Objective studies of the face of Noonan, Cardio-facio-cutaneous, and Costello syndromes: A comparison of three disorders of the Ras/MAPK signaling pathway

Noonan, Cardio-facio-cutaneous, and Costello syndromes are disorders of the Ras/MAPK pathway that share many clinical features. This observational and anthropometric study was conducted to describe the key facial features of each syndrome in order to improve discrimination between the three conditions, particularly in young children where diagnosis is most challenging. Direct measurement of the head and face was used to enhance diagnostic accuracy, and identify the most unusual or specific dimensions. The Noonan syndrome cohort included 123 individuals, aged 6 months to 41 years. There were 20 children and adolescents with Cardio-facio-cutaneous syndrome, and 28 individuals with Costello syndrome, aged 1–32 years. The facial phenotypes of these syndromes, particularly Noonan syndrome, are well-described but objective data have not been published in peer-reviewed literature. In this study, subjective observations, in the main, were validated by anthropometry with one exception. In individuals with Costello syndrome, mouth width was normal, thus the impression of wide mouth is likely due to full lips or the mouth being viewed in relation to a narrow lower face. When the three conditions were compared objectively, syndrome-specific pattern profiles showed high concordance in early life. At older ages, Cardio-facio-cutaneous syndrome was distinguished by increased width of the mid/lower face, and reduced growth of maxillary and mandibular dimensions was noted in both Noonan and Costello syndromes. Despite substantial similarities in face shape in older individuals with these two conditions, bulbous nasal tip, full lips, and an apparently wide mouth in those with Costello Syndrome facilitate discrimination from Noonan syndrome. © 2016 Wiley Periodicals, Inc.

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Emerging targeted drug therapies in skeletal dysplasias

Quantum advances have occurred in the field of human genetics in the six decades since Watson and Crick expressed their "wish to suggest a structure for the salt of deoxyribose nucleic acid." These culminated with the human genome project, which has opened up myriad possibilities, including that of individualized genetic medicine, the ability to deliver medical advice, management, and therapy tailored to an individual's genetic blueprint. Advances in genetic diagnostic capabilities have been rapid, to the point where the genome can be sequenced for several thousand dollars. Crucially, it has facilitated the identification of targets for "precision" treatments to combat genetic diseases at their source. This manuscript will review the innovative, pathogenesis-based therapies that are revolutionizing management of skeletal dysplasias, giving patients and families new options and outcomes. © 2016 Wiley Periodicals, Inc.

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The Fourth International Symposium on Genetic Disorders of the Ras/MAPK pathway

The RASopathies are a group of disorders due to variations of genes associated with the Ras/MAPK pathway. Some of the RASopathies include neurofibromatosis type 1 (NF1), Noonan syndrome, Noonan syndrome with multiple lentigines, cardiofaciocutaneous (CFC) syndrome, Costello syndrome, Legius syndrome, and capillary malformation–arteriovenous malformation (CM-AVM) syndrome. In combination, the RASopathies are a frequent group of genetic disorders. This report summarizes the proceedings of the 4th International Symposium on Genetic Disorders of the Ras/MAPK pathway and highlights gaps in the field. © 2016 Wiley Periodicals, Inc.

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Trisomy 13 and gallbladder agenesis

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Evaluation of the palatal split pattern in surgically rapid maxillary expansion—comparison of two techniques

Abstract

Purpose

Surgically assisted rapid maxillary expansion is performed to correct transverse deficiencies of the maxilla, and it is indicated in specific clinical situations. The literature presents different opinions in several aspects, mainly regarding the effect of disjunction of the pterygoid plates. The aim of this study was to evaluate the pattern of maxillary expansion obtained with two surgical techniques, with and without disjunction of the pterygoid plates.

Methods

Twenty patients treated with surgically assisted rapid maxillary expansion for correction of transversal discrepancies were included in this retrospective study and divided into two groups: (G1) patients operated without disjunction of pterygoid plates and (G2) patients treated with release of the pterygoid plates.

Results

There were seven male and 13 female patients, and the mean age was 29.9 years. Cone beam computed tomography images obtained after final activation of the expansion device were evaluated and complete disjunction of the midpalatal suture (type I) was present in 75 % of the patients whereas incomplete disjunction of the midpalatal suture (type II) was observed in 25 %. Chi-square test showed no statistically significant difference between groups (p = 0.606).

Conclusion

No difference was found in relation to the maxillary disjunction pattern irrespective of the treatment given to pterygoid plates.

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Parotid Masson's tumor: case report.

Parotid Masson's tumor: case report.

Braz J Otorhinolaryngol. 2016 Mar 29;

Authors: Carta F, Sionis S, Ledda V, Gerosa C, Puxeddu R

PMID: 27150026 [PubMed - as supplied by publisher]

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Magnetization Transfer MR Imaging to Monitor Muscle Tissue Formation during Myogenic in Vivo Differentiation of Muscle Precursor Cells.

Magnetization Transfer MR Imaging to Monitor Muscle Tissue Formation during Myogenic in Vivo Differentiation of Muscle Precursor Cells.

Radiology. 2016 May 6;:152330

Authors: Rottmar M, Haralampieva D, Salemi S, Eberhardt C, Wurnig MC, Boss A, Eberli D

Abstract
Purpose To determine whether magnetization transfer (MT) magnetic resonance (MR) imaging may serve as a quantitative measure of the degree of fiber formation during differentiation of muscle precursor cells into engineered muscle tissue as a potential noninvasive monitoring tool in mice. Materials and Methods The study was approved by the local ethics committee (no. StV 01/2008) and the local Veterinary Office (license no. 99/2013). Human muscle progenitor cells (hMPCs) derived from rectus abdominis muscles were subcutaneously injected into CD-1 nude mice (CD-1 nude mice, Crl:CD1-Foxn1(nu); Charles River Laboratories, Wilmington, Mass) for development of muscle tissue. The mice underwent MR imaging examinations at 4.7 T at days 1, 3, 7, 14, 21, and 28 after cell transplantation by using a gradient-echo sequence with an MT prepulse and systematic variation of the off-resonance frequency (50-37 500 Hz) at an amplitude of 800°. Direct saturation was estimated from a Bloch equation simulation. The MT ratio (MTR) was correlated to immunohistochemistry findings, Western blot results, and results of myography. Data were analyzed by using one-way or two-way analysis of variance with the Sidak or Tukey multiple comparisons test. Results In the reference skeletal muscle, highest MT was found for 2500 Hz off-resonance frequency with an MTR ± standard deviation of 57.5% ± 3.5. The developing muscle tissue exhibited increasing MT values during the 28 days of myogenic in vivo differentiation and did not reach the values of native skeletal muscle. Mean values of MTR (2500 Hz) for hMPCs were 27.6% ± 6.3 (day 1), 24.7% ± 8.7 (day 3), 28.2% ± 5.7 (day 7), 35.9% ± 5.0 (day 14), 37.0% ± 7.9 (day 21), and 39.9% ± 8.1 (day 28). The results from MT MR imaging correlated qualitatively well with muscle tissue expression of specific skeletal markers, as well as muscle contractility. Conclusion MT MR imaging may be used to noninvasively monitor the process of myogenic in vivo differentiation of hMPCs as a biomarker of the quantity and quality of muscle fiber formation. (©) RSNA, 2016 Online supplemental material is available for this article.

PMID: 27152553 [PubMed - as supplied by publisher]

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CT Features of Primary Graft Nonfunction after Liver Transplantation.

CT Features of Primary Graft Nonfunction after Liver Transplantation.

Radiology. 2016 May 6;:152157

Authors: Kim JS, Kwon JH, Kim KW, Kim J, Kim SY, Jeong WK, Park SH, Yu E, Lee J, Lee SJ, Lee JS, Kim HJ, Song GW, Lee SG

Abstract
Purpose To determine computed tomographic (CT) features of primary graft nonfunction (PNF) after liver transplantation in comparison with those of early graft failure or death by identifiable causes. Materials and Methods Institutional review board approval was obtained and informed consent was waived. Among 3947 adult liver transplantations performed in one institution between May 2002 and May 2015, 72 patients died or had graft failure within 10 days, and 38 of them were evaluated with CT. PNF was diagnosed in 21 patients. The other 17 patients who died or had early graft failure were considered the non-PNF control group. On unenhanced CT images, graft attenuation was compared qualitatively. Graft attenuation was measured quantitatively and, if available, the difference between preoperative and postoperative CT (interval change) attenuation was evaluated. Unenhanced CT was evaluated for relative parenchymal enhancement. Statistical analyses included the Fisher exact and χ(2) tests with Yates correction and the Student t test. Results On unenhanced CT images, grafts with PNF more commonly showed low (eight of 26 [31%]) or extremely low (18 of 26 [69%]) qualitative attenuation compared with grafts in the non-PNF group (three of 21 [14%], one of 21 [5%]; P < .001). The mean attenuation value (30.5 HU ± 10.8) was significantly lower and the mean interval change (24.7 HU ± 12.5) was significantly higher in the PNF group than in the non-PNF group (49.7 HU ± 8.0 and 9.7 HU ± 10.1, respectively; P < .001 and P = .001). There was no significant difference in the proportion of grafts that showed poor enhancement on postcontrast CT images between the PNF group and the non-PNF group (nine of 24 [38%] vs two of 20 [10%], respectively; P = .08). Conclusion Recipients with PNF after liver transplantation tended to show low or extremely low attenuation on unenhanced CT images, and this finding was seen more frequently in patients with PNF than in those who died of identifiable causes and in those with early graft failure. (©) RSNA, 2016 Online supplemental material is available for this article.

PMID: 27152552 [PubMed - as supplied by publisher]

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Cell origin in the macula flava of the human newborn vocal fold.

Cell origin in the macula flava of the human newborn vocal fold.

J Laryngol Otol. 2016 May 6;:1-6

Authors: Sato K, Chitose S, Kurita T, Umeno H

Abstract
BACKGROUND: There is growing evidence to suggest that cells in the maculae flavae are tissue stem cells of the human vocal fold and maculae flavae are a stem cell niche.
METHODS: Three newborn vocal folds were investigated. Immunoreactivity to antibodies directed to cytokeratin, desmin, glial fibrillary acidic protein, vimentin, cluster of differentiation 34, cluster of differentiation 45, collagen type I, telomerase reverse transcriptase, SOX17 and stage-specific embryonic antigen 3 was investigated.
RESULTS: The cells in the newborn maculae flavae expressed haematopoietic markers (cluster of differentiation 34, cluster of differentiation 45) and collagen type I, which are the major makers of bone marrow derived circulating fibrocytes. The cells expressed epithelium, muscle, neural and mesenchymal cell associated proteins, and endodermal marker, indicating that they are undifferentiated and express proteins of all three germ layers. The cells also expressed stage-specific embryonic antigen 3 and telomerase reverse transcriptase.
CONCLUSION: The cells in the newborn maculae flavae are undifferentiated cells arising from the differentiation of bone marrow cells. The results of this study are consistent with the hypothesis that the cells in maculae flavae are tissue stem cells.

PMID: 27150338 [PubMed - as supplied by publisher]

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Antimicrobial Activities of 1-H-Benzimidazole-based Molecules.

Antimicrobial Activities of 1-H-Benzimidazole-based Molecules.

Curr Top Med Chem. 2016 May 6;

Authors: Ates-Alagoz Z

Abstract
Benzimidazole is a heterocyclic aromatic organic compound which has been an important pharmacophore and privileged structure in medicinal chemistry. Substituted benzimidazoles have considerable interest as compounds with a wide spectrum of biological activity and low toxicity. Benzimidazole derivatives are structurally related to purine nucleoside bases, which allow them to interact easily with the biopolymers of the living systems. Different substituted benzimidazoles have an extensive range of biological activities including: antiviral, antifungal, antimicrobial, antiprotozoal, anti-inflammatory, anticancer, antioxidant, anticoagulant, antidiabetic and antihypertensive activities. Infectious diseases are those whose incidence in humans has increased during the past few decades. They cause suffering and death and an enormous financial burden. Antimicrobial drugs have saved the lives of millions of people. However, the dramatic increase in drug-resistant microbes is threatening to reverse medical progress of the past 50 years. Benzimidazoles are very effective compounds with respect to their bacteria inhibitory activity. Biochemical and pharmacological studies have showed that these molecules are effective against various strains of microorganisms. Some benzimidazole compounds inhibit the biosynthesis of ergosterol, required in the cell membrane of fungi and protozoa and a useful target for antifungal drugs. The result of many efforts to develop new molecules for effective antimicrobials reveals that the benzimidazoles are still one of the most versatile class of compounds against microbes.

PMID: 27150377 [PubMed - as supplied by publisher]

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Correlation of MRI Brain Injury Findings with Neonatal Clinical Factors in Infants with Congenital Diaphragmatic Hernia.

Correlation of MRI Brain Injury Findings with Neonatal Clinical Factors in Infants with Congenital Diaphragmatic Hernia.

AJNR Am J Neuroradiol. 2016 May 5;

Authors: Radhakrishnan R, Merhar S, Meinzen-Derr J, Haberman B, Lim FY, Burns P, Zorn E, Kline-Fath B

Abstract
BACKGROUND AND PURPOSE: Infants with congenital diaphragmatic hernia are reported to have evidence of brain MR imaging abnormalities. Our study aimed to identify perinatal clinical factors in infants with congenital diaphragmatic hernia that are associated with evidence of brain injury on MR imaging performed before hospital discharge.
MATERIALS AND METHODS: MRIs performed before hospital discharge in infants with congenital diaphragmatic hernia were scored for brain injury by 2 pediatric neuroradiologists. Perinatal variables and clinical variables from the neonatal intensive care unit stay were analyzed for potential associations with brain MR imaging findings.
RESULTS: Fifty-three infants with congenital diaphragmatic hernia (31 boys) were included. At least 1 abnormality was seen on MR imaging in 32 infants (60%). The most common MR imaging findings were enlarged extra-axial spaces (36%), intraventricular hemorrhage (23%), ventriculomegaly (19%), white matter injury (17%), and cerebellar hemorrhage (17%). The MR imaging brain injury score was associated with extracorporeal membrane oxygenation (P = .0001), lack of oral feeding at discharge (P = .012), use of inotropes (P = .027), and gastrostomy tube placement before hospital discharge (P = .024). The MR imaging brain injury score was also associated with a large diaphragmatic defect size (P = .011).
CONCLUSIONS: Most infants with congenital diaphragmatic hernia have at least 1 abnormality identified on MR imaging of the brain performed before discharge. The main predictors of brain injury in this population are a requirement for extracorporeal membrane oxygenation, large diaphragmatic defect size, and lack of oral feeding at discharge.

PMID: 27151752 [PubMed - as supplied by publisher]

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Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms.

Cerebral CTA with Low Tube Voltage and Low Contrast Material Volume for Detection of Intracranial Aneurysms.

AJNR Am J Neuroradiol. 2016 May 5;

Authors: Ni QQ, Chen GZ, Schoepf UJ, Klitsie MA, De Cecco CN, Zhou CS, Luo S, Lu GM, Zhang LJ

Abstract
BACKGROUND AND PURPOSE: Multidetector row CTA has become the primary imaging technique for detecting intracranial aneurysms. Technical progress enables the use of cerebral CTA with lower radiation doses and contrast media. We evaluated the diagnostic accuracy of 80-kV(peak) cerebral CTA with 30 mL of contrast agent for detecting intracranial aneurysms.
MATERIALS AND METHODS: Two hundred four patients were randomly divided into 2 groups. Patients in group A (n = 102) underwent 80-kVp CTA with 30 mL of contrast agent, while patients in group B (n = 102) underwent conventional CTA (120 kVp, 60 mL of contrast agent). All patients underwent DSA. Image quality, diagnostic accuracy, and radiation dose between the 2 groups were compared.
RESULTS: Diagnostic image quality was obtained in 100 and 99 patients in groups A and B, respectively (P = .65). With DSA as reference standard, diagnostic accuracy on a per-aneurysm basis was 89.9% for group A and 93.9% for group B. For evaluating smaller aneurysms (<3 mm), the diagnostic accuracy of groups A and B was 86.3% and 90.8%, respectively. There was no difference in diagnostic accuracy between each CTA group and DSA (all, P > .05) or between the 2 CTA groups (all, P > .05). The effective dose in group A was reduced by 72.7% compared with group B.
CONCLUSIONS: In detecting intracranial aneurysms with substantial radiation dose and contrast agent reduction, 80-kVp/30-mL contrast CTA provides the same diagnostic accuracy as conventional CTA.

PMID: 27151751 [PubMed - as supplied by publisher]

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Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

AJNR Am J Neuroradiol. 2016 May 5;

Authors: Law BK, King AD, Bhatia KS, Ahuja AT, Kam MK, Ma BB, Ai QY, Mo FK, Yuan J, Yeung DK

Abstract
BACKGROUND AND PURPOSE: Pretreatment prediction of patients with nasopharyngeal carcinoma who will fail conventional treatment would potentially allow these patients to undergo more intensive treatment or closer posttreatment monitoring. The aim of the study was to determine the ability of pretreatment DWI to predict local failure in patients with nasopharyngeal carcinoma based on long-term clinical outcome.
MATERIALS AND METHODS: One hundred fifty-eight patients with pretreatment DWI underwent analysis of the primary tumor to obtain the ADC mean, ADC skewness, ADC kurtosis, volume, and T-stage. Univariate and multivariate analyses using logistic regression were performed to compare the ADC parameters, volume, T-stage, and patient age in primary tumors with local failure and those with local control, by using a minimum of 5-year follow-up to confirm local control.
RESULTS: Local control was achieved in 131/158 (83%) patients (range, 60.3-117.7 months) and local failure occurred in 27/158 (17%) patients (range, 5.2-79.8 months). Compared with tumors with local control, those with local failure showed a significantly lower ADC skewness (ADC values with the greatest frequencies were shifted away from the lower ADC range) (P = .006) and lower ADC kurtosis (curve peak broader) (P = .024). The ADC skewness remained significant on multivariate analysis (P = .044). There was a trend toward higher tumor volumes in local failure, but the volume, together with T-stage and ADC mean, were not significantly different between the 2 groups.
CONCLUSIONS: Pretreatment DWI of primary tumors found that the skewness of the ADC distribution curve was a predictor of local failure in patients with nasopharyngeal carcinoma, based on long-term clinical outcome.

PMID: 27151750 [PubMed - as supplied by publisher]

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The CT Prevalence of Arrested Pneumatization of the Sphenoid Sinus in Patients with Sickle Cell Disease.

The CT Prevalence of Arrested Pneumatization of the Sphenoid Sinus in Patients with Sickle Cell Disease.

AJNR Am J Neuroradiol. 2016 May 5;

Authors: Prabhu AV, Branstetter BF

Abstract
BACKGROUND AND PURPOSE: Arrested sphenoid pneumatization is an incidental radiologic finding on CT and MR imaging that may be confused with more aggressive pathologic conditions. No definite etiology for arrested sphenoid pneumatization has been established, though changes in regional blood flow during childhood, as is seen with sickle cell disease, have been proposed. The purpose of our study was to compare the prevalence of arrested pneumatization of the sphenoid sinus in patients with and without sickle cell disease.
MATERIALS AND METHODS: We retrospectively identified 146 patients with sickle cell disease who had undergone CT scans of the skull base between January 1990 and May 2015. We identified 292 control patients without sickle cell disease matched for age and sex in a 1:2 ratio. We tabulated the prevalence of arrested pneumatization as well as the location and size of the lesions. We used the Fisher exact test to correlate sickle cell disease with arrested pneumatization of the sphenoid sinus and the t test to correlate sickle cell disease with lesion size.
RESULTS: Of the 146 patients with sickle cell disease, 14 (9.6%) had arrested pneumatization of the sphenoid sinus. In the 292 control patients, 6 (2.1%) had arrested pneumatization. Patients with sickle cell disease had a statistically significant higher rate of arrested pneumatization compared with patients without sickle cell disease (P < .001). There was no statistically significant correlation between lesion size and diagnosis of sickle cell disease.
CONCLUSIONS: Patients with sickle cell disease have a greater prevalence of arrested pneumatization of the sphenoid sinus than patients without sickle cell disease. This supports the theory that either regional blood flow anomalies or increased serum erythropoietin causes arrested sinus pneumatization.

PMID: 27151749 [PubMed - as supplied by publisher]

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Ventricular Microaneurysms in Moyamoya Angiopathy Visualized with 7T MR Angiography.

Ventricular Microaneurysms in Moyamoya Angiopathy Visualized with 7T MR Angiography.

AJNR Am J Neuroradiol. 2016 May 5;

Authors: Matsushige T, Kraemer M, Schlamann M, Berlit P, Forsting M, Ladd ME, Sure U, Wrede KH

Abstract
The pathophysiologic role of hemodynamic alteration to peripheral vessels in Moyamoya angiopathy and the formation of microaneurysms remains unclear. The purpose of this study was to investigate microaneurysms in collateral Moyamoya vessels by using 7T ultra-high-field MR imaging. Ten patients with Moyamoya disease were evaluated with TOF-MRA at 7T acquired with 0.22 × 0.22 × 0.41 mm(3) resolution. In 10 patients, 4 microaneuryms located in the ventricles were delineated. The mean diameters of collateral vessels and microaneurysms arising from those vessels were 0.87 mm (range, 0.79-1.07 mm) and 0.80 mm (range, 0.56-0.96 mm), respectively. In 1 case with follow-up scans 6 months after a direct extracranial-intracranial bypass operation, the microaneurysm disappeared. Ventricular microaneurysms in Moyamoya angiopathy collateral vessels, inaccessible by conventional imaging techniques, can be detected by 7T TOF-MRA.

PMID: 27151748 [PubMed - as supplied by publisher]

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Biomarkers assessment in the peacock blenny Salaria pavo exposed to cadmium

Abstract

Cadmium (Cd) is one of the most toxic metals and is widely distributed in freshwater and marine environments. It has received much attention from a toxicological perspective. The aim of this study was to assess the effect of Cd in the peacock blenny Salaria pavo, a species of the family of blennies that was used as bioindicator of water pollution. We performed a sublethal contamination of fish to 2 mg CdCl₂ L⁻¹ during 1, 4, 10, and 15 days. Cd accumulation was measured in gills and liver and displayed a significant increase of its concentration throughout the experiment, with slightly higher levels in the liver, except after 4 days. Partial-length cDNA of mt1, mt2, mnsod, cuznsod, cat, and gpx were characterized. Results from mRNA expression levels displayed an up-regulation of mt2 and mnsod. Biomarker activities were determined in gills and liver. In gills, data displayed an inhibition of EROD and GST activities. Cd exposure significantly increased GPx activities but did not affect CAT levels throughout the experiment. No LPO induction was observed in gills of exposed fish. Regarding the liver, the activity of all enzymes and MDA levels increased significantly from the beginning of the experiment except EROD that increased after 15 days of contamination only. At the histological level, fish exhibited pathological symptoms in gills and liver with a predominance of circulatory disturbances in gills and regressive changes in the liver. Our results displayed that peacock blennies are able to survive Cd toxicity due to various physiological adaptation mechanisms.

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Toward a novel membrane process for organic carbon removal—fate of slowly biodegradable substrate in super fast membrane bioreactor

Abstract

The study tested the performance of super fast membrane bioreactor (SFMBR) using starch as a slowly biodegradable substrate, exploring the fate of starch, and the response of the microbial community. SFMBR was operated at extremely low sludge ages of 0.5–2.0 days, with a hydraulic retention time of 1.0 h. Average values for permeate chemical oxygen demand (COD) always remained in the narrow range between 14 and 18 mg/L, regardless of the selected mode of MBR operation at different sludge ages. Soluble COD levels in the reactor were consistently higher than the corresponding permeate COD. Parameters defining process kinetics, determined by model calibration of oxygen uptake rate (OUR) profiles, varied as a function of sludge age. Model simulation of SFMBR performance indicated total removal of hydrolysis products so that permeate COD consisted of residual microbial products. PCR-DGGE experiments revealed significant shifts in the composition of the microbial community imposed by variations in the sludge age, reflecting on corresponding process kinetics.

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Effects of linear alkylbenzene sulfonate (LAS) on the interspecific competition between Microcystis and Scenedesmus

Abstract

The widespread use of detergents increases the concentration of surfactant in lakes and reservoirs. High surfactant loads produces toxicity to algae; however, the influence of the increasing surfactant on the competition between algae is not clear. In this paper, different amounts of linear alkylbenzene sulfonate (LAS) were added to test the effects of LAS on the competition between Microcystis aeruginosa and Scenedesmus obliquus under eutrophic condition. In single culture, the growth of S. obliquus was promoted under lower LAS concentrations (1 and 20 mg L⁻¹), but cell density of S. obliquus reduced when treated with higher LAS concentration (100 mg L⁻¹). The growth of M. aeruginosa was inhibited markedly with 20 and 100 mg L⁻¹ LAS. Compared with single culture, the result was opposite in co-cultures and the cell density of S. obliquus increased significantly when treated with LAS of 1, 20, and 100 mg L⁻¹. The specific growth rates of S. obliquus and M. aeruginosa in both cultures were 0.4–0.5 day⁻¹ and 0.6–0.7 day⁻¹, respectively, except that the specific growth rate of M. aeruginosa in both cultures treated with 100 mg L⁻¹ LAS was about 0.2 day⁻¹. M. aeruginosa dominated over S. obliquus in the co-culture without LAS, while the competition was completely opposite with the addition of 20 mg L⁻¹ LAS. The growth of S. obliquus treated with 20 mg L⁻¹ LAS was not affected significantly in single culture but was promoted by 75 % in co-culture. Moreover, the growth of S. obliquus in co-culture treated with 100 mg L⁻¹ LAS was promoted by more than 97 %. These results suggested that the increasing LAS would overturn the competition of algae in freshwater ecosystems.

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Breakage and regrowth of flocs formed by sweep coagulation using additional coagulant of poly aluminium chloride and non-ionic polyacrylamide

Abstract

The breakage and regrowth of flocs formed by sweep flocculation were investigated on different flocculation mechanisms using additional dosage coagulant of poly aluminium chloride (PACl) and non-ionic polyacrylamide (PAM) to explore the reversibility after floc breakage. The optimal dosage of PACl was 0.15 mM (as alum), and zeta potential exceeding 1 mV meant that sweep flocculation was dominant in the pre-flocculated process. Re-coagulation efficiency increased with additional coagulants dosing, and sedimentation rates of flocs re-formed by small additional dosage of non-ionic PAM are faster than that of flocs re-formed by additional PACl. For additional inorganic coagulant (PACl) during regrowth processes, few negatively charged particles that existed in water sample restricted the effect of charge neutralization. An amorphous aluminum hydroxide precipitation could re-activate the weaker points on the broken floc surface, but regrown flocs have loose structure indicating worse settleability. For additional non-ionic PAM dosing, lower dosage showed large values of fractal dimension and average size, probably due to that unfolded curly molecular chain and exposed amide groups of non-ionic PAM which provide superb conditions for amide group interacting with particles. The use of non-ionic PAM in flocculation has advantage of being more effective than the cationic PACl, probably because it may avoid the re-stabilization of broken flocs by polymer adsorption driven by electrostatic attraction. Hence, appropriate dosing of PAM after breakage could improve the flocs characteristics with large size and compact structure.

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Phosphorus released from sediment of Dianchi Lake and its effect on growth of Microcystis aeruginosa

Abstract

Phosphorus stored in lake sediments is an inner nutrient source and can be released into overlying water to exacerbate algal blooms. A simulated microcosm of Dianchi Lake was built to investigate phosphorus release from sediments to overlying water and its effect on the growth of Microcystis aeruginosa. The sediments of Dianchi Lake had a total phosphorus (TP) content of 1.7–1.8 mg g⁻¹ with Ca bound phosphorus (Ca-P, 50–54 %) and organic phosphorus (Org-P, 28–32 %) as the main fractions. The sediments released 8 % of TP into the overlying water with Fe/Al bound phosphorus (Fe/Al-P, 26 %) and Org-P (65 %) being the main fractions released. The phosphorus concentration of the overlying water increased from 0.14–0.16 to 0.28–0.33 mg L⁻¹. The biomass density of M. aeruginosa was positively correlated (R ² = 0.825) with the concentration of orthophosphate, which was the predominant bioavailable phosphorus fraction for algal growth. Org-P can be partly utilized by M. aeruginosa but will not cause a bloom. A good understanding of the geochemical cycles of phosphorus is needed for regulating phosphorus release from sediments and thereby reducing the risk of cyanobacterial blooms.

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Influence of shifting cultivation practices on soil–plant–beetle interactions

Abstract

Shifting cultivation (jhum) is a major land use practice in Mizoram. It was considered as an eco-friendly and efficient method when the cycle duration was long (15–30 years), but it poses the problem of land degradation and threat to ecology when shortened (4–5 years) due to increased intensification of farming systems. Studying beetle community structure is very helpful in understanding how shifting cultivation affects the biodiversity features compared to natural forest system. The present study examines the beetle species diversity and estimates the effects of shifting cultivation practices on the beetle assemblages in relation to change in tree species composition and soil nutrients. Scarabaeidae and Carabidae were observed to be the dominant families in the land use systems studied. Shifting cultivation practice significantly (P < 0.05) affected the beetle and tree species diversity as well as the soil nutrients as shown by univariate (one-way analysis of variance (ANOVA), correlation and regression, diversity indices) and multivariate (cluster analysis, principal component analysis (PCA), detrended correspondence analysis (DCA), canonical variate analysis (CVA), permutational multivariate analysis of variance (PERMANOVA), permutational multivariate analysis of dispersion (PERMDISP)) statistical analyses. Besides changing the tree species composition and affecting the soil fertility, shifting cultivation provides less suitable habitat conditions for the beetle species. Bioindicator analysis categorized the beetle species into forest specialists, anthropogenic specialists (shifting cultivation habitat specialist), and habitat generalists. Molecular analysis of bioindicator beetle species was done using mitochondrial cytochrome oxidase subunit I (COI) marker to validate the beetle species and describe genetic variation among them in relation to heterogeneity, transition/transversion bias, codon usage bias, evolutionary distance, and substitution pattern. The present study revealed the fact that shifting cultivation practice significantly affects the beetle species in terms of biodiversity pattern as well as evolutionary features. Spatiotemporal assessment of soil–plant–beetle interactions in shifting cultivation system and their influence in land degradation and ecology will be helpful in making biodiversity conservation decisions in the near future.

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Phytoremediation of chlorpyrifos in aqueous system by riverine macrophyte, Acorus calamus : toxicity and removal rate

Abstract

The potential of Acorus calamus to remove chlorpyrifos from water was assessed under laboratory conditions. Toxic effects of the insecticide in A. calamus were evaluated using pulse-amplitude modulated chlorophyll fluorescence techniques as well. At exposure concentrations above 8 mg L⁻¹, A. calamus showed obvious phytotoxic symptom with significant reduction in quantum efficiency of PSII (ΦPSII) and photochemical quenching coefficient (qP) in 20-day test; the inhibition of maximal quantum efficiency of PSII (Fv/Fm) was accompanied by a significant rise in initial chlorophyll fluorescence (Fo) within 15-day exposures. Fv/Fm and Fo recover to the normal level after 20-day exposure. The reduced removal rate to chlorpyrifos was observed with increase of initial chlorpyrifos concentrations. At application levels of 1, 2, and 4 mg L⁻¹, the disappearance rate of chlorpyrifos in the hydroponic system with plants was significantly greater than that without plants during the 20-day test periods. Chlorpyrifos was taken up from medium and transferred to above ground tissues by the plant and significant amounts of chlorpyrifos accumulated in plant tissues. The result indicated that A. calamus can promote the disappearance of chlorpyrifos from water and may be used for phytoremediation of water contaminated with a relatively low concentration of chlorpyrifos insecticide (<4 mg L⁻¹).

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Removal of Zn 2+ and SO 4 2− from aqueous solutions on acidic and chelating dehydrated carbon

Abstract

The agricultural waste, date palm leaflets, was carbonized chemically using sulfuric acid treatment. Produced dehydrated carbon (DC) was subjected to surface functionalization using ethylene diamine producing chelating dehydrated carbon (CDC). In the process, ∼80 % of the carboxylic content on DC was converted to amide successfully. DC acts as a cation exchanger because of the high content of carboxylic groups on its surface showing acidic nature. However, CDC possesses amine and amide groups showing basic nature. Both amine and amide groups are capable of chelating Zn²⁺ at high pH; however, at low pH, the amine group becomes protonated acting as anion exchanger. Sorption of Zn²⁺ and SO₄²⁻ was investigated in terms of contact time, initial pH, concentration, and carbon reuse. Zn²⁺ shows maximum sorption at initial pH 5; however, maximum sorption of SO₄²⁻ takes place at initial pH 2. Kinetic and equilibrium studies were carried out at initial 5 and 2 for Zn²⁺and SO₄²⁻, respectively. Sorption kinetics data follow well the pseudo second-order model. The equilibrium sorption data follow the Langmuir isotherm more than the Freundlich isotherm. CDC shows better sorption performance for Zn²⁺ and SO₄²⁻ than DC. DC and CDC show combined equimolar removal of both Zn²⁺ and SO₄²⁻ at initial pH 2.3 and 2.6, respectively, with efficient recycle properties. Combined removal of Zn²⁺ and SO₄²⁻ from spiked municipal wastewater shows less uptake on both carbons than from deionized water.

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Sodium butyrate mitigates in vitro ammonia generation in cecal content of laying hens

Abstract

One of the environmental challenges that modern poultry industry faced is odor pollution caused by ammonia emission. The objectives of the study were to determine the effect of sodium butyrate on the production of ammonia in the cecal contents of laying hens using in vitro gas production study and to elucidate the mechanism behind it. The study consisted of a control (without sodium butyrate), and three experimental groups added with 10, 15, and 20 mg of sodium butyrate, respectively. Results showed that ammonia production in headspace of the syringe decreased by 8.2, 23, and 23 %, respectively, while ammonium production from the fermentation broth decreased by 6.3, 14.4, and 13.7 %, respectively. Sodium butyrate had no significant effect on the contents of uric acid and urea, nitrate-N, or total N in all treatments. However, sodium butyrate decreased the urease and uricase activities (P < 0.05) in the fermentation broth. Sodium butyrate also altered volatile fatty acids profile of the fermentation broth by decreasing the production of isovalerate (P < 0.05) and increasing those of acetate, butyrate, and isobutyrate (P < 0.05). The MiSeq System Sequencing results showed that sodium butyrate increased the relative abundance of Bacteroides and Faecalibacterium (P < 0.05) and decreased the relative abundance of Desulfovibrio, Helicobacter, and Campylobacter (P < 0.05).Our results concluded that sodium butyrate changes the diversity and relative abundance of the microbes which altered the fermentation characteristics leading to reduction in ammonia production.

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Analysis of the relationship between economic growth and industrial pollution in Zaozhuang, China—based on the hypothesis of the environmental Kuznets curve

Abstract

In Zaozhuang, economic development affects the discharge amount of industrial wastewater, chemical oxygen demand (COD), and ammonia nitrogen (NH₃-N). To reveal the trend of water environmental quality related to the economy in Zaozhuang, this paper simulated the relationships between industrial wastewater discharge, COD, NH₃-N load, and gross domestic product (GDP) per capita for Zaozhuang (2002–2012) using environmental Kuznets curve (EKC) models. The results showed that the added value of industrial GDP, the per capita GDP, and wastewater emission had average annual growth rates of 16.62, 16.19, and 17.89 %, respectively, from 2002 to 2012, while COD and NH₃-N emission in 2012, compared with 2002, showed average annual decreases of 10.70 and 31.12 %, respectively. The export of EKC models revealed that industrial wastewater discharge had a typical inverted-U-shaped relationship with per capita GDP. However, both COD and NH₃-N showed the binding curve of the left side of the "U" curve and left side U-shaped curve. The economy in Zaozhuang had been at the "fast-growing" stage, with low environmental pollution according to the industrial pollution level. In recent years, Zaozhuang has abated these heavy-pollution industries emphatically, so pollutants have been greatly reduced. Thus, Zaozhuang industrial wastewater treatment has been quite effective, with water quality improved significantly. The EKC models provided scientific evidence for estimating industrial wastewater discharge, COD, and NH₃-N load as well as their changeable trends for Zaozhuang from an economic perspective.

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Transference factors as a tool for the estimation of arsenic milk concentration

Abstract

The Chaco Pampean Plain of central Argentina represents one of the largest regions with high levels of arsenic (As) in groundwater. The aim of this study was the assessment of a biotransference factor (BTF) as a tool for the estimation of As concentration in cow's milk from As drinking water concentration. Total As content in livestock drinking water, soil, forage, and milk was determined in farms located in an area of high As groundwater, in order to analyze the relation between As uptake and its transfer to milk. The concentrations of As in milk ranged from 0.5 to 8.0 μg/L. From the results obtained, drinking water may be considered the main source of exposure to As, and the biotransference factor for milk ranges from 1.5 × 10⁻⁵ to 4.3 × 10⁻⁴. Therefore, BTF provides a simple tool for the estimation of arsenic levels in milk through the As livestock drinking water content.

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Multielemental analysis of 20 mushroom species growing near a heavily trafficked road in Poland

Abstract

The aim of this work was to compare 10 mostly edible aboveground and 10 wood-growing mushroom species collected near a heavily trafficked road (approximately 28,000 vehicles per 24 h) in Poland with regard to their capacity to accumulate 26 trace elements (Ag, Al, As, Au, B, Ba, Bi, Cd, Co, Cr, Cu, Fe, Ga, Ge, In, Li, Mn, Ni, Pb, Re, Sb, Se, Sr, Te, Tl, and Zn) in their fruit bodies in order to illustrate mushroom diversity in element accumulation. All analyses were performed using an inductively coupled plasma optical emission spectrometry (ICP-OES) spectrometer in synchronous dual view mode. The aboveground species had significantly higher levels of 12 elements, including Ag, As, Pb, and Se, compared to the wood-growing species. An opposite relationship was observed only for Au, Ba, and Sr. The results of principal component analysis (PCA) and hierarchical cluster analysis (HCA) implied some new relationships among the analyzed species and elements. Of the analyzed mushroom species, lead content in Macrolepiota procera would seem to pose a health risk; however, at present knowledge regarding lead bioaccessibility from mushrooms is quite limited.

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Spatial-temporal variations of phosphorus fractions in surface water and suspended particles in the Daliao River Estuary, Northeast China

Abstract

The transport and storage of phosphorus in estuary is a complex biogeochemical process as the result of the convergence of fresh and saline water. The objective of the current study is to investigate the spatial-temporal variations of phosphorus fractions in surface water and suspended particles of Daliao River Estuary, China. Samples were collected in August (wet season) and November (dry season), 2013. The results showed that total particulate phosphorus (TPP) in water accounted for more than 50 % of the total phosphorus (TP). Meanwhile, in suspended particles, more than 62 % of particulate phosphorus was in the form of bioavailable phosphorus, including exchangeable phosphorus (Exc-P), extractable organic phosphorus (Exo-P), and iron-bound phosphorus (Fe-P), which meant that the potential impacts of bioavailable phosphorus in suspended particles on estuarine water environment cannot be ignored. There were significantly seasonal variations of phosphorus fractions in the Daliao River Estuary. The concentrations of phosphorus fractions in water in wet season were much lower than that in dry season because of the dilution effect of larger rainfall in wet season. In addition, spatial distribution characteristics of phosphorus fractions were also obvious. Due to terrigenous phosphorus input from the upstream of tidal reach and seawater dilution effect in coastal estuary, total dissolved phosphorus (TDP) concentrations in water gradually decreased from tidal reach to coastal estuary. However, the concentrations of TPP and TP in water and Exo-P in suspended particles presented spatial fluctuation, and these were greatly attributed to sediment re-suspension in coastal estuary.

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Catalytic destruction of PCDD/Fs over vanadium oxide-based catalysts

Abstract

Vanadium oxide-based catalysts were developed for the destruction of vapour phase PCDD/Fs (polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans). A vapour phase PCDD/Fs generating system was designed to supply stable PCDD/Fs steam with initial concentration of 3.2 ng I-TEQ Nm⁻³. Two kinds of titania (nano-TiO₂ and conventional TiO₂) and alumina were used as catalyst supports. For vanadium-based catalysts supported on nano-TiO₂, catalyst activity is enhanced with operating temperature increasing from 160 to 300 °C and then reduces with temperature rising further to 350 °C. It is mainly due to the fact that high volatility of organic compounds at 350 °C suppresses adsorption of PCDD/Fs on catalysts surface and then further inhibits the reaction between catalyst and PCDD/Fs. The optimum loading of vanadium on nano-TiO₂ support is 5 wt.% where vanadium oxide presents highly dispersed amorphous state according to the Raman spectra and XRD patterns. Excessive vanadium will block the pore space and form microcrystalline V₂O₅ on the support surface. At the vanadium loading of 5 wt.%, nano-TiO₂-supported catalyst performs best on PCDD/Fs destruction compared to Al₂O₃ and conventional TiO₂. Chemical states of vanadium in the fresh, used and reoxidized VOx(5 %)/TiO₂ catalysts at different operating temperature are also analysed by XPS.

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Bioaccumulation of trace metals in Hexaplex trunculus : spatial and temporal trends from 2004 to 2011 along the Tunisian coast

Abstract

Cd, Zn, Cu, As, Fe, Cr, Ni, Al, and Pb were analyzed in the edible and inedible parts of the muricid gastropod Hexaplex trunculus sampled along the Tunisian coast in 2004, 2007, and 2011. The concentration ranges (μg/g dry weight) in the whole soft tissue were 0.1–19.2 for Cd, 198.7–564.6 for Zn, 31.9–363.1 for Cu, 12.8–177.8 for As, 35.4–179.0 for Fe, 0.0–5.8 for Cr, 0.1–4.6 for Ni, 1.0–41.4 for Al, and 0.0–0.6 for Pb. The highest concentrations were recorded in Gabès for Cd, Menzel Jemil for Zn and Cu, Bizerte channel for As, Zarat for Cr and Pb, and Tunis North Lake for Fe, Al, and Ni. The European standards compiled by FAO for mollusks were exceeded in several localities. The temporal trends revealed a decreasing metal contamination in most sampling stations from 2004 to 2011. The calculated intake of metals (μg/week/kg body weight) through human consumption of the snail edible portion varied from 0.0 to 4.4 of Cd, 55.9 to 172.1 of Zn, 8.7 to 92.7 of Cu, 3.0 to 42.6 of As, 9.5 to 49.1 of Fe, 0.0 to 1.52 of Cr, 0.0 to 1.4 of Ni, and 0.3 to 11.4 of Al. Comparison of these metal intakes with those of the standard provisional tolerable weekly intake (PTWI) values stipulated by the WHO recommends precaution in terms of human consumption of this marine snail.

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Oncomirs miRNA-221/222 and Tumor Suppressors miRNA-199a/195 Are Crucial miRNAs in Liver Cancer: A Systematic Analysis

Abstract

Background

The high mortality rate of hepatocellular carcinoma (HCC) is partly due to a lack of good diagnostic markers and treatment strategies. Recently, several microRNA (miRNA) profiling studies were conducted with HCC; however, their inconsistency means that their diagnostic or therapeutic value is debatable.

Aims

This study aims to systematically evaluate the consistency of miRNAs from multiple independent studies.

Methods

A systematic analysis of miRNAs from eligible publications was conducted, followed by real-time PCRs. The targets of highly consistent miRNAs were collected using online programs, followed by enrichment analyses for gene ontology terms and Kyoto encyclopedia of genes and genomes pathways.

Results

In total, 241 differentially expressed miRNAs were reported in 13 HCC profiling studies, of which 137 were upregulated and 104 downregulated. Among consistently upregulated miRNAs (cutoff > fourfold), miRNA-222, miRNA-21, miRNA-221, miRNA-210, and miRNA-224 were found increased in 8, 6, 6, 5, and 5 different studies, respectively. Among 137 downregulated miRNAs, miRNA-195, miRNA-199a, miRNA-125b, and miRNA-99a were reported in 8, 8, 5, and 5 studies, respectively. These results were confirmed by real-time PCR. Enrichment analyses demonstrated that programmed cell death and proliferation play important roles during the interplay of miRNA with HCC.

Conclusions

miRNAs most consistently related to HCC are oncomirs miRNA-221/222 and tumor suppressors miRNA-199a/195.

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Benefits of microvascular decompression on social anxiety disorder and health-related quality of life in patients with hemifacial spasm

Abstract

Background

Hemifacial spasm (HFS), an involuntary movement disorder characterized by unilateral spasms of the muscles innervated by the facial nerve, is likely to cause social anxiety disorder due to its significant facial disfigurement and may have a significant influence on a patient's health-related quality of life (HRQoL). The goal of this study was to investigate the influence of microvascular decompression (MVD) on the severity of social anxiety symptoms and HRQoL in patients with HFS.

Methods

Patients who underwent MVD from January to May 2015 were included in this study. Demographic data were collected before surgery. Clinical data, including the standardized measures of anxiety and depression (Hospital Anxiety Depression Scale, HADS), social anxiety (Liebowitz Social Anxiety Scale, LSAS), and the severity of HFS were assessed before surgery and 6 months after surgery. HRQoL data were also collected before surgery and 6 months after surgery using the Korean version of the short form 36 (SF-36).

Results

Six patients (21.4 %) scored 60 or greater on the preoperative LSAS and were considered to have generalized social anxiety disorder (high-LSAS group). The duration of symptom was significantly higher in the high-LSAS group than in the low-LSAS group (7.8 ± 2.2 vs. 4.1 ± 2.6; p = 0.011). The high-LSAS group was more likely to have psychological comorbidities and had a more impaired quality of life than the low-LSAS group at preoperative evaluation. Six months after MVD, a significant improvement, compared to preoperative scores, was observed for the total LSAS score (p = 0.007) and anxiety subscale score of HADS (p = 0.012) in the high-LSAS group. Other significant improvements were also observed in role-emotional (p = 0.039) and mental component summary (p = 0.024) of the SF-36 in the high-LSAS group compared to the low-LSAS group.

Conclusions

This study shows that HFS patients seem to gain benefits from MVD not only for their facial disfigurement but also for social anxiety symptoms that may be associated with mental health improvements in their quality of life.

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Daphnia magna's sense of competition: intra-specific interactions (ISI) alter life history strategies and increase metals toxicity.

Daphnia magna's sense of competition: intra-specific interactions (ISI) alter life history strategies and increase metals toxicity.

Ecotoxicology. 2016 May 5;

Authors: Gust KA, Kennedy AJ, Melby NL, Wilbanks MS, Laird J, Meeks B, Muller EB, Nisbet RM, Perkins EJ

Abstract
This work investigates whether the scale-up to multi-animal exposures that is commonly applied in genomics studies provides equivalent toxicity outcomes to single-animal experiments of standard Daphnia magna toxicity assays. Specifically, we tested the null hypothesis that intraspecific interactions (ISI) among D. magna have neither effect on the life history strategies of this species, nor impact toxicological outcomes in exposure experiments with Cu and Pb. The results show that ISI significantly increased mortality of D. magna in both Cu and Pb exposure experiments, decreasing 14 day LC50 s and 95 % confidence intervals from 14.5 (10.9-148.3) to 8.4 (8.2-8.7) µg Cu/L and from 232 (156-4810) to 68 (63-73) µg Pb/L. Additionally, ISI potentiated Pb impacts on reproduction eliciting a nearly 10-fold decrease in the no-observed effect concentration (from 236 to 25 µg/L). As an indication of environmental relevance, the effects of ISI on both mortality and reproduction in Pb exposures were sustained at both high and low food rations. Furthermore, even with a single pair of Daphnia, ISI significantly increased (p < 0.05) neonate production in control conditions, demonstrating that ISI can affect life history strategy. Given these results we reject the null hypothesis and conclude that results from scale-up assays cannot be directly applied to observations from single-animal assessments in D. magna. We postulate that D. magna senses chemical signatures of conspecifics which elicits changes in life history strategies that ultimately increase susceptibility to metal toxicity.

PMID: 27151402 [PubMed - as supplied by publisher]

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Are fiducial markers useful surrogates when using respiratory gating to reduce motion of gastroesophageal junction tumors?

Are fiducial markers useful surrogates when using respiratory gating to reduce motion of gastroesophageal junction tumors?

Acta Oncol. 2016 May 6;:1-7

Authors: Liu F, Ng S, Huguet F, Yorke ED, Mageras GS, Goodman KA

Abstract
BACKGROUND: Radiation therapy (RT) is an integral component of the management of gastroesophageal junction (GEJ) tumors. We evaluated the use of implanted radiopaque fiducials as tumor surrogates to allow for more focal delivery of RT to these mobile tumors when using respiratory gating (RG) to reduce motion.
MATERIAL AND METHODS: We analyzed four-dimensional computed tomography scans of 20 GEJ patients treated with RG and assessed correlation between tumor and implanted fiducial motion over the whole respiratory cycle and within a clinically realistic gate around end-exhalation. We evaluated fiducial motion concordance in 11 patients with multiple fiducials.
RESULTS: Gating reduced anterior-posterior (AP) and superior-inferior (SI) mean tumor and fiducial motions by over 50%. Fiducials and primary tumor motions were moderately correlated: R(2) for AP and SI linear fits to the entire group were 0.54 and 0.68, respectively, but the correlation had strong inter-patient variation. For all patients with multiple fiducials, relative in-gate displacements were below 3 mm; results were similar for eight of 11 patients over the whole cycle.
CONCLUSION: Implanted fiducial and gross tumor volume (GTV) motions correlate well but the correlation is patient-specific and may be dependent on the location of the fiducials with respect to the GTV.

PMID: 27152887 [PubMed - as supplied by publisher]

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Determinants of non-participation in a mass screening program for colorectal cancer in Finland.

Determinants of non-participation in a mass screening program for colorectal cancer in Finland.

Acta Oncol. 2016 May 6;:1-5

Authors: Artama M, Heinävaara S, Sarkeala T, Prättälä R, Pukkala E, Malila N

Abstract
BACKGROUND: For an effective colorectal cancer (CRC) screening program, high participation rate is essential. However, non-participation in CRC screening program has increased in Finland.
MATERIAL AND METHODS: The study was based on a population-based nationwide cohort of persons invited for CRC screening in 2004-2011. Information on the first round of the CRC screening participation and related background factors was obtained from the Finnish Cancer Registry, and information about health behavior factors from the Health Behavior Survey (HBS) in 1978-1999. Non-participation in CRC screening was analyzed with Poisson regression as incidence rate ratios (IRR) with 95% confidence intervals (95% CI).
RESULTS: Of all persons invited for CRC screening (79 871 men and 80 891 women) 35% of men and 21% of women refused. Of those invited for screening, 2456 men (3.1%) and 2507 women (3.1%) were also invited to the HBS. Persons, who declined HBS, were also more likely to refuse CRC screening (men IRR 1.40, 95% CI 1.26-1.56, women 1.75, 1.52-2.02) compared to HBS participants. Never married persons had about a 75% higher risk for refusing than married ones. The youngest age group (60 years) was more likely to refuse screening than the older age groups (62 or >64 years). Smoking was associated with non-participation in screening (current smokers, men: IRR 1.32, 95% CI 1.05-1.67, women: 2.10, 1.61-2.73).
CONCLUSIONS: Participation in CRC screening was affected by gender, age, and marital status. Persons, who refused the HBS, were also more likely to refuse CRC screening. Smoking was a risk factor for non-participation in CRC screening.

PMID: 27152755 [PubMed - as supplied by publisher]

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Pattern of relapse after breast conserving therapy, a study of 1519 early breast cancer patients treated in the Central Region of Denmark 2000-2009.

Pattern of relapse after breast conserving therapy, a study of 1519 early breast cancer patients treated in the Central Region of Denmark 2000-2009.

Acta Oncol. 2016 May 6;:1-6

Authors: Bodilsen A, Offersen BV, Christiansen P, Overgaard J

Abstract
BACKGROUND: The continuous improvements in diagnosing and treatment of breast cancer are reflected in the ever changing pattern of recurrence. The aim of the study was to investigating recurrence pattern and prognostic factors of recurrence in a population-based cohort.
MATERIAL AND METHOD: In total 1519 consecutive patients treated with breast conserving therapy (BCT) for invasive carcinoma between 2000 and 2009 in the Central Region of Denmark was included. Patients received adjuvant irradiation and systemic treatment according to the guidelines of the Danish Breast Cancer Cooperative Group, including boost for young women and those with a narrow margin.
RESULTS: Median follow-up was 5.3 years (range 0.3-14.4). In total 183 women experienced breast cancer recurrence, 44 ipsilateral breast cancer recurrence, 13 regional recurrences, and 126 distant metastasis (DM). This corresponds to a cumulative risk of DM as first event at five and nine years of 6.5% and 12.6%, respectively. Further 42 women developed breast cancer in the contralateral breast. Disease-free survival (DFS) at five and nine years was 88% and 76%, respectively. Large tumor size (>20 mm), lymph node involvement, and vascular invasion were significantly associated with increased risk of DM. Margin width and age were not associated with risk of DM.
CONCLUSION: Acceptable recurrence rates and DFS were observed. Patients with large tumors, lymph node involvement, and vascular invasion had an increased risk of DM.

PMID: 27152670 [PubMed - as supplied by publisher]

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Insulin glargine use and breast cancer risk: Associations with cumulative exposure.

Insulin glargine use and breast cancer risk: Associations with cumulative exposure.

Acta Oncol. 2016 May 6;:1-8

Authors: Peeters PJ, Bazelier MT, Leufkens HG, Auvinen A, van Staa TP, de Vries F, De Bruin ML

Abstract
BACKGROUND: This study was aimed to assess the risk of breast cancer associated with exposure to insulin glargine in women with type 2 diabetes and evaluate whether the pattern of risk concurs with the hypothesized trend of an increase in risk with longer duration of use, taking into account previous cumulative exposure to other types of insulin.
METHODS: We performed a restrospective cohort study (2002-2013) in the Clinical Practice Research Datalink among adult female patients with a first ever insulin prescription (n = 12 468). Time-dependent exposure measures were used to assess associations with duration of use of: (1) other insulin types before glargine was first prescribed (i.e. among switchers); and (2) of glargine during follow-up. Analyses were performed separately for insulin-naïve glargine users and patients switched to glargine. Cox proportional hazards models were used to derive p-trends, hazard ratios (HR) and 95% confidence intervals (CI) for breast cancer associated with glargine use.
RESULTS: During 66 151 person years, 186 breast cancer cases occurred; 76 in glargine users (3.0/1000 years) and 110 in users of other insulins (2.7/1000 years). Among insulin-naïve women, no association with cumulative glargine use was observed (p-trend = 0.91), even after ≥5 years (HR = 1.06, 95% CI 0.48-2.33). Among switchers, a linear trend with years of prior exposure to other insulins was found (p-trend = 0.02). An increased risk was observed in glargine users with extensive (>3 years) past exposure to other insulins (HR = 3.17, 95% CI 1.28-7.84). A non-significant trend with cumulative glargine exposure was found among switchers (p-trend = 0.24).
CONCLUSIONS: Exposure to glargine was not associated with an increased breast cancer risk in insulin-naïve patients. Exposure to other insulins prior to the start of glargine appears to be relevant when studying breast cancer risk associated with glargine use.

PMID: 27150973 [PubMed - as supplied by publisher]

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The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma.

The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma.

Eur Arch Otorhinolaryngol. 2016 May 5;

Authors: Tsushima N, Sakashita T, Homma A, Hatakeyama H, Kano S, Mizumachi T, Kakizaki T, Suzuki T, Fukuda S

Abstract
Prophylactic neck dissection (PND) for patients with clinically N0 (cN0) tongue carcinoma remains controversial. We assessed the efficacy of PND for patients with cN0 tongue squamous cell carcinoma (SCC) and investigated the prognostic role of tumor thickness as assessed by diagnostic imaging in predicting the risk of nodal micrometastasis or late nodal recurrence. Eighty-eight patients with cN0 tongue carcinomas underwent surgical treatment. Tumor thickness was measured from magnetic resonance (MR) images or computed tomography (CT) scans. The overall survival rates of patients with or without PND were 94 and 81 %, respectively (p = 0.2857). MR images or CT scans were available for 68 patients. A tumor thickness ≥10 mm or ≥5 mm did not increase the probability of nodal metastasis, with late nodal metastasis observed in 15 % of patients with graphically undetected small tumors. PND appears to have the potential to improve overall survival for patients with cN0 tongue SCC. Careful follow-up management or PND is considered to be needed regardless of tumor thickness in the pre-treatment evaluation.

PMID: 27149875 [PubMed - as supplied by publisher]

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Evaluation of Malassezia and Common Fungal Pathogens in Subtypes of Chronic Rhinosinusitis.

Evaluation of Malassezia and Common Fungal Pathogens in Subtypes of Chronic Rhinosinusitis.

Int Forum Allergy Rhinol. 2016 May 6;

Authors: Gelber JT, Cope EK, Goldberg AN, Pletcher SD

Abstract
BACKGROUND: Fungal hypersensitivity and fungal microbiome dysbiosis are possible etiologies of chronic rhinosinusitis. The sinus fungal microbiome is not well characterized; novel sinus-associated fungi, including Malassezia, have only recently been described. The goals for this study were to verify Malassezia as a dominant component of the sinus microbiome, to speciate sinus Malassezia, and to compare select fungal species in chronic rhinosinusitis (CRS) subtypes with known fungal association to chronic rhinosinusitis with polyps (CRSwNP) and healthy controls.
METHODS: Twenty-eight patients were enrolled and categorized as CRSwNP (n = 15), fungus ball (n = 3), allergic fungal rhinosinusitis (AFRS, n = 3), or healthy control (n = 7). Brush samples were taken from ethmoid or maxillary sinus mucosa and tested for DNA from 7 index fungi using quantitative polymerase chain reaction. Index fungal species were chosen based on existing data of the sinus fungal microbiome.
RESULTS: Malassezia species were detected in 68% of patients, without variation among clinical phenotypes (p > 0.99). Malassezia restricta was more commonly detected than Malassezia globosa (p = 0.029). Presence of one Malassezia species predicted the presence of the other (p = 0.035). Aspergillus was identified in 2 of 3 of fungus ball patients (both A. fumigatus) and 2 of 3 AFRS patients (1 A. fumigatus and 1 A. flavus). Aspergillus was absent in control and CRSwNP patients (p < 0.001).
CONCLUSION: This study confirmed and speciated Malassezia in healthy and diseased sinuses. Presence of Malassezia species in all groups suggests a commensal role for the fungus. Future work will determine whether Malassezia influences CRS pathogenesis. Aspergillus species were identified in fungal CRS subtypes despite negative surgical cultures, highlighting the importance of culture-independent technology.

PMID: 27153455 [PubMed - as supplied by publisher]

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Using Organotypic Epithelial Tissue Culture to Study the Human Papillomavirus Life Cycle.

Using Organotypic Epithelial Tissue Culture to Study the Human Papillomavirus Life Cycle.

Curr Protoc Microbiol. 2016;41:14B.8.1-14B.8.19

Authors: Lee D, Norby K, Hayes M, Chiu YF, Sugden B, Lambert PF

Abstract
Human papillomaviruses (HPVs) are small double-stranded DNA viruses that are associated with greater than 95% of cervical cancers and 20% of head and neck cancers. These cancers arise from persistent infections in which there is continued expression of the HPV E6 and E7 oncogenes, often as a consequence of integration of HPV DNA into the host genome. Such cancers represent "dead ends" for the virus as integration disrupts the viral genome and because the cancers are defective in normal epithelial differentiation, which is required for production of progeny papillomavirus. In order to study the full viral life cycle, from the establishment to maintenance to productive stages, our lab makes use of the organotypic epithelial tissue culture system. This system allows us to mimic the three-dimensional structure of epithelia whose differentiation is tightly linked to the completion of the HPV viral life cycle. In this chapter we describe how various aspects of the HPV life cycle are monitored in raft cultures making use of an immortalized keratinocyte cell line. © 2016 by John Wiley & Sons, Inc.

PMID: 27153383 [PubMed - as supplied by publisher]

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Myofascial Trigger Points and Migraine-related Disability in Women with Episodic and Chronic Migraine.

Myofascial Trigger Points and Migraine-related Disability in Women with Episodic and Chronic Migraine.

Clin J Pain. 2016 May 5;

Authors: Ferracini GN, Florencio LL, Dach F, Chaves TC, Palacios-Ceña M, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D, Speciali JG

Abstract
OBJECTIVE: The aim of this study was to investigate the differences in the presence of head and neck-shoulder trigger points (TrPs) between women with episodic or chronic migraine and their association with migraine-related disability.
METHODS: One hundred and forty-three women, aged 18-60 years, suffering from migraine were recruited to participate. Migraine-related disability was evaluated with the migraine disability assessment questionnaire (MIDAS). TrPs were explored bilaterally within the masseter, temporalis, suboccipital, sternocleidomastoid, upper trapezius, and splenius capitis muscles.
RESULTS: Ninety-eight women exhibited episodic migraine and 45 chronic migraine. Women with chronic migraine reported higher related-disability than those with episodic migraine (P=0.045). Women with episodic migraine had a similar number of TrPs (total number: 4.3±3.3; active TrPs: 3.0±2.9; latent TrPs: 1.3±2.1) to those with chronic migraine (total number: 4.8±3.2; active TrPs: 3.4±2.9; latent TrPs: 1.4±1.9). No linear association between the number of TrPs and migraine-related disability was observed in women with episodic or chronic migraine.
CONCLUSION: Women with episodic and chronic migraine had a similar number of TrPs. TrPs may be considered as a trigger factor that can facilitate the onset of migraine or also can potentially also be a promoting factor for pain once the migraine attack has started and hence may contribute to related-disability. Nevertheless, we observed that the number of TrPs in head and neck-shoulder muscles in an interictal state was not associated with the degree of migraine-related disability, suggesting a multi-factorial nature of self-perceived disability in this population.

PMID: 27153358 [PubMed - as supplied by publisher]

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Stability of the aVOR to Repeat Head Impulse Testing.

Stability of the aVOR to Repeat Head Impulse Testing.

Otol Neurotol. 2016 May 5;

Authors: Schubert MC, Migliaccio AA

Abstract
OBJECTIVE: The angular vestibulo-ocular reflex (aVOR) is known to be influenced by factors such as arousal and cognition during traditional vestibular function testing. However, the inherent variability of the aVOR to head impulse testing has not been explicitly examined. The purpose of this study was to determine the variability of the aVOR to active and passive head impulses using the gold standard scleral search coil method to record head and eye rotation.
STUDY DESIGN: Descriptive.
SETTING: Tertiary referral center.
PATIENTS: Twenty six healthy control subjects agreed to active and passive horizontal head impulse testing on at least two separate sessions from two unique institutions. An additional 27 individuals with cochlear implantation (CI) underwent passive horizontal and vertical semicircular canal plane head impulse testing. Test sessions were separated from 3 to 210 days in the normal subjects and from 49 to 537 days in the subjects with CI.
MAIN OUTCOME MEASURE(S): Reliability of the angular VOR gain (eye velocity/head velocity) over time.
RESULTS: In the healthy control subjects, there was no difference in aVOR gain between right and left ears, between session one and session two, or between active (self-generated, 0.99 ± 0.08) or passive (imposed, 1.0 ± 0.08) head impulses. In the patients, we also found the aVOR gain very stable over time. However, the aVOR gains of the patients were different across the semicircular canal planes tested (p < 0.001) with the four vertical semicircular canals having lower aVOR gains than the two horizontal canals.
CONCLUSIONS: Our data suggest the aVOR gain is quite stable when tested across unique days in healthy controls and patients with auditory-only inner ear pathology.

PMID: 27153330 [PubMed - as supplied by publisher]

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Cochlear Implantation Improves Spatial Release From Masking and Restores Localization Abilities in Single-Sided Deaf Patients.

Cochlear Implantation Improves Spatial Release From Masking and Restores Localization Abilities in Single-Sided Deaf Patients.

Otol Neurotol. 2016 May 5;

Authors: Grossmann W, Brill S, Moeltner A, Mlynski R, Hagen R, Radeloff A

Abstract
HYPOTHESIS: Adult patients with acquired single-sided deafness (SSD) benefit from binaural hearing after cochlear implantation (CI).
BACKGROUND: To spatially separate the signal of interest from noise is of utmost importance for the speech understanding in challenging listening situations. This ability, however, largely depends on binaural hearing. CI in acquired SSD restores hearing on the deaf ear. This study intended to test, if this is accompanied by a restoration of binaural functions of the auditory system.
METHODS: Eleven CI users with SSD and normal hearing to mild sensorineural hearing loss in the contralateral ear participated in this study. Speech reception thresholds (SRT) were obtained using the Oldenburg Sentence Test (OLSA) sentence test in competing two talker babble noise. To evaluate spatial release from masking, seven spatial configurations of speech and noise were used in a free field setup: noise originated from 0 degree, ±45 degrees and ±90 degrees incidence angles, whereas speech was either presented from the front or ±90 degrees. In addition, localization ability in the frontal horizontal plane was assessed with a 1 s Comité Consultatif International Téléphonique et Télégraphique (CCITT) noise stimulus using an array of nine equally spaced loudspeakers. All tests were conducted in acoustic normal hearing ear alone (AH) and aided conditions.
RESULTS: In conditions with spatially separated signal and noise sources, significant benefit of the aided over the AH condition was observed, even when noise was presented from the AH side. Localization ability significantly improved in the aided condition.
CONCLUSION: The present data demonstrates that spatial release from masking can be restored in patients with SSD using a cochlear implant.

PMID: 27153328 [PubMed - as supplied by publisher]

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Long-Term Outcomes After Middle Fossa Approach for Traumatic Facial Nerve Paralysis.

Long-Term Outcomes After Middle Fossa Approach for Traumatic Facial Nerve Paralysis.

Otol Neurotol. 2016 May 5;

Authors: Cannon RB, Thomson RS, Shelton C, Gurgel RK

Abstract
OBJECTIVES: Controversy exists regarding the role of surgery for patients with skull base trauma and facial paralysis. Our goal is to report the long-term outcomes of early facial nerve decompression and repair via the middle fossa (MF) approach for patients with traumatic paralysis.
STUDY DESIGN: Retrospective case series.
SETTING: Academic medical center.
PATIENTS: There were 18 patients who met surgical criteria: immediate complete paralysis, greater than 90% degeneration on electroneurography (ENoG), and no voluntary electromyography (EMG) potentials within 14 days after trauma and 1 year minimum follow-up.
INTERVENTION: MF approach for traumatic facial paralysis and for irreversible injuries nerve grafting was performed.
MAIN OUTCOME MEASURE: Long-term facial function, hearing results, and surgical complications.
RESULTS: At MF decompression, 11 patients had an anatomically intact facial nerve. Of these patients with intact nerves, 72.7% obtained normal to near normal facial function (HB I or II) at 1 year: 27.3% to HB I, 45.5% to HB II, and 27.3% to HB III. At surgery, seven patients were found to have injuries that required nerve grafting and 100% improved to HB III. For all patients, facial nerve function significantly improved after surgery (p < 0.01). The average difference in pure tone average and word recognition after surgery was +2.9 dB and +3.3%, respectively (p = 0.44; p = 0.74). Minor, transient complications occurred in three patients and an abscess required drainage in one patient, but no other major complications.
CONCLUSION: In our series, all patients with traumatic complete paralysis and poor facial prognosis achieved a long-term outcome of HB III or better after MF approach for decompression and repair of the facial nerve.

PMID: 27153325 [PubMed - as supplied by publisher]

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Reevaluation of postoperative radiation dose in the management of human papillomavirus-positive oropharyngeal cancer.

Reevaluation of postoperative radiation dose in the management of human papillomavirus-positive oropharyngeal cancer.

Head Neck. 2016 May 6;

Authors: Chin RI, Spencer CR, DeWees T, Hwang MY, Patel P, Sinha P, Gay HA, Haughey BH, Nussenbaum B, Adkins DR, Lewis JS, Thorstad WL

Abstract
BACKGROUND: The purpose of this study was to compare outcomes of patients with p16-positive oropharyngeal squamous cell carcinoma (SCC) treated with postoperative intensity-modulated radiotherapy (IMRT) before and after an institutional dose reduction policy effective on February 2009.
METHODS: Between 1998 and 2013, 175 consecutive patients with p16-positive oropharyngeal SCC with extracapsular extension (ECE) and/or close or positive margins were treated postoperatively to 66 Gy (n = 109) or 60 Gy (n = 66) in 2 Gy/fx.
RESULTS: Between the 66 and 60 Gy groups, there was no difference in tumor classification (pT4 vs pT1-T3; p = .181) and nodal classification (pN2c-N3 vs pN0-N2b; p = .704), and American Joint Committee on Cancer (AJCC) group stage (IV vs I-III; p = .473). Median follow-up was 5.9 years overall (66 Gy: 7.4 years; 60 Gy: 4.0 years). There was no difference in locoregional recurrence-free survival (2-year: 98.1% vs 98.5%; p = .421).
CONCLUSION: This study suggests that treating p16-positive oropharyngeal SCC with ECE and/or close or positive margins with postoperative IMRT to 60 Gy may not compromise locoregional recurrence-free survival compared to 66 Gy. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27152851 [PubMed - as supplied by publisher]

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Platelets Guide Leukocytes to Their Sites of Extravasation.

Platelets Guide Leukocytes to Their Sites of Extravasation.

PLoS Biol. 2016 May;14(5):e1002459

Authors: Zuchtriegel G, Uhl B, Puhr-Westerheide D, Pörnbacher M, Lauber K, Krombach F, Reichel CA

Abstract
Effective immune responses require the directed migration of leukocytes from the vasculature to the site of injury or infection. How immune cells "find" their site of extravasation remains largely obscure. Here, we identified a previously unrecognized role of platelets as pathfinders guiding leukocytes to their exit points in the microvasculature: upon onset of inflammation, circulating platelets were found to immediately adhere at distinct sites in venular microvessels enabling these cellular blood components to capture neutrophils and, in turn, inflammatory monocytes via CD40-CD40L-dependent interactions. In this cellular crosstalk, ligation of PSGL-1 by P-selectin leads to ERK1/2 MAPK-dependent conformational changes of leukocyte integrins, which promote the successive extravasation of neutrophils and monocytes to the perivascular tissue. Conversely, blockade of this cellular partnership resulted in misguided, inefficient leukocyte responses. Our experimental data uncover a platelet-directed, spatiotemporally organized, multicellular crosstalk that is essential for effective trafficking of leukocytes to the site of inflammation.

PMID: 27152726 [PubMed - as supplied by publisher]

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Survival outcomes after endoscopic resection for sinonasal squamous cell carcinoma arising on inverted papilloma.

Survival outcomes after endoscopic resection for sinonasal squamous cell carcinoma arising on inverted papilloma.

Head Neck. 2016 May 6;

Authors: Karligkiotis A, Lepera D, Volpi L, Turri-Zanoni M, Battaglia P, Lombardi D, Accorona R, Bignami M, Nicolai P, Castelnuovo P

Abstract
BACKGROUND: Sinonasal inverted papillomas (IPs) can be associated synchronously or metachronously to invasive squamous cell carcinoma (SCC) in 5% to 10% of cases. The purposes of the present study were to analyze the outcomes of patients with sinonasal SCC arising from inverted papilloma (IP-SCC) treated through an endoscopic approach and review the pertinent literature.
METHODS: The medical records of all patients treated for IP-SCC between 1997 and 2014 at 2 referral centers following a uniform policy were retrospectively analyzed.
RESULTS: Thirty-four patients fulfilled the inclusion criteria. The 5-year overall survival (OS), disease-specific survival (DFS), and recurrence-free survival (RFS) rates were 66.8 ± 0.99%, 71.2 ± 0.96%, and 73.1 ± 0.82%, respectively. Multivariate analysis revealed that the advanced pT classification (pT3 or greater), the high-grade of tumoral differentiation, the cranioendoscopic approach, and the recurrence of disease impacted negatively on survival rates.
CONCLUSION: The endoscopic approach provides encouraging oncologic outcomes for sinonasal IP-SCC, comparable to those observed with traditional external approaches while minimizing morbidity for patients. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27152722 [PubMed - as supplied by publisher]

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The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer.

The potential impact of prophylactic human papillomavirus vaccination on oropharyngeal cancer.

Cancer. 2016 May 6;

Authors: Guo T, Eisele DW, Fakhry C

Abstract
The incidence of oropharyngeal cancer (OPC) is significantly increasing in the United States. Given that these epidemiologic trends are driven by human papillomavirus (HPV), the potential impact of prophylactic HPV vaccines on the prevention of OPC is of interest. The primary evidence supporting the approval of current prophylactic HPV vaccines is from large phase 3 clinical trials focused on the prevention of genital disease (cervical and anal cancer, as well as genital warts). These trials reported vaccine efficacy rates of 89% to 98% for the prevention of both premalignant lesions and persistent genital infections. However, these trials were designed before the etiologic relationship between HPV and OPC was established. There are differences in the epidemiology of oral and genital HPV infection, such as differences in age and sex distributions, which suggest that the vaccine efficacy observed in genital cancers may not be directly translatable to the cancers of the oropharynx. Evaluation of vaccine efficacy is challenging in the oropharynx because no premalignant lesion analogous to cervical intraepithelial neoplasia in cervical cancer has yet been identified. To truly investigate the efficacy of these vaccines in the oropharynx, additional clinical trials with feasible endpoints are needed. Cancer 2016. © 2016 American Cancer Society.

PMID: 27152637 [PubMed - as supplied by publisher]

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Implementation of a comprehensive competency-based transoral robotic surgery training curriculum with ex vivo dissection models.

Implementation of a comprehensive competency-based transoral robotic surgery training curriculum with ex vivo dissection models.

Head Neck. 2016 May 6;

Authors: Sobel RH, Blanco R, Ha PK, Califano JA, Kumar R, Richmon JD

Abstract
BACKGROUND: Despite its increasingly widespread adoption of transoral robotic surgery (TORS), there is still no uniform training curriculum. The purpose of this study was to describe the results of our novel TORS curriculum training program in which we introduce ex vivo dissection models for radical tonsillectomy and base of tongue (BOT) resections.
METHODS: Prospective blinded data collection and objective assessment of a novel training curriculum. Trainee performance was evaluated on objective structured assessments of technical skills (OSATS) metrics, measured resection time, and margin analysis. Additionally, 4 expert TORS surgeons completed the ex vivo dissections.
RESULTS: Trainees achieved OSATS scores similar to those of experts in both the BOT resection and radical tonsillectomy models. Peripheral and deep surgical margin measurements in the BOT model were significantly improved after training and were comparable to experts.
CONCLUSION: This graduated curriculum provides a realistic training experience to develop competency with oropharyngeal resections before transition to the operating room. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27152633 [PubMed - as supplied by publisher]

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

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

Plast Reconstr Surg. 2016 Apr 29;

Authors: Chen YC, Scaglioni MF, Carrillo Jimenez LE, Yang JC, Huang EY, Lin TS

Abstract
BACKGROUND: The purpose of this study was to compare the clinical outcomes and donor site morbidity between the suprafascial and subfascial harvesting of anterolateral thigh (ALT) flaps.
METHODS: Sixty-one patients who underwent free flap reconstruction (30 suprafascial ALT flaps and 31 subfascial ALT flaps) were included in this study. The patients assessed the subjective donor-site morbidity and satisfaction with the overall functional result using a self-reported questionnaire. The flap characteristics (perforator number, flap size, and harvest time) and outcomes (success rate, partial necrosis, infection, hematoma and fistula) were compared.
RESULTS: The success rates of suprafascial ALT flaps and subfascial ALT flaps were 96.7 percent and 96.8%. There were no significant differences in the flap size, harvest time or overall complication rates. The suprafascial ALT flap group experienced fewer abnormal sensations (p < 0.001). and better subjective satisfaction at the donor site than did the subfascial ALT flap group (p = 0.03).
CONCLUSIONS: In terms of reducing donor-site morbidity, the suprafascial ALT flap group showed fewer sensory disturbances in donor thighs and exhibited better patient satisfaction than did the subfascial ALT flap group, but meticulous dissection of tiny perforators above the fascia is required for the former procedure.

PMID: 27152581 [PubMed - as supplied by publisher]

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