Endoscopically-Associated Hairline Approach to Excision of Second Branchial Cleft Cysts

Abstract

To improve the treatment outcome and post-operation rehabilitation of patients with second branchial cleft cysts (SBCC), 46 patients were operated for SBCC. 22 patients were operated by conventional approach, 22 patients were operated by original occipital hairline approach and 2 patients were operated via axillary approach. Assessment of intra-operation and post-operation complications was done and comparative evaluation of the preparations of the morphological structure in the main and reference group I was conducted. Clinical psychological assessment was performed in the post-operation period. Based on the clinical criteria and morphological method, the authors made conclusions on the benefits of the proposed approach to the excision of SBCC and determined indications and contraindications to endoscopically-associated surgery via the proposed approach. Comparative analysis of beneficial outcome clinically significant criteria of the conventional, axillary and proposed original approaches showed differences in the following criteria: "average operation time", "average wound dressing duration", "average duration of hospitalization" and "subjective satisfaction with incision scar". There were no differences revealed in the criteria "average incision length". The proposed approach allowed the authors to shorten the treatment duration and to accelerate the patients port-operation recovery. Due to the proposed approach, the incision opened the fascial layer where the cyst was located. The dissection was performed along the hairline and did not involve upper and lower located layers. Minimal surgery traumatic rate of the proposed approach was proved by the morphological studies.

https://ift.tt/2B65yos

Effect of water activity, temperature, and incubation period on fungal growth and ochratoxin A production on Nyjer seeds

Abstract

Aspergillus fresenii and Aspergillus sulphureus produce ochratoxin A (OTA), which is a secondary metabolite of Aspergillus and Penicillium species, with nephrotoxic effects and potential carcinogenic activity. The aim of this study was to determine the effects of temperature (20, 30, and 37 °C), water activity (0.82, 0.86, 0.90, 0.94, and 0.98 a_w), incubation period (5, 10, 15, and 30 days) on fungal growth, and OTA production by A. fresenii and A. sulphureus on Nyjer oil seeds. There was no fungal growth at 0.82 a_w. The two fungal species were able to produce OTA from the fifth day of incubation from 0.86 to 0.98 a_w and temperature 20 to 37 °C. Aspergillus fresenii produced the highest concentration of OTA (643 μg/kg) at 0.90 a_w and 37 °C within 15 days, while A. sulphureus produced the highest level of OTA (724 μg/kg) at 0.98 a_w and 20 °C within 10 days. The optimum water activity and temperature for the growth of both fungi were similar at 0.94 a_w and at 30 °C. There was statistically significant difference between the levels of OTA production among the two fungi. Overall, A. sulphureus produced significantly higher levels of OTA (p < 0.05). Higher temperature (37 °C) and 0.90–0.94 a_w were optimal for OTA production by A. fresenii. Our results show that Nyjer seeds can support the growth of A. fresenii and A. sulphureus and OTA production, and the two species had similar temperature and water activity requirements for growth but different requirements for OTA production on Nyjer seeds.

https://ift.tt/2B7lSFq

Editorial: the middle cranial fossa approach

No abstract available

https://ift.tt/2OqJmHi

Validation of the Oncomine ™ focus panel for next-generation sequencing of clinical tumour samples

Abstract

The clinical utility of next-generation sequencing (NGS) for a diverse range of targets is expanding, increasing the need for multiplexed analysis of both DNA and RNA. However, translation into daily use requires a rigorous and comprehensive validation strategy. The aim of this clinical validation was to assess the performance of the Ion Torrent Personal Genome Machine (IonPGM^™) and validate the Oncomine^™ Focus DNA and RNA Fusion panels for clinical application in solid tumour testing of formalin-fixed, paraffin-embedded (FFPE) tissue. Using a mixture of routine FFPE and reference material across a variety of tissue and specimen types, we sequenced 86 and 31 samples on the Oncomine^™ Focus DNA and RNA Fusion assays, respectively. This validation considered a number of parameters including the clinical robustness of the bioinformatics pipeline for variant detection and interpretation. The Oncomine^™ Focus DNA assay had a sample and variant-based sensitivity of 99.1 and 97.1%, respectively, and an assay specificity of 100%. The Oncomine^™ Focus Fusion panel had a good sensitivity and specificity based upon the samples assessed, however requires further validation to confirm findings due to limited sample numbers. We observed a good sequencing performance based upon amplicon, gene (hotspot variants within gene) and sample specific analysis with 92% of clinical samples obtaining an average amplicon coverage above 500X. Detection of some indels was challenging for the routine IonReporter^™ workflow; however, the addition of NextGENe® software improved indel identification demonstrating the importance of both bench and bioinformatic validation. With an increasing number of clinically actionable targets requiring a variety of methodologies, NGS provides a cost-effective and time-saving methodology to assess multiple targets across different modalities. We suggest the use of multiple analysis software to ensure identification of clinically applicable variants.

https://ift.tt/2MKULRO

Successful endobronchial treatment of a non-healing tracheoesophageal fistula from a previous histoplasmosis capsulatum infection using decellularized porcine urinary bladder matrix†

Abstract

Tracheoesophageal fistulas (TEF) are pathologic communications between the esophagus and the trachea or bronchi. The development of a TEF can result from malignant or benign etiologies. A common approach for the treatment of TEFs is the placement of endobronchial and esophageal stents to facilitate healing of the communication. This case report describes the successful treatment of a TEF resulting from calcified mediastinal lymphadenopathy due to a previous Histoplasmosis capsulatum infection. In addition to placement of endobronchial and esophageal stents, the non-healing TEF was treated with ACell (Gentrix^®) decellularized porcine urinary bladder matrix to facilitate complete closure of the fistulous tract.

https://ift.tt/2B1b9fP

Fibrous dysplasia and Klippel–Trenaunay syndrome: a rare association

Abstract

Fibrous dysplasia is a rare congenital disorder, with abnormal hypertrophy of affected bone. A 17-year-old girl with a protrusion on her right forehead presented and was diagnosed as craniofacial fibrous dysplasia. Although she had no gait problem, her right leg was longer than the other. She had vascular malformation on the right leg. The condition was diagnosed as Klippel–Trénaunay syndrome, which also is a rare disorder. As the prevalence of these disorders is scarce, the probability of coincidental association of them is extremely low. No previous report about the association of fibrous dysplasia and Klippel–Trénaunay syndrome could be found. We concluded that, those two rare congenital disorders arose coincidentally in this patient.

https://ift.tt/2vEnilI

Editorial: the middle cranial fossa approach

No abstract available

https://ift.tt/2OqJmHi