model comprised both monocytic and granulocytic MDSCs. The evidence that conventional Ly6G/Ly6C marker analysis may not be suited to study of inflammation-induced MDSCs led to the development of a novel strategy of distinguishing granulocytic MDSCs from monocytic MDSCs in septic mice by expression of CD48. Application of this novel model should help achieve a more accurate understanding of the inflammation-induced MDSC activity.

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Massive MIMO Relay Systems with Multipair Wireless Information and Power Transfer

This paper investigates destination-aided simultaneous wireless information and power transfer (SWIPT) for a decode-and-forward relay network, in which massive multiple-input multiple-output antennas are deployed at relay to assist communications among multiple source-destination pairs. During relaying, energy signals are emitted from multiple destinations when multiple sources are sending their information signals to relay. With power splitting and unlimited antennas at relay, asymptotic expression of harvested energy is derived. The analysis reveals that asymptotic harvested energy is independent of fast fading effect of wireless channels; meanwhile transmission powers of each source and destination can be scaled down inversely proportional to the number of relay antennas. To significantly reduce energy leakage interference and multipair interference, zero-forcing processing and maximum-ratio combing/maximum-ratio transmission are employed at relay. Fundamental trade-off between harvested energy and achievable sum rate is quantified. It is shown that asymptotic sum rate is neither convex nor concave with respect to power splitting and destination transmission power. Thus, a one-dimensional embedded bisection algorithm is proposed to jointly determine the optimal power splitting and destination transmission power. It shows that destination-aided SWIPT are beneficial for harvesting energy and increasing sum rate. The significant sum rate improvements of the proposed schemes are verified by numerical results.

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Ranking of Sites for Installation of Hydropower Plant Using MLP Neural Network Trained with GA: A MADM Approach

Every energy system which we consider is an entity by itself, defined by parameters which are interrelated according to some physical laws. In recent year tremendous importance is given in research on site selection in an imprecise environment. In this context, decision making for the suitable location of power plant installation site is an issue of relevance. Environmental impact assessment is often used as a legislative requirement in site selection for decades. The purpose of this current work is to develop a model for decision makers to rank or classify various power plant projects according to multiple criteria attributes such as air quality, water quality, cost of energy delivery, ecological impact, natural hazard, and project duration. The case study in the paper relates to the application of multilayer perceptron trained by genetic algorithm for ranking various power plant locations in India.

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Term Abdominal Pregnancy Revealed by Amnioperitoneum in Rural Area

Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients. She did only two antenatal consultations: her main complaint was abdominal pain but five echographies concluded to normal intrauterine pregnancy. Findings at laparotomy were as follows: amnioperitoneum, a live female baby weighing 3.4 kilogrammes without deformities and a placenta deeply inserted on the uterine fundus. Removal of the placenta triggered massive bleeding (2400 milliliters) with shock managed with a tourniquet on the lower uterine segment and fluid resuscitation. Outcome was favourable for the mother and child. Prevention of vertical transmission of HIV was successful with antiretroviral therapy.

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Πληροφορίες

Κυριακή 26 Φεβρουαρίου 2017

Objectives

Background

Methods

Results

Conclusions

Abstract

Introduction

Objectives

Materials and Methods

Results

Conclusions

Abstract

Purpose

Methods

Results

Conclusions

Abstract

References

Δημοφιλείς αναρτήσεις