A prospective randomized trial of LigaSure Small Jaw® versus conventional neck dissection in head and neck cancer patients

Abstract

Objectives

We compared the differences between LigaSure Small Jaw^®-assisted and conventional neck dissection in head and neck cancer patients.

Design

Prospective randomized study.

Setting

Tertiary referral hospital.

Participants

Patients scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. The study group was treated using the LigaSure vessel sealing system (Small Jaw^®; Covidien, Colorado, USA) for dissection and hemostasis throughout the whole procedures. (ClinicalTrials . gov number : NCT02597582).

Main outcomes measures

Operation duration, perioperative blood loss, postoperative drainage amount, and postoperative pain status.

Results

The study group consisted of 21 patients while the control group had 20 patients. The operation duration was shorter (97.1 versus 116.3 minutes, P = 0.022) and the average amount of injected analgesics was lower (8.8 versus 17.7 ampules, P = 0.037) in the study group.

Conclusions

The assistance of the LigaSure Small Jaw^® during functional neck dissection shortened operation duration and decreased the amount of injected analgesics needed.

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Expressions of isopeptide bonds and corneodesmosin in middle ear cholesteatoma

Abstract

Objective

Isopeptide bonds form cross-links between constituent proteins in the horny layer of the epidermis. Corneodesmosin (CDSN) is a major component of corneodesmosomes, which bind corneocytes together. Both play important roles in maintaining epidermal barrier functions. In the present study, we investigated the expressions of isopeptide bonds, CDSN, and related enzymes in middle ear cholesteatoma in comparison with the skin.

Methods

Cholesteatoma and normal postauricular skin were collected from patients with acquired middle ear cholesteatoma during tympanomastoidectomy. Expression of ε-(γ-glutamyl)lysine isopeptide bonds was examined by immunohistochemistry; Expressions of transglutaminase (TGase)1, TGase2, TGase3, and TGase5 by immunohistochemistry and quantitative RT-PCR (qRT-PCR); expression of CDSN by immunohistochemistry, qRT-PCR, and Western blot; and expressions of tissue kallikrein-related peptidase (KLK)5, KLK7, KLK14, and serine peptidase inhibitor Kazal type 5 (SPINK5) by qRT-PCR.

Results

TGase2 was higher (P=0.0046) and TGase5 was lower (P=0.0008) in cholesteatoma than in the postauricular skin. Immunoreactivity for isopeptide bonds was localized in the granular and horny layers, and was not different between the two tissues. Immunoreactivity for CDSN was localized in the granular layer, and was lower in cholesteatoma than in the skin (P=0.0090). Western blot and qRT-PCR confirmed that the expression of CDSN was lower in cholesteatoma than in the skin. Expressions of KLK5, KLK7, KLK14, or SPINK5 were not different between the two tissues.

Conclusions

These results indicate that the production of CDSN is likely to be suppressed in cholesteatoma, which would account, at least in part, for the mechanical fragility and increased permeability of the cholesteatoma epithelium.

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Quiz: Where should you take your long-overdue vacation from the station?

Every EMT on this planet deserves a vacation. EMS is a stressful job. Whether you can actually take one is a different story.

It's OK to dream, though, and when the time comes for your long-overdue break, this quiz will show you exactly where you should take your next vacation from the station.

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Issue Information – Copyright

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Liganded thyroid hormone receptors transactivate the DNA methyltransferase 3a gene in mouse neuronal cells

Endocrinology, Early Release.


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Gq-protein-Coupled Membrane-Initiated Estrogen Signaling Rapidly Excites Corticotropin-Releasing Hormone Neurons in the Hypothalamic Paraventricular Nucleus in Female Mice

Endocrinology, Early Release.


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