Optimal Time Points for Scintigraphic Imaging of Pleuroperitoneal Shunts.

Objective: Nuclear imaging can confirm pleuroperitoneal shunt as the cause of pleural effusion. No society guidelines exist for scintigraphic pleuroperitoneal shunt detection. Our institutional protocol was evaluated to determine optimal imaging time points for shunt detection. Methods: Pleuroperitoneal shunt studies over 4 years were blindly reviewed by 2 nuclear radiologists. Data from blinded review included presence or absence of pleuroperitoneal shunt, laterality of shunt and time points for shunt detection. Results: Chart review yielded 30 studies. Three cases were excluded because of improper injection. Imaging was positive for pleuroperitoneal shunt in 81% (22/27) of cases. In positive cases, activity was identified in the right hemithorax in 82% (18/22), left hemithorax in 9% (2/22), and bilaterally in 9% (2/22). One-hour imaging demonstrated 91% (20/22) of positive cases. The remaining 2 positive cases were negative at 1 hour but positive after 4 hours. No study was negative at 1 and 4 hours and positive at 24 hours. All negative cases (5/27) were confirmed on 24-hour imaging. Conclusions: The majority of positive pleuroperitoneal shunt examinations will demonstrate activity in the right hemithorax on 1-hour imaging. Although no case was negative at 1 and 4 hours and positive at 24 hours, imaging at 24 hours may still be necessary to confirm absence of shunt. Therefore, optimal imaging time points consist of early 1-hour and delayed 24-hour images if the 1-hour time point was negative. The 4-hour time point may be considered optional, thereby potentially optimizing patient safety and resource utilization. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Serial 18F-FDG PET/CT Findings in a Patient With IgLON5 Encephalopathy.

We presented the serial FDG PET/CT brain scans of a 64-year-old woman with IgLON5 encephalopathy, which is a novel syndrome in association with antibodies to a neuronal cell adhesion protein named IgLON5, and FDG PET findings have not been characterized previously. For our case, the relatively hypermetabolism in primary sensorimotor cortices, basal ganglia, and cerebrum comparing to other cortical regions on the pretreatment FDG PET/CT was partially recovered on the follow-up FDG PET/CT scan after immunotherapy, corresponding with the alleviation of clinical syndromes. The metabolic change pattern was not similar as other types of autoimmune encephalitis. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Aspecific Uptake of 68GA-PSMA in Paget Disease of the Bone.

68Ga-PSMA plays an increasing role in prostate cancer management, but several instances of false positivity have now been recognized. We present a patient with metastatic prostatic carcinoma who also showed overexpression of PSMA in Paget disease of the humerus on 68Ga-PSMA PET. This probably relates to bone remodeling and increased vascularity. It is important to be aware of this aspecific uptake because its recognition may avoid overstaging and may alter the therapeutic choice. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Deep Vein Thrombosis Presenting on Pulmonary Ventilation and Perfusion Scintigraphy.

A 52-year-old woman presenting with dyspnea was referred for a ventilation and perfusion scan (VQ). VQ images (with 99mTc-DTPA [diethylene triamine pentaacetic acid aerosol] and 99mTc-MAA [macroaggregated albumin]) initially appeared normal; however, count rates on perfusion images were similar to ventilation images, implying little 99mTc-MAA had reached the lungs. Spot images of the injected extremity demonstrated focal 99mTc-MAA accumulation worrisome for a venous thrombus, subsequently confirmed by Doppler ultrasound. Careful attention to relative radiotracer count rates on VQ scans is crucial to ensure diagnostic utility. In addition, abnormal low perfusion radiotracer counts may unveil other pathology with important clinical implications. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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68Ga-PSMA PET/CT False-Positive Tracer Uptake in Paget Disease.

65-year-old man with left-sided pelvic pain on evaluation was found to have features suggestive of either Paget disease or prostatic bone metastasis of the left hemipelvis based on 99mTc-MDP bone scan and MRI. 68Ga-PSMA PET/CT to assess the possibility of primary prostate cancer and if present to stage it helped to rule out prostate cancer because of absence of focal abnormal increased tracer uptake in the prostate gland. However, false-positive tracer uptake was noted in the left hemipelvis, which was subject to biopsy and histopathologically proven to be Paget disease involvement. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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MRI and FDG PET/CT Findings of Primary Orbit Leiomyosarcoma.

Primary leiomyosarcoma of the orbit is extremely rare. Here we report the case of a 32-year-old woman who presented with proptosis and diplopia of the left eye. MRI examination showed a solid mass in the left orbit with invasion to adjacent tissue, and the lesion had intense FDG uptake with SUVmax of 18.7 on 18F-FDG PET/CT. Primary orbit leiomyosarcoma was diagnosed by surgery-pathology. 18F-FDG PET/CT has an advantage in excluding secondary or metastatic orbit malignancy. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Unusual Uptake of Radioiodine in a Subcutaneous Lipoma in a Patient With Differentiated Thyroid Cancer.

A 68-year-old man underwent adjuvant radioiodine therapy for follicular variant papillary thyroid carcinoma. Post-therapeutic whole-body 131I scan showed abnormal radioiodine uptake on the right side of back. SPECT/CT localized this abnormal activity from a small subcutaneous lesion with fat density between the right 10th and 11th rib. Under ultrasound-guided autopsy, the lesion was confirmed as lipoma. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Serendipitous Detection of Hodgkin Lymphoma by 18F-NaF PET/CT.

A 17-year-old girl underwent 18F-NaF PET/CT to evaluate bone pain after an accident. The images did not identify any osseous lesion. However, there was a focally increased activity in the left upper chest, which corresponded to a partially calcified soft tissue mass in the mediastinum, suggestive of malignancy. The result led to subsequent 18F-FDG PET/CT imaging, which demonstrated intense activity in the mediastinal mass and in multiple cervical, supraclavicular, and mediastinal lymph nodes. Hodgkin lymphoma was diagnosed histopathologically following the biopsy. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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False Suggestion of Malignant Transformation of Benign Bone Tumor by 18F-FDG PET/CT: A Potential Pitfall.

A 68-year-old man underwent serial 18F-FDG PET/CT scan follow-up for lung cancer. Then 5.5 years after the initial 18F-FDG PET/CT scan, the presumed benign bone tumor in the left clavicle showed markedly increased FDG uptake during follow-up; in contrast, the 99mTc-MDP bone scan paradoxically exhibited no apparent interval change since last bone scan 5.5 years earlier. He underwent a CT-guided biopsy, and the pathological diagnosis was benign fibrous histiocytoma. The result was consistent with the lack of progression in 99mTc-MDP bone scan, whereas the 18F-FDG PET/CT scan gave a false-positive impression of malignant transformation. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Non-Prostate-Specific Membrane Antigen-Avid Metastatic Lung Nodule From Primary Prostatic Adenocarcinoma.

68Ga-prostate-specific membrane antigen (PSMA) PET/CT is increasingly used to evaluate recurrent prostatic malignancy due to its high specificity. A 56-year-old man with previous history of treated prostate cancer 4 years earlier presented with rising prostate-specific antigen level and underwent 68Ga-PSMA PET/CT, which demonstrated an enlarging pulmonary nodule without PSMA avidity. The pulmonary nodule, however, showed moderate uptake on a corresponding FDG PET/CT study, suspicious of primary lung malignancy. Cytological and histopathological examination of the pulmonary nodule confirmed a metastatic deposit from ductal prostatic adenocarcinoma, an uncommon variant of prostatic malignancy. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.

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Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond.

Spectrum of Third Window Abnormalities: Semicircular Canal Dehiscence and Beyond.

AJNR Am J Neuroradiol. 2016 Aug 25;

Authors: Ho ML, Moonis G, Halpin CF, Curtin HD

Abstract
Third window abnormalities are defects in the integrity of the bony structure of the inner ear, classically producing sound-/pressure-induced vertigo (Tullio and Hennebert signs) and/or a low-frequency air-bone gap by audiometry. Specific anatomic defects include semicircular canal dehiscence, perilabyrinthine fistula, enlarged vestibular aqueduct, dehiscence of the scala vestibuli side of the cochlea, X-linked stapes gusher, and bone dyscrasias. We discuss these various entities and provide key examples from our institutional teaching file with a discussion of symptomatology, temporal bone CT, audiometry, and vestibular-evoked myogenic potentials.

PMID: 27561833 [PubMed - as supplied by publisher]

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Blood-based biomarkers for monitoring antiangiogenic therapy in non-small cell lung cancer

Abstract

Tumor angiogenesis pathways have been identified as important therapeutic targets in non-small cell lung cancer. However, no biomarkers have been described as predictors of response to antiangiogenic therapy in these patients. In this study, plasma levels of VEGF, bFGF, E-selectin, and S-ICAM and gene expression profiles of peripheral blood mononuclear cells from non-small cell lung cancer patients treated with chemotherapy plus bevacizumab were analyzed before and after treatment. Values were correlated with clinicopathological characteristics and treatment response. Plasma factor levels were measured using commercially available ELISA kits. The TaqMan^® human angiogenesis array was used to investigate the effect of treatment on gene expression profiles. Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment analysis was performed for differentially expressed genes using WEB-based GEne SeT AnaLysis Toolkit. Our results suggest a benefit for patients with increased plasma levels of VEGF, E-selectin, and S-ICAM in the course of bevacizumab treatment. Also, we identified differentially expressed genes between paired blood samples from patients before and after treatment, and significantly perturbed pathways were predicted. These changes in gene expression and levels of plasma factors could be used to assess the effectiveness of antiangiogenic therapy, in addition to standard clinical and radiological evaluations.

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Evaluation of weekly paclitaxel, carboplatin, and cetuximab in head and neck cancer patients with incurable disease

Abstract

Weekly paclitaxel, carboplatin, and cetuximab (PCC) has been found to be efficacious and well-tolerated in patients with squamous cell carcinoma of the head and neck (SCCHN) with good performance status (PS) when used as induction chemotherapy. Use of PCC in incurable SCCHN in patients with poor PS or in a non-induction setting is an area which warrants further evaluation. Current recommendations for incurable disease consist of a platinum-based regimen with fluorouracil and cetuximab. Studied in patients with PS of 0 to 1, the fluorouracil-based regimens were associated with significant toxicities. Therefore, weekly PCC may offer an appealing, less toxic alternative for incurable patients with poor PS. This retrospective analysis evaluated 41 patients with very advanced or metastatic head and neck cancer who had received PCC (paclitaxel 80 mg/m², carboplatin AUC 2, and a cetuximab 400 mg/m² loading dose, followed by 250 mg/m² weekly) for up to 6 cycles between April 2008 and September 2014. Maximal response achieved and progression-free survival (PFS), as well as dose intensity and adverse effects, were evaluated. Of the 41 patients evaluated, baseline PS ranged as follows: PS of 2 (41 %), PS of 1 (54 %), and PS of 0 (5 %). Patients received 2 to 6 cycles, averaging 4 cycles. Thirty-one patients (76 %) required treatment to be held, delayed or dose reduced, most commonly for hematologic toxicities. Grades 3/4 neutropenia occurred in 16 patients (39 %), grades 1/2 neutropenia in 12 patients (29 %), with grades 3/4 thrombocytopenia in 1 patient (2 %), and grades 1/2 thrombocytopenia in 2 patients (4 %). No patients developed febrile neutropenia or required hospitalization due to treatment. Partial radiographic response occurred in 15 patients (37 %), complete radiographic response in 2 patients (5 %), stable disease in 14 patients (34 %), and progression in 8 patients (20 %). PFS ranged from 1.6 to 45 months, with a median duration of 4.6 months, and median overall survival of 5.25 months. Analysis indicates that use of weekly PCC appears to be an effective and well-tolerated treatment option for patients with incurable squamous cell carcinoma of the head and neck, specifically with PS of 0 to 2.

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Targeted molecular profiling of rare genetic alterations in colorectal cancer using next-generation sequencing

Abstract

Mutation frequencies of common genetic alterations in colorectal cancer have been in the spotlight for many years. This study highlights few rare somatic mutations, which possess the attributes of a potential CRC biomarker yet are often neglected. Next-generation sequencing was performed over 112 tumor samples to detect genetic alterations in 31 rare genes in colorectal cancer. Mutations were detected in 26/31 (83.9 %) uncommon genes, which together contributed toward 149 gene mutations in 67/112 (59.8 %) colorectal cancer patients. The most frequent mutations include KDR (19.6 %), PTEN (17 %), FBXW7 (10.7 %), SMAD4 (10.7 %), VHL (8 %), KIT (8 %), MET (7.1 %), ATM (6.3 %), CTNNB1 (4.5 %) and CDKN2A (4.5 %). RB1, ERBB4 and ERBB2 mutations were persistent in 3.6 % patients. GNAS, FGFR2 and FGFR3 mutations were persistent in 1.8 % patients. Ten genes (EGFR, NOTCH1, SMARCB1, ABL1, STK11, SMO, RET, GNAQ, CSF1R and FLT3) were found mutated in 0.9 % patients. Lastly, no mutations were observed in AKT, HRAS, MAP2K1, PDGFR and JAK2. Significant associations were observed between VHL with tumor site, ERBB4 and SMARCB1 with tumor invasion, CTNNB1 with lack of lymph node involvement and CTNNB1, FGFR2 and FGFR3 with TNM stage. Significantly coinciding mutation pairs include PTEN and SMAD4, PTEN and KDR, EGFR and RET, EGFR and RB1, FBXW7 and CTNNB1, KDR and FGFR2, FLT3 and CTNNB1, RET and RB1, ATM and SMAD4, ATM and CDKN2A, ERBB4 and SMARCB1. This study elucidates few potential colorectal cancer biomarkers, specifically KDR, PTEN, FBXW7 and SMAD4, which are found mutated in more than 10 % patients.

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MarcEdit for Mac and the rare books researcher

Welsh, A; (2016) MarcEdit for Mac and the rare books researcher. Catalogue and Index (In press).

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Between Consensus and Contestation

Weale, AP; (2016) Between Consensus and Contestation. Journal of Health Organization and Management , 30 (5) pp. 786-795. 10.1108/JHOM-03-2016-0040 . Green open access

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Genome-wide association of multiple complex traits in outbred mice by ultra-low-coverage sequencing

Nicod, J; Davies, RW; Cai, N; Hassett, C; Goodstadt, L; Cosgrove, C; Yee, BK; Nicod, J; Davies, RW; Cai, N; Hassett, C; Goodstadt, L; Cosgrove, C; Yee, BK; Lionikaite, V; McIntyre, RE; Remme, CA; Lodder, EM; Gregory, JS; Hough, T; Joynson, R; Phelps, H; Nell, B; Rowe, C; Wood, J; Walling, A; Bopp, N; Bhomra, A; Hernandez-Pliego, P; Callebert, J; Aspden, RM; Talbot, NP; Robbins, PA; Harrison, M; Fray, M; Launay, JM; Pinto, YM; Blizard, DA; Bezzina, CR; Adams, DJ; Franken, P; Weaver, T; Wells, S; Brown, SD; Potter, PK; Klenerman, P; Lionikas, A; Mott, R; Flint, J; - view fewer (2016) Genome-wide association of multiple complex traits in outbred mice by ultra-low-coverage sequencing. Nature Genetics 10.1038/ng.3595 . (In press).

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Early pathological features of corticobasal degeneration

Ling, H; Holton, J; Revesz, T; (2016) Early pathological features of corticobasal degeneration. In: Proceedings of the 11th European Congress of Neuropathology. European Confederation of Neuropathological Societies (Euro-CNS) / French Society of Neuropathology: Bordeaux, France.

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Rapid genotype imputation from sequence without reference panels

Davies, RW; Flint, J; Myers, S; Mott, R; (2016) Rapid genotype imputation from sequence without reference panels. Nature Genetics , 48 (8) pp. 965-969. 10.1038/ng.3594 .

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Participation in Environmental Decision-making: Reflecting on planning and community benefits for major wind farms

Armeni, C; (2016) Participation in Environmental Decision-making: Reflecting on planning and community benefits for major wind farms. Journal of Environmental Law (In press).

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Christ vs. Communism: Communism as a Religious Social Problem in Finland's Proto-Fascist Lapua Movement in the 1930s

Hjelm, T; Koskelainen, S; (2016) Christ vs. Communism: Communism as a Religious Social Problem in Finland's Proto-Fascist Lapua Movement in the 1930s. Journal of Historical Sociology (In press).

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Counting sub-multisets of fixed cardinality

Ferraris, S; Mendelson, A; Ballesio, G; Vercauteren, T; (2015) Counting sub-multisets of fixed cardinality.

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Educational differences in likelihood of attributing breast symptoms to cancer: A vignette-based study

Marcu, A; Lyratzopoulos, G; Black, G; Vedsted, P; Whitaker, KL; (2016) Educational differences in likelihood of attributing breast symptoms to cancer: A vignette-based study. Psycho-Oncology 10.1002/pon.4177 .

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"Too taxing on the mind!" Authentication Grids Are Not For Everyone

Krol, K; Papanicolaou, C; Vernitski, A; Sasse, A; (2015) "Too taxing on the mind!" Authentication Grids Are Not For Everyone. In: Tryfonas, T and Askoxylakis, I, (eds.) Human Aspects of Information Security, Privacy, and Trust: Third International Conference, HAS 2015, Held as Part of HCI International 2015, Los Angeles, CA, USA, August 2-7, 2015. Proceedings. (pp. 71-82). Springer International Publishing: Switzerland. Green open access

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Accuracy Analysis of an Image Guided Robotic Urology Surgery System

Thompson, SA; Penney, G; Carter, T; Dasgupta, P; Hawkes, D; (2009) Accuracy Analysis of an Image Guided Robotic Urology Surgery System. In: (Proceedings) MICCAI 2009 Workshop on Geometric Accuracy in Image Guided Intervention, 20 September 2009, London, UK. (In press).

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Validation of NODDI estimation of dispersion anisotropy in V1 of the human neocortex

Tariq, M; Kleinnijenhuis, M; Van Cappellen van Walsum, A-M; Zhang, H; (2015) Validation of NODDI estimation of dispersion anisotropy in V1 of the human neocortex. In: Proceedings of the ISMRM 23rd Annual Meeting & Exhibition. (pp. p. 3928). International Society for Magnetic Resonance in Medicine (ISMRM): Toronto, Canada.

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De la mentalisation a la confiance epistémique: Echafauder les systèmes d'une communication thérapeutique

Debbane, M; Fonagy, P; Badoud, D; (2016) De la mentalisation a la confiance epistémique: Echafauder les systèmes d'une communication thérapeutique. Revue Québécoise de Psychologie (In press).

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Optimal Real-Time Bidding for Display Advertising

Zhang, W; (2016) Optimal Real-Time Bidding for Display Advertising. Doctoral thesis, UCL (University College London). Green open access

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Explaining the dynamics of the ultra-relativistic third Van Allen radiation belt

Mann, IR; Ozeke, LG; Murphy, KR; Claudepierre, SG; Turner, DL; Baker, DN; Rae, IJ; Mann, IR; Ozeke, LG; Murphy, KR; Claudepierre, SG; Turner, DL; Baker, DN; Rae, IJ; Kale, A; Milling, DK; Boyd, AJ; Spence, HE; Reeves, GD; Singer, HJ; Dimitrakoudis, S; Daglis, IA; Honary, F; - view fewer (2016) Explaining the dynamics of the ultra-relativistic third Van Allen radiation belt. Nature Physics (In press).

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Photonic Torque Microscopy of the Nonconservative Force Field for Optically Trapped Silicon Nanowires

Irrera, A; Magazzù, A; Artoni, P; Simpson, SH; Hanna, S; Jones, PH; Priolo, F; Irrera, A; Magazzù, A; Artoni, P; Simpson, SH; Hanna, S; Jones, PH; Priolo, F; Gucciardi, PG; Maragò, OM; - view fewer (2016) Photonic Torque Microscopy of the Nonconservative Force Field for Optically Trapped Silicon Nanowires. Nano Letters , 16 (7) pp. 4181-4188. 10.1021/acs.nanolett.6b01059 .

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Building community resilience to disasters in WaSH (water, sanitation and hygiene) during recovery

Krishnan, S; (2016) Building community resilience to disasters in WaSH (water, sanitation and hygiene) during recovery. Doctoral thesis, UCL (University College London). Green open access

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An unusual case of CD5 negative Mantle cell lymphoma presenting with IgM monoclonal gammopathy

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Overview of the New Japanese Guideline2012 for the Medical Treatment of Acute Stage of Kawasaki Disease

Abstract

In the research of the treatment of acute stage of Kawasaki disease, only small case series of initial treatment were reported in decades ago. However recently, more reliable results with high-evidenced outcomes from well-designed and with high quality clinical trials like RAISE study have been increasingly reported. We here introduce the revised guideline of the medical treatment of acute phase of KD in 2012 (KDGL 2012), organized by the Japanese Society of Pediatric Cardiology and Cardiac Surgery (Pediatr Int 56:135–58, 2014).

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Endoscopic resection of the pterygoid plates following incomplete transoral resection of an odontogenic myxoma

Publication date: Available online 27 August 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): S. Subramaniam, A. Nastri, J. King, T. Iseli




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Odontogenic infections: a national survey to assess confidence of the OMFS “first on-call”

Publication date: Available online 27 August 2016
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Sharmista Roy, Sajid Sainuddin, Stuart Clark
Odontogenic infections can range from simple toothache to life-threatening swellings in the neck. We conducted a national survey to assess the confidence of the "first on-call" in oral and maxillofacial surgery (OMFS) to admit or discharge these patients, and to see if local protocols or guidelines were in place to aid decision-making. We designed a questionnaire and emailed it to all OMFS units across the UK over a 3-week period in June 2015. We also contacted first on-call OMFS juniors by phone. A total of 54 respondents were confident and 24 were very confident to admit patients with odontogenic infections without a senior review, but only 45 were confident and 9 very confident to discharge patients from the emergency department without a senior review. Twenty-one were fairly confident to admit patients, and 37 were fairly confident to discharge them. One respondent was not confident to admit patients at all, and 9 did not feel confident to discharge patients without a senior review. Seventy-eight reported that no local protocols or structured guidance on odontogenic infections were used in their unit. This survey highlights the need for admission criteria to help junior clinicians decide whether to admit or discharge these patients.



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Determining Serum Zinc and Magnesium Levels in Hemodialysis Patients Could be Helpful for Clinicians

Abstract

Trace element determination is requested rarely for critically ill patients in Iran, due to the underestimation of the trace element determination by Iranian physicians. The aim was to compare the levels of Zn and Mg in a group of hemodialysis patients and normal individuals. This study shows that trace element determination is helpful for management of hemodialysis patients. Fifty-three hemodialysis patients and 51 control individuals were randomly analyzed for Zn and Mg serum levels. Comparison of before or after dialysis and with normal individuals was done and receiver operating characteristics (ROC) curves were plotted to evaluate the analytical sensitivity and specificity of Zn and Mg determination. Confidence interval for all statistical methods was 95 %. Zinc serum levels were decreased after hemodialysis insignificantly (P = 0.201) but Mg levels were decreased significantly (P = 0.000). Both Zn and Mg levels, before and after hemodialysis were meaningfully lower than normal controls (P < 0.05). ROC analysis showed that the area under the curve was high for Zn levels both before and after hemodialysis but it was high for Mg only before hemodialysis. Current study shows that serum Zn and Mg measurements can have clinical importance. Both before and after hemodialysis, serum Zn = 297.5 µg/L and Mg = 2.295 µg/L are proposed as cut-off values with about 90 % specificity, for monitoring of these two element in hemodialysis patients. It is suggested that clinicians consider the measurement of these trace elements for hemodialysis patients routinely or periodically as clinical chemistry tests.

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CYSTINURIA: Crystals that Make a Baby Cry

Abstract

Cystinuria is a common aminoaciduria due to a COAL transporter defect in renal tubular epithelium. Increased level of cystine in urine with occasional cystine crystal can be diagnostic. With reference to clinical examinations, symptoms and laboratory reports we present a case of primary cystinuria. Prevention of complication in cystinuric relies on detection at early stage and targeting treatment towards maintaining low level of urinary cystine level.

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A novel computational approach to approximate fuzzy interpolation polynomials

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Minimizing conservativity violations in ontology alignments: algorithms and evaluation

Abstract

In order to enable interoperability between ontology-based systems, ontology matching techniques have been proposed. However, when the generated mappings lead to undesired logical consequences, their usefulness may be diminished. In this paper, we present an approach to detect and minimize the violations of the so-called conservativity principle where novel subsumption entailments between named concepts in one of the input ontologies are considered as unwanted. The practical applicability of the proposed approach is experimentally demonstrated on the datasets from the Ontology Alignment Evaluation Initiative.

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Spinal sensory circuits in motion

Publication date: December 2016
Source:Current Opinion in Neurobiology, Volume 41
Author(s): Urs Lucas Böhm, Claire Wyart
The role of sensory feedback in shaping locomotion has been long debated. Recent advances in genetics and behavior analysis revealed the importance of proprioceptive pathways in spinal circuits. The mechanisms underlying peripheral mechanosensation enabled to unravel the networks that feedback to spinal circuits in order to modulate locomotion. Sensory inputs to the vertebrate spinal cord were long thought to originate from the periphery. Recent studies challenge this view: GABAergic sensory neurons located within the spinal cord have been shown to relay mechanical and chemical information from the cerebrospinal fluid to motor circuits. Innovative approaches combining genetics, quantitative analysis of behavior and optogenetics now allow probing the contribution of these sensory feedback pathways to locomotion and recovery following spinal cord injury.



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Effects of a balance-based exergaming intervention using the Kinect sensor on posture stability in individuals with Parkinson’s disease: a single-blinded randomized controlled trial

The present study examined the effects of a balance-based exergaming intervention using the Kinect sensor on postural stability and balance in people with Parkinson's disease (PD).

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Skeletal stability of maxillary advancement with and without a mandibular reduction in the cleft lip and palate patient

Publication date: Available online 27 August 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): F.X. Wong, A.A. Heggie, J.M. Shand, P.M. Schneider
The stability of surgical maxillary advancement in a consecutive series of patients with cleft lip and palate who underwent Le Fort I osteotomy with and without simultaneous mandibular setback surgery was evaluated. Preoperative, postoperative, and follow-up lateral cephalograms of 21 patients were assessed to compare differences in surgical movement and postoperative relapse between two groups: those who underwent maxillary surgery alone and those who underwent bimaxillary surgery. Differences in the number of patients who experienced relapse of <2mm, 2–4mm, and >4mm between the groups were also compared. Mean advancement of the cleft maxilla was 5.5mm in the maxilla only group and 3.6mm in the bimaxillary group, with a mean horizontal relapse of 0.8mm and 0.2mm, respectively. Mean surgical movement in the vertical dimension was comparable in the two groups and the magnitude of vertical relapse was less than 0.4mm overall. Approximately 80% of patients in both groups experienced horizontal relapse of less than 2mm. There was no significant difference in the degree of postoperative relapse between those who had single-jaw surgery and those who had two-jaw surgery.



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Changes in heart rate during third molar surgery

Publication date: Available online 27 August 2016
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): M.H.J. Hollander, J. Schortinghuis, A. Vissink
Anxiety is an undesirable psychological phenomenon. Patients are usually anxious when subjected to third molar surgery, but the pattern of anxiety is unknown. The aim of this study was to assess the intensity and course of anxiety during third molar surgery. This study included 48 consecutive patients (mean age 25±6 years) who had a third molar removed surgically under local anaesthesia. The heart rate was monitored continuously during treatment as a measure of anxiety. Preoperative anxiety was scored with the Modified Dental Anxiety Scale. Each patient's anxiety level was assessed when in the waiting room, sitting down in the dental chair, during the application of local anaesthesia, application of surgical drapes, time-out procedure, incision, alveolotomy, removal of the third molar, and suturing, and at the end of the procedure. The lowest heart rates were recorded in the waiting room, in the dental chair, during anaesthesia, when applying surgical drapes, during suturing, and at the end of the procedure. The highest values were obtained during the time-out procedure, incision, and alveolotomy (P<0.005). In conclusion, the intensity and course of anxiety has a specific pattern during third molar surgery, with the lowest levels of anxiety prior to surgery and directly postoperative and the highest during the time-out procedure and the actual surgery.



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Ophthalmic clues to the endocrine disorders

Abstract

Purpose

Eye is a vital sense organ and reflects the physical and mental wellbeing of a person. Detailed examination of the eye is an essential part in the clinical evaluation of patients with any systemic disorder. The interaction between ophthalmologists and endocrinologists is often limited to Graves' ophthalmopathy and diabetic retinopathy. However, there are many ophthalmic manifestations, which are characteristically seen in endocrine disorders. In this review, we shall discuss the ocular manifestations of the endocrine syndromes excluding the Graves' ophthalmopathy and diabetic retinopathy.

Methods

We performed a PubMed search of articles published in English showing the ophthalmic features in the endocrine disorders. Relevant cited articles were also retrieved.

Results

Most of the publications included in the review were case reports and review articles. Many endocrine disorders have characteristic manifestations pertaining to the various structures of the eye. The involvement is seen from the external structures of the eye to the inner most layers of the retina. Many ocular-endocrine syndromes also exist with characteristic clues to the clinical diagnosis.

Conclusion

The endocrinologists need to be aware of these ocular signs that help in the early diagnosis of the underlying disorder. A syndromic approach is essential in the diagnosis of endocrinopathy in patients presenting with ophthalmic features.

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Are extremely high progesterone levels still an issue in IVF?

Abstract

Background

Premature luteinization of one or more developing follicles complicates 1–2 % of controlled ovarian stimulation cycles for assisted reproduction. The management of this complication is controversial, with cycle cancellation likely representing the most commonly used strategy. The aim of this study was to evaluate the efficacy of the "freeze-all" policy—where the entire cohort of blastocysts is cryopreserved for subsequent frozen-thawed embryo transfer—in treating cases of premature luteinization.

Methods

Patients experiencing premature luteinization during controlled ovarian stimulation—identified by extremely high progesterone levels at induction (P levels ≥3.0 ng/ml and/or P/estradiol ratio ≥1, n = 42)—were included in a "freeze-all" program and compared to controls undergoing a "freeze-all" program with normal progesterone levels at induction (P < 1.5 ng/ml, n = 67).

Results

Blastulation rate was comparable between patients with premature luteinization and controls (48.1 ± 20.5 % in Cases vs. 52.3 ± 24.9 % in Controls, p = 0.36). Ongoing pregnancy rates after the first frozen-thawed embryo transfer (38.1 % in Cases and 41.0 % in Controls, p = 0.83) and cumulative ongoing pregnancy rates after three frozen-thawed embryo transfer cycles (40.5 % in Cases vs. 47.8 % in Controls, p = 0.55) were also similar.

Conclusions

These results show that extremely marked progesterone elevation throughout controlled ovarian stimulation does not impair blastocyst development and implantation potential in the context of a "freeze-all" strategy. Based on this, adoption of the "freeze-all" strategy represents a valuable tool in treating premature luteinization. In contrast, cycle cancellation—likely the most frequently used method for management of this complication—currently represents a misconduct.

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L’ankylose temporo-mandibulaire

Publication date: Available online 27 August 2016
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Author(s): H. Bénateau, A. Chatellier, A. Caillot, D. Diep, J.-D. Kün-Darbois, A. Veyssière
L'ankylose de l'articulation temporo-mandibulaire est définie comme une constriction permanente des mâchoires avec ouverture buccale inférieure à 30mm mesurée entre les incisives, survenant en raison d'une fusion osseuse, fibreuse ou fibro-osseuse. Il en découle des complications à type de troubles de l'élocution, de la mastication, de la déglutition et un défaut d'hygiène buccodentaire. L'incidence globale est en diminution mais reste encore importante dans certains pays en voie de développement. L'étiologie la plus fréquemment retrouvée dans les pays dits développés est l'ankylose post-traumatique dans un contexte de fracture du condyle. D'autres étiologies sont possibles : infectieuses (en baisse depuis l'avènement des antibiotiques), inflammatoires (polyarthrite rhumatoïde et spondylarthrite ankylosante notamment) et congénitales (très rares). La prise en charge est toujours chirurgicale : résection du bloc d'ankylose, associée à une coronoïdectomie bilatérale… La résection du bloc peut être compensée par l'interposition d'un lambeau de fascia temporal, d'une greffe chondrocostale ou encore d'une prothèse d'ATM en fonction de la perte de hauteur et de la répercussion sur l'articulé dentaire. La rééducation postopératoire est indispensable, précoce, intense et prolongée. Une rééducation mal conduite est la cause principale de la récidive.Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence.



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Genomic profiling of breast cancer in African-American women using MammaPrint

Abstract

Breast cancer in African-American females (AAF) has a less favorable outcome than that in Caucasians. More information is needed regarding its biology. We evaluated gene expression in tumors from AAF presenting with early stage or locally advanced breast cancer using MammaPrint^®, BluePrint ^® (molecular subtype) and TargetPrint ^® [estrogen receptor (ER), progesterone receptor, and Human Epidermal Growth Factor Receptor 2 (HER2) mRNA levels]. Genomic information was correlated with clinical and pathologic characteristics and Oncotype DX^® Recurrence Score^® (RS). One hundred Patients were enrolled, 1 not evaluable by BluePrint. The median age was 60 years (range 22–98), and eighty-four (84 %) patients had stage I or II disease. High Risk MammaPrint was present in 66 % of patients and in 52 % of patients with stage I disease. High Risk MammaPrint was associated with young age (p = 0.02), high grade (p < 0.0001), HER2 expression (p = 0.016), and triple-negative phenotype (p < 0.001). Sixty-four tumors (65 %) were Luminal type (47 % of these were classified as High Risk), 26 (26 %) were Basal type, and 9 (9 %) HER2 type. Twenty-two cancers were triple negative (TN) by IHC and 19 (90 %) Basal type. Among the 15 tumors HER2 positive by IHC/FISH, 8 (53 %) were HER2 type by BluePrint. Eleven tumors with ER expression of 1–9 % were ER negative by TargetPrint and none of these was Luminal type. None of the seven tumors HER2 positive by IHC/FISH but negative by TargetPrint was HER type. RS results were available in 29 patients: two had High Risk both by RS and MammaPrint; eight had intermediate RS, with four High Risk by MammaPrint; 19 had a low RS, with eight High Risk by MammaPrint. AAF with stage I to III breast cancer often present with High Risk disease. Molecular heterogeneity is present within TN, HER2-positive, and ER-positive breast cancer. RS and MammaPrint offer different prognostic information.

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Xitong Wan attenuates inflammation development through inhibiting the activation of nuclear factor-κB in rats with adjuvant-induced arthritis

Publication date: 4 December 2016
Source:Journal of Ethnopharmacology, Volume 193
Author(s): Ping Jia, Gang Chen, Wen-Yi Qin, Yu Zhong, Juan Yang, Xiao-Feng Rong
Ethnopharmacological relevanceXitong Wan (XTW), a traditional Chinese herbs formula, has been used to treat "Bi Zheng" in the clinical practice of traditional Chinese medicine (TCM) for hundreds of years. However, no scientific validation is available on the anti-rheumatic effect of XTW.Aim of studyThis study was carried out to investigate the effects of XTW on joints swelling, joints destruction, production of inflammatory mediators and nuclear factor-κB (NF-κB) activation in rats with adjuvant-induced arthritis (AIA).Materials and methodsAIA was induced by intradermal injection of Complete Freund's adjuvant in the footpad of Wistar rats. Paw volume was measured every 7 days during XTW treatment. Histological score was calculated by hematoxylin and eosin staining. Osteoclast number in articular tissues was counted by tartrate-resistant acid phosphatase staining. Levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 in serum were detected by enzyme-linked immunosorbent assay. Levels of NF-κBp65 and inhibitor of NF-κB (IκB)α in synovium were analyzed by Western blot assay.ResultsCompared with AIA group rats, XTW significantly decreased the paw volume of AIA rats. Meanwhile, XTW significantly reduced the histological score and osteoclast number in articular tissues of AIA rats. In addition, XTW markedly abated the levels of TNF-α, IL-1β and IL-6 in serum, as well as enhanced the level of IκBα in synovium of AIA rats. However, XTW did not show significant effect on the level of p65 in synovium of AIA rats.ConclusionsThese results suggest that XTW attenuates the inflammation development through inhibiting the NF-κB-mediated proinflammatory cytokines production in AIA rats. Our study provides the scientific evidence of XTW on treatment of rheumatoid arthritis in the clinical practice of TCM.

Graphical abstract

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Panax notoginseng saponins attenuate lung cancer growth in part through modulating the level of Met/miR-222 axis

Publication date: 4 December 2016
Source:Journal of Ethnopharmacology, Volume 193
Author(s): Qinbo Yang, Peiwei Wang, Jingang Cui, Wenjian Wang, Yu. Chen, Teng Zhang
Ethnopharmacological relevancePanax notoginseng saponins (PNS) are the major chemical constituents of Panax notoginseng (Burkill) F.H. Chen (Araliaceae), a medicinal herb extensively used in China for the treatment of various diseases including cancer. PNS have been reported to contribute to the therapeutic effects of Panax notoginseng in disease conditions including lung cancer.Aim of the studyThe current study aims to further understand the molecular mechanisms implicated in the pharmacological activities of PNS in attenuating lung cancer growth.Materials and methodsLewis lung carcinoma (LLC) cell line was employed and the impact of PNS treatment on the viability of LLC cells was first examined in vitro. The tumor-suppressive effect of PNS was further validated in vivo by assessing the tumor growth in BALB/c mice inoculated with LLC cells. Whole genome microarray and real-time PCR analyses were performed to examine and verify altered expression of genes associated with PNS treatment. Real-time PCR and western blotting analyses were also carried out to investigate the implication of microRNA (miRNA)-mediated gene expression regulation in the anti-tumor activity of PNS.ResultsPNS treatment resulted in selective impairment of the survival of LLC cells. Furthermore, PNS treatment led to attenuated growth of tumors derived from inoculated LLC cells in mice. Bioinformatic analyses of gene expression profiles revealed that multiple pathways associated with tumorigenesis were significantly modulated by PNS treatment in vivo. The expression of an array of genes promoting tumorigenesis and progression including Hgf, Met, Notch3, Scd1, Epas1, Col1a1, Raf1, Braf1 and CDK6 was significantly decreased by PNS treatment, whereas the expression of tumor suppressive Rxrg was significantly increased as a result of PNS treatment. The level of miR-222, a miRNA regulated by Met, was significantly decreased by PNS treatment. The expression of tumor suppressor p27 and PTEN, miR-222 target genes, was significantly increased by PNS treatment.ConclusionOut work here presented novel evidence demonstrating that multiple mechanisms were implicated in the anti-tumor effects of PNS in lung cancer models. Particularly, PNS treatment significantly modulated the level of Met/miR-222 axis in LLC cells. Increased understanding of the anti-tumor mechanisms of PNS may provide further experimental evidence to help optimize the therapeutic modalities for the treatment of lung cancer and other types of cancer.

Graphical abstract

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Kai-Xin-San, a traditional Chinese medicine formula, induces neuronal differentiation of cultured PC12 cells: Modulating neurotransmitter regulation enzymes and potentiating NGF inducing neurite outgrowth

Publication date: 4 December 2016
Source:Journal of Ethnopharmacology, Volume 193
Author(s): Yue Zhu, Xiuzhu Duan, Feiyu Huang, Xiaonan Cheng, Liu Zhang, Pei Liu, Su Shulan, Jin-ao Duan, Tina Ting-Xia Dong, Karl Wah-Keung Tsim
Ethnopharmacological relevanceKai-Xin-San, an ancient formula composed of Ginseng Radix et Rhizoma, Polygalae Radix, Acori Tatarinowii Rhizoma and Poria, was frequently applied for major depression disorders for thousands of years. However, its molecular mechanism has not clearly been investigated.Aim of the studyWe aimed to reveal the action mechanism of KXS on anti-depression on inducing neuronal differentiation on PC12 cells.Materials and methodsA chemically standardized water extract of KXS was applied onto cultured PC12 cells in determining its effect on neurotransmitter regulation enzymes and neurite outgrowth.ResultsSingle KXS treatment showed obvious changes in the expression of neurofilament and neurotransmitter regulation enzymes, which in parallel to treatment of nerve growth factor (NGF). Although KXS by itself did not show significant inductive effect on neurite outgrowth of PC12 cells, KXS could potentiate the NGF induced neurite outgrowth. Among the three ratios, K-652 showed the most powerful effect and cAMP-dependent pathway might play the major role.ConclusionsKXS might exert the anti-depressant-like action of be inducing neuronal differentiation, which supported the clinically usage of this decoction.

Graphical abstract

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