Different HIV-1 env frames: gp120 and ASP (antisense protein) biosynthesis, and theirs co-variation tropic amino acid signatures in X4- and R5-viruses

Abstract

Antisense protein (ASP) is the new actor of viral life of Human Immunodeficiency Virus type 1 (HIV-1) although proposed above 20 years ago. The asp ORF is into complementary strand of the gp120/gp41 junction of env gene. The ASP biological role remains little known. Knowing the Env markers of viral tropism, a dataset of sequences (660 strains) was used to analyze the hypothetical ASP involvement in CCR5 (R5) and/or CXCR4 (X4) co-receptor interaction. Preliminarily, prevalence of ASP and gp120_V3 mutations was performed; following association among mutations were elaborate. The classical V3 tropic-signatures were confirmed, and 36 R5- and 22 × 4-tropic ASP mutations were found. Moreover, by analyzing the ASP sequences, 36 out of 179 amino acid positions significantly associated with different co-receptor usage were found. Several statistically significant associations between gp120_V3 and ASP mutations were observed. The dendrogram showed the existence of a cluster associated with R5-usage and a large cluster associated with X4-usage. These results show that gp120_V3 and specific amino acid changes in ASP are associated together with CXCR4 and/or CCR5-usage. These findings implement previous observations on unclear ASP functions. This article is protected by copyright. All rights reserved

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Epidemiology and genetic diversity of group A rotavirus in acute diarrhea patients in pre-vaccination era in southwest China

Abstract

Group A rotavirus (RVA) is one of the leading cause of acute diarrhea worldwide, the RVA-related disease burden and the genotypes of RVA is important reference to introduce RVA variance to national immunisation programmes, 1,121 diarrhea cases and 319 healthy controls were recruited from four sentinel hospital outpatient from July 2014 to June 2015. The prevalence of RVA was 244 (21.8%) in gastroenteritis cases and in 12 (3.8%) in healthy controls across all age group (OR = 7.12, 95%CI = 3.93–12.89); the detection rate of RVA in diarrhea patients under five years was more higher than in diarrhea cases over five years (26.1%, 222/850; 8.1%, 22/271, respectively, P = 0.000), Of 244 RVA strains isolated from acute diarrhea cases, G9 (66.4%) was predominant G genotype, followed by G3 (18.7%), G1 (8.9%) and G1G3 (3.8%); P[8] was the overwhelming prevalence P genotype, followed by P[4] (4.7%); G9P[8] (54.9%) was most common G and P Combination, followed by G3P[8] (17.6%) and G1[8] (8.6%). The conclusion of the study was important to provide reference for introducing the RVA vaccine to prevent and control RVA-associated disease burden. This article is protected by copyright. All rights reserved

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Impact of resistance-associated variant dominancy on treatment in patients with HCV genotype 1b receiving daclatasvir/asunaprevir

Abstract

Sustained virological responses (SVR) by daclatasvir (DCV) and asunaprevir (ASV) therapy for genotype 1b hepatitis C virus (HCV) infected patients has been significantly affected by pre-existence of Y93H resistance-associated variants (RAVs) in the non-structural protein 5A (NS5A) region. The aim of this study was to elucidate the dominancy of naturally occurring RAVs in viral quasispecies on treatment outcomes in patients with HCV. In total, 138 patients were prospectively selected from 152 patients treated with DCV and ASV, where evaluation of treatment outcomes at 12 weeks post-treatment was possible. Pre-treatment RAVs in the non-structural protein 3 and NS5A regions were detected by polymerase chain reaction (PCR)-Invader assays, and the ratio of Y93H RAVs in viral quasispecies was measured by quantitative PCR-Invader assay. Among 25 patients detected the Y93H RAV, the Y93H ratio was 1–25% in 5 patients, 26–75% in 7 patients, and ≥76% in 13 patients. Overall, SVR at 12 weeks after the completion of treatment (SVR12) was 91% (125/138), and those with Y93H ratios of <1%, 1–25%, 26–75%, and ≥76% were 99%, 100%, 71%, and 23%, respectively. Thus, the SVR12 decreased as the HCV Y93H ratio increased (p < 0.0001). The dominancy of pre-treatment RAVs of DCV and ASV affected its treatment outcomes, suggesting that evaluating the dominancy of HCV RAVs could be required for every other direct-acting antiviral agent treatments. This article is protected by copyright. All rights reserved

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Increased replication capacity following evolution of PYxE insertion in gag-p6 is associated with enhanced virulence in HIV-1 subtype C from East Africa

Abstract

Background

A lower virulence of HIV-1 subtype C (HIV-1C) is suggested to be related to the global dominance of HIV-1C. In this observational study, combining in vivo (clinical monitoring) and in vitro (genotypic, biochemical, and phenotypic assays), we explored whether HIV-1C from East Africa (HIV-1C_EA) is more pathogenic due to the evolution of a PYxE-insertion (C_PYxEi) in the gag-p6 that also could affect the therapy response.

Methods

HIV-1B (n = 112) and HIV-1C_EA (n = 128) infected individuals residing in Sweden were analysed with regard to Gag-p6 genotype and clinically monitored. Based on the Gag-p6 characteristics, three HIV-1C_EA and one HIV-1B patient derived p2-INT-recombinant virus (gag-p2/NCp7/p1/p6/pol-PR/RT/IN) were constructed to analyse viral growth kinetics (VGKs) and drug sensitivity assays. Reverse transcriptase (RT) from the same samples was cloned into the heterodimer expression plasmid (pRT6H-PROT) to analyse catalytic efficiency of RT.

Results

A higher viral failure rate and lower pre-therapy CD4⁺ T-cell counts were observed in HIV-1C_EA infected patients compared to HIV-1B-infected patients. In Gag-p6, PTAP-duplication was more common in HIV-1C. HIV-1C_EA–infected patients with signature C_PYxEi, evidenced very low pre-therapy CD4⁺ T-cell counts and suboptimal gain in CD4⁺ T-cells following therapy, as compared to the non-C_PYxEi-strains indicating higher virulence. VGKs, showed a statistically significant higher replication capacity (RC) for the C_PYxEi viruses than the other two non-C_PYxEi strains. No statistically significant difference was observed in the catalytic efficiency among HIV-1C RTs.

Conclusions

This is the first evidence of polymerase independent increased virulence and RC in HIV-1C_EA following PYxE-insertion that is associated with suboptimal CD4⁺ T-cell gain following therapy initiation. This article is protected by copyright. All rights reserved

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Clinical characterization of influenza A and human respiratory syncytial virus among patients with influenza like illness

Abstract

Background

Influenza A and Respiratory Syncytial Virus (RSV) has been recognized as a major cause of acute respiratory tract infection. H1N1 is one of the subtypes of influenza A, pandemic worldwide in July2009, causing 18,449 deaths globally.

Objectives

To investigate the prevalence and clinical manifestation of the influenza A, H1N1pdm09 and RSV.

Method

Throat/nasal swab collected from the patients of all age group either outpatients/inpatients having respiratory illness from 2 to 5 days. The clinical data were recorded in a predesigned questionnaire. RNA was extracted and analyzed by real time PCR at a tertiary care center, 2009–2014.

Results

Total 4352 samples tested for influenza A and H1N1. Out of 4352, 32.2% (median positivity 21%; range 16-41% during six years) were positive for influenza A and 19% were H1N1 (median positivity 16.7%; range 8.7-23% during six years). Total 1653 samples were analyzed for RSV from 2011-2014, 12% were RSV positive (median positivity11.35%; range 10-16.3% during four years). Pharyngitis, dyspnea were frequent symptoms in influenza A and H1N1 (p < 0.005) whereas bronchiolitis and pneumonia were commonly present in RSV (p < 0.005). The positivity of influenza A and H1N1 was higher in age-group 21-30, whereas RSV in infant and children.

Conclusion

H1N1and RSV were co-circulated and have common clinical symptoms particularly in lower age group. Therefore, laboratory confirmation is necessary for further disease prognosis. Age was an important risk factor that affects the positivity of influenza A, H1N1 and RSV. Different clinical manifestation of H1N1 and RSV will be helpful for early and accurate diagnosis. This article is protected by copyright. All rights reserved

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Identification of two unique naturally occurring Vpr sequence polymorphisms associated with clinical parameters in HIV-1 chronic infection

ABSTRACT

HIV-1 viral protein R (Vpr) plays important roles in HIV-1 replication. Despite the identification of a number of HLA class I-associated immune escape mutations; it is yet known whether immune-driven Vpr polymorphisms are associated with disease outcome. Hereby, we comprehensively analyzed Vpr sequence polymorphisms and their association with disease outcome and host HLA genotypes, by using plasma viral RNA isolated from 444 HLA-typed, treatment-naïve, chronically HIV-1 infected individuals. Vpr amino acid residues at positions 13, 37, 45, 55, 63, 77, 84, 85, 86 and 93 were significantly associated with patients' plasma viral load and/or CD4 count. Further analysis revealed Ala at position 55 was significantly associated with lower plasma viral load; and Thr at position 63 was significantly associated with lower plasma viral load and higher CD4 count. Also, the number of amino acid residues at the two positions, located in a functionally-important α-helical domain, correlated inversely with plasma viral load and positively with CD4 count. Moreover, a phylogenetically corrected method revealed residues at positions 55 and 63 are associated with patients' HLA genotypes. Taken together, our results suggest that Vpr polymorphisms at functionally-important and immune-reactive sites may contribute, at least in part, to viral replication and disease outcome in vivo. This article is protected by copyright. All rights reserved

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Intergenotype recombinant analysis of full-length hepatitis B virus genomes from 516 Chinese patients with different illness categories

Abstract

This study aimed to reveal characteristics and clinical relevance of HBV intergenotypic recombinants. Serum samples of 516 patients from Northern China were collected, including 131 with acute hepatitis B (AHB), 239 with chronic hepatitis B (CHB) and 146 with acute-on-chronic liver failure (ACLF). Full-length HBV genomes were sequenced and HBV genotypes were analyzed. Genotype C, B, D, and intergenotypic recombinants were detected in 71.12% (367/516), 19.96% (103/516), 0.78% (4/516), and 8.14% (42/516) of the patients. The latter comprised 21 with AHB, ten with CHB and eleven with ACLF; and the occupations of intergenotypic recombinants in AHB, CHB, and ACLF groups were 16.03%, 4.18%, and 7.53% (P <0.01), respectively. HBV B/C and C/D hybrids accounted for 85.71% (36/42) and 14.29% (6/42) of the intergenotypic recombinants. In AHB and CHB groups, serum HBV DNA levels were significantly lower in patients with intergenotypic recombinants than those without intergenotypic recombinants. Difference in basal core promoter A1762T/G1764A mutations and precore G1896A mutation incidences was not significant between B/C recombinant and genotype B or C virus, although the significance was there between genotype B and C viruses. Clonal sequence analysis showed that intergenotypic recombinant viral strains existed in single or in concomitance with other genotype virus. Phenotypic analysis showed that viral replication capacity was similar between recombinant and non-recombinant strains in tested samples. Taken together, the occurrence of intergenotypic recombinant HBV is relatively low in HBV-infected patients in Northern China, and intergenotypic recombinant HBV infection is likely favorable to induce an acute course of disease. This article is protected by copyright. All rights reserved

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Diverse Physiological Roles of Calcitonin Gene-Related Peptide in Migraine Pathology: Modulation of Neuronal-Glial-Immune Cells to Promote Peripheral and Central Sensitization

Abstract

The neuropeptide calcitonin gene-related peptide (CGRP) is implicated in the underlying pathology of migraine by promoting the development of a sensitized state of primary and secondary nociceptive neurons. The ability of CGRP to initiate and maintain peripheral and central sensitization is mediated by modulation of neuronal, glial, and immune cells in the trigeminal nociceptive signaling pathway. There is accumulating evidence to support a key role of CGRP in promoting cross excitation within the trigeminal ganglion that may help to explain the high co-morbidity of migraine with rhinosinusitis and temporomandibular joint disorder. In addition, there is emerging evidence that CGRP facilitates and sustains a hyperresponsive neuronal state in migraineurs mediated by reported risk factors such as stress and anxiety. In this review, the significant role of CGRP as a modulator of the trigeminal system will be discussed to provide a better understanding of the underlying pathology associated with the migraine phenotype.

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Stem cells for tissue engineered vascular bypass grafts.

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Stem cells for tissue engineered vascular bypass grafts.

Artif Cells Nanomed Biotechnol. 2016 Jun 21;:1-12

Authors: Askari F, Solouk A, Shafieian M, Seifalian AM

Abstract
Despite great advances in tissue engineering, there have been very few reports on the successful clinical use of small-diameter tissue-engineered vascular grafts (TEVGs). Small-diameter (<6 mm internal diameter) is considered as unmet clinical need. This review critically examines the role of stem cells that have been proposed and used in development of TEVGs, and assesses the viability of such graft to clinical pathway. With over 20 years of expertise in development of bypass graft and a number of grafts under clinical trial, this team will offer potential areas for future research that may help improve the current state-of-the-art technology.

PMID: 27327775 [PubMed - as supplied by publisher]

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Structural characterization and evaluation of mosquito-larvicidal property of silver nanoparticles synthesized from the seaweed, Turbinaria ornata (Turner) J. Agardh 1848.

Related Articles

Structural characterization and evaluation of mosquito-larvicidal property of silver nanoparticles synthesized from the seaweed, Turbinaria ornata (Turner) J. Agardh 1848.

Artif Cells Nanomed Biotechnol. 2016 Jun 21;:1-9

Authors: Deepak P, Sowmiya R, Ramkumar R, Balasubramani G, Aiswarya D, Perumal P

Abstract
The silver nanoparticles synthesized from Turbinaria ornata (To-AgNPs) showed spherical with crystalline nature (20-32 nm) was evaluated against fourth instar larvae of three mosquitoes. The maximum activity of To-AgNPs was recorded on Aedes aegypti followed by Anopheles stephensi and Culex quinquefasciatus with the following lethal concentration values (μg/ml): LC50 of 0.738, 1.134, and 1.494; and LC90 of 3.342, 17.982, and 22.475, respectively. The obtained respective values (μg/ml) vis-a-vis aqueous extract (To-AE) were: 2.767 and 40.577; 4.347 and 158.399, and 7.351 and 278.994. The findings revealed that To-AgNPs could form a base for the development of an eco-friendly, low-cost pesticide.

PMID: 27327539 [PubMed - as supplied by publisher]

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Evaluation of anti-cancer activity of PLGA nanoparticles containing crocetin.

Related Articles

Evaluation of anti-cancer activity of PLGA nanoparticles containing crocetin.

Artif Cells Nanomed Biotechnol. 2016 Jun 21;:1-6

Authors: Hafezi Ghahestani Z, Alebooye Langroodi F, Mokhtarzadeh A, Ramezani M, Hashemi M

Abstract
Poor solubility of crocetin has limited its use as a potential chemotherapeutic agent. In this study, a crocetin nanocarrier was formulated based on poly(lactic-co-glycolic acid) (PLGA) polymer. The effect of preparation conditions on the size and entrap efficiency of PLGA nanoparticles (NPs) via single emulsion/solvent evaporation method was evaluated. Cytotoxicity of crocetin and crocetin-encapsulated PLGA NPs was assayed in MCF-7 cell line. In PLGA formulations, the optimal condition was found to be 5% polyvinyl alcohol (PVA), crocetin:polymer ratio 1:20 and dichloromethane as organic solvent. Obtained results demonstrated that the encapsulation of crocetin in PLGA significantly increased the cytotoxicity of this compound.

PMID: 27327450 [PubMed - as supplied by publisher]

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Working mechanisms of a behavioural intervention promoting physical activity in persons with subacute spinal cord injury

Journal of Rehabilitation Medicine

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Nonossifying fibromas of the distal tibia: Possible etiologic relationship to the interosseous membrane

Journal of Children's Orthopaedics

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Prehospital Indicators for Disaster Preparedness and Response: New York City Emergency Medical Services in Hurricane Sandy

Disaster Medicine and Public Health Preparedness

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Windswept hip deformity in children with cerebral palsy: A population-based prospective follow-up

Journal of Children's Orthopaedics

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[Efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo in different age groups].

Related Articles

[Efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo in different age groups].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Dec;29(23):2053-6

Authors: Zhang H, Li J, Guo P, Tian S, Li K

Abstract
OBJECTIVE: To observe the short and long-term efficacy of quick repositioning maneuver for posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in different age groups.
METHOD: The clinical data of 113 adult patients with single PC-BPPV who underwent quick repositioning maneuver from July 2009 to February 2015 were retrospectively analyzed. The quick repositioning maneuver was to roll the patient from involved side to healthy side in the coronal plane for 180° as quickly as possible. The patients were divided into 3 groups according to different ages: young group (< 45 years), middle-age group (45 ≤ age < 60 years) and old group (≥ 60 years). The short and long term outcomes of the three groups were observed.
RESULT: The left ear was involved in 58 cases (51.3%) and the right ear in 55 cases (48.7%). The short term improvement rates of the young, middle-age and the old groups were 92.5%, 93.6% and 92.3% respectively, and the long term improvement rate was 90.0%, 85.1% and 73.1% respectively. There was no significant difference among the three groups in short and long term outcomes (P > 0.05). The recurrence rate of the three groups was 5.0%, 6.4% and 15.4% respectively, also no significant difference (P > 0.05).
CONCLUSION: The quick repositioning maneuver along the coronal plane for PC-BPPV has a definite effect for every age groups. The method is simple, rapid and easy to master, and the patients are tolerated the maneuver well without evident side effect.

PMID: 27101677 [PubMed - indexed for MEDLINE]

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[Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

Related Articles

[Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Sep;29(18):1627-9

Authors: Zhou F, Fu M, Zhang N, Xu Y, Ge Y

Abstract
OBJECTIVE: To investigate the prognosis-related influence factors of the residual symptoms after the canalith repositioning procedure (CRP) for the benign paroxysmal positional vertigo (BPPV) in the second affiliated hospital of dalian medical university.
METHOD: Among patients who were diagnosed with BPPV and treated by CRP, the one that still show residual symptoms were enrolled in our study, then make a follow-up irregularly about the tendency of their residual symptoms' self-healing,and respectively record in their gender, age and chronic diseases and so on. Single-factor analysis and multi-factors analysis was utilized to investigate the residual symptoms' related influencing factors.
RESULT: In this study, 149 cases of patients were in record, for the residual symptoms, 71 patients can go to self-healing, 78 patients can not; age is 23-88, 30 cases in the young group, 46 cases in the middle aged group, 47 cases in the young elderly group, 26 cases in the elderly group; patients suffering from high blood pressure are 76 cases, 76 cases had diabetes, 47 cases had hyperlipidemia, 110 cases had heart disease, 43 cases had ischemic encephalopathy.
CONCLUSION: The residual symptoms in the elderly females patients and patients suffering from the hypertension, diabetes, heart disease patients and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms.

PMID: 26790263 [PubMed - indexed for MEDLINE]

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Evaluating the Epley maneuver.

Related Articles

Evaluating the Epley maneuver.

Can Fam Physician. 2015 Sep;61(9):779

Authors: Braschi E, Ross D, Korownyk C

PMID: 26371102 [PubMed - indexed for MEDLINE]

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Radiomic Profiling of Glioblastoma: Identifying an Imaging Predictor of Patient Survival with Improved Performance over Established Clinical and Radiologic Risk Models.

Radiomic Profiling of Glioblastoma: Identifying an Imaging Predictor of Patient Survival with Improved Performance over Established Clinical and Radiologic Risk Models.

Radiology. 2016 Jun 20;:160845

Authors: Kickingereder P, Burth S, Wick A, Götz M, Eidel O, Schlemmer HP, Maier-Hein KH, Wick W, Bendszus M, Radbruch A, Bonekamp D

Abstract
Purpose To evaluate whether radiomic feature-based magnetic resonance (MR) imaging signatures allow prediction of survival and stratification of patients with newly diagnosed glioblastoma with improved accuracy compared with that of established clinical and radiologic risk models. Materials and Methods Retrospective evaluation of data was approved by the local ethics committee and informed consent was waived. A total of 119 patients (allocated in a 2:1 ratio to a discovery [n = 79] or validation [n = 40] set) with newly diagnosed glioblastoma were subjected to radiomic feature extraction (12 190 features extracted, including first-order, volume, shape, and texture features) from the multiparametric (contrast material-enhanced T1-weighted and fluid-attenuated inversion-recovery imaging sequences) and multiregional (contrast-enhanced and unenhanced) tumor volumes. Radiomic features of patients in the discovery set were subjected to a supervised principal component (SPC) analysis to predict progression-free survival (PFS) and overall survival (OS) and were validated in the validation set. The performance of a Cox proportional hazards model with the SPC analysis predictor was assessed with C index and integrated Brier scores (IBS, lower scores indicating higher accuracy) and compared with Cox models based on clinical (age and Karnofsky performance score) and radiologic (Gaussian normalized relative cerebral blood volume and apparent diffusion coefficient) parameters. Results SPC analysis allowed stratification based on 11 features of patients in the discovery set into a low- or high-risk group for PFS (hazard ratio [HR], 2.43; P = .002) and OS (HR, 4.33; P < .001), and the results were validated successfully in the validation set for PFS (HR, 2.28; P = .032) and OS (HR, 3.45; P = .004). The performance of the SPC analysis (OS: IBS, 0.149; C index, 0.654; PFS: IBS, 0.138; C index, 0.611) was higher compared with that of the radiologic (OS: IBS, 0.175; C index, 0.603; PFS: IBS, 0.149; C index, 0.554) and clinical risk models (OS: IBS, 0.161, C index, 0.640; PFS: IBS, 0.139; C index, 0.599). The performance of the SPC analysis model was further improved when combined with clinical data (OS: IBS, 0.142; C index, 0.696; PFS: IBS, 0.132; C index, 0.637). Conclusion An 11-feature radiomic signature that allows prediction of survival and stratification of patients with newly diagnosed glioblastoma was identified, and improved performance compared with that of established clinical and radiologic risk models was demonstrated. (©) RSNA, 2016 Online supplemental material is available for this article.

PMID: 27326665 [PubMed - as supplied by publisher]

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Dilated Cardiomyopathy: Phosphorus 31 MR Spectroscopy at 7 T.

Dilated Cardiomyopathy: Phosphorus 31 MR Spectroscopy at 7 T.

Radiology. 2016 Jun 20;:152629

Authors: Stoll VM, Clarke WT, Levelt E, Liu A, Myerson SG, Robson MD, Neubauer S, Rodgers CT

Abstract
Purpose To test whether the increased signal-to-noise ratio of phosphorus 31 ((31)P) magnetic resonance (MR) spectroscopy at 7 T improves precision in cardiac metabolite quantification in patients with dilated cardiomyopathy (DCM) compared with that at 3 T. Materials and Methods Ethical approval was obtained, and participants provided written informe consent. In a prospective study, (31)P MR spectroscopy was performed at 3 T and 7 T in 25 patients with DCM. Ten healthy matched control subjects underwent (31)P MR spectroscopy at 7 T. Paired Student t tests were performed to compare results between the 3-T and 7-T studies. Results The phosphocreatine (PCr) signal-to-noise ratio increased 2.5 times at 7 T compared with that at 3 T. The PCr to adenosine triphosphate (ATP) concentration ratio (PCr/ATP) was similar at both field strengths (mean ± standard deviation, 1.48 ± 0.44 at 3 T vs 1.54 ± 0.39 at 7 T, P = .49), as expected. The Cramér-Rao lower bounds in PCr concentration (a measure of uncertainty in the measured ratio) were 45% lower at 7 T than at 3 T, reflecting the higher quality of 7-T (31)P spectra. Patients with dilated cardioyopathy had a significantly lower PCr/ATP than did healthy control subjects at 7 T (1.54 ± 0.39 vs 1.95 ± 0.25, P = .005), which is consistent with previous findings. Conclusion 7-T cardiac (31)P MR spectroscopy is feasible in patients with DCM and gives higher signal-to-noise ratios and more precise quantification of the PCr/ATP than that at 3 T. PCr/ATP was significantly lower in patients with DCM than in control subjects at 7 T, which is consistent with previous findings at lower field strengths.

PMID: 27326664 [PubMed - as supplied by publisher]

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Interventional MR Imaging for Deep-Brain Stimulation Electrode Placement.

Interventional MR Imaging for Deep-Brain Stimulation Electrode Placement.

Radiology. 2016 Jun 20;:151136

Authors: Chansakul T, Chen PN, Lee TC, Tierney T

Abstract
Purpose To investigate the safety and targeting errors of deep-brain stimulation (DBS) electrodes placed under interventional magnetic resonance (MR) imaging, which allows near real-time anatomic placement without physiologic mapping. Materials and Methods Retrospectively evaluated were 10 consecutive patients (five women, five men) with a mean age of 59.9 years (age range, 17-79 years). These patients underwent interventional MR imaging-guided DBS placement for movement disorders from September 2013 to August 2014 for placement of 19 DBS electrodes in cases where traditional frame-based surgery may be challenging because of the following: dystonia resulting in difficulty in placing the patients in frame, patient's inability or unwillingness to tolerate awake surgery, or anatomic anomaly or variant that could increase the risk of bleeding from microelectrode mapping. Outcomes measured included perioperative hemorrhage, death, and stroke, and electrode functionality assessed at 2 weeks after the operation. In addition, the mean radial error and mean trajectory error were calculated. Results No intraoperative neurologic complications (n = 10 [95% confidence interval: 0%, 31%]) were observed. One patient developed aspiration pneumonia in the postoperative period. Mean radial error was 0.7 mm ± 0.4 (standard deviation) and mean trajectory error was 0.5 mm ± 0.4. All leads delivered clinically effective stimulation. Conclusion Interventional MR imaging-guided DBS electrode placement may be a safe and effective alternative to conventional frame-based surgery in well-selected patients. (©) RSNA, 2016.

PMID: 27326663 [PubMed - as supplied by publisher]

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Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Quality of Life and Hearing Eight Years After Sudden Sensorineural Hearing Loss.

Laryngoscope. 2016 Jun 21;

Authors: Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Vasama JP

Abstract
OBJECTIVES/HYPOTHESIS: To explore long-term hearing results, quality of life (QoL), quality of hearing (QoH), work-related stress, tinnitus, and balance problems after idiopathic sudden sensorineural hearing loss (ISSNHL).
STUDY DESIGN: Cross-sectional study.
METHODS: We reviewed the audiograms of 680 patients with unilateral ISSNHL on average 8 years after the hearing impairment, and then divided the patients into two study groups based on whether their ISSNHL had recovered to normal (pure tone average [PTA] ≤ 30 dB) or not (PTA > 30 dB). The inclusion criteria were a hearing threshold decrease of 30 dB or more in at least three contiguous frequencies occurring within 72 hours in the affected ear and normal hearing in the contralateral ear. Audiograms of 217 patients fulfilled the criteria. We reviewed their medical records; measured present QoL, QoH, and work-related stress with specific questionnaires; and updated the hearing status.
RESULTS: Poor hearing outcome after ISSNHL was correlated with age, severity of hearing loss, and vertigo together with ISSNHL. Quality of life and QoH were statistically significantly better in patients with recovered hearing, and the patients had statistically significantly less tinnitus and balance problems. During the 8-year follow-up, the PTA of the affected ear deteriorated on average 7 dB, and healthy ear deteriorated 6 dB.
CONCLUSION: Idiopathic sudden sensorineural hearing loss that failed to recover had a negative impact on long-term QoL and QoH. The hearing deteriorated as a function of age similarly both in the affected and the healthy ear, and there were no differences between the groups. The cumulative recurrence rate for ISSNHL was 3.5%.
LEVEL OF EVIDENCE: 4 Laryngoscope, 2016.

PMID: 27328455 [PubMed - as supplied by publisher]

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Analytical data in support of the liver and peripheral blood concentration (L/P) ratio as a marker of postmortem redistribution

2016-06-22T04-06-49Z
Source: European Journal of Forensic Sciences
Iain M McIntyre.
Postmortem redistribution (PMR) refers to the changes that can occur in drug concentrations after death. Consequently, postmortem blood concentrations may not always reflect the antemortem drug levels. A recent literature review has postulated a model describing drugs with a liver (L) to peripheral blood (P) concentration ratio less than 5 L/kg as being prone to little or no PMR, while drugs with an L/P ratio greater than 20-30 L/kg exhibit propensity for substantial PMR. Antidepressants including tricyclic antidepressants and some selective serotonin re-uptake inhibitors, for example, were obviously distinguished from drugs confirmed to be free from, or demonstrate little PMR. This current paper presents analytical L/P data from 867 postmortem cases yielding a ranking of 44 different drugs propensity for (and degree of) PMR.


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Tibiofemoral contact forces during walking, running and sidestepping

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): David J. Saxby, Luca Modenese, Adam L. Bryant, Pauline Gerus, Bryce Killen, Karine Fortin, Tim V. Wrigley, Kim L. Bennell, Flavia M. Cicuttini, David G. Lloyd
We explored the tibiofemoral contact forces and the relative contributions of muscles and external loads to those contact forces during various gait tasks. Second, we assessed the relationships between external gait measures and contact forces. A calibrated electromyographydriven neuromusculoskeletal model estimated the tibiofemoral contact forces during walking (1.44±0.22ms⁻¹), running (4.38±0.42ms⁻¹) and sidestepping (3.58±0.50ms⁻¹) in healthy adults (n=60, 27.3±5.4years, 1.75±0.11m, and 69.8±14.0kg). Contact forces increased from walking (∼1–2.8 BW) to running (∼3–8 BW), sidestepping had largest maximum total (8.47±1.57 BW) and lateral contact forces (4.3±1.05 BW), while running had largest maximum medial contact forces (5.1±0.95 BW). Relative muscle contributions increased across gait tasks (up to 80–90% of medial contact forces), and peaked during running for lateral contact forces (∼90%). Knee adduction moment (KAM) had weak relationships with tibiofemoral contact forces (all R²<0.36) and the relationships were gait taskspecific. Step-wise regression of multiple external gait measures strengthened relationships (0.20<Radj2<0.78), but were variable across gait tasks. Step-wise regression equations from a particular gait task (e.g. walking) produced large errors when applied to a different gait task (e.g. running or sidestepping). Muscles well stabilized the knee, increasing their role in stabilization from walking to running to sidestepping. KAM was a poor predictor of medial contact force and load distributions. Step-wise regression models results suggest the relationships between external gait measures and contact forces cannot be generalized across tasks. Neuromusculoskeletal modelling may be required to examine tibiofemoral contact forces and role of muscle in knee stabilization across gait tasks.



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Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain

Publication date: Available online 21 June 2016
Source:Gait & Posture
Author(s): Pakzad Mohamad, Fung Joyce, Preuss Richard
It has been hypothesized that individuals with low back pain (LBP) will have higher trunk muscle activity during gait, in an attempt to limit spine motion, and that this "guarding strategy" may be influenced by the person's psychological response to pain. This study investigated whether the amplitude of trunk muscle activation differs between persons with chronic LBP and healthy individuals during walking, and whether changes in muscle activation were related to pain catastrophizing. Thirty persons with chronic non-specific LBP, stratified into 2 groups of high (HLBP) and low (LLBP) pain catastrophizing, were contrasted with a control group of 15 healthy individuals during walking on a treadmill at a self-selected speed. Surface electromyographic (EMG) data were recorded from 10 trunk muscles. The effects of Group and gait Sub-phase on EMG activation amplitudes were assessed. The HLBP group exhibited higher activation of certain muscles throughout the gait cycle, and reduced variability of others at specific sub-phases of gait. A significant correlation was found between activation amplitude and pain catastrophizing in most muscles, when controlling for gait speed and pain intensity. These data indicate that altered trunk muscle activation is present in some patients with LBP during walking, but does not represent a universal increase in activation for all muscles. This altered neuromotor control is, however, more strongly associated with pain catastrophizing than with pain intensity, and appears to represent a non-functional, maladaptive behavior, as it alters the normal, phasic pattern of activation in certain trunk muscles.



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Impact of thyroid cancer on the incidence and survival of adolescents and young adults with cancer.

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Impact of thyroid cancer on the incidence and survival of adolescents and young adults with cancer.

Thyroid. 2016 Jun 21;

Authors: Brito JP, Bleyer A

PMID: 27324868 [PubMed - as supplied by publisher]

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Follicular and Diffuse Sclerosing Variant Papillary Thyroid Carcinomas as Independent Predictive Factors of Loco-regional Recurrence: A Comparison Study Using Propensity Score Matching.

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Follicular and Diffuse Sclerosing Variant Papillary Thyroid Carcinomas as Independent Predictive Factors of Loco-regional Recurrence: A Comparison Study Using Propensity Score Matching.

Thyroid. 2016 Jun 21;

Authors: Kim SK, Park I, Woo JW, Lee JH, Choe JH, Kim JH, Kim JS

Abstract
BACKGROUND: Only about half of papillary thyroid carcinoma (PTC) cases are classified as conventional PTC (CV-PTC), whereas various histologic variants constitute the remaining cases. Since controversies about the clinical behavior and outcomes of PTC variants continue, the purpose of this study was to compare the outcomes of patients with PTC variants who were treated at a large tertiary referral center in Korea.
METHODS: The medical records for 15,598 CV-PTCs, 435 follicular variants of PTC (FV-PTCs), and 66 diffuse sclerosing variants of PTC (DSV-PTCs) were retrospectively reviewed. Loco-regional recurrences (LRR) among PTC variants were compared using propensity score matching.
RESULTS: Analysis I compared CV-PTC with FV-PTC. After rigorous matching, 367 pairs were established. Recurrence-free survival (RFS) rates in CV-PTC were 96.1% at 5 years, 92.2% at 10 years, and 92.2% at 15 years, while those for FV-PTC were 98.8% at 5 years, 98.8% at 10 years, and 98.8% at 15 years (p = 0.026). Analysis II compared CV-PTC with DSV-PTC. Rigorous matching yielded 56 pairs. RFS rates for CV-PTC were 87.4% at 5 years, 87.4% at 10 years, and 87.4% at 15 years, while those for DSV-PTC were 68.9% at 5 years, 57.5% at 10 years, and were not available at 15 years (p = 0.013).
CONCLUSIONS: Compared with CV-PTC, FV-PTC showed less aggressive behaviors and more favorable outcomes. However, DSV-PTC showed more aggressive behaviors than CV-PTC and less favorable outcome. Therefore, the management strategy and follow-up plan for PTC should be differentiated according to the histologic variant.

PMID: 27324748 [PubMed - as supplied by publisher]

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Hypermetabolism on 18F-FDG PET scan does not influence the interpretation of thyroid cytopathology and nodules with SUVmax

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Hypermetabolism on 18F-FDG PET scan does not influence the interpretation of thyroid cytopathology and nodules with SUVmax <2.5 are not at increased risk for malignancy.

Thyroid. 2016 Jun 21;

Authors: Valderrabano P, Montilla Soler J, Mifsud MJ, Leon ME, Centeno BA, Khazai L, Padhya T, McCaffrey TV, Russell JS, McIver B, Otto KJ

Abstract
BACKGROUND: Hypermetabolism of thyroid nodules on 18F-fluorodeoxyglucose positron emission tomography (PET) is associated with higher prevalence of malignancy. However, the definition of hypermetabolism and its impact on cytological interpretation are unclear.
METHODS: Medical records of all patients with thyroid nodules that had undergone cytological evaluation at Moffitt Cancer Center between October 2008 and May 2014 were retrospectively reviewed. Those with a PET scan performed within 1 year of the cytology composed the study group, and the rest were used as controls. The distribution of the cytological categories, percentage of resection and prevalence of malignancy among each Bethesda category was compared between both groups.
RESULTS: Fifteen percent (436) of all thyroid nodules with cytological evaluation were in the study group. Maximum standardized uptake (SUVmax) values were directly associated with the probability of having a malignant or a follicular neoplasm cytological diagnosis; and inversely associated with the probability of having a benign cytological diagnosis. However, the prevalence of cancer within each Bethesda category was not associated with SUVmax values. We found that the prevalence of malignant cytology increased above 5% with SUVmax values ≥2.5. SUVmax values were significantly higher in malignant than in benign nodules on histology (mean values 10.8 vs. 5) but with significant overlap between both groups for either the whole cohort or nodules with indeterminate cytology only limiting its use for differential diagnosis.
CONCLUSIONS: The prevalence of malignancy in thyroid nodules with SUVmax <2.5 is similar to the general population and management should not be modified in those patients. The increased prevalence of malignancy among hypermetabolic thyroid nodules (SUVmax ≥2.5) is well characterized by cytology and does not impact the interpretation of cytological categories. Therefore, SUVmax value does not add relevant information once cytology is available.

PMID: 27324615 [PubMed - as supplied by publisher]

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Pioglitazone, a PPARγ agonist, upregulates the expression of caveolin-1 and catalase, essential for thyroid cell homeostasis. A clue to the pathogenesis of Hashimoto's thyroiditis.

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Pioglitazone, a PPARγ agonist, upregulates the expression of caveolin-1 and catalase, essential for thyroid cell homeostasis. A clue to the pathogenesis of Hashimoto's thyroiditis.

Thyroid. 2016 Jun 20;

Authors: Werion A, Joris V, Hepp M, Papasokrati L, Marique L, de Ville de Goyet C, Van Regemorter V, Mourad M, Lengelé B, Daumerie C, Marbaix E, Brichard S, Many MC, Craps J

Abstract
CONTEXT: Peroxisome proliferator-activated receptor γ (PPARγ) is a transcriptional factor that regulates the expression of multiple target genes involved in several metabolic pathways as well as in inflammation. The expression and cell localization of caveolin-1 (Cav-1), thyroid peroxidase (TPO), and dual oxidase (DUOX), involved in the extracellular iodination, is modulated by Th1 cytokines in human normal thyroid cells and in Hashimoto's thyroiditis (HT).
OBJECTIVES: 1) To analyze the PPARγ expression at the follicular level in HT versus controls in correlation with the one of Cav-1, 2) to study the effects of Th1 cytokines on PPARγ and catalase expression in human thyrocytes primary cultures, 3) to study the effects of pioglitazone, a PPAR γ agonist, on thyroxisome's components (Cav-1, TPO, DUOX) and on antioxidant defenses (catalase).
RESULTS: Although the global expression of PPARγ in the whole Hashimoto's glands was not modified as compared to controls, there was a great heterogeneity among glands and among follicles in a same gland. Besides normal type 1 follicles, there were, around inflammatory zones, hyperactive type 2 follicles with high PPARγ and Cav-1 expression and inactive type 3 follicles unable to form T4, which did not express PPARγ nor Cav-1. In human thyrocytes in primary cultures, Th1 cytokines decreased PPARγ and catalase expression; pioglitazone increased Cav-1, TPO and catalase expression.
CONCLUSION: PPARγ plays a central role in normal thyroid physiology by upregulating Cav-1, essential for the thyroxisome's organization and the extracellular iodination. By upregulating catalase, PPARγ also maintains the cell homeostasis. The inhibitory effect of Th1 cytokines on PPARγ expression may be considered as a new pathogenetic mechanism for Hashimoto's thyroiditis and the use of PPARγ agonists could open a new therapeutic approach.

PMID: 27324467 [PubMed - as supplied by publisher]

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Endoscopic endonasal skull base surgery for vascular lesions: a systematic review.

Endoscopic endonasal skull base surgery for vascular lesions: a systematic review.

J Neurosurg Sci. 2016 Jun 21;

Authors: Vaz-Guimaraes F, Gardner PA, Fernandez-Miranda JC, Wang EW, Snyderman CH

Abstract
Endoscopic endonasal skull base surgery for vascular lesions is a controversial topic in neurosurgical practice. Concerns regarding the ability to effectively work through the relatively narrow and deep endonasal corridor and manage serious hemorrhagic complications such as inadvertent internal carotid artery (ICA) injury during endoscopic endoscopic surgery (EES) are relevant sources of disagreement between neurosurgeons. Nevertheless, following careful preoperative evaluation, EES may be indicated for rare, well- selected cases, including medially-projecting paraclinoid aneurysms and cavernous malformations (CMs) located next to the ventral surface of the brainstem. To date, only small retrospective case series and case reports, attesting the safety, feasibility and technical aspects of the EES for aneurysm clipping, CM resection and arterio-venous malformations (AVMs), have been published in the literature. In this manuscript, we conducted a systematic review of the literature applying the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines on EES for treatment of intracranial vascular lesions. We also report two new cases (one frontal lobe cavernoma and one dural arterio-venous fistula successfully resected via EES). We discuss the indications, advantages, limitations and technical aspects of EES for vascular lesions. Although rarely indicated, EES may be considered as an alternative treatment and part of the armamentarium of cerebrovascular neurosurgeons dealing with these challenging lesions.

PMID: 27327518 [PubMed - as supplied by publisher]

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An olfactory groove schwannoma with a pseudocyst compressing the basal ganglia, internal capsule and optic tracts.

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An olfactory groove schwannoma with a pseudocyst compressing the basal ganglia, internal capsule and optic tracts.

Childs Nerv Syst. 2016 Jun 21;

Authors: Liby P, Zamecnik J, Kyncl M, Tichy M

Abstract
INTRODUCTION: Olfactory groove schwannomas (OGSs) are extremely rare tumours, particularly in the paediatric population.
CASE REPORT: A 13-year-old girl presented with two epileptic seizures, papilloedema and incomplete binasal quadrantanopia. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated a large heterogeneously enhancing tumour of the anterior skull base with a prominent dorsal pseudocyst. Interestingly, the pseudocyst embraced the right ICA bifurcation and displaced the optic tracts, optic chiasm and optic nerves and the ipsilateral basal ganglia. The patient underwent surgery via the frontolateral approach, and the tumour was completely removed. The pseudocyst was opened, and its wall was partially resected. It subsequently resolved completely. Histopathological examination yielded the rare diagnosis of schwannoma of the anterior skull base.
CONCLUSION: Although extremely rare, olfactory groove schwannomas can be seen in paediatric patients. Our patient is the youngest ever reported with this histopathological diagnosis along with the formation of a large pseudocyst.

PMID: 27325302 [PubMed - as supplied by publisher]

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Management of Skull Base Tumor-Associated Facial Pain.

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Management of Skull Base Tumor-Associated Facial Pain.

Neurosurg Clin N Am. 2016 Jul;27(3):337-44

Authors: Reddy GD, Wagner K, Phan J, DeMonte F, Raza SM

Abstract
Cancer-associated facial pain can be caused by a variety of pathologic conditions. Here the authors describe the symptoms and incidence of facial pain secondary to three separate anatomic subcategories of cancer. The authors subsequently discuss the effectiveness and drawbacks of the most common methods of treatment.

PMID: 27325000 [PubMed - in process]

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Endoscopic and Microscopic Microvascular Decompression.

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Endoscopic and Microscopic Microvascular Decompression.

Neurosurg Clin N Am. 2016 Jul;27(3):305-13

Authors: Piazza M, Lee JY

Abstract
The introduction of the endoscope into the neurosurgeon's armamentarium has revolutionized ventral and anterior skull-base surgery and, more recently, has been used in the surgical treatment of cerebellopontine angle (CPA) pathology. The utilization of the endoscope in microvascular decompression (MVD) for trigeminal neuralgia and other associated cranial nerve hyperactivity syndromes allows for unparalleled panoramic views and illumination of the neurovascular structures within the CPA and identification of vessel-nerve contact traditionally unseen using the microscope. In this article, the technical advantages and challenges of using the endoscope for MVD, operative technique, and patient outcomes of endoscopic MVD are discussed.

PMID: 27324997 [PubMed - in process]

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Overview and History of Trigeminal Neuralgia.

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Overview and History of Trigeminal Neuralgia.

Neurosurg Clin N Am. 2016 Jul;27(3):265-76

Authors: Patel SK, Liu JK

Abstract
Although the symptoms associated with trigeminal neuralgia have been well documented, the root cause of this disease initially eluded most surgeons. Although early remedies were haphazard because of a lack of understanding about the condition, near the 20th century both medical and procedural therapies were established for the treatment of trigeminal neuralgia. These treatments include a variety of medications, chemoneurolysis, radiofrequency lesioning, percutaneous ablative procedures, stereotactic radiosurgery, and open rhizotomy and microvascular decompression. This report recounts the history of trigeminal neuralgia, from its earliest descriptions to the historical evolution of nonsurgical and surgical therapies.

PMID: 27324994 [PubMed - in process]

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Ultra-fast all-optical self-aware protection switching based on a bistable laser diode

We propose a novel concept of all-optical protection switching with link failure automatic awareness based on AOWFF. The scheme is experimentally demonstrated using a single MG-Y laser diode with a record switching time similar to 200 ps.

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Combined resection of aberrant right hepatic artery without anastomosis in panceaticoduodenectomy for pancreatic head cancer: A case report.

Combined resection of aberrant right hepatic artery without anastomosis in panceaticoduodenectomy for pancreatic head cancer: A case report.

Int J Surg Case Rep. 2016 Jun 15;25:66-70

Authors: Nanashima A, Imamura N, Tsuchimochi Y, Hiyoshi M, Fujii Y

Abstract
INTRODUCTION: This case report is intended to inform pancreas surgeons of our experience in operative management of aberrant pancreatic artery.
PRESENTATION OF CASE: A 63-year-old woman was admitted to our institute's Department of Surgery with obstructive jaundice, and the pancreas head tumor was found. To improve liver dysfunction, an endoscopic retrograde nasogastric biliary drainage tube was placed in the bile duct. Endoscopic fine-needle aspiration showed a pancreas head carcinoma invading the common bile duct, the aberrant right hepatic artery arising from the superior mesenteric artery, and the portal vein. Enhanced computed tomography showed the communicating artery between the right and left hepatic artery via the hepatic hilar plate. By way of imaging preoperative examination, a pancreaticoduodenectomy combined resection of the aberrant right hepatic artery and portal vein was conducted without arterial anastomosis. Hepatic arterial flow was confirmed by intraoperative Doppler ultrasonography, and R0 resection without tumor exposure at the dissected plane was achieved. The patient's postoperative course was uneventful.
DISCUSSION: In this case report, perioperative detail examination by imaging diagnosis with respect to hepatic arterial communication to achieve curative resection in a pancreas head cancer was necessary. Non-anastomosis of hepatic artery was achieved, and the necessity of R0 resection was stressed by such management.
CONCLUSION: By the preoperative and intraoperative imaging managements conducted, combined resection of the aberrant right hepatic artery without anastomosis was achieved by pancreaticoduodenectomy for pancreas head cancer. However, improvements in imaging diagnosis and careful management of R0 resection are important.

PMID: 27327560 [PubMed - as supplied by publisher]

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Selective elaboration of aminodiols towards small ring α- and β-amino acid derivatives that incorporate an aziridine, azetidine, or epoxide scaffold

The osmium-catalyzed dihydroxylation of N-substituted alkyl 2-(aminomethyl) acrylates resulted in the efficient synthesis of 2-(aminomethyl)-2,3-dihydroxypropanoates in good yields (82-89 %). The resulting aminodiols were elaborated in a selective diversity-oriented synthesis to produce the corresponding 2-(aminomethyl) oxirane-2-carboxylates, functionalized aziridine-2-carboxylates, and azetidine-3-carboxylates by using straightforward reactions.

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Study of the chemoselectivity of multicomponent heterocyclizations involving 3-amino-1,2,4-triazole and pyruvic acids as key reagents, and biological activity of the reaction products

Three-component reactions involving 3-amino-1,2,4-triazole, aldehydes, including salicylic aldehydes, and pyruvic acids were studied in detail. The reaction pathway and products of the heterocyclizations could be changed by variation of the reaction parameters. The broad antimicrobial activity of the products was also studied. Compound 9d showed specific anti-influenza virus (A/H1N1) activity, with an IC50 of 0.57 mu M and a CC50 of >100 mu M.

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Solvent-free mechanochemical synthesis of a bicyclononyne tosylate: a fast route towards bioorthogonal clickable poly(2-oxazoline)s

The mechanochemical synthesis of a bicyclononyne tosylate (BCN-OTs) is presented. BCN-OTs is demonstrated to be a good initiator for the cationic ring-opening polymerization of 2-ethyl-2-oxazoline directly yielding BCN functional poly(2-ethyl-2-oxazoline) (PEtOx-BCN) with high chain end fidelity. Subsequent strain-promoted cycloadditions of the resulting PEtOx-BCN enable efficient additive-free conjugation reactions as demonstrated for the formation of a block copolymer and a PEtOx-protein conjugate.

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Integrated silicon-organic hybrid (SOH) frequency shifter

We demonstrate a waveguide-based frequency shifter on the silicon-organic hybrid (SOH) platform, enabling frequency shifts up to 10 GHz. Spurious side-modes are suppressed by more than 23 dB using temporal shaping of the drive signal.

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Morphometric anatomical and CT study of the human adult sacroiliac region.

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Morphometric anatomical and CT study of the human adult sacroiliac region.

Surg Radiol Anat. 2016 Jun 20;

Authors: Postacchini R, Trasimeni G, Ripani F, Sessa P, Perotti S, Postacchini F

Abstract
PURPOSE: To identify and describe the morphometry and CT features of the articular and extra-articular portions of the sacroiliac region. The resulting knowledge might help to avoid complications in sacroiliac joint (SIJ) fusion.
METHODS: We analyzed 102 dry hemi-sacra, 80 ilia, and 10 intact pelves and assessed the pelvic computerized tomography (CT) scans of 90 patients, who underwent the examination for conditions not involving the pelvis. We assessed both the posterior aspect of sacrum with regard to the depressions located externally to the lateral sacral crest at the level of the proximal three sacral vertebrae and the posteroinferior aspect of ilium. Coronal and axial CT scans of the SIJ of patients were obtained and the joint space was measured.
RESULTS: On each side, the sacrum exhibits three bone depressions, not described in anatomic textbooks or studies, facing the medial aspect of the posteroinferior ilium, not yet described in detail. Both structures are extra-articular portions situated posteriorly to the SIJ. Coronal CT scans of patients showing the first three sacral foramens and the interval between sacrum and ilium as a continuous space display only the S1 and S3 portions of SIJ, the intermediate portion being extra-articular. The S2 portion is visible on the most anterior coronal scan. Axial scans show articular and extra-articular portions and features improperly described as anatomic variations.
CONCLUSIONS: Extra-articular portions of the sacroiliac region, not yet described exhaustively, have often been confused with SIJ. Coronal CT scans through the middle part of sacrum, the most used to evaluate degenerative and inflammatory conditions of SIJ, show articular and extra-articular portions of the region.

PMID: 27324173 [PubMed - as supplied by publisher]

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Occipital artery arising from the internal carotid artery: a case report.

Related Articles

Occipital artery arising from the internal carotid artery: a case report.

Surg Radiol Anat. 2016 Jun 20;

Authors: Özgür Ö, Sindel M, Hizay A, Öztürk S, Aytaç G, Sindel T

Abstract
Variations of the branches of the external carotid artery have been well documented in the available literature. However, variation of the occipital artery arising from the internal carotid artery is extremely rare case. A 42-year-old man patient who suffered from subarachnoid hemorrhage with suspicious vascular anomalies was found to have this variation on the right side by angiography during selective catheterisation of main carotid artery for vascular mapping. Our literature searches revealed that there was rare case such variations. We think that this variation should contribute to literature and should be kept in mind during surgical, radiological and diagnostic procedures.

PMID: 27324172 [PubMed - as supplied by publisher]

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Early Postnatal NT-3 Gene Delivery Enhances Hearing Acquisition in the Developmental Period.

Early Postnatal NT-3 Gene Delivery Enhances Hearing Acquisition in the Developmental Period.

Laryngoscope. 2016 Jun 21;

Authors: Jin Y, Lyu AR, Park SJ, Xu J, Cui J, Sohn KC, Hur GM, Jin Y, Park YH

Abstract
OBJECTIVES/HYPOTHESIS: The purpose of this study was to investigate the effect of early postnatal neurotrophin-3 (NT3) support on hearing acquisition.
STUDY DESIGN: A prospective experimental animal study.
METHODS: Adenoviral (Ad) vectors expressing green fluorescence protein (GFP) alone or in combination with NT3 were injected into the scala tympani through the round window of 5-postnatal-day-old (P5) rats. Changes in NT3 mRNA level, hearing thresholds, and morphological studies were done after the viral vector injection.
RESULTS: NT3 mRNA was significantly increased in the Ad-GFP-NT3 group compared to the normal-developmental group and Ad-GFP alone group. GFP was widely expressed in the cochlea such as in the hair cells, supporting cell area, and spiral ganglion neurons. Auditory brainstem response thresholds were significantly lower in the Ad-GFP-NT3 group compared to the normal-developmental group and Ad-GFP alone group at P15.
CONCLUSIONS: These results show that early postnatal NT3 overexpression may accelerate the acquisition of hearing in rats.
LEVEL OF EVIDENCE: NA Laryngoscope, 2016.

PMID: 27328420 [PubMed - as supplied by publisher]

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Therapeutic efficacy of cancer stem cell vaccines in the adjuvant setting.

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Therapeutic efficacy of cancer stem cell vaccines in the adjuvant setting.

Cancer Res. 2016 Jun 20;

Authors: Hu Y, Lu L, Xia Y, Chen X, Chang AE, Hollingsworth RE, Hurt E, Owen JH, Moyer JS, Prince ME, Dai F, Bao Y, Wang Y, Whitfield J, Xia J, Huang S, Wicha MS, Li Q

Abstract
Dendritic cell (DC)-based vaccine strategies aimed at targeting cancer stem-like cells (CSC) may be most efficacious if deployed in the adjuvant setting. In this study, we offer preclinical evidence this is the case for a CSC-DC vaccine as tested in murine models of SCC7 squamous cell cancer and D5 melanoma. Vaccination of mice with an ALDHhigh SCC7 CSC-DC vaccine after surgical excision of established SCC7 tumors reduced local tumor relapse and prolonged host survival. This effect was augmented significantly by simultaneous administration of anti-PD-L1, an immune checkpoint inhibitor. In the minimal disease setting of D5 melanoma, treatment of mice with ALDHhigh CSC-DC vaccination inhibited primary tumor growth, reduced spontaneous lung metastases and increased host survival. In this setting, CCR10 and its ligands were downregulated on ALDHhigh D5 CSCs and in lung tissues respectively after vaccination with ALDHhigh D5 CSC-DC. RNAi-mediated attenuation of CCR10 blocked tumor cell migration in vitro and metastasis in vivo. T cells harvested from mice vaccinated with ALDHhigh D5 CSC-DC selectively killed ALDHhigh D5 CSCs, with additional evidence of humoral immunological engagement and a reduction in ALDHhigh cells in residual tumors. Overall, our results offered a preclinical proof of concept for the use of ALDHhigh CSC-DC vaccines in the adjuvant setting to more effectively limit local tumor recurrence and spontaneous pulmonary metastasis, as compared with traditional DC vaccines, with increased host survival further accentuated by simultaneous PD-L1 blockade.

PMID: 27325649 [PubMed - as supplied by publisher]

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Loss of expression of AZGP1 is associated with worse clinical outcomes in a multi-institutional radical prostatectomy cohort.

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Loss of expression of AZGP1 is associated with worse clinical outcomes in a multi-institutional radical prostatectomy cohort.

Prostate. 2016 Jun 21;

Authors: Brooks JD, Wei W, Pollack JR, West RB, Shin JH, Sunwoo JB, Hawley SJ, Auman H, Newcomb LF, Simko J, Hurtado-Coll A, Troyer DA, Carroll PR, Gleave ME, Lin DW, Nelson PS, Thompson IM, True LD, McKenney JK, Feng Z, Fazli L

Abstract
BACKGROUND: Given the uncertainties inherent in clinical measures of prostate cancer aggressiveness, clinically validated tissue biomarkers are needed. We tested whether Alpha-2-Glycoprotein 1, Zinc-Binding (AZGP1) protein levels, measured by immunohistochemistry, and RNA expression, by RNA in situ hybridization (RISH), predict recurrence after radical prostatectomy independent of clinical and pathological parameters.
METHODS: AZGP1 IHC and RISH were performed on a large multi-institutional tissue microarray resource including 1,275 men with 5 year median follow-up. The relationship between IHC and RISH expression levels was assessed using the Kappa analysis. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazards models and the Log-rank test.
RESULTS: Absent or weak expression of AZGP1 protein was associated with worse recurrence free survival (RFS), disease specific survival, and overall survival after radical prostatectomy in univariable analysis. AZGP1 protein expression, along with pre-operative serum PSA levels, surgical margin status, seminal vesicle invasion, extracapsular extension, and Gleason score predicted RFS on multivariable analysis. Similarly, absent or low AZGP1 RNA expression by RISH predicted worse RFS after prostatectomy in univariable and multivariable analysis.
CONCLUSIONS: In our large, rigorously designed validation cohort, loss of AZGP1 expression predicts RFS after radical prostatectomy independent of clinical and pathological variables. Prostate © 2016 Wiley Periodicals, Inc.

PMID: 27325561 [PubMed - as supplied by publisher]

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Reirradiation of Head and Neck Cancers With Proton Therapy: Outcomes and Analyses.

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Reirradiation of Head and Neck Cancers With Proton Therapy: Outcomes and Analyses.

Int J Radiat Oncol Biol Phys. 2016 Apr 13;

Authors: Phan J, Sio TT, Nguyen TP, Takiar V, Gunn GB, Garden AS, Rosenthal DI, Fuller CD, Morrison WH, Beadle B, Ma D, Zafereo ME, Hutcheson KA, Kupferman ME, William WN, Frank SJ

Abstract
PURPOSE: Reirradiation of head and neck (H&N) cancer is a clinical challenge. Proton radiation therapy (PRT) offers dosimetric advantages for normal tissue sparing and may benefit previously irradiated patients. Here, we report our initial experience with the use of PRT for H&N reirradiation, with focus on clinical outcomes and toxicity.
METHODS AND MATERIALS: We retrospectively reviewed the records of patients who received H&N reirradiation with PRT from April 2011 through June 2015. Patients reirradiated with palliative intent or without prior documentation of H&N radiation therapy were excluded. Radiation-related toxicities were recorded according to the Common Terminology Criteria for Adverse Events Version 4.0.
RESULTS: The conditions of 60 patients were evaluated, with a median follow-up time of 13.6 months. Fifteen patients (25%) received passive scatter proton therapy (PSPT), and 45 (75%) received intensity modulated proton therapy (IMPT). Thirty-five patients (58%) received upfront surgery, and 44 (73%) received concurrent chemotherapy. The 1-year rates of locoregional failure-free survival, overall survival, progression-free survival, and distant metastasis-free survival were 68.4%, 83.8%, 60.1%, and 74.9%, respectively. Eighteen patients (30%) experienced acute grade 3 (G3) toxicity, and 13 (22%) required a feeding tube at the end of PRT. The 1-year rates of late G3 toxicity and feeding tube independence were 16.7% and 2.0%, respectively. Three patients may have died of reirradiation-related effects (1 acute and 2 late).
CONCLUSIONS: Proton beam therapy can be a safe and effective curative reirradiation strategy, with acceptable rates of toxicity and durable disease control.

PMID: 27325480 [PubMed - as supplied by publisher]

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Clinically Applicable Monte Carlo-based Biological Dose Optimization for the Treatment of Head and Neck Cancers With Spot-Scanning Proton Therapy.

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Clinically Applicable Monte Carlo-based Biological Dose Optimization for the Treatment of Head and Neck Cancers With Spot-Scanning Proton Therapy.

Int J Radiat Oncol Biol Phys. 2016 Apr 6;

Authors: Wan Chan Tseung HS, Ma J, Kreofsky CR, Ma DJ, Beltran C

Abstract
PURPOSE: Our aim is to demonstrate the feasibility of fast Monte Carlo (MC)-based inverse biological planning for the treatment of head and neck tumors in spot-scanning proton therapy.
METHODS AND MATERIALS: Recently, a fast and accurate graphics processor unit (GPU)-based MC simulation of proton transport was developed and used as the dose-calculation engine in a GPU-accelerated intensity modulated proton therapy (IMPT) optimizer. Besides dose, the MC can simultaneously score the dose-averaged linear energy transfer (LETd), which makes biological dose (BD) optimization possible. To convert from LETd to BD, a simple linear relation was assumed. By use of this novel optimizer, inverse biological planning was applied to 4 patients, including 2 small and 1 large thyroid tumor targets, as well as 1 glioma case. To create these plans, constraints were placed to maintain the physical dose (PD) within 1.25 times the prescription while maximizing target BD. For comparison, conventional intensity modulated radiation therapy (IMRT) and IMPT plans were also created using Eclipse (Varian Medical Systems) in each case. The same critical-structure PD constraints were used for the IMRT, IMPT, and biologically optimized plans. The BD distributions for the IMPT plans were obtained through MC recalculations.
RESULTS: Compared with standard IMPT, the biologically optimal plans for patients with small tumor targets displayed a BD escalation that was around twice the PD increase. Dose sparing to critical structures was improved compared with both IMRT and IMPT. No significant BD increase could be achieved for the large thyroid tumor case and when the presence of critical structures mitigated the contribution of additional fields. The calculation of the biologically optimized plans can be completed in a clinically viable time (<30 minutes) on a small 24-GPU system.
CONCLUSIONS: By exploiting GPU acceleration, MC-based, biologically optimized plans were created for small-tumor target patients. This optimizer will be used in an upcoming feasibility trial on LETd painting for radioresistant tumors.

PMID: 27325476 [PubMed - as supplied by publisher]

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Granular Cell Tumour of the Larynx.

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Granular Cell Tumour of the Larynx.

Head Neck Pathol. 2016 Jun 20;

Authors: Sproat R, Wong G, Rubin J

Abstract
A 55-year-old lady with a 6 month history of hoarse voice presented to our ENT department. Endoscopic examination displayed a white left arytenoid lesion. Biopsy of this lesion displayed a nodule covered with non-keratinizing stratified squamous epithelium, with a central core of polygonal cells, positive for S-100 staining. This confirmed a granular cell tumour. CO2 laser was utilised to excise this benign tumour. Granular cell tumours of the head and neck are common, but are infrequently found in the larynx. This case report highlights the importance for the otolaryngologist to be aware of this differential diagnosis, particularly as histologically they may be confused with squamous cell carcinoma.

PMID: 27325237 [PubMed - as supplied by publisher]

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Therapies in the pipeline for small-cell lung cancer.

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Therapies in the pipeline for small-cell lung cancer.

Br Med Bull. 2016 Jun 20;

Authors: Romanidou O, Imbimbo M, Mountzios G, Abidin A, Morgillo F, Califano R

Abstract
INTRODUCTION OR BACKGROUND: Small-cell lung cancer (SCLC) represents ~15% of all cases of lung cancer and is characterized by a rapid tumour doubling time, early onset disease dissemination and high sensitivity to chemotherapy.
SOURCES OF DATA: We searched MEDLINE and OVID databases for articles in English published from January 1980 to February 2015.
AREAS OF AGREEMENT: Platinum-based chemotherapy, thoracic radiotherapy and prophylactic cranial irradiation are standard of care. Benefit from second-line chemotherapy is limited.
AREAS OF CONTROVERSY: The role of platinum/irinotecan chemotherapy in the Western population and the role of maintenance therapies remain to be established.
GROWING POINTS: Knowledge of the biology of SCLC has expanded exponentially and many potential therapeutic targets have been identified.
AREAS TIMELY FOR DEVELOPING RESEARCH: The use of circulating tumour cells can help investigating molecular alterations occurring within tumour cells, understanding drug resistance mechanisms and evaluating new treatments.

PMID: 27325208 [PubMed - as supplied by publisher]

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[Human papilloma viruses: other risk factor of head and neck carcinoma].

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[Human papilloma viruses: other risk factor of head and neck carcinoma].

Bull Soc Pathol Exot. 2016 Jun 20;

Authors: Woto-Gaye G, M'Farrej MK, Doh K, Thiam I, Touré S, Diop R, Dial C

Abstract
Head and neck carcinoma (HNC) occupy the sixth place as the most frequent type of cancer worldwide. Next to alcohol and tobacco intoxication, other risk factors (RF) are suspected, including the human papilloma viruses (HPVs). The aim of this study was to highlight the prevalence of HPVs and histo-epidemiological characteristics of HNC HPV+ in Senegal. This is a prospective, multicenter preliminary study of 18 months (January 1, 2012-June 30, 2014). The cases of HNC histologically confirmed in Senegal were then sent to the bio-pathology department of the Curie Institute in Paris to search HPVs. In the 90 included cases, the PCR technique was successful in 54 cases (60%). HPVs were found in seven cases, that is, a prevalence of 13%. HPVs were associated with 5 cases of hypopharyngeal carcinoma and 2 cases of carcinoma of the oral cavity. Patients with HNC HPV+ had a median age of 42 years against 49 years for HPV-patients. Three patients (42.8%) with HPV+ carcinomas were smokers. Of the 47 HPV-patients, 40 patients (87.1%) had alcohol intoxication and/or smoking. The concept of oral sex was refuted by all our patients. Squamous cell carcinoma was the only histological type found. HPV+ cell carcinoma showed no specific histological appearance. HPVs are another certain RF of HNC in Senegal. The major therapeutic and prognostic impact of HPVinduced cancers requires the systematic search of the viruses by the PCR technique.

PMID: 27325173 [PubMed - as supplied by publisher]

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