Anomalous hyperplastic anterior choroidal artery and its mimicker: a case series

xlomafota13 shared this article with you from Inoreader Anomalous hyperplastic anterior choroidal artery and its mimicker: a case series Via radiol anat Surg Radiol Anat. 2021 Jun 5. doi: 10.1007/s00276-021-02777-8. Online ahead of print. ABSTRACT The anomalous hyperplastic anterior choroidal artery (AchoA) is a rare anomaly due to incomplete distal annexation between the primitive AchoA and posterior cerebral artery (PCA). It is often misdiagnosed or misunderstood as a duplicated or fetal type PCA because of its supply distribution. In addition, its aneurysm incidence is much higher than the overall aneurysm incidence of Ac hoA. Thus, endovascular procedures or surgery without comprehensive understanding of this anomaly can cause critical complications. Herein, we present a case series of anomalous hyperplastic AchoA and its mimicker, along with schematic images for comprehensive understanding. PMID:34089349 | DOI:10.1007/s00276-021-02777-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Fold Cyst Formation after Photoangiolytic KTP Laser Treatment of Early Glottic Cancer

xlomafota13 shared this article with you from Inoreader Vocal Fold Cyst Formation after Photoangiolytic KTP Laser Treatment of Early Glottic Cancer Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jun 4:34894211022233. doi: 10.1177/00034894211022233. Online ahead of print. ABSTRACT OBJECTIVE: The incidence of post-operative glottic cyst (POGC) formation in patients treated with transoral laser microsurgery with potassium-titanyl-phosphate laser (TLM-KTP) photoablation of early glottic carcinoma (EGC) has not previously been described. METHODS: A retrospective chart review was performed to identify all patients with early glottic can cer who underwent with single-modality TLM-KTP at our institution. Each patient received regular follow up with videostroboscopy for tumor surveillance. New glottic cysts seen on surveillance examinations were noted and their management was documented. RESULTS: A total of 33 patients met inclusion criteria. Eight patients (24%) developed POGC's within the original geographic perimeter of the cancerous vocal fold(s): 6 in the infraglottic region and 2 near the vocal process, at an average of 8 months after their initial cancer surgery. Of these 8 POGC's, 7 were at the periphery of the original tumor distribution and 1 was in the center of it. No POGC's were associated with any change in voice. Four of the 8 POGC's were phonosurgically excised, all without evidence of malignancy on pathology. The remaining 4 were monitored: 2 were stable for an average of 49 months of follow up; the remaining 2 resolved spontaneously by 7 and 31 months after first identification. CONCLUSIO NS: POGC's are a frequent sequela of TLM-KTP for EGC. While these results suggest that they are unlikely to represent submucosal recurrences, surgeons should have a low threshold to biopsy if there is clinical concern for such and should counsel patients pre-operatively about the potential for their formation. PMID:34088223 | DOI:10.1177/00034894211022233 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frugal 3D scanning using smartphones provides an accessible framework for capturing the external ear

xlomafota13 shared this article with you from Inoreader Frugal 3D scanning using smartphones provides an accessible framework for capturing the external ear Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 May 3:S1748-6815(21)00238-2. doi: 10.1016/j.bjps.2021.03.131. Online ahead of print. ABSTRACT Three-dimensional (3D) scanning technologies, such as medical imaging and surface scanning, have important applications for capturing patient anatomy to create personalised prosthetics. Digital approaches for capturing anatomical detail as opposed to traditional, invasive impression techniques significantly reduces turnaround times and lower production costs while still maintaining the high aesthetic quality of the end product. While previous case studies utilise expensive 3D scanning and modelling frameworks, their clinical translation is limited due to high equipment costs. In this study, we develop and validate a low-cost framework for clinical 3D scanning of the external ear using photogrammetry and a smartphone camera. We recruited five novice operators who watched an instructional video before scanning 20 healthy adult participant ears who did not have microtia. Our results show that the smartphone-based photogrammetry methodology produces 3D scans of the external ear that were accurate to (1.5 ± 0.4) mm and were (71 ± 14) % complete compared with those from a gold standard reference scanner, with no significant difference observed between operators. A moderate to strong interrater reliability was determined for all novice operators, suggesting that all novice operators were able to capture repeatable scans. The development of this smartphone photogrammetry approach has the potential to provide a non-invasive, inexpensive and accessible means to capture patient morphology for use in clinical assessment and personalised device manufacture, specifically for ear prostheses. We also demonstrate that inexperienced operators can rapidly learn and apply smartphone photogrammetry for accurate and reliable scans of the external ear with important applications for future clinical transla tion. PMID:34088646 | DOI:10.1016/j.bjps.2021.03.131 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-Year Intermediate Results of a Prospective Multicenter Study Investigating the use of Smooth, Semi-Smooth, Microtextured and Macrotextured Implants from a Single Manufacturer in Breast Augmentation and Reconstruction Procedures

xlomafota13 shared this article with you from Inoreader Three-Year Intermediate Results of a Prospective Multicenter Study Investigating the use of Smooth, Semi-Smooth, Microtextured and Macrotextured Implants from a Single Manufacturer in Breast Augmentation and Reconstruction Procedures Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 May 12:S1748-6815(21)00240-0. doi: 10.1016/j.bjps.2021.01.020. Online ahead of print. ABSTRACT Silicone gel-filled implants exist in a wide range of shapes and textures, and yet there are relatively few long-term large-scale studies, particularly on recently developed "semi-smooth" implants. The present study fills this gap by presenting the 3-year findings from an ongoing 10-year multicenter prospective study on breast implants with four different surface types: smooth, semi-smooth, microtextured, and macrotextured. A total of 908 patients were recruited in 15 investigational sites across Europe and divided into three groups: 653 primary augmentations in Group 1, 144 revision augmentations in Group 2, and 111 reconstructions in Group 3. All 4 types of implant shells were manufactured by the same company using the same silicone material. Surgeons were free to choose their preferred technique and impl ant surface, but data were collected using a standardized software and included all complications, and satisfaction levels reported by the patients at each visit. The incidence of post-operative complications was estimated based on Kaplan-Meier risk rates, on a per patient basis. At 3 years post implantation, capsular contracture (Baker grade III/IV) was the most common complication, with a per-patient risk rate of 1.5% in Group 1. Interestingly, there was no capsular contracture in this group when semi-smooth implants were used. The risk of implant rupture in Group 1 was 0.2%. The preliminary findings of this 10-year prospective study indicate that, 3 years after the operation, the four types of silicone gel-filled implants investigated were safe, with a low complication rate in comparison with the most favorable results published in other similar studies. PMID:34088647 | DOI:10.1016/j.bjps.2021.01.020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiological and Audiological Assessment in Patients with Adenoid Hypertrophy Undergoing Adenoidectomy

xlomafota13 shared this article with you from Inoreader Radiological and Audiological Assessment in Patients with Adenoid Hypertrophy Undergoing Adenoidectomy Via Otolaryngology Indian Abstract Enlarged adenoids in children can lead to obstruction of the ET, leading to negative intratympanic pressure and development of Otitis media effusion. Adenoid-nasopharyngeal ratio (ANR) on lateral radiograph of nasopharynx, is one of the most reliable and cost-effective ways of determining the size of adenoids with respect to the nasopharyngeal space. Patients who were clinically diagnosed with adenoid hypertrophy, above the age of 5 years, undergoing adenoidectomy were included in the study. Lateral nasopharynx radiograph, Pure tone audiometry (PTA) and tympanometry were performed. The ANR calculated, graded, and compared with the PTA, tympanograms and size on endoscopic assessment. Taking 0.835 as cut-off value, significant correlation of ANR with PTA and impedance (p = 0.002) was found. 71% abnormal PTA and tympanogram was found with ANR > 0.835 whereas 30.8% with ANR < 0.835. ANR is a useful adjunct as a pre-operative tool for d etermining the need for adenoidectomy in paediatric patients who are not easily willing to undergo endoscopic evaluation. A major drawback is the lack of identification of lateral extent of adenoids. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Induction of T helper 17 cell response by interleukin-7 in patients with primary cutaneous melanoma

xlomafota13 shared this article with you from Inoreader Induction of T helper 17 cell response by interleukin-7 in patients with primary cutaneous melanoma Via Melanoma Research - Published Ahead-of-Print Interleukin (IL)-7 plays a vital role in proliferation and activation of T cells, however, its signaling through CD127 is impaired in T cells in cancers and chronic infections. The mechanisms underlying T helper 17 (Th17) cell responses by IL-7 in melanoma remain not fully understood. The aim of this study was to assess the effect of IL-7 signaling on Th17 responses in patients with primary cutaneous melanoma. Healthy and primary cutaneous melanoma donors were selected for this study of Th17 cell function. IL-17+CD4+ Th17 cells and CD127 expression on Th17 cells were determined by flow cytometry. Cytokine level was measured by ELISA. Peripheral and tissue-infiltrating CD4+ T cells were isolated using magnetic beads, and then stimulated with IL-7 and/or signal transducer and activator of transcription 5 inhibitor. Activated signaling molecules were analyzed by flow cytometry. Peripheral and tumor-infiltrating Th17 cells percentage was decreased, while peripheral IL-7 level was also reduced in melanoma patients. There was no significant difference of CD127 expression on Th17 cells between melanoma patients and controls. Antiapoptotic protein Bcl-2 was downregulated, whereas proapoptotic protein-activated caspase-3 was upregulated in peripheral and tissue-infiltrating Th17 cells in melanoma patients. Higher concentration of IL-7 (10 ng/mL), but not lower IL-7 concentration (1 ng/mL), promoted Bcl-2 expression and decreased caspase-3 expression in Th17 cells in melanoma patients. Inhibition of signal transducer and activator of transcription 5 resulted in the downregulation of Bcl-2 while upregulation of caspase-3 in Th17 cells. The present data suggested that reduced IL-7 responsiveness might be insufficient for Th17 activation in patients with primary cutaneous mela noma. # Hongxia He and Binjun Qiao contributed equally to the writing of this article. Received 4 March 2021 Accepted 16 April 2021 Correspondence to Hongxia He, MM, Department of Dermatology, The First Hospital of Shanxi Medical University, 85 South Jiefang Road, Taiyuan, 030000, Shanxi Province, China, Tel/fax: +86 351 4639549; e-mail: fwxz2019@163.com Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complete response of brainstem metastasis in BRAF-mutated melanoma without stereotactic radiosurgery after initiation of encorafenib and binimetinib

xlomafota13 shared this article with you from Inoreader Complete response of brainstem metastasis in BRAF-mutated melanoma without stereotactic radiosurgery after initiation of encorafenib and binimetinib Via Melanoma Research - Published Ahead-of-Print Metastatic melanoma is often accompanied by the development of brain metastases, at presentation or during the course of therapy. Local therapies such as surgery and radiation have been considered standard treatments for intracranial disease. However, the emergence of systemic therapies has been changing the treatment paradigm for the management of brain metastases. In patients with BRAF-mutated melanoma, combined BRAF and MEK inhibition has been found to elicit significant clinical responses. Patients who develop resistance to MAP kinase (MAPK) targeted therapy can achieve significant responses upon rechallenge. In this case, a 68-year-old woman with metastatic melanoma who had received multiple treatment courses including combination immunotherapy and combination MAPK-targeted ther apy presented with a brainstem metastasis and demonstrated a complete response upon initiation of encorafenib and binimetinib, thereby obviating the need for stereotactic radiosurgery. Received 25 February 2021 Accepted 18 April 2021 Corresponding Author: Joseph P. Weiner, MD, Department of Radiation Oncology Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ 08901, USA, Tel: +732 253 3939; e-mail: weinerjp@cinj.rutgers.edu Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Histone Deacetylase inhibitor Vorinostat (SAHA) suppresses micropthalmia transcription factor expression and induces cell death in nevocytes from large/giant congenital melanocytic nevi

xlomafota13 shared this article with you from Inoreader Histone Deacetylase inhibitor Vorinostat (SAHA) suppresses micropthalmia transcription factor expression and induces cell death in nevocytes from large/giant congenital melanocytic nevi Via Melanoma Research - Published Ahead-of-Print Large/giant congenital nevi (L/GCMN) are benign neoplasms of the melanocytic neural crest lineage covering extensive areas of skin presenting risk for melanoma. Surgical resection often leads to scarring and trauma. Histone deacetylase inhibitors (iHDACs) as topical therapeutic agents may prove beneficial as an alternative/adjunct to surgery in this disease. Here we describe the effect of in vitro treatment of iHDACs drugs on primary nevocytes isolated from L/GCMN patients. Micropthalmia transcription factor (MITF) expression in L/GCMN patients' lesions was detected by immunohistochemistry, in cultured nevocytes by immunofluorescence, immunoblot and quantitative polymerase chain reaction. Cellular senescence was detected by SA-ß galactosidase activity. Markers for melanocytic d ifferentiation were evaluated by immunoblot analysis and extracted melanin content was estimated spectrophotometrically. Cell death was measured by lactate dehydrogenase (LDH) assay and necrosis confirmed by polymerase (PARP) cleavage and acridine orange staining of the nuclei. MITF was expressed ubiquitously in nevocytes and melanocytes in patients' lesions. In culture, iHDAC treatment suppressed MITF protein and mRNA expression resulting in a senescent-like phenotype with positive ß-galactosidase staining, progressing to necrotic cell death as evidenced by increased LDH activity, appearance of cleaved PARP and necrotic nuclei. This is the first report showing evidence of iHDACs-induced MITF suppression in congenital nevocytes in vitro leading to a morphologic change with positive ß-galactosidase staining, followed by necrotic cell death in nevocytes, indicating that iHDAC drugs could be valuable therapeutic agents for treatment of L/GCMN lesions. Received 28 January 2021 Accepted 16 April 2021 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.melanomaresearch.com. Correspondence to Dipanjan Basu, PhD, Department of Pathology, School of Medicine, University of Pittsburgh. 200 Lothrop St., South BST S455, Pittsburgh, PA 15261, USA, Tel: +412 692 5314; fax: +412 692 5723; e-mail: basud@upmc.edu Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

C-reactive protein as a biomarker for immune-related adverse events in melanoma patients treated with immune checkpoint inhibitors in the adjuvant setting

xlomafota13 shared this article with you from Inoreader C-reactive protein as a biomarker for immune-related adverse events in melanoma patients treated with immune checkpoint inhibitors in the adjuvant setting Via Melanoma Research - Published Ahead-of-Print The objective of this study was to evaluate the utility of serum C-reactive protein (CRP) as biomarker for the early diagnosis of immune-related adverse events (irAEs) in melanoma patients treated with immune checkpoint inhibitors (ICIs) in the adjuvant setting, and its potential correlation with relapse-free surv ival (RFS). Prospectively collected data from 72 melanoma patients treated with adjuvant ICIs were pooled. CRP values at diagnosis of 10 irAEs were descriptively analysed. Correlations between RFS and the occurrence of irAEs, the grade of the irAE, the extent of CRP-elevation and the use of corticosteroids for irAE treatment were investigated. A total of 191 irAEs (grade 1/2, n = 182; grade 3/4, n = 9) occurred in 64 patients [skin toxicity (n = 70), fatigue (n = 50), thyroiditis (n = 12), musculoskeletal toxicity (n = 11), sicca syndrome (n = 10), other (n = 23), pneumonitis (n = 6), colitis (n = 4), hepatitis (n = 3) and hypophysitis (n = 2)]. In pneumonitis and hypophysitis, the median CRP levels at diagnosis exceeded the upper limit of normal (ULN, 5 mg/L). After a median follow-up of 26.5 months, 28 patients (39%) had been diagnosed with a melanoma relapse. Patients who experienced no irAE were at the highest risk for relapse (P = 0.008). A trend was observed for patients diagnosed with an irAE that was associated with an elevated CRP (>2xULN) to be at higher risk for relapse as compared to those diagnosed with an irAE and CRP View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Prognostic Value of Lymph Node Burden in Oral Cavity Cancer: Systematic Review and Meta‐Analysis

xlomafota13 shared this article with you from Inoreader The Prognostic Value of Lymph Node Burden in Oral Cavity Cancer: Systematic Review and Meta‐Analysis Via The Laryngoscope Objectives Lymph node burden has been proposed to estimate the cumulative adverse effect of nodal metastasis. In this study, a meta-analysis was conducted to evaluate the prognostic value of lymph node burden in oral cavity squamous cell carcinoma. Study Designs Systemic review and meta-analysis. Methods PubMed, EMBASE and the Cochrane Library as well as manual searches were performed until April 2020. The adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival, disease-specific survival, and disease-free survival were extracted and pooled. Results Eleven included studies were published between 2009 and 2019. The cumulative number of patients was 20,607 (range 35–14,554). Extranodal extension was adjusted or evaluated in all of the studies. The meta-analysis indicated that a higher lymph node burden was significantly related to worse overall survival (HR 2.62, 95% CI 2.12–3.25), worse disease-specific survival (HR 3.14, 95% CI 1.85–5.33) and worse disease-free survival (HR 2.30, 95% CI 1.62–3.26). The highest hazard ratio was observed when the cutoff value was 3 for overall survival, 3 for disease-specific survival, and 4 for disease-free survival. The hazard ratio showed an upward trend before the cutoff value of 3 but no significant incremental change when the cutoff exceeded 3. Conclusions In oral squamous cell carcinoma, lymph node burden is an independent prognosticator for survival outcomes. However, more prospective or high-quality studies are required to determine the optimal cutoff. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A non‐contact device for fast screening of wound infections

xlomafota13 shared this article with you from Inoreader A non‐contact device for fast screening of wound infections Via Experimental Dermatology Abstract Screening for wound infection relies on the expertise of the provider. Clinical diagnosis of infections based on wound swab/biopsy results often takes a few days and may not assess the full wound. There is a need for a non-invasive tool that can quickly and accurately diagnose wound infection. Leukocyte esterase strips are used to identify various infectious diseases. However, it is not clear whether infected wounds also have elevated leukocyte esterase activities as compared with non-infected wounds. To achieve the objective, a device was developed to detect elevated leukocyte esterase activities in wounds by measuring wound exudates adsorbed onto wound dressings in 3 minutes. The efficacy of the device in assessing leukocyte esterase activities across various chronic wounds was tested. Such measurements were unaffected by the type of underlying wound dressing. By correlating the device outputs with clinical adjudication of infection, we found that this device had high posit ive predictive values for diagnosing wound infection in a wide variety of chronic wounds. In addition, a positive device output increases the probability of detecting infected wounds, while the negative device output reduces the probability of detecting infected wounds. This rapid non-contact and disposable diagnostic tool may serve as a rapid and accurate indication of infection in the chronic wound. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.